A C4386 BAT 55 Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea FOR THE YEAR 1956 by J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH. Battersea Borough Council With the Compliments of the Medical Officer of Health Public Health Department Electric House, 204 Lavender Hill, Battersea, I. W.11. Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea FOR THE YEAR 1956 by J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH. 2 health, Baths and Wash-houses Committee. As constituted 23rd May, 1955. Chairman: Alderman Miss E. A. Coles, j.p. The Worshipful the Mayor (Councillor E. G. Perry, j.p.) Councillor H. F. W. Ashby. „ Miss N. F. Clark- Lawrence. „ Mrs. E. A. Cooper, j.p. „ Mrs. C. M. Davis. „ F. J. J. Harper. „ C. E. Lang. „ Mrs. P. G. Mitchell. Alderman S. E. Paul. Councillor Mrs. E. Reynolds. „ T. J. A. Rose. G. Whitehead. health Committee. As constituted 23rd May, 1956. Chairman: Councillor Miss E. A. Coles, j.p. The Worshipful the Mayor (Councillor Mrs. E. A. Cooper, j.p.) Councillor Mrs. C. M. Davis. „ Dr. J. Fairlee. „ E. J. Getting. Alderman Mrs. H. N. Halsey. „ D. King (appointed September). Councillor C. E. Lang (Vice-Chairman). Alderman S. E. Paul (resigned June). Councillor Mrs. E. Reynolds. „ T. J. A. Rose. Alderman Mrs. A. M. Smith. Councillor C. F. Waller. „ 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 Public Health Inspector G. W. P. Weeks (b c e). Deputy Chief Public Health Inspector J. R. Holloway (a c). Public Health Inspectors: District. 1. W. E. Selway (b c). 2. L. H. Whanslaw (b c). 3. A. Webb (b c). 4. A. W. E. Porter (b c). 5. J. R. Glover (b c) (resigned July). J. W. Parton (b) (appointed October). 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). 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: P. Brocking. A. C. Cooles. (Mrs.) V. J. Dawson (resigned February). (Miss O. L. Goldsmith (appointed March). R. Greaves. E. B. Moreton. (Miss) E. Town. S. J. P. Whitbread. 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 (d) Health Visitors' certificate, Board of Education. (e) Smoke Inspectors' Certificate of the Royal Sanitary Institute. 3 INDEX TO SECTIONS. PAGE Preface 4 Health Committee 2 Staff of the Public Health Department 2 Principal Figures for 1956 8 Vital Statistics 9 Infectious and Other Diseases 15 Sanitary Circumstances 20 Protection of Food Supply: — (а) Inspection of Food Premises 27 (b) Sampling of Food and Drugs 34 housing 37 Factories, Outworkers and Shops 40 Miscellaneous Matters 45 4 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Mr. Mayor, Ladies and Gentlemen, It is a privilege and a pleasure once again to present to you my Annual Report on the health of Battersea for the year 1956. As in previous years, the Report is mainly statistical, with comments on the figures as appear to be necessary and appropriate. In this preamble to the Report, I draw attention to one or two matters which appear to be of particular interest. The population of the Borough, which has been decreasing over the last two or three years, further decreased in 1956, when the estimated population was 112,900. The live birth rate was 15.6, a very slight increase over the previous year, while the death rate was 10.8, which was a slight reduction over the previous year. As in the previous year. three women died from causes associated with childbirth. In the year 1956, 42 infants died before attaining their first birthday, which gives an infant mortality rate of 23.7, a slight reduction over 1955, but still above the low rates achieved in 1952, 1953 and 1954. There was a considerable drop in the number of infectious diseases notified during the year, accounted for in the main by the diminished incidence of measles. In 1956, only 274 cases of measles were notified as compared with 1,934 in 1955. A total of 29 cases of poliomyelitis were notified, but in 6 of these the diagnosis was not confirmed. There was one death from this disease. During 1956, we experienced a sharp increase in the incidence of dysentery. The form of dysentery which occurred is known as Sonne dysentery, and over the past decade this form of dysentery has shown a considerable increase in many parts of the country. It is not a serious disease in the sense that it has a high mortality, except possibly in young babies or old people, but, nevertheless, it has a considersable nuisance value. In spite of its being a comparatively trivial disease, we regard its prevention as being very important, and a considerable amount of effort is expended to bring outbreaks, when they occur, under control. Extensive use is made of bacteriological examination, arrangements being made by the Inspectors and staff of the Department, and in all 553 persons were examined in connection with the outbreaks, and total of 1,755 specimens were submitted to the Laboratory for exarnination. I should like to express my thanks and appreciation of the help and co-operation we have received from the Public Health Laboratory in this work. We always know that however many specimens are submitted to the Laboratory, they will be expeditiously examined and reported upon, whereupon the appropriate action can be taken at the first opportunity. A large proportion of cases occurred in school children, and I should like also to express my thanks for the help and assistance we have received from the head teachers of the school affected. Outbreaks of dysentery in schools can give rise to considerable complications, and head teachers naturally are only too glad to do all they can to help us bring outbreaks under control. There was a further drop in the number of cases of tuberculosis primarily notified to us, thus continuing the downward trend which has been noted over the past five years. During the year there was a total 5 of 15 deaths from pulmonary tuberculosis. This compares with 14 during the previous year. I made some reference in my Report for last year to the problems arising in the care of old people. These have continued, and a good deal of attention has been paid to them. I am glad to say that it was only necessary to seek compulsory powers for the removal of one old Person to hospital. Probably the most important legislation affecting our work to be introduced in 1956 was the Food Hygiene Regulations, 1955. Part of these Regulations came into effect in January, but the more important ones did not take effect until July 1st. Some account of the Regulations to given in the body of the Report. At the time of writing, I am glad to be able to say that considerable progress has been made, and it is most gratifying to be able to state that we have received considerable co-operation from tradespeople in implementing the Regulations. It is not to be expected that the effect of the Regulations will be to produce a sudden and spectacular improvement in the short-term standards of food hygiene, although I think it is right to say that this is already being noticed. The main effect of the Regulations will undoubtedly be longterm, and will be achieved as much by education and persuasion of those traders whose standards are lower than desirable, as by legal action. the should like at this stage to express my appreciation of the work which the Public Health Inspectors have put in, in connection with these Regulations, in producing the results which have already been achieved. It is sometimes of interest and not without profit to stop a-while and look back over the years that have gone by, and the fact that it is just about a hundred years since Battersea first appointed a Medical Officer of Health provides an appropriate opportunity of doing so. It is interesting to look back therefore ONE HUNDRED YEARS AGO to the first report submitted on the health of Battersea. It will be remembered that the Metropolis Management Act of 1855 laid down that every Vestry and District Board should appoint a Medical Officer of Health and such number of persons to be Inspectors of Nuisances as might be necessary. For the purposes of the Act, parishes were united into Districts. Dr. William Connor was responsible for Battersea's first Annual Report in 1856 from which the following paragraphs are quoted:— "The 320 deaths, from all causes, which have been registered in this parish during the year may thus be enumerated—1 from small-pox, 7 from measles, 5 from scarlatina, 4 from whooping-cough, 13 from diarrhoea and dysentery, 8 from fever, 6 from erysipelas, 41 from lung diseases, excluding phthisis, 31 from phthisis, 56 from hydrocephalus, atrophy scrofula and convulsions of children, 120 from all other diseases not enumerated amongst the foregoing, and 24 from violence, privation Premature birth." "Of the total number of deaths amongst all classes (320) occurring in this sub-district, 95 took place in the workhouse, where very many of the Poor, either worn out by age or labouring under chronic diseases, or those but seldom admitting of cure, are sent to die—the majority coming from other sub-districts in the Union." 