Library S4Tc 22 BOROUGH OF SUTTON AND CHEAM ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year 1958 BOROUGH OF SUTTON AND CHEAM ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 19 58 PUBLIC HEALTH COMMITTEE THE WORSHIPFUL THE MAYOR (Councillor R.W. Jenkins, J.p.) Alderman D. Sparks (Mrs.) M. B. E. Alderman F. Warren Councillor G. Armstrong " R. A. Beuzeval (Chairman) " L. B. Blackler " A. W. Letts Councillor K.J. Martin " F. R. Muddle " D.M. Pettlngell (Mrs.) " A. Sullivan " A. G. Taylor PUBLIC HEALTH OFFICERS OF THE AUTHORITY Medical Officer of Health ENEAS J. MACINTYRE M.D., D.P.H. (Manor Park House, Manor Park Road, Sutton, Surrey. Vigilant 6603) Chief Public Health Inspector ARTHUR SYDNEY WILLIAMS Cert. R.S. I., Cert. Meat & Food Deputy Chief Public Health Inspector REGINALD WILLIAM NORMAN Cert. R. S. I. and S. I.E.J.B., Cert. Meat & Food Additional Public Health Inspectors JOHN BAMFORD Cert. R.S.I. and S. I.E.J. B., Cert. Meat & Food KEMPTON HUDDLESTONE PRIOR Cert. R.S.I. and S.I.E.J.B., Cert. Meat & Food CYRIL WILLIAM SOUTHERBY Cert. R.S.I. and S.I.E.J.B., Cert. Meat & Food FRANK SUTCLIFFE Cert. R.S.I. and S.I.E. J.B., Cert. Meat & Pood Public Analyst DANIEL D. MOIR, M.Sc., F.R.I.C., Analytical and Consulting Chemist (Part-time) 1 TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF SUTTON AND CHEAM Mr., Mayor, Ladies and Gentlemen, I have the honour to present to you the Annual Report on the health of the Borough for the year 1958, on behalf of my predecessor in office, Dr. E.J. Maclntyre. The general health of the community was good. The estimated population showed an increase of two hundred and fifty. The birth rate increased from 12.3 to 13.1 per thousand of population. The death rate rose slightly from 11.3 to 12.3 per thousand of population. The infantile mortality rate was lower. There was one maternal death. There was a lower incidence of infectious diseases. There were fewer cases of Measles, Whooping Cough, Pneumonia, Dysentery and Food Poisoning. Two cases of Poliomyelitis were notified. No case of Diphtheria occurred. A Mass X-Ray Unit visited the Borough in January for one week, with good result. The council's Housing Programme is limited by scarcity of sites. Consequently slum clearance is retarded. Forty one new houses or flats were completed during the year. At the end of the year thirty four houses or flats were planned or under construction. In addition an allocation of fifty properties has been made at Frimley and Camberley under the Town Expansion Scheme for occupation between 1959 and 1962. The work of sanitation, of the prevention of nuisances and of the protection of food was efficiently carried out under the direction of the Chief Public Health inspector, Mr. A.S. Williams, to whom I am indebted for his helpful collaboration. Work on the second stage of the reconstruction of the Worcester Park Sewage Works has not proceeded as quickly as planned, but it is anticipated that the new Sludge Digestion Tank will now be completed during 1959. Meantime the design of Stage III is proceeding. The water supply of the district maintained a high standard of chemical and bacteriological purity. Effective control by sampling and by chlorlnatlon was continued. Thanks are due to the Members of the Council for their advice and help during the year and to the Officers of the Council for their co-operation. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, JOHN C. BIRCHALL Medical Officer of Health 2 STATISTICS OF THE AREA 1957 1958 Area in acres 4338.15 4338.15 Registrar General's estimate of the Resident Population 78.960 79,210 Number of inhabited houses (end of year) according to the Rate Book 23,692 24,626* Rateable value and sum represented by a £1,539,785 £1,554,114 Penny Rate £6,259 £6,313 *This figure includes 622 dwellings assessed with business premises, not previously included. EXTRACTS FROM VITAL STATISTICS (Comparative of the Years 1957 and 1958) 1957 1958 England & Wales 1958 Total Male Female Total Male Female Live Births 970 493 477 1035 516 519 Legitimate 939 478 461 1002 500 502 Illegitimate 31 15 16 33 16 17 Birth Rate per 1000 of the Estimated Resident Population 12.3 13.1 16.4 Still Births 18 8 10 9 5 4 Legitimate 16 7 9 9 5 4 Illegitimate 2 1 1 — — - Rate per 1000 total (live and still births) 18.2 8.6 21.6 Deaths 890 415 475 971 461 510 Death Rate per 1000 of the Estimated Resident Population 11.3 12.3 11.7 Deaths from Sepsis 0 0 Other Maternal Causes 0 1 Death Rate from Maternal Causes per 1000 total (live and still births) 0.00 0.96 0.43 Deaths of Infants under one year of age All Infants per 1000 live births 26.8 16.4 22.5 Legitimate Infants per 1000 legitimate live births 24.5 14.5 Illegitimate Infants per 1000 illegitimate live births 96.9 60.1 3 4 CAUSES OF DEATH IN THE BOROUGH OF SUTTON AND CHEAH DURING 1958 M. F. Total 1. Tuberculosis, respiratory 5 3 8 2. Tuberculosis, other 1 1 2 3. Syphilitic disease 1 1 2 4. Diphtheria - - - 5. Whooping Cough - - — 6. Meningococcal infections - - - 7. Acute Poliomyelitis - - - 8. Measles - - - 9. Other Infective and parasitic diseases 5 2 7 10. Malignant neoplasm, stomach 15 10 25 11. Malignant neoplasm, lung, bronchus 29 7 36 12. Malignant neoplasm, breast 1 14 15 13. Malignant neoplasm, uterus - 4 4 14. Other malignant and lymphatic neoplasms 46 37 83 15. Leukaemia, aleukaemia 4 4 8 18. Diabetes 1 5 6 17. Vascular lesions of nervous system 55 89 144 18. Coronary diseases, angina 122 62 184 19. Hypertension with heart disease 7 13 20 20. Other heart disease 41 123 164 21. Other circulatory disease 12 17 29 22. Influenza - 4 4 23. Pneumonia 12 15 27 24. Bronchitis 31 15 46 25. Other diseases of respiratory system 5 3 8 26. Ulcer of stomach and duodenum 8 2 10 27. Gastritis, enteritis and diarrhoea 2 1 3 28. Nephritis and nephrosis 4 2 6 29. Hyperplasia of prostate 9 - 9 30. Pregnancy, childbirth, abortion - 1 1 31. Congenital malformations 6 1 7 32. Other defined and Ill-defined diseases 25 51 76 33. Motor vehicle accidents 6 5 11 34. All other accidents 3 9 12 35. Suicide 4 9 13 36. Homicide and operations of war 1 - 1 TOTALS 461 510 971 Mortality The principal causes of death were diseases of the heart and circulation (56 per cent.) and cancer (17.6 per cent.) Deaths from cancer of the lung decreased from thirty eight to thirty six Deaths from coronary diseases increased from one hundred and thirty to one hundred and eighty four. Deaths from accidents declined from twenty four to twenty three, of which eleven were due to motor vehicles. Epidemiological and statistical studies have directed attention to factors which are contributory to constitutional diseases There is definite statistical correlation between the smoking of cigarettes and cancer of the lung. The risk of mortality can be reduced by abstinence from tobacco. DEATHS FROM CANCER OF THE LUNG, 1951 to 1958 1951 1952 1953 1954 1955 1956 1957 1958 Males 15 29 36 35 26 28 33 29 Females 8 7 3 3 6 3 5 7 Totals 23 36 39 38 32 31 38 36 Maternal Mortality. There was one maternal death. This was due to paralytic ileus following a Caesarian operation. Infantile Mortality. There were seventeen deaths of infants under one year in 1958, compared with twenty six in 1957. The infantile mortality rate was 16.4 per thousand live births, compared with 22.5 per thousand live births for England and Wales. Of the seventeen deaths, eleven occurred in the neo-natal period within one month of birth as is shown in the following table of causes and age groups. AGE GROUPS Causes of Death Under 1 month 1-12 months Prematurity 6 Congenital abnormality 2 2 Birth injury 2 Broncho Pneumonia - 2 Accident - 1 Other causes 1 1 Totals 11 6 5 GENERAL PROVISION OF PUBLIC HEALTH SERVICES FOR THE AREA NEW LEGISLATION The Bousing (Financial Provisions) Act, 1958 This deals with financial assistance for housing accommodation provided by local authorities and others and deals particularly with subsidies for rehousing for the purpose of slum clearance. It also deals with improvement grants to privately owned properties and it empowers the lending of money by local authorities for purchase of houses, etc. The Slaughterhouses Act, 1958 The Act amends certain provisions of the Food and Drugs Act, 1955 relating to slaughterhouses and knackers yards and it also amends the Slaughter of Animals Acts, 1935 to 1954 and Section 151(1) of the Factories Act, 1937. The Act came into operation on 1st August, 1958. The Slaughter of Pigs (Anaesthesia) Regulations, 1958 These Regulations permit the use of a process of anaesthesia by Carbon Dioxide Gas in connection with the slaughtering of pigs under safeguards against the infliction of unnecessary suffering. The Regulations came into operation on 1st December, 1958. REMOVAL OF PERSONS IN NEED OF CARE AND ATTENTION The National Assistance Act, 1948:- Section 47 No action was necessary under this Section of the Act. BURIAL AND CREMATION OF THE DEAD The national Assistance Act, 1948:- Section 50 Three burials were arranged under the powers granted to the Council by this Section. MORTUARY One hundred and eighty seven bodies were received and one hundred and eighty seven post mortem examinations were made, The Mortuary premises, which include a three body refrigerated chamber, have been well maintained. At the end of the year sketch designs for a new Mortuary had been approved by the Council and submitted for Town Planning approval. It is hoped that building may commence before the end Of 1959. 6 LABORATORIES The Public Health Laboratory, Epsom, serves the Borough for bacteriological examinations. This service is supplemented by the use of the laboratories at Sutton and Cheam Hospital and St. Heller Hospital. CLINICS Details of the clinics available in the district are given at the end of this report. SANITARY CIRCUMSTANCES OF THE AREA Water Supply. The water supply is mainly derived from the deep wells in the chalk of the Sutton District Water Company, situated at Sutton, Cheam and Woodmansterne. A small area in the North Ward is supplied by the Metropolitan Water Board. The water from all wells of the Sutton District Water Company is softened to nine degrees of hardness. Chlorine is applied in the form of chloramlne as a protective measure. Samples of the raw and treated waters are examined dally by the laboratory at the Sutton Works. Samples are also examined at monthly intervals by the Company's Consultant Analyst, and monthly samples are examined in rotation by the District Councils in the area of supply. The supply from all sources has been satisfactory in quality and quantity All the dwelling houses have a direct supply from the public mains, Below is the average of monthly analyses. Chemical Results in Parts per Million Average Total Solids 197.75 Ammonia 0.10 Ammonia, Albuminoid 0.00 Nitrogen in Nitrates 7.60 Nitrogen in Nitrites 0.00 Oxygen Absorbed 0.08 Chlorine in Chlorides 16.86 Hardness total (grains per gallon) 7.88 Bacteriological Results No. of Bacteria growing on Agar per ml. for 3 days at 20° C. 1 No. of Bacteria growing on Agar per ml. for 1 day at 37° C. 0 Presence of Bacillus Coll in 100 ml. 0 Swimming Baths. Satisfactory control over residual chlorine and pH has been maintained in the two swimming baths. Five samples taken at peak periods of attendance gave satisfactory chemical and bacteriological results. 