Respectful Insolence

Autism clusters and “toxins”

Time to get back to business after yesterday’s festivities.

One of the items of Gospel Truth among the “autism biomed” movement, which consists of people who fervently believe that autism is caused by some sort of external “toxin,” infection, or vaccines and that subjecting children to various forms of quackery designed either to “detoxify” or reverse whatever physiological derangement believed to be at the root of autism will “recover” these children from autism. Of course, there are a lot of antivaccine believers in the autism biomed movement, and arguably the vast majority of “autism biomeddlers” are fervently antivaccine. That’s the reason why, whenever you see a claim that “environmental influences” are a major cause of autism are trotted out, it’s almost always joined at the hip with antivaccinationists. Antivaccinationists and autism biomeddlers are also very quick to pounce on any study that seems to support an environmental cause for autism. Unfortunately, many legitimate scientists are all too eager to provide such studies. Of course, sometimes true believers produce studies, such as studies claiming that mercury emissions from nearby power plants are associated with autism, but by and large it’s real scientists producing studies that either aren’t very good or are so preliminary as to be poor evidence.

No one denies that making connections between environmental influences and conditions like autism is very difficult. Particularly difficult are studies seeking to find environmental causes through looking for geographic clustering of cases. It’s hard enough to do such studies for diseases like various cancers, and all too frequently when such geographic and environmental associations are claimed to be identified for cancer (often otherwise known as finding “cancer clusters”), media attention and emotions often get the better of science. One wonders if a study about “autism clusters” that I just became aware of will result in the same sort of reaction. I found out about it in Dr. Sanjay Gupta’s column yesterday for MedPage Today, entitled Environmental Factors Tied to Autism Clusters:

An analysis of an insurance claims database of 100 million patients has found clustering of autism spectrum disorder (ASD) and intellectual disability (ID) in counties across the U.S.

The clustering appears to be linked to environmental factors and, to a lesser extent, economic incentives at the state level that affect diagnosis, the researchers reported.

The researchers used male congenital malformations as a surrogate for parental exposures to environmental insults — including pesticides, lead, sex hormone analogs, medication, and plasticizers, among others — which are believed to play a role in the causation of ASD and ID.

“Adjusted for gender, ethnic, socioeconomic, and geopolitical factors, the ASD incidence rates were strongly linked to population-normalized rates of congenital malformations of the reproductive system in males — an increase in ASD incidence of 283% for every percent increase in incidence of malformations (95% CI 91-576, P<6 x 10-5),” wrote Andrey Rzhetsky, PhD, of the University of Chicago, and his co-authors March 13th in PLOS Computational Biology.

Now seems like a good time for a preemptive science-based analysis of the study, as I haven’t seen any antivaccine websites taking it on yet.The study was published yesterday in PLoS Computational Biology and entitled, Environmental and State-Level Regulatory Factors Affect the Incidence of Autism and Intellectual Disability. The investigators come from the University of Chicago at Illinois, Stanford University, and the University of Chicago. Basically, the authors used de-identified patient data from the Truven Health Analytics MarketScan Commercial Claims and Encounters Database to provide geocoded diagnosis counts by gender. This particular database spans the years 2003 to 2010 and contains approved commercial health insurance claims for between 17.5 and 45.2 million people annually. It’s linked across years, so that it yields a total of approximately 105 million patient records contributed by well over 100 insurance carriers and large self-insuring companies. The authors looked at approximately 4.6 billion inpatient and outpatient service claims and identified 6 billion diagnostic codes. Once duplicates were identified and removed, there were left almost 1.3 billion diagnostic codes associated with 99.1 million individuals. All patient-level personal information was redacted and geocoded by county level.

These data were then augmented with US census data consisting of county-level measurements for various socioeconomic and demographic factors, including: Gender, average per capita income, income, percent ethnicity (separately for American Indians, AmInd, Asians, Asian, White Hispanics, WHisp, White non-Hispanics, W, Black Hispanics, BHisp, Black non-Hispanics, B, and Pacific Islanders, Pacific), and the proportions of various socioeconomic groups (poor, Poor, urban, Urban, insured, Insured). County-level environmental indicators were used as fixed-effect covariates (normalized by county population size) and included congenital malformations excluding malformations of the genitals (separately for females and males), congenital malformations of the genitals (separately for females and males), viral infections, ectopic pregnancy, abnormal conception, spontaneous abortion, and multiple gestations.

So right off the bat, we see that this is basically an ecological study. True, it does use patient-level data, but that data is aggregated at the county level and correlated with county-level data from census data to look for correlations and clustering. In other words, the group, not the individual, is the unit of analysis, here county-level aggregated data. In particular, the authors used genetic abnormalities leading to malformations of the genitals as a surrogate for exposure to “toxins” and then tried to correlate the incidence of autism and autism spectrum disorders (ASDs) and intellectual disability (ID) to this surrogate marker. Now, there is an inherent problem with ecological studies in that they have a very high tendency to find spurious correlations and to exaggerate real correlations. This is known as the ecological fallacy or ecological bias. In any case, it’s a reason to be skeptical right off the bat. Add to that the underlying assumption that the birth defects examined are reliable surrogates for exposure to “toxins,” and there’s even more reason to be skeptical. I’ll show you what I mean.

Let’s look at what the authors found:

Adjusted for gender, ethnic, socioeconomic, and geopolitical factors, the ASD incidence rates were strongly linked to population-normalized rates of congenital malformations of the reproductive system in males (an increase in ASD incidence by 283% for every percent increase in incidence of malformations, 95% CI: [91%, 576%], p<6×10−5). Such congenital malformations were barely significant for ID (94% increase, 95% CI: [1%, 250%], p = 0.0384). Other congenital malformations in males (excluding those affecting the reproductive system) appeared to significantly affect both phenotypes: 31.8% ASD rate increase (CI: [12%, 52%], p<6×10−5), and 43% ID rate increase (CI: [23%, 67%], p<6×10−5)

Of this, the lead author Andrey Rzhetsky said in Dr. Gupta’s article:

“I suspected that connection between environmental status to rate of autism might exist, but the signal is much stronger than I expected,” Rzhetsky told MedPage Today in an email.

Well, maybe. It’s true that the authors did analyses to control for several putative confounding variables, specifically county-specific median mother’s age at childbirth, and the proportion of county population in the childbearing age. Several other socioeconomic factors were adjusted for as well, as shown in Table I. However, it’s already known that birth defects are associated with autism. For instance, an Australian study found a 2-fold increase in birth defects in children with autism autism, but not Asperger’s syndrome, while this study also found an association, specifically between urogenital defects and autism. Moreover, it’s already known that there’s an correlation between autism and exposure to teratogens, specifically at least maternal rubella infection, thalidomide, valproic acid, and misoprostol. The authors (sort of) acknowledge this association:

It is known that some birth malformations are caused by de novo genetic events, such as large copy number variants that have been found to increase the risk for ASD by approximately 400% [32]. Single-gene deletions, for example, involving CHD7 are known to cause CHARGE syndrome [33], [34] associated with genital abnormalities and putatively associated with ASD [35]. However, these genetic events may have currently poorly identified environmental triggers, and 70 to 80% of male congenital malformations of the reproductive system have no clear genetic causes [36]. Instead, they appear to be driven by specific environmental insults that were not serious enough to lead to more serious adverse events during pregnancy, such as spontaneous abortion. Therefore, in this study, we used the rate of birth malformations as a surrogate measure for environmental burden.

In other words, the implicit assumption behind this study is that some “toxins” associated with environment cause genetic changes that cause both congenital anomalies and autism. While this is possible, we have no way of knowing how likely this hypothesis is compared to the alternate hypothesis, namely that there is simply an association between congenital anomalies and autism, no environmental “toxins” necessary to explain it. It’s also clear that there are confounders not accounted for in the analysis, as the authors themselves acknowledge. If you look at Figure 2, you’ll find rather clear state boundaries in many instances, and the authors point out that their estimates of random effects suggest unidentified confounders at both county and state levels.

Ya think?

Of course, one major issue with any study of this type is what’s known as the Texas Sharpshooter Fallacy. Basically, that’s a fallacy named after the concept often used to illustrate it: A “sharpshooter” shoots at the side of a barn randomly, and then draws a bullseye around the bullet holes. In the case of geographic clusters, a number of cases might be noticed, and investigators could draw its population from the smallest area possible, without considering that the cases come from a large population. (A good lay person-accessible explanation of the perils and pitfalls of geographic clustering being used as evidence for an environmental cause of a condition—in this case cancer, but it could just as well apply to autism—can be found here.)

The bottom line is that it’s very difficult to know what the best geographic level of grouping is that will minimize the noise in the signal while still not missing potential associations. The smaller the geographic area, the more variation will be seen, and county-level information is generally not very large. In the case of autism, clustering could easily be due to better resources and more intensive screening, which would identify more cases and, given the known association between ASDs and congenital anomalies, there would be a correlation found, no need to invoke environmental “toxins” necessary. For example, look at South Dakota in Figure 2. ASD incidence is very low in some of the counties there. (An annoying thing about this graph: Dark colors mean less autism.) It’s highly unlikely that ASD prevalence would be that low (less than 10-4)anywhere where good pediatric screening programs exist. Even taking into account that this is prevalence and not incidence, that seems way low. Had I reviewed this paper, I would have asked what the heck was going on with these counties and what was going on in South Dakota.