6 When these words were written the population of Battersea was 10,560 and the number of births amounted to 517. The following table shows the age distribution of the total deaths at that time:— Under 1 year 1— 5— 10— 20— 40— 60— 80 + Total Deaths 74 53 15 19 42 42 55 20 320 Percentage of total 23.1 16.5 4.7 6.0 13.1 13.1 17.2 6.3 100.0 From the preceding figures it has been possible to ascertain the following rates and their comparison with figures for 1956:— 1856 1956 Death rate per 1,000 population 30.40 10.83 Birth rate per 1,000 population 48.98 15.67 Infant mortality per 1,000 live births 143.13 23.74 These figures speak for themselves, and give some indication of the tremendous progress which has been made in improving public health over the years. We can, I think, read a little deeper, and it is not difficult to imagine the conditions which must have existed in those days, one hundred years ago. It would be wrong to allow the obvious evidences of improvement to lull us into a false sense of complacency. Public health and social well-being, which in many ways are terms synonymous with the progress of the human race, can never be static: if they do not progress they must go back, and while many problems have at least been partly solved, other new ones arise. I made some reference in my previous report to the steps to be taken to reduce still further the infant mortality rate. Other problems which, if they did exist a hundred years ago, must have been submerged in the more obvious and pressing questions of the day, are the so-called "stress" diseases, about which much has recently been written, particularly as to what extent the prevention of these diseases may be a public health matter. One does not wish to be technical here, and opinion is by no means unanimous, but by "stress" diseases is generally meant such conditions as high blood pressure (hypertension) and diseases of the heart blood vessels (coronary arterial disease) which in some ways may possibly be associated with the stresses and strains of modern urban civilisation. It is certainly the case that coronary arterial disease, for instance, must now be reckoned as an important cause of death in men, and to a lesser extent in women, in the most productive period of life. This disease is most fatal in the age group 45 - 65, which in many ways is the most important period of life from the economic, social and productive point of view. How this and other similar problems can be tackled by Public Health Department as they now exist, it is not easy to say. The cause of the condition. and why it is more predominant in men, can be little more than a matter for conjecture, although a great deal of research work is now being undertaken. It is at least possible that there may be social and/or enviromental conditions to account for the considerable preponderance of deaths from this disease in this age group in men. If Public Health Departments are to carry out their primary tion of safe-guarding the health and well-being of the public, it may be that we should be considering how to tackle this problem of coronary arterial disease. This brings me back to the point made above, that public health is not static, but constantly changing. It changes as the 7 environment, in which the human community lives, changes. Over the last hundred years the figures quoted above indicate clearly what improvements have been achieved. It is likely, however, that the law of diminishing returns is as true in the field of public health as it is in the economic and industrial spheres, and that as successes are achieved, the efforts needed to achieve still further successes will be proportionately much greater. In other words, although considerable advances in medical knowledge, together with legal enactments and social advancement, have been necessary to achieve the results of the past hundred years, the further efforts needed to reduce or abolish the newer problems which are arising may be even greater. While it can be said that Public health committees and those who serve them can look back over the past with a sense of not inconsiderable achievement, the progress to be made in coming years, although likely to be less spectacular than in the past, will undoubtedly provide scope for every effort and ability Once again, I should like to express my thanks for the help I and the Department have received during the year. Again, Miss E. A. Coles, J.P., Chairman of the Health Committee, has given her every help and guidance, and the various Committees with which the Department is associated, particularly the Health Committee and the Housing Committee, have accorded us their usual support in the many matters which we brought before them. The Chief Officers of the Council and their Departments have again been most helpful, and I am very grateful to them. Finally, I should like to thank all members of the staff of the Health Department, headed by the Chief Public Health Inspector, Mr. Weeks, in all grades and sections, for the excellent and efficient work they have carried out during the year, and again I would like to thank my colleague, Dr. Garland, for the great help he has been to me. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J. TUDOR LEWIS, Medical Officer of Health. August, 1957. 8 Principal Figues for 1956. Area of Borough, excluding tidal water (acres) 2,163 Home population (1951 Census) 117,140 Home population (Registrar-General's Mid-Year Estimate) 112,900 Structurally separate occupied dwellings 29,770 Births (live, 1,769; still, 48) 1,817 Live Birth rate 15.67 Deaths—1,223. Death rate 10.83 Maternal Deaths—3. Maternal death rate 1.65 Infant Deaths—42. Infant mortality rate 23.74 9 Vital Statistics. POPULATION. The Registrar-General's estimate of the mid-year home population of Battersea was 112,900 as compared with 113,700 in 1955, a decrease of 800. The estimated population at the Census taken in April, 1951, was 117,140; the 1956 figure of 112,900, when compared with this, shows a decrease of 4,240 (or 3.6 per cent.). The estimated mid-year home population figure of 112,900 has been adopted for the purpose of the statistics contained in this Report. BIRTHS. The number of live births registered in the Borough during 1956 was 665 (353 male, 312 female). Of this number 143 were transferred out, the permanent residence of the parents being outside the Borough, and 1,247 registered outside the Borough were transferred in, giving on balance a total of 1,769 births (923 male, 846 female, an excess of 77 males) relating to Battersea residents, and a live birth rate of 15.67 per 1,000 population. This is an increase of 0.37 on that of 1955. Of the Battersea births (522 live and 9 still) which occurred within the Borough, 487 were " domiciliary births." Illegitimate live births numbered 123 or 7.0 per cent. of the live births. The live birth rate for England and Wales was 15.7. Still-Births. The registration of still-births is made compulsory by the Births and Deaths Registration Act, 1926. During 1956 there were 14 still-births registered in Battersea, of which 9 were of Battersea parents. Thirty-nine still births occurring outside the Borough were registered as belonging to Battersea, making 48 in all, representing a still-birth rate 26.42 per 1,000 births (live and still) registered. Of the 48 still-births 6 (12.5 per cent.) were registered as illegitimate. The number of Battersea still-births registered and the still-birth rates from 1943 to 1956, were as under:— No. Rate No. Rate 1943 36 21.6 1951 37 19.2 1944 40 24.0 1952 42 23.2 1945 38 23.3 Mean 1946 59 22.7 1943-52 47 22.9 1947 74 27.0 1953 38 20.9 1948 46 20.1 1954 50 28.0 1949 43 20.8 1955 32 18.1 1950 53 27.2 1956 48 26.42 still-birth rate in 1956 for England and Wales was 23.0. 10 MARRIAGES. The marriages registered in Battersea during 1956 numbered 896. The marriage rate (i.e., the number of persons married per 1,000 of the population) was 15.9. Year. Marriages. Marriage Rate. 1951 929 15.9 1952 884 15.2 1953 876 15.3 1954 912 16.0 1955 971 17.1 Mean 1951/55 914 15.9 1956 896 15.9 The marriage rate for England and Wales was 15.8. DEATHS. The number of deaths registered in the Borough during 1956 was 2,022. Of these, 1,170 were deaths of non-residents and were transferred to the districts in which the person ordinarily resided. There were, on the other hand, 471 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths belonging to the Borough was 1,223 (659 males and 564 females). This gives a recorded death rate of 10.83 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 1956: — Under 1 year 1— 5— 15— 25— 45— 65— 75+ Total M. 30 2 6 11 33 184 190 203 659 F. 12 — 6 2 19 87 152 286 564 Totals 42 2 12 13 52 271 342 489 1,223 % of total 3.4 0.2 1.0 1.1 4.2 22.1 28.0 40.0 100.0 Of the 1,223 Battersea deaths (683 or 55.8 per cent.) occurred 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 1947 62.6 1952 67.7 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 1956 66.9 *During 1953 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. 11 The deaths of 831 residents of Battersea aged 65 years and upwards were registered during 1956. These 831 deaths constituted 68.0 per cent. of the total deaths at all ages. The natural increase of population (that is, excess of births over deaths) was 546 in 1956 as compared with 448 in 1955. The causes of the 1,223 deaths in 1956 classified in various age groups, are shown in the following table. Causes of Death at Different Periods of Life in Battersea during 1956. 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. 659 30 2 6 11 33 184 190 203 f. 564 12 — 6 2 19 87 152 286 1. Tuberculosis, respiratory m. 8 — — — — — 6 1 1 f. 6 — — — — 2 — 3 1 2. Tuberculosis, other forms m — — — — — — — — — f. 1 — — — — — 1 — — 3. Syphilitic disease M. 4 — _ — — 1 2 1 — f. 4 — — — — 1 1 1 I 4. Diphtheria m. — — — — — — — — — f. — — — — — — — — — 5. Whooping cough m — — — — — — — — — f. — — — — — — — — — 6. Meningococcal infections ... M. — — — — — — — — — f. — — — — — — — — — 7. Ac. poliomyelitis and polioencephalitis m. 1 — — 1 — — — — — f — — — — — — — — — 8. Measles m. — — — — — — — — — f. — — — — — — — — — 9. Other infective and parasitic diseases M 1 — — 1 — — — — — f. — — — — — — — — — 10. Cancer of stomach M. 18 — — — — — 4 9 5 f. 18 — — — — — 6 2 10 11. Cancer of lung, bronchus m. 49 — — 5 23 15 6 f. 8 — — — — — 4 4 — 12. Cancer of breast m — — — — — — — — — f. 17 — — — — 4 8 2 3 13. Cancer of uterus m. — — — — — — — — — f. 7 — — — — 1 2 4 — 14 Cancer of other sites M. 67 — 1 4 23 18 21 f. 47 — — 1 — 1 12 12 21 15. Leukaemia, aleukaemia m. 4 — 1 1 1 1 f. 5 — — — — 1 2 1 1 12 Causes of Death, 1956—(contd.). Causes of Death Sex All Ages 0— 1— 5— 15— 25— 45— 65— 75— 16. Diabetes m. 3 — — — — — — 1 2 f. 3 — — — — — — 2 1 17. Vascular lesions of nervous system m. 66 — 1 19 17 29 f. 75 — — — — — 8 22 45 18. Coronary disease, angina m. 99 5 37 38 19 f. 66 — — — — 1 10 27 28 19. Hypertension with heart disease m. 10 — — — — — 4 3 3 f. 17 — — — — — — 5 12 20. Other heart disease m. 67 1 3 9 12 42 f. 109 — — 1 1 10 21 76 21. Other circulatory disease m. 29 — — — — — 4 6 19 f. 33 — — — — 7 11 15 22. Influenza m 1 — — — — 1 — — -- f. 4 — — 1 — — 1 — 2 23. Pneumonia m 32 4 — — — — 9 9 10 f. 26 — — — — — 1 8 17 24. Bronchitis m. 83 1 2 25 36 19 f. 32 — — — — — 4 7 21 25. Other diseases of respiratory system m. 13 — — — — 1 1 8 3 f. 7 — — — — — 2 1 — 26. Ulcer of stomach and duodenum m 9 — — _ _ 1 3 1 4 F. 3 — — — — — — — 3 27. Gastritis, enteritis and diarrhœa M. 2 — — — — — — 2 — f. 2 — — — — 1 — — — 28. Nephritis and nephrosis m. 6 1 1 1 1 2 f. 4 — — — — 1 — 2 1 29. Hyperplasia of prostate m. 3 — — — — — — 1 2 f. — — — — — — — — — 30. Pregnancy, childbirth, abortion M. — — — — — — — — — f. 3 — — — — 3 — — — 31. Congenital malformations M. 7 4 1 2 — f. 5 4 — — — — — — 1 32. Other defined and ill-defined diseases m. 48 21 — — 2 1 5 8 11 F. 42 8 — — — 2 4 12 16 33. Motor vehicle accidents m. 7 — 1 — 3 1 1 — 1 f. 4 — — 2 1 — 1 — — 34. All other accidents M. 11 1 — 1 2 3 1 — 3 F. 11 — — 2 — — 1 2 6 35. Suicide m. 11 1 2 4 3 1 f. 5 — — — — — 2 3 — 36. Homicide and operations of war m. — — — — — — — — — F. — — — — — — — — — 13 Infant Mortality. During 1956 the deaths of 42 infants under 1 year of age were registered as belonging to Battersea. The total number of live births registered during the year was 1,769 giving an infant mortality rate of 23.74 per 1,000 live births as compared with 24.71 in 1955 and 18.99 in 1954. The infant mortality rate in England and Wales during 1956 was 23.8. The following table sets out the causes of death in detail. Infant Mortality, 1956. 