Library Barn2 BOROUGH OF BARNES Annual Report OF THE Madical officer of health For the Year 1953 BOROUGH OF BARNES Annual Report OF THE Madical officer of health For the Year 1953 BOROUGH OF BARNES the Annual Report of the Medical Officer of Health for the year 1953 ROSETTA HILL, M.B., B.Ch., 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 :— William L. Leach, D.P.A. (London), M.S.I.A.*tt Deputy Chief Sanitary Inspector :— P. J. Shannon, M.S.I.A.*† District Sanitary Inspectors :— F. A. Sadler, M.S.I.A., A.M.R.S.I.*†‡ E. J. Silvester, M.S.I.A.*† * Certificate of Royal Sanitary Institute and Sanitary Inspectors Examination Joint Board, †Certificate of Royal Sanitary Institute as an Inspector of Meat and Other Foods. ‡ Certificate in Sanitary Science as applied to Buildings and Public Works. Clerical Staff:— Miss L. M. Fairclough. Mrs. J. D. Wallis. J. M. Shearer. Public Analyst :— D. D. Moir, Esq., M.Sc., F.R.I.C. PUBLIC HEALTH COMMITTEE, 1953-1954 Councillor F. A. W. Counter (Chairman) Councillor F. R. Cooper (Deputy Chairman) The Mayor (Councillor F. W. M. Moore) The Deputy Mayor (Councillor W. J. Irwin) Alderman E. S. Stevens Alderman H. Thomas, J.P. Councillor E. S. Bolton Councillor H. G. Caswell Councillor F. D. Christian Councillor W. A. Hornshaw Councillor Mrs. M. E. Hull Councillor D. Lee Councillor Mrs. D. White 4 Public Health Department, Municipal Offices, Sheen Lane, S.W.14. To the Mayor, Aldermen and Councillors of the Borough of Barnes. I have the honour to present my Annual Report for the year 1953. In accordance with the Ministry of Health Circular 1/54, the report 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. During the year the health of the Borough has been good, and the incidence of infectious disease low. The population, as estimated by the Registrar General, is now 40,110 as compared with 40,400 of the previous year. The birth rate has risen from 10.4 in 1952 to 10.8 in 1953, and the death rate is also increased from 10.8 in 1952 to 11.34 in 1953. There was a decrease in the number of deaths of infants under 1 year, there being 10 deaths this year as compared with 13 last year. The infant mortality rate for this area is 23.0 per 1,000 live births. In presenting this report I should like to express my thanks to the Council for their continued help and support, and also pay tribute to all the members of the staff for their good work and loyal co-operation throughout the year. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, ROSETTA HILL, July, 1954 Medical Officer of Health. 5 BOROUGH OF BARNES. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1953 PREFACE The Registrar General supplies 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 AND DUTIES There have been no changes of staff in the Public Health Department during the year. The Medical Officer of Health and Sanitary Inspectors carry out all the duties laid down by the Sanitary Officers Regulations, with the exception of those relating to Diseases of Animals and Public Cleansing. In addition the Sanitary Inspectors carry out the full provisions of the Shops Acts, the Pet Animals Act, Petroleum Acts, Heating Appliances (Fireguards) Act, and assist the Medical Officer of Health in connection with duties under the National Assistance Act relating to the welfare of aged, infirm or chronic sick cases. All work carried out by the Department is dealt with by the Public Health Committee with the exception that rehousing matters are taken by the Housing Committee. Shops Act matters are brought before the General Purposes Committee. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES Generally The incidence of Infectious Disease during the year was low. The cases of Scarlet Fever were only half the number of those in 1952, and there were three cases of Poliomyelitis compared with eight in the previous year. Although 1953 was the epidemic year for measles, there were only 57 cases more than in the previous year. There were no cases of Diphtheria. 