Dietary exposures of consumers to 30 elements (aluminium, antimony, arsenic, barium, bismuth, boron, cadmium, calcium, chromium, cobalt, copper, germanium, gold, iridium, iron, lead, lithium, manganese, mercury, molybdenum, nickel, palladium, platinum, rhodium, ruthenium, selenium, strontium, thallium, tin and zinc) estimated from the UK 1994 Total Diet Study are reported, and compared with those from previous UK Total Diet Studies and those from other countries. Dietary exposure estimates were generally low and, where comparisons are possible, similar to those from other countries and below the relevant Provisional Tolerable Weekly Intakes and Provisional Maximum Tolerable Daily Intakes. For most of those elements included in previous UK Total Diet Studies, dietary exposures have declined.

Concentrations of aluminium, arsenic, cadmium, chromium, copper, lead, mercury, nickel, selenium, tin and zinc were determined in samples from the 1997 UK Total Diet Study and used to estimate dietary exposures of the general UK population. Population average dietary exposures to aluminium (3.4 mg/day), arsenic (0.065 mg/day), cadmium (0.012 mg/day), chromium (0.10 mg/day), copper (1.2 mg/day), mercury (0.003 mg/day), nickel (0.13 mg/day), tin (1.8 mg/day) and zinc (8.4 mg/day) are similar to those from previous UK Total Diet Studies and are below the appropriate PTWIs, PMTDIs and TDIs. Dietary exposure of the UK population (0.026 mg/day) to lead is falling as a result of measures taken to reduce lead contamination of the environment and food and is well below the PTWI. There has been little change in UK estimates of selenium exposure since the 1994 Total Diet Study but current-estimates (0.039 mg/day) are lower than those derived from earlier Total Diet Studies.

Dietary exposures to nitrate have been estimated for two different groups of UK consumers. The daily dietary exposure of the general population was estimated from the UK 1997 Total Diet study to be 52 mg/day. Vegetables contributed approximately 70% to this total dietary exposure. Dietary exposure estimates for adult consumers of vegetables commonly eaten in the UK were 93 mg/day and 140 mg/day for mean and 97.5th percentile consumers, respectively. Dietary exposures to nitrate of UK consumers are similar to those in other European countries and are less than the Acceptable Daily Intake (ADI) for nitrate set by the European Commission's Scientific Committee for Food.

SUMMARY Three cases are reported of a lethal multiple congenital anomaly syndrome. The infants had moderate limb shortening, joint contractures, polydactyly, and the two with male karyotypes had female external genitalia. Internal anomalies included unilobular lungs, hypoplasia of the anterior portion of the tongue, and renal hypoplasia.We report three unrelated infants with a lethal multiple congenital anomaly (MCA) syndrome who had moderately short limbs, polydactyly, and valgus deformity of the feet with syndactyly. All had female external genitalia but two had 46,XY karyotypes. All This apparently female infant was born at 35 weeks' gestation, the first child of a healthy, unrelated, Caucasian 26 year old woman and 30 year old man. The mother had had a healthy baby and a termination of pregnancy in a previous relationship. In this pregnancy urinary and serum oestriols were low when measured between 32 and 35 weeks' gestation, but human placental lactogens were normal. The baby, which had female external genitalia, died of respiratory failure at the age of 11/2 hours.The baby weighed 2*325 g, length 45 cm, occipito-

Concentrations of bromine and iodine were analysed in samples from the 1997 UK Total Diet Study (TDS) using ICP-MS. The data has been used to estimate dietary exposures of UK consumers to these elements from the typical UK diet. Samples for the 20 TDS food groups were obtained from 20 towns in the UK in 1997 and analysed in 1998/99 for total bromine and total iodine concentrations. These samples were also analysed for 12 other elements. The UK regulatory authority had considered iodine recently, but had not considered bromine before. This survey provides up-to-data baseline data for those two elements. Iodine concentrations are similar to those found in recent surveys. Levels of bromine were consistent with previous data where available. Dietary exposures to bromine and iodine were calculated to see if there were any risks to health from the levels of these elements found in the UK diet. The estimated population average exposure to iodine was 0.25 mg d-1, which is within the range of previous estimates (1995, 0.21 mg d-1; 1991, 0.17 mg d-1; 1985, 0.28 mg d-1). The estimated population average exposure to bromine was 3.6 mg d-1.

The usefulness of micronutrient antioxidant therapy for recurrent (nongallstone) pancreatitis has recently been endorsed by a do-week doubleblind double-dummy cross-over trial in 20 patients. Treatment was delivered as two types of tablets, providing daily doses of 600 pg organic selenium, 9000 i.u. p-carotene, 0.54 g vitamin C, 270 i.u. vitamin E and 2 g methionine. We report antioxidant profiles in blood samples collected before entry, at the cross-over stage and upon completion of trial. Baseline serum concentrations of selenium, ,&carotene and vitamin E in the patients were significantly lower than in healthy controls, were unaltered by placebo and normalized by active treatment, but reverted to basal values in the subgroup that received placebo subsequently. The baseline serum concentration of a free radical marker-the 9-cis, 1 I-trans isomer of linoleic acid-was significantly higher in the patients than in controls, fell inexplicably in the placebo phase and fell further upon active treatment. Discriminant analysis eliminated the overlap in free radical marker and selenium concentrations between control sera on the one hand and baseline or post-placebo samples from the patients on the Correspondence to: Dr J. M. Braganza, Department of Gastroenterology, Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. 229

Selenium status and its relationship to lowered platelet glutathione peroxidase activity was investigated in 18 subjects with aspirin (ASA)-induced asthma and in asthmatic and non-asthmatic ASA-tolerant subjects. Mean serum selenium concentration in ASA-tolerant asthmatics (1.25 microns/l; 98.5 micrograms/l) was significantly higher than that in ASA-induced asthma subjects (1.14 microns/l; 89.7 micrograms/l) and than that in healthy controls (1.15 microns/l; 91 micrograms/l). Although there was a correlation between serum selenium concentration and platelet glutathione peroxidase activity, enzyme activity was significantly lower in the ASA-induced asthma group compared to other groups even after correcting for selenium status. These results indicate that lowered platelet glutathione peroxidase activity in ASA-induced asthma is a product of both selenium availability and an unidentified syndrome-specific (possibly genetic) factor.

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