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INTERNAL MIGRATION
1126 substances must be handled. This seems to- be what the Standard Oil Company is doing ; and it rests with countries where new refineries are being set up to do the same.
carcinogenic
Annotations TEAM-WORK AGAINST A CANCER HAZARD
CATALYTIC cracking of petroleum was developed in America during the late war to meet the demand for
MIGRATION immense quantities of high-octane petrol. The process " FOR my part, I travel not to go anywhere, but to has come to stay, and already refineries are coming into go. I travel for travel’s sake. The great affair is to operation or are being constructed in England and move." So said Robert Louis Stevenson, but a report Holland.1 from the General Register Office1 tells a still stranger Certain mineral and lubricating oils have been tale. If we imagine ourselves a staid stay-at-home folk, known to be carcinogenic to man and animals, but This study of population let us look at the facts. cancer due to other derivatives movement in and Wales occupational petroleum brings something of England has so far been a less serious industrial hazard. The the shock which greets the beginner with the microscope new catalytic cracking process-i.e., the subjection of who looks down at a still drop of pond-water and the oil to temperatures up to 950°F in the presence of discovers a fantastic world of living things which are a mixture of alumina and silica, which serves as the never at rest. We know well- that the dramatic impact of induscatalyst-introduced factors which led to the suspicion that the high-boiling derivatives might contain carcinotrialism has changed the face of our land in the last genic hydrocarbons or other closely related compounds. two centuries from a nation of small agricultural The greater part of the October issue of the Archives of settlements with a population of 6 million to a nation Industrial Hygiene and Occupational Medicine is devoted of town-dwellers more than seven times as numerous. to reporting2 the efforts of a group of specialists who have Cultural lag leaves John Bull still dressed in the garb been working on cancer control in this industry. This of a yeoman farmer well lined with roast beef, when is the kind of team-work in which our American he would more correctlv be clad in overalls and his at least the facts tell colleagues excel, and it is much to the credit of the preference is for Standard Oil Company that in 1945 it supported a prous that only one-fifth of our population today live in rural districts, although a recent opinion poll showed gramme of research into the problem of the carcinogenic properties of catalytically cracked oil. Sugiura found that the Englishman’s first preference was to be a that the high-boiling fraction of such oil induced papil. farmer. Even before the first world war there was lomas and carcinomas of the skin in mice, rabbits, and evidence of some change in the pattern of population monkeys and this observation was followed by extensive growth. For the first time female migration exceeded testing of materials from many phases of refinery opera- that of males, as women began to take over clerical and tions. The scale of these tests can be gauged from the fact other jobs previously done by men. There was a reducthat, in all, the skins of 6990 animals were painted, and tion of the rate of growth in the industrial counties 30 mice were used for each sample tested. Broadly speakand an increase in certain agricultural areas, but this ing, the tests showed that carcinogenic activity was was due to manufacturing and residential development conferred on the oil by the cracking process and was most overspilling from expanding towns. The 1914-18 war potent in oils boiling above 700°F. The carcinogenic inevitably brought with it an ebb and flow of shifting material was contained in the aromatic-fraction compopulation ; yet it is surprising to learn that the 1921 ponents of the oils. Carcinogenic activity was reduced census revealed over-all changes less extensive than by blending potent oils with non-carcinogenic oils, but those of the first ten years of the century. Afterwards in order to produce a non-carcinogenic oil it was necessary the process of decentralisation continued. Further to keep down the proportion of cracked oil to about in and communications and the improvements transport 10%. When aromatic components were present in diffusion of electric power encouraged the shift from town unrefined waxes, these were also carcinogenic. The centres. The census of 1931 showed the effects of the next step was to discover the actual carcinogenic great depression in the areas of heavy industry, and components ; this work is not yet finished, but two especially in some of the mining areas ; for example, in substances-an isopropyl-l:2-benzanthracene and a South Wales and Northumberland and Durham a methyl-chrysene-were isolated in a fair state of purity. reduction of population was recorded for the first time (These compounds are related to the series of polycyclic