AC 4386 II Library BAT 62 Metropolitan Borough of Battersea. REPORT on the HEALTH OF THE Metropolitan Borough of Battersea FOR THE YEAR ENDING 1963 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 ENDING 1963 BY J. TUDOR LEWIS, M.D., D.P.H. MEDICAL OFFICER OF HEALTH. Medical Officer Health Department. 207 Lavender Hill, Battersea, S.W.11. Telephone No.: BATtersea 8899. 2 health Committee. As constituted 23rd May, 1962 Chairman: Councillor Miss E. A. Coles, j.p. Vice-Chairman: Councillor G. Whitehead Councillor P. J. Arnould „ A. J. Buss Alderman Mrs. E. A. Cooper, j.p. Mrs. C. M. Davis Councillor Dr. J. Fairlee J. A. Golding Dr. H. L. Gulati, j.p. „ C. E. Lang Miss G. A. Morgan „ J. Stewart Ex-officio Members: The Worshipful the Mayor (Councillor J. H. Dunning, j.p.) Alderman H. Harling, j.p. Councillor H. W. Sendall, f.inst.l.ex. „ C. F. Waller As constituted 20th May, 1963 Chairman: Councillor Miss E. A. Coles, j.p. Vice-Chairman: Councillor G. Whitehead Councillor A. J. Buss Alderman Mrs. E. A. Cooper, j.p. Councillor Dr. J. Fairlee J. A. Golding Dr. H. L. Gulati, j.p. Mrs. H. N. Halsey C. E. Lang Miss G. A. Morgan „ J. Stewart Alderman F. J. Wingrove, j.p. Ex-Officio Members'. The Worshipful the Mayor (Councillor J. Parker, j.p.) Alderman H. Harling, j.p. Councillor H. W. Sendall, f.inst.l.Ex. „ C. F. Waller 3 Staff of public health Department. Medical Officer of Health J. Tudor Lewis, m.d., d.p.h. Deputy Medical Officer of Health T. A. Plumley, m.b., b.s., m.r.c.s., l.r.c.p., d.p.h., d.obst., r.c.o.g. Chief Public Health Inspector and Principal Administrative Officer G. W. P. Weeks (b d e) Deputy Chief Public Health Inspector and Principal Administrative Officer R. J. McCarthy (a d) Public Health Inspectors: I- R. Lewis (b d) E. Selway (b d) M. Southwick (b d e) W. E. Porter (b d) Food: A. Trevethick (b d) Student Public Health Inspectors Senior A. Webb (b d) District D. E. Bull (c d) G. Jones (c d) (resigned December) P. Ianson (b d) Other Catering Establishments: Miss A. L. Jones (b d) B. A. Knight P. W. Gunnell R. E. Cook (appointed September) Administrative and Clerical Staff: D. Bell (temporary) A. C. Cooles (appointed September) m.t. Corker (temporary) p. brocking g.t.g northwood Miss. S. M. Carter Miss e. Town R.E. Cook (resigned September) s. j. P. Whitbread G. e. Thurgood Smoke Control Assistants e. f. Capewell Mrs. M. I. Richards, s.r.n. (resigned March) Visitor (Old People and Infectious Disease) Mrs. D.W. Morley, S.R.N., S.C.M. (appointed April) Senior Rodent Operative L. Mayo (appointed January) Disinfecting station - Superintendent J. Mandry '^ Morturay-Superintendent W. Trendell 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) Public Health Inspectors' certificate of the Public Health Inspectors' Examination Board. (d) Meat and Other Foods certificate. (e) Smoke Inspectors' certificate of the Royal Sanitary Institute. 4 INDEX TO SECTIONS. page Preface Health Committee 2 Staff of the Public Health Department 3 Principal Figures for 1963 Vital Statistics 10 Infectious and Other Diseases 16 Sanitary Circumstances 21 Housing 29 Factories and Outworkers 32 Atmospheric Pollution 34 Protection of Food Supply : — (a) Inspection of Food Premises 37 (b) Sampling of Food and Drugs 39 Miscellaneous Matters 45 5 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Battersea. Mr. Mayor, Ladies and Gentlemen, I have pleasure in presenting to you the Annual Report on the health and sanitary conditions of the Borough of Battersea for the year 1963, which follows the usual form of previous reports. The decline in population continued, for in 1963 the Registrar General's mid-year estimate of the population of Battersea was 102,940, against 104,020 for 1962. The live birth rate was very slightly increased to 20.87 per thousand the population as against 20.81 for 1962, being based on a total of 2,361 live births. The rate for England and Wales as a whole was 18.2 and for London 20.1. The death rate increased in 1963 from 11.90 to 12.76 per thousand the population, although the number of deaths attributed to Battersea was reduced from 1,345 to 1,288 in 1963, the increase in the rate being due to the reduction in population. The corresponding rates for England and Wales and London were 12.2 and 12.4 respectively. The number of deaths of children under the age of one year was 47 as against 45 in 1962, but owing to the increased number of live births, here was a reduction in the infant mortality rate to 19.91 per thousand live births in 1963 as against 20.59 in 1962. There was, as in the previous year, one death due to puerperal causes giving a maternal mortality rate of 0.42 per thousand live births. The incidence of infectious diseases did not present any particularly °table features except for the expected increase in the number of measles cases, since 1963 was a measles year. There were in fact 703 cases of measles notified as against 165 in 1962. For the second year in succession, no cases of poliomyelitis occurred in the Borough, nor were there any cases of smallpox, but a number of indirect contacts arriving from endemic areas, who were not in possession of valid certificates of vaccination, were kept under surveillance. In 1962 there was a very low incidence of whooping cough. In the current year 105 cases were notified but many of these were mild cases where the diagnosis might well have been in doubt because the widespread use of immunisation against whooping cough can sometimes make diagnosis difficult. There were no deaths from whooping cough or from measles. There was a reduction in the number of dysentery cases notified, namely 30 as against 94 in 1962. It is very satisfying to report a considerable reduction both in the number of notification and in the number of deaths from pulmonary During 1963 46 cases of tuberculosis (all forms) were notified in Battersea as against 75 in 1962 and 63 in 1961. In addition 40 cases as against 49 were reported or otherwise came to the notice of the Health Department, making a total of 88 cases of which we became aware in 1963 as compared with 124 in the previous year. At the end of the year there were 841 as against 947 cases of pulmonary tuberculosis on the Tuberculosis Register. 6 As regards deaths from tuberculosis, the figures are equally gratifying, for in 1963 deaths from pulmonary tuberculosis registered as belonging to the Borough of Battersea numbered 7 as against 12 in the previous year. The table on page 17 shows the death rate expressed per hundred thousand of the population. Thus in 1963 both notifications and deaths from this disease were the lowest ever recorded. As mentioned elsewhere in the report this decline is due to many factors, including modern drug treatment, better housing and living conditions and the vaccination with B.C.G. of school children which was introduced in the Borough in 1955. One of the features of 1963, which might have had an effect on the health of the Borough, was the very severe winter; one of the most severe in living memory, when the extremely cold weather extended into March. During this period, the Health Department was called upon to deal with a number of problems notably in relation to burst pipes, and it was known also that the difficulties of some old people were extenuated during the cold weather. Apart from this, however, there did not appear to be any obvious deterioration in the general health of the Borough, and this is confirmed by the statistics for the year which do not reveal any direct adverse consequences of the severe weather. One might have expected that deaths from pneumonia and bronchitis for that period might have been higher, and in fact during the first quarter of 1963 there was an increase in deaths both of pneumonia and bronchitis as compared with 1962. However, the total number of deaths from these diseases for the whole year showed very little change between the two years. The figures are too small for statistical analysis, and it is not possible to say definitely that the increase in deaths from pneumonia and bronchitis in the first quarter of 1963 was in fact directly due to the cold weather, although, of course, this might have been a factor. The work undertaken by the Department in connection with houses in multiple occupation under the Housing Act, 1961, continued in 1963 and a short account of this work is given in the body of the reportAs I pointed out last year, rapid progress in this work is not to be expected, but certainly some results have been achieved in improving property and one Management Order was made by the Council. The Housing Bill, 1963, has not yet become law, but it seems that some of its provisions will extend to houses in multiple occupation, and it is clear that these two separate but related pieces of legislation will need to be dealt with side by side. The whole problem of houses in multiple occupation and the improvement of existing houses as envisaged under the Housing Bill, 1963, will certainly need further close study. During 1963 the work under the Clean Air Act, 1956, continuedBattersea No. 3 Smoke Control Order became operative during the year and the No. 4 Area has now been put forward by the Council. Owing to the change of policy in relation to gas production, some doubt has been expressed as to future supplies of gas coke. The situation needs to be clarified, as continued uncertainty could impede further progress in this work. The plan on page 35 shows pictorially the progress achieved and proposed. Our efforts in dealing with the care of old people continued during the year, and I am pleased to record the happy relationships and close co-operation received from the Battersea Old People's Welfare 7 mittee and all the other voluntary organisations and social workers in the Borough in this connection. The Home Bathing Service has been welcomed by an increasing number of old people, so that it became necessary to engage additional staff for this purpose. I should like again to thank the many people who have contributed to the work of the Health Department, particularly the Committees and their Chairmen with whose responsibilities I am mainly concerned, and Specially Councillor Miss E. A. Coles, J.P., Chairman of the Health Committee, for her continued help and guidance. I should also like to express my personal thanks to the members of the Health Department for their work during the year and to all Chief Officers and staff of other departments for their help and co-operation. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, June. 1964. J. TUDOR LEWIS, Medical Officer of Health. 8 Public Health in Retrospect 1863-1963 Readers of this Report may be interested in the following extracts and figures taken from the Annual Report by the Medical Officer of Health for the Parish of Battersea, Dr. W. Connor, for the year 1863. Corresponding statistics for 1963 have been given for comparison. The population of Battersea in 1863 was estimated to be 21,230, an increase of 930 over the previous year. (1963—102,940, a decrease of 1,080 compared with 1962.) " The general mortality of this sub-district was higher than that of 1862, but the deaths arising from zymotic, or preventible disease, I am happy to say, have much decreased, which I hope may be attributed to the improved sanitation." The total number of deaths of Battersea residents in 1863 was 445, compared with 411 in 1862 (1963—1,288) and the death rate was quoted and gives the small proportions of 46 deaths in 930 cases treated." "Sickness and Mortality amongst the Out-door Poor." A table attached to Dr. Connor's Report " exhibits the nature and amount of sickness amongst the pauper population of the sub-district compiled from the Medical Relief Books of the Parochial Medical Officer, as well as the deaths that have resulted from disease and other causes, and gives the small proportions of 46 deaths in 930 cases treated." Comparing the proportion of births to deaths, Dr. Connor reports-— "There have been 1,042 (1963—2,361) births during the year; 528 males, and 514 females (1963—1,175 males and 1,186 females), presenting the large excess of 520 births over deaths (1963—1,073) which excess gives, of course, the natural increase of the population. This excess is much larger than has been before noted, which speaks much for the sanitation carried out in this sub-district having exercised a very great influence in promoting the health and comfort of the inhabitants." Among the sanitary operations carried out were the emptying and cleansing of 100 cesspools; the construction of 507 water-closets; 507 houses supplied with water; the provision of 507 dustbins; and 3 pig nuisances were removed. Dr. Connor concludes his Report by saying—" It will be manifest . . . that sanitary improvements have been carried out with the same unabated energy as in previous years." 