Tuesday, October 10, 2006

Autism in the Faroe Islands

I was directed to this today:

1. Ellefsen, A., Kampmann, H., Billstedt, E., Gillberg, I. C., Gillberg, C. (2006). Autism in the Faroe Islands. An Epidemiological Study. Journal of Autism and Developmental Disorders. [Electronically published ahead of print]

The rate of .56% of the population translates to 56 per 10,000. This is well within the margin of error as the rate in the US, Canada, and the UK (60 per 10,000).

This is a “genetically distinct population” in a northern Europe. Their diet consists mostly of meat, including mutton, fish, and whale meat/blubber. Whale meat is known to be extremely mercury
heavy.

This is reminiscent of in terms of fish and even whale meat intake to:

E, Fombonne., J, Morel., J, Macarthur. (2006). No Autism Amongst Inuits From Northern Quebec. Paper Presented at IMFAR. June, 2006.

Except that Fombonne et al. found no autism in Inuit population (which is also genetically distinct), but who have excellent health care including full vaccines. It was argued the Inuits (a closed population) may have developed a natural and high, self-chelation ability. Unfortunately this is not shown by any research and it is a dogmatic fallacy, almost a Lamarckian fallacy, to claim that because it would make sense for a population to develop a given trait, that they actually have.

This may not be a "nail in the coffin", but it is defiately getting harder and harder to ascribe the potential "epidemic of autism" to mercury.

15 Comments:

Anonymous Mimi said...

One is starting to feel sorry for the law firm of Waters & Kraus... or not.

7:36 PM  
Blogger Joseph said...

The difference with the Inuit study is that this one was a full screening of all school children of a certain age. In fact, I'm a bit surprised they didn't find more like 1% of children with ASD. It would be interesting to know what the administrative prevalence was in the island before the screening, just to once again have a clear picture of how easily ASD can be missed.

7:45 PM  
Blogger María Luján said...

Hi Jonathan
I commented about your post in Autismweb.
Thanks

9:33 PM  
Blogger Interverbal said...

Maria: Hi, my answer is up.

Mimi: I don't feel sorry for them at all.

Joseph: (crinkles forehead) You know, I am also suprised that there wasn't a greater prevalence. I am also surprised that seems to be almost no difference at all. The scores are almost absurdly close.

I try to keep an open mind about what the epi shows in autism, but man, the game seems almost over in terms of the epi.

This research backs up Fombonne and shuts down the criticim of his Inuit research. What do you think?
I have never felt the thimerosal etiology theory was so weak as I do right now.

9:48 PM  
Blogger María Luján said...

Hi Jonathan
The "thimerosal theory" such as it was proposed has been discarded as SUCH as a CAUSAL theory. That is. For me only in very very few cases thimerosal ONLY produces autistic traits in an non-autistic child. Other point is the impact of HM/xenobiotics in an autistic person. BUT the thimerosal came in vaccines therefore there is no way to separate the whole effect in susceptible children of the overall composition. Even more, if 5-20 genes are involved, why Heavy metals from ALL sources are going to be discarded=Pb, Cd, As and others such as Al (that we all ingest a lot in the food and other OTC medicines)?And why if vacines are going to be considered- and therefore the immune system would be the target other things known to affect the immune system are not going to be problematic- what about antibiotics, immunodepression, autoimmunity processes? And therefore I return to my point.
If a careful clinical study of the transport of xenobiotics /heavy metals/Al in the body PLUS the excretion HM metabolic paths-BOTH in genetics and metabolism and biochemistry- would be present or under development in autistic people, I consider we would have more clues. If more careful clinical studies would be present about autistic people immune system more profoundly - Dr P. Ashwood is I think a good example of this kind of studies- more clues would be present. If more careful studies-clinical- about the GI problems in autistic people and their interaction with immune systems- and the importance of the interaction with the CNS more clues would be present. If the impact in the neurophysiology of the brain- more than the structure- of all this is going to be studied more carefully more clues would be present.
The point for me is not to study the 300000000 potential stressors, but to focus in the autistic person and his/her physical health, immune system, GI issues, neurotransmiter issues, HPA axis problems, if present - to understand and to improve his/her life´s quality because you are not going to touch genes, but you can test/diagnose/treat the results of the interaction of the expression of the genes with the envirome.
María Luján

4:35 AM  
Blogger Joseph said...

