AC 439 (1)BRENTFROD CHISWICK Borough of Brentford and Chiswick ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1953 BOROUGH OF BRENTFORD AND CHISWICK ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1953 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 Councillor P. W. T. Haines. M Be Hennessey. ” A. G. Nay. ” H. F. Parker. ” Mrs. M. G. Saint. Councillor B. J. Samels. Ex- Officio: Councillor E.A.C. Branczik, J.P., Alderman H. Deane and Councillor T. J. Crispin. Alderman Mrs. A. J. Burden ” R.S. Howard. Councillor A. H. Bulmer. ” H. L Chambers " G. Ao Coleshill STAFF - PUBLIC HEALTH DEPARTMENT Medical Officer of Health Margaret A. Glass5 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 T. M. Johnson, M.S.I.A., A.R.Sanvi., Cert.R.San.I., Cert. Insp. of Meat and Other Foods. Deputy Chief Sanitary Inspector A. G. Robinson, and Shops Inspector M.S.I.A., Cert.R.San.I. and S.I.E. Joint Board, Cert. Insp. of Meat and Other Foods. Sanitary Inspectors and Shops R. A. G. James, Inspectors 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., Cert.R.San.I. and S.I.E. Joint Board, Cert. Insp. of Meat and Other Foods. Administrative Assistant R. P. Hill. 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 26th 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 Sate rose from 14.21 in 1952 to 14.3. in 1953. This figure had previously continued to fall since 1946 and was this year again lower than the average for the whole of England and Wales which was 15.5. The Death Rate fell from 11.27 in 1952 to 10.16 in 1953. The corresponding National figure was 11.4. Infant Mortality rose slightly in 1953 from 17.61 in 1952 to 19.95 per 1,000 live births. As can be seen from the table on causes of infant deaths, 12 of the 17 infants who died in the first month of life perished from causes which could be considered preventable, and it appears that education of expectant mothers in the care of the new born and prevention of infectious disease is still a very important matter. The principal causes of death were again circulatory diseases, heart disease and cancer. Infectious Disease notifications rose and were higher by 468 than in 1952. This rise was more than accounted for by the increase in measles and whooping cough notifications, and it is satisfactory to be able to report a drop in the figures for Scarlet Fever, Puerperal Pyrexia and Poliomyelitis. There were no notifications of Diphtheria, and this has been the case each year since 1948, and suggests that the immunisation state of the population is being maintained satisfactorily, additional evidence of this being afforded by the figures reported from the County Health Department with regard to the number attending for immunisation during 1953. It is also noteworthy that the numbers brought for vaccination against Small Pox have risen very considerably for the first time since 1948. 7 Of the six notifications of Poliomyelitis received, one death occurred and two suffered some residual paralysis. Inspection of Food Premises and Catering Establishments continued throughout the year and was combined with personal propaganda to the Managers and Employees engaged in the handling of food, A particularly gratifying figure in connection with the hygiene of food is that for the results of the analyses of ice cream samples, of 90 samples taken at various times from the different manufacturers, no less than 84 were returned as GRADE I Ice Cream and no poor grade (GRADE IV) samples were Obtained. There was a significant increase in the number of visits requiring to be paid by the Sanitary Inspectors throughout the year and as a result of this work the number of housing defects remedied rose from 989 in 1952 to 1,896 in 1953. The year was a noteworthy one from the point of view of Public Health in the Borough as a real start was made with the resumption of the work of slum clearance, something which has not been possible since 1939. An area of 4.98 acres was scheduled for clearance and work begun in rebuilding on the site. One of the most satisfactory events in the life of a Medical Officer of Health is to be able to ask for the removal of families from overcrowded and slum dwellings, to see them transferred to decent homes and then to see the unhealthy insanitary heartbreaking and morale breaking dwellings giving place to healthy airy and comfortable homes, and this particular area of slum housing had been giving concern in the Public Health Department for many years before the War. Following the great fog of December 1952 the amount of pollution of the atmosphere and the effects of this pollution were very much in the public mind during 1953 and complaints with regard to specific instances of nuisance from smoke were somewhat more numerous and necessitated an increased amount of time spent on obsarvation of particular chimneys,, It is therefore pleasant to record that further low record figures were obtained from the testing apparatus during certain months of the year and also that the figures for Brentford and Chiswick continued to compare very favourably with those obtained in other parts of the Greater London Area. Work on the Welfare of Old People continued and a number of cases were brought to the attention of the Public Health Department for assistance. These cases very often required a considerable amount of visiting and investigation as the nature of the 8 needs not only varies from case to case but may vary for the same case at different times and help may be asked from the Welfare Authority, the Home Help Service, the Hospital Authorities, or the Old Polks Fund Committee, which can arrange for home visiting, provision of comforts or delivery of meals to the homes. In the report on Rodent Control it will be seen that the rat infestation in the Borough continues to decline, so much so that work on the sewers no longer requires to be carried out on such a large scale as in former years. Acknowledgements are due to the many people who have supplied information for the purpose of thi6 Report including 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, the County Public Control Officer, the Divisional Officers of the British Red Cross and St. John's Ambulance Associations, the Organiser of Invalid Kitchens of London, the Secretary of the Old Polks Pund and Chief Officers of Brentford and Chiswick Borough Council. In conclusion, I should like to thank the 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 STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH. 1Q^ 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 1953) 59,560 Population - Census 1951 59,367 Number of Inhabited Houses according to Rate Book 15,589 Rateable Value at 1.4.1953 £724,323 Sum produced by Id Rate £2,970 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. During the year there has been some progress in the work of demolition of insanitary or dilapidated houses, and details of this will be found later in the Report. A study of the figures from the last Census reveals that out of a total of 19,982 households there were still in mid 1951 8539 families sharing houses and still 6126 households not possessing a fixed bath. These figures will already be improved as a result of the work on Slum Clearance as reported later in this book5 and further demolitions and the abolition (proposed for 1954) of the caravan sites existing in the Borough will improve them still further. 10 Overcrowding of houses is still a major problem although during 1953 the Council's Housing Department provided accommodation for many overcrowded families. From the Cencus it can be seen that 1.79 % of the population live in conditions where there are more than two persons inhabiting every room this figure, however, compares well with the 1931 figure in which 7.39 % lived in these conditions. 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 24.2 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 1953 36,641 Average number per day 115 Maximum number using baths on one day 449 Chiswick Open Air Pools:- Large Pool Area 7,500 sq.ft. Capac1ty 33,750 c.ft. Small Pool Area 3,500 sq.ft. Capacity 18,375 c.ft. Total number of persons using baths in 1953 63,459 Average number per day 426 Maximum number using baths on one day 2,731 The purification of the water of these pools is by intermittent chlorination and the amount of free chloride aimed at is 0.6 parts per million. Water samples are taken daily throughout the season. 