BAT 52 Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea FOR THE YEAR 1953 by J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH. V Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea FOR THE YEAR 1953 by J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH. 2 Health Committee. As constituted 21st May, 1952. Chairman: Councillor Mrs. E. A. Cooper, j.p. The Worshipful the Mayor (Alderman Miss E. A. Coles, j.p.) Councillor C. J. Bennett. „ Miss N. F. Clark- Lawrence. „ Mrs. C. M. Davis. „ L. W. Goodwin. „ Miss B. L. Hayr. Alderman A. P. Holden. Councillor C. E. Lang. „ Miss G. A. Morgan. Alderman A. A. Rignall. Councillor Mrs. N. E. Roberts. „ Dr. I. N. Samuel. Health, Baths and Wash=houses Committee.* As constituted 20th May, 1953. Chairman: Alderman Miss E. A. Coles, j.p. The Worshipful the Mayor (Councillor H. F. Harrison, j.p.) Councillor Miss N. F. Clark- Lawrence. „ Mrs. E. A. Cooper, j.p. „ Mrs. C. M. Davis. Alderman J. H. Dunning. Councillor F. J. J. Harper. „ C. E. Lang. „ Mrs. P. G. Mitchell. „ Mrs. J. O. Parry. Williams Alderman S. E. Paul. Councillor Mrs. E. Reynolds. G. Whitehead. * As from 20th May, 1953, the Health Committee and the Baths and Wash-houses Committee were amalgamated. Staff of public Health Department. Medical Officer of Health J. Tudor Lewis, m.d., d.p.h. Deputy Medical Officer of Health A. Garland, m.d., m.r.c.p., d.p.h. Chief Sanitary Inspector F. H. Chuter (a c). Deputy Chief Sanitary Inspector J. R. Holloway (a c). Sanitary Inspectors: District. 1. W. E. Selway (b c). 2. G. W. P. Weeks (b c). 3. A. Webb (b c). 4. P. D. O'Grady (b c). 5. J. R. Glover (b c). 6. R. J. McCarthy (a c). 7. R. C. Decent (b) (Resigned in August). 8. J. R. Holloway (a c). 9. P. Ianson (b c). 10. J. J. K. Helmer (b c). Other (Food) J. A. H. Brownlow (b c). (Factories, I. R. Lewis (b c). etc.) Miss J. Round (a d). (Catering Establishments) Miss A. L. Jones (b c). Rodent Officer: F. G. Daniels. Administrative and Clerical Staff: W. Halstead (Superannuated 31st October). P. Brocking. E. B. Moreton. (Miss) E. Town. (Miss) P. J. Blow. S. Whitbread. W. A. G. Griffiths (temporary) Disinfecting Station—Superintendent—J. Mandry. Mortuary—Superintendent—W. Newman. Public Analyst J. E. Woodhead, b.sc., f.r.i.c., p.h.c Deputy Public Analyst (Vacant) (a) Sanitary Inspectors' certificate of the Sanitary Inspectors' Examination Board. (b) Sanitary Inspectors' certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (c) Meat and other Foods certificate, Royal Sanitary Institute, or Sanitary Inspectors' Examination Board. (d) Health Visitors' certificate, Board of Education. 3 INDEX TO SECTIONS. PAGE Preface 4 health Committee and Health, Baths and Wash-houses Committee 2 Staff of the Public Health Department 2 Principal Figures for 1953 5 Vital Statistics 6 Infectious Diseases13 Tuberculosis 16 Cancer 19 bacteriological Examinations 19 Sanitary Circumstances 21 Protection of Food Supply:— (a) Inspection of Food Premises 31 (b) Sampling of Food and Drugs 36 Housing 43 factories and Homework 47 Miscellaneous Matters 50 4 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Mr. Mayor, Ladies and Gentlemen, I beg herewith to present to you the Annual Report on the health and sanitary conditions of the Borough for the year 1953. The Report covers all aspects of our work and should be consulted for details. All I shall do here is to point out one or two matters of more general interest. In 1952, the population of Battersea showed a slight decline over the previous year, and this decline has continued in 1953. The Registrar General's estimate of the population for the year was 114,800, a decrease of 1,600 compared with 1952. The live birth rate was 15.49 per thousand of the population, a slight increase over 1952, while the death rate was 12.84, slightly above that for the previous year Last year I noted a remarkable drop in the infant mortality rate from 27 in 1951 to 17 in 1952, and I noted that this was the lowest infant mortality rate ever recorded in Battersea. In 1953 there was a very slight increase, the rate being 18.56 per thousand live births, a slight regression over the previous year. This low rate, however, still compares extremely favourably with that of the County of London and England and Wales which in 1953 was 24.8 and 26.8 respectively. When we are thinking in terms of such a comparatively low infant death rate one or two unavoidable deaths per year might make a big difference to the rate. Of the total number of infant deaths, slightly over a half occurred within the first four weeks of life, which again demonstrates the importance of studying the first four weeks of life in our efforts to reduce still further the deaths of young infants. As with last year, infectious diseases did not provide us with any great problems. There was a small reduction in the number of notifications, mainly due to a decrease in the number of cases of measles but this was partly offset by an increase in the number of cases of whooping cough. 12 confirmed cases of poliomyelitis occurred in Battersea in 1953, 10 having some form of paralysis. There were no deaths. Only one case of diphtheria was notified, and this child, who was not immunized, recovered. A good deal of attention was again given to the important subject of food hygiene and the supervision of catering establishments, and in the latter part of the year, after due consideration, the Health, Baths and Wash-houses Committee decided that the district Sanitary Inspectors should be given specific instructions to participate in the day to day work of safeguarding the Borough's food supplies. This, I am sure, was a move in the right direction. Once again, the care and welfare of old people occupied a good deal of our time, working in close conjunction with both the voluntary bodies, which are doing such excellent work for the old people, and with other statutory organisations. This important part of our work is likely to increase as the age of the population increases. One of the great social and health problems of the time is housing of the people. Satisfactory living conditions are as importan 5 to the individual, and even more vital, to the welfare of the family as a whole, as are good food, pure water and fresh air. No community can ever be considered a really healthy community or can achieve social adjustment until it is satisfactorily housed. A major part of the work of the Health Department is, of course, concerned directly or indirectly with the living conditions of the people, and we act both under the Provisions of the Public Health Act and the Housing Acts. Since the war, most of our work has been conducted under the Public Health Act, but there are signs that shortly a vigorous attack will be made on the demolition of insanitary and slum houses, and, at the time of writing, it is hoped shortly to represent the first area for demolition in Battersea. The more I see of public health work, and the practice of social and preventive medicine, the more convinced I become that every effort to improve the health and welfare of the people must essentially be a team effort. In this connection, I referred last year to the great help, kindness and co-operation which I had received from everyone concerned with the work of the Health Department, and I have the greatest Pleasure in recording again that this kindly help has continued unstinted in 1953. I should like, particularly, to thank the two Chairmen of the Health, Baths and Wash-houses Committee under whom I have served during the year, namely Councillor Mrs. E. A. Cooper, J.P., and Alderman Miss E. A. Coles, J.P., and to acknowledge gratefully the courtesy and assistance which I received from the Committees with whose work I was concerned. In the same way, the Chief Officers and the Senior Officers of Battersea have done everything to help me, Particularly Mr. R. G. Berry, O.B.E., the Town Clerk. Once again the officers and staff of the Health Department in all sections have given me loyal service, and it is a pleasure to thank, particularly, my Deputy, Dr.Garland, and the Chief Sanitary Inspector, Mr. Chuter. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J. TUDOR LEWIS, Medical Officer of Health. may, 1954. Principal Figures for 1953. Area of Borough, excluding tidal water (acres) 2,163 Home population (1951 Census) 117,140 Home population (Registrar-General's Mid-Year Estimate) 114,800 Structurally separate occupied dwellings 27,627 Births (live, 1,778; still, 38) 1,816 Live birth rate 15.49 Deaths—1,474. Death rate 12.84 Maternal Deaths—1 Maternal death rate 0.55 Infant deaths—33. Infant mortality rate 18.56 6 Vital Statistics. POPULATION. The Registrar-General's estimate of the mid-year home population of Battersea was 114,800 as compared with 116,400 in 1952, a decrease of 1,600 (1.4 per cent). The estimated mid-year home population figure of 114,800 has been adopted for the purpose of the statistics contained in this Report. During the year, the Registrar-General published a report on the Census taken in April, 1951, and the following are extracts from this report: — Population in Wards and Districts. Acres Density per acre Population Males Females Total North Battersea No. 1. Nine Elms 313 22.8 3,552 3,585 7,137 No. 2. Park 302 26.2 3,615 4,289 7,904 No. 3. Newtown 67 93.0 3,053 3,178 6,231 No. 4. Latchmere 126 71.2 4,286 4,689 8,975 No. 5. Queenstown 117 80.0 4,505 4,854 9,359 No. 9. Church 110 74.9 3,881 4,353 8,234 No. 10. Vicarage 101 70.3 3,457 3,641 7,098 No. 11. Winstanley 85 98.1 4,046 4,296 8,342 Totals 1,221 51.8 30,395 32,885 63,280 South Battersea No. 6. Shaftesbury 120 61.8 3,449 3,962 7,411 No. 7. Stormont 71 99.1 3,234 3,805 7,039 No. 8. Lavender 53 95.1 2,355 2,684 5,039 No. 12. St. John 120 67.1 3,765 4,284 8,049 No. 13. Bolingbroke 79 54.5 1,982 2,321 4,303 No. 14. Thornton 137 41.5 2,458 3,231 5,689 No. 15. Broomwood 75 64.7 2,206 2,646 4,852 No. 16. Nightingale 287 40.0 5,008 6,470 11,478 Totals 942 57.2 24,457 29,403 53,860 BOROUGH 2,163 54.2 54,852 62,288 117,140 7 Population in Age Groups. Males Females Totals 0–4 5,276 5,042 10,318 5–9 4,154 3,908 8,062 10–14 3,565 3,519 7,084 15–19 2,673 3,464 6,137 20–24 3,581 4,238 7,819 25–29 4,700 4,829 9,529 30–34 4,490 4,743 9,233 35–39 4,884 4,922 9,806 40–44 4,539 4,638 9,177 45–49 3,921 4,019 7,940 50–54 3,065 3,695 6,760 55–59 2,576 3,455 6,031 60–64 2,387 3,401 5,788 65–69 2,018 3,016 5,034 70–74 1,485 2,411 3,896 75–79 978 1,721 2,699 80–84 420 864 1,284 85–89 120 314 434 90–94 19 76 95 95 + 1 13 14 Totals 54,852 62,288 117,140 BIRTHS. The number of live births registered in the Borough during 1953 was 1,422 (743 male, 679 female). Of this number 665 were transferred out the permanent residence of the parents being outside the Borough, balance 1,021 registered outside the Borough were transferred in, giving on balance a total of 1,778 births (918 male, 860 female, an excess of 58 males) relating to Battersea residents, and a live birth rate of 15.49 per 1,000 population. This is an increase of 0.33 on that of 1952. Of the Battersea births (757 live and 15 still) which occurred within the Borough, 461 were "domiciliary births." Illegitimate births numbered 99 or 5.6 per cent, of the live births. The live birth rate was 17.5 for the County of London, and 15.5 for England and Wales. Still-Births. The registration of still-births is made compulsory by the Births and Deaths Registration Act, 1926. During 1953 there were 38 still-births registered in Battersea, of which 15 were of Battersea parents. 23 still-births occurring outside the Borough were registered as belonging to Battersea, making 38 in all, representing a still-birth rate of 20.92 per 1,000 births (live and still) registered. Of the 38 still-births 1 (2.6 per cent.) was registered as illegitimate. 