AC.4413 (1) M.T 30 Library BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1961 BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1961 MITCHAM H. G. Mather, Ltd., Caxton Works, Lower Green, 3 Borough of Mitcham HEALTH REPORT FOR 1961 To the Mayor, Aldermen and Councillors. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year 1961. The general health in the Borough has been good and there was no special outbreak of infectious disease. The notifications of infectious diseases were 960 compared with 338 in 1960. The increase was mainly due to measles for which 1961 was a year of high incidence. There were no cases of poliomyelitis. Since 1957 there has been only one case which occurred in 1959. Whooping cough notifications at 58 shewed a return to the downward trend. In December, 1961, outbreaks of smallpox, brought in from Pakistan, started in several areas of England and Wales which led to a widespread request for vaccination. As there were no cases in this area the Ministry did not recommend general vaccination. The very high vaccination rate in Mitcham is worthy of note, namely 75 per cent. of all babies under one in 1961 and an average of 72 per cent. over the past five years, which compares with just over 41 per cent. for England and Wales. It is also of interest that I have done about one third of the babies vaccinated in the six years 1956-1961 inclusive. Incidentally, the success rate was 99.85 per cent. there being only two failures at the first attempt in the 1,341 vaccinations carried out. 4 In the six-year period General Practitioners carried out 23 per cent. of the vaccinations. Last year the figures for ordinary immunisation, mostly with the triple antigen, against diphtheria, whooping cough and tetanus, amounted to about 85 per cent. of all children under one year of age, again a very high rate. The tuberculosis death rate at 0.06 compares with 0.07 per 1,000 population for England and Wales. Notifications were 21 compared with 17 for the previous year. Ten years ago there were more than 100 each year. Dysentery was notified in one case only as against 6 for 1960. There were no cases of enteric fever. The birth rate of 14.55 per 1,000 population becomes, after correction by the comparability factor, 14.26 compared with 17.4 for England and Wales. The death rate of 10.22 becomes, after correction by the comparability factor, 12.06 per 1,000 population, against 12.00 for England and Wales. It is almost invariably below that of England and Wales. The increase in deaths in 1961 was mainly due to respiratory diseases and accidents. The death rate from cancer for Mitcham in 1961 stayed the same at 2.25 while that for England and Wales increased from 2.16 to 2.17 per 1,000 population. Deaths from lung cancer have been at much the same level for the past seven years in Mitcham. As regards infant mortality the local rate was 18.32 and the rate for England and Wales, 21.6 per 1,000 live births, the lowest ever recorded. A Home Safety Committee was set up in September which participated in Fire Prevention Week and instituted other Home Safety measures. The Meals-on-Wheels service, run by the W.V.S., was able, thanks to the recruitment of more voluntary drivers, to increase its service to the housebound to four days a week and the number of meals supplied rose from 3,633 in 1960 to 4,959 in 1961. 5 Clean Air Act. Although there are no smoke control areas at present, a scheme has been put forward to cover the Borough in eight stages over a period of eight years. 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 Gendemen, Your obedient servant, A. R. GRAHAM, Medical Officer of Health. Public Health Department, Mitcham Court, Mitcham. 6 BOROUGH OF MITCHAM PUBLIC HEALTH COMMITTEE Chairman Councillor E. J. Mills His Worship the Mayor (Alderman T. L. Ruff, J.P.) Aldermen— Mrs. L. Crump G. W. Pearce, J.P. W. E. M. Townsend Councillors— E. E. Field A. S. Hutchin R. W. Muggeridge J. W. Overy D. A. Small Mrs. J. E. Spalding Representatives of the Council on Other Authorities: WANDLE VALLEY JOINT SEWERAGE BOARD His Worship the Mayor (Alderman T. L. Ruff, J.P.) (ex-officio) Alderman T. J. Higgs, J.P. Councillors— D. J. Hempstead R. E. Roberts NORTH EAST DIVISIONAL HEALTH SUB-COMMITTEE (SURREY COUNTY COUNCIL) Aldermen— G. W. Pearce, J.P. H. T. Simms W. E. M. Townsend Councillors— A. S. Hutchin D. J. B. Vale 7 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) Additional Public Health and Meat Inspector, deputising for Chief Inspector G. E. Hayne (1, 2, 3) (a) Additional Public Health and Meat Inspectors L. Gleed (1, 2, 3) J. E. Higgs (1, 2) (fc) E. J. Sluis (1, 2) 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 (c) Chief Clerk and Administrative Assistant—F. H. White (d) Senior Clerk—F. G. Taylor (e) Secretary—Miss V. I. Hill (f) Mrs. M. Drewett (/) Mrs. K. North (a) Commenced 31st July, 1961. (b) Commenced 8th August, 1961. (c) 75 per cent. Surrey County Council duties. (d) 25 per cent. Surrey County Council duties. (e) 20 per cent. Surrey County Council duties. (f) 40 per cent. Surrey County Council duties. 