BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1954 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1954 MITCHAM G. Mather, Ltd., Caxton Works, Lower Green 3 Borough of Mitcham HEALTH REPORT FOR 1954 To the Mayor, Alderman and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1954. The general health in the Borough has been good, and there was no special outbreak of infectious disease. In fact the notifications of infectious diseases were remarkably low at 450 against 1,396 last year, which had a large epidemic of measles. No cases of poliomyelitis were reported during the year. The absence of diptheria is almost taken for granted now with no cases for the fifth year in succession. Only two cases have occurred in the past seven years, although cases averaged sixty per year before that. The death rate from tuberculosis was 0.17, a slight increase on the low record of 0.15 last year, but better than 0.18 for England and Wales. New tuberculosis notifications show a welcome decrease with 64 new cases of tuberculosis notified in 1954 as against 85 in 1953. Cases notified as dysentery rose from 15 to 46 of which 26 were confirmed by bacteriological findings. They were usually single cases or family outbreaks mostly due to the mild form of D. sonnei. There were also 16 cases of food poisoning, mostly single cases, or affecting several members of a family. There were no deaths due to dysentery or food poisoning and the diseases were usually mild and of short duration. 4 The birth rate of 13.65, after correction by the comparability factor to correspond with the average age and sex grouping of the whole population, becomes 11.97, which compares with 15.2 for England and Wales. The actual death rate of 8.80, which after applying the comparability factor becomes 10.03, compares with 11.3 for the whole country. The infant mortality rate is again the lowest recorded in Mitcham, and is 13.32 compared with 25.5 for England and Wales, which itself is the lowest ever recorded for this country. The death rate from cancer has gone down a little to 1.64 although that of England and Wales has again risen to the highest ever, being 2.04 per 1,000 population. I wish to thank the Chairmen of the Committees for their friendly support, and all the members of the staff for their loyalty and service throughout the year. I have the honour to be, Ladies and Gentlemen, Your obedient servant, A. R. GRAHAM, Medical Officer for Health. Public Health Department, Mitcham Court, Mitcham. 5 BOROUGH OF MITCHAM PUBLIC HEALTH COMMITTEE Chairman - - Alderman Mrs. J. C. Ericson His Worship the Mayor (Councillor J. H. S. Bradley, J.P.) Aldermen— Mrs. L. Crump Mrs. H. E. Niven G. W. Pearce Councillors— Mrs. W. R. Martin H. J. H. Beaumont E. Gulliver W. Lancaster R. Stanley Representatives of the Council on Other Authorities: WANDLE VALLEY JOINT SEWERAGE BOARD His Worship the Mayor (ex-officio) Alderman W. Jeffery Councillors— D. W. Fido E. E. Mount NORTH-EAST DIVISIONAL HEALTH SUB-COMMITTEE (SURREY COUNTY COUNCIL) Alderman G. W. Pearce Councillors— Mrs. W. R. Martin L. A. Cobb R. Stanley W. E. M. Townsend 6 STAFF Medical Officer of Health A. R. Graham, M.B., Ch.B., D.P.H., Barrister-at-Law Chief Sanitary and Meat Inspector Petroleum Inspector Shops Act Inspector K. J. Gutteridge (1, 2) Assistant Sanitary and Meat Inspectors L. Gleed (1, 2, 3) E. J. Sluis (1, 2) L. M. Edwards (1, 2) F. A. Evans (1, 2) 1. Certificate R.S.I, and Sanitary Inspectors' Examination Joint Board. 2. Certificate Meat and Foods R.S.I. 3. Smoke Inspector's Certificate. Clerks L. J. Bellingham Miss V. I. Hill (a) Miss M. Sanders (b) Miss K. E. Becket (c) Miss C. F. M. Hollingsworth (a) Part-time—40 per cent. Surrey County Council. (b) Part-time—40 per cent. Surrey County Council. Resigned 31st March, 1954. (c) Part-time—40 per cent. Surrey County Council. Commenced duties 12th May, 1954. 7 REPORT STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,932 acres Population, Census 1921 35,119 „ 1931 56,856 „ „ 1951 (32,384 M.; 34,885 F.) 67,269 Registrar-General's estimate of population mid-year, 1954 66,050 Density of Population, 1951 22.9 persons per acre Number of inhabited houses, 1921 7,150 „ 1931 13,187 „ 1954 19,521 Rateable Value, 1954 £580,200 Sum represented by a Id. rate £2,371 The Borough of Mitcham is an irregular oval in shape, situated in North-East Surrey adjoining the south-west border of the London metropolitan area. It is a fairly flat and low lying area, with some 600 acres of open space including the 440 acres of Mitcham Common. The River Wandle, which forms the south-west and western boundary, separates Mitcham from Beddington and Wallington in the south and Carshalton in the west, as it runs a northwards course towards the Thames. The soil of Mitcham consists of up to four feet of top-soil with about ten feet of gravel sub-soil, except for one or two parts where London clay comes to the surface. Below the gravel London clay extends downwards for 200 to 300 feet. Mitcham, with over 300 factories, has a great variety of industries, of which the chief ones are paint and varnish, chemical, engineering, margarine and dairy products. The unemployment position was one of continuing improvement, the best months being as usual the late summer with a subsequent increase of unemployment following the usual seasonal trend, but finishing up with the best figures for the last five years. 8 Although Mitcham is chiefly a working class area, there are no real slums and no back-to-back houses. Nearly two-thirds of the houses have been built since 1921 and more than 50 per cent, of all the roads are tree-lined. Mitcham is now a fairly densely populated area, with the few available building sites being rapidly filled up. STATISTICS. Live Births. Total Male Female Rate per 1,000 of population Legitimate 866 428 438 Illegitimate 35 20 15 Total 901 448 453 13.65 After correction by the comparability factor becomes 12.97 Still Births. Total Male Female Rate per 1,000 total births Legitimate 21 12 9 Illegitimate 5 2 3 Total 26 14 12 28.86 Deaths. Total Male Female Rate per 1,000 of population 581 314 267 8.80 After correction by the comparability factor becomes 10.03 Deaths from pregnancy, childbirth and abortion: — Rate per 1,000 total births Number of cases Nil — Deaths of infants under one year of age: — All infants per 1,000 live births 13.32 Legitimate infants per 1,000 live legitimate births 12.70 Illegitimate infants per 1,000 live illegitimate births 28.57 Deaths from: — Cancer (all ages) 108 Measles — Whooping cough (all ages) — Enteritis and Diarrhoea under two years of age — 9 Percentage of Births Occurring in Institutions Year Total births Births in hospitals, etc. Percentage of births occurring in institutions 1934 982 428 43.5 1935 969 474 48.9 1936 1033 497 48.1 1937 976 501 51.3 1938 1028 569 56.3 1939 966 518 53.7 1940 854 453 53.0 1941 737 408 55.4 1942 986 518 52.5 1943 1048 727 69.4 1944 996 678 68.1 1945 993 661 66.5 1946 1290 845 65.5 1947 1405 956 68.0 1948 1215 855 70.37 1949 1129 832 73.69 1950 933 718 76.96 1951 926 703 75.92 1952 929 749 80.62 1953 950 735 77.37 1954 927 673 72.71 10 The birth rates, death rates per 1,000 of population, and the infantile mortality rates for the years 1935—54 are shown in the following table: — Year Births per 1,000 population Deaths per 1,000 population Infant Mortality per 1,000 live births mitcham England & Wales mitcham England & Wales mitcham England & Wales 1935 15.6 14.7 7.7 11.8 49.5 57 1936 15.4 14.8 9.1 12.1 48.0 59 1937 14.3 14.9 8.5 12.4 43.4 58 1938 15.1 15.1 8.3 11.6 38.0 53 1939 15.2 15.0 8.6 12.1 31.0 50 1940 15.4 14.6 11.8 14.3 46.0 55 1941 13.57 14.2 11.06 12.9 55.4 59 1942 17.54 15.8 9.81 11.6 43.75 49 1943 18.75 16.5 10.77 12.1 36.2 49 1944 18.99 17.6 11.88 11.6 36.8 46 1945 18.01 16.1 10.19 11.4 31.83 46 1946 20.3 19.1 9.2 11.5 19.9 43 1947 21.39 20.5 9.47 12.0 38.60 41 1948 17.99 17.9 8.79 10.8 23.49 34 1949 16.45 16.7 9.17 11.7 24.48 32 After 1949 the actual Birth and Death Rates for Mitcham are modified by a comparability factor to correspond with the average age and sex distribution of England and Wales. 