BOROUGH OF MITCHAM REPORT of the Medical Officer of Health for the YEAR 1964 1. BOROUGH OF MITCHAM HEALTH REPORT FOR 1964 To the Mayor, Aldermen and Councillors London Borough of Merton This is the last report on the Health of the Borough of Mitcham which on the 1st April 1965 ceased to exist as a corporate entity and in association with the Urban District of Merton and Morden and the Borough of Wimbledon now forms part of the London Borough of Merton. This report would normally have been made by Dr.Graham, Medioal Officer of Health, who resigned his office on 31st March 1965. I feel sure that all those who have been in any way associated with Dr. Graham in the past would wish to join me in expressing appreciation of the service he has rendered the Community since he took office as Medioal Officer of Health for Mitcham in 1950. Appreciation is due also to Mr. K.J.Gutteridge, Chief Public Health Inspector, who retired on March 31st 1965 after nearly twenty-eight years in that office. The general health in the Borough during 1964 was good and there was no special outbreak of infectious disease. In fact, there were 531 notifications compared with 874 in 1963. The decrease was mainly due to a fall in measles cases from 770 to 433. It is gratifying to record that there were no cases of poliomyelitis and only two oases have occurred sinoe 1957. I have no doubt that poliomyelitis vaocination has contributed to this satisfactory state of affairs and would advooate that we should persist in our efforts to vaccinate those at risk against this dangerous and crippling disease. 59 cases of whooping cough were notified which is about average for the past seven years. There was no case of diphtheria nor tetanus. 2. Diphtheria has for many years been controlled by immunisation at an early age. In faot infants are immunised against whooping cough, diphtheria and tetanus by three oombined injections at monthly intervals. Parents would be well advised to make sure their children are immunised and have appropriate reinforcing doses. Infants should also be vaocinated against smallpox, provided there is no contra indication, early in their seoond year of life. The tuberculosis death rate of 0.05 per 1000 population is the same as that for England and Wales. There were 21 notifications compared with 11 for 1963. Ten years ago there were more than 100 cases notified eaoh year and this satisfactory state of affairs is due to more potent anti tuberoulosis drugs. There were no notified cases of dysentery or enteric fever. The birth rate of 16.21 per 1000 population compares with 18.if for England and Wales, both of which are the highest for over a decade. The orude death rate of 9.92 compares favourably with 11.3 per 1000 for England and Wales. The death rate from cancer for Mitoham in 1964 was 2.32 as oompared with 2.20 for England and Wales per 1000 population. The death rate from lung canoer inoreased slightly from 0.69 - 0.72 per 1000 population oompared with 0.54 for England and Wales. The infantile mortality rate was 18 per 1000 live births and although inoreased from 10.18, a remarkably low rate, still compares favourably with the rate for England and Wales - 20 per 1000 live births. Clean Air Act - Smoke Control work progressed steadily. I would like to conclude by saying the old Mitcham Health Department is fitting very happily into the new Merton Health Department now housed at the Vestry Hall, Mitoham. On Dr. Graham's behalf I would like to thank the Chairman and members of the Health Committee and all members of the staff who supported him so loyally during the year. As regards this report, I would like to thank especially the Chief Public Health Inspector and Deputy Chief Public Health Inspector of the London Borough of Merton, Mr. G.H.Cockell and Mr. G.E.Hayne, for their assistance in preparing the section dealing with the sanitary ciroumstances of the area. I would also like to express my appreciation of Mr. F.G.Taylor's help in preparing the general body of the report. I would also like to thank all the members of the staff for their loyal co-operation during the diffioult days of local government re-organisation. I have the honour to be, Ladies and Gentlemen, Tour obedient servant, P.J. DOODY Medical Officer of Health 3. BOROUGH OF MITCHAM PUBLIC HEALTH COMMITTEE CHAIRMAN Alderman G.W.Pearce, J.P. His Worship the Mayor (Councillor W.Lancaster, J.P.) Aldermen- Mrs. L.Crump (Vioe-Chairman) E.J. Mills Councillors- D.A.Small Mrs. J.E.Spalding A.S.Hutchin Mrs. J.E.Vowles J.W.Overy H.R.Veal Mrs. V.M.Bonner R. Taylor Representatives of the Council on Other Authorities: WANDLE VALLEY MAIN DRAINAGE AUTHORITY His Worship the Mayor (Councillor W. Lancaster, J.P.) (ex-officio) Councillors- D.J.Hempstead W.G.Mansfield W.H.Sanderson NORTH-EAST DIVISIONAL HEALTH SUB-COMMITTEE (SURREY COUNTY COUNCIL) Aldermen- G.W.Pearce, J.P. Mrs. L. Crump Councillors- A.S.Hutchin H.R.Veal Mrs. J.E.Spalding 4. STAFF Medioal Officer of Health A. R. Graham, M.B., Ch.B., D.P.H., Barrister-at-Law Chief Publio Health and Meat Inspector Petroleum Inspeotor Shops Act Inspeotor K. J. Gutteridge (1, 2) Deputy Chief Public Health Inspector G.E.Hayne (1,2,3) Additional Public Health and Meat Inspectors L.Gleed (1,2,3) J.E.Higgs (1,2) E. J. Sluis (1, 2) C. S. Smith (1, 2) Student Publio Health Inspector J.H.Chalkley 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 (a) Chief Clerk and Administrative