THE NEW STATE TRANSIT PERMIT

Under Regulation 9, Transportation of dead bodies by common carriers, recently added to Chapter VII of the Sanitary Code by the Public Health Council, it is provided that "the transportation of dead human bodies by common carriers shall be conducted in such manner as not to be a menace to health and the manner of transportation shall be subject to the special administrative regulations of the State Commissioner of Health."

This provision takes effect throughout the State of New York, except in the city of New York, on August 1. Special Administrative Rules relating to the transportation of dead bodies by common carriers have been prepared by the Commissioner and are printed on the reverse side of the new official form of State transit permit (Form VS No. 62), which is supplied to local registrars and undertakers by the State Department of Health. They are as follows:

Special administrative rules relating to the transportation of dead bodies by common carriers

[In effect throughout the State of New York, except in the City of New York, on August 1, 1915]

RULE 1. A transit permit and transit label issued by the local registrar of vital statistics must accompany each dead body transported by a common carrier.

The transit permit shall state the date of issuance, the name, sex, race and age of the deceased, and the cause and date of death. The transit permit shall also state the date and route of shipment, the point of shipment and destination, the method of preparation of the body, and shall bear the signature of the undertaker and the signature and official title of the officer issuing the permit.

The transit label shall state the date of issuance, the name of the deceased, the place and date of death, the name of the escort or consignee, the point of shipment and destination; and shall bear the signature and official title of the officer who issued the transit permit. The transit label shall be attached to the outer box or case.

RULE 2. The transportation by common carriers of bodies dead of any diseases other than those mentioned in Rule 3 shall be permitted only under the following conditions:

(a) The coffin or casket shall be encased in a strong outer box made of good sound lumber, not less than 7% of an inch thick. All joints shall be securely put together and the box tightly closed. Either the coffin or casket, or the outer box or case, shall be watertight.

(b) When the destination cannot be reached within 24 hours after death, all body orifices shall be closed with absorbent cotton, and the body placed at once in a coffin or casket which shall be immediately closed and the coffin or casket shall be encased in a strong outer box made of good sound lumber not less than 7% of an inch thick. All joints must be securely put together and the box tightly closed, and either the coffin or casket, or the outer box or case, shall be watertight.

RULE 3. The transportation by common carrier of bodies dead of smallpox, plague, Asiatic cholera, typhus fever, diphtheria (membranous croup, diphtheritic sore throat), scarlet fever (scarlet rash, scarlatina), shall be permitted only under the following conditions:

All body orifices shall be closed with absorbent cotton, the body shall be enveloped in a sheet saturated with an effective disinfecting fluid and shall be placed at once in a coffin which shall be immediately and permanently closed.

The coffin or casket shall be encased in a strong outer box made of good sound lumber, not less than 7% of an inch thick, all joints of which shall be securely put together and the box shall be tightly and permanently closed. Either the coffin or casket, or the outer box or case, shall be watertight. RULE 4. No dead body shall be disinterred for transportation by common carrier without the previous consent of authorities having jurisdiction at the place of disinterment. The transit permit and transit label shall be required as provided in Rule 1, and Paragraph (a) of Rule 2 shall apply.

RULE 5. Every outside case holding any dead body offered for transportation by common carrier shall bear at least four handles and when over 5 feet 6 inches in length, shall bear six handles.

Albany, June 25, 1915

By the Commissioner

DELANCEY K. JAY
Secretary

HERMANN M. BIGGS

Commissioner of Health, State of New York

The regulations in effect after August I provide (Rule 1) that “A transit permit and transit label issued by the local registrar of vital statistics must accompany each dead body transported by a common carrier." The new "Transit Permit " therefore consists of two parts (a) the transit permit proper, which contains the undertaker's certificate with respect to the preparation of the body and the local registrar's permit for removal and shipment, and (b) the transit label, which also contains the local registrar's permit and the detailed routing of the body.

It will be noted that transit permits can hereafter be issued only by the local registrar, as is the case with ordinary burial and removal permits. Transit permits must not be issued by health officers nor be accepted by common carriers for transportation unless regularly made out by the local registrar, his deputy or subregistrar. The permit accompanies the body to the place of interment, where, if within the State of New York, the sexton will indorse it and return it to the local registrar precisely in the way in which an ordinary burial or removal permit is treated. The same action should be taken on a transit permit from another State.

Local registrars are cautioned not to issue transit permits unless they first have in their possession a complete and satisfactory certificate of death, legibly written in durable black ink.

MEDICAL EXAMINER IN HYGIENE AND SANITATION Dr. William G. Bissell, widely known for his services to public health as Director of the Bacteriological Laboratories of the City of Buffalo, has been reappointed as State Medical Examiner, and will have special supervision of the subjects of hygiene and sanitation.

SUMMARY OF VITAL STATISTICS-JUNE, 1915

CRESSY L. WILBUR, M.D.

