1. Health

Study's Conclusion: Living Near a Freeway Associated With Autism

From Lisa Jo Rudy, About.com GuideDecember 17, 2010

A group of highly-regarded researchers at UC Davis's CHARGE (Childhood Autism Risks from Genetics and the Environment) conducted a multi-year study to determine whether effects of air pollution are likely to have an impact on the incidence of autism.  Today, they have published findings that suggest an association between autism and proximity, during the third trimester of pregnancy, to freeways.  It's important to note that the study does NOT provide any insight into what specific pollutant, if any, could be responsible for a higher rate of autism.

Here is the abstract from the report:

Background: Little is known about environmental causes and contributing factors for autism. Basic science and epidemiological research suggest that oxidative stress and inflammation may play a role in disease development. Traffic-related air pollution, a common exposure with established effects on these pathways, contains substances found to have adverse prenatal effects.

Objectives: To examine the association between autism and residence proximity, during pregnancy and near the time of delivery, to freeways and major roadways as a surrogate for air pollution exposure.

Methods: Data were from 304 autism cases and 259 typically developing controls enrolled in the Childhood Autism Risks from Genetics and the Environment (CHARGE) Study. The mother's address recorded on the birth certificate and trimester specific addresses derived from a residential history obtained by questionnaire were geo-coded and measures of distance to freeways and major roads were calculated using ArcGIS software. Logistic regression models compared residential proximity to freeways and major roads for autism cases and typically developing controls.

Results: Adjusting for sociodemographic factors and maternal smoking, maternal residence at the time of delivery was more likely be near a freeway (≤309 meters) for cases, as compared to controls (odds ratio (OR), 1.86, 95% confidence interval (CI) 1.04-3.45). Autism was also associated with residential proximity to a freeway during the third trimester (OR, 2.22, CI, 1.16-4.42). After adjustment for socio-economic and demographic characteristics, these associations were unchanged. Living near other major roads at birth was not associated with autism.

Conclusions: Living near a freeway was associated with autism. Examination of associations with measured air pollutants is needed.

This study is by no means the first to associate autism with pollution or toxins.  Pesticides, pet shampoos and emissions from coal burning  plants have all come under scrutiny.  What makes this study particularly significance is the quality of the researchers, the size and scope of the study, and the fact that the numbers were adjusted for several possible confounding factors (socioeconomic and demographic status).  This might suggest that an earlier study which linked higher socio-economic levels to autism may relate more to location than to genetics - though of course the study did not look at this issue, and my thoughts about it are simply speculation.

More Articles on Causes of Autism


Comments
December 17, 2010 at 9:47 am
(1) barbaraj says:

I remember reading a book, I believe it was called “The Poisoning of America”, that described the methods used to dispose of toxic waste by the mob. The scariest that has “stuck” with me, was the practice of waiting until a rain , loading up huge tanker trucks, opening the valve and running them down major highways until empty, “NJ turnpike” was a favorite. However, that book was dated back to the decades of LoveCanal , Times Beach, and the like, not a time when autism was prevalent, not even among the populations of those fallen towns. Today ,when thinking of major highways, I95 and similar I think of population shifts, away from older cities,the building of newly populated areas along transportation routes. With newer development comes a different set of possibilities, access to large hospital/health clinics, off gasing of materials used in newer housing, and the “dreaded” chemical lawn care.
This is an interesting artifact, yet conclusions, especially conclusions of air pollution, may not be “ripe” for the picking. We have tracking of air pollution here, most often the less populated areas , away from the highways receive the heaviest dose due to wind shift and topography. I see this as likely a fact, “living close to freeways influences rates of autism”, yet I see no viable conclusion beyond that. Interesting but it needs work.

December 17, 2010 at 9:55 am
(2) barbaraj says:

Maybe you could take a poll, how many of us lived near urban centers, freeways, etc. I was on bed rest from cerclage at 12 weeks until cut and delivery with my last three, I have an air cleaner on my furnace and central air, no exposures here. I was on a terbutaline pump and bed rest with 1996, my asd child was 2000. I am several miles from a freeway, and live in an urban setting.

December 17, 2010 at 10:00 am
(3) MJ says:

The first two links in your post are bad.

December 17, 2010 at 10:15 am
(4) autism says:

Thanks, MJ – I’ve fixed it.

Lisa

December 17, 2010 at 10:44 am
(5) ANB says:

This just confirms what I’ve said all along – the autism epidemic started in 1955, with the passage of the Interstate Highway Act.

December 17, 2010 at 4:23 pm
(6) Bill says:

Quite a few years back, researchers “discovered” that living near power lines caused childhood leukemia. Curiously, when they measured the electrical field exposure they found it to be negligible compared to normal sources of electrical fields, like an electric blanket, or a clock radio. So what was really measured was that people who buy property with ugly power lines next to them were more likely to have children with leukemia, since the electric fields were not a factor.

Looking at today’s headlines, I see people are jumping to conclusions again. All this study has proved is that people who buy property near highways are more likely to have autistic children. Why? Well, lets think about property next to highways (or power lines for that matter). It is usually cheaper to purchase because it is aesthetically less desirable; thus poorer people tend to buy these properties. Another factor would be not caring about the highway (or power line) and how it would affect their children. Might a person who does not care how their actions/choices affect other people be considered somewhat autistic? Would a person who is somewhat autistic be more likely to pass on those genes?
The social disruption of autistic tendencies does tend to make for bad outcomes, which makes for less desirable job choices, which results in less income, which results in only being able to afford property near highways.

A similar mistake has been made repeatedly with power plants. You build a power plant in a rural area, and suddenly it’s that area’s largest employer. Many of these employees are engineers & technicians. Engineers & technicians are many times more likely than the general population to be “geeks”, the old euphemism for what we now know is Asperger’s. These geeks went to land grant colleges and met and married nursing students they met in chemistry class. Surprise, surprise, suddenly there are a bunch of autistic children near power plants, so of course, mercury must be to blame.

December 17, 2010 at 5:04 pm
(7) vmgillen says:

Bill, generally I agree with you re. “jumping to conclusions” – especially when it comes to “weekly reader” science reports and headlines on studies, but in this instance I beg to differ. Those electric power lines and transformer stations are proven mutagenic agents. It’s still murky on the ELFs (electric blankets, cel phones, eg). Of course, since Autism still, still, still has NO etiology who knows whether mutagens have anything to do with incidence…

Reading through this research gives food for thought: exposure to lead (reduced in gasoline, but still present) leads to many symptoms which could lead to an ASD Dx. Similarly, diesel fumes contain particulate matter which has been incontrovertibly tied to birth defects.

As usual, it is not clear what “functioning levels” were presented in the study, but my “Autism” is non-verbal, self-injurious… and certainly not involved in buying a house.

I subscribe to a multiple-hit theory: a genetic prediliction COMBINED WITH environmental factors is responsible – apply that to your geeks ‘n nurses ‘n power plant scenario.

December 17, 2010 at 8:14 pm
(8) Bill K says:

Bill, good points. It’s still interesting though. Even if it’s not pollution, it’s got to be something, right? What could it be?

December 17, 2010 at 8:18 pm
(9) AutismNewsBeat says:

There’s a simpler explanation for the MIND freeway study – data mining. There is so much scatter in the MIND data that you can find just about any association.

December 17, 2010 at 9:53 pm
(10) barbaraj says:

ANB “This just confirms what I’ve said all along – the autism epidemic started in 1955, with the passage of the Interstate Highway Act.”
and the beginning of the Salk vaccine that year, as well..

December 18, 2010 at 8:35 am
(11) ANB says:

Right. And Elvis made his first TV appearance on March 3rd of that year on Louisiana Hayride. And the very next day, the first radio facsimile transmission was sent across the North American continent. The coincidences are just too great to ignore.

December 18, 2010 at 11:22 am
(12) Val says:

Barbaraj Some kind of OF OLDER air filters actually put pollution in the house.

December 18, 2010 at 2:16 pm
(13) Bill says:

I am endowed with Asperger’s.

There is an article in the current online issue of “Discover” which helps give perspective on some of the studies you see out there; I can’t begin to say it as well as this author has:

http://discovermagazine.com/2010/jul-aug/29-why-scientific-studies-often-wrong-streetlight-effect/article_view?b_start:int=0&-C=

Regardless of which side of these issues you are on, you need a healthy skepticism of studies.

December 18, 2010 at 2:34 pm
(14) barbaraj says:

No, mine was great, gone now with the newer furnace, it used to happily pop pop while zapping, then the regular filter did it’s job last. I had it installed for my daughter’s health after her bout with kawasaki, and while I didn’t know what caused kawasaki I thought clean air was in order.

ANB yes, but to add honesty to this, logic to this,where are those families , where are those autistic adults, I don’t see them and I live in a huge city, grew up here, stayed here, my grandparents lived here, my parents lived here, my entire extended family lived here, we have such history as to have noticed autism in our community. Among the hundreds of families we knew, we had few problems, one family as example had two sons develop schizophrenia and a daughter have a stroke all in the same year, the boys were 12/14 the girl 11, it was the biggest mystery on the block. The one son died of liver failure due to over medication, the father died mysteriously , found in a creek face down in PA. It was all very tragic and horrible and remains a mystery. Until that year he was a respected builder/developer in the area,and the family was perfect. Our own health problems were few, with the biggest excitement when my sister ate a crab cake and my mother had to run her across the street for the doc to give her a shot of epinephrine. Ah, but no highways,instead deli’s and butcher shops, fruit and vegetable stands, we ate clean, now it’s 2010 and we have one deli, one bakery, one fruit and vegetable front, and the prices are so high we turned to the grocery stores where the source is questionable at best. My money is on an acquired mitochondrial disorder through toxic exposures with vaccine in the lead by adding the toxins through the quickest route of exposure, direct injection. Last count, six ASD kids on the block!!