1950 12.56 15.8 10.66 11.6 29.64 29.8 1951 12.54 15.5 11.32 12.5 25.47 29.6 1952 12.62 15.3 10.87 11.3 19.80 27.6 1953 13.21 15.5 10.52 11.4 18.39 26.8 1954 12.97 15.2 10.03 11.3 13.32 25.5 11 Infant Mortality During the year year of age: — 12 deaths were registered of infants under one Males Females Total Legitimate 5 6 11 Illegitimate 1 — 1 Totals 6 6 12 as compared with 17 deaths last year. The following table shows the principal causes of death in the various age groups: — Deaths of Infants under One Year of Age Age No. Cause of Death Prematurity Congenital Defects Accidents of birth Infectious conditions Other conditions Under 24 hrs 4 — 1 2 — 1 1-7 days 2 2 — — — — 8 days - 1 mth. 2 1 — — 1 — 1 mth. - 12 mths. 4 — 1 — — 3 Total 12 3 2 2 1 4 Eight infants failed to survive the first month of life, and prematurity was certified as the cause of death of three of these cases. This gives Mitcham a neo-natal mortality rate of 8.88 per 1,000 related live births as compared with 17.7 for England and Wales. Maternal Mortality During the year no death was registered as compared with one in 1953. Inquests Inquests were held on 25 residents dying within the district and on 11 Mitcham residents who died outside the district, a total 12 of 36. In addition, post-mortems without inquests were held on 78 residents dying within the district, and on 69 Mitcham residents who died outside the district, a total of 147. The following table shows the results of the findings of these inquests: — Accidental death 13 Death from misadventure 3 Suicide 14 Natural death 3 Murder 1 Open verdict 2 Total 36 13 Deaths Registered during the Year 1954 Cause of Death Males Females Total 1 Tuberculosis, respiratory 6 2 8 2 Tuberculosis, other 2 1 3 3 Syphilitic disease 3 ... 3 4 Diphtheria ... ... ... 5 Whooping cough ... ... ... 6 Meningococcal infections ... ... ... 7 Acute Poliomyelitis ... ... ... 8 Measles ... ... ... 9 Other infective and parasitic diseases 1 ... 1 10 Malignant neoplasm, stomach 8 10 18 11 Malignant neoplasm, lung, bronchus 23 4 27 12 Malignant neoplasm, breast ... 10 10 13 Malignant neoplasm, uterus ... 1 1 14 Other malignant and lymphatic neoplasms 31 21 52 15 Leukaemia, aleukaemia 3 1 4 16 Diabetes ... 1 1 17 Vascular lesions of nervous system 33 35 68 18 Coronary disease, angina 67 33 100 19 Hypertension with heart disease 4 8 12 20 Other heart disease 30 44 74 21 Other circulatory disease 20 19 39 22 Influenza ... ... ... 23 Pneumonia 10 13 23 24 Bronchitis 21 18 39 25 Other diseases of respiratory system 2 1 3 26 Ulcer of stomach and duodenum 9 ... 9 27 Gastritis, enteritis and diarrhoea 1 1 2 28 Nephritis and nephrosis 6 2 8 29 Hyperplasia of prostate 2 ... 2 30 Pregnancy, childbirth, abortion ... ... ... 31 Congenital malformations 2 ... 2 32 Other defined and ill-defined diseases 14 30 44 33 Motor vehicle accidents 2 2 4 34 All other accidents 5 4 9 35 Suicide 9 5 14 36 Homicide and operations of war ... 1 1 All causes 314 267 581 14 Birth-Rates, Death-Rates, Analysis of Mortality and Maternal Mortality in the Year 1954. England and Wales Mitcham Rates per 1,000 home population Births— Live 15.2 12.97 0.36 0.39 Still 23.4* 28.86* Deaths— All causes 11.3 10.03 Malignant neoplasm—lung, bronchus 0.37 0.41 Whooping cough 0.003 ... Diphtheria 0.0002 ... Tuberculosis—all forms 0.18 0.17 Influenza 004 ... Acute Poliomyelitis 0.003 ... Pneumonia 0.41 0.35 Coronary disease—angina pectoris 1.51 1.51 Maternal mortality 0.69* ... Notifications (Corrected)— Scarlet Fever 1.00 0.71 Whooping Cough 2.39 2.77 Diphtheria 0.004 ... Measles 3.32 1.98 Acute Poliomyelitis— Paralytic 0.03 ... Non-Paralytic 0.01 ... Enteric or Typhoid Fever 0.003 0.015 Para-typhoid Fever 0.010 0.015 Meningococcal Infection 0.03 0.03 Erysipelas 0.12 0.09 Dysentery 0.72 0.70 Acute Encephalitis— Infective 0.003 ... Post-Infectious 0.002 ... Acute Pneumonia 0.60 0.24 Food Poisoning 0.20 0.18 Tuberculosis— Respiratory 0.87 0.80 Non-Respiratory 0.13 0.17 * Per 1,000 total (live and still) births. 15 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA LABORATORY FACILITIES Most of the bacteriological examinations for this district were carried out at the Emergency Public Health Laboratory at Epsom, including bacteriological examinations of milk, water and ice-cream. The chemical analysis of milk, water and foodstuffs was carried out by the Public Analyst, Daniel D. Moir, M.Sc., F.R.I.C., 16, Southwark Street, London, S.E.l. AMBULANCES The Ambulance service is supervised by the Surrey County Council. The ambulances are controlled from St. Helier Hospital (Telephone: Fairlands 8893), some of them being stationed at Mitcham Court. DISINFECTION The disinfection of houses is undertaken by the Council. Disinfection of bedding, etc., is done at the Wandle Valley Isolation Hospital. No charges are made for disinfections carried out in cases of notifiable infectious disease. Public library books which have been in contact with cases of infectious disease are disinfected at the Public Health Department. Number of disinfections carried out by Wandle Valley Isolation Hospital 11 Number of rooms disinfected by fumigator 84 Number of library books disinfected 261 HOSPITALS The hospitals direcdy concerned with the Mitcham area are administered by the St. Helier Group Hospital Management 16 Committee, which is situated at Carshalton, Surrey, and itself comes under the South-West Metropolitan Regional Hospital Board. General Cases.—The principal hospitals are the Wilson Hospital which is situated within the district, and the St. Helier Hospital, Carshalton, which caters for all types of cases. The Nelson Hospital at Merton and the London hospitals are also used. Infectious Diseases.—Cases usually go to the Wandle Valley Isolation Hospital at Beddington Corner, Mitcham Junction, or to the Grove Hospital, Tooting. Smallpox Cases.—By agreement with the South-East Metropolitan Regional Hospital Board, any cases are admitted to the Joyce Green Hospital, Dartford, Kent, upon application. Maternity Cases.