PEDIATRICS Vol. 53 No. 5 May 1974, pp. 792-799
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How Environmental Effects on Child Health Are Recognized

Robert W. Miller M.D.1

1 Epidemiology Branch, National Cancer Institute, Bethesda, Maryland

There is no doubt that the fetus and child have special susceptibility to the harmful effects of chemical pollutants.

EPIDEMIOLOGIC CASE REPORTS

Example 1

"Strange incidents occurred in villages along Minamata Bay in [the] Kyushu district in Japan, in which many cats went mad and died. These incidents were the prelude to [an] epidemic of a mysterious disease in human beings."1 In this way Japanese scientists began their account of the link between the ailment, now known as Minamata disease, and pollution of water with methylmercury.

Initially, a degenerative neurological disease was observed only in older children and adults. Apparently no one thought of possible fetal effects. In consequence, they went unnoticed for several years before it was realized that an epidemic of cerebral palsy had paralleled the illness in adults and older children. This was the first evidence that a chemical pollutant could harm the human fetus.

Methylmercury was identified as the cause of the epidemic by looking back into the histories of affected persons. The frequency and seriousness of the effect was greatest in the families of fishermen. It had been noted that fish in the Bay swam erratically. Fishermen sold their best catch and used the sickest looking fish as food for their families. Twenty-three children developed cerebral palsy after intrauterine exposure. Six percent of births during the interval were affected, as compared with 0.5% elsewhere in Japan. Although brain damage in the children was severe, only one of their mothers showed signs of the disease.

The methylmercury came from waste flushed into the Bay by a factory that made vinyl plastic.