Another thing that annoys me about this study, and it’s the way that the authors throw around the term “toxin,” not being particularly precise in their definition. In the world of woo, “toxins” are the magical miasmas that cause all disease but are never defined, although they must always be removed and the patient be “detoxified.” I know the authors don’t know this and didn’t intend it, but their article comes across to me as custom-made to be quote-mined. It doesn’t help that the authors write things like this:

Following similar logic, in addition to causing birth defects, environmental toxins, such as pesticides [38], [39] can substantially weaken the human immune system, especially in men, which results in more frequent infections.

Clearly, they are not immunologists, and clearly they aren’t familiar with woo-speak.

Another thing it’s important to remember is that this dataset is not a random sampling of the US population. As the authors note in the methods, the compilation of the dataset required agreements between Truven and numerous individual insurance providers to share data, and the providers inherently had uneven and nonrandom coverage of geographic areas, which could lead to what the authors refer to as “traces of hidden correlations imposed by the data collection method.” On the plus side, it does include Medicare and Medicaid (presumably Medicare and Medicaid HMOs, given that it wasn’t clear to me whether Medicare and Medicaid claims themselves were included, but I don’t know that for sure and couldn’t clarify this point before posting this).

Finally, there’s one other interesting finding:

Furthermore, the state-mandated rigor of diagnosis of ASD by a pediatrician or clinician for consideration in the special education system was predictive of a considerable decrease in ASD and ID incidence rates (98.6%, CI: [28%, 99.99%], p = 0.02475 and 99% CI: [68%, 99.99%], p = 0.00637 respectively). Thus, the observed spatial variability of both ID and ASD rates is associated with environmental and state-level regulatory factors; the magnitude of influence of compound environmental predictors was approximately three times greater than that of state-level incentives.

Of course, this is not unexpected. The more diagnostic rigor there is when it comes to diagnosis, the lower the reported incidence will be, virtually no matter what the condition or disease is. What would have been interesting to know, and what the authors didn’t investigate, is what effect screening programs have on the incidence of autism and ASDs. I again liken it to mammography. The more intensely you screen for a condition or disease, the more of it you will find, almost always. It’s not hard to imagine a confounding factor in which counties and states with more intensive developmental screening programs might tend to screen more aggressively for congenital anomalies, meaning a higher incidence of both, due both to screening and the known association between autism and congenital anomalies. I would suggest this as another area of investigation.

The bottom line is that this study reports some intriguing results, but it is not really strong evidence for an environmental toxin as being a major cause of autism. Geographic clusters of conditions and diseases (like cancer clusters) do occur randomly, and ecological studies like this tend to produce a lot of false positives. Also, the authors, after establishing a baseline incidence of autism and ID across the country, interpreted deviations from this baseline as due to local effects. That might not be an unreasonable interpretation, but “local effects” do not equal “toxins”; yet the inference is very strong in the paper that this must be true. Personally, I’d wonder about deviations below the baseline rate as well. In counties with lower than baseline incidences of autism, is there something that’s protective against autism? Yet this question is never even mentioned, much less considered. I realize that the authors weren’t looking for this, but considering the question addresses plausibility. If the authors consider it plausible that local “toxins” cause autism and congenital anomalies, then why are there a number of counties with very low autism and ID incidence? It’s the flip side to asking why there are counties with high incidences.

I’ll finish with a random provocative question that popped up in my mind as I was reading this paper: Where are the superfund sites? These are chemical disposal sites for which the federal government created a fund to clean up. They’re frequently used as a surrogate for known exposures to potentially cancer-causing and teratogenic chemicals. It wouldn’t have taken that much more to look at the counties in which there are superfund sites to see if there is a correlation between autism incidence and being in the same county as (or an adjacent county to) a superfund site.

And if the investigators do this analysis and haven’t already thought of it, please at least give me an acknowledgment in the paper.

Oh, and this:

While the effect of vaccines was not analyzed as part of this study, Rzhetsky notes that the geographic clustering of autism and ID rates is evidence that if vaccines have a role, it’s a very weak one as vaccinations are given uniformly across the US.

Hmmm. Maybe antivaccine activists won’t be citing this paper much, after all.

Comments

  1. #1 Sarah A
    March 14, 2014

    Hmmm. Maybe antivaccine activists won’t be citing this paper much, after all.

    Right – because antivaxers would never quote isolated passages from a paper out of context to imply that it says something it really doesn’t ;)

    I’m unclear on what the authors were trying to prove here. I thought it was already well established that exposure to teratogens early in pregnancy increases the risk of autism.

  2. #2 Julian Frost
    March 14, 2014

    [I]t’s already known that birth defects are associated with autism. For instance, an Australian study found a 2-fold increase in birth defects in children with autism autism, but not Asperger’s syndrome, while [a swedish] study also found an association, specifically between urogenital defects and autism

    I was curious, so I clicked through. The swedish study had this:

    The risk of autism was associated with daily smoking in early pregnancy…cesarean delivery…being small for gestational age…a 5-minute Apgar score below 7…and congenital malformations

    “Daily smoking in early pregnancy” is an obvious confounder.

  3. #3 Orac
    March 14, 2014

    D’oh! I should have noted that. :-)

  4. #4 Too Old For This
    March 14, 2014

    I couldn’t tell if the authors had taken into account the “chatty mom” effect, where clusters of pathology depend on informal screening when people compare notes in playgroups, PTA’s, local chapters of interest groups, church congregations, etc.

  5. #5 Eric Lund
    March 14, 2014

    For example, look at South Dakota in Figure 2. ASD incidence is very low in some of the counties there.

    Small number statistics probably comes into play here. The population density in that part of South Dakota is very low, so it is possible that those counties are seeing no autism cases at all, just by luck. Conversely, other small-population counties show up as white (for instance, the Texas county with a total population in three figures, which is the white spot just south of the New Mexico border), because even one autism case produces a high overall incidence.

    • #6 Orac
      March 14, 2014

      Which, of course, is part of the reason why I find the correlations found to be…not nearly as convincing as the study’s authors do. :-)

  6. #7 jane
    March 14, 2014

    The study isn’t solid proof of environmental influences on autism, but there’s virtually never solid proof of any influence of any environmental factor on anything where free-living humans are concerned. When you’re dealing with substances that humans consume voluntarily, the best you can get is prospective observational studies combined with animal studies. When substances that are consumed, breathed, etc. unintentionally are involved, especially when you do not assume that only one such substance has any effect, it may be that population-level studies are the best you can manage.

    There are now an increasing number of studies that measure bisphenol A levels in individual pregnant women, for example, and correlate them with unwanted outcomes in the offspring. But you couldn’t possibly do such a study that measured exposures to every conceivable pesticide and plasticizer. Nor could you do one with millions of mothers, so participant numbers are relatively small and results easy to handwave away. Hence an alternative approach is the population-level study. Attempting not just to acknowledge that method’s real and significant limitations, but to dismiss all such studies altogether with scientistic claims that they constitute this or that Fallacy, is the behavior of someone who suspects that such studies may give results that will not suit his ideology.

  7. #8 Chris Hickie
    March 14, 2014

    “local effects” could be clustering of genetically related families in which autism diagnoses run strong. I don’t see how they could have controlled for that.

    Also, Medicare claims are almost never for children. If Medicare claims coding for autism are used, you may be looking at older, institutionalized patients–who will by nature of their care, be clustered.

  8. #9 Mu
    March 14, 2014

    I wouldn’t be surprised if there is a strong correlation of environmental effects or toxins and autism – but through pre – and early pregnancy exposure of the mother, not the baby. Of course, that finding wouldn’t help all the warrior mothers at all, as it means that it’s a) their fault b) too late to do anything about it. So they’ll fight any results indicating it just like the rest of the scientific data they don’t like.

  9. #10 AdamG
    March 14, 2014

    here’s virtually never solid proof of any influence of any environmental factor on anything where free-living humans are concerned

    Yet another broad, unsupported claim from jen. Just because you don’t follow the literature on Gene X Environment interactions doesn’t mean it’s nonexistent. Here’s one to get you started.

    http://www.ncbi.nlm.nih.gov/pubmed/21874000

  10. #11 Todd W.
    http://www.harpocratesspeaks.com
    March 14, 2014

    @Mu

    They already blame themselves to some degree: “Why did I poison my child?” This just moves the timing back a bit.

    I wonder how long it will be before Kim Stagliano points to this study as proof that the flu shot she got caused her youngest (completely unvaccinated) daughter’s autism?

  11. #12 Matt Carey
    March 14, 2014

    I would predict the vaccine/autism groups will ignore or mock this study.

    “Environmental” to them means vaccines. Any environmental risk factor other than vaccines is ridiculed.