—Expectant mothers, if home conditions or medical history do not permit of home confinement, are admitted to the St. Helier Hospital, Carshalton. The Woodlands Maternity Home situated within the district was closed as a Maternity Home on the 31st May, 1953, and reopened as an Old People's Home on the 18th January, 1954. The number of beds available is 21. Tuberculosis Cases.—The Regional Hospital Board is responsible for providing the specialist services for the tuberculous, also for institutional treatment. Dr. J. M. Hill is the chest physician for Mitcham patients and holds a clinic at the St. Helier Hospital, Carshalton, every Monday at 9.30 a.m., Wednesday at 1.50 p.m., Thursday at 9.30 a.m., and Friday at 9.30 a.m. A clinic is held for old cases only, on every fourth Wednesday at 5 p.m. A Refill Clinic is also held every Monday at 2 p.m., at Cumberland Hospital. The Cumberland Hospital, which is situated in Mitcham, deals only with tuberculosis and has 100 beds available. Venereal Diseases Clinics.—Confidential treatment can be obtained at the St. Helier Hospital, Carshalton, and the Croydon General Hospital. Treatment can also be obtained from the outpatients' departments of many of the London Hospitals. 17 CLINICS AND TREATMENT CENTRES (Under control of the Surrey County Council) Welfare Clinics Infant Welfare Centres are held at the following places: — Cavendish Road Welfare Centre.—Sessions are held every Monday afternoon. St. Barnabas Church Hall, Gorringe Park Avenue.—Sessions are held every Tuesday afternoon. Sherwood House, Commonside East.—Sessions are held every Thursday morning and Monday afternoon. Church Road Centre.—Sessions are held every Thursday afternoon and Wednesday afternoon. Meopham Road Clinic.—Sessions are held each Wednesday afternoon. Toddlers' Clinics for children between the ages of two to five years are held on Monday mornings, other than the first Monday in the month, by appointment. Ante-Natal Clinics An Ante-natal session is held at the Church Road Clinic every Tuesday and Friday morning, and a clinic for cases booked by midwives is held on Tuesday and Friday afternoons. An ante-natal session is held at the Cavendish Road Clinic every 2nd and 4th Monday morning during the month. X-Ray examinations necessary for expectant mothers are carried out at the Wilson Hospital. Post-Natal Clinic A post-natal clinic is held at Church Road Clinic on the first Monday in the month. Dental Clinics Dental services are provided for expectant and nursing mothers, toddlers and school children at the Church Road, Western Road and Meopham Road Clinics. 18 Speech Clinic An all day session is held at Western Road Clinic on Tuesday, Wednesday and Thursday when two speech therapists are in attendance. Ophthalmic Clinic An eye specialist attends Western Road Clinic on Tuesday mornings and Wednesday afternoons. Minor Ailments A session is held at Western Road Clinic on Monday and Friday mornings, with a doctor in attendance, and on Wednesday mornings under the supervision of a nurse. U.V. Radiation Clinics Sessions are held as follows: — Church Road Clinic : Monday afternoons, Thursday mornings. Sherwood House Clinic : Tuesday afternoons, Friday afternoons. Diptheria and Whooping Cough Immunisation Vaccination against Smallpox (Under the direction of the Medical Officer of Health.) Clinics are held as follows: — Cavendish Road Clinic.—Each Monday afternoon in conjunction with Welfare Clinic. Church Road Clinic.—On 1st, 3rd and 5th Wednesdays of the month in the morning. Meopham Road Clinic.—Each Wednesday afternoon in conjunction with Welfare Clinic. St. Barnabas Clinic.—On 1st, 3rd and 5th Tuesdays of the month in the afternoon. Sherwood House Clinic.—Each Monday afternoon (immunisation only) and each Thursday morning (immunisation and vaccination) in conjunction with Welfare Clinics. 19 Day Nursery The Surrey County Council provide one day nursery in Mitcham, at Eagle House, London Road, Mitcham, with 49 places. Health Visiting Health visitors are under the control of the Surrey County Council. There were nine Health Visitors employed in visiting the mothers and children in this district under the supervision of a Divisional Superintendent Health Visitor. Every Health Visitor carries out the combined duties of District Health Visitor and School Health Visitor. Home Help Service The Home Help Service, which is under the control of the Surrey County Council, has proved most successful. Applications for assistance are made to the Divisional Medical Officer at Mitcham Court. National Society for Prevention of Cruelty to Children The Society does very valuable work in the Borough and there is very close co-operation between the officials of the Public Health Department and the officers of the Society. Number of Mitcham cases dealt with in 1954 28 Number of children affected 69 Number of visits paid 200 National Assistance Act, 1948: Section 47 Removal to Suitable Premises of Persons in Need of Care and Attention. There were no cases during the year that required action under the above-named Act or under the National Assistance (Amendment) Act, 1951. All authorities concerned co-operate to avoid court action if possible. One case which might have required such action was persuaded to enter voluntarily a Hospital establishment. 20 SANITARY CIRCUMSTANCES OF THE AREA WATER SUPPLY Except for eight houses in Goat Road, supplied by the Sutton Water Company, the whole of Mitcham is supplied by the Metropolitan Water Board. A few factories have an additional supply from deep wells. There are six licensed caravan yards, each with a stand pipe, supplying altogether a total of 20 caravans. The water has been of a consistently high standard of purity and there is no record of any case of infectious disease being transmitted by water. A large number of houses in the Borough have no supply of drinking water direct from the main, but are supplied from a tank in the roof. Provided the tank is properly covered and is cleansed regularly, it provides a satisfactory supply. RIVERS AND STREAMS Visits have been paid to all works suspected of discharging effluent into surface water sewers. CLOSET ACCOMMODATION The whole of the district is on the water carriage system, the houses being drained to the public sewer, then treated at the works of the Wandle Valley Joint Sewerage Board. PUBLIC CLEANSING A weekly collection of house refuse is carried out by direct labour. Eight refuse collection vehicles are in use. ERADICATION OF BED BUGS Number of Council houses found infested during the year, 36. Number of other houses found infested during the year, 8. Number of requisitioned, etc., houses found infested during the year, 4. Total number of houses disinfested during the year, 48. 21 Methods employed: — 48 houses treated with insecticide spray. Number of houses disinfested of beetles, 42. Number of houses disinfested of other insects, 16. SCHOOLS The supervision of the public elementary schools is under the control of the Education Department of the Surrey County Council. The sanitary fittings, etc., however, are inspected periodically by the sanitary inspector. All schools have a constant supply of water from the mains of the Metropolitan Water Board. Medical Inspection.