AC 4386 NCK 26/9/56 PB. BAT 54 Metropolitan Borough of Baţersea. REPORT ON THE HEALTH OF THE Metropolitan Borough of Battersea FOR THE YEAR 1955 BY J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH. Batterstea Borough Council with the Bamphilments of the medical officer of Health Public Health Department, Electric House, 204 Lauender Hill, Poallessea, P.W.11 Metropoloitan Borough of Battersea. REPORT ON THE HEALTH OF THE Metropolitan Borough of Battersea FOR THE YEAR 1955 BY J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH. health Baths and wash=bouses Committee. As constituted 23rd May, 1955. As constituted 24th May, 1954. Chairman: Chairman: Alderman Miss E. A. Coles, J.P. Alderman Miss E. A. Coles, J.P. The Worshipful the Mayor The Worshipful the Mayor (Councillor E. G. Perry, J.P ) (Councillor S. F. C. Sporle, J.P.) Councillor Miss N. F. Clark- Councillor H. F. W. Ashby. Lawrence. „ Miss N. F. Clark- Lawrence. „ Mrs. E. A. Cooper, J.P. „ Mrs. C. M. Davis. Mrs. E. A. Cooper, J.P. „ F. J. J. Harper. Mrs. C. M. Davis. „ F. J. J. Harper. „ C. E. LANG. „ Mrs. P. G. Mitchell. „ C. E. Lang. „ Mrs. D. L. L. Newman. „ Mrs. P. G. Mitchell. Alderman S. E. Paul. Alderman S. E. Paul. Councillor Mrs. E. Reynolds. Councillor Mrs. E. Reynolds. „ T. J. A. Rose. „ T. J. A. Rose. „ G. Whitehead. „ G. Whitehead. 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 (appointed in March) G. W. P. Weeks (b c e) Deputy Chief Sanitary Inspector J. R. Holloway (a c). Sanitary Inspectors: District. 1. W. E. Selway (b c). 2. L. H. Whanslaw (b c) (appointed July). 3. A. Webb (b c). 4. A. W. E. Porter (b c). 5. J. R. Glover (b c). Other. (Food) J. A. H. Brownlow (b c). (Factories, I. R. Lewis (b c). etc) Miss J. Round (a d). Rodent Officer: F. G. Daniels. Administrative and Clerical Staff: P. Brocking. E. B. Moreton. (Miss) E. Town. S. J. P. Whitbread. R. M. Nicol (resigned April). 6. R. J. McCarthy (a c). 7. L. Burrows (b c). 8. J. R. Holloway (a c). 9. P. Ianson (b c). 10. J. J. K. Helmer (b c). (Catering Establishments) Miss A. L. Jones (b c). A. C. Cooles (appointed June). W. A. G. Griffiths (temporary). (In H.M. Forces). H. P. Reed (temporary) (resigned March). (Mrs.) V. J. Dawson (temporary). R. Greaves (temporary) (appointed April). Disinfecting Station —Superintendent—J. Mandry. Mortuary—Superintendent—W. Newman. Public Analyst J. E. Woodhead, B.SC, F.R.I.C,PH. C. Deputy Public Analyst D. G. Forbes, B.SC., F.R.I.C. (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. (e) Smoke Inspectors' Certificate of the Royal Sanitary Institute. INDEX TO SECTIONS. Preface PAGE health, Baths and Wash-houses Committee 2 Staff of the Public Health Department 2 Principal Figures for 1955 6 Vital Statistics 7 Infectious and Other Diseases 13 Unitary Circumstances 18 Protection of Food Supply: — ( a ) Inspection of Food Premises 25 Sampling of Food and Drugs 30 Hous ing 36 Factories and Homework 39 Miscellaneous Matters 42 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in presenting to you the Annual Report on the health and sanitary conditions of the Borough for the yea r 1955, the fourth complete year for which I have had the privilege of being responsible for the health services in the area. The statistical tables in the report give a factual account of our work and I refer hers only to one or two features of our work of particular interest. The population of the Borough has decreased slightly over the past two years, and this decrease was continued in 1955, in which year the population was estimated at 113,700. The birth rate was 15.3, a slight increase over the previous year, while the death rate was 11.36, also showing a slight increase over the previous year. The infant mortality rate was 24.7, this being an increase over the rate for the year 1954. I dealt in my report for last year on certain aspect of the infant mortality rate, and it is with some disappointment that I report that the rate for 1955 is higher than that for 1954. Where, however, we are dealing with comparatively small figures, it must be expected that there will be fluctuations from year to year. I the view in last year's Report that a further reduction in the infa' 1 mortality rate is to be brought about by an attack on those adverse factors which affect the expectant mother and her unborn child, pointed out how complicated are these factors, involving the interplay of genetical, obstetrical, environmental and social factors. At the tim e of writing it is interesting to note that a National Committee has be 6" set up to study the Maternity Services, and the report of this Con 1 ' mittee will be awaited with the keenest interest, as it may have ' bearing on some at least of the factors that might contribute to th deaths of infants in the first month of life. With regard to infectious diseases, a large increase was noted, total of 2,468, as compared with 648 cases in the previous 1 This increase was principally due to the number of cases of meas les which occurred in the early part of the year. As is well known, the incidence of measles in London tends to arise in waves, every two years, and 1955 was a "measles" year. There was also an increasese in the number of cases of whooping cough, 177 cases in 1955, as compared with 116 in 1954. Again I have to report that no case of diphtheria was notified. In 1954 five cases of poliomyelitis Were notified, whereas in 1955 twenty cases were brought to our notice. In two of these cases, however, the diagnosis was not confirmed, so we were left with eighteen cases of poliomyelitis, of which nine had some form of paralysis, and nine were non-paralytic. Of the infectious diseases, sixty-two cases of scarlet fever were notified, and thirty cases of dysentery of a mild type. Tuberculosis showed a drop in the number of cases notified, namely, 129, as compared with 140 in 1954, and 165 in 1953, but in addition to the cases notified, other cases were reported or came to our not ices, so that in all we were aware of a total of 209 cases of tuberculosis during the year, as compared with 221 during the previous year. The number of deaths from pulmonary tuberculosis was also fewer in 1955 there being 14 compared with 24 in the previous year. Reference to the table in the body of the report showing deaths from tuberculosis indicates how the death rate over the years has progressively dropped. Among the matters to which we have been giving attention is the care of old people. This has come to be an extremely important subject, because the proportion of old people in the population is gradually increasing. Our lady Sanitary Inspector does a great deal of work in connection with old people, and in conjunction with the health services of the London County Council much can be done to help them and to ease their path by arranging for the services of a Home Help and, if necessary, a Home Nurse. In addition to these, many old people welcome the "Meals on Wheels" service, and the Battersea Old People's Welfare Committee does excellent work. Nevertheless, occasions do occur when individual old people give us a good deal of anxiety, particularly in those cases where an old person lives alone, and has often to be left alone at night. There is often considerable pressure on hospital beds, and it is not always possible to obtain the admittance of an old person to hospital immediately. Moreover, many old people wish, and quite rightly so, to remain at home, and will not consent to go into hospital even though such a course may be advisable. In some such cases, action may have to be taken for the compulsory removal to hospital, but every effort is made to P ersuade the old person to go away voluntarily. There is little doubt that the problem of the care of old people will make increasing demands on Health Departments in the coming years, and it is one to which we are giving a good deal of our attention. I reported last year the resignation of Mr. F. H. Chuter as Chief Sanitary Inspector, and the Council in due course selected Mr. G. weeks to succeed him as Chief Sanitary Inspector. Mr. Weeks had already served the Council as a Sanitary Inspector for over twenty years and thus had a wide knowledge of the area. It is with great pleasure he that I welcome Mr. Weeks to the new and important office Which he has taken over, with the good wishes of everybody. It is almost a matter of custom, in the annual report by the Medical Officer of Health, to acknowledge the help and assistance that one receives from various agencies and people, without whose help and assistance the work of the Health Department would be immeasurably more difficult. Because I once again this year so acknowledge the help I have received, I would not wish it to be thought that this is merely a matter of routine, since I am again very sincerely grateful to all those people who have rendered the Health Department their usual help and ass istance during the year. It is a pleasure to thank Miss E. A. Coles, J.P., the Chairman of the Battersea Health Committee, for her support and guidance on so many matters; and also the various Committees with the work of which I am concerned, particularly the Health, Baths and Wash-houses Committee, and the Housing Committee. Again the Chief Officers of the Council have given me every possible helP, in particular Mr. R. G. Berry, O.B.E., the news of whose retirement from the service of the Council was received with very great regret by everybody, none more so than myself and the Helth Department. For the four years during which I had the privilege of working with Mr. Berry he was of the greatest possible help to me, and his unfailing courtesy and encouragement were very 6 greatly appreciated. I should like to thank Mr. Berry very much for the help he rendered me during the time I was associated with him. Mr. C. M. W. S. Freeman succeeded Mr. Berry as Town Clerk in November, 1955, and I should like to thank him for the help he has already rendered to me. Finally, I should again like to express my appreciation to the Officers and Staff of all sections and grades in the Health Department for their loyal and efficient service, and again to thank my colleague, Doctor Garland, for the excellent support which he gives me. