BARN 20 BOROUGH OF BARNES Annual Report of the Medial Officer of Health For the Year 1952 BOROUGH OF BARNES the Annual Report of the Medical Officer of Health for the year 1952 ROSETTA HILL, B.Ch., m.b., d.p.h. Medical Officer of Health, 3 BOROUGH OF BARNES. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health :— Rosetta Hill, M.B., B.Ch., D.P.H. Chief Sanitary Inspector W. L. Leach, D.P.A.(Lond.), Cert. S.I.B., Cert. Meat and Food Inspector. Deputy Chief Sanitary Inspector:— P. J. Shannon, Cert. S.I.B., Cert. Meat and Food Inspector. Additional Sanitary Inspectors:— F. A. Sadler, Cert. S.I.B., Cert. Meat and Food Inspector. E. J. Silvester, Cert. S.I.B., Cert. Meat and Food Inspector. Clerical Staff:— Miss L. M. Fairclough. Mrs. J. D. Wallis J. M. Shearer 5 Public Health Department, Municipal Offices, Sheen Lane, S.W.14. To the Mayor, Aldermen and Councillors of the Borough of Barnes. Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report for the year 1952. During the year the health of the Borough has been good, and the incidence of infectious disease low. Housing remains our most acute problem in public health. There are still many families who require urgent rehousing for medical reasons, and whose health is further deteriorating through living in poor conditions. In presenting this report I should like to thank the Council for their continued support and interest in all public health matters. Also I have to thank the staff for their good work during the year. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, ROSETTA HILL, July, 1953. Medical Officer of Health. 7 BOROUGH OF BARNES. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1952 PREFACE In accordance with Ministry of Health Circular 2/53 the Annual Report for 1952 has been prepared on the same lines as previous years, and consists of two parts—a preface in which reference is made to items of special interest, and an appendix in which is tabulated the statistics relating to the health of the district. The Registrar General is now supplying local authorities with "Comparability Factors" in respect of births and deaths, and you will see that these have been used in the compilation of the various statistics. I would explain that the use of the factors supplied by the Registrar General give corrected figures to the local rates, enabling truer comparisons to be made with the remainder of the country—i.e. as though the ages and sexes of the local population were in the same proportion as those for the whole country. STAFF There have been no changes of staff in the Public Health Department during the year. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES Generally The incidence of Infectious Disease during the year was low, although there was an increase in the number of cases of scarlet fever, and poliomyelitis, as compared with the previous year. 1952 was an inter-epidemic year for measles, and less than half the number of cases of the previous epidemic year were reported. Again there were no cases of Diphtheria notified. Poliomyelitis There were eight cases of Poliomyelitis notified during the year (seven paralytic and one non-paralytic) all of them children up to the age of 16. Of these three recovered completely with no residual paralysis, and of the remaining cases three had slight paralysis, whilst two had more extensive paralysis. There was one death from Poliomyelitis assigned to Barnes during the year. This was the case of a child, who was ordinarily resident 8 in this area and who developed Poliomyelitis whilst living temporarily in another district, and died there. Tuberculosis There was one more case of Pulmonary Tuberculosis notified during this year as compared with 1951. There were seven cases of Non-Pulmonary Tuberculosis notified as against one new case in the previous year. Death Rate The death rate from Pulmonary Tuberculosis was increased this year. There were 13 deaths as compared with eight in 1951, but the deaths from Non-Pulmonary Tuberculosis were the same as last year, namely two cases. MASS RADIOGRAPHY UNIT Arrangements were made for the Mass Radiography Unit of the South-West Metropolitan Regional Hospital Board, to visit the borough from 10th November-28th November, 1952, to afford free facilities for X-Ray of the chest to anyone wishing to attend. Besides sessions for the general public, special sessions were held for school children, and the staffs of business houses and large firms. The Unit was based in the Public Health Department, and the visit was widely publicised. The numbers attending were less than the previous year. I feel that many more people should avail themselves of the opportunity to attend for X-Ray, and thus secure an important check-up on their health. The following is a summary of the findings of the Survey:— male female total Total number examined 1,275 1,617 2,892 male female Pulmonary Tuberculosis, Active 6 4 „ „ Inactive 61 60 Non-tuberculous abnormalities 48 38 MATERNAL MORTALITY RATE It is a matter of regret to record one maternal death during the year, where death was caused through attempts to procure a criminal abortion. This is the only maternal death which has occurred in this area since 1948. INFANT MORTALITY RATE There was an increase in the number of deaths of infants under one year, there being 13 deaths this year as compared with 11 in 1951. The Infantile Mortality Rate for this area is thus 31.0 as compared with 27.6 the Infant Mortality Rate for England and Wales. 