December 18, 2010 at 3:05 pm
(15) Val says:

barbaraj
I hope you do have a good one
Here is the info on filters some fancy electric filters actually ozone Generators

Here some links
http://www.thedailygreen.com/green-homes/eco-friendly/ozone-air-purifiers-55121004

http://www.arb.ca.gov/research/indoor/ozone.htm

http://www.healthpress.us/ozone-generators-are-not-air-cleaners/

December 18, 2010 at 4:03 pm
(16) val says:

barbaraj
Wish more vegetables were grown locally across the us.

6 kids on one block with ASD is a bit on the high side so I would look for something specific in your neighborhood not something that everyone does “Vaccinations”

Here is more on ozone filters.
http://www.epa.gov/iaq/pubs/ozonegen.html

Genetic and misdiagnoses is a big factor in autism. I have a condition often misdiagnosed as ASD or ADHD called dyspraxia in the UK. There is also the epilepsy drug Depakote which is linked to autism when mothers take it prenatally .
Smog, second hand smoke, I believe are big factors.
Not all pollution is easily seen. One smaller study showed that farmers who use certien pestisides have a higher increase of autism in the surrounding neighborhoods.

mitochondrial disorders are always genetic. It’s a disorder passed on only through the mother. They can’t just be acquired by someone who does not have the genetic makeup to have them.

Polly Hanning’s disorder wasn’t caused by vaccines but was aggravated because of improper dosage for some with her disorder.

It was advised because she wasn’t feeling well to wait to give her all the vaccines at once. 9 vaccines at once or someone suffering mitochondrial disorders is not recommended.
They need speak to their doctor and at least go by the schedule.

I believe as much as genetic.

December 18, 2010 at 5:47 pm
(17) Autismnewsbeat says:

“…where are those autistic adults”

Just because you don’t notice something doesn’t mean it doesn’t exist. What do you think an autistic adult looks like?

December 18, 2010 at 10:03 pm
(18) C. S. Wyatt says:

The autistic adults do exist, they just were not counted in the past. Again, from 2009:

On Sept. 22, England’s National Health Service (NHS) released the first study of autism in the general adult population. The findings confirm the intuitive assumption: that ASD is just as common in adults as it is in children. Researchers at the University of Leicester, working with the NHS Information Center found that roughly 1 in 100 adults are on the spectrum — the same rate found for children in England, Japan, Canada and, for that matter, New Jersey.

Read more: http://www.time.com/time/health/article/0,8599,1927415,00.html#ixzz18WUKidww

December 19, 2010 at 12:59 am
(19) barbaraj says:

‘m certain autistic adults exist, but in small numbers, not one in every seventy men in any community…or 1 in 38 men in the UK.
VAL quote:
Not all pollution is easily seen. One smaller study showed that farmers who use certien pestisides have a higher increase of autism in the surrounding neighborhoods.

mitochondrial disorders are always genetic. It’s a disorder passed on only through the mother. They can’t just be acquired by someone who does not have the genetic makeup to have them.

No, we have known of acquired mitochondrial dysfunction, it does exist, and one of the culprits has been identified among a class of pesticides. What you suggest in areas of agricultural use is correct. This fact was uncovered in the late seventies when a few found pentachlorophenal was a great way to lose weight, they died , earlier a number of babies died after the hospital laundry added too much hexachlorophene to the diaper wash and again in France talcum with the same caused neonatal deaths. ..here’s a link to some info.. http://hexachlorophenerremi.blogspot.com/2005/12/mitochondrial-neurot_12.html

The ages of the autistic children in my neighborhood is interesting, and I need to correct myself, two ages 22 ( not children), two ages 14, and two ages 10…all boys. At my baby’s birthday party, with 25 children present, four were autistic, three age ten (boys) and one (girl) age 8. None of these children live on my block, one boy and girl are siblings.
I live in a big city , there are approx. 130 to 140 people on my block. I do believe our city is one of the highest in compliance to vaccines in the country..99.5% !! and I do remember the cdc used Maryland among 14 testing sites in 2002 and we were higher in autism rates than half, had they only used the city we would have likely been considered “unusually” high..those stats remain unknown.

December 19, 2010 at 10:11 am
(20) Sandy says:

The 2002 study included U.S. eight-year-old children born in 1994 from 14 states – Alabama, Arizona, Arkansas, Colorado, Georgia, Maryland, Missouri, New Jersey, North Carolina, Pennsylvania, South Carolina, Utah, West Virginia and Wisconsin, and they were looking at the prevalence of autism, not the prevalence of vaccines. Maryland wasn’t included in that study. The highest autism rates per this study was New Jersey.

The 2000 study which included 6 cities: Arizona, Georgia, Maryland, New Jersey, South Carolina and West Virginia and again they were looking at prevalence of autism and of the 6 cities, Maryland wasn’t the highest. I believe again it was New Jersey.

One should look at each states industries, such as New Jersey which has the highest autism reates, not compliance to vaccines.

December 19, 2010 at 10:38 am
(21) barbaraj says:

Yes, you named Maryland in the 2002 study and no it wasn’t the highest at that point, as I said half among the fourteen, were lower in autism rates than us, I am pointing out that the city is, out of all cities in the country, among the top six in vaccine compliance. Maybe this is something they should factor in? Our vaccine compliance rate..in the early 90’s was 60%..but yes we will likely always be in a study,unlike California, imagine living near a freeway in California, ludicrous! :)

December 19, 2010 at 11:10 am
(22) Sandy says:

You’re right, Maryland was there in both, but it wasn’t the highest autism rates and they didn’t factor in vaccines or freeways. Of the 2002 study, of the 14 sites, 12 were clustered in a tighter range (5.2–7.6 per 1,000 children), and these rates did not differ from each other significantly, Maryland didn’t stand out. New Jersey and Alabama did.
They should look at industrial plants and maybe freeway pollution because that is every day exposure to both mother and child where as vaccine as the common factor is guessing. New Jersey also has alot of chemical plants and oil refineries. Does maryland have any?

December 19, 2010 at 1:45 pm
(23) barbaraj says:

Yes, we have pollution, mercury has contaminated our bay and caused alerts to anglers to limit fish intake.
I don’t doubt there are many exposures to mercury, seriously how can we allow the direct injection to be minimized as not potentially lethal to mitochondria . The acquired damaged needs further study, then the answers may fall in place. It’s new, that’s the problem, anyone with a text book ten years old has likely never heard of acquired mitochondrial disease or the list of drugs and chemicals that can cause it.

of..for ANB..Crest introduced flouride toothpaste in 1955..another poison..

December 19, 2010 at 2:00 pm
(24) autismnewsbeat says:

The great fluoride scare of the 50s was fueled by fear of communism., and was as misguided as present concerns over thimerosal.

December 19, 2010 at 2:53 pm
(25) Sandy says:

“I don’t doubt there are many exposures to mercury, seriously how can we allow the direct injection to be minimized” An injection is of course not the same as what comes from mercury contamination from a bay or a refinery. They are 2 very different things, and of course daily exposure is quite different from an injection that isn’t daily.
I myself have never really heard of acquired mitochondrial diseases other than what some sites and orgs try to associate to that. That’s what makes it ‘new’. Most of the mitochondrial diseases have been known for over 10 years, and it is true, most are genetic. Of course the aging process plays a part in this, why some people ‘acquire’ cancer. Type one diabetes is a mitochondrial diseases where as type 2 isn’t. Those who have inherited type one, there does seem to be a susceptibility to an environmental trigger that those w/o that genetics wouldn’t have, and the trigger often is certain infections which by the way is considered an environmental trigger. Vaccines is not the trigger but even if it was, you’d have to have those genetics. Gestational diabetes isn’t caused by vaccines, either.

I highly doubt fluoride has much to do with autism.

December 19, 2010 at 2:58 pm
(26) barbaraj says:

I gotya’, similar to what’s going on this week with the liberal treehuggers that want us all to buy smart cars or stay off the freeway?

December 19, 2010 at 2:58 pm
(27) C. S. Wyatt says:

(19) barbaraj

“Im certain autistic adults exist, but in small numbers, not one in every seventy men in any community…”

The NHS has found identical prevalence rates among adult and teen males, adjusting for the higher mortality rates of individuals on the spectrum. Yes, men with ASDs seem to die about ten years earlier (only an average) than their peers, so over the age of 60 we have no consistent data.

The rate for adults is 1:100, the rate for teens is 1:100, and the diagnostic rate in the U.K. for children remains 1:100, +/- 10 each year, in each of these groups depending on the study methodology. At most, you find a rate difference of 1:109 for adults over 25 compared to 1:95 for children under 18.

From the most recent (2009) census by the NHS: (quoting)

A study of rates of autism spectrum disorder among adults suggests that one in every 100 people over the age of 18 has the condition — broadly the same as that cited for children.

The data, collected by the NHS Information Centre, is the first to show how autism affects people over the course of a lifetime, concluding that it is similar across all ages.

People in more than 4,000 households in England were asked a series of questions aimed at assessing their psychiatric health. The results were used to identify adults with an autism spectrum disorder, including Asperger’s syndrome.

The study was funded by the Department of Health. It found that rates of autism were higher among men (1.8 per cent or 1:52) than among women (0.2 per cent). This reflects studies in children, which have shown higher rates among boys (1:48) than girls.

