Releases Saturday 7 April 2001
No 7290 Volume 322

Please remember to credit the BMJ as source when publicising an
article and to tell your readers that they can read its full text on the
journal's web site (http://bmj.com).

If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).



(1) IQ LINKED TO LONG LIFE

(2) IMMUNISATION IS NOT LINKED TO SUDDEN INFANT
DEATH

(3) SEX INEQUALITIES FOUND IN PRIMARY CARE
TREATMENT OF HEART DISEASE

(4) HOME CHEMOTHERAPY IS A VIABLE ALTERNATIVE
TO HOSPITAL TREATMENT

(5) FATIGUE IS AN IMPORTANT FACTOR IN SERIOUS
ROAD CRASHES



(1) IQ LINKED TO LONG LIFE

(Longitudinal cohort study of childhood IQ and survival up to
age 76)
http://bmj.com/cgi/content/full/322/7290/819

Children with higher IQs may live longer, suggests a study in this
week's BMJ. These findings add to our knowledge of the
personal traits in youth that contribute to survival in adult life.

Results of an intelligence test, given to all 11-year olds attending
Aberdeen schools in 1932, were used to determine survival up
to 76 years. Of 2,230 subjects traced, those who died before 1
January 1997 had a significantly lower IQ at age 11 years than
those who were alive or untraced. This suggests that high mental
ability in late childhood reduces the chances of death up to age
76. The effect was weaker in men than in women, partly because
men with high IQ were more likely to die in active service during
the second world war.

The reason for this association is unclear, say the authors, as the
effect of IQ is difficult to separate from the effects of social class
and education. Future studies on the causes of inequalities in
health and mortality should investigate childhood mental ability as
one of the factors, they conclude.

Contacts:

Linda Menzies, Communications and Public Affairs, University
of Edinburgh, Edinburgh, Scotland.
Email: Linda.Menzies@ed.ac.uk

Angela Begg, External Relations, University of Aberdeen,
Aberdeen, Scotland.
Email: a.begg@abdn.ac.uk

(2) IMMUNISATION IS NOT LINKED TO SUDDEN INFANT
DEATH

(The UK accelerated immunisation programme and sudden
infant death in infancy: case-control study)
http://bmj.com/cgi/content/full/322/7290/822

Vaccination against diphtheria, tetanus and pertussis is now given
at ages 2, 3 and 4 months in the UK, which coincides with the
peak age for the sudden infant death syndrome (SIDS).
However, a study in this week's BMJ finds that immunisation is
not linked to sudden unexpected death in infancy and may even
protect against it.

All sudden unexpected deaths (both explained and unexplained)
of infants aged 1 week to 1 year in five regions of England were
investigated over a period of three years. For each death,
parental interviews were conducted. Four age-matched control
families were also visited within two weeks of each death.

Immunisation uptake was lowest among the infants who died,
even after taking account of all potential bias. Furthermore, no
relation was found between the time of vaccination and time of
death, signs and symptoms of illness before death, or sudden
unexpected deaths due to explained causes, particularly
infection. These results suggest that, when all potentially
confounding factors are controlled for, immunisation does not
contribute to the risk of SIDS and may protect against it, say the
authors.

They conclude: "the accelerated immunisation programme in the
United Kingdom is not associated with sudden unexpected death
in infancy, whether the death is explained or unexplained."

Contact:

Peter Fleming, Professor of Infant Health and Developmental
Physiology, Institute of Child Health, Royal Hospital for
Children, Bristol, UK
Email: peter.fleming@bris.ac.uk

(3) SEX INEQUALITIES FOUND IN PRIMARY CARE
TREATMENT OF HEART DISEASE

(Sex inequalities in ischaemic heart disease in general practice:
cross sectional survey)
http://bmj.com/cgi/content/full/322/7290/832

A study in this week's BMJ reports that treatment of heart
disease in primary care is systematically biased towards men,
despite no suggestion of sex differences in the management of
these patients in England's national service framework for
coronary heart disease.

