BRE 19 Borough of Brenford and Chiswick REPORT ON THE HEALTH OF THE DISTRICT DURING 1951 BOROUGH OF BRENTFORD AND CHISWICK REPORT ON THE HEALTH OF THE DISTRICT DURING THE YEAR 1951 MARGARET A. GLASS, B.Sc., M.B., Ch.B.(Glas.), D P.H.(Cantab.), Medical Officer of Health BOROUGH OF BRENTFORD AND CHISWICK PUBLIC HEALTH COMMITTEE Councillor Copp, Chairman Alderman Fullerton-Bustard. " Howard. " Pett. Councillor Crispin. " Deane, P. " Hennessey. Councillor Nay. " Parker " Mrs. Saint. " Samels. " Taylor. Ex-Officio: County Councillor Charlton, J.P., Alderman Mrs. Burden and Councillor Brenton. STAFF - PUBLIC HEALTH DEPARTMENT Medical Officer of Health Margaret A. Glass, (Part-time) B.Sc., M.B.,Ch.B.(Glasgow), D.P.H. (Cantab). Chief Sanitary Inspector, L.C.Webb, Shops Inspector, Canal Boats A.R.San.I., Cert.R.San.I., Inspector, Inspector for Cert. Insp. of Meat and Factory Acts and Rodent Officer. Other Foods. Deputy Chief Sanitary Inspector T.M.Johnson, and Shops Inspector A.R.San.I., Cert. R.San.I., Cert. Insp. of Meat and Other Foods. Sanitary Inspectors and Shops A.G. Robinson, Inspectors M.S.I.A., Cert. R.San.I. and S.I.E. Joint Board, Cert. Insp. of Meat and Other Foods. C.H. Wright, M.S.I.A., Cert. R.San. I. and S.I.E. Joint Board, Cert. Insp. of Meat and Other Foods, R.S.I. Smoke Cert. R.A.G.James, Cert. R.San.I. and S.I.E. Joint Board. Administrative Assistant R.P. Hill. Deputy Senior Clerk D.G. Hill. Clerk N.J. Rogers. Shorthand-Typist Mrs .V.I.Merrifield. Junior Clerk Mrs.M.M.Bishop. (Appt. 11.6.51) Disinfector C. Clark. Rodent Operators G. Skipp. A. Scutchings. BOROUGH OF BRENTFORD AND CHISWICK Public Health Department, Town Hall, Ghiswick, W.4. To the Mayor, Aldermen and Councillors of the Borough of Brentford and Chiswick. Mr. Mayor, Ladies and Gentlemen, I have the honour to present the 24th Annual Report on the Health and Sanitary circumstances of the population of the Borough of Brentford and Ghiswick. The health of the people continued to be good. The birth rate fell from 14.82 in 1950 to 14.61 in 1951. This figure has continued to fall since 1946 and is this year again lower than the average for the whole of England and Wales, which is 15.5. The death rate rose from 11.75 1950 to 12.49 in 1951. The corresponding national figure is 12. 5. The number of infant deaths occurring in 1951 was 26, six more than occurred in 1950. This increase, however, was not unduly alarming as death from congenital malformation accounted for ten as compared with three in 1950, and these deaths do not come into the category of preventable occurrences. Apart from the heavy incidence of measles in the early part of the year, the number of notifications of infectious disease was comparatively small. In my Report special mention is made of the threat of epidemic influenza which fortunately did not materialize, and it is very pleasant to be able to record that no case of poliomyelitis occurred in Brentford and Ghiswick. The notifications of new cases of tuberculosis and the number of deaths from that disease were both less than in 1950, and whilst one year's figures are not an indication that any great improvement in the control of this disease has been obtained, the figures are encouraging. The expected visit of the Mass X-ray Unit to the Borough in 1952 is welcomed as a means of diagnosing early cases among factory workers and the general public, so that if any persons should be found to have suspicious symptoms, treatment can be started at a time when it is most likely to succeed in eradicating the disease from those persons affected. Health propaganda was continued throughout the year and included poster displays, addresses to meetings, personal talks on food hygiene to canteen workers and staffs of catering establishments, and a special showing of films on the handling of food to workers in the food industry. - 7 - A survey of all the catering establishments in the Borough was carried out and this disclosed fairly satisfactory hygienic conditions in most of the premises. It will be seen from the Report that with the ready co-operation of the proprietors of these establishments most of the defects found were remedied„ The few remaining at the end of the year were held up only because of difficulty or delay in obtaining equipment. The welfare of Old People continued to be a most important problem, and every effort was made to assist in the improvement of the conditions of distressed cases by the co-ordination of voluntary societies and statutory bodies responsible for particular functions with regard to Old People,, The Public Health Department of the Borough is the place to which people in need of advice and help on health matters, and indeed on many matters which seem not to have a direct bearing on healthy often turn. We do not discourage people from doing this as so many of the problems of living causing these enquiries are having an immediate, or are likely to have, a delayed, effect on the physical and mental health of the people concerned., The routine work of the Sanitary Inspectors on housing, overcrowding, nuisances, shop inspections etc. continued throughout the year and in fact increased in amount over that reported in 1950, partly because many properties were getting older and therefore in more frequent need of repair, and partly because of additional inspections carried out in shops and catering establishments following the issue of the Council's new Bye-laws on the Handling, Wrapping and Delivery of Food. In the eastern end of the Borough a survey was commenced on an area proposed for clearance and re-development. The measurements of atmospheric pollution by assessment of the amount of smoke and sulphur dioxide deposited daily in the Borough was continued throughout the year at the two selected sites. Comment is made in the Report on the summarised results which tend to show that the air in the Borough is not heavily polluted at any time of the year. Sanitary Inspectors continued to visit and advise at factories or other premises likely to cause smoke nuisance, in an endeavour to reduce the pollution that exists. I should like to thank all the members of the Health Department staff for their very great assistance with the preparation of this Report, and also for their willing and efficient service throughout the year. I am, Your Worship, Ladies and Gentlemen, Medical Officer of Health - 8 - GENERAL STATISTICS AMD SOCIAL CONDITIONS OF THE BOROUGH,1951 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 1951) 59,960 Population - Census 1951 59,354 Number of Inhabited Houses according to Rate Book 15,365 Rateable Value at 1.4.1951 £708,698 Sum produced by Id Rate £2,891 The Borough is divided into nine Wards: Brentford; Brentford East Brentford West Brentford Central Chiswick: Chiswick Park Grove Park Bedford Park Gunnersbury Old Chiswick Turnham Green The houses in the district are occupied by a mixed type population including artisans, factory workers, clerical and professional people of all grades, and the types of dwelling vary from small working class property to detached residences of fair size. Some of the old property has deteriorated partly through age and partly through effects of war damage to such an extent that it will require to be demolished when the housing situation will allow. The proportion of this type of home is not great. The problem of overcrowding in the Borough while still presenting some difficulties, is not of the very distressing nature found in certain other parts of London. It will be noted that on population figures the average number of persons per inhabited house amounts to 4. - 9 - Parks and Open Spaces controlled by the Council Area in Acres Boston Manor Park and Island 40.7 Carville Hall Park South 5.8 Carville Hall Park North 10.3 St. Paul's Recreation Ground 4.3 The Ham Recreation Ground 1.3 Chiswick Common South 8.7 Chiswick House 65.9 Stamford Brook Common 2.5 Homefields Recreation Ground 10.2 Strand Open Space 2.5 Turnham Green Common 7. 5 Duke's Meadows Sports Ground 19.9 Embankment Promenade 12.5 Future Embankment Promenade 15.3 Swimming Baths controlled by the Council Brentford Indoor Swimming Baths:- Area 2,430 sq.ft. Capacity 12,049 c.ft. Total number of persons using baths in 1951 52,005 Average number per day l6l Maximum number using baths on one day 497 Chiswick Open Air Pools:- Large Pool Area 7,500 sq.ft. Capacity 33,750 c. ft. Small Pool Area 3, 500 sq.ft. Capacity 18,375 c.ft. Total number of persons using baths in 1951 66 , 569 Average number per day 435 Maximum number using baths on one day 1,950 The purification of the water of these pools is by intermittent chlorination and the amount of free chlorine aimed at is 0.6 parts per million. Water samples are taken daily throughout the season. Public Baths and Washhouses Brentford In Clifden Road, Brentford, the Council maintains premises containing 21 slipper baths comprising? 