Library BARN 22 BOROUGH OF BARNES Annual Report OF THE Medical Officer of Health For the Year 1954 BOROUGH OF BARNES the Annual Report of the Medical Officer of Health for the year 1954 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.'tJ Deputy Chief Sanitary Inspector:— P. J. Shannon, M.S.I.A.*† District Sanitary Inspectors:— F. A. Sadler, M.S.I.A., A.R.San.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, 1954-1955 Councillor F. W. M. Moore, Deputy Mayor, (Chairman) Councillor F. R. Cooper (Deputy Chairman) The Mayor (Councillor G. T. Craker) Alderman E. S. Stevens Alderman H. Thomas, J.P. Councillor E. S. Bolton Councillor F. A. W. Counter Councillor Mrs. M. E. Hull Councillor F. J. Hutton Councillor W. J. Irwin 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. Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report for the year 1954. In accordance with the Ministry of Health Circular 28/54, 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 very low. The population, as estimated by the Registrar General, is now 40,170 as compared with 40,110 of the previous year. The birth rate has fallen from 10.8 in 1953 to 10.1 in 1954, and the death rate has also decreased from 11.34 in 1953 to 10.5 in 1954. There was a decrease in the number of deaths of infants under 1 year, there being 9 deaths this year as compared with 10 last year. The infant mortality rate for this area is 22.1 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, August, 1955 Medical Officer of Health. 5 BOROUGH OF BARNES. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1954 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 very low. There was a slight increase in the number of cases of Scarlet Fever, there being 29 cases as compared with 21 in 1953. There was only one case of Poliomyelitis notified during the year. The very low figure of 5 cases of measles occurred during the year. There were no cases of Diphtheria. t 6 Poliomyelitis The case of Poliomyelitis notified was a woman who had a slight degree of paralysis. She made a good recovery with no residual paralysis. Tuberculosis There was a marked decrease in the incidence of Pulmonary Tuberculosis, there being 10 cases less than in the previous year. The Non-pulmonary cases notified were 3, being the same as in the previous year. Death Rate There were 8 deaths from Pulmonary Tuberculosis during 1954. Ten persons whose names were included in the Tuberculosis Register died during the year, of these eight were certified due to Pulmonary Tuberculosis and the remaining two were due to other causes. This compares favourably with 11 deaths due to Pulmonary Tuberculosis in the previous year. MASS RADIOGRAPHY UNIT Arrangements were made for the Mass Radiography Unit of the South-West Metropolitan Regional Hospital Board, to visit the borough from 5th February to 22nd February 1954, 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 widely publicised. The numbers attending showed a substantial increase on the previous visit. I feel that many more people should avail themselves of this opportunity of having an annual X-ray of chest, which is a most important check-up on health. I give below a brief summary of the findings of the Survey:— Male Female Total Total number X-rayed 1,484 1,930 3,414 Pulmonary tuberculosis—ACTIVE 3 2 5 Pulmonary tuberculosis—INACTIVE 66 82 148 Non-tuberculous abnormalities 74 67 141 MATERNAL MORTALITY RATE One maternal death occurred where the interval between the maternal condition and death was stated to exceed 12 months. INFANT MORTALITY RATE The number of deaths of infants under one year was one less than in 1953. 