AC. 4413(1) BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1960 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1960 MITCHAM H. G. Mather, Ltd., Caxton Works, Lower Green. 3 Borough of Mitcham HEALTH REPORT FOR 1960 To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1960. The general health in the Borough has been good and there was no special outbreak of infectious disease. The notifications of infectious diseases were 338 compared with 1,000 in 1959. The decrease was mainly due to measles for which 1960 was a year of low incidence. There were no cases of poliomyelitis and I think it can safely be said that this is due to the beneficial effect of polio immunisation. The downward trend for England and Wales has continued for some years now. Whooping cough notifications rose to 118 after two years of very low figures. The tuberculosis death rate at 0.05 compares with 0.07 per 1,000 population for England and Wales. Notifications were 17 compared with 28 for the previous year. This is the first time that annual notifications have dropped below 20. Ten years ago there were more than 100 each year. Dysentery was notified in 6 cases as against 10 for 1959. There were no cases of enteric fever. The birth rate of 14.87 per 1,000 population becomes, after correction by the comparability factor, 14.42 compared with 17.1 for England and Wales. It is the highest in Mitcham since 1949. 4 The death rate of 9.35 becomes, after correction by the comparability factor, 11.12 per 1,000 population, against 11.5 for England and Wales. It is almost invariably below that of England and Wales. The death rate from cancer for Mitcham in 1960 stayed the same at 2.25 while that for England and Wales increased from 2.14 to 2.16 per 1,000 population. As regards infant mortality the local rate was 22.26 and the rate for England and Wales, 21.9 per 1,000 live births, the lowest ever recorded. The meals-on-wheels service, run by the W.V.S., continues to be appreciated in supplying hot meals to the house bound and also to able-bodied old people who attend the Old People's Welfare Centre in London Road. I wish to thank the Chairmen of the Committees for their unfailing 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 of Health. Public Health Department, Mitcham Court, Mitcham. 5 BOROUGH OF MITCHAM PUBLIC HEALTH COMMITTEE Chairman Alderman Mrs. J. C. Ericson The Worshipful the Mayor (Councillor Mrs. Evelyn G. Baker, J.P.) Aldermen— Mrs. L. Crump G. W. Pearce Councillors— E. E. Field A. S. Hutchin E. J. Mills E. E. Mount D. A. Small Mrs. J. E. Spalding W. Whittaker Representatives of the Council on Other Authorities: WANDLE VALLEY JOINT SEWERAGE BOARD The Worshipful the Mayor (Councillor Mrs. Evelyn G. Baker, J.P.) (ex-officio) Alderman T. J. Higgs Councillors— D. J. Hempstead L. A. Cobb NORTH-EAST DIVISIONAL HEALTH SUB-COMMITTEE (SURREY COUNTY COUNCIL) The Worshipful the Mayor (Councillor Mrs. Evelyn G. Baker, J.P.) Alderman G. W. Pearce Councillors— D. A. Small R. Taylor W. E. M. Townsend 6 STAFF Medical Officer of Health A. R. Graham, M.B., Ch.B., D.P.H., Barrister-at-Law Chief Public Health and Meat Inspector Petroleum Inspector Shops Act Inspector K. J. Gutteridge (1, 2) Assistant Public Health and Meat Inspectors L. Gleed (1, 2, 3) E. J. Sluis (1, 2) J. E. Higgs (1, 2) (a) Pupil Public Health Inspector C. S. Smith 1. Certificate R.S.H. and Public Health Inspectors' Examination Joint Board. 2. Certificate Meat and Foods R.S.H. 3. Smoke Inspector's Certificate. Clerks (b) Chief Clerk and Administrative Assistant—F. H. White (c) Senior Clerk—F. G. Taylor (d) Secretary—Miss V. I. Hill (e) Mrs. M. Drewett (e) Mrs. K. North. (a) Resigned 11th September, 1960. (b) 75 per cent. Surrey County Council duties. (c) 25 per cent. Surrey County Council duties. (d) 20 per cent. Surrey County Council duties. (e) 40 per cent. Surrey County Council duties. 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, 1960 64,090 Density of Population, 1951 22.9 persons per acre Number of inhabited houses, 1921 7,150 „ „ „ 1931 13,187 „ „ „1960 19,650 Rateable Value, 1960 £1,112,489 Sum represented by a Id. rate £4,540 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 fairly flat and low lying, 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. There was practically full employment during the year with perhaps a greater turnover than usual. 8 There were vacancies in all classes of work for those willing and able. Mitcham is chiefly a working class area. Nearly two-thirds of the houses have been built since 1921 and more than 50 per cent, of all roads are tree-lined. Virtually no building land is available except for the £2} million Phipps Bridge scheme on which preliminary work has been done. STATISTICS Live Births. Total Male Female Rate per 1,000 of population. Legitimate 914 452 462 Illegitimate 39 18 21 Total 953 470 483 14.87 After correction by the comparability factor becomes 14.42 Illegitimate live births per cent. of total live births 4.27 Still Births. Total Male Female Rate per 1,000 total births Legitimate 17 7 10 Illegitimate 1 — 1 Total 18 7 11 18.54 Deaths. Total Male Female Rate per 1,000 of population 599 310 289 9.35 After correction by the comparability factor becomes 11.12 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 22.26 Legitimate infants per 1,000 live legitimate births 20.79 Illegitimate infants per 1,000 live illegitimate births 51.28 9 Deaths from: — Cancer (all ages) 144 Measles – Whooping cough (all ages) – Enteritis and Diarrhoea under two years of age – Percentage of Births Occurring in