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 Percentape of Total 1-2 2-3 3-4 1-3 3-6 6-9 9-12 Pneumonia m. f. m. F. m. f. m. f. m. f. m. F. m. f. m. f. m. f. m. f. m. F. — — — — 2 — — — — — 2 — 1 — 1 — — — — — 4 — 96 Congenital malformations — 1 — 1 2 — — — — — 2 2 2 1 — — — 1 — — 4 4 19.0 other defined and ill-define diseases:— Prematurity 7 4 9 4 — — — — — — 16 8 — — — — — — — — 16 8 57.1 Other causes 2 — 3 — — — — — — 5 — — — — — — — — — 5 — 12.0 Accidents — — — — — — — — — — — — — — 1 — — — — — 1 — 2.3 Totals 9 5 12 5 4 — — — — — 25 10 3 1 2 — — 1 — 30 12 100.0 14 17 4 — — 35 4 2 1 — 42 Percentage of total 33.2 40.4 9 .6 83.2 9.6 4.8 2.4 100.0 m. 71.4 F. 28.6 There were 35 deaths of infants during the first four weeks of life (or 83.2 per cent, of the total infant deaths) as compared with 30 deaths (or 69.8 per cent.) in 1955 and a percentage for the quinquennium 1951-1955 of 63.3. table showing Deaths of Infants under 1 day, under 1 week and under 4 weeks from 1951 to 1956. 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 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 1955 13 15 2 30 69.8 Mean 10 12 3 25 63.3 1956 14 17 4 35 83.2 14 Deaths of Illegitimate Infants. The death rate amongst illegitimate children during 1956 was 48.78 per 1,000 illegitimate live births, as compared with 34.48 in 1955. The corresponding death rate of legitimate children in 1956 was 21.87, the ratio of mortality rate of illegitimate infants to that of legitimate being 223 to 100. The corresponding figure for 1955 was 144 to 100. Maternal Mortality. During 1956 there were three deaths from "diseases or accidents of child-birth," which is equivalent to a fatality rate of 1.65 per 1,000 births (live and still). There were three such deaths during 1955. The rate for England and Wales in 1956 was 0.56. 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 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 1.69 24.7 1956 112,900 15.7 10.8 1.65 23.7 15 Infectious and Other Diseases. There was a large decrease in the number of notifications received during 1956, as compared with 1955. Notifications to the number of 910 were received, which, compared with 2,468 received during the Previous year, shows a decrease of 1,558. This is accounted for mainly a drop in the incidence of measles, 1,934 cases being notified in 1955 against 274 in 1956, a decrease of 1,660. There was, however, a sharp rise in the incidence of dysentery, 157 notifications being received in the present year as compared with 30 in 1955. The outbreak commenced in the spring of the year and continued into the summer. Those affected were mainly children under age of fifteen years. In all, 290 persons were either formally notified or reported by schools and day nurseries to be affected. Bacteriological examinations were made in connection with all cases, including contacts. In all, 553 persons were examined, and in 216 Cases the organisms of shigella sonnei were found. A total of 1,755 specimens were submitted for examination, and 166 premises visited. There was again no case of diphtheria notified, the last case occurring in 1953. There were 29 cases of poliomyelitis notified during the year, but in 6 of these the diagnosis was not confirmed. Of the 23 confirmed cases (17 paralytic and 6 non-paralytic) 18 occurred in children under fifteen years of age. The death of a boy aged nine years was recorded as due to this disease. Diphtheria and Whooping Cough Immunisation, Smallpox and Anti-Poliomyelitis Vaccination. Diphtheria and whooping cough immunisation and vaccination against smallpox and poliomyelitis were carried out during the year under the control of the London County Council. During May and June, and later in December a limited number of children were vaccinated with anti-poliomyelitis serum. No case, either confirmed or suspected, occurred among the vaccinated children. 16 Analysis of Cases (after Correction of Diagnosis) of Infectious Disease Notified during the Year 1956. Notifiable Disease Cases Notified in Battersea, at Ages (Years) Total 0— 1— 2— • 3— 4— 5— 10- 15— 25— 45— 65 & over Diphtheria — — — — — — — — — — — Dysentery 157 2 10 18 10 14 47 13 9 21 6 7 Encephalitis (acute): — Infective — — — — — — — — — — — — Post-infectious — — — — — — — —" — — —- Enteric (typhoid or paratyphoid) fever — — — — — — — — — — — — Erysipelas 16 — — — — — — — 1 6 4 5 Food poisoning 25 2 — 3 2 — 2 1 3 8 3 1 Malaria — — — — — — — — — — — — Measles 274 8 20 28 39 25 149 3 — 2 — — Membranous croup — — — — — — — — — — — — Meningococcal infection 2 — — — 1 — 1 — — — — — Ophthalmia neonatorum 1 1 — — — — — — — — — — Pneumonia, acute primary 33 2 1 — — 1 1 — 2 10 5 11 Pneumonia, acute influenzal 12 — — — 1 — 2 — — 2 6 1 Poliomyelitis (acute):— Paralytic 17 — 3 1 2 1 2 3 2 3 — — Non-paralytic 6 — — — — — 5 1 — — — — Puerperal pyrexia 2 — — — — — — — 2 — — — Scabies 7 — — — 1 — 1 — 1 3 1 — Scarlet fever 72 1 — 4 9 11 40 5 2 — — — Smallpox — — — — — — — — — — — — Tuberculosis:— Pulmonary 102 — — — 2 — 4 2 12 44 29 9 Non-pulmonary 6 — 1 — — — 1 1 — 3 — — Whooping cough 178 26 15 19 17 23 70 5 — 3 — Totals 910 42 50 73 84 75 325 34 34 105 54 34 TUBERCULOSIS. During the year 1956 there were 108 cases of tuberculosis (all forms) notified in Battersea as compared with 129 in 1955, 140 in 1954, 165 in 1953, 188 in 1952 and 162 in 1951. In addition 57 cases were reported or otherwise came to the knowledge of the Medical Officer of Health, making a total of 165 cases for the year. The case rate per 100,000 population was 146.1. The tables on page 18 give details in age groups of the 165 cases. Deaths from Tuberculosis. During 1956 deaths from tuberculosis registered as belonging to the Borough of Battersea numbered 15, of which 14 were due pulmonary tuberculosis, and 1 to another form 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, 1953. 1954, 1955 and 1956 are given in the following table:— 17 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 1954 17.5 3.5 21.0 1955 12.3 12.3 Average (5 years 1951/55) 24.1 2.8 26.9 1956 12.4 0.9 13.3 The death rate per 100,000 population was 12.1 for England and Wales Tuberculosis, 1956. Cases Added to and Removed from Notification Register. Pulmonary Non- Pulmonary Grand Total Males Fem. Total Males Fem. Total Males Fem Total Already on Register, 31/12/55 652 551 1,203 31 61 92 683 612 1,295 Primary notifications 62 40 102 2 4 6 64 44 108 Notified after death 1 — 1 — — — 1 — 1 Unnotified deaths 2 1 3 1 1 2 2 4 Restored 1 1 2 — — — 1 1 2 Removals into Borough 21 29 50 2 — 2 23 29 52 From other sections — — — — — — — — — Total additions 87 71 158 4 5 9 91 76 167 Deaths 12 6 18 — 12 6 18 Notified after death 1 — 1 — — 1 — 1 Unnotified deaths 2 1 3 — 1 1 2 2 4 Removals from Borough 56 54 110 7 6 13 63 60 123 Recovered 26 19 45 3 9 12 29 28 57 Diagnosis not confirmed 4 2 6 — — — 4 2 6 To other sections total DELETIONS — — — — — — — — — 101 82 183 10 16 26 111 98 209 Net increase _ _ — — — — Net decrease 14 11 25 6 11 17 20 22 42 On Register at 31/12/56 638 540 1,178 25 50 75 663 590 1,253 18 Formal Notifications, 1956. 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 — — 1 3 — 3 2 7 16 10 14 6 — 62 Respiratory, Females — — 1 1 2 3 4 10 11 5 — 3 — 40 Non-Respiratory, Males — — — — — — — 2 — — — — — 2 Non-Respiratory, Fem. — 1 — 1 1 — — 1 — — — — — 4 New cases of Tuberculosis coming to the knowledge of the Medical Officer 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 RegistrarGeneral (transferable deaths) r. M — — — — — — — — — — — 1 — 1(a) F — — — — — — — — — — — — — -(B) n.r. M — — — — — — — — — — — — — -(C) F — — — — — — — — — 1 — — — l(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 — — — — — 1 2 8 2 4 2 2 — 21(a) F — — — — — 4 4 15 3 — 3 — — 29 (B) n.r. M — — — — — — — 1 1 — — — — 2(C) F — — — — — — — — — — — — — -(D) R—Respiratory. Totals (A) 24 N.R.—Non-Respiratory. ,, (B) 30 ,, (C) 2 ,, (D) 1 Total number of informal notifications 57 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, County Hall, Westminster Bridge, S.E.1. No charge is made to the Council for these examinations. During the year 1,850 examinations were made as follows:— Description Disease Number of Specimens or Food Samples Positive Results Faeces Dysentery or Food Poisoning 1,810 592 Throat Swabs Diphtheria 29 Nil Nasal Swabs Whooping Cough 5 1 Foodstuffs Food Poisoning 6 2 INTERNATIONAL CERTIFICATES OF VACCINATION and INOCULATION. At the request of the Ministry of Health arrangements are made for the authentication, by the Medical Officer of Health, of certificates of vaccination and inoculation issued by medical practitioners in the Borough in respect of persons going abroad. During 1956, 376 certificates were authenticated. CANCER. During 1956 the number of deaths of Battersea residents from cancer was 231 (134 males, 97 females) as compared with 247 in 1955, 214 in 1954, 242 in 1953 and 239 in 1952. The death rate from the disease per 1,000 of the population was 2.05. The deaths from cancer constitute 18.9 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 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 1951-1955 2.07 1926-1930 1.51 1956 2.05 Details in age groups and the localisation of this disease will be found on page 11. 