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Seventy-fourth Annual Report of the Public Health Services of British Columbia HEALTH BRANCH DEPARTMENT… British Columbia. Legislative Assembly 1971

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 PROVINCE OF BRITISH COLUMBIA
Seventy-fourth Annual Report of the
Public Health Services
of British Columbia
HEALTH BRANCH
Department of Health Services and Hospital Insurance
YEAR ENDED DECEMBER 31
1970
Printed by K. M. MacDonald. Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1971
 DEPARTMENT OF HEALTH SERVICES
AND HOSPITAL INSURANCE
(HEALTH BRANCH)
The Honourable Ralph R. Loffmark, Q.C.
Minister of Health Services and Hospital Insurance
SENIOR PUBLIC HEALTH ADMINISTRATIVE STAFF
J. A. Taylor
Deputy Minister of Health and Provincial Health Officer
G. R. F. Elliot
Director, Bureau of Special Health Services
A. H. Cameron
Director, Bureau of Administration
K. I. G. Benson
Director, Bureau of Local Health Services
G. F. Kincade
Director, Division of Tuberculosis Control
E. J. Bowmer
Director, Division of Laboratories
H. K. Kennedy
Director, Division of Venereal Disease Control
J. H. Smith
Director, Division of Occupational Health
C E. Bradbury
Director, Division of Rehabilitation
J. H. Doughty
Director, Division of Vital Statistics
A. A. Larsen
Director, Division of Epidemiology
Mrs. M. Green
Director, Division of Public Health Nursing
F. McCombie
Director, Division of Preventive Dentistry
W. Bailey
Director, Division of Environmental Engineering
R. G. Scott
Director, Division of Public Health Inspection
M. A. Kirk
Senior Consultant, Division of Public Health Education
Miss P. Wolczuk
Consultant, Public Health Nutrition
H. J. Price
Departmental Comptroller
The Hon. Ralph R. Loffmark, Q.C.
Minister of Health Services and
Hospital Insurance
J. A. Taylor,
Deputy Minister of Health and
Provincial Health Officer
 Office of the Minister of Health Services
and Hospital Insurance,
Victoria, British Columbia, January 26, 1971.
To Colonel the Honourable John R. Nicholson, P.C., O.B.E., Q.C, LL.D.,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour:
The undersigned respectfully submits the Seventy-fourth Annual Report of the
Public Health Services of British Columbia for the year ended December 31, 1970.
RALPH R. LOFFMARK,
Minister of Health Services and Hospital Insurance.
 Department of Health Services and Hospital
Insurance (Health Branch),
Victoria, British Columbia, January 26, 1971.
The Honourable Ralph R. Loffmark, Q.C,
Minister of Health Services and Hospital Insurance,
Victoria, British Columbia.
Sir,—I have the honour to submit the Seventy-fourth Annual Report of the
Public Health Services of British Columbia for the year ended December 31, 1970.
A. TAYLOR, B.A., M.D., D.P.H.,
Deputy Minister of Health.
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1
 The Health Branch is one of the three branches of the Department of Health
Services and Hospital Insurance, together with the branches of Mental Health Services and the British Columbia Hospital Insurance Service. Each is headed by a
Deputy Minister under the direction of the Minister of Health Services and Hospital
Insurance.
In the Health Branch, the Deputy Minister of Health and the Directors of the
three bureaux form the planning and policy-making group. Under them the divisions provide consultative and special services to all public health agencies throughout the Province.   The chart on the previous page shows the organization.
Direct services to the people in their communities, homes, schools, and places
of business are provided by personnel of local health departments. Greater Vancouver and Greater Victoria have their own metropolitan organizations, which,
though not under jurisdiction of the Health Branch, co-operate closely and receive
special services and financial assistance from the Provincial and Federal Governments. The remainder of the Province is covered by 18 health departments, known
as health units, which are under the jurisdiction of the Health Branch. Each unit is
complete in itself and serves one or more population centres and the rural areas adjacent to it.
 TABLE OF CONTENTS
Page
Introduction     9
Communicable and Reportable Disease  13
Health and Our Environment  16
Community and Family Health  19
Maternal and Child Health  24
Immunization  25
School Health  26
Home Care  28
Preventive Dentistry  30
Nutrition Service  33
Public Health Education  34
Vital Statistics  35
Extended Care  37
Rehabilitation  38
Kidney Failure Correction Programme  40
Laboratory Services  41
Poison Control  44
Emergency Health Service  45
Council of Practical Nurses  47
Publications, 1970  48
Tables—
I.—Approximate Numbers of Health Branch Employees by Major
Categories at the End of 1970  49
II.—Organization and Staff of Health Branch (Location and Approximate Numbers of Persons Employed at End of 1970)  49
III.—Comparison of Public Health Services Gross Expenditures for the
Fiscal Years 1967/68 to 1969/70  51
IV.—Per Diem Rates for In-patient Care during the Fiscal Year April 1,
1969, to March 31, 1970  51
V.—Training of Health Branch Staff Proceeding toward a Diploma or
Degree in a Public Health Specialty  52
VI.—Training of Health Branch Staff by Means of Short Courses  52
VII.—Reported Communicable Diseases in British Columbia, 1966-70
(Including Indians)  54
VIII.—Reported Infectious Syphilis and Gonorrhoea, British Columbia,
1946, 1951, 1956, 1961, 1964-70  54
IX.—Statistical Summary of Public Health Inspectors' Activities, 1968—
70, for 17 Provincial Health Units  55
X.—Public Health Inspectors' Time-study  56
XI.—Statistical Summary of Selected Activities of Public Health Nurses,
September, 1969, to August, 1970, Inclusive  56
 Page
XII.—Summary of Service Provided in Three Areas by Employees'
Health Services Staff, 1970  57
XIII.—Enrolment in Public and Private Schools in British Columbia,
June, 1970  58
XIV.—Number of Pupils Receiving Basic Immunization Prior to Entering
Grade I, September, 1969  58
XV.—Pupils Referred for Health Services  58
XVI.—Registrations Accepted under Various Acts  59
XVII.—Case Load of the Division of Rehabilitation, January 1 to December 31, 1970  60
XVIII.—Statistical Report of Examinations and Work Load in 1969 and
1970, Main Laboratory  61
XIX.—Statistical Report of Examinations and Work Load during the
Year 1970, Branch Laboratories  62
XX.—Emergency Health Service Medical Units Pre-positioned Throughout British Columbia  62
XXI.—Licensing of Practical Nurses  63
 Seventy-fourth Annual Report
of the Public Health Services of British Columbia
HEALTH BRANCH
Department of Health Services and Hospital Insurance
YEAR ENDED DECEMBER 31, 1970
This Seventy-fourth Annual Report of the Public Health Services of British
Columbia presents an outline of the measures undertaken in the field of preventive
medicine to promote and safeguard the health of the people of the Province. These
preventive services constitute only a small segment of the total volume of health
care now available through Government which also provides many therapeutic services which are much more extensive and costly. Nonetheless, the effect of the
preventive services is significant when measured in terms of reduction of need for
therapeutic care, in prevention of individual suffering, in a decrease in human mortality, and in a financial saving in total health costs. There is little doubt that in
specific fields the preventive measures of the public health service have proven their
worth. The introduction of mass immunization clinics, while lowering biological
disease incidence almost to zero, also led to the disappearance of isolation hospitals,
a decrease in the need for hospital beds (at least in specific fields), and added to
longevity, health, and happiness while contributing to the Provincial economy.
Funds spent in preventive services represent an investment in the most important of
all the Province's natural resources—people.
As scientific medical research continues, other diseases are added to those identified as being conquerable through biological immunization. Each discovery promotes its individual and collective rewards within each community.
Immunization is not the only field in which concentration upon preventive medicine has promoted human well-being. Each of the tasks performed by the separate
divisions within the Department is designed with health promotion in mind, encouraging techniques to minimize disease development and encourage healthful communities. These call up the skills of a group of trained personnel and appeal to
people to have regard for those things that will help them to maintain ideal individual
health and thereby community health. This report recounts the things that have
been done with that objective in mind.
In dealing with the field of human health there is always a need for a critical
review of accomplishments by the services and programmes administered through
the Health Branch, becoming all the more necessary with the rising costs of providing total health services. There will continue to be real concern about those costs.
Inflationary trends in the economy will increase the costs without adding benefits
to existing programmes or services. Nor are escalating costs entirely the result of
a changing economy. Many factors warrant a searching analysis of every facet of
delivery of health services, an analysis that will promote greater stability of costs
without infringing on quality of service.
This topic was the subject of much discussion during the Federal-Provincial
Conference of Ministers of Health in 1969. As a result, a decision was made to
organize a study into the costs of health services. Not only monetary costs, but
efficiency of services was to be taken under consideration.   This study was to cover
J
 J 10 PUBLIC HEALTH SERVICES REPORT, 1970
three major areas—hospital services, medical care, and public health services.
A Steering Committee comprising seven task forces was established to undertake
the requisite examination of all the factors that might be involved. That task force
made its report to the Conference of Health Ministers in November, 1969, following
which it was decided that a continuing study to implement the recommendations
should be maintained. During the year the various reports of the Task Force on
Costs of Health Services in Canada have been reviewed. It is interesting to note
the changing role forecast for public health as contained in the statement of the
group assigned to deal with costs of public health services. The following view is
expressed:—
" That the practice of public health involves three components—
• Prevention to include health promotion and maintenance:
• Concern with the organization and delivery of health care at the community level to include the assessment of resources in relation to actual
and anticipated health needs:
• The early identification and bringing under adequate care of individuals in need of health care."
Such views have been discussed with Medical Health Officers practising in
British Columbia and have been generally accepted as goals toward which health
services and programmes should be directed in the interests of promoting a unified
community health service.
THE PROVINCE AND ITS PEOPLE
An increase in the number of people, more marriages, a practically constant
birth rate, and a record low death rate were the statistical factors revealed in a
study of the health features affecting the people of British Columbia in 1970.
The population in the Province at the mid-year was estimated as 2,137,000,
representing an addition of some 70,000 people over the previous year. With the
estimated number of births totalling 36,900, a major portion of the population
increase is attributable to the 50,000 people who have immigrated to the Province.
This increase in the population approaches a 3V_i per cent annual growth rate,
an extremely high factor and one which, if continued, would result in a tripling of
the population by the year 2001.
Within that population, preliminary figures would indicate marriages totalled
19,900, providing a rate of 9.3 per 1,000 population, somewhat higher than last
year's rate of 8.8.
The preliminary estimate of 36,900 births produces a birth rate of 17.3 per
1,000 population, slightly above last year's rate of 17.1 and also above the 1968 low
of 16.8. Among those births, the proportion of illegitimate births was substantially
the same as in 1969, 13.9 per cent, the first sign of a halt in the steadily increasing
trend commencing in 1960.
There was a record low death rate estimated to be 7.8 per 1,000 population.
Last year the rate was 8.4. A substantial contribution to this lowered mortality was
evident in the sharply reduced number of deaths from heart disease. The rate
recorded for the conditions in this category was 270 per 100,000 population, a
reduction of over 9 per cent from the 1969 figure and about 23 per cent below
the rate recorded as recently as 1964. The 1970 rate marks a continuation in the
almost unbroken record of improvement in heart disease mortality rates since that
latter date. It may be a reflection of the improved medical techniques that are being
developed in the field of cardiac disease.
 INTRODUCTION J 11
This same trend toward a lower mortality attributable to afflictions of the
arterial system of the body was paralleled in the rate of deaths from cerebral vascular
lesions affecting the central nervous system. During 1970 the rate of 82 per 100,000
population was below the previous year's rate of 86 per 100,000 population.
Regrettably, a similar favourable trend could not be observed in deaths classified as being due to cancer. This cause of mortality remains fairly constant at a rate
of 156 per 100,000 population, almost the same as recorded in 1969.
Accidents continue to take their toll with a rate of 75 per 100,000 population,
an increase over the rate of 70 recorded in the previous year. Among these, fatalities
caused by motor-vehicles retained a major significance in accounting for 36 per cent
of the total accident mortality, slightly below the figure prevailing for the year 1968.
Deaths from poisoning caused 15 per cent of all accidental deaths, an increase in
number of almost a quarter, making poisoning second in the list of leading causes of
accidental deaths. Fatalities due to falls accounted for 12 per cent of the deaths due
to accidents, slightly less than in the previous year. Deaths due to drowning were the
highest for many years, increasing by almost 60 per cent in 1970 as compared
with 1969.
The rate of deaths from suicide at 15 per 100,000 population this year was
down slightly from the 1969 figure.
The infant mortality rate has declined each year since 1966 when it was 24
infant deaths per 1,000 live births. In 1969 the rate was 17.8 and, in 1970, it
was 16.4.
In so far as mortality is concerned as an index of health, there is room for
considerable improvement. Certainly, the increasing numbers of accidental deaths
are to a large degree preventable and, therefore, justify intensified effort to promote
improvement. The fact that so many deaths are due to accidents involving motor-
vehicles is particularly significant. There is also little doubt that many other deaths
occurring as a result of poisoning, falls, and drownings could have been prevented
by the judicious exercise of caution and attention to safety measures.
In the field of communicable disease, efforts have been continued through a
vigorous immunization programme to eradicate biologically preventable disease.
