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Methylmercury and the developing brain.


We reported that prenatal exposure to methylmercury causes cognitive impairment in an estimated 316,588 children born in the United States each year, costing this nation $8.7 billion annually in lost productivity (Trasande et al. 2005). Each year, this exposure also causes an estimated 1,566 cases of mental retardation mental retardation, below average level of intellectual functioning, usually defined by an IQ of below 70 to 75, combined with limitations in the skills necessary for daily living.  (Trasande et al. 2006). The principal (70%) source of the mercury that enters the bodies of American children is combustion of coal in electricity-generating plants.

In their reanalysis of our data, Griffiths et al. (2007) made a series of incorrect judgments and poorly considered assumptions, each of which diminishes the import of our findings. We note the following errors in their analysis:

First, Griffiths et al. (2007) incorrectly used a linear model to relate cognitive function cognitive function Neurology Any mental process that involves symbolic operations–eg, perception, memory, creation of imagery, and thinking; CFs encompasses awareness and capacity for judgment  to prenatal methylmercury exposure, despite the National Research Council's (NRC NRC
abbr.
1. National Research Council

2. Nuclear Regulatory Commission

Noun 1. NRC - an independent federal agency created in 1974 to license and regulate nuclear power plants
) clear finding that a logarithmic logarithmic

pertaining to logarithm.


logarithmic relationship
when the logs of two variables plotted against each other create a straight line.
 model provides a better statistical fit. The NRC, in their examination of the Faroe Islands cohort study, the study on which they place greatest reliance, stated that "[b]ecause these calculations necessitate extrapolating to estimate the mean response at zero exposure level," logarithmic models "lead to lower estimates of the Benchmark Dose (BMD BMD

In currencies, this is the abbreviation for the Bermudian Dollar.

Notes:
The currency market, also known as the Foreign Exchange market, is the largest financial market in the world, with a daily average volume of over US $1 trillion.
) than linear or K-power models" (NRC 2000, p. 294).

Recent analyses of early childhood lead exposure further corroborate To support or enhance the believability of a fact or assertion by the presentation of additional information that confirms the truthfulness of the item.

The testimony of a witness is corroborated if subsequent evidence, such as a coroner's report or the testimony of other
 the validity of logarithmic models in representing subclinical subclinical /sub·clin·i·cal/ (sub-klin´i-k'l) without clinical manifestations.

sub·clin·i·cal
adj.
Not manifesting characteristic clinical symptoms. Used of a disease or condition.
 dose-response relationships of neuro-developmental injury (Canfield et al. 2003).

Second, Griffiths et al. (2007) unwisely based their analysis on potentially biased data from the Seychelles cohort study. By contrast, our model (Trasande et al. 2005), like that of the NRC, is based primarily on Faroes data. We chose not to use Seychelles data because of concern that the tests of neurobehavioral function used there were not well validated for a non-American population and therefore may not have been sensitive to detect cognitive impairment (Landrigan and Goldman 2003).

Another major potential source of bias in the Seychelles study, not acknowledged by Griffiths et al. (2007), is that it fails to consider the potentially beneficial nutrients found in the fish-based diet of the Seychelles. These nutrients, omega-3 fatty acids This is a list of omega-3 fatty acids.

Common name Lipid name Chemical name
α-Linolenic acid (ALA) 18:3 (n-3) octadeca-9,12,15-trienoic acid
Stearidonic acid 18:4 (n-3) octadeca-6,9,12,15-tetraenoic acid
 in particular, may partially offset the toxicity of methylmercury. Indeed, if maternal fish intake is taken into account in the Seychelles cohort, as recently was done, the estimate of methylmercury toxicity increases (Budtz- Jorgensen et al. 2007).

Griffiths et al. (2007) cited previous meta-analyses of the Faroes, Seychelles, and New Zealand studies by Ryan (2005) in applying IQ decrements of 0.13-0.18 points/ppm hair mercury, but these are likely underestimates, and further invalidate the analysis of Griffiths et al.

Third, in attributing mercury deposition to sources of emission, Griffiths et al. (2007) relied inexplicably and without justification on a mathematical model that posits that only 16% of deposits are attributable to American sources. They ignored empiric data from the U.S. Environmental Protection Agency Environmental Protection Agency (EPA), independent agency of the U.S. government, with headquarters in Washington, D.C. It was established in 1970 to reduce and control air and water pollution, noise pollution, and radiation and to ensure the safe handling and  (EPA EPA eicosapentaenoic acid.

EPA
abbr.
eicosapentaenoic acid


EPA,
n.pr See acid, eicosapentaenoic.

EPA,
n.
)-sponsored Steubenville study, which found that 80-90% of mercury emissions deposit within 30-50 miles of the source (U.S. EPA 2007); and from the Electric Power Research Institute, which estimated that 30% of mercury deposits are attributable to American sources (Seigneuret al. 2004).

