Sanitation is greatest medical milestone since 1840
(18 January 2007)
The event was webcast live - view an archive of the webcast here: http://www.bma.public-i.tv/site/player/pl_compact.php?a=7696&t=&m=wm&l=en_GB
Sanitation has been voted the greatest medical milestone since 1840, said the BMJ today.
Over the last 10 days, more than 11,000 people from around the world have voted in the BMJ’s poll to find the greatest medical breakthrough since the journal began.
The project is a celebration of the most important medical advances of the past 166 years to mark a complete redesign of the journal and its website.
Sanitation beat 15 other medical advances, including the discovery of antibiotics, the creation of the Pill, and the development of vaccines.
Despite the strong field, sanitation was the undisputed winner with 1,795 votes. Antibiotics was a close second with 1,642 votes and anaesthesia took third place.
Leading doctors and scientists championed each milestone. Speaking after the results were announced, Professor Johan Mackenbach of Erasmus University Medical Center, Rotterdam, the Netherlands, who championed sanitation, said: “I’m delighted that sanitation is recognised by so many people as such an important milestone. The general lesson which still holds is that passive protection against health hazards is often the best way to improve population health.
The original champions of the sanitary revolution were John Snow, who showed that cholera was spread by water, and Edwin Chadwick, who came up with the idea of sewage disposal and piping water into homes.
Inadequate sanitation is still a major problem in the developing world. In 2001, unsafe water, sanitation and hygiene accounted for over 1.5 million deaths from diarrhoeal disease in low and middle-income countries. Clearly, sanitation still plays a vital role in improving public health now and in the future."
Dr Fiona Godlee, BMJ Editor said: “The response to our poll has been overwhelming, it is deeply heartening to see science and medicine provoke such passion and debate. Selecting just one winner was always going to be difficult, but I’m delighted that the BMJ has helped to remind everyone of the great contribution that medicine and science has made to our lives now and in the future.”
The total number of votes received was 11,341
BMJ Medical Milestones: Poll results: Top 5
 | Votes | Proportion (%) |
| Sanitation (clean water and sewage disposal) | 1795 | 15.8 |
| Antibiotics | 1642 | 14.5 |
| Anaesthesia | 1574 | 13.9 |
| Vaccines | 1337 | 11.8 |
| Discovery of DNA structure | 1000 | 8.8 |
Full results
| Number | Proportion (%) |
| Anaesthesia | 1574 | 13.9 |
| Antibiotics | 1642 | 14.5 |
| Chlorpromazine | 73 | 0.6 |
| Computers | 405 | 3.6 |
| Discovery of DNA structure | 1000 | 8.8 |
| Evidence-based medicine | 636 | 5.6 |
| Germ theory | 843 | 7.4 |
| Immunology | 182 | 1.6 |
| Medical imaging (x-rays, etc.) | 471 | 4.2 |
| Oral contraceptive pill | 842 | 7.4 |
| Oral rehydration therapy | 308 | 2.7 |
| Risks of smoking | 183 | 1.6 |
| Sanitation (clean water and sewage disposal) | 1795 | 15.8 |
| Tissue culture | 50 | 0.4 |
| Vaccines | 1337 | 11.8 |
| Total Respondents | 11341 | 100.0 |
Visitor category – Top 4
| Number | Proportion (%) |
| Doctor | 3198 | 28.6 |
| Member of the public | 2438 | 21.8 |
| Student | 1582 | 14.2 |
| Academic researcher | 1144 | 10.2 |
Country
| Number | Proportion (%) |
| Australia | 315 | 2.8 |
| Bulgaria | 573 | 5.0 |
| Canada | 604 | 5.3 |
| Germany | 200 | 1.8 |
| India | 256 | 2.3 |
| Italy | 547 | 4.8 |
| Spain | 324 | 2.8 |
| United Kingdom | 4281 | 37.7 |
| United States | 2270 | 20.0 |
| Other countries | 1992 | 17.5 |
| Total respondents | 11362 | 100.0 |
Go to www.bmj.com