David Kirby Evidence of Harm

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David Kirby Evidence of Harm

• UPDATE ON RECENT DEVELOPMENTS IN THE
  MERCURY-AUTISM DEBATE
• Autism One
• May 2007 - CHICAGO

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• RECENT DEVELOPMENTS IN RESEARCH

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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).
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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.

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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.

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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

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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.

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Asperger coprophyrin profiles matched control
cases, not autism
TOXICOLOGY AND APPLIED PHARMACOLOGY - 15.3
(March, 2006)
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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

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• RECENT DEVELOPMENTS
• IN GOVERNMENT

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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
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DENMARK AUTISM RATES DROP
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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) .

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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.

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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

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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

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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

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What About California?

• Rates have not dropped among kids born 2001-2003
  Why not?

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All ages Rate of increase rises again in 2006
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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

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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

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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?

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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

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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.

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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
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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

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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

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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
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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.
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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

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Northern California KaiserEarly Intervention
Program 2004-2006
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NCK vs CDC vs VSD
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California DDS 1st Quarter Data on Youngest
Cohort (3 year olds)
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California Autism casesWhite vs.
Asian/Hispanic (1st Quarter)
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White, Black, Hispanic, Asian, Filipino and
OtherPercentage in DDS with Autism
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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

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California autism increase in DDS cases by
ethnic group 2003-2007
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PDD rates in Lester B. Pearson School Board
(LBPSB) Montreal
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PDD in Lester B. Pearson School Board (LBPSB)
MontrealHighest in the District Also highest
immigration rate
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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