Like most bloggers, I suspect, I like to know who's linking to me. Unfortunately, the majority of bloggers appear not to use TrackBacks, and even when they do for some reason the TrackBacks often don't register. Couple that with a level of comment spam that sometimes outnumbered my legitimate TrackBacks by at least 200:1, and you see that TrackBacks aren't a great way of knowing who's linking to you. Consequently, a couple of times a week, I do quick Technorati and Google Blog Searches on the URL of Respectful Insolence to see who happens to be linking to me.
That's how I found this brief mention of my article on how that mercury militia luminary Dr. Mark Geier lost and lost big in a recent court case in which the plaintiffs were suing a company based on the claim that thimerosal in RhoGAM had caused their child's autism, a ruling in which the judge administered a truly deserved epic slapdown of Geier's testimony, qualifications, and science. This ruling gave me hope that the legal system might actually do a better job dealing with pseudoscientific claims of vaccines causing autism than it did with cases against manufacturers of silicone breast implants. Indeed, it was almost as satisfying to read as Judge Jones' even more epic slapdown of "intelligent design" creationism in Kitzmiller v. Dover.
Apparently, the owner of the blog, Charles Fox, is a lawyer, and he had commented himself on my own article on the Geiers. His blog, Special Education Law Blog, focuses on special needs law and cases.
Here's what he said about my article:
There has been a recent case where the science linking between mercury and autism has been thoroughly rejected. The author of the article seems to be on a mission to discredit any and all evidence of a mercury-autism linkage.
Uh-oh. It looks as though Mr. Fox is humbly requesting a dose of Respectful Insolence⢠of Orac. And Orac is almost always willing to grant such requests.
I'll just take this opportunity to set Mr. Fox straight. I don't need to "discredit any and all evidence of a mercury-autism linkage." It's already been discredited in the one way that truly counts: through the science. Each new study that comes out is yet another nail in the coffin of this dubious hypothesis, which sounded superficially plausible scientifically a few years ago but hasn't been supported by the science since, with each new well-designed basic science and epidemiological study failing to support such a link. Indeed, just this month, yet another large, well-designed epidemiological study has failed to find any linkage whatever between mercury and autism (or MMR and autism as well). In fact, autism rates in the study population continued to rise at the same rate after thimerosal was removed from vaccines in 1996.
The only reason that the postulated linkage between mercury and autism fails to die, not unlike a certain undead dictator that keeps popping up on my blog from time to time, is not because of the science, which killed it dead at least a year ago, but rather because a dedicated contingent of activists keep agitating and "investigators" such as Mark and David Geier (most prominent among this group) keep churning out studies chock full of bad statistics, bad medicine, bad science, and dubious ethics, often published in dubious antivaccination "journals" that purport to "prove" a link and use this "link" to justify using powerful and expensive sex hormone suppressing drugs like Lupron to "treat" children with autism. Never mind Dr. Geier's financial incentive, as he makes a considerable amount of money treating autistic children with chelation therapy (and now Lupron) and has even applied to patent his Lupron protocol.
To me, it's obvious that the insinuation behind Mr. Fox's claim that I am on a "mission to discredit any and all evidence of a mercury-autism linkage" is to imply so much bias in my opinion that I should not be taken seriously on this issue. My retort to that is that the only "bias" I have is that I highly value evidence-based medicine, sound science, and good epidemiology. Unlike the mercury militia's reaction to recent studies casting doubt on their pet hypothesis, if I were presented with a well-designed basic scientific or epidemiological study that actually did suggest a link between thimerosal and autism or a well-designed clinical trial that showed that chelation therapy for autism actually did something other than line the pockets of chelationists with greenery and put autistic children at risk, I'd definitely rethink my position. No such studies exist. His comment also seems to try to paint me as some sort of fanatic. Nothing could be further from the truth. What I try to do is to combat pseudoscience and quackery. I'm not out to "discredit" sound science. I wish I didn't need to try to discredit unsound science, but the mercury militia's activism and the truly shoddy and biased science used to "prove" a link between mercury and autism leaves me little choice.
