BRE 10 BOROUGH OF BRENTFORD & CHISWICK INTERIM REPORT ON THE HEALTH OF THE DISTRICT AND SCHOOL MEDICAL SERVICE DURING THE YEAR 1942. R.C. LEANING, M.B., B.S., (Lond), M.R.C.S., L.R.C.P., D.P.H., R.C.S., (Eng). Medical Officer of Health, School Medical Officer. -1- BOROUGH OF BRENTFORD &, CHISWICK public health department, TOWN HALL, CHISWICK, To the Mayor, Aldermen and Councillors of the Borough of Brentford and Chiswick. ladies and gentlemen, This report as in other war time reports consists entirely of tables indicating the work that has been undertaken without comment or elaboration. It will be noted that attendances at the Clinics increased but did not reach the pre-war standard with the exception of the Immunisation Clinic (figures on pages 7, 8 & 21) The general health of the district is indicated by the Table on pages 3, 4, 5, 16, 19 & 20. The incidence and distribution of infectious and notifiable diseases is (shown on pages 16,17,18 & 20 where it will be noted that the cases of Scarlet Fever were moderate in number and there were no fatal cases. Diphtheria, 35 cases, were confined to those who had not been immunised, and there were three fatal cases. Measles was epidemic in April, May, June and July, and there were two fatal cases. Chickenpox took on an epidemic form in November and December. Whooping-Cough was present in moderate numbers through the year, with one death. Mumps was epidemic from February to July. Also, there was considerable increase in Scabies, especially during the colder months of the year. It is to be regretted that the Infantile Mortality figure (calculated on 53 deaths under 1 year) showed an increase over last year, viz., from 51 to 67. This was caused by the increased number of deaths fro;.. Gastro- Enteritis (15) and Pneumonia (9 ). There were two Maternal Deaths registered, as agai 1st nil in 1940 and 1941. Tuberculosis continues to be very prevalent, especially between the ages of 15 and 35. The figures for the last two years of new notified cases of all types are: 1941 - 83 cases with 42 deaths, and 1942 - 87 cases with 28 deaths. It is with very sincere regret that I have to record that our Junior Clerk, James Friar, was killed in action in North Africa on November 15th. He was a Staff Sergeant Pilot, and at one time the youngest member of the R.A.F. with "Wings". As the pilot of a Spitfire he saw considerable operational service over the North Sea and France, He went with the Expeditionary Force to North Africa, where he gave his life for his Country. He was a very bright cheery youth and will always be remembered with honour and affection by his colleagues. -2- Mr. R. James, the Senior Clerk' and Assistant Sanitary Inspector joined the Airborne Section of the R.A.M.C., at the beginning of the year. I am, Ladies and Gentlemen, Your obedient Servant, B.C. LEANING. Medical Officer of Health. -3- EXTRACTS FROM VITAL STATISTICS: The number of live-births, still-births, and deaths are those REGISTERED (out excluding re-registered) during the calendar year, adjusted for inward and outward transfers. Non-civilian deaths and non-civilian notifications are excluded. LIVE BIRTHS BIRTHS. TOTAL MALE FEMALE TOTAL 787 394 393 Legitimate 742 370 372 Illegitimate 45 24 21 STILL BIRTHS • TOTAL MALE FEMALE TOTAL 23 14 9 Legitimate 22 13 9 Illegitimate 1 1 - DEATHS TOTAL MALE FEMALE . . Deaths (all causes) 651 342 309 Deatns from Puerperal causes - - - DEATHS OF INFANTS UNDER 1 YEAR OF AGE. TOTAL MALE FEMALE TOTAL 53 34 19 Legitimate 52 33 . 