achd C. 4378 BER 80 METROPOLITAN BOROUGH OF BERMONDSEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1958 B. J. L MOSS, M.B., B.5., D.C.H., D.P.H. Medical Officer of Health BER 80 METROPOLITAN BOROUGH OF BERMONDSEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1958 B. J. L. MOSS, M.B., B.S., D.C.H., D.P.H. Medical Officer of Health McC.—8/59 PUBLIC HEALTH DEPARTMENT MUNICIPAL OFFICES, SPA ROAD, S.E.16 Bermondsey 2441 PUBLIC HEALTH COMMITTEE (As at 31st December, 1958) Chairman Councillor JOS. MAHONEY Vice-Chairman Councillor F. W. FLORANCE Alderman A. M. Downing Councillor W. E. Nicklin „ A. V. Kidd „ Miss M. Shaw „ Miss I. G. Neighbour „ G. H. Tindall Councillor W. L. Ellis „ Mrs. E. V. Coyle, J.P. „ L. A. J. Henley „ J. Lacey „ Mrs. A. E. Martin „ Mrs. I. B. Thomas „ J. H. Newbery „ T. Hendy Ex-Officio Councillor W. H. WARDELL, J.P., Mayor of Bermondsey STAFF MEDICAL OFFICER OF HEALTH B.J.L. Moss, M.B., B.S., D.C.H., D.P.H. ADMINISTRATIVE OFFICER J.W.J. Saward, A.F.C., M.R.I.P.H.H. PUBLIC ANALYST D. G. Allen, B.Sc., F.R.I.C. PUBLIC HEALTH INSPECTORS F. L. Richardson, Chief Public Health Inspector and Drainage Inspector. H. E. Butcher, Wharves Inspector. W. C. Tapsfield, Wharves Inspector. W. A. Campbell, Wharves Inspector. A. W. Hancock, Food and Drugs Inspector. L. T. Knott, District Inspector. W. F. Smith, District Inspector. C. H. Whitelock, District Inspector. R. C. Charlton, District Inspector. G. Shakespeare, District Inspector. CLERICAL STAFF H. D. White (Senior Clerk). A. E. Gambrell. E. T. Hodgkins. G. A. Blake. G. A. Hunt (Transferred to Libraries Dept. Dec. 1958) A. J. Kiddell. E. M. Watkins. M. W. Bridgman Student Public W. T. Evans }Health Inspectors WELFARE ASSISTANTS Mrs. M. V. Reynolds, M.W.I. Miss E. B. Collins, S.R.N. (Temp. app. w.e.f. 20th Oct, 1958) Mrs. P. Kirby, S.R.N. (Temp. app. w.e.f. 27th Oct. 1958) MUNICIPAL CLUB LEADER Miss S. A. Denham STREET AND OPEN MARKETS J. A. Hart, C. E. Featherstone— Market Collectors and Supervisors. DISINFECTING AND CLEANSING STATION R. Towll, Supervisor. 1 Foreman Disinfector & Drain Tester. 4 Disinfectors/Washing Machine Attendants. 3 Laundresses. 1 Stoker. RODENT CONTROL H. E. Staples, Rodent Control Officer. 3 Rodent Operators. PUBLIC CONVENIENCES 16 Female Convenience Attendants. 16 Male Convenience Attendants. 2 Urinal Cleaners. Borough of Bermondsey ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH To the Mayor, Aldermen and Councillors of the Borough of Bermondsey. I have the honour to present my Annual Report on the health and sanitary circumstances of the Borough. Several new projects have been undertaken during this last year but of particular importance has been the work carried out amongst elderly people. Interesting results are available from the survey of old people now being undertaken in the Borough. Information is already available on some 800 cases fully investigated and a further 800 case reports will be available for study at a later date. If the figures published are a true reflection of the position in regard to old people in Bermondsey as a whole, then the implications are a matter for serious consideration. Housing policy may have to be remoulded in the light of these findings to cope with the increasing numbers of old people. Furthermore, there is little doubt that fuller powers should be given to Borough Councils who wish to undertake a progressive and courageous policy of help to the elderly. Once again dysentery has been a problem in some of the schools in the Borough. In order that the investigations and follow up of cases could be more satisfactorily and speedily undertaken, a request was made to the Minister to extend notification to include acute gastro enteritis. This has now come into effect for a trial period of 3 years but already it has shown that it is a worth while procedure. A number of outbreaks have been abated at an early stage by exclusion of patients with diarrhoea. The Municipal Club has well justified its inception, having brought comfort, good food and happiness to many. As a result of its steady growth and obvious success the Council are now investigating the possibilities of extending the work in this field. Further extensions are anticipated in the meals service and a site for another club and meals centre is under consideration. During the autumn it was discovered that livers infected with echinococcus cyst were reaching retail butchers' shops in various parts of London although, fortunately, not in Bermondsey. Investigation revealed that the livers were imported theoretically for animal feeding stuff but, once having evaded the wharf inspector's supervision, they were being removed from the marked bags and passed out for distribution as sound meat, a much higher price being obtained in this way than if the goods had gone for animal feeding. A request was made that all these infected livers should be stained if imported for animal feeding and unfit for human consumption. Having agreed to the request and made the appropriate regulation, the Ministry then changed their minds. Undoubtedly, the importation of this type of meat should be prohibited. Unfit as it is for human consumption it is a positive danger to many animals. Failure to take action in this matter is little short of condoning the dissemination of a parasite dangerous to man and animals. One Smoke Control Area is already in existence in the Borough. A second area has been agreed to in principle by the Minister and is being surveyed in detail for final submission and confirmation. A further large area and several small areas are also under consideration for inclusion in plans for 1959. During the year a number of investigations has taken place with the wholehearted co-operation of the general practitioners in the Borough. 1 would like to thank them for their help and support which have been much appreciated. Despite many difficulties and setbacks I think that the year has indeed been a successful one. To the Public Health Committee and my staff I should like to give thanks for all the help and encouragement I have received. I am, Sir, Ladies and Gentlemen, Your obedient Servant, B. J. L. MOSS VITAL STATISTICS. AREA The area of the borough (exclusive of area covered by water) is 1,336 acres. POPULATION Census Estimate of Registrar-General 1931 1951 to 30th June, 1957 to 30th June, 1958 111,542 60,640 54,750 54,450 Rateable Value, 1st April, 1958 £1,306,040 Estimated net product of Id. rate £5,159 Estimated number of separately assessed dwellings. 1st April, 1958 15,164 BIRTHS The total number of births belonging to the borough registered during 1958 was 915 consisting of 474 males and 441 females. The number for 1957 was 946. Live Births 891 Live Births, rate per 1,000 population 16.37 Still Births 24 Still Births, rate per 1,000 live and still births 26.66 Total live and still births 915 Infant Deaths 18 Infant Mortality rate per 1,000 live births (Total) 20.20 Infant Mortality rate per 1,000 live births (legitimate) 19.99 Infant Mortality rate per 1,000 live births (illegitimate) 24.39 Neo-natal Mortality rate per 1,000 live births 16.84 Illegitimate live births % of total live births 4.59 Maternal deaths Nil Maternal mortality per 1,000 live and still births Nil DEATHS The total number of deaths belonging to the borough registered during 1958 was 632, consisting of 329 males and 303 females. The number for 1957 was 629. The death rate for 1958 was 11.6 per thousand persons living, compared with 11.5 for 1957. The incidence of coronary disease as a cause of death has increased by 17% in the case of males and 35% in the case of females compared with the previous year's figures. There is a further increase in the deaths from malignant disease affecting men chiefly. Although there is a slight fall in the number of deaths from cancer of the lung this is not significant as it is probably due to the fall in total deaths. MARRIAGES The total number of marriages in the borough in 1958 was 357 being 73 below the number for 1957, and 167 below the average for the last 10 years. The figures have been supplied by the Superintendent Registrar. Year No. Rate 595 19.70 1948 1949 609 20.15 18.23 1950 545 19.28 1951 582 1952 516 17.26 1953 520 17.52 475 1954 16.21 501 1955 17.40 1956 468 16.60 1957 15.70 430 Average for years 1948—1957 524 17.80 357 13.3 1958 INFANTILE MORTALITY Year Whole Borough London No. of Deaths Rate per 1,000 Births No. of Deaths Rate per 1,000 Births 1948 20 16 1,869 31 1949 29 1,517 33 27 1950 23 20 1,372 26 1951 27 25 1,333 25 1952 20 20 23 1,189 1953 27 27 1,216 24 1954 23 24 21 1,047 1955 21 23 1,157 23 18 1956 16 1,106 21 20 21 1,160 22 1957 Average for years 1948-1957 22 1,296 24 23 18 19 1,218 1958 22.6 TUBERCULOSIS OF THE RESPIRATORY SYSTEM In the following Table will be found particulars of deaths from Tuberculosis of the Respiratory System since the year 1948. Year Whole Borough London No. No. Rate Rate 45 0.74 2,044 0.62 1948 1949 41 0.68 1,900 0.57 1950 0.47 23 0.38 1,585 1951 21 0.35 1,225 0.36 1952 20 0.35 0.34 1,154 1953 14 0.24 933 0.28 14 1954 0.24 596 0.18 8 0.14 517 1955 0.16 1956 10 0.18 423 0.13 378 1957 9 0.16 0.12 Averages for years 1948-1957 20 0.34 1,075 0.32 379 0.12 1958 6 0.11 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1958. Causes of Death Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District. All Ages 0-4 5—14 15—24 25—44 45—64 65—74 75 & over M F M F M F M F M F M F M F M F Tuberculosis, respiratory 5 1 _ _ _ _ _ _ 1 1 1 _ 1 _ 2 _ Tuberculosis, other - 1 _ _ - _ _ _ - _ _ _ _ 1 _ _ Syphilitic disease _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Diphtheria - - - - - - - - - - - - - - - - Whooping Cough - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ Meningococcal infections _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Acute poliomyelitis _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Measles _ _ _ _ _ _ - - - - - - - - - - Other infective and parasitic diseases 1 1 - - - - - - - - - 1 - - 1 - Malignant neoplasm, stomach 17 5 - - - - - - - - 9 1 5 3 3 1 Malignant neoplasm, lung, bronchus 34 - - - - - - 1 - 19 1 10 1 4 5 2 Malignant neoplasm, breast 15 - - - - - - - - - 6 - 4 - 5 - 1 - 1 - 1 - 1 Malignant neoplasm, uterus - 4 - - - - - - - Other malignant and lymphatic neoplasms 39 28 1 1 - - - - 2 3 17 7 6 10 13 7 Leukaemia, aleukaemia 1 3 - - - - - 1 - - - - - 1 1 1 Diabetes 1 2 - - - - - - 1 - - - 1 1 - - Vascular lesions of nervous