Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea FOR THE YEAR 1958 by J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH. Metropolitan Borough of Battersea. REPORT on the HEALTH of the Metropolitan Borough of Battersea FOR THE YEAR 1958 by J. TUDOR LEWIS, M.D., D.P.H. MEDICAL, OFFICER OF HEALTH. Public Health Department, Electric House, 204 Lavender Hill, Battersea, S.W.11. Telephone Nos.: BATtersea 2201, 6627, 6628. 2 Health Committee. As constituted 20th May, 1957. Chairman: Councillor Miss E. A. Coles, j.p. The Worshipful the Mayor (Councillor E. W. Boys, j.p.) Councillor Mrs. E. A. Cooper, j.p. „ S. A. T. Cooper. „ Mrs. C. M. Davis. „ Dr. J. Fairlee. „ E. J. Getting. Alderman Mrs. H. N. Halsey. Councillor C. E. Lang. „ Mrs. E. Reynolds. „ T. J. A. Rose. Alderman Mrs. A. M. Smith. Councillor G. Whitehead. As constituted 19th May, 1958. Chairman: Councillor Miss E. A. Coles, j.p. The Worshipful the Mayor (Councillor C. E. Lang, j.p.) Councillor Mrs. L. Allen „ R. Bottomley „ Mrs. E. A. Cooper, j.p. „ S. A. T. Cooper „ Mrs. C. M. Davis „ E. J. Getting „ 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 D. M. O. Lowry, m.a., m.R.C.S. l.r..C,. p., d p h.,D.I.H. Chief Public Health Inspector and Principal Administrative Officer G. W. P. Weeks (b c e). Deputy Chief Public Health Inspector and Principal Administrative Officer R. J. McCarthy (a. c). Public Health Inspectors: District 1. W. E. Selway (b c). 2. Vacant. 3. A. Webb (b c). 4. A. W. E. Porter (b c). 5. G. Jones (f) (appointed October) 6. K. J. McCarthy (a c). 7. L. Burrows (b c).(resigned April) 8. Vacant. 9. P. Ianson (b c). 10. J. J. k. Helmer (b c). (,resigned July). 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). Administrative and Clerical Staff: P. Brocking. A. C. Cooles. (Miss) O. L. Goldsmith. R. Greaves. P. W. Gunnell (temporary) . (appointed November). E. B. Moreton. (Miss) E. Town. S. J. P. Whitbread. Rodent Officer F. G. Daniels Student Public Health Inspector D. E. Bull (appointed April) Smoke Control Area—Assistant W. C. Terry Disinfecting Station—Superintendent J. Mandry Mortuary—Superintendent W. F. Haines (Superannuated May) W. Trendell (appointed May) Public Analyst J. E. Woodhead, b.sc., f.r.i.C., PH.C. Deputy Public Analyst D. G. Forbes, b.sc., F.R.I.C. (a) Sanitary Inspectors' certificate of the Sanitary Inspectors' Examination Board. (b) Sanitary Inspectors' certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board (c) Meat and Other Foods certificate, Royal Sanitary Institute, or Sanitary Inspectors' Examination Board. (d) Health Visitors' certificate, Board of Education. (e) Smoke Inspectors' Certificate of the Royal Sanitary Institute. (/) Public Health Inspectors' Certificate of the Public Health Inspectors' Examination Board. 3 INDEX TO SECTIONS. PAGE Preface 4 Health Committee 2 Staff of the Public Health Department 2 Principal Figures for 1958 8 Vital Statistics 9 Infectious and Other Diseases 15 Sanitary Circumstances 20 Atmospheric Pollution 25 Protection of Food Supply:— (а) Inspection of Food Premises 28 (b) Sampling of Food and Drugs 31 factories, Outworkers and Shops 37 Housing 42 Miscellaneous Matters 44 4 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Mr. Mayor, Ladies and Gentlemen, I beg to present to you the Annual Report on the Health of the Borough of Battersea for the year 1958. The population of Battersea, which has been slowly decreasing. showed a further drop in 1958, the mid-year estimate being 110,400 compared with 111,800 in 1957. There were 1,917 births, including 39 still births, to Battersea residents, which gives a live birth rate (corrected) of 16.16, compared with 15.44 the previous year. The death rate (corrected) was slightly lower at 11.07 per thousand, compared with 11.10. The corrected rates are arrived at after applying the area comparability factor supplied by the Registrar-General. Only 1 mother died as a result of pregnancy and childbirth, compared with 3 in the previous year, and this gave a maternal mortality rate of 0.52 per thousand births. The infant mortality rate was 23.96, a slight increase over 1957. This rate was based on a total of 45 deaths in infants under 1 year, and of these 35 or 77.8 per cent, occurred in the first four weeks of life. I have on previous occasions referred to the difficulty of reducing still further the infant mortality rate, particularly in infants in the first month of life. This neo-natal rate has so far not responded to the measures that have brought about a reduction in the general infant mortality rate. There was a reduction in the number of cases of infectious disease, owing in the main to a fall in the incidence of measles, for in 1958 there were only 614 cases of measles compared with 1,402 in the previous year. There was also a slight reduction in the number of cases of whooping cough notified. No case of diphtheria occurred during the year, nor was there a case of poliomyelitis. In 1957, 11 cases of poliomyelitis were notified, of which 9 were confirmed, and in 1956, there were 23 confirmed cases. Dysentery of the Sonne type continued to be a nuisance, and the was an increase from 32 cases in 1957 to 195 in 1958, the majority occurring in the summer or early autumn. Most of these cases were associated with an outbreak in one particular school. As regards infectious disease there is little of further note to report except to mention that in the latter months of 1957 and the early part of 1958 Battersea was affected by the outbreak of "Asian" influenza. It is not possible to say how many cases occurred, but undoubtedly the illness was widespread, although fortunately of a mild type. Many children schools were affected as well as the adult population, and the disease petered out in the early months of the year. I referred in my Annual Report for 1956 to the increasing toll that some diseases such as high blood pressure and diseases of the heart blood vessels (coronary arterial disease) is taking, particularly in males in what is probably the most productive period of life. In 1958, there were 171 deaths from coronary arterial disease and angina, compared with 168 in 1957. This, however, does not give the full picture, because of the 171 deaths in 1958 from this cause 106 were in men. In the age groups 25-45 and 45-65, the contrast between the sexes is even more marked. For instance, in the age group 25-45, 5 males died compared with 2 females, but in the age group 45-65, 40 males died compared with only 3 females. The trend of increasing deaths with a particularly heavy incidence in males in the age groups 25-65 continues. It will be asked 5 What, if anything, can be done to prevent this wastage of the manpower of the Nation, for the experience in Battersea is paralleled by the experience of the Country in general. More particularly it may be asked what can Public Health Departments, whose duty it is to safeguard the health of the community, do. Unfortunately, the answer must be that at the present time there seems to be comparatively little that we can do. As I pointed out in my earlier Report, there may well be social and environmental conditions at present not known which account for the high prevalence of deaths from this disease in these age groups. A great deal of research in many countries of the world is being carried out, but the problem is one of considerable magnitude and complexity, The effect, or possible effect, of such factors as diet, exercise and occupation, have been carefully looked into, without so far any final opinions being arrived at. Bio-chemical investigations have suggested that one factor may be a disordered state of the fatty constituents of the blood and other tissues, arising possibly from dietary causes. When large amounts of fatty foods, particularly animal fats, are taken over many years, it is suggested that this disease may arise, although clear Proof is lacking. The effect of exercise and of the type of work in relation to exercise has been looked into, and there is some reason to think that people working in active routine occupations may be less likely to become victims than those engaged in more sedentary occupations. However, these researches, at the moment, do little more than provide pointers to the more definite answers which undoubtedly will emerge in due course. In the meantime, what can be done in the light of existing knowledge to prevent this form of heart disease? No categorical answer can be given to this question, but observance of what are usually recognised as the rules of health may at least do something to avert this illness, and certainly can do no harm. Regular habits, steady work within the individual's capacity, reasonable outdoor exercise in relation to age and fitness, temperance in eating, particularly of fatty foods,and drinking, are all facets of the kind of life which most ordinary sensible people would in any case follow. Nevertheless, it is the case that people who conform to these rules may become victims of the disease, whereas others who prefer to ignore them, and live a more unrestricted king of life, may be affected; which merely serves to emphasise that there is great deal yet to be learnt about diseases of the coronary The number of notifications of tuberculosis in 1958 was 75, pared with 100 in 1957. 