8 The number of Battersea still-births registered, and the still-birth rates from 1943 to 1953 were as under:— No. Rate No. Rate 1943 36 21.6 1949 43 20.8 1944 40 24.0 1950 53 27.2 1945 38 23.3 1951 37 19.2 1946 59 22.7 1952 42 23.2 1947 74 27.0 Mean 1948 46 20.1 1943-52 47 22.9 1953 38 20.92 MARRIAGES. The marriages registered in Battersea during 1953 numbered 876. The marriage rate (i.e., the number of persons married per 1,000 of the population) was 15.3. Year. Marriages. Marriage Rate. 1948 988 17.0 1949 1,031 17.2 1950 949 16.1 1951 929 15.9 1952 884 15.2 Mean 1948/52 956 16.3 1953 876 15.3 DEATHS. The number of deaths registered in the Borough during 1953 was 1,958. Of these, 815 were deaths of non-residents and were transferred to the districts in which the persons ordinarily resided. There were, on the other hand, 331 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths belonging to the Borough was 1,474 (758 males, 716 females). This gives a recorded death rate of 12.84 compared with 12.5 for London, and 11.4 for England and Wales. 9 The following table shows the age and sex distribution of the total deaths (corrected) in Battersea during 1953:— Under 1 year 1— 5— 15— 25— 45— 65— 75 + Total M. 17 2 4 3 33 192 240 267 758 F. 16 8 1 7 22 107 175 380 716 Totals 33 10 5 10 55 299 415 647 1,474 % of Total. 2.2 0.7 0.3 0.7 3.7 20.3 28.2 43.9 100.0 Of the 1,474 Battersea deaths, 852 (or 57.8 per cent.) occurred in hospitals, etc. It is well-known that in almost all districts the average age at death tends to increase. The position of Battersea in this respect is illustrated by the following figures:— Average Age at Death. Mean, 1940/1944 60.9 1945 62.4 1946 61.4 1947 62.6 1948 63.3 1949 65.3 Mean, 1945/1949 63.0 1950 65.5 1951 66.7 1952 67.7 1953 68.9 The deaths of 1,062 residents of Battersea aged 65 years and upwards were registered during 1953. These 1,062 deaths constituted 72.0 per cent of the total deaths at all ages. The natural increase of population (that is, excess of births over deaths was 304 in 1953 as compared with 378 in 1952. The causes of the 1,474 deaths in 1953 classified in various age groups, are shown in the following table. 10 Causes of Death at Different Periods of Life in Battersea during 1953. The following table is compiled from figures supplied by the Registrar-General:— Causes of Death. Sex. All Ages. 0– 1– 5– 15– 25– 45– 65– 75– All Causes m. 758 17 2 4 3 33 192 240 267 f. 716 16 8 1 7 22 107 175 380 1. Tuberculosis, respiratory m. 8 – – – – 1 5 1 1 f. 6 – – – 1 2 2 – 1 2. Tuberculosis,other forms m. 1 – – – – 1 – – – f. 4 – 1 – 1 – – – 2 3. Syphilitic disease m. 3 – – – – – 2 1 – f. 2 – – – – – – 2 – 4. Diphtheria M. – – – – – – – – – f. – – – – – – – – – 5. Whooping cough M. – – – – – – – – – f. – – – – – – – – – 6. Meningococcal infections M. – – – – – – – – – f. 1 – – – – – 1 – – 7. Ac. polio-myelitis and polio-encephalitis M. – – – – – – – – – f. – – – – – – – – – 8. Measles M. – – – – – – – – – f. 1 1 – – – – – – – 9. Other infective and parasitic diseases M. – – – – – – – – – f. 2 1 – – – – 1 – – 10. Cancer of stomach M. 22 – – – – 1 7 12 2 f. 17 – – – – 1 6 6 4 11. Cancer of lung, bronchus M. 49 – – – – 1 29 13 6 f. 10 – – – – 3 6 1 12. Cancer of breast M. – – – – – – – – – f. 24 – – – – 2 7 9 6 13. Cancer of uterus M. – – – – – – – – – f. 5 – – – – – 1 2 2 14. Cancer of other sites M. 58 – 1 – – 1 10 27 19 f. 57 – – – – 3 16 18 20 15. Leukaemia, aleukæmia M. 3 – – 1 – – 1 – 1 f. 2 – – – – – 2 – – 16. Diabetes M 4 – – – – – 2 1 1 f. 4 – – – – – – 2 2 17. Vascular lesions of nervous system M. 84 – – – – 2 16 23 43 f. 110 – – – – 1 11 34 64 18. Coronary disease, angina M. 89 – – – – 5 28 34 22 f. 55 – – – – – 5 18 32 19. Hypertension with heart disease M. 29 – – – – – – 9 20 f. 20 – – – – – 1 5 14 11 Causes of Death, 1953–(contd.). Causes of Death. Sex. All Ages. 0– 1– 5– 15– 25– 45– 65– 75– 20. Other heart disease M. 118 – – – – 2 12 24 80 f. 160 – – – – 4 11 24 121 21. Other circulatory disease M. 28 – – – – – 6 7 15 f. 46 – – – – 2 6 11 27 22.Influenza M. 9 – – – – 1 2 6 – f. 11 – – – – – 4 2 5 23.Pneumonia M. 43 1 – – – – 10 16 16 f. 40 4 1 – – – 4 9 22 24.Bronchitis M. 96 – – – – 2 33 41 20 F. 45 1 – – – 1 8 15 20 25.Other diseases of respiratory system M. 11 – – 1 – 2 4 2 2 f. 5 – 1 – – – – 1 3 26.Ulcer of stomach and duodenum M 12 – – – – 1 4 6 1 f. 5 – – – – – 1 1 3 1 27.Gastritis, enteritis and diarrhœa M. 9 4 – . – – – 4 F. 4 2 – – – – – 1 1 28.Nephritis and nephrosis M. 6 1 – – – 1 1 2 1 f. 3 – – – – 1 – – 2 29.Hyperplasia of prostate M. 9 – – – – – 1 3 5 F. – – – – – – – – – 30.Pregnancy, childbirth, abortion M. – – – – – – – – – F. 1 – – – 1 – – – – 31.Congenital malformations M. 2 2 – – – – – – – f. 4 – 2 – – 1 1 – – 32.Other defined and illdefined diseases M. 41 8 1 2 – 2 8 11 9 f. 51 6 3 – 3 4 9 3 23 33.Motor vehicle accidents M. 4 – – – 2 1 1 – – f. 7 – – 1 – – – 4 2 34.All other accidents M 15 1 – – 1 9 3 – 1 f. 6 1 – – – – 1 1 3 25.Suicide M. 4 – – – – – 2 1 1 F. 7 – – – 1 – 5 1 – 36.Homicide and operations of war M. 1 – – – – – 1 – – f. 1 – – – – – 1 – – Infant Mortality. . During 1953 the deaths of 33 infants under 1 year of age were registered as belonging to Battersea. The total number of live births registered during the year was 1,778 giving an infant mortality rate 18.56 per 1,000 live births as compared with 17.56 in 1952 and 27.57 in 1951. The infant mortality rates in the County of London and in England and Wales during 1953 were 24.8 and 26.8, respectively. 12 The following table sets out the causes of death in detail. Infant Mortality, 1953. Nett Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH AGE PERIODS Under 24 hours. 1-7 days. Weeks. Total under 4 weeks Months. Total deaths under 1 year age of Total 1-2 2-3 3 4 1-3 3-6 6-9 9-12 M. F M F M F M F M F M F M F M F M F M F M F Measles 1 1 3 Infective and parasitic diseases 1 1 3 Pneumonia 1 1 2 1 1 1 1 4 15.2 Bronchitis 1 1 34 Gastritis, enteritis and diarrhoea 1 1 1 1 2 1 4 2 18.2 Nephritis 1 1 3 Congenital malformations l 1 1 2 6 Other defined and ill-defined diseases 30.5 Prematurity 3 2 2 2 1 5 5 5 5 12 Other causes 3 3 1 3 1 6.2 Accidents 1 1 1 1 1 100.0 4 3 6 2 2 1 10 8 2 3 4 3 1 1 1 17 16 Totals 7 8 2 1 18 5 7 2 1 33 Percentage of total 21.2 24.2 6.1 3.0 54.5 15.2 21.2 6.1 3.0 100.0 M.51.5 F.48.5 There were 18 deaths of infants during the first four weeks of life (or 54.5 per cent. of the total infant deaths) as compared with 17 deaths (or 54.8 per cent.) in 1952 and a percentage for the quinquennium 1948-1952 of 58.8. Table showing Deaths of Infants under 1 day, under 1 week and under 4 weeks from 1948 to 1953. Year Under 24 hours 1 to 7 days 1 to 4 weeks Total under 4 weeks Percentage deaths under 4 weeks of total infant deaths 1948 14 12 7 33 46.4 1949 13 13 7 33 64.7 1950 14 15 5 34 66.7 1951 8 21 3 32 61.5 1952 8 8 1 17 54.8 Mean 11 14 5 30 58.8 1953 7 8 3 18 54.5 13 Deaths of Illegitimate Infants. The death rate amongst illegitimate children during 1953 was 70.71 Per 1,000 illegitimate live births, as compared with 41.23 in 1952, 42.73 in 1951, 40.40 in 1950 and 22.73 in 1949. The corresponding death rate of legitimate children in 1953 was 15.49, the ratio of mortality rate of illegitimate infants to that of legitimate being 456 to 100. The corresponding figure for 1952 was 255 to 100. Maternal Mortality. During 1953 there was one death of a woman from "diseases or accidents of child-birth," which is equivalent to a fatality rate of 0.55 Per 1,000 births (live and still). There were three such deaths during 1952. The rate for England and Wales in 1953 was 0.76. Comparative Statistics of Births, Mortality, etc. (Compiled from Registrar-General's Returns.) Year Population Live Birth Rate Death Rate Maternal Death Rate Infant Mortality Rate 1944 85,380 19.0 17.7 1.22 49.8 1945 90,420 17.6 13.8 1.23 40.8 1946 108,610 23.4 13.5 1.54 42.4 1947 114,960 23.2 12.6 0.73 31.5 1948 116,500 19.3 11.3 1.00 31.6 1949 117,510 17.2 12.1 0.97 25.2 1950 117,700 16.1 11.2 1.02 26.9 1951 117,000 16.1 12.4 0.00 27.6 1952 116,400 15.2 11.9 1.66 17.6 1953 114,800 15.5 12.8 0.55 18.6 Infectious Diseases. There was a small decrease in the number of notifications received during 1953, there being 1,612 during the year as compared with 1,661 in 1952, a decrease of 49. Notifications of measles dropped from 1,007 in 1952 to 762 in 1953, decrease of 245, but notifications of whooping cough rose by 269, there being 410 in 1953 as compared with 141 in 1952. Notifications of scarlet fever, acute primary pneumonia, and tuberculosis decreased slightly, but there was an increase in the number of cases of dysentery, there being 24 cases during the year comparing with 10 in 1952. A case of acute encephalitis (infective) was notified, which case Proved fatal. Fourteen cases of polio-myelitis were notified, but in two of these cases the diagnosis was not confirmed, leaving 12 confirmed cases (10 paralytic and 2 non-paralytic) nine of these cases occurring in children under 15 years of age. A further 12 suspected cases were removed to hospital where it was found that the patients were not suffering from this disease. 14 There were 23 confirmed cases in 1947, 5 in 1948, 28 in 1949, 7 in 1950, 2 in 1951 and 14 in 1952. During the year there was only one case of diphtheria in the Borough, occurring in a child who had never been immunised. The following table shows the number (corrected) of cases notified during 1953 and, for the purpose of comparison, the average number of cases notified annually in the five years, 1948–1952:– Notified Average 1953 1948/52/ Diphtheria 1 5 Erysipelas 20 24 Scarlet fever 90 176 Enteric (Typhoid) fever 1 1 Continued fever 1 – Puerperal pyrexia 32 23 Meningococcal infection 5 3 Ophthalmia neonatorum 2 4 Acute Encephalitis 1 1 Polio-myelitis & Polio-encephalitis 12 11 Malaria – – Dysentery 24 10 Pneumonia (Acute primary) 60 91 (Acute influenzal) 14 10 Scabies 8 39 Food poisoning 4 6 Whooping cough 410 327 Measles 762 1,315 Tuberculosis (all forms) 165 181 Totals 1,612 2,227 Diphtheria and Whooping Cough Immunisation, Smallpox Vaccination. Diphtheria and whooping cough immunisation and vaccination against smallpox were carried out throughout the year under the control of the London County Council. 15 Analysis of Cases (after Correction of Diagnosis) of Infectious Disease Notified during the Year 1953. Notifiable Disease. Cases Notified in Battersea, at Ages (Years). 0— 1— 3— 5— 10— 15— 25— 35— 45— 65 & over Total Small pox — — — — — — — — — — — Diphtheria — 1 — — — — — — — — 1 Erysipelas 1 — — — — 1 2 5 8 3 20 Scarlet fever — 7 19 55 6 2 1 — — — 90 Enteric (typhoid) fever — — — — — — 1 — — — 1 Continued fever — — — — — — 1 — — — 1 Puerperal pyrexia — — — — — 17 9 6 — — 32 Meningococcal infection — 1 — 2 — — — — 2 — 5 Ophthalmia neonatorum 2 — — — — — — — — — 2 Polio-myelitis: — Paralytic — 1 3 3 1 — 1 — 1 — 10 Non-paralytic — — 1 — — — — 1 — — 2 Acute Encephalitis: — Infective — — — — — — — — 1 — 1 Post-infectious — — — — — — — — — — — Malaria — — — — — — — — — — — Dysentery — 5 3 9 4 — — 2 1 — 24 Acute primary pneumonia — 2 1 7 — 3 3 9 19 16 60 Acute influenzal pneumonia — 1 — 1 — 1 — 3 4 4 14 Scabies — 2 — 2 1 1 — 2 8 Food poisoning — 1 — — 1 — 2 — 4 Whooping cough 30 107 115 146 7 1 1 3 — — 410 Measles 36 190 224 288 9 11 3 1 — — 762 Tuberculosis:— Pulmonary — 4 5 3 3 29 33 27 34 14 152 Non-pulmonary — 1 1 1 1 1 5 3 13 Totals 69 322 373 517 32 68 60 62 72 37 1,612 16 TUBERCULOSIS. During the year 1953 there were 165 cases of tuberculosis (all forms) notified in Battersea as compared with 188 in 1952, 162 in 1951. 