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LEAD-POISONING
13 without the benefit of chromosome studies. It seems probable that this earlier child represents the other expected (unbalanced) segregant. A full report of this family will be presented elsewhere when family studies are complete.
ATHLETIC ACTIVITY AND LONGEVITY
trisomy
Cytogenetics Laboratory, Department of Pathology,
University of Dundee.
MICHAEL FAED
JANET ROBERTSON.
BLOOD-LEAD LEVELS IN LONDON TAXI DRIVERS
SIR,-I apologise to Dr. Jones and his colleagues for misinterpreting (Sept. 2, p. 485) the only times quoted in their article (Aug. 12, p. 302) to be the working-shift times of the taxi drivers, rather than the times at which the authors visited the cab-company’s operations room to collect blood-samples. The relevant information-namely, that shift lengths were on average 7-9 hours-is given for the first time in their more recent letter (Oct. 21, p. 881). The fact remains that the effect of exposure to lead in the working shift may well be masked by the lead exposure during non-taxi-driving hours, for the equilibration time for atmospheric lead with blood-lead is longer than 7-9 hours. It is still difficult to draw any conclusions from this without further factual information about lead exposure throughout the whole 24-hour period. The length of shift is not relevant to the other points I made concerning lead intake from food and atmosphere, and blood-lead levels in smokers and non-smokers. School of Pathology, Middlesex Hospital Medical School, London W1P 7LD.
R. M. HICKS.
LEAD-POISONING SIR,-In his letter of Oct. 14 (p. 817) criticising the generally accepted toxic threshold for blood-lead of 80 g. per 100 ml., Professor Bryce-Smith refers to two reports of clinical plumbism due to defective lead-glazed earthenware with " blood-lead levels of 59, 63, 78, 79, and 83 g. per 100 ml. measured at or about the time of diagnosis ". Dr. Clark, the author of one of these reports,! gave no estimate of the time lapse between the cessation of exposure and the blood-lead estimations of 63 and 78 fLg. per 100 ml. As the author of the other report,2 I think I made it clear that the first blood-lead of 83 f.g. per 100 ml. (122 fLg. per 100 ml. corrected for haemoglobin) was obtained at least 18 days after exposure had ceased, and that the readings of 63 and 78 g. per 100 ml. were both obtained a further 15 days after that. Since Professor Bryce-Smith subsequently refers to the well-known " fall in blood-lead levels which can occur soon after abnormal exposure ceases ", I wonder why he uses our data to conclude that the toxic threshold of 80 g. " per 100 ml. is contradicated by the published evidence " ? Incidentally, the duplicated estimations of 79 and 59 g. per 100 ml.l and 78 and 63 jjt.g. per 100 ml. seem good evidence of another well-known fact-that not all published figures are highly accurate. In fact, far greater differences than these are still common,3 and may account for some of the gross discrepancies of opinion to be found in the literature, whichwith judicious selection can thus be used to justify almost any flight of fancy. Sharston Lodge,
Fortyfoot Road, Leatherhead, Surrey. 1. 2.
M. K. WILLIAMS.
Clark, K. G. A. Lancet, Sept. 23, 1972, p. 662. Williams, M. K. ibid. Sept. 2, 1972, p. 480. 3. Berlin, A., Del Castilho, P., Smeets, J. International Symposium " Environmental Health Aspects of Lead", Amsterdam, Oct. 2-6, 1972, Preprint no. 92.
p.
SiR,—The discussion between Dr. Schnohr (Sept. 16, 605) and Dr. Largey (Aug. 5, p. 286) misses the point,
which is that different sports involve athletes of different somatotypes. The mesomorphic football players are in the susceptible group for coronary disease, especially if they cease their early athletic activity-which is usually the case. Runners on the other hand are ectomorphic, which gives them an edge on natural longevity. They also tend to continue their lonely physical activities in some way, such as walking and cycling. Rook’s work came before our current pandemic of coronary-artery disease. I believe his study would not stand up now. American-football players may differ from rugby players, although I doubt it. Track athletes incidentally should not be lumped together. Sprinters are of different build and personality from the 10,000-metre men. 79 West Front Street, Red Bank, New Jersey 07701, U.S.A.