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J. TUDOR LEWIS, Medical Officer of Health. July, 1956. Principal Figures for 1955. 2,163 Area of Borough, excluding tidal water (acres) 117,1 40 Home population (1951 Census) 113,700 Home population (Registrar-General's Mid-Year Estimate) 28,080 Structurally separate occupied dwellings 1,7 72 Births (live, 1,740; still, 32) 15.30 Live Birth rate 11.36 Deaths—1,292. Death rate 1.69 Maternal Deaths—3. Maternal death rate 24 .71 Infant deaths—43. Infant mortality rate Vital Statistics. POPULATION. The Registrar-General's estimate of the mid-year home population of Battersea was 113,700 as compared with 114,300 in 1954, a decrease of 600. The estimated population at the Census taken in April, 1951, Wa s 117,140; the 1955 figure of 113,700, when compared with this, sh ows a decrease of 3,440 (or 2.9 per cent.). The estimated mid-year home population figure of 113,700 has been adopted for the purpose of the statistics contained in this Report. BIRTHS. The number of live births registered in the Borough during 1955 was 875 (443 male, 432 female). Of this number 340 were transferred ou t, the permanent residence of the parents being outside the Borough, and 1,205 registered outside the Borough were transferred in, giving on balance a total of 1,740 births (896 male, 844 female, an excess of 52 males) relating to Battersea residents, and a live birth rate of 15.30 per 1,000 population. This is an increase of 0.09 on that of 1954. Of the Battersea births (535 live and 11 still) which occurred within the Borough, 432 were "domiciliary births." Illegitimate births numbered 116 or 6.7 per cent, of the live births. The live birth rate for England and Wales was 15.0. Still-Births. The registration of still-births is made compulsory by the Births and Deaths Registration Act, 1926. Dur ing 1955 there were 23 still-births registered in Battersea, of which 11 were Battersea parents. Twenty-one still-births occurring outside the Borough were registered as belonging to Battersea, making 32 in all, representing a still-birth rate of 18.06 per 1,000 births (live and still) registered. Of the 32 still-births 6 (18.8 per cent.) were registered as illegitimate. The number of Battersea still-births registered and the still-birth rates from 1943 to 1955, were as under:— No. Rate No. Rate 19 43 36 21.6 1950 53 27.2 1944 1951 37 19.2 40 24.0 19 45 1952 42 23.2 38 23.3 19 46 Mean 59 22.7 1943-52 47 22.9 19 47 74 27.0 1953 38 20.9 1948 46 20.1 1954 50 28.0 1949 43 20.8 1955 32 18.1 The still-birth rate in 1955 for England and Wales was 23.1. MARRIAGES. The marriages registered in Battersea during 1955 numbered 971. The marriage rate (i.e., the number of persons married per 1,000 of the population) was 17.1. Year. Marriages. 949 Marriage Rate. 1950 16.1 1951 929 15.9 1952 884 15.2 876 15.3 1953 912 1954 16.0 910 15.7 Mean 1950/54 971 17.1 1955 The marriage rate for England and Wales was 16.1. DEATHS. The number of deaths registered in the Borough during 1955 was 2,076. Of these, 1,188 were deaths of non-residents and were transferred to the districts in which the persons ordinarily resided. There were, on the other hand, 404 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths belonging to the Borough was 1,292 (665 males, 627 females). This gives a recorded death rate of 11.36 compared with 11.7 for England and Wales. The following table shows the age and sex distribution of the total deaths (corrected) in Battersea during 1955:— Under 1 year 5— 15— 45— 65— Total 1— 25— 75+ 665 195 M. 3 3 30 177 2 24 231 F. 19 2 6 627 5 24 113 154 304 Totals 8 4 54 308 331 535 43 9 1,292 % of total 3.4 0.6 0.3 0.7 4.2 23.8 25.6 41.4 100.0 Of the 1,292 Battersea deaths, 708 (or 54.8 per cent.) occu rred in hospitals, etc. The average age at death is shown in the following table:- Average Age at Death. 1945 62.4 1950 65.5 1946 61.4 1951 66.7 67.7 1947 62.6 1952 1948 63.3 1953 68.9* 1949 65.3 1954 67.2 Mean, 1945/1949 63.0 Mean, 1950/1954 67.4 1955 67.7 *All deaths, with the exception of those from tuberculosis, that occurred in St. John's Hospital, a hospital for the aged sick, were assignable to Battersea, irrespective of the home address of the patient prior to admission, during the year 1953. The deaths of 866 residents of Battersea aged 65 years and upwards were registered during 1955. These 866 deaths constituted 67.0 per cent. of the total deaths at all ages. The natural increase of population (that is, excess of births over deaths) was 448 in 1955 as compared with 587 in 1954. The causes of the 1,292 deaths in 1955 classified in various age groups, are shown in the following table. Causes of Death at Different Periods of Life in Battersea during 1955. The following table is compiled from figures supplied by the Registrar-General:— Sex All Ages 0- 1— —5 15— 25— 45— 65 — 75— Causes of Death All causes M. 30 231 665 24 3 3 195 177 2 F. 627 19 5 2 6 113 154 304 1. Tuberculosis, respiratory 24 M. 11 - - - - 7 3 1 - 3 2 F. - - - - - - 1 2. Tuberculosis, other forms - - - - - - - M. - - F. - - - - - - - - - 3. Syphilitic disease M. 3 - - - - - 1 1 1 1 - F. 2 - - - - - 1 4. Diphtheria - - - - - - - M. - - F. - - - - - - 5. Whooping cough - - - - - - - - - - - - M. F. 1 - - - - - - 1 6. Meningococcal infections - - - - - - - - - M. - F. 1 1 - - - - - - - 7. Ac. poliomyelitis and polioencephalitis M. - - - - - - - - - F. - - - - - - - - - 8. Measles M. - - - - - - - - - F. - 9. Other infective and parasitic diseases - - - - - - - - M. 1 1 - - - - - - - F. - - - - - - - - - 10. Cancer of stomach M. 25 1 12 7 5 - - - - F. 11 - - - - 1 1 5 4 11. Cancer of lung, bronchus M. 49 2 27 12 8 - - - - F. 14 3 3 - - - - 1 7 12 . Cancer of breast M. - - - - - - - - - 13. Cancer of uterus F. 27 - - 1 10 5 11 - - M. - - - - - - - - - 14. Cancer of other sites F. 11 1 7 3 - - - - - M. 60 1 1 1 14 19 24 - - 15 Leukaemia, aleukaemia F. 50 - - - - 8 16 15 11 M. 4 - 1 1 2 - - - - F. 2 - - 1 - 1 - - - 10 Causes of Death, 1955 —(contd.). Causes of Death Sex All Ages 0- 1- 5- 15- 25- 45- 65- 75- 16. Diabetes 1 1 - M. 2 - - - - - 3 6 1 2 F. - - - - - 2 - - 12 13 17. Vascular lesions of nervous system M. 73 - - 46 - 1 53 F. 99 - 19 26 - - - - 36 37 42 M. 118 - - 3 18. Coronary disease, angina 30 F. 55 - - 9 16 - - - 6 - - 2 7 19. Hypertension with heart disease M. 16 - - 1 4 - 2 11 F. 17 - 41 - - - - 15 14 20. Other heart disease M. 71 - - - 1 89 F. 127 - 1 3 9 25 - - 3 2 - - 8 21. Other circulatory disease M. 13 - - - 24 4 6 F. 35 - 1 - - - - - 1 1 M. 2 - - - 22. Influenza - 3 F. 5 - - 1 - 1 - - 11 - - 6 M. 29 3 - 9 23. Pneumonia 23 - - 3 2 F. 30 2 - - 22 - 21 25 M. 70 1 - - 1 24. Bronchitis 13 F. 28 - - 4 11 - - - -- 1 - - 2 - 2 1 M. 25. Other diseases of respiratory system 6 2 4 1 - 1 - F. - - - 5 - 2 4 26. Ulcer of stomach and duodenum M. 13 - - - 2 3 F. 5 - - - 2 - - - - - - - - - - - - 27. Gastritis, enteritis and diarrhoea M. 2 - - 1 1 - F. 4 - - - - 1 28. Nephritis and nephrosis M. 3 - - - 2 - 3 F. 8 1 1 - 3 - - - 2 - 29. Hyperplasia of prostate 4 - - - - - 2 M. - - - - F. - - - - - - - - - - 30. Pregnancy, childbirth, abortion M. - - - - - - 1 - F. 3 2 - 3 - - - - 1 31. Congenital malformations M. 12 6 - 2 - - F. 3 2 - - 1 - 6 - - 10 6 1 32. Other defined and ill-defined diseases M. 46 14 - 15 16 - 1 1 11 F. 52 13 1 9 - 3 1 - 1 33. Motor vehicle accidents M. 9 - - 4 - - F. 2 - 2 - - - - - - - - 6 3 34. All other accidents M. 12 - - 3 5 1 - F. 12 - 1 2 - - - 5 35. Suicide M. 13 - - 1 2 3 2 - F. 6 - - 1 4 1 - - - - - - 36. Homicide and operations of war M. - - - - - - 1 - - F. 1 - - - - 11 Infant Mortality. During 1955 the deaths of 43 infants under 1 year of age were re gistered as belonging to Battersea. The total number of live births re gistered during the year was 1,740 giving an infant mortality rate of 24.71 per 1,000 live births as compared with 18.99 in 1954 and 18.56 in 1953. The infant mortality rate in England and Wales during 1955 Was 24.9. The following table sets out the causes of death in detail. Infant Mortality, 1955. Nett deaths from stated causes at various ages under 1 year. C AUSES OF DEATH I . AGE PERIODS 1-7 days M. F. Weeks Percentage of Total Total deaths under 1 year Total under 4 weeks Under 24 hours Months ... 1-2 2-3 3-4 1-3 3-6 6-9 9-12 M. F. M. 3 F I ... 