The report also found higher rates of autism among single people, among men with no university degree and among men who rent their homes rather than those in other types of housing.

Many of these men were previously undiagnosed.

December 19, 2010 at 3:20 pm
(28) barbaraj says:

I’m sorry, I do not believe that. There may be many YOUNG adults , yet even at that, they don’t near the numbers that were born since 1996, when compliance to hepb at birth rose above 85%. Ask five pediatricians in any area , those who have been in practise for 20+ years, they see it, the epidemic exists.

December 19, 2010 at 4:05 pm
(29) C. S. Wyatt says:

(28) Barbaraj

Your beliefs do not constitute research data, nor do conservations with doctors. The only data that matter are new surveys of individuals using consistent diagnostic criteria administered in a uniform matter by researchers (as opposed to clinicians, which have a different mandate).

No amount of data will change your mind, not even the NHS crosstabs of more than 4000 individuals. The crosstabs show no variance by generation. None. It didn’t matter if we studied the 40-59, 20-39, or 10 to 19 groups, the data for males did not vary by more than 0.2% — a margin so small as to be deemed statistically insignificant. But, no amount of data will persuade you because you have “belief” and that will always trump the data.

I have no such data for the U.S. because such studies are generally impossible — we do not have, nor do I foresee any support for, a national database of all individuals and their health care histories.

I’m sure it wouldn’t matter anyway. People “believe” what they experience anecdotally, which is why no one in Minnesota is going to be talking about global warming this month…

December 19, 2010 at 4:08 pm
(30) AutismNewsBeat says:

Do you have any real reasons to doubt CSW’s UK data? Your strongly held beliefs may seem real to you, but they are strongly contradicted by facts.

December 19, 2010 at 6:03 pm
(31) Sandy says:

I don’t know about those ‘tree huggers’ and smart cars, however there is no doubt gasoline powered cars cause much damage to the environment and those who live in colder states and have their cars running in the garage could contribute to many affects. It’s not something to simply ignore.
I also agree with C. S. Wyatt, there’s never going to be an accurate number of adults with any disorder, it violates privacy for one thing. But that doesn’t mean the population still isn’t valid. I believe the UK has near close to the same autism rates as does the USA, so their study of adults is very interesting.

I also agree, no one in Minnesota is going to be talking about global warming this month or lack of snow. Get ready because we have more snow coming. That out door football game should prove interesting.

December 19, 2010 at 6:21 pm
(32) ANB says:

Barb was just flexing her anti-science bona fides. Best not to ask her what she meant, or Lisa Jo will shut down the comments.
; -)

December 19, 2010 at 6:39 pm
(33) Twyla says:

“Many of these men were previously undiagnosed.” They were not diagnosed until this survey was done? How were they then diagnosed, and why not diagnosed before? Did this survey count every lonely nerd as autistic?

Dr. Thomas Insel, chair of the Interagency Autism Coordinating Committee (IACC) and director of the National Institute of Mental Health, says there is no question that the increase is real and significant. He says that factors such as ascertainment don’t explain away the “huge increase”.

Click on the link to Dr. Insel’s comments at the end of this article:
http://www.ageofautism.com/2009/12/david-kirby-dr-insel-on-rising-asd-numbers-no-question-about-environmental-factors-.html

Dr. Insel mentions three sources for information on questions of prevalence: HRSA phone surveys, the CDC “which has been using basically the same methodology across all of these different cohorts focusing just on 8 year olds and using secondary data sources” and “the California registry, the DDS data, which goes back to 1987 and has data from every year on children who were referred in for services. In which case, because it is a disability services registry, you are talking about children who are on the more severe end of the autism spectrum…”

He also says that “My personal sense, just from my clinical experience… when I was in training, I never saw a child with autism. So I went through four years of training as a psychiatrist, including a rotation – a long one – through a year of child psychiatry, and never saw a case. I got interested in autism through work I was doing in basic science research, and I wanted to see children with autism. I couldn’t find them. This was in the mid-1980s, and I had to find a specialty clinic at Children’s Hospital in Washington, and I got to see my first case there. And now I wouldn’t have to go any further than the block where I live to see kids with autism today. So if that’s not a change, I don’t know what is. “

December 19, 2010 at 7:16 pm
(34) Twyla says:

In 1935 Dr. Leo Kanner wrote a 527 page textbook called “Child Psychiatry” which was a comprehensive diagnostic handbook of children’s disorders, based on his years of research and experience, including as head of children’s psychiatric services at Johns Hopkins Hospital. He wrote that “The present volume… is offered as an atttempt to cover the entire field of children’s personality disorders…” This comprehensive textbook did not describe autism by any name.

In 1943 Dr. Leo Kanner wrote, “Since 1938, there have come to our attention a number of children whose condition differs so markedly and uniquely from anything reported so far…” Autism was new. Yet, it was still rare. In the course of his career he saw few cases of autism, even though families came from all over the U.S. and beyond to have their children evaluated at Johns Hopkins.

In January 2009 “A study by researchers at the UC Davis M.I.N.D. Institute has found that the seven- to eight-fold increase in the number children born in California with autism since 1990 cannot be explained by either changes in how the condition is diagnosed or counted …”
http://www.medicalnewstoday.com/articles/134717.php

Barbaraj is not “anti-science”, and she has many facts on her side.

December 19, 2010 at 7:29 pm
(35) Sandy says:

“In January 2009 “A study by researchers at the UC Davis M.I.N.D. Institute has found that the seven- to eight-fold increase in the number children born in California with autism since 1990 cannot be explained by either changes in how the condition is diagnosed or counted”

Barbaraj was going off the year 1996 not 1990, but of that study above, obviously they didn’t factor in freeway exposures. Of all places, California’s air pollution exposure could very well explain the autism increase in that state.
Thanks for pointing to that study. It goes very well with htis article about freeway air pollution. Could also explain the high rates in New Jersey, which has the highest population density which could very well equal more cars.

December 19, 2010 at 7:39 pm
(36) Twyla says:

The high rates in NJ may be due to the many pharma companies dumping thimerosal waste.

My comment was in response to the comments above; I did not begin the discussion about autism prevalence.

CA has had air pollution for decades. The air in L.A. has gotten better.

December 19, 2010 at 7:56 pm
(37) ANB says:

They were not diagnosed until this survey was done? How were they then diagnosed, and why not diagnosed before? Did this survey count every lonely nerd as autistic?

In the last CDC survey, 21% of the eight year olds identified with an ASD had no recorded autism diagnosis before the CDC researchers did their assessment. One in five kids identified as autistic had either been misdiagnosed, or totally missed.

One of the most egregious conceits of the anti-vaccine movement is that autism is somehow easy to recognize. We are suppose to assume, for instance, that Dan Olmsted counted most or all of the autistic Amish. Kirby asks “where are all the spinning, flapping autistic adults?” Mark Blaxill thinks there was no autism until 75 years ago because there is no mention of the hundreds of millions of autistic persons who have ever lived in the historical record.

December 19, 2010 at 8:09 pm
(38) Sandy says:

I did not begin the discussion about autism prevalence, either but just like me, you added to it. Not sure what difference it makes who started, or who added to it.
Pharma companies don’t ‘dump’ unused vaccines, they know it an we know it, it’s toxic ;) I can just see a clinic ‘dumping’ it down the sink, as they do all medications unused. There was an article last year and some other sites made a big deal out of what they do with them, which was actually what they’re suppose to do with them. And let’s say pharma’s did just dump them, the rates then would be in clusters to the dumping site.

Air pollution for decades of course can lead to genetic differences along the generation lines, and also since it’s more recently affected that ozone layer, that freeway pollution makes some sense.

December 19, 2010 at 8:33 pm
(39) Twyla says:

Full blown autism is hard to miss.

There is no “anti-vaccine movement”.

December 19, 2010 at 10:22 pm
(40) C. S. Wyatt says:

A reminder: I, and many people like me, were classified under “retardation” and “brain injury” for convenience. I was born in rural California in the 1960s.

I was not reclassified to “autism” until after 2006, when we moved to Minnesota and the Mayo Clinic and a private neuro-psychologist became involved.

By today’s standards, I would have exhibited “Kanner’s classic autism” as a child, until age two or three, and I still exhibit “classic” autism under stress and sometimes randomly. This had been classified as “seizure-like” behavior for several years.

California’s diagnostic patterns are a mess. The distribution of researchers and experts is uneven, primarily to the West of Interstate 5, along the populated coastline. Studies are also highly political.

Even as late as 2000, learning specialists and a Stanford neurologist did not consider, would not consider, anything other than ADD/ADHD, seizure disorder, and brain trauma as a mix-n-match diagnosis.

I’ve met dozens and dozens of people like myself who were not diagnosed until late adulthood. That means a lifetime of misdiagnosis, minimal supports, and relegation to the margins.

Where were we? We are here… and always were. Just shoved into convenient dark corners. A most adults with the diagnoses of ASDs I know? They aren’t able to work, struggle to get any fiscal aid, and, sadly, feel invisible. People claim we don’t exist. It’s a lousy feeling.

December 19, 2010 at 10:23 pm
(41) Sandy says:

The anti-vaccine movement is harder to miss than autism. Most parents past or present don’t advertise their disabled children, and if one was to see a disabled child, unless the parent directly tells strangers what their child’s diagnosis is, one assumes what it might be. Not everyone with autism hand flaps and spins, yet I know typical children who have done those same two things.

December 20, 2010 at 1:42 am
(42) Twyla says:

“Anti-vaccine movement” is a misnomer.

