4u 13 (3) y Ma o Hata 5B Co4 26 2) february HEALTH REPORT for 1958 for the COULSDON & PURLEY URBAN DISTRICT by the MEDICAL OFFICER OF HEALTH PRINTED BY RAYNES PARK PRESS LTD., LONDON, S.W.20. CONTENTS. Page INTRODUCTION 4 Part 1. THE DISTRICT - ITS NATURAL FEATURES, AREA, POPULATION AND GROWTH 5 Part 2. ASSESSMENT OF THE HEALTH OF THE DISTRICT 6 Vital statistics 6 Infectious diseases and their prevention 11 Part 3. PERSONAL HEALTH SERVICES 18 Addresses for reference 20 Part 4. REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR 23 APPENDICES 47 1 URBAN DISTRICT COUNCIL OF COULSDON AND PURLEY. 1958. Public Health Committee. Chairman: R. W. Kersey, B.SC., A.R.I.C. Councillor B. E. Eastoe, a.c.a. Councillor H. O. Faircloth. „ H. W. Hayden, j.p. „ Mrs. D. Pattison, b.a. F.B.O.A., F.S.M.C., M.R.S.H. „ Miss J. C. slmpson, J.P., M.A. S. E. Littlechild. „ s. A. Bliss D. M. Weightman, m.a. „ p. Simpson, f.i.a.c. „ Mrs. K. M. Platt. Ex-Officio: Councillor R. N. Saunders, j.p. Representatives on the South Eastern Divisional Health Sub-Committee. Councillor C. J. ffield, B.SC. Councillor Mrs. K. M. Platt. „ R. N. Saunders, J.P. „ R. W. Kersey, „ F. Simpson, F.I.A.C. B.SC., A.R.I.C. Public Health Department. STAFF: Medical Officer of Health: F. R. Edbrooke, M.B., CH.B., D.P.H. (Retired 30/9/58) *J. B. Morwood, M.B., F.R.C.S.I., D.P.H. (From 1/1/59) Deputy Medical Officer of Health: *T. R. Bennett., M.R.C.S., L.R.C.P., D.P.H. Chief Public Health Inspector: W. Haworth, F.A.P.H.I. Deputy Chief Public Health Inspector: W. Rice-Jones, M.A.P.H.I. Additional Public Health Inspectors: E. R. Rogers, M.A.P.H.I. G. H. Bourne, M.A.P.H.I. G. N. Hart (From 1/3/58) Assistant to Public Health Inspectors: W. H. Sands. Rodent Operative: H. M. Key. Chief Clerk: *D. V. Prothero. Clerks: Mrs. G. Edmonston (Until 27/9/58) Mrs. L. R. Proctor. F. J. Smith. *Mrs. B. N. Flin (From 3/11/58) (* Part-time appointment only to this Council.) 3 TO THE CHAIRMAN AND MEMBERS OF THE COULSDON AND PURLEY URBAN DISTRICT COUNCIL. Mr. Chairman, Ladies and Gentlemen, I have the honour to submit the Annual Report for the year 1958 which has been prepared in accordance with Ministry of Health Circular 22/58. The health of the District remains good and the vital statistics compare favourably with those of the country as a whole. The situation with regard to the infectious diseases is especially encouraging. For the first time for six years there has been no case of poliomyelitis and although the cold wet summer may have been a factor, this does indicate that immunisation against this disease is having an effect. The incidence of whooping cough has also been exceptionally low and immunisation appears to be proving effective. The number of cases of tuberculosis is the lowest since 1937. Here again an effective vaccine is available for young people and the recent extension of the B.C.G. vaccination scheme to include students attending universities and other establishments of further education is especially welcome. In the preparation of this report I am greatly indebted to the Deputy Medical Officer of Health who was in charge of the Department from the retirement of Dr. F. R. Edbrooke on 30th September, 1958 until I took up my appointment on 1st January, 1959, and to the Chief Public Health Inspector. In conclusion, Mr. Chairman, Ladies and Gentlemen, may I express my thanks for your warm welcome to my wife and myself and the support you have given me since I took up my appointment. I also wish to express my thanks to the District Inspectors, the Chief Clerk and the staff of the Department for their loyal co-operation. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, J. B. MORWOOD, Medical Officer of Health. 4 HEALTH REPORT FOR 1958. PART 1 The Urban District of Coulsdon and Purley was constituted by an Order of the Local Government Board dated 1st November, 1914, and came into existence on the 7th April, 1915. It has therefore been a separate District for just over 44 years. Situated on the North Downs immediately to the south of Croydon, it is a well-favoured "dormitory" suburb, with a very considerable proportion of its area forming part of the "Green Belt". Thanks to successful Town Planning Schemes in the past there is comparatively little dense development, most of the houses being well spaced. The majority of the residents who work do so in London or Croydon, travelling to and fro daily. Locally there are no really large manufacturing or other industries, most of the residents employed in the District being connected with building and decorating, with the provision of food and the other wants of the inhabitants, or attached to the mental hospitals. The amount of unemployment, apart from temporary unemployment pending transfer, is still negligible. AREA AND POPULATION. The District has an area of 11,142 acres, these being distributed among the wards as follows:- Coulsdon East 2,812 Coulsdon West 1,253 Kenley 1,292 Purley 685 Sanderstead 2,311 Selsdon and Farleigh 1,924 Woodcote 865 and at the time of the 1951 census the population was shown to be 63,770 as compared with 68,580 for the mid-year 1958. These numbers include persons resident in Institutions in the District, the numbers of which at the end of 1958 were as follows:- Cane Hill Hospital 2,380 Netherne Hospital 2,592 Russell Hill School 227 Reedham School 254 5 In December, 1958 there were 20,574 occupied houses, distributed as follows:— Coulsdon East 3,515 Coulsdon West 3,226 Purley 2,775 Woodcote 1,825 Sanderstead North 2,428 Sanderstead South 3,104 Selsdon 1,929 Kenley 1,772 This gives an average of 3.33 persons per occupied house in 1958, or 3.06 if the institutional population is excluded. PART 2 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 11,142 Registrar-General's estimate of population, mid 1958 68,580 Population, Census 1931 37,666 Population, Census 1951 63,770 Number of occupied houses, December, 1958 20,574 Number of occupied houses, 1931 9,533 Number of occupied houses, 1951 18,071 Rateable Value, December, 1958£1,310,768 Sum represented by a penny rate £5,275 VITAL STATISTICS FOR THE YEAR 1958 M F Live Births 980 Live Births - Legitimate 488 460 Live Births - Illegitimate 10 22 Live birth rate per 1,000 population 15.8* Still-births 13 Still-births - Legitimate 7 6 Still-births - Illegitimate - - Still-birth rate per 1,000 live and still-births 13.0 Total live and still-births 992 Infant deaths 17 Infant deaths - Legitimate 6 9 Infant deaths - Illegitimate - 2 Infant mortality rate per 1,000 live births - total 17.3 Infant mortality rate per 1,000 live births - legitimate 15.8 Infant mortality rate per 1,000 live births - illegitimate 62.5 Neo Natal Mortality rate per 1,000 live births (first four weeks) 12.3 Illegitimate live births per cent of total live births 3.2% Maternal deaths (including abortion) 1 Maternal mortality rate per 1,000 live and still-births 1.00 M F Deaths 877 370 507 Death rate per 1,000 population 8.7* * Corrected. 6 VITAL STATISTICS. The following table gives the average population, birth, death, maternal and other important mortality rates for the quinquennial periods 1920-1954 together with the actual figures for 1957 and 1958. Rates per 1,000 population. 19201924. 19251929. 19301934. 19351939. 19401944. 19451949. 19501954. 1957. 1958. Birth rate 13.5 12.9 11.6 12.8 15.2 15.2 12.0 14.1 14.3 Percentage illegitimate 3.4% 3.7% 2.8% 3.4% 3.9% 3.4% 2.7% 2.0% 3.2% Stillbirth rate — — — 0.43 0.48 0.40 0.24 0.26 0.18 Death rale 7.4 7.0 7.4 8.3 11.4 9.7 12.1 14.8 12.8 Cancer death rate 0.96 1.15 1.35 1.19 1.70 1.75 2.02 2.27 1.80 Tuberculosis death rate (per 100,000 population) 57 36 38 35 48 36 25 7 11 Violence including Suicide 0.44 0.35 0.32 0.46 0.82 0.37 0.46 0.46 0.55 Maternal mortality rate per 1,000 live and still births 2.08 2.66 3.21 2.27 2.10 1.12 1.01 1.00 1.00 Infant mortality rate (per 1,000 registered births) 28 38 32 38 40 26 21 17 17 Neo-natal mortality rate - - - 26 28 19 15 14 12 Estimated population 21,351 28,950 41,616 53,084 49.880 60,610 64,466 67,830 68,580 BIRTHS. During the year 1958, 980 births were registered as occurring in the District, of which 498 were male and 482 female, compared with 957 in 1957. It will be seen by reference to the preceding table that this is equal to an annual birth rate of 14.3 per 1,000 population, as compared with 14.1 in 1957. If this rate is corrected in accordance with the RegistrarGeneral's assessment of the atypical constitution of the population it becomes 15.8 and this is comparable with the birth rates for England and Wales which was 16.4. Illegitimacy:—In 1958, of the births registered, 32 were illegitimate (10 males and 22 females), this being 13 more than in the preceding year. Stillbirths.—The number of stillbirths registered during 1958 was 13 (7 males and 6 females), which is 5 more than last year. None of the stillbirths was in respect of an illegitimate child. The local stillbirth rate was 13.0 per thousand live and still births. 