Disease Risks & Drug News / Public health

This file includes links to papers published by Eubios Ethics Institute, and some other organizations, in the first section. Next it includes topical extracts from EJAIB and EEIN between January 1994 - 2006 (older news items are in separate files). Last date of updating is referenced in the main News page. Latest news and papers is at the bottom of each of the two sections.

Pharmacy and Bioethics - Towards the "Doctor Of Pharmacotherapy" in a Drugstore - Olga A. Khroutski and Konstantin S. Khroutski EJAIB 12 (May 2002), 97-103.

EJAIB 14 (2004), 61-63 Cyber-pharmacies and ethical concerns over marketing drugs online - Vinod Scaria
Hans-Martin Sass, Emergency Management in Public Health Ethics: Triage, Epidemics, Biomedical Terror and Warfare EJAIB 15 (Sept. 2005), 161-7.

Arthur Saniotis, Health, Illness and Medical Bioethics: An Islamic Perspective EJAIB 16 (May 2006), 71-6.

The medically recommended weekly dose of alcohol is 21 units for men and 14 units for women (1 dose is about a glass of wine); BMJ 307 (1993), 1373-4. Any more is much more likely to result in health damage. Excessive drinking is shown to cause neuronal damage in Lancet 342 (1993), 1201-4. A paper looking at the question of freedom of choice and the nature of addiction is G. Oddie, "Addiction and the value of freedom", Bioethics 7 (1993), 373-401.

Passive smoking has been labelled as a health risk and carcinogenic. A paper supporting this is S.S. Hecht et al., "A tobacco-specific lung carcinogen in the urine of men exposed to cigarette smoke", NEJM 329 (1993), 1543-6. This shows that a carcinogen was inhaled into the body due to passive smoking. Letters on the subject of smoking are in NEJM 329 (1993), 1580-2, JAMA 270 (1993), 1742-3, 2536; BMJ 307 (1993), 1381-4. The commercial aspects of smoking advertisements using Joe Camel, the AMA, are debated in JAMA 270 (1993), 1978-82. A study of smoking in Japanese doctors found that the incidence of smoking is less than the general public and calls for them to be more active in preventing smoking, AJPH 83 (1993), 1640.

A study of the cause of deaths in the USA found that about 400,000 deaths in 1990 could be attributed to tobacco, 300,000 to diet, 100,000 to alcohol, 35,000 to guns, 30,000 to sexual behaviour, 25,000 to motor vehicles and 20,000 to illicit use of drugs; JAMA 270 (1993), 2207-12.

An opinion article on "how reliable are doctor's prescriptions?" is in Bioethics Research Notes 5 (4) (1993), 29-30. It concludes that they are not very reliable, this is especially true in countries where doctors profit from the prescriptions directly, such as in Japan. A study on the prescribing of drugs in the UK that is relevant is BMJ 307 (1993), 1118-20.

There are a few recent studies on the harmful effects of radiation on health; BMJ 307 (1993), 959-66, 966-71, 1391-7. However, the link between leukemia and radiation from Sellafield nuclear reprocessing plant is "fragile" according to a recent UK government study, BMJ 307 (1993), 955, 1094; Science 262 (1993), 648-9; Lancet 342 (1993), 981, 1106; New Scientist (4 Sept, 1993), 6; (16 Oct 1993), 6; (30 Oct 1993), 10; (13 Nov 1993), 25-9. The link was too weak to be successfully brought in court. A study of US personnel exposed to nuclear tests has found increased incidence of thyroid cancer, JAMA 270 (1993), 2076-82. The latest data from Chernobyl shows a dramatic increase in thyroid cancer in children, BMJ 307 (1993), 1230. Several papers on "Why we need nuclear power" are in New Scientist (6 Nov, 1993), 3, 14-5, 34-9. In India the government is establishing controls on the use of medical x-ray equipment, BMJ 307 (1993), 1094. Germany is still dealing with cases where patients at Hamburg University hospital were exposed with very high doses of radiation, Lancet 342 (1993), 544.

The link between EMF fields and certain childhood cancer is weak, but appears to exist according to the most extensive studies, those from Nordic countries, Lancet 342 (1993), 1295-6.

Two European studies support the view that consumption of vegetables high in flavonoids, or b-carotene may reduce the risk of coronary heart disease, A.F.M. Kardinaal et al., "Antioxidants in adipose tissue and risk of myocardaal infarction: the EURAMIC study", Lancet 342 (1993), 1379-84; M.G.L. Hertog et al., "Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly study", Lancet 342 (1993), 1007-11. The recent guidelines from the FDA on dietary supplements, and labelling requirements, are summarised in FDA Consumer (Nov 1993), 8-13. Letters on the reduction in incidence in heart disease associated with vitamin E use are in NEJM 329 (1993), 1424-6. Studies on the relationship between stress and hypertension and death are in JAMA 270 (1993), 2439-43; BMJ 307 (1993), 1102-5. The benefits of moderate exercise are discussed in NEJM 329 (1993), 1730-1.

A paper showing that the daily use of sunscreen in Australia reduces skin cancer is in NEJM 329 (1993), 1147-51, 1193-4. A report from the Council of Scientific Affairs of the AMA on silicone gel breast implants is in JAMA 270 (1993), 2602-8.

A study of US gun ownership has found that rather than being protective the ownership of guns is associated with increased risk of homicide by a family member, NEJM 329 (1993), 1084-91; 1117-8. A plea for prevention of fatal bicycle accidents by use of helmets is in J. Pediatric Surgery 28: 214-6. They found that 89% of fatalities were caused by head injuries.

A US court has dismissed a claim by farmers that a CBS programme presented false data on the dangers of the pesticide Alar, Science 262 (1993), 35. A pesticide link to breast cancer is reported in New Scientist (25 Sept, 1993), 4. On the subject of carcinogens, see letters in Science 262 (1993), 638-9. The costs and benefits of lead screening are discussed in JAMA 270 (1993), 2054-5, 2555-7; Science 262 (1993), 323.

Book reviews of K.R. Foster et al. (eds), Phantom Risk: Scientific Inference and the Law (MIT Press 1993, 457pp., US$40) and L.A. Cole, Element of Risk: The Politics of Radon (AAAS Press 1993, 246pp, US$30) are in Nature 367 (1994), 227-8. Both these books suggest that the name of science is being misused in claiming that there is scientific risk associated with substances whose effects are very difficult to measure. The risks discussed include animal carcinogen testing, radiation for electromagnetic fields (EMF), and chemicals. The book on radon is extremely critical of the way standards are set in the USA, but suggests there is some risk. A recent Swedish study suggesting little risk from radon to lung cancer is G. Pershagen et al., "Residential radon exposure and lung cancer in Sweden", NEJM 330 (1994), 159-64; Science 263 (1994), 465.

A book review of V. Beral et al. (eds) Childhood Cancer and Nuclear Installations (BMJ 1993, 453pp., US$54) is in Nature 367 (1994), 421. Comments on the study reported last issue of 20,000 British soldiers exposed to radiation in various tests that found no extra cancer as a result, are in Science 262 (1993), 1976. An analysis of the possible mechanisms that might link paternal exposure to radiation to disease is in Nature 367 (1994), 678-80. A book review on the topic of nuclear weapons is Nature 367 (1994), 63-4.

A specific mutation in the p53 gene is proposed as a measure of the exposure to UV light in a paper, H. Nakazawa et al., "UV and skin cancer: Specific p53 gene mutation in normal skin as a biologically relevant exposure measurement", PNAS 91 (1994),, 360-4. A letter on the relationship between dioxin and cancer is in Science 263 (1994), 14. Measurement of lead in bone (as a result of work or pollution exposure) is possible through a technique reported in JAMA 271 (1994), 197-203, 239-40.

A commentary on the declining health in Eastern Europe is in Nature 367 (1994), 313-4. The main factors may not be economic, but lifestyle factors of tobacco abuse, diet, alcohol and obesity. Half of the gap may be due to tobacco alone. A review of the development of smoking policy is in Science 262 (1993), 1750-1, and also on risk from smoking, Science 262 (1993), 1375. Recently McDonalds has announced no smoking will be allowed in its US restaurants. A book review of J.C. Burnham, Bad Habits. Drinking, Smoking, Taking Drugs, Gambling, Sexual Misbehavior and Swearing in American History (New York University Press 1993, 385pp.) is in Science 262 (1993), 2067-8. The new program and emphasis on preventive medicine, Science 262 (1993), 1508-9, is long overdue in most countries. Diet is discussed in regard to health in Nature 367 (1994), 404; AJPH 84 (1994), 14-9; JAMA 271 (1994), 98; and coffee-associated osteoporosis in JAMA 271 (1994), 280-3. Targets for improvement in Scottish persons diet have been set, BMJ 308 (1994), 80. A paper looking at the role of free radicals and aging at the biochemical level is Biotechnology 12 (1994), 37-40.

An opinion on the reliability of doctor's prescriptions is in Bioethics Research Notes 5(Dec 93), 29-30. It discusses the reliability of randomised clinical trials, and calls for continued study of drug safety after it enters the real world of use. A similar conclusion is made in NEJM 329 (1993), 2029-30. Treatments to avoid blood-clotting (TPA, streptokinase etc) may be underused despite their proven efficacy; Scientific American (Feb 1994), 11-2. A review of the uses of aspirin is in FDA Consumer (Jan/Feb 1994). Letters on anabolic steriod abuse in the USA are in JAMA 271 (1994), 347-8.

Papers reporting the prevention of head injuries from wearing bicycle helmets are in BMJ 308 (1994), 173-6, 177; MJA 159 (1993), 719-21, 783-6.

The Russian Federation has signed a memorandum of understanding with the US FDA effectively making the FDA the safety channel for all US produced drugs and products to be distributed in Russia; GEN (1 March 1994), 35. This is saves the time and money of checking new products. European standardisation is described in TIBTECH 11 (1993), 375-8; and a new publication from WHO is WHO Expert Committee on Biological Standardization, 43rd Report (WHO Technical Report Series 840, 1994).

The results of Swedish studies which allow estimates of the risks of radon in homes causing lung cancer suggest current standards used in the UK are safe enough for non-smokers; Nature 368 (1994),97-8; but there is still uncertain data for smokers.

The study discussed in the animal genetic engineering section above on fruit fly supported the free radical theory of aging. This suggests that antioxidants would slow down aging; Science 263 (1994), 1094, 1128+. A book review of D.W.E. Smith, Human Longevity (Oxford University Press 1993, 175pp., Ł27.50) is in Nature 368 (1994), 199. A nutrition and dietary fat study in Manitoba, Canada is reported in Can. J. Public Health (1993), 389+. The possibilities for lowering population cholesterol concentrations are discussed in BMJ 308 (1994), 351-2. Letters on the economic and social consequences of being overweight in adolescence are in NEJM 330 (1994), 647. The benefits of apple eating have been claimed for centuries, and discussions are in NEJM 330 (1994), 797-8.

Some studies describe significant correlations between sugar intake and destructive activity, and hyperactivity, but a study finding no strong link is M.I. Wolraich et al., "Effects of diets high in sucrose or aspartame on the behaviour and cognitive performance of children", NEJM 330 (1994), 301-7, 355-6.

The benefits of aspirin for reducing vascular diseases is reported in studies in Antiplatelet Trialists' Collaboration, "Collaborative overview of randomised trials of antiplatelet treatment. I. Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients", BMJ 308 (1994), 81-106, ++, 71-2. Aspirin is effective at least at 325mg, and may be at lower levels, and is as good as any other agent tested.

A letter on the Delaney clause (which prohibits the addition of any carcinogen at any level to food) and cancer risk is Nature 368 (1994), 580, 582. On the topic of dioxin and cancer, Science 263 (1994), 1545-6. Environmental causes of breast cancer (see also environment section), are discussed in S.S. Epstein, "Environmental and occupational pollutants are avoidable cause of breast cancer", Int. J. Health Sciences 24: 145-50. Also on cancer risk, BMJ 308 (1994), 545. Data on cancer rates in Britain finds that except for smoking related cancer, there is no general increase in cancer, but several specific tumours are increasing, BMJ 308 (1994), 705-8. On US trends in cancer, and Sweden, which suggest some extra cancer rates, JAMA 271 (1994), 431-7. See also Lancet 343 (1994), 494-5; and book reviews in NEJM 330 (1994), 443-5.

The FDA is considering labelling nicotine, thus including cigarettes, as drugs; BMJ 308 (1994), 617; Science 263 (1994), 1555-6; Nature 368 (1994), 83-4, 382; Lancet 343 (1994), 664. When cigarettes are made, the manufacturers spray nicotine onto the dried cut leaves, and it is claimed that they increase the amount to increase the chance the smokers will become addicted. The US is already trying to stop teenagers smoking, BMJ 308 (1994), 677; JAMA 271 (1994), 643. On the politics of antismoking laws, J. Health Politics, Policy & Law 18 (1993), 787-820. A study in Michigan finds that reducing smoking would increase employment, JAMA 271 (1994), 771-6. The elimination of smoking adverts in Western Australia, and other action, is reported in BMJ 308 (1994), 395-8. A summary of action in New South Wales, Australia to stop smoking is in Lancet 343 (1994), 349. African efforts are summarised in BMJ 308 (1994), 189-91. A list of magazines that have stopped advertising tobacco is in JAMA 271 (1994), 571-6. A survey in Japanese life insurance companies found 27% of the female employees smoked, whereas the prevalence throughout Japan in women is 14% - asking what they sell; Lancet 343 (1994), 675.

The dangers of second-hand smoke have been further clarified with an animal study showing the development of arterial plaques in chickens exposed to smoke, that resemble those found in human smokers, which can lead to heart disease; Science 264 (1994), 30. As reported last issue, a urine test has shown that chemicals derived from smoke are found in non-smokers exposed to smoke, New Scientist (29 Jan 1994), 16. A Chinese study is Y. He et al., "Passive smoking at work as a risk factor for coronary heart disease in Chinese women who have never smoked", BMJ 308 (1994), 380-4; and a UK study suggesting mother's smoking is a more important risk factor for children than fathers, is D.G. Cook et al., "Passive exposure to tobacco smoke in children aged 5-7 years: individual, family, and community factors", BMJ 308 (1994), 384-9. See letters in JAMA 271 (1994), 583-5. Predicting smoking cessation may be possible during the first two weeks behaviour with the nicotine patch, JAMA 271 (1994), 589-4; see also p. 595-600.

A editorial saying that no smoker should be denied urgent heart surgery is in BMJ 308 (1994), 607-8. Several months ago the major gene responsible for bone mass loss was isolated (see previous issues; New Scientist (29 Jan 1994), 14), and the effects of lifetime smoking for a woman is estimated to be a 10% loss of bone mass in J.L. Hopper & E. Seeman, "The bone density of female twins discordant for tobacco use", NEJM 330 (1994), 387-92, 430-1. The pill may raise cervical cancer rate among smokers, New Scientist (8 Jan 1994), 16; and smoking reduces sperm density by about 13-17%; F&S 61 (1994), 35-43. A paper on the human costs of tobacco use is in NEJM 330 (1994), 907-12.

A general description of the US drug laws is in NEJM 330 (1994), 356-60. A study suggesting high tolerance to alcohol puts people at risk for alcoholism is reported in Amer. J. Psychiatry (Feb 1994), Science 263 (1994), 1094-5. The misuse of alcohol and drugs among elderly people may lead to special management schemes; BMJ 308 (1994), 608-9. In the USA about 50% of all deaths are "avoidable", i.e. being related to risk behaviour (it may be better to use the term "early deaths"); JAMA 271 (1994), 659-61; Lancet 343 (1994), 594.

