Tuberculosis in the Merchant Navy

Abstract

It is difficult to obtain figures for incidence of disease in a roving population such as comprises the Merchant Navy, but fairly reliable mor-tality data are available. An investigation in 1927 had revealed that the death rate for all seamen afloat was nearly double the calculated rate. A further investigation covering the period 1929-1930 revealed a death rate from respiratory tuberculosis among British seamen of all ages of 2.37 per 1,000, and the proportion of deaths from respiratory tuberculosis to total deaths was 9.5%. In 1934, a report of the deaths occurring within 12 months of leaving sea-going employment found that 20% were due to tuberculosis. The author studied the period of 3 yrs., 1930-1932, and found that in the age group 25-65, of the 6,645 deaths re-ported, 1,231 were due to tuberculosis. Furthermore, tuber-culosis was found to be the most frequent single cause of death for the total age group of 25 to 65. In 1936, a study by J. G. Wilson of the tuberculosis mortality rates in various districts of Cardiff for the period 1923 to 1934, revealed the death rate in the dock areas to be 3.4 per 1,000[long dash]twice as high as in the other areas. In reviewing the con-dition of men admitted for treatment and the result of such treatment it was found that of 300 British seamen admitted to the sanatorium 54% were found to be in class B-3 (far advanced). Of this group, 30% died and 43% made no material improvement. Only 24 of the 300 cases admitted were in class A (minimal). The chief factor for these conditions, according to the author, is the overcrowding in living and sleeping quarters which is almost universal. A further factor in the present situation is the terrific mental and physical strain imposed by war conditions. At present no physical examination is required by law for men entering the Merchant Navy. This would be an excellent group for survey by means of mass radiography. Such a study is now being carried on by means of voluntary effort by the author in an attempt to bring about earlier diagnosis and hence earlier treatment.