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TX: 02.07.03 - COULD A TOXIC CHEMICAL BE CAUSING AN MS CLUSTER IN TWO SMALL COASTAL VILLAGES IN WEST SCOTLAND?



PRESENTER: WINIFRED ROBINSON


ROBINSON
Multiple Sclerosis is a disease with no known cause and no known cure. It affects people differently - some can carry on with life and work for many, many years, others quickly lose the use of their limbs or their eyesight and they suffer severe pain. Because so little is known for sure there's lots of speculation about the causes, particularly in places where the incidence of multiple sclerosis is high. When a recent report in a newspaper revealed that levels of the toxic chemical - TBT or tributyltin - were high in Loch Ryan near Stranraer on the west coast of Scotland some people began to wonder if it could have caused the 10 cases of MS in two small coastal villages. TBT's used to paint the bottom of boats to stop barnacles growing on them. Among those worried about a possible link are Colin Dodd and Marion McHarg.

MCHARG
I was first diagnosed with multiple sclerosis 12 years ago after moving here to this area - 19 to 20 years ago. In this area there is 10 of us in the parishes of Leswalt and Kirkcolm with multiple sclerosis. I think it would be a good thing if it's highlighted that it is this TBT, if it was to be the case. Because I mean a cause is half way to getting a cure.

DODDS
I didn't realise at the start that there were so many cases which blows the statistics out of the water really. I would like to see if there was any connection there. I know I think it's the Shetlands and Orkneys I think it's the highest in Scotland, that's coastal as well and a lot of fishing industry and they use TBT in the fishing boats. So I think if they had a look round to see if the TBT was present in coastal areas and if there was a high incidence of MS in that area.

ROBINSON
Colin Dodd and Marion McHarg. Well their local member of the Scottish Parliament, Alex Fergusson, has promised to take up their cases.

FERGUSSON
What we have is a possible coincidence of very high readings of tributyltins in the Loch Ryan and a similar high incidence, a 1 in 60 incidence, of multiple sclerosis in the two nearest villages to that loch. I think that is worthy of questions. We're about to see changes in the use of Loch Ryan as the ferry company that currently operates from Stranraer moves further up the loch and there's a great deal of speculation as to whether or not we might open up more of a leisure industry based around that loch, that will be difficult to do if there are unexplained high and low readings of chemicals such as tributyltin which need an explanation.

ROBINSON
Alex Fergusson. But the fact is that it may prove impossible to establish if 10 cases in two such small villages constitute what's known as a significant cluster. A study by the Dumfries and Galloway health board, due at the end of the summer, may come up with an answer. But even that won't prove if the cases are due to the boat paint pollution. So what are the chances that there may be a link? I asked Dr Giles Elrington, who's consultant neurologist at the Royal London Hospital, what he thinks.

ELRINGTON
I really want to know the reason why my patients get MS and I think they do too and if anyone comes up with an idea that might help us then we have to look at it. But I think it is unlikely that TBT or any other toxin in the environment is the cause of MS. MS is a disease of the brain and spinal cord, and TBT will very rarely cause a disease of the peripheral nervous system - that is the nerves that links the spine to the body and vice versa and it's a completely different disease. Most likely it's caused by an interaction between genetic factors and infection acquired in childhood. But it could be that there are some toxins in the environment which could be contributory to the disease in some people.

ROBINSON
Why do you say that it's mostly likely there's a genetic factor and childhood infection?

ELRINGTON
Well we know that genes are important in MS, for example if you have an identical twin with MS then you're much more likely to get MS than if you have a non-identical twin with MS. And we know that where you were brought up has a major factor upon whether you're going to get MS and the patterns of risk with an increased incidence of MS away from the Equator and the risk changing with moving before the age of 15 suggests there's some kind of infective factor involved.

ROBINSON
The people with MS in Scotland believe that there may be a cluster around their villages, where in the world are the clusters?

ELRINGTON
Yeah there have been lots of clusters of MS that have come up and for example there's a lot more MS in Shetland and Orkneys than in other parts of Scotland and the UK. You see a similar gradient if you go south in the Southern Hemisphere.

ROBINSON
What theories have been advanced as possible reasons for clusters that have occurred?

ELRINGTON
The most likely reason is that it's genetic and so if you've got a lot of families in the area just by chance with MS and they breed together then you will have more cases of MS.

ROBINSON
But what about theories that we've read about - things like scrapie in sheep or sexually transmitted infection, there have been others haven't there?

ELRINGTON
Scrapie is a very different disease from MS and I don't think that the idea - it's a very nice idea - that MS relates to scrapie really holds water if you look at it in the long term. And there's another even less common disease of sheep called swayback disease and it happens that four out of seven scientists studying that disease developed MS quite close together - gosh and that's jolly frightening but it's almost certainly just a fluke.

ROBINSON
I understand there actually is a cluster in Norway in an inland area is that right?

ELRINGTON
People in Norway who live near the coast are less likely to have MS than people who live inland. It's not so much a cluster as you see it along the coastline there but if this was caused by something nasty caught off the bottom of ship deposited in the water then one would expect to see it in the folk in the fjords and not in the chaps inland. But it's possible that MS is a number of different diseases, it may be that in different ethnic groups there are different triggers, maybe in Scotland they have different triggers from in Norway. But I don't think that we're likely to find the cause of MS in some kind of environmental toxin, it's possible that we might, we must be open minded but not gullible.

ROBINSON
Dr Giles Elrington.






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