The commercialisation of sunscreen, and there effectiveness, is discussed in New Scientist (22 Jan 1994), 21-2; and some link between frequent sunburn and melanoma has been shown; BMJ 308 (1994), 75-6; Lancet 343 (1994), 484. Radiation risk and cancer is debated in BMJ 308 (1994), 60; NEJM 330 (1994), 442; Lancet 343 (1994), 111, 598-9.

Germany is seeking a European ban on British beef based on fears of bovine spongiform encephalopathy; Nature 368 (1994), 178.

The risks of autoimmune disease from silicone breast implants is discussed in Lancet 343 (1994), 229, 353-4. US companies have began to pay for health damage caused by implants, Lancet 308: 555-6. There is also controversy in France, Lancet 343 (1994), 722.

Comments against making cycle helmets mandatory are in CMAJ 149 (1993), 342-4. Data suggesting helmets lower serious injury is BMJ 308 (1994), 173-6, 177. Letters on guns and homicide are NEJM 330 (1994), 365-7, 373-5; JAMA 271 (1994), 495; and on violence in the media, Lancet 343 (1994), 127-8. Lead poisoning from shooting clubs is another risk, Lancet 343 (1994), 6-7.

The US is still discussing the classification of nicotine as a drug, which is under much pressure from the tobacco producers, New York Times (29 June 1994), A1, 20; and on the US debate, JAMA 271 (1994), 1387-90, 1562; BMJ 308 (1994), 1444; JAMA 271 (1994), 1575-6; Nature 369 (1994), 691-2. The level of nicotine is claimed to be manipulated also, New Scientist (23 April 1994), 6; Nature 369 (1994), 696. The company that is said to have doubled the natural level is Brown and Williamson Tobacco Co. The FDA found its genetically modified tobacco plant, which was also being bred to increase nicotine levels. There were also claims that companies hid data about harm of nicotine, Science 264 (1994), 196-7, 766-7.

From July, Canada became the first country in the world to ban smoking from all flights of its national airlines, New York Times (29 June 1994), A20. Many countries have national bans, but this is the beginning of international bans. Canadian airlines fears losses on Japan routes, as at the moment there are only two other non-smoking flights to Japan (on Singapore Airlines). In Japan in 1993 lung cancer surpassed stomach cancer as the leading cause of death for men; Yomiuri Shinbun (24 June), 34. A comparison of the rates of cigarette smoking is D.E. Nelson et al., "Trends in cigarette smoking among US physicians and nurses", JAMA 271 (1994), 1273-5. The greatest reduction took place in 1974. Issues in how to stop young people using tobacco are discussed in AJPH 84 (1994), 543-7; Lancet 343 (1994), 1109-10; BMJ 308 (1994), 1241.

The second part of a paper on the human costs of tobacco use is NEJM 330 (1994), 975-80. On passive smoking and carcinogens, NEJM 330 (1994), 1016-7. Workplace restrictions on smoking may reduce the smoking of the smokers also, according to AJPH 84 (1994), 773-8.

Letters on the question of vascular surgery in smokers are BMJ 308 (1994), 978-9, 1435-6. Some of the arguments include the lower recovery rate if people continue to smoke after the surgery.

The link between EMF and breast cancer is debated in papers in the J. National Cancer Institute (15 June); Science 264 (1994), 205, 1658; BMJ 308 (1994), 1162-3. A study of women electrical engineers, and telephone installers, found a 38% higher incidence of breast cancer than other workers, but there is much debate as to whether there is any significance. Occupational health is discussed in JAMA 271 (1994), 1691-2; BMJ 308 (1994), 1115-6. Accusations that the French government have tried to muzzle a researcher who has studied the hazards of glycol ethers, by firing him, are in Science 264 (1994), 898-9, 1076.

The dangers of old nuclear reactors in the UK are discussed in New Scientist (7 May 1994), 4. The government has rejected a call for an inquiry into nuclear waste, Nature 369 (1994), 346; despite the finding that death from leukemia in workers was related to radiation dose, Lancet 343 (1994), 1220; Radiat. Res. 138: 224-38. The collecting of DNA from all babies born over the next five years in Cumbria has been approved by the West Cumbria research ethics committee. A letter on paternal exposure to radiation, and sperm damage is Lancet 343 (1994), 973-4. Protests in Japan against plutonium may have been involved with some recent decisions to cut back production goals, Nature 369 (1994), 596; and uranium fuel is also causing debate with Germany; Nature 369 (1994), 89. Letters on the p53 mutations associated with radon are in Lancet 343 (1994), 1158-9; and on radon risks, Science 264 (1994), 1239-30.

A New York state department of health report suggests some breast cancer in older women was associated with a chemical plant close-by; BMJ 308 (1994), 1057-8. Genetic variation in clearance of carcinogens is reported in P. Vieis et al., "Genetically based N-acetyltransferase metabolic polymorphism and low-level environmental exposure to carcinogens", Nature 369 (1994), 154-7. On the topic of toxic risks: JAMA 271 (1994), 1292-3; Science 264 (1994), 183; on pesticide poisoning, AJPH 84 (1994), 731-6; Science 264 (1994), 499-500; on dangers of carcinogens in overdone red meat, AJPH 84 (1994), 856-8; and hot dogs, Science 264 (1994), 1255; on contrasting views of the risks of dioxin between the FDA and EPA, Science 264 (1994), 1071. The use of thalidomide among leprosy sufferers in Brazil is discussed in Time (13 June), 37; Lancet 343 (1994), 1041; BMJ 308 (1994), 1061, 1437-8.

The balance between privacy and public safety in drug testing for detecting illegal drugs or dangerous ones is debated in HCR 24(2): 17-27. On drug prohibition see JAMA 271 (1994), 1635-48; Lancet 343 (1994), 967. The public disgrace of Diego Maradona at the Soccer World Cup for drug use also heightens the problem of sports use of drugs. On alcohol use: BMJ 308 (1994), 1003-6; Lancet 343 (1994), 810. The effect of alcohol on sex hormones (testesterone) in women taking the pill has been found to be much greater than that on women not taking it, Nature 369 (1994), 711.

The FDA has announced its decision on Halcion, accusing Upjohn of misconduct, Lancet 343 (1994), 1216-7; BMJ 308 (1994), 1321-2. A book review of FDA food and drug approval is Nature 369 (1994), 27-8. Debate over the safety of the potential anticancer drug, tamoxifen, is delaying clinical trials, Science 264 (1994), 1524-7; BMJ 308 (1994), 1318. An NIH advisory panel has rejected the Persian Gulf syndrome, Nature 369 (1994), 8. The reasons for the deaths of 15 patients who received an experimental drug Sorivudine in Japan has been featured in many Japanese newspapers; Yomiuri Shinbun (23 June), 27; Nature 369 (1994), 697. They dies and others became sick due to the reactions with anticancer medicines they were taking. Japanese patients are often not told they have cancer, yet are given unknown drugs, and may also go to other doctors freely, increasing the chances of such a drug reaction.

A discussion of eating natural foods to obtain vitamins is Newsweek (25 April), 42-7; and on antioxidants, NEJM 330 (1994), 1148-9. A Tohoko University study has suggested b-carotene is useful to treat Alzheimer's; Yomiuri Shimbun (28 June 1994), 31. However, antioxidants may have dangers, Science 264 (1994), 500-1. A vitamin E supplement does not appear to reduce lung cancer in male smokers, and may actually make it worse; NEJM 330 (1994), 1029-35, 1080-1, 1608-9. The idea of taking vitamins while smoking seems contradictory to me - the best way to reduce the risk is to quit smoking! The difficulties of interpreting cholesterol data are debated in BMJ 308 (1994), 1025-9. A review is W.C. Willet, "Diet and health: What should we eat?", Science 264 (1994), 532-7. Also on food, FDA Consumer (May 1994), 15-9; Lancet 343 (1994), 1127-30. Bone density seems to be linked to increased milk consumption (calcium intake), BMJ 308 (1994), 939-41, 930-1; which reduces the risk of disability in later life, JAMA 271 (1994), 1093-8.

A settlement for payments for breast implant health damage is reported in Lancet 343 (1994), 845, 1153. On their potential danger to infants, Lancet 343 (1994), 1043-4. Cosmetic labels are discussed in FDA Consumer (May 1994), 20-1.

The benefits of exercise are shown in T.A. Lakka et al., "relation of leisure-time physical activity and cardiopulmonary fitness to the risk of acute myocardial infarction in men", NEJM 330 (1994), 1549-54. The wrong sort of exercise can cause harm, e.g. bungee jumping can cause visual loss, Lancet 343 (1994), 853. A review of preventive medicine is NEJM 330 (1994), 1589-95; also JAMA 271 (1994), 1301, 1566, 1704-5. Health risk behaviours in young US people are discussed in JAMA 271 (1994), 1311. A paper on the complex relationship between religion and health, is SSM 38 (1994), 1475-82.

A debate over what the safe level of blood alcohol concentration is for driving is in BMJ 308 (1994), 1055-6. They say less than 0.8g/l, the current level. However, the studies to find a safe level differ, and we could suggest that a much lower level be adopted. In some countries, such a Japan, a total ban on drinking is generally followed by drivers. A US study on the alcohol-related causes in traffic deaths is JAMA 271 (1994), 1397-8. Speed cameras have been linked to reduced deaths and slower driving, BMJ 308 (1994), 999, also 1176. Cycle helmets are called for in AJPH 84 (1994), 653-6; BMJ 308 (1994), 1164-5. Papers on child injury control include: AJPH 84 (1994), 537-9; J.A. Waller, "Reflections on half a century of injury control", AJPH 84 (1994), 664-70; BMJ 308 (1994), 1312-3. Drowning rates of infants in the USA have remained similar over the last ten years, despite the access to pool fencing, but deaths in older children have fallen, JAMA 271 (1994), 1606-8.

Papers on the subject of violence and how to reduce it include: AJPH 84 (1994), 539-41, 612-7; JAMA 271 (1994), 1147+1281-2.

On May 18, 1994 the Japan Pharmaceutical Manufacturers Association released guidelines aimed at eliminating some part of the corruption found in Japanese pharmaceutical research. The new guidelines apply to four main ares: research commissions that accompany requests for clinical tests; travel expenses for organising and attending study meetings; travel expenses for attending academic conferences to present test results; and donation of gifts and equipment and entertainment (Ross, C. "Japan's medical information transparency", Lancet 343 (1994), 1418-9.). In fact the MHW had reservations about the public release of the guidelines, as was reported in national newspapers. However the guidelines do not mention any penalties. The guidelines detail ways that have been used to pay extra rewards to health care institutions and health care professionals, and they are a significant part of the financial income for a significant number of facilities. For example, excessive amounts of money have been given to doctors for conducting clinical tests, to promote the claims of the drugs under development. Physicians have solicited large sums of money from some companies where the clinical trial success or failure will have large financial implications. All the necessary trials for drug approval are conducted at universities and research organisations, and there have been cases of bribery.

On May 20, 1994 the chairman of Japan's fourth largest pharmaceutical's wholesaler, resigned to take public responsibility for insider trading among employees, and for the sale of sorivudine, which has led to the deaths of 18 people. The company had reached settlements with 10 of the 23 families of patients who died or had serious consequences as a result of using it, by May 1994 (Ross, 1994). In this incident these court cases are avoided, and the families received compensation rapidly for Japanese malpractice cases. However, the government also imposed a penalty of a 105 day suspension of production at the Nippon Shoji Kaisha Ltd. Okayama prefecture factory (Japan Times, 2 Sept., 1994, 1). This penalty was in response to the company failing to report the deaths of two persons during clinical trials. This is the longest ever suspension of products because of an infringement of the Drugs, Cosmetics and Medical Instruments Law. Kyoto prefecture also decided not to purchase any of the 179 medicines or cosmetics that the company makes.

Sorivudine was an antivirus drug approved in 1993 for use in shingles, herpes zoster. The drug had especially severe side effects in some people who were taking anti-cancer medication (especially the drugs Tegafur and Doxifluridine), but many people are not told what medicine they are taking so they suffered. The problem of lack of knowledge of medicines that are consumed is much more general. The patients can read the number codes of drugs in books, but most drugs do not come with labels. The MHW also decided following this case to instruct drug manufacturers to provide doctors with detailed information concerning the side effects and toxicity of their products, in particular 12 of the 50 anticancer drugs used in Japan. Many of these drugs cause side effects yet are only effective in 20-30% of patients, and are not used overseas. One of the drugs included is a new drug, Irinotecan Hydrochloride, which was approved despite the deaths of 22 people during trials.

A discussion of drug trials is FDA Consumer (July 1994), 16-9; and a book review of M.W. DeGregorio & V.J.Wiebe, Tamoxifen and Breast Cancer, Yale University Press 1994, 112pp., US$10, is New Scientist (11 June 1994), 44. In the UK a court case on Halcion has been decided with benefits to UpJohn for libel in a BBC program, and to the opposing professor in a counter-libel case, BMJ 308 (1994), 1455-6; Lancet 343 (1994), 1422. Racial differences in blood vessel dilation are reported in New Scientist (2 July 1994), 7.

The US is still discussing the classification of nicotine as a drug, and it appears the FDA will regulate them in this way, GEN (August 1994), 41; Science 265 (1994), 863; New Scientist (13 Aug 1994), 10; NEJM 331 (1994), 123-5; BMJ 309 (1994), 7. The panel of the FDA set up to examine the question judged it to be addictive. The question is now to define the lowest level which is addictive, Nature 370 (1994), 402. Labelling is debated in JAMA 272 (1994), 312-4. Mississippi state is suing the 13 major US tobacco companies to pay for the tobacco-related medical costs incurred by the state; BMJ 308 (1994), 1455. India has proposed a law to ban all tobacco advertising, to prohibit smoking in public, and to ban the sale of tobacco within 100m of educational institutions, medical colleges and hospitals; BMJ 308 (1994), 1528-9.

Also on tobacco, BMJ 309 (1994), 59; Lancet 343 (1994), 1492; AJPH 84 (1994), 1081-93; Amer.J. Med.Sci. 308: 32-4. Smoking cessation is discussed in BMJ 308 (1994), 1478-82; JAMA 271 (1994), 1940-7; and the lack of efforts by Japanese doctors in CMAJ 150 (1994), 1673-4. Smoking in adolescence is a negative factor for obtaining high peak bone mass; BMJ 309 (1994), 230-5. Publications about environmental smoke exposure are reviewed in JAMA 272 (1994), 133-6, and a study showing increased risk of cancer in exposed nonsmokers is E.T.H. Fontham et al., "Environmental tobacco smoke and lung cancer in nonsmoking women. A multicenter study", JAMA 271 (1994), 1752-9.

Zurich is considering legalising the use of heroin among some addicts. Australia is also considering drug laws, BMJ 308 (1994), 1526-7. Letters on drugs are in NEJM 331 (1994), 126-9. However, in New York City a link between cocaine use and firearms is found, JAMA 272 (1994), 43-6. Is may be because of lack of money, and gang systems, but it makes a note of caution.

