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Head injury is a major cause of morbidity and mortality in all age groups. Injury to the head can result in traumatic brain injury (TBI) of varying severity. TBI is common, with a self-reported lifetime prevalence of up to 40% in adults.1 Currently, there is no effective treatment to reverse the effects of the primary brain injury sustained, and treatment is aimed at minimising the secondary brain injury that can occur due to the effects of ischaemia, hypoxia and raised intracranial pressure. This can occur immediately, within the following hours or days, or after a further head injury. An understanding of the epidemiology of head injury is essential for devising preventive measures, to plan population-based primary prevention strategies and to provide effective and timely treatment, including provision of rehabilitation facilities to those who have suffered a head injury. This information can then be used to improve TBI outcomes.
Lithium can be found naturally in drinking water. In clinical practice, it
is widely used in pharmacological doses for the treatment of bipolar
disorder; and may also prevent suicidal behaviour in people with mood
disorders. In two studies, lithium levels in tap water have been
significantly and negatively correlated with suicide. We measured lithium
levels in tap water in the 47 subdivisions of the East of England and
correlated these with the respective suicide standardised mortality ratio in
each subdivision. We found no association between lithium in drinking water
and suicide rates across the East of England from 2006 to 2008.