AC 4391 DBREMEORD BRE 16 Borough of Brntford and Chiswick REPORT ON THE Health of the District during 1948 MARGARET A. CLASS, B.Sc., M.B., Ch.B. (Glas.), D.P.H.(Cantab.) Medical Officer of Health The Brentford Printing & Publishing Go., Ltd. BOROUGH OF BRENTFORD AND CHISWICK PUBLIC HEALTH COMMITTEE Councillor Mrs. Burden, Chairman. Alderman Edwards. Councillor Pollard, J.P. ,, Howard. ,, Riederer. ,, Leahy. ,, Samels. Councillor Braithwaite. ,, Mrs. Saint. ,, Mrs. Buck. ,, Wood. ,, Copp. Ex-offficio : Alderman Fullerton-Bustard, J.P., Councillors Fry and Sinclair, J.P. MATERNITY AND CHIILD WELFARE COMMITTEE # Councillor Wood, Chairman. Alderman Leahy. Councillor Deane, H. Councillor Bentley. ,, Johnson. ,, Mrs. Buck. ,, Riederer. ,, Mrs. Burden. ,, Mrs. Saint. ,, Copp. Co-opted Members : Mesdames A. D. Cory, A. Jones, M. A. J. Langford, J.P., L. Mountford and F. M. Wright. N.B.—This Committee ceased to function on 5th July, 1948, when Child Welfare services were transferred to the control of the Middlesex County Council, under the provisions of the National Health Service Act, 1946. STAFF—PUBLIC HEALTH DEPARTMENT MEDICAL (Whole Time). O. C. Dobson, M.D., B.S., D.P.H., B.Hy.(Durham), L.R.C.P., M.R.C.S., D.P.A.(Lond.), Barrister-at-Law (Middle Temple), Medical Officer of Health and School Medical Officer. (Resigned, 30.9.48). *Miss P. Griffiths, M.R.C.S., L.R.C.P., D.P.H., Assistant • Medical Officer of Health and Assistant School Medical Officer. E. g. Millar, B.A., M.B., B.Ch., B.A.O., Assistant Medical Officer of Health and Assistant School Medical Officer. (Resigned 31.5.48). *Miss A. Stewart, L.D.S.(St. Andrews), Divisional Dental Officer. *Miss S. M. Harrison, L.D.S., R.C.S.(Edinf), Dental Officer. *Miss I. Miller, L.D.S., R.C.S.(Glasgow), Dental Officer. MEDICAL (Part-Time). *C. F. Ballard, M.R.C.S., L.R.C.P., L.D.S., Orthodontist. *Miss J. M. Brookhouse, Diploma in Speech Therapy, Assistant Speech Therapist. *J. Cholmeley, F.R.C.S., Consulting Surgeon to Orthopædic Clinic. *Miss M. Dodge, M.C.S.P., Physiotherapist. *W. C. King-Brown, M.B., B.S., M.R.C.S., Immunisation Clinics Specialist. *Miss E. G. Richnell, Diploma in Speech Therapy, Senior Speech Therapist. *A. F. L. Shields, M.B., B.Ch., B.A.O., D.O.M.S.(Eng.), Ophthalmic Surgeon. *G. Slot, M.D., M.R.C.P., D.P.H., Consulting Physician to Rheumatism Clinic. *Miss M. Scott, L.D.S., Orthodontist. (Appointed, 7.4.48). SANITARY INSPECTORS. L. C. Webb*, A.R.San.I., Certified Inspector of Meat and Other Foods, etc., Certificates of Royal Sanitary Institute, Chief Sanitary Inspector, Inspector for Shops Acts, Factory Acts and Canal Boats. T. M. Johnson, A.R.San.I., Certified Inspector of Meat and Other Foods, etc., Certificates of Royal Sanitary Institute, Sanitary Inspector, Inspector for Shops Acts. 2 SANITARY INSPECTORS—(Continued). A. G. Robinson, M.S.I.A., Certified Inspector of Meat and Other Foods, etc., Certificates of Royal Sanitary Institute, Sanitary Inspector, Inspector for Shops Acts. R. A. G. James, Cert. S.I.B., Sanitary Inspector and Inspector for Shops Acts. HEALTH VISITORS AND SCHOOL NURSES. *Miss P. Airdrie, S.R.N., Health Visitor's Certificate of Royal Sanitary Institute, Certificate of Central Midwives Board. *Mrs. R. E. L. Clarke, S.R.N., Health Visitor's Certificate of Royal Sanitary Institute, Certificate of Central Midwives Board. *Miss B. Cox, S.R.N., Health Visitor's Certificate of Royal Sanitary Institute, Certificate of Central Midwives Board. *Miss A. M. Doreen, S.R.N., Health Visitor's Certificate of Royal Sanitary Institute, Certificate of Central Midwives . Board. (Appointed, 22.3.48). *Miss A. M. Edwards, S.R.N., Health Visitor's Certificate of Royal Sanitary Institute, Certificate of Central Midwives Board. *Miss C. E. Jenkins, S.R.N., Health Visitor's Certificate of Royal Sanitary Institute, Certificate of Central Midwives Board. *Miss E. M. Sawkins, S.R.N., Health Visitor's Certificate of Royal Sanitary Institute, Certificate of Central Midwives Board. *Miss V. S. G. Trestrail, S.R.N., Health Visitor's Certificate of Royal Sanitary Institute, Certificate of Central Midwives Board. DAY NURSERY MATRONS. *Miss S. Robinson, S.R.N., Certificate of Central Midwives Board. *Miss O. M. Sansom, S.R.C.N CLERICAL, etc., STAFF. *P. G. Smith, Chief Clerk. R. P. Hill, Clerk, Public Health Department. D. G. Hill, Clerk, Public Health Department. Mrs. E. M. Bartlett, Clerk, Public Health Department (Parttime). (Resigned, 31.8.48). Mrs. B. E. Clark, Clerk, Public Health Department. (Appointed, 6.9.48). *Miss K. Bates, Sales Clerk, Chiswick Child Welfare Clinic (Part-time). 