7 DEATHS. The number of deaths registered during 1958 as belonging to this District was 877, (370 males and 507 females), which is 124 more than last year. It will be remembered that the Registrar General now attributes to this District all deaths of those who have over six months residence in the mental hospitals, it being suggested that as the majority of the in-patients in these hospitals are long stay cases, they should be regarded as forming part of the normal population. Numerically of course, they are included in the population, but, their death rate being inevitably higher than the average, the effect on the local death rate is misleading. Applying the "comparability factor" supplied by the Registrar General, the gross local death rate of 12.8 is decreased to a corrected one of 8.7 but it is doubtful if this is really comparable with the national death rate of 11.7 for 1958. In order that a more accurate comparison can be made the records in respect of the normal residents have been kept separate from those of the mental hospital patients, who would previously have been transferred to their own districts, and as far as practicable throughout this Report a distinction has been made between them. The principal causes of death locally during 1958 are shown in the following table, the corresponding figures in respect of ordinary residents only being shown in brackets:— Cause. Number of Deaths. Heart and circulatory diseases 361 (258) Cancer, malignant disease 124 (108) Pneumonia 71 (19) Bronchitis 23 (22) Accidents 30 (19) (A full list of the causes of deaths and the ages at which they occurred is given in Table IV. in the Appendix.) HEART AND CIRCULATORY DISEASE. Among the ordinary residents the death rate from heart and circulatory disease was 3.76 compared with an average of 4.22 in the preceding five years. This group includes a high proportion of elderly people dying virtually of old age. Ignoring the mental hospital group, this year 68 per cent of residents dying from heart and circulatory disease were over 65 years of age at the time of death, compared with an average of 77 per cent in the previous five years. CANCER. The cancer death rate in respect of normal residents was 1.80 in 1958 compared with an average of 1.82 in the previous five years. 8 9 CANCER TABLE 1958. * 0-30. 30-40. 40-50. 50-60. 60-70. 70-80. Over 80. TOTAL. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. H. P. d. Skin and Tongue - - - - - - - - - - - - - - - - - - - - 1 - - - - - - - 1 - - - Brain and Thyroid - - - - - - - - 1 - - - 2 - - - 1 - - - - - - - - - - - 4 - - - Bone - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Oesophagus - - - - - - - - - - - - - - - 1 1 - - - 1 - - - - - 1 - 2 - 1 1 Stomach & Duodenum — — — — — — 1 — — — 2 — — - 3 - 1 2 - 2 - 3 - 1 - 3 - 5 1 14 - intestines — — — — — — 1 — — — — — - — — — 1 - 1 - 2 - — - - — 3 — 3 - 5 — Liver - - - - - - - - - - - - - - - - 1 - - - - - - - - - 1 - 1 - 1 - Pancreas - - - - - - - - - - - - 1 - - - 1 - - - - - - - 1 - 1 - 3 - 1 - Lungs - - - — - - - - 2 — - - 4 - 1 - 5 - 1 - 3 - 1 1 2 4 — 1 16 4 3 2 Bladder - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2 Prostate - - - - - - - - - - - - - - - - 1 - - - - - - - 3 - - - 4 - - - Uterus - - - - - - - - - - - - - - - - - - - - - - 1 - - - 1 - - - 2 - Vagina and Ovary - - - - - - - - - - 1 - - - 3 - - - 1 1 - - 2 - - - - - - - 7 1 Breast - - - - - - - - - - 3 - - - 3 - - - 6 - - - 2 - - - 4 - - - 18 — Kidneys - - - - - - - - - - 1 - - - 3 - - - 1 - - - 2 - - - 1 - - - 8 — III-defined - - - — - - - - - - 1 - 3 - - - - - 5 3 - - 1 - - - 2 - 3 - 9 3 TOTAL - - - - - - 2 - 3 - 8 - 10 - 13 1 13 1 17 4 9 - 12 2 7 4 17 2 42 5 69 9 * H = Hospital cases. P = normal residents. 10 INFANT MORTALITY DURING THE YEAR 1958 Cause of Death Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total deaths under 1 year. Cerebral hæmorrhage 1 — — — 1 — — — — 1 Meningitis — — — — — — 1 — 1 2 Congenital malformations 2 1 — 1 4 — 1 — — 5 Prematurity 3 — — — 3 — — — — 3 Pulmonary embolism — — — — — — 1 — — 1 Atelectasis 3 — — — 3 — — — — 3 Broncho pneumonia 1 — — — 1 — — — — 1 Homicide — — — — — — 1 — — 1 TOTAL 10 1 — 1 12 — 4 — 1 17 The following table gives the causes of the 17 deaths which occurred during 1958, together with the age at death. INFECTIOUS DISEASE The following table indicates the number of cases of infectious disease notified during 1958, the number treated in hospital and the number of deaths which occurred. Disease. Numbers Notified. Treated in Hospital. Total Deaths. Diphtheria 1 1 1 Scarlet fever 49 5 — Erysipelas 4 1 — Puerperal pyrexia 1 — — Pneumonia, primary 22 3 - Encephalitis, acute 1 1 — Dysentery 35 6 — Poliomyelitis — — — Measles 103 1 — Whooping cough 41 — — Food poisoning 1 1 — Meningoccal infection 1 1 — Totals 259 20 1 A further analysis of these cases by age, wards and the months during which they occurred is given in Tables I and II in the Appendix, while a full statement of the cases of infectious disease notified since 1928 is presented in Table III in the Appendix. It will be seen that tuberculosis is omitted from this list of acute infectious diseases, this chronic disease being dealt with separately later. Measles was the commonest disease notified, followed by scarlet fever and whooping cough, cases of the latter being the lowest number notified for many years. SMALLPOX. No case of this disease has occurred in this District since 1932 and during the year 1958 only one suspected case was visited for the purpose of diagnosis. DIPHTHERIA During 1958 one notification of diphtheria was received. The patient, a married woman of 45 years with no children, died as a result of this disease. Investigation failed to produce any evidence as to where the patient had contracted the disease. This is the first case of diphtheria since 1946. 11 SCARLET FEVER. There were 49 cases of scarlet fever, mostly of a very mild type. Five cases were admitted to the Wandle Valley Isolation Hospital. The disease has for some years been mainly associated with school children and particularly the 5-10 years old age group, nearly 50% being in this age group in 1958, compared with 30% in those under school age and 20% in older school children. Only one adult case was notified. Almost all the schools in the District, including a number of private schools, had one or more cases. ERYSIPELAS. Only four isolated cases occurred during the winter, one of which was admitted to hospital. As is usual with this mild form of streptococcal infection, all cases recovered. ENTERIC FEVER No confirmed case was notified during the year. OPHTHALMIA NEONATORUM For the eighth year in succession no case was notified. PUERPERAL PYREXIA. During the year only one case was notified as suffering from puerperal pyrexia, compared with the recent average of 2 per annum. The patient was confined in her home and recovered without being removed to hospital. PNEUMONIA. During 1958 22 cases of acute primary or influenzal pneumonia occurred, the majority in the first four months of the year when some residents suffered from influenza. This is the lowest number of notified cases since 1952, and only 3 of the cases were admitted to hospital DYSENTERY. It will be noted in Table III in the Appendix that this disease first became prevalent during the war and until 1955/1956 there was a tendency for the number of cases to decrease. Until then the cases were almost all due to the more severe Flexner type of the disease and were usually inmates of the mental hospitals. During 1957 only two cases were notified but in 1958, 35 notifications were received. Of the latter number, 32 cases were due to 12 an outbreak of this disease which occurred during December in a Croydon school situated on the Sanderstead border. All the cases notified during 1958 were of the much milder Sonne form of dysentery. FOOD POISONING. Only one confirmed case of food poisoning was notified during 1958, the person affected being a mental hospital patient. POLIOMYELITIS. No case was notified during 1958. This was probably due to the cold and wet summer together with the rapid expansion of the Poliomyelitis Immunisation Scheme. By the 31st December, 1958 approximately 12,000 children under the age of 15 years in this Urban District had received a primary course consisting of two injections against this disease and a start had been made on giving the third injections. ENCEPHALITIS. One case, a child, was notified in July as suffering from encephalitis. He made a satisfactory recovery. MENINGOCOCCAL INFECTION. One case of meningococcal infection was notified during 1958. The patient was a child of two years who was admitted to hospital which he is still attending as an out-patient. MEASLES. This most common infection is more prevalent in alternate years and as over 1,000 cases had occurred in 1957 it was not surprising that only 103 cases were notified in 1958. The disease was again of a mild type and as far as it is known only one case was admitted to hospital. WHOOPING COUGH. Forty-one cases of this disease were notified during 1958, this being the lowest number of notifications received since 1946. Just over 50% were children between the ages of 5 and 10 years. I would like to emphasise that this disease can be very serious and often gives rise to complications. The immunisation of all children against it is strongly recommended and this treatment should be commenced by at least the sixth month of life. 13 TUBERCULOSIS. The following table presents concisely the position with regard to tuberculosis in the District during 1958:— Pulmonary. Nonpulmonary. Total. M. F. M. F. M. F. Number of cases on register 270 188 26 23 296 211 Additions:— New cases notified 17 14 — 1 17 15 Cases removed into district 22 14 — 1 22 15 Restored 5 2 — — 5 2 Total Additions 44 30 — 2 44 32 Removals:— Deaths from T.B. 8 7 1 1 9 8 Other causes — — — — — — Removed from district 19 20 1 — 20 20 Recovered 19 9 6 4 25 13 Non T.B 2 1 — — 2 1 Total Removed from Register 48 37 8 5 56 42 Number of cases on register, 1st January, 1958 266 181 18 20 284 201 The following table shows the age-groups in which notifications and deaths occurred:— Age Periods. New Cases. Deaths. Pulmonary Nonpulmonary. Pulmonary. Nonpulmonary. M. F. M. F. M. F. M. F. Under 1 year - - - - - - - - 1 and under 5 1 - - - - - - - 5 and under 10 1 - - - - - - - 10 and under 15 - - - - - - - - 15 and under 20 2 3 - - - - - — 20 and under 25 2 - - - - - - - 25 and under 35 — 4 — — — — — — 35 and under 45 3 3 - - 1 2 — — 45 and under 55 4 2 — — 3 1 1 — 55 and under 65 2 1 — — 1 3 — — 65 and over 2 1 — 1 3 1 - 1 Totals 17 14 — 1 8 7 1 1 14 The new cases were distributed amongst the wards as follows:- Localisation. Coulsdon East. Coulsdon West. Kenley. Purley. Sanderstead. Selsdon. Woodcote. Pulmonary 2 7 3 8 9 2 - Nonpulmonary — — — — — — 1 Totals 2 7 3 8 9 2 1 The following table illustrates the trend of this disease since the formation of the District. 