The Medical Denial of Environmental Illnesses

[Guest guest]

The Medical Denial of Environmental Illnesses

Harold E Buttram, MD

http://www.mercola.com/2001/dec/1/immunizations2.htm

Introduction:

As a matter of personal opinion and observation, there is at present

a dichotomy of almost schizophrenic proportions between ongoing

American scientific research in the medical field, most of which

takes place in academic institutions and medical centers, and the

genuine needs of the American public.

The scope and direction of this research, most of which is funded by

the National Institute of Health (NIH), is of tremendous importance

in that it forms a source of guidelines and a scientific foundation

for the clinical practice of medicine. In other words, the clinical

practice of medicine as it exists today has been largely shaped by

decisions made in the NIH and other government health agencies in

the granting of research money.

This is a system which has existed since the 1930s, but there may be

serious misdirections which are proving to be very costly in terms

of the health and welfare of the American public, especially as

applies to its children.

There are two medical conditions from which it is predictable that

American society and economy will be strained to the breaking points

in coming years by overwhelming numbers of medical indigents unless

these conditions are addressed effectively and decisively in the

very near future.

The two conditions to which I refer are childhood autism and

environmental illness with chemical sensitivity, neither of which

are being recognized for their true nature by mainstream medicine

because of a misdirection of research funding in certain key areas,

as will be reviewed in the following:

Childhood Autism, Predominantly an Environmental Illness

In regards to childhood autism, a condition characterized by severe

mental regression, fifty or so years ago autism was so rare that

many pediatricians had never heard about it. At least this was the

experience of Dr. Bernard Rimland, founding director of Autism

Research Institute. In 1956 Dr. Rimland, whose Ph.D. is in research

psychology, had a son who was later found to be autistic.

In his annual DAN (Defeat Autism Now) conferences Dr. Rimland is

fond of telling the story about the early days with his son during

which he had great difficulty in finding a pediatrician who knew

anything about or who had ever seen a case of autism. How different

it is now. Childhood autism has become so prevalent that there are

very few who do not know of a family with an autistic child.

Families with two autistic children are not uncommon, and I

personally have seen a family in which all three of the family's

children were autistic.

Latest statistics estimate that over one half million American

children are autistic, (1) and with numbers steadily growing, there

is no end in sight. It can be expected that treatments will improve

the outlook of these children, but as far as is known at present,

many or most of these will require custodial care for life, at an

average cost to society as much as three million dollars per child.

(2)

In the opinion of this observer, the misdiagnoses in childhood

autism come not in the diagnosis of the condition itself, something

that is unmistakable once one has seen a few children with the

condition, but from a failure to recognize autism as predominantly

an environmental illness. (In this instance the term, " environmental

illness, " is used to include illnesses brought about by exposures to

commercial chemicals and medical interventions as well infectious

microorganisms and other exposures from the natural environment).

This statement is based on a recent seminar on childhood autism held

in the Washington D.C. area as sponsored by the National Institute

of Health and other health agencies September 6th and 7th, 2001, at

which the largest portion of the meeting was devoted to areas of

genetics and neuropathology of autism. (3)

As related to childhood autism, it should be stressed that the field

of genetics involves a susceptibility to autism but, except in rare

instances, has nothing to do with its causes. The same could be said

about virtually all epidemic-type diseases, in which there will be

variability in genetic susceptibility.

By their very nature, epidemics always arise from environmental

sources of one type or another and not from genetic causes. Genetic

changes take place very slowly in an evolutionary scale over a

period of millennia and never with the rapid increases as seen today

with autism.

Major areas now under suspicion as being causally related to

childhood autism include childhood immunizations, (4) toxic

environmental chemicals, (5) commercial food processing, (6) and the

overuse of antibiotics. (7) The only possible way of salvaging the

situation is to find and modify the causes while at the same time

doing the very best we can to develop effective treatments for those

already afflicted with this condition.

Childhood Immunizations - Deficiencies in Basic Science and Safety

Guidelines

As reflected in a series of U.S. Congressional Hearings concerning

issues of vaccine safety which have taken place annually since 1999,

(4) there is now growing awareness of major deficiencies in safety

testing for current childhood immunizations.

A few examples will be given here:

(a) Safety studies on vaccinations are limited to short time periods

only: several days to several weeks. There are no (none) long-term

(months or years) safety studies on any vaccination or immunization.

