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On, welcomes possibilities to extend and develop such hospital partnerships.E A E Robinson Medical director National Blood Service, Oak Home, Watford, Hertfordshire WD1 1QH1 Booth F. UK blood donation wants reorganisation. BMJ 1998;317:281. (28 July.)fly; this would distort the measurement of exposure to cosmic radiation. Furthermore, the cabin attendants with breast cancer would possibly have had fewer flights inside the year before the diagnosis owing to the undiagnosed breast cancer. Ideally, exposure needs to be measured till the year ahead of diagnosis to prevent this bias. The breast may be the organ most sensitive to radiation carcinogenesis in postpubertal ladies,2 and hence cosmic radiation can’t be ruled out as a prospective element in the aetiology of breast cancer. A cohort study of Canadian air pilots showed an increased risk of acute myeloid leukaemia, the type of leukaemia induced by exposure to radiation (standardised incidence ratio 4.72 (90 self-assurance interval two.05 to 9.31)).3 Recall bias wants to become thought of in any study in which exposure is measured following a disease has been diagnosed or an event has occurred.four Within the case of exposure to DDT, recall bias could have led for the nonsignificant boost in danger that Wartenberg and Stapleton found. Due to the powerful link between pesticides and cancers, flight attendants with breast cancer would have been a lot more likely than controls to recall pesticide spray. It is normally vital to verify the records, if they’re readily available, to measure their agreement with reported exposure inside a MedChemExpress 4EGI-1 proportion of circumstances and controls. Even though the point estimate for exposure to DDT that Wartenberg and Stapleton report is higher (odds ratio 2.2), the wide confidence interval (0.4 to ten.9) suggests that recall bias could account for the observed odds ratio. We agree with PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20185337 the authors’ suggestion that huge studies might be the way forward to decide the function of DDT in breast cancer amongst airline attendants. These research should really also explore the joint effect of DDT and cosmic radiation.P Badrinath Specialist registrar in public wellness medicine Sam Ramaiah Director of public wellness medicine Walsall Heath Authority, Walsall WS1 1TE [email protected] Wartenberg D, Stapleton Computer. Risk of breast cancer can also be elevated amongst retired US female airline cabin attendants. BMJ 1998;316:1902. (20 June.) 2 Land CE. Low-dose radiation–a result in of breast cancer Cancer 1980;46(suppl four):868-73. 3 Band PR, Le ND, Fang R, Deschamps M, Coldman AJ, Gallagher RP, et al. Cohort study of Air Canada pilots: mortality, cancer incidence, and leukemia threat. Am J Epidemiol 1996;143:137-43. 4 Hennekens CH, Buring JE. Epidemiology in medicine. Boston: Brown, 1987.UK blood service is responding to present needsEditor–Booth’s comments on blood donation have to be deemed within the context of delivering a national service to donors, hospitals, and patients. The National Blood Service needs to collect ten 000 voluntary blood donations each day to meet the requires of all the hospitals in England and north Wales. We are keen to consider partnerships with hospitals where our combined efforts could present a much better at the same time as a price powerful service to patients and donors. Certainly, we already hold numerous sessions on hospital internet sites all through the country. Nonetheless, voluntary blood donor sessions need to be positioned within the centre of communities to produce it easy for donors to attend. To improve flexibility and convenience for donors we h.

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