The Relationship Between Crib Mattresses and Crib Death

Abstract

Over the past 11 years there has been a growing controversy about the safety of baby mattresses. In particular, scientific research has taken place that has implicated crib mattresses in the cause of Crib Death. The proponents of this research claim that poisonous gases generated by fungal activity within a baby's mattress can be deadly. Critics do not disagree, but argue that there is no controlled study and therefore no scientific proof. As a consequence no warning that a possible danger has been issued.

The following paper presents a reason and a case for all parties concerned about baby safety to come together and to agree that chemical compounds placed in baby mattresses should not be considered safe for several reasons, which will be discussed in more detail.

In the first part the reader will be introduced to the controversy. Next there will be a general discussion about chemical compounds found in baby mattresses made from PVC.

This will be followed by well known scientific facts about mildew, a form of fungus, which is often found in conjunction with these chemical compounds particularly in a baby's mattress.

Next, the positions taken by proponents and critics of a poison gas explanation for SIDS will be delineated and an attempt will be made to establish a "common ground." Hopefully, this will allow everyone concerned with the health of babies to agree that there is a need to protect all babies from contaminated or for lack of a better word "dirty" mattresses.

The most important component is for everyone concerned to agree "to agree" that placing a baby down for sleep in an environment containing chemical compounds, mildew and dust mites no longer makes good sense.

Finally the question will be asked and answered about what steps we can take in the United States to protect our babies while we attempt to resolve this controversy.

David Denton Davis, M.D.

In 1986 a New Zealand chemist, Dr. T. James Sprott, proposed that babies dying of Crib Death-known as Cot Death or SIDS in his country - were in all likelihood dying from a gas poisoning. Although he was uncertain at that time of the gas or gases, he believed that one or more were being generated from within a baby's mattress. In 1989 an English chemist, Mr. Barry A. Richardson identified one of the gases as stibine.

In his experiments using pieces of polyvinyl chloride (PVC) taken from 200 mattresses upon which a baby had died from SIDS, he was able to conclude that a fungus, which had also become established in the same mattresses, was generating this poisonous gas from antimony.

Antimony had been added to mattresses as a fire retardant.

Richardson, who had published over 247 scientific papers and was considered to be an expert on the subject also drew attention to the fact that the gases of the elements phosphorus and arsenic, which had also been added to baby mattress PVC, were also probably involved. Due in large part to the media attention he received, Richardson was forced to make public his findings prior to having them published in the scientific literature.

As the direct result of his research, Richardson recommended that parents place their babies in the back position for sleep. He also recommended that parents wrap baby mattresses, if they were unable to purchase a new mattress for every new baby, with a thick clear polyethylene material until mattress manufacturers removed the chemical compounds in question.

The reaction of the traditional medical community in England and the Foundation for the Study of SIDS was swift. Rather than issue a warning while further research was conducted, Richardson was accused of unscientific behavior due to the fact that newspapers and television had been resorted to in an attempt to frighten mothers.

The Health Ministry ordered further investigations to counter Richardson's findings and to hopefully disprove his results for ill defined reasons. Rather than acknowledge the possibility that Richardson's work had added some new and important information about SIDS critics instead chose to denounce the findings.

While people in England were taking sides on this issue, parents and healthcare workers in the United States heard very little if anything about the growing controversy Richardson's work had created in his country. In order to understand the controversy more must be known about chemical compounds and mildew.

The Chemical Compounds Implicated in the Controversy

Certain chemical compounds have been added to baby products, especially those manufactured from polyvinyl chloride also known as PVC.

Governmental regulations in England, as in the United States, had forced mattress manufacturers to add fire retardants to crib mattresses and approved antimony for this purpose after PVC was found to be useful for making inexpensive crib and bassinet mattresses.