since 1801. Conversely the population had grown in hydrocarbons first discovered and tested by Cook and the rapidly developing new industrial areas of the South, Kennaway.3) especially around London. The above experiments led to inquiries regarding the All these changes, however, could be recorded only at employees among a population of 4000 who might come the decennial census periods, and then only in terms of in daily contact with these compounds during their work, It is national net gains or losses in different areas. and then to measures which might diminish the hazard. established in September, 1939, which shows registration, These consist in strict medical supervision to ensure what a poor half-told story of movement we picked up early diagnosis and treatment of any skin lesions, and in the past ; for the register permits continuing study in measures of hygiene which will diminish contact with of fluctuation and change, with a blow-by-blow account the oils. No-one can say at this stage how many of this of that gross movement in and out of any locality which population will eventually develop tumours of the skin makes up the net change. In this field the most noteas a result of the exposure already experienced. Now, worthy events of the last war were, of course, the result however, that the danger has been recognised no time of bombardment, especially of London. There were should be lost in finding new industrial processes which about 33 million moves across local-authority boundaries, will remove the carcinogenic substances at the source, and the bulk of which were associated with the tremendous in insisting on hygienic measures where, for the present, ebb and flow of population to and from the target towns. Nevertheless, even under the stress of bombing the 1. Manchester Guardian, Dec. 5, 1951. 2. Page, R. C. Arch. industr. Hyg. 1951, 4, 297. Smith, W. E., movement was not in one direction only ; the places Sunderland, D. A., Sugiura, M. Ibid, p. 299. Fischer, H. G.M., of some of the evacuees were inevitably taken by people Priestley, W. jun., Eby, L. T., Wanless, G. G., Rehner, J. into the danger-areas. jun. Ibid, p. 315. Holt, J. P., Hendricks, N. V., Eckardt, moving R. E., Stanton, C. L., Page, R. C. Ibid, p. 325. Blanding, F. H., INTERNAL
long
fish-and-chips ;
.
King, W. H. jun., Priestley, W. jun., Rehner, J. jun.
Ibid,
p. 335.
3. Barry, G., Cook, J. W., Haslewood, G. A. D., Hewett, C. L., Kennaway, E. L. Proc. roy. Soc. B. 1935, 117, 318.
1. General Register Office. Studies on Medical and Population Subjects, no. 5 : Internal Migration. By MARY P NEWTON, H.M. Stationery Office. 1951. M.A., and JAMES R. JEFFERY. Pp. 44. 1s. 6d.
1127 Even national registration has its limitations, for it provides figures readily only for moves across localgovernment boundaries; and it is estimated that as many moves take place within boundaries a,s across
the two central incisor teeth in the upper jaw, caused by continually putting the loop of a hairpin against the upper teeth over a period of many years. The dental surgeon is sometimes called in by the them. How great the total movement must be may be police to identify artificial dentures he has made or to judged from the fact that in each of the post-war years recognise fillings he has done for a patient. In 1943 the dismembered body of a woman, aged between 40 and there have been some 4 million moves across boundaries, 50, was identified in this way. The upper jaw was intact; many of them over long distances. The total volume of four teeth had been filled, several teeth were missing, movement into and out of localities far exceeds the and there were marks of a denture. A dental surgeon net changes in population in these localities due to migration. This is true in all areas, although the volume - found that the teeth and fillings corresponded exactly with his record of a patient he had treated ; and when of movement has differed in different regions. Thus the shown the skull he identified his own dental repair work Greater London area, and other parts of the South and South-East, were experiencing high rates of movementB -he had inadvertently left two roos behind after compared with Northern industrial counties such as extractions. In this case all the other evidence might have referred to someone else, but when the judge came Durham and Northumberland, the East and West Ridings of Yorkshire, and Lancashire and Cheshire. to the two roots in his summing up he said : " This is not a probability ; it is almost a certainty. It was very Indeed it is a feature of this migration that total movement both inward and outward tends to be highest in fortunate that a radiograph of the jaw had been taken." the expanding areas. This restless picture suggests that In the recent " acid-bath " murders dentures were the new and developing areas are populated not by single sole means of identifying one of the victims. Dr. Simpson movements of who strike found some intact upper and lower acrylic-resin dentures, purposeful people immediately their roots, but rather by the experimental