20 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 1956. Sanitary Operations. Inspections— Complaints 3,471 Houses let in lodgings 36 Certificates of Disrepair 105 Slum clearance 653 Urinals and conveniences 199 Caravans 78 Water certificates 98 Infectious disease cases— Notifiable 701 Non-notifiable 161 Tuberculosis 61 Drainage inspections 2,073 Other visits 2,200 Re-inspections 15,290 Notices served— Intimation 1,882 Statutory (Secs. 197 and 200) 87 Statutory (Fifth Schedule) 946 Summonses issued 140 Magistrates' Orders obtained 34 Work carried out— Drains— Smoke tests 89 Water tests 617 Found defective 56 Repaired 116 Reconstructed 22 Sealed off 14 Ventilated 38 Frontages laid 15 Roofs repaired 726 Rainwater pipes and gutters paired 349 Dampness remedied 834 Waste pipes renewed/ repaired 124 Work carried out—(contd.) Water closets repaired or cleansed 292 Water closets installed 75 Water cisterns cleansed or repaired 69 Water supplies reinstated 174 Water fittings renewed or repaired 138 Water certificates issued 204 Sinks, lavatory basins, baths renewed 49 Plaster renewed 625 Floors and stairs repaired 223 Doors and windows repaired 457 Fireplaces and flues repaired 178 Additional lighting, ventilation Rooms cleansed 82 Premises disinfested 140 Dustbins provided 90 Yard paving renewed or repaired 70 Dangerous structures referred to District Surveyor 157 Other defects remedied 454 Premises disinfected 720 Articles disinfected 5,559 Personal Cleansing Treatments— To adults 262 To children 1,517 Rodent Control— Premises dealt with— Rats 199 Mice 81 Inspections 3,347 21 Legal Proceedings. During the year, legal proceedings were taken by the Council in 143 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 141 21, 22 Food and Drugs Act, 1955 1 36 National Assistance Acts 1 45 143 Fines totalling £10 0s. 0d. were imposed in connection with these Proceedings, and £30 5s. 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, 1,882 Intimation Notices (relating to 1,440 Premises) and 946 Statutory (Nuisance) Notices (relating to 806 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 found necessary to refer 271 cases to the Council's Solicitor with instructions to take steps, by legal proceedings if necessary, to enforce compliance with Statutory Notices. In 131 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 result, Nuisance Orders were made by the Court in 34 instances. The remaining 106 summonses were ultimately withdrawn, the Notices having been complied with subsequent to the issue of the summonses. In 19 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. During the year defective conditions in 1,359 houses were remedied—653 by owners following the service of Intimation Notices; 687 by owners following the service of Statutory Notices, and the Council's workmen entered and did work in default of the owners on 19 occasions. Dustbins. Procedure with regard to the service of notices requiring the provision of dustbins has been simplified with the passing of the London County Council (General Powers) Act, 1954. The notice is served upon the owner, and he has a right of appeal to the Court. information as to these rights is always included when notice is served. 22 The London County Council (General Powers) Act, 1955. Section 25 of the above Act relative to choked drains was used on 22 occasions. This Section enables a notice to be served upon an owner or occupier to clear a stopped-up drain, water closet or soil pipewithin forty-eight hours. If the notice is not complied with the Council may carry out the work and recover the cost. It was necessary for the Council to do the work on three occasions. Section 26 enables the Council to re-instate a water supply to a dwelling after the supply has been withdrawn by the Metropolitan Water Board following a defect in the supply pipe or fittings. Notices were served on four occasions and in one case the Council did the work in default. Authority was given by the Council to the Medical Officer of Health, the Deputy Medical Officer of Health, and the Chief Public Health Inspector to serve Section 27 notices on behalf of the Council to remedy nuisances within a specific time where unreasonable delay would be occasioned by following the normal procedure. No occasion arose for the service of such a notice. 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. All the lavatory accommodation at each of the conveniences is provided free, and, in the interests of public health, free washing facilities are also available. 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. 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 204 new buildings, and the drains of 22 old buildings were partially or entirely reconstructed under the supervision of the Officers of the Health Department. 118 plans of proposed drainage work were deposited in 1956, as compared with 135 in 1955. During the year drains were tested by smoke on 89 occasions and 56 were found defective. The water test was applied on 61' occasions, this being mainly to drains in course of construction. The frontage drains of 15 premises were constructed or reconstructed. One summons was issued against an owner under the Public Health (London) Act, 1936, for the recovery of the cost of drainage work carried out by the Council. The amount claimed and costs were paid before the summons was heard. Combined Drainage. No claims were made against the Council in connection with combined drainage. 23 Atmospheric Pollution. During the year, 21 complaints were made alleging nuisances from smoke, dust, grit, etc., emitted from premises in various parts of the Borough. All these complaints received careful and sometimes prolonged investigation. 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 295 observations were made. Three notices were served. Smoke Measuring Station. A smoke measuring station was set up in the Public Health Department in the latter part of the year. Sufficient readings had not been taken by the end of the year to include in this Report any information of value. This information will be given either in figures or graph formation in a subsequent Report. I append a short description of the work involved. A measured quantity of air is drawn in from the outside of the building, and passed through a filter paper, which traps the suspended impurities in the atmosphere, and gives a " smoke stain." The air then passes through a bubbling tube containing dilute hydrogen peroxide which traps the sulphur contained in the air. Readings are taken every 24 hours. The smoke stains are matched against a series of shades, each having a prescribed value and by calculation the concentration of smoke in the air in milligrams per cubic metre can be obtained. The sulphur dioxide is removed from the air, as it passes through the bubbling tube, and forms sulphuric acid. At the end of the day's run, the volume of standard alkali needed to neutralise the sulphuric acid is measured, and the average concentration of sulphur dioxide is calculated by formula. These calculations are sent to the Department of Scientific & Industrial Research, who collate the information supplied by Authorities all over the Country, and a picture can be gained of the average concentration of smoke and sulphur dioxide in the various areas. The daily readings are taken principally by two of the Public Health Inspectors. Clean Air Act, 1956. The Clean Air Act, 1956, received the Royal Assent on the 5th July, 1956, and the appointed day for the operation of certain provisions of the Act was the 31st December, 1956. These provisions related to smoke from furnaces, smoke control areas, extension of the Alkali Works Regulation Act to cover the emission of smoke, grit and dust from premises controlled under that Act, colliery spoil banks, and the constitution of the Clean Air Council. One of the most important provisions as it relates to the Council is the authority given to establish smoke control areas. The Smoke Control Areas (Authorised Fuels) Regulations came into operation at the same time as the Appointed Day Order, and declare the following fuels as authorised fuels for the purposes of the Act: —anthracite; 24 briquetted fuels carbonised in the process of manufacture; coke; electricity; gas; low temperature carbonisation fuels; low volatile steam coals. Following the coming into operation of a Smoke Control Order, if on any day smoke is emitted from a chimney of any building within the area the occupier of the building would be guilty of an offence. The question of the establishment of a smoke control area is at present under consideration by the Council. Offensive Trades. There are two premises in the Borough at which the scheduled offensive trade of fat melting is carried on. The firms concerned have been established for many years, and the trades are conducted satisfactorily. Water Supply. During the year certificates under Section 95 (2) of the Public Health (London) Act, 1936, were issued in respect of 204 new or re-erected dwellings. Fifty-two notices of waste of water from defective fittings, etc.. observed 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. I am indebted to the Director of Water Examination of the Metropolitan Water Board for the following information in connection with water supplied by the Board to the Borough generally. "The supply to the Battersea area has been satisfactory both quantity and quality during the year 1956. The water is all River Thames-derived. It is stored in the Board's reservoirs at Staines, Laleham and Walton and treated in the Board's works at Hampton, Surbiton and Walton. The method of purification is by storage, filtration and terminal chlorination and contact tanks are in operation at Hampton and Walton to ensure efficient disinfection of the water. Plans are progressing for the construction of a contact tank at the Surbiton works. Samples are collected on five days in every week and more frequently if required, from each stage of the purification process and in the distribution system. Tests include physical, chemical and microbiological examination of the water. All new and repaired mains are chlorinated before being restored to service and samples of water from them are tested bacteriologically to ensure that its quality is up to that normally supplied. The water supplied to the Borough of Battersea is not plumbosolvent." 