    Large variations in prevalence argue against a universal exposure–such as vaccines. You can’t say, “the birth dose of the HepB vaccine causes a huge increase in autism…except for South Dakota…and counties in North Carolina…and…and…”

    Of course, one must wait to see if Blaxill and Olmsted decide to come up with “But, it’s the combination of 2 or three factors in a biologically implausible way that causes autism”. Like they did with polio and lead based pesticides…which morphs into polio with DDT causing paralysis. Because lead and DDT are so similar.

  12. #13 AlisonM
    http://adhdcommunity.boards.net/
    March 14, 2014

    Agree with Chris Hickey. There’s already pretty strong evidence of heritability. Do these studies in areas where small groups of families live for generations and intermarry, you’ll find that they have a lot of higher incidences of shared characteristics.

  13. #14 lilady
    March 14, 2014

    There’s a back story about that Long Island New York breast cancer incidence and breast cancer “cluster” study. There was a local breast cancer support group “1 in 9″ where women impacted by breast cancer would meet to exchange information about treatments…and to discuss what appeared to be clusters. (before they had the benefit of internet breast cancer sites).

    Senator Al D’Amato (Rep) who was affectionately called Senator Pothole for his quick response to any of his constituents’ concerns (such as street repairs and cancer clusters), met with the “1 in 9″ founder and her constiuents. Senator D’Amato and Senator Tom Harkin co-sponsored appropriation bills adding up to $30,000,000 to fund a breast cancer registry and multiple breast cancer studies, which found that there were no clusters and Long Island women diagnosed with breast cancer had KNOWN risks factors for breast cancer.

    http://ww5.komen.org/Content.aspx?id=19327353757

    “….Two of the best-studied breast cancer clusters are in Long Island, New York and Marin County, California (San Francisco Bay area).5-6 In the 1990’s, rates of new cases of breast cancer were higher than expected in these areas. So, these breast cancer clusters were reported and investigated. Many studies looked at known risk factors and possible environmental factors that might be related to the excess number of breast cancer cases in these areas. These factors included pesticides, industrial chemicals and electromagnetic fields (EMF).
    Known risk factors

    Findings from the Long Island and Marin County studies showed the excess breast cancers in both areas were mainly due to known risk factors. Living on Long Island or in Marin County did not appear to increase the risk of breast cancer. Rather, women who lived in these areas and developed breast cancer were more likely to have known risk factors compared to other women. These women were more likely to:

    Be older5,7-8
    Be white8
    Have Ashkenazi Jewish heritage9
    Have a family history of breast cancer5,7
    Be older when they first gave birth to a child5,7,9-11
    Never have given birth5,7-11
    Have a higher socioeconomic status (higher income or higher education level) 5,7-8,11-12
    Drink alcohol10-9,11
    Use postmenopausal hormones13 (From 1999 to 2004, breast cancer rates in Marin County declined and were similar to those in other parts in California.9,13 This decline appeared to be due, in part, to large declines in the use of postmenopausal hormones in the area.13-14)

    Environmental factors

    Although researchers looked for environmental factors that might help explain the cancer clusters on Long Island and in Marin County, most of these factors were not found to be related to breast cancer risk including:

    Organochlorine pesticides, such as DDT, DDE, dieldron and chlordane15-17
    Industrial chemicals, such as polychlorinated biphenyl (PCB)15-17
    EMF, such as power lines and electric blankets16-18

    Findings from one of the Long Island studies suggested exposure to polycyclic aromatic hydrocarbons (PAH), a chemical found in cigarette smoke and grilled foods, slightly increased the risk of breast cancer.19 More recent studies on PAH and breast cancer risk have not confirmed these findings.20-21 This topic remains under active study….”

  14. #15 Jeff1971
    March 14, 2014

    The antivaxxers have always had a problem with clustering. If vaccines the cause autism, and everything would tell us that vaccines are given uniformly across the population, how can there be clusters.

    The other antivax dilemma, of course, is the sharp fall in the burden of thimerosal in the population, and the inexorable rise in autism diagnoses.

    Head in the sand. La la la, can’t hear you!

  15. #16 Denice Walter
    March 14, 2014

    I think that anti-vax groups might say that the study is just SBM’s desperate attempt to take focus off of vaccines.

    Another possibility is that if *toxins* DO cause autism through pre-natal exposure, post-natal exposure to *similar* toxins ( say, uh…vaccines) will cause autism in *vulnerable* children. The said vulnerability might be genetic or could possible be through genes damaged by vaccines which the mother received long ago.

    I’ve got a few dozen more…

  16. #17 Denice Walter
    March 14, 2014

    @ lilady:

    Marin County?* No es possible!* They have all of that pristine Nature in their backyard; many are vegan, eat organic foods; they go mountain biking and hiking. They have Dr Ornish ! And spas!
    Only joking, I read about it long ago.

  17. #18 lilady
    March 14, 2014

    I think there is little danger of seeing an analysis of this study on AoA, for the simple reason that Olmsted’s most recent attempts to conduct his own study (The Amish Anomaly), was met with universal derision:

    http://en.wikipedia.org/wiki/Amish_anomaly

    How about this study of dysmorphic facial features, for identifying autistic kids…which the brain trust at AoA has never attempted to analyze or debunk?

    http://sfari.org/news-and-opinion/in-brief/2012/clinical-research-facial-features-can-help-diagnose-autism

  18. #19 lilady
    March 14, 2014

    @ Denice Walter: I saw whiffs of smoke coming out of my laptop…emanating from the picture of the Orac computer, just after I posted about the $ 30,000,000 appropriation for breast cancer cluster research.

    Si! es posible!!!

  19. #20 herr doktor bimler
    March 14, 2014

    For example, look at South Dakota in Figure 2. ASD incidence is very low in some of the counties there.
    Not enough difference from neurotypical South Dakotans. It’s the Scandiwegian background.

  20. #21 JerryA
    March 14, 2014

    1. While this is not my field, I read the journal article to try to answer the following question: How did the authors account for the fact that US households move fairly frequently (on average, every 7-8 years) to control for a difference between the location of gestation and the location of insurance claims (at child age of onset of autism)? I did not see this addressed, but maybe I missed it.
    2a. The authors assume that “toxins” lead to birth defects, which correlate with autism. That’s one huge hand-waving assumption that I cannot accept without evidence and some degree of detail. Which toxins? How strongly connected? The Australian study mentioned above has the level of detail needed, not this one.
    2b. Being a non-preschool teacher shows a lower rate of autism for the child. Now that makes no sense to me- if environmental “toxins” were a cause of autism, then anyone of childbearing age exposed to the noxious concentrated brewing vat of disease that is an elementary or middle or high school classroom should have a higher rate of autism. Unless, maybe, vaccines are helpful in protecting teachers from the more serious diseases spread by the vermin who infest schools, I mean those dear sweet cherubs? (Yes, I will never become a teacher, luckily for the rugrats.)
    3. The authors said they controlled for financial factors, such as moving to counties that provide better than federal law minimum assistance to families with autistic kids. That said, did they control for the fact that many states with more cows than people don’t even have a hospital within driving distance, never mind a physician or psychiatrist with sufficient expertise in helping autistic kids?

  21. #22 JerryA
    March 14, 2014

    Here is a very good read for scientists and non-scientists alike, published in the British Medical Journal.
    “Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials”
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/
    You ask, perhaps indignantly, “What does parachute use have to do with vaccinations or autism?”. Please do read the article- it is short but has a very good point.

    I realize in my comment # 21, part 2b, I was as guilty as the authors of the journal article of conflating vague “toxins” with a specific causal factor of autism. Yes, true. I, however, did not try to write a journal article based on that crappy stupid vague assumption.

  22. #23 herr doktor bimler
    March 14, 2014

    IIRC, clustering of *leukemia* turned out to correlate with social mobility (i.e. new people moving into an area because of new industry or construction), hence a theory that some undiagnosed infection during pregnancy was a contributing factor (rather than, say, cell towers or EMF from overhead transmission lines).

  23. #24 palindrom
    March 14, 2014

    OT, but when is this really OT?

    The Daily Beast posted an article yesterday called “Thanks, Anti-Vaxxers. You Just Brought Back Measles in NYC.” It’s written by a pediatrician, and let’s just say it pulls no punches.

    Over 900 comments so far, many by flying monkeys.

    I was touted onto it by a favorable mention on Charles’ Pierce’s politics blog on Esquire; his take: “I do believe that Stop Being Stupid, America, should now be a regular feature at every broadcast and cable newscast, every day for the rest of the century.”

  24. #25 Anthony
    March 14, 2014

    To what degree would the fact that people different areas likely visit different hospitals account for differences? There are a fair number of edge cases possible for autism, where one doctor might diagnose autism while another wouldn’t, or there would be disagreement on severity, so you should get some clustering just due to visiting different doctors (and/or groups of doctors with similar standards).

