Monday, March 10, 2008

Area Tap Water Has Traces of Medicines

Tests Find 6 Drugs, Caffeine in D.C., Va.

By Carol D. Leonnig
Washington Post Staff Writer
Monday, March 10, 2008; B01

The Washington area's drinking water contains trace amounts of six commonly used drugs that typically turn up in wastewater and cannot be filtered out by most treatment systems.

The pharmaceuticals -- an anti-seizure medication, two anti-inflammatory drugs, two kinds of antibiotics and a common disinfectant -- were found in very small concentrations in the water supply that serves more than 1 million people in the District, Arlington County, Falls Church and parts of Fairfax County. But scientists say the health effects of long-term exposure to such drugs are not known.

Pharmaceuticals, along with trace amounts of caffeine, were found in the drinking water supplies of 24 of 28 U.S. metropolitan areas tested. The findings were revealed as part of the first federal research on pharmaceuticals in water supplies, and those results are detailed in an investigative report by the Associated Press set to be published today.

In addition to caffeine, the drugs found in water treated by the Washington Aqueduct include the well-known pain medications ibuprofen and naproxen, commonly found in Aleve. But there were also some lesser-known drugs: carbamazepine, an anti-convulsive to reduce epileptic seizures and a mood stabilizer for treating bipolar disorders; sulfamethoxazole, an antibiotic that can be used for humans and animals in treating urinary tract and other infections; and monensin, an antibiotic typically given to cattle. In addition, the study uncovered traces of triclocarban, a disinfectant used in antibacterial soaps.

That the drugs were found so commonly nationwide highlights an emerging water dilemma that the public rarely considers. The drugs we use for ourselves and animals are being flushed directly into wastewater, which then becomes a drinking water source downstream. However, most wastewater and drinking water treatment systems, including Washington's, are incapable of removing those drugs.

And although the chemicals pose no immediate health threat in the water, the health effects of drinking these drug compounds over a long period is largely unstudied. Some scientists said there is probably little human health risk; others fear chronic exposure could alter immune responses or interfere with adolescents' developing hormone systems.

Washington's water regulators and utility officials say they are not alarmed by the findings because the drugs are found at such low levels -- parts per trillion, a tiny fraction of the amount in a medical dose. But they do view these "emerging contaminants" with concern.

"What concerns me is we're finding pharmaceuticals in the river that we rely upon for drinking water," said Thomas P. Jacobus, general manager of the Washington Aqueduct. "If we can't get them out, we have to find a way to neutralize them if we find there's a health effect from them."

Jacobus said the aqueduct leadership will recommend in the next few months likely upgrades for water treatment to deal with an array of newly identified and increasing contaminants in the water. The aqueduct uses chlorine, which kills a wide group of bacteria and breaks down some chemicals but cannot disrupt pharmaceuticals. Studies show ozone water treatment is the most effective in zapping such drugs.

The U.S. Geological Survey and the U.S. Department of Agriculture have been screening Washington's and other cities' water supplies for pharmaceuticals in the first research project on pharmaceuticals in the water. The Washington Aqueduct, an arm of the U.S. Army Corps of Engineers, does not regularly screen for caffeine or pharmaceuticals, nor do most water utilities.

The drugs discovered in testing over the past two years typically get into the water supply because they pass through a user's body and are flushed downstream. The U.S. Environmental Protection Agency is studying some pharmaceuticals for their impact on public health but has not set safety standards for any of the drugs.

"We recognize it is a growing concern, and we're taking it very seriously," Benjamin H. Grumbles, the EPA's assistant administrator for water, said of the drugs' presence.

There is no clear evidence of a human health threat from such low levels of pharmaceuticals. But scientists warn that, because there has been very little study of the long-term or synergistic effects of this kind of drug exposure, water providers and regulators need to exercise caution. Although experts agree that aquatic life are most at risk from exposure to the drugs in rivers and streams, researchers are concerned about what they don't know about human health effects.

In other findings from its reporting, the AP said officials in Montgomery County and Fairfax have found numerous pharmaceuticals in their environmental watersheds but do not test their drinking water supplies for the same chemical compounds.

Nationwide, the AP reported that researchers found anti-depressants, antacids, synthetic hormones from birth control pills, and many other human and animal medicines in the water. In San Francisco, tests found a sex hormone. In New York, the water tested positive for heart medicines and a prescription tranquilizer.

The Associated Press contributed to this report.

Saturday, March 8, 2008

FDA/EPA advisory on the dangers of methylmercury

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March 2004EPA-823-R-04-005
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What You Need to Know About Mercury in Fish and Shellfish

2004 EPA and FDA Advice For:
Women Who Might Become Pregnant
Women Who are Pregnant
Nursing Mothers
Young Children

Fish and shellfish are an important part of a healthy diet. Fish and shellfish contain high-quality protein and other essential nutrients, are low in saturated fat, and contain omega-3 fatty acids. A well-balanced diet that includes a variety of fish and shellfish can contribute to heart health and children's proper growth and development. So, women and young children in particular should include fish or shellfish in their diets due to the many nutritional benefits.