system 20 35 - - - - - - 1 4 6 7 12 9 16 - CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1958—continued. Causes of Death Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District All Ages 0 - 4 5—14 15—24 25—44 45—64 65—74 75 & over M F M F M F M F M F M F M F M F Hypertension with heart disease 5 - - - - - - - - - 3 3 2 2 10 15 Other heart disease 32 33 - - - - - 1 - 11 7 7 5 14 20 - Other circulatory disease 12 25 - - - - - - - 1 4 2 4 7 4 15 Influenza - 1 - - - - - - - - - - - - - 1 Pneumonia 24 27 2 2 - - 1 1 2 1 3 4 16 19 - - Bronchitis 30 18 - - - - - - - - 7 - 13 10 10 8 Other diseases of respiratory system 5 - - - - - 1 - 2 - 2 - - 1 1 - Ulcer of stomach and duodenum 7 1 - - - - - - - 2 - 1 - 4 1 - 1 1 Gastritis, enteritis and diarrhoea 2 3 - - - - - - - - 1 1 1 - Nephritis and nephrosis 2 - - - - - 2 - - - - - - - - - Hyperplasia of prostate 1 - - - - - - - - - - - - 1 - - Pregnancy, childbirth, abortion - - - - - - - - - - - - - - - - Congenital malformations 4 2 2 1 1 - 1 - - - - - - 1 - - Other defined and ill-defined diseases 15 29 6 6 1 - - 1 - 1 1 2 3 6 4 13 Motor vehicle accidents 3 1 - - - - - - - - 2 - 1 1 - - All other accidents 8 5 2 - - - - - 1 - 2 1 - 1 3 3 Suicide 6 2 - - - 1 1 2 1 1 - - - 2 - - Homicide and operations of war - - - - - - - - - - - - - - - - 329 303 13 10 2 - 4 10 12 109 46 89 90 104 141 2 INFECTIOUS DISEASES NOTIFICATION OF INFECTIOUS DISEASES Every medical practitioner attending on, or called in to visit a patient, shall, as soon as he becomes aware that the patient is suffering from a notifiable infectious disease, send to the Medical Officer of Health of the district in which the disease occurs a certificate stating the name and address of the patient and the disease from which the patient is suffering. Books of certificates are available free of charge from this Department. The following diseases are notifiable: — Acute Encephalitis Malaria Acute Influenzal Pneumonia Measles Acute Primary Pneumonia Membranous Croup Acute Poliomyelitis Meningococcal Infection Anthrax Ophthalmia Neonatorum Cholera Plague Continued Fever Puerperal Pyrexia Diphtheria Relapsing Fever Dysentery * Scabies Enteric Fever (includes Typhoid and Paratyphoid) Scarlatina or Scarlet Fever Erysipelas Small-pox Food Poisoning Tuberculosis Glanders Typhus Fever Hydrophobia in Man Whooping Cough Leprosy (to be notified to Chief Medical Officer, Ministry of Health). *A notification is not required where to the knowledge of the medical practitioner, a case of scabies has occurred in the house and has been notified within the four weeks immediately preceding the date on which he first became aware of the disease in the case he is attending. FOOD POISONING Thirty-three cases of food poisoning were notified to me during the year under The Food and Drugs Act, 1955, Section 26, CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1958 NOTIFIABLE DISEASE NUMBER OF CASES NOTIFIED Whole Borough Saints Neckinger Central Tunnel Dockyard Park Raymouth South Thorburn Willow Walk South West Abbey Leather Market TOTAL Total Cases removed to Hospital At all Ages At Ages—Year 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Tuberculosis — Respiratory System 51 2 - 1 4 7 8 7 10 4 8 - 4 1 4 6 - 2 5 1 2 9 8 4 5 51 - - Other forms 9 9 - 1 1 4 - - 1 - - 1 1 - 1 - - 1 - 1 - 1 - - - - 5 - 52 - 19 30 3 - Scarlet Fever - - - - - - - 2 2 4 15 3 1 4 - 3 7 2 6 3 52 - Whooping Cough 32 4 19 8 1 - - - - - - - 3 1 3 8 4 4 3 - 1 1 3 1 1 32 - - Acute Poliomyelitis 2 - - 1 - - - 1 - - - - - - - - - 1 - - 1 - - - 2 - - — Measles 268 15 146 104 1 - 1 - - - 1 - 12 9 14 45 20 6 17 18 44 16 17 29 21 268 - - Pneumonia 47 5 3 1 1 1 2 6 - 10 10 8 1 5 1 9 1 1 3 1 1 1 8 7 5 47 3 — Dysentery 183 7 47 52 18 6 4 16 7 11 10 5 - 1 16 20 57 25 6 23 5 10 5 1 11 3 183 - Erysipelas 3 - - - - - - - - 2 - 1 - - 1 - 1 - 1 - - - - - - 3 - - Food Poisoning 33 1 4 5 - 2 1 4 5 6 3 2 - - 4 8 10 - 1 1 - 4 - - 5 - 33 - 11 - 2 2 1 1 3 1 - 1 - - 3 - - - - - Scabies 1 - - 2 2 1 2 11 - — CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEARS 1949-1958 Notifiable Disease 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 82 59 85 72 I 62 113 82 69 52 Scarlet Fever Whooping Cough 40 267 75 40 124 135 51 43 113 32 Acute Polio-Myelitis and Acute Polio- Encephalitis 3 1 2 - I 2 - 14 2 4 514 183 1271 1099 268 771 367 1197 716 149 Measles 2 2 1 1 - Diphtheria 65 3 - - - 4 25 56 29 164 7 183 Dysentery 1 131 7 6 3 Meningococcal Infection 1 6 2 1 1 - - - 47 Pneumonia (Acute Primary and Acute Influenzal) 16 28 25 19 30 32 40 23 43 1 - Enteric or Typhoid Fever - 1 - - - - - - - 1 - aratyphoid Fevers - - - 2 1 - - 9 9 8 7 7 7 4 3 3 Erysipelas 7 7 2 19 7 33 Food Poisoning - - - - - 76 59 72 54 Tuberculosis — Respiratory System 105 63 60 51 89 120 10 6 6 9 Other Forms of Tuberculosis 12 10 9 8 10 - - Anthrax - - - - - - - - - 1 - - - - - Malaria - - - - 2 18 19 1 1 1 1 - Puerperal Pyrexia 5 4 1 1 - Ophthalmia Neonatorum 3 - 1 2 1 - - 7 11 7 2 6 4 5 4 4 Scabies - TOTALS 1,164 863 1,656 558 1,588 1,420 691 980 857 564 Immunisation During the year it is reported that some 7,600,000 people were immunised in Great Britain against Poliomyelitis and yet there is still a reluctance on the part of parents to accept this procedure for the protection of their children. Similarly, the immunisation programme in regard to diphtheria and whooping cough is jeopardised by the apathy of parents. The following table records the immunisations carried out in the Borough during the year. Welfare Centres and Nurseries Under 5 years 5—14 General Practitioners Under 5 years 5—14 Completed Cases Total Diphtheria Prophylaxis only 151 49 28 7 235 Combined antigen: Diphtheria and Whooping Cough 78 9 49 3 139 Triple antigen: Diphtheria, Whooping Cough and Tetanus 390 1 93 — 484 Diphtheria Boosting doses—all ages 661 73 734 Whooping Cough only— all ages (completed cases) 64 5 69 Subsequent to the introduction of the scheme for protection against poliomyelitis, it has been shown that the risks of getting paralysis are eight times as high in the unprotected as in those who have been immunised. Dysentery In the early part of July an outbreak of dysentery occurred, involving 62 children. During the course of investigation into the cause and mode of spread of the outbreak the school was visited and a report was made to the London County Council on the unsatisfactory conditions found. As many as 4 out of 5 lavatories were found to be defective and at least a quarter were nailed up as repairs had not been effected. In addition to this, however, the dining rooms, and particularly the facilities for washing up, were found to be both defective and inadequate. After some 4or 5 months a new draining board has been fitted to one of the sinks. It had been in the dining room for at least two months before being fitted. As to providing double sinks and adequate hot water—so far only seven months have passed and only one further outbreak of dysentery has occurred. No amount of health lectures or propaganda by means of pretty pictures is going to educate the young child if his school environment is to be allowed to be so deplorable ! Fortunately, as a result of a closer liaison with head-teachers in the Borough many small outbreaks of dysentery have been quickly brought under control. A feature, however, which is of concern is the increasing number of organisms which are found to be resistant to a wide range of antibiotics. Road Accidents If there had been 72 cases of poliomyelitis in the Borough it would have been considered a serious outbreak and the public would quite rightly wish to take every step to prevent it. There was, however, an epidemic of road accidents involving 72 children —an epidemic of just as serious a nature from which one can certainly die. During 1958 there were 1,132 accidents, resulting in personal injury to 395 people. Of these, three died, and a further 58 suffered serious injury. Oblivious to the trail of sorrow and hardship that accompanies these casualty figures, it is easy for one to dismiss them as mere statistics! In no less than 753 instances the cause of the accident was said to be due to errors of judgment which is more significant still when read in conjunction with the report of the medical officer of a transport organisation which indicated that, of applicants to drive, 50 per cent, at interview, were rejected as unsatisfactory and that 20 per cent of the remainder were found to be medically unfit, more than half because of defective vision. Lung Cancer Cancer of the lung still takes its toll. Since 1950, when the connection between cigarette smoking and lung cancer was first demonstrated, over 100,000 deaths have occurred in Britain from this disease. Each year the tobacco companies spend £2,000,000 in making their products known to the public; this excludes the money spent on commercial television. Highly competent advertisers are paid fabulous sums to delude the public into a sense of complacency. Yet, as the deaths due to lung cancer rise to 33% of all males, the Treasury collects £700,000,000 in tax from the victims of this addiction and are too mean to offer more than a pittance towards health education and research. As recent research has shown that less than 35% of the cases discovered are considered operable, few of the victims of smoking are able to make much comment by the time they know the consequences of addiction. Out of every 100 cases diagnosed not more than 5 or 6 will be alive in 5 years time and it is estimated that a further million victims will die of this disease before the end of the century. Preventable Deaths Approximately 45 persons lose their lives every day in Great Britain as a result of accidents; seventy per cent of these are said to be sustained by old people, approximately two thirds of these being women. Falls account for fifty-eight per cent of the fatal home accidents and no less than ninety per cent of these relate to the elderly. In Bermondsey five men and two women died as the result of falls; four of these were sustained by persons over 80 and another by a person aged 72. Coal gas poisoning also constitutes a particular hazard for the elderly whose sense of smell is impaired. Unfortunately, it was also the means by which four people committed suicide. Although burns account for ten per cent of the accidents in the home and fifty-eight per cent of these are among old people, no deaths due to burns have occurred in the