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疫苗與環境對兒童健康之影響
 

疫苗與環境對兒童健康之影響

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Vaccines, Environment & Children Health

Vaccines, Environment & Children Health

Louis Lee

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    疫苗與環境對兒童健康之影響 疫苗與環境對兒童健康之影響 Presentation Transcript

    • Vaccines, Environment & Children Health Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 1
    • 李德初 , MD,MBA,ND, MIFM,FCPM, HMD 中華民國外科專科醫師 &( 會員 ) 中華民國急診醫學科專科醫師 英國自然醫學醫學院遠東區總教長 - CMNUK(FA) Chief Rector 美國自然醫學專科醫師 , 美國自然醫學會遠東 區教授 Microcosm University. Visiting Professor 教授  中華民國急救加護醫學會專科醫師  美國 Institute For Functional Medicine 研究員  高雄醫學大學醫學系 .  英國 LEICESTER UNIVERSITY, MBA  美國中醫藥針灸研究所 AACC 研究員 Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.  美國 WEIMAR INSTITUTE 預防醫學研究員 2
    • 李德初 ,M D,M BA ,ND,M IFM ,FCPM • 現任中華功能醫學研究機構 H.Y.C. 院長 • 現任台北宏恩醫院急診、重症醫學顧問醫師 • • • • 現任功能性醫學會顧問醫師 前任赫尼曼自然醫學診所院長 前任台北振興醫學中心急診、重症醫學特約主治醫師 前任行政院衛生署台北醫院主治醫師 • • • • 前任安法水蓮抗衰老預防醫學負責醫師 前任台北宏恩醫院急診、重症醫學主任醫師 復興廣播電台生活廣播網 中華能量医學學會理事 • 前任基督復臨安息日會台安醫院 NEWSTART 負責醫師 Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 3
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 4
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 5
    • 100.00% 90.00% Milk Egg white york Egg 80.00% Gluten Peanut Soy bean 70.00% Cheese 60.00% Goat Milk 50.00% Almond Wheat Eel Yorget 40.00% Pineapple Grapefruit 30.00% Rice Yeast 20.00% Green bean Cod Kidney Bean 10.00% M ilk Ch ee Eg se gy ork Gl ute n Yo rg et Ye as t Co d W he at Pe an Ki ut dn ey Be an 0.00% Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. Milk Goat Milk Cheese Egg white Egg york Almond Gluten Grapefruit Yorget Soy bean Yeast Eel Cod Pineapple Wheat Rice Peanut Green bean Kidney Bean 6
    • Avoid the allergic Foods & Detoxify the Antibodies 1. 2. 3. 4. 5. 6. Dairy products Egg ( York & white) Gluten Peannut Soy Almond Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 7
    • • • • • • • • • Wheat Eel Cod Grapefruit Pineapple Rice Green bean Kidney bean Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 8
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 9
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 10
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 11
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 12
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 13
    • 90% 鉛Pb 80% 70% 60% 砷As 銻Sb 汞Hg 錫Tn 50% 鋁Al 40% 30% 20% 10% 鎘Cd 鎢Tw 鉍Bi 鎳Ni 鈦Ti 銀 0% Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 鋁Al 銻Sb 砷As 鉍Bi 鉛Pb 汞Hg 鎳Ni 錫Tn 鈦Ti 鎘Cd 鎢Tw 銀 14
    • Where are the toxic from? Jul.15.2008 • • • • • • • • • Pb Hg Al Sb As Ba Bi Cd Ni Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 15
    • OFFICIAL STATEMENT: US Centers for Disease Control and Prevention (CDC) • “Mercury occurs naturally and is found everywhere in the environment.” • “The level of mercury exposure from vaccines is low.” • “Evidence is accumulating of lack of harm resulting from exposure to thimerosal in vaccines.” Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 16
    • Mercury and Vaccines (Thimerosal Thimerosal is a mercury-containing preservative used in some vaccines and other products since the 1930s. There is no convincing scientific evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site. However, in July 1999, the Public Health Service agencies, the American Academy of Pediatrics, and vaccine manufacturers agreed that thimerosal should be reduced or eliminated in vaccines as Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. a precautionary measure.---CDC Jul.15.2008 17
    • Since 2001 • , with the exception of some influenza (flu) vaccines, thimerosal is not used as a preservative in routinely recommended childhood vaccines --CDC Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 18