67 other cases came to our notice otherwise than by notification. As is well known, there has been, in the last decade a considerable improvement in the outlook for tuberculosis. In some ways the number of deaths from this disease gives a better indication of the Progress that has been made in controlling it than the notifications, and the figures are striking. For instance, in 1958 there were 17 deaths from pulmonary tuberculosis, compared with 44 deaths in 1950. A better idea of what is happening in the field of chest diseases generally can be obtained by comparing the deaths from pulmonary tuberculosis with other chest diseases, particularly lung cancer and bronchitis. In 1958, there were 69 deaths from lung cancer in Battersea, compared with 36 in 1950.In regard to bronchitis, in 1958 there were 87 deaths compared with 80 in 1950. In other words, while there has been a marked reduction in the number of deaths from tuberculosis in the 8 years from 1950, there has been an equally marked increase in the number of deaths from lung cancer, whereas the number of deaths from bronchitis has 6 virtually remained unchanged. Clearly while tuberculosis still remains a problem, it has proportionately become less so, while lung cancer as a threat to public health has become more serious. In spite of the advances that have been made in the diagnosis and treatment of tuberculosis, there are no grounds for undue satisfaction, and it is unlikely that we shall see the end of this disease in the near or medium-term future, although it is not too much to hope that if the present trend continues this happy state will be achieved in the life-time of many people living today. As to lung cancer and chronic bronchitis, the immediate outlook is not hopeful. Associated as they are in differing degree with heavy cigarette smoking and atmospheric pollution, social and environmental factors not capable of quick and easy change, it is to be expected that in the years immediately ahead, there will be more deaths from these diseases. No doubt, if and when heavy cigarette smoking becomes less ingrained as a social habit, there will be fewer cases of lung cancer. In the same way, as clean air campaigns in large cities get under way, the bronchitis outlook will be improved. The greatest hope in the immediate future lies in early diagnosis of lung cancer cases and more research into the physiological causes and means of prevention and treatment of chronic bronchitis. In connection with this all-important subject of atmospheric pollution, it is pleasing to report that the Council's first smoke control area declared during the year has now been confirmed by the Minister, and will come into operation in October, 1959. Work is in progress in approving the adaptations to fireplaces in the area, and preliminary work will shortly commence on the next area to be declared a smoke control area. Plans also are now being drawn up for a period of about 8 years, which it is felt is as far ahead as can be usefully foreseen. It is hoped and expected that conversion of Battersea into a complete smoke control area will proceed with energy. The routine work of the Public Health Inspectors has continued. handicapped, as I have pointed out in previous years, by the shortage of staff. Nevertheless, headway has been made in implementing the Food Hygiene Regulations, and in general it can now be said that the Rcgulations are being reasonably complied with. Housing work continued in 1958, particularly the representation individual unfit houses, and in 1958 work under the Rent Act, 1957, also continued. Apart from the inspection of property by the Public Health Inspectors, this Act involves a large volume of office and administrative routine, to ensure that the various procedures under the Act are being complied with. During 1958, the Council decided that the Health Committee should be charged with the responsibility for considering matters relating to home accidents, and a number of reports to the Committee on this subject have been made. For the first time this year, I have devoted a small section of the Report to accidents in the home. It is not Possible to obtain absolutely accurate figures, but from data obtained from the London Ambulance Service, it has been possible to calculate for 1956, 1957 and 1958 some figures which I think are reasonably accurate and it is hoped to continue this over the years, so that we shall have a record of home accidents in our population. The measures most likely to reduce these accidents are educative, through the medium of our Public Health Inspectors, Health Visitors and other workers. 7 During the year, all my colleagues in the Public Health Department have worked well, energetically supported, as usual, by the Chairman of the Health Committee, Miss E. A. Coles, J.P., to whom I once again extend my thanks for her help and guidance. I should like also to thank all the staff of the Health Department, particularly Mr. Weeks, the Chief Public Health Inspector, and Dr. Lowry, for their help and assistance during the year. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, J. TUDOR LEWIS, Medical Officer of Health. August, 1959. Public Health in Retrospect 1858-1958. Last year I gave an extract from a report made by one of my Predecessors one hundred years ago. This year I continue the record with extracts from a report made by Dr. Connor, Medical Officer of Health for the Battersea Parish, in 1858. "I regret to state the health of the sub-district compared with that of the previous year is not so favourable. "The amount of sickness that prevailed is less, but the rate of mortality greater; which last is attributable to a very severe and fatal epidemics of scarlet fever, that prevailed in the last two quarters, and which has been much increased by the unhealthy practice of pig-keeping -a very general custom in the parish, and to which I took occasion to direct the attention of your Board in November last. "It is remarkable, but nothing more than could have been expected, that the mortality fell with great violence on pig-keeping districtsparticularly on localities where it is most general and most crowded." "This excess, (the number of deaths of children under 10 years over the number at all other ages from disease) it will be seen, is not peculiar to this sub-district, but appears to be everywhere the result of a crowded industrial population, engaged principally in factory and field labour. "The employment of women in these occupations, the majority of whom are there, is an evil for which the present condition of society, it is believed, is quite incompetent to supply an effectual remedy." ". . . the opinion entertained by your Health Officers, viz.: that as the end and aim of all the sanitation with the execution of which local authorities have been recently charged by the legislature, is to eradicate diseases, or to deprive them of their fatality; to strengthen the healthy and to assist the suffering, so must it be their unceasing endeavour to carry their greatest reforms into and about the dwellingplaces of the indigent; for nothing can be less open to dispute than that, in proportion as sickness and its consequences can be diminished amongst the poor of this great nation, will prosperity accrue to it, the best interests of the community at large be promoted, civilization advanced, and the fullest harmony of corporeal existence amongst all classes secured." 8 Principal Figures for 1958. Area of Borough, excluding tidal water (acres) 2,163 Home population (1951 Census) 117,140 Home population (Registrar-General's Mid-Year Estimate) 110,400 Structurally separate occupied dwellings 29,649 Births (live, 1,878; still, 39) 1,917 Live Birth rate 16.16 Deaths—1,247. Death rate 11.07 Maternal Deaths—1. Maternal death rate 0.52 Infant Deaths—45. Infant mortality rate 23.96 9 Vital Statistics. For the purpose of standardisation, the Registrar-General's area comparability factors which make allowance for the way in which the sex and age distribution of the local population differs from that of England and Wales as a whole, have been applied to the rates for births and deaths. The factor for births is 0.95, and for deaths 0.98. POPULATION. The Registrar-General's estimate of the mid-year home population of Battersea was 110,400 as compared with 111,800 in 1957, a decrease of 1,400. The estimated population at the Census taken in April, 1951, as 117,140; the 1958 figure of 110,400, when compared with this, shows a decrease of 6,740 (or 5.8 per cent.). The estimated mid-year home population figure of 110.400 has been adopted for the purpose of the statistics contained in this Report. BIRTHS. The number of live births registered in the Borough during 1958 was 499 (260 males, 239 females). Of this number 14 were transferred out, the permanent residence of the parents being outside the Borough, and 1,393 registered outside the Borough were transferred in, giving on balance a total of 1,878 births (944 males, 934 females, an excess of 10 males) relating to Battersea residents, and a live birth rate of 16.16 per 1,000 population. Of the Battersea births (485 live and 6 still) which occurred within the Borough, 473 were "domiciliary births." Illegitimate live births numbered 174 or 10.2 per cent. of the live births. The live birth rate for England and Wales was 16.4. Still-Births. The Registration of still-births is made compulsory by the Births and Deaths Registration Act, 1926. During 1958 there were 9 still-births registered in Battersea, of which 6 were Battersea parents. Thirty-three still-births occurring outside the Borough were registered as belonging to Battersea, making 39 in all, representing a still-birth rate of 20.34 per 1,000 births (live and still) registered. Of the 39 still-births 7 (17.9 per cent.) were registered as illegitimate. The number of Battersea still-births registered and the still-birth rates from 1943 to 1958 were as under:— No. Rate No. Rate 1943 36 21.6 1952 42 23.2 1944 40 24.0 Mean 1945 38 23.3 1943-52 47 22.9 1946 59 22.7 1953 38 20.9 1947 74 27.0 1954 50 28.0 1948 46 20.1 1955 32 18.1 1949 43 20.8 1956 48 26.42 1950 53 27.2 1957 51 27.01 1951 37 19.2 1958 39 20.34 The still-birth rate in 1958 for England and Wales was 21.6. 