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David Kirby Evidence of Harm

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Title: David Kirby Evidence of Harm


1
David Kirby Evidence of Harm
  • UPDATE ON RECENT DEVELOPMENTS IN THE
    MERCURY-AUTISM DEBATE
  • Autism One
  • May 2007 - CHICAGO

2
  • RECENT DEVELOPMENTS IN RESEARCH

3
NEW CDC findings ONE IN 150 -- Feb 8,
2007 8 year olds in 2000 and 2002 (born 1992
1994) Average ASD was 6.7 per 1,000 for
8-year-olds in 2000 (1992 birth cohort) and 6.6
per 1,000 8-year-olds in 2002. About 1 in 150
children. Most sites found 5.2 to 7.6 per 1,000.
(A 46 difference). Prevalence was much lower
(3.3 per 1,000) in Alabama and higher (10.6 per
1,000) in New Jersey in 2002. Prevalence
increased 10 from 1992 cohort to 1994 cohort in
the six sites with data for both years (HiB,
HepB, Rho-D added 1988-1992).
4
Autism Genome Project
  • Linkage Scores 5.4 is highly significant, over
    3.6 is significant, and over 2.2 is
    suggestive. These are known as the
    Lander-Kruglyak criteria.
  • Only one region produced a linkage score that
    reached the level of suggestive. This was in
    chromosome 11, and NOT in the areas that
    researchers had suspected for years.
  • The abnormal gene (neurexin) was found in only
    ONE family out of the 1168 families studied.
  • One would expect to get one random suggestive
    score in any genome scan, and one out of 10 scans
    would report a significant linkage, due to
    chance alone.
  • This finding is what youd expect from a random
    number generator. -- Mark Blaxill, SafeMinds.

5
February 11, 2007Study Low toxicant levels
damage brainResearchers cells shut down when
exposed to small amounts of mercury, lead
  • Micromolars of mercury and lead can damage
    developing brain cells.
  • Glial progenitor stem cells simply shut down at
    mercury levels previously thought to be safe in
    humans.
  • Progenitor stem cells are extraordinarily
    vulnerable to low levels of toxins. Up to 25
    percent of the progenitor glial cells shut down
    when exposed to low levels of lead or mercury.

6
SF ASD kids more likely born in polluted areas
  • 284 ASD children 657 controls, born in 1994 in
    Bay Area.
  • Assigned exposure level by birth tract for 19
    chemicals.
  • Risks for autism were elevated by 50 in tracts
    with the highest chlorinated solvents and heavy
    metals.
  • Highest risk compounds were mercury, cadmium,
    nickel, trichloroethylene, and vinyl chloride.
  • Risk from heavy metals was almost twice as high
    as solvents.
  • Our results suggest a potential association
    between autism and estimated metal
    concentrations, and possibly solvents, in ambient
    air around the birth residence.
  • ENVIRONMENTAL HEALTH PERSPECTIVES Vol. 114 No.
    9, September, 2006

7
TOXICOLOGY AND APPLIED PHARMACOLOGY - 15.3
(March, 2006)
  • Urine samples from 100s of French children
    yielded evidence for a link between autism and
    heavy metals.
  • Samples from ASD children had high levels of
    porphyrins used to produce of haem, the
    oxygen-carrying component in haemoglobin.
  • Heavy metals block haem, causing porphyrins to
    accumulate in urine.
  • Coproporphyrin was 2.6 times higher in autism
    cases than controls.
  • One author said it was Highly likely heavy
    metals are responsible for childhood autism in a
    majority of cases.

8
Asperger coprophyrin profiles matched control
cases, not autism
TOXICOLOGY AND APPLIED PHARMACOLOGY - 15.3
(March, 2006)
9
OTHER POSSIBLE ENVIRONMENTAL TRIGGERS??
  • Mercury in fish/air/amalgams
  • Pesticides
  • PCBs
  • Flame retardants
  • Jet fuel
  • Live virus in vaccines (MMR?)
  • As-yet unidentified virus (Lyme?)
  • Rampant cell phone TV use
  • Sonograms

10
  • RECENT DEVELOPMENTS
  • IN GOVERNMENT

11
THIMEROSAL EXPOSURE AUTISM RATES IN DENMARK
1981-2000
SOURCE Stehr-Green, et al, AMERICAN JOURNAL OF
PREVENTIVE MEDICINE, 25, no. 2 (August 2003)
101-6
12
DENMARK AUTISM RATES DROP
13
NIH PANEL QUESTIONS CDC METHODS AND DATA - 12/06
  • Congress requested NIEHS to convene a panel about
    whether the VSD could be used to compare autism
    rates before and after Hg was phased out.
  • In December, panel "identified several serious
    problems" with the database.
  • Several "weaknesses" and "limitations" associated
    with the database would render a comparative
    analysis "uninformative and potentially
    misleading.
  • Panel was concerned about how autism diagnoses
    were made and recorded by HMO's -- asked if they
    had adequate services for autism families, who
    might seek care elsewhere.
  • These and other problems likely led to an
    "under-ascertainment" of cases. (State rates were
    3-4 per 1,000, but VSD reported a rate of 1.1 per
    1,000) .