11 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 50.50 " 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 25,787 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 41,842 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 1953, 1,876 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. 12 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 Chiswick 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. 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 Borough:- (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 Wednesday and Thursday afternoons 2 to 4 p.m. Diphtheria and Whooping Alternate Tuesday afternoons 2 Cough Immunisation and to 3.30 p.m. Vaccination Clinics Rheumatism Clinics Thursday mornings 9 to 10 a.m. Day Nursery Portsdown House, The Butts, Brentford. Chiswick Ante-Natal Clinics and Tuesday and Thursday mornings 9 Post-Natal Clinics to 12 a.m. Infant Welfare Clinics Tuesday, Wednesday, Thursday and Friday afternoons 2 to 4 p.m. Diphtheria and Whooping Monday afternoons 2 to 2.30 p.m. Cough Immunisation and Vaccination Clinics 13 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). (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:- Under 5 yrs 5-64 yrs 65 yrs and over Total Grand Total M F M F M F M F Medical 35 23 225 299 143 280 403 602 1005 Surgical 9 - 9 19 16 13 34 32 66 Infectious Disease 5 1 2 4 1 2 8 7 15 Tuberculosis - - 44 20 2 1 46 21 6 7 Maternal Complications - - - 20 - - 20 20 Others - - - 1 - 1 - 2 2 Totals 49 24 280 363 162 297 491 684 1175 14 (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 Service: The County Mental Health Service deals with persons suffering from mental deficiency or mental illness. There is a Divisional Office at the County Offices, Great West Road, Brentford (EALing 1801), where five mental welfare officers and a psychiatric social worker carry out the County's community duties under the Lunacy, Mental Treatment and Mental Deficiency Acts. A twenty-four hour emergency service is also covered. At the Methodist Church Hall, Clifden Brentford, the County provides an occupation centre with 65 places where mentally defective children attend daily from 9.30 a.m. to 3.30 p.m. (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 clinicss- Minor Ailment Clinic Monday, Tuesday, Thursday, (Chiswick) Friday and Saturday 9 to 10 a.m. Monday 9 to 12 a.m. with doctor. Minor Ailment Clinic Monday, Tuesday. Wednesday, (Brentford) Thursday and Saturday 9 to 10 a.m. Friday 9 to 12 a.m. with doctor. Orthopaedic Treatment Clinic With Surgeon - every first and (Brentford) third Monday in each month from 2 to 5 p.m. Ophthalmic Clinic Tuesday and Friday 9 to 12 a.m. (Brentford) Physiotherapy Treatment Monday, Wednesday and Thursday Clinic 9 to 4.30 p.m. (Brentford) 15 Speech Clinic Tuesday 1 to 4 p.m. (Brentford) Speech Clinic Tuesday 9 to 12 a.m. Friday (Chiswick) 1 to 4 p.m. Dental Clinic By appointment. (Brentford and Chiswick) Ultra-Violet Light Treatment Monday and Thursday 9 to 10 a.m. Clinic (Brentford) (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. (i) Prevention of Illness. Care and After-Care: The County Council's scheme includes provision for the admission of suitable cases to recuperative rest homes. (Such cases should not be in need of medical or nursing). The care and after-care of tuberculous persons is dealt with through the Welfare Officers of 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 Services: An Ambulance Service is provided for the removal to hospital, where necessary, of accident and sickness cases. This service is combined with the Fire Service. (l) Chiropody Service: Old Age Pensioners are referred to private practitioners. An assessment scheme is in operation. 16 vital statistics, 1953 Live Births Total Male Female Legitimate 807 389 418 Birth Rate per 1,000 of the estimated resident population = 14.3 Illegitimate 45 29 16 Total 852 418 434 Stillbirths Total Male Female Legitimate 21 11 10 Rate per 1,000 total (live and still) Births = 25.17 Illegitimate 1 1 - TOTAL 22 12 10 Deaths Total Male Female 605 317 288 Death Rate per 1,000 of the estimated resident population = 10.16 Deaths from Puerperal Causes Puerperal Sepsis - Rate per 1,000 total (live and still) Births = Nil. Other Puerperal Causes . - Deaths of Infants under 1 Year of Age Total Male Female Legitimate 16 12 4 Illegitimate 1 - 1 Total 17 12 5 17 Deaths and Death Rate The Death Rate decreased in 1953 from the 1952 figure of 11,27 to 10.16 after a considerable decrease the previous year from 12.49. The principal causes of death were:- 1953 1952 1951 Circulatory Disease 173 217 195 Heart Disease 100 113 155 Cancer 119 128 131 There is a considerable fall in the number of deaths from each of the three principal causes, and this is very satisfactory following the previous year's drop in deaths from heart disease and cancer. It might be deduced that the pace of living had slowed a little and that anxiety caused by fear of unemployment and fear of war amongst other things had lessened, but against this is to be noted a slight rise in the number of deaths from ulcer of the stomach and duodenum which, sinci| death from this cause is very unusual, may indicate a much higher incidence of this illness, in the causation of which anxiety plays nc small part. There were no maternal deaths. Deaths from Tuberculosis are again reduced for the third year in succession and the comparison is as follows:- Year Number of deaths from tuberculosis Male Female Total 1950 20 14 34 1951 11 14 25 1952 9 6 15 1953 8 1 9 Poliomyelitis was the cause of one death and whooping cough one. The total number of deaths from violent causes is reduced for the third year in succession, i.e.:- 1953 1952 1951 1950 17 21 23 28 Seven residents died through involvement in road accidents. The ages at death of these cases were:- Males: 6, 27, 32, 33, 47. Females: 22, 22. 18 3 of these died within the Borough. In all 7 persons (including residents of other places) died as the result of road accidents occurring in Brentford and Chiswick, one motor cyclist, two pedal cyclists, three pedestrians and one child tricyclist. The sites of the incidents varied and no place could be cited as a danger spot from these particular findings. The local Death Rate, 10.l6, is lower than the figure of 11.4 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. Death Rate of all infants per 1,000 live births 19.95 Death Rate of all legitimate infants per 1,000 legitimate live births 19.83 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) 119 Deaths from Tuberculosis Tall ages) 9 Birth Rate The Birth Rate which has been falling since 1946 shows a rise from 14.21 in 1952 to 14.3 in 1953. This compares with a National Birth Rate figure of 15.5. INFANT MORTALITY During 1953 the number of births recorded was 852: 807 legitimate and 45 illegitimate. There were 17 deaths of infants under one year of age as compared with 15 in 1952, giving an infant mortality rate of 19.95 for 1953, a slight rise on the figure for 1952, i.e. 17.61 which was the lowest ever recorded in the Borough. The local figure compares with an Infant Mortality Rate of 26.8 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 1953 was 43, including premature stillbirths. Of the 35 premature infants born alive, 1 was born at home, but did not survive to the end of one month. 34 were born in hospital, of whom 31 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 DURING THE~PERIOD 1900 - 1953 DEATHS PER 1000 BIRTHS 20 TABLE I PARTICULARS OF DEATHS AS SUPPLIED BY THE REGISTRAR - GENERAL FOR THE YEAR 1951 Cause of Death Males Females All Causes 317 288 1. Tuberculosis, respiratory 8 1 2. Tuberculosis, other - - 3, Syphilitic Disease 2 - 4. Diphtheria - - 5. Whooping Cough 1 - 6. Meningococcal Infections - - 7.Acute Poliomyelitis 1 - 8. Measles — - 9. Other infective and Parasitic Diseases - - 10. Malignant Neoplasm, stomach 5 4 11. Malignant Neoplasm, lung, bronchus 25 6 12. Malignant Neoplasm, breast - 12 13. Malignant Neoplasm, uterus — 9 14, Other Malignant and lymphatic neoplasms 30 28 15. Leukaemia, aleukaemia 2 3 l6. Diabetes - 5 17. Vascular lesions of the nervous system 30 49 l0. Coronary disease, angina 51 22 19. Hypertension with heart disease 5 ? 