Borough. During the year one accident occurred which profoundly shocked many people. A small boy, aged 2, playing on a bomb site was decapitated when a section of wall fell on him. Subsequently, the property adjoining, which had, on many occasions been the subject of complaint, was demolished. There was a considerable increase in the number of suicides occurring in 1958. Although domestic coal gas was the predominant method, other means employed included barbiturate poisoning, hanging, jumping from a height and a self-inflicted stab wound. National Assistance Act 1948 Section 47 Under this section of the Act, the Council are authorised to apply for a Court Order for the removal to hospital, or institution, of an aged, infirm, or physically incapacitated person whose living conditions are insanitary. The National Assistance (Amendment) Act 1951 also makes provision for a magistrate to order the emergency removal of such persons to an institution for a period not exceeding twenty-one days, on certification by the Medical Officer of Health and a general practitioner. During the year, 13 persons were persuaded, in their own interests, to enter institutions voluntarily and only in the case of one old lady, aged 87, was it considered necessary to make application for a committal order. During the course of regular visits it had become increasingly evident that this old person, who was living alone and had no known relatives, was incapable of caring for herself adequately. When the committal order expired the old lady decided to remain in the home to which she had been admitted. Fortunately, it is rarely necessary for such action to be taken and it is only resorted to when there is no alternative and all persuasive efforts have failed. B Section 50 This section of the Act requires the Council to arrange for burial or cremation of a person dying in the Borough where there are no relatives or friends prepared to accept the responsibility. Where appropriate, the Council's costs, inclusive of administrative expenses, are recoverable from the deceased's estate. During the year, two burials were arranged at the request of the Coroner's Officer, one being that of a still-born child whose body was recovered from the Thames on 8th March 1958. The other burial was that of a man aged 67 who died at his lodgings on 6th April 1958. It was believed that the deceased had a surviving son but all efforts to trace him proved to be fruitless. Expenses incurred by the Council in this case were reimbursed by the Ministry of Pensions and National Insurance in the payment of a death grant. Insofar as this Borough is concerned, it is pleasant to be able to report that during 1958 no bodies of suicides were recovered on the Thames foreshore. Public Health (London) Act 1936, Section 122 The Council are authorised to remove and cleanse personal effects where the Medical Officer considers that the condition of such articles is likely to cause the spread of infectious disease. During the year, the Medical Officer visited the homes of 41 old people who were seriously ill or senile. Quantities of soiled bedding and personal clothing were found in each case and it was necessary for these articles to be regularly collected for cleansing in the Disinfecting Station and returned to the owners. Municipal Club For a number of years, the Public Health Committee have been conscious of the ever increasing problem of the care of old people. Sufficient evidence was produced by the Welfare Assistants to show that, in addition to the Meals on Wheels service, there was need for a club which could provide hot mid-day meals to elderly persons who were not housebound and, therefore, did not come within the scope of the service. There were many individuals, living a solitary existence, who found that, apart from the expense involved, it had become too much of an effort to cook a daily meal for themselves and they had gradually adopted a regular diet of bread, margarine and tea. This is frequently the case when a man loses his wife and finds great difficulty in fending for himself. A diet of this kind rapidly causes deterioration in mind and body and, if not supplemented, often produces a condition from which there is little likelihood of recovery. B1 TRUMPED! CORNER OF DINING ROOM IN THE WORKSHOP THE OLD TIME DANCING CLASS Although the Borough is fortunate in that it has a number of voluntarily operated clubs which are an invaluable source of relaxation for old people it was obvious that, mainly because of the shortage of voluntary assistance, alternative methods would have to be adopted if a meals club were to be operated successfully and the Council therefore considered the possibility of opening a Municipal Club under the provisions of Section 4 of the Physical Training and Recreation Act 1937. Whilst the matter was under discussion the Hospital Management Committee announced that certain hospital services were being transferred from the Public Health Centre in Grange Road to St. Olave's Hospital and that, consequently, half the first floor of the building, which had hitherto been used for physio-therapeutic treatment, would become vacant. The Council have always regarded the Public Health Centre with pride as, before the war, it was considered to be one of the finest centres of its kind in Europe, and it was felt that there was no better purpose for which this vacant accommodation could be used than to provide additional comfort for elderly people in the Borough. The fact that it had been used for physio-therapy meant that the heating installation was such that a temperature higher than that which is considered adequate for the average building could be maintained. The rooms were decorated in varying pastel shades, suitable furniture and kitchen utensils and equipment were purchased and, in January 1958, a Club Leader was appointed. These preparations were completed in late April and the club began to operate on 1st May after those qualified for membership had been made aware of the facilities being offered. It was emphasised that these facilities were additional to those being provided by voluntarily conducted old people's clubs and that membership of the Municipal Club was in no way to be considered prejudicial to membership of any of the former. The club was officially opened by His Worship the Mayor, Councillor T. Hendy,J.P.,on 15th May,in the presence of Council members, welfare workers and club members. This provided a favourable opportunity for the reactions of the old people to be obtained. Perhaps not surprisingly, some of the subsequent reactions of members to the facilities provided at the club were not anticipated. For instance, one large room was divided into fairly spacious cubicles and it was thought that these would be suitable for uninterrupted games of dominoes or cards, or even group gossip, but it soon became apparent that members preferred the community atmosphere of the main club room. This was also found to be true in the workrooms where it was evident that employees preferred to work as one unit rather than in small groups. In view of this, the Public Health Committee gave authority for the cubicles to be dismantled and it is proposed to use the accommodation as an additional dining room as well as for social activities during the afternoon when the club is often full to capacity. As a result, it is anticipated that approximately 50 meals per sitting, from Monday to Friday, can now be served as compared with the estimated number of 30 when the club was being planned. Frequently over 60 meals are served per day. Members are encouraged to assist as much as possible in running the club. There is no shortage of volunteers to wash up, serve meals or prepare tea during the afternoon, and it is evident they appreciate the fact that good quality plates, cruets, cutlery, &c., do much to enhance the enjoyment of a meal. In fact they are so anxious to help that some tact is needed when, at times, the number of willing helpers has, of necessity, to be reduced. As many entertainments as possible are arranged during the afternoon. The Council's Entertainments Officer has been most co-operative in this respect, and arrangements have also been made with the Libraries Department for films to be shown once a fortnight during the winter months. Community singing is greatly enjoyed and members of the staff have often given their spare time to play the piano for the old people. During the summer, members paid for a coach to visit the seaside, the cost of tea and lunch being met from a fund organised by the staff, in co-operation with the club members, to raise money by selling jumble and other articles which are donated. The Club Leader is always willing to accept small contributions from the members so that, when outings are arranged, a sum of money is available to help meet the cost. Insofar as the old people who attend the club are concerned, it would appear that while, like nearly everyone else, they would not be unappreciative of an increased income, shortage of money is not one of their main worries. A visit was also made to a Women's Institute where members were invited to tea, shown the surrounding countryside and entertained during the evening. The club members reciprocated by inviting a number of members of the Women's Institute to Bermondsey where they were received by the Mayor and shown the regalia and the Council Chamber. After a visit to the Norwegian Church they were entertained to tea at the club where they joined in community singing. These mutual visits were enjoyed very much and it is hoped to repeat them during the following year. In October, the girls of Fawcett House at the Aylwin School decided to adopt the Municipal Club as it is one of their objects to assist some local social activity. They subsequently decided to pay for relay wireless to be installed on the premises and three receivers are in operation. This service is very much appreciated, particularly by employees in the workrooms who enjoy "Music While You Work" programmes. A Harvest Festival was also organised by the Headmistress of Laxon Street School and pupils were invited to bring gifts of tea and packed groceries. These gifts were presented to the Municipal Club in such quantities that it will be possible for the members engaged in the workrooms to have cups of tea free of charge for the next twelve months. The packed groceries were divided as equally as possible