View report page

8
Tuberculosis—Pulmonary.
We are witnessing a most important development in tuberculosis, which,
although still the most important infectious disease, seems to be on the
point of control. The number of notifications dropped in the year to 93,
from 126 the year before. There is no doubt that the tuberculosis bacillus
is less widely spread in the community; tuberculin-testing in school leavers,
as part of the B.C.G. vaccination procedure, demonstrates this in a most
effective fashion. A positive tuberculin test, whilst not necessarily a sign
of disease, demonstrates that the individual has been infected at some time
with the germ. The percentages of positive reactors in the years 1954 to
1958 inclusive were 18, 13.5, 10.8, 6.3 and 6.2, demonstrating a drop in
the pool of infection to nearly a third in five years. Nevertheless, the
number on the register of cases is still rising, in five successive years being
1,453, 1,451, 1,480. 1,510 and 1,525. This rise is due to the fact that many
sufferers who would otherwise be dead are still with us, thanks to modern
treatment. We were at one time worried that this development would
cause an increased hazard to the community as more possible carriers of the
disease would be abroad. The tuberculin-test figures quoted show that this
danger is not important.
Radioactivity.
Medical Officers of Health are worried that they and their staffs are
not competently trained to evaluate radiation hazards and feel that the
Ministry of Health is showing unnecessary reluctance in providing this
training. We hope that the Ministry will shortly make it possible for local
authorities to take an active part in controlling and evaluating this potential
hazard, but the experience of the Essex County Council with regard to their
own scheme does not give rise to optimism. It is true that if a hazard
is suspected the Medical Officer of Health can obtain a trained expert from
the Ministry who will visit, inspect and advise, but how can one even
suspect a hazard which is only demonstrable with special instruments that
one doesn't possess, or how can suspicion be aroused by industrial or
medical use of radioactive materials when information with regard to
supply of these materials is withheld ?
Our only recourse is to the members of the Civil Defence Corps with
their Geiger counters. Their delicate instruments will show radioactivity
which is far too low to be any hazard, they have no right of entry, and
little technical knowledge of the processes involved. However, alarm resulting
from a Civil Defence exercise will require the attendance, probably
unnecessary, of a Ministry Official. Maybe many such unnecessary
attendances will demonstrate to the Ministry the need for local knowledge.
I describe no imaginary situation, an example occurred recently locally.
The problems of radioactivity are far more subtle and all-pervading
than hazards from atom-power stations or industrial usage of isotopes.
Natural background radiation varies enormously, for example in certain
sands in India, granite formations in Scotland, and heights above sea-level,
the extra amount above the average far exceeds that due to the testing of
H-bombs to date. In fact, certain scientists in the U.S.A. have suggested
from research data that human congenital malformations vary from residential
district to residential district according to the backgound radiation
resulting from different geological formations. Why then is the Medical
Officer of Health not encouraged and made technically capable of a suitable
study of the area he serves, or even given sufficient instruction so that
he may decide what is reasonabily within his competence and what is not.
O. & M. Report.
During the year a consultant firm in Organisation and Methods visited
the department, and have since reported to the Council. We feel we came
out of the scrutiny with credit, but not without some forcible discussion with
the consultants, who seemed to think that clerical time could advantageously