It is absolutely ridiculous to continue to argue that autism has not increased, and that today’s middle aged and elderly adults have as much autism as today’s children and teenagers, and that autism was simply missed even as recently as in the 1960’s through 1980’s, when autism was clearly defined but was just so much more rare than today.

December 20, 2010 at 6:58 am
(43) Sandy says:

There cant be any arguing. It’s already a known fact many were misdiagnosed. Autism wasn’t missed, many doctors diagnosed it as something else and it still happens today, regardless how defined it was in medical books. Temple Gradin was lucky to had been given the diagnosis at the time.

Back in the 1970’s and 80’s the diagnosis of the day was ADHD, everyone knew someone who had a child with ADHD. We know from a recent study many were misdiagnosed. So that epedemic of ADHD wasn’t even real either.

Back to pollution, it is one thing that it every day exposure that probably every one has exposure to.

December 20, 2010 at 9:14 am
(44) autismnewsbeat says:

Twyla, if the purported autism epidemic is so obvious, then then why don’t we have reliable data which point to an increase in incidence, as opposed to prevalence?

You say “full blown” autism is hard to miss, so why is it so hard for you to separate it from less severe cases, which comprise 2/3 of the spectrum? You can’t have it both ways. Thirty years ago, only “full blown” autism (Kanner’s) was recognized. The rate was about 5:10,000, and when Lorna Wing added less severe cases it was about 15:10,000. Today, the prevalence for autistic disorder is about 24:10,000. That’s not even close to the 100-fold increase claimed by the anti-vaccine movement.

Is it ridiculous to argue that what we call autism exists on a spectrum? Or that diagnostic substitution has occurred over the years? That as many as one in five children who present with ASD behaviors are currently misdiagnosed or undiagnosed? That diagnoses follow services?

Is it ridiculous to argue by assertion, rather than with facts and data?

December 20, 2010 at 9:18 am
(45) sharon says:

Misdiagnosis comes from lack of true understanding, thank you psychs. As ADD/ADHD was the pet disease in 1970s and 80s and Depression in the 1990s. Diagnosis by psychs depends more on what the latest drug kickback is than any true disease. Which is disheartenning to those who have a real need and are seeking help from people who claim to have researched the human condition. Drugs once given for schizophrania are now given for Depression (why not, depression is more “easily” diagnosed. anyone who has suffered a natural loss in their life can be “diagnosed” with depression and prescribed Prozac). And it will always be easier to prescribe a drug then to treat the real person.
Is our environment more toxic today than it was in 1940? of course it is
Can environmental toxins cause disease? NSS (no shit sherlock)
Is “living near a freeway” a root cause of autism? Please spare me the rediculous datamining.
Many of you sound very educated on Autism. You deal with Autism daily (as do friends of mine with children with autism). Finding a root cause, if it is out there, would be a wonderful step in the fight against these types of diseases. Please don’t hold your breath. Environmental toxins are more ubiquitous than the specific cases of PCB, PBB and dioxin infused communities. The levels of these toxins are going to vary by community, but rarely be nonexistant. Not in this day and age. Autism, MS, and many other diseases are definitely clustered. This does tell us that there are environmental factors affecting these diseases. By the time researchers find the root cause (be it mercury, selenium, dioxin or others) your only choice will be to move.

December 20, 2010 at 9:20 am
(46) autism says:

what exactly is the definition of “full blown” v “less severe” for the purposes of this type of conversation?

For example – are we talking diagnoses? That is – Aspies as opposed to everyone else?

Are we talking about verbal abilities? That is – if a person can effectively communicate verbally, are they “less severe?”

Are we talking about life skills? That is – if a person can live independently and hold down a job, is he “less severe?”

Unfortunately, PDD-NOS is not necessarily a term meaning “less severe,” and informal terms like “mild” or “high functioning” autism have no formal definition.

How did Lorna Wing do it?

Lisa

December 20, 2010 at 9:43 am
(47) sharon says:

Misdiagnosis will alway be rampant in a field like Psychiatry, where diagnosis depends more on the lastest “wonderdrug” and the field of drug kickbacks than on real science. Too bad people who have a great need and are seeking help are relying on people who prescribe Prozac like it’s candy.
If you were diagnosed in 1980 you had ADD/ADHD
In the 1990s, Depression (never mind that you just had a death in the family, you need Prozac!), Manic or Bipolar
What next!?!
People who have real problems need help, but psychiatry is too busy developing “wonderdrugs” to do anything real. Friends whos children have Autism fight constantly to get assistance because it is easier to prescribe than help. It is cheaper to prescribe a drug than to work with children.
Is our environment more polluted today than it was 50 years ago? well of course it is!
Are diseases like Autism and MS clustered, indicating some kind of environmental effect? unfortunately, yes
Is living near a freeway a root cause of Autism? Spare us your rediculous datamining.
I would love for researchers to find the root cause of autism, but I will not hold my breath. If it’s mercury, selenium, dioxin, PCB, PBB, or others, these toxins have become ubiquitous in our industrial age. By the time researchers find the root cause, our only recourse will be to move, and even that might not be far enough.

December 20, 2010 at 10:03 am
(48) Sandy says:

Actually, they may find it sooner than thought. Newest study out there flooding news feeds is “Genetic Basis of Brain Diseases: Set of Proteins Account for Over 130 Brain Diseases”

As for the definition of “full blown” v “less severe”, an example was my child was diagnosed with autism, with descriptive sentences behind it such as severe,, non verbal, infantile onset, so dibilitating it affected every minute of his day. To me, that is full blown. Yet I didn’t parade him around when he was young, family knew but the few times we did venture out with him into the public, those who did acknowledge his behavior always made the comment ‘giving him too much sugar?”. I still hear that comment.

Of course, the percentage of those who always remain severe is small. All children will progress so by the time the public does see that child out and about, yes it could be hard to miss or attributed to something else other than autism.

December 20, 2010 at 10:07 am
(49) Sandy says:

By the way, my son is on Zoloft. It wasn’t given like candy and after starting it, for whatever reason his sleep became better and so did his verbal skills pertaining to humor.

Adults don’t get an RX for a psych drug without going to the doctor attempting to seek help. It isn’t so much those doctors giving it out as candy as it is people always want a fix-it medicine. Also, they have to create different drugs since not all drugs work the same for all people.

I am very pleased with the meds my child is on, and I am thankful they were an available option to us.

December 20, 2010 at 10:29 am
(50) barbaraj says:

My computer is taking it’s last breaths, so I missed a bit while rebooting and cleaning. Twyla, thanks for providing the facts and understanding the position of all of us that are labeled “anti-vaccine”..we know we are not anti vaccine, we are just banging our heads against a brick wall, trying to force some safety into a program that has taken the promise of providing a “strong body and mind through modern health care” away from our children. The issue should be in the hands of the pediatricians, and ,while I’ve seen a few come forward with letters to the AAP , most seem to be cowering under the shadow of big pharm and it’s tentacles.

Sorry Sandy I was being a bit sarcastic, I am a tree hugger, and I am a liberal, it was just a comment following ANB’s “communism/flouride” mention. ..and really I appreciate information from ANB and CS it provides some insight as to what others believe. I’m just loving everyone today, must be some prozac in our municipal water system:)

December 20, 2010 at 11:30 am
(51) Malia says:

I find the rhetoric and “politicking” that has crept into the discussions regarding autism vs. other mental health disorders disturbing. An example: http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml

Note that autism is the only disorder in the list given where it states point blank that the rates are difficult to pin down… despite the fact that (a) many of the other disorders include similar symptoms and (b) that many autistics were originally (allegedly) misdiagnosed as having these other disorders (plus a few others that do not appear on the list).

ANB lists a rate of “full-blown” (Kanner’s) autism 30 years ago of 5:10,000; however, the rate I was cited 17 years ago (when my son was diagnosed) was lower – i.e. 1:10,000, up from a published rate of 1:15,000 only a few years before that. The problem with the rates, I believe, has as much to do with the varying political agendas of the people citing them as anything else.

December 20, 2010 at 12:02 pm
(52) Sandy says:

The rates also has to do with where they’re obtained from. Those who are in school and have an IEP with autism as the primary is one count, but that same IEP doesn’t specify that nameless child also has county services which is also where the rates come from so that same child was counted twice. Back when C.S was a child, had he been in any other state, who knows if there even was county services for autism to obtain a count but had he been labeled that and had an IEP, he wouldn’t had been counted since IDEA didn’t add autism until the 1990’s. And as C.S. mentioned, California’s diagnosing is a mess, even today. The autism rates probably will always be inaccurate and hard to get a specific true number. But however high the rate is at any given time, it certainly doesn’t point to any one cause, either.

December 20, 2010 at 12:14 pm
(53) Twyla says:

It’s interesting to me that bloggers defending vaccines frequently state that Hannah Poling, Bailey Banks, and Evan McCarthy are/were not really autistic, even though they had the classic signs such as loss of language, social interaction, and eye contact, and self-stimming repetative behaviors — and they were all diagnosed with autism by professionals.

Yet these same bloggers insist that there are thousands, or maybe millions, of adults who have never been diagnosed with autism — today and in prior generations.

Someone who is a bit of a nerd, good at math, and has poor social skills may possibly obtain a diagnosis of aspbergers but is not at the same level of disability as someone who has limited language, major behavioral issues, cannot cross the street safely, and is incapable of living independently or holding a job without a lot of support. I’m tired of people pointing out adults who have trouble making friends and saying that person is “actually” autistic and that the existence of such people shows that autism is not increasing.

