At the border between clinical decision-making and national policy, epidemiology is vital in understanding the health of populations, as well as how best to serve them. From the question of the usefulness of iron fortification to the causation between industry and lung disease, the following interviewees have contributed to legislative change, clinical and research breakthroughs, as well as major technological advances during their careers – among their numerous achievements.
A public health expert, Dr David Bainton studied the respiratory and cardiovascular health of miners at the MRC Epidemiological Research Unit in South Wales during the 1970s. He also had a long career in academia, as Senior Lecturer of Applied Public Health Medicine at the University of Wales and Honorary Consultant in Public Health Medicine at Gwent Health Authority; both posts held until his retirement in 2001.
As Director of the Epidemiological Research Unit in South Wales from 1974 until its closure in 1995, Professor Peter Elwood OBE tackled a variety of public health issues. He studied, for example, the benefits of iron fortification in reducing anaemia morbidity, and flax workers’ long-term respiratory problems, or ‘byssinosis’, in Northern Ireland. With several honorary Professorships to his name – Bristol, Wales, and Ulster – he wilfully ignored the advice to retire in 1995 and remained active in medical research.
A leading figure in Chest Medicine, Dr Phillip Hugh-Jones (1917–2010) researched the respiratory impact of gun fumes on soldiers during the Second World War. Post War, he studied pneumoconiosis, tuberculosis and asthma, contributing to technological advances in lung function testing on the scientific staff of the MRC Pneumoconiosis Unit. He became Consultant Physician/Director of King’s College Chest Unit, and a part-time Director of the MRC Clinical Pulmonary Physiology Research Unit at Hammersmith Hospital.
Having joined the MRC Epidemiological Research Unit in 1964, Mrs Janie Hughes worked on the first aspirin studies, eventually proving its effectiveness in the prevention of cardiovascular disease. She was also a field worker on studies exploring anaemia, lead toxicity and water hardness, to name but a few. Exploring the changing attitudes of both the public and the medical research community towards epidemiological studies, she provides an insight into the early workings of the MRC.
From 1967, Mrs Marion Jones was a field worker at the Epidemiology Research Unit, continuing for some 30 years. Trained in clerical work, she carried out fieldwork and administration for many of the Unit’s major projects, such as the Rhondda coalminers, and the ‘anaemia and milk’ studies. Here, she reflects on the variety of her work and her contribution to the Unit over its lifetime.
Registrar at the Pneumoconiosis Research Unit in the 1950s, Professor Stewart Kilpatrick was involved in epidemiological research and the day-to-day care of the patients participating in the Unit’s studies. He was appointed Professor of Tuberculosis and Chest Diseases at the University of Wales in 1971, and Dean of Clinical Studies.
Since graduating in mathematics from Oxford in 1964, Professor Alison Macfarlane has spent her career working in public health. She has held positions both in governmental and academic institutions, as a statistician for research in agriculture, transportation studies, and environmental science. After helping to develop studies at the MRC Air Pollution Unit during the 1970s, she has been primarily interested in maternal and child health, and became Professor of Perinatal Health at City University, London.
As a physician, Dr William Miall worked in the MRC’s Pneumoconiosis Research Unit during the 1950s, carrying out medical examinations on miners. He produced pioneering research in hypertension, and led the first large hypertension trial. He was Director of the MRC Epidemiology Unit in Jamaica, and a Consultant in epidemiology and member of the scientific staff in the Epidemiology and Medical Care Unit at Northwick Park Hospital until 1983.
Trained as a statistician, Professor Andrew Nunn started working in the MRC Tuberculosis and Chest Diseases Unit in 1966. He played a key part in the TB research that led to the development of a short-course chemotherapy treatment for the disease. In Uganda, he worked on HIV research in the late 1980s, returning to the UK as a Senior Statistician on multidrug-resistant TB trials.
A medical graduate, Dr Selwyn St Leger began his career as a statistician, medic and field worker at the MRC Epidemiology Unit in South Wales in the 1970s, contributing to the coalminers’ pneumoconiosis studies. Having worked on various epidemiological studies there, such as the effect of lead in water on blood levels, he took on a teaching role as Consultant and Senior Lecturer in Public Health at the University of Manchester.
For more than 30 years, Mr Peter Sweetnam was a statistician at the MRC Epidemiological Research Unit in South Wales. He was a key figure in the design and delivery of the Unit’s various large-scale and influential projects, such as the Caerphilly, aspirin, and anaemia studies.
Working at the MRC Epidemiological Research Unit during the 1960s, Dr Julian Tudor-Hart and Mrs Mary Thomas as a medical epidemiologist and field worker, respectively, reflect on the professional and practical challenges of working within a growing and maturing field.
A clinician in the Pneumoconiosis Research Unit in Llandough Hospital (Cardiff), Professor Estlin Waters conducted groundbreaking research on the diagnosis and treatment of migraine. He was appointed Senior Lecturer in epidemiology at the University of Southampton in 1970, where the new medical school was a leading centre for the subject. He was Professor of Community Medicine at Southampton from 1976 to 1990.
After graduating in medicine from Manchester University, Dr John Yarnell took a Diploma in Public Health in Bristol, where he worked on measles vaccine uptake at the Health Education Council’s medical research unit. At the MRC’s Epidemiological Research Unit, he contributed to respiratory and anaemia studies in South Wales, from 1975 to 1993, and was a key figure in the well-known Caerphilly prospective study.