8 REPORT STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,932 acres Population, Census 1921 35,119 „ „ 1931 56,856 „ „ 1951 67,269 „ „ 1961 63,653 Registrar-General's estimate of population mid-year, 1961 63,790 Density of Population, 1961 21.4 persons per acre Number of inhabited houses, 1921 7,150 „ „ „ 1931 13,187 „ „ „ 1961 20,145 Rateable Value, 1961 £1,123,849 Sum represented by a 1d. rate £4,585 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. 9 In 1961 the employment position was satisfactory. There was no significant change in employment figures compared with the previous year, but slightly more unemployed in the summer months. There was an unsatisfied demand for skilled workers, particularly in the engineering industry. Virtually no building land is available except for the Phipps Bridge scheme of about 776 houses and flats. The first stage comprising 72 flats and a laundry is nearing completion and it is hoped that the first flat will be ready for occupation in the autumn of 1962. STATISTICS Live Births. Total Male Female Rate per 1,000 of population Legitimate 879 453 426 Illegitimate 49 30 19 Total 928 483 445 14.55 After correction by the comparability factor becomes 14.26 Illegitimate live births per cent. of total live births 5.28 Still Births. Total Male Female Rate per 1000 total births Legitimate 5 3 2 Illegitimate 1 1 — Total 6 4 2 7.28 Deaths. Total Male Female Rate per 1,000 of population 652 351 301 10.22 After correction by the comparability factor becomes 12.06 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 18.32 Legitimate infants per 1,000 live legitimate births 19.30 Illegitimate infants per 1,000 live illegitimate births Nil 10 Deaths from: — Cancer (all ages) 145 Measles - Whooping cough (all ages) 1 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 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 1961 934 690 73.87 11 The birth rates, death rates per 1,000 of population, and the infant mortality rates for the years 1942-1961 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 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 1961 14.26 17.4 12.06 12.0 18.32 21.6 12 Infant Mortality During the year 17 deaths were registered of infants under one year of age: — Males Females Total Legitimate 11 6 17 Illegitimate - - — Total 11 6 17 as compared with 21 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 4 — — — — 1-7 days 10 3 5 2 1 — 8 days - 1 mth. — — — — — — 1 mth.. -12 mths. 2 — 1 - 1 — Total 17 7 6 2 2 — Fifteen infants failed to survive the first month of life, giving Mitcham a neo-natal mortality rate of 16.16 per 1,000 related live births as compared with 15.5 for England and Wales. Maternal Mortality For the sixth successive year, no deaths were registered. Inquests Inquests were held on 26 residents dying within the district and on 12 Mitcham residents who died outside the district, a total of 38. In addition, post-mortems without inquests were held on 91 residents 13 dying within the district, and on 53 Mitcham residents who died outside the district, a total of 144. The following table shows the results of the findings of these inquests: — Accidental death 23 Death from misadventure 3 Suicide 11 Natural causes 1 Total 38 14 Deaths Registered During the Year 1961 Cause of Death Males Females Total 1 Tuberculosis, respiratory 2 ... 2 2 Tuberculosis, other 1 1 2 3 Syphilitic disease ... 1 1 4 Diphtheria ... ... ... 5 Whooping cough 1 ... 1 6 Meningococcal infections ... ... ... 7 Acute Poliomyelitis ... ... ... 8 Measles ... ... ... 9 Other infective and parasitic diseases 1 ... 1 10 Malignant neoplasm, stomach 14 11 25 11 Malignant neoplasm, lung, bronchus 33 6 39 12 Malignant neoplasm, breast ... 7 7 13 Malignant neoplasm, uterus ... 5 5 14 Other malignant and lymphatic neoplasms 29 34 63 15 Leukaemia, aleukæmia 3 3 6 16 Diabetes 2 2 4 17 Vascular lesions of nervous system 25 52 77 18 Coronary disease, angina 83 50 133 19 Hypertension with heart disease 4 7 11 20 Other heart disease 25 30 55 21 Other circulatory disease 16 19 35 22 Influenza ... 1 1 23 Pneumonia 27 13 40 24 Bronchitis 29 12 41 25 Other diseases of respiratory system 1 ... 1 26 Ulcer of stomach and duodenum 5 1 6 27 Gastritis, enteritis and diarrhoea 1 1 2 28 Nephritis and nephrosis 2 2 4 29 Hyperplasia of prostate 3 ... 3 30 Pregnancy, childbirth, abortion ... ... ... 31 Congenital malformations 2 1 3 32 Other defined and ill-defined diseases 20 27 47 33 Motor vehicle accidents 12 1 13 34 All other accidents 4 9 13 35 Suicide 6 5 11 36 Homicide and operations of war ... ... ... All causes 351 301 652 15 Birth Rates, Death Rates, Analysis of Mortality and Notifications of Infectious Diseases in the Year 1961 England and Wales Mitcham Rates per 1,000 home population Births— Live 17.4 14.26 Still 0.33 0.09 19.1* 7.28* Deaths— All causes 12.0 12.06 Malignant neoplasm—lung, bronchus 0.49 0.61 Whooping cough ... 