and a parcel was presented to each club member at a Christmas Party. At the outset, it was decided to operate strictly on club lines because it was considered to be essential that the Club Leader should have the right to say who should be admitted, and members are required to sign an attendance book when they arrive. Fortunately, the need for any person to be excluded has not arisen, membership is increasing and it will, consequently, be necessary for additional furniture, crockery, &c., to be purchased. It has been observed that the old people are particularly appreciative of the club's facilities during winter months because they are able to economise in the use of fuel, gas or electricity in their own homes. Survey of Old People Although, for some years, the people of Bermondsey have been endowed with that family spirit which made them realise that the care of the more elderly members was the responsibility of the community, it was not until 1957 that a planned assessment of their conditions was commenced. In the spring of that year two welfare workers began what may now be termed as "Operation Ferret". Their orders were simple: To locate the old people in the Borough and bring succour to them where necessary. Putting this operation into effect, however, was a laborious task. Phase I A meeting was called of all those people and organisations having any connection with the care of the elderly. At this meeting, it was proposed that the Town Hall, on account of its central position, should become a co-ordinating centre for all welfare problems relating to old people. By this means, it was hoped to prevent duplication of visiting and also to be able to collect information not only for the use of the Public Health Department but also for hospitals or other agencies dealing with old people. Phase II Following this meeting many cases of an urgent nature requiring immediate action were referred to the department, and visiting was also commenced in Borough Council flats. With the co-operation of the Housing Department, a list was compiled of all old people and this was divided into two groups— (a) those considered by the estate superintendent to be in urgent need of help, and (b) those not in such great need. Phase III After all these cases had been located, systematic visiting of private property was commenced. Results During 1957 there were many interruptions to the visiting programme. Unfortunately, this also occurred in the early part of the following year and, as a result, the clerical work got far behind. Despite this, however, it has been possible to produce a detailed account of the findings for 1958. Additional information for the preceding year will be available at a later date. Thus, the figures relate to the last 804 cases found and not to the total number on the register which amounts to 1,642 cases. One additional factor is that during 1957 most of the really bad cases were seen, whereas the year under review probably gives a more reliable picture of the current position, Table I— Age and sex distribution Age Male Female 50—59 5 7 60—64 8 50 65—69 36 118 70—74 70 152 75—79 67 133 80—89 47 105 90+ 1 5 234 570 Total This table shows the preponderance of females at all ages, especially 65 years and onwards. Table II— Mobility Male Housebound Female Housebound Bed bound Bedbound Age Mobile Mobile 50—59 2 1 2 3 4 - 60—64 - 6 2 44 5 1 65—69 32 2 2 106 11 1 70—74 58 12 - 129 19 4 75—79 55 8 4 102 26 5 80—89 34 9 4 61 37 7 90+ 1 4 1 - - - Total 188 32 14 446 106 19 While showing the proportionate distribution of homebound cases, this table gives, for both sexes, some idea of the problem of growing old, i.e., the range of mobility gradually diminishes and as it does the patient is gradually cut off more and more from outside contacts and friends. This increasing isolation is not, however, the only problem, for arthritis and other disabilities reduce not only the facility to work but the ability to keep both home and person clean. Unfortunately, this often gives rise to discouragement and unless help is forthcoming the pensioner may give up hope, becoming resentful and antagonistic. Whereas it would appear that the males do not live long enough to become housebound, a quarter of the number of women will inevitably become so. Table III —Isolation Male Living alone Female Living alone No next of kin No next of kin Age Total Total 50—59 5 3 1 7 3 - 60—64 8 4 2 50 28 9 65—69 36 8 118 42 5 — 70—74 70 22 6 152 74 5 75—79 67 17 3 133 77 8 80—89 47 24 3 105 67 9 90 + 1 1 5 2 - - 234 79 15 570 293 36 Total This table shows the large number of old people who do, in fact, live alone. From the experience already gained, it is known that these are the very ones who are probably most in need of help. Particularly significant is the large number with no known relatives and, therefore, with no one to care for them. Although the number found at first may appear small, when it is realised that the present survey figures cover about a tenth only of the aged population then the seriousness of the problem of old people becomes at once apparent. Age MALE FEMALE Dist. Nurse Home Help Bathing Laundry Meals on Wheels Home Help Dist. Nurse Bathing Laundry Meals on Wheels 1 1 - 1 - 1 - - - - 50—59 3 - - - 2 2 1 - 1 6 60—64 1 1 3 - 10 2 32 - 4 - 65—69 3 1 14 2 3 4 21 9 - 70—74 1 7 - 5 15 1 4 41 3 75—79 3 3 12 - 4 11 80—89 19 - 4 5 46 16 - 1 2 1 - - - - - 3 90 + 63 15 127 38 21 2 1 26 13 10 (25) This table shows clearly the increasing demands made by the old of both sexes as age advances. Further study of the comparative figures in each age group showing the extent to which the home-help service is utilised also substantiates the impression gained by field workers that those living alone are most in need of help. Male Female Total Home Help Living alone & Home Help Total Home Help Living alone & Home Help Age 70—74 10 13 14 21 75—79 15 6 41 23 80 + 20 11 49 35 49 27 (55%) 111 71 (64%) Total all ages Table V— Disability Distribution Although no attempt has been made to ascertain all disabilities or to grade them, yet it was considered to be worth recording when the disability was of sufficient severity to handicap the old person in living a normal life. In a few cases there was more than one handicap. The following table gives an idea of the increasing incidence and distribution. Male Age No. Disability 50—59 5 Respiratory System 1 60—64 6 Locomotion 2 Gastro Intestinal Tract 1 65—69 35 Locomotion 1 Gastro Intestinal Tract 1 70—74 67 Locomotion 6 Cardio Vascular System 1 Respiratory System 10 Deaf and blind 1 75—79 64 Locomotion 1 Respiratory System 4 Cardio Vascular System 5 Gastro Intestinal Tract 5 Deaf 1 Blind 1 80 & over 43 Locomotion 5 Respiratory System 2 Cardio Vascular System 2 Gastro Intestinal Tract 2 Deaf 2 Blind 2 Female Age No. Disability 50 — 59 6 Locomotion 3 60 — 64 49 Respiratory System 6 Locomotion 6 Gastro Intestinal Tract 1 Cardio Vascular System 1 Blind 1 65 — 69 116 Locomotion 11 Respiratory System 3 Gastro Intestinal Tract 1 Blind 2 Deaf 1 70 & over 147 Locomotion 16 Cardio Vascular System 10 Respiratory System 2 Blind 3 Gastro Intestinal Tract 7 Thus it may be seen that the primary cause of hardship is the impairment of locomotion. Even in the small numbers recorded the preponderance of respiratory embarrassment is noted in the males. No special note has been made of the frequent mental impairment that is seen as this is considered to be almost within the normal for the aged. Many of those who are a source of worry during their life on account of increasing mental deterioration often die of some intercurrent infection even though gross cerebrovascular degeneration may be noted at autopsy. Table VI—Housing It was felt to be worth while to discover the relative distribution of old people amongst different classes of property. This, it was considered, might throw some light on the problem to be faced in dealing with the rehousing of people from proposed clearance areas. Subject to the information being obtained early enough it might even be taken into account at the planning stage of the rehousing programme. Male Female Private L.C.C. Private Age L.C.C. B.B.C. B.B.C. 50—59 3 2 1 4 2 — 60—69 3 15 26 52 116 — 70—79 2 44 91 77 208 — 80—89 14 33 2 26 77 — 90+ 1 1 — — - 4 5 76 153 3 160 407 Total From this table it is obvious that in rehousing occupants of properties in clearance areas it will be essential to take into consideration the needs of old people. With their limited capabilities it will, therefore, be most desirable that accommodation should be available which will be sufficiently small for them to keep clean. Table VII —Deaths During the year, 31 deaths occurred amongst the old people on the register. Of these, 20% had been known to the department for less than a week before death; 50% survived for less than a month from the time they were first notified and over 75% died within six months of their being registered. Two thirds of the deaths occurred in hospital and, of those dying at home only two cases were those of old people living entirely alone. Home Hospital Relatives Living alone Relatives Living alone Total Male 3 2 3 5 13 Female 6 5 7 18 - It was also considered of interest to note the place where death took place and the interval between finding the patients and their ultimate decease. Nearly half the deaths occurred amongst those living alone, the great majority dying in hospital. Although the numbers involved are too small to draw any definite conclusion, it would appear that, with the exception of two males, all cases were under the supervision of relatives or in hospital at the time of death. Atmospheric Pollution During periods of high concentration smog kills whilst the sub-acute pollution that occurs as a nearly constant feature of winter nights in urban areas produces marked deterioration in the condition of patients with bronchitis or cardiac conditions. There is also growing evidence that atmospheric pollution is an important factor in the causation of chronic bronchitis. Reference to Charts numbered 1, 2 and 3, shows the steady build up of smoke and SO2 during the last quarter. The relatively low figures found from mid-April to October are probably accounted for to a considerable extent by the fact that it was the period of maximal rainfall in 1958. Sufferers from coronary disease and bronchitis are amongst those whose condition is most aggravated by the products of atmospheric