10 MARRIAGES. The marriages registered in Battersea during 1958 numbered 876. The marriage rate (i.e., the number of persons married per 1,000 of the population) was 15.7. Year Marriages Marriage Rate 1953 876 15.3 1954 912 16.0 1955 971 17.1 1956 896 15.9 1957 966 17.3 Mean 1953/57 924 16.3 1958 876 15.7 The marriage rate for England and Wales was 15.1. DEATHS. The number of deaths registered in the Borough during 1958 was 2,064. Of these 1,191 were deaths of non-residents and were transferred to the districts in which the persons ordinarily resided. There were, on the other hand, 374 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths belonging to the Borough was 1,247 (623 males and 624 females). This gives a recorded death rate of 11.07 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 1958:— Under 1 year 1— 5— 15— 25— 45— 65— 75+ Total M. 21 2 — 4 36 194 163 203 623 F. 24 — 1 4 22 84 140 349 624 Totals 45 2 1 8 58 278 303 552 1,247 % of total 3.6 0.2 0.1 0.6 4.6 22.3 24.3 44.3 100.0 Of the 1,247 Battersea deaths 792 (or 63.5 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 1957 67.2 1958 68.3 11 The deaths of 855 residents of Battersea aged 65 years and upwards were registered during 1958. These 855 deaths constituted 68.6 per cent. of the total deaths at all ages. The natural increase of population (that is, excess of births over deaths) was 631 in 1958 as compared with 619 in 1957. The causes of the 1,247 deaths in 1958 classified in various age groups, are shown in the following table. Causes of Death at Different Periods of Life in Battersea during 1958. 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. 623 21 2 — 4 36 194 163 203 F. 624 24 — 1 4 22 84 140 349 1. Tuberculosis, respiratory M. 13 — — — — 2 7 4 — F. 4 — — — — 2 2 — — 2. Tuberculosis, other forms M. 1 — — — — 1 — — F. 2 — — — — — — — 2 3. Syphilitic disease M. 1 — — — — — — 1 — F. 1 — — — — — 1 — — 4. Diphtheria M. — — — — — — — — — F. — — — — — — — — — 5. Whooping cough M. — — — — — — — — — F. — — — — — — — — — 6. Meningococcal infections M. — — — — — — — — — F. — — — — — — — — — 7. Ac. poliomyelitis and polioencephalitis M. — — — — — — — — — F — — — — — — — — — 8. Measles M. — — — — — — — — — F. — — — — — — — — — 9. Other infective and parasitic diseases M. 2 — — — — — 1 — 1 F. — — — — — — — — 10. Cancer of stomach M. 18 — — — — 2 3 6 7 F. 14 — — — — — 4 5 5 11 Cancer of lung, bronchus M. 56 — — — — 2 34 14 6 F. 13 — — — — — 6 5 2 12. Cancer of breast M. 1 — — — — — — — 1 F. 15 — — — — i 4 3 5 13 Cancer of uterus M. — — — — — — — — — F. 5 — — — — 1 — 2 2 14. Cancer of other sites M 67 — — — — 5 27 19 16 F. 52 — — — — 2 17 14 19 15. Leukaemia, aleukaemia M. 2 — — — — 1 — 1 — F. 4 — — — 1 — — 1 2 12 Causes of Death, 1958—(contd.). Causes of Death Sex All Ages 0— 1— 5— 15— 25— 45— 65— 75- 16. Diabetes m. 3 – – – – – – 1 2 f. 3 – – – – 1 – 2 — 17. Vascular lesions of nervous system m. 65 – – – – 1 17 17 30 f. 108 – – – – 2 11 28 67 18. Coronary disease, angina m. 106 – – – – 5 40 30 31 f. 65 – – – – 2 3 21 39 19. Hypertension with heart disease m. 6 – – – – – 1 2 3 f. 20 – – – – – – 9 11 20. Other heart disease m. 59 – – – – 3 10 11 35 f. 123 – – – – 4 9 13 97 21. Other circulatory disease m. 26 – – – 1 1 6 12 6 f. 42 – – – – – 4 7 31 22. Influenza m. – – – – – – – – – f. 3 – – – – – – 1 2 23. Pneumonia m. 45 1 – – – 5 8 14 17 f. 29 2 – – – – 1 4 22 24. Bronchitis m. 58 – – – – 1 17 17 23 f. 29 – – – – 1 4 7 17 25. Other diseases of respiratory system m. 10 – – – – – 3 3 4 f. 5 – – – – – 3 1 1 26. Ulcer of stomach and duodenum m. 7 – – – – – 1 4 2 F. 2 – – – – – 1 1 – 27. Gastritis, enteritis and diarrhoea m. 1 – – – – – 1 – – f. 7 1 – – – 1 1 2 2 28. Nephritis and nephrosis m. 4 – –_ – –_ 1 2 –_ 1 f. 3 – – – – – – – 3 29. Hyperplasia of prostate m. 3 – – – – – 1 2 f. – – – – – – – – – 30. Pregnancy, childbirth, abortion m. – – – – – – – – – f. 1 – – – 1 – – – – 31. Congenital malformations m. 5 2 1 – – – 2 – – f. 8 7 – – – – 1 – – 32. Other defined and ill-defined diseases m. 40 18 – – – 2 6 5 9 f. 46 14 1 – 1 3 6 9 12 33. Motor vehicle accidents m. 5 – – – 3 1 1 – – f. 3 – – – – – 1 1 1 34. All other accidents m. 11 – 1 – – 2 2 1 5 f. 12 – – – – – 3 3 6 35. Suicide m. 8 – – – – 1 5 – 2 f. 5 – – – 1 – 2 1 1 36. Homicide and operations of war m. – – – – – – – – – f. – – – – – – – – – 13 Infant Mortality. . During 1958 the deaths of 45 infants under 1 year of age were Registered as belonging to Battersea. The total number of live births registered during the year was 1,878 giving an infant mortality rate 23.96 per 1,000 live births as compared with 22.33 in 1957 and 23.74 in 1956. The infant mortality rate in England and Wales during 1958 Was 22.6. The following table sets out the causes of death in detail. Infant Mortality, 1958. 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 Percentage of Total 1-2 2-3 3-4 1-3 3-6 6-9 9-12 m. F. m. F. m. f. m. f. m. f. m. F. m. F. m. F. m. F. m. F. m. F. Pneumonia – – – – – – – – – – – – 1 1 – 1 – – – – 1 2 6.7 bronchitis – – – – – – – – – – – – – – – – – – – – – – – Gastritis, enteritis and diarrhoea – – – – – – – – – – – – – 1 – – – – – – – 1 2.2 Congenital malformations 1 1 _ 1 – 2 – 1 – 1 1 6 1 – – – – – 1 2 7 20.0 Other defined and ill-defined diseases:- Prematurity 6 7 2 1 – – – – 1 – 9 8 1 1 – – – – – – 10 9 42.2 Other causes 6 3 2 – – – – – – – 8 3 – 1 – – – – – 1 8 5 28.9 TOTAL 13 11 4 2 – 2 – 1 1 1 18 17 3 4 – 1 – – – 2 21 24 100.0 24 6 2 1 2 35 7 1 – 2 45 Percentage of total 53.4 13.4 4.4 2.2 4.4 77.8 15.6 2.2 – 4.4 100.0 M.46.7 F. 53.3 There were 35 deaths of infants during the first four weeks of life (or 77.8 per cent. of the total infant deaths) as compared with 34 deaths (or 83.0 per cent.) in 1957 and a percentage for the quinquennium 1953-1957 of 73.3. 14 Table showing Deaths of Infants under 1 day, under 1 week and under 4 weeks from 1953 to 1958. 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 1953 7 8 3 18 54.5 1954 15 6 4 25 75.8 1955 13 15 2 30 69.8 1956 14 17 4 35 83.2 1957 23 6 5 34 83.0 Mean 14 10 4 28 73.3 1958 24 6 5 35 77.8 Deaths of Illegitimate Infants. The death rate amongst illegitimate children during 1958 was 34.48 per 1,000 illegitimate live birth, as compared with 46.36 in 1957. The corresponding death rate of legitimate children in 1958 was 22.89, the ratio of mortality rate of illegitimate infants to that of legitimate being 151 to 100. The corresponding figure for 1957 was 230 to 100. Maternal Mortality. During 1958 there was one death from "diseases or accidents of child-birth," which is equivalent to a fatality rate of 0.52 per 1,000 births (live and still). There were three such deaths during 1957. The rate for England and Wales in 1958 was 0.43. Comparative Statistics of Births, Mortality, etc. (Compiled from Registrar-General's Returns.) Year Population Live Birth Rate (Crude) Death Rate (Crude) Maternal Death Rate Infant Mortality Rate 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 1957 111,800 16.4 10.9 1.59 22.3 1958 110,400 17.01 11.29 0.52 23.9 15 Infectious and Other Diseases. During the year, 1,152 notifications were received, which, when compared with 1,831 cases notified in 1957, shows a decrease of 679. This was mainly due to a fall in the incidence of measles, 1,402 cases being notified in 1957, against 614 in 1958, a decrease of 788. There was also a decline in the notifications of whooping cough from 118 to 90. There was, however, a sharp rise in the incidence of dysentery, 195 notifications, as against 32 in 1957. The largest number of cases occurred in the late summer and the early autumn. A large proportion of the cases of dysentery, not all notified, was due to an outbreak in one school where 132 cases occurred; 361 persons were examined and 150 were reported as positive for shigella sonnei; altogether 1,402 faecal specimens were obtained. In connection with all cases of dysentery, suspected and otherwise, 328 premises were visited, 678 persons were examined, and in 283 cases the organisms of shigella sonnei were found. A total of 2,406 specimens were submitted for examination. No case of diphtheria occurred during the year, the last case being notified in 1953. No cases of poliomyelitis were notified during the year. In 1957, 11 cases were notified, nine of which were confirmed, and in 1956, 29 were notified, 23 of which were confirmed. Three cases of typhoid fever occurred during the year, of which only two were notified. One of the cases, an adult male, thought to have been infected by eating a meal of oysters, presented some features of considerable epidemiological interest. The other two cases were connected with each other, one a girl aged 7 years, and a boy aged 8 years. At the time they resided in the same house and attended the same school. The girl was removed to hospital and reported to be suffering from gastro-enteritis. Some considerable time elapsed before it was known that the child was in fact a case of typhoid fever. In the meantime the boy and his family had moved to another address in the Borough. Subsequent investigations revealed that this boy was a typhoid carrier. Prolonged and extensive treatment and hospitalization failed to clear him. There lived in the house another family, which created a problem at the time, as there was only one water closet, which had to be shared by all concerned. Although T.A.B. vaccination was arranged for all members of the household, there was still a risk that could not be ignored, as the possibility of infection was constant. After serious consideration it was decided to rehouse the family, who were, of course, agreeable. This was done, and an undertaking obtained from the boy's father (the owner) not to relet. Eventually the boy's parents agreed to a cholecystectomy; this was performed with success, and the boy is now considered to be clear of typhoid. He has now returned to school after an absence of nearly Diphtheria and Whooping Cough Immunisation, Smallpox and 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. 