25 Rag and Bone Dealers. Premises occupied by rag and bone dealers in the Borough are subjected to regular inspection. During the year 122 inspections were made. One case was reported by the Police of an itinerant rag dealer, who was 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. The case was dealt with by cautionary letter, and the Medical Officer of Health in whose Borough the rag dealer resided was informed of the action taken. 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 Public Health 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, 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 — 1 —_ Dwelling houses — 75 37 Business premises — 123 44 — 199 81 The total number of visits made to the above premises, and to others which were found not to be infested, was 3,347. 26 Verminous Premises. During the year 140 premises which were found to be infested with vermin were disinfested. The insecticide used contains Pybuthrin and Lindane/D.D.T. and gives a prolonged residual effect. 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 any dangerous condition appertaining to a building be noticed, the District Surveyor of the London County Council is notified for any action he may decide to take, 157 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 rebuilding and 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. 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 on the premises of an additional sanitary convenience for the use of a female employee. The application was granted on the understanding that a bolt and a "Vacant/Engaged" sign was affixed to the door of the existing convenience. 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. 27 Protection of Food Supply. (A)—INSPECTION OF FOOD PREMISES. The regular inspection of all premises where food for human consumption is prepared, stored or sold has always been carried out as a routine. The Food and Drugs Act, 1955, which came into operation °n the 1st January, 1956, was a consolidation measure repealing the Food and Drugs Amendment Act, 1954, and consolidating it with the Food and Drugs Act, 1938, the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, and certain other enactments amending and supplementing Part V of the Act in relation to slaughterhouses and knackers' yards. The Food Hygiene Regulations made under the new Act came into operation on the 1st January, 1956, and have been implemented during the year. They modify and extend the hygiene requirements in Section 13 of the Food and Drugs Act, 1938. This section has applied to premises, yards and forecourts, but the Regulations include a number or provisions affecting stalls and vehicles, and also certain general requirements that apply wherever food is handled. They apply to the supply of food in the course of a business, which is defined so as to include canteens, clubs, schools and other institutions, as well as Undertakings carried on by public and local authorities. The principal extensions of the previous law are:— (1) Specific requirements designed to prevent the contamination of food. (2) Provision of sinks or other facilities for washing food and equipment. (3) The provision of a constant supply of hot water for sinks, and wash basins in food premises, and a supply of hot water on stalls and vehicles. (4) Restrictions on the preparation and packing of food in or about domestic premises. (5) The condition under which certain foods that provide a particularly favourable medium for food poisoning organisms are to be kept in food premises. (6) A requirement to provide vehicles used for the transport of meat with duckboards and separate receptacles for offal, and, where the vehicles are not enclosed, a covering supported by a frame or poles. (7) The circumstances in which persons carrying meat are required to wear overalls and head coverings. Regulation 31 enables the Council to issue a certificate of exemption in certain cases where compliance cannot reasonably be required because of restricted accommodation or some other special Circumstances. There is an appeal to a court of summary jurisdiction against the refusal or withdrawal of a certificate. The Regulations relating to the provision of wash-hand basins, sinks, hot and cold water supply, clothing accommodation and the regulation governing the temperature at which certain foods shall be kept, came into operation on the 1st July, 1956. 28 It will be seen that the Regulations are quite extensive, and there are many new provisions other than those covered by Section 13 of the 1938 Act, which previously governed food premises. All food premises in the Borough were circularised with a resume of the Regulations and a notice governing food handling. A letter was also included informing the occupier or person having control that an Inspector would be visiting to advise them as to their liability in regard to the Regulations, and to give them any advice they required. A complete register of all food premises in the Borough has been compiled, showing the result of the initial inspection and notices served where necessary to make premises comply with the Regulations. One exemption certificate was granted in connection with the Regulations during the year. FOOD PREMISES. As at 31st December, 1956. Milk Distributors 38 Wholesale Milk Dealers (registered as Dairymen) 2 Restaurants, Cafés 153 Canteens, Kitchens 58 Butchers 69 Horseflesh (for human consumption) 2 Ice Cream (Sale) 239 Ice Cream (Manufacture) 4 Fish Shops (Wet and Fried) 45 Food Factories 25 Bakehouses (Not underground) 21 Bakehouses (Underground) 4 Preserved Food 101 Bakers 50 Greengrocers 79 Confectioners 205 Grocers and Provisions 267 Miscellaneous (Chemists, Public Houses, Off-Licences) 201 Stalls:— Confectionery 2 Grocers 2 Greengrocers and Fruiterers 67 Fish and/or Poultry 11 There are 1,073 food premises in the Borough, together with 82 food stalls. Some of the premises shown above are listed under more than one trade category. 29 Dairies and Milk Distributors. At the end of the year there were 140 premises in the Borough registered for the sale of milk. Two of these premises, occupied by wholesale dealers, were registered as dairies. The occupiers of the remaining 138 premises were registered as milk distributors. All these premises were visited during the year, and 28 notices concerning non-compliance with the Food Hygiene Regulations were served. In addition, 29 distributors selling milk in Battersea from premises in other Boroughs were on the "Out-of-Borough" Register. Milk (Special Designations) Regulations. Under the above Regulations three designations are 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 the premises at which the bottle was filled and the words "Tuberculin Tested Milk." Any other type of container must be closed with a 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 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 under 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 1956 was as follows:- Full Supplementary Tuberculin Tested 64 25 Pasteurised 97 26 Sterilised 136 26 297 77 One licence to sterilise milk was issued, and is included in the above figures. Details of examination of samples of pasteurised and sterilised milk are given on page 35. Ice Cream Premises. Section 16 (a) of the Food and Drugs Act, 1955, provides for the registration of premises used for the sale, or manufacture for the purpose of sale, of ice cream, or the storage of ice cream intended for sale. The number of premises registered at the end of the year was 243, and 444 inspections were carried out during the course of the year. To ensure compliance with the Food Hygiene Regulations, 47 notices were served. 30 Particular attention is paid to premises where manufacture takes place. 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. There are 4 such premises registered in the Borough. Butchers' Shops. There are 71 butchers' shops in the Borough, and in addition a number of shops where cooked meats are sold. All these shops are systematically inspected, 967 visits having been made during the year. In general, the shops are well conducted, but 27 notices concerning noncompliance with the Food Hygiene Regulations were served. Two shops where horseflesh is sold for human food are included among the butchers' shops mentioned above. 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 are 45 such shops in the Borough. 220 inspections were made, and 15 notices served in respect of breaches of the Food Hygiene Regulations. Preserved Food Premises. Section 16 (b) of the Food and Drugs Act, 1955, provides for the registration of premises used for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for saleA total of 101 premises were registered at the end of the year. In addition to butchers and fish shops, 37 inspections of other preserved food premises were carried out, and 41 notices served under the Food Hygiene Regulations. Catering Establishments. All restaurants, cafes, canteens and kitchens are regularly inspected throughout the year. There are 211 of these premises on the Register, and 798 inspections were made. Food 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 has not been found possible at present to implement the question of washing facilities for stalls, as provided for in the Food Hygiene Regulations, in any very satisfactory manner. As a temporary measure it has been agreed, providing the stallholder has access to washing facilities in an adjoining shop or house and has obtained permission to use them, he need not, at present, provide means of hand washing at his stall. Such arrangements have been made individually by the stallholders and these have been investigated by the Public Health Inspectors and reported as satisfactory. 