J. W. Webb

A survey of childhood malignancies.

SECTION I. BACKGROUND TO THE SURVEY The present survey is based on an earlier study of the vital statistics relating to leukaemia (Hewitt, 1955). This had revealed an unusual peak of mortality in the third and fourth years of life which indicated that the subsequent survey should, in the first instance, be restricted to children. The earlier investigation had also led to the suggestion that it might be particularly worth while to study modern innovations, such as radiology.

Social Medicine Studies based on Civilian Medical Board Records I. National Service Rejects

By the regular publication of statistics based on Census data and death certificates the General Register Office has kept the United Kingdom so well informed that even the man in the street is aware when mortality changes of a disquieting or reassuring nature have occurred. But nowadays, when disease more often causes loss of working efficiency than premature death, a more sensitive instrument than mortality statistics is needed to measure the public health. Since there is no immediate possibility of supplementing the national register of deaths with one of disabilities, it is relevant to ask whether the optimum use is being made of the records of routine health examinations, in particular those of Civilian Medical Boards.

Social Medicine Studies based on Civilian Medical Board Records: IV. Occupational and Physical Characteristics of Men with Certain Digestive Disorders

In a large sample of wartime Civilian Medical Board (C.M.B. passim) records it was found that 1 • 2 per cent, of the men examined were unfit for military service because of a peptic ulcer, and a fur0*25 per cent, because of other digestive disorders (Stewart, Webb, and Hewitt, 1955a). In addition to this loss of manpower at the screening stage there was a further heavy loss from the same causes among men accepted for military service : peptic ulcer ranked second only to psychiatric disorder as a reason for discharge from the army (War Office, 1948). Thus digestive disorders caused more serious disability than any of the other disease groups so far dealt with in this series (foot defects, varicosities, and skin diseases). In some ways this means that peptic ulcer is less suitable for study through massed medical records. The condition may, for example, make a patient lose weight or change his job, so that it becomes difficult, in a statistical analysis, to distinguish between cause and effect. Despite this difficulty it was felt that an analysis of the peptic ulcer records both by occupation and by physique could be of value, provided the results were interpreted with caution. To this study has been added a similar analysis of other types of dyspepsia and of appendicitis.

Social Medicine Studies based on Civilian Medical Board Records: V. Physical and Occupational Characteristics of Men with Hernia, Spinal Curvature, and Rheumatism

In previous papers we have discussed the following conditions recorded by Civilian Medical Boards: all causes of rejection from military service; varicosities; skin diseases; digestive disorders; and foot defects (Stewart, Webb, and Hewitt, 1955, a, b, c, d; Hewitt, Stewart, and Webb, 1953). On this occasion we shall be considering three disease groups which have little in common except that they have an obscure aetiology and were recorded sufficiently often to merit statistical analysis: namely, hernia, spinal curvature, and rheumatism. The basic material and methods of analysis remain unchanged (Stewart and others, 1955b) and wherever comparisons are made in terms of Standardized Prevalence Ratios (S.P.Rs) they incorporate an allowance both for regional variation in standards of recording (Essex, Northamptonshire, and Leicester) and for differences in age distribution.

SPREAD OF TUBERCULOSIS FROM HOUSE TO HOUSE

This investigation originates from an observation made in 1948 that many tuberculous patients in Northampton lived next door to one another. It was decided to find out whether the pattern of the disease in this town suggested that persons living next door to tuberculous subjects are unduly prone to contract the disease. The first step was to discover the position of houses from which cases of tuberculosis had been notified from 1921 to 1948. We next studied other possible influences on the pattern of the disease, to see whether, allowing for these, the position of the affected houses suggested a random distribution of cases, or revealed the transmission of disease between neighbours. Finally, to decide whether the setting of the investigation was exceptional, the population and social conditions of Northampton were examined, by comparing the borough as a whole with other towns, and by comparing different districts within the borough.