9 REMOVAL OF PERSONS IN NEED OF CARE AND ATTENTION, Section 47, National Assistance Act, 1948 During the year there were 26 cases of old people in need of care and attention reported, and each one was visited by the District Sanitary Inspector. In no case was it found necessary to take action under Section 47 of the National Assistance Act. It was possible in all of the very urgent cases to arrange admission to hospital within a short time through co-operation with the Regional Hospital Board. The County Welfare Department also co-operated well in providing residential accommodation for suitable cases. FOOD With the welcome reduction in the volume of work necessary to deal with housing defects it has been possible to devote more attention to the supervision of the preparation and handling of food. Steady progress has been made in securing improvements in this type of premises, and there are now no establishments in the district which are considered to be really unsatisfactory. Naturally, many of the older premises fall short of what is considered desirable, but good management usually compensates for structural inadequacies. The question of the unsatisfactory condition in which meat and bacon is often delivered to butchers' and grocers' shops has again received much attention. However, any improvement in the method of transport and handling is likely to increase the retail price of meat. With the present-day high prices, and the reluctance of housewives to pay any more, it is inevitable that considerations of cost weigh heavily when handling arrangements are reviewed. Another unsatisfacory feature of existing arrangements is the difficulty in allocating blame when the meat passes through so many hands. Paradoxically, the best quality meat is unwrapped! The question of the open-fronted fish shop received some attention during the year. There are many advantages in this type of display, but there is some difficulty in complying with the provisions of the Food Byelaws, especially where traders persist in displaying their wares as near to the pavement as possible, where they may be the subject of investigation by dogs and young children, in addition to receiving a good share of the street dust, dirt and splashing. Fortunately, such commodities are almost invariably washed by the housewife, in whose hands the safety of the domestic food supply is finally secured. HOUSING It will be seen from the statistical data available elsewhere in this Report that there were slightly fewer complaints received in connection with items of disrepair. Many old properties have had a new lease of life given to them on account of the substantial war damage repairs carried out. 10 Although there are no areas in the district which can be considered as requiring clearance procedure, there are a few small areas where the property is old and of a very poor standard, and where the land on which the property stands would be better used for more modern and perhaps more numerous dwellings. On the other hand, of course, these small areas help to reduce the overcrowding on space which is noticeable in some parts of the Borough. The consideration of this type of redevelopment, however, can only take place when the Council is in a position to deal with the temporary rehousing of the displaced residents. A disturbing feature of the housing shortage has been the bringing into use of various basement dwellings, which are not really fit for habitation. These become known to the Department only when applications are received for assistance in rehousing. Often the owners themselves are unaware that these basements have been sub-let. Apart from chronic dampness, lack of light and other defects, basement dwellings, especially in the vicinity of the River Thames, are not suitable for night time occupation. It became necessary to review the question of procedure in enforcing notices to repair against reluctant owners. Many of the older properties, which are often poorly let to several families, cannot be reconditioned to a really satisfactory standard at anything like a "reasonable expense" within the meaning of the Act. With action under Section 9, Housing Act, 1936, there is a snag in that there is a definite