7 DRAINAGE AND SEWERAGE Worcester Park Sewage Disposal Works. The work on Stage II of the Reconstruction Scheme has proceeded during the year and it is anticipated that the new Sludge Digestion Tank will be brought into operation during 1959. The design of Stage III is proceeding and the Ministry of Health has indicated that loan sanction will be given. The effluent being discharged to the Beverley Brook continues to be of good quality. Sutton Sewage Disposal Works. These works continue to discharge a good quality effluent to the Pylbrook. Flooding. The Surrey County Council has completed the work of improvements to the Pylbrook at the rear of the properties in Hamilton Avenue. The laying of a new surface water sewer in Matlock Crescent has been completed. The design of a relief surface water sewer for the lower portion of the High Street, Sutton, has been completed and so has the design of a relief surface water sewer in Morden Way. The designs of a new soil sewer in Cuddlngton Way to the Borough boundary and a new relief soli sewer from Ventnor Road to Downs Road, Belmont, have also been prepared and it is hoped to obtain loan sanctions for the carrying out of the works during the Financial Year 1959/60. Refuse Collection and Scavenging. The collection and disposal of house refuse and salvage, together with the scavenging of public highways is carried out under the supervision of the Borough Engineer and Surveyor. The work has been executed in a satisfactory manner. Rivers and Streams. Subject to the remarks under "Flooding" above, the streams within the Borough have been maintained in a satisfactory condition. Closet Accommodation. There are Tour premises with cesspools in use. Only two pall closets and two chemical closets are in use. In the past thirty years, one hundred and sixty one premises, originally with cesspool drainage, have been connected to sewers. 8 SANITARY INSPECTION OF THE AREA Report of the Chief Public Health Inspector under Article 27 of the Sanitary Officers (Outside London) Regulations 1935-1951 (Pages 9 to 37 ) RECORD OF INSPECTIONS MADE AND NOTICES SERVED Visits Special Inspections; interviews and advisory visits 1,366 Reinspectlon visits 2,781 Visits to works in progress 350 " Factories/Workplaces 565 " Bakehouses 13 " Outworkers premises 81 " Butchers/Grocers/Greengrocers/Flshmongers etc. 927 " Dairies/Milk Purveyors 27 " Ice Cream Premises (Manufacture and sale of) 128 " Restaurant/Cafe Kitchens, Dining Rooms etc. 91 " School/Industrial Canteen Kitchens 40 " Stables/Passages/Plggerles and Ditches 33 " Premises in connection with rodent control 5,220 " Cinemas/Theatres/Halls 11 " Hairdressers and Barbers Premises 40 " School and Public Conveniences 26 " Verminous Premises 32 " Shops under the Shops Act 489 " Licenced Public Houses 11 " Hospitals - spraying of kitchens 17 Visits re infectious Diseases 95 " Food Poisoning Enquiries " Overcrowding and permitted numbers 143 " Food and Drugs sampling 258 " Sampling of milk and water (Bacteriological) 113 " Sampling of ice cream (Bacteriological) 155 " Merchandise Marks Acts 297 " Rag Flock Act 3 " Pet Animals Act 7 " Heating Appliances (Flregiard Regulations) 18 " Atmospheric Pollution Gauges/Smoke observations 61 Miscellaneous visits 1,356 Total 14,754 Number of complaints received and investigated 453 Premises at which defects or nuisances were discovered 1,426 Dwelling-houses surveyed for housing defects under the Public Health or Housing Acts 175 Number of defects or nuisances discovered 2,034 " " " remedied 1,317 " " "in hand 160 " " " outstanding 557 Number of informal notices served 746 9 STATUTORY NOTICES WERE SERVED AS UNDER Housing Act 1957 Sections 9 and 10 3 Public Health Act 1936, Section 24 39 " " " 39 7 " " " 45 1 Sutton and Cheam Corporation Act, 1951, Section 42 1 Total 51 SUMMARY OF REMEDIAL WORKS AND SANITARY IMPROVEMENTS CARRIED OUT Drainage and Sanitary Fittings Number of houses and other premises redrained 2 Number of houses and other premises connected to soil and surface water sewers 1 Repairs and amendments to existing drains (930 feet laid) 49 Drains or gullies unstopped or cleansed (involving 988 premises) 341 Sanitary fittings repaired/renewed provided or cleansed 243 Water service pipes/cisterns repaired renewed or cleansed 4 Water, smoke and chemical tests applied 112 W. C. Apartments W.C. Apartments provided 6 " lighted and/or ventilated 9 " provided with ventilated lobbies 3 " screened 2 " cleansed and/or repaired 13 Separate W.C. accommodation provided for the sexes 1 Structural Repairs or Improvements Carried Out Number of roofs repaired or renewed 66 " guttering and rainwater pipes provided repaired etc. 74 " damp walls remedied 36 " walls repointed repaired or re-rendered 48 " chimney stacks repaired or rebuilt 22 " yards paved or repaired 16 " floors relald or repaired 38 " windows/cills/sashcords repaired or renewed 178 " doors/thresholds provided or repaired 38 " staircases/handrails provided or repaired 5 " ranges/stoves/coppers renewed or repaired 16 " food cupboards provided/ventilated Cleansing Number of rooms/passages/larders cleansed and/or repaired 95 " trade premises cleansed 37 " verminous premises disinfested for bugs/fleas 19 " premises sprayed for cockroaches/crlckets/wood beetles etc. 23 " premises disinfected after various diseases 99 " School Canteens/Kitchens sprayed for flies and ants 11 " Hospital kitchens sprayed 7 10 Various Number of dustbins provided 18 " accumulations of refuse removed 11 11 wasp nests destroyed 41 " miscellaneous Items remedied 78 HOUSING lo Inspection of Dwelling-Houses during the Year:- (1) (a) Total number of dwelling-houses inspected under the Public Health or Housing Acts 175 (b) Number of inspections made for the purpose 646 (2) Number of dwelling-houses found not to be in all respects reasonably fit for human habitation 163 2, Remedy of Defects during the year without service of Formal Notices:- Number of defective dwelling-houses rendered fit in consequence of Informal action by the Local Authority or their officers (Including 4 for 1957) 31 Action under Statutory Powers during the Years:- (A) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1957:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs 4 (2) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) By Owners 3 (b) By Local Authority in default of owners 1 (B) Proceedings under the Public Health Act:- (1) Number of dwelling-houses in respect of which Notices were served requiring defects to be remedied 9 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) By Owners 6 (b) By Local Authority in default of owners 3 (C) Proceedings under Section 17 (1) of the Housing Act, 1957:- (1) Number of houses demolished as the result of formal action by the Local Authority 1 (2) Number of houses demolished as the result of informal action by the Local Authority 11 4. Clearance Arena - Section 42 of the Housing Act„ 1957:- A representation in respect of Nos. 25 to 43 (odd) Maiden Road, Cheam was made to the Borough Council on 18th February, 1958 and a resolution was passed declaring the area defined and coloured pink, upon the map marked "Borough of Sutton and Cheam (Maiden Road) Clearance Area 1958" to be a clearance area under Section 42 of the Housing Act, 1957 and that the land comprised in the area be purchased and the demolition of the buildings on the land be undertaken or otherwise secured by the Borough Council. The District Valuer was asked to negotiate for the purchase of the land comprised in the area by agreement, but no agreement had been reached by the year end. RENT ACT, 1957 This Act came into operation on the 6th July 1957 and applies primarily to privately owned property let unfurnished as separate dwellings, but it also affects furnished lettings. The main effect of the Act was to free from rent control houses and flats with rateable values exceeding £40 in the Metropolitan Police District, and the City of London, or over £30 elsewhere in England and Wales, and to allow limited increases in the rents of houses and flats still under rent control. The Act has the general objective of enabling rented properties to be put in repair, of increasing the total stock of rented accommodation, and of securing a better use of existing housing accommodation. The following summary shews the number of applications received for 'Certificates of Disrepair', and for the cancellation there of during the period 6th July 1957 to 31st December 1958:- (A) ADDllcatlons for Certificates of Disrepair From 6.7.57 to end of 1958 1958 only Number of applications received 116 68 Number of decisions not to issue certificates Nil Nil Number of applications withdrawn 8 5 Number of decisions to issue certificates 105 60 (a) in respect of some but not all defects 84 53 (b) in respect of all defects 21 7 Number of undertakings given by landlords under paragraph 5 of the First Schedule (Form K) 58 36 Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule Nil Nil Number of certificates of disrepair issued (1 withdrawn after service of Form J.) 46 34 (B) Applications for Cancellation of Certificates Number of applications received 12 12 Number of objections to cancellation received 2 2 Number of certificates cancelled 9 9 Number of certificate cancellations pending 2 2 Number of objections to cancellation upheld 1 1 12 INSPECTION OF FACTORIES AND OTHER PREMISES factories Acts 1937-1948 - (Part I of the Act) 1. Inspections made by Public Health Inspectors for the purpose of provisions as to healths:- Type of Premises Number on Register Number of Inspections Notices, written and/or oral (1) Factories without mechanical power 55 57 2 (2) Factories with mechanical power 315 331 26 (3) Other premises (excluding outworkers premises) 19 39 3 Total 389 427 31 2. Defects found in factories and other premises under the Act:- Particulars Number of cases In which defects were found Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness 8 4 - - Overcrowding - — - - Unreasonable temperature - - — — Inadequate Ventilation - - — _ Ineffective drainage of floor - - - - Sanitary Conveniences (a) Insufficient 3 3 - 1 (b) Unsuitable or defective 15 8 - 1 (c) Not separate for the Sexes 1 1 - - Other offences against the Act (not including offences relating to outwork) 4 2 - - Total 31 18 - 2 3. Outwork (Sections 110 and 111) Nature of Work No. of out-workers as recorded in the August list No. of cases of default in sending list to the Council Notices served Wearing apparel (Making etc.) 34 - - Umbrellas etc. 15 - - Lampshades 30 - - Total 79 - - 81 visits were made during the year to the homes of outworkers residing in the Borough. 