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BMJ No 7103 Volume 315 Press Releases Saturday 2 August 1997 Embargoed: 00.01 Hrs 1 August 1997 UK time
Large increase in teenage drug deaths The period 1985-95 saw a large increase in accidental deaths from drug poisoning among teenagers, says a paper in this week's BMJ. Over the 11 year period the overall rate for accidental drug deaths among those aged 15-19 increased by 8% per year. The authors studied the records of all deaths from injury and poisoning among the relevant age group, and found that from 1985-89 17 teenagers died from taking opiates and related narcotics; for the period 1991-95 this had risen to 67. This category of drugs accounted for 11% of deaths from accidental poisoning in 1985 and for 37% in 1995. Death rates from poisoning by other mind-altering drugs, such as ecstasy, increased by 23% per year over the 11 years. From 1985-89 there were eight deaths in this category, but from 1991-95 there were 32. The authors also found a decrease in the death rate from poisoning where the deceased's intent was unclear, and no substantial increase in the suicide rate during the study. "Although data on accidental poisoning are likely to underestimate the total number of drug related deaths, these data underscore the public health impact of drug use among teenagers and the need to identify effective drug control strategies," they conclude.
Contact:
Dept of Epidemiology
Tel: 0171 242 9789
Deaths from childhood leukaemia in Berkshire and Oxfordshire are more common in areas close to nuclear sites, says a letter in this week's BMJ. Districts with significantly higher risks are those which contain the outfalls for licensed releases of radioisotopes from the nuclear sites at the Atomic Energy Research Establishment, Harwell; the Atomic Weapons Establishment, Aldermaston; and the Royal Ordnance Factory, Burghfield. All three nuclear sites release radioactive gases into the immediate surroundings and liquid effluents into nearby rivers. Since there is no sea dilution effect in the area pollution is likely to remain in the local environment, unlike releases at Sellafield, say the authors, and it is possible that these radioactive emissions might have harmful effects on those living near the sites or in areas close to the rivers where effluents are discharged.
Contact:
Green Audit (Wales) Tel: 01970 611 226
Children born to women who suffer from insulin-dependent diabetes (IDD) are 10 times more likely to have congenital anomalies and five times more likely to be stillborn, says a paper in this week's BMJ. The authors studied 462 pregnancies in 355 women with IDD and although there were 351 live births, 78 miscarried spontaneously, 9 resulted in stillbirth and 24 were terminated. Nine of the terminations were for congenital abnormality, the prevalence of which was 94 per 1,000 live births, compared with 9.7 per 1,000 in the general population. This prevalence of congenital defects can be reduced by good management of blood sugar levels before and at the time of conception, say the authors, but the challenge will be to implement this through the diabetic population. Contact: The University of Liverpool
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...by improved care before conception[Prospective population based survey of outcome of pregnancy in diabetic women: results of the Northern Diabetic Pregnancy Audit, 1994]Diabetic pregnancy remains a high risk state, says another paper in this week's BMJ. In 1989, say the authors, the St. Vincent declaration stated as a five year goal that "outcome of diabetic pregnancy should approximate that of the non-diabetic population". They studied the records of all diabetic pregnancies during 1994 in the former Northern regional health authority and compared them with non-diabetic pregnancies in the same region. They found that the perinatal mortality rate among children born to diabetic mothers was five times higher, the neonatal mortality rate 15 times higher, and the congenital malformation rate four times higher than in the general population. There was also a substantial excess of premature births among diabetic mothers. The outcome of diabetic pregnancy remains poor, they conclude. "Though two thirds of the pregnancies were planned by the mother, most women had not established good diabetic control before conception. Preconceptual care reduces major congenital malformations and the spontaneous abortion rate. It is essential that we should improve delivery of this cost effective care."
Contact: Hartlepool General Hospital Tel: 01429 266654
UK care in diabetic pregnancy falls short[Persistently poor pregnancy outcome in women with insulin]Why has the UK not achieved the St. Vincent declaration's target on the reduction of mortality and malformation among babies born to women with diabetes, asks an editorial. Pregnancy outcomes in Scandinavia have improved to the extent that, in Sweden, the rate of spontaneous abortion is similar between diabetic and non-diabetic women, and rates of congenital malformation have more than halved. It would seem, says the author, that regular blood sugar monitoring among women who are pregnant or planning to be so should ensure that the St. Vincent's target would be reached. But with unplanned pregnancies and pregnancies among women who have not received preconceptual care still common, the services for non-pregnant women need to be as effective as for those attending preconceptual or ante-natal clinics. "This means that diabetes services in general need to be reconfigured to optimise glycaemia over the whole population."
Contact:
Middlemore Hospital
Tel: 00 64 9 276 0076 Suicide pacts on decrease[Epidemiology of suicide pacts in England and Wales, 1988-92]Suicide pacts are less common today than they were 35 years ago, says a paper in this week's BMJ. People who commit suicide in a pact are more likely to be female, older, married, and of a higher social class than those who do so alone. The authors studied the death statistics of the 19,721 people recorded as having committed suicide between 1988 and 1992. They concluded that 62 pairs of people had planned to kill themselves together. Forty eight pairs were husband and wife, five were close blood relatives, four were lovers, three were cohabiting couples, and two were friends. Fifty seven pairs lived in the same household, and only two people lived alone, in contrast to lone suicides, of whom only half are married and a quarter live alone. The ratio of males to females was one to one, another difference from lone suicides, where it is 3 to one in favour of males. The average age of people committing suicide together was higher, and nearly half the sample was in social class 1 or 2. Eleven people worked in professions relating to medicine. Couples used non-violent methods, which permitted them to die painlessly and simultaneously. Suicide notes were left in 52 pacts, and both partners signed in 33 of these. In all 69% signed a suicide note, again a higher proportion than among lone suicides (30-40 per cent). Fifteen of the married couples were remembered by witnesses as talking of "dying together" and "not bearing to be parted". This suggests that there was no coercion, say the authors.
Contact:
St James's Hospital,
Tel: 01705 471 551 Make use of refugee doctors[Refugee doctors: a wasted resource]An estimated 200 refugee doctors - a number equivalent to the annual output of an average medical school - are languishing in Britain, their skills unused, says an editorial in this week's BMJ. When 500 new doctors, each costing around £200,000 to train, are required in the UK, why do we not develop a package to integrate refugee doctors into the workforce, ask the authors. In addition to providing a valuable resource and saving the country money, this would also satisfy what the UN High Commission for Refugees considers one of the three rights of refugees: local integration without dependence on welfare. "Overall this could be a win-win situation," conclude the authors.
Contact:
Imperial College School of Medicine Tel: 0171 485 1905 (home)
Embargoed: 00.01 Hrs 1 August 1997 UK time
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