Life and death in 1960’s Civil Service: Whitehall Study I collection now available

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Chris Olver, Cataloguing Archivist, London School of Hygiene & Tropical Medicine


The London School of Hygiene & Tropical Medicine has been at the centre of excellence for epidemiology and medical statistics for 90 years. Researchers at the school have contributed to our understanding of disease outbreaks, effectiveness of drug and vaccination treatments and effect of environmental and lifestyle choices on population health. The papers of one of the most renowned longitudinal studies on population health, Whitehall Study, is now available for consultation at the School’s Archive Service.

Infographic showing clinical procedure for health screening of the Whitehall Study volunteers. 

The Whitehall Study I, also known as the ‘Health Survey of Male Civil Servants aged 40 or over’, was a longitudinal health survey of male Civil Servants, aged 40-60, based in London, conducted from 1967-1970 by the London School of Hygiene & Tropical Medicine and Guy’s Hospital. The study involved a mass health screening of 18300 subjects selected across 38 departments conducted in a special screening centre situated in Whitehall. The initial purpose of the study was to identify early signs of cardiovascular, respiratory and metabolic diseases and refer at risk patients onto medical services. The second phase of the study involved selecting subjects for a series of controlled studies on effectiveness of intervention methods, these included weight loss trials, exercise trials and a smoking cessation study involving 1445 men. The entire study cohort were then monitored and tracked by the survey team, through the Office of Population Censuses and Surveys (OPCS), with any deaths and certain disease diagnoses recorded.

Table showing smoking habits of Grade I (Administrators). The questionnaire asked volunteers about current smoking habits, previous smoking history along with a supplementary section for pipe and cigar smokers.

 

It was through the analysis of the resulting mortality data that the most famous finding of the study was revealed. Sir Michael Marmot noticed that lower grade employees were a third more like to die from various mortality causes than those employed at higher grades. This finding showed a clear social gradient in mortality and led to a second Whitehall Study being created that focused directly on the extent and causes of the social gradient. The Stress and Health Study, or Whitehall II, followed a new cohort of 10,308 male and female subjects, aged 35-55, from 1985 to the present day.

 

The archive collection provides an invaluable resource of the data collection, monitoring work and analysis conducted on the original Whitehall Study. The majority of the papers include raw data from the health screening, primarily questionnaires but also clinical test results including electrocardiograms, X-ray and blood results. Mortality data includes photocopies of death certificates, medical coding and computer coding forms and sickness absence reports collected from across the participating departments. Other material includes follow-up studies, primarily relating to the smoking cessation trial and graphs, tables and working papers regarding data analysis. The collection also includes a rich holding of material from preceding health surveys conducted at the School including material relating to General Post Office (GPO) health trials, 1964-1993, and the survey on the effects of air pollution on rates of chronic bronchitis in the Civil Service, 1950-1958.

 

Blank questionnaire from 1966 General Post Office health survey

The Whitehall Cataloguing Project sought to preserve, catalogue and make available the Whitehall Study collection for wider access. It was undertaken by the LSHTM Library & Archives Service between January and September 2017, with funding provided by a Wellcome Trust Research Resources grant. The catalogue description is available on the London School of Hygiene and Tropical Medicine online catalogue and can also be viewed on the AIM25, Archive Hub and the National Archives Discovery catalogue.

The Neurosurgical Case Notes of Sir Geoffrey Jefferson

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By Karen Rushton, Wellcome Archivist/Curator, University Archive & Records Centre, The University of Manchester (Karen.rushton@manchester.ac.uk)


 

At the University of Manchester thanks to a generous Wellcome Trust grant we are currently working to catalogue the case files of 20th century neurosurgeon Sir Geoffrey Jefferson (1886-1961). Jefferson was the UK’s first Professor of Neurosurgery who spent most of his career at the Manchester Royal Infirmary (MRI).