( In 1994 a special committee of the National Academy of Sciences

(Institute of Medicine) published a comprehensive review of the

safety of the hepatitis B vaccine. When the committee, which carries

the responsibility for determining the safety of vaccines by

Congressional mandate, investigated five possible and plausible

adverse effects, they were unable to come to conclusion for four of

them because they found that relevant safety research had not been

done.

Furthermore, they found that serious " gaps and limitations " exist in

both the knowledge and infrastructure needed to study vaccine

adverse events. Among the 76 types of vaccine adverse events

reviewed by the IOM, the basic scientific evidence was inadequate to

assess definitive vaccine causality for 50 (66%). The IOM also noted

that " if research…(is) not improved, future reviews of vaccine

safety will be similarly handicapped. (8)

© In an article published in Adverse Drug Reaction & Toxicology

Review, (9) researchers Wakefield and Montgomery, who

have been investigating a possible causal relationship between the

MMR vaccine (measles-mumps-rubella) and the autism enterocolitis

syndrome, carefully reviewed inadequacies of the early pre-licensing

trials of the MMR vaccine with a maximum follow up of 28 days and

even shorter periods in some of the studies.

They stressed that such short periods of observation following the

vaccine were totally inadequate to detect delayed reactions,

including pervasive developmental delay (autism), immune

deficiencies, and inflammatory bowel disease, which are known from

earlier published reports to occur following both the natural

measles infection and the measles vaccine.

The most interesting feature of the Wakefield/Montgomery article was

that it was reviewed by four leading British authorities, all of

whom had previously held positions in the regulation and licensing

of medicines in the United Kingdom. (10) Taken as a whole, the

reviewers were supportive of the article, three highly so.

Fletcher, formerly a senior professional medical officer for the

Department of Health wrote, " being extremely generous, evidence on

safety (of the MMR vaccine) was very thin. "

Noting that single vaccines for measles, mumps, and rubella already

existed, he argued, " caution should have ruled the day…the granting

of a product license was definitely premature. " Professor Duncan

Vere, former member of the Committee on the Safety of Medicines,

agreed that the periods for tests were too short. " In almost every

case, " he wrote, " observation periods were too short to include the

onset of delayed neurological or other adverse events. "

(d) In 1984 an intriguing study was reported in a little noted

letter-to-the-editor in the New England Journal of Medicine in which

a significant though temporary drop in T-helper lymphocytes was

found in 11 healthy adults following routine tetanus booster

immunizations. (11) Special concern rests in the fact that, in 4 of

the subjects, the T-helper lymphocytes fell to levels seen in active

AIDS patients.

If this was the result of a single vaccine in healthy adults, it is

sobering to think of the possible consequences of multiple vaccines

(19) within the first 6 or so months of life at latest count) given

to infants with their immature and vulnerable immune systems.

Unfortunately, other than clinical observation, we can only

speculate at these consequences, as the test has never been

repeated.

Environmental Illness - Deficiencies in Basic Science and Safety

Measures

In my opinion, the second area of misdiagnosis is the common

approach of mainstream medicine in dealing with environmental

illness and its related condition of multiple chemical sensitivity

(MCS). In contrast to the American Medical Association, which denies

the existence of MCS as a valid diagnosis, there is a group of

physicians in the field of environmental medicine who believe that

millions of Americans are being made ill and sensitized in various

degrees to toxic airborne chemicals from a class of chemicals known

as volatile organic compounds (VOCs).

(12) Illnesses brought about by breathing these chemicals inside

buildings are referred to as " The Sick Building Syndrome. " A number

of official government and health agency publications have been

issued on this subject. (13-18) However, the major thrust of most of

these publications is to stress how little we actually know about

the effects of these chemicals and emphasize the over-riding need

for further safety research in this area.

As pointed out in the text, Multiple Chemical Sensitivity, (National

Research Counsel, 1989), " about 70,000 chemicals are used in

commerce, of which several hundred are known to be neurotoxic.

However, except for pharmaceuticals, only 10% have had any testing

at all for neurotoxicity, and only a handful of these have been

evaluated thoroughly. " (19)

Since the publication of Multiple Chemical Sensitivity, the

situation has changed in one respect: There is now a substantial

body of literature dealing with occupational exposures to solvent-

type chemicals or VOCs, prominent among which are publications by

Morrow and coworkers at the University of Pittsburgh, several

of which are sited here. (20-23)

For the issue of multiple chemical sensitivity, on the other hand,

it is far different. Once again we are faced with major deficiencies

in safety-oriented studies on the effects of potentially toxic

environmental chemicals on the human system and of safety measures

that would have followed, had these studies been done. Basic science

in this area, at very best, has been fragmentary.