Studies have shown that diagnoses of other forms of mental illness have not decreased to account for the increase in autism diagnoses. Among others, two UC Davis studies have confirmed this. Studies of school statistics confirm this as well.
http://www.thoughtfulhouse.org/tech-labs/disabilities/reports/CA-Autism-Statistics-Prevalence-Incidence-Rates.pdf

December 20, 2010 at 12:24 pm
(54) Malia says:

However, one would think that such county to county or school vs. medical variances would also affect other mental health diagnoses… presumeably making the cited rates for those disorders as allegedly unreliable as the numbers for autism… yet, NIMH has the confidence to cite specific rates for the other mental disorders on the list without making such a sweeping proviso as to their reliability as they do make under the autism section.

December 20, 2010 at 12:30 pm
(55) Twyla says:

Yes, maybe ultimately we never know anything for sure except for “cogito ergo sum”. We can spend all day arguing the fine points of statistics and definitions. Holes can be poked in any study — often by the same people who say we should have so much respect for science. It is an endless debate, but bottom line is we have a generation reaching adulthood with a very high rate of disability. And while nerds may have been overlooked in prior generations, it’s very hard to overlook a child who doesn’t learn to talk. That is something so significant that it would be reported in medical literature, popular literature, and the press. Before ABA or speech therapy existed, outcomes would have been even more likely to be extremely challenging.

And btw there’s been a forty-fold increase in bipolar disorder among youth age 19 & under between 1994 and 2003. Just one example of another diagnostic category increasing (rather than decreasing due to supposed diagnostic substitution).

Here’s an article about a very thorough study in North Dakota showing a rate of autism in 1987 of 3.3 per 10,000.
http://www.ageofautism.com/2009/09/autism-not-really-on-the-rise-967-impossible.html

December 20, 2010 at 12:32 pm
(56) Twyla says:

That’s a very interesting point, Malia, about how NIMH reports rates for other mental health diagnoses without the same disclaimers as for autism.

December 20, 2010 at 12:39 pm
(57) Sandy says:

As for McCarthy, she herself in a magazine interview hinted to Landau-Kleffner syndrome, which is often misdiagnosed as autism. Had she not done that, bloggers wouldn’t then had started questioning the diagnosis.
At the same time, many are misdiagnosed by professionals to be simply MR or ADHD.
Any professional can be wrong and often they are. Look at all the misdiagnosed with ADHD.

December 20, 2010 at 1:04 pm
(58) autism says:

“bipolar disorder” is a new designation as well (it was “manic depression”), and is also now considered to be a “spectrum disorder.”

the criteria and designations change all the time, as do our perceptions, awareness and exposure to people with different types and levels of difference/disability.

this is one of the many reasons it is so difficult to determine whether levels of a psychiatric disorder have increased, decreased or remained stable across decades.

Lisa

December 20, 2010 at 1:07 pm
(59) Twyla says:

ANB, do you consider the authors of this study to be “anti-freeway”?

December 20, 2010 at 1:25 pm
(60) passionlessDrone says:

Hello friends –

I have a few thoughts on this paper and this discussion:

1) A very similar study, methodologically, was in the press a few months ago, wherein the authors performed a GIS mapping of people with children with autism, and determined that because they were in proximity to other people with children with autism, the relationship was caused a social network based on living close to one another. In fact, a prominent skeptical blog claimed that this association ‘accounted’ for 16% of autism diagnosis. If the confounding factors in this study (of which there are many) are fatal to its findings, I think the Bearman studies are similarly flawed. This is the kind of study that should only be used as a guide to drive further studies.

2) Those that cling to the English study claiming to find a 1% prevalance in adults as evidence of a static rate of autism are subsisting on thin, thin gruel. The idea that we can use one single study, in a field with dozens or hundreds of studies in children, which included a total of 17 adults diagnosed with autism, who were competent to respond to questions such as their preference for fiction over non fiction in recreational reading, to come to any conclusions of incidence with certainty, have no means on which to stand on high scientific ground.

TBC. . .

December 20, 2010 at 1:26 pm
(61) passionlessDrone says:

3) The current freeway study, while limited, does have biologically plausbile mechanisms underneath the hood; interferrence with development as a result of exposure to a variety of pollutants. The next logical step might be a biomarker based study in pregnant women, perhaps those that already have a child with autism, to see if levels of polycyclic aromatic hydrocarbons or other endocrine disurptors known to be related to automobile exhaust, and already associated with decreased proximity to freeways.

4) There is a tendency to over simplify these types of findings; i.e., ‘This must mean that the Interstate system is the cause of the epidemic’, for reasons I do not understand. With the repeated failures to find driving genetic factors capable of causing more than a tiny fraction of our autism cases, the consensus seems to be forming around the idea of ‘low penetrance’ genetic participation; i.e., having several genes that provide a small, but real, push towards the autistic phenotype. There is absolutely no reason that environmental impacts could not similarly be similarly low penetrance; i.e., perhaps, having the right mix of genes, and exposure to endocrine disruptors during development leads to a developmental path of autism. It is a messy possibility if our goal is to find binary explanations, but it does lend itself nicely the world of reality.

- pD

ps – Lisa: The 2000 character limit is bogus.

December 20, 2010 at 1:32 pm
(62) Twyla says:

“Landau-Kleffner syndrome (LKS) is a rare, childhood neurological disorder characterized by the sudden or gradual development of aphasia (the inability to understand or express language) and an abnormal electro-encephalogram (EEG). LKS affects the parts of the brain that control comprehension and speech. The disorder usually occurs in children between the ages of 5 and 7 years. Typically, children with LKS develop normally but then lose their language skills for no apparent reason. While many of the affected individuals have seizures, some do not. ”
http://www.ninds.nih.gov/disorders/landaukleffnersyndrome/landaukleffnersyndrome.htm

The main difference between regressive autism and LKS is the age of onset. Other than that, is quite possible that some children could meet the criteria for both diagnoses. Both autism and LKS are defined by symptoms/signs/behaviors, not by etiology or medical test. Both could result from brain inflammation arising from vaccines or toxic exposures (or other causes).

I think there was recently a long rather pointless arguement about EEGs and autism. An abnormal EEG is mentioned as a characteristic of LKS. Many people with autism have abnormal EEGs too. Many people with autism have never had an EEG, so it’s not known whether it would be abnormal.

December 20, 2010 at 1:44 pm
(63) Sandy says:

It doesn’t really matter about Landau-Kleffner syndrome, except no one was frequently stating anything about McCarthy’s son’s diagnosis until McCarthy herself brought up that disorder. So it really has nothing to do with bloggers defending vaccines. People should question those who say one thing and then say another.

My son’s had an EEG, it was required prior to diagnoing autism. An MRI was also required. All depends on where one lives as to what doctors require. Some of course do no medical tests at all and just hand out a diagnosis, but they should do some medical tests.

December 20, 2010 at 1:48 pm
(64) Twyla says:

Thanks, Pd, for commenting! I agree that “This is the kind of study that should only be used as a guide to drive further studies,” and that “Those that cling to the English study claiming to find a 1% prevalance in adults as evidence of a static rate of autism are subsisting on thin, thin gruel,” and that there is “repeated failures to find driving genetic factors capable of causing more than a tiny fraction of our autism cases.” Thank you for always reading the studies thoroughly and having something intelligent and individual to say. I agree that the search for a single cause clouds an accurate view of a complex reality.

And, yes, some would point out that I seem to focus exclusively on vaccines — and I do believe they are the primary cause of the increase in ASD we have seen over the past 20 or so years. But clearly there are other factors at work as well, including environmental toxins and genetic susceptibility. And even vaccine causation is multi-factorial, not only the result of one ingredient, one vaccine, or one type of susceptibility. It does seem to me that recognition and understanding of vaccine causation could lead to some of the most effective prevention and treatment, while it is harder to control, for example, coal burning power plants in China, or to change genetic susceptibility.

I guess the 2000 word limit encourages us to be concise, but at least you can still post additional comments to finish what you have to say!

December 20, 2010 at 1:50 pm
(65) Twyla says:

Sandy, my point is that Jenny mentionning LKS was no reason for people to say that her son was not really autistic. The two syndromes are quite similar and can overlap. Pro-vaccine bloggers just jump on that as an opportunity to try to discredit her.

December 20, 2010 at 2:07 pm
(66) Malia says:

One unexplained issue I would tend to associate with freeway proximity and autism is the failure of a sharp rise in autism rates in areas around freeway in the 1970’s… i.e. before catalytic converters, widespread use of unleaded gasolines, and other emissions controls were brought in to effect. Some of the larger North American cities had huge air quality control issues in the 1970s that were, for a time, improved dramatically when these measures were brought in. I would think there should have been a recognizable “bump” in autism rates if general air quality is a major cause of autism. Perhaps studies looking into additives introduced during the 80s would unearth something more specific?

December 20, 2010 at 2:08 pm
(67) Sandy says:

How would you tell Landau-Kleffner syndrome and autism? How would one tell if they were over lapping?

McCarthy mentioning it is every reason to question it, more so when she is stating to everyone that her son is recovered when Landau-Kleffner syndrome recovery can occur within days or years.

December 20, 2010 at 2:16 pm
(68) Twyla says:

Malia, another good point.

December 20, 2010 at 2:38 pm
(69) ANB says:

In the late 1970s, prior to DSM-III, Lorna Wing was finding children she knew were autistic but did not fit precisely into Lotter’s criteria. So she came up with the triad of impairments and autistic spectrum.