Antimony is an extremely rare element in the earth's crust and as a result, except in certain volcanically active regions of the World, is not found readily in either soil or vegetation. Therefore, antimony is not commonly found in water supplies or foods, except in those parts of the World, which have repeatedly experienced volcanic activity since the creation. In these lands several natural products such as sheepskins, tea tree bark and kapok may also contain antimony with occasional traces of arsenic.

These chemical elements are not considered to be nourishment so grazing sheep will rid their bodies of these elements by expelling them into their excretions or into their fleece. Trees may contain these elements in their bark.

Antimony is not considered an essential element for life. As a matter of fact, antimony should be considered dangerous. Occupational exposures may become life threatening.

Antimony has chemical properties, which make it similar to lead.

Arsenic is also an element and compounds of arsenic have been added to baby mattresses. This practice also deserves special attention, because arsine gas derived from compounds containing arsenic has been a well-known poison for over a century.

The United States Ambassador to Italy, Claire Booth Luce, became ill while residing in her embassy. The gas of arsenic, arsine was found to be the source. The arsenic entering the ambassador's body was found to be coming from the action of fungal microorganisms also known as mildew.

Mildew growths within wallpaper paste and ceiling paint were consuming the compounds containing arsenic and expelling arsine into the air. Ironically, the discovery of the source of this poisoning was facilitated by the fact that thousands of infants had died of a similar poisoning in Italy during the 1890's.

At that time the source of the poisoning was a green pigment known as Paris green, which had been manufactured into fashionable fabrics. Paris green was made from a chemical compound containing arsenic. The gas of arsenic was being released by fungal activity. This gas, being heavier than air, was accumulating near the floor making babies crawling or sleeping near the floor susceptible.

It is reasonable to conclude from these two examples that the gas generated by fungal activity on compounds containing arsenic is well known and can be deadly.

It would also be reasonable to conclude that compounds containing arsenic are not effective in killing microorganisms such as mildew. Nevertheless, even today arsenic is still being used for this purpose and can still be found in some baby mattresses made from PVC.

Phosphorus, unlike antimony and arsenic, is a common element found naturally in the body. It will be found commonly with calcium. It is not considered toxic, but organo-phosphates, which are used as insecticides and pesticides, are extremely dangerous.

Phosphorus found an important role following the discovery of PVC , because it strengthens the plasticizer and softens the material. Phosphorus also has fire retardant properties similar to antimony. Unfortunately the gas of phosphorus known as phosphine has properties similar to mustard gas used in World War I.

Sarin gas used in the subway attack in Tokyo and in Saddam Hussein's war with Iran is also similar. The creation of the gas of phosphorus, much like those of antimony and arsenic, occurs naturally in our environment by microbiological activity. It is commonly produced in estuaries and swamps. When methane ignites the gas of phosphorus the phenomena known as "swamp fires" can be seen. Therefore the microbiological creation and the existence of these gases in our environment is a scientific fact.

Those of you interested in the reasons why phosphorus, antimony and arsenic behave similarly should go to the periodic table. There they will find these three elements are grouped together with nitrogen. Nitrogen is the major source of nutrition for fungal organisms. It should not be surprising that fungal organisms may metabolize these elements as well.

Dr. T. J. Sprott points to this close relationship in his book titled "Cot Death Cover-up?" which was published in New Zealand and Great Britain by Penguin Press. He provides a detailed explanation why these elements can each be converted from their elemental form to their gas by the activity of microorganisms.

In particular he notes that the outer electron ring structures of all four elements are virtually identical, which is the reason they are grouped together in the first place.

Even a lay person, as a consequence of this similarity should be able to understand why a microorganism such as a fungus may have difficulty distinguishing what it is consuming as a food source. This chemical fact makes an extremely strong case in support of the fungal generation of gases. Although the circumstances that encourage the consumption of elements other than nitrogen may not be fully understood the possibility, it would once again be reasonable to conclude, cannot be ignored or dismissed.

This is especially important because the gases of phosphorus, antimony and arsenic are extraordinarily toxic.

