439(1) ACT 59 BOROUGH OF ACTON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH TOGETHER WITH THE REPORT ON THE MEDICAL INSPECTION OF SCHOOLS FOR THE YEAR 1956 B. BOROUGH OF ACTON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH TOGETHER WITH THE REPORT ON THE MEDICAL INSPECTION OF SCHOOLS FOR THE YEAR 1956 2 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1956 Public Health Department, Town Hall, Acton, W.3. To the Mayor, Aldermen and Councillors of the Borough of Acton. I submit the Annual Report of the health of the Borough of Acton for 1956. The Borough has remained free of any serious outbreak of infectious disease, there being 79 cases of Whooping Cough confined chiefly to children under nine years of age, and there were 97 cases of measles as compared with 1955 when 647 cases were notified. Only six cases of poliomyelitis were confirmed and there were no deaths from this disease. The number of deaths from Cancer were 148 as compared with 151 in 1955. As may be seen from the following table the number of deaths from Cancer of the lung and Bronchus fell from 37 in 1955 to 28. 3 DEATHS FROM CANCER OF THE LUNG AND BRONCHUS— 1952 to 1956 Year Total 25—45 45—65 65+ Bronchus Lung Bronchus Lung Bronchus Lung M. F. M. F. M. F. M. F. M. F. M. F. 1952 28 1 1 1 _ 10 1 3 — 8 — 3 — 1953 23 1 — — — 10 2 4 2 2 — 2 — 1954 26 3 — — 1 7 4 1 1 6 2 — 1 1955 37 1 — 1 — 9 — 6 3 8 2 6 1 1956 28 — — — — 12 1 3 1 8 — 1 2 I should like to remind the Council that vaccination (immunisation) to prevent Poliomyelitis has been carried out for the first time in this district, and only amongst selected groups. It is too early yet to assess the value of this safeguard but I hope to do so in a later report. I should like to take this opportunity of expressing to the staff of the Public Health Department my appreciation of their cooperation and loyalty throughout the year. I remain, Your obedient servant, George E. B. Payne. 4 LIST OF CONTENTS Introduction 2 List of Staff 5 Section A.—Statistics and Social Conditions 6 Section B.—General Provision of Health Services in the Area 12 Section C.—Health Services Provided by Middlesex County Council 14 Section D.—Infectious and other Diseases, Scabies and other Conditions 19 Section E.—Housing 24 Section F.—Sanitary Circumstances of the Area 24 Section G.—Inspection and Supervision of Food Premises and Food Handling 33 Section H Diseases of Animals 43 Section J.—Atmospheric Pollution 43 Annual Report of the School Medical Officer 47 5 STAFF Medical Officer of Health George E. B. Payne, m.d., m.r.c.s., l.r.c.p., d.p.h Deputy Medical Officer of Health Margaret Heller, m.d. (Vienna), l.r.c.p. & s., (Edin.), d.c.h. Chief Public Health Inspector (Inspector under Diseases of Animate Acts, Rag Flock and Other Filling Materials Act, and Fabrics Misdescription Act). J. J. Matthews, m.r.s.h. (a) (c) (d). Deputy Chief Public Health Inspector M. Dowie. (b) (c) (d). Public Health Inspectors G. 0. Axon, (b) (c) (Appointed 9-7-56) G. W. Burden, (b) (c) C. Codrington. (Temporary) (a) (c) W. G. Collam. (b) (c) D. W. Foster, m.r.s.h. (b) (c) (Appointed 1-8-56) J. R. Glover, (b) (c) (Appointed 9-7-56) A. C. Jenkins, (b) (c) D. A. Parker, (b) J. P. Smith, (b) W. G. Thurgood. (b) (c) (Appointed 2-7-56) Pupil Public Health Inspector (Vacancy.) Clerical Staff * A. S. M. Pratt, Barrister-at-Law, Chief Clerk. J. Burrows, Senior Clerk. Mrs. M. E. Jones. Mrs. I. P. Lee. Mrs. G. D. Macdonald. Miss J. A. Robertson. * Transferred to Middlesex County Council under the National Health Service Act, 1946. Part-time officer to the Acton Town Council. 6 (a) Certificate, Royal Sanitary Institute. (b) Certificate, Royal Sanitary Institute and Sanitary Inspectors Examination Joint Board. (c) Certificate, Royal Sanitary Institute for Inspectors of Meat and other Foods. (d) Certificate, Royal Sanitary Institute for Smoke Inspectors. SECTION A STATISTICS GENERAL STATISTICS Area (acres) 2,319 Population: Census, 1931 70,008 1951 67,424 Registrar General's Estimate Mid.—1956 Home Population 66,240 Rateable Value at 31st March, 1956 £1,589,461 Product of a penny rate for year ending 31st March, 1956 £3,627 General Rate in the £ at 31st March, 1956 22s. 2d. Number of Inhabited Dwellings at 31st March, 1956 — 18,992 VITAL STATISTICS (Comparable figures for 1955 in brackets) Live Births: total males females Legitimate 850 (808) 449 (413) 401 (395) Illegitimate 65 (42) 39 (17) 26 (25) Totals 915 (850) 488 (430) 427 (420) Birth rate per 1,000 estimated population—13.81 (12.75). Corrected birth rate per 1,000 estimated population— 12.84 (11.85). 7 Still Births: total males females Legitimate 21 (14) 13 (5) 8 (9) Illegitimate 2 (1) 2 (–) – (1) Totals 23 (15) 15 (5) 8 (10) Deaths: total males females 723 (694) 362 (388) 361 (306) Death rate per 1,000 inhabitants 10.91 (10.40). Corrected death rate 11.33 (10.19). Deaths from Puerperal Causes Deaths Rate per 1,000 Live & Still Births Puerperal Sepsis — (—) — (—) Other Puerperal Causes — (—) — (—) Death Rate of Infants under 1 year of age: All infants per 1,000 live births (E. & W.—23.80) 23.0 (20.0) Legitimate infants per 1,000 legitimate live births 24.7 (21.0) Illegitimate infants per 1,000 illegitimate live births 0.0 (0.0) Deaths from selected causes Deaths from Cancer (all ages) 148 (151) Deaths from Measles (all ages) — (—) Deaths from Whooping Cough (all ages) — (—) Deaths from Diphtheria (all ages) — (—) Deaths from Gastro-Enteritis (under 2 years of age) —(—) Death rate from Gastro-Enteritis (under 2 years of age) per 1,000 live births 0.0 (0.0) 8 AGES AT DEATH AND WARD DISTRIBUTION OF DEATHS IN 19S6 Causes of Death Total Under 1 year 1—2 2—5 5—15 15—25 25—45 45—65 65 + Ward Distribution N.E. N.W. C. S.E. S.W. S. w. E. Bronchitis 49 2 – – – – – 17 30 6 5 4 3 8 7 10 6 Cancer 148 – 1 – – – 6 49 92 16 13 26 8 21 19 30 15 Cerebral Haemorrhage & Thrombosis 87 – – – – – 1 11 75 10 8 16 18 5 12 10 8 Circulatory Disease 140 – – – – – 4 43 93 17 14 20 30 7 15 22 15 Gall Bladder Disease 3 – – – – – – – 3 – – – – – 2 1 – Congenital Debility & Prematurity 13 13 – – – – – – – 2 2 – 1 2 1 3 2 Diabetes 6 – – – – – – 1 5 2 1 1 – – 1 1 – Digestive Tract Disease 14 – – – – – – 2 12 1 – – 3 3 5 2 – Heart Disease 51 – – – – 1 3 8 39 10 6 8 6 3 11 5 2 Leukaemia & Diseases of Blood Forming Organs 8 – – – – – – 1 7 – 1 – 1 – – 4 2 Meningitis 1 1 – – – – – – – – – – – – – – 1 Carried forward 520 16 1 – – 1 14 132 356 64 50 75 70 49 73 88 51 9 AGES AT DEATH AND WARD DISTRIBUTION OF DEATHS IN 1956 —contd. Causes of Death Total Under 1 year 1—2 2—5 5—15 15—25 25—45 45—65 65 + Ward Distribution N.E. N.W. C. S.E. S.W. S. W. E. Brought forward 520 16 1 – – 1 14 132 356 64 50 75 70 49 73 88 51 Nervous System 6 – – – 1 – 2 1 2 1 3 1 – – – 1 – Nephritis 20 – – – – – 2 6 12 3 3 2 3 3 4 2 – Peptic Ulcer 13 – – – – – – 2 11 1 1 1 1 4 1 3 1 Pneumonia 56 5 1 – – – – 6 44 11 3 7 6 10 6 7 6 Prostatic Hypertrophy 6 – – – – – – – 6 2 1 1 – – – 1 1 Pulmonary Tuberculosis 9 – – – – 1 2 3 3 1 1 – – 1 3 1 2 Other Respiratory Diseases 16 – – 1 – – 2 3 10 3 4 4 – 1 3 – 1 Sarcoma 3 – – – – – – 2 1 1 – – – – 1 1 – Senility 34 – – – – – – – 34 10 3 8 1 3 5 1 3 Suicides 13 – – – – 1 5 5 2 – 4 4 1 2 2 – Violent Deaths—Accidents 27 – – 1 1 1 2 11 11 3 3 2 2 5 6 2 4 TOTALS 723 21 2 2 2 4 29 171 492 100 76 105 83 77 104 109 69 10 CAUSES OF DEATH IN CHILDREN UNDER ONE YEAR 11 Males 10 Females Disease Under 1 wk. 1—2 wks. 2—3 wks. 3—4 wks. Total under 1 month. 1—3 mths. 8—6 mths. 6—9 mths. 9—12 mths. Total 1—12 m'ths. Acute Bronchitis – – – 1 1 – – 1 – I Congenital Heart 1 – – – 1 – – – – – Prematurity 7 – – – 7 – – – – – Respiratory Causes 1 – – – 1 3 2 – – 5 Meningitis – – – – – – – – 1 1 Other Causes 4 – – – 4 – – – – – TOTALS 13 – – 1 14 3 2 1 1 7 MATERNAL MORTALITY There were no maternal deaths during the year. INQUESTS Suicides 12 Carbon Monoxide Poisoning 1 Poisoning 1 Drowning 1 Accidental Falls at home 7 Road Accidents 17 Other Causes 1 TOTAL 50 POST MORTEMS, WITHOUT INQUEST Respiratory causes 22 Heart and Circulatory Disease 11 Cerebral Disease 6 Cancer 4 Intestinal Complaints 5 Other Causes 4 TOTAL 52 11 SUMMARY OF STATISTICS The following table shows the birth rates and death rates for Acton as compared with England and Wales since 1946. Year Live Birth Rate Still Birth Rate Death Rate Maternal Mortality Rate Infantile Mortality Rate Acton E. & W. Acton E. & W. Acton E. & W. Acton E. & W. Acton E. & W. 1947 20.08* 20.5 22.9 24.1 10.5* 12.0 0.00 1.17 33.8 41 1948 16.7* 17.9 16.3 23.2 9.4* 10.8 0.00 1.02 24.4 34 1949 15.4* 16.7 19.8 22.7 10.9 11.7 0.00 0.98 23.04 32 1960 13.6 15.8 28.3 22.7 11.4 11.6 0.00 0.86 25.1 29.8 1951 13.7 15.5 28.9 23.0 11.4 12.5 0.00 0.79 23.7 29.6 1952 13.2 15.3 23.2 22.7 10.08 11.3 0.00 0.72 18.6 27.6 1953 12.3 15.5 21.8 22.5 10.14 11.4 0.00 0.76 25.7 26.8 1954 13.5 15.2 20.0 23.5 9.42 11.3 0.00 0.69 16.4 25.4 1955 11.8 150 17.4 23.2 * 10.19 11.7 0.00 0.64 20.0 24.9 1956 12.8 15.7 24.5 23.0 11.33 11.7 0.00 0.56 23.0 23.8 * Birth and death comparability factors were not available during these years. Consequently it is not strictly possible to compare the birth and death rates for Acton with those for England and Wales. 