pollution. During the last ten weeks of the year there were repeated periods of fog and 16 people died of coronary thrombosis and a further 18 of bronchitis. Undoubtedly, the winter of 1958 will be remembered by the surviving patients, and relatives of many, on account of the suffering and deaths that occurred. From 27th October until Christmas there were no less than 26 days on which fog occurred. Traffic was frequently disorganised. The Emergency Bed Service was hard put to it on many occasions to find beds for the most deserving cases. Already Bermondsey has taken active steps to combat this menace to the inhabitants of towns. One smokeless zone has been declared, another has had the preliminary approval of the Minister and further extensive areas are being investigated with a view to extending the clean areas of the Borough. It has been noted that another London Borough has been pressing the Minister to make grants available to everyone who voluntarily incurs expense in altering grates and fireplaces whether or not they live in a smoke control area. Every effort should be made to encourage people to become clean air conscious. Investigation into the extent of atmospheric pollution has been continued during the year in co-operation with the Department of Scientific and Industrial Research and the tables hereunder show the concentration of smoke and sulphur-dioxide, as recorded at the Municipal Offices, and the amount of deposited matter recorded by the deposit gauges at Brunel Road, Rotherhithe, and the Public Health Centre, Grange Road. Concentration of Smoke and Sulphur-Dioxide Smoke expressed in mgs.per cubic metre Sulphur dioxide expressed in parts per million Month Monthly Average Highest Daily Average Monthly Average Highest Daily Average January .201 .711 .222 .443 February .139 .231 .733 .213 March .257 .700 .140 .308 .345 .112 .337 April .169 May .070 .266 .080 .223 June .060 .093 .072 .158 .036 July .135 .052 .116 August .035 .090 .066 .147 .094 September .060 .144 .184 October .993 .112 .278 .192 November .559 1.690 .200 .382 December .517 .203 .540 1.273 Deposited Matter Month Grange Road Brunei Road Rainfall ins. Matter deposited in tons per sq. ml. Rainfall ins. Matter deposited in tons, per sq. ml. January 1.61 22.62 1.75 26.37 February 2.04 23.73 no analysis made March 1.03 1.07 26.11 29.66 April 21.58 1.17 1.57 14.80 May 1.71 16.85 2.04 16.48 June 5.39 19.34 4.70 19.99 July 1.38 1.98 15.37 11.21 August 19.59 3.37 12.04 3.40 September 3.54 24.25 3.67 19.98 October 2.40 18.93 2.17 14.37 November 1.74 23.82 1.64 10.87 December 2.74 32.11 23.25 2.56 Chart showing the Concentration of Sulphur Dioxide in Bermondsey in 1958 MONTHS Chart showing the Concentration of Smoke in Bermondsey during 1958 MONTHS Chart showing Deposited Matter at Two Centres in Bermondsey during 1958 MONTHS Firework Injuries During the firework 'season' an investigation was carried out with the co-operation of a number of general practitioners and two local hospitals, and it was ascertained that 24 casualties occurred due to fireworks. The table below shows the numbers of patients treated by general practitioners and in hospital and the risk of injury from fireworks according to age group. Age Treated Treated at group by G.P.s Hospital Risk 4 & under — 1 1:5,000 5-9 1 9 1:400 10—20 8 5 1:500 Although the numbers are small, the seriousness of this hazard is shown by the fact that over 20% had injuries involving the region of the eye, one of these cases being of such severity as to require transfer to a specialist eye hospital. In addition, one unfortunate victim required a circumcision to repair the damage inflicted when a firework exploded in his pocket. Influenza Complications Reports appeared in medical journals concerning complications ensuing after the 1957/58 influenza epidemic, and it was considered to be worth investigating whether or not this virus infection had any effect on pregnancy or the resulting offspring. Careful examination of the numbers of stillborn children and congenital abnormalities, in conjunction with other relevant factors, failed to reveal any undue increase in complications which could be related to the influenza virus. This work was greatly facilitated by close collaboration with many other South London Medical Officers of Health. FOOD CONTROL PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937/48. FOOD AND DRUGS ACT, 1955. 116 samples were taken during the year by the Wharves Inspectors. Article Examined No. of Samples Purpose of Examination Result Action Apples 1 For metallic contamination Satisfactory Released „ 1 „ Apple Juice For presence of preservatives Apricots, Dried 14 „ „ For presence of preservatives 8 „ „ Contained excess Sulphur Dioxide Detained „ „ 1 Released with warning. „ „ „ „ „ „ „ „ De-sulphured and released „ „ 1 „ „ Beans, Stringless Satisfactory 1 For preservatives and metallic contamination Released Bouillon Texton „ „ 2 „ „ Butter 18 To ascertain condition „ „ „ 2 Contained excess moisture „ „ Detained 2 Cabbage, Stuffed For presence of preservatives Released with warning regarding labelling Satisfactory Caviar (Lumpfish) 1 „ „ Contained 992 p.p.m. Benzoic Acid Detained Cheese Delites To ascertain composition Released 1 Satisfactory Cheese Powder „ 1 To ascertain condition „ Chocolates, Milk 2 „ „ „ „ „ „ Cucumbers in Brine 2 For presence of preservatives Article Examined No. of Samples Purpose of Examination Result Action 1 To ascertain composition Satisfactory Released with warning regarding labelling Dill Sauce, Dried Frankfurters in Brine 2 For preservatives and metallic contamination For presence of preservatives Released „ 1 Released with warning regarding labelling „ Gherkins 1 To ascertain composition „ Goulash „ „ 1 „ Released „ „ „ Ham, chopped For presence of preservatives „ 1 „ „ 1 Ham & Tongue „ „ „ Ham & Chicken Roll „ 1 „ „ „ Hamburger Patties 1 To ascertain composition „ „ 1 „ Herring Fillets in Mustard Sauce „ For preservatives and metallic contamination 1 Released with warning regarding labelling „ Java Crackers To ascertain composition 1 Contained excess Benzoic Acid Ketchup For preservatives and metallic contamination Detained 2 Satisfactory Released To ascertain condition Lard „ For presence of preservatives Lemon Juice 1 „ Lollipops For preservatives and metallic contamination 1 „ „ Luncheon Meat 1 „ For presence of preservatives „ 1 „ „ „ „ „ Released with warning regarding labelling 1 Meatballs with Spaghetti For preservatives and metallic contamination Released „ Article Examined No. of Samples Purpose of Examination Result Action Milk, Evaporated 1 To ascertain condition Satisfactory Released „ 1 For presence of preservatives Mushrooms, Dried „ „ „ Contained excess Benzoic Acid Mustard, Liquid 1 Detained 1 „ „ Released Satisfactory „ „ 1 Noodles with Meat Detained (Imported without Official Certificate) To ascertain composition „ For preservatives and metallic contamination „ 1 Octopus on Skewer Released „ Oranges & Wrappers „ 1 For presence of preservatives 1 „ Ox Tongue (Canned) „ For preservatives and metallic contamination „ 1 Papain „ For presence of preservatives „ 1 Peas, Canned „ „ „ 1 „ „ „ „ Released with warning regarding labelling „ „ „ 1 „ Pork Cutlets Released 3 „ Pork Luncheon Meat „ „ „ 1 „ „ „ Released with warning regarding labelling „ „ „ „ To ascertain composition 1 Pork Paste Released 1 For presence of preservatives „ „ Released with warning regarding labelling Pork Slice „ Poulet de la Bonne Femme 1 „ Released Purpose of Examination Result Action Article Examined No. of Samples Premier Jus 1 To ascertain condition Satisfactory Released Re-exported (Imported without Official Certificate „ „ 1 „ „ „ Red Currant Juice For presence of preservatives 1 Released „ 1 Rice with Meat To ascertain composition Detained (Imported without Official Certificate) „ Salmon For metallic contamination Released 1 „ 1 To ascertain composition Sambal Manis „ „ 2 „ For metallic contamination Sardines in Oil „ „ Sardines in Tomato 1 „ „ „ 1 Sauerkraut with Meat To ascertain composition Released with warning regarding labelling „ 1 Smoked Salmon Mayonnaise For preservatives and metallic contamination Released „ „ 1 For preservatives and metallic contamination Soup, Canned „ Soup Powder For presence of preservatives „ 1 „ Released with warning regarding labelling „ „ 2 „ „ „ Sultanas For presence of preservatives 2 „ Released „ 1 For preservatives and metallic contamination „ Turkey, Boneless 1 „ „ „ Turkey in Natural Jelly „ PHARMACY AND POISONS ACT 1933 AND PHARMACY AND MEDICINES ACT 1941 54 premises were entered on the Council's list for the year under report. MILK PREMISES FOOD AND DRUGS ACT 1955 MILK AND DAIRIES REGULATIONS 1949 14 milk sellers were registered under the above-mentioned Acts during 1958 and 15 were removed from the Register. There were 134 milk sellers on the Register at the end of the year. MILK (SPECIAL DESIGNATION) (RAW MILK) REGULATIONS, 1949 MILK (SPECIAL DESIGNATION) (PASTEURISED AND STERILISED) REGULATIONS, 1949 During the year under report the following licences were granted:— Dealers' Licences. To sell Tuberculin Tested Milk 38 To sell Pasteurised Milk 91 To sell Sterilised Milk 108 Supplementary Licences To sell Pasteurised Milk 15 To sell Tuberculin Tested Milk 15 To sell Sterilised Milk 21 All premises used for the sale of milk are regularly inspected to ensure that the standard of cleanliness laid down is maintained, MILK SAMPLING Samples of milk, both for bacteriological and chemical examination, are taken from milksellers and special arrangements are made for the sampling of the milk supplied to all schools, school meals services and hospitals in the borough. The total number of samples submitted for analysis during 1958 was 375 of which number 180 were taken from schools, hospitals, etc. For Chemical (i.e., Fat and non-Fatty Solids Analysis). Condensed Milk 6 Evaporated Milk 6 Sterilised Milk 19 Pasteurised Milk 148 Tuberculin Tested (Pasteurised) Milk 7 Channel Islands Milk 8 Dried Milk 1 195 For Bacteriological Examination. Pasteurised Milk: For tubercle bacilli 2 For brucella abortus 1 3 For Examination under Milk (Special Designations) Regulations. Pasteurised Milk (from schools, hospitals, etc.) 90 Pasteurised Milk (other than from schools) 37 Tuberculin Tested (Pasteurised) Milk 36 Sterilised Milk 17 180 (40) ICE CREAM 47 samples of ice cream have been examined, with the following results:— 