  25. #26 Bluebird
    March 14, 2014

    @lilady Not sure what that facial feature study (?) was supposed to be about, but here’s one fact: Fetal Alcohol Syndrome is associated with certain facial features (like those mentioned) and one observation: FAS/ARND does often result in behavior that mimics autism and other issues like LDs, ADD. I’m just a parent not an expert in any of the above, so please use that information wisely.

    @palindrom …Stop Being Stupid America… Perfect.

    Now, back to lurking.

  26. #27 Mrs Grimble
    March 14, 2014

    Her doktor bimler @23: You’re probably thinking of the Sellafield leukemia cluster of the 1970s and 1980s, when there was an unusual number of childhood leukemia cases around the Sellafield nuclear plant in NW England. There was simply not enough radioactive material detected in the environment to cause such illnesses, so it was a mystery for quite a while.
    Then somebody came up with the theory (later vindicated) that this type of leukemia could be caused by a viral infection, and that the increased inward social mobility in the villages around the plant (because of all the workers and their families moving in) had bought in new infections.

  27. #28 lilady
    March 14, 2014

    @ palindrom: I beat you to it. I already posted a link to the Daily Beast article, as part of yesterday’s lilady’s Media Update:

    http://www.thedailybeast.com/articles/2014/03/13/thanks-anti-vaxxers-you-just-brought-back-measles-in-nyc.html

    There are three additional (suspect) cases (total now, 16 confirmed/3 suspect measles cases), and Slate has a post up:

    http://www.slate.com/articles/health_and_science/explainer/2014/03/measles_outbreak_in_new_york_should_people_get_revaccinated.html

    I just posted a comment and I’ll be getting lonely at Slate. :-)

  28. #29 anon
    March 14, 2014

    #27 Sorry off topic but interesting follow-up to Sellafield. I must be ADD I’m always wandering off topic.
    http://www.bbc.com/news/uk-england-24206028

  29. #30 Shay
    March 14, 2014

    Lilady, when I looked at Slate a couple of hours ago there were only two anti-vaxxers desperately trying to drive back the tide of reason.

  30. #31 anon
    March 14, 2014

    #27 OOPs sorry back again -this time with a story of a cover-up….
    reaching for the Ritalin now……
    http://www.theguardian.com/environment/2012/mar/11/sellafield-stories-book-nuclear-accident

  31. #32 Shay
    March 14, 2014

    Oh, and if Bears fans didn’t already have good reasons to despise Jay Cutler, he and his reality-TV celebrity wife are in thrall to Eisenstein and won’t vaccinate their children.

  32. #33 Denice Walter
    March 14, 2014

    Never a slacker, la Dachel links to a Philly.com story about the study (@ AoA). She obviously isn’t pleased because it didn’t include vaccines.

  33. #34 ChrisP
    March 15, 2014

    Well the former Australian Vaccination Network ie trumpeting the study.

    “Toxins cause autism and the worst toxins are vaccines”

    I am sure no one there has actually bothered to read the study.

  34. #35 Krebiozen
    March 15, 2014

    @jane #7,

    The study isn’t solid proof of environmental influences on autism, but there’s virtually never solid proof of any influence of any environmental factor on anything where free-living humans are concerned.

    That’s just not true. What about mesothelioma from asbestos, fluorosis from high levels of fluoride in water, lung cancer from radon, cancer and other diseases from arsenic in drinking water, asthma and other respiratory diseases from air pollution, impaired intellectual development from lead, skin cancer from ultraviolet light and dozens of other environmental factors that have compelling evidence to support their adverse effects on health?

    Attempting not just to acknowledge that method’s real and significant limitations, but to dismiss all such studies altogether with scientistic claims that they constitute this or that Fallacy, is the behavior of someone who suspects that such studies may give results that will not suit his ideology.

    Orac didn’t dismiss ecological studies altogether, he said that the use of this type of methodology is, “a reason to be skeptical right off the bat”. Are you suggesting we should accept the findings of studies with “real and significant limitations” uncritically? Are you telling us that the ecological fallacy is a “scientistic” invention? That clustering isn’t a characteristic of random distribution? That the other problems Orac points out are irrelevant attempts to “handwave away” valid results?

    I’m being led to the inescapable conclusions that you have such rigidly fixed beliefs that you are unable to accept anything that doesn’t fit with them, and label it ‘scientism’. If you have a way of finding the the truth in these areas that is superior to logic and the scientific method, do share.

  35. #36 herr doktor bimler
    March 15, 2014

    How about this study of dysmorphic facial features, for identifying autistic kids…which the brain trust at AoA has never attempted to analyze or debunk?
    http://sfari.org/news-and-opinion/in-brief/2012/clinical-research-facial-features-can-help-diagnose-autism

    I recall someone commenting along similar lines <a href="http://scienceblogs.com/insolence/2011/10/20/whither-the-anti-vaccine-movement/#comment-165739"a couple of years ago.

  36. #37 herr doktor bimler
    March 15, 2014

    How about this study of dysmorphic facial features, for identifying autistic kids…which the brain trust at AoA has never attempted to analyze or debunk?
    http://sfari.org/news-and-opinion/in-brief/2012/clinical-research-facial-features-can-help-diagnose-autism

    I recall someone commenting along similar lines a couple of years ago.

  37. #38 Militant Agnostic
    March 15, 2014

    @Krebiozen

    Are you suggesting we should accept the findings of studies with “real and significant limitations” uncritically?

    Based on Calamity’s past form I would say yes, in cases when those studies support her ideology.

  38. #39 Denice Walter
    March 15, 2014

    It’s nice to be quoted by an antipodean Scandiwegian**…

    An any rate, that study addresses intra-facial proportions. If you would take a peek at the TMs’ video section, they have a photo essay of their children- you’ll notice that quite a few of the kids bear physical resemblence to each other despite being unrelated ( only one or two are IIRC). There are a few apparent proportions that make them look a bit different from average kids ( Jenny’s son might fit in with them). I wonder what an artist ( e.g.The Face of the Future) might find if he or she compiled their photos.
    I have a good guess.

    If you study art, you’ll know that artists often try to create ideal or real faces ( see the Italian Renaissance esp) and obviously children’s facial proportions are different from adults. We know that certain genetic and early gestationally occuring syndromes can produce particular facial differences. I’m sure you are familar with a few of those.

    The TMs and a few AoA mavens consistently talk about their “beautiful children” – and it’s true, many of them are very attractive in a *particular* way. I remember an (NT) actress, Michelle Williams, being described as looking “elfin” and perhaps that’s related to what I mean.
    Overall, these studies show intra-facial, head size/ shape and expression differences as well as asymmetries.

    So vaccines at age 14 months can do all that?

    ** probably the best kind.

  39. #40 lilady
    March 15, 2014

    Dr. bimler: you have an amazing memory. Thanks for the link. :-)

  40. #42 Jeff1971
    March 15, 2014

    There seems to be a cluster at Age of Autism. Recently somebody called Tim Welsh, who spends his life obsessively tweeting, confirmed that his autistic son is the fourth generation in the family with autistic traits.

    Now someone called Cia Parker has explained that she and her mother were also autistic. I don’t know about Mr Welsh, but Ms Parker explains it as vaccine damage.

  41. #43 Lancelot Gobbo
    March 15, 2014

    My grandfather was an engineer, my father was an engineer, and my son is autistic. Who’s surprised (especially when you consider I hang around places like this under the adopted name of an obscure Shakespearean character)? I don’t need no stinkin’ toxins, I gots bad genes!

  42. #44 Yodelady
    March 16, 2014

    I agree they really need to discuss the counties where the incidence is remarkably low. In South Dakota, and some of the other Western states, it appears to me the dark (low incidence) places on the map coincide with Indian Reservations. Here’s a map of SD’s reservations: http://upload.wikimedia.org/wikipedia/commons/7/72/National-atlas-indian-reservations-south-dakota.gif

    The dark splotch in the SW corner of SD would be the Rosebud Reservation. I think the dark splotches in Arizona and Wyoming are probably reservations as well. It could be as simple as the fact the study got its data from insurance claims. Would that include information from Bureau of Indian Affairs hosptials?

  43. #45 Yodelady
    March 16, 2014

    I’m not feeling compulsive enough to beat my hypothesis to a pulp tonight, but this map does seem to show that those dark splotches in South Dakota coincide with the location of Indian Health Service facilities. http://www.ihs.gov/forpatients/findhealthcare/

    My mentioning the Bureau of Indian Affairs was wrong — Health and Human Services administers health services now, through the Indian Health Service (IHS).

  44. #46 Denice Walter
    March 16, 2014

    OT- but not entirely so because the spectacle of anti-vaccine loons using every trick in the book in order to draw attention to themselves is NEVER truly OT @ RI.

    Mikey announces that Neil DeGrasse Tyson has the same core values as Natural News: they both “follow the evidence and question everything”. And Mike runs his own lab. AND was a fan of the original “Cosmos” series. AND endorses True Science ™ not “distorted corporate-based anti-science profit agendas” and the Church of Scientism.

    Yes, he’s like Galilieo. A *real* sceptic. Or so he tells us.