19151924 19251934 19351944 19451949 19501954 1957 1958 Pulmonary— New cases notified 22 29 35 49 43 45 31 *Case rate 115 82 68 81 67 66 45 Deaths 12 13 21 27 16 5 5 *Death rate 65 37 42 44 22 7 7 Non-Pulmonary— New cases notified 3 6 7 8 5 2 2 *Case rate 15 18 15 13 8 4 2 Deaths 3 3 2 2 2 — 3 *Death rate 15 8 5 3 4 — 4 * (The rates quoted are per 100,000 population). During 1958 the number of new notifications of pulmonary tuberculosis decreased to 31 compared with 45 last year, and an average of 39 in the last five years. The steady improvement in the death rate from pulmonary tuberculosis is encouraging as is the decreasing prevalence and death rate from non-pulmonary tuberculosis. The Council is responsible for one of the most important measures aimed at combating this disease, viz. rehousing, and also for disinfection, but the County Council bears the responsibility for all other preventive measures except the treatment of cases which is that of the Regional Health Boards. THE CONTROL OF INFECTIOUS DISEASE. When it can be used, immunisation is the most valuable of the measures for the control of infectious disease, but its usefulness 15 naturally depends on the effectiveness of the vaccine, and otherwise is proportional to the degree of public support and the standard of immunity which is maintained by reinforcing doses, if and when these are necessary. DIPHTHERIA IMMUNISATION. As previously stated it is still very important that the parents of all children should ensure that they are kept as highly immune as possible against diphtheria by early immunisation and periodical enhancing doses. This can still be the most deadly of the infectious diseases but immunisation against it has proved more effective than any other form of vaccination or immunisation. The following table shows the treatments given during 1958:- Centres and Clinics (including day nurseries). Number who completed Primary treatment 377 Number of "Booster" doses given 99 Schools. Number who completed Primary treatment 69 Number of "Booster" doses given 713 General Practitioners. Number who completed Primary treatment 528 Number of "Booster" doses given 473 SMALLPOX VACCINATION. The following table shows the number of vaccinations performed in the District during 1958:— Welfare Centres. Primary vaccinations 307 General Practioners. Primary vaccinations 0-15 years 457 „ „ over 15 years 38 Re-vaccinations 0-15 years 28 „ over 15 years 125 16 WHOOPING COUGH IMMUNISATION. The following numbers were treated during 1958 and it is noted that 26 fewer children were given primary courses and 45 fewer received reinforcing doses than in 1957. Welfare Centres. Number who completed Primary treatment 409 Number of "Booster" doses given 135 General Practioners. Number who completed Primary treatment 467 Number of "Booster" doses given 199 BACTERIOLOGICAL AND CHEMICAL EXAMINATIONS Almost all the specimens requiring bacteriological examination in the interests of the public health are sent to the Public Health Laboratory, West Hill House, West Hill Road, Epsom, and during 1958 reports were received on the following specimens:— Milk, ice cream, and water samples 421 Food utensils 431 Nose or throat swabs 13 Food 5 Faeces 266 Sputum 3 Pus swab 1 Samples of milk for biological examination are sent by the Local Authority to the Public Health Laboratory Service, while samples of water requiring chemical analysis and Food and Drug samples are submitted to the Public Analyst. 17 PART 3 PERSONAL HEALTH SERVICES. Since 1948 the local Council has been represented on the S.E. Divisional Health Sub-Committee of the County Health Committee and the corresponding Educational Executive, which bodies have certain specified powers and responsibilities for the Personal Health Services. The Medical Officer of Health for this District and his Deputy, who hold similar positions in the Caterham and Warlingham Urban District, are the responsible officers for the Divisional Health Services which include the following:— Ante Natal Clinic. An Ante Natal Clinic is held at 62 Whytecliffe Road, Purley, every Wednesday, 10 a.m. - 12 noon. Home Help Service. The activities of this service continue to increase, particularly as there is no comparable agency in this District, and applications for the service of a Home Help should be addressed to the Home Help Organiser, 115 Brighton Road, Purley. In case of emergency the following telephone numbers may be used: UPLands 7014 or 9277, preferably between 9.30 and 10.30 a.m. Home Helps can only be supplied to cases genuinely needing their assistance in which ill-health or old-age are involved; the capacity of the Service is limited but preference is given to those in greatest need, the degree of help varying with the physical and social circumstances of the family. Family Planning. The local Family Planning Clinic is now held at the Surrey County Council Clinic, Westway, Caterham-on-the-Hill. Residents needing advice are seen only by appointment and this should be obtained by application to the Divisional Medical Officer at 115 Brighton Road, Purley. Health Visiting. The Health Visitors can be contacted through the Divisional Health Visitor between 9.0 and 10 a.m. daily at 115 Brighton Road, Purley, UPLands 9277. Infant Welfare Centres. The following Infant Welfare Clinics are held regularly from 2-4 p.m. except Purley Clinic which is held from 10 a.m. - 12 noon Purley Clinic, 62 Whytecliffe Road, Purley Every Tuesday Methodist Church, Brighton Road, Coulsdon Every Thursday. Church of St. Francis, Rickman Hill, Coulsdon Every Tuesday. 18 St. John's Hall, Bradmore Green, Old Coulsdon Every Wednesday. Methodist Church, Sylverdale Road, Purley ... Every Friday. Baptist Church, Addington Road, Selsdon ... Every Monday. Congregational Church, Sanderstead Road, Sanderstead Every Wednesday. St. Anthony's Church, Wentworth Way, Sander- 1st and 3rd Thurs- stead day in each month. Church Hall, Mitchley Avenue, Purley ... 2nd and 4th Tuesday in each month. Community Centre, Hooley ... 1st and 3rd Wednesday in each month. Rent Office, Cherry Tree Farm Estate, Sanderstead 2nd and 4th Thurs- day in each month. Rent Office, Wontford Road, Purley ... 1st and 3rd Tuesday in each month. Mothercraft and Relaxation Classes. Classes covering these subjects were commenced in Purley at the end of 1953 and the numbers attending have increased very rapidly, hence it is hoped to extend the facilities in the near future. It is now necessary for expectant mothers wishing to join these classes to make application to the Divisional Health Visitor at 115 Brighton Road, Purley, who will inform them as soon as a vacancy occurs. School Health Service. The basis of this service is the periodical medical and dental inspection of all the children in attendance at the local schools who, in this Division, now number over 14,000 compared with 7,490 in 1946. Several full and part time doctors and one full time dentist are employed on the work in this District. Some of the defects noted need to be kept under observation and others are referred for treatment by private doctors, hospitals or specialist clinics. Among the clinics organised by the Education Authority are the dental, eye, speech, general medical, child guidance and remedial exercise clinics. Special attention is given to handicapped children, some of whom require to be admitted to special schools, e.g. those for the deaf, mentally or physically sub-normal. As is noted in other parts of this Report, the condition of the school premises and of the school meals service is kept under supervision and special steps are taken to prevent the spread of infectious diseases, including the immunisation of school children. This well established service performs a very useful function but does not often attract the attention of the majority of residents. 19 Welfare Services. The staff of the Health Department work in close cooperation with the local representatives of the County Council's Welfare, Children's and Education Departments and such voluntary bodies as the Guild of Social Service, N.S.P.C.C. and Marriage Guidance Council. The Divisional Medical Officer has become responsible for co-ordinating the activities of all concerned with "Problem Families" and children neglected in their own homes, and, in addition to emergency meetings, all current cases are reviewed at quarterly case conferences. NATIONAL ASSISTANCE ACT, 1948, SECTION 47. The powers given under this Section for securing the removal of aged persons from insanitary conditions were not utilised during 1958. Periodically border-line cases occur in which the Welfare Officers seek advice, but every endeavour is made to find a satisfactory solution without resorting to compulsory powers. NATIONAL ASSISTANCE ACT, 1948, SECTION 50. Under the above section, as from 5th July, 1948, the Council became responsible for the disposal of the remains of any person dying in the District, where suitable arrangements would not otherwise be made, and during the year the Council dealt financially with two cases of this type. HEALTH PROPAGANDA. Constant attention is given to the opportunities for health propaganda at the Clinics and Centres in the area and during the visits made by the Health Visitors and Public Health Inspectors. In addition each year a number of talks are given by the Officers to various organisations who request their assistance. If time permitted doubtless more of these could be given to advantage. The material supplied by the Central Council for Health Education and other bodies is extremely useful. Addresses for Reference. Telephone : Public Health Inspectors' Office, 69 Brighton Road, UPLands 6981 Purley UPLands 9644 Ambulances. Ambulance Station, 115a Brighton Road, Purley. Sanderstead Fire and Ambulance Station, Limpsfield Road, Sanderstead. Requests should be made to MITcham 2084, or in cases of emergency dial 999. 