13 WORKPLACES - Public health Act, 1936 Inspections Number of written and verbal notices Occupiers prosecuted 51 8 - CLEAN AIR ACT. 1956 The remaining provisions of the Act, not already covered by the Clean Air Act {appointed day) Order 1056, and 'The Dark. Smoke (permitted Periods) Regulations, 1958' came into operation on the 1st June, 1958. Section 1 of the Act prohibits, with certain exceptions, the emission of dark smoke from chimneys. A chimney is defined as including structures and openings of any kind from or through which smoke may be emitted (e.g. louvres in the roofs of buildings). The regulations permit the following:- (1) Not more than 10 minutes of dark smoke in the aggregate from any chimney in any period of 8 hours, or 14 minutes in 8 hours if soot-blowing is carried out within that period. These periods are extended in the case of chimneys serving more than one furnace. (2) No continuous emission of dark smoke (other than that caused by soot-blowing) shall exceed 4 minutes: and (3) No emission of black smoke (i.e. as dark or darker than shade 4 on the Rlnglemann Chart) shall exceed 2 minutes in the aggregate in any period of 30 minutes. In the case of proceedings for discharging dark smoke it would be a defence to prove that the emission was solely due (a) to the lighting of a furnace from cold, (b) to some failure of a furnace or of apparatus, and (c) to the use of unsuitable fuel when suitable fuel was unobtainable. Section 2 of the Act also provides a further defence available until 4th July 1963, if it can be proved that the emission of dark smoke was due to the nature of the building and equipment, and not due to failure of proper maintenance and it had not been practicable to alter or equip the building so as to enable it to be used for the purpose for which it was intended without the likelihood of contraventions of Section 1. Sections 5 to 9 relating to grit and dust from furnaces; Section 16 - abatement of smoke nuisances; and Section 19 relating to Railway Engines, also came into operation on the 1st June, 1958. Smoke Abatement and Atmospheric Pollution There are but few industrial chimneys in the Borough. Nineteen complaints of smoke emission were received and 14 dealt with during the year, sixteen of these were in respect of bonfires and three from boiler stacks attached to industrial premises. Grit Deposit Measuring Gauges In conjunction and With the co-operation of the Department of Scientific and Industrial Research, the grit deposit measuring gauges have been maintained and samples collected monthly for analytical examination. The following is a summary of the results obtained:- MONTH Gauge No. 2 Gauge No. 6 Gauge No. 7 Rainfall in inches Total Solids (Tons per sq.mlle) Rainfall in inches Total Solids (Tons per sq.mlle) Rainfall in inches Total Solids (Tons per sq.mlle) January 1.90 10.31 1.93 12.19 1.81 8.19 February 1.98 9.94 1.85 13.66 1.74 8.68 March loll 11.00 1.21 12.74 0.94 11.00 April 1.26 15.58 1.21 10.90 1.01 11.90 May 8.58 10.77 2.77 14.75 2.48 8.49 June 4.53 11.14 5.26 23.32 4.29 11.13 July 1.73 8.75 1.85 11.56 1.89 7.79 August 2.87 9.02 3.53 25.82 2.91 8.91 September 3.94 9.88 5.94 35.33 3.88 8.51 October 2c 93 7.06 3.45 7.45 2.62 7.56 November 1.54 7.86 1.75 8.03 1.67 8.02 December 2.58 9.38 3.04 9.42 2.45 9.28 Yearly Totals 28.95 120.69 33.79 185.17 27.69 109.46 Monthly average 2.41 10.05 2.81 15.43 2.30 9.12 Gauges Nos. 6 and 7 were re-sited on the 1st October,, 1958. The Borough is now adequately covered by the three grit deposit gauges which are roughly 1½ miles apart. 15 DAILY MEAN CONCENTRATION OF SMOKE AND SULPHUR DIOXIDE A smoke filter and volumetric sulphur dioxide apparatus was installed in Manor Park House after consulting the Department of Scientific and Industrial Research as to the suitability of the site. A dally record has been kept, since the 1st November, 1958, of the amount of smoke or suspended matter and sulphur dioxide in the air. It has long been recognised that a distinction must be drawn between relatively coarse particles of solid matter which are quickly deposited by their own weight,, and which comprise most of the particulate matter collected in the deposit gauge, and the very fine particles which settle slowly. If at all. These fine particles, commonly referred to as "smoke", are less than about 20 microns (0.002 cm) in size and consist largely of carbonaceous matter, including tar, produced by the incomplete combustion of coal; some fine ash is also included. It is important to realise that little of this fine material is collected in the deposit gauge which in consequence gives no Information about pollution by smoke. To obtain such Information a smoke filter is necessary. The following table gives a summary of the dally readings taken during the months of November and December, 1958 after installation of the apparatus at Manor Park House. Smoke (Milligrams per 100 cu.,metres) Sulphur Dioxide (Parts per 100 million) Highest Dally Reading Lowest Dally Reading Average Dally Reading Highest Dally Reading Lowest Dally Reading Average Dally Reading November 60 3 26 25.4 1.7 10.7 December 62 1 22 25.2 0.8 9.5 16 INSPECTION AND SUPERVISION OF FOOD food and Drugs Act, 1955 Sampling. During the year two hundred and twenty-one sample (comprising fifty-nine formal and one hundred and sixty-two informal samples) were submitted to the Public Analyst for analysis as follows:- Type of Sample Number of Samples Examined Unsatisfactory _ Samples Formal Informal Total Formal Informal Total Ale (Home Brewed - 1 1 - - - Almonds - ground - 4 4 — - - Almond Paste - 1 1 — - - Antibiotic Lozenges - 1 1 — - - Asparagus Tips - 1 1 — — — Aspirin - 1 1 - — — Blackcurrant Syrup - 2 2 - — - Blood Tonic — 1 1 - - — Brandy 2 - 2 — - - Brandy Butter - 1 1 - 1 1 Breadcrumbs - 1 1 - — - Bread - wholemeale - 1 1 - - — Bread and Butter Sandwiches - 1 1 - - - Brine - 1 1 - 1 1 Butter 1 2 3 - — — Cake Mix - 1 1 - - - Cheese Spread - 3 3 - — — Cheese Spread with Ham - 1 1 — - — Chill Sauce - 1 1 - - — Christmas Pudding - 1 1 - - - Cinnamon - ground - 1 1 - - — Coffee and Chicory Essence - 1 1 - - — Condensed Milk. - 1 1 - - - Confectionery - chocolate 1 4 5 1 4 5 Confectionery-flour - 2 2 - 1 1 Confectionery - sugar - 16 16 - — — Cordial 1 2 3 - - — Cough Syrup - 1 1 - - — Crab - 1 1 - — — Cream - 4 4 - — — Curry Powder - 1 1 - - - Custard Powder - 1 1 - — - Dandelion Coffee Essence - 1 1 - - — Diabetic Chocolate - 1 1 - - - Diabetic Beer - 1 1 - - — Egg Handles - 1 1 - - — Egg Soup Fancies - 1 1 - 1 1 Epsom Salts - 1 1 - — — Essence for making Non-Brewed Condiment 1 1 - 1 1 Fish Cakes 1 - 1 - - - Gelatine - 1 1 - - - Ginger - 1 1 - - - Glauber Salts - 1 1 - - - Gravy Powder - 1 1 - - - Gravy Salt - 1 1 - — - Health Salt - 1 1 - - - Ice Cream - 11 11 - 1 1 Ice Lollie - 2 2 - - - Instant Icing - 2 2 - - — Iodine Liniment - 1 1 - - - Jam - 2 2 - - - Carried Forward 6 92 98 1 10 11 17 Type of Sample Number of Samples Examined Unsatisfactory Samples Formal Informal Total Formal Informal Total Brought Forward 6 92 98 1 10 11 Jelly Crystals - 1 1 - - - Junket Crystals - 1 1 - - - Lemonade Crystals - 1 1 - - - Lemon Curd - 1 1 - - - Liniments for Muscular Pains - 2 2 - - - Linseed, Liquorice and Chlorodyne Lozenges - 1 1 - - - Liqueur Chocolates - 1 1 - — — Liquid Paraffin - 1 1 - — — Luncheon Meat 1 1 2 1 - 1 Milk 29 11 40 - — — Milk. - Channel Island 15 - 15 — — - Milk - South Devon 1 — 1 - - - Milk Shake Cordial - 1 1 - - — Milk Shake in a Straw - 1 1 - 1 1 Milk Diet Supplement - 1 1 — — — Milk Pudding - 1 1 - - - Mlncement - 1 1 - - - Mint in Vinegar - 1 1 — - - Non-Brewed Condiment 1 1 - 1 - 1 Non-Brewed Condiment Essence 1 — 1 - - - Non-Brewed Vinegar 1 - 1 1 — 1 Nutmeg-ground - 1 1 — - - Pain Relief Tablets - 2 2 - - - Panadol Tablets - 1 1 - - - Pancake Mixture - 2 2 - - - Paste (Turkey and Tongue). - 1 1 - - - Peas - 1 1 - - - Peel-mixed, cut — 3 3 - 1 1 Pepper-white - 2 2 - - - Pheasant Savoury - 1 1 - - - Rose Hip Syrup - 1 1 - - - Salmon with Mayonnaise - 1 1 — - - Sauce - 2 2 - - - Sausages - beef 1 - 1 - - - Sausages - pork - 2 2 — - - Sausage-meat, beef 1 — 1 - - - Slimming Tablets - 1 1 - - - Soft Drink Base - 1 1 - - - Spinach Puree - 1 1 — - - Steak — 1 1 - - - Strawberry Syrup — 1 1 - - - Stuffing, Sage and Onion - 1 1 - - - Sweetener - concentrated - 1 1 - - - Tablet Dessert — 2 2 - - - Tartare Sauce - 1 1 - - - Tartaric Acid - 1 1 - - - Tea — 1 1 — - - Tomato Paste — 1 1 - - - Tonic Elixir - 1 1 - - - Tonic Phosphates - 1 1 - - - Trout Savoury - 1 1 - - - Turtle Jelly - 1 1 - — - Vanilla Flavouring Essence - 1 1 - - - Vanilla Sugar - 1 1 - — — Vienna Sausages - 1 1 - 1 1 Vinegar - 1 1 - - - Wheat Embryo — 1 1 - - - Whisky 2 - 2 - - - Total 59 162 221 4 13 17 18 The following details classify the type of irregularity or infringement and the action taken in connection with the seventeen unsatisfactory samples:- Sample No. Article Sampled Type of Infringement Action taken and Remarks 2509 (Informal) Brandy Butter Labelling Infringement This article contained sugar, butter, brandy and nutmeg. The nutmeg was not declared on the label as one of the ingredients. Cautioned. The manufacturers amended the label by adding the words "added spices" to the list of ingredients previously stated. 