A paper reporting effects of Chernobyl in Berlin is K. Sperling et al., "Significant increase in trisomy 21 in Berlin nine months after the Chernobyl reactor accident: temporal correlation or causal relation?", BMJ 309 (1994), 158-62, 139-40. 12 cases were found instead of the expected 2 or 3, and the low iodine content of the Berlin diet is suggested as a cause for absorption of the radioactive iodine from Chernobyl. Thyroid cancer in children from Chernobyl is reported, Lancet 344 (1994), 184, 259. However, no extra childhood leukemia is reported in Finland or Sweden, BMJ 309 (1994), 151-4, 154-7. Chernobyl is also being still discussed in the media, BMJ 309 (1994), 208-9; and other Soviet radiation risks are mentioned in Scientific American (July 1995), 20-1. General childhood cancer links are discussed in a book review in BMJ 309 (1994), 136-7.

Increased thyroid cancer is reported in atomic bomb survivors in S. Nagataki et al., "Thyroid diseases among atomic bomb survivors in Nagasaki", JAMA 272 (1994), 364-70. See book reviews of James V. Neel's autobiography in JAMA 272 (1994), 407-8; New Scientist (9 July 1994), 42-3. A US-Japan joint research group has said that the DNA of descendents of atomic bomb survivors is not affected by the radiation their parents were exposed to, Yomiuri Shimbun (9 Aug 1994), 22. The financing of a radiation effects research center in Japan is discussed in Science 265 (1994), 727. Radon risks are debated in Lancet 344 (1994), 127-8, 143-4; Scientific American (Aug 1995), 14-5. EMF links are debated in Science 264 (1994), 1658. Prevention of skin cancer by avoiding the sun is called for in BMJ 309 (1994), 285-6.

A US federal court has approved the biggest liability settlement in US history, with US$4.25 billion awarded to the women who were damaged by silicone breast implants (1 Sept). There were objections because foreign women will receive 40-90% of the payments to US women. There are 90,000 women included, with 500 foreign, in the registrations to date. The range of personal claim varies from $104,000 to $1.4 million in the USA. Papers providing data on health damage of breast implants include S.E. Gabriel et al., "Risk of connective-tissue diseases and other disorders after breast implantation", NEJM 330 (1994), 1697-702; JAMA 272 (1994), 271-4; BMJ 309 (1994), 349. An alternative Soya bean oil breast implant has begun clinical trials in the USA, New Scientist (13 Aug 1994), 12.

Research suggests that by changing diet people can reduce the risk of cancer by one third or more, BMJ 308 (1994), 1610-4. The consumption of soya is one of the apparent benefits, New Scientist (9 July 1994), 14-5. The health effects of fat consumption are discussed in BMJ 309 (1994), 2-3, 11-5; Lancet 343 (1994), 1445, 344: 276. Overweight in the USA is increasing, JAMA 271 (1994), 1788-9, 272: 205-11, 238-9. Debate over the effects of sugar on children's behaviour is in NEJM 330 (1994), 1901-4. Doubts on the role of fibre and placebo in the effect of bran on constipation are in Lancet 344 (1994), 3. Baby milk formulas are discussed in Lancet 343 (1994), 1492. Bones of postmenopausal women can be aided by potassium bicarbonate, NEJM 330 (1994), 1776-81, 1821-2. Risks of alcohol consumption and where to place a safe limit are discussed in BMJ 308 (1994), 1549-52; New Scientist (2 July 1994), 12-3.

The trend to make more drugs available over the counter is discussed in Lancet 343 (1994), 1374-5; JAMA 272 (1994), 30-1; and on rational prescribing, MJA 160 (1994), 564-7. Beneficial effects of vitamin C have been claimed for emphysema, following hamster research, Science 265 (1994), 871; PNAS (1 August).

Pesticide harms are discussed in BMJ 308 (1994), 1520-1; Science 264 (1994), 1829-30; J. Public Health Med. 16: 141-4; and environmental estrogens in Science 265 (1994), 308-10. On thalidomide, Lancet 344 (1994), 196-7. On public health, Lancet 344 (1994), 141-2; AJPH 84 (1994), 1077-80. Cycle injuries and mandating helmet usage are discussed in BMJ 308 (1994), 1521-2, 1534-7, 1537-40; also Lancet 343 (1994), 1504.

Occupational disease is discussed in Lancet 344 (1994), 4-5; BMJ 308 (1994), 1581-2; Scientific American (Aug 1995), 89. Farm safety is debated in AJPH 84 (1994), 1171-7.

High levels of lead in wine made from vineyards in France around major roads have been found, and can be traced through vintage years, Lancet 344 (1994), 326. Lead poisoning is discussed in JAMA 272 (1994), 277-83, 284-91, 315-6; Lancet 343 (1994), 1495-6. There has been a substantial decline in blood lead levels in the USA, linked to replacement of lead in gasoline and in cans.

The WestLakes Research Institute in the UK, funded by British Nuclear Fuels is starting to collect a bank of blood and DNA samples from all the estimated 10,000 babies born in west Cumbria over the next 3-5 years; GenEthics News 2 (1994), 1-2. In addition to general genetics research they will also look at mutation rate. Samples will be taken with consent of parents from he umbilical cord.

The effects of radiation on children's leukemia are dismissed in BMJ 309 (1994), 501-5. On the general dangers of low level radiation, EST 28 (1994), 488-92A; Chernobyl, Nature 371 (1994), 556; and on radon, Lancet 344 (1994), 750-1. The Japanese radiation center funding is discussed in Science 265 (1994), 727. Beef irradiation is being called for in the USA to stop E. coli infections, Lancet 344 (1994), 397.

A study in the US finds that passive smoking increases by 20-70% the chance of heart disease, Lancet 344 (1994), 465. A report from the American Heart Association finding passive smoking affects the health of children is JAMA 272 (1994), 841. Also on smoking and ill-health, Lancet 344 (1994), 629-30; NEJM 331 (1994), 618; AJPH 84 (1994), 1235-42; and on cigarette regulation by the FDA, Science 265 (1994), 863-4. Drug policy is discussed in NEJM 331 (1994), 748-52, 537-9. On drinking alcohol, AJPH 84 (1994), 1402-6, 967-8; and on caffeine dependence, JAMA 272 (1994), 1043-8, 1065-6.

The Canadian silicone breast settlement is considered unfair, as it is less than US women, Lancet 344 (1994), 465-6; BMJ 309 (1994), 626-7. On studies of the leakage of silicone, Science 265 (1994), 1654.

Diet is discussed in Stevens, J. et al. "Attitudes toward body size and dieting: Differences between elderly black and white women", AJPH 84 (1994), 1322-5; Lancet 344 (1994), 461; BMJ 309 (1994), 555-7; NEJM 331 (1994), 8215-6. Free radicals and disease are discussed in Lancet 344 (1994), 721-4, 793-5, 796-8; NEJM 331 (1994), 611-4. The risk factors in lifestyle choice are debated in AJPH 84 (1994), 1214-7; JAMA 272 (1994), 568; Lancet 344 (1994), 390-1. The regulation of foods & drugs is discussed in Scientific American (Sept 1995), 99-101.

The Japanese ban on sorivudine, a drug against shingles, that reported last issue, is in BMJ 309 (1994), 627; Nature 371 (1994), 89-90. Questions about the anti-depression drug Prozac and cancer are in BMJ 309 (1994), 487; Scientific American (Sept 1995), 22-3. Diethylstilboestrol problems with cancer are still being reported, Brit. J. O&G 101 (1994), 748-50. Medical device risks and regulation is in JAMA 272 (1994), 955-6, 968-9. The WHO Criteria on medicinal drug promotion are in IDHL 45: 229-34. Children's use of drugs that are available over-the-counter is debated, Lancet 344 (1994), 754; and a US survey,JAMA 272 (1994), 1025-30, 1063-4.

Dioxins are detectable in the blood of Swedish phenoxy herbicide workers, Lancet 344 (1994), 611-2. Agent Orange is being linked with birth defects, Time (26 Oct), (17 Oct), 6. The risks of low levels of chemicals are debated in Science 265 (1994), 1157, 1507; Scientific American (Sept 1995), 112; Nature 371 (1994), 214. The EPA is campaigning for safer chemicals, Science 265 (1994), 1519; but it is being challenged on its decision that dioxins probably cause human cancer, Nature 371 (1994), 272. On the general dangers of industrial pollution, BMJ 309 (1994), 425-6. Mercury in fish is reviewed in FDA Consumer (Sept 1994), 5-8. Lead pollution is is falling, but still detectable, JAMA 272 (1994), 999; SSM 39 (1994), 757-66.

The problems of dental materials are discussed in BMJ 309 (1994), 620-2. Osteoporosis and exercise is reviewed in BMJ 309 (1994), 400-3; and benefits of milk consumption are reported in, AJPH 84 (1994), 1319-22.

Intervention for habitual drinkers may save lifes according to a study, NEJM 331 (1994), 513-7; and other drugs may be useful for testing, NEJM 331 (1994), 518-22. Cycle helmets are discussed in BMJ 309 (1994), 541-2.

A new European Medicines Evaluation Agency (EMEA) began to operate in London from 1 January; Gene Therapy Newsletter 4: 22- 3. It is established by EC Regulation 2309/93, which outlined the new European Community guidelines on the authorisation of medicinal products for human and veterinary use. A study of horsemeat imports from the USA has found they have caused worm infections in thousands of Europeans, New Scientist (1 Oct 1994), 5. Food control in the Caribbean is reviewed from a conference in IDHL 45 (1994), 391-3. On possible changes to the FDA see Biotech 13 (1995), 7, 25-9.

There is increasing evidence that asthma is related to traffic fumes, New Scientist (1 Oct 1994), 4. Traditional life in Navajos in the USA means smoky houses with increased respiratory disease. New fuel, namely roots to burn is being tried, New Scientist (15 Oct 1994), 11.

Shanghai has baned smoking in many indoor public places, BMJ 309 (1994), 1460; and New York City has also banned smoking (to take effect from April). A study showing that tobacco smoking kills about one in two of smokers is Doll, R. et al. "Mortality in relation to smoking: 40 years' observations on male British doctors",BMJ 309 (1994), 901-11, 889-91; New Scientist (15 Oct 1994), 4. The USA is still moving to make nicotine a regulated drug, New Scientist (13 Aug 1994), 10; NEJM 331 (1994), 1531-3. Studies finding tobacco money influences policy are Moore, S. et al. "Epidemiology of failed tobacco control legislation", JAMA 272 (1994), 1171-5 (US federal government); Glantz, S.A. & Begay, M.E. "Tobacco industry campaign contributions are affecting tobacco control policy- making in California", JAMA 272 (1994), 1176-82, 1217-8. More on smoking hazards, CMAJ 151 (1994), 508-11; CJPH 85: 82-109; BMJ 309 (1994), 937-9, 1036-7; Lancet 344 (1994), 942, 1357; JAMA 272 (1994), 1724.

A study in the UK found that women are more likely to change their purchases of tobacco if the price changes, Townsend, J. et al. "Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity", BMJ 309 (1994), 923-7. The removal of an advert from UK television because it appealled more to teenagers than adults is documented in Hastings, G.B. et al. "Cigarette advertising and children's smoking: why Reg was withdrawn", BMJ 309 (1994), 933-7. A study of the costs on work is Hocking, B. et al., "Cost to industry of illnesses related to alcohol and smoking. A study of Telecom Australia employees", MJA 161: 407-12. At least 25% of the sick leave was due to these two factors, and if it is the same for all workers in Australia the cost would be at least A$2 billion a year - mostly from smoke. Reasons why people smoke are discussed from a US survey in JAMA 272 (1994), 1648-9.

A study in Sweden has found that the drug simvastatin can safely lower cholesterol in older persons and reduce heart disease, Lancet 344: 1383-9. However a study finding little link between cholesterol and coronary heart disease in persons over 70 years age is JAMA 272 (1994), 1335-40, 1372-4. A study suggesting aging in men is associated with a lack of when to know how to stop eating, JAMA 272 (1994), 1601-6. A positive effect from consuming green vegetables in reducing chances of a type of blindness, macular degeneration, is reported, JAMA 272 (1994), 1413-20, 1455-6. Carotenoids were associated with a reduced risk (who said carrots are good for sight?). Also on diet and heart disease, Lancet 344 (1994), 1358. An Indian study showing higher incidence of heart disease in rural areas, which also correlated with less educated and increased smoking is Gupta, R. et al. "Educational status, coronary heart disease, and coronary risk factor prevalence in a rural population of India", BMJ 309 (1994), 1332-6. Counseling can improve health as shown in Dracup, K. et al. "Management of heart failure. II. Counseling, education, and lifestyle modifications", JAMA 272 (1994), 1442-6. See also a book review in Nature 372 (1995), 329.

The use of steroids in young Canadians is still increasing despite warnings, CMAJ 151 (1994), 844-6. Alcohol abuse is discussed in JAMA 272 (1994), 1672-7, 1733, 1782-7. The WHO has denounced any benefits of mild alcohol consumption, and said it is bad to give any good image to alcohol, BMJ 309 (1994), 1249; another study suggesting mild consumption is positive is Doll, R. et al. "Mortality in relation to consumption of alcohol: 13 years' observations on male British doctors", BMJ 309 (1994), 911-8. On drug use in young Australians, MJA 161 (1994), 566-8, 569-70; and a book review, Nature 372: 52-3. The problems of food additives in children's behaviour are discussed in MJA 161 (1994), 581-2.

Letters on breast implants are in NEJM 331 (1994), 1231-4; Lancet 344: 1451-2, 1499. These follow claims that there is little damage from the implants, in NEJM 330 (1994), 1697-702, as reported earlier.

German data has now been released after changes to the data protection law, and it links dioxin to immune system damage, New Scientist (10 Sept 1994). Dioxin and damage it causes are discussed in Science 266 (1994), 349-52, 1141-5, 1162, 1628-9. The EPA and environmental estrogens is discussed in letters in Science 266 (1994), 525-8. The role of doctors in environmental health debates is increasing, CMAJ 151 (1994), 1048-50.

The link between DNA damage and sunburn and UV light is becoming clearer, Lancet 344 (1994), 1499; Nature 372 (1995), 413-4, 730-1, Ziegler, A. et al. "Sunburn and p53 in the onset of skin cancer", Nature 372 (1995), 773-6.

The US radiation regulations are being changed, Science 266 (1994), 1311; though a study finding little error with current estimates of risk is IARC Study group on Cancer Risk among Nuclear Industry Workers, "Direct estimates of cancer mortality due to low does of ionising radiation: an international study", Lancet 344 (1994), 1039-43, 1037. Continued radioactive pollution at Dounreay in the UK is unexplained, New Scientist (26 Nov 1994), 4.

A library is being planned for the 250,000 documents so far assembled to look at the human radiation experiments in the USA, Science 266 (1994), 1467. Two book reviews of interest about the history of the atomic bomb are in Science 266 (1994), 466-8, 663-4. People who cleaned up Chernobyl have been found to have a higher rate of stomach and lung cancer, and several other diseases, BMJ 309 (1994), 1321, see also pp. 1298-301. In Japan all major parties have agreed with the plutonium recycling policy, Nature 372 (1995), 491. A study finding a high incidence of bone cancer linked to radium in drinking water is prompting further study to see whether the risk is significant and the radium should be removed, CMAJ 151 (1994), 565+. The dangers of radon from well insulated houses that are being made to protect the environment are discussed in Nature 372 (1995), 327.

A legal review from a US case is Annas, G.J. "When should preventive treatment be paid for by health insurance?", NEJM 331 (1994), 1027-30. On preventive health care, JAMA 272 (1994), 1315; BMJ 309: 1168, 1449; CMAJ 151 (1994), 521-2; IDHL 45 (1994), 394-6; NEJM 331 (1994), 1156-9;World Health Forum 15 (1994), 340-4. The health risks of low temperature are discussed in BMJ 309 (1994), 1029-30.