0.016 Diphtheria ... ... Tuberculosis—all forms 0.07 0.06 Influenza 0.15 0 016 Acute Poliomyelitis 0.001 ... Pneumonia 0.65 0.63 Coronary disease—angina pectoris 2.07 2.08 Maternal mortality 0.33* ... Notifications (Corrected)— Scarlet Fever 0.43 0.50 Whooping Cough 0.53 0.91 Diphtheria 0.001 ... Measles 16.50 13.32 Acute Poliomyelitis— Paralytic 0.016 ... Non-Paralytic 0.004 ... Enteric or Typhoid Fever 0.002 ... Para-typhoid Fever 0.005 ... Meningococcal Infection 0.014 0.016 Erysipelas 0.05 0.094 Dysentery 0.44 0.016 Acute Encephalitis— Infective 0.003 ... Post-Infectious 0.003 ... Acute Pneumonia 0.40 0.11 Food Poisoning 0.16 0.031 Tuberculosis— Respiratory 0.41 0.33 Non-Respiratory 0.06 * Per 1,000 total (live and still) births. 16 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 — Number of rooms disinfected by fumigator 31 Number of library books disinfected 477 HOSPITALS The hospitals direcdy 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. 17 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 morning, and a clinic for cases booked by midwives is held on Tuesday and Friday afternoons. 18 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 Friday afternoon. 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. 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. 19 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 on 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. 20 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 90 parttime workers are usually employed. Enough workers cannot be obtained to satisfy the full demand although we are not far short. 21 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 1961 52 Number of children affected 156 Number of visits paid 253 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 five licensed caravan yards, each with a stand pipe, supplying altogether a total of 34 caravans. The standard of purity of the water was raised to an even higher level and the Board's latest report shews the highest degree of bacteriological purity ever reached. There is no record in the Borough 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 22 in the roof. Provided the tank is properly covered and is cleansed regularly, it provides a satisfactory supply. SWIMMING BATHS Samples were again taken with satisfactory results. A small open air swimming bath was constructed and brought into use during the year at the Alfred Mizen school. In both this and the public bath, water from the mains is circulated continuously through a filter plant and chlorinated. 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, situated in Mitcham. PUBLIC CLEANSING In the winter a weekly collection of house refuse is carried out and in the summer more frequently. Eleven refuse collection vehicles are in use. CLEAN AIR ACT, 1956 Although there are no smoke control areas as yet, a provisional scheme has been put forward to cover the whole of the Borough in eight stages over a period of eight or nine years. ERADICATION OF BED BUGS Number of Council houses found infested during the year, 16. Number of other houses found infested during the year, 6. Total number of houses disinfested during the year, 22. 23 Methods employed: — 22 houses treated with insecticide spray. Number of houses disinfested of beetles, 94. Number of houses disinfested of other insects, 25. 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 4,212 Complaints received 757 Number of treatments re rat infestation, including test baits, as result of inspection and complaints 896 Factory and business premises treated 93 Visits by Public Health Inspectors 94 Two sewer maintenance treatments were carried out in the year; 261 manholes were baited. A total of 47 baits were taken compared with 63 taken in 1960. 24 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 411 Nuisances found 267 Verbal Notices given 127 Verbal Notices complied with 77 Informal Notices served 148 Informal Notices complied with 101 Statutory Notices served 77 Statutory Notices complied with 57 Revisits 1,383 Houses inspected for defects 532 Visits made for this purpose 583 Drains tested and inspected 126 Private houses found verminous 9 Visits to butchers 183 Visits to slaughterhouses 627 Visits to dairies 17 Visits to retail milk shops 29 Visits to restaurant kitchens 279 Visits to ice-cream premises 42 Visits to bakehouses 47 Visits to other food premises 1,114 Number of notices served under Food Hygiene Regulations, 1955 12 Number of notices complied with 12 Visits to factories 203 Visits to workplaces 21 Visits to outworkers 65 Visits to stables 72 Visits to piggeries 27 Visits re poliomyelitis survey 181 Visits re Home Safety 571 25 Visits to caravan yards 65 Smoke observations 94 Visits re infectious disease cases 82 Visits re smallpox contacts - Visits re food poisoning 3 Visits re rats and mice 94 Visits re Shops Acts 93 Visits re schools 34 Visits re Rent Act, 1957 78 Visits to sewage works 12 Sundry visits 371 Character of Work Done Roofs repaired 54 Rainwater piping or gutters repaired or renewed 52 Yards paved or repaired 1 Dampness