12 SECTION B GENERAL PROVISION OF HEALTH SERVICES IN THE AREA LABORATORY FACILITIES These continue as in previous years. The Ministry of Health Emergency Medical Service provides a Pathological Service at the King Edward VII Memorial Hospital Laboratory at Ealing. The following Table gives the types, and number, of specimens submitted for examination. Type No. of specimens examined Throat and Nose Swabs 141 Sputum 13 Faeces 247 Hair, Widals, etc. 11 Milk 51 Milk Bottles 8 Water 30 Ice-Cream 129 Miscellaneous Foods 9 HOSPITAL PROVISION The Regional Hospital Board of the N.W. Metropolitan Area, which includes Acton, is responsible for hospital treatment of the sick. The most difficult cases for which to obtain treatment are old persons or chronic sick who become acutely ill or who are in the terminal stage of their illness. These types of cases need continuous care and treatment, and it is just these requirements which cannot be met in the home. 13 NATIONAL ASSISTANCE ACT, 1948 Under Section 47 of this Act power is given to the Councils of County Boroughs and County Districts to apply to a Court of Summary Jurisdiction for an Order for removal and detention, in a suitable hospital or other place, of persons who (a) are suffering from grave chronic disease, or, being aged, infirm or physically incapacitated, are living in insanitary conditions; and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention. Application is made to the Court only as a last resort, and in several cases which came to my notice during the year it was possible, either to persuade the persons concerned to enter a hospital or home voluntarily, or to provide home help, nursing and other local services so that they could remain in their own homes. However, in two cases it was found necessary to take action under Section 47. The first of these cases concerned a woman aged 56 who was found to be suffering from chronic Arthritis and Anaemia and was completely bed ridden. She was not receiving the care and attention which she needed so I decided that it would be in the woman's interest if she was removed to hospital. An order was obtained authorising her detention for three months, and this period was extended as her physical condition did not improve. She was still in hospital at the end of the year. The other case was that of a woman aged 74 who had fractured her thigh. She refused admission to hospital and as she was not receiving any proper care and attention it was necessary to obtain an emergency order for her detention in hospital for three weeks. At the end of this period she became a voluntary patient. Under Section 50 of this Act the Borough Council arranged for the burial of 3 persons where no other provision was being made. PUBLIC HEALTH LAUNDRY SERVICE The Public Health Act, 1936, Section 84, dealing with the cleansing of filthy articles gives power to a Local Authority "to cleanse at the Authority's expense any article which upon a certificate of the Medical Officer of Health or Public Health Inspector require to be cleansed in order to prevent injury or danger of injury to the health of any person on the premises." 14 Under this section the Council commenced a laundry service on the 17th November, 1955, to assist incontinent old persons and to relieve their relatives of the burden of washing soiled linen, often with inadequate facilities. By arrangement with the Central Middlesex Group Hospital Management Committee( the soiled articles are sent to Neasden Hospital, where they are washed, dried and ironed at a cost of 4¼d. per lb. Collection and delivery are made twice weekly, the transport being provided by the Department's van. The service is running smoothly and has settled down to between 10 and 15 patients per week. There is of course a steady change in the number of cases and this is due to removal to and discharge from hospital, deaths, etc. There is no doubt that a service' of this kind is of great value to the community. Commercial launderies will not accept articles in the condition dealt with under the Council scheme, and the relief is greatly welcomed by patients and relatives. It is certain that in some cases relatives would be unable to cope with these incontinent old people and removal to hospital would be necessary. I give below details of the cases dealt with during 1955. Number of cases dealt with 31 Number of cases died 4 Number of cases removed to hospital 17 Number of cases where other arrangements made 1 Number of collections 652 SECTION C HEALTH SERVICES PROVIDED BY MIDDLESEX COUNTY COUNCIL AMBULANCE FACILITIES The Middlesex County Council is responsible for this service. NURSING IN THE HOME This service is administered locally by the Middlesex County Council. 15 The number of sick persons under care in Acton during the year was 964 necessitating 35,387 visits. MATERNITY AND CHILD WELFARE No change has to be reported in the siting of the Clinics this year. The former Palmerston Road Health Visiting district was successfully absorbed at Avenue Road, for both Child Welfare and Ante-Natal purposes, while the Family Planning Association was accommodated at Trinity Way, East Acton. CHILD WELFARE CLINICS The average attendances per session for the six Child Welfare Clinics are given below, last year's figures being shown in brackets. Avenue Road 5 sessions weekly 23.6 (25.8) Trinity Way 2 sessions weekly 38.3 (36.9) Cloister Road 2 sessions weekly 27.5 (27.0) Steele Road 2 sessions weekly 27.4 (28.5) Pierrepoint Road 3 sessions weekly 32.5 (30.8) Total number of children who first attended the clinics during the year, and who, on the date of their first attendance were: Under one year of age 893 Between the ages of one and five 71 Total number of children who attended during the year, and who, at the end of the year were:— Under one year of age 773 Over one year 2,003 Total number of attendances at Centres during the year: By children under one year of age 13,744 By children between one and five years 6,665 16 HEALTH VISITING Number of visits during the year by all Health Visitors working in this area:— To expectant mothers—First visits 425 Total visits 547 To children under one year of age—First visits 957 Total visits 3,851 To children between the age of one and five years—Total visits 5,043 MIDWIFERY SERVICE Domiciliary Midwifery was performed as in previous years by the Midwives of Queen Charlotte's Hospital. Only 15% of the total births were home confinements. The bulk of the hospital confinements were accepted at Central Middlesex and Queen Charlotte's Hospitals, the table below giving the distribution:— Central Middlesex Hospital 36.0% Queen Charlotte's Hospital 26.5% Hammersmith Hospital 9.9% Other Hospitals 12.1% * Nursing Homes 0.5% Confined at home (Queen Charlotte's midwives attending) 15.0% 17 ANTE-NATAL CLINIC Avenue Road Wednesday mornings and afternoons. Cloister Road Alternate Friday mornings Pierrepoint Road Alternate Thursday mornings Trinity Way Alternate Thursday mornings The following table shows the number of attendances made throughout the year: Number of new cases attending during the year 521 Total number who attended during the year 649 Total number of attendances made 2,432 Average number who attended per session 13.4 POST-NATAL CLINICS There were no specific post-natal clinics as the majority of patients return to hospital for this examination. The domiciliary cases who had been attended by Queen Charlotte's Midwives also attended the post-natal clinic at the hospital. Only five women attended the local ante-natal clinic for their post-natal examination. ANTE-NATAL EXERCISES Avenue Road One session weekly. Pierrepoint Road One session weekly, but a second session was held as required. 