The "thimerosal theory" such as it was proposed has been discarded as SUCH as a CAUSAL theory.

It is obviously discarded as an epidemic theory. I bet not even Blaxill would suggest right now that an increase in thimerosal exposure explains the autism epidemic.

Once it is discarded as an epidemic theory, I'd ask, why are we even looking at it as possible causative or contributing factor? What is its merit compared to any other toxin?

BTW, I think the epidemiology doesn't even support the idea that thimerosal contributes in the least. It's basically a non-factor.

8:23 AM  
Blogger María Luján said...

Hi Joseph
Sorry I disagree.
How do you know, with the lack of knowledge about transport of HM and Al and excretion paths in autistics if Hg, Pb, Cd, As and Al have not a role as collaborators in the symptomatology, even if the mechanism is unknown and even if the information is anecdotic?
We do not know, simply.
therefore, I consider that nothing can be discarded. For me what is a POTENTIAL factor is Hg ( whatever the form) and in this sense thimerosal is an item in the long list of forms of Hg : inhalated, ingested or injected. What about all the forms of all the others, for example? What about speciation and synergy? What about polymorphisms studies about transport and excretion??
What about accumulation with other immune problems?
María Luján

8:32 AM  
Blogger notmercury said...

Everything is a potential factor
Maria. Instead of discarding it we need to recognize that it never should have qualified as causative factor to begin with.

Or as you say "We do not know, simply." but that doesn't mean it can't be considered at some point in the future should some new and compelling evidence arise.

8:45 AM  
Blogger Joseph said...

How do you know, with the lack of knowledge about transport of HM and Al and excretion paths in autistics if Hg, Pb, Cd, As and Al have not a role as collaborators in the symptomatology, even if the mechanism is unknown and even if the information is anecdotic? We do not know, simply.

How do you know that any element in the periodic table does not have a role in the symptomatology? Maybe each one should be looked at and ruled out.

If the epidemiology doesn't show anything significant, I think it's important to move on.

8:53 AM  
Blogger María Luján said...

Hi Joseph
Sadly, you miss my point, as many other times.
I am talking about strong candidates and not the full PT.
This kind of argument are not respectful TO ME, Joseph, nor useful or productive, but if you like them it is up to you.
If the epidemiology doesn´t show anything significant it can be because the right epidemiology has not been done, considering the potential confounders. With the lack of knowledge about proteomics and metabolomics in ASD I do think it is the case. Genetic epidemiology is much stronger in nature to this kind of studies.
I think that I will not continue to this thread. It is time to stop, for me.

Thanks for your time.
María Luján

9:53 AM  
Blogger notmercury said...

Maria,
I don't see Joseph comments as disrespectful at all. Good science requires good criticism and whatever it is that you are proposing is too vague to evaluate in a critical fashion.

What is the theory and is it falsifiable?

11:31 AM  
Blogger Interverbal said...

Folks,

This blog will have no moderator, peoples comments are a testament to the quality of their thought, at that time, so they will not be removed (hoping I don’t regret that).

Maria,

I disagree that Joseph crossed any lines. In fact I have never known him to do so. At no point did Joseph comment about you personally. He did not even show contempt for the idea you offer. He did question however it and is welcome to do so.

This is a science/skepticism blog, debate is inevitable and will occur here. Whether or not one participates here is up to them, they are welcome to do so, if they so choose; or not, as they like.

12:10 PM  
Blogger Ian Parker said...

Jonathan wrote:

"Except that Fombonne et al. found no autism in Inuit population (which is also genetically distinct), but who have excellent health care including full vaccines."

I'm curious as to whether this is the first time ever that anyone has stated that the Inuit have access to excellent health care (other than those who have a responsibility for actually providing said care).

6:37 PM  
Blogger Interverbal said...

Hi Ian,

to my knowledge "yes". They do have all the vacciens up to date seemingly at the very least.

10:52 PM  
Blogger Ian Parker said...

Hi Jonathan,

No dispute on the vaccines. It is the word 'excellent' in relation to the overall quality of Inuit health care that I would question.

11:30 PM  

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