1. Bacterial Count. Up to 500 per 1 c.c. 26 Over 500 to 1,000 per 1 c.c. 6 Over 1,000 to 5,000 per 1 c.c. 5 Over 5,000 to 10,000 per 1 c.c. 1 Over 10,000 to 50,000 per 1 c.c. 6 Over 50,000 per 1 c.c. 3 47 2. Presence of B. Coli. B. Coli present in 1 c.c. and 1 10th c.c. and 1 100th c.c. - B. Coli present in 1 c.c. and 1 10th c.c. - B. Coli present in 1 c.c. - B. Coli absent in 1 c.c., 1 10th c.c. and 1 100th c.c. 47 47 3. Methylene Blue Grading. Grade 1 32 2 10 3 2 4 2 Not graded 1 47 4. CHEMICAL ANALYSIS. Nine samples of ice cream were submitted for chemical analysis under the Food Standards (Ice Cream) Order, 1953. All samples were satisfactory. Bread —Notes on an Investigation Although there is undoubtedly a greater variety of food offered to the general public than ever before, bread is still of major importance in the diet, particularly in families where there are children. Bread is still in fact the staple food. This is made clear in the National Food Survey Committee's Report (1956), published by Her Majesty's Stationery Office, which says: "In 1956, bread and flour provided, in the average diet, 24.7% of the energy; 26.3% of the protein; 26.9% of the vitamin B; 24.2% of the nicotinic acid; and 23% of the iron." It was with this point in mind that, during November and December, a special investigation into the nutritional quality of the various types and makes of bread on sale in the Borough was undertaken. In recent years there has been a big change in the baking industry. The number of small "one-man bakeries" has declined considerably and their place has been taken by large combines in which the baking of bread is less of an art and more of a scientifically controlled industry. In 1939 in Bermondsey there were 45 small bakeries; there are now only 9 and, in addition, a number of bakers' shops which are, in effect, retail selling points for the factory made products. The standard of hygiene of the factory bakery and of the retail shops it controls is generally higher than that found in the small bakehouse. There are several reasons for this, the two main ones being: 1. The use by the small baker of old premises which are difficult to keep clean and are often on projected clearance areas; 2. The lack of capital with which to effect any lasting and radical alterations in premises or plant. Against this must be set the decided views of many people who are prepared to sacrifice a little hygiene for what they consider to be the superior taste and appearance of bread baked on the "oven bottom". Since the war and, to some extent, following the American pattern, various new types of bread have been put on sale with such names as "American type", "Super", and "Enriched". These breads usually sell at higher prices and the investigation included an assessment of the claims made for them. Bread is made essentially from flour, water and salt, with yeast as the raising agent. The quality of the bread and, to some extent its keeping properties, depend on the quality of the flour and the skill with which the various fermentation and baking processes are carried out, but the addition of other ingredients can have a big effect. These additional ingredients may be fat and milk products, usually skim milk powder, and both increase the nutritional value of the bread which is, however, basically determined by the flour used. Soya flour products are known to be widely used in very small quantities in bread making (12 ozs per sack of 280 lbs of flour) and cannot easily be detected. Addition of soya flour to such a small extent is not sufficient to affect the nutritive value of the bread but, at the same time, it cannot be regarded as a chemical addition. It is said to inhibit staling. All the samples examined were made from white flour. Analytical Results In the detailed examination undertaken the following constituents were determined: 1. Moisture This is not significant in itself, but the higher the moisture content, the more the other constituents are diluted. 2. Protein This is an important factor. Normally it would be derived solely from the flour but if a milk product has been used as an ingredient this would substantially increase the protein content. 3. Fat Flour naturally contains a trace of oil, and bread made with no added fat would contain about 0.7 to 1.2 per cent oils and fats. 4. Mineral Matter This consists of (1) the salt which has been added (approximately 1 per cent), (2) potash, lime, magnesia, iron, phosphates and sulphur compounds natural to wheat flour, and (3) additives, viz., creta praeparata and iron. 5. Carbohydrates This is mainly starch, but includes a very small proportion of fibre, natural to wheat flour, which is not digestible. 6. Iron The human diet must contain sufficient iron. If the outside portion of the wheat grain is discarded (as in the case when white flour is milled, with only 70 to 72 per cent extraction) the iron content is drastically reduced; from 3.55 mgms per 100 gms for wholemeal flour, down to 0.92 mgms per 100 gms for white flour (70 to 72 per cent extraction). Under the Flour (Composition) Regulations all flour must contain not less than 1.65 mgms iron per 100 gms. corresponding to a minimum of 1.2 mgms per 100 gms. of bread. The natural iron content of flour varies to some extent, and it is difficult for the millers to ensure even distribution of the added iron which goes into the flour as a master mix of iron and vitamins (see below). It might be expected, therefore, that the iron content might vary somewhat. 7. Calcium This is the basic element in lime and chalk, and is very important in human nutrition. Under the Flour (Composition) Regulations, small quantities of "creta praeparata" (purified chalk) have to be added to flour (not less than 235 mgms. and not more than 390 mgms per 100 gms). The natural calcium present in flour is of the order of 37 mgms per 100 gms (expressed as chalk). If milk product is added to bread, this would increase the calcium content since milk is rich in lime. The figure for calcium (as calcium carbonate) given in the tables below includes the small quantities of magnesia naturally present in flour. 8. Milk Powder This is sometimes added to bread, usually in the form of skim milk powder. It produces a finer texture bread and increases its nutritional value, particularly the protein and mineral constituents. 9. Vitamin B1 This is one of the important vitamins present in flour, and which is substantially decreased if the wheat grain is milled to a low percentage extraction. For this reason, the Flour (Composition) Regulations require all flour to contain not less than 0.24 mgms vitamin B1 per 100 grams of flour. The extra is added by the millers in the form of a master mix containing vitamin concentrate and iron. Vitamin B1 is not very stable, and some is lost during baking. 10. Glyceryl mono-stearate This is a chemical substance which acts as an anti-staling agent and was found in two samples of the bread examined. So far as is known this substance is quite harmless and, in fact, is used as an emulsifier in other food industries. 17 samples of bread were examined, 12 being ordinary or "standard" bread and 5 "American-type" or "enriched" bread sold at a premium. The samples show the following variations in composition and price (ranging from maxima to minima): — STANDARD BREAD "ENRICHED BREAD" 8.69—7.97% Protein 9.33—7.95% 8.45% Average 8.60% 37.00—34.7% Moisture 36.00—34.70% 36.06% Average 35.47% 1.55—0.56% Oil and Fat 4.04 —1.61% 1.20% Average 2.74% 1.87—1.60% Mineral Matter 2.05 —1.25% 1.74% Average 1.78% 54.18 —51.58% Carbohydrates 52.86—50.49% 52.55% Average 51.41% 424-283 mgms/100gms Calcium 477-354 mgms/100gms 2.36—1.42 mgms/100 gms Iron 2.46—1.54 mgms/100gms 0.14—0.08 mgms/100gms Vitamin B1 0.12—0.07mgms/100gms 0.53%—NIL Milk Solids 20%—NIL Not Fat .63d—.411d Price per oz .619d —571d .495d Average .597d In the "standard" bread examined only two samples contained skim milk. The average figure for oil and fat present was of the order of that normally expected in flour although fat has certainly been added in more than half the samples. The price of .63d per oz of one sample of "standard" bread was very much higher than any of the remaining samples. The prices generally were remarkably even throughout. One sample of "standard" bread was claimed to have been "ultra-violet ray treated" but the irradiation of cereal products in this way has no recognised nutritional benefit. In the five samples of "enriched" bread the main form of enrichment in every case was additional fat and/or skim milk powder. The claims made in every sample except one were considered to be justified by reason of the presence of this additional fat and/or skim milk powder. In one case the claim of enrichment was not considered to be accurate and the firm concerned were advised of this. A subsequent sample was found to be satisfactory. To sum up, to-day's "standard" loaf appears to compare favourably with the pre-war loaf in nutritional value whatever one may think of the taste and appearance. The claims of enrichment for the "enriched" bread which costs Id to 1½d more for a small loaf (14 oz) are based, in the main, on additional fat and/or skim milk powder which does increase the nutritional value and may improve the texture of the crumb. Whether these advantages are worth a 20% increase in price is not within the scope of this investigation. Pre-War White Loaf For purposes of comparison, the average composition of the pre-war white loaf is given below: Protein 7.9% Moisture 32.0% Fat 0.7% Mineral matter 1.5% Carbohydrates 57.9% 100.0 Calcium (as calcium carbonate) 35mgms per 100gms I ron 1.00mgms per 100gms Vitamin B1 0.04 mgms per 100gms SECTION 14, FOOD & DRUGS ACT Inspections Ice Cream Premises 201 60 Preserved Food, etc. 84 280 DISPOSAL OF UNSOUND FOOD Condemned food suitable for animal feeding is disposed of for this purpose under supervision. Condemned food for destruction is collected by Council's van and barged with household refuse. FOOD PREMISES AND TYPES OF BUSINESS Restaurants, cafes and snack bars 132 Factory Canteens 79 Grocers and General Provisions 131 Butchers 52 Greengrocers and Fruiterers 76 Fishmongers and Curers 28 Bakers and Pastrycooks 31 Confectioners 80 Public Houses 144 Food Factories 178 Wholesale Food Stores 112 Food Wharves and Depots 53 CATERING ESTABLISHMENTS Inspections and re-visits 744 Notices served 45 UNSOUND FOOD The general