moves of which had completely resisted the action of the acid ; vastly greater numbers of people who follow each other and the missing woman’s dentist identified these in and out, a comparatively small proportion of whom dentures. settle down. Sir William Kelsey Fry, in the discussion that followed Who are these migrants who take part in this continual Dr. Keith Simpson’s lecture, spoke of the need- for Even the national register cannot folk-wandering constructing dentures in such a way as to provide some tell us everything we should like to know about them. means of identification. He referred to the practice in They are predominantly young adults ; and the numbers the R.A.F. and the U.S.A. Forces of embodying in of children involved are smaller than would be expected dentures some ’Nylon ’ gauze on which the Serviceman’& from the composition of the adult group. This corresstation and number are marked, so that if an accident with the the Social in of Willesden occurs and the dentures are found the man can be traced. ponds Survey findings that those willing to move to a new town had smaller Now that so many people wear dentures it- might be families than the average for their age-groups. Perhaps advisable to make similar provision for civilians. This the disposition or ability to make a change of locality would aid identification in air, train, or road accidents, is less among families with children, and certainly the and in cases of mistaken identity. A legal point arises in difficulties facing such families if they move are great connection with taking an impression from the teeth of in this time of acute housing shortage. The report a suspected person. Consent must be obtained, and it on slender but somewhat evidence, must not be obtained under duress; - otherwise the speculates intriguingly, on the existence of what it terms the " migrant type " question of a technical assault might arise, just as it can one -or what might call the rolling-stone prone. if a medical examination is made without consent. Developing areas collect the rolling stones, and many of them continue to roll, so accounting in part for the PROGRESS IN CEYLON great volume of movement in such areas ; whereas the Ceylon is rather more than three-quarters "of the relative stasis where development is slow or stopped is partly due to the loss of migrant types. This is only size of Ireland, and in 1950 its population was 7,550,000, its birth-rate 40-3, death-rate 12-6, and infant-mortality speculative, but it is a challenge to further study. rate 84. Since the beginning of the century the population has doubled, and the death and infant-mortality FORENSIC IMPORTANCE OF TEETH rates have been halved. A notable reduction in these TEETH, both natural and artificial, are important rates took place about the years 1946-47, and coincided means of identification, and have often played a decisive with the widespread application of D.D.T. as a residual part in reconstructing crime. They survive fire and insecticide for the control of malaria. The estimated decomposition, and, like bones, persist when the rest of increase of population in 1950 over the previous yearthe body has disintegrated. Artificial dentures not only was 253,000. survive the normal process of decay, but even resist In his annual report1 Dr. W. G. Wickremasinghe, the attack by concentrated sulphuric acid, as happened in director of medical services, remarks that the medical the recent acid-bath murders. department " assumes responsibility almost solely for In a lecture to the British Dental Association, Dr. the curative and preventive services of the entire Keith Simpson1 remarked that age can be assessed from country on a national scale." In 1950 there were 232 the teeth, particularly in children. In one murder case hospitals, 99 maternity homes, 240 central dispensaries it was important to distinguish the body of a 35-year-old with 852 branches, 91 health units, 701 health centres, woman from that of her maid, who was 23 years of age. and various special organisations for malaria, tubereuThe age of the teeth was arrived at by assessing the degree losis, venereal diseases, filariasis, and leprosy. The staff of calcification of unerupted third molars ; this gave a of the department numbered 15,529, and there were fair indication of an age between 22 and 25. Gustafson2 19,959 hospital beds. has lately described a method for assessing the age of a It is not easy to find the causes of the 95,262 deaths tooth within five years. This is partly based on attrition registered in the year. The major communicable diseases of enamel and dentine, the formation of secondary were not much in evidence. There was no cholera or dentine or periodontosis, and root resorption. Occupation little smallpox, some typhoid fever (no doubt plague, can sometimes be discovered by examining the teeth. more than was notified), and some dysentery, but Dr. Simpson identified a hairdresser by linear erosions in _
1.
Simpson, K. Brit. dent. J. 1951, 91, 229. 2. Gustafson, G. J. Amer. dent. Ass. 1950, 41, 45. 1.
