Conor, Autism Disorders and Traffic-Related Air Pollution

Photo by Harold L Doherty, Toronto, CN Tower, 2008

Conor Doherty, 1 Day Old, February 20, 1996 

Joseph Brant Memorial Hospital, Burlington

Photo by Dad

A new study Traffic-Related Air Pollution, Particulate Matter, and Autism published online in the JAMA Archives of General Psychiatry examines the relationship between traffic-related air pollution, air quality, and autism.  The study researchers found that Children with autism were more likely to live at residences that had the highest quartile of exposure to traffic-related air pollution, during gestation and during the first year after birth compared with control children.  In the study abstracts the researchers concluded:

"Exposure to traffic-related air pollution, nitrogen dioxide, PM_2.5, and PM₁₀ during pregnancy and during the first year of life was associated with autism. Further epidemiological and toxicological examinations of likely biological pathways will help determine whether these associations are causal."

Autism Speaks has issued a news release which comments on the study report: 

"Despite an increase in research and funding, “we have not yet fully described the causes of ASD or developed effective medical treatments for it,” Dr. Dawson writes. “[This issue’s] articles point to an urgent need for more autism funding. We especially need more research on prenatal and early postnatal brain development in autism, with a focus on how genes and environmental risk factors combine to increase risk for ASD.” .....  Research presented in this issue reports a three-fold increase in autism risk associated with exposure to high levels of traffic-related air pollution during pregnancy and the first year of life. The study’s lead author, Heather Volk, Ph.D., M.P.H., is the recipient of an Autism Speaks research grant to study autism risk and gene-environment interactions involving air pollution." [Bold, underlining added -HLD]

The possible association between autism and traffic related air pollution is of specific interest to me.  We were living in Burlington, Ontario when my wife Heather was pregnant with our now 16+ son Conor who has severe Autistic Disorder.  We moved back to Fredericton, New Brunswick 4 months after Conor's first birthday.  Burlington is located between Hamilton and Toronto, Ontario off the Queen Elizabeth Highway, the QEW, which runs between those two cities. It is  one of the busiest automobile traffic areas in Canada. 

Like the study's careful authors I do not jump to any definite conclusion about the the traffic related air condition as a cause of Conor's autism.  I do strongly suspect the combination of environmental pollutants in that area MAY have been factors in causing or triggering autism in Conor.  In addition to heavy auto traffic Burlington is also adjacent to Hamilton with steel mills that emit considerable air pollution as was described in  a study I commented on in 2008 in Autism, Environment and Genetic Mutations: Hamilton Steel Mills and Conor's Autism Disorder. including references to a study Germ-line mutations, DNA damage, and global hypermethylation in mice exposed to particulate air pollution in an urban/industrial location and a Toronto Star article which reported on the story:

"Mice breathing the air downwind from Hamilton's two big steel mills were found to have significantly higher mutation rates in their sperm, a new Health Canada-led study says. While there's no evidence that residents of the area are experiencing the same genetic changes, the project's lead author says the findings do raise that question. "We need to do that experiment and find out," said Carole Yauk, a research scientist with Health Canada. A future study will look at "DNA damage in the sperm of people living in those areas."

...

Dr. Rod McInnes, director of genetics at Canadian Institutes of Health Research, said the mice could be "the canary in the coal mine" signalling the genetic risks to humans of breathing toxic air. ... While genetic changes in sperm would not affect a male directly, they'd get passed on to the offspring that receive his DNA. The story reports on a study indicating that the mice living under the Burlington skyway downwind from 2 Hamilton steel mills and breathing the air from those mills for a period as short as 10 weeks were found to have significant sperm mutations."

I was interested enough in the Hamilton steel mill's air pollution study that I contacted Dr. Yauk referenced in the Toronto Star article quoted above. Dr. Yauk was kind enough to reply to my email in some detail:

"Dear Mr. Doherty,

I'm very sorry to hear of your son's autism. Certainly many of the chemicals emitted from the steel industry into the air are highly mutagenic. There are numerous sources of mutagenic chemicals in that evironment (emissions from the cars/trucks on the QEW will be high as well), and we have definite plans to follow-up our earlier results. At the moment, we are applying for funding to continue the research. There will be 2 arms of work: one on mice to try to look at a full panel of potential health effects and causative agents, and the other will begin to look at DNA damage and changes in sperm from men living in the area. One of the things that I would like to investigate is whether there is evidence of large rearrangements and gains and losses in DNA regions in mice breathing air in that environment. These types of mutation have been shown to be associated with autism in an earlier study from another group (and various

other types of diseases). However, these experiments are extremely expensive, and we have not been successful in obtaining funding as of yet (it is very competitive these days to get grants). Hopefully we'll have some success soon - I am optimistic as we have an outstanding panel of investigators on the project from McMaster University, McGill, and Health Canada.

Thank you for your interest. Please feel free to email me again in the  future.

Best regards,

Carole

Carole Yauk, Ph.D.

Research Scientist, Health Canada

Adjunct Professor, Carleton University

Associate Editor, Environmental and Molecular Mutagenesis.

Environmental Health Centre"

The gene environment model of autism causation has gained ground in recent years. Autism Speaks deserves some credit for this advance with its more balanced funding of genetic and environmental studies.  

Scientists like Dr. Carole Yauk, Dr. Irva Hertz-Picciotto, Dr. Heather Volk, Dr. Philip J. Landrigan and Dr. Linda Birnbaum are the people advancing our knowledge of possible causes of autism disorders.  This father of an autistic son  salutes them and wishes them well in their never ending efforts to enhance our understanding of the environmental factors contributing to the very real autism crisis confronting our children. 

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Autism Is Genetic Eh? Really?

Autism, it's gotta be genetic, even if we can't see the evidence

No one disputes that autism has a genetic link or links somewhere, now if only we can find it ............  or them.