 

The case files we hold cover Jefferson’s time working at the MRI between 1927-1940 on a wide range of neurological disorders including brain tumours, epilepsies, neuralgias, head injuries, and congenital spinal deformities. We also see references to lingering war injuries from WWI, occupational and traffic accidents, neurosyphilis, and the use of surgical and diagnostic techniques later considered to be controversial. The files themselves contain a number of record types including detailed case notes and accounts of surgery, correspondence, x-rays, and both clinical and pathological photographs.

Neurosurgery lecture, with Sir Geoffrey Jefferson on the back row second from the left & Norman Dott on the second row from the back on the left, n.d. ref: JEF/1/10/3

 

Going into the project the first major decision centred on what information we wished to record. The Lothian Health Services Archive in Edinburgh have recently completed a similar project centred on the case files of neurosurgeon Norman Dott (1897-1973) and so it was very helpful to be able to talk to staff there about their approach to the records. Most importantly we recognised that the Jefferson collection is one of a number of neurosurgery collections held across the country and it was important to recognise its part in a wider research web and so make our catalogue comparable to that of the Dott Collection.

 

When dealing with relatively modern patient records considerations surrounding data protection were paramount and procedures are in place to produce a public facing catalogue with all personal information removed and a complete catalogue for use in-house and to be accessed by approved researchers. MeSH has been employed throughout for indexing purposes and provides an invaluable tool for selecting files based on conditions and symptoms. It is here where expert advice from a neurologist based within the University has aided us in creating accurate indexing terms and updating old-fashioned terminology. However, the major barrier with MeSH has arisen regarding the potential indexing of surgical procedures. As a neurosurgeon rather than a neurologist the procedures that Jefferson performed were seen as being a very important factor in the descriptive content of the catalogue, but whether or not it was appropriate to index them or not was another matter. As a thesaurus of modern medical terminology MeSH essentially is not fit for this purpose. Whilst old-fashioned terms for conditions can be updated there is no appropriate terminology for now obsolete surgical procedures such as the frontal lobectomy.

 

Having worked on other medical case note projects in the past, namely the Stannington Project at Northumberland Archives dealing with children’s TB files, I was well prepared for the kinds of challenges we might encounter. Nonetheless there is an inevitable variation in the content of the records and in turn the approach to outreach activities and potential researchers. As all the Stannington files related exclusively to children many of the former patients were still alive meaning we were fortunate enough to be able to interact directly with subjects of the records. Equally the subject of TB feeds very well into existing narratives on public health and has many links to social history. Neurosurgery on the other hand is much less overtly approachable to those with a non-scientific or medical background and it is here where interpretative events and blogs have been essential in drawing out less obvious themes and material such as the possibility of the use of visual material in the files by artists working in the medical humanities.

 

Illustration of a brain aneurysm by Dorothy Davison, c.1940s, ref: uncatalogued

 

The cataloguing process is nearing completion but conservation and outreach work will be on-going as the project continues. As part of the Wellcome funding we will also be tackling several other medical collections including the work of 20th century medical illustrator Dorothy Davison, medical artwork from the teaching collections of 19th century obstetrician Thomas Radford, and papers relating to the pioneer of the artificial hip Sir John Charnley.

Open source archive software: a report on National Archive’s workshop on ATOM and Archivematica

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By Geoffrey Browell, Head of Archive Services, King’s College London 


 

I co-organised a workshop in early December at The National Archives (TNA) on ATOM and Archivematica software, along with TNA’s Higher Education Archive Programme  and Artefactual Systems, the Canadian development company which supports both these applications.

The workshop was attended by around 40 archivists and records managers from around the UK, including existing or prospective users of the systems and those simply interested in learning more.

ATOM’s development was supported by the ICA and it is used across the world to manage and publish descriptions of archives. Archivematica manages digital preservation workflows for digitised and born digital content.