19 Illegitimate 1 1 - DEATH RATS OF INFANTS UNDER 1 YEAR OF AGE. All infants per 1,000 live births 67 Legitimate infants per 1,000 legitimate births 70 Illegitimate infants per 1,000 illegitimate births 22 Deaths from Cancer (all forms at all ages) 113 Deaths from Measles (all ages) 2 Deaths from Whooping Cough 1 Deaths from Diarrhoea (under 2 years of age) 17 Total deaths from the seven principle zymotic diseases 23 -4- TABLE '1' PARTICULARS OF BIRTHS AND DEATHS AS SUPPLIED BY THE REGISTRAR-GENERAL FOR THE YEAR 1942. CAUSE OF DEATH MALES FEMALES All causes 342 309 1. Typhoid Fever etc. - - 2. Cerebro-Spinal fever - - 3. Scarlet Fever - - 4. Whooping Cough 1 - 5. Diphtheria 1 2 6. Tuberculosis of respiratory system 13 12 7. other forms of Tuberculosis - 2 8. syphilitic diseases 3 - 9. Influenza 1 - 10. Measles 1 1 11. Acute Polio-Myelitis and Polio-Encephalitis - - 12. Acute Inf. Encephalitis 1 - 13. Cancer b, Cav: & Oesopnagus (M) Uterus (F.) 8 11 14. Cancer of stomach and Duodenum 5 8 15. Cancer of Breast - 9 16. Cancer of all other sites 34 38 17. Diabetes - 3 18. Intra-cranial vascular lesions 30 36 19. Heart Disease 94 73 20. other disorders of circulatory system 11 12 21. Bronchitis 22 14 22. Pneumonia 19 19 23.. other respiratory diseases 6 - 24. Ulcer of stomach or duodenum 5 2 25. Diarrhoea under 2 years 11 6 26. Appendicitis 2 - 7 27. other digestive diseases 8 Nephritis 4 4 28. 29. Puerperal and Post Aoortive Sepsis - - 30. other Maternal Causes - - 31. premature Berths 7 2 32. Congenital Malformation, Birth Injury, 9 3 33. Suicide 4 1 34. Road Traffic accidents 3 2 35. other violent causes 15 5 36. All other causes 24 37 ALL CAUSES: 342 309 -5- TABLE 11 INFANTILE MORTALITY DURING THE YEAR 1942. Net deaths from stated causes at various ages under one year. CAUSE OF DEATH Under one week 1-2 weeks. 2-3 weeks 3-4 weeks Total under 4 weeks 1-3 months 3-6 months 6-9 months ! 9 -12 months Total under 1 year. 1. . Smallpox - - - - - - - - - - 2. Chickenpox - - - - - - - - - - 3. Measles - - - - - — - - 1 1 4. Scarlet Fever - - - - - - - - - - 5. Whooping cough - - - - - 1 - - - 1 6. Diphtheria or Croup - - -- - - - - - - - 7. Erysipelas - - - - - - - - - - 8. Meningitis (non T.B.) 1 - - - 1 1 - - - 2 9. Abdominal Tuberculosis - - - - - - - - - - 10. Other Tuberculosis Diseases - - - - - - - 1 - 1 1l. Tuberculosis Meningitis - - - - - - - - - - 12. Convulsions - - - - - - - - - - 13. Laryngitis - - - - - - - •• - — 14. Bronchitis - - - - - - - - - - 15. Pneumonia (all forms) 1 - - - 1 1 5 2 - 9 l6. Diarrhoea - - - -- - - - - - - 17. Enteritis - - - 2 2 5 6 2 - 15 18. gastritis - - - - — - - - - - 19. Rickets - - - - - - — - - — 20. Suffocation (overlying) - - - - - - - - - - 21. Injury at Birth - - - - - - - - - — 22. Atelectasis 1 - - - 1 - - - - 1 23. Atrophy; Debility & Marasmus - - - - -. 