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the Medical Officers of Health, and of the hospitals with their medical and nursing
staffs which were concerned in the initial notifications to the local authorities. The
British Medical Association's survey of 1964 into "Accidents in the Home" provided
much useful material and ideas for the conduct of this present study and
has enabled useful comparisons to be drawn between the data collected then and
now. It is hoped that, when the full report is made available to the Medical
Commission, publication will be arranged in one of the appropriate medical journals,
for undoubtedly much of the statistical data revealed in the preliminary
report should be of interest to medical and para-medical workers in this field. The
comments listed by Mr. Robarts in the preliminary report are as follows:
(a) The possible fall in incidence of thermal injuries, compared with the findings
in earlier surveys, is interesting. Could it relate to publicity, fireguards, manufacturing
standards, non-flammable fabrics, etc. ?
(b) The probable rise in poisoning, compared with the findings in earlier surveys,
is alarming, especially medicinal poisoning and this certainly seems most
worthy of an extended investigation and continuing publicity.
(c) Many falls about the house result in contusion injuries against sharp corners,
especially in furniture. Could design reduce this?
(d) Lacerations are often from glass and this, as a container material, in the presence
of adequate alternatives, could be reconsidered, especially in the milk
and soft drink distribution trades, as now so many articles are non-returnable
and glass is indisposable.
(e) It is the bystander child who often becomes the victim of injury by swing,
bat or club in playground or garden. Notices of these dangers should be
displayed in these public areas.
(f) Crush injuries to fingers should remind all adults in the presence of children
to look at and close gently all doors, especially in cars.
(g) Accident-proneness certainly deserves a wider and more deeply penetrating
investigation.
(h) The influence of the menstrual cycle and pregnancy on accident-proneness
also deserves fuller investigation.
(1) Play facilities in older properties, and even more importantly, both indoors
and out of doors in areas of new housing schemes and multi-storey developments,
seem to require much more consideration from architects and local
authorities than they have received in the past. Many problems, both physical
and psychological, would seem to pertain to this modern housing conception."
Phenylketonuria
I mentioned in my last annual report that a child who had two negative tests
carried out at the child welfare clinic in its second month of life was diagnosed at
almost a year old as suffering from phenylketonuria and that mental retardation was
then present. This occurrence emphasized the potential unreliability of urine testing
as a screening procedure and for some time efforts had been made to introduce for
routine screening of infants the more accurate blood test of Scriver or Guthrie but
laboratory facilities were not yet available to carry out the tests within the hospital
catchment areas of the Borough.
In October 1968, a circular (CMO 12/68) was received from the Chief Medical
Officer of the then Ministry of Health which referred to the report of the working
party on phenylketonuria of the Medical Research Council which was set up to study
and report on different mass screening methods for the early detection of phenylketonuria.
The report which had now been received by the Department recommended
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