3 CLERICAL, ETC., STAFF—(Continued). *Miss J. Brickwood, Dental Clerk. *Miss M. V. Crosse, Clerk, Maternity and Child Welfare, Brentford. *Miss K. M. Crum, Clerk, Maternity and Child Welfare, Chiswick. *Miss A. Duke, School Medical Clerk (Part-Time). Miss K. Fleetwood, School Medical Clerk. (Resigned, 28.2.48). *Miss J. Hammond, School Medical Clerk. (Appointed, 22.3.48). *Miss F. M. Harrington, Sales Clerk, Brentford Child Welfare Clinic (Part-Time). *Mrs. M. Joyce, Dental Attendant (Part-Time). *Miss M. Marshall, Clerk, Maternity and Child Welfare, Chiswick. *Mrs. J. M. Robbins, Home Help Organiser. *Mrs. M. C. Smith, Dental Attendant. *Miss S. B. Williamson, School Medical Clerk. *Mrs. G. Sproat, Dental Attendant. (Appointed, 23.2.48). *Staff marked thus were transferred to the Middlesex County Council on 5.7.1948, under the provisions of the National Health Service Act, 1946. 4 BOROUGH OF BRENTFORD AND CHISWICK REPORT ON THE HEALTH OF THE DISTRICT DURING THE YEAR 1948 (including Maternity and Child Welfare Report for the period January 1st to July 4th) MARGARET A. GLASS, B.Sc., M.B., Ch.B.(Glas.), D.P.H.(Cantab.), Medical Officer of Health. 5 BOROUGH OF BRENTFORD AND CHISWICK Public Health Department, Town Hall, Chiswick, W.4. To the Mayor, Aldermen and Councillors of the Borough of Brentford and Chiswick. Ladies and Gentlemen, I have the honour to present the 21st Annual Report on the Health and Sanitary circumstances of the Borough of Brentford and Chiswick. On July 5th,, 1948, the Maternity and Child Welfare services which were previously your responsibility, were transferred to the control of the County Council of Middlesex, and therefore in this Report statistics and remarks on the conduct of the Maternity and Child Welfare services will be confined to the period from 1st January to 4th July, 1948. All other information relates to the whole of the calendar year. The health of the population continued to be good. A study of the vital statistics demonstrates a fall in the birth rate, which was 17.9 compared with 19.2 in 1947. In the year 1946 the birth rate was 23.6, but this appears to have been a peak year for the district as previous rates were very much lower. The general trend, however, appears to be for an annual decrease in the birth rate in the district. The death rate was 11.5—this is a reduction from 12.1 in 1947. The number who died from tuberculosis was 39 as compared with 38 in 1947, and there was also an increase of one in the number dying from cancer. Cancer (115 deaths) was the second largest cause of death ; the largest being heart disease, deaths from which numbered 165. A very noteworthy figure is the infant mortality rate of 28.7 the corresponding figure for 1947 is 36.6. The particulars on Table II of the causes of infant deaths do not indicate an outstanding reduction in any particular cause, but a point, however, to be noted is that only one infant died from enteritis during the year, whereas there were four such deaths during 1947. The infant mortality rate in 1948 for England and Wales was 34, that for London 31, and for the County Boroughs and Great Towns (including London) 39, so that the local figure is well below all these. 7 I would refer you also to the graph on page 14 which shows the dramatic fall in infant mortality rate over the years since 1900. The fact that there were nine deaths from premature birth and ten from pneumonia, both of which in theory should be preventable, indicates that there is still plenty of scope for the teaching, not only in clinics to expectant mothers, but wherever an opportunity arises, and to the potential parents and even the potential grandparents, of the principles of nutrition, hygiene and the maintenance of health. "Old Wives' Tales," hallowed by tradition, have always hindered progress in maternity and child welfare. The work of the clinics continued normally throughout the six months during which they were subject to the control of the Brentford and Chiswick Borough Council. The number of Clinic attendances and the number of home visits paid by the Health Visitors corresponded closely with the figures shown in the 1947 report. Treatment for Mothers and Children was available at the various specialised clinics which were all well attended and the number immunised against diphtheria and whooping cough increased. The incidence of infectious disease during the year was not high, there was no case of diphtheria, a moderate number of cases of chicken pox, measles and mumps occurred. The severity of the illness in these cases was not great and no deaths occurred. 1948 could be considered a year without epidemic disease and there was no outbreak of food poisoning reported. Following a fairly high incidence of poliomyelitis in 1947, it is satisfactory to be able to report that only one case of this disease occurred in the Borough during 1948. Provision of care for the children of working mothers in Day Nurseries was available to the same extent as in 1947. The demand for this service continually increased and the waiting list for Nursery places grew steadily. Home Help and Ambulance Services continued to be used to capacity and the laboratory service for the investigation of suspected disease was provided by the King Edward Memorial Hospital Pathological Laboratory, Ealing, W.13. The new Chiropody service, commenced in 1947, and restricted to needy adults and Old Age Pensioners, began to be widely known and appreciated and the numbers of persons wishing to take advantage of it increased rapidly. 