    • 本則新聞由中時電子報提供 2008/06 04:16 • 國人使用俗稱「銀粉」的「汞齊」( Amalgam )補牙行之多年 ,但近年相關研究顯示,人體長期攝入汞齊,將導致罹患阿茲海 默症風險大增。衛生署長林芳郁昨天表示,將指示所屬針對相關 問題進行專案研究,若證實汞齊對人體有害,不排除全面禁用。  立委賴士葆昨天在立法院質詢衛生署長林芳郁,他說,相關資 料顯示,健保目前補助民眾補牙用的醫療用素材包括汞齊、樹脂 、玻璃離子體,推估國內至少有四分之一牙醫師用汞齊為患者補 牙。 •  他說,汞齊中除了銀、水銀,還有錫、鋅、銅等重金屬,其中 水銀亦即汞的含量,至少就占了五成。  衛生署官員指出,汞齊 對人體的危害性在國外一直有爭議,歐美等國已有許多牙醫師推 行「除汞運動」,瑞典更早在多年前就禁用汞齊補牙。美國食品 暨藥物管理局(FDA)日前也宣布,即日起就汞齊補牙的安全 性廣徵各界意見,預訂明年七月就是否修改汞齊使用規範,作出 結論。  衛生署藥政處長廖繼洲表示,目前相關研究僅知汞齊 可能對人體有神經毒性,若FDA證實汞齊補牙對人體有害,進 而宣布全面禁用,我國也會跟進。現階段他建議,六歲以下兒童 、孕婦、哺乳婦女及免疫不全患者,最好能使用汞齊以外的材質 補牙。  他強調,至於已用汞齊補牙者,也不須刻意敲掉,因 為重做填牙的過程中,患者吞入碎裂汞齊的機率可能更大。 19 Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
    • Presentation 1/11/05 Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 20
    • • FAMILIES: KEY TO THIS STORY • SCIENCE PART I: CAUSES OF AUTISM • LAW: COMPENSATION, LITIGATION, INVESTIGATION • POLITICS: PHARMA & THE FEDS • SCIENCE PART II: SEARCH FOR A “CURE” Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 21
    • THE SCIENCE: SEARCH FOR A CAUSE The etiology of autism Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 22
    • AUTISM BY THE NUMBERS: US & EUROPE • • • • USA - 1980’s: 1-2 per 10,000 children USA – Late 1990’s: 1 in 500 (20 per 10K) USA – 2000: 1 in 250 (40 per 10K) USA – 2004: 1 in 166 (60 per 10K) ------------• UK – 2004: 1 in 166 (60 per 10K) • Denmark – 2004: 1 in 1,300(7.7 per 10K) Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 23
    • OTHER POSSIBLE ENVIRONMENTAL “TRIGGERS”?? • • • • • • • • Mercury in fish/air/amalgams Pesticides PCB’s Flame retardants Jet fuel Live virus in vaccines (MMR) As-yet unidentified virus Rampant cell phone use Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 24
    • KNOW YOUR MERCURY (Hg) TYPE SOURCE EXPOSURE Elemental Hg Thermometers Vapor Amalgams Lights/batteries Inorganic Hg (hydrophilic) Coal power plants Volcanoes Air pollutants Organic Methyl Hg (lypophilic) Fish Ingestion Organic Ethyl Hg (lypophilic) Thimerosal Fish(?) Jul.15.2008 Vaccines OTC Topicals Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 25
    • ETHYL VS METHYL • Main chemical difference: Ethyl form contains extra carbon compound on molecule, making it larger. • Some scientists contend extra carbon compound makes ethylmercury less likely to cross the blood-brain barrier. • Methylmercury shown to remain in blood longer than ethyl (1/2 life of 50 days vs. 7 days for ethyl); it accumulates more readily in the body. But ethyl converts more readily to inorganic Hg, which appears to remain in brain longer. • Despite these differences, FDA researchers assumed that the two forms of mercury were equal in toxicity. • Arsenic is “less toxic” than cyanide. Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 26
    • HOW MUCH Hg IS TOO MUCH? EPA SAFETY LIMIT: 0.1 mcg* per kg per day (Methylmercury) Avg. 6oz TUNA STEAK (@17mcg/oz): 102 mcg Avg. 6oz SWORDFISH STEAK (@30mcg/OZ) 180 mcg Avg. VACCINE: 25mcg ________________ EPA SAFETY LIMIT FOR: 165 lb man = 8 mcg/day 110 lb woman = 5mcg/day 16 lb infant = 0.7mcg/day (6 Months old) Tuna 12.8x 20.4x -- 22.5x 36.0x -- Swordfish Vaccine 3x 5x 35.7x *1mcg = 1 millionth of a gram Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 27
    • Maximum Hg exposure in 1st year of life US Childhood Schedule - 1992-200? AGE SHOTS HG CONTENT BIRTH Hep B 12.5mcg 8lb infant (3.6kg)– EPA Hg limit: 0.36mcg = 35 times over 4lb infant (1.8kg) – EPA Hg limit: 0.18mcg = 70 times over 2 MONTHS Hep B HIb DTaP 12.5mcg 25.0mcg 25.0mcg (subtotal for visit): 62.5mcg Avg. weight: 10lbs/4.5kg EPA limit: 0.45mcg = 138 times over 4 MONTHS HIb DTaP 25.0mcg 25.0 mcg (subtotal for visit): 50.0 mcg Avg weight: 14lbs/6.5kg EPA limit: 0.65mcg = 72 times over Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 28
