Thimerosal is a preservative that contains mercury and was used for many years as an additive in some routinely administered children's vaccines. Fears developed a few years ago that the additive might have been causing dangerously elevated levels of mercury in infants, resulting in neurological impairment and, in some cases, autism.

Studies thus far have neither shown nor ruled out a link between the vaccines and neurological damage in children. But in the summer of 1999 the American Academy of Pediatrics and the Public Health Service urged vaccine manufacturers to stop using thimerosal as quickly as possible.

Thus, thimerosal, which was developed by Eli Lilly & Company in the 1920's and was in widespread use by the 1990's, is no longer added to vaccines commonly given to children. But a serious controversy continues. Lawsuits have been filed by parents across the country who are convinced that their children suffered severe neurological damage from the mercury in the vaccines. Talking to them can be heartbreaking.

Lyn Redwood, a nurse practitioner and the wife of a physician in suburban Atlanta, spoke to me last week about her 8-year-old son, Will. "I have a little boy who was completely normal at birth — walking, talking, smiling, meeting all of his developmental landmarks," she said. "Then, shortly after he turned 1 year old, he lost his ability to speak, to make eye contact. He started regressing and ultimately was diagnosed with pervasive developmental disorder, which falls into a spectrum of autism disorders."

Ms. Redwood contends that three infant vaccines administered to her son when he was 2 months old exposed him to levels of mercury that far exceeded all safety guidelines. At this point we must interrupt our narrative and turn our attention to the federal government's effort to fight terrorism in the United States.

Last week the Senate approved legislation to establish a Department of Homeland Security and it will soon be signed into law by the president. Buried in this massive bill, snuck into it in the dark of night by persons unknown (actually, it's fair to say by Republican persons unknown), was a provision that — incredibly — will protect Eli Lilly and a few other big pharmaceutical outfits from lawsuits by parents who believe their children were harmed by thimerosal.

Now this has nothing to do with homeland security. Nothing. This is not a provision that will in any way protect us from the ferocious evil of Osama bin Laden and Al Qaeda. So why is it there? Perhaps it has something to do with the fact that the major drug companies have become a gigantic collective cash machine for politicians, and that the vast majority of that cash goes to Republicans.

Or maybe it's related to the fact that Mitch Daniels, the White House budget director, is a former Eli Lilly big shot. Or the very convenient fact that just last June President Bush appointed Eli Lilly's chairman, president and C.E.O., Sidney Taurel, to a coveted seat on the president's Homeland Security Advisory Council.

There's a real bad smell here. Eli Lilly will benefit greatly as both class-action and individual lawsuits are derailed. But there are no fingerprints in sight. No one will own up to a legislative deed that is both cynical and shameful.

An official spokesman for Eli Lilly, Edward Sagebiel, insists the company knew nothing about it, nothing at all. While the vote for the Homeland Security Department was overwhelming, even some Republicans were upset by the provision to benefit Lilly and the other drug companies.

Senator John McCain of Arizona characterized the provision as "among the most inappropriate" in the homeland security legislation. He said: "This language will primarily benefit large brand-name pharmaceutical companies which produce additives to children's vaccines — with substantial benefit to one company in particular. It has no bearing whatsoever on domestic security."

The politicians with their hands out and the fat cats with plenty of green to spread around have carried the day. Nothing is too serious to exploit, not even the defense of the homeland during a time of terror.

Lyn Redwood put together an advocacy group, called Safe Minds, for parents struggling with the thimerosal issue. They're at a slight disadvantage, wielding a popgun against the nuclear-powered influence of an Eli Lilly. 

Harmful effects of mercury debated

Studies on toxic fish and links to heart disease contradict

ASSOCIATED PRESS

Nov. 27 — Two studies have yielded contradictory findings about the possible heart dangers of eating mercury-laden fish. Plenty of research shows that mercury accumulated from fish can harm the developing brain of a fetus or child, but far less is known about how the toxic, widespread pollutant affects the heart. TWO STUDIES in Thursday’s New England Journal of Medicine on the long-term effects of mercury exposure on the hearts of middle-aged and elderly men had opposite findings. One found no clear link between mercury levels in the body and the risk of developing heart disease; the other found men who had suffered a heart attack had higher mercury levels than similar men who had not.

That left the researchers, Food and Drug Administration officials and other experts agreeing on just two things: More research is needed, and people should not stop eating fish, because minerals and fatty acids in fish protect the heart. Also, many fish, such as salmon and shrimp, contain little or no mercury.  “The bottom line is, yes, you should eat fish, and yes, you should know which fish have mercury” levels considered unsafe, said Dr. Daniel M. Shindler, a cardiologist at Robert Wood Johnson Medical School in New Brunswick, N.J., who was not involved in either study.

The FDA, Environmental Protection Agency and many state agencies report such information. For years, they have warned women who are pregnant, nursing or of childbearing age to avoid fish from mercury-contaminated waterways, and large, long-lived predators such as sharks and swordfish, which accumulate mercury from all the smaller fish they eat.

 Besides nature's own emissions, humans release mercury as well, mostly via the air and eventually into water where fish absorb particles. The American Heart association, citing new research showing the omega-3 fatty acids in fish reduce the risk of heart disease, last week reiterated its guidelines that people eat at least two servings of fish per week, preferably fatty fish. One of the New England Journal studies indicated that the mercury contamination in fish offsets the benefits of a key fatty acid, DHA.

Researchers at the Johns Hopkins Bloomberg School of Public Health reviewed data and tissue samples from an earlier, nine-country European cardiac study. They compared 684 middle-aged men who had had one heart attack with 724 similar men who had not had a heart attack. They looked at the men’s health history, use of tobacco and alcohol, and toenail clippings and fat withdrawn from their buttocks. Toenails hold accumulated mercury, and fatty tissue accumulates DHA; their levels in each subject were measured.

Those with the highest mercury levels were nearly 2.2 times more likely than those with the lowest levels to have had a heart attack, said Dr. Eliseo Guallar, assistant professor of epidemiology at Hopkins.

