ANOTHER
INCONVIENT TRUTH
by
DONNA JACKSON NAKAZAWA
_______________________
Donna
Jackson Nakazawa is the author of The Autoimmune Epidemic:
Bodies Gone Haywire in a World Out of Balance." Her
website is donnajacksonnakazawa.com
Some
weeks ago, my husband and I treated ourselves to a night at
the movies and caught a showing of The Diving Bell and the
Butterfly, the story of a successful French journalist
who suffers a massive stroke that changes his life.
As
I watched the opening scene and the moment when the main character
realizes that he's trapped inside his own body, incapable of
moving or communicating with those around him, a shiver of recognition
washed over me. Two years ago, I also lay paralyzed in a hospital
bed, unable to use my arms or legs, to hug my young son or daughter,
or to type a word to meet an impending book deadline. Unlike
the movie's protagonist, however, I was immobilized by a type
of disorder that afflicts nearly 24 million Americans -- and
counting.
BODIES
GONE HAYWIRE
Autoimmune
diseases -- a group of about 100 conditions in which the body's
immune system turns on the body itself -- are reaching epidemic
proportions. In the past decade, 15 top medical journals have
reported rising rates of lupus, multiple sclerosis, scleroderma,
Crohn's disease, Addison's disease and polymyositis in industrialized
countries around the world. Over the past 40 years, rates of
Type 1 diabetes have increased fivefold; in children 4 and under,
it's increasing 6 percent a year.
If
I wanted to make a movie about my life, I'd pitch it to Hollywood
as The Diving Bell and the Butterfly meets An Inconvenient
Truth, the Academy Award-winning Al Gore documentary about
global warming. Rising levels of autoimmune disease may well
prove to be the next environmental disaster -- only in this
case, the changes taking place degree by degree are in the interior
landscapes of our bodies.
My
paralysis was caused by Guillain-Barr¿ syndrome, an autoimmune
disease in which the nerves' myelin sheaths are destroyed by
the body's immune system, short-circuiting messages from the
brain to the muscles. I've been paralyzed twice in the past
seven years. Each time, months of rigorous physical therapy
and treatment have enabled me to walk again. But remnants of
the disease -- and other autoimmune conditions that have simultaneously
ravaged my body -- have left me with a pacemaker, little feeling
in my hands and feet, legs that can't ice skate or chase a child,
a low white blood cell count and gastrointestinal problems that
can land me in the hospital in a blink. Still, I consider myself
one of the lucky ones. I know patients who are far less fortunate.
I've
spent the past two years interviewing leading experts at top
medical institutions nationwide to find out why cases of autoimmune
disease are skyrocketing. In recent years, many allergists and
immunologists have been attributing the rise to the "hygiene
hypothesis" -- the theory that our germ-free homes and
childhood vaccinations have eliminated challenges to our immune
systems so that they don't learn how to defend us properly when
we're young. The scientists I interviewed tended to discard
the idea that this alone is responsible. They agreed almost
to a person that our day-to-day exposure to environmental toxins
-- through the air we breathe and the chemicals we absorb through
our skin -- is a major trigger of autoimmune disease. "Exposures
from our environment are a significant contributor to today's
rising rates," says Douglas Kerr, director of the Johns
Hopkins Transverse Myelitis Center and a top clinician at the
Johns Hopkins Multiple Sclerosis Center.
IN
A WORLD OUT OF BALANCE
In
2003, the Centers for Disease Control and Prevention sampled
2,500 people nationwide looking for the "body burden,"
or amount of chemicals and pollutants each individual carried.
They found traces of all 116 chemicals and pollutants they tested
for, including PCBs, insecticides, dioxin, mercury, cadmium
and benzene, all highly toxic in higher doses. Then, in 2005,
researchers from the Environmental Working Group found something
more alarming: a cocktail of 287 pollutants -- pesticides, dioxins,
flame retardants -- in the fetal-cord blood of 10 newborn infants
from around the country.
Because
most toxins are found in only trace amounts, it has been difficult
to gauge what effect they might be having on our health. Yet
studies of both lab animals and people provide disturbing insights
into how even low exposures can cause our immune systems to
go haywire. Mice exposed to pesticides at levels four times
lower than the level the Environmental Protection Agency sets
as acceptable for humans are more susceptible to getting lupus
than control mice. Mice that absorb low doses of trichloroethylene
-- a chemical used in dry cleaning, household paint thinners,
glues and adhesives -- at levels the EPA deems safe and equal
to what a factory worker might encounter today, quickly develop
autoimmune hepatitis. And low doses of perfluorooctanoic acid,
a breakdown chemical of Teflon found in 96 percent of humans
tested for it, impair rats' development of a proper immune system.
Evidence
from occupational studies is even more worrisome -- because
the "guinea pigs" are people. Last year, scientists
from the National Institutes of Health and the University of
Washington released the findings of a 14-year study of 300,000
death certificates in 26 states: Those who worked with pesticides,
textiles, solvents, benzene, asbestos and other compounds were
significantly more likely to die from an autoimmune disease
than people who didn't. Other recent studies show links between
working with solvents, asbestos, PCBs and vinyl chloride and
a greater likelihood of developing autoimmune disease.
Proving
an absolute link between chemicals and autoimmune disorders
in humans won't be easy. Researchers can expose rodents to low
doses of chemicals and look for signs of autoimmune disease
about six weeks to three months later. But in humans, autoimmune
diseases are long, slow-brewing conditions that smolder for
a decade or more before symptoms appear. Moreover, Kerr says,
it may be that a combination of exposures rather than a single
acute dose increases the risk of autoimmune disease.
Meanwhile,
we may all be unwitting participants in an uncontrolled experiment
as we wait to see whether rising levels of toxins and pollutants
in our blood are the cause of climbing rates of autoimmune disease.
Our children are the high-stakes pawns in this game: Pound for
pound, they eat more food and drink more water than adults,
and their immune systems are still developing and vulnerable.
What
can we do to lower the stakes for future generations? We could
take a page from European environmental policy and its "precautionary
principle" of preventing harm before it occurs. Last June,
the European Union implemented legislation that requires companies
to develop safety data on 30,000 chemicals over the next decade
and places responsibility on the chemical industry to demonstrate
the safety of its products.
We
also need to look beyond the "hygiene hypothesis"
as the sole explanation for the autoimmune epidemic and wake
up to what immunotoxicologists have been telling us for years:
Our immune systems may be less prepared because we're confronting
fewer natural pathogens, but we're also encountering an endless
barrage of artificial pathogens that are taxing our systems
to the maximum.
Finally,
we've waited too long for Congress to allocate funding to finding
out what toxic exposures can cause our immune systems to turn
against us. Though it estimates that 24 million Americans suffer
from autoimmunity, the NIH spent only $591.2 million on autoimmune
disease research in 2003, the last year for which figures are
available, compared with the $5 billion annual budget for cancer,
which afflicts 9 million. The NIH budget for cardiovascular
disease, affecting 22 million Americans, is four times that
of autoimmune diseases.
My
health right now is stable. There are challenges, to be sure
-- I type these words with braces on my arms. But my legs take
me where I need to go. Still, I live in fear of the day when
that creeping paralysis could steal my life away again. Only
if we take concrete steps now will the movie of my life and
that of millions of other Americans have a chance at a happy
ending.
©
Donna Jackson Nakazawa
The Autoimmune Epidemic: Bodies Gone Haywire in
a World Out of Balance
Donna Jackson Nakazawa
Publisher: Simon & Schuster/Touchstone 2008
ISBN-13: 9780743277754
The book is available at Barnes & Noble, Borders
and Amazon