149 in 1950, 194 in 1949 and 213 in 1948. In addition 58 cases were reported or otherwise came to the knowledge of the Medical Officer of Health, making a total of 223 cases for the year. The case rate per 100,000 population was 194.3. The tables on page 18 give details in age groups of the 223 cases. Deaths from Tuberculosis. During 1953 deaths from tuberculosis registered as belonging to the Borough of Battersea numbered 19, of which 14 (i.e., 73.7 per cent.) were due to pulmonary tuberculosis, 5 (i.e., 26.3 per cent.) to other forms of the disease. The death rate per 100,000 of the population during the 50 years ended 1950 in quinquennial averages and the years 1951, 1952 and 1953 are given in the following table: — Years Pulmonary NonPulmonary Total 1901-1905 138.1 50.9 189.0 1906-1910 126.8 45.9 172.7 1911-1915 124.2 33.8 158.0 1916-1920 134.8 30.0 164.8 1921-1925 92.6 23.0 115.6 1926-1930 91.1 14.2 105.3 1931-1935 81.8 14.4 96.2 1936-1940 76.1 9.2 85.3 1941-1945 91.8 11.0 102.8 1946-1950 53.1 6.1 59.2 Average (50 years) 101.0 23.9 124.9 1951 39.3 3.4 42.7 1952 29.2 2.6 31.8 1953 12.2 4.4 16.6 The death rate per 100,000 population was 20 for England and Wales, and 24 for the County of London. 17 Tuberculosis, 1953. Cases Added to and Removed from Notification Register. PULMONARY NON-PULMONARY GRAND TOTAL Males Females Total Males Females Total Males Females Total Already on Register, 31/12/52 567 496 1,063 43 84 127 610 580 1,190 Primary notifications 98 54 152 6 7 13 104 61 165 1 — 1 — — — 1 — 1 Unnotified deaths 1 1 2 — 2 2 1 3 4 Restored — — — — — — — — — Removals into Borough 29 21 50 2 1 3 31 22 53 From other sections — — — — — — — — — TOTAL ADDITIONS 129 76 205 8 10 18 137 86 223 14 7 21 2 1 3 16 8 24 1 — 1 — — — 1 — 1 Unnotified deaths 1 1 2 — 2 2 1 3 4 46 43 89 4 6 10 50 49 99 Recovered 12 12 24 5 5 10 17 17 34 Diagnosis not confirmed 1 1 2 1 — 1 2 1 3 To other sections — — — — — — — — — TOTAL DELETIONS 75 64 139 12 14 26 87 78 165 Net increase 54 12 66 — — — 50 8 58 Net decrease — — — 4 4 8 — — — On Register at 31/12/53 621 508 1,129 39 80 119 660 588 1,248 18 Formal Notifications, 1953. Age Periods Number of Primary Notifications of new cases of tuberculosis 0– 1– 2– 5– 10– 15– 20– 25– 35– 45– 55– 65– 75– Total (all ages) Respiratory, Males – 3 3 2 1 5 12 18 17 12 14 9 2 98 Respiratory, Females – – 3 1 2 5 7 15 10 6 2 2 1 54 Non-Respiratory,Males – – 1 1 – – – 3 1 – – – – 6 Non-Respiratory, Fem. – – 1 – 1 1 – 2 2 – – – – 7 New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health otherwise than by formal notification. Source of Information Number of cases in age Groups 0– 1– 2– 5– 10– 15– 20– 25– 35– 45– 55– 65– 75– Total Death Returns from Local Registrars R. M – – – – – – – – – – 1 – – 1 (A) F – – – – – – – – – 1 – – – 1 (B) N.R. M – – – – – – – – – – – – – – (C) F – – – – – – – – – – – – – – (D) Death Returns from Registrar-General (Transferable Deaths) R. M – – – – – – – – – – – – – – (A) F – – – – – – – – – – – – – – (B) N.R. M – – – – – – – – – – – – – – (C) F – – – – – – 1 – – – – – 1 2 (D) Posthumous Notifications R. M – – – – – – – – – 1 – – – 1 (A) F – – – – – – – – – – – – – – (B) N.R. M – – – – – – – – – – – – – – (C) F – – – – – – – – – – – – – – (D) "Transfers" from Other Areas (excluding transferable deaths) R. M – – – 2 2 2 – 2 13 3 4 – 1 29 (A) F – – – – 1 – 4 3 10 3 – – – 21 (B) N.R. M – 1 – – – – – 1 – – – – – 2 (C) F – – – – – – – – – 1 – – – 1 (D) Other Sources R. M – – – – – – – – – – – – – – (A) F – – – – – – – – – – – – – – (B) N.R. m – – – – – – – – – – – – – – (C) – – – – – – – – – – – – – – (D) R.–Respiratory. Totals (A) 3l N.R.–Non-Respiratory. ” (B) 22 ” (c) 2 ” (D) 3 Total number of Informal Notifications 58 19 BACTERIOLOGICAL EXAMINATIONS. The bacteriological examination of clinical material (with the exception of sputum which is dealt with at the Chest Clinic) and foodstuffs suspected as being the cause of food poisoning was carried out by the Public Health Laboratory Service, 134 Denmark Hill, S.E.5, until the 20th September, and after that date by the same Service at their laboratory at County Hall, Westminster Bridge, S.E.I. No charge is made to the Council for these examinations. During the year 209 examinations were made as follows:— Description Disease Number of Specimens or Food Sample Positive Results Faeces Dysentery 161 17 do. Thread Worm 1 Nil Throat Swabs Diphtheria 26 Nil Foodstuffs Food Poisoning 21 1 MASS X-RAY. Visits by a Mass X-Ray unit of the South-West Metropolitan Regional Hospital Board were made in the Borough during 1953. A unit was stationed at the Battersea Central Mission, York Road, S.W.ll, during the period 27th January to the 25th February. A total of 5,639 people (3,044 men and 2,595 women) were examined, 19 men and 11 women were found to have radiologically significant lesions, probably tuberculous, requiring investigation and were referred to chest clinics. In addition 10 men and 5 women were found to have lesions probably of no clinical significance and were considered to merit only an occasional follow-up film by the Mass X-Ray Service. Later in the year a unit was stationed at the Battersea Town Hall (Lower Hall) during the period 24th June to the 20th July. 3,891 people (2,028 men and 1,863 women) were X-Rayed at this Centre. Of these 12 men and 5 women were found to have radiologically significant lesions, probably tuberculous, and requiring investigation at a chest clinic. In addition 11 men and 2 women were to be followed up with an occasional film through the X-Ray Service. Apart from the visits to the above two centres, a mobile unit visited Battersea Polytechnic where 607 students and staff were X-Rayed. CANCER. During 1953 the number of deaths of Battersea residents from Cancer was 242 (Males, 129; females, 113) as compared with 239 in 1952, 252 in 1951, 237 in 1950 and 269 in 1949. The death rate from the disease per 1,000 of the population was 2.11. The deaths from cancer constitute 16.4 per cent, of the total Battersea deaths during the year. 20 The following gives the comparative average death rates from cancer in Battersea for quinquennial periods since 1901. 1901-1905 0.88 1931-1935 1.75 1906-1910 0.95 1936-1940 1.99 1911-1915 1.11 1941-1945 2.44 1916-1920 1.28 1946-1950 2.11 1921-1925 1.33 1951 2.15 1926-1930 1.51 1952 2.05 1953 2.11 Details in age groups and the localisation of this disease will be found on page 10. 21 Sanitary Circumstances. The following table sets out in summarised form the details of the main work of the Department in relation to sanitation:— Summary of Main Operations for the Year 1953. Sanitary Operations. Inspections— New houses—certificates issued re water supply 464 New houses 464 House-to-house — Houses supplied with water and fittings repaired 30 Houses let in separate tenements — Houses—following complaints 4,196 Additional water supplies to tenement houses Houses—following infectious disease 1,812 Water closets provided, supplied with water, or supply disconnected from drinking water cisterns 15 Gipsy vans 11 Public urinals and chalets 71 Re-inspections 19,151 Other visits 2,323 Water closets and urinals cleansed and repaired 347 Notices served— Intimations 2,058 Drinking water cisterns cleansed and repaired 71 Statutory (Sec. 197 and 200) 158 Rain-water and waste pipes disconnected or repaired 214 Statutory (Fifth Schedule) 992 Summonses issued 91 Magisterial Orders obtained 55 Soil pipes and drains ventilated 96 Drains laid to new houses 464 Defective roofs and gutters repaired 944 Drains relaid (wholly or partly) 14 Dustbins provided 26 Drains cleansed and rePaired 215 Yards paved or repaired 79 Premises disinfected 857 Drains tested (smoke) 208 Persons cleansed (including 1,943 children) 2,087 Found defective 34 Drains tested (water) 1,438 Articles disinfected 7,380 Drainage plans received 123 Rodent Control— Frontage drains constructed or reconstructed 21 Premises infested 452 Inspections 6,776 Protection of Food Supply. inspections— Inspections—contd. Butchers' and other Ice cream premises 302 food shops 1,076 Restaurant kitchens 909 Fish shops 299 Samples taken 586 Food storage premises 252 Summonses issued 5 Dairies and milk shops 302 Factories, Workshops and Shops. Inspections— Inspections—contd. Shops 61 Outworkers 1,203 do. (Pharmacy Act) 19 Smoke observations 180 Rag flock 11 Intimation notices served 34 Pet shops 15 Statutory notices served 1 Factories 1,967 Summonses issued — 22 Legal Proceedings. During the year, legal proceedings were taken by the Council in 98 cases, for the enforcement of various Acts, by-laws, regulations, etc., administered by the Health Department. A summary is set out below, and further details will be found in the sections dealing with the respective matters at the oases stated. Cases Page No Public Health (London) Act, 1936 86 22 Food and Drugs Act, 1938, and By-laws 5 32,35 London County Council By-laws as to Drainage 5 24 London County Council (General Powers) Act, 1952 1 25 Housing Act, 1936 1 45 98 Fines totalling £18 0s. 0d. were imposed in connection with these proceedings, and £64 1s. 0d. costs were awarded to the Council. Public Health (London) Act, 1936. The provisions of this Act in regard to Nuisances continued to afford the main means whereby the remedy of insanitary conditions found in dwelling houses could be secured. During the year, 2,058 Intimation, and 992 Statutory (Nuisance) Notices were served. The high proportion of Statutory to Intimation Notices shows the continuing difficulty, referred to in previous reports, of securing the remedy of these conditions. Furthermore, it was found necessary to refer 155 cases to the Council's Solicitor with instructions to take steps, by legal proceedings if necessary, to enforce compliance with Statutory Notices. In 69 of these cases a warning letter from the Solicitor had the desired effect. In the remaining 86 cases, however, summonses had to be issued. As a result, Nuisance Orders were made by the Court in 55 instances. The remaining 31 summonses were ultimately withdrawn, the Notices having been complied with subsequent to the issue of the summonses. In 23 cases action to enforce compliance with Nuisance Orders had to be taken, and the Council carried out the work in default of the persons on whom the Orders were made. In those cases, the Council were entitled to recover the cost of the works from those persons, and accounts were accordingly rendered to them. Dustbins. Under Section 105 of the Public Health (London) Act, 1936, if any house is found to be without a proper dustbin, the Council may serve notice on the owner or occupier requiring provision to be made. The same Section, as amended by the London County Council (General Powers) Act, 1951, provides that any person aggrieved may appeal to a court of summary jurisdiction. Similar provisions are contained in the Public Health Act, 1936, which applies to England and Wales outside the administrative County of London. 