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still very great and much time and energy is spent at the Chest Clinic
assisting these cases and deciding on their individual treatment. 95 cases
were sent away from Deptford for treatment in hospitals or sanatoria
during the year. A great many more cases are treated at home and
some are allowed to return to work whilst on active treatment if they are
not a danger to themselves or others in so doing.
Chronic bronchitis and other similar chest diseases are also responsible
for much of the Chest Physician's work in this area, which, like many
parts of the Thames valley, is low-lying and subject to fog, often contaminated
by gross atmospheric impurities.
Many cases attending the Chest Clinic were subject to intensive investigations
to exclude cancer of the lung. 19 new cases of this disease were
discovered during 1959 of whom no less than 18 were males. More than
half occurred during the working period of life. One of the great tragedies
is the relative lateness at which cases of cancer of the lung present
themselves—11 of the 19 cases when first seen here were considered to be
beyond the possibility of operation to remove the growth. Of the 19
cases 18 had smoked possibly over 20 cigarettes a day for 20 years or
more, many greatly in excess of this figure. A glance at the residences
of the patients found to suffer from cancer, reveals that well over 60%
were living along main highways or bus routes. It has long been held
in some quarters that the exhaust fumes, particularly from diesel engines,
are a dangerous factor in the causation of lung cancer. It has certainly
been proved that Benzypyrene is a well-known agent in cancer formation
and occurs in the exhaust fumes of motor vehicles. I understand that
considerable research has recently been carried out, particularly in
California, where a law is being passed that every motor vehicle should
be fitted with an ' after burner' which would burn the dangerous Benzpyrene
from the exhaust gases. It would indeed be a great step forward
if some similar measure could be taken in congested urban areas.
It is, of course, difficult to draw conclusions from the above-mentioned
small number of cases of cancer, but I still hold from previous experience
of this disease that heavy tobacco smoking is a main factor in its
causation."
Mass Miniature Radiography
I append below a report I have received from the Director of the Mass
Radiography Unit:
" I enclose analyses of results of surveys carried out during the year
1959.
In the overall analysis of those mass X-rayed in Deptford, you will note
that fifteen close supervision or treatment type cases of tuberculosis were
found in a total of 9,474, an apparent incidence of 1.6. These can be
sub-divided into nine cases found amongst those not previously mass
X-rayed within the last five years and six amongst those previously mass
X-rayed. The actual discovery rates, therefore, are nine cases out of
2,444 not previously examined and six cases among the 7,030 previously
examined, giving incidences of 3-7 and 0-9 respectively.
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