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An analysis of 100 million US medical records reveals that autism and intellectual disability (ID) rates are correlated at the county level with incidence of genital malformations in newborn males, an indicator of possible congenital exposure to harmful environmental factors such as pesticides.

Autism rates — after adjustment for gender, ethnic, socioeconomic and geopolitical factors — jump by 283 percent for every one percent increase in frequency of malformations in a county. Intellectual disability rates increase 94 percent. Slight increases in autism and ID rates are also seen in wealthier and more urban counties.

The study, published by scientists from the University of Chicago March 13 in

PLOS Computational Biology, confirms the dramatic effect of diagnostic standards. Incidence rates for Autism and ID on a per-person basis decrease by roughly 99 percent in states with stronger regulations on diagnosis of these disorders.

“Autism appears to be strongly correlated with rate of congenital malformations of the genitals in males across the country,” said study author Andrey Rzhetsky, PhD, professor of genetic medicine and human genetics at the University of Chicago. “This gives an indicator of environmental load and the effect is surprisingly strong.”

Although autism and intellectual disability have genetic components, environmental causes are thought to play a role. To identify potential environmental links, Rzhetsky and his team analyzed an insurance claims dataset that covered nearly one third of the US population. They used congenital malformations of the reproductive system in males as an indicator of parental exposure to toxins.

Male fetuses are particularly sensitive to toxins such as environmental lead, sex hormone analogs, medications and other synthetic molecules. Parental exposure to these toxins is thought explain a large portion of congenital reproductive malformations, such as micropenis, hypospadias (urethra on underside of the penis), undescended testicles and others.

The researchers created a statistical baseline frequency of autism and ID across the country. They then looked at the actual rates of these disorders, county-by-county. Deviations from the baseline are interpreted as resulting from local causes. Factors such as age, ethnicity, socioeconomic groups and geopolitical statuses were analyzed and corrected for.