RBAR 3 BARWET RURAL DISTRICT Annual Report OF THE MEDICAL OFFICER OF HEALTH For the Year 1940 BY CHARLES F. HARDIE, M.A., M.B., B.Ch. (Cantab) TOGETHER WITH The Report OF THE SANITARY INSPECTOR A. D. S. BLACKHALL, A.R.San.I. BARNET RURAL DISTRICT Annual Report OF THE MEDICAL OFFICER OF HEALTH For the Year 1940 BY CHARLES F. HARDIE, M.A., M.B., B.Ch. (Cantab) TOGETHER WITH The Report OF THE SANITARY INSPECTOR A. D. S. BLACKHALL, A.R.San.I. Members of the Council Chairman: R. J. MACNAUGHTON, J.P. Vice-Chairman : G. I. BREW Members : E. H. CLARK T. H. COCHRANE H. T. A. DASHWOOD, M.A., J.P. REV. CANON A. R. T. EALES, M.A. MRS. A. M. R. HOOPER W. G. TAYLER J. R. YOUNG. Medical Officer of Health : CHARLES F. HARDIE, M.A., M.B., B.Ch.(Cantab.) Sanitary Inspector: A. D. S. BLACKHALL, A.R.San.I. Junior Clerk : J. S. RUCK Public Health Department: 11 Shenley Road, Boreham Wood, Herts Annual Report OF THE MEDICAL OFFICER OF HEALTH 4 To the Chairman and Members of the Bar net Rural District Council. Mr. Chairman, Madam and Gentlemen, I have much pleasure in presenting the annual report on the health of the district for the year 1940, which was prepared by Dr. Hardie for whom I have been acting since April 1941. The Minister of Health in Circular 2314 of the 26th March, 1941, has recommended that interim reports only should be made in respect of the year 1940 and that all statistical information if omitted from the report should be carefully preserved. In this report therefore, wherever curtailment is compatible with completeness, it has been effected ; the usual tables have however been incorporated in the report in order that the annual records in respect of the district may, as far as practicable, be continuous and complete. As was the case during the first year of war much has been accomplished during the year now under review despite additional duties imposed upon the staff. That there has been no relaxation in the attentions devoted to public health matters is borne out by the Sanitary Inspector's records of inspections, notices served and improvements effected during the year. Details of these will be found on pages 11, 12 and 13 respectively. The Measles and Whooping Cough Regulations came into force during the year whereby these diseases became notifiable. A minor epidemic of measles was experienced towards the close of the year. I am, Your obedient Servant, G. Winn Everett, Acting Medical Officer of Health. 5 SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 8339 acres Population, 1921 Census 4>5i3 Population, 1931 Census 6,400 Registrar-General's estimate of (a) resident population mid-1940 10,800 (b) average population appropriate to the calculation of death rates 10,800 Number of inhabited houses , (end of 1940) accordiner to Rate Books Elstree 1,936 2.559 Shenley 548 Ridge 75 Rateable Value (1st April, 1941) £114,810 Estimated product of a penny rate (1st April, 1941) £380 SOCIAL CONDITIONS Vide Annual Report for 1939. VITAL STATISTICS Total M. F. Live Births Legitimate 135 69 66 Illegitimate 9 3 6 Birth Rate : 13.3 per 1,000 estimated resident population mid-1940. Stillbirths 1 1 — Rate : 6.9 per 1,000 total (live and still) births. Deaths 70 39 31 Death Rate : 6.48 per 1,000 estimated average population. The Comparability Factor of 1.11 (furnished by the RegistrarGeneral to correct anomalies in age and sex distribution, compared with the country as a whole) gives a Standardised Death Rate of 7.19. The Death Rates tor England and Wales and tor the Administrative County of London respectively are given as 14.3 and 17.8 per 1,000 population. 6  Deaths Rate per 1,000 total (live and still) births. Deaths from puerperal causes:— Puerperal sepsis Nil — Other puerperal causes Nil — Total Nil — Death rates of infants under one year of age:— All infants per 1,000 live births 27.8 Legitimate infants per 1,000 legitimate live births 29.6 Illegitimate infants per 1,000 illegitimate live births — Deaths from Cancer (all ages) 10 Deaths from Measles (all ages) — Deaths from Whooping Cough (all ages) — Deaths from Diarrhoea (under 2 years of age) — SECTIONS B, C, D and E. Sections B to E dealing respectively with general provision of health services for the area, sanitary circumstances of the area, housing and food inspection have been omitted from my report as there is nothing noteworthy to add to the details given on pages 8 to n of my report for 1939. Statistics which fall within the purview of these sections are given in the Sanitary Inspector's Report, which opens on page 10. SECTION F PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES There were 35 cases of Scarlet Fever of which 7 occurred in private households; of this latter number 6 were removed to hospital. The remaining 28 cases occurred among the patients and staff of the Middlesex Colony, Shenley. 