    According to Mike, no true scientist can support mercury used in vaccines and dental fillings, fluoride and GMO-laden foods.

    So , he’s offering a public challenge to Tyson to denounce this witchcr… I mean, the use of mercury in medicine. ( links to CoMeD) Then he asks his million plus friends to bombard the scientist on facebook.

    You see, MIke says that he has the * full power of the laws of physics and chemistry* ( in bold) to back him up.
    And who can argue with them?

  45. #47 Lawrence
    March 16, 2014

    @Denise – perhaps Mikey missed the part where Dr. Tyson also talked about abandoning failed hypotheses as well…….

  46. #48 Zoe
    March 16, 2014

    Great article. Any chance you could respond to http://gianelloni.wordpress.com/2013/09/13/the-myth-of-herd-immunity/ if you have not already? Or anybody have a link to a response.

  47. #49 Lawrence
    March 16, 2014

    @zoe – pretty much everything in that article is BS.

  48. #50 herr doktor bimler
    March 16, 2014

    but this map does seem to show that those dark splotches in South Dakota coincide with the location of Indian Health Service facilities.
    Now you’ve given Dan Olmsted the idea for his next book on “Why the Lakota don’t get autism”.

  49. #51 Zoe
    March 16, 2014

    Obviously bs. However I need a response for someone I know, and don’t have the time to write one. I’ve heard a lot lately how herd immunity is a myth.

  50. #52 Lawrence
    March 16, 2014
  51. #53 Narad
    March 16, 2014

    I’ve heard a lot lately how herd immunity is a myth.

    It’s a simple mathematical outcome. You have four buckets: susceptible, exposed, infected, and recovered (or removed from the population, i.e., dead). Reduce S, and you reduce E and I. Reduce E and I to the point that every member of the buckets contributes less than one additional infection, and outbreaks die out. That’s it.

  52. #54 Lawrence
    March 16, 2014
  53. #55 Lawrence
    March 16, 2014
  54. #56 Chris,
    March 16, 2014

    Zoe: “I’ve heard a lot lately how herd immunity is a myth.”

    That is a good indicator the folks making that declaration do not understand basic statistics and epidemiology. So avoid those sources for any actual information.

  55. #57 Chris
    March 16, 2014

    Zoe, that page is just a blog. If you really care, then do a search on this site about the “authorities” cited. None of them are experts in disease epidemiology. Just like the authors of the website.

    Especially since they have don’t understand the difference of immunology between measles and pertussis. One is a virus and the other is a bacteria. They are very different from each other, so have different characteristics as far as infectiousness and immune response.

    (bacteria are more complex, and sometimes there is no immunity from some bacteria after infection like strep, tetanus and diphtheria)

  56. #58 Zoe
    March 16, 2014

    When I said great article, I was referring to autism clusters, not the one I asked about. Sorry. It is not me you need to convince. My observation is that there is some confusion, even among otherwise smart people, about what herd immunity actually is. Specifically, the misconception that vaccine induced herd immunity is different than natural immunity somehow. I have a thread amongst people I know using this article as justification that herd immunity is a myth. I need a line by line “bullshit meter” response to rebut it. If someone knows of one, thank you. Obviously one should not use that blog as scientific evidence, but this person is trying,

  57. #59 dingo199
    March 16, 2014

    Zoe, as it is just a blog, populated by comments from believers firmly wedded to the antivax lies.
    I’d be tempted to let it go.
    Difficult, I know, but all you do by responding is to get caught in a comment battle where you may find many of your posts are “moderated” into oblivion, you greatly increase hits on the site and raise its profile.
    Save your powder for media articles which have a high volume of passing traffic.

  58. #60 Science Mom
    http://justthevax.blogspot.com/
    March 16, 2014

    Zoe, if you want to refute the “herd immunity is a myth” commentors then why don’t you ask them how smallpox was eradicated, how polio is eliminated from the Western Hemisphere, how rhinderpest in cattle was eradicated and how indigenous measles cases in the U.S. were eliminated? The U.S. has only imported cases and almost all are in unvaccinated children. You may also wish to ask why there have been no indigenous cases of congenital rubella syndrome too. Good luck, the ones who can’t seem to understand herd immunity in the face of so much evidence are some of the thickest.

  59. #61 Chris,
    March 16, 2014

    Zoe, like Dingo says: it is best to just ignore that particular blog. It is just some random folks publishing their uneducated opinions.

  60. #62 Zoe
    March 16, 2014

    Well, it’s a private group, composed of other women I know personally. It is about evenly divided and the person making the specific argument IS a scientist. I almost never comment on blogs or groups in general, my computer time is very limited. So yes, I’m tempted to let it go as well.

    Science mom, yes, those are the types of arguments I would make, in addition to graphs showing the introduction of the vaccine to decline in the disease. The specific misconception here seems to that because pertussis is on the rise and because our immunity sometimes wanes when we become adults, herd immunity is a myth.

  61. #63 Zoe
    March 16, 2014

    To be more clear, a mom in my private group linked to this blog as “evidence.” But I have heard from a couple of people in different places that herd immunity is a myth. I did search RI and across some interesting older articles before I commented.

  62. #64 Narad
    March 16, 2014

    Zoe, if you want to refute the “herd immunity is a myth” commentors then why don’t you ask them how smallpox was eradicated

    The linked post has chiropractor O’Shea advancing that it “burned out,” which represents “natural selection,” so that’s a nonstarter.

  63. #65 Narad
    March 16, 2014

    The specific misconception here seems to that because pertussis is on the rise and because our immunity sometimes wanes when we become adults, herd immunity is a myth.

    Which gets right back to the basic math. It is known that there’s a gap in pertussis boosters (around age 10, IIRC); this increases S. There is now concern about the appearance of pertactin-negative strains, which subtly (because the lack of this adhesin affects the time frame for the pathogen to establish itself) modifies I. To the extent that the vaccine – as opposed to waning immunity – allows asymptomatic transmission, I is also increased.

    None of this has anything to do with the herd effect’s being a “myth,” and the gibberish in that blog post does even less.

  64. #66 Chris,
    March 16, 2014

    The trouble with trying to deal with community immunity is that each disease is different. Some are more contagious, and others like to fool immune systems.

    That is why the epidemiology equations have so many variables. Things like reproduction number, force of infection, contact numbers, etc. Here is one page, you might want to brush up on your nonlinear differential equations:
    http://en.wikipedia.org/wiki/Compartmental_models_in_epidemiology

    (There is a simplified explanation in the movie “Contagion”… perhaps your group should have a video night to watch it.)

    For instance, measles is very very infectious. If you are not immune and go into a room where someone who was harboring a measles infection left a couple of hours before, you have a high chance of getting measles.

    But its vaccine is very effective.

    The thing with pertussis is even after living through two months of a coughing up your lungs with an infection, you can get infected again after just five years. And it is impossible in the real world to get a vaccine to give better immunity than the disease.

    Even worse, if you survive either tetanus and diphtheria, you are not even immune. You can get it again. By the way, there is no community immunity for tetanus, as it exists in the environment. The vaccines for these are based on the toxins the bacteria produce. It trains your body to deal with tetanospasmin, and diptheria toxin.

    This is why we can dismiss a blog post written by someone with a masters in (I think) educational counseling. So, in the future, you are okay if you question the credentials of the writer of anything scientific.

  65. #67 Science Mom
    http://justthevax.blogspot.com/
    March 16, 2014

    Science mom, yes, those are the types of arguments I would make, in addition to graphs showing the introduction of the vaccine to decline in the disease. The specific misconception here seems to that because pertussis is on the rise and because our immunity sometimes wanes when we become adults, herd immunity is a myth.

    What Narad and Chris said but that would fly right over their wee heads I’m sure. Just because there are some vaccines which can’t confer herd immunity doesn’t mean herd immunity is a myth. It’s simply the way some pathogens and immune responses behave. There are a number of naturally-occuring infectious diseases that we can be repeatedly infected with e.g. noroviruses, staph, strep, etc. Honestly, it isn’t rocket science to see that for vaccines that confer a high duration of immunity that morbidity and mortality drastically fell with the introduction of the vaccine. Chiroquacks don’t know squat about infectious disease let alone statistics and any scientist arguing against herd immunity isn’t a very good or qualified scientist at all.

  66. #68 anon
    March 16, 2014

    From the CDC:
    Doesn’t herd immunity protect most people?
    A: Herd immunity, or community immunity, is a situation in which, through vaccination or prior illness, a sufficient proportion of a population is immune to an infectious disease, making its spread from person to person unlikely. Even individuals not vaccinated (such as newborns and those with chronic illnesses) are typically protected because the disease has little opportunity to spread within their community. Since pertussis spreads so easily, vaccine protection decreases over time, and acellular pertussis vaccines may not prevent colonization, we can’t rely on herd immunity to protect everyone.
    Vaccines are the most effective tool we have to provide protection against pertussis. It’s important that everyone get their recommended pertussis vaccines to protect themselves.
    http://www.cdc.gov/pertussis/about/faqs.html#booster

  67. #69 Chris,
    March 16, 2014

    anon, well that is one disease. And I have already explained that as a bacterial infection it is more difficult to get immunity even after an infections.