Mildew

Based upon the above it would appear reasonable to conclude that chemical compounds containing these elements, which are present in most baby mattresses manufactured in the United States may become dangerous. If gases can occur naturally as the result of the activity of fungal organisms it would seem reasonable to conclude that this process can and will take place in the home or nursery. However, it would first be helpful to know more about the fungal organisms, which are commonly called mildew or molds.

Fungi have caused human misery since the beginning of time.

Mildew spores can travel across oceans, survive the cold of the North and South Poles and temperatures above 170 degrees. It isn't surprising that when food is readily available mildew will thrive and take on different characteristics. Nitrogen compounds as noted earlier are the major food source of fungi, such as mildew and molds.

Most washing detergents, fabric softeners, milk cheeses and breads contain large amounts of nitrogen. It should not be surprising therefore that baby mattresses are an ideal location for mildew.

Interestingly, ammonia the gas generated from nitrogen is irritating to the eyes, mouth and lungs, but is not considered poisonous unless there is no escape from these fumes. Microorganisms release ammonia within the crib environment as might be expected so this smell is commonly encountered when changing baby diapers.

Mildew thrives on nitrogen containing products but also requires sources of moisture and heat. Mattresses, especially baby bassinet and crib mattresses, readily offer these essential ingredients. Therefore practically all baby mattresses will quickly become contaminated.

Recently destructive molds have caused entire homes to be torn down and mildew pneumonia deaths have been reported.

Consequently, some forms of mildew may be far more dangerous than the so-called "Super-bugs," which are commonly being found inhabiting hospital operating rooms, which are extremely resistant to antibiotics. Organisms formerly killed by antibiotic activity now flourish.

While the war on bacteria is being waged, very little attention has been paid to fungal organisms such as molds and mildew.

These organisms are the ultimate opportunists. They thrive on diminished resistance and disability. They are extraordinary in there own resistance to anti-fungal agents. Certain forms are virtually indestructible.

The Old Testament of the Bible refers to homes, which had to be destroyed if a "spreading leprosy" appeared on the inside walls.

This greenish-red growth described in Leviticus was in all likelihood a mold, which was known, even in ancient times to be a harbinger of a plague, which would cause disease and death.

Baby Mattress Chemical Compounds and Mildew

It would be entirely reasonable at this point for anyone, who is now somewhat more familiar with the history and behavior of these chemical compounds to be even more alarmed and concerned by the fact that most, if not all, are found in baby mattresses with mildew.

This alone makes a good case for implicating these chemicals in infant morbidity and mortality and especially SIDS because SIDS had been unrecognized as a diagnostic entity prior to the use of PVC in baby mattresses.

It would seem reasonable to acknowledge that the natural history of a relationship between microorganisms and certain chemical compounds combined with scientific evidence of a danger should have. at the very least have served as a warning.

Opponents of a possible mattress danger for babies, as a consequence of the above, would be forced to defend chemical compounds and mildew and to disclaim that there was any possible relationship with illness or death.

Some outspoken opponents to Richardson's explanation might even go so far as to declare that all baby mattress chemical compounds and mildew are absolutely safe and represent no danger to babies.

However, the more cautious would most likely prefer a more middle of the road approach. James Kemp M.D., a SIDS researcher from St. Louis in a recent newspaper story was quoted as follows " why would any parent want to place their kid in a pile of chemicals (and mildew) regardless of whether or not they believed Richardson?"

Most parents after learning just a little about these chemicals state that having an infant sleep and play in a pool of potentially dangerous chemical compounds simply does not make sense.

Preventing baby mattresses from burning by using antimony and phosphorus as fire retardants was never either scientifically proven to be safe or effective in saving lives. Smoke inhalation and a lack of oxygen are the real causes of death. Therefore, these chemicals have no place especially next to a baby

An even stronger argument can be made for the immediate removal of chemical compounds from a baby's environment by adding mildew to the environment of a baby. It has long been known that the risk of a baby dying from SIDS is greatest during the winter months. No researcher has ever been able to explain this known fact. However, it would be reasonable to conclude that during the winter the combination of indoor heating and a lack of fresh air may contribute to the growth of mildew.