—The medical inspection of school children is carried out by the School Health Service of the Surrey County Council. Closure of Schools.—No school has been closed by the local authority during the year by reason of infectious disease. Infectious Diseases.—Scholars in contact with a case of infectious disease are excluded from school, the period of the exclusion being that set out in a memorandum of the County School Medical Officer to the Surrey Education Committee. The head teacher of the school concerned is always notified of this exclusion and the reason. PREVENTION OF DESTRUCTION BY PESTS ACT, 1949 Two full-time and one part-time Rodent Operators were employed. Properties inspected 5,943 Complaints received 580 Number of treatments re rat infestation including test baits as result of inspection and complaints 1,122 Factory and business premises treated 107 Visits by Sanitary Inspectors 114 Two sewer maintenance treatments were carried out; 211 manholes were baited. Twelve intercepting chambers were also baited during the two maintenance treatments. A ten per cent. test of all the sewer manholes in the district was also carried out. 22 THE ANNUAL REPORT OF THE CHIEF SANITARY INSPECTOR To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gendemen, I beg to submit a summary of the visits and works carried out in the Borough by myself and the District Sanitary Inspectors: — Complaints received 696 Nuisances found 556 Verbal Notices given 132 Verbal Notices complied with 77 Informal Notices served 464 Informal Notices complied with 241 Statutory Notices served 178 Statutory Notices complied with 139 Revisits 2,198 Houses inspected for defects 795 Visits made for this purpose 885 Drains tested and inspected 247 Private houses found verminous 20 Visits to butchers 186 Visits to slaughterhouses 444 Visits to dairies 10 Visits to retail milk shops 34 Visits to restaurant kitchens 292 Visits to ice-cream premises 63 Visits to bakehouses 69 Visits to other food premises 482 Number of notices served under Food and Drugs Act, 1938 24 Number of notices complied with 24 Visits to factories 210 Visits to workplaces 80 Visits to outworkers 33 Visits to stables 69 Visits to piggeries 86 Visits to marine stores Visits to caravan yards 88 23 Smoke observations 51 Visits re infectious disease cases 491 Visits re smallpox contacts 11 Visits re food poisoning 20 Visits re rats and mice 114 Visits re Shops Acts 77 Visits re schools 29 Visits to Refuse Tipping Site, Mitcham Common 62 Sundry visits 227 Character of Work Done Roofs repaired 110 Rainwater piping or gutters repaired or renewed 97 Yards paved or repaired 4 Dampness remedied 124 Water service pipes repaired 15 Waterclosets: Repairs to structure 10 Flushing apparatus repaired or renewed 42 New pans and traps fitted 27 Water storage cisterns cleansed, repaired or renewed 13 Water supply reinstated 3 Flooring of rooms repaired and sub-floor ventilation improved 65 Rooms cleansed and redecorated 7 Sinks and handbasins repaired or renewed 5 Waste pipes and traps repaired or renewed 23 Window frames and sashes repaired or renewed 28 Window sills repaired or renewed 12 External brickwork (repaired, pointed or rendered) 19 Drains repaired or obstructions removed 110 Drains inspection covers renewed 20 Drains tested 75 Grid and mica flaps provided 11 Firegrates repaired (including surrounds and hearths) 12 Stoves, coppers, ranges, etc., repaired 7 Chimney stacks repaired 11 Staircases repaired 17 Doors repaired 13 24 Internal plaster repairs 156 Sash cords renewed 73 Dustbins provided 37 Accumulations removed 13 All ponds and ditches in the Borough where mosquito breeding was likely were sprayed with insecticide twice during the year. LEGAL PROCEEDINGS Section 94, Public Health Act, 1936.—One application was made to the Justices for a summons against a property owner who failed to carry out works of repair. The summons was withdrawn as the work was completed before the date of the hearing. Section 68, Mitcham Urban District Council Act, 1923.—Two applications were made to the Justices requiring the provision of dustbins. The summonses were withdrawn as the dustbins were supplied before the date of the hearing. Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929.—97 licences to store petroleum spirit and/or petroleum mixtures were issued for a total of 210,827 gallons (inclusive of cellulose solutions). Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Carbide of Calcium) Order, 1929.—Three licences were issued for the storage of 2,364 lbs. (plus 448 lbs. temporary re-supply) of carbide of calcium. Unsound Food Dealt With Beef 785 lbs. Fish 508 lbs. Pork 45½ „ Currants 8 „ Corned Beef 46¾ „ Fruit, Dried 15 „ Rabbit 57 „ Tomato Paste 70 „ Veal 89 „ Dry Vegetables 20 „ Lamb 35¼ „ Marshmallow 980 „ Beef Fat 6½ „ Potatoes 145 „ Jellied Veal 24 „ Trufflits 3394 „ Stewed Beef 85 „ Chocolate 143½ „ Stewed Steak 9 „ Biscuits 3½ „ 25 Stewed Mutton 151 „ Cheese 111½ „ Minced Beef Loaf 1¾ „ Margarine 24 „ Ox Kidneys 151 „ Xmas Pudding 8 „ Luncheon Meat 111½ „ Cereals 12 pkts. Ham 112 „ Tinned Foods 498 tins Bacon 164 „ Assorted 16 pkts. Yours faithfully, K. J. GUTTERIDGE, Chief Sanitary Inspector. HOUSING STATISTICS Total Number of Inhabited Houses—19,521. Permanent buildings built by the Council before the war—1,461. Permanent buildings built by the Council after the war—1,915. Other Housing Accommodation Available:— A. Requisitioned and sundry properties 321 B. Temporary buildings, Arcon bungalows 345 C. Hutments, 320 originally, now reduced to 108 D. Gunsite hutments, 61 originally, now reduced to 8 E. Therefore, total number of properties used for housing by the Mitcham Borough Council is 4,158 Number of People Rehoused. About 9,200 applicants have registered since 1945, and the current list is still about 2,000, so that some 7,200 applicants have been dealt with. Types of Accommodation. The Nissen huts and gunsite hutments were built to last only a few years, and do not always give protection against the weather, although much has been spent on improvements. The numbers are gradually being reduced and the Mitcham Borough Council is acquiring the sites for permanent housing purposes, where possible. 