102 new patients were taken on during the year and there was a total of 793 attendances, an average of 7.2 per session. PREMATURE INFANTS Number of Premature Live Births (a) In Hospital 58 (b) At Home 3 (c) In Private Nursing Homes – 61 18 Number of Premature Stillbirths (a) In Hospital 13 (b) At Home — (c) In Private Nursing Homes — 13 Live Premature Births TOTAL Died within 24 hrs. Died between 1st day and. 28th day Surviving at end of 28 days Born in Hospital 58 3 4 51 Born at Home 3 — — 3 Born in Nursing Home — — — — BIRTH CONTROL CLINIC As in previous years, arrangements for this purpose with the North Kensington Women's Welfare Association were continued. One clinic weekly was held at Trinity Way, East Acton. Seven new patients were referred for advice in 1956. HOME HELP SCHEME At the end of the year there were 7 full-time Home Helps, and 63 part-time Staff. The following table shows the number of cases actually attended:— Maternity 29 Tuberculosis 12 Chronic Sick 396 Other cases 64 19 SECTION D INFECTIOUS AND OTHER DISEASES, SCABIES AND OTHER CONDITIONS DIPHTHERIA IMMUNISATION Immunisation was carried out along the lines indicated in previous reports, although the normal programme was somewhat interrupted in the Summer months by the introduction of vaccination against Poliomyelitis, and by the priority necessarily afforded to the latter scheme. Publicity on behalf of Diphtheria Immunisation was relaxed in order that there might be no overlapping of injections in the age groups to which Poliomyelitis vaccine was available, but in spite of this there was still a good response and the number of children immunised against Diphtheria showed a great increase on the previous year's figures. All immunised cases were followed up and, at the end of three years, each child was offered a boost dose. At the age of 11 years or over, this was preceded by a Schick test. All children under 5 who had not had the disease, were inoculated against Whooping Cough at the same time as they were inoculated against Diptheria, i.e., they had three doses of protective material at monthly intervals. Owing to the fact that estimates of child population are no longer supplied by the Registrar General, it is not possible to give the proportion of children immunised against Diphtheria, but the actual number at 31st December, is as follows : Children under 5 years of age 2,632 Children 5 to 15 years of age 8,047 The figures of work carried out during 1956 are given below: DIPHTHERIA IMMUNISATION, 19S6 Total number of under 5s inoculated 799 Total number of over 5s inoculated 14 Boost dose after 3 years 1,388 Schick Test after 3 years—Negative 468 Positive 11 Primary Schick Test —Negative 19 Positive 10 20 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR (Corrected), Notifiable Disease Cases notified in whole District At Ages—Years Ward Distribution Hospital Cases At all ages Under 1 year 1—2 3—4 6—9 10—14 15—24 25—44 45—64 Over 64 N.E. N.W. S. S.E. S.W. E. W. C. Scarlet Fever 35 – 8 7 19 – 1 – – – 5 3 4 5 6 2 3 7 3 Whooping Cough 79 10 12 21 34 2 – – – – 6 5 8 4 18 11 10 17 4 Measles 97 4 26 28 35 3 1 – – – 50 7 7 11 3 2 9 8 3 Acute Poliomyelitis (Paralytic) 3 – – – 1 – 1 1 – – 1 1 – – – – – 1 3 Acute Poliomyelitis (NonParalytic) 3 1 1 1 – – – – – 1 – – 1 – 1 – – 3 Tuberculosis (Pulmonary) 37 – – – 1 1 9 12 10 4 2 4 4 2 10 2 8 5 – Tuberculosis (Meninges & C.N.S.) – – – – – – – – – – – – – – – – – – – Diphtheria – – – – – – – – – – – – – – – – – – – Smallpox – – – – – – – – – – – – – – – – – – – Tuberculosis (other forms) 7 – – – 1 – 1 3 1 1 – – 2 1 – 2 – – – Meningococcal Infection 2 1 1 – – – – – – – – – – – – 2 – – 2 Acute Encephalitis – – – – – – – – – – – – – – – – – – – Dysentery 13 2 2 3 1 2 1 1 1 – – – 2 2 6 – 3 – 1 Ophthalmia Neonatorum – – – – – – – – – – – – – – – – – – – Pneumonia 16 – – – 2 – 1 6 5 2 1 1 4 – 5 – 4 1 3 Puerperal Pyrexia 4 – – – – – 1 3 – – – – – 1 1 – 1 1 – Paratyphoid 2 – – – – – – – – – 1 – – – – – 1 – 2 Typhoid Fever 2 – – – – – 1 – 1 – – – – – 2 – – – 2 Food Poisoning 33 — 1 3 3 — 3 12 9 2 8 10 4 – 1 1 – 9 4 Erysipelas 4 – – – – – – – 2 2 2 1 – – – – 1 – – TOTALS 337 17 51 64 98 8 21 38 29 11 77 32 35 27 52 23 40 51 30 21 INFECTIOUS DISEASES During the year 337 cases of infectious diseases were notified compared with 956 during 1955. The decrease was mainly due to the fact that there were only 97 cases of measles notified compared with 647 last year. Food Poisoning Thirty-three cases of food poisoning or suspected food poisoning were notified, none of them being associated with an outbreak. In 5 cases salmonella organisms were responsible for the illness, the causative agent not being discovered in the remainder. Typhoid Fever Two cases of typhoid fever were notified during the year. A male Polish National was admitted to hospital with typhoid fever. Following investigation his mother, with whom he was living, was admitted to hospital as a voluntary patient for treatment as a carrier. Treatment proved unsuccessful and she was discharged. Her son discharged himself after 8 weeks treatment, classified as a convalescent carrier. The strain of salmonella typhi isolated belongs to an untypable Vi strain and resembles the strain isolated during the outbreak amongst the Polish Community in Acton last year but no link could be found between these cases. Two typhoid carriers have been kept under surveillance following the 1955 outbreak. Faecal specimens submitted were negative. 22 Age Periods NEW CASES DEATHS Respiratory Non-Respiratory Respiratory Non-Respiratory Male Female Male Female Male Female Male Female 0 — — — — — — — — — 1 — — — — — — — — — 5 — — 2 1 — — — — — 15 — 6 3 1 — — 1 — — 25 — 2 4 1 1 — 2 — 85 — 5 1 1 — — — — — 45 — 5 2 — — 2 — — — 55 — 3 — — 1 — — — — 65 upwards 2 2 1 — 3 — — — 23 14 5 2 5 3 — — 23 STATEMENT OF PARTICULARS APPEARING ON THE REGISTER OF CASES OF TUBERCULOSIS—1956 Pulmonary NonPulmonary Total (a) Number of cases of tuberculosis on the Register at the commencement of the year 615 males 439 females 92 males 111 females 1,257 (b) Number of cases notified for the first time during the year 23 males 14 females 5 males 2 females 44 (c) Number of cases previously removed from the Register which have been restored thereto during the year * — males — females — males 1 female 1 (d) Number of cases added, to the Register other than by notification during the year 35 males 17 females — males 1 female 53 (e) Number of cases removed from the Register during the year 35 males 19 females 4 males 8 females 66 (f) Number of cases remaining on the Register at the end of the year 638 males 451 females 93 males 107 females 1,289 SCABIES AND VERMINOUS CONDITIONS As in previous years, cases suffering from the above conditions have been referred to the Kensington Medicinal Baths for cleansing treatment. During the year 4 persons were treated for dirty heads. Three of these were referred for treatment by the medical staff of factories within the Borough. Nine persons were treated for scabies, and one person for body lice. 24 SECTION E HOUSING I am indebted to the Borough Engineer for the following information showing the progress made since the end of the war. Temporary Prefabricated Dwellings. Occupied 31.12.56 208 New Permanent Dwellings. (1) Within the Borough: Completed and occupied 31.12.56 1,013 (2) Outside the Borough: Completed and occupied 31.12.56 435 SECTION F SANITARY CIRCUMSTANCES OF THE AREA WATER SUPPLY The Borough is supplied with water by the Metropolitan Water Board. The whole of the population is supplied from the public water mains direct to each house and the supply has been satisfactory. Waste of water has been notified to the Metropolitan Water Board on 69 occasions and, in addition to saving a measure of water supply, these notifications have been the means of preventing nuisance from dampness in many cases. In addition to the public supply, there are three deep wells in the district, two at factory premises, and one at the Public Baths. Samples of water from these wells have been taken from time to time and in the course of the year a total of 30 samples were submitted to the Council's analyst or pathologist for examination as to chemical or bacteriological content, and the results indicated a satisfactory supply. 