Assistant - F. H. White (b) Senior Clerk - F. G. Taylor (o) Secretary - Miss V. I. Hill (d) Mrs. K. North (de; Miss V. Tucker (f) Mrs. W. Iyon (f) Mrs. B. Wallace (d g) Miss M. Golding Smoke Investigators (h) W. Voller A. R. Bannister (a) 75 per cent. Surrey County Council duties (b) 25 per cent. Surrey County Council duties (c) 20 per cent. Surrey County Council duties (d) 40 per cent. Surrey County Council duties (e) Resigned 16.10.64 (f) Smoke Control Commenced 16.11.64 (h) Resigned 31.12.64 5. REPORT STATISTICS AND SOCIAL CONDITIONS OP 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, 1964 62,580 Density of Population, 1961 21.4 persons per acre Number of inhabited houses, 1921 7,150 " " " " 1931 13,187 " " " " 1964 20,676 Rateable Value, 1964 £3,281,708 Sum represented by a 1d. rate £13,335 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, whioh 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, dairy products, and confectionery. Slum Clearance The nine areas submitted to the Minister in 1963 were approved with sane minor amendments. Recommendations for further areas involving 219 houses were adopted as the Council's proposals for slum clearance during the next five year clearance programme. 6. STATISTICS Rate per 1,000 LIVE BIRTHS Total Vale Female of population Legitimate 912 459 453 Illegitimate 73 38 35 Total 985 497 488 15.74 After correction by the comparability factor becomes 16.21 Illegitimate lire births per cent. of total live births 7.41 STILL BIRTHS Total Male Female Rate per 1,000 total births Legitimate 16 7 9 Illegitimate Total 16 7 9 16.00 DEATHS Total Male Female Rate per 1,000 of population 622 339 283 9.94 After correction by the comparability factor beoomes 11.42 Deaths from pregnancy, childbirth and abortion:- Rate per 1,000 total births Number of oases Nil - Deaths of infants under one year of age:- All infants per 1,000 lire births 18.00 Legitimate infants per 1,000 lire legitimate births 17.26 Illegitimate infants per 1,000 lire illegitimate births 13.69 Deaths from:- Cancer (all ages) 145 Measles Whooping cough (all ages) - Enteritis and diarrhoea under two years of age 1 7. PERCENTAGE OP BIRTHS OCCURRING IN INSTITUTIONS Year Total births Births in hospitals, etc. Percentage of births occurring in institutions 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 1962 955 683 71.5 1963 991 756 76.4 1964 1001 791 79.1 The birth rates, death rates per 1,000 of population, and the infant mortality rates for the years 1945-1964 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 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 8. 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 Vales. 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 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 1962 14.41 18.0 12.37 11.9 14.94 20.7 1963 15.95 18.2 12.78 12.2 10.18 20.9 1964 16.21 18.4 11.42 11.3 18.00 20.0 INFANT MORTALITY During the year 18 deaths were registered of infants under one year of age:- Males Females Total Legitimate 10 7 17 Illegitimate 11 Total 10 8 18 as oompared with 10 deaths last year. 9. 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 - 1 - 1 1 - 7 days 4 2 1 - - 1 8 days - 1 mth. 2 1 1 - - - 1 nth. -12 mths 7 - 2 - 2 3 Total 18 6 4 1 2 5 Eleven infants failed to survive the first month of life, giving Mitoham a neo-natal mortality rate of 11.00 per 1,000 related live births as oompared with 13.8 for England and Wales. MATERNAL MORTALITY For the ninth successive year, no deaths were registered. INQUESTS Inquests were held on 15 residents dying within the district and on 12 Mitcham residents who died outside the district, a total of 27. In addition, post-mortems without inquests were held on 66 residents dying within the district, and on 59 Mitcham residents who died outside the district, a total of 125. The following table shows the results of the findings of these inquests:- Accidental death 16 Death from misadventure 2 Suicide 8 Natural causes 1 Total 27 10. DEATHS REGISTERED DURING THE YEAR 1964 Cause of Death Males Females Total 1 Tuberculosis, respiratory 2 1 3 2 Tuberculosis, other - - - 3 Syphilitic disease - 1 1 4 Diphtheria - - - 5 Whooping cough - - - 6 Meningococcal infections - 1 1 7 Acute Poliomyelitis - - - 8 Measles - - - 9 Other infective and parasitic diseases - - - 10 Malignant neoplasm, stomach 6 5 11 11 Malignant neoplasm, lung, bronchus 39 6 45 12 Malignant neoplasm, breast - 14 14 13 Malignant neoplasm, uterus - 2 2 14 Other malignant and lymphatic neoplasms 45 28 73 15 Leukaemia, aleukaemia - - - 16 Diabetes 1 1 2 17 Vascular lesions of nervous system 32 34 66 18 Coronary disease, angina 92 56 148 19 Hypertension with heart disease - 6 6 20 Other heart disease 13 31 44 21 Other circulatory disease 14 26 40 22 Influenza - - - 23 Pneumonia 12 15 27 24 Bronchitis 24 8 32 25 Other diseases of respiratory system 6 1 7 26 Ulcer of stomach and duodenum 3 4 7 27 Gastritis, enteritis and diarrhoea 1 5 6 28 Nephritis and nephrosis 2 - 2 29 Hyperplasia of prostate 2 - 2 30 Pregnancy, childbirth, abortion - - - 31 Congenital malformations 6 4 10 32 Other defined and ill-defined diseases 21 25 46 33 Motor vehicle accidents 4 1 5 34 All other accidents 11 3 14 35 Suicide 3 5 8 36 Homicide and operations of war - - - All causes 339 283 622 11. BIRTH RATES, DEATH RATES, ANALYSIS OF MORTALITY AND NOTIFIC OF INFECTIOUS DISEASES IN THE YEAR 1964 IATI0NS and Wales Mitcham