2545 (Informal) Brine This article was a sample of brine solution taken from a galvanised container used for pickling meat in a Butcher's shop, and found to contain 28 parts per million of zinc. The Butcher was informed of the zinc content of the brine, and subsequently provided a noncorrosive container for the storage of pickling brine. 2532 (Informal) Chocolate Dates This article was found to be dates coated with a milk, chocolate substitute - composed of sugar, fat (other than cecoa butter), skimmed milk (dried or condensed) and cocoa. Cautioned Chocolate is an article of confectionery prepared with sugar, cocoa butter and ground cocoa beans. It should contain no fat other than cocoa butter. Milk chocolate should contain milk fat corresponding to the whole milk used. 2496 (Informal) Cream Slices Labelling Infringement The sample contained a substance resembling cream in appearance, but composed of an emulsified mixture of butter or butter-fat, and some edible fat with sugar and water added. A notice was exhibited in the shop stating "Rich Dairy Cream is now used in all our cakes Cautioned The retailer immediately withdrew the notice, and instructions given that the term 'cream' must not be used in relation to this article in future. 2510 (Informal) Egg Soup Fancies Labelling Infringement The article consisted of soup garnish prepared from two or more ingredients not specified on the label. Cautioned The Importers were informed of the infringement, and arrangements made for the relabelling of stocks to conform with the Labelling of Food Order, 1953. 19 Sample No. Article Sampled Type of Infringement Action taken and Remarks 2598 (Informal) Ice Cream The Ice Cream was found to contain 8.7% of sugar instead of 10% minimum content required under the Food Standards (Ice Cream) Order, 1953. Cautioned Repeat samples taken from the local manufacturer were found to be satisfactory. A1040 (Formal) Luncheon Meat The Luncheon Meat contained 68% of meat instead of a reasonable minimum of 80% as considered by the Public Analyst. Cautioned The French Manufacturers were informed of the deficiency. They maintained it was manufactured in such a manner that the meat content should have been 80% and could not account for the deficiency. 2512 (Informal) Milk Chocolate This article was found to contain no milk fat and little. if any, cocoa butter, It was in fact a milk chocolate substitute prepared with sugar fat (other than cocoabutter), skimmed milk powder and cocoa. Cautioned The article was immediately withdrawn from sale, and a promise given by the retailer to discontinue the 'line'. 2527 (informal) A106 8 (Formal) Milk. Chocolate The article consisted of a milk chocolate substitute prepared with sugar, fat (other than cocoa-butter), skimmed milk powder (or its equivalent) and cocoa. Cautioned The manufacturers were informed of the infringement and stated that this article was no longer being manufactured.. A formal sample was taken some 3 months later and the facts reported to the Public Health Committee, when it was decided to again warn the manufacturer and consider taking action if a further sample was found to be of similar quality. l 2533 (Informal) Milk Chocolate Nougat This article was found to be nougat coated with a milk chocolate substitute composed of ingredients mentioned in connection with samples Nos. 2527 and A1068. Cautioned The manufacturer was informed of the infringement, and the question of the composition of chocolate coverings in general was fully discussed at a meeting with one of the Directors. The matter is still under review. 2536 (Informal) Milk Shake in a straw Labelling Infringement This article consisted of straws containing a compound colouring, flavouring and sweetening substance, the ingredients of which included sugar, 3odlum bicarbonate, citric acid, saccharin, colouring and flavouring which were not fully specified on the label. Cautioned The manufacturers were in formed ofthe infrlingement and arrangements made for the printing of new labels in conformity with the requirements of the Order. 20 Sample NO. Article Sampled Type of Infringement Action taken and Remarks 2608 (Informal) Mixed Cut Peel Labelling Infringement The ingredients contained in this article were not specified on the label. Cautioned The manufacturers stated that arrangements had been made for a statement of ingredients to be included in the new packages being printed, A1047 (Formal) Non-Brewed Vinegar The sample had been purchased as NonBrewed Vinegar, whereas it was anon-brewed condiment containing 3.5% w/v of acetic acid instead of a minimum of 4% w/v. Cautioned The retailer prepared the article Tor sale by adding water (in a fixed proportion) to a non-brewed essence which was labelled 'Concentrated solution of Acetic Acid'. The retailer was advised to sell the article under its proper designation. 2529 (Informal) Essence for malting NonBrewed Condiment This article was found to contain 46,8% w/v of acetic acid instead of 52% w/v as stated on the container. Cautioned The manufacturers carried out a thorough investigation but were unable to account for the deficiency in this particular sample. The sample was taken in order to establish responsibility for the deficiency of acetic acid in Formal Sample No.1047. A1062 (Formal) Non-Brewed Condiment The non-brewed condiment contained 3.7% w/v of acetic acid instead of a minimum Of 4% W/V. Cautioned This was a follow-up to informal sample No.2529. The retailer was requested to exercise care, when diluting the essence, by adding the correct amount of water in future. 2518 (Informal) Vienna Sausages Labelling Infringement The sausages contained tripe, beef, por, etc., as stated on the label; but tripe was the major ingredients therefore not entitled to the description 'Vienna Sausages', (Vienna Sausages are a type of continental sausage prepared with pork as the major meaf. ingredient, the total meat content being not less than 80% of which fourfifths Is pork). Cautioned The manufacturers of this foreign product suggested that the sausages be described as 'Charma Sausage' and this description was agreed to by the Public Analyst, therefore no further action was considered necessary. 21 Sampling Observations. It will be seen from the detailed classification that of the two hundred and twenty-one samples taken during the year 4.98% were found to be other than genuine and labelling infringements accounted for a further 2.71%, making a total of 7,69%. For comparative purposes the figures for 1957 were 2.30% and 4.16% respectively, making a total of 6.46%, The pattern of sampling has followed that of previous years in that a wide range of commodities has been covered. A satisfying result has emerged since the infringements revealed were generally of a minor character and with the willing co-operation of retailers and manufacturers were usually readily adjusted. COMMENTS BY THE PUBLIC ANALYST (Food and Drugs Act, 1955) The sampling of Foods and Drugs in the Borough during 1958 has followed the usual pattern and details of the action taken in those instances where 'adulteration" has been reported are included in the Chief Public Health Inspector's Report. As usual a number of interesting points have been discovered and in most cases any alleged offences against the Act have been rectified by negotiation with the vendors or manufacturers of the article concerned. In these notes I usually confine myself to a discussion of one or two of the more interesting cases and make comments on the general working of the Food and Drugs Act as it appears to the Public Analyst I shall do the same this year, During the first quarter a sample of luncheon meat was found to contain only 68 per cent of meat and., although there is no legal standard of quality for this article in this country, your public analyst is of the opinion that a minimum of 80 per cent meat content is reasonable I have discussed before the reasons why the public analyst has to make up his own mind as to what is a reasonable standard for foods which have none prescribed by law and, indeed, it is his inescapable duty to do so. In the case of luncheon meat and of many other types of canned meats there has been a tendency in the last few years for manufacturers to lower the meat content in order to satisfy what has been described as a public demand for a lower priced article. The public, however, is often unable to distinguish between a meat preparation containing a large amount of cereal or potato filler and additional water from one which is composed essentially of meat We have exactly the same difficulty with sausages,. It is imperative that the public should not be misled by the description of articles of food and luncheon meat is essentially a meat product containing only small amounts of other substances if imitation foods containing less meat and with a lower meat content are to be sold they should not be described by the same name. This question is somewhat complicated by the fact that large amounts of canned meats are imported from other Countries, and manufacturers abroad often find it difficult to understand our point of view,, Patient negotiations and Instruction are usually the best way of dealing with the problem and It Is these methods which the Borough has 22 used with frequent success in the past in connection with most of the samples which I have found to he irregular. There are, however, from time to time cases where negotiation is rejected by the manufacturer or where the seriousness of the offence is such that legal action is called for and a case in point this year was in connection with the sample of Milk. Chocolate, No,Al068, This sample was found to be a substitute of the worst possible type in which the whole milk traditionally present in milk chocolate had been replaced by skimmed milk and the natural cocoa butter by some other vegetable fat, The fact that this article could be sold at something like half the price of genuine milk chocolate is of particular interest. For various reasons no legal action was taken in this case and the article Itself appears to have gone off the market, but it illustrates the point that adulteration of a serious nature does still occur and that it will be necessary for Food and Drugs Authorities to bring such cases to the Courts if the public are to be protected from such misdescription. Excluding milk samples,, all of which were satisfactory, the number of samples found to be irregular were seventeen out of a total of 165 - or 10.3. per