25 DRAINAGE AND SEWERAGE All the dwelling houses are provided with water closets and are connected to the sewerage system which discharges, by an arrangement with the L.C.C., into the London sewers. Stormwater is filtered and emptied into the Thames. PUBLIC CLEANSING The amount of house refuse collected by the Council in 1956 was 15,076 tons and trade refuse collected amounted to 1,976 tons. All was removed to controlled shoots. In addition to the foregoing, 1,695 tons of salvage were sold. RODENT CONTROL Test baiting of public sewers and treatment as necessary have been maintained and this work contributes largely to the improved conditions in the matter of infestation on the surface. The services of the Council's Rodent Destruction staff continue to be divided between work of destruction of newly discovered rats and mice by intensive treatment and regular visitation and examination of business premises to prevent infestation. The Borough is free from serious infestation. Investigation, destruction and maintenance have entailed a total of 5,220 visits by the Rodent Operatives, 2,077 to business premises and 3,143 to dwellings, in addition to inspections by the Public Health Inspectors as noted elsewhere. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 Under the above Act, seventeen premises are registered for the manufacture of articles of upholstery, toys, etc., and two premises were licensed for the storing of rag flock. In the course of inspections it has been noted that rag flock and other filling materials are stored and used under hygienic conditions. Section 154 of The Public Health Act makes it an offence for any person collecting or dealing in rags, old clothes or similar articles, to sell or deliver, whether gratuitously or not any article whatsoever to a person under the age of 14 years. 26 During the year a person was convicted of such an offence within the Borough and the magistrates imposed a fine of £1 and awarded the Council £1 Is. Od. costs. It has been noted that such offences are most likely to occur in the vicinity of schools and observations are kept from time to time accordingly, with a view to preventing this practice of exchange. COMPLAINTS The number of complaints registered at the counter was 1,319 and by letter 284. INSPECTION OF FACTORIES The number of factories in the Borough is 639 and these have been subject to inspection by the Public Health Inspectors to ascertain that the provisions of the Factories Act, 1937, and regulations as to sanitary accommodation are complied with. The usual work of inspection of factory canteens has been maintained, and advice given as necessary as to fitness or otherwise of food for human consumption. The home addresses of 96 outworkers engaged in work at home for Factories within and outside the Borough, have been visited to ascertain hygienic conditions and freedom from infectious disease. 27 FACTORIES ACT, 1937 PART I OF THE ACT 1. INSPECTIONS for the purpose of provisions as to health (including inspections made by Public Health Inspectors). Premises Number on Register Number of Inspections Number of Written Notices Occupiers Prosecuted Factories without mechanical power 36 10 1 — Factories with mechanical power 594 187 18 — Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) 9 8 — — TOTAL 639 205 19 — 2. CASES IN WHICH DEFECTS WERE FOUND. Particulars Number of Delects Prosecutions Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of cleanliness (S.l.) — — — — — Unreasonable Temperature (S.3.) 1 1 — — — Inadequate Ventilation (S.4.) 1 1 — — — Conveniences (S.7.) (a) Insufficient 1 1 — — — (b) Unsuitable or defective 26 26 — 17 — TOTAL 29 29 — 17 — 28 PART VIII OF THE ACT OUTWORK—(Section 110) No. of out-workers in August list required by Sect. 110 (1) (c):— Stuffed Toys 47 SANITARY INSPECTION OF THE AREA The following table includes the tabular statements by the Chief Public Health Inspector under article 27 (18) of the Sanitary Officers (Outside London) Regulations, 1935. Tabulated Statement of Inspections and Details of work carried out by the Public Health Inspectors: Number of Inspections made and Action taken:— Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 1,547 (1) Dealt with by service of informal notice 1,052 (2) Dealt with by service of Statutory Notice under Section 9 Housing Act, 1936 328 (3) Dealt with by service of Statutory Notice under Public Health Acts 60 (4) No defects found 74 Premises (other than defective dwelling houses) inspected for nuisances and miscellaneous defects 2,471 (1) Dealt with by service of informal notice 46 (2) Dealt with by service of Statutory Notice under Public Health Acts, etc. - Re-inspections subsequent to Service of Notice 6,689 Inspections after notifications of Infectious Disease 96 Premises inspected under Prevention of Damage by Pests Act, 1949 and Infestation Order, 1943 93 The general improvement and condition of occupied houses has been maintained by requirements of repairs and the compliance by owners under Section 9 of the Housing Act, 1936. During the year 53 Notices were passed to the Town Clerk for work to be done in default of owners. 29 The following table indicates the extensive and varied nature of the defects and dilapidations which have been made good following inspection by the Public Health Inspectors. Sanitary dustbins provided 90 Yards paved or yard paving repaired 26 Insanitary forecourts remedied 1 Defective drains repaired or reconstructed 76 Defective soil pipes and ventilating shafts repaired or renewed 18 Defective fresh air inlets repaired or renewed 20 Defective gullies removed and replaced by new 15 Rainwater downpipes disconnected from drain — Dishings or curbs to gully repaired or new gratings fixed 15 Defective W.C. pans and traps removed and replaced by new 39 Defective W.C. flushing apparatus repaired or new fixed 46 Defective W.C. seats repaired or new fixed 25 Defective flush pipe connections repaired 18 Insanitary sinks removed or new fixed 19 Sink waste pipes repaired or trapped 52 Insanitary wall surface over sinks remedied 12 Ventilated food cupboards provided 3 Drinking water cisterns cleansed 8 Defective covers to drinking water cisterns repaired or new fixed 6 Insanitary sites beneath floors concreted — Spaces beneath floors ventilated 17 Dampness in walls from defective damp proof coursing remedied 196 Dampness from defective roof, rainwater gutterings, etc., remedied 1,022 Defective plastering repaired (number of rooms) 689 30 Rooms where dirty walls and ceiling have been cleansed and redecorated 808 Defective floors repaired 133 Defective or dangerous stairs repaired 37 Defective doors and windows repaired 1,269 Defective kitchen ranges and firegrates repaired 223 Defective washing coppers repaired 2 Coal cupboards provided or repaired — Accumulations of offensive matter removed 9 Drains unstopped and cleansed 86 Drains tested, exposed for examination, etc. 85 Smoke observations and inspections made 34 Smoke nuisance abated on service of notice 14 Miscellaneous nuisances abated 128 New W.C. apartments — Verminous rooms disinfested 111 HOUSING REPAIRS AND RENTS ACT 1954 Applications received 19 Applications withdrawn 2 Applications refused , 1 Certificates granted to occupiers 16 Applications for certificates of revocation 20 Applications refused 2 Certificates granted to owners 18 PREMISES UNDER PERIODICAL INSPECTION Factories and Workshops 639 Piggeries 1 Rag Dealers 5 Mews 4 Public House Urinals 34 Hairdressers 45 31 School Buildings:— Grammar 1; Primary and Secondary 11; Technical 2; Special 1; Private 3; Total 18 Butchers' Shops 35 Fish Shops 24 Fish and Chip Shops 16 Greengrocers' Shops 89 Grocery and Provision Shops 154 Milk Shops 42 Bakehouses 20 Slaughterhouses 2 Restaurants, Cafes, etc. 129 Industrial Canteens 203 Horseflesh (human consumption) shops 2 Premises where ice-cream is manufactured 6 Premises where ice-cream is sold 129 Premises registered under Section 14, Food & Drugs Act, 1938 (other than Ice-Cream premises):— Manufacture of sausages 30 Manufacture of sausage casings 1 Manufacture of pies 2 Manufacture of brawn 1 Preparation of pickles 2 Preparation of preserves 2 Preparation of lard 1 Preparation of dripping 1 Curing of bacon 2 Cooking of ham 1 Smoking of fish 1 Preserving of meat 6 Potting of meat 2 Canning of fruit 1 - Total 53 32 Dairies registered under the Milk & Dairies Regulations, 1949:— 2 The Public Health Inspectors continue to devote a very large amount of their time to work of meat inspection at the slaughterhouse premises. This permits only the minimum amount of district inspection, and house to house inspection has been considerably reduced. In the latter part of the year four vacancies for district inspectors were filled. 