23 In the last few years, a number of such appeals have been made, some of them being subsequently taken to the Divisional Court. As a result, the principle has been established that, in deciding whether notice should be served on the owner or on the occupier, the local authority must consider all the circumstances of the individual case. It had previously been the practice of the Council, save in very exceptional circumstances, to regard the provision of dustbin accommodation as a matter for the owner, and accordingly to serve notice on him. In view, however, of the situation created by the various appeals referred to above, the Health Committee decided in 1949 that in future the circumstances of each case (e.g., net rent of house, number of tenants, existence of any tenancy agreement, financial circumstances of the occupier, etc.) should be submitted to them for their decision as to whether the notice is to be served on the owner or occupier. It should, however, be made clear that whatever the Committee may decide, the Person served with a notice still has his right of appeal to the court. During the year, 22 such cases were considered by the Committee, in all of which it was decided to serve the notice on the owner. In 4 of the cases (4 flats in a block of dwellings where each flat normally has its own small dustbin) the owner appealed against the notices. At the same time as he lodged his appeals, he wrote to the tenants requesting them to provide the dustbins. Three of them did so, and the appeals were not proceeded with. In the fourth case, the hearing of the appeal was deferred pending settlement of a dispute between the owner and the tenant as to the legality of the latter's occupation of the flat. This was not decided at the end of the year. Common Lodging Houses. There are no Common Lodging Houses or Seamen's Lodging Houses in the Borough. Public Lavatory Accommodation. Five public conveniences for both sexes and one for females only are provided by the Council in various parts of the Borough, two being underground. In addition to the usual lavatory accommodation (at least one free water-closet being provided for each sex) facilities for washing are also provided. Three public urinals are also maintained. In addition, the urinals attached to nine licensed premises are, by arrangement with the owners, available to the general public. The Council provide, in the interests of public health, free washing facilities at each of the public conveniences in the Borough. Drainage Work. The by-laws made by the London County Council under the Metropolis Management Acts with regard to drainage, and also those under the Public Health (London) Act, 1936, relating to water closets, etc., are enforced by the Council. During the year new drains were constructed to 466 new buildings, and the drains of 14 old buildings were partially or entirely reconducted under the supervision of the Officers of the Health Department. 123 plans of proposed drainage work were deposited in 1953, as compared with 104 in 1952. 24 During the year drains were tested by smoke on 208 occasions and 34 were found defective. The water test was applied on 1,438 occasions, this being mainly to drains in course of construction. The frontage drains of 21 premises were constructed or reconstructed. In 2 cases, the Council carried out drainage works in default of compliance by the owners with the requirements of notices served under the Public Health (London) Act, 1936, the cost being recoverable from the respective owners. Under the provisions of the London County Council (General Powers) Act, 1951, which came into operation on the 1st August, 1951, appeals against acts and decisions of sanitary authorities in regard to drainage and water closets, which formerly had to be made to the London County Council, now have to be made to a court of summary jurisdiction. No such appeal was made during the year. Five summonses were issued under the Drainage By-laws against a firm of builders, one summons for failing to deposit proper plans of drainage work they had carried out and four for carrying out work in a manner contrary to the requirements of the By-laws. However, the plans were deposited, and the faulty work rectified, before the date of hearing of the summonses, which were then withdrawn on payment of £1 1s. 0d. costs. Combined Drainage. Claims were made by the owners of two houses, the drainage system of which had been found to be defective, that the combined portion of this system was a "sewer" repairable by the Council. The claim was admitted and the work to the combined drain was carried out by the Council. Smoke Nuisances. During the year 13 complaints were made, alleging nuisances from smoke, dust, grit, etc., emitted from premises occupied by various industrial and public utility undertakings in the Borough. All such complaints were carefully investigated. The most serious and persistent source of dust and grit emissions has again been a large gas works. This has been referred to in previous Annual Reports and is due principally to the operation of plant of an obsolete type, replacement of which does not seem likely to take place for a number of years. Apart from this instance, the complaints related to emissions from various industrial plants. On investigation, they were found to be due to some transient cause such as the use of unsuitable fuel, or temporary breakdown of some part of the plant. The total number of observations made was 180. Four notices (three intimation and one statutory) were served and were complied with. Effluvium Nuisances. A small number of complaints alleging nuisance from effluvia emitted from various industrial and business premises were received. They were all of a minor nature and were successfully dealt with by informal action. 25 Offensive Trades. There are two premises in the Borough at which scheduled offensive trades are carried on. These businesses have been established for many years and are satisfactorily conducted. Water Supply. During the year certificates under Section 95 (2) of the Public Health (London) Act, 1936, were issued in respect of 464 new or re-erected dwelling houses or tenements. Forty-two notices of waste of water from defective fittings, etc., observed during routine inspections of various premises, were sent to the Metropolitan Water Board. At the public baths in Latchmere Road there are deep wells which supply water, not only to the Baths Establishments, but also, for all domestic purposes, to over 360 tenements on the Council's Latchmere Estate. Formerly, supplies were adequate for all these purposes, but of recent years the yield from the wells has fallen, so that supplies from the mains of the Metropolitan Water Board had to be drawn upon to an increasing extent. During 1950, the existing air-lift pumps on two of the borings were replaced by electrically operated submersible pumps of modern design, with the result that the yield from these borings is now sufficient for normal requirements. The water is chlorinated as a safety measure, before passing into supply. A sample of the chlorinated water is taken every fortnight, and in addition, every three months a sample is taken from the rising main of each borehole (i.e., before chlorination). These samples are submitted, for bacteriological examination, to the Public Analyst, whose reports show that the water consistently maintains a high degree of Purity. Rag and Bone Dealers. Premises occupied by rag and bone dealers in the Borough are subjected to regular inspection. During the year 141 inspections were made. Various small irregularities found to exist were brought to the notice of the occupiers of the premises and were remedied without recourse to formal action. Proceedings were taken against an itinerant rag and bone dealer for giving a balloon to a child in exchange for rags, contrary to Section 26 of the London County Council (General Powers) Act, 1952. The Court, however, dismissed the summons absolutely under the Criminal Justice Act, 1948. Fouling of Footpaths by Dogs. No offence against the Council's By-law relating to this matter was reported during the year. Verminous Premises. During the year 255 premises which were found to be infested with vermin (principally bed-bugs) were disinfested. The usual method of treatment is by a D.D.T./pyrethrum spray. 26 Van Dwellings. There are four sites in the Borough on which van dwellings have regularly been placed for many years. The number of vans on the sites varies from time to time. All the sites are subject to regular inspection and are in general reasonably well kept. Dangerous Structures. 74 cases in which structures or parts thereof had been noted, in the course of inspections for various purposes, as appearing to be unsafe, were referred to the District Surveyor of the London County Council for his attention. Prevention of Damage by Pests Act, 1949. This Act, which came into operation on the 31st March, 1950, repealed, and re-enacted, with many alterations and additions, the Rats and Mice (Destruction) Act, 1919. It gives power generally to the Council to require steps to be taken to eradicate infestations of rats and mice, and to prevent infestations. These duties are carried out by the Rodent Officer, assisted by three Rodent Operatives. All infestations coming to light, whether by way of complaint or otherwise, are systematically investigated, and the appropriate action taken. Where the cause of the trouble is obviously defective drains or other defects in the building, the owner is called upon to effect the necessary repairs. This aspect of the work involves close co-operation between the Rodent Control Staff and the Sanitary Inspectors. In other cases, the occupier is called on to set traps, lay baits or take other action as the circumstances may require. The setting of traps and laying of baits is, on request, carried out by the Rodent Control Staff, charges being made for this service. These charges are usually nominal except in the case of business premises, where the cost is charged in full. The sewers under the control of the Council are treated twice yearly, in accordance with the suggestion of the Ministry of Agriculture and Fisheries (Infestation Control Division). Their recommended method of treatment, namely, the laying of prebait (unpoisoned) on two days, followed on the third day by poisoned bait, is followed. The Ministry make a grant of 50 per cent. towards the cost of the service, in so far as this is not recovered from the owners or occupiers of premises. The following table shows the prevalence of rats and mice in the Borough for the year:— Property Infested by Rats Seriously infested by Mice Major Minor Council's properties — 9 2 Dwelling houses -— 164 44 Business premises — 143 90 — 316 136 The total number of visits made to the above premises, and to others which were found not to be infested, was 6,776. 27 Vacant Sites, Static Water Tanks, ctc. Nuisances caused by the dumping of rubbish and the accumulation of rainwater in disused static water tanks, and the dumping of rubbish on cleared sites, showed a considerable diminution over those arising in previous years, although in a number of cases the Council had to clear these deposits. The diminution was no doubt largely due to the removal of a number of tanks and the use of the sites for rebuilding or other purposes. Arrangements are in operation whereby the Council are empowered to clear static water tanks and to obtain refund of the cost from the London County Council. It was not found necessary to make use of these arrangements during the year. Burial of Deceased Persons. Under Section 50 of the National Assistance Act, 1948, the Council are responsible for the burial or cremation of the body of any person dying, or being found dead, in the Borough, and have power to recover from the estate of the deceased person, or from any person who, under the Act, was liable to maintain the deceased immediately prior to his death, their expenses incurred in carrying out the duty, in so far as these expenses are not covered by any grant made under the National Insurance Act, 1946. During the year, 8 cases were dealt with. The burials arranged by the Council are carried out by a local undertaker under contract, and not more than one coach is provided for followers. The Health Department make the arrangements and collect all available information regarding any estate left by the deceased, perticulars of his National Insurance, and the existence of any "liable" relatives. This information is passed to the Borough Treasurer so that he may take steps to recover the cost. The total cost incurred in dealing with the 8 cases was £90 of which £41 had been recovered by the end of the year. Aged and Infirm Persons. Under Section 47 of the National Assistance Act, 1948, the Council are