Poor ventilation due to closed windows may partially explain why the death rate rises during the winter. The additional knowledge that chemical compounds can be converted into gases by mildew should be sufficient to concern everyone.

Therefore it is doubtful that even the most outspoken critic of chemical gases would be prepared to defend the role this combination of winter, mildew and chemicals might play. Also at this point it is extremely unlikely that anyone can still remain convinced and comfortable that a baby is safe when chemical compounds and mildew are present together in a bassinet or crib mattress.

For anyone to believe otherwise would place that person in conflict with scientific evidence and history. The proponents of the potential danger inherent in a mildew and chemical environment beneath a baby would become the obvious winners if a debate took place.

The Controversy That Never Should Have Taken Place

In retrospect following Richardson's initial work if the word SIDS had not become the issue it is likely that babies in the United States would now be sleeping on chemical free surfaces that would not support the growth of mildew.

Unfortunately, this entire matter has become terribly polarized. Instead of the scientific publication of Richardson's findings in 1989 followed by a simple warning that may have resulted in the removal of these chemical compounds, a protracted battle has taken place over the past eleven years.

The Richardson/Sprott side claims SIDS is caused by the fungal generation of gases, while the more traditional side has continued to maintain the opposing view.

If only both sides had come together in 1989 and agreed that no baby deserved to sleep on a used mattress containing chemicals and mildew, this entire issue may have been resolved. If everyone at that time had agreed that chemical compounds and mildew were unhealthy and should be removed from a baby's environment it is possible that today SIDS, like other diseases would be a diagnosis of the past.

If only the Health Ministry of England had agreed that babies did not need to be exposed to both mildew and chemicals and had recommended protecting babies this entire controversy could possibly have been avoided. A likely outcome, if a warning had been issued, would have been a sudden and dramatic decline in infant mortality.

This was not to be the case.

While the medical and SIDS establishments of England were attempting to disprove Richardson's explanation, baby mattress manufacturers quietly began to voluntarily remove these chemical compounds from baby products as early as 1991.

Parents had also begun to cover their babies' mattresses with the polyethylene material Richardson had recommended. The death rate began to fall and has continued to fall.

Meanwhile, while the debate continued to rage in England, on the other side of the World Dr. T. J. Sprott had launched his own campaign in New Zealand and elsewhere in 1995. Instead of stating, as the Health Ministry of England should have done earlier, that his objective was to protect babies from mattress chemicals, and mildew he stated in no uncertain terms that his goal was the prevention and elimination of SIDS.

Sprott had no doubts that gases were causing deaths in infants. As might be expected by now, the New Zealand medical community and Cot Death Association reacted in the same fashion as these groups had reacted five years earlier in England. These groups as well as individual doctors rose up in opposition stating in no uncertain terms once again that there was no scientific proof to support Sprott's claims.

This outcome was predictable. However, it is possible that if Sprott's opposing groups had been carefully educated about the danger of chemicals and mildew they might have reacted differently. The very fact that New Zealand's death rate from SIDS was the highest in the World should have become a reason to try anything in addition to the back position for sleep, including a polyethylene cover or a chemical free environment.

The battle that had started in England has continued in New Zealand. But today there is little doubt that Sprott is making significant progress.

In fact, no baby sleeping on a Sprott polyethylene protected mattresses has died from SIDS in over six years.

From a statistical standpoint approximately 250 babies have not died from SIDS. This fact is of growing significance. Although it is hard to imagine, Sprott's opposition has continued to claim that his results are unscientific and therefore should be considered invalid.

Sprott on the other hand vehemently argues that any future scientific study that deliberately exposed any baby to chemicals and mildew would be immoral and unethical. Sprott goes on to argue that while no polyethylene protected baby has died in six years over 400 unprotected babies have died during the same period.

