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quarter of a century to a very considerable degree In the Urban
District of Crayford 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
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 of Bexley, a small number of cases
occurring, also, in the Borough of Erith and the Urban District
of Crayford (3)
Cancer of the lung, which has attracted much attention in
recent years because of its apparent association inter alia,
with smoking, caused two more deaths in Crayford in 1956, (12
cases) than in 1955 (10 cases), and this accords with the experience
in the country as a whole in which 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 gradual expansion of smoke control
areas and the need to work in close collaboration with neighbouring
authorities Although the Urban District does not experience
the worst effect of atmospheric pollution, it will be recalled
that about 50 per cent of such pollution results from the domestic
hearth and much foresight will be called for in the installation
in new housing estates of heating appliances capable of burning
smokeless fuels The availability of these fuels is an important
(4)