2 1 - - 3 24. Congenital Malformation 2 1 - 1 4 - 2 - - 6 25. Premature Birth 8 - 1 - 9 - — - - 9 25. Pemphigus Neonatorum - - - - - - - - - - 27. Other causes - - - 1 1 - 4 - - 5 TOTALS: 13 1 1 4 19 10 18 5 1 53 BIRTHS; Legitimate 742 DEATH: Legitimate 52 Illegitimate 45 Illegitimate 1 "INFANTILE MORTALITY RATE PER 1,000 BIRTHS = 67 -6- SECTION B. GENERAL PROVISION OF HEALTH SERVICES IN THE BOROUGH. (a ) Separation of Civil Ambulance. Service from Fire Brigade Control The Home Office, Fire Service Department, Circular Ho.79/1941 laid it down that it would not be possible for the National Fire Service to carry out any ambulance duties as previously carried out by Local Fire Brigades. The Ministry of Health Circular No.2502 dated 19th November, 1942 drew Attention to this fact, and suggested that the Civil ambulance Service should be attached to the Civil Defence Ambulance Depots within the area. After full consideration of the matter, the Council decided to put such suggestion; into operation and that one Civil Ambulance should be Stationed at C.D. Ambulance Station No.l at Brentford and two Civil Ambulances at the C.D. Ambulance Station. No.2. in the Chiswick area. They further decided to engage the services of four full time ambulance drivers for this service, and to rely on the Civi. 1 Defence personnel to supply attendants and relief drivers when necessary and possible After the completion of the necessary details ;of organisation in regard to telephones, housing etc., the actual transfer took place in April, 1942, and the Service came under the control of the Medical Officer of Health. (b) Work of Civil Ambulances during the year. Number of public calls dealt, with during 1942 = 646 Number of private calls dealt with during 1942 = 463 Maternity & Child Welfare - (Table attached) Ante-Natal (Table attached) Supply of Milk and Food (Table attached) Maternal Mortality Two maternal deaths were reported during tr year.* The following table shows the number of maternal deaths connected with pregnancy during the last 10 years:- Died from Sepsis Died from other causes connected with pregnancy. 1933 3 2 1934 1 3 1935 - - 1936 2 3 1937 - - 1938 2 2 1939 - 2 1940 - - 1941 - - 1942 - 2* TOTAL 8 14 * Cause of deatht:- Acute dilatation of heart. Chronic Rheumatoid carpitis. Caesarian section at term. P.M. Tetanus following septic endometritis with abrasions of uterus and vagina. Deceased douched herself whilst three months pregnant. P.M. Accidental death. -7- SUMMARY OF WORK AT THE MATERNITY AND CHILD WELFARE CLINICS, 1942. BRENTFORD AREA. CHISWICK AREA Grand Totals 1942 Grand Totals 1941 Monday Clinics. Wednesday Clinics. TOTAL. Wednes. Clinics. Thurs. Clinics Friday Clinics TOTAL. Number of new Members enrolled during the year:- Under 1 year 112 100 212 - 217 128 34.5 557 454 Over 1 year 21 25 46 - 101 60 161 207 235 Totals 133 125 258 - 316 187 506 764 689 Number of children attending and weighed:- Under 1 year 1500 1871 3371 - 3213 2187 5400 8771 7373 Over 1 year . 1032 1832 2864 - 1054 1009 2063 4927 4140 Totals 2532 3703 6235 - 4267 3196 7463 13698 11513 Number of children seen by Doctor:- Under 1 year 453 . 437 890 — 720 529 1249 2139 • 1681 Over 1 year 274 397 671 - 331 384 715 1386 1449 Totals 727 834 1561 - 1051 913 1964 352 5 3130 -8- AFTE-NATAL CLINICS. DISTRICT Number of Clinics held during year. number of expectant mothers attending for the first time. Total number of expectant mothers attending. Number of post-natal mothers attending. Total number of attendances made. Average attendances per session. BRENTF0RD 50 195 210 5 845 17 CHISWICK 103 442 478 28 2289 22 TOTALS 153 637 688 33 3134 20 -9- SUPPLY OF MILK ANDT FOOD. (Other than under the National milk and vitamins scheme). Terms supply Milk. Meals supplied at During Centres Other Food.