9 Principal Figures for 1963. Area of Borough, excluding tidal water (acres) 2,164 Home population (1961 Census) 105,870 Home population (Registrar-General's Mid-Year Estimate) 102,940 Structurally separate occupied dwellings 29,008 Births (live 2,361, still 38) 2,399 Live Birth rate 20.87 Deaths—1,288. Death rate 12.76 Maternal Deaths—1. Maternal death rate 0.42 Infant Deaths—47. Infant mortality rate 19.91 10 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 0.91, and for deaths 1.02. POPULATION. The Registrar-General's estimate of the mid-year home population of Battersea was 102,940, which shows a decrease of 1,080 on the previous year's estimated figure of 104,020. This estimate has been adopted for the purpose of the statistics contained in this Report. The population of the Borough at the Census taken in 1961 was 105,870 (50,620 males and 55,250 females, a proportion of 100 males to 109 females). The present estimated population of 102,940 shows a decrease of 2,930 (or 2.8 per cent.). Just over a hundred years ago in the year 1857 the population of Battersea was estimated at 15,970, and appears to have reached its maximum density in 1910 when it was reported to be 188,222. Since then there has been a steady and gradual decline to its present estimated figure of 102,940. BIRTHS. The number of live births registered in the Borough during 1963 was 462 (225 males, 237 females). Of this number 6 were transferred out, the permanent residence of the parents being outside the Borough and 1,893 registered outside the Borough were transferred in, giving on balance a total of 2,361 births (1,175 males, 1,186 females, an excess of 11 females) relating to Battersea residents, and a live birth rate of 20.87 per 1,000 population. All the Battersea births (462 live and 4 still) which occurred within the Borough were "domiciliary births." Illegitimate live births numbered 316 or 13.4 per cent. of the live births. The live birth rate for England and Wales was 18.2. Still-Births. The registration of still-births is made compulsory by the Births and Deaths Registration Act, 1953. During 1963 there were 4 still-births registered in Battersea, all relating to Battersea parents. Thirty-four still-births occurring outside the Borough were registered as belonging to Battersea, making 38 in all, representing a still-birth rate of 15.84 per thousand births (live and still) registered. Of the 38 still-births 6 (15.8 per cent.) were registered as illegitimate. The number of Battersea still-births registered and the still-birth rate from 1954 to 1963 were as under : — No. Rate No. Rate 1954 50 28.0 1959 36 17.42 1955 32 18.1 1960 35 17.78 1956 48 26.42 1961 37 19.93 1957 51 27.01 1962 44 19.73 1958 39 20.34 1963 38 15.84 The still-birth rate in 1963 for England and Wales was 17.33 11 MARRIAGES. The marriages registered in Battersea during 1963 numbered 949 The marriage rate (i.e., the number of persons married per 1,000 of the population) was 18.4. Year Marriages Marriage Rate 1958 876 15.7 1959 876 16.2 1960 961 17.9 1961 935 17.8 1962 949 18.1 Mean 1958/62 919 17.1 1963 949 18.4 The marriage rate for England and Wales was 14.9 DEATHS. The number of deaths registered in the Borough during 1963 was 2,452. Of these, 1,531 were deaths of non-residents and were transferred the districts in which the persons ordinarily resided. There were, on the other hand, 367 deaths of Battersea residents registered outside the Borough. The total (corrected) number of deaths belonging to the Borough was 1,288 (610 males and 678 females). This gives a recorded death rate of 12.76. The rate for England and Wales was 12.2. Of the 1,288 Battersea deaths 900 (or 69.9 per cent.) occurred in hospitals etc. The average age at death is shown in the following table : — Average Age at Death. 1945 62.4 1955 67.7 1946 61.4 1956 66.9 1947 62.6 1957 67.2 1948 63.3 1958 68.3 1949 65.3 1959 67.7 Mean, 1945/1949 63.0 Mean, 1955/59 67.6 1950 65.5 1960 66.9 1951 66.7 1961 67.4 1952 67.7 1962 68.5 1953 68.9 1963 68.2 1954 67.2 Males 64.9 Mean, 1950/1954 67.4 Females 71.0 12 The deaths of 868 residents of Battersea aged 65 years and upwards were registered during 1963. These 868 deaths constituted 67.4 per cent. of the total deaths at all ages. The natural increase of population (that is, excess of births over deaths) was 1,073 in 1963 as compared with 841 in 1962. The causes of the 1,288 deaths in 1963, classified in age groups, are shown in the following table, compiled from figures supplied by the Registrar-General: — Causes of Death in Age Groups during 1963. Causes of Death Sex All Ages Per cent of total —4 wks. 4 wks. to 1 year 1— 5— 15— 25— 35— 45— 55— 65- 75 All causes Percentage of Males m. 610 47.36 13 11 5 2 7 7 18 60 125 164 198 100.0 21 1-8 0-8 0-3 11 11 30 98 20-5 2/-0 32.5 Percentage of Females f. 678 5?:64 12 11 3 1 6 7 13 40 79 136 370 100.0 1.8 1.6 0.4 0.1 0.9 1.0 1.9 5.9 11.7 20.1 54.6 1. Tuberculosis, respiratory m. 3 0.21 – – – – – – – 1 – 1 1 f. 4 0.31 – – – – – – – 1 2 1 – 2. Tuberculosis,other forms m. – – – – – – – – – – – – – f. 1 0.08 – – – – – – – – 1 – – 3. Syphilitic disease m. 2 016 – – – – – – – – – 1 1 f. 2 016 – – – – – – – – 1 – 1 4. Diphtheria m. – – – – – – – – – – – – – f. – – – – – – – – – – – – – 5. Whooping cough m. – – – – – – – – – – – – – f. – – – – – – – – – – – – – 6. Meningococcal infections m. 1 0.08 – – – – – – – – 1 – – f. 3 0.23 – 1 2 – – – – – – – – 7. Ac. poliomyelitis and polio-encephalitis M. – – – – – – – – – – – – – f – – – – – – – – – – – – – 8. Measles m. – – – – – – – – – – – – – f. – – – – – – – – – – – – – 9. Other infective and parasitic diseases m. 1 0.08 – – – – – – – – 1 – – f. 1 0.08 – – – – – – – – – 1 1 10. Cancer of stomach m. 11 0.85 – – – – – – – 2 4 4 3 f. 12 0.93 – – – – – – – 2 4 5 11. Cancer of lung, bronchus m 57 4.43 – – – – – – 2 7 73 20 2 f. 11 0.85 – – – – – – 2 4 3 – 12. Cancer of breast M – – – – – – – – – – – – – f. 23 1.79 – – – – – – 3 4 7 2 7 13. Cancer of uterus m. – – – – – – – – – – – – – f. 13 1.01 – – – – – – – 5 5 2 1 14. Cancer of other sites m. 53 4.12 – – – – 1 2 5 6 12 11 16 f. 54 4.20 – – – – 1 – 2 4 13 10 24 15. Leukaemia, aleukaemia m. 3 0.23 – – – – 1 – – 2 —. – – F. 2 0.16 – – – – – – 1 1 – – – 13 Causes of Death, 1963—(contd.). Causes of Death Sex All Ages Per cent of total wks. 4 wks. to 1 year 1— 5— 15— 25— 35— 45— 55— 65— 75— 16. Diabetes m. 4 0.31 — — — — — 1 — 1 — — 2 f. 7 0.54 — — — — — — 1 1 1 3 1 17.Vascular lesions of vous system m. 52 4.04 — — — — 1 — — 4 10 13 24 f. 112 8.69 — — — — — 1 —— 8 9 20 74 18. Coronary disease, angina M. 114 8.85 — — — — — — 4 14 29 34 33 f. 79 6.13 — — — — — — 1 1 6 29 42 19. Hypertension with heart disease M. 8 0.62 — — — — — — — 1 — 4 3 f. 13 1.1 — — — — — — — — — 4 9 20. Other heart disease m. 54 4.20 — — — — — 1 —_ 5 5 14 29 f. 106 8.3 — — — — — — 1 3 6 19 77 21. Other circulatory disease m. 26 2.02 — — — — — — — — 6 4 16 f. 39 3.3 — — — — — — 1 2 5 9 22 22.Influenza M. 5 0.39 — — — — — — — — — 1 4 f. 3 0.23 — — — — — — — — — — 3 23.Pneumonia m. 44 3.42 1 5 1 — — — — 2 5 9 21 f. 51 3.96 — 4 — — — — — — — 4 43 24.Bronchitis m. 66 5.12 — 1 — — — — — 5 11 26 23 f. 33 2.56 — — — — — — — 1 4 11 17 25.Other diseases of atory system M. 17 1.32 — — — — 1 — 1 3 4 6 2 f. 7 0.54 — — — — — 1 —— — — — 6 26. Ulcer of stomach and duodenum M. 8 0.62 — — — — — — 2 — — 2 4 f. 1 0.08 — — — `— — — — — — — 1 27.Gastritis, enteritis and diarhoea m 1 0.08 — — — — — — — 1 — — — f. 5 0.39 — 1 — — — — — — 1 1 3 28. Nephritis and nephrosis M. 4 0.31 — — — 1 — — — 2 — — 1 f. 5 0.39 — — — — — 1 — — 2 —— 2 29.Hyperplasia of prostate M. 6 0.47 — — — — — — — — — — 6 f. — — — — — — — — — — — — — 30. Pregnancy, childbirth, abortion M — — — — — — — — — — — — — f. 1 0.08 — — — — 1 — — — — — 31. Congential ations m. 6 0.47 — 3 1 — — — — — — 2 — f. 7 0.54 1 3 — — 1 — — — 1 1 —— 32. Other defined and defined disease M. 36 2.79 12 2 — — — 1 — — 10 8 3 f. 61 4.74 10 1 — 1 — 1 2 3 4 12 27 33. Motor vehicle accidents M 9 0.69 — — 2 — 2 1 1 — 1 1 — F. 4 0.31 — — — — — — 1 — 1 1 1 34. All other accidents M. 12 0.93 — — 1 1 1 — — 3 2 1 3 F. 9 0.69 1 1 1 — 1 — — — — 1 4 35.Suicide M. 7 0.54 — — — — — 1 — 1 1 1 — f. 9 0.69 — — — — 2 3 — 2 2 — — 36.Homicide and operations of war M. — — — — — — — — — — — — — f. — — — — — — — — — — — — — 14 Cancer Deaths During 1963 the number of deaths of Battersea residents from cancer was 234 (121 males, 113 females), as compared with 247 in 1962. The death rate from the disease per 1,000 of the population was 2.27. The deaths from cancer constitute 18.2 per cent, of the total Battersea deaths during the year. The following gives the comparative average death rates from cancer in Battersea for quinquennial periods since 1901. 1901-1905 0.88 1931-1935 1.75 1960 2.45 1906-1910 0.95 1936-1940 1.99 1961 2.36 1911-1915 1.11 1941-1945 2.44 1962 2.38 1916-1920 1.28 1946-1950 2.11 1963 2.27 1921-1925 1.33 1951-1955 2.07 1926-1930 1.51 1956-1960 2.29 Details in age groups and the location of this disease will be found on page 12. Infant Mortality. During 1963 the death of 47 infants under 1 year of age were registered as belonging to Battersea. The total number of live births registered during the year was 2,361, giving an infant mortality rate of 19.91 per 1,000 live births as compared with 20.59 in 1962 and 21.41 in 1961. The infant mortality rate in England and Wales during 1963 was 20.9. The following table sets out the causes of death in detail. Infant Mortality, 1963. Nett deaths from stated causes at various ages under 1 year. CAUSES OF DEATH AGE PERIODS ' Under 24 hours 1-6 days Weeks Total under 4 weeks Months Total deaths under 1 year Percent age of Total 1 2 3 1-3 4-6 7-9 10-11 M. F. M. F. m. F. m. F. m. F. m. F. m. F. m. F. m. F. m. F. m. F. Meningococcal septicaemia — — — — — — — — — — — — — — — 1 — — — — — 1 2.1 Pneumonia — — 1 — — — — — — — 1 — l 4 2 — 2 — — — 6 4 21.3 Bronchitis — — — — — — — — — — — — — — 1 — — — — — 1 — 2.1 Gastritis — — — — — — — — — — — — — 1 — — — — — 1 2.1 Congenital malformations — — — 1 — — — — — — — 1 2 1 1 2 — — — — 3 4 14.9 Other defined and ill-defined diseases:— Prematurity 4 3 1 1 1 2 .