Rates per 1,000 home population Births Live 18.4 16.21 Still 0.31 0.26 16.4* 16.00* Deaths:- All causes 11.3 11.42 Malignant neoplasm - Lung, bronchus 0.54 0.72 Whooping oough 0.00 • • • Diphtheria • • • • • • Tuberculosis - all forms 0.05 0.05 Influenza 0.02 Acute Poliomyelitis 0.00 • • • Pneumonia 0.63 0.43 Coronary disease - angina pectoris 2.24 2.26 Maternal mortality 0.25 • • • Notifications (Corrected) Scarlet Fever 0.42 0.48 Whooping Cough 0.66 0.94 Diphtheria 0.000 • • • Measles 6.45 6.92 Acute Poliomyelitis Paralytic 0.001 • • • Non-Paralytic 0.000 • • • Enteric or Typhoid Fever 0.002 Para-typhoid Fever 0.005 • • • Meningococcal Infection 0.011 • • • Erysipelas 0.037 • • • Dysentery 0.42 ... Acute Encephalitis Infective 0.002 • • • Post Infectious 0.003 0.016 Acute Pneumonia 0.19 0.096 Food Poisoning 0.11 0.016 Tuberculosis Respiratory 0.32 0.287 Non-Respiratory 0.05 0.048 *Per 1,000 total (lire and still) births 12. GENERAL PROVISION OP HEALTH SERVICES FOR THE AREA LABORATORY FACILITIES Host 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.So., P.R.I.C., 16, Southwark Street, London, S.E.1. 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 oases of notifiable infectious disease. Public library books which hare been in oontaot with oases of infectious disease are disinfeoted at the Public Health Department. Number of disinfeotions carried out by Wandle Valley Isolation Hospital 1 Number of rooms disinfeoted by fumigator 5 Number of library books disinfeoted 341 HOSPITALS The hospitals directly conoerned with the Mitoham 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. General Cases The principal hospitals are the Wilson Hospital, which is situated within the district, and the St.Helier Hospital, Carshalton, which oaters for all types of cases. The Nelson Hospital at Merton and the London hospitals are also used. 13. Infectious Diseases Cases usually go to the Wandle Valley Isolation Hospital at Beddington Corner, Mitcham Junction, or to St.George's Hospital, Tooting. Smallpox Cases By agreement with the South-East Metropolitan Regional Hospital Board, any oases that mihgt 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 oonfinement, 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 tuberoulosis 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 he obtained from the out-patients' 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 on first, third and fifth Friday afternoons, and a clinic for oases booked by midwives is held on Tuesday afternoons. 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. 14. CHILD WELFARE CLINICS Infant Welfare sessions are held at the following places:- Cavendish Road Clinic: Every Monday afternoon and Friday morning. St.Barnabas Church Hall, Gorringe Park Avenue: Every Tuesday afternoon. Wide Way Clinic: Every Monday afternoon and Thursday morning. Church Road Clinic: Every Wednesday afternoon and Thursday afternoon. Meopham Road Clinic: Every Wednesday afternoon. Toddlers' Clinics for children between the ages of two to five years are held monthly 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 Clinios. Western Road, Mitcham: Every weekday morning and afternoon. Church Road, Mitcham: Monday morning and afternoon; Tuesday morning; Thursday morning; Friday morning and afternoon. Meopham Road: Every weekday morning and afternoon. DIPHTHERIA, WHOOPING COUGH, TETANUS AND POLIOMYELITIS IMMUNISATION, VACCINATION AGAINST SMALLPOX Clinios are held as follows: Cavendish Road Clinic: Each Monday afternoon in conjunction with Welfare Clinic. Church Road Clinic: On first, third and fifth Wednesdays of the month in the morning. Meopham Road Clinic: Second and fourth Mondays of the month in the afternoon. St.Barnabas Clinic: On first, third and fifth Tuesdays of the month in the afternoon. 15. 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 Poliomyelitis immunisation is by oral vaccine at ordinary immunisation clinios 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 dootor in attendance. MOTHERCRAFT CLASSES Wide Way Clinio: Wednesday, 2 p.m. Church Road Clinio: Friday, 9.30 a.m. Cavendish Road Clinio: Thursday, 2 p.m. OPHTHALMIC CLINIC An eye specialist attends Western Road Clinic on Wednesday afternoons, and Wide Way Clinic on Tuesday mornings. PARENTCRAFT CIRCLE Church Road Clinio: Monday 2 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 clinios. SPEECH CLINIC A session is held at Western Road Clinic on Wednesday (all day). A speech therapist also holds a session at Wide Way Clinic on Friday afternoons. 16. HEALTH VISITING Health Visitors are under the control of the Surrey County Counoil. There are nine Health Visitors, who are under the supervision of a Divisional 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, continues to function successfully, although enough workers cannot he recruited to satisfy the full demand. At present there are 69 home helps in the Mitcham area covering a weekly case load of 425 households. The Neighbourly Help scheme, which started in 1962, continued to provide useful help in a number of cases. Applications for assistance are made to the Divisional Medical Offioer 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 1964 70 Number of children concerned 185 Number of visits paid 396 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 oases in this oategory during the year. 17. 