20.Other heart disease 40 46 21. Other circulatory disease 9 12 7 5 23. Pneumonia 11 13 24. Bronchitis 38 20 25. Other diseases of respiratory system 7 1 24. Ulcer of stomach and duodenum 9 7 27. Gastritis, enteritis and diarrhoea - - 28.Nephritis and Nephrosis 4 3 29. Hyperplasia of prostate 2 — 30. Pregnancy, childbirth, abortion - - 31. Congenital malformations 2 3 32. Other defined and ill-defined diseases 21 20 33. Motor vehicle accidents 5 2 34. All other accidents 1 7 35.Suicide 1 1 36. Homicide and operations of war — — ALL CAUSES 317 288 21 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 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 l yr. Chicken Pox - - - - - - - - - - - - - - - - - - - - - - Measles - - - - - - - - - - - - - - - - - - - - - - Scarlet Fever - - - - - - - - - - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - 1 - - - - - - - - - 1 Diphtheria or Group - - - - - - - - - - - - - - - - - - - - - - Erysipelas - - - - - - - - - - - - - - - - - - - - - - Tuberculous Meningitis - - - - - - - - - - - - - - - - - - - - - - Abdominal Tuberculosis - - - - - - - - - - - - - - - - - - - - - - Other Tuberculosis Diseases - - - - - - - - - - - - - - - - - - - - - - Meningitis (non -T . B ) - - - - - - - - - - - - - - - - - - - - - - Convulsions - - - - - - - - - - - - - - - - - - - - - - Laryngitis - - - - - - - - - - - - - - - - - - - - - - Bronchitis - - - - - - - - - 1 - - - 1 - - - - - - - 2 Pneumonia (all forms) - - - - - - - - - - 1 1 1 1 - - - - 1 - 1 6 Diarrhoea - - - - - - - - - - - - - - - - - - - - - Enteritis - - - - - - - - - - - - - - - - - - - - - - Gastritis - - - - - - - - - - - - - - - - - - - - - - Rickets - - - - - - - - - - - - - - - - - - - - - - Suffocation 1 - - - - - - - - - - - - - - - - - - - 1 Injury at Birth - - - - - - - - - - - - - - - - - - - - - - Atelectasis 1 - - - - - - - - - 1 - - - - - - - - - - 3 Congenital Malformation 1 - - - - - - - - - - - - - - - - - - - - l Premature Birth - 1 1 - - - - - - - - - - - - - - - - - - 2 Atrophy,Debility and Marasmus - - - - - - - - - - - - - - - - - - - - - - Pemphigus Neonatorum - - - - - - - - - - - - - - - - - - - - - - smallpox - - - - - - - - - - - - - - - - - - - - - - Other Causes - - - - - - - - - - 1 - - - - - - - - - - 1 TOTALS 3 1 1 1 - - - - - 1 3 2 1 2 - - - - 1 - 1 17 22 TABLE III MATERNAL MQBT^ITY ,iM) MORBIDITY Deaths from Puerperal Causes:- Puerperal Sepsis - Other Causes - 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 1944 - 2 1945 - - 1946 - 3 I947 - 1 1948 - - 1949 - - 1950 - - 1951 - - 1952 - 1 1953 — — During the year 18 cases of puerperal pyrexia were notified, as compared with 35 in 1952. 6 of these did not belong to the Borough but had been admitted from other areas to the local hospital. The definition of puerperal pyrexia for notification purposes is "any febrile condition occurring in a woman in whom a temperature of 100.4degrees Fahrenheit (38degrees Centigrade) or more has occurred within fourteen days after childbirth or miscarriage". 23 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 (124) 32 (69) - (-) Whooping Cough 141 ( 28) 10 ( 5) 1 (l) Measles 810 (413) 17 (18) - (-) Pneumonia (notifiable) 43 ( 13) 7 ( 5) 24 .(28)‡ Dysentery 11 ( 14) 5 ( 6) - (-) ‡ Paratyphoid - ( 2) - ( 2) - (-) Puerperal Pyrexia 18 ( 35) 18 (35) - (-) Erysipelas 3 ( 14) 1 ( 5) - (-) Meningococcal Infection 2 ( 1) 2 ( 1) - (1) Food Poisoning 23 ( 3) - ( 3) - (-) Ophthalmia Neonatorum 1 (-) 1 ( -) - (-) Malaria 1 ( -) 1 ( -) - (-) Acute Poliomyelitiss- Paralytic 3 ( 8) 3 ( 8) 1 (2) Non-Paralytic 3 ( 1) 3 ( 1) - (-) Diphtheria -* ( -) - ( -) - (-) TOTALS 1124 (656) 100 (158) 26(32) * In addition, one case originally notified and admitted to hospital was subsequently diagnosed not Diphtheria. ‡Includes deaths from non-notifiable pneumonia. (1952 figures in brackets) TABLE V OPHTHALMIA NEONATORUM Gases Notified Cases treated at home Gases treated in hospital Vision unimpaired Vision impaired Total blindness Deaths 1 - 1 1 - - - - 24 - TABLE VI AGES OF GASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1953 Disease Number Of Gases N®tified 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 - 2 6 2 7 37 8 2 - 1 - - Whooping Cough 141 17 12 18 17 17 56 4 - - - — - Measles 810 18 88 106 104 108 363 9 2 6 5 1 - Pneumonia 43 3 - 1 - - 3 - 2 4 6 13 11 Ac. PoliomyelitisParalytic 3 - - - - - - - - 3 - - 11 Non-Paralytic 3 - - - - 1 1 - - 1 - - - Meningococcal Infection 2 - - - - - - - - - - 1 Dysentery 11 - 3 - 2 - 3 1 - - - - 1 Puerperal Pyrexia 18 - - - - - — — - 17 1 - - Erysipelas 3 - - - - - _ - 1 - - 2 - Food Poisoning 23 1 — — c= — 5 2 2 4 3 2 4 Diphtheria - - - - - - - - - - - - - Ophthalmia Neonatorum 1 1 - - - - - - - - - - - Malaria 1 - - - - - - - - 1 - - - * In addition, one case originally notified was subsequently diagnosed not Diphtheria. - 25 - TABLE VII CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1953 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 10 13 9 2 4 8 13 1 5 65 Whooping Cough 19 22 14 6 12 12 21 17 18 141 Whooping Cough 138 85 42 50 114 94 77 111 99 810 Measles 9 9 2 2 2 4 8 3 4 43 Acute Poliomyelitis- - — - — 1 1 1 - - 3 Non-Paralytic — — - — - 1 - 1 1 3 Meningococcal Infection 2 — — — - — — — — 2 Dysentery 2 2 — 5 — 1 - 1 11 Puerperal Pyrexia 1 2 1 - 1 2 3 6 2 18 Ery sipelas — 1 1 — - - 1 — _ 3 Food Poisoning — 3 3 1 4 4 4 3 1 23 Ophthalmia Neonatorum - — - - - - - 1 — - Tuberculosis :- Re spiratory 18 12 2 9 16 14 13 7 25 116 Non-Respiratory - - — 1 1 3 1 1 3 10 Malaria — - — — — — - 1 — 1 - 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 : 7 * Number of children examined s- Primary Schools 14,567 Secondary Modern Schools 4,265 18,832 Number of children requiring treatment 118 Number of children in respect of whom cleansing notices were issued 48 Number of children cleansed by Local Health Authority 25 There was an increase of 750 in the total number of cleanliness inspections but a drop in the number of children who had become infested with head lice, from 149 in 1952 to 118 in 1953. The figures are showing an improvement each year which is extremely satisfactory, but a comparison with the figures for the whole of the County shows that of total inspections throughout the year, the percentage of children found unclean was o55 while in Brentford and Chiswick the percentage was 1o6. During the year, applications were received for the cleansing of 3 verminous persons The treatments were carried out at Hammersmith Cleansing Station by arrangement with the Medical Officer of Health of Hammersmith. INFECTIOUS DISEASES The rise in the total number of notifications during 1953 was Principally occasioned by the higher incidence of measles and whooping cough. The type of measles was mild with no deaths occurring. There was one death from whooping cough - an infant of 2 months. poliomyelitis 6 notifications of poliomyelitis were received during the year. These were all confirmed as poliomyelitis, 3 non-paralytic, 3 paralytic. one death occurred from this disease. 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 7 years, still requires physiotherapy treatment for paralysis of right leg and wears a walking caliper. Cases notified in 1950: Case A - An adult male patient - condition stationary. 