6 Poliomyelitis During 1953 there were 3 cases of Poliomyelitis (Paralytic). Two of these cases, which were severe, have now completely recovered. The third case which was of moderate severity was still in hospital at 31st December 1953 and making good progress. Tuberculosis The number of new cases of Pulmonary Tuberculosis notified was two less than in 1952, and there were only three cases of Non-pulmonary Tuberculosis notified, as against 7 in 1952. Death Rate The death rate from Pulmonary Tuberculosis in 1953 was the same as last year. Seventeen persons on the Tuberculosis Register died during the year, and of these 11 were certified due to Pulmonary Tuberculosis and the remaining 6 were due to other causes. MATERNAL MORTALITY RATE There was one maternal death recorded during the year. This death occurred in hospital, and was due to obstretic shock associated with post partum haemorrhage, and toxaemia of pregnancy. INFANT MORTALITY RATE There was a decrease in the number of deaths of infants under one year, there being 10 deaths this year as compared with 13 in the year 1952. The Infant Mortality Rate for this area is thus 23.0 as compared with 26.8, the Infant Mortality Rate for England and Wales. REMOVAL OF PERSONS IN NEED OF CARE AND ATTENTION, Section 47, National Assistance Act, 1948 During the year there were reported 20 cases of old people in need of care and attention. It was not found necessary in any case to take action under Section 47 of the National Assistance Act. Although the position regarding admission of old people to hospital is still very difficult, it was possible to secure admission for all the very urgent cases through co-operation with the Regional Hospital Board. The County Welfare Department was always most helpful in providing residential accommodation for suitable cases. FOOD POISONING Number of cases notified11 Number of deaths Nil Two of the cases were children attending school in another area where there was an outbreak following consumption of a school dinner. The cause of the outbreak was proved to be infected dried milk, which had been used in the preparation of cream, and the infecting organism 7 was a coagulase positive staphylococcus. The illness, although severe at onset, was of short duration. Four of the cases occurred in an outbreak in a food factory of a neighbouring area, when a meal of stuffed ox heart and sauce served in the canteen was suspected as being the cause. The illness was slight. The remaining five were single cases, where it was not possible to discover the cause. In some cases there was none of the suspected food available for examination, and in others no specific organisms were isolated. FOOD The conditions under which food is stored, prepared or offered for sale have again received considerable attention. It is gratifying to note that there were no serious outbreaks of food poisoning originating in this district. The obscurity of the causes of infection emphasises the need for sustained vigilance and the maintenance of a high standard of conduct and premises in the catering trades. A single lapse from strict cleanliness may lead to severe illness or even death. There must be many cases of minor food poisoning which are not reported and investigated. It is the policy of the Department to inculcate the simple principles of food hygiene whenever the opportunity occurs during inspections of food premises. Some food handlers are naturally clean in their persons and habits. Others require continual supervision, and it should be possible to exclude these persons from employment in the food trades. One local food trader, on being requested to protect some exposed food from flies, promptly pulled out his pocket handkerchief and " flicked " the flies from the food, which incidentally was of a nature highly susceptible to infection ! HOUSING It is the declared policy of the Government that the pre-war campaign against bad housing conditions shall now be resumed. The general position in Barnes is that there are no large scale areas for slum clearance. There is a considerable amount of bad housing through improper conversions and adaptations of old property, and there is also a certain amount of property which is nearing the end of its useful life. These conditions are not to be compared with those existing in the large industrial towns, nor in the crowded districts of the East End of London. Nevertheless, poor housing causes a great amount of discomfort and unhappiness, and vigorous action can now be taken to improve the general standard of housing accommodation. It will be necessary for a fairly detailed survey to be made so that proposals can be formulated and a policy decided. Unfortunately the tempo of the campaign must be regulated to the rehousing position. 