remedied 68 Water service pipes repaired 10 Waterclosets: Repairs to structure 4 Flushing apparatus repaired or renewed 17 New pans and traps fitted 17 Water storage cisterns cleansed, repaired or renewed 5 Water supply reinstated 8 Flooring of rooms repaired and sub-floor ventilation improved 49 Rooms cleansed 8 Sinks and handbasins repaired or renewed 11 Waste pipes and traps repaired or renewed 10 Window frames and sashes repaired or renewed 12 Window sills repaired or renewed 12 External brickwork (repaired, pointed or rendered) 15 Drains repaired or obstructions removed 85 Drains inspection covers renewed 5 Drains tested 31 Grid and mica flaps provided 1 Firegrates repaired (including surrounds and hearths) 4 Stoves, coppers, ranges, etc., repaired 2 Chimney stacks repaired 4 Staircases repaired 7 26 Doors repaired 8 Internal plaster repairs 81 Sash cords renewed 23 Dustbins provided 10 Accumulations removed 12 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.—There were no legal proceedings in 1961. Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum {Mixtures) Order, 1929.—100 licences to store petroleum spirit and/or petroleum mixtures were issued for a total of 246,410 gallons (inclusive of cellulose solutions). 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 94 lbs. Poultry 500 lbs. Ham 232 „ Lamb 40 „ Corned beef 66 „ Suet 20 „ Pork luncheon meat 40 „ Dripping 50 „ Liver 10 „ Coconut confectionery 104 „ Veal 36 „ Toffee 4 „ Pork 71 „ Cauliflower in brine 200 gal. Fish 52 „ Assorted 182 tins Sausages 51 „ Yours faithfully, K. J. GUTTERIDGE, Chief Public Health Inspector. 27 HOUSING STATISTICS Total Number of Inhabited Houses—20,145 The total number of housing properties now owned by the Council is 4,327 including 345 temporary dwellings. About 160 cottage flats or bungalows have been built for old people since the war. During the year 32 flats and maisonettes were completed and let. Altogether 96 families were rehoused from the waiting list during 1961, leaving 1,130 families still on the waiting list at the end of the year. Rent Act, 1957 Sixteen applications were made for Certificates of Disrepair during the year. In 12 cases undertakings were given by the various landlords and in the remaining four cases certificates were issued. Four certificates were cancelled during the year on application by landlords, the works specified having been completed. In one case cancellation was refused as the work had not been satisfactorily completed. INSPECTION AND SUPERVISION OF FOOD One thousand seven hundred and eleven 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 Cafe & General Stores 1 Groceries 83 Roadside Snack Bars 2 Butchers 40 Fishmongers 10 Greengrocer & Fruiterers 57 Fried Fish Buffets 8 Greengrocer & General Provisions 2 Fried Fish 3 Bakers and Confectioners 17 Confectionery 73 Milk & Provisions 11 Chemists 15 Public Houses 30 Restaurants & Cafes 32 Off-Licences 10 28 Food premises by type, registered under Section 16, Food and Drugs Act, 1955. The storage and sale of ice-cream 169 The manufacture for sale of ice-cream 1 The preparation or manufacture of sausages, or potted, pressed, pickled or preserved food 40 Dairies registered under the Milk and Dairies (General) Regulations, 1959 1 Number of inspections of registered food premises during the year 454 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. FOOD AND DRUGS ACT, 1955 Formal Samples. Fifty formal samples were taken as follows: — Milk 33 Beef Sausages 3 Pork Sausages 5 Salmon Fish Cakes 1 Plum Jam 1 Chop Sauce 1 Mentholated Balsam 1 Hamburgers 1 Dairy Butter 2 Minced Beef 1 Blackcurrant Juice 1 Informal Samples. Eighty-nine informal samples were taken as follows: — Instant Coffee 2 Double Devon Cream 1 Casserole Meat 1 Apple Sauce 1 Custard Powder 2 Dairy Cream Doughnuts 1 Fruit Pudding 1 Mince Meat 2 Cheese Spread 3 Chicken Noodle Soup 1 Crab Spread, with Butter 1 Stewed Steak 1 Ground Almonds 1 Instant Mashed Potatoes 1 Norway Sild in Oil 1 Corned Beef 1 Steaklets 1 Creamery Butter 1 29 Frankfurters 1 Margarine 1 White Pepper 1 Cream Layer Sponge 1 Pease Pudding 1 Creamed Rice Milk Pudding 1 Creamed Mushrooms 1 Red Cherries in Syrup 1 Curried Chicken with Mushrooms 1 Vegetable Juices 1 Pure Dairy Butter 2 Viennese Coffee with Fig Flavouring 1 Pure Lard 1 Pork Luncheon Meat 2 Casserole Lamb & Peas with Gravy 1 Tomato Purée 1 Beefsteak with Gravy 1 Chocolate Sponge Mix 1 Stewed Steak 1 Cheese Spread with Shrimp 1 Ceylon and Indian Tea 1 Starch Reduced Rolls 1 Batter Flour 1 Strawberry Jam 1 Cereal Beverage 1 Danish Pork Luncheon Meat 1 Australian Butter 1 Kosher Tomar Margarine 1 Cornish Pasty 1 Tenderising Salt 1 Fridge Freeze Ice Pops 1 Ice-cream 5 Yorkshire Relish 1 Ice-cream Mix, pre-freezing 1 Gluten nutmeat 1 Steak & Kidney Pie 1 Veal Curry 1 Beef Sausages 1 Breakfast Grill 1 Chicken Pie, frozen 1 Chutney 1 English Stewed Steak in Gravy 1 Chicken & Ham Meat Paste 1 Piccalilli 1 College Cream Biscuits 1 Raspberry Milk Shake Syrup 1 Yellow Cling Peaches 1 Self-Raising Flour 1 Portuguese Sardines in Pure Olive Oil 1 Batter & Pancake Flour 1 Marmalade 1 Blackcurrant Jam 1 Unsweetened Full Cream Evaporated Milk 1 Beans in Tomato Sauce 1 French Mustard 1 Concentrated Blackcurrant Vitamin C Drink 1 Fruit Caramels 1 Butter, including Imported Butter 1 Luncheon Meat 1 Vita Cup 1 30 The following sample was not up to standard and a warning letter was sent to the firm concerned: — Informal.