33 SECTION G INSPECTION AND SUPERVISION OF FOOD PREMISES AND FOOD HANDLING The numbers and types of food premises in the area are noted under Section "F" of the report, as are the numbers of food premises by type registered under Section 14 of the Food & Drugs Act, 1938 and the number of dairies registered under the Milk & Dairies Regulations, 1949. Inspections of registered food premises are carried out from time to time and further action taken as necessary to ensure the premises and method of production being maintained at a satisfactory standard. Members of the Public Health Inspectors staff from time to time give lectures with film strip displays to stimulate and maintain interest in food hygiene and the general work of the Public Health Department. The Food Hygiene Regulations 1955 came into force on the 1st January 1956, and with the special provisions of the Food Wrapping in Domestic Premises becoming operative on July 1st, 1956 the practice of home sweet wrapping in Acton ceased. In order to ensure the fullest possible implementation of the Regulations the Public Health Inspectors have carried out a number of inspections of food premises, particularly catering establishments, and works of repair and installation of equipment have followed as necessary. Regulation No. 9 on Personal Cleanliness prescribes that a person engaged in the handling of food, shall, while so engaged " refrain from the use of tobacco (including snuff) while he is handling any open food or is in any food establishment in which there is open food." Early in the year a person employed in a Provision Shop in the Borough was observed to be smoking in contravention of this regulation. He was cautioned, but repeated the offence some days later. The Council prosecuted in respect of both offences and fines totalling £6 were inflicted by the Justices and £2 2s. costs awarded to the Council. FOOD INSPECTION Reference to special examinations of consignments of food follow in this section of the report and while details of the quantity condemned are noted, it is not practicable to collate total quantities. 34 The amount of food-stuffs surrendered owing to deterioration or damage is largely related to the extensive work of food manufacture and distribution in the Borough. Much inferior food material is received into the Borough for manufacturing purposes on licence by Port Health Authorities and subject to control by this Local Authority, and the Public Health Inspectors carry out necessary examinations to ensure that only sound material is used for human consumption. There are two large wholesale grocery Depots within the Borough, and hence surrenders of canned and packeted goods are made to this Authority; these surrenders constitute the major part of such foodstuff noted. The following list collated for convenience shows some details of the surrendered food-stuffs: Bacon 492 lbs. Cream 61 tins Fish, wet 15 stone „ tinned 738 tins Flour and Flour Products 77 tins ,, 54 pkts. Fruit, tinned 23,083 tins ,, dried 149 lbs. Ham, tinned 136 lbs. Meat:— Fresh 42,489 lbs. Tinned 972 tins Corned beef 220 tins Offal 270 lbs. „ 22 tins Milk, Condensed 1,028 tins Pastes, Pickles, etc. 116 jars Poultiy:— Chickens 3 lbs. Preserves 1,292 tins Puddings, sweet and savoury 104 tins Soup, Strained Foods, etc. 748 tins Vegetables 3,376 tins Miscellaneous 67 jars, etc. 35 DISPOSAL OF CONDEMNED FOOD There has been no change in the methods of disposing of condemned and surrendered food noted in the report. At the large slaughterhouse and bacon factory in the Borough all diseased or infected carcases, and parts of carcases, are destroyed in special plant producing inedible material — bone meal, fertiliser, etc.— under supervision of the Council's Meat Inspectors. Apart from condemned food material dealt with at these slaughterhouse premises all surrendered diseased, or unsound, food is disposed of for animal feeding purposes, or otherwise as appropriate. FOOD COMPLAINTS There were 30 complaints as to unsound food, etc., and in 3 cases the Council instituted legal proceedings. Details are as follows: — A bakery firm was fined £10 for selling bread containing tobacco. Costs of £2 2s. Od. were awarded to the Council. A dairy firm was fined £5 for selling milk which contained mould. Costs of £5 5s. Od. were awarded to the Council. Another dairy firm was fined £2 for selling milk in a dirty bottle. £3 3s. Od. costs were awarded to the Council. MILK There are only two dairies in the Borough and the practice of distributing milk wholesale in bottles from large bottling depots to local depots, for delivery by roundsmen, or over the counter in milk shops remains. 51 samples of milk were taken throughout the Borough and following submission to the Pathological Laboratory of the Ministry of Health, the results of the bacteriological examinations indicated that generally satisfactory conditions of processing and storage were maintained. The wholesale, pasteurising and bottling centre in Bollo Lane has continued in operation without cause for complaint, and 8 empty bottles taken from the filling lines for examination as to sterility, were found to be sterile. The following licences were granted under the Milk (Special Designation) (Pasturised and Sterilised Milk) Regulations 1949 to 1953, and the Milk (Special Designation) (Raw Milk) Regulations 1949 to 1954. 36 Dealers' Licences:— Tuberculin Tested Milk 20 Pasteurised Milk 36 Sterilised Milk 30 Supplementary Licences:— Tuberculin Tested Milk 12 Pasteurised Milk 13 Sterilised Milk 13 124 ICE-CREAM The number of manufacturers of ice-cream in the Borough is now 5. Each of them is equipped to produce pasteurised ice-cream, and production is in every way in accord with the Ice-Cream (Heat Treatment etc.,) Regulations, 1947/1952. There are 129 premises where ice-cream is not manufactured, but where the commodity is sold in the main from pre-packed stocks. During the year 129 samples were taken, 83 of ice-cream manufactured in the Borough, and 46 from shops or itinerant vendors trading in icecream manufactured outside the Borough. The high bacteriological standard reflected in the results of examination of samples of ice-cream, together with inspection of plant and premises, has shown that processing and storage conditions are satisfactory and well maintained. MEAT INSPECTION AT SLAUGHTERHOUSES Regular slaughtering of pigs at the slaughterhouse of T. Wall and Sons has grown during the year and has necessitated the permanent attendance of a larger staff of the Local Authority in the course of meat inspection, with increased hours of overtime duty. Early in the year the slaughterhouse premises which had been occupied mainly for the slaughter of horses for human consumption was closed in the course of the Council's scheme for re-development in South Acton, and this accounts for the fact that only 364 of the animals noted in the table on Carcass Inspection on page 37 were inspected at this slaughterhouse. 37 CARCASES AND OFFAL INSPECTED AND CONDEMNED IN WHOLE OR IN PART Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Horses Goats 1. Number killed 10 66 1 12 163,600 90 5 2. Number inspected 10 66 1 12 163,749 90 5 3. Dead on arrival or died in pens — — — — 149 — — 4. All diseases Except Tuberculosis Whole carcases condemned — — — — 191 — — Carcases of which some part or organ was condemned 2 31 — 8 23,708 15 — Percentage of the number inspected affected with disease other than Tuberculosis 20.00% 46.98% — 66.67% 14.60% 16.66% — 5 Tuberculosis only Whole carcases condemned — 1 — — 106 — — Carcases of which some part or organ was condemned — 13 — — 5,694 — — Percentage of the number inspected affected with Tuberculosis — 2112% — — 3.54% — — 6. Cysticercosis Carcases of which some part or organ was condemned — — — — — — — Carcases submitted to treatment by refrigeration — — — — — — — Generalised and totally condemned — — — — — — — 38 NUMBER OF PIGS' CARCASES INSPECTED AT T. WALL & SONS LTD. SLAUGHTERHOUSE DURING 1956 WITH ANALYSIS OF SURRENDERS ON ACCOUNT OF DISEASE Month PARTS CONDEMNED Pigs Inspected Carcases Heads Collars Fore Qtrs. Hind Qtrs. Legs Skins Hocks Flares Pieces of Pork Plucks (Lungs, Livers, Hearts, Lights). Wt. of Mesente. ries, Stomachs & Intestines. January 15,843 27 274 4 1 — 77 6 — 7 301 lbs. 2,346 2,750 lbs. February 14,081 24 218 3 2 — 89 4 2 5 175 lbs. 2,258 2,630 lbs. March 12,076 23 227 — — 2 87 3 1 11 637 lbs. 2,084 3,090 lbs. April 13,346 19 245 5 — — 88 1 3 12 229 lbs. 2,728 2,760 lbs. May 14,240 29 235 2 2 — 80 5 — 15 164 lbs. 2,143 2,940 lbs. June 12,007 25 205 2 3 — 61 5 2 11 357 lbs. 1,901 3,010 lbs. July 14,876 30 227 1 — — 48 7 2 12 159 lbs. 2,036 2,610 lbs. August 13,168 28 192 1 — — 51 16 — 5 117 lbs. 1,795 3,040 lbs. September 13,178 29 207 1 1 — 56 16 1 3 179 lbs. 1,983 2.130 