For the most part, a high level of community immunity has been maintained sufficient
to prevent epidemic outbreaks. Nonetheless, the occurrence of seven cases of
diphtheria among unimmunized children is an indication that eradication is not
complete as yet. The measles immunization programme introduced a year ago
continues. Continuous educational programmes will be offered to illustrate the
advantages of immunization as a preventive of this childhood infection. To the
armamentarium of immunizable diseases the introduction of rubella vaccine this
year appears to have provided a valuable addition. Approximately 240,000
children were immunized in the latter half of the year. Rubella vaccination will
become a member of those routine immuninological procedures offered annually,
and there is every prospect that cyclic epidemics of this disease will no longer
significantly affect the health of the people of this Province.
Despite concentrated efforts on the part of the health team to educate food-
handlers to the importance of sanitary food-handling in eating establishments, outbreaks caused by improper food-handling continue to occur. This year there were
532 cases of Salmonella food poisoning reported, a marked increase over that for
the year previous.   This infection, under proper control, is preventable.
The incidence of tuberculosis, which is generally regarded as no longer of
serious importance, nevertheless remains a matter of some concern. Over 500
active cases are identified annually within the Province.    In spite of intensive
 I 12 PUBLIC HEALTH SERVICES REPORT, 1970
efforts, limited progress is being made in further reduction of the incidence of
infection. This indicates the need for maintaining an active case-finding programme
throughout the Province.
In the field of venereal disease control, continuous progress is being made in
the treatment of syphilis. This is the fifth successive year in which there have been
less than 80 cases of infectious syphilis reported. On the other hand, gonorrhoea
has shown a marked increase in incidence for the second successive year. This
year there were an estimated 5,900 cases, seemingly attributable to the sociological
development within our society referred to as " transient youth." During the three
summer months, 60 per cent of the patients attending the Vancouver Clinic were
transient youths, half of whom were from other provinces of Canada, and half
from the United States.
In general, the people of British Columbia enjoyed a year free from any major
epidemics, with advancements in the control of preventable diseases and with a
significant lowering of the over-all mortality rate. Based on those factors there is
reason for some satisfaction with the health services designed in the public interest.
However, there are a number of areas where improvement is yet to be realized
wherein further human benefits can be attained. There is a continuing need for
intensification of public health services throughout all the communities of the
Province.
 COMMUNICABLE AND REPORTABLE DISEASE
J 13
COMMUNICABLE AND  REPORTABLE  DISEASE
There were no serious outbreaks of communicable disease this year, but a few
localized incidents emphasized the need for constant vigilance.
DIPHTHERIA
Nine cases of diphtheria were reported, a decrease of five from the previous
year. Most of these cases occurred in two small communities in the northern part
of the Province, and several were in children whose parents, for personal reasons,
had chosen not to have them immunized.
FOOD POISONING
Reported Salmonella food-poisoning cases numbered 532, a sharp increase
over 1969. Improper food-handling or inadequate facilities are generally responsible. Frequent and regular surveillance of all food-handling establishments by
public health inspectors usually results in keeping this type of condition under
control.
INFECTIOUS HEPATITIS
Infectious hepatitis cases were down to 1,910 from 2,139 in 1969. This infection remains a constant threat, particularly among groups of young people living
under communal conditions.
TUBERCULOSIS
Tuberculosis continues to be a source of infection, with over 500 active cases
occurring annually in British Columbia. There has been no appreciable reduction
in the incidence of the disease during the past six years.
It is evident that the problem is deep-rooted because the most intensive efforts
in tuberculosis control create only a gradual reduction in the incidence of the
disease. It is probable that most people who now develop tuberculosis were
infected decades ago. However, satisfactory progress is being made in protecting
the present growing generation. The infection rates in this group, as shown by the
tuberculin test, have been markedly reduced.
Small epidemics of tuberculosis continue to occur. In one recent outbreak,
active cases of tuberculosis developed among contacts of a man who had spread
the disease under confined working conditions.
The following points summarize the current tuberculosis situation in the
Province:—
• Undiagnosed cases of tuberculosis with positive sputum are a potent factor
in the spread of disease and warrant special emphasis on intensive contact
tracing once discovered. Results of contact examinations in British
Columbia show that 3.6 per cent of those in close contact with cases having
positive sputum develop active disease.
• Twenty years ago there were 292 deaths from tuberculosis in British Columbia and the death rate was 25.1 per 100,000. Last year this was reduced
to 29 deaths from tuberculosis and the death rate was 1.4 per 100,000.
• Death rates from tuberculosis are probably no longer a useful yardstick in
measuring progress but do indicate the effectiveness of treatment with
present-day methods. The need for admissions to the hospitals operated
by the Division of Tuberculosis Control has been gradually lessening and,
as a result, it is now possible to serve the Province with 172 sanatorium
beds, equally divided between Pearson Hospital and Willow Chest Centre.
 I 14
PUBLIC HEALTH SERVICES REPORT, 1970
• Most active cases of tuberculosis are treated initially outside hospital.
• Cases of tuberculosis are only admitted to hospital if they cannot be treated
at home; when special problems arise with their drug therapy; when they
do not progress favourably on treatment at home; or when they are unable
to co-operate because of alcoholism or recalcitrance.
Native Indians pose a special problem in treatment because many live on
remote reserves where treatment facilities are not available. Among them there
is need for intensive education in personal hygiene, and for these reasons a higher
proportion of them enter a sanatorium for initial therapy and require a longer stay
in hospital.
Treatment programmes have resulted in lowering the number of sanatorium
beds. About 80 per cent of all new active cases under treatment are outside a
sanatorium and these represent over 1,000 cases of tuberculosis on a home-treatment
basis, with many patients continuing to work. This is but one example of the
benefits to society derived from a public health service that includes home care
among the programmes administered by professional public health nurses.
The Diagnostic Clinics of the Division of Tuberculosis Control are responsible
for case-finding and for the follow-up of about 20,000 known cases of tuberculosis
and suspects throughout the Province. The effect of the work of these clinics may
be summarized as follows:—
• It has been possible to decrease dramatically the number of sanatorium beds.
• The travelling clinics visit 66 centres which are responsible for about 1,000
cases of tuberculosis on antimicrobial therapy on an out-patient basis.
Successful treatment is dependent on adequate supervision and constant
review.
A Public Health Inspector checks the temperature of broiled chicken at an up-to-date
kitchen. Temperature levels in cooking chicken are of prime importance in the fight
against food poisoning.
 COMMUNICABLE AND REPORTABLE DISEASE
J 15
• Case-finding continues to be carried out by community tuberculosis surveys
and by local health units, where miniature X-ray facilities have been
established in 24 centres. However, there is still a great need for X-ray
service in the smaller and outlying communities and the future emphasis
should be directed toward these centres.
In Community Tuberculosis Surveys, combined tuberculin testing and X-raying
have been carried on for over 10 years. For the future it is planned to do these
diagnostic procedures separately because the point has now been reached where
many persons covered by these surveys might receive tuberculin tests needlessly.
Therefore,
• tuberculin testing will not usually be done on the X-ray buses,
• tuberculin tests will periodically be administered to young people (including
pre-school groups and those in school) and adults on request.
The collection of sputum for cytological examination has been added to the
survey procedure and a significant number of cases of respiratory cancer have been
detected.
VENEREAL DISEASE CONTROL
Gonorrhoea has shown a marked increase in incidence for two successive years.
In 1968 there were 4,179 reported cases. In 1969 the number has risen to 4,780,
and in 1970 to 5,900.   (See Table VIII.)
This increase is attributable to the sociological development referred to as
" transient youth." This group has caused a substantial increase in the number of
persons visiting the Vancouver Clinic, where the average attendance of males has
increased from 30 to 40 a day and the average attendance of females from 12 to
15 per day.
During the three summer months, 60 per cent of the Vancouver Clinic patients
were transient youth. Half were from other parts of Canada and half from the
United States.
In order to prevent the spread of gonorrhoea in this transient population a
public health nurse was employed to promote treatment and preventive measures
among identified groups. This procedure has been very effective, although the
nurse is called on to provide many medical services in addition to gonorrhceal control.
Requests for help include birth-control information, lice control, scabies control,
and advice regarding respiratory infections.
The outlook is brighter, so far as syphilis is concerned. The disease continues
to exhibit the gains to be derived from control endeavours with this, the fifth year,
in which less than 80 infectious cases have been reported. The laboratory has introduced a new procedure of fluorescent technique of staining for syphilis organisms in
eye fluid, making it possible to positively identify syphilis lesions of the eye.
THE PUBLIC HEALTH NURSE AND DISEASE CONTROL
Disease control is a traditional area of concern to the public health nurse.
Among the important aspects of prevention and control is supervision of tuberculosis
patients and contacts. A total of 437 patients and families were under health
supervision, and this year 8,723 home visits were made on their behalf. In addition,
public health nurses conducted 15,316 tuberculin tests, while tests for other communicable diseases amounted to 5,388, a 78 per cent increase over last year. Public
health nurses performed 3,562 services in connection with control of venereal
disease, and regularly supervised the health of 1,135 children on rheumatic fever
prophylaxis. In addition, 8,723 services were provided in disease control and
included epidemiological investigations and injections for infectious hepatitis.
 J  16 PUBLIC HEALTH SERVICES REPORT, 1970
HEALTH  AND OUR  ENVIRONMENT
Health and environment are of vital interest to three divisions of the Health
Branch within the Bureau of Local Health Services—Environmental Engineering,
Occupational Health, and Public Health Inspection.
The main functions of the Environmental Engineering Division are
• to serve as a consultative agency in analysis of engineering procedures that
may be adopted to protect the public health;
• to review engineering plans and specifications for approval of all proposed
public waterworks systems within the Province;
• to provide consultative services to Medical Health Officers and public health
inspectors in matters relating to water supplies and treatment, sewage-
disposal systems, solid-waste disposal, public swimming-pools, and subdivision developments;
• to consult with the Pollution Control Board and to advise on public health
hazards likely to be created from waste-disposal sources;
• to keep records and statistics on Provincial waterworks systems and to
provide technical information to public health inspectors;
• to draft informative articles on technical subjects related to waterworks and
waste disposal.
Special projects during the year included reporting on fluoridation installations,
writing waterworks-design standards for the Province, and designing a data and
record card for waterworks systems.
POLLUTION CONTROL
All pollution control permit applications are reviewed jointly by the Division
of Environmental Engineering and the Medical Health Officer affected. Departmental policy requiring at least primary sewage treatment to produce a water quality
acceptable within the Recommended Standards continued to provide the principal
guidelines for recommendations to the Pollution Control Branch concerning these
applications.
There has been a shift to the Director of Pollution Control of responsibility in
matters relating to regulations and enforcement of environmental management. The
Health Department has become more directly concerned with surveillance and
advice, an approach which will prove effective in the long term. Emphasis will be on
research and study of new methods and materials used in the field of waste treatment
and disposal.
The Director of the Division of Occupational Health was appointed to the
advisory panel for the public inquiry held in August to investigate pollution caused
by the forest products industry. The hearing continued over a two-week period and
a considerable amount of time was spent afterward preparing the report for the
Director of the Pollution Control Branch.
Individual problems have arisen during the year, the most notable being the
lead pollution of a small area of Richmond municipality in close proximity to a
lead-smelting plant.
As the Pollution Control Branch of the Department of Lands, Forests, and
Water Resources assumes responsibility for the control of air pollution on January
1, 1971, the Health Branch air pollution advisory committee is being phased out.
The Director of Occupational Health and members of the Provincial Laboratory
 HEALTH AND OUR ENVIRONMENT
J 17
and Public Health Engineering staff will continue to act as advisers to the Health
Branch and to the Pollution Control Branch.
RADIATION
The Director of the Division of Occupational Health is a member of the safety
advisory committee for the TRIUMF (Tri-University Meson Facility) project at
the University of British Columbia. Plans are being made for a comprehensive
radiation survey in order to obtain background data before the cyclotron goes into
operation.
The radium-leak testing procedures developed for mass surveying proved so
successful and accurate that the Radiation Protection Division of the Department
of National Health and Welfare adopted the method and, from September, 1970,
instituted a similar programme on a national basis for all radium users.
On May 13, 1970, the Federal Government received royal assent for the
Radiation-Emitting Devices Act. Salient features of the Act and its significance for
the Provincial Radiation Protection Section may be summarized as follows:—
• The Act deals with the importation and sale of X-ray and radiation-emitting
devices to ensure that they conform to national and international standards
of radiation safety.
• The widespread use of microwave devices, particularly microwave ovens
and laser generators, has given rise to much concern, and these will now be
covered by the Act so far as their sale in Canada is concerned.
• The Act specifically states that it is the responsibility of each Province to
ensure that radiation-emitting devices are maintained in a safe and working
condition and free of radiation hazards.
During the visit of an American nuclear submarine to Canadian waters, the
mobile field laboratory was called out for radiation surveillance. There was no
recorded release of radioactivity during its stay.
There were several incidents during the year involving alleged improper use of
radioactive sources that required investigation by inspectors. None turned out to
be a health hazard.
To eliminate the possibility of leakage of radioactive material which might
contaminate food and drink being processed in the Province on bottling-lines, six
radioisotope gauges have been installed and a strict programme of inspection and
leak testing continues to be carried out.