Here’s something Wing wrote on The Definition and Prevalence of Autism: A Review

http://www.mugsy.org/wing.htm

December 20, 2010 at 2:55 pm
(70) Sandy says:

Good link, ANB. Thanks.

December 20, 2010 at 3:01 pm
(71) AutismNewsBeat says:

Wing and Gould found 20:10,000 in 1979, prior to DSM-III. In the late 1990s, Wing said the real rate of all ASDs was close to 90:10,000. A Swedish researcher came to a similar conclusion in the early 90s. That study was cited by Andrew Wakefield in his 1997 patent application.

December 20, 2010 at 3:43 pm
(72) Malia says:

Therefore, before 1979, wide variances (now identified as published rates varying from 1:15000 to 20:10000) cannot be explained away by definitional changes made in the DSM criteria much later since they would have been working within the definitional parameters set at that time. It also seems to me that the scientists were anticipating that the definitional change in 1994 would bring the rate of diagnosis up to around 90:10000; however, we would appear to be dealing with rates significantly higher than that today.

Interesting… please continue.

December 20, 2010 at 6:43 pm
(73) AutismNewsBeat says:

Therefore, before 1979, wide variances … cannot be explained away by definitional changes made in the DSM criteria much later since they would have been working within the definitional parameters set at that time.

Wide variances pre-DSM III are explained by different methodologies in collecting data. Lorna Wing actually created her own “definitional parameters” to include children who showed autistic behaviors, but were still missed by Kanner’s and Lotter’s criteria. Wing explains that very well in the link I provided.

It also seems to me that the scientists were anticipating that the definitional change in 1994 would bring the rate of diagnosis up to around 90:10000; however, we would appear to be dealing with rates significantly higher than that today.

What does this mean? Which scientists, and when? How are today’s rates “significantly higher” than 90:10,000? That’s 1% of the population.

December 20, 2010 at 7:06 pm
(74) Malia says:

Rates have been cited in the news as high a 1:58 (for boys) or 1:60 (families in military service).

The scientists I’m referring to are the ones you alluded to with the statement “A Swedish researcher came to a similar conclusion in the early 90s.” This essentially means to me that a rate 90:10,000 was predicted at a point in time when the changes to the DSM were being contemplated and the diagnosis rate at that time was significantly less than 90:10,000. I’m asking you to clarify your point. Was the effect of changing the DSM anticipated by the scientifici community before it was implemented?

December 20, 2010 at 7:23 pm
(75) Autismnewsbeat says:

So you’re saying the 1:58 found in boys is significantly higher than 90:10,000 found in boys and girls? Am I the only one who sees a problem with this?

Ehlers & Gillberg (1993) estimated the number of autistic children with IQ>70. Wing and Potter (1998) didn’t predict 91:10,000 – they drew on Gillberg to estimate the true prevalence of all ASDs:

“Because we concentrated on the children with learning disabilities (IQ under 70) we saw very few with the pattern described by Asperger. We had to wait for the study by Christopher Gillberg in Gothenberg to find out how many children with IQ of 70 and above were also in the autistic spectrum. As described above, combining the results of these two studies gave an overall prevalence rate for the whole autistic spectrum, including those with the most subtle manifestations, of 91 per 10,000 – nearly 1% of the general population.”

December 20, 2010 at 7:28 pm
(76) Malia says:

There was clearly a wide variance in popularly reported autism rates long before the tinkering with the DSM criteria occurred. The rate I was cited when my son was diagnosed was actually significantly lower that even Kanner’s initial rate, and my son was diagnosed only a very short time before the DSM-IV came into effect… I’m naturally curious as to why that would be.

December 20, 2010 at 7:37 pm
(77) Malia says:

So now am I to understand that autism rates commonly published before 1993 essentially excluded individuals with IQs higher than 70?

December 20, 2010 at 7:43 pm
(78) Malia says:

When my son was diagnosed and in order to cheer me up, I was handed a newspaper article about a girl with autism who had just become a Rhodes scholar… Does anyone else see a discrepancy here?

BTW, I have also seen rates for boys and girls at 1:91 (which is also higher than 1% of the populations).

December 20, 2010 at 9:47 pm
(79) C. S. Wyatt says:

Something I just realized — I have never, never lived more than four blocks from a freeway when in town. I don’t know if anyone has ever looked at a map of California, but how the heck can you not live near a freeway or state highway?

Heck, a highway splits my home town in two, right down the middle, so you’re never more than a mile from the highway. Even my wife, who grew up on a family farm, was less than a mile from a state highway.

I’d have to ponder, but 309 meters = 1013ft is under a quarter mile. That’s pretty specific and I have no idea without satellite images where things were. Then again, every hospital I recall is near a freeway, too.

What a strange study “finding” and now I’m going to have to tear apart any published crosstabs and raw data.

BTW: I have the OSEP IDEA data from 1991 – 2008 (last published) and the fall in “retardation” does parallel, almost precisely, the rise in autism. I wasn’t sure if that would continue, as the old data I had ended in 2005, but it does still hold true.

December 20, 2010 at 10:01 pm
(80) C. S. Wyatt says:

Okay, here’s what I found examining the data by county (using the GIS data): Of the 58 counties in California, the same top-ten for cancers associated with air pollution are the top-ten for autism diagnoses. These are also among the most affluent counties, of the 58, which is curious. Might explain why they have the freeways, too:

Rank County Added cancer risk (per 1,000,000)
1. SAN FRANCISCO 2500
2. ORANGE 1500
3. LOS ANGELES 1100
4. VENTURA 1000
5. ALAMEDA 1000
6. SAN MATEO 940
7. SANTA CLARA 930
8. SAN DIEGO 770
9. CONTRA COSTA 730
10. RIVERSIDE 690

I only found the top nine for autism rates:

Autism Risk by County
1. Alameda County
2. Contra Costa County
3. Marin County
4. San Francisco County
5. San Mateo County
6. Santa Clara County
7. Los Angeles County
8. Orange County
9. Riverside County

December 20, 2010 at 10:19 pm
(81) C. S. Wyatt says:

pD: (not sure of the number, as those vanished)

From the last NHS survey of household data (sorry it doesn’t paste well:

True standard errors and 95% confidence intervals for Autism Spectrum Disorder (ASD: ADOS 10+ was used in 2007, and the AQ-20 in the 2009 study)
Base Characteristic % Sample Weighted size
Men 1.8% 1114 (raw) 3517 (wtd)
Women 0.2% 1740 (raw) 3814 (wtd)
Adult Presence of ASD 1.0% 2854 (raw) 7358 (wtd)

A study with a raw count of 2854 adults seems a lot more detailed than “17 adults diagnosed” — though that might be something mentioned elsewhere.

The data above is from NHS Autism Census 2007, two years before the 2009 census of adults.

Are there many freeways / highways in the U.K.? (kidding, people, kidding!)

http://www.ic.nhs.uk/webfiles/publications/mental%20health/mental%20health%20surveys/APMS_Autism_report_standard_20_OCT_09.pdf

December 20, 2010 at 11:25 pm
(82) Malia says:

As I understand the study, it is specific to where the mothers lived during their 3rd trimester, not where the child or adult with autism ma have lived or be living at any other point in their lives. From a personal perspective only, this is unlikely to have been a factor in my son’s autism since we had moved onto a farm well over 1/4 mile from any major roadway and definitely nowhere near any freeway. I was probably exposed to far less air pollution during that pregnancy than at any other time in my life.

December 21, 2010 at 6:39 am
(83) Sandy says:

“The study examined the locations where the children’s families’ lived during the first, second and third trimesters of their mothers’ pregnancies, and at the time of the baby’s birth and looked at the proximity of these homes to a major road or freeway.”
Since the study ages were between the ages of 24 and 60 months at the start of the study and lived in communities around Los Angeles, San Francisco and Sacramento, it would be difficult to determine which was worse, prenatal exposure or exposures once the child was born to how long the families remained living where they did. Exposure to air pollution during the first months of life has also been linked to cognitive developmental delay. However, the authors said that this study is the first to link exposure to vehicular pollutants with autism risk, though direct measurements of pollutants were not made. However one looks at it, this study came out with data of two-fold increase in autism risk for those who did live near a freeway.

December 21, 2010 at 8:27 am
(84) Malia says:

Still, the results given in the abstract seem to be very specific about “maternal residence at the time of delivery” and “during the third trimester.” Their claims seem to suggest that they were able to isolate this period.

(Lisa, some of the links aren’t working for me even today. the second one takes me right back to a different view of this blog article. Not sure why.)

December 21, 2010 at 8:51 am
(85) Sandy says:

Well, the interesting thing about this study again is age of children at the start of the study. Had the study started prenatal and had direct measurements of pollutants were made, more answers could be made.
But since the children were 24 and 60 months at the start of the study, the association was not altered by adjustment for child gender or ethnicity, maximum education in the home, maternal age, or prenatal smoking, however a lot of exposure can happen during the first 2 years of life regardless if you live near a free way or road.

December 21, 2010 at 8:59 am
(86) ANB says:

The study doesn’t control for urbanicity.

December 21, 2010 at 9:00 am
(87) Malia says:

Actually, I haven’t lived within a 1/4 mile of a major roadway since early on in my first trimester. At that time, we did live near a fairly major highway, but it would hardly rate as a freeway and traffic on it at that time was still quite light. I also haven’t lived near any industrial plants since I was a young girl… and even then I think it was probably still more than 1/4 mile away.