lbs. October 15,161 29 291 — 3 — 29 7 2 12 82 lbs. 2,329 2.76a lbs. November 13,521 23 207 1 — — 46 9 — 8 243 lbs. 2,236 2.960 lbs. December 12,072 11 179 1 1 — 59 27 2 6 152 lbs. 1,681 3,080 lbs. TOTALS 163,569 297 2,707 21 13 2 771 106 15 107 2,795 lbs. 25,520 33,760 lbs. 39 The total weights of meat and offal surrendered were:— BEEF Tons cwts. qrs. lbs. 1 CARCASE — 2 3 — 74 PARTS — 9 3 19 — 12 2 19 MUTTON AND LAMB Tons cwts. qrs. lbs. — CARCASES — — — — 8 PARTS — — — 18 — — — 18 HORSEFLESH Tons cwts. qrs. lbs. — CARCASES — — — — 15 PARTS — 2 — 18 — 2 — 18 PORK Tons cwts. qrs. lbs. 297 CARCASES 33 13 — 25 33,090 PARTS 87 12 1 22 121 5 2 19 FOOD AND DRUGS The Middlesex County Council is the Food and Drugs Authority in this area, and the Chief Officer of the Public Control Department has supplied the following figures and notes:— 40 List of samples procured in the Borough of Acton during the year. Article Total samples procured Unsatisfactory Milk, new 5 2 Milk, various 95 2 Butter 23 — Cakes 14 3 Cheese 1 1 Cooked meats 5 — Cream 24 — Drugs 17 — Fish and fish products 7 — Fruit 3 — Ice Cream 15 — Margarine 13 — Meat and meat products 19 — Preserves 4 1 Sausages, etc. 12 — Vinegar 13 — Wines and Spirits 16 — Miscellaneous 11 — TOTALS 296 9 Milk "Two samples of milk were slightly deficient in solids-not-fat but associated samples were genuine and no further action was taken. Two bottles of milk contained pieces of glass. The bottlers were prosecuted and a fine of £5 0s. Od. plus £1 1s. 0d. costs was imposed in respect of each of two summonses. Cakes "Three cakes, described as 'Cream Doughnut' Cream Slice and 'Cream Shell' respectively, contained imitation cream. An official caution was issued. 41 Cheese " A sample, described and sold as ' cream cheese ' was found to be curd cheese. The firm of grocers was prosecuted and fined £5 Os. Od. plus £5 15s. Od. costs. Preserves " A sample of preserves, described as ' Butterscotch Spread ' contained no butter. An official caution was issued. " Section 47 of the Food and Drugs Act, 1955, contains new provisions concerning the descriptions which can be applied to certain substances which resemble cream in appearance but are not cream. This has necessitated the making of many inspection visits and the giving of advice to all traders likely to be concerned to ensure that they were fully aware of these new requirements. Merchandise Marks Acts, 1887-1926. " 188 inspections of shops were undertaken to ensure that the Marking Orders relating to certain imported foodstuffs made under the Merchandise Marks Act, 1926 were complied with. 703 separate displays of meat, apples, tomatoes, poultry, butter, dried fruit, bacon and honey were examined. Verbal cautions were given in respect of minor infringements not being found so serious as to warrant more stringent action. " A firm of fishmongers and poulterers were summoned for selling and exposing for sale poultry bearing a false description of weight, and exposing for sale imported poultry not marked with the country of origin. They were fined a total of £23 0s. Od., and ordered to pay £3 3s. Od. costs. " Two partners in a firm of greengrocers were each summoned for exposing for sale imported apples and tomatoes not marked with the country of origin. They were each fined £2 0s. Od. and ordered to pay £1 1s. Od. costs. " A butcher was summoned for selling and exposing for sale imported meat not marked with the country of origin. He was 42 fined £1 0s. 0d. on each of two summonses, and ordered to pay £ 1 1s. 0d. costs. The Labelling of Food Order, 1953 "This Order requires that, in general, pre-packed foods shall bear on the label a clear statement of the designation of the food and, in the case of compound foods, the ingredients. It also requires that the name and address of the packer or labeller appears. At 86 premises 316 articles of pre-packed food were examined. No proceedings were taken in respect of any of the infringements detected and manufacturers took immediate steps to correct unsatisfactory labels as soon as their attention was drawn to them. False or Misleading Descriptions "A considerable amount of work is carried out each year in scrutinising advertisements and the labelling of pre-packed food and taking such action as is possible to secure satisfactory amendments in those cases where a label or advertisement contains a false or misleading description of the food to which it relates. This work is of benefit to all districts of Middlesex, irrespective of where the offending advertisement or label is discovered, and during the year under review corrective action has been taken in respect of cherry wine, biscuits, chocolate Easter eggs, flour and sugar confectionery, imitation caviare, blackcurrant punch, fruit juice drinks and creme de menthe. Special Designated Milk "During the year in question one licence was issued by my Council in respect of the use of the special designation ' pasteurised' for milk processed within your area. The premises wer inspected regularly and compliance with the requirements of the Act or Regulations was maintained. 45 samples were taken, all of which were certified as being satisfactory. Safe Milk "In addition to the foregoing, 16 samples of raw milk were procured within the Borough and submitted to test for the presence of tubercle bacilli. None was found contaminated." 43 SECTION H DISEASES OF ANIMALS Throughout the year, the Borough remained free from any outbreak of notifiable disease. SECTION J ATMOSPHERIC POLLUTION There has been no major change in the siting or recording of the three deposit gauge and seven lead peroxide stations and analyses have been maintained throughout the year. ESTIMATION OF ATMOSPHERIC SULPHUR BY THE LEAD PEROXIDE METHOD The monthly figures for each station for the years 1955 and 1956 are shown on page 44 and the 1956 figures are illustrated graphically on page 45. The station with the highest monthly figure—5.5 and with the highest average figure—2.9—was Bashley Road. The station with the lowest monthly figure—0.5—and with the lowest average figure —1.8—was Acacia Road. The average of all stations for the year was 2.42 which is below that of the previous year. DEPOSIT GAUGES The monthly figures for each station are shown statistically on page 46 and graphically on page 45. The yearly average figure—18.65 tons/sq. mile—has fallen below that of the previous year although the amount of combustible material in the deposit has again increased by a small amount. Once again the station with the greatest monthly deposit— 41.45 tons/sq. mile—and the greatest average deposit—22.32 tons/sq. mile—was Bashley Road. The Town Hall gauge showed the lowest monthly deposit of 3.31 tons/sq. mile and the lowest average deposit of 16.17 tons/sq. mile. 44 ESTIMATION OF ATMOSPHERIC SULPHUR BY LEAD PEROXIDE INSTRUMENTS Weight of S03 in Milligrams per 100 Square Centimetres per day. Station Town Hall Canham Road Wells Hse. Road Bashley Road Wesley Road Kendal Avenue Acacia Road Borough Average Month & Year 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 January 6.32 5.02 7.70 4.85 3.99 4.53 5.81 5.53 5.27 5.0 6.06 3.95 3.78 4.16 5.56 4.72 February 4.36 4.26 4.57 4.42 4.62 4.34 5.22 3.97 4.16 3.84 3.83 4.48 3.88 4.56 4.38 4.27 March 3.74 4.56 3.87 4.87 3.77 4.23 4.24 5.44 3.18 4.7 4.19 4.8 3.20 3.59 3.74 4.59 Winter (Oct-Mar.) 4.10 4.32 3.96 4.02 3.48 3.83 4.40 4.79 3.81 4.03 3.46 3.83 3.07 3.75 3.75 4.07 April 2.32 2.80 1.91 3.37 2.11 2.94 2.77 3.76 2.29 2.97 1.76 3.37 1.82 2.22 2.14 3.06 May 3.49 1.30 2.41 1.1 3.56 1.4 3.09 1.8 3.19 1.0 2.46 0.86 3.01 0.67 3.03 1.16 June 2.45 1.03 2.52 0.94 2.34 1.4 3.06 1.45 2.19 0.87 2.29 0.76 2.08 0.76 2.42 1.03 July 1.70 1.2 1.68 0.8 1.69 1.1 2.19 1.6 1.49 0.9 1.92 0.8 1.59 0.6 1.75 1.00 August 2.08 0.9 1.84 0.8 1.80 10 2.09 1.4 1.45 0.8 1.88 0.6 1.85 0.5 1.86 0.86 September 1.78 1.6 1.37 1.4 1.57 1.4 2.27 1.0 1.55 1.5 1.46 1.4 2.38 0.9 1.80 1.3 Summer (Apr-Sep.) 2.30 1.26 1.95 1.2 2.18 1.3 2.58 1.6 2.03 1.15 1.96 1.11 2.12 0.81 2.16 1.2 October 3.16 2.1 2.52 2.0 2.52 2.1 3.90 2.5 2.72 1.6 2.42 1.4 2.42 1.0 2.81 1.8 November 5.16 3.1 3.91 2.8 4.03 2.5 4.62 3.2 4.21 2.6 4.34 2.0 — 1.6 4.38 2.54 December 3.79 3.5 3.57 2.8 336 2.9 5.29 3.3 3.74 2.6 3.00 1.9 311 1.7 3.69 2.7 Monthly Average 3.36 2.61 3.16 2.51 2.95 2.49 3.71 2.91 2.95 2.36 2.97 2.19 2.65 1.85 311 2.42 45 46 DEPOSIT GAUGES MONTHLY DEPOSIT IN TONS PER SQUARE MILE Station Town Hall Bashley Rd. Kendal Ave. Borough Average Month & Year 1955 1956 1955 1956 1955 1956 1955 1956 January 35.52 25.35 