8 Property owners are to receive increased rents only where the houses are in good repair, both as respects structure and decoration. Those owners whose property is already in poor repair will receive no increases presumably because appropriate amounts have not been spent on repairs in past years. These owners will now have to find the money to bring their property up to a reasonable standard or sell it at its market value. The problem of the dilapidated house can now be dealt with. There remains, however, one feature of sub-standard housing in the district for which there is no statutory remedy. This is the lack of privacy inherent in the house which has been adapted for occupation by more than one family. Unless the houses have been properly converted families have to share common staircases, landings, bathrooms, sanitary conveniences, yards, etc. This causes a great deal of inconvenience and leads to unpleasantness and, in some cases, open strife. The new standard of fitness does not take a lack of privacy into account at all. Is it that domestic privacy, like hot water supply and a fixed bath, is considered a luxury ! The recently published Census Report for the County of Surrey reveals some very interesting figures showing the housing position in Barnes. The actual figures must be treated with some reserve because of the varying interpretations put on the questions asked on the Census forms, and answered by the housholders. For instancee, it would appear from the figures returned on the forms that there were 775 families (excluding those in shared dwellings) who did not have the exclusive use of a piped water supply from a tap. As far as the Department is aware there are only one or two such cases, and these are in circumstances peculiar to themselves. From these figures it appears that nearly 2,000 households have not the use of a fixed bath. Over 75% of the people living in houses occupied by more than one family (2,697 persons) have either not got the use of a bath or must share with members of another family. SANITARY CIRCUMSTANCES The question of the accumulations of refuse and discarded articles which are dumped in back passages, etc., referred to in my last Annual Report has not improved at all. Nearly all cases of rat infestation investigated reveal these unnecessary dumps which harbour vermin. It has been necessary to take formal action in a few cases. A new scale of charges has been fixed by the Council for the removal of rubbish which does not come within the ordinary domestic refuse category. The charges are considered to be very reasonable, and members of the public and traders should make greater use of this service. Unfortunately, however, the cost of dealing with incombustible refuse is 9 still a problem, and the Council cannot undertake to dispose of such material as builders' refuse, rubble, etc. Pest control measures have proved quite effective. Very few complaints have been received, and the number of rat infestations of property has been markedly reduced. All stagnant pools and marshy ground is treated early in the season. Places where animals are kept are visited regularly, and no undue difficulty has been experienced in preserving the amenities of the Borough. ATMOSPHERIC POLLUTION The Council has agreed to set up apparatus for measuring the amount of pollution in the air. There is a Deposit Gauge, for ascertaining the total deposited matter, a Daily Smoke Filter, which continuously extracts a sample of the air, filters it, and determines the amount of sulphur dioxide in the sampled air, and a Lead Peroxide Instrument for estimating the extent of pollution. These are all standard instruments and the results will be used in the nation-wide survey which is now being undertaken. It is to be hoped that before long some definite proposals will be issued so that uniform action can be taken by all authorities in the London area to eliminate atmospheric pollution. It would be possible to take certain action to establish smokeless zones within small areas in which the Council control all buildings, but this would impose some restrictions on the inhabitants of these areas which may be considered as being unjustified. Perhaps in the redevelopment schemes for the older parts of the Borough, consideration may be given to this aspect of planning for the future. SEWERAGE AND SEWAGE DISPOSAL The Richmond Main Sewerage Board is the authority for sewage disposal. The work of modernising the disposal plant is almost complete, but the final changeover is being held up by staffing difficulties. Meanwhile, the Engineer and his staff have perforce to keep the plant in operation as best they can. In spite of these difficulties no complaints whatever have been received by this Department from the operation of the disposal works. It is hoped that the new layout and plant will be fully operational well before the end of 1954, when the full benefits of reorganisation will be realised. 