Institutions Year Total births Births in hospitals, etc. Percentage of births occurring in institutions 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 1955 869 628 72.28 1956 888 661 74.44 1957 899 650 72.22 1958 944 670 70.97 1959 859 604 70.32 1960 971 704 72.5 10 The birth rates, death rates per 1,000 of population, and the infant mortality rates for the years 1941-1960 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 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 comparability factor to correspond with the average age and sex distributions 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 1955 12.40 15.0 10.81 11.7 15.20 24.9 1956 12.91 15.7 11.49 11.7 13.73 23.8 1957 13.05 16.1 11.07 11.5 12.36 23.0 1958 13.91 16.4 11.48 11.7 20.48 22.5 1959 12.76 16.5 12.6 11.6 14.17 22.2 1960 14.42 17.1 11.12 11.5 22.26 21.9 11 Infant Mortality During the year 21 deaths were registered of infants under one year of age: — Males Females Total Legitimate 9 10 19 Illegitimate 2 — 2 Total 11 10 21 as compared with 12 deaths last year. Deaths of Infants under One Year of Age The following table shows the principal causes of death in the various age groups:— Age No. Cause of Death Prematurity Congenital Defects Accidents of birth Infectious conditions Other conditions Under 24 hrs 5 3 2 — — — 1-7 days 10 3 2 — — 5 8 days - 1 mth. 3 — 1 — — 2 1 mth.-12 rnths. 3 — 2 — — 1 Total 21 6 7 — — 8 Eighteen infants failed to survive the first month of life, giving Mitcham a neo-natal mortality rate of 18.89 per 1,000 related live births as compared with 15.6 for England and Wales. Maternal Mortality For the fifth successive year, no deaths were registered. Inquests Inquests were held on 13 residents dying within the district and on 17 Mitcham residents who died outside the district, a total of 30. In addition, post-mortems without inquests were held on 87 residents 12 dying within the district, and on 68 Mitcham residents who died outside the district, a total of 155. The following table shows the results of the findings of these inquests: — Accidental death 18 Death from misadventure 2 Suicide 6 Open verdict 1 Natural causes 2 Resulting from the operations of war 1 Total 30 13 Deaths Registered During the Year 1960 Cause of Death Males Females Total 1 Tuberculosis, respiratory 3 … 3 2 Tuberculosis, other … … … 3 Syphilitic disease 2 … 2 4 Diphtheria … … … 5 Whooping cough … … … 6 Meningococcal infections … … … 7 Acute Poliomyelitis … … … 8 Measles … … … 9 Other infective and parasitic diseases 2 1 … 10 Malignant neoplasm, stomach 9 7 16 11 Malignant neoplasm, lung, bronchus 31 5 36 12 Malignant neoplasm, breast 1 18 19 13 Malignant neoplasm, uterus … 4 4 14 Other malignant and lymphatic neoplasms 31 30 61 15 Leukæmia, aleukæmia 5 3 8 16 Diabetes 1 2 3 17 Vascular lesions of nervous system 27 47 74 18 Coronary disease, angina 79 46 125 19 Hypertension with heart disease 2 9 11 20 Other heart disease 14 31 45 21 Other circulatory disease 9 22 31 22 Influenza … 1 1 23 Pneumonia 16 11 27 24 Bronchitis 21 6 27 25 Other diseases of respiratory system 4 1 5 26 Ulcer of stomach and duodenum 2 2 4 27 Gastritis, enteritis and diarrhœa 4 2 6 28 Nephritis and nephrosis 2 1 3 29 Hyperplasia of prostate 5 … 5 30 Pregnancy, childbirth, abortion … … … 31 Congenital malformations 6 4 10 32 Other defined and ill-defined diseases 18 27 45 33 Motor vehicle accidents 3 1 4 34 All other accidents 8 6 14 35 Suicide 4 2 6 36 Homicide and operations of war 1 … 1 All causes 310 289 599 14 Birth Rates, Death Rates, Analysis of Mortality and Notifications of Infectious Diseases in the Year 1960 England and Wales Mitcham Rates per 1,000 home population Births— Live 17.1 14.42 Still 0.34 0.29 19.7 18.54* Deaths— All causes 11.5 11.12 Malignant neoplasm—lung, bronchus 0.48 0.56 Whooping cough 0.001 … Diphtheria … … Tuberculosis—all forms 0.07 0.05 Influenza 0.02 0 015 Acute Poliomyelitis … … Pneumonia 0.55 0.42 Coronary disease—angina pectoris 2.01 1.95 Maternal mortality 0.39* …* Notifications (Corrected)— Scarlet Fever 0.703 0.374 Whooping Cough 1.270 1.841 Diphtheria 0.001 … Measles 3.482 2.53 Acute Poliomyelitis— Paralytic 0.006 … Non-Paralytic 0.003 … Enteric or Typhoid Fever 0.002 … Para-typhoid Fever 0.005 … Meningococcal Infection 0.014 0.016 Erysipelas 0.065 0.078 Dysentery 0.946 0.094 Acute Encephalitis— Infective 0.003 … Post-Infectious 0.003 … Acute Pneumonia 0.318 0.156 Food Poisoning 0.169 0.094 Tuberculosis— Respiratory 0.462 0.234 Non-Respiratory 0.058 0.031 * 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.I. AMBULANCES The Ambulance service is supervised by the Surrey County Council. The ambulances operate from the Ambulance Control Station, Hill House, Bishopsford Road, Morden (Telephone: MAL 7733). DISINFECTION The disinfection of houses is undertaken by the Council. Disinfection of bedding, etc., is done either at the Wandle Valley Isolation Hospital, or in the home. 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 1 Number of rooms disinfected by fumigator 38 Number of library books disinfected 413 HOSPITALS The hospitals directly concerned with the Mitcham area are administered by the St. Helier Group Hospital Management Committee, which is situated at Carshalton, Surrey, and itself comes under the South-West Metropolitan Regional Hospital Board. 16 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 St. Georges Hospital, Tooting. Smallpox Cases.—By agreement with the South-East Metropolitan Regional Hospital Board, any cases that might occur would be 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, or occasionally to other hospitals such as the Nelson Hospital, Kingston Road, Merton, S.W.20. 