26 The temporary Arcon bungalows, however, give very good housing accommodation. The chief new development is that of building large blocks of flats to get the greatest number of families rehoused with a limited building space available. A housing estate is also being constructed outside the borough at Banstead in conjunction with the neighbouring authorities of Merton and Morden Urban District Council and the Borough of Sutton and Cheam. One hundred and eighty-four houses are now occupied. The Mitcham Borough Council is increasing the number of aged persons' dwellings being built. The post-war housing is also making provision for the communal needs of the occupants of the new estates by proposed community centres, erection of garages, etc. 1. Inspection of Dwelling Houses during the Year:— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 795 (b) Number of inspections made 885 2. Remedy of Defects during the Year:— Number of dwelling houses rendered fit in consequence of informal action by the local authority or their officers 196 Number of dwelling houses rendered fit in consequence of formal action by the local authority or their officers 134 3. Action under Statutory Powers During the Year:— Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which notices were served requiring repairs — 27 (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) By owners 2 (b) By local authority in default of owners 1 Proceedings under Section 11 of the Housing Act, 1936, and Section 10 of the Local Government (Miscellaneous Provisions) Act, 1953:— (1) Number of houses in which demolition orders were made 2 (2) Number of houses closed in pursuance of an undertaking given by the owners and still in force 3 Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of houses in which closing orders were made for underground rooms — (2) Parts of buildings closed — 4. Rent and Mortgage Interest (Restrictions) Act, 1920-1938, and Housing Repairs and Rents Act, 1954:— Number of certificates issued to occupiers that houses were not in a reasonable state of repair 10 Number of Revocations of Certificates issued 2 28 INSPECTION AND SUPERVISION OF FOOD CLEAN FOOD CAMPAIGN Examinations are made of all food premises, the desirable features carefully assessed and marks awarded on a special form. The premises were on the whole satisfactory with some minor adjustments necessary. Food premises by type of business, General Stores 18 Groceries 79 Butchers 36 Continental Butchers (Horseflesh) 3 Greengrocer & Fruiterers 61 Greengrocer & General Provisions 2 Confectionery 71 Confectioner & Greengrocers 1 Chemists 16 Restaurants 7 Cafes 24 Cafe & General Stores 1 Roadside Snack Bars 3 Fishmongers 11 Fried Fish Buffets 5 Fried Fish 12 Bakers and Confectioners 17 Milk & Provisions 13 Public Houses 28 Off-Licences 9 Food premises by type, registered under Section 14, Food and Drugs Act, 1938. The storage and sale of ice-cream 131 The manufacture for sale of ice-cream 4 The preparation or manufacture of sausages, or potted, pressed, pickled or preserved food 42 Dairies registered under the Milk and Dairies Regulations, 1949 1 Number of inspections of registered food premises during the year 191 All condemned food is incinerated at the Refuse Destructor, Garth Road, Morden, by arrangement with the Merton and Morden Urban District Council. 29 FOOD AND DRUGS ACT, 1938 Formal Samples. Seventy-eight formal samples were taken as follows:— Milk 44 Cake Mix 1 Medicinal Glucose Powder 1 Sausages, pork 8 Sausages, beef 2 Wine Gums 1 Compound Fat 1 Butter 3 Margarine 2 Margarine (10 per cent. Butter) 1 Gelatine 1 Halibut Liver Oil Capsules 1 Coffee and Chicory 2 Apricot Jam 1 Lemon Flavour Pie Filling 2 Banana Curd 1 Chocolate Drink 1 Glucodin 1 Vitamin Tablets, Vitamin C plus Glucose 1 Butterscotch Toffees 1 Vinegar 1 Plum Jam 1 Informal Samples. Sixty-two informal samples were taken as follows:— Fresh Orange Drink 1 Processed Peas 1 Pickle 1 Pickled Onions 1 Sardines in Olive Oil 1 Milk Pudding (Macaroni) 1 Compound Tablets of Codeine, B.P. 1 Essence of Rennet 2 Swiss Roll, chocolate flavour 1 Beef Steak Pudding 1 Curry Powder 1 Banana Essence 1 Mixed Fruit Pudding 1 Fruit Enriched Bread 1 Vienna Sausage 1 Orange Juice 1 Vegetable Soup 1 Cough Syrup 1 Chocolate Spread 1 Custard Powder 1 Mixed Pickling Spice 1 White Pepper 3 Porage Oats 1 Pure Dairy Cream (Danish) 1 Chocolate covered Roll 1 Ice-Cream 8 Bicarbonate of Soda 1 Ham and Beef Luncheon Meat 1 Lemon Flavour Pie Filling 1 Worcestershire Sauce 2 Sardines in Oil 1 Mustard Pickle 1 30 Dressed Crab 1 Creamed Cottage Cheese 2 Lard 3 Roasted and Salted Peanuts 1 Roll-Mop Herrings in Vegetable 1 Peanut Butter 1 Tomato Chutney 1 Chocolate Drink 1 Almond Culinary Flavouring 1 Savoury Spread with Gorgonzola 1 Flour 1 Samonaize Fish Spread 1 Christmas Pudding 1 Steak and Kidney Pudding 1 Cherry Bark and Glycerine Cough Cure 1 Cream of Tartar 1 All samples were satisfactory with the exception of two formal samples (milk 1, coffee and chicory 1) and one informal sample (rollmop herrings in vegetable 1). A warning letter was sent to the firm concerned in two of these cases, the exception being Roll-Mop Herrings in Vegetable and in this case the firm withdrew all stocks from sale. On complaints being received the following cases were reported to the Public Health Committee:— One dirty milk bottle. One of foreign body in a loaf of bread. One of glass in a bottle of school milk. One dirty churn of milk. Legal action was taken against the two firms concerned in the case of the dirty churn of milk and fines of £15 (£5 5s. costs) and £12 (£5 5s. costs) respectively were imposed. In the case of a foreign body in a loaf of bread, legal action was taken against the baker and a fine of £10 with £2 2s. costs was imposed. Warning letters were sent to the firms concerned in the other cases. Ice-Cream Four premises in the Borough are registered for the manufacture of ice-cream and 131 for the storage of ice-cream. Sixty-three visits were paid during the year. 31 Twenty-five samples of ice-cream were taken and examined for bacteriological purity. Eight samples were also tested for fat content. The results are tabulated below:— Provisional Grade I II Ill IV Coliforms absent 12 4 3 — Coliforms present in 1/10h ml 2 — 4 — Fæal coli present (in addition to above) - - - - Fat Content 3 4 5 6 7 per cent. per cent. per cent. per cent. per cent. 8 9 10 11 12 per cent. per cent. per cent. per cent. per cent. 1 3 1 2 — Bacteriological Examination of Cups and Glasses Seventy-three swabs were taken from tea cups at various catering establishments and thirteen swabs were taken from beer glasses at various public houses during the year, and were submitted to the Public Health Laboratory for bacteriological examination. The results are tabulated below:— Tea Cup Swabs. Colony Count (per cup) Coliforms Fæcal Coli Result Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 1 42 — 1 43 — 100-200 1 8 — 1 — 9 200-500 1 6 — 1 — 7 500-1,000 — 4 — — — 4 1,000-1,500 - - - - - - 1,500-2,000 - - - - - - 2,000 and over 2 8 — 2 — 10 Total 5 68 — 5 43 30 Beer Glass Swabs (per glass). Under 100 1 7 — 1 8 — 100-200 — 1 — - — 1 32 200-500 1 — — 1 — 1 500-1,000 - - - - - - 1,000-1,500 — 2 — — — 2 1,500-2,000 - - - - - - 2,000 and over 1 — — 1 — 1 Total 3 10 - 3 8 5 The result of the swabs was sent to the establishments concerned. MILK (SPECIAL DESIGNATION) (PASTEURISED AND STERILISED MILK) REGULATIONS, 1949 to 1953 During the year the Council granted the following number of licences under the above-named Regulations:— Dealer's (Pasteuriser's) Licences 1 Dealer's Licences— Pasteurised 24 Sterilised 39 Supplementary Licences— Pasteurised 16 Sterilised 16 MILK (SPECIAL DESIGNATION) (RAW MILK) REGULATIONS, 1949 to 1954 During the year the Council granted the following number of licences under the above-named Regulations:— Dealer's Licences (Tuberculin Tested) 17 Supplementary Licences (Tuberculin Tested) 16 One hundred and twenty-nine samples of Graded Milk were submitted for bacteriological examination. One hundred and twentyeight samples were satisfactory and one was unsatisfactory. A communication was sent to the dairy concerned regarding the unsatisfactory sample. BAKEHOUSES The number of bakehouses in the district is ten. Sixty-nine visits have been paid. 33 DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year ten visits of inspection were paid. SLAUGHTERHOUSES There are two registered slaughterhouses in the Borough; 444 visits have been paid. SLAUGHTER OF ANIMALS ACT, 1933 TO 1954 Eleven licences were issued to slaughtermen in accordance with the requirements of the above Act. MEAT INSPECTION Carcases Inspected and Condemned Cattle, excluding cows Cows Calves Sheep and Lambs Pigs Number killed 100 ... 