For this reason and this reason alone, evidence for support of the

diagnosis of MCS has not yet reached standards of scientific proof.

However, the fact that adequate research has not yet been done to

prove its existence, it does not follow that MCS has been disproved

or that it does not exist. Yet, this is the practical conclusion one

generally finds in mainstream medicine.

Based on my own experiences in many workman's compensation cases

involving airborne chemical exposures, the near universal response

of mainstream medicine has been to deny its existence.

As a result, many patients with more advanced forms of chemical

sensitivity are becoming like the lepers of ancient times, disabled

outcasts of society, and their numbers are growing larger by the

day. (24)

However, we are not entirely barren in this area. Though small in

number and preliminary in nature, there are a number of publications

tending to confirm a widespread presence of MCS in our population,

publications which can form a nucleus for further study. A few of

these are enumerated below:

(a) Two publications involving studies with SPECT brain scans have

shown impairments in brain functions resulting from chemical

exposures. (20,25)

( In a recent study of a group of veterans with the Persian Gulf

War Illness, an activated coagulation system was found with platelet

activation and fibrin deposits on the endothelial surfaces of blood

vessels, which resulted in a constriction of blood flow. The authors

concluded that heavy exposures to toxic chemicals during the Gulf

War in all probability were the underlying cause of the pro-

coagulant state, although other possible causes were also mentioned

in the article. (26)

© Studies of patients with chronic fatigue and fibromyalgia at the

Electron Microscopy Unit at the Adelaide Institute of Medical and

Veterinary Science, Australia demonstrated deformities in the red

blood cells (RBCs) of these patients described as dimpled

spherocytes (rather than the normal oval shapes of RBCs) along with

increased rigidity of the RBC membranes, these changes resulting in

reduced flow of the RBCs as a result of their deformities.

The article went on to point out that a great majority of these

patients had been exposed to environmental chemicals, some working

in chemical factories, others in wheat fields or orchards subject to

periodic pesticide/herbicide sprayings, many patients noting

deterioration following these exposures. (27)

(d) In an article by P Beaune and coworkers, the term " suicide

inactivation " was used to describe the mechanism whereby foreign

toxic chemicals may damage and cripple the enzyme systems necessary

for detoxification and elimination of toxic chemicals. (28) This now

thought or suspected of being a major factor in the pathogenesis of

MCS.

(e) Among those working in the field of environmental medicine, (12)

The Environmental Health Center in Dallas, Texas has always been

considered a major center of research in this field. Authored by

J. Rea, M.D., much of the work of this center has been

recorded in a four-volume set of books with the simple title,

Chemical Sensitivity. (29)

Many of those familiar with this center believe it will in time be

accredited with being one of the earliest centers to fully recognize

the increasing impact of foreign chemicals on human health and to do

meaningful, systematic study in this area.

With reports such as these now in the scientific literature, further

documentation and confirmation of environmental illness and MCS as

valid diagnoses cannot be long in following, along with a more

realistic appraisal of their prevalence.

Finally, no treatment of environmental illness would be complete

without mention of possible ongoing damage being done to the

reproductive systems of both men and women when exposed to toxic

airborne chemicals during their reproductive years, (30) or of fetal

damage when women work in such conditions during their pregnancies.

(5) Although as yet largely theoretical, sooner or later these are

issues which must be addressed.

Conclusions:

In the late 1800s and early 1900s there was a time now referred to

as the golden age of medical diagnosis. Those were the times of Sir

Osler of s Hopkins University, remembered as the father

of internal medicine, and of other stellar names of the times. In

those days doctors took time to listen to their patients, and

equally important, took very seriously the information given by the

patient.

It was a time of clinical observation, when doctors believed what

their eyes told them and deduced diagnoses based on these

observations. It is no small coincidence that the mythical master of

observation and deduction, Sherlock Holmes, the creation of Sir A

Conan Doyle, was based on a physician that Doyle had known in his

student days.

How does this compare with today? Based on personal experience, very

few doctors listen to parents of autistic children, or if they

listen to them, very few believe what they are told by the parents.

(31)

This is even truer for patients with environmental illness who, in a

majority of cases in my experience, are commonly referred to

psychiatrists or psychologists by their physicians, their physicians

telling them that their symptoms are psychosomatic or imagined.