understanding that the Council considers the house to be quite fit when the specified works have been completed. Action in respect of this type of property therefore must needs be taken under the old "nuisance procedure" of the Public Health Acts. In some respects this procedure is more salutary, involving, as it does, the issue of summonses and a hearing in the Magistrates' Court, nevertheless, the time and trouble taken to bring about a satisfactory conclusion is out of all proportion to the needs of the case. Many months may elapse between the issue of a notice and final completion of the work. Although there is a comparatively rapid scheme of action for defective drainage and sanitary fittings, there is no statutory provision for rapid action in respect of such urgent items as leaking roofs, dangerous floors, Burst water pipes, etc. Unfortunately, in dealing with bad housing conditions in this area, it is not only those houses which are in disrepair which call for attention. A considerable number of families are living in sub-let accommodation, both furnished and unfurnished, often in very congested conditions. The proposed new Houses Let in Lodgings Byelaws, which, it is hoped, will set a higher standard of accommodation, have not been forthcoming. Even with a new legal standard, considerable difficulty will be encountered in enforcement, as no doubt 11 many "landlords" (and landladies) will seek to evict the sub-tenants rather than provide proper sinks and other necessary amenities. SANITARY CIRCUMSTANCES There has been little change in the amount of work carried out to preserve the general amenities of the district. Indiscriminate dumping of rubbish and discarded articles is a frequent source of complaint. There are no facilities in the area for the disposal of the type of refuse and rubbish which does not come within the category of "household refuse". The Council itself is faced with the problem of disposal of incombustible waste to a final dump outside the area. Wherever possible salvage is practised, but articles such as worn-out tyres, water cisterns, basket chairs, etc., have little value and find their way on to odd pieces of waste land, behind fences and down back passages. This problem is to receive consideration by the Public Health Committee in the near future. ATMOSPHERIC POLLUTION There were two main sources of atmospheric pollution. The first was our own Refuse Destructor chimney. Although not actually creating much trouble in this borough, repeated complaints were received from the adjoining Borough of Richmond, and the Borough of Brentford and Chiswick. Trouble arises mainly from the change in the nature of refuse now being burned, and the increased withdrawal of valuable commodities for salvage purposes, reducing the amount of combustible material in the refuse. At certain times of the year, too, excessive proportions of damp garden refuse make more smoke inevitable. The Public Health Committee were very concerned about this state of affairs, and arrangements are now well in hand for the provision of water type dust traps to counteract the nuisance as much as possible. The other main source of pollution was from similar operations, i.e., the refuse disposal arrangements of the Hammersmith Borough Council. Nuisance arose when refuse was tipped into barges moored in the Thames near Hammersmith Bridge. Much more satisfactory arrangements are now in force, all refuse being transferred to special road vehicles, and tipping into barges has been discontinued. There are a few chimneys in the district which give trouble, but no undue difficulty has been experienced in dealing with these. Excessive smoke usually means lost efficiency and fuel wastage, and managements react accordingly. This district was badly affected by the great fog which lasted several days in December. The number of deaths from respiratory causes in the material period was 13 as compared with three deaths from similar causes during the same period in 1951. Whilst this 12 district is singularly fortunate as far as direct pollution in the area is concerned, nevertheless, atmospheric conditions may cause pollution from other areas to settle in this district. It is satisfactory to note that some action is likely to result from this tragic reminder of the need for smoke abatement. The Council itself has implemented the recommendations of the Ministry in providing high efficiency fuel burning appliances in the post-war dwellings erected by the Council, but unless these appliances are used to burn appropriate smokeless fuels the efforts in this direction will be wasted. There is confusion in the minds of many people on the difference between the installation of continuous burning grates, which may cause excessive smoke, although maintaining a steady heat, and the more efficient independent stoves which consume the