AC 439 (1) BRENT FORD Library BRE 20 Borough of Brentford and Chiswick ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1952 BOROUGH OF BRENTFORD AND CHISWICK ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1952 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 Alderman H. P. Copp, Chairman Alderman Mrs. A. J. Burden. " R. P. Sinclair. Councillor E. Davies. " P. W. T. Haines. " R. Hennessey. Councillor A. G. Nay. " H. F. Parker. " Mrs. M. G. Saint " B. J. Samels. " A. W. Walker. Ex-Officio: Councillor H. Deane, J.P., Alderman R. S. Howard and Councillor T. J. Crispin. STAFF - PUBLIC HEALTH DEPARTMENT Medical Officer of Health (Part-time) Margaret A. Glass, B. Sc., M.B., Ch. B.(Glasgow), D.P.H. (Cantab). Chief Sanitary Inspector, Shops Inspector, Canal Boats Inspector, Inspector for Factory Acts and Rodent Officer L. C. Webb, A.R.San.I., Cert.R.San.I., Cert. Insp. of Meat and Other Foods. (Died - 9.3.52) T. M. Johnson, A.R. Sane.I., Cert.R. San.I., Cert. Insp. of Meat and Other Foods. (From 19.3.52) Deputy Chief Sanitary Inspector and Shops Inspector T. M. Johnson, A.R.San.I., Cert.R.San.I., Cert. Insp. of Meat and Other Foods. A. G. Robinson, M.S.I.A., Cert.R.San.I. and S.I.E. Joint Board, Cert. Insp. of Meat and Other Foods. (From 5.6.52) Sanitary Inspectors and Shops Inspectors A. G. Robinson, M.S.I.A., Cert.R.San.I. and S.I.E. Joint Board, Cert. Insp. of Meat and Other Foods. R.A.G. James, 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. C.E. Mallett, M.S.I.A., Gert.R.San.I. and S.I.E. Joint Board, Cert. Insp. of Meat and Other Foods. (Appointed 7.7.52) 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. Disinfector C. Clark. Rodent Operators G. Skipp. A. Scutchings. 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. Mr. Mayor, Ladies and Gentlemen, I have the honour to present the 25th Annual Report on the Health and Sanitary Circumstances of the population of the Borough of Brentford and Chiswick. The health of the people continued to be good. The birth rate fell from 14.6l in 1951 to 14.21 in 1952. 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 15.3. The death rate fell from 12.49 in 1951 to 11.27 in 1952. The corresponding national figure was 11.3. Infant mortality fell to 17.6l per thousand live births. This is the lowest ever recorded in the Borough, and Graph "A" of the text shows the progress of infant mortality through the years since 1900. Only a few years ago it was thought that the low infant mortality reached in New Zealand of 27 per thousand births was still rather a distant goal difficult of attainment, and so this figure is extremely satisfactory. It could, however, be reduced further since deaths from preventable causes such as pneumonia and prematurity in young infants are included in the total of 15. The notifications of infectious diseases were lower by 446 during 1952, principally due to a decrease in the incidence of measles and whooping cough. There was a rise in the figure for scarlet fever notifications, but the disease was not of a severe type. Nine cases of poliomyelitis occurred with two deaths, one of which, however, was due not to the poliomyelitis, but to coronary thrombosis. Five of these patients suffered from residual paralysis requiring further treatment. No case of diphtheria has occurred during the past five years, and particulars of the immunisation state of the children of the Borough are included in this Report. Approximately 50% of children have completed a course of injections to protect them from diphtheria. There was an increase in the number of infants receiving vaccination against smallpox during the first year of life from 25% of infants born in 1951 to 35% of infants born in 1952. 7 During the visit of the Mass X-Ray Unit in January almost 10,000 people were examined; the percentage of people found to have signs of active tuberculosis was considered to be fairly high, and several of these positive cases were residents of other Boroughs who were employed in local factories. The visit of the Unit did not greatly increase the number of new notifications during the year, and a fall in the number of deaths from 25 in 1951 to 15 in 1952 gives grounds for cautious optimism with regard to the progress of prevention of this disease. Work on the hygiene of food was a particular concern of the Sanitary Inspectors during the year. 793 visits were paid to food shops, restaurants and other places where food for sale could be subject to contamination. Following the complete survey of all catering establishments during 1951, a system of routine inspection was established so that any premises falling below the standards achieved as a result of the survey could be quickly discovered. The total number of Sanitary Inspectors' visits increased slightly during the year, but the number of statutory defects discovered was very much lower than in 1951 i.e. 989 as compared with 2327, suggesting that the gradual clearing of old property and provision of new building is beginning to have effects likely to be of benefit to the Public Health. The welfare of Old People continued to be a matter of great concern in the Department and the number of cases brought forward for assistance increased. Although the voluntary helpers in this field are numerous and well-meaning, it is a sad fact that in those cases where the Medical Officer is asked to assist, generally the individuals concerned have been left by family and friends to deteriorate physically and mentally and alone until they become a public "health nuisance. New low records in Atmospheric Pollution were achieved during the year, though the devastating effects of the December fog tended to overshadow these both literally and metaphorically. Study of the figures for Rodent Control shows a steady decrease of the sewer rate population over the past six years, and there was a reduction in the number of premises requiring treatment for rat or mice infestation, from 306 in 1951 to 259 in 1952. In an endeavour to make this Report as comprehensive as possible of the work on public health in the Borough, information has been obtained from many sources and special thanks are due to the Secretary of the South West Middlesex Hospital Management Committee, the County Medical Officer, the Area Medical Officer, the Physicians of the Chest Clinics in Ealing and Hounslow and of the Mass X-Ray Unit, the County Public Control Officer, the Divisional Officers of the British Red Gross and St. John's Ambulance Associations, the Organiser of Invalid Kitchens of London, the Secretary of the Old Folks Fund and Chief Officers of Brentford and Ghiswick Borough Council. 8 The Department suffered a loss in March, 1952, by the death of the Chief Sanitary Inspector, Mr. L. C. Webb, after a long period of illness, Mr. Webb had been in the service of the Borough Council for 45 years. In conclusion, I should like to thank the present Chief Sanitary Inspector and all members of the Public Health Department for the good work they do, not only in assisting with the preparation of this Report, but at all times. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health 9 GENERAL STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH, 1952 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 1952) 59,970 Population - Census 1951 59,354 Number of Inhabited Houses according to Rate Book 15,476 Rateable Value at 1.4.1952 £715,638 Sum produced by 1d Rate £2,934 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 through age and the damage of war to a condition in which it can be considered no longer fit for human habitation and sections of this old property are in the process of survey with a view to demolition and rebuilding. Details concerning this will be found later in the Report. Overcrowding of individual houses is still a considerable problem in spite of the extensive building programme carried out by the Borough Council, and although the majority of applicants for Council housing made their requests since the War, there are still some pre-War applicants not yet housed because of having to give way to the greater claims of those from overcrowded or insanitary dwellings. 