Unformatted text preview: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11/04/2003 TUE 16:34 FAX VOL. LXXXVIII NO. 74 Lonely Crusade
One Man's Suffering Spurs Doctors to Probe Pesticide-Drug Link 9“ Tom Latimer. Tagamet User.
Fell 111 After He Mowed
Lavm That Was Treated A Problem IE Understood . By Fem: Euwann AILEH
Stair ltrportrr o! Tel-z WALL arr-Inti- Jam-u. DALLAS—Thomas Latlmer used to be a
vigorous. athreuc man. a succeastui pen-o-
Ieum engineer with a bright rutura. Then he mowed the lawn. On a summer Saturday In teas. Mr. Lat-
Imer spent an hour or so cutting the grass.
picking up the clippbrgs and edging the
walkways around his modest two-bedroom
home. Soon. something was lenith wrong.
He lelt diary and nauseated. His nose was
running and his chest was tight. He had a
pounding headache. Ten days later. he was still siclt. so he wont to Egee a doctor. But he Itept getting
worse. e sullered .. .
constant head pain. _ :F' '-.'. His eyes began to
In NDvember 1985.
he developed testicu-
lar cancer. How. six
years and 20 doctors
later—alter Ilver bl-
taps. CAT scans. ra-
sleep studies and .;
many other team-—
Mr. isomer. 36. ac- mm“ mm”
cepts tlie diagnosis 0! doctors: that he was
poisoned by an organophosphate pesticide
used to treat his yard. Doctors say the [son was absorbed
through his skin an by his inhaling the
pesticide tomes. Millions of people are eit-
posed to those same tomes and residues
every year: normally. the body ﬂushes out
small or moderate amounts of an organe-
phosphate in ii to to hours. But Mr. Latl-
Irrer's doctors say his that! has a compli-
cating tactor: He was taltlng prescribed
daily doses at am milligrams of Tasmet.
the popular ulcer drug. A toxicologlst. three neuroiDEIET-‘i Mid
two acorn-ophthalmologists who emit-limit
him all concluded Independently that the
Tagainet suppressed the normal role at his
liver In metabolizing the poison and expel-
ling It. They believe the medication caused
the poison to accumulate throughout his
body and thus to become more potent In Its
attack on the nervous system. I i
l Scientists Intrigued " " his. tattmer can no longer ride a bilte.
He has dittlculry walking. At night. to com-
bat brain seizures and nightmares. he
take: an epileptic mt‘diclne. Until recently.
he cottld steep tor only about an hour at a
time. Doctors sustiect the poisoning also Ili-
terlered with his brunune System. leading
to viral growuLs on his vocal cords that
have required annual laser surgery. The matters oi the
and oi Tagamet firmly deny that their
products had anything to do with Mr. Lati-
mer‘s condition. The pesticide malter says
It doesn't even believe he was armed to
Its product. And In tact. Mr. Iatimor lost a
lawsuit he tiled against the companies.
Even so. the case intrigues scientists and
regtdatore because It Illustrates the need
lot better understanding ol the complex in-
teractions between such everyday chemi- cals as pesticidea and prescription drugs.
Neither the Food and Drug Administra- tion nor the Environmental Protection
Agency conducrs routine tests tor such In~
teractiuns. Indeed. the EPA doesn‘t even
evaluate the synergy at two or more pestl-
cides cotrunohly used together. "We have
not developed ways to test any at that."
says an EPA spokesman. "We don‘t iotow
now to do It." And a new congressional re-
port says the FIJA lacks both the resources
and the enlorcemeni powers to protect
Americans from all kinds of poisons. No Interaction Testing Dompanim that melts and market posti-
cides are required to conduct a standard
battery of laboratory tests on animals to
assem various risks. But the compth
don't have to periorm any tests tor Interac-
tions with prescription drugs. With thou-
sands ot drugs and thousands at pesticides.
