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61
30% overweight while the risk of myocardial infarction was
trebled in those who were 20% over average. Other aspects which
have a bearing on heart disability are dietary imbalance—lack of
physical exercise with a consequent rise in body weight—smoking
—the connection of coronary disease with "stress and strain" and
with diabetes—genetic tendencies. Several of these predisposing
factors have their origins in self-indulgence and the remedies are
obvious. However, until our knowledge of cause and effect is complete,
ft would be unwise to delay introduction of preventive
measures such as the adoption of a balanced diet and the restriction
of the intake of animal fat, weight reduction, control of smoking,
introduction of regular exercise and, most important, the dissemination
of reliable information by health education officers.
Fluoridation of water supplies would appear to have no relationship
with heart disability but in a recent investigation in the U.S.A.
into the effect upon osteoporosis of fluorides in the water supply it
was found, quite fortuitously, that there was a striking difference
between the high and low fluoride areas and the number of calcified
aortas—the difference being in the order of 40% less in the high
fluoride area. Confirmation of such a discovery would emphasise
the significant role which fluoride consumption could play not
only in the treatment of osteoporosis and dental caries but also in
preventing calcification of the cardiac vessels.
Infective Hepatitis
Infective hepatitis, which is transmitted mostly by person to
person contact but which may also be passed on parenterally like
serum hepatitis, has an incubation period of, usually, from 15 to
40 days. A common source of spread is via communities of children
who may infect susceptible adults in their households. Water and
food outbreaks are rare.
Cases of both serum and infective hepatitis have been reported
in connection with intermittent haemodialysis for the treatment of
chronic renal failure.
It was suggested in my 1965 Report that viral hepatitis should be
made the subject of official notification throughout the country in
order that more precise information could be obtained concerning
its epidemiological background thus enabling the introduction of
effective measures to prevent its dissipation.
An increase in drug addiction has tended to focus attention on the
transmission of infective hepatitis by contaminated syringes and
needles and, conversely, drug addiction has been revealed by the
occurrence of infective hepatitis.