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Tuberculosis is a disease which, from the national point
of view, is diminishing both in incidence and mortality and,
by a combination of B.C.G. vaccination, mass radiography
and modern medical and surgical treatment combined with
the close supervision of infective cases within the community,
it is likely that the risks from this disease could be
reduced in the next quarter of a century to a very considerable
degree. In the Borough of Bexley a study of the figures
for notifications and deaths over the past 20 years shows
that, while deaths have fallen considerably, notifications of
new cases have not decreased to the same extent but this
may be due to better methods of ascertainment, e.g. by
Mass Miniature Radiography. It cannot be stressed too
often that tuberculosis, when associated with a serious
degree of overcrowding and the presence of susceptible
children, is a hazard which must constantly be borne in
mind.
During 1956, a small outbreak of paratyphoid B infection
was experienced in the Borough, a small number of
cases occurring also, in the Borough of Erith and the Urban
District of Crayford. Full details of this outbreak are given
on page 43.
Cancer of the lung, which has attracted much attention
in recent years because of its apparent association, inter
alia, with smoking, caused fewer deaths in the Borough
in 1956 (28 cases) than in 1955 (48 cases) but there is no
cause for complacency as statistics show that, taking the
country as a whole, the mortality from this disease continues
to rise. In my 1955 Report I stated, " In the circumstances
it seems reasonable to advise young people not to take up
smoking and, in the case of heavy smokers of middle age,
to say that published data indicate that there may be some
diminution in risk to those who give up smoking even after
many years of addiction." I think this is a warning which
deserves to be repeated in view of the evidence, on good
authority, that smoking among late schoolagers, in many parts
of the country, is by no means inconsiderable.
With the passing of the Clean Air Act, 1956, the prevention
of atmospheric pollution received its main legislative
impetus, although one should not minimise the long
term nature of the project which the Act envisages and the
difficult technical problems which are involved. Locally, of
course, the main emphasis is on the establishment and
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