Stehr-Green Paul, Tull Peet, Stellfeld Michael, Mortenson Preben-Bo, Simpson Diane
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA.
Am J Prev Med. 2003 Aug;25(2):101-6. doi: 10.1016/s0749-3797(03)00113-2.
In 1999, concerns were raised that vaccines containing the preservative Thimerosal might increase the risk of autism and/or other neurodevelopmental disorders.
Between the mid-1980s through the late-1990s, we compared the prevalence/incidence of autism in California, Sweden, and Denmark with average exposures to Thimerosal-containing vaccines. Graphic ecologic analyses were used to examine population-based data from the United States (national immunization coverage surveys and counts of children diagnosed with autism-like disorders seeking special education services in California); Sweden (national inpatient data on autism cases, national vaccination coverage levels, and information on use of all vaccines and vaccine-specific amounts of Thimerosal); and Denmark (national registry of inpatient/outpatient-diagnosed autism cases, national vaccination coverage levels, and information on use of all vaccines and vaccine-specific amounts of Thimerosal).
In all three countries, the incidence and prevalence of autism-like disorders began to rise in the 1985-1989 period, and the rate of increase accelerated in the early 1990s. However, in contrast to the situation in the United States, where the average Thimerosal dose from vaccines increased throughout the 1990s, Thimerosal exposures from vaccines in both Sweden and Denmark-already low throughout the 1970s and 1980s-began to decrease in the late 1980s and were eliminated in the early 1990s.
The body of existing data, including the ecologic data presented herein, is not consistent with the hypothesis that increased exposure to Thimerosal-containing vaccines is responsible for the apparent increase in the rates of autism in young children being observed worldwide.
1999年，有人担心含有防腐剂硫柳汞的疫苗可能会增加患自闭症和/或其他神经发育障碍的风险。
在20世纪80年代中期至90年代后期，我们将加利福尼亚州、瑞典和丹麦自闭症的患病率/发病率与含硫柳汞疫苗的平均暴露量进行了比较。采用图形生态学分析方法，研究了来自美国（全国免疫接种覆盖率调查以及加利福尼亚州寻求特殊教育服务的被诊断为自闭症谱系障碍儿童的数量）、瑞典（自闭症病例的全国住院数据、全国疫苗接种覆盖率以及所有疫苗的使用情况和硫柳汞的疫苗特定含量信息）和丹麦（住院/门诊诊断自闭症病例的国家登记册、全国疫苗接种覆盖率以及所有疫苗的使用情况和硫柳汞的疫苗特定含量信息）的基于人群的数据。
在所有这三个国家，自闭症谱系障碍的发病率和患病率在1985 - 1989年期间开始上升，并且在20世纪90年代初上升速度加快。然而，与美国的情况形成对比的是，在美国整个20世纪90年代疫苗中的硫柳汞平均剂量增加，而瑞典和丹麦两国疫苗中的硫柳汞暴露量在20世纪70年代和80年代一直较低，在20世纪80年代后期开始下降，并在20世纪90年代初消除。
现有数据，包括本文所呈现的生态学数据，与含硫柳汞疫苗暴露增加导致全球观察到的幼儿自闭症发病率明显上升这一假设不一致。