— — 1 — 7 6 — — — — — — — — 7 6 27.7 Other causes 2 2 3 1 — — — — — 1 5 4 — 1 2 — — — — — 7 5 25.5 Accident — 1 — — — — — — — — — 1 — — — 1 — — — — — 2 4.3 6 6 5 3 l 2 — — 1 1 13 12 3 6 6 5 2 — — — 24 23 100.0 TOTALS 12 8 3 — 2 25 9 11 2 — 47 Percentage of total 25.5 170 6.4 — 4.3 53.2 19.1 23.4 4.3 — 100.0 M.51.1 F.48.9 15 There were 25 deaths of infants during the first four weeks of life (or 53.2 per cent. of the total infant deaths) as compared with 30 deaths (or 66.7 per cent.) in 1962 and a percentage for the quinquennium of 1958-1962 of 70.9. Table showing Deaths of Infants under 1 day, under 1 week and under 4 weeks from 1958 to 1963. Year Under 24 hours 1 to 6 days 1 to 3 weeks Total under 4 weeks Percentage deaths under 4 weeks of total infant deaths 1958 24 6 5 35 77.8 1959 13 13 2 28 63.6 1960 11 11 3 25 71.4 1961 15 12 6 33 75.0 1962 16 11 3 30 66.7 Mean 16 11 4 30 70.9 1963 12 8 5 25 53.2 Deaths of Illegitimate Infants The death rate amongst illegitimate children during 1963 was -2.15 per 1,000 illegitimate live births, as compared with 32.45 in 1962. The corresponding death rate of legitimate children in 1963 was 19.56, the ratio of mortality rate of illegitimate infants to that of legitimate being 113 to 100. The corresponding figure for 1962 was 176 to 100. Maternal Mortality. There was one death from "diseases or accidents of child-birth" during 1963, which is equivalent to a fatality rate of 0.42 per 1,000 births (live and still). This was due to septic abortion. The rate for England and Wales in 1963 was 0.28. Comparative Statistics of Births, Mortality, etc. (Compiled from Registrar-General's Returns.) Year Population Live Birth Rate Death Rate Maternal Death Rate Infant Mortality Rate 1953 114,800 14.25 12.45 0.55 18.6 1954 114,300 13.98 9.77 0.56 19.0 1955 113,700 14.08 11.02 1.69 24.7 1956 112,900 14.60 10.80 1.65 23.7 1957 111,800 15.44 11.09 1.59 22.3 1958 110,400 16.16 11.07 0.52 23.9 1959 108,500 17.96 11.63 0.97 21.7 1960 107,120 17.50 10.09 0.00 18.1 1961 104,980 19.18 10.87 0.00 21.4 1962 104,020 20.81 11.90 0.45 20.6 1963 102,940 20.87 12.76 0.42 19.9 16 Infectious and Other Diseases. During the year 937 notifications of infectious disease were received which when compared with 424 in 1962 shows an increase of 513. This increase was anticipated for 1963 was a "measles year", the number of cases notified being 703 as compared with 165 in 1962. For the second year in succession no cases of poliomyelitis occurred in the Borough. There were no cases of smallpox during the year but two indirect contacts arrived from endemic areas. As they were not in possession of valid international certificates of vaccination against smallpox they were visited daily for 17 days. It is interesting to note that the number of tuberculosis notifications received during 1963 was the lowest ever recorded in Battersea—46 (all types) as compared with 75 (all types) in 1962. The number of notifications received each year has been steadily declining for the past ten years both in pulmonary and non-pulmonary cases, 152 pulmonary and 13 non-pulmonary in 1953 to 41 and 5 respectively this year. This decline is, of course, due to many factors including modern chemotherapy, better housing, nutrition and, of course, B.C.G. vaccination of schoolchildren which was introduced into the Borough during 1955. Analysis of Cases (after Correction of Diagnosis) of Infectious Disease Notified during the Year 1963. Notifiable Disease Cases Notified in Battersea, in Age Groups Total 0— 1— 2— 3— 4— 5— 10— 15— 25— 45— 65 & over Anthrax — — — — — — — — — — — — Diphtheria — — — — — — — — — — — — Dysentery 30 2 3 4 1 1 4 1 3 8 2 1 Encephalitis (acute): — Infective — — — — — — — — — — — — Post-infectious — — — — — — — — — — — — Enteric (typhoid or typhoid) fever — — — — — — — — — — — — Erysipelas — — — — — — — — — — — — Food poisoning 11 — 1 — — — — — 3 3 2 2 Malaria — — — — — — — — — — — — Measles 703 34 78 103 105 107 257 11 7 1 — — Membranous croup — — — — — — — — — — — — Meningococcal infection 4 2 — — 1 1 — — — — — — Ophthalmia neonatorum — — — — — — — — — — — — Pneumonia, acute primary 20 5 1 — 1 — 3 2 — 2 3 3 Pneumonia,acute influenzal 9 — — — — — — — — — 4 5 Poliomyelitis (acute):— Paralytic — — — — — — — — — — — — Non-paralytic — — — — — — — — — — — — Puerperal pyrexia — — — — — — — — — — — — Scabies — — — — — — — — — — — — Scarlet fever 9 — — — 3 1 3 1 — 1 — — Smallpox — — — — — — — — — — — — Tuberculosis:— Pulmonary 41 — — 1 1 — — 1 7 12 17 2 Non-pulmonary 5 — 1 — 1 — 1 1 — 1 — — Whooping cough 105 14 14 18 14 8 27 9 1 — — — Totals 937 57 98 126 127 118 295 26 21 28 28 13 17 TUBERCULOSIS. During the year 1963 there were 46 cases of tuberculosis (all forms) notified in Battersea as compared with 75 in 1962, 63 in 1961, 79 in 1960, 75 in 1959 and 75 in 1958. In addition 42 cases were reported or otherwise came to the knowledge of the Medical Officer of Health, making a total of 88 cases for the year. The case rate per 1,000 population (excluding inward transfers) was 0.45 or 45 per 100,000. At the end of the year there were 841 Pulmonary cases and 47 non-pulmonary cases of tuberculosis on the Register. This is equal to a morbidity rate per 1,000 population of 8.17 in the case of pulmonary, and 0.46 in the case of non-pulmonary tuberculosis or 8.63 both types. The tables on page 18 give details of additions and deletions of cases on the Register during the year. Deaths from Tuberculosis. During 1963 deaths from tuberculosis registered as belonging to the Borough of Battersea numbered 8, of which 7 were due to pulmonary tuberculosis and 1 to other forms of the disease. The death rates per 100,000 of the population during the 60 years ended 1960 in quinquennial averages, and for the years 1961, 1962 and 1963, are given in the following table : — Years Pulmonary NonPulmonary Total 1901-1905 138.1 50.9 189.0 !906-1910 126.8 45.9 172.7 19ll-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 1951-1955 22.1 2.8 24.9 1956-1960 9.7 1.1 10.8 Average (60 years) 86.9 20.2 107.1 1961 11.4 1.0 12.4 1962 11.5 11.5 1963 6.8 1.0 7.8 The death rate per 100,000 population was 6.3 for England and Wales. 18 Tuberculosis, 1963. 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, 31/12/62 518 429 947 25 28 53 543 457 1,000 Primary notifications 24 17 41 3 2 5 27 19 46 Notified after death — — — — — — — — — Unnotified deaths 2 — 2 — — — 2 — 2 Restored — — — — — — — — — Removals into Borough 18 21 39 — 1 1 18 22 40 From other sections — — — — — — — — — TOTAL ADDITIONS 44 38 82 3 3 6 47 41 88 Deaths 14 8 22 — 1 1 14 9 23 Notified after death — — — — — — — — — Unnotified deaths 2 — 2 — — — 2 — 2 Removals from Borough 38 42 80 3 1 4 41 43 84 Recovered 50 32 82 4 3 7 54 35 89 Diagnosis not confirmed 1 1 2 — — — 1 1 2 To other sections — — — — — — — — — TOTAL DELETIONS 105 83 188 7 5 12 112 88 200 Net increase — — — — — — — — — Net decrease 61 45 106 4 2 6 65 47 112 On Register at 31/12/63 457 384 841 21 26 47 478 410 888 Formal Notifications, 1963. Number of primary notifications of new cases of tuberculosis Age Periods 0— 1— 2— 5— 10— 15— 20- 25— 35— 45— 55— 65— 75— Total (all ages) Respiratory Males — — 2 — — 2 — 4 4 2 9 1 — 24 Respiratory Females — — — — 1 3 2 2 2 4 2 — 1 17 Non-Respiratory Males — — — 1 1 — — 1 — — — — — 3 Non-Respiratory Females — 1 1 — — — — — — — — — — 2 19 New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health otherwise than by formal notification. Source of information Number of cases in age groups 0— 1— 2— 5— 10— 15— 20— 25— 35— 45— 55— 65— 75— Total Death returns from local registrars r. M — — — — — — — — — — 1 — — 1(a) F — — — — — — — — — — — — — — (b) n.r M — — — — — — — — — — — — — — (c) F — — — — — — — — — — — — — — (d) Death returns from Registrar- General (transferable deaths) r. M — — — — — — — — 1 — — — — 1(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 cluding ferable deaths) r. M — — — — — 1 — 7 7 1 2 — — 18(a) F — — 3 2 — — 1 8 3 3 — 1 — 21 (B) n.r M — — — — — — — — — — — — — — (c) F — — — — — — — 1 — — — — — 1 (d) R.- Respiratory. Totals (A) 20 N.R.-Non-Respiratory. „ (B) 21(C)— ,,(D) 1 Total number of informal notifications 42 Diphtheria, Tetanus and Whooping Cough Immunisation, Smallpox and Poliomyelitis Vaccination. Diphtheria, tetanus and whooping cough immunisations and vaccination against smallpox and poliomyelitis were carried out during the year under the arrangements made by the London County Council. 20 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 1963, 563 certificates were authenticated. London County Council (General Powers) Act, 1959, Section 26. This section is concerned with the prevention of the spread of notifiable infectious diseases, and the diseases to which section 23 of the Food and Drugs Act, 1955, applies. It authorises a Metropolitan Borough Council, if they think fit, to compensate a person who is required by the Medical Officer of Health to cease his or her employment to prevent the spread of the disease. The Health Committee decided that compensation to be paid should be based on the merits of each case reported. No cases were dealt with during the year. 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 examinations. BACTERIOLOGICAL EXAMINATIONS During the year 690 examinations were made as follows : — Description Disease Number of Specimens Positive Results Faeces Dysentery or Food Poisoning 669 119 Throat Swabs Diphtheria 21 — 21 Sanitary Circumstances. The following table sets out in summarised form the details of the work of the Department in relation to sanitation: — Inspections— Complaints 2,984 Rent Act 47 Urinals and conveniences 449 Caravans 150 Water certificates 78 Infectious disease cases— Notifiable 124 Non-notifiable 15 Drainage 3,237 Shops (Shop Act) 66 Rag flock premises 6 Pet shops 28 Hairdressers 149 Rodent control 4,008 Other visits 4,959 Re-inspections 9,281 Notices served— Public Health (London) Act, 1936— Fifth Schedule (Intimation) 1,146 Fifth Schedule (Statutory) 467 Section 197, etc. (Infectious Disease) 9 L.C.C. (General Powers) Acts 116 Shops Act, 1950 3 Factories Act, 1961 23 Pood Hygiene Regulations, 1960 26 Summonses issued 72 Magistrates' Orders obtained 29 Other work carried out— Dangerous structures referred to District Surveyor 79 Water waste referred to M.W.B 52 Drains- Smoke tests 98 Water tests 1,272 Found defective 65 Water certificates issued 26 Land Charge enquiries 1,870 remises disinfected 1,054 Articles disinfected 7.976 Personal Cleansing Treatments— To adults 152 To children 219 Defects Remedied— Drains— Repaired 96 Reconstructed 34 Sealed off 134 Ventilated 56 Cleared 186 Frontages laid 27 Roofs repaired 466 Rainwater pipes and gutters renewed/repaired 210 Dampness remedied 605 Waste pipes renewed/ repaired 89 Water closets repaired or cleansed 191 Water closets installed 142 Water cisterns cleansed or repaired 23 Water supplies reinstated 147 Water fittings renewed or repaired 126 Additional water supply to tenement houses — Sinks, lavatory basins, baths renewed 79 Plaster renewed 580 Floors and stairs repaired 137 Doors and windows repaired 195 Fireplaces and flues repaired 55 Additional lighting, ventilation 4 Rooms cleansed 43 Premises disinfected 132 Dustbins provided 62 Yard paving renewed or repaired 39 Other defects remedied 253 Rodent control— Premises dealt with— Rats 292 Mice 96 22 Legal Proceedings. During the year, legal proceedings were taken by the Council in 79 cases, for the enforcement of various Acts, By-laws, Regulations, etc., administered by the Health Department. A summary is set out below:- Cases Public Health (London) Act, 1936 72 Housing Act, 1957 2 Food and Drugs Act, 1955, and Food Hygiene (General) Regulations, 1960 4 London County Council (General Powers) Act, 1959 1 79 Fines totalling £38 0s. 0d. were imposed in connection with these proceedings, and £39 0s. 0d. costs were awarded to the Council. Public Health (London) Act, 1936. The provisions of this Act in regard to Nuisances continued to afford the main means whereby the remedy of insanitary conditions found in dwelling-houses could be secured. During the year, Intimation Notices (relating to 845 premises) and Statutory (Nuisance) Notices (relating to 487 premises) were served. It was found necessary to refer 163 cases to the Council's Solicitor with instructions to take steps, by legal proceedings if necessary, to enforce compliance with Statutory Notices. In 91 of these cases a warning letter from the Solicitor had the desired effect. In the remaining 72 cases, however, summonses had to be issued. As a result, Nuisance Orders were made by the Court in 29 instances. The remaining 43 summonses were ultimately withdrawn, the Notices having been complied with subsequent to the issue of the summonses. Defective conditions in 801 houses were remedied—438 by owners following the service of Intimation Notices; 416 by owners following the service of Statutory Notices, and in 17 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. London County Council (General Powers) Act, 1955. Section 25 of the above Act relative to choked drains was used on 87 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 30 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. Notice were served on nine occasions and in seven cases the Council did the work in default. 