b.2 September 1912 d.15 February 2000
MRCS LRCP(1936) MB BS Lond(1937) MRCP(1942) MD(1964) FRCP(1966) FFCM(1974) FFOM
Muriel Lina Newhouse, known as ‘Mollie’, made several significant contributions to our knowledge of occupational disease by her research into the epidemiology of occupational dermatitis and, most significantly, to the relationship between asbestos exposure and mesothelioma. She was born in South Africa, the daughter of Hans Newhouse, a barrister, and Amy Henrietta née Haas. The family moved to London in 1922, where she and her sister went to St Paul’s School. She qualified from the Royal Free Hospital Medical School in 1936 and did her first house jobs there. At that time she met two young women doctors, Alice Stewart [Munk’s Roll, Vol.XI, p.550] and Barbara Thomas, who were to become lifelong friends; each had a strong influence on her choice of career and subsequent success in medical research. She gained her early clinical experience at Nottingham Children’s Hospital, in casualty at Queen’s Hospital, Hackney, and as a house physician in the Nuffield department of medicine, Radcliffe Hospital, Oxford. She took and passed the examination for membership of the College in 1942, when the pass rate was in the very low percentages.
In 1942 Mollie was called up into the Royal Army Medical Corps. Her first two years in various military hospitals in Britain were spent mastering Army documentation; she reckoned that for every ten minutes spent at the bedside she spent 50 doing the paper work. Although only one Army doctor in 20 was a woman, she found little prejudice amongst the troops she cared for. In the units she was known as ‘Doc’ and her word as an officer was law. Although officially the soldiers were supposed to call her ‘Ma’am’, she was occasionally addressed as ‘Miss Newhouse, Sir’. Soon after D-Day in 1944 Mollie and her medical unit landed in Normandy onto Mulberry Harbour, right in the heart of the battle zone. Although officially a specialist physician, she was rapidly drawn into the treatment of casualties in a front line field hospital, often acting as an anaesthetist under fire. She survived this stressful period and in 1945 was posted to India. She soon became accustomed to a comparatively luxurious lifestyle, acquired a bearer, a horse and the household befitting a major in the RAMC. Her last posting was to Singapore, caring for prisoners of war returning from the dreadful conditions in the Japanese prisons in Burma and Malaya. In 1946 she flew home in an RAF flying boat to be demobbed as a lieutenant colonel.
In 1947, she returned to the Radcliffe in Oxford, as first assistant in the Nuffield department of medicine, where, in addition to her clinical work, she did some research into hepatitis. Once the NHS came into being, Mollie moved to the department of medicine and paediatrics at Barnet General Hospital as a senior registrar, where she remained until 1953. It was there that she completed her training as a general physician with an interest in paediatrics; she became a very competent clinician, which was to stand her in good stead for the rest of her professional career. Occupational medicine was always for Mollie primarily a hands-on clinical specialty.
From 1954 to 1959 she practised as a general physician, both in England and in Cyprus, where she was also a part-time government medical officer. Her brother John persuaded Mollie to return to England in 1959 to do a course in occupational medicine at the London School of Hygiene. This led to a lifelong interest in occupational diseases, in particular skin and pulmonary disease, and an appointment in London as a research assistant at the institute of dermatology at St John's Hospital, where she remained from 1960 to 1963. At that time the Ford Motor Company was concerned about the prevalence of industrial dermatitis amongst assembly workers; their medical officer asked for the help of the institute and Mollie became the research investigator. In 1961 she published the first of a number of papers about this problem in the Transactions of St John’s Hospital Dermatological Society and later wrote a seminal paper in the British Journal of Industrial Medicine.
When she was granted her MD in 1964, Mollie was invited to join the teaching staff at the department of occupational health at the London School of Hygiene, initially as a lecturer. She remained in this department under the benevolent guidance of Richard Schilling [Munk’s Roll, Vol.X, p.434] for the rest of her distinguished career, until her official retirement as a reader in 1977. During all her years at the TUC centenary institute (as the department became), she took an active part in the teaching of postgraduate medical students and science graduates. Many came from overseas, often returning to head up government factory medical inspectorates or equivalent government departments.
One of Mollie’s earliest and most interesting research projects was an investigation into a rare form of skin disease among trawlermen, known as ‘Dogger Bank itch’. In May 1965, at the request of the British White Fish Authority, a survey was carried out by Newhouse and Schilling, which involved studying fishing methods at sea. Richard Schilling had to go to sea with the trawlers because it was considered bad luck to take a woman aboard! But otherwise the research was conducted entirely by Mollie on site at Lowestoft. Her conclusion was that Dogger Bank itch is due to an allergic skin reaction to a seaweed (Alcyonidium gelatinosum). The resulting paper shows her dogged determination to complete a survey of those at risk and her use of the combination of clinical and epidemiological techniques which was to become the hallmark of her work.
But the work for which she was to become a world leader was her group of studies of the prevalence of mesothelioma in people working with asbestos, people living with asbestos workers and those living in the neighbourhood of asbestos factories. It had been known for many years that exposure to asbestos dust caused asbestosis (a form of pneumoconiosis) and bronchial carcinoma, especially in tobacco smokers. The Asbestos Regulations of 1931 laid down strict conditions to reduce exposure, which resulted in a significant decrease in the disease. However, it was not realised that much lower concentrations of asbestos dust could cause a completely different disease – mesothelioma of the pleura and peritoneum. In 1960 an increased incidence of mesothelioma was noticed in workers in South Africa exposed to crocidolite asbestos, and this prompted Newhouse to look into the prevalence of mesothelioma in east London, where there was a large asbestos factory.
The London Hospital produced records of 83 patients with mesthelioma diagnosed over a 50-year period. Mollie carried out a meticulous survey of their occupations, their domicile and their relationships with asbestos workers in east London. She concluded that 53 per cent of patients with the disease had exposure to asbestos, either in the factory or in the homes of workers (wives used to clean clothes worn at work) or in the neighbourhood of the factory. Exposure varied enormously from as little as two months to more than 50 years, but the concentration of dust which caused mesothelioma was far lower than the standards set by the 1931 Asbestos Regulations. The time between exposure and diagnosis also varied widely, from 16 to 55 years.
The conclusions were to have a resounding effect on the whole attitude to asbestos exposure in government, in industry and amongst the public, and were to lead eventually to the widespread removal of asbestos lagging from all buildings and its replacement with other forms of insulation materials such as glass fibre. Very few research workers can have had, in their own life time, such a profound effect on the use of a common substance which had been regarded as beneficial and relatively harmless. This work led eventually to the development of the Asbestos Regulations of 1969.
Mollie Newhouse officially retired in 1977, but continued to carry out research, much of it collaborative, for the next ten years; she was always a popular guest contributor at international conferences. As a researcher she richly deserved Richard Schilling’s soubriquet of a “benign but fearsome ferret”. She was an inspiring teacher, an argumentative colleague, quick to penetrate the chinks in the armour of others’ opinions, but always courteous. She never married, but had a large and affectionate family of nieces and nephews. She enjoyed travel, particularly to the Middle East, and was a great music lover; she enjoyed gardening at her cottage in Oxfordshire and studied the history of gardens. She was proud to be a member of a liberal synagogue. She lived for many years in a south-facing flat overlooking Hyde Park, where she exercised her poodle Perry. Her collection of lustre ware jugs was much admired, as was her skill at Scrabble. Her family loved her for her kindness, her generosity, her sense of humour and willingness to listen.
William M Dixon
[Brit.med.J.,2000 320 944]
(Volume XII, page web)
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