Of the many possible causation/risk factors I’ve considered for my son’s autism, air pollution resulting from traffic seems the least likely to me so far. Of course, that isn’t to say it couldn’t be a causation factor for others or that even light pollution couldn’t contain high quantities of some specific toxin that might be the underlying cause of their results.

I’m also curious about the results that suggest that other major roadways would not be a factor. With the city closet to me, air quality nearest the city center is usually far more polluted than in most outlying areas. I would also think that prevailing winds could play a part… potentially making living on one side of a freeway safer than on the other.

Another thought I had… what about freeway noise as a potential cause rather than air quality? Many children with autism do have hearing related sensitivities. I know I’m just speculating here, but I don’t think it’s really too far fetched to suggest that such a sensitivity might conceivably be caused by inutero overexposure to even specific frequencies.

December 21, 2010 at 9:23 am
(88) Malia says:

Sandy, they do specifically say they made adjustments for prenatal smoking.

December 21, 2010 at 9:29 am
(89) Sandy says:

Of me personally, free way pollution wouldn’t be a factor either. I’ve always lived in the boonies and never had city water. However, a year prior to concepting, during pregnancy and a year after, living in the boonies didn’t eliminate the huge crackling power lines that were a block away running for miles across the boonies. But then again, my son’s dad is just like my son, and so is that grandmother so other than genetics, maybe the pollutant of up-wind pig, turkey and cow manure is a trigger.

December 21, 2010 at 9:37 am
(90) Sandy says:

I said “the association was not altered by adjustment for child gender or ethnicity, maximum education in the home, maternal age, or prenatal smoking” which means yes, they did take those things into account and it didn’t altered the results they got.

December 21, 2010 at 10:05 am
(91) Malia says:

Lol Sandy. Interesting that we are both on a rural/well water supply. One thing that did occur in my first trimester was a brief overexposure to a chemical used for getting iron out of well water.

I come from a pretty small family. I would say there have been some familial indications of individual autistic-like traits (even in some very early ancestors); however, my son was the first (and so far the only one in the family) who has had real language development difficulties and notable difficulties in getting through school as a result. It could also be that I fell victim to a common tendency to “see” autistic-like traits in almost everyone when one’s child is diagnosed.

I do suspect he would be the only one in the family who would be diagnosed in our family up to now (i.e. even under the DSM-IV). He was first diagnosed under the DSM-IIIR and this was reconfirmed under the DSM-IV. As I read things, he could potentially lose his diagnosis under the proposed DSM-V.

December 21, 2010 at 10:29 am
(92) Malia says:

Sorry, I misunderstood your post re prenatal smoking.

December 21, 2010 at 11:58 am
(93) Sandy says:

I come from a larger family where as my sons dad is quite small. Through out my mothers family, which is huge, a few of her siblings could had easily been diagnosed with autism or aspergers including my mother. None of my cousins have had issues but I have second cousins which do but no one dares ask the diagnosis. My son is the first to have the diagnosis and severe; but a younger boy was born later just as severe as my son. All boys.

On my sons dads side, there’s only 3 grandchildren, 2 boys and a girl; both boys have IEP’s but a different diagnosis, and when the other boy was being diagnosed and they heard family history and about my son, for some odd reason the were very interested. The 2 boys are only 5 months apart and both lived in the boonies.

Studies like these are interesting, the newest one out there is even more interesting “Scientists find gene clue to 130 brain diseases” which would more personally pertain to my family.

December 21, 2010 at 12:15 pm
(94) barbaraj says:

I’m pasting this morning, because I believe what Davis uncovered last month may be the direction this “highway” study is going. We are discovering , more and more, the real existence of acquired mitochondrial disease, and while “smoking guns” have provided a list of medications, dyes, and other known exposures, we do not know how many more are lurking in our air, water, drugs, vaccines that as yet need to be identified.

“The researchers found that mitochondria from children with autism consumed far less oxygen than mitochondria from the group of control children, a sign of lowered mitochondrial activity. For example, the oxygen consumption of one critical mitochondrial enzyme complex, NADH oxidase, in autistic children was only a third of that found in control children.

http://www.ucdmc.ucdavis.edu/mindinstitute/newsroom/newsdetail.html?key=4765&svr=http://www.ucdmc.ucdavis.edu&table=published

The above is amazing information a 66% decrease in oxygenation in at least one area in autistic children!!

“Because mtDNA is more prone than nuclear DNA to acquired mutations, mitochondrial disease also may be acquired. Transient mutations (most commonly deletions) may be induced by medications such as propofol and nucleoside analogs. Additionally, given the poor repair and replication mechanisms and the oxidative environment of the mitochondria, sporadic mutations of mtDNA occur in everyone. Since these mutations accumulate as one ages, people born with different burdens of mtDNA may reach the threshold for the expression of their disease during infancy, adolescence, or adulthood.

http://chestjournal.chestpubs.org/content/120/2/634.full

Again “burden” being the key word, imo,what toxic overloads are our children experiencing?

continued

December 21, 2010 at 12:16 pm
(95) barbaraj says:

I like the word “prone” however, it rings “genetic” too often, leaving us with blinders on, we need to expand a bit, to consider a “toxic overload” in those that perhaps aren’t “prone” as well as in those who need less to tip their scales.

We need to know what to avoid, clearly killing a dandelion should be off of our spring cleaning list, as that class of chemicals is known to disrupt mitochondria, 48% of the mercury in our bodies can be found bound to our mitochondria. What about our highway toxins, surely among that soup there should be info on each chemical . Yesterday’s city water assessments, chromium 6, take a look at CA!! Autism likely is a mitochondrial disease, and we aren’t up to par in labeling all of the potential threats. Why does it coincide with vaccines? Likely our vaccines are depositing that toxic load that tips the scales in already environmentally exposed children. We continue to need a vax vs unvax’d study to determine if most children can clear their bodies of typical exposures , thus avoiding autism, while vax’d children have been (for lack of a better word) overdosed. jmo

December 21, 2010 at 1:10 pm
(96) Malia says:

I agree barbaraj, but fear that the various toxins have become simply too numerous to isolate… and too imbedded in our environment and our societal economics to eliminate. In addition, while I’m not opposed to vaccines, I also believe that they are not necessarily completely “off the hook” as a possible contributor to autism.

As a result, I do cringe at commercials I see on TV now advertising vaccines for some fairly “minor” issues (such as one I saw this morning for a vaccine against traveller’s diarrhea). I believe vaccines are a powerful and necessary tool against some pretty lethal diseases and that we should be “saving” them to fight the diseases that present the greatest risks to us… particularly if there is any possibility that there is a “threshhold” tolerance related to them. Many antibiotics have become ineffective due to overuse and improper application. I would really hate to see vaccines somehow suffer the same fate.

It seems to me that, when they relate to autism, the studies that are released become highly politicized almost immediately as both pro-vaccine and anti-vaccine advocates mine them for tidbits that either support their position or detract from the opposing side’s position. As I mentioned in an earlier comment regarding the clear variance in language used on the NIMH website to describe autism rates, all this “politicking” concerns me. I think overall it impedes real progress being made on a number of different fronts.

December 22, 2010 at 1:02 am
(97) barbaraj says:

Yes, however the studies are all interesting, the freeway study the vaccinated monkeys, all should serve the purpose of moving forward in identifying a cause and the likely “causes”.
Toxicology has proven, mercury has an affinity to mitochondria a good starting point in proving vaccines play a part. Exposures to freeways proves something is flying off the roadways, not a leap to vaccuum up some particles over time and identify them , or possibly as in the case of our highways, there is “CONSTANT” use of those weedkillers along the grassy areas, the same for power lines, weedkillers are used all along their path,as well. They are known mitochondrial dysruptors. Then the med, the frightening tylenol, that many use like candy. While we fear hepb, tylenol is the leading cause of liver failure in children..and..in children with high iron levels there is synergy involved in the damage. Many pump infants full of iron enriched formula thinking it’s wise, again, probably not. continue

December 22, 2010 at 1:07 am
(98) barbaraj says:

We need to understand the vaccine ingredients, taking out thimerosal and turning toward phenoxyethanol may , just may be replacing one toxin for another.
Should we load our kids up with antioxidants to protect them, probably. The answer to all of this isn’t going to be in debate, or in the studies thrown at us left and right, it’s going to take the retrieval of toxicological studies on individual poisons and determining their effects alone and in combination. When my mother first called chemlawn, the manager told her the name of two chemicals used in their program, when the lawyers subpeonaed the log sheets, there were 32 chemicals in a toxic soup being dumped on lawns all over suburbia. Worse some of the water used was siphoned from nearbye contaminated streams, giving another possible scenario, the possible enhancement of pathogens…and worse yet some of the companies dumped this mix into those same streams at the end of the day. What was happening was not just children showing up with neurological complaints such as seizures, but ER’s clueless to the cause and unable to provide treatment ..how were they to guess that some had organophosphate poisoning and children with waterborne illnesses that had not been near water. Yes, the world has become a toxic place, but we can’t be hopeless, and that’s how I feel when I engage in debate that suggest we can fix it psychiatrically or blame genetics. The funding for autism studies needs to be directed to the toxicologists , imo. To the nerds who believe their superior engineering skills are related, perhaps, yet perhaps the social part of the brain is being depleted of energy allowing for enhancement of the “working part”. No energy, failing mitochondria, just makes sense, but many have more failure and are far worse off.

December 22, 2010 at 8:57 am
(99) AutismNewsBeat says:

We need to understand the vaccine ingredients..

Yes, you do.

December 22, 2010 at 9:31 am
(100) Sandy says:

One interesting part of that comment 94, near the bottom.