23 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. It was necessary to serve 15 such notices during the year, and the Council carried out the work in default of the owner on eight occasions. London County Council (General Powers) Act, 1925, Section 33. Because of recurring nuisances arising from the deposition of insanitary refuse, and the improper use of open sites, action was taken under the provisions of the above Section. Three Notices were served, and in each instance the Council carried out the clearance and the enclosure of the site in default of the owner, the cost being chargeable to the owner. Dustbins. During the year, five notices were served under Section 12 of the London County Council (General Powers) Act, 1954, concerning the Provision of dustbins, and 62 dustbins were provided, 3 being supplied by the Council in default of the owners, from whom the cost was afterwards recovered. 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 officers of the Department. Drains were constructed to 401 new dwellings, and 193 plans of Proposed work were deposited in connection with drainage generally, During the year, 98 drains were tested with smoke—65 of these were round to be defective. The water test was applied on 1,272 occasions to drains in the course of construction. 27 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. In 4 instances it was necessary to request the Council's Solicitor to take legal action for non-compliance with the By-laws in connection with the failure by persons concerned to notify the Council of the work to be carried out, or work carried out which did not comply with the requirements of the By-laws. In each instance the By-laws were complied with before summonses were heard. Sewerage and Sewers. The sewerage system, in common with other London Boroughs, discharges into the main London County Council's sewers, and disposal is carried out by the County Council. The Borough Council's brick and pipe sewers are regularly cleansed, and are adequate for their purpose. Occasional back-flooding is experienced in the lower part of the Borough during heavy summer storms; these conditions are receiving attention the London County Council are reconstructing and enlarging some their existing main sewers with a view to overcoming this problem. 24 Reconstruction of the pumping station at Creek Street is in hand, and a new pumping station has been constructed at Nine Elms. This station has been functioning for approximately a year with noticeable effect in the Silverthorne Road area. No complaints of sewer surcharge and consequential back flooding were received during the year from this area. Complaints of backflooding in those areas of the Borough generally affected were less during the year, and were not as serious in their consequences. Water Supply. The major part of the water supply in Battersea, in common with other Metropolitan Boroughs, is obtained from the mains of the Metropolitan Water Board, who are responsible for its purity, and with whom close liaison is maintained. One part of the Borough, however, namely the Council's Latchmere Estate, is supplied from deep wells situated at the Latchmere Baths adjoining the Estate. Bacteriological examination of the well-water before chlorination, and prior to its supply to the Estate, is carried out at fortnightly intervals. Chemical analysis shows no significant change in the character of the water. In the event of a breakdown of the pumping apparatus serving the Latchmere Estate, or any other contingency, the system can be adjusted to receive water from the mains of the Metropolitan Water Board. All the premises in the Borough have a mains water supply. During the year 26 certificates under Section 95 (2) of the Public Health (London) Act, 1936, were issued in respect of 401 new or re-erected dwellings. Fifty-two notices of waste of water from defective fittings, etc., observed during routine inspections of various premises, were sent to the Metropolitan Water Board. Caravans. All caravan sites in the Borough are licensed under the provisions of the London County Council (General Powers) Act, 1959. The conditions attaching to licences granted relate to the number of moveable dwellings which may be kept on any particular area of land ; the amount of free space between the dwellings ; the provision of a water supplysanitary conveniences, adequate paving, dustbin accommodation, fire protection arrangements and the prevention of nuisance from noise. The five sites in the Borough are regularly inspected, and during the year 150 inspections were made. During the year a summons was issued against the owner of a caravan for using it on land without a licence, contrary to Section 22 of the Act. The defendant, who pleaded "not guilty", was fined 10s. 0d., and removed the caravan from the site. Mobile Dwellings. In addition to the five permanent sites, during the year licences have been granted on the application of the London County Council for the siting of " mobile " dwellings on areas of land cleared for development 25 Purposes, but not required for immediate use. The sites covered are as follows:— Stainforth Road 29 bungalows Site of Nos. 2/13 Arden Street 9 bungalows The intention is to move these dwellings on to other sites when the site so used is required for permanent building. It is on this basis that the dwellings are erected—the drainage being of pitch fibre, which can be readily moved from site to site, and in place of concrete over-site, Pre-cast paving slabs are used and jointed. Prevention of Damage by Pests Act, 1949. This Act gives power generally to the Council to require steps to be taken to eradicate infestation of rats and mice and where possible to Prevent infestations occurring. These duties are carried out by the Senior Rodent Operative, 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 baiting of sewers under the control of the Council is undertaken three times during the year. Similar work is carried out by all London Boroughs, and has the result of reducing the rat population not completely, but to an irreducible minimum. The following table shows the number of premises inspected which were found to be infested with rats or mice: — Property Infested by Rats Mice Major Minor Major Minor Council's properties — 4 1 — Dwelling houses — 249 19 63 Business premises — 39 6 7 —. 292 26 70 The total number of visits made to the above premises, and to others which were found not to be infested, was 4,008. Verminous Premises. During the year 64 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. This is a considerable reduction in verminous premises dealt with compared with last year, when the figure was 140. 26 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 informed for any action he may decide to take. There were 79 such cases notified during the year. 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, 1,870 enquiries were dealt with. Shops Act, 1950. It is the duty of the Council to carry out the requirements of Section 38 of the Shops Act, 1950. Inspections are carried out with regard to the provision of ventilation to shops; the means for providing a reasonable temperature; adequate and suitable sanitary conveniences for the use of persons employed in or about a shop; adequate lighting; suitable washing facilities, and suitable facilities for the taking of meals in a shop where this is considered necessary. During the year 66 inspections were made, and 3 notices were served in connection with the provision of the required facilities. Common Lodging Houses. There are no registered common lodging houses in the Borough. Rag Flock and Other Filling Materials Act, 1951. There are three registered premises in the Borough at which filling material other than rag flock are used. Samples of the fillings used are submitted for analysis. There are no premises at present dealing with rag flock. Six visits were made to registered premises during the year, but no contravention of the Act was discovered. Rag Dealers and Sorters. Premises occupied by rag sorters in the Borough are subjected to regular inspection. During the year 90 inspections were made. 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. Pharmacy and Poisons Act, 1933. This Act is chiefly concerned with the distribution by sale or otherwise of poisonous substances. The list of poisons is contained in Order made under the Act. This Order is divided into Part I and 27 Part II. With the poisons contained in Part I, the Council are not concerned, since an "authorised seller" is a pharmacist registered with the Pharmaceutical Society, and enforcement is entrusted to Inspectors appointed by that Society. Substances specified in Part II may be sold by "listed sellers" and these are persons who, on written application in a prescribed form, and on payment of stated fees, are recorded by the Council as "persons entitled to sell poisons in Part II of the Poisons List" at the premises recorded on the Register. The Council are required to enforce the Act and Orders so far as they relate to "listed sellers" and have appointed the Public Health Inspectors as Inspectors under the Act. At the end of the year there were 83 persons registered under the Act. Pet Animals Act, 1951. The object of the Act is to regulate the sale of pet animals, with particular reference to their welfare whilst 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 10 shops and 28 visits were made during the year. Animal Boarding Establishments Act, 1963. This Act provides that no person may keep a boarding establishment for animals (i.e. cats and dogs) in the Borough except under the authority of a licence granted by the Council. Considerations which the local authority must have in mind before granting a licence are laid down, and an applicant has the right of appeal to a Magistrates' Court. Contravention of the Act is punishable on summary conviction by a fine not exceeding £25, or imprisonment for not exceeding three Months, or both. The Council charge a fee of ten shillings in respect of the grant of a licence, and have authorised the Health Committee to act on its behalf for the purposes of the Act. They have also authorised the Medical Officer of Health and the Public Health Inspectors to carry out inspections in this connection The operative date of the Act was 1st January, 1964. Barbers and Hairdressers. London County Council (General Powers) Act, 1954—Section 18. . The Council, under the provisions of the above-named Section, registers all barbers and hairdressers and their premises. At the end of the year there were 91 registered premises in the Borough, and 149 inspections were carried out. Noise Abatement Act, 1960. Since the passing of this Act, the number of complaints concerning noise have grown considerably. in prior to the passing of the Act, the law governing noise nuisance in London was contained in the London County Council (General Powers) Act, 1937, which provided that any "excessive, unreasonable unnecessary noise which was injurious to health "could be dealt 28 with summarily as a nuisance. The proof necessary to satisfy these requirements before Court procedure could be instituted was often difficult to obtain. The new Act substitutes for these words "noise which is a nuisance'', and the procedure is thereby