Commentaries
The etiology of autism spectrum disorders (ASD) remains unknown but is thought to involve early
exposure to neurotoxicants acting upon genetically susceptible individuals. This gene by environment
interaction is believed to affect neural development and lead to the behavioral phenotype of ASD char acterized by impaired social reciprocity and communication as well as restricted interests and behaviors.
The list of potential neurotoxicants as candidates is long and includes metals, solvents, herbicides,
pesticides, and drugs. Likewise, the list of gene candidates is long and includes those involved in neuronal
development, neurotransmitter synthesis and degradation, toxicant metabolism, and the management of
reactive oxygen species. No single toxicant and no single gene alteration have been identi ed as causal
and, indeed, it may be naive to conclude that such would be the case. We now hypothesize that ASD are
associated with early and repeated exposures to any of a number of toxicants or mixtures of toxicants, and
that it is the cumulative effects of these repeated exposures acting upon genetically susceptible individuals
that leads to the phenotypes of ASD.
To date, most studies assessing the etiology of ASD have examined the body burden of one or more
toxicants in the affected individual and/or the mother of the affected individual. With very few exceptions,
the limitations of such studies include failure to identify dose, frequency of exposure(s), and timing of
exposure(s) to the various toxicants. In addition, the general mobility of families makes it difcult to
identify the local environment during which the critical exposure(s) might have occurred.
Nevertheless, Palmer et al. (2006) found a signicant increase in the rates of special education students
and autism rates associated with increases in environmentally released mercury in the State of Texas
(U.S.A). Furthermore, Palmer et al. (2008) found, in the same state, that there was correla tion between the
increase in autism rate and power plant emission. An independent inverse association of distance of
residence to the industrial or power plant emission sources and the rate of autism was reported. Another
study suggested a potential association between autism and estimated metal
Correspondence: Xue Ming, M.D., Ph.D., 90 Bergen Street, DOC 8100, Newark, NJ 07103.
Tel: 973-972-5204; Fax: 973-972-9553; Email: mingxu@umdnj.edu
Copyright in this article, its metadata, and any supplementary data is held by its author or authors. It is published under the
Creative Commons Attribution By licence. For further information go to: http://creativecommons.org/licenses/by/3.0/.
Environmental Health Insights 2008:2 55
59
Ming et al
ed toxic land
lls
Ming et al
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connectic
ut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachu
setts
Michigan
Minnesot
a
Mississip
pi
Missouri
Montana
Nebraska
Nevada
New
Hampshir
e
New
Jersey
New
EPA
Autism Populatio Autism
Superfund Incidence
n3
rate per
2
Sites1
1000
0.15065
13
670
4,447,100
9981
0.26318
5
165
626,932
6438
0.17483
8
897
5,130,632
2262
0.20947
10
560
2,673,400
1086
33,871,64 0.24728
93
8,376
8
6462
0.08137
17
350
4,301,261
1486
0.30303
14
1,032 3,405,565
3417
0.31648
14
248
783,600
8004
15,982,37 0.19483
49
3,114
8
9591
15
1,602 8,186,453 0.19568
9146
3
198
1,211,537 0.16342
8769
0.18470
6
239
1,293,953
5318
12,419,29 0.19606
42
2,435
3
5911
0.34207
29
2,080 6,080,485
7976
0.18555
11
543
2,926,324
7033
0.17519
10
471
2,688,418
597
14
739
4,041,769 0.18284
0731
11
1,032 4,468,976 0.23092
5384
0.28080
12
358
1,274,923
1272
17
1,551 5,296,486 0.29283
5665
31
543
6,349,097 0.08552
3973
66
3,449 9,938,444 0.34703
6216
24
1,958 4,919,479 0.39800
9627
3
333
2,844,658 0.11706
1524
26
1,361 5,595,211 0.24324
3731
0.14076
14
127
902,195
7794
0.16888
13
289
1,711,263
1113
0.13661
1
273
1,998,257
9064
20
268
1,235,786 0.21686
6027
115
2,378
12
193
8,414,350 0.28261
2442
1,819,046 0.10609
(Continued)
Environmental Health Insights 2008:2
ed toxic land
lls
Table 1. (Continued)
States
EPA
Autism Populatio Autism
Superfund Incidence
n3
rate per
2
Sites1
1000
Tennesse
0.14395
13
819
5,689,283
e
4871
20,851,82 0.24621
Texas
42
5,134
0
352
0.21135
Utah
14
472
2,233,169
8836
0.26280
Vermont
11
160
608,827
0434
Virginia
29
1,714 7,078,515 0.24214
1184
Washingt
47
1,376 5,894,121 0.23345
on
Sources:
1. www.epa.gov/superfund/sites 2. U.S. Individuals2961
With Disabilities Education Act data: http://www.IDEAdata.org, Speci cs on
whether
indicates1,808,344
Autistic Disorder
or Autism Spectrum Disorders is not available. 3. www.census.gov
West the diagnosis
9 of Autism262
0.14488
Virginia
3938
Wisconsi
37
1,445 5,363,675 0.26940
Disclosure
References
Palmer, R.F., Blanchard, S., Stein, Z., Mandell, D. and Miller, C. 2006.
Environmental mercury release, special education rates, and autism
disorder: an ecological study of Texas. Health Place, 12(2):2039.
Palmer, R.F., Blanchard, S. and Wood, R. 2008. Proximity to point
sources of environmental mercury release as a predictor of autism
prevalence. Health Place, doi:10.1016/j.healthplace.2008.02.001.
Windham, G.C., Zhang, L., Gunier, R., Croen, L.A. and Grether, J.K.
2006. Autism spectrum disorders in relation to distribution of hazardous
air pollutants in the San Francisco bay area. Environ Health Perspect,
114(9):143844.http://www.state.nj.us/dep/srp/kcs-nj/www.IDEAdata.org
www.census.gov