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 Cumberland Hospital, Mitcham, every Monday and Wednesday afternoon and Thursday morning. A clinic is held for old cases only, on every fourth Thursday at 5 p.m. The Cumberland Hospital, which has 100 beds available, deals principally with tuberculosis although an increasing number of other chest diseases are dealt with. 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. CLINICS AND TREATMENT CENTRES (Under control of the Surrey County Council) Ante-Natal Clinics An ante-natal session is held at the Church Road Clinic every Tuesday, and a clinic for cases booked by midwives is held on Tuesday and Friday afternoons. 17 Ante-natal supervision for some St. Helier bookings is undertaken at Mitcham clinics. An ante-natal session is held at the Cavendish Road Clinic every second and fourth Friday afternoon of the month. An ante-natal session is held at Wide Way Clinic on Friday mornings, and on Wednesday afternoons for cases booked by midwives. X-Ray examinations necessary for expectant mothers are carried out at the Wilson and St. Helier Hospitals. Child Welfare Clinics Infant Welfare sessions are held at the following places: — Cavendish Road Clinic.—Every Monday afternoon. St. Barnabas Church Hall, Gorringe Park Avenue.—Every Tuesday afternoon. Wide Way Clinic.—Every Thursday morning and Monday afternoon. Church Road Clinic.—Every Thursday afternoon and Wednesday afternoon. Meopham Road Clinic.—Every 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. Child Guidance Clinic This is held on four days a week, at Sherwood House, by appointment. More sessions had to be allocated this year because of the increasing number of cases requiring treatment. It has the services of a psychiatrist, a psychologist and a social worker. 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 Western Road, Mitcham.—Every weekday morning and afternoon. Church Road, Mitcham.—Every weekday morning and afternoon. Meopham Road.—Every weekday morning and afternoon. Diphtheria, Whooping Cough, Tetanus and Poliomyelitis Immunisation. Vaccination against Smallpox 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. Wide Way Clinic.—Each Monday afternoon (immunisation only—in conjunction with Welfare Clinic), each Thursday morning (immunisation and vaccination in conjunction with Welfare Clinic), and each Wednesday morning. Poliomyelitis Immunisation A large number of sessions are held in schools and a large number on Saturday mornings and Tuesday evenings in rotation at the various clinics, for children and adults. Minor Ailments Sessions are 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; at Wide Way Clinic on Wednesday mornings, with a doctor in attendance. Mothercraft Classes Wide Way Clinic.—Thursday, 2 p.m. Church Road Clinic.—Friday, 9.30 a.m. Cavendish Road Clinic.—Thursday, 2 p.m. 19 Ophthalmic Clinic An eye specialist attends Western Road Clinic on Thursday mornings and Wednesday afternoons, and Wide Way Clinic on the 1st, 3rd and 5th Tuesdays of the month, in the morning. Parentcraft Circle Church Road Clinic.—Monday, 3 p.m. Post-Natal Clinic The post-natal clinics at Church Road, Cavendish Road and Wide Way are held in conjunction with the ante-natal clinics. Speech Clinic A session is held at Western Road Clinic on Tuesday (all day), and Thursday (all day). A speech therapist also holds a session at Wide Way Clinic on Friday afternoons. U.V. Radiation Clinics Sessions are held during the winter months, as follows: — Church Road Clinic.—Thursday mornings and Monday afternoons. Wide Way Clinic.—Tuesday afternoons, Friday afternoons. Health Visiting Health Visitors are under the control of the Surrey County Council. There are nine Health Visitors, who are 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. Over 80 parttime workers are usually employed. Enough workers can not be obtained to satisfy the full demand. 20 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 1960 50 Number of children affected 133 Number of visits paid 318 National Assistance Act, 1948: Section 47 National Assistance (Amendment) Act, 1951 Removal to Suitable Premises of Persons in Need of Care and Attention There were no cases in this category. 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 four licensed caravan yards, each with a stand pipe, supplying altogether a total of 14 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 21 in the roof. Provided the tank is properly covered and is cleansed regularly, it provides a satisfactory supply. SWIMMING BATHS The only swimming bath in the district is the public bath in London Road, which is owned by the Corporation. Water is from the mains supply and the modern process of continuous circulation through a filter plant with chlorination is used. The water was sampled periodically and found to be satisfactory. 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 bouses being drained to the public sewer, then treated at the works of the Wandle Valley Joint Sewerage Board, situated in Mitcham. PUBLIC CLEANSING In the winter a weekly collection of house refuse is carried out and in the summer more frequently. Ten refuse collection vehicles are in use. CLEAN AIR ACT, 1956 There are no Smoke Control Areas as yet, as the time is not considered appropriate. The position in Mitcham is to be reviewed from time to time taking into account the progress in neighbouring areas. ERADICATION OF BED BUGS Number of Council houses found infested during the year, 22. Number of other houses found infested during the year, 2. Total number of houses disinfested during the year, 24. 