simplified, the nuisance depending on opinion. It is not necessary to prove injury to health, or that the noise was excessive, unreasonable or unnecessary. With regard to industrial noise, however, it is still a good defence to prove that the best practicable means have been used to prevent or counteract its effect. As well as the Council having authority to take action, any three persons who are aggrieved by a noise nuisance can take action by complaining to a Magistrate. It has been the practice of the Health Department to take all the necessary action when complaints of noise have arisen in connection with a trade or business. Industrial noise clearly has a health angle, in that it is often continuous and of considerable intensity. The service of Notices has not been necessary, because a letter calling attention to the complaint has invariably had the desired results. Complaints, however, received from persons who complain that rowdy parties take place at certain times in adjoining premises, or that the person in the flat above causes undue noise, are not considered the type of complaint that should be dealt with by the Inspectors. There would appear to be no specific hazard, but rather a personal problem arising from, in the majority of cases, behaviour difficulties between neighbours. This is the type of complaint that could well be dealt with by the persons aggrieved. Consumer Protection Act, 1961. This Act repealed the Heating Appliances (Fireguards) Act, 1952, and the Oil Burners (Standards) Act, 1960, but Regulations made under the former Act concerning fireguards on certain heating appliances offered for sale are still in force, and new Regulations have been made concerning oil burners, specifying standards of safety, and prohibiting the sale of oil heaters or component parts which do not comply with the Regulations. No contraventions of the Regulations were reported during the year. Licensing Act, 1961. Under Section 31 of the Licensing Act, 1961, it is provided that where a Club applies for a registration certificate for the sale intoxicating liquor in respect of any premises, an Officer of the Local Authority, authorised in writing, may inspect the premises. The Public Health Inspectors have been so authorised. The inspection is primarily concerned to see that adequate sanitary facilities are available, but the Inspector is also required to report upon the suitability of the premises for the proposed use. Following an adverse report by an Inspector on one such case, and an objection by the Council, the application for renewal of a registration certificate was refused by the Magistrate, and the premises were disqualified from occupation and use as a registered club for twelve months. 29 Housing. Provision of New Accommodation. During the year 1963 construction of the following 401 new dwellings was completed:— By the Battersea Borough Council:— Dwellings 10/15 (consec.) Dickens Street 6 2/20a (even) Elspeth Road 16 Gagarin House, Winstanley Road 35 1, 3, 5 Gowrie Road 3 Humphrey Court, Battersea High Street 16 Kiloh Court, Winstanley Road 24 Lindsay Court, Battersea High Street 60 1 / 7b (odd) Mysore Road 8 59, 60, 61 Parma Crescent 3 Prichard Court, Granfield Street 8 20/28 (even) Taybridge Road 5 30/35 (consec.) Trollope Streeet 6 190 By the London County Council:— Eden House, Falcon Estate 24 Ridley House, Falcon Estate 24 Temple House, Falcon Estate 24 Tidbury Court, Tidbury Street 12 Tidbury House, Tidbury Street 54 Mobile dwellings:— Sleaford Street 3 Stainforth Road 33 — 174 By Private Owners:— 2 Albert Bridge Road 3 "Old Swan" P.H., Battersea Church Road 1 109 Chatham Road 1 307, 309 Eversleigh Road 2 58, 60 Grayshott Road 6 79, 79a Kyrle Road 2 St. Anthony's Court, Nightingale Lane 18 19, 20 Sudbrooke Road 2 58, 60 Wickersley Road 2 37 401 Slum Clearance. During the year, six small areas (Barmore Street Areas Nos. 1-6) ■n Winstanley Road Scheme XII—Part I, and one area in the York ^°ad Area (Stage I) (Part I), were represented for slum clearance, and were declared as clearance areas by the Council. A total of 211 houses ere inspected, and 100 were represented as unfit. Inspections made during 1963 totalled 507. 30 Closing Orders. Under Section 17 of the Housing Act, 1957, four Closing Orders in respect of dwelling houses were made during the year; 19 underground rooms and 4 rooms in other parts of dwellings were closed under Section 18 of the Act. Legal proceedings were taken against a tenant for unlawfully using underground rooms in contravention of Closing Orders contrary to Section 27 (1) of the Act, and against the landlord for permitting such use. Both defendants pleaded "Guilty", and each were fined £5 and ordered to pay £1 costs. Demolition Orders. One Demolition Order, in respect of a caravan, was made during the year. Overcrowding. Nine cases of overcrowding creating offences against the provisions of Section 78 of the Housing Act, 1957, were investigated and appropriate action taken to secure the abatement of the overcrowding. Houses in Multiple Occupation. An area comprising approximately 130 houses is at present being inspected, and providing undertakings are received from the owners of properties to carry out all the necessary work, including the provision of additional facilities and the means of escape in case of fire, formal notices are not served. In the event of work in connection with these undertakings not being carried out within a reasonable time, authority is obtained from the Housing Committee to serve formal notices. No displacement of persons from premises, because of the use of rooms in the premises to provide additional facilities for the families in occupation, has yet occurred. The standards required are based on those suggested by the Metropolitan Boroughs' Standing Joint Committee and cover:— natural and artificial lighting ; ventilation; water supply; personal washing facilities; drainage and sanitary conveniences; facilities for the storage and preparation and cooking of food, and the disposal of waste water; installations for space heating, or for the use of space heating appliances. One notice, under Section 12 (2) of the Housing Act, 1961, of the Council's intention to make a Management Order was served, and the Order was duly made. 31 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 13 Decisions to issue Certificates of Disrepair (Form J) 14 Undertakings received from landlords (Form K) 5 Undertakings received from landlords (Form K) accepted 5 Certificates of Disrepair (Form L) issued 7 Certificates of Disrepair refused Nil Applications for cancellation of Certificates of Disrepair (Form M) received 16 Cancellations of Certificates of Disrepair issued 12 Applications for Certificate re undertakings (Form O) received from landlords 6 Applications for Certificates re undertakings (Form O) received from tenants Nil Certificates re undertakings (Form P) issued to landlords 6 Certificates re undertakings (Form P) issued to tenants Nil Inspections carried out 47 Work under the Rent Act still continues, and whilst there was a slight decrease in the number of applications for Certificates of Disrepair, the number of applications for cancellation increased, as did the applications from owners for Certificates re Undertakings. At the end of 1963 there were 150 Certificates of Disrepair still in force. 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. He also refers certain cases in which some special feature is involved (e.g., fitness of basement rooms). During 1963 a total of 480 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 25 applications and 11 cases were referred to the Housing committee for special consideration on these grounds. In 1 case the maximum points were given for pulmonary tuberculosis. In 22 cases of ground applications, rehousing was recommended as essential on medical 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. 32 Factories and Outworkers. Factories Act, 1961. Metropolitan Borough Councils are responsible for the enforcement of the provisions of this Act in regard to:— (i) Sanitary conveniences—Section 7—In all factories. (ii) Cleanliness, Overcrowding, Temperature, Ventilation, and Drainage of Floors—Sections 1, 2, 3, 4 and 6—In all factories where mechanical power is not used. (iii) Certificates of Suitability for Basement Bakehouses—Section 70—In all basement bakehouses. (iv) Water Supply (where derived from a source other than the public mains)—Section 57—In all factories. A table giving the number of factories on the register at the end of the year, with the number of inspections, defects found, and action taken, is, at the request of the Minister of Health, given as an annexe to this Report. The following table shows the factories in the Borough, classified according to the trades carried on. Factories Classified according to Trades. Trade Mechanical Factories Non-Mechanical Factories At 1 Jan. At 31 Dec. At 1 Jan. At 31 Dec. Building and Allied 31 33 19 18 Clothing and Allied 38 37 15 15 Engineering and Heavy Industry 56 58 — Electrical and Allied 27 26 — — Food and Allied 26 25 2 2 Furniture and Allied 16 14 3 3 Metal Worker 17 19 — — Printer and Allied 33 34 2 1 Road Vehicle Repairer 56 54 18 14 Steam Laundry 9 9 — — Transport (Road & Rail) 18 18 — — Others 70 61 41 31 Total 397 388 100 84 Bakehouses. There were 11 bakehouses on the register at the end of the year. All these are classed as factories, and 9 of them use mechanical power. Forty-four inspections were made and three notices served. Two of the bakehouses were "basement bakehouses" within the meaning of Section 70 of the Factories Act, 1961, one having closed during the year. 33 Outworkers. During the year, in February and August, lists of outworkers were received from Battersea employers and from other authorities as required by the Factories Act, 1961. 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 110 (including 1 contractor). The total number of inspections made was 127. The premises were found to be generally satisfactory, and it was not necessary to serve any notices or to take any other action. The following table gives details of the outworkers' premises: — Trade Number on Register Premises Workrooms Persons employed Wearing Apparel 73 74 75 Curtains 1 1 1 Boxes, etc. 3 3 3 Artificial Flowers 3 3 3 Lamp Shades 29 29 29 Weaving of Textile Fabrics 1 1 1 110 111 112 A further table, giving prescribed particulars under Part VIII of the Act, will be found as part of the annexe to this Report. 34 Atmospheric Pollution. Clean Air Act, 1956. Smoke Control Areas. By the end of 1963, 1,422 applications for approval of proposed works of adaptation or conversion of fireplaces, and of payment of grant, in the No. 3 Smoke Control Area had been approved, and over £18,800 had been paid in grants by the Council in respect of these cases. The applications related to 3,141 fireplaces. The Battersea No. 3 Smoke Control Order, which became operative on the 1st July, 1963, was varied by the No. 3 Smoke Control (Variation) Order, 1963, which exempted two fish curing premises in the Area from the requirements of Section 11 of the Clean Air Act, 1956. The proposed No. 4 Area extends that part of the Borough covered by the Nos. 1, 2 and 3 Smoke Control Orders to Lavender Hill and St. John's Hill on the north, to the railway lines to the west and the Borough boundary on the east. (See map on next page). This Area covers 144 acres and contains 4,593 dwellings; the survey of the Area continued throughout the year, but it was not possible to declare the Area before the end of 1963. During the year 4,038 visits were made in connection with inspections of completed work in No. 3 Area and the survey of the proposed No. 4. Area. Smoke, etc., Nuisances and Observations. During the year, 25 complaints were made alleging nuisances from smoke, dust, grit, etc., emitted from the 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 observations, and the appropriate action taken. A total number of 263 observations were made. One notice was served. The effluvia nuisance, to which reference has been made in previous Annual Reports, which appears to emanate from the manufacturing processes of one firm, was the subject of several reports to the Health Committee during the year. The assistance of Dr. Hockin, the Alkali Inspector of the Ministry of Housing and Local Government, was obtained and he reported on the measures which the firm in question were taking to eliminate, as far as practicable, the cause of the emissions. It was upon this report that the Committee came to the conclusion that no further action could be usefully taken at the present time, but that the matter should be kept under continual surveillance. 