relatively smokeless fuels. There has been increased interest in fuel economy, which is bound up closely with the prevention of atmospheric pollution. The facts should be made more widely known so that the toll of death, illness and material damage caused by smoke in the atmosphere may be measured against the comfort of bright and cheerful fires. As with other drawbacks of civilisation, such as road accidents, child neglect, bad housing, defence costs, etc., it is for the nation to decide, after measuring the risks involved, whether stronger measures should be taken to ensure a cleaner atmosphere. SEWERAGE AND SEWAGE DISPOSAL It was anticipated that the remodelled plant and new layout would be in full operation by the end of the year, but unfortunately, work was delayed. The works are being kept going under considerable difficulties, and the absence of serious complaint reflects great credit on the Engineer and his staff. It is hoped that the full change over will be effected some time in 1953. WATER SUPPLY The water supply arrangements have remained unchanged, a good supply, both as regards quantity and quality, being maintained by the Metropolitan Water Board. Very few complaints were received, and in no case was this due to the main supply. The Board exercises close chemical and bacteriological analytical control and promptly deals with any matters referred to it. BOROUGH OF BARNES APPENDIX TO THE ANNUAL REPORT OF THE Medical Officer of health 1952. 15 STATISTICS and TABLES BOROUGH OF BARNES. VITAL STATISTICS. The following statistical information relating to the Borough has been completed on receipt of the Local and National Statistics issued by the Registrar-General in connection with Population, Birth-rate, Death-rates, Maternal Mortality, Infantile Mortality, and Incidence of Notifiable Infectious Disease. Members of the Armed Forces stationed in the area are now included in the population figures, also in the Birth and Death Rates. TABLE 1.—STATISTICAL SUMMARY, 1952. Population:— Census, 1931 42,440 Census, 1951 40,558 Estimated—Mid-year, 1952 (Registrar General) 40,400 Births:— Birth-rate (per 1,000 of population) Uncorrected 10.4 Corrected (Registrar General's Comparability Factor 0.94) 9.8 Live Births:— Total. M. F. Legitimate 404 214 190 Illegitimate 15 8 7 Total 419 222 197 Still Birth-rate (per 1,000 total births) 35.8 Total. M. F. Still Births (Legit. 14 ; Illegit. 1) 15 6 9 Deaths:— Death-rate, all causes (per 1,000 of population) Uncorrected 12.6 Corrected (Registrar General's Factor 0'86) 10.8 Total M. F. Deaths (all causes) 508 250 258 Death-rate from Cancer (per 1,000 of population), 91 deaths 2.3 Death-rate from Zymotic (Epidemic) Diseases (per 1,000 of population) 0.09 Death-rate from Maternal Causes (per 1,000 total births) Pregnancy; Child-birth; Abortion (1 death) 2.39 Death-rate of infants (per 1,000 live births) (a) Under 4 weeks of age (10 deaths) 23.9 (b) Under 1 year (13 deaths) 31.0 Death-rate for Legitimate infants (12 deaths) 28.6 Death-rate for Illegitimate infants (1 death) 2.4 16 17 Table 2.—Vital Statistics of the Borough of Barnes during 1952 and previous 5 Years Year. Registered Births Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District. Uncorrected Number. Nett. Of nonresidents registered in the District. Of residents registered outside the District. Under 1 year of age At all ages. Number. Rate. Number. Rate per 1,000 nett births Number Rate Number. Rate. 1 2 3 4 6 6 7 8 9 10 11 12 1947 658 701 17.1 337 8.2 27 206 26 37.1 512 12.5 1948 460 576 14.2 252 6.2 23 216 12 20.8 445 11.0 1949 247 516 12.6 326 7.9 60 205 7 13.5 471 10.0 1950 530 498 11.4 357 8.6 52 216 10 21.0 515 10.8 1951 452 430 10.5 322 8.0 43 226 11 25.5 513 12.6 1952 443 419 10.4 350 8.7 59 218 13 31.0 508 12.6 18 Table 3.—Birth-rate, Death-rate, and Analysis of Mortality during the Year 1952, with corresponding rates for England and Wales, 160 great towns, 160 smaller towns, and for the County of London for comparison. Birthrate perl,000 Total Population. Annual Death-rate per 1,000 Population. Death rate per 1,000 Births. Maternal Mortality Rate per 1,000 Total Births All Causes. Typhoid & Paratyphoid Whooping Cough. Diphtheria. Tuberculosis Influenza. Small-pox Poliomyelitis Enceph. Pneumonia Diarrhoea and Enteritis (under 2 years). Total Deaths under One Year. All Causes. Puerperal Infection. Other Causes. England and Wales 15.3 11.3 0.00 0.00 0.00 0.24 0.04 - 0.01 0.47 1.1 27.6 0.72 0.50 0.22 160 County Boroughs and Great Towns, including London 16.9 12.1 0.00 0.00 0.00 0.28 0.04 - 0.01 0.52 1.3 31.2 Not avail able 160 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census, 1951) 15.5 11.2 0.00 0.00 0.00 0.22 0.04 - 0.00 0.43 0.5 25.8 London 17.6 12.6 — 0.00 0.00 0.31 0.05 - 0.01 0.58 0.7 23.8 Barnes Borough 9.8 10.8 — - — 0.30 0.02 - 0.02 0.5 — 31.0 — - - 19 Table 4.