2 11.6 M. F. M. F. M. F. M. F. M. F. M. F. F. I M. F. M. 1 Bronchtis 1 J 2.3 1 Meningococcal infections 1 2.3 1 Congenital malformations 6 3 20.9 1 2 1 3 1 2 1 1 Other defined a nd ill-defined diseases:- Prematurity Other causes 42.0 8 10 8 3 4 5 5 1 10 2 2 2 1 4 3 1 1 6 3 20.9 16 14 24 19 100.0 TOTALS 3 7 6 8 1 1 3 2 I 2 3 7 30 15 43 13 2 6 2 2 3 Percentage of total 69.8 M. 55.9 F. 44.1 35.0 4.6 100.0 30.2 14.0 4.6 4.6 7.0 There were 30 deaths of infants during the first four weeks of life (or 69.8 per cent. of the total infant deaths) as compared with 25 de aths (or 75.8 per cent.) in 1954 and a percentage for the quinquennium 1950-1954 of 62.7. Table showing Deaths of Infants under 1 day, under 1 week and under 4 weeKs from 1950 to 1955. Year Under 24 hours 1 to 7 days 1 to 4 weeks Percentage deaths under 4 weeks of total infant deaths Total under 4 weeks 1950 14 15 5 34 66.7 1951 8 21 3 32 61.5 1952 8 8 1 17 54.8 1953 7 8 3 18 54.5 1954 15 6 4 25 75.8 Mean 12 10 3 62.7 25 1955 13 15 30 69.8 2 1 2 1 1 1 12 Deaths of Illegitimate Infants. The death rate amongst illegitimate children during 1955 was 34.48 per 1,000 illegitimate live births, as compared with 42.55 in 1954, 70.71 in 1953, 41.23 in 1952 and 42.73 in 1951. The corresponding death rate of legitimate children in 1955 was 24.01, the ratio of mortality rate of illegitimate infants to that of legitimate being 144 to 100. The corresponding figure for 1954 was 241 to 100. Maternal Mortality. During 1955 there were three deaths from "diseases or accidents of child-birth," which is equivalent to a fatality rate of 1.69 pe r 1,000 births (live and still). There was one such death during 1954. In one of the three deaths in 1955 the interval between the maternal condition and death was stated to exceed 12 months. The rate for England and Wales in 1955 was 0.64. Comparative Statistics of Births, Mortality, etc. (Compiled from Registrar-General's Returns.) Live Birth Rate Maternal Death Rate Infant Mortality Rate Death Rate Year Population 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 1954 114,300 15.2 10.1 0.56 19.0 1955 113,700 15.3 11.4 24.7 1.69 13 Infectious and Other Diseases. There was a large increase in the number of notifications received during 1955. Notifications received numbered 2,468, as compared with 648 in the previous year, 1954, an increase of 1,820. This Increase was due mainly to an outbreak of measles, occurring in the spring, the incidence of this disease rising from 192 in 1954, to 1,934 in 1955. There was also a rise in the incidence of whooping cough, 177 cases being notified in 1955 as compared with 116 in 1954. No case of diphtheria was notified. Twenty cases of poliomyelitis were notified, but in 2 of these cases the diagnosis was not confirmed, leaving 18 confirmed cases (9 Paralytic and 9 non-paralytic), of which 16 occurred in children under 15 years of age. In comparison there were 4 cases in the previous year, and in the years 1947 and 1949 when the incidence of this disease was high, 23 and 28 cases respectively. The following table shows the number (corrected) of cases notified during 1955 and, for the purpose of comparison, the average number of c ases notified annually in the five years 1950-1954:— Notified 1955 Average 1950/54 Diphtheria 1 - Erysipelas 19 18 Scarlet fever 62 109 Paratyphoid fever 1 - Continued fever - - Puerperal pyrexia 28 7 Meningococcal infection 4 3 Ophthalmia neonatorum - 1 Acute Encephalitis 1 - Poliomyelitis and Polio-encephalitis 18 8 Malaria - - Dysentery 16 30 Pneumonia (Acute primary) 51 68 9 (Acute influenzal) 6 Scabies 11 14 Food poisoning 20 8 Whooping cough 177 269 Measles 1,934 971 Tuberculosis (all forms) 129 161 Totals 2,468 1,686 Diphtheria and Whooping Cough Immunisation, Smallpox Vaccination. Diphtheria an d whooping cough immunisation and vaccination against smallpox were carried out throughout the year under the control of the London County Council. 14 Analysis of Cases (after Correction of Diagnosis) of Infectious Disease Notified during the Year 1955. Cases Notified in Battersea, at Ages (Years) 65 & over Total 0- 1- 3- 5- 10- 15- 25 - 35- 45- Notifiable Disease. - - - - - - - - - - Smallpox - - - - - - - - - - Diphtheria - 1 - 1 4 2 19 - - - - 11 Erysipelas - 62 6 14 35 5 1 1 - - Scarlet fever - - - - Paratyphoid fever - - - - - - - - - - - - - - - - - Continued fever - - - - 3 2 1 7 Puerperal pyrexia - - 1 - - - - 4 3 1 - - - - Meningococcal infection - - - - - - Ophthalmia neonatorum - - - - - - - - 1 1 - - - Poliomyelitis:- 1 1 4 9 Paralytic 1 - 9 - 3 4 2 - - - - - Non-paralytic - - - Acute Encephalitis:- - - - - - - - Infective - - - - - - - - - Post-infectious - - - - - 3 - - - - - - - Malaria - - - 8 2 2 1 - 30 Dysentery 1 3 2 5 5 51 2 - 1 2 1 4 5 4 18 1 2 Acute primary pneumonia 6 1 5 Acute influenzal pneumonia - - - - - - - 1 5 3 11 - 3 - 2 - - Scabies - - 4 1 4 - 20 Food poisoning 2 - 1 5 - 7 177 Whooping cough 16 47 48 58 1 - - - — 1,934 16 10 1 - - Measles 75 446 542 842 2 15 3 5 1 24 32 2 Tuberculosis:- 29 115 Pulmonary 4 - 1 14 1 2 1 1 4 1 3 - Non-pulmonary - 2,468 Totals 620 967 40 55 51 33 16 99 512 75 TUBERCULOSIS. During the year 1955 there were 129 cases of tuberculosis (all forms) notified in Battersea as compared with 140 in 1954, 165 in 1953, 188 in 1952, 162 in 1951 and 149 in 1950. In addition 80 cases were reported or otherwise came to the knowledge of the Medical Officer of Health, making a total of 209 cases for the year. The case rate per 100,000 population was 183.8. The tables on page 16 give details in age groups of the 209 cases. Deaths from Tuberculosis. During 1955 deaths from tuberculosis registered as belonging to the Borough of Battersea numbered 14, and were all due to pulmonary tuberculosis. The death rate per 100,000 of the population during the 50 years ended 1950 in quinquennial averages and the years 1951, 1952, 1953, 1954 and 1955 are given in the following table:- 15 Pulmonary Non- Pulmonary Total Years 1901-1905 138.1 50.9 189.0 1906-1910 126.8 45.9 172.7 19 11-1915 33.8 158.0 124.2 19 16-1920 134.8 30.0 164.8 1921-1925 92.6 23.0 115.6 1 926- 1930 91.1 14.2 105.3 1 931-1935 81.8 14.4 96.2 1 936- 1940 76.1 9.2 85.3 1 941-1945 91.8 11.0 102.8 1 946- 1950 53.1 6.1 59.2 Average (50 years) 101.0 23.9 124.9 1951 39.3 42.7 3.4 1952 29.2 2.6 31.8 1953 12.2 4.4 16.6 1954 17.5 3.5 21.0 1955 12.3 12.3 - The death rate P er 100,000 population was 14.6 for England and Wals. Tuberculosis, 1955. Cases Added to and Removed from Notification Register. Pulmonary Non-Pulmonary Grand Total Males Fem. 542 Total Males Fem. Total Males Fem. Total Already on Register, 31/12/54 634 615 1,284 1,176 73 108 669 35 Primary notifications 66 7 7 14 73 56 129 115 49 - Notified after death Unnotified deaths - - - - - - - - Restored 5 5 1 1 2 6 1 7 - Removals into Borough 1 1 2 - - - 1 1 2 41 31 72 - 1 1 41 32 73 1 From other sections 1 - 1 - - - 1 - 114 81 17 122 90 TOTAL ADDITIONS 195 8 212 9 18 Deaths 14 4 18 - - - 14 4 Notified after death - - - - - - - - - Unnotified deaths 5 - 1 1 2 6 1 7 5 Removals f r om Borough 57 50 107 5 8 13 62 58 120 Recovered 19 16 35 4 10 14 23 26 49 Diagnosis not con fi rm ed 1 2 3 1 2 3 2 4 6 - - 1 - 1 1 To other sections - 1 - 96 72 12 21 33 93 201 TOTAL DELETIONS 168 108 Net increase 18 9 - - - 14 - 11 27 - - 4 12 16 - 3 - Net decrease - 652 551 31 61 92 683 612 1,295 On Register at 31/12/55 1,203 16 Formal Notifications, 1955. Number of Primary Notifications of new cases of tuberculosis 2- 5- 10- 15- 20- 25- 35 - 45- 55- 65- 75- Totals (all age) Age Periods 0- 1- 3 2 66 - Respiratory, Males - 2 4 8 4 12 8 13 10 - 1 49 2 Respiratory, Females - - 1 9 17 7 - 6 3 3 - 7 1 - - 1 1 1 - 1 1 - - - Non-Respiratory, Males 1 7 - 1 - - - 3 - 2 - - Non-Respiratory, Fem. 1 - - New cases of Tuberculosis coming to the knowledge of the Medical Officer of Hea? otherwise than by formal notification. Source of Information Number of cases in age Groups A I II Totals 20- 0- 1- 2- 5- 10- 15- 25- 35- 45- 55- 65- 75- 4 Death Returns from Local Registrars R. M F - - - - - - 2 1 1 - - - - - - - - - - - - - - - - - - N.R. M F - - - - - - - - - - - - - - 1 - - - - - - - - 1 - - - - 1 - Death Returns from Registrar-General (Transferable Deaths) R. M F - - - - 1 - - - - - - - - - - - - - - - - - - - - - 1 N.R. M F - - - - - - - - - 1 - - - - - - - - - - - - - - - - - - Posthumous Notifications R. M F - - - - - - - - - - - - - - - - - - - - - - - - - - - - N.R. M F - - - - - - - - - - - - - - - - - - - - - - - - - - 41 - "Transfers" from Other Areas (excluding transferable deaths) R. M F 2 1 3 5 18 6 - - - 5 1 - - 31 7 3 1 - - - 1 - 1 3 13 2 - - N.R. M F - - - - - - - -- - - - - - - 1 - - - - - - - 1 - - - - - - - - - - - - - - - - - Other Sources R. M F - - - - - - - - - - - - - - - - - - - - - - - - N.R. M F - - - - - - - - - - - - - - - - - - - R.—Respiratory. N.R .—Non-Respiratory. 46 (A) Totals 31 (B) 1 „ (C) „ 2 (D) „ 80 Total number of Informal Notifications 17 BACTERIOLOGICAL EXAMINATIONS. The bacteriological examination of clinical material (with the e xception 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, County Hall, Westminster Bridge, S.E.1. No charge is made to the Council for these examinations. During the year 435 examinations were made as follows:- Description Disease Number of Specimens or Food Samples Positive Results Faeces 70 Dysentery or Food Poisoning 400 Throat Swabs Diphtheria 21 Nil Nasal Swabs Nil Whooping Cough 9 Foodstuffs Food Poisoning 1 5 1 INTERNATIONAL CERTIFICATES OF VACCINATION and INOCULATION. At the request of the Ministry of Health arrangements are made of the authentication, by the Medical Officer of Health, of certificates of Vaccina t ion and inoculation issued by medical practitioners in the Borough in respect of persons going abroad. During 1955, 232 certificates were authenticated. CANCER. During 1955 the number of deaths of Battersea residents from cancer was 247 (134 males, 113 females) as compared with 214 in 1954, 242 in 1953, 239 in 1952 and 252 in 1951. The death rate from the disease per 1,000 of the population was 2.17. The deaths from can cer constitute 19.1 per cent. of the total Battersea deaths during the year. The following gives the comparative average death rates from cancer in Battersea for quinquennial periods since 1901. 1901-1905 0.88 1941-1945 2.44 1906-1910 0.95 1946-1950 2.11 1911-1915 1.11 1951 2.15 1 916-1920 1.28 1952 2.05 1921-1925 1.33 1953 2.11 1926-1930 1.51 1954 1.87 !931-1935 1.75 1955 2.17 2.07 1936-1940 1.99 Mean 1951-1955 Details in age groups and the localisation of this disease will be found on page 9. 