10 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 28.4 acres of the above open space land is used as allotments. 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 1952 60,267 Average number per day 189 Maximum number using baths on one day 616 Ghiswick 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 1952 87,219 Average number per day 585 Maximum number using baths on one day 3,905 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. Other Facilities in the Borough for Open Air Recreation Privately owned open spaces and sports grounds . 109.95 acres Council owned open spaces and sports grounds leased to private clubs etc. 67.94 " School playing fields 36.50 " 11 Public Baths and Washhouses Brentfords:- In Clifden Road, Brentford, the Council maintains premises containing 21 slipper baths comprisings 8 first class (male) 4 first class (female) 6 second class (male) 3 second class (female) Total number using baths 24,950 Chiswicks:- In Belmont Road, Ghiswick, 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 48,936 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 1952, 1,902 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 situated within the Borough, administered by the South West Middlesex Hospital Management Committee under the provisions of the National Health Service Act, 1946. The former is a cottage type hospital, staffed by general practitioners and visiting consultants, and has 33 beds dealing with general medical and surgical cases. Chiswick Maternity Hospital which is an integral part of the West Middlesex Hospital has 66 maternity beds and 55 maternity cots. A considerable number of Brentford and Ghiswick people receive their hospital treatment at the West Middlesex Hospital, Isleworth, and the majority of cases of infectious disease requiring hospital isolation are admitted to the South Middlesex Hospital, Isleworth. 12 Chest Clinic patients residing on the north side of the Borough attend the Ealing Chest Clinic for their examinations, X-rays and out-patient treatment, and the patients from the remaining area of the Borough attend the Hounslow Chest Clinic, which is administered by the Staines Group Hospital Management Committee. County Council of Middlesex The County Council of Middlesex is the Local Health Authority under the National Health Service Act, 1946, and provides the following services in the Boroughs:- (a) Care of Mothers and Young Children: Brentford:- Ante-Natal Clinics and Post-Natal Clinics Wednesday mornings 9 to 12 a.m. Infant Welfare Clinics Monday and Thursday afternoons 2 to 4 p.m. Diphtheria and Whooping Cough Immunisation and Vaccination Clinics Alternate Tuesday afternoons 2 to 3.30 p.m. Rheumatism Clinics Thursday mornings 9 to 10 a.m. Day Nursery Port sdown House, The Butts, Brentford. Chiswick:- Ante-Natal Clinics and Post-Natal Clinics Tuesday and Thursday mornings 9 to 12 a.m. Infant Welfare Clinics Tuesday, Wednesday, Thursday and Friday afternoons 2 to 4 p.m. Diphtheria and Whooping Cough Immunisation and Vaccination 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. 13 (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). (d) Home Nursing and Nursing Equipment: Home Nurses are employed to undertake the nursing of persons in their own homes. (This work was formerly 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. Details of the work of the Home Nurses in the Borough during the year are as follows:- Type of case Age Groups Total Grand Total Under 5 yrs 5-64 yrs 65 yrs and over M F M F M F M F Medical 31 19 181 285 118 227 330 531 861 Surgical 14 2 16 21 13 10 43 33 76 Infectious Disease - 1 2 4 - - 2 5 7 Tuberculosis - - 28 19 - - 28 19 47 Maternal Complications - - - 14 — — - 14 14 Others - - 8 6 1 11 9 17 26 Totals 45 22 235 349 132 248 412 619 1031 (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) Mental Health Services: The Mental Health Service deals with persons suffering from mental deficiency or mental illness. 14 (g) School Health Service: The County Council is also the authority responsible for providing the school health service under the provisions of the Education Act. 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. Monday 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 9 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 Clinic (Brentford) Monday and Thursday 9 to 10 a.m. (h) 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. 15 (i) Prevention of Illness, Care and After-Care: The County Council's scheme includes provision for the admission of suitable cases to recuperative resthomes. (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 Officers at the Chest Clinics. The Chest Clinics serving the Borough are situated at No. 28 Bell Road, Hounslow, Middlesex, and Green Man Passage, West Ealing, W. 13. (j) 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 or a child not over compulsory school age, is provided under the County Council's scheme. (k) 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. (1) Chiropody Service: Old Age Pensioners are referred to private practitioners. An assessment scheme is in operation. 16 VITAL STATISTICS, 1952 Live Births Total Male Female Legitimate 802 396 406 Birth Rate per 1,000 of the estimated resident population = 14.21 Illegitimate 50 22 28 TOTAL 852 418 434 Stillbirths Total Male Female Legitimate 11 6 5 Rate per 1,000 total (live and still) Births = 13.89 Illegitimate 1 1 - TOTAL 12 7 5 Deaths Total Male Female 676 335 341 Death Rate per 1,000 of the estimated resident population = 11.27 Deaths from Puerperal Causes Puerperal Sepsis - Rate per 1,000 total (live and still) Births = 1.16 Other Puerperal Causes . 1 Deaths of Infants under 1 Year of Age Total Male Female Legitimate 15 11 4 Illegitimate - - - TOTAL 15 11 4 17 Deaths and Death Rate The Death Rate decreased in 1952 to 11.27 from 12.49 in 195l. The principal causes of death were:- 1252 1951 Circulatory Disease 217 195 Heart Disease 113 155 Cancer 128 131 It will be noted that there is a considerable fall in the numbers dying from heart disease, in fact, this combined with the fall in the total number of deaths from respiratory diseases accounts for the whole of the reduction in the death rate. It is interesting that the respiratory disease death rate should have fallen in this year when the severe fog occurring in early December had such great effect on the death rate in the County of London. But the actual number of deaths from respiratory disease other than tuberculosis during December was 20 as compared with 4 in December, 1951, which suggests that the fog did in fact increase the mortality rate from these diseases in the Borough. Deaths from Tuberculosis are down again and the comparison is as follows:- Year Number of deaths from tubercnlosis Male Female Total 1950 20 14 34 1951 11 14 25 1952 9 6 15 There were no deaths from Diphtheria, but one from Whooping Cough and one from Poliomyelitis are of particular note. There was one death (abortion) associated with childbirth. A slight reduction occurred in deaths from violence, including road accidents, i.e. from 23 in 1951 to 21 in 1952, (5 which resulted from motor vehicle accidents). The corresponding figure for 1950 was 28. The local Death Rate compares with a figure of 11.3 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. 