Mr. Fox, however, seems to have a bias of his own, namely that there is something to the claim that mercury causes autism. He approvingly quotes a study that he apparently found convincing as evidence for a link between heavy metals and autism. Not Mercury has pointed out its many flaws (particularly its probably fatal flaw of using ratios of urinary markers to creatinine rather than measuring 24 hour excretions of these markers), and Kevin Leitch has also pointed out that some of the investigators in the study are anything but unbiased. Worse, he seems to believe that chelation can actually help, when in reality for treating autism chelation therapy is nothing more than quackery, and potentially dangerous quackery at that."
To be fair, the mercury-autism issue only takes up a small portion of posts on Mr. Fox's blog, and, as The Probe (who has ample reason to know) informs me, there's actually a fair amount of decent information there. However, he undermines the useful information by mixing it with commentary like this regarding a lawsuit over thimerosal:
The case is far from a certainty as the plaintiffs still have to prove that the mercury/thimerosal caused the child's autism; this argument has strong proponents and opponents each armed with studies and research. Even if this suit fails it is still an important round one in what promises to be the beginning of many such cases. The tobacco cases went on for years with the defendants winning every case until the fairly recent past. At the very least the arguments and science that link autism and mercury/thimerosal will finally get a full hearing before a jury and a court with powers to order damages that actually compensate the full measure of harm.
The big difference is that the scientific, clinical, and epidemiological evidence that tobacco smoking can cause lung cancer and other life-threatening conditions like heart disease is overwhelming to the point of being scientifically indisputable and has been for decades. In contrast, the evidence supporting the claim that mercury from vaccines causes autism is junk science of the worst order and getting weaker with each new study. It didn't pass muster with Judge Beatty, and, if the Daubert standard is correctly applied, it's highly unlikely to pass muster in any other court, given how work by the Geiers, Boyd Haley, etc. all reference each other. A commenter on my own blog (whom I'm going to steal from) put it quite well:
Why did Big Tobacco start losing lawsuits after winning all of the early ones? It had nothing to do with science, because the science was on the side of the plantiffs for the longest time. No, lawyers started winning more often when they took the tact not that cigarettes were defective (because they weren't - they did what they were designed to do) but that the manufacturers of cigarettes lied about the risks. It's one thing to say "cigarettes are bad for you, if you want to smoke go ahead", quite another to downplay or dismiss the risks altogether.
This is the crux of the mercury militia's case - that drug companies knew thimerosal could cause neurological disorders and continued to put it in vaccines. The problem with that argument is that unlike Big Tobacco, there is very little evidence that thimerosal plays even a minor role in such conditions. And it goes without saying there is even less evidence that drug companies knew that thimerosal could cause these conditions and chose to cover it up. If the best "smoking gun" you've uncovered in all your months and years of discovery is a memo from Maurice Hilleman expressing concern about thimerosal content in vaccines, then you've got no chance to win a lawsuit.
Indeed, even the "mercury militia" is starting to see the writing on the wall and reluctantly being forced to start to face reality by the weight of the evidence. As Kevin Leitch points out, they are mentioning mercury in vaccines less and less and starting to be more vague, listing mercury among "other" vaguely specified environmental factors or even switching their attention to aluminum compounds in vaccines. (Of course, to them, it still has to be the vaccines, putting the lie to their claims that they are not antivaccination, but that's the topic for another post.)
What's kept the myth that mercury in vaccines causes autism alive is not science, but rather a combination of factors, including a group of parents who, when faced with an autistic child, have difficulty accepting that their child was almost certainly born that way; a general suspicion of big pharma, vaccine manufacturers, leading to a tendency towards conspiracy mongering; plus a veritable industry of quackery that's sprung up to offer false hope that these children can somehow be miraculously "cured" with modalities like chelation therapy or Lupron. These people are egged on by "journalists" like David Kirby (who seems to be becoming a bit quieter about the mercury-autism conspiracy-mongering lately and has been busily shifting the goalposts as far as what epidemiological evidence would convince him that there is no link between thimerosal and autism) and activists like Robert F. Kennedy, Jr. (who, unfortunately, is like the Energizer Bunny on this issue). If Mr. Fox wants to perceive my position as being "on a mission to discredit any and all evidence of a mercury-autism link," he's only partially correct. I'm on a mission to discredit pseudoscience used to "support" a mercury-autism link and the quackery to "treat" autism that flows from that pseudoscience. Show me some credible evidence from well-designed scientific experiments and clinical studies that truly does suggest a link, I will consider it with an open mind, but with the usual skepticism that I try to apply to every scientific paper that I read.
