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David Kirby

David Kirby. DEBATE WITH ARTHUR ALLEN U.C.S.D. JANUARY 13, 2007. What is “AUTISM?”. AUTISM SPECTRUM DISORDERS (ASD) DSM-IV: “Classic” or “Full Spectrum” PDD-NOS: “Milder” or “Higher Functioning” ASPERGERS: “Savant” or “High Functioning” MORE THAN ONE CAUSE / NAME? Autisms?

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David Kirby

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  1. David Kirby DEBATE WITH ARTHUR ALLEN U.C.S.D. JANUARY 13, 2007

  2. What is “AUTISM?” AUTISM SPECTRUM DISORDERS (ASD) • DSM-IV: “Classic” or “Full Spectrum” • PDD-NOS: “Milder” or “Higher Functioning” • ASPERGERS: “Savant” or “High Functioning” MORE THAN ONE CAUSE / NAME? • Autisms? • Autism Type I, II, III? • Autism (genetic) vs. Acquired Neuroimmune Disorder (environmental)?

  3. KNOW YOUR MERCURY (Hg) TYPE SOURCE EXPOSURE Elemental Hg Thermometers Vapor Amalgams Lights/batteries Inorganic Hg Coal power plants Air pollutants (hydrophylic) Volcanoes Wildfires, etc. Organic Methyl Hg Fish Ingestion Organic Ethyl Hg Thimerosal Injected vaccines/Rho-GAM Fish(?) OTC topical meds

  4. 7 MAIN ARGUMENTS AGAINST THE THIMEROSAL HYPOTHESIS • Autism is genetic, there is no epidemic. • Mercury level in vaccines was very low, “like a tuna sandwich.” • Autism is not the same thing as mercury poisoning. • CDC study of federal data shows no damage from mercury in vaccines. • IOM REPORT: Thimerosal was not linked to autism in five large population studies from the US, Denmark, Sweden and UK • Ethyl mercury is “less toxic” than methyl mercury. • Thimerosal was removed from vaccines in 1999 and there has been no decline in autism cases in California and elsewhere.

  5. Argument #1 “Autism is genetic. There is no epidemic.”

  6. AUTISM BY THE NUMBERS: US & EUROPE USA - 1980’s: 1-2 per 10,000 children • Late 1990’s: 1 in 500 (20 per 10,000) • 2000: 1 in 250 (40 per 10,000) • 2004: 1 in 166 (60 per 10,000) • “DSM IV”: (40 per 10,000) “OTHER ASD”: (20 per 10,000) ------------- • UK – 2004: 1 in 166 (60 per 10,000)“DSM IV”: (20 per 10,000) “OTHER ASD”: (40 per 10,000) Denmark – 2004: 1 in 1,300 (8 per 10,000) Evidence of Harm

  7. Mercury in US childhood vaccines tripled (from 75mcg to 237.5mcg) between 1988-1992

  8. Autism cases spiked at same time “Effect is greatest for cohorts born between 1987 and 1992.” “Clear differences: the prevalence increases with younger birth cohorts.” “No concomitant decreases in categories of mental retardation or speech/language impairment were seen.” “Curves for children with ADHD also showed strong cohort differences.” “Cohort curves suggest that autism prevalence has been increasing with time.” “The narrowing of cohort curves in recent years may mark a slowing in the autism prevalence increase.”

  9. Autism Soars, disabilities steady1993-2003 – US I.D.E.A.

  10. BUT – US Dept. Of Education Regs Were Changed in 1992 to Expand Autism Criteria • Before change: Many states only recognized and counted DSM IV, “classic” autism. • After change: Many states added PDD-NOS, Aspergers. • Reported rates of “autism” in Illinois schools went from 5 cases in 1992 to 1,101 in 1996 – a jump of 21,920%! • In same period, US numbers rose 178.6% • BUT - California never expanded inclusion criteria

  11. TOTAL Hg BURDEN AND AUTISM RATES IN CALIFORNIA 1985-98 SOURCE: Mark Blaxill, SAFEMINDS, 2001

  12. The Hidden Horde? • 1-in-104 American boys have some form of ASD. If it is genetic, then the same should be true for American men who are 20, 30, 40, etc. • Where are they? Did they “outgrow” their autism? • Why are American schools struggling with ASD students in the last 10 years, and not before?

