BARN 27 Library BOROUGH OF BARNES ANNUAL REPORT OF THE Medical Officer of Health For the Year 1959 BOROUGH OF BARNES thb ANNUAL REPORT of the Medical Officer of Health for the year 1959 ERIC PEREIRA, M.B., B.S., 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. (Eric Pereira, M.B., B.S., D.P.H.). Chief Public Health Inspector :— William L. Leach, D.PA. (London), M.A.P.H.I *†‡ Deputy Chief Public Health Inspector:— P. J. Shannon, M.A.P.H.I. *† District Public Health Inspectors:— F. A. Sadler, M.A.P.H.I. *†‡ C. E. Mallett, M.A.P.H.I. *† * Certificate of Public Health Inspectors' Board (formerly R.S.I, and J.S.I.B.). † Certificate of Royal Society of Health as an Inspector of Meat and Other Foods. ‡ Certificate of Sanitary Science as applied to Buildings and Public Works. T echnical Assistant (Clean Air J :— T. S. Rodwell. Clerical Staff :— G. W. Nickolls. Mrs. J. D. Wallis. Miss D. R. Day (Mrs. E. R. Gathard). Public Analyst:— D. D. Moir, Esq., M.Sc., F.R.I.C. PUBLIC HEALTH COMMITTEE 1959-1960. Alderman E. S. Stevens (Chairman). The Mayor (Councillor Mrs. M. E. Hull) (Deputy Chairman). Alderman F. W. Moore Alderman H. Thomas Councillor A. Beilby Councillor E. S. Bolton Councillor F. A. Coldman Councillor F. R. Cooper Councillor F. A. W. Counter Councillor M. A. E. Cresswell Councillor D. Lee Councillor Mrs. P. K. M. Lomer Councillor G. B. Naylor Councillor E. T. Rann 4 Telephone: PROspect 3443. 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 the Annual Report of the Medical Officer of Health for the year 1959, upon the Sanitary Circumstances, Sanitary Administration and Vital Statistics of the Borough. The form of the Report is in accordance with the instructions of the Minister of Health, and special mention is made of certain subjects at the Minister's request. The Report is in two parts — a Preface in which reference is made to items of particular interest, and an Appendix in which is tabulated the statistics relating to the health of the district and the work done by the Public Health Inspectors. After twelve years' service Dr. Rosetta Hill resigned her appointment as your Medical Officer of Health, and left at the end of August to take up duties in another district. She was, therefore, responsible for the work of the Department for the greater part of the year under review. I think that the Report shows that the health of the residents of the Borough has been excellent, and that a great deal of preventive work has been done to help maintain this high standard. I am indebted to Mr. Leach, Chief Public Health Inspector, who has submitted his Report on the Sanitary Circumstances of the district, and to Mr. Nickolls, Chief Clerk, who has dealt with the statistics and has prepared the Report for the printers. Finally, I wish to say that I am very happy to have been appointed your Medical Officer, and that already I have received every support and encouragement from my Chairman and Members of the Council, and from my colleagues and the staff of the Health Department. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, ERIC PEREIRA, Medical Officer of Health. 15 th July, 1960. 5 PREFACE STAFF AND DUTIES Miss D. R. Day resigned from the clerical staff early in the year, and the vacancy was filled by the appointment of Mrs. E. R. Gathard as Shorthand-Typist. Mr. T. S. Rodwell was appointed as Technical Assistant in connection with the Clean Air Act, and he commenced duty with this Department on 17.8.59. SECTION 'A' — STATISTICS AND SOCIAL CONDITIONS OF THE AREA Population. The Registrar General's estimate of the population in 1959 was 38,880 which can be compared with the 1951 census population of 40,558 and the population for 1958 which was 39, 220. Births. During the year 476 births were recorded. This figure may be compared with 456 in 1958. Both the still-birth and the infant mortality rates have fallen slightly compared with the previous year, and in both cases the rates compare favourably with those for London and for England and Wales. Deaths. The total number of deaths occurring amongst residents was 535 compared with 486 in 1958. The rate, when corrected to allow for the high proportion of elderly residents, was 11.28 per thousand population which compares favourably with other towns in the country. There were 8 deaths of infants under one year which gives an infant mortality rate of 17.1 per thousand live births compared with 18.2 in the previous year. There were no maternal deaths. Social Conditions. The Borough of Barnes, in the County of Surrey, is situated on the South Bank of the River Thames between Richmond and Putney. One of the great advantages of the Borough is the fact that open spaces comprise almost half of its area, including Richmond Park, the River Thames, Barnes Common, Sheen Common, and other parks and recreation grounds. The Borough is mainly residential in character with some light industry. 