Editor’s note: The following article was originally published in NUVO, Indianapolis’ alternative newsweekly. Since its publication on March 4, 2009, a study from the University of Northern Iowa has found children living within 10 to 20 miles of toxic waste sites in Minnesota to have twice the rate of autism as children living farther away.
When it comes to autism and the release of toxic chemicals into the environment, Hoosiers play second fiddle to no one.
A 2008 article titled “Increasing Incidence of Autism Spectrum Disorders Continues in Indiana” noted that Indiana’s autism rate is above the 1 in 150 children that the Centers for Disease Control (CDC) found in a 2007 study.
"Last year 1 in 128 students were served under the eligibility category of autism spectrum disorders," Indiana Resource Center for Autism (IRCA) Director Cathy Pratt wrote. "This year's identification rate is 1 in 113."
On the Trail: Autism and the Environment
A journalistic journey into autism and industrial chemicals
According to the U.S. Environmental Protection Agency (EPA), Indiana industries, utilities and governmental facilities released 266 million pounds of toxic chemicals into the air, land and water in 2006. Only Alaska, with 18 times the land mass, and Ohio, with 181 percent the population, released more than Indiana.
"The incidence of autism has risen dramatically since the anti-environmental Reagan Revolution of 1980."
And if the proposition of Philippe Grandjean from the Harvard School of Public Health and Dr. Philip Landrigan from the Mount Sinai School of Medicine proves correct, these two realities may be more than coincidence.
They co-authored a paper published in the November 2007 issue of the British medical journal The Lancet that addressed the role of toxic chemicals in “neurodevelopmental disorders” like autism, attention-deficit hyperactivity disorder (ADHD), cerebral palsy and mental retardation.
“The researchers found that 202 industrial chemicals have the capacity to damage the human brain,” a Harvard news release said, “and they conclude that chemical pollution may have harmed the brains of millions of children worldwide.”
Autism is not a disease, rather, it’s a band of neurodevelopmental abnormalities called Autism Spectrum Disorders (ASDs). The CDC says citizens with ASDs “have significant impairments in social skills and communication. They often have repetitive behaviors and unusual interests.”
The incidence of autism has risen dramatically since the anti-environmental Reagan Revolution of 1980.
In 2001, the Journal of the American Medical Association published a study from the California Department of Health Services that said the incidence of children with ASDs increased 373 percent, from 1980 to 1994, from 0.44 cases per 1,000 live births to 2.08.
In 2007, the CDC published two studies that put the rate among 8-year-olds at 6.7 and 6.6 cases per 1,000, or 1 in 150. Researchers reviewed records of children born in 1992 and 1994.
The first study analyzed data collected in 2000 from six states. The second expanded the sample to 14 states in 2002. Neither included Indiana.
"Indiana ranks 17th in the nation in the release of mercury and mercury compounds, with 10,071 pounds reported in 2006."
Comparing the CDC’s data with California’s, autism incidence rates increased 1,422 percent between 1980 and 2002, and 222 percent between 1994 and 2002.
The IRCA is part of IU-Bloomington’s Indiana Institute on Disability and Community. Pratt, who also serves as the board chair for the National Autism Society of America, noted in her article that the organization cannot quantify how many Hoosiers are autistic. "No database exists of the actual numbers of people on the autism spectrum," she wrote.
However, Indiana school districts that receive state funding must report to the Indiana Department of Education how many students receive special education and their diagnoses. Based on the “2007-2008 Child Count Data,” autism is particularly prevalent among Hoosier families.
The data say 7.8 in 1,000 Indiana students had ASD diagnoses in 2007. The figure jumped to 8.8 in 2008.
Of the 14 states studied by the CDC, only New Jersey’s 10.6 per 1,000 autism incidence rate was higher than Indiana’s.
Landrigan, a Harvard-trained pediatrician, professor and chair of Community and Preventive Medicine at the Mount Sinai, specializes in the study of industrial toxins and their impacts on human health. PBS journalist Bill Moyers introduced him on a May 10, 2002, edition of NOW:
“Dr. Phil Landrigan is a renowned expert on environmental health and pediatrics who has worked to translate science into public policy and introduce children's environmental health into mainstream medical education,” Moyers said.
A professor of pediatrics and director of Mount Sinai’s Children’s Environmental Health Center, Landrigan has studied the impacts of industrial toxins on children since the 1970s. He has long characterized the release of tens of thousands of industrial chemicals into the environment as a “massive, toxicological experiment, with our children and our children’s children as the experimental subjects.”