20 Authorised Officer for Mental Health Services. Telephone: Mr. D. E. Twivey, 44, Reigate Hill, Reigate Reigate 3357 Blind Welfare Worker. Miss C. M. Barnard, County Health Dept., County Telephone: Hall, Kingston-on-Thames KINgston 1050 Children's Officer for the District. Mrs. Docherty, Children's Department, County Hall, Telephone: Kingston-upon-Thames KINgston 1050 Divisional Health and School Health Services. Immunisation and Family Planning. Telephone: Divisional Medical Officer, 115, Brighton Road, Purley. UPLands 9277 Divisional Education Executive. Telephone: 38, Grovelands Road Purley UPLands 7601 Emergency Units ('Flying Squads'). Telephone: Redhill County Hospital, Earlswood Common, Redhill Redhill 3581 St. Helier Hospital, Wrythe Lane, Carshalton ... FAIrlands 6622 May Day Hospital, Mayday Road, Croydon THOrnton Heath 6999 Hospital Groups. Telephone: Croydon General Hospital, London Road, Croydon ... CROydon 7755 Redhill County Hospital, Earlswood Common, Redhill Redhill 3581 School Clinics. S.C.C. Clinic, 62, Whytecliffe Road, Purley Fridays 9—11 a.m. Baptist Church, Addington Road, Selsdon Mondays 1.30—2.0 p.m. St. John's Hall, Bradmore Green, Old Coulsdon ... Wednesdays 1.45—2.0 p.m. School Dental Clinics. S.C.C. Clinic, 62, Whytecliffe Road, Purley Monday, 9.45 a.m. or by appointment. Welfare Officers. Telephone : 115a, Brighton Road, Purley UPLands 0776 Mr. E. G. Griffiths (Principal Divisional Welfare Officer) WALington 9237 Mrs. J. M. Parker, (Divisional Welfare Officer) ... Caterham 4713 Welfare Homes. Telephone : "Chipstead Lodge", Hazelwood Lane, Chipstead ... Downland 4811 "Santa Tecla", Stanstead Road, Caterham Caterham 2641 21 Road Safety Committee (Coulsdon and Purley). Telephone : Organiser: Mr. P. E. Arthur, Council Offices, Purley UPLands 4844 Caterham 4018 Voluntary Bodies. Moral Welfare. Telephone : Miss Scoones, 1 Sunnyrise, Caterham Caterham 3728 National Society for the Prevention of Cruelty to Children. Inspector A. J. G. Budge, 37, Hartley Road, Croydon THOrnton Heath 4250 Coulsdon and Purley Guild of Social Service. Secretary: Miss Honeyman, 105, Brighton Road, Purley UPLands 6800 Coulsdon and Purley Old People's Welfare Association. Secretary: Miss D. M. Barnett, 71, Brighton Road, Purley. Coulsdon and Purley Marriage Guidance Council. Secretary: Mrs. H. W. Pritchard, 38, Russell Hill, Purley UPLands 9029 Home Safety Council (Coulsdon and Purley). Secretary: Mrs. A Pope, 34, Grasmere Road, Purley ... UPLands 8047 22 EXHIBITION ILLUSTRATING THE WORK OF THE PUBLIC HEALTH INSPECTOR PART 4 REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR 1958 TO THE CHAIRMAN AND MEMBERS OF THE COULSDON AND PURLEY URBAN DISTRICT COUNCIL Mr. Chairman, Ladies and Gentlemen, I have the pleasure to submit herewith a report on the work of the Public Health Inspectors for the year 1958. It was a year during which considerable routine work of a useful nature was carried out and the number of visits and inspections made by the Inspectors compared favourably with recent years. Much time was taken up in the supervision of drainage repair works, including, in particular, works carried out by the Council in default or on behalf of owners. Investigation of cases of infectious disease and control of contacts was another essential duty that demanded and received much effort and attention. On the other hand, rodent control work tended to slacken somewhat, but it remains to be seen whether this is merely transitory or an indication of more lasting success in the war on these pests. Following a very severe thunderstorm on the evening of the 5th September when almost 1½ inches of rain fell in half an hour, flooding occurred in several parts of the District including, of course, Purley Corner. This unwelcome event resulted in much work for the department in the inspection of contaminated foodstuffs and supervision of cleansing operations. An event that gave considerable satisfaction to the staff was the staging of an exhibition in the foyer of the Council Offices, illustrating the work of the Public Health Inspector. The exhibit was very well received and was the subject of favourable comment in the press. In conclusion I should like to welcome to the department Dr. Morwood, our new Medical Officer of Health. Reference should also be made to the resignation of Mrs. Edmonston during the year, and 1 pay tribute to her long service. To the remaining members of the staff I express my appreciation and thanks for their assistance and co-operation during the year. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, W. HAWORTH, Chief Public Health Inspector. 23 HOUSING. The following is a summary of work carried out in respect of the sanitary condition of dwelling houses during the year. 1. Inspection of Dwelling Houses during the year 1958. (i) Total number of houses inspected for housing defects (under Public Health or Housing Acts) 324 (ii) Number of dwelling houses [included under subhead (i) above] which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 16 (iii) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 4 (iv) Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 259 2. Remedy of Defects during the year without service of Formal Notices — Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 215 3. Action under Statutory Powers during the year. (a) Proceedings under Sections 9, 10 and 12 of the Housing Act, 1957 — (i) Number of dwelling houses in respect of which notices were served requiring repairs Nil (ii) Number of dwelling houses which were rendered fit after service of formal notices (a) By owners Nil (b) By Local Authority in default of Owners Nil (b) Proceedings under the Public Health Acts — (i) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 36 (ii) Number of dwelling houses in which defects were remedied after service of formal notices — (a) By owners 7 (b) By Local Authority in default of Owners 40 24 (c) Proceedings under Sections 17 and 23 of the Housing Act, 1957 — (i) Number of dwelling houses in respect of which Demolition Orders were made 1 (ii) Number of dwelling houses demolished in pursuance of Demolition Orders 1 (d) Proceedings under Section 18 of the Housing Act, 1957 — (i) Number of separate tenements or underground rooms in respect of which Closing Orders were made ... Nil (ii) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit ... Nil 4. Housing Act, 1957 — Part IV — Overcrowding. (a) (i) Number of dwellings overcrowded at the end of the year ... Nil (ii) Number of families dwelling therein ... Nil (iii) Number of persons dwelling therein ... Nil (b) Number of new cases of overcrowding reported during the year ... 1 (c) (i) Number of cases of overcrowding relieved during the year ... 1 (ii) Number of persons concerned in such cases 8 (d) Particulars of any case in which dwelling houses in respect of which the Local Authority have taken steps for the abatement of overcrowding have again become overcrowded ... Nil Number of New Houses erected during the year. By the Local Authority 130 By other persons 269 In a district such as Coulsdon and Purley where the general standard of housing is very good indeed, the impact of post-war legislation, having as its objective the clearance of unfit houses and the improvement and repair of the remaining sub-standard housing units in the area, is not so apparent as in less fortunate districts. Nevertheless, the efforts of the Public Health Inspectors in this sphere have met with modest success as will be seen from the record of work carried out during the year. 25 The administration of The Rent Act, 1957, has provided further work in investigating applications for Certificates of Disrepair and advising landlords and tenants on the very complicated procedure involved. Fourteen such applications were received and in all cases with, or without modification, decisions to issue Certificates were made. In only one case was it necessary to issue a Certificate of Disrepair while in the remaining cases the landlords gave undertakings to carry out the necessary repair work. During the year ten houses were demolished as part of the Council's Clearance Programme, and the site of six of these houses in Edward Road is being utilised by the Council for the erection of a block of eight fiats. The Purley Car Park is to be extended on the site of the remaining four houses. A demolition order was made in respect of a temporary structure used for human habitation on Farthing Downs and an undertaking not to relet obtained in respect of a further building on the same site. It is in the field of house modernisation or improvement, however, that disappointment has to be registered. For some years the Council has been prepared in approved cases to make Improvement Grants under the provisions of The Housing Acts in respect of works for the purpose of improving sub-standard properties, and although many enquiries have been made and encouragement given as to the availability of grants for this kind of work, only three houses, in fact, were improved during the year at a total cost of £1,480. Two of these were agricultural tied cottages and the third an owner occupied house. In all cases 50% grants were made and a high standard of improvement was achieved with extensive repairs being carried out concurrently with the improvement works. The lack of response from landlords to this opportunity to bring otherwise structurally sound cottage type property up to a more modern standard is not a good augury for the future of rented properties of this kind. This trend has not gone unnoticed by the Ministry concerned and at the time of writing this report a further measure entitled "House Purchase and Housing Act, 1959" has just come into force with the object inter alia of simplifying the procedure and making less onerous the conditions and consequential obligations of accepting an Improvement Grant. A new "Standard Grant" in addition to the existing "Discretionary Grant" is now available for providing certain "standard amenities" in older houses, i.e. a fixed bath or shower in a bathroom, a wash-hand basin, a hot water supply, a water closet in or contiguous to the dwelling, and satisfactory facilities for storing food. Subject to certain reasonable requirements an owner or leaseholder can obtain as of right, a "Standard Grant" of