6 SECTION — GENERAL PROVISION OF HEALTH SERVICES IN THE AREA (a) Services Provided by the Surrey County Council. These are organized on a Divisional Basis, the Northern Division comprising the boroughs of Barnes and Richmond. The Medical Officer df Health for the Districts is also the Divisional Medical Officer, and this arrangement assists co-ordination of the personal health services and environmental health. Administrative, Infant Welfare and School Medical functions are carried out from the following Centres : — Divisional Health Office and Welfare Centre, King's Road, Richmond. Welfare Centre, Essex House, Barnes. Welfare Centre, North Worple Way, Mortlake. Health Visitors are employed and are based at the above centres. District 1purses and Midwives are provided and their main centre in Barnes is the Nurses Home, 31/32, Ranelagh Avenue, Barnes. They work under the direct supervision of the general practitioners. Moral Welfare or the care of unmarried mothers and illegitimate children, is undertaken by an officer based at the Divisional Health Office. A Home Help Service provides for domestic help in the home in cases of home confinement or illness. The service is under the management of the Home Help Supervisor who is based at the Divisional Health Office. An Ambulance Service is provided from the Station in King's Road, Richmond, which operates under the Control Station in Maiden. A Day Nursery for the care of children up to the age of 5 years is located at 45, Castelnau, Barnes. (b) Services Provided by the Regional Hospital Board. Hospitals. The Royal Hospital and Kingston Hospital provide general treatment for both in-patients and out-patients. In addition, many residents make use of the West London Hospital, Hammersmith and other London Hospitals. 7 Patients suffering from infectious diseases are admitted to Tolworth Isolation Hospital and to the Western Fever Hospital, Fulham. Psychiatric Services. The Medical Staff of Banstead Hospital hold out-patient clinics at the Royal Hospital on Tuesdays and Fridays for residents of Barnes and Richmond. Diseases of the Chest. A Chest Clinic is run jointly by the Regional Hospital Board and the Surrey County Council, and is located over the Welfare Centre, North Worple Way, Mortlake. Laboratory Facilities. The Laboratory of the Royal Hospital is available for specimens sent in by general practitioners. The Public Health Laboratory, Epsom is available for the examination of samples of milk and ice-cream, and any pathological specimens. The Staff is always available to assist the Medical Officer of Health in the case of epidemics or outbreaks of food poisoning. The Central Public Health Laboratory, Colindale, is available for advice, special immunizing agents and special investigations. Mortuary. This is provided and maintained by Richmond Borough Council on a site close to the Petty Sessions Court. It is well equipped with two post-mortem tables. Barnes Borough Council make an annual payment for this service. (c) Services Provided by the Surrey Executive Council. The Surrey Executive Council provides General Medical and Dental Services, Pharmaceutical Services and Supplementary Ophthalmic Services. More than twenty doctors living within the borough have undertaken to provide General Medical Services. Several of these have also undertaken to provide Maternity Medical Services. Care of the Aged and the Chronic Sick. The scheme for the care of the aged and the chronic sick is working fairly well and improves each year. 8 The Geriatrician based at Kingston Hospital has the services of a full'time Health Visitor and is able to visit and assess the needs of all cases reported as requiring admission to hospital. Continued shortage of beds in Hospitals and Homes causes delay in admission during certain months of the year, but a desperate case is invariably admitted in a very short time. Cases awaiting admission are supervised by the Geriatric Health Visitor while those who are in frail health are visited by the general Health Visitors. A great deal is done to assist the aged by the local voluntary services through schemes such as "Meals on Wheels", Old Peoples' Clubs, Chiropody, etc. The Barnes Day Club is of tremendous benefit to those who would otherwise be more or less house-bound, and there is every reason to expect that existing facilities will be expanded in the future. Laundry Service. The Council acts as an Agent for the County Council in providing this service. It is confined exclusively to patients who are incontinent, and articles laundered are limited to sheets and draw sheets. Although the number of cases served is small, the benefits to exhausted relatives are enormous. It enables them to nurse at home in comfort a patient who otherwise would have had to be admitted to hospital. National Assistance Act, 1948, Section 47. In some cases the old people create their own problems by refusing to leave their homes when they can only be properly cared for in a Hospital or a Home. Under these circumstances it becomes necessary for the Council to apply to the Court for an Order for the compulsory removal of the patient to a hospital or other suitable accommodation. During the year 29 cases of old people in need of care and attention were investigated, but formal action under this section of the Act was taken in only one instance. This was the case of an old lady who had lived alone for many years and had been neglecting herself and her home more and more during recent months. She was very dirty in her person and she repeatedly burned her legs by falling asleep while seated in front of a gas fire. The situation became even more unsatisfactory when she fell and injured her clavicle. As she still refused admission to hospital an Order was applied for and she was removed to Kingston Hospital. She settled quite nicely but died some months later. 