[HeyJoe]

The Times of London

September 17, 2007
DNA test that could quickly solve thousands of sick workers’ claims

Nigel Hawkes, Health Editor

A new technique for testing DNA could transform civil litigation cases by supporting or refuting people’s claims that their health has been damaged by exposure to toxic chemicals.

Samples of DNA are taken from a healthy person and exposed to the chemical in question to see which genes are affected. This is then used as a blueprint against which a claimant’s DNA can be compared.

The technique is expected to transform the quality of evidence in civil cases. It could dramatically reduce the time it takes to settle cases where miners, industrial workers and others seek compensation for illnesses caused by exposure to asbestos, coal dust or other environmental toxins.
Such cases can often run for decades, or rely on evidence only available from a postmortem examination.

DNA evidence from living persons could also potentially eradicate false claims, ensuring that compensation is paid only to those whose health has actually been affected.

Last night solicitors welcomed the advance, saying that DNA evidence could provide a “litmus test” for compensation claims. It will be up to individual judges to decide, case by case, if such evidence is admissible.
Claims for diseases caused by asbestos are rising and not expected to peak until at least 2010.

Pat Troop, chief executive of the Health Protection Agency, told The Times recently that with more than 100,000 chemicals currently circulating in the environment, the lack of knowledge of the health impact was a serious concern.

It is one of the key topics to be discussed at the agency’s annual conference, which takes place this week.

Bruce Gillis, the scientist who developed the technique, said that it would allow some people to win cases they might otherwise have lost, while others would find themselves with no case because their diseases were not caused by the chemicals to which they were exposed.

While DNA evidence is a mainstay in criminal prosecutions, it makes very rare appearances in civil courts – such as when victims of rape or other crimes sue their alleged attackers.

In California, courts have heard more than 20 cases that used evidence from the technique, developed at the University of Illinois College of Medicine by Dr Gillis and his colleagues.

In one case, a worker at a company selling tyres sued his employers alleging that he had suffered illness as a result of exposure to benzene. Liberty Mutual, the employer’s insurers, spent $12,500 on the test, which proved that his illness was not caused by benzene, saving an estimated $2 million (£1 million) in damages.

In other cases, the DNA technique worked to the benefit of claimants. “A man had been exposed to a mixture of eight chemicals and developed gall bladder cancer,” Dr Gillis said. “None of the chemicals was a carcinogen on its own, but we showed that in combination they increased the activity of cancer-causing genes.

“This was a case where we truly answered an important question. The man’s heirs won the case – he, unfortunately, had already died.”

The technique, called msds1, uses commercially available DNA micro-arrays to work out which of thousands of genes are affected by exposure to a certain chemical. The arrays consist of thousands of pits containing fragments of DNA which highlight the effects of dangerous chemicals.
For example, benzene – a common pollutant found in petrol that can cause leuakaemia – was found to affect about 150 genes, half of which were increased in activity (upregulated) and the other half reduced (down-regulated). The pattern of activation provides a “fingerprint” of how benzene affects blood cells. This can then be compared with the pattern found by testing the plaintiff’s blood cells. If they match, the plaintiff’s injury was caused by benzene; if not, it was not.

The court can be shown a simplified graphical display of the genes that are affected, laid alongside the results from the plaintiff. A match or lack of a match is plain to see.

Dr Gillis can also trace the pattern of release of signalling chemicals called cytokines triggered by an injury or an exposure to a chemical. In one case in the US, a nurse said that an injury was causing her such extreme pain that she could not work. However, tests showed that she was not expressing the cytokines that would be triggered by pain, enabling the defence to claim successfully that the pain did not exist.

Apart from the cost of testing and judges’ discretion, there would be few impediments to using similar evidence in a British court, lawyers said.

[MelodyL]

Well, I hope they bring this test over here to the USA, and the people who were damaged by the toxic stuff at the World Trade Center, well maybe they can prove their cases.

When we went to NY Methodist, I met a doctor who said "I am seeing lots of cases of neuropathy in people who are not diabetic, but who went down and were first reponders on 9/11"

my oh my

Melody

[HeyJoe]

yeah i was thinking the same thing while i was reading this. I also looked up a few more articles and looked at the doctors company web site. It is geared toward trying to attract insurance companies and employers trying to disprove claims more than in people being able to prove them. Call me cynical but if the procedure proves too many cases of harm as a result of exposure to toxins wouldnt that put a crimp in his business with insurance companies? Someone expert in the field would have to look at the parameters that they use to determine that exposure did cause damage, for example are the number of markers that this company determines is necessary to prove damage from exposure excessive? Until a number of companies are doing this again it would cast a shadow of doubt in my mind as too which way this testing is skewed. As far as detecting pain i was wondering two things, well actually three, 1. people have different thresholds of pain 2. you can get used to pain and not respond to as great a degree as you did when you first got the pain. As Wings has shown you can learn to live with it and not let it rule your life. 3. How would long term use of pain killers affect this test.