SEWERAGE PLAN REVIEW
The responsibility of sewerage plan review was transferred from the Division
to the Pollution Control Branch during the year. A co-ordinated arrangement with
the latter branch has been evolved whereby engineers supervising plans of sewerage
systems will analyze them from both aspects. Thus, a permit from the Pollution
Control Branch implies acceptance from a public health point of view.
The Division of Public Health Inspection has an administrative as well as
consultative function. Continued in-service training courses have been provided
for public health inspectors to assure a high quality of service. Greater efficiency
is encouraged through consultation, programme planning, and evaluation studies.
There are 59 public health inspectors employed in 18 health units.
The Division co-operates with other governmental agencies and health departments, including Metropolitan Health Departments and the Medical Services
Directorate within the National Department of Health and Welfare.
 I 18 PUBLIC HEALTH SERVICES REPORT, 1970
SURVEYS
Barbecued Chicken.—A survey of barbecued-chicken operations in British
Columbia in 1967 indicated several potentially dangerous food-handling practices
which prompted a further survey in December, 1969, and January, 1970. Inspectors visited a total of 90 food stores, 46 of which were in the City of Vancouver and
North Vancouver. It was noted that 77 per cent of the barbecue operations showed
a holding temperature of less than 140° F. Such insufficient holding temperatures
serve to incubate bacterial production, thus creating potential food infection. Two
incidents of staphylococcal food infection, related to barbecued chicken during the
past year in British Columbia, demonstrate the careful precautions required in
retail outlets selling such produce. Public health inspectors have been required to
impress operators about the potential health dangers inherent in the procedure.
Mobile Homes.—The Health Branch, in co-operation with the Department of
Industrial Development, Trade, and Commerce, completed a survey of mobile-
home parks with the assistance of Provincial health units and the two Metropolitan
Health Departments of Greater Victoria and Vancouver. The total number of
mobile-home parks in British Columbia is 515. The total number of spaces is
12,376. The total number of spaces occupied is 9,984 (based on 74 per cent of
returns from a survey).
FOOD-HANDLER CLASSES
A total of 778 food-handlers employed by the British Columbia Ferries Division attended courses on " Safe Food Handling." Four health units were involved
in conducting the classes. Those in attendance were given certificates signed by
the Medical Health Officer and Senior Public Health Inspector.
A number of 35-mm. slides showing the preparation of a turkey dinner, the
most popular ferry meal, were taken by the Health Education Division with the
co-operation of the Catering Superintendent of the British Columbia Ferries and
the Boundary Health Unit. These were used on food-handling courses with marked
success.
FOOD POISONING
Outbreaks of food poisoning from various food establishments indicate a need
for frequent inspections and continuing education of food-handlers. A food-
premises regulation has been prepared with the objective of placing greater emphasis on improved food-handling. A comparison of food poisoning cases notified is
given below:—•
1970 1969
Salmonella  560 400
Staphylococcal intoxication  8 29
Botulism  2 8
Foodpoisoning type unspecified  6 19
Totals  576 456
PUBLIC HEALTH INSPECTORS' ACTIVITIES
Public health inspectors in 17 health units took part in a two-week time-study
in the spring and the information obtained is set out in Table X.
A statistical summary of public health inspectors' activities is shown in
Table IX.
 COMMUNITY AND FAMILY HEALTH
I  19
COMMUNITY AND  FAMILY HEALTH
The public health nurse continues to hold a high place in Provincial public
health programmes and her duties are the direct concern of the Public Health
Nursing Division.*   This division
• assists health units in evaluating programmes being carried out by public
health nurses in order that services may be provided as efficiently and
economically as possible;
• plans and arranges for educational and technical training to enable the
upgrading of public health nursing services.
To facilitate these aims, four nursing consultants visit health units at regular
intervals to provide consultations and advice on general public health nursing, as
well as in certain specialties such as school health, mental health, home care, and
communicable diseases. In addition, the Division is concerned with co-ordinating
services with various other health agencies such as the Red Cross, Medical Services,
Division of the Department of National Health and Welfare, the University of
British Columbia, the Registered Nurses' Association of British Columbia, and
Canada-wide organizations including the Canadian Public Health Association.
FAMILY HEALTH SERVICE
Public health nursing is a family health service given in the community setting
and involves health promotion, illness prevention, and the provision of certain
treatment services. It is available to all persons whether healthy, sick, or disabled.
In summary:—
• Service is not limited to any segment of society or age-group and is therefore given in a variety of settings such as homes, schools, certain institutions,
and health centres.
• Service is provided within the established policies of the health unit and the
Health Branch.
• In the performance of her duties, the public health nurse is assisted by health
unit aides, by registered nurses who assist with the home nursing service, and
by volunteers who assist with clinics and other activities. In this way the
public health nurse extends her skills to serve more people.
• Certain programmes and services are directed to selected age-groups and
situations where there is a " risk " factor which provides a focal point for
health promotion.
• Public health nurses made 175,069 visits to homes during the year (a 2 per
cent increase over 1969) and provided 199,123 individual services by telephone.   (See Table XI for detailed statistics.)
The special programmes and services rendered by public health nurses in health
units during the year were many and varied.
MENTAL HEALTH
In this, as in so many of the assignments performed by public health nurses,
prevention of mental illness is the prime objective. Toward such an achievement,
efforts were made to identify potential problems at child health conferences, pre-
* A statistical summary of selected activities of public health nurses is shown in Table XI.
 J 20 PUBLIC HEALTH SERVICES REPORT,  1970
natal classes, schools, and in home visits. School children received 43 per cent and
adults 50 per cent of the visits, with pre-school children making up the balance.
Nevertheless, some members of the public do develop mental illness and are
referred to the Mental Health Branch for care. Changing trends in treatment encourage the patient to maintain community residence where possible. This poses a
need for frequent home visits to foster individual patient improvement. As a key
community health worker, the public health nurse is involved in this.
There were 11,820 visits to persons receiving treatment because of an emotional
disturbance, and half of these were to school-children.
REHABILITATION NURSING
Consultant public health physiotherapists assisted in nine health units with
home care and rehabilitation nursing. During the year they participated in 142
group meetings and lectures in addition to 491 consultations with public health
nurses regarding patients under care.
Hospital liaison is necessary to ensure that rehabilitation nursing programmes
initiated in hospital are continued when patients are discharged. Public health
physiotherapists made 468 hospital liaison visits, 1,267 home visits, 521 individual
patient assessments, and 566 re-assessments of patients and their environment.
Other activities include assistance in developing rehabilitation and recreational
programmes for patients in private nursing homes and similar institutions and
advice to schools in relation to children with physical handicaps in special classes
and in schools for the retarded.
ADULT AND GERIATRIC SERVICES
Services to adults for general health supervision (in addition to those for mental
health, tuberculosis, venereal disease, prenatal or nursing care) form an important
part of the public health nurse's work. During the year, 57,226 services were
rendered for general health appraisal and resulted in persons obtaining early diagnosis, treatment, and care for medical conditions, nutrition counselling, health
counselling, or referral to another agency.
SERVICE TO INDIANS
Certain Indian reserves receive public health nursing services from the health
units through a special arrangement with the Medical Services Directorate of the
Department of National Health and Welfare. This year, 10,174 Indians on 71
reserves were included in the general health service.
It is interesting to note that 14,082 of 46,911 Indians resident in British Columbia now live permanently off the reserve and receive general health service in the
communities in which they are resident. Also, most Indian children now attend
community schools and receive the general school health service.
SPEECH-THERAPY SERVICES
Attention has continued to be given to this service and, as a result, there is
a wider understanding of the problems of speech-and-hearing handicapped people.
Health Branch staff met with representatives from the Department of Education; the Department of Rehabilitation and Social Improvement; Metropolitan
Health Services; the British Columbia Oto-Ophthalmological Society; the Department of Paediatrics and Division of Audiology and Speech Sciences, University of
British Columbia;  the Western Institute for the Deaf;  and the British Columbia
 COMMUNITY AND FAMILY HEALTH
J 21
Speech and Hearing Association during the spring and summer. In the fall, a
Provincial Speech and Hearing Planning Committee was established to advise these
Government departments and community agencies on planning and co-ordination
of services for the people with communication problems.
Since it is important for staff to have the opportunity of participating in
continuing-education programmes, the Health Branch sponsored a workshop in
Audiology and the Needs of the Hearing Handicapped Population in British
Columbia, in co-operation with the Western Institute for the Deaf. This workshop
was attended by teachers of the deaf and hard-of-hearing, audiologists, otologists,
hearing-aid dealers, speech therapists, psychologists, and consultants in special
education from all areas of the Province.
In the health units in which speech therapists are located, the emphasis on
services to the pre-school and early school-age child has been maintained. Consultation with parents, teachers, and hospital nurses in relation to the older child and
adult with severe disorders of communication have also been undertaken on specific
request.
MOTOR-VEHICLE ACCIDENT PREVENTION
The Health Branch continued to provide a consultative service to the Driver
Licensing Division of the Motor-vehicle Branch and to give advice on the ability
of persons with medical defects to drive safely. A revision of The Guide to Physicians in Determining Fitness to Drive a Motor-vehicle, produced some years ago,
has been started. It is hoped that it will be ready for distribution to all practising
physicians soon.
Public health nurse checks child's hearing prior to school entry.
 J 22 PUBLIC HEALTH SERVICES REPORT, 1970
COMMUNITY CARE FACILITIES
The Director of the Division of Epidemiology has continued to act as chairman
of the Interdepartmental Community Care Facilities Licensing Board, which investigated a number of complaints and directed the operators of the institutions
involved to correct deficiencies.
There has been a substantial increase in the number of individuals and agencies
wishing to provide some form of day care for children of working mothers. The
quality of care offered by some of these facilities was found to be only marginal,
and this led to a considerable increase in the work load of the Board and its
Inspectors.
An increase in the construction of highrise accommodation for elderly people
who require some form of supervision or help in order to carry out the task of daily
living has required careful supervision to assure that the needs of elderly citizens
are not subordinate to the accommodation of the maximum number of people in
the minimum of space.
RHEUMATIC FEVER
The number of children on the British Columbia Rheumatic Fever Prophylaxis
Programme, as of October 1, 1970, was 1,332. This approximates the number
one year ago.
Although the programme has continued unchanged during 1970, an Advisory
Committee is assessing the situation to determine if the number can be decreased
by approximately one third.
It is now felt that children who do not develop evidence of cardiac damage
following their first attack of rheumatic fever within five years of such an attack are
far less likely to develop such damage at a later date. For this reason it is considered
that some revision of the criteria, which would phase out children after a five-year
period if there was no evidence of cardiac damage, might be possible without
sacrificing the purpose of the programme.
Until this year, children accepted on the programme in their late 'teens were
allowed to continue for five years, even though they had passed the age of 21.
The provision of free penicillin has now been entirely discontinued at the age of 21.
In 1968 a study was conducted to develop an accurate method of detecting
children who were not taking their penicillin regularly. The study was completed
in 1969 and the results published in the July-August edition of the Canadian Public
Health Association Journal.
AGAMMAGLOBULINEMIA
The Canadian Red Cross Blood Transfusion Service has for many years
provided immune serum globulin free of charge to people suffering from a relatively
uncommon but life-threatening disease called " agammaglobulinemia." The Red
Cross organization discontinued this service early in the year. The product is
expensive, and many people who must have monthly injections of immune serum
globulin in order to live a normal life found themselves unable to pay the retail
price for this serum.
The Health Branch, by purchasing larger quantities of this product through
competitive tender, has been able to obtain immune serum globulin at a much
reduced price and is now providing it free of charge to those who require it to
sustain life. An advisory committee with representation from the Departments of
Pediatrics and Pathology of the University of British Columbia and the Transfusion
Service of the Canadian Red Cross is assisting the Health Branch in evaluating each
 COMMUNITY AND FAMILY HEALTH J 23
application. By the end of the year six people were accepted on the programme
and fourteen rejected for lack of proper medical indication of their need for routine
injections.
OCCUPATIONAL HEALTH
Occupational health physicians and nurses traditionally have been concerned
with the health consequences of the interaction between the employed person, his
supervisors, and his work environment. This concern, which has been narrowly
defined, should now be expanded and related to the total health care system.
For the employed person, the medical department of the work place represents
a natural point of first contact and a door to the health care system. It can serve
this purpose only if it is an integral part of the total community resource and not an
isolated entity.
With this end in view, the Division of Occupational Health operates a Provincial Government Employees' Health Service. The staff consists of three public health
nurses who serve the employees in the Victoria, Vancouver, and Essondale areas.
Supervision and special consultations are provided by a physician. The staff of the
service work closely with the employees' supervisors, departmental personnel officers, and the Civil Service Commission. Where indicated, discussions are held with
the family doctor or the Workmen's Compensation Board.
Table XII summarizes the work of this service.
 I 24 PUBLIC HEALTH SERVICES REPORT, 1970
MATERNAL AND CHILD  HEALTH
Attendance at prenatal classes held throughout the Province by public health
nurses is increasing. This is particularly true of prospective fathers who attended
classes in 1970 at a rate 30 per cent higher than in 1969. It is noted that prospective parents show readiness to accept health education.
Teaching centres around problems of pregnancy, normal development, family
relationships, and meal planning. Included are recommended relaxation exercises.