36 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. Notification of Installation of Furnaces. Notification is required under Section 3 of the Clean Air Act, 1956, of the installation of any furnace with a heating capacity of 55,000 B.T.U's or more per hour. The Section does not generally apply to furnaces designed solely or mainly for use for domestic purposes. The purpose of the Section is to see that any new furnaces installed shall be, so far as is practicable, capable of being operated without emitting smoke. Seven such notifications were received during the year. Chimney Heights. A Circular was received from the Minister of Housing and Local Government, referring to the duty of the local authority to satisfy themselves that new chimneys, to which Section 10 of the Clean Air Act applies, should be high enough to prevent, as far as practicable, smoke, grit, dust and gases emitted from the chimney becoming prejudicial to health or a nuisance. A Memorandum was enclosed to assist in the calculation of chimney heights, based on the amount of flue gases the chimney would be expected to emit as a function of the maximum rate of emission of sulphur dioxide. The Memorandum was not applicable to all chimneys and applied only to: — (a) chimneys of industrial boiler plant of a maximum continuous rating greater than approximately 650 lb. steam/hr. and not exceeding 450,000 lb. steam/hr. or (b) to chimneys serving furnaces burning fuel at a maximum rate greater than approximately 100 lb./hr. of coal or 50 lb./hr. of oil, and not exceeding 50,000 lb./hr. of coal or 30,000 lb./hr. of oil. The method was to be regarded as a guide rather than a mathematically precise way of reaching a final decision on chimney height, and modified in the light of particular local circumstances. The question of chimney height is considered in the light of the Minister's Memorandum when notification of the installation of a boiler is made under Section 3 of the Act. Exemption of Premises engaged in Investigation and Research. Section 21 of the Clean Air Act, 1956, provides for firms engaged in research with regard to air pollution and the efficiency of furnaces generally to apply for exemption in the event of emission of smoke above the prescribed density. One application for exemption under this Section was received, and this was granted for one year. No untoward emissions were observed. 37 Protection of Food Supply. (A)—INSPECTION OF FOOD PREMISES. The regular inspection of all premises where food for human consumption is sold or stored is carried out. The Food and Drugs Act, 1955, and regulations made thereunder, is the principal Act under which action is taken. FOOD PREMISES. As at 31st December, 1963. Milk Distributors 133 Restaurants, Cafés 137 Canteens, Kitchens 66 Butchers 63 Ice Cream (Sale) 267 Ice Cream (Manufacture) 13 Fish Shops (Wet and Fried) 37 Food Factories 20 Bakehouses (Not underground) 9 Bakehouses (Underground) 2 Preserved Food 103 Bakers 42 Greengrocers 73 Confectioners 207 Grocers and Provisions 241 Miscellaneous (Chemists, Public Houses, Off-Licences) 192 Stalls:— Grocers 3 Greengrocers and Fruiterers 57 Fish and/or Poultry 7 There are 968 food premises in the Borough, together with 67 food stalls. Some of the premises shown above are listed under more than one trade category. Milk Distributors. At the end of the year there were 133 premises in the Borough whose occupiers were registered as milk distributors. All these premises were visited during the year, and one notice concerning non-compliance with the Food Hygiene Regulations was served. 38 Milk (Special Designation) Regulations. The number of Dealers' (Pre-packed Milk) licences issued during 1963 was six. Normally, licences granted since the Regulations were made in 1960 axe valid until the 31st December 1965, but in September, 1963, the Milk (Special Designation) Regulations, 1963, were issued. These Regulations re-enact with amendments the Milk (Special Designation) Regulations, 1960. The principal changes are that on and after the 1st October, 1964: — (a) "Untreated" replaces "Tuberculin Tested", as the special designation for raw milk. Current licences for Tuberculin Tested milk will not be valid after that date, and new licences issued for Untreated milk will expire on 31st December, 1965. (b) The test for untreated milk will be the half hour Methylene Blue Test. (c) From the 29th September, 1963, until the 31st December, 1964, a person holding the appropriate licence may use the words "Tuberculin Tested Milk (Pasteurised)" as an alternative to the words "Pasteurised Milk". (d) From the 1st October, 1964, until the 31st December, 1964, milk may be labelled as "Tuberculin Tested Milk" if the conditions applicable to the use of the special designation "Untreated" are otherwise satisfied. 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 280. Prior to registration, the premises are inspected as to suitability before recommendation to the Health Committee. The majority of applications are for the sale of pre-packed ice cream from refrigerated containers. Particular attention is paid to the 13 premises where manufacture takes place, and samples of the product are taken for examination. (See page 43). Butchers' Shops. There are 63 butchers' shops in the Borough. All these shops are systematically inspected, 1,047 visits having been made during the yearIt was not necessary to serve any notices concerning non-compliance with the Food Hygiene Regulations. 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 inspectedThere are 37 such shops in the Borough. 156 inspections were madeand four notices were served under the Food Hygiene Regulations. 39 Preserved Food Premises. Section 16 (b) of the Food and Drugs Act, 1955, provides for the registration of premises used for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale. A total of 103 premises (63 butchers' shops, 37 fish shops and 3 other premises) were registered at the end of the year. In addition to visits to butchers' and fish shops, 19 inspections of other premises were carried out. Four notices under the Food Hygiene Regulations were served. Catering Establishments. All restaurants, cafes, canteens and kitchens are regularly inspected throughout the year. There are 203 of these premises on the Register, and 728 inspections were made, 8 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. Three summonses were issued against one stall-holder for placing food on the public footway so as to involve the risk of contamination. He pleaded "Not guilty" on one occasion, and "Guilty" on the other two, and was fined £1 with 5s. 0d. costs on each of the three summonses. There are 67 food stalls in the Borough, the majority of them being in the two street markets in Battersea High Street and Northcote Road. FOOD PREMISES. Summary of Operations. Inspections— Summonses issued 3 Butchers' shops 1,047 Work carried out— Fish shops 156 Sanitary conveniences cleansed, improved or repaired 6 Milk shops 80 Ice cream premises 157 Preserved food premises 19 Cold water provided 12 Other food shops 681 Hot water provided 20 Food stalls 82 Wash-hand basins provided 11 Food storage premises 6 Sinks provided 12 Catering establishments 728 Premises cleansed or repaired 40 Notices served 26 (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, D. G. Forbes, Esq., b.sc., f.r.i.c., his premises, 325 Kennington Road, London, S.E.11. General bacteriological examination, and the examination of samples 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 1963 was 79. In addition, 377 informal samples were procured. 40 The following tables give details of the articles of food and drugs of which samples were obtained for the purpose of analysis. Nature of Sample EXAMINED ADULTERATED Formal Informal Total Formal Informal Total Almonds, Ground 1 1 — — Arrowroot — 4 4 — — Baby Foods — 7 7 — — Baking Powder ... — 3 3 — — Batter Mix — 4 4 — — Beef Extracts — 3 3 — — Biscuits (rye) — 1 1 — — Blancmange Powder — 4 4 — — Bread Crumbs — 5 5 — — Cake — 2 2 — — Caraway, Ground 2 — 2 2 2 Chicken minced in jelly ... — 2 2 — — Chicken and Rice — 1 1 — — Chicken Stock Tablets ... — 1 1 — — Chocolate Spread — 2 2 — — Cocoa — 2 2 — — Coconut, Desiccated — 4 4 — — Coffee 1 1 2 — — Coffee and Chicory — 2 2 — — Coffee and Chicory Essence — 2 2 — — Colouring — 4 4 — — Condiments — 12 12 — — Confectionery 1 10 11 — — Cornflour ... — 11 11 Cream — 7 7 — — Custard Powder — 5 5 — — Dessert Preparations — 18 18 — — Egg and Bacon Breakfast — 1 1 — — Essence of Rennet — 1 1 — — Fats — 5 5 — — Fish — 3 3 — — Fish Paste — 8 8 — 3 3 Flavouring — 9 9 — — — Flour — 5 5 — — — Frosting Mix — 1 1 — — — Fruit Juice and Squash ... — 6 6 — — — Gelatine — 3 3 — — —- Gravy Preparations — 9 9 — — — Herbs — 7 7 — — —- Honey — 5 5 — — — Ice Cream ... — 4 4 — — —- Jams and Preserves 2 15 17 2 3 5 Lemon Curd — 1 1 — — —- Liqueur Chocolates — 4 4 — — —• Meat Paste — 7 7 — 2 2 Milk 70 70 — — — Milk, Canned — 1 1 — — Carried forward .. 77 212 289 4 8 12 41 Nature of Sample EXAMINED ADULTERATED Formal Informal Total Formal Informal Total Brought forward 77 212 289 4 8 12 Milk Pudding, Canned — 1 1 — — — Oatmeal — 3 3 — — — Orange Syrup — 1 1 — — — Orange and Lemon Crystals — 2 2 — — — Pease Pudding — 2 2 — — — Pie Filling — 7 7 — — — Polenta — 1 1 — — Potato Flour — 1 1 — — Potted Beef — 1 1 — — Pudding Mix — 1 1 — — — Raising Powder — 1 1 — — — Rice, Ground — 10 10 — — Sago — 4 4 — — — Salad Cream — 2 2 — — — Sandwich Spread — 1 1 — — — Sauces, Pickles and Relish — 33 33 — — — Savoury Cheese — 4 4 — — — Soup — 25 25 — — — Spaghetti — 4 4 — — — Spices — 16 16 — — — Sponge and Cake Mix 1 15 16 — — — Stuffing — 4 4 — — — Table Jellies 8 8 — — Tapioca — 3 3 — — — Tea 1 1 2 — — Tomatoes and Beef — 1 1 — — — Tomato Paste 1 1 — Vegetables, Mixed — 1 1 — — — Vinegar — 7 7 — — — Totals 79 373 452 4 8 12 Drugs. Nature of Sample EXAMINED ADULTERATED Formal Informal Total Formal Informal Total Bicarbonate of Soda — 4 4 — — — Unsatisfactory Samples. Of the 79 formal samples taken for analysis, four samples (5.1 per cent.) were reported by the Public Analyst to be not up to the required standard. In the case of informal samples, 377 were taken of which eight (2.1 per cent.) were found to be not up to standard. Three informal samples of fish paste were deficient in fish content. Additional samples were taken which were satisfactory. No further action was considered necessary. 