Ancient lead from smelting during the Roman Empire days has been detected in Greenland ice, New Scientist (1 Oct 1994), 14. A review finding only some intelligence loss in exposure to lead in children is BMJ 309 (1994), 1189-97. Air pollution and lung disease is reviewed in Lancet 344 (1994), 930-3.

The risks of anesthesia are decreasing in NSW, Australia, MJA 161: 585-93. Cats and leukemia are possibly linked if the cat is infected with feline leukemia virus, Lancet 344 (1994), 971-2.

The benefits of cycle helmets are discussed in Lancet 344 (1994), 965; JAMA 272 (1994), 1506-11, 1535-8; and on seat belt benefits, AJPH 84 (1994), 1732-7. The dangers of firearms are discussed in JAMA 272 (1994), 1246, 1406-9. A study showing increased injury risk in night workers is Lancet 344 (1994), 1137-39, 1099-100; and on workplace homicide in health workers in the USA, JAMA 272 (1994), 1686-8. Video-game epilepsy is reviewed in Lancet 344 (1994), 1102-3.

A report in French on the ethics of drug addiction from the French National Consultative Ethics Committee is in Les cahiers No.2, 3-53. Several papers on the ethics and law of drug abuse are JLME 22 (1994), 197-256. The issue of legalising marijuana for pain relief is also discussed in BMJ 309 (1994), 1532-3, and it is legal in ACT, Australia. A UK survey has found a great increase in people's knowledge of illicit drugs in the last 5 years, BMJ 310 (1995), 20-4.

On alcohol use, AJPH 84 (1994), 1913-7; Am. J. Psychiatry 151 (1994), 1723-34. A study of the French case of low heart disease associated with moderate drinking of red wine, which doesn't recommend its general use is Criqui, M.H. & Ringel, B.L. "Does diet or alcohol explain the French paradox?", Lancet 344 (1994), 1719-23. Vitamin E may be safer, and is discussed in Lancet 345 (1995), 170-5; NEJM 332 (1995), 1720-1.

In Japan, the Ministry of Health and Welfare has introduced some changes to the regulation of morphine, to make it easier to use. In 1983 only 40kg was used, in 1993, 504kg was used, but still some doctors are reported to be against it for reasons of lack of knowledge, fear of drug addition, pain relief being a sign of defeat in medical care, and the strict control; Yomiuri Shimbun (4 March 1995), 1.

Canada has revealed its plans for charging those who apply for regulatory permission for biotechnology or pharmaceutical products user fees, GEN (15 Jan 1995), 20. New risk assessment laws may be put in effect in the USA, Nature 373 (1995), 180; BMJ 310 (1995), 137. European medicine assessment following the establishment of the new agency is discussed in Lancet 345 (1995), 1-2.

Silicone breast implants are discussed in Lancet 345 (1995), 319. The psychology of breast implants is discussed in BMJ 309 (1994), 1649-52. Dental material effects are debated in BMJ 310 (1995), 58.

Ethical and etiquette issues regarding reducing the risk of cardiovascular disease are debated in Lancet 344 (1994), 1586-7. Stress is another factor, Lancet 344 (1994), 1713-4; Lancet 344 (1994), 1583-4; 345: 140-1. A book review of Marcus, A.I. Cancer from Beef. DES, Federal Food Regulation, and Consumer Confidence (John Hopkins Uni. Press, 1994, 235pp., US$38.50) is in Science 267 (1995), 394. Also on diet, NEJM 332 (1995), 339-40; Lancet 345 (1995), 269-7, 273-8. Calcium is discussed in JAMA 272 (1994), 1942-7.

Smoking and health is discussed in Lancet 344 (1994), 1627; 345: 315; BMJ 310 (1995), 124; JAMA 272 (1994), 1825-31. Diet also affects lung health, BMJ 310 (1995), 75-6. Asthma in New Zealand is discussed in Pearce, N. et al. "End of New Zealand asthma mortality epidemic", Lancet 345 (1995), 41-4, also p.2-3. The cases were linked to the drug fenoterol. See also NEJM 332 (1995), 133-8, 181-2. NZ has lost its Public Health Commission, Lancet 344 (1994), 1761.

Several studies of plants around the US Navy's 90km long submarine radio network antenna's have found enhanced growth, said to be sue to the electromagnetic radiation; Science 267 (1995), 451. A study finding that mercury increases the damage caused by radiation is introduced in EST 29 (1995), 18A. Lead screening is being reduced in the USA, Lancet 344 (1994), 1587-8 Dioxin risks and the EPA report (see also environment section) are discussed in EST 29 (1995), 24-5A+.

Reducing falls among elderly persons is discussed in NEJM 332 (1995), 268-9.

A report on the results of a meeting in Chelyabinsk, Russian in which the results of a 30 year study on the effects of plutonium pollution on cancer rates in persons living down a river were made public is Science 267 (1995), 1084-6. The data has much potential for developing better safety guidelines. There has been concern over the funding of future studies of the survivors of the Japanese atomic bombs, Science 267 (1995), 611, 1077; Nature 374 (1995), 106, but the National Academy of Sciences will continue to pay the US share of the project, Science 267 (1995), 951. In the UK, as mentioned last issue, there will be a DNA database set up in Cumbria around the Sellafield reprocessing plant, Nature Medicine 1 (1995), 105. There has been much controversy over the transport of radioactive materials in the open sea by Japan; Nature 374 (1995), 7; New Scientist (21 Jan, 1995), 9; (4 Feb), 7; and on the 21 March Chile forced the ship out of its waters fearing a pollution disaster with the plutonium. On general fears, Scientific American (March 1995), 28-9.

A review of Proctor, R.N. Cancer Wars: How Politics Shapes What We Know and Don't Know About Cancer (Basic Books 1995, 356pp., US$25) is Nature 374 (1995), 417-8. A mistake in asbestos regulations in the 1960s in UK buildings is likely to cause many deaths, and there is concern also about current regulations, New Scientist (11 March, 1995), 4. US lead regulations are being criticised again, Science 267 (1995), 1089-90; and on lead and intelligence, BMJ 310 (1995), 397. A letter on the difficulties of assessing low level risk exposures is Science 267 (1995), 603-4. Drinking water in Australia is also a hazard to a persons health, MJA 162 (1995), 115-6. On fungicide regulation, Science 267 (1995), 1080-1. A review is Meulenberg, E.P. "Immunoassays for pesticides", EST 29 (1995), 553-61. On public health in general, Lancet 345 (1995), 597-9, 636; Scientific American (April 1995), 124-30.

There is a growing use of medicinal plant substances in the US, which is causing the FDA to examine them more, JAMA 273 (1995), 607-9. An historical study of drug prescribing is in Marks, H.M. "Revisiting The origins of compulsory drug prescriptions", AJPH 85 (1995), 109-15. The dangers of suicidal abuse of drugs is discussed in MJA 162 (1995), 174-5. Assessment methods for drugs in general are also discussed in Nature 374 (1995), 204; Lancet 345 (1995), 375; AJPH 85 (1995), 10-3, 18-9; Int. J. Health Services 25 (1995), 153-65; and a review is Kessler, D.A. & Feiden, K.L. "Faster evaluation of vital drugs", Scientific American (March 1995), 48-54.

A study in New Zealand has found a significant decline in smoking among young people between 1960s and the 1990s, suggesting the efforts to change attitudes and smoking policies may be working, NZMJ 108: 85-8. A US study has found the rate of decline in smoking has decreased since 1985, especially among blacks, suggesting advertising campaigns are having some effect, AJPH 85 (1995), 34-40. There are also mixed results in the adult population, AJPH 85 (1995), 156-63, 183-92, 193-200, 201-8.

A study has found that non-smokers are more likely to develop heart disease than smokers from the same amount of smoke exposure, because their bodies have not built up resistance to the chemicals in the smoke, Japan Times (6 April 1995), 20. Smoking has now been linked to non-insulin dependent diabetes, BMJ 310 (1995), 555-9. In general on health affects, BMJ 310 (1995), 396.

Austria has made a draft law to ban smoking in many public buildings, but it is still to pass the Parliament. Japan is also considering tightening their smoking regulations for commercials, in response to a WHO call for more measures, Japan Times (30 March 1995), 3. New York City has passed a new law which has placed strict limits on where people can smoke (i.e. not in restaurants with more than 35 persons, nor sitting down in bars). A discussion of smoking policies in 8 US states is JAMA 273 (1995), 531. A Californian judge has ruled that the diversion of antismoking money to causes other than smoking prevention is illegal, JAMA 273 (1995), 610-1.

In the UK legal aid to help 200 ex-smokers make claims against the tobacco industry has been given to call in expert witnesses to assess the case, BMJ 310 (1995), 349. There is also a growing number of lawsuits in the USA, Lancet 345 (1995), 574.

The debate between moderation or abstinence for alcoholic recovery is debated in Newsweek (27 March), 49. Mortality and alcohol is debated in BMJ 310 (1995), 325-6; AJPH 85 (1995), 16-7, 61-6; Carmelli, D. et al. "World-War II-Veteran male twins who are discordant for alcohol consumption: 24 year mortality", AJPH 85 (1995), 99-101. They found 24 deaths in 24 years of follow-up among abstaining twins and 14 deaths among twins who were mild drinkers, and conclude there is some protective effect, however, that it is lost in smokers.

A discussion of whether there is an early origin of coronary heart disease risk is BMJ 310 (1995), 411-2, 423-7, 428-32, 432-6, 436-9. Immigrants from India have higher serum cholesterol concentration after living in the UK, which is not very surprising, Lancet 345 (1995), 405-9. However it can lead to health problems. A letter on the lack of knowledge about effects of stress is Lancet 345 (1995), 589. On obesity, Scientific American (March 1995), 34-5; AJPH 85 (1995), 20-5, 236-9; NEJM 332 (1995), 673-4. The amino acid requirements of diet can be guessed from the composition of the body, but ideally a better standard should be developed, PNAS 92 (1995), 300-4. Silicone breast implants may not result in increased connective tissue damage according to a UK study, Lancet 345 (1995), 642.

The paper by Goldsmith in this issue discusses radiation and health A call to ban atomic weapons is BMJ 310 (1995), 993-4; however, France has announced it will resume testing in the South Pacific. The French embassy in Australia was bombed, and the fire service decided not to respond since no human lives were in danger - so the fire burnt! It is a sign of the opposition to the tests in the South Pacific - but raises questions about the politicalisation of emergency services! Health effects of atomic bomb tests are discussed in Watanabe, K.K. et al. "Cancer mortality risk among military participants of a 1958 atmospheric nuclear weapons test", AJPH 85 (1995), 523-7; Nature Medicine 1 (1995), 190. The death and disease rate of children exposed in Chernobyl are discussed in NS (1 April 1995), 7; Nature 375 (1995), 365; Lancet 345 (1995), 1168; BMJ 310 (1995), 801.

The adverse health of uranium miners is reported in a study 23 years after the people stopped mining, Roscoe, R.J. et al. "Mortality among Navajo Uranium Miners", AJPH 85 (1995), 535-40. A German plutonium plant has been blocked, and the waste will be processed at Sellafield, NS (8 April 1995), 8. A discussion that supports radiation damage is Kinlen, L.J. et al. "Childhood leukemia and non-Hodgkin's lymphoma near large rural construction sites, with a comparison with Sellafield nuclear site", BMJ 310 (1995), 763-8. dismisses a general association between Sellafield radiation and paternal mutation damage is Tawn, E.J. "Leukaemia and Sellafield; is there a heritable link?", JMG 32 (1995), 251-6; BMJ 310 (1995), 1198. A comment in Japan against the Japanese policy on reprocessing is Japan Times (20 April 1995), 18. An editorial on nuclear power is Nature 375 (1995), 91-2.

Letters on cancer risk and electromagnetic fields are in Nature 375 (1995), 22-3; NS (18 March 1995), 18. They show the difficulty in finding any effect on gene expression, or biological explanation for the epidemiological data. A paper reporting a model on the survival of microbes after exposure to pulsed electrical fields is in J. Sci. Food Agric. 67 (1995), 93-9. Papers on the medical use of X-rays include BMJ 310 (1995), 614-5, 640-2.

A paper looking at the role of UV A in solar mutagenesis, i.e. not only UV B is involved, is PNAS 92 (1995), 2350-4. A study dismissing increased skin cancer in Chile is Schein, O.D. et al. "Ocular and dermatologic health effects of ultraviolet radiation exposure from the ozone hole in Southern Chile", AJPH 85 (1995), 546-50. A paper showing that the UV protection of cotton may increase after washing, perhaps by shrinking of the holes is MJA 162 (1995), 422-5.

An in vitro testing system to replace more animal tests is being sought, and a review of some FDA contracts is GEN (15 April 1995), 6-7; Science 268 (1995), 356-7. The FDA proposals to streamline drug testing are reviewed in GEN (1 April 1995), 3, 28; and a view from a patient is FDA Consumer (March 1995), 6-7. In general on the FDA, JAMA 273 (1995), 1066-7. Drug trials are discussed in BMJ 310 (1995), 1279, 1305-6; and cancer survival rates in JAMA 273 (1995), 1000; BMJ 310 (1995), 617, 1352-3.

A survey of the ability of doctor's to calculate drug doses found poor performance, BMJ 310 (1995), 1173-4. A study finding 11% of information from drug sales reps contradicted information available to them is JAMA 273 (1995), 1296-8. In the UK special licensing may be given for herbal medicines, BMJ 310 (1995), 1023-4. A UK hospital was banned from neonatal heart operations after bad performances, BMJ 310 (1995), 960, 1195. Risks of ulcers from aspirins are discussed in BMJ 310 (1995), 827-30.

A study finding the cause of the oxidative damage of smoking is Morrow, J.D. et al. "Increase in circulating products of lipid peroxidation (F2-isoprotanes) in smokers", NEJM 332 (1995), 1198. The claim that the tobacco industry makes jobs is refuted by a UK study, Tobacco and Jobs, which says that if 40% of smokers stopped smoking by the year 2000, the money could create up to 150000 new jobs; Lancet 345 (1995), 1360. A study on the number of deaths passive smoking at work causes is Environmental Research 68 (1995), 3-9; and on heart disease in passive smokers, Glantz, S.A. & Parmley, W.W. "Passive smoking and heart disease", JAMA 273 (1995), 1047-53. A study finding that the smoking and drinking habits of Aborigines are responsible for many of the excess deaths is MJA 162 (1995), 475-8. On stereotypes of aboriginal health, MJA 162 (1995), 553; and on the Australian Tobacco Institute's problems, BMJ 310 (1995), 620. However in the USA, a survey shows that black children are stopping the habit, in a 1993 survey, 4.4% of African Americans but 23% of whites, Newsweek (15 May 1995), 52. The black children often say smoking is not cool, it is a white thing. A letter from a Japanese doctor calling for a boycott of the Japan Tobacco Corporation which is now marketting anti-cancer drugs is, Lancet 345 (1995), 1314.

A review is Bartecchi, C.E. et al. "The global tobacco epidemic", SA (May 1995), 44-51. A study on the difficulties of implementing tobacco restrictions is JAMA 273 (1995), 805-7; and on Israelis law on cigarette labelling, Lancet 345 (1995), 977. The French ban on advertising has had several exceptions introduced, BMJ 310 (1995), 962. A study of cigarette smuggling in Europe finds that expensive brands are being moved, BMJ 310 (1995), 1393-7. A review of the US state claims against tobacco industry for their health expenditures are JAMA 273 (1995), 1080-1; and on use of California's tobacco tax for research on smoking, Lancet 345 (1995), 781. A review of an Institute of medicine report on how to stop childhood smoking which is the main cause of addiction is JAMA 273 (1995), 1326; and on children's attitudes in the UK to health, BMJ 310 (1995), 1029-33.