“people born with different burdens of mtDNA may reach the threshold for the expression of their disease during infancy, adolescence, or adulthood.”

I would think ‘born with’ are those 2 key words.

December 22, 2010 at 10:20 am
(101) Malia says:

Sandy, I take it then that you see no need to even attempt to control various toxins in the environment since such mutations are inevitable and preordained… written into the genetic code.

December 22, 2010 at 11:00 am
(102) Malia says:

I agree barbaraj, there are many, many variables in all of this that need to be understood. I’m just not sure that merely identifying whatever toxins come off our highways (if vacuumed) is going to get us there. The problem being that the process would probably just reveal a huge toxic soup of so many different chemicals that we won’t ever be able to sift out which exact ones are the culprits or which ones are perhaps even suppressing the effects of other culprits. I sincerely hope it isn’t hopeless, but I certainly fear that it might be.

December 22, 2010 at 11:09 am
(103) Sandy says:

Mary, of course I never said that and it’s quite rude of you to make that comment to me. A better way would had been to outright just ask instead of “I take it”.

Of comment 94 “induced by medications such as propofol and nucleoside analogs”, they are saying “may be induced by medications”. The use of the word ‘may’ isn’t concrete it will, and they’re talking about medications, not toxins. Propofol is a hypnotic agent and nucleoside analogs are a set of antiviral drugs. But it says taking those medications ‘may’ result in a mitochondrial disease, doesn’t mean it will.

So if are people born with different burdens of mtDNA, and have the need at some point in life for chemotherapy, or have acquire hepatitis B or for some odd reason are given a intravenously administered hypnotic agent, I’d guess there’s side effects no matter what you may be born with. But I’d imagine you’d need drug intervention if you had hepatitis B regardless.

As for the link about New Study Links Mitochondrial Issues and Autism, that was covered here November 30th, and that study included 10 children. That 66% decrease in oxygenation of course doesn’t speak of all those with an autism diagnosis nor does that study point to cause, either.

December 22, 2010 at 11:31 am
(104) Malia says:

Sandy, I said it not to be rude, but because I felt that your comment to barbaraj was a little rude and ultiamately unclear… It seemed to me that her main point was that we need to investigate environmental impacts on genetics further, and with such a short “snippet” of a retort, I couldn’t follow just exactly where you were intending to take the discussion. I simply don’t have ESP. Your second post is much clearer. Thank you.

December 22, 2010 at 11:46 am
(105) Sandy says:

Whatever barbaraj’s point was, I was talking about the main point of the link and of course not adding toxins to it. Not sure why anyone would think that was rude or unclear, or why born with different burdens of mtDNA wasn’t an important factor to the copy and pasted info. The fact is, if you are born with, it just may be inevitable that sometime during life, a disease during infancy, adolescence, or adulthood the disease might shows up. But the idea of that ‘acquired’ mitochondrial diseases, you still have to be born with burdens of mtDNA. The only thing we do know is, from that link, is if you’re not born with different burdens of mtDNA, the chances of a disease is far less, regardless of the repeated implications of vaccines.

December 22, 2010 at 11:53 am
(106) barbaraj says:

It would seem unlikely that any child born in the modern toxic environment is born without any mitochondrial stressors. ..and maybe the degree of future exposures could take any one of them over the edge, (not likely an immunity to poison). If bilirubin wouldn’t affect the brain’s mitochondria why would we bother to treat it? Honest question, as I don’t know.

December 22, 2010 at 12:20 pm
(107) Sandy says:

Of course the newest study from a few days ago which I keep bringing up “Set of Proteins Account for Over 130 Brain Diseases” which include diseases such as Alzheimer’s disease, Parkinson’s disease, epilepsy and forms of autism and learning disability, from an article
http://www.sciencedaily.com/releases/2010/12/101219140817.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29

“The team examined the rate of evolution of the PSD proteins over millions of years of mammalian evolution, expecting the proteins to evolve at the same rate as other proteins. In a fascinating and unexpected twist to the story, the team found that the PSD proteins changed much more slowly than expected, revealing that the PSD has been highly conserved or constrained from changing during evolution.
“The conservation of the structure of these proteins suggests that the behaviours governed by the PSD and the diseases associated with them have not changed much over many millions of years,”

So the idea of a toxic modern world may play a very small role in mitochondrial as related to autism. I cant assume what a child born would be born with or without however in comment 95, it clearly states “people born with different burdens of mtDNA” so I wont and cant assume that came from a toxic world or vaccines, and that link also mentions “Alzheimer’s disease, Parkinson’s, just as Set of Proteins Account for Over 130 Brain Diseases mentions them.

December 22, 2010 at 12:48 pm
(108) barbaraj says:

But does the study address the chemical/drug damage done to these proteins? Within only one little comment..The findings provide deep insights into how a DNA mutation can impact on fundamental aspects of our behaviour. So back to here we are, lets study “similar” rats..which has always sounded like a good idea to me.

Let’s look at those vaccine ingredients, and clear them as suspects first!

dtap (infanrix):aluminum hydroxide, bovine extract, formaldehyde ,glutaraldhyde, 2-phenoxyethanol, polysorbate 80

dtap-hepb-ipv (pediarix) aluminum hydroxide, bovine protein, lactalbumin hydrolysate, formadehyde or formalin, glutaraldhyde, monkey kidney tissue, neomycin, 2-phenoxyethanol, polymyxinb, polysorbate 80,yeast protein

mmr : amino acid, bovine albumin,chick embryo fibroblasts, human serum albumin, gelatin, glutamate, neomychin, phosphate buffers, sorbito, sucrose, vitamins

here’s one msds..note ..many risks are unknown!
http://www.sciencelab.com/xMSDS-2_Phenoxyethanol-9926486

December 22, 2010 at 12:58 pm
(109) Sandy says:

Let’s not look at vaccine ingredients. They didn’t have to and vaccines is quite limited to the large scope of things:

“The conservation of the structure of these proteins suggests that the behaviours governed by the PSD and the diseases associated with them have not changed much over many millions of years”

This study about free way pollution of course has nothing to do with vaccines, either.

December 22, 2010 at 1:51 pm
(110) Malia says:

“Not sure why anyone would think that was rude or unclear, or why born with different burdens of mtDNA wasn’t an important factor to the copy and pasted info.”

However, I’m quite certain that it IS rude to imply that someone else is uniquely stupid.

December 22, 2010 at 2:00 pm
(111) Malia says:

I make no apologies for finding the statement vague and unclear.

December 22, 2010 at 2:02 pm
(112) Malia says:

… or for finding short, vague statements to be “a little rude.”

December 22, 2010 at 2:26 pm
(113) Sandy says:

Mary, odd, ANB made a comment even shorter than mine and that didn’t seem to bother you. Why is it you pick at mainly my comments? You’re always making my comments what they are not, be it intentional or not but it seems to be that I am always your target. And yes, “I take it then that you see no need to even attempt to control various toxins in the environment” had nothing to do with what anyone else had to say; I noted it wasn’t a question (no question mark was included. It was a statement you made about me without any reference to anyone else, which appeared you did have ESP. I also never said you were stupid, either and if that’s what you think my comments means, you run with it. I wont stop you.

You make this personal towards me, and it’s not fair that you do and it so takes away for any attempt of a discussion.

December 22, 2010 at 3:23 pm
(114) Lisa Jo says:

Hi, guys. Do you want me to end comments here? Seems like the conversation is disintegrating a bit…

Lisa

December 23, 2010 at 8:48 am
(115) Malia says:

Sandy, ANBs comment contained nothing worth inquiring about in order to try to understand. As I explained, I made my initial comment on your comment not to be rude but to try to ascertain what point it was you were trying to make. You clarified your position in your response and I did thank you for that. How does that constitute picking on you?

December 23, 2010 at 9:03 am
(116) Malia says:

Lisa, From my point of view, I would prefer you not end the comments right now. I would sincerely like to work this discussion through and don’t feel that the language or tone is truly out of line at this point.

Sandy, I became upset the next post ONLY because it contained the sentence I quoted, which does seem to clearly imply that I misunderstand things in ways no one else on the planet is capable of (i.e. that I’m somehow “uniquely stupid.”) ANB’s comment was not about me, yours was – so again, I have to ask, how does responding to that constitute picking on you? How did inserting that sentence about me advance your point? (which was, IMO, a rather good one… once I understood it properly).

December 23, 2010 at 10:45 am
(117) Malia says:

“I also never said you were stupid, either and if that’s what you think my comments means, you run with it. I wont stop you.”

I also think this one winds up being just a rude comment and I have to wonder who’s picking on who.

December 23, 2010 at 10:49 am
(118) autism says:

I’m going to end comments here.

Happy Holidays!

Lisa

December 23, 2010 at 10:49 am
(119) Twyla says:

Regarding genetic causation, see:

The Great DNA Data Deficit: Are Genes for Disease a Mirage?
The Bioscience Resource Project
8th December 2010
“We can reiterate that according to the best available data, genetic predispositions (i.e. causes) have a negligible role in heart disease, cancer, stroke, autoimmune diseases, obesity, autism, Parkinson’s disease, depression, schizophrenia and many other common mental and physical illnesses that are the major killers in Western countries.”
http://www.bioscienceresource.org/commentaries/article.php?id=46

Leave a Comment

Line and paragraph breaks are automatic. Some HTML allowed: <a href="" title="">, <b>, <i>, <strike>

©2012 About.com. All rights reserved.

A part of The New York Times Company.

We comply with the HONcode standard
for trustworthy health
information: verify here.