Director, Division of Vital Statistics

The total number of births registered and promptly returned in the State of New York for the month of June was 20,004, an increase of 672 over the number for the preceding month (19,332), and of 237 over the number (19,767) registered for June, 1914. The birth rate per 1,000 estimated population was 24.2 for the State as a whole, 18.7 for the rural population and 25.8 for the cities. New York City showed a rate of 22.6, Buffalo of 27.3, Rochester of 26.6, Syracuse of 24.6, Albany of 18.6, Yonkers of 23.9, Schenectady of 22.0, Utica of 30.0, Troy of 18.8, and Binghamton of 27.6. The smaller cities had lower rates than the larger ones as a rule, the group of third class cities with populations from 20,000 to 50,000 having an average rate of 22.9, cities from 10,000 to 20,000 a rate of 20.5, and cities under 10,000, a rate of 21.0. It should be understood that these rates, although based on monthly returns, are necessarily stated in the form of annual rates, the assumption being made that the frequency of birth continues for a year; also, for small areas, the accidental addition or loss of a few births would greatly affect the apparent rates. In some instances the rates. are abnormally low because of defective or tardy registration; in other cases the basis of population, which is the midyear estimate. supplied by the U. S. Census Bureau, will be subject to considerable change as soon as the results of the recent State Census become available. Hence the figures for birth rates, as well as those for other rates presented in this bulletin, must be taken as subject to revision and as presenting the facts only so far as available at the present time.

The total number of deaths registered for June, 1915, was 10,994, corresponding to a death rate of 13.3 for the State. This number is 1,344 less than that for the preceding month (12,338) but 371 more than the number recorded for June, 1914. The death rate for the month, 13.3 per 1,000 population, was over a point lower than that for May (14.4) and only slightly exceeded the rate of June, 1914, which was 13.1. June is usually one of the most favorable months of the year with respect to low mortality.

The rural death rate, 13.8 per 1,000, was somewhat higher than the rate shown for the cities of the State, which was 13.2. The larger cities had rates as follows: New York, 13.1;* Buffalo, 13.0; Rochester, 11.8; Syracuse, 13.3; Albany, 15.7; Yonkers, 9.2; Schenectady, 9.0; Utica, 13.7; Troy, 20.6; Binghamton, 17.5. Cities of the third class, * Death rate based on local estimate of population is 12.3

with populations from 20,000 to 50,000, averaged 12.7; those with populations from 10,000 to 20,000, 15.4; and cities of less than 10,000 population, 11.7. Here as with births, monthly rates for small populations must be used cautiously and as indicating merely the rate of mortality at the brief period of observation. Reference should be made to the columns showing deaths in institutions and deaths of nonresidents, which particularly affect the mortality of certain cities. Also the fact should be borne in mind that unfavorable age distribution, especially a large proportion of elderly persons in the population, markedly affects the general death rate.

Comparison of the changes in the mortality from certain important causes of death may be made in the table on page 253, which gives the number of deaths registered and the death rates for June, 1915, the preceding month and the corresponding month of last year. As compared with May, there was a general decrease in deaths from important causes, the respiratory diseases particularly — pneumonia, influenza and tuberculosis-showing a notable recovery from their unusually heavy fatalities this spring. Only measles, diarrheal diseases of infants and violent deaths showed any noticeable increase over last month. As usual in June, there was an increase of accidental deaths due to an increased number of cases of drowning. The increased rate for June, 1915, as compared with June, 1914, was slight. Infant mortality was slightly higher (6 per 1,000 births), but the chief increase shown was from pneumonia and bronchopneumonia (22.0 per 100,000). Measles and influenza had markedly higher rates while tuberculosis (all forms) declined.

With the compilation of the returns for June, a comparative statement can be presented, as in the following table, for the first two quarters and first half year of 1915, 1914, and the five year period 1910 to 1914.

The total number of births registered for the half year, January to June, 1915, was 121,259, corresponding to an annual birth rate of 24.0, which is slightly higher than the rate for the first half of 1914 and the average for the past five years (23.4). The death rate for the six months (15.3 per 1,000) is lower than that for the corresponding portion of 1914 (15.7) and the preceding five years (16.1). While the reduction is only fractional, the basis of population is so large that an apparently slight decrease in the rate of mortality may mean a good many lives saved. Thus, with a total population of 10,000,000, each point of the annual death rate equals 10,000 lives and a reduction of .5 per 1,000 would be equivalent to 5,000 fewer deaths each year. The estimated population of the State is somewhat in excess of ten mil

lions (10,086,568). Hence, should the conditions of mortality of the first six months continue through the year, the conclusion is a conservative one that 1915 will show a saving of some 8,000 lives as compared with the average rate of mortality during the preceding five-year period.

Infant mortality shows a slight decrease for the first six months of 1915 as compared with 1914 and 1910-14; the chief diseases of childhood also show satisfactory amounts of reduction (least for whooping cough, which is practically unrestricted in many localities). The rate for measles, which was very low for the first quarter of 1915, was increased by unusual prevalence in the second quarter. Tuberculosis continues to decrease, as indicated by comparison of the quarters and half year, cancer to increase, and pneumonia (all forms) shows substantially the same rate for 1915 (January to June) as for 1910–14; the first quarter of 1915 had lower and the second quarter had higher rates from this disease than the rates for the preceding year and period. The figures, however, can not be discussed in detail at this point, but may be examined in the table itself, which summarizes the results of the year up to the present time.

State of New York. Comparison of Returns of Vital Statistics for the First and Second Quarters and First Half Year: 1915, 1914, and Five-year Period 1910-14.