9 SECTION 'F' — PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES Measles. There was the expected epidemic of measles which was widespread throughout the country. Of the 433 cases notified eight occurred in infants under the age of 1 year and 3 were sufficiently severe to warrant removal to hospital. Generally the disease was of moderate severity and there were no deaths. Whooping Cough. Only two cases were notified, and these were not severe enough to require admission to hospital. The majority of infants are immunnised against this disease and this is helping substantially to reduce the incidence and mortality rate. Poliomyelitis. In June a 4-year old boy was removed to hospital suspected to be suffering from non-paralytic poliomyelitis. He had received two doses of vaccine during the previous year. The diagnosis was not confirmed by culture and the child made an. uninterrupted recovery. This may have been a true case in which paralysis was prevented by vaccination, or, alternatively, the diagnosis may have been incorrect. By 1959 a high proportion of children living in the borough had received protective inoculation, and it is possible that this has contributed to the low incidence. Dysentery. Five cases of dysentery were notified. These were isolated cases and in four instances the causal organism was not isolated. In the fifth the organism was found to be Shigella Sonnei. Food Poisoning. An outbreak of food poisoning occurred amongst employees of an engineering firm, all of whom had taken a meal at a certain cafe. Symptoms of food poisoning occurred about 12 hours after consuming a meal which, in every case, included chicken. Six persons reported sick and others had very mild symptoms. All made rapid recoveries. Bacteriological investigation of the patients and food handlers proved negative, and there were no food remmants available for examination. Enquiries revealed that an undrawn chicken was delivered to the cafe on the Friday. It was cooked on the Sunday and served after re-heating on the Monday. 10 It is very probable that the outbreak was due to the unsatisfactory manner in which the chicken was dealt with. An organism known as Clostridium Welchii may be a normal inhabitant of the intestine of poultry. Long storage and faulty cooking could provide opportunity for the organism to multiply and elaborate its toxin. Cooking would destroy the organism but would leave the toxin to cause symptoms in the patient. In addition, one case of suspected food poisoning was notified. This was a girl aged 7 who had returned from a holiday in Wales. She had symptoms suggesting food poisoning but all bacteriological investigations were negative and the cause could not be established. Paratyphoid Fever. In April a woman was admitted to hospital suffering from diabetes and, in the course of investigation, it was found that she was infected with Salmonella Paratyphi B. Enquiries subsequently revealed that she had suffered from "typhoid fever" thirty years earlier, and that since then she had been subject to attacks of enteritis. It seemed therefore that this was not a recently infected case, but rather a patient who had been carrying the organism for many years. Later examination of specimens showed this to be the case. IMMUNISATION AND VACCINATION This work is organized from the Divisional Health Office, Sheen Road, Richmond, and is carried out at the Clinics and in the Schools. Prevention of Diphtheria and Whooping Cough. The majority of babies are immunized against these two diseases. Every effort is made to get as high a proportion as possible protected in the first year of life, but use of separate antigens during the warm quarters of the year makes this very difficult. Prevention of Smallpox. It is estimated that 53.1% of babies under one year old were vaccinated. This is not high enough but is considerably better than in many parts of the country. Prevention of Poliomyelitis. Supplies of vaccine were adequate throughout the year. A drive was made to complete the immunization of all children with considerable success. A scrutiny of all schools showed that with the exception of a few objectors protection was virtually complete. In the spring there was a sudden demand for protection from young people aged 15-25 years, and facilities were made available. Large numbers were immunized and, in addition, an unknown number of our young residents were given the inoculations at their place of work. 11 Prevention of Tuberculosis. B.C.G. inoculation is offered to all children who are in their 13 th year. The object is to provide artificial immunity during the adolescent period when young people are most susceptible to this disease. Mobile Radiography Unit. The Mobile Chest Radiography service for general practitioners which was organized at the end of last year has proved to be a great convenience to the local doctors and their patients. The Unit operates outside the Municipal Offices every Monday evening from 5.45 to 6.45. Patients are X'Rayed expeditiously and the Unit can readily cover the demand. Good use has been made of the service and attendance in this area is said to be the highest in Surrey. All Council employees who have not proof of recent Chest X-Ray are referred to the Unit, and the report can be a considerable help in assessing their fitness for employment. During the year 46 employees were examined in this way, prior to inclusion in Sickness and Superannuation Schemes. 