Although the present results indicate a possible occupational cause of prostatic cancer, this had little effect on the overall health of the atomic energy authority's workforce. Exposure to the radionuclides associated with prostatic cancer was uncommon: only 3% of the controls in this study had known contamination and 11% had worked in places where contamination might have occurred. Fourteen men with known contamination and 28 who had worked in places where contamination might have occurred developed prostatic cancer in the 41 years from 1946 to 1986. During the same period 5509 deaths were reported in the authority's cohort study, and the total death rate was 22% below the national average.'The members of the Epidemiological Monitoring Unit were funded by the Medical Research Council through contracts held with the United Kingdom Atomic Energy Authority. We thank members of these organisations for their support and cooperation, in particular Len Salmon, Dallas Law, Jean Rose, medical staff, and health physicists for their help. We also thank Lucy Carpenter, David Dunn, Dudley Goodhead, Peter Smith, and Hazel Inskip for advice and Sarah Firsht, Anja Griffioen, Evangelia Tzala, and Craig Higgins for help with data processing. 5 Fraser P, Carpenter L, Maconochie N, Higgins C, Booth M, Beral V. Cancer mortality and morbidity in employees of the United Kingdom Atomic Energy Authority, 1946-86. BrJ Cancer 199367:615-24. Antibiotics are prescribed for various reasons.' Some patients demand antibiotic treatment for fatigue and others refuse such treatment because they believe it to be responsible for the onset of fatigue. It is reasonable to assume that fatigue is secondary to the initial illness rather than to the treatment itself. To check this hypothesis we compared placebo with amoxycillin in a double blind, randomised crossover trial in healthy volunteers. Our particular aim was to find out whether certain psychological characteristics are linked to side effects during clinical trials.
Subjects, methods, and resultsInformed, healthy medical students or nurses volunteered for the study. A personality questionnaire including Bortner's rating scale2 and Levenson's locus of control scale3 was completed at the start of the trial. Bortner's scale ranges from 0 (extreme type A behaviour: competitive, impatient) to 24 (extreme type B behaviour: relaxed, easy going). Levenson's scale measures whether subjects consider themselves to be in control of life events (intemal locus of control) or more dependent on outside factors (extemal locus of control). Subjects received in a randomised order amoxycillin 500 mg thrice daily or placebo for one week, with a two week wash out period.At the end of each treatment period the subjects were compared for the presence or absence of fatigue by using the X2 test. Psychological profiles were compared with the sum of the fatigue scores recorded at the end of the two treatment periods (verbal score with six points from 0 to 5) by using the nonparametric Kruskal-Wallis test. We estimate...