* Expectant Mothers. ' Nursing Mothers. Children under 5 years of age. Expectant Mothers. ' Nursing Mothers Children under 5 years of age. Expectant Mothers Nursing Mothers Children under 5 years of age. Free, or at less than cost price in necessitous cases. YES YES YES NO NO NO YES YES YES At cost price in other cases (e.g.,s le of dried milk at Centres). YES YES YES NO NO NO YES YES YES * Cod liver oil and malt, Virol, Bemax, etc. -10- Health Visitors:- Five Nurses and on.; temporary are on the staff for this and the School Medical Service. The table sets out a brief summary of the work of the Health Visitors during the years:- (a) To expectant mothers: First visits 308 Total visits 474 (b) To children under 1 year of age: First visits 602 Total visits 17 (c) To children between the ages of 1 and 5 years: Total visits 2446 ' (d) Ophthalmic visits 7 (e) Other visits: Measles and German Measles 17 Whooping Cough 10 Infant Life Protection visits 112 Post-Natal 3 Diphtheria Immunisation 44 Infant Mortality 10 TOTAL 4827 Child Life protection (under the Public Health Act, 1936). The following table sets out particulars of registration during the year:- (1) Number of foster-parents on the Registerr:- (a) At the beginning of the year 19 (b) At the end of the year 23 (2) Number of children on; the Register:- (a) At the beginning; of the year 28 (b) At the end of the year 27 (c) Who died during the year Nil (d) On whom inquests were held during the year Nil Day Nursery:- Record of attendances during the year, 1942:- Whole-days 11,155 Half-days 1,294 -11- SECTION 'C' The figure set out in the tables included in this section give details of work directly connected with Public Health. (1) SANITARY INSPECTION OF THE AREA.: Tabular Statement of 'the Work of the Sanitary Department, 1942. INSPECTIONS. Number of Premises inspected on complaint 584 Number of Premises inspected in connection with infectious disease 98 Number of primary inspections l926 Number of re-inspections 1059. Total number of inspections and re-inspections 2965 ACTION TAKEN (other than Housing Act, 1936). Cautionary or intimation notices served 377 Statutory Orders issued (under Public Health Acts) 1 Summonses served Nil Number of Certificates under Rent & c.(Restrictions) Acts issued to Tenants 1 Number of Clearance Certificates issued to owners 2 Particulars of Sanitary Defects referred to in Notices served, and other matters. (a)DRAINAGE OF EXISTING BUILDINGS: New W.C.S provided, repaired, supplied with water or otherwise' improved 105 Percentage of houses provided with waterclosets 100 DRAINS: Tested (smoke) 19 Unstopped, repaired, trapped etc 30 Waste pipes, rainwater pipes disconnected, repaired etc 37 New soil pipes and ventilating shafts fixed 5 New sinks provided 1 Disconnecting traps and chambers inserted 11 Reconstructed (whole system) - Reconstructed (connections) 5 Percentage of houses draining into sewers 99.9 Surface water drains reconstructed - Surface water drains repaired 3 (b) WATER SUPPLY and WATER SERVICE: Draw taps on main 9 Percentage of houses supplied from Public Water Service 99.9 (c) REFUSE. New bins provided 96 Frequency of refuse removed