half the cost 26 up to a maximum of £155 of providing all, or any, of the amenities specified that might be needed. It is hoped that these new arrangements will become widely known and the department will be ready and willing to advise and assist would-be applicants with their particular problems. WATER SUPPLY The water supply of the district is provided by The Sutton District Water Company and The East Surrey Water Company from deep wells or borings in the chalk. The water is softened and chlorinated and all houses in the District are provided with a direct supply. There are no private wells in the District with the exception of one at Cane Hill Hospital which is used to supplement the public supply. Routine samples of the treated water in public supply were submitted quarterly for bacteriological and chemical examination. In addition, both the Water Companies and Local Authorities sharing these public supplies provided the Department with copies of reports on the samples taken by them. No unsatisfactory report was received and no complaints were received during the year with regard to the quality or quantity of water supplied by the Companies. Fifty-two samples were taken from the supplies of the two Companies and examined for hardness by the Department, all of which were satisfactory in that adequate softening had been carried out as required. The private supply at Cane Hill Hospital is kept under supervision and sampled regularly by the Public Health Department of the London County Council. Copies of reports on the samples taken are submitted to the department for information. Rainfall. The rainfall registered by the automatic rain gauge installed at Alderstead Heath, was 37-26 inches in 1958, this being an increase of 8-33 inches compared with the previous year and the highest since 1951 when 44-45 inches was recorded. The monthly totals throughout the year were as follows— inches January ... 3.105 February ... 2.63 March ... 2.01 April ... 1.42 May ... 2.64 June ... 4.47 27 July ... 2.20 August ... 3.31 September ... 5.69 October ... 3.65 November ... 2.54 December ... 3.595 DRAINAGE AND SEWERAGE During the year a total length of 1,079 yards of new soil sewer was laid in the District. This total included the provision of a new soil sewer of approximately 330 yards in length in Rydons Lane, Coulsdon, which has provided main drainage for four existing houses and a house in course of erection. Two further houses were connected to main drainage and in one case where the Council's sewer was in excess of 100 feet from the house the Council in pursuance of its policy to eliminate cesspool drainage where possible, made an ex gratia payment towards the costs incurred. In all, seven cesspools were abolished and there remain ninety-four cesspools and seven pail closets in the District at the end of the year. By agreement sewage from the district drains into the sewerage systems of The Croydon Borough Council and The West Kent Main Sewerage Board for treatment. The sewerage problem at Purley Corner is the subject of a report by an Engineer appointed jointly by all the Authorities concerned, to prepare a scheme and report upon the remedial measures required. PUBLIC CLEANSING. This service is administered under the direction of the Engineer and Surveyor — Mr. H. M. Collins, and he has kindly provided information for this section of the report. A weekly collection of house refuse is in operation and during the year the number of collecting areas for refuse collection purposes was increased from three to five, with consequent adjustments in the sizes of the areas covering the district and the numbers of vehicles and men operating therein. This re-organisation made necessary the acquisition of a further refuse vehicle and the employment of a further four Ashbinmen. The separate trade refuse collection service which had hitherto operated was discontinued, and under the new arrangements the personnel in each of the five collecting areas now collect both house refuse and trade refuse as part of the daily routine. 28 There were no alterations in the methods of cesspool emptying or the disposal of refuse during the year under consideration. House refuse is disposed of partly by incineration at Kenley Works and partly by means of controlled tipping. Cesspool contents are emptied into the sewer. Charges are made for the removal of trade refuse and for cesspool emptying. The charges for cesspool emptying at private properties were reviewed during the year. The Public Health Committee were of the opinion that the existing charges were uneconomic and that they should be increased, especially in the case of newly erected properties at which the Committee felt the construction of new cesspools should not be encouraged. Accordingly, as from the 1st April, 1958, the charge for emptying existing cesspools at private properties was increased to 10/— per load for the first 12 loads in any year, the charge for any additional loads in the same year being 15/- per load. As from the same date, a standard charge of 15/- per load was approved for the emptying of cesspools constructed on or after that date at newly erected properties in the district. The charge for emptying cesspools at commercial premises remains at 25/- per load. RIVERS AND STREAMS. The only water courses in the District are those provided by the intermittent Bourne flows. These present no difficulties apart from occasional rat infestation along the banks. INSPECTION OF THE DISTRICT. It is the statutory duty of a Public Health Inspector to inspect and have a thorough knowledge of the sanitary circumstances of the district in order that action may be taken if necessary to abate conditions that give rise to nuisance. Under the following headings comment is made on particular aspects of this work, concluding with a summary of the complaints received, visits made, notices served, works carried out and defects remedied during the year. Camping Sites. In view of the rural character of much of the Council's district, a close watch has to be maintained for unauthorised siting of movable dwellings. Control is exercised mainly through planning powers although prohibition orders obtained in 1951 in respect of two areas in the district under the provisions of the Surrey County Council Act have continued to prove effective in preventing nuisance arising from itinerant gypsy encampments. No serious difficulties have been experienced during the year. 29 The permanent Boy Scouts' Camp at Featherbed Lane continues to be used in a very satisfactory manner and the residential caravan camp established on land at Dean Lane, Merstham, still operates subject to a final extension of permission granted by the Ministry of Housing & Local Government which expires in January, 1960. The maximum number of caravans that may be stationed on the land during the limited period is 140. Clean Air. On the 1st June, 1958, the remaining provisions of The Clean Air Act, 1956, came into force. These additional powers cover the prohibition of dark smoke from chimneys, control of grit and dust from furnaces, abatement of smoke nuisances and the application of certain parts of the Act to railway engines and shipping. Local Authorities are required also to report to the responsible Minister on any contraventions occurring at Crown premises. It is considered unlikely that the provisions relating to dark smoke will affect the users of appliances in private dwellings which rarely make dark smoke as defined in the Act. The nuisance provisions replace sections in The Public Health Act, 1936, dealing with smoke nuisances and may be useful in the control of incinerators or bonfires in gardens. It will be seen that short of the establishment of Smoke Control Areas, there is very little control over the emission of smoke from private dwellings, yet as was stated in the Beaver Report on Air Pollution, nearly half of all the smoke in the air comes from domestic chimneys. It is incumbent upon all householders, therefore, even in areas not so liable to air pollution to do whatever possible to minimize the emission of smoke by the use of approved appliances and smokeless fuel. During the year a number of complaints of smoke nuisance was received and investigated. Most were of a minor character only and were remedied following representation to the persons concerned. There is little or no industrial smoke in the district. Hairdressing Establishments. Byelaws are now in force in the district which provide for securing the cleanliness of premises and the instruments, towels, equipment and materials used in the premises. Heating Appliances (Fireguards) Act, 1952. Inspections are carried out, as necessary, to ensure that domestic heating appliances offered or exposed for sale are fitted with proper guards complying with standards prescribed in regulations made under the Act. 30 Any contraventions noted are usually confined to secondhand articles, and during the year five such appliances were altered or withdrawn from sale as a result of representations made by the department. Mines & Quarries Act, 1954. This Act requires compliance with provisions designed to prevent accidents arising through lack of proper fencing or too easy access. Routine visits are made to quarries in the district and in one instance the sealing of a disused entrance to an underground tunnel was required. Schools. In co-operation with the Divisional Medical Officer and in the course of milk sampling, schools are visited from time to time and matters requiring attention are directed to the officer concerned. Shops Act. As far as possible inspections have been made in respect of the provision and maintenance of sanitary accommodation, washing facilities, heating, lighting and ventilation in shops. By arrangement with the Engineer & Surveyor, the department is given an opportunity of examining all plans submitted for the construction of new shops or alteration of existing premises, with a view to obtaining proper compliance with the requirements of the Act. This is generally appreciated by shop developers who are usually very willing to co-operate. The Council is also the Authority responsible for enforcement of the Shops Hours of Closing and Sunday Trading provisions of the Act. Routine surveys and inspections are carried out for this purpose but no serious difficulty has been experienced during the year. Swimming Baths. There are two swimming baths in the district used by the public; one an open-air pool at Selsdon is owned privately and although operating primarily in conjunction with a large hotel, is made available to the general public at a charge. The second is a covered bath situate at Reedham Orphanage which is used extensively by the Divisional Education Authority for school children. Both baths are provided with the necessary plant for chlorination and filtration. During the year 17 samples of the water in these baths were submitted for chemical and bacteriological examination and all were found to be satisfactory. In addition, at the Reedham Bath, regular tests are carried out by an Inspector to check the ohlorine content and the Ph value of the water. 