However, in defense of doctors directly involved in care of the

public, it is doubtful that there has ever been a time with greater

demands on their time combined with greater economic/political

pressures intervening in the care of their patients than at present.

Most of them are doing the best they can under the circumstances.

I take great pride in being a medical doctor. I would not change

places with anyone in the world. But I also fear for the future of

my profession. Whether in the realm of nature or human affairs, all

things must remain relevant to survive. In the natural world all

life forms must adjust to their environment or perish.

In the healing professions, these professions must both recognize

and address the genuine needs of the public or stand in danger of

passing into the limbo of forgotten things. Actually I believe the

medical profession will survive, but to do so will require a higher

level of vision with issues surrounding childhood autism and

environmental illness than has been the norm until now.

For practicing physicians to recognize the nature of their patients'

problems and treat them properly, the physicians must be provided

with valid science by those engaged in research, science

realistically directed at the genuine health needs of the public.

References

References:

(1) On April 25, 2001 J Bradstreet, MD, F.A.A.F.P gave

testimony before the US House of Representatives, Committee on

Government Reform recalling his own experiences with an autistic son

as well as providing a broad review of issues surrounding childhood

autism. In a written supplement to the oral presentation, which can

be accessed on the website:

http://www.gnd.org/Testimony/Congressional.htm, Dr. Bradstreet

provided current statistics on autism, pages 3-7.

(2) Ibid

(3) NIH/ACC 2001 Conference: Potential Cellular and Molecular

mechanisms in autism and Related disorders Sponsored by NICHD and

NIEHS, Co-Sponsored by NIMH, NINDS, and NIDCD, September 6-7, 2001,

Bethesda, land. (Having personally had the privilege of

attending the meeting, there were very excellent presentations

having to do with neuro-anatomical findings as well as genetics of

autism, areas constituting basic science for the field. A portion of

the meeting was also devoted to the possible roles of pesticides and

other neurotoxicants in causing autism, but even these were of an

academic nature. Clinical studies of potential value in either the

prevention or treatment of autism were notable by their absence.)

(4) Annual hearings specifically dealing with questions about

vaccine safety have been taking place in the U.S, House of

Representatives since 1999. This is only one of many indications of

growing public and professional concern on this issue.

(5) Edelson SB & DS Cantor, Autism: xenobiotic influences,

Toxicology and Industrial Health, 1998; 14(4):553-563. (This study,

which appears to be the first of its kind, points out that the

breathing of toxic, chemical-laden air in sick buildings by women

during their pregnancies may be a contributing cause of brain damage

to the fetus and a common factor in the rising incidence of

childhood autism).

(6) Among the many works dealing with the adverse health

consequences of " fast foods, " which form an increasing pattern in

the diets of American children, two books are recommended here:

Nourishing Traditions, by Sally Fallon with Pat Connolly and G

Enig, Ph.D., ProMotion Publishing, San Diego, 1995 and Special Diets

for Special Kids, by , Ph.D., Future Horizons, Arlington,

Texas, 1998.

(7) No reference is needed here - the overuse of antibiotics in

medicine and the food industry is now universally recognized and is

being taught at leading medical centers.

(8) Stratton KR, CJ Howe and RB ston, Jr., Editors, Adverse

Events Associated with Childhood Vaccines; Evidence Bearing on

Causality, Institute of Medicine, National Academy Press, Washington

D.C., 1994, pp 211-236.

(9) Wakefield AJ & S Montgomery, Measles, mumps, rubella vaccine:

through a glass darkly, Adv Drug React Toxicol Rev, January, 2001; 19

(3):1-19.

(10) Hurley DR, DW Vere, A P Fletcher, Referee 1, 2, 3, & 4, Adverse

Drug React Toxicol Rev, 2001; 19(4):1-2.

(11) Eibl M et al, Abnormal T-lymphocyte subpopulations in healthy

subjects after tetanus booster immunization, (letter), NEJM, 1984;

310(3):198-199.

(12) American Academy of Environmental Medicine, with headquarters

at American Financial Center, 7701 East Kellogg, Suite 625, Wichita,

Kansas 67207-1705, phone (316) 684-5500, Fax (316) 684-5709.

(13) Pesticides in the Diets of Infants and Children, National

Research Counsel, National Academy Press, Washington D.C., 1993.

(Although this book deals with foods rather than air, it provides

further evidence of concern in leading scientific circles about the

potential impact of toxic chemicals on human health).

