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JAMA BOOKE REVIEW ON Chemical Brain Injury by Kaye H. Kilburn, M.D

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Book Review by Alan R. Hirsch, MD JAMA. 1999;282:800

Chemical Brain Injury

Kaye H. Kilburn

[W]e have witnessed a century of proliferation of synthetic chemicals and during the same time period humans have experienced great increase in cancer, brain damage, asthma, and other epidemic degenerative diseases such as arthritis and coronary artery disease....Our civilization reeks with chemicals....Human health has been sacrificed to economic growth and profits, the twin idols of our time.

[C]hemicals are costing us dearly in new and dreadful ways including eroded brain and degeneration. Programmed cell death (apoptosis) is out of control.

Chemicals have injured human brains in the United States in many people who are not aware that they have been chemically exposed. Unless this pandemic is stopped, it threatens our existence.

So alleges Kaye H. Kilburn, MD, in this scholarly treatise. To prove his hypotheses, he argues as follows: at industrial sites (and becoming progressively ubiquitous in our environment) neurotoxins are released. These toxins are inhaled and absorbed into the blood, and traverse or bypass the blood-brain barrier via the olfactory nerve. Once in the brain, they inhibit astrocytic function, which induces a cascade of accumulation of endogenous neurotoxins. These eventually cause neuron death, which induces a further release of endogenous neurotoxins, causing a positive feedback loop of progressive neural destruction. Neuronal kindling may occur concurrently with these events. Since the limbic system is most intertwined with olfactory projections, this area displays the greatest effects. This manifests clinically as delayed and possibly progressive deterioration in neural and psychiatric function. Since affected individuals were at the site of chemical release, and no better explanation exists as a cause of their neurologic dysfunction, the industrial neurotoxin is ascribed as the origin of their disorder.

Initially, I was skeptical of Kilburn's means of demonstrating neurologic dysfunction, which, contrary to traditional neurology, include neither a detailed neurologic history nor a full neurologic examination. Rather, specific questions and parameters are assessed (profile of mood states, blink reflex latency, etc) in exposed subjects and matched, nonexposed subjects. Kilburn has found that dysfunction in the exposed group is statistically significantly greater.

As part of litigation, prior to this book and independent of Dr Kilburn, our center assessed olfactory function and performed classic neurologic histories, physical examinations, and ancillary tests on several hundred of the same patients he assessed at five exposure sites; exposures had been to a multitude of toxins including arsenic, chlordane, polychlorinated biphenyls, trichlorethylene, and toluene. Although we used standard clinical techniques of neurologic history and physical examination, markedly different from the modalities of Dr Kilburn, our diagnoses generally concurred. (These results encourage speculation as to what is really necessary in a history and physical examination and whether there are more quantitative time-effective methods of determining neurologic dysfunction than are traditionally taught and performed by neurologists.)

One troubling aspect of Kilburn's treatise is an apparent disdain for psychiatry and psychiatric diagnoses. He suggests that posttraumatic stress disorder and somatization disorder are frequently misdiagnoses of chemical toxicity. He concludes that the diagnosis of a psychiatric illness is a denial mechanism, preventing the recognition of the true disorder: chemical toxicity.

Notwithstanding, for those interested in environmental illness and neurotoxicity, I highly recommend this exposition on a potentially "hidden pandemic."

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NOHA - REVIEW  CHEMICAL BRAIN INJURY

Chemical Brain Injury * by Kaye H. Kilburn, MD, is a deeply disturbing book. It was recommended by Professor Nicholas Ashford of Massachusetts Institute of Technology at the November 1999 Attention Deficit Hyperactivity Disorder Conference, reported in NOHA NEWS, Winter 2000. The book covers the work of many years. 

. . . we all become impaired by the ubiquitous toxic chemical exposures that float through the air and contaminate our water, our food, and the earth.

Dr. Kilburn has done numerous statistical studies of variously exposed people, many of whom took part in legal action. He had large samples and lots of statistical measurements of brain function. His tests were not only the usual psychological ones but also included exceedingly precise and objective tests of balance, reaction times, vision field tests, and hearing. He chose control groups without particular exposures and got many statistically significant observed differences, meaning that there was a low probability of the differences appearing by chance. Often in his studies the observed test differences between the exposed and the unexposed were so great and the variability within each group was so small that the probability of the test differences appearing by chance was exceedingly low.

Interestingly, many of the "control" groups were significantly impaired compared to four groups that seemed least exposed. Scary! We begin to realize that we all become impaired by the ubiquitous toxic chemical exposures that float through the air and contaminate our water, our food, and the earth.

Dr. Kilburn has often been an "expert witness." His credentials are impeccable and could not be challenged in court. In many of the legal cases where he found significant differences, the exposed people got settlements from the huge corporations. However, these results do NOT satisfy Dr. Kilburn because he really wants the public to know of the practically ubiquitous brain damage that we are suffering. Often the injury appears just like accelerated aging. Most certainly, we don’t need a senile population to face up to all our problems.

His tests were not only the usual psychological ones but also included exceedingly precise and objective tests of balance, reaction times, vision field tests, and hearing.

Dr. Kilburn has great quotes in his concluding chapters. For example:

"The use of pesticides in and about the home absolutely must stop. People must make peace with their insect coinhabitants of the earth and realize that the insects have natural predators. . . . A corollary is to demand organic produce from the grocer."

*Van Nostrand Reinhold, New York 1998

Article from NOHA NEWS, Vol. XXV, No. 1, Winter 2000, page 1, and from NOHA NEWS, Vol. XXV, No. 2, Spring 2000, page 5.

 

 

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