Sir Richard Doll | |
|---|---|
 Richard Doll in 2002 | |
| Born | William Richard Shaboe Doll (1912-10-28)28 October 1912 |
| Died | 24 July 2005(2005-07-24) (aged 92) Oxford, England |
| Alma mater | St Thomas's Hospital Medical School |
| Known for | Epidemiology of smokingArmitage–Doll model |
| Awards | Gairdner Foundation International Award (1970) Buchanan Medal (1972) Charles S. Mott Prize (1979) Royal Medal (1986) Prince Mahidol Award (1992) Shaw Prize (2004) Gold Medal for Radiation Protection (2004) King Faisal International Prize (2005) |
| Scientific career | |
| Fields | Physiology Epidemiology |
Sir William Richard Shaboe DollCH OBE FRS (28 October 1912 – 24 July 2005)[1] was a British physician who became anepidemiologist in the mid-20th century and made important contributions to that discipline. He was a pioneer in research linkingsmoking to health problems. WithErnst Wynder,Bradford Hill andEvarts Graham, he was credited with being the first to prove that smoking increased the risk oflung cancer andheart disease. (German studies had suggested a link as early as the 1920s but were forgotten or ignored until the 1990s.)[2][3]
He also carried out pioneering work on the relationship between radiation andleukaemia as well as that betweenasbestos and lung cancer, andalcohol and breast cancer. He however, initially for many years, stood in opposition to research done byAlice Stewart which connected radiation exposure of pregnant mothers to development ofleukaemia in their children due to her 'questionable' analysis.[4][5] On 28 June 2012, he was the subject of an episode ofThe New Elizabethans, a series broadcast onBBC Radio Four to mark theDiamond Jubilee of Queen Elizabeth II, dealing with 60 public figures from her reign.[6]
Doll was born atHampton,Middlesex (now part of south-west London) into an affluent family, though his father's work as a doctor was cut short bymultiple sclerosis. Educated first atWestminster School, Doll originally intended (against the wishes of his parents that he become a doctor like his father) to study mathematics atTrinity College, Cambridge. Doll later recalled he failed the final of four examinations for a college scholarship through having drunk three pints of the College's 8% alcohol own-brewed beer the night before. He was offered an exhibition instead, but refused to take it up.[7]
He chose instead to follow his parents' wishes and study medicine atSt Thomas's Hospital Medical School (since merged intoKing's College London) from where he graduated in 1937.[8] Doll was a socialist, and one of the significant figures in theSocialist Medical Association whose campaign helped lead to the creation of Britain's postwarNational Health Service. He joined theRoyal College of Physicians after the outbreak ofWorld War II and served for much of the war as a part of theRoyal Army Medical Corps on a hospital ship as a medical specialist.[citation needed]
After the war, Doll returned to St Thomas's to researchasthma. In 1948 he joined a research team under DrFrancis Avery-Jones at theCentral Middlesex Hospital, run under the auspices of the statistical research unit of theMedical Research Council. Over a 21-year career in the unit, Doll rose to become its director. His research there initially focused on the role of occupational factors in causingpeptic ulcers.[9]
In 1950, he undertook, withAustin Bradford Hill, a study of lung cancer patients in twenty London hospitals, at first under the belief that it was due to the new materialtarmac, or motor car fumes, but rapidly discovering thattobacco smoking was the only factor they had in common.[10] Doll himself stopped smoking as a result of his findings, published in theBritish Medical Journal in 1950, which concluded:
The risk of developing the disease increases in proportion to the amount smoked. It may be 50 times as great among those who smoke 25 or more cigarettes a day as among non-smokers.
Four years later, in 1954, theBritish doctors study, a study of some 40,000 doctors over 20 years, confirmed the suggestion,[11] based on which the government issued advice that smoking and lung cancer rates were related. In 1955, Doll reported a case-controlled study that firmly established the relationship between asbestos and lung cancer.[12]
In 1966, Doll was elected to theRoyal Society. The citation stated:[13]
Doll is distinguished for his researches in epidemiology, and particularly the epidemiology of cancer where in the last 10 years he has played a prominent part in (a) elucidating the causes of lung cancer in industry (asbestos, nickel & coal tar workers) & more generally, in relation to cigarette smoking, and (b) in the investigation of leukaemia particularly in relation to radiation, where using the mortality of patients treated with radiotherapy he has reached a quantitative estimate of the leukaemogenic effects of such radiation. In clinical medicine he has made carefully controlled trials of treatments for gastric ulcer. He has been awarded the United Nations prize for outstanding research into the causes & control of cancer & the Bisset Hawkins medal of the Royal College of Physicians for his contributions topreventative medicine.
