From: Robina Suwol
Date: 10 Feb 2002
Remote Name: 188.8.131.52
In Hampton Roads, Studies of Miscarriages Cause Concern, Spark Lawsuits
By Anita Huslin
Washington Post Staff Writer
Sunday, February 10, 2002
Annette Spaven already had three children when she found out she was pregnant again four years ago. She and her husband were surprised but pleased by the prospect of welcoming another child into their Chesapeake, Va., home. So when she suffered a miscarriage in the first trimester, they tried again. Six months later, she lost another baby. "I wondered if something was wrong with me," said Spaven, 38.
About the same time, two women on her block had miscarriages. Across town, a woman gave birth to a boy who died shortly after birth. For more than a decade, they and others wondered why they'd suddenly lost their pregnancies. Today, many are also wondering something else: Might they have lost their babies simply because they drank tap water while they were pregnant? It's a question that has roiled this booming port community ever since residents became aware of controversy surrounding chemicals in the public drinking supply.
Now, 25 women are suing the city, and nearly 170 more have filed their intentions to do so. Fueling their fears are a growing number of studies that link birth defects and miscarriages to chemicals that are produced when chlorine, used to purify drinking water, mixes with organic matter, such as fertilizer in surface water. Chemical and water industry officials maintain that the body of scientific evidence linking so-called chlorination byproducts to adverse birth effects is inconclusive. "To have liability, in our opinion, you have to prove there's a cause and an effect," Chesapeake city attorney Ronald Hallman said. "I haven't seen any study that has proven a causal connection."
In a statement last month, the Environmental Protection Agency called the issue of chlorination byproducts in drinking water "an important health concern." The federal agency will be proposing new water quality reporting requirements for utilities this summer and plans to fund further research. Meanwhile, however, millions of Americans are unaware of what their water utilities know: The levels of chlorination byproducts in their drinking water often spike higher than the EPA's allowable annual average. This happens as well throughout the Washington area, utility records show, though the EPA does not require the information to be included in regular water quality reports from utilities.
Chesapeake residents learned about the problem only when the city's public health director issued a bulletin about it. And then more stories from women like Spaven started to come out. And so did the lawyers. Now, the Hampton Roads city has become a test case for the nation. Water utility operators across the country, including the Washington Suburban Sanitary Commission, are watching to see what becomes of the lawsuits. The women are alleging that the city did not adequately warn them about potentially harmful levels of toxins in their water, sometimes nearly 10 times higher than the danger level identified in the largest public health study to date. Chesapeake documents obtained by the women's attorneys show that the city had seen significant spikes in chlorination byproducts since the early 1980s.
No comprehensive study of the city's miscarriage or birth defect rates has ever been done, so it is impossible to draw a comparison between the period when the byproducts were spiking and when they were not. Nationally, about one in six women suffer miscarriage, according to federal statistics. The first 25 women suing all suffered miscarriages in the mid- to late 1990s. The 168 other cases date to the 1980s. Altogether, attorneys are seeking nearly $1 billion in damages. "I just hope that . . . people will pay attention to what's going on in their cities," Spaven said. "No one should have to go through what we have." First Reports Nancy Welch, the director of the Chesapeake Public Health Department, hadn't even heard of chlorination byproducts or the term "trihalomethanes" -- also known as THMs -- before the city's public utilities director came to her office one day in early February 1998 with a problem.
The city was preparing to tear down two purifying towers at its water processing plant to make way for a system that would help solve chronic water quality problems. Seated near the mouth of the Chesapeake Bay, the city for yearsstruggled to manage the salt that rises with the tides. Until it built the two towers, it had also quietly grappled with the problem of THMs. Now, it was going to tear down the towers. Once that happened, chlorine byproduct levels could rise precipitously, perhaps even exceeding EPA limits, utility director Amar Dwarkanath said. The city planned to ask for a waiver of EPA water quality standards, at least during this phase of construction, but it would need a letter from Welch supporting the request. And there was one more thing. Dwarkanath gave Welch a copy of a report that was about to be published in the medical journal Epidemiology. It was a study done in California, where Department of Health Services researchers followed more than 5,000 pregnant women. They found that those who drank five or more glasses of tap water a day containing 75 or more parts per billion of chlorination byproducts were 65 percent more likely to suffer a miscarriage.
