Autism explosion starts to look like "It's the environment, stupid" (not the vaccinations)

There were two pretty big developments on the autism story today. You've no doubt heard that for a while there it looked like a preservative in vaccinations given to children for measles, mumps and rubella was responsible for the increasing incidence of autism in American kids.

Not so much, it seems. Today the Lancet medical journal retracted a pivotal scientific paper in support of this concept. Meanwhile, The Wall Street Journal offered some tantalizing research tidbits that, while not identifying a cause, certainly seem to point toward an environmental factor or factors... or possibly social factors.

The backdrop here is that autism rates are skyrocketing in American children. My InvestigateWest colleague Carol Smith was onto this trend more than a decade ago, when the incidence was running  no higher than 1 out of every 500 children. It's now up at something more like 1 in 100 children. That's 1 percent of the population!

In today's news, first the retraction: It was a paper by a bunch of scientists led by one Dr. Andrew Wakefield that in 1998 set off a bit of a panic among parents, particularly in Britain, about the possibilty that vaccinations could be causing autism.

It was an appealing hypothesis, because it would explain why autism rates are increasing seemingly all over.

But years of studies followed. And the autism rate kept going up even though the mercury-containing preservative, thiomersal, was removed from the vaccines -- and even though vaccination rates in the UK and United States took a noticeable downward dip, along with health outcomes for unvaccinated children.

A British journalist whose name I unfortunately cannot find right now later revealed that Wakefield had conflicts of interest that he did not disclose, including the fact that plaintiffs'-bar lawyers helped fund Wakefield's research. Wakefield also had come up with a measles vaccine that might have become popular in the absence of the measles-mumps-rubella vaccine, Gardiner Harris reports today in The New York Times.

The Lancet's action comes a week after Britain's General Medical Council found that Wakefield had acted with "callous disregard" for his test subjects. He apparently took blood samples from 12 kids gathered for a birthday party.

Now, of course, not everyone is convinced that vaccines are off the hook. The most lucid defense of this point of view that I saw came from author David Kirby over at HuffPo. Still, when almost every scientist on a paper withdraws and the leader-holdout is facing censure by colleagues, it doesn't look good for that point of view . . .  no matter what the subject.

Now, on to Melinda Beck's fortuitously timed piece in this morning's Journal. Her lede:

Why is a child born in northwest Los Angeles four times as likely to be diagnosed with autism as a child born elsewhere in California?

Hard not to keep going, eh?

The really interesting thing here is that an area that includes posh Beverly Hills represents 3 percent of California's autism cases even though it represents just 1 percent of the state's population.

Unsurprisingly, the Columbia University study and another California  autism research project by UC-Davis researchers found no links to vaccinations. Both also noted that autism diagnoses are more prevalent in upper-income areas.

And it's clear that there's a geographical spottiness to these rates, Beck notes: Autism is diagnosed in greater Phoenix at twice the rate it is in northern Alabama, for instance.

The Davis study pinpointed clusters of high-diagnosis areas in Santa Ana, San Diego, San Francisco, Santa Clara, Fresno and Stockton. There, kids had at least a 70% greater chance of being diagnosed with autism than in surrounding areas, Beck reports.

The question, though, is whether these higher diagnosis rates are the result of more-educated parents recognizing a problem, versus some kind of actual environmental factor.

Current research doesn't settle the question. More to come.

-- Robert McClure

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