47 ... 7,412 Number inspected 100 ... 47 ... 7,412 All diseases except tuberculosis: Whole carcases condemned ... ... ... ... 8 Carcases of which some part or organ was condemned 6 ... ... ... 204 Percentage of the number inspected affected with disease other than tuberculosis 6.00 ... ... ... 2.86 Tyberculosis only: Whole carcases condemned 1 ... ... ... 4 Carcases of which some part or organ was condemned 7 ... ... ... 98 Percentage of the number inspected affected with tuberculosis 8.00 ... ... ... 1.39 FOOD PREPARING FACTORIES There are 17 factories which are engaged in the manufacture and preparation of food products. All of these are systematically visited. 34 INFORMAL ACTION TAKEN UNDER SECTION 13, FOOD AND DRUGS ACT, 1938 Number of notices served, 24. Number of notices complied with, 24. PIGGERIES There are 30 piggeries in the Borough. Eight-six visits were paid during the year. PET ANIMALS ACT, 1951 Five licences were issued to occupiers of pet shops. 35 FACTORIES ACT, 1937 1.—Inspections for purposes of provisions as to health (including inspections made by Sanitary Inspectors):— Premises M/c line No. Number on Register Number of M/c line No. Inspections Written notices Occupiers prosecuted (1) (2) (3) (4) (5) (6) (7) (i) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 1 24 3 ... ... 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 271 177 9 ... 2 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 3 28 21 ... ... 3 TOTAL 323 201 9 ... ... 36 2.—Cases in which defects were found:— Particulars M/c line No. Number of cases in which defects were found Number of cases in which prosecutions were instituted M/c line No. Found Remedied Referred To H.M. Inspector By H.M. Inspector (1) (2) (3) (4) (5) (6) (7) (8) Want of cleanliness (S.l) 4 ... ... ... ... ... 4 Overcrowding (S.2) 5 ... ... ... ... ... 5 Unreasonable temperature (S.3) 6 ... ... ... ... ... 6 Inadequate ventilation (S.4) 7 ... ... ... ... ... 7 Ineffective drainage of floors (S.6) 8 ... ... ... ... ... 8 Sanitary Conveniences (S.7) (a) Insufficient 9 2 2 ... 2 ... 9 (b) Unsuitable or defective 10 12 12 ... 3 ... 10 (c) Not separate for sexes 11 ... ... ... ... ... 11 Other offences (not including offences relating to Homework) 12 6 6 ... ... ... 12 TOTAL 60 20 20 ... 5 ... 60 37 3.—Outwork (Sections 110 and 111):— Nature of Work M/c line No. Section 110 Section 111 M/c line No. Number of out-workers in August list required by Sect. 110 (1) (c) Number of cases of default in sending lists to the Council Number of prosecutions for failure to supply lists Number of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) (8) (9) Wearing apparel Making, etc. 13 142 13 Cleaning and washing 14 14 Household linen 15 15 Lace, lace curtains and nets 16 16 Curtains and furniture hangings 17 17 Furniture and upholstery 18 18 Electro-plate 19 19 File making 20 20 Brass and brass articles 21 21 Fur pulling 22 22 Iron and steel cables and chains 23 23 Iron and steel anchors and grapnels 24 24 Cart gear 25 25 Locks, latches and keys 26 26 Umbrellas, etc. 27 27 Artificial flowers 28 1 28 38 3.—Outwork (Sections 110 and 111) continued :— Nets, other than wire nets 29 29 Tents 30 30 Sacks 31 31 Racquet and tennis balls 32 32 Paper bags 33 33 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 34 18 34 Brush making 35 35 Pea picking 36 36 Feather sorting 37 37 Carding, etc., of buttons, etc. 38 38 Stuffed toys 39 6 39 Basket making 40 40 Chocolates and sweetmeats 41 41 Cosaques, Christmas crackers, Christmas stockings, etc. 42 36 42 Textile weaving 43 1 43 Lampshades 44 4 44 TOTAL 70 208 70 39 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1954 was 450. Contacts, Suspects, Etc. The Medical Officer of Health is called in consultation by medical practitioners to see patients in their homes, as required. Visits Sanitary Inspectors to common infectious diseases 491 Sanitary Inspectors to smallpox contacts 11 Total 502 Rooms disinfected after infectious disease 84 40 The monthly incidence of infectious disease was:— Smallpox Scarlet Fever Diphtheria Typhoid Fever Erysipelas Pneumonia Puerperal Pyrexia Ophthalmia Neonatorum Dysentery Meningococcal Infections Poliomyelitis Paralytic Poliomyelitis Non-Paralytic Measles Whooping Cough Food Poisoning Paratyphoid Malaria Acute Encephalitis Infective Acute Encephalitis Post-Infectious Totals January ... 6 ... 1 1 1 ... ... ... ... ... ... 17 ... ... ... ... ... 26 February ... 2 ... ... ... 1 ... 1 ... 1 ... ... 4 26 1 ... ... ... ... 36 March ... 10 ... ... ... 4 1 ... 2 ... ... ... ... 29 ... ... ... ... ... 46 April ... 7 ... ... ... 4 1 ... 1 ... ... ... ... 22 ... ... ... ... ... 35 May ... 5 ... ... 1 2 ... ... 10 1 ... ... 1 8 ... ... ... ... ... 28 June ... 5 ... ... 1 1 ... ... 20 ... ... ... ... 10 3 ... 1 ... ... 41 July ... 4 ... ... ... 1 ... ... 6 ... ... ... 2 7 3 ... ... ... ... 23 August ... 2 ... ... 3 ... ... ... 3 ... ... ... ... 2 ... ... ... ... ... 10 September ... 1 ... ... ... ... ... ... 3 ... ... ... 3 4 ... ... ... ... ... 11 October ... ... ... ... 1 1 ... ... ... ... ... ... 92 19 3 ... ... ... ... 116 November ... 2 ... ... ... ... ... ... 1 ... ... ... 21 13 ... ... ... ... ... 37 December ... 3 ... ... ... 1 ... ... ... ... ... ... 8 26 2 1 ... ... ... 41 Totals ... 47 ... 1 6 16 3 1 46 2 ... ... 131 183 12 1 1 ... ... 450 41 Infectious Disease Notifications, 1935-54. Disease 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1.1.48 to 4.7.48 5.7.48 to 31.12.48 1949 1950 1951 1952 1953 ] Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 143 171 192 150 61 48 75 175 212 97 147 95 62 35 57 89 110 111 225 86 47 Diphtheria 80 104 89 64 27 36 72 25 42 10 63 32 4 ... 1 1 ... ... ... ... ... Typhoid Fever 3 5 ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... ... 1 Puerperal Pyrexia 4 11 5 4 7 2 2 6 3 5 8 6 9 3 ... 2 ... 13 23 11 3 Meningococcal Infections 1 3 1 2 1 13 12 6 8 3 3 1 2 1 1 ... 1 3 1 ... 2 Erysipelas 20 22 16 8 19 17 19 7 22 13 16 25 9 18 6 12 7 8 14 11 6 Measles ... ... ... ... ... 301 194 599 651 112 739 358 533 818 252 354 354 1386 591 888 131 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Acute Poliomyelitis: Paralytic ... ... 