from each house weekly Number of complaints received - Dealt with by Engineer's Department. Method of disposal: Barging away to controlled tip. -12- (d) SUNDRY NUISANCES. Overcrowding (Urgent cases reported to Housing Committee.) Smoke - Minor complaints only Accumulation of refuse 1 Foul ditehes, ponds etc., and stagnant water - Dampness 91 Years repaired or repaved - Leaky roofs and eaves guttering 129 Premises repaired and cleansed 133 Other nuisances 301 (e) DISINFECTION:Premises disinfected: Ordinary, notifiable diseases 95 Phthisis 15 Cancer 17 Other diseases 17 Rooms stripped and cleansed (Section 167, Public Health Act, 1936 - Premises treated for vermin 47 Premises treated for other pests 19 (f) SLAUGHTERHOUSES: Number on Register (including one Knacker's Yard) 5 Contraventions of bye-laws - Slaughter of Animals Act, 1933. (vide Livestock (Restriction on Slaughter) Order 1940) Number of licences to slaughter animals issued during the year:New Licences Ni1 Renewed Licences Nil FOOD & DRUGS ACT, 1938. MILK (SPECIAL DESIGNATIONS) ORDER 1936. MILK & DAIRIES ORDER, 1926. Number of premises on register 21 Number of Licences issued to sell:- (a) Tuberculin Tested Milk 7 (b) Accredited milk Nil (c) Pasteurised milk 17 BAKEHOUSES. Number, in district in use 16 Contraventions of Factory Acts - -13- UNSOUND FOOD: Fruit & Vegetab1es (Fr esh) Apples 134 lbs Savoy Greens 11 tons 4 cwt. Carrots 19 cwts 6 lbs. Potatoes 179 lbs Peas 1 ton 19 cwt 2 arts. Fresh Fish Catfish 5 Stone Cod 21 stone Whiting 4½ stone Smoked Mackerel 3 stone Soft Roes 5 stone Haddock 24 stone Smoke Fillets l ½ stone General Provisions et. Bacon 26½ lbs Cheese 378½ lbs Chickens 87 lbs Sugar 33½ lbs Tea 22 lbs Eggs 1,156 Ducks 5 Paste 18 jams Rabbits 494 lbs Jam and Marmalade I6½ lbs Fruit Cake 51 lbs Sultanas 3 lbs Biscuits 3½ lbs Pickles 10 jars Lard 1 lb Vinegar 1 bottle Calf' s Head 4¾lbs Pig's Pluck and Intestines 10 lbs 10 ozs. Oxtail 1 lb Pork Sausages 72 lbs Lemon Cheese 1 Jar Jam Rolls 13 Margarine 5 lbs Dried Milk 2 tins Fish Cakes 72 Tinned Foods (Miscellaneous). Luncheon Meat 2,021 lbs Sausage Meat 146½ lbs Chopped Ham 176½ lbs Tongues 85½ lbs Pease Pudding 1,323 tins Beetroot 5 tins Steak & Kidney Pudding 66 tins Egg Substitute 188 pkts Gravy Mixture 79 pkts Rabbit ???tins Pineapple 61 tins Raspberries 2 tins Beef Galatine 1 tin Spaghetti 2 tins Pressed Brisket 20 lbs Evaporated Milk 3,414 tins Full Cream Condensed Milk 37 tins Skimmed Milk 303 tins -14- Tinned Foods (contd) Beans 237 tins Stewec Steak 8,004 tins Vegetables 3,026 tins Apples 34 tins Tomatoes 971 tins Sardines 3,347 tins Pilchards 54 tins Plums 80 tins Salmon 18 tins Carrots 345 tins Peas 511 tins Heady Meals 25 tins Soups 712 tins Fruit Salad 1 tin Peaches 2 tins Apricots 1 tin Rhubarb 3 tins Herrings 24 tins Oranges 1 tin Crawfish 5 tins Pears 4 tins Gooseberries 2 tins Aspargas 1 tin Rice Puddings 2 ,541 tins Bacon 11 tins Harriett Oxtail 485 tins Marmalade Puddings 19 tins Sausages 7 tins Potatoes 119 tins Margarine 1 tin Carned Beef 1 tin Date Buddings 12 tins Beef Hash 8 tins Lobster 1 tin Mackerel 1 tin Confectionery Fruit and' Cream Nougat 9 lbs. OFFENSIVE TRADES: Number of premises in. district 3 Nature-of Trades: One soap boiler, 2 rag and bone dealers CANAL BOATS: Number of Boars on Register: Motor propelled boats 97 Other Boats 