3 Excellent work was carried out in the Dental Clinic as is shown by the proportion of fillings to extractions. This is particularly noteworthy in the case of the children under five, as conservative treatment for these children is, of course, the ideal of dentistry—until such time as the ideal of preventive medicine, completely sound temporary and permanent teeth for all ages, is attained in some future generation. Although the total amount of visiting carried out by the Sanitary Inspectors was approximately the same in 1948 as in 1947, it is noteworthy that the number of defective or unclean premises found was considerably fewer. There might be several reasons for this. As War Damage gets cleared up more attention can be paid by property owners and shop keepers to the general principles of sanitation and clean living. The relaxation of restrictions on repair licences for property also permits of more work being done and it is hoped also that propaganda, not only visual, but the daily personal propaganda of Sanitary Inspectors and other Health Workers in the course of their duties, has its effect in raising the standards of hygiene both of persons and of premises. I should like to take this opportunity of thanking all the members of the Health Department staff for their assistance in the preparation of this Report, and I should like also to acknowledge the co-operation and assistance afforded to me by the Area Medical Officer and his staff. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, in angaua a. glass Medical Officer of Health. 9 1.—GENERAL STATISTICS, 1948. Area in acres (including 116 acres of foreshore of River Thames and 24 acres of inland water) 2,449.5 Population—Census 1931 62,617 Population—Registrar-General's Estimate for area (mid 1948) 59,340 2.—VITAL STATISTICS. Live Births. Total Male Female Legitimate 1001 527 474 Birth Rate per 1,000 of the estimated resident population = 17.9 Illegitimate 62 23 39 TOTAL 1063 550 513 Stillbirths. Total Male Female Legitimate 14 8 6 Rate per 1,000 total (live and still) Births = 13.0 Illegitimate — — — TOTAL 14 8. 6 Deaths. Total M ale Female 681 340 341 Death Rate per 1,000 of the estimated resident population = 11.48 Deaths from Puerperal Causes. Puerperal Sepsis — Rate per 1,000 total (live and still) Births = NIL Other Puerperal Causes — 10 Deaths of Infants under 1 Year of Age. Total Male Female Legitimate 25 13 12 Illegitimate 5 — 5 TOTAL 30 13 17 Death Rate of all infants per 1,000 live births 28.7 Death Rate of all legitimate infants per 1,000 legitimate live births 24.9 Death Rate of all illegitimate infants per 1,000 illegitimate live births 80.7 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea (under 2 years of age) 2 Deaths from Cancer (all ages) 115 Deaths from Tuberculosis 39 11 TABLE I. PARTICULARS OF BIRTHS AND DEATHS AS SUPPLIED BY THE REGISTRAR-GENERAL FOR THE YEAR 1948 Cause of Death Males Females All Causes 340 341 1. Typhoid Fever, etc. - — 2. Cerebro-Spinal Fever — — 3. Scarlet Fever — — 4. Whooping Cough 1 — 5. Diphtheria — — 6. Tuberculosis of the respiratory system 18 16 7. Other forms of Tuberculosis 2 3 8. Syphilitic Diseases 5 2 9. Influenza 2 3 10. Measles — — 11. Acute Poliomyelitis and Polio-Encephalitis — — 12. Acute Inf. Encephalitis — — 13. Cancer b. Cav. and Oesophagus (M), Uterus (F) 11 3 14. Cancer of Stomach and Duodenum 7 8 15. Cancer of Breast — 14 16. Cancer of all other sites 40 32 17. Diabetes 1 5 18. Intra-Cranial Vascular Lesions 31 49 19. Heart Disease 84 81 20. Other disorders of the Circulatory System 12 26 21. Bronchitis 35 13 22. Pneumonia (all forms) 12 21 23. Other respiratory diseases 5 — 24. Ulcer of Stomach or Duodenum 4 — 25. Diarrhoea under 2 years 2 — 26. Appendicitis — 2 27. Other digestive diseases 7 7 28. Nephritis 4 8 29. Puerperal and Post Abortive Sepsis — — 30. Other Maternal Causes — — 31. Premature Births 3 8 32. Congenital Malformation, Birth Injury, Infantile Disorders 7 5 33. Suicide 9 4 34. Road Traffic Accidents 8 5 35. Other Violent Causes 9 10 36. All other causes 21 16 ALL CAUSES 340 341 12 TABLE II. NFANTILE MORTALITY DURING THE YEAR 1948 Vet deaths from stated causes at various ages under one year. Cause of Death Under 1 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. Small-pox — — — — — — — — — — 2. Chicken-pox — — — — — — — — — — 3. Measles — — — — — — — — — — 4. Scarlet Fever — — — — — — — — — — 5. Whooping Cough — — — — — — — — — — 6. Diphtheria or Croup — — — — — — — — — — 7. Erysipelas — — — — — — — — — — 8. Tuberculous Meningitis — — — — — — — — — — 