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. Many minor complaints about defective fittings, bursts, etc. have been referred to the Board, and then have invariably had prompt and efficient attention. Borough of Barnes APPENDIX to the ANNUAL REPORT of the Medical officer of health 1953. 13 STATISTICS and TABLES BOROUGH OF BARNES. VITAL STATISTICS. The following statistical information relating to the Borough hu,s 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, 1953. Population :— Census, 1931 42,440 Census, 1951 40,558 Estimated—Mid-year, 1953 (Registrar General) 40,110 Births :— Birth-rate (per 1,000 of population) Uncorrected 10.8 Corrected (Registrar General's Comparability Factor l'OO) 10.8 Live Births :— Total. M. F. Legitimate 420 197 223 Illegitimate 14 7 7 Total 434 204 230 Still Birth-rate (per 1,000 total births) 16.1 Total . M. F. Still Births (Legit. 6; Illegit. 1) . 7 2 5 Ueaths :— Death-rate, all causes (per 1,000 of population) Uncorrected 14.0 Corrected (Registrar General's Factor 0.81) 11.34 Total M. F. Deaths (all causes) 563 272 291 Death-rate from Cancer (per 1,000 of population), 94 deaths 2.3 Death-rate fromZymotic(Epidemic) Diseases (per 1,000 of population) 0.05 Death-rate from Maternal Causes (per 1,000 total births) Pregnancy ; Child-birth; Abortion (1 death) 2.3 Death-rate of infants (per 1,000 live births) (a) Under 4 weeks of age (9 deaths) 20.7 (b) Under 1 year (10 deaths) 23.0 Legitimate infants (9 deaths) . . 20.7 Death-rate Legitimate infants (1 death) .. 2.3 14 COMPA RA 77 VE BIRTH C PEA TH RA TES per 1000 population 15 Table 2.—Vital Statistics of the Borough of Barnes during 1953 and previous 5 Years Year. Registered Births Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett. Number. Rate. 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 1 2 3 4 5 6 7 8 9 10 11 12 1948 460 576 142 252 62 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 1953 453 434 10.8 387 9.6 17 194 10 23.0 564 14.1 16 Table 3.— Birth.rate, Death.rate, and Analysis of Mortality during the Year 1953, with corresponding rates for england and wales, 160 great towns, 160 smaller towns, and for the County of London for comparison. Birthrate PERl.ooo Total Population. All Causes. Annual Death.Rate per 1,000 Population Death rate per 1,000 Births. maternal Mortality Rate per 1,000 Total Births Typhoid Paratyphoid Whooping Cough. Diphtheria, Tuberculosis Influenza, Small.pox Poliomyelitis Enceph. , Pneumonia Diarrhcea and Enteritis (under 2 years). Total Deaths under One Year. All Causes Puerperal Infection. Other Causes. England and Wales 15.5 11.4 0.00 o.oi o.oo 0.20 0.16 — 001 0.55 1*1 26.8 0.76 0.52 0.24 160 County Boroughs and Great Towns, including London 17.0 12.2 o.oo 0.01 0.00 0.24 0.15 - o.o1 0.59 1.3 30.8 Not available 160 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census, 1951) 15.7 11.3 0.00 o.oo o.oo 0.19 0.17 - o.o1 0.52 0.9 24.3 London 17.5 12.5 — 0.00 o.oo 0.24 0.15 — o.o1 0.64 1.1 24.8 Barnes Borough 10.8 11.34 - - - 0.30 0.25 - - 0.75 — 23.0 - - - 17 Table 4.— Causes of Death during the Year 1953. Causes of Death (Registrar-General's short list of causes) Total Deaths Male Female 1 Tuberculosis, respiratory 11 6 5 2 Tuberculosis, other 1 1 — 3 Syphilitic diseases 2 2 — 4 Diphtheria - — — 5 Whooping Cough — — — 6 Meningococcal infections — — — 7 Acute poliomyelitis — — — 8 Measles — — — 9 Other infective and parasitic diseases — — — 10 Malignant neoplasm, stomach 11 4 7 11 Malignant neoplasm, lung, bronchus 14 13 1 12 Malignant neoplasm, breast 9 — 9 13 Malignant neoplasm, uterus 9 — 9 14 Other malignant and lymphatic neoplasms 51 25 26 15 Leukaemia, aleukaemia 3 1 2 16 Diabetes 3 2 1 17 Vascular legions of nervous system 91 27 64 18 Coronary disease, angina 71 54 17 19 Hypertension with heart disease 10 4 6 20 Other heart disease 70 25 45 21 Other circulatory diseases 40 19 21 22 Influenza 10 6 4 23 Pneumonia 30 11 19 24 Bronchitis 27 23 4 25 Other diseases of respiratory system — — — 26 Ulcer of stomach and duodenum 7 1 6 27 Gastritis, enteritis and diarrhoea 5 2 3 28 Nephritis and nephrosis 6 4 2 29 Hyperplasia of prostate 2 2 — 30 Pregnancy, childbirth abortion 1 — 1 31 Congenital malformations 8 6 2 32 Other defined and ill-defined diseases 52 22 30 33 Motor vehicle accidents 5 4 1 34 All other accidents 12 6 6 35 Suicide 2 2 — 36 Homicide and operations of war — — — All Causes 563 272 291 18 Table 5.