    That is not the same for vaccines for viral infections like measles and polio.

    It is more complicated. You simply cannot take what happens with one vaccine and assume it happens with another. And I’m okay with folks not knowing that different viruses behave differently, or the same with bacteria…

    … but why they can’t figure out that viruses and bacteria are not the same!

  68. #70 Chris,
    March 16, 2014

    Narad: “The linked post has chiropractor O’Shea advancing that it “burned out,” which represents “natural selection,” so that’s a nonstarter.”

    Yeah, that totally ignores the fact that babies are always getting born, providing another fresh set of vulnerable kids.

  69. #71 Narad
    March 16, 2014

    Here is one page, you might want to brush up on your nonlinear differential equations

    There’s no need. As I’ve noted in the past, this can be intuited by anyone who can vaguely understand Conway’s Game of Life.

  70. #72 Chris,
    March 16, 2014

    Oh, wow. I forgot about that. I played that in high school with fellow nerds. I think watching “Contagion” might be a bit more on her group’s intellectual level.

  71. #73 Zoe
    March 16, 2014

    Yes, I think the simpler the better. The whole argument also seems to be related to “pertussis and measles rates are climbing, thus vaccines don’t work.” And, “vaccinated people come down with these diseases too. ” Therefore, herd immunity doesn’t exist.

  72. #74 LW
    March 16, 2014

    And, “vaccinated people come down with these diseases too. ” Therefore, herd immunity doesn’t exist.

    Maybe part of the trouble is the term “herd immunity”. Some people are offended at the implication that they are part of a “herd”, and also “immunity” is a misnomer. The population isn’t “immune”; most of the individuals are, but not all — some aren’t vaccinated and some are but the vaccine failed on them — so the population as a whole is resistant rather than immune. Diseases can be introduced and can spread a bit, even to the vaccinated, but they die out because each infected person tends to be surrounded by a lot of immune people.

    You might use the analogy that an well-vaccinated population is like a pile of damp wood. If you stick a match into a pile of damp wood, some bits may catch fire because they weren’t quite so damp, but the pile as a whole will not burn.

    A non-immune population is like dry wood — introduce a match into dry wood and the whole thing may catch; introduce a contagious disease into a non-immune population (e.g. measles and smallpox to the Native Americans), and the disease spreads like … well, like wildfire.

  73. #75 Chris,
    March 16, 2014

    Except for one thing: most of the folks coming down with measles are vaccinated. Before the vaccine almost all kids had had it before age fifteen, and a few hundred ended up buried in a cemetery, plus thousands more ended up with permanent disabilities like blindness, paralysis, etc.

    For some measles outbreaks see:
    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6236a2.htm

    Which says:

    Most cases were in persons who were unvaccinated (131 [82%]) or had unknown vaccination status (15 [9%]). Thirteen (8%) of the patients had been vaccinated, of whom three had received 2 doses of measles, mumps, and rubella (MMR) vaccine. Among 140 U.S. residents who acquired measles, 117 (84%) were unvaccinated, and 11(8%) had unknown vaccination status. Of those who were unvaccinated, 92 (79%) had philosophical objections to vaccination, six (5%) had missed opportunities for vaccination, 15 (13%) occurred among infants aged <12 months who were not eligible for vaccination, and for four (3%) the reason for no vaccination was unknown (Figure 3). Among the 21 U.S resident patients who traveled abroad and were aged ≥6 months, 14 (67%) were unvaccinated, five (24%) had unknown vaccination status, and two had received 1 dose of MMR vaccine.

    And then there is the issue that the DTaP is not perfect because the world is not perfect (Nirvana Fallacy). But here is some community immunity numbers I came up with:

    Some community immunity arithmetic:

    Take 1000 people (ignoring the infants under 2 months who cannot be vaccinated, or babies under a year who can only be partially vaccinated), if 5% refuse vaccines then the numbers are:

    950 vaccinated persons (assuming full schedule)
    50 unvaccinated persons

    The pertussis vaccine is actually only 80% effective at worse, so the numbers are:

    760 protected persons
    190 vaccinated but vulnerable persons
    50 unvaccinated persons

    There is an outbreak and it gets spread to 20% of the population, then:

    760 protected persons without pertussis

    38 vaccinated persons get pertussis
    152 vaccinated person who may still get pertussis

    10 unvaccinated persons get pertussis
    40 unvaccinated persons who may still get pertussis.

    This is how more vaccinated persons get the disease than unvaccinated. Even if the infection rate was at 100%, there would still be more of the vaccinated getting the diseases because there are more of them!

  74. #76 Dangerous Bacon
    March 16, 2014

    An update on those lovable antivax nitwits Down Under:

    The Australian Vaccination Network, forced to change its misleading name by government regulators, has reinvented itself as the Australian Vaccination-Skeptics Network. Aside from the lame attempt to co-opt the word “skeptic”, this change (and especially the publicity over the AVN’s antics to avoid altering its name) should help alleviate any confusion about its goals.

    Unfortunately for the AVSN, its new name hasn’t erased its ongoing troubles. A government investigation of its allegedly dodgy finances and charges of abusing its charity status is underway:

    “The Office of Liquor Gaming and Racing has confirmed it is investigating ”problems” in the Australian Vaccination-Skeptics Network’s financial statements.”

    “The anti-vaccine group has raised nearly $2 million in the past seven years but has never done any ”charity”, according to Stop the AVN, a coalition of critics formed after the parents of a baby who died of whooping cough were targeted by the network.”

    http://www.smh.com.au/nsw/antivaccine-groups-charity-status-opposed-20140314-34rq0.html#ixzz2wBTBAqS1

  75. #77 Narad
    March 16, 2014

    Oh, wow. I forgot about that. I played that in high school with fellow nerds.

    Just in case anyone thought the link was to a version of Conway, it’s a bunch of Java cellular-automaton applets allowing one to play around with different parameters for SEIR instantiations.

  76. #78 Chris,
    March 17, 2014

    Out version during lunch was a printed grid and colored poker chips. It was the mid-1970s.

  77. #79 Chris,
    March 17, 2014

    Type alert: “Out” is supposed to be “Our.”

  78. #80 Narad
    March 17, 2014

    introduce a contagious disease into a non-immune population (e.g. measles and smallpox to the Native Americans)

    Vulnerable to the bogus “natural selection” routine: I spent some time a couple of weeks ago making well and clear that “sabelmουse” didn’t know what she was talking about when claiming that American Indians were grievously affected by measles when it was introduced because they “didn’t evolve with it.”

    I probably should have saved the myriad links to the disparate outcomes of virgin-soil introductions of pathogens.

  79. #81 The Very Reverend Battleaxe of Knowledge
    March 17, 2014

    LW @ 74:

    You might use the analogy that an well-vaccinated population is like a pile of damp wood. If you stick a match into a pile of damp wood, some bits may catch fire because they weren’t quite so damp, but the pile as a whole will not burn.

    A non-immune population is like dry wood — introduce a match into dry wood and the whole thing may catch; introduce a contagious disease into a non-immune population (e.g. measles and smallpox to the Native Americans), and the disease spreads like … well, like wildfire.

    My favorite illustration is critical mass, because the arithmetic is actually pretty much the same (except, as Chris said, there are more variables in epidemiology). If there’s no such thing as herd immunity, then there’s no such thing as a subcritical mass of plutonium—any amount, no matter how small, should experience a runaway chain reaction and explode. Yet this is demonstrably false. You can hold the pit of an atomic bomb in your hand—4 kg. or so of plutonium, just sitting there, enjoying herd immunity. That is, until explosives force it into a smaller volume, like a doctor’s waiting room, then: Kablooey!

  80. #82 Narad
    March 17, 2014

    You can hold the pit of an atomic bomb in your hand—4 kg. or so of plutonium, just sitting there, enjoying herd immunity. That is, until explosives force it into a smaller volume unless it’s the Demon Core

    FTFY.

  81. #83 The Very Reverend Battleaxe of Knowledge
    March 17, 2014

    You can hold the pit of an atomic bomb in your hand—4 kg. or so of plutonium, just sitting there, enjoying herd immunity. That is, until explosives force it into a smaller volume unless it’s the Demon Core

    Yeah, maybe surrounding it with tungsten carbide blocks is more like the doctor’s waiting room, and imploding it, reducing the mean free path, is more like increased air travel.

  82. #84 herr doktor bimler
    March 17, 2014

    You can hold the pit of an atomic bomb in your hand—4 kg. or so of plutonium, just sitting there
    Apart from the “spontaneously catching on fire from time to time” part.

  83. #85 Science Mom
    http://justthevax.blogspot.com/
    March 17, 2014

    Except for one thing: most of the folks coming down with measles are unvaccinated.

    I know that was a typo Chris so I FTFY.