You are a fanatic: For good science. And people say that like it's a bad thing. I suppose next, they'll whine about police officers being fanatics about catching criminals.
I don't think you're a fanatic. I think, like me, you hate to see misleading or fraudulant opinions being expressed as proven fact. I enjoy reading your blog.
I for one have a very hard time getting my trackbacks to Science Blogs to work. I use Blogger, and Haloscan, and though it tells me the trackback is successful, more often than not it never shows up on the SB page. Don't know why...
Your quote of Mr. Fox:
""The case is far from a certainty as the plaintiffs still have to prove that the mercury/thimerosal caused the child's autism; this argument has strong proponents and opponents each armed with studies and research. Even if this suit fails it is still an important round one in what promises to be the beginning of many such cases. The tobacco cases went on for years with the defendants winning every case until the fairly recent past. At the very least the arguments and science that link autism and mercury/thimerosal will finally get a full hearing before a jury and a court with powers to order damages that actually compensate the full measure of harm.""
Actually, he raises a very interesting point, but does not realize the implications of Daubert as applied to the tobacco litigation and tne thimerosal litigation.
In the case of tobacco, there was very good science and epidemiology which documented the relationship between smoking and various diseases. This body of evidence supported the experts, and constituted good sceince. Some of the experts actually worked as scientists in the tobacco industry. I do not believe that this body of evidence and legion of experts would have been excluded under the most rigorous application of Daubert and its progeny.
Contrast that to the lack of good evidence and the existence of refutational epidemiology in the thimerosal litigation. This is compounded by the lack of highly qualified experts, and the utter lack, to my knowledge, of industry experts willing to support a link. It is further compounded by the highly questionable ethics, e.g. the IRB, of Geier. (There will be another bombshell in this venue in the next few days).
Thus, I disagree with Mr. Fox where he feels that these cases will go to juries. Daubert will prevent it, for the foreseeable future. The only way to circumvent Daubert is to have good science prove a link, and then, no one would argue with relief being given under the law.
There are many things confused here. Citing lack of evidence for the thimerosal-autism link, and pointing out the possibly unethical (or at least unscientific) behavior of some people who promote that idea is one thing. However, mercury has been no way cleared of involvement in the etiology of autism. Mercury is one of the most significant forms of chemical pollution in our environment--that is, there are many other more significant sources than thimerosal--and it is very feasibly a factor in autism.
"Discredit" implies some sort of focussed effort to make the evidence look bad. Completely the wrong word. The evidence makes itself look bad, as soon as you put it under the spotlight of scientific enquiry. The Geiers make themselves look bad by creating a suspect IRB for their research.
You're not discrediting the research any more than a judge discredits a fraudster. You're putting it on trial.
"However, mercury has been no way cleared of involvement in the etiology of autism. Mercury is one of the most significant forms of chemical pollution in our environment--that is, there are many other more significant sources than thimerosal--and it is very feasibly a factor in autism."
The majority of research on the development of autism suggests it's nonenvironmental. There's no epidemiology (let alone mechanistic evidence) to suggest that mercury, aluminium, or coffee cause it. Researchers are starting to sway towards a genetic basis.
We're not talking absence of proof of a link here, we're talking proof of absence.
The lupron thing will be the end of the Geiers. Their recommendations for misdiagnosing it on purpose in order to get insurance to pay for it will be all the proof that those organizations need to convict them of insurance fraud. Docs go to jail for insurance fraud even when they hide it, when they document to the world how to get away with it, it will take even less time.