"Researchers say they have identified gene mutations that contribute to autism in three separate studies. The mutations identified were rare and aren’t necessarily present in the parents, only the offspring, which has made finding them difficult for scientists.     [Emphasis added - HLD]

“It just goes to show how complex the genetic architecture of autism is,” says Thomas Lehner, chief of the NIMH Genomics Research Branch, which funded one of the studies and helped to create the Autism Sequencing Consortium. Together, the studies allow scientists to estimate for the first time that some 500 to 1,000 mutations are likely involved in autism, Lehner tells the Health Blog. Abstracts for the studies, which were published in Nature, can be found here, here, and here. 

The work, conducted by three separate research groups on independent patient samples, also confirms earlier research that older paternal age appears a risk factor for the condition."

Wall Street Journal Health Blog, Complex Genetic Mutations Contribute to Autism, Studies Say

Notwithstanding the lack of any specific identifiable genes directly connected  to autism disorders researchers continue to push their beliefs that autism is primarily genetic.  Actually what they are really saying is autism is a disorder found in humans with different genetic makeups for which .... however ... there is no need to devote research dollars to conducting serious environmentally focused autism research.  After all if man made toxins are involved in any way in causing or triggering autism disorders then presumably corporate profit making ventures could be put at risk.  Better to mention paternal age again and invent a new genetic paradigm to explain why, notwithstanding the lack of any real evidence, we have to believe, we must believe, that autism is genetic.  Profits depend on us being devout in our "autism is genetic" faith.  Oh and by the way autism is not really rising despite changes in estimates, in less than two decades from 1 in 500 to 1 in 88.  

The explanations for the failure to identify specific genes connected to autism are beginning to sound funny.  Or they would be funny if autism research wasn't a serious matter for those who are, or whose children are, severely impacted by autism disorders. 

While parents and researchers calling for more environmentally focused autism research are demeaned or, at best, ignored, the autism research community by and large remains unwavering in its devoutly held faith that autism is, autism has to be, genetic.

The word from the autism research community remains the same: Carry on regardless.  Carry on regardless of whether we see any evidence to support the autism is genetic belief.

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A Focused Environmental Autism Research Strategy Is Needed

If you have a child who is severely affected by an autism disorder, whose ability to understand the world is limited, who wanders into dangerous traffic, lakes or rivers,  is prone to seizures or  engages in serious self injurious behavior autism is not just an alternative way of thinking or an opportunity to build a career mouthing empty feel good cliches about autism acceptance on twitter.  If you are a parent with a severely autistic child you will probably fight for evidence based autism interventions, accommodation in the schools for autistic students and a place for them to live with dignity as you grow old and ultimately die.  These are the harsh realities faced by  parents with low functioning autistic children who must look at autism seriously and not as an opportunity to tell the world that everything problematic about autism is solved if we all just accept autism in our child. For many parents we would like to see solid scientific research into all the causes and conditions that create autism in our children, genetic and environmental causes.

Autism may be prevented, treated or even cured in the future if the research is done.  If that research leads us to the age of the father in some cases then that is important to know. If that research leads us into the multitude of possible impacts on children while in the incredibly important environment known as the womb then that research must be done.  What will not help in understanding autism is simply throwing our hands up in the air and arguing that we should not conduct research on the prenatal environment or in mocking attempts to research possible environmental causes of autism as some Neurodiversity bloggers like to do.  

For many of us our child's Autistic Disorder is a serious, life impairing disorder, and a mystery  that must be solved by solid research, genetic and environmental. Environmental research has been short changed and a solid environmental research strategy is required as recently advocated by Philip Landrigan and his colleagues in A Research Strategy to Discover the Environmental Causes of Autism and Neurodevelopmental Disabilities. Landrigan and his colleagues Luca Lambertini and Linda Birnbaum of the Children’s Environmental Health Center, Mount Sinai School of Medicine, New York and NIEHS and NTP, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina.  

The distinguished authors argument includes a "proof of principle" segment in which they list studies linking various toxic substances to neurodevelopmental impairments:

"Exploration of the environmental causes of autism and other NDDs has been catalyzed by growing recognition of the exquisite sensitivity of the developing human brain to toxic chemicals (Grandjean and Landrigan 2006). This susceptibility is greatest during unique “windows of vulnerability” that open only in embryonic and fetal life and have no later counterpart (Miodovnik 2011). “Proof of the principle” that early exposures can cause autism comes from studies linking ASD to medications taken in the first trimester of pregnancy—thalidomide, misoprostol, and valproic acid—and to first trimester rubella infection (Arndt et al. 2005; Daniels 2006).

This “proof-of-principle” evidence for environmental causation is supported further by findings from prospective birth cohort epidemiological studies, many of them supported by the National Institute of Environmental Health Sciences (NIEHS). These studies enroll women during pregnancy, measure prenatal exposures in real time as they occur, and then follow children longitudinally with periodic direct examinations to assess growth, development, and the presence of disease. Prospective studies are powerful engines for the discovery of etiologic associations between prenatal exposures and NDDs. They have linked autistic behaviors with prenatal exposures to the organophosphate insecticide chlorpyrifos (Eskenazi et al. 2007) and also with prenatal exposures to phthalates (Miodovnik et al. 2011). Additional prospective studies have linked loss of cognition (IQ), dyslexia, and ADHD to lead (Jusko et al. 2008), methylmercury (Oken et al. 2008), organophosphate insecticides (London et al. 2012), organochlorine insecticides (Eskenazi et al. 2008), polychlorinated biphenyls (Winneke 2011), arsenic (Wasserman et al. 2007), manganese (Khan et al. 2011), polycyclic aromatic hydrocarbons (Perera et al. 2009), bisphenol A (Braun et al. 2011), brominated flame retardants (Herbstman et al. 2010), and perfluorinated compounds (Stein and Savitz 2011).

Toxic chemicals likely cause injury to the developing human brain either through direct toxicity or interactions with the genome...."

Landrigan, Lambertini and Birnabaum generated a list of 10 chemicals that they recommended as priorities for investigation.  They expressly stated that the list is not intended to be exhaustive but is intended to provide a strategic environmental research focus to catalyze new evidence based programs for prevention of neurodevelopmental disorders in children. The  list includes some very well known dangerous substances:

1. Lead (Jusko et al. 2008)
2. Methylmercury (Oken et al. 2008)
3. Polychlorinated biphenyls (Winneke 2011)
4. Organophosphate pesticides (Eskenazi et al. 2007; London et al. 2012)
5. Organochlorine pesticides (Eskenazi et al. 2008)
6. Endocrine disruptors (Braun et al. 2011; Miodovnik et al. 2011)
7. Automotive exhaust (Volk et al. 2011)
8. Polycyclic aromatic hydrocarbons (Perera et al. 2009)
9. Brominated flame retardants (Herbstman et al. 2010)
10. Perfluorinated compounds (Stein and Savitz 2011).
    