—Causes of Death during the Year 1952. Causes of Death (Registrar-General's short list of causes). Total Deaths Male Female 1 Tuberculosis, respiratory 11 7 4 2 Tuberculosis, other 1 - 1 3 Syphilitic diseases 1 1 - 4 Diphtheria - - - 5 Whooping Cough - - - 6 Meningococcal infections - - - 7 Acute poliomyelitis 1 - 1 8 Measles - - - 9 Other infective and parasitic diseases 2 2 - 10 Malignant neoplasm, stomach 14 8 6 11 Malignant neoplasm, lung, bronchus 24 21 3 12 Malignant neoplasm, breast 8 - 8 1 13 Malignant neoplasm, uterus 1 - 14 Other malignant and lymphatic neoplasms 44 30 14 15 Leukaemia, aleukæmia 1 1 - 16 Diabetes 4 1 3 17 Vascular legions of nervous system 84 26 58 18 Coronary disease, angina 78 40 38 19 Hypertension with heart disease 9 2 7 20 Other heart disease 60 24 36 21 Other circulatory diseases 32 14 18 22 Influenza 1 1 - 23 Pneumonia 21 10 11 24 Bronchitis 17 9 8 25 Other diseases of respiratory system 4 3 1 26 Ulcer of stomach and duodenum 10 7 3 27 Gastritis, enteritis and diarrhœa 3 1 2 28 Nephritis and nephrosis 4 4 - 29 Hyperplasia of prostate 3 3 - 30 Pregnancy, childbirth abortion 1 - 1 31 Congenital malformations 7 2 5 32 Other defined and ill-defined diseases 49 25 24 33 Motor vehicle accidents 1 1 - 34 All other accidents 8 3 5 35 Suicide 4 4 - 36 Homicide and operations of war - - - All Causes 508 250 258 20 Table 5.—Infant Mortality during the Year 1952. Causes of death, at various ages, of infants under one year. Cause of Death Under 1 Week 1-2 Weeks 2-3 Weeks 3-4 Weeks Total under 4 w'ks 1-3 Months 3-6 Months 6-9 Months 9-12 Months Total under 1 year Deaths in the Borough Deaths outside Borough Anencephaly 1 .. .. .. 1 .. .. .. .. 1 .. 1 Prematurity 1 .. .. .. 1 .. .. .. .. 1 .. 1 Intracranial Haemorrhage— Prematurity 1 .. .. .. 1 .. .. .. .. 1 .. 1 Prematurity and congenital megalo colon (operation) 1 .. .. .. 1 .. .. .. .. 1 .. 1 Prematurity 1 .. .. .. 1 .. .. .. .. 1 .. 1 Asphyxia— Atelectasis Toxic hepatitis 1 .. .. .. 1 .. .. .. .. 1 .. 1 Multiple congenital defects 1 .. .. .. 1 .. .. .. .. 1 .. 1 Prematurity 1 .. .. .. 1 .. .. .. .. 1 .. 1 Congenital Heart disease (patent inter ventricular septum) .. 1 .. .. 1 .. .. .. .. 1 .. 1 Pyelonephritis Meningocele .. .. .. .. .. .. .. .. .. 1 .. 1 Bilateral subdural hæmatoma .. .. .. .. .. .. .. 1 .. 1 .. 1 Acute superative bronchitis .. .. .. .. .. 1 .. .. .. 1 1 .. Drowning in River Thames 1 .. .. .. 1 .. .. .. .. 1 1 .. All causes 9 1 .. .. 10 2 .. 1 .. 13 2 11 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. Incidence of Notifiable Infectious Diseases. Comparison between the incidence of certain of the notifiable infectious diseases in Barnes, and in London and England and Wales, is shown on next page. 21 Table 6.—Infectious Diseases: Incidence per 1,000 of the Population in 1952. Disease. Barnes. London. England and Wales. Typhoid Fever — 0.00 0.00 Paratyphoid Fever 0.02 0.01 0.02 Meningococcal Infection — 0.02 0.03 Scarlet Fever 1.00 1.56 1.53 Whooping Cough 0.47 1.66 2.61 Diphtheria — 0.01 0.01 Erysipelas 0.20 0.14 0.14 Small-pox — — 0.00 Measles 6.16 9.23 8.86 Pneumonia 0.51 0.57 0.72 Acute poliomyelitis (including polioencephalitis) Paralytic 0.17 0.06 0.06 Non-paralytic 0.02 0.03 0.03 Food Poisoning 0.02 0.18 0.13 Puerperal Pyrexia 0.10 30.77* 17.87* Dysentery 0.27 — — *Per 1,000 Total (Live and Still) Births. Table 7.—Notifiable Infectious Diseases, 1952. Diseases. Total Cases Notified. Ages, in years. Parish Removed to Hospital. Total Deaths of Residents. † Under 1 year l to 2. 2 to 3. 3 to 4. 4 to 6. 5 to 11. 10 to 15. 15 to 20 20 to 25. 25 to 35. 35 .o 45. 45 to 65. 65 and over. Barnes. Mortlake. Diphtheria - - - - - - - - - - - - - - - - - - Scarlet Fever 42 - - - 7 - 27 4 3 — 1 - - - 23 19 14 - Poliomyelitis 8 - 2 — 2 — 2 — 2 - - - - - 3 5 8 1 Acute Encephalitis— post infs. - - - - - - - - - - - - - - - - - - Measles 749 6 20 - 52 - 153 13 - 4 1 - - - 137 112 3 - Whooping Cough 19 - 1 - 7 - 9 - - - 2 - - - 3 16 - - Pul. Tuberculosis 39 - - - - - - 1 3 6 13 4 9 3 21 18 - 11 Non-Pul. Tuberculosis 7 - - - - 1 - - 1 1 1 1 1 1 4 3 - 1 Pneumonia 21 - - - - - - 1 - - - 5 10 5 6 15 - - Erysipelas 8 - - - - - - - - - - 1 7 - 5 3 - - Ophthalmia neonatorum - - - - - - - - - - - - - - - - - - Meningococcal Infect'n - - - - - - - - - - - - - - - - - - Puerperal Pyrexia 4 - - - - - - - - 2 1 1 - - 4 - - - Typhoid - - - - - - - - - - - - - - - - - - Dysentery l1 - - - - 3 - 2 - - - 5 1 - 6 5 - - Food Poisoning l - - - - - - - - - - 1 - - - 1 1 — Paratyphoid 1 — - - - - - 1 - - - - - - 1 - - - All Diseases 410 6 23 - 68 4 191 22 9 13 19 18 28 9 213 197 26 13 †The deaths recorded in this column are the total corrected number of deaths assignable to the District, and are not necessarily deaths of persons recorded as notified during the year. 22 Table 8.