18 Death Rate of all infants per 1,000 live births 17.61 Death Rate of all legitimate infants per 1,000 legitimate live births 18.7 Death Rate of all illegitimate infants per 1,000 illegitimate live births Nil Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea or Gastro-Enteritis (under 2 years) Nil Deaths from Cancer (all ages) 128 Deaths from Tuberculosis (all ages) 15 Birth Rate The Birth Rate which has been falling since 1946 again shows a reduction from 14.61 to 14.21 in 1952. This compares with a National Birth Rate figure of 15.3. INFANT MORTALITY During 1952 the number of births recorded was 852: 802 legitimate and 50 illegitimate. There were 15 deaths of infants under one year of age as compared with 26 in 1951, giving an infant mortality rate of 17.61 for 1952, the lowest ever recorded in the Borough. The local figure compares with an Infant Mortality Rate of 27.6 for England and Wales. The graph on page 20 shows the progress of Infant Mortality since the beginning of the century. The number of premature infants born in 1952 was 48. Of these 2 were born at home, 1 of whom survived to the end of one month. 46 were born in hospital, of whom 41 survived to the end of one month. Causes of infant deaths are shown on Table II on page 22 . 19 GRAPH "A" GRAPH SHOWING INFANTILE MORTALITY RATES HIRING THE PERIOD 1900 - 1952 20 TABLE I PARTICULARS OF DEATHS AS SUPPLIED BY THE REGISTRAR - GENERAL FOR THE YEAR 1952 Cause of Death Males Females All Causes 335 341 1. Tuberculosis, respiratory 9 4 2. Tuberculosis, other - 2 3. Syphilitic Disease 2 3 4. Diphtheria - 5. Whooping Cough 1 - 6. Meningococcal Infections - 1 7. Acute Poliomyelitis 1 - 8. Measles - — 9. Other infective and Parasitic Diseases 1 — 10. Malignant Neoplasm, stomach 9 13 11. Malignant Neoplasm, lung, bronchus 24 3 12. Malignant Neoplasm, breast 2 9 13. Malignant Neoplasm, uterus - 5 14. Other malignant and lymphatic neoplasms 29 34 15- Leukaemia, aleukaemia - 1 16. Diabetes 2 2 17. Vascular lesions of the nervous system 27 54 18. Coronary disease, angina 60 28 19. Hypertension with heart disease 8 13 20. Other malignant and lymphatic neoplasms 37 55 21. Other circulatory disease 15 33 22. Influenza 1 2 23. Pneumonia 13 15 24. Bronchitis 37 17 25. Other diseases of respiratory system 2 2 26. Ulcer of stomach and duodenum 8 3 27. Gastritis, enteritis and diarrhoea 1 2 28. Nephritis and Nephrosis 4 1 29. Hyperplasia of prostate 2 - 30. Pregnancy, childbirth, abortion - 1 31. Congenital malformations 2 3 32. Other defined and ill-defined diseases 25 27 33. Motor vehicle accidents 3 2 34. All other accidents 7 6 35. Suicide 3 - 36. Homicide and operations of war - - ALL CAUSES 335 341 21 TABLE II INFANTILE MORTALITY DURING THE YEAR 1952 Net deaths from stated causes at various ages under one year Under 1 day 1 day 2 days 3 days 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 months Total under 1 yr Chicken Pox - - - - - - - - — - - - — - - - - v - - - - 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) - - - - - - - - - - 2 — 1 - - - - - - - - 3 Diarrhoea - - - - - - - - — - - - - — — - - - - - - - Enteritis - - - - - — - - - - - - - — - — - - - - - - Gastritis - - - - - - - - - - - - - - - - - - - - - - Rickets - - - - — - - - - - - - - - - - - - - - - - Suffocation - - - - - - - - - - - - - 1 - — - - - - - 1 Injury at Birth 1 - - - - - - - - - - - - — - - - - - - - 1 Atelectasis - - - - - - - - - - - — - - - - - - - - - - Congenital Malformation 2 - - - - - - - - - - - - - - - - - - - - 3 Premature Birth 2 2 - - - - 1 - - - - - - - - - - - - - - 5 Atrophy, Debility and Marasmus - - - - - - - - - - - - - - - - - - - - - - Pemphigus Neonatorum - - - - - - - - - - - - - - - - - - - - - - Smallpox - - - - - - - - - - - - - - - - - - - - - 1 Other Causes - - - - - - - - 1 - - - - - - - - - - - - - TOTALS 5 2 - - - - 1 - 1 - 3 - 1 1 - - 1 - - - - 15 22 TABLE III MATERNAL MORTALITY AND MORBIDITY Deaths from Puerperal Causes:- Puerperal Sepsis - Other Causes 1 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 1943 3 2 1944 - 2 1945 - - 1946 - 3 1947 - 1 1948 - - 1949 - - 1950 - - 1951 - - 1952 1 During the year 35 cases of puerperal pyrexia were notified, as compared with 21 in 1951. 27 of these did not belong to the Borough but had been admitted from other areas to the local hospital. The increase in this figure is likely to be mainly due to the operation of the new Puerperal Pyrexia Regulations in that while formerly a rise of temperature occurring within fourteen days of childbirth did not require to be notified unless it persisted for 24 hours, it is now necessary to notify pyrexia if it occurs at all. 1 maternal death occurred following abortion. 23 TABLE IV PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES NOTIFIABLE DISEASES DURING THE YEAR 1952 Disease Total cases notified Cases admitted to hospital Total deaths Scarlet Fever 124* (65) 69 (35) - (-) Whooping Cough 28 (90) 5 (8) 1 (-) Measles 413ø (863) 18 (21) - (-) Pneumonia (notifiable) 13 (32) 5 (1) 28‡ (40)‡ Dysentery 14 (15) 6 (10) (-) Paratyphoid 2 (-) 2 (-) - (-) Puerperal Pyrexia 35 (21) 35 (21) - (-) Erysipelas 14 (8) 5 (3) - (-) Meningococcal Infection 1≠ (1) 1 (l) 1 (-) Food Poisoning 3 (6) 3 (-) - (-) Acute Encephalitis:- Post-Infectious - (1) (1) - (-) Acute Poliomyelitis:- Paralytic 8 (-) 8 (-) 2 (-) Non-Paralytic 1+ (-) 1 (-) - (-) TOTALS 656 (1102) 158 (101) 32 (40) * In addition, seven 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 Meningococcal Infection. ≠ In addition, one case originally notified and admitted to hospital was subsequently diagnosed not Non-Paralytic Poliomyelitis: ø In addition, one case originally notified and admitted to hospital was subsequently diagnosed not Measles. ‡ Includes deaths from non-notifiable pneumonia. (1951 figures in brackets). TABLE V OPHTHALMIA NEONATORUM Cases notified Cases treated at home Cases treated in hospital Vision unimpaired Vision impaired Total blindness Deaths - - - - - - - 24 TABLE VI AGES OF CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1952 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 124* — - 5 11 17 82 6 1 2 - - - Whooping Cough 28 2 1 4 2 - 18 - - - 1 - - Measles 413ø 15 37 52 42 57 177 15 3 13 1 — 1 Pneumonia 13 - 1 - - - 1 - - 1 1 7 2 Ac. Poliomyelitis: Paralytic 8 - 1 1 1 - 1 - - 1 2 1 — Non-Paralytic 1† - - - - - 1 - - - - - - Meningococcal Infection l≠ - - 1 - - - - - - - - - Dysentery 14 1 1 1 - 1 3 - - 4 2 1 — Puerperal Pyrexia 35 - - - - - - - 2 30 3 - - Erysipelas 14 - - - - - 1 1 - 3 1 6 2 Food Poisoning 3 - - - - - - - - 2 - 1 - Paratyphoid 2 — — - - - 1 1 - - - - - * In addition, eight cases originally notified were subsequently diagnosed not Scarlet Fever. ≠ In addition, two cases originally notified were subsequently diagnosed not Meningococcal Infection. † In addition, one case originally notified was subsequently diagnosed not Non-Paralytic Poliomyelitis. ø In addition, one case originally notified was subsequently diagnosed not Measles. 