    

Landrigan, Lambertini and Birnbaum recognize the importance of genetic research but, as other learned authorities have noted, genetic research has received the overwhelming share of autism research dollars. The recent IMFAR conference in Toronto left me with the impression that the "it's gotta be genetic" trend of channeling autism research overwhelmingly toward genetic research  is continuing. As these learned authors have argued so compellingly it is critically important that environmental autism research be focused .... and funded ... if autism disorders are to be prevented, treated or cured in future.

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Strategic Research of Environmental Causes of Autism and Neurodevelopmental Disabilities

In A Research Strategy to Discover the Environmental Causes of Autism and Neurodevelopmental Disabilities, an editorial in the current issue of Environmental Health Perspectives, authors Philip J. Landrigan, Luca Lambertini and Linda S. Birnbaum make a  compelling argument for strategically researching environmental causes of autism and neurodevelopmental disabilities. In the process they provide an understanding of autism as a family of disorders.   The authors point out that, despite the attention paid to genetic causes of autism disorders,  a large number of genes have been identified as candidates in causing autism disorders with no single dominant genetic anomaly and with no disorders attributable to 60-70% of autism disorders: 

The candidate genes most strongly implicated in NDD causation encode for proteins involved in synaptic architecture, neurotransmitter synthesis (e.g., γ-aminobutyric acid serotonin), oxytocin receptors, and cation trafficking (Sakurai et al. 2011). No single anomaly predominates. Instead, autism appears to be a family of diseases with common phenotypes linked to a series of genetic anomalies, each of which is responsible for no more than 2–3% of cases. The total fraction of ASD attributable to genetic inheritance may be about 30–40%.

Landrigan, Labertini and Birnbaum summarize the evidence for the "proof of principle" that early exposures during “windows of vulnerability” that open only in embryonic and fetal life and have no later counterpart can cause autism.  They review the large numbers of synthetic chemicals, many of them untested, some of which are known to have toxic properties. The authors propose a strategic approach to researching possible environmental causes of autism by focusing:

"research in environmental causation of NDDs on a short list of chemicals where concentrated study has high potential to generate actionable findings in the near future. Its ultimate purpose is to catalyze new evidence-based programs for prevention of disease in America’s children."

The authors recognize that the list of 10 possible environmental causes deserving of focused research at this time would expand with time and scientific developments.  As a start though they propose based on the studies referenced following the substance: Lead (Jusko et al. 2008) Methylmercury (Oken et al. 2008) Polychlorinated biphenyls (Winneke 2011) Organophosphate pesticides (Eskenazi et al. 2007; London et al. 2012) Organochlorine pesticides (Eskenazi et al. 2008) Endocrine disruptors (Braun et al. 2011; Miodovnik et al. 2011) Automotive exhaust (Volk et al. 2011) Polycyclic aromatic hydrocarbons (Perera et al. 2009) Brominated flame retardants (Herbstman et al. 2010) Perfluorinated compounds (Stein and Savitz 2011).

The strategic approach to environmental autism research is an idea who time has come.  In fact it is long overdue. The respected authors of the EHP editorial will undoubtedly be vilified by the usual suspects, Neurodiversity ideologues and industrial and pharmaceutical spin doctors employed to cast doubt on the need for any environmentally focused autism research.  However, given the support of the NIEHS and Autism Speaks, there is substantial reason to hope that the strategic focused study of environmental causes of autism and other neurodevelopmental disorders is underway.

It's about time. 

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Do Genetics Play ANY Role in Causing Autism?

"Autism is linked to different genes in different people, 
and multiple genes could be involved in each affected person."
Genetic Engineering & Biotechnology News, November 1, 2011

Do genetics play ANY role in causing autism?

The view that autism is caused purely by genetics held sway for many years especially with respect to funding autism research. The "it's gotta be genetic" mindset has seen research dollars dedicated overwhelmingly towards genetic based autism research.  Research into possible environmental causes or contributors to autism has been minuscule by comparison. What have those genetic autism research dollars produced? I am a humble, irrational, distraught parent of a son with severe autistic disorder but as I read commentaries by people who know much more than I do about these subjects what I see is doubt about the role of genetics in causing autism.

Genomic Studies Are Adding to Evidence of Autism’s Highly Complex Nature, an article by Patricia F. Dimon, Ph.D.,  published November 1, 2011 on the Genetic Engineering & Biotechnology web site makes the argument that current research, like that arising from the AGRE (autism genetic resource exchange), is providing some idea of where some common underlying genetic factors involved with autism might be found but in making that argument also makes statements suggesting a limited role for genetics in causing autism disorders:

"From a biological perspective, autism presents a “profoundly complicated” array of disorders with significant genetic components and genomic alterations thought to “organize around a central theme of neural network infirmities and neuroimmunodysregulations,” according to Daniel J. Guerra, writing in the March issue of Autism Research and Treatment.

Autism is linked to different genes in different people, and multiple genes could be involved in each affected person. These genetic factors, in turn, may interact with as yet unidentified environmental factors. It is now known that new mutations show up in children whose parents do not carry the mutation. Additionally, it turns out that in cases where underlying genetic mutations have been identified, the gene abnormalities don’t necessarily predict the disorder.

“Do we really know that every time you make that mutation or you delete one copy of that gene, you cause autism?” asked John Constantino, M.D., a pediatric psychiatrist at Washington University in St. Louis, in an interview with Los Angeles Times. “We have no idea.”" (Underlining added - HLD)

How can we continue to play the "it's gotta be genetic" card of autism research, and ignore possible environmental causes or contributing factors, when genetic autism research has failed to provide any tangible results?  

