Fw: No Effect Of MMR Withdrawal On The Incidence Of Autism: A TotalPopulation Study

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No Effect Of MMR Withdrawal On The Incidence Of Autism: A

> TotalPopulation Study

>

>

> SCHAFER AUTISM REPORT " Healing Autism:

> No Finer a Cause on the Planet "

> ________________________________________________________________

> Monday, March 7, 2005 Vol. 9 No. 38

>

>

>

> COMMENTARY

> * No Effect Of MMR Withdrawal On The Incidence Of Autism: A Total

> Population Study

>

> RESEARCH

> * US Study Confirms Bowel Disease Findings In Children With Autism

> * How Mirror Neurons Help Us to Empathize, Really Feel Others' Pain

>

> CARE

> * How Four-Year-Old Tenny Stole My Heart

>

> PUBLIC HEALTH

> * Schools Moving to Rid Mercury From Labs

>

> EVENTS

> * The Real World of Autism With Chantal on www.autismone.org

>

> LETTERS

> * Cherchez La Cause

>

>

>

> COMMENTARY

>

> No Effect Of MMR Withdrawal On The Incidence Of Autism: A Total Population

> Study

> Journal of Child Psychology and Psychiatry. February 2005

>

> [by Honda H, Shimizu Y and Rutter M.]

>

> Japanese study is the strongest evidence yet for a link between MMR

> and autism. J Wakefield FRCS FRCPath and Carol M Stott PhD Honda

> and colleagues present a fascinating report on the cumulative incidence

> (numbers of new cases with time) of autistic spectrum disorders (ASDs) in

> the Kohoku Ward, Yokohama, Japan, for children born 1988 to 1996. The

> study

> seeks to examine the relationship between ASD and MMR vaccination. Japan

> is

> unique since MMR was introduced in 1989 and discontinued in April 1993.

> Honda et. al. see this as providing an ideal opportunity to test whether

> there is a causal association between MMR exposure and incidence of ASDs.

> They predict that, if MMR causes autism, stopping MMR should result in a

> subsequent decline in incidence. This was not seen. In fact, there was a

> striking rise in the incidence of ASDs in this population over time, with

> a

> marked rise postdating the removal of MMR. The authors state that their

> finding 'implies that MMR could not cause a substantial proportion of

> cases

> of autism'.

> In conducting a study of this kind it is important to consider the

> background against which earlier hypotheses relating to the possible

> association between measles containing vaccines such as MMR, bowel disease

> and childhood developmental disorders were formulated, and according to

> which any relevant data should be interpreted.

> The above notwithstanding, the authors of the Japanese study are

> confident in the completeness of ascertainment of ASD cases, the accuracy

> and precision of their screening, and the quality of diagnostic services

> for

> developmental disorders. Given this level of confidence in the incidence

> figures, the data merit further scrutiny in light of Japan's unique

> experience with the vaccines of interest.

>

> Background

> In 1998 one of us (AJW) made a recommendation in relation to how

> parents might wish to protect their child from the relevant infections -

> measles, mumps and rubella - by vaccination. This recommendation was based

> upon published scientific studies from his own laboratory together with an

> extensive examination of safety studies conducted in relation to measles

> vaccine either given alone or in combination with the other viral

> vaccines.

> The recommendations were that consideration should be given to (i) having

> M,

> M and R separately as the individual component vaccines and (ii) allowing

> an

> interval of one year between the vaccines.

> The basis for these recommendations came from the following

> observations.

> First, that the safety studies of MMR vaccine were inadequate, a

> conclusion subsequently endorsed by independent scientific review .

> Second, that there was clear evidence from the early clinical trials

> of MMR, of 'interference' between the component viruses in the combined

> vaccine, an influence apparently mediated through an altered immune

> response

> to the vaccines when given together . The safety consequences of this

> 'interference' are completely unknown since they have not been

> investigated

> as they should have been.

> Third, that children that had experienced concurrent natural measles

> (or single measles vaccine) and natural mumps infections within the same

> year were at significantly greater risk of later inflammatory bowel

> disease

> . The latter finding is consistent with a natural 'interference'

> phenomenon

> that potentially increases the risk of long-term measles virus infection

> and

> delayed disease. It is quite possible that this effect could operate for

> an

> interval of one-year or more between exposure to two different viruses.