25 TABLE VII CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1952 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 Soarlet Fever 8 11 18 5 20 12 10 29 11 124 Whooping Cought - - - 3 9 2 2 5 7 28 Measles 79 45 36 10 40 60 52 25 66 413 Pneumonia 3 5 - - 1 1 1 2 - 13 Acute Poliomyelitis:- Paralytic 2 - 1 1 2 1 - 1 - 8 Non-paralytic - - 1 - - - - - - 1 Meningococcal Infection - - - - - - 1 - - 1 Bysentery 1 2 - - - - 7 3 1 14 Puerperal Pyrexia 1 — 3 - 1 - 2 27 1 35 try sipelas 4 4 - 1 - - 1 1 3 14 Food Poisoning - - - 2 - - - - 1 3 Paratyphoid - - - 1 - 1 - - - 2 Tuberculosiss:- Respiratory 8 4 5 9 15 17 10 9 24 101 Non-Respiratory 1 2 - l 1 - - l - 6 26 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 13,857 Secondary Modern Schools 4,245 18,082 Number of children requiring treatment 149 Number of children in respect of whom cleansing notices were issued 79 Number of children cleansed by Local Health Authority 40 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 158 in 1951 to 149 in 1952. There is a continuing improvement in these figures but it is noted that 40 children required cleansing by the Local Health Authority as compared with 20 in 1951, which suggests that the number of more severe infections was greater. During the year, applications were received for the cleansing of 3 persons who had become infested with Scabies, one of the persons also being verminous. The treatment was carried out at Hammersmith Cleansing Station with the kind co-operation of the Medical Officer of Health of Hammersmith. INFECTIOUS DISEASES The fall in the total number of notifications during 1952 resulted from the lower incidence of measles and whooping cough. Measles is known to have a biennial fluctuation and this was the year when figures would be expected to drop, but 413 is still a considerable number and the increasing flow of notifications in December gave evidence of the commencement of an early high wave of epidemic measles. There were no deaths from measles. Poliomyelitis 10 notifications of poliomyelitis were received during the year. Of these, 1 was not confirmed as poliomyelitis, 1 was non-paralytic, 2 died in hospital, and 6 suffered some degree of paralysis. Up to date information regarding these cases and those poliomyelitis cases noted in previous years as still showing residual paralysis is as follows. 27 Case notified in 1949: This patient, now a child of 6 years, still requires physiotherapy treatment for paralysis of right leg and wears a walking calliper. Cases notified in 1950: Case A - An adult male patient - condition stationary. Wear 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 - condition complicated by development of pulmonary tuberculosis. Partial paralysis of left biceps - nearly ready for operation to improve function of the arm. Case C - A boy now 11 years of age - still showing signs of steady improvement, but continues to have physiotherapy for paralysis right leg. Cases notified in 1951: No paralytic poliomyelitis occurred in 1951. Cases notified in 1952: Case D - Boy aged 5 years - severe case - paralysis of both upper and both lower limbs. Was discharged from Isolation Hospital direct to Queen Mary Hospital, Carshalton, for orthopaedic treatment. Case E - Boy aged 2 years - paralysis of limbs - discharged from physiotherapy department of Sick Children's Hospital in December, 1952. Fully recovered. Case F - Boy aged 3 years - facial paralysis. Recovery practically complete. Case G - Adult male - paralysis both shoulders. Very good recovery - little residual paralysis. Case H - Child aged 1 year 8 months - paralysis left arm and shoulder. Still requires physiotherapy for partial paralysis. Case J - Adult female - paralysis both arms and spine. Still requires physiotherapy for partial paralysis. 28 Smallpox During the year one contact of a suspected smallpox case was notified to this Department from the Port Medical Officer. The contact was followed up but before the prescribed period had elapsed a further communication was received stating that the original case was found to be not smallpox. Vaccination against Smallpox The following information regarding vaccinations against smallpox carried out in the Borough during 1952 has been supplied by the County Medical Officer. Age Groups Under 1 yr 1-2 yrs 2-4 yrs 5-14 yrs 15 and over Total Primary Vaccination 297 19 16 18 23 373 Re-vaccination 4 - 9 21 146 180 It will be noted that 301 children under 1 year of age were vaccinated out of 852 born during the year i.e. 35%. This is a slight improvement over the percentage for 1951 which was less than 25. The increase in the percentage of children vaccinated in Infancy is encouraging, as this number has been dropping each year to an alarming extent. Smallpox is a disease constantly present in countries formerly so far distant as to render the admission of infected persons to this country very unlikely, but in this age of jet propulsion, the smallpox contact has again become our close neighbour, and however vigilant the care of immigration authorities, the unsuspected case may obtain entry and a vulnerable unvaccinated population is fertile ground for the propagation of the infectious virus. Infant vaccination is our best security, and the adult vaccinated in infancy can be revaccinated at need without the risks attending on adult first vaccination. 29 Scarlet Fever An increase in the number of notifications of Scarlet Fever is to be seen, the figures rising from 65 in 1951 to 124 in 1952; although 69 cases were admitted to hospital, the disease did not appear to be severe in type. Eleven secondary cases occurred, i.e. patients developing the infection subsequent to the first case occurring in the same household, and in two of these incidents the original patient was nursed at home. Diphtheria No cases of diphtheria occurred during the year. The last confirmed case of diphtheria in the Borough was in 1948. Information concerning immunisation against Diphtheria has been supplied by the County Medical Officer and is as follows:- Number of Children who completed a full course of Primary Immunisation in the Borough (including Temporary Residents) during the year. Age at Date of Final Injection Under 1 1 2 3 4 5-9 10- 14 Total 343 207 26 13 14 26 1 630 Number of Children who were given a Secondary or Re-inforcing Injection (i.e. subsequent to a complete full course) during the year. Age at Date of Re-inforcing Injection Under 1 1 2 3 4 5-9 10 - 14 Total - - - 5 241 157 9 412 30 The following table shows the number of children in the Borough at the 31st December, 1952, who had completed a course of immunisation against Diphtheria at any time before that day (i.e. since 1st January, 1938) together with an estimate of the mid-year child population. Age at 31.12.52 Under 1 1 2 3 4 5 - 9 10-14 Total under 15 Number Immunised 345 487 632 611 364 2274 1968 6681 Estimated midyear child population 1952 4413 7057 11470 Dysentery and Food Poisoning There was no outbreak of either during 1952, the number of single notifications was small and the distribution of cases not localised in any particular part of the district. Paratyphoid Fever Two cases of this disease were notified during the year, one in June and one in August, the first case was a school child and the source of his infection was not discovered - no other cases occurred in his family or at his school (in Acton) and all his relations gave negative results to specimen testing. The second case, aged 10 years, had been camping on a tributary of the Thames and swallowing river water during bathing, a possible source of contamination. Enquiries made by the Health Department responsible for that area did not reveal positively any origin of infection. 