cento This is a high proportion, but it should not be inferred that Sutton and Cheam is a 'black spot' in this respect, I feel sure it is due to the intelligent keenness with which the Chief Public Health Inspector and his staff approach this aspect of their work and in these comments I am happy to express my thanks for their help and co-operation. Finally a word about contamination by radioactivity. This is a subject Which is in everybody's mind and is the natural concern of Public Health Authorities throughout the country, I felt strongly during 1958 that Public Analysts should be ready as far as possible to advise their authorities on the scientific aspects of this problem and to examine where necessary samples of foods, waters, effluents, soil etc. for possible contamination, Under the Food and Drugs Act, as far as foods are concerned, it will of course be the duty of a public analyst to consider this in his general survey when passing certain foods as suitable for human consumption and I have gone to some considerable trouble and expense in equipping myself with the necessary up-to-date knowledge and instruments for carrying out this work. How far local authorities will become involved in the immediate future is a matter of conjecture but in the coming atomic age vigilance will always be necessary. MILK SUPPLY Food and Drugs Act, 1955 Milk and Dairies Regulations 1949-1953 The Milk (Special Designation) (Raw Milk) Regulations 1919-1954 The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949-1953 The Borough of Sutton and Cheam is a specified area for the purpose of the Milk (Special Designations) (Specified Areas) Order 1951, therefore all milk sold in the Borough is designated milk, 23 All milk, distributors in the area are licenced to use the special designation in relation to the milk: retailed;, and are granted a dealer s or supplementary licence for that purpose. Routine inspection of milk pasteuriser's and distributors' premises reveals that the provisions of the various Regulations are generally well observed. The following licences to sell graded milks in the Borough were granted in 1958:- Grade of Milk. TYPE OF LICENCE Dealers Supplementary Pasteuriser's Tuberculin Tested 18 12 - Pasteurised 30 12 1 Sterilised 30 13 - TOTAL 78 37 1 CHEMICAL ANALYSIS OF MILK AND CREAM SAMPLES MILK Forty-five formal and eleven informal samples of milk, were taken for chemical analysis; all of which were found to be genuine. Sixteen samples of "Channel Island' and 'South Devon' milk contained satisfactory averages of 4.57% milk fat and 8.96% milk solids other than milk fat; and forty other samples of milk contained satisfactory averages of 3 76% milk fat and 8.66% milk solids other than milk fat. The results were well above the minimum standard of 4% milk fat laid down in The Milk and Dairies (Channel Island and South Devon Milk) Regulations 1956; and of 3% milk fat and 8.5% milk solids other than milk fat required under The Sale of Milk Regulations 1939. CREAM Analysis of the four Informal samples of cream showed the two double cream samples to contain an average of 48.7% milk fat and the two single cream samples a satisfactory average of 23.1% milk fat. The minimum standards in relation to cream are as follows:'double cream' not less than 48% by weight of milk fat; and 'other creams' described as single cream, pouring cream, coffee cream, fruit creams or as any other description of cream - not less than 18% by weight of milk fat. 24 BACTERIOLOGICAL EXAMINATION OF MILK SAMPLES One hundred and twenty-seven samples of milk were examined as followss- Number of samples examined Type of Test applied Results Class of Milk Passed Failed Pasteurised 73 Phosphatase Methylene Blue 73 - 71 2 Sterilised 10 Turbidity 10 - Tuberculin Tested Pasteurised 19 Phosphatase Methylene Blue 19 - 19 - Tuberculin Tested (Farm Bottled) 25 Methylene Blue 23 2 TOTALS 127 123 4 To comply with the Milk (Special Designation) (Raw Milk.) Regulations, Tuberculin Tested Milk must not decolourise Methylene Blue within hours if the sample is taken during 1st May to 31st October, or within hours if taken between the 1st November to 30th April. Of the total samples examined under these Regulations two samples of Tuberculin Tested (Farm Bottled) Milks failed to pass the prescribed test Both samples were taken during the hours test period and decolourised Methylene Blue in 3½ hours„ It is the practise immediately to notify failures of farm bottled milk to the dairy company concerned so that the matter may be taken up with the responsible producers as speedily as possible. To comply with the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations. Tuberculin Tested (Pasteurised) and Pasteurised Milk must not give a reading of more than 2.3. Lovlbond blue units in the phosphatase test and must not decolourise methylene blue in 30 minutes. Of the 92 samples examined under these Regulations two decolourised methylene blue in 20 mlnutes= Both samples were taken from Milk Vending Machines in the Borough ICE CREAM Ice Cream (Beat Treatment Btc.) Regulations 1917-1952 Registrations. During the year six applications for the registration of premises for the sale and storage of ice cream were received and granted. At the end of 1958 a total of one hundred and sixty-one premises had been registered for the sale of ice-cream in accordance with Section 16 of the Food and Drugs Act. 1955, and on three of these premises ice cream could be manufactured. 25 BACTERIOLOGICAL SAMPLING OF ICE CREAM During the year seventy four samples of ice cream were obtained for bacteriological examination and provisional gradlngc The following table shows the 1958 percentage results in each grade and for comparative purposes the results obtained in 1957. Grading of Samples 1958 Grade 1 72 samples 97.30% "2 1 sample 1.35% ,, 3 1 ,, 1.35% ,, 4 — ,, - TOTAL 74 Grading of Samples 1957 Grade 1 66 samples 91.67% "2 5 " 6.94% ,, 3 - ,, ,, 4 1 sample 1.39% TOTAL 72 It is most gratifying to record that 98.65% of the samples were placed in grades 1 and 2 one in grade 3 and none in grade 4. The following table shows the average percentage and other details in connection with the samples obtained from individual manufacturers., Producers Code ' Number of samples ' taken Type of Sample Average percentage In each grade Wrapped , Loose Grade 1 r Grade 2 Grade 3 i Grade 4 A 15 15 - 100.00% - - - B 16 15 1 100.00% - - - C 12 12 - 100.00% - - - D 8 8 - 87.50% 12.50% - r E * 9 - 9 100.00% - - - F * 7 - 7 85.71% - 14.29% - G 4 - 4 100.00% - - - H i 1 - 100.00% - - - I * 2 1 1 100.00% — — — TOTAL 74 52 22 97.30% l.35% l.35% Nil * Denotes locally produced CHEMICAL SAMPLING OF ICE CREAM The Food Standards (Ice Cream) Order 1953 prescribes (with certain exceptions) the following standard for ice creams- Fat 5% Sugar 10% and milk solids other than fat 7½% 26 Eleven samples of locally produced ice cream were submitted to chemical examination and found to contain constituent percentages well above the prescribed standard, except one sample which was deficient In sugar, as under: - Sample No. Fat CONSTITUENT PERCENTAGES Milk Solids other than fat Sucrose Total Sugars 2474 7.5 12.2 20,0 25.4 2497 6.8 14.7 20.0 20.0 2498 7.5 12.0 13.8 13.8 2513 11.9 10.9 22.7 22.7 2528 6.9 11.0 14.1 14.1 2544 11.2 14.8 16.0 16.0 2546 7.2 10.0 12.8 12.8 2547 8.3 12.2 15.5 15.5 2597 12.7 11.9 14.1 14.1 2598 8.9 13.2 8.7 8.7 2611 6.7 10.8 11.8 11.8 Average 8.7 12.2 15.4 15.9 ICE LOLLIES- BACTERIOLOGICAL EXAMINATION There is no prescribed standard for water ices or ce lollies sold as such, but as in former years it was decided to submit samples to a test similar to the one applied to ice cream., Forty-three lollies were examined and found to be satisfactory,, FOOD HYGIENE REGULATIONS 1955-57 These regulations replace Section 13 of the Food and Drugs Act, 1938 (which dealt with precautions against contamination of food) and add a number of new provisions in respect of the hygienic handling of food and the construction and maintenance of premises, stalls, vehicles etc. where food is handled They also replace regulations 19, 20 and 21 of the Public Health (Meat) Regulations, 1924 in respect of the transport and carrying of meat. The regulations lay down requirements in respect of (a) the cleanliness of food premises and stalls etc., and of apparatus and equipment, (b) the hygienic handling of food, (c) the cleanliness of persons engaged in the handling of food and of their clothing, and the action to be taken where they suffer from, or are carriers of, certain infections, (d) the construction of food premises, the repair and maintenance of food premises, stalls, vehicles etc., and the facilities to be provided, and (e) the temperature at which certain foods that are particularly liable to transmit disease are to be kept in food premises. 27 The Food Hygiene (Amendment) Regulations, 1957 amend regulation 7 of the 1955 Regulations (which restricts the giving out of food for preparation or packing in domestic premises). The new regulation 7 permits the giving out of shrimps, prawns and onions for peeling on domestic premises if the premises are registered for the preparation of the food in question with the local authority under section 16 of the Food and Drugs Act, 1955 and certain other requirements are complied with. The following is a summary of the number of food premises in the Borough;- Bakehouses 15 Butchers (including one horseflesh shop) 55 Confectioners (sugar and flour) 172 Fishmongers/Stalls/Fried Fish Shops 27 General Stores/Shops 17 Greengrocers/Stalls/Stores 86 Grocers 143 Ice Cream (Manufacture and sale of) 161 Licenced Public Houses 35 Milk Purveyors/Depots/Dairies 40 Restaurants/Cafes/Snack Bars/Dining Rooms 65 School and Industrial Canteens/Kitchens/ Service Rooms 35 Other food premises 12 TOTAL 863 During the year 1,237 visits were made to food business premises, 100 notices were served in connection with the 180 infringements discovered as detailed in the following tables- Food Hygiene Regulations Contraventions Number of Infringements found in 1958 Number of Infringements rectified in 1958 including infringements discovered in 1957 but rectified in 1958 Regulation No. 5 2 1 " 6 16 10 " 8 12 17 " 9 28 21 " 14 24 29 " 15 1 13 " 16 30 24 " 17 5 13 " 10 6 16 " 19 8 15 " 20 - 1 " 21 1 4 " 23 30 43 " 24 - 1 " 26 15 2 " 28 2 — TOTAL 180 210 28 It is gratifying to record that the majority of the traders have shown a willing co-operation to comply with the requirements of the Regulations, This is revealed in the above table by the number of infringements rectified in the relatively short time the Regulations have been in force. Mention must also be made that the standard of hygiene in the various food premises and the cleanliness of the persons engaged in the handling of food continued to improve. REGISTERED FOOD PREMISES The following table shows the number of food premises registered by type of business, and the number of inspections made- A. Section 16 - Food and Drugs Act 1955 B. Milk and Dairies Regulations 1949-1954. C. ice Cream (Heat Treatment etc) Regulations 1947-1952 and D. Number of Inspections made. A B C D Type of Registered Premises Preserved Foods Milk Ice Cream Inspections Butchers 47 - - 139 Confectioners (Sugar and Flour) - 1 94 173 Fruiterers - - 4 18 General Shops/Stores - - 7 11 Grocers 15 32 48 168 Ice Cream (Manufacture) - - 3 11 Milk Depots/Dairies - 7 - 27 Sundry Premises - Newsagents etc - - 5 17 TOTAL 62 40 161 564 PROSECUTIONS - FOOD HYGIENE REGULATIONS. 