Effects of moon phase and other temporal variables on absenteeism

Human responses to the geophysical daily, annual and lunar cycles

Collectively the daily, seasonal, lunar and tidal geophysical cycles regulate much of the temporal biology of life on Earth. The increasing isolation of human societies from these geophysical cycles, as a result of improved living conditions, high-quality nutrition and 24/7 working practices, have led many to believe that human biology functions independently of them. Yet recent studies have highlighted the dominant role that our circadian clock plays in the organisation of 24 hour patterns of behaviour and physiology. Preferred wake and sleep times are to a large extent driven by an endogenous temporal program that uses sunlight as an entraining cue. The alarm clock can drive human activity rhythms but has little direct effect on our endogenous 24 hour physiology. In many situations, our biology and our society appear to be in serious opposition, and the damaging consequences to our health under these circumstances are increasingly recognised. The seasons dominate the lives of non-equatorial species, and until recently, they also had a marked influence on much of human biology. Despite human isolation from seasonal changes in temperature, food and photoperiod in the industrialised nations, the seasons still appear to have a small, but significant, impact upon when individuals are born and many aspects of health. The seasonal changes that modulate our biology, and how these factors might interact with the social and metabolic status of the individual to drive seasonal effects, are still poorly understood. Lunar cycles had, and continue to have, an influence upon human culture, though despite a persistent belief that our mental health and other behaviours are modulated by the phase of the moon, there is no solid evidence that human biology is in any way regulated by the lunar cycle.

The epidemiology and chronobiology of epistaxis: an investigation of Scottish hospital admissions 1995-2004

OBJECTIVES

This study aimed at investigating aspects of the epidemiology and chronobiology of emergency admissions with epistaxis in Scotland between 1995 and 2004. In particular, we sought to examine the epidemiology of hospital admission with epistaxis and effects of factors such as day of week, time of year and lunar cycle.

DESIGN

A statistical analysis, in terms of descriptive statistics, logistical regression and linear regression, was carried out on data obtained from the Scottish Morbidity Records related to emergency Ear, Nose and Throat (ENT) admissions.

SETTING AND PARTICIPANTS

All emergency inpatient admissions for Scottish residents to ENT wards in Scottish NHS hospitals during the 10-year period, between 1st January 1995 and December 31st 2004 were studied. This study only looked at admissions and thus excludes Accident and Emergency attendances caused by epistaxis.

MAIN OUTCOME MEASURES

Age, gender, year, month and day of the week of admission were considered, as was relationship to the moon phase.

RESULTS

During the study period, the mean daily admission rate with epistaxis was six. Epistaxis accounted for 33% of all ENT emergency admissions. The average age of non-epistaxis ENT emergency admission was 31 years. For epistaxis emergency admissions the median age was 70 years. There were fewer admissions in the summer months [August RR: 0.59 (95% CI: 0.54-0.65) P < 0.001]. There were more admissions at the weekends and on non-weekend public holidays [RR: -0.115 (95% CI -0.160-0.071) P < 0.001]. There was a trend towards a reduction in admission rates from the year 2001. Despite the fluctuations with season and weekday, there was no relationship with phase of the moon [RR: 0.98 (95% CI: 0.88-1.09) for day of the full moon compared with non-full moon weekday].

CONCLUSIONS

This study underlines the importance of epistaxis as the single most frequent emergency diagnosis in ENT. The frequency and patterns of admission show pronounced fluctuations. The observed increase in winter admissions confirms earlier work and may have implications for health resource allocation. Relationships between weekends/public holidays and increased admissions with epistaxis may correspond with social patterns of alcohol use (a known aetiological factor). The lunar cycle does not have an effect on the frequency of epistaxis admissions.

Effect of lunar cycle on temporal variation in cardiopulmonary arrest in seven emergency departments during 11 years

OBJECTIVE

To determine the effect of the phase of the full and new moon on the variation in the number of daily cardiopulmonary resuscitations.

DESIGN

A retrospective analysis of a computerized billing database of emergency department visits in a cohort of seven northern New Jersey (USA) emergency departments.

PARTICIPANTS

Consecutive patients seen by emergency department physicians over an 11-year period (1 January 1988 to 31 December 1998). We determined the timing of full and new moon days from the National Oceanographic and Aeronautic Administration website.

INTERVENTIONS

Time series regression estimated the independent effect of full and new moon days on the daily variation in cardiopulmonary resuscitations. Tests of statistical significance were made at alpha=0.05.

RESULTS

A total of 2 370 233 emergency department visits were made during the 4018-day period of study. A total of 6827 had an emergency department diagnosis of cardiopulmonary resuscitation. We found no significant difference in the occurrence of cardiopulmonary resuscitations during the full moon (P=0.97). On average there were 6.5% fewer cardiopulmonary resuscitations during new moon days (P=0.02; 95% confidence interval 1.3-11.7%).

CONCLUSION

Contrary to the traditional belief that more cardiopulmonary resuscitations occur during the full moon, we were unable to identify a significant effect during full moon days. However, there were on average 6.5% fewer cardiopulmonary resuscitations during new moon days than other days.

Barking mad? another lunatic hypothesis bites the dust

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.

LUNACY REVISITED

The idea that the stars and planets may influence human health and behavior can be traced to at least Roman times, and research suggests a high proportion of health professionals continue to hold this belief. Nevertheless, evidence for the supposed influence of the moon on human behavior has proved particularly elusive, and research has tended to suffer from weaknesses in methodology and data analysis. This article reports findings drawn from a re-analysis of data from a research study into the functioning of a sample of mentally ill people living in the community. The mental health and quality of life of a sample of 100 people were assessed on four occasions during a 30-month period. Data were aggregated to represent the span of one lunar month, with scores being allocated to the relevant week of the lunar cycle during which each assessment was made. Comparison of mean values across the weeks of the lunar cycle was preformed using the ANOVA, Results showed significant change at the time of the full moon only in subjects with a diagnosis of schizophrenia (n = 56), where deterioration was observed in three areas of psychopathology and one area of quality of life. Some implications for nursing practice are discussed, and it is suggested that future research into the possibility of a lunar effect on human life should focus on the direct measurement of functioning in people with schizophrenia.

Suicides and the lunar cycle

The existence of lunar influence on the frequency of suicide is tested by means of a permutation test. A total of 897 suicide deaths reported by the Anatomical Forensic Institute of Madrid were analyzed by a permutation test, a direct application of Fisher's ideas. Noteworthy in this study are the testing method used and the accuracy of timing of the deaths. Both factors provide firm ground for our conclusion: there appears to be no relationship between lunar phases and suicide.

Lunar cycle and consultations for anxiety and depression in general practice

The influence of the moon on patient consultations for anxiety or depression in general practice was assessed through a retrospective survey based on general practice medical records and on lunar records detailing the dates and times of different phases of the moon. Seven-hundred-eighty-two patients continuously registered in a general practice in Beckenham, South London, between 1971 and 1988 were included in analyses. No statistically significant lunar effect was found by setting the expected surge in consultations one to three days after the full moon and the period of the sine-wave curve to 30 days. Similarly, no statistically significant lunar effect was found, when the period of the sine-wave curve was allowed to vary in order to best fit the data. The moon had little influence on when individuals consulted their general practitioner with anxiety or depression.