Federal toxicology researchers on Monday finally published a long-controversial analysis that claims to find a link between high levels of fluoride exposure and slightly lower IQs in children living in areas outside the US, mostly in China and India. As expected, it immediately drew yet more controversy.

The study, published in JAMA Pediatrics, is a meta-analysis, a type of study that combines data from many different studies—in this case, mostly low-quality studies—to come up with new results. None of the data included in the analysis is from the US, and the fluoride levels examined are at least double the level recommended for municipal water in the US. In some places in the world, fluoride is naturally present in water, such as parts of China, and can reach concentrations several-fold higher than fluoridated water in the US. //

The inclusion of urinary fluoride measurements is sure to spark criticism. For years, experts have noted that these measurements are not standardized, can vary by day and time, and are not reflective of a person's overall fluoride exposure.