Preventable childhood deaths in Wolverhampton.

A retrospective survey was undertaken of all deaths in children under 5 in the borough of Wolverhampton over the years 1976-82. Cause of death was classified in terms of preventability and possibly preventable deaths studied in more detail. Birth weight in the study group was significantly lower than that of the local population; there was no difference in ethnic origin, but there were significantly more Asian girls than Asian boys. The association between potentially preventable death and various socioeconomic indicators in the electoral wards in the borough was investigated. A significant association was found between mortality and overcrowding, lack of household amenities, unemployment, lack of car ownership, and households where the head was born in the new Commonwealth or Pakistan.     

Ecology of dental disease

Trace elements in the dental enamel of 43 prehistoric Indians from Illinois, Maryland and Virginia show concentration differences by age, sex and geographical locality. Sample areas on an incisor or first molar were blocked off with paraffin, washed twice with distilled water and etched 7 times with 6N HCl. An optical emission spectrophotometer was used to analyze the 9 samples, representing surface contamination and sequential enamel layers. Al, B, Ba, Cu, Fe, K, Mg, Mn, Na, Si, Sr, and Ti were present in most samples in micro or trace quantities; other elements were detected with less regularity. Comparisons of the 2 water washes with the 3 superficial, 4 deep and 7 total acid etches, suggest that during burial the residual inorganic portion of the enamel exchanged little or nothing with the soil. Enamel from archeological teeth may therefore be utilized in host factor studies in dental paleopathology. The Jy 50 Illinois Indians differ from the Potomac Creek, Virginia, Indians both in quantities of elements present and in internal sample variability. In each group, the sexes differ in 4 or more elements, both as to content and variability. Similarly, the older half of each sample differs from the younger. Patterns of sex and age difference are irregular, suggesting cultural differences, rather than physiological, in utilizing the environment during enamel-forming years. Enamel composition, as affected by differential environment utilization, may partially explain sex, age and geographical differences in dental pathology rates.     

Relation between medicines sweetened with sucrose and dental disease.

The teeth of 44 children aged under 6 years who had been taking syrup medicines regularly for at least six months were compared with those of a control group of 47 children of similar ages. Dental disease was assessed by measuring dental caries, dental plaque, and gingivitis. The children who were receiving sucrose-based medicines had significantly more carious teeth and gingivitis. It is concluded that sucrose-based medicines continuously administered to children cause dental caries and gingivitis. Liquid medicines for children should be either unsweetened or sweetened with non-cariogenic substances.     

Food habits and dental disease in an iron-age population.

Tooth diseases and wear record valuable information on diet and methods of food preparation in past human populations. In this paper the teeth of an Iron-Age population (Monte Bibele, Bologna) are analyzed to reconstruct their nutritional situation. The analysis of caries frequency and distribution indicates a level of carbohydrate consumption which is consistent with an agricultural way of life. The presence of calculus indicates that proteins were present in the diet of the Monte Bibele population. The frequency of antemortem tooth loss and of dental abscesses is in harmony with the results of the analysis of caries and calculus. The examination of dental wear suggests the presence of a substantial vegetable component in the diet. From the analysis of the dental characteristics one can conclude that the population of Monte Bibele had a prevalent agricultural economy. The presence of some diachronic variations in the distribution of the examined characters suggest changes in the diet in the course of time.     

Halothane Hepatitis—A Preventable Disease?

Eleven patients with acute hepatitis following multiple anaesthetics with halothane have been seen at two hospitals during the last four years. Six had massive hepatic necrosis and died. Unexplained fever occurred in nine of the patients; two of these and one other had had previous episodes of jaundice after halothane anaesthesia. Thus, in ten patients the disease could have been avoided.     

Preventable diseases; the scope of public health

The purpose of a department of public health is to put into effect for the benefit of all the people of a community the practical lessons of preventive medicine. The scope of public health work is chiefly determined by our knowledge of the causes of the preventable diseases. We do not know how to prevent all diseases. We do, however, know effective ways to prevent or to reduce the occurrence of at least a dozen varieties of disease. Every health department ought to provide for a program and services which will prevent so far as possible the preventable diseases and the preventable hazards to health. To concentrate on prevention is to avoid diversion by specious arguments into the fields of medical care of the sick.