14
NIH PANEL QUESTIONS CDC METHODS AND DATA
  • Panel cited many other problems with the study
    design, particularly that "a large proportion,
    around 25, of births were excluded from the
    analysis."
  • These same children "may represent a susceptible
    population whose removal from the analysis might
    unintentionally reduce the ability to detect an
    effect of thimerosal."
  • Other "serious problems" included no
    consideration of Rho-GAM or "other vaccinations
    given during pregnancy, and no accounting for
    "the cumulative exposure to organic mercurials
    through diet or other environmental sources.
  • These problems "reduce the usefulness" of the VSD
    to prove or disprove a link between thimerosal
    and autism, though suggestions were given to
    address the problem.

15
Quotes on the NIH report from UPI - Age of
Autism, Dan Olmsted Dec. 11, 2006
  • The (VSD study) wasn't the last word things
    need to be looked at again,
  • perhaps with different methodology,"
  • --NIH Panel Chair Irva Hertz-
    Picciotto, Professor of Public Health,
    UC-Davis School of Medicine.
  • "Some studies are stronger than others. The
    Verstraeten study was an
  • improvement on other studies, including the two
    in Denmark, both of which had
  • serious weaknesses in their designs.
  • --Dr. Hertz-Picciotto
  • "We actually just got the (NIH) report and
    haven't had a chance to assess it."
  • --CDC spokesman Glen Nowak

16
IOM Workshop April 18-19, 2007Autism and the
Environment Challenges and Opportunitiesfor
Research
  • IOM Forum on Neuroscience and Nervous System
    Disorders Pharma sponsored.
  • Request from Secretary of HHS to host workshop on
    the potential relationship between autism and an
    array of environmental exposures (EXCEPT FOR
    VACCINATIONS deleted 2/2/07)
  • 1. What are the most promising scientific
    opportunities for improving the understanding of
    potential environmental factors in autism?
  • 2. What scientific tools and technologies are
    available, what research approaches are needed?
  • 3. What opportunities exist for public private
    partnerships?
  • On the Committee Mark Blaxill, SAFEMINDS, Laura
    Bono, NAA

17
OTHER RECENT DEVELOPMENTS
  • Imus sacked, Rosie leaves, Jenny speaks up
  • Katie Wright, Oprah, FAIR Interview
  • Autism Speaks Environmental push?
  • Senate HELP Committee Tom Harkin
  • Geier case series Journal of Toxicology
    Environmental Health
  • Fombonne Hg in blood and hair IMFAR
  • Discover Magazine article
  • EOH Movie 2nd draft completed

18
What About California?
  • Rates have not dropped among kids born 2001-2003
    Why not?

19
All ages Rate of increase rises again in 2006
20
Yearly trends for 3-5 year olds Rate of
increase soars in 2006
  • Year Net Gain Change
  • ages 3-5
  • 2003 572 n/a
  • 2004 545 -4.72
  • 2005 524 -3.85
  • 2006 668 27.48

21
CDC/ACIP survey of Hg containing vaccines 2001
2002
  • Convenience sample of vaccine providers under
    CDC contract.
  • Sept 2001 225 sites 5.6 TMC
  • Feb 2002 447 sites 1.9 TMC

22
CDC/ACIP survey of Hg containing vaccines 2001
2002
  • CDC contract sites are public health and county
    clinics not HMOs or private practices.
  • CDC aggressively purchased Hg free vaccines after
    1999 how much was left for private sector to
    buy (at a premium price)?
  • California has 50 HMO enrollment twice as
    high as the second highest state, Florida (at
    25). What is the CDC contracted rate?
  • How many of the 449 sites were in California?