8 first class (male) 4 first class (female) 6 second class (male) 3 second class (female) Total number using baths 24,619 Chiswick:- In Belmont Road, Chiswick, the Council maintains premises containing 31 slipper baths comprising: 14 first class (male) 5 first class (female) 8 second class (male) 4 second class (female) Total number using baths 40,885 In these premises are also 30 washing compartments comprising 30 coppers, a rinsing section, 30 drying horses, hot air drying compartments and 2 mangling machines. Ratepayers are entitled to use these washing facilities at a small charge of 4d per hour, and during 1951, 2,208 persons took advantage of the service. Health Services provided by Other Authorities North West Metropolitan Regional Hospital Board South West Middlesex Hospital Management Committee Brentford Hospital and Chiswick Maternity Hospital are two hospitals in the Borough administered by the South West Middlesex Hospital Management Committee under the provisions of the National Health Service Act, 1946. The former is of the Cottage Hospital type with 33 beds dealing with general medical and surgical cases. Chiswick Maternity Hospital which is an integral part of West Middlesex Hospital has 66 Maternity beds and 55 Maternity cots. A considerable number of Brentford and Chiswick people receive their hospital treatment at the West Middlesex Hospital, Isleworth, which is also administered by the South West Middlesex Hospital Management Committee. - 11 - County Council of Middlesex The County Council of Middlesex is the Local Health Authority under the National Health Service Act, 194-6, and provides the following services in the Boroughg- (a) Care of Mothers and Young Children: Brentfords- Ante-Natal Clinics and ) Wednesday mornings 9 to 12 a.m. Post-Natal Clinics ) Infant Welfare Clinics Monday and Wednesday afternoons 2 to 4 p.m. Diphtheria Immunisation Clinics Tuesday afternoons 2 to 3.30 P.m. Rheumatism Clinics Thursday mornings 9 to 10 a.m. Day Nursery Portsdown House, The Butts, Brentford. Chiswiek:- Ante-Natal Clinics and ) Tuesday and Thursday mornings by appointment. Post-Natal Clinics ) Infant Welfare Clinics Tuesday, Wednesday, Thursday and Friday afternoons 2 to 4 p.m. Diphtheria Immunisation Clinics Monday afternoons 2 to 2.30 p.m. Day Nursery Bennett Street, Chiswick, W. 4. Priority Dental Service for expectant and nursing mothers and children under school age. (b) Midwifery Service: Certified Midwives are employed for attendance on women in their homes in the Borough as midwives or as maternity nurses during childbirth. (c) Health Visitors: Health Visitors are employed to undertake home visiting for the purpose of giving advice on the care of young children, to persons suffering from illness, to expectant and nursing mothers and on the measures necessary to prevent the spread of infection. (The Health Visitors also act as School Nurses). - 12 - (d) Home Nursing and Nursing Equipment: Home Nurses are employed to undertake the nursing of persons in their own homes. (This work was fomerly undertaken by "District Nurses"). Where nursing equipment is required for use in the home, it is available on loan through the British Red Cross Society. (e) Vaccination and Immunisation: In addition to the immunisation of infants and young children carried out at the clinics referred to in (a) above, vaccination against smallpox and immunisation against diphtheria is carried out by those general practitioners who have agreed to co-operate in the County Council's scheme. (f) Prevention of Illness, Care and After-Care: The County Council's scheme includes provision for the admission of suitable cases to holiday rest homes. (Such cases should not be in need of medical or nursing care). The care and after-care of tuberculous persons is dealt with through the Welfare Officer at the Chest Clinic. The Chest Clinic serving the Borough is situated at No. 28 Bell Road, Hounslow, Middlesex. (g) Domestic Helps: Home Help for householders where this is required owing to the presence of a person who is ill, lying in, an expectant mother, mental defective, disabled or aged, is provided under the County Council's scheme. (h) Ambulance Service: An Ambulance Service is provided for the removal to hospital, where necessary, of accident and sickness cases. This service is organised in association with the Fire Service. (i) Mental Health Services The Mental Health Service deals with persons suffering from mental deficiency or mental illness. (j) School Health Service: The County Council is also the authority responsible for providing the school health service under the provisions of the Education Act. This service is closely co-ordinated with the services set out above. - 13 - Medical inspection and dental inspection of school children is arranged by the County Council through the Divisional Executive„ Medical and dental treatment is provided by the County Council in the Borough at the following clinics:- Minor Ailment Clinic (Chiswick) Monday, Tuesday, Thursday, Friday and Saturday 9 to 10 a.m. Wednesday 9 "to 12 a.m. with doctor. Minor Ailment Clinic (Brentford) Monday, Tuesday, Wednesday, Thursday and Saturday 9 to 10 a.m Friday 9 to 12 a.m. with doctor. Orthopaedic Treatment Clinic (Brentford) With Surgeon - every first and third Monday in each month from 2 to 5 p.m. Ophthalmic Clinic (Brentford) Tuesday and Friday 9 to 12 a.m, Physiotherapy Treatment Clinic (Brentford) Monday, Wednesday and Thursday 8.30 a.m. to 4.30 p.m. Speech Clinic (Brentford) Tuesday 1 to 4 p„m. Speech Clinic (Chiswick) Tuesday 9 to 12 a.m. Friday 1 to 4 p.m. Dental Clinic (Brentford and Chiswick) By appointment. Ultra-Violet Light Treatment Monday and Thursday 9 to 10 a.m. Clinic (Brentford) (k) Care of Children: In addition to the foregoing services the County Council through the Children's Department is also concerned in caring for children deprived of a normal home life. Area Children's Officers have been appointed to deal locally with such cases as they arise. - 14 - VITAL STATISTICS, 1951 Live Births Total Male Female Legitimate 821 411 410 Birth Rate per 1,000 of Illegitimate 55 35 20 the estimated resident TOTAL 876 446 430 population = 14.6l Stillbirths Total Male Female Legitimate 16 11 5 Rate per 1,000 total Illegitimate 3 - 3 (live and still) Births TOTAL 19 11 8 = 21.23 Deaths Total Male Female 749 383 366 Death Rate per 1,000 of the estimated resident population = 12.49 Deaths from Puerperal Causes Puerperal Sepsis Rate per 1,000 total Other Puerperal Causes (live and still) Births = NIL Deaths of Infants under 1 Year of Age Total Male Female Legitimate 24 18 6 Illegitimate 2 - 2 TOTAL 26 18 8 - 15 - Deaths and Death Rate A rise in the Death Rate occurred from 11.75 1950 to 12.49 in 1951° The principal causes of death were:- 1951 1950 Circulatory Disease 195 184 Heart Disease 155 152 Cancer 131 112 and it will be observed that all these are higher in 1951 than in 1950. The figure for deaths from tuberculosis is more satisfactory, as it has fallen from 34 to 25, which latter figure is the same as that for 1949. Of the 25 deaths this year, 24 were from respiratory tuberculosis, 1 from non-respiratory. This lowered death rate is accompanied by a reduction in the number of" notifications and on this, comment is expressed later in the report. There were no deaths associated with childbirth and there was a slight reduction in deaths from violence, including road accidents, i.e. from 28 in 195° to 23 in 1951. & of these resulted from motor vehicle accidents. The local Death Rate compares with a figure of 12.5 which was the Death Rate from all causes in the whole of England and Wales. Table I gives a list of Causes of Death as classified according to the new International system agreed by the World Health Organisation and in operation since November, 1949. This system in operation is proving helpful for the extraction of statistics, as death certification has now become more easily divisible into immediate and remote causes. Death Rate of all infants per 1,000 live births 29.68 Death Rate of all legitimate Infants per 1,000 legitimate live births 29.23 Death Rate of all illegitimate infants per l,000 illegitimate live births 36.36 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea or Gastro-Enteritis (under 2 years) 1 Deaths from Cancer (all ages) 131 Deaths from Tuberculosis (all ages) 25 - 16 - TABLE I PARTICULARS OF DEATHS AS SUPPLIED BY THE REGISTRAR - GENERAL FOR THE YEAR 1951 Cause of Death Males Females All Causes 383 366 1. Tuberculosis, respiratory 11 13 2. Tuberculosis, other - 1 3. Syphilitic Disease 6 - 4. Diphtheria — - 5. Whooping Cough - - 6. Meningococcal infections — - 7. Acute Poliomyelitis - - 8. Measles - - 9. Other infective and Parasitic Diseases 1 1 10. Malignant Neoplasm, stomach 10 9 11. Malignant Neoplasm, lung, bronchus 23 4 12. Malignant Neoplasm, breast - 17 13. Malignant Neoplasm, uterus - 5 14. Other malignant and