16 Analysis of Cases (after Correction of Diagnosis) of Infectious Disease Notified during the Year 1958. Notifiable Disease Cases Notified in Battersea, at Ages (Years) Total 0— 1— 2— 3— 4— 5— 10- 15— 25— 45— 65 & over Diphtheria — — — — — — — — — — — — Dysentery 195 16 12 18 14 12 60 18 9 22 9 5 Encephalitis (acute):— Infective 1 — — — — — — — 1 — — — Post-infectious — — — — — — — — — — — Enteric (typhoid or paratyphoid) fever 2 — — — — — 1 — — — 1 — Erysipelas 14 — — — — — — — 1 2 7 4 Food poisoning 19 2 1 2 1 — 1 — 2 5 4 1 Malaria — — — — — — — — — — — — Measles 614 16 53 79 77 86 291 5 2 3 2 — Membranous croup — — — — — — — — — — — — Meningococcal infection 3 2 — — — — — 1 — — — — Ophthalmia neonatorum 1 1 — — — — — — — — — — Pneumonia, acute primary 48 4 1 — 3 1 5 2 3 8 9 12 Pneumonia,acute influenzal 8 — 1 — 1 — 1 — — 1 2 2 Poliomyelitis (acute):— Paralytic — — — — — — — — — — — — Non-paralytic — — — — — — — — — — — — Puerperal pyrexia — — — — — — — — — — — Scabies 6 1 1 3 1 — — Scarlet fever 76 1 1 3 7 4 43 13 4 — — — Smallpox — — — — — — — — — — — — Tuberculosis Pulmonary 67 v — — — 1 — — 17 21 25 3 Non-pulmonary 8 — — 1 — — — — 1 6 — — Whooping cough 90 7 10 14 9 17 30 3 — — — — Totals 1152 49 79 117 112 121 433 43 43 68 59 27 TUBERCULOSIS During the year 1958 there were 75 cases of tuberculosis (al' forms) notified in Battersea as compared with 100 in 1957, 108 in 1956' 129 in 1955, 140 in 1954 and 165 in 1953. In addition 67 cases were reported or otherwise came to the knowledge of the Medical Officer of Health, making a total of 1^2 cases for the year. The case rate per 1,000 population (excluding inward transfers) was 0.67 or 67.0 per 100,000. At the end of the year there were 1,1^" pulmonary cases and 73 non-pulmonary cases of tuberculosis on the Register. This is equal to a morbidity rate per 1,000 population 0 10.35 in the case of pulmonary, and 0.66 in the case of non-pulmonary tuberculosis or 11.01 both types. The tables on page 17 give details of additions and deletions of cases on the Register during the year. Deaths from Tuberculosis. During 1958 deaths from tuberculosis registered as belonging the Borough of Battersea numbered 20, of which 17 were due 10 nulmonarv tuberculosis, and 3 to other forms of the disease. The death rates per 100,000 of the population during the 55 years ended 1955 in quinquennial averages and the years 1951 to 1958 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) 22.1 2.8 24.9 1956 12.4 0.9 13.3 1957 8.9 0.9 9.8 1958 15.4 2.7 18.1 The death rate per 100,000 population was 10,0 for England and Wales. Tuberculosis, 1958. 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, 31/12/57 643 548 1,191 23 52 75 666 600 1,266 Primary notifications 44 23 67 3 5 8 47 28 75 Notified after death — — — — — — — — — Unnotified deaths — 1 1 — 2 2 — 3 3 Restored 2 1 3 — — — 2 1 3 Removal into Borough 32 29 61 2 1 3 34 30 64 From other sections — — — — — — — — — TOTAL ADDITIONS 78 54 132 5 8 13 83 62 145 Deaths 26 7 33 — — — 26 7 33 Notified after death — — — — — — — — — Unnotified deaths — 1 1 — 2 2 — 3 3 Removal into Borough 51 48 99 1 5 6 52 53 105 Recovered 25 20 45 1 6 7 26 26 52 Diagnosis not confirmed — 2 2 — — — — 2 2 To other sections — — — — — — — — — TOTAL DELETIONS 102 78 180 2 13 15 104 91 195 Net increase — — — 3 — — — — — Net decrease 24 24 48 — 5 2 21 29 50 On register at 31/12/58 619 524 1,143 26 47 73 645 571 1,216 18 Formal Notifications, 1958. 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 — — — — — 5 8 7 1 10 11 2 — 44 Respiratory, Females — — 1 — — 1 3 7 6 2 2 — 1 23 Non-Respiratory, Males — — — — — 1 — 1 1 — — — — 3 Non-Respiratory, Fern. — — 1 — — — — 2 2 — — — — 5 New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health otherwise than by formal notification. Source of information Number of cases in age groups 0— 1— 2— 5— 10— 15— 20— 25— 35— 45— 55— 65— 75— Total Death returns from local registrars r. M — — — — — — — — — — — — — — (A) F — — — — — — — — — — 1 — 1 (B) n.r. M — — — — — — — — — — — — — -(c) F — — — — — — — — — — — — 2 2 (D) Death returns from RegistrarGeneral (transferable deaths) r. M — — — — — — — — — — — — — -(a) F — — — — — — — — — — — — — -(B) n.r. M — — — — — — — — — — — — — -(C) F — — — — — — — — — — — — — -(d) Posthumous notifications r. M — — — — — — — — — — — — — -(a) F — — — — — — — — — — — — — -(B) n.r. M — — — — — — — — — — — — — -(C) F — — — — — — — — — — — — — -(D) 'Transfers'from other areas (excluding transferable deaths) r. M — — — — 1 1 7 11 5 5 1 1 — 32(A) F — — 1 1 — 2 8 10 5 2 — — — 29(B) n.r. M — — — — — — 1 1 — — — — — 2(C) F — — — — — — — 1 — — — — — 1(D) R.—Respiratory. N.R.—Non-Respiratory. Totals (A) 32 ,, (B) 30 ,, (C) 2 ,, (D) 3 Total number of informal notifications 67 19 BACTERIOLOGICAL EXAMINATIONS The bacteriological examination of clinical material (with the exception of sputum which is dealt with at the Chest Clinic) 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 examinattions. During the year 2,684 examinations were made as follows:— Number of Positive Description Disease Specimens Results Faeces Dysentery or Food Poisoning 2,549 821 Faeces Typhoid or Paratyphoid Fever 117 5 Throat Swabs Diphtheria 18 Nil 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 1958, 337 certificates were authenticated. CANCER. During 1958 the number of deaths of Battersea residents from cancer was 241 (142 males, 99 females), as compared with 278 in 1957, 231 in 1956, 247 in 1955 and 214 in 1954. The death rate from the disease per 1,000 of the population was 2.18. The deaths from cancer constitute 19.3 per cent. of the total Battersea deaths during the year. The following gives the comparative average death rates from cacer in Battersea for quinquennial periods since 1901. 1901-1905 0.88 1936-1940 1.99 1906-1910 0.95 1941-1945 2.44 1911-1915 1.11 1946-1950 2.11 1916-1920 1.28 1951-1955 2.07 1921-1925 1.33 1956 2.05 1926-1930 1.51 1957 2.49 1931-1935 1.75 1958 2.18 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:- Sanitary Operations, 1958. Inspections— Work carried out—(contd.) Complaints 3,163 Dampness remedied 1,065 Houses let in lodgings Rent Act 8 730 Waste pipes renewed/ repaired 59 Slum clearance 365 Water closets repaired or cleansed 186 Urinals and convenience; 186 Caravans 261 Water closets installed 90 Water certificates 72 Water cisterns cleansed or repaired 26 Infectious disease cases- Notifiable 524 Water supplies reinstated 72 Non-notifiable 68 Drainage 1,917 Water fittings renewed or repaired 50 Smoke Control Area 982 Other visits 2,363 Additional water supply to tenement houses 1 Re-inspections 11,118 Notices served— Water certificates issued 10 Intimation 1,602 Sinks, lavatory basins, baths renewed 101 Statutory (Infectious Disease) 83 Plaster renewed 842 Statutory (Nuisance) 878 Floors and stairs repaired 287 L.C.C. (General Powers) Acts 81 Doors and windows repaired 472 Summonses issued 125 Magistrates' Orders obtained 39 Fireplaces and flues repaired 168 Dangerous structures referred to District Surveyor 169 Additional lighting, ventilation 2 Rooms cleansed 54 Water waste referred to Premises disinfested 207 M.W.B 24 Dustbins provided 70 Work carried outDrains— Yard paving renewed or repaired 80 Smoke tests 85 Other defects remedied 381 Water tests 540 Premises disinfected 762 Found defective 37 Articles disinfected 5,152 Repaired 40 Articles disinfected Reconstructed 33 Personal Cleansing Sealed off 35 Treatment 288 Ventilated 25 To adults 1 756 Cleared 40 To children Frontages laid 17 Rodent Control— Roofs repaired 836 Premises dealt with— Rainwater pipes and gutters renewed / repaired 368 Rats 169 Mice 57 Inspections 3,253 21 Legal Proceedings. During the year, legal proceedings were taken by the Council in 30 cases, for the enforcement of various Acts, By-laws, Regulations, administered by the Health Department. A summary is set out below :- Cases Public Health (London) Act, 1936 115 L.C.C. (General Powers) Act, 1954 3 National Assistance (Amendment) Act, 1951 1 Food and Drugs Act, 1955 1 Housing Act, 1957 3 By-laws re drainage 6 By-laws re water-closets 1 130 Fines totalling £33 0s. 0d. were imposed in connection with these Proceedings, and £52 5s. 6d. costs were awarded to the Council. Public Health (London) Act, 1936. The provisions of this Act in regard to Nuisances continued to afford the main means whereby the remedy of insanitary conditions found in dwelling houses could be secured. During the year, 1,602 Intimation Notices (relating to 1,277 Premises) and 878 Statutory (Nuisance) Notices (relating to 707 Premises) were served. It was found necessary to refer 158 cases to the Council's Solicitor with instructions to take steps, by legal proceedings if necessary, to enforce compliance with Statutory Notices. In 43 of these cases a warning letter from the Solicitor had the desired effect. In the remaining 115 cases, however, summonses had to be issued. As a result Nuisance Orders were made by the Court in 39 instances. The remaining 76 summonses were ultimately withdrawn, the Notices having been complied with subsequent to the issue of the summonses. Defective conditions in 1,299 houses were remedied—680 by owners following the service of Intimation Notices; 600 by owners following the service of Stationary Notices, and 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. Dustbins. During the year, 25 notices were served under Section 12 of the London County Council (General Powers) Act, 1954, concerning he provisions of dustbins, and 70 dustbins were provided, 6 being supplied by the Council in default of the owners, from whom the cost was afterwards recovered. 22 The London County Council (General Powers) Act, 1955. Section 25 of the above Act relative to choked drains was used on forty-three occasions. This Section enables a notice to be served upon an owner or occupier to clear a stopped-up drain, water closet or soil pipe, within 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 fourteen 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 thirteen occasions and in each case the Council did the work in default. Authority has been 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, but it was not necessary to serve any such notices during the year. Drainage Work. Drainage work to new premises, reconstruction of drains to existing premises, and drainage in connection with conversion schemes, are carried out under the supervision of the officers of the Department. Drains were constructed to 79 new dwellings, and 159 plans of proposed work were deposited in connection with drainage generallyDuring the year, 85 drains were tested with smoke—37 of these were found to be defective. The water test was applied on 540 occasions to drains in the course of construction. 