31 TABLE VIII LABORATORY WORK The following table sets out a record of the bacteriological work done during the years:- Nature of Specimen Result Positive Negative Total Diphtheria - swabs - 60 60 Scarlet Fever Contacts - swabs - 22 22 Faces etc 7 53 60 Sputa - 1 1 Totals 7 136 143 TABLE IX TUBERCULOSIS - 1952 Age Groups New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory Male Female Male Female Male Female Male Female Under 1 year - - - - - - - - 1-5 years 4 - - - — - - - 5-15 " 2 1 - - - — — - 15 - 25 " 6 18 1 2 - - - - 25 - 35 " 20 11 - - 2 2 - - 35 - 45 " 7 8 - 1 — — - 1 45 - 55 " 12 1 - - - - - - 55 - 65 " 2 2 - 2 3 1 - - 65 yrs and over 5 2 - - 4 1 — 1 Totals 58 43 1 5 9 4 - 2 Of the 15 recorded deaths, 13 were previously notified as cases of Tuberculosis, 2 had not been so notified. In addition, 4 patients already notified as tuberculous died from other causes. 32 TABLE X TABLE OF TUBERCULOSIS GASES IN YEARS Year NEW CASES DEATHS Respiratory NonRespiratory Total Respiratory NonRespiratory Total M F M F M F M F 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 1952 58 43 1 5 107 9 4 - 2 15 33 GRAPH "B" GRAPH OF CASES NOTIFIED AND DEATHS FROM TUBERCULOSIS DURING THE PERIOD 1932 - 1952 34 The total number of cases on the Tuberculosis Register at the end. of 1952 was 994, viz., pulmonary 867, non-pulmonary 127. TABLE XI Tuberculosis Register - 1952 Pulmonary Non-Pulmonary Total Male Female Male Female Male Female (a) Number of Gases on Register at commencement of year 431 392 51 75 482 467 (b) Number of Gases notified for first time during year under Regulations 52 38 1 5 53 43 (c) Gases restored to Register during year 1 2 - - 1 2 (d) Gases added to Register otherwise than by notification under Regulations:(1) Transferred from other districts 6 2 - - 6 2 (2) Non—notif1ed deaths — 3 - - - 3 (e) Number of Gases removed from Register 28 32 1 4 29 36 (f) Number of Gases remaining on Register at end of year 462 405 51 76 513 481 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 - 1 1 2 1 1 15 20 8 3 3 5 28 32 NON-PULMONARY - 1 - 1 1 - - 1 - - - 1 1 4 35 The occupations of cases of tuberculosis notified during the year have been classified under 11 headings and are shown in Table XII below with the comparable figures for the year 1951. TABLE XII Occupations 1952 1951 M F M F Outdoor Occupations transport 2 - 1 - Other 8 - 2 - Indoor Occupations Heavy Manual — — 1 - Light Manual 11 7 10 3 Clerical or Sedentary 18 12 10 8 Other 3 1 4 4 Housewife and Domestic - 18 - 18 Schoolchild 2 1 6 3 Shop Assistant 2 2 1 - Under School Age 4 - 1 2 Occupation Unknown 9 7 17 12 TOTALS 59 48 53 50 There is a slight rise in the number of new notifications of tuberculosis. The actual figure is 107 compared with last year's total of 103. This figure, however, is a good one when considered with the information given in the paragraph on Mass X-ray in which it can be seen that 18 unsuspected cases were found by Mass X-ray which might have been expected to give a substantial rise in the notification figures. The fall in deaths from tuberculosis is very gratifying - from 34 in 1950 to 25 in 1951, then to 15 in 1952. There were on the Register at the end of 1952, 994 names of persons known to have been suffering from tuberculosis. It was noticed that in some cases no information had been received for some considerable time, and it was decided to make a careful scrutiny of all case records. This was carried out and it appears that after further investigation some 200 cases, particularly cases of long standing, can be removed next year from the register as cured or transferred to another district. Extremely good liaison is now maintained with the Regional Board Chest Clinics, which means that there is fuller and earlier exchange of relevant information than in former years. 36 Facilities for diagnosis and treatment of Pulmonary Tuberculosis, as well as prevention and after care, are provided by the Hounslow Chest Clinic. Examination of contacts and B.C.G. inoculation for the prevention of this disease are handled by the Tuberculosis Health Visitors. 280 family contacts residing in the Borough were given B.C.G. inoculation during 1952. A prominent part in the treatment is played by domiciliary chemo-therapy with the aid of the "Home Nurses" (formerly District Nurses) provided by the Middlesex County Council. Apart from institutional treatment provided by the local Hospital Management Committees and by the North West Metropolitan Regional Hospital Board in General hospitals and in Chest Hospitals, there is now also a Middlesex County Council Hostel for chronic ambulant male tuberculous patients. Facilities for convalescence, rehabilitation and training are provided by the Middlesex County Council and the North West Metropolitan Regional Hospital Board. The social side of the treatment and prevention of pulmonary tuberculosis is dealt with by the Welfare Department of the Hounslow Chest Clinic. HOUSING CONDITIONS OF CASES OF TUBERCULOSIS N0TIFIED-DURING 1952 The housing conditions of the 107 new cases of tuberculosis were found to be as follows:- 69 patients lived in sufficiently satisfactory housing accommodation, 31 in flats, 19 in houses, 10 in lodgings or furnished rooms, 4 in pre-fabricated dwellings, 4 in Institutions and 1 in a houseboat. In 7 cases the housing was unsatisfactory or dilapidated and in 3 cases there was overcrowding. Of these 10, 6 have either been rehoused or have left the district. 12 new notifications came from homes already returning one or more cases of tuberculosis. 5 of these came from houses classed as unsatisfactory or dilapidated, and 1 from an overcrowded tome. There have been 4 notifications of tuberculosis from one poor type house, 3 of them being submitted in 1952. 8 cases were inward transfers from other districts and, therefore, had not developed their illness while resident in Brentford and Chiswick. 37 These figures compare with 2 living in unsatisfactory housing conditions and 3 overcrowded in 195l. Of these 5 cases, 1 has since been rehoused within the Borough, and 1 has removed to another district. There were 7 outstanding cases of tuberculosis from the 1950 notifications living in insanitary or overcrowded conditions. 2 of these have left the district, one is now dead and the other four are still living in unsatisfactory housing conditions. MASS X-RAY An the beginning of the year, facilities were given for the Mobile Mass X-Ray Unit of the North West Metropolitan Regional Hospital Board to spend six weeks in the Borough. For the first five weeks, use of the Town Hall was granted free of charge and the other week was divided between the Brentford Gas Works and the Park Baptist Church Hall, Brentford, at which place factory employees from Brentford were X-rayed. In the Town Hall, members of the general public were seen individually and organised parties were given group appointments. Preliminary propaganda by means of Press and poster publicity and house to house delivery of leaflets brought a very good response and a great deal of help was given by the voluntary associations of the Borough both with leaflet distribution and word of mouth publicity. 9,472 persons were X-rayed, made up as follows:- Chiswick Town Hall:- Organised groups 4509 General public 3147 7656 Brentford Gas Works 273 Park Baptist Church Hall 1543 9472 The number of active cases discovered was 35, giving a rate per thousand of 3.7. This was reported to be considerably higher than that for any former general surveys of this kind which usually produced between 2 and 2.5 active cases per thousand. Out of the 35 active cases discovered, 18 were residents of this Borough. 