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The survey figures may be minimal for the reasons given in paragraph 10 and by the
fact that some of the staff retired permanently unfit may have had a comparatively short
expectation of life. The low mortality rate for teachers is not altogether unexpected—they
have a low occupational mortality, a standardised mortality ratio of 66 compared with
the national figure of 100 for the whole population (Registrar General, Occupational
Mortality, 1951).
20. Less striking, but also of some importance, are the high figures for the incidence of
psychoneuroses and psychoses in A.P.T. & C. grades and teachers referred to in paragraph
13. This cause of sickness is more understandable with teachers than office staff but the
figures (paragraph 13) show that as a cause of premature retirement it is higher in A.P.T.
& C. grades than in teachers. Also of some concern should be the high incidence of accidents
not on duty sustained by firemen and ambulance staff.
21. The high incidence of psychoses and psychoneuroses and of accidents off duty in
certain categories of staff obviously calls for further study, both to confirm the validity
of the problems disclosed and to elucidate their causes. Two methods of study are available.
First, the study of the individual case histories of those cases brought to light in the present
study (or a random sample of them); second, a prospective study beginning now and
continuing into the future in which the records of certain categories of staff with certain
types of illness are made in such a way that additional information will be available which
may serve to confirm or refute certain hypotheses.
It may be mentioned that neither the original survey that brought to light the suggestive
findings nor either of the suggested methods of following-up these findings would have
been possible without the special recording procedure in use during the last three years.
Summary
22. This survey has shown that comprehensive recording of long-term sickness in the
Council's staff is possible; in addition certain significant findings have been disclosed.
In the grades of staff where the numbers were adequate for a comparison between the
sexes—A.P.T. & C. group and teaching staff—the incidence of long-term sickness was
generally higher in females than in males. The incidence of sickness in A.P.T. & C. grades
was about twice that in teachers; in nursing staff it approximated to that in female A.P.T.
& C. grades; and fire and ambulance staff had the highest incidence of all, but this may have
been due to the practice within these two grades of earlier referral to the examining medical
officer.
The wastage rate by permanent unfitness for further duty or by death in the service
amounted to as much as five per cent. a year for both men and women aged 55-64 years
in the administrative, professional, technical and clerical staff.
Psychoneuroses and psychoses were the principal causes of long-term sickness in female
A.P.T. & C. grades, in both men and women teachers and was the second principal cause
in male A.P.T. & C. grades. Fire and ambulance staffs had proportionately fewer psychoneurotic
difficulties but experienced more hernias, diseases of the bone and organs of
movement and accidents not on duty.
Diseases of the genital organs were relatively common (8-11 per cent. of all causes) in all
grades of female staff, more noticeable around the age of the menopause.
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