—Notifiable Infectious Diseases, 1942 to 1952. Year 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 Diphtheria 6 3 15 12 5 2 3 - - - - Scarlet Fever 34 184 50 36 43 27 30 38 27 17 42 Typhoid Fever - 2 - - - - - 1 - 2 - Paratyphoid Fever - 1 - - 1 - - - 1 - 1 Puerperal Pyrexia 4 1 - 3 1 - - 1 1 - 4 Erysipelas 6 5 10 3 5 10 10 8 4 2 8 Continued Fever - - - - - - - - - - - Relapsing Fever - - - - - - - - - - - Typhus Fever - - - - - - - - - - - Small-pox - - - - - - - - - - - Cholera - - - - - - - - - - - Plague - - - - - - - - - - - Tuberculosis. P. 42 43 50 39 35 62 40 32 37 38 39 „ Non-P. 7 7 1 6 5 9 5 6 2 1 7 Ac. Encephalitis (Post Infections) 3 2 - - 2 1 - 1 1 - - Poliomyelitis 1 - - - 1 4 4 10 1 - 8 Ophthalmia Neonatorum - 1 1 1 2 2 1 - - - - Meningococcal Infect'n - - - - - - - - - 2 - Measles 712 111 68 358 177 437 158 588 124 541 249 Encephalitis Lethargica - - - - - - - - - - - Polioencephalitis - - - - - 1 - - - - - Malaria - 1 - - - - - - - - - Dysentery 1 2 1 9 71 - 4 - 3 4 11 Pneumonia 16 20 18 20 19 16 20 21 13 29 21 Whooping Cough 73 82 108 71 66 94 56 15 58 82 19 Food Poisoning - - - - - - - - - - 1 Table 9.—Schools. Number of Schools attended Number of who suffered Scarlet Fever scholars from:— Diphtheria County Primary Schools:— 7 - Church of England, Mullins Path 1 - East Sheen Cty. Prim. 5 - Lowther Cty. Prim. 5 - Lr. Richm'd Rd. Nursery Sch. 1 - Mortlake Cty. Prim. 3 - Railwayside County Prim. 4 - Vineyard Cty. Prim., Richmond 1 - County Secondary Schools:— 1 - Lonsdale Rd. Cty. Secy. Girls 1 - County Grammar School:— 1 - Richmond and East Sheen Cty. Grammar (Boys) 1 - Private Schools:— 7 - Belle Vue Nursery School 1 - Castelnau College 1 - Froebel Institute, Roehampton 3 - Sacred Heart Convent, Barnes 1 - Sacred Heart Convent, West Hill, S.W. 18 3 - Sheen Gate School, Sheen Lane 1 - Miss Young's Private School, 2 Orchard Rise 1 - Total 16 33 - 23 24 TUBERCULOSIS. Notification Register. The Register of Notifications has been kept revised in accordance with the requirements of the Public Health (Tuberculosis) Regulations, 1952. The number of cases added to or removed from the Register during the year and the number remaining on the Register on December 31st, 1952 are as under:— Table 10.—Tuberculosis Register. Form of Disease. On Register, 1st Jan., 1952 Cases Added. Removed from Register. Remaining on Register 31st Dec., 1962 Primary Notif'ns Otherwise. Restored Total. NonTub. Cured Left District Dead Total Pulmonary 297 39 16 1 353 - 14 23 13 50 303 Non-Pulm'y 42 7 2 — 51 — 2 4 2 8 43 339 46 18 1 404 - 16 27 15 58 346 Table 11.—Tuberculosis: New Cases and Mortality, 1952. Age-Periods. New Cases.* Deaths. Pulmonary. NonPulmonary. Pulmonary NonPulmonary. Male Fem'le Male Fem'le Male Fem'le Male Fem'le 0-1 years - - - - - - - - 1-5 „ - - - 1 - - - - 5-10 „ - - - - - - - - 10-15 „ - 1 - - - - - - 15-20 „ 3 - - 1 - - - 1 20-25 „ 4 4 - 1 - 1 1 - 25-35 „ 11 7 - 2 - 1 - - 35-45 „ 5 5 - 1 1 - - - 45-55 „ 5 2 - 1 4 2 - - 55-65 „ 6 - - 1 3 - - - 65 ,, and over 3 - - 1 1 - - - All ages 37 19 - 9 9 4 1 1 * In addition to primary notifications, all other new cases coming to the knowledge of the Medical Officer of Health are included in these figures. Incidence-rate Pulmonary 0.7 All forms 1.14 Non-pulmonary 0.17 Death-rate -Pulmonary 0.3 All Forms 0.35 Non-pulmonary 0.05 25 Table 12.—Infected Rooms and Articles (dealt with by the Council). Premises disinfected 33 Lots of bedding disinfected 54 „ „ destroyed 14 HOUSING. Table 13.—HOUSING STATISTICS FOR THE YEAR 1952. 1. Number of Dwellings Owned by the Local Authority:— Number of houses 256 Total 779 „ „ 11 flats 523 (Including corporate properties.) 2. Unfit Houses. (I) Inspection of Dwelling Houses during the Year:— (i) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 578 (b) Number of inspections made for the purpose 1,639 (ii) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 Nil (b) Number of re-inspections made under the Regulations Nil (in) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (iv) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 94 (II) Remedy of Defects during the Year without service of formal notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers (including 63 cases outstanding from the previous year) 156 26 (III) Action under Statutory Powers during the Year:— A. Proceedings under sections 9, 10 and 16 of the Housing Act, 1936:— (i) Number of dwelling-houses in respect of which notices were served requiring repairs 8 (ii) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners (including 1 case from 1951) 4 (b) By Local Authority in default of owners (including 3 cases from 1951) 5 B. Proceedings under Public Health Acts:— (i) Number of dwelling-houses in respect of which notices were served, requiring defects to be remedied 45 (ii) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners (including 2 cases from 1951) 35 (b) By