Indeed, why "pick" on mercury, when there are other candidates floating around our environment. If a chemical is at fault why not dioxin, or teflon, or something used to replace lead in paint? After all a supposed rise in the rates of autism mirrors the increasing amounts of such chemicals in the environment. In a way its sort of the reverse side of claims made for alternative treatments, where one thing is said to cure a host of illnesses, many of which are unrelated to each other ie take our pill and cure your ulcers, lung cancer, Chrohn's Disease etc.
"However, mercury has been no way cleared of involvement in the etiology of autism."
Well no, it hasn't. Neither have Chlorpyrifos, PDBE, French Fries, neutrinos, "stealth" viruses, fruity pebbles, Meitnerium exposure, antibiotics, diesel fumes, television ---- oh dear, this could be a long list.
If only we had a method of narrowing the list of likely suspects. What could we call such thing?
As always, it is a pleasure to read your blog. Please keep up the great work.
That is true only in the narrow sense that, in science, no hypothesis is ever completely ruled out. The mercury -> autism hypothesis is, however, looking extremely unlikely to be true, and looking unlikelier as the evidence rolls in. Forgive me for saying so, but invoking environmental mercury appears to be a clutching at straws. Consider the results of research into the genetics of autism:
That's a telling result. When studies looking for an environmental effect fail to find it, and studies looking for a genetic effect find a strong one, it becomes awfully tough to argue convincingly that the primary cause of autism is environmental.
Sorry to be so brief. No one doubts a genetic effect in autism, or indeed in any disease. However some syndromes related to austims involve failures at the celular level that clearly correspond to environmental factors. One candidate is mercury. That is all I am saying.
Although the increase in autism has been exaggerated and we have problems of an ever-widening definition of the condition, there is still a trend that simply can't be explained by genetic factors alone.
Small note, Ron: Thimerosal breaks down into ethyl mercury, not ionic mercury or metallic mercury, just like fire breaks wood down into H20 and CO2 (if it's perfectly clean burning), rather than explosive hydrogen gas and soot/graphite/diamond.
"However, mercury has been no way cleared of involvement in the etiology of autism."
"Well no, it hasn't. Neither have Chlorpyrifos, PDBE, French Fries, neutrinos, "stealth" viruses, fruity pebbles, Meitnerium exposure, antibiotics, diesel fumes, television ---- oh dear, this could be a long list.
If only we had a method of narrowing the list of likely suspects. What could we call such thing?"
How about we vote? That works well for a lot of things, doesn't it? Put me down for the fruity pebbles--I always thought they looked *very* suspicious ...
failures at the celular level
which would that be and why would something at a "cellular level" point to an environmental factor?
How about we vote? That works well for a lot of things, doesn't it?
Game Boy! MUST be it. My son does not have one and does not have autism - my friend's son has one and is on the spectrum. That is the proof! I think there is mercury in the Game Boy battery, too. Also, there were very few game boys in 1969 and look how few cases of autism we had back then.
"which would that be and why would something at a "cellular level" point to an environmental factor?"
Well cells do have environments and they are affected by them.
I just wanted to add that the Game Boy Advance now comes with an Aluminum case - this cannot be a coincidence. I also forgot that many more boys play with Game Boys (it is the name already), which explains the gender difference in incidence...I have to go open a yahoo group on that now....
Well cells do have environments and they are affected by them.
I am sorry, I don't quite get this. Could you spell this out? There is a huge difference between our environment and the microenvironment around the cells in our body.
Ron: I think you may find that just saying "cellular level" won't get you a lot of respect around here. Maybe you should try "quantum level"...
Actually, I don't think that will work, either.
I stuck myself under a big magnifying glass. My cells are definately failing at the metaphysical level.
I haven't wanted to get into details because this is still very new and speculative. It is possible that defects in electrical activity of neurons early in life are involved in some autisms. This is clearly related to certain mutations but an environmental factor may play a role as well Mercury can affect processes such as dendritic arborization. The microenvironment around neurons is not independent of our environment as organisms
This is really not the point, I was merely suggesting you be more precise. It is true that the supposed link between thimerasol in vaccines and autism has been pretty much discredited. But it is an unjustified jump to then say that any link between mercury and autism has been discounted. That is just not the case.