18 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 1955. Inspections- Sanitary Operations. Houses supplied with water and fittings repaired New houses 294 House-to-house 57 28 Houses let in separate tenements 2 Additional water supplies to tenement houses 1 Houses-following complaints 3,581 Water closets provided, supplied with water, or supply disconnected from drinking water cisterns Houses-following infectious disease 1,078 Van dwellings 4 20 Public urinals and chalets 84 Re-inspections 19,163 Water closets and urinals cleansed and repaired 415 Other visits 2,790 Notices served- Intimations Drinking water cisterns cleansed and repaired 76 1,991 Statutory (Sees. 197 and 200) Rain-water and waste pipes disconnected or repaired 112 242 Statutory (Fifth Schedule) 1,096 Soil pipes and drains ventilated 33 Summonses issued 142 Magisterial Orders obtained Defective roofs and gutters repaired 1,077 57 Drains laid to new houses 294 Dustbins provided 112 Drains relaid (wholly or partly) Yards paved or repaired Premises disinfected 124 795 8 Drains cleansed and repaired Personal Cleansing Treatments- 229 266 Drains tested (smoke) 87 To adults 2,318 Found defective 26 To children 5,578 Drains tested (water) 803 Articles disinfected Drainage plans received 135 Rodent Control- Premises Frontage drains constructed or reconstructed 221 9 Rats 102 New houses-certificates issued re water supply Mice 3,347 294 Inspections Protection of Food Supply. Inspections- Inspections-contd. 174 1,991 Butchers' and other food shops Ice cream premises 829 Fish shops 268 Restaurant kitchens 560 Food storage premises 188 Samples taken 3 Dairies and milk shops 290 Summonses issued Factories, Workshops and Shops. Inspections— Shops 42 Inspections—contd. Smoke observations Complaints dealt with Intimation notices served Statutory notices served Summonses issued 207 do. (Pharmacy Act) 8 126 Rag flock 12 29 Pet shops 29 1 Factories 1,782 Nil Outworkers 894 19 Legal Proceedings. During the year, legal proceedings were taken by the Council in 145 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 pages stated. Cases Page No. Public Health (London) Act, 1936 140 19 Food and Drugs Acts, 1938 3 28,29 London County Council by-laws as to Drainage 2 20 145 Fines totalling £14 10s. 0d. were imposed in connection with these proceedings, and £50 18s. 6d. 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, 1,991 Intimation Notices (relating to 1,603 premises) and 1,096 Statutory (Nuisance) Notices (relating to 815 premises) were served. The high proportion of Statutory to Intimation Notices shows the continued difficulty, referred to in previous reports, of securing the remedy of these conditions. Furthermore, it was foun d necessary to refer 223 cases to the Council's Solicitor with instructions to take steps, by legal proceedings if necessary, to enforce compliance with Statutory Notices. In 83 of these cases a warning letter from the Solicitor had the desired effect. In the remaining 140 cases, however, summonses had to be issued. As a r esult, Nuisance Orders were made by the Court in 57 instances. The remaining 83 summonses were ultimately withdrawn, the Notices having been complied with subsequent to the issue of the summonses. In 42 cases action to enforce compliance with Nuisance Orders had to be taken, and the Council carried out the work in default of the P er sons 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. During the year defective conditions in 1,730 houses were remedied—873 by owners following the service of Intimation Notices; 800 by owners following the service of Statutory Notices, and the Council 's workmen entered and did work in default of the owners on 57 occasions. Dustbins. Pr o ce dure with regard to the service of notices requiring the provision of dustbins has been simplified with the passing of the London Count y Council (General Powers) Act, 1954. The notice is served u pon the owner, and he has a right of appeal to the Court. Information as to these rights is always included when notice is served. 24 The London County Council (General Powers) Act, 1955. The above Act came into operation in December, 1955, and Part V contains provisions giving Borough Councils powers to: — (1) Deal more expeditiously with choked and defective drains; (2) to repair defective pipes or apparatus where the Metropolitan Water Board has ceased to supply the premises with water by reason of the defect; (3) to deal more expeditiously with nuisances where unreasonable delay would be occasioned by following the normal procedure; (4) to require information as to ownership of premises from occupiers and persons receiving rent. 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 is provided for each sex. Facilities for washing are also provided. Three public urinals are maintained, and in addition the urinals attached to ten licensed premises are, by arrangement with the owners available to the general public. The Council provide, in the interests of public health, fr ee washing facilities at each of the public conveniences in the Borough. Drainage Work. The by-laws made by the London County Council under th e Metropolis Management Acts with regard to drainage and also thos e 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 294 new buildings, and the drains of 8 old buildings were partially or entirely reconstructed under the supervision of the Officers of the Health Department. 135 plans of proposed drainage work were deposited in 1955, as compared with 141 in 1954. During the year drains were tested by smoke on 87 occasions and 26 were found defective. The water test was applied on 803 occasions, this being mainly to drains in course of construction. The frontage drains of 9 premises were constructed or reconstructed. Two summonses were issued against a builder under the Drainage By-laws for failing to give notice to the Council of his intention to construct a sink waste pipe, and for improperly fitting the same. A fine was imposed, and costs were awarded to the Council. Combined Drainage. Following an infestation of rats in two houses, the drain common to both premises was found to be defective. A claim by one of the owners showed the common portion was a "sewer" repairable by the Council, and this work was carried out by the Council. 21 Atmospheric Pollution. During the year, 20 complaints were made alleging nuisances from smoke, dust, grit, etc., emitted from premises in various parts of the Borough. All these complaints receive careful and sometimes prolonged investigation. In one case, a screen was erected around a coal-storage ground of one of the bigger industrial plants, on advice from the Department, to mitigate the dispersal of coal dust, and to contain dust blown from the heap inside the screen boundaries. In addition to dealing with specific complaints, observations are kept upon the chimneys of any industrial plant which merits observation and the appropriate action taken. A total number of 207 observations were made. Two notices were served. 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 294 new or re-e rected dwelling houses or tenements. Forty notices of waste of water from defective fittings, etc., o bser ved during routine inspections of various premises, were sent to the Metropolitan Water Board. The deep wells at the Latchmere Road Public Baths are again functioning, supplying the Baths Establishment and the Council's Latchmere Estate. Following the overhaul of the pumps and the replacement of the storage tank, a series of samples taken of the water supply proved consistently good. Check samples are taken of the Water at fortnightly intervals, and submitted to the Public Health Laboratory Service for analysis. Application was made by a firm in the Borough to use artesianwell w ater as a drinking supply for their staff. The necessary chlorinating plant was installed, and the water analysed by the Public Analyst with a satisfactory result. Arrangements have been made for the firm to submit to me the results of chemical analyses and bacteriological examinations of the water at regular stated times. The re sults have proved consistently good. Rag and Bone Dealers. Premises occupied by rag and bone dealers in the Borough are subjected to regular inspection. During the year 118 inspections were made. Two ca ses were reported by the Police of itinerant rag dealers, who were exchanging toys for rags with children under the age of 15 years. This is an offence against Section 26 of the London County Council (General Powers) Act, 1952. Both cases were dealt with by cautionary letter, and the Medical Officer of Health in whose Borough the rag dealers resided was informed of the action taken. 22 Prevention of Damage by Pests Act, 1949. This Act gives power generally to the Council to require steps to be taken to eradicate infestations of rats and mice and where possible to prevent infestations occurring. 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 th e Borough for the year:— Seriously infested by Mice Property Council's properties Infested by Rats Major Minor - 12 4 - 41 Dwelling houses 91 57 Business premises - 118 102 221 - The total number of visits made to the above premises, and to others which were found not to be infested, was 3,347. Rag Flock and Other Filling Materials Act, 1951. The principal provisions of the Act related to registration of premises in which rag flock or other materials are used in upholstery, etc., and the licensing of premises used for the manufacture and storage of rag flock. An authorised officer of the Council has the right of entry, inspection and sampling of any filling materials. The Medical Officer of Health and Sanitary Inspectors are deemed to be authorised officers. Subsequent Regulations made by the Minister prescribed the standard of cleanliness for each kind of filling material, the methods of testing samples and the nature of the tests to be applied. 