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 oaravan yards, each with a stand pipe, supplying altogether a total of 23 caravans. The standard of purity of the water was maintained at the usual high level. There is no record in the Borough of any case of infeotious disease being transmitted by water. A large number of houses in the Borough have no supply of drinking water direot from the main, but are supplied from a tank in the roof. Provided the tank is properly covered and is cleansed regularly, it provides a satisfactory supply. SWIMMING BATHS Seven samples from the Alfred Mizen school swimming baths and 18 from the Corporation baths were sent for bacteriological examination during the year All were satisfactory. RIVERS AND STREAMS Visits have been paid to all works suspected of discharging effluent Into surface water sewers. CLOSET ACCOMODATION The whole of the district is on the water carriage system, the houses being drained to the publio 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 oarried out and in the summer more frequently. Eleven refuse collection vehioles are in use. 18. CLEAN AIR ACT. 1956 The Borough of Mitcham (No.2) Smoke Control Order, oovering an area of 703 acres containing 2146 properties, came into operation on 1st November 1964. Survey of the third area was completed in 1964 and the Borough of Mitcham (N0.3A) Smoke Control Order, covering 151 acres containing 1702 properties comes into operation on 1st November 1965. A survey of the fourth area was commenced before the end of the year. DISINFESTATIONS Number of Council houses found infested during the year 9 Number of other houses found infested during the year 9 Total number of houses disinfested during the year 18 Number of houses disinfested of beetles, 27 Number of houses disinfested of other insects 30 PREVENTION OF DAMAGE BY PESTS ACT, 1949 Two full-time and one part-time Rodent Operators were employed. Complaints received 583 Properties inspected 4,632 Number of treatments including test baits 946 Factory and business premises treated 100 Two sewer treatments were carried out during the year using fluoracetamide A subsequent test baiting of 53 of the manholes treated showed no takes. VISITS AND INSPECTIONS Complaints investigated 414 Revisits 1,388 Houses inspected for defects 539 Visits made for this purpose 595 Drains tested and inspected 126 Visits to Butchers 304 Visits to slaughterhouses 476 Visits to dairies 13 Visits to retail milk shops 39 Visits to restaurant kitchens 448 Visits to icoe-cream premises 40 Visits to bakehouses 32 Visits to other food premises 1,837 19 VISITS AND INSPECTIONS (Continued) Visits to factories 347 Visits re: Housing Survey 319 Visits to workplaces 37 Visits to outworkers 72 Visits to stables 67 Vixsits to piggeries 57 Visits re: Smoke Control 103 Visits to caravan yards 30 Smoke and noise observations 198 Visits re: infectious disease cases 56 Visits re: smallpox contacts 13 Visits re: food poisoning 8 Visits re: rats and mice 134 Visits re: Shops Acts 109 Visits re: schools 11 Visits re: Rent Act, 1957 41 Visits to sewage works 22 Sundry visits 716 Visits re: Offices, Shops and Railway Premises Act, 1963 1,137 Work Done Roofs repaired 37 Rainwater piping or gutters repaired or renewed 30 Yards paved or repaired 3 Dampness remedied 37 Water service pipes repaired 4 Waterclosets: Repairs to structure 4 Hushing apparatus repaired or renewed 24 New pans and traps fitted 13 Water storage cisterns cleansed, repaired or renewed 3 Water supply reinstated 4 Flooring of rooms repaired and sub-floor ventilation improved 30 Rooms cleansed 17 Sinks and handbasins repaired or renewed 4 Waste pipes and traps repaired or renewed 6 Window frames and sashes repaired or renewed 27 Window sills repaired or renewed 20 External brickwork (repaired, pointed or rendered) 24 Drains repaired or obstructions removed 61 Drains inspection covers renewed 10 Drains tested 21 Grid and mica flaps provided 2 Fire grates repaired (including surrounds and hearths) 5 Stoves, coppers, ranges, etc., repaired 1 Chimney stacks repaired 2 Staircases repaired 4 Doors repaired 6 20. VISITS AM) INSPECTIONS (Continued) Internal plaster repairs 56 Sash cords renewed 48 Dustbins provided 21 Aooumulations removed 24. 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 impraotioable, were treated with a fog generating apparatus, with satisfactory results. Disinfestation of dust chutes at the Counoil's blocks of flats was carried out by means of the high pressure fogging apparatus whioh was most effeotive: all sohool canteens were similarly treated. LEGAL PROCEEDINGS There were no legal proceedings in 1964. PETROLEUM LICENCES Petroleum (Regulations) Acts, 1928 and 1936. and Petroleum (Mixtures) Order. 1929.Ninety-eight licences to store petroleum spirit and/or petroleum mixtures were issued for a total of 293,365 gallons (inclusive of cellulose solutions). Petroleum (Carbide of Calcium) Order. 