22 Methods employed: — 24 houses treated with insecticide spray. Number of houses disinfested of beetles, 56. Number of houses disinfested of other insects, 9. 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 public health 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 cases of certain infectious diseases 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 the reason. PREVENTION OF DAMAGE BY PESTS ACT, 1949 Two full-time and one part-time Rodent Operators were employed. Properties inspected 2,958 Complaints received 680 Number of treatments re rat infestation, including test baits, as result of inspection and complaints 776 Factory and business premises treated 138 Visits by Public Health Inspectors 90 Two sewer maintenance treatments were carried out in the year; 212 manholes were baited. A total of 63 baits were taken compared with 10 taken in 1959. 23 THE ANNUAL REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I beg to submit a summary of the visits and works carried out in the Borough by myself and the District Public Health Inspectors: — Complaints received 395 Nuisances found 289 Verbal Notices given 99 Verbal Notices complied with 69 Informal Notices served 204 Informal Notices complied with 144 Statutory Notices served 70 Statutory Notices complied with 62 Revisits 1,247 Houses inspected for defects 722 Visits made for this purpose 782 Drains tested and inspected 130 Private houses found verminous 3 Visits to butchers 175 Visits to slaughterhouses 755 Visits to dairies 16 Visits to retail milk shops 32 Visits to restaurant kitchens 249 Visits to ice-cream premises 40 Visits to bakehouses 44 Visits to other food premises 989 Number of notices served under Food Hygiene Regulations, 1955 4 Number of notices complied with 4 Visits to factories 211 Visits to workplaces 11 Visits to outworkers 69 Visits to stables 56 Visits to piggeries 30 24 Visits to caravan yards 228 Smoke observations 39 Visits re infectious disease cases 62 Visits re smallpox contacts – Visits re food poisoning 19 Visits re rats and mice 90 Visits re Shops Acts 46 Visits re schools 18 Visits re Rent Act, 1957 61 Visits to refuse tipping site, Mitcham Common 31 Visits to sewage works 12 Sundry visits 402 Character of Work Done Roofs repaired 72 Rainwater piping or gutters repaired or renewed 61 Yards paved or repaired 11 Dampness remedied 77 Water service pipes repaired 13 Waterclosets: Repairs to structure 4 Flushing apparatus repaired or renewed 22 New pans and traps fitted 7 Water storage cisterns cleansed, repaired or renewed 5 Water supply reinstated 5 Flooring of rooms repaired and sub-floor ventilation improved 33 Rooms cleansed – Sinks and handbasins repaired or renewed 5 Waste pipes and traps repaired or renewed 14 Window frames and sashes repaired or renewed 41 Window sills repaired or renewed 22 External brickwork (repaired, pointed or rendered) 11 Drains repaired or obstructions removed 87 Drains inspection covers renewed 18 Drains tested 43 Grid and mica flaps provided 3 Firegrates repaired (including surrounds and hearths) 8 Stoves, coppers, ranges, etc., repaired 2 25 Chimney stacks repaired 7 Staircases repaired 10 Doors repaired 11 Internal plaster repairs 79 Sash cords renewed 45 Dustbins provided 22 Accumulations removed 17 All ponds and ditches in the Borough where mosquito breeding was likely were sprayed with insecticide twice during the year and larger areas where mosquitoes were found to be breeding but spraying was impracticable, were treated with a fog generating apparatus with satisfactory results. Disinfestation of dust chutes at the Council's blocks of flats was carried out by means of the high pressure fogging apparatus which was most effective: all school canteens were similarly treated. LEGAL PROCEEDINGS Public Health Act, 1936.— A summons was issued against the occupier of a caravan on vacant land in Queen's Road, under Section 269 of the above Act. At the hearing at Wallington on 28th January, 1960, the Court imposed a fine of £5 and awarded the Council £2 2s. costs. Summonses were issued against the occupiers of caravans on vacant land in Bath Road and on Rock Terrace Recreation Ground. At the hearing on 25th February, 1960, the Court imposed fines of £20 and £1 respectively. A summons was issued against the occupier of a caravan on vacant land in Queen's Road for the enforcement of penalties for failing to remove her caravan. At the hearing at Wallington on 24th March, 1960, the Court imposed a fine of £15. Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929.—99 licences to store petroleum spirit and/or petroleum mixtures were issued for a total of 253,795 gallons (inclusive of cellulose solutions). 26 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Carbide of Calcium) Order, 1929.