38 HYGIENE OF FOOD Catering Establishments Following the initial total survey of catering establishments throughout the Borough during 1950 and 195l, constant observation was maintained until such sanitary defects as had been discovered were remedied. Details of these inspections and the subsequent action and improvements are as follows:- Public Houses Cafes etc. Canteens Clubs Total Number of premises visited 10 97 33 4 144 Number of visits made 10 136 50 5 201 Number of premises satisfactory 10 63 22 2 97 Number of premises not wholly satisfactory - 34 11 2 47 Preliminary Notices served - 2 1 - 3 Preliminary Notices complied with - 2 1 — 3 Clean Food Letters sent - 20 3 2 25 Clean Food Letters complied with - 11 2 1 14 Verbal Notices given - 10 6 - 16 Verbal Notices complied with - 8 6 - 14 Special Letters sent - 2 1 - 3 Special Letters complied with - 2 1 - 3 Improvements carried out as a result of action taken:- Walls and ceilings cleansed 37 Walls and ceilings repaired 7 Floors repaired, cleansed 5 Walls glazed tiled 2 Sinks renewed 4 Hot water supply installed 1 Dustbins supplied 1 Sink waste to soil drain provided 1 Improved ventilation-extractor fans fixed 2 Provision of soap and towels obtained 2 Yard paving repaired 1 Leaky roof repaired 1 Covering for food display provided 2 39 Unsound Food 15 complaints concerning food alleged to be unsound were received in the Department during the year. Legal action was not necessary in any of the cases. In five instances the Council gave instructions for warning letters to be sent to the firms concerned and in another two cases for no further action to be taken. In eight other cases the complaints were not substantiated. Food Sampling By the courtesy of the County Council Public Control Officer the following details of food sampling within the Borough are available:- TABLE. XIII Article Total samples procured Unsatisfactory Milk 75 - Blancmange powder 1 - Cakes (various) 16 - Camphorated Chalk 2 - Cooked Meats 5 - Fish (various) 21 4 Fish Paste 2 - Grapes in Syrup 1 - Ice Cream 1 - Macaroni 2 - Malted Milk 1 - Meat Pie 2 - Mixed Spice 1 - Non-Brewed Condiment 2 - Orange Curd 1 1 Salad Cream 1 - Sausages 24 - Tomato Soup 2 - Victoria Plums (tinned) 4 - Vinegar 20 2 Wines and Spirits 35 2 TOTALS 219 9 The total number of samples taken shows an increase of 24 over last year's figure of 195. In the cases of four of the unsatisfactory samples, an official caution was given. Legal action was taken by Middlesex County Council as Food and Drugs Authority in four other cases and the prosecutions resulted in conviction and fines. In one case follow up was satisfactory without need for official action. In addition 84 samples of Ice Cream were taken by the Borough's Sanitary Inspectors. The results of this sampling are shown on page 54 40 Free Washing Facilities in Public Conveniences Facilities for free handwashing are available in 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, hut also through the increase in their personal security by themselves taking advantage of the service. During 1952, 1,900 paper towels and 10 pints of liquid soap were issued, showing a limited 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 8,269 of these towels were also used; the use of this service appears to have increased during the year. HEALTH PROPAGANDA The education of the Public in Health Matters was continued throughout the year by means of poster displays, leaflet distribution, conversations with food handlers in dairies, grocers' shops, butchers' shops, cafes, school canteens and factories, and also by means of talks to both small ana large groups. it is noticed that at group meetings there are always questioners who have remained unaware of the work of the Public Health Department, in spite of past publicity, and of many of the rules of positive health, showing that continued propaganda on hygiene is most necessary. There is no doubt that poster publicity has become somewhat wearisome to the general public. They are blinded with admonitions to buy this or go there or drink that, and it quite often occurs that a member of the public, asked his opinion of some particular poster or newspaper advertisement which he has looked at every day, may reply truthfully that he has never seen it. And so, to be sure of getting propaganda over, there is no doubt the technique of discussion In small groups with plenty of give and take between teacher and taught, is the most useful. The special propaganda campaign for the use of the Mass X-Ray Unit has already been mentioned on another page of this Report. 41 WELFARE Old People During 1952 twenty-nine 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. In addition to the assistance detailed in the list below, many of the cases required other help throughout the year, for instance, several of those later removed to hospital were assisted by obtaining Home Help, National Assistance Board grants for provision of extra bedding or household necessities, or Home Nursing. A scheme whereby funds formerly possessed by the Brentford and Chiswick District Nursing Association were transferred to the Old Folks Fund Committee to be used to help needy cases was commenced, and it is hoped that from this extra comforts and replacements of household necessities may be made available for old people in distressed circumstancs Details of progress of the 29 cases are as follows:- Removed to hospital 14 Removed to Old People's Home 1 Assisted holiday provided through Brentford Philanthropic Society 1 Remained at home 13 With regard to the 13 cases remaining at home, 1 was provided with a Home Nurse, 6 with Home Help assistance, 1 had list of private old people's homes provided, 1 wanted special housing on ground floor and the remaining four refused Home Help. During the year a total of 201 aged persons or aged chronic sick persons in the Borough received help from the Home Help Service. 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 l,476 baths were taken in Chiswick and 440 in Brentford. These numbers are 491 greater than in 1951, probably because of the spread of information by means of the Old People's Clubs regarding the facilities available. 42 Meals on Wheels The provision of wid-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 Folks Kind Committee: 1,049 such meals were delivered during 1952. In addition to this service, the Invalid Kitchens of London provided meals for 6 residents of the Borough. In each of these cases the number of meals provided was either 4 or 5 per week and individual provision was made for persons requiring special diets. General The Superintendent of the local St. John's Ambulance Association and the Divisional Director of the British Red Cross 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. (7) Courses of lectures on First Aid to factory staffs and local factory fire brigade personnel. 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) Ambulance transport for the sick to supplement the County Ambulance facilities. 