lymphatic neoplasms 37 26 15. Leukaemia, aleukaemia 3 1 16. Diabetes 2 3 17. Vascular lesions of the nervous system 42 50 18. Coronary disease, angina 43 31 19. Hypertension with heart disease 15 13 20. Other heart disease 45 82 21. Other circulatory disease 13 16 22. Influenza 4 2 23. Pneumonia 19 21 24. Bronchitis 41 24 25. Other diseases of respiratory system 3 2 26. Ulcer of stomach and duodenum 5 4 27. Gastritis, enteritis and diarrhoea 4 - 28. Nephritis and Nephrosis 3 2 29. Hyperplasia of prostate 6 - 30. Pregnancy, childbirth, abortion - - 31. Congenital malformations 8 4 32. Other defined and ill-defined diseases 23 28 33. Motor vehicle accidents 4 2 34. All other accidents 11 5 35. Suicide 1 - 36. Homicide and operations of war - - ALL CAUSES 383 366 - 17 - Birth Rate The Birth Rate which has been falling since 1946 again shows a reduction from 14.82 to 14.61 in 1951. This compares with a National Birth Rate figure of 15.5. INFANT MORTALITY During 1951 the number of births recorded was 876: 821 legitimate and 55 illegitimate. There were 26 deaths of infants under one year of age as compared with 20 in 1950, giving an infant mortality rate of 29,68 for 1951. This rate compares with one of 22.37 for 1950, and is therefore an increase on last year's figure which was the lowest ever recorded in the Borough. As, however, the whole of this increase is accounted for by the rise in the number of deaths from congenital malformations, which were 10 in 1951 and only 3 in 1950; and which are not truly preventable by public health measures in the way that other infant deaths could be, it is not in any way an alarming figure. The local figure compares with the Infant Mortality Rate of 29.6 for England and Wales. The graph on page 19 shows the progress of Infant Mortality for the past 51 years. The number of premature infants born in 1951 was 40. Of these 8 were born at home, all of whom survived to the end of one month. 32 were born in hospital, of whom 26 survived to the end of one month. Causes of infant deaths are shown on Table II on page 20. - 18 - GRAPH "A" GRAPH SHOWING INFAMTILE MORTALITY RATES DURING THE PERIOD 1900 - 1951 - 19 - TABLE II INFANTILE MORTALITY DURING THE YEAR 1951 Net deaths from stated causes at various ages under one year Under 1 day 1 day 2 days 1 days S 4 days 5 days 6 days 7-14 days 14-21 days 21-28 days 1-2 months 2 months 3 months 4 months 5 months 6 months 7 months 8 months 9 months 10 months 11-12 mths Total under 1 yr Chicken Pox - - - - - - - - - - - - - - - - - - - - - - Measles - - - - - - - - - - - - - - - - - - - - - - Scarlet Fever - - - - - - - - - - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - - - - - - - - - - Diphtheria or Croup - - - - - - - - - - - - - - - - - - - - - - Erysipelas - - - - - - - - - - - - - - - - - - - - - - Tuberculous Meningitis - - - - - - - - - - - - - - - - - - - - - - Abdominal Tuberculosis - - - - - - - - - - - - - - - - - - - - - - Other Tuberculous Diseases - - - - - - - - - - - - - - - - - - - - - - Meningitis (Non-T.B.) - - - - - - - 1 - - - - - - - - - - - - 1 Convulsions - - - - - - - - - - - - - - - - - - - - - - Laryngitis - - - - - - - - - - - - - - - - - - - - - - Bronchitis - - - - - - - - - - - - - - - - - - - - - - Pneumonia (all forms) - - - - - - - - - - - 1 - - - - - - 1 - - 2 Diarrhœ - - - - - - - - - - - - - - - - - - - - - - Enteritis - - - - - - - - - - - - - - - 1 - - - - - 1 Gastritis - - - - - - - - - - - - - - - - - - - - - - Rickets - - - - - - - - - - - - - - - - - - - - - - Suffocation (overlying) - - - - - - - - - - - 1 - - - - 1 - - - - 2 Injury at Birth 1 - - - - - - - - - - - - - - - - - - - - 1 Atelectasis - 1 - - - - - - - - - - - - - - - - - - - 1 Congenital Malformation 1 1 l 1 - - 2 1 - - - 1 - - - - - - 1 1 - 10 Premature Birth . 4 1 - - - 1 - - - - - - - - - - - - - - - 6 Atrophy, Debility and Marasmus - - - - - - - - - - - - - - - - - - - - - - Pemphigus Neonatorum - - - - - - - - - - - - - - - - - - - - - - Smallpox - - - - - - - - - - - - - - - - - - - - - - Other Causes 2 - - - - - - - - - - - - - - - - - - - - 2 TOTALS 8 3 1 1 - 1 2 1 1 - - 3 - - - 1 1 - 2 1 - 26 - 20 - TABLE III 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 1942 - 2 1943 3 2 1944 - 2 1945 - - 1946 - 3 1947 - 1 1948 - - 1949 - - 1950 - - 1951 - - During the year 21 cases of puerperal pyrexia were notified; there were no maternal deaths. It is satisfactory to note that for four years in succession there have been no deaths associated with child birth. The figure for Puerperal Pyrexia notifications which appears very high is off-set by the fact that 18 of the notified cases were admitted from other areas to the local hospital. The actual figures for Puerperal Pyrexia cases belonging to the Borough is 3, as compared with 5 in 1950, and all these made an uneventful recovery. - 21 - TABLE IV PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES NOTIFIABLE DISEASES DURING THE YEAR 1951 Disease Total cases notified Gases admitted to hospital Total deaths Scarlet Fever 65 (50) 35 (25) - (-) Whooping Cough 90 (33) 8 (1) - (-) Diphtheria - (-) - (-) - (-) Measles 863 (269) 21 (8) - (-) Pneumonia (notifiable) 32 (15) 1 (l) 40± (32)± Typhoid Fever - (l) - (1) - (-) Dysentery 15 (9) 10 (6) - (-) Ophthalmia Neonatorum - (2) - (2) - (-) Puerperal Pyrexia 21 (l8) 21 (18) - (-) Smallpox - (-) - (-) - (-) Erysipelas 8* (2; 3 (2) - (-) Meningococcal Infection . 1≠ (-) 1 (-) - (-) Food Poisoning 6 (6) - (3) - (-) Malaria - (-) - (-) - (-) Acute Encephalitis:- Infective - (-) - (-) - (-) Post-Infectious 1 (-) 1 (-) - (-) Acute Poliomyelitis:- Paralytic - (5) - (5) - (-) Non-Paralytic -† (4) - (3) - (-) Totals 1102 (414) 101 (75) 40 (32) * In addition, one case originally notified and admitted to hospital was subsequently diagnosed not Erysipelas. ≠ In addition, one case originally notified and admitted to hospital was subsequently diagnosed not Meningococcal Infection. †One case originally notified as Non-Paralytic Poliomyelitis and admitted to hospital was subsequently not confirmed. ± Includes deaths from non-notifiable pneumonia. (1950 figures in brackets). TABLE V OPHTHALMIA NEONATORUM Cases notified Cases treated at home Cases treated in hospital Vision unimpaired Vision impaired Total blindness Deaths - - - - - - - -22- TABLE VI AGES OF CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 19 51 Disease Number of Cases Notified At all ages At ages-years Under 1 1 2 3 4 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 Over 65 Scarlet Fever 65 3 - 4 3 9 42 4 1 1 - 1 - Whooping Cough 90 7 15 9 13 13 28 3 - 1 - 1 - Measles 863 18 90 102 123 140 359 14 4 11 2 - - Pneumonia 32 - 1 - - - 2 - - 3 1 15 10 Ac. Poliomyelitis:- - - - - - - - - - - - - - Non-Paralytic -† - - - - - - - - - - - -- Ac. Encephalitis:- Post-Infectious 1 - - - - - - - - 1 - - - Meningococcal Infection 1≠ - 1 - - - - - - - - - - Dysentery 15 1 - 2 - 2 5 - - 4 - - - Puerperal Pyrexia 21 - - - - - - - - 18 3 - - Erysipelas. 8* - - - - - - - - 3 - 2 3 Food Poisoning 6 1 - 1 - 1 l - - 2 - - - * In addition, one case originally notified was subsequently diagnosed not Erysipelas. ≠ In addition, one case originally notified was subsequently diagnosed not Meningococcal Infection. † One case originally notified as Non-Paralytic Poliomyelitis was subsequently not confirmed. - 23 - TABLE VII GASES OF INFECTIOUS DISEASE NOTIFIED DURING TEE YEAR 1951 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 Cases Scarlet Fever 9 6 - 1 5 14 8 11 11 65 Whooping Cough 17 15 6 5 6 19 - 9 10 90 Measles 130 110 71 45 110 112 89 96 100 863 Pneumonia 14 6 6 - - 2 - - 1 32 Meningococcal Infection - - - - - 1 - - - 1 Acute Encephalitis:- Post-Infectious - - - 1 - - - - - 1 Dysentery - - 8 - - 1 1 4 1 15 Puerperal Pyrexia - - - - - 2 1 18 - 21 Erysipelas 1 - 4 - 1 - 2 - - 8 Food Poisoning - - - 1 1 - 2 1 1 6 Tuberculosis:- Respiratory 7 5 10 13 16 9 7 15 11 93 Non-Respiratory - - - 1 1 3 2 2 1 10 - 24- - CONTROL OF VERMIN AND SCABIES By the courtesy of the School Medical Officer particulars regarding the cleanliness surveys in schools have been obtained and are as follows:- Number of children examined Primary Schools 11,227 Secondary Modern Schools 3,593 14,820 Number of children requiring treatment 158 Number of formal cleansing notices issued 88 Number of children cleansed by Local Health Authority 20 There was an increase of over 3,000 in the number of cleanliness inspections but a drop in the number of children who had become infested with head lice, from 286 in 1950 to 158 in 1951. This is a very satisfactory sign of improvement in personal cleanliness amongst the school population. During the year applications were received for the cleansing of 3 persons who had become infested with Scabies. The treatment was carried out at Hammersmith Cleansing Station with the kind co-operation of the Medical Officer of Health of Hammersmith. INFECTIOUS DISEASES With the exception of measles, the