Re: RE: 3 Chemical Brain Injury...- Barb and

[Guest guest]

No problem Rosie, anytime.

spam: RE: 3 [] Chemical Brain Injury...- Barb and

> Dear Barb and .

>

> You two are wonderful. Thanking you both for your hard work helping to

> find

> credible article for the neurologist that will help my friend.

>

> I will print out and give to my friend and also save in my hard drive to

> share with others in the future.

>

> Can't thank you both enough for your concern and taking the time in your

> busy life to help with this.

> Huggies of appreciation to both of you,

> Rosie

>

>>>Just found the following article. Thought info. under

> #3 was especially interesting.

> Barb

> Why is chemical brain injury ignored? Pondering causes

> and risks - Editorial

> Archives of Environmental Health, March, 2003 by

> Kaye H. Kilburn

>

> NEARLY A DECADE AGO, I was persuaded that the brain

> was more sensitive to chemicals than were other

> organs. (1) Evidence originated from studies conducted

> by myself and others; we investigated the possible

> association between human brain damage and exposure to

> various chemicals contained in gases, organic

> solvents, and pesticides. My earlier resistance to

> this possibility originated from a lingering personal

> doubt and a sincere hope that it was not true. Growing

> support from the study of individuals--alone and in

> groups (i.e., clinical epidemiology)--has challenged

> the belief that epidemiology cannot prove causation.

> (2,3) Repeated strong associations that establish

> cause and effect in clinical medicine are considered

> only suggestive, but this is not sufficient in

> epidemiology.

>

> During the past 50 yr, the hesitancy of researchers to

> distinguish causes from risk factors has been an

> unfortunate legacy of this paradigm of chronic-disease

> epidemiology; it derives, in part, from the difficulty

> in the extension of Koch's postulates beyond

> infectious disease. (3) Forgotten is the observation

> made 150 yr ago that halting exposure to fecal and

> insect-borne agents stopped epidemics. This

> observation was made prior to the postulates

> introduced by Koch, (4) and the concept of

> " infection " had not yet been introduced. A classic

> example is Snow's mapping of London's cholera cases;

> this approach allowed for the evolution of the

> association with water from the Broad Street pump,

> which was contaminated with human excrement. (4)

>

> I presume that the numerous factors that currently

> slow both individuals' and society's acceptance of

> chemicals as major causes of diseases are the same as

> those that created opposition so many years ago to the

> demonstration that fecal contamination of water caused

> cholera. I think it imperative to identify 13 such

> factors.

>

>

> 1. Concealed damage. This factor is familiar to

> shippers; often, an individual must open a package

> before discovering damage not visible on the surface.

> By analogy, subtle tests may be needed for the

> identification of chemical brain injury. The wide gulf

> between abnormal findings detected by subtle testing

> and an individual appearing maimed encourages skeptics

> to cry for strong proof that impairments truly exist.

> When such findings were evident on sensitive tests,

> they portended important defects or deficiencies that

> needed follow-up studies to show progression. After 10

> yr of follow-up, brain injury had worsened. (6)

>

> 2. Psychic resistance to vulnerability. The reluctance

> of individuals to consider that the brain could be

> vulnerable is an emotional defense to fear or

> terror--like the outcry upon learning of the

> unexpected death of a loved one. Inasmuch as we know

> that the human brain is protected by a bony skull, and

> that a barrier between blood and brain filters out

> bacteria, we hope it also deflects harmful chemicals.

> But, in another compartment of our logical brain, we

> know that the barrier does not filter out anesthetic

> gases (ether), alcohol contained in drinks, or

> injected (street) drugs.

>

> 3. " It's all in your head. " Sometimes physicians

> dismiss unfamiliar problems of patients with this

> rejoinder, implying that the perceived problem stems

> from a mind disorder or a psychiatric problem. Seldom

> is the broader, literal interpretation made--that " in

> your head " means a brain problem. While " mind " may be

> a nebulous concept, brain dysfunction is susceptible

> to orderly, objective investigation. It is strange

> that few psychiatrists, when evaluating chemically

> exposed patients, consider that the depression, mania,

> and other disorders they treat with drugs (chemicals)

> could be caused by other chemicals. Instead, the

> tendency is to prescribe more chemicals (drugs), thus

> further poisoning the brains of such patients.

>

> 4. Acceptance of mind-altering drugs. The average

> citizen is well aware of the effects on the mind-brain

> of illicit chemicals, such as heroin and cocaine,

> marijuana, and lysergic acid diethylamide (LSD), as

> well as legal chemicals like alcohol and caffeine, and

> prescribed (and street) amphetamines. Many physicians

> have prescribed Paxil and Prozac " reflexively " to

> improve mood--especially for the treatment of

> depression. Such obvious connections should not be

> ignored. Thorazine, the first widely prescribed

> psychic or mind-altering drug, has been prescribed for

> 50 yr, and iproniazid (a monoamine oxidase inhibiter

> related to isoniazid, which is used to treat

> tuberculosis) has been available for a similar time

> period.