Researchers at Harvard School of Public Health studied 470 men who had had heart surgery or a heart attack, comparing each with a similar man without heart disease. Dr. Walter C. Willett, a professor of epidemiology and nutrition, said mercury levels in the men’s toenails corresponded well with the levels of fish they reported eating, but his team found no association between mercury exposure and risk of heart disease. “We can’t exclude the possibility that there’s some moderate risk,” Willett said.  Willett and Guallar said there could be several explanations for their disparate results, from differences in the fish eaten in America and Europe to how the patient and comparison groups were picked in each study.

Both studies followed up on a 1995 Finnish study that found an increased risk of heart disease in people whose hair had high mercury levels. The new studies looked only at men, and Shindler said the findings cannot necessarily be applied to women, because of weight and other gender differences.

 Mercury may outweigh health benefits of fish

Contaminant can result in dangerous effects 

Nov. 27 —  Wendy Moro wanted a healthy diet, so she began eating lots of fish. But then she started feeling severe fatigue. Eventually Dr. Jane Hightower, a San Francisco internist, diagnosed Moro as having excess mercury in her body. Hightower says she sees the problem in many of her health-conscious patients. 

“IN THE last 20 years, fish has been pushed as good nutrition. But no one told us that some of these fish can have contaminants,” says Hightower. Mercury is a natural element — it’s the familiar liquid in thermometers. Because it is in coal, air pollution puts it into the atmosphere and eventually it settles in the ocean where it builds up in the flesh of fish, especially large fish. There is no question that high doses of mercury can be extremely toxic, even fatal. Just how much danger Americans face from the mercury they get by eating fish remains a subject of debate among scientists. But many are concerned by a number of potential health effects. “The symptoms that were really frightening were these symptoms of muscle weakness and muscle pain and numbing.” says Moro.
       
STUDIES HIGHLIGHT CONTROVERSY
Two studies released Wednesday looked at the relationship between mercury and heart disease. One  concluded mercury actually increases the risk, possibly counteracting the benefits for the heart from fish in the diet. A second study found no danger to the heart. “Even if high mercury intake does not cause heart disease, I think there still is legitimate concern about high mercury intake from some types of fish,” says Dr. Walter Willett of the Harvard School of Public Health.
 
The biggest worry is potential brain damage, especially in unborn infants. That’s why the Food and Drug Administration now recommends that pregnant women avoid fish with the highest mercury content, such as tilefish, swordfish, mackerel and shark, and not eat more than 12-ounces a week of other fish. Health experts emphasize that fish is indeed healthy food and some kinds, such as salmon and many small fish, contain very little mercury. But increasingly researchers warn that the health benefits of some seafood might be offset by the dangers of mercury pollution.
       

The Not-So-Crackpot Autism Theory

By ARTHUR ALLEN

http://www.nytimes.com/2002/11/10/magazine/10AUTISM.
html?pagewanted=1

Neal Halsey's life was dedicated to promoting vaccination. In June 1999, the Johns Hopkins pediatrician and scholar had completed a decade of service on the influential committees that decide which inoculations will be jabbed into the arms and thighs and buttocks of eight million American children each year. At the urging of Halsey and others, the number of vaccines mandated for children under 2 in the 90's soared to 20, from 8. Kids were healthier for it, according to him. These simple, safe injections against hepatitis B and germs like haemophilus bacteria would help thousands grow up free of diseases like meningitis and liver cancer.
 

Halsey's view, however, was not shared by a small but vocal faction of parents who questioned whether all these shots did more harm than good. While many of the childhood infections that vaccines were designed to prevent -- among them diphtheria, mumps, chickenpox and polio -- seemed to be either antique or innocuous, serious chronic diseases like asthma, juvenile diabetes and autism were on the rise. And on the Internet, especially, a growing number of self-styled health activists blamed vaccines for these increases.
 

Like all medical interventions, vaccines sometimes cause adverse reactions. But unlike pills, vaccines come packaged with high expectations, which make them particularly vulnerable to public criticism. Vaccines don't cure people, and they are administered to healthy children, which gives them few opportunities for good press. When they work, nothing happens. When vaccinated children become ill, their parents are grief-stricken and often enraged, even if vaccines aren't proved to be at fault. All of this puts public-health advocates like Halsey on the defensive. Most attacks on vaccines, they say, are based on hysteria, bad science and dubious politics.
 

Halsey, 57, has green eyes, a white beard that makes him look like a ship's captain and an air of careful authority. As chairman of the American Academy of Pediatrics committee on infectious diseases from 1995 through June 1999, he often appeared in the media administering calm reassurance. ''Many of the allegations against vaccines,'' Halsey said in one interview, ''are based on unproven hypotheses and causal associations with little evidence.''
 

And then suddenly in June 1999, during a visit to the Food and Drug Administration, a squall appeared on the horizon of Halsey's confidence. Halsey attended a meeting to discuss thimerosal, a mercury-containing preservative that at the time was being used in several vaccines -- including the hepatitis B shot that Halsey had fought so hard to have administered to American babies. By the time the dust kicked up in that meeting had settled, Halsey would be forced to reckon with the hypothesis that thimerosal had damaged the brains of immunized infants and may have contributed to the unexplained explosion in the number of cases of autism being diagnosed in children.
 

That Halsey was willing even to entertain this possibility enraged some of his fellow vaccinologists, who couldn't fathom how a doctor who had spent so much energy dismantling the arguments of people who attacked vaccines could now be changing sides. But to Halsey's mind, his actions were perfectly consistent: he was simply working from the data. And the numbers deeply troubled him. ''From the beginning, I saw thimerosal as something different,'' he says. ''It was the first strong evidence of a causal association with neurological impairment. I was very concerned.''

The investigation into mercury vaccines was instigated in 1997 by Representative Frank Pallone Jr., a New Jersey Democrat whose district includes a string of shore towns where mercury in fish is one of many environmental concerns. Pallone, who had been pressing the government to re-evaluate its overall guidelines on mercury toxicity, attached an amendment to an F.D.A. bill requiring the agency to inventory all mercury contained in licensed drugs and vaccines.
 

The job of adding up the amount of mercury in vaccines and assessing its risk fell to Robert Ball, an F.D.A. scientist, and two F.D.A. pediatricians, Leslie Ball, Robert's wife, and R. Douglas Pratt. Thimerosal, which is 50 percent ethyl mercury by weight, had been used as a vaccine preservative since the 1930's in the diphtheria-tetanus-pertussis shot, known as D.T.P., and it was later added to some vaccines for hepatitis B and haemophilus bacteria, which by the early 1990's had become routine immunizations for infants.
 