42 Two formal samples of ground caraway were deficient in volatile oil. A cautionary letter was sent to the suppliers who had already withdrawn the consignment from sale. Five samples of jam, two formal and three informal, were deficient in fruit content. A letter cautioning the manufacturers was sent and further samples are being obtained. Two informal samples of meat paste were deficient in meat content. Later samples were satisfactory, and no further action was considered necessary. The percentages of samples reported by the Public Analyst to be adulterated or otherwise unsatisfactory during the quinquennia 1921 to 1960 are given in the following table. The years 1960, 1961, 1962 and 1963 are shown separately. Year Formal samples (per cent.) Informal samples (per cent.) Mean 1921—1925 „1926—1930 „1931—1935 „1936—1940 „1941—1945 „1946—1950 „1951—1955 „1956—1960 1960 1961 1962 1963 6.4 3.3 1.8 0.9 1.4 1.0 2.1 1.1 1.9 0.0 0.0 5.1 7.4 2.4 2.1 0.9 1.1 1.1 2.2 0.9 0.5 0.0 1.0 2.1 Milk. Seventy formal samples of milk were taken during the year. Of the 70 samples, 18 were designated as "Channel Islands" or "South Devon" milk, for which a higher minimum percentage (viz., 4 per cent.) of milk fat content is provided for under arrangements made between the producers and the Ministry of Agriculture, Fisheries and Food. All of these samples were reported to be in conformity with this standard, their average composition being : — Milk fat 4.58 per cent. Non-fatty solids 8.98 Total milk solids 13.56 The milk fat content of the 18 samples of "Channel Islands" or "South Devon" milk ranged as under: — between 4.8 and 4.9 per cent. 2 samples. 4.7 ,, 4.8 ,, 5 „ 4.6 ,, 4.7 ,, 5 „ 4.5 ,, 4.6 ,, 1 sample 4.4 ,, 4.5 ,, 3 samples 4.3 ,, 4.4 ,, 1 sample 4.2 ,, 4.3 ,, 1 „ 18 43 All the 52 samples of ordinary milk were reported as genuine and the average composition was as follows:— Milk fat 3.76 per cent. Non-fatty solids 8.68 Total milk solids 12.44 „ Their content of milk fat ranged as follows:— Over 4.0 per cent. 4 samples between 3.9 and 4.0 „ 7 „ „ 3.8 „ 3.9 „ 20 „ „ 3.7 „ 3.8 „ 5 „ „ 3.6 „ 3.7 „ 10 „ „ 3.5 „ 3.6 „ 4 „ „ 3.4 „ 3.5 „ Nil „ „3.3 „ 3.4 „ 2 „ 52 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 results set out : — Phosphatase Methylene Blue Satisfactory Failed Satisfactory Failed Pasteurised 20 — 20 — Turbidity Satisfactory Failed Sterilised 19 — Monthly returns of the samples taken, and of the results of the ^animations sent to the Milk Division of the Ministry of Agriculture, 'sheries and Food were discontinued in September at the Ministry's request. Ice-Cream. Sixty-six samples of ice-cream were taken during the year, each sample being submitted to the methylene blue test. The samples were, as a result of the test, placed in the following grades :— Provisional Grade 1 26 „ „ 2 11 „ „ 3 17 „ „ 4 12 66 44 FOOD POISONING. Eleven cases of food poisoning were notified during the year and a further seven cases were otherwise ascertained. In 13 cases the causive organism was found to be of the following types:— Salmonella Brandenburg 7 Salmonella Typhi-Murium 5 Staphylococci 1 13 The causative organisms of the remaining 5 cases were not identified. Foreign Matter in Food. There were five instances of foreign matter in food reported to the Health Committee during the year. The Committee instructed that the four following cases should be dealt with by cautionary letters : — Dirt and paint film in a bottle of milk. Insect shell in high protein cereal. Screw in meat pie. Maggot in a bar of chocolate nougat. In the fifth case, that of a cigarette in a loaf of bread, on the Committee's instructions legal proceedings were instituted under Section 2 of the Food and Drugs Act, 1955. The vendors, who pleaded " Guiltywere fined £25, and £5 5s. Od. costs were awarded to the Council. Unsound Food. The following table gives particulars of the unsound food which, under the provisions of the Public Health (London) Act, 1936, Section 180 (8), were voluntarily surrendered to the Council. Commodity Lbs. Tins Jars Pkts. Number Cheese 12¼ Cream 31 16 Eggs 6,480 Fish (wet) 286 Fish (preserved) 145 Fruit 2,231 1,810 2 Meat (fresh) 2,599½ Meat (preserved) 1,789 107 5 22 Milk (tinned) 25 Offal 54¼ Poultry 1,588½ Rabbit 120 Sauces and Pickles 41 Soups 12 Vegetables 9,528½ 223 4 Other foods 94 79 32 1,725 Three cases of mould on meat pies, a sausage roll and a pork pie were reported during the year and, following correspondence with the manufacturers and the retailers, cautionary letters were sent in each case. 45 Miscellaneous Matters. Conferences. The Council were officially represented at the undermentioned Conferences dealing with matters within the purview of the Public Health Department. Conference Central Council for Health Education, London — 24th January. Greater London and Middlesex Home Safety Committee (Area 10); "Home Safety and Accident Prevention Wood Green— 16th March. Royal Society of Health, Eastbourne—29th April to 3rd May. Association of Public Health Inspectors, Eastbourne -— 24th to 27th September. Royal Institute of Public Health and Hygiene, Harrogate—25th to 27th September. National Society for Clean Air, Scarborough—8th to 11th October. Royal Society for the Prevention of Accidents; "Home Safety"; London —10th and 11th October. Central Council for the Disabled, London— 18th December. Delegates Aid. Mrs. E. A. Cooper, J.P. Mrs. M. Richards, Visitor. Cllr. Miss E. A. Coles, J.P., and the Medical Officer of Health. Cllr. G. Whitehead and Miss A. Jones, Public Health Inspector. Cllr. Miss E. A. Coles, J.P., and the Medical Officer of Health. Aid. Mrs. E. A. Cooper, J.P., and Mr. I. R. Lewis, Factories and Workshops Inspector. Cllr. Miss G. A. Morgan. Qlr. Dr. J. Fairlee. Care of Old People, The steady expansion in services for the old people of the Borough hascontinued during 1963, but I am still not entirely happy that we are reaching all cases of old people who are in need of help. Aged persons are still found living in unsatisfactory conditions, and not only lacking but often actively refusing, care and attention from the outside world, but I am happy to say that such cases are becoming fewer in number, and this opinion is reinforced by the fact that no resort has been made to compulsory removal under Section 47 of the National Assistance Act, 1948, during the past year. 46 In all types of effective social work close co-operation and happy relationships between the various social workers, whether statutory or voluntary, are essential, and I am confident that these qualities exist in full measure amongst all concerned with the welfare of old persons in this Borough. The enterprise and growth of the Battersea Old People's Welfare Committee's range of activities have done a great deal in publicising and meeting the varying needs of the elderly. The persevering day-to-day achievements of the Women's Voluntary Service in running the Meals on Wheels service through the snow and ice in the early part of the year must not be forgotten and the regularity of this service and " the lifting eye " which all members involved keep on the housebound aged cannot be too highly praised. I am indebted to the various general practitioners consulted during the year for their ready assistance in cases, and also to Dr. Sthyr, the Consultant Geriatrician and Medical Superintendent of St. John's Hospital, who has been ever ready to help when an old person required in-patient treatment. Many seriously ill old people have been sufficiently rehabilitated to be able to return home with support from local authority after-care services. We were sorry to lose Mrs. M. I. Richards, the Old People's Visitor, in March, to the Lambeth Borough Council, as she was very much concerned in building up the present Borough services for old people, including the Home Bathing Service. Mrs. D. W. Morley was appointed in her place in April, and has settled into the work very quickly and successfully. Altogether 648 visits were made by the Old People's Visitor during the year. Home Bathing Service. The Home Bathing Service, which was started in 1962, has proved to be an essential adjunct to the many other services provided for old people in the Borough. In addition to the actual bathing service, many visits are made to old people by the Home Bathing Attendants, and these visits become a welcome and beneficial interlude in the lives of the elderly house-bound. The Attendants work in close co-operation with the Borough Council's Old People's Visitor, who is kept more readily acquainted with any change in an old person's circumstances or health When this service was initiated, one Attendant was appointed on a part-time basis, but by the end of 1963, owing to the large demand, three part-time Attendants were employed, and 97 old people were on the register for this service. During the year, 1,274 baths were given, and 1,031 other visits were made by the Attendants, thus showing the necessity for such a provision. Laundry Service for Incontinent Persons. There is an increasing demand for the Department's Laundry Service for incontinent persons, and whereas in 1962 4,377 articles were laundered by the Cleansing Station, at the end of 1963 the number had risen to 5,314 articles. This is a vital service in assisting an infirnJ old person to remain at home and in relieving some of the burden relatives, who are often aged and infirm themselves. 47 Use of Slipper Baths by Old Age Pensioners. The Council make available to old age pensioners free use of the Ripper baths at their Baths Establishments on production of their pension books. This facility has also been extended to blind persons. During the year 1963 this arrangement was taken advantage of at the respective Baths Establishments as follows:— Males Females Latchmere 3,827 3,551 Nine Elms 407 159 Plough Road 2,007 2,056 Total 6,241 5,766 Home Safety Act, 1961: Accidents in the Home. The Home Safety Act, 1961, repealed and replaced Section 82 of the London County Council (General Powers) Act, 1957. The Act empowers the Council to promote safety in the home, by publishing or making other arrangements for giving information or advice relating to the prevention of accidents in the home, and to contribute to non-profit taking organisations concerned with the promotion of home safety. The following tables, compiled from reports made by the London Ambulance Service, indicate the estimated number of accidents occurring in Battersea homes. Table I shows the number of accidents in 1963 in age groups; Table II gives the numbers from various causes each year since 1959. HOME ACCIDENTS IN BATTERSEA. Table I Year Age group (years) M. F. Total under 1 1 2-4 5-14 15-24 25-44 45-64 65-74 75 plus 1963 5 10 28 26 23 42 56 39 70 109 190 299 % (1.6) (3.4) (9.4) (8.7) (7.7) (13.9) (18.6) (13.2) (23.5) (36.5) (63.5) (100.0) 48 Table 11 Cause of Accident 1959 1960 1961 1962 1963 Fall: On stairs 36 39 30 25 30 From ladder 4 6 2 3 6 From chair 7 6 7 5 5 Outside (i.e., windows, balconies, roofs, etc.) 9 6 5 8 9 In garden 10 10 11 9 8 In bath 1 1 — 1 1 From one level to another (i.e., tables, boxes, beds, etc.) 12 10 13 17 15 On same level (i.e., in room, over objects) 31 32 31 28 34 Unspecified 72 101 108 128 107 Hit by Object 6 6 6 10 10 Cooking stove (saucepans, water, fats, etc.) 4 4 4 4 6 Teapot 2 2 2 2 2 Other boiling water 5 4 6 8 8 Electric shock 1 1 1 1 2 Poisoning (including foreign objects) 8 14 14 14 15 Gassing 6 3 4 4 10 Knife-like wounds (including spikes and cuts from glass) 7 14 12 14 12 Fires 4 3 5 5 6 Windows (trapping) 1 2 1 1 1 Suffocation 1 1 — 1 2 Not specified 13 11 12 13 10 Total 240 276 274 301 299 Rate per 10,000 population 22.1 25.8 26.1 28.9 29.0 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, undef the Act, was liable to maintain the deceased immediately prior to his death, their expenses incurred in carrying out the duty, in so far a® these expenses are not covered by any grant made under the Nation3' Insurance Act, 1946. During the year, 3 cases were dealt with. The burials arranged by the Council are carried out by a local undertaker under contract. The Health Department make the arrangements and collect all available information regarding any estate left W the deceased, particulars of his National Insurance, and the existence of any "liable" relatives. This information is passed to the Borough Treasurer so that he may take steps to recover the cost. The total cost incurred in dealing with the 3 cases was £33 lis. 6d., and of this amount £31 9s. 0d. was recovered. Public Swimming Baths. The Council maintain four public swimming pools—three at Latchmere Baths and one at Nine Elms Baths. 