>

> 5. Not an imminent threat. Chemical brain damage is

> not generally considered an imminent or personal

> threat, like, for example, anthrax or

> terrorist-piloted airliners. Exposure to Sarin in the

> Tokyo subway, however, demonstrated that chemical

> warfare is effective on large numbers of people. The

> methyl isocyanate disaster at Bhopal, India, in 1984

> had a worse outcome than that experienced in Tokyo.

> Possible personal harm from chemical exposure has not

> been inferred. Individuals with chemical brain injury

> are frequently labeled as " emotionally disordered, "

> but they should be viewed as a vanguard of individuals

> who are knowledgeable about chemicals by virtue of

> experience. There is no evidence that the

> aforementioned individuals " were differently

> susceptible. " Rather, they just happened to be present

> when the exposure event occurred--for example, like

> the victims on September 11, 2001.

>

> 6. Competition from other threats. This factor has

> been suggested to be an explanation for indifference.

> Critical review evidences little substance in these

> " competing " threats. Recognition that a bacterial

> infection (Helicobacter pylori) caused peptic ulcer

> was only a minor newsmaker. Enormous concern has been

> generated regarding acquired immune deficiency

> syndrome (AIDS) and associated problems, which are

> sexually transmitted diseases and threaten to

> depopulate Africa. (7) AIDS is a serious brain

> infection and intoxication. The emerging resistance of

> bacteria to antibiotics was hyped in The Coming

> Plagues (7) and Secret Agents: The Menace of Emerging

> Infections. (8) Antibiotic resistance is a well-known

> result of short-sighted practices, abetted by treating

> colds and sore throats with antibiotics and adding

> antibiotics to animal feed for the increase of

> productivity (meaning: profits). Clearly, anthrax,

> smallpox, and similar agents resemble the

> aforementioned chemicals--Sarin and methyl

> isocyanate--in being extremely difficult to guard

> against.

>

> 7. Delay in acknowledging health risks. This factor

> was a 20th century theme. Cigarette smoke was

> associated with lung cancer in the 1950s. Inasmuch as

> many physicians quit smoking, their rates of lung and

> other cancers dropped quickly; myocardial infarction

> and stroke decreased greatly by 1975. Twenty-five

> years following 1975, nonsmokers' rights were

> recognized, and indoor smoking was curtailed--despite

> lobbying by powerful and rich tobacco interests under

> the pretense of guarding the rights of smokers, but

> whose underlying impetus was the protection of their

> immense profits. The proscription of asbestos exposure

> was, by far, more difficult than was the proscription

> of spitting on the sidewalk or the quarantining of

> tuberculosis patients. The banning of asbestos

> required 75 yr--a time period that exceeded that

> required for the banning of indoor cigarette smoke.

> The asbestos lobby protected profits until companies

> filed for bankruptcy in the early 1990s. American

> corporations' general rule appears to be that the

> health of workers takes a back seat to profits.

>

> 8. Economic interests. Economic interests may

> discourage prevention--even of cancer. The avoidance

> of exposure to toxins halted scrotal cancer in chimney

> sweeps, bladder cancers in Rehm's aniline dye workers,

> and radon lung cancers in miners in the late 19th

> century. Enormous, expensive institutions do " research

> on cancer, " and dedicated public organizations pursue

> the biologically implausible myth of cancer cures. The

> fact is that big reductions in lung cancer mortality

> occurred when cigarette smokers quit smoking. Another

> success was achieved when exposure to ionizing

> radiation was curtailed following the bombing of

> Hiroshima and Nagasaki, and after the Nevada/Utah

> atomic testings. It is safe for us to assume that

> other cancers can be prevented by the cessation of

> exposure to cancer-causing chemicals (e.g.,

> polyaromatic hydrocarbons from petroleum,

> polychlorinated biphenyls).

>

> 9. The promise of human genome mapping. Genome mapping

> is viewed as the key to human disease, and it

> threatens to replace cancer as a rallying cry for

> " believers. " Attention is consistently deflected from

> the reality that only 5% of human diseases has a

> genetic basis, with, perhaps, an additional 10%

> showing genetic influence. Worst are the hollow claims

> that we must know the site at which chemicals affect

> the genome to stop their inhalation or withdraw them

> from use--thus ignoring the lessons since cholera.

>

> 10. Splintering of medical and surgical practice. This

> ongoing aforementioned process is creating experienced

> technicians (still licensed as physicians and

> surgeons) who cannot see and understand the interplay

> of factors in their patients. These individuals have

> been trained to perform triple-bypass surgery; to

> transplant kidneys, livers, and hearts; to perform

> angioplasties and stent blood vessels; to cannulate

> intrahepatic bile ducts; and to conduct bronchoscopic,

> gastroscopic, and colonoscopic examinations.

> Therapeutic oncologists and hematologists wield

> powerful chemicals to cure the 1st cancer and cause

> the 2nd. Technical engineering characterizes doctors

> who can barely perceive the edges of their

> subspecialties--they might be sued if they venture

> beyond set boundaries. Few academic departments train

> internists or surgeons who consider problems in whole

> patients or inquire beyond reflex responses when

> unusual problems strike.