As a consequence, a reasonable recommendation that all babies should be protected from chemical and mildew contaminated - "dirty" mattresses - has failed to emerge from the Health Ministry of that country. This entire matter appears to have become totally convoluted.

Opponents who might have supported the reasonableness of the original premise of a mildew and chemical free sleeping and playing place for an infant, instead have reacted and continue to react to the Sprott's premise that there is a direct link between mattresses and SIDS. This controversy deepens as it spills over into the United States.

The claims that crib mattresses have a relationship to SIDS have already drawn the attention of the medical community, SIDS organizations, and the FDA. Critics here have and will continue to claim that the evidence, which has been brought forward in support of a link between "dirty" mattresses and SIDS, remains anecdotal and unscientific.

Without scientific proof to substantiate any claims that are made in regard to the prevention of SIDS the FDA can declare the Sprott protective cover is an illegal medical device in the United States.

As a consequence of this action, these groups, including the FDA will be forced into the position of continuing to defend "dirty" mattresses. One outcome may be the production of protective covers that will be marketed and sold for reasons other than the prevention of SIDS. This may be a good outcome, because the more parents who choose to protect their babies the better.

As the number of protected baby's increase, we may begin to experience a corresponding decline in deaths similar to what has happened elsewhere. If these covers meet the same specifications that Dr. Sprott has established and are sold for the purpose of protecting babies from environmental contaminants an extremely important outcome may result. Unfortunately it may also lead to inferior products and parents improperly using a protective cover or incorrectly wrapping their own babies' mattresses in polyethylene.

Before considering a more reasonable and logical alternative to a continuation of this growing controversy here in the United States it should be pointed out that the reason why turning a baby on his or her back has saved lives has no scientific explanation. When this recommendation was introduced in the United States there was no "double blinded" scientific study that had been completed.

Fortunately, we can now look back at the results and claim the original recommendation, which was anecdotal, has been 38% successful. Therefore the back position for sleep has been validated as a SIDS risk reduction step for one out of three potential victims by time rather than a controlled study. In retrospect a questionnaire has become validated. The back position reduces SIDS.

Due to the fact that scientific evidence exists that chemical compounds can be converted to dangerous gases by fungal activity, everyone concerned with SIDS should acknowledge that there is at the very least a need for a warning at this point in time based upon the available evidence.

This evidence exceeds the evidence that was present at the time the back position was introduced and became the recommendation for sleep. This is both scientifically justifiable and totally reasonable. The United States must take some action for the future rather than talk about what has happened elsewhere in the past.

The answer is yes and we must, simply because it is extremely unfortunate that the majority of the scientific community in this country has relied upon erroneous reports from England that the Sprott/Richardson explanation for SIDS was disproved.

Before identifying what must take place it is wise to examine in more detail the evidence. It is important to try to understand the significance of what has been reported and why so little information has reached parents in the United States. The first step will be to examine the reports that have reached the American research community.

The Turner Committee and Limerick Commission Reports, which have been released by the Health Ministry in England, have been cited in editorials in medical journals. Editorials it must be pointed out are only the opinions of the authors.

Therefore an editorial may in fact be untrue. It is clear that neither of these reports disproved the fact that mildew can generate gases. This would have required changing nature and history. Therefore, it is of critical importance for the research community in the United States to ignore editorial opinions.

As an example and as a matter of record, an editorial appeared in an American Journal of Pediatrics after the American Academy of Pediatrics agreed to adopt the recommendation from New Zealand and England that babies be placed on their backs for sleep.

The author of this editorial, who was a former President of the same academy, stated that acting upon and instituting the back position for sleep in the United States would actually increase the death rate from SIDS. Thank goodness the American Academy of Pediatrics ignored the opinion of a most prominent member and proceeded to officially adopt the back position.

However, it would be fair to say that many pediatricians and other healthcare workers read that editorial and as a consequence may have delayed promoting the academy's recommendation. History now shows that that particular editorial opinion has turned out to be entirely incorrect.