> Measles virus and measles vaccines can suppress the immune system for a

> prolonged period after exposure . This effect is exemplified by the excess

> mortality and immunosuppression associated with potent measles vaccines,

> observed in developing countries, which led to these vaccines being

> abandoned (reviewed in 3).

> Having established this background, one can examine the relevant

> events in Japan.

> Vaccination policy and policy change in Japan Monovalent measles

> vaccine was introduced in Japan in 1978 and was recommended to be given at

> 12 - 72 months of age. Rubella vaccine was introduced in 1977 and was

> recommended for junior high school female students. An MMR vaccination

> program was launched in April 1989 for children aged between 12 and 72

> months with the majority receiving the vaccine by 18 months of age. There

> was no mumps vaccine used in Japan before the introduction of MMR.

> It is notable that various brands of MMR vaccine were licensed in

> Japan, some of them containing the mumps Urabe AM9 strain. Due to

> increasing

> public and professional concern about reported incidences of meningitis

> following MMR, public confidence declined over the years following its

> introduction and MMR vaccine uptake fell. Subsequent studies confirmed

> that

> the Urabe AM9 mumps vaccine was causally associated with meningitis. This

> resulted in the termination of the MMR program in April 1993, and no child

> in the current study received MMR from 1992 onwards. The Urabe AM9 mumps

> vaccine was discontinued and replaced with a strain of mumps vaccine which

> did not cause meningitis. Single measles, mumps, and rubella vaccines

> replaced the combined vaccine in 1993 in a new immunization schedule,

> which

> was formalised the following year. The recommendation was for Japanese

> children to receive monovalent measles, mumps and rubella vaccines to be

> given to infants spaced by a period of not less than four weeks.

> Against the background of this changing vaccination policy the

> cumulative incidence curve of ASD in this population is very interesting

> (see Figure One).

> The Japanese study does not tell us anything about the incidence of

> ASD prior to 1988; prevalence data are used as an estimate of the upper

> limit (Figure 1). Following the introduction of MMR there was a rise in

> annual incidence of ASDs to 85.9 for children born in 1990. The incidence

> subsequently declined to 55.8 for children born in 1991.

> The incidence then rose again sharply, to a level of 161

> (121.8-200.8)

> in 1994. During this time the single vaccine option gained further

> acceptance as public and professional confidence was restored following

> the

> removal of the Urabe mumps vaccine. The authors note that beyond 1994 the

> Kohuku Ward was redistricted but claim no effect of this on interpretation

> of the data. It is interesting to note, however, that the confidence

> intervals on the point estimates of ASD incidence increase in parallel

> with

> this demographic change. A result of this is that the precision of the

> point

> estimates appears to have been compromised after this time. ASD incidence

> beyond 1994 is, therefore, is not as accurate as preceding years.

> The multiphasic shape of the incidence curve is strikingly different

> from that seen in the UK (Figure 2) and the US (Figure 3) where

> distributions are primarily monophasic (i.e. a continuous rise). The shape

> of the Japanese graph would be consistent with an influence of an

> additional

> factor(s) on the evolution of an environmentally induced disease where,

> overall, exposure to the cause was increasing over time.

> In light of the biological nature of viral interactions

> ('interference') and the protracted effects on the immune system of

> measles

> exposure in particular (either as natural infection or vaccination) it is

> evident that, although MMR vaccine itself was discontinued in this infant

> population beyond 1993, for all practical purposes children vaccinated

> according to the recommended schedule were still receiving 'M-M-R' at age

> one. In other words the administration of the separate vaccines in close

> temporal proximity amounts, in biological terms, to overlapping exposure.

> Such close proximity of exposure is clearly atypical and something that

> would have been very rare with natural infection to measles, mumps and

> rubella viruses. The Japanese data are therefore not at odds with the

> original interpretation and the subsequent recommendations referred to

> earlier. They are entirely consistent with what is known about the

> behavior

> of these viruses. The authors of the Japanese study make the error of

> examining MMR as the single exposure of interest without giving any

> consideration to the arguments that have been put forward or the data upon

> which those arguments were based.