1929- Two licenoes were issued for the storage of 1,224 1bs. of carbide of calcium. HOUSING STATISTICS Total Number of Inhabited Dwellings- 20,676 Housing properties now owned by the Council amount to 4,666, including 326 temporary dwellings. During the year 214 families were rehoused from the waiting list, 168 in Mitcham, 40 by nomination to the Primley and Camberley U.D.C. under the Town Expansion Scheme, and 6 in New Towns under the Industrial Selection Scheme. Seven families were rehoused from dwellings in Slum Clearance areas. The number of new registrations continued to increase and at the end of the year the housing register stood at 1,438, representing a net increase of 125 over the previous year. 21. RENT ACT. 1957 Seven applications were made for Certificates of Disrepair during the year. In four oases undertakings were given by the various landlords and in the remaining three cases Certificates were issued. No Certificates were cancelled during the year. INSPECTION AND SUPERVISION OF FOOD Two thousand, seven hundred and thirteen 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 12 Grooeries 62 Butchers 34 Greengrocer 4 Fruiterers 48 Greengrooer 4 Fried Fish 1 Greengrocer 4 General Provisions 3 Confectionery 76 Chemists 13 Restaurants 4 Cafes 36 Cafe 4 General Stores 1 Roadside Snack Bars 2 Fishmongers 8 Fried Fish Buffets 9 Fried Fish 3 Bakers 4 Confectioners 14 Milk 4 Provisions 10 Public Houses 30 Off-Licences 13 Multiple Food Stores 7 Food premises by type, registered under Section 16. Food and Drugs Apt, 1955 The storage and sale of ice-cream 151 The manufacture for sale of ice-cream 3 The preparation or manufacture of sausages, or potted, pressed, pickled or preserved food 36 Dairies registered under the Milk and Dairies (General) Regulations, 1959 1 Number of inspections of registered food premises during the year 396 Unsound Food Dealt with Beef 36 lb s. Ham 540 lbs. Corned Beef 36 lbs. Pork Luncheon Meat 32 lbs. Steak 14 lbs. Pork 74 lh s. Ox Tongue 12 lbs. Fish 63 lbs. Steak 14 lbs. Lambs Liver 10 lbs. Potatoes 452 lbs. Sugar 20 lbs. Canned Rhubarb 37 lbs. Jellied Veal 8 lbs. Bacon 10 lbs. Assorted packets and tins 1,102 lbs. 22. All condemned food was 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 DHUGS ACT. 1955 Formal Samples Thirty-four formal samples were taken as follows:Milk 30 Pork Sausages with preservative 4 Informal Samples One hundred and thirty-nine informal samples were taken as follows:- Double Devon Cream 1 Milk-Shake Syrup (Pineapple) 1 Butter Sponge Syrup Pudding 1 Chocolate Swiss Roll (Vanilla Filled) 1 English Stewed Steak in Gravy 1 Creamed Horseradish 1 Strawberries in Heavy Syrup 1 Vegetable Shortening 1 Margarine (containing 10% Butter) 2 Cheez Wiz 1 Acetyl Salicylic Acid with Ipecac and Opium Tablets B.P.C. 1 Bismuth Compound Lozenges B.P.C. 1 Calcium with Vitamin D Tablets B.P.C. 1 Dramamine Tablets 1 Bread 2 Raspberry Yogurt 1 Military Pickle 1 Instant Coffee 1 Tomato Ketchup 1 Beef Curry with Rice 1 Benzoic Acid Solution 1 Capsicium Ointment B.P.C. 1 Aluminium Compound 1 Liquorice Compound Powder 1 Clotted Cream 1 Spaghetti with Bolognese Sauoe 1 Tomato and Cheese Sauce 1 Spanish Rice with Tomatoes, Pork and Peppers 1 Capriton Tablets 1 Prodexin Tablets 1 Instant Coffee 1 Ground Paprika 1 Pure Almond Marzipan 1 Vegetables and Liver (Junior Dinner) 1 Double Cream 1 Raspberry Yogfruit 1 Minced Beef with Onion and Gravy 1 Orange Drink 1 Pure Honey 1 Christmas Pudding 1 Mincemeat 1 Sunnybisk 1 Brown Crispbread 1 Danish Camembert Cheese 1 Rivella Health Drink 1 Benemid Tablets 1 Home Farm Tips Tea 1 Baked Beans in Tomato Sauce 1 Processed Peas 1 "Handy" Milk Tops 1 Grated Cheese 1 French Cream 1 Cookeen- Compound Fat 1 Prawn Curry with Rice 1 Savoroni (Chicken Flavour) 1 Chili-Con-Came Chili Beef with Beans 1 Magnesium Trisilicate Powder B.P. 1 Folic Acid Tablets 1 Nicotinic Acid Tablets 1 23. Pure Butter (Unsalted) 1 Butter 1 Curry Paste 1 Sliced Roast Beef with Rich Gravy 1 Metatone 1 Dequadin Lozenges 1 Agarol 1 Choledyl Tablets 1 Mushroom Ketchup 1 Pure Honey (Pasteurised) 1 Gravy Salt 1 Corn Flake Crumbs 1 Beans with Pork Sausage and Tomato Sauce 1 Pickling Spice 1 Mixed Peel 1 Seedless Raisins 1 Kidney Flavour Soup 1 Cream of Mushroom Soup (Condensed) 1 Processed Peas 1 Tea 1 Cream of Tomato Soup (Condensed) 1 Cranberry Sauce 1 Paella with Chicken and Prawns 1 Savoroni Spanish Mix 1 Blackcurrant Health Drink 1 Corned Beef 2 Chocolate Drops Cake Mix 1 Fruit Jellies 1 Vitaminised Iron and Teast Tonic Tablets 1 Herbal Tranquillisers 1 Custard Powder 1 Quick Dried French Beans 1 Stewed Steak 1 Stewed Steak in Gravy 1 Pork Brawn 1 Beef Sausages containing preservative 1 Cough Linctus 1 Vitamin B - Complex Tablets 1 Mysoline Tablets 1 Tolazoline Tablets (Priscol) B.P. 1 Ready Mix Ice Cream 1 Meat Pudding 1 Pink Salmon 1 Portuguese Sardines 1 Pure Danish Cream 1 Shredded beef suet with flour 1 "Whitehall" fruit cake 1 Australian butter 1 Lemon Pie filling 1 Avonmine tablets 1 Benadryl Elixir 1 Priscal tablets 1 Veganin tablets 1 Tuna 1 Steak and Kidney Pudding 1 Marcaite 1 Bovril 1 Steak and Kidney Pie 1 Black Pudding 1 Strawberry Low Fat Yogurt 1 Orange and Passion Fruit Drink 1 Vitacup 1 Fersamal Tablets 1 Benadryl Capsules 1 Glycerin of Phenol B.P. 1 Pork Kidneys 1 Corn Relish 1 Celery Salt 1 Sugared Strands 1 Chow Mein 1 Ground Almonds 1 Dolly Mixture 1 Opal Mints 1 Dressed Crab 1 Tuna 1 Calf's Foot Jelly 1 Coffee and Chicory Essence 1 24. All samples were satisfactory except for four, three being cases of incorrect labelling and the fourth of deficiency of a constituent part of a drug. The labels were re-printed to comply and the drug, a small quantity which was probably made to an out of date B.P.C. standard, was destroyed. Complaints from the public relating to food were as follows:- Mould in a flan case Mould in an iced cake Mould in sausage rolls Foreign body in a milk bottle Piece of metal in sliced