>

> 11. Neurology has been slow to consider causes.

> Perhaps this slowness occurs because neurology focuses

> on the structure of the brain, not its function.

> Pathophysiological thinking began prior to 1950 in the

> field of hematology, and shortly thereafter in the

> pulmonary disease and cardiology specialties. In

> contrast, neurology adopted the electroencephalogram

> mainly to confirm seizures, and the computerized axial

> tomography scanner and magnetic resonance imaging to

> find localized lesions, but otherwise, with the

> assistance of 19th century methods, it estimates

> muscle strength, body balance, visual function,

> memory, and problem-solving. Psychological testing,

> such as that developed by Wechsler in 1940 and

> Halstead (to Reitan) in 1950, is also ancient and

> largely obsolete. (6)

>

> 12. Resistance to the idea that chemicals damage

> brains and may cause chronic brain diseases. This

> " bridge concept " has few disciples in neurology.

> Examples of damage from specific organic solvents

> include n-hexane and acrylacmide, both of which

> destroy nerves (9); clioquinol (hydroxyquinoline),

> which produces optic atrophy and permanent vision

> loss; and ethambutol (for the treatment of

> tuberculosis), which causes optic neuritis and the

> loss of red and green discrimination. Regarding these

> as special cases--not to be generalized to anticipate

> similar problems from other chemicals--impairs

> progress. Recall that Parkinson's disease,

> described in 1817, was epidemic in manganese refiners

> in 1837; and that new but strong associations have

> been found between dying cells in the brain's

> striatonigral system and herbicides and the street

> drug MPTP

> (1-methyl-4-phenyl-1,7,3,6-tetrahydropyridine).

>

> 13. Failure to recognize potential harm from low

> chemical concentrations. Despite awareness that the

> brain has enormous amplifier capacity, most

> neurologists ignore--and some deplore--the concept of

> sensitivity to low concentrations of chemicals. The

> case in point is Multiple Chemical Sensitivity

> Syndrome, which is labeled as " fringe " or " kooky, " as

> if the battlements of medical thought must be defended

> from such an idea. Some held to these biases while

> they treated Gulf War veterans who died of premature

> amyotrophic lateral sclerosis. In contrast,

> occupational neurotoxicity has a rich history,

> including the disturbance of brain function by mercury

> in mirror silverers in 1700, and palsy and psychosis

> caused by lead, as described in 1737 by Ben lin

> in fellow printers who handled lead type. These 13

> explanations for delayed acceptance of the reality of

> chemical brain injury illustrate a cultural lag in

> medical thinking and in society as a whole. Acceptance

> of a new idea can take a generation--or 2 or 3. Recall

> the classic hazards of cigarette smoking recognized in

> the 1950s, of asbestos in the 1960s, and of nuclear

> (ionizing) radiation (also in the 1960s). Half a

> generation has ensued, so perhaps the existence of

> chemically induced brain injury will be accepted by

> 2010. Ironically, acceptance will be slower if many

> decision makers' brains have been damaged, and it will

> be accelerated if damage has been limited to a few.

>

> References

>

> (1.) Kilburn KH. Is the human nervous system most

> sensitive to environmental toxins? Arch Environ Health

> 1989; 44:343-44.

>

> (2.) Hill AB. Principles of Medical Statistics. 9th

> ed. London, U.K.: Lancet, 1971.

>

> (3.) Hill AB. The environment and disease: association

> or causation. Proc Roy Soc Med 1965; 58:295-300

>

> (4.) Koch R. Postulates. Berlin Klin Woschenschr.

> 1882; 19:221-43.

>

> (5.) Snow J. The mode of communication of cholera

> (1855). Reprinted in: Snow on Cholera. New York: The

> Commonwealth Fund, 1936.

>

> (6.) Kilburn KH. Chemical Brain Injury. New York:

> Wiley and Sons, 1998.

>

> (7.) Garrett L. The Coming Plague. New York: Farrar

> Strauss Geroux, 1994.

>

> (8.) Drexler M. Secret Agents: The Menace of Emerging

> Infections. New York: ph Henry Press, 2002.

>

> (9.) Schaumburg HH, Spencer PS. Recognizing neurotoxic

> disease. Neurology 1987; 37:276-78.

>

> (10.) Ambrose SE. Nothing Like It in the World. New

> York: Simon and Schuster, 2000.

>

> (11.) Daubert v. Merrell Dow Pharmaceuticals, Inc. 509

> U.S. 579, 1251 Ed 469 (1993).

>

> KAYE H. KILBURN, M.D.

>

> University of Southern California Keck School of

> Medicine Environmental Sciences Laboratory, Bldg. A7

> #7401 1000 S. Fremont Avenue, Unit 2 Alhambra, CA

> 91803

>

> E-mail: kilburn@...

>

> COPYRIGHT 2003 Heldref Publications

> COPYRIGHT 2003 Gale Group

>

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