31 Disinfection and Disinfestation. Disinfection is carried out when considered necessary following cases of infectious disease and otherwise on request and on payment of a small charge. Bedding and other clothing if possible is disinfected by arrangement with the Wandle Valley Hospital in a steam disinfector at the hospital. Sick rooms and other articles are disinfected by means of formaldehyde gas or spray, and library books are treated in a disinfecting chamber at the offices at 69, Brighton Road, Purley. During 1958 the following disinfections were carried out:— Free of cost Upon Payment Total Loads of bedding, etc. 23 6 29 Houses disinfected 40 1 41 Parcels of clothing 1 – 1 Library books 424 – 424 Disinfestation work is now largely confined to the more common domestic pests such as flies, ants, cockroaches and wasps, although during the year two cases of bug infestation were discovered and received the appropriate treatment. School canteens are sprayed annually with a liquid insecticide to prevent fly infestation. The use of proprietary insecticides principally of the liquid variety and having a residual effect, is proving very effective in dealing with all types of insect pests. During the year 111 cases of infestation were dealt with by the department. COMPLAINTS RECEIVED. General disrepair and insanitary conditions 23 Dampness 17 Defective drainage systems 14 Blocked drainage systems 189 Defective drainage fittings 14 Defective W.C. pans and flushing apparatus 11 Defective service water pipes 6 Absence of, or defective dustbins 6 Accumulation of refuse, etc. 29 Rats and mice 238 Keeping of animals 5 Insect pests, etc. 33 Wasps nests 134 Smoke nuisance 16 Contaminated food 22 Unsound food 27 Flooding 30 Miscellaneous 33 Total 847 32 VISITS CARRIED OUT AND INTERVIEWS. Number of houses visited in respect of improvement and repair 329 Number of reinspections made to above houses in respect of improvement and repair 3,469 Verminous premises 28 Insect pests 230 Water supply 18 Tents, vans and sheds 40 Schools 18 Places of entertainment 1 Licensed premises 91 Storage of refuse 46 Accumulation 99 Piggeries, fowls and other animals 96 Stables 12 Rodent control 4,223 Drainage inspected 1,940 Drainage tested 391 Pail closets 2 Cesspools 79 Urinals 7 Sewers and street gullies 132 Dairies and milkshops 75 Ice cream premises 27 Meat shops 93 Food preparing premises 451 Other food shops 684 Bakehouses - Power 44 -Other 1 Slaughterhouses 17 Food inspection - meat 19 Food inspection - other food 55 Factories - Power 98 - Other 13 Workplaces 59 Outworkers 62 Heating Appliances (Fireguards) Act 9 Rag Flock etc. Act 1 Pet Animals Act 10 Shops Act 775 Mines and Quarries Act 15 Clean Air Act 35 Hairdressing Establishments 18 Infectious disease enquiries 335 Infectious disease contacts 113 Food poisoning enquiries 25 Disinfection 89 Disinfestation 51 Swimming baths 59 Sampling - Food and Drugs Act, 1955 197 - Ice Cream 131 33 Sampling - Milk (Bacteriological) 264 - Water 28 Interviews 2,577 Number of telephone calls and personal callers received at the office 1,778 Miscellaneous visits 1,070 NOTICES SERVED. Preliminary Notices 487 Statutory Notices 50 WORK CARRIED OUT AND DEFECTS REMEDIED. Drainage and Sanitary Fittings— Drains repaired or reconstructed 84 Blocked drains cleared 203 Disused drains sealed off 23 Soil and vent pipes repaired/renewed 10 Inspection chambers provided or repaired 118 Fresh air inlets repaired or renewed 20 Stoppers to interceptors renewed 11 New W.C. pans fixed 16 W.C. cisterns repaired or renewed 8 Cesspools abolished and filled in 7 Drainage disconnected from cesspool and connected to sewer 6 Cesspools repaired, renewed, enlarged 1 Eaves gutters and rainwater pipes renewed/repaired 37 Lavatory basins renewed or provided 4 Baths renewed or provided 2 Sinks renewed or provided 5 Waste pipes renewed or repaired 8 Sink gully curbs and dishings renewed 16 Soakaways reconstructed or provided 27 Miscellaneous 14 General Housing Repairs:— Defective roofs repaired 32 Chimney stacks repaired or rebuilt 20 External walls repaired 24 Yards paved or paving repaired 10 Steps repaired or renewed 8 External paintwork renewed 12 Boundary fences and gates repaired or renewed 14 Coalsheds repaired or renewed 4 Dampness in walls remedied 35 Damp-proof courses provided 13 Walls and ceilings repaired 76 New ceilings provided 4 Walls of rooms cleansed or redecorated 40 Ceilings of rooms cleansed or redecorated 36 Floors repaired or renewed 39 Internal woodwork cleansed or redecorated 10 Staircases repaired or renewed 3 34 Windows repaired or renewed 93 Doors repaired or renewed 35 Firegrates repaired or renewed 14 Domestic hot water systems repaired or renewed 7 Water storage tanks repaired or renewed 1 Water service pipes repaired or renewed 8 Walls and ceilings of W.C. compartments repaired 13 Walls and ceilings of W.C. compartments cleansed 7 Floors to W.C. compartments repaired or renewed 2 Portable dustbins provided 9 Miscellaneous 15 Food Premises:— Premises reconstructed 3 Premises altered and improved structurally 6 Floors repaired/renewed/recovered 31 Walls and ceilings of rooms repaired 36 Walls of rooms cleansed or redecorated 96 Ceilings of rooms cleansed or redecorated 64 Windows repaired or renewed 12 Doors repaired or renewed 7 Woodwork cleansed or redecorated 38 Roofs repaired 5 Rainwater pipes and gutters repaired or renewed 1 Yards paved or paving repaired 3 Food stores provided 2 Sinks renewed or new sinks provided 21 Draining boards provided 5 Hot water supply provided for personal ablution purposes 27 Hot water supply provided for cleansing purposes 7 Waste pipes repaired or renewed 6 Towels, soap, nailbrushes supplied 10 First-aid equipment supplied 33 Lockers for clothing provided 21 Equipment cleansed 10 Equipment renewed or repaired 24 New equipment provided 5 Additional lighting provided 13 Additional ventilation provided 14 Sanitary accommodation provided for staff 4 Sanitary accommodation repaired 16 Sanitary accommodation cleansed 42 Lavatory basins provided 28 Miscellaneous 62 Rat proofing :— Work carried out by occupiers of premises after completion of treatment 2 Heating Appliances (Fireguards) Act, 1952 :— Fires altered or withdrawn from sale 5 Shops Act :— Additional sanitary accommodation provided 2 Sanitary accommodation redecorated 1 Washing facilities provided 1 35 FACTORIES ACTS 1937 and 1948. PART I OF THE ACT. 1. Inspections for purposes of provisions as to health (including inspections made by Public Health Inspectors). Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 38 30 1 – (ii) Factories not included in (i) in which Section 7 is enforced by the local Authority 155 142 1 – (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 13 42 1 – Total 206 214 3 – 2. Cases in which defects were found. Particulars Number of cases in which defects were found No. of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) – – — — — Overcrowding (S.2) ... — — – — — Unreasonable temperature (S.3) — — — – — Inadequate ventilation (S.4) – – — — — Ineffective drainage of floors (S.6) ... — – — — — Sanitary conveniences (S.7) (a) Insufficient 1 1 – 1 – (b) Unsuitable or defective 10 14 – 2 – (c) Not separate for sexes — — – — – Other offences against the Act (Not including offences relating to outwork) 2 2 – – – Totals 13 17 – 3 — 36 PART VIII OUTWORK - (Sections 110 and 111) Section 110 Section 111 Nature of work No. of Outworkers in A ug. list required by Section 110(1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwhole some premises Notices served Prosecutions Wearing apparel (Making etc. cleaning and washing) 35 – – – – Household linen 1 — — — — — Umbrellas, etc. 1 — — — — — Making boxes 1 — — — — — Carding, etc., of buttons, etc. 22 – – – – – Duster Dolls 5 – — — — — Cosaques, Christmas crackers, Christmas stockings, etc. 3 – – – – – Total 68 — — — — — PREVENTION OF DAMAGE BY PESTS ACT, 1949 RODENT CONTROL. The Council employ the services of a rodent operator assisted as necessary by another officer in the department for work under this heading. Compared with 1957 there was an appreciable decrease in the number of complaints received and premises found to be infested by rats and mice. The department does not, of course, rely solely on the receipt of complaints as an indication of infestation and routine inspections of dwelling houses, business premises including agricultural holdings, council owned properties and land are carried out from time to time and in conjunction with treatment on adjoining premises. During the year a reorganisation in the Ministry of Agriculture, Fisheries & Food's Infestation Division took place and in future the Divisional Executive Officer and his pests staff stationed at Guildford will undertake the liaison with authorities in this area. 37 Meetings of the No. 10 London Workable Area Committee of which this authority is a member, are