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Copyright © 2000, BMJ Barking mad? Another lunatic hypothesis bites the dust Department of Public Health and Community Medicine, University of Sydney, NSW 2006, Australia Contributors: SC was bitten by the hypothesis, fetched the data, and reviewed the literature. SM analysed the data and inserted the worst puns. SC is guarantor. Correspondence to: S Chapman simonc/at/health.usyd.edu.au This article has been cited by other articles in PMC.Abstract Objective To assess whether dog bites requiring hospital admission occur more at the full moon. Design Review of dates of admission for dog bites to accident and emergency departments, June 1997 to June 1998, compared with dates of the full moon. Setting All public hospitals in Australia. Main outcome measures Admissions for dog bites. Results 12 peak clusters of admissions were unrelated to the time of the full moon. Conclusion Dog bites are no more frequent on full moons than at any other time of the month. Sceptics rejoice. Introduction After publicity about the paper (by SC) on a randomised controlled trial to reduce dog bites,1 we were contacted by a farmer who asked: “Have you university types ever looked at whether dog bites happen more around the full moon? It's a well known fact that they do.” Farmers are often storehouses of folkloric knowledge said to be derived from a rich tradition of empirical observation of, for example, sky colour and the weather (“red sky at night, shepherd's delight; red sky in the morning, shepherd's warning”) or avoiding the wrath of bulls (“red rag to a bull”)—so we leashed our scepticism and investigated. The influence of the full moon remains one of the more resilient popular explanations of a wide range of mostly traumatic or bizarre events. There is a pale reflection of this in epidemiology—recall bias—where those affected by a rare or severe disease are more inclined to associate unrelated non-disease exposures to the disease. Although more women have been documented to menstruate around the full moon,2 research has generally failed to confirm any association between the full moon and the manifestation of psychiatric disorders or violence in psychiatric settings,3,4 consultations for anxiety or depression in general practice,5 suicide and self poisoning,6,7 agitation among nursing home residents,8 car accidents,9 major trauma,10 or emergency department admissions.11 Weak associations have been reported between the full moon and the distribution of spontaneous full term deliveries,12 small increases in meal size and reduced alcohol consumption,13 unintentional poisonings,14 absenteeism,15 aggression in Dade County, Florida,16 and reports of crimes to three police stations in India between 1978 and 1982. The latter, in a nation devoted to astrology, was posited by the authors to be caused by “human tidal waves” caused by the gravitational pull of the moon.17 So it seems that humans are mostly impervious to putative effects of the full moon on mental health and behaviour. But what about our best friend, Phideau? Do howling dogs feel more inclined to bite humans during the full moon than at other times? Or are their barks worse than their bites when a human interrupts their canine arias? Such questions have dogged science for so long that they can no longer be ignawed. Methods We obtained from the National Injury Surveillance Unit 12 months of data on daily admissions for dog bites to all accident and emergency departments in public hospitals in Australia. We chose a year of data for analysis that would supply sufficient event numbers, both of dog bites and full moons, and would enable us to sniff out any seasonal variation in dog bite admissions. Age and sex of victims, but not perpetrators, were available. Daily admissions for 13 June 1997 to 12 June 1998 were plotted against the occurrence of a full moon. Mean daily admission numbers were analysed in relation to the presence or absence of a full moon, stratified by day of the week so that comparisons between full moon and non-full moon days were for the equivalent day of the week. Mean dog bite admissions during full moons occurring on, for example, a Monday were compared with dog bite admissions for all other Mondays. Results Altogether 1671 accident and emergency admissions for dog bites occurred during the study period (938 males, 733 females), representing an overall mean admission rate of 4.58 per day. Figure Figure11
Comparison of hospital admissions by day of the week is shown in figure figure2.2
Discussion In Australia at least, no positive relation seems to exist between the full moon and dog bites severe enough for hospital treatment. Myers's critical appraisal of gravitational lunacy theory18 argued that, because tidal gravity fluxes are semidiurnal, with smaller diurnal and even smaller fortnightly components, there are no unique monthly gravitational components that would correspond to the period of the full moon. Also, the gravitational effects associated with the times of high tide are greater than those associated with moon phases. By applying this principle to absurd lengths, Myers suggested that any lunacy effects should occur twice each day with high tides and also should be more pronounced during the new moon and full moon (spring tides). Our data recorded time of bite, but investigation of Myers's hypothesis was muzzled by small numbers. As the plot of dog bite admissions and full moons clearly shows, more caution with dogs might be exercised over Christmas and especially at New Year—irrespective of the full moon.
