Ac 439 (1) BREMFORD BRE 22. Borough of Brentford and Chismick ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1954 BOROUGH OF BRENTFORD AND CHISWICK ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1954 MARGARET A. GLASS, B.Sc., M.B., Ch.B.(Glas.), D.P.H.(Cantab.), Medical Officer of Health BOROUGH OP BRENTFORD AND CHISWICK PUBLIC HEALTH COMMITTEE Councillor P. W. T. Haines,, Chairman Alderman Mrs. A. J. Burden Councillor E. Davies “ R. S. Howard “ Mrs A. Godfrey “ G. Jenkin “ J. R. Grieve Councillor A. H. Bulmer “ L. H. Maynard H. L. Chambers “ Mrs. M. G. Saint Councillor E. Waller Ex-Officio: Alderman J. Connor. J. P. Councillor E. A. C. Branczik Councillor T. J. Crispin STAFF - PUBLIC HEALTH DEPARTMENT Medical Officer of Health Margaret A. Glass, B. Sc., M. B. Ch. B. (Glasgow), D. P. H. (Cantab). Chief Sanitary Inspector, Slops Inspector, Housing and Canal Boats Officer, and Rodent Officer T.M. Johnson, M. S. I. A. , A R San I., Cert. R. San. I., Cert. Insp. of Meat and Other Foods. Deputy Chief Sanitary Inspector and Slops Inspector A. G. Robinson, 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 Inspectors 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.,, Cert R. San, I. and S.I. E Joint Board, Cert. Insp. of Meat and Other Foods. W. A. Watts, M. R. San. I., M S I. A. , Cert.R. San, I, and S.I. E. J. B., Cert. Insp. of Meat and Other Foods R. S. I. Smoke Cert. (apptd. 12/7/54). Administrative Assistant R.P. Hill. Senior Clerk D. G. Hill. (resigned 14/8/54). S. W. Trowbridge, (appointed 1/12/54). Clerks N J. Rogers. Mrs. M. M. Bishop. Shorthand Typist Mrs. V. I. Merrifield. Junior Clerk D.H. Vousden. (appointed 4/10/54). Disinfector/Rodent Operative C. Clark. Rodent Operatives G. Skipp (retired 22/6/54). 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 27th 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. All the many sided activities of the work of the Public Health Department are devoted to the single aim of obtaining a population which is so sound and well-balanced in mind and body that resistance to illness is constant. There can beno sensational or glamorous display of success in this work. The dramatic moments come when epidemic disease breaks out and is subdued and controlled or environmental sanitation breaks down and is restored without much damage, but these are more the evidence of failure than of success in the work that is being attempted, so that an uneventful year is a satisfying one, and I am happy to be able to state that the year 1954 was uneventful. Some slight evidence, however, of a general improvement in the total health of the community can be gauged from the vital statistics, and the fact that in 1954, the Infectious Diseases notification rate and the rate of notifications and deaths from tuberculosis all decreased, gives grounds for satisfaction. There was, however, a slight rise in the Death Rate and there were four more infant deaths than in 1953, There were no notifications of diphtheria but it is rather disturbing to note the fall in the Vaccination and Immunisation ratesin 1954, as Smallpox is still a problem in many countries, and could be very easily brought into Britain, while Diphtheria still exists in this country and there are still children who die every year from this cause. Poliomyelitis notifications were few, and only 3 cases were confirmed, one of whom recovered completely, while the other two, though having some residual paralysis, are making good progress, and may possibly be cured completely in time. The drop in Tuberculosis notifications and deaths is a pleasing figure of the statistics,, there seems little doubt that this disease is on the wane. Although it is early yet to become too confident, the combined effects of improved housing, reduction of overcrowding, prompt discovery by Mass X-ray and Tuberculin Testing, B. C. G. vaccination and the new methods of drug treatment discovered in the last decade, seem gradually to be having an effect upon the incidence and spread of this infectious disease,, Fifty years ago in the two districts of Brentford and Chiswick with a total population of 48,922 there were 80 deaths -7- from tuberculosis, a rate of 1,6 per 1,000 of population. (This compares with the present rate of .07). 14 of these deaths occurred In infants under one year of age. It is less satisfactory to note that of the 94 newnotifications 21 patients each came from a home in which there were already one or more cases. Infection may not, but could have occurred within the home in these instances but it is extremely interesting to note that none of these secondary cases were from houses where there was Statutory overcrowding, or a grossly insanitary environment, and it seems that some other fault must have been present, either general lowering of disease resistance from malnutrition or other chronic disability, or else careless hygiene. The Housing Repairs and Rents Act which came into force at the end of August, 1954, made it possible to step up the work on Slum Clearance, a very important part of environmental hygiene. It is perhaps not understood by all, that not only are slum dwellings unhappy and unhealthy places to live in, they are also a continuing cost to the community in many ways, i.e. slum dwellings require much more attention from the Public Health Department officers than dwellings which are not slums, while their devitalising and resistance reducing effects on the physical and mental health of the inhabitants inevitably increase the requirements for medical and hospital provision under the National Health Service Act. During 1954, slum clearance and re-development were progressing actively within the