418 PETROLEUM ACTS: Number of applications received for licences to store and sell petroleum spirit 94 Number of applications received for licences to store- and- sell petroleum. . mixture 14 Number of applications received for licences to store and sell carbide of calcium 9 -15- PET'ROLEUM ACT: (contd) Number of gallons of petroleum spirit covered by licences 200,808 Number of gallons of petroleum mixture covered by licences 8,050 Quantity of carbide of calcium covered by licences 42,468 lbs HOUSING. The difficulty experienced by builders in obtaining labour and necessary materials, the usual routine house-to-house inspection in the Borough was suspended. Housing Act 1936. The position in regard to the progress of programmes under this Act is exactly the same as that shown for the preceding war years. _ ...... Where cases of over-crowding have occurred these- have been referred. to the Council's special Housing Department and satisfactorily dealt with. -16- SECTION 'D' PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. A.- NOTIFIABLE DISEASES DURING THE YEAR. Disease. Total Cases notified. Cases admitted to hospital. Total Deaths. ; . | Small-pox - - - Scarlet Fever 53 37 - Diphtheria 35 35 3 Enteric Fever (including Paratyphoid) .- - - Ophthalmia Neonatorium - - - Pneumonia 14 4 38 Erysipelas 5 1 - Measles 313 8 2 Whooping Cough 44 2 1 Cerebro-Spinal Fever 6 * 4 - Acute Polio-enceohalitis - - - Dysentery 4 ø 4 - Malaria - - - * 3 Gases Non-Civilian included, ø 1 Case Non-Civilian included. B. - OPHTHALMIA NEONATORUM. Cases Notified Cases treated at Home Cases treated in Hospital Vision un- impaired Vision impaired Total Blindness Deaths - - - - -i - - -17- C. - AGES OF GASES OF INFECTIOUS DISEASES NOTIFIED DURINGC THE YEAH 1942. DISEASE NUMBER OF CASES NOTIFIED At all Ages Under 1 At Ages - Years 1 2 3 4 5 and under 10 10 and under 15 15 and under 20 20 and undre 35 35 and under 45 45 and under 65 and over Small-pox - - - - - - - - - - - - - • Scarlet Fever 53 - 1 3 6 5 26 6 2 3 1 - - Diphtheria 35 1 2 4 - 4 10 4 4 5 1 - - Enteric Fever(including Paratyphoid). - - - - - - - - - -. - - - Ophthalmia Neonatorium - - - - - - -. - - - - - - Pneumonia 14 - - - - - 1 - 1 1 - 6 5 Erysipelas 5 - - - - - - - - - - 4 1 Gerebro-Spinal Fever 3 - - - - - 1 - - 1 - 1 -- Acute Polio -encephalitis - - - - - - - - - - - - - -- Dysentery 3 - - - - 1 1 - - 1 - - -- Measles 313 8 29 28 36 38 161 8 1 2 2 - r 1 Whooping Cough 44 4 2 4 4 6 20 3 1 - - - - -18- D - CASES OF INFECTIOUS DIESES NCTFIED DURING THE YEAR 1942 CLASSIFIED IN WARDS. NOTIFIABLE DISEASES NUMBER OF CASES NOTIFIED Brentford East Brentford Central Brentfor West Bedford Park Chiswick Park Grove Park Gunnersbury Old Chiswick Turnham Green Scarlet Fever — 3 10 2 15 2 3 10 . 8 Diphtheria .ø 3 1 6 - 5 8 4 ! 5 3 Enteric Fever (including paratyphoid) - - - - - - - - - Ophthalmia Neonatorium - - - - - - - - - pneuimonia 3 3 3 - 2 1 - 1 1 Erysipelas - - - - 1 1 1 1 1 Cerebro-Spinal Fever * - - - - 1 1 1 - - Measles 22 6l 6l 16 51 17 23 - 21 Whooping Cough 2 2 4 5 2 3 9 12 5 Acute Polio-encephalitis - - - - - - - - - Dysentery - - - - - 3 .. - 1 Malaria (induced) - - - - - - - • : * - Tuberculosis: Respiratory 4 13 7 3 14 6 7 10 14 Non-respiratory . - 1 3 1 2 1 1 - - • *- In addition~3 cases notified 'Non-Civilian X-i ^uditioii 1 case