Acknowledgments We thank Malinda Steenkamp from the National Injury Surveillance Unit, Adelaide, for data.Footnotes Funding: No special funding. Competing interests: Neither author owns a dog, but both quite like them. They are unscarred by bites. References 1. Chapman S, Cornwall J, Righetti J, Sung L. Preventing dog bite in children: a randomised controlled trial of an educational intervention. BMJ. 2000;320:1512–1513. [PubMed] 2. Law SP. The regulation of menstrual cycle and its relationship to the moon. Acta Obstet Gynecol Scand. 1986;65:45–48. [PubMed] 3. Raison CL, Klein HM, Steckler M. The moon and madness reconsidered. J Affect Disorders. 1999;53:99–106. [PubMed] 4. Owen C, Tarantello C, Jones M, Tennant C. Lunar cycles and violent behaviour. Aust N Z J Psychiatry. 1998;32:496–499. [PubMed] 5. Wilkinson G, Piccinelli M, Roberts S, Micciolo R, Fry J. Lunar cycle and consultations for anxiety and depression in general practice. Int J Soc Psychiatry. 1997;43:29–34. [PubMed] 6. Mathew VM, Lindesay J, Shanmuganathan N, Eapen V. Attempted suicide and the lunar cycle. Psychological Reports. 1991;68:927–930. [PubMed] 7. Buckley NA, Whyte IM, Dawson AH. There are days . . . and moons. Self-poisoning is not lunacy. Med J Aust. 1993;159:786–789. [PubMed] 8. Cohen-Mansfield J, Marx MS, Werner P. Full moon: does it influence agitated nursing home residents? J Clin Psychol. 1989;45:611–614. [PubMed] 9. Laverty WH, Kelly IW. Cyclical calendar and lunar patterns in automobile property accidents and injury accidents. Perceptual & Motor Skills. 1998;86:299–302. [PubMed] 10. Coates W, Jehle D, Cottington E. Trauma and the full moon: a waning theory. Ann Emerg Med. 1989;18:763–765. [PubMed] 11. Thompson DA, Adams SL. The full moon and ED patient volumes: unearthing a myth. Am J Emerg Med. 1996;14:161–164. [PubMed] 12. Ghiandoni G, Secli R, Rocchi MB, Ugolini G. Does lunar position influence the time of delivery? A statistical analysis. Eur J Obst Gynecol Reprod Biol. 1998;77:47–50. [PubMed] 13. De Castro JM, Pearcey SM. Lunar rhythms of the meal and alcohol intake of humans. Physiol Behav. 1995;57:439–444. [PubMed] 14. Oderda GM, Klein-Schwartz W. Lunar cycle and poison center calls. J Toxicol Clin Toxicol. 1983;20:487–495. [PubMed] 15. Sands JM, Miller LE. Effects of moon phase and other temporal variables on absenteeism. Psychological Reports. 1991;69:959–962. [PubMed] 16. Lieber AL. Human aggression and the lunar synodic cycle. J Clin Psychiatry. 1978;39:385–392. [PubMed] 17. Thakur CP, Sharma D. Full moon and crime. BMJ. 1984;289:1789–1791. [PubMed] 18. Myers DE. Gravitational effects of the period of high tides and the new moon on lunacy. J Emerg Med. 1995;13:529–532. [PubMed] |
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BMJ. 2000 Jun 3; 320(7248):1512-3.
[BMJ. 2000]Acta Obstet Gynecol Scand. 1986; 65(1):45-8.
[Acta Obstet Gynecol Scand. 1986]J Affect Disord. 1999 Apr; 53(1):99-106.
[J Affect Disord. 1999]Aust N Z J Psychiatry. 1998 Aug; 32(4):496-9.
[Aust N Z J Psychiatry. 1998]Int J Soc Psychiatry. 1997 Spring; 43(1):29-34.
[Int J Soc Psychiatry. 1997]Psychol Rep. 1991 Jun; 68(3 Pt 1):927-30.
[Psychol Rep. 1991]Eur J Obstet Gynecol Reprod Biol. 1998 Mar; 77(1):47-50.
[Eur J Obstet Gynecol Reprod Biol. 1998]Physiol Behav. 1995 Mar; 57(3):439-44.
[Physiol Behav. 1995]J Toxicol Clin Toxicol. 1983 Jul; 20(5):487-95.
[J Toxicol Clin Toxicol. 1983]Psychol Rep. 1991 Dec; 69(3 Pt 1):959-62.
[Psychol Rep. 1991]J Clin Psychiatry. 1978 May; 39(5):385-92.
[J Clin Psychiatry. 1978]J Emerg Med. 1995 Jul-Aug; 13(4):529-32.
[J Emerg Med. 1995]