23 There are 6 premises in the Borough at which filling materials other than rag flock are used, and these are registered. There are no premises at present dealing with rag flock. Twelve 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 Ins pectors 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. Licences were issued in respect of 12 shops and 29 visits were ma de during the year. Verminous Premises. During the year 183 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. Van Dwellings. The sites in the Borough in which van dwellings have regularly been placed for many years are generally well kept. The newer sites, however, need constant inspection to prevent overcrowding of the site, and to ensure that sufficient watercloset accommodation and water supply are available. Dangerous Structures. During the course of inspection for any purpose carried out by the officers of the Department, should any dangerous structure or an y dangerous condition appertaining to a building be noticed, the Dist r ict Surveyor of the London County Council is notified for any action he may decide to take. 124 of such cases were notified. Vacant Sites, Static Water Tanks, etc. 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, is still proving a problem, but the number of complaints is gradually diminishing due to the sites being used for rubuilding and other purposes. Arra ngements are in operation whereby the Council are empowered to clear stat ic water tanks and to obtain refund of the cost from the london County Council. 24 Shops Act, 1950. One exemption certificate was issued under Section 38 of this Act in respect of a shop where restricted space precluded the provision of a sanitary convenience on the premises and where the applicant was able to secure suitable alternative accommodation within reasonable distance. An undertaking was given that the sale of food for human consumption would not be carried on at the premises. Heating Appliances (Fireguards) Act, 1952. The Act came into operation in March, 1953, and the Regulations known as the Heating Appliances (Fireguards) Regulations, 1953, followed in October of that year. The Regulations prescribed that heating appliances suitable for use in a dwelling house or other residential premises shall be fitted with a robustly made guard securely attached to the appliance, and shall satisfy certain other tests set out in a Schedule to the Regulations. It has been found, since the passing of the Act, that almost without exception appliances on sale are sold to a British Standard specification, which gives the double assurance of their being subject to inspection at the place of manufacture. 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. 25 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 hygieric 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 s pecial 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 re s ponsibility for the inspection of all food premises to specialist ins pectors. 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 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. 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 3r d November, 1952. They are designed to secure the observance of san itar y 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 ar e, 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). Talks to School Children. By arrangement with the London County Council, talks were given by the Food Inspector and visits to a milk processing plant arranged for the benefit of school children in the Borough. The Inspector responsible for food hygiene in catering establishments lectur ed on several occasions to women's organisations in connection with clean food. These talks and visits are greatly appreciated and are of considerable educational value. 26 Festival Pleasure Gardens, Battersea Park. Regular inspections are made of catering establishments in these Gardens. Any alterations to such premises entailing drainage work are carried out under the jurisdiction of Council officers. Many thousands of visitors use these Gardens, and there was no recorded case of an illness being traced to food purchased in the Gardens. Butchers' Shops. There are 72 butchers' shops in the Borough, and in addition a number of shops where cooked meats are sold. All these shops are systematically inspected, 904 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 in the above figure. Dairies and Milk Distributors. At the end of the year there were 151 premises in the Borough registered for the sale of milk, 6 new registrations having been effected during the year. Thirty-nine of these premises, including 7 wholesale dealers, were registered as dairies. The occupiers of the remaining 112 premises were registered as milk distributors. A total of 290 visits were made to these shops during the year. Generally they are very well conducted, and in no case was any contravention of the Statutory requirements found. In addition, 30 persons selling milk in Battersea from premise in other Boroughs were on the " Out-of-Borough" Register. Milk and Dairies Regulations, 1949. Enforcement of these Regulations, which relate to premises wher e milk is stored, processed, or sold, is dealt with in the preceding paragraph. 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 above Regulations three designations only are no w prescribed—Tuberculin Tested, Pasteurised and Sterilised. Tuberculin Tested milk must be supplied in a properly closed container. If the container is a bottle, the cap must bear the address of the premises at which the bottle was filled and the words "Tuberculin Tested Milk." Any other type of container must be closed with tightly fitting cover and suitably sealed and labelled. Pasteurised milk must be delivered in containers closed at the dairy where they were filled, with a cap or cover over-lapping the lip of the container and labelled "Pasteurised Milk." 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, 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 u nder one or other of the special designations. The whole of the County of London is included in such areas. The number of licences issued by the Council for 1955 was as follows:- Full Supplementary Tuberculin Tested 61 22 Pasteurised 99 23 Sterilised 141 24 301 69 One licence to sterilise milk was issued, and is included in the above figures. Details of examination of samples of pasteurised and sterilised milk re given on page 34. 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 270, 9 having been added and 3 removed during the course of the year. These premises are regularly inspected and particular attention is P aid to premises where manufacture takes place. Not only are the P re mises, plant and methods of operation scrutinised, but samples of the products are taken for examination by the methods suggested by the Ministry of Health. There are 6 such premises in the Borough. Fish Shops. Shops in which fish, either cooked or uncooked, is sold, or where the cur ing or smoking of fish is carried on, are regularly inspected. There are 47 such Shops i n th e Borough. 268 inspections were made. It was not found necessary to serve any notices in respect of these shops during the year. Street Stalls. All street stalls from which food for human consumption is sold are re gularly 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. 28 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 of these foodstuffs were ultimately used for the manufacture of animal feeding stuffs. Fish (preserved) 1 St., 2 lbs., 336 tins Fish (wet) 8 cwts., 2 qtrs., 1st., 8¾ lbs. Whelks and eels 6 galls., 1 bowl Meat and meat products (preserved) ... 14 cwts., 1 qtr., 8¾lbs., 1,755 tins Meat (fresh) 1 ton, 8 cwts., 2 qtrs., 1 st., 4 lbs. Meat pies and pastries ... 39 Offal 5 cwts., 1 qtr., 12½ lbs. Poultry ... 3 cwts., ¾ lb., 22 portions, 60 whole chickens Vegetables (preserved) 1,048 tins, 22 packets Vegetables (fresh) 40 boxes of tomatoes Fruit (preserved) 12 cwts., 2 qtrs., 902 tins Fruit (fresh) 1 cwt., 3 qtrs., 10 lbs. bananas, 74 boxes, 220 stems Milk (tinned) 520 tins Cream (tinned) 18 tins Eggs (shell) 919 egg s Cheese 1 cwt., 3 St., 2 lbs. Cakes and biscuits 1 qtr., 1 st., 9½ lbs. Jams, syrups and preserves 48 tins Pickles and sauces 2 qtrs., 1 st., 10 lbs., 5 jar s Paste (meat) 15 jars Patent foods and beverages 2 lbs., 1 bottle, 2 packed Sweets and chocolates 10½ lbs., 720 marshmallows Soups 61 tins Cordials and fruit juices 3 galls., 1 tin Ice creams 86 The following two cases are of interest. A case taken against a firm following a complaint of a piece metal in a cream-filled cake, under Section 9 of the Food and Drugs Act, was successful in the Magistrates' Court; a fine was imposed, and costs were given to the Council. The firm, however, appealed against the decision on the grounds that the case should have been taken under Section 3 of the Act—"not of the nature, substance and quality demanded" and not under Section 9 as "food unfit for humen consumption." The former Section allows the defendant the use of defences set out in Section 4, giving greater scope for defence and carrying less severe penalties. The appeal was allowed, with costs against the Council. 