12 THE REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR Mr. W. L. LEACH, IS CONTAINED IN THE FOLLOWING SECTIONS 'C', 'D' and 'E'. SECTION 'C' — SANITARY CIRCUMSTANCES OF THE AREA Water Supply. There has been no change in the method of collection, purification and storage of the domestic water supply for the district. Daily samples are taken by officers of the Metropolitan Water Board at each stage, and the results of the bacteriological and chemical examinations are summarised in Table 12. A uniformly high standard of purity and quality was maintained. The only complaints are in respect of drinking water supplied from storage cisterns. It should be obligatory for all water used for drink' ing purposes to be taken direct from the mains, as the storage cisterns are virtually the only remaining sources of potential contamination. The Boards waters are not plumbo'solvent and are derived from the non-tidal portion of the River Thames, stored in the Metropolitan Water Board reservoirs at Staines, Littleton and Walton, and filtered and chlorinated at the Hampton Works. We are indebted to Dr. Windle Taylor, Director of Water Examination to the Board, for the information in Table 12. SEWERAGE AND SEWAGE DISPOSAL During the summer months and in a spell of hot, dry weather, the receipt of strong complaints of smells from the Richmond Main Sewerage Works led to an investigation. It was discovered that effluent was being discharged to the Works at too high a temperature and creating unfavourable conditions. The matter was soon remedied and there has been no recurrence from this source. Complaints of swarms of small flies have, however, been received from residents in the vicinity of the Works. A\though energetic measures are taken regularly and frequently to combat this nuisance, control is not easy. VERMINOUS PREMISES ETC. Rodent Control. There were two major treatments of the sewers against rat infestation during 1959. Warfarin poison was used instead of the usual zinc phosphide or arsenic and proved particularly successful. It can now be said that the infestation of the sewers has been reduced to almost negligible proportions. A few areas are left where concentrated and sustained efforts should lead to complete success. The 13 number of infestations by rats and mice reported showed a substantial decline on previous years, indicating the success of modern techniques. With the presence of the River Thames on three sides of the Borough, however, coupled with the habit of many householders of throwing out too much bread "for the birds", there will always be a "reservoir" of infestation which would soon spread if eradication efforts were to be eased. Other Pests. The year 1959 was notable for a marked increase in the number of wasps' nests reported. Although the Council are under no statutory obligation to deal with these complaints, a destruction service is maintained provided the nest can be dealt with without disturbing any structural features. In all 126 wasps' nests were destroyed without charge. This is five times the usual number and was no doubt accounted for by the prolonged good weather in the summer and early autumn. ATMOSPHERIC POLLUTION The implementation of those provisions of the Clean Air Act, 1956 dealing with Smoke Control Areas was begun during the year. It was decided to commence the ten year programme, for dealing with the whole Borough, in the Castelnau area. This part of the Borough was selected because it will link up with the areas already planned in adjoining parts of West London, and thus form an ever expanding Smokeless Zone. It also has the advantage of having the River Thames on three sides to form a natural boundary, thereby reducing the number of anomalies where one house may be in a Smoke Control Area and next door may be in an area not being dealt with for some years. This No. 1 Area should be confirmed by the Minister of Housing and Local Government in 1960 and will then come into operation at the commencement of the 1961 heating season. This will allow ample time for householders to make arrangements for any necessary conversions or adaptations to their fuel burning appliances. Where appropriate, 70% grants will be paid based on the estimated minimum costs of work necessary to comply with the Clean Air Act. Householders should be very careful, however, to seek approval to their proposals before starting work if they wish to receive a Grant. Arrangements are well in hand to bring in a Second Area which will extend from Castelnau as far South as Church Road and Barnes High Street. This area may also come into operation late in 1961. The results of the observations carried out at the three recording stations in the Borough indicate an overall slight lessening of pollution from smoke. It is regretted, however, that the volume of sulphur dioxide shows no reduction. These results are now available for the 14 last four years and should provide interesting comparisons as the programme for Smoke Control Areas proceeds. The latest information on the supply position for smokeless fuels indicates that only difficulties of retail distribution remain to be resolved as production is now adequate to meet any demand, except perhaps for those who may insist on some specific proprietary brand of fuel. Complaints of pollution are confined to one or two installations which have given trouble for years. It is hoped that the expected replacement of these old furnaces with modern types will produce final and