"the combinations and permutations would
he asoonomlcal.“ says Darrell Sunuier. a
toxicology specialist at Clha-Gelgy Corp..
which made the pesticide used on Mr. Lati-
mer's lawn. Ciba—Geigy says that the In-
dustry already spends Ba mutton to the
million per pesticide on tests to quality
tor registration wiut the EPA. Every year [or the past arcade. the
EPA estimates. more than 25 million
pounds oi herbicides and 30 million pounds
of insecticides were applied to residential
lawns and gardens. About 40% of yards are
so treated. and about 2] million people do
the job themselves. Complicating this is the ever-heavier
use or prescription drugs. Tagamet. lor in-
stance. is one ol the most widely used
drugs ever. taken by more than 15 million
people since 1975. And drug metabolism
varies widely by age. physique. sex. ethnic
group and other factors. In reconstructing what had happened to
Mr. Lntiltier. doctors noted that. In addi-
tion to the treatment of his lawn. he had
slu'nyed an organophosphate or. some am
hills and Insect nests In his yard that sum-
|Irt‘r. He and his ville had both worked in
tin.- yard In hare arms and shorts. digging
around ﬂower beds and shrubbery that Please Turn to Page A i. Coiurrm i pesticide. dlazlnon. i/ ﬁts/lentil LIBRARY '
ONLY 11/04/2003 TUE 16:34 FAX @00'2'2003 """" " nU -'- . A4 THE WALL STREET JOURNAL MONDAY. OCTOBER H. 1991 :Lonely Crusade: Doctors Probe Pcsticides' Interaction With Drugs Continued From First Page were treated. His wile. who wasn't taltlng
Tagamet. didn't get sick. Thomas Lee Kurt. a nationally recog-
nized toxicologist who was a medical direc-
tor of the North Texas Poison Center at the
time. diagnosed Mr. Ladmer‘s condition as
"enhanced organophosphate toxicity due to
Tagamet." The pesticide and the medicine
were. in silent. "competing with each
enter" to be metabolized. he says. He corn.
pales It to having hundreds or people try-
Ing to escape down the same narrow hail-
way: The hall bacomes lamrned.’ 311d
many can't get out. ' .- Aitredo A. Sedan. a professor at neuro-
sUrgery and ophthalmology at the Univer-
sity at Southern Caiilornla who has treated
victims oi aerial malathlon spraying. says
tailing a medication like Tagamet "can
make a person 100 to Lilli times more sen-
sitive to organophosphate poisoning." Dr.
Sadun. who conducted extensive tests in
evaluating Mr. Latimer's eye disorder.
also named the cause as organophosphate
poisoning. exacerbated by the Tagamet. "I
see no eddcnce that it could be anything
else." he says. Because of such cases. pressure is
growing on me EPA. the FDA. the Federal
Trade Commission and Congress to
toughen rules on labeling. advertising.
spraying methods and applicator train-
lug. User Beware "Pesticides are biologically active ' chemicals with potential says Vic-
tor J. Klrnm. a deputy assistant adminis- trator oi the EPA. "Many people haven‘t lully appreciated the inherently tonic na- ture oi lawn-care pesticide products." Chemical matters and applicators acknowl- edge that pesticides obviously have inher~ ant risks—they are designed. after all. to kill living things. But they generally argue . that rigorous tastingprocedures. and years
oi use. Show that their products are sate
when used correctly. Statistics compiled by the American A5-
sociation of Poison Control centers indi-
cate a steady Increm in the proportion of
the as. population being exposed annually .atrisk to toxic pesticides. Last year. 56.365 accl-
dental exposures to Insecticides and herbi-
cldes were reported through 72 regional
centers. By tar the largest muuber ol
cases— IEJJlE- Involved organophosphates.