29 Views had been expressed in cases similar to this that a local Authority can proceed under either Section, but it is now settled law that Section 9 is not applicable. Under Section 3, the summons must state whether it is "the Mature," "the substance" or "the quality" of the article which is alleged to be to the prejudice of the purchaser. During the course of the argument in this case, the Lord Chief Justice said that "substance" appeared to him to be appropriate. If the presence of extraneous matter affects the substance of the art icle and turns it rotten or putrid, then Section 9 would be appropriate. If, however, apart from the extraneous matter, neither the substance, nor the nature or the quality of the article itself is affected, then Section 3 is the appropriate Section. A consignment of Chinese egg albumen, which is used in the baking and confectionery trade for sponge mixtures and for glazing buns, was found to contain the organism of Salmonella thompson. The consignment was immediately surrendered, and samples were ta Ken of all other firms in the Borough using egg albumen from the same suppliers. Both these and second samples proved satisfactory. Other than the case previously mentioned, there were seven cases concerning the presence of foreign matter in food. In one case proceedings were instituted, and a fine of £3 10s. 0d. was imposed and £1 1s. 0d. costs were awarded to the Council. The other cases were dealt with by cautionary letters. FOOD POISONING. Two cases of botulism, a rare but dangerous form of food poisoning, were notified in July. The illness affected two adults, brother and sister, who had partaken of fish pickled in Mauritius and brought to this country by a friend of the family. Both patients suffered from the charactersitic symptoms of botulism, for the nervous system was predominantly attacked. Treatment was prompt and recovery complete. Examination of the fish extract showed the presence of toxin produced by Clostridium botulinum Type A. The species of fish was identified as Lethrinus variegatus, and according to the Natural History Department of the British Museum this species may contain toxic substances. On June 22nd, an outbreak of food poisoning occurred in a canteen. The illness affected 7 of 60 persons, and the symptoms lasted 24 hours. There were no fatalities. Examination of specimens revealed the presence of heat resisting Clostridium welchii in two cases. The or ganism was also recovered from the canteen cook, who was consider d to be a carrier. Examination of specimens of food failed to show the presence of the organism. Criticism was levelled, however, at the mode of preparation of the meal of roast pork, for the meat had been cooked the previous day, and served after re-heating. With the ready Co_o pe ra ti on of the management, preventive measures were instituted immediately. These measures provided for adequate facilities for washing of hands. 30 (B)—SAMPLING OF FOOD AND DRUGS. The analysis of samples of food and drugs purchased formally and informally under the Food and Drugs 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. General bacteriological examination, and the examination of samples of heat-treated milk and of ice-cream, is carried out by the Public Health Laboratory Service. The total number of formal samples taken under the Act during 1955 was 299, of which 9, or 3.0 per cent., were certified to b e adulterated. In addition, 261 informal samples were procured, of which 5, or 1.9 per cent., were reported against. The percentages of samples reported by the Public Analyst to be adulterated during the quinquennia 1921 to 1955 are given in the following table. The year under review is shown separately. Year Formal samples (per cent.) Informal samples (per cent.) Mean 1921—1925 7.4 6.4 1926—1930 2.4 3.3 „ 1931—1935 1.8 2.1 0.9 0.9 „ 1936—1940 „ 1941—1945 1.4 1.1 „ 1946—1950 1.0 1.1 „ 1951—1955 2.1 2.2 1955 3.0 1.9 Milk. One hundred formal samples of milk were taken during the y ear Of the 100 samples, 20 were designated as "Channel Islands or " South Devon" milk, for which a higher minimum percental (viz., 4 per cent.) of milk fat content is provided for under arrangeme nt . made between the producers and the Ministry of Agriculture, Fished and Food. Nineteen of these samples were reported to be in co ll ' formity with this standard, their average composition being:— Milk fat 4.26 per cent. Non-fatty solids 9.05 „ Total milk solids 13.31 35 The milk fat content of the 19 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 „ 1„ „ 4.4 „ 4.5 „ 2 samples „ 4.3 „ 4.4 „ 2 „ „ 4.2 „ 4.3 „ 9 „ 4.1 „ 4.2 „ 2 „ „ 4.0 „ 4.1 „ 2 „ 19 The one remaining sample of " Channel Island " milk, which was reported to be 11 per cent, deficient in milk fat, was referred to Ministry of Agriculture, Fisheries and Food. Seventy-eight samples of ordinary milk were reported as genuine their average composition was as follows: — Milk fat 3.54 per cent. Non-fatty solids 8.73 12.27 Total milk solids Their content of milk fat ranged as follows:— Between 3.9 and 4.0 per cent. 2 samples or 2.56 per cent. „ 3.8 „ 3.9 „ 8 „ „ 10.26 „ „ 3.7 „ 3.8 „ 10 „ „ 12.82 „ „ 3.6 „ 3.7 7 „ „ 8.97 „ „ 3.5 „ 3.6 „ 22 „ „ 28.21 „ „ 3.4 „ 3.5 „ 7 „ „ 8.97 „ „ 3.3 „ 3.4 „ 17.95 „ 14 „ „ „ 3.2 „ 3.3 „ 8 „ „ 10.26 „ 100.00 78 to Of the two remaining samples (of ordinary milk) one was certified 6 per cent, extraneous water, and the other 3 per cent. A cautionary letter was sent in each case. In the five years 1950-54 and in 1955 the percentage of adulterated samples of milk was as under:— Year Samples taken Adulterated No. Percentage 1950 462 0 0.0 1951 428 1 0.2 1 95 2 101 0 0.0 195 3 100 1 1.0 1954 6.0 100 6 1955 3 100 3.0 32 The following tables give details of the articles of food of which samples were obtained for the purpose of analysis. Nature of Sample Baking Powder EXAMINED ADULTERATED Formal Informal Total Formal Informal Total - 3 3 - - - 4 4 - Blancmange Powder - - - 7 7 - Bread - - - - 33 2 Butter 33 2 - 13 Cake and Pudding Mixture - 13 - - - 1 Cereal Preparations 12 13 - - - Cheese 1 2 3 - Cider Vinegar 1 - 1 - Cocoa 1 ? 4 - - Coconut, Desiccated 1 - - - 1 - 4 2 6 - Coffee - - Coffee and Chicory Essence 4 6 2 - - - 8 12 1 1 Confectionery Flour 4 - 3 1 Confectionery Sugar 7 10 1 - 1 - Cream, Tinned - 1 - - Custard Powder - 3 3 - - - - - Fish Paste 16 16 - - - Flavourings - 5 5 - - - Flour, Self Raising 6 6 - - - Foam Crystals 1 1 - - - - Food-Colour 3 3 - - - - 8 Fruit, Dried 8 - - - - 3 - Fruit Preserving Tablets - 3 - Gelatine - 4 4 - - - 11 - - Gin 1 - - 3 Glucose - 3 - - - Golden Raising Powder - 4 4 - - - Gravy Preparations - 10 - - - Ice Cream 6 - — 6 - 6 - Jams and Preserves 5 11 - - - Jelly 9 3 12 1 1 - 2 2 - Junket Preparations - - - 19 - 19 - 1 Lard and other Fats 1 3 3 - 1 1 Lemonade Crystals - 3 4 - Margarine 1 - - - Meat Preparations:— 1 - 1 - Beef, Minced 1 - - Black Pudding 1 - - 1 - Faggots 1 - - - - - Meat Extract - 3 3 - - Meat Paste 14 - - 14 - - 3 1 4 - Meat Pies - - Sausages 26 1 26 - 1 - - Sausage, Breakfast 1 - 1 - - 1 - Sausage, Liver 1 2 - - Sausage, Luncheon - 1 1 - - - - Sausage Rolls 1 - 1 - - 1 100 245 - 1 - Savoury Rolls - - 3 Milk 152 100 397 3 - 3 1 Carried forward 8 33 Nature of Sample Brought forward EXAMINED ADULTERATED Formal Informal Formal Informal Total Total 397 8 3 11 245 152 Mustard 6 6 - - - - Non-brewed Condiment 4 4 - - - - Nut Oil 1 1 - - - Olive Oil 4 4 - - - - Pea Flour 3 3 - - - - Peel, Mixed 3 3 - - - - pepper 3 3 - - - - Pickles 5 5 - - - - Saccharin Tablets 1 1 - - - - fauces 3 18 21 - - - Soft Drinks 5 5 10 - - - Soups, Canned 1 1 - - - - Soups, Powder 2 2 - - - - Sices and Condiments 16 16 1 1 - - Stuffing 6 6 - - 3 - - Suet 3 1 1 - - Sugar 1 1 - - - - Tea 1 1 - - - - Vi negar 17 2 19 - - - Wine 3 3 - - - - Yeast Extract 1 1 - - - - 13 Totals 290 221 511 9 4 Drugs. The following table gives details of the drugs of which samples were obtained for the purpose of analysis:— Nature of Sample EXAMINED ADULTERATED Informal 2 Formal Informal Total Total Cream of Tartar Formal - 2 - - - - Glycerin 5 5 - - - - Honey and Lemon 1 1 - - - Iodine, Tincture of 2 2 - 1 1 - Linctus 1 2 - 1 - - Oil Camphorated 2 2 - - - - Oil, Castor 3 - 3 - - - Oil, Halibut 1 - 1 - - - Ointment, Sulphur 3 - 3 - - - Ointment, Zinc 3 3 - - - - Paraffin, Liquid 5 - - 1 - - - - 2 2 - Salts, Epsom - - 2 2 - - Salts, Glauber - 1 1 - - Salts, Fynnon - - 1 1 - Seidlitz Powder - - - 7 7 - - Soda, Bicarbonate of - - 1 - Syrup of Figs Tablets:- 1 — - - - 4 - Aspirin 4 - - 5 5 - - Soda Mint - - 1 - 1 SulPhur - — 1 Totals 40 49 1 9 34 Adulterated Samples other than Milk. The following action was taken in regard to the 11 samples certified as adulterated : — Formal Samples. No. 134. Pork sausage, 7½ per cent, deficient in meat.-" Cautionary letter. No. 155. Beef dripping, acid value (4.5) excessive.—Cautionary letter. No. 161. Butter, excess of 1 per cent, water. —Cautionary letter. No. 163. Cokernut ice, containing dirt, dust and grit fibres.-' Cautionary letter. No. 207. Butter, excess of 1.5 per cent, water. —Cautionary letter. No. 282. Shredded suet, per cent, deficient in fat. —Caution* ary letter. Informal Samples. No. 49. Curry powder, containing 20 parts per million ot lead.—Cautionary letter, remainder of stock with* drawn from sale. No. 64. Lemonade crystals, containing 20 parts per milliC 1 of lead.—Cautionary letter. No. 65. Table jelly, 4 per cent, deficient in sugar.—Lette f from manufacturer as to the possible cause accepted' No. 99. lodine, excess of 14 per cent, iodine and a deficiency of 16 per cent, potassium iodide.-—Remainder stock returned to manufacturer. No. 258. Cheesecake, portions of a Silico-gel Cautionary letter. Bacteriological Examination of Food. In addition to samples taken for chemical examination, samp le of food were submitted for bacteriological examination. These were all reported to be satisfactory. Heat Treated Milk. Samples of pasteurised and sterilised milk are taken at regular intervals for submission to the Public Health Laboratory Service the prescribed tests, and during the year samples as under were tak en with the results set out: — Phosphatase Methylene Blue Satisfactory Failed Satisfactory Failed Pasteurised ... 48 — 48 Turbidity Satisfactory Failed Sterilised ... 36 Monthly returns of the samples taken, and of the results of the examinations, are sent to the Milk Division of the Ministry of Agriculture, Fisheries and Food, and they are at once notified any adverse report. 