Judge rules that birth defects could have been caused by toxic waste from steel worksBMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b3162 (Published 04 August 2009) Cite this as: BMJ 2009;339:b3162
All rapid responses
Two to three percent of newborn babies are affected by birth defects
(congenital anomalies). Despite the recent High Court verdict implicating
toxic substances, the cause of the reported ‘cluster’ of children born
with limb defects in Corby has yet to be found. There are wider
implications to this story than those reported by the media, and not just
for the families involved but to all interested in the health of newborn
babies. This concerns the identification of clusters of congenital
anomalies through routine surveillance and the rigorous scientific
research needed to identify potential causes.
Following the thalidomide “epidemic” the government set up a national
surveillance system (the National Congenital Anomaly System) for England
and Wales in 1964. It is now accepted that congenital anomalies are under
reported to this system and in response to this knowledge regional
registers have been set up in some areas(1,2). However, these registers
cover less than half of all births in England. These registers are all
members of the British Isles Network of Congenital Anomaly Registers
(BINOCAR, www.binocar.org/) which aims to provide continuous monitoring of
the frequency, nature, causes and outcomes of congenital anomalies for the
British Isles by means of national regional and disease specific
At present the funding of these English registers is precarious. If
accurate knowledge on the background frequency of different congenital
anomalies, and thus identification of clusters, is thought to be
important, long term secure funding is vital. The need for central core
funding for the national coverage of England by regional registers was
highlighted in the CMO’s 2004 report(3). Despite widespread support for
this, funding has yet to materialise.
It is BINOCAR’s position that a scientific link between inhalation or
ingestion of airborne pollutants and specific congenital anomalies remains
to be proved, but the need for accurate data about anomaly occurrence,
gathered longitudinally from multiple sources, is paramount. There is
scope for the prevention of some congenital anomalies. However, this
requires the continuous collection of good quality data without which any
putative associations will remain inconclusive.
Members of the BINOCAR Management Committee.
1. Boyd PA, Armstrong B, Dolk H, Botting B, Pattenden S, Abramsky L,
Rankin J, Vrijheid M, Wellesley D. (2005) Congenital anomaly surveillance
in England- ascertainment deficiencies in the national system. British
Medical Journal 330, 27-31.
2. Misra T, Dattani N, Majeed A. (2005) Evaluation of the National
Congenital Anomaly System in England and Wales. (2005) Archives of Disease
in Childhood Fetal & Neonatal Edition 90, F368-73.
3. Chief Medical Officer (2005) Gastroschisis: a growing concern.
Annual Report of the Chief Medical Officer 2004: On the State of Public
Health. Department of Health.
Competing interests: No competing interests