Causes of autism

Leonardo Trasande, MD, explains how the increases in autism diagnosis may be related to environmental chemicals and which environmental factors could be behind the rise in autism
Increases In Autism Related To Environmental Chemicals and Factors
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Causes of autism

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Over the past two decades, serial studies have documented increases in the number of children who have carried a diagnosis of autism. This has brought a lot of attention and a lot of concern to the public, and rightly so. Parents are concerned naturally that there is some environmental factor that is contributing to that. We do know that there's been increasing attention, so some of that increase in the trend for autism can be attributed to increased diagnosis, but there's mounting evidence to suggest environmental concerns as contributors. One environmental contributor that has received, I would argue, too much attention is childhood vaccines. Multiple studies have examined childhood vaccines and a particular ingredient in childhood vaccines in the form of ethyl mercury, a form of mercury that has been used for many years as a preservative in vaccines. Those studies have consistently failed to identify a link between ethyl mercury, or vaccines in general, and the development of autism. What I hope we can do is transition to a mode that focuses more broadly on environmental chemicals that are even more likely contributors. Right now, we don't have the evidence to pin down on one or two particular chemicals of concern, but there is a substantial body of evidence that suggests that environmental chemicals do contribute to autism, whether it be lead, methylmercury, pesticides or a host of other environmental chemicals. We still need larger scale studies to identify those environmental causes, but I think we need to shift gears in thinking about the environmental causes of autism and focus on lesser-studied and potentially higher-likelihood candidates.

Leonardo Trasande, MD, explains how the increases in autism diagnosis may be related to environmental chemicals and which environmental factors could be behind the rise in autism

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Leonardo Trasande, MD, MPP

Associate Professor, NYU School of Medicine

Dr. Leo Trasande's research focuses on identifying the role of environmental exposures in childhood obesity and cardiovascular risks, and documenting the economic costs for policy makers of failing to prevent diseases of environmental origin in children proactively. Dr. Trasande is perhaps best known for a 2012 Journal of the American Medical Association study associating Bisphenol A exposure in children and adolescents with obesity, and a 2011 study in Health Affairs which found that children's exposures to chemicals in the environment cost $76.6 billion in 2008. His analysis of the economic costs of mercury pollution played a critical role in preventing the Clear Skies Act (which would have relaxed regulations on emissions from coal-fired power plants) from becoming law. He has also published a series of studies which document increases in hospitalizations associated with childhood obesity and increases in medical expenditures associated with being obese or overweight in childhood.

These studies have been cited in the Presidential Task Force Report in Childhood Obesity, and another landmark study identified that a $2 billion annual investment in prevention would be cost-effective even if it produced small reductions in the number of children who were obese and overweight. He serves on the Executive Committee of the Council for Environmental Health of the American Academy of Pediatrics, and on the Scientific and Technical Advisory Committee for the World Trade Center Health Program. He recently served on a United Nations Environment Programme Steering Committee which published a Global Outlook on Chemicals in 2013, and on the Board of Scientific Counselors for the National Center for Environmental Health at the Centers for Disease Control and Prevention.

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Transcription: 
Over the past two decades, serial studies have documented increases in the number of children who have carried a diagnosis of autism. This has brought a lot of attention and a lot of concern to the public, and rightly so. Parents are concerned naturally that there is some environmental factor that is contributing to that. We do know that there's been increasing attention, so some of that increase in the trend for autism can be attributed to increased diagnosis, but there's mounting evidence to suggest environmental concerns as contributors. One environmental contributor that has received, I would argue, too much attention is childhood vaccines. Multiple studies have examined childhood vaccines and a particular ingredient in childhood vaccines in the form of ethyl mercury, a form of mercury that has been used for many years as a preservative in vaccines. Those studies have consistently failed to identify a link between ethyl mercury, or vaccines in general, and the development of autism. What I hope we can do is transition to a mode that focuses more broadly on environmental chemicals that are even more likely contributors. Right now, we don't have the evidence to pin down on one or two particular chemicals of concern, but there is a substantial body of evidence that suggests that environmental chemicals do contribute to autism, whether it be lead, methylmercury, pesticides or a host of other environmental chemicals. We still need larger scale studies to identify those environmental causes, but I think we need to shift gears in thinking about the environmental causes of autism and focus on lesser-studied and potentially higher-likelihood candidates.