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 - condition complicated by development of pulmonary tuberculosis. Partial paralysis of left biceps - operation in 1953 gave good movement of elbow and forearm. Shoulder joint out of action. Condition stationary. Case C - A boy now 12 years of age- paralysis right leg still partial paralysis with very little improvement during year. Cases notified in 1951: No Paralytic poliomyelitis occurred in 1951, Cases notified in 1952: Case D - Boy now aged 6 years - severe case - paralysis of both upper and lower limbs. Now recovered except for a very slight limp of right foot. Case F - Boy now 4 years - facial paralysis. Recovery now complete. Case G - Adult male - paralysis both shoulders - slight residual paralysis - now removed from district. Case H - Child now aged 2 years - paralysis left arm and shoulder. Still requires physiotherapy for partial paralysis. Case J - Adult female - paralysis both arms and spine. Almost complete recovery. Still has physiotherapy treatment. Cases notified in 1955: Case K - Adult female - partial paralysis right leg. Condition much improved. Slight residual weakness. Case L - Adult male - paralysis right side of neck, right arm and forearm, right leg and thigh. Condition much improved. Right leg in caliper. Attends for physiotherapy, - 28 - Smallpox During the year six contacts of suspected smallpox cases were notified to this Department from various sources„ The contacts were followed up but no sickness developed,, Vaccination against Smallpox The following information regarding vaccinations against smallpox carried out in the Borough during 1953 has been supplied by the County Medical Officer. Age Groups Under 1 yr 1 yr 2-4 yrs 5-14 yrs 15 and over Total Primary Vaccinationo 469 33 11 20 15 548 Re-vaccination - - 3 16 136 155 Total number of first vaccinations:- 1951 1952 1953 298 373 548 It will be noted that 469 children under 1 year of age were vaccinated out of 852 born during the year i0e0 55%. This is a considerable improvement over the percentage for 1952 which was 350 It is satisfactory to be able to record a more substantial attendance for infant vaccination as in recent years the fact that smallpox is of rare occurrence in this country has tended to lull the citizens into a feeling of false security - false, inasmuch as that while smallpox is still a major cause of illness and death in Parts of the British Commonwealth, it must be a danger,, The incoming traveller from a smallpox area can arrive by air transport in such a short time that he may be unknowingly infected and within the incubation Period of the disease, all between leaving the one country and arriving ln the uther0 Airport Medical Staff are kept informed of all smallpox occurring in the World and persons coming from smallpox areas are most carefully supervised, but there is still the risk that the odd first case from an area supposed to be free from smallpox may get into this country and travel about spreading infection before developing symptoms, The real protection is vaccination; and infant vaccination while not Providing lifelong immunity gives immunity for some years and in addition minimises the risk of post vaccinal comnlications in later life. The improvement in the vaccination figures is possibly due to some extent to the County Council's new arrangements for vaccination at infant welfare clinics, and to some extent to the increase in propaganda, both local and national, during 1953. - 29 - Scarlet Fever A fall in the number of notifications of Scarlet Fever is to be seen, the figures being 65 in 1953 as compared with 124 in 1952. 32 cases were admitted to hospital and the disease did not appear to be severe in type. 8 secondary cases occurred,i.e. patients developing the infection subsequent to the first case occurring in the same household, and in three 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 and also Whooping Cough in the Borough during 1953, has been supplied by the County Medical Officer and is as follows:- Age at date of final or re-inforcing injection. Children who completed a full course of Primary Immunisation. Children given a secondary or re-inforcing injection, Diphtheria only Combined Diphtheria and Whooping cough. Whooping cough only Diphtheria only Combined Diphtheri and whoop ing cough Whoop- a ing -cougb only. Under 1 117 286 21 1 - 1 35 126 27 1 - - 2 13 17 5 - - - 3 12 10 - 3 1 - 4 3 3 - 194 1 - 5-9 36 6 1 187 6 - 10-14 7 - - 3 - - 15 and over. - - - - - - TOTAL 223 448 54 389 8 - The following table shows the number of children under 15 in the Borough at the 31st December, 1953, who had completed a course of immunisation against Diphtheria at any time before that date. - 30 - Age at 31.120 53 i.e. born in year. Under 1 1953 1-4 1952-1949 5-9 1948-1944 10-14 1943-1939 Under 15 total last complete course of injections (whether primary or booster, A.1949-1953 109 2,237 2,164 194 4, 704 B0 1948 or earlier0 - - 1,319 2,224 3,543 There has been no great increase in the number of primary immunisations against diphtheria - the total for 1953 being 671 as compared with 630 in 1952 - but the general level-is satisfactory as it amounts to roughly 79% of the children born during the year0 Whooping Cough The figures for this disease, which has been a notifiable Infectious Disease since October, 1939, show the highest number of cases ever notified in the Borough in one year0 In both 1952 and 1953 one death occurred from this cause,, It has been recognised in recent years that Whooping Cough is becoming a more serious danger to health than formerly and in 1951 arrangements were made by the Middlesex County Council for immunisation against Whooping Cough to be carried out in County Clinics, hoping thereby to reduce the incidence of the disease in a few years. During 1953, 502 children were immunised against Whooping Cough for details see table on previous page. Dysentery and Food Poisoning0 There was no serious outbreak of dysentery or food poisoning during the yearQ Twenty-three cases of gastro-intestinal disturbance were notified to the Department as food poisoning0 Of these fourteen were instances where single cases only occurred, in three cases two people were ill, and in one case three persons in the same family were ill. In the latter case, considerable investigations were made as to the source of infection, but with negative results, Malaria This was a case of benign tertian malaria contracted by a Service man in Korea The case was under full control by the time the patient returned to this country and no spread of the infection was possible. TABLE VIII LABORATORY WORK The following table sets out a record of the bacteriological work done during the year:- Nature of Specimen Result Positive Negative Total Diphtheria - swabs - 35 35 Scarlet Fever Contacts - swabs 1 18 19 Dysentery - faeces 7 56 63 Paratyphoid - faeces - 26 26 Other - l 1 Totals 8 136 144 Of the 9 recorded deaths, 8 were previously notified as cases of Tuberculosis, 1 had not been so notified. In addition, 1 patient already notified as tuberculosis died from other causes. - 32 - TABLE IX 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 3 1 - 1 - - - _ 5-15" 2 - - 2 - - - 15 - 25 " 11 14 1 1 - - - 25 - 35 " 18 18 1 1 1 - - - 35 - 45 " 16 3 1 - - - - - 45 - 55 " 13 3 - 1 2 1 - - 55 - 65 " 8 2 - - 2 - - - 65 yrs. and over 4 - — 1 3 — — - Totals 75 41 3 7 8 1 - - TABLE X TABLE OP TUBERCULOSIS CASES IN YEARS Year NEW CASES DEATHS Respiratory NonRespiratory Total Re spiratory NonRespiratory Total M F M J F M F M F 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 I 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 l 34 1951 49 44 4 6 103 11 13 1 25 1952 58 43 1 5 107 9 4 2 15 1953 75 41 3 7 126 8 1 - - 9 - 33 - GRAPH "B" GRAPH OF GASES NOTIFIED AND DEATHS FROM TUBERCULOSIS DURING THE PERIOD 1911 - 1951 NUMBER Notified Gases of Tuberculosis Deaths from Tuberculosis -34 - The total number of cases on the Tuberculosis Register at- the end of 1953 was 726, viz., pulmonary 663, non-pulmonary 63. TABLE XI - Tuberculosis Register - 1951 Pulmonary Non-Pulmonary Total Male Female Male Female Male Felmale (a) Number of Gases on Register at commencement of year 462 405 51 76 513 481 (b) Number of Gases notified for first time during year under Regulations 69 31 3 6 72 37 (c) Gases restored to Register during year 2 3 - - 2 3 (d) Gases added to Register otherwise than by notification under Regulationss(i) Transferred from other districts 4 10 4 10 (ii) Non-notified deaths 2 - 1 2 1 (e) Number of Gases removed from Register during years- (i) Routine 32 33 3 2 35 35 (ii) Under special survey 125 135 29 40 154 175 (f) Number of Gases remaining on Register at end of year 382 281 22 41 404 322 Gases removed from the Register shown under (e)(i) are accounted for as followss- Found not to be ToB. 