    • Maximum Hg exposure in 1st year of life US Childhood Schedule - 1992-200? AGE SHOTS 6 MONTHS HiB DTaP (subtotal for visit): HG CONTENT 25.0mcg 25.0mcg 50.0mcg Avg. weight: 16lbs/7.3kg EPA limit: 0.73mcg = 68 times over 12 MONTHS HiB DTaP (subtotal for visit): 25.0mcg 25.0mcg 50.0mcg Avg. weight: 20lbs/9kg EPA Hg limit: 0.9mcg = 55 times over TOTAL Hg EXPOSURE IN FIRST Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. YEAR: 212.5mcg 29
    • Bolus vs. Chronic Exposure FDA’s “Interpretation” • FDA totaled 4 large “bolus” doses at birth, 2, 4, & 6 months (162.5mcg) and divided by 180 days. • 162.5mcg divided by 180 = 0.9mcg per day. • This “average” daily exposure was just above the EPA limit, but below FDA and CDC limits. • Analogy: You can take 2 tylenol a day for 60 days and be fine. But 120 tylenol in one day is a lethal dose. Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 30
    • Safe Minds: Common Symptoms of Autism & Mercury Poisoning IMPAIRMENTS IN SOCIABILITY Mercury Poisoning Autism Social deficits, shyness, social withdrawal Social deficits, social withdrawal, shyness Depression, mood swings; mask face Depressive traits, mood swings; flat affect Anxiety Anxiety Lacks eye contact, hesitant to engage others Lack of eye contact, avoids conversation Irrational fears Irrational fears Irritability, aggression, temper tantrums Irritability, aggression, temper tantrums Impaired face recognition Impaired face recognition Schizoid tendencies, OCD traits Schizophrenic & OCD traits Repetitive, stereotypic behaviors Repetitive, stereotypic behaviors Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 31
    • IMPAIRMENTS IN SPEECH AND LANGUAGE Mercury Poisoning Autism Loss of speech, failure to develop speech Delayed language, failure to develop speech Dysarthria; articulation problems Dysarthria; articulation problems Speech comprehension deficits Speech comprehension deficits Verbalizing & word retrieval problems Echolalia; word use & pragmatic errors Hearing loss; deafness in very high doses Mild to profound hearing loss Poor performance on language IQ tests Poor performance on verbal IQ tests Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 32
    • SENSORY AND MOTOR ABNORMALITIES Mercury Poisoning Autism Abnormal sensation in mouth & extremities Abnormal sensation in mouth & extremities Sound sensitivity Sound sensitivity Abnormal touch sensations; touch aversion Abnormal touch sensations; touch aversion Impaired visual fixation Problems with joint attention Involuntary jerking movements – arm flapping, ankle jerks, circling, rocking Stereotyped movements - arm flapping, jumping, circling, spinning, rocking Deficits in eye-hand coordination; limb apraxia; intention tremors Poor eye-hand coordination; limb apraxia; problems with intentional movements Gait impairment; ataxia – from incoordination & clumsiness to inability to walk, stand, or sit; loss of motor control Abnormal gait and posture, clumsiness and incoordination; difficulties sitting, lying, crawling, and walking Difficulty in chewing or swallowing Difficulty chewing or swallowing Unusual postures; toe walking Unusual postures; toe walking Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 33
    • 90.00% 鉛Pb 80.00% 砷As 汞Hg 70.00% 60.00% 錫Sn 鋁Al 銻Sb 鋁Al 50.00% 銻Sb 鎘Cd 40.00% 30.00% 砷As 鉍Bi 鎢Tw 鉛Pb 鎳Ni 汞Hg 鎳Ni 20.00% 鉍Bi 10.00% 銀Ag 錫Sn 鈦Ti 鎘Cd 0.00% 鋁Al Jul.15.2008 銻Sb 砷As 鉍Bi 鉛Pb 汞Hg 鎳Ni 錫Sn 鈦Ti Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 鎘Cd 鎢Tw 銀Ag 鎢Tw 銀Ag 34
    • 鎢Tw 銀Ag 鋁Al 鎘Cd 鋁Al 砷As 鉍Bi 鉛Pb 汞Hg 鎳Ni 錫Sn 鈦Ti 鈦Ti 銻Sb 鎘Cd 鎢Tw 銀Ag 銻Sb 錫Sn 砷As 鎳Ni 鉍Bi 汞Hg 鉛Pb Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 35
    • • 89 in 125 = 69.6% autistic children have both Lead and also Mercury Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 36