  13. Number of California Children with Full-Spectrum Autism in DDS, Avg. Per Age Group, Oct. 2006 2,132 2,063 1,539 983 505 3-5 6-9 10-13 14-17 18-21 SOURCE: California DDS

  14. 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

  15. TEXAS: HIGHER RISK OF AUTISM NEAR COAL-FIRED PLANTS • Study looked at Texas county levels of emissions, compared to ASD rates and special ed in 1,200 school districts. • Autism increased as mercury emissions rose. For every thousand pounds of Hg, there was a 61 percent increase in autism rates. • One county with low mercury emissions but significant autism rates was found to harbor one of the nation’s largest mercury mines. • Author: “A potentially important connection between environmental exposure to mercury and the development of autism.” HEALTH & PLACE: 12 (2006) 203-209

  16. Argument # 2 Mercury levels in vaccines was very low: “like a tuna sandwich”

  17. THE "THIMEROSAL GENERATION”Maximum Exposure in 1st year of life - US Schedule - 1992-200? AGE SHOTS HG CONTENT BIRTH Hep B 12.5mcg 8lb infant (3.6kg)– EPA Hg limit: 0.36mcg = 35 times over 4lb infant (1.8kg) – EPA Hg limit: 0.18mcg = 70 times over 2 MONTHS Hep B 12.5mcg HIb 25.0mcg DTaP 25.0mcg (subtotal for visit): 62.5mcg Avg. weight: 10lbs/4.5kg EPA limit: 0.45mcg = 138 times over EPA LIMIT: 0.1mcg per kg per day ADULT MALE: 138 times over EPA limit = 1,300mcg or 1.3 milligrams

  18. Continued exposures in 1st year of life AGE SHOTS HG CONTENT 4 MONTHS HIb 25.0mcg DTaP 25.0 mcg (subtotal for visit): 50.0 mcg Avg. weight: 14lbs/6.5kg EPA limit: 0.65mcg = 72 times over 6 MONTHS HiB 25.0mcg DTaP 25.0mcg (subtotal for visit): 50.0mcg Avg. weight: 16lbs/7.3kg EPA limit: 0.73mcg = 68 times over 12 MONTHS HiB 25.0mcg DTaP 25.0mcg (subtotal for visit): 50.0mcg Avg. weight: 20lbs/9kg EPA Hg limit: 0.9mcg = 55 times over

  19. Typical Tuna Sandwich 20 micrograms, methyl-mercury, ingested, contains selenium

  20. TYPICAL FLU SHOT 25 micrograms ethyl-mercury, injected, contains aluminum, etc. 110 lb woman = 5 times over EPA daily mercury limit 1.1 lb fetus = 50 times over EPA daily limit

  21. Argument # 3 “Autism is not the same as mercury poisoning.”

  22. ACRODYNIA (PINK DISEASE)Cause: Inorganic Hg used in teething powders • Afflicted tens of thousands of children in 1930-1950’s. • Symptoms: weepy rash & peeling skin -AND- withdrawal, poor eye contact, poor coordination and muscle control, lethargy, repetitive behaviors, rocking, spastic movements, emotional outbursts, self-injury, sensitivity to light, visual impairments, drooling, insomnia, general ill health. • 1-in-500 exposed children developed the disease. • Years passed before mercury poisoning was gradually accepted as the cause, despite stiff resistance by industry. • By 1954, most mercury was eliminated from teething powders. Cases fell sharply and then disappeared entirely. • Today, Pink disease is virtually unheard of.

  23. Acrodynia is not Autism • And neither is Minimata Disease • Nor Mad Hatters’ Disease (“The Danbury Shakes”) • Nor Iraqi Grain Disease • There is no SINGLE type of Hg poisoning • Symptoms depend on age, weight, sex, type of mercury, amount of mercury, route of exposure, genetic sensitivity, etc.