complete remedies. Even with the introduction of modern oil burning appliances, however, skilled and careful maintenance is necessary to achieve maximum economic efficiency and freedom from smoke. A surprising number of inconsiderate traders and householders continue to give offence to their neighbours by having regular bonfires on their premises in circumstances where it must be obvious that a nuisance is being caused. SECTION 'D' — HOUSING The programme for dealing with unfit properties, drawn up in November 1955, has been brought nearer completion by the closing and demolition of 12 properties during 1959. It is confidently expected that the target set five years ago will be met in 1960, despite difficulties in connection with re-housing. Although there are many obsolete type dwellings left in the Borough, nevertheless the lower standard of fitness laid down by the Housing Act, 1957 requires only that houses shall be in reasonable repair, free from damp and provided with the bare necessities for cooking and sanitary accommodation. Under present conditions houses are being vacated, sold and reconditioned, which formerly would have been allowed to decay to the point where demolition was the only answer. As a result of this policy, old houses badly designed, of poor appearance, and often crowded together, are being given disproportionate values, thereby hindering proper re-development. It is evident that, despite the continuance of protective control for the lower rated houses and flats, many tenants have become nervous of complaining about items of disrepair and fewer notices to repair have been served. To meet this, and to save certain blocks of property from decline, routine house to house inspections will be re-commenced as was the practice before the War. The demand for accommodation in this District has led to the re-occupation of many basement premises closed voluntarily in prewar years. Many of these basements are dark and damp. Usually 15 situated in large houses now carved up into "flats" many of the corrrespondingly large gardens have been built on with the result that very little can be done to improve the natural lighting to these basements. Here again the demand for accommodation of any kind results in comparatively large sums being paid to keep this poor type of dwelling in occupation. No matter how elaborately "modernised" or decorated, basements do not make satisfactory dwellings, especially in low lying districts near the River. Now that all the houses which were considered fit only for demolition and closing have been dealt with, these basements will form the bulk of the next five year programme. As a result of the influx of Commonwealth and foreign immigrants there have inevitably been a few complaints about overcrowding and unsatisfactory living conditions. The natural exuberance, colourful attire and strange habits of some of these families have been resented by established residents, but investigations rarely reveal any cause for complaint on public health grounds. OVERCROWDING The position with regard to statutory overcrowding is reasonably satisfactory, owing to the special consideration which such cases receive when allocations of Corporation dwellings are made. The number of overcrowded families re-housed during the year was 34. SECTION 'E' —INSPECTION AND SUPERVISION OF FOOD The routine supervision of food handling establishments has continued on a modest scale. Some of the outstanding problems in connection with the administration of the Food Hygiene Regulations have been probed further, and a fairly satisfactory working standard has now been formulated in connection with the provision of suitable hand washing facilities in older premises where the cost of providing proper facilities, nearer to the point of handling, would be prohibitive. Very few complaints were received regarding the quality of food sold in the shops. Competition amongst traders is now so acute that every effort is made to satisfy customers' legitimate complaints. There was only one complaint about a dirty milk bottle but several relating to mould in bread, especially sliced and wrapped bread. The general standard of food handling is reasonably satisfactory, but investigations show that expediency is still the main criteria in the food trades. The cooking of meat the day before it is to be consumed is probably the most serious of the bad practices encountered. BOROUGH OF BARNES APPENDIX to the ANNUAL REPORT of the Medical Officer of Health 1959 19 SECTION 'A' — STATISTICS AND TABLES 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. TABLE 1. —STATISTICAL SUMMARY, 1959. Area 2,650 acres Population : — Census, 1931 42,440 Census, 1951 40,558 Registrar General's estimate, mid-1959 38,880 Rating : — Number of inhabited houses 12,324 Rateable Value £894,157 Product of a penny rate £3,560 Mortality : Males Females Total Number of Deaths 250 285 535 Death Rate per 1,000 population :— Uncorrected 13.76 Corrected (Comparability Factor 0.82) 11.28 Deaths from Cancer (all ages) 100 Deaths from Measles (all ages) NIL Deaths from Whooping Cough (all ages) NIL Deaths from Diarrhoae (under 2 years of age) 1 Live Births: — Number 468 Rate per 1,000 population 12.04 Illegitimate Live Births per cent of total live births 4.49 Stillbirths: — Number 8 Rate per 1,000 total live and still births 16.8 Total Live and Still Births 476 Infant Deaths (deaths under 1 year) 8 Infant