—Two licences were issued for the storage of 1,224 lbs. of carbide of calcium. Unsound Food Dealt With Beef 92 lbs. Pork 30 lbs. Ham 743 „ Fish 6 stone Corned beef 36 „ Stewed steak 5 tins Pork luncheon meat 113½ „ Ox head 1 Liver 30 „ Vinegar 45 btls. Jellied veal 12 „ Assorted 188 tins Yours faithfully, K. J. GUTTERIDGE, Chief Public Health Inspector. HOUSING STATISTICS Total Number of Inhabited Houses—19,950. Permanent buildings built by the Council before the war—1,461. Permanent buildings built by the Council after the war—2,343. Other Housing Accommodation Available:— A. Sundry properties 226 B. Temporary buildings, Arcon bungalows 345 Therefore, total number of properties used for housing by the Mitcham Borough Council is 4,376 Number of People Rehoused About 10,800 applicants have registered since 1945, and the current list is still about 1,000, so that some 9,800 applicants have been dealt with. About 159 cottage flats or bungalows have been built for old people since the war. All the hutments have now been cleared. Rent Act, 1957 Twenty applications were made for Certificates of Disrepair during the year. In one case it was decided not to issue a certificate, 27 in 11 cases undertakings were given by the various landlords and in the remaining 8 cases certificates were issued. Five certificates were cancelled during the year on application by landlords, the works specified having been completed. In four cases cancellation was refused as the work had not been satisfactorily completed. INSPECTION AND SUPERVISION OF FOOD One thousand five hundred and forty-five inspections were made of food premises other than slaughterhouses. The premises were on the whole satisfactory with some minor adjustments necessary. Food premises by type of business. General Stores 15 Groceries 82 Butchers 36 Greengrocer & Fruiterers 62 Greengrocer & General Provisions 2 Confectionery 69 Chemists 15 Restaurants & Cafes 32 Cafe & General Stores 1 Roadside Snack Bars 2 Fishmongers 10 Fried Fish Buffets 6 Fried Fish 1 Bakers and Confectioners 14 Milk & Provisions 13 Public Houses 30 Off-Licences 10 Food premises by type, registered under Section 16, Food and Drugs Act, 1955. The storage and sale of ice-cream 166 The manufacture for sale of ice-cream 1 The preparation or manufacture of sausages, or potted, pressed, pickled or preserved food 38 Dairies registered under the Milk and Dairies (General) Regulations, 1959 1 Number of inspections of registered food premises during the year 303 All condemned food is either incinerated at the Refuse Destructor, Garth Road, Morden, by arrangement with the Merton and Morden Urban District Council, or treated with dye and disposed of to fat and bone merchants. 28 FOOD AND DRUGS ACT, 1955 Formal Samples. Sixty-eight formal samples were taken as follows: — Milk 41 Arrowroot 1 Pink Salmon 1 Salmon Fish Cakes 1 Confectionery 4 Cream of Asparagus 1 Bronchial Mixture 1 Margarine 1 Pork Sausages 4 Dairy Butter 1 Lard 1 Beef Sausages 2 Ice Cream 1 Frankfurters 1 Marmalade 1 Christmas Pudding 1 Margarine (10% Butter) 1 Butter 1 Cheese Spread 1 Sterilised Cream 1 Almond Marzipan 1 Informal Samples. One hundred and one informal samples were taken as follows: — Jelly Cream 1 Cheese Spread 4 Grated Cheese 1 Milk Chocolate Covered Slices 1 Milk Food Drink 1 Strawberry Jam 3 Casserole Meat 1 Boneless Chicken 1 Mixed Dried Fruit 1 Tomato Puree 1 Mixed Vegetables 1 Sponge Drops 1 Stewed Steak 4 Sardines in Pure Olive Oil 1 White Pepper 1 Horseradish Sauce 1 Chocolate Covered Swiss Roll 1 Garibaldi Biscuits 1 Desiccated Coconut 1 Aspirin Tablets 1 Baby Soup (Chicken Variety) 1 Coffee and Chicory Mixture 1 Double Cream 1 Beef Steak with Gravy 1 Salmon Spread 1 Instant Coffee 1 Orange Crush 1 Glucose Drink with Lemon 1 Self Raising Flour 3 Madeira Cake Mix 1 Variety Cheese Pack 2 Luncheon Meat 2 Irish Stew 2 Minced Meat Loaf 2 29 Dairy Cream Sponge 1 Lemon Fruit Drink 1 Blackcurrant Drink 1 Fish Paste (Sardine & Tomato) 1 Milk (Half-Pint Carton) 1 Cream of Chicken Soup 1 Sweet Bake (Pudding) 1 Fruit Sauce 1 Curry Powder 1 Orange Drink 1 Minced Beef with Gravy 1 Spaghetti Bolognaise 2 Stuffed Pork Roll 1 Custard Powder 1 Farmhouse Onions 1 Pork Sausages 1 Tomato Flavouring 1 Fruit Pastilles 1 Beef Suet 1 Butter 1 Danish Blue Cheese 1 Caerphilly Cheese 1 Beef Steak Pudding 1 Fruit Salad 2 Cashew Nuts 1 Seafood 1 Corned Beef 1 Lemon Juice 1 Evaporated Milk 2 Pineapple Flavour 1 Chicken Noodle Soup 1 Ball Chewing Gum 1 Raising Powder 1 Ginger Bun Mixture 1 Chiffon Lemon Mixture 1 Gravy Powder 1 Food Beverage 1 Ground Nut Cooking Oil 1 Bedtime Drink 1 Sugared Strands 1 Lemon Flavour 1 Chicken Vol-au-vent 1 Lemon Mousse 1 Primula Crispbread 1 Baked Beans with Pork in Tomato Sauce 1 Milk Caramels 1 Hamburger Patties with Gravy (Fried) 1 Sauce Tartare 1 Natural Yogurt 1 Cocktail Sausages in Brine 1 The following samples were not up to standard and warning letters were sent to the firms concerned: — Formal.—Pork sausages, cream of asparagus soup. Informal.—Milk caramels. Complaints from the public relating to food were as follows: — Two of mouldy meat pies. Three of foreign matter in a loaf. 30 One each of: — Glass in a milk bottle. Mould on chocolate swiss roll. Mouldy veal, ham and egg pie. Nail in toffee. Warning letters were sent to the firms concerned.' Ice-Cream One establishment in the Borough is registered for the manufacture of ice-cream and 166 for the storage and sale of ice-cream. Forty visits were paid during the year. Four samples of ice-cream were taken and examined for bacteriological purity. The results are tabulated below: — Provisional Grade. I II III IV Coliforms absent 2 1 1 — Coliforms present in 1/10th ml — — — — Faecal coli present (in addition to above) – – – – Bacteriological Examination of Cups and Glasses Eighty swabs were taken from tea cups at various catering establishments and fourteen 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 Faecal Coli Result Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 3 60 1 2 62 1 100-200 4 2 — 4 — 6 200-500 3 2 — 3 — 5 500-1,000 4 2 — 4 — 6 1,000-1,500 – – – – – – 1,500-2,000 – – – – – – 2,000 and over – – – – – – Total 14 66 1 13 62 18 31 Beer Glass Swabs. Colony Count (per glass). Coliforms