In an unpublished essay titled “Emerging Technologies,” intended to be a chapter in the forthcoming third edition of the American Academy of Pediatrics' Handbook on Children's Environmental Health, Landrigan writes about the profoundly transformed environment future generations will inherit.
“Today, there are more than 80,000 chemicals registered for commercial use with the U.S. Environmental Protection Agency,” he wrote. “Most of these chemicals are new synthetics, and nearly all have been invented in the past 50 years. They did not exist previously in nature.”
EPA’s Toxic Release Inventory (TRI) measures the release of “nearly” 650 of these chemicals into the air, water and land each year, according to the agency’s TRI Program Fact Sheet. These releases are self-reported annually by regulated industries and facilities, including manufacturing, coal mining and electric utilities.
The primary means by which chemicals are “released” include disposal in landfills, injection into underground wells and escape into the air and water. Hoosier industries, utilities and government facilities reported 266 million pounds of TRI chemicals released in 2006.
Indiana’s most toxic county is Spencer, known as Abe Lincoln’s childhood home, where his mother died and is buried, and for a Holiday World amusement park in a town named Santa Claus.
Located just east of Evansville on the Ohio River, Spencer County is also home to two world-class polluters -- AK Steel and American Electric Power (AEP). Together, this modern steel plant and antiquated, coal-fired electric power plant release more than twice the pollution of the environmentally infamous Lake County and its neighbor, the city of Chicago, combined.
AK Steel and AEP reported combined releases of 36.77 million pounds of TRI chemicals in 2006. All Lake County industries collectively reported 15.35 million pounds. Cook County, Ill., reported 11.85 million pounds.
Autism’s cause is unknown. In its 2007 study, the CDC noted: “The complex nature of these behaviorally defined disorders, together with the current lack of genetic or biologic markers for early and consistent identification, make epidemiologic investigation challenging.”
"Mercury emissions from power plants are considered the largest (man-made) source of mercury released to the atmosphere.”- Indiana Geological Survey
Since the late 1990s, concerns about a link between autism and childhood vaccines like the measles, mumps and rubella (MMR) have spawned debate.
A British gastroenterologist published a paper in The Lancet in 1998 proposing a link between the MMR vaccine and autism. He suggested that interaction between viruses in the vaccine could lead to possible brain damage and ASDs.
The National Institute of Child Health and Human Development reported that other studies in England and Sweden in 1997, 1998 and 1999 found no link. The Lancet later called the British study “fatally flawed” on a number of grounds, including sample size.
In 2000, the Institute of Medicine (IOM) at the National Academy of Sciences found “the evidence reviewed did not support an association between autism and the MMR vaccine.”
A London Times investigative report published in February found the British researcher “changed and misreported results in his research, creating the appearance of a possible link with autism” in the 1998 study.
The vaccine debate, however, reinforced Landrigan’s point that industrial toxins are omnipresent in the environment.
Central to the vaccination arguments was a preservative called thimerosal, which is “a mercury-containing organic compound,” according to the U.S. Food and Drug Administration (FDA). “Since the 1930s, it has been widely used as a preservative in a number of biological and drug products, including many vaccines.”
"The scientists identified an area in southeastern Indiana where high mercury concentrations in the rain had contributed to some of the highest mercury deposition in the U.S."
- U.S. Geological Survey
In mercury-poisoning incidents in other countries, the U.S. Department of Health and Human Services (HHS) says, people who ate fish or grains contaminated with methylmercury or other mercury compounds developed permanent damage to the brain and kidneys. “Permanent damage to the brain has also been shown to occur from exposure to sufficiently high levels of metallic mercury,” HHS says.
The FDA’s inability to say whether the mercury in thimerosal posed a threat to the developing bodies of children reinforces another of Landrigan’s long-held arguments -- of the 80,000 chemicals out there, little is known about their toxicities.
By weight, thimerosal is 50 percent ethyl-mercury. But guidelines for acceptable mercury exposure are based upon studies on methylmercury.
“There is, therefore, an uncertainty that arises in applying the methylmercury-based guidelines to thimerosal,” FDA says. “Lacking definitive data on the comparative toxicities of ethyl- versus methylmercury, FDA considered ethyl- and methylmercury as equivalent in its risk evaluation.”
As a precaution, the Public Health Service agencies, the American Academy of Pediatrics and vaccine manufacturers agreed in 1999 that thimerosal should be reduced or eliminated in vaccines, the CDC says on a Web page titled “Mercury and Vaccines (Thimerosal).”