bread Mould in sliced bread Warning letters were sent to the firms concerned. Ice-Cream Three establishments in the Borough are registered for the manufacture of ice-cream and 151 for the storage and sale of ice-cream. Forty visits were paid during the year to the premises manufacturing ice-cream. Bacteriological Examination of Cups and Glasses Sixty-three swabs were taken from tea cups at various catering establishments and fifteen 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) Coliform Bacilli. Present Absent Bact. Type Present Coli I Absent Satisfactory Result Unsatisfactory Rather High Under 100 2 53 1 1 54 1 - 100-200 - 1 - - - - 1 200-500 1 - - 1 - - 1 500-1,000 1 2 - 1 - 1 2 1,000-1,500 - - - - - - - 1,500-2,000 - 2 - - - 1 1 2,000 and orer - 1 - - - - 1 Total 4 59 1 3 54 3 6 Beer Class Swabs Colony Count (per glass) Coliform Bacilli. Present Absent Bact. Type Present Coli I Absent Satisfactory Result Unsatisfactory Rather High Under 100 1 8 - 1 9 - - 100-200 1 - - 1 - - 200-500 2 - - - - 2 c/fwd 1 11 - 1 10 - 2 25. Colony Count (per glass) Coliform Bacilli. Bact. Coli Type I Satisfactory Result Unsatisfactory Rather High Present Absent Present Absent B/fwd 1 11 - 1 10 - 2 500-1,000 - 1 - - - - 1 1,000-1,500 - - - - - - - 1,500-2,000 - - - — — — — 2,000 and over 2 — 1 1 - 1 1 Total 3 12 1 2 10 1 4 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 During the year the Council granted the following number of licences:- Dealer's (Pre-packed Milk) Licences- Pasteurised 3 Pasteurised and Sterilised 3 Pasteurised, Sterilised and Tuberculin Tested 2 One hundred and twenty-nine samples of graded milk were submitted for bacteriological examination. Five were void owing to temperature change and three were unsatisfactory. Letters were sent to the suppliers in these cases and further samples taken were satisfactory. BAKEHOUSES The number of bakehouses in the district is three. Thirty-two visits have been paid. DAIRIES There is one registered dairy and pasteurising establishment within the district. During the year thirteen visits of inspection were paid. SLAUGHTERHOUSES During the year four hundred and seventy-six visits were made to the slaughterhouse. SLAUGHTER OF ANIMALS ACT, 1958 Ten licences were issued to slaughtermen in accordance with the requirements of the above Act. 26. MEAT INSPECTION Carcases and Offal Inspected and Condemned in Whole or in Part Cattle, excluding cows Cows Calves Sheep and Lambs Pigs Number killed 195 49 163 468 14,967 Number Inspected 195 49 163 468 14,967 All diseases except tuberculosis and cysticerci: Whole carcases condemned ... •• ••• 7 27 Carcases of which some part or organ was condemned 9 •• 1 13 2,047 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 4.6 •• 0.6 4.3 13.8 Tuberculosis only: Whole carcases condemned ••• •• ••• ••• ••••• Carcases of which some part or organ was condemned ••• •• ••• ••• 307 Percentage of the number inspected affected with tuberculosis ••• •• ••• ••• 2.1 FOOD PREPARING FACTORIES There are fourteen 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, sixteen. Number of notices complied with, sixteen. PIGGERIES There are three piggeries in the Borough. Fifty-seven visits were paid during the year. PET ANIMALS ACT. 1951 Four licences were issued to occupiers of pet shops, one on a change of proprietor. 27 FACTORIES ACT. 1961 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 6 36 ••• ... 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 328 348 1 ••• 2 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 3 ••• ••• ••• ••• 3 TOTAL ••• 334 384 1 ••• ••• 28. 2. Cases in which defects were found:- Particulars (1) M/c line No. (2) Number of Cases Which Defect were found Number of cases in which prosecutions were instituted (7) M/c line No. (8) Found (3) Remedied (4) Refe To H.M. Inspector (5) rred By H.M. Inspector (6) Want of cleanliness (S.1) 4 3 3 ••• ••• ••• 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 9 9 ••• 1 ••• 10 (c) Not separate for sexes 11 ••• ••• ••• ••• ••• 11 Other offences (not including offences relating to Homework) 12 1 1 ••• ••• ••• 12 TOTAL 13 13 ••• 1 ••• 29. 3. Outwork (Sections 110 and 111):- Nature of Work (1) Section 110 Section 111 M/C line No. (9) M/C line No. (2) 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 40 13 Cleaning & washing 14 14 Household linen 15 1 15 Lace, lace curtains and nets 16 16 Curtains & furniture hangings 17 17 Furniture and upholstery 18 2 18 Locks, latches and keys 26 5 26 Cosaques, Christmas crackers, Christmas stockings, etc. 42 3 42 Lampshades 44 70 44 TOTAL 121 30. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES INFECTIOUS DISEASE NOTIFICATIONS The total number of confirmed notifications received during 1964 was 531. 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 56 Public Health Inspectors to smallpox contacts 13 69 Rooms disinfected after infectious disease 5 31. 