no-t.i£ied non—civillan. -19- E. TUBERCULOSIS. NEW CASES DEATHS Respiratory non- Respiratory. Respiratory Non- Respiratory. Male. Female e Male. . Female Male. Female Male. Female. Under 1 year - 1 - - - 1 - - 1 to 5 years - 2 - 2 - ~ - - 5 to 15 years 3 - - ] - — - - 15 to 25 years 9 15 1 3 2 3 - 1 25 to 35 years 10 13 - - 4 4 - - 35 to 45 years 7 2 - 1 1 2 - - 45 to 55 years 7 1 — - 1 - - - 55 to 65 years 3 - -. - 4 2 - - 65 and over 3 2 - 1 2 - - 1 TOTALS 42 36 1 8 14 12 - 2 (b) Laboratory Work. The following Table sets out a record of the bacteriological work during the year, all of which was carried out in the Council's Laboratory. Suspected Disease Result s . . Positive Negative Diphtheria 15 279 294 Tuberculosis 6 64 70 Cerebro Spinal Meningitis - 73 73 Other Diseases 1 6 7 « JOINT COMMITTEE FOR EDUCATION IN BRENTFORD AND CHISWICK. ANNUAL REPORT ON THE MEDICAL INSPECTION OF ELEMENTARY SCHOOL CHILDREN FOR THE YEAR ENDING 31ST DECEMBER, 1942. R.C.LEANING., M.B., B.S., (Lond). M.R.C.S., L.R.C.P., D.P.H., R.C.S (Eng). School Medical Officer. -20- BOROUGH OF BRENTFORD & GHISWICK. EDUCATION ACT, 1921. REPORT OF THE MEDICAL INSPECTION AND TREATMENT OF ELEMENTARY SCHOOL CHILDREN FOR THE YEAR ENDING 31ST DECEMBER, 1942. To the Chairman and Members of the Education Committee. Ladies and Gentlemen, I beg to submit tables indicating the work of the School Medical Service during 1942. The Nursery Schools at Belmont, Strand and Lionel Road, were opened during war time Nursery hours for the children (of Nursery School age)of mothers engaged in essential war work. The incidence of Infectious Disease in the schools is indicated in the following table:- 1942 ACTUAL CASES. Jan Feb Mar Apr May Jne. Jly. Aug. Sept. Oct. Nov. Dec. Total Scarlet Fever 2 9 4 3 2 1 3 - 3 3 8 10 48 Diphtheria 7 9 9 1 2 1 3 - - - - 2 34 Chicken-pox 8 9 2 1 2 10 2 - 1 6 36 88 165 Measles - 2 2 66 97 85 58 - 25 14 18 4 371 Whooping Cough 8 5 7 11 13 23 22 - 3 1 5 14 112 Mumps. 7 65 87 51 111 111 - 4 5 23 10 548 Ringworm 1 - - - - - 1 - - - l 1 4 Impetigo 2 4 5 6 3 6 2 - 9 16 19 12 84 Exzema - - - - 1 1 - - - - 1 - 3 Verminous 9 5 9 8 10 6 6 - 9 9 9 5 85 Scabies 43 35 23 27 24 13 18 - 29 24 27 28 291 Other Skin 1 - 1 - 1 1 - 1 2 - 2 9 Totals 88 143 149 174 266 258 189 - 84 81 147 176 1755 -21- The following figures and tables of work in this service are in addition to the Statutory Tables issued to the Board of Education:- ORTHOPAEDIC CLINIC.- Total number of attendances 656 Number of individual children 50 Surgeon.- Total number of attendances 617 Number of individual children 108 SUN-RAY CLINIC.- Total number of attendances 686 Number of individual children 70 RHEUMATISM CLINIC.- Total number of attendances 284 Number of individual children 83 MINOR AILMENT CLINIC.- Total number of attendances 11073 Number of individual children 1538 Total number of exclusions 989 Total number of re-admissions 631 Number of Special cases 1129 Number of Special cases re-inspected 746 OPHTHALMIC CLINIC.- Number of attendances 621 New cases 194 Retinoscopy 196 Glasses prescribed 136 Glasses issued 113 Other cases 301 Individual children 268 IMMUNISATION CLINIC.- Number of attendances (School) 3309 Number of attendances (Welfare) 3526 PERSONAL HYGIENE.- Number of visits to schools 276 Average number of visits to schools 12.3 Number of examinations 23729 Number of individual children defective 296 Number of re-examinations 886 VISITS.