7 The Infant Mortality rate for this area is thus 22.1 as compared with 25.5 the Infant Mortality rate for England and Wales. REMOVAL OF PERSONS IN NEED OF CARE AND ATTENTION, Section 47, National Assistance Act, 1948 There were reported 20 cases of old people in need of care and attention during the year. In only one case was it found necessary to take action under Section 47 of the National Assistance Act. The patient was a woman aged 91 years, who was suffering from grave chronic disease, living in insanitary conditions and was unable to devote to herself, and was not receiving from other persons, proper care and attention. She was removed to Barnes Hospital where she died five weeks later. Dysentery In September there was an outbreak of dysentery in Mortlake County Primary School. The infecting organism was Shigella Sonnei, which gives rise to a mild form of dysentery. Cases were isolated as soon as possible and referred to their own doctors for treatment. Contacts were excluded from school until bacteriological examinations were proved negative. Altogether there were 73 notified cases in this epidemic; a big proportion of these were children in the age group 5-7 years. Two other cases of Sonnei dysentery occurred earlier in the year, but were not related to this epidemic. FOOD POISONING Number of cases notified 5 Number of deaths Nil Three of these cases occured in a factory canteen, where the cause was found to be "braised steak", which had been cooked and then reheated before serving. The infecting organism was Clostridium Welchii. One case was a child of 1 year of age, who developed an infection with Salmonella Typhi-murium, the source of which was not traced. One case was a man who became ill immediately on his return from Germany; he travelled by air. The infecting organism was found to be Salmonella San Diego, and the food suspected of causing it was thought to be cream, although this was not proved. FOOD The general standard of Food Hygiene has been maintained and in certain cases, mainly where premises have changed hands or new premises opened, there has been considerable improvement. With the older premises, however, it is evident that food hygiene is practised 8 only where it pays cash dividends or where failure to comply with the obvious requirements of the Food and Drugs Act would result in penalties. With the employees it seems that expediency comes first and too high a proportion are careless, thoughtless and conscienceless in handling and preparing food which others must eat. Employers have not the same control of staff as in less flourishing times and it may be necessary to deal more directly with workers in food premises who contravene the Food Byelaws. Unfortunately, visits of inspection are necessarily limited and odd acts of neglect and abuse are often not sufficiently serious to warrant proceedings. They do, however, give a good indication of what goes on most of the time and it may be necessary to take a few examples. There is evidence that some of the practices adopted during war time periods of shortage and difficulty are being kept up. Butchers are still incorporating odd lumps of fat in rolled " joints " and slices of " bread and butter " are often really " bread and marge "! Buyers should be more precise in their ordering so that complaints can be taken up and dealt with. Too often it is found that the customer merely asked for " A pound of that " or " About seven and sixpence worth please The requirements as to labelling of food have been tightened up considerably in recent years and fewer exaggerated claims are being met with. HOUSING After about twelve months' experience of the working of the Housing Repairs and Rents Act 1954 the conclusions arrived at are that it has been only moderately successful. Whereas it was forecast that wholesale increases would be imposed and that the Department would be inundated with applications for Certificates of Disrepair this has not proved to be the case. The forms have proved to be almost beyond the comprehension of the average small landlord and the tenants. The principles behind the increase have been only partly understood and there has been more comparison with what increases neighbours have suffered (or escaped) than with the relationship between repairs and rents! The most noticeable failure has been in respect of Improvement Grants. Not a single application was received in respect of rented properties in 1954 and this experience seems to be common in other areas. A preliminary survey of houses likely to be the subject of Closing or Demolition Orders reveals comparatively few which will need to be dealt with. The good work carried out in pre-war years, when systematic house to house inspections were made and wholesale repairs effected, has proved to have been the means of preserving many hundreds of the older houses. 