Group classes are held at most of the 80 health centres in the health units. Attendance of mothers and fathers was 20,840, or an increase of 14 per cent over 1969.
In 1970, 21 per cent of all expectant mothers attended classes.
Some health units participated in television education to reach expectant
mothers who have not attended classes. Public health nurses made 4,240 prenatal
and 19,746 postnatal visits. The latter indicates that approximately 95 per cent of
all new mothers have at least one visit from the public health nurse to assess the
health needs of the mother and new baby.
INFANT AND PRE-SCHOOL CHILDREN
Special attention to infants and pre-school children will assist in disclosing many
potential health problems, enabling timely corrections to be made. PubUc health
nurses are involved in programmes to determine the status of the child's physical and
emotional health. The work includes screening programmes for hearing loss, vision,
and retardation. Assessments are made at special clinics, conferences, and in the
home situation.
During the year:—
• Public health nurses made 36,114 visits to homes of infants for the purpose
of general health assessment and counselling.
• Newborn infants, numbering 16,946, attended the local regular child health
conferences held in local communities. This indicates that approximately
75 per cent of all infants received continuing public health nursing health
supervision.
• Attendance was up 4 per cent for infants and 8 per cent for pre-school
children over 1969, with an attendance of 60,435 infants and 89,423 preschool children.
• Public health nurses made 33,612 visits to homes on behalf of pre-school
children, of which 7 per cent were for primary or secondary prevention in
mental health.
SPECIAL STUDIES
In 1970 more emphasis was directed toward special pre-school clinics for
3- and 4-year-old children. Three health units were involved in special studies to
determine the best screening methods for detecting deviations from normal health.
The South Okanagan Health Unit is testing the validity of the Denver Developmental
Screening Test designed to test motor, language, and the personal-social development
of pre-school children. In the Boundary Health Unit a study to detect visual problems in infant and pre-school children was completed. The Central Vancouver
Island Health Unit is involved in another study to document the results of screening
programmes for hearing, vision, and general development.
It is felt that emphasis on prevention and early correction of defects will contribute a great deal to future progress and eliminate costly treatment at a later date.
 IMMUNIZATION
J 25
IMMUNIZATION
Immunizations form an important part of the communicable disease control
programme for those diseases where some measure of control is possible by this
procedure.   During 1970:—
• 480,610 doses of biologicals were given for protection against diphtheria,
pertussis, smallpox, rubeola (measles), and poliomyelitis. This was an
increase of approximately 60,000 doses over 1969 (see Table XIV on page
58).
• In addition to the conservation of human health, immunizations, as completed by public health nurses, provided a great measure of saving to the
British Columbia Medical Plan, which might otherwise be charged at a rate
of $2 per injection or dose. The over-all saving is estimated to be $960,000.
Of particular interest were the following:—
Rubella.—A major programme of immunization against rubella (German
measles) was undertaken in late summer. Funds were provided jointly by the
Health Branch, a number of philanthropic foundations, and local municipalities,
and made possible a project in which 240,000 doses of vaccine were purchased and
given to children between the ages of 1 and 11. This programme is expected to
lead to a major decrease in the number of infants born with congenital defects due
to this infection.
Rubeola.—The rubeola (measles) immunization programme initiated in 1969
was continued through 1970 with disappointing public acceptance. There is no
doubt that the cost of medical and hospital care for the victims of measles far
exceeds the cost of immunizing every newborn infant.
Immunizations are available at health centres, child health conferences, special
clinics, and schools.
This young girl is one of many who received rubella vaccine from the public health nurse.
 J 26
PUBLIC HEALTH SERVICES REPORT,  1970
SCHOOL  HEALTH
The health of school children was under constant care by public health nurses
in 1970, which saw an enrolment increase of approximately 15,000 children in
areas served by the Health Branch. This figure includes an increase of about 1,600
kindergarten pupils to whom public health nursing service is made available as a
follow-up of the supervision given in the child's pre-school years.
Main features of the programme are:—
• In the pre-school and kindergarten services, vision and hearing screening,
combined with health education and general observation, help to ensure
that a child will enter Grade I with a positive attitude to health and with
known defects under adequate care. It will be noted from Table XIV
that a high percentage of pupils have basic immunization prior to entering
Grade I.
• Ideally, the school health programme beyond Grade I should be mainly
concerned with maintaining an existing high standard of health and conducting intensive follow-up of emergent problems.
• To provide health services to the increasing number of children, it is necessary for the public health nurse to be selective. She therefore spends most
of her time with children with special problems and arranges needed services.     Selection of children for special follow-up  is  accomplished by
Public health nurse preparing child for vision test.
 SCHOOL HEALTH
I 27
teacher referral, review of the individual and family health history, teacher-
nurse conferences, school liaison committees, and routine screening.
In Provincial health units, public health nurses held 64,784 conferences and
2,769 meetings with teachers. The number of individual services to pupils increased 32 per cent to 406,790, and 4 per cent of these services were given by
health unit aides under direction of the public health nurse. In an effort to help
families meet health needs of their school children, 45,852 home visits were made
by public health nurses.
An active programme of referral and follow-up is shown in Table XV, and it
will be noted that approximately 15 per cent of pupils were referred to the public
health nurse and 9 per cent were referred by her for further care. These figures
show a continuing close involvement of the public health nurse in helping to meet
the physical and emotional needs of children.
For further information on School Health Services, see Table XIII.
Public health nurse visits a patient in hospital before discharge and
admission to the home-care programme.
 J 28
PUBLIC HEALTH SERVICES REPORT, 1970
HOME CARE
Home care is an important aspect of community health care as it represents an
efficient and economical way of caring for patients who can remain at home but
need part-time nursing and related health services. Home care is provided by the
public health nurses as part of their general programme of nursing. Auxiliary
services which may be available from local agencies or groups are arranged by the
public health nurse as required for the patient's care. These services might include
homemakers, medical supplies, meals-on-wheels, visiting volunteers, occupational
therapy, and physiotherapy. If the home care service were not available, many of
the patients would be occupying acute, extended, or other types of institutional beds
at a much greater cost to the taxpayer. Because of many variables it is impossible
to place a value on the increased social well-being of patients being cared for in their
own home environment.
Home care service is available in 113 communities to almost 80 per cent of
the population in the health unit areas.
Important features of the programme were:—
• During the year there were 77,766 home nursing visits for care of physical
conditions, an increase of 2 per cent over 1969.
• In addition, 5,449 additional visits were made to patients under psychiatric
treatment. In this way some remissions are prevented and many patients
can be rehabilitated to community life.
• 83,255 visits were made for tertiary prevention concerned with improving,
rehabilitating, or maintaining patients with both mental and physical conditions at home.
• It is possible that savings to the British Columbia Medical Plan amounted
to over $166,000, as comparisons with nursing visits made by a voluntary
nursing organization indicate this would be an acceptable charge to the plan
at $2 per visit.
An elderly citizen relaxes while the public health nurse
changes a dressing in the home-care programme.
 HOME CARE
J 29
^^^MfcwJasSaaf-
 I 30 PUBLIC HEALTH SERVICES REPORT, 1970
PREVENTIVE  DENTISTRY
During the past two decades British Columbia's preventive dental services have
given maximum attention to infants, pre-school, and elementary school-children,
and to young parents, endeavouring to develop a new generation with greatly improved dental health. Programmes, so far, have concentrated on the provision of
early and regular dental treatment, commencing at 3 years of age, and on the prevention of dental caries.
As a result, there has been
• some reduction in prevalence of dental caries;
• a very considerable improvement in the provision of early and regular dental
care by dental practitioners and in the acceptance of the necessity for such
treatment by young parents.
In the future, attention must be given to the prevention of malocclusion
(crooked teeth) and of periodontal (gum) disease. This latter condition, at present,
is the major cause of tooth-loss in adults. Furthermore, malocclusion is a predisposing cause to periodontal disease.
The Health Branch continues to provide annual grants-in-aid to the dental
health division of the Greater Vancouver Metropolitan Health Service and to the
dental department of the Greater Victoria school district. In these metropolitan
areas, children of elementary grades receive annual classroom dental inspections,
with parents being notified of the findings. Assistance is provided to schools for
the better teaching of dental health in the regular curricula.
For the remainder of the Province, five regional dental consultants work with
three to five, usually adjacent, health units. They assist health unit directors and
public health nurses in planning and administering local dental health programmes.
In addition, the consultants endeavour to improve dental health knowledge, attitudes,
and habits of the people in the communities they serve.
In most communities of health unit areas there are now 3-year-old birthday
card dental programmes. As children reach their third birthday, the health unit
mails a birthday card with enclosure. The card entitles the child to visit the family
dentist and, at no direct cost to the parents, to receive the following services:—
• Examination (with X-rays, if necessary).
• Counselling as to diet and oral hygiene.
• A topical application (painting) of the teeth with a decay-preventing solution.
If further treatment is necessary, costs are borne by the parents. Currently
programmes are operating in 38 school districts and are being organized in a
further six districts. There remain 11 districts where there are one or more resident
dentists, but programmes have not commenced. It is hoped that programmes may
be started in these districts when the acute shortage of dentists' time has been alleviated.
In communities where programmes do operate at maximum efficiency, more
than 80 per cent of all 3-year-olds visit the family dentist.
During the period August, 1969, and September, 1970, more than 7,000 such
children benefited by this service, an increase of about 12.5 per cent compared with
the same period 12 months earlier.
Remote areas of the Province without a resident dentist are visited annually by
a dental public health extern. (Each year several young fully qualified dentists are
so engaged for a 10- or 12-month period.)    Each dentist is provided with highly
 PREVENTIVE DENTISTRY
J 31
specialized and modern portable dental equipment, and work in this field may be
summarized as follows:—
• In most communities visited, dental care is provided to pre-school and
Grade I children, with parents paying a nominal registration fee.
• In most cases the local Board of School Trustees assists the Health Branch in
meeting the cost.
• During the 1969/70 school-year, 1,100 children benefited from the services.
Many native Indian children are included in these programmes. Older children and adults are also treated, but on a fee-for-service basis. Currently
being served are some 35 communities.
During 1970, 20 communities were deleted from this programme because they
are reasonably close to adequate resident dental services. Methods will be explored
to ascertain if dental service to remaining communities can be continued on a nearly
self-sustaining basis. It is hoped moneys released may be utilized for the inauguration of more dental hygiene programmes throughout the Province.
In the Okanagan region and in the Alberni Valley, dental hygienists have
carried out most effective dental health educational programmes. These include
classroom dental inspections, counselling, and group instruction in the elementary
grades. Use is also made of radio, television, and newspapers for further dental
health education.
In Kelowna, a community dental health centre was inaugurated in the fall of
1970, and the value of its services will be most carefully evaluated. There will be
developed, with the co-operation of the local dental practitioners, a new concept in
the total delivery of dental care. Patients will be referred to the centre for special
preventive and educational services, to be given either singly or when appropriate,
in groups.
Instruction and services for the prevention of periodontal disease will be available for people of all ages; for young persons, preventive services for dental caries
and malocclusion; and, for the elderly, early diagnosis of oral lesions for the possibility of cancer. Funds for extra staff to provide these additional services have
been made available through a National Health Research Grant.
All dentists newly registering to practise in British Columbia are provided with
kits for the taking of a small section or a smear for the accurate diagnosis of a
suspected pre-cancerous or other suspicious lesion of the oral cavity. Kits are made
up by the office of the College of Dental Surgeons of British Columbia. Cytological
diagnosis of oral smears and pathological diagnosis of biopsy sections are carried
out by the British Columbia Cancer Institute. This service is providing a certain
stimulus to the early diagnosis and, thereby, more successful treatment of oral cancer.
Surveys to evaluate the dental health status of the total child population (7-15
years) of the Province were first carried out in the period 1958-60 by the examination of a random sample of 9,300 children. A second series was completed during
the years 1961-67, when 9,500 children were examined. Many improvements in
dental health status of the children were demonstrated. The third series commenced
in 1968 and will be concluded in 1974. In each region surveyed a third time, further
consistent and significant trends toward better dental health are evident.
Current methods available for the prevention of dental caries, periodontal disease, and malocclusion are either unacceptable to large segments of the population
or are entirely inadequate. Further field research projects are necessary to discover
more effective methods for dental health improvement. During 1970 the following
research projects were completed:—
 J 32 PUBLIC HEALTH SERVICES REPORT, 1970
• Dental-treatment needs measured by a simplified epidemiological method.
• The incidence of staining of permanent teeth by the tetracyclines.
• Evaluation of dental caries in subjects chewing a gum containing dicalcium
phosphate dihydrate.
• Motivation of parents to provide their children with urgently needed dental
treatment, using messages containing different methods of persuasion.
Research projects currently being planned include
• evaluation of decay-preventing properties of two mouth rinses;
• value and practicality of daily supervised classroom tooth-brushing in early
grades;
• supervised distribution of fluoride supplements;
• conceptual model of a children's dental care programme on a prepayment
basis, with subsidized premiums for low-income families.
In summary, much has been accomplished, programmes have been changed
to meet altered circumstances and will continue to change, but much remains to be
done to improve further the dental health of the people of British Columbia.
 NUTRITION SERVICE J 33
NUTRITION  SERVICE
Community nutrition services in British Columbia are made effective by the
teaching and support of the public health nurse and other public health staff working
in co-operation with the medical profession, hospitals, schools, and social service
agencies in the community. Consultant services are provided by the public health
nutritionist on the headquarters staff of the Health Branch to ensure that the community is well informed on nutrition matters.