incidence of notifiable infectious disease was very low in 1951. No case of diphtheria occurred, and of the four cases of cerebrospinal infection notified only two were confirmedg one, a man aged 32, as Acute Encephalitis, - this illness followed on an attack of Chicken Pox and the patient made a satisfactory recovery: and one as Meningitis, an infant of one year, who also made a satisfactory and complete recovery. There was a minor epidemic of measles in the first months of 1951 and notifications were very high during January, February and March, the type of illness was not however a severe one and no deaths occurred from measles. There was no outbreak of dysentery or food poisoning, cases being single and scattered over the Borough; the highest number notified in any one month was four. There were some signs in the early weeks of 1951 that influenza was likely to assume epidemic form. Information received from local practitioners and from the office of the Ministry of National Insurance seemed to show that the incidence of sickness in the working population was increasing abnormally during January and that - 25 - the increase was mainly in cases of influenza of a mild type. The Regional Officer of the Ministry of National Insurance kindly arranged for regular figures of local sickness certifications to be supplied for a time, and although the districts of this Ministry do not correspond with the Borough boundaries, the information enabled us to assess in a general way rises and falls in the amount of sickness in the corresponding periods compared with the previous year. The epidemic quickly died down but there were six deaths registered as having been due directly or indirectly to influenza during the first six weeks of the year. No confirmed case of Poliomyelitis occurred in 1951. Of the Poliomyelitis cases noted in the 1950 Annual Report as still showing residual paralysis, up to date information is as follows:- Case notified in 1949: This patient, now a child of 5 years, is still making progress, and although there is some paralysis of the right leg, the condition is improving. Gases notified in 1950: Case A - An adult male patient -his condition is more or less stationary. He wears an instrument to control his dropfoot, and suffers from some circulatory disturbance. He carries out full-time work as a lorry driver and finds no difficulty in performing his duties. Case B - An adult female patient - developed pulmonary tuberculosis before she was fully recovered from Poliomyelitis. She has made a fair recovery but her chest condition prevented further operative treatment on the left arm, still showing paralysis., She will probably be able to have this operation later, and meantime she is to be allowed to take up work. Case C - A boy now 10 years of age - is still showing signs of steady improvement. New Regulations came into force in 1951 concerning the notification of certain infectious diseases. The Public Health (Leprosy) Regulations, 1951 required that a medical practitioner attending, or called on to visit, a person suffering from Leprosy should notify the Chief Medical Officer of the Ministry of Health by certificate on a prescribed form. The local authority was required to supply a copy of the Regulations to medical practitioners practising within the district and these were circulated together with a small supply of certificates to be used in connection therewith, before the operative date, the 22nd June, 1951. - 26 - The Puerperal Pyrexia Regulations, 1951 These modified to a slight degree, the Puerperal Pyrexia Regulations of 1926, 1928 and 19390 Puerperal Pyrexia continued to be a notifiable disease, but the definition of the disease was altered, medical practitioners being required to notify to the Medical Officer of Health any febrile condition occurring in a woman in whom a temperature of 100.4°F (38°C), or more, took place within fourteen days of child birth or miscarriage. The local authority was instructed to send a copy of these Regulations to the general practitioners, and this was done before the operative date, which was 1st August, 19 Infectious Diseases and Food Poisoning In a circular from the Ministry of Health a recommendation was put forward that instead of the different types of notification forms formerly used for different kinds of infectious disease, a comprehensive form should be used, to include tuberculosis, food poisoning, puerperal pyrexia and poliomyelitis. It was suggested that the use of this form should be brought into practice at a reasonably early date. The scheduled type of form was produced and issued to general practitioners. Scarlet Fever The number of cases of Scarlet Fever notified was slightly increased in 195l, being 65 as compared with 50 in 1950. The type of disease, however, was mild and many of the cases were nursed at home with no secondary cases developing and no severe complications. During the year six contacts of smallpox cases abroad were notified to this Department from the Port Medical Officers and the Air-port Medical Officers. The contacts were followed up and kept tinder observation for the prescribed period but no illness developed. Vaccination against Smallpox By the courtesy of the County Medical Officer I am able to supply the following information concerning vaccinations carried out during the years. Age Persons Vaccinated Persons Revaccinated Under 1 year 202 2 Between 1-2 years 13 2 „ 2 - 5 „ 6 1 „ 5-15 „ 25 6 15 years and over 42 143 Totals 298 154 - 27 - It will be noted that 204 children under 1 year of age were vaccinated out of 876 children born during the 12 months, i.e. less than 25%. In view of the constant danger that smallpox may be introduced to the country from abroad, since persons are constantly arriving from areas where this disease is endemic, it is most alarming that the facilities for infant vaccinations are being used less each year. This is no doubt partly due to the feeling of security which the absence of smallpox from this country for a number of years engenders, but while the constant vigilance of Seaport and Airport Medical Officers is maintaining this happy state, it is in no way a surety that persons coming from abroad in the very short time which is now possible by means of air travel, could not bring with them dangerous germs which might not be discovered in time to prevent epidemic disease. There is a world wide interchange of information concerning the occurrence of disease wherever it may be and certain areas of the world are always black spots from which any person arriving in this country is suspect, but individual cases in areas other than black spots, or missed cases, might result in the infection of carriers with no possibility of anyone being aware of the fact. It has been established that adults going abroad or adults receiving vaccination on their entry into H. M. Forces are, to a certain degree, more severely affected by vaccination and more liable to its complications if they have not previously been vaccinated in infancy. Parents are not sufficiently aware of this fact, and the advisability of infant vaccination is constantly stressed in our Health Propaganda. Food Poisoning There were 6 cases of food poisoning notified during the year. These were notified on symptoms alone. Pathological examination revealed salmonella typhi-murium as the causative organism in two cases. In the other four cases no bacterial source was found. The source of the infecting organism in the two cases mentioned was not traceable. Symptoms were not severe in any one case and recovery was rapid. - 28 - TABLE IX LABORATORY WORK The following table sets out a record of the bacteriological work done during the year 1951:- ature of Specimen Result Positive Negative Total Diphtheria - swabs - 17 17 Scarlet Fever Contacts - swabs 1 17 18 Faeces etc. 17 36 53 Totals 18 70 88 TABLE X TUBERCULOSIS - 1951 Age Groups New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory Male Female Male Female Male Female Male Female Under 1 year - - - - - - - - 1-5 years 1 1 - 1 - - - - 5-15 „ 4 2 2 1 - - - - 15-25 „ 5 11 1 - 1 2 - 1 25-35 14 12 - 1 2 2 - - 35 - 45 „ 9 6 - 1 2 2 - - 45 - 55 „ 6 5 - - 1 - - - 55 - 65 „ 6 3 1 2 3 4 - - 65 yrs and over 4 4 - - 2 3 - - Totals 49 44 4 6 11 13 - 1 of the 25 recorded, deaths, 14 were previously notified as cases of Tuberculosis, 11 had not been so notified. In addition. 