—Casserole meat. Complaints from the public relating to food were as follows: — Three of foreign matter in a loaf. Two of a foreign body in a botde of milk. One each of: — Foreign matter in butter. Decomposition in fried fish. Wasp in a jam tart. Glass in a bottle of milk. Foreign body in water ices. Ant-infested nut-crisp. Mould growth in a meat pie. Larvæ in self-raising flour. Warning letters were sent to the firms concerned. Ice-Cream One establishment in the Borough is registered for the manufacture of ice-cream and 169 for the storage and sale of ice-cream. Forty-two visits were paid during the year. Eight samples of ice-cream were taken and examined for bacteriological purity. The results are tabulated below: — Provisional Grade. I II III IV 7 — 1 — Bacteriological Examination of Cups and Glasses Fifty-nine swabs were taken from tea cups at various catering establishments and seven 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: — 31 Tea Cup Swabs. Colony Count (per cup). Conform Bacilli. Bact. Coli Type I. Result Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 7 43 3 4 48 2 100-200 3 3 2 1 3 3 200-500 1 1 1 — 2 — 500-1,000 1 — — 1 — 1 1,000-1,500 — — — — — — 1,500-2,000 — — — — — — 2,000 and over — — — — — — Total 12 47 6 6 53 6 Beer Glass Swabs. Colony Count (per glass). Conforms Bacilli. Bact. Coli Type I. Result Satisfactory. Unsatisfactory. Present. Absent. Present. Absent. Under 100 — 5 — — 5 — 100-200 — — — — — — 200-500 — 1 — — — 1 500-1,000 — — — — — — 1,000-1,500 1 — 1 — — 1 1,500-2,000 — — — — — — 2,000 and over — — — — — — Total 1 6 1 — 5 2 The results of the swabs were sent to the establishments concerned and visits were paid to premises where the results were unsatisfactory. MILK (SPECIAL DESIGNATION) REGULATIONS, 1960 Licences under these regulations are now renewable every five years instead of annually as heretofore. During the year the Council granted the following number of licences: — Dealer's Licences— Pasteurised 7 Sterilised 6 Tuberculin Tested 5 32 One hundred and thirty-three samples of Graded Milk were submitted for bacteriological examination. All were satisfactory. BAKEHOUSES The number of bakehouses in the district is five. Forty-seven visits have been paid. DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year seventeen visits of inspection were paid. SLAUGHTERHOUSES One of the two licensed slaughterhouses in the borough was closed. During the year 627 visits were made to slaughterhouses. SLAUGHTER OF ANIMALS ACT, 1958 Eleven licences were issued to slaughtermen in accordance with the requirements of the above Act. One licence was granted to slaughter only under supervision. 33 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) 216 19 2179 1171 11,767 Number Inspected 216 19 2179 1171 11,767 All diseases except tuberculosis and cysticerci: Whole carcases condemned ... ... ... ... 74 Carcases of which some part or organ was condemned 15 ... 4 21 1031 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 6.94 ... 0.18 1.79 9.40 Tuberculosis only: Whole carcases condemned ... ... ... ... 9 Carcases of which some part or organ was condemned 2 ... ... ... 49 Percentage of the number inspected affected with tuberculosis 0.93 ... ... ... 0.49 FOOD PREPARING FACTORIES There are 16 factories which are engaged in the manufacture and preparation of food products. All of these are systematically visited. INFORMAL ACTION TAKEN UNDER THE FOOD HYGIENE (GENERAL) REGULATIONS, 1960 Number of notices served, 12. Number of notices complied with, 12. PIGGERIES There are five piggeries in the Borough. Twenty-seven visits were paid during the year. PET ANIMALS ACT, 1951 Four licences were issued to occupiers of pet shops. 34 FACTORIES ACT, 1937 1.—Inspections for purposes of provisions as to health (including inspections made by Public Health Inspectors): — Premises (1) M/c line No. (2) Number on Register (3) Number of M/c line No. (7) Inspections (4) Written notices (5) Occupiers prosecuted (6) (i) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 1 10 17 ... ... 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 321 196 10 ... 2 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 3 ... ... ... ... 3 TOTAL ... 331 213 10 ... ... 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 ... ... ... ... ... 4 Overcrowding (S.2) 5 ... ... ... ... ... 5 Unreasonable temperature (S.3) 6 ... ... ... ... ... 6 Inadequate ventilation (S.4) 7 1 1 ... ... ... 7 Ineffective drainage of floors (S.6) 8 ... ... ... ... ... 8 Sanitary Conveniences (S.7) (a) Insufficient 9 ... ... ... ... ... 9 (b) Unsuitable or defective 10 10 10 ... ... ... 