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Mattress link to cot death ruled out

(5/24/98)

Dear Friends,

A number of articles hit the news the past several years regarding mattress fumes and SIDS. The news refers to a 1989 British Study. A May 23, 1998 British Medical Journal News release concludes, in part, that "there is no evidence to suggest that an interaction between mould and fire retardants used in PVC and other materials used to manufacture cot mattresses causes the sudden infant death syndrome". More information follows. We have received many e-mail messages asking for more information. The public has been on an information roller coaster, the result of an explosion of medical reports, each heralding a "breakthrough in SIDS research." We need to help people separate myth from fact and risk factor from cause. We will post information as it becomes available to us.

Please keep the following in mind:

- When it comes to media coverage of SIDS, we often feel a sense of frustration in being confronted with misleading headlines, announcements of so-called breakthroughs and statements taken out of context.

- Please read the article, "Mass Media's" Role in SIDS Education, at <http://sids-network.org/media.htm>.

We are currently gathering more information about this specific research and will keep you updated.

Thanks!

Chuck Mihalko
Executive Manager
SIDS Network

bullet Background: In 1989 it was claimed by a scientist that he had discovered that fire retardant used in mattresses were releasing toxic gases as a result of fungal activity. It was feared this may have been one of the main causes of SIDS. The Government looked into it and appointed a committee of experts to report. The Turner report was published in 1991. They relied on attempts by the Government Chemist to recreate the work of Barry Richardson but to no avail. Their methods have been criticized by Richardson. They reported that there was no independent proof. The Government responded by rebutting the theory and promoting a "back to sleep" campaign, i.e. put baby to sleep on the back. This appears to have been successful in reducing the numbers by half. Some claimed that it is not inconsistent with the gas theory since, as the gases are heavy and lay close to the surface of the mattress thus not causing much risk to babies whose noses are up and away from the mattress, it is akin to saying that you can avoid poisoning by carbon monoxide leaks by opening the windows. An independent television company specializing in medical tragedies completed two years of research which formed the basis of a major program "The Cook Report". That program revealed that tests they had carried out on tissue samples of SIDS babies, and which some members of the Turner Committee had asked to carry out in 1989, which requests had been refused by Government, had shown significant traces of one of the chemicals, antimony, whereas there were no significant levels in the samples from non-SIDS babies. Graham Ross was shown that evidence before the program and was interviewed to comment on the legal implications. Graham Ross took the view that if the theory is correct that new strict product liability laws would make it difficult for the manufacturers to avoid liability and, further, that the Government could be liable in negligence if the criticisms of their actions following the first publication of the theory in 1989 were well founded. Since that program was broadcast shops have ceased stocking mattresses containing antimony and the Government has set up another expert panel under Lady Limerick to re-address the issue.
bullet Mattress link to cot death ruled out: news (BMJ No 1553 Volume 316 Saturday 23 May 1998)
bullet Response from FSID to final report of the government appointed Expert Group to Investigate Cot Death Theories: Toxic Gas Hypothesis
bullet Final Report (May 1998)

BMJ 1998;316:1553 ( 23 May )
News

Mattress link to cot death ruled out

Caroline White, London

There is no evidence to suggest that an interaction between mould and fire retardants used in PVC and other materials used to manufacture cot mattresses causes the sudden infant death syndrome (SIDS).

This is the conclusion reached by an expert group set up to investigate cot death theories in its final report, published this week. The group was set up in December 1994 after the transmission of The Cook Report programme on ITV. Worried parents made thousands of calls to the television network after the broadcast.

The programme investigated the hypothesis, originally suggested by an independent consultant, that lethal toxic gases are formed by the degradation of chemicals in cot mattresses and their covers by the fungus Scopulariopsis brevicaulis. The consultant Mr Richardson recommended that parents should buy a new mattress for every new child or that old mattresses should be covered with a polythene sheet to prevent contamination. The Cook Report also claimed to substantiate his hypothesis with new data on potentially fatal antimony concentrations in infants.

A report commissioned by the Department of Health and published in 1991 had already refuted Mr Richardson's hypothesis, but unlike this latest report, the working party had not been able to reproduce Mr Richardson's experiments, examine tissue samples from SIDS babies, or analyse the circumstances in which antimony can be biomethylated.

Contamination of cot mattresses with S brevicaulis is rare, concludes the report, and is no more common among those used by SIDS babies. There are no in vivo conditions in which phosphorus, arsenic, and antimony from PVC mattresses can interact with the fungus.

The amount of antimony found in tissue samples from fetal lungs, livers, and umbilical cords indicates that infants acquire the substance prenatally, says the report; antimony can be transferred from childcare articles to the baby, there are several environmental sources other than mattress fire retardants, and its concentrations are not excessive in SIDS babies, it concludes.

"It has taken so long to disprove this hypothesis because it is biologically plausible and supported by the epidemiology and physiology," comments Peter Fleming, a professor of infant health and developmental physiology at the University of Bristol. "But closer scrutiny of the data shows that they distort realities."

Mr Richardson had also asserted that the changing rates of SIDS corresponded to the introduction and removal of fire retardants in cot mattresses that contained antimony and phosphorus. However, this was not found to be true. The sharpest decline in the rate of SIDS occurred in 1992 when concentrations of the retardant in cot mattress materials were still high, which coincided with the Department of Health's "Back to Sleep" campaign in the autumn of 1991.

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