Mortality Rates: — Total infant deaths per 1,000 total live births 17.1 Legitimate infant deaths per 1,000 legitimate live births 15.66 Illegitimate infant deaths per 1,000 illegitimate live births 47.6 Neo-natal Mortality Rate (deaths under 4 week per 1,000 total live births) 14.9 Early Neo-natal Mortality Rate (deaths under 1 week per 1,000 total live births) 14.9 Perinatal Mortality Rate (stillbirths and deaths under 1 week combined per 1,000 total live and stillbirths) 31.5 Maternal Mortality (including abortion): — Number of deaths NIL Rate per 1,000 total live and still births NIL 20 Table 2. — Vital Statistics of the Borough of Barnes during 1959 and previous 5 Years. Year Registered Births Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District Total Live Births Of nonresidents registered in the District Of residents registered outside the District Under 1 year of age At all ages Number Rate per 1,000 Population Number Rate per 1,000 Population Number Rate per 1,000 live births Number Rate per 1,000 Population 1 2 3 4 5 6 7 8 9 10 11 12 1954 417 407 10.1 344 8.6 30 207 9 22.1 521 13.0 1955 437 430 10.7 334 8.3 20 218 5 11.6 532 13.2 1956 484 475 11.8 345 8.6 29 208 5 10.5 524 13.05 1957 446 441 11.2 313 7.9 17 220 9 20.4 516 13.1 1958 456 440 11.2 284 7.2 35 237 8 18.2 486 12.4 1959 476 468 12.04 333 8.6 47 249 8 17.1 535 13.8 21 Table 3. — Birth-rate, Death-rate, and Analysis of Mortality from Certain Causes during the Year 1959, with corresponding rates for England and Wales, and for the County of London for comparison. AREA AND POPULATION Live Births Deaths (excluding Stillbirths) DEATHS FROM Stillbirths Deaths of Infants under 1 year of age Malignent neoplasm lung, bronchus Whooping cough Diphtheria Tuberculosis (all forms) Influenza Acute Poliomyelitis Pneumonia Coronary and arteriosclerotic heart disease England and Wales (45,386,000) 16.5 11.6 0.46 0.00 — 0.08 0.17 0.00 0.60 1.87 20.9 22.2 London (3,204,000) 17.3 11.9 0.64 0.00 — 0.11 0.18 0.00 0.82 1.89 19.3 22.3 Barnes Borough (38,880) 12.0 11.3 0.77 — – 0.05 0.36 – 0.82 2.6 16.8 17.1 Live birth and death rates per 1,000 population. Stillbirth rates per 1,000 total (live and still) births. Infantile mortality rates per 1.000 live births. 22 Table 4. — Causes of Death during the Year 1959. Causes of Death (Registrar-General's short list of causes) Total Deaths Male Female 1 Tuberculosis, respiratory 2 1 1 2 Tuberculosis, other - — - 3 Syphilitic diseases 1 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 10 5 5 11 Malignant neoplasm, lung, bronchus 30 23 7 12 Malignant neoplasm, breast 10 - 10 13 Malignant neoplasm, uterus 4 - 4 14 Other malignant and lymphatic neoplasms 46 22 24 15 Leukaemia, aleukæmia 3 2 1 16 Diabetes 1 1 - 17 Vascular lesions of nervous system 59 17 42 18 Coronary disease, angina 100 54 46 19 Hypertension with heart disease 8 1 7 20 Other heart disease 61 25 36 21 Other circulatory diseases 50 15 35 22 Influenza 14 10 4 23 Pneumonia 32 16 16 24 Bronchitis 22 16 6 25 Other diseases of respiratory system 4 1 3 26 Ulcer of stomach and duodenum 10 8 2 27 Gastritis, enteritis and diarrhoea 4 2 2 28 Nephritis and nephrosis 3 2 1 29 Hyperplasia of prostate 6 6 – 30 Pregnancy, childbirth abortion - - - 31 Congenital malformations - - - 32 Other defined and ill-defined diseases 36 13 23 33 Motor vehicle accidents 4 1 3 34 All other accidents 9 6 3 35 Suicide 5 2 3 36 Homicide and operations of war - - - All Causes 535 250 285 23 Table 5. — Infant Mortality during the Year 1959. 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 Atelactasis 1 – - – l – – – – 1 – l Bronchopneumonia 1 - - - l - - - - l - l Heart Failure 1 - - - 1 - - - - 1 - 1 Prematurity 3 - - - 3 - - - - 3 - 3 Acute respiratory infection 1 - - - 1 - - - - 1 - 1 Acute gastro enteritis and dehydration - - - - - 1 - - - 1 - 1 7 - - - 7 1 - - - 8 - 8 24 SECTION 'F' — PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Table 6. — Notifiable Infectious Diseases, 1949 to 1959. Year 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 Diphtheria - - - - - - - - - - - Scarlet Fever 38 27 17 42 21 29 7 8 5 10 9 Typhoid Fever 1 - 2 - - 1 - - - - - Paratyphoid Fever - 1 - 1 - - 2 - 1 - 1 Puerperal Pyrexia 1 1 - 4 1 - 3 3 1 - - Erysipelas 8 4 2 8 7 2 7 2 1 1 - Continued Fever - - - - - - - - - - - Relapsing Fever - - - - - - - - - - - Typhus Fever - - - - - - - - - - - Small-pox - - - - - - - - - - - Cholera - - - - - - - - - - - Plague - - - - - - - - - - - Tuberculosis, Pul. 32 37 38 39 37 27 23 18 19 28 19 „ Non-Pul. Ac. Encephalitis (Post 6 2 1 7 3 3 3 3 4 - 1 Infectious) 1 1 - - - - - - - - - Poliomyelitis, Paralytic 10 1 - 8 3 1 7 4 1 1 - „ Non-Paralytic Ophthalmia - - - - - - 1 2 - - 1 Neonatorum - - - - - - - 1 - - - Meningococcal Infect'n - - 2 - - 2 - - - - - Measles 588 124 541 249 306 5 489 16 606 136 433 Encephalitis Lethargica - - - - - - - - - - - Polioencephalitis - - - - - - - - - - - Malaria - - - - 2 - 1 1 - 2 2 Dysentery - 3 4 11 25 75 - 4 - 3 5 Pneumonia 21 13 29 21 27 11 31 25 28 47 61 Whooping Cough 15 58 82 19 136 25 42 17 37 6 2 Food Poisoning - - - 1 11 5 10 11 5 l 25 Table 7. — Certain Infectious Diseases: Incidence per 1,000 of the Population in 1959. Disease Barnes London (a c.) England and Wales Scarlet Fever 0.23 0.82 1.05 Diphtheria - 0.02 0.00 Enteric Fever - 0.02 0.01 Acute Pneumonia 1.57 0.6 0.59 Dysentery 0.13 1.11 0.78 Acute Poliomyelitis— Paralytic - 0.04 0.02 Non-Paralytic 