1 ... ... ... ... ... ... ... 2 3 11 2 2 6 2 1 4 4 ... Non-Paralytic ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... Ophthalmia Neonatorum 4 3 1 3 3 1 3 10 4 4 ... 2 2 6 3 8 2 l 4 ... 1 Acute Encephalitis: Infective ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... Post-Infectious ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... Pneumonia 35 36 32 43 ... 30 22 20 50 37 33 41 37 30 13 19 28 24 26 27 16 Malaria ... ... ... ... ... ... ... ... 1 1 ... 1 ... 1 ... ... ... ... 1 ... 1 Whooping Cough ... ... ... ... 4 16 186 161 162 166 96 234 216 117 149 212 387 420 112 336 183 Food Poisoning ... ... ... ... 4 4 6 11 ... ... 5 1 ... ... ... 6 3 4 10 17 12 Dysentery ... ... ... ... ... ... ... ... 4 67 13 6 1 2 5 7 16 7 16 15 46 Paratyphoid ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... 1 ... ... 1 Totals 293 357 338 275 125 468 591 1021 1161 515 1126 807 888 1033 490 717 911 1980 1027 1396 450 42 Smallpox No case of smallpox was notified during the year 1954. The last case was in 1932. Scarlet Fever The number of cases of scarlet fever notified during the year was 47 as compared with 86 in 1953, equivalent to a case rate of 0.71 per 1,000 population. This disease has continued mild in character. Of the total number of cases notified 13 were treated in hospital and 34 were treated at home Diphtheria No case of diphtheria was notified for the fifth year in succession and only two in the past seven years, whereas before that cases averaged sixty per year. Immunisation and reinforcing doses were available to every school child whose parents gave consent. Diphtheria Immunisation There are five clinics within relatively easy reach of everyone, as well as immunisation sessions held in the schools. Efforts have continued during the year to obtain the immunisation of every child before the first birthday. The health visitors urge mothers at the welfare centres, and at home visits, to have their children immunised, making special visits in difficult cases. The following figures show the number of children immunised and reinforced during the year (this includes those children who received the combined diphtheria and whooping cough prophylaxis):— Immunised. Reinforced. Total. Under five years 795 46 841 Five to fourteen years 215 1,299 1,514 Totals 1,010 1,345 2,355 43 The following figures show the number of the child population considered immunised at 31st December, 1954:— Age at 31.12.54, i.e. born in year Under 1 1954 1 to 4 1953-1950 5 to 9 1949-1945 10 to 14 1944-1940 Under 15 Total Last complete course of injections (whether primary or booster) A. 1950-1954 51 2165 4012 2957 9185 B. 1949 or earlier — — 518 466 984 C. Estimated mid-year child population 876 4028 9576 14480 Immunity Index 100 A/C 5.82 53.75 72.78 63.43 Whooping Cough Immunisation This is carried out at the same clinics as diphtheria immunisation, but special visits to schools are not made as this inoculation is intended primarily for children under five years old. 44 The following figures show the number of children immunised and reinforced during the year (this includes those children who received the combined diphtheria and whooping cough prophylaxis):— Age at date of final injection (as regards A) or of re-inforcing injection (as regards B) Under 1 1 2 3 4 5 to 9 10 to 14 Total A. Number of children who completed a course of inoculation with pertussis vaccines (including suspended diphtheria pertussis prophylactic and adsorbed diphtheria pertussis prophylactic) during the year ended 31st December, 1954. 47 491 149 33 40 76 2 838 B. Number of children who received a secondary (reinforcing) injection (i.e. subsequently to primary immunisation at an earlier age) during the year ended 31st December, 1954. - - 1 1 8 28 1 39 Enteric Fever No case was notified during the year. Diarrhoea and Enteritis Under Two Years of Age No death was registered during the year. 45 Food Poisoning Outbreaks There were sixteen cases of food poisoning in 1954 comprising four family outbreaks, together with five single cases. The illness was caused by Salmonella Typhimurium but the source of the disease could not be discovered. Encephalitis Lethargica No case was notified during the year. Erysipelas Six cases were notified. Two cases were removed to hospital. Puerperal Pyrexia Three cases were notified during the year. Pneumonia Sixteen cases of primary pneumonia were notified during the year. The number of deaths from all forms of pneumonia, some of which are not notifiable, was 23, of which 10 were males and 13 females. Meningococcal Infections Two cases occurred during 1954. Influenza During the year no death was recorded. The previous year eight deaths were registered. Prevention of Blindness This comes under the control of the Surrey County Council. Ophthalmia Neonatorum During the year one case of ophthalmia neonatorum was notified. Poliomyelitis No case was notified during the year. 46 School Notifications The school intimation notices of infectious disease are always compared with the notifications received from the medical practitioners. If any case on the school return is found to be unnotified, investigations are made in order to find out if the patient is receiving medical attention. The school notices also give information of the prevalence of non-notifiable infectious disease, such as chicken pox, mumps, etc. The numbers were as follows:— Chicken pox 79 Mumps 205 Ringworm 2 Rubella 2 Impetigo 3 Jaundice 4 Influenza 7 Rheumatic Fever 1 Cancer The number of deaths from cancer registered during the year was 108, of which 62 were males and 46 were females. This is a decrease from last year although the trend for England and Wales is continuing upwards. The site distribution for 1954 was as follows:— Digestive organs 18 cases Respiratory organs 27 „ Breast 10 „ Genito-urinary organs 1 „ Other sites 52 „ Total 108 The following table shows the number of deaths from cancer, together with the death rate as compared with England and Wales:— 47 Year Number of Deaths Death Rate per 1,000 of population Mitcham England and Wales 1935 61 1.0 1.58 1936 80 1.2 1.61 1937 76 1.1 1.63 1938 103 1.5 1.66 1939 73 1.12 1.64 1940 94 1.55 1.66 1941 84 1.6 1.67 1942 104 1.90 1.698 1943 95 1.7 1.74 1944 83 1.6 1.7 1945 103 1.91 1.74 1946 108 1.74 1.76 1947 103 1.60 1.86 1948 111 1.67 1.85 1949 124 1.85 1.87 1950 102 1.51 1.89 1951 108 1.61 1.90 1952 128 1.91 1.94 1953 129 1.94 1.95 1954 108 1.64 2.04 Tuberculosis During the year 64 new cases of tuberculosis were notified, viz:- Males Females Total Pulmonary 26 27 53 Non-Pulmonary 6 5 11 Totals 32 32 64 Twenty-eight cases were transferred into the Borough as follows: — Males Females Total Pulmonary 9 18 27 Non-Pulmonary — 1 1 Totals 9 19 28 48 The total number of deaths from tuberculosis was: — Males Females Total Pulmonary 6 2 8 Non-Pulmonary 2 1 3 Totals 8 3 11 England and Wales Mitcham Death rate from tuberculosis, all forms, per 1,000 population 0.18 0.17 The following table shows the number of new cases, the type of disease and the deaths from tuberculosis during the year: — Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. Under 1 year ... ... ... ... ... ... ... ... 