Professor Charles Fletcher CBE FRCP in interview with Max Blythe: Interview 2


Part One: Pneumoconiosis In this interview, Professor Charles Fletcher talks of his appointment in 1945 as director of the Medical Research Council Pneumoconiosis Research Unit in Cardiff, set up in response to concern about the incidence of dust-related disease among the coalminers of South Wales, and the consequent loss to the workforce. He acknowledges the early help of Dr Alice Stewart. The interview moves on to the unit's research - comparing the progression of pneumoconiosis in miners who had left the industry with those remaining in the mines. The problems of accurate interpretation of X-rays and the establishment of a radiographic classification of pneumoconiosis are discussed. Professor Fletcher reflects on the results of the study of miners, which identified two different forms of the disease - simple pneumoconiosis and progressive massive fibrosis (PMF) - and found that the former had to be at a certain stage before the progressive disease developed. These results formed the basis of industry compensation schemes.Professor Fletcher goes on to discuss the contribution of the epidemiologist Dr Archie Cochrane to the unit, including his study of simple pneumoconiosis, PMF and tuberculosis in the Rhondda Fach and Aberdare Valley. The interview ends with reflections on the near disappearance of pneumoconiosis among working miners due to a regular X-raying programme and a reduction of dust in the mines.Part Two: Bronchitis and Emphysema At the start of this interview Professor Fletcher talks of the effects of the week-long smog in London in 1952. This contributed to 1000 deaths from bronchitis and prompted the MRC to set up a committee on the aetiology of chronic bronchitis, with Professor Christie of St Bartholemew's Hospital as chairman and Charles Fletcher as secretary. The discussion moves on to the CIBA symposium that he chaired which produced a report in 1959 containing definitions of bronchitis, emphysema and asthma which became generally accepted, and the discovery that emphysema occurred almost entirely among smokers. Next, Professor Fletcher reflects on the study, running from 1961 to 1968, of the prevalence of respiratory disease amongst Post Office and London Transport workers, which indicated a difference in the rate of decline of lung-function between smokers and non-smokers. He acknowledges Richard Peto's contribution to the statistical analysis of these results. In the final part of the interview Professor Fletcher outlines the problems of distinguishing between bronchitis and asthma.Part Three: Action Against Smoking Professor Fletcher first talks of Professor Austin Bradford-Hill and Dr Richard Doll's influential epidemiological study into the possible causative factors of lung cancer, which had increased in incidence during the 1930s. The study identified smoking as a factor, and by 1968 further studies had indicated that smoking was related to the development of other diseases. The interview moves on to the Royal College of Physician's famous report on smoking published in 1962. The result of a meeting between Professor Fletcher and Dr George Godber, then Deputy Chief Medical Officer, to discuss what action could be taken against smoking, it raised the profile of the issue, and the College produced three other reports over the years. The Surgeon General's reports on smoking in the United States, instigated by President Kennedy in 1964, are described as a response to this initiative. Next, Professor Fletcher speaks of his chairmanship of the Health Education Council, which identified smoking as a priority issue, and the setting up of the pressure group ASH (Action on Smoking and Health) in 1971. He acknowledges the contribution of Mike Daube to the dissemination of the anti-smoking message in the media. The interview ends with a discussion of changing levels of smoking and attitudes towards smoking in different social groups. Professor Fletcher talks about the failure to get across the message of the dangers of smoking, and criticises government for their stance on tobacco advertising.


Epidemiology, Occupational medicine, Pulmonary medicine (respiratory medicine),

Project reference numbers

vid-076, MSVA_001.1

DOI (Digital Object Identifier)

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Attached files


Fletcher, Charles
Blythe, Max

Oxford Brookes departments

Learning Resources


Original artefact: 1984
RADAR resource: 2017


Oxford, UK

© Oxford Brookes University; The Royal College of Physicians
Published by Oxford Brookes University
All rights reserved.

Related resources

This RADAR resource is Part of Medical Sciences Video Archive
This RADAR resource Continues Interview 1
This RADAR resource is Continued by Interview 3


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