43 (3) The maintenance of a medical equipment loan depot at No. 16 Heathfield Terrace, Chiswick, W.4., open on Mondays and Wednesdays from 7.30 to 8.30 p.m. Emergency contact can be made with Miss Wallace - telephone number Chiswick 2353. (4) Occupational therapy for disabled ex-Service pensioners and for Chest Clinic cases. (5) The provision of a library service for home-bound tuberculous 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 convalescence. ATMOSPHERIC POLLUTION The two stations set up for the measurement of Smoke and Sulphur Dioxide in the atmosphere continued to function throughout the year. One, sited at Chiswick Town Hall, provided a straightforward record without breaks. The other, which had been sited at Brentford Baths was moved during the summer as a result off complaints of smoke and dust nuisance in the Boston Manor area. This apparatus was set up at Boston Manor House and four months complete results i.e. August to November inclusive, were recorded. Unfortunately the damp conditions in the house caused fusing of the motor which is part of the apparatus. It was decided not to subject the new motor to the same conditions at Boston Manor House, but to return to the Brentford Baths site. The breakdown conncided with the period of the great London Fog, so that no Brentford readings were available in a week when the deposit in Chiswick was so heavy as to be above the reading scale and to require special photo-electric estimation. Table XV gives the daily Chiswick readings for the fog period and can be compared unfavourably with the general averages in Table XIV. 44 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 and studied in the Public Health 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. The graph on page 47 shows that on monthly averages calculated from the daily readings there is little difference between pollution of the two parts of the Borough. One interesting point is that the July reading for Smoke in Brentford and in Chiswick was the lowest ever recorded by us, also the September reading for Sulphur Dioxide in Chiswick is the lowest since estimations were begun. It will be observed that Sulphur Dioxide readings were high at the Boston Manor Station during the months of recording, whereas in 1951 at the Brentford Baths site the curve of the graph followed closely that of Chiswick. Factory pollution was suspected to be the reason for this and certain suspect chimneys were investigated and improvements obtained. The figures for 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. Smoke Complaints During the year there were complaints of nuisance from smoke or grit, involving three laundry premises, five chimneys of industrial undertakings in Brentford, the chimney of a factory in a neighbouring Borough, and the chimney of the refuse destructor of an adjoining Borough, the latter being mentioned also in the 1951 Report. No statutory nuisance was found in any case, but by co-operation with the managements of the premises within the Borough improvements were effected. The neighbouring Borough Council's Officers, on being informed of the complaints relevant to their districts, took steps to improve conditions; the delay in improvement from the refuse destructor was due to difficulties in the supply position, now overcome. 45 TABLE XIV Month Highest Daily Average Monthly Average Sulphur Dioxide p.p.m. Smoke mg/m3 Sulphur Dioxide p.p.m. Smoke mg/m3 Btfd. Chis. Btfd. Chis. Btfd. Chis. Btfd. Chis. Jan. 0.198 0.156 0.356 0.406 0.080 0.076 0.154 0.152 Feb. 0.302 0.158 0.385 0.433 0.096 0.075 0.213 0.186 Mar 0.144 0.137 0.257 0.296 0.065 0.060 0.115 0.098 Apr. 0.118 0.094 0.303 0.162 0.056 0.046 0.080 0.078 May. 0.088 0.103 0.181 0.168 0.040 0.043 0.071 0.076 Jun. 0.057 0.068 0.081 0.058 0.023 0.023 0.041 0.031 Jul. 0.069 0.051 0.064 0.060 0.024 0.024 0.032 0.027 Aug. 0.269 0.199 0.092 0.115 0.067 0.024 0.048 0.042 Sep. 0.139 0.032 0.184 0.123 0.060 0.012 0.071 0.056 Oct. 0.158 0.080 0.427 0.238 0.033 0.028 0.111 0.097 Nov. 0.338 0.218 0.297 0.523 0.086 0.088 0.126 0.188 Dec. 0.122 0.848 O.361 0.665 0.074 0.119 0.203 0.219 TABLE XV Summary of Readings taken at the Chiswick Station during the Fog Period - 3rd to 9th December. Date Sulphur Dioxide p.p.m. Smoke mg/m3 3.12.52 0.019 0.223 4.12.52 0.074 0.665 5.12.52 0.341 0.642 6.12.52 0.848 0.421 7.12.52 0.309 0.351 8.12.52 0.309 0.351 9.12.52 0.168 0.498 46 GRAPH "C" VARIATION IN AVERAGE MONTHLY CONCENTRATIONS OF SMOKE AND SULPHUR DIOXIDE IN BRENTFORD AND CHISWICK DURING 1952 47 GRAPH "D" COMPARISON OF CONCENTRATIONS OF SMOKE IN THE AIR AT BRENTFORD, CHISWICK, CENTRAL LONDON, LEEDS AND LERWICK 48 PET ANIMALS ACT, 1951 A new Act for the regulation of the sale of pet animals came into force in April, 1952. This Act requires all premises in which animals are sold for pets to be licensed by the local authority. In connection with this the Royal Society for the Prevention of Cruelty to Animals prepared a draft list of conditions to which licencees should conform, and Brentford and Chiswick Council agreed to use a similar list. Three premises were inspected and granted licences during the year. 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 - 49 SANITARY INSPECTION OF THE AREA. Inspections Number of primary inspections made:- (a) On Complaint 1,284 (b) Routine 1,297 (c) In connection with infectious disease 164 Total 2,745 Number of re-inspections 2,701 Total number of inspections and re-inspections 5,446 Action taken other than Housing Act, 1936 Cautionary or intimation notices served 588 Statutory Notices issued (Under Public Health Acts) 29 Summonses served 3 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 during the year as a result of notices serveds- Brickwork, repaired 9 Choked drains, unstopped 35 Chimney stacks and flues, repaired and made good 17 Ceilings, repaired and made good 66 Doors and frames, repaired 12 Dustbins, supplied 11 Dampness in walls, remedied 15 Fresh air inlets and interceptor caps etc., provided 29 Firegrates, cooking stoves, repaired or renewed . 30 Floors, joists and staircases repaired or renewed 45 Gutterings repaired or renewed or cleaned out 4o Inspection covers and frames renewed 10 Leaky roofs and skylights repaired 121 Plaster to walls, repaired and made good 94 Rainwater pipes, repaired or renewed 13 Soil pipe ventilators, repaired or renewed 4 Sinks replaced Seats to W.C’s, repaired or renewed 6 Waste water preventors, repaired or renewed 12 Walls and ceilings, cleansed or redecorated 117 Waste pipes, repaired or renewed 14 Window frames, sash cords, sills, repaired or renewed 83 W.C's replaced 24 Yard Paving, repaired and made good 11 Miscellaneous items 48 TOTAL 989 50 In addition, the following drainage works were carried out during the year under the supervision of the Public Health Departments- Drains tested (smoke) 24 New soil pipe ventilators fixed 2 New interceptors fixed 1 New surface water and soil gullies fixed 13 New manholes constructed 13 Manholes reconstructed or repaired 3 Whole of drainage system relaid (soil) 4 Soil drainage connections repaired or relaid 34 Surface water connections repaired or relaid 5 Soil main drains repaired or relaid 11 Surface water main drains repaired or relaid 1 New W.C's provided and fixed 33 New sinks provided and fixed 14 Sanitary Services Percentage of houses draining into sewers 99° 9% Percentage of houses provided with water closets 100% Enquiries - outstanding Sanitary Notices During the year 751 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 WATEB 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. 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. 51 HOUSING Hogarth Lane and Walnut Tree Road Re-development Areas During the year a survey was made of a portion of the Hogarth Lane Re-development Area and the Walnut Tree Road Re-development Area, and the number of houses inspected was as followss Hogarth Lane Re-development Area 46 Walnut Tree Road Re-development Area 28 A report thereon was sent to the Town Clerk for submission to the Housing Committee., Statement of (a) Rebuilt (war damage.) and (b) New Dwellings erected by the borough Counci1 and Private Enterprise between the end of the Second World War and the 31st December, 1952 Permanent Housing Houses Flats Maisonettes Bungalows Total By Borough Council (a) Rebuilds 23 11 2 - 36 (b) New 121 295 24 19 459 Total 495 By Private Enterprise (a) Rebuilds . 115 135 15 2 267 (b) New . 