Borough, and the Survey requested by the Ministry of Housing and Local Government for the purposeof finding out the total problem was well under way. Atmospheric pollution continued to be very much a nation wide problem throughout 1954, and the observations on the amount of pollution locally continued throughout the year, the overall figures for the whole year showing a reasonable improvement at the Brentford station, although at the Chiswick station there was very little difference between the figures for 1953 and 1954. Cases of old people living in conditions of distress or neglect continued to come to the notice of the Department during the year, and many authorities and voluntary associations co-operated in providing measures of relief. In no case was it necessary to use the powers provided by the National Assistance Act, whereby such people may be removed to a suitable place for care against their will, the charity of the voluntary societies and the goodwill and skill of the various welfare departments made this possible. The Meals on Wheels service wrs increased during the year by the obtaining of the services of the Invalid Kitchens of London and a special van was provided by that body for provision of meals within the Borough to the aged and chronic sick; meals were supplied daily and the Borough Council agreed to pay a small grant towards the cost of each meal in order that old people living on limited incomes need not be deprived of this excellent service because of lack of means, The importance of this service cannot be underestimated and the demand has been very great. Acknowledgements are due to the many people who have supplied information for the purpose of this 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, -8- the Secretary of the Old Polks Fund, the local Medical Practitioners 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 STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH, 1954 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 - Census 1951 59,367 Population - Registrar General's Estimate for area (mid 1954) 59,160 Number of Inhabited Houses according to Rate Book 15,654 Rateable Value at 1.4.1954 £722,564 Sum produced by 1d Rate £2,919 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 Borough of Brentford and Chiswick is mainly residential, although there is a factory zone in the western part of the Borough, and a certain amount of industrial buildings of the smaller type scattered throughout. There are 630 acres of open space within the Borough, with ample facilities for refreshment and recreation both for the public in general and for the sporting activities of particular groups. The proportion of open space of this character to the total area of the Borough is approximately 25% which is very high for a Borough in the Metropolitan Police area. The residents of the Borough are of mixed categories, including professional and clerical people of all grades,, artisans, factory workers, etc., and the types of dwelling vary from flatted houses and cottages to large detached residences in their own surrounding grounds. Here and there are very old properties which have deteriorated and the work of removing these slum dwellings and replacing them with modern houses is proceeding. Overcrowding of homes while still a considerable problem in the district seems gradually to be diminishing. The proportion of overcrowded houses is certainly lower than at the end of 1953, partly because of the increase in the rate of Council house and private building, and partly because of the transfer of some of the residents to New Town accommodation. -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 25. 7 Embankment Promenade 12.5 Future Embankment Promenade 15.3 16 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 1954 69,363 Average number per day 232 Maximum number using baths on one day 581 Chiswick Open Air Pools:- Large Pool Area 7,500 sq. ft. Capacity 33,750 c. ft. Small Pool Area 3,500 sq. ft. Capacity 18,375 c. ft. Total number of persons using baths in 1954 48,109 Average number per day 323 Maximum number using baths on one day 2,193 The overall total attendance figure at the swimming baths shows a considerable increase over the comparable figure for 1953. The very marked increase in the use of the indoor bath at Brentford is likely to be due to the fact that the summer of 1954 was cool with considerable rainfall. 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 113.71 acres Council owned open spaces and sports grounds leased to private clubs etc. 67.94 " School playing fields 50.50 " Gunnersbury Park (owned jointly by Acton, Brentford & Chiswick and Ealing Councils) 186.00 " Public Baths and Washhouses Brentford:- In CIifden Road Brentford, the Council maintains premises containing 21 slipper baths comprising: 8 first class (male) 4 first class (female) 6 second class (male) 3 second class (female) Total number using baths 24,764 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 42 227 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 1954, 1,850 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 3orough 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: Brentford:- Ante-Natal Clinics and ) Post-Natal Clinics ) Tuesday mornings 9 to 12 a.m. Infant Welfare Clinics Wednesday and Thursday afternoons 2 to 4 p.m. Diphtheria and Whooping ) Cough Immunisation and ) Alternate Friday afternoons Vaccination Clinics ) 2 to 4.30 p.m. Day Nursery Portsdown House, The Butts, Brentford. Chiswick:- Ante-Natal Clinics and ) Tuesday and Thursday mornings Post-Natal Clinics ) 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 ) Monday afternoons 2 to 4.30 