After so many years of siphoning off autism research dollars has genetic research helped us understand how autism is caused or developed?

Do genetics really play any role in causing autism?

Apparently .... we have no idea.

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Autism and Environmental Pollution: Review Shows Serious Study Needed

EPA, United States Environmental Protection Agency

Judith Pinborough-Zimmerman, research assistant professor in the University of Utah’s Department of Psychiatry,  has called for more serious study of links between toxic pollution and autism spectrum disorders after a  preliminary review showed that children with autism spectrum disorders and other intellectual disabilities are more likely to have been born near industries that emit toxic chemicals or heavy metals. As reported by Heather May of Utah News the researchers found that children of mothers living within a mile of "Toxic Release Inventory" sites were were more likely to have autism spectrum disorders and intellectual disabilities:

"They found that children born to mothers who lived within a mile of what are called Toxic Release Inventory sites that emit certain chemicals and heavy metals were more likely to have those problems. TRI facilities release or dispose toxic chemicals regulated by the Environmental Protection Agency. The EPA maintains a database of all such facilities and the type and amount of chemicals they release.

• The risk of having an autism spectrum disorder was 3.5 times greater for children born within a mile of a site releasing between 5,000 and 10,000 pounds of halogenated chemicals (dioxins, polychlorinated biphenyls and trichloroethylene). There were five such TRI sites emitting at those levels in the mid-1990s.

• The risk of having an autism spectrum disorder was twice as big when living within a mile of one of six TRI sites emitting up to 5,000 pounds of the heavy metals arsenic, cadmium, lead, nickel and mercury."

To this lay person a finding that risk of autism spectrum disorders arises by 2 to 3.5 times with children born of mothers living near one of these pollution sites seems to be a very strong indicator of the need for further "serious" study as indicated by Assistant Professor Pinborough-Zimmerman.   We can always cling to the unproven assumption that autism has a 100% genetic basis and keep finding excuses for why autism rates continue to climb for a purely genetic disorder.  Or we could actually try to find out what has been happening to our children.

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Will New Prohibition Against Exploring Possible Vaccine Autism Connections Stop ALL Environmental Autism Research?

The last few years have seen an all out offensive to shut down discussion of vaccines as possible triggers of autism disorders.  The withdrawal of the 1998 Lancet article, the banishment of Dr. Andrew Wakefield by British medical authorities, the conviction of Andrew Wakefield of fraud in The Court of Brian Deer and the mainstream media puppeting and promotion of the Deer conclusions have occupied much public space in discussion of autism disorders.  And of course no less a public figure than Bill Gates has accused those who question vaccine safety of killing children around the globe. Autism Speaks has declared that it "is time to change the conversation".  In other words "sssshhhhhhhhhhhhhhhuuuuuttttttt up" or face the consequences.

In the era of the New Prohibition, the prohibition against discussion of  possible vaccine autism discussions, will research which MIGHT implicate vaccines as possible be prohibited? Environmental autism research focused on prenatal and early postnatal environmental impacts on the fetus and developmental disruption has been featured in reports to the US senate on the State of Research on Potential Environmental Health Factors with Autism and Related Neurodevelopment Disorders:

Paul Anastas Ph.D. Assistant Administrator for Research and Development and Science Advisor U.S. Environmental Protection Agency (EPA)

Because of its extraordinary complexity, prenatal and early postnatal brain and nervous system development can be disrupted by environmental exposures at much lower levels than would affect adults.5,6,7,8,9 We are learning that there are critical windows of susceptibility both prenatally and in early childhood, during which the effects of exposures to environmental contaminants, depending on dose and timing, can be significantly more severe and can lead to permanent and irreversible disability.10,11,12 For these and many other reasons, EPA is especially concerned about potential effects of environmental chemicals on children’s health and neurodevelopment.

Linda Birnbaum, Ph.D., D.A.B.T., A.T.S. Director, National Institute of Environmental and Health Sciences and National Toxicology Program National Institutes of Health, United States Department of Health and Human Services

Development of the nervous system begins in the womb and extends through childhood. During these periods of rapid development, the brain is vulnerable to some environmental exposures that may have the potential to disrupt the chemical signals that organize development. Even small changes in the timing of critical development events can potentially have major consequences for brain structure and function. Thus even brief exposures at these vulnerable stages can have lasting effects on adult brain function. We refer to "windows of susceptibility: to mean the life stage at which the brain is exposed, during which different agents can effect the brain in specific and deleterious ways. For example, the dose of lead that is neurotoxic to an infant is much less than the dose that would be neurotoxic for an adult, so infancy in this case is a "window of susceptibility" .... Learning disabilities are on the rise in the United States and we now have a significant body of information on how exposure to certain environmental agents can affect children's intelligence quotients (IQs). For example, scientific literature attests to the effect of lead exposure in early life on IQ. ... Mercury also has been shown in multiple studies to be a developmental neurotoxicant. .... A study published last year from Columbia University showed that a mother's exposure to urban air pollutants known as polycyclic aromatic hydrocarbons (PAHs) can adversely affect a child's IQ.  PAHs are released into the air from the burning of coal, diesel, oil, gas and other organic substances such as tobacco.  In urban areas motor vehicles are a major source of PAHs. 

Bruce P. Lanphear MD, MPH Senior Scientist, Child & Family Research Institute, Professor, Simon Fraser University, Vancouver, BC, Adjunct Professor, Cincinnati Children's Hospital Medical Center

Children’s environmental health -- the study and prevention of disease and disabilities in children from exposures to social, physical, biologic, and chemical agents -- has emerged as a new field of research, policy, and clinical practice (Landrigan et al. 1998). The growth of this field has been fueled by the emergence of new morbidities in children, research showing that the fetus and child are particularly vulnerable to environmental influences, and mounting evidence implicating environmental exposures as major risk factors for prevalent diseases and disabilities in children (Lanphear, 2005).