Key questions/points that inspired the day included:

  • Examples of the real application of Archivematica – how difficult is it to customise and how easy is it to use?
  • Do regional consortia offer the best opportunity for the application of digital preservation?
  • How can data on other systems such as CALM be imported into ATOM?
  • How is training best delivered?
  • How will these open source systems be best supported given the limitations of institutional IT?

 

The day began with an introduction and overview of both systems from Artefactual’s Justin Simpson and Dan Gillean. Their slides are available here.

There were then a series of five/ten minute presentations from invited speakers. Gary Tuson, County Archivist at Norfolk Record Office (NRO), spoke eloquently about the Eastern Region Archivematica trial that saw a number of archives in that Region, led by NRO, use Archivematica for digital preservation. He offered real encouragement that a regional model might help, although it was only a small-scale trial. Archivematica, unlike ATOM, is not available with multi-tenanted functionality. This places some limitations on the creation of a genuinely collaborative initiative and more work needs to be done to assess the viability of consortia – perhaps involving trials in other regions such as London.

Lindsay Ould, Borough Archivist at Croydon, described her experience of migrating elderly CALM data into a new instance of ATOM. Their existing CALM system was used by Archives, Museums and Local Studies, meaning that the style and structure of data was very diverse and often unclean and out of date. More than 1000 collection and accession records were migrated to a new hosted version of ATOM. Lindsay described working with an external developer to cleanse the data and she pointed out that this took up a disproportionate amount of time. Lastly, she spoke about developing a simple search interface and future plans to also make museum descriptions visible.

David Cordery, of Max Communications, was next up and spoke about the challenges of migrating data into ATOM, similar to those which Lindsay had experienced. He stressed the usability and intuitive controls provided by ATOM, but also the ability for users to customise the front end delivery of archive data and that the system is especially useful when managing images. Max provides a service to extract, clean and re-publish data in new ATOM instances and offers ongoing support.

Jenny Mitcham of York spoke next on the use of Archivematica to manage research data – a proof of concept joint venture between the Universities of Hull and York, The National Archives and JISC. Research data management is a big challenge for universities, as it is a requirement of the Research Councils that such data, for example generated by scientific research, be preserved and managed for a time. Jenny highlighted the concept of ‘parsimonious preservation’ coined by Tim Gollins of The National Archives – essentially doing ‘just enough’ to capture the right information in digital preservation, and avoiding unnecessary processes. Jenny listed a number of pros and cons of using Archivematica, including its versatility, flexibility and ability to integrate with other systems, versus its fiddly processes, unsophisticated user interface and the need to train staff to use it. This impressive project is now hoping to move to a production phase and bring on board the Borthwick Institute and integrate Archivematica more fully with ATOM. Much more information can be found on the project website and digital archiving blog.

Ed Pinsent of the Digital Preservation Training Programme at ULCC, is working with Artefactual to develop more mature training in the use of the two systems. He revealed the results of a survey of the digital preservation community in 2015, which highlighted the need for practical (and less theoretical) hands-on training, especially using real tools. ULCC will be working closely with Artefactual on UK Archivematica training in 2017. Learn more about the work of ULCC’s DP training here.

The second half of the workshop focused on hands-on sessions using the two systems and work-sheets provided by Artefactual. This gave the opportunity for attendees, working in groups, to import, manage and manipulate test data and gain a better understanding of what the systems have to offer. Test instances were set up, enabling attendees and those not present to explore the systems from their workplaces.

More information about Archivematica can be found here; and on ATOM, a series of YouTube tutorials here.

Overall, this was a very useful workshop, not least in bringing together a diverse collection of archivists and records managers from higher education, local authorities and other sectors, and others such as representatives of Arkivum, the DP specialists. It is hoped that an ATOM user group will be founded as a consequence of the workshop, to complement a thriving Archivematica group.

I would like to thank The National Archives for hosting and helping to organise the day, and Artefactual for their assistance throughout the day and since.


The blog was originally posted on the King’s Collection blog: https://blogs.kcl.ac.uk/kingscollections/2016/12/20/open-source-archive-software/