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 - 1 - - - 2 - - - - - - 18 8 1 - - - - 30 February - 2 - - - 2 - - - - - - 32 8 - - - - - 44 March - 2 - - - 1 - - - - - - 11 2 - - - - - 16 April. - 1 - - - 1 - - - - - - 1 6 - - - - 1 10 May - 3 - - - - - - - - - - 5 3 - - - - - 11 June - 4 - - - - - - - - - - 3 4 - - - - - 11 July - 6 - - - - - - - - - - 26 6 - - - - - 38 August - 1 - - - - - - - - - - 18 3 - - - - - 22 September - - - - - - - - - - - - 5 12 - - - - - 17 October - 1 - - - - - - - - - - 7 4 - - - - - 12 November - 3 - - - - - 1 - - - - 28 2 - - - - - 34 December - 6 - - - - - - - - - - 279 1 - - - - - 286 Totals - 30 - - - 6 - 1 - - - - 433 59 1 - - - 1 531 32. INFECTIOUS DISEASE NOTIFICATIONS 1955-64 DISEASE 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 Smallpox - - - - - - - - — — Scarlet Fever 33 56 18 75 69 24 32 34 28 30 Diphtheria - - - - - - - - - - Typhoid Fever - 1 - - - - - - - - Puerperal Pyrexia 1 - - - - 5 1 1 2 - Meningococcal Infections — 1 - - 1 1 1 1 - - Erysipelas 9 7 4 3 4 5 6 6 3 - Measles 1059 50 1358 172 847 162 850 200 770 433 Acute Poliomyelitis 7 13 3 - 1 - - 1 - - Ophthalmia Neonatorum — - - - 2 1 1 - - 1 Acute Encephalitis - - 2 - - - - - 1 1 Pneumonia 34 19 24 12 22 10 7 3 14 6 Malaria - - - - - - 1 - - - Whooping Cough 167 103 130 45 17 118 58 16 35 59 Food Poisoning 8 11 4 9 27 6 2 1 2 1 Dysentery 17 60 47 8 10 6 1 8 19 - Paratyphoid - 1 - 1 - - - - - - Totals 1335 322 1590 325 1000 338 960 271 874 531 33. SMALLPOX There were no oases or direct contacts in 1964. The last case was in 1932. Thirteen visits were made to un-vaccinated passengers on a cruise liner which made an un-scheduled stop at a port where smallpox is endemic. VACCINATION AGAINST SMALLPOX Number vaccinated in 1964 Age at date of vaccination Under 1 1 2-4 5-14 15 or over Total Primary vaccinations 31 499 26 5 2 563 Revaccinations - - 4 5 5 14 SCARLET FEVER The number of cases of scarlet fever notified during the year was 30 as compared with 28 in 1963, equivalent to a case rate of 0.48 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 fifteenth year in succession, whereas cases used to average 60 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 give the triple antigen against diphtheria, whooping cough and tetanus. The following table shows the number of children immunised and reinforced against diphtheria, whooping cough and tetanus in 1964. 34. 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 1964 1963 1962 1961 1960 1955-9 1950-54 Total A. Diphtheria 344 469 48 18 8 49 8 944 Primary Course Whooping Cough 344 462 48 18 5 9 - 886 against: Tetanus 344 469 49 18 6 51 6 943 B. Diphtheria - 121 216 29 40 564 311 1281 Reinforcing Whooping Cough - 117 206 26 34 107 4 494 injection against: Tetanus - 121 217 28 39 231 41 677 POLIOMYELITIS There were no cases of poliomyelitis during the year. Since 1957 there have been only two cases notified in Mitcham, one in 1959 and one in 1962. POLIO VACCINATION Numbers Immunised in 1964 Year of Birth Primary oourses Third doses Fourth doses 1964 117 - - 1963 610 6 - 1962 98 14 - 1944-1961 94 37 352 1943 and before 34 5 1 Total 953 62 353 The total number immunised since the beginning of polio vaccination is now 26,459. Practically all poliomyelitis immunisation is carried out now with oral vaccine. ENTERIC FEVER There were no cases of enteric fever during the year. 35. DIARRHOEA AND ENTERITIS UNDER TWO YEARS OF AGE One death was registered during the year. FOOD POISONING OUTBREAKS Only one case was notified in 1964. Neither the oause nor the source could be ascertained. ENCEPHALITIS There was one post infectious case during the year. The patient was removed to hospital. ERYSIPELAS There were no cases notified in 1964. FUERPERAL PYREXIA There were no cases of puerperal pyrexia during the year. PNEUMONIA Six 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 12 were males and 15 females. MENINGOCOCCAL INFECTIONS There were no cases during 1964. INFLUENZA In 1964 there were no deaths from influenza. OPHTHALMIA NEONATORUM There was one case of opthalmia neonatorum during 1964. 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. 36. 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 261 Mumps 201 Ringworm - Rubella 30 Influenza 1 Glandular fever 1 CANCER The number of deaths from cancer registered during the year decreased slightly to 145, of which 90 were males and 55 females. This compares with 147 in 1963. The trend for England and Wales is continuing upwards. The site distribution for 1964 was as follows:- Stomach 11 cases Respiratory organs 45 „ Breast 14 „ Genito-urinary organs 2 „ Other sites 73 „ Total 145 The following table shows the number of deaths from cancer, together with the death rate as compared with England and Wales:- Year Number of Death Rate per 1000 of population Deaths Mitcham England and Wales 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 37 Year Number of Deaths Death Rate per 1000 of population Mitcham England and Wales 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 1962 142 2.23 2.19 1963 147 2,29 2.18 1964 145 2.32 2.20 DEATHS IN MITCHAM PROM LEUKAEMIA AND LUNG CANCER, 1955-1964 Year Deaths from Leukaemia Deaths from Lung Cancer 1955 2 40 1956 3 36 1957 3 41 1958 2 26 1959 3 32 1960 8 36 1961 6 39 1962 2 49 1963 6 44 1964 - 45 The deaths from lung cancer in Mitcham rose from 44 in 1963 to 45, less than one third of all deaths from cancer. There were no deaths from leukaemia. TUBERCULOSIS During the year 21 new cases of tuberculosis were notified, viz: Males Females Total Pulmonary 10 8 18 N on-Pulmonary - 3 3 Totals 10 11 21 Fifteen oases were transferred into the Borough as follows:- Hales Females Total Pulmonary 7 8 15 Non-Pulmonary — — — Totals 7 8 15 38. The total number of deaths from tuberculosis was:- Males Females Total Pulmonary 2 1 3 Non-Pulmonary - - - Totals 2 1 3 England and Vales Mitcham Death rate from tuberculosis, all forms, per 1,000 population 0.05 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. F. F. Under 1 year - - - - — — - — 1 year to 4 years - - - - - - - - 5 years to 9 " - - - - - - - - 10 " " 14 " - 1 - - - - - - 15 " " 19 " - 1 - - - - - - 20 " " 34 " 5 3 - - - - - - 35 " " 44 ” 2 1 - 1 1 1 - - 45 " " 64 " 2 2 - 1 - - - - 65 " and upwards 1 - - 1 1 - - - Totals 10 8 - 3 2 1 - - 39. 