However, nearly all fish and shellfish contain traces of mercury. For most people, the risk from mercury by eating fish and shellfish is not a health concern. Yet, some fish and shellfish contain higher levels of mercury that may harm an unborn baby or young child's developing nervous system. The risks from mercury in fish and shellfish depend on the amount of fish and shellfish eaten and the levels of mercury in the fish and shellfish. Therefore, the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) are advising women who may become pregnant, pregnant women, nursing mothers, and young children to avoid some types of fish and eat fish and shellfish that are lower in mercury.

By following these 3 recommendations for selecting and eating fish or shellfish, women and young children will receive the benefits of eating fish and shellfish and be confident that they have reduced their exposure to the harmful effects of mercury.

  1. Do not eat Shark, Swordfish, King Mackerel, or Tilefish because they contain high levels of mercury.

  2. Eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury.

    • Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish.

    • Another commonly eaten fish, albacore ("white") tuna has more mercury than canned light tuna. So, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of albacore tuna per week.

  3. Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers, and coastal areas. If no advice is available, eat up to 6 ounces (one average meal) per week of fish you catch from local waters, but don't consume any other fish during that week.

Follow these same recommendations when feeding fish and shellfish to your young child, but serve smaller portions.

Frequently Asked Questions about Mercury in Fish and Shellfish:

  1. "What is mercury and methylmercury?"
    Mercury occurs naturally in the environment and can also be released into the air through industrial pollution. Mercury falls from the air and can accumulate in streams and oceans and is turned into methylmercury in the water. It is this type of mercury that can be harmful to your unborn baby and young child. Fish absorb the methylmercury as they feed in these waters and so it builds up in them. It builds up more in some types of fish and shellfish than others, depending on what the fish eat, which is why the levels vary.

  2. "I'm a woman who could have children but I'm not pregnant - so why should I be concerned about methylmercury?"
    If you regularly eat types of fish that are high in methylmercury, it can accumulate in your blood stream over time. Methylmercury is removed from the body naturally, but it may take over a year for the levels to drop significantly. Thus, it may be present in a woman even before she becomes pregnant. This is the reason why women who are trying to become pregnant should also avoid eating certain types of fish.

  3. "Is there methylmercury in all fish and shellfish?"
    Nearly all fish and shellfish contain traces of methylmercury. However, larger fish that have lived longer have the highest levels of methylmercury because they've had more time to accumulate it. These large fish (swordfish, shark, king mackerel and tilefish) pose the greatest risk. Other types of fish and shellfish may be eaten in the amounts recommended by FDA and EPA.

  4. "I don't see the fish I eat in the advisory. What should I do?"
    If you want more information about the levels in the various types of fish you eat, see the FDA food safety website www.cfsan.fda.gov/~frf/sea-mehg.html or the EPA website at www.epa.gov/ost/fish.

  5. "What about fish sticks and fast food sandwiches?"
    Fish sticks and "fast-food" sandwiches are commonly made from fish that are low in mercury.

  6. "The advice about canned tuna is in the advisory, but what's the advice about tuna steaks?"
    Because tuna steak generally contains higher levels of mercury than canned light tuna, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of tuna steak per week.

  7. "What if I eat more than the recommended amount of fish and shellfish in a week?"
    One week's consumption of fish does not change the level of methylmercury in the body much at all. If you eat a lot of fish one week, you can cut back for the next week or two. Just make sure you average the recommended amount per week.

  8. "Where do I get information about the safety of fish caught recreationally by family or friends?"
    Before you go fishing, check your Fishing Regulations Booklet for information about recreationally caught fish. You can also contact your local health department for information about local advisories. You need to check local advisories because some kinds of fish and shellfish caught in your local waters may have higher or much lower than average levels of mercury. This depends on the levels of mercury in the water in which the fish are caught. Those fish with much lower levels may be eaten more frequently and in larger amounts.

For further information about the risks of mercury in fish and shellfish call the U.S. Food and Drug Administration's food information line toll-free at 1-888-SAFEFOOD or visit FDA's Food Safety website www.cfsan.fda.gov/seafood1.html

For further information about the safety of locally caught fish and shellfish, visit the Environmental Protection Agency's Fish Advisory website www.epa.gov/ost/fish or contact your State or Local Health Department. A list of state or local health department contacts is available at www.epa.gov/ost/fish. Click on Federal, State, and Tribal Contacts. For information on EPA's actions to control mercury, visit EPA's mercury website at www.epa.gov/mercury.