The actual evidence that has emerged from investigations into the Sprott/Richardson explanation suggests that although the first government sponsored group in England to study the possibility of mildew chemical gas production in baby mattresses could not duplicate Richardson's original work, there were several profound recommendations. These were neither reported nor contained in any editorial.

The first report recommended the removal of the chemicals in question from baby mattresses. This Turner Committee Report, as it was called, also recommended that children be tested country wide for antimony.

These recommendations are unusual unless of course the committee remained concerned about a danger in spite of the fact that they had not successfully demonstrated Richardson's gas. The authors of the editorials that followed and members of the Health Ministry of England, for reasons known only to them, had apparently ignored these two recommendations.

They had instead chosen to emphasize their own conclusion, which was that Richardson had been proven wrong. The chairman of that committee, Professor Paul Turner was one of the first people to state that this conclusion was untrue. In fact, he also noted that another of his committee's recommendation had been ignored which was that further research would be necessary.

As a result, American researchers, who had relied on this editorial comment, have simply ignored that there might be any possibility that Richardson had discovered new and important information.

Nevertheless the fact remained that poisonous gases are naturally generated from fungal activity. To deny that this can happen in a crib mattress is inconsistent with history and also rather foolish.

While little or no attention has been paid to the gas explanation for SIDS on this side of the Atlantic and Pacific Oceans Barry Richardson, who demonstrated the gas of antimony coming from cot death mattresses he examined has continued to stand firm.

He has steadfastly pointed to his own scientific credentials and to the flaws in studies that have been attempted to duplicate his work.

Richardson has pointed to the fact that research, which has been conducted by the British government to disprove his work, has in fact substantiated his findings.

It is also important to note that a recently completed study failed to find the gas of antimony, but no mention was made of the fact that compounds of antimony were removed from baby mattress in the early 1990's.

Meanwhile, Dr. Sprott as noted earlier had successfully waged a
single-handed battle with his own country's medical and cot death
establishments in New Zealand. He pointed to his own results.

He has argued that based upon the statistical evidence that had been collected since the introduction of his cover chemical compounds must be removed from baby mattresses. Some well-meaning non-partisan observer might agree that there has already been a control group of SIDS deaths similar to those babies who died from SIDS while sleeping on their tummies after the back position was recommended.

It deserves to be mentioned that at the Sixth International SIDS Conference in February 2000, Dr. Sprott was invited to speak about his results. It now appears that his words at that meeting and his accomplishments have not outwardly convinced many of his critics.

Ironically, at the same conference, Dr. William Cullen, a scientist from Canada presented evidence that a sheepskin he had examined that was slept upon by a baby, who died from crib death in New Zealand, contained both antimony and a fungus.

The fungus Cullen found was new and he reported that it is closely related to the original fungus found by Richardson in all 200 SIDS mattresses studied in England in 1989, except for the fact that the new fungus was even more efficient in producing stibine gas from antimony.

Any person who is interested in trying to understand more about the Sprott/Richardson side of this controversy should take a close look at the native New Zealand Maori population in light of the Cullen discovery just mentioned.

Most people appreciate the fact that New Zealand is a beautiful country that is known for, among other things, sheep. However, the volcanic nature of this country provides soil that contains antimony. Consequently grass will contain antimony.

As a consequence sheep fleeces contain antimony. Most people are not aware of the fact that the Maori population continues to have one of the highest, if not the highest rate of SIDS in the World. Sheepskins become excellent hosts for the growth of mildew.

The Maoris have used sheepskins for their babies to sleep on as part of their culture. In spite of the fact that their death rate from SIDS is now 12-15 times higher than their Caucasian counter parts, the removal of sheepskins from a Maori baby's environment has been met with strong opposition and resistance. This has been due in large part to the failure of the Health Ministry to take a leading role.