35 Ice-Cream. Thirty-three samples of ice-cream were taken during the year, eac h 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 25 „ „ 2 5 „ „ 3 2 „ „ 4 1 33 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 are su ggested. Lollies. A sample of a cream-type lolly submitted for bacteriological examination was found to contain the presence of faecal coli. As there as n o apparent source of infection from the shop where the sample was, taken, I reported the matter to the Medical Officer of Health of the Borough where the lollies were manufactured. th e reply I received was to the effect that the factory concerned was Ins P ecte d at regular intervals by the sanitary inspector, and that the method of manufacture, and the premises, were entirely satisfactory. Samples of lollies taken over a long period have shown a consistent degree of purity. Further samples of lollies taken from the shop have proved satisfactory, and further action was, therefore, not resorted to. Milk supplied in Schools and Hospitals. Samples of milk in course of delivery to Schools and Hospitals in the Borou g h are regularly taken, both for chemical analysis and for submission to the prescribed tests for such milk. The samples are included in the general totals given on pages 31, 32 and 34. The results of the analyses and tests are communicated to the London country council or to the appropriate Hospital Management Committee. 36 Housing. Provision of New Accommodation. During the year 1955 construction of the following 294 neW houses and flats was completed:- By Battersea Borough Council: — 60/78 (even) Sisters Avenue 10 houses 38, 40 Marjorie Grove 2 flats 12/24 (even) Brynmaer Road 12 „ 136/158 (even) Wycliffe Road 12 „ 36 By London County Council:— Patmore Estate:— Brady House 31 flats Marsh House 52 „ Morgan House 19 „ Banister House 12 „ Hookham Court 40 „ Locke House 12 „ Statham House 10 „ Ashcroft House 10 „ Woods House 10 „ Drury House 45 „ 241 By Private Enterprise:— 32, 34, 36 Lavender Hill 3 flats 2a 2b, 4a 4b 6a 68, Ba 8b 10a 10b 12a 12b Brassey Square 12 „ 37 Sudbrooke Road 1 house St. Andrew's Vicarage, Patmore Street 1 „ 17 29 4 Total Housing Act, 1936. Housing Repairs and Rents Act, 1954. Representations for slum clearance were made in respect of se ver areas comprising 67 dwellings, and a Public Inquiry held concerning two of them at the Municipal Buildings. The Orders were subsequent confirmed. 37 Applications for Certificates of Disrepair continue and the follow-ing table shows the comparison between the previous year's and this Year 's applications:— L 1954 1955 Applications for Certificates of Disrepair received 154 258 Applications for Certificates of Disrepair withdrawn 11 11 Certificates of Disrepair issued 120 251 Certificates of Disrepair refused 2 17 Applications for revocation of Certificates received 12 297 Revocations of Certificates issued 11 253 Revocations of Certificates refused Nil 39 Closing Orders. Ten Closing Orders under Section 12 of the Housing Act, 1936, were made during the year, in respect of basement rooms, and five closing Orders in respect of dwelling houses under Section 11 of the Act as amen ded by Section 10 of the Local Government (Miscellaneus Provisions) Act, 1953. Demolition Orders. f or A Demolition Order was recommended in one case, the house hem P art a clearance area. The majority of individual unlit houses are dealt with by Closing Orders. Houses Let in Lodgings. since the repeal of By-laws relating to houses let in lodgings, such houses have been dealt with by Sections 11 and 12 of the Housing Repairs and Rents Act, 1954. Power is given to the local authority to restrict the num ber of persons occupying the house, and to ask for adequate facilities for those persons in occupation. Cases have been referred to the Housing Committee for authority to serve notices on two occasions. Overcrowding. Five cases of overcrowding were discovered during the year. Thirteen overcrowded families were rehoused during the year, 12 by this Council and 1 by the London County 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 include applications for transfer from Council tenants and licensees of requisitioned 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, lac* of a separate home, etc., and he refers to me cases of ill-health (f° { which additional points up to a maximum of 15 for pulmonary tuber' culosis 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 bedroorflj required by the family. Applications with the highest number ot points in each group are submitted to the Housing Committee instructions. Cases where the applicant or a member of his household is suffering from pulmonary tuberculosis and is infectious, and whef 6 the accommodation is considered to be inadequate, are submitted 10 the Committee irrespective of the total number of points allocated. The points scheme does not apply to applications for transfers fr° n1 Council or requisitioned property, which are still dealt with under previous system, " essential " and " advisable " recommendations made on medical grounds. During 1955 a total of 440 cases were dealt with under t 1 arrangements set out in the three preceding paragraphs. TP maximum number of points on medical grounds other than pulmoru' tuberculosis were allocated to 3 applications, and they were referrf to the Housing Committee for special consideration on these ground"" In 9 cases the maximum points were given for pulmonary losis, 6 of these being referred to the Housing Committee for spe cll 'f consideration as the accommodation was inadequate. In 10 cases 0 transfer applications, rehousing was recommended as essential 0 medical grounds. The London County Council also refer cases in which there appear to be overcrowding, for the submission, in appropriate case-/ of a special form. Overcrowding was found to exist in 2 instance-' The London County Council also notify cases in which application alleges sanitary defects. The houses are inspected, afl action to secure the remedy of any defects found is taken. 38 39 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 —Sec- tion 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. 1.—INSPECTIONS for purposes of provisions as to health. Premises Number of Number on Register Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 5 656 121 - Factories not included in (i) in which Section 7 is enforced by the Local Authority 359 1,273 9 - Other Premises in w hich Section 7 is enforced by the Local Authority (excluding outworkers' premises) 37 - 28 2 To tal 16 508 1,966 - 40 2.—CASES in which DEFECTS were found. Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred Particulars To H.M. Inspector By H.M. . Inspector Want of cleanliness (S.I.) 9 9 - - - - Overcrowding (S.2.) - - - - - - Unreasonable temperature (S.3.) - - - - Inadequate ventilation (S.4.) - - - - - - Ineffective drainage of floors (S.6.) - - - - - Sanitary Conveniences (S.7.) (a) Insufficient 1 1 - - (b) Unsuitable or defective - 14 11 - - (c) Not separate for sexes - 1 1 - Other offences against the Act (not including offences relating to Out-work) - - - - - - - TOTAL 25 - 22 The following table shows the factories in the Borough, classified according to the trades carried on. Factories Classified according to Trades. Mechanical Factories Non-Mechanical Factories Trade At 1 Jan. At 31 Dec. At 1 Jan. At 31 Dec. Building and Allied 27 21 22 27 17 Clothing and Allied 45 44 17 Engineering and Heavy Industry 48 49 2 2 Electrical and Allied 12 13 1 1 Florist 2 2 - - 51 4 Food and Allied 47 4 4 Furniture and Allied 13 15 4 Metal Worker 10 10 - - 2 Printer and Allied 24 26 2 19 Road Vehicle Repairer 41 42 19 - Steam Laundry 10 10 - Transport (Road & Rail) 20 19 - 56 - Others 57 48 49 121 359 357 121 Total 41 Bakehouses. There were 29 bakehouses on the register at the end of the year, three having been closed during the year. All of these are classed as factories, and 26 of them use mechanical power. 103 inspections were made and 1 notice served. Five of the bakehouses were " basement bakehouses" within the meaning of Section 54 of the Factories Act, 1937. Outworkers. During the year lists of outworkers were received from Battersea employers and from other authorities as required by the Factories Act, 1937. Some of these lists included outworkers not residing in Battersea, and these were forwarded to the appropriate authorities. at ( The total number of registered outworkers' premises in the Borough ha cat the end of the year was 411 (including 6 contractors), 125 premises ni /nhaving been added, and 89 removed, during the year. The total | n ' number of inspections made was 894, most of them by the female it P Inspector. The premises were found to be generally satisfactory, and as not necessary to serve any notices or take any other action. Eighteen cases of infectious diseases occurred at outworkers' Premises, a nd the usual precautions to prevent spread of infection re taken. The following table gives details of the outworkers' premises:— Number on Register Trad e Premises Workrooms Persons employed Wearing Apparel 271 275 309 Linen 1 1 1 Artificial Flowers 2 2 2 Paper Bags 8 8 8 Boxes etc. 6 6 6 Stuffed Toys 5 5 5 Lampshades 65 65 65 Ch r istmas Stockings, etc. 1 1 1 Toys, etc. 52 52 52 411 415 449 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, Bournemouth —26th to 29th April. National Association for the Prevention of Tuberculosis, London —21st to 25th June. Central Consultative Committee on the Welfare of Old People, London—Bth July. Sanitary Inspectors' Association, Scarborough—l3th to 16th September. National Smoke Abatement Society, Bournemouth — 28th to 30th September. Delegates. Cllr. C. E. Lang and the Medica Officer of Health. Cllr. Mrs. E. A. Cooper, J.P- Cllrs. Mrs. C. M. Davis Mrs. E. Reynolds. Ald. S. E. Paul and Mr. W- Selway, Sanitary Inspector. Cllr. Mrs. E. A. Cooper, and Mr. I. R. Lewis, Sanitary Inspector. Aged and Infirm Persons. Under Section 47 of the National Assistance Act, 1948, the are empowered to apply to a Court of Summary Jurisdiction for Order for the removal to a hospital or other suitable place of any P erS °g j who is aged or infirm or suffering from some grave chronic dise^s: • and is living under insanitary conditions. This power is on the certificate of the Medical Officer of Health. Seven clear days' notice of the intention of making an app lica tion to the Court must be given to the person concerned, or to some person in charge of him. The Order remains operative for a period of three months, but the Court may, on application by the Coun cil extend it for such further periods, not exceeding three months each, as are considered necessary. The procedure under Section 47, as outlined above, was amendded by the National Assistance (Amendment) Act, 1951, which came into operation on the Ist 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 certicates of the Medical Officer of Health and another registered medical practioner Make an Order without formal notice of the application having been given to the person concerned or to the hospital authority, subj ect. in the case of the latter, to evidence being produced of their to admit the person. The length of time a person may be detained under such an Order is limited to three weeks, instead of three nio nt j (1 and any application for an extension of this period must be accordance with the procedure laid down in Section 47. An application under the new Act may be made by the Medical Officer of Health. 