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. 31 Talks to Food Handlers. The Inspector responsible for hygiene in catering establishments Save a series of talks to employees of a large firm engaged in the handling of food. The talks were given at the request of the management and were greatly appreciated. FOOD PREMISES. Summary of Operations. Inspections— carried out— Butchers' shops 967 Sanitary conveniences cleansed, improved or repaired Fish shops 220 44 Milk shops 131 Cold water provided 53 Other Food shops 2,495 Hot water provided 137 Wash hand basins provided rood stalls 126 106 Food storage premises 75 Soap, drying facilities, etc., provided 61 Ice cream premises 444 Sinks provided 61 Preserved food premises 37 Ventilation provided or improved Catering establishments 798 14 Premises cleansed or repaired 83 Notices served 177 (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 1956 was 281, of which 2, or 0.7 per cent., were certified to be adulterated. In addition, 273 informal samples were procured, all of which were reported as genuine. 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 1955 and 1956 are shown separately. 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—1955 2.1 2.2 1955 3.0 1.9 1956 0.7 0.0 32 Milk. One hundred formal samples of milk were taken during the year. Of the 100 samples, 26 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 Agriculture, Fisheries and Food. All of these samples were reported to be in conformity with this standard, their average composition being:— Milk fat 4.44 per cent. Non-fatty solids 9.11 „ Total milk solids 13.55 „ The milk fat content of the 26 samples of "Channel Island" or " South Devon " milk ranged as under:— Between 4.8 and 4.9 per cent. 1 sample. „ 4.7 „ 4.8 „ 2 samples „ 4.6 „ 4.7 „ 2 „ „ 4.5 „ 4.6 „ 4 „ „ 4.4 „ 4.5 „ 6 „ ,, 4.3 „ 4.4 „ 3 „ „ 4.2 „ 4.3 „ 5 „ „ 4.1 „ 4.2 „ 2 „ „ 4.0 „ 4.1 „ 1 sample. 26 All the 74 samples of ordinary milk were reported as genuine and their average composition was as follows:— Milk fat 3.61 per cent. Non-fatty solids 8.77 Total milk solids 12.38 Their content of milk fat ranged as follows:— Between 3.9 and 4.0 per cent. 8 samples or 10.81 per cent. „ 3.8 „ 3.9 „ 12 „ „ 16.22 „ „ 3.7 „ 3.8 „ 13 „ „ 17.57 „ „ 3.6 „ 3.7 „ 10 „ „ 13.51 „ „ 3.5 „ 3.6 „ 8 „ „ 10.81 „ „ 3.4 „ 3.5 „ 12 „ „ 16.22 „ 3.3 „ 3.4 „ 8 „ „ 10.81 „ „ 3.2 „ 3.3 „ 3 „ „ 4.05 „ 74 100.00 In the five years 1951-5 and in 1956 the percentage of adulterated samples of milk was as under:— Year Samples taken Adulterated No. Percentage    1951 428 1 0.2 1952 101 0 0.0 1953 100 1 1.0 1954 100 6 6.0 1955 100 3 3.0 1956 100 0 0.0 33 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 — 1 1 — — — Bananas — 13 13 — — — Biscuits — 2 2 — — — Blancmange Powder — 5 5 — — — Bread 1 6 7 — — — Butter 29 — 29 1 — 1 Cake and Pudding Mixture — 29 29 — — — Cereal Preparations — 11 11 — — — Cheese 1 — 1 — — — Cider Vinegar 1 — 1 — — — Chocolate Spread — 2 2 — — — Cocoa — 7 7 — — — Coffee 3 1 4 — — — Coffee and Chicory Essence 1 4 5 — — — Confectionery Flour 8 2 10 — — — Confectionery Sugar 3 4 7 — — — Custard Powder ... — 4 4 — — — Fish Paste — 26 26 — — — Flavourings — 5 5 — — — Flour 10 2 12 — — — Foam Crystals — 1 1 — — — Fruit, Dried 4 — 4 — — — Fruit Preserving Tablets — 1 1 — — — Gelatine — 6 6 — — — Glucose — 5 5 — — — Golden Raising Powder — 3 3 — — — Gravy Preparations — 3 3 — — — Ice Cream 4 — 4 — — — Jams and Preserves 6 4 10 — — — Jelly 15 3 18 — — — Junket Preparations — 4 4 — — — Lard and other Fats 15 — 15 — — — Meat Preparations:- Beef, Minced 1 — 1 — — — Black Pudding 1 — 1 — — — Meat Paste — 34 34 — — — Meat Pies 2 — 2 — — — Pork Brawn 1 — 1 — — — Rissole 1 — 1 — — — Sausages 21 — 21 — — — Sausage, Liver 3 — 3 — — — Sausage, Luncheon 2 — 2 — — — Sausage Rolls 2 — 2 — — — Milk 100 — 100 — — — Milk, Condensed 1 — 1 — — — Carried forward 236 188 424 1 — 1 34 Nature of Sample EXAMINED ADULTERATED Formal Informal Total Formal Informal Total Brought forward 236 188 424 1 — 1 Mustard — 3 3 — — — Non-brewed Condiment 1 — 1 — — — Olive Oil 3 — 3 — — — Pea Flour — 2 2 — — — Pepper — 4 4 — — — Pickles — 5 5 — — Plum Pudding — 1 1 — — Saccharin Tablets — 1 1 — — — Sandwich Spread — 1 1 — — Sauces — 9 9 — — — Soft Drinks 2 2 4 — — Soups, Canned — 1 1 — — Soups, Powder — 4 4 — — Spices and Condiments — 13 13 — — — Stuffing —4 4— — — Suet 2 — 2 — — — Sugar 1 — 1 — — Tea 4 — 4 — — — Vinegar 24 — 24 1 — 1 Totals 273 238 511 2 — 2 Drugs. The following table gives details of the drugs of which sample were obtained for the purpose of analysis:— Nature of Sample EXAMINED ADULTERATED Formal Informal Total Formal Informal Total Glycerin 4 — 4 — — — Linctus 4 1 5 — — — Lozenges — 2 2 — — — Oil, Camphorated — 5 5 — — — Oil, Castor — 7 7 — — — Ointment, Sulphur — 1 1 — — — Ointment, Zinc — 1 1 — — — Paraffin, Liquid — 2 2 — — — Salts, Epsom — 4 4 — — — Salts, Glauber — 3 3 — — — Seidlitz Powder — 2 2 — — — Soda, Bicarbonate of ... — 4 4 — — — Tablets:— Aspirin — 2 2 — — — Soda Mint — 1 1 — — Totals 8 35 43 — — — 35 Adulterated Samples. The following action was taken in regard to the 2 formal samples certified as adulterated:— No. 183. Butter, excess of 0.3% water. Cautionary letter. No. 198. Vinegar, 7% deficient in acetic acid.—Cautionary letter. Follow-up action showed no deviation from the standard set. Bacteriological Examination of Food. In addition to samples taken for chemical examination, samples food were submitted for bacteriological examination. In two cases, in connection with an outbreak of food poisoning, the results were Positive. Heat Treated Milk. Samples of pasteurised and sterilised milk are taken at regular intervals for submission to the Public Health Laboratory Service for prescribed tests, and during the year samples as under were taken with the results set out:— Phosphatase Methylene Blue Satisfactory Failed Satisfactory Failed Pasteurised 33 — 33 — Turbidity Satisfactory Failed Sterilised 31 — 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 of any adverse report. Milk supplied in Schools and Hospitals. Samples of milk in course of delivery to Schools and Hospitals in the Borough 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 32, 33 and 35. the results of the analyses and tests are communicated to the London County Council or to the appropriate Hospital Management Com- mittee. Ice-Cream. Thirty-six 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 17 „ 2 14 „ 3 4 „ 4 1 36 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 suggested. 36 Foreign Matter in Food. There were ten instances of foreign matter in food dealt with during the year, and in nine of them cautionary letters were sent to the persons concerned. In one case a summons was issued and a fine of £10 obtained with £3 3s. 0d. costs to the Council. This was in connection with a cigarette in a loaf of bread. A complaint of mould in a milk bottle was referred to the Medical Officer of Health of the Borough in which the milk was bottled. 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. Cakes and biscuits 1 qtr., 1 st., 15 packets. Cheese 1 cwt., 26 boxes. Cream 8 tins. Fats 3 lbs. Fish (wet) 10 cwts., 2 qtrs., 2 boxes fish roes. Fish (preserved) 8 cwts., 2 qtrs., 295 tins, 6 jars. Flour and cereals 1 lb., 16 tins. Fruit juices 4 tins. Fruit (fresh) 299 boxes of pears. Fruit (preserved) 13 cwts., 1st., 6 lbs. 1107 tins. Jams, syrups and preserves 1½ lbs., 62 tins. Meat, meat products (preserved) 8 cwts., 3 qtrs., 1 lb., 808 tins. Meat (fresh) 18 cwts., 2 qtrs., 1 St., 5¾ lbs. Milk (tinned) 63 tins. Offal 1 cwt., 1 qtr., 11 lbs. Paste (meat and fish) 1 tin. Pickles and sauces 9 jars, 2 barrels. Poultry 102 chickens, 4 jars, 92 turkeys. Pudding and cake mixture 2 tins, 4 puddings. Soups 30 tins. Sweets and chocolate 24 doz. packets, 23 bars, 288 marshmallows. Vegetables (fresh) 19 cwts., 1 st., 10 lbs., 72 boats of tomatoesVegetables (preserved) 1,221 tins. FOOD POISONING. On the 28th August, an outbreak of food poisoning was reported from a Works Canteen. The onset of the illness occurred within 3 to 4 hours of ingestion of the meal, and 16 out of a possible 160 persons were affected. The main symptoms were vomitting, diarrhoea and stomach pains. The duration of the illness varied between 1 to 3 days. Laboratory investigation of those affected and of the food handlers in the Canteen prove negative, but Staphylococci aureus was isolated from some of the remaining food. Every endeavour to trace the source of infection was made, but without success. All those affected made a complete recovery. 37 Housing. Provision of New Accommodation. During the year 1956 construction of the following 204 new houses and flats was completed:— By Battersea Borough Council:— 23 Prince of Wales Drive 4 flats 94, 94a, 94b, 96, 96a, 96b, 98, 98a, 98b Battersea Rise 9 „ 35/39 (odd) Brynmaer Road 6 „ 21/25 (odd) Anhalt Road 6 „ 52/60, 66/72 (even), 37/45, 45a (odd) Devereux Road 15 „ 63, 65 Albert Bridge Road 9 „ Wittering House, Anerley Street 16 „ Rushlake House, Anerley Street 16 „ Hopkinson House, Anerley Street 16 „ Berry House, Anerley Street 20 „ Lavenham Court, Beauchamp Road 6 „ Pavilion Chambers, Lavender Hill 17 „ 25/35 (odd) Shirley Grove 6 houses „ 146 By London County Council:— 261/275 (odd) York Road 8 flats Drury House, Patmore Estate 45 „ Shop and maisonette, Patmore Estate 1 flat 54 By Private enterprise:— 10 Barnard Road 3 flats 17 Sumburgh Road 1 house 4 Total 204 Slum Clearance. Representations for slum clearance were made in respect of nine areas, 58 premises being represented out of 144 inspected. The nine areas concerned are situated in the Battersea High Street area and the Winstanley Road area. Following a Public Inquiry concerning one area represented in 1955, the Order was subsequently confirmed. 