10 (c) Not separate for sexes 11 ... ... ... ... ... 11 Other offences (not including offences relating to Homework) 12 ... ... ... ... ... 12 TOTAL 11 11 ... ... ... 36 3.—Outwork (Sections 110 and 111): — Nature of Work (1) M/c line No. (2) Section 110 Section 111 M/c line No. (9) Number of out-workers in August list required by Sect. 110 (1) (c) (3) Number of cases of default in sending lists to the Council (4) Number of prosecutions for failure to supply lists (5) Number of instances of work in unwholesome premises (6) Notices served (7) Prosecutions (8) Wearing apparel Making, etc. 13 51 13 Cleaning and washing 14 14 Household linen 15 2 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 6 34 Brush making 35 35 Pea picking 36 36 Feather sorting 37 37 Carding, etc., of buttons, etc. 38 1 38 Stuffed toys 39 39 Basket making 40 40 Chocolates and sweetmeats 41 41 Cosaques, Christmas crackers, Christmas stockings, etc. 42 12 42 Textile weaving 43 43 Lampshades 44 59 44 TOTAL 131 38 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1961 was 960. 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 82 Public Health Inspectors to smallpox contacts — Total 82 Rooms disinfected after infectious disease 31 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 ... 7 ... ... ... 3 ... ... 1 ... ... ... 21 18 1 ... ... ... ... 51 February ... 2 ... ... ... 1 ... 1 ... ... ... ... 54 5 ... ... ... ... ... 63 March ... 3 ... ... ... 1 ... ... ... ... ... ... 130 7 ... ... ... ... ... 142 April ... 2 ... ... ... 1 ... ... ... ... ... ... 152 3 ... ... ... ... ... 158 May ... 3 ... ... ... 1 ... ... ... ... ... ... 198 7 1 ... ... ... ... 210 June ... ... ... ... 1 ... ... ... ... ... ... ... 112 14 ... ... ... ... ... 127 July ... ... ... ... ... ... ... ... ... ... ... ... 98 1 ... ... ... ... ... 100 August ... 1 ... ... ... ... ... ... ... ... ... ... 47 ... ... ... 1 ... ... 49 September ... 4 ... ... 1 ... ... ... ... ... ... ... 21 1 ... ... ... ... ... 27 October ... 2 ... ... 1 ... ... ... ... ... ... ... 17 ... ... ... ... ... ... 20 November ... 5 ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 7 December ... 3 ... ... 2 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 6 Totals ... 32 ... ... 6 7 1 1 1 1 ... ... 850 58 2 ... 1 ... 960 40 Infectious Disease Notifications, 1942/61 Disease 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 1961 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever 175 212 97 147 95 62 35 57 89 110 111 225 86 47 33 56 18 75 69 24 32 Diphtheria 25 42 10 63 32 4 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... Typhoid Fever ... 1 ... 1 ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... ... ... ... Puerperal Pyrexia 6 3 5 8 6 9 3 ... 2 ... 13 23 11 3 1 ... ... ... ... 5 1 Meningococcal Infections 6 8 3 3 1 2 1 1 ... 1 3 1 ... 2 ... 1 ... ... l 1 1 Erysipelas 7 22 13 16 25 9 18 6 12 7 8 14 11 6 9 7 4 3 4 5 6 Measles 599 651 112 739 358 533 818 252 354 354 1386 591 888 131 1059 50 1358 172 847 162 850 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 10 4 4 ... 2 2 6 3 8 2 1 ... ... 1 ... ... ... ... 2 1 1 Acute Encephalitis: Infective 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Post-Infectious ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 ... ... ... ... Pneumonia 20 50 37 33 41 37 30 13 19 28 24 26 27 16 34 19 24 12 22 10 7 Malaria ... 1 1 ... 1 ... 1 ... ... ... ... 1 ... 1 ... ... ... ... ... ... 1 Whooping Cough 161 162 166 96 234 216 117 149 212 387 420 112 336 183 167 103 130 45 17 118 58 Food Poisoning 11 ... ... 5 1 ... ... ... 6 3 4 10 17 12 8 11 4 9 27 6 2 Dysentery ... 4 67 13 6 1 2 5 7 16 7 16 15 46 17 60 47 8 10 6 1 Paratyphoid ... ... ... ... 1 2 ... ... ... ... 1 ... ... 1 ... 1 ... 1 ... ... ... Totals 1021 1161 515 1126 807 888 1033 490 717 911 1980 1027 1396 450 1335 322 1590 325 1000 338 960 41 Smallpox No case of smallpox was notified during the year 1961. 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 679 24 20 27 36 786 Number re-vaccinated — — 7 12 67 86 During the year 75 per cent, of babies under one year of age were vaccinated and over the last five years an average of 72 per cent, as against 41 per cent, for England and Wales in 1960 and about the same level for the previous years. The bulk of vaccinations are carried out in the clinics, 77 per cent, of babies under one year being done by the assistant medical officers. Scarlet Fever The number of cases of scarlet fever notified during the year was 32 as compared with 24 in 1960, equivalent to a case rate of 0.50 per 1,000 population. This disease has continued mild in character. All cases were treated at home. Diphtheria No case of diphtheria was notified for the twelfth year in succession, whereas cases used to average sixty per year. Immunisation and reinforcing doses were available to every child whose parents gave consent. Immunisation Against Diphtheria, Whooping Cough and Tetanus There are five clinics within relatively easy reach of everyone, as well as immunisation sessions held