Until this technology has been around for a while and the 99.9% accuracy verified in the real world I have a wait and see attitude.

That said, when i read it and even now, I and im sure many others who see this will be thinking i want to take that test and stick it to those who put us through so many stalling and delaying and denial tactics.

If it proves accurate it could also make it much easier to obtain the pain relief you need if the test shows you are in pain. That is if the cost comes down over time so it is more affordable.

[Marlene]

This topic comes up over and over on the Aplastic Anemia board. It's known that toxic exposure can cause this disease. However, most get dismissed by their doctors because the disease does not hit immediately after exposure. And, no one ever looks at the synergistic effects of multiple chemicals.

So some chemical(s) probably caused John's AA, then to add insult to injury, the toxic effect of drugs caused his PN.

Thank you for posting this.

Marlene

Wife to John with PN acquired during treatment for Aplastic Anemia.

[HeyJoe]

Hi Marlene, He is not alone, almost everyone is dismissed by doctors for toxic exposures that either take decades to show damage or from a synergistic effect of being exposed to multiple toxins in a short period of time. The very concept of synergistic effect is controversial because it has not been tested and the effects have not been documented over the periods again of decades that it might take for symptoms of damage to manifest.A synergistic effect that leads to a type of cancer that usually takes decades to emerge after an exposure but manifests itself much sooner than if it was a single toxin exposure is also controversial and not accepted by most doctors. The rebuttal to that is treat the disease taking into account that it may well have been from an exposure to a toxin because we dont have the time to wait decades to prove it. Case in point the man they describe in the article who was vindicated after he was dead. Also way too common.

[glenntaj]

And I think the devil will most certainly be in the details. I can already hear the argument that while the cellular damage pattern of certain chemicals in vitro may well match that found in individual blood samples, indicating that an individual is chemically damaged, there is still no direct evidence that the particular DANA damage pattern is linkable with particular conditions. In other words, the individual shows chemical damage that indisputably shows toxic exposure, but does that exposure result in this claimant's disease.

I'm sure the insurance companies will try to throw the burden of proof for the linkage back on the plaintiffs.

I'd love to look at the technical specs of this testing process (being the geeky nerd that I am); are there any ways to find it?

[HeyJoe]

http://www.cytokineinstitute.com/pdfs/chromium.pdf




This is from the cytokine institute also, not too hard after reading this to see where they envision it going, and its not concern for health of the person.

AccuHealth Monitoring™ Type II

Providing a basic and accurate understanding of insurance applicants, the AccuHealth Monitoring™ Type II protocol affords the determination of the overall health and well-being of that individual in comparison to known standards of normalcy. Because it provides a more complete health picture than Type I monitoring, it offers an opportunity to inform applicants of possible occult disease processes which could have acute, chronic, and/or future adverse health consequences.

AccuHealth Monitoring™ Type II is a 15-part cytokine/chemokine protocol that provides objective evidence for identifying numerous risk factors for maladies, including, but not limited to, cardiovascular disease, oncologic illnesses, spinal cord injuries, central nervous system disorders, ongoing traumatic processes, joint-related disease, fibromyalgia, autoimmune ailments, pulmonary maladies ranging from asthma to emphysema, diabetes, and cerebrovascular disease. Whether a health questionnaire was completed accurately or a pre-insurance physical examination was done thoroughly, the ability to detect and monitor numerous acute and chronic maladies can uncover and delineate a far more insightful medical picture of an about-to-be insured. By uncovering this information, individuals can be counseled to seek appropriate medical intervention and institute any necessary preventive or therapeutic medical care.

[glenntaj]

--which, of course, heightened my suspicions that this technology will be used for pre-certification exams for insurance and to deny coverage before the fact (in the same way we suspect much of our genetic testing advances will be used).

[darlindeb25]

Case in point the man they describe in the article who was vindicated after he was dead. Also way too common.

So true--way too common--a dollor short and a day late.

heightened my suspicions that this technology will be used for pre-certification exams for insurance and to deny coverage before the fact

It is sad how our country works, isn't it?