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 2 3 2 3 17 25 4 1 7 - 32 33 NON-PULMONARY - - 2 - - 1 1 - - - - 1 3 2 - 35 - Tuberculosis Register - 1953° Gases removed from the Register shown under (e)(2). As intimated in the 1952 Report it was felt that full information on old cases had not previously been supplied to this Department and in order to check if this was so a full survey of all the names on the Tuberculosis Register was carried out, and enquiries were made with regard to those found not to have been recently reviewed in any way. As a result, 329 names of patients who had either recovered, died or left the district, details of which we had not been given previously, were removed from the active list. The occupations of cases of tuberculosis notified during the year have been classified under 11 headings and are ^iown in Table XII below with the comparable figures for the years 1951 and 1952. TABLE XII Occupations 1953 1952 1951 M F M F M F Outdoor Transport 2 - 2 - 1 - Occupations Other 9 - 8 - 2 - Indoor Heavy Manual 1 - - 1 - Occupations Light Manual 18 2 11 7 10 3 Clerical or Sedentary 15 6 18 12 10 8 Other 7 1 3 1 4 4 Housewife and Domestic — 22 - 18 - 18 Schoolchild 4 2 2 1 6 3 Shop Ass1stant 2 1 2 2 1 - Under School Age 3 2 4 - 1 2 Occupation Unknown l8 11 9 7 17 12 TOTALS 79 47 59 48 53 50 A rise is shown in incidence of tuberculosis as evidenced by the increased notification figure, 126 as compared with 107 in 19525 but as this is coupled with a further fall in the number of deaths from the disease, it seems reasonable to suggest that this rise may be the result of better notification due to earlier discovery of cases in a stage of the illness where treatment can effect a cure. The fall in deaths from tuberculosis is very gratifying - from in 1950 to 25 in 1951 to 15 in 1952 then to 9 in 1953. - 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. The arrears in B.C.G. vaccination of contacts of tuberculous patients have now been dealt with. B.C.G. inoculation is now offered to all the Mantoux negative contacts of newly discovered tuberculous cases % 22 residing in this Borough were inoculated during 1953. A prominent part in the treatment is played by domiciliary ehemo-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 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 NOTIFIED DURING 1953 The housing conditions of 89 of the 126 new cases of tuberculosis were found to be as follows :- 8l patients lived in sufficiently satisfactory housing accommodation, 33 in flats, 30 in houses, 13 in lodgings or furnished rooms, and 5 Institutions. In 7 cases the housing was unsatisfactory or dilapidated and in 1 case there was overcrowding. Of these 8, 1 has left the district. lb new notifications came from homes already returning one or more cases of tuberculosis. 2 of these came from houses classed as unsatisfactory or dilapidated. There have been 4 notifications of tuberculosis from one poor type house, 3 of them being submitted in - 37 - 16 cases were inward transfers from other districts and, therefore, had not developed their illness while resident in Brentford and Chiswick., These figures compare with 7 living in unsatisfactory housing conditions and 3 overcrowded in 19520 Of these 10 cases, 9 have subsequently been rehoused or have removed from the district. There were 3 outstanding cases of tuberculosis from the 1951 notifications living in insanitary or overcrowded conditions. No improvement in these conditions has yet been obtained. Of 4 outstanding cases from 1950 living in insanitary or overcrowded conditions, 1 has been rehoused and in the other 3 conditions remain the same. MASS X-BAY A trial scheme for the investigation of the high incidence of Tuberculosis amongst young adults, by means of an examination of school leavers, and an annual review subsequently of those volunteering to enter the scheme^ was begun in October, 1952 by the staff of the Mass X-Ray Unit. Part of the scheme also consisted of preliminary propaganda in the schools and the distribution of explanatory letters to parents. Ten education areas in Middlesex were brought into this scheme - including Brentford & Chiswick, and in this Borough 560 school leavers were invited to take part (295 boys and 265 girls)o Of these 180 consented to do so (100 boys and 80 girls). The percentage response was therefore 34% boys and girls which is fair though not as good as might be wished. The full-results of this scheme will not of course, be available for a number of years as it is designed to cover a ten year age group, i.e. 15 - 24, and the incidence of tuberculosis morbidity during the ten years after leaving school, and will depend to a great extent on the continued co-operation of the individuals concerned, and with results. - 38 - TABLE Xlli CANCER DEATHS Site of Primary Growth Male Female 4 3 Stomach 24 5 Lung, Bronchus - 10 Uterus - 9 Intestinal 6 13 Prostate 1 - Bladder 2 2 Brain 1 4 Other 22 13 Totals 60 59 CANCER DEATHS - Age Groups Male Female Between 30 - 35 years 1 - " 35 - 40 " 1 — " 40 - 45 " 2 4 " 45 - 50 " 3 7 " 50 - 55 " 5 1 " 55 - 60 " 10 8 " 60 - 65 " 7 7 " 65 - 70 " 9 9 " 70 - 75 " 9 8 " 75 - 80 " 6 6 " 80 - 85 " 4 6 " 85 - 90 " 3 3 " 90 - 95 " - - Totals 60 59 The distribution of cancer deaths in sites and ages is shown in the above Table. The numbers are too small for any significant conclusions to be drawn from them but it is interesting that 25% were lung cancers as compared with 17% intestinal and 8% cancer of the breast. - 39 - FOOD CONTROL Number and Type of Food Premises in the Borough Bakers and Confectioners 25 Butchers 33 Confectioners (Sweets) 67 Cafes, Dining Rooms etc 85 Delicatessen 4 Eel and Pie Shops 2 Factory and Works Canteens 76 Fishmongers 10 Fish and Chips 10 Greengrocers and Fruiterers 53 Grocery and Provisions 82 General Stores 7 Ice Cream Manufacturers 4 Public Houses and Off Licences 59 Snack Bars 28 School Canteens 15 Registered Premises - Ice Cream During the year, 90 samples of ice cream were taken for bacteriological examination. Hie results of these examinations are as follows Grade I 84 Grade II 3 Grade III 3 Grade IV These results show a considerable improvement on those obtained last year when 84 samples were taken and only 45 were in Grade I, 8 in Grade II, 19 in Grade III and 12 in Grade IV. No cases occurred during the year of ice cream being in such poor bacteriological condition as to necessitate the stoppage of saleoo The total number of ice cream premises on the register at the end of the year was as unders- Sale only 163 Manufacture and Sale 4 Storage only 1 Total 168 Thirteen new premises were registered during the year in accordance with Section 14, Food & Drugs Act, 1938, for the sale of ice cream. - 40 - Preserved Foods Forty-one premises are registered In connection with the manufacture and/or preparation of preserved foods mider Section 14 of the Food & Drugs Act, 1938. A summary of the processes carried on at these premises is as underi— Sausage manufacture 11 Sausages and pickled meat 28 Cooking of Ham and other meat 2 Total 41 The total number of inspections of registered food premises made during the year was 238. Catering Establishments During the year, 112 inspections and revisits were made to catering establishments in the Borough. In no case was formal action necessary to secure improvements or to have carried out works found to be necessary. In the majority of cases, verbal notice to the occupiers was sufficient. In November, all proprietors of catering establishments in the Borough were sent a circular letter calling their attention to a booklet published by the Ministry of Food entitled "Clean Catering" and strongly recommending them to obtain a copy. Food Complaints During the year, 21 cases concerning food alleged to be unsound were received in the Department. In 3 cases, the Council gave instructions for warning letters to be sent to the firms concerned and the remainder of the complaints were not substantiated. Food Sampling By the courtesy of the Chief Officer, Public Control Department of the Middlesex County Council, the following details of food sampling within the Borough are available. - 41 - Article Total Samples procured Unsatisfactory Milk (various) 87 2 Arrowroot 5 - Beans (in Sauce) 1 - Cakes 29 - Cheese 1 - Chops 4 - Coffee and Chicory Essence 1 - Cooked Meat 12 - Condensed Milk 1 - Cream 7 2 Curry Powder 2 - Desiccated Coconut 1 - Dripping 1 - Drugs 6 - Evaporated Milk 3 - Fish 21 3 Fish Paste 4 - Ice Cream 8 2 Jam 2 - Jelly 2 - Lemon Curd 1 - Marzipan 1 - Minced Meat 9 - Non-Brewed Condiment 4 - Peas (Tinned) 1 - Pork 2 - Sausages and Sausage Meat 25 2 Soup 1 - Sweets 1 - Stewed Steak 1 - Suet 4 - Victoria Plums 8 1 Vinegar 17 2 Welsh Rarebit 1 - Wines and Spirits 24 - Yoghourt 2 - Totals 300 14 The total number of samples taken shows an increase of 81 over last year's figure of 219, and the number of unsatisfactory samples increased from 9 to 