The F.D.A. team's conclusions were frightening. Vaccines added under Halsey's watch had tripled the dose of mercury that infants got in their first few months of life. As many as 30 million American children may have been exposed to mercury in excess of Environmental Protection Agency guidelines -- levels of mercury that, in theory, could have killed enough brain cells to scramble thinking or hex behavior.
 

''My first reaction was simply disbelief, which was the reaction of almost everybody involved in vaccines,'' Halsey says. ''In most vaccine containers, thimerosal is listed as a mercury derivative, a hundredth of a percent. And what I believed, and what everybody else believed, was that it was truly a trace, a biologically insignificant amount. My honest belief is that if the labels had had the mercury content in micrograms, this would have been uncovered years ago. But the fact is, no one did the calculation.''
 

Making matters worse, the latest science on mercury damage suggested that even small amounts of organic mercury could do harm to the fetal brain. Some of the federal safety guidelines on mercury were relaxed in the 90's, even as the amount of mercury that children received in vaccines increased. The more Halsey learned about these mercury studies, the more he worried.
 

''My first concern was that it would harm the credibility of the immunization program,'' he says. ''But gradually it came home to me that maybe there was some real risk to the children.'' Mercury was turning out to be like lead, which had been studied extensively in the homes of the Baltimore poor during Halsey's tenure at Hopkins. ''As they got more sophisticated at testing for lead, the safe level marched down and down, and they continued to find subtle neurological impairment,'' Halsey says. ''And that's almost exactly what happened with mercury.''
 

Halsey was beginning to think that it would be prudent to limit thimerosal-containing vaccines and urge pediatricians to use thimerosal-free shots when possible. But his decision inflamed some of his peers. After all, although the thimerosal data was worrisome to Halsey, the available science offered no clear proof that the preservative posed a genuine danger to children when given in parts per million. Moreover, it wasn't clear that there were enough thimerosal-free vaccines available for diseases like pertussis and hepatitis B. Should an unproven fear justify the cessation of a procedure that protected children from proven dangers?
 

Halsey looked into the matter further and found only complexity. In the medical literature, most cases of acute mercury poisoning result from doses hundreds or thousands of times higher than what infants received with thimerosal-laden vaccines. And although the thimerosal levels in vaccines exceeded the E.P.A.'s guidelines for methyl mercury, thimerosal contained ethyl mercury, a compound that behaves somewhat differently in the body. The E.P.A. based its guidelines on a series of studies of 917 children born in 1987 in the Faeroe Islands, a windswept North Atlantic archipelago, to women who ate methyl-mercury-tainted whale meat. The Faeroes children, whose umbilical cord blood averaged four times the E.P.A.'s daily ''safe'' dose -- which was 0.1 micrograms per kilo -- exhibited small but measurable neurological deficits seven years later. They had slower reaction times and diminished attention spans and their word choice and memorization were less keen than those of their classmates who had been exposed to less mercury, according to Philippe Grandjean, a Danish researcher who leads the continuing Faeroes study and teaches at Boston University.
 

During most of the 90's, many American 6-month-olds received a total of 187.5 micrograms of ethyl mercury through vaccination. While the Faeroes children were exposed to mercury as developing fetuses, and therefore were more vulnerable than the vaccinated American infants, the American babies included about 60,000 each year who had already been exposed to high mercury levels because their mothers had eaten a lot of contaminated fish. What's more, hundreds of thousands of Rh-negative pregnant women and their unborn Rh-positive babies received additional thimerosal each year through injections designed to keep the mothers' immune systems from attacking the fetuses.
 

The Faeroes studies, though they dealt with methyl mercury, unnerved Halsey. Other researchers were troubled, too. George Lucier, a toxicologist who led a 1998 White House review of mercury's dangers, went so far as to say it was ''very likely'' that thimerosal had damaged some children. There was precious little data to back up that precise suspicion -- and little to dismiss it -- because of the lack of toxicology research on ethyl mercury.
 

On July 7, 1999, at Halsey's urging, the American Academy of Pediatrics and the Public Health Service released a statement urging vaccine manufacturers to remove thimerosal as quickly as possible and advising pediatricians to postpone giving most newborns the birth dose of the hepatitis B vaccine. The decision, which helped to create vaccine shortages and led some babies to become infected with hepatitis B, outraged some senior vaccine experts. Walter Orenstein, director of the National Immunization Program at the Centers for Disease Control and Prevention, would charge that the rush to remove thimerosal-containing vaccines was ''precipitous.'' Stanley Plotkin, a renowned vaccine developer, said that it was fruitless to try to soothe vaccination critics. ''If antivaccinationists did not have mercury, they would have another issue,'' he said at one meeting. ''One cannot prevent them from making hay regardless of whether the sun is shining or not.''
 

In Halsey's view, however, thimerosal wasn't simply a bone for rabid vaccine opponents to gnaw on. In the middle of that hectic summer he took a vacation in Maine. Canoeing on a lake, he came across posters that advised fishermen to ''protect your children -- release your catch.'' Halsey took that message to heart. If the government was warning people against eating fish with mercury, he asked his colleagues, ''does it make sense to allow it to be injected into infants?'' Although other vaccinologists criticized Halsey, many of his colleagues rallied around him. ''Neal put kids ahead of the vaccination program, which was gutsy,'' says Lynn Goldman, a former E.P.A. official who has been on the Hopkins faculty since 1999 and worked with Halsey on thimerosal. ''It would have been easier for him to line up on the other side.''
 

Few scientists believe that the spike in autism could have been caused solely by the thimerosal in vaccines, but in October 2001, a vaccine-safety committee at the starchy Institute of Medicine confirmed that it was ''biologically plausible'' -- though by no means proved -- that thimerosal could be related to neurodevelopmental delays in some children. The committee recommended that thimerosal be removed from vaccines and called for extensive research to determine any damage it had caused.
 