4 patients already notified as tuberculous died from other causes. - 29 - TABLE XI TABLE OF TUBERCULOSIS GASES IN YEARS Year NEW GASES DEATHS Respiratory NonRespiratory Total Respiratory NonRe spiratory Total M F M F M F M F 1931 38 34 7 6 85 24 17 1 7 49 1932 40 31 8 8 87 28 12 3 4 47 1933 34 44 10 2 90 33 26 5 1 65 1934 49 42 4 7 102 49 42 3 3 97 1935 46 47 3 5 101 21 15 5 1 42 1936 40 33 4 5 82 26 24 1 2 53 1937 38 46 9 9 102 22 13 1 3 39 1938 54 39 8 7 108 29 8 2 2 41 1939 36 33 9 7 85 18 18 2 3 41 1940 42 27 7 7 83 20 10 3 5 38 1941 52 25 3 3 83 23 12 5 2 42 1942 42 36 1 8 87 14 12 - 2 28 1943 52 29 3 5 89 25 11 - 1 37 1944 57 39 3 7 106 16 11 3 4 34 1945 46 41 9 6 102 18 11 1 2 32 1946 68 49 5 7 129 23 6 2 5 36 1947 62 36 4 4 106 30 8 - - 38 1948 61 47 1 6 115 18 16 2 3 39 1949 53 44 6 7 110 13 7 3 2 25 1950 59 39 4 6 108 19 13 1 1 34 1951 49 44 4 6 103 11 13 - 1 25 - 30 - GRAPH "B" GRAPH OF CASES NOTIFIED AND DEATHS FROM TUBERCULOSIS LURING THE PERIOD 1931 - 19,51 - 31 - The total number of cases on the Tuberculosis Register at the end of 1951 was 949, viz., pulmonary 823, non-pulmonary 126. TABLE XII Tuberculosis Register - 1951 Pulmonary Non-Plumonary Total Male Female Male Female Male Female (a) Number of Gases on Register at commencement of year 422 378 52 72 474 450 (b) Number of Cases notified for first time during year under Regulations 33 38 3 4 36 42 (c) Cases restored to Register during year 2 4 - - 2 4 (a) Gases added to Register otherwise than by notification under Regulations:- (1) Transferred from other districts 9 4 1 - 10 4 (2) Non-Notified deaths 7 2 - 2 7 4 (e) Number of Gases removed from Register during year 42 34 5 3 47 37 (f) Number of Gases remaining on Register at end of year 431 392 ...... 51 75 482 467 Cases removed from the Register shown under (e) are accounted for as follows:- Found not to be T. B. Recovered Lost sight of Removed to another area Died at home Died at Sanatorium or other Institution Total M F M F M F M F M F M F M F PULMONARY 2 - 1 4 - 2 19 16 7 7 13 5 42 34 NON-PULMONARY - - 1 1 1 - 3 - - - — 2 5 3 The occupations of cases of tuberculosis notified during the year have been classified under 11 headings and are shown in Table XIII below with the comparable figures for the year 1950. TABLE XIII Occupations 1951 1950 M F M F Outdoor Occupations Transport 1 - 1 - Other 2 - 4 - Indoor Occupations Heavy Manual 1 - 1 1 Light Manual 10 3 20 1 Clerical or Sedentary 10 8 8 7 Other 4 4 7 2 Housewife Domestic - 18 - 19 Schoolchlid 6 3 3 2 Shop Assistant 1 - 3 3 Under School Age 1 2 5 6 Occupation Unknown 17 12 11 4 TOTALS 53 50 63 45 There is a slight drop in the number of new notifications of tuberculosis. The actual figure is 103 compared with last year's total of 108 and combined with a fall in the number of tuberculosis deaths from 34 in 1950 to 25 in 1951, gives reason for modest hopes that the danger from tuberculosis in the Borough is at last declining. There is, however, no ground for complacency as it can be seen that there are on the register 949 known cases of tuberculosis i.e. one in every 63 of the Borough's population. MASS X-RAY An offer from the North West Metropolitan Regional Hospital Board to bring the Mass X-ray Unit into Brentford and Chiswick for a five week period in the beginning of 1952 was welcomed and accepted by the Borough Council. At a meeting held on the 29th October, 1951, with the Mayor and the Chairman of the Public Health Committee present, the requirements of the Unit were outlined by the Mass X-ray Unit Liaison Officer and representatives of all the local organisations in the Borough were invited to assist in publicising the facilities to be offered to the people of the Borough. The Council agreed to give the use of the Town Hall, and to make a grant towards the expenses of preliminary publicity. -33- HOUSING CONDITIONS OF GASES OF TUBERCULOSIS NOTIFIED DURING 1951 The housing conditions of the 103 new cases of tuberculosis were found to be as follows:- 83 patients lived in sufficiently satisfactory housing accomodation, 23 in flats, 56 in houses, 2 in lodgings, 1 in an ex-Army hut, and 1 in an Institution. In 2 cases the housing was unsatisfactory or dilapidated and in 3 cases there was overcrowding. 6 new notifications came from homes already returning one or more cases of tuberculosis, and none of these houses were unsatisfactory, dilapidated or overcrowded. 14 were inward transfers from other districts and therefore had not developed their illness while resident in Brentford and Chiswick. These figures compare with 5 living in unsatisfactory housing conditions and 14 overcrowded in 1950, and on these two years' results it would be difficult to say that the spread of tuberculosis from one person to another was more frequent in occurrence in insanitary or overcrowded houses - one gets the impression that those people who develop tuberculosis in unfavourable homes pay more attention to the laws of personal hygiene, are more anxiously aware of the risks to their relations, and being in constant fear of harming them do, in effect, limit their own infectivity. This is not to say, however, that overcrowding and defects of housing should not be abated at the earliest opportunity. Of the 14 cases of overcrowded housing with tuberculosis mentioned in the 1950 Report, 3 have since been rehoused within the Borough and the overcrowding abated, and 4 have removed to other districts. - 34 - HYGIENE OF FOOD Bye-laws New Bye-laws on the Handling, Wrapping and Delivery of Food on the lines of the Model Bye-laws of the Ministry of Food, were brought into operation during 1951, and each food shop, food factory and catering establishment in the Borough was supplied with a copy. Catering Establishments The survey of all catering establishments in the Borough reported as having commenced in 1950 was completed during the first part of 1951. The total number of establishments inspected was 292 classified as follows:- Hotels and Inns 54 Cafes and Restaurants 86 Factory Canteens 76 Clubs 31 Snack Bars 28 School Canteens 15 Hospital Kitchens 2 It was found at these visits that 101 premises had conditions up to or above statutory standards leaving l8l requiring work to be done to bring them up to these standards. In 10 cases the businesses were discontinued. While no premises were of a grossly unsatisfactory nature, in many the elementary principles of care in food handling were not fully understood and the inspectors' visits were used for health education purposes in addition to inspection. Complete co-operation was obtained from the owners of the establishments and every facility given for inspection, and in many cases agreement was obtained to the provision of sanitary equipment far in excess of the statutory requirements. With the co-operation of the Education Officer and School Meals Organiser, the County Council's School Canteens were included in the Survey and any defects found either in premises or methods of handling food were discussed and suitable remedial action taken. It is a source of satisfaction that no statutory enforcement was needed in any case, and there is no doubt that personal discussions of problems and possibilities between the visiting inspector and the establishment owners are much more productive of improvements than formal service of statutory notices; if owners were compelled only to conform to these the wording is sufficiently vague to permit of very small improvements being sufficient to meet the legal requirements. A considerable number of the catering establishments were found to have an initial and fundamental handicap in that the space allocated to cooking and washing was very limited in relation to - 35 - the number of meals prepared. This tends towards bad siting of the equipment, to a breaking down of the system of a properly run catering business especially during rush periods, and to a greater difficulty in maintaining a state of cleanliness. Cookers, steamers, etc. which in well-planned kitchens should be sited in the centre of the room to give adequate space for proper cleansing were found to be fixed within inches of a wall rendering the cleansing of the rear of the equipment, walls and floor almost an impossibility. Space allocated between the separate pieces of the equipment was also limited, creating a similar difficulty in the cleansing of the intervening space, and of the sides of the equipment. It was stressed at the Royal Sanitary Institute Congress 1951 that the planning of all catering establishments, canteens, etc., should be carefully scrutinised by the Public Health Department and that all plans for such establishments should be discussed jointly by officials from the Planning Department and the Health Department, and this liaison is now an established arrangement in the Borough, plans for new kitchens being studied by the staff of the Borough Engineer & Surveyor' s and Health Departments together. Whilst the floors of the kitchens were on the whole kept in a reasonable state of cleanliness, the walls, ceilings, windows and woodwork had not always received the attention necessary to keep them in a clean condition, in some cases years had elapsed between even the washing down of these parts. The cleansing of the cutlery, crockery and other utensils was on the whole satisfactory, but more use of detergents and of the two sink method was desirable. Details of inspections are as follows:- Number of first inspections 292 Number of premises found satisfactory 101 Number of businesses discontinued 10 Number of premises unsatisfactory l8l Number of revisits 232 Number of premises rendered fit within a short period 124 Notices served and complied with:- Served Complied with Preliminary Notices 18 10 Clean Food Letters(Food & Drugs Act) 72 50 Verbal Notices 75 58 Letters (advisory) 19 6 TOTALS 184 124 -36- Defects found and remedied:- Defects Found Remedied by December, 1951 Structural 135 Cleanliness 226 221 W.C. and drains 51 5l Sinks 39 38 Dustbins l8 18 Equipment 18 16 Water supply l6 16 TOTALS 503 492 By the end of 1951 a very great deal of work had been carried out on these premises and there remained out-standing five cases only:- 1. Awaiting Building Licence. 