14. The following is an extract from the Chief Officer's report on the unsatisfactory samples:- - 42 - "Hie two samples of milk reported as unsatisfactory were samples of hot milk procured from a local cafe and both of them were found on analysis to contain added water- The trader was prosecuted and fined £2 and 2 guineas costs. With regard to the two unsatisfactory samples of cream, in one case the trader was cautioned verbally and in the other a subsequent sample was found to be genuine. With regard to the three samples of fish, in each case smoked cod was supplied when smoked haddock had been demanded. These samples were all purchased from the same shop the proprietor of which was prosecuted and fined £10 and 3 guineas costs. The Manager of the shop was also prosecuted in respect of the same offences and fined £5. The two samples of ice cream were both deficient in milk fat content and in view of the previous good record of the trader concerned the matter was dealt with by sending him an official caution. The two samples of sausages were unsatisfactory as each contained an undeclared preservative and the two samples of vinegar were unsatisfactory since non-brewed condiment was supplied. In each case the traders concerned were officially cautioned. The sample of Victoria plums shown as unsatisfactory were in fact Ponds Seedlings and which the trader had exposed for sale bearing a show ticket "Victoria Plums". This trader was prosecuted in respect of an infringement under the Food and Drugs Act and also for an infringement of the Defence (Sale of Food) Regulations, and was fined a total of £2 and one guinea costs." During the year, representatives of Brentford and Chiswick Council met the Chairman of the Middlesex County Council Public Control Committee with officers of both authorities in attendance in an informal discussion designed to secure more liaison between the two authorities dealing with the hygiene of food, and methods of exchanging information and the sharing of knowledge at this meeting has already had beneficial results. Meat and Other Foods During the year under review a total of 76 pigs were slaughtered in the Borough. These were all slaughtered under licences issued by the Ministrv of Food, were inspected at the time of slaughter and, with two exceptions, 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. - 43 - TABLE XIV Carcases Inspected and Condemned: Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed (if known) - - - - 76 Number inspected - - - - 76 All diseases except Tuber Whole carcase condemned culosis: - - - - Carcases of which some part or organ was condemned - - - - 2 Percentage of the number inspected affected with disease other than Tuberculosis - - - - 2.63 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. 1953. Fruit and Vegetabled 3,000 lbs Fish 45 stone Meat 24. 3 cwt Perishable Goods 46.5 cwt Tinned Foods 12,893 tins - 44 - SIaught erhouses Number on the Register (including one Knacker's Yard) 2 Contravention of Bye-laws Slaughter of Animals Act, 1955 (vide Livestock (Restrictions on Slaughter) Order, 1940) Number of Licences to Slaughter Animals issued during the year:- New Licences Renewed Licences Milk During 1953, the following licences were issued under the Regulations mentioned:- Milk (Special Designation) (Pasteurised & Sterilised Milk) Regs., 1949 Dealer's Licences 52 Supplementary Licences 18 Milk (Special Designation)(Raw Milk) Regulations, 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. Bakehouses Number in district in use 13 Contraventions of Food & Drugs Act, 1938 The one underground Bakehouse in the Borough was closed during the year and was re-built at ground level. 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. - 45 - HEALTH PROPAGANDA The importance of the education of the public in matters of health has become increasingly realised during the past few years and there are many new methods of propaganda which have been devised to reach the public ear or eye. Throughout the year the staff of the Department continued this work and poster publicity, talks to individuals, talks to small groups, talks to larger groups, some of them illustrated with film strin Pictures, were continuous. Special subjects for poster publicity were influenza, smoke abatement, anti-diphtheria immunisation and clean food, as these points became topical. A campaign in the spring of the year was organised by the Ministry of Health for a nation wide drive for anti-diphtheria immunisation because of the dangerous drop in the number of parents bringing their children to be immunised. The local health authority co-operated with the local sanitary authority in this, and new posters, film slides and leaflets on the subjects were given as wide distribution as possible. The question of smoke abatement having become very urgent as a result of the great fog of December, 1952, part of the year was devoted to special work in the education of the public against unnecessary smoke emission, the use of smokeless fuel and special appliances for burning this material were advocated and advice given to boiler house stokers and railway engine firemen in an effort to reduce smoke from factories and railway sidings. There was a continued drive for the improvement of food handling and distribution in the Borough, and shops, canteens, catering establishments and hawkers were encouraged to bring their standards not only up to those recommended in the bye-laws for this purpose, but beyond. At a Seminar held in London by the Central Council for Health Education Medical Officers for all types of authorities gathered to exchange information and ideas on the subject of Health Education in a Sanitary Authority. It was interesting to compare the results obtained by different methods of approach to Health Education and many helpful suggestions have since been adopted within the Borough. It is believed that certain ideas of our own were useful to other authorities o Home Accidents The very high figure for Home Accidents which had been recently publicised gave rise to concern about this matter. As all home accidents are preventable this seemed a very important subject for health education, and a request was made to the local medical practitioners, the Medical Directors of the local hospitals and to - 46 - other persons likely to have knowledge of accidents occuring in the home and resulting in disability, slight or serious, or even in death, were asked to notify this Department of such cases coming to their knowledge. The response was very disappointing, as although information was promised from many of these sources, in fact only eight home accidents were notified - seven of these occurred to young children, including three scalds, and all might have been prevented by a little more care in such matters as keeping kettles and teapots out of reach of young hands, and there seems to be a considerable need for continuous education of the public on this subject. WELFARE Old People During 1953 thirty 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 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 Beard grants for provision of extra bedding or household necessities, Home Nursing or a grant from the Sick Poor Persons Fund instituted in 1952 with the money no longer required by the District Nursing Association. Details of progress of the thirty cases are as follows Removed to hospital 8 Awaiting admission to Old People's Home 4 Removed to Old People's Home 3 Recuperative holiday 1 Removed to private nursing home 1 Remained at home 5 Died at home 2 Awaiting rehousing 2 Refused help 4 With regard to the 5 cases remaining at home, 1 was provided with a Home Nurse, 3 with Home Help assistance and special comforts. Disinfestation of one home was necessary. - 47 - During the year a total of 186 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 the reduced rates (2d per bath) of Slipper Baths for Old People at the Public Baths Establishments 1,819 baths were taken in Chiswick and 571 in Brentford. These numbers are 474 grerter than in 1952, and 965 greater than in 1951, showing an increasing use of this service, probably because of the spread of information by means of the Old People's Clubs regarding the facilities available. 