empowered to apply to a Court of Summary Jurisdiction for an Order for the removal to a hospital or other suitable place of any person who is aged or infirm or suffering from some grave chronic disease, and is living under insanitary conditions. This power is exercisable on the certificate of the Medical Officer of Health. The Order remains operative for a period of three months, but the Court may, on application by the Council, extend it for such further periods, not exceeding three months each, as are considered necessary. The procedure under Section 47, as outlined above, was amended by the National Assistance (Amendment) Act, 1951, which came into operation on the 1st September, 1951, for the purpose of enabling very urgent cases to be dealt with more expeditiously. This new Act provides that the Court, or a single Justice of the Peace, may, on the certificates of the Medical Officer of Health and another registered medical tioner, make an Order without formal notice of the application having been given to the person concerned or to the hospital authority, subject, in the case of the latter, to evidence being produced of their willingness to admit the person. The length of time a person may be detained 28 under such an Order is limited to three weeks, instead of three months, and any application for an extension of this period must be made in accordance with the procedure laid down in Section 47. An application under the new Act may be made by the Medical Officer of Health without special authority from the Health Committee in each individual case, provided a general authority to act is given. Such general authority has been given by the Council to the Medical Officer of Health and his Deputy. It was found necessary to use these emergency powers in one case during the year. This case was a woman of 84 years of age, who was living alone in one room under most insanitary conditions and was clearly quite unable, by reason of her age and physical infirmity, to devote to herself proper care and attention, and who had no relatives or other persons who would assist her in any way. All efforts to persuade her to enter hospital voluntarily were unsuccessful, and application had therefore to be made to the Court for an Order for her compulsory removal. This Order was granted and subsequently executed. She eventually agreed to remain in the hospital and to give up her room, so that it was not necessary to apply for a further Order. Many other cases of persons, mostly of advanced age, alleged to be living under unsatisfactory conditions, were reported and investigated. In some of these it was found possible to arrange voluntary admission to a hospital or other suitable place, and some cases were still under observation at the end of the year. Care of the Aged. The welfare of the aged continues to be of immediate concernFortunately, the old people's clubs provide an opportunity for old folk to meet and to help one another should the need arise. Close liaison is maintained between the secretaries of these clubs, the Battersea Old People's Welfare Committee and the staff of the Health Department. By virtue of this co-ordination a chiropody service operating entirely on a voluntary basis was inaugurated in 1952. Subsidised by the Battersea Old People's Welfare Committee, the service has proved to be a success. Old age pensioners are now able to obtain treatment by qualified chiropodists at a specially reduced charge. Thanks are due to the chiropodists who have expressed their interest in the scheme, and who have agreed to give full treatment at reduced fees. Old people who are unable to attend club meetings would welcome visits by their relatives, friends and neighbours. In some cases, however, elderly people lead a lonely existence. Instead of achieving the peace that comes of experience, they touch the lowest level of depression. It is precisely in these circumstances that a visit by a member of the staff of the Health Department contributes to theiR welfare and well-being. In addition, visits are paid by a group of voluntary workers, including the personnel of the Meals-on-Wheels Organisation. Nevertheless, there is room for expansion. More volunteers are urged to come forward in order to lighten the task and to ensure an equitable distribution of visits throughout the Borough. Any elderly person, who would like to be visited, should apply to the Health Department so that arrangements may be made accordingly. So far as possible, the visit will be made by a volunteer residing in the vicinity, but the success of these arrangements will depend largely 29 upon whether sufficient volunteers are prepared to offer their help. For preference, every one of the sixteen Wards of the Borough should be represented by a voluntary worker. Rag Flock and other Filling Materials Act, 1951. This Act, which came into force on the 1st November, 1951, and is enforceable by the Council, repealed the Rag Flock Acts, 1911 and 1928, and Section 136 of the Public Health (London) Act, 1936, which dealt with the sale of rag flock. It enacts new provisions relating not only to rag flock, but also to a number of other filling materials, e.g., kapok, feathers, down, straw, hair, unwoven cotton and woollen substances, etc., specified in it. The Minister of Local Government and Planning, and the Home Secretary, acting jointly, have power to extend this list. The principal provisions of the Act are as follows:— Registration: Premises in which rag flock or other filling materials are used in upholstering, or the stuffing or lining of bedding, toys, baby carriages, and any other articles prescribed by regulations, must, with certain exceptions, be registered with the Council. Licensing: Premises used for the manufacture or storage of rag flock (but not other filling materials) must be licensed by the Council. Entry, Inspection and Sampling: An authorised officer of the Council has right of entry at all reasonable times to registered or licensed premises, or premises which he has grounds for believing should be registered or licensed. He may inspect any articles, and take samples of any filling materials. The Medical Officer of Health, and Sanitary Inspectors, are deemed to be authorised officers. The Minister subsequently made the Rag Flock and Other Filling Materials Regulations, 1951, prescribing standards of cleanliness for each king of filling material, the methods of testing samples, the nature of the tests to be applied, the names and addresses of Analysts, the form of certificate of analysis, and the fees payable. There are no premises in the Borough dealing with rag flock. There are, however, six premises at which other filling materials are used in such circumstances as to require them to be registered, Registration of these premises has been duly effected. Eleven visits were made to registered premises during the year, but no contravention of the Act was discovered. Three informal samples of filling materials were taken and submitted to the Analyst. All were certified to be in conformity with the Regulations. Pet Animals Act, 1951. This Act came into operation on the 1st April, 1952, and is enforceable by the Council, who authorised the Medical Officer of Health, the Deputy Medical Officer of Health, and the Sanitary Inspectors to act on their behalf. The object of the Act is to regulate the sale of pet animals, with particular reference to their welfare while kept for sale in pet shops. A pet shop may not be kept except under the authority of a licence granted in accordance with the provisions of the Act. The keeping of a pet shop is defined as the carrying on at premises of any nature (including a private dwelling and a stall or barrow in a market) of a 30 business of selling animals as pets or keeping them with a view to sale. "Animal" is defined as "any species of vertebrate." Licences are renewable annually, and a fee of 10s. may be charged for them. In considering an application for a licence, the Council must have regard to the need for securing:— (a) that animals will at all times be kept in accommodation suitable as regards size, temperature, lighting, ventilation and cleanliness; (b) that animals will be adequately supplied with suitable food and drink, and (so far as necessary) visited at suitable intervals; (c) that mammals will not be sold at too early an age; (d) that all reasonable precautions will be taken to prevent spread of infectious disease among animals; (e) that appropriate steps will be taken in case of fire or other emergency. These matters are without prejudice to the Council's discretion to withhold a licence on other grounds. It is also required that the licence shall specify such conditions as the Council consider necessary to secure all or any of the objects set out above. In this connection the Council adopted a standard set of conditions prepared by the Metropolitan Boroughs' Standing Joint Committee. A person aggrieved by the refusal of a licence, or by any condition subject to which it is proposed to be granted, has a right of appeal to a Court of Summary Jurisdiction. Licences were issued in respect of 13 shops, and 15 visits were made during the year. Heating Appliances (Fireguards) Act, 1952. This Act received Royal assent on the 1st August, 1952, but did not come into operation until the 23rd March, 1953, the date fixed by Order of the Secretary of State. It is enforceable by the Council, who have authorised the Medical Officer of Health, the Deputy Medical Officer of Health, and the Sanitary Inspectors to act on their behalf. The Act prohibits, subject to certain minor exceptions, the sale or exposure for sale, or the letting or offer for letting under a hirepurchase agreement or on hire, of any appliance required by Regulations to be made under the Act to be fitted with a guard, if either the guard is not fitted or it does not comply with the standard prescribed for by the Regulations. The Regulations, known as the Heating Appliances (Fireguards) Regulations, 1953, were made by the Secretary of State and came into operation on the 1st October, 1953, except in regard to appliances manufactured in Great Britain before that date. For the latter, the operative date will be 1st October, 1954. The Regulations prescribe that every heating appliance of a type which is so designed that it is suitable for use in a dwelling house or other residential premises shall be fitted with a guard which shall be robustly made and securely attached to the appliance, and shall satisfy certain tests which are set out in a Schedule to the Regulations. These tests comprise a loading test of rigidity, the use of probes of specified shapes and dimensions to check the mesh of the guard, and the placing of flannelette on the guard while the fire is alight, the requirement being that the flannelette must not smoulder or ignite within a period of ten seconds. 