p.m Vaccination Clinics ) 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 Hurses 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 years 5 -- 64 years 65 years and over Total Grand Total M F M F M F M F Medical 23 16 171 275 143 317 337 608 945 Surgical 4 - 11 17 11 8 26 25 51 Infectious Disease - - 1 1 - - 1 1 2 Tuberculosis - - 28 19 1 - 29 19 48 Maternal Complications - - - 11 - - - 11 11 Others - - - - 1 2 1 2 3 TOTALS 27 16 211 323 156 327 394 666 1,060 -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 general practitioners who participate 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, Brent ford (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 Road, 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. Mental Health Sessions are held at the Brentford Clinic on the second and third Tuesday of each month from 2 to 4 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 clinics:- Minor Ailment Clinic Monday to Saturday 9 to 10 a. m. (Chiswick) Monday 9 to 12 a.m. with doctor. Minor Ailment Clinic Monday to Saturday 9 to 10 a.m. (Brentford) Thursday 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 Clinic Monday, Wednesday and Thursday (Brentford) 9 a.m. to 4.30 p.m. Speech Clinic Wednesday 9 a.m. to 12 a.m. (Brentford) 1.30 to 4.30 p.m. Speech Clinic Tuesday 9 a.m. to 12 a.m. (Chiswick) 1.30 to 4.30 p.m. Thursday 1.30 to 4.30 p.m -15? Dental Clinic By appointment. (Brentford and Chiswick) Ultra Violet Light Treatment Clinic Monday and Thursday 9 to 10 a.m. (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 care). 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 Service: 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. (1) Chiropody Service: Old Age Pensioners are referred to private chiropodists An assessment scheme is in operation. -16- VITAL STATISTICS, 1954 Live Births Total Male e Legitimate 755 391 364 Birth Rate per 1,000 of the estimated resident population - 13.573 I11egitimate 48 25 23 TOTAL 803 416 387 Stillbirths Total Male Female Legitimate 11 4 7 Rate per 1,000 total (live and still) Births - 13.513 I11egitimate - - - TOTAL 11 4 7 Deaths Total Male Female 661 342 319 Death Rate per 1,000 of the estimated resident population - 11.173 Deaths from Puerperal Causes Puerperal Sepsis - Rate per 1,000 total Other Puerperal Causes - (live and still) Births - Nil. Deaths of Infants under 1 Year of Age Total Male Female Legitimate 21 9 12 Illegitimate - - - TOTAL 21 9 12 -17- Deaths and Death Rate The Death Rate increased in 1954 from the 1953 figure of 10.16 to 11.17 after a decrease the previous year from 11.27. The principal causes of death were:- 1954 1953 1952 1951 Circulatory Disease 205 173 217 195 Heart Disease 98 100 113 155 Cancer 159 119 128 131 The improvements seen in the figures for 1953 for the three principal causes of death, were not maintained in 1954, and the number of deaths from cancer is the highest on record. The distribution of cancer deaths in sites and ages is shown below. Site of Primary Growth Male Female 1954 1953 1954 1953 Stomach 14 4 11 3 Lung, Bronchus 30 24 6 5 Breast - - 15 10 Uterus - - 2 9 Intestinal 1 6 5 13 Prostate 10 1 - - B1adder 1 2 2 2 Brain - 1 1 4 Other 28 28 32 13 Total 84 60 74 59 Age Groups Male Female 1954 1953 1954 1953 Between 15 = 20 years 1 - - - “ 20 - 25 “ - - - - “ 25 - 30 “ 1 - 1 - “ 30 - 35 “ - 1 1 - “ 35 - 40 “ 3 1 - - “ 40 - 45 “ 5 2 4 4 “ 45 - 50 “ 4 3 2 7 “ 50 - 55 “ 6 5 4 1 “ 55 - 60 “ 12 10 11 8 “ 60 - 65 “ 11 7 11 7 “ 65 - 70 “ 11 9 8 9 “ 70 - 75 “ 13 9 14 8 “ 75 - 80 “ 10 6 8 6 “ 80 - 85 “ 5 4 4 6 “ 85 - 90 “ 2 3 4 3 “ 90 - 95 “ - - 2 - Totals 84 60 74 59 -18- An unusual occurrence is the report of three cancer deaths in persons below the age of 30. The high proportion of cancer of the lung in males is most significant in view of current medical opinion which tends to relate lung cancer to lung irritation from chemical inhalants or atmospheric pollution. The figure for deaths from cancer of the stomach has risen considerably in the last year. There were no maternal deaths. Deaths from Tuberculosis are again reduced for the fourth 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 1954 3 1 4 The total number of deaths from violent causes increased for the first time since 1950:- 1954 1953 1952 1951 1950 27 17 21 23 28 Seven residents died through involvement in road accidents. The ages at death of these cases were:- Males: 82, 23, 72, 42, 21, 10. Females: 61. None of these died in the Borough. In all, 6 persons (including residents of other places) died as the result of road accidents occurring in Brentford and Chiswick, one motor cyclist, four pedestrians and one motor car passenger, The sites of the incidents varied and no place could be cited as a danger spot from these particular findings. The local Death Rate, 11.17, is lower than the 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 International system agreed by the World Health Organisation and in operation since November, 1949. -19- Death Rate of all infants per 1,000 live births ... 26.15 Death Rate of all legitimate infants per 1,000 legitimate live births 27.95 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea or Gastro-Enteritis (under 2 years) Nil Deaths from Cancer and Leukaemia (all ages) 162 Deaths from Tuberculosis (all ages) 4 Birth Rate The Birth Rate which had been falling since 1946 showed a rise from 14.21 in 1952 to 14.3 in 1953 but has now fallen to 13,57 in 1954. This compares with a National Birth Rate figure of 15. 2. INFANT MORTALITY During 1954 the number of births recorded was 803: 755 legitimate and 48 illegitimate. There were 21 deaths of infants under one year of age as compared with