23
What is a convenience sample?
  • Scientific Consensus Data are highly
    unreliable, not fit for publication, and should
    NEVER be used to predict larger trends.
  • GOOGLE Web Definitions of Convenience Sample
  • A sample for which cases are selected only on the
    basis of feasibility or ease of data collection.
    This type of sample is rarely useful in
    evaluation and is usually hazardous.
    www.ojp.usdoj.gov
  • Individuals or groups selected at the convenience
    of the investigator or primarily because they
    were available at a convenient place.www.research
    -nurses.com/methodology_terminology.html
  • A sample where researchers make little or no
    effort to insure an accurate representation of
    some larger group or population.www.ori.dhhs.gov/
    education

24
Convenience samplesKey points
  • There is no attempt to match the characteristics
    of the convenience sample to the general
    population.
  • The extent to which a convenience sample
    represents the traits or behaviors of the general
    population cannot be known regardless of how
    large the sample may be.
  • When someone tries to draw a conclusion about the
    broader general population, they run a real
    danger of drawing exceptionally wrong
    conclusions.
  • Using data from a convenience sample to describe
    characteristics which the study did not intend to
    model will almost certainly result in erroneous
    conclusions.
  • Study authors who use convenience samples nearly
    always warn against using their data to
    characterize the general population.

25
Mercury remained in some vaccines until 2003
  • The latest vaccines that contained any
    thimerosal as a preservative, with the exception
    of some flu vaccines, were completed in 2001 and
    outdated in 2003.

Dr. Harvey Fineberg, IOM President Meet the
Press, August 7, 2005
26
Mercury Remained in Some Rho-GAM Shots Until 2003
  • On April 16, 2001, Ortho
  • Clinical Diagnostics was
  • approved by FDA to
  • produce RhoGAM without
  • thimerosal The product
  • has a 2-year dating
  • period.
  • FDA Statement www.fda.gov

27
The flu shot may matter
  • A pregnant woman receives 25mcg, fetus is also
    exposed. Much is absorbed by fetal brain stem.
  • Human maternal/cord blood ratio is 12).
  • An 8oz fetus (0.25kg) is 1000 times over EPA
    limit.
  • (WILD ASSUMPTION Mercury is 4 times more toxic
    to a fetus than to an adult, thus toxic
    equivalency is 4,000 times over EPA)
  • At 6 months, a 16lb baby receives 12.5mcg or
    17 times over limit. At 7 months, baby receives
    12.5 mcg.
  • At 18 months, child receives 25mcg
  • Other shots contain 10 mcg in residual Hg.
  • Total possible exposure by 18 mos 585 mcg.Max
    exposure in UK 75mcg

28
Coal use goes way up in China 1996-2010
  • 1996
  • 1,500 million short tons

2010 2,666 million short tons
Source DOE/EIA, 1998, reference case
29
THE SHANGHAI PLUME(Moves up and down Pacific
Coast)
Lower urban mercury plume. 10-day traverse from
South China Sea, ending May 5, 2002. Trajectory
calculations by N.O.A.A.
30

31
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32
Early Intervention Producing More Diagnoses Among
3-5 Year Olds?
  • Average Age of
  • Diagnosis 1990 5.3 years
  • Average Age 2000 4.4 years
  • Average Age 2006 3.1 years

33
Northern California KaiserEarly Intervention
Program 2004-2006
34
NCK vs CDC vs VSD
35
California DDS 1st Quarter Data on Youngest
Cohort (3 year olds)
36
California Autism casesWhite vs.
Asian/Hispanic (1st Quarter)
37
White, Black, Hispanic, Asian, Filipino and
OtherPercentage in DDS with Autism
38
Hispanics have highest rate of increase, closely
followed by Asian and Filipino children 2003-2007
  • Ethnic Group 2003 2007 Change
  • Other 2,502 3,545 41.7
  • White 9,296 13,811 48.6
  • Black 1,898 2,862 51.6
  • Asian 1,684 3,015 79.0
  • Filipino 617 1,108 79.6
  • Hispanic 5,000 9,212 84.2
  • Total 22,040 33,553 52.2

39
California autism increase in DDS cases by
ethnic group 2003-2007
40
PDD rates in Lester B. Pearson School Board
(LBPSB) Montreal
41
PDD in Lester B. Pearson School Board (LBPSB)
MontrealHighest in the District Also highest
immigration rate
42
Judgment Day? June 2007 US Court of Claims
  • Vaccine Injury Compensation Program (Vaccine
    Court)
  • 3-Judge Panel will rule on causation
  • 5,000 cases pending
  • Closed to public and press?
  • Influenced timing of April IOM workshop?
  • Will have huge impact, either way, BUT
  • Neither side will accept ruling as last word
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