9. Abdominal Tuberculosis — — — — — — — — — — 10. Other Tuberculous Diseases — — — — — — — — — — 11. Meningitis (Non-T.B.) — — — — — — — — — — 12. Convulsions 1 — — — 1 — — — — 1 13. Laryngitis — — — — — — — — — — 14. Bronchitis — — — — — — — — — — 15. Pneumonia (all forms) 3 — — 1 4 2 — 1 3 10 16. Diarrhoea — — — — — — — — — — 17. Enteritis — — — — — — — — 1 1 18. Gastritis — — — — — — — — — — 19. Rickets — — — — — — — — — — 20. Suffocation, overlying — 1 — — 1 — — — — 1 21. Injury at Birth 1 — — — 1 — — — — 1 22. Atelectasis 1 — — — 1 — — — — 1 23. Congenital Malformation 2 1 — — 3 — — — — 3 24. Premature Birth 9 — — — 9 — — — — 9 25. Atrophy, Debility and Marasmus — — — — — — — — — — 26. Pemphigus Neonatorum — — — — — — — — — — 27. Other Causes 2 — — — 2 — — — 1 3 TOTALS 19 2 — 1 22 2 — 1 5 30 Births. Deaths. Legitimate 1001 Legitimate 25 Illegitimate 62 Illegitimate 5 Infantile Mortality Rate per 1,000 Births = 28.7 13 14 GENERAL PROVISION OF HEALTH SERVICES IN THE BOROUGH. Civil Ambulance Service. Under the provisions of the National Health Service Act, 1946, the ambulance service, consisting of three ambulances, manned day and night by eight driver-attendants, working on 24-hour shifts, was transferred to the Middlesex County Council on the 5th July, 1948. A satisfactory service is being maintained in the Borough. The following are details of work performed by Borough Ambulances during the period 1st January to 4th July, 1948. Accident Cases 85 Maternity Cases 209 Private Cases 408 Public Cases 257 Cases dealt with for other Boroughs 107 TOTAL 1066 Maternal Mortality and Morbidity. Deaths from Puerperal Causes :— Puerperal Sepsis None Other Causes None The following table shows the number of maternal deaths connected with pregnancy during the last 10 years :— Year Died from Sepsis Died from other causes connected with pregnancy 1939 — 2 1940 — — 1941 — — 1942 — 2 1943 3 2 1944 — 2 1945 — — 1946 — 3 1947 — 1 1948 — — During the year 15 cases of puerperal pyrexia were notified ; there were no maternal deaths. Twelve of the cases occurred in institutions, eight of whom were residents of other boroughs who had been admitted to Chiswick Maternity Hospital. 15 16 SUMMARY OF WORK AT THE MATERNITY AND CHILD WELFARE CLINICS—(1st January to 4th July, 1948) BRENTFORD AREA CHISWICK AREA Queen Char. Hosp. Clinic Grand Total 1948 Grand Total 1947 Mon. Clinics Wed. Clinics Total Tues. Clinics Wed. Clinics Thurs. Clinics Fri. Clinics Total Number attending for the first time during the year :— Under 1 year of age 65 57 122 105 85 81 64 355 48 525 1035 Over 1 year of age 17 10 27 30 25 27 25 107 5 139 190 TOTALS 82 67 149 135 110 108 89 462 53 664 1225 Number of children attended and weighed :— Under 1 year of age 973 1210 2183 1776 1581 1423 894 5674 261 8118 17159 Over 1 year of age 359 512 871 754 701 601 764 2820 50 3741 5694 TOTALS 1332 1722 3054 2530 2282 2024 1658 8494 311 11859 22853 Number of children seen by Doctor :— LJnder 1 year of age 214 195 409 376 314 311 228 1229 151 1789 3752 Over 1 year of age 158 180 338 234 215 199 234 882 21 1241 1832 TOTALS 372 375 747 610 529 510 462 2111 172 3030 5584 These Clinics were transferred to the control of Middlesex County Council on 5th July, 1948. 17 ANTE-NATAL CLINICS (1st January to 4th July, 1948) 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 BRENTFORD 26 98 138 6 555 21.3 CHISWICK 103 249 373 46 1405 14.5 TOTALS 129 347 511 52 2050 15.9 These Clinics were transferred to the control of Middlesex County Council on 5th July, 1948. SUPPLY OF MILK AND FOOD. (Other than under the National Milk and Vitamins Scheme) Terms of Supply Milk Meals supplied at Dining 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., sale of dried milk at Centres) YES YES YES NO NO NO YES YES YES * Cod Liver Oil and Malt, Virol, Bemax, etc. DENTAL INSPECTION. Treatment of Ante-Natal and Post-Natal Mothers and Children under five years of age from 1st January to 4th July, 1948. 1. Inspections 440 2. Referred for Treatment 343 3. Sessions : (a) Inspection — (b) Treatment 156 (c) Administration — TOTAL 156 4. Treated 334 5. Attendances 1272 6. Fillings : (a) Permanent Teeth 597 (b) Temporary Teeth 281 TOTAL 878 7. Extractions : (a) Permanent Teeth 259 (b) Temporary Teeth 127 TOTAL 386 8. Administration of Gas (N20) 112 9. Other Operations : (a) Permanent Teeth 227 (b) Temporary Teeth 224 TOTAL 45 Orthopaedic Clinic. (Children under 5 years of age). Total number of attendances ... ... ... 501 Number of indivi dual children ... ... ... 37 Number seen by Surgeon ... ... ... ... 