Local Authority in default of owners 1 (iii) Number of dwelling-houses in respect of which abatement orders were made by Magistrates Nil C. Proceedings under sections 11 and 13 of the Housing Act, 1936:— (i) Number of dwelling-houses in respect of which Demolition Orders were made - (ii) Number of dwelling-houses demolished in pursuance of Demolition Orders 2 D. Proceedings under section 12 of the Housing Act, 1936:— (i) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (ii) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil 3. Overcrowding. The position with regard to statutory overcrowding has been much improved, owing to the special consideration which such cases receive when the allocation of Corporation dwellings is being made. (i) Number of inspections made to cases of alleged overcrowding 23 (ii) Number of revisits — (iii) Number of overcrowded families rehoused 20 27 4. Disinfestation. As the Borough Cleansing Station is not now in use, arrangements were made for the treatment of one man for body lice, at the Municipal Baths, operated by the Hammersmith Borough Council. Disinfestation by spraying or fumigation was carried out in 29 houses or flats, including 5 Council-owned properties, by Corporation staff. 14 lots of bedding, furniture, etc., were destroyed, mainly as a result of deaths or infestation. INSPECTION AND SUPERVISION OF FOOD. Table 14.—Food Premises. The following inspections were made in respect of premises where food is prepared, handled and distributed:— Nature of inspection Number of premises Number of visits Notices issued and complied with Bakehouses 9 57 - Bread and Cakes 17 12 2 Butchers 28 144 — Cafes, Restaurants, etc. 40 207 — Cooked Meats 63 95 — Dairies 17 22 — Fishmongers 12 98 — Greengrocers 37 96 3 Grocers 79 275 1 Ice Cream:— Note : No Ice Cream produced during year. Manufacturers 2 2 Retailers 73 84 Public Houses 31 41 1 Street Traders 9 44 — Sweets, Confectionery 47 13 — Other Food Premises or Visits 87 17 1 School Kitchens 5 50 — Table 15.—Milk Sampling. Chemical Analysis. 37 samples of milk were taken and submitted to the Public Analyst for chemical analysis. These samples, taken from milk roundsmen and local retailers, proved to be quite satisfactory. 28 Table 16.—Sampling of Other Foods and Drugs. (a) Chemical Analysis—Samples procured under the provisions of the Food & Drugs Act, 1938, included:— Foods. Appella Gin Pork Sausages Apricots in Syrup Gooseberries in Syrup Pork Sausage Meat Auntie's Tea Scone Mix Ground Almonds Pork Sausage Rolls Bard's Orange Flavour Herring Roes Sardines Jelly Horseflesh Snap Orangeade Beef Sausages Juice of real Lemons Steak Pie Beef Sausage Meat Lemon Curd Sugary Shapes Bread Lemonade Powder Symington's Soup Cheese Malt Vinegar Tea Cherries Meat Pie Tomato Puree Flaked Rice Meat Paste Tomato Soup F'ruit Sauce Mint Sauce Whisky Garden Peas Morton's Tomato Soup 7-Up (Mineral Water) Sample No. 375—Gin. Contained 12.8% of excess water. The alcoholic strength of the sample was 43.3 degrees under proof. This was a sample of Gin taken at a Dance held on licensed premises and was purchased at the bar. The vendors were prosecuted and pleaded guilty. The Magistrates, in view of certain mitigating circumstances which tended to implicate an employee, granted an unconditional discharge, and ordered that an entry be made in the Licensing Register. Sample No. 390—Sausages—Pork. Contained only 60 % of meat instead of a minimum 65 %. After due consideration the Council decided not to institute proceedings in this case, but warned the vendor that the standard of 65 % meat content for pork sausages should be regarded as a minimum standard and not an average standard, and that serious consideration would be given in the event of further sub-standard samples. Sample No. 433—Preserved Pork Sausages. Contained:—Sulphur dioxide—430 parts per million. Sample No. 434—Pork Sausage Meat. Meat, including fat 52 %. Pork sausage meat of ordinary commercial quality contains not less than 65 % of meat, including fat. After consideration of the circumstances surrounding the purchase of this sample, and the fact that a check sample proved to be genuine, the Public Health Committee decided that proceedings be not taken in this instance, and a warning letter was sent to the producer. Sample No. 467—Canned Cherries. The can in which these cherries were contained exhibited a distinct hydrogen swell and there was a failure in the inside lacquer coating. Although the contents were not unfit for human consumption, the condition of the can would be likely to cause complaint. The sample contained 20 parts per million of tin, and 200 parts per million of iron. This sample was from a stock of canned cherries, with many other cans in a similar condition, and which were reported to the Department by the retailer. The retailer surrendered the blown tins and received credit from the wholesaler. 