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 ntinued throughout the year by the Old Folks Fund Committee - 1,186 such meals were delivered during 1953° In addition to this service, the Invalid Kitchens of London provided meals for 8 residents of the Borougho 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 St0 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. - 48 - (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. (3) The maintenance of a medical equipment loan depot at No. 16 Heathfield Terrace, Chiswick, W040 open on Mondays and Wednesdays from 7030 to 8.30 p.m. Emergency contact can be made with Miss Wallace telephone number Chiswick 2353° (4) Occupational therapy for the 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, except for a period of two and a half months during which the apparatus at Brentford first required overhaul and then re-siting to Boston Lodge in order to obtain more evidence of pollution specifically complained of in that area. - 49 - 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 XV 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 52 shows that on the monthly averages calculated from the daily readings there was little difference between pollution of the two parts of the Borough. Brentford figures were much worse in the Spring, and the subsequent improvement during the latter part of the year may have resulted from the work mentioned in the following report on smoke complaints. 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 factories within the Borough boundaries. Complaints of nuisance from smoke and grit from the Brentford Gas Works were received during the year. Observations of the smoke emission from the Gas Works and other premises numbered 175* No Statutory nuisance was confirmed in any case. Discussions with the various managements took place, and improvements were achieved. The Inspector of Alkali etc. Works of the Ministry of Housing and Local Government visited Brentford Gas Works and gave his comments and recommendations for the reduction of smoke and grit. Further, a technical officer from the Ministry of Fuel and Power visited various factories and gave advice, as a result of requests made by the Public Health Department. Improvements were obtained as a result of the action taken. In annual reports for 1951 and 1952 mention was made of smoke and grit nuisance from a refuse destructor in a neighbouring district grit arrestors were installed there and some improvement has resulted. - 50 - TABLE XV ]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. 0.193 0.167 0.570 0.556 0.078 0.066 0.249 0.220 Feb. 0.240 0.141 0.750 0.513 0.091 0.058 0.213 0.149 Mar. 0.298 0.169 0.574 0.368 0.114 0.076 0.224 0.153 Apr. 0.255 0.163 0.245 0.143 0.090 0.058 0.121 0.065 May - 0.067 - 0.111 - 0.041 - 0.049 Jun. - 0.067 - 0.114 - 0.036 - 0.042 Jul. 0.040 0.071 0.056 0.066 0.018 0.019 0.035 0.029 Aug. 0.046 0.036 0.236 0.214 0.021 0.019 0.092 0.096 Sep. 0.066 0.079 0.108 0.175 0.036 0.022 0.044 0.051 Oct. 0.193 0.207 0.405 0.406 0.085 0.071 0.163 0.173 Nov. 0.214 0.199 0.482 0.607 0.074 0.085 0.156 0.219 Dec. 0.243 0.179 0.506 0.557 0.108 0.094 0.213 0.240 - 51 - GRAPH "C" VARIATION IN AVERAGE MONTHLY CONCENTRATIONS OF SMOKE AND SULPHUR DIOXIDE IN BRENTFORD AND CHISWICK DURING 19 - 52 - GRAPH "D" COMPARISON OF CONCENTRATIONS OF SMOKE IN TBS AIR AT BRENTFORD, CHISWICK, CENTRAL LONDON, LEEDS AND LERWICK - 53 - SANITARY INSPECTION OF THE AREA Inspections The total number of inspections and re-inspections made during the year was 7,101. The following is a summary of the inspections made by the Sanitary Inspectors during the years:- Inspections Reinspections. Atmospheric Pollution Stations 276 - Bakehouses 11 16 Complaints 1,047 - Complaints - following up inspections - 2,498 Caravans, House-boats, etc 12 32 Catering Establishments 65 47 Drainage work 140 511 Factories - with mechanical power 34 27 Factories - without mechanical power. 9 1 Food premises (excluding catering establishments) 237 38 Food premises - Inspection of unsound food 327 - Houses - Housing Acts 428 91 Houses - Rehousing applications 22 - Houses - Overcrowding 55 - Ice Cream Vendors 176 - Infectious Disease enquiries 144 - Rats and Mice 72 36 Shops - Shops Act Inspections 209 15 Slaughterhouses 27 - Smoke observations 141 34 Vermin, insects, etc 35 - Miscellaneous 279 9 3,746 3,355 Action taken other than Housing Act, 1936 Cautionary or Intimation Notices served 570 Statutory Notices issued (under Public Health Acts; 41 Number of summonses served 6 Number of Certificates under Rents etc(RestrictionsJ Acts issued to tenants 1 Number of Clearance Certificates issued to Owners Nil - 54 - The following list shows the number of defects remedied during the year as a result of notices served:- Brickwork, repaired 19 Choked drains, unstopped 17 Chimney stacks and flues, repaired and made good 39 Ceilings, repaired and made good 150 Doors and frames, repaired 26 Dustbins, supplied 36 Dampness in walls, remedied 285 Fresh air inlets and interceptor caps etc,.provided 24 Firegrates, cooking stoves, repaired or renewed 101 Floors, joists and staircases repaired or renewed 95 Gutterings repaired or renewed or cleaned out 64 Inspection covers and frames renewed 11 leaky roofs and skylights repaired 213 Plaster to walls, repaired and made good 207 Rainwater pipes, repaired or renewed 25 Soil pipe ventilators, repaired or renewed 11 Sinks replaced 8 Seats to W.C's, repaired or renewed 8 Waste water preventors, repaired or renewed 10 Walls and ceilings, cleansed or redecorated 166 Waste pipes, repaired or renewed 18 Window frames, sash cords, sills, repaired or renewed 211 W.C's replaced 63 Yard Paving, repaired and made good 8 Miscellaneous items 81 TOTAL 1,896 In addition, the following drainage works were carried out during the year under the supervision of the Public Health Department Drains tested (smoke) 27 New soil pipe ventilators fixed 5 New interceptors fixed 2 New surface water and soil gullies fixed 9 New manholes constructed 13 Manholes reconstructed or repaired 1 Whole of drainage system relaid (soil) 1 Soil drainage connections repaired or relaid 47 Surface water connections repaired or relaid 3 Soil main drains repaired or relaid 11 Surface water main drains repaired or relaid 2 New W.C's provided and fixed 28 New sinks provided and fixed 14 Drain Ventilators fixed 2 New sewer connections 2 - 55 - 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 747 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 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. - 56 - HOUSING Hogarth Lane Re-Development Area In the year under review Clearance Orders were made in respect of 5 Areas situated in the Hogarth Lane Re-Development Area, These Clearance Orders dealt with 57 houses, and other sites or properties in the Area were acquired either by private negotiation or by Compulsory Purchase Orders. Demolition or Closing of Properties During the year the under-mentioned 40 houses were demolished Bennett Street - Nos 1-14 Furze Street - Nos 8-14 Devonshire Road- Nos 171 - 179 Ferry Square Almhouses (9) Goat Wharf Nos 1-4 and No 51 High Street In addition to the above, the under-mentioned properties (28) were closed owing to their being unfit for occupation Devonshire Road - Nos 151/157 Nos 113, 115, 119 and 141 Devonshire Place- Nos 13, 15, 17, 18, 24, 28 and 29 Wood Street - Nos 17, 24 and 30 Devonshire Street Nos 6 and 8 Boar"s Head Yard Nos 19 and 21 Church Alley Nos 5 and 6 Market Place No. 19 High Street No. 141 Fisher's Lane No. 22 Coombe Road No 23 (Basement only; Further, the undermentioned properties (74) were demolished since 1945 and prior to the year under review, in connection with He-Development Schemes; Horticultural Place - Nos 1-5 Powell Road etc. No 29 Hign Street Nos 112 - 126 " " Nos 82 - 83 Boar's Head Yard Nos 2 - 10 " " " Nos 5-7 Bennett Street Nos 26 - 39 - 57 - Statement of (a) Rebuilt (war damage) and (b) New Dwellings erected by the Borough Council and Private Enterprise during 1953. Permanent Housing Houses Flats Maisonettes Bungalows  By Borough Council (a) Rebuilds - - - - - (b) New 2 38 80 - 120/120 TOTAL By Private Enterprise (a) Rebuilds — - - - - (b) New 3 - - - 3/3 TOTAL - 58 - Statement of (ay Rebuilt (war damage) and (b) New Dwellings erected by the Borough Council and Private Enterprise between the end of the Second World War and the 31st December,1953 Permanent Housing