119 18 Sun-Ray Clinic. (Children under 5 years of age). Total number of attendances 648 Number of individual children 32 Ophthalmic Clinic. (Children under 5 years of age). Number of attendances 106 New cases 26 Retinoscopy 26 Glasses prescribed 14 Glasses issued 12 Other cases 30 Individual children 38 Immunisation Clinic. (Children under 5 years of age). Number of attendances:— Diphtheria 1998 Whooping Cough 1207 Health Visitors. Eight Nurses were on the staff for this and the School Medical Service. The following is a summary of the work of the Health Visitors during the period 1st January to 4th July, 1948 :— (a) To expectant mothers :— First Visits 231 Total Visits 320 (b) To children under 1 year of age :— First Visits 560 Total Visits 1351 (c) To children between the ages of 1 and 5 years :— Total Visits 2065 (d) Ophthalmic Visits ("Sticky Eye") 5 (e) Other Visits :— Stillbirth 1 Child Life Protection 38 Infectious Disease 1 Miscellaneous (Special Visits, etc.) 49 TOTAL 3830 19 Child Life Protection (under Sections 206-220 of the Public Health Act, 1936). The following table gives particulars of registration during the year:— (1) Number of foster-parents on the Register :— (a) at the beginning of the year 22 (b) at the end of the year 14 (2) Number of children on the Register :— (a) at the beginning of the year 17 (b) at the end of the year 13 (c) who died during the year — (d) on whom inquests were held during the year — Bennett Street Day Nursery (equipped for 45 children) Total attendances during the period 1st January—4th July, 1948 6291 Ealing Road Day Nursery (equipped for 28 children) Total attendances during the period 1st January—4th July, 1948 2780 Nursery Classes. 'Total attendances during the year 1948 :— Beverley Road (equipped for 25 children) 8483 Strand-on-the-Green (equipped for 50 children) 16291 Lionel Road (equipped for 50 children) 9690 St. George's (equipped for 60 children) 8500 Home and Domestic Help Service. This service was inaugurated in 1945 and a full-time Organiser was appointed in November, 1946. Seventeen Helps (part-time) were employed on 4th July, 1948, and attended both domestic and confinement cases! In common with other branches of the Health Services, this service was transferred to the control of the Middlesex County Council on 5th July, 1948, under the provisions of the National Health Service Act, 1946. No. of cases in which help was supplied during the period 1st January to 4th July, 1948 83 20 Chiropody Service. Total number of cases treated during the period 1st January—4th July, 1948 75 Number of cases on register at 5th July, 1948 73 Total attendances during the period 1st January—4th July, 1948 243 Care of Premature Infants. This work has been carried out on the lines set out in Ministry of Health Circular 20/44, dated March, 1944, as described in the Report for 1945. Care of Illegitimate Children. The Borough continued to participate in the County Scheme and use has been made of the Hostels at 16, The Park, Holders Green, and "Marylands," Hendon. Control of Lice Infestation. No change was made in the policy adopted in previous years. SANITARY INSPECTION OF THE AREA. Tabular Statement of the Work of the Sanitary Department—1948 Inspections. Number of premises inspected on complaint 1878 Number of premises inspected in connection with infectious disease 95 Number of primary inspections Number of re-inspections Total number of inspections and re-inspections 2645 2995 5640 Action Taken (other than Housing Act, 1936). Cautionary or intimation notices served 1040 Statutory Notices issued (under Public Health Acts) 9 Summonses served — Number of Certificates under Rent, etc. (Restrictions) Acts issued to tenants 6 Number of Clearance Certificates issued to owners 3 21 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 195 Percentage of houses provided with water-closets 100% Drains:— Tested (smoke) 11 Unstopped, repaired, trapped, etc. 112 Waste pipes, rainwater pipes, disconnected, repaired, etc. 134 New soil pipes and ventilating shafts fixed 20 New sinks provided 35 Disconnecting traps and chambers inserted 9 Reconstructed (whole system) 4 Reconstructed (connections) 27 Percentage of houses draining into sewers 99.9% Surface water drains reconstructed - Surface water drains repaired 9 (h) Water Supply and Water Services. Draw taps on main 16 Percentage of houses supplied from Public Water Service 100% The whole of the district is supplied by Metropolitan Water Board Mains. There are two wells in the Borough and the following is the position with regard to these wells. (i) Mr. A. Knapp, 21, Grove Park Gardens—well working, but used for washing purposes only. Drinking water obtained direct from mains. (ii) Green's Boat House, Riverside Lands—well working, but used for washing purposes only. Drinking water obtained direct from mains. The mains water supply is satisfactory both in quality and quantity and reports of the bacteriological and chemical analyses carried out by the Metropolitan Water Board are issued from time to time. 22 (c) Refuse. New bins provided 70 Frequency of refuse removed from each house weekly Method of disposal—carried by collecting freighters to Controlled Tip outside the Borough. (d) Sundry