586 Patients with cervical carcinoma showed the highest percentage of antibody prevalence (43%) whereas only 5 female controls (10%) had H.s.v. 2 antibodies. Among the husbands of women with cervical carcinoma H.s.v. 2 antibodies were found in 10 of 36 sera while in the male controls the proportion was only 2 out of 36.
Institüt fur Medizimsche und Epidemiologie,
Mikrobiologie
Frauenklinik, und Dermatologische Klinik, Wilhelm-Pieck-Universitat, 25 Rostock, East Germany
MARGARETE KUNKEL HEIDEROSE OBERENDER LOTAR GÄRTNER REINHARD HOFMANN KARL-HEINZ RÄTZ HELMUT HEISE
SEXUALITY AND THE DISABLED to see your note on the new journal and Disability (Aug. 12, p. 385) conclude that the papers on disabled people’s sexual problems are unlikely to be of practical day-to-day use for the average medical man. Harris1 has shown that 1 in 13 people aged sixteen or over living in private households has some physical, mental, or sensory impairment; and Stewart2 found that over 52% of a sample of disabled people admitted to sexual problems. Since both spouses in a "disabled" marriage are candidates for sexual counselling, something like 8% of a general practitioner’s patients may be in need of help in this very important area. I suggest that this counselling could well come into "practical dayto-day use". It is not that your reviewer apparently got his sums wrong that is depressing but the all-too-common disregard of a serious problem that can affect many more than the two people immediately concerned.
SIR,-It is discouraging
Sexuality
Committee on Sexual Problems of the 49 Victoria Street, London SW1H 0EU
Disabled,
DUNCAN GUTHRIE Chairman
1. 2.
Harris, A. Handicapped and Impaired in Great Britain. H.M. Stationery Office, 1971. Stewart, W. F. R. Sex and the Physically Handicapped. Research Institute for Consumer Affairs, 1975.
Commentary from Westminster From
our
Parliamentary Correspondent
HEALTH AND SAFETY IN MEDICAL ESTABLISHMENTS
THE case of smallpox in Birmingham (see p. 560) illustrates again the risks faced by staff working in medical establishments. There are still large areas where protection of staff is less adequate than it might be. One body which is attempting to remedy these defects is the Health and Safety Executive, a relative newcomer to the scene but now with an established part to play. After a pilot survey of hospital safety in the London region, the Executive has decided to embark on a five-year programme of hospital inspection. In addition to hospitals, the programme will include all premises staffed by employees of the area or regional health authorities, such as health centres, blood-transfusion centres, and ambulance stations. The aim is for each area of the Executive to undertake the basic inspection of some 20% of its hospitals each year, the intention being to complete the first round by 1982.
Because many of these premises have not previously been subject to occupational safety and health legislation, the Executive accepts that its programme will raise many new problems. So it has produced some useful guidelines to explain its methods of inspection and to try to allay concern in the medical profession. The first aim of the inspection will be to ensure that each health authority has an adequate health and safety policy and that it has set up a management organisation to implement that policy. This organisation should include a senior member of management responsible to the authority for coordinating the implementation of the policy and monitoring the authority’s performance. A statement on safety policy, in addition to dealing with such matters as the safety of mechanical and steam plant and electrical and fire precautions, should also cover policy for the control of hazards of particular significance in the health field, such as infection and radiation. An effective system would be required by which to identify, record, investigate, and monitor accidents and cases of occupational disease or other illhealth. The statement should also deal with the control of dangerous drugs and toxic materials used in laboratories, as well as with procedures for protecting employees against violence. It is the intention of the Health and Safety Commission that employees in hospitals should receive no less protection against risk of injury or danger to health than they would receive in other areas of employment. But it recognises that financial and staff resources will not always be available to remedy immediately all the matters identified by the inspector as requiring attention. Inspectors will be prepared to discuss priorities with management with a view to phasing the less urgent matters. In the protection of patients the Health and Safety Executive is going out of its way to allay fears among some doctors. Section 3 of the Health and Safety at Work Act is concerned with the responsibility of the employer towards people not in his employment but who may be exposed to risks to their health and safety as a result of his activities. This section is primarily intended to cover members of the public-in the case of the N.H.S., the patients. But, as the guidance from the Executive makes clear, it is not at all certain how far Section 3 should apply to the treatment of patients. So inspectors will initially take the line that they will not concern themselves with the medical or nursing care of patients except as far as it may be necessary to do so when dealing with certain systems of work or the fitness of plant or equipment. As Crown bodies, regional and area health authorities are exempt from prosecution and the enforcmentnotice procedure under the Health and Safety at Work Act. Until the Commission manages to convince the Government to change this anomaly, it has instructed its Executive to implement a "Crown notice procedure" equivalent to the issue of a prohibition or improvement notice (as it did last week in prohibiting work at Birmingham University on smallpox virus or any other similarly dangerous pathogen until the recommendations of the working party on the laboratory use of dangerous pathogens had been carried out). If an authority fails to comply with the procedure the matter would be taken up at higher levels both in the Government and the Executive.