43.38 33.95 31.34 22.94 36.75 27.41 February 22.40 19.38 27.51 41.45 15.60 18.65 21.84 26.49 March 26.94 29.13 39.52 29.44 23.56 29.06 30.01 29.21 Winter (Oct-Mar) 23.95 22.10 32.16 34.31 23.75 21.94 26.62 26.12 April 16.27 16.57 20.97 21.01 18.69 15.20 18.64 17.59 May 34.06 3.31 40.85 9.37 40.47 9.35 38.46 7.34 June 19.88 12.79 26.18 17.20 — 17.22 23.03 15.77 July 13.65 17.82 20.31 22.47 13.82 22.73 15.95 21.01 August 14.35 12.62 21.01 14.60 21.04 14.25 18.80 13.82 September 15.91 14.61 21.21 18.00 19.26 15.37 18.79 15.99 Summer(Apr-Sep) 19.02 12.95 25.09 17.11 22.66 15.69 22.23 15.25 October 14.25 15.60 33.35 20.57 20.14 16.11 22.58 17.43 November 22.20 10.24 37.42 17.00 20.91 10.34 26.84 12.53 December 22.35 16.56 30.24 22.84 19.94 17.40 24.18 18.93 Total Deposit 257.80 193.85 361.95 267.90 244.77 208.62 288.17 223.52 Monthly Average 21.48 16.17 30.16 22.32 22.25 17.39 24.63 18.63 RAINFALL AVERAGE OF THREE DEPOSIT GAUGE STATIONS IN INCHES Month Jan. Feb. Mar. Apr.! May Jun. Jul. Aug. Sep. Oct. Nov Dec. Total 1955 1.90 1.22 0.90 0.55 3.91 1.59 0.11 0.68 1.53 3.06 0.82 1.86 18.13 1956 3.43 0.11 0.88 1.00 0.16 2.03 4.45 3.41 2.76 1.89 0.30 2.44 22.86 47 ANNUAL REPORT OF THE SCHOOL MEDICAL OFFICER FOR THE YEAR 1956 The Statistics of the School Health Services are set out below: DIPHTHERIA IMMUNISATION Percentages of School Children Inoculated: Acton Wells Primary 85.66 Berrymede Boys' Primary 76.86 Berrymede Girls' Primary 78.55 Berrymede Infants' 74.15 Bromyard Secondary 88.29 Central Secondary 89.52 Derwentwater Primary 89.81 Derwentwater Infants' 81.12 East Acton Infants' 84.11 John Perryn Primary 86.52 John Perryn Infants' 91.40 Priory Boys' Secondary Modern 80.71 Priory Girls' Secondary Modern 80.21 Priory Infants' 82.81 Rothschild Primary 86.28 Rothschild Infants' 81.10 Southfield Primary 86.25 Southfield Infants' 90.38 St. Mary's R. C., Turnham Green 90.23 West Acton Infants' 89.64 48 REPORT OF THE SCHOOL OCULIST Attendances at the Clinic were very satisfactory during the year, 1,436 children were seen. 461 children were refracted and of those, 362 were known to have obtained their glasses. Thirty-one children were referred to be seen by the orthoptist. DENTAL REPORT—MATERNITY AND CHILD WELFARE Expectant Nursing Children Mothers Mothers under 5 Number examined by Dental Officer 83 23 203 Number needing treatment 83 23 197 Number of cases made dentally fit 44 16 165 Forms of dental treatment provided: — Teeth extracted 140 33 164 • Anaesthetics: (a) Local 43 16 — (b) General 35 5 73 No. of fillings 182 21 220 Scaling or scaling and gum treatment 73 10 — Silver nitrate treatment 189 Dressing 29 3 77 Radiographs 2 3 — Other operations 9 23 Denture Dressings 48 35 — Dentures provided: — (a) full 3 5 — (b) partial 14 10 — Number of attendances 272 86 362 Number of appointments not kept 44 21 93 49 SPEECH THERAPY REPORT No. of children treated 125 No. of children discharged 36 No. of children new 43 No. of sessions 321 Total attendances 1,168 The Speech Therapy department is functioning for seven sessions per week; a.m. p.m. Wed. —Avenue Road—E.S.N. School Avenue Road Thur.—Cloister Road Avenue Road (two Therapists) Fri. —Avenue Road The department has consisted of one Head Speech Therapist, Miss Sawkins and two colleagues, Miss Ash and Mrs. Barrett (nee Road) covering the district as follows : — Avenue Road Mrs. Barrett 3 Sessions Miss Ash 1 ,, Miss Sawkins 1 ,, Cloister Road Miss Ash 1 ,, E.S.N. School Miss Ash 1 ,, The session at Cloister Road was resumed this year as several cases in that district came into our care. Schools Liaison with the schools has been good. Whenever possible the therapists tried to keep Head Teachers informed on the progress of their children. Thirteen departments have been visited. Attendance Good attendances have been maintained, more parents have been seen this year and have been able to help the children with their work at home. Also, we have had a good year of attendances from staff which brings our figures for the year above the 1955 level. SPECIAL SCHOOL The School for Educationally Sub-normal Children was open for the whole of 1956 and at the end of the year 40 Children were on the roll. During the year 9 new cases were admitted. 50 SPECIAL SURVEYS Two mass x-ray surveys were carried out in the area. Haberdashers' Aske's School. A girl who had left school was found to be suffering from pulmonary tuberculosis. A mass x-ray survey of all the contacts, 8 teachers and 72 girls was arranged with the unit at Central Middlesex Hospital. All results were satisfactory. Three girls were x-rayed at Willesden Chest Clinic with satisfactory results. Bromyard School. A case of pulmonary tuberculosis was found in this school. The class mates were patched and those who showed a negative result had a patch test repeated after two months. They were still negative and numbered 27. Two were sent for x-ray as they were already known to be positive before the investigation started. Arrangements were made for all teachers who had come in contact, to be x-rayed. All school entrants, whose parents consented, were patch tested. These numbered 725. 720 were negative and 5 were positive. One was referred to the Ealing Chest Clinic, she has an active primary infection but did not require any special treatment. Another was referred to Ealing Chest Clinic and her chest x-ray was found to be satisfactory. The third one had previously been referred to the Chest Clinic but had failed appointments. The fourth one was referred to the Chest Clinic. His x-ray shows an enlarged hilar gland on the left side. His father has been admitted to hospital. The fifth one has left the district. HEALTH EDUCATION In several schools, weekly talks are given by the Health Visitors. The Assistant Medical Officer of Health also has given talks at school to the children and Parents' -Teachers' Association. 51 VISITS PAID BY SCHOOL NURSES The following is the number of home visits paid by the Nurses during the year. The visits have been divided into school distribution. Acton Well's 38 Berrymede 77 Bromyard 21 Derwentwater 22 East Acton 67 John Perryn 124 Priory 28 Roman Catholic 21 Rothschild 40 Southfield 41 West Acton 30 Special School 11 Other Schools 94 TOTAL 614 MEDICAL INSPECTION Medical Inspection of pupils attending Maintained Primary and Secondary Schools (including Special Schools). Periodic Medical Inspections Other periodic inspections Special inspections Ke inspections Entrants Second age group Third age group Total 781 757 502 2,040 472 1,713 1,165 Periodic age groups inspected Numbers of Pupils inspected Satisfactory U nsatisfactory No. % of Col. 2 No. % of Col. 2 Entrants 781 778 99.62 3 .38 Age 10 & 11 years 757 755 99.74 2 .26 Leavers Additional periodic 502 502 100 — — inspections 472 471 99.79 1 .21 TOTAL 2,512 2,506 99.76 6 .24 52 Defects found by Medical Inspection during the Year Defect or Disease Periodic Inspections Special Inspections No. of defects No. of defects Requiring treatment. Requiring to be kept under observation but not requiring treatment. Requiring treatment Requiring to be kept under observation but not requiring treatment. (1) (2) (3) (4) (5) Skin 61 12 286 14 Eyes—a. Vision 191 176 132 63 b. Squint 31 17 7 6 c. Other 4 8 32 25 Ears—a. Hearing 6 17 38 18 b. Otitis Media 4 5 8 6 c. Other — 3 6 2 Nose and Throat 26 24 31 33 Speech 13 3 43 13 Lymphatic glands — — — 7 Heart and Circulation — 27 — 30 Lungs — 50 — 49 Developmental— a. Hernia 3 3 — 2 b. Other 26 8 — 1 Orthopaedic— a. Posture 10 7 2 — b. Flat foot 8 15 4 5 c. Other 2 15 13 14 Nervous system— a. Epilepsy — 1 — — b. Other 1 2 — — Psychological— a. Development 4 9 — 5 b. Stability — 10 4 37 Other 3 72 80 187 53 Pupils found to require treatment Number of individual pupils found at periodic medical inspection to require treatment (excluding dental disease and infestation with vermin). Group. For defective vision (excluding squint). For any other conditions Total individual pupils. Entrants 12 92 98 10 and 11 years 88 57 137 Leavers 66 38 100 Total (prescribed group) 166 187 335 Other periodic inspections 25 15 38 TOTALS 191 202 373 TREATMENT TABLES MINOR AILMENTS (a) Diseases of the Skin. Number of cases treated or under treatment during the year By the Authority Otherwise Ringworm—(i) Scalp — — (ii) Body 4 — Scabies 2 — Impetigo 36 — Other skin diseases 153 — TOTAL 195 — (b) Other treatment. Number of cases treated By the Authority Otherwise Miscellaneous minor ailment 738 — 54 EYE DISEASE, DEFECTIVE VISION AND SQUINT. Number of cases dealt with