This position of Nutrition Consultant was filled in the spring after it had been
vacant for some months. The new Consultant visited the majority of the health
units at least once during the remainder of the year. Discussion focused on individual community problems within the broad subject areas of normal nutrition education, therapeutic diet counselling and institutional food services.
Emphasis in nutrition education was placed on food budgeting and on weight
control. Educational kits were developed for both these topics. Additional teaching tools were devised for certain aspects of meal service in supervised boarding
homes licensed by the Community Care Facilities Licensing Board and for therapeutic diet counselling.
Co-ordination of community nutrition resources was maintained by liaison with
related professionals in the academic and business community and in other Government departments. These included the British Columbia Nutrition Co-ordinating
Committee, the British Columbia Dietetic Association, the British Columbia Home
Economics Association, and the Departments of Education, Agriculture, and Rehabilitation and Social Improvement.
The following activities are planned for 1971/72:—
• Participation of British Columbians in the first phase of a Canadian National
Nutrition Survey in the summer of 1971.
• Emphasis on prenatal and child nutrition in education materials.
• Increased use of mass media in nutrition education.
 J 34 PUBLIC HEALTH SERVICES REPORT, 1970
PUBLIC  HEALTH  EDUCATION
Health education in its broadest sense encompasses every effort by Health
Branch staff to create awareness, influence attitudes, and stimulate desirable behavioural change as these efforts relate to the solution of community and individual
health problems. All public health workers are, therefore, " health educators " and,
throughout this Annual Report of the Health Branch, there are many examples of
the educational activities of the health officers, public health nurses, dental officers,
public health inspectors, nutritionists, physiotherapists, speech therapists, radiation
inspectors, and other Health Branch staff.
All of these are given professional and technical assistance by the Division of
Public Health Education. This Division, which is located at Health Branch headquarters, has on its staff several consultants who are specially qualified in health
education.
During the year, these consultants co-ordinated the development and preparation of educational materials for use by the other staff members of the Health Branch
and for distribution to the public. These materials included illustrative slides for
use with projectors, tapes of recorded commentaries, filmstrips, film-loops, pamphlets, posters, and leaflets. Important publications in 1970 were a pamphlet Drug
Abuse and You, of which 150,000 were printed and distributed throughout the
Province and a brochure How to Be a Good Loser, which was prepared by the Consultant in Nutrition and published in the late fall.
Five Provincial health units prepared and developed half-hour television programmes as part of a series of 13 on " The Child in the Family," which were presented on the Jean Cannem Show during February, March, April, and May. The
purpose of these programmes was to stimulate interest in specific areas of health and
to make the viewers aware of available public health services. These programmes
were presented by a variety of public health workers from the Provincial health
units, Metropolitan Health Service of Greater Vancouver, and other community
agencies. The activities of the staff of the Provincial health units in this television
series were co-ordinated by the Division of Public Health Education.
 VITAL STATISTICS
J 35
VITAL  STATISTICS
The work of the Division of Vital Statistics covered a wide variety of data collection, processing, and comparison. The large volume of information which arrived
at the Division's headquarters was carefully collated and correlated with other data
to produce statistical information for a large number of users. The Division continued to carry out its statutory functions connected with the administration of the
Vital Statistics Act, the Marriage Act, the Change of Name Act, and the operation
of a Registry of Wills Notices under the Wills Act. (Services are provided to the
public through the main office in Victoria and 109 district offices and sub-offices
situated throughout the Province.)
Table XVI indicates the volume of registrations accepted under the above-
mentioned Acts in 1969 and 1970.
The work of the Division may be summarized as follows:—
• The total volume of registrations accepted showed increases over the preceding year for all items except deaths and stillbirths.
• Divorce registrations continued to rise steeply, following the introduction
of the Federal Divorce Act in 1968.
• Under the Marriage Act, the number of marriage licences issued and the
number of civil marriages performed increased by approximately 7 per cent.
• Under the Wills Act, a steady increase of notices filed during 1969, when
17,331 entries were made, continued in 1970 when entries totalled 18,137.
• An increase from 714 in 1969 to 800 in 1970 occurred in the number of
registrations for changes of name under the Change of Name Act.
• A considerable amount of statistical work in connection with cancer was
carried out by the Division, which provided services to the central Cytology
Laboratory in connection with the screening programme for cancer of the
cervix. Approximately 340,000 forms, representing that number of cervical
smears, was submitted to the Division for mechanical tabulation in 1970.
(A research officer served as a member of the committee of the International
Collaborative Study on Uterine Cancer and provided statistical data for a
follow-up study on women who were screened and found to have preclinical
carcinoma of the cervix.) A committee established during the year for the
review of cancer care in British Columbia also received statistical advice
and assistance.
• Intensified efforts to secure the co-operation of all pathologists in the Province have resulted in an increase in the total number of new notifications
during 1970, which were recorded on the Cancer Register.
• The Registry for Handicapped Children and Adults maintained a high level
of registration of handicapping conditions, and approximately 250 registrations per month were recorded.
• During the year the genetic and pediatric consultants to the Registry introduced a genetic counselling programme for advice to families of affected
children through the co-operation of several local health units and the family
physicians in those health unit areas.
• In the field of dental studies, assistance was given to the Division of Preventive Dentistry by providing analytical and mechanical tabulation services in
connection with the projects which are outlined in the report of that Division.
 J 36 PUBLIC HEALTH SERVICES REPORT,  1970
• The Division also continued to provide biostatistical services to other divisions, other departments of Government, and voluntary agencies.
• For several years, detailed information relating to newborn infants has been
collected in four Vancouver hospitals by means of an obstetrical discharge
summary form. During 1970 the second report on the data for 1963-70
was released- This report dealt principally with the incidence of stillbirth
and early neo-natal deaths in relation to other relevant factors, and has
been made available to health units.
A large volume of case records is maintained in Vancouver by the
Registry for Handicapped Children and Adults.
 EXTENDED CARE
J 37
EXTENDED CARE
Pearson Hospital serves two broad categories of patients—those with tuberculosis or other respiratory problems and those who are in need of extended care,
including those suffering from the effects of poliomyelitis.
Among staff changes, the most significant was the retirement during the early
summer of Dr. H. S. Stalker, who had been with the Public Health Service since
1937 and has served as Pearson Medical Superintendent since 1952.
Prominent among hospital activities were the following:—
• Many items of furniture and equipment were added or modernized.
• Extensive renovations were made in the main kitchen and staff lunchroom
and in the administration building.
• The clinical laboratory section of the hospital continued to function well, and
the total work load of the laboratory showed a 9 per cent increase (over an
11-month period).
• The physiotherapy and occupational therapy departments have been very
active and the occupational therapist continued to work closely with the
rehabilitation nurse in devising and providing specialized equipment such
as braces and feeding-aids.
• For the first time, students from the School of Rehabilitation Medicine at the
University of British Columbia were assigned to the Physiotherapy Department, so that both occupational and physiotherapy aspects are part of the
educational programme.
• The Social Service Department has been actively reviewing its function and
has established closer working relationships with other professional disciplines.
WOMEN'S AUXILIARY
Assistance from the Auxiliary continued to be a welcome facet of hospital life.
The efforts of the members has made it possible to maintain a high degree of programme activity.
This artist, working at the Pearson Hospital, produces beautiful work
on a commercial basis.
 J 38
PUBLIC HEALTH SERVICES REPORT, 1970
REHABILITATION
Rehabilitation is the restoration of the handicapped to the fullest physical,
mental, social, economic, and vocational usefulness of which they are capable.
This idealistic concept of a total rehabilitation programme was developed in a
conference in Washington, D.C., in 1942. In North America, most rehabilitation
programmes are administered or financed by government agencies. In British
Columbia, rehabilitation of handicapped persons has been a responsibility of the
Health Branch since the first rehabilitation programme was launched in 1946. In
the main, programmes have been developed to provide vocational rehabilitation
services which are concerned with those processes of assessment, physical restoration,
counselling, and training which will enable a disabled person to overcome a handicap
to employment.
The historical background to rehabilitation in British Columbia is interesting,
and a comparison of 1970 with 1947 amply illustrates progress in work among
handicapped people. At the end of 1947 the vocational rehabilitation staff consisted
of one person, the budget for the year was $2,050, and the case load was 37 inpatients and 29 out-patients—all suffering from pulmonary tuberculosis. Services
such as psychological testing and vocational training, elemental in a vocational
rehabilitation programme, were almost unknown. At the end of 1970 the administration of the programme attained divisional status and numbered among its staff
This man is one of many men and women who are actively engaged in work under
the Provincial rehabilitation programme. This photograph was taken at a Vancouver
rehabilitation centre.
 REHABILITATION J 39
a director, assistant director, four highly qualified rehabilitation consultants located
in regions of the Province, and appropriate clerical and support staff.
The case load at the end of the year was approximately 1,070, in which nearly
every degree and category of physical, mental, or social disability was represented.
The work in 1970 was carried out on a budget of $500,000, through Rehabilitation
Committees located in 28 Provincial centres. In only the extreme northwest area
are vocational rehabilitation services not available.
Rehabilitation begins with a medical evaluation of the problem presented to the
client by his disabilities. The first requirement is a medical assessment through which
the d'sability is described, the treatment prescribed, and the resultant handicap
estimated. In addition to the medical problem, the nature and extent of social and
vocational and other problems are explored so that a course through the rehabilitation process can be charted.
Some of the services and aids provided by the Health Branch:—
• Diagnostic and treatment services not covered under plans such as the
British Columbia Medical Plan and the British Columbia Hospital Insurance Service, which may be deemed necessary to correct or alleviate a disability.
• Provision of prostheses, braces, hearing-aids, and such other medical services or items that may be required to further a vocational rehabilitation plan.
• Psychological and vocational testing and counselling services.
• Specific vocational training or retraining where necessary. (The Health
Branch, therefore, underwrites the cost of job-training at almost any level
from industrial workshops through vocational schools, schools of technology,
junior colleges, and universities, when such training will result in employment. In addition to tuition, maintenance allowances, textbooks, supplies,
and transportation may be paid for.)
A close liaison with the Federal Division of Manpower has been maintained, so
that at the completion of the rehabilitation process employment may be sought. It
is often a matter of years before the problems of disability, psychological preparation,
vocational counselling, and job-training can be overcome. The matter of job placement is most important, and every resource is utilized.
The Division of Rehabilitation seeks to utilize many professional skills and
acknowledges help from many quarters and assists with major subsidization of the
professional staff of several voluntary agencies designated as part of the rehabilitation programme- Foremost among these are the Goodwill Enterprises for the Handicapped in Victoria, the Opportunity Rehabilitation Workshop in Vancouver, and
the Western Institute for the Deaf.
For further information on rehabilitation, see Table XVII.
 I 40
PUBLIC HEALTH SERVICES REPORT, 1970
KIDNEY  FAILURE CORRECTION  PROGRAMME
In British Columbia, most persons who suffer kidney failure are now maintained
by haemodialysis, which involves the use of a special machine to remove toxic substances from the patient. As a result of improvements in equipment and techniques
during the last several years, it has become possible for the procedure to be performed by the patient in his own home, in which an artificial-kidney machine has
been placed. This is much less costly than providing the service in a hospital,
although it is still necessary to train the patient in the hospital before he is sent home.
There are three hospitals now training patients to operate artificial-kidney
machines at home—the Vancouver General and St. Paul's in Vancouver, and the
Royal Jubilee in Victoria. In addition, the hospitals at Kamloops and Trail have
artificial-kidney machines, but are not engaged in training patients for home haemodialysis.
When a patient has been trained to operate the equipment, a machine is supplied
to him and necessary alterations to the water and electrical supplies in his home are
carried out. It costs an average of $6,000 to establish a patient in his home in this
way. In addition, it costs an average of $2,150 a year for supplies and materials.
(This form of treatment in hospital costs an average of $14,000 a year per patient.)
While maintained on this service, the patient is able to work and live a nearly normal
life for many years.
The first 16 patients were placed on this service in 1969 and a further 35 during
1970. It is anticipated that there will be a need to give similar help to an additional
35 patients each year.
In addition, financial assistance is provided to 46 patients who are still receiving
dialysis in hospital but who cannot afford the cost of the necessary drugs. This cost
averages $375 annually for each patient.
There are also eight patients who have received kidney transplants and who are
provided with the necessary drugs at an annual cost of $115 per patient.
A laboratory technician examines cultures at the Health Branch laboratory in Vancouver.
(See next page.)
 LABORATORY SERVICES J 41
LABORATORY SERVICES
PUBLIC HEALTH LABORATORY SERVICES
The Health Branch's Division of Laboratories continued to provide services in
the field of microbiology, virology, and chemistry during 1970.
In Table XVIII, the number of tests and the work load in Dominion Bureau
of Statistics units performed at the main laboratory in 1970 are compared with
the figures for 1969- The work load increased by 19 per cent, from 1,081,700 units
in 1969 to 1,289,550 units in 1970. (These figures do not include the tests performed in virology, because D.B.S. units have not as yet been established for such
work.) The main increases in work load in bacteriology were in tests and examinations for diphtheria, gonorrhoea, intestinal parasites, and tuberculosis.