The rise of alcoholism in the Russian Federation is discussed in BMJ 310: 646-8. Studies reporting low alcohol intake has a lower risk of cardiovascular disease are Gronbaek, M. et al. "Mortality associated with moderate intakes of wine, beer, or spirits", BMJ 310 (1995), 1165-9; Fuchs, C.S. et al. "Alcohol consumption and mortality among women", NEJM 332 (1995), 1245-50. It makes us remember the old proverb, a little bit of wine helps the digestion! A letter on whether a doctor should counsel patients to drink is JAMA 273 (1995), 1415-6.

Letters on caffeine dependence are JAMA 273 (1995), 1417-9; Lancet 345 (1995), 1066. US parents can check their children for drug use, Newsweek (24 April 1995), 45. A mail order company in the UK is selling the US home testing kit to check whether children are using drugs, Sunday Telegraph (30 April 1995), 1. The success of drug abuse programs is shown in JAMA 273 (1995), 1106-12. A WHO report on the global use of cocaine is discussed in BMJ 310 (1995), 825-6.

The mysterious Gulf War syndrome could have been caused by combined effects of a pill to protect against nerve gas and an insect repellant, NS (22 April 1995), 5. The persistence of dioxin from Agent Orange is shown in Schecter, A. et al. "Agent Orange and the Vietnamese: The persistence of elevated dioxin levels in human tissues", AJPH 85 (1995), 516-22, p. 476-8. There is also potential problems from dioxin that is missing from chemical use elsewhere, Nature 375 (1995), 353-4. A biochemical basis for DDT harm is in Nature 375 (1995), 538-9, 581-5.

In the US a pesticide applicator who used an unapproved pesticide has been sentenced to 5 years in prison, FDA Consumer (May 1995), 33-4. Repeated exposure to organophosphates is linked to long term mental change in Stephens, R. et al. "Neuropsychological effects of long-term exposure to organophosphates in sheep dip", Lancet 345 (1995), 1135-9. Diethylstilbestrol is discussed in Science 268 (1995), 16-7; and estrogen in FDA Consumer (April 1995), 25-9.

A study of recycled drinking water safety is EST 29 (1995), 174-9A. Lead poisoning is discussed in AJPH 85 (1995), 528-34; BMJ 310 (1995), 1408-9. Environmental health risks are discussed in Lancet 345 (1995), 1035-6; AJPH 85 (1995), 481-3; and gene-environment links in AJHG 56 (1995), 821-3.

The costs of obtaining consent from children in child survey research is discussed in Science 268 (1995), 967-8. Physician's roles in public health are discussed in JAMA 273 (1995), 1150-1, 1561-2; BMJ 310 (1995), 889. A number of papers on public health are in the Annual Review of Public Health; see also: Lancet 345 (1995), 1050, 1158-60; BMJ 310 (1995), 1212; JAMA 273 (1995), 1123-9. On epidemiological studies, BMJ 310 (1995), 752-4; AJPH 85 (1995), 474-6, 484-91.

The lack of a system for monitoring the health effects of body implants is criticised in NS (12 March 1995), 12-3. On silicone breast implants, MJA 162 (1995), 432-4; NEJM 332 (1995), 1306-7. The US product liability system is not being reformed, despite calls for it for several years, Lancet 345 (1995), 1359. From 1 July, the new Product Liability Law will take effect in Japan.

On asthma in New Zealand, Lancet 345 (1995), 984-5. Asbestos and cancer links are stronger following a new UK study, NS (8 May 1995), 8. Occupational health and lung cancer is discussed in SSM 40 (1995), 961-75. On epilepsy and driving, BMJ 310 (1995), 885-6; and on occupational disease, BMJ 310 (1995), 1282.

A Harvard University study has suggested only vigorous exercise will lead to longer life, not gentle exercise, Lee, I.M. et al. "Exercise intensity and longevity in men. The Harvard Alumini Health study", JAMA 273 (1995), 1179-84; Time (1 May 1995), 51. However general fitness also has benefits, JAMA 273 (1995), 1093-8; Bulletin WHO 73 (1995), 135-6. Hip fracture risks are discussed in NEJM 332 (1995), 814-5; and on osteoporosis, JAMA 273 (1995), 1082; BMJ 310 (1995), 989-92.

The protective effects of green tea on heath are shown in Imai, K. & Nakachi, K. "Cross sectional study of effects of drinking green tea on cardiovascular and liver diseases", BMJ 310 (1995), 693-6. Diet and health are discussed in BMJ 310 (1995), 823, 901-4, 1075, 1280-1; NEJM 332 (1995), 977-82, 1024-5; Lancet 345 (1995), 1107-10; JAMA 273 (1995), 1329-31, 1429-35; AJPH 85 (1995), 622-4. A study finding no correlation between baseline lipoprotein(a) and risk of future stroke is JAMA 273 (1995), 1269-73; however, fruits and vegetables did help, Gillman, M.W. et al. "Protective effect of fruits and vegetables on development of stroke in men", JAMA 273 (1995), 1113-7, p. 1077-8. A Finnish study linking low cholesterol with depression is NS (29 April 1995), 10; Amer. J. Epidemiology (April). The cost analysis of the use of HGM-CoA reductase inhibitors in reducing heart disease is JAMA 273 (1995), 1032-8. A paper on why people diet is Biener, L. & Heaton, A. "Women dieters of normal weight: Their motives, goals and risks", AJPH 85 (1995), 714-7. Measures against the food disease listeriosis in the USA appear to have worked, JAMA 273 (1995), 1118-22. On vitamin E, Lancet 345 (1995), 737.

Efforts to harmonise regional \occupational health laws are in AJLM XXI (1995), 7-44. A discussion of European and FDA procedures is Biotechnology 13 (1995), 636-8; Nature 376 (1995), 713-4. The FDA has given another 5 years before prescription drugs should all have drug information available to give to patients, and providing three quarters of the patients with this information, JAMA 273 (1995), 1815-6. The incidence of adverse drug reactions is reviewed in JAMA 273 (1995), 29-34, 35-43. In Japan, the MHW has produced an interim report calling for drug monitoring after approval, in response to the Sorivudine deaths, Japan Times (18 July 1995), 2.

As is discussed in the genetic disease markers section below, one of the major genes causing obesity has been found; Science 269 (1995), 475-6, 540-9. Discussion of whether obesity in Britain is "gluttony or sloth" is in BMJ 311 (1995), 279, 437-9; and also on dieting, Nature 376 (1995), 557; Lancet 345 (1995), 1537-40. Health is also falling in Japan, with rising cholesterol, Japan Times (24 August 1995), 2. A Japan-US comparison finds cholesterol levels are related to heart disease mortality, Iribarren, C. et al. "Serum total cholesterol and mortality", JAMA 273 (1995), 1926-32; Verschuren, W.M.M. et al. "Serum total cholesterol and long-term coronary heart disease mortality in different cultures", JAMA 274 (1995), 131-6.

Vitamin C may help vascular disease risk reduction but a large study needs to be done, BMJ 310 (1995), 1548-9, 1559-63, 1563-6. Vitamin supplements may benefit some people, Lancet 346 (1995), 85-9; and vitamin A deficiency did not respond to increased green vegetables in a UK study, Lancet 346 (1995), 75-81. Inadequate vitamin D status is reported in elderly people across Europe, Lancet 346 (1995), 207-10. On healthy eating, BMJ 311 (1995), 1453-5; and antioxidants, Lancet 346 (1995), 36-8.

The use of molecular genetics studies on cancer genes to study radiation harm is discussed in Land, C.E. "Studies of cancer and radiation dose among atomic bomb survivors", JAMA 274 (1995), 402-7. Also on radiation damage: Chernobyl victims, JAMA 273 (1995), 408-12, 427-8. The future of radiation and health studies between Japan and USA is still uncertain, but some funding has been given, Science 268 (1995), 1835; Nature 376 (1995), 709. Book reviews of James N Yamazaki, J.N. with Fleming, L.B., Children of the Atomic Bomb: An American Physician's Memoir of Nagasaki, Hiroshima, and the Marshall Islands (398pp.) and Kenzaburo Oe, Hiroshima Notes, in BMJ 311 (1995), 398. See the environment section for nuclear protests against France; and scientific ethics section also. Dangers of medical radiation are the subject of a new book, claiming that they are linked to breast cancer, JAMA 273 (1995), 367+. A study finding little risk of radiologists for breast cancer is JAMA 273 (1995), 394-401. On using heavy ion radiation as a therapy for cancer, Nature Medicine 1 (1995), 606-7.

A review is Ames, B.N. et al. "The causes and prevention of cancer", PNAS 92 (1995), 5258-65. The Delaney clause, in the USA regulations that no carcinogen should be added to food, is soon to be updated, Nature 376 (1995), 109. The joint studies on dioxin effects between USA and Vietnam have found authorities in Vietnam resistant to passage of biological samples, Science 269 (1995), 298. Also on dioxin, EST 29 (1995), 302A. Chemical toxins are increasing and there is more likelihood to have disasters, SA (July 1995), 22-3. Skin cancer mechanisms are discussed in JAMA 273 (1995), 445; and on stress and disease, Lancet 346 (1995), 104-6; Nature 376 (1995), 785-8.

A small alcoholic drink every day does not appear to be linked to hypertension, Lancet 345 (1995), 1588; BMJ 311 (1995), 3-4; NEJM 332 (1995), 1782-3; MJA 162 (1995), 565. A call for marihuana to be considered a medicine is made in JAMA 273 (1995), 1875-6. The prescribing of heroin for users is debated in Holland, BMJ 310 (1995), 1625; and Australia, Sydney Morning Herald (10 July 1995), 1; MJA 163 (1995), 62. However, a study showing that fatal injuries among cocaine users after use accounts for many of the young persons deaths in New York city, and 27% of all residents receiving fatal injuries have cocaine in their blood, would make us cautious; NEJM 332 (1995), 1753-7.

Poland's lower house voted on 27 August to ban smoking in most public places. A study suggests 80% of Israel's workplaces comply with a smoking ban, BMJ 311 (1995), 1487-8. The effects of laws on smoking bans in US hospitals have been found to be effective, but still some hospitals are to comply, JAMA 273 (1995), 488-91, 491-4. A study of restaurants in a Texas city finds no decrease in sales after smoking bans, JAMA 273 (1995), 206-7. The FDA has said nicotine is a drug, Nature 376 (1995), 205, 539; BMJ 311 (1995), 211; NEJM 333 (1995), 186-8; Newsweek (21 August 1995), 21-2. The costs of smoking to lost work are seen in SSM 41 (1995), 437-46. Attitudes to smoking among young people in Holland differ between the poor and rich, SSM 41 (1995), 419-24. Smoking on the airline Qantas may soon end, following a judges decision to pay compensation to non-smokers forced to sit in smoking seats (sounds very familiar!), BMJ 311 (1995), 38-40.

On the dangers of smoking, BMJ 310 (1995), 1431-3; 311 (1995), 142-3; JAMA 273 (1995), 155-60, 199-202, 208-9, 214-5; Lancet 346 (1995), 64, 168-9, 261. Brown and Williamson, the tobacco company, has withdrawn its claim on one third of 4,000 pages of internal documents held at the Library of the University of California SF; Nature Medicine 1 (1995), 397-8. Legal tactics of this and other tobacco companies are reviewed in JAMA 273 (1995), 219-24, 225-33, 234-40, 241-7, 254-7.

Grain dust is another risk factor for chronic renal failure, Lancet 346 (1995), 7-11. Safety in the Australian coal industry is reviewed in MJA 162 (1995), 7. Asbestos risk is debated in Lancet 346 (1995), 304-6.

The US gun control debate and various studies on the effects of guns on death are in JAMA 273 (1995), 1739-41, 43, 49-67, 1781, 1788-93. Canadian gun control debate, CMAJ 152 (1995), 2024-6, 28. The results of sarin poisoning in Matsumoto, Japan are published in Lancet 346 (1995), 290-3, 260; and on the deaths in Tokyo subways, Lancet 345 (1995), 1446-7; JAMA 274 (1995), 379. The OM religious cult has been found to be involved in a range of activities, and the bodies of a lawyer who started to investigate them has been found 6 years after death and burial, following confession of one of the murderers.

On public health in general, Biotechnology 13 (1995), 724; JAMA 273 (1995), 1712-3; Lancet 346 (1995), 1611-5; and on the limits of epidemiology, Science 269 (1995), 164-9. Psychosocial disorders are rising among young people in Europe and North America, BMJ 310 (1995), 1429.

The dangers of estrogen therapy for women are discussed in Time (26 June 1995), 52-9; NEJM 332 (1995), 1589-93, 1638-9; JAMA 274 (1995), 137-42, 178-9; O&G 86 (1995), 306-16. A study that did not find incidence of breast disease from breast implants is Sanchez-Guerrero, J. et al. "Silicone breast implants and the risk of connective-tissue diseases and symptoms", NEJM 333 (1995), 1666-70. Higher sexual activity and use of doxorubicin (used against childhood cancer) are risk factors for cardiac abnormalities in women, NEJM 332 (1995), 1738-43. On women's health, BMJ 311 (1995), 270.

A US study showing that low cholesterol can predict coronary heart disease mortality is JAMA 274 (1995), 539-44; 575-7; but improvements in monitorring are also needed, JAMA 274 (1995), 801-6; NEJM 333 (1995), 740-1; AJPH 85 (1995), 1207-11. There is a US study suggesting a link between low cholesterol to violence via serotonin, Science 270 (1995), 237. Letters on the reduction of heart disease with fish intake are in NEJM 333 (1995), 937-8. On the merits of physical activity, JAMA 274 (1995), 533-5, 1132-3. Obesity is related to earlier death, Lancet 346 (1995), 636-7; NEJM 333 (1995), 677-85, 686-92, 723-4; and avoiding premature coronary deaths in Asians in Britain is discussed in BMJ 311 (1995), 1035-6. Genetic factors are discussed in Lancet 346 (1995), 708-9.

A study of schizophrenic patients linking welfare payment to purchases of cocaine is NEJM 333 (1995), 777-83, 794-6. Book reviews on the history of drug use are in Nature 377 (1995), 23-4. In the UK there is debate over the use of cannabis for medicine, and the Dutch guidelines on addictive medicine are being revised, Lancet 346 (1995), 761-2. The majority in the USA are against the use of marijuana, JAMA 274 (1995), 598-9. The effects of alcohol on the liver urge caution for drinkers, Lancet 346 (1995), 987. Guidelines for alcohol use are examined in Lancet 346 (1995), 716.

Aspirin has some protective effect against colon cancer, after a decade of use, Giovannucci, E. et al., "Aspirin and the risk of colorectal cancer in women", NEJM 333 (1995), 609-14; 656-7. Studies of aspirin use in diabetic patients have found only slight reduction in cardiovascular events, BMJ 311 (1995), 641-2. An extract from the bark of an East African tree has been found to be an anticancer substance, Nature Medicine 1 (1995), 1046-51; Lancet 346 (1995), 1028.

It is expected that bills to reform the Food and Drug Administration (FDA) will be introduced later in 1995 in the USA, Lancet 346 (1995), 981; Science 269 (1995), 1038-41. One of the international problems is the expense of drugs, especially under Orphan drug acts, Lancet 346 (1995), 917. On the pharmaceutical drug industry, BMJ 311 (1995), 1101-2. The FDA has approved a new drug, Rilutek for treating amyotrophic lateral sclerosis, Lancet 346 (1995), 897.