Pregnant women are generally advised by their doctors to drink at least eight eight-ounce glasses of a water to avoid dehydration. And now Chesapeake was facing the very real possibility that its tap water would become awash with consistently high THMs, possibly even for months. Welch examined the research closely, then called some colleagues for advice. Half said they would inform the public; half said they wouldn't.
On March 24, 1998,Welch wrote a letter to Dwarkanath with her conclusions, suggesting that the city ensure that pregnant women who got their water from the Chesapeake plant use bottled water. On March 31, 1998, she sent a public health bulletin to family practitioners, OB-GYNs, internists and the media, urging pregnant women who drink five or more glasses of water a day to drink primarily bottled water and to boil their tap water for a minute or install a tap filter. Almost immediately, the phones started ringing. Worried pregnant women called, and so did those who had lost babies, wondering aloud if the water might have been the reason. Welch could not answer all of their questions. But, she said, she believed the California study raised enough questions to warrant warning the public about THMs.
But there are many reasons miscarriages occur, she pointed out, and it's often difficult to pinpoint one. "When there's a limited amount of research, you go with what you have," she said. "I'll never apologize for informing the public." But to determine whether THMs absolutely cause miscarriage or birth defects, she said, "you've got to do more research . . . and that takes time." After a few weeks, Welch's phones quieted down and things at the Chesapeake public health department got back to normal. But in the community, people were sharing stories. Stories like those told by Marcy Shaffer, now 38, who lived in Chesapeake and gave birth to Peter just before Christmas in 1997. He was born with just a bundle of nerve endings in his half-formed skull. He lived for a couple of hours, long enough for her to wrap him in a white blanket and for her family to say their goodbyes.
About the time of Spaven's miscarriages, two neighbors across the street also lost their babies. After carrying her baby for 8 1/2 months, Shelley Rapada, now 22, gave birth to Haley Renee in the spring of 1998, then buried her in a tiny ivory-colored casket at the foot of her grandmother's grave. Her best friend, Michelle Rapada, now 21, suffered two miscarriages that fall. In conversations during lunch breaks, after church or over coffee with a neighbor, more accounts were circulating. It would not be long before someone would try to piece it all together.
The cases started coming to Louis Napoleon "Mike" Joynes in the same way that most business arrives at his firm. The Joynes & Gaides law office sits at a busy intersection near the edge of Chesapeake, and the increasing traffic in what is the fastest-growing city in Virginia provides at least one new customer a week. It was one of these clients, an auto accident victim, who mentioned his wife's miscarriage to Joynes and asked: Could that have had something to do with the city water? Joynes, who had not paid close attention to the public health bulletin, said he'd look into it. So he called up a colleague at Willcox & Savage, an old Virginia blue blood firm with several lawyers who focus on environmental law. They were familiar with THMs and the issues associated with them, so they began researching the city's water situation.
"What we discovered was that the levels of THMs in Chesapeake were some of the highest we'd ever heard of -- 700, 800 parts per billion," said Gary Bryant, who specializes in environmental litigation. He had spoken to some experts in environmental health who were familiar with the research on the issue and their response was the same: "They were pretty much shocked by this," Bryant said. "All of the scientific reports showing health impacts from THMs involved levels much lower than what we were seeing here." But little of that information has reached the public anywhere. In Montgomery County, officials recently started asking questions about THMs at a special hearing called after utility data obtained by Environmental Working Group, a chemical industry watchdog, revealed THM spikes in water supplied by WSSC.
Officials at WSSC, which provides water and sewer services to 1.6 million residents in the Washington area, acknowledged that the spikes were a concern but noted that the utility continues to meet EPA water quality standards. The Chlorine Chemistry Council, a national trade group, maintains that the research to date "has been inadequate to definitively demonstrate an association" between THMs and birth defects, miscarriages and stillbirths.
In Chesapeake, lawyers wondered just how many women could have been affected. In July 2000, Joynes & Gaides started running television and radio ads seeking women who had suffered miscarriages or delivered babies with birth defects. And the phones started ringing again. 'All This Pain' Annette Spaven was one of the hundreds of women who called. The ads didn't say anything about Chesapeake water, but she wondered if that was behind it all. She had grown up in Chesapeake, then moved away after getting married.