compounds that km by intertering with
nerve transmissions. About tam organo- phosphate incidents reatured treatment in
health-care lacllltles. Three accidental ex- posures resulted in deaths. Such acute exposures are only part oi
the problem. it growing body at research
Indicates that many Americans may be
vulnerable to chronic. low-level exposure
to lllese pesticides that can produce severe
abdominal pain and headaches. nausea
and other eilects. Over tlma. as these
toxins accumulate in body tissue. research
shows that the risks include cancer. birth
detects and damage to the liver. kidneys
and nervous system. But these risks still aren't widely
known. Many do-it-yoursellers still don't
read the labels. Many who do read them
can't understand what they say. and others
don't understand the dangers ol inning to
lollow the lush-actions. "People assume
that If they inﬂow the label. there won't be-
any ill effects." says Jay Feldmao. coordi-
nator tor the Nannal Coalition Agautst the
Misuse oi Pesticides. "There needs to be a
wanting. sintllar to What's on cigarette
packaging. The labels need to say you are
u even it you iouow the direc- soiuy is Set Prompted by Interest in the iatimer
case. the National instltute oi Environmen-
ial Health Science decided this summer
to study the Interaction between Tagamet
and diaslnon. Dlatinon is too toxic to test
in humans. so the study will use animals.
The institute says any retarding ol the me-
tabolism oi the pesticide would indicate “a
longer residence time in tile body." which would Increase toxicity.
"All our testing is done with a single agent. but in the real world. people are ex-
posed io ntixiures." tatys John Doull ol the University of Kansas. head ol the National
Academy ol Sclences' toxicology commit- tee. He says interaction between pesticides
and prescription drugs is “not nearly as
well studied as It needs to be." Physicians
and researchers have documented interac-
tions with Tagamet that sharply increased
the blood-plasma concentrations of Valium
and at least an other prescription drugs. Many ol these Interaction mechanisms
are so complex that they sun aren't well
understood. Robert Palmer. vice president
tor gastroenteroiogy tor Smithltiine Bee-
cham Pic. which makes Tagamet. con-
cedes that Tagamet Inhibits the metabo-
lism oi dlazinon. but he and other re- searchers say they aren't sure where the ' tuunetabolized poison goes. They suspect
much at it accumulates in high concentra-
tions in fatty tissues throughout the body.
where It may stay hideilhltely. (Other
studies have shown that in lactating
women who were exposed to pesticides and
who later undertook weight-loss regimens.
the poison broke loose lrom iatty tissue
and was expelled through breast milk.) Even more frustrating to investlealorS.
ute results at chemical-interacﬂon and tort-
lcity studies in animals can be lnconsis~
tent. Dr. Palmer cites two separate rat
studies in 1986. one suggesting that Taga- met reduces oreanophosphate toxicity and
the other concluding that Tagamet In- creases lt exponentially. He says. "That
just show you can't predict with rats." 'No Ralph Nader' Mr. Latimer simply wants the public to
be warned. "We don't want to ban Taga-
met or dlazlnon." he says. "We Just want
people to be aware oi the possible risks."
Dr. Kurt. now the FDA's medical olllcer
tor the Southwest. says at Mr. Latirner:
"He Is a credible man. neither a rabble
rouser nor a Ralph Nader. He's Just very persistent." Illness and its consequences have ialten
a toll on Mr. Latirner's Job. marriage and
family. At ute oliice. he spealts slowly and
often loses his train oi thought. l-lis intel-
lect hasn‘t been impaired. but because 0i
his eye disorder. he can read only a it"
minutes at a time. "My daughter has
grown up knowing i can‘t read her a bed-
time story." he says. "By evening. I can't _ __.._. -—— —-.__—__ 11/04/2003 TUE 16:35 FAX see to read the words and don't have a
voice to speak with. i have to use sign lan-
guage to tell her i love her.“ To tight bitterness and depression. he
has turned his ordeal into a I'ruest to in-
crease awareness about the hazards oi
home pesticides. He and his wile. Carol.
an emergency-room nurse. have appealed
to regulators and Congress- seeking
clearer warning labels on pesticides. When they discovered Mr. Ladmer's
cancer. they accelerated their plans tor
starting a latruly. even creating their own
sperm bank. Now. "we have two beautiful
children. but our marriage has changed a
lot." says Mrs. Latll'ner. "Our goals are an
diiterent now. 1t'our needs and wants change a whole lot when you go through
something like this." ' ' ‘ Companies Dispute Claims Ciba—Gelgy and Chevron Corp" whose
Doha division distributes diasinon. think
it's time the isomers threw in the towel.
