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organs were especially important in women, ranking second in order of importance,
between the ages of 35-54 years. Arthritis and rheumatism (very much related to age),
were not as important as may be generally supposed, ranking in order of importance sixth
in women and seventh in males. Of the causes of death, cancer and heart disease were the
most important in males whilst in females 13 of the 16 deaths recorded were due to cancer.
The diseases mainly causing retirement from the service on medical grounds were in males
psychoneuroses, diseases of the nervous system (strokes) and bronchitis, whilst in females
psychoneuroses was the outstanding cause.

14. Among nurses, section C, the biggest causes of sickness were psychoneuroses.
cancer, heart and circulatory diseases, and diseases of genital organs in that order—the
same sort of pattern, with minor variations in order of preference, as was found with
female A.P.T. & C. grades and women teachers. Heart and circulatory diseases were the
principal causes of invaliding from the service, followed by psychoneuroses; cancer was
the only cause of death in the service recorded.
15. For firemen, section D, the principal causes in order of importance were accidents
(not on duty), heart and circulatory diseases, psychoneuroses, diseases of the stomach and
duodenum (code No. 35), arthritis and rheumatism and hernia (code No. 37). Compared
with male A.P.T. & C. staff and teachers, firemen experienced proportionately less cancer,
less psychoneurotic illness and far less respiratory disease; they experienced proportionately
many more accidents (three times as many), more diseases of the stomach and duodenum
and for the first time in these tables hernia becomes of some importance. The lower
incidence of cancer and respiratory diseases can be partly explained by fire staff having a
younger age composition than A.P.T. & C. staff and teachers (see table 1, sections A, B
and D). The higher rate from hernia is understandable because of the standards of fitness
required in their occupation: a small hernia in, say, a clerical officer might not give rise to
invaliding from the service, whereas the same sized hernia in a fireman might mean permanent
unfitness for duty. This in itself may also contribute to the high proportion of
sickness noted earlier in this grade of staff. Heart and circulatory diseases, diseases of bones
and organs of movement, arthritis and rheumatism, and accidents were the principal cause
of permanent unfitness for further service.
16. Ambulance staff, section E, showed a similar pattern of sickness to firemen (including
a proneness to accidents not on duty), except that they had fewer psychoneuroses (the
lowest of any grade of staff in this survey) and an incidence of respiratory disease more
in line with that for men A.P.T. & C. grades and men teachers—the latter can probably be
accounted for by a somewhat older staff (fewer young men). Hernia again is of some
importance in this grade, ranking fifth in order of importance—lifting is also very much
a part of an ambulance driver's duties and hernia is therefore an invaliding condition.
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