Faecal Coli Result Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 — 9 — — 9 — 100-200 — 1 — — — 1 200-500 1 — 1 — — 1 500-1,000 — — — — — — 1,000-1,500 — — — — — — 1,500-2,000 — — — — — — 2,000 and over 2 1 1 1 — 3 Total 3 11 2 1 9 5 The result of the swabs was sent to the establishments concerned and visits were paid to premises where the results were unsatisfactory. MILK (SPECIAL DESIGNATION) REGULATIONS, 1960 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 45 Sterilised 59 Tuberculin Tested 27 One hundred and forty-two samples of Graded Milk were submitted for bacteriological examination. All were satisfactory. BAKEHOUSES The number of bakehouses in the district is six. Forty-four visits have been paid. DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year sixteen visits of inspection were paid. 32 SLAUGHTERHOUSES There are two licensed slaughterhouses in the borough; 755 visits have been paid. SLAUGHTER OF ANIMALS ACT, 1958 Fifteen licences were issued to slaughtermen in accordance with the requirements of the above Act. MEAT INSPECTION Carcases and Offal Inspected and Condemned in Whole or in Part. Cattle, excluding cows Cows Calves Sheep and Lambs Pigs Number killed (if known) 117 11 4258 2231 12,017 Number Inspected 117 11 4258 2231 12,017 All diseases except tuberculosis and cysticerci: Whole carcases condemned … … … … 34 Carcases of which some part or organ was condemned 3 … 9 72 911 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 2.56 … 0.198 3.22 7.86 Tuberculosis only: Whole carcases condemned … … … … 6 Carcases of which some part or organ was condemned … … … … 65 Percentage of the number inspected affected with tuberculosis … … … … 0 59 FOOD PREPARING FACTORIES There are 17 factories which are engaged in the manufacture and preparation of food products. All of these are systematically visited. 33 INFORMAL ACTION TAKEN UNDER THE FOOD HYGIENE (GENERAL) REGULATIONS, 1960 Number of notices served, 4. Number of notices complied with, 4. PIGGERIES There are six piggeries in the Borough. Thirty visits were paid during the year. PET ANIMALS ACT, 1951 Four licences were issued to occupiers of pet shops. 34 FACTORIES ACT, 1937 I.—Inspections for purposes of provisions as to health (including inspections made by Public Health 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 11 8 … … 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 338 187 … … 2 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 3 … … … … 3 TOTAL … 349 195 … … … 35 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 1 2 … 1 … 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 … … … … … 9 (b) Unsuitable or defective 10 … 1 … 1 … 10 (c) Not separate for sexes 11 … … … … … 11 Other offences (not including offences relating to Homework) 12 3 3 … … … 12 TOTAL … 4 6 … 2 … … 36 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 64 13 Cleaning and washing 14 14 Household linen 15 3 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 28 37 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 10 34 Brush making 35 35 Pea picking 36 36 Feather sorting 37 37 Carding, etc., of buttons, etc. 38 2 38 Stuffed toys 39 1 39 Basket making 40 40 Chocolates and sweetmeats 41 41 Cosaques, Christmas crackers, Christmas stockings, etc. 42 14 42 Textile weaving 43 43 Lampshades 44 58 44 TOTAL 152 38 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1960 was 338. Contacts, Suspects, Etc. The Medical Officer of Health is called in consultation by medical practitioners to see patients in their homes, as required. Visits Public Health Inspectors to common infectious diseases 62 Public Health Inspectors to smallpox contacts — Total 62 Rooms disinfected after infectious disease 38 39 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 … 2 … … 1 … … … … … … … 3 1 1 … … … … 8 February … 2 … … 1 1 1 … … … … … ... 2 1 … … … … 8 March … 3 … … 2 3 … … 3 … … … 2 1 1 … … … … 15 April … 7 … … … 1 1 1 … … … … 2 1 … … … … … 13 May … … … … … ... … … 2 … … … 25 22 1 … … … … 50 June … 2 … … … … … … … … … … 45 8 … … … … … 55 July … … … … … … … … … … … … 32 20 1 … … … … 53 August … … … … … 1 … … … … … … 30 13 … … … … … 44 September … 1 … … 1 … … … 1 … … … 6 5 … … … … … 14 October … 3 … … … … … … … 1 … … 5 5 1 … … … … 15 November … 1 … … … 3 3 … … … … … 5 14 … … … … … 26 December … 3 … … … 1 … … … … … … 7 26 … … … … … 37 Totals … 24 … … 5 10 5 1 6 1 … … 162 118 6 … … … … 338 40 Infectious Disease Notifications, 1941/60 Disease 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 1954 1955 1956 1957 1958 1959 1960 Smallpox … … … … … … … … … … … … … … … … … … … … … Scarlet Fever 75 175 212 97 147 95 62 35 57 89 110 111 225 86 47 33 56 18 75 69 24 Diphtheria 72 25 42 10 63 32 4 … 1 1 … … … … … … … … … … … Typhoid Fever … … 1 … 1 … … … … … 1 … … … 1 … 1 … … … … Puerperal Pyrexia 2 6 3 5 8 6 9 3 … 2 … 13 23 11 3 1 … … … … 5 Meningococcal Infections 12 6 8 3 3 1 2 1 1 … 1 3 1 … 2 … 1 … … 1 1 Erysipelas 19 7 22 13 16 25 9 18 6 12 7 8 14 11 6 9 7 4 3 4 5 Measles 194 599 651 112 739 358 533 818 252 354 354 1386 591 888 131 1059 50 1358 172 847 162 Typhus Fever … … … … … … … … … … … … … … … … … … … … … Acute Poliomyelitis: Paralytic … … … … 2 3 11 2 2 6 2 1 4 4 … 4 5 2 … 1 … Non-Paralytic … … … … … … … …… … … … … … 1 … 3 8 1 … … … Ophthalmia Neonatorum 3 10 4 4 … 2 2 6 3 8 2 1 4 … 1 … … … … 2 1 Acute Encephalitis: Infective … 1 … … … … … … … … … … … … … … … … … … … Post-Infectious … … … … … … … … … … … 1 … … … … … 2 … … … Pneumonia 22 20 50 37 33 41 37 30 13 19 28 24 26 27 16 34 19 24 12 22 10 Malaria … … 1 1 … 1 … 1 … … … … 1 … 1 … … … … … … Whooping Cough 186 161 162 166 96 234 216 117 149 212 387 420 112 336 183 167 103 130 45 17 118 Food Poisoning 6 11 … … 5 1 … … … 6 3 4 10 17 12 8 11 4 9 27 6 Dysentery … … 4 67 13 6 1 2 5 7 16 7 16 15 46 17 60 47 8 10 6 Paratyphoid … … … … … 1 2 … … … … 1 … … 1 … 1 … 1 … … Totals 591 1021 1161 515 1126 807 888 1033 490 717 911 1980 1027 1396 450 1335 322 1590 325 1000 338 41 Smallpox No case of smallpox was notified during the year 1960. The last case was in 1932. The following table shows the number vaccinated during the year: — Age at date of vaccination Under 1 1 2-4 5-14 15 or over Total Number vaccinated 643 13 16 3 26 701 Number re-vaccinated 1 1 1 3 46 52 Over the last five years an average of 75 per cent. of the children born each year have been vaccinated. Scarlet Fever The number of cases of scarlet fever notified during the year was 24 as compared with 69 in 1959, equivalent to a case rate of 0.37 per 1,000 population. This disease has continued mild in character. Of the total number of cases notified one was treated in hospital and 23 were treated at home. Diphtheria No case of diphtheria was notified for the eleventh year in succession, whereas cases used to average sixty per year. Immunisation and reinforcing doses were available to every 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 triple—diphtheria—whooping cough—tetanus— antigen):— 42  Immunised. Reinforced. Total. Under five years 954 135 1,089 Five to fourteen years 179 985 1,164 Totals 1,133 1,120 2,253 The following figures show the number of the child population considered immunised at 31st December, 1960: — Age at 31.12.60, i.e. born in year Under 1 1960 1 to 4 1959-1956 5 to 9 1955-1951 10 to 14 1950-1946 Under 15 Total Last complete course of injections (whether primary or booster) A. 1956-1960 416 2657 4082 2775 9930 B. 1946-1955 — — 674 1975 2649 C. Estimated mid-year child population 872 3268 9479 13619 Immunity Index 100 A/C 47.7 81.3 72.3 72.9 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. 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 or the triple tetanus, diphtheria, whooping cough antigen): — 43 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 combined vaccines) 809 128 28 29 9 8 1 1004 B. Number of children who received a secondary (reinforcing) injection during 1960 — — 1 3 71 70 2 147 Poliomyelitis There were no cases of poliomyelitis during the year. The immunisation campaign was undoubtedly responsible for the diminishing number of cases. For England and Wales the number of cases goes down considerably year by year. Polio Vaccination The scheme now includes all up to 40 years of age. Those over 40 may be inoculated by private practitioners commencing 1.1.61. Numbers vaccinated in 1960 Primary courses Third injections 0-17 years 899 1,721 Over 17 years 2,941 3,535 The total number inoculated since the inception of the scheme is 20,412, which includes 13,534 children or 84 per cent. of the estimated child population. Clinics are now held on Tuesday evenings, 5—7 p.m., in rotation at the various clinics. Enteric Fever There were no cases of enteric fever during the year. 44 Diarrhœa and Enteritis Under Two Years of Age No death was registered during the year. Food Poisoning Outbreaks There were six notified cases in 1960 and a further 43 cases occurred in a factory. The six notifications were all of single cases, the illness being caused by S. Typhimurium in three cases and S. Kotbuss in one. In the remaining two cases the agent could not be identified. In the factory outbreak the cause was CI. Welchii. It was thought to be due to infected fresh meat that was cooked, not eaten at the time, and subsequently reheated. Encephalitis Lethargica There were no cases notified during the year. Erysipelas Five cases were notified. None was removed to hospital. Puerperal Pyrexia There were five cases of puerperal pyrexia during the year. Pneumonia Ten 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 27, of which 16 were males and 11 females. Meningococcal Infections One case was notified during the year. Influenza There was only one death from influenza, compared with seven last year. Ophthalmia Neonatorum During the year one case of ophthalmia neonatorum was notified. 45 Prevention of Blindness This comes under the control of the Surrey County Council. School Notifications The school intimation notices of infectious disease are 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 111 Mumps 354 Ringworm — Rubella 2 Impetigo 1 Jaundice — Influenza 1 Glandular fever 1 Cancer The number of deaths from cancer registered during the year was 144, of which 77 were males and 67 females. The trend for England and Wales is continuing upwards. The site distribution for 1960 was as follows: — Stomach 16 cases Respiratory organs 36 „ Breast 19 „ Genito-urinary organs 4 „ Other sites 69 „ Total 144 46 The following table shows the number of deaths from cancer, together with the death rate as compared with England and Wales: — Year. Number of Deaths. Death Rate per 1,000 of population Mitcham. England and Wales. 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 1ll 1.67 1.85 1949 124 1.85 1.87 1950 102 1.51 1.89 Year. Number of Deaths. Death Rate per 1,000 of population Mitcham. England and Wales. 