August 5, 2015

Garrett Damrath
Chief Environmental Planner
Caltrans - District 7
100 S. Main Street, MS 16A
Los Angeles, California 90012
Dear Mr. Damrath:
I'm writing to you to formally submit the following comments on the SR- 710 Draft EIR/S. I'm
well aware of the many letters you have already received commenting on the need for a more
serious health impact assessment of all the proposed project alternatives, but particularly the
tunnel freeway one. I've decided to call your attention to a deficiency that is very significant and
needs to be addressed. That is the epidemic of Autism and Autism Spectrum Disorders that the
medical community is grappling with. The prevalence of these disorders are clearly on the rise
and in some geographic areas the rates as as high as 1 in 25 children. I would like to call your
attention to the CHARGE study which concludes that living near a freeway during pregnancy is
associated with higher likelihood of having a child with autism, but living near major boulevards
is not.
Here's a link to the full study:
http://www.researchgate.net/profile/Fred_Lurmann/publication/
49681794_Residential_proximity_to_freeways_and_autism_in_the_CHARGE_study/links/
0912f509d2f503e0e0000000.pdf
Here's the study abstract:
Background: Little is known about environmental causes and contributing factors for autism.
Basic science and epidemiologic research suggest that oxidative stress and inflammation may
play a role in disease development. Traffic-related air pollution, a common exposure with
established effects on these pathways, contains substances found to have adverse prenatal
effects.
Objectives: We examined the association between autism and proximity of residence to
freeways and major roadways during pregnancy and near the time of delivery, as a surrogate for
air pollution exposure.
Methods: Data were from 304 autism cases and 259 typically developing controls enrolled in the
Childhood Autism Risks from Genetics and the Environment (CHARGE) study. The mothers
address recorded on the birth certificate and trimester-specific addresses derived from a
residential history obtained by questionnaire were geocoded, and measures of distance to
freeways and major roads were calculated using ArcGIS software. Logistic regression models
compared residential prox-imity to freeways and major roads for autism cases and typically
developing controls.
Results: Adjusting for sociodemographic factors and maternal smoking, maternal residence at
the time of delivery was more likely be near a freeway ( 309 m) for cases than for controls

[odds ratio (OR) = 1.86; 95% confidence interval (CI), 1.043.45]. Autism was also associated
with residential proximity to a freeway during the third trimester (OR = 2.22; CI, 1.164.42). After
adjustment for socioeconomic and sociodemographic characteristics, these associations were
unchanged. Living near other major roads at birth was not associated with autism.
Conclusions: Living near a freeway was associated with autism. Examination of associations
with measured air pollutants is needed.
KEY WORDS: autism, epidemiology, geneenvironment interaction, roadway proximity, traffic
emissions. Environ Health Perspect 119:873877 (2011). doi:10.1289/ehp.1002835 [Online 16
December 2010]
I request that you address the findings in this study, and tell the public how a freeway extension
of approximately 6.5 miles, with 4.5 miles in a tunnel, will impact the residents living near the
proposed route of extension in terms of expected increase in offspring Autism rates. Also, tell us
how you would mitigate this increased risk.
Respectfully yours,
Marina Khubesrian, M.D., FAAFP
818-245-5122
Mkhubesrianmd@gmail.com