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David Kirby – Evidence of Harm

David Kirby – Evidence of Harm. UPDATE ON RECENT DEVELOPMENTS IN THE MERCURY-AUTISM DEBATE Autism One May 2007 - CHICAGO. RECENT DEVELOPMENTS IN RESEARCH. “ NEW ” CDC findings – ONE IN 150 -- Feb 8, 2007 8 year olds in 2000 and 2002 (born 1992 & 1994)

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David Kirby – Evidence of Harm

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  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 you’d 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. 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.” TOXICOLOGY AND APPLIED PHARMACOLOGY - 15.3 (March, 2006)

  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 • PCB’s • 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, 2007“Autism 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 ~1:2). • 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. 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

  31. Northern California KaiserEarly Intervention Program – 2004-2006

  32. NCK vs CDC vs VSD

  33. California DDS – 1st Quarter Data on Youngest Cohort (3 year olds)

  34. California – Autism casesWhite vs. Asian/Hispanic (1st Quarter)

  35. White, Black, Hispanic, Asian, Filipino and “Other”Percentage in DDS with Autism

  36. 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

  37. California autism: increase in DDS cases by ethnic group: 2003-2007

  38. PDD rates in Lester B. Pearson School Board (LBPSB) Montreal

  39. PDD in Lester B. Pearson School Board (LBPSB) MontrealHighest in the District – Also highest immigration rate

  40. 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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