38 One Inspector is engaged with the initial inspections and the submission of detailed reports. Further inspections are made by the Medical Officer of Health and the Chief Public Health Inspector, and the selected premises are then represented. Determination as to unfitness for human habitation is governed by Section 9 of the Housing Repairs and Rents Act, 1954, in individual cases, and by this Section and Section 25 of the Housing Act, 1936, as respects an area to be represented. A considerable amount of specialised work devolves on the clerical side of the Department. Closing Orders. Five Closing Orders under Section 12 of the Housing Act, 1936, were made during the year, in respect of basement rooms, and six Closing Orders in respect of dwelling houses under Section 11 of the Act as amended by Section 10 of the Local Government (Miscellaneous Provisions) Act, 1953. Demolition Orders. A Demolition Order was recommended in one case, the house forming part of a clearance area. The majority of individual unlit houses are dealt with by Closing Orders. Housing Repairs and Rents Act, 1954. Certificates of Disrepair. Applications for Certificates of Disrepair continue, though to a lesser degree, and the following table shows the comparison between the previous year's and this year's applications:— 1956 1955 Applications for Certificates of Disrepair received 33 258 Applications for Certificates of Disrepair withdrawn 5 11 Certificates of Disrepair issued 28 251 Certificates of Disrepair refused 1 17 Applications for revocation of Certificates received 47 297 Revocations of Certificates issued 49 253 Revocations of Certificates refused 3 39 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 number of persons occupying the house, and to require adequate facilities for those persons in occupation. One case was referred to the Housing Committee for authority to serve a notice under Section 11. 39 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). During 1956 a total of 362 cases were dealt with on the grounds of ill-health or unsuitable accommodation. The maximum number of Points on medical grounds other than pulmonary tuberculosis were allocated to 1 application, and it was referred to the Housing Committee for special consideration on these grounds. In 12 cases the maximum Points were given for pulmonary tuberculosis, 3 of these being referred to the Housing Committee for special consideration as the accommodation was inadequate. In 5 cases of transfer applications, rehousing was recommended as essential on medical grounds. The London County Council refer cases in which there appear to be overcrowding, for the submission, in appropriate cases, of a special form. Overcrowding was found to exist in one instance. The London County Council also notify cases in which the application alleges sanitary defects. The houses are inspected, and action to secure the remedy of any defects found is taken. 40 Factories. Outworkers and Shops, Factories Act, 1937. Metropolitan Borough Councils are responsible for the enforcement of 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. 1.—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 130 695 7 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 358 1,905 31 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 18 41 - - TOTAL 506 2,641 38 - 41 2.—CASES in which DEFECTS were found. Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l.) 32 32 — — — 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 5 5 — — — (c) Not separate for sexes ... — — — — — Other offences against the Act (not including offences relating to Out-work) — — — — — TOTAL 38 38 — — — The following table shows the factories in the Borough, classified Wording 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 27 26 22 22 Clothing and Allied 44 41 17 16 Engineering and Heavy Industry 49 46 2 2 Electrical and Allied 13 13 1 1 Florist - - 2 2 Food and Allied 47 43 4 4 Furniture and Allied 15 15 4 5 Metal Worker 10 9 - - Printer and Allied 26 28 2 2 Road Vehicle Repairer 42 43 19 19 Steam Laundry 10 10 - - Transport (Road & Rail) 19 19 - - Others 57 56 48 48 Total 359 349 121 121 42 Barbers and Hairdressers. The London County Council (General Powers) Act, 1954, Section 18, gave the Council authority as from the appointed day to register barbers or hairdressers and their premises, and no person should carry on such a business unless both he and the premises are registered. Model By-laws were adopted and the appointed day fixed as the 1st January, 1956. A register was compiled of all such establishments in the Borough, and inspections carried out. Any person registered under this Section must keep displayed in the premises in respect of which he is registered a copy of his certificate of registration and of any by-laws made by the Council. At the end of the year there were 72 registered premises in the Borough, and 220 inspections were carried out. Pet Animals Act, 1951. 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 13 shops and 32 visits were made during the year. One application for a licence was refused. Rag Flock and Other Filling Materials Act, 1951. The principal provisions of the Act related to registration 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 Public Health 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 applied. 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. Eighteen 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. Heating Appliances (Fireguards) Act, 1952 Regulations under the above Act prescribe 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. 43 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. Occasional cases of second-hand appliances of an old type being offered for sale may occur, however, and a constant watch is kept for such appliances. Bakehouses. There were 27 bakehouses on the register at the end of the year, two having been closed during the year. All of these are classed as factories, and 24 of them use mechanical power. 122 inspections were made and 5 notices served. Five of the bakehouses were "basement bakehouses" within the leaning 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 1937. Some of these lists included outworkers not residing in Battersea, and these were forwarded to the appropriate authorities. The total number of registered outworkers' premises in the Borough at the end of the year was 365 (including 5 contractors), 65 premises having been added, and 111 removed, during the year. The total number of inspections made was 508, most of them by the female Inspector. The premises were found to be generally satisfactory, and was not necessary to serve any notices or take any other action. Five cases of infectious diseases occurred at outworkers' premises and the usual precautions to prevent spread of infection were taken The following table gives details of the outworkers' premises:— Trade Number on Register Premises Workrooms Persons employed Wearing Apparel 252 256 282 Linen 1 1 1 Artificial flowers 1 1 1 Paper Bages 14 14 14 Boxes etc. 4 4 4 Stuffed Toys 5 5 5 Lampshades 56 56 56 Christmas Stockings, etc. 2 2 2 Toys, etc. 28 28 28 Brasswork 1 1 1 Curtains 1 1 1 365 369 395 44 FACTORIES, OUTWORKERS AND SHOPS. Summary of Operations. Inspections— Shops 330 Shops (Pharmacy Act) 11 Rag flock premises 18 Pet shops 32 Hairdressers 220 Outworkers 508 Factories 2,019 Inspections—cont'd. Workplaces 154 Smoke observations 295 Complaints dealt with 162 Intimation notices served 38 Statutory notices served 28 Summonses issued Nil. 45 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 Society of Health, Blackpool — 24th to 27th April. Sanitary Inspectors' Association, Bournemouth — 18th to 21st September. National Smoke Abatement Society, Southport — 3rd to 5th October. Delegates. Ald. Miss E. A. Coles, J.P., and the Medical Officer of Health. Cllr. Miss E. A. Coles, J.P., and Mr. G. W. P. Weeks, Chief Public Health Inspector. Cllr. C. E. Lang and Mr. I. R. Lewis, Public Health Inspector. 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 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. Seven clear days' notice of the intention of making an application 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 Council, extend it for such further periods, not exceeding three months each, as are concidered 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 practi- tioner, make and 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 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. One such Order was obtained during the year, relating to an elderly male, who was living in insanitary and dangerous circumstances, and was not receiving proper care and attention. Every effort was made to help him, but he refused all assistance. 46 Care of the Aged. The work and problems as outlined in previous Reports remain, and during the year there have been no outstanding developments. One of our Public Health Inspectors devotes a considerable part of her time to the care of old people, and at the end of the year had 219 old people on her Register whom she visited and kept in touch with. Close liaison is maintained with other organisations and agencies concerned with the care of old people, particularly the London County Council local Health Department, the Home Help Organisation and the Battersea Old People's Welfare Committee. As I stated previously, was fortunately only necessary to take compulsory action for the removal to hospital in the case of one old person. Use of Slipper Baths by Old Age Pensioners. The Council make available to old age 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 also been extended to blind persons. During the year 1956 this arrangement was taken advantage at the respective Baths Establishments as follows:— Males Females Latchmere 2,759 3.717 Nine Elms 1,135 316 Plough Road 1,291 1,813 Total 5,185 5,846 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, 9 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 an collect all available information regarding any estate left by the deceased. 