In 1969, Doll moved toOxford University, to sit as theRegius Professor of Medicine, succeeding the clinical researcher Sir George Pickering. Initially, epidemiology was held in low regard, but in his time at Oxford he helped reverse this. He was the primary agent behind the creation ofGreen College, which was founded in 1979. Doll was appointed the first Warden of Green College, whence he retired in 1983. Green College merged withTempleton College in 2008 to becomeGreen Templeton College, which is located on the site that was previously Green College.[citation needed]
Doll also helped found theNational Blood Service, and was key in avoiding a system of paying donors for their blood, as had been adopted in the United States. His continued work intocarcinogens at theImperial Cancer Research Centre at theJohn Radcliffe Hospital, Oxford, working as part of theClinical Trial Service Unit, notably including a study undertaken withRichard Peto, in which it was estimated that tobacco, along with infections and diet, caused three-quarters of all cancers, which was the basis of any of theWorld Health Organization's conclusions on environmental pollution and cancer.[citation needed]
Doll was made aFellow of the Royal Society (FRS) in 1966,knighted in 1971, and awarded theEdward Jenner Medal of theRoyal Society of Medicine in 1981. Also in 1981, Doll became a founding member of theWorld Cultural Council.[14] He was a member of theNorwegian Academy of Science and Letters from 1976.[15]
In 1996, he was made aMember of the Order of the Companions of Honour (CH) for "services of national importance". International honours included the Presidential Award of theNew York Academy of Sciences as well as a United Nations Award for his research into cancer. In April 2005, he was awarded the Saudi ArabianKing Faisal International Prize for medicine jointly with Peto for their work on diseases related to smoking. In 2004, he was awarded the inauguralShaw Prize for Life Sciences and Medicine for his contribution to modern cancer epidemiology. He was also awarded honorary degrees by thirteen different universities.[citation needed]
He was a supporter of theLiberal Democrats at the2005 general election.[16]
He died on 24 July 2005, at theJohn Radcliffe Hospital inOxford after a short illness.[17]
On 7 June 2015, ablue plaque was unveiled at his home at 12Rawlinson Road.[18][19]
He was an atheist.[20]
The Richard Doll Building inHeadington, eastOxford, designed byNicholas Hare Architects in 2006, was named in his honour and opened shortly before his death.It houses theClinical Trial Service Unit,Cancer Epidemiology Unit andNational Perinatal Epidemiology Unit. The building received anRIBA Award in 2007.A plaque inside the building contains the following quotation from Doll:[21]
Death in old age is inevitable, but death before old age is not. In previous centuries 70 years used to be regarded as humanity's allotted span of life, and only about one in five lived to such an age. Nowadays, however, for non-smokers in Western countries, the situation is reversed: only about one in five will die before 70, and the non-smoker death rates are still decreasing, offering the promise, at least in developed countries, of a world where death before 70 is uncommon. For this promise to be properly realised, ways must be found to limit the vast damage that is now being done by tobacco and to bring home, not only to the many millions of people in developed countries but also the far larger populations elsewhere, the extent to which those who continue to smoke are shortening their expectation of life by so doing.
One of the buildings of theInstitute of Cancer Research inSutton, London is also named after Sir Richard Doll.[22]
After Richard Doll's death, some controversy arose over aspects of his research funding when his papers, held at theWellcome Library, indicated that for many years he had received consultancy payments from chemical companies whose products he was to defend in court.
These include US$1,500 per day consultancy fee from theMonsanto Company for a relationship which began in 1976 and continued until 2002. During this period Doll wrote to aRoyal Commission in Australia investigating whether the Monsanto-produced herbicideAgent Orange, which was used during theVietnam War, was carcinogenic, claiming that there was no evidence that it caused cancer.[23]
He also received £15,000 from theChemical Manufacturers Association,Dow Chemicals, andICI for a review published in 1988 that concluded that workplace exposure tovinyl chloride did not increase the chance of contracting cancer, with the exception ofangiosarcoma of the liver, contradicting two previous reviews by theWorld Health Organization'sInternational Agency for Research on Cancer.[23][24][25]
Some donations, including a £50,000 gift from asbestos companyTurner and Newall, were given in a public ceremony toGreen College, Oxford, but most fees and payments remained undisclosed to the public, Oxford University and colleagues until his death. His defenders point out that his connections to industry were widely known by those in the field, that he did his work before formal disclosure of commercial interests became commonplace and that on occasion, he came to conclusions that were unpalatable to the companies who consulted him.[citation needed] His own view, as reported byRichard Peto – who criticised the allegations, claiming they originated with people aiming to damage Doll's reputation – was that it was necessary to co-operate with companies for access to data which could prove their products to be dangerous. Peto said also that Doll gave all his fees from such work to Green College, Oxford, which he had founded.
Some controversy arose over the fact that he did not publish a paper on 'A tentative estimate of the leukaemogenic effects of test thermonuclear explosions' in theJournal of Radiation Protection in 1955 which stated that 'there is no threshold [radiation] dose below which no effect is produced' in humans. He withdrew it on advice from SirHarold Himsworth, Secretary of the MRC (Medical Research Council), who in turn was advised by theAtomic Energy Authority not to publish because it would be contrary to their interests. It was only published in 1996 when this kind of view was more acceptable to the nuclear industry.[26][27][28]
[our] approach requires either much larger doses than were encountered in the Hanford study or a much larger data base
The 90 percent confidence interval is bounded by the range from 380 to 448 cancer deaths. Thus 442 deaths is not a statistically significant deviation from the average expectation.…Kneale and Stewart do not claim their results to be statistically significant