    • CHILD WITH ACRODYNIA (Mercury poisoning) Jul.15.2008 CHILD WITH AUTISM (Will Redwood) Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 37
    • INJECTING POISON? Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 38
    • 1991: LILLY WARNING ON THIMEROSAL TOXICITY 39
    • 1991: LILLY WARNING ON THIMEROSAL TOXICITY 40
    • 1999 MSDS: “Nervous System and Reproduction Effects; Effects of exposure include fetal changes; Mercury poisoning may occur; Exposure in children may cause mild to severe mental retardation; Hypersensitivity to mercury is a medical condition aggravated by exposure; Hazardous substance, toxic waste disposal." 1991 MSDS: “Use of chelating agents may be needed to treat ingestion of mercury” 41
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 42
    • What is CHELATION? • • • • From Greek chele, or claw. Developed for lead poisoning by Army. Sulfur-based agents bind with heavy metals. Use ONLY under doctor’s supervision. • Two main agents currently in use: DMSA: Di-Mercapto-Succinic Acid IV, or more typically in children, orally DMPS: Di-Mercapto-Propane-Sulfonate Transdermal patch (untested, controversial, more potent?) Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 43
    • TOTAL Hg BURDEN AND AUTISM RATES IN CALIFORNIA 1985-98 Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 44
    • BRADSTREET ET. AL. – Autistic kids excrete 6 times more Hg Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 45
    • Mercury is high, cadmium & lead levels similar (autistic vs. controls) Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 46
    • 90.00% 鉛Pb 80.00% 砷As 汞Hg 70.00% 60.00% 錫Sn 鋁Al 銻Sb 鋁Al 50.00% 銻Sb 鎘Cd 40.00% 30.00% 砷As 鉍Bi 鎢Tw 鉛Pb 鎳Ni 汞Hg 鎳Ni 20.00% 鉍Bi 10.00% 銀Ag 錫Sn 鈦Ti 鎘Cd 0.00% 鋁Al Jul.15.2008 銻Sb 砷As 鉍Bi 鉛Pb 汞Hg 鎳Ni 錫Sn 鈦Ti Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 鎘Cd 鎢Tw 銀Ag 鎢Tw 銀Ag 47
    • 鎢Tw 銀Ag 鋁Al 鎘Cd 鋁Al 砷As 鉍Bi 鉛Pb 汞Hg 鎳Ni 錫Sn 鈦Ti 鈦Ti 銻Sb 鎘Cd 鎢Tw 銀Ag 銻Sb 錫Sn 砷As 鎳Ni 鉍Bi 汞Hg 鉛Pb Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 48
    • • 89 in 125 = 69.6% autistic children have both Lead and also Mercury Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 49
    • Mady Hornig – Columbia University Hornig used one mouse strain with genetic Hg sensitivity and autoimmunity and two strains without them, then replicated the immunization schedule using thimerosal-containing vaccines. • Sensitive mice showed significant delay in weight gain. • Sensitive mice had enlarged brains, noted in autistic children, vs. controls. • “Behavioral impoverishment” was highly significant the sensitive strain. • 40 percent of sensitive mice were “self-mutilatory” at six months, ie, frantically grooming or biting tails. • One mouse groomed through partner’s skull. 50
    • THIMEROSAL EXPOSURE & AUTISM RATES IN SWEDEN: 1980-1996 Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 51
    • THIMEROSAL EXPOSURE & AUTISM RATES IN DENMARK 1981-2000 Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 52
    • OFFICIAL STATEMENT: World Health Organization (WHO) before 2001 “The latest studies do not support concerns over safety of thiomersal in vaccines. There is no reason to change current immunization practices, since the benefit outweighs any unproven risks.” Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 53
    • OFFICIAL STATEMENT: Committee on Safety of Medicines (CSM) –United Kingdom “There is no reliable evidence of neurological adverse effects caused by thiomersal in vaccines. The balance of benefits and risks of thiomersal-containing vaccines therefore remains overwhelmingly positive.” Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 54
    • TVS.D 5 GENERATIONS Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 55