31 It is estimated that there are about 60 shops and other premises in the Borough at which heating appliances are sold or let on hire. In view however, of the exception, until 1st October, 1954, of appliances made before 1st October, 1953, little can be done until after the former date to enforce the requirements of the Regulations. Use of Slipper Baths by Old Age Pensioners. On the 30th January, 1952, the Council, on a recommendation of The Health Committee (with which the Baths and Wash-Houses Committee were in agreement) decided to make available to old age pensioners free use of the slipper baths at their Baths Establishments (with use of towel) on production of their pension books. During the year 1953 this arrangement was taken advantage of by 9,852 persons—4,453 men and 5,399 women. Public Swimming Baths. The Council maintain four public swimming pools—three at Latchmere Baths and one at Nine Elms Baths. Samples of the water from these pools are taken weekly for bacteriological examination. The results show that the water has consistently maintained a high degree of purity. Protection of Food Supply. (A)—INSPECTION OF FOOD PREMISES. Regular inspection of all premises where food for human consumption is prepared, stored, or sold has always been carried out as a routine measure, for it is evident that constant inspection and supervision is the only really satisfactory way of securing and maintaining satisfactory hygienic conditions in such premises. Abundant evidence of this is provided by the immense improvement in the conditions at catering establishments which, in the past three years, have had special attention paid to them. In all these inspections, emphasis is on advice and education rather than upon formal enforcement of statutory provisions, the latter being invoked only when peaceful persuasion fails to achieve the desired improvement. For many years it had been the practice in Battersea to allocate the responsibility for the inspection of all food premises to specialist inspectors. The increasing recognition of the importance to public health of those premises, and the increase in legislation affecting them, however, has made it evident that an increase in the volume of inspection had become a matter of urgent necessity. The Council, therefore, decided that as from 1st November, 1953, the District Sanitary Inspectors should be given responsibilities in this field, and accordingly they are now undertaking the routine inspection of certain food premises in their various districts. 32 By-laws for the Protection of Food. These By-laws, made by the London County Council under Section 15 of the Food and Drugs Act, 1938, came into operation on the 3rd November, 1952. They are designed to secure the observance of sanitary and cleanly conditions and practices in connection with the handling, wrapping and delivery of food sold or intended for sale for human consumption, and in connection with the sale or exposure for sale in the open air of food intended for human consumption. They are, of course, in addition to and not in substitution for, other statutory requirements on the same subjects (e.g., Section 13 of the Food and Drugs Act, 1938). A copy of the By-laws was sent to each food trader in the Borough, and they will all subsequently be visited by one of the Sanitary Inspectors; who, in addition to ascertaining whether the By-laws are being complied with, will offer advice to the trader on any aspect ot them on which he may be in doubt. Legal proceedings were taken against a firm of horse slaughterers carrying on business in a northern city in respect of the transport and delivery to a shop in Battersea, under unhygienic conditions, of horseflesh intended for human consumption. Two summonses were issued under the By-laws. The defendant firm did not appear, but wrote to the Court pleading guilty. The Court imposed a fine of £4 and awarded £1 1s. Od. costs on each summons. Subsequent observations on this firm's deliveries showed that the prosecution had had the desired effect. Talks to School Children. By arrangement with the London County Council as Education Authority, two of the Sanitary Inspectors visited a number of local schools at various times during the year and gave talks to the pupils on hygiene in the kitchen, and on clean milk production. Arrangements were also made for parties of pupils to visit food factories and milk processing depots. These talks and visits were greatly appreciated and are undoubtedly of considerable educational value. Festival Pleasure Gardens, Battersea Park. In the Annual Report for 1951, an account was given of the catering arrangements in these Gardens and of the control exercised over them by the Council's Officers. The Gardens were again open to the public for a period of about six months during 1953. The attendance was considerably below that of 1951, but the number of catering establishments, ice cream kiosks, etc., was much the same as in previous years. Close supervision of these premises was maintained, and once again it is gratifying to record that no case of serious illness was traced to any food purchased in the Gardens, nor was any complaint made about the catering arrangements. Slaughterhouses. There is only one licensed slaughterhouse in the Borough. Its use ceased about the middle of 1950 and has not been resumed. 33 Butchers' Shops. There are 73 butchers' shops in the Borough, and in addition a lumber of shops where cooked meats are sold. All these shops are systematically inspected, 1,076 visits having been made during the year. In general, the shops are well conducted, and no formal action was found necessary. Four shops where horseflesh is sold for human food are included the above figure. Public Health (Meat) Regulations, 1924. No offence against the Regulations was reported during the year. Dairies and Milkshops. The following table gives the dairies and milkshops registered in the Borough, and the changes during 1953:— (a) Dairies where loose milk is sold, and both the premises and the occupier are registered:- Retail Wholesale total On register at 1st January 40 7 47 Transferred to (b) below 3 — 3 On register at 31st December 37 7 44 (b) Milkshops, where milk is sold only in sealed containers, and only the occupier is registered as a distributor:— On register at 1st January 93 Added during year, by new registrations 6 Transferred from (a) above 3 102 Removed during year 3 On register at 31st December 99 (c) " Out-of-Borough " registrations (i.e., persons selling milk in Battersea from premises in other boroughs):— On register at 1st January 29 New registrations 2 31 Removed during year 1 On register at 31st December 30 A total of 302 visits were made to these shops during the year. Generally conducted. In no case was any contravention of the Statutory requirements found. Milk and Dairies Regulations, 1949. Enforcement of these Regulations, which relate to premises where milk is stored, processed, or sold, is dealt with in the preceding paragraph. 34 It was not found necessary to take any action under Regulation 20, which gives power to the Medical Officer of Health to stop the supply of milk suspected of conveying infectious disease. Milk (Special Designations). Under the two sets of Milk (Special Designations) Regulations issued in 1949, four designations are prescribed, namely, Accredited, Tuberculin Tested, Pasteurised, and Sterilised. Accredited Milk may not be heat-treated. Tuberculin Tested milk may be pasteurised of sterilised, provided it is so described. Pasteurised milk must be so treated by either the "Holder" or "High Temperature Short Time" processes, and must comply with the "phosphatase" and "Methylene blue" tests. Sterilised milk must be filtered or clarified, homogenised, and heated to and maintained at a temperature of not less than 212° F. for such time as will ensure that it complies with the "turbidity" test. All persons who pasteurise or sterilise, or deal in special designation milk, are required to hold licences, which (except in the case of producers of raw milk) are issued by Food and Drugs Authorities. The Milk (Special Designations) (Specified Areas) Order, 1951. which came into force on the 1st October, 1951, requires that all milk sold by retail (other than in catering establishments as part of a meal or refreshment) in the areas specified must be sold under one or other of the special designations. Among such areas is the whole of the County of London. The number of licences issued by the Council for 1953 was as follows:- Full Supplementary Accredited — — Tuberculin Tested 54 21 Pasteurised 99 22 Sterilised 137 23 290 66 One licence to pasteurise, and one to sterilise milk were issued, and are included in the above figures. Details of examination of samples of pasteurised and sterilised milk are given on page 42. Ice Cream Premises. The number of premises registered for the manufacture, storage, and/or sale of ice-cream at the end of the year was 238, 18 having been added and 13 removed during the course of the year. All these premises are regularly inspected, 302 visits being made. Particular attention is paid to premises where manufacture takes place, and not only are the premises, plant, and methods of operation scrutinised, but samples of the products are taken for examination by the methods suggested by the Ministry of Health. The premises generally are found to be well conducted. Further details in regard to sampling of ice-cream will be found on page 42 35 Fish Shops. Shops in which fish, either cooked or uncooked, is sold, or where the curing or smoking of fish is carried on, are regularly inspected. There were 47 such shops in the Borough in 1953. 299 inspections were made, and 2 notices were served for minor matters which were remedied without difficulty Street Stalls. All street stalls from which food for human consumption is sold are regularly inspected and, where the food sold is stored in the Borough, the storage places are also inspected. It was not found necessary to take any formal action during the year. Unsound Food. The following table gives particulars of the unsound foodstuffs which, under the provisions of the Public Health (London) Act, 1936, Section 180 (8), were voluntarily surrendered to the Council. Most these foodstuffs were ultimately used for the manufacture of animal feeding stuffs. Fish (preserved) 103 tins, 3 boxes Fish (wet) 4 st., 36 boxes Meat and meat products (preserved) 19 cwts., 3 qtrs., 1 st, 5½ lbs., 1,034 tins Meat (fresh) 1 ton, 11 cwts., 1 qtr, 1 st., 11 lbs. Poultry 29 lbs. Vegetables (preserved) 2,058 tins Vegetables (fresh) 20 bags Fruit (preserved) 2 cwts. 9 lbs., 2,688 tins Fruit (fresh) 1 St., 11 lbs., 330 trays Milk (tinned) 749 tins Cream (tinned) 23 tins Eggs (shell) 1.914 Eggs (frozen) 1 tin Cheese 3 qtrs., 1 St., 9 lbs., 444 packets Cakes and biscuits 9 lbs. Jam rolls 190 Pudding mixture 9 packets Flour and cereals 19 tons, 3 qtrs., 1 St., 13i lbs. Jams, syrups and preserves 344 jars and tins Pickles and sauces 125 jars, bottles and tins Paste (fish) 1 tin Patent foods and beverages 9 lbs., 3 tins Confectionery 1 ton, 19 cwts., 1 qtr., 1 st., 3 lbs., 6,053 bars Soups 105 tins Cordials and fruit juices 74 bottles and tins Seven cases of the presence of foreign matter in food were reported during the year. Legal proceedings were taken in three cases, in all of which convictions were secured. Fines totalling £9 were imposed, and £11 11s. 0d. costs awarded to the Council. The remaining four cases were dealt with by cautionary letters. 