— Infant Mortal1ty dur1ng the Year 1953. Causes of death, at var1ous ages, of 1nfants 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 1n the Borough Deaths outs1de Borough Bronch1al Obstruct1on by b1rth, flu1d due to 1nattent1on at b1rth 1 .. .. .. 1 .. .. .. .. 1 1 .. Prematur1ty 1 .. .. .. 1 .. .. .. .. 1 .. 1 Congen1tal Heart D1sease— Mongol1an, Mental Def1c1ency .. .. 1 .. .. .. .. .. .. 1 .. 1 Anencepholy 1 .. .. .. 1 .. .. .. .. 1 .. 1 Myelocele .. 1 .. .. 1 .. .. .. .. 1 .. 1 Congen1tal Heart D1sease— S1ngle Ventr1cle and absent pulmonary trunk 1 .. .. .. 1 .. .. .. .. 1 .. 1 Inter-cran1al haemorrhage— Operat1ve del1very 1 .. .. .. 1 .. .. .. .. 1 .. 1 Atelectas1s (Pulm.)— Hyal1ne Membrane d1sease Prematur1ty 1 .. .. .. 1 .. .. .. .. 1 .. 1 Prematur1ty 1 .. .. .. 1 .. .. .. .. 1 .. I Congen1tal Heart d1sease .. .. .. .. .. .. .. .. 1 1 1 .. All causes 7 1 1 .. 9 .. .. .. 1 10 2 8 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. Inc1dence of Not1f1able Infect1ous D1seases. Compar1son between the 1nc1dence of certa1n of the not1f1able 1nfect1ous d1seases 1n Barnes, and 1n London and England and Wales, 1s shown on next page. 19 Table 6.—Infectious Diseases: Incidence per 1,000 of the Population in 1953. Disease. Barnes London England and Wales Typhoid Fever - 0.01 0.00 Paratyphoid Fever - 0.01 0.01 Meningococcal Infection - 0.03 0.03 Scarlet Fever 0.52 1.02 1.39 Whooping Cough 3.39 3.30 3.58 Diphtheria - - 0.01 Erysipelas 0.17 0.12 0.14 Small-pox - - - Measles 7.63 8.09 12.36 Pneumonia 0.67 0.73 0.84 Acute poliomyelitis (including polioencephalitis) Paralytic 0.07 0.07 0.07 Non-paralytic - 0.03 0.04 Food Poisoning 0.30 0.38 0.24 Puerperal Pyrexia 0.02 28.61 18.23 Dysentery 0.62 - - Malaria 0.05 - - Table 7.—Notifiable Infectious Diseases, 1953. Diseases. Total Cases Notified Ages, in years. Parish Removed to Hospital Total Daths of Residents† Under 1 year 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 65 65 and over Barnes Mortlake Diphtheria - - - - - - - - - - - - - - - - - - Scarlet Fever 21 - - - 4 - 14 1 - - 2 - - - 6 15 4 - Poliomyelitis 3 - - - 1 - 1 - - - 1 - - - - 3 3 - Measles 306 7 16 - 75 - 197 8 1 - 2 - - - 82 224 6 - Whooping Cough 136 15 6 - 29 - 80 3 1 - 2 - - - 36 100 3 - Pul. Tuberculosis 37 - - - - - - 3 2 7 10 5 9 1 11 26 27 11 Non-Pul. Tuberculosis 3 - - - - - - - 1 1 1 - - - 2 1 2 1 Pneumonia 27 - - - - - - 3 - 6 - - 13 5 16 11 2 5 Erysipelas 7 - - - - 1 - - - - - - 3 3 4 3 - - Ophthalmia neonatorum - - - - - - - - - - - - - - - - - - Meningococcal Infect'n - - - - - - - - - - - - - - - - - - Puerperal Pyrexia 1 - - - - - - - - 1 - - - - 1 - - - Typhoid - - - - - - - - - - - - - - - - - - Dysentery 25 - - - - 11 - 6 - - - 7 1 - 14 11 - - Food Poisoning 11 - - - - - - 2 - - - 6 2 1 4 7 1 - Para Typhoid - - - - - - - - - - - - - - - - - - Malaria 2 - - - - - - - - 2 - - - - 2 - 2 - All Diseases 579 22 22 - 109 12 292 26 5 17 18 18 28 10 178 401 50 17 † 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. 20 Table 8.—Notifiable Infectious Diseases, 1943 to 1953. Year 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 Diphtheria 3 15 12 5 2 3 - - - - - Scarlet Fever 184 50 36 43 27 30 38 27 17 42 21 Typhoid Fever 2 - - - - - 1 - 2 - - Paratyphoid Fever 1 - - 1 - - - 1 - 1 - Puerperal Pyrexia 1 - 3 1 - - 1 1 - 4 1 Erysipelas 5 10 3 5 10 10 8 4 2 8 7 Continued Fever - - - - - - - - - - - Relapsing Fever - - - - - - - - - - - Typhus Fever - - - - - - - - - - - Small-pox - - - - - - - - - - - Cholera - - - - - - - - - - - Plague - - - - - - - - - - - Tuberculosis. P. 43 50 39 35 62 40 32 37 38 39 37 „ Non-P. 7 1 6 5 9 5 6 2 1 7 3 Ac. Encephalitis (Post Infections) - - - 2 1 - 1 1 - - - Poliomyelitis - - - 1 4 4 10 1 - 8 3 Ophthalmia Neonatorum 1 1 1 2 2 1 - - - - - Meningococcal Infect'n - - - - - - - - 2 - - Measles 111 68 358 177 437 158 588 124 541 249 306 Encephalitis Lethargica - - - - - - - - - - - Polioencephalitis - - - - 1 - - - - - - Malaria 1 - - - - - - - - - 2 Dysentery 2 1 9 71 - 4 - 3 4 11 25 Pneumonia 20 18 20 19 16 20 21 13 29 21 27 Whooping Cough 82 108 71 66 94 56 15 58 82 19 136 Food Poisoning - - - - - - - - - 1 11 Table 9.