0.03 0.02 0.01 Food Poisoning 0.03 0.63 0.22 Tuberculosis— Respiratory 0.48 0.88 0.54 Others 0.03 0.07 0.06 Table 8. — Notifiable Infectious Diseases, 1959. Diseases Total Cases Notified Ages, in years Parish Removed to Hospital Under 1 year ] I to 2 2 to 3 3 to 4 4 to 5 5 to 9 |10 to 14 15 to 19 20 to 24 25 to 34 35 to 44 45 to 64 65 and over | Barnes Mortlake Erysipelas – – – – – – – – – – – – – – – – – Malaria 2 – – – – – – – – 2 – – – – – 2 2. Scarlet Fever 9 - - – 1 1 5 2 – – – – – – 3 6 – Whooping Cough 2 1 - - - – 1 - - - - - - - - 2 - Measles 433 8 44 46 53 52 211 11 5 – 3 — - - 166 267 3 Poliomyelitis—Paralytic - - - - - - - - - - - - - - - - - „ Non-Paralytic 1 – – – – 1 – – – – – – – – – 1 1 Pul. Tuberculosis 19 – – – – – – – 2 2 3 5 6 1 14 5 14 Non-Pul. Tuberculosis 1 – – – – – – – – – 1 – – – – 1 1 Diphtheria – – – – – – – – – – – – – – – – – Smallpox – – – – – – – – – – – – – – – – – Cholera – – – – – – – – – – – – – – – – – Plague – – – – – – – – – – – – – – – – – Tuberculosis other f'rms – – – – – – – – – – – – – – – – – Meningococcal Infect'n – – – – – – – – – – – – – – – – – Typhus Fever – – – – – – – – – – – – – – – – – Relapsing Fever – – – – – – – – – – – – – – – – – Dysentery 5 - - - 1 - 1 1 - - 2 - - - 4 1 - Ophthalmia Neonatorum – – – – – – – – – – – – – – – – – Puerperal Pyrexia - - - - - - - - - - - - - - – - - Acute Pneumonia 61 1 - 1 - 4 4 - 2 - 1 6 16 26 34 27 5 Paratyphoid Fever 1 1 - 1 1 Typhoid Fever – – – – – – – – – – – – – – – – – Food Poisoning 1 – – – – – 1 – – – – – – – – 1 – 535 10 44 47 55 58 223 14 9 4 10 11 22 28 221 314 27 26 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, 1959 are as under : — Table 9. — Tuberculosis Register. Form of Disease On Register, 1st Jan., 1959 Cases Added Removed from Register Remaining on Register, 31st Dec. 1959 Primary Notif'ns Otherwise Restored Total NonPul. Cured Left District * Dead Total Pulmonary 211 19 21 1 252 1 53 16 7 77 175 Non-Pulm'y 20 1 4 – 25 - 5 - 1 6 19 Totals 231 20 25 1 277 1 58 16 8 83 194 * Includes 5 Pulmonary cases deceased from other causes. Includes 1 Non-Pulmonary case deceased from other causes. Table 10. — Tuberculosis: New Cases and Mortality, 1959. Age-Periods New Cases* Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary Male Fem'le Male Fem'le Male Fem'le Male Fem'le 1- 5 years – – – – – – – – 5-14 „ — - — — — — — — 15-24 „ 3 2 - - - - - - 25-44 „ 11 8 2 - - - - - 45-64 „ 7 7 1 2 1 - - - 65 „ and over 2 1 - - - 1 - - All ages 23 18 3 2 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 1.05 (per l.ooo population) Non-Pulmonary 0-13 All forms 1.18 Death-rate—Pulmonary 0.05 (per l ,000 population) Non-Pulmonary Nil 27 PULMONARY TUBERCULOSIS New Notifications Deaths 28 Table 11.—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 1959 2,388 4,415 Number immunised during 1959 323 16 Number re-immunised during 1959 49 470 Total number immunised at 31st December, 1959 1,485 4,238 Percentage immunised at 31st December, 1959 62.2% 96% Whooping Cough Immunisation. Number of children immunised by primary course 323 Vaccination against Smallpox. Number of Vaccinations carried out during 1959 : — Children Primary Vaccination 297 Re-vaccination 6 Number of Vaccinations carried out at Clinics 194 Number of Vaccinations done by private doctors 103 Figures showing percentage of children under 1 year vaccinated during 1959:— Number Vaccinated under 1 year 246 Estimated Mid-year population under 1 year 463 Percentage Vaccinated 53.1% 29 SECTION 'C' — SANITARY CIRCUMSTANCES OF THE AREA Table 12.— Water Supply — Bacteriological Sampling. Type of Test WATER PASSING INTO PUBLIC SUPPLY — Hampton Works. Plate Count per millilitre on agar 20/24 hrs. at 37°C Average Result 6.7 Coliform Test (Count per 100 ml). 100.0 Negative Escherichia Coli Test (Count per 100 ml). 100% Negative Table 13. — Infected Rooms and Articles (dealt with by the Council). Premises disinfected 4 Lots of bedding disinfected 4 ,, ,, destroyed 7 Table 14. — Disinfestations (Dealt with by the Council). Disinfestation by spraying or fumigation was carried out at various premises for the following infestations : — Mosquitoes 4 Flies 7 Bugs 9 Bats 1 Wasps 126 Ants 5 Fleas 7 Beetles 3 Red Mites 1 Table 15.—Rodent Control. Summary of work carried out: — Premises visited 249 Inspections made 352 Treatment visits 526 Premises treated 95 Minor infestations of Rats 97 Minor infestation of Mice 5 30 Table 16. — Atmospheric Pollution. Deposit Gauges. Average Total Deposit expressed as Tons per sq. mile : Year. 1956. 1957. 1958. 1959. Castelnau 12.67 14.25 14.11 11.99 Furness Lodge 9.25 9.2 10.97 9.27 Lead Peroxide Instruments. Average Sulphur Dioxide (Mgms per 100 sq. cms exposed) : Year. 1956. 1957. 1958. 1959. Castelnau 1.75 2.129 2.4 2.63 Furness Lodge 2.8 2.125 2.05 2.21 Volumetric Apparatus. Average Smoke (Mgms per 100 cu metres): 1956. 1957. 1958. 1959. 19.03 20.24 14.9 14.0 Average Sulphur Dioxide (per 100 million parts of Air): 1956. 1957. 1958. 1959. 6.15 4.53 4.5 5.23 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 17.—Factories. No. of Premises on Register. Inspection. Number Written Notices Served Factories with mechanical power 144 42 – „ without „ „ 21 1 – Other premises in which Sect. 7 is enforced by local authorities 22 – –- Total 187 43 – Legal proceedings :— No legal proceedings were necessary during 1959. 