36 Food Poisoning. During the year 4 cases of food poisoning were notified. All were isolated cases and of a minor nature, and call for no special comment. On 15th and 16th July, 1953, an outbreak of food poisoning occurred in two Battersea schools. The outbreak affected 10 members of the staff and 117 children. Fortunately the illness was mild in character and the symptoms subsided within 12 hours. The cases were not formally notified. With regard to the cause of the outbreak, a spray skim milk powder came under immediate suspicion. The powder had been employed as a cold mix for a school meal. Bacteriological examination of a sample of the powder revealed the presence of the infecting organism, staphylococcus aureus. The powder was withdrawn from use and no more cases occurred. (B)—SAMPLING OF FOOD AND DRUGS. The analysis of samples of food and drugs, procured under the provisions of the Food and Drugs Act, 1938, or informally (i.e., without following the procedure prescribed by the Act) is carried out by the Public Analyst for the Borough (J. E. Woodhead, Esq., B.sc., F.R.I.C., ph.c.) at his laboratory at 325 Kennington Road, London, S.E.11. The Public Analyst had also carried out the examination of samples of heat-treated milk and of ice cream by the prescribed tests since the inception of those tests, but as from 21st September, 1953. this particular work was transferred to the Public Health Laboratory Service. As the latter Service make no charge for this work, the arrangement enabled an increase to be made in the number of samples for chemical, etc., analysis submitted to the Public Analyst while keeping within the sum provided in the Annual Estimates. The total number of formal samples taken under the Act during 1953 was 304, of which 8, or 2.6 per cent., were certified to be adulterated. In addition, 211 informal samples were procured, of which 6, or 2.8 per cent., were reported against. The percentages of samples reported by the Public Analyst to be adulterated during the quinquennia 1921 to 1950 and in 1951, 1952 and 1953 are given in the following table:— Year Formal samples (per cent.) Informal samples (per cent.) Mean 1921—1925 6.4 7.4 „ 1926—1930 3.3 2.4 „ 1931—1935 1.8 2.1 „ 1936—1940 0.9 0.9 „ 1941—1945 1.4 1.1 „ 1946—1950 1.0 1.1 1951 1.1 1.9 1952 1.6 2.6 1953 2.6 2.8 37 Milk. 100 formal samples of milk were taken during the year. Of the 100 samples, 17 were designated as "Channel Islands" or "South Devon" milk, for which a higher minimum percentage (viz., 4 Per cent.) of milk fat content is provided for under arrangements made between the producers and the Ministry of Food. 16 of these samples were reported to be in conformity with this standard, their average imposition being:— Milk fat 4.32 per cent. Non-fatty solids 9.09 Total milk solids 13.41 The remaining sample was reported to be deficient in milk fat to the extent of 3 per cent. The facts of this case were reported to the Ministry of Food as soon as the result of the analysis was known. their request, further samples were obtained from the supplier and Proved to be satisfactory. The remaining 83 samples (of ordinary milk) were all reported as genuine and their average composition was as follows:— Milk fat 3.59 per cent. Non-fatty solids 8.74 „ Total milk solids 12.33 „ The milk fat content of the 17 samples of "Channel Island" or "South Devon" milk ranged as under:— Between 4.6 and 4.7 per cent. 1 sample „ 4.5 „ 4.6 „ — „ „ 4.4 „ 4.5 „ 4 samples „ 4.3 „ 4.4 „ 5 „ „ 4.2 „ 4.3 „ 6 „ Under 4.0 per cent. 1 sample 17 Their content of milk fat ranged as follows: — 4 per cent, and over ... 2 samples or 2.4 per cent. Between 3.9 and 4.0 per cent 9 „ „ 10.9 „ „ 3.8 „ 3.9 „ 6 „ „ 7.2 „ „ 3.7 „ 3.8 „ 6 „ „ 7.2 „ „ 3.6 „ 3.7 „ 20 „ „ 24.1 „ „ 3.5 „ 3.6 „ 20 „ „ 24.1 „ „ 3.4 „ 3.5 „ 14 „ „ 16.9 „ „ 3.3 „ 3.4 „ 4 „ „ 4.8 „ „ 3.2 „ 3.3 „ 1 sample „ 1.2 „ „ 3.1 „ 3.2 „ 1 „ „ 1.2 „ „ 3.0 „ 3.1 „ — — 83 100.0 38 In the five years 1948-52 and in 1953 the percentage of adulterated samples of milk was as under:— Year Samples taken Adulterated No. Percentage 1948 402 0 0.0 1949 421 10 2.4 1950 462 0 0.0 1951 428 1 0.2 1952 101 0 0.0 Mean 363 2 0.5 1953 100 1 1.0 39 The following tables give details of the articles of food of which samples were obtained for the purpose of analysis. Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Baking Powder — 3 3 — — — Barley Crystals — 1 1 — — — Bread — 1 1 — — — Butter 16 — 16 1 — 1 Cake and Pudding Mixture — 10 10 — — — Cereal Preparations 9 14 23 — 1 1 Cocoa — 8 8 — — — Coconut, Desiccated — 3 3 — — — Coconut, Sweetened — 1 1 — — — Coffee 1 2 3 — — — Coffee and Chicory Essence 8 3 11 — — — Confectionery Flour 21 1 22 — — — Confectionery Sugar 18 2 20 5 1 6 Cream, double — 1 1 — — — Cream, single — 1 1 — — — Cream, tinned — 3 3 — — — Custard Powder — 2 2 — — — Fish Cakes 1 — 1 — — — Fish Paste 1 14 15 — — — Flavouring — 4 4 — — — Fruit, tinned 1 — 1 — — — Fruit Preserving Tablets — 1 1 — 1 1 Gelatine — 4 4 — — — Ginger, ground — 1 1 — — — Glucose 1 1 2 — — — Golden Raising Powder — 3 3 — — — Gravy Preparations — 6 6 — — — Ice Cream 1 — 1 — — — Jam 4 — 4 — — — Jelly 5 5 10 — 1 1 Jelly Crystals 1 — 1 — — — Junket Preparations — 2 2 — — — Lard 2 — 2 — — — Lemonade Crystals — 1 1 — — — Lemon Juice — 1 1 — — — Marmalade 1 — 1 — — — Mayonnaise 2 — 2 — — — Carried forward 93 99 192 6 4 10 40 Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Brought forward 93 99 192 6 4 10 Meat Preparations:— Black Pudding 1 — 1 — — — Meat Paste — 13 13 — — — Meat Pies 3 — 3 — — — Pork Pies 1 1 2 — — — Veal and Ham Pie 1 — 1 — — Sausages, Beef 2 — 2 — — — Sausages, Liver 2 1 3 — — — Sausages, Luncheon 1 — 1 — — — Sausages, Meat 3 — 3 — — — Sausages, Pork 10 — 10 — — — Sausage Rolls 2 — 2 — — — Milk 100 — 100 1 — 1 Mincemeat 1 — 1 — — — Mint — 1 1 — Mustard — 3 3 — Non-brewed Condiment 4 — 4 — — — Nutmeg, ground — 1 1 — — — Olive Oil 4 — 4 — — — Peanut Butter 1 — 1 Pea Flour — 1 1 — Peel, mixed 3 — 3 Pepper-flavoured Compound — 1 1 — — — Pepper, White — 2 2 — — —- Pickles — 4 4 — —- Raisins 2 2 Saccharin Tablets — 2 2 Sage — 1 1 — —- Sandwich Spread — 3 3 — — — Sauces 15 8 23 Soft Drinks 4 1 5 Soups, canned — 2 2 Soups, powder — 2 2 — — Spices and Condiments — 6 6 __ Stuffing — 4 4 Suet 5 5 Sultanas 7 __ 7 Tea 1 1 Vinegar 23 23 Wine, British 2 2 ____ . Yeast Extract 1 1 Yoghourt — 1 1 — — — Totals 291 158 449 7 4 11 41 Drugs. The following table gives details of the drugs of which samples were obtained for the purpose of analysis:— Nature of Sample Examined Adulterated Formal Informal Total Formal Informal Total Cream of Tartar 1 1 — Glycerine 5 — 5 — — — Iodine, Tincture of ... — 3 3 — — Linctus 2 1 3 — — Menthol Pastilles 1 1 — Gil, Camphorated — 4 4 — — — Gil, Castor — 4 4 — — Ointment, Boric — 1 1 — 1 1 Ointment, Sulphur ... 4 4 Ointment, Zinc 1 6 7 1 1 2 Paraffin, Liquid 1 1 2 — Salts, Epsom 2 2 4 — — Salts, Glauber — 1 1 — — — Seidlitz Powder — 4 4 — — — Soda, Bicarbonate of 3 3 — Tablets:— — Aspirin — 9 9 — — — Energy 1 1 — Soda Mint 4 4 __ Sulphur — 5 5 — — — Totals 13 53 66 1 2 3 Adulterated Samples. The following action was taken in regard to the 8 formal samples certified as adulterated:— No. 4. Buttermint Ovals deficient in butter fat. Total fat 1.7 per cent, including not more than 0.5 per cent. butter fat. Label misleading.—Cautionary letter. No. 86. Devon Butter Pats 72.5 per cent. deficient in butter fat. Label misleading.—Cautionary letter. No. 90. Butter 0.3 per cent. excess of water.—Cautionary letter. No 103. South Devon Milk. 3 per cent. deficient in milk fat.— Referred to Ministry of Food. No 136. Zinc ointment 12 per cent. deficient in zinc oxide.— Cautionary letter. No 245. Butter Brazils at least 50 per cent. deficient in butter fat. Label misleading.—Cautionary letter. No 272. Butter Brazils at least 49 per cent. deficient in butter fat. Label misleading.—Cautionary letter. No. 274. Butter Almonds at least 49 per cent. deficient in butter fat. Label misleading.—Cautionary letter. 42 Cream. In addition to samples taken for chemical examination, 4 samples of natural cream and 1 of synthetic cream, were taken and submitted for bacteriological examination to the Public Health Laboratory. All these samples were reported to be satisfactory. Heat Treated Milk. Samples of pasteurised and sterilised milk are taken at regular intervals for submission to the Public Analyst for the prescribed tests, and during the year samples as under were taken with the results set out:— Phosphatase Methylene Blue Satisfactory Failed Satisfactory Failed Pasteurised 24 1 25 — Turbidity Satisfactory Failed Sterilised 22 — Monthly returns of the samples taken, and of the results of the examinations, are sent to the Milk Division of the Ministry of Food, and they are at once notified of any adverse report. Ice-Cream. Nineteen samples of ice cream were taken during the year, each sample being submitted to the methylene blue test. The samples were, as a result of the test, placed in the following grades: — Provisional Grade 1 7 „ 2 9 „ 3 1 4 2 19 Where samples of ice cream made at premises in the Borough receive unsatisfactory reports, the premises, plant, and methods of operation are examined, and, where possible, improvements suggested. Milk supplied to Schools and Hospitals. Samples of milk in course of delivery to Schools and Hospital in the Borough are regularly taken, both for chemical analysis and for submission to the prescribed tests for such milk. These samples included in the general totals given on pages 37, 40 and 42. The results of the analyses and tests are communicated to the London Courntry Council or to the appropriate Hospital Management Committee. 43 Housing. Provision of New Accommodation. During the year 1953 construction of the following 464 new houses flats was completed:— By Battersea Borough Council:— Rollo Court Battersea Park Road _ Scheme 40 flats Alfreda Court 34 „ Ravenet Court 34 „ Bank Court 18 „ Newtown Court 35 ,, Queens Court, Meath Street 9 „ Balfern Street, 33/39 4 houses Parma Crescent, 5/11 (cons.) 7 Stanmer Street, 32/38 4 Lavender Sweep, 17/27 6 St. James's Close, 1/8 8 Cambridge Road, 24, 24a, 26, 26a, 28, 28a 6 flats Silverthorne Road, 34/37 (cons.), and Froude Street, 5 and 6 6 „ Battersea Park Road, 208a/218a 6 „ Devereux Road, 47, 47a, 49, 49a 4 „ Gowrie Road, 11/33 12 „ Stormont Road, 98 and 100 2 „ Longhedge Street, 1/11 6 houses New Lodge, Battersea Rise Cemetery 1 house 242 By London County Council:— Beattie House Patmore Street Estate 52 flats Bonsor House 52 „ Cudworth House 52 „ Wainwright House 15 „ Bridlington House Usk Road Estate 6 Filey House 20 „ Lerwick House 20 „ Schoolkeeper's House, Bradmede School 1 house Schoolkeeper's House, John Milton School 1 „ Schoolkeeper's House, Joseph Tritton School 1 „ 220 By Private Enterprise:— 22 Marmion Road 1 house Caretaker's flat, Coventry Compressors, Ltd., Stewarts Road 1 flat 2 Total 464 44 Construction of the following new houses and flats was in progress at the end of the year:— By Battersea Borough Council:— 1 10 houses Sisters Avenue/Marjorie Grove 1 flat 1 maisonette Rawson Court, Battersea Park Road 64 flats Site of 116/118 Lavender Hill 4 „ Site of 154/156 Lavender Hill 4 „ St. James's Drive Extension 30 „ Site of 1/15 Salcott Road 8 „ 122 By London County Council:— Patmore Street Estate 418 flats Usk Road Estate 20 „ 438 By Private Enterprise:— Site of 69/73 Beaufoy Road 2 houses 34 Culvert Road 1 house 40 Taybridge Road 1 4 Total 564 A number of other sites were under consideration at the end the year, with a view to their being utilised for housing purposes. Closing Orders. Two Closing Orders under Section 12 of the Housing Act, 1936 were made during the year, in respect of basement rooms. Demolition Orders. It was not found necessary to make any Order under Section 11 of the Housing Act, 1936. Houses Let in Lodgings. No special action was taken in respect of such houses. Overcrowding. 35 cases of overcrowding were discovered during the year, 33 in consequence of applications for housing accommodation made to this Council, and 2 to the London County Council. 44 overcrowded families were rehoused during the year, 28 by this Council and 16 by the London County Council. 