—Schools. N umber of Schools attended Number of scholars who suffered from:— Scarlet Fever Diphtheria County Primary Schools:— 7 Church of England, Mullins Path 1 - Castelnau Cty. Prim. (Fanny Road) 1 - Darell Road, Richmond—Nursery 1 - East Sheen Cty. Prim. 4 - Mortlake Cty.—Nursery 1 - Mortlake, R.C. 1 - Westfields 1 - Private Schools:— 4 Froebel School, Roehampton 2 - Gateways, East Sheen 1 - Old Vicarage, Richmond 1 - Tower House 1 - Total 11 15 - 21 PULMONARY TUBERCULOSIS 22 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, 1953, are as under:— Table 10.—Tuberculosis Register. Form of Disease. On Register 1st Jan, 1953 Cases Added. Removed from Register. Remaining on Register 31st Dec., 1953 Primary Notif ns Otherwise. Restored Total NonTub. Cured Left District Dead Total Pulmonary 303 37 32 3 375 1 34 35 17 87 288 Non-Pulm'y 43 3 1 - 47 - 6 - 1 7 40 346 40 33 3 422 1 40 35 18 94 328 Table 11.—Tuberculosis: New Cases and Mortality, 1953. 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 „ - - - - - - - - 5-10 „ - - - - - - - - 10-15 „ 2 1 - - - - - - 15-20 „ 1 3 - - - - - - 20-25 „ 7 9 1 1 1 1 - - 25-35 „ 10 12 - 1 - - - - 35-45 „ 6 5 - - 1 1 - - 45-55 „ 8 1 1 - 1 - 1 - 55-65 „ 2 1 - - 4 1 - - 65 ,, and over 2 2 - - 4 3 - - All ages 38 34 2 2 11 6 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 0.90 Non-pulmonary 0.07 All forms 0.97 Death-rate Pulmonary .42 Non-pulmonary .02 All forms 0.44 23 Table 12.—IMMUNISATION and VACCINATION. Diphtheria Immunisation. The following Table shows the state of Diphtheria Immunisation of the Children of Barnes:— Infants 0-4 inclusive School Children 5-14 inclusive Estimated Child population 2,449 4,442 Number immunised during 1953 334 27 Number re-immunised during 1953 42 267 Total number immunised during 1953 1,410 4,100 Percentage immunised at 31st December, 1953 57.6% 92.3% Whooping Cough Immunisation. Number of children immunised by primary course 407 Number of children who had a reinforcing injection 25 Vaccination against Smallpox. Number of Vaccinations carried out during 1953:— Children Adults Primary Vaccination 370 15 Re-vaccination 13 117 Number of Vaccinations carried out at Clinics 272 12 Number of Vaccinations done by private doctors 111 120 Figures showing percentage of children under 1 year vaccinated during 1953:— Number Vaccinated under 1 year 334 Live births 1952 431 Percentage Vaccinated 77.5% 24 Table 13.—Infected Rooms and Articles (Dealt with by the Council). Premises disinfected 42 Lots of bedding disinfected 34 „ „ destroyed 3 HOUSING Table 14.—HOUSING STATISTICS FOR THE YEAR 1953. 1. Number of Dwellings Owned by the Local Authority:— Number of houses 260 Total 775 „ „ flats 515 (Including corporate properties.) 2. Unfit Houses. Informal Action Number of unfit or defective houses repaired during the period as a result of informal action by the local authority or officers under the Public Health or Housing Acts 195 Number of houses inspected in respect of unsatisfactory living conditions, but where no repairs were required (excluding Overcrowding and Verminous houses) 326 Total number of inspections (including re-inspections) made in respect of unsatisfactory housing conditions 2,006 Action under Statutory Powers Public Health Acts Number of houses in which defects were remedied after service of formal notices :— (a) By owners 33 (b) By local authority in default of owners 1 Housing Act, 1936 Number of Houses made fit after service of formal notices (Sections 9, 10, 11 and 16:)— (a) By owners 4 (b) By local authority in default of owners — Proceedings under sections 11 and 13 of the Housing Act, 1936:— (a) Number of dwelling-houses in respect of which Demolition Orders were made Nil (b) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil 25 Proceedings under section 12 of the Housing Act, 1936:— (a) Number of separate tenements or underground rooms in respect of which Closing Orders were made 1 (b) 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. (?) Number of inspections made to cases of alleged overcrowding 8 (ii) Number of revisits 3 (in) Number of overcrowded families rehoused 7 ABSTRACTS FROM 1951 CENSUS REPORT COUNTY OF SURREY 40,281 residents comprised 13,665 households (families) and occupied 61,040 rooms. 