“Since 2001, with the exception of some influenza (flu) vaccines, thimerosal is not used as a preservative in routinely recommended childhood vaccines,” the CDC says.
Methylmercury is among the TRI chemicals that the Grandjean-Landrigan study says could contribute to developmental disorders like autism and ADHD. Others are lead, arsenic and toluene.
In 2006, Indiana facilities released 7.78 million pounds of lead and lead compounds, 2.85 million pounds of toluene and 811,884 pounds of arsenic and arsenic compounds into the environment, according to the TRI database.
Indiana ranks 17th in the nation in the release of mercury and mercury compounds, with 10,071 pounds reported in 2006. More than a third of these emissions -- 3,739 pounds -- came from Southwest Indiana power plants.
Mercury is a chemical component of coal and is released into the air during combustion and into the water in coal ash after burning.
“Mercury emissions from power plants are considered the largest (man-made) source of mercury released to the atmosphere,” according to a 2007 paper titled “Mercury Content of Indiana Coals” from the Indiana Geological Survey (IGS).
Although the elemental mercury emitted from coal-fired power plants is not considered harmful, it can transform into methylmercury, which “can become concentrated in fish and birds, and from there enter the human body,” the IGS paper said.
Lead and arsenic are also byproducts of coal combustion.
In Indiana public schools, more than one in six – 17.8 percent – received special education last year, according to the Child Count data. The 2007 Grandjean/Landrigan study puts the incidence of neurodevelopmental disorders at one in six children. And they say a new direction in U.S. environmental policy based on precaution is overdue.
"After two years of the Republican Mitch Daniels administration, (toxic chemical) releases in Indiana grew to a 15-year high in 2006 -- 145 million pounds."
“The Precautionary Principle needs to be the bedrock of this new national framework,” Landrigan writes in the “Emerging Technologies” essay. “The key element of the Precautionary Principle is that it provides justification for acting in the face of uncertainty. It is a tool for acting on the basis of early warnings.”
The Precautionary Principle shifts the burden such that chemicals are no longer presumed safe until proven dangerous, Landrigan writes.
Grandjean is known for his work in neurotoxicity. In an e-mail, he cited the confusing evidence on the causes of autism and other types of abnormal brain development as justification for precautionary approaches to controlling chemicals that can damage the brain.
Vaccines serve a beneficial purpose, he wrote. “But they should nonetheless be safe.”
The failure to link vaccines and autism “should not generate an erroneous impression that environmental factors are without importance,” he wrote. Nor should the lack of documentation “be misunderstood as an indication that environmental chemicals play no role.”
Precaution has never been a hallmark of Indiana environmental policy, as historical TRI data clearly show, regardless of which party is in power.
When Democratic Lt. Gov. Frank O’Bannon was elected to replace Democratic Gov. Evan Bayh in 1996, Indiana reported 95 million pounds of chemical releases into the environment, according to the TRI database. When O’Bannon was re-elected in 2000, the total grew to 102 million.
"In Indiana public schools, more than one in six – 17.8 percent – received special education last year, according to the Child Count data."
When 16 years of Democratic governors ended in 2004, the state reported releases of 136 million pounds. After two years of the Republican Mitch Daniels administration, TRI releases in Indiana grew to a 15-year high in 2006 -- 145 million pounds.
On Jan. 5, the U.S. Geologic Survey (USGS) released a study of mercury in precipitation in Indiana in 2004-2005.
“The scientists identified an area in southeastern Indiana where high mercury concentrations in the rain had contributed to some of the highest mercury deposition in the U.S.,” according to the USGS. “The maps indicate that high annual mercury emissions in the area may be an important factor affecting mercury concentrations in precipitation.”
Like Southwest Indiana, Southeastern Indiana around Madison is home to coal-burning electric power plants.
Meanwhile, a study in the January 2009 issue of the journal Epidemiology says the rise in autism rates in California cannot be explained by changing diagnostic or counting techniques.
"It's time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism," University of California-Davis researcher Irva Hertz-Picciotto told Medical News Today.
Steven Higgs can be reached at .
For more information
- On the Rise -- NUVO
- Ockham's Razor and autism: The case for developmental neurotoxins contributing to a disease of neurodevelopment -- University of Northern Iowa
- Genetics + Environmental Chemical Soup = Autism? -- American Association for Health Freedom
- Autism Spectrum Disorders and Identified Toxic Land Fills: Co-Occurrence Across States -- Generation Rescue