> In light of these observations the data could be interpreted as

> indicating a major influence of the pattern of exposure to these vaccine

> viruses on ASD incidence in this Japanese population. Moreover, it

> suggests

> a possible re-challenge effect of close temporal exposure to these vaccine

> viruses on ASD incidence at the population level, whereby the exposure

> (MMR)

> has been introduced, removed (voluntarily through lack of public

> confidence)

> and then re-introduced (as M, M and R close together). Nonetheless the

> interpretation by Public Health authorities that this is the 'last word on

> the subject' and that these data prove that MMR is safe is misleading and

> suggests a very limited perspective of the issues and a misunderstanding

> of

> the previously published concerns that have guided the research of those

> involved with examining the safety of measles vaccines. Enthusiasm to

> exonerate the MMR vaccine is no excuse for misrepresenting the published

> basis for the safety concerns.

>

> Regressive autism: methodological flaws

> It is also worth commenting on one major methodological flaw in the

> paper. The original description by Wakefield et al and subsequent studies

> indicate that any potentially causal relationship between MMR and ASD

> relates to a regressive form of autism, in which the child developed

> normally prior to exposure.

> In the study of Honda et al, children underwent routine developmental

> assessment at 3 months and 18 months of age, while the recommended

> schedule

> for MMR vaccination was 12 months of age. The authors define regression as

> demonstrable loss of skills after 18 months of age. Therefore children who

> have developed normally for the first year of life, who then receive an

> MMR

> at 12 months of age and who subsequently regress over the course of the

> next

> 6 months, will be misclassified as non-regressive cases when in fact quite

> the opposite may be the case. Misclassification of the children's autism

> in

> this way will render meaningless, the authors sub-analysis comparing

> regression and non-regression. This is supported to by the fact that the

> shape of the respective incidence curves in the regression and

> non-regression sub-groups is similar. The regression data, therefore, do

> not

> merit further consideration.

> The authors conclusion that their '.findings indicate that simply

> terminating MMR vaccination programs will not lead to a reduction in the

> incidence of ASD' is self-evident. The original recommendation however

> made

> no such naïve claim. The recommendations were that the vaccines should be

> given separately and spaced by one year; this was based on empirical data,

> which indicated a serious adverse effect of close temporal exposure to two

> or more of these vaccines. The Japanese data give no reason to change

> theses

> recommendations.

>

> Legend to Figure 1.

> * The published prevalence of ASD did not exceed 25 per 10,000 at any

> time in Japan before the introduction of MMR. This prevalence figure is

> therefore an overestimate of the incidence figure in this population.

> M-M-R

> = separate measles, mumps and rubella vaccines.

> For graphics: http://www.sarnet.org/img/awart.gif

>

>

>

>

>

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>

>

> * * *

>

> RESEARCH

>

> US Study Confirms Bowel Disease Findings In Children With Autism

>

> Neuropsychobiology. 2005 Feb 28;51(2):77-85

> Dysregulated Innate Immune Responses in Young Children with Autism

> Spectrum

> Disorders: Their Relationship to Gastrointestinal Symptoms and Dietary

> Intervention.

> Jyonouchi H, Geng L, Ruby A, Zimmerman-Bier B.

> Department of Pediatrics, New Jersey Medical School, UMDNJ, Newark,

> N.J., USA.

>

> Autism researchers at the University of New Jersey Medical School in

> the US have confirmed the original findings of researchers from the UK, by

> finding evidence of marked inflammatory and immune abnormalities in

> children

> with autism associated with gastrointestinal symptoms.

> The study compared the production of inflammatory and

> anti-inflammatory molecules by immune cells in autistic children on

> unrestricted (n = 100) or elimination (n = 77) diets with developmentally

> normal children with non-allergic food hypersensitivity on unrestricted (n

> =

> 14) or elimination (n = 16) diets, and healthy typically developing

> children.

> In response to challenge with bacterial toxins or dietary proteins

> from cow's milk, immune cells from autistic children with bowel symptoms

> showed a strong pro-inflammatory response and a reduced ability to switch

> off immune system activity compared with the other children.

> The authors conclude that the findings indicate intrinsic defects of

> these immune responses in autistic children with intestinal problems,

> suggesting a possible link between gastrointestinal and behavioral

> symptoms

> mediated by immune abnormalities.

> Dr Wakefield who led the team that first described intestinal disease

> in UK children with autism and demonstrated very similar immune

> abnormalities to those described by the New Jersey researchers in this

> group

> of patients, now heads up Thoughtful House Center for Children in Austin,

> Texas. Dr Wakefield confirmed the importance of these new findings and

> stressed their potential for increasing our understanding the role of

> gastrointestinal inflammation in the behavioural symptoms in children with

> developmental disorders such as autism.