17 frontage drains (the length of drain between the house property to its connection with the sewer) were constructed or reconstructed. This work is carried out by the Council's workmen under the supervision of the Inspectors. Drainage and Watercloset By-laws made by the London County Council are enforced by the Council. During the year, 6 summonses for non-compliance with the Drainage By-laws, and 1 for non-compliance with the Watercloset By-laws, were issued. Fines totalling £6 were imposed, and £1 10s. Oncosts awarded to the Council. Combined Drainage. No claims were made against the Council in connection with combined drainage. Local Land Charges. Enquiries relating to Local Land Charges in connection with Notices served by the Department, information concerning the issue of Disrepair Certificates, and the way in which premises are drained, are regularly received. These enquiries require a careful search of records and drainage plans. During the year, 1,089 enquiries were dealt with 23 Water Supply. During the year 10 certificates under Section 95 (2) of the Public Health (London) Act, 1936, were issued in respect of 79 new or re-erected dwellings. Twenty-four notices of waste of water from defective fittings, etc., observed during routine inspections of various premises, were sent to the Metropolitan Water Board. Rag Dealers and Sorters. Premises occupied by rag sorters in the Borough are subjected to regular inspection. During the year 87 inspections were made. 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 two 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 the case of private dwellings the work of disinfestation is carried out by the Rodent Control Staff free of cost, and on request at business Premises, where the cost is charged in full. The sewers under the control of the Council are treated twice Yearly, in accordance with the suggestion of the Ministry of Agriculture and Fisheries (Infestation Control Division). Their recommended method of treatment, namely, the laying of unpoisoned bait on the first and third days, followed on the fifth day by poisoned bait, is followed. The Ministry make a grant of 50 per cent. towards the cost of the service. 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 — 2 — Dwelling houses — 105 35 Business premises — 62 22 — 169 57 The total number of visits made to the above premises, and to others which were found not to be infested, was 3,253. 24 Verminous Premises. During the year 207 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 on 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. Inspections were carried out on 261 occasions. 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. 169 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. No exemption certificates were issued under Section 38 of this Act. 25 Atmospheric Pollution. Clean Air Act, 1956. Smoke Control Areas. The Clean Air Act, 1956, (Appointed Day) Order, 1958, made the 1st June 1958, the second appointed day, and on that date all those Provisions of the Act not already in force came into operation. Section 11,one of the already effective Sections, gave the Council power to establish smoke control areas by means of Orders confirmed by the Minister. Following the coming into operation of a smoke control Order, if on any day smoke is emitted from a chimney within the area, the occupier of the building would be guilty of an offence, the maximum Penalty being £10 for each day the offence is committed. No offence, however, will be committed providing an authorised fuel has been used, The Act provides for payment of Exchequer and Council grants towards the cost of conversion or adaptation of any fireplace to burn smokeless fuel in a private dwelling. The Council had decided on their first smoke control area, which comprised an area of 50 acres surrounding St. James' Hospital, and approximately 570 private dwellings were involved. Following a detailed survey, the Council declared the area, and the Order, cited as The Metropolitan Borough of Battersea (No. 1) Smoke Control Order, 1958, to become operative from the 1st October, 1959, awaited confirmation of the Minister of Housing and Local Government. Clean Air Exhibition. The Exhibition was opened by His Worship the Mayor on the 18th October 1958, and was on view during the following week. The Coal Utilisation Council, Coal Utilisation Research Association, South Eastern Gas Board, and the London Electricity Board, were the major exhibitors and provided their own staff. The Public Health Department also exhibited, showing maps of the proposed Smoke Control Area, smoke recording apparatus, and examples of atmospheric pollution. Members of the staff were available to answer questions, and a keen interest was shown by persons attending. On the opening day, approximately 600 persons visited the Exhibition, and an average of 500 persons daily until the final day. Atmospheric Pollution. During the year, 32 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 213 observations were made. No notices were served. 26 Smoke Measuring Station. The smoke measuring station installed in the Department in 1956 continues to give valuable information concerning smoke density and sulphur dioxide in the atmosphere. The readings are taken by members of the staff of the Department, and the Department of Scientific and Industrial Research receive the results and collate the information with other results obtained from Authorities all over the Country. The following graph shows the readings obtained throughout the year. Notification of Installation of Furnaces. Notification is made in accordance with Section 3 of the Act, provides that the installation of any boiler with a heating capacity 55,000 or more British Thermal Units per hour must be notified the Local Authority. Two such notifications were made, and both were in respect of oil-fired furnaces. Alkali, etc., Works Order, 1958. This Order came into operation in June, 1958, and extends the list of works scheduled under the Alkali, etc., Works Regulation Act, 1906. The additions are extensive, and the list of works to be control by the Order has been notified to the Council by the Minister. 27 The effect of the Order is to place these works under the control of the Alkali Inspector, and proceedings cannot be instituted by the Council in respect of smoke or grit upon the premises except with the consent of the Minister. 28 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 on 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. They are in the main being implemented, and a complete register of all food premises in the Borough has been compiled. FOOD PREMISES. As at 31st December, 1958. Milk Distributors 133 Wholesale Milk Dealers (registered as Dairymen) 2 Restaurants, Cafes 151 Canteens, Kitchens 72 Butchers 70 Horseflesh (for human consumption) 1 Ice Cream (Sale) 261 Ice Cream (Manufacture) 3 Fish Shops (Wet and Fried) 44 Food Factories 20 Bakehouses (Not underground) 18 Bakehouses (Underground) 5 Preserved Food 116 Bakers 49 Greengrocers 78 Confectioners 210 Grocers and Provisions 268 Miscellaneous (Chemists, Public Houses, Off-Licences) 202 Stalls : — Grocers 2 Greengrocers and Fruiterers 64 Fish and/or Poultry 8 There are 1,092 food premises in the Borough, together with food stalls. Some of the premises shown above are listed under more than one trade category. Dairies and Milk Distributors. At the end of the year there were 135 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 133 premises were registered as milk distributors. 29 All these premises were visited during the year, and 6 notices concerning non-compliance with the Food Hygiene Regulations were served. In addition, 28 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 of 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 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 1958 was as follows:- Full Supplementary Tuberculin Tested 72 23 Pasteurised 101 23 Sterilised 129 25 302 71 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 264, and 142 inspections were carried out during the course of the year. To ensure compliance with the Food Hygiene Regulations, 4 notices were served. 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 three such Premises registered in the Borough. 30 Butchers' Shops. There are 71 butchers' shops in the Borough. All these shops are systematically inspected, 1,067 visits having been made during the year. In general, the shops are well conducted, and only two notices concerning non-compliance with the Food Hygiene Regulations were served. One shop where horseflesh is sold for human food is 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 44 such shops in the Borough. 158 inspections were made, and 3 notices served in respect of breaches of the Food Hygiene Regulations. Preserved Food Premises. Section 16 (b) of the 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 sale. A total of 116 premises were registered at the end of the year. In addition to butchers' and fish shops, 19 inspections of other preserved food premises were carried out. Catering Establishments. All restaurants, cafes, canteens and kitchens are regularly inspected throughout the year. There are 223 of these premises on the Register. and 830 inspections were made, 6 notices under the Food Hygiene Regulations being served. 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. FOOD PREMISES. Summary of Operations. Inspections— Work carried out— Butchers' shops 1,067 Sanitary conveniences cleansed, improved or repaired 15 Fish shops 158 Milk shops 20 Cold water provided l7 Ice cream premises 142 Hot water provided Wash hand basins 31 19 Preserved food premises 19 vided Other Food shops 695 Soap, drying facilities, 16 Food stalls 88 etc., provided Sinks provided 2 Food storage premises 37 Ventilation provided or improved Nil Catering establishments 830 Premises cleansed or repaired 49 Notices served 29 31 (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., at his laboratory at 325 Kennington Road, London, S.E.ll. 