Halsey's fellow researchers were right about one thing. Antivaccine advocates immediately seized upon the thimerosal theory, and Halsey became something of an unwilling hero to the vaccine-safety advocates with whom he had so often sparred. In fact, thousands of parents with autistic children have responded to the Institute of Medicine report by filing lawsuits. Michael Williams, who has won millions in toxic tort settlements from pharmaceutical companies, was among the first lawyers to sue vaccine manufacturers, on behalf of William Mead, a 4-year-old Portland, Ore., boy with autism. Williams also filed a separate class-action lawsuit with William's healthy older sister, Eleanor, as lead plaintiff, demanding that vaccine makers also pay for studies to determine thimerosal's effects on millions of children who might have lower I.Q.'s or other less obvious signs of mercury poisoning. Past studies have shown that mercury's effects vary tremendously from person to person, presumably because of genetic differences in the body's capacity to protect delicate organs from it.
 

'In order to win the Eleanor lawsuit you need to establish liability, but I don't think that is going to be that hard,'' Williams said in a recent chat in his Portland office. ''Organic mercury is a very serious neurotoxin.'' Williams embodies the vaccine establishment's worst fear about Halsey's course of action -- which is that taking the precautionary step of eliminating thimerosal would be read as an admission of fault. ''The agenda was set by the lawyers and the antivaccine activists,'' a source close to a number of manufacturers complained to me. ''The scientists responded to it scientifically, and that put them behind the eight ball right away. You had Neal Halsey running around saying: 'We've got to do something! We've got to show we're concerned!'''
 

Paul Offit, a vaccinologist at the Children's Hospital of Philadelphia, takes it a step further. ''In some instances I think full disclosure can be harmful,'' he says. ''Is it safe to say there is zero risk with thimerosal, when it is remotely possible that one child would get sick? Well, since we say that mercury is a neurotoxin, we have to do everything we can to get rid of it. But I would argue that removing thimerosal didn't make vaccines safer -- it only made them perceptibly safer.''
 

For Halsey, thimerosal injury is a possibility that must be addressed -- but by science, not by the courts. The scientific agenda, however, is already deeply politicized. From the start, the C.D.C.'s efforts to examine the possibility of thimerosal damage became snarled in acrimony. Critics of the vaccination system don't trust the C.D.C., which monitors evidence of adverse reactions to vaccines through the Vaccine Safety Datalink, a computerized set of 7.5 million medical records. Safe Minds, an advocacy group of parents who believe that their autistic children were damaged by thimerosal, has used the Freedom of Information Act to obtain documents showing that as early as December 1999 the C.D.C. had reason to believe that thimerosal caused developmental delays in some children. It was far from conclusive evidence, but vaccine critics charged that the C.D.C. tried to play it down. One of those critics was Dan Burton, a Republican congressman from Indiana, who says he firmly believes that his grandson's autism is a result of vaccines. ''I'm so ticked off about my grandson, and to think that the public-health people have been circling the wagons to cover up the facts!'' Burton fumed at a June hearing. ''Why, it just makes me want to vomit!''
 

What comes through in an examination of the documents uncovered by Safe Minds is less a coverup than an impression of scientists anxiously watching over their shoulders as they work. One document, for example, records comments made by Robert Brent, a Philadelphia pediatrician who served as a consultant for the thimerosal study. ''The medical-legal findings in this study, causal or not, are horrendous,'' Brent said. ''If an allegation was made that a child's neurobehavioral findings were caused by thimerosal-containing vaccines, you could readily find a junk scientist who would support the claim with a reasonable degree of certainty. But you will not find a scientist with any integrity who would say the reverse with the data that is available. . . . So we are in a bad position from the standpoint of defending any lawsuits if they were initiated.''
 

More research is in the works. The C.D.C. is setting up a study of neurodevelopmental effects based in part on the Faeroe Islands model. The N.I.H. is financing studies of thimerosal metabolism in animals and children. (An early University of Rochester study was reassuring: it indicated that children eliminate thimerosal much more quickly than expected.) Clearly, a lot is riding on this research, and pressure is being brought to bear on both sides. Can the vaccine authorities accept a positive answer? Can the vaccine opponents accept a negative one? ''No one wants to think that harm might have been done,'' Halsey says. ''I don't want to think harm might have been done.''

American children still receive up to 20 vaccines in the first two years of life. The first symptoms of autism often appear between the ages of 12 and 24 months. Most autism experts say that the two facts are coincidental, but as a major California study recently confirmed, autism is being diagnosed in numbers far higher than ever before, suggesting that a nongenetic cause may be partly to blame. In some children, the behavioral traits of autism present themselves along with physical problems like sensory dysfunction and motor disorders that have rough correlates in the mercury-poisoning literature. For some parents, thimerosal provides a grand unifying theory that squarely points the finger at the government and vaccine makers.
 

During much of the 20th-century, children suffered from an ailment called pink disease, which caused peeling skin on the extremities as well as regressive behavior. In 1948, a keen-eyed Cincinnati pediatrician named Josef Warkany noticed a common risk factor in these children: they had all been given teething powders containing calomel, a mercury derivative. Only about 1 in 500 children whose parents gave them calomel got pink disease -- suggesting that a constitutional vulnerability to mercury was part of the clinical picture. Soon after the powders were taken off the market, pink disease disappeared.
 

Autism is a global phenomenon that was first reported in America in 1943, long before the potential dangers of thimerosal vaccines were raised. Removing the preservative won't -- even in the best case -- eliminate the illness. But scientists estimate that the current rate of autism in its various forms might be as high as 1 in 500. If the autism trend begins to recede now that thimerosal has been removed, it could certainly suggest a cause. If it does decline, we might have Neal Halsey to thank. If it doesn't, his colleagues in the vaccine establishment may blame him for stoking an irrational protest from the public.
 

Halsey, who still heads the Hopkins Institute for Vaccine Safety, which he was a founder of in 1997, is on the fence. ''I don't believe the evidence is convincing now that there has definitely been harm done by thimerosal,'' he says, absently stroking his balding head. But to keep the vaccine program on a steady keel, Halsey says, the public-health authorities simply must follow through with the studies and face the consequences without flinching. If there is damage, he says, ''there should be some kind of compensation, though I don't know how.'' He pauses, and sighs. ''I empathize with families of children with these disorders. How are you going to put dollar values on that?''