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 9 cases was £119 approximately, and of this amount approximately £75 was recovered by the end of the year. 47 Personal Cleansing Station. There are facilities for treatment of scabies and verminous conditions at the Personal Cleansing Station, Sheepcote Lane. During the year 367 treatments were given to persons suffering from or contacts of scabies—143 to adults, 173 to school children, and 51 to children under school age. In addition to the above, 119 adults and 1,293 children found to be verminous were cleansed. Of the 1,293 children, 1,255 attended from local schools by arrangement with the London County Council, Who have entered into a contract with the Council for the use of the Personal Cleansing 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 clothing and, if necessary, of the homes is carried out by the Borough Council's staff. The following table shows the number of treatments at the Personal Cleansing Station and the expenditure incurred since 1950:— Year Adults Children *Expenditure *Amount Contributed Verminous and Scabies Verminous and Scabies £ £ 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 1954 214 2,383 1,966 512 1955 246 2,318 2,371 526 1956 262 1,517 2,681 547 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 annum. Arrangements have been made with the Wandsworth Borough Council, and the Lambeth Borough Council, for certain of the residents in those Boroughs, who require treatment or cleansing, to attend at the Battersea Personal Cleansing Station, the cost of this service being borne by the respective Boroughs in the which the patients are resident. During the year, 91 treatments were given to Wandworth residents and 82 treatments to Lambeth residents. 48 Methods of Treatment:— Scabies: Persons attending for treatment are given a hot bath for twenty to thirty minutes, thoroughly dried, and Benzyl Benzoate applied to the whole of the body. This is repeated on alternate days, there being three treatments in all. Verminous heads: The hair is treated with a preparation containing cotton-seed oil, tar oil, paraffin oil and oil of lemon grass, and then washed with a shampoo of soft soap and borax. It is then dried thoroughly, combed with a Sacker's comb to remove nits, washed, dried and combed again. The operation takes approximately half an hour for each child, and a final check is made by the Sister in attendance. The Council have two flats attached to the Personal Cleansing Station for the temporary use in emergency of people or a family displaced, usually following fumigating procedure. The Council have agreed that these shelters may be used for Wandsworth residents at an annual fee of £25 for the right to use the shelters and a weekly charge of £1 10s. 0d. per shelter for every case sent there. Disinfection and Disinfestation. The disinfection plant at the Council's Disinfecting Station, Sheep' cote Lane, comprises two large steam disinfectors, and disinfection is carried out at 12 lbs. pressure and a temperature of 239° F. An instrument charts the pressure and temperature during the process and these records are kept. Methods of Disinfection : Following the notification of a case of infectious disease requiring disinfection, an inspection is made and the following methods used. The patient's room is sprayed with a formaldehyde solution. The doors and windows are closed and the room can be used again after five or six hours. Bedding and clothing are collected and steam treated at the StationSheets, pillow cases and hand towels are exposed to formalin vapour in a special chamber prior to being washed in the adjoining laundry. Books and other articles which cannot be steam disinfected are also treated by exposure to a formalin vapour. Disinfestation of Verminous Rooms : Articles in the room requiring treatment are removed for steam disinfestation. The room is sprayed with an insecticide containing Pybuthrin and Lindane/D.D.T., which gives a prolonged residual effect. In the case of a heavy infestation. architraves and mouldings are required to be eased for deeper penetration of the insecticide. Control of Insect Pests: The construction by the Council of large blocks of flats containing covered ducts taking hot water, plumbing and drainage pipes has raised a problem of insect infestation. These ducts form an ideal harbourage for insects which would be difficult to deal with by normal hand spraying. A Microsol Mist Generator has been purchased by the Council, and this fitting, having a small motor unit, is capable of spraying a fine mist or fog of insecticide to a distance of 50 feet, the mist settling out on to the surfaces of the duct and the piping contained therein. This fitting is in use and is proving very successful. 49 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 1956, are set out in following table:— Battersea Mortuary, 1956. Details of Bodies Received Usual Place of Residence Total Battersea Wandsworth Elsewhere Residence unknown Post-mortem only 163 387 192 38 780 Post-mortem and inquest 25 86 32 2 145 Total post-mortems 188 473 224 40 925 Inquest only — — — — — Total inquests 25 86 32 2 145 Sanitary and other reasons — 4 — — 4 Total bodies received 188 477 224 40 929 Verdicts at Inquests held - Natural causes 1 6 2 1 10 Accident and misadventure 12 36 21 — 69 Open verdict — 7 3 — 10 Suicide 11 34 4 1 50 Homicide — 1 1 — 2 Alcoholism — 1 — — 1 Industrial disease — 1 1 — 2 Self-induced abortion 1 — — — 1 TOTAL 25 86 32 2 145 In addition to the above, thirty-five inquests, including an inquest on thirteen fatalities resulting from the Barnes railway accident occurring in December, 1955, were held at the Coroner's Court. No bodies were received into the Mortuary for these inquests. The Wandsworth Borough Council made a grant of £475 towards the cost of maintaining the Mortuary. The London County Council pay a rent of £450 for the use of the Coroner's Court. 50 INDEX. Page No. Adulterated Samples 31, 32, 33, 34, 35 Aged and Infirm Persons 45 Atmospheric Pollution 23 Bacteriological Examinations 19, 35 Bakehouses 43 Barbers and Hairdressers 42 Baths—Personal Cleansing Station 47 „ —Public Swimming 26 „ , Slipper—Use by Old Age Pensioners 46 Births 9 Burials 46 Butchers' Shops 30 Cancer 19 Catering Establishments 30 Certificates of Disrepair 38 Clean Air Act, 1956 23 Closing Orders 38 Combined Drainage 22 Committee—Health 2 Comparative Statistics 14 Conferences 45 Coroner's Court and Mortuary 49 Dairies 29 Dangerous Structures 26 Deaths 10 „ , Infant 13 „ , Maternal 14 „ , from Tuberculosis 16 Deceased Persons—Burial of 46 Demolition Orders 38 Diphtheria Immunisation 15 Diseases—Infectious and Other 15 Disinfecting Station 48 Disinfection 48 Disinfestation 48 Drainage, Combined 22 „ Work 22 Drugs—Sampling 34 Dustbins 21 Examinations—Bacteriological 19, 35 Exemption Certificates—Shops Act, 1950 26 „ „ —Food Hygiene Regulations, 1955 27 Factories Act, 1937 40 „ „ , Outworkers and Shops 40 „ , „ „ „ —Summary of Operations 44 Festival Pleasure Gardens, Battersea Park 30 Fish Shops 30 Food—Bacteriological Examination 19,35 Food and Drugs Act, 1955 27 „ —Festival Pleasure Gardens, Battersea Park 30 „ Foreign Matter in 36 „ Hygiene Regulations, 1955 27 51 Page No. Food Poisoning 36 „ Premises 31 „ „ —Inspections 27 „ „ —Summary of Operations 31 „ Protection—Talks 31 „ Sampling 33 „ Stalls 30 „ Supply—Protection of 27 „ , Unsound 36 Hairdressers and Barbers 42 Health Committee 2 Heat Treated Milk 35 Heating Appliances (Fireguards) Act, 1952 42 Houses Let in Lodgings 38 Housing 37 „ Accommodation Applications 39 „ —New Accommodation 37 Ice Cream Premises 29 „ „ Sampling 35 Illegitimate Infants—Deaths of 14 Immunisation—Diphtheria and Whooping Cough 15 Infant Mortality13 Infectious and Other Diseases 15 Inquests 49 Inspections 20 „ —Dwelling Houses 38 „ —Factories, Outworkers and Shops 40 „ —Food Premises 27 International Certificates of Vaccination and Inoculation 19 Legal Proceedings 21 London County Council (General Powers) Act, 1955 22 Marriages 10 Maternal Mortalit 14 Milk Distributors and Dairies 29 „ , Heat Treated 35 " Samples 32, 33, 34 „ „ , Adulterated 32 „ (Special Designations) Regulations 29 „ Supplied in Schools and Hospitals—Sampling 35 Miscellaneous Matters 45 Mortality—Infant13 „ —Maternal 14 Mortuary and Coroner's Court 49 National Assistance Act, 1948 45 „ „ (Amendment) Act, 1951 45 New Housing Accommodation 37 Nuisances—Public Health (London) Act, 1936 21 „ Smoke 23 Offensive Trades 24 Old Age Pensioners—Use of Slipper Baths 46 Outworkers 43 Personal Cleansing Station 47 Pet Animals Act, 1951 42 Population 9 Post-mortems 49 52 Page No. Preserved Food Premises 30 Prevention of Damage by Pests Act, 1949 25 Principal Figures 8 Protection of Food Supply 27 Public Conveniences 22 „ Health (London) Act, 1936—Nuisances 21 „ Lavatory Accommodation 22 „ Swimming Baths 26 Rag and Bone Dealers 25 Rag Flock and Other Filling Materials Act, 1951 42 Rodent Control 25 Samples—Adulterated 31, 32, 33, 34, 35 „ —Drugs 34 „ —Food 31 „ —Heat Treated Milk 35 „ —Ice Cream 35 „ —Milk 32, 33 „ — „ , Heat Treated 35 „ — „ Supplied in Schools and Hospitals 35 Sanitary Circumstances 20 „ „ —Summary of Main Operations 20 Shops Act, 1950 26 „ , Butchers' 30 „ , Fish 30 „ , Ice Cream 29 „ , Milk, and Dairies 29 „ , Pet 42 Slipper Baths—Use by Old Age Pensioners 46 Slum Clearance 37 Smallpox Vaccination 15 Smoke Measuring Station 23 „ Nuisances 23 Staff 2 Stalls, Food 30 Static Water Tanks 26 Statistics—Comparative 14 „ —Vital 9 Still-births 9 Swimming Baths 26 Talks on Food Protection 31 Tuberculosis 16 „ Deaths 16 „ Notifications 18 Unsound Food 36 Urinals 22 Vacant Sites 26 Vaccination—Smallpox 15 „ —International Certificates 19 Van Dwellings 26 Verminous Premises 26 Vital Statistics 9 Water Supply 24 Wells 24 Whooping Cough Immunisation 15 H. J. Rowling & Sons Ltd. (T.U.), Battersea. S.W.11