Houses Flats Maisonettes Bungalows Total By Borough Council (a) Rebuilds 23 11 2 36 (b) New 123 333 104 19 579 TOTAL 615 By Private iSnterprise (a) Rebuilds 115 135 15 2 267 (b) New 8 20 - 1 29/296 TOTAL Temporary Housing. Houses Flats Maisonettes Bungalows Total 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, Overcrowding 55 cases of alleged overcrowding were investigated by the Department during the year. Of these 55 cases 22 were found to be Statutorily overcrowded and were accordingly notified to the Housing Department for consideration by the Housing Committee, 7 of these cases of overcrowding have now been rehoused, 4 are to be rehoused when suitable accommodation becomes available, 1 case has been referred to the London County Council, 2 cases have been deferred in Compulsory Order and Clearance area, 7 cases have been deferred for further consideration, and in 1 case no application was received, DISINFECTION, Premises disinfected; - Ordinary notifiable diseases 51 Tuberculosis 8 Cancer 29 Other diseases 1 Premises treated for vermin 22 Premises treated for other pests (wasps, moths, ants and beetles) 21 An arrangement is in force whereby the South West Middlesex Hospital Management Committee undertakes to carry out emergency disinfection of vermin-infested or smallpox-infected clothing and bedding on demand, - 59 - FACTORIES ACT, 1937 Inspections: TABLE XVI Premises Number on Register Number of Inspections made Written Notices Occupiers Prosecuted (i) Factories in which Sees. 1,2,3,4 & 6 are to be enforced byLocal Authorities 144 10 1 - (ii) Factories not included in (i) in which Section 7 is enforced by L.,A. 303 61 2 - (iii) Other premises in which Section 7 is enforced by L.A. (excluding outworkers premises) 20 - - - Totals 467 71 3 - TABLE XVII Cases in which Defects were found: Particulars Number of Cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred to HMI by HMI Want of cleanliness (Sec.1) 2 2 - 2 - Sanitary Conveniences (Sec.7):(a) Insufficient - - - - - (b) Unsuitable or defective 1 1 - 1 - (c) Not separate for sexes 1 1 - 1 - TOTALS 4 4 - 4 - - 60 - 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 (1)(c) No. of cases of default in sending lists to Council No. of prosecutions for failure to supply list No. of instances of work in unwholesome premises Not- | ices Served ' Pros ecut ions Wearing Apparel: Making etc Cleaning and 24 - - - - - Washing - - - - - - Artificial Flowers 7 - - - - - Feather Sorting 1 - - - - - Stuffed Toys 11 - - - - - Curtains and Furniture Hangings 2 - - - - - Totals 45 - - - - - - 61 - RODENT CONTROL During the year 2,484 primary visits and re-visits were made by the Rodent Operatives to premises in the district in connection with rodent disinfestation0 The number of premises where treatment was carried out is as follows Private Houses 264 Factories 16 bhops 32 Schools In addition to the above, two maintenance treatments to the sewers were carries: out under the direction of the Ministry of Agriculture and Fisheries during the periods January to March,and June to August, 1953, 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 - March '48 390 2nd Maintenance June - Sept„ '48 260 3rd Maintenance Jan, - March '49 193 4th Maintenance June - Aug. '49 135 5th Maintenance Jan „ - March '50 179 6th Maintenance June - Aug. '50 163 7th Maintenance Jan o - March '51 141 8th Maintenance June - Aug. '51 122 9th Maintenance Jan. - March '52 137 10th Maintenance June - Aug. '52 97 11th Maintenance Jan. - Feb. '63 103 12th Maintenance May - July '53 64 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. - 62 - miscellaneous Pet Animals Act, 1951 This Act for the regulation of the sale of pet animals came into force in Aprils 1952, and requires all premises in which animals are sold for pets to be licensed by the local authority. One shop was inspected during the year and the licence renewed. Rag Flock and Other Filling Materials Act, 1951 Three premises are registered in the Borough for the use of filling materials. Establishments for Massage and Special Treatment Eight 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 1 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. During 1953, 1,700 paper towels 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 8,375 of these towels were also used; the use of this service appears to have decreased during the year and further publicity of the facilities available appears to be indicated. - 63 - River Pollution The increasing urbanisation of the County of Middlesex and the growing numbers of factory buildings situated on or near the River Brent has given rise to serious doubts concerning the purity of the water of the river. As a portion of the river flows through Brentford it was important to us that any Public Health risks should be minimised in our area, and Medical Officers of Health of other districts bordering on the stream felt the same about their own areas. As a result, a meeting between the Officers of the Middlesex County Council, which is the authority for Rivers Inspection,, and the Borough Engineers and Medical Officers of Health of the various districts concerned was held at the latter end of 1952, and the whole matter was discussed thoroughly. Following this it was arranged that monthly reports would be submitted to the Borough Engineers and Medical Officers of Health of the appropriate authorities containing the results of analyses of the river water samples drawn from various points along its courses, and these have been submitted regularly ever since. Results have fluctuated from good to doubtful, and whenever doubtful results were obtained, the Officers of the local authority concerned communicated with the Middlesex County Council Officers and an endeavour was made to pinpoint the source or sources of any offending matter being allowed to enter into the stream. As a result of this, much good work has been done in the reducing of pollution, a matter of most particular concern in Brentford and Chiswick at the terminal and therefore the receiving end of the river. 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. Canal Boats Number of Boats on Register:- Motor Propelled Boats 94 Other Boats 407 - 64 - INDEX Accidents, Home 46 Accidents, Road 18,19 Area of Borough 10 Allotments 11 Atmospheric Pollution 8,49,50,51,52,53 Bakehouses 45 Baths and Washhouses 12,48 Births and Birth Rate 7,17,19 Brentford Market 45 British Red Cross Society 49 Canal Boats 64 Cancer 7,18,39 Catering Establishments 8,41 Causes of Death 18,21 Chest Clinics 13 Condemned Food 44 Deaths and Death Rate 7,17,18,19,24 Diphtheria 7,30 Diphtheria Immunisation 7,30,31 Disinfection 59 Dysentery 31 Factories Act, 1937 60 Food Control 40 Food Poisoning 31 Food Premises 40 Food Hawkers 64 Food Sampling 41,42,43 Free Washing Facilities 63 Health Propaganda 46 Health Services provided by Otter Authorities 12,13,14,15,16,37 Hogarth Lane Redevelopment Area 57 Hospitals 12 Housing 10,57,58 Hygiene of Food 8 Ice Cream Sampling 8,40 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 Malaria 31 Mass X-Ray 38 Massage and Special Treatment Establishments 63 Maternal Morbidity and Mortality 17,18,23 Meals on Wheels 48 Measles 7,19 Meat and Other Foods 43,44 Milk Regulations 45 Notifiable Diseases 24 Old People 8,47 Ophthalmia Neonatorum 24 Outworkers 61 Overcrowding 11,59 Parks and Open Spaces 11 Pet Animals Act, 1951 63 Poliomyelitis 8,18,27,28 Population 10 Premature Infants 19 Preserved Foods 41 Public Health Committee 3 Puerperal Pyrexia 7,23 Rag Flock, etc Act, 1951 63 Rateable Value 10 Refuse 56 River Pollution 64 Rodent Control 9,62 Sanitary Inspection of the Area 8,54,55 Sanitary Services 56 Scarlet Fever 30 Slaughterhouses 45 Slum Clearance 8,10,57 Smallpox 29 Smallpox Vaccinations 7,15,29 Smoke Pollution 8,50 St. John's Ambulance Brigade 48 Staff 5 Statistics and Social Condxtions 10 StillbirthS 17 Street Trading 64 Swimming Baths 11 Tuberculosis 13,18,19,32,34,36,37 Tuberculosis Register 35,36 Tuberculosis, Housing Conditions of Newly Notified Cases 37 Tuberculosis, Occupations of Newly Notified Cases 36 Tuberculosis, Cases in Years 33 - 65 - Unsound Food 41,44 Vermin 27 Vital Statistics 17 Wards 10 Water Supply and Water Services 56 Welfare: Old People 8,47 General 48,49 Wells 56 Whooping Cough 7,18,19,27 Whooping Cough Immunisation .30,31 - 66 -