Greatest medical milestone revealed

The development of sewers had a major impact on people's health
The development of sewers had a major impact on people's health

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Sanitation is the greatest medical milestone since 1840, according to a poll of more than 11,000 people.

The British Medical Journal (BMJ) had asked people to vote for the most important breakthrough of the last two centuries after leading scientists picked 16 medical advances for a shortlist.

And the move to provide the public with clean water and sewers has been chosen, with 1,795 people from across the world voting for it online.

Antibiotics were seen as the second-most important with 1,642 votes, while anaesthesia was third.

Speaking after the results were announced, Professor Johan Mackenbach of Erasmus University Medical Centre, Rotterdam, the Netherlands, who was the scientist 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 importance of sanitation was originally established by John Snow and Edwin Chadwick in the 19th century, who respectively explained that the lethal cholera was spread by water and promoted the use of sewers in domestic life.

Some 1.5 million people are said to have died as a result of poor sanitation in 2001, with those in the developing world particularly at risk of disease from unsafe water.

Fiona Godlee, the BMJ's editor, said the response to the poll, with resulted in 11,341 votes, was "overwhelming".

"It is deeply heartening to see science and medicine provoke such passion and debate," she said.

"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 greatest medical breakthroughs since 1840

1) Sanitation (clean water and sewage disposal) - 15.8 per cent
2) Antibiotics - 14.5 per cent
3) Anaesthesia - 13.9 per cent
4) Vaccines - 11.8 per cent
5) Discovery of DNA structure - 8.8 per cent

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