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 1958 was 235, of which 4, or 1.7 per cent., were certified to be adulterated. In addition, 321 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 years 1956, 1957 and 1958 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 1956 0.7 0.0 1957 0.4 2.8 1958 1.7 0.0 Milk. Ninety-three formal samples of milk were taken during the year. Of the 93 samples, 14 were designated as "Channel Islands" or "South Devon" milk, for which a higher minimum percentage (viz.,4per 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 4.37 per cent. Non-fatty solids 9.11 ,, Total milk solids 13.48 ,, 32 The milk fat content of the 14 samples of " Channel Islands" or " South Devon " milk ranged as under :— between 4.8 and 4.9 per cent. Nil. ,, 4.7 „ 4.8 „ 2 samples. ,, 4.6 „ 4.7 „ 2 ,, ,, 4.5 „ 4.6 „ 3 ,, ,, 4.4 „ 4.5 ,, 2 „ „ 4.3 „ 4.4 ,, 3 ,, ,, 4.2 „ 4.3 ,, 2 „ 14 All the 79 samples of ordinary milk were reported as genuine and their average composition was as follows : — Milk fat 3.72 per cent. Non-fatty solids 8.78 ,, Total milk solids 12.50 ,, Their content of milk fat ranged as follows :— Over 4.0 per cent. 9 samples or 11.39 per cent. between 3.9 and 4.0 „ 11 „ „ 13.93 ,, „ 3.8 „ 3.9 „ 13 „ „ 16.46 ,, „ 3.7 „ 3.8 „ 14 „ „ 17.72 ,, ,, 3.6 „ 3.7 ,, 15 „ „ 18.99 ,, ,, 3.5 „ 3.6 ,, 10 „ ,, 12.66 ,, ,, 3.4 „ 3.5 ,, 3 „ ,, 3.79 ,, ,, 3.3 „ 3.4 ,, 3 ,, ,, 3.79 ,, ,, 3.2 „ 3.3 „ 1 sample „ 1.27 „ 79 100.00 In the years 1953 to 1958 the percentage of adulterated samples of milk was as under :— Year Samples taken Adulterated No. Percentage 1953 100 1 1.0 1954 100 6 6.0 1955 100 3 3.0 1956 100 0 0.0 1957 100 0 0.0 1958 93 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 Almonds — 1 1 — — — Baking Powder — 5 5 — — — Batter Mixture — 3 3 — — — Bovril — 1 1 — — — Bread — 7 7 — — — Butter 21 21 1 1 Cake and Pudding Mixture — 28 28 — — — Caraway Seeds — 1 1 — — — Cereal Preparations — 19 19 — — —- Cheese Spread — 1 1 — — — Chicken, Minced — 1 1 — — — Chocolate Spread — 3 3 — — — Cocoa — 5 5 — — — Coconut 6 6 — Coffee 1 1 2 — — — Coffee and Chicory Essence 1 5 6 — — — Colouring — 4 4 — — — Confectionery, Flour 13 — 13 — — — Confectionery, Sugar 4 1 5 — — — Custard Powder — 9 9 — — — Fish Paste — 9 9 — — — flavouring — 4 4 — — — Flour 3 1 4 — — — Fruit, Dried 9 — 9 1 — 1 Fruit, Preserved — 1 1 — — — Gelatine — 4 4 — — — Glucose Tablets — 4 4 — — — Golden Raising Powder — 4 4 — ,— — Gravy Preparations 9 9 — Herbs, Mixed — 3 3 — — — Honeycomb Mould — 4 4 — — — Ice Cream 1 — 1 — — — Instant Whip — 2 2 — — — James and Preparations 2 5 7 — — — Jellies and Blancmanges 6 13 19 — — — Junket Preparations — 6 6 — — — Lard and other Fats 14 — 14 — — — Margarine 1 — 1 — — — Mayonnaise 1 — 1 — — — Meat Preparations:— frankfurters 1 — 1 1 — 1 Meat Paste — 9 9 — — — Meat Pie 3 — 3 — — — Sausages 21 — 21 1 — 1 Sausage, Liver 1 — 1 — — — Sausage Meat 1 — 1 — — — Sausage Rolls 2 — 2 — — — Milk 93 — 93 — — — Carried forward 199 179 378 4 — 4 34 Nature of Sample EXAMINED ADULTERATED Formal Informal Total Formal Informal Total Brought forward 199 179 378 4 — 4 Milk, Dried — 1 1 — — - Milk Shake - 1 1 Milk, Tinned 1 — 1 — — - Mint — 3 3 — — - Olive Oil 4 3 7 — — - Pea Flour — 1 1 — — - Pickles — 7 7 — — - Sandwich Spread — 2 2 — — - Sauces 1 17 18 — — - Soft Drinks and Powder 5 7 12 — — - Soups — 10 10 — — - Spices and Condiments — 24 24 — — - Stuffing — 4 4 — — - Suet 1 — 1 — - Tea 6 1 7 - Vinegar 11 11 Wines 3 3 Yeast — 3 3 — — - Totals 231 263 494 4 — 4 Drugs. The following table gives details of the drugs of which samples were obtained for the purpose of analysis:— Nature of Sample EXAMINED ADULTERATED Formal Informal Total Formal Informal Total Bile Beans — 1 1 — — — Cream of Tartar — 2 2 — — — Glycerine 1 2 3 — — — Laxative — 1 1 — Linctus 2 — 2 — Liquid Paraffin — 2 2 — — — Oil, Camphorated — 7 7 — — — Oil, Castor — 9 9 — — — Ointment, Sulphur — 2 2 — — — Ointment, Zinc — 3 3 — — — Pastilles — 2 2 — — Salts — 8 8 — — — Seidlitz Powder 1 1 2 — — — Soda, Bicarbonate of — 3 3 — — — Syrup of Figs — 1 1 — — — Tablets :— Aspirin — 6 6 — — — Digestive — 1 1 — — — Lime Sulphur — 1 1 — — — Liquorice Compound — 1 1 — — — Milk of Magnesia — 1 1 — — — Saccharin — 2 2 — — — Soda Mint — 2 2 — — — Totals 4 58 62 — — — 35 Adulterated Samples. The Public Analyst reported adversely on four formal samples— butter, sultanas, pork sausages and frankfurters. The butter contained an excess of 0.22 water, the sultanas contained a live maggot, and the frankfurters a fly. A reprimand was sent to the manufacturers of the butter and the frankfurters, and the shopkeeper was advised regarding the sultanas. The pork sausages were reported as having only a meat content of 57%, which is below the generally recognised standard, but they were otherwise genuine and no action could be taken. Heat Treated Milk. Samples of pasteurised and sterilised milk are taken at regular intervals for submission to the Public Health Laboratory Service for the prescribed tests, and during the year samples as under were taken with the result set out:- Phosphatase Satisfactory Failed Methylene Blue Satisfactory Failed Pasteurised 28 — 28 — Turbidity Satisfactory Failed Sterilised 24 — 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 taken, both for chemical analysis and for submission to the prescribed tests for such milk. The samples are included in the general totals given on pages 31, 33 and 35. The results of the analysis and tests are communicated to the London County Council or the appropriate Hospital Management Committee. Ice-Cream. Twenty-six samples of ice-cream were taken during the year, each samples being submitted to the methylene blue test. The samples were, as a result of the test, placed in the following grades:- Provisional Grade 1 22 „ ,, 2 4 „ ,, 3 Nil ,, ,, 4 Nil 26 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 5 instances of foreign matter in food dealt with during the year, and in 4 of them cautionary letters were sent to the persons concerned. In one case a summons was issued and a fine of £25 obtained with £4 16s. Od. costs to the Council. This was in connection with a cake fouled by mice droppings. 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. Butter 3 lbs. Cakes and biscuits 8 pkts. Cheese 1 St., 1 lb. Coffee 5 tins. Cream 3 tins. Fish (wet) 6 cwts. 1 St., 8 lbs. Fish (preserved) 2 qtrs., 10 lbs., 83 tins, 10 jars. Flour and cereals 1 tin. Fruit (fresh) 29 crates of cherries. Fruit (preserved) 582 tins. Jams and preserves 46 tins, 14 jars. Meat (fresh) 1 ton, 5 cwts., 7 lbs. Meat (preserved) 1 ton, 13 cwts, 2 qtrs., 1 St., 1 lb., 363 tins. Milk (tinned) 38 tins. Offal 3 cwts., 12 lbs. Paste (meat and fish) 80 jars Pickles, sauces, etc. 14 tubes, 18 tins, 9 bottles Poultry 62 turkeys, 16 lbs., 4 tins. 12 chickens, 1 cwt., 1 qtr., 1 lb. Rabbit 8½ lbs. Sandwich spread 4 jars. Soups and gravy preparations 264 tins. Vegetables (preserved) 432 tins. Two complaints were received during the year concerning pies., which when purchased were found to be affected by mould. Following the usual enquiries, the vendor in each case stated that the pie had been sold in error for a fresh pie. A cautionary letter was sent to both shop-keepers. FOOD POISONING. Nineteen cases of food poisoning were notified during the and 9 other cases were otherwise ascertained. In 17 cases the causitive organism was found to be Salmonella of the following types:— Anatum 2 cases Bovis-morbificans 4 „ Heidleberg 2 „ Schwarzengrund 1 case Thompson 1 „ Typhi-murium 7 cases Two other cases were due to Staphylococci infection, and other cases the agent was not identified. 37 Factories, Outworkers and Shops (other than food shops). Factories Act, 1937. Metropolitan Borough Councils are responsible for the enforcement the provisions of this Act in regard to:— (i) Sanitary conveniences—Section 7—In all factories. (ii) Cleanliness, Overcrowding, Temperature, Ventilation, and Drainage of Floors—Sections 1, 2, 3, 4 and 6—In all factories where mechanical power is not used. (iii) Certificates of Suitability for Basement Bakehouses—Section 54—In all basement bakehouses. (iv) Water Supply (where derived from a source other than the public mains)—Section 53—In all factories. The following table gives the number of factories on the register the end of the year, with the number of inspections, defects found, 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 120 598 7 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 372 1,654 4 Other Premises in which Section 7 is enforced by the Local Authority (excluding outWorkers' premises) 25 29 — - TOTAL 517 2,281 11 — 38 2.—CASES in which DEFECTS were found. Particulars Number of cases in which defects were found Number of cases in which prosecutions were stituted Found Remedied Referred To H.m. Inspector By h.m. Inspector Want of cleanliness (S.l.) 1 1 — 1 — Overcrowding (S.2.) — — — — — Unreasonable temperature (S.3.) — — — — — Inadequate ventilation (S.4.) — — — — — Ineffective drainage of floors (S.6.) — — — — — Sanitary Conveniences (S.7.) (a) Insufficient 4 4 — — — (b) Unsuitable or defective 5 5 — — — (c) Not separate for sexes 1 1 — — — Other offences against the Act (not including offences relating to Out-work) 3 3 — 3 — TOTAL 14 14 — 4 — The following table shows the factories in the Borough, classify according to the trades carried on. Factories Classified according to Trades. Trade Mechanical Factories Non-Mechanical Factories At 1 Jan. At 31 Dec. At 1 Jan. At 31 Dec. Building and Allied 25 25 22 22 Clothing and Allied 40 38 15 15 Engineering and Heavy Industry 49 58 1 1 Electrical and Allied 14 14 1 1 Florist — — 2 2 Food and Allied 40 39 4 4 Furniture and Allied 17 16 5 5 Metal Worker 10 9 — Printer and Allied 28 30 2 2 Road Vehicle Repairer 43 46 20 19 Steam Laundry 10 10 — — Transport (Road & Rail) 19 19 — — Others 61 68 48 49 Total 356 372 120 120 39 Bakehouses. There were 23 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 20 of them use mechanical power. Seventy-six inspections were made but it was not necessary to serve any notices. Five of the bakehouses were "basement bakehouses" within the meaning of Section 54 of the Factories Act, 1937. Under this Section, it is the duty of the Council, at five-yearly intervals, to inspect their underground bakehouses to ascertain whether the Certificates of Suitability originally issued under the Factory and Workshops Act, 1901, should still remain in force. The Council agreed to certain standards being maintained in such bakehouses, and the present year being the final year of the quinquennial period, inspections were carried out. Certificates of Suitability were recommended to remain in force with regard to the three underground bakehouses remaining in operation in the Borough. 