Ceylon: Administration Report of the Director of Medical and Sanitary Services for 1950. Government Publications Bureau, Colombo. 1951. Pp. 223. Rs 4.80.
carcinogenic
Annotations TEAM-WORK AGAINST A CANCER HAZARD
CATALYTIC cracking of petroleum was developed in America during the late war to meet the demand for
MIGRATION immense quantities of high-octane petrol. The process " FOR my part, I travel not to go anywhere, but to has come to stay, and already refineries are coming into go. I travel for travel’s sake. The great affair is to operation or are being constructed in England and move." So said Robert Louis Stevenson, but a report Holland.1 from the General Register Office1 tells a still stranger Certain mineral and lubricating oils have been tale. If we imagine ourselves a staid stay-at-home folk, known to be carcinogenic to man and animals, but This study of population let us look at the facts. cancer due to other derivatives movement in and Wales occupational petroleum brings something of England has so far been a less serious industrial hazard. The the shock which greets the beginner with the microscope new catalytic cracking process-i.e., the subjection of who looks down at a still drop of pond-water and the oil to temperatures up to 950°F in the presence of discovers a fantastic world of living things which are a mixture of alumina and silica, which serves as the never at rest. We know well- that the dramatic impact of induscatalyst-introduced factors which led to the suspicion that the high-boiling derivatives might contain carcinotrialism has changed the face of our land in the last genic hydrocarbons or other closely related compounds. two centuries from a nation of small agricultural The greater part of the October issue of the Archives of settlements with a population of 6 million to a nation Industrial Hygiene and Occupational Medicine is devoted of town-dwellers more than seven times as numerous. to reporting2 the efforts of a group of specialists who have Cultural lag leaves John Bull still dressed in the garb been working on cancer control in this industry. This of a yeoman farmer well lined with roast beef, when is the kind of team-work in which our American he would more correctlv be clad in overalls and his at least the facts tell colleagues excel, and it is much to the credit of the preference is for Standard Oil Company that in 1945 it supported a prous that only one-fifth of our population today live in rural districts, although a recent opinion poll showed gramme of research into the problem of the carcinogenic properties of catalytically cracked oil. Sugiura found that the Englishman’s first preference was to be a that the high-boiling fraction of such oil induced papil. farmer. Even before the first world war there was lomas and carcinomas of the skin in mice, rabbits, and evidence of some change in the pattern of population monkeys and this observation was followed by extensive growth. For the first time female migration exceeded testing of materials from many phases of refinery opera- that of males, as women began to take over clerical and tions. The scale of these tests can be gauged from the fact other jobs previously done by men. There was a reducthat, in all, the skins of 6990 animals were painted, and tion of the rate of growth in the industrial counties 30 mice were used for each sample tested. Broadly speakand an increase in certain agricultural areas, but this ing, the tests showed that carcinogenic activity was was due to manufacturing and residential development conferred on the oil by the cracking process and was most overspilling from expanding towns. The 1914-18 war potent in oils boiling above 700°F. The carcinogenic inevitably brought with it an ebb and flow of shifting material was contained in the aromatic-fraction compopulation ; yet it is surprising to learn that the 1921 ponents of the oils. Carcinogenic activity was reduced census revealed over-all changes less extensive than by blending potent oils with non-carcinogenic oils, but those of the first ten years of the century. Afterwards in order to produce a non-carcinogenic oil it was necessary the process of decentralisation continued. Further to keep down the proportion of cracked oil to about in and communications and the improvements transport 10%. When aromatic components were present in diffusion of electric power encouraged the shift from town unrefined waxes, these were also carcinogenic. The centres. The census of 1931 showed the effects of the next step was to discover the actual carcinogenic great depression in the areas of heavy industry, and components ; this work is not yet finished, but two especially in some of the mining areas ; for example, in substances-an isopropyl-l:2-benzanthracene and a South Wales and Northumberland and Durham a methyl-chrysene-were isolated in a fair state of purity. reduction of population was recorded for the first time (These compounds are related to the series of polycyclic since 1801. Conversely the population had grown in hydrocarbons first discovered and tested by Cook and the