Ellen Maldonado. aChevron attorney. says
her company believes there was no evi-
dence that Mr. Latimer was exposed to
gillliilllltln. Basic questions were never re-
tsoived: exactly when Mr. Lattmer'a Ian
.was treated by a lavmvservice comm!!! iand what was used. But even II he had .' boon exposed. the Chevron attorney says.
there was no evidence the diaztnoo would
have caused his injuries._ . The companies argue that the diasinon I'ln the lawn would have degraded” or van- ished. But soil studies performed by triba- Geigy show disalnon's rate at degradation
[varies with soil type. temperature and other tactors. The studies show that soil
- with organic material. such as lawns. can
.- retain about 50% ct applied diaslnon tor up
a to live weeirn and iti‘l‘a for Evan months, in Mr. Latimer's yard: soil analysts round diatihon residues trots”. (our years altar
- his episode. t " Clue-Geigy says it is satisﬁed the case
was "thoroughly investigated? before it
it says Its own animal tests Drove dtazinoh
products it sells in the 0.3. aren't potent
enough to cause humannerve damage. Smithitlhie won't ctn'ntrteotonldr. Lati-
mer's cam hut deieods the record clings- . met..which has spared more? people trortt ulcer surgery and. helped nuiiions cope
. with avarier o! gastrointestinal aihneots
'. and other conditions. -
' Dr. Pahner says Smithtcllne has. "no
ireason to believe.'t'agamet enhanced or
.ganophosphate toxicity" to humans. And tindeed. it's just about impossible In a case -.iilta Mr. Latirner's to” prove the exact . cause. Lawyers for SmithKilne argued in
court that Mr. Lntimer's condition might be the result of multiple sclerosis. a stroke
or a venereal disease. iHis doctors did tests that they say ruled out those possi-
bilities and others} - In general. drug and pesticide compa
nies argue In courts that there needs to be
epIdEmlological drool-mass data from hu-
man exposure—to establish a connection between exposure to a substance and a
health cite-ct. Such proof is all but impossi-
ble to obtain. says Anthony 2. Roisman.
a lower Justice Department litigator and
motion chlet tor hazardous waste. And the
courts have generally agreed: Mr. Rois-
man notes in a legal journal that sneral
U.& district courts and a majority or
judges to- three 1.1.5. circuit courts have
ruled that "the only way to prove medical
carnation ls through epidemiology.“
indeed. it: was generally on those 'groundstharthejudgedi-m'tissedhitiatt- rner's case. although he didn't explain his
ruling in detail. hir. iattmet. who is seelt-
ing a new trial. ﬁnds such rulings uolatr.
He believes it is his right to have a jury.
not just a judge. decide what caused his lil-
oess. - -\- - . . I On sortie days when. Mrs. Latirner is
working. his: Latimer takes his iouoyear-
old daughter 1tlt'lth him to the grocery store.
His eyu can't hack to look at the shelves.
but the- can. pit-it out containers ol
asparagus and cottage cheese by recognis-
lng pictures on the labels. in the evenings.
Mr. Laurner does the dishes with scalding
water and no gloves. "it's a good way at
distracting my head pain." he says. "i
have discovered that I can test path in
only one place at a time.“ Sitting in the den as she nurses their lnv
rant son. Mrs. Lathner talks about her atti-
tude. “People have asited us why we don't
just accept ads as our late and leave It
alone;" she says. "But we are still mad
enough about this. even after sin years.
that we want some resolution. something
to come out ol ll: "1 would hire to get to the point where
the poisoning is not the ﬁrst thing in our
tile and we can just go on. but i am not
sure we will ever get to that point.” 4....-.- . . . . . . . . . .. ...
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