There is some increased risk of breast cancer in women with more than 5 years of use of hormonal supplements, BMJ 311 (1995), 699-700. A book review of Reducing Breast Cancer Risk in Women is NEJM 333 (1995), 885-6. Letters on epidemiology are in Science 269 (1995), 1325-9.

A US survey on human exposure to major environmental pollutants is reported in EST 29 (1995), 398-9A. Thalidomide is being used for several diseases in experiments, despite its known adverse affects on fetal growth because it may be effective in treating adult disease, SA (Nov 1995), 20-2; Science 269 (1995), 1340. There are a growing number of drugs which are used for applications that they are not approved for, Time (25 Sept 1995), 46-7.

A review is Davis, D.L. & Bradlow, H.L. "Can environmental estrogens cause breast cancer?", SA (Oct 1995), 166-72. A letter on effects of testosterone is Science 269 (1995), 1341, 3. Letters on dioxin use and effects in Vietnam are Science 270 (1995), 217.

An editorial criticising the flaws in carcinogen testing is Science 270 (1995), 215; and on the development of new criteria at the EPA, EST 29 (1995), 448-9A. An anticancer drug is being reviewed because it may cause cancer, Science 270 (1995), 19. There is some evidence to suggest fiberglass may cause cancer, SA (Nov 1995), 16-8. In France a minister has promised to clean up asbestos; BMJ 311 (1995),898. Silicosis is another disease that should be eliminated, AJPH 85 (1995), 1346-7. On breast implants and disease, NEJM 333 (1995), 526; Newsweek (13 Nov 1995), 75. A Nevada women has been awarded US$4 million in compensation for health damage in a record decision which challenges the rest of the many cases.

The history of the censorship of the casualty data from the atomic bombs in Japan is reported in Nishimura, S. "Censorship of the atomic bomb casualty reports in occupied Japan. A complete ban vs. temporary delay", JAMA 274 (1995), 520-2. A book review on the bombings is Science 270 (1995), 1455-7; BMJ 311 (1995), 1100-1. The Nobel Peace Prize 1995 was awarded to the campaign against atomic weapons, Nature 377 (1995), 564. On nuclear waste storage, Science 269 (1995), 906-7, 1653-7.

A report on the debate on the dangers of electromagnetic radiation is SA (Oct 1995), 26-31. A draft report from a panel of the National Council on Radiation protection and measurements includes some dangers of EMF radiation, Science 270 (1995), 911. There is no threshold given, but it urges due diligence in reducing exposure. However, studies have failed to find a link to mutation of the myc oncogene, Science 269 (1995), 1816-7.

A paper showing slow decay in the radiocesium in the air and deposits in Bavaria since Chernobyl is in Naturwissenschaften 82 (1995), 417-20. Thyroid cancer cases are one of the results in the Ukraine since the accident, Lancet 346 (1995), 719. A radioactive contamination incident at MIT is being investigated, Nature 377 (1995), 563; as is one in NIH, Science 270 (1995), 379.

There are legal battles in the USA over the moves to regulate nicotine as an addictive drug by the FDA, Lancet 346 (1995), 453; see also Lancet 346 (1995), 510, 704-5, 831; Nature 378 (1995), 124. Smoking has some affect on the thyroid gland, NEJM 333 (1995), 1001-2. The Bellagio statement on tobacco and sustainable development, and smoking in the developing world is in, CMAJ 153 (1995), 1109-10, 1111-6. A survey in China has found that smokers in China spend about 60% of personal income and 17% of household income on average on cigarettes, JAMA 274 (1995), 1232-4. The dangers of occupational passive smoking are reported in JAMA 274 (1995), 956-60. The Canadian Supreme Court has ruled 5-4 to overturn a 7 year ban on tobacco advertising, though the tobacco industry has said it will attempt to obtain a mutually acceptable way to resume advertising, Lancet 346 (1995), 893. Both taxes and media campaigns can be effective to reduce smoking, AJPH 85 (1995), 1218-22. A survey of smoker's rights publications is AJPH 85 (1995), 1212-7. Letters on smoking doctors: BMJ 311 (1995), 945.

The consequences of driving ability tests and sight for persons over 70 years is reviewed in JAMA 274 (1995), 1026-30, 1060. A discussion of how social policy affects children is Roberts, I. & Pless, B. "Social policy as a cause of childhood accidents: the children of lone mothers", BMJ 311 (1995), 925-8. They conclude provision of day care would avoid some accidents.

An editorial calling for a ban on boxing is Nature 377 (1995), 561-2. The US Air Force Academy has ceased to make boxing mandatory in response to medical protests, JAMA 274 (1995), 784. The use of helmets is discussed in JAMA 274 (1995), 939-42. Violence is discussed in JAMA 274 (1995), 1031-6; Lancet 346 (1995), 563-4, 971; CMAJ 153 (1995), 879, 1261+. The dangers and crime to humanity of land mines are shown in Lancet 346 (1995), 715, 721-4. In the Mozambique household survey up to 1.6% of people had casualties, with half being fatal. On the pursuit of war technology, Science 269 (1995), 1599-600.

The relationship of the doctor-patient relationship to the way that public health information can be passed on is explored in a UK study in Makoul, G. et al. "Health promotion in primary care: Physician-patient communication and decision making about prescription medications", SSM 41 (1995), 1241-54. Schools also have a role in public health campaigns, JAMA 274 (1995), 1195. Under the Community Health Law (Chiki Hoken Ho) introduced in 1994, the health centre system in Japan is being changed, and will complete implementation by April 1997; Lancet 346 (1995), 494. The Health Centre Law will be replaced, and the number of health care centres reduced, and a move made to municipal health care centres who will take over the responsibility of community screening programs. A review of UK public health is BME 111 (Sept 1995), 13-18.

Design of attractive buildings in a hospital may increase recovery rates, NEJM 333 (1995), 735-9. A review of environmental medicine issues is Lancet 346 (1995), 860. A book review of Chasing Dirt. The American Pursuit of Cleanliness, is Science 270 (1995), 859-60.

A review of a book on human responses to disaster (see also EJAIB 5 (1995), 113-5, papers by D.Macer and F.Leavitt) is on, Ursano, R.J. et al. eds. The structure of human chaos (Cambridge University Press 1994), in Lancet 346 (1995), 490-1.

An editorial discussing the public concepts of risks to health, especially given recent UK government statements, is BME 112 (1995), 1. Comments on the FDA are in the section on recombinant product safety, see also, Lancet 346 (1995), 1492; TIBTECH 13 (1995), 235-6. Letters on the use of animals to determine cancer risk are in Science 270 (111091-95), 2; and Tennant, R.W., "Identifying chemical carcinogens and assessing potential risk in short-term bioassays using transgenic mouse models", Environmental Health Perspectives 10 (1995), 942-7. On taxomifen trials, Science 270 (1995), 910. A drug has been banned in Italy, after being used for several years without testing, as anticancer drug, Nature Medicine 1 (1995), 982. The dangers of herbal remedies are discussed in NS (4 Nov 1995), 36-40. A commentary looking at the apparently slower rate of treatment discover between 1965 to 1995 is Nature Medicine 1 (1995), 1122-5. On Japan's unsafe drugs, BMJ 311 (1995), 1522.

There appear to be numerous effects on health due to Chernobyl, NS (9 Dec 1995), 14-5. Thyroid cancer rates are dramatically increased (up to 100-fold) in exposed children, though there are some questions over how much is due to increased attention to it, Lancet 346 (1995), 1223-4, 1482; NS (2 Dec 1995), 4. The future of Chernobyl reactors is uncertain, Science 270 (1995), 567. Results of health effects from uranium mining in West Bohemia are reported in Environmental Health Perspectives 10 (Suppl. 2, 1995), 55-7, also pp. 49-53.

A study has found no genetic instability in certain genomic elements from survivors of the Japanese atomic bomb blasts, Kodaira, M. et al. "Lack of effects of atomic bomb radiation on genetic instability of tandem-repetitive elements in human germ cells", AJHG 57 (1995), 1275-83, 1263-6. On resistance to radiation, Science 270 (1995), 1318; NS (9 Dec 1995), 18. French and British researchers have been debating the "safe" limits of radiation exposure for nuclear workers, NS (2 Dec 1995), 3, 10. In Russia it is claimed 8000 people die each year due to excess radiation received in medical examinations, BMJ 311 (1995), 1120; and a claim that 75% of breast cancer is due to medical irradiation in the USA is JAMA 274 (1995), 1762. The NIH radiation poisoning case has led to tightened rules, Nature 378 (1995), 757.

A book review on EMF radiation is NEJM 333 (1995), 1293-4; and debate in NS (7 Oct 1995), 4; (18 Nov), 74. There are several papers on EMF radiation and health studies in Environmental Health Perspectives 10 (Suppl. 2, 1995), 59-62,63-7, 69-74. A study of increased breast cancer in female flight attendants in Finland is suggested to be linked to increased immune reactivity following radiation exposure at higher altitude, Lancet 346 (1995), 1379.

Melanoma and sun exposure is debated in Lancet 346 (1995), 1224-5; MJA 163 (1995), 511-2; NZMJ 108 (1995), 344-6, 508-10. Diet and fat consumption is discussed in JAMA 274 (1995), 1350-1, 1423-5, 1450-5; BMJ 311 (1995), 1239-40, 1251-4, 1255-9, 1260-4; NZMJ 108 (1995), 447-9; NS (21 Oct 1995), 28. Adverse of salt are shown in a study in chimpanzees, Nature Medicine 1 (1995), 994-6, 1001-16. Diet is a predictor of overall survival in elderly people in Greece, BMJ 311 (1995), 1457-60. On coronary heart disease in women, NEJM 333 (1995), 1570-1. Homocysteine is found to be a marker of cardiovascular risk in JAMA 274 (1995), 1526-33. Osteoporosis still needs drugs for treatment, Nature Medicine 1 (1995), 1130-1. The limits of starvation were extended in Somalia with a body mass index (body weight in kg divided by height in metres squared) of less than 10 kg per square metre, Nature Medicine 1 (1995), 810-4.

Breast implants and connective tissue diseases are debated in NEJM 333 (1995), 1423-4; FDA Consumer (Nov 1995), 11-6; Int. J. Health Services 25 (1995), 573-92. A jury in Nevada awarded a woman US$14 million in compensation, but Dow chemicals is appealing, BMJ 311 (1995), 1388; Newsweek (13 Nov 1995), 75; Lancet 346 (1995), 1287. A survey in the UK finds more female doctors take hormone replacement than the general public, BMJ 311 (1995), 1399-401; see also pp. 1193-6; MJA 163 (1995), 483-5.

Pesticides are discussed in the Environment section. On the dangers of chemicals in the developing world due to ignorance, NS (9 Dec 1995), 8. There is likely to be a world-wide ban against persistent chemicals, NS (11 Nov 1995), 7. A new International Society of Cancer Chemoprevention has been founded, Lancet 346 (1995), 1222. Occupational injuries, illness affect 1 in 13 Canadians, CMAJ 153 (1995), 1782-3.

Letters on alcohol consumption and female mortality, NEJM 333 (1995), 1081-2. Alcohol is considered a threat to young persons equal to drugs, BMJ 311 (1995), 1388.

On nicotine addiction, NEJM 333 (1995), 1196-1203, 1225-6; JAMA 274 (1995), 1347-52, 1353-8, 1390-1; BMJ 311 (1995), 1250; Science 270 (1995), 573-4. The Wall Street Journal has charged that a US company uses additives in cigarettes, Lancet 346 (1995), 1151. BAT industries increased profits by 34% in 1995 due to increased sales in poorer countries, BMJ 311 (1995), 1321; and on mortality, BMJ 311 (1995), 1530-3. The US government has continued support of tobacco exports, Nature Medicine 1 (1995), 989-90. Sales in Japan continue to increase mortality due to lung cancer, Economist (4 Nov 1995); links seen everywhere also, NZMJ 108 (12995), 419-20. In New Zealand between 1976 and 1991 the prevalence of cigarette smoking in adults decreased from 36 to 26%, NZ Public Health Report 2 (1995), 89-91. On dangers of passive smoking in children, BMJ 311 (1995), 1152-4, 1164; Science 270 (1995), 903. In New Zealand a divorced father has been denied access by a court to children if he smokes in their presence. A sociological study of UK middle class smoking and drinking is Sociology of Health & Illness 17 (1995), 668-80. Cessation of smoking may result in slight increase in overweight persons, NEJM 333 (1995), 1165-70, 1214-6.

Tightened controls on boxing have been made in the UK, and the government is reluctant to ban it, BMJ 311 (1995), 1183. A study in young monkeys suggests that the wearing of spectacles in young children may alter eye development, Nature Medicine 1 (1995), 737-9, 761-6.

A call for daytime running lights to be mandatory, as is already done in 7 countries, is made in Public Health Reports 110 (1995), 233-9. Airbags have saved many lives already and will become mandatory in new cars in some countries, however there have been several child deaths which suggests further improvements are needed, JAMA 274 (1995), 1752-3. A study has found increased mortality among Dutch development workers, especially traffic accidents, BMJ 311 (1995), 1343-4. A study showing that anticipation of job loss affects health even before change in employment, Ferrie, J.E. et al. "Health effects of anticipation of job change and non-employment: longitudinal data from the Whitehall II study", BMJ 311 (1995), 1264-9.

Computer based prescribing is recommended in BMJ 311 (1995), 1181-2; and on drug errors, BMJ 311 (1995), 1367-8. Patients given LSD in the UK in the late 1950s have won legal aid to seek compensation, BMJ 311 (1995), 1185-6. A call to deglamorise cannabis is made in Lancet 346 (1995), 1241. A vaccine against cocaine is reported in Nature 378 (1995), 666-7, 727-30.

A paper reporting the cloning of the obese gene, ob, and the demonstration that it encodes a secreted protein (leptin) that binds specifically to a receptor (OB-R) in the brain, have shown that it is the same as the diabetes gene, Science 271 (1996), 994-99, see also 913. The most potent regulator of feeding yet found is glucagon-like peptide-1 has been found, Lancet 347 (1996), 47; as report last time, Nature 379 (1996), 6-72; and on leptin, NEJM 334 (1996), 292-5, 324-5. Weight loss is better than exercise to reduce risk of heart attack, JAMA 274 (1995), 1915-21, 1964-5.

Mid-life systolic blood pressure is a predictor of reduced cognitive function in later life, JAMA 275 (1996), 1846-51. On cholesterol, Science 271 (1996), 460-1; Lancet 346 (1995), 1647-53. Advice not to generally take lipid-lowering drugs because of possible carcinogenicity is JAMA 275 (1996), 55-60, 67-9. A review of the US diet and recommendations for improvement is AJPH 85 (1995), 1609-10, 1623-9. A US study has found no evidence of a link between breast cancer and higher dietary fat intake, NEJM 334 (1996), 356-61; nor is there is evidence of weight gain with hormone replacement therapy, JAMA 275 (1996), 46-9. Beta-carotene has been reported to have mortality, causing cessation of some cancer trials in the USA, Lancet 347 (1996), 249. The benefits of exercise encourage work on education at school level, BMJ 312 (1996), 199.