in the schools. Every effort is made to have as many babies as possible immunised before their first birthday, the policy nowadays being to 42 give the triple antigen against diphtheria, whooping cough and tetanus. It was commenced in 1958 but as large numbers were not done till 1960, the tetanus part has lagged behind the others. The following table shews the number of children immunised and reinforced against diphtheria, whooping cough and tetanus in 1961. Whooping cough immunisation is not carried out in schools as it is intended primarily for children under five years old. Number of children receiving:— Year of Birth 1961 1960 1959 1958 1957 1956-2 195147 Total A. Primary Course against: Diphtheria 327 496 81 44 25 223 46 1242 Whooping Cough 325 491 77 40 24 41 2 1000 Tetanus 326 492 65 35 22 44 6 990 B Reinforcing injection against : Diphtheria — 11 3 7 48 899 510 1478 Whooping Cough — 11 3 7 31 162 22 236 Tetanus - 11 3 4 12 80 19 129 Poliomyelitis There were no cases of poliomyelitis during the year. For England and Wales the number of cases goes down year by year, for which the immunisation campaigns are undoubtedly responsible. Polio Vaccination The scheme now includes all up to 40 years of age. Those over 40 may be inoculated by private practitioners. Fourth injections were given, for the first time this year, starting with the age group 5-11 years. Numbers vaccinated in 1961 Primary courses Third injections Fourth injections 0-18 years 1,414 1,246 3,594 Over 18 years 1,669 2,305 — 43 The total number inoculated since the inception of the scheme is 23,495 which includes 14,948 persons 0-18 years of age. Oral immunisation against poliomyelitis will commence early in 1962. 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. Diarrhcea and Enteritis Under Two Years of Age No death was registered during the year. Food Poisoning Outbreaks There were two notified cases in 1961. In neither case could the cause nor the source be identified. Encephalitis Lethargica There were no cases notified during the year. Erysipelas Six cases were notified. Two were removed to hospital. Puerperal Pyrexia There was one case of puerperal pyrexia during the year. Pneumonia Seven 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 40, of which 27 were males and 13 females. Meningococcal Infections One case was notified during the year. Influenza As in 1960, there was only one death from influenza. 44 Ophthalmia Neonatorum During the year one case of ophthalmia neonatorum was notified. 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 54 Mumps 49 Ringworm 1 Rubella 15 Influenza 38 Glandular fever 1 Cancer The number of deaths from cancer registered during the year was 145, of which 79 were males and 66 females. This compares with 144 in 1960. The trend for England and Wales is continuing upwards. The site distribution for 1961 was as follows:— Stomach 25 cases Respiratory organs 39 „ Breast 7 „ Genito-urinary organs 5 „ Other sites 69 „ Total 145 45 The following table shows the number of deaths from cancer, together with the death rate as compared with England and Wales:— Year. Numbers of Deaths. Death Rate per 1,000 of population 1 Mitcham. England and Wales. 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 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 1961 145 2.27 2.17 Deaths in Mitcham from Leukjemia and Lung Cancer, 1952-1961 Year. Deaths from Leukaemia. Deaths from Lung Cancer. 1952 3 31 1953 5 17 1954 4 27 1955 2 40 1956 3 36 1957 3 41 1958 2 26 1959 3 32 1960 8 36 1961 6 39 46 The deaths from lung cancer in Mitcham have been fairly static over the last seven years. As in England and Wales cancer of the lung accounts for between one quarter and one third of all deaths from cancer. In the case of leukaemia the rate increased sharply in 1960 and 1961; but as the numbers are so relatively few, conclusions cannot be drawn from this area alone. Tuberculosis During the year 21 new cases of tuberculosis were notified, viz:— Males Females Total Pulmonary 17 4 21 Non-Pulmonary — — — Totals 17 4 21 Twenty-one cases were transferred into the Borough as follows:— Males Females Total Pulmonary 10 9 19 Non-Pulmonary — 2 2 Totals 10 11 21 The total number of deaths from tuberculosis was:— Males Females Total Pulmonary 2 — 2 Non-Pulmonary 1 1 2 Totals 3 1 4 England and Wales. Mitcham. Death rate from tuberculosis, all forms, per 1,000 population 0.07 0.06 47 The following table showing the number of 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 1 ... ... ... ... ... ... ... 5 year9 to 9 „ ... ... ... ... ... ... ... ... 10 „ „ 14 „ ... ... ... ... ... ... ... ... 15 „ „ 19 1 ... ... ... ... ... ... ... 20 „ „ 34 2 2 ... ... ... ... ... ... 35 „ „ 44 2 1 ... ... ... ... ... ... 45 „ 64 10 1 ... ... ... ... ... ... 65 „ and upwards 1 ... ... ... 2 ... 1 1 Totals 17 4 ... ... 2 ... 1 1 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 ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Pulmonary Females ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Non-Pulmonary: Males ... ... ... ... ... ... ... ... ... ... ... ... ... Nil Non-Pulmonary: Females ... ... ... ... ... ... ... ... ... ... ... ... 