inspection of food in shops and on stalls forms part of the duty of the District Public Health Inspectors. Food, in the quantities stated, came under the notice of the Inspectors during the year, and being found unfit for human consumption was destroyed or disposed of for purposes other than human food. Description of Food Weight tons cwts. qrs. lbs. Meat - 1 2 6 - Meat, Canned Poultry 6 3 1 1 1 - - Offals 3 14 - — 1 18 Fruit, Canned - - Fish, Canned 7 - - - Fish - 1 3 - 26 Milk, Canned - - - Preserves - 1 2 8 2 Vegetables, Canned - - 1 - 2 9 Various - Total 8 - 15 - Food Hygiene During the year, six lectures on food hygiene were arranged for persons employed in the food trade in the Borough. There was a total attendance of 69. Films were shown at each lecture and particular emphasis was placed on personal cleanliness and the proper storage of food. The attendance was not very encouraging and it continues to be very difficult to get people to come along. Those who did attend showed considerable interest. Food Hygiene Regulations, 1955 During the year, legal proceedings were taken in respect of two premises for contravention of the Food Hygiene Regulations. In one case, four infringements were proved against the proprietor of a small cafe and the magistrate imposed fines of £11 with £6.6.0 costs. In the other case, which involved a factory bakehouse, six infringements were proved and fines totalling £69 were imposed and £31.10.0 costs awarded to the Council. FOOD AND DRUGS During the year 787 samples were submitted by the Food and Drugs Inspector. In 36 cases the analysis disclosed an infringement of the law. Date purchased Sample Infringement Remarks 1.1.58 Pork Sausages Contained 51% meat instead of not less than 65% Prosecution: — Summons dismissed with £5.5.0 costs Date purchased Sample Infringement Remarks No. Contained 44% meat instead of not less than 50% 1.1.58 Beef Sausages Prosecution:— Summons dismissed with £5.5.0 costs Letter to manufacturer 264 Minced Beef Loaf 27.1.58 331 Contained 68% meat instead of not less than 80% 27.1.58 Ham Roll— Chicken Centre Contained 56% meat instead of not less than 65% and chicken centre contained starchy materials „ „ 332 Canned Braised Steaks „ „ 12.2.58 Contained 55% meat instead of not less than 75% and label incorrect 385 Letter to supplier 13.2.58 Milk Contained fragment of glass 387 17.2.58 Spaghetti in Tomato Sauce with Cheese Letter to manufacturer 392 Contained 270 parts per million tin instead of not more than 250 parts per million Contained 21% fat instead of not less than 25% 10.3.58 Puff Pastry „ „ 448 13.3.58 Ham Roll— Chicken Centre Chicken centre contained starchy materials 464 „ „ 19.3.58 Juniper Backache Kidney and Bladder Pills „ „ Contained 37.5% potassium nitrate whereas label declared 42.85% 479 2.4.58 530 „ „ Meat Pie Contained 13.5% meat instead of not less than 20% 23.4.58 Beef Sausages 574 Contained 44% meat instead of not less than 50% Prosecution:— Absolute Discharge with £5.5.0 costs 619 12.5.58 Glycerin B.P. Did not satisy requirements of British Pharmacopoeia and contained 96.5% of Glycerin instead of not less than 98% Letter to manufacturer 13.6.58 Pickling Spice 711 Contained pieces of stone and coarse grit Warning to manufacturer 16.6.58 716 Pork Luncheon Meat Contained 67% meat instead of not less than 90% Letter to manufacturer 3.7.58 785 Contained 95 milligrams Creta Praeparata per 100 gm. instead of not less than 235 milligrams Plain Flour „ „ 892 Currants— Cleaned 6.8.58 Letter to supplier Currants had not be properly cleaned No. Date purchased Sample Infringement Remarks 920 Infested with live insects Remainder of stock destroyed Dried Parsley 18.8.58 Presence of sodium nitrite not declared on label Luncheon Meat 921 18.8.58 Letter to importer 22.8.58 936 Malted Milk Biscuits Contained no milk fat and milk solids present were derived from skimmed milk Letter to manufacturer 1.9.58 5.3% deficient in milk fat 966 Sterilised Milk Letter to supplier 968 1.9.58 Milk Gums Contained no milk fat and milk solids present were derived from skimmed milk Letter to manufacturer 22.9.58 10 Butter Contained 17.1% water instead of not more than 16% Letter to supplier 10.9.58 Fat used was mixture of butter and margarine in equal proportions 998 Buttered Rolls Letter to retailer 15.10.58 88 Contained 45 milligrams Creta Praeparata per 100 gm. instead of not less than 235 milligrams Plain Flour Letter to manufacturer 27.10.58 Contained 63% meat instead of not less than 80% 113 Luncheon Meat „ „ 27.10.58 Contained 550 international units of Vitamen A instead of not less than 760 116 Margarine „ „ 27.11.58 Dripping 212 Contained 1.60% free fatty acids instead of not more than 1.5% Remainder of stock withdrawn 2.12.58 Apricot Jam Contained 28% fruit instead of not less than 40% 225 Letter to manufacturer 2.12.58 Bread (Enriched) Description 'Enriched' unjustified „ „ 232 „ „ „ „ 273 15.12.58 Orange Squash Contained 2 gallons instead of 2½ gallons orange juice per 10 gallons squash d 1 246 Contained 78.4% beef fat instead of not less than 83% Shredded Beef Suet 8.12.58 „ „ Lentil Soup with Smoked Ham 942 Absence of solid pieces of smoked ham 25.8.58 Date purchased Sample Infringement Remarks 29.12.58 Cut Stringless Beans Presence of added salt not declared on label Letter to importer 30.12.58 Contained 16.45% water instead of not more than 16% Prosecution: — Absolute Discharge with £5.5.0 costs Butter Six warning letters were sent to manufacturers in respect of articles of food complained of by members of the public. SAMPLING OF EGG PRODUCTS 1958 Sampling of egg products to determine possible contamination by Salmonella organisms was continued during 1958. The total amount of egg entering the borough proved to be almost double that of 1957. Under the Public Health (Imported Food) Regulations 1937 local authorities are allowed only 48 hours as a period of detention for sampling purposes and, in order to obtain a punctual examination and rapid decision, the importers paid for a considerable number of the samples to be examined privately. The method of sampling was by batch numbers (signifying packing dates). Where a sample showed evidence of contamination the whole batch was placed under detention and later either reexported or released for pasteurisation before use. The main importations were of frozen whole egg of which the chief exporters were China and Australia and laboratory results showed that 4.6% of the samples taken from these consignments contained Salmonellae. The total number of samples from all egg products found to be contaminated was 244 and the following table shows the type of contamination. No. of samples Salmonella aberdeen 17 Salmonella anatum 5 Salmonella bareilly 1 Salmonella bovis morbificans 1 Salmonella muenchen 3 Salmonella newport 12 Salmonella potsdam 4 Salmonella senftenbure 2 Salmonella thompson 147 Salmonella typhi-murium 51 Salmonella thompson & typhi-murium 1 244 IMPORTATION OF EGG PRODUCTS, 1959 Type of Egg Product Quantity Imported (to nearest cwt.) No.of sampls taken No.of sampls positive Quantity of contaminated egg Disposal of contaminated egg Country of Origin Re-exported Still under detention Released for heat treatment T. c. Q. L. T. C. Q. L. c. Q. L. T. c. Q. L. T. c. Q. L. T. ARGENTINE Frozen Albumen 95 62 - 2 5 - - 1 24 1 2 Dried Whole Egg 24 18 - - - - - - - - 4156 42 1508 25 14 AUSTRALIA Frozen Whole Egg 85 10 - 4 4 59 - - - - - - - 3107 535 Frozen Whole Egg 13975 171 1396 687 18 - - 13 172 9 - - CHINA 5 - - - - - - - 23 3 2040 1 563 11 31 19 8 16 - - Frozen Albumen - - - - - - 4 2 - Frozen Yolk 15 - - 185 5 5 16 Dried Whole Egg 596 19 16 5 - - - - - - 15 1 2 36 4 2 13 13 Dried Yolk - - - - - - 34 2 Dried Albumen 12 - DENMARK 17 17 8 - - - - - - - 6 Dried Yolk 3 3 - - - 18 - GERMANY Frozen Albumen 24 8 - - Frozen Whole Egg HOLLAND 1 2 - - - - 50 20 - Frozen Albumen 6 - - Dried Whole Egg 10 1 - - - - - - Dried Albumen 4 2 7 1 5 5 - - - - - - 16 - ITALY Dried Albumen 1 10 1 1 3 3 3 - - - - - IRELAND 2 1 - Frozen Whole Egg - - - 30 10 POLAND Frozen Whole Egg - - - — 29 16 5 - Dried Whole Egg - — 4 Dried Albumen 6 U.S.A. - 19 - - 747 8 - - 584 10 Totals 21093 6 - - 5590 244 1525 17 - - 193 19 - ) — - (53) PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937/48 Disposed of for purposes other than human food Weight Destroyed Weight Removed for sorting under Sanitary Authority Weight Re-exported Weight T. c. Q. L. T. c. Q. L. T. c. Q. L. T. c. Q. L. Bacon - - - - - - - 16 3 15 - 15 - - - - Beans 48 2 - 3 - 8 - 5 17 — - - - - - Butter - 1 1 - - - - 21 2 4 1 25 - - - - - Casings - - - 3 3 - - - - - - - - - - - Cheese - - 4 1 2 1 - - 19 10 16 - - - - Cheese, Processed - - - - - - - - 17 3 - - - - - 4 27 - Cocoa 19 1 - 1 - - - - - - - - - - - Coconut - 7 - 2 2 - - - - - - - - - - Coffee 1 19 - - - - 1 - - - - - - - Confectionery - - - 83 10 - - 61 6 2 7 - - - - - - - - Dhall 17 - - 2 1 - - - - - 3 - - - - Egg Albumen - - - - - - - - - - 15 14 1 - - - 1 Egg, Dried - - - - - - - - - - 13 - 3 4 - - 1 4 4 3 488 Egg, Frozen 2 - - 14 19 2 24 146 4 2 24 - Egg Yolk - - - - - - - - - - - 3 16 - - Fish - - 2 25 - - - - - - - - - - - - Fish, Canned - - 3 27 - - - 3 - - - - - - - Flour 15 - - - 2 4 - - - - - - - - - - - Fondant - - 3 - - - - - - - - - - - - - Fruit - - 2 2 - - 2 9 6 5 13 8 1 5 - Fruit, Canned - 2 - - 18 5 8 - - - - - - - - - - Fruit, Dried - - - 1 5 27 - - - - - - - - - - Fruit Juice and Pulp - - - 17 17 2 3 - - - - - - 17 - - - Gherkins - 1 9 - - - - - - - - - - - - - - 8 - - Lard - 3 18 2 17 - - - - 3 - - Lentils - 3 7 - - - - - - - - - - - - Maize - - 9 - - - - - - - - - - - - Margarine 3 - - - - - 2 4 - - - - - - Meat - - - - 16 2 - 3 - - 12 2 - 9 - 11 Meat, Canned 8 - - - 6 30 1 - 24 4 - 16 - 3 2 1 - - - Milk, Canned 1 3 12 - - - - - - - - - - - - - - - Milk Powder - - 1 - - - - - - - - - - - Mushrooms - - - - - - - - - 1 16 - - - - - Mustard - - - - - - - - - - - - 3 - Nuts 5 - - 4 2 27 - 11 3 2 3 - 3 8 80 - Offals - - - 6 2 1 1 3 18 - - - 16 - - - - - Onions 4 - - - - 1 - - - - - - - 3 19 - 6 - - - Peas 2 13 - - - - - Poultry - - - - - - - - 19 - - - - 5 - - - - - - - Poultry, Canned - 3 - - - 6 15 - - - - - - - Potatoes - 7 - - - - - - - - - - - - - - Premier Jus - - - - - - - - - - 23 5 2 - - - - - Preserves - - - - 3 16 - - - - - - - Rice - - - 7 8 2 1 6 2 - - - - - 2 9 - Sausage, Smoked - - - 14 1 - - - - 1 - - - - - - - - Soups, Canned - - - 16 2 4 - - - - - - - - Sugar - - - - - - 1 - - - - - - - Tapioca - - - - - 4 3 16 - - - - - - - - - - - - Tea - - - - - - - - - - - - 6 14 - Tomatoes - - - - 2 1 8 - - - - - - - Tomatoes, C'ned - - - - - 11 18 25 - - - - - - - - - - - Tomato Juice - - 2 - 6 21 - - - - - - - - - - Tomato Ketchup - - - - - - - - - - - - 2 - - - Tomato Paste - - - 12 1 3 - - - - - - - - - - Tomato Puree 15 - - 8 12 - - - - - - - - - 2 - - Various 11 109 12 3 - - - - - - - - - - - Vegetables, C'ned - 6 23 - - - - 4 - - - - - - - - 311 21 1 3 Total 2 11 1 15 14 6 162 15 4 500 303 23 (54) WORK OF THE WHARVES AND FOOD INSPECTORS, 1958. Mr. BUTCHER Mr. TAPSFIELD Mr. CAMPBELL Mr. HANCOCK TOTALS Food Wharves and Depots 2013 1348 1443 - 4804 148 235 143 526 Visits Food Factories - 343 Food Stores 447 417 133 1340 252 447 71 1335 Condemnation of Food 565 Milksellers - - 192 192 - - Ice Cream Premises - - 60 60 - - 41 41 Pharmacy and Poisons - 744 Catering Establishments - - - 744 653 113 994 Various 71 157 98 56 239 85 - Consignments of Imported Food detained 1166 328 55 Certificates issued for Unsound Food 470 313 2 - - 47 49 Intimations Served Chemical 788 - - 788 Food and Drugs - 58 - Imported Food Regulations 28 30 116 91 260 22 - 373 Egg Products Number of samples taken for analysis Bacteriological - Frozen Foods - - 6 6 - 6 - - Fish, Canned 6 Jellied Eels and Shellfish - 10 17 - 7 Canned and Cooked Meals 8 11 - - 3 - 2 Other Foods - - 2 - 180 180 Milk (Special Designation) Regulations - - - - 2 2 Milk for T.B. - - - 1 Milk for Brucella Abortus - 1 Ice Cream - - - 47 47 STREET AND OPEN MARKETS Bermondsey Square (New Caledonian) Number of licences in operation 248 Income for 1958 £3677 15 6 Street Markets Total Income for 1958 £3983 3 6 Number of licences in operation: Albion Street 7 Bermondsey Street 43 Railway Approach 15 Southwark Park Road 38 Tower Bridge Road 30 Trident Street 2 Various 15 Total 150 There were no prosecutions for unlicensed trading during 1958. SANITARY CIRCUMSTANCES OF THE BOROUGH HOUSING During the year two areas were represented—the Cranham Road/Parfitt Road Area comprising 140 dwelling houses and 2 shops with dwellings over and the Alice Street Area comprising 11 houses and 1 shop with dwelling over. The Borough Council completed 102 flats, 295 were in course of erection at the end of the year and plans for 994 were prepared or in course of preparation. 227 families from the waiting list, clearances areas etc. have been rehoused and 270 transfers and exchanges were arranged. This has resulted in 497 families being provided with improved accommodation by the Borough Council. 357 families were rehoused by the London County Council and 23 families were accommodated in new towns. 33 E.F.M. Bungalows were demolished during the year and 175 remain. HOUSING ACT, 1957—OVERCROWDING The following new cases of overcrowding have been encountered during the year:— In private dwellings 14 In Bermondsey Borough Council dwellings 7 In London County Council dwellings 1 Total 22 Total number of cases of overcrowding at present on the Register 105 ERADICATION OF BED BUGS The following table shows the fumigations carried out during 1958:— Disinfested Council houses or flats 65 Other houses or flats 173 (56) INSPECTIONS, PROCEEDINGS, ETC. Hereunder will be found particulars of Inspections, Proceedings, etc., for the year 1958:— Inspection of Dwelling-Houses during the Year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2,836 (b) Number of Inspections made for the purpose 19,335 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 103 (b) Number of Inspections made for the purpose 187 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 131 (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 36 Remedy of Defects during the Year without Service of Formal Notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 663 Action under Statutory Powers during the Year:— (A) Proceedings under the Housing Act, 1957:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil. (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners Nil (b) By Local Authority in default of owners Nil (B) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 1,417 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 499 (b) By Local Authority in default of owners 3 (C) Proceedings under Housing Act 1957:— (1) Number of dwelling-houses in respect of which Demolition Orders were made 2 (2) Number of dwelling-house in respect of which Closing Orders were made 2 (3) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (4) Number of separate tenements or underground rooms in respect of which Closing Orders were made 10 (5) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil Prosecutions Under the Public Health (London) Act, 1936:— (1) Number of prosecutions 4 (2) Fines imposed - (3) Costs awarded £12 12 0 REGISTERED PREMISES— Number on Register at end of 1957 Premises Number of Inspections Number of Prosecutions Common Lodging Houses 69 2 - 134 192 - Milkshops Ice Cream Premises 201 60 - 8 - Offensive Trades (including Poultry Slaughter-houses) 18 175 Hairdressers and Barbers 51 - (58) SMOKE NUISANCES— Number of observations 213 Number of notices — Number of complaints 4 Number of summonses — SALE OF FOOD— Number of premises used other than ice-cream premises, milk-shops and cowsheds 609 Number of inspections 2,590 RAG, FLOCK AND OTHER FILLING MATERIALS ACT, 1951: Number of premises registered 3 DRAINAGE WORK Particulars of work carried out by the Drainage Inspector during 1958: — Drains Tested 482 Visits to new building works 1,123 Other Visits 378 Total visits 1,983 RENT ACT, 1957 Number of applications for Certificates of Disrepair 121 Number of decisions not to issue Certificates — Number of decisions to issue Certificates — (a) in respect of some but not all defects 106 (b) in respect of all defects 15 Number of undertakings given by landlords 100 Number of undertakings refused - Number of Certificates issued 21 Number of applications by landlords for cancellation of certificates 13 Number of objections by tenants to cancellation of certificates - Number of decisions to cancel in spite of tenants' objection — Number of Certificates cancelled 13 (59) WORK OF DISTRICT INSPECTORS, 1958. Mr. SMITH Mr. SHAKESPEARE Mr. WHITELOCK Mr. KNOTT Mr. CHARLTON TOTALS 1 House-to-House 267 114 168 449 95 1093 2 1276 619 Special Inspections 675 4381 747 1064 3 245 417 304 443 Complaints 445 1854 4 76 140 110 336 Infectious Diseases 105 767 5 - 86 23 30 Rats 37 176 6 17 19 11 11 25 Outworkers' Inspection 83 7 21 10 39 Drains Tested 51 14 135 8 1593 2598 1851 3835 1145 11022 Other Calls and Visits 9 26 146 3 2 36 Chimneys watched 213 10 Bakehouses 14 22 52 12 3 103 11 41 28 - 69 Common Lodging Houses - - Butchers 106 183 111 48 86 12 534 13 21 20 156 28 17 Fishmongers, Friers and Curers 242 14 80 123 322 171 64 Food Stores 760 15 8 19 127 28 22 Fruiterers and Greengrocers 204 16 Pet Animals 1 - 57 1 3 62 Markets 121 - 3 82 289 83 17 Restaurants and Eating Houses - 57 2 8 81 18 14 19 Destruction of Food 27 18 7 19 21 92 Hairdressers 23 23 88 22 19 175 20 21 Factories 33 81 19 68 171 372 22 Inspections under Rent Act, 1957 - 166 3 36 51 256 23 Offensive Trades 17 - - 1 - 18 Totals 3993 217 4810 194 4315 303 6141 491 3722 223 22981 1428 {Visits {Intimation Notices FACTORIES AND OTHER PREMISES INSPECTION Number of Number on Register Premises Written Notices Occupiers Prosecuted Inspections (i) Factories in which Sections 1,2,3,4 and 6 are to be enforced by Local Authorities - - 227 489 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 414 616 - - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers premises) 49 - 198 - Total 690 1303 — - DEFECTS FOUND Number of Cases in which Defects were found Number of defects in respect of which Prosecutions were instituted Particulars Found Remedied Referred I to H.M. Inspector Referred by H.M. Inspector Want of Cleanliness (S.1.) - - - - - Overcrowding (S.2.) - - - - - Unreasonable Temperature (S.3.) - - - - - Inadequate Ventilation (S.4.) - - - - - - - - - - Ineffective Drainage of Floors (S.6.) Sanitary Conveniences (S.7.)— 1 Insufficient 1 - - - 2 Unsuitable or Defective Not separate for Sexes Other Offences 2 - 1 - - - - - - - - - - - (Not including offences relating to Home Work) Total 3 2 - 2 - FACTORIES AND OTHER PREMISES HOMEWORK Section 111 Section 110 Number of out-workers in August list required by Section 110 (1) (c) Number of cases of default in sending lists to the Council Number of instances of work in unwholesome premises Number of prosecutions for failure to supply lists NATURE OF WORK Notices served Prosecutions Wearing Apparel— Making 31 - - - - - - - Sacks 8 - - - - Making of boxes, etc. 5 - - - - 5 - Carding of Buttons, etc. - - - - Christmas Crackers 1 - - - - - - Total 50 - - 1 (62) (63) RODENT CONTROL Prevention of Damage by Pests Act, 1949. Type of Property Local Authority Dwelling Houses All other (including Business and Industrial) I. Total number of properties in Local Authorities District 33 15,164 2,283 (a) 14 276 140 11. Number of properties inspected by the Local Authority during 1953 as a result of (a) of notification or (6) otherwise. - 664 (b) 14 111. Number of properties (under II) found to be infested by rats. - Major 1 9 250 Minor 15 160 IV. Number of properties (under II) found to be seriously infested by mice 7 116 137 V. Number of infested properties (under 111 and IV) treated by the Local Authority 23 276 288 VI. Number of Notices served under Section 4:- 1. Treatment - - - 2. Structural Works (i.e. Proofing) - - - Total - - - VII. Number of cases in which default action was taken by Local Authority following issue of Notice under Section 4 - - - VIII. Legal Proceedings - - - FACTORY BAKEHOUSES There are nine factory bakehouses in use, all of them situated above ground. HOUSE, TRADE AND MARKET REFUSE The following table shows the amount of house, trade and market refuse disposed of during 1958: — tons cwts. qrs. Loads Disposal 5 - 16,536 House Refuse to Barge 10,890 5,620 4 Trade Refuse to Barge 4,568 - Street and Open Markets Refuse to Barge 6 482 - 887 15 16,345 22,638 - Totals OFFENSIVE TRADES The offensive trades on the Register are as follows:— Fellmongers 3 Dresser of Fur Skins 4 Glue and size makers 1 PET ANIMALS ACT, 1951 During the year 5 licences to keep a pet shop were granted. Two of these were in respect of stalls in market places. Inspections are made to ensure that the terms of the licence are complied with.