5 20 - 1 26 Total 293 Temporary Housing By Borough Council (a) Rebuilds - - - - - (b) New - - - 150 150 Total 150 It should be noted that the Borough Council's figures include a number of dwellings on the Syon Estate, Isleworth, which is in the adjoining Borough of Heston and Isleworth. 52 Overcrowding 34 cases of alleged overcrowding were investigated by the Department during the year, 1 of which was on behalf of another Authority. Of the remaining 33 cases, 14 were found to be Statutorily overcrowded and were accordingly notified to the Housing Department for consideration by the Housing Committee. 3 of these cases of overcrowding have now been re-housed, 1 is to be re-housed when suitable accommodation becomes available, 5 cases were deferred for further consideration, 4 were abated and 1 is in a proposed Re-development Area. Of the 9 cases of statutory overcrowding still remaining unabated at the end of 195l, 4 families were rehoused in 1952, 1 granted a building licence in 1951 has not yet removed to new premises, 2 await rehousing when suitable accommodation becomes available and 2 remain deferred. DISINFECTION Premises disinfecteds- Ordinary notifiable diseases 81 Phthisis 8 Cancer 20 Other diseases 1 Premises treated for vermin 21 Premises treated for other pests (wasps, moths, ants and beetles) 21 New arrangements were made during the year whereby the South West Middlesex Hospital Management Committee undertook to carry out emergency disinfection of vermin-infested or smallpox-infected clothing and bedding on demand. SLAUGHTERHOUSES Number the Register (including one Knacker's Yard) 3 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 years New Licences 1 Renewed Licences - 53 MILK During 1952 the following licences were issued under the Regulations mentioned:- Milk (Special Designation)(Pasteurised & Sterilised Milk) Regs., 1949 Dealer's Licences 49 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 premisess. ICE CREAM During the year 84 samples of ice cream were taken and tested bacteriologically The results of these tests are as follows:- Grade I 45 Grade II 8 Grade III 19 Grade IV 12 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 31 in all, were obtained from 7 firms. These firms were kept under observation and advice given. BAKEHOUSES Number in district in use 15 Contraventions of Food & Drugs Act, 1938 1 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 64 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, with one exception, were all found to be in good condition and passea fit for human consumption. No beasts or sheep were slaughtered in the Borough during the year. 54 TABLE XVI Carcases Inspected and Condemned: Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed (if known). — — — — 64 Number inspected — — — — 64 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 — — — — 1.56 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, 1952 Fruit and Vegetables 70¼ lbs. Fish 10½stone, Meat 26½cwt. Perishable Goods 65 cwt. Tinned Foods 12,361 tins. 55 BRENTFORD MARKET Frequent visits were paid by the Sanitary Inspectors to Brentford Market which is mainly used for the wholesale distribution of fruit, vegetables and flowers. Visits are also paid to wholesalers in the Market who deal in groceries, tinned foods etc., in connection with the condemnation of such of these goods as are unfit for human consumption. STREET TRADING Certain prescribed areas in the district are allocated for street trading purposes, and are frequently visited to ensure that they are being maintained in good condition and in accordance with the Bye-laws. Visits were also paid to the premises of street hawkers who deal in food stuffs. FACTORIES ACT, 1917 TABLE XVII 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. 144 25 1 - (ii) Factories not included in (i) in which Section 7 is enforced by L.A. 321 61 2 (iii) Other premises in which Section 7 is enforced by L.A. (excluding outworkers premises). - - - - Totals 465 86 3 - 56 TABLE XVIII Cases in which Defects were founds Particulars Number of Cases in -which defects were found r of cases in which prosecutions were Instituted Found Remedied Referred to HM I by HM I Want of cleanliness (Seed) 1 1 - 1 Sanitary Conveniences (SeC.7):- (a) Insufficient 2 2 - 2 - (b) Unsuitable or defective 5 4 - 5 (c) Not separate for sexes 2 1 - 2 - Totals 10 8 - 10 - TABLE XIX 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 No. of pro secutions for failure to supply list No. of instance s of work in unwholesome premises Notices Served Prosecutions Wearing Apparels. Making etc. 43 - - - - - Cleaning and Washing - - - - - - Artificial Flowers 2 - - - - - Household Linen 1 - - - - - Stuffed Toys 48 - - - - - Christmas Crackers 1 - - - - - Totals 95 - - - - - 57 CANAL BOATS Number of Boats on Registers:- Motor Propelled Boats 94 Other Boats 407 RODENT CONTROL During the year 2,097 primary visits and re-visits were made by the Rodent Operatives to premises in the district in connection with rodent disinfestation. The number of premises where treatment was carried out is as follows- Private Houses 203 Factories 30 Shops 14 Schools 12 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 to March, and June to August, 1952,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. '50 179 6th Maintenance June - Aug. '50 163 7th Maintenance Jan. - Mar. '51 141 8th Maintenance June - Aug. '51 122 9th Maintenance Jan. - Mar. '52 137 10th Maintenance June - Aug. ' 52 97 The work of Rodent Control is carried out under the supervision of the Chief Sanitary Inspector by two Rodent Operatives who have the assistance of a labourer during such time as the sewers are being treated. 58 INDEX Area of Borough 10 Allotments 11 Atmospheric Pollution 44,45,46,47,48 Bakehouses 54 Baths and Washhouses 12,42 Births and Birth Rate 19 Brentford Market 56 British Red Cross Society 43 Canal Boats 58 Cancer 18 Catering Establishments 8,39 Causes of Death 18,21 Chest Clinics 13 Condemned Food 55 Deaths and Death Rate 7,17,l8,19 Diphtheria 7,30 Diphtheria Immunisation 7,30,31 Disinfection 53 Dysentery 31 Factories Act, 1937 56 Food Poisoning 31 Food Hawkers 56 Food Sampling 40 Free Washing Facilities 41 General Statistics 10 Health Propaganda 41 Health Services provided by Other Authorities 12,13,14,15,l6 Housing 10,52 Hygiene of Food 8,39 Ice Cream Sampling 54 Infant Mortality 7,17,19,20,22 Infectious Disease 7,27 Infectious Disease, Prevalence and Control of 24 Infectious Disease, Ages of Cases 25 Infectious Disease, Classified in Wards 26 Isolation Hospital, Admissions 24 Laboratory Work 32 Mass X-ray 8,38 Massage and Special Treatment Establishments 49 Maternal Morbidity and Mortality 17,23 Meals on Wheels 43 Meat and Other Foods 54,55 Milk Regulations 54 Notifiable Diseases 24 Old People 8,42 Ophthalmia Neonatorum 24 Outworkers 57 Overcrowding10,53 Paratyphoid Fever 31 Parks and Open Spaces 11 Pet Animals Act, 1951 49 Poliomyelitis 7,27,28 Population 10 Premature Infants 19 Public Health Committee 3 Puerperal Pyrexia 23 Rateable Value 10 Refuse 51 Rodent Control 8,58 Sanitary Inspection of the Area 8,50 Sanitary Services 51 Scabies 27 Scarlet Fever 30 Slaughterhouses 53 Smallpox 29 Smallpox Vaccinations 7,29 Smoke Pollution 44,45,46,47,48 St John's Ambulance Brigade 43 Staff 4,5 Stillbirths 17 Street Trading 56 Swimming Baths 11 Tuberculosis 8,13,18,32,34,36,37 Tuberculosis Register 35,36 Tuberculosis, Housing Conditions of Newly- Notified Cases 37 Tuberculosis, Occupations of Newiy-Notified Cases 36 Tuberculosis, Cases in Years 33 Unsound Food 40,55 Vermin 27 Vital Statistics 17 Water Supply and Water Service 51 Welfares: Old People 8,42 General 43 Wells 51 Wards 10 59