9 In dealing with housing repairs the new standard of fitness still leaves much to be desired. A local authority must decide whether or not a house is unfit before action can be taken to secure necessary repairs. The standard requires that the house shall be considered unfit if, and only if, it is so far defective that it is not reasonably suitable for occupation in that condition. Presumably no action can be taken to enforce minor repairs and defects are to be allowed to become serious before remedial action can be taken. The label " unfit house " should be reserved for houses which are scheduled for early demolition. Houses which require repair only could then be considered from a different standpoint and more regard could be had to amenities and appearance, which have such an effect on the happiness and comfort of the occupants. Such items as defective plaster and badly fitting doors and windows could then be considered on their own demerits rather than on the grounds of actual prejudice to health, which is difficult to sustain in many cases, especially where tenants are obviously fit. The necessity to rehouse displaced families now living in insanitary conditions is an added burden on the overcrowded waiting lists. Is it better for a family to live in a damp, dark and dreary basement with enough room and privacy, than to eat and sleep crowded into a small bedroom grudgingly made available by relatives or landladies of " furnished " bedsitters ? These are the families who must compete with the tuberculous, the severe cardiac cases and those who are unfortunate enough to have been rehoused in requisitioned premises. There has been comparatively little difficulty in securing necessary repairs to houses. Lack of funds is still the main reason for neglect, another being the lack of care taken by tenants in helping to maintain their homes. Routine inspections for reconditioning are to be resumed shortly and a better impression will then be obtained as to whether the backlog of neglect over the past fifteen years can be made up, and whether rent increases are having the desired effect. ATMOSPHERIC POLLUTION Some delay has been occasioned because the site proposed for the installation of recording apparatus for the daily measurement of smoke and sulphur dioxide was not acceptable to the Department of Scientific and Industrial Research (Fuel Research Station) and no other suitable site could be found. It has now been possible to site the apparatus at the new Civil Defence Training Centre and it is hoped to commence readings at an early date so that we can play our part in filling the gaps in the knowledge of conditions in the London Area. It is not known yet how far the proposals for a cleaner atmosphere envisaged in the Bill 10 now to be introduced will affect this district but it must be several years before conditions of fuel supply and the modifications of fuel burning appliances will enable positive results to be achieved. SANITARY CIRCUMSTANCES The absence of complaints of flies has been noticeable and can be mainly attributed to the discontinuance of the street pig bins. The usual measures were taken to deal with places likely to harbour mosquitoes, midges etc. A troublesome infestation by midges arose in the Glentham Road area due to a plague of " Chironomidae (Midges). These insects breed in the reservoirs and emerge in clouds to cluster in doorways, street lamps and around windows. Experience of worse trouble in other areas has enabled remedial steps to be taken but unfortunately the infestation in Barnes did not follow true to pattern and the trouble arose when it was not expected. The situation is being watched and it is hoped that preventive measures will be taken in time in future. SEWERAGE AND SEWAGE DISPOSAL The new sewage disposal works are now in operation. Some trouble has been experienced with effluvia but it is hoped that arrangements can be made to overcome this. There is a certain amount of injurious matter finding its way into the sewers from time to time which is difficult to trace. 