  24. Argument # 4 “A CDC study of federal data showed no damage from mercury in vaccines.”

  25. VSD - Generation “Zero”Nov-Dec 1999 Very high relative risks for outcomes. Autism Relative Risk = 7.6 UNPUBLISHED STUDY OBTAINED THROUGH FOIA

  26. VSD: Generation Zero

  27. “IT JUST WON’T GO AWAY”

  28. VSD Generation 1: Autism(Verstraeten – 2/2000)

  29. VSD Generation 2: Autism(Simpsonwood & ACIP 6/2000)

  30. VSD Generation 3: Autism(IOM Presentation 7/2001)

  31. Generation 4: Autism(Pediatrics Article, 11/2003) Vol. 112 No. 5 November 2003, pp. 1039-1048 “In no analyses were significant increased risks found for autism or attention-deficit disorder.”

  32. Autism Risks Across 5 Generations GEN 0 GEN 1 GEN 2 GEN 3 GEN 4 7.62 2.48 1.69 1.52 0.00 Evidence of Harm

  33. Argument # 5 IOM REPORT: Thimerosal was not linked to autism in five large population studies from the US, Denmark, Sweden and UK

  34. THIMEROSAL EXPOSURE & AUTISM RATES IN SWEDEN: 1980-1996 SOURCE: Stehr-Green, et al, AMERICAN JOURNAL OF PREVENTIVE MEDICINE, 25, no. 2 (August 2003): 101-6

  35. 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

  36. IOM Report: Deference toepidemiology over biology • Epidemiology “not acceptable” to disprove causation: Federal Court System. • Epidemiological studies were questioned by lead investigators themselves • Danish authors: exponential expansion of patients (inpatient-outpatient) “may have spuriously increased the apparent number of autism cases.” • Verstraeten: “We found no evidence against an association, as a negative study would. On the contrary, additional study is recommended, which is the conclusion to which a neutral study must come.” • IOM final report: “Cannot rule out, based on the epidemiology, possibility that vaccines contribute to autism in some small subset.”

  37. 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) .

  38. 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.

  39. Quotes on the NIH report from “UPI - Age of Autism,” Dan Olmsted Dec. 11, 2006 “The results from this study suggest there is not a 'cause and effect' relationship between thimerosal and autism or ADD.“ --CDC Website “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

  40. Young Cohort Reduces Signal • “Over one quarter of the children were under the age of ascertainment for autism - 44 months - causing the signal to disappear.” – Mark Blaxill • “There is certainly an under-ascertainment of cases. Some children are just not old enough to be diagnosed. Crude incidence rates are much lower because the cohort is still very young.” – Thomas Verstraeten • “A CDC official accepted the critics’ charge that it contained many children too young to be diagnosed as autistic. ’This is true,’ said scientist Frank DeStefano,” Neil Munro, National Journal

  41. SOURCE: VSD Analysis, February 2000 – Obtained through FOIA

  42. Biological Studies that Support the Mercury Hypothesis

  43. MEET THE “MERCURY CAPTURERS” • Thiol – A class of SULFUR-BASED proteins that bind with heavy metals and eliminate them from the system. • Thiols include – Glutathione, cysteine and metallothioneine. • Synonym for thiol = “mercaptan” from the Latin mercurium captans: or literally, “mercury capturer.”

  44. Dr. Jill James and team: • Discovered that ASD kids have low or depleted levels of “thiols,” including glutathione – a powerful antioxidant. • Low thiols levels are thought to be based on genes - and possible mercury exposure (See: R. Deth). • Methionine “metabolites” (methionine, cysteine, glutathione) in 20 children with autism compared vs. controls revealed severely abnormal profiles. • Targeted nutritional intervention for three weeks with Folinic acid, and Betaine (1000 mg. BID) resulted in significant improvement in methylation capacity in children with autism. • Addition of methyl B-12 to “cocktail” brought all autistic children within normal levels of methionine, cysteine and glutathione

  45. Chelation results from autistic child

  46. Holmes, Haley and Blaxill Baby Haircut Study 2003

  47. 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)

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

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