Nuisances. Overcrowding (urgent cases reported to Housing Committee) 30 Smoke Minor complaints only Accumulation of refuse 4 Foul ditches, ponds, etc., and stagnant water 2 Dampness 391 Yards repaired or repaved 17 Leaky roofs and eaves gutterings 408 Defective flooring, joists and skirtings 231 Defective plasterwork to walls and ceilings 901 Premises cleansed and redecorated 573 Other defects 785 (e) Disinfection. Premises disinfected:— Ordinary notifiable diseases 91 Phthisis 21 Cancer 33 Other diseases 6 Rooms stripped and cleansed (Section 167, Public Health Act, 1936) — Premises treated for vermin 35 Premises treated for other pests (wasps, moths, ants, beetles) 13 (/) Slaughterhouses. Number on Register (including one Knacker's Yard) 5 Contravention of Byelaws — Slaughter of Animals Act, 1933. (vide Livestock (Restrictions on Slaughter) Order, 1940) Number of Licences to slaughter animals issued during the year:— New Licences Renewed Licences - 23 FOOD AND DRUGS ACT, 1938. MILK (SPECIAL DESIGNATIONS) REGULATIONS, 1936-1946 MILK AND DAIRIES ORDER, 1926. Number of premises on Register 20 Number of Dealer's Licences issued to sell:— (a) Tuberculin Tested Milk 5 (b) Accredited Milk - (c) Pasteurised Milk 14 Number of Supplementary Licences issued to sell:— (a) Pasteurised Milk 3 (b) Tuberculin Tested Milk 3 Bakehouses. Number in district in use 17 Contraventions of Factory Acts - Meat and Other Foods. During the year under review a total of 108 pigs were slaughtered in the Borough. These were all slaughtered under licences issued by the Ministry of Food and were mainly the property of various Pig Clubs situated in this and neighbouring Boroughs. The total of 108 was made up as follows (Airducts Pig Club, Brentford, 18; Henlys Pig Club, Brentford, 2; Barnes Artisan Pig Club, Barnes, 12; Limes Pig Club, Barnes, 17; Chertsey Court Pig Club, Barnes, 7; Watneys Pig Club, Barnes, 17; Westfield Pig Club, Barnes, 4; Palewell Pig Club, Barnes, 1; Enmore Pig Club, Barnes, 4; Ranelagh South Side Pig Club, Barnes, 2; Sandersons Pig Club, Perivale, 12; Greenford Pig Club, 2; Carrier Engineering Pig Club, Wembley, 5; County Perfumery Pig Club, Stanmore, 4; and St. Joseph's Hospital, Chiswick, 1). All were inspected at the time of slaughter and with one exception were found to be in good condition and passed fit for human consumption. The one exception was found to be one of Generalised Tuberculosis and the entire carcase and offal were destroyed at the Ealing Council's destructor situated at Greenford. No beasts or sheep were slaughtered in the Borough during the year. 24 25 CARCASES INSPECTED AND CONDEMNED Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed (if known) — — — — 108 Number inspected — — — — 108 All Diseases except Tuberculosis: Whole carcase condemned — — — — — Carcases of which some part or organ was condemned — — — — 1 Percentage of the number inspected affected with disease other than tuberculosis - - - — 0.9% Tuberculosis only:-. Whole carcase condemned — — — — 1 Carcases of which some part or organ was condemned — — — — — Percentage of the number inspected affected with disease other than tuberculosis — — — — 0.9% A total of 621 Food Shops and places where food is prepared were inspected and a list of foods condemned is tabulated below. Not all this food, however, was destroyed; where possible it was released for animal feeding or salvage. UNSOUND FOOD. List of Food condemned during the year 1948. Fruit and Vegetables: Brussels Sprouts 58 bags Onions (Dehydrated) 47½ lbs. Oranges 1½cases Potatoes 36 cwts. Meat: Beef 314¼ lbs. Beef, Minced 64¾ lbs. Chicken 257¼ lbs. Duck 14 lbs. Lamb3 lbs. Mutton 47 lbs. Pork 264¾ lbs. Rabbits 233 lbs. Sausages (Pork) 8 lbs. Sausage Meat 1 lb. Tripe 115 lbs. Fish: Bloaters 2 stone Cod 28 stone Eels 84 lbs. Fillet, Smoked 112 lbs. Haddock, Fresh 14 stone Haddock, Smoked 11½ stone Hake 5 stone Herrings, Fresh 8½ stone Kippers 30½ stone Plaice 10 stone Rock Fish 3½ stone Roe, Cod 5 stone Skate 14½ stone Whelks 20 galls. Whiting, Smoked 13¾ stone Witches 5 stone 26 General Provisions Bacon Barley Flakes Beans, Butter Beef, Cubes Biscuits Black Pudding Brawn Butter Cake Cake Mixture Cereal Cheese Cherries Chocolate (Sweet) Chocolate Spread Cocoa Coffee Coffee Essence Cooking Fat Custard Powder Dar Vita Dates Egg, Dried Eggs Figs, Dried Flour Fondant Cream Gherkins Ham Honey Horse-Radish Jam Lemon Curd Macaroni Malt Margarine Marmalade Mincemeat Paste Paste Peas, Dried Peel Pickles Pickles Plums Prunes 197 lbs. 18 lbs. 1¾ cwts. 240 14 lbs. 4 lbs. 16 lbs. 31 lbs. 126 lbs. 19 pkts. 12 pkts. 167¼lbs. 3 bottles 108 lbs. 1 lb. 35¾lbs. 11½lbs. 3 bottles 67 lbs. 16¼lbs. 9 pkts. 1 box 2 lbs. 168 56 lbs. 55 lbs. 14 lbs. 1 jar ¾ lbs. 7 lbs. 1 jar 215¾lbs. 1 lb. 3½ lbs. 73 cwts. 289½lbs. 212 lbs. 19½lbs. 174 tins 9 jars 46 lbs. 70 lbs. 106 bottles 51 tins 18 bottles 5½lbs. 27 General Provisions (Continued) Salad Cream 75 jars Salt 2 lbs. Sauce 10 bottles Semolina 3½ lbs. Soysim 20 lbs. Spaghetti 28 lbs. Stuffing 3 pkts. Sugar 16 lbs. Syrup 24 lbs. Tea 1 lb. Wheat Flakes 1 pkt. Tinned Foods (Miscellaneous): Anchovy 2 tins Apple Butter 112½ lbs. Apple Jelly 3 lbs. Apple Juice 1 tin Apple Sauce 2 tins Apples 1 tin Apricots 23 tins Beans 47 tins Beans, Baked 57 tins Beef, Corned 816 lbs. Beetroot 32 tins Beetroot 1 jar Blackberries 1 tin Brawn 3 tins Carrots 56 tins Cherries 2 tins Cod 30 tins Crab 5 tins Damsons 6 tins Date Pudding 1 tin Fish Balls 7 tins Fish Cakes 38 Fruit Cocktail 32 tins Gooseberries 153 tins Grapefruit 1291 tins Grapefruit Juice 9 tins Grapes 3 tins Hake 22 tins Herrings 2 tins Loganberries 25 tins Luncheon Meat 45¾ lbs. Meat & Vegetable Ration 94 tins Meat Roll 9 lbs. Milk, Condensed 99 tins 28 Inned Foods—(Continued) Milk, Evaporated 700 tins Milk, Skimmed 72 tins Mussels 45 tins Orange Juice 31 tins Oranges 71 tins Oysters 1 tin Parsnips 14 tins Pate de Foie 6 tins Peaches 38 tins Pears 8 tins Peas 371 tins Pease Pudding 2 tins Pilchards 39 tins Pineapple Juice 9 tins Plums 324 tins Potatoes 6 tins Rhubarb 5 tins Rock Fish 3 tins Roe 7 tins Salmon 27 tins Sardines 18 tins Snoek 1 tin Soups 71 tins Spaghetti 12 tins Spinach 6 tins Steak, Stewed 21 tins Steak and Kidney 3 tins Stew, Irish 24 tins Strawberries 1 tin Tomato Juice 20 tins Tomatoes 50 tins Tomatoes 9 jars Tongue, Lambs' 7 lbs. Tongue, Ox 18 lbs. Veal Loaf 35¼ lbs. Vegetable Salad 10 tins Whiting 1 tin OFFENSIVE TRADES: Number of premises in district 3 Nature of Trades:— One soap boiler; two Rag and Bone Dealers. CANAL BOATS: Number of Boats on Register:— Motor Propelled Boats 94 Other Boats 415 29 HOUSING. Housing Act, 1936. Owing to the difficulty experienced by builders in obtaining labour and necessary materials, the usual routine house-to-house inspection in the Borough was again suspended during the year. FACTORIES ACT, 1937. Inspections: Premises Number on Register Number of Inspections Made Written Notices Occupiers Prosecuted (i) Factories in which Sees. 1, 2, 3. 4 and 6 are to be enforced by Local Authorities 153 70 - - (ii) Factories not included in (i) in which Section 7 is enforced by L.A. 294 88 9 - (iii) Other premises in which Section 7 is enforced by L.A. (excluding outworkers' premises) - - - - TOTALS 447 158 9 — Cases in which Defects were Found: Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M.I. By H.M.I. Want of cleanliness (Sec. 1) 1 1 - 1 - Ineffective drainage of floors (Sec. 6) - - - - - Sanitary conveniences (Sec. 7)— (a) Insufficient 1 1 - - - (b) Unsuitable or defective 7 3 - 7 - (c) Not separate for sexes 4 1 - 4 — Other offences against the Act (not including offences relating to Outwork) 5 1 - 3 - TOTALS 18 7 - 15 - 30 Outwork (Sections 110 and 111). Nature of Work Section 110 Section 111 No. of outworkers in August list required by Section 110 (1) (c) No. of cases of default in sending lists to Council No. of prosecutions for failure to supply list No. of instances of work in unwhole some premises Notices served Prosecutions Wearing Apparel: Making, etc. 26 - - - - - Cleaning and Washing 1 - - - - - Household Linen 1 - - - - - Cosaques, Christmas Crackers, Christmas Stockings, etc. 4 - - - - - TOTALS 32 - - - - - PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. A.—Notifiable Diseases during the Year 1948. Disease Total cases notified Cases admitted to hospital Total Deaths Scarlet Fever 78* 70 - Whooping Cough 36 § 3 1 Diphtheria 1† 1 - Measles 335+ 21 - Pneumonia 13 5 33 Paratyphoid Fever l* 1 - Acute Poliomyelitis 1 1 - Dysentery 4 4 - Ophthalmia Neonatorum 7 1 - Puerperal Pyrexia 15 15 - Small-pox - - - Erysipelas 4 — — Malaria (contracted abroad) — — — Ac. Polio-encephalitis — - - * In addition, four cases originally notified and admitted to Hospital were subsequently diagnosed not Scarlet Fever. In addition two cases originally notified and admitted to Hospital were subsequently diagnosed not Poliomyelitis. † In addition nine cases originally notified and admitted to Hospital were subsequently diagnosed not Diphtheria. ‡ In addition, two cases originally notified and admitted to Hospital were subsequently diagnosed not Measles. In addition, one case originally notified and admitted to Hospital was diagnosed not Whooping Cough. * Originally notified as Cerebro-Spinal Fever. 31 B.—Ophthalmia Neonatorum. Cases notified Cases treated at home Cases treated in hospital Vision unimpaired Vision impaired Total blindness Deaths 7 6 1 7 — - - 32 33 C.