Data for over 5,000 men and women with ischaemic heart
disease in the Trent health region were analysed. Men were
more likely than women to have cardiovascular risk factors and
blood cholesterol levels recorded on computer. Although a
higher proportion of women had raised cholesterol levels, men
were more likely to have a diagnosis of hyperlipidaemia, and
take cholesterol lowering drugs.

These differences persist when age and other risk factors are
taken into account, say the authors, and suggest a systematic
bias towards men compared with women in terms of secondary
prevention of ischaemic heart disease.

Contact:

Julia Hippisley-Cox, Senior Lecturer in General Practice,
Nottingham University, Nottingham, UK
Email: julia.hippisley-cox@nottingham.ac.uk

(4) HOME CHEMOTHERAPY IS A VIABLE ALTERNATIVE
TO HOSPITAL TREATMENT

(Compliance, satisfaction, and quality of life of patients with
colorectal cancer receiving home chemotherapy or outpatient
treatment: a randomised controlled trial)
http://bmj.com/cgi/content/full/322/7290/826

(Editorial: Home delivery: chemotherapy and pizza?)
http://bmj.com/cgi/content/full/322/7290/809

Home chemotherapy is a safe and acceptable alternative to
hospital treatment for patients with colorectal cancer that may
improve compliance with treatment, according to a study in this
week's BMJ.

Of 87 patients receiving chemotherapy for colorectal cancer, 42
were treated at an outpatient clinic and 45 at home, over a
12-month period. The two groups were similar in terms of age,
sex, site of cancer, and disease stage. Home chemotherapy had
no effect on patients' quality of life. However, compliance with
treatment and patient satisfaction, particularly with regard to
nursing care, were higher in the home treatment group.
Furthermore, home chemotherapy was not associated with an
increased use of health services such as primary care or
emergency departments.

Although these results may not apply to newer or more
complicated chemotherapy regimens, this study contributes to
the assessment of home care for cancer patients and has shown
that home chemotherapy could be advantageous for patients by
increasing satisfaction and compliance with treatment, conclude
the authors.

Contacts:

Josep M Borras, Cancer Prevention and Control Unit, Catalan
Institute of Oncology, Spain
Email: jmborras@ico.scs.es

Josep R Germà, Department of Pharmacy, Catalan Institute of
Oncology, Spain
Email: jrgerma@ico.scs.es

(5) FATIGUE IS AN IMPORTANT FACTOR IN SERIOUS
ROAD CRASHES

(Fatigue, alcohol, and serious road crashes in France: factorial
study of national data)
http://bmj.com/cgi/content/full/322/7290/829

(Editorial: Fatigue: time to recognise and deal with an old
problem)
http://bmj.com/cgi/content/full/322/7290/808

Fatigue, especially when combined with alcohol, presents a
particularly high risk of road crashes resulting in death or serious
injury, finds a study in this week's BMJ.

Data from the French Ministry of Transport was used to
investigate the role of fatigue in serious, single-vehicle crashes
during 1994-8. About 10% of the crashes were related to
fatigue and 23% to alcohol. The risk of death and severe injury
was highest when alcohol and fatigue were combined.

During the daytime, fatigue, distraction and weekend (versus
weekday) were significant factors associated with non-alcohol
related crashes resulting in death. However, for alcohol related
crashes resulting in death, only fatigue was significant.

There was also a strong relation between time of day and cause
of crash, with many alcohol related crashes occurring at night,
say the authors. Given that crashes related to fatigue can be
difficult to identify, police officers are likely to attribute such
crashes only to alcohol, even when fatigue is present, they
conclude.

Contact:

Pierre Philip, Consultant, Clinique du Sommeil, Centre
Hospitalier Universitaire, Bordeaux, France
Email: pierrephilip@compuserve.com


FOR ACCREDITED JOURNALISTS

Embargoed press releases and articles are available from:

Public Affairs Division
BMA House
Tavistock Square
London WC1H 9JR
(contact: pressoffice@bma.org.uk)

and from:

the EurekAlert website, run by the American Association for the
Advancement of Science
(http://www.eurekalert.org)