Table XIX shows that the number of tests and work load in units performed
at the branch laboratories in Nelson and Victoria increased approximately 20 per
cent in 1970.
The routine work load of the division in 1970 comprised the following:—
D.B.S. Units
Main laboratory   1,289,548
Nelson branch laboratory        33,518
Victoria branch laboratory      151,590
Total   1,474,656
PUBLIC HEALTH CHEMISTRY SERVICE
The past year brought many changes to the Chemistry Service, with the expansion of some programmes and the suspension of others. In co-operation with the
Fire Marshal, physical changes were made because of potential fire hazards in the
main water and air chemistry laboratories.
To provide necessary additional space for the chemistry section, arrangements
were made in September to accommodate some of the staff and equipment in the
facilities of the British Columbia Research Council located on the grounds of the
University of British Columbia. At the year's end, these arrangements were being
assessed to determine what further changes should be made.
WATER MICROBIOLOGY
Table XVIII shows that the labour load in the Division's main laboratory in
Vancouver increased by approximately 20 per cent in water samples submitted for
the coliform test, the number of coliform tests completed, and the number of standard
plate counts. There was a large increase in the number of fecal coliform tests performed (3,770 in 1970) because of the surveys of bathing-beaches.
WATER AND WASTEWATER CHEMISTRY
The water and wastewater chemistry work load increased in 1970 to 184,500
units from 109,200 units in 1969 (69 per cent). This increase was made possible
by utilization of automated analytical testing equipment. Three additional automatic analyzers were obtained in 1970.
The members of the staff participated in the Federal-Provincial Okanagan Lake
study by performing chemical analyses of outfall and stream samples.
 I 42
PUBLIC HEALTH SERVICES REPORT, 1970
AIR CHEMISTRY
The Lower Mainland air-quality study to determine the relationship of air
quality and meteorology was continued. The final report is scheduled for completion
in September, 1971.
Financing the Lower Mainland study was shared by Health Branch, the Pollution Control Branch of the Water Resources Service, and the Data Processing Centre.
A study of lead contamination in one area of Richmond was completed for the
Richmond Health Department.
VIROLOGY SERVICE
The Virology Service recorded a substantially increased demand for diagnostic
procedures from physicians and hospitals. An epidemic of influenza due to type
A2 influenza virus occurred in the early weeks of the year and was followed by a
sharp outbreak of rubella (German measles). Virological studies tended to indicate
an upswing in the incidence of rubella in the first quarter of the year, which seemed
to be continued at a rate much higher than would normally be expected throughout
the summer.
While rubella is usually a mild disease of childhood, it can cause severe developmental abnormalities in unborn babies when non-immune pregnant women
contract the disease during pregnancy. Laboratory tests can determine whether a
pregnant patient has had rubella as a child and is thus immune for life, or whether
she is non-immune and therefore susceptible to infection.
i
Laboratory workers check readings on the atomic absorption spectrophotometer.
This piece of equipment provides an analytical method for the determination of the
concentration of metals and semimetals in solution. It is used mainly for water
sampling—testing drinking-water for lead, mercury, and copper to make sure they are not
more than the toxic limit.
 LABORATORY SERVICES J 43
Expansion of the Virology Service was authorized so that rubella tests could
be available to all pregnant women in British Columbia.
Other viral infections were identified in patients with encephalitis, meningitis,
pericarditis, myocarditis, pneumonia, and gastro-enteritis.
CLINICAL LABORATORY SERVICES
For a number of years the Laboratory Advisory Council has continued to
advise the British Columbia Hospital Insurance Service before grants are awarded
to hospitals for the purchase of diagnostic and laboratory equipment. (During the
year the Council assessed approximately $700,000 worth of equipment). The Council consists of representatives from the British Columbia Medical Association, the
Health Branch, the Department of Pathology of the Faculty of Medicine at the
University of British Columbia, and the British Columbia Hospital Insurance Service.
In British Columbia, clinical laboratory services have been regionalized and
there are now nine in existence throughout the Province. These laboratories offer
many dianostic tests to in-patients and out-patients of hospitals. It is interesting to
note that the organization now in existence in British Columbia has become a prototype for other Canadian provinces.
The Council prepared outlines of information required for assessing plans to
assist architects and the Hospital Construction and Planning Division of the British
Columbia Hospital Insurance Service. Plans for 20 laboratories were either under
review or at the working-drawing stage in 1970.
Diagnostic centres housing X-ray and laboratory facilities were proposed for
new communities. A joint committee of the British Columbia Association of Pathologists and the Laboratory Advisory Council was formed to advise the British
Columbia Hospital Insurance Service on laboratory facilities in Diagnostic and
Treatment Centres. Comprehensive reports were given for proposed facilities at
Clearwater and Houston and deliberations were under way for similar facilities at
Port Hardy and Rumble Beach.
The British Columbia Hospital Insurance Service asked for studies to be conducted on the feasibility of a new regional pathology service to include Dawson
Creek, Fort St. John, Fort Nelson, and Chetwynd.
L
J
 J 44
PUBLIC HEALTH SERVICES REPORT,  1970
POISON  CONTROL
The Health Branch, in collaboration with the Faculty of Pharmaceutical Sciences at the University of British Columbia, has now established 48 Poison Control
Information Centres throughout the Province. They are located in acute general
hospitals and are fully operative. In 1970, reports were received on over 6,000
cases of poisoning, and in each case information on diagnosis and treatment was
provided from one of the centres. In 1969, over 5,000 instances of accidental
poisoning were reported. In addition to providing service to physicians called on
to treat the victims of accidental poisoning, a number of lectures and talks stressing
prevention were given to physicians and parents during the year.
The establishment of a referral centre where physicians can obtain advice on
the treatment of difficult cases is nearing completion. All the equipment for the
centre has been obtained, and it is expected that it will be operational early in the
new year.
 EMERGENCY HEALTH SERVICE
J 45
EMERGENCY  HEALTH  SERVICE
The provision of mass casualty care and emergency public health service in
the event of major natural or wartime disaster is the objective of the British Columbia
Emergency Health Service. The Provincial service is closely linked with the emergency health services of the Federal Government and of other provinces.
There has been considerable progress during 1970 in the pre-positioning of
emergency medical units. The pre-positioning programme is approximately 75 per
cent complete, and the emphasis should now be on training personnel to be familiar
with the equipment which is distributed throughout the Province at strategic points
and is valued at $1,500,000.
The pre-positioning and maintenance of emergency medical units is an active
programme. Tentative storage sites for two 200-bed emergency hospitals have become available in two zones, leaving two emergency hospitals for which storage
sites need to be found in another two zones. The latter units will be considered in
future planning.
Exercising the facilities provided in the Province is an important matter:—
• An exercise based on the 200-bed emergency hospital is planned for the
annual meeting of the Union of British Columbia Municipalities.
• It is planned to hold one exercise a year, using this training unit.
• During 1970, Prince George Regional Hospital and St. Joseph's General
Hospital in Dawson Creek exercised their disaster plans, based on a simulated local disaster in the community.
• The British Columbia Medical Association Disaster Plan was completely
revised and an exercise held in October, 1970.
• Two well-attended one-day public health disaster institutes were held in
Trail and Penticton during April. These institutes are designed to orientate
public health staff with their duties and responsibilities should a major
disaster occur.
Tabletop displays of the Emergency Hospital Advanced Treatment Centre and
Casualty Collecting Units were used successfully in Vancouver, Victoria, and Summerland at a meeting of the Union of British Columbia Municipalities, and at the
annual conference of the British Columbia Hospitals' Association.
Sections of the 200-bed emergency hospital were displayed to hospital personnel at Canadian Forces Base Esquimalt, to public health personnel at their annual
institute, to pharmacists participating in a continuing education course, at the annual
meeting of the Pharmaceutical Association of British Columbia held in Kelowna,
and at the annual meeting of the Canadian Society of Radiological Technicians held
in Vancouver.
Other activities of the Emergency Health Service may be summarized as
follows:—
• Equipment from the Training Advanced Treatment Centre was again made
available as part of emergency services at the Abbotsford Air Show.
• A three-day indoctrination course was presented for community and hospital
pharmacists, 15 of whom attended.
• A Casualty Simulation Course was conducted for 16 candidates at the Provincial Civil Defence Headquarters.
 J 46
PUBLIC HEALTH SERVICES REPORT,  1970
• A meeting was held with the Victoria Group of Hospital Administrators
who are interested in a Community Disaster Plan similar to that of the
Lower Mainland.
• A demonstration and display of the 200-bed emergency hospital, conducted
by the Alberta Emergency Health Services in Edson, Alta., was attended
by British Columbia's Co-ordinator of Emergency Health Services.
• Lectures were given at the Provincial Civil Defence training courses, the
Public Health Disaster Institute, the Pharmacy Undergraduate Course in
Community Health, and to student nurses during their final year of training
at St. Joseph's and Royal Jubilee Hospitals in Victoria.
• Arrangements were made for 14 persons from various parts of the Province
to attend courses on community emergency health planning, presented by
the Federal authorities at the Civil Defence School in Arnprior, Ont.
A list of locations of emergency medical units is shown in Table XX.
 COUNCIL OF PRACTICAL NURSES
J 47
COUNCIL OF  PRACTICAL  NURSES
British Columbia's licensing programme for practical nurses (the main function
of the Council) was implemented late in 1964 and the first licences were issued in
1965. The 10 members of the Council are appointed by Order of the Lieutenant-
Governor in Council on the basis of nominations submitted by
(a) the Minister of Health Services and Hospital Insurance (two members);
(b) the College of Physicians and Surgeons of British Columbia (one member);
(c) the Registered Nurses' Association of British Columbia (two members);
(d) the Minister of Education (one member);
(e) the British Columbia Hospitals' Association (one member);
(/) the Licensed Practical Nurses' Association of British Columbia (three
members).
The Council operates by the authority of the Practical Nurses Act and the
regulations made under the Act.
During 1970, there were six meetings of the Council as a whole, bringing to
38 the number of meetings held since licensing was implemented.
There were also numerous meetings of several committees appointed by the
Council. Probably the most important of these committees is the Committee on
Credentials, which assesses the qualifications of applicants and submits recommendations to the Council. The final decision concerning the approval or rejection of
each application is made by the Council as a whole. Table XXI shows the disposition of applications received since the inception of the programme.
Under the Act, the Council has some responsibilities in addition to licensing
and it devoted significant attention to these during the year. Most important was the
Council's continued close work with the Department of Education in the matter of
training of practical nurses. A major feature of this was the development of a pilot
training programme to assess the merits of a course of 10 months' duration instead
of the present course of 12 months. The Council also undertook a review of a
publication entitled Outline of Duties to Be Used as a Guide in the Employment of
the Licensed Practical Nurse in British Columbia, which the Council prepared and
issued in 1966. In another activity of long-range significance, a committee appointed
by the Council began a study of the Act and regulations to determine whether
changes should be recommended to the Minister.
 J 48 PUBLIC HEALTH SERVICES REPORT, 1970
PUBLICATIONS,  1970
Four Year Effect of a Dental Birthday Card Programme for Three Year Old Children, J.C.D.A. 36:192, May, 1970, by A. S. Gray, Donna M. Gunther, and
Irene I. Jordan.
The Incidence of Staining of Permanent Teeth by the Tetracyclines, C.M.A.J.
105:351, August, 1970, by J. M. Conchie, J. D. Munroe, and D. O. Anderson.
A Simplified Method of Determining Dental Treatment Needs of a Population, J.
Public Health Dent, (accepted for publication), by J. M. Conchie, K. L. Scott,
and J. J. Philion.
Flash Flood at Trail, British Columbia, 1969, C.J.P.H. 61:104, March/April, 1970,
by N. Schmitt, H. B. Catlin, E. J. Bowmer, and A. A. Larsen.
Rheumatic Fever Prophylaxis—A Method for Detecting Lapses from Continuous
Oral Medication, C.J.P.H. 61:325, July/August, 1970, by A. A. Larsen, L. D.
Kornder, and E. J. Bowmer.
Family Life Education in a School District, C.J.P.H., March, 1969, by G. A. Gibson
and M. B. Maclean.
"Battle of the Buttle" or the Buttle Lake Situation, C.J.P.H., April, 1969, by S.
Chamut.
Sex Linked Cleft Plate in a British Columbia Indian Family, Pa. diatrics, Vol. 46, No.
6, July, 1970, by R. B. Lowry.
Registry for Handicapped Children and Adults, British Columbia, Mental Retardation, Vol. 20, No. 2, April, 1970, by Miss A. E. Scott.