rapidly developing new industrial areas of the South, Kennaway.3) especially around London. The above experiments led to inquiries regarding the All these changes, however, could be recorded only at employees among a population of 4000 who might come the decennial census periods, and then only in terms of in daily contact with these compounds during their work, It is national net gains or losses in different areas. and then to measures which might diminish the hazard. established in September, 1939, which shows registration, These consist in strict medical supervision to ensure what a poor half-told story of movement we picked up early diagnosis and treatment of any skin lesions, and in the past ; for the register permits continuing study in measures of hygiene which will diminish contact with of fluctuation and change, with a blow-by-blow account the oils. No-one can say at this stage how many of this of that gross movement in and out of any locality which population will eventually develop tumours of the skin makes up the net change. In this field the most noteas a result of the exposure already experienced. Now, worthy events of the last war were, of course, the result however, that the danger has been recognised no time of bombardment, especially of London. There were should be lost in finding new industrial processes which about 33 million moves across local-authority boundaries, will remove the carcinogenic substances at the source, and the bulk of which were associated with the tremendous in insisting on hygienic measures where, for the present, ebb and flow of population to and from the target towns. Nevertheless, even under the stress of bombing the 1. Manchester Guardian, Dec. 5, 1951. 2. Page, R. C. Arch. industr. Hyg. 1951, 4, 297. Smith, W. E., movement was not in one direction only ; the places Sunderland, D. A., Sugiura, M. Ibid, p. 299. Fischer, H. G.M., of some of the evacuees were inevitably taken by people Priestley, W. jun., Eby, L. T., Wanless, G. G., Rehner, J. into the danger-areas. jun. Ibid, p. 315. Holt, J. P., Hendricks, N. V., Eckardt, moving R. E., Stanton, C. L., Page, R. C. Ibid, p. 325. Blanding, F. H., INTERNAL
long
fish-and-chips ;
.
King, W. H. jun., Priestley, W. jun., Rehner, J. jun.
Ibid,
p. 335.
3. Barry, G., Cook, J. W., Haslewood, G. A. D., Hewett, C. L., Kennaway, E. L. Proc. roy. Soc. B. 1935, 117, 318.
1. General Register Office. Studies on Medical and Population Subjects, no. 5 : Internal Migration. By MARY P NEWTON, H.M. Stationery Office. 1951. M.A., and JAMES R. JEFFERY. Pp. 44. 1s. 6d.
1127 Even national registration has its limitations, for it provides figures readily only for moves across localgovernment boundaries; and it is estimated that as many moves take place within boundaries a,s across
the two central incisor teeth in the upper jaw, caused by continually putting the loop of a hairpin against the upper teeth over a period of many years. The dental surgeon is sometimes called in by the them. How great the total movement must be may be police to identify artificial dentures he has made or to judged from the fact that in each of the post-war years recognise fillings he has done for a patient. In 1943 the dismembered body of a woman, aged between 40 and there have been some 4 million moves across boundaries, 50, was identified in this way. The upper jaw was intact; many of them over long distances. The total volume of four teeth had been filled, several teeth were missing, movement into and out of localities far exceeds the and there were marks of a denture. A dental surgeon net changes in population in these localities due to migration. This is true in all areas, although the volume - found that the teeth and fillings corresponded exactly with his record of a patient he had treated ; and when of movement has differed in different regions. Thus the shown the skull he identified his own dental repair work Greater London area, and other parts of the South and South-East, were experiencing high rates of movementB -he had inadvertently left two roos behind after compared with Northern industrial counties such as extractions. In this case all the other evidence might have referred to someone else, but when the judge came Durham and Northumberland, the East and West Ridings of Yorkshire, and Lancashire and Cheshire. to the two roots in his summing up he said : " This is not a probability ; it is almost a certainty. It was very Indeed it is a feature of this migration that total movement both inward and outward tends to be highest in fortunate that a radiograph of the jaw had been taken." the expanding areas. This restless picture suggests that In the recent " acid-bath " murders dentures were the new and developing areas are populated not by single sole means of identifying one of the victims. Dr. Simpson movements of who strike found some intact upper and lower acrylic-resin dentures, purposeful people immediately their roots, but rather by the experimental moves of which had completely resisted the action of the acid ; vastly greater numbers of people who follow each other and the