Fourth, Griffiths et al. (2007) incorrectly assumed that reductions in mercury emissions from power plants do not result in any reduced levels of fish contamination until after 15 years. This is not correct. Reductions in power-plant emissions in 2008 will, in fact, begin immediately to minimize methylmercury body burden among children born to women in 2008, and the degree of reduction will increase further in subsequent years, perhaps through 2038, thus reducing the number of children damaged, the severity of the prenatal brain damage in these children, and the resulting economic burden.

Finally, Griffiths et al. (2007) incorrectly based their estimate of the economic value of a child's social productivity on the 1992 Current Population Survey rather than on the currently available 2005 data set. This miscalculation mis·cal·cu·late  
tr. & intr.v. mis·cal·cu·lat·ed, mis·cal·cu·lat·ing, mis·cal·cu·lates
To count or estimate incorrectly.



mis·cal
 substantially underestimates the economic impact of methylmercury on the developing brain. Viscusi and Aldy (2004) estimated that this value is currently on the order of $4-9 million/child, a value far greater than that used by Griffiths et al., and greater even than our estimate.

The authors declare they have no competing financial interests.

Leonardo Trasande

Philip J. Landrigan

Mount Sinai School of Medicine
This page is about a medical school in New York. For other uses, please see: Mount Sinai (disambiguation)


Mount Sinai School of Medicine is a medical school found in the borough of Manhattan in New York City.
 

New York, New York

E-mail: leo.trasande@mssm.edu

Clyde B. Schechter

Albert Einstein College of Medicine
For the engineering company, see AECOM


The Albert Einstein College of Medicine (AECOM) is a graduate school of Yeshiva University. It is a private medical school located in the Jack and Pearl Resnick Campus of Yeshiva University in the Morris Park
,

Bronx, New York

Richard F. Bopp

Rensselaer Polytechnic Institute Rensselaer Polytechnic Institute, at Troy, N.Y.; coeducational; founded and opened 1824 as Rensselaer School; chartered 1826. It was called Rensselaer Institute from 1837 to 1861.  

Troy, New York Troy is a city in New York, U.S., and the county seat of Rensselaer County. As of the 2000 census, the population was 49,170; in 1910, the population was 76,813. The city's motto is Ilium fuit, Troja est, which means "Troy was, Troy is.  

REFERENCES

Budtz-Jorgensen E, Grandjean P, Weihe P. 2007. Separation of risks and benefits of seafood intake. Environ Health Perspect 115:323-327.

Canfield RL, Henderson CR Jr, Cory-Slechta DA, Cox C, Jusko TA, Lanphear BP. 2003. Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter deciliter /dec·i·li·ter/ (dL) (des´i-le?ter) one tenth (10minus;1) of a liter; 100 milliliters.
Deciliter (dL)
100 cubic centimeters (cc).

Mentioned in: Hypercholesterolemia
. N Engl J Med 348(16):1517-1526.

Griffiths C, McGartland A, Miller M. 2007. A comparison of the monetized impact of IQ decrements from mercury emissions. Environ Health Perspect 115:841-847.

Landrigan PJ, Goldman L. 2003. Prenatal methylmercury exposure in the Seychelles [Letter]. Lancet 362(9384):666. NRC (National Research Council). 2000. Toxicological Effects of Methylmercury. Washington, DC:National Academy Press.

Ryan LM. 2005. Effects of Prenatal Methylmercury on Childhood IQ: A Synthesis of Three Studies. EPA-HQ-OAR-2002-0056- 6048 and EPA-HQ-OAR-2002-0056-6049. Available: http://www.regulations.gov [accessed 20 January 2006].

Seigneur C, Vijayaraghavan K, Lohman K, Karamchandani P, Scott C. 2004. Global source attributions for mercury deposition in the United States. Environ Sci Technol 38(2):555-569.

Trasande L, Schechter C, Haynes KA, Landrigan PJ. 2006. Mental retardation and prenatal methylmercury toxicity. Am J Ind Med 49:153-158.

Trasande L, Schechter C, Landrigan PJ. 2005. Public health and economic consequences of environmental methylmercury toxicity to the developing brain. Environ Health Perspect 113:590-596.

U.S. EPA. 2006. Evaluation Report. Monitoring Needed to Assess Impact of EPA's Clean Air Mercury Rule on Potential Hotspots. Report No. 2006-P-00025. Available http://www.epa.gov/oig/reports/2006/20060515-2006-P- 00025.pdf [accessed 29 January 2007.]

Viscusi WK, Aldy JE. 2004. The Value of a Statistical Life: A Critical Review of Market Estimates Throughout the World. NBER NBER National Bureau of Economic Research (Cambridge, MA)
NBER Nittany and Bald Eagle Railroad Company
 Working Paper 9487. Available http://www. nber.org/papers/w9487 [accessed 2 July 2004].
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Title Annotation:Perspectives Correspondence
Author:Trasande, Leonardo; Landrigan, Philip J.; Schechter, Clyde B.; Bopp, Richard F.
Publication:Environmental Health Perspectives
Date:Aug 1, 2007
Words:1021
Previous Article:Ionizing radiation and childhood leukemia.(Correspondence)
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