One in six American children have a developmental problem, from a subtle learning disability to overt behavioral disorders, such as attention deficit hyperactivity disorder (ADHD) or autism (Boyle et al. 1994; Hertz-Picciotto, 2009). These conditions can severely impair a child’s ability to succeed in school, elevate their risk for violent and criminal behaviors, and dramatically diminish their ability to contribute to society. The findings from some of the most thoroughly studied and widely dispersed environmental toxicants indicate that exposure to exceedingly low levels are risk factors for the “new morbidities” of childhood -- intellectual impairments, behavioral problems, asthma and preterm birth (Lanphear, 2005). Indeed, there is often no apparent threshold and, in some cases the effects appear to be greater at the lowest levels of exposure (England et al. 2001; Canfield et al. 2003; Lanphear et al. 2005; Yolton et al. 2005).

Exposures to established environmental toxicants -- such as lead, tobacco, PCBs and mercury -- have consistently been linked with higher rates of intellectual impairment or behavioral problems, such as conduct disorder and ADHD (Needleman et al. 1990; Schantz et al. 2003; Kahn et al. 2003; Wakschlag et al. 2002; Stewart et al. 2003; Needleman et al. 1979; Lanphear et al. 2005; Yolton et al. 2005). There is emerging evidence that a whole host of new environmental chemicals – such as Bisphenol A, PBDEs, pesticides, phthalates, and airborne pollutants – are associated with intellectual deficits or behavioral problems in children, but the evidence is not as conclusive (Rauh, 2006; Engel, 2010; Eskenazi, 2007; Braun, 2009; Perera 2009; Herbstman, 2010). Much of this research was done by the NIEHS/US EPA Children’s Environmental Health Research Centers working collaboratively with the Centers for Disease Control and Prevention.


Children’s developing brains are more vulnerable to certain toxicants and pollutants than adults. The central nervous systems of the fetus and young child, which are undergoing rapid changes, are particularly vulnerable to some toxicants. The fetus is a recipient of toxicants through placental transfer (Perera et al. 2003; Whyatt and Perera 1995; Bearer 2003). In some cases, such as mercury, the fetus is exposed to a larger dose than the mother (Ramirez et al. 2000). In other cases, such as organophosphate pesticides, the fetus may lack critical enzymes to metabolize environmental toxicants (Chen et al. 2003). Toddlers are often at greater risk for exposure to many environmental toxicants because they have a high degree of hand-to-mouth activity and they absorb some toxicants more efficiently (Bearer 1995).

As the above quotes illustrate environmental  research is examining many potential causes and triggers of autism disorders at the prenatal and early childhood stages.  Mercury is only one of the potential causes of autism being researched but it is one which is very sensitive to those who insist that discussion and research of possible vaccine autism issues must stop.   Teresa Binstock wrote about the "it's gotta be genetic" model of autism and the consequences for any professional who explored vaccine autism connections over a decade ago.   Much of what Binstock discussed is taking place now as Dr. Andrew Wakefield is well aware.  The current suppression of vaccine safety discussion and research will probably be accompanied by a complete return to the 100% genetic model of autism, a model which has already sucked the life out of environmental autism research funding for decades.  All serious efforts to find the environmental causes of the vaccine epidemic, to find out what is really happening to  our children are likely to come to an end.

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lbrb Blog Opposes Autism Causation Research? Why Now?

At the risk of encouraging visitors to head over to the lbrb site I feel compelled to question the  rationale for the site continuing to describe itself as being one about "autism news, science and opinion".  Frequent lbrb blogger Sullivan  states in a comment titled Upcoming IACC Subcommittee on Safety Conference Call – Wednesday, January 12, 2011 that:

"At present, much of the focus and the budget recommended by the IACC goes towards causation (with the majority of that of that going towards environment and gene-environment causation) and early childhood therapies."(Bold highlighting and underlining added for emphasis HLD.)

Sullivan appears to go on to suggest that services would be a more proper focus for autism funding. It is only now after more than a decade of  an almost exclusive concentration of funding of autism research dollars on genetic autism research that LBRB blogger Sullivan objects to autism research because the money should not be spent at all on causation?

Dr. Irva Hertz-Picciotto, who knows something about autism research as a lead autism researcher with the CHARGE study and with UC Davis M.I.N.D. Institute,  stated on the UC Davis web site in early 2009 that:

"Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones. We need to even out the funding."   -  (bold highlighting and underlining added for emphasis HLD)

Even NIH and IACC director Dr. Thomas Insel acknowledges that research dollars have flowed predominantly toward genetic focused autism research at the expense of environmental autism research:

"As with many complex disorders, causation is generally thought to involve some forms of genetic risk interacting with some forms of non-genetic environmental exposure. ... In addition, a number of other environmental factors are being explored through research because they are known or suspected to influence early development of the brain and nervous system. Recent studies suggest factors such as parental age, exposure to infections, toxins, and other biological agents may confer environmental risk. ... Progress in identifying environmental factors which increase autism risk has been made recently (Eskenazi et al., 2007; Palmer et al., 2006; Palmer, Blanchard,; Wood, 2009; Rauh et al., 2006; Roberts et al., 2007; Windham et al., 2006), although this area of research has received less scientific attention and far fewer research dollars than genetic risk factors"  (bold highlighting and underlining added for emphasis - HLD)

Sullivan and LeftBrainRightBrain now sense a move toward a balanced distribution of autism research funding dollars and object to causation research receiving funding at all?  

Why now? Do they really believe that parents who actually care about finding out what  happened to our children that resulted in these life limiting disorders are going to stop asking for autism causation research to be done? Do they really think it is unimportant to find out what causes these serious disabilities and try to prevent them from arising in future or finding treatments and cures for those who suffer from autism disorders today?  Are they concerned that environmental research will find external triggers and causes of autism that might undermine the neurodiversity ideology, the autism is just a beautiful, natural variation, a different way of thinking, nonsense that they have peddled to a gullible mainstream media and some ill informed members of the public since 2003? 

lbrb is abandoning the science component of their autism blog now that the "it's gotta be genetic" autism balloon is collapsing?  Curious, very curious. 

