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a broad interpretation; it can cover not only considerations
like space, light, heat and noise, but also the
nature and interest of the work itself, and the kind of
journey to and from work. It would be interesting to
obtain evidence of the relative health record of those
City workers who are provided with an organized
occupational health service and those who are not.
Certain factors in my view must make for positive
health in City workers. However long and tiring the
journey to and from the City may be, there is still an
irreducible amount of walking. Few people get from one
point in the "square mile" to another except by walking.
The nature of the terrain often makes it the quickest and
most convenient method, more so than ever now that
parking restrictions and parking meters have spread to
the City. My own public health inspectors always walk on
duty. The illustration at the head of this paper shows the
workers, looking not too unhappy even on a rainy day,
walking over London Bridge from the railway terminus
south of the Thames. Mostly, City workers seem to walk
quickly at almost any time of day. Then I think, too, that
the mental health of workers is helped by the idea that
they all belong to a sort of club at the "hub of the universe";
a great world centre backed by centuries of
tradition, much of it of exceptional interest like that of
the City Livery Companies. A "job in the City" may not
carry the same status as it did in Dickens' time, but it
still means something.
Last but by no means least, since October 1955, City
workers have been able to breathe clean air, the City
now being, by private legislation, a smokeless zone.
Through the energetic enforcement of the Dark Smoke
(Permitted Periods) (Vessels) Regulations 1958, by the
Corporation of London acting in its capacity as Port of
London Health Authority, the hazards of smoke from
Thames vessels have also been largely removed.
At the time when the Marsh Bill was first under debate
in Parliament, the Corporation of London, through its
Health Committee decided to undertake a pilot survey
of office enviromental conditions. This was started by City
public health inspectors in March 1960. No extra
staff were taken on in this earlier survey and the work
had to be fitted in as and when convenient with the
routine duties of the three district inspectors. Before the
survey was commenced, the medical officer of health
and the inspectors met a number of times to work out a
standard form or schedule for use in the survey.
One hundred firms were visited. The buildings
inspected were chosen in the first instance according
to age: (a) those built from 1900 up to the beginning
of World War II and: (b) those built since the end
of the War. A further subdivision was made in
accordance with size—small, large and medium. The
results of the pilot survey are shown on a prototype of
the form of schedule that was used in the survey, and
this is reproduced in Table I.
The results of this small pilot survey at first sight appear
to argue that the City's offices are not after all so bad an
environment to work in. But a closer scrutiny of our
results showed that the picture may have some distortions
in it. To begin with the sample, for reasons beyond our
control at that time, was not selected statistically at random,
and similarly preference tended to be given by the
inspectors to premises well-known to them. The sample
of 100 is too small—under one per cent—to reflect very
accuratelytheuniverseof City offices which number 12,000.
Detailed environmental measurements, particularly of
space, lighting and ventilation, proved impossible to
carry out, and these three are in many ways the chief
arbiters of health in the office room itself. The 400 cubic
feet fixed as a minimum is both an absolute minimum and
a very tiny space. It should never be regarded as a figure to
be complacent about. Glare is a problem recognized long
ago but not easily evaluated accurately without detailed
readings of illumination and space. And how is the office
worker to be persuaded to open windows?
Nevertheless, certain undesirable facts emerged.
Seventy-three out of 102 rooms were at temperatures
above 65°F, 25 of them being over 70°F. Opinions differ,
but most health specialists would agree that 70°F and
above is unnecessarily warm. Though 43 offices were
daylighted in the sense that they did not need artificial
light during morning and most of the afternoon, the
source of the light—the sky—was invisible to most of the
occupants. Sixteen firms had canteens; 84 had no facilities
for eating meals on the premises. It is our impression that
not enough attention is paid to this absence of a place to
relax in at the midpoint of the working day. Finally teamaking,
by no means only a Civil Service ritual, goes on
all over the place in a variety of spots often undesirable
from a food-hygiene aspect.
Dr. R. Owen, Her Majesty's Medical Inspector of
Factories, whose division includes the City area, has
supplied interesting particulars about factories in the
City. They are given in Table II.

From these factories issue an immense variety of
products. Whilst heavy industry is absent, there are
many examples in clothing and textiles, furnishings,
food and drink, jewellery, rubber and leather and sundry
products, engineering, chiefly of a light instrument
nature, and, of course, a tremendous weight of printing
and allied trades, including photography. There are also
dozens of warehouses and a handful of curious and
interesting small trades.
Factory workers have the protection of legislation
from environmental hazards. Because the dangers to
health of the white-collared worker are more subtle, less
easily discernible and therefore less dramatic, he (and
she) have been denied the environmental protection
which is their due.
Factory workers have, in some cases at least, services
to guard their health during working hours. Industrialists
are convinced of the value of these services. If it were not
so one would hear of surgeries being closed and staff
dismissed. The logic of extending occupational health
coverage to the white-collared worker has been recognized
by the British Medical Association in their admirable
publication The Future of Occupational Health
Services:
"The Association believes that there is a need for
occupational health services to be extended to all types
of employment. It therefore endorses the recommendation
of the Dale Committee (1951) that:
'there should eventually be some comprehensive
provision for occupational health, covering not only
industrial establishments of all kinds, both large and
small, but also the non-industrial occupations referred
to in the report of the Gowers Committee.' "
Do not let us ask ourselves if we can afford to establish
occupational health services for the non-manual worker.
Let us rather put the question—can we any longer afford
to neglect the health of so many by leaving unfilled this
breach in the ramparts of health?
The Corporation of London appointed an Assistant Medical Officer, Dr. Alan Robinson, on
1st June 1961 to conduct a survey of occupational health conditions in the City of London before
considering the setting up of an Occupational Health Service to cater for City workers mainly in
small firms not already covered by their own occupational health services. Dr. Robinson will
commence duties on 1st January 1962.
The following photographs (a) show throngs of City workers coming over London Bridge in the
rush hour (b) illustrate two types of offices that will be surveyed by Dr. Robinson, the older one
is adjacent to a house formerly occupied by Dr. Samuel Johnson from 1748 to 1759, the other
was first put into use in September, 1960.
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