On December 21, 1995 the Supreme Court of Canada dismissed an appeal by Dow Corning Corporation against a lower court finding of negligence in the manufacture of a breast implant. The plaintiff, had undergone breast implant surgery in 1983. In 1985 the right implant had to be removed because it had ruptured. In 1989 she sued Dow and the doctor who had performed the initial surgery. The Supreme Court stated that "The principles underlying the doctrine of 'informed consent' apply to the relationship between manufacturers of medical products and consumers. The manufacturer-consumer relationship, unlike the doctor- patient relationship, is characterized primarily by a lack of direct communication which creates a relationship of complete dependency between manufacturer and patient. Manufacturers, therefore, can be reasonably required to make clear, complete and current informational disclosure to consumers concerning the risks inherent in the ordinary use of their products." According to the "learned intermediary" rule a manufacturer of medical devices may discharge this duty of disclosure by informing doctors of the risks associated with the use of the product. The doctor will in turn inform the patient. However, in this case Dow's warning to the surgeon was inadequate, and so the judgment against the company will stand, Canadian Bioethics Report (Jan 1996). See a letter on another disease, JAMA 275 (1996), 184-5.

A link has been made showing the level of the B form of monoamine oxidase is reduced in people who smoke by about 40%, which in turn increases the addictive nature of smoking, Nature 379 (1996), 677-8. Smoking in Canada is discussed in CMAJ 154 (1996),159+, 191-2, 226-32. Some affect is being seen from the tough smoking law in Ontario. On tobacco advertising bans in the UK, IDHL 46 (1995), 575. Thailand is requiring a list of additives to be shown on the tobacco, something other countries could also do, Lancet 347 (1996), 112. There are also tobacco wars in China, Lancet 346 (1995), 1695. The link between smoking and increased heart attacks is explained in Wang, XL et al. "A smoking-dependent risk of coronary artery disease associated with a polymorphism of the endothelial nitric oxide synthase gene", Nature Medicine 2 (1996), 41-5. Another health effect is also observed in passive smokers, NEJM 334 (1996), 150-4. A call for inclusion of tobacco related disease in the list of diseases is renewed in JAMA 275 (1996), 276-80; and on publishing research sponsored by the tobacco industry, BMJ 312 (1996), 133-4.

A review of addiction is Lancet 347 (1996), 162-6; and the question of legal regulation is in Lancet 347 (1996), 301-5. Letters on decriminalization of cannabis are in Lancet 347 (1996), 1708-10. A criticism of the British government's decision to increase recommended drinking allowances is Lancet 347 (1996), 1643-4.

A FDA committee has recommended calcium-blockers are safe, Lancet 347 (1996), 313. On the ethics of drug testing, NEJM 334 (1996), 126. Thompson NP "Genetics versus environment in inflammatory bowel disease: results of a British twin study", BMJ 312 (1996), 95-6. On general environmental and genetic links, BMJ 312 (1996), 271. On general public health, Lancet 346 (1995), 1545-6; 347 (1996), 3-4; NEJM 334 (1996), 203-7. More victims of Minamata disease in Japan have been given compensation, Lancet 346 (1995), 1695-6.

The health dangers of EMF radiation are discussed in NS (17 Feb 1996), 4; Nature Medicine 2 (1996), 23-4; Nature 379 (1996), 571; BMJ 312 (1996), 463. The health dangers of nuclear radiation are reviewed in NEJM 333 (1995), 1787-8; JAMA 275 (1996), 72-3; JMG 32 (1995), 997; and on medical X-rays, Lancet 346 (1995), 1701-2. In Japan there is much public distrust of nuclear power (see also the paper by Macer et al. in this issue (March 1996) and in D. Macer, Bioethics for the People by the People (1994). This has grown with a sodium coolant leak in Monju fast breeder reactor, which was still in a test phase of development, Nature 379 (1996), 196.

The UK Ministry of Defense has ordered a new study into Gulf War syndrome, Nature 379 (1996), 482. A report from experiences during the Great Hanshin earthquake of 1995 is Lancet 347 (1996), 307. In the USA, the National Highway System Designation Act was passed which included removing the 55 miles per hour national maximum speed limit, which will result in increased traffic deaths, Lancet 347 (1996), 1547.

There is increasing use of behaviour pills in US schools, NS (9 March 1996), 7. A letter on effects of sugar on children's behaviour is JAMA 275 (1996), 756-7; and on antisocial behaviour, JAMA 275 (1996), 403-4.

A US study of 43757 health care professionals between 40-75 years of age has found fiber intake reduces heart disease, Rimm, EB et al. "Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men", JAMA 275 (1996), 447-51, 486-7. Coffee is not linked to heart disease in women, JAMA 275 (1996), 458-62. Research on obesity is reviewed in Biotechnology 13 (1995), 1060-3. WHO is launching a campaign against obesity, Lancet 347 (1996), 751; and on health effects, NEJM 334 (1996), 732-3; AJPH 86 (1996), 25-30. A study finding vitamin E may decrease risk and beta-carotene may increase risk of angina is JAMA 275 (1996), 693-8; and a study showing beneficial effects of vitamin E from the Cambridge Heart Antioxidant Study is Lancet 347 (1996), 776-7, 781-6. Personality is also linked to heart disease, Lancet 347 (1996), 417-21; AJPH 86 (1996), 301-3. Consumption of oily fish may protect against asthma, MJA 164 (1996), 137-40; and on diet, BMJ 312 (1996), 931-40.

Silicone breast implants are discussed in SA (April 1996), 36-7; and a study of health care professionals confirms some health effects, JAMA 275 (1996), 616-21, 680; BMJ 312 (1996), 595. An Australian study finds people spend twice as much on alternative medicines as they do on contributions to pharmaceuticals, Lancet 347 (1996), 569-73, 972-3; and on profits from nutriceuticals, Lancet 347 (1996), 775. A study finding religious belief is positive for health is Kark, JD. et al. "Does religious observance promote health? Morality in secular vs. religious Kibbutzim in Israel", AJPH 86 (1996), 341-6.

On March 13 the history of US smoking court cases was changed when the Liggett Group, the 5th largest tobacco company in the USA, agreed to settle a court case out of court and pay for prevention programs and pay funds to states for health damage, Lancet 347 (1996), 823. Also, NS (30 March 1996), 10; AJLM XXI (4, 1995), 445-72. Passive smoking is discussed in JAMA 275 (1996), 441-2; MJA 164 (1996), 260-1, 266-9; BMJ 312 (1996), 997-8, 1051-2. Dangers of maternal smoking and congenital urinary tract anomalies are confirmed, AJPH 86 (1996), 249-53. There is controversy in Cambridge over the funding of a professorship by BAT industries (a tobacco company), BMJ 312 (1996), 721-2, 773-4; see also a series of papers in Science 272 (1996), 488-94. People may misunderstand current tar values on cigarettes, AJPH 86 (1996), 18-24, 231-6. A study of the length of time adolescent smokers use cigarettes is in AJPH 86 (1996), 156-8, 214-20, 253-6; also p.221-4. Dopamine may reinforce smoking addiction, BMJ 312 (1996), 529.

Confirmation of the role of mild alcohol use in reducing heart disease is BMJ 312 (1996), 731-6, 736-41; and on alcoholism, JAMA 275 (1996), 803-4; Lancet 347 (1996), 545-6; MJA 164 (1996), 133-4, 141-5. There will be stricter control on soft drugs in the Netherlands, Lancet 347 (1996), 895; to control harder drugs, also see BMJ 312 (1996), 635-7. Heavy marijuana use appears to impair brain function, JAMA 275 (1996), 521-7, 560-1. Drug testing is being made tougher in the 1996 Olympic Games, but it is still difficult to detect all, JAMA 275 (1996), 348-50.

Book reviews on the health effects of radiation are NEJM 334 (1996), 544-5; Lancet 347 (1996), 525-6; Science 271 (1996), 1821-2; and of health and nuclear weapons, JAMA 275 (1996), 808-9; Science 271 (1996), 1664. The efforts to attempt a nuclear test ban treaty are discussed in NS (9 March 1996), 6. A review of the ten year's since Chernobyl is SA (April 1996), 44-9; NS (20 April 1996), 40-3; Science 272 (1996), 352-60; BMJ 312 (1996), 1052-3. Floods in Chernobyl have threatened millions of people from radiation, NS (23 March 1996), 4. Also fish in the North Atlantic could be threatened by past radioactive dumping by Russia, NS (2 March 1996), 7. On Seascale cancer cluster, BMJ 312 (1996), 865. Some medical isotopes may be misused, Science 271 (1996), 1221.

On regulation of Euromedicines, Lancet 347 (1996), 483. Over-the-counter drugs and the social effects are discussed in BMJ 312 (1996), 629-32, 644, 688-91, 758-60.

An ethical debate on the law is Unwin, NC. "Cycle helmets - when is legislation justified?", JME 22 (1996), 41-5. On the use of airbags, Lancet 347 (1996), 560; and seatbelts, AJPH 86 (1996), 31-4. Reviews of triage are in NEJM 334 (1996), 438-44, 460-1.

A study in the UK found women in houses with gas cookers have more respiratory problems, Lancet 347 (1996), 426-31. Asbestos and the amphibole hypothesis is discussed in AJPH 86 (1996), 179-86 The future of dental care is discussed in Nature Medicine 2 (1996), 283.

An English summary of the Health Council of the Netherlands April 1995 report on environmental risk assessment is Network 10 (March 1996), 26-8; (June 1996), 8-9; and of toxic substances levels in the workplace, Network 10 (March 1996), 28-32. A special issue of The Science of the Total Environment 184 (1996), 1-147 is on "Ethical and philosophical issues in environmental epidemiology", from a 1994 WHO/ISEE international workshop. A review of this volume is expected in the next issue of EJAIB. The National Research Council of the USA is supporting a new approach to assessment, Nature 381 (1996), 638, 659; Lancet 347 (1996), 1179; EST 30 (1996), 238-9A; and a review is Perera, F. "Uncovering new clues to cancer risk", SA (May 1996), 54-62. Air pollution in homes may be more important than outdoor pollution but is difficult to monitor, BMJ 312 (1996), 1316.

On antioxidants such as carotene and cancer risk, studies have found no benefits!, NEJM 334 (1996), 1145-9, 1150-5, 1189-90. Letters on the link between dietary fat and breast cancer are in NEJM 334 (1996), 1606-7; Lancet 347 (1996), 1346, 1351-6. Calls for reducing salt are made in BMJ 312 (1996), 1239-41, 1287-9. A series of papers on heart attacks are in Science 272 (3 May 1996), 629+. Nonsteriodal anti-inflammatory drugs and estrogen reduce risk of Alzheimer's risk, JAMA 275 (1996), 1389-90. There is much debate over melatonin and health, BMJ 312 (1996), 1242-3. Herbal medicines may do more harm then good sometimes, Newsweek (13 May 1996), 44-54. Obesity gene is discussed in MJA 164 (1996), 393-4; also Science 272 (1996), 959. In the USA, Dexfenfluraine (Redux) is the first obesity pill to be approved for 20 years, Lancet 347 (1996), 1321.

EMF fields and cancer are debated in Goldsmith, JR. "Epidemiological studies of radio-frequency radiation: current status and areas of concern", Science of the Total Environment 180 (1996), 3-8; Lancet 347 (1996), 1059-60.

Papers discussing the health effects of Chernobyl include: Nature 380 (1996), 653, 658, 665-6; Dubrova YE et al. "Human minisatellite mutation rate after the Chernobyl accident", Nature 380 (1996), 683-6; Baker, RJ et al. "High levels of genetic change in rodents of Chernobyl", Nature 380 (1996), 707-8; NS (27 April 1996), 6; BMJ 312 (1996), 1119; Lancet 347 (1996), 1176, 1178, 1482-3; Science 272 (1996), 935-6. The mutation rate in children doubled. In the study of voles living next to the reactor, every individual had a different DNA sequence at the gene studied, mitochondrial cytochrome b, which is unprecedented DNA diversity. The base-pair substitution rates of 1 in 10,000 per generation are the highest known, yet the vole population remains healthy. On nuclear power protests, NS (18 May 1996), 3; (15 June 1996), 6; Nature 381 (1996), 199-200; and on cleaning up Hanford in the USA, SA (May 1996), 88-97; and storage of waste at Yucca mountain, SA (June 1996), 72-9. Natural radiation may account for 3% of deaths in the UK according to research on low level gamma radiation, NS (4 May 1996), 4. There are claims of radiation safety breaches at CERN in France, Science 272 (1996), 655.

A recommended vitamin C dose of no more than 400mg is suggested by the kinetics in volunteers, and a safe dose is less than 1000mg a day, PNAS 93 (1996), 3704-9. The benefits of moderate alcohol consumption are raised in BMJ 312 (1996), 1179-80. There are still dangers driving under the influence and Europe is working on an action plan, Lancet 347 (1996), 985-6.

Positive results of hospital smoking bans have been found in the USA, JAMA 275 (1996), 1252-7, 1281-4. There is still widespread residual serum traces of tobacco in most of the population, JAMA 275 (1996), 1233-40. Also on tobacco, JAMA 275 (1996), 1217-9, 1285, 1301; Lancet 347 (1996), 1476, 1546; Science 272 (1996), 1247. A new low smoke cigarette is being marketed by Reynolds as one which does not annoy non-smokers, NS (11 May 1996), 11. A Danish study finding smoking is the major cause for differences in lung cancer incidence, BMJ 312 (1996), 1259-63. The Netherlands has proposed new anti-smoking laws, BMJ 312 (1996), 1440.

A series of papers on inappropriate distribution of medicines by professionals in developing countries is SSM 42 (1996), 1117-1200+ (No. 8), a problem not limited to there. On FDA drug approvals, Nature Biotechnology 14 (April 1996), editorial, 511-2. Different drugs can also have different names in different countries which is confusing to patients, BMJ 312 (1996), 1315-6. A review of taxoids for use against cancer is SA (June 1996), 94-8. More mechanisms by which cocaine interferes with the brain has been found, Science 272 (1996), 957.

On breast implants, Angell, M. "Evaluating the health risks of breast implants: The interplay of medical science, the law and public opinion", NEJM 334 (1996), 1513+. France has extended its moratorium, Lancet 347 (1996), 1543 Subclinical neurological damage of organophosphate pesticides has been found in BMJ 312 (1996), 1312-3. Du Pont may face compensation claims from 40 British families whose children were born without eyes depending on the results of a Florida trial of benomyl, a pesticide, BMJ 312 (1996), 1247. Pesticides may link with estrogen to develop breast cancer, EST 30 (1996), 210-1A. Dangers of lead are discussed in MJA 164 (1996), 390-1. Exposure to environmental lead during the first seven years of life is associated with cognitive deficits that seem to persist into later childhood; Tong, S. et al. Lifetime exposure to environmental lead and children's intelligence at 11-13 years: the Port Pirie cohort study, BMJ 312 (1996), 1569-75. On mercury EST 30 (1996), 193A.

A study on the role of age in sun cancer avoidance is Carmel, S. et al. "The role of age and an expanded health belief model in predicting skin cancer protective behavior", Health Education Research 9 (1994), 433-47. A year study found no link between arthritis pain and the weather, PNAS 93 (1996), 2895-6. There are numerous comments on tougher gun laws in Australia, including BMJ 312 (1996), 1378; Lancet 347 (1996), 1616; also, CMAJ 154 (1996), 1619.