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 they have invariably had prompt and efficient attention. BOROUGH OF BARNES APPENDIX to the annual report op the Medical Officer of Health 1954. 13 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, 1954. Population:— Census, 1931 42,440 Census, 1951 40,558 Estimated—Mid-year, 1954 (Registrar General) 40,170 Births:— Birth-rate (per 1,000 of population) Uncorrected 10.1 Corrected (Registrar General's Comparability Factor l.00 10.1 Live Births:— Total. M. F. Legitimate 390 200 190 Illegitimate 17 9 8 Total 407 209 198 Still Birth-rate (per 1,000 total births) 24.6 Total. M. F. Still Births (Legit. 10) . 10 3 7 Deaths:— Death-rate, all causes (per 1,000 of population) Uncorrected 12.9 Corrected (Registrar General's Factor 0.81) 10.5 Total M. F. Deaths (all causes) 518 248 270 Death-rate from Cancer (per 1,000 of population), 100 deaths 2.5 Death-rate from Zymotic (Epidemic) Diseases (per 1,000 of population) 0.02 Death-rate from Maternal Causes (per 1,000 total births) Pregnancy; Child-birth; (1 death) 2.5 Death-rate of infants (per 1,000 live births) (a) Under 4 weeks of age (7 deaths) 17.2 (b) Under 1 year (9 deaths) 22.1 Death-rate for Legitimate infants (7 deaths) 17.2 Illegitimate infants (2 deaths) 4.9 14 COMPARATIVE BIRTH & DEATH RATES 15 Table 2.—Vital Statistics of the Borough of Barnes during 1954 and previous 5 Years Year. Registered Births Total Deaths Registered in the District Transferable Deaths Nett Deaths belonging to the District. Un. corrected 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. Number. Kate per 1,000 nett births Number Rate 1 2 3 4 6 6 7 8 9 10 11 12 1949 247 516 126 326 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 1954 423 407 10.1 344 8.6 30 207 9 22.1 521 13.0 16 Table 3.—Birth-rate, Death-rate, and Analysis of Mortality during the Year 1954, with corresponding rates for england and wales, 160 great towns, 160 smaller towns, and for the County of London for comparison. Birthrate per l,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 Diarrhœa and Enteritis (under 2 years). Total Deaths under One Year. Total Maternal Mortality Maternal causes (excluding abortion) Due to Abortion England and Wales 15.2 11.4 0.00 0.01 0.00 0.18 0.19 — 0.01 1.93 0.8 23.0 0.69 0.58 0.11 160 County Boroughs and Great Towns, including London 16.8 12.0 0.00 0.01 0.01 0.20 0.16 — 0.01 2.00 0.8 29.2 Not available 160 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census, 1951) 15.4 11.4 0.00 0.01 o.oo 0.17 0.18 — 0.01 1.97 0.5 23.8 London 17.5 11.7 — 0.00 o.oo 0.19 0.02 — o.oo 0.49 0.00 15.4 Barnes Borough 10.1 10.5 — — — 0.20 0.02 — — 0.65 — 22.1 — — — 17 Table 4.—Causes of Death during the Year 1954. Causes of Death (Registrar-General's short list of causes) Total Deaths Male Female 1 Tuberculosis, respiratory 8 5 3 2 Tuberculosis, other — — — 3 Syphilitic diseases 3 2 1 4 Diphtheria — — — 5 Whooping Cough — — — 6 Meningococcal infections — — — 7 Acute poliomyelitis — — — 8 Measles — — — 9 Other infective and parasitic diseases 1 1 — 10 Malignant neoplasm, stomach 11 5 6 11 Malignant neoplasm, lung, bronchus 20 17 3 12 Malignant neoplasm, breast 12 — 12 13 Malignant neoplasm, uterus 6 — 6 14 Other malignant and lymphatic neoplasms 51 22 29 15 Leukæmia, aleukæmia 3 3 — 16 Diabetes — — — 17 Vascular legions of nervous system 90 31 59 18 Coronary disease, angina 75 48 27 19 Hypertension with heart disease 14 5 9 20 Other heart disease 58 25 33 21 Other circulatory diseases 30 12 18 22 Influenza 1 1 — 23 Pneumonia 26 16 10 24 Bronchitis 26 19 7 25 Other diseases of respiratory system 4 2 2 26 Ulcer of stomach and duodenum 4 2 2 27 Gastritis, enteritis and diarrhœa — — — 28 Nephritis and nephrosis 5 1 4 29 Hyperplasia of prostate 4 4 — 30 Pregnancy, childbirth abortion 1 — 1 31 Congenital malformations 3 2 1 32 Other defined and ill-defined diseases 45 16 29 33 Motor vehicle accidents 3 2 1 34 All other accidents 11 5 6 35 Suicide 3 2 1 36 Homicide and operations of war — — — All Causes 518 248 270 18 Table 5.