2. Awaiting delivery and erection of extractor fan and ducts. 3. Work in progress but not complete. 4.) Delay caused by divided responsibility and 5.) of ownership; awaiting committee decisions - no refusal to carry out work. All catering establishments which have been brought up to Food and Drugs Act standards are to be reviewed every six months. By this method any lowering of standards can be brought to the notice of the persons responsible, whether owners or employees. Unsound Food A number of complaints of alleged unsound food were received in the Department during the year. Legal action was taken in six cases with the results as under Complaint Result of Legal Action Razor Blade in Bread £5 fine and £2. 2s costs Hairs in Doughnut £5 fine and £5. 5s costs Nail in Cake £5 fine and £5. 5scosts Unsound Sliced Pork £5 fine and £5 5s costs Matchstick in Bread Roll £10 fine and £5. 5s. costs Metal Bolt in Tin of Gooseberries £2 fine and £2. 2s costs In addition to the above, the Council gave instructions in three instances for warning letters to be sent to the firms concerned and in another four cases for no further action to be taken. In twelve other cases the complaints were not substantiated. - 37 - Food Sampling By the courtesy of the County Council Public Control Officer the following details of food sampling within the Borough are available Article Total samples procured Unsatisfactory Milk 100 - Almond Marzipan 1 - Black Pudding 3 - Cake 18 - Cheese 1 - Coffee & Chicory Essence 1 - Cooked Meat 4 - Demerara Sugar 1 - Fish 8 - Fish Paste 1 - Fish Cake 1 - Gin 4 - Honey Crisp Bar 1 - Ice Cream 4 - Jelly 3 - Meat Pie 3 - Orange Curd 2 - Red Cherries in Syrup 2 2 Rissole 1 - Rum 1 - Saccharin Tablets 1 - Salad Cream 1 - Sausages, various 21 - Sausage Meat 4 - Sherbert 1 1 Sherry 1 - Tomato Sauce 1 - Whisky 4 - Yoghourt 1 - TOTALS 195 3 In the cases of the three unsatisfactory samples an official caution was sent to the Manufacturers of the articles. No legal action was taken by Middlesex County Council as Food and Drugs Authority during the year. In addition, 71 samples of Ice Cream were taken by the Borough's Sanitary Inspectors. The results of this sampling are reported on page 50. - 38 - Free Washing Facilities in Public Conveniences In October, 1951, facilities for free handwashing were made available in the Kew Bridge (Ladies'), Kew Bridge (Men's), High Road (Men's) and Turnham Green (Ladies') Public Conveniences, paper hand towels and liquid soap in tilting dispensers being issued to each. The scheme was designed in the first place in order that food handlers such as roundsmen or hawkers could find it easy to maintain personal hygiene when working for lengthy periods of time away from their shops or homes, although as a general public health measure it is a good thing for all, and the citizens who pay for the service in their rates can benefit from it not only through the greater safety of their food when delivered by uncontaminated hands, but also through the increase in their personal security by taking advantage of the service themselves. Up to the end of 1951, 2,700 paper towels had been issued and 24 pints of liquid soap, showing a fair use of the service. In addition, those who preferred linen hand towels and tablet soap were able to hire these at a cost of 3d each and in the same conveniences 1,849 of these towels were also used. HEALTH PROPAGANDA A continuous programme of distribution of health advice and information was maintained throughout the year. General talks aimed at the dissemination of useful knowledge on the prevention of infection and the maintenance of physical and mental health were given to audiences composed of members of societies and members of youth groups. Posters were displayed on health matters of topical interest, and personal talks given to factory managers, cafe proprietors, food handlers, and householders during the ordinary visits paid by the medical officer of health or sanitary inspectors. At a meeting of the Borough Public Relations Council which consists of representatives of most of the voluntary and trade societies, a talk and demonstration of film strips prepared by the Gentral Council for Health Education on the subject of Hygiene in the Handling and Preparation of Food was given. The Central Office of Information was asked to arrange a programme of films on the 9th January for the purpose of educating food handlers on the importance of clean food. Three sessions were held during one day and the proprietors of all the catering establishments and food factories were notified and asked to publicise the information and to permit as many of their employees as possible to attend during working hours. Included in each programme was the film "Another Case of Food Poisoning". General propaganda was begun to make the public aware of the facilities for Mass X-ray diagnosis of Tuberculosis which were to be made available early in 1952. A special meeting of representatives of voluntary associations, employers, trades councils, and local government bodies was convened for the purpose of obtaining sufficient assistance with the broadcasting of posters and leaflets to make certain that no person in the Borough could remain unaware of the fact that the Unit was to be operating. - 39 - WELFARE Old People During 1951 twenty-one cases of old people in need of care and attention were brought to the notice of the Public Health Department. No patient was found to be living in such conditions as to require Statutory action under the National Assistance Act. Each case of this nature requires a good deal of investigation as the needs of the patients vary so much - hospital admission is the most difficult thing to obtain, though I must express my most grateful appreciation of the help given by the Hospital Almoners of West Middlesex Hospital. Accommodation in County Homes for Old People is slowly increasing and the delays formerly experienced in obtaining Hostel accommodation have been reduced from years to months, and now we can hope to have really urgent cases placed reasonably quickly. Details of the action taken on these cases are as follows:- Removal to hospital 11 3 were subsequently transferred to Old Peoples Homes. 3 died following admission to hospital. 1 was discharged to own home. Removed under Mental Health Powers 3 Remaining at home because night nurse obtained 2 Remaining at home with Home Help assistance 2 Died at home before removal could be effected 3 Slipper Baths Under the scheme for the provision at reduced rates (2d per bath) of Slipper Baths for Old People at the Public Baths Establishments 1,230 baths were taken in Ghiswick and 195 in Brentford. Meals on Wheels The provision of mid-day meals once a week cooked at the Town Hall Staff Canteen and conveyed to the homes of the housebound elderly or chronic sick was continued throughout the year by the Old People's Welfare Committees 1,015 such meals were delivered during 1951 . - 40 - General The Superintendent of the local St. John's Ambulance Association and the Divisional Director of the British Red Gross Society have kindly supplied information concerning their welfare work in the Borough:- St. John's Ambulance Brigade (1) Attendance at sports meetings, public gatherings and entertainments to render first aid if required. (2) Conveyance of patients by ambulance to supplement the County Ambulance facilities. (3) Maintenance of comforts depot from which supplies of medical equipment can be issued on loan. (4) The provision of instructors for classes in First Aid and Home Nursing to Civil Defence volunteers, adult and youth groups. (5) Voluntary aid in hospital wards, male and female. (6) Provision of nursing attendants for meetings and outings of old persons organised by the various Old People's Associations. British Red Cross Society (1) The arrangement of sessions for the taking of blood for the transfusion service, and the provision of volunteer assistants during the periods of the blood transfusion service operations. (2) The maintenance of a medical equipment loan depot. (3) Ambulance transport for the sick to supplement the County Ambulance