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Autism Speaks Role in Exploring the Environmental Causes of Autism and Other Learning Disabilities

Autism Speaks has been open to legitimate criticism on several aspects of its autism advocacy of late including promoting the views of those who do not view autism disorders as medical disorders and do not think that autism disorders should be cured.  AS even promotes the views of Alex Plank, a very high functioning young man, with no obvious or apparent autism deficits, who runs a forum which, amongst other disreputable behavior, actually permitted posters to cheer the passing of Dr. Ivar Lovaas.  On its official blog site though Autism Speaks has just given notice  that it can still engage in some  genuine, and much needed, autism advocacy with its sponsorship of, and reporting on, the Mount Sinai Children's Environmental Health Center's workshop "Exploring the Environmental Causes of Autism and Other Learning Disabilities".     , 

In Feeling exposed? Insights from a new meeting on environmental impacts in autism Autism Speaks board member, and co-founder and Executive Director of Safe Minds, Sallie Bernard provides an overview of “Exploring the Environmental Causes of Autism and Learning Disabilities” a conference  organized  by the Children’s Center for Environmental Health at the Mount Sinai School of Medicine in New York City run by Dr. Phil Landrigan.

Dr. Landrigan is no vaccine patent holder or industrial  or  pharmaceutical company apologist. His credibility on children's health areas is well summarized on Wikipedia.

"Landrigan's reputation rests largely on his role as a highly credible evidence-based advocate for public health, specifically in his focus on reducing the level of children's exposure to lead and pesticides and for his participation in the World Health Organization's global campaign to eradicate smallpox. 


He was also a central figure in developing the National Children's Study[1][3] and in the medical and epidemiological studies that followed the destruction of the World Trade Center on September 11, 2001.[4] Additionally, from 1995 to 1997, Landrigan served on the Presidential Advisory Committee on Gulf War Veteran’s Illnesses,[5] and, in 1997 and 1998, served as Senior Advisor on Children's Health to the Administrator of the U.S. Environmental Protection Agency, where he helped establish the Office of Children's Health Protection.


He has been awarded the Meritorious Service Medal of the US Public Health Service[6] and is a frequent consultant to the World Health Organization, which called Landrigan's work "instrumental in passing the Food Quality Protection Act of 1996."


In 2005, Landrigan, along with Drs. Ramon Murphy and David Muller, founded the Global Health Center, a division of the Mount Sinai Medical Center dedicated to finding evidence-based solutions to global health problems.[7]"

The Autism Speaks summary of the conference points out that the primary purpose of the conference was to highlight the fact that environmental autism science should now be considered mainstream.  Hopefully if this message permeates the consciousness of mainstream media decision makers it will  lead to fewer personal attacks on those who advance environmental theories of autism causation and more serious investigation of all possible environmental causes of autism disorders.  Some of the key points as reported by Autism Speaks:

"A few interesting bits of information came out of the conference. One was the definition of “environment” that the insiders use. It covers synthetic chemicals like pesticides, flame retardants and plasticizers; heavy metals like arsenic, lead and mercury; combustion and industrial by-products; diet and nutrients; medications, medical interventions, and substance abuse; infections; the microbiome; heat and radiation; and lifestyle factors. Some may be harmful; others protective. They may operate before conception, during pregnancy or in early life, and some may alter gene expression through epigenetic modifications to chemicals surrounding our genes. Craig Newshaffer, who runs the EARLI study to look at environmental factors among younger autism siblings, referred to the concept of the “exposome”, that is, everything we are exposed to and its effects on health. Dr. Birnbaum’ made the point that health does not equal medicine, and prevention through reduction in chemical exposures is of equal importance to health. Colleen Boyle from the CDC stated that the next prevalence report will be issued in April 2011. We will see if the 1 in 110 number from last year’s report has changed. New research from Korea was unable to confirm increased risk of autism due to parental age or low birth weight, which have been identified as risk factors in Western studies.


The most informative talk was by Dr. Irva Hertz-Picciotto from UC-Davis. She explained how changes in diagnosis do not account for most of the increase in autism rates, and how recent research by their group on mercury and flame retardant blood levels do not address whether these substances are causative for autism because the blood samples were taken years after the autism diagnosis. A paper out this week from UC-Davis found that proximity to traffic air pollution during pregnancy almost doubles the risk of autism. Another paper just accepted by a journal has found higher antibodies to cerebellar tissue in children with autism relative to controls, highlighting the immune component in autism.

Other than these interesting items, the conference covered minimal new ground as far as the science goes. Rather, the points of the meeting seemed to be to make the case that environmental factors research in autism must now be considered mainstream science and to showcase the work being done or about to be done to investigate the issue. Dr. Landrigan made the case for an environmental role by noting that the rate of autism has increased too much to be solely genetic, and that at most, genetics alone will end up explaining 40% of autism cases with the likely percentage much lower."

I appreciate Autism Speaks and Sallie Bernard's  reporting on this conference. I depart from Ms Bernard's description slightly in referring to the information as being just "interesting" points.  In my view it is critically important that the mainstream media, dependent as it is on advertising dollars from business interests, to hear directly from such credible sources as Dr. Landrigan that genetics alone does not explain the incredible increases in autism diagnoses, that environmental factors play a role.  It is also very important for people to understand that the environment can impact child neurological development in many different ways at different developmental times.  The specific reports by Dr. Hertz-Piccotto, herself a leading figure in environmental autism research, are worthy of substantial mainstream media attention.

Autism Speaks has stepped up to the plate with its support for this important conference and by reporting it on their official blog site.  But Autism Speaks can, and should, do more. No one can question the demonstrated ability of Autism Speaks to raise media attention for autism disorders.  Autism Speaks should use its ability to  break through the fog of mainstream media understanding of autism disorders and convince institutions like CNN, CBC, NY Times, Newseek, and all the major television networks to start understanding the environmental component of autism.

The Offit Offensive, with its focus on personally discrediting anyone who questions possible vaccine autism connections,  has dominated mainstream media discussion of any environmental component of autism.  That offensive has not worked and may have been counter productive. Regardless, the vaccine issue is only one component of possible environmental contributors to autism disorder increases as the conference highlights.  It is time that mainstream media began to demonstrate awareness of this reality. No one is better able to help the mainstream media understand the full scope of environmental issues and autism disorders  than Autism Speaks.  I hope  Autism Speaks dedicates more of its impressive resources to doing exactly that. 

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Autistic Disorder Began Increasing Worldwide in 1988?