> Thoughtful House in a not-for-profit organization dedicated to

> recovering children with developmental disorders through a unique

> combination of state of the art medical care, education and research.

> * * *

>

> How Mirror Neurons Help Us to Empathize, Really Feel Others' Pain

>

> [by Sharon Begley for the Wall Street Journal, online.]

> http://tinyurl.com/4bwfd

>

> As the argument at the bar grows more heated, you notice that you're

> right in the flight path should the ranting man decide to turn glassware

> into missiles. You watch tensely as he clasps and unclasps the tumbler in

> front of him, and then suddenly his grip changes. Is he about to take a

> gulp

> ... or fire the glass in your direction?

> If you duck just as it sails over your head, you can thank a cluster

> of neurons whose existence scientists didn't even know about a few years

> ago: mirror neurons.

> Their modest name reflects their most obvious function but hardly

> does

> justice to their talents, which neuroscientists seem to uncover more of

> every time they look -- from intuiting other people's intentions to

> feeling

> their pain. Literally.

> " Mirror neurons promise to do for neuroscience what DNA did for

> biology, " neurobiologist V.S. Ramachandran of the University of

> California,

> San Diego, has written, explaining " a host of mental abilities that have

> remained mysterious. "

> In 1992, biologists at the University of Parma, Italy, were probing

> the brains of macaque monkeys when they made a curious discovery. It had

> been known for years that brain cells in the premotor cortex, the area

> that

> plans movements, fire right before the monkey grasps, manipulates or

> reaches

> for something such as fruit. But it turns out that these specialized

> neurons

> also fire when the monkey sees someone else (monkey or human) do so.

> Whether

> planning a movement or seeing one, mirror neurons fire the same way: The

> firing pattern that precedes, say, the monkey's lifting a raisin to its

> mouth is identical to the pattern when it sees someone else doing that.

> The human brain has mirror neurons, too, and recently neuroscientists

> have been behaving like Egyptologists after the discovery of the Rosetta

> Stone: using mirror neurons to explain a backlog of enigmas.

> For one thing, mirror neurons may be how we understand the intentions

> of other people, a crucial social skill whether or not you frequent

> fight-prone bars. In a new study, neuroscientists scanned the brains of

> volunteers while they watched videos of a hand reaching for a mug. In one

> clip, the mug sat in a neat arrangement of teapot, mug, pitcher of milk

> and

> plate of cookies; in another, it sat amid a knocked-over pitcher, used

> napkin and cookie crumbs; in a third the mug sat alone.

> If the only thing mirror neurons do is fire when they see someone

> perform a movement, the volunteers' brains should have shown the same

> activity whether the hand was reaching for the mug as if to drink, in the

> first scene, to clean up in the messy scene or with no context. But that's

> not what happened. As Marco Iacoboni of UCLA and colleagues report in the

> March issue of PLoS Biology, mirror neurons were only a little active when

> the hand grasped the lone mug. But they perked up when the hand reached

> for

> the cup as if to drink from it (in preparty mode) or to wash it (post

> party).

> " This suggests that mirror neurons do not simply recognize actions

> but

> are also involved in decoding people's intentions, " says Prof. Iacoboni.

> " People seem to have specific neurons that code the 'why' of some action,

> predicting the behavior of others. "

> And that makes social interactions possible. At the annual meeting of

> the American Association for the Advancement of Science last month,

> researchers said that because these neurons fire both when we see someone

> move as when we move ourselves, they make equivalent " what others do and

> feel and what we do and feel. " We do not just see an action; we also

> experience what it feels like to someone else.

> Mirror neurons " re-create the experience of others within ourselves, "

> as UCLA's Mark put it in his AAAS remarks. They " allow us to put

> ourselves in the shoes of another. " That makes them the neural basis of

> empathy.

> " To function well with other people, we need to understand where

> they're coming from so as not to misread their intentions, " says Regina

> Pally, a psychotherapist in Los Angeles and a clinical professor at UCLA.

> " Mirror neurons are what let us understand others' emotions. " In fact,

> mirror neurons in people are connected to the brain's emotion region, the

> limbic system: When your mirror neurons fire in a reflection of someone

> else's, it triggers empathic emotions.

> Mirror neurons also let us feel another person's pain. The same

> cortical neurons that process the sense of touch also fire when you see

> someone else touched. And a region that registers disgust that you feel

> directly also fires when you see expressions of disgust on others (hence

> the

> visceral wallop of " Fear Factor " ).