In 1993, after moving back to Chesapeake, the couple had their third and, they thought, last child. When Spaven unexpectedly became pregnant in 1997, something wasn't right. She started cramping and bleeding one morning, so she went to the hospital, where doctors ordered an ultrasound. The results showed simply a mass of tissue growing in her womb, with none of the early signs of a baby that they would have expected. Hours later, she suffered a miscarriage. Later that year, she got pregnant again. This time, she said, she worked very hard to make sure she did everything right, including drinking more than the recommended eight glasses of water a day. When she had cravings, she ate ice -- lots of it -- from the ice-maker in her freezer.
In early 1998, she miscarried again. "That was it for me," she said. "I wasn't going to try again." Then, when the television ads came out, she started wondering and turned to the Internet for answers. What she found infuriated her. "I couldn't believe it. I'd sit there every night and tell my husband, 'Look at this stuff.' All these people, all this pain."
The first lawsuit was filed last April, and a hearing date has been scheduled for September. City attorneys are trying to block the case by arguing that the plaintiff filed her lawsuit more than two years after her miscarriage, too late for what the law requires. A court date for Spaven's case has not yet been set. In some ways, she said, she believes the outcome of her case is unimportant.
When you've lost two pregnancies, nothing will change that. But her story and those of other women should be heard, she said, to warn the public about these once-obscure chlorination byproducts. "You just take for granted . . . that you never have to second-guess what's in your water," she said.
In January 1999, Spaven moved to Virginia Beach. Ten months later, she delivered Kerrigan, a healthy baby girl.
From: Robina Suwol
Date: 19 Dec 2006
Remote Name: 184.108.40.206
French researchers identify gene linked to autism Sun Dec 17, 2:43 PM ET French researchers have discovered a new gene linked to autism, a mental disability which prevents sufferers from communicating and forming relationships normally and whose causes are unknown. The study, published Sunday online by Nature Genetics journal, found that all of five autistic children studied had anomalies in the SHANK3 gene, responsible for making the connections in the brain necessary for language development. The most distinctive symptoms of autism are problems with communication, forming relationships and developing strong obsessional traits. The Institut Pasteur study showed "the key role of the gene in the organisation of neurone connections" in the brain, lead researcher Thomas Bourgeron told AFP. "This gene, named SHANK3, does not explain all forms of autism" warned Bourgeron, but it might help explain the communication difficulties which provide major social obstacles to many sufferers. The study sample included five people from three families, each suffering either from autism or Asperger's Syndrome. Asperger's Syndrome is an autistic spectrum disorder (ASD) which shares most of the symptoms of autism with less severe communication problems. "It (ASD) affects about one child in 200 and four times' more boys," Bourgeron said of the lifelong disorders. In 2003, Bourgeron's team identified anomalies on SHANK3, which produces the proteins necessary to construct synapses, the junctions between the brain's neural pathways. They discovered significant "deletions" to various degrees in the gene. One participant, who was autistic but had learned to talk, was found to have a "duplicate" of the gene. The research was conducted with Paris' psychiatric services institute Inserm, and the University of Gothenberg in Sweden. Autism usually does not appear in infants before the age of three, though it can be diagnosed as early as 18 months. Children who suffer from it display impaired social skills and communications abilities throughout their lives, and their families bear a substantial financial and emotional burden in caring for them. Global statistics on autism are limited, with figures appearing to show the disease on the rise. According to the Autism Society of America, 10 percent to 17 percent more people are diagnosed with autism each year, but this may be partly due to increasing awareness and identification of the disease. The US Center for Disease Control estimates that between one child in 500 and one in 166 may be diagnosed with a disease on the autism spectrum. The causes of autism remain mysterious. Years of research have gone into identifying a genetic cause. US autism researcher Bernard Rimland, who died in November, courted controversy by claiming that an increase in autism diagnoses might be caused by childhood vaccinations. Research is increasingly addressing the idea that autism may be caused by a combination of genetic and environmental factors.