View report page

TUBERCULOSIS
The number of cases notified during the year was 16 compared with 26 in 1969. There were
three deaths due to tuberculosis during the year, all males aged 45 years and over and none of them
amongst the notified cases. This compares with five deaths in 1969.
PROTECTION OF CHILDREN AGAINST TUBERCULOSIS
In addition to B.C.G. Vaccination against Tuberculosis another protective measure was taken
early in 1970. It was arranged with the Director of the Mass Miniature Radiography Service and
the Chief Education Officer to station the MMR Unit at certain convenient points in the Borough
for the benefit of teachers who were then able to avail themselves of the service. It was estimated
that coverage of the teacher population would be complete within 1% to 2 years. Up to September
only one case had not been pronounced clear and this case was not due to Tuberculosis.
All cases not cleared at the first screening are further investigated and the Principal School
Medical Officer is informed.
CHEST CARE AND AFTER CARE
In recent years the welcome fall in tuberculosis rates of notification and mortality
unfortunately has been matched by a rise in other conditions, notorious amongst them being
bronchitis, lung cancer and coronary heart disease, all having very strong links with cigarette
smoking. Nationally this trend has been shown during the sixties in relation to sickness benefit
(D.H.S.S. Annual Report of Chief Medical Officer 1970). In these terms bronchitis continues to
account for by far the highest number of lost days due to certified incapacity for both males and
females and it must be expected to go on doing so until the campaign against cigarette smoking is
more successful. During the last decade male and female lung cancer death rates nationally have
gone up remorselessly year after year, particularly so for females who did not become involved in
the cigarette smoking epidemic until much later in this century than was the case for males. Much
has been written about the concurrent rise in mortality from heart disease which prompted the
choice of the new title for the National Association for the Prevention of Tuberculosis, now the
Chest and Heart Association. During the year in Bexley London Borough there were two features
of after-care which reflected these trends. In the early months of the year the Bexley Chest and
Heart Care Committee confirmed its position in relation to these changing needs and in doing so
invited medical and nursing representation from the Health and Welfare Department, thereby
ensuring a mutually satisfactory framework for the after-care of such patients. In the second
place, the health visitors at chest clinics had been dealing with more and more non-tubercular
conditions. This change also was confirmed and the after-care arrangements were extended to
include other respiratory diseases and the patients of any other chest consultant who might
request this service.
104