45 Legal proceedings were taken against the landlord of a house who had let it out in furnished rooms in such circumstances as to cause four of the rooms to be overcrowded and thereby to create offences against the Housing Act, 1936. Three of the tenants having vacated their rooms while the matter was under consideration, the proceedings are taken only in respect of the fourth room. In this case also, the tenant vacated before the summons came before the Court. The andlord pleaded guilty and was fined £1, and £1 1s. Od. costs were awarded to the Council. Housing Accommodation Applications. All applications made to the Council are normally dealt with by the Housing Manager, who refers to me those cases in which the application is based wholly or partly on medical grounds. These cases indelude applications for transfer from Council tenants and licensees of requistioned premises. He also refers certain cases in which some special feature is involved {e.g., fitness of basement rooms). Under the Council's "Points Scheme," points are allocated by the Housing Manager for statutory overcrowding, bedroom deficiency, lack of a .searate home, etc., and he refers to me cases of ill-health (for which additional points up to a maximum of 15 for pulmonary tuberculosis and 10 for other conditions can be allocated), and unsuitable accommodation (for which the maximum additional points is 10). Each case is placed in a group according to the number of bedrooms requird by the family. Applications with the highest number of points in each group are submitted to the Housing Committee for insrructions Cases where the applicant or a member of his household is suffering from pulmonary tuberculosis and is infectious, and where the accommodiation is considered to be inadequate, are submitted to the Committee irrespective of the total number of points allocated. The points scheme does not apply to applications for transfers from Council or requisitioned property, which are still dealt with under the previous system, " essential" and " advisable " recommendations being made on medical grounds. During 1953 a total of 752 cases were dealt with under the arrangements set out in the three preceding paragraphs. The maximum number of points on medical grounds other than pulmonary tuberculosis were allocated to 8 applications. In 18 cases the maximum points were given for pulmonary tuberculosis, 8 of these being referred to the Housing Committee for special consideration as the accommodation was indicate. In 21 cases of transfer applications, rehousing was recomended as essential on medical grounds. to London County Council also refer cases in which there appear to be overcrowding, for the submission, in appropriate cases, of an ''orange" form." Overcrowding was found to exist in 2 instances. The London County Council also notify cases in which the application allegs sanitary defects. The houses are inspected, and action to secure the remedy of any defects found is taken. 46 Increase of Rent, &c., Acts. One certificate that a house was not in a reasonable state of repair was issued to the tenant. One report that a house was in a reasonable state of repair was issued to the landlord. Statistics for the Year ended 31st December, 1953. Number of new dwellings erected or re-erected 464 Number of houses demolished:— In pursuance of clearance orders Nil In pursuance of demolition orders Nil In pursuance of undertakings to demolish Nil Number of dwelling houses inspected for housing defects (under Public Health and Housing Acts) 3,664 Number of inspections made for that purpose 27,482 Number of houses at which defects found:— Dealt with under Housing Act (informally) Nil Dealt with under Housing Act (formally) Nil Dealt with under Public Health (London) Act 1,646 1,646 Number of houses where defects remedied:— As result of action under Housing Act Nil As result of action under P.H. Act 1,886* 1,886 Number of houses in respect of which demolition orders were made Nil Number of houses in respect of which undertakings under Section 11(3) were accepted Number of underground rooms in respect of which closing orders were made 2 Number of closing orders determined Nil * Representing 2,197 notices complied with. In 23 of these cases the Council carried out the work in default of the owner. 47 Factories and Homework. Factories Act, 1937. Metropolitan Borough Councils are responsible for the enforcement the provisions of this Act in regard to:— (i) Sanitary conveniences—Section 7—In all factories. (ii) Cleanliness, Overcrowding, Temperature, Ventilation, and Drainage of Floors—Sections 1, 2, 3, 4 and 6—In all factories where mechanical power is not used. (iii) Certificates of Suitability for Basement Bakehouses—Section 54—In all basement bakehouses. (iv) Water Supply (where derived from a source other than the public mains)—Section 53—In all factories. The following table gives the number of factories on the register at the end of the year, with the number of inspections, defects found, and action taken. INSPECTIONS for purposes of provisions as to health. Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 114 843 15 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 331 1,096 6 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 14 28 — — total 459 1,967 21 — 48 2.—CASES in which DEFECTS were Found. Number of cases in which defects were found Number of cases in which prosecutions were instituted Particulars Referred Found Remedied To h.m. Inspector By h.m. Inspector Want of cleanliness (S.l.) 1 1 — 1 Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) 1 1 1 1 Ineffective drainage of floors (S.6) _ _ _ Sanitary Conveniences (S.7) (a) Insufficient 2 2 — — — (b) Unsuitable or defective 11 11 3 (c) Not separate for sexes 1 1 - Other offences against the Act (not including offences relating to Out-work) — — — — — TOTAL 16 16 1 5 — 49 The following table shows the factories in the Borough, classified according to the trades carried on. Factories Classified according to Trades. Trade Mechanical Factories Non-Mechanical Factories At 1 Jan. At 31 Dec. At 1 Jan. At 31 Dec. Building and Allied 26 25 19 20 Nothing and Allied 42 43 18 18 Engineering and Heavy Industry 40 46 — 1 Electrical and Allied 11 11 1 1 Florist — — 2 2 Food and Allied 55 53 5 4 Furniture and Allied 10 12 3 4 Metal Worker 8 9 — — Printer and Allied 20 23 3 2 Road Vehicle Repairer 42 42 15 17 Steam Laundry 10 10 — — Others 54 57 43 45 Total 318 331 109 114 Outworkers. During the year 63 lists of outworkers were received, 26 from Battersea employers, containing 213 names, and 37 from other authoritirs containing 203 names. Some of these lists included outworkers not residing in Battersea. These were forwarded to the appropriate authorities. After eliminating them, and duplicate entries, there remained 208 names and addresses of Battersea outworkers. The total number of registered outworkers' premises in the Borough at the end of the year was 428 (including 7 contractors), 105 premises having been added, and 110 removed, during the year. The total number of inspections made was 1,203, most of them by the female Inspector. The premises were found to be generally satisfactory, and it was not found necessary to serve any notices or take any other action 17 cases of infectious diseases occurred at outworkers' premises, and the usual precautions to prevent spread of infection were taken. 50 The following table gives details of the outworkers' premises:- Number on Register Trade Premises Workrooms Persons employed Wearing Apparel 259 263 312 Linen 1 1 1 Curtains, etc. 2 2 2 Artificial Flowers 4 4 4 Paper Bags 9 9 9 Boxes, etc. 10 10 10 Stuffed Toys 1 1 1 Lampshades 142 142 149 428 432 488 Bakehouses. There were 34 bakehouses on the register at the end of the year. All of these are classed as factories, and 31 of them use mechanical power. 93 inspections were made and 3 notices served. Five of the bakehouses were "basement bakehouses" within the meaning of Section 54 of the Factories Act, 1937. Miscellaneous Matters.. Conferences. The Council were officially represented at the undermentioned Conferences dealing with matters within the purview of the Public Health Department. Conference. Royal Sanitary Institute, Hastings —28th April to 1st May. Central Consultative Committee on the Welfare of Old People, London—19th June. Sanitary Inspectors' Association, Morecambe — 8th to 11th September. National Smoke Abatement Society, Glasgow—30th September to 2nd October. Delegates. Cllr. Mrs. E. A. Cooper, J.P.. and the Medical Officer of Health. Cllr. Mrs. C. M. Davis and Mrs. E. Reynolds. Cllr. Mrs. C. M. Davis and Mr. I. R. Lewis, Sanitary Inspector. Cllr. Mrs. E. A. Cooper, and Mr. G. W. P. Weeks. Sanitary Inspector. Personal Cleansing Station. During the year 1953 there were 1,943 children and 144 adults cleansed and treated at the Station. Of the 1,943 children attending. 169 were suffering from scabies or itch, a contagious parasitic skin affection. The remainder were verminous. Of these children 1,879 attended from the schools in the Borough by arrangement with the London County Council, who have entered into a contract with the Battersea Borough Council for the use of their Personal Cleansing 51 Station. The cleansing and treatment of the school children is carried out under the supervision of officers of the London County Council while the disinfestation of the clothing and (if necessary) of the homes is carried out concurrently by the Borough Council's sanitary staff. The homes of all cases of scabies that come to the knowledge r of the Medical Officer of Health are visited by the Council's Sanitary Inspectors. The following table shows the numbers of persons cleansed and treated at the Personal Cleansing Station and the expenditure incurred since 1906, the year in which the cleansing of verminous persons was begun:- Number of Baths, &c. Year Adults Children *Expenditure *Amount Contributed Verminous and Scabies Verminous and Scabies £ £ 1906-1915 10,443 6,430 1,037 303 1916-1925 3,269 39,117 5,007 3,155 1926-1935 2,404 39,293 8,521 4,045 1936 265 4,524 723 403 1937 389 4,256 729 403 1938 432 3,808 820 402 1939 534 2,820 795 402 1940 778 3,497 866 404 1941 2,558 5,456 1,026 435 1942 3,083 6,656 1,059 440 1943 2,017 5,223 1,149 422 1944 1,798 3,931 1,100 441 1945 1,885 3,277 1,179 454 1946 1,822 4,229 1,352 443 1947 986 4,179 1,402 424 1948 497 3,266 1,808 408 1949 286 2,773 1,534 411 1950 226 2,238 1,750 410 1951 200 1,858 1,992 406 1952 176 1,994 1,956 535 1953 144 1,943 1,932 508 Financial year ending 31st March. Other columns, calendar year. The contract with the London County Council, referred to above, provides for the payment by them of 3s. 6d. for each treatment given, whether for vermin or for scabies, with a minimum payment of £500 per annum. The Council, at their meeting on the 23rd May, 1951, decided, on the recommendation of the Health Committee, to accede, until further order, to a request of the Divisional Medical Officer, No. 9 Division, 52 London County Council, for the use of the Station for the treatment of a small number of children suffering from minor ailments, without charge. The number of children requiring such treatment has, however, increased over the last year or so to such an extent that the accommodation at the Station became inadequate. The London County Council therefore decided to make other arrangements, and the use of the Station for the purpose ceased on the 9th September, 1953. Coroner's Court and Mortuary. Details as to the number of inquests held at the Coroner's Court and bodies received into the Mortuary, during 1953, are set out in the following table. Battersea Mortuary, 1953. Details of Bodies received Usual place of residence Total Battersea Wandsworth Elsewhere Residence unknown Post-mortem only 170 333 114 17 634 Post-mortem and inquest 35 82 48 7 172 Total post-mortems 205 415 162 24 806 Inquest only — — 1 — 1 Total inquests 35 82 49 7 173 Sanitary and other reasons 1 — — 1 2 Total bodies received 206 415 163 25 809 VERDICTS AT INQUESTS HELD Natural causes 2 1 5 1 9 Accident and misadventure 15 51 31 1 98 Open verdict 5 2 1 2 10 Suicide 12 27 11 2 52 Homicide — 1 1 1 3 Self-Neglect 1 — — — 1 Total 35 82 49 7 173 In addition to the above, eight inquests were held on non-residents, and in each case the body was absent, not having been brought into the Mortuary. The Wandsworth Borough Council again made a grant of £250 towards the cost of maintaining the Mortuary. The London County Council pay a rent of £450 for the use the Coroner's Court.