—Infant Mortality during the Year 1954. 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 Cerebral Contusion, Rapid delivery, Prematurity 1 .. .. .. .. .. .. .. .. 1 .. 1 Asphyx1a neonatorum, Massive diaphragmatic hernia 1 .. .. .. 1 .. .. .. .. 1 .. 1 Polycystic disease of kidney, Prematurity 1 .. .. .. 1 .. .. .. .. 1 .. 1 Congestive cardiac failure, Cyanoctic congenital heart .. .. .. .. .. 1 .. .. .. 1 .. 1 Anencephaly 1 .. .. .. 1 .. .. .. .. 1 .. 1 Atelectasis, Extreme prematurity 1 .. .. .. 1 .. .. .. .. 1 .. 1 Post mortem—Open verdict 1 .. .. .. 1 .. .. .. .. 1 1 .. Prematurity 1 .. .. .. 1 .. .. .. .. 1 .. 1 Broncho Pneumonia, Otitis Media .. .. .. .. .. .. .. 1 .. 1 1 .. 7 .. .. .. 7 1 .. 1 .. 9 2 7 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. 19 Table 6.—Infectious Diseases: Incidence per 1,000 of the Population in 1954. Disease. Barnes London England and Wales Typhoid Fever 0.02 0.01 0.03 Paratyphoid Fever — 0.01 Meningococcal Infection 0.05 0.03 0.03 Scarlet Fever 0.72 0.73 0.97 Whooping Cough 0.62 1.40 2.39 Diphtheria — — 0.04 Erysipelas 0.05 — 0.12 Small-pox — — — Measles 0.12 2.23 3.33 Pneumonia 0.27 0.45 1.20 Acute poliomyelitis (including polioencephalitis) Paralytic 0.02 0.02 0.03 Non-paralytic — 0.01 0.01 Food Poisoning 0.12 0.32 0.20 Dysentery 1.87 1.28 0.72 Table 7.—Notifiable Infectious Diseases, 1954. Diseases. Tote! Cases Notified Ages, in years. Parish Removed to Hospital Total Deaths of Residents† Under 1 year 1 to2 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 29 — 2 — — — 23 2 — — 2 — — — 8 21 3 — Poliomyelitis 1 — — — — — — — — — 1 — — — — 1 1 — Measles 5 — — — 1 — 2 2 — — — — — — — 5 — — Whooping Cough 25 3 2 1 4 — 12 1 — 1 1 — — — 12 13 — — Pul. Tuberculosis 27 — — — 1 — — — 2 5 6 4 7 2 11 16 — 8 Non-Pul. Tuberculosis 3 — — — — — — — — — 1 1 — 1 1 2 — — Pneumonia 11 — 1 1 — — — 3 — — — 1 4 1 6 5 1 — Erysipelas 2 — — — — — — — — — — — 1 1 1 1 — — Ophthalmia Neonatorum — — — — — — — — — — — — — — — — — — Meningoccal Infection 2 1 — 1 — — — — — — — — — — 2 — — — Puerperal Pyrexia — — — — — — — — — — — — — — — — — — Typhoid 1 — — — — — — — — — — 1 — — — 1 — — Dysentery 75 — 1 4 5 6 30 11 4 1 6 3 1 3 4 71 1 — Food Poisoning 5 — 1 — — — — — — — 2 2 — — 3 2 — — Para Typhoid — — — — — — — — — — — — — — — — — — All Diseases 186 4 7 7 11 6 67 19 6 7 19 12 13 8 48 138 6 8 †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, 1944 to 1954. Year 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 Diphtheria 15 12 5 2 3 — — — — — — Scarlet Fever 50 36 43 27 30 38 27 17 42 21 29 Typhoid Fever — — — — — 1 — 2 — — 1 Paratyphoid Fever — — 1 — — — 1 — 1 — — Puerperal Pyrexia — 3 1 — — 1 1 — 4 1 — Erysipelas 10 3 5 10 10 8 4 2 8 7 2 Continued Fever — — — — — — — — — — — Relapsing Fever — — — — — — — — — — — Typhus Fever — — — — — — — — — — — Small-pox — — — — — — — — — — — Cholera — — — — — — — — — — — Plague — — — — — — — — — — — Tuberculosis, P. 50 39 35 62 40 32 37 38 39 37 27 „ Non-P. 1 6 5 9 5 6 2 1 7 3 3 Ac. Encephalitis (Post Infections) — — 2 1 — 1 1 — — — — Poliomyelitis — — 1 4 4 10 1 — 8 3 1 Ophthalmia Neonatorum 1 1 2 2 1 — — — — — — Meningococcal Infect'n — — — — — — — 2 — — 2 Measles 68 358 177 437 158 588 124 541 249 306 5 Encephalitis Lethargica — — — — — — — — — — — Polioencephalitis — — — 1 — — — — — — — Malaria — — — — — — — — — 2 — Dysentery 1 9 71 — 4 — 3 4 11 25 75 Pneumonia 18 20 19 16 20 21 13 29 21 27 11 Whooping Cough 108 71 66 94 56 15 58 82 19 136 25 Food Poisoning — — — — — — — — 1 11 5 Table 9.