I fail to see a big difference. If you want to research it, go ahead.
All the negative studies, combined with most advocates I've met favoring dirty rhetorical games, rather than looking for evidence has gotten me a healthy dose of negative confidence in the game.
It is possible that defects in electrical activity of neurons early in life are involved in some autisms.
And everyone knows that mercury is a metal and decent electrical conductor, the proof is in my thermostat! It must be shorting out the electrical activity in the neurons. What we need is some teflon to insulate the neurons. Problem solved.
"Mercury can affect processes such as dendritic arborization."
Oh yeah, and of course there was that recent study on the effects of thimerosal on mouse dendritic cells, which of course has nothing to do with dendritic arborization, but there is the word 'dendritic'
Bronze Dog,
If you 'don't see the difference' then you are basically supporting the Geier et al position. The exposure to mercury through a dose of vaccine is probably insignificant compared to the exposure (of children and fetuses) to methylmercury through the food chain, especially fish and shellfish. Known effects on the fetus of these exposures (unacceptably high blood mercury levels in at least 7% of pregnant women according to CDC)do not currently include autism. There are also a significant number of incidents (on the increase) of exposure of children to improperly discarded metallic mercury and there are other sources.(Power plants are still major ultimate sources of mercury pollution, thanks to W)
There *is* a difference between the Geier's and other's hype about thimerosal and the real threat of mecury exposre to children. Whether this is contributing to patterns of autism we are observind does seem to me to be a worthy subject for research. Perhaps the worst effect of these charletons is that it has distracted proper attention from this issue.
Someone's misreading something, since I don't follow that line of logic, either. I mean it's impossible to prove most negatives: We'll never be *certain* that thimerosal doesn't cause autism. All we can do is show the repeated negative results and the failures of the advocates to prove their case.
You won't get an argument from me about real mercury contamination, and they certainly are distracting from that issue. I still doubt it's contributing to autism, but I won't complain about anyone researching it.
failures at the cellular level
I think we've just found the Geiers' new collective nickname.
I just found it interesting that when I tried to post on the special education blog, it never materialized. The guy has comments moderated, and I guess he didn't like mine. I wasn't being a dick by any means, I just informed him that I thought it was strange of him to say you are on a mission. But even if you were on a mission, would it be a bad thing if there truly is no link. No, but don't try telling that to Charles Fox.
The whole "mercury in the environment" schtick has one big hole in it: mercury in the environnment has been decreasing since 1961, well before the beginning of the "autism epidemic", and continues to decrease.
(see: Use of Br and Se in peat to reconstruct the natural and anthropogenic fluxes of atmospheric Hg: A 10000-year record from Caribou Bog, Maine, ENVIRONMENTAL SCIENCE & TECHNOLOGY 40 (10): 3188-3194 MAY 15 2006 Roos-Barraclough F, Givelet N, Cheburkin AK, Shotyk W, Norton SA)
No, I think that the mercury-causes-autism hypothesis has been pretty thoroughly discredited. In fact, the efforts of its remaining advocates to prop it up are pretty thoroughly discrediting them.
Prometheus
"Oh yeah, and of course there was that recent study on the effects of thimerosal on mouse dendritic cells, which of course has nothing to do with dendritic arborization, but there is the word 'dendritic'"
Or autism for that matter.
"I haven't wanted to get into details because this is still very new and speculative."
If it's a speculative hypothesis, it ain't evidence of anything. Come back when it's on a similar footing to the genetics of autism.
"Known effects on the fetus of these exposures (unacceptably high blood mercury levels in at least 7% of pregnant women according to CDC)do not currently include autism."
Now, you've sort of stumbled there. You tell us that 7% of pregant women have high blood mercury levels, but that's not evidence of known effects of exposure, that's just evidence of the exposure itself.
"...the only 'bias' I have is that I highly value evidence-based medicine, sound science, and good epidemiology." - Orac
May I use this as a sigfile?
Keep on doing your good work! Your blog rules!