42 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. Care of the Aged. The care of old people living alone continues to demand special attention. No difficulty arises while they remain physically able to attend to their personal needs and to maintain the home in a satisfactory factory condition. In this respect, interests outside the home serve a useful purpose. For example, many old folk in Battersea are members of old people's clubs and derive benefit, both directly and indirectly, from regular attendance at club meetings. On the other hand, when an old person takes no interest in clubs and dislikes going out or rece iving visitors there is always a risk that, sooner or later, with the onset of physical disability a deterioration may develop in the old Person's general standards. At this stage much may still be accomplished by relatives and by the various domiciliary services. Nevertheless, the care of frail old people during the night is always a source of anxiety when it is not possible for attendants to maintain Constant vigilance, and no campaign against accidents in the home can be considered complete without due regard to this aspect of the Problem. Use of Slipper Baths by Old Age Pensioners. On the 30th January, 1952, the Council decided to make available to the old pensioners free use of the slipper baths at their Baths Establishments (with use of a towel) on production of their pension books. This facility has now been extended to blind persons. Durin g the year 1955 this arrangement was taken advantage of at the respective Baths Establishments as follows:— Males Females Latchmere 3,130 3,945 Nine Elms 1,123 309 1,215 5,468 Plough Road 1,636 5,890 Total Burial of Deceased Persons. Und er 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 es tate 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, 5 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. 47 particulars 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 5 cases was £" approximately, and this amount was recovered by the end of the financial year at the 31st March, 1956. Personal Cleansing Station. During the year 1955, 447 treatments were given to person 5 suffering from, or contacts of, scabies. 115 of these treatments we re given to adults, 249 to school children, and 83 to other children under school age. In addition to the above, 131 adults and 1,986 children found to verminous, were cleansed. Of the 1,986 children cleansed, 1,808 attended 1 from local schools by arrangement with the London County Councilwho have entered into a contract with the Battersea Borough CounC' for the use of their Personal Cleansing Station. The cleansing treatment of the school children is carried out under the supervision of officers of the London County Council while the disi 11 ' testation of the clothing and (if necessary) of the homes is carried ° u concurrently by the Borough Council's sanitary staff. The homes of all cases of scabies that come to the knowledfi of the Medical Officer of Health are visited by the Council's Sanita r - Inspectors. . The following table shows the number of treatments at the Person? Cleansing Station and the expenditure incurred since 1906, the year 1 which the cleansing of verminous persons was begun: — Number of Baths, Etc. *Amount Contributed *Expendi- ture Year Adults Children Verminous and Scabies Verminous and Scabies £ £ 1906-1915 10,443 6,430 1,037 303 1916-1925 3,269 3,155 39,117 5,007 2,404 4,045 1926-1935 39,293 8,521 4,206 1936-1945 13,739 43,448 9,446 1946 1,822 4,229 1,352 443 1947 986 4,179 1,402 424 1948 497 3,266 1,808 408 1949 286 2,773 411 1,534 1950 226 410 2,238 1,750 1951 200 406 1,858 1,992 1952 535 176 1,994 1,956 508 1953 144 1,943 1,932 512 1954 214 2,383 1,966 1955 246 2,318 2,371 526 * 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. 44 During the year, because of shortage of staff at the Wandsworth cleansing Station, it was arranged for such women patients who attended for cleansing to be transferred to the Battersea Personal Cleansing Station, the cost of treatment being borne by the Wandsworth Borough Council. The Council have two flats attached to the Personal Cleansing Station for the temporary use in emergency of people or a family dis placed, usually following fumigating procedure. The Council have agreed that these shelters may be used for Wandsworth residents at an a nnual fee of £25 for the right to use the shelters and a weekly charge of £1 10s. Od. per shelter for every case sent there. 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 1955, are set out in the following table :- Battersea Mortuary, 1955. Usual Place of Residence Details of Bodies Received Residence unknown Total Battersea Wandsworth Elsewhere Post-mortem only 171 350 126 12 8 659 Post mortem and inquest 35 112 30 185 Total post-mortems 206 462 156 20 844 Inquest only - 6 1 1 8 Total inquests 35 118 31 9 193 san itary and other reasons 1 1 1 1 4 Total bodies received 207 469 158 22 856 Verdicts at Inquests Held — Natural causes - 3 3 2 8 Accident and misadventure 13 66 21 4 104 Open verdict 5 7 1 1 14 Suicide 15 37 5 1 58 Homicide - 3 1 4 - Alcoholism 1 2 3 - - Inttention at birth - 1 1 - - Industrial disease 1 1 - - - TOTAL 35 118 31 9 193 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 of coroner's Court. 45 INDEX. Page Adulterated Samples 31, 32, 33, Aged and Infirm Persons 21 Atmospheric Pollution 17.34 Bacteriological Examinations 41 Bakehouses 44 Baths —Personal Cleansing Station 24 „ —Public Swimming 43 „ , Slipper—Use by Old Age Pensioners 7 Births Botulism 29 43 Burials Butchers' Shops 17 Cancer 37 Certificates of Disrepair 37 Closing Orders 20 Combined Drainage 2 Committee—Health, Baths and Wash-houses 12 Comparative Statistics 42 Conferences 45 Coroner's Court and Mortuary 26 Dairies 23 Dangerous Structures 8 Deaths 11 „ , Infant 12 „ , Maternal 14 „ , from Tuberculosis 43 Deceased Persons —Burial of 37 Demolition Orders 13 Diphtheria Immunisation 13 Diseases—lnfectious and Other 20 Drainage, Combined 20 „ Work 33 Drugs—Sampling 19 Dustbins 34 Examinations—Bacteriological 17, 24 Exemption Certificates—Shops Act, 1950 39 Factories 39 Act, 1937 39 and Homework 26 Festival Pleasure Gardens, Battersea Park 27 Fish Shops 28 Food and Drugs Act, 1938, Sections 3 and 9 —Appeal 25 „ —By-laws for Protection of 26 „ —Festival Pleasure Gardens, Battersea Park 29 —Foreign Matter in 28. t „ Poisoning 25 Premises—lnspections 18, 25 Protection—Talks Sampling A „ Supply—Protection of 28 „ , Unsound 2 Health, Baths and Wash-houses Committee $ Heat Treated Milk 46 gating Appliances (Fireguards) Act, 1952 Page No. 24 Houses Let in Lodgings 37 Housing 36 Accommodation Applications 38 „ —New Accommodation ... I OA 36 Ce Cream Premises ... ... 27 Tn' .. >• Sampling 35 Infants —Deaths of ... 12 Immunisation—Diphtheria and Whooping Cough 13 Infant Mortality 11 Infectious and Other Diseases 13 Inquests 45 inspections 18 International Certificates of Vaccination and Inoculation ... 17 Legal Proceedings 19 Lollies 35 London County Council (General Powers) Act, 1954 „ „ „ „ „ „ 1955 1N/frvl' . 99 99 99 99 99 1955 ... 20 Marriages 8 Maternal Mortality 12 Milk and Dairies Regulations, 1949 26 pistributors and Dairies 26 Heat Treated 34 " Samples 30, 34, 35 „ , Adulterated 31 (Special Designations) Regulations, 1949 26 Supp|ied, in Schools and Hospitals—Sampling 35 Mort i- aneous Matters 42 ur tali t y—Infant 11 —Maternal 12 Mortuary and Coroner's Court 45 Nationnal Assistance Act, 1948 42, 43 " (Amendment) Act, 1951 42 New, Housing Accommodation 36 Nuisances—Public Health (London) Act, 1936 19 —Smoke 21 Offensive Trades 21 Old Age Pensioners —Use of Slipper Baths 43 Outworkers 41 Overcrowding 37 Personal Cleansing Station 44 Pet Animals Act, 1951 23 Population 7 Post Mortems 45 Prevention of Damage by Pests Act, 1949 22 Principal Fi gres 6 Protection of Food Supply 25 Public Conveniences 20 „ Health (London) Act, 1936—Nuisances 19 „ Lavatory Accommodation 20 „ Swmming Baths 24 Rag and Bone Dealers 21 Rag Flock a nd Other Filling Materials Act, 1951 22 Rodent Control 22 47 Page No. ' 31, 32, 33,34 Samples—Adulterated 33 „ —Drugs 30 „ —Food 34 „ —Heat Treated Milk 35 „ —Ice Cream 35 „ —Lollies 35 „ —Milk 30, 34, 34 „ — „ , Heat Treated „ — „ Supplied in Schools and Hospitals 35 18 Sanitary Circumstances 18 „ „ —Summary of Main Operations 24 Shops Act, 1950 26 „ , Butchers 27 „ , Fish 27 „ , Ice Cream 26 „ , Milk, and Dairies 23 „ , Pet 43 Slipper Baths—Use by Old Age Pensioners 36 Slum Clearance 13 Smallpox Vaccination 21 Smoke Nuisances 2 Staff 27 Stalls 23 Static Water Tanks 12 Statistics —Comparative 7 „ —Vital 7 Still-births 27 Street Stalls 24 Swimming Baths 25 Talks on Food Protection 14 Tuberculosis 14 Deaths 14 Notifications 28 Unsound Food 20 Urinals 23 Vacant Sites 13 Vaccination—Smallpox 17 „ —International Certificates 23 Van Dwellings 23 Verminous Premises 7 Vital Statistics 21 Water Supply 21 Wells 13 Whooping Cough Immunisation 48