— Ages of Cases of Infectious Disease Notified during the Year, 1948. Disease NUMBER OF CASES NOTIFIED At ages—years At all ages Under 1 1 2 3 4 5 and under 10 10 and under 15 15 and under 20 20 and under 35 35 and under 45 45 and under 65 65 and over Scarlet Fever 78* - 1 8 6 13 33 11 2 2 1 1 - Whooping Cough 36§ 2 8 7 1 3 11 2 — 1 — 1 — Diphtheria 1† — — — — — — — — 1 — — — Measles 335‡ 12 39 40 40 62 122 8 3 6 3 — — Pneumonia 13 2 1 — 1 — 1 — — 2 4 2 — Paratyphoid Fever lx — — — — — 1 — — — — — — Acute Poliomyelitis 1 — — 1 — — — — — — — — — Dysentery 4 3 — 1 — — — — — — — — — Ophthalmia Neonatorum 7 7 — — — — — — — — — — — Puerperal Pyrexia 15 — — — — — — — 1 10 4 — — Smallpox — — — — — — — — — — — — — Erysipelas 4 — — — — — — — — — 2 1 1 Malaria (Contracted Abroad) — - - - - - - - - - - - - Acute Polioencephalitis — — — - — — — — — — — — — * In addition, four cases originally notified were subsequently diagnosed not Scarlet Fever. ‡ In addition, nine cases originally notified were subsequently diagnosed not Diphtheria. || In addition, two cases originally notified were subsequently diagnosed not Poliomyelitis. ‡ In addition, two cases originally notified were subsequently diagnosed not Measles. § In addition, one case originally notified was subsequently diagnosed not Whooping Cough. x Originally notified as Cerebro-Spinal Fever. D.—Cases of Infectious Disease Notified during the Year, 1948. 34 Classified in Wards. Disease NUMBER OF CASES NOTIFIED Brentford West Brentford Central Brentford East Bedford Park Chiswick Park Grove Park Gunnersbury Old Chiswick Turnham Green Total. Casks Scarlet Fever 14 11 15 8 9 3 3 6 9 78 Whooping Cough 4 1 1 7 3 8 10 — 2 36 Diphtheria 1 — — — — — — — — 1 Measles 36 36 31 34 34 47 48 33 36 335 Pneumonia 4 5 - 1 — — 1 1 1 13 Paratyphoid Fever — — - — 1 — — — — 1 Acute Poliomyelitis — — — - — — - 1 — 1 Dysentery 1 — — — 2 — - - 1 4 Ophthalmia Neonatorum — 1 — 1 1 2 2 - — 7 Puerperal Pyrexia 1 1 1 — — — — 12 — 15 Erysipelas 1 1 — — — — 1 1 — 4 Malaria (Contracted Abroad) — — — — — — — — — — Acute Polioencephalitis — — — — — — — — — — Tuberculosis— Respiratory 14 11 13 15 13 5 13 11 13 108 Non-Respiratory 1 - 4 - - 1 1 - - 7 E.—TUBERCULOSIS—1948. Age Groups NEW CASES DEATHS Respiratory NonRespiratory Respiratory NonRespiratory Male Female Male Female Male Female Male | Female Under 1 year - - - - - - - - 1—5 years 1 3 1 1 — 1 1 1 5—15 years 4 4 — 2 — 1 — — 15—25 years 12 17 — 1 3 4 1 — 25—35 years 17 12 — 1 1 6 — — 35—45 years 13 6 — — 4 2 — — 45—55 years 5 1 — — 2 — — — 55—65 years 7 4 — 1 5 2 — 2 65 years and over 2 — - — 3 - — — TOTALS 61 47 1 6 18 16 2 3 During the year seven non-notified tuberculous deaths were recorded. OTHER DISEASES. Food Poisoning. There were no outbreaks of Food Poisoning reported in the Borough during the year. LABORATORY WORK. The following table sets out a record of the bacteriological work during the year 1948. Suspected Disease Result Positive Negative Total Diphtheria - 157 157 Tuberculosis 3 9 12 Other Diseases 1 8 9 TOTALS 4 174 178 35 The following table shows the incidence of Infectious Disease in schools during the year 1948. Jan. Feb. Mar. Apl. May Jun. Jly Aug. Sep. Oct. Nov. Dec. Tot. Scarlet Fever 10 4 6 7 5 4 7 — 2 2 1 2 50 Diphtheria - - - - - - - - - - - - - Chicken-pox 32 21 35 8 16 2 5 — 1 10 38 17 185 Measles 5 50 27 12 20 2 9 — — — 5 36 166 Whooping Cough 2 2 6 3 9 8 2 — 1 — 1 3 37 Mumps 16 12 40 30 13 34 14 — 5 23 22 39 248 Ringworm 11 4 — 2 — 1 — — — 2 1 1 22 Impetigo 3 5 — 5 2 — — — 2 4 2 — 23 Eczema - - - - - - 1 - - - - - 1 Verminous 2 — — 3 5 3 2 — 1 4 1 1 22 Scabies 3 1 - 4 1 1 — — 1 1 — — 11 Other Skin Diseases - - - - 1 - - - - 1 1 — 3 German Measles — — 1 — 1 — 3 — — 1 3 3 *12 TOTALS 84 99 115 74 73 55 43 - 12 48 75 102 780 36 INDEX Page Ambulance facilities 15 Ante-natal clinics 17 Area of Borough 10 Assisted Services 15 Bakehouses 24 Births and Birth Rate 13 Canal Boats 29 Cancer 11 Causes of Death 12 Child Life Protection 20 Chiropody Service 21 Clinics 16 Day Nurseries 20 Deaths and Death Rate 11 Dental Treatment 18 Diphtheria 31 Diphtheria Immunisation 19 Disinfection 23 Factories Act 30 Food Poisoning 35 Foster Children 20 General Statistics 10 Health Services, General sion of 15 Health Visiting 19 Home Help Service 20 Housing 30 Immunisation:— Diphtheria 19 Whooping Cough 19 Infant Mortality 13 Infant Welfare Clinics 16 Infectious Diseases, Prevalence and Control of 31 Isolation Hospital—Admissions . 31 Laboratory Facilities and Work 35 Lice Infestation 21 Maternal Morbidity and Mortality 15 Page Maternity and Child Welfare 16 Maternity and Child Welfare Committee 1 Meat and Other Foods 24 Milk Grants 17 Milk Regulations 24 Notifiable Diseases 33 Nursery Classes 20 Offensive Trades 29 Ophthalmia Neonatorum 32 Ophthalmic Clinic 19 Orthopaedic Clinic 18 Outworkers 31 Overcrowding 23 Poliomyelitis 8 Population 10 Post Natal Clinics 17 Premature Infants 21 Pre-school Medical Inspection 16 Public Health Committee 1 Puerperal Pyrexia 10 Refuse 23 Sanitary Inspection 21 Scarlet Fever 31 Shops 26 Slaughterhouses 23 Small-pox 31 Staff 2 Statistics—General and Vital 10 Stillbirths 10 Sunray Clinic 19 Tuberculosis 35 Unsound Food 26 Vermin 23 Vital Statistics 10 Water Supply 22 Water Services 22 Wells 22 37 .