Prometheus said: "No, I think that the mercury-causes-autism hypothesis has been pretty thoroughly discredited. In fact, the efforts of its remaining advocates to prop it up are pretty thoroughly discrediting them."
You are being a bit narrow. The movement is not so much regarding thimerosal in vaccines, but the existence and use of vaccines. Thimerosal is a convenient scapegoat, sinmply because it is a known neurotoxin and we have been trying to decrease the amount in the envirnment as you point out. There are those anti-vacs who are now moving on to the other components of vaccines, and you will see them claiming it is Aluminum, aborted fetal cells, etc. in their efforts to stop vaccination. Why they are doing this is a big a mystery to me as why John Wayne Gacy and Charles Manson did what they did. The implications of that analogy are intended.
Good news everyone! My cells are reconstructing themselves at the anthropomorphic level. I'm fine now.
I am the parent of a child with autism. My child has been tested and found to have high levels of Antimony;(fire retardant,) Aluminum; (a heavy metal,) and Mercury (another heavy metal) which is one of the most toxic elements on earth,)in his blood. And for the record, my child has been partially chelated, with dramatic results.
Have you ever done a search on early recordings of Autism in History? Some of the earliest results are from the time of the Roman Empire. Autism, during Roman times, was theorized to have been caused by lead (another heavy metal)which came from tainted water in the aqua ducts, and lead-line tea pots.
And, by the way some of us do not believe in a genetic cause as: 1.We, ourselves, do not have autistic symptoms, 2. We do not believe in genetic epidemics.
So much for thinking you are superior and knowledge about Autism and heavy metals. Your ranting and ravings truly are insufferable.
Interesting Elaira. Could you tell us the name of the lab you used and whether or not you ran a second test with another lab?
"Have you ever done a search on early recordings of Autism in History? Some of the earliest results are from the time of the Roman Empire. Autism, during Roman times, was theorized to have been caused by lead (another heavy metal)which came from tainted water in the aqua ducts, and lead-line tea pots."
Interesting. If true, so much for the mercury militia's claims that there was in essence no such thing as autism until thimerosal was used in vaccinations as a preservative. Isn't that what David Kirby and Robert F. Kennedy, Jr. (not to mention J. B. Handley and Boyd Haley) have been claiming. You should tell them how wrong they are. In any case, I'd be interested in seeing a citation to support your assertion.
As for your "not believing" in a genetic cause, the beautiful thing about science is that it doesn't matter in the least what you or I do or do not believe. Our beliefs are irrelevant as far as science goes. Scientists only care where the evidence leads, and there's lots of evidence supporting a primarily genetic cause for autism. At the same time, all the large recent studies looking at for a link between thimerosal-containing vaccines and autism have utterly failed to find any evidence of an association between thimerosal-containing vaccines and autism.
Finally, I "insufferably" echo caseofthevapours' question about what lab. Most labs that find "elevated" mercury levels are of dubious reputation at best.
Another thing: Just what definition of "epidemic" are you using? Most people who use that word about autism can't even keep the prevalence consistent from sentence to sentence.
On what planet is aluminum a "heavy metal"?
There is a reason that it is used in airplanes:
http://en.wikipedia.org/wiki/Aluminium
More about autism and history... Here is an interesting paper about legends of changelings in Europe that you might find interesting:
http://adc.bmjjournals.com/cgi/content/full/90/3/271
Also, a very good book that looks into some of the history is by a father of an autistic child, _Not Even Wrong_ by Paul Collins:
http://www.amazon.com/Not-Even-Wrong-Fathers-History/dp/1582344787/
"Have you ever done a search on early recordings of Autism in History? Some of the earliest results are from the time of the Roman Empire. Autism, during Roman times, was theorized to have been caused by lead (another heavy metal)which came from tainted water in the aqua ducts, and lead-line tea pots."
Here's some more reading for you about the Roman aqueduct system and lead poisoning.
Vitruvius, Lead Pipes and Lead Poisoning
A. Trevor Hodge
American Journal of Archaeology
Vol. 85, No. 4 (Oct., 1981), pp. 486-491
Apparently, it's not likely they caused lead poisoning.