By the Authority Otherwise External and other, excluding errors of refrection and squint 56 _ Errors of refraction (including squint) 77 461 TOTAL 132 461 DISEASES AND DEFECTS OF EAR, NOSE AND THROAT. Number of cases treated By the Authority Otherwise Received operative treatment: (a) for diseases of the ear — — (b) for adenoids and chronic tonsillitis — 73 (c) for other nose and throat conditions — — Received other forms of treatment 107 — TOTAL 107 73 ORTHOPAEDIC AND POSTURAL DEFECTS. Number of pupils treated By the Authority Otherwise Number of Pupils known to have been treated at Clinics or at out-patients departments — 24 SPEECH THERAPY. Number of pupils treated By the Authority Otherwise Speech Therapy 126 — Number of pupils for whom spectacles were prescribed — 362 55 DENTAL INSPECTIONS AND TREATMENT Age Groups No. inspected No. found to require treatment No. referred for treatment under Local Authority arrangements to County Council Clinics Specials 1,161 1,132 1,132 Under 5 — — — 5 — 16+ 5,203 3,571 3,365 TOTALS 6,364 4,703 4,497 Number of pupils actually treated 2,574 Number of attendances made for treatment 6,384 Number of half days devoted to (a) Inspections 58 (b) Treatment 873 Fillings :— Permanent Teetb 4,091 Temporary Teeth 1,051 TOTAL 5,142 Number of teeth filled :— Permanent Teeth 3,465 Temporary Teeth 966 TOTAL 4,431 Extractions :— Permanent Teeth 426 Permanent Teeth for Orthodonture 128 Temporary Teeth 1,895 TOTAL 2,449 56 Anaesthetics :— (a) General 1,040 (b) Local 735 (c) Regional 166 TOTAL 1,941 Other Operations :— (a) Permanent Teeth 863 (b) Temporary Teeth 970 TOTAL 1,833 Number of impressions, etc 42 Number of dentures fitted 20 Number of radiographs:— (a) Dental Clinics 81 (b) Hospitals — Number of appointments not kept 1,481 ORTHODONTIC EXAMINATION AND TREATMENT Age Groups No. of pupils examined No. of pupils selected for treatment Age 5 1 1 „ 6 — — „ 7 2 2 „ 8 28 27 „ 9 24 24 „ 10 13 13 ,, 11 19 19 „ 12 5 5 „ 13 4 4 „ 14 + 9 9 TOTAL 105 104 57 Number of pupils commenced treatment (first attendance) 367 Number of attendances made for treatment 2,503 Number of impressions, etc. 2,464 Number of fixed appliances 4 Number of appliances removed 190 Number of pupils treatment completed 86 Number of radiographs :— (a) at Dental Clinics 633 (b) at Hospitals — Number of Orthodontic sessions (1/2 day) 308 EMPLOYMENT OF CHILDREN AND YOUNG PERSONS (1) Number of children medically examined in order to ascertain whether they were physically fit to undertake employment of a light nature outside school hours 144 (2) Number of instances in which the state of health was found to be such that certificates were withheld — (3) Number of children examined as to fitness to take part in entertainments 13 (4) Number of cases in which certificates to take part in entertainments were withheld — EDUCATION ACT, 1944 — SECTIONS 87 (3) AND S7 (fl) Cases notified under Section 57, Education Act, 1944 : Sub-section 3 4 Sub-section 5 4 Cases de-notified under Section 8, Education (Miscellaneous Provisions) Act, 1948 — INFESTATION WITH VERMIN (i) Total number of examinations 25,087 (ii) Total number of pupils found to be infested 153 (iii) Number of individual pupils in respect of whom cleansing orders were issued (Section 54 (2), Education Act, 1944) 132 (iv) Number of individual pupils in respect of whom cleansing orders were issued (Section 54 (3), Education Act, 1944) 24 58 HANDICAPPED PUPILS. Category No. of new cases ascertained during the year No. of Ascertained cases known last day of year In Special day Schools In Special Residential Schools In maintained Primary & Secondary Schools In Independent Schools Not at School TOTAL B G B G B G B G B G B G B G B G Blind Pupils — — — — — — — — — — — — — — — — Partially-sighted Pupils — — 6 6 — 1 1 1 5 4 — — — — 6 6 Deaf Pupils 1 — 4 3 3 3 1 — — — — — — — 4 3 Partially Deaf Pupils 1 — 3 2 1 — 1 — 1 2 — — — — 3 2 Delicate Pupils 5 2 22 7 2 2 6 2 14 3 — — — — 22 7 Educationally Subnormal Pupils 4 7 21 20 19 15 1 3 1 2 — — — — 21 20 Epileptic Pupils — — 7 — — — 1 — 1 — — — — — 2 — Maladjusted Pupils 2 2 16 9 — — 15 7 1 2 — — — — 16 9 Physically Handicapped Pupils 3 — 16 9 8 5 — 2 5 2 1 — 2 — 16 9 Pupils with Speech Defects — 1 — I — 1 — — — — — — — — 2 1 Pupils with Multiple Defects 1 1 2 1 1 1 1 — — — — — — — 2 1 TOTAL 17 13 92 58 34 28 27 15 28 15 1 — 2 — 92 58 59 AVERAGE HEIGHTS AND WEIGHTS—INFANTS School Total No. Seen. 2 YEARS 3 YEARS 4 YEARS 5 YEARS 6 YEARS 7 YEARS BOYS No. seen Ht. ins. Wt. lbs. No. seen Ht. ins. Wt. lbs. No. seen Ht. ins. Wt. lbs. No seen Ht. ins. Wt. lbs. No. seen Ht. ins. Wt. lbs. No. seen Ht. ins. Wt. lbs. Acton Wells 20 15 41.23 39.52 5 41.85 40.9 Berry mede 65 4 38.5 35.25 40 41.08 38.78 18 43.28 42.67 3 45.42 46.83 Derwentwater 45 10 42.95 42.95 30 43.32 43.12 3 45. 49.33 2 46.5 50. East Acton 39 30 41.08 37.98 9 43.94 47.17 John Perryn 27 6 40.75 39.17 12 41.96 38.67 9 43.5 39.33 Priory 46 1 35. 31. 9 39.47 36.33 19 41.3 40.36 12 43.48 42.88 4 45.19 48.69 1 49.25 67.5 Roman Catholic 18 15 43.9 44.97 2 46. 46.75 1 55.5 95.5 Rothschild 56 32 41.09 40.63 19 42.54 40.04 4 43.88 43.13 1 47.5 49. Southfield 45 22 41.23 39.55 22 43.39 42.42 1 47.5 50. West Acton 30 4 41.06 39.5 21 41.21 38.64 4 46.25 54.81 1 46. 43. TOTAL 391 1 35. 31. 23 39.91 37.43 201 41.29 39.43 143 43.38 42.98 18 45.17 46.79 5 49.05 62.4 GIRLS Acton Wells 16 1 39.75 34.5 7 41.79 41.8 5 44.25 45.35 3 46. 31.17 Berry mede 54 3 38.67 34.83 30 40.42 38.9 18 42.31 41.32 3 43.67 45. Derwentwater 40 14 41.57 41.55 23 43.38 42.14 3 47.67 46.42 East Acton 37 1 35.5 31. 24 41.1 37.82 11 43.41 41.41 1 48. 58. John Perryn 30 3 38.67 33.5 16 40.63 37.03 11 42.82 41.23 Priory 45 3 34.83 33.92 12 38.06 34.04 17 41.37 38.96 12 42.81 41.77 1 40.5 35.25 Roman Catholic 21 1 44.5 46.5 20 43.8 46.9 Rothschild 55 29 41.6 39.72 23 42.9 42.61 1 45.25 42.25 2 48. 50.25 Southfield 46 17 41.79 40.49 28 43.21 43.04 1 53. 49.75 West Acton 47 6 39.54 35.13 33 41.52 39.62 8 43.5 41.22 TOTAL 391 3 34.83 33.92 26 38.51 34.22 188 41.27 39.34 159 43.17 42.79 13 46.06 47.15 2 48. 50.25 60 AVERAGE HEIGHTS AND WEIGHTS — INTERMEDIATES School BOYS Total No. Seen. 7 YEARS 8 YEARS 9 YEARS 10 YEARS 11 YEARS No seen Ht. ins. Wt. lbs. No. seen Ht. ins. Wt. lbs. No seen Ht. ins. Wt. lbs. No. seen Ht. ins. Wt. lbs. No. seen Ht. ins. Wt. lbs. Acton Wells 50 1 52.0 74. 1 52.0 60. 11 55.68 81.27 37 56.11 78.29 Berrymede 91 1 52.5 77.0 2 51.38 58.63 46 55.32 75.41 42 55.23 76.58 Derwentwater 60 34 58.09 74.40 26 57.96 81.70 John Perryn 64 2 46.75 56.38 1 48.5 53.8 2 55.78 73.5 38 60.05 83.64 21 55.05 74.07 Roman Catholic .... 19 1 51.5 61.0 5 54.6 71.3 13 55.42 71.81 Rothschild 67 1 47.5 46.5 18 55.85 75.47 48 56.25 76.32 Southfield 63 3 51.0 62.67 2 52.5 60.5 2 54.88 88.5 31 55.97 79.09 25 56.16 80.05 Special 6 3 51.67 63.08 3 57.17 96.0 TOTAL 420 6 49.0 57.88 5 51.6 65.16 11 52.89 68.32 183 56.58 76.47 215 56.07 77.58 GIRLS Acton Wells 29 4 53.19 67.38 25 55.9 79.47 Berrymede 85 1 47.5 54.5 1 43.0 41.5 27 54.81 77.12 56 55.10 81.11 Derwentwater 52 2 55.25 87.38 1 52.5 53.75 25 56.63 74.22 24 57.54 77.84 Jhon Perryn 74 3 49.33 54.33 50.8 60.25 29 55.97 78.35 39 55.93 81.57 Roman Catholic 13 1 51. 37. 6 55.58 80.33 6 56.83 78.58 Rothschild 45 l 52.5 65.0 10 56.0 77.35 34 56.18 77.32 Southfield 60 1 46.5 47.0 3 48.37 58.33 3 31.67 65.67 30 56.53 75.51 23 55.29 81.15 Special 8 2 54.75 78.5 2 54.0 70.75 11 56.65 79.0 TOTAL 366 1 46.5 47.0 10 50.15 60.43 11 51.36 63.18 133 55.10 75.25 218 54.10 77.35 61 AVERAGE HEIGHTS AND WEIGHTS—LEAVERS. SCHOOL BOYS Total No. Seen 11 YEARS 12 YEARS 13 YEARS 14 YEARS 15 YEARS Nc seei . Ht. i ins. Wt. lbs. No. Ht. seen ins. Wt. lbs. No seer . Ht. ins. Wt. lbs. No seen Ht. ins. Wt. lbs. No. seen Ht. ins. Wt. lbs. Acton Central 33 2 54.0 73.75 1 60.25 91.0 26 65.06 113.04 4 68.13 116.75 Bromyard 78 3 57.17 97.67 2 61.25 93. 2 59.25 89.0 68 63.68 112.98 3 62.0 127.33 154 8 56 75 74.31 6 58.08 96.42 2 59.75 96.75 1 64.14 112.76 3 66.33 159.83 12 2 61.25 107.75 8 64.38 112.13 2 68.0 125.25 Special 7 2 58.5 94.75 1 68.5 148.75 3 60.17 99.17 1 62.5 102. Total 284 13 56.12 79.62 11 58.93 95.0 7 61.29 104.96 240 64.07 112.66 13 65.85 129.31 GIRLS Acton Central 51 3 62.0 95.67 46 63.99 109.15 2 64.0 120.63 Bromyard 68 2 52.25 84.25 1 57.5 67. 60 62.27 108.18 5 64.8 129.8 Priory 128 2 59.75 94.75 4 64.5 76.06 118 62.63 112.91 4 63.19 119.5 Roman Catholic 14 2 62.5 107.75 12 62.79 112.29 Special 11 6 56.67 94.25 3 61. 108.5 2 63.25 131.75 Total 272 4 56. 89.5 15 60.6 91.48 4 60.13 98.13 236 62.81 110.94 13 63.94 125.52