1 year to 4 years ... ... ... ... ... ... ... ... 5 years to 9 „ 3 ... ... ... ... ... ... ... 10 „ „ 14 1 7 ... ... ... ... ... ... 15 „ „ 19 „ ... 6 1 1 ... ... ... ... 20 „ „ 34 7 8 2 3 ... 1 ... ... 35 „ „ 44 2 5 3 1 ... ... ... ... 45 „ „ 64 „ 11 1 ... ... 1 1 1 ... 65 „ and upwards 2 ... ... ... 5 ... 1 ... Totals 26 27 6 5 6 2 2 1 New cases coming to the knowledge of the Medical Officer of Health during the year through death returns; and posthumous notifications:- 49 Age Periods 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Pulmonary: Males ... ... ... ... ... ... ... ... ... ... 1 ... 2 3 Pulmonary: Females ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Pulmonary: Males ... ... ... ... ... ... ... ... ... ... ... ... ... ... Non-Pulmonary: Females ... ... ... ... ... ... ... ... ... ... ... ... ... ... The sources from which information as to the above-mentioned cases was obtained are as follows: — Number of Cases Pulmonary NonPulmonary Death Returns (a) From Local Registrar 1 ... (b) Transferable deaths from Registrar General 2 ... Posthumous notifications from doctors ... ... The percentage of non-notified tuberculosis deaths (i.e., new cases coming to the knowledge of the Medical Officer of Health after death of the case) is 27.27. Non-notified tuberculosis deaths 3 Total tuberculosis deaths 11 Miniature Mass Radiography A mass radiography unit comes to Mitcham every year and is granted free use of the Vestry Hall (Town Hall). In 1954 the unit carried out its work from 30th August to 1st October and the following summary was supplied by the Medical Director of the Unit, Dr. F. J. H. Walters: — 50 Male. Female. Total number examined 3,060 3,241 Pulmonary tuberculosis active 6 7 Pulmonary tuberculosis inactive 140 120 Non-tuberculous abnormalities 105 73 The above figures do not apply to Mitcham residents only, as anyone may make use of the service whether resident or non-resident. The examination is of value in the early diagnosis and treatment of pulmonary tuberculosis and other non-tuberculous abnormalities. Mitcham, Beddington and Wallington Tuberculosis Care Committee Functions of the Committee 1. To alleviate want or distress amongst those suffering from tuberculosis, providing where necessary, extra nourishment, clothing, bedding, coal, surgical appliances, travelling expenses and help in the home. 2. To care for the families of patients who are in sanatoria so that their changed economic circumstances shall not result in impaired health, and that the sufferer shall not be harassed by undue anxiety. Christmas gifts are given to hardship cases. Assistance is given towards extra nourishment, beds and bedding, occupational therapy material, education, clothing, provision of wireless, holidays, fares for relatives to visit, pocket money for patients, removal expenses, etc., etc. The Committee also carry for distribution a stock of milk foods, blankets and sheets. The help given improves the morale of the patient or the well-being of his or her family. The Committee has the task of raising the larger portion of the funds necessary, the bulk coming from the sale of Christmas seals and donations from voluntary associations. 51 INDEX page Abortion, Deaths 8, 13 Ambulances 15 Ante-Natal Clinics 17 Area 7 Bacteriological Examination of Cups and Glasses 31, 32 Bakehouses 32 Bed Bugs, Eradication of 20, 21 Bedding, Disinfection of 15 Birth Rates 8, 10, 14 Births, Illegitimate 8 — In Institutions 9 — Live 8 — Still 8 Blindness, Prevention of 45 Books disinfected, Library 15 Cancer 46, 47 — Deaths from 8, 46, 47 Caravans 20 Causes of Deaths 11-13 Chief Sanitary Inspector's Report 22-25 — — Inspector, Visits by 22 Cleansing, Public 20 Clinics 17, 18 Closet Accommodation 20 Committees, Members of Health 5 Cups and Glasses, Examination of 31, 32 Dairies 33 Day Nursery 19 Death Rates 8, 10, 14 Deaths 8,10-14,46-49 Dental Clinics 17 Diarrhoea and Enteritis 44 — — — — Deaths from 8 52 « page Diphtheria 42 Diphtheria Immunisation 42, 43 — — Clinics 18 Disinfection 15, 39 Encephalitis Lethargica 45 Enteric Fever 44 Eradication of Bed Bugs 20, 21 Erysipelas 45 Factories Act, 1937 35-38 — — — Defects found 36 — — — Inspections 35 — — — (Sections 110 and 111) Outwork 37, 38 Food and Drugs Act, 1938 29, 30 — — — — Section 13 34 — — — — Section 14 28 — Dealt with, Unsound 24, 25 — Inspection and Supervision of 28-34 — Preparing Factories 33 — Campaign, Clean 28 — Poisoning 45 — — Case Rates 14 General Provision of Health Services for the Area 15-19 Health Visiting 19 Home Help Service 19 Hospitals 15, 16 Houses, Disinfection of 15 — Inhabited 7, 25 — Inspection of Dwellig 26, 27 Housing Act, 1936 (Sections 9, 10 and 16) 26 — — — (Section 11) 27 — — — (Section 12) 27 — Statistics 25-27 Ice Cream 30 — — Samples 31 Immunisation and Vaccination Clinics 18 — Diphtheria 42, 43 Infant Mortality 8, 10, 11 53 page Infectious Disease Case Rates 14 — — Contacts 39 — — Hospitals 16 Infectious Disease, Monthly Incidence of 40 — — Notifications 39, 41 — — — School 46 — — Sanitary Inspectors' Visits 39 Influenza 45 Inquests 11, 12 Inspection and Supervision of Food 28-34 Laboratory Facilities 15 Legal Proceedings 24 Library Books, Disinfection of 15 Maternal Mortality 8, 11, 13 Maternity, Hospital Treatment 16 Measles, Case Rates 14 — Deaths from 8, 13 Meat Inspection 33 Meningococcal Infection 45 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 and 1950 32 Milk (Special Designation) (Raw Milk) Regulations, 1949 and 1950 32 Mortality, Analysis of 14 National Assistance Act, 1948, Section 47 19 N.S.P.C.C 19 Notification, Infectious Disease 14, 39, 40,41 — School 46 Nursery, Day 19 Ophthalmia Neonatorum 45 Outworkers (Sections 110 and 111—Factories Act, 1937) 37, 38 Persons in Need of Care and Attention 19 Pests Act, 1949, Prevention of Destruction by 21 Pet Animals Act, 1951 34 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929 24 54 page Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Carbide of Calcium) Order, 1929 24 Piggeries 34 Pneumonia 45 Poisoning, Food 45 Poliomyelitis 45 Population 7 Post-Natal Clinic 17 Public Cleansing 20 Puerperal Pyrexia 45 Public Analyst 15 Radiography, Miniature Mass 49, 50 Rateable Value 7 Rent and Mortgage Interest (Restrictions) Act, 1920/1938 27 Rivers and Streams 20 Rodent Operations 21 Rooms Disinfected, Number of 15, 39 Samples, Food 29-32 Sanitary Circumstances of the Are 20, 21 — Inspectors, Chief's Report 22-25 Scarlet Fever 42 Schools 21 — Notifications 46 Slaughterhouses 33 Slaughter of Animals Act, 1933 33 Smallpox 42 — Vaccination Clinics 18 — Hospital 16 Social Conditions 7, 8 Staff 6 Statistics 7-14 — Housing 25-27 — Vital 7 Still Births 8 Supervision of Food, Inspection and 28-34 Swabs, Tea Cups 31, 32 55 page Tuberculosis 47-49 — Care Committee 50 — Clinic 16 Unsound Food dealt with 24, 25 Venereal Diseases Clinics 16 Visits by Sanitary Inspectors 22, 23, 39 Vital Statistics 7 Water Supply 20 Welfare Clinics 17 Whooping Cough, Deaths from 8 — — Immunisation 43, 44 135