1955 Proceedings were taken during the year in two instances, both under Regulation 9(e), as follows:- (a) Smoking a cigarette whilst handling open food in a food room - FINED 30/- (b) Smoking a cigarette whilst delivering unwrapped bread to a householder - FINED £5,0s„0d, PROSECUTIONS - FOOD ANDDRUGS ACT ,1955 Proceedings were also taken under Section 2 of the Act for selling to the prejudice of the purchaser food not of the substance demanded,, as follows;- 29 (a) Selling a loaf of bread containing tobacco. The Bakers were fined £20 .Os.Od and £5 .5S.0d costs and the actual offender in the bakehouse was fined £5,0s0d. (b) Selling a loaf of wrapped bread containing cigarette tobacco - FINED £20.0s .0d. (c) Selling a loaf of wholemeal bread containing a metal rivet with matted fibres attached - FINED £20.0s.0d with £5.5s.0d costs,, SALE OR OTHERWISE OF FOOD UNFIT FOR HUMAN CONSUMPTION The following complaints were received and investigated during the year and advice given regarding various types of foodstuffs alleged to contain foreign matter. Dirty milk bottles (3) Splinter in loaf Dirty wholemeal loaf Unsound imported mutton Mouldy loaf (3) Larvae in loaf Glass in bread Mouldy cream cakes (2) Sediment in milk bottle Glass in homemade marmalade Gramophone needle in cake Cloth fibres in loaf Wire in loaf Moth infested chocolate (2) Mouldy dried milk powder Unfit mince meat Drawing pin in bread. The general circumstances did not warrant legal proceedings being taken and each case was dealt with by appropriate warnings being given where necessary. 30 UNSOUND FOOD The following diseased and/or unsound meat and other foods have been surrendered and destroyed or, where suitable, utilised for pig food. Type of Food Condemned , lbs. Tins Bottles or Jars NOS. Almonds, Walnuts ground 7½ - - - Apricot Pulp ll - - - Beef, corned 72 1 - - Beef (imported) 111 - - - Blanc Mange Powders - - - 26 Bread Pudding 9½ - - - Brown Sugar 1 - - - Cereals - 3 - - Chickens - - - 4 Chicken and Ham (Minced) - - 3 - Cocoa - - - 1 Concentrated Pomodoro - - - 1 Cornflakes - - - 1 Crlspbread - - - 3 Culinary Mixtures and Powders - 3 2 8 Cumberland Rum Butter - - 3 - Fish - 7 2 - Fish Paste - 2 - - Fish (wet and dry) 456½ - - - Flour 6 - - - Frankfurters - 1 1 - Fruit (Dried) 11 — "" Fruit Juices - 2 - Fruit/Vegetables - 98 - - Gooseberry Pie 8½ - - - Ham/Shoulders 173½ 12 - - Jam/Marmalade/Syrup/Honey - 8 7 - Jam Sponges 8 - - 3 Jellies - - 2 - Kidneys (Pig) 28 - - - Livers (Lamb and Pig) 2½ 1 - - Meat (Canned) 36¼ 26 - - Melts (Pigs) 77 - - - Milk/Cream - 7 1 - Mutton (Imported) 3¼ - - - Orange Squash - - 1 - Peas/Beans/Baked Beans - 16 - - Potatoes 560 - - - Salad Cream - 1 2 - Soups/Pickles/Sauces - 29 9 1 Spaghetti - 4 - — Sponge Mixture - — - 18 Strained Food - 2 - - Sweet Corn - 2 - - Tails (Ox) 13 - - - Tongues (Ox) - 1 - - Tongues (Lamb) - 2 - — Venulcell1 — — - 1 TOTALS 1,595½ 228 33 67 31 SLAUGHTERING OF ANIMALS FOR HUMAN CONSUMPTION No animals were slaughtered within the Borough during the year. SLAUGHTER OF ANIMALS ACT, 1933 One licence to act as slaughterman was granted in 1950. BAKEHOUSES There are fifteen bakehouses in the Boroughs all of which are provided with mechanical power, The standard of cleanliness and the sanitary conditions in the majority of cases were found to be satisfactory, SHOPS ACT Four hundred and eighty nine visits were made to various premises under the Shops Act and revealed that the arrangements made for the health and comfort of the shop workers are in the majority of cases satisfactory. SCHOOLS The sanitary conditions and the water supply to the Schools in the area are generally satisfactory HAIRDRESSERS AND BARBERS PREMISES There are seventy-one establishments in the Borough. The premises inspected during the year were found to conform generally to the requirements of the Hairdressers and Barbers Bye-laws 1947. MERCHANDISE MARKS ACT Two hundred and ninety seven visits were made to food premises under this Act, The infringements discovered were principally in connection with the marking of imported apples, tomatoes and dead poultry, RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 The intention of the Act is to secure the use of clean filling materials in upholstered articles, and other articles which are stuffed or lined. The Act provides for the registration of certain premises by the Local Authority on payment of a registration fee and the licensing of certain other premises on payment of a statutory fee. 32 One application for renewal of Licence to store rag flock was received and granted in 1958, PET ANIMALS ACT, 1951 This Act came into operation on 1st April 1952 and provides that no person shall keep a pet shop except under the authority of a licence granted by the Local Authority in accordance with the provisions of the Act and on payment of a fee not exceeding ten shillings Seven visits of inspection were made during the year. Six licence renewal applications and one new application for a licence were received and granted during 1958. LICENCED PLACES OF PUBLIC ENTERTAINMENT There are eighteen licenced places of public entertainment in the Boroughs They are used mainly for cinematograph shows, concerts, dancing and social functions. The general standard of cleanliness was good. LICENCED PUBLIC HOUSES Eleven visits of inspection were made to the licenced public houses in the Borough. As a result of the Food Hygiene Regulations a considerable number of improvements have been carried out at many public houses, These include the provision of additional or improved sanitary conveniences, washbasins, hot water supply, improved ventilation to kitchens, bars and cellars, and the more general use of detergents and sterilising agents for the washing of utensils, beer pipe lines and pumps. HEATING APPLIANCES (FIREGUARDS; ACT. 1952 Eighteen visits were made to premises which sold heating appliances. This involved the carrying out of numerous tests on the many types and designs of heaters offered for sale. Six infringements of the Act were discovered and rectified. DISINFECTION AND DISINFESTATION Council Private Other Houses Houses Premises Number of houses treated with insecticide for bugs and fleas 3 16 33 Eleven school canteen kitchens and seven hospital kitchens were sprayed for files, ants and moths. The insecticides used were Pybuthrin, D.D.T. residual and municipal spray, Gammexane Liquid Spray, Zaldlclde M. Powder and Fumex Fumlgators. RODENT CONTROL The Prevention of Damage by Pests Act, 1919 A - Surface Treatments (1) 4,736 visits were made during the year by the Rodent Operator and 484 by the Public Health Inspectors to premises infested or possibly harbouring rats or mice 454 premises were cleared of rats or mice and no major infestations were recorded,, (2) The work for the year is generally summarised as under: - Complaints received or cases discovered and investigated 495 Number of premises found to be infested 466 Number of premises where no evidence of rodents found 29 Number of premises cleared of rats or mice (including 81 previous year's cases) 454 Number of premises still being treated at the year end . 93 (3) The cause or site of infestation at the 466 infested premises was:- Keeplng of poultry 18 Inside premises (under floors etc.) - rats 20 Inside premises (under floors etc.) - mice 50 Buries, scrapes etc. in gardens, land etc 228 Under or inside sheds 161 Defective drains 4 TOTAL 481 (4) Type of premises found to be infested:- With Rats With Mice Total Council Property 12 2 14 Dwellinghouses 348 19 367 Business Premises, etc. 32 27 59 Schools, Hospitals, Canteens etc. 7 18 25 Land 1 — 1 TOTAL 400 66 466 34 (5) Summary of the type of premises and methods employed in clearing premises of rats and mices- Type of Premises Cleared Dwelllnghouses (mainly in gardens) 362 Food shops and food premises 45 Non-food shops 10 Waste land and building sites 1 Hospitals and Schools 6 Factories and Workplaces 7 Council Premises (other than dwellings) 15 Miscellaneous 8 TOTAL 454 (6) Methods employed in clearing 454 premises of rats and mice:- Warfarin and other Poison Baits 454 Bat and Mouse Proofing 2 Drains repaired 4 TOTAL 460 B - Sewer Treatments (1) Treatment No. 24 - Second Maintenance Treatment (1957-1958) The second maintenance treatment of soil sewer manholes in areas found to be infested during the previous treatment was completed on the 22nd March, 1958. Prebaiting with damped sausage rusks with 0.25% paranltrophenol added as a bait preservative was carried out on the first and fifth days and the same bait base with 2% Antu added was laid on the tenth day with the following results:- SECTIONS A B C D E TOTAL Number of Manholes pre-baited ... 23 Not baited 149 88 55 315 Complete prebalt takes ... ... 6 23 28 22 79 Partial prebalt takes ... 2 16 19 19 56 Percentage of takes (C. and P.).. 34.8 26.2 53.4 74.5 42.9 Number of manholes poison baited. 9 56 53 47 165 The number of prebalt takes shows a decrease of 8.3% on the previous maintenance treatment. 