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The rate for spina bifida is certainly the evidence from South Wales do not support this idea","author":"experimentally","year":"1959","unstructured":"-5 12-7 Coffey and Jessop, 1955"},{"key":"ref_13","article-title":"highest so far recorded if it is accepted that the The same is true for radioactive fall-out, which could Dublin series (Coffey and Jessop, 1955) is likely to not have been a factor before the second world war, be a selected one","unstructured":"-1 6-9 Record and McKeown, 1949"},{"key":"ref_14","article-title":"but has been incriminated elsewhere (le Vann, 1963, Marked geographical variations in the incidence","year":"1965","unstructured":"0 58 Record and McKeown, 1949"},{"key":"ref_15","article-title":"of central nervous system malformations exist even The urban\/rural gradient noted by Edwards","year":"1958","unstructured":"experimentally, and background radiation has been The South Wales incidence of central nervous suspected as an aetiological factor (Gentry, Parksystem malformations is one of the highest so far hurst, and Bulin, 1959), several investigations in reported, exceeded only by that from Belfast North America (Grahn and Kratchman, 1963; (Stevenson and Warnock, 1959) of the population Segall, MacMahon, and Hannigan, 1964) and the surveys. The rate for spina bifida is certainly the evidence from South Wales do not support this idea."},{"key":"ref_16","article-title":"and for high figures in others because of inevitably What factor in these variations is responsible in selected hospital series. The Chinese and Japanese South Wales has not been identified. Although the and other Far-Eastern races seem to have a low people themselves and the mode of life appear to be incidence (Neel, 1958; Searle, 1959). The same seems different in the rural areas, they seem to come from to be true for the Negroes in North America (Alter, the same stock and they seem to have a fairly similar","unstructured":"highest so far recorded if it is accepted that the The same is true for radioactive fall-out, which could Dublin series (Coffey and Jessop, 1955) is likely to not have been a factor before the second world war, be a selected one."},{"key":"ref_17","article-title":"and also possibly in Africa as well. On the other social class structure. Housing density could in some hand, Europeans and probably to a lesser extent way possibly be a factor","unstructured":"but has been incriminated elsewhere (le Vann, 1963, Marked geographical variations in the incidence 1965)."},{"key":"ref_18","article-title":"The high rate reported from Alexandria The West\/East upward gradient in incidence","volume-title":"is one of the more which seems to stand up to several different statistical notable exceptions and will need further inquiry. tests, would appear to be highly significant. So far no These community differences must to some extent be satisfactory geographical explanation has emerged","author":"rates","year":"1966","unstructured":"of central nervous system malformations exist even The urban\/rural gradient noted by Edwards (1958)"},{"key":"ref_19","series-title":"of course, always posin France (Frezal, Kelley, Guillemot, and Lamy, sible that the explanation may lie in some epidemi","article-title":"due to genetic differences in susceptibility. However, Nor does there appear to be a convincing ethnic, it is questionable whether the marked local differsociological, or economic basis for it (Laurence, ences recorded for a hospital survey of anencephaly Carter","year":"1968","unstructured":"and for high figures in others because of inevitably What factor in these variations is responsible in selected hospital series. The Chinese and Japanese South Wales has not been identified. Although the and other Far-Eastern races seem to have a low people themselves and the mode of life appear to be incidence (Neel, 1958; Searle, 1959). The same seems different in the rural areas, they seem to come from to be true for the Negroes in North America (Alter, the same stock and they seem to have a fairly similar"},{"key":"ref_20","article-title":"and for central nervous system malformations ological quirk which may become exposed by time","unstructured":") and also possibly in Africa as well. On the other social class structure. Housing density could in some hand, Europeans and probably to a lesser extent way possibly be a factor. This, however, is a difficult"},{"key":"ref_21","article-title":"in various parts of England, in Scotland (Edwards, 1958), and now in Wales, can be explained on SUMMARY genetic grounds alone","unstructured":"rates. The high rate reported from Alexandria The West\/East upward gradient in incidence, (Stevenson and others, 1966) is one of the more which seems to stand up to several different statistical notable exceptions and will need further inquiry. tests, would appear to be highly significant. So far no These community differences must to some extent be satisfactory geographical explanation has emerged."},{"key":"ref_22","article-title":"This is an investigation into as complete as possible The secular trends, such as the marked fall in the an ascertainment of cases of anencephaly, spina incidence in New York State between 1945 and 1959 bifida cystica (and encephalocoele), and congenital (Gittelsohn and Milham, 1962), and the steady hydrocephalus born between 1956 and 1962 in the fluctuation which has taken place in Birmingham mining valleys of Glamorganshire, east of Neath and over the last 25 years (Leck, 1966), do not seem to of Monmouthshire, and in the Vale of Glamorgan, have taken place in South Wales. In any case no in a population of 850,000 with 102,786 total births","unstructured":"due to genetic differences in susceptibility. However, Nor does there appear to be a convincing ethnic, it is questionable whether the marked local differsociological, or economic basis for it (Laurence, ences recorded for a hospital survey of anencephaly Carter, and David, 1968). It is, of course, always posin France (Frezal, Kelley, Guillemot, and Lamy, sible that the explanation may lie in some epidemi-"},{"key":"ref_23","article-title":"cephalus) were found, partly retrospectively and in Various geographical factors have been incrimipart prospectively, are discussed. The incidence of nated from time to time. In Holland there seems to be total central nervous system malformations of 8 * 1 per a positive relationship between rainfall and anen-1,000 births is one of the highest recorded and that cephaly and a negative one with sunshine (Rootselaar for spina bifida (4-1 per 1,000 births) the highest in a and Beks, 1967). 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Genet., 15, 329 (Variation in neonatal death rate and birth weight in the United States and possible relations to environmental radiation, geology and altitude).","journal-title":"Brit. J. prev. soc. Med"},{"issue":"2","key":"ref_40","article-title":"(In preparation) (Spina bifida cystica in South Wales","volume":"8","author":"Tew, B.J.; A, David P.","year":"1968","unstructured":"Griffin, G. V., and Sorrie, G. S. (1964). Med. Offr, 112, 197 (Congenital abnormalities in Reading, 1958-63).","journal-title":"The Natural History); A socio-genetic survey of the major central nervous system malformations in South Wales"},{"key":"ref_41","first-page":"740","article-title":"Proc. 5th int. Congr. Neuropathology, Zurich, 1965","volume":"100","author":"In","year":"incidence","unstructured":"Laurence, K. M. (1966). Develop. Med. 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