29 Sample No. 465—Tomato Puree. Contained 7.6 grains of tin per pound instead of a maximum of two grains. The whole of the remaining stock of this product was withdrawn from sale by the firm as a result of representation by the Department. No further action was considered necessary. Sample No. 466—Cream Tomato Soup. Contained only 0.8 % by weight of edible oil or fat, whereas cream soups ordinarily contain not less than 3½ %. It was ascertained that this consignment of soup was of Empire origin and presumably was imported before the present standards were formulated. The retailer undertook to obliterate the description "cream" from all remaining stock. (b) Bacteriological Analysis. The facilities provided by the Public Health Laboratory Service have been used for the following examinations:— (i) Ice Cream and Rinse Water. Five Samples of Ice Cream were taken and submitted for bacteriological examination. Of these, three samples were in grade 2 and two samples were in grade 4. In addition two samples of rinse water, in which ice-cream serving utensils are kept, were examined. The result was satisfactory for one of the samples, but for the other the result was not very satisfactory. Ail the unsatisfactory samples were from one establishment which voluntarily gave up the sale of ice cream. (ii) Swabs from Cups and Plates. The bacteriological results from swabs taken from two cafes were used to illustrate the necessity for improved kitchen hygiene. (iii) Sausage Meat. The result of this examination illustrated to a local butcher the need for stricter cleanliness in the preparation of his sausages and led to a distinct improvement. 30 Table 17.—Unsound Food. The following articles were voluntarily surrendered and destroyed as being unfit for human consumption:— Meat and Meat Products, etc. Other Foods Bacon lbs. 16½ Almond Paste lb. 1 Beef lbs. 463 Baby Food tins 5 Canned Meat tins 191 Biscuits lbs. 3½ Frozen Irish Rabbits lbs. 60 Bovril jars 2 Ox Tongue Roots lbs. 145 Butter lbs. 5½ Ox Tongues (home killed) lbs. 10½ Cakes — 2 Cake Mixture pkts. 76 Pigs' Tongues 5 Cereals—various pkts. 21 Pork lbs. 151 Cheese pkts. 14 Sausages (Beef) lbs. 25½ Chocolate pkts. 4 „ (Pork) lbs. 9¾ Christmas Puddings pkts. 2 Poultry Cocoa tins 23 Cooking Fat lbs. 21 Chickens lbs. 72 Eggs (liquid) tins 2 Eggs (Ducks) — 360 „ 10 Flour lbs. 273 Fish Irish Stew tins 15 Jam tins 15 Canned Fish tins 29 Margarine lbs. 13½ Dog Fish lbs. 3 Marmalade tins 10 Fruit Milk tins 26 Mincemeat jar& tin 2 Canned Fruit tins 296 Oatmeal lbs. 49 Prunes lbs. 67¾ Pastes (Fish & Meat) jars 5 „ boxes 7 Paxo Stuffing pkts. 1 Vegetables Pickles jars 6 Porridge Oats pkts. 3¾ Sauce O.K. btles 2 Baked Beans tins 11 Soup tins 12 Canned Tomatoes tins 15 Sorento Walnuts lbs. 8 Canned Vegetables tins 79 Spaghetti pkts. 111 Spice—mixed tins 4 Steak & Vegetables tin 1 Stewed Steak tins 4 Syrup tin 1 Tomato Juice tin 1 Table 18.—Slaughter-houses. The district does not now possess a slaughter-house. During the year under review 31 pigs were slaughtered on pig club premises, the slaughtering being carried out under hygienic conditions and by a licensed slaughterman. All carcases were inspected by a Sanitary Inspector. No evidence of any diseased conditions was found. 31 ROUTINE INSPECTIONS. The following premises are subject to inspection from time to time as a routine measure. Registers are maintained of these premises and appropriate action taken where conditions warrant it. Table 19.—Factories. No. of Premises on Register. Inspection. Number Written Notices Served Factories with mechanical power 137 124 4 „ without „ „ 28 25 1 Other premises in which Sect. 7 is enforced by local authorities 1 - — Total 166 149 5 Contraventions:— Discovered. Remedied. Want of Cleanliness 1 1 San. Accom.—Unsuitable/Defective 3 — Other Offences against the Act 1 1 Total 5 2 Matters referred to H.M. Inspector of Factories — Notifications received from H.M. Inspector of Factories 4 Legal proceedings:— No legal proceedings were necessary during 1952. Table 20.—Home Workers. Work Undertaken No. on Register Wearing apparel 65 Lamp Shades 13 Curtain makers and upholstery 10 Household linen 2 Instrument cases 2 Stuffed toys and Nursery Articles 5 Xmas Crackers 2 Artificial Flowers 2 Textile Weaving 1 Total 102 32 Table 21.—Other Premises. Nature of inspection Number of premises Number of visits Notices issued and complied with Schools 21 50 — Public Halls and Cinemas 5 5 — Piggeries and Stable Yards 17 78 — Public Conveniences 39 24 — In addition to the above, 121 visits were made by Sanitary Inspectors to premises in connection with infectious disease. Altogether, 293 non-effective visits were made to premises of all types where no access was gained. R. W. Simpson & Co., Ltd., Printers. 70. She en Road, Richmond, and Barnes High Street.