   

I have produced below the abstract for an article titled Timing of Increased Autistic Disorder Cumulative Incidence published online at Environmental Science and Technology. I added the bold emphasis to the statement that both genetic and environmental factors are implicated in its etiology. It is long past time that environmental autism, and autistic disorder,  research received more funding priority from public authorities which have favored genetic based autism research almost exclusively for decades with few significant results. Authors of the study are Michael E. McDonald and John F. Paul of the National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, MD-B343-06, Research Triangle Park, North Carolina 2771.

It is interesting to note that cumulative increase was observed worldwide beginning in 1988 several years prior to the publication of the DSM-IV  in 1994 AND that the data relates to Autistic Disorder not the broader "autism spectrum" of disorders.

Environ. Sci. Technol., 2010, 44 (6), pp 2112–2118, DOI: 10.1021/es902057k, Publication Date (Web): February 16, 2010,Copyright © 2010 American Chemical Society

Autistic disorder (AD) is a severe neurodevelopmental disorder typically identified in early childhood. Both genetic and environmental factors are implicated in its etiology. The number of individuals identified as having autism has increased dramatically in recent years, but whether some proportion of this increase is real is unknown. If real, susceptible populations may have exposure to controllable exogenous stressors. Using literature AD data from long-term (10-year) studies, we determined cumulative incidence of AD for each cohort within each study. These data for each study were examined for a changepoint year in which the AD cumulative incidence first increased. We used data sets from Denmark, California, Japan, and a worldwide composite of studies. In the Danish, California, and worldwide data sets, we found that an increase in AD cumulative incidence began about 1988−1989. The Japanese study (1988−1996) had AD cumulative incidence increasing continuously, and no changepoint year could be calculated. Although the debate about the nature of increasing autism continues, the potential for this increase to be real and involve exogenous environmental stressors exists. The timing of an increase in autism incidence may help in screening for potential candidate environmental stressors.

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Autism Speaks Supports More Environmental Research? Terrific! Now Please Help Even Out the Funding

Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones.

We need to even out the funding.

Dr. Irva Hertz-Picciotto, UC Davis M.I.N.D. Institute


I have been a  supporter of Autism Speaks over the course of its brief existence. I appreciate the media savvy and political skills of its leadership. The World Autism Awareness Day that it assisted in bringing into existence is, in my humble opinion, a great accomplishment in itself.  The connections and skills of Autism Speaks leadership have been very impressive in bringing in people and events who, by themselves command attention, from NASCAR to Jerry Seinfeld, people and events that are seen and heard focusing on autism.  Well done, very well done.

I have though been concerned, rightly or wrongly, about  what I thought was a  subscription by Autism Speaks to the "it's gotta be genetic" mindset which has dominated autism research  and hindered  progress in understanding autism disorders and developing treatments and cures.   I was pleasantly surprised when I received from Jane Rubenstein of Rubenstein Communications Inc. the Autism Speaks statement  "HEARING ON STATE OF RESEARCH ON POTENTIAL ENVIRONMENTAL HEALTH FACTORS WITH AUTISM AND RELATED NEURODEVELOPMENT DISORDERS U.S. Senate Committee on Environment & Public Works, Subcommittee on Children’s Health".   In the statement Autism Speaks Chief Science Officer Dr. Geri Dawson states unequivocally Autism Speaks endorsement on the need for more environmentally based autism research:

(NEW YORK, N.Y., August 4, 2010) – Autism Speaks’ Chief Science Officer Geraldine Dawson, Ph.D. emphasized the importance of research on environmental risk factors for autism spectrum disorders as the U.S. Senate Committee on Environment & Public Works, Subcommittee on Children’s Health convened a special hearing yesterday on potential environmental health factors associated with autism spectrum disorders (ASD) and related neurodevelopmental disorders. The hearing examined the latest research on potential environmental factors that may increase the risk for autism spectrum disorders.

As this hearing reviewed studies funded by the Environmental Protection Agency and the National Institute of Environmental Health Sciences on environmental factors associated with autism, including toxins and other factors that can influence brain development, Dr. Dawson reiterated that it is important to remember that, “Although genetic factors clearly contribute to the causes of autism, we also need to understand environmental factors and their interactions with genetic susceptibility.”

Dr. Dawson's statement  includes examples of  what appear to be impressive  initiatives undertaken by Autism Speaks in support of environmental autism research.  The links to review these initiatives can be found on the Autism Speaks web site, science section.  What isn't clear is the level of financial commitment to environmental autism research compared to genetic research.  Does, or will, Autism Speaks commit to balanced funding of environmental and genetic autism research as called for by Dr. Irva Hertz-Picciotto of the UC David MIND Institute?

If I have wronged Autism Speaks with my perception of an imbalance on its part in favor of genetic over environmental autism research I would genuinely appreciate being notified of my error. If that is the case then I will apologize but would humbly and respectfully ask Autism Speaks to use its proven and impressive communication skills to convince public health funding authorities to follow the approach recommended by Dr. Hertz-Picciotto. 

Much valuable time has been lost with the autism is genetic obsession.

Balanced funding of environmental and genetic autism research is needed now, not tomorrow.

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Dr. Philip J. Landrigan Calls for Expanded Research Into Environmental Causes of Autism

Dr. Philip J. Landrigan  has published, in the April 201 edition of Current Opinion in Pediatrics,   an article  titled  What causes autism? Exploring the environmental contribution in which the he calls for expanded research into environmental causes of autism.  As set out in the abstract summary:

"Expanded research is needed into environmental causation of autism. Children today are surrounded by thousands of synthetic chemicals. Two hundred of them are neurotoxic in adult humans, and 1000 more in laboratory models. Yet fewer than 20% of high-volume chemicals have been tested for neurodevelopmental toxicity. I propose a targeted discovery strategy focused on suspect chemicals, which combines expanded toxicological screening, neurobiological research and prospective epidemiological studies."