  84. #86 Scottynuke
    March 17, 2014

    Just so long as the plutonium pit doesn’t shed any particles while you’re inhaling… :O

  85. #87 Chris
    March 17, 2014

    Ask! That was a typo! Thanks, Science Mom.

  86. #88 Chris
    March 17, 2014

    And hit with auto-correct… not “ask”, but:

    Ack!

  87. #89 John Berkowitz
    March 17, 2014

    Well written post. Even though I’m a social scientist, I’m happy to see the same fervor to maintain rigorous results in other disciplines. As you pointed out, it is not possible to make conclusions about something without being precise about where your numbers come from and how did you get them. It is a very usual mistake. And the definition of toxins seems vague. We are being forced to believe that pesticides are something absolutely evil, yet we consume them in great variety. We are also exposed to many health hazards just by living in old houses.

  88. #90 Jamie Gegerson
    March 17, 2014

    What about clusters around medical (or not) practices and facilities that specialize in diagnosis of ASD? Is this another possible issue with the data collected? If so, is it taken into account anywhere in the study?

  89. #91 Zoe
    March 17, 2014

    Well the response to my couple of pointed questions was “herd immunity does not exist, but vaccine conferred immunity in subsets of population can. ” @@

  90. […] environmental factors such as toxins contribute to autism? On Respectful Insolence, Orac looks at a new study which found a correlation between birth defects […]

  91. #93 ChemE
    Georgia
    April 11, 2014

    1) South Korea has the highest autism rate, 1/38 and the highest installed concentration of microwave Doppler radars
    2) Minnesota Study 800% rise in autism in ’95 & ’96 time frame same time they started up two high powered pulsed overlapping radars.
    3) All sites from the 2010 UC Davis autism cluster study have overlapping 1,120,000 watt pulsed microwave radars
    4) The US now has over 600,000,000 watts of pulsed microwave doppler radiation 24/7 reflecting off the overhead atmosphere and penetrating all biology.
    5) Over 30 studies now showing the 2.0 – 6.0 GHz frequency range emitted from the Dopplers is bad for biology
    Research @ darkmattersalot

  92. #94 Scottynuke
    April 12, 2014

    Necromancing off-topic poster is necromancing off-topically…

  93. #95 Narad
    April 12, 2014

    Necromancing off-topic poster is necromancing off-topically…

    I replied to it once yesterday. It doesn’t seem capable of responding. (VHF doesn’t “reflect off the atmosphere.”)

  94. #96 Johnny
    127.0.0.1
    April 12, 2014

    VHF doesn’t “reflect off the atmosphere.”

    Yep. That’s why we use VHF and up to talk to spacecraft (in addition to other terrestrial services), and not 30MHz and below. Below 30MHz or so, radio waves will bounce around, but much above that, they just shoot off into space. Over the horizon radar is all below 30MHz for just this reason.

  95. #97 herr doktor bimler
    April 12, 2014

    I replied to it once yesterday.
    ChemE Stewart, the Microwave Doppler Radiation loon, espouses an interesting J.G.Ballard-style scenario in which Doppler-shifted electromagnetic radiation causes unnatural aging of biology and geology. It seems to be a time-dilation thing.

  96. #98 Narad
    April 13, 2014

    Over the horizon radar is all below 30MHz for just this reason.

    Ah, the Woodpecker(s).

  97. #99 Kayleigh Baxter (14021651)
    Pretoria
    April 30, 2014

    Well written post. Even though I’m only a student currently, I’m happy to see the same fervor to maintain rigorous results in other disciplines. As you pointed out, it is not possible to make conclusions about something without being precise about where your numbers come from and how did you get them. It is a very usual mistake. And the definition of toxins seems vague. We are being forced to believe that pesticides are something absolutely evil, yet we consume them in great variety. We are also exposed to many health hazards just by living in old houses.
    The study isn’t solid proof of environmental influences on autism, but there’s virtually never solid proof of any influence of any environmental factor on anything where free-living humans are concerned. When you’re dealing with substances that humans consume voluntarily, the best you can get is prospective observational studies combined with animal studies. When substances that are consumed, breathed, etc. unintentionally are involved, especially when you do not assume that only one such substance has any effect, it may be that population-level studies are the best you can manage.

    There are now an increasing number of studies that measure bis-phenol A levels in individual pregnant women, for example, and correlate them with unwanted outcomes in the offspring. But you couldn’t possibly do such a study that measured exposures to every conceivable pesticide and plasticizer. Nor could you do one with millions of mothers, so participant numbers are relatively small and results easy to handwave away. Hence an alternative approach is the population-level study. Attempting not just to acknowledge that method’s real and significant limitations, but to dismiss all such studies altogether with scientific claims that they constitute this or that Fallacy, is the behavior of someone who suspects that such studies may give results that will not suit his ideology. (14021651)

  98. #100 ChemE
    Georgia
    May 2, 2014

    Guys,

    Don’t believe me, believe nature. We have Chronic wasting of biology around all of our radar/missile bases, including Cape Canaveral, White Sands, Pacific Sands and Guam. Doppler radar EMF is designed to reflect off “Weather”. I have good statistics (p<0.01) that says there is a strong correlation between pulsed Doppler microwave radar tower locations (FAA, Weather & Military) and fish dying due to hypoxia and associated with algae blooms.

    http://darkmattersalot.com/2014/01/31/the-killing-fields/
    http://darkmattersalot.com/2014/01/12/florida-2/

  99. #101 ChemE
    Georgia
    May 2, 2014

    I hope you guys have heard of the “Doppler Effect” right?
    Because without it our Weather, FAA and Military radars would not work. It is the radar “scatter” of EMF that is leading to the increase in autoimmune diseases and autism.

    http://en.wikipedia.org/wiki/Weather_radar

  100. #102 Lawrence
    May 2, 2014

    Wow – that’s some Grade A crazy right there…..

  101. #103 Shay
    May 2, 2014

    ChemE, what are the autism stats for the children of military personnel stationed at these places? Because if they are no higher than the mainstream, it holes your theory below the waterline.

  102. #104 Mephistopheles O'Brien
    May 2, 2014

    ChemE – you state in your blog that waterspouts (and possibly sinkholes as well, the sentence is unclear) are “evidence of weakly ionized plasma”. I’ve never heard that there was any connection between waterspouts – or tornadoes as we call them over land – and any form of plasma (except for plasma tornadoes on the sun, but that’s a somewhat different phenomenon).

  103. #105 ChemE
    May 2, 2014

    Waterspout as “dusty” weakly ionized plasma
    http://epsppd.epfl.ch/London/pdf/P4_062.pdf

    Some pof them I would call “strongly ionized”….
    http://www.abovetopsecret.com/forum/thread575270/pg1

  104. #107 Shay
    May 2, 2014

    From the Mayo clinic:

    Military service. Recent studies indicate that people who have served in the military are at higher risk of ALS. Exactly what about military service may trigger the development of ALS is uncertain, but it may include exposure to certain metals or chemicals, traumatic injuries, viral infections and intense exertion.

    I would add that at least until recently, the percentage of smokers in the military was higher than the civilian population.

  105. #108 Shay
    May 2, 2014

    The ALS link also does not have any mention of radar scatter as a cause.

  106. #109 ChemE
    May 2, 2014

    They don’t know what is causing it.

    I have good statistics in florida around military/weather radars that fish are dying due to hypoxia, which is a marker for autism. Algae blooms are blooming like crazy in the area also. I think that is a sign of free radicals/oxidative stress.

    Here is an article on autism in military kids. I have not researched it. It implies it is HIGHER.

    http://www.ageofautism.com/2008/07/autism-in-the-m.html

  107. #110 Shay
    May 2, 2014

    If they don’t know what’s causing it, then stop offering those links as proof that radar scatter is to blame.

    Algae blooms may be prevalent near radar sights but algae blooms are also prevalent elsewhere, so that’s hardly definitive. Plus, there are a number of other causal factors that are present around military sites.

    And anyone who cites Age of Autism as a reliable source is terribly, terribly misinformed.