7 The following table gives details of the incidence of notifiable diseases during the year: Disease Total notified Total cases admitted to Hospital Total Deaths Smallpox — — — Scarlet Fever 35 34 — Diphtheria 1 1 — Enteric Fever — — — Puerperal Fever — — — Puerperal Pyrexia — — — Pneumonia 2 — — Erysipelas 8 — — Ophthalmia Neonatorum — — — Measles 136 — — Malaria — — — Whooping Cough 5 — — Cerebro-spinal fever 2 2 — Age-Group Under 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 25 35 to 45 45 to 65 65 and up Scarlet Fever 1 14 13 4 3 Measles 3 10 7 9 9 78 14 3 3 Diphtheria 1 1 Pneumonia 1 1 spinal Fever 1 1 Whooping Cough 1 4 Erysipelas 1 1 1 4 1 Tuberculosis—New cases and mortality during 1940. Age Periods New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. 1-5 1 5-10 1 20-25 2 25-35 2 35-45 1 45-55 1 1 Totals 5 3 1 1 3 Annual Report OF THE SANITARY INSPECTOR 10 To the Chairman and Members of the Bar net Rural District Council. Mr. Chairman, Madam and Gentlemen, My second annual report, abridged in accordance with the recommendations of the Ministry of Health, has been pruned and attentuated ad nauseam ; it goes to press in the semblance of a catalogue, tabulated statement upon tabulated statement, dull and spiritless. Nevertheless, its compilation has been a pleasant task, and though the crust is not so nicely browned as I would wish, the pie is full of meat ! Duties in connection with billeting and rehousing developed apace towards the close of the year when there was a considerable influx into the district of homeless persons and certain priority classes from evacuation areas. The work involved made tremendous inroads into my time and in the multiplicity of other civil defence duties which were assigned to me there were moments when I might almost have forgotten that I was primarily a sanitary inspector. Indeed I hope that ultimately, when the tumult and the shouting have died, such I shall be, wholeheartedly and unfettered. For vital public health work must and shall go on ; wars and rumours of wars retard the ennobling pursuit but cannot subdue it. Not once, even in the thick of these extraneous obligations, have I been tempted to apostrophize the spirit of public health with the words of Henry V's admonition to Falstaff—" I know thee not, old man ; fall to thy prayers " ! Two years in your service have heightened my indebtedness to my colleagues for their ungrudging co-operation and as I place my report in your hands I cannot but reiterate with renewed sincerity my profound gratitude to you for your continued confidence and support. I have the honour to remain, Mr. Chairman, Madam and Gentlemen, Your obedient Servant, A. D. S. Blackhall. Sanitary Inspector. 11 PARTICULARS OF INSPECTIONS DURING THE YEAR Housing inspections - Housing re-inspections 48 Public Health Act inspections 43 Public Health Act re-inspections 95 Visits re overcrowding, including computation of permitted numbers 67 Visits in respect of:— Infectious diseases 62 Verminous premises 15 Accumulations 30 Animals 7 Bakehouses 6 Dirty houses 9 Drainage 220 Factories 28 Smoke 3 Outworkers - Offensive Trades 2 Water supply 11 Cowsheds 89 Dairies 106 Milkshops 19 Food Preparers 24 Slaughterhouses 42 Stables and Piggeries 2 Ice Cream Manufacturers and Dealers 7 Dustbins 13 Tents, Vans and Sheds (Moveable dwellings) 26 Passage Paving 6 Offices 1 Conveniences 17 Rats 2 Shops 10 Milk Samples 4 Other inspections 6 Total 1,020 12 DETAILS OF INTIMATION AND STATUTORY NOTICES SERVED DURING THE YEAR Intimation Notices Nature of Defects No. of Notices served General housing defects including leaking roofs, dampness, defective plaster, floors, window-frames, etc. 21 Houses not reasonably fit (inspections under Housing Consolidated Regulations) - Absence of necessary information in rent books (Sections 4 and 62 of the Housing Act, 1936) 12 Drainage 55 Defective w.c. connections 3 Absence of, or dilapidated dustbins 5 Choked water courses 4 Dirty and insanitary houses 2 Insufficient water supply 4 Waste of water (referred to Colne Valley Water Board) 4 Offensive accumulations 4 Improper keeping of animals 1 Smoke nuisances 1 Dairies and cowsheds 12 Food Preparers 2 Shops 1 Factories 3 Total 134 Statutory Notices Nature of Defects Statute No. of Notices served No. of Houses affected General Housing Defects Section 9 Housing Act, 1936 4 4 Nuisances Section 93 Public Health Act, 1936 4 2 