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80
Thirty-seven deaths occurred from tuberculosis (all forms), 34
of these being pulmonary cases. The number of deaths in institutions
was 18.
The death rate for tuberculosis (all forms) during 1930 was
0.82 per 1,000 population, compared with 0.9 for the previous year.
Of the 37 deaths from tuberculosis 3 had not been notified to
us before death—i.e., 8.1 per cent. of the total deaths from
tuberculosis.
No action has been taken for wilful neglect or refusal to notify,
because none of the 3 cases comes within such category.
The figures in Barking in any one year are not sufficiently
large for us to express any opinion as to if and whether there is
evidence of any excessive incidence of, or mortality from, tuberculosis
in any particular occupation in the area, but the association
of tuberculosis with asbestosis is well known, and I understand
that the figures for the nation as a whole show that there is an
increased incidence of tuberculosis amongst these workers in
asbestos.
During the year 1930 your Medical Officer of Health has
continued to be Tuberculosis Officer, and this fact has mitigated
to a large extent the disability of divorcing work associated with
the detection of tuberculosis from the general duties of the Medical
Officer of Health.
With the development of Barking some variation in our present
plan of operation is necessary, and a review of the situation would
not be out of the way here, particularly so in view of the fact that
the situation in Barking has been interesting as an experiment.
It must be remembered that a Tuberculosis Service consists
essentially of three more or less distinct factors. These of course
overlap to a certain extent.
First of all we have prevention, then we have detection and
then we have treatment. It is obvious that of these three factors