- Total number by School Nurses 832 This number includes all children attending the Clinic. The number of those actually treated was 640. The remainder were thœse referred to other clinics, to their own doctor, to hospital - those given advice or kepi under observation. BOARD OF EDUCATTON. MEDICAL INSPECTION AND TREATMENT RETURNS. YEAR ENDED 31ST DECEMBER,1942. TABLE 1. MEDICAL INSPECTIONS OF CHILDREN ATTENDING PUBLIC ELEMENTARY SCHOOLS. A.-ROUTINE MEDICAL INSPECTIONS. (1) No. of Inspections: Entrants 458 Second Age Group 320 Third Age Group 270 TOTAL 1048 (2) No. of other* Routine Inspections 171 GRAND TOTAL 1219 B.-OTHER INSPECTIONS. No. of Special Inspections and Re-inspectionS: TABLE 11. CLASSIFICATION OF THE NUTRITION OF CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS. Number of Children Inspected A. B. C "D o (Excellent) (Normal) !(Slightly s subnormal. (Bad) No. % No. % No. % No. % Entrant 458 177 38.6 232 50.7 47 10.3 2 0.4 Second 320 115 35.9 183 57.2 22 6.9 - - Third 270 96 35.5 148 54.8 25 9.3 1 0.4 Other 171 66 90 52.6 15 8.8 — - Total 1219 454 37.2 653 53.6 109 8.9 3 0.2 TABLE 111. GROUP I.-Treatment of Minor Ailments (excluding uncleanliness). Total Number of Defects treated or under treatment during the year under the Authority's Scheme 640 GROUP II.- Treatment of Defective Vision and Squint. Under the Authority's Scheme. ERRORS OF REFRaCTION(including squint) 196 Other defect or disease of the eyes (excluding those recorded in Group I) _ No. of Children for whom spectacles were Under the Authority's Scheme. (a) Prescribed 136 (b) Obtained 113 GROUP III.- Treatment of Defects of Nose and Throat. Under the Authority's Scheme. Received Operative Treatment 102 Received other forms of Treatment 61 Total number treated 163 TABLE IV DENTAL INSPECTION AND TREATMENT. (1) Number of children. inspected by the Dentist (a) Routine age-groups (b) Specials. 1109 (c) TOTAL (Routine and Specials) 2377 (2) Number found to require treatment 1918 (3) Number actually treated 1345 (4) Attendances made by children for treatment 3824 (3) Half-days devoted to:- Inspection 19½ Treatment 379¾ 398¾ (6) Fillingss:- Permanent Teeth 2093 Temporary Teeth 596 2689 (7) Extractions:- Permanent Teeth 364 Temporary Teeth 1893 2257 (8) Administrations of general anaesthetics for extractions 942 (9) Other Operations:- Permanent Teeth 885 Temporary Teeth - 885 TABLE V. (1) Average number of visits per school made during year by the School Nurses 12.3 (2) Total number of examinations of children in the Schools by School Nurses 23729 (3) Number of individual children found unclean 296 (4) Number of individual children cleansed under Section 87(2) and (3) of the Education Act,1921 2 (5) Number of cases in which legal proceedings were taken:- (a) Under the Education Act, 1921 — (b) Under School Attendance Byelaws - TABLE VI Number of totally or almost totally blind and deaf children who are not at the present time receiving education suitable for their special needs. The return should relate to all such children including evacuees resident in the Authority's area. 1 2. 3 At a Public Elementary School At an institution other than a Special School. At no School or Institution Blind Children - - - Deaf Children - - —