The gas explanation for SIDS will in all likelihood be proven once and for all when and if Dr. Sprott is successful in replacing all sheepskins with chemical free covers and mattresses. If the Maori death rate decreases 74% as it has among the Caucasian population since the introduction of the Sprott cover there will be few doubters left.

It also deserves to be noted that the evidence of a link between mattresses and SIDS is strongly supported by several additional important scientific facts.

The first fact is that a second or a third baby in the same family has a risk of SIDS that is two to three times greater than the first child does. There is also a greater likelihood that a second or later child in the same family will sleep on a used mattress. This increased death rate associated with the re-use of baby mattresses was clearly demonstrated by a study conducted by the Scottish Cot Death Trust.

Secondly, the fact that the incidence of having a SIDS baby in the United States is three times greater in African-Americans has recently been acknowledged and is also significant, because lower economic circumstances appear to be related to the re-use of older baby mattresses.

It is reasonable, as a consequence, to conclude that socioeconomic circumstances are related to SIDS. This makes many of the so-called multi-factors irrelevant. However, few, if any scientific studies, except as noted above have paid any attention to the age of a mattress upon which a baby died.

Thirdly, recent evidence of a shift in the incidence of SIDS to daycare centers is very alarming but also predictable, because it is a well-known fact that mattress re-use in this particular setting is a common practice.

It is also a fact that babies are oftentimes allowed to sleep near the floor in playpens or on mats. If gases form that are heavier than air they will accumulate near or on the floor especially if ventilation is poor. The gas of antimony is more than twice the density of air.

Although critics of a SIDS link to older mattresses and a gas, view the growing incidence of daycare SIDS as "worrisome;" no warning about the possible danger is likely to be forthcoming. This will be the case unless everyone can somehow agree that frequently used mattresses are by definition "dirty" and as a result deserve to be covered or replaced with a material other than PVC.

Next, the risk of "bed-sharing" has been widely publicized, most recently by the Consumer Products Safety Commission (CPSC). The risk of a baby dying from SIDS is three times greater in a family or parents' bed. Once again the mattress is the only plausible reason this should happen.

Lastly, the Limerick Commission itself concluded that there was evidence that the gas of antimony could be generated by fungal activity in mattresses, but it went on to conclude that it was extremely unlikely for this to take place in a baby's mattress.

This finding and fact can not be lightly dismissed. It is extremely unfortunate that this part of the Limerick Report has been largely ignored. This represents another reason why American researchers should not refuse to take a closer look at mattress chemicals and mildew.

These facts are also the reasons the American media, which has usually relied upon the medical establishment, must have a change in policy and report this story with or without this approval. It would be fair to state the media is already aware of some of these facts. It would also be fair to say that some members of the media have actually covered the story, but so far have been encouraged not to release it.

There is little doubt that this controversy is growing and will not go away. The fact that it has already received wide spread medical and media attention in other countries including New Zealand and Great Britain, is evidence that it is already well established in the United States.

This author for one has placed the SIDS gas explanation information on the Internet at www.criblife2000.com and has been completing a book on the same subject in conjunction with Dr. T. J. Sprott with the help of Mr. Barry Richardson.

At the very least mothers deserve to receive information from both sides of this potential danger coming from mattresses in general and baby mattresses in particular. Even if the risk is remote that a baby is in danger sleeping on a PVC mattress contaminated with mildew, this possibility deserves everyone's attention.

It is far better to be safe than sorry.

This information is especially important in light of recent movies, which have been based upon cover-ups in the tobacco and water industries. A good case might be made from the evidence that is now available, which is apparently being ignored that there is an ongoing attempt being made to suppress the story.

Recommendations

As a medical doctor I have investigated the issues and facts embedded in this story. I have gone from the position of a critic and skeptic of the "accidental poisoning explanation" for SIDS to the opposite extreme.

I have taken the position and have already gone on record that at present there is enough circumstantial and actual evidence to support the existence of link between SIDS and mattress chemicals and mildew that something must be done to protect babies as soon as possible.