  108. #111 ChemE
    May 2, 2014

    Autoimmune at one of our largest radar bases
    http://darkmattersalot.com/2014/04/04/guilefulguamguano/

    http://www.ncbi.nlm.nih.gov/pubmed/19929726
    Excitement about neurogenetics in the last two decades has diverted attention from environmental causes of sporadic ALS. Fifty years ago endemic foci of ALS with a frequency one hundred times that in the rest of the world attracted attention since they offered the possibility of finding the cause for non-endemic ALS throughout the world. Research on Guam suggested that ALS, Parkinson’s disease and dementia (the ALS/PDC complex) was due to a neurotoxic non-protein amino acid, beta-methylamino-L-alanine (BMAA), in the seeds of the cycad Cycas micronesica. Recent discoveries that found that BMAA is produced by symbiotic cyanobacteria within specialized roots of the cycads; that the concentration of protein-bound BMAA is up to a hundred-fold greater than free BMAA in the seeds and flour; that various animals forage on the seeds (flying foxes, pigs, deer), leading to biomagnification up the food chain in Guam; and that protein-bound BMAA occurs in the brains of Guamanians dying of ALS/PDC (average concentration 627 microg/g, 5 mM) but not in control brains have rekindled interest in BMAA as a possible trigger for Guamanian ALS/PDC. Perhaps most intriguing is the finding that BMAA is present in brain tissues of North American patients who had died of Alzheimer’s disease (average concentration 95 microg/g, 0.8mM); this suggests a possible etiological role for BMAA in non-Guamanian neurodegenerative diseases. Cyanobacteria are ubiquitous throughout the world, so it is possible that all humans are exposed to low amounts of cyanobacterial BMAA, that protein-bound BMAA in human brains is a reservoir for chronic neurotoxicity, and that cyanobacterial BMAA is a major cause of progressive neurodegenerative diseases including ALS worldwide. Though Montine et al., using different HPLC method and assay techniques from those used by Cox and colleagues, were unable to reproduce the findings of Murch et al., Mash and colleagues using the original techniques of Murch et al. have recently confirmed the presence of protein-bound BMAA in the brains of North American patients dying with ALS and Alzheimer’s disease (concentrations >100 microg/g) but not in the brains of non-neurological controls or Huntington’s disease. We hypothesize that individuals who develop neurodegenerations may have a genetic susceptibility because of inability to prevent BMAA accumulation in brain proteins and that the particular pattern of neurodegeneration that develops depends on the polygenic background of the individual.

    It’s the F’ing pulsed microwave radars.

  109. #112 Shay
    May 2, 2014

    We hypothesize that individuals who develop neurodegenerations may have a genetic susceptibility because of inability to prevent BMAA accumulation in brain proteins and that the particular pattern of neurodegeneration that develops depends on the polygenic background of the individual.

    You realize that your citation does not, in fact, prove (or even hint) that it’s the pulsed microwave radars.

  110. #113 Calli Arcale
    http://fractalwonder.wordpress.com
    May 2, 2014

    Waterspouts as evidence of weakly ionized plasma? Okay, first of all, what’s weakly ionized plasma? Plasma is, by definition, ionized. You don’t get weakly or strongly ionized plasma.

    Secondly, waterspouts and dust devils are not evidence of plasma. They’d be incandescent if they were. Ionization does happen in them, definitely, due to triboelectric charging as particles move around the vortex. But this is an *effect* of the waterspout, not a cause, any more than shuffling across the carpet and then touching your little brother on the ear is evidence of plasma in the area.

    I would not be surprised if autism is more commonly diagnosed in military kids, for several reasons. 1) They’re under far more stress than other kids, and autistic kids can’t cope with stress as well, so more of them will have a condition that moves from just being a quirk to being of clinical significance. 2) They have Tricare, so they’re more likely to be able to *afford* to get their kid diagnosed.

  111. #114 Calli Arcale
    http://fractalwonder.wordpress.com
    May 2, 2014

    BTW, this is only tangentially related, but perhaps our Blinky Box might be interested: a recent study purports to show a correlation between strokes and geomagnetic storms, suggesting a 20% increase in incidence during a geomagnetic storm. I have only seen mass media reporting, but my bad-science-sense was tingling; I am wondering whether they collected their data in a sensible way. It’s a pretty extraordinary claim, after all.

  112. #115 ChemE
    Georgia
    May 2, 2014

    Right, they don’t know, I have shown it in my research.

    I have good statistics on a strong correlation between fish dying due to hypoxia associated with increased algae blooms around microwave radar towers. Algae blooms are also associated with BMAA accumulation

    http://theconversation.com/toxic-load-blue-green-algaes-role-in-motor-neuron-disease-16041

    In the Indian River Lagoon in Florida, they are pulsing over 10,000,000 watts of microwaves 24/7 and fish are dying, algae is blooming, dolphins, manatees & pelicans are dying, many showing signs of electromagnetic shock.
    http://articles.orlandosentinel.com/2014-02-01/news/os-manatee-deaths-indian-river-20140201_1_indian-river-lagoon-katie-tripp-dead-manatees

  113. #116 ChemE
    Georgia
    May 2, 2014

    Guys, you can call me weird names and keep your heads stuck in the sand. I am a professional Chemical/Environmental Engineer with 28 years of experience, graduated near the top of my class, did a thesis, I have been researching this for two years and I am working with two biologists with a hell of a lot of initials after their names in preparation for a peer reviewed paper. With 1/68 kids in the US now being born with “brain damage/autism” and 1/6 kids with some type of learning disability, and 50 million Americans with an “Auto Immune” disease, everyone should take a serious look at all possibilities.

    http://www.aarda.org/autoimmune-information/autoimmune-statistics/

    Go ahead and keep right on joking

  114. #117 Lawrence
    May 2, 2014

    @ChemE – not what that article says….”shock” can mean many types of shock….(i.e.y it doesn’t specifically mention electro-magnetic anything).

  115. #118 ChemE
    Georgia
    May 2, 2014

    Guys,

    Believe what you want. I was not put on this Earth to convince you of anything.

    http://darkmattersalot.com/2014/04/24/a-shocking-discovery/

    If you guys want to comment back to me you can do it on my blog. I will post the comment as long as it is respectful.

    Later

  116. #119 novalox
    May 2, 2014

    @cheme

    First of all autism is not brain damage, it is developmental delay. Your characterization of autism is a terrible disservice to those who have autism and those who care for them.

    Second, you do know that correlation does not mean causation, right? Your cites and links do not point to any such link, and at best, points to a very weak correlation.

    Finally, where is your evidence? If what you have posted is the best evidence you have, then you really have to find some stronger evidence.

  117. #120 Johnny
    127.0.0.1
    May 2, 2014

    I have good statistics on a strong correlation between fish dying due to hypoxia associated with increased algae blooms around microwave radar towers.

    Do you have any evidence that shows areas with reduced RADAR have fewer events? Sure, fish die where RADAR is, but do they die where it isn’t?

  118. #121 The Very Reverend Battleaxe of Knowledge
    May 2, 2014

    Re the paper ChemE quotes @ 111:

    “Guamanian”? Is this really the intellectual level of scientific papers these days? The people of Guam, Saipan, Tinian, and Rota are “Chamorros”, in case anyone was wondering.

  119. #122 ChemE
    May 2, 2014

    Yes, dummy radar towers were shuffled around the State.

    2 years, >900 fish kill event locations, >50,000 dead fish, 61 radar locations, 61 “random/polyline” locations”, entire State of Florida, shuffled 10,000 times, multiple runs. p-Values <0.01 consistently for null hypothesis "no relation between doppler microwave radar tower locations and fish kills" . Not correlated directly with Human population, Melbourne Fl. is the 27th largest town but has the highest fish kills/algae problem. It just so happens that the fish kills are also occurring in areas where the limestone has given way/dissolved more often triggering "cover collapse" sinkholes, also more algae blooms in those areas.

    And "that ain't good"

  120. #123 novalox
    May 2, 2014

    @cheme

    [citation needed]

  121. #124 ChemE
    Georgia
    May 2, 2014

    Brain Damage

    Citation: Translational Psychiatry (2012) 2, e134; doi:10.1038/tp.2012.61
    Published online 10 July 2012

    Evidence of oxidative damage and inflammation associated with low glutathione redox status in the autism brain
    Open

    You’ll get the citation on my wildlife study in a few more weeks when it is published. A researcher is running my radar database against a human health database. I have some epidemiology plots on my blog that point strongly to a spatial relationship to human disease.

  122. #125 Narad
    May 2, 2014

    Believe what you want. I was not put on this Earth to convince you of anything.

    Then perhaps you could go somewhere else and busy yourself with not convincing other people of anything.

  123. #126 Alain
    moderated
    May 3, 2014

    @ChemE,

    With 1/68 kids in the US now being born with “brain damage/autism”

    Could you please either prove there is brain damage in autism or else, just fuck off. Better yet, tell the biologist you’re working with to put up the evidence?

    Alain

  124. #127 Denice Walter
    May 3, 2014

    Translational Psychiatry? Oh where oh where have I heard of that before?

    -btw- Dan Olmsted perseverates on today @ AoA taking on an issue that is indeed beyond his ken.
    But actually, most everything is beyond his ken.

  125. #128 Narad
    May 3, 2014

    Dan Olmsted perseverates on today @ AoA taking on an issue that is indeed beyond his ken

    I am relieved to learn that he is an “unapologetic progressive.”

  126. #129 ChemE
    Georgia
    May 4, 2014

    Direct Evidence of Oxidative Injury in Autism.
    Injury = Damage.

    http://www.autismtoday.com/library-back/Oxidative%20Stress%20in%20Autism1.pdf

    Also cellular mutations.
    http://www.sciencedaily.com/releases/2013/11/131121125912.htm

    Not just “developmental delays” although that sounds much kinder and gentler

  127. #130 herr doktor bimler
    May 4, 2014

    http://www.autismtoday.com/library-back/Oxidative%20Stress%20in%20Autism1.pdf

    Woody McGinnis, I fear, is a crank with a mercury obsession.

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