missing woman’s dentist identified these in and out, a comparatively small proportion of whom dentures. settle down. Sir William Kelsey Fry, in the discussion that followed Who are these migrants who take part in this continual Dr. Keith Simpson’s lecture, spoke of the need- for Even the national register cannot folk-wandering constructing dentures in such a way as to provide some tell us everything we should like to know about them. means of identification. He referred to the practice in They are predominantly young adults ; and the numbers the R.A.F. and the U.S.A. Forces of embodying in of children involved are smaller than would be expected dentures some ’Nylon ’ gauze on which the Serviceman’& from the composition of the adult group. This corresstation and number are marked, so that if an accident with the the Social in of Willesden occurs and the dentures are found the man can be traced. ponds Survey findings that those willing to move to a new town had smaller Now that so many people wear dentures it- might be families than the average for their age-groups. Perhaps advisable to make similar provision for civilians. This the disposition or ability to make a change of locality would aid identification in air, train, or road accidents, is less among families with children, and certainly the and in cases of mistaken identity. A legal point arises in difficulties facing such families if they move are great connection with taking an impression from the teeth of in this time of acute housing shortage. The report a suspected person. Consent must be obtained, and it on slender but somewhat evidence, must not be obtained under duress; - otherwise the speculates intriguingly, on the existence of what it terms the " migrant type " question of a technical assault might arise, just as it can one -or what might call the rolling-stone prone. if a medical examination is made without consent. Developing areas collect the rolling stones, and many of them continue to roll, so accounting in part for the PROGRESS IN CEYLON great volume of movement in such areas ; whereas the Ceylon is rather more than three-quarters "of the relative stasis where development is slow or stopped is partly due to the loss of migrant types. This is only size of Ireland, and in 1950 its population was 7,550,000, its birth-rate 40-3, death-rate 12-6, and infant-mortality speculative, but it is a challenge to further study. rate 84. Since the beginning of the century the population has doubled, and the death and infant-mortality FORENSIC IMPORTANCE OF TEETH rates have been halved. A notable reduction in these TEETH, both natural and artificial, are important rates took place about the years 1946-47, and coincided means of identification, and have often played a decisive with the widespread application of D.D.T. as a residual part in reconstructing crime. They survive fire and insecticide for the control of malaria. The estimated decomposition, and, like bones, persist when the rest of increase of population in 1950 over the previous yearthe body has disintegrated. Artificial dentures not only was 253,000. survive the normal process of decay, but even resist In his annual report1 Dr. W. G. Wickremasinghe, the attack by concentrated sulphuric acid, as happened in director of medical services, remarks that the medical the recent acid-bath murders. department " assumes responsibility almost solely for In a lecture to the British Dental Association, Dr. the curative and preventive services of the entire Keith Simpson1 remarked that age can be assessed from country on a national scale." In 1950 there were 232 the teeth, particularly in children. In one murder case hospitals, 99 maternity homes, 240 central dispensaries it was important to distinguish the body of a 35-year-old with 852 branches, 91 health units, 701 health centres, woman from that of her maid, who was 23 years of age. and various special organisations for malaria, tubereuThe age of the teeth was arrived at by assessing the degree losis, venereal diseases, filariasis, and leprosy. The staff of calcification of unerupted third molars ; this gave a of the department numbered 15,529, and there were fair indication of an age between 22 and 25. Gustafson2 19,959 hospital beds. has lately described a method for assessing the age of a It is not easy to find the causes of the 95,262 deaths tooth within five years. This is partly based on attrition registered in the year. The major communicable diseases of enamel and dentine, the formation of secondary were not much in evidence. There was no cholera or dentine or periodontosis, and root resorption. Occupation little smallpox, some typhoid fever (no doubt plague, can sometimes be discovered by examining the teeth. more than was notified), and some dysentery, but Dr. Simpson identified a hairdresser by linear erosions in _
1.
Simpson, K. Brit. dent. J. 1951, 91, 229. 2. Gustafson, G. J. Amer. dent. Ass. 1950, 41, 45. 1.
Ceylon: Administration Report of the Director of Medical and Sanitary Services for 1950. Government Publications Bureau, Colombo. 1951. Pp. 223. Rs 4.80.