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 - - - - - - - - - - - - - Nil HOME SAFETY The aspects of Home Safety stressed during the past year were "Sight Protection" and "Do it Yourself with Safety". Booklets, leaflets and posters were sent to school clinics and suitable organisations. In view of the success of competitions for schoolchildren in previous years it was decided to continue this form of Home Safety education. A simple form of competition was devised and nearly three thousand entries were received. Prizes were presented by the Mayor. MEALS ON WHEELS This much appreciated service continued to function with the smoothness and efficiency shown in previous years. 5902 meals were supplied during the year to the housebound and to the Old Age Pensioners' Club in London Road, for whivh thanks are due to the organiser, Mrs. Forsdick and her voluntary workers. Mrs. Frost continued as caterer during and, once again, supplied all the old people with a free Xmas dinner. Free dinners were also supplied at New Tear and Easter by friends of the W.V.S. MINIATURE MASS RADIOGRAPHY A general public session was held at the Vestry Hall May 5th-15th and a number of factories were also visited. Statistics are shown below:- Male Female Total number examined 1260 1630 Significant pulmonary tuberculosis 3 3 Primary lung cancer 1 1 40. 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 employees come from outside Mitcham. 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 During the year the Committee oontinued to help patients and, where necessary, their families. Assistance is given towards extra nourishment, beds and bedding, occupational therapy, education, clothing, provision of wireless and television and payment of licence fees, holidays, fares for relatives to visit, pocket money for patients, removal expenses, internal decorations, hire purchase arrears, insurance, etc., etc. The fund necessary for this work is mostly raised through the efforts of the voluntary committee. The help given improves the morale of the patient and/or his family. The proportion of T.B. cases dealt with continues to diminish each year. 41. INDEX Page Abortion, Deaths 6,10 Ambulances 12 Ante-Natal Clinics 13 Area 3 Bacteriological Examination of Cups and Glasses 24,25 Bakehouses 25 Bedding, Disinfection of 12 Birth Rates 6,8, 11 Births, Illegitimate 6 In Institutions 7 Live 6 Still 6 Cancer 36, 37 Deaths from 6,36,37 Caravans 17 Causes of Deaths 6, 8-11 Child Guidance Clinic 14 Child Welfare Clinics 14 Clean Air Act, 1956 18 Cleansing, Public 17 Clinics 13-15 Closet Accommodation 17 Committees, Health, Members of 3 Dairies 25 Death Rates 6-9 Deaths 6-9 Dental Clinics 14 Diarrhoea and Enteritis 6 Diphtheria 33 Diphtheria Immunisation 33,34 Disinfection 12,30 Encephalitis Lethargica 35 Enteric Fever 34 Erysipelas 33 Factories Act, 1937 27-29 Food and Drugs Act, 1955 22-25 Section 16 21 Hygiene, General Regulations, 1960 26 Dealt with, Unsound 21-22 Inspection and Supervision of 21 Preparing Factories 26 Poisoning 35 Case Rates 11 Sampling 22—23 42. Page General Provision of Health Services for the Area 12-16 Health Visiting 16 Home Help Service 16 Home Safety 39 Hospitals 12, 13 Houses, Disinfection of 12 Inhabited 5, 20 Housing Statistics 20 Ice Cream 21, 24 Immunisation and Vaccination Clinics 14,15 Infant Mortality 6-9 Infectious Disease Case Rates 11 Contacts 35 Hospitals 13 Monthly Incidence of 31 Notifications 31-36 School 36 Public Health Inspectors' Visits 18,19,30 Influenza 35 Inquests 9 Laboratory Facilities 12 Legal Proceedings 20 Library Books, Disinfection of 12 Maternal Mortality 6,9,10 Maternity, Hospital Treatment 13 Meals—on—Wheels 39 Measles, Case Rates 11 Deaths from 6,10,11 Meat Inspection 26 Meningococcal Infection 35 Milk (Special Designation) Regulations 25 Mortality, Analysis of 11 National Assistance Act, 1948, Section 47 16 N.S.P.C.C. 16 Neonatal Mortality 9 Ophthalmia Neonatorum 35 Outworkers (Section 11 and 111- Factories Act, 1937) 29 Persons in Need of Care and Attention 116 Pests Act, 1949, Prevention of Damage by 18 Pet Animals Act, 1951 26 Petroleum (Regulations) Acts, 1928 and 1936, and Petroleum (Mixtures) Order, 1929 20 Petroleum (Regulations) Acts, 1928 and 1936, and Petroleum Carbide of Calcium Order, 1929 20 Piggeries 26 Pneumonia 35 Poliomyelitis 34 Immunisation 34 43. Page Population 5 Post-Natal Clinics 15 Puerperal Pyrexia 35 Public Analyst 12 Radiography, Miniature Mass 39 Rateable Value 5 Rent Act, 1957 21 Rivers and Streams 17 Rodent Operations 18 Rooms Disinfected, Number of 12,30 Sanitary Circumstances of the Area 17 Scarlet Fever 33 Slaughterhouses 25 Slaughter of Animals Act, 1958 25 Smallpox 33 Vaccination 33 Vaccination Clinics 14 Hospital 13 Smoke Control Areas 18 Social Conditions 5 Staff 4 Statistics 6—11 Housing 20 Still Births 6 Tuberculosis 37-39 Care Committee 40 Clinic 13 Unsound Food dealt with 21 Venereal Disease Clinic 13 Visits by Public Health Inspectors 18,19 Water Supply 17 Whooping Cough, Deaths from 6,10,11 Immunisation 33 R2/68