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. Outworkers. During the year lists of outworkers were received from Battersea employers and from other authorities as required by the Factories Actt, 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 271 (including 5 contractors), 66 premises having been added, and 67 removed, during the year. The total number of inspections made was 338, most of them by the female Inspector. The premises were found to be generally satisfactory, and it was not necessary to serve any notices or take any other action. No cases of infectious diseases occurred at outworkers' premises. The following table gives details of the outworkers' premises:— Trade Number on Register Premises Workrooms Persons employed Wearing Apparel 202 212 234 Linen 1 1 1 Artificial Flowers 2 2 2 Paper Bags 8 8 8 Boxes, etc. 4 4 4 Stuffed Toys 1 1 1 Lamp shades 35 35 37 Toys, etc. 11 13 17 Basswork 1 1 1 Curtains 1 1 1 Buttons 1 1 1 Other trades 4 4 4 271 283 311 40 Barbers and Hairdressers. The London County Council (General Powers) Act, 1954, Section 18, gave the Council authority 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. 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 77 registered premises in the Borough, and 117 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 12 shops and 35 visits were made during the year. Rag Flock and Other Filling Materials Act, 1951. The principal provisions of the Act relate to registration of premises in which rag flock or other materials are used in upholstery, etc., and the licensing of premises used for the manufacture and storage of rag flock. An authorised officer of the Council has the right of entry, inspection and sampling of any filling materials. The Medical Officer of Health and 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 be 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. Eleven visits were made to registered premises during the year, but no contravention of the Act was discovered. 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. 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. 41 FACTORIES, OUTWORKERS AND SHOPS. (Other than food shops). Summary of Operations. Inspections— Inspections—cont'd. Shops 25 Workplaces 97 Shops (Pharmacy Act) 12 Smoke observations 213 Rag flock premises 11 Complaints dealt with 144 Pet shops 35 Hairdressers 117 Intimation notices served 11 Outworkers 338 Statutory notices served Nil. Factories 1,590 Summonses issued Nil. 42 Housing. Provision of New Accommodation. During the year 1958 construction of the following 79 new dwellings was completed:— By Battersea Borough Council:— 1/24 (consecutive) Farrant House, Winstanley Road 24 4, 4a, 6, 6a, 8, 8a, 8b, 8c Hafer Road 8 1/24 (consecutive) Jackson House, Winstanley Road 24 68, 68a, 70, 70a, 72, 72a, 72b, 72c Lavender Sweep 8 79/87 (odd) Sisters Avenue 6 24/30 (even) Stormont Road 4 120/128 (even) Thurleigh Road 5 79 Closing Orders. Under Section 17 of the Housing Act, 1957, 36 Closing Orders in respect of dwelling houses were made during the year, and 52 basement rooms and 2 other parts of dwelling houses were closed under Section 18 of the Act. Demolition Orders. No Demolition Orders under Section 17 of the Housing Act, 1957. were made during the year. Certificates of Disrepair. Rent Act, 1957. The following table shows the work carried out during the year in connection with Certificates of Disrepair:— Applications for Certificates of Disrepair (Form I) received 350 Decisions to issue Certificates of Disrepair (Form J) 373 Undertakings received from landlords (Form K) 251 Undertakings received from landlords (Form K) accepted 243 Certificates of Disrepair (Form L) issued 170 Certificates of Disrepair refused 15 Applications for cancellation of Certificates of Disrepair (Form M) received 112 Cancellations of Certificates of Disrepair (Form N) issued 80 Cancellations of Certificates of Disrepair issued under the Housing Repairs and Rents Act, 1954 4 Applications for Certificates re undertakings (Form O) received from landlords 88 Applications for Certificates re undertakings (Form O) received from tenants 133 Certificates re undertakings (Form P) issued to landlords 79 Certificates re undertakings (Form P) issued to tenants 126 In comparison with 1957, the volume of work did not decrease as although the number of applications by tenants for Certificates of Disrepair declined in the latter part of the year, this was offset by the number of applications from landlords and tenants for certificates relating to undertakings given by landlords, and by applications from landlords for cancellation of Certificates of Disrepair. 43 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 1958 a total of 483 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 7 applications and 13 cases were referred to the Housing Committee for special consideration on these grounds. In 7 cases the maximum points were given for pulmonary tuberculosis, one of these being referred to the Housing Committee for special consideration as the accommodation was inadequate. In 14 cases of transfer applications, rehousing was recommended as essential on medical grounds. The London County Council notify cases in which the application to that Council alleges sanitary defects. The houses are inspected, and action to secure the remedy of any defects found is taken. 44 Miscellaneous Matters. Conferences. The Council were officially represented at the undermentioned Conferences dealing with matters within the purview of the Public Health Department. Conference Central Council for Health Education, London—23rd January. Royal Society of Health, Eastbourne—28th April to 2nd May. Fifth Commonwealth Chest Conference of the National Association for the Prevention of Tuberculosis, London—1st to 4th July. Association of Public Health Inspectors, Blackpool— 16th to 19th September. National Society for Clean Air, Llandudno—1st to 3rd October. Delegates. Alderman Mrs. A. M. Smith. Cllr. Miss E. A. Coles, J.P., the Medical Officer of Health. Cllr. Mrs. E. A. Cooper, J.P. Cllr. Miss E. A. Coles, J.P., and the Chief Public Health Inspector. Cllr. Mrs. E. A. Cooper, J.P., and Mr. I. R. Lewis, Factories and Workshops Inspector. Care of the Aged. There has been an increased amount of work throughout the past year. The aim of the Department has been to anticipate needs, and to provide elderly people with adequate facilities in their own homes in an attempt to prevent or retard the onset of serious deterioration in health. A great deal can be done to help the aged in this way. Prorper diet, companionship and hygiene are of prime importance. Several flats have been specially converted by the Council for the use of the elderly, and have been adapted to meet their particular requirements. The Department has maintained close co-operation and good relations with general practitioners, hospitals, and the services who visit and help the aged at home. In the past year, the Health Committee has been asked to approve provisionally the compulsory removal of two old people under the National Assistance Acts. Happily, no action was necessary in either of these cases. 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. 45 During the year 1958 this arrangement was taken advantage of the respective Baths Establishments as follows:— Males Females Latchmere 3,752 3,643 Nine Elms 1,054 428 Plough Road 1,004 1,008 Total 5,810 5,079 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 fortnightly for bacteriological examination. The results show that the water has consistently maintained a high degree of purity. 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. Accidents in the Home. The Committee charged with matters relating to home accidents in Battersea is the Health Committee. As with all public health matters, information as to what is happening is essential to preventive action, and I, therefore, have gone to some pains to obtain data about home accidents in Battersea. Unfortunately, there is no very definite information to hand relating to home accidents. There are certain national figures but not many relating to individual areas or boroughs. Recently, however, the County Medical Officer of Health for London informed me that he was taking steps to obtain from hospitals certain data relating to admission to hospitals of home accident cases, both in-patients and out-patients. These would be obtained for a period of six months and will, it is hoped, be a representative cross-section of the types of 46 accidents occurring in the London boroughs, including Battersea. It will be some time before this data is available but in the meantime, from returns made by the London Ambulance Service, I have been able to calculate figures for Battersea. I should say that the figures provided do not refer to any individual borough but they are available for the nine health divisions of the County. By means of certain calculations, I have been able to extract figures relating to Battersea from the overall figures presented for Health Division 9 of the London County Council and these are shown in Tables 1 and 2. They represent the home accident cases conveyed to hospitals in London by London Ambulances and