Whitehall Study I

Papers relating to the 'Health Survey of Male Civil Servants aged 40 or over', more widely referred to as the Whitehall Study or Whitehall I (Whitehall II Study began in 1985 and is currently ongoing). The collection holds: planning and administrative papers relating to conducting the health survey, 1966-1973; a large volume of raw data relating to the health screening conducted on the Civil Servants, 1967-1970, including questionnaires, appointment schedules and recorded clinical results from blood, X-ray and electrocardiogram assessments; material relating to long-term monitoring of the survey population, including nominal rolls and index cards of survey volunteers; sickness absence records, 1964-1971, and notifications of departmental transfers and deaths in the cohort; background papers and results of control and follow-up studies of survey population, including material relating to smoking cessation study, dietary and exercise habits, 1969-1981; research material relating to the case-control study, conducted as part of the Stress and Health Study (also known as Whitehall II Study), 1991-1994; Whitehall Study I result tables and graphs; data analysis and calculations of morbidity and mortality data and publications relating to survey findings, 1970-1992. Additional material includes preceding health surveys, such as the G.P.O. [General Post Office] health surveys, 1964-1968, conducted by the Medical Statistical Department at London School of Hygiene and Tropical Medicine and other departmental papers relating to teaching and research in the department.

The department began in 1927 with the appointment of Major Greenwood at the School as Professor of Epidemiology and Vital Statistics. From its inception, the department provided teaching in epidemiology and research on medical statistical investigations on occupation health, air hygiene, tuberculosis and clinical trials on effectiveness of vaccines and treatments for whooping cough, influenza and chronic rheumatic diseases. Following Major Greenwood's retirement in 1945, Austin Bradford Hill took over running the department (where it became the Department of Medical Statistics and Epidemiology), and it was during this period that he conducted the famous study of the causes and effect of smoking and lung cancer with Richard Doll. Donald Reid succeeded Bradford-Hill as Director in 1961, where the department shifted its focus to looking at chronic, non-communicable disease such as the effect of air pollution, cancer incidence and cardiovascular disease. Under the influence of Reid and Geoffrey Rose, the department became an authority on teaching the epidemiology of cardiovascular disease and led to longitudinal and comparative studies such as the Whitehall Study of civil servants and international migrant studies which was carried on into the 1980s with the INTERSALT Study. Tropical epidemiology was adopted in the 1970s thanks to support from the Wellcome Trust.

Donald Darnley Reid (1914-1977), the greatly admired epidemiologist and former head of Department of Medical Statistics and Epidemiology (1961-1977). Donald Reid began his medical career at University of Aberdeen, serving on his qualification as a house physician and house surgeon at the Royal Northern Infirmary (1937-1938). With the outbreak of the Second World War, he joined the Royal Air Force and served as a station medical officer, where began to research the physical and mental stresses of the aircrews, and how they might be medically alleviated. His work brought him into contact with Sir Austin Bradford Hill, who became his mentor and persuaded him to join him at the Department of Medical Statistics and Epidemiology at LSHTM. His main research interest lay in the influence of the environment upon the spread of respiratory disease. In his analysis of Post Office sickness records, he identified the importance of exposure to air pollution among outdoor workers. Reid also specialised in the epidemiology of cardiovascular and respiratory diseases. He was one of the first to initial the international study of migrants who had moved from the UK or Norway to the USA, was heavily involved in the MRC Anti-Coagulant Trials on myocardial infarction and was one of the principle investigators working on the Whitehall Study. His work led to many honours including chair of the medical section of the Royal Statistical Society (1956-1958), and President of the section of epidemiology and community medicine of the Royal Society of Medicine (1960-1968). In recognition for his work, LSHTM set up the Donald Reid Medal in 1979 to recognise distinguished contributions to epidemiology.

Geoffrey Arthur Rose (1926-1993), eminent epidemiologist and key figure in the epidemiology and prevention of cardiovascular disease. He was educated at Queen's College, Oxford, then St Mary's Hospital Medical School, London, qualifying in 1949, where he began a lifelong association. He joined the research staff of the London School of Hygiene and Tropical Medicine in 1959 and held various positions at the School before being appointed the Professor of Epidemiology in 1977. His early work concentrated on improving the standardised methods for measuring cardiovascular conditions, including the development of a random zero sphygmomanometer for measurement of blood pressure, Rose cardiovascular questionnaire and the Minnesota Code for the classification of electrocardiographic abnormalities. These methods were all adopted during the original Whitehall Study health survey of civil servants and other research projects at the school, including the MRC Anti-Coagulant therapy trial and the General Post Office health survey. He is later research on the INTERSALT Study, an international cooperative study on blood pressure patterns and their determinants in 52 communities, led to his most fundamental appraisal of the relationship between ill health in individuals and ill health in populations. Alongside his research work, he was greatly admired teacher and author, notably for his 1992 publication, 'The Strategy of Preventive Medicine', where Rose developed his population strategy approach to preventive medicine and public health.

Patrick John Sinclair Hamilton (1934-1988), Scottish epidemiologist who was widely respected for his contributions to both community and tropical medicine. He initially joined in 1966 and was the lead organiser of the Whitehall Study survey and follow-up study on the examination of the risks of smoking and the effects of anti-smoking programmes. In 1971, he became head of the newly created tropical epidemiology unit within the School before leaving to Trinidad as director of the Caribbean Epidemiology Centre in 1975. He returned to the London School as professor of community health in 1982, with one of his last acts being the establishment of a research group to the study of the social impact of AIDS [GB 0809 AIDS Social History Programme], which included the appointment of a historian to the School's staff.