1,400 rooms were vacant. Density of Persons in Private Houses Persons per Habitable Room. (A normal standard is considered to be 1 person per room. Both living and sleeping rooms are counted. More than 2 persons per room is tending to overcrowding.) Density Number of Houses Number of Persons affected All Households Shared Dwellings More than 3 persons per room 24 .2 % 18 124 2-3 persons per room 83 0.6 % 50 438 l½-2 335 2.5 % 189 1,502 1-1½ 931 6.8% 303 4,607 Less than 1 „ 12,292 89.9% 2,975 33,610 The following abstracts are of interest showing extent of overcrowding :— One-roomed Dwellings In 117 cases 2 persons were accommodated in One room only. „ 40 „ 3 „ „ „ „ 15 4 „ „ „ „ 5 „ 5 „ „ „ „ 1 case 6 „ „ „ 26 Two-roomed Dwellings In 137 cases 3 persons were accommodated in Two rooms only. „ 44 „ 4 „ „ „ „ 11 „ 5„ „ „ „ 4 „ 6 „ „ „ „ 1 case 8 „ „ „ „ 1 ,, 10 or more persons were accommodated in Two rooms only. In 1931 3.03% of. residents occupied homes at density of more than 2 persons per room. In 1951 1.40% do. do. Household Arrangements in Private Houses All Households Houses occupied by more than one family Total Number 13.655 3.535 Piped Water Supply inside Dwelling Sharing with other Householders 2,629 19% 1,854 53% Without 13 11 Cooking Stoves Sharing with other Householders 798 7% 671 23% Without 175 154 Kitchen Sink Sharing with other Householders 999 10 % 857 34% Without 425 359 Water Closet Sharing with other Householders 2,150 16% 1,813 51% Without 10 4 Fixed Bath Sharing with other Householders 2,513 33 % 2,166 76% Without 1,954 531 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 15 houses or flats, including 4 Council-owned properties, by Corporation staff. 10 lots of bedding, furniture, etc., were destroyed, mainly as a result of deaths or infestation. INSPECTION AND SUPERVISION OF FOOD. Table 15.—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 38 - Bread and Cakes 17 41 3 Butchers 29 151 1 Cafes, Restaurants, etc. 40 177 3 Cooked Meats 62 107 - Dairies 16 33 - Fishmongers 11 88 2 Greengrocers 42 133 - Grocers 75 242 6 Ice Cream:— Note:No Ice Cream produced during year. Manufacturers 2 13 Retailers 74 100 Public Houses 31 40 — Street Traders 9 16 — Sweets, Confectionery 56 84 — School Kitchens 5 16 — Table 16.—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 17.—Sampling of Other Foods and Drugs. (a) Chemical Analysis.—76 Samples procured under the provisions of the Food & Drugs Act, 1938, included:— Foods. Barker's Extra Savoury Marmalade Beef Sausage Meat Marzipan Chocolates Breakfast Sausage Marzipan Coconut in Syrup Meat Soup Cream of Chicken Soup Milk Pudding "Ambrosia" Chicken Noodle Soup Mint Jelly Celery Soup Mixed Fruit Drops Coloured Eggs Pork Sausages Custard Powder Randall's Milk Chocolate Cake Flour with Eggs Raspberry Jelly de Luxe Cream Rich Christmas Pudding Fruit Gums "Ribena" (1 bottle) Fruit Drops Sandwich Spread Gee's Linctus B.P.C. Spearmint Wafers Garden Mint in Vinegar Stewed Steak Garden Peas Stoned Dates Glucose Fruit Drops Sweetened Afternoon Tea Cakes Gin Sweets Halibut Liver Oil Capsules Tomatoes Honey Veal and Ham Paste Irish Mince Meat Welsh Rarebit Kidney Soup Whisky Lemon Curd White Pepper Liver Sausage Wine Gums Malt Vinegar The following samples were reported as being sub-standard or otherwise irregular:— Sample No. 25—Halibut-Liver Oil Capsules. These capsules contained 6050 units of vitamin A per capsule. The standard of the British Pharmaceutical Codex for the vitamin A content of Capsules of Halibut-liver Oil is 3750 units to 5250 units in each capsule. These capsules therefore contained 15% more vitamin A than the maximum permitted by the B.P.C. The question of the content and labelling of this article was taken up with the manufacturers, and it is confidently expected that suitable modification will be effected. There is no appreciable risk to consumers. Sample No. 4—Malt Vinegar Contained 0.9% of added salt which is not a natural ingredient of malt vinegar. Sample No. 27—Gee's Linctus G.P.C. Weight per ml. at 20° C. slightly in excess of B.P.C. maximum. The weight per ml. of this sample was 1.192 g. whereas the B.P.C. limits are 1.175-1.185 g. in the opinion of the Public Analyst the reason for the higher weight per mil. of this sample was the presence of a slightly higher proportion of total sugars than is normal in this medicament. In other respects the sample conformed with the standard. The attention of the vendor was drawn to the result of the analysis of this sample. As a result the remaining stock was withdrawn from sale, and fresh supplies will be closely checked. 