Autism - Etiology:

Autism and disorders resembling autism can be caused by a number of disorders, including Fragile X Syndrome, tuberous sclerosis, and phenylketonuria, and by at least one notable chromosomal abnormality, an inverted duplication of a portion of chromosome 15. But for the vast majority of cases of autism today, there is no strictly genetic explanation. As with many chronic disorders, most cases of autism appear to be caused by some genetic predisposition coupled with some early environmental insult.

Several recently-released reports point to the occurrence of an autism epidemic" with the latest incidence figures quoted to be on the order of 1 out of every 250 children. The Report on Autism to the California Legislature released in 1999 documents a large increase in full-blown DSM IV autism alone, with other disorders increasing at the same rate as population growth. F. E. Yazbak, M.D. found similar rates of increasing incidence in other states reported in his Autism 99: A National Emergency. The Center for Disease Control’s own investigation of Brick township, New Jersey found a very high incidence of autism as well. Some noted sources attribute the apparent increase in autism incidence to better diagnoses on the part of pediatricians and the various pediatric specialties. Most, however, are unable to fully accept this simplistic explanation because the diagnosis is strictly a behavioral one, and it is highly doubtful that the highly skilled diagnosticians of earlier years could have overlooked such obvious behavioral anomalies occurring in such a large proportion of children. Furthermore, since it is impossible to have a "genetic epidemic", one must examine possible early environmental insults for clues to explain the increase in autism cases.

Bernard, et al, have written an excellent article comparing autism with mercury poisoning. All aspects of both disorders are examined, including symptoms, signs and findings on laboratory tests. The parallels between the two disorders is disturbingly obvious, even to the most casual reader. This, coupled with many case reports of clinical improvement among autistic children upon removal of at least a small part of their whole-body load of mercury, seems to indicate that many cases of autism today are, in fact, cases of mercury poisoning. The early environmental insult, in these cases, is mercury exposure that overwhelmed the body’s attempts at detoxification.

How does mercury gain access to a fetus or an infant? First of all, mercury is ubiquitous. It is in our water supply. In this setting, it exists mainly in cationic (1+ or 2+) form. This form is largely unabsorbed. Fish and shellfish are a known source of organic mercury (methyl mercury). Organic mercury is absorbed reasonably well by the gastrointestinal tract. Exposure via these two routes is common, but it is far exceeded by exposure via dental amalgams and thimerosal-containing vaccines. Mercury vapor is known to be released from dental amalgams, and it is known to cross the placenta with ease. It is not too far-fetched to assume that some mercury vapor (Hg - 0) is released from the dental amalgams of the mother, she inhales the vapor it enters her bloodstream, some crosses the placenta and enters the developing fetus. Once metallic mercury (vapor, Hg - 0) enters the cell, it can be easily converted to its cationic form, and in this form, readily binds to sulfhydryl groups on enzymes and other proteins. Once tightly bound via this mechanism, it is in the body for a long time. Thimerosal-containing vaccines are now given with abandon. Upon its arrival into our world, the newborn is greeted with a Hepatitis B vaccine. He then receives several more doses of this vaccine along with DPT and Hib vaccines. All three of these vaccines contain relatively large amounts of thimerosal, which is 49.6% ethyl-mercury by weight. It was not long ago that the only vaccine containing thimerosal was the DPT vaccine. But, the Hepatitis B vaccine was made "mandatory" in 1991 and the Hib vaccine a few years earlier. Is it a coincidence that the incidence rate of autism has soared in the 1990's? Is it better diagnosis or is it more mercury early in life? Add onto these noted exposures the thimerosal-containing RhoGam injection. A reasonable conclusion of greatly increased mercury exposure to developing fetuses, newborns and young infants being responsible for the obvious autism epidemic" is almost inescapable.

Why isn’t every child equally affected? The answer remains unknown at the present time, although recent investigations point to the possibility of problems with at least one form of metallothionein. Studies further investigating the structure and amounts of various metallothionein proteins in autism will be done later this year.
 

Evidence conflicts on mercury, heart disease link

http://www.heartcenteronline.com/myheartdr/home/research-
detail.cfm?reutersid=3188&nl=4

Dec 02 (Reuters Health) - Will consuming mercury- contaminated fish increase a man's risk for heart disease? Maybe yes and maybe no, according to two new studies with essentially opposite findings published in Thursday's issue of The New England Journal of Medicine.

While experts know that exposure to high levels of mercury can cause neurologic and kidney damage, little is known about the long-term consequences of low levels of exposure.

Previously, Finnish researchers reported a link between heart disease and increased levels of mercury in men whose mercury levels were measured from hair samples. The authors of one of the current studies note that the men were likely exposed to mercury by eating locally contaminated fresh water fish.

While consumption of fish rich in heart healthy omega-3 fatty acids is believed to cut heart disease risks, the researchers, led by Dr. Eliseo Guallar of Johns Hopkins Medical Institutions in Baltimore, Maryland, questioned whether the mercury often contained in fish might offset such benefits or increase the risk of heart disease.

To investigate, Guallar and colleagues measured levels of DHA, a type of omega-3 fatty acid, in fat tissue and mercury levels from toenail clippings in 684 men who previously suffered a heart attack. Their results were compared to a similar group of 724 men with no history of heart disease ("controls").

Mercury levels in the men who had a heart attack were "15% higher than those in controls," Guallar and colleagues write. And those with the highest levels of mercury were more than twice as likely to have had a heart attack than the men with the lowest mercury levels, the authors add.

In addition, the researchers found that after adjusting for mercury levels, high DHA levels were "inversely associated" with heart attack risk. In other words, higher levels of DHA appeared to lower a man's risk of having had a heart attack and vice versa.

Guallar's team points out that the US Food and Drug Administration currently advises pregnant women and women who may become pregnant to steer clear of fish known to have higher levels of mercury, including tilefish, shark, swordfish and mackerel. In light of the new findings, they suggest that perhaps such advice should be "extended to the general adult population."

"However, our findings do not imply that people should stop eating fish," Guallar and colleagues write. "Our mercury-adjusted analysis is consistent with a protective effect of dietary fish, provided it is not heavily contaminated."

