What is the role of mercury toxicity in the etiology of autism?

Updated: Nov 05, 2018
  • Author: David A Olson, MD; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Answer

Exposure to mercury has been suggested to contribute to the development of autism in children. Although the mechanism for this disorder has many hypotheses, no evidence has confirmed a causal relationship between mercury exposure and the development of autism. In fact, in one study, the discontinuation of thimerosal-containing vaccines in Denmark seemed to be followed by an increase in incidence of autism. [59]

In 2004, Immunization Safety Review Committee of the US Institute of Medicine (IOM) shifted from the position of neutrality to the conclusion that "the evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism." [60] Since 2004, 2 cohort studies from the United Kingdom examined the relationship between thimerosal contained within vaccines and autism, and their conclusions were in agreement with the IOM that there is no causal relationship between the two.

A recommendation from the American Academy of Pediatrics and the US Public Health Service states that the use of products containing thimerosal is preferable to withholding vaccinations, which protect against diseases that represent immediate threats to infants (ie, pertussis, H influenzae). For the hepatitis B vaccine, adjustments in timing within the ranges proposed in the immunization schedule provide additional opportunities to minimize thimerosal exposure to infants. If thimerosal-free vaccine is not available, the hepatitis B virus vaccination should be initiated in infants aged 6 months.


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