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To the Editor.— Adverse effects caused by acupuncture have been documented,^1-3 including serious complications such as pneumothorax, septicemia, and spinal lesions. Norheim and Fønnebø³ reported that pneumothorax, fainting, local infections, and increased pain are fairly common based on their survey of 1135 randomly selected physicians and 197 acupuncturists in Norway. To determine the risk of acupuncture in a practice of trained acupuncturists, we studied the adverse events related to acupuncture treatment at our institution in Japan.

Tsukuba College of Technology Clinic is a unique national medical facility at which more than 60% of outpatients (approximately 17000 per year) undergo acupuncture treatment. All the acupuncturists are either preceptors or interns. Intern acupuncturists receive instruction for 3 months before taking charge of their own practice. Instruction is given by both lectures and practical training and includes information about anatomically risky depth of insertion and use of aseptic procedure for puncturing.

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