facilities. (4) Occupational therapy for disabled ex-Service pensioners and for Chest Clinic cases. (5) The provision of a library service for home-bound tuberculosis patients. (6) Home visiting in cases of distress and the provision of urgently required household articles or home nursing, (7) The provision of volunteer workers to travel to and from hospital with sick, aged, blind people or children. (8) The supply of instructors in First Aid for Civil Defence volunteers, adult and youth groups. (9) The allocation of accommodation in Red Cross Homes, short or long stay, for old people and convalescents. - 41 - ATMOSPHERIC POLLUTION The measurement of Atmospheric Pollution as assessed by the deposit of Smoke or Sulphurous gases in the Borough was continued throughout the year. The first station, already well-established at the Public Health Department premises, worked satisfactorily for the whole of the year with the exception of one short period of a few days when the electric motor broke down. The new station sited at Glifden Road Baths, Brentford, came into operation at the end of 1950, and recordings were taken from 1st January, 1951. The amount of smoke content and sulphur dioxide deposit was recorded for each twenty-four hour period, with a daily note of the local weather conditions and the average wind direction for the day. On 99 days of the year the wind was Westerly, on 43 days South Westerly and on 48 days Easterly. On the other days of the year the wind was fairly equally distributed between the remaining points of the compass. On examination of the daily figures there was no apparent increase of pollution between estimations taken when the drift was from due West or East. Monthly reports of recordings and other particulars were submitted to the Fuel Research Station of the Department of Scientific and Industrial Research for comparison with the rest of the country, and the officers of the Fuel Research Station were consulted at any time when special problems occurred concerning the reading of results or breakdown of equipment.. Bulletins from the Department of Scientific and Industrial Research were received regularly in the Department so that results could be compared with those in other areas. A brief summary of the year's recordings follows in Table XIV, and are represented in graph form as Graph "C". Graph "D" shows the monthly rise and fall in the pollution figures for Brentford and Chiswick, also Leeds, Central London and Lerwick. These latter places have been chosen in order to illustrate the varying amounts of pollution from a virtually smokeless atmosphere i.e. Lerwick, to an industrial area i.e. Leeds, It will be noted from Table XIV that smoke pollution in Brentford was higher than in Chiswick for the first six months of the year and again in December, while for the period July to November figures were either level or slightly to the disadvantage of Chiswick. On the whole, however, there was very little difference in the amount of pollution between the two experimental sites for the complete year. The figures tor both parts of the Borough compare very favourably with London itself, and even more favourably with the industrial Midlands, this in spite of the fact that there is a high proportion of factory premises within the Borough boundaries. - 42 - Smoke Complaints Daring the year there were 7 specific complaints of nuisance from smoke in the Borough, 5 from residents of Brentford concerning smoke emissions from factories in the Brentford area. These were investigated and smoke observations taken. No statutory nuisance was confirmed, but suggestions on the methods of stoking were given at the factories concerned. In the case of Chiswick, 2 complaints were received. In one case the smoke was being emitted from a laundry chimney in the Borough, whilst in the other the refuse destructor of a neighbouring Borough was concerned. The complaint at the laundry was investigated and no statutory nuisance confirmed. With regard to the refuse destructor, the Borough concerned was informed of the conditions complained of and action was taken to reduce the emission of smoke. TABLE XIV Month Highest Diaily Average Monthly Average Sulphur Dioxide Smoke Sulphur Dioxide Smoke Btfd. Chis. Btfd. Chis. Btfd. Chis. Btfd. Chis. Jan. 0.181 0.226 0.354 0.348 0.072 0.064 0.154 0.144 Feb. 0.141 0.136 0.337 0.303 0.060 0.057 0.155 0.137 Ear. 0.179 0.153 0.383 0.324 0.085 0.069 0.208 0.191 Apr. 0.226 0.197 0.276 0.304 0.084 0.064 0.116 0.104 May. 0.141 0.103 0.223 0.198 0.054 0.046 0.093 0.075 Jun. 0.125 0.135 0.105 0.098 0.047 0.040 0.060 0.053 Jul. 0.205 0.088 0.069 0.120 0.049 0.039 0.036 0.046 Aug. 0.060 0.056 0.106 0.106 0.021 0.023 0.041 0.041 Sep. 0.060 0.064 0.120 0.188 0.022 0.023 0.051 0.064 Oct. 0.256 0.179 0.542 0.476 0.097 0.098 0.167 0.208 Nov. 0.129 0.185 0.247 0.231 0.058 0.072 0.119 0.130 Dec. 0.267 0.282 0.632 0.683 0.086 0.087 0.212 0.198 - 43 - GRAPH "G" VARIATION IN AVERAGE MONTHLY CONCENTRATIONS OF SMOKE AND SULPHUR DIOXIDE IN BRENTFORD AND CHISWICK DURING 1951 - 44 - GRAPH "D,t COMPARISON OF CONCENTRATIONS OF SMOKE IN THE AIR AT BRENTFORD,"" CHISWICK - CENTRAL LONDON, LEEDS AND LERWICK - 45 - ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT Seven establishments were inspected for licence under this heading and all were found to be satisfactory for the purpose which was intended. Details are as follows:- Purpose No. of Licences Massage only - Chiropody only 3 Massage and Chiropody - Massage, Chiropody and Electrical Treatment 2 Massage and Electrical Treatment 2 Chiropody and Electrical Treatment - - 46 - SANITARY INSPECTION OF THE AREA Inspections: Number of primary inspections made:- (a) On Complaint 1,625 (b) Routine 758 (c) In connection with infectious disease 90 Total 2,473 Number of reinspections 2,958 Total number of inspections and reinspections 5,431 Action taken other than Housing Act, 19365 Cautionary or intimation notices served 719 Statutory Notices issued (under Public Health Acts) 42 Summonses served 10 Number of certificates under Rent etc. (Restrictions) Acts issued to tenants 2 Number of Clearance Certificates issued to owners 1 The following list shows the number of defects remedied as a result of notices served during the year:- Choked drains, unstopped 62 Chimney stacks, repaired and made good 11 Ceilings, repaired and made good 128 Dustbins, supplied 24 Dampness in walls, remedied 400 Fresh air inlets, repair or renewed 13 Firegrates, cooking stoves, repaired or renewed 98 Floors, joists and staircases repaired or renewed 107 Guttenngs repaired or renewed or cleaned out 89 Inspection covers and frames renewed 6 Leaky roofs and skylights repaired 297 Miscellaneous items 155 Plaster to walls, repaired and made good 269 Rainwater pipes, repaired or renewed 36 Soil pipe ventilators repaired or renewed 5 Sinks, replaced 12 Seats to W.C.'s, repaired or renewed 21 Waste water preventors repaired or renewed 36 Waste pipes, repaired or renewed 20 Walls and ceilings cleansed or redecorated 310 Window frames, sash cords, sills repaired or renewed l8l W.C.'s replaced 31 Yard paving, repaired and made good 16 Total 2,327 - 47 - In addition to the above, the following drainage works were carried out during the year under the supervision of the Public Health Department:- Drains tested (smoke) 13 New soil pipe ventilators fixed 5 New sinks provided and fixed 20 New interceptors fixed 3 New surface water and soil gullies fixed 18 New manholes constructed 26 Manholes reconstructed or repaired 9 Whole of drainage system relaid (soil) 6 Whole of surface water system relaid 4 Soil drainage connections repaired or relaid 72 Surface water connections repaired or relaid 6 Soil main drains repaired or relaid 14 Surface water main drains repaired or relaid 2 New W.C.'s provided and fixed 24 New sinks provided and fixed 20 Sewer connections repaired or relaid 2 Sanitary Services Percentage of houses draining into sewers 9% Percentage of houses provided with water closets 100% Enquiries - outstanding Sanitary Notices During the year 833 letters were received from the Town Clerk enquiring whether there were any outstanding sanitary notices with respect to certain properties in the district. The necessary searches were made and the required information furnished WATER SUPPLY AND WATER SERVICES The whole of the district is supplied by Metropolitan Water Board Mains. There are no standpipes now remaining in the district for the supply of persons inhabiting dwelling houses 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 is obtained direct from mains (ii) Green's Boat House, Riverside Lands - well working but used for washing purposes only Drinking water is 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 - 48 - REFUSE COLLECTION Refuse is collected once per week from each house in the Borough and is disposed of by collecting freighters to a Controlled Tip outside the Borough. HOUSING Hogarth Lane Re-development Area During the year a survey was made of a portion of the Hogarth Lane Re-development Area bounded by Bennett Street, Devonshire Road Furze Street and Bennett Street Passage. The number of houses inspected was 27, and a report thereon was sent to the Town Clerk for submission to the Housing Committee. Overcrowding 14 cases of alleged overcrowding were investigated by the Department during the year, 2 of which were on behalf of other Authorities. Of the remaining 12 cases 8 were found to be Statutorily overcrowded and were accordingly notified to the Housing Department for consideration by the Housing Committee. 