49 The source of water supply at the Latchmere Baths is from deep Wells. In the event of breakdown or any temporary cessation of supply from the wells, the water is obtained from the mains of the Metropolitan Water Board. The Nine Elms Baths are supplied from the Board's mains. The Bath water is effectively chlorinated, and there is a turnover or change of water in the Baths approximately every 3| hours. Samples of water from the swimming pools are taken at fortnightly intervals and submitted for bacteriological examination. The results have been satisfactory. 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. One public urinal is maintained, and in addition the urinals attached to six licensed premises are, by arrangement with the owners, available to the general public. Disinfection and Disinfestation. Methods of Disinfection: Following the notification of a case of infactious 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. Advice is also given to the occupier that a thorough "spring cleaning" of the room is a very effective "disinfection" process, and should be carried out in addition to the work of disinfection by the Council's staff. Bedding and clothing are collected and steam-treated at the Station, where the disinfection plant consists of two large steam disinfectors. 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 gives a prolonged residual effect. In the case of a heavy infestation, architraves and mouldings are required to be eased for deeper penetration of the insecticide. Control of Insect Pests: The construction by the Council of large blocks of flats containing covered ducts taking hot water, plumbing and drainage pipes has raised a problem of insect infestation. These ducts from 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. 50 Personal Cleansing Station. There are facilities for treatment of scabies and verminous conditions at the Personal Cleansing Station, Sheepcote Lane. During this year 196 treatments were given to persons suffering from or contacts of scabies—110 to adults, 40 to school children, and 46 to children under school age. In addition to the above, 42 adults and 133 children found to be verminous were cleansed. Of the 133 children, 107 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 home 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 1959 221 1,259 2,259 560 1960 142 640 2,529 545 1961 86 305 2,280 540 1962 188 301 2,807 518 1963 152 219 2,342 543 *Financial year ending 31st March. Other columns, calendar year. Of the £2,342 expenditure during the financial year 1963 /64. approximately £966 was spent on wages and materials for the Home Bathing service. 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 oI £500 per annum. Arrangements have been made with the Wandsworth Borough Council, and the Lambeth Borough Council, for certain of the resident in those Boroughs, who require treatment or cleansing, to attend at tn Battersea Personal Cleansing Station, the cost of this service being born by the respective Boroughs in which the patients are resident. During the year 58 treatments were given to Wandsworth resident and 35 treatments to Lambeth residents. 51 Methods of Treatment:— Scabies: Persons attending for treatment are given a hot bath for twenty to thirty minutes, thoroughly dried, and Benzyl Benzoate applied to the whole of the body. This is repeated on alternate days, there being three treatments in all. Verminous heads: The hair is treated with a preparation containing cotton-seed oil, tar oil, paraffin oil and oil of lemon grass, and then washed with a shampoo of soft soap and borax. It is then dried thoroughly, combed with a Sacker's comb to remove nits, washed, dried and combed again. The operation takes approximately half an hour for each child, and a final check is made by the Sister in attendance. The Council have two flats attached to the Personal Cleansing Station for the temporary use in emergency of people or a family displaced, usually following fumigating procedure. The Council have agreed that these shelters may be used for Wandsworth residents at an annual fee of £25 for the right to use the shelters and a weekly charge of £1 10s. Od. per shelter for every case sent there. Coroner's Court and Mortuary. Details as to the number of inquests held at the Coroner's Court, and bodies received into the Mortuary, during 1963, are set out in the following table:— Details of Bodies Received Usual Place of Residence Total Battersea Wandsworth Elsewhere Residence unknown Post-mortem only 179 650 155 10 994 Post-mortem and inquest 24 112 37 3 176 Total post-mortems 203 762 192 13 1,170 Inquest only — 2 1 — 3 Total inquests 24 114 38 3 179 Sanitary and other reasons 2 1 — — 3 Total bodies received 205 765 193 13 1,176 Verdicts at Inquests held — Accidental 9 57 31 2 99 Alcoholism — 1 2 — 3 Natural causes — 2 — — 2 industrial disease 2 1 — — 3 Open verdict 1 5 3 1 10 Suicide 11 45 2 — 58 Womicide 1 — — — 1 Referred to higher court — 3 — — 3 TOTAL 24 114 38 3 179 In addition to the above, a further fifty inquests were held at the Coroner's Court in respect of which no bodies were received into the 52 The Wandsworth Borough Council made a grant of £850 per annum towards the cost of maintaining the Mortuary. The London County Council pay a rent of £525 per annum for the use of the Coroner's Court. During 1962 a request was received from the Borough of Southwark to receive bodies during the reconstruction of their own Mortuary. It was found possible to assist in this way, and the Health Committee agreed to the request. Bodies from Southwark were received into the Mortuary from November, 1962, until January, 1964, and the total admitted during that period amounted to 826. Personnel from the Southwark Mortuary were used to assist our own Mortuary Staff, and this arrangement was found to be very satisfactory. 53 ANNEXE. Annual Report of the Medical Officer of Health in respect of the year 1963 for the Metropolitan Borough of Battersea in County of London. Prescribed Particulars on the Administration of the Factories Act, 1961. Part I of the Act. 1.—INSPECTIONS for purposes of provisions as to health, (including inspections made by Public Health Inspectors). 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 84 273 6 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 388 1,346 17 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 20 40 - - total 492 1,659 23 — 54 2.—CASES in which DEFECTS were found Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l.) 16 16 — — — Overcrowding (S.2.) — — — — — Unreasonable temperature (S.3.) — — — — — Inadequate ventilation (S.4.) — — — — — Ineffective drainage of floors (S.6.) — — — — — Sanitary Conveniences (S.7.) (a) Insufficient 3 3 — — — (b) Unsuitable or defective 14 14 — — — (<•) Not separate for sexes 4 4 — — — Other offences against the Act (not including offences relating to Out-work) — — — — — TOTAL 37 37 — — — Part VIII of the Act. Outwork. (Sections 133 and 134) Nature of Work Section 133 Section 134 No. of out-workers in August list required by Sect. 133 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing apparel (Making, etc., cleaning and washing) 44 — — — — — Artificial Flowers 3 — — — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper 3 — — — — — Textile Weaving 1 — — — — — Lampshades 5 — — — — — TOTAL 56 — — — — — 55 INDEX. Page No. Accidents in the Home 47 Adulterated Samples 41 Aged and Infirm Persons—Care of 45 Animal Boarding Establishments Act, 1963 27 Atmospheric Pollution 34 Bacteriological Examinations 20 Bakehouses 32 Barbers and Hairdressers 27 Baths—Home 46 „ —Personal Cleansing Station 50 „ —Public Swimming 48 „ , Slipper—Use by Old Age Pensioners 47 Births 10 Burials 48 Butchers' Shops 38 Cancer Deaths 14 Caravans 24 Care of Old People 45 Catering Establishments 39 Causes of Death 12 Certificates of Disrepair 31 Chimney Heights 36 Clean Air Act, 1956 34 „ „ „ „ , Section 21—Exemptions 36 Clearance Areas 29 Closing Orders 30 Committee—Health 2 Common Lodging Houses 26 Comparative Statistics 15 Conferences 45 Consumer Protection Act, 1961 28 Coroner's Court and Mortuary 51 Dangerous Structures 26 Death—Causes of 12 Deaths 11 „ , Cancer 14 „ of Illegitimate Infants 15 „ , Infant 14 „ , Maternal 15 „ , from Tuberculosis 17 Deceased Persons—Burial of 48 Demolition Orders 30 Diphtheria Immunisation 19 Diseases—Infectious and Other 16 56 Page No. Disinfecting Station 49 Disinfection 49 Disinfestation 49 Drainage Work 23 Drugs—Sampling 39 Dustbins 23 Examinations—Bacteriological 20 Exemptions—Gean Air Act, 1956, Section 21 36 Factories Act, 1961 32, 53 and Outworkers 32, 53 Fish Shops 38 Food and Drugs Act, 1955 37 „ , Foreign Matter in 44 „ Poisoning 44 „ Premises 37 „ „ —Inspections39 „ „ —Summary of Operations 39 „ Sampling 39 „ Stalls 39 „ Supply—Protection of 37 „ , Unsound 44 Hairdressers and Barbers 27 Health Committee 2 Heat Treated Milk 43 Home Accidents: Home Safety Act, 1961 47 „ Bathing Service 46 Houses in Multiple Occupation 30 Housing 29 „ Accommodation Applications 31 „ —New Accommodation 29 Ice Cream Premises 38 „ „ Sampling 43 Illegitimate Infants—Deaths of 15 Immunisation—Diphtheria, Tetanus and Whooping Cough 19 Infant Mortality 14 Infectious and Other Diseases 16 Inquests 51 Inspections 21 „ —Dwelling Houses 21 „ —Factories and Outworkers 53 „ —Food Premises39 Installation of Furnaces—Notification of 36 International Certificates of Vaccination and Inoculation 20 Laundry Service for Incontinent Persons 46 Legal Proceedings 22 Licensing Act, 1961 28 57 Page No. Local Land Charges 26 London County Council (General Powers) Act, 1925: Section 33 23 London County Council (General Powers) Act, 1954: Section 12 23 London County Council (General Powers) Act, 1955: Sections 25, 26, 27 22 London County Council (General Powers) Act, 1959 : Section 26 20 Marriages 11 Maternal Mortality 15 Milk Distributors 37 „ , Heat Treated 43 „ Samples 42 „ (Special Designation) Regulations 38 Miscellaneous Matters 45 Mobile Dwellings 24 Mortality—Infant 14 „ —Maternal 15 Mortuary and Coroner's Court 51 Multi-occupied Houses 30 National Assistance Acts 45, 48 New Housing Accommodation 29 Noise Abatement Act, 1960 27 Notification of Installation of Furnaces 36 Nuisances—Public Health (London) Act, 1936 22 Nuisances—Smoke 34 Offensive Trades 26 Old Age Pensioners—Use of Slipper Baths 47 Old People's Welfare Committee 45 Outworkers 33, 54 Overcrowding 30 Personal Cleansing Station 50 Pet Animals Act, 1951 27 Pharmacy and Poisons Act, 1933 26 Poliomyelitis Vaccination 19 Population 10 Post-mortems 51 Preserved Food Premises 39 Prevention of Damage by Pests Act, 1949 25 Principal Figures 9 Protection of Food Supply 37 Public Conveniences 49 „ Health (London) Act, 1936—Nuisances 22 „ Lavatory Accommodation 49 „ Swimming Baths 48 58 Page No- Rag Dealers and Sorters 26 Rag Flock and Other Filling Materials Act, 1951 26 Rent Act, 1957 31 Rodent Control 25 Samples—Adulterated 41 „ —Drugs 41 „ —Food 39 „ —Heat Treated Milk 43 „ —Ice Cream 43 „ —Milk 42 „ — „ , Heat Treated 43 „ —Unsatisfactory 41 „ —Water, Swimming Baths 49 Sanitary Circumstances 21 Sewerage and Sewers 23 Shops Act, 1950 26 „ , Butchers' 38 „ . Fish 38 „ , Ice Cream 38 „ , Milk 37 „ , Pet 27 Slipper Baths—Use by Old Age Pensioners 47 Slum Clearance 29 Smallpox Vaccination 19 Smoke Control Areas 34 „ Measuring Station 36 „ Nuisances and Observations 34 Staff 3 Stalls, Food 39 Statistics—Comparative 15 „ -Vital 10 Still-births 10 Swimming Baths 48 Tetanus Immunisation 19 Tuberculosis 17 „ Deaths 17 „ Notifications 18 Unsatisfactory Samples 41 Unsound Food 44 Urinals 49 Vaccination—Smallpox and Poliomyelitis 19 „ —International Certificates 20 Verminous Premises 25 Vital Statistics 10 Water Supply 24 Whooping Cough Immunisation 19