    • Generation “Zero” Nov-Dec 1999 Recently rediscovered. First run of the numbers. Very high relative risks for outcomes. Autism RR = 7.6 UNPUBLISHED STUDY OBTAINED THROUGH FOIA 56
    • Generation 1 Verstraeten 2/2000 Verstraeten reruns numbers, risks are lower. Still, significant outcomes “just won’t go away.” Autism RR = 2.48 UNPUBLISHED STUDY OBTAINED THROUGH FOIA Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 57
    • Generation 2: Simpsonwood - ACIP 6/2000 CDC, FDA, AAP, PHARMA, etc. meet in secret on Hg and NDDs. Verstraeten presents at public CDC meeting, says RR’s for outcomes increase with rising exposure. Autism RR = 1.69. SIMPSONWOOD MINUTES OBTAINED THROUGH FOIA – ACIP MINUTES NEVER POSTED ONLINE Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 58
    • Generation 3: IOM 7/2001 Verstraeten presents at IOM on same day he begins work at Glaxo. By this time, more children have been added to study population, and RR’s have been reduced even further. HMO C shows no “consistent” evidence of harm. Autism RR = 1.52. Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 59
    • Generation 4: Pediatrics 11/2003 Final version of study published 4 years after it began. Relative risks for all outcomes reduced to null or near null. Autism RR: NO LONGER STUDIED. Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 60
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 61
    • “IT JUST WON’T GO AWAY” Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 62
    • VSD: Generation Zero Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 63
    • VSD Generation 4: Autism (Pediatrics Article, 11/2003) V ol 112 No. 5 Novem ber 2003, . pp. 1039-1048 Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 64
    • Generation 4: All Outcomes • HMO A: Cumulative exposure at 3 months resulted in a significant positive association with tics (RR:1.89) • HMO B, increased risks of language delay were found for cumulative exposure at 3 months (RR: 1.13) and 7 months (RR: 1.07) • HMO C, no significant associations were found. • CONCLUSION: No consistent significant associations were found between for neuro-developmental outcomes. Conflicting results were found at different HMOs for certain outcomes. Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 65
    • GEN 0 Autism Risks Across 5 Generations GEN 1 GEN 2 GEN 3 7.62 2.48 1.69 Evidence of Harm 1.52 GEN 4
    • COMPLIANCE RATES AND OUTCOME RATES AT THREE HMO’S HMO B (NCK) HMO A (GHC) HMO C (HP) Population size 114,965 15,929 17,547 Compliance rate 15% 60% 65% NDD rate 1.3% 3.9% n/a Speech delay rate 2.6% 3.9% 4.5% (at three months of age) Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 67
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 68
    • David Kirby – Evidence of Harm UPDATE ON RECENT DEVELOPMENTS IN THE MERCURYAUTISM DEBATE Autism One May 2007 - CHICAGO Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 69
    • “NEW” CDC findings – ONE IN 150 -- Feb 8, 2007 8 year olds in 2000 and 2002 (born 1992 & 1994) Average ASD was 6.7 per 1,000 for 8-year-olds in 2000 (1992 birth cohort) and 6.6 per 1,000 8-year-olds in 2002. About 1 in 150 children. Most sites found 5.2 to 7.6 per 1,000. (A 46% difference). Prevalence was much lower (3.3 per 1,000) in Alabama and higher (10.6 per 1,000) in New Jersey in 2002. Prevalence increased 10% from 1992 cohort to 1994 cohort in the six sites with data for both years (HiB, HepB, Rho-D added 1988-1992). Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 70
