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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 Jerlt uncuntrollably. In NDvember 1985. he developed testicu- lar cancer. How. six years and 20 doctors later—alter Ilver bl- opstes. spinal-fluid taps. CAT scans. ra- dioactive brain blood-flow studies. 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 ' U$E 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 wasdisrnissedhyalederaleotu'tinnallns. 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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