1951 108 1.61 1.90 1952 128 1.91 1.94 1953 129 1.94 1.95 1954 108 1.64 2.04 1955 132 2.02 2.06 1956 135 2.08 2.07 1957 134 2.06 2.09 1958 122 1.89 2.12 1959 145 2.25 2.14 1960 144 2.25 2.16 Tuberculosis During the year 17 new cases of tuberculosis were notified, viz: — Males Females Total Pulmonary 8 7 15 Non-Pulmonary 1 1 2 Totals 9 8 17 Twenty-three cases were transferred into the Borough as follows: — 47  Males Females Total Pulmonary 12 11 23 Non-Pulmonary — — — Totals 12 11 23 The total number of deaths from tuberculosis was: — Males Females Total Pulmonary 3 — 3 Non-Pulmonary — — — Totals 3 — 3 England and Wales. Mitcham. Death rate from tuberculosis, all forms, per 1,000 population 0.07 0.05 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 „ … … … … … … … … 10 „ „ 14 „ … … … … … … … … 15 19 1 … … … … … … … 20 „ „ 34„ 2 6 1 ... … … … … 35 „ „ 44 „ … … … … … … … … 45 „ 64 „ 3 1 … 1 2 … … … 65 „ and upwards 2 … … … 1 … … … Totals 8 7 1 1 3 … … … 48 New cases coming to the knowledge of the Medical Officer of Health during the year through death returns and posthumous notifications:— Age Periods 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Pulmonary: Males … … … … … … … … … 1 … … … 1 Pulmonary Females … … … … … … … … … … … … … Nil Non-Pulmonary: Males ... ... … … … … … … … … … … … Nil Non-Pulmonary: Females … … … … … … … … … … … … … Nil 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 … … 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 33i per cent. Non-notified tuberculosis deaths 1 Total tuberculosis deaths 3 Miniature Mass Radiography The was no public session by the mass radiography unit at the Vestry Hall in 1960. Instead, the unit was concentrated on factories, and between 80 and 90 per cent. of the factories in Mitcham were 49 visited. The following summary was supplied by the Medical Director of the unit, Dr. F. J. H. Walters: — Male Female Total number examined 1,019 1,325 Pulmonary tuberculosis (active) 3 — Primary lung cancer — — The main non-tuberculous abnormalities revealed were abnormal heart conditions, bacterial and virus infections of the lung and pulmonary fibrosis. The above figures do not apply to Mitcham residents only, as a number of the factory personnel live outside the area. The examination is of value in the early diagnosis and treatment of pulmonary tuberculosis and non-tuberculous abnormalities. Mitcham, Beddington and Wallington Care Committee for Tuberculosis and Diseases of the Chest Functions of the Committee 1. To alleviate want or distress amongst those suffering from tuberculosis and diseases of the chest, 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. 50 INDEX page Abortion, Deaths 8, 13 Ambulances 15 Ante-Natal Clinics 16, 17 Area 7 Bacteriological Examination of Cups and Glasses 30, 31 Bakehouses 31 Bed Bugs, Eradication of 21 Bedding, Disinfection of 15 Birth Rates 8, 10, 14 Births, Illegitimate 8 — In Institutions 9 — Live 8 — Still 8 Blindness, Prevention of 45 Cancer 45, 46 — Deaths from 9, 45, 46 Caravans 20 Causes of Deaths 9, 11-14 Chief Public Health Inspector's Report 23-26 Inspector, Visits by 23, 24 Clean Air Act 21 Cleansing, Public 21 Clinics, 16-19 Closet Accommodation 21 Committees, Health, Members of Dairies 31 Day Nursery 8, 10, 11, 14 Deaths 8-14 Dental Clinics 17 Diarrhoea and Enteritis 9, 44 Diphtheria 41 Diphtheria Immunisation 41, 42 — Clinics 18 51 PAGE Disinfection 15, 38 Encephalitis Lethargica 44 Enteric Fever 42 Erysipelas 44 Factories Act, 1937 34-35 — — — Defects found 35 — — — Inspections 34 — — — (Sections 110 and 111) Outwork 36, 37 Food and Drugs Act, 1955 28-30 — — — — Section 16 27 — Hygiene, General Regulations, 1960 33 — Dealt with, Unsound 26 — Inspection and Supervision of 27-32 — Preparing Factories 32 — Poisoning 44 — — Case Rates 14 — Sampling 28-30 General Provision of Health Services for the Area 15-20 Health Visiting 19 Home Help Service 19 Hospitals 15, 16 Houses, Disinfection of 15 — Inhabited 7, 26 Housing Statistics 25, 26 Ice Cream. 30 Immunisation and Vaccination Clinics 18 — Diphtheria 41, 42 — Poliomyelitis 43 — Whooping Cough 42 Infant Mortality 8, 10, 11 Infectious Disease Case Rates 14 — — Contacts 38 — — Hospitals 16 — — Monthly Incidence of 39 — — Notifications 39-44 — — — School 45 — — Public Health Inspector's Visits 38 52 PAGE Influenza 44 Inquests 11, 12 Laboratory Facilities 15 Legal Proceedings 25 Library Books, Disinfection of 15 Maternal Mortality 8, 11, 13 Maternity, Hospital Treatment 16 Measles, Case Rates 14 — Deaths from 9, 13 Meat Inspection 32 Meningococcal Infection 44 Milk (Special Designation) Regulations 30 Mortality, Analysis of 14 National Assistance Act, 1948, Section 47 20 N.S.P.C.C. 20 Neonatal mortality 11 Ophthalmia Neonatorum 44 Outworkers (Sections 110 and 111—Factories Act, 1937) 36, 37 Persons in Need of Care and Attention. 20 Pests Act, 1949, Prevention of Damage by 22 Pet Animals Act, 1951 33 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929 25 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum Carbide of Calcium Order, 1929 26 Piggeries 33 Pneumonia 44 Poliomyelitis 43 — Vaccination 43 Population Post-Natal Clinics 19 Public Cleansing 21 Puerperal Pyrexia 44 Public Analyst 15 Radiography, Miniature Mass 48, 49 Rateable Value Rent Act, 1957 26, 27 53 PAGE Rivers and Streams 21 Rodent Operations 22 Rooms Disinfected, Number of 15, 38 Sanitary Circumstances of the Area 20, 21 Scarlet Fever 41 Schools 22 Slaughterhouses 32 Slaughter of Animals Act, 1958 32 Smallpox 41 — Vaccination Clinics 18 — Hospital 16 Social Conditions 7, 8 Staff 6 Statistics 7-1 — Housing 26 — Vita 14 Still Births 8 Tuberculosis 46-48 — Care Committee 49 — Clinic 16 Unsound Food dealt with 26 Venereal Disease Clinic 16 Visits by Public Health Inspectors 23, 24 Water Supply 20 Welfare Clinics 17 Whooping Cough, Deaths from 9, 13, 14 — — Immunisation 41, 42