35 {21 Test Baiting (1958-1959) The Borough was divided into five section,s as in previous tests and a test baiting of i0% of the soil-sewer manholes in areas previously cleared or thought not to be Infested was carried out during the month of August All the manholes baited were checked three days after the baits had been deposited with the following results:- SECTIONS A B C D E TOTAL Number of manholes baited 13 i9 50 66 32 180 Complete bait takes 1 - 12 18 4 35 Partial bait takes - 1 5 3 - 9 Baits not taken 11 17 30 42 28 128 Baits washed off 1 1 3 3 - 8 (3) Treatment No 25 - First Maintenance Treatment {1958-1959) This treatment was confined to the sections known to have been nfested during the previous maintenance treatment together with sections proved to be nfested by the annual 10% Test, and operations were completed on the 18th October, 1958 Prebaltlng with damped sausage rusks with 0.25% of paranltrophenol added as a bait preservative was carried out on the first and fifth days,, and the same bait base with 2% Antu added was laid on the tenth day The following is a tabulated summary of the results achieved:- SECTIONS A B C D E TOTAL Number of manholes prebalted 14 4 109 127 61 315 Complete prebalt takes 3 - 32 35 37 107 Partial prebalt takes 1 - 3 3 3 10 Percentage of takes (C, and P. 28 28.6 - 32.1 29.9 65.6 37.1 Number of manholes poison baited 10 - 36 41 40 127 The number of prebalt takes shows a decrease of 5, 8% on the previous maintenance treatment 36 KEY TO SECTIONS Section "A" - Sutton - All roads south of the Sutton Station and east of Brighton Road, Section " B" - Sutton and Cheam - All roads south of Mulgrave Road and Upper Mulgrave Road and West of Brighton Road, Section "C" - Sutton - All roads east of the Railway and north from Sutton Station. Section "D" - Cheam - All roads between London Road, Stonecot Hill and west of the Railway. Section "E" - Worcester Park. 37 eNCSDENCE OF AND CONTROL OVER INFECTIOUS DSSEASES Two hundred and fifty five cases of infectious diseases were notified during 1958, compared with nine hundred and fifteen cases in 1957. This decrease was due to a lower ncidence of Measles, Whooping Cough and Pneumonia. There were also decreases in Dysentery and Food Poisoning, There was a slight ncrease in Scarlet Fever, No case of Diphtheria was notified. The severe epidemic of Influenza which started in the Autumn of 1957 died out in the first two to three weeks of January. Scarlet Fever. Fifty nine cases were notified, an increase of four cases. The case rate was 0,74 per thousand of populations, compared with 0.86 per thousand of population for England and Wales, The illness was generally mild. There was no death. Diphtheria- No case was notified. This confirms the value of immunisation. Diphtheria Antitoxin. The possibility of Diphtheria must always be kept in mind in the differential diagnosis of infections of the throat, The early injection of antitoxin is the only effective treatment of Diphtheria. Swabs for diagnosis should be taken before any antibiotic is administered. Any suspected cases should be given antitoxin at once or admitted to isolation hospital for diagnosis and treatment Diphtheria immunisation. Outbreaks of Diphtheria can only be avoided by maintaining a high standard of immunisation. Diphtheria has not been eliminated. Diphtheria is still a danger. Immunisation is safe, simple and effective. Every child should be immunised before the age of twelve months. Reinforcement injections are necessary before entry to nursery school or day school and again at the age of eight to nine years. Immunisation is free of charge and can be arranged through the family doctor or at child welfare clinics. During 1958 six hundred and eighty nine children were immunised and their ages at the dates of immunisation were as follows: - Age: under 112 3 4 5-9 10-14 Over 15 Total Number immunised: 425 153 30 11 4 66 - - 689 Nine hundred and twenty one children received reinforcing injections. A survey at the end of 1958 of the state of immunisation of nine hundred and seventy babies born in i957 showed that five hundred and ninety flve, representing 81 per cent., had been immunised. Of the children under five years of age two thousand five hundred and fifty five, representing 54 per cent., had been immunised. Of the school children of five to fourteen years of 38 age, five thousand one hundred and ninety four, representing 49 per cent had been effectively immunised by receiving primary or reinforcing injections within the past five years; and three thousand one hundred and eighty four, representing 30 per cent., who had been previously immunised, were In need of reinforcement. Measles, One hundred and thirty cases were notified in 1950, compared with six hundred and seventy seven cases in 1957, The case rate was 1.04 per thousand of population, compared with 5.76 per thousand of population for England and Wales, There was no death. Sixty nine of the cases occurred during the third quarter of the year. The monthly incidence of notified cases is shown in the following table - January 4 July 43 February 14 August 23 March 6 September 3 April 4 October - May 6 November 3 June 20 December 4 There is often difficulty in recognising the early catarrhal signs of illness. Measles commences like a common cold with a rise of temperature, running of the nose, an occasional sneeze, watering of the eyes and a slight sore throat. The child is usually out of sorts and disinclined for food or play. After three to five days the rash appears. The catarrhal phase is highly infectious, Prevention of infection requires early recognition of the symptoms and early isolation It isimportant that babies and weakly children should be protected from acquiring infection. Isolation should be continued until all symptoms and signs have disappeared. The danger of complications by secondary infection has been reduced by the Judicious use of Sulphonamldes and antibiotics, but there is sometimes an exceptional child who reacts badly to this virus infection and careful nursing and careful convalescence are always necessary The illness can be prevented or modified by the injection of gamma globulin early in the incubation period, A small quantity is available to doctors for cases of special risk, Health visitors are informed of notified cases of children under five years of age so that they may give advice where necessary Whooping Cough. Fourteen cases were notified in 1958, compared with eighty six cases in 1957, The case rate was 0.18 per thousand of population, compared with 0,74 per thousand of population for England and Wales There was no death. The general Incidence was very low Seven of the cases were infants under five years of age and three were under one year. The monthly incidence of notified cases is shown in the following table - 39 January 2 February 4 March 1 April May 2 June 1 July 2 August 2 September- October November- December - Whooping cough is a serious infection in early infancy. The cough imposes a severe strain on the lung tissues. The danger of mortality is highest in the first three months of life and diminishes with age, Every effort should be made to protect babies and weakly infants from contact with infection., The vaccines give substantial protection. Immunisation should commence not later than three months of age. It is important that older susceptible children in the family should be immunised in order to protect the baby. Every child should be immunised before entry to school. Health Visitors are informed of notified cases of children under five years of age so that they may give advice where necessary. immunisation Against Whooping Cough, Immunisation against Whooping Cough is available free of charge for children under five years of age either through the family doctor or at Child Welfare Clinics. In 1958 six hundred and nine children received immunising injections., The material used was H.Pertussis suspended vaccine (20,000 million bacilli per C.C.). Three injections of 1.c.c. are given at monthly intervals. The injections are given subcutaneously Fifty two children were given reinforcing injections during 1958. Smallpox. No case was notified. Vaccination Against Smallpox, The speed of travel has increased the risk of Smallpox being imported,, Our protection depends on vaccination There s no drug which will cure the illness. Vaccination in infancy provides a basal immunity which can be reinforced later with reduced reaction. Vaccination is safest in infancy, Vaccination is voluntary and free of charge and can be arranged through the family doctor or at the nearest Child Welfare Centre In 1950 six hundred and fifty one babies under the age of one year were vaccinated The percentage of 62.9 compares with 56.9 In 1957 and 53.7 in 1956. 40 The following table shows the number of vaccinations during 1958 - Age Number Vaccinated Number Re-Vaccinated Under 1 651 - 1 38 - 2 16 - 3 8 2 4 7 3 5-9 8 18 10-14 3 18 Over 15 44 252 Totals 775 293 Puerperal Pyrexia. Twelve cases were notified in 1958, compared with twenty three cases in 1957, Puerperal Pyrexia is "any febrile condition occurring in a woman, In whom a temperature of 100.4° Fahrenheit (38° Centigrade) or more has occurred within fourteen days after childbirth or miscarriage". The early notification of Puerperal Pyrexia is of primary importance in the prevention of maternal mortality. Medical practitioners should make the fullest use of the consultant, bacteriological and hospital services and ensure the isolation of any suspected infection occurring in a maternity or nursing home. Tetanus. A scheme for the immunisation of children against Tetanus on request by parents Is in operation. The Tetanus bacillus is present in horse manure and in manured land. Infection enters the body through contaminated wounds and abrasions which ma; be so slight as to escape notice. The object of immunisation is to prepare the tissues in advance to resist the Tetanus bacillus. All who work in agriculture or in stables should be immunised. Children are prone to abrasions and should be protected from the Incidental risk of infection., At present it is a routine to inject anti-tetanic serum after wounds. This serum occasionally causes undesirable allergic reactions and its use can be avoided by precautionary immunisation with toxoid before injury. immunlsatloin requires three injections at. monthly intervals. These can be combined with immunisation against Diphtheria and Whooping Cough. Immunisation must be sustained by reinforcement injection at the end of one year and thereafter at intervals not exceeding five years. A record of the dates of injection should always be carried on the person. During 1958 one hundred and ninety three children received primary injections. Food Poisoning, Three