—Not included this year. 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, 1954, are as under:— Table 10.—Tuberculosis Register. Form of Disease. On Register, 1st Jan, 1054 Cases Added. Removed from Register. Remaining on Register 31st Dec., 1954 Primary Notifications Otherwise. Restored Total NonTub. Cured Left District Dead Total Pulmonary 288 27 13 — 328 — 19 22 10 51 277 Non-Pulm'y 40 3 1 — 44 — 3 2 — 5 39 Totals 328 30 14 — 372 22 24 10 56 316 Table 11.—Tuberculosis: New Cases and Mortality, 1954. 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 „ — — — 1 — — — — 10-15 „ — 1 — — — — — — 15-20 „ 1 1 — — — — — — 20-25 „ 5 3 — — 1 — — — 25-35 „ 6 5 1 — 1 1 — — 35-45 „ 4 3 — 1 1 1 — — 45-55 „ 4 1 — — 1 — — — 55-65 „ 2 1 — — 1 — — — 65 „ and over — 2 — 1 — 2 — — All ages 22 18 1 3 6 4 — — *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 0.67 All forms 0.74 Non-pulmonary 0.07 Death-rate —Pulmonary .24 All forma 0.24 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 2,363 * 4,511 Number immunised during 1954 506 57 Number re-immunised during 1954 78 683 Total number immunised during 1954 1,554 4,197 Percentage immunised at 31st December, 1954 65.8% 93.0% Whooping Cough Immunisation. Number of children immunised by primary course 525 Number of children who had a reinforcing injection 57 Vaccination against Smallpox. Number of Vaccinations carried out during 1954:— Children Adults Primary Vaccination 273 29 Re-vaccination 18 104 Number of Vaccinations carried out at Clinics 182 7 Number of Vaccinations done by private doctors 109 126 Figures showing percentage of children under 1 year vaccinated during 1954:— Number Vaccinated under 1 year 236 Live births 1953 438 Percentage Vaccinated 53.9% 24 Table 13.—Infected Rooms and Articles (dealt with by the Council). Premises disinfected 23 Lots of bedding disinfected 20 „ „ destroyed 4 HOUSING Table 14.—HOUSING STATISTICS FOR THE YEAR 1954 1. Number of Dwellings Owned by the Local Authority:— Number of houses 252 Total 788 „ „ flats 536 (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) 352 (b) Number of inspections made for the purpose 1,435 (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 (iii) 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 126 (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 20 cases outstanding from the previous year) 104 25 (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 3 cases from 1953) 42 (b) By Local Authority in default of owners B. Proceedings under Public Health Acts:— (i) Number of dwelling-houses in respect of which notices were served, requiring defects to be remedied 16 (ii) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners (including 13 cases from 1953) 17 (b) By Local Authority in default of owners 5 (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 Closing Orders were made 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 13 (ii) Number of revisits — (iii) Number of overcrowded families rehoused 9 26 4. Disinfestation. As the Borough Cleansing Station is not now in use, arrangements were made for the treatment of one person (female) for scabies at the Medicinal Baths of the Hammersmith Borough Council. Disinfestation by spraying or fumigation was carried out in 11 houses or flats, including 2 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 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 10 30 — Bread and Cakes 18 33 2 Butchers 28 128 2 Cafes, Restaurants, etc. 42 144 2 Cooked Meats 63 69 — Dairies and Milk Shops 25 7 — Fishmongers 11 53 1 Greengrocers 43 85 2 Grocers 75 220 3 Ice Cream:— Note: No Ice Cream produced during year. Manufacturers 2 1 Retailers 75 40 Public Houses 31 38 — Street Traders 8 5 — Sweets, Confectionery 56 36 — School Kitchens 5 26 — Table 16.—Milk Sampling. Chemical Analysis. 34 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, except No. 25 :— Sample No. 25—Milk. Slightly deficient in milk solids other than milk fat. The freezing point did not indicate the presence of added water. 