29 Sample No. 28—Vinegar. Contained 1.0% of added salt. Salt is not a natural ingredient of malt vinegar. This was loose vinegar. Although there was a printed statement on the bulk container that the vinegar contained added salt, no statement was made or notice given at the time of purchase. The attention of the vendor was drawn to this irregularity. Sample No. 39—Channel Island Milk. Contained only 3.32% of butterfat instead of a minimum of 4% This was a routine sample of milk purchased from a roundsman. The colour of the cap on the bottle, the price paid, and the Public Analyst's report indicated that the milk was intended to be Tuberculin Tested (Pasteurised) Milk. As such it would be genuine. The embossed label, however, read "Channel Island Milk—Pasteurised". Investigation showed that there had been a failure to change the labelling machinery when this milk was being bottled. No one was actually prejudiced, and arrangements have been made to ensure that this does not happen again. (b) Bacteriological Analysis.— The facilities provided by the Public Health Laboratory Service have been used for the following examinations:— Ice Cream and Rinse Water. Five samples of Ice Cream were taken and submitted for bacteriological examination:— Of these, four samples were in Grade I, and one sample was in Grade III. In addition one sample of rinse water, in which ice cream serving utensils are kept, was examined. Result unsatisfactory. Coliform bacilli = more than 1,800 per 100 ml. Faecal coli present. Colony count = more than 1 million per ml. Appropriate advice was given in respect of the unsatisfactory samples. 30 Table 18.—Unsound Food The following articles were voluntarily surrendered and destroyed as being unfit for human consumption:— Where quantities are insufficient for salvage all unsound food is collected and disposed of at the Council's Refuse Destructor, by incineration. Meat and Meat products, etc. Other Foods Bacon lbs. 14 Biscuits lbs. 30½ Beef lbs. 1,158¾ Butter lbs. 11 Canned Meat lbs. 352½ Cake Mixture pkts. 42 Lambs' Tongues lb. ¾ Cereals lb. 1 Mutton lbs. 11½ Cheese lbs. 39 3/8 Pork lbs. 10 3/4 Chocolates lbs. 70 Pork Pies 19 at 6d. each Confectionery lbs. 2½ „ 1½ at 3s. each Flour lbs. 24 Pork Sausages lbs. 45¼ Fruit Cordials bottles 2 Sausage Rolls 44 at 4d. each Ground Almonds lbs. 6 Steak & Vegetables (Canned) lbs. 13 Honey lbs. 4 Jam lbs. 40 3/4 Poultry Margarine lbs. 66 Rabbits lbs. 91 Marmalade lbs. 17 Fish Meat Paste ozs. 3 3/4 Canned Fish lbs. 15½ Milk (Canned) lbs. 2½ Cod stones 2 „ „ pints 80 3/4 Dog Fish stones 8 Pickles lbs. 7¼ Frozen Herrings stones 8 Puddings — 6 Golden Fillets lbs. 14 Robinson's Patent Barley lbs. 15 Skate stones 8 Whiting lbs. 14 Sandwich Spread lb. ¼ Fruit Sauces lbs. 10 3/8 Canned Fruit lbs. 696 1/8 Soups lbs. 37 1/8 Dates lbs. 6 5/8 Spaghetti lb. 1 Prunes lbs. 29 3/4 Sponge Mixture lbs. 13½ Sugar lbs. 22 Prunes in Syrup (Canned) lbs. 22½ Syrup lb. 5/8 Tea lbs. 40 Vegetables Tomato Juice lbs. 3¼ Canned Baked Beans lbs. 10 White Loaves (large) - 2 Canned Baked Beans in Tomato Sauce lbs. 38 3/4 Canned Tomatoes lbs. 50 3/8 Canned Vegetables lbs. 36 5/8 Potatoes cwts. 10 Table 19.—Slaughter-houses. The district does not now possess a slaughter-house. During the year under review 38 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 20.—Factories. No. of Premises on Register. Inspection. Number Written Notices Served Factories with mechanical power 136 106 4 „ without „ „ 22 27 1 Other premises in which Sect. 7 is enforced by local authorities 1 — — Total 159 133 5 Discovered. Remedied. Contraventions:— San. Accom. Unsuitable/Defective 4 4 Insufficient 1 1 Total 5 5 Matters referred to H.M. Inspector of Factories — Notifications received from H.M. Inspector of Factories 5 Legal proceedings:— No legal proceedings were necessary during 1953. Table 21.—Home Workers. Work Undertaken No. on Register Wearing apparel 79 Lamp Shades 12 Curtain makers and upholstery 9 Household linen 2 Furniture and Upholstery 2 Stuffed toys and Nursery Articles 4 Xmas Crackers 2 Artificial Flowers 3 Textile Weaving 1 Total 114 32 Table 22.—Other Premises. Nature of inspection Number of premises Number of visits Notices issued and complied with Schools 20 22 — Public Halls, Cinemas and Public Conveniences 44 51 1 Piggeries and Stable Yards 15 38 1 In addition to the above, 236 visits were made by Sanitary Inspectors to premises in connection with infectious disease. Altogether, 334 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.