held from time to time to discuss problems and new developments in connection with rodent control. As a consequence of the reorganisation mentioned, the Ministry notified local authorities that the Rat Destruction Service hitherto undertaken by the Ministry Staff at agricultural premises, was to be rundown as from 1st April, 1958. A list of contracts held within the area of this Council was supplied in order that the Council might offer an alternative service and this has been done. It is the legal responsibility of the occupier of premises to keep the premises free from infestation by rats and mice, and in view of this the Council has maintained the principle that a small charge should be made in respect of destruction work carried out by the Council at private dwellings. A nominal charge of 5/- is made therefore for this service which is generally appreciated and in respect of which no serious difficulty has been experienced since it was first put into practice in 1951. Work carried out at business premises including agricultural holdings is charged at the full cost which, during 1958, continued at the rate of 10/8d. per hour plus cost of materials. In view of the comparative freedom from rat infestation of the Council's sewerage system it was agreed with the Infestation Division of the Ministry that only a modified testing and treatment of part of the system was necessary during the year. A total of 43 manholes was test baited and in only one manhole was there any evidence of infestation. For a number of years the department has relied principally on the use of Warfarin as a convenient and very effective poison for surface treatment, but on the advice of the Ministry its use has now been extended to sewer treatment by the addition of a preservative which inhibits mould growth in the poison. The Council has continued to undertake rodent control at local schools for The Surrey County Council on a contract basis. 38 39 RODENT CONTROL. The following table is a tabular statement indicating the action taken in 1958. Type of property Number of properties inspected by the Local Authority as a result of: Number of properties found to be infested by Number of treatments carried out by the Department by arrangement with occupier Number of Notices served under Section 4 Number of inspections made Notifica tion Otherwise Total Rats Mice Rats Mice Treatment Structural works, i.e. proofing Primary and reinspec tions Sewer treatment Total Local Authority 2 13 15 5 – 5 — — — Dwelling Houses 204 55 259 142 23 127 23 — — Business Premises 32 61 93 28 9 28 8 — — 3,809 414 4,223 Agricultural 3 24 27 4 5 3 5 — — Total 241 153 394 179 37 163 36 — — INSPECTION AND SUPERVISION OF FOOD. THE FOOD AND DRUGS ACT, 1955. The Food Hygiene Regulations, 1955. These regulations set the standard of food hygiene required in all food premises and by all food handlers and there is no doubt that their introduction in 1956 coupled with the publicity that has been given to the subject in recent years, has had a very beneficial effect on the manner in which food is now handled. The progressive food trader has been quick to recognise the sales value of a high standard of food hygiene and the public are becoming more discerning and appreciative of such enterprise. A further indication of the public's interest in the subject is the number of complaints received in respect of contaminated food and/or containers. During the year, 22 such cases were thoroughly investigated and the necessary representations made where necessary. The high incidence of food poisoning in post war years is another factor that stimulates the desire by Local Health Authorities to obtain yet better standards. The Public Health Inspectors continue to press for improved equipment and better facilities where considered necessary, in addition to normal maintenance requirements, and every effort is made also to ensure that new food shops and alterations to existing premises comply with the structural requirements of the regulations. The extent of these works will be seen in the tabular statement of work carried out at these premises. Advisory work is also carried out by the Inspectors and the bacteriological examination of food and equipment is a method used extensively in assessing Clean Food standards. During the year 70 swabs were taken from 353 items of washed crockery and glassware. Further details of food sampling are recorded elsewhere in this report. The register of premises coming within the scope of the Food Hygiene Regulations at present includes the following :— Confectioners 58 Butchers 30 Fishmongers (wet and dry) 13 Fishmongers (fried) 6 Bakers 22 Greengrocers and Fruiterers 43 Cafes and Restaurants 41 Grocers 73 Chemists 18 Licensed premises 30 Hospitals. Nursing Homes, Guest Houses Hotels 14 Canteens, Clubs, Halls, etc 47 Schools 46 40 Six grocers' shops and one baker's premises are registered for the preparation of preserved meat, etc., and all the fish friers' premises are similarly registered in respect of fish frying. Milk. Milk & Dairies Regulations, 1949-1954. The handling and retail distribution of milk in Urban areas has become a concentrated and well organised industry. Apart from small quantities bottled on the farm, milk is collected in the distant producing areas and transported in bulk to large processing plants situate in the consuming centres where it is pasteurised or sterilised and bottled for sale by a comparatively few large dairy companies. Residents in this district rely in the main on these sources of supply, there being only one registered dairy now operating in the Council's area. These latter premises were recently rebuilt and re-equipped with the most modern High Temperature Short Time Pasteurisation plant. General control by the department is exercised under the above regulations and only pasteurised, tuberculin tested or sterilised milk can be sold in the district as a result of a Special Designations Order made in 1951. The entries in the register, which has to be kept, were as follows :— Distributors of Milk in the District 20 Premises registered as Dairies 1 Under the Milk (Special Designation) Regulations, 1949-1954, the following licences to sell milk were issued during the year:— Dealers: Supplementary : Tuberculin Tested 19 Tuberculin Tested 9 Pasteurised 22 Pasteurised 9 Sterilised 16 Sterilised 7 Pasteuriser's 1 A total of 264 samples of milk was submitted for bacteriological examination, with the results set out in the following table — TESTS REQUIRED BY THE MILK (SPECIAL DESIGNATION) REGULATIONS 1949-1954 Designation Number Methylene Blue Phosphatase Turbidity Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Pasteurised 197 195 2 197 — — — T.T. (Raw) 13 13 – – – – – T.T. (Pasteurised) 28 28 — 28 — — — Sterilised 26 — — — — 26 — Total 264 236 2 225 — 26 — 41 It will be seen that of these samples only two failed to pass the methylene blue (keeping quality) test and the efficiency of modern pasteurisation is reflected in the results of the phosphatase testing of the samples. A total of 78 washed milk bottles was submitted for bacteriological examination with satisfactory results. Ice Cream. The Ice Cream (Heat Treatment etc.) Regulations, 1947 to 1952. Ice cream which is now an important and popular item of food, has been the subject of special legislation and more strict control in post war years with the result that its manufacture is mainly undertaken by the large companies who produce an article of uniform quality, pre-packed in a variety of ways for sale by local retailers, from modern refrigerated units. One hundred and six premises are registered for the sale of ice cream within the district and although two premises are also registered for the manufacture of this product, no manufacture has been carried out for some years. A total of 129 samples of ice cream was examined for bacterial quality by submission to the methylene blue reduction test, and placed in the following provisional grades — Grade I 128 Grade II 1 Grade III — Grade IV — These results can be considered very satisfactory. Meat. Slaughterhouses Act, 1958. Slaughter of Animals Act, 1958. Public Health (Meat) Regulations 1924-1955. There are no slaughterhouses in the District apart from the one at Netherne Hospital which is used for the slaughter of surplus animals from the Hospital farm to provide meat for consumption by hospital inmates. The arrangement to carry out post mortem inspection of all animals slaughtered at this slaughterhouse continued, and during the year the carcases and offals of eight cattle, one calf, and one sheep were inspected for evidence of disease. The carcases and offals of two cows were condemned as unfit for food. During the year the Slaughterhouses Act, 1958 came into force and in due course the Council will be required to review and report to the Minister of Agriculture, Fisheries & Food on :— (a) the existing and probable future requirements of their district for slaughterhouse facilities having regard to the needs both 42 of persons requiring the use of such facilities and of other persons; and (b) the slaughterhouse facilities which are, or are likely to become, available to meet those requirements. Consultations are taking place with other local authorities' officers and organisations representing the interests concerned as a preliminary to the preparation of the report. One slaughterman's licence was issued under the Slaughter of Animals Act for the purpose of slaughtering at Netherne Hospital. There are 30 butchers' shops in the District, all registered for the preparation or manufacture of sausages or potted, pressed, pickled or preserved meat under the provisions of Section 16 of the Food and Drugs Act, 1955. Retailers obtain supplies of fresh and imported meat from The Croydon Abattoir and Meat Market and the Smithfield Market, and in addition small quantities of fresh meat direct from Scotland. Unsound Food. The following is a list of foodstuffs including drink which after inspection were classified as unfit for human consumption. The quantities are much in excess of previous years, as a result of the flooding incidents that occurred in the district during the year. With the exception of certain commodities that were released for reprocessing or excise purposes, the foodstuffs were destroyed at the Council's refuse destructor at Kenley. cwts. lbs. ozs. Butter, fats and cheese 23 27 4 Sugar, jams, etc. 18 67 9 Tea 1 5 4 Flour, bread, cereals and biscuits 27 38 14 Canned fruit — 107 9 Canned milk — 6 9 Meat, poultry and bacon 10 95 4 Fresh fish 2 24 — Fresh vegetables 1 45 — Fresh fruit — 43 — Dried fruit and nuts 1 103 — Eggs 13 48 4 Tinned meat 3 101 4½ Tinned fish — 39 11½ Tinned vegetables 2 51 — Miscellaneous 1 69 11½ Total 109 89 4½ 43 Drink. Wines, spirits, etc. 63 gallons Beer, etc. 640 „ Soft drinks 155 „ Food & Drug Samples. During the year a total of 168 samples of food and drugs, including 66 milk samples, were purchased for the purpose of analysis by the Public Analyst. The milk samples, with one exception, were of good quality, and only two adverse reports were received on the remaining samples. Particulars of the unsatisfactory samples are as follows :— Cream Doughnuts—Although this article was sold as a cream doughnut, the filling consisted of imitation cream. A warning letter was sent to the vendor concerned. Milk.