Institüt fur Medizimsche und Epidemiologie,
Mikrobiologie
Frauenklinik, und Dermatologische Klinik, Wilhelm-Pieck-Universitat, 25 Rostock, East Germany
MARGARETE KUNKEL HEIDEROSE OBERENDER LOTAR GÄRTNER REINHARD HOFMANN KARL-HEINZ RÄTZ HELMUT HEISE
SEXUALITY AND THE DISABLED to see your note on the new journal and Disability (Aug. 12, p. 385) conclude that the papers on disabled people’s sexual problems are unlikely to be of practical day-to-day use for the average medical man. Harris1 has shown that 1 in 13 people aged sixteen or over living in private households has some physical, mental, or sensory impairment; and Stewart2 found that over 52% of a sample of disabled people admitted to sexual problems. Since both spouses in a "disabled" marriage are candidates for sexual counselling, something like 8% of a general practitioner’s patients may be in need of help in this very important area. I suggest that this counselling could well come into "practical dayto-day use". It is not that your reviewer apparently got his sums wrong that is depressing but the all-too-common disregard of a serious problem that can affect many more than the two people immediately concerned.
SIR,-It is discouraging
Sexuality
Committee on Sexual Problems of the 49 Victoria Street, London SW1H 0EU
Disabled,
DUNCAN GUTHRIE Chairman
1. 2.
Harris, A. Handicapped and Impaired in Great Britain. H.M. Stationery Office, 1971. Stewart, W. F. R. Sex and the Physically Handicapped. Research Institute for Consumer Affairs, 1975.
Commentary from Westminster From
our
Parliamentary Correspondent
HEALTH AND SAFETY IN MEDICAL ESTABLISHMENTS
THE case of smallpox in Birmingham (see p. 560) illustrates again the risks faced by staff working in medical establishments. There are still large areas where protection of staff is less adequate than it might be. One body which is attempting to remedy these defects is the Health and Safety Executive, a relative newcomer to the scene but now with an established part to play. After a pilot survey of hospital safety in the London region, the Executive has decided to embark on a five-year programme of hospital inspection. In addition to hospitals, the programme will include all premises staffed by employees of the area or regional health authorities, such as health centres, blood-transfusion centres, and ambulance stations. The aim is for each area of the Executive to undertake the basic inspection of some 20% of its hospitals each year, the intention being to complete the first round by 1982.
Because many of these premises have not previously been subject to occupational safety and health legislation, the Executive accepts that its programme will raise many new problems. So it has produced some useful guidelines to explain its methods of inspection and to try to allay concern in the medical profession. The first aim of the inspection will be to ensure that each health authority has an adequate health and safety policy and that it has set up a management organisation to implement that policy. This organisation should include a senior member of management responsible to the authority for coordinating the implementation of the policy and monitoring the authority’s performance. A statement on safety policy, in addition to dealing with such matters as the safety of mechanical and steam plant and electrical and fire precautions, should also cover policy for the control of hazards of particular significance in the health field, such as infection and radiation. An effective system would be required by which to identify, record, investigate, and monitor accidents and cases of occupational disease or other illhealth. The statement should also deal with the control of dangerous drugs and toxic materials used in laboratories, as well as with procedures for protecting employees against violence. It is the intention of the Health and Safety Commission that employees in hospitals should receive no less protection against risk of injury or danger to health than they would receive in other areas of employment. But it recognises that financial and staff resources will not always be available to remedy immediately all the matters identified by the inspector as requiring attention. Inspectors will be prepared to discuss priorities with management with a view to phasing the less urgent matters. In the protection of patients the Health and Safety Executive is going out of its way to allay fears among some doctors. Section 3 of the Health and Safety at Work Act is concerned with the responsibility of the employer towards people not in his employment but who may be exposed to risks to their health and safety as a result of his activities. This section is primarily intended to cover members of the public-in the case of the N.H.S., the patients. But, as the guidance from the Executive makes clear, it is not at all certain how far Section 3 should apply to the treatment of patients. So inspectors will initially take the line that they will not concern themselves with the medical or nursing care of patients except as far as it may be necessary to do so when dealing with certain systems of work or the fitness of plant or equipment. As Crown bodies, regional and area health authorities are exempt from prosecution and the enforcmentnotice procedure under the Health and Safety at Work Act. Until the Commission manages to convince the Government to change this anomaly, it has instructed its Executive to implement a "Crown notice procedure" equivalent to the issue of a prohibition or improvement notice (as it did last week in prohibiting work at Birmingham University on smallpox virus or any other similarly dangerous pathogen until the recommendations of the working party on the laboratory use of dangerous pathogens had been carried out). If an authority fails to comply with the procedure the matter would be taken up at higher levels both in the Government and the Executive.