The Whitehall Study, or the health survey of male civil servants strung out of the developments and research which had been undertaken under the directorship of Donald Reid. Close connections with the Civil Service Medical Department had been fostered with the School through previous collaborations since the end of the Second World War. Through the work of Geoffrey Rose, standardised techniques on measuring cardiovascular and respiratory health had been developed in the early 1960s, and after piloting the methodology on General Postal Office health survey, 1966-1968, the stage was set for the Whitehall Study to begin. From 1967-1970, 18300 subjects were examined as part of a health screening. The short-term aim of the study was to identify subjects showing early signs of cardiovascular disease, respiratory conditions and diabetes and refer subjects on for treatment. The long-term aspect of the project was to assess the effectiveness of intervention trials on high risk subjects through a series of programmes designed to stop smoking, reduce weight and lower blood sugar levels. All subjects were subsequently monitored for the rest of their lives, with all mortality notifications provided by the OPCS (Office of Population Censuses and Surveys). It was through looking at the long-term effects of risk factors on mortality that some of the key findings of the study were uncovered, described in the 1982 paper by Michael Marmot et al. which showed a clear social gradient on the rates of mortality based on employment grade. The findings of this study led on to the creation of the Stress and Health Study, more commonly referred to as Whitehall II, in 1985, based at University College London. The second study followed a new Civil Servant cohort composed of 10,308 male and female subjects, aged 35-55, focusing more on the social and occupational environment. This study continues to provide findings.

The collection has been arranged into six series:

1) Planning and administration

2) Health screening data collection

3) Longitudinal health monitoring

4) Control studies and follow-up studies

5) Data analysis

6) Department of Medical Statistics & Epidemiology

The series broadly reflects the working method of the survey, with each stage roughly following a chronological sequence. There are some overlap between these series as each of these activities were often occurring simultaneously, involving the same personnel. For example, questionnaires with death certificates relate to both data collection and longitudinal health monitoring. The last series contains items relating to Whitehall Study such as the Framingham Heart Study and WHO mortality rates and wider research activities of the department. Most of these papers were created or collected by Donald Reid or Linda Colwell, who both worked on the Whitehall Study.

This collection is open for consultation but with some exceptions listed below. Please contact the Archivist to arrange an appointment. All researchers must complete and sign a user registration form, which signifies their agreement to abide by the archive rules. All researchers are required to provide proof of identity bearing your signature (for example, a passport or debit card) when registering. Please see website for further information at www.lshtm.ac.uk/library/archives. The following files are closed under the Data Protection Act: GB 0809 Whitehall/01/03; GB 0809 Whitehall/01/05; GB 0809 Whitehall/02/01, GB 0809 Whitehall/02/03/02, GB 0809 Whitehall/02/04/03, GB 0809 Whitehall/02/05/01; GB 0809 Whitehall/04/01/01; GB 0809 Whitehall/04/01/02; GB 0809 Whitehall/04/01/03; GB 0809 Whitehall/04/01/04; GB 0809 Whitehall/04/01/05; GB 0809 Whitehall/04/01/07; GB 0809 Whitehall/06/01/01; GB 0809 Whitehall/06/03/01; GB 0809 Whitehall/06/03/02; GB 0809 Whitehall/06/08. Please see relevant files for details of the closure and the duration of the closure.

The bulk of the collection was deposited in the Gower Street vaults c. 1998, according to a preservation assessment in 2006 [Whitehall Study preservation survey]. The collection was assessed in 2012 as part of the Wellcome scoping grant, and was repackaged and moved into the Keppel Street basement stores in the summer of 2012. Additional material was added to the collection from the Director's office [GB 0809 Whitehall/03/05/04] and accessioned papers from the Department of Medical Statistics & Epidemiology [GB 0809 Whitehall/04/02/06, GB 0809 Whitehall/04/01/09; GB 0809 Whitehall/05/02/08, GB 0809 Whitehall/05/03/01, GB 0809 Whitehall/06/04/02/01-06].

Mixed modern archive material. Primarily A4 and legal sized paper archive with overhead presentation acetates; card indexes; computer print outs and printed material. Some items are oversized and stored separately from main body of the collection.

Compiled by Chris Olver as part of the Wellcome Trust Research Resources project, Cataloguing and Preservation of the Whitehall Study, August 2017.

Duplicate survey stationary and departmental ephemera were removed from the collection along with copies of published material, primarily statistical journal articles. It was also decided to retain a sample of the electrocardiograms of Whitehall Study volunteers, on the basis that they were unlikely to have much research value, with the results and analysis were recorded elsewhere in the collection.

There is no documentation of where the archive was held before being deposited into the archive stores, c. 1998.

Additional material relating to the Whitehall Study and the Department of Medical Statistics and Epidemiology may be found within accessions. Available related material is available in the Departments collection. Donald Reid, the lead investigator on the Whitehall Study also contributed to the Medical Research Committee (MRC) Long Term Anticoagulant Therapy Trials for Acute Myocardial Infarction (GB 0809 MRC Anticoagulant Therapy Trial) with this collection initially deriving from his papers.