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55
Although W.H.O. regards alcoholism as the fourth most
important problem in the world today, this country can scarcely
consider itself in the "van" with regard to its approach to the treatment
and eradication of alcoholism.
Hitherto, by leaving alcoholism mainly in the hands of reformers
and moralists, the medical profession as a whole has forfeited an
opportunity to clarify the aetiology and render the problem less
intractable.
In a survey report "Alcoholism in Industry" issued by a consortium
of charities connected with rehabilitation of alcoholics, it
was estimated that working time lost by people whose drinking
problems were known to their employers costs the country £24
million per year. Investigations covered by the report revealed that,
on an average, the alcoholic lost 86 days per year because of
drinking and only 1.5% had not lost time during the previous year
because of their problem. Some 40% admitted missing a Monday
morning's work once or twice a month and 38% of the cases interviewed
had been dismissed during the previous year because of
their drinking habits. A substantial number (76%) considered that
promotion had been denied them because of their drinking and
11% thought that this was the cause of an accident sometime
during the previous year.
Locally, a survey among 247 firms in a neighbouring borough
revealed that 3.45 men per 1,000 and 0.19 women per 1,000 were
alcoholics known to their employers. If this were repeated nationally
it would mean a total of 57,750 men and 900 women with
known drinking problems in industry. However, because alcoholics,
generally, are particularly adept at hiding their problems, these
figures must substantially understate the position.
Apart from all the medical and social implications, such evidence
suggests that alcoholism is a serious industrial disease warranting
immediate attention. Meanwhile, voluntary endeavour would seem
to be worthy of greater central and local government support.
Cancer
We have moved some way from the concept that cancer is a
single disease. Over recent years our laboratory, clinical and
epidemiological researchers have demonstrated that there are
numerous and varied cancers among which only the industrial types
are, at the moment, subject to primary prevention. Nevertheless,
the ultimate control of cancer must be based on prevention.
If preventive action is to be effective, it must take account of
all the accumulated knowledge concerning neoplastic disease and
the causative factors, where known, and apply them in such
practical ways as will produce the maximum impact on the public.