“…There is little evidence, for example, that the assumed 'under reporting' linked to undetermined deaths markedly affects the overall results (Holding and Barraclough, 1978;. This is not to deny variations in coroners court decisions, though any bias is likely, paradoxically, to be systematic (Kessel, 1965), with a tendency for variations to be evened out in the national statistics (Ascencio et al, 1988;Chambers and Harvey, 1989). Neck (1988) proposed that only changes of 1OYo or more in an annual rate should be considered significant and this article accordingly uses this figure.…”