In the second study, Dr. Kazuko Yoshizawa of the Harvard School of Public Health in Boston, Massachusetts, and colleagues found no association between mercury levels and heart disease.

The researchers measured levels of mercury in toenail clippings from 33,737 male health professionals between the ages of 40 and 75. After 5 years follow-up, 470 cases of heart disease were diagnosed among the group. While mercury levels were significantly correlated with fish consumption and dentists showed the highest mercury levels, there was no correlation between the amount of mercury in toenails and heart disease risk.

"Our findings do not support an association between total mercury exposure and the risk of coronary heart disease, but a weak relation cannot be ruled out," Yoshizawa and colleagues conclude.

The opposing findings of the two studies underscore the controversy of whether or not mercury, especially from eating fish, endangers the heart, note Drs. P. Michael Bolger and B. A. Schwetz of the US Food and Drug Administration in College Park, Maryland. "The notion that methylmercury contributes to cardiovascular disease is certainly a testable hypothesis and one that warrants further testing," they write. But evidence for such a link from large, well-designed studies of populations who rely on fish as a staple food would be needed to justify changes in dietary recommendations, Bolger and Schwetz conclude.

SOURCE: The New England Journal of Medicine 2002;347:1735-1736, 1747-1754, 1755-1760.

© Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

 

http://www.elsevier.com/cdweb/views/article.htt?jnl=0300
483X&iss=1-2&vol=185&pii=S0300483X0200588

Toxicology
Volume 185, Issue 1-2, pp. 23 - 33, 14 March, 2003

Placental transfer of mercury in pregnant rats which received dental amalgam restorations

Authors
Y. Takahashi, S. Tsuruta, M. Arimoto, H. Tanaka, M.
Yoshida

Abstract
Mercury vapor released from one, two and four amalgam restorations in pregnant rats and mercury concentrations in maternal and fetal organs were studied. Dental treatment was given on day 2 of pregnancy. Mercury concentration in air samples drawn from each metabolism chamber with a rat were measured serially for 24 h on days 2, 8 and 15 of pregnancy. On each day of pregnancy, the amount of mercury in 24 h air samples was in proportion to the amalgam surface areas. Linear regression analysis showed relatively high correlation coefficients between the mercury content and amalgam surface areas, and the coefficients were statistically significant. A highly significant correlation was also found between the number of amalgam fillings and their surface areas. Mercury concentrations in major maternal organs with one, two and four amalgam fillings tended to increase with the increasing amalgam surface areas. Spearman's rank correlation test revealed significant correlations in the brain, liver, kidneys and placenta but not in the lung. Furthermore, significant correlations were also found between the mercury concentrations in all maternal organs and the amount of mercury in 24 h air samples on day 15 of pregnancy.

Mercury concentrations in fetal brain, liver and kidneys were much lower than those of the dams but liver and kidneys showed positive correlations between the mercury content and maternal amalgam surface areas. Similar correlations were observed between the mercury concentrations in fetal organs and the amount of mercury in 24 h air samples on day 15 of pregnancy. In fetal brain, no significant correlations were found between either maternal amalgam surface areas or the amount of mercury in 24 h samples on day 15 of pregnancy but significant uptake of mercury was found in the samples from the dams given four amalgam fillings. The results of the present study demonstrated that mercury vapor released from the amalgam fillings in pregnant rats was distributed to maternal and fetal organs in dose-dependent amounts of the amalgam fillings.
 

Most vaccines free of 'toxic' preservative

http://www.triplicate.com/news/story.cfm?story_no=801

Published: December 23, 2002

By Kent Gray

Triplicate staff writer

A trace amount of a controversial preservative found in a Del Norte County vaccine is minute and not cause for alarm, according to local health officials. The preservative, thimerosal, is an ingredient in the county's hepatitis B vaccine, called Engerix B. The preservative has been under fire by critics for decades because it contains ethyl mercury, allegedly linked to neurodevelopmental disorders and autism in children.

Public Health Officer Dr. Warren Rehwaldt said of approximately seven vaccines in the county, only the hepatitis B vaccine contains any thimerosal, and it only has a 'trace amount.' "Most of the formulas have been improved in recent years and exclude (thimerosal)," Rehwaldt said. "The risk of consequences from diseases that vaccines prevent is still much higher than risks from vaccines and their contents."

Thimerosal critics cite tests for methyl mercury, a different form of mercury proven to have a toxic effect on humans, as evidence against thimerosal. The Food and Drug Administration, the Center for Disease Control and the Institute of Medicine all claim laboratory tests are inconclusive linking ethyl mercury to neurodevelopmental disorders. The Institute of Medicine's Immunization Safety Review Commission, however, concluded it is still best for infants and pregnant women to avoid any form of mercury. "Full consideration (should) be given to removing thimerosal from any biological product to which infants, children and pregnant women are exposed," the commission said in its findings.

The FDA, however, concluded that a 'trace amount' of ethyl mercury, and even methyl mercury, in vaccines is within safe limits for humans. A 'trace amount' is less than one microgram per one-cubic-centimeter dose of vaccine. This is equivalent to the amount found in Engerix B in Del Norte County.

Congressman Dan Burton (R-Ind.) is leading a legislative charge against thimerosal in Washington. Aside from calling for a recall of the product, Burton is sponsoring adding the preservative to the National Vaccine Injury Compensation Program list for individuals claiming injury from childhood immunizations.

"We cannot in good conscience leave thimerosal-containing vaccines on the shelf until used up, potentially exposing our children to chemicals that may lead to neurodevelopmental disorders. Mercury is toxic to the human body," Burton said last year." "... I am asking every doctor, every health clinic, and every facility that provides childhood immunizations to check your vaccine supplies and return all thimerosal-containing vaccines and request thimerosal-free vaccines."

 

Continuing Use of Mercury in Vaccines Questioned
      Consumer Groups Call On Drug Makers, Congress and the White House to Stop Thimerosal Use-Especially in Infants and Pregnant Women
    
WASHINGTON, DC, Jan. 8 -/E-Wire/-- Parents and advocates are meeting today on Capital Hill to ask the Nation's leaders and pharmaceutical companies to stop using the mercury preservative thimerosal in all vaccines, to inform Americans about vaccines with mercury, and to recall  existing thimerosal stocks from health care facilities.  Mercury is a known neurotoxin and has been linked to brain disorders including autism, Alzheimer's and other chronic neurological dysfunction.  