31 Table 18. — Out Workers. Work Undertaken No. on Register Notices Served Wearing apparel 67 – Lamp Shades 16 – Curtain makers 3 – Stuffed Toys and Nursery Articles 1 – Xmas Crackers etc. 11 – Artificial Flowers 1 – Carding of buttons 5 – Total 104 – Legal proceedings :— No legal action was necessary during 1959. Table 19. — Other Premises. Nature of inspection Number of premises Number of visits Notices issued and complied with Schools 21 12 – Public Houses, Public Halls, Cinemas and Public Conveniences 41 38 – Stable Yards 5 2 – In addition to the above, 50 visits were made by Public Health Inspectors to premises in connection with infectious disease. Altogether, 193 non-effective visits were made to premises of all types where no access was gained. SECTION 'D' — HOUSING Table 20. — Housing Inspections. Number of houses inspected in respect of unsatisfactory housing conditions 311 Number of re-inspections 1,281 Number of houses inspected in respect of unsatisfactory living conditions, but where no repairs were required 59 Number of Informal Notices served 113 Number of Informal Notices complied with 119 32 Table 21.— Rent Act, 1957. Applications for Certificates of Disrepair. Period ended :— Dec. 57. Dec. 58. Dec. 59. l. No. of applications for Certificates 44 31 16 2. No. of decisions not to issue Certificates – – – 3. No. of decisions to issue Certificates 44 31 16 (a) in respect of some but not all defects 31 26 8 (b) in respect of all defects 13 5 8 4. No. of undertakings given by landlords under para. 5 of the First Schedule 24 21 9 5. No. of undertakings refused by local authority under proviso to para. 5 of the First Schedule – – – 6. No. of Certificates issued 10 18 8 Applications for Cancellation of Certificates. 7. Applications by landlords to local authority for cancellation of Certificates 1 14 9 8. Objections by tenants to cancellation of Certificates – 6 5 9. Decisions by local authority to cancel in spite of tenant's objection – 2 10. Certificates cancelled by local authority – 8 6 SECTION 'E'— INSPECTION AND SUPERVISION OF FOOD Table 22.— Food Premises. The following inspections were made in respect of premises where food is handled and distributed: — Nature of inspection Number of premises Number of visits Notices issued and complied with Bakehouses 8 42 2 Bread and Cakes 16 43 – Butchers 29 137 3 Cafes, Restaurants, etc. 42 145 – Canteens, etc. 10 8 – Cooked Meats 70 103 – Dairies and Milk Shops 24 26 – Fishmongers 15 49 2 Fried Fish Shops 3 9 – Greengrocers 40 87 1 Grocers 77 295 4 Ice Cream :— Retailers 93 160 1 Public Houses 30 18 – Street Traders 8 1 – Sweets, Confectionery 64 120 — 33 Table 23. — Sampling of Other Food and Drugs. (a) Chemical Analysis. —-58 Samples procured under the pn> visions of the Food and Drugs Act, 1938, included: — Foods. Bread Sweets Cakes and Confectionery Sauces Fruit Drinks Soups Jams Canned Meat Medicines „ Fish Packaged Food Mixes „ Fruit Pastes „ Veg. Pies (b) Hereunder I give the Public Analyst's reports on the samples examined which were found to be irregular or substandard. Whilst no legal proceedings were instituted the matters complained of were taken up with the manufacturers concerned with satisfactory results: Sample No. 199. — Hamburger. Hamburgers should contain about 80% or more of meat. This sample, which contained 55% meat and 150 parts per million by weight sulphur dioxide, is of the nature of beef sausage meat. If this article be regarded as uncooked beef sausage meat it is allowed to contain sulphur dioxide as a preservative provided a declaration of the addition is made in a prescribed form. The addition of preservative to Hamburgers is not justified. Sample No. 200. — Cheese Spread with Gorgonzola. Cheese spread should contain not less than 20% of butterfat and not more than 60% of moisture. This sample contained 17.6% butterfat and 61% moisture. Sample No. 205. — Pale Ale. The sample contained a flocculent sediment and a piece of matted substance which was identified as a growth of a mould of the genus Penicillium. The growth measured about l½" by ½"; it was of a yellowish green colour, with white fringes. The flocculent matter consisted partly of disintegrated mould mycclia, spores etc. Sample No. 211. — Canned Drained Peas. This article was submitted following a complaint of a bitter taste. The Analyst confirmed that the taste of these peas was unusual, but there was no evidence of the presence of any foreign or deleterious ingredients or impurities. He attributes the unusual taste to a natural condition of these particular peas. Samples Nos. 225 and 226. — Raspberry Lollies. Although these lollies contained a little fruit juice they were also strongly flavoured artificially, and a complaint as to taste had been received. Within limits, the nature and degree of this flavouring is the responsibility of the manufacturer in supplying what he believes to be acceptable to the public, and although the Analyst did not personally appreciate the flavour, he was not prepared to report against these lollies on the grounds of quality. 34 Table 24. — 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. lbs. Vegetables. lbs. Bacon 33 Baked Beans—Canned 1 Beef 163 Canned Tomatoes 14 Canned Meat 135 Canned Vegetables 6 Pork 85 Mutton 15 Rabbits 28 Other Foods. Poultry. Sausages 20 Cheese 10 Chicken (Canned) 45 Milk 6 Chicken 46 Fish. Soup 2 Orange Juice 10 Canned Fish 2 Confectionary 46 Dog-fish 84 Marmalade 1 Fruit. Cake 1 Canned Fruit 115 Various 1