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zoom RSS 自閉症の急激な増加/米国 カリフォルニア

<<   作成日時 : 2009/01/16 01:45   >>

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 新たな研究で、1990年代以来カリフォルニアでみられる自閉症の増加は、診断基準の変化ではなく大部分は実際に増加していることが示唆された。
 増加傾向が軽度の症例を含めたためかどうかを評価した最初の研究である。5才以下の子どもの自閉症は1990年出生1万人あたり0.8だったのが2006年出生で11.2まで着実に増加した。1万出生あたりの累積発症数は1990年の6.2から2001年に42.5まで上昇した。5歳時に診断される割合は1990年54%だったが1991年には61%となった。軽症例を含めたことで56%が説明でき、診断時の年齢変化で12%説明できる。自閉症の発症増加が真実の可能性となり、環境要因が関係あるだろうか。
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自閉症児の増加はワクチン添加物と関連しない
http://kurie.at.webry.info/200801/article_27.html
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Soaring Autism Rates in California Not an Artifact
Rise Is Not Because of Increased Detection, New Research Suggests
January 14, 2009
http://abcnews.go.com/Health/AutismNews/wireStory?id=6645353

画像CA Autism
Climbing rates of autism in California cannot be chalked up to better screening alone, new research says.
(ABC News/AP/Getty)

NEW YORK (Reuters Health) - The increasing number of autism cases seen in California since the 1990s is in large part real, not simply the result of changes in diagnostic criteria or in how autism cases are counted, new research suggests.

This study is the first to assess whether the autism trends in California might be explained by changes in age at diagnosis or by inclusion of milder cases, Dr. Irva Hertz-Picciotto and Dr. Lora Delwiche, from the University of California, Davis, note.

Using data from the California Department of Development Services, the researchers found that autism rates among children aged 5 years or younger rose steadily from 0.8 per 10,000 children born in California in 1990 to 11.2 per 10,000 children born in 2006.

The cumulative incidence per 10,000 births climbed from 6.2 in 1990 to 42.5 in 2001.

The proportion of cases that were diagnosed by 5 years of age rose only slightly from 54 percent to 61 percent for 1990 to 1996 births, according to a report in the January issue of Epidemiology.

A change in the age at diagnosis could explain 12 percent of the increase in autism rates, while inclusion of milder cases could explain 56 percent.

"With evidence of a leveling off, the possibility of a true increase in (autism) incidence deserves serious consideration," the investigators emphasize.

"It's time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California," Hertz-Picciotto added in a statement.

SOURCE: Epidemiology, January 2009.

Copyright 2009 Reuters News Service. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

------------------------------------------------
The Rise in Autism and the Role of Age at Diagnosis.

Early Development
画像Epidemiology. 20(1):84-90, January 2009.
Hertz-Picciotto, Irva a,b; Delwiche, Lora a

Abstract:
Background: Autism prevalence in California, based on individuals eligible for state-funded services, rose throughout the 1990s. The extent to which this trend is explained by changes in age at diagnosis or inclusion of milder cases has not been previously evaluated.

Methods: Autism cases were identified from 1990 through 2006 in databases of the California Department of Developmental Services, which coordinates services for individuals with specific developmental disorders. The main outcomes were population incident cases younger than age 10 years for each quarter, cumulative incidence by age and birth year, age-specific incidence rates stratified by birth year, and proportions of diagnoses by age across birth years.

Results: Autism incidence in children rose throughout the period. Cumulative incidence to 5 years of age per 10,000 births rose consistently from 6.2 for 1990 births to 42.5 for 2001 births. Age-specific incidence rates increased most steeply for 2- and 3-year olds. The proportion diagnosed by age 5 years increased only slightly, from 54% for 1990 births to 61% for 1996 births. Changing age at diagnosis can explain a 12% increase, and inclusion of milder cases, a 56% increase.

Conclusions: Autism incidence in California shows no sign yet of plateauing. Younger ages at diagnosis, differential migration, changes in diagnostic criteria, and inclusion of milder cases do not fully explain the observed increases. Other artifacts have yet to be quantified, and as a result, the extent to which the continued rise represents a true increase in the occurrence of autism remains unclear.

(C) 2009 Lippincott Williams & Wilkins, Inc.

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