27 Table 17.—Sampling of Other Foods and Drugs. (a) Chemical Analysis.—70 Samples procured under the provisions of the Food & Drugs Act, 1938, included:— Foods. Almond Macaroon Biscuits Grapes—White and Black Apples Ground Almonds Apple rings Ground Nutmeg Apricots—dried Ground White Pepper Baked Beans Honeycomb Mould—Raspberry Beef Sausages Jelly Beef Sausage Meat Lettuce Bubble Gums Margarine and 10 % Butter Buckling Meat Soup Cauliflower Muscatels Certo Fruit Pectin Neville's Brownie Cheese Spread Peppermints Chicken—Boned Piccalilli Chicken Broth Pickles Chocolate Drink Prunes Chop Sauce Pork Sausages Cream Buns Pork Sausage Meat Cream Powder—synthetic Rock Lobster Cream Slices Scotch Kippers Cream Square "Sherbits" Currants Smoked Cod Fillet Dressed Crab Sponge Mix (sweetened) Flaked Rice Sprouts Foto Gums Stewed Steak Fruit Pectin Strawberries Fruit Loaf Tomatoes—Canned Gees Linctus Pastilles Tomato Ketchup Gelatine Tomato Puree Glycerine Lemon and Honey Pastilles Whiskey The following sample was reported as being sub-standard or otherwise irregular:— Sample No. 52—Chicken—Boned. A statement on the can in which this article was sold stated " The dry content of this tin is 6 oz. being the equivalent of approx. 10 oz. boneless raw chicken ". Although the drained cooked chicken meat amounted to just over 6 oz. the dry solids content of the combined chicken and juice was only 3.22 oz. The sample contained:— Liquid Juice—9.5 oz. Drained chicken meat—6.2 oz. Dry solids—3.22 oz. This sample was from old stock and the remaining cans were withdrawn from sale. 28 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 Beans with Pork lbs. 2 Biscuits lbs. 14 Beef lbs. 953¼ Blancmange packets 3 Canned Meat lbs. 192 2/8 Cereals lbs. 16 Beef lbs. 953i Cheese lbs. 8 1/8 Canned Steak and Vegetables, etc. lbs. 21½ „ boxes 3 „ packet 1 Pork lbs. 34 Cheese Spread lbs. 1½ Pork Chipolates lbs. 2 Chocolate Mallows 1 tin contg. 64 Pork Sausages lbs. 13 Coffee lb. 3 Tongues (Lambs) lb. 1 Flour lbs. 57¼ Fruit Cocktail bottle 1 Poultry Jam lbs. 52 3/4 Canned Rabbit lb. 1 Lyons Quoffy lbs. 2 3/4 Marmalade lbs. 4 Fish Mayonnaise lb. ¼ Canned Fish lbs. 48¼ Milk pints 66 Cod stones 5 „ tins 8 Dog Fish stones 7¼ Mint Sauce lb. 7/8 Kippers lbs. 14 Nescafe tin 1 Skate stones 7 Orange Juice lb. 1 1/8 Whiting stones 7 Pickles lbs. 5/8 Puddings — 12 Fruit Sandwich Spread lb. ½ Canned Fruit lbs. 453 1/8 Sauces lbs. 8¼ Cochineal bottle 1 Vegetables Soups lbs. 32 1/8 Baked Beans lbs. 23 5/8 Spaghetti lbs. 2J Canned Tomatoes lbs. 41 5/8 Split Peas lb. ¾ Canned Vegetables lbs. 29 ½ Vitacup lb. ¾ Table 19.—Slaughter-houses. The district does not now possess a slaughter-house. During the year under review 30 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. 29 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 139 99 4 „ without „ „ 22 5 — Other premises in which Sect. 7 is enforced by local authorities 3 3 1 Total 164 107 5 Discovered Remedied Inadequate Ventilation 1 1 Sanitary Conveniences (s.7)— (a) Insufficient 1 1 (b) Unsuitable or defective 2 1 Other offences against the Act (not including offences relating to Outwork) 1 1 Total 4 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 1954. Table 21.—Home Workers. Work Undertaken No. No. on Register Wearing apparel 83 Lamp Shades 12 Curtain makers and upholstery 8 Household linen 2 Stuffed toys and Nursery Articles 4 Xmas Crackers 2 Artificial Flowers 6 Textile Weaving 1 Total 118 30 Table 22.—Other Premises. Nature of inspection Number of premises Number of visits Notices issued and complied with Schools 21 26 - Public Halls, Cinemas and Public Conveniences 44 28 1 Piggeries and Stable Yards 15 46 - In addition to the above, 425 visits were made by Sanitary Inspectors to premises in connection with infectious disease. Altogether, 308 non-effective visits were made to premises of all types where no access was gained. W Simpson & Co.. Ltd:. 'Printers. 70. Sheen Road. Richmond, and Barnes High Street.