In order to help facilitate a change, I am purposely revising my personal strategy in attempting to do something about the problem. My immediate objective will be to form strategic alliances with others interested in the health and safety of babies by establishing a common ground that everyone can agree upon.

The ground that seems to be acceptable is simple-no baby deserves to be placed in an environment containing chemical compounds, mildew and dust mites. The majority of existing mattresses are manufactured from PVC that has stitching, ticking and in many cases PVC foam.

Therefore, I believe that the single best solution is to have chemical free baby mattresses manufactured inexpensively that will not support the growth of mildew.

In the meantime, a thick polyethylene cover placed over all existing mattresses should be agreeable to all concerned parties. Although it has been suggested that all babies deserve a new mattress, this remains potentially dangerous due to the presence of chemical compounds. For this effort to be successful it will require the cooperation of all doctors, midwives, nurses and hospitals providing maternity services.

In addition agencies that currently help new mothers through their pregnancies and assist with nursery furnishings must become involved, because many inner city mothers are now receiving donated used mattresses. Organizations currently involved with SIDS victim's parents and research, as well as organizations promoting child safety should also become involved.

While a campaign to cover mattresses is taking place manufacturers and government agencies should quietly remove phosphorus, antimony and arsenic from baby mattresses and products. Alternatives to PVC mattresses and the current chemical compounds used as fire retardants and anti-fungal agents must be explored.

During this transition period some babies will probably continue to die from SIDS, but the incidence should decline. If the decrease in the SIDS rate is similar to what happened with the "Back to Sleep" campaign, all parties would welcome that outcome.

No change in the SIDS rate would become a strong case against the explanation that mildew and chemicals play the most significant role in SIDS. Although, this would not be an expected outcome in light of Dr. Sprott's six year 100% success in New Zealand and elsewhere it is a possibility. Of course all mattresses must be properly covered with the same polyethylene material and instructions used by Dr. Sprott.

The goal of a campaign to isolate babies from mattress chemicals and mildew would be to protect babies, as well as parents. It is reasonable to predict one outcome will be that babies will do better in a more sanitary environment.

Simply isolating babies from the accumulation of household dust mites may reduce the incidence of asthma. Another scientific point that deserves to be made is simple- more than fifty per cent of babies by the age of 5 months will roll onto their tummies during sleep.

Parents and caregivers cannot and should not be held responsible if a baby over this age is found face down on any mattress. The stomach position is a more natural position for sleep.

I believe that anyone who has read this article, regardless of his or her previous beliefs, will sleep more comfortably knowing babies sleeping on protected mattresses, who may roll on to their tummies, will continue to sleep isolated from chemicals and mildew.

The fact remains that suspicion and guilt go hand in hand with SIDS. If a baby is found face down regardless of the fact that a parent or caregiver is certain that the baby was placed on his or her back there will be doubts. A simple cover may be all that is necessary. The Sprott polyethylene cover developed and tested for six years in New Zealand should become the standard cover during this period.

If parents cannot afford to buy a cover it must be provided free of charge. The combination of a chemical free environment that will not support the growth of mildew or the accumulation of dust mites must become an immediate goal of all parties in the same way that infant car seats have become the standard.

No baby should be allowed to go home from the hospital without a Sprott polyethylene cover with installation instructions or a mattress that is chemical free.

In conclusion, I believe everyone can agree that previously used mattresses are by definition "dirty." They can no longer be considered safe for a baby to sleep upon in a bassinet, crib or parents' bed. This must become the "common ground" that everyone concerned with infant safety and mortality must rally around. In order to avoid FDA imposed regulations that would outlaw the Sprott cover; this cover must be introduced nation-wide as a prophylactic measure until more scientific research can be conducted.

This can be accomplished best by removing the SIDS prevention claim that has been attached to this product. Although I personally know that a correlation between "dirty" mattresses and SIDS exists, I will refrain from making this claim. However, I will continue to insist that no group or parent ignore the information provided above.