This document is available on the web at http://www.cfsan.fda.gov/~dms/admehg3.html.


This document is also available in brochure format in both English and Spanish.

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Deal in an Autism Case Fuels Debate on Vaccine

March 8, 2008

WASHINGTON — Study after study has failed to show any link between vaccines and autism, but many parents of autistic children remain unconvinced. For the skeptics, the case of 9-year-old Hannah Poling shows that they have been right along.

The government has conceded that vaccines may have hurt Hannah, and it has agreed to pay her family for her care. Advocates say the settlement — reached last fall in a federal compensation court for people injured by vaccines, but disclosed only in recent days — is a long-overdue government recognition that vaccinations can cause autism.

“This decision gives people significant reason to be cautious about vaccinating their children,” John Gilmore, executive director of the group Autism United, said Friday.

Mr. Gilmore has filed his own claim that his son became autistic as a result of vaccinations.

Government officials say they have made no such concession.

“Let me be very clear that the government has made absolutely no statement indicating that vaccines are a cause of autism,” Dr. Julie L. Gerberding, director of the Centers for Disease Control and Prevention, said Thursday. “That is a complete mischaracterization of the findings of the case and a complete mischaracterization of any of the science that we have at our disposal today.”

Hannah, of Athens, Ga., was 19 months old and developing normally in 2000 when she received five shots against nine infectious diseases. Two days later, she developed a fever, cried inconsolably and refused to walk. Over the next seven months she spiraled downward, and in 2001 she was given a diagnosis of autism.

Hannah’s father, Dr. Jon Poling, was a neurology resident at Johns Hopkins Hospital at the time, and she underwent an intensive series of tests that found a disorder in her mitochondria, the energy factories of the cells.

Such disorders are uncommon, their effects can be significant but varied, and the problems associated with them can show up immediately or lie dormant for years.

There are two theories about what happened to Hannah, said her mother, Terry Poling. The first is that she had an underlying mitochondrial disorder that vaccinations aggravated. The second is that vaccinations caused this disorder.

“The government chose to believe the first theory,” Ms. Poling said, but added, “We don’t know that she had an underlying disorder.”

In a news conference on Thursday, Dr. Edwin Trevathan, director of the National Center for Birth Defects and Development Disabilities at the disease control agency, said, “I don’t think we have any science that would lead us to believe that mitochondrial disorders are caused by vaccines.”

Dr. Trevathan explained that children with mitochondrial disorders often develop normally until they come down with an infection. Then their mitochondria are unable to manufacture the energy needed to nourish the brain. As a result, they regress.

The Poling case has become a flashpoint in the long-running controversy over thimerosal, a vaccine preservative containing mercury. Some people believe that thimerosal is behind the rising number of autism diagnoses. Among them is Lyn Redwood, director of the Coalition for SafeMinds.

Many of the vaccines Hannah received contained thimerosal, and to Ms. Redwood, she is more proof of thimerosal’s dangers.

The disease control centers, the Food and Drug Administration, the Institute of Medicine, the World Health Organization and the American Academy of Pediatrics have all largely dismissed the notion that thimerosal causes or contributes to autism.

Five major studies have found no link, and since thimerosal’s removal from all routinely administered childhood vaccines in 2001, there has been no apparent effect on autism rates.

Many of those who believe in an autism-vaccine link dismiss all this evidence, and Hannah’s case fuels their cause.

“Her story is very important because it echoes so many others, and it’s clear that thimerosal played a role,” said Rita Shreffler, executive director of the National Autism Association.

Dr. and Mrs. Poling said Hannah did not prove the case against thimerosal, but Dr. Poling noted that there was no debate that vaccines had risks.

“They’re not safe for everybody,” he said, “and one person for whom they proved unsafe happened to be my daughter.”

Dan Burton: Statement of Support of the Combating Autism Act (S.843)


Mr. Speaker, I rise in support of the Combating Autism Act of 2006 (S.843) as amended. I want to thank Chairman Nathan Deal and Chairman Joe Barton, and the Energy & Commerce Committee staff, for bringing this bill to the floor today.

Over the last five years or more, many of you have heard me speak many times on this floor about the subject of autism and you will likely continue to hear me speak on this issue because I believe we truly have our work cut out for us. About 20 years ago, autism was considered a rare disease, affecting about 1 in 10,000 children. Now, that rate is about 1 in 166; making autism the third most common developmental disability that children face, even more prevalent than things such as Down's Syndrome and other childhood cancers. In my own home State of Indiana we experienced a 923% cumulative growth rate for autism from 1992-2003. The annual growth rate of autism in Indiana averaged 27 % compared to an average of 7% for the growth rate of all disabilities.