   "Why are vaccine makers still using thimerosal and unnecessarily  exposing infants, pregnant women an unsuspecting Americans-including members of Congress-to mercury?" asked  Michael Bender, Director, Mercury Policy Project. "Vaccines are supposed to help prevent health problems and not create them. Continued use of mercury in medical products for any human use, where avoidable, is  simply irresponsible and not worth the risk."

US health and governmental officials seem to agree.  In 1982, a Food and Drug Administration (FDA) expert panel recommended that mercury be eliminated from over-the-counter health products. In 1999, the FDA and the American Academy of Pediatrics (AAP) urged manufacturers to  remove thimerosal from childhood vaccines. In 2001, the Institute of Medicine recommended that children and pregnant women avoid thimerosal whenever possible.

While today, most but not all infant vaccines are mercury-free, the preservative is still added to formulations for influenza (flu vaccines),diphtheria-tetanus, tetanus, hepatitis B, pneumococcal and rabies.  This year the Centers for Disease Control (CDC) recommended for the first time that healthy children receive influenza vaccine. No influenza vaccines are available that are completely mercury-free, although two brands only contain trace amounts.

   "During the past decade children were given many more vaccines containing mercury, and the rate of autism skyrocketed. Mercury can cause the same symptoms and abnormalities we see in autism. Like lead exposures, there is no "safe" level for mercury," said Sallie Bernard, Director, SAFE MINDS. "The removal of thimerosal from OTC products and most childhood vaccines shows this preservative is an absolutely unnecessary ingredient. We urge that US policies be changed and that vaccines manufacturers completely and unequivocally refrain from using this deadly toxin without delay."

The US health science panel that extensively reviewed thimerosal was unable to  "either accept or reject a causal relationship" between autism and thimerosal, and stated that additional studies were needed. According to the Institute of Medicine's 2001 Immunization Safety Review Committee, "While the available scientific data do not establish that these neurodevelopmental disorders are caused by thimerosal, at the same time, they do not establish that these neurodevelopmental disorders are  not caused by thimerosal.  The hypothesis that exposure to thimerosal-containing vaccines could be associated with neuordevelopmental disorders was biologically plausible."

   "Vaccine manufacturers have now been given protection from financial liability for mercury-related vaccine injuries in the Homeland Security Act so they don't have to worry about the harm it's caused to the brains of children and adults," said Barbara Loe Fisher, Co-founder & President, National Vaccine Information Center. "They may be off the hook financially but they are not off the hook morally. They should do the right thing and make all vaccines mercury-free.
 

For Immediate Release

Continuing Use of Mercury in Vaccines Questioned
Consumer Groups Call On Drug Makers, Congress and the White House to Stop Thimerosal Use-Especially in Infants and Pregnant Women


Washington, DC - January 8, 2003 - Parents and advocates are meeting today on Capitol Hill to ask the Nation's leaders and pharmaceutical companies to stop using the mercury preservative thimerosal in all vaccines, to inform Americans about vaccines with mercury, and to recall existing thimerosal stocks from health care facilities.  Mercury is a known neurotoxin and has been linked to brain disorders including autism, Alzheimer's and other chronic neurological dysfunction.

"Why are vaccine makers still using thimerosal and unnecessarily exposing infants, pregnant women and unsuspecting Americans-including members of Congress-to mercury?," asked Michael Bender, Director, Mercury Policy Project. "Vaccines are supposed to help prevent health problems and not create them. Continued use of mercury in medical products for any human use, where avoidable, is simply irresponsible and not worth the risk."

US health and governmental officials seem to agree.  In 1982, a Food and Drug Administration (FDA) expert panel recommended that mercury be eliminated from over-the-counter health products. In 1999, the FDA and the American Academy of Pediatrics (AAP) urged manufacturers to remove thimerosal from childhood vaccines. In 2001, the Institute of Medicine recommended that children and pregnant women avoid thimerosal whenever possible.

While today, most, but not all, infant vaccines are mercury-free.  The preservative is still added to formulations for influenza (flu vaccines), diphtheria-tetanus, tetanus, hepatitis B, pneumococcal and rabies.  This year the Centers for Disease Control (CDC) recommended for the first time that healthy children receive influenza vaccine. No influenza vaccines are available that are completely mercury-free, although two brands only contain trace amounts.

"During the past decade children were given many more vaccines containing mercury, and the rate of autism skyrocketed. Mercury can cause the same symptoms and abnormalities we see in autism. Like lead exposures, there is no "safe" level for mercury," said Sallie Bernard, Director, SAFE MINDS. "The removal of thimerosal from OTC products and most childhood vaccines shows this preservative is an absolutely unnecessary ingredient. We urge that US policies be changed and that vaccines manufacturers completely and unequivocally refrain from using this deadly toxin without delay."

The US health science panel that extensively reviewed thimerosal was unable to  "either accept or reject a causal relationship" between autism and thimerosal, and stated that additional studies were needed. According to the Institute of Medicine's 2001 Immunization Safety Review Committee, "While the available scientific data do not establish that these neurodevelopmental disorders are caused by thimerosal, at the same time, they do not establish that these neurodevelopmental disorders are not caused by thimerosal.  The hypothesis that exposure to thimerosal-containing vaccines could be associated with neuordevelopmental disorders was biologically plausible."

"Vaccine manufacturers have now been given protection from financial liability for mercury-related vaccine injuries in the Homeland Security Act so they don't have to worry about the harm it's caused to the brains of children and adults," said Barbara Loe Fisher, Co-founder & President, National Vaccine Information Center. "They may be off the hook financially but they are not off the hook morally. They should do the right thing and make all vaccines mercury-free.

To view the Center for Disease Controls list of influenza vaccines
containing mercury, see:
http://www.909shot.com/Issues/mercury.htm.

To view the manufacturers list of vaccines still containing mercury, see:
http://www.vaccinesafety.edu/thi-table.htm.