GEORGE A. SHEEHAN.
AUSTRALIAN COLLEGE OF MEDICAL ADMINISTRATORS
SiR,—The report of the working-party on medical administrators1 and the subsequent commentary 2-4 underline reference to the formation of a Faculty of Community Medicine in Great Britain,1,6and prompt me to refer to the objectives and activities of the Australian College of Medical Administrators.7 In 1965 a group of leading medical administrators in Victoria formed a steering committee and fostered interest throughout the Commonwealth and Territories of Australia. The Australian College of Medical Administrators was incorporated on March 21, 1967, and the interim council first met on April 20 of that year. Foundation fellows were drawn from all those areas of community medicine involved in the specialist practice of medical administration of a Health Service. Inauguration and foundation convocation took place in May, 1968. Council, being convinced that the standing of the College depended on the academic quality of its fellowship by examination, appointed an education committee to review the material to be studied by intending candidates. The first election of fellows qualifying for election upon examination occurred in 1970. The valuable contributions of the censor-in-chief, education committee, and court of examiners have provided a sound foundation whereby the fellowship of the Australian College of Medical Administrators is now recognised throughout the Commonwealth as an appropriate higher qualification in the specialty of medical administration. The principal objectives of the College are: To establish and maintain the
highest standards of learning,
skill, and conduct in the field of medical administration. To promote and advance the dissemination in all ways of to the field of medical administration. To promote mutual understanding and fellowship between persons engaged in the field of medical administration and to promote good relations between such persons and other persons engaged in the practice of medicine and between such persons and the community.
knowledge related
Report of the Working Party on Medical Administrators (chairman, Dr. R. B. Hunter). H.M. Stationery Office, 1972. 2. Lancet, 1972, i, 1221. 3. Hosp. Hlth Serv. Rev. 1972, 68, 217, 256. 4. Br. med. J. 1972, ii, 601. 5. Lancet, 1971, ii, 813. 6. Br. med. J. 1971, iv 117. 7. Med. J. Aust. 1968, i, 1095. 1.
ATHLETIC ACTIVITY AND LONGEVITY
trisomy
Cytogenetics Laboratory, Department of Pathology,
University of Dundee.
MICHAEL FAED
JANET ROBERTSON.
BLOOD-LEAD LEVELS IN LONDON TAXI DRIVERS
SIR,-I apologise to Dr. Jones and his colleagues for misinterpreting (Sept. 2, p. 485) the only times quoted in their article (Aug. 12, p. 302) to be the working-shift times of the taxi drivers, rather than the times at which the authors visited the cab-company’s operations room to collect blood-samples. The relevant information-namely, that shift lengths were on average 7-9 hours-is given for the first time in their more recent letter (Oct. 21, p. 881). The fact remains that the effect of exposure to lead in the working shift may well be masked by the lead exposure during non-taxi-driving hours, for the equilibration time for atmospheric lead with blood-lead is longer than 7-9 hours. It is still difficult to draw any conclusions from this without further factual information about lead exposure throughout the whole 24-hour period. The length of shift is not relevant to the other points I made concerning lead intake from food and atmosphere, and blood-lead levels in smokers and non-smokers. School of Pathology, Middlesex Hospital Medical School, London W1P 7LD.