This literal epidemic of autism is a looming and immediate economic crisis to our education system, our health care systems, our long-term housing and care system for the disabled, and most especially, to an ever increasing number of families across the country. Autism is a condition that has no known cure which means that this is a crisis that is simply not going to ``go away.''

Today we take a huge step forward in terms of dealing with this problem. Although in my opinion, only a down payment on the resources that we must invest in order to defeat this terrible scourge, the Combating Autism Act, commits nearly $1 billion - in essence almost a doubling of funding for autism - to autism research, including essential research on environmental factors, treatments, early identification and support services. This bill amounts to a long over due and vitally needed declaration of war by the Congress of the United States on autism.

Even so, while a needed step forward, this is not a perfect bill, because I believe we are missing a crucial opportunity to use this bill to help unravel the mystery of autism. Specifically, while the bill before us does include language on the need to research the environmental factors which may contribute to autism, it does not include a specific mandate that environmental research topics must include vaccines, other biologics, and their preservatives. Now I am not against vaccinations, but I do believe, as do many of my colleagues that there is a strong link between the mercury contained in a product called thimerosal - commonly used as a vaccine preservative - and children developing neurological disorders such as autism. In fact, my own grandson became autistic after receiving 9 shots in one day, 7 of which contained thimerosal.

Because of what happened to my grandson I took it upon my self to learn about autism and what I discovered during my research was deeply disturbing. During my tenure as Chairman of Government Reform Committee (1997-2002), and as Chairman of the Subcommittee on Human Rights & Wellness (2003-2005), a number of very credible national and international scientists testified at a series of hearings that the mercury in vaccines is a contributing factor to developing neurological disorders, including, but not limited to, modest declines in intelligence quotient (IQ), autism, and Alzheimer's Disease. And the body of evidence to support that conclusion gets larger every day.

Yet we continue to hear repeatedly in Congressional hearings, in media communications, and through government and scientific reports that ``there is no evidence that proves a connection between vaccines and autism." This conclusion is not too surprising when you consider that our health agencies seem to routinely dismiss out of hand any scientific study that does conclude thimerosal is a danger.

Experience tells us that, as with any other epidemic, while there may be underlying genetic susceptibilities, there usually is some type of environmental trigger as well, such as a virus, fungus, heavy metals, pollutants, or whatever. There has never, to the best of my knowledge, been a purely genetic epidemic. So, genetics alone cannot explain how we went from 1 in 10,000 children with autism spectrum disorders twenty years ago to 1 in 166 today. Considering that mercury is a base element and the most toxic substance known to science outside of radioactive materials, it is biologically plausible that mercury is an environmental trigger of autism.

Recent studies indicate that more than half of pediatricians said that in the previous year they had encountered at least one family that refused all vaccines, while 85 percent said they'd had a parent turn down at least one shot. Whether it's because of fear that mercury used as a preservative in childhood vaccines causes autism, or that the dangers of immunizations far outweigh their benefits, or that there is a conspiracy by drug companies, doctors and vaccine makers to conceal the harm, the facts are clear, more and more American families are fighting immunization.

It is imperative that we do all we can to restore the public's trust in vaccinations. And the only way we are going to resolve the conflict of opinion over thimerosal is through more research. Unfortunately, if the Department of Health and Human Services never funds or conducts the right studies, and given their current track record on the subject that is very likely what will happen, this question will forever remain unanswered. That will be a national tragedy because often once an environmental cause is discovered, immediate steps can be taken to prevent new cases and abate the epidemic. In addition, knowledge of the environmental cause or triggers often leads directly to more effective treatments.

For example, this bill promotes the use of evidence-based interventions for those at higher risk for autism. However, so long as we ignore the potential danger of mercury many biomedical interventions, such as restricted diet, applied kinesiology and/or chelation therapy - which many families have found to be the best treatments for their children with autism - will be excluded from the list of evidence-based treatments.

I stand here today not just as a concerned grandfather of an autistic child but as the voice for the hundreds of parents and families who continue to contact my office looking for help for their children. They are our constituents, we represent them in the People's House, and I hope we are all listening to them. The debate about mercury in vaccines must be addressed, investigated and resolved. Parents have a right to know what happened to their children regardless of where the truth lies. And we have a responsibility to those children and families already suffering. In the meantime, we should err on the side of caution and remove thimerosal, even trace amounts, from all vaccinations.

By failing to provide a clear Congressional mandate to research ALL of the potential environmental causes of Autism Spectrum Disorders (ASD), including vaccines and their preservatives, I believe we are handicapping our efforts to give all ASD patients the best possible quality of life and the ability to make the greatest possible contributions to society. I hope that in the coming weeks, months and years this Congress will push for further research into the question of thimerosal and autism so that one day we will be able to say that we have done everything possible to stop and treat this epidemic. In the meantime, I urge my colleagues to support this very good bill.