More information is available at -
aap.org/advocacy/archives/julvacc.htm
http://www.iom.edu/IOM/IOMHome.nsf/Pages/thimerosal+report
www.safeminds.org
www.mercurypolicy.org
www.909SHOT.com

 

Poison at the end of the rainbow:
In a shantytown in Ecuador, mercury poisoning plagues children of miners
By William J. Cromie
Gazette Staff
http://www.news.harvard.edu/gazette/2003/01.30/01-mercury.html

All photos courtesy of S. Allen Counter

It sounds like an "Alice in Wonderland" tale. Children intoxicated by mercury shake and grab themselves like Mad Hatters in a mountain settlement known as the place that no one can find.

But, sadly, it's a true story. Mercury vapors from gold mining are causing brain damage in the children of Nambija, an Indian word that means "the place that no one can find." It's a shantytown in southern Ecuador that represents a piece of a large and growing health problem.

"What's happening in Nambija is a local example of what's happening to children of gold miners in indigenous communities all over the Andean and Amazon regions of South America," says S. Allen Counter, an associate professor of neurology at the Harvard Medical School. A humanitarian and an explorer as well as a doctor, Counter describes the problem in the January issue of the Journal of Occupational and Environmental Medicine. "We have laboratory evidence of what mercury poisoning does to gold miners," he says, "but this is the first time we have been able to show from tests in the field what is happening to their children and wives."

The evidence he and his colleagues have found in the blood and brains of children in Ecuador also bears on growing concerns in the United States. Some hospitals and doctors' offices are replacing blood pressure gauges that contain mercury, and at least one state, Connecticut, is phasing in a ban on mercury thermometers.

Counter is also concerned about other uses of mercury in the United States and Africa. Some immigrants to the United States from Caribbean countries, such as Haiti, scatter mercury powder around their homes as part of religious rituals. Unusually high levels of mercury in the urine of people living around Lake Victoria in East Africa have been traced to skin lighteners that contain the element. A small group of doctors in the United States worries that mercury, used as a preservative in children's vaccines, may underlie the alarming increase in cases of autism in this country. Gold poaching

In Nambija, and many other gold camps, men break up gold-containing rock with dynamite, then carry the fragments in sacks to processing areas. On the way, they surreptitiously drop off some of the ore for their wives to pick up. The women mix the ore with quicksilver, or liquid mercury. Gold flecks combine with the mercury and the amalgam can be easily separated from worthless soil and rock.

It's a common sight to see Indian women, with children on their backs, or together in a small hut, heating the silver-colored, gold-flecked amalgam balls in metal pots. The heat vaporizes the mercury, leaving a pot of pure gold worth about $100 to impoverished families. The process also leaves mercury vapors that are inhaled by the children.

Some of the women are aware enough about the danger to cover their mouths with shirts or cloths, but that's ineffective. It doesn't stop poisonous vapors from passing into the lungs and from there into blood vessels. This blood carries mercury to the brain, and can affect the brains of fetuses in the womb.


After overcoming the reluctance of children to get stuck by needles, Counter's group took samples of their blood. When these samples where analyzed in a U.S. laboratory, it was found that the Andean children had extravagantly high levels of mercury.

In this country, 0.3 micrograms of mercury per liter of blood is average for the general population, 10 micrograms is the level at which dental technicians, dentists, and others who handle mercury (for tooth fillings) begin to worry. Indian children in Nambija reach 26, 59, even 89 micrograms. Some of their mercury intoxication may also come from eating fish from local rivers contaminated by mercury spills from the mines.

Anomalies appear in the way information is processed by the brains of these children. Nerve signals generated by outside sounds and sights move more slowly than normal and sometimes disappear completely. Outward physical signs include involuntary shaking, grabbing their heads and upper bodies, and hyperactivity. Counter compares their activities to those of the Mad Hatter in "Alice in Wonderland," a character based on hat makers in England who used mercury to give their products shape.

Masking the problem

Counter is the Indiana Jones of neurology. He has studied acupuncture in China, deafness in the Inuits of the Arctic, and poisoning among Indians in Ecuador who use lead from old batteries to glaze roof tiles. Crossing swift rivers and hiking uphill to Nambija, 6,000 feet into the mountains, is routine for him. Gold bandits, armed soldiers, 12-year-old boys with automatic rifles, and dynamite explosions in mining caves do not deter him, nor does the stance of mining companies toward his "interfering" in their business. In addition to everything else he does, Counter directs the Harvard Foundation for Intercultural Studies, an institution dedicated to fostering greater understanding and interaction between different cultures and races. So he is used to people telling him to mind his own business.

At first, the women of Nambija denied that they were poaching and cooking gold ore. It is, after all, illegal. But the practice is too widespread to hide. With the help of Fernando Ortega, from the Universidad de San Francisco de Quito in Ecuador, Counter explained how mercury was poisoning them. He distributed medicine, nutritional supplements, and respirator masks to the women and children, purchased with funds he raised from Harvard alumni and other contributors. He has informed the government of Ecuador about the situation, and insists that the gold can be separated from soil and rock particles without mercury.

Counter intends to bring some of the most severely affected victims to Children's Hospital in Boston. Michael Shannon, a Harvard Medical School pediatrician, and Leo Buchanan of Harvard University Health Services have volunteered to treat the children as they have those in Ecuador. Since the Sept. 11, 2001, terrorist attacks, however, visas for foreigners have been much harder to obtain.

In addition to helping such children, Counter thinks the United States should take a closer look at the use of mercury in religious rituals. In some inner-city enclaves, people who have come here from various Caribbean nations burn mercury powders that create vapors similar to those that come from burning amalgam in Nambija. Counter would like to see an education program for these people like the one he created for the gold mining families.

He also brings experts together to discuss other possible sources of mercury poisoning. In one such meeting they talked about the fact that many vaccines used to immunize children against diseases like whooping cough contain a mercury-based preservative. Most vaccine makers no longer use the preservative, and there is no proof that it is tied to recently documented increases in autism. Nevertheless, lawsuits have been filed against drug companies by the parents of autistic children.

"We should do further research to determine if a connection does exist," Counter comments.

The principal of the school in Nambija was so pleased with Counter's efforts that he offered him a piece of rock laced with gold. Counter looked up at the excavations that have gouged and despoiled the mountain from which the gold came, and thought of a woman whose five children have been poisoned by mercury - children like his own two young daughters. "No thank you," he said politely.