A new neuropeptide Y receptor involved in obesity has been found, Gerald, C. et al. "A receptor subtype involved in neuropeptide-Y-induced food intake", Nature 382 (1996), 168-71; GEN (August 1996), 1, 8. It is the most potent appetite stimulator so far described. The role of leptin is discussed in Nature Medicine 2 (1996), 723-4; PNAS 93 (1996), 5793-6, 6221-4, 6231-5. Also on obesity, SA (August 1996), 88-94; JAMA 276 (1996), 445; Lancet 347 (1996), 1756; AJPH 86 (1996), 798-803. Dietary fat and risk of coronary heart disease in men is studied in BMJ 313 (1996), 84-90. On calcium channel blockers and safety, Lancet 348 (1996), 488-9. On adverse effects of salt, Lancet 348 (1996), 250-1; and positive effects of vitamin E, Lancet 347 (1996), 1689-91. Garlic eaten raw is perhaps the best of easily acceptable foods that improves heart condition.

Herbal medicine research from Chinese medicine is discussed in GEN (15 June), 29, 32; (August 1996), 10, 35; NS (13 July 1996), 12-3; Lancet 348 (1996), 5-6; Science 273 (1996), 578. Too much fibre may damage health, Lancet 348 (1996), 319-20. The USA is relaxing the Delaney clause, so that foods can contain carcinogens if they pose a negligible risk, NS (27 July 1996), 9.

Cigarette advertising and onset of smoking in children is studied in BMJ 313 (1996), 398-9, 400-1. Also on smoking, BMJ 313 (1996), 96. Methods to stop smoking are discussed in JAMA 275 (1996), 1882-3, 276 (1996), 371-2. Although we will enter the 21st century with 3 fewer diseases than 100 years ago, smallpox, Guinea worm disease and polio, but tobacco is predicted to triple its annual death toll over the next 3 decades, JAMA 275 (1996), 1846-7. On tobacco companies, AJPH 86 (1996), 1073-5; NS (24 August 1996), 6. Massachusetts has had success in reducing alcohol-impaired driving, AJPH 86 (1996), 791-7. On addiction, Science 273 (1996), 611-2; Pontieri, FE et al. "Effects of nicotine on the nucleus accumbens and similarity to those of addictive drugs", Nature 382 (1996), 255-7, 206-7.

A review of the mechanism that sunlight can cause skin cancer is in SA (July 1996), 52-9. In France patient groups have accused the government of delaying for years the removal of asbestos from buildings, Lancet 348 (1996), 53. On environmental knowledge, Hearne, SA. "Tracking toxics. Chemical use and the use of the public's right to know", Environment 38 (July/August 1996), 4-9, 28-34. EPA reassessment has found there maybe 20 times less cancer risk from PCBs as was first thought, EST 30 (1996), 332-3A. A review of occupational medicine is JAMA 275 (1996), 1831-2. The question why developing countries are slow to remove lead from petrol is discussed in NS (27 July 1996), 12-3.

Anabolic steroid abuse by body builders is associated with male subfertility, BMJ 313 (1996), 100. On the use of drugs and ethics, Catlin, DH & Murray, TH. "Performance-enhancing drugs, fair competition, and Olympic sport", JAMA 276 (1996), 231-7. On the dangers of sport, Lancet 348 (1996), 277; NEJM 335 (1996), 281-3. Papers on the links between availability of guns and violence are in Blendon RJ et al. "The American public and the gun control debate", JAMA 275 (1996), 1719-22, 1723-4, 1729-33, 1765-7; yet still some people promote guns, Lancet 348 (1996), 52. Australia has passed tighter laws on gun control, Lancet 348 (1996), 327. One risk factor for hospitalization for injury is prior injury, AJPH 86 (1996), 929-34.

The dangers of ionizing radiation to diagnosis are discussed in MJA 165 (1996), 743-7. A commentary on the mysteries of childhood leukaemia are in Nature 382 (1996), 303-4. Letters on breast cancer among radiologic technologists are in JAMA 276 (1996), 369-70. On the health effects in survivors of Chernobyl see letters in JAMA 275 (1996), 1881-2; Science 273 (1996), 313, 562-4. The USA and Belarus have began building a power plant to burn contaminated forest trees from Chernobyl, Science 273 (1996), 37. The US-Japan long term study on health effects of atomic bomb survivors has been given more secure funding, Science 273 (1996), 171. Bacteria may pose some concerns about safety of long term radiation storage, NS (7 Sept 1996), 12. A report on the Canberra Commission on the Elimination of Nuclear Weapons is NS (24 August 1996), 7.

Analysis of why stress is bad for our brains is Science 273 (1996), 749-50. A review of psychiatric drug development in Japan is in Science 273 (1996), 318-9. A survey in Australia has found many laboratories have high error rates, MJA 165 (1996), 128-30. Letters on breast implants and connective tissue disease are in JAMA 276 (1996), 101-3; and a book review in Science 273 (1996), 917.

A study concluding that typical residential magnetic fields generated by high voltage power lines do not seem to be related to the risk of overall cancer in adults. A study of 383,700 people who lived during 1970-89 within 500 metres of overhead power lines of 110-400kV in a magnetic field calculated to be greater than or equal to 0.01 micro T, found 8,415 cases of cancer; Verkasalo, PK et al. "Magnetic fields of high voltage power lines and risk of cancer in Finnish adults: nationwide cohort study", BMJ 313 (1996), 1047-50. All incidence rate ratios for both sexes combined were non-significant and between 0.91 and 1.11. Significant excesses were observed in multiple myeloma in men (incidence rate ratio 1.22) and in colon cancer in women (1.16). The previously suggested associations between extremely low frequency magnetic fields and tumours of the nervous system, lymphoma, and leukaemia in adults and breast cancer in women were not confirmed. A letter on leukemia in Japan is Lancet 348 (1996), 821-2.

Letters that do not conclude there is a higher mutation rate in children exposed to nuclear bomb blasts in Japan or Chernobyl accident, are in Nature 383 (1996), 226; and on a letter opened to the public that was a British study criticizing the US researchers in Japan after the bombs because they failed to note the residual radiation effects, Lancet 348 (1996), 620. See also Lancet 348 (1996), 748; Science 273 (1996), 1787. On the nuclear weapons test ban, NS (28 Sept. 1996), 59.

Studies on women and men showing that cigarette smoking is an independent and avoidable risk factor for Age-Related Macular Degeneration are JAMA 276 (1996), 1141-1146; 1147-1151. On the blindness risk with smoking, BMJ 313 (1996), 898. On the dangers, Phillips, AN et al. "Life expectancy in men who have never smoked and those who have smoked continuously: 15 year follow up of large cohort of middle aged British men", BMJ 313 (1996), 907-8. When study estimates were combined with those from national mortality statistics for men aged 20-40, only an estimated 42% (95% confidence interval 36% to 50%)of lifelong smokers alive at the age of 20 would be alive at 73, compared with 78% (74% to 82%) of lifelong non-smokers. A book review of Smoke Screen: Women's Smoking And Social Control is BMJ 313 (1996), 1018. Passive smoking is discussed in BMJ 313 (1996), 929-933; AJPH 86 (1996), 1267-72, 1303-5; JAMA 276 (1996), 595, 603-4; and non-smoking spouses of smokers have more coronary heart disease due to the smoke, Lancet 348 (1996), 673; Circulation 94 (1996), 622-8. Smoke slows down the development of children's lungs, NEJM 335 (1996), 931-7. A report of the FDA regulation of tobacco products since 23 August is NEJM 335 (1996), 988-94. On seeking smoke-free workplaces, JAMA 276 (1996), 909-13; and on book reviews, NEJM 335 (1996), 981-2. On brain effects of nicotine, Nature 383 (1996), 670-1.

Mutational hotspots in P53 gene have been found for cigarette components, Denissenko, MF. et al. "Preferential Formation of Benzo[a]pyrene Adducts at Lung Cancer Mutational Hotspots in P53", Science 274 (1996), 430-2. The distribution of benzo[a]pyrene diol epoxide (BPDE) adducts along exons of the P53 gene in BPDE-treated HeLa cells and bronchial epithelial cells was mapped at nucleotide resolution. Strong and selective adduct formation occurred at guanine positions in codons 157,248, and 273. These same positions are the major mutational hotspots in human lung cancers. Thus, targeted adduct formation rather than phenotypic selection appears to shape the P53 mutational spectrum in lung cancer. These results provide a direct etiological link between a defined chemical carcinogen and human cancer. A study of lung damage by particulate air pollution has found more ozone increases the damage, EST 30 (1996), 382A. A study of the types of p53 mutations in murine skin cancers induced by PUVA therapy (includes UV light) is PNAS 93 (1996), 7961-5.

Leptin in obesity is discussed in BMJ 313 (1996), 953-4. Paul Zimmet et al. "Serum leptin concentration, obesity, and insulin resistance in Western Samoans: cross sectional study", BMJ 313 (1996), 965-8. They conclude the strong relation of leptin with obesity is consistent with leptin production being proportional to mass of adipose tissue. The relation with insulin independent of body mass index suggests a possible role for leptin in insulin resistance or hyperinsulinaemia

A call for healthy diets and to enjoy your fruits and vegetables is in Key TJA et al. "Dietary habits and mortality in 11000 vegetarians and health conscious people: results of a 17 year follow up", BMJ 313 (1996), 775-8; 765-6. In this cohort of health conscious individuals, daily consumption of fresh fruit is associated with a reduced mortality from ischaemic heart disease, cerebrovascular disease, and all causes combined. The incidence of high cholesterol has fallen with changed cooking oil in Mauritius, BMJ 313 (1996), 1044-6; and on a study of fish eaters in Tanzania, Lancet 348 (1996), 784-8. Also on diets and disease, Lancet 348 (1996), 670, 834, 904-6, 956-9; NEJM 335 (1996), 716-20, 738-9, 1065-9; JAMA 276 (1996), 647-8, 875-81. 882-8, 914-5; Nature 383 (1996), 589-90.

Pesticides have been linked to Gulf war syndrome, BMJ 313 (1996), 897; as have chemical weapons exposure from exploding ammunition dumps in Iraq. Exposure to 2,4-D and MCPA herbicides in farmers has a short term immuno-suppressive activity, Occupational & Environmental Medicine 53 (1996), 583-5. Methods for global tracking of persistent organic pollutants are reviewed in EST 30 (1996), 390-6. On the dangers of infected water, AJPH 86 (1996), 1203-4. On the removal of the Delaney clause in the USA, Nature Biotechnology 14 (1996), 1056; EST 30 (1996), 380A. A review of the dangers of cadmium exposure to health is Ambio 25 (1996), 370-6.

A code of ethics for Organizations is in , J. Occupational & Environmental Medicine 38 (1996), 869-83. Certain workers have a higher rate of germ cell testicular cancer, seminoma for miners and food and beverage processors, and utilities employees, while leather industry employees have more nonseminoma, in an Ontario study, J. Occupational & Environmental Medicine 38 (1996), 884+.

Hormone Replacement Therapy may increase bone density. A retrospective study of 13 women runners shows that a combination of estrogen and progestin significantly increased bone density among women getting hormone replacement therapy, Arch Internal Med. 156 (1996), 2193-2195. A letter on breast cancer and hormone exposure is Lancet 348 (1996), 682-4. Letters on evaluating the health risks of breast implants are in NEJM 335 (1996), 1154-6.

A UK survey (N=2000) is Priest, RG et al. "Lay people's attitudes to treatment of depression: result of opinion poll for Defeat Depression Campaign just before its launch", BMJ 313 (1996), 858-60. The lay public in general seemed to be sympathetic to those with depression but reluctant to consult. Most (1704 (85%)) believed counseling to be effective but were against antidepressants as addictive. They concluded, although people are sympathetic towards those with depression, they may project their prejudices about depression and the rationale for antidepressant treatment. Age differences in depression in Japan are reported in SSM 43 (1996), 967-74.

On morals and public health, Lancet 348 (1996), 618-9. Secrecy in drug safety can destroy trust, according to a critical report in the UK, NS (28 Sept. 1996), 4; Lancet 348 (1996), 765. In general on public health, JAMA 276 (1996), 923-4; NS (14 Sept. 1996), 3-4. Getting guns out of society and homes is discussed in BMJ 313 (1996), 739-40, 1030-1. A commentary on responses to disasters is AJPH 86 (1996), 1207-10. A paper showing that lowering US state legal blood alcohol limits to 0.08% would result in a reduction by 500-600 in the fatal crashes each year, AJPH 86 (1996), 1297-9. A survey of UK university student alcohol use is Lancet 348 (1996), 922-5.

A report released at the end of 1996 by the US National Research Council, Possible Health Effects of Exposure to Residential Electric and Magnetic Fields, Washington, DC: National Academy Press; 1996 (US$45), says, there remains unexplained a "weak but statistically significant" association between high levels of exposure to EMF and childhood leukemia--the observation made 20 years ago that triggered public concern over the issue (Am J Epidemiol. 1979; 1209: 273-284); Science 274 (1996), 910. The committee reviewed more than 500 reports of exposure to EMF; these reports investigated both electric fields, which are produced by any electrically charged particle, and magnetic fields, which occur when electrically charged particles are moving. The committee evaluated the epidemiologic evidence, experimental animal data, and in vitro data contained in the reports. "Over the years, a number of epidemiologists have found that children who live near concentrations of electric power lines are about 1.5 times more likely to contract leukemia [than those who live elsewhere]. The council report states that animal and laboratory studies of cells and tissues showed no discernible effects from exposure to EMF at intensities similar to those found in homes (50 Hz to 60 Hz). Only at extremely high field intensities, thousands of times higher than those found in homes, do cells react. In the USA, a major program of EMF investigations called Research and Public Information Dissemination (RAPID) is currently under way. It has about $65 million in funding from the US Department of Energy, National Institute of Environmental Health Sciences, and industry.

A legal court case is underway in the USA following claims of experiments on the corpses of those who died who had been involved in radiation experiments, NS (2 Nov 1996), 10. There are also claims in the UK that the government continues to hide experiments there, NS (30 Nov 1996), 3. Chernobyl forests that were contaminated are going to be burnt to generate electric power. About a quarter of the country of Belarus is contaminated, NS (26 Oct 1996), 9. However it may take 70 years to make the reactor area safe by sealing the reactor, and extracting radioactive fuel. France has started to demolish its facilities on Mururoa, NS (26 Oct 1996), 7. The US has approved salt bed burial of nuclear waste in New Mexico, Nature 383 (1996), 752; whereas Russia continues to pump waste into the ground, SA (Dec 1996), 20, 24. Yucca mountain repository is still expected to be the largest in the USA, Science 273 (1996), 913-4.

There have been direct links established between benzopyrene, a carcinogen in cigarette smoke, and p53 gene mutations, Lancet 348 (1996), 1157; Science 274 (1996), 430-2. Letters on nicotine and addiction are in Nature 383 (1996), 18-9; and alcohol makes the addictive crave for nicotine stronger, NS (23 Nov 1996), 18. Heavy smokers are recommended to avoid high dose beta-carotene supplements, Lancet 348 (1996), 1369. Canada is introducing tough laws on smoking advertisements, NS (14 Dec 1996), 3-4; Ontario already had some guidelines, as did other provinces, Health Law Journal 4 (1996), 221-58. On the FDA campaign to stop children smoking, FDA Consumer (Oct 1996), 7.

The receptor for morphine has been shown to be the u-opioid receptor, Nature 383 (1996), 759-60, 819-23; as may be the cocaine receptor, Zubieta, JK. et al. "Increased mu opioid receptor binding detected by PET in cocaine-dependent men is associated with cocaine-craving", Nature Medicine 2 (1996), 1225-9. There are differences between men and women, Nature Medicine 2 (1996), 1184-5, 1248-50. California and Arizo