cases were notified in 1958, compared with four cases in 1957, One was an adult and two were children. One case was due to Staphylococcal infection acquired outside the Borough, Two were caused by Salmonella Typhimurium. The sources of infection were obscure. The low incidence of infections due to Salmonellae and Staphylococci in food is satisfactory. Prevention of infection depends on scrupulous cleanliness in the production, storage, 41 manufacture and distribution of food The washing of hands after use of the W. c. is the most effective protective measure against intestinal carriers of infection. Early notification of cases of food poisoning is necessary so as to obtain the residue of suspected food for bacteriological examination. Dysentery, Two cases were notified in 1958, compared with fifteen cases in 1957. Both were of the Sonne type. Sonne Dysentery is a highly infectious form of gastroenteritis. The infection is spread by faecal contamination of hands, objects;, and, in particular, lavatory seats. Prevention depends on the washing of hands after use of the W.C. and on the efficient cleansing of communal W. Cs. in schools and public places. Typhoid and Paratyphoid Fevers. No case was notified. Meningococcal Infections. No case was notified. Poliomyelitis,, Two cases were notified In 1958, compared with eleven cases In 1957. Both were adults. One was paralytic and one non-paraiytiC A man, aged 27 years, contracted infection while on holiday abroad and has residual paralysis of the legs. A woman, aged 30 years, has recovered completely. The reduction in the number of cases is gratifying and the absence of cases among children suggests a definite protective effect from immunisation. Vaccination against Poliomyelitis was extended by the end of 1958 to all persons aged six months to twenty five years, together with some special categories During the year approximately nine thousand six hundred persons were vaccinated against Poliomyelitis in the following groups. (1) Children 6 months to 15 years 8,760 (2) Young people 15 to 25 years 290 (3) Other priority groups 550 Pneumonia, There were twenty seven deaths from Pneumonia in 1958, compared with twenty three in 1957. Thirty four cases of Pneumonia were notified in 1958, compared with forty three in 1957. Twenty one were cases of Influenzal Pneumonia. Non-Notifiable Diseases School teachers reported two hundred and thirty cases of Mumps, one hundred and nineteen cases of Chicken Pox and fifty six cases of German Measles. School returns are a useful Index of the prevalence of non-notifiabie diseases and are a basis for consultation with the school medical officer. infestations Six cases of Scabies and six cases of infestation by head lice were treated during the year. The total number of treatments was forty three. 42 43 NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING 1958 Disease AGE IN YEARS TOTALS Removed to Hospital Died * Under 1 1 2 3 4 5 10 15 20 35 45 Over 65 Scarlet Fever - - - 3 3 37 13 1 2 - - - 59 8 - Diphtheria - - - - - - - - - - - - - - - Smallpox - - - - - - - - - - - - - - - typhoid Fever - - - - - - - - - - - - - - - Paratyphoid Fever - - - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - - 12 - - - 12 1 - Pneumonia - - - 1 - 3 - 1 1 5 5 18 34 2 27 Erysipelas - - - - - - - - - - 1 - 1 - - Dysentery - - - - - - - - 2 - - - 2 - - Poliomyelitis - - - - - - - - 2 - - - 2 2 - Meningococcal Infection - - - - - - - - - - - - - - - Post-infectious Encephalitis - - - - - 1 - - - - - - 1 1 - Measles 2 15 13 14 10 67 7 - 2 - - - 130 - - Whooping Cough 3 - 2 1 1 5 2 — - — — — 14 - — * Under column "Died", all deaths, whether notified in the district or outside it. or not notified at all, are included. 44 DISTRIBUTION OF NOTIFIABLE DISEASES IN WARDS Disease WARDS Case Rate per 1,000 population (Mid-year) Case Rate per l,000 England and Wales N. N.W. N.E. W.C. E.C. E. S.W. S.E. S. TOTAL Populations:- 9711 8727 11052 11934 7044 7848 7758 6069 9067 79210 Scarlet Fever 6 2 7 16 7 10 3 4 4 59 0.74 0.86 Diphtheria - - - - - - - - - - 0.00 0.00 Smallpox - - - - - - - - - - 0.00 0.00 Typhoid Fever - - - - - - - - - - 0.00 0.00 Paratyphoid Fever - - - - - - - - - - 0.00 0.00 Puerperal Pyrexia - - - - 1 - - 11 - 12 - - Pneumonia 1 3 1 - 2 9 3 3 12 34 0.43 0,49 Erysipelas - - 1 - - - - - - 1 0.01 0.07 Dysentery - - - 1 - - - 1 - 2 0.02 0.62 Poliomyelitis - - - - 1 - - 1 - 2 0.02 0.04 Meningococcal Infection - - - - - - - - - - 0.00 0.02 Post-InfectIous Encephalitis 1 - - - - - - - - 1 0.01 0.00 Measies 40 26 9 6 8 11 11 5 14 130 1.64 5.76 Whooping Cough 5 2 1 1 - 3 - 2 - 14 0.18 0.74 TOTALS 53 33 19 24 19 33 17 27 30 255 TUBERCULOSIS On 31st December 1958, there were on the register nine hundred and thirteen cases of Tuberculosis, of whom eight hundred and one were Pulmonary and one hundred and twelve non-pulmonary, In 1958 there were eight deaths from Pulmonary Tuberculosis, The death rate was 0.10 per thousand of populations as against 0.06 in 1957, There were two deaths from non-pulmonary Tuberculosis, giving a death rate of 0.025 per thousand of population For England and Wales the death rate for Pulmonary Tuberculosis was 0.09 per thousand of population and for nonpulmonary Tuberculosis 0.01 per thousand of population,, The number of new cases of Pulmonary Tuberculosis was thirty three, compared with thirty two new cases in 1957. Residual foci of infection still persist, particularly among the middle aged and elderly, and Intensive search will be necessary to eliminate the disease. The use of B.C.G vaccine in adolescent children gives a high measure of protection, Five hundred and six children received injections in 1958, The response rate was 67 per cent. Four new cases of non-pulmonary Tuberculosis were notified in 1958, compared with three new cases in i957, Infections of glands bones and Joints and serous membranes are caused by the human or bovine types of the bacillus In this Borough all milk Is designated or pasteurised. The Tuberculosis Care Committee is a valuable organisation not only in relation to the specific service which the Committee performs in promoting the well being and reablement of patients suffering from Tuberculosis, but also as a model for the extension of care to patients suffering from other disabling diseases. The Committee provides additional nourishment, clothing and bedding Grants are made to provide occupational therapy Holidays are arranged for children, mothers and convalescent patients. The voluntary services of the members are highly appreciated. The Hon Secretary is County Alderman Mrs, Margaret Walkden, o.B E., J.P., 9, All Saints Road, Sutton, The following table shows the new cases and deaths in age groups - PERIODS NEW CASES DEATHS Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M F M F M F M F 0 - - - - - - - - 1 - - - - - — - - 15 4 7 1 - - - - - 25 2 2 2 - - - 1 - 35 1 4 - - - - - - 45 6 1 i - 1 1 - - 55 1 - - - 1 - - 1 65 and above 3 2 - - 3 2 - - TOTALS 17 16 4 - 5 3 1 1 45 Notification of Tuberculosis Respiratory forms of death - Six out of eight cases were notified. Other forms of death - One out of two cases was notified, MASS RADIOGRAPHY A Mass Radiography Unit visited the Borough from 8th to 15th January 1958 and was stationed at the Co-operative Hall, Longfellow Road, Worcester Park. One thousand, six hundred and sixty persons were examined,, The results were as follows;- Total Examined No. of cases No. of cases Non- of active of inactive Tuberculous Pulmonary Pulmonary abnormalities Tuberculosis Tuberculosis M. F. T. M. F. M. F. M. F. 741 919 1660 2 1 18 23 47 37 The incidence of Pulmonary Tuberculosis was 1.8 per thousand persons examined, compared with 1.0 per thousand in the area served by this X-Ray unit, which includes the County of Surrey. The findings are an index of infection in a sample of the population. They show the value of Mass Radiography in securing diagnosis and treatment. The finding of non-tuberculous abnormalities gives an opportunity for advice and treatment and the prevention of disablement. 46 CLINICS AVAILABLE FOR THE DISTRICT Methodist Church Hall, Station Road, Belmont Infant Welfare Thursdays, 2 p.m. to 4 p.m. Minor Ailments (School Children) Thursdays, 1.30 p.m. to 2 p.m. The Clinic, Priory Crescent, Cheam Ante-Natal Mondays and Fridays, 9.30 a.m. to 12 noon. Mothercraft, and Relaxation Sxercises (Expectant Mothers) Thursday mornings, by appointment. Infant Welfare Mondays and Thursdays, 1.30 p.m. to 4 p.m. Minor Ailments (School Children) Wednesdays, 10.45 a.m. to 12 noon. Physiotherapy (Children) Tuesday afternoons, Thursday mornings, and Friday afternoons, by appointment. Dental (Mothers and Children) Mondays to Fridays, by appointment. The Parochial Rooms, The Broadway, Cheam Infant Welfare Wednesdays, 1.30 p.m. to 4 p.m. The Clinic, Stonecot Hill, Sutton Ante-fatal Tuesdays, 9.30 a.m. to 12 noon. Mothercraft, and Relaxation Sxercises (Expectant Mothers) Thursday mornings, by appointment. Infant Welfare Mondays, Wednesdays and Fridays, 1.30 p.m. to 4 p.m. Minor Ailments (School Children) Wednesdays, 9.30 a.m. to 10.30 a.m. Physiotherapy (Children) Friday mornings, by appointment. 47 Ths Clinic. 1, Robin Hood Lane, Sutton Ante fatal Wednesdays, 9.30 a.m. to 12 noon. Infant Welfare Tuesdays and Thursdays, 1.30 p.m. to 4 p.m. Minor Ailments (School Children) Mondays, 9.30 a.m. to 12 noon. Physiotherapy (Children) Monday and Thursday afternoons, by appointment. Ophthalmic (Children) Friday afternoons, by appointment. Dental (Mothers and At 3, Robin Hood Lane, Sutton, Children) Mondays to Fridays, by appointment. Wesley Hall, Ruskin Drive,, Worcester Park Infant Welfare Fridays, 2 p.m. to 4 p.m. Child Guidance C1inic. 25. Worcester Road. Sutton Child Guidance Mondays to Fridays, by appointment. Speech Therapy Tuesdays and Wednesdays, by appointment. immunisation against Polioreye)itis. Diphtheria, Whooping Cough and Tetanus and Vaccination against Smallpox By appointment at Child Welfare Clinics or by arrangement with Family Doctors SCABIES CLINIC St. Nicholas Road. Sutton. Every Thursday. at 10 a.m. CHEST CLINIC St. Helier Hospital, Wrythe Lane, Carshalton Mondays, Tuesdays and Fridays, at 9.30 a.m. Wednesdays and Thursdays, at 2 p.m. The second Wednesday in each month at 5.30 p.m. (By appointment) VENEREAL DISEASES CLINIC St. Helier Hospital,, Wrythe Lane, Carshalton Males: Mondays, 4 pro. to 6 p.m. Females; Wednesdays, 5 p.m. to 7 p.m. 48 * .