1 1 48 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 25 per cent. Non-notified tuberculosis deaths 1 Total tuberculosis deaths 4 Home Safety A Home Safety Committee was set up on 28th September, 1961, under the Public Health Committee. All members of the Public Health Committee are automatically members and all outside bodies concerned in home safety are represented on the committee. The committee participated in Fire Prevention Week, setting up stands in public places, distributing leaflets, pamphlets, posters and book marks and giving lectures. General Home Safety propaganda was also issued. Miniature Mass Radiography The mass radiography unit paid an extended visit to Mitcham this year the following sessions being held: one of a week at Colliers Wood, one of a week at Pollards Hill and one of a fortnight at the public baths. The following figures were supplied by the Medical Director of the unit, Dr. F. T. H. Walters. Male Female Total number examined 4,716 2,604 Pulmonary tuberculosis (active) 8 — Primary lung cancer 4 — 49 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 the service is available to any member of the public. 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. 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. This year, the Committee has also been able, through the generosity of a Mitcham firm, to arrange for the rental of one or two television sets at a small cost. Help has also been given with the licences. The number of non-T.B. cases dealt with is now almost equal to the number of notified patients. 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. This is becoming more difficult each year. 50 INDEX page Abortion, Deaths 9, 14 Ambulances 16 Ante-Natal Clinics 17, 18 Area 8 Bacteriological Examination of Cups and Glasses 30, 31 Bakehouses 32 Bed Bugs, Eradication of 22, 23 Bedding, Disinfection of 16 Birth Rates 9, 11, 15 Births, Illegitimate 9 — In Institutions 10 — Live 9 — Still 9 Blindness, Prevention of 44 Cancer 44, 45 — Deaths from 10, 44, 45 Caravans 21 Causes of Deaths 10, 12-15 Chief Public Health Inspector's Report 24-26 — — — Inspector, Visits by 24, 25 Child Guidance Clinic 18 Child Welfare Clinics 18 Clean Air Act 22 Cleansing, Public 22 Clinics 17-20 Closet Accommodation Committees, Health, Members of 6 Dairies 32 Death Rates 9, 11, 12, 15 Deaths 9-15 Dental Clinics 18-19 Diarrhoea and Enteritis 10, 43 Diphtheria 41 Diphtheria Immunisation 41, 42 — — Clinics 19 51 PAGE Disinfection 16, 38 Encephalitis Lethargica 43 Enteric Fever 43 Erysipelas 43 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 28 — Hygiene, General Regulations, 1960 33 — Dealt with, Unsound 26 — Inspection and Supervision of 27-33 — Preparing Factories 33 — Poisoning 43 — — Case Rates 15 — Sampling 28-30 General Provision of Health Services for the Area 15-21 Health Visiting 20 Home Help Service 20, 21 Home Safety 48 Hospitals 16, 17 Houses, Disinfection of 16 — Inhabited 8, 26 Housing Statistics 27 Ice Cream 30 Immunisation and Vaccination Clinics 19 — Diphtheria 41, 42 — Poliomyelitis 42 — Whooping Cough 41 Infant Mortality 9, 11, 12 Infectious Disease Case Rates 15 — — Contacts 38 — — Hospitals 17 — — Monthly Incidence of 39 — — Notifications 39-44 — — — School 44 — — Public Health Inspector's Visits 25, 38 52 PAGE Influenza 43 Inquests 12, 13 Laboratory Facilities 16 Legal Proceedings 26 Library Books, Disinfection of 16 Maternal Mortality 9, 12, 14 Maternity, Hospital Treatment 17 Meals-on-Wheels 4 Measles, Case Rates 15 — Deaths from 10, 14 Meat Inspection 33 Meningococcal Infection 43 Miik (Special Designation) Regulations 31 Mortality, Analysis of 14 National Assistance Act, 1948, Section 47 21 N.S.P.C.C 21 Neonatal mortality 12 Ophthalmia Neonatorum 44 Outworkers (Sections 11 and 111—Factories Act, 1937) 36, 37 Persons in Need of Care and Attention 21 Pests Act, 1949, Prevention of Damage by 23 Pet Animals Act, 1951 33 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929 26 Petroleum (Regulation) Acts, 1928 and 1936, and Petroleum Carbide of Calcium Order, 1929 26 Piggeries 33 Pneumonia 43 Poliomyelitis 42 — Vaccination 42, 43 Population 8 Post-Natal Clinics 20 Public Cleansing 22 Puerperal Pyrexia 43 Public Analyst 16 Radiography, Miniature Mass 48, 49 Rateable Value 8 Rent Act, 1957 26, 27 53 PAGE Rivers and Streams 22 Rodent Operations 23 Rooms Disinfected, Number of 16, 38 Sanitary Circumstances of the Area 21-23 Scarlet Fever 41 Schools 23 Slaughterhouses 32 Slaughter of Animals Act, 1958 32 Smallpox 41 — Vaccination Clinics 19 — Hospital 17 Smoke Control Areas 22 Social Conditions 8, 9 Staff 7 Statistics 8-15 — Housing 27 — Vital 15 Still Births 9 Tuberculosis 46-48 — Care Committee 49 — Clinic 17 Unsound Food dealt with 26 Venereal Disease Clinic 17 Visits by Public Health Inspectors 24, 25 Water Supply 21 Whooping Cough, Deaths from 10, 14, 15 — — Immunisation 41, 42