(14) Neurotoxicity, Identifying and Controlling Poisons of the

Nervous System, Superintendent of Documents, Government Printing

Office, Washington D.C., GPO Stock # 052-003-01184-1, April, 1990.

(15) Environmental Hazards in Your School, A Resource Handbook, US

Environmental Protection Agency, Washington D.C., Publication # 201-

2001, October, 1990.

(16) The Healthy School Handbook, Norma L , Ed.D., Editor, a

National Education Association professional Library Publication,

National Education Association, Washington D.C., 1995.

(17) Multiple Chemical Sensitivities at Work, Produced by The Labor

Institute, NYC, 853 Broadway, Room 2014, New York, NY 10003, 1993

(funded by a grant from the New York State Department of labor,

Occupational Safety and Health Training and Education Program).

(18) Multiple Chemical Sensitivities, National Research Counsel,

National Academy Press, Washington D.C., 1989.

(19) Ibid, page 2.

(20) Callender TJ, L Morrow, & K Subramanian, Evaluation of chronic

neurological sequelae after acute pesticide exposure using SPECT

brain scans, J Toxicol Environm Health, 1994; 41:275-284.

(21) Morrow LA, CM , & M Hodgson, Cacosmia and neurobehavioral

dysfunction associated with occupational exposure to mixtures of

organic solvents, Am J Psychiatry, 1988; 145:1442-1445.

(22) Morrow LA, MJ Hodgson, & N Robin, Assessment of attention and

memory efficiency in persons with solvent neurotoxicity,

Neuropsychologia, 1992; 30(10):911-922.

(23) Morrow LA, CM , MJ Hodgson, & N Robin, Risk factors

associated with persistence of neuropsychological deficits in

persons with organic solvent exposure, J Nervous & Mental Dis, 1991;

179:540-545.

(24) Conlin, Is your office killing you?, Business Week,

June 5, 2000, pages 114-125. (In this article the authoress

stated, " Experts predict that the 5% to 10% of the population that

is allergic to chemicals will grow to 60% by 2020. " She did not

state where she obtained these figures, but a general observation of

the American scene tends to support their validity.)

(25) Simon TR, DC Hickey, CE Fincher et al, Single photon emission

computed tomography of the brain in patients with chemical

sensitivity, Toxicol Industr Health, 1994, 10(4/5):573-577.

(26) Hannan KL, DE Berg, W Baumzweiger, HH on et al,

Activation of the coagulation system in Gulf War Illness: a

potential pathophysiologic link with chronic fatigue syndrome - a

laboratory approach to diagnosis, Blood Coagulation and

Fibrinolysis, 2000; 11:673-678.

(27) Buist RA, Chronic fatigue and chemical overload, Intern Clin

Nutrition Rev, Oct., 1988, 8(4):173-175.

(28) Beaune P et al, Autoantibodies against cytochrome P-450; role

in human disease, Adv Pharmacol, 1994; 30:199-245. (Note:

detoxification in the body is centered around two enzyme systems.

The first is the P-450 system which, by a process of oxidization,

converts the lipid-soluble state of volatile organic compounds into

a more water soluble form, in which form they are more readily

excreted by the kidneys. There is a price to pay, in that the water-

soluble forms of VOCs may be more toxic than their parent compounds.

In health the second phase of detoxification, that of conjugation,

takes place immediately to neutralize the toxicity in which process

the toxic product is combined with various natural substances in the

body, predominantly glutathione. In many instances in chemical

sensitivity there appears to be a relative deficiency of the

conjugation enzyme activity which results in an accumulation of the

more toxic products of phase I oxidation.

(29) Chemical Sensitivity, Volumes I - IV, J. Rea, M.D.,

Publishers, Boca Raton, FL , Vol I, 1992, Vol II, 1994, Vol

III, 1995, Vol IV, 1997.

(30) The Case for Preconception Care of Men and Women, Margaret and

Arthur Wynn, AB Academic Publishers, PO Box 42, Bicester, Oxon, 0X6

7NW England 1991.

(31) Among the parents with autistic children, a significant portion

of these parents believe that their children have been damaged by

vaccines. A common story in such instances is that the child was

developing normally into his or her second year, was beginning to

speak a few words, was affectionate with parents and playful with

siblings until a vaccination took place, after which the child lost

all speech and regressed into a world of its own, no longer

responding to parents or playmates.