As a miner’s lamp makes its way around Wales to mark the 70th anniversary of the NHS, we reflect on a pioneering study of Welsh miners’ lung disease from that time that changed the face of public health forever, and lives on through our national project for better health, HealthWise Wales.
Back when the NHS was established in 1948, more than 700,000 men worked gruelling, dirty and dangerous shifts in Britain’s coal mines. Over 22,000 struggled with the lung disease pneumoconiosis, or ‘black lung’, with 85% of those living and working in South Wales.
It was this disease that Archie Cochrane, a doctor at Llandough Hospital in Penarth, tackled head-on with an ambitious study of entire mining communities in the Rhondda Fach and Aberdare valleys.
On a scale never before seen, chest x-rays and detailed health surveys were performed to see whether a particularly crippling form of lung disease –progressive massive fibrosis - was caused by a combination of black lung and tuberculosis.
They found out much more than that, linking coal dust with a range of disabilities and ill health amongst these communities.
An astonishing 95% of the community – some 25,000 people – agreed to take part thanks to the highly organised, intensive work of a field team of medics, nurses and disabled miners using ground-breaking methods (including offers of lifts to x-ray clinics in Archie’s Jaguar!).
That remarkable level of participation and wealth of detailed data collected demonstrated the feasibility of such an approach, launching a new era of public health research and earning Cochrane the mantle ‘the father of evidence-based medicine’.
Those remarkable men of Caerphilly
In the late 1960’s, Cochrane’s work investigating whether aspirin could prevent heart disease inspired his colleague Professor Peter Elwood to study how lifestyle habits affect chronic disease and health.
Tracking the lifestyle habits of 2,500 middle aged men from Caerphilly South Wales since 1979, the Caerphilly Cohort study became and remains one of the most important health studies ever conducted. Looking at how our environment influences risk of chronic diseases, like heart disease, diabetes and obesity, is entirely dependent on the dedication and commitment of the men taking part. These 2,500 men of Caerphilly have for 19 years continuously given their time and data, including 5am blood tests before their first meal of the day, to help us better understand health.
The study’s greatest success is in giving rock-solid evidence of the cumulative benefits of healthy habits for people’s health. Although now common knowledge, this study this was the first to show that not smoking, having low alcohol intake, maintaining a healthy weight, having a balanced diet and exercising regularly dramatically lowered peoples’ risk of conditions like diabetes, cancer, heart disease and dementia. It also showed that the more of these habits someone demonstrated, the greater the benefit.
Professor John Gallacher, director of Dementia’s Platform UK, who worked on the study said:
“The Caerphilly study has been ground-breaking for the range and depth of findings that it gas produced with the publication of many hundreds of scientific papers.
“The study shows how a generous community, like Caerphilly, can have a truly international impact.
“Through lessons learned from the Caerphilly study, a new generation of bigger and more detailed population studies has been born.
“Well done Caerphilly!”
The next 70 years
That research has had huge influence globally, providing a reference point for other and future research - including Wales’ national project to better understand and improve our health and care for the next 70 years, HealthWise Wales.
Funded by Health and Care Research Wales and true to Archie Cochrane’s vision and approach, HealthWise Wales is the largest research study of its kind ever in Wales.
Launched in 2015, it’s collecting the information to better prevent and treat long-term health conditions, such as heart disease, diabetes and dementia. It aims to involve everyone over the age of 16 in Wales in improving the health and well-being of the population through simple, 10 minute online questionnaires every six months.
Professor Shantini Paranjothy, scientific lead of HealthWise Wales, said: “HealthWise Wales is a great opportunity to take part in something that will contribute to the health of the nation, where your information will be used to answer those important questions the NHS needs answers to, in order to plan their service for the future. The information gathered also allows scientists to develop better and targeted treatments.”
The study aims to build an in depth picture of the health of the nation, giving the data for the evidence-based medicine of the future.
Get involved with HealthWise Wales here.