    • SF: ASD kids more likely born in polluted areas • 284 ASD children & 657 controls, born in 1994 in Bay Area. • Assigned exposure level by birth tract for 19 chemicals. • Risks for autism were elevated by 50% in tracts with the highest chlorinated solvents and heavy metals. • Highest risk compounds were mercury, cadmium, nickel, trichloroethylene, and vinyl chloride. • Risk from heavy metals was almost twice as high as solvents. • “Our results suggest a potential association between autism and estimated metal concentrations, and possibly solvents, in ambient air around the birth residence.” ENVIRONMENTAL HEALTH PERSPECTIVES – Vol. 114 No. 9, September, 2006 Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 71
    • TOXICOLOGY AND APPLIED PHARMACOLOGY - 15.3 (March, 2006) • Urine samples from 100s of French children yielded “evidence for a link between autism and heavy metals.” • Samples from ASD children had high levels of porphyrins – used to produce of haem, the oxygen-carrying component in haemoglobin. • Heavy metals block haem, causing porphyrins to accumulate in urine. • Coproporphyrin was 2.6 times higher in autism cases than controls. • One author said it was “Highly likely heavy metals are responsible for childhood autism in a majority of cases.” Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 72
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 73
    • Mercury remained in some vaccines until 2003 “The latest vaccines that contained any thimerosal as a preservative, with the exception of some flu vaccines, were completed in 2001 and outdated in Dr. Harvey Fineberg, IOM President 2003.” “Meet the Press,” August 7, 2005 Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 74
    • Coal use goes way up in China 1996-2010: 2010: 2,666 million short tons 1996: 1,500 million short tons Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 75 Source: DOE/EIA, 1998, reference case
    • THE SHANGHAI PLUME (Moves up and down Pacific Coast) Jul.15.2008 Lower Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. urban mercury plume. 10-day traverse from South China Sea, ending May 5, 2002. Trajectory calculations by N.O.A.A. 76
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 77
    • Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 78
    • Early Intervention Producing More Diagnoses Among 3-5 Year Olds? Average Age of Diagnosis 1990: 5.3 years Average Age 2000: 4.4 years Average Age 2006: 3.1 years Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 79
    • California – Autism cases White vs. Asian/Hispanic (1st Quarter) 14,000 12,000 10,000 8,000 6,000 White 2003 2004 2005 2006 2007 9,296 10,715 11,812 12,725 13,811 Asian/Hispanic 7,301 8,781 10,135 11,560 13,335 Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 80
    • Vaccination News Comprehensive Daily News On Vaccines http://www.vaccinationnews.com/default.htm Redflagsdaily.com Health News, Column, Features, and Investigation http://www.redflagsweekly.com/ Toxic Exposure Study Trust (TEST) Foundation "Absence of proof is not proof of absence." http://www.testfoundation.org/ MMR and Vaccine Information The latest press on the MMR vaccine and autism http://www.jabs.org.uk/pages/mmr/main.asp Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 81
    • Autism : Is there a vaccine connection? (1999) F. E. YAZBAK, M.D. & K.YAZBAK,B.A., M.A. Part I. Vaccination after delivery. http://www.garynull.com/Documents/autism99b Part II. Vaccination around Pregnancy. http://www.garynull.com/Documents/autism99b Part III. Vaccination Around Pregnancy, The Sequel http://www.garynull.com/Documents/autism99b3.htm Autism, MMR and 60 Minutes (11/12/2000) Another Pediatrician’s Perspective F. Edward Yazbak, MD, FAAP http://lib.tcu.edu/www/staff/lruede/60minutesc Jul.15.2008 Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 82
    • “All truth goes through three stages. First it is ridiculed. Then it is violently opposed. Finally, it is accepted as selfevident.” -Arthur Schopenhauer Jul.15.2008 ( 德國哲學家叔本華 ) Louis LEE,M.D., H.M.D., N.M.D.,M.B.A. 83