A mysterious cluster of unexplained birth defects is baffling health officials in a corner of Washington state.
A higher than average number of babies are being born with anencephaly, a severe birth defect in which children are born with part of their brain and skull missing. It is normally a rare condition, so when 23 cases were noted within a three year period between January 2010 and January 2013 in Yakima Valley, an agricultural area in south-central Washington, medical staff began to ask questions.
In a career spanning over 30 years, Nurse Sara Barron had previously seen only two cases of anencephaly, but noted two cases in two months whilst working at a hospital in Washington state during 2012.She raised the issue with an obstetrician friend from another hospital 30 miles away and discovered that a case had also been seen there. This prompted Barron to report the matter to the Washington Department of Health, who studied hospital records and discovered that an unprecedented 23 cases had occurred over three years across a three county area near Yakima Valley. This works out at 8.4 cases per 10,000 live births, a figure that is four times the national average of 2.1 cases per 10,000 live births.
“This is bizarre,” Barron commented. “This is a very, very small area.”
An enquiry was launched into the matter, and investigators pored over the medical records of 27 area women in the area who had affected pregnancies, along with 108 matched controls who had attended the same 13 prenatal clinics. A number of factors were examined, including the occupation of each woman, their race and country of origin, their smoking, drinking and other lifestyle habits, the medications they had taken, the location of their home and the source of their home water supply.
Despite a thorough review of the subjects, no factors were found to link the affected women together and provide an explanation for the development of birth defects in their offspring. State officials declared that there were “no common exposures, conditions or causes” to connect any of the births.
Dr. Beate Ritz, the vice chair of the epidemiology department at the UCLA Fielding School of Public Health, was not surprised that the research did not yield any positive results. Her view is that merely examining the medical records of individuals is unlikely to supply enough information to make an informed hypothesis, as the data in the records is not consistent and relies on the diligence of the attending physician to record all relevant information regarding medication history, diet and lifestyle habits. Consequently, the information contained in the records is unreliable and likely to be incomplete.
"From a research point of view, this is very bad research," commented Dr. Ritz. "The data quality on medical records is so low that it's not really research."
A press release from the Department of Health confirmed Dr. Ritz's doubts, stating:
"Medical record reviews might not have captured all information, preventing a cause from being identified."
Compiling proper and comprehensive research data would involve contacting each family personally and would be extremely costly, exceeding the available budget of the state health departments.
Nevertheless, the problem is most concerning, and Barron feels that the cost would be justified:
"I think it's very scary. I think there's absolutely something going on that needs to be investigated more thoroughly," she said. "I wish they would take it more seriously."
Mandy Stahre, the state epidemiologist heading the investigation into the birth defects, worries that some mothers might be intimidated or worried if the health department contacted them directly. The experience of having a baby identified as suffering from anencephaly is very traumatic, and there are concerns that some may find the subsequent enquiries into their personal details distressing.
Nevertheless, the investigation is still ongoing, and if more babies are born with the defects then there are plans to conduct interviews with the mothers.
"We're still investigating this," stated Stahre. "This is nowhere near finished."
There are others, however, who suggest that the health department is looking in the wrong place for the answers. Due to the proximity of Yakima to the western coastal region of the U.S. , a possible connection to the radiation leaking across the Pacific ocean from the stricken Fukushima nuclear power plant in Japan is being mooted by some. A magnitude 9.0 earthquake off Japan on March 11, 2011, created huge tsunamis that devastated the Fukushima Daiichi nuclear power plant, releasing radiation into the ocean and atmosphere. Studies confirm that radiation is definitely leaking into the ocean, but scientists maintain that it is soon diluted in sea water and poses no threat to human health in the U.S.
A system of air monitoring known as "Radnet" tests air, food and water at locations throughout the U.S. on behalf of the Environmental Protection Agency (EPA), and a statement from the organisation's website reads thus:
"EPA is aware of some public concern that has been raised by recent articles about the impact of the potentially ongoing radioactive leaks from the damaged nuclear reactors in Fukushima. EPA’s air monitoring data have not shown any radioactive elements associated with the damaged Japanese reactors since late 2011, and even then, the levels found were very low—always well below any level of public health concern."
Immediately after the disaster, there were reports of elevated radiation readings found in the atmosphere, grasses and cow's milk, but levels have allegedly declined since then.
There is little conclusive evidence, therefore, to link the birth defects seen in Yakima to the Fukushima disaster, but many residents of the west coast and Canada are still very concerned about the possible effects to health in the past, present and future. Certainly, none of the babies suffering from anencephaly have been checked for radiation, so theoretically it cannot be ruled out as a potential cause until this angle has been thoroughly investigated.
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