Insufficient closet accommodation Section 44 Public Health Act, 1936 1 1 Cowsheds and dairies Milk & Dairies Order, 1926 7 - Absence of, or dilapidated, dustbins Section 75 Public Health Act, 1936 1 1 Insanitary conditions in shops Section 10 Shops Act, 1934 1 - Totals 18 8 13 IMPROVEMENTS CARRIED OUT IN PURSUANCE OF INSPECTIONS MADE AND NOTICES SERVED No. of Houses Repairs to plastering and woodwork 18 Floors repaired 4 Window frames repaired and sash cords renewed 11 Leaking roofs repaired 7 Gutterings repaired, cleansed and renewed 6 External brickwork repointed 10 Chimneys repaired and repointed 2 Domestic coppers repaired 3 Dirty rooms redecorated 11 Handrails provided for staircases 5 Dampness remedied 11 Cooking ranges and firegrates repaired or renewed 10 Glazed sinks provided in lieu of insanitary stone sinks 4 Adequate water supply provided 5 Drains cleared and drainage systems repaired 28 W.c. connections repaired 6 Paving to yards and passages repaired 9 Ashbins provided 12 Water courses cleansed 5 Accumulations removed 7 Nuisance from the keeping of animals abated 1 Cowsheds and dairies limewashed 12 Dairy accommodation provided or improved 2 Cowshed approaches cleansed 1 Cowshed floors repaired 1 Food Preparers'premises improved 1 Rooms disinfected 7 Verminous houses disinfested *3 202 *-Verminous houses—Eradication of the Bed Bug. Three Council houses were found to be verminous upon changes of occupancy. Disinfestation was carried out by the Council's workmen under the supervision of the sanitary inspector. Cimex blocks were used and in one case it was found necessary to disinfest the premises a second time, as the tenant experienced a recurrence of the trouble. Subsequently no further bugs were seen at any of the houses. 14 MILK AND DAIRIES ACTS AND ORDERS. Number of accredited milk producers 12 Number of tuberculin tested milk producers 1 Number of other producers 9 Number of retail purveyors 18 During the year 214 inspections were made of cowsheds, dairies and milkshops. Four samples were taken from purveyors within the district the results of which are enumerated below:— No. Designation Result of bacteriological examination Action methylene blue test Coliform bacillus in 1/100 ml. 1 Pasteurised Satisfactory Absent Bacterial count 4,800. Letter to producer complimenting him on excellent quality of milk. 2 Accredited Satisfactory Absent Producer (local) complimented. 3 Accredited Unsatisfactory Present in 3 tubes. Letter to producer (local). Farm visited and suggestions made to improve standard of milk. 4 Accredited Satisfactory Absent Producer complimented. 15 ANIMALS SLAUGHTERED AND INSPECTED AND PARTICULARS OF CONDEMNATIONS Cattle ex. Cows Cows Calves Sheep and Lambs Pigs Number killed (estimated) 2 105 9 40 320 Number inspected 2 1 5 22 187 All diseases except Tuberculosis Whole carcases condemned — — — — 1 Carcases of which some part or organ was condemned — — — — 1 Percentage (of the number inspected) affected with disease (other than tuberculosis) — — — — 1.1% Tuberculosis only Whole carcases condemned — — — — — Carcases of which some part or organ was condemned — — — — 1 Percentage (of the number inspected) affected with tuberculosis — — — — 0.5% HOUSING Summary of action taken 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 21 Action under Statutory Powers During the Year A. Proceedings under sections 9, 10 and 16 of the Housing Act, 1936. (1) Number of dwelling-houses in respect of which notices were served requiring repairs 4 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners 4 (b) By local authority in default of owners None B. Proceedings under Public Health Acts (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 4 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 1 (b) By local authority in default of owners None 16 ANNUAL REPORT ON THE ADMINISTRATION OF THE FACTORIES ACT, 1937 1. Inspections made by the Sanitary Inspector for the purposes of provisions as to health Particulars Number of Inspections Written Notices Prosecutions. Factories with mechanical power 18 2 — Factories without mechanical power 10 i - Other premises 1 — — Total 29 3 - 2. Defects Found Particulars Number of Defects Number of offences in respect of which Prosecutions were instituted Found Remedied Referred to H.M. Inspector Want of Cleanliness — — — — Overcrowding — — — — Unreasonable temperature Inadequate ventilation — — — — Ineffective drainage of floors — — — — —Sanitary conveniences Insufficient — — — — Unsuitable or defective 2 2 — — Not separate for sexes 1 1 — — Other offences 2 — 2 — Total 5 3 2 — Bournehall Press, Bushey, Herts.