Dr. Landrigan notes that genetic factors are implicated in causing autism but only in a very small number of cases and they do not explain key clinical and epidemiological features. He suggests as a hypotheses that early environmental factors could contribute.  Dr. Landrigan notes two important indirect sources of support for the hypothesis: "studies demonstrating the sensitivity of the developing brain to external exposures such as lead, ethyl alcohol and methyl mercury" and, more importantly, "studies specifically linking autism to exposures in early pregnancy – thalidomide, misoprostol, and valproic acid; maternal rubella infection; and the organophosphate insecticide, chlorpyrifos."

In December 2009 I  wrote a blog comment on this very subject Autism and Human Exposure to Environmental Chemicals: Time to Put a Stake Through the Heart of the "It's Gotta Be Genetic" Model of Autism Research. My comment was based on the CDC Fourth National Report on Human Exposure to Environmental Chemicals, which:

"measured 212 chemicals in people's blood or urine—75 of which have never before been measured in the U.S. population. The new chemicals include acrylamide, arsenic, environmental phenols, including bisphenol A and triclosan, and perchlorate"

I noted that this alarming report had been released just days before Christmas when it would attract little public attention. But I am not a scientist and even worse, I am a parent of an autistic child, which means that my opinion about the realities of autism disorders,  is generally worth less than nothing in public health authority circles.  I am very pleased that someone as distinguished as Dr. Landrigan has in fact been paying attention to the possible role played by untested synthetic chemicals in causing autism in children. For those who do not know who Dr. Philp J. Landrigan is I am citing, in full his bio,  as listed on the Environmental Health Perspectives site:

"Philip J. Landrigan, MD
Center for Children's Health and the Environment
Department of Community &  Preventive Medicine
Mount Sinai School of Medicine

Philip J. Landrigan, a pediatrician, is the Ethel H. Wise Professor and chair of the Department of Community and Preventive Medicine at the Mount Sinai School of Medicine. He also holds a professorship in pediatrics at Mount Sinai. He directs the Mount Sinai Center for Children's Health and the Environment. Landrigan is a member of the Institute of Medicine of the National Academy of Sciences (NAS) and is currently editor-in-chief of the American Journal of Industrial Medicine. He has served in many other capacities, including editor of Environmental Research and committee chair at the NAS on Environmental Neurotoxicology (NAS 1992) and on Pesticides in the Diets of Infants and Children (NAS 1993).

The report of the NAS committee that Landrigan chaired on pesticides and children's health was instrumental in securing passage of the Food Quality Protection Act of 1996, the major federal pesticide law in the United States. In New York City, he served on the Mayor's Advisory Committee to Prevent Childhood Lead Paint Poisoning and on the Childhood Immunization Advisory Committee. He is chair of the New York State Advisory Council on Lead Poisoning Prevention. From 1995 to 1997, Landrigan served on the Presidential Advisory Committee on Gulf War Veteran's Illnesses. In 1997 and 1998, he served as senior advisor on children's health to the administrator of the U.S. Environmental Protection Agency (EPA). He was responsible at the U.S. EPA for helping to establish a new Office of Children's Health Protection."

Hopefully Dr. Insel and the IACC will take seriously the warning sounded by Dr. Landrigan. With his qualifications and experience his is a voice that should be heeded if we are to ever find out what is happening to our children, what is causing them to develop so many neurodevelomental disorders in such alarming numbers.  Rooting endlessly through the genetic family histories of autistic children has not  helped.  Fudging the facts, distorting the picture by periodic DSM changes will not help our children. It is time the IACC and other public health authorities joined respected voices like Dr. Landrigan, Dr. Irva Hertz-Picciotto, Dr. Jon Poling and others who have called for research into the environmental causes of autism disorders.  

Autism is rising. It is time to quit the genetic stalling game and find out why.

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UK Immigrant Autism Rates Study Confirms Environmental Component of Autism Causation?

The BBC is reporting a study that shows an increased risk of autism in children emigrating to the UK from Africa, the Caribbean and Asia with the risk being as much as 5 times greater for children of parents from Caribbean countries. The study may be the final nail in the coffin of the "it's gotta be genetic" cult like mindset that has dominated the thinking of  public health authorities over the past twenty years:

Speaking on Health Check, Dr Daphne Keen, from St. George's Hospital London, said while the findings show a clear link between immigration and autism - they could not determine exactly why this was the case.

The research covered 428 children diagnosed with autism during a six-year period. "We didn't find there was an increased risk in the parents who had migrated from other European countries," Dr Keen added. "The size of the increased risk was greatest for the Caribbean group. This was at least five times. "The risk was also very significant, but slightly less, for the African population and much lower, but still a little present, for the Asian population." Two factors The study took into consideration that it may just be a case of ethnicity - rather than migration - that caused the rise in cases.

The study took into consideration that it may just be a case of ethnicity - rather than migration - that caused the rise in cases. However, researchers compared their results with children born of UK-born parents with Caribbean, African and Asian roots. "We found when we analysed the two factors together, that the risk fell considerably.

"It seemed to suggest that immigration was the major factor, and ethnicity was just possibly a factor." One theory is that the stress of migrating could act as a "trigger" for the disability, a factor discovered in similar studies looking at the causes of schizophrenia."

It is interesting that the study authors immediately point to "stress" and "isolation" as possible factors but the obvious point is that there could be many different environmental factors arising in each area that contribute to the different rates of autism disorders.  Perhaps those who are genuinely interested in discovering all possible causes of autism disorders could look at exposure to toxic environmental substances from industries like mining,, differing vaccination schedules, exposure to different quality vaccines etc in the various countries studied even. 

If the reported autism rates are closely tied to the process of emigration per se then perhaps it would be helpful to  examine the vaccine schedules of people emigrating from the Caribbean and compare them to vaccines required from people emigrating to the UK from other European countries. Are children emigrating from the Caribbean required to take more vaccines closer together in time  in order to become eligible to emigrate to the UK than children from other European countries?

If the door to an open mindset on the environmental causes of autism has finally been kicked open then let's leave it wide open and do some real environmentally focused  autism disorder research.  Let us not assume that stress and isolation cause autism and that lead, cadmium, mercury and vaccines do not.  Parents genes have been under the microscope for decades.  It is long past time for the IACC and other world health authorities to stop pretending that autism iis 100% genetic and do some real autism research.

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