 TABLES
I 49
TABLES
Table I.—Approximate Numbers of Health Branch Employees by Major
Categories at the End of 1970
Physicians in local health services	
Physicians in institutional and other employment
Nurses in local health services	
Nurses in institutions	
Public health inspectors	
Dentists in local health services
Bacteriologists
Laboratory technicians
Public health engineers
Statisticians  	
Others 	
20
17
310
83
58
5
22
35
5
7
693
Total
1,255
Table II.—Organization and Staff of Health Branch (Location and Approximate
Numbers of Persons Employed at End of 1970)
Health Branch headquarters, Legislative Buildings, Victoria..    42
Health Branch office, 828 West Tenth Avenue, Vancouver....    27
        69
Division of Vital Statistics—
Headquarters and Victoria office, Legislative Buildings,
Victoria      67
Vancouver office, 828 West Tenth Avenue, Vancouver      18
        85
Division of Tuberculosis Control—
Headquarters, 2647 Willow Street, Vancouver     11
Willow Chest Centre, 2647 Willow Street, Vancouver  114
Pearson Hospital, 700 West 57th Avenue, Vancouver.... 323
Victoria and Island Chest Clinic,  1902 Fort Street,
Victoria     11
New Westminster Chest Clinic, Sixth and Carnarvon,
New Westminster        4
Travelling clinics, 2647 Willow Street, Vancouver     10
Survey programme, 2647 Willow Street, Vancouver       6
      479
Division of Laboratories—
Headquarters  and Vancouver Laboratory,  828  West
Tenth Avenue, Vancouver     95
Nelson Branch  Laboratory,  Kootenay Lake  General
Hospital        1
Victoria Branch Laboratory, Royal Jubilee Hospital1	
        96
i Services are purchased from the Royal Jubilee Hospital, which uses its own staff to perform the tests.
 J 50
PUBLIC HEALTH SERVICES REPORT, 1970
Table II.—Organization and Staff of Health Branch (Location and Approximate
Numbers of Persons Employed at End of 1970)—Continued
Division of Venereal Disease Control—Headquarters and Vancouver Clinic, 828 West Tenth Avenue, Vancouver	
Division of Rehabilitation—
Headquarters, 828 West Tenth Avenue, Vancouver
Nanaimo 	
Chilliwack	
Prince George	
Local Public Health Services (Health Units)-
East Kootenay, Cranbrook	
Selkirk, Nelson	
West Kootenay, Trail	
North Okanagan, Vernon ._
South Okanagan, Kelowna
South Central, Kamloops
Upper Fraser Valley, Chilliwack
Central Fraser Valley, Mission ...
Boundary, Cloverdale 	
Simon Fraser, Coquitlam	
Coast-Garibaldi, Powell River	
Saanich and South Vancouver Island, 780 Vernon Avenue, Victoria	
Central Vancouver Island, Nanaimo	
Upper Island, Courtenay	
Cariboo, Williams Lake	
Skeena, Prince Rupert
Peace River, Dawson Creek	
Northern Interior, Prince George
25
14
22
23
36
27
26
26
50
32
17
39
47
20
16
27
17
34
17
11
498
Total
1,255
There were also part-time employees in many of the places listed. The part-
time employees serving on a continuous basis totalled the equivalent of approximately 63 full-time employees.
 TABLES
J 51
Table III.—Comparison of Public Health Services Gross Expenditures
for the Fiscal Years 1967/68 to 1969/70
Gross Expenditure
Percentage of
Gross Expenditure
Percentage
Increase or
Decrease
of Current
Over
Previous
Year
1967/68
1968/69
1969/70
1967/68
1968/69
1969/70
$3,830,907
4,941,338
2,025,871
707,011
580,627
491,641
162,231
$3,765,566
5,467,761
2,639,181
929,735
638.210
$4,200,358
5,924,284
2,637,205
899,100
860.196
30.0
38.8
15.9
5.5
4.6
3.9
1.3
26.6
38.7
18.7
6.6
4.5
3.7
1.2
27.5
38.8
17.3
5.9
5.6
3.7
1.2
+11.5
+ 8.3
-0.1
—3.3
+34.8
Cancer, arthritis, rehabilitation, and research	
General administration and
consultative services	
Division of Vital Statistics	
Division of Venereal Disease-
521,397 1       560,231
173,225 |       176,973
+7.4
+2.2
Totals	
$12,739,626 |$14,135,075 |$15,258,347
1
100.0
100.0
100.0
+7.9
Table IV.—Per Diem Rates for In-patient Care during the Fiscal Year
April 1, 1969, to March 31, 1970
Tuberculosis Hospitals
Operating cost—
Willow Chest Centre
$887,374
Pearson Tuberculosis Unit     701,496
Total  $1,588,870
Number of patient-days—
Willow Chest Centre       25,405
Pearson Tuberculosis Unit       24,744
Total number of days' care .
Per capita cost per diem—
Willow Chest Centre	
Pearson Tuberculosis Unit	
Combined per capita cost per diem .
50,149
$34.93
$28.35
$31.68
Pearson Extended-care Unit
Operating cost	
Number of patient-days
Per capita cost per diem.
$1,555,469
59,873
$25.98
Poliomyelitis Pavilion (Pearson Unit)
Operating cost	
Number of patient-days
Per capita cost per diem .
$410,638
13,632
$30.12
 J 52 PUBLIC HEALTH SERVICES REPORT, 1970
Table V.—Training of Health Branch Staff Proceeding toward a Diploma or
Degree in a Public Health Specialty
(Types of training, universities or other training centres attended,
and numbers trained.)
Completed training during 1970—
Diploma in Public Health Nursing (British Columbia)   9
Administration of Hospital Nursing Units (British Columbia)  1
Diploma in Public Health Dentistry (Toronto)   1
Bachelor of Science in Nursing (Montreal and Halifax)  2
Masters Degree in Dental Biology (Montreal)  1
Total  14
Commenced training during 1970—
Canadian Hospitals' Association's Medical Records Clerk Course
(correspondence)   2
Masters Degree in Speech Pathology (Oregon)   1
Diploma in Public Health Nursing (British Columbia)  3
Diploma in Public Health Nursing (Ottawa)  1
Diploma in Public Health (Toronto)   2
Diploma in Dental Public Health (Toronto)   1
Bachelor of Science in Nursing (McGill University)   1
Bachelor of Science in Nursing (University of Washington)  1
Total  12
Table VI.—Training of Health Branch Staff by Means of Short Courses
(Types of training, universities or other training centres,
and numbers trained.)
13th Annual Refresher Course for Medical Health Officers (University of Toronto)      1
Speech and Hearing Clinic for Speech Therapists (University of
Washington)       1
The Woodlands School Workshop for Public Health Nurses (New
Westminster)   45
Continuing Education Course for Health Officers (University of British Columbia)  17
The Fifth Annual Neuropsychology Workshop (University of Victoria)      2
Introduction to Television Production (University of Victoria)     1
Sixth Annual Seminar of Washington State Society of Hospital Pharmacists (Seattle, Wash.)     1
Nursing Assessment (University of British Columbia)     2
Nursing Care for Maternity Patients (University of British Columbia)    5
Developing Leadership in Supervision of Nursing Services (University
of Toronto)      2
Space Management, Functional and Neuromuscular Problems (School
of Dentistry, University of Washington)     1
Marriage, the Family, and Human Sexuality (Vancouver)     5
Seminar on the Medical Aspects of Safe Driving (Toronto)     1
 TABLES J 53
Table VI.—Training of Health Branch Staff by Means of Short Courses—Continued
Implementation of Change in Nursing Service (University of British
Columbia)      9
Fluorescent Antibody Techniques (Ottawa)      1
" Obesity " (University of British Columbia)     1
Psychiatric Affiliation for Public Health Nurses (Riverview Hospital,
Essondale)    12
Air Pollution Course for Public Health Inspectors (University of British Columbia)   25
Second International Congress of the Radiation Protection Association (Brighton, England)      1
Changing Role of the Manager (University of Victoria)     1
Certificate (Correspondence) Course in Environmental Health Administration (Ryerson Institute)   10
Electronic Circuits and Principles II (British Columbia Institute of
Technology, Nanaimo)     1
Conference on Adolescence (University of British Columbia)     4
Joint Convention of the Canadian Speech and Hearing Association
and the Speech and Hearing Association of Alberta (Glenrose
Hospital, Edmonton)        1
" Environmental Management " (Bayshore Inn, Vancouver)      2
" Therapeutic Use of Self " (University of British Columbia)      1
Air Pollution Control Association (Pacific Northwest International
Section) Conference (Spokane, Wash.)      1
Sociology and Psychology (University of Lethbridge)      1
Workshop for Supervisory Nurses, " Expertise in Public Health Nursing " (Grosvenor Hotel, Vancouver)   32
 J 54                               PUBLIC HEALTH SERVICES REPORT,
1970
Table VII.—Reported Communicable Diseases in British Columbia, 1966-70
(Including Indians)
(Rate per 100,000 population.)
Reported Disease
1966
1967
1968
1969
1970
Number
Number
Number
Number
Number
of
Rate
of
Rate
of
Rate
of
Rate
of
Rate
Cases
Cases
Cases
Cases
Cases
1
1         0.1
2
0.1
8
0.4
2
0.1
1
0.1
1
0.1
Diarrhoea of the  newborn
(.E. colt)	
31
1.7
16
0.8
19
0.9
23
1.1
54
2.5
Diphtheria	
	
	
1
0.1
8
0.4
14
0.7
9
0.4
2
0.1
4
0.2
12
0.6
4
0.2
203
10.8
138
7.1
276
13.8
64
3.1
166
7.8
367
19.6
489
25.1
165
8.2
209
10.1
143
6.7
Food poisoning—
Staphylococcal   intoxica-
12
342
0.6
18.2
9
256
0.5
13.1
9
165
0.4
8.2
29
400
1.4
19.3
8
532
0.4
24.9
4
0.2
24
1.2
311
15.5
19
0.9
6
0.3
844
45.0
1,664
85.4
2,032
101.3
2,139
103.3
1,910
89.4
1
0.1
Meningitis, viral or aseptic—
Due to Coxsackie virus	
	
	
9
0.5
1
0.1
1
0.1
	
1
0.1
,
31
1.7
31
1.6
42
2.1
20
0.9
32
1.5
Meningococcal infections .. .
11
0.6
12
0.6
17
0.8
13
0.6
14
0.6
Pemphigus neonatorum	
	
	
3
0.1
1
0.1
Pertussis	
311
16.6
264
13.5
136
6.8
59
2.8
155
7.2
988
52.7
695
35.6
300
15.0
56
2.7
98
4.6
796
42.5
1,782
91.5
720
35.9
1,180
57.0
546
25.5
Tetanus  .               ...
3
0.2
2
0.1
1
0.1
3
0.2
10
0.5
3
0.1
3
0.1
4
0.2
1
0.1
4
0.2
2
0.1
2
0.1
1
0.1
Totals	
3,944
210.5
5,413
278.0
4,215
210.0
4,256 | 205.6
1
3,685
172.4
Table VIII.—Reported Infectious Syphilis and Gonorrhoea,
British Columbia, 1966-70
Infectious Syphilis
Gonorrhoea
Number
Ratel
Number
Ratel
1966
71
3.8
5,415
7.90 R
1<>67                                                     ,
72
3.7
4,706
241.7
1968	
68
3.4
4,199
209.2
19fi9
45
2.5
4,797
232.0
1970        	
772
3.252
6,0912
28032
i Rate per 100,00
0 populat
ion.
2 Prelim
inary.
 TABLES
J 55
Table IX.—Statistical Summary of Public Health Inspectors' Activities,
1968-70, for 17 Provincial Health Units
19681
1969
1970
(Estimate)
Food premises—
Eating and drinking places.
Food processing	
Food stores..
Other..
Factories	
Industrial camps..
Hospitals..
Boarding homes..
Schools	
Summer camps	
Other institutions-
Housing.
Mobile-home parks.
Camp-sites.
Hairdressing places-
Farms	
Fairs	
Parks and beaches...
Swimming-pools—
Inspection	
Sample-
Surveys (sanitary and other) .
Waste disposal-
Private water supplies-
Inspection	
Sample-
Public water supplies—
Inspection. 	
Sample-
Pollution samples—
Bacteriological	
Chemical	
Field tests	
Municipal outfalls and plants-
Private sewage disposal	
Plumbing-
Subdivisions	
Site inspections-
Nuisances—
Sewage..
Garbage and refuse-
Other (pests, etc.)—
Disease investigation	
Meetings-
Educational activities ..
4,808
320
1,111
184
424
325
79
308
492
289
120
2,079
(2)
(2)
667
595
52
775
1,920
1,199
1,128
2,680
2,159
2,675
1,453
6,044
2,401
1,040
(2)
1,056
11,380
277
3,755
8,453
3,855
2,295
2,637
423
2,492
1,145
4,390
765
1,558
410
748
375
119
374
956
179
197
1,721
1,287
779
682
339
37
692
1,505
1,122
876
1,057
2,172
3,353
1,108
5,044
2,379
1,251
682
888
11,130
211
4,195
8,084
3,886
2,536
2,059
310
3,287
1,253
3,934
608
1,086
306
506
390
59
338
514
203
201
1,520
1,309
790
386
425
45
274
1,275
1,602
671
1,053
1,687
3,242
916
4,971
2,263
1,119
279
10,721
152
3,627
7,455
2,927
2,134
2,324
327
2,551
1,081
i These are projected figures for the year.
2 Not classified.
Information was only available in part of 1968.