> Instead of merely seeing what other people do and feel, said

> Christian

> Keysers of the University of Groningen, the Netherlands, " we start to feel

> their actions and sensations in our own cortex as if we would be doing

> these

> actions and having those sensations. "

> Except when we don't. In children with autism, " there may be a

> deficit

> in the mirror-neuron system, " says Prof. Iacoboni, which may explain why

> they are unable to infer the mental state and intentions of others.

> Without

> mirror neurons to serve as bridges between minds, everyone seems like a

> cipher.

>

>

>

>

> -- > THE SCHAFER AUTISM REPORT IS < --

>

> 0 Canada's most read autism publication

> 0 United Kingdom's most read autism publication

> 0 The United States' most read autism publication.*

>

> A Calendar of Events makes sense.

> http://www.sarnet.org/events

>

> Free Listing here

> http://www.sarnet.org/frm/cal-frm.htm

>

> _______________________________________________________

> * Whew! That's a pretty tall claim. Here are more details:

> ~200 editions, times 12 pages each, times ~20,000 circulation

> comes to 48 million electronic pages per year.

>

> * * *

>

> CARE

>

> How Four-Year-Old Tenny Stole My Heart

>

> [by Mallick for the Toronto Globe and Mail. Thanks to Beth

> Nolan.]

> http://tinyurl.com/5tjf7

>

> How awkward it is to fall in love again at my stage of life. And how

> humbling to learn how families struggle bravely through extended

> catastrophes. I can cope with personal disaster. Raised to be a pessimist,

> I

> expect no less.

> But the sufferings of children? They unhinge me.

> Then I met Tennyson Quance and her family. " Tenny " is 4½ years old.

> She would not have come into my life had her mother, a beautiful woman

> named

> Quance, not been photographing me for a book I wrote last year.

> And, as happens with women, the conversation got around to thorns that

> need

> plucking from the skin. Tennyson is autistic.

> There are various forms of autism, all notoriously difficult to

> diagnose. I am not talking about cutesy American film travesties like Rain

> Man or Forrest Gump. Neither do I mean Asperger syndrome, which is another

> matter.

> Autism is treatable, but not curable. It is Tennyson's fate. And she

> has been treated with heartless disdain, as autistic children are in

> almost

> all of Canada. There is a way to help her. It is called " writing a cheque "

> on an account that has been set aside for autistic children under 6. The

> Ontario government won't do it, despite the pleas of parents.

> Once more, I note with mystification that North Americans really do

> not appear to like children much.

> Tennyson's parents, and her husband, Brett, had a busy life

> in Toronto with two healthy children and Tennyson, who at 2 was becoming

> strangely off-kilter. They did research, saw doctors, heard diagnoses and

> found that the best treatment possible had to be done fast. Toddlerhood is

> the time of greatest malleability, your best shot at teaching life skills.

> Those skills are things like looking people in the eye, reading

> social

> signals, dressing yourself, eating with a fork and then remembering to put

> the fork down -- tiny, crucial things that will make Tennyson seem less

> odd

> to other children. She has to be gently guided, and rewarded with big

> smiles, a cheerful voice and " Good job, Tenny! " for hours on end. She has

> to

> sit up in a chair rather than slump and slide off it.

> It's both painful and humbling to watch on her treatment videos: The

> therapist works as unsparingly as a surgeon reconnecting veins, hundreds

> of

> veins, until even a four-year-old itching with energy will tire. I can

> immediately see why treatment is so costly. Very few people would have the

> skill or patience to learn it.

> Tennyson's intensive therapy takes place at a private agency. While

> bureaucrats dither over misallocated funds, the minister responsible

> admitted, when and Tennyson visited the Ontario Legislature two

> weeks ago, that there aren't enough teachers. Tennyson was on a waiting

> list

> for public care, but even her parents, with the help of a good MPP,

>

> Prue, couldn't discover her place on the list.

> So they pay $6,680 a month -- $80,160 a year on their line of credit

> -- and are driving themselves into bankruptcy.