—A sample of farm bottled Channel Islands milk contained only 3.85% milk fat instead of the minimum 4% required by The Milk & Dairies (Channel Islands and South Devon Milk) Regulations 1956. An examination of the producer's records of sampling carried out by the Milk Marketing Board and the results of weekly control samples taken by the retailing company, suggested that this adverse report was an isolated occurrence due probably to faulty mixing. A warning letter was sent to the producer. Marzipan Slices.—This was a sample of flour confectionery, the marzipan coating of which contained not more than 12 per cent of ground almonds. The Public Analyst is of the opinion that a reasonable minimum ground almond content for marzipan is 25 per cent. The vendor and maker of this product was a local baker and it was ascertained that he was using a proprietary brand of almond paste having insufficient almond content to justify the use of the term "marzipan". A warning letter was sent to the baker concerned who sought the advice of the British Baking Industries Research Association and his trade organisation as to the use of such products in the future. 44 LIST OF SAMPLES. Article A nalysed Non-Genuine Formal Informal Total Formal Informal Total Almonds, ground 1 — 1 Aspirin 1 — 1 — — — Beer 2 — 2 — — — Biscuits 2 .– 2 — — — Black Pudding 1 — 1 — — — Brandy 1 — 1 — — — Brandy Butter 1 — 1 — — — Bread 3 – 3 — — Breadcrumbs 1 .– 1 — — — Butter 2 — 2 — — Buttered chocolate 1 — 1 — Cake 1 — 1 — — Cake Decorations 1 — 1 — Cheese 2 — 2 — Chicken broth 1 – 1 — Chicken, frozen sliced 1 – 1 — Chocolate "Mikky" 1 — 1 Chocolate flav. straws 1 — 1 — Coffee 2 — 2 Cocktail Pies 1 – 1 Crab, dressed 1 – 1 Confectionery 6 – 6 — — — Curry Powder 1 – 1 — — — Dates 1 — 1 — — — Doughnut, cream 1 — 1 1 — 1 Dried Fruit Mixture l — 1 — — — Faggotts 1 — 1 — — — Fish Cakes 1 – 1 — — .— Gin l — 1 — — Ginger, ground 1 — 1 — — — Glucose Drink l — 1 — — — Grocery Crystals 1 – 1 — — — Ham, Devilled l — 1 — — — Ice Cream — 1 1 — — Jam 2 — 2 — — — Marmalade 1 – 1 — — Marjoram 1 — 1 — — — Margarine 1 — 1 — — — Marzipan 2 — 2 — — — Marzipan slices 1 — 1 1 — 1 Meat Paste l 1 2 — — — Meat Pudding l – 1 — — — Mincemeat 1 .— 1 — — — Milk 59 7 66 1 — 1 Mixed Candied Peel 1 — 1 — — — Mushrooms (tinned) 1 — 1 — — — Oil, cooking 1 — 1 — — — Olive Oil 1 — 1 — — — Orange Squash — 1 1 — — — Onions, cocktail 1 — 1 — — — Pepper 1 — 1 — — — Pickle 1 1 Rum 1 1 — — Robinsons Patent Groats 1 — 1 — — — Rennet, essence 1 — 1 – — — Salmon Spread 1 — 1 — — — Total C/fwd. 126 10 136 3 — 3 45 Article Analysed Non-Genuine Formal Informal Total Formal Informal Total Total B/fwd. 126 10 136 3 — 3 Salmon, tinned 1 — 1 — — — Soup 1 — 1 — — — Sauce, mint 2 — 2 — — — Semolina 1 — 1 — — — Sausages, pork 4 — 4 — — — Sausages, beef 1 — 1 — — — Sausages, tinned 1 — 1 — — — Sage & Onion Stuffing 1 — 1 — — — Syrup, cough 2 — 2 — — — Syrup of Figs 2 — 2 — — — Shrimps, potted 1 — 1 — — — Steak & Kidney Pie 1 — 1 — — — Steak & Kidney Pudding 1 — 1 — — — Steak, tinned 1 — 1 — — — Salt, iodised 2 — 2 — — — Scone Mix 1 — 1 — — — Table Jelly 1 — 1 — — — Tomato Juice 2 — 2 — — — Tinned Fruit 2 — 2 — — — Tea 2 — 2 — — — Vinegar 1 — 1 — — — Whiskey 1 — 1 — — — Totals 158 10 168 3 — 3 46 47 TABLE I. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1958. Number of cases notified. At Ages—Years. Total cases notified in each Ward. Disease. At all ages. Under 1 year. 1 and under 2. 2 and under 3. 3 and under 4. 4 and under 5. 5 and under 10. 10 and under 15. 15 and under 20. 20 and under 35. 35 and under 45. 45 and under 65. 65 and over. Coulsdon East. Coulsdon West. Purley. Kenley. Sanderstead. Selsdon and Farleigh. Woodcote. Diphtheria 1 — — — — — — — — — — 1 — — — — 1 — — — Scarlet fever 49 — — — 8 6 27 6 1 — 1 — — 1 15 8 — 20 4 1 Pneumonia 22 — — — — — 1 1 2 3 — 8 7 — 1 11 1 5 4 — Measles 103 1 11 11 9 11 55 4 1 — — — — 3 36 17 25 8 11 3 Whooping cough 41 4 2 3 3 3 22 1 1 — 1 1 — 19 3 7 2 8 2 — Erysipelas 4 — — — — — — — — 1 1 1 1 — 2 2 — — — — Dysentery 35 1 — — 1 1 18 5 — — 3 5 1 1 7 2 21 4 — — Poliomyelitis (Paralytic) — — — — — — — — — — — — — — — — — — — — Poliomyelitis (Non para.) — — — — — — — — — — — — — — — — — — — — Meningococcal infection 1 — 1 — — — — — — — — — — — — — — 1 — — Puerperal pyrexia 1 — — — — — — — — 1 — — — — — 1 — — — — Encephalitis 1 — — — — — 1 — — — — — — — — — — 1 — — Food poisoning 1 — — — — — — — — — — — 1 — 1 — — — — — Totals 259 6 14 14 21 21 124 17 5 5 6 16 10 24 65 48 50 47 21 4 48 TABLE II. THE MONTHLY INCIDENCE OF INFECTIOUS DISEASE, 1958. Disease. Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Diphtheria 1 — — — — — — — — — — — 1 Scarlet fever 9 6 5 2 2 7 3 2 3 4 6 49 Pneumonia 6 7 2 5 — 1 — — — — 1 22 Measles 3 1 1 4 4 11 26 18 1 2 13 19 103 Whooping cough 1 — 1 3 2 5 3 5 10 2 7 2 41 Erysipelas 1 — 1 — — — — — — 2 — 4 Dysentery — — 2 — — — 1 — — — 32 35 Poliomyelitis — — — — — — — — — Meningococcal infection 1 — — — — — — — — 1 Puerperal pyrexia — — — — — — — 1 — — 1 Encephalitis — — — — — — 1 — — — — 1 Food poisoning — — — — — — — — — — — 1 1 Totals 22 14 10 16 8 24 33 24 13 8 26 61 259 49 TABLE III. INFECTIOUS DISEASE NOTIFIED EACH YEAR SINCE 1928. Disease 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 Smallpox 2 2 3 4 — — — — — — — — — — — — — — — — — — Scarlet fever 94 125 69 45 29 69 119 124 117 62 71 65 61 39 45 184 88 67 93 78 62 138 149 90 80 118 68 46 41 47 49 Diphtheria 23 26 17 8 21 16 24 52 35 8 10 10 25 7 9 7 19 15 8 — — — — — — — — — — — 1 Erysipelas 8 3 11 8 11 23 17 11 12 14 13 10 17 27 22 5 9 4 8 5 8 4 4 3 — 3 4 4 8 1 4 Typhoid and paratyphoid fever 9 6 4 4 7 5 5 1 3 26 5 1 53 12 3 1 6 4 4 2 2 2 1 11 1 — 1 3 3 — — Meningococcal infection 1 _ 1 1 4 8 6 1 4 2 1 3 1 1 — — — 1 — — — — — 1 Puerperal fever — 1 — 1 1 — 1 1 1 5 Puerperal pyrexia 1 1 1 3 5 1 2 1 — 2 5 3 2 — 2 3 1 2 2 1 2 2 2 3 2 3 — 3 2 4 1 Poliomyelitis 1 — 1 — 2 — 1 1 — 3 1 1 1 2 3 — — 2 1 11 2 9 10 — 8 9 1 17 7 13 — Polio-encephalitis — — — — — — — — — — — — — — — — — — 1 — — — — — — — — — — — — Acute encaphalitis 1 — — — — — — — — — — — — — — — 1 — — — — — — — 1 — 1 1 1 1 Ophthalmia neonatorum 3 1 1 2 1 1 1 1 1 1 1 _ 1 1 1 — — — — — — Pneumonia 7 38 11 14 29 28 20 32 13 30 12 52 19 32 38 27 9 17 16 20 13 5 23 51 21 44 20 31 36 26 22 Malaria — — — — — — — — — — — — — — — — — — — — — — 1 — — — — — 2 — — Measles 2 11 214 479 275 52 705 41 218 567 600 477 810 170 1319 9 1012 82 1184 103 Dysentery — 5 — — — — — 6 — 1 2 10 85 224 121 21 42 172 82 43 7.1 14 28 22 48 13 12 93 81 2 35 Whooping cough 6 1 136 36 55 51 100 31 115 201 42 242 204 196 66 131 64 93 58 41 Food poisoning 2 6 2 5 2 74 5 8 3 1 Tuberculosis :— Pulmonary 23 22 38 44 36 44 28 30 27 36 32 31 31 32 43 39 51 44 38 59 48 57 47 60 42 37 31 47 41 45 31 Other forms 4 2 7 4 6 10 17 5 3 7 10 12 8 11 7 9 7 3 7 11 13 5 7 4 4 3 7 3 3 2 1 Totals 174 232 162 135 154 196 235 265 213 197 162 207 323 743 809 632 337 1137 335 564 990 880 998 1260 579 1617 359 1333 40S 1386 291 TABLE IV. DEATHS OCCURRING DURING THE YEAR 1958. Cause of death. Private Residents Hospital Cases Total. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and over. Males Females Males Females Males Females Respiratory tuberculosis 3 2 — — 3 2 — — — — — 2 1 2 Other tuberculosis 1 2 — — 1 2 — — — — — 1 1 1 Syphilitic disease 1 2 — — 1 2 — — — — — — 3, Diphtheria — 1 — — — 1 — — — ' — — 1 — Whooping cough — — — — — — — — — — — — — Meningococcal infections — — — — — — — — — — — — Poliomyelitis — — — — — — — — — — — — Measles — — — — — — — — — — — — Other infective and parasitic diseases 1 1 5 1 6 — 1 — — — — 1 5 Cancer 42 66 9 7 51 73 — — — — — 6 57 61 Leukaemia — 3 — — — 3 — — 2 — — — 1 — Diabetes 1 — — — 1 — — — — — — — — 1 Vascular lesions of nervous system 40 47 9 12 49 59 1 — — — 2 9 16 80 Coronary disease, angina 70 46 15 14 85 60 — — — — — 2 21 122 Hypertension with heart disease 8 10 2 17 10 22 — — — — — — 2 30 Other heart disease 34 63 7 33 41 96 — — — — — 2. 6 129 Other circulatory disease 9 18 4 16 13 34 — — — — — 1 8 38 Influenza 1 — — — 1 — — — — — — 1 Pneumonia 11 8 18 34 79 42 — — — 1 2 6 62 Bronchitis 14 8 — 1 14 9 — — — — — — 3 70 Other respiratory diseases 4 1 1 3 5 4 — — — — 1 — 4 4 Ulcer of stomach and duodenum 8 3 — — 8 3 — — — — — — 6 5 Gastritis, enteritis Nephritis 1 5 3 1 — — 1 5 3 1 — — — — — — 1 4 5 Hyperplasia of prostate Pregnancy 1 1 — — 1 1 — — — — 1 — — 1 Congenital malformation 6 7 — — 6 7 12 — — 1 — — — — Other defined and illdefined diseases 21 30 3 27 74 57 3 — 2 3 — 3 77, 48 Motor vehicle accidents All other accidents 9 3 1 6 3 8 9 6 1 14 — — — 2 1 1 3 1 2 3 2 15 Suicide 3 3 — 1 5 4 — — — — 3 5 1 Homicide – 1 — — — 1 1 — — — — — — — Totals 299 334 71 173 370 507 17 1 4 7 6 35 167 640 50