they include both fatal and non-fatal cases and also some that are treated as out-patients as well as others treated as in-patients. I have calculated the figures for Battersea for 1956, 1957 and 1958. I would stress that the figures as set out are not absolutely accurate although I do not think that the errors are likely to be very large. Generally speaking, they can be taken as a reasonably accurate picture of the home accidents which have occurred in Battersea in 1956, 1957 and 1958. The figures speak for themselves and need little explanation. The main points of interest are the high proportion of cases occurring in the age groups over 60 and also in the age group under 5. Falls of various kinds provide the greatest number of accidents although quite a percentage are also brought about by knife-like wounds. What is to be learnt from these figures? In most households where a severe accident has already occurred, this very fact is probably enough to ensure caution and care in the future. Our main effort, therefore, should be directed towards education of the public, particularly in those age groups most likely to be affected, that is to say, in early and later life. This has now become a routine part of the work of health visitors and public health inspectors working closely with other organisations, both statutory and voluntary. The trend of the figures in future years will be watched with interest as some indication of the effect which our efforts are having. HOME ACCIDENTS IN BATTERSEA, 1956 -1958 Table I Year Age group (years) M. F. Total Under 1 1 2 3 and 4 5-19 20-59 60-69 70-79 80 plus 1956 3 9 10 10 32 83 32 50 41 98 172 270 (%) (1.2) (3.2) (3.7) (3.8) (11.7) (31.0) (11.6) (18.5) (15.3) (36.0) (64.0) (100.0) 1957 4 8 8 12 27 78 30 44 40 85 166 251 (%) (1.4) (3.3) (3.4) (4.6) (10.7) (30.7) (12.0) (17.7) (16.2) (34.3) (65.7) (100.0) 1958 4 10 10 12 28 80 28 47 43 88 174 262 (%) (1.5) (3.8) (3.8) (4.6) (10.7) (30.5) (10.7) (18.0) (16.4) (33.6) (66.4) (100.0) 47 Table II Cause of Accident 1956 1957 1958 Fall: On stairs 40 37 41 From ladder 7 6 4 From chair 6 6 7 Outside (i.e., windows, balconies, roofs, etc.) 11 6 5 In garden 15 10 8 In bath — 1 — From one level to another (i.e., tables, boxes, beds, etc.) 14 14 11 On same level (i.e., in room, over objects) 26 19 35 Unspecified 74 80 85 Hit by Object 15 5 5 Cooking stove (saucepans, water, fats, etc.) 5 2 4 Teapot 1 1 2 Other boiling water 6 8 4 Electric shock 1 — 1 Poisoning (including foreign objects) 9 12 8 Gassing 3 3 4 Knife-like wounds (including spikes and cuts from glass) 23 17 12 Fires 8 3 8 Windows (trapping) 2 2 2 Suffocation — 1 1 Not specified 4 18 15 Total 270 251 262 Rate Per 10,000 population 22.9 21.3 23.7 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, 7 cases were dealt with. The burials arranged by the Council are carried out by a local undertaker under contract, and not more than one coach is provided for followers. The Health Department make the arrangements and collect all available information regarding any estate left by the deceased, particulars of his National Insurance, and the existence of any "liable" relatives. This information is passed to the Borough Treasurer so that he make take steps to recover the cost. The total cost incurred in dealing with the 7 cases was £124 approximately, and of this amount £105 was recovered. 48 Personal Cleansing Station. There are facilities for treatment of scabies and verminous conditions at the Personal Cleansing Station, Sheepcote Lane. During the year 337 treatments were given to persons suffering from or contacts of scabies—163 to adults, 125 to school children, and 49 to children under school age. In addition to the above, 125 adults and 1,582 children found to be verminous were cleansed. Of the 1,582 children, 1,504 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 2,499 1,966 512 1955 246 2,318 2,371 526 1956 262 1,517 2,681 547 1957 289 1,535 3,202 553 1958 288 1,756 2,536 560 * Financial year ending 31st March. Other columns, calendar year. The contract with the London County Council, referred to above provides for the payment by them of 3s. 6d. for each treatment given, whether for vermin or for scabies, with a minimum payment of £500 per annum. 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 which the patients are resident. During the year 122 treatments were given to Wandsworth residents and 80 treatments to Lambeth residents. 49 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 thoroughtly, 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. Od. per shelter for every case sent there. Disinfection and Disinfestation. The disinfection plant at the Council's Disinfecting Station, Sheepcote 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 Station. Sheets, 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 geves 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. 50 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 1958, are set out in the following table:— Battersea Mortuary, 1958. Details of Bodies Received Usual Place of Residence Total Battersea Wandsworth Elsewhere Residence unknown Post-mortem only 134 381 144 45 704 Post-mortem and inquest 26 85 21 9 141 Total post-mortems 160 466 165 54 845 Inquest only — — — — — Total inquests 26 85 21 9 141 Sanitary and other reasons 2 2 — — 4 Total bodies received 162 468 165 54 849 Verdicts at Inquests held— Natural causes — 1 2 2 5 Accident and misadventure 11 43 15 6 75 Open verdict 5 1 3 — 9 Suicide 10 34 5 — 49 Alcoholism — 1 — — 1 Industrial disease 1 1 — — 2 Referred to Central Criminal Court — 4 — — 4 TOTAL 27 85 25 8 145 In addition to the above, sixteen inquests were held at the Coroner's Court. No bodies were received into the Mortuary for these inquests. The four cases referred to the Central Criminal Court proved to be one homicide, one infanticide and two of unlawfully killing by a motor car. 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 per annum for the use of the Coroner's Court. 51 INDEX. Page No. Accidents in the Home 45 Adulterated Samples 31, 32, 33, 35 Aged and Infirm Persons—Care of 44 Alkali, etc., Works Order, 1958 27 Atmospheric Pollution 25 Bacteriological Examinations 19 Bakehouses 39 Barbers and Hairdressers 40 Baths—Personal Cleansing Station 48 ,, —Public Swimming 45 „ „ Slipper—Use by Old Age Pensioners 44 Births 9 Burials 47 Butchers' Shops 30 Cancer 19 Care of the Aged 44 Catering Establishments 30 Certificates of Disrepair 42 Clean Air Act, 1956 25 „ „ Exhibition 25 Closing Orders 42 Combined Drainage 22 Committee—Health 2 Comparative Statistics 14 Conferences 44 Coroner's Court and Mortuary 50 Daries 28 Dangerous Structures 24 Deaths 10 „ , Infant 13 „ , Maternal 14 „ from Tuberculosis 16 Deceased Persons—Burial of 47 Demolition Orders 42 Diphtheria Immunisation 15 Diseases—Infectious and Other 15 Disinfecting Station49 Disinfection 49 Disinfestation 49 Drainage, Combined 22 „ Work 22 52 Page No. Drugs—Sampling 34 Dustbins 21 Examinations—Bacteriological 19 Exemption Certificates—Shops Act, 1950 24 Factories Act, 1937 37 „ , Outworkers and Shops 39 „ , „ „ „ —Summary of Operations 41 Fish Shops 30 Food—Bacteriological Examination 19 „ and Drugs Act, 1955 28 „ , Foreign Matter in 36 „ Hygiene Regulations, 1955 28 „ Poisoning 36 „ Premises 28 „ „ —Inspections 28, 30 „ „ —Summary of Operations 30 „ Sampling 31, 33 „ Stalls 28, 30 „ Supply—Protection of 28 „ , Unsound 36 Hairdressers and Barbers 40 Health Committee 2 Heat Treated Milk 35 Heating Appliances (Fireguards) Act, 1952 40 Home Accidents 45 Housing 42 „ Accommodation Applications 43 „ —New Accommodation 42 Ice Cream Premises 29 „ „ Sampling 35 Illegitimate Infants—Deaths of 14 Immunisation—Diphtheria and Whooping Cough 15 Infant Mortality 13 Infectious and Other Diseases 15 Inquests 50 Inspections 20 „ —Dwelling Houses 20 „ —Factories, Outworkers and Shops 37, 41 „ —Food Premises 28, 30 Installation of Furnaces—Notification of 26 International Certificates of Vaccination and Inoculation 19 Legal Proceedings 21 53 Page No. Local Land Charges 22 London County Council (General Powers) Act, 1955 22 Marriages 10 Maternal Mortality 14 Milk Distributors and Dairies 28 „ , Heat Treated 35 „ Samples 31, 32, 35 „ „ , Adulterated 32 " (Special Designations) Regulations 29 „ Supplied in Schools and Hospitals—Sampling 35 Miscellaneous Matters 44 Mortality—Infant 13 „ —Maternal 14 Morrtuary and Coroner's Court 50 National Assistance Acts 44 New Housing Accommodation 42 Notification of Installation of Furnaces 26 Nuisances—Public Health (London) Act, 1936 21 „ —Smoke 25 Offensive Trades 39 Old Age Pensioners—Use of Slipper Baths 44 Outworkers 39 Personal Cleansing Station 48 Per Animals Act, 1951 40 Poliomyelitis Vaccination 15 Population 9 Post-mortems 50 Preserved Food Premises 30 Prevention of Damage by Pests Act, 1949 23 Principal Figures 8 Protection of Food Supply 28 Public Conveniences 45 „ Health (London) Act, 1936—Nuisances 21 „ Lavatory Accommodation 45 „ Swimming Baths 45 Rag Dealers and Sorters 23 Rag Flock and Other Filling Materials Act, 1951 40 Rent Act, 1957 42 Rodent Control 23 Samples—Adulterated 31, 32, 33, 35 „ —Drugs 34 „ —Food 33 54 Page no. Samples—Heat Treated Milk 35 „ —Ice Cream 35 „ —Milk 31, 32, 35 „ — „ , Heat Treated 35 „ — „ Supplied in Schools and Hospitals 35 „ —Water, Swimming Baths 45 Sanitary Circumstances 20 Shops Act, 1950 24 „ , Butchers' 30 „ , Fish 30 „ , Ice Cream 29 „ , Milk, and Dairies 28 „ , Pet 40 Slipper Baths—Use by Old Age Pensioners 44 Smallpox Vaccination 15 Smoke Control Area 25 „ Measuring Station 26 Smoke Nuisances 25 Staff 2 Stalls, Food 28, 30 Static Water Tanks 24 Statistics—Comparative 14 „ —Vital 9 Still-births 9 Swimming Baths 45 Tuberculosis 16 „ Deaths 16 „ Notifications 17 Unsound Food 36 Urinals 45 Vacant Sites 24 Vaccination—Smallpox and Poliomyelitis 15 „ —International Certificates 19 Van Dwellings 24 Verminous Premises 24 Vital Statistics 9 Water Supply 23 Whooping Cough Immunisation 15 H. J. Rowling & Sons, Ltd. (t.u.), 36 York Road, Battersea, London, S.W. 11.