> Governments have time. Tennyson doesn't. Friends threw a fundraiser

> in

> my neighbourhood and collected $54,000. It will pay for only seven months

> of

> help, but will give Tenny a fighting chance at acquiring the social skills

> she'll need to fit in, and not be sneered at as she was recently for

> screeching as she watched her brother at the ice rink. Another hockey mom

> asked viciously that Tenny be removed. Yes, you can always rely on the

> cruelty of strangers. It wasn't until an older man stepped in and gently

> asked if she needed help that began weeping.

> Tennyson, who has huge magical eyes as blue as Jude Law's, and a face

> so lovely she could make even a child-hating woman lactate, is going to

> have

> an appalling life without this help.

> Treatment varies across Canada, even though some experts say autism

> is

> now more common than Down syndrome, childhood cancer and cystic fibrosis.

> Brushing them aside is shortsighted, a false economy. Taxes will have to

> support autistic adults for life. A big gulp of help early would save us

> all

> so much grief.

> Tennyson's father says his daughter was at one time in such a bad

> state that she spent six months staring at closets and clocks, while

> rubbing

> her hands together.

> As I watch her videos from that time, her eyes scare me. They are

> distant and tired, like a child losing interest in life. Thus, when I met

> Tennyson in person, I was expecting a numbed, distracted little girl.

> Instead, the most extraordinary thing happened.

> She walked up to me, stared deeply into my eyes, and kissed me on the

> mouth. Children have their own style of kisses. My little stepdaughter

> would

> give me something resembling the brush of a butterfly's wing. Tenny's was

> a

> funny kiss, confident, firm, something wonderful conferred. Nothing in

> this

> world has given me greater delight, no, not even my Nobel for physics.

> What the Quances and other families need is publicly paid autism

> therapy or money (back pay and current pay) for the private therapy they

> obtain by begging and borrowing, until age 6 when another battle begins

> with

> school boards for classroom help.

> Here's what you can do for autistic kids. Ask your MPP and your

> premier to hand over the autism money now. It was an election promise.

> Alfred, Lord Tennyson, after whom she is named, was the one who

> wrote,

> " To strive, to seek, to find and not to yield. " That's my promise to

> little

> Tennyson. How does that old rhyme go? Say I'm weary, say I'm sad, say that

> health and wealth have missed me. Say I'm growing old, but add--Tenny

> kissed

> me!

> * * *

> PUBLIC HEALTH

>

> Schools Moving to Rid Mercury From Labs

> http://tinyurl.com/55ljp

>

> As mercury spills in schools disrupt classes, teachers and

> environmental groups want to rid student labs of the versatile but

> dangerous

> metal.

> In recent weeks, mercury was found in stairwells and corridors of a

> high school in the nation's capital. The building had to be closed twice

> for

> decontamination and still more traces were found Sunday even as cleaning

> crews were wrapping up their work in preparation for reopening the school

> Monday.

> " We're shocked, " District of Columbia Public Schools spokeswoman

> Leonie said.

> The building would be closed again Monday, school officials

> announced.

> They were searching for an alternate location to hold classes.

> + Full story here: http://tinyurl.com/55ljp

> * * *

>

> EVENTS

>

> The Real World of Autism With Chantal on www.autismone.org

>

> Tuesdays at 1:30- 2:00 EST, 10:30 Pacific Standard Time

>

> March 8- Dr. Esther Hess, a LA psychologist discussing her work

> with children and adolescents with ASD's using Floortime, and providing

> support to siblings and families affected by ASD's.

> March 15 -Shirley Fett, President of the San Diego Chapter of the

> Autism Society of America (SDASA). Shirley will talk about the innovative

> Camp ICAN program founded by the SDASA in partnership with the local

> Mission Valley YMCA.

> March 22 - Temple Grandin, Ph.D. will be discussing her latest book

> (co-author ) 'Animals in Translation' as well as her

> book

> (co-author Kate Duffy) 'Developing Talents - Careers for Individuals with

> Asperger's Syndrome and High-Functioning Autism.'

> March 29 - Bernard Rimland Ph.D. - will be discussing how 'Autism is

> Treatable' and Defeat Autism Now!.

> * * *

>

> LETTERS

>

> Cherchez La Cause

>

> Something that I haven't seen anyone mention are chemotherapy drugs.

> People working with chemo drugs are cautious not to handle the urine

> of people receiving chemo because 70 percent of the very caustic drugs are

> unchanged when excreted, and flushed down the toilet. I have often

> wondered

> if those drugs are indeed filtered out at the WWTPs, and if not, what the

> effect they are having.

> - Snyder

>

>

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