A B D U L L A H I F I D O / Kuwait University- Kuwait & S A M I R A A L - S A A D / Kuwait Autism Center- Kuwait
The potential usefulness of hair analysis has been established in the past decade. The origins of trace elements in hair have to be distinguished as exogenous and endogenous.
A B S T R AC T Excess or deficiency of natural trace elements has been implicated in the etiology of autism. This study explores whether concentration levels of toxic metals in the hair of children with autism significantly differ from those of age- and sex-matched healthy controls. In-hair concentration levels of antimony, uranium, arsenic, beryllium, mercury, cadmium, lead and aluminum from 40 boys with autism and 40 healthy boys were determined by Perkin–Elmer mass spectrometry.
The children with autism had significantly (p < 0.001) higher in-hair concentration levels of lead, mercury and uranium.There was no significant difference between the two groups in the other five toxic elements. The ratio between nutritional elements and toxic metals among children with autism was within the normal range.
The possible sources of the toxic metals are discussed. Such testing is informative but at present the practical implications in terms of diagnosis and clinical management are limited.
ADDRESS Correspondence should be addressed to: DR ABDULLAHI FIDO,
Chairman, Department of Psychiatry, Faculty of Medicine, Kuwait University, PO Box 24923 Safat, Kuwait 13110. e-mail:
هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.
Trace elements that occur in the body at less than 0.01 percent of body weight have been shown to play an important role in the central nervous system (Assaf and Chung, 1984).
Excess or deficiency of trace elements has been implicated in a variety of Neuropsychiatric conditions including Parkinson's disease (Johnson, 2001), Down's syndrome (James, 1991) and Alzheimer's disease (Strausak et al., 2001). While indices of nutritional trace element concentrations such as Fe, Zn, Cu, Mg and Se obtained from blood and hair have been examined in a descriptive manner involving children with Down's syndrome (Barlow et al., 1981), learning disability (Benton, 2001) and autism (Shearer et al., 1982), the possible association of high levels of toxic trace elements such as Sb, U, As, Be, Cd, Pb and Hgwith autistic disorder has not been explained.
Kuwait is a rapidly developing country. During the past 20 years, it has experienced enormous social and economic changes. From a nomadic,
Bedouin inhabited desert enclave, it has become a major oil and financial center.
Rapid industrialization without environmental control has resulted in heavy metal contamination. In the aftermath of the Gulf War, Kuwait suffered from an environmental disaster of the highest proportions, which resulted in major public health problems. The rates of breast cancer (Luqmani et al., 1999), leukaemia (Abiake et al., 2001), post-traumatic stress disorder (Al Naser et al., 2000) and infertility (Omu et al., 1999)have risen. The overall impact of this disaster on public health is still being evaluated.
Unfortunately, there is little information available concerning the biological monitoring of heavy toxic metals in school environments in Kuwait.
The existing Kuwaiti Authority for Environmental Protection Control (KAEPC) deals solely with marine life pollution. The current situation raises the probability that the number of children affected by this environmental pollution is increasing. An earlier study reported a significant decrease of nutritional trace elements in the hair of children with autism compared with healthy controls (Fido et al., 2002). However, to date no study has addressed the potential associates of toxic trace elements and autism in
The primary purpose of the present study was to check whether the concentration levels of toxic metals in the hair of children with autism significantly differed from those of age-matched healthy controls, and to discuss possible links of these toxic elements to autism.
If such relationship were to be found, this would support the potential usefulness of hair analysis in the early detection of such metabolic disequilibria in children with autism and provide support for the validity of hair analysis as a biological monitor for the detection of excesses or deficiencies of trace elements in the human body.
Materials and methods
The participants were 40 boys aged 4–7 years (mean age 4.2, SD ±2.2) from single-incidence autism families. All met DSM-IV-R criteria(American Psychiatric Association, 1994) for the diagnosis of childhood autism (i.e. impairments of language, social skills and restricted stereotyped interest or activity).
They were enrolled at the Kuwait Autism Center and were studied over a 12 month period. The study sample was compared with an age-matched sample of 40 healthy boys aged 4–8 years (mean age 4.3,SD ±2.6) who were attending normal nursery schools and included normal siblings of children in the autistic group. The Kuwait Autism Center is the only institution of its kind in Kuwait. Currently, the center hosts 250 children and provides special education for children with pervasive
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