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June 27, 2005
MY TWO CENTS
Please click here for my disclosure statements relating to the subject matter of this post.
I am not a scientist, so I'm open to one telling me that the following question is bunk for some reason. But I've got the following question about the supposed thimerosal-autism link anyway:
A common refrain among the exponents of a potential thimerosal-autism link is that, in the words of David Kirby, thimerosal may "trigger adverse reactions in a subset of children with a genetic predisposition to mercury sensitivity." This assertion is often used as a response as to why the large-scale epidemeological studies do not pick up on the thimerosal-autism link (i.e., that susceptible subset may be underepresented in the population studied). But as I understand it, those large-scale studies do in fact pick up on the increase itself of autism diagnoses; it's just the connection between such increases and thimerosal that fails to stand up.
If all those are true, then in order to be the, or a, major cause of the increase in autism diagnoses, thimerosal must "trigger adverse reactions in a subset of children with a genetic predisposition to mercury sensitivity:" with such subset simultaneously being
a) small enough to evade detection in the large-scale studies that have been conducted so far (i.e., without being fleshed out as a group disproportionally susceptible to autism by virtue of thimerosal exposure); and
b) big enough to account for the increase in estimated incidence from 1 in 10,000 to 1 in 166 or thereabouts.
How can both of those things be true? If a particular subset of children is particularly susceptible to mercury exposure, large enough to account for the increases in diagnoses and not being picked up in the studies previously conducted, then those studies also shouldn't reflect an increase in autism cases generally - but they do, as far as I know. And if the subset is big enough to at least be a main factor in accounting for the increase, shouldn't it be detectable in the large-scale studies that have been conducted? And if it isn't big enough...then the point has been conceded; even if there is a small subset of children particularly susceptible to mercury exposure, we must look elsewhere to find the main cause of increased diagnoses.
(If only all pharmaceutical targeted interventions worked as well as thimerosal is argued to do, then perhaps Big Pharma would deserve the dark, satanic power ascribed to it by the thimerosal-link activists.)
I welcome comments from people who have greater knowledge of scientific study methods, statistics or the subject matter generally.
Posted by Dr. Manhattan at 12:36 AM | Permalink
Comments
Also,
c) This small group of mercury-sensitive children never show the usual symptoms of mercury poisoning.
Posted by: markm | June 27, 2005 5:21 PM
Dr. Manhattan:
The problem with your criticism is as follows: the hypothesis that some children have a genetic sensitivity to mercury such that mercury exposure might cause autism in those children is just that -- a hypothesis, one that explains why a small subset children in a large population might be affected in an unusual way by mercury exposure. Assuming arguendo that it's true, we don't have any way of testing for it at present, and there is no reason that a study collecting data on thimerosal exposure and autism would allow us to identify that group.
(Consider the BRCA genetic mutations which predispose women who carry them to braest cancer. Lots and lots of epidemiological studies on braest cancer were performed before those mutations were identified -- the carrier subgroup doesn't just jump out of the data.)
markm:
There's no reason a mercury-sensitive person would exhibit classic symptoms of mercury poisoning. Like most people, if I eat too many peanuts, I get heartburn. That doesn't mean someone doesn't have a peanut allergy if the symptoms of his allergic reaction don't include heartburn.
(This is not to say that I buy this hypothesis; just that I don't think these are valid criticisms.)
(Also, there is a word deliberately misspelled above to avoid the comment filter.)
Posted by: alkali | June 27, 2005 6:38 PM
The BRCA comment is true, but only serves to reinforce Dr. Manhattan's point. BRCA carriers are a very small proportion of patients with braest cancer. Only around 2% of braest cancer patients carry them, maybe 5-6% in young patients. They are very important in that small subset, but they are generally not that significant in the overall population. If a similar proportion of the population had some sort of mercury "sensitivity" that led to autism, it would not account for the supposed "epidemic."
(Words intentionally mispelled to avoid comment filter. BTW, as much as I like your post, your comment filter sucks because it blocks a post based solely on that word.)
Posted by: Orac | June 27, 2005 7:13 PM
There may be no reason that a study collecting data on thimerosal exposure and autism would allow us to identify a particular, highly sensitive group, but I don't think that's the point. Holding the size of the sensitive group constant, increased exposures to mercury through thimerosal should be strongly positively correlated with increased levels of autism, if the thimerosal is causing autism for that group.
I thought that the point of the post was this: If the increased levels of autism show up in the data, and if those levels are driven by increased exposure to mercury through vaccinations, then shouldn't the correlation between thimerosal and autism also show up in the data?
Posted by: Ann | June 27, 2005 7:22 PM
Orac: There's no reason to expect that the percentage of the population with the BRAC mutation is comparable to the (hypothetical) percentage of the population that is mercury-sensitive.
Ann: Suppose 99.5% of the population can tolerate the levels of mercury involved in a full course of childhood immunizations with mercury-preserved vaccines, and 0.5% can only tolerate 1/3 of the course with mercury-preserved vaccines. Then you would have many children with no autism and a lot of mercury exposure and a few children with autism and not very much mercury exposure. Any correlation would be very weak, even though the mercury -- together with the mercury-sensitive genetic predisposition -- is actually causing the autism.
(Again, I'm not saying I buy this hypothesis. I'm just explaining why a big, well-performed epidemiological study might not identify this particular mechanism, if it actually existed.)
Posted by: alkali | June 28, 2005 9:36 AM
alkali,
Your example proves the point. The jump is autism has been enormous - much larger than such a small group could account for.
Posted by: Deoxy | June 29, 2005 11:13 AM
Indeed, alkali seems to have shot down his own argument. A small subset of people with a "sensitivity" to mercury could not account for the "epidemic" that mercury-autism advocates claim.
Posted by: Orac | July 15, 2005 2:38 PM