Table X.—Public Health Inspectors' Time-study
Food premises	
Industrial camps and factories
Hospitals and community care (includes summer camps)
Housing	
Mobile home and camp-sites
Barber shops and beauty parlours
Offensive trade, farms __
Air pollution
Fairs, parks, rest-rooms (other)
Sewage 	
Per Cent
of Time
3.5
0.6
0.7
1.0
1.6
0.2
0.6
0.2
0.3
6.0
 J 56 PUBLIC HEALTH SERVICES REPORT, 1970
Table X.—Public Health Inspectors' Time-study—Continued
Per Cent
of Time
Subdivision and site inspection  7.1
Common carrier and Indian reserves  0.2
Surveys  0.8
Waste disposal  0.7
Schools  0.2
Water supplies  2.1
Swimming-pools  0.5
Water quality (samples)   0.6
Nuisances (refuse, sewage, pests, and others)   4.0
Consultations with Health and allied local personnel  9.1
Meetings (staff, other)  3.2
Supervision (Senior Public Health Inspectors)   1.0
Educational activities  2.0
Other activities  4.2
Travel time  21.3
Community activities  1.0
Office—
(a) Professional activities—
Letters and reports  7.6
Review of plans  2.5
Telephone consultations  5.3
Public inquiries  6.1
Other  4.5
(b) Non-professional activities (clerical filing and
recording)   1.3
Normal duty time  100.0
Table XI.—Statistical Summary of Selected Activities of Public Health Nurses,
September, 1969, to August, 1970, Inclusive1
School service— 196g/69 1969'70
Direct by nurse and aide  307,534 406,790
Teacher/Nurse conferences   6,956 6,570
Home visits  40,350 45,852
Conference with staff  62,965 64,784
Meetings   2,398 2,769
Expectant parents—
Class attendance by mothers  14,989 16,517
Class attendance by fathers  3,231 4,323
Prenatal home visits  3,875 4,240
Postnatal visits  18,920 19,746
Child health-
Infants—
Conference attendance  58,169 60,435
Home visits  34,944 36,114
Pre-school—
Conference attendance  71,587 89,423
Home visits  32,139 33,612
i Services provided by public health nurses under the jurisdiction of the Health Branch, but does not include
service provided by Greater Vancouver, Victoria, Esquimalt, Oak Bay, and New Westminster.
 TABLES
J 57
Table XI.—Statistical Summary of Selected Activities of Public Health Nurses,
September, 1969, to August, 1970, Inclusive1—Continued
Home Care— 1968/69 1969/70
Nursing care visits  76,193 77,766
Physiotherapist assessments       1,220 1,267
Visits to personal care institutions  979 1,248
Adult health supervision visits  44,119 57,226
Mental health visits  17,310 17,749
Disease control—
Tuberculosis visits       9,662 8,723
Venereal disease visits       3,286 3,562
Communicable disease visits       9,327 9,635
Rheumatic fever patients       1,121 1,135
Immunizations—
Measles (rubeola)
Smallpox	
Poliomyelitis 	
Basic series	
Other 	
92,194
158,621
21,565
149,398
47,648
97,388
157,148
22,877
155,549
Total doses
Tests-
Tuberculin
Other 	
Total visits to homes.
421,778        480,610
     14,904 15,316
       3,043 5,388
  172,062 175,069
Professional services by telephone  176,672 199,123
1 Services provided by public health nurses under the jurisdiction of the Health Branch, but does not include
service provided by Greater Vancouver, Victoria, Esquimalt, Oak Bay, and New Westminster.
Table XII.—Summary of Service Provided in Three Areas by
Employees' Health Services Staff, 1970
Service Rendered
Provincial Mental
Hospital
Vancouver Area
Victoria Area
Health counselling and (or) examination-
Occupational health nursei	
Physiciani  	
Immunizations administered (includes
routine and influenza)	
Medical and surgical treatment	
372
104
766
625
767
183
1,294
594
374
46
1,602
1,569
i An occupational health nurse provides full-time service in each area. A physician is available on request, in the Vancouver area, for two days a month in the Provincial Mental Hospital,
and one or two days a month in the Victoria area.
 J 58
PUBLIC HEALTH SERVICES REPORT, 1970
Table XIII.—Enrolment in Public and Private Schools in British Columbia,
June, 1970
Grade Schools
Kindergartens
Schools for
Retarded Children
Total
Greater Vancouver—
Public	
143,022
7,713
41,998
2,447
299,120
10,660
7,908
2,856
2,404
712
10,522
6,210
301
83
82
151,231
10,652
44,484
3,159
Greater Victoria—
Public.                	
Private	
Remainder of Province—
PubUc	
Private	
532
347
310,174
17,217
Totals-
Public.	
Private
484,140
20,820
20,834
9,778
915
430
505,889
31,028
Grand totals	
504,960
30,612
1,345            1           536,917
1
Table XIV.—Number of Pupils Receiving Basic Immunization
Prior to Entering Grade I, September, 1969
Greater
Vancouver
Greater
Victoria
Remainder of
Province
Total pupils enrolled..
Smallpox-
Diphtheria, pertussis, and tetanus	
Poliomyelitis  	
12,708
8,918 (70.2%)
9,755 (76.8%)
7,695 (60.6%)
3,556
2,669 (75.1%)
2,808 (79.0%)
2,045 (57.5%)
27,340
19,564 (71.6%)
21,141 (77.3%)
15,941 (58.3%)
Table XV.—Pupils Referred for Health Services
Greater
Victoria
Number referred to public health nurse—
By school personnel  3,763
From other sources  3,042
Totals
6,805
Province i
29,548
20,435
49,983
Number referred by public health nurse for
further care—
To private physician for other than
vision defect	
1,759
To investigator of vision defects  1,607
To speech therapist       68
To mental health clinic        69
To other clinics        78
Totals
11,323
14,193
616
1,462
1,425
3,581        29,019
i Excluding Greater Vancouver and Greater Victoria.
 TABLES J 59
Table XVI.—Registrations Accepted under Various Acts
Registrations accepted under Vital
Statistics Act  1969 (Preliminary)
Birth registrations  35,512 36,900
Death registrations  17,597 16,800
Marriage registrations  18,502 19,900
Stillbirth registrations  469 425
Adoption orders  2,736 3,150
Divorce orders  4,279 5,450
Delayed registrations of birth  417 436
Registrations of wills notices accepted
under Wills Act       17,331 18,137
Total registrations accepted     96,843 101,198
Legitimations of birth affected under
Vital Statistics Act  271 260
Alterations  of  given  name  effected
under Vital Statistics Act.  175 187
Changes of name under Change of
Name Act  714 840
Certificates issued—
Birth certificates  60,267 62,255
Death certificates  10,223 8,596
Marriage certificates  6,815 6,959
Baptismal certificates  16 10
Change of name certificates  901 999
Divorce certificates  251 234
Photographic copies  7,344 7,233
Wills notice certification  10,777 10,160
Total certificates issued.      96,594 96,446
Non-revenue searches for Government
departments        15,120 12,178
Total revenue  $357,060        $347,644
Table XVII.—Case Load of the Division of Rehabilitation,
January 1 to December 31,1970
Accepted cases active at January 1, 1970  1,032
New cases referred to local rehabilitation committees  606
New cases referred from other sources  288
Cases reopened  137
Total referrals  considered for rehabilitation services,
January 1, 1970, to December 31, 1970  1,031
Total  2,063
 J 60 PUBLIC HEALTH SERVICES REPORT, 1970
Table XVII.—Case Load of the Division of Rehabilitation,
January 1 to December 31, 1970—Continued
Analysis of Closed Cases
Cases closed, January 1 to December 31, 1970—
Employment placements made—
Canada Manpower centres     45
Division of Rehabilitation staff     20
Placements on graduation from training  153
  218
Resumed former activities     97
Job placement not feasible (physical restoration only)....    43
Deceased        4
Awaiting job placement     25
Other (unable to locate clients, moved from Province,
lack of motivation, etc.)   115
      502
Cases assessed and rejected as not capable of rehabilitation      589
Cases currently under assessment or receiving rehabilitation
services       972
Total  2,063
 TABLES
J 61
Table XVIII.—Statistical Report of Examinations and Work Load in
1969 and 1970, Main Laboratory
Uniti
Value
1969
Tests
Performed
Work-load
Units
1970
Tests
Performed
Work-load
Units
Bacteriology Service
Enteric Laboratory—
Cultures—
Salmonella-Shigella	
Pathogenic E. coli..
Food-poisoning examination—
Miscellaneous Laboratory—
Animal virulence (diphtheria).
Cultures—
C diphtheria	
Hemolytic staph.-strep..
Miscellaneous	
Fungi..
N. gonorrhoea..
Smears for—
N. gonorrhcece..
Miscellaneous-
Serology Laboratory—
Agglut.—Widal, Paul-Bunnell,
Brucella	
Anti-streptolysin test-
Blood—
V.D.R.L.(qual.)	
V.D.R.L.(quant.)-
F.T.A.-Abs	
C.S.F.—V.D.R.L	
Darkfield—T. pallidum..
Tuberculosis Laboratory—
Animal inoculation	
Anti-microbial sensitivity-
Atypical mycobacteria..
Cultures for M. tuberculosis—
Smears for M. tuberculosis	
Intestinal parasites	
Chemistry Service
Water microbiology—
Algse enumeration	
Coliform test—
Presumptive confirmed test-
Completed test..
Fascal coliform test	
F__cal streptococcal test-
Shellfish	
Standard plate count..
Water/Wastewater Chemistry—
Check test	
Routine test-
Extended	
B.O.D	
Partial	
Air-quality investigation-
Dust fall—total	
Lead peroxide candle-
Soiling index tape .
Suspended particulate matter-
Partial 	
Totals.
7
10
15
2
5
1
2
10
2
3
10
25
25
6
2
3
10
5
2
4
5
15
2
19
63
117
30
25
10
20
3
15,260
3,510
97
15
1,037
5,371
3,782
5,828
7,568
46,807
3,314
10,905
8,461
149,648
1,945
2,605
2,986
182
532
1,118
248
28,879
16,715
5,874
18,581
1,973
280
434
8,464
106,820
35,100
1,455
90
5,185
26,855
18,910
29,140
37,840
93,614
6,628
21,810
42,305
149,648
3,890
26,050
5,972
546
5,320
27,950
6,200
173,274
33,430
17,622
92,905
3,946
14,000
34,720
60,468
18,670
3,444
123
53
1,296
4,822
4,222
6,099
9,965
55,057
3,569
12,970
8,884
164,856
2,163
2,747
3,120
137
677
1,059
269
29,592
18,875
7,298
13
22,407
2,222
3,770
120
7
2,337
34
29
354
497
18,919
6
7
8
40
9
352,419    | 1,081,693
410,746
130,690
34,444
1,845
318
6,480
24,110
21,110
30,495
49,825
110,114
7,138
25,940
44,420
164,856
4,326
27,470
6,240
411
6,770
26,475
6,725
177,552
37,750
21,894
130
112,035
4,444
15,080
600
105
4,674
646
1,827
41,418
14,910
125,699
150
70
160
120
86
1,289,548
i One D.B.S. unit=10 minutes of work.
 J 62
PUBLIC HEALTH SERVICES REPORT, 1970
Table XIX.—Statistical Report of Examinations and Work Load during
the Year 1970, Branch Laboratories
Uniti
Value
Nelson
Victoria
Tests
Performed
Work-load
Units
Tests
Performed
Work-load
Units
Enteric Laboratory—
Cultures—
Salmonella-Shigella
7
10
15
6
5
5
5
5
5
2
2
2
5
1
2
2
3
10
6
2
3
5
2
4
2
295
2,065
4,356
1,101
24
1
220
5,463
23
2,177
1,998
2,133
813
966
429
10,198
60
708
3
22
2,113
1,594
1,649
/   2,958
295
349
398
30,492
11,010
360
Miscellaneous Laboratory—
6
Cultures—
105
924
826
525
4,620
4,130
1,068
1,044
704
4,170
22
1,100
27,315
115
10,885
9,990
Smears for—
534
522
352
4,266
1,626
Serology Laboratory—
Agglut.—Widal, Paul-Bunnell,
1,932
2,145
Blood—
V.D.R.L. (qual.)
vn.R T., (quant.)
4,170
11
10,198
120
C.S.F.—V.D.R.L	
1,416
Darkfield—T. pallidum      	
9
Tuberculosis Laboratory—
220
12,678
Smears for M. tuberculosis	
102
75
2,901
118
204
225
14,505
236
3,188
4,947
Water Laboratory—
14,790
590
1,396
	
796
Tntnli
	
10,935
33,518
40,051
151,590
1 One D.B.S. unit=10 minutes of work.
Table XX.—Emergency Health Service Medical Units Pre-positioned
Throughout British Columbia
Emergency hospitals (operational)
Emergency hospitals (training)
Advanced treatment centres (training)
Casualty collecting units (operational)
Casualty collecting units (training)
Hospital disaster supply units	
Blood donor packs	
  13
  1
Advanced treatment centres (operational)  36
  1
  56
  1
 .  236
  22
 TABLES
Table XXI.—Licensing of Practical Nurses
(Disposition of applications received since inception of programme
in 1965 to end of 1970.)
J 63
Received	
Approved—
On the basis of formal training  3,494
On the basis of experience only—
Full licence  396
Partial licence  874
  1,270
6,398
Rejected 	
Deferred pending further training, etc.	
Deferred pending receipt of further information from applicants 	
Awaiting assessment at end of 1970      126
Total	
4,764
888
551
69
6,398
Printed by K. M. MacDonald, Printer to the Queen's Most Excellent Majesty
in right of the Province of British Columbia.
1971
780-1270-9405
J

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