2 of these cases of overcrowding were subsequently abated, 3 are to be rehoused when suitable accommodation becomes available, 1 applicant was granted a building licence and 2 cases were deferred. DISINFECTION Premises disinfected:- Ordinary notifiable diseases 59 Phthisis 16 Cancer 35 Other diseases 6 Premises treated for vermin 34 Premises treated for other pests (wasps, moths, ants and beetles) 17 SLAUGHTERHOUSES Number on the Register (including one Knacker's Yard) 5 Contravention of Bye-laws Slaughter of Animals Act, 1933 (vide Livestock (Restrictions on Slaughter) Order, 1940) Number of Licences to slaughter animals issued during the year: New Licences 2 Renewed Licences 2 - 49 - MILK During 1951 the following licences were issued under the Regulations mentioned:- Milk (Special Designation)(Pasteurised & Sterilised Milk) Regs., 1949 Dealer's Licences 45 Supplementary Licences 17 Milk (Special Designation)(Raw Milk) Regs., 1949 Dealer's Licences 22 Supplementary Licences 9 Routine inspection of dairies was carried out in order to maintain the standard laid down by the Food & Drugs Act, 1938, for the condition of such premises. ICE CREAM During the year 71 samples of ice cream were taken and tested bacteriologically. The results of these tests are as follow:- Grade I 46 Grade II 9 Grade III 13 Grade IV 3 No cases occurred during the year of Ice Cream being in such poor bacteriological condition as to necessitate the stoppage of sale. Grades III and IV samples totalling 16 in all, were obtained from 5 firms. These firms were kept under observation and advice given. BAKEHOUSES Number in district in use 15 Contraventions of Factory Acts - There is one underground bakehouse in the Borough which is under observation and which is kept in satisfactory condition MEAT AND OTHER FOODS During the year under review a total of 69 pigs were slaughtered in the Borough. These were all slaughtered under licences issued by the Ministry of Food, were inspected at the time of slaughter and were all found to be in good condition and passed fit for human consumption. No beasts or sheep were slaughtered in the Borough during the year. -50- TABLE XV Carcases Inspected and Condemned: Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed (if known) - - - - 69 Number inspected - - - - 69 All diseases except Tuberculosis: Whole carcase condemned - - - - - Carcases of which some part or organ was condemned - - - - - Percentage of the number inspected affected with disease other than Tuberculosis - - - - - Tuberculosis only: Whole carcase condemned - - - - - Carcases of which some part or organ was condemned - - - - - Percentage of the number inspected affected with. Tuberculosis - - - - - Food Condemned During the Year 1951 Fruit and Vegetables 106½ cwts Fish 32 stone Meat 12¼ Cwts Perishable Goods l8½ cwts Tinned Foods 10, 2 70 tins - 51 - BRENTFORD MARKET During the year the Sanitary Inspectors paid numerous visits to Brentford Market which is a large centre for the wholesale distribution of fruit, vegetables and flowers. There are also firms in the market which deal in wholesale groceries, tinned foods etc., and these were visited in connection with condemnation of unsound food. STREET TRADING The sites which are allocated for street trading were visited on numerous occasions to ensure that they were being maintained in accordance with the Bye-laws and particularly with regard to the handling of food. In addition, the premises of street hawkers who deal with food stuffs were inspected. FACTORIES ACT, 1917 TABLE XVI Inspections: Premises Number on Register Number of Inspections made Written Notices Occupiers Prosecuted (i) Factories in which Secs. 1?2,3?4? & 6 are to be enforced by Local Authorities. 150 9 - - (ii) Factories not included in (i) in which Section 7 is enforced by L.A. 319 45 4 - (iii) Other premises in which Section 7 is enforced by L.A. (excluding outworkers' premises) - - - - Totals 469 54 4 - - 52 - TABLE XVII Gases in which Defects were founds Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred to HMI by HMI Want of cleanliness (Sec .l) 2 2 - 2 - Sanitary Conveniences (Sec.7):- (a) Insufficient - - - - - (b) Unsuitable or defective 8 7 - 7 - (c) Not separate for sexes 1 1 - 1 - Totals 11 10 - 10 - TABLE XVIII Outwork (Sections 110 and 111): Nature of Work Section 110 Section 111 No. of out workers in Aug. list required by Section 110 (l)(c) No. of cases of default in sending lists to Council NOo of prosecut ions for failure to supply list No. of instances of work in unwholesome premises Notices served Prosecut ions Wearing Apparel: Making etc. 21 - - - - - Gleaning and Washing - - - - - - Furniture and Upholstery 1 - - - - - Making of boxes of paper . 6 - - - - - Stuffed Toys 23 - - - - - Christmas Crackers etc. 1 - - - - - Lampshades 1 - - - - - Totals 53 - - - - - - 53 - RAG FLOCK & OTHER FILLING MATERIALS ACT, 1951 The above Act came into force on 1st November, 1951 and three premises in the area were registered in accordance with Section 2. No Licences to Manufacture or to Store Rag Flock were issued. CANAL BOATS Number of Boats on Register:- Motor Propelled Boats 94 Other Boats 407 RODENT CONTROL During the year 2,199 primary visits and re-visits were made by the Rodent Operators to premises in the district in connection with rodent disinfestation. The number of premises where treatment was carried out is as follows:- Private Houses 248 Factories 25 Shops 18 Schools 15 In addition to the above, two maintenance treatments to the sewers were carried out under the direction of the Ministry of Agriculture and Fisheries during the periods January - March, and June to August, 1951, and the following table shows the number of manholes found to be infested since these treatments were commenced in 1946. Treatment Date Manholes found to be infested Initial Treatment June - Sept. '46 397 1st Maintenance Dec. '47 -Mar. '48 390 2nd Maintenance June - Sept. '48 260 3rd Maintenance Jan. - Mar. '49 193 4th Maintenance June - Aug. '49 135 5th Maintenance Jan. - Mar. '50 l79 6th Maintenance June - Aug. '50 163 7th Maintenance Jan. - Mar. '51 141 8th Maintenance June - Aug. '51 122 The work of Rodent Control is carried out under the supervision of the Chief Sanitary Inspector, by two Rodent Operators who have the assistance of a labourer during such time as the sewers are being treated. - 54 - INDEX Area of Borough 9 Atmospheric Pollution8,42,43,44 ,45 Bakehouses 50 Baths and Washhouses 11,40 Births and Birth Rate Brentford Market 52 British Red Gross Society . 41 Canal Boats 54 Chancer 16 Catering Establishments 8,35 Causes of Death 16,17 Clean Food Bye-laws 8,35 Condemned Food 51 Deaths and Death Rate 7,l5,l6 Disinfection 49 Factories Act, 1937 52 Food Poisoning 28 Food Hawkers 52 Food Sampling 38 Free Washing Facilities 39 General Statistics 9 Health Propaganda 7,39 Health Services provided by Other Authorities 11,12,13,14 Housing 9,49 Hygiene of Food 35 Ice Cream Sampling 38,50 Infant Mortality 7,l5,l8,19,20 Infectious Disease 7,25,27 Infectious Disease, Prevalence and Control of 22 Infectious Disease, Ages of Cases 23 Infectious Disease, Classified in Wards 24 Influenza 25,26 Isolation Hospital, Admissions 22 Laboratory Work 29 Leprosy 26 Mass X-ray 7,33,39 Massage and Special Treatment Establishments 46 Maternal Morbidity and Mortality 15,21 Meals on Wheels 40 Meat and Other Foods 50 Milk Regulations 50 - 55 - Notifiable Diseases 22 Old People 8,40 Ophthalmia Neonatorum 22 Outworkers 53 Overcrowding 9,49 Parks and Open Spaces 10 Poliomyelitis 26 Population 9 Premature Infants 18 Public Health Committee 3 Puerperal Pyrexia 21,27 Rag Flock & Other Filling Materials Act, 1951 54 Rateable Value 9 Refuse 49 Rodent Control 54 Sanitary Inspection of the Area 47 Sanitary Services 4b Scabies 25 Slaughterhouses 49 Smallpox 27 Smallpox Vaccinations 27,20 Smoke Pollution 8,43 St. John's Ambulance Brigade 41 Staff 5 Stillbirths 15 Street Trading 52 Swimming Baths 10 Tuberculosis 7,16,29,31 Tuberculosis Register 32 Tuberculosis, Housing Conditions of Newly- Notified Cases 34 Tuberculosis, Occupations of Newly-Notified Cases 33 Tuberculosis, Cases in Years 30 Unsound Food 37 Vermin 25 Vital Statistics 15 Water Supply and Water Services 48 Welfare: Old People 8,40 General 41 Wells 48 Wards 9