R. M. HICKS.
LEAD-POISONING SIR,-In his letter of Oct. 14 (p. 817) criticising the generally accepted toxic threshold for blood-lead of 80 g. per 100 ml., Professor Bryce-Smith refers to two reports of clinical plumbism due to defective lead-glazed earthenware with " blood-lead levels of 59, 63, 78, 79, and 83 g. per 100 ml. measured at or about the time of diagnosis ". Dr. Clark, the author of one of these reports,! gave no estimate of the time lapse between the cessation of exposure and the blood-lead estimations of 63 and 78 fLg. per 100 ml. As the author of the other report,2 I think I made it clear that the first blood-lead of 83 f.g. per 100 ml. (122 fLg. per 100 ml. corrected for haemoglobin) was obtained at least 18 days after exposure had ceased, and that the readings of 63 and 78 g. per 100 ml. were both obtained a further 15 days after that. Since Professor Bryce-Smith subsequently refers to the well-known " fall in blood-lead levels which can occur soon after abnormal exposure ceases ", I wonder why he uses our data to conclude that the toxic threshold of 80 g. " per 100 ml. is contradicated by the published evidence " ? Incidentally, the duplicated estimations of 79 and 59 g. per 100 ml.l and 78 and 63 jjt.g. per 100 ml. seem good evidence of another well-known fact-that not all published figures are highly accurate. In fact, far greater differences than these are still common,3 and may account for some of the gross discrepancies of opinion to be found in the literature, whichwith judicious selection can thus be used to justify almost any flight of fancy. Sharston Lodge,
Fortyfoot Road, Leatherhead, Surrey. 1. 2.
M. K. WILLIAMS.
Clark, K. G. A. Lancet, Sept. 23, 1972, p. 662. Williams, M. K. ibid. Sept. 2, 1972, p. 480. 3. Berlin, A., Del Castilho, P., Smeets, J. International Symposium " Environmental Health Aspects of Lead", Amsterdam, Oct. 2-6, 1972, Preprint no. 92.
p.
SiR,—The discussion between Dr. Schnohr (Sept. 16, 605) and Dr. Largey (Aug. 5, p. 286) misses the point,
which is that different sports involve athletes of different somatotypes. The mesomorphic football players are in the susceptible group for coronary disease, especially if they cease their early athletic activity-which is usually the case. Runners on the other hand are ectomorphic, which gives them an edge on natural longevity. They also tend to continue their lonely physical activities in some way, such as walking and cycling. Rook’s work came before our current pandemic of coronary-artery disease. I believe his study would not stand up now. American-football players may differ from rugby players, although I doubt it. Track athletes incidentally should not be lumped together. Sprinters are of different build and personality from the 10,000-metre men. 79 West Front Street, Red Bank, New Jersey 07701, U.S.A.
GEORGE A. SHEEHAN.
AUSTRALIAN COLLEGE OF MEDICAL ADMINISTRATORS
SiR,—The report of the working-party on medical administrators1 and the subsequent commentary 2-4 underline reference to the formation of a Faculty of Community Medicine in Great Britain,1,6and prompt me to refer to the objectives and activities of the Australian College of Medical Administrators.7 In 1965 a group of leading medical administrators in Victoria formed a steering committee and fostered interest throughout the Commonwealth and Territories of Australia. The Australian College of Medical Administrators was incorporated on March 21, 1967, and the interim council first met on April 20 of that year. Foundation fellows were drawn from all those areas of community medicine involved in the specialist practice of medical administration of a Health Service. Inauguration and foundation convocation took place in May, 1968. Council, being convinced that the standing of the College depended on the academic quality of its fellowship by examination, appointed an education committee to review the material to be studied by intending candidates. The first election of fellows qualifying for election upon examination occurred in 1970. The valuable contributions of the censor-in-chief, education committee, and court of examiners have provided a sound foundation whereby the fellowship of the Australian College of Medical Administrators is now recognised throughout the Commonwealth as an appropriate higher qualification in the specialty of medical administration. The principal objectives of the College are: To establish and maintain the
highest standards of learning,
skill, and conduct in the field of medical administration. To promote and advance the dissemination in all ways of to the field of medical administration. To promote mutual understanding and fellowship between persons engaged in the field of medical administration and to promote good relations between such persons and other persons engaged in the practice of medicine and between such persons and the community.
knowledge related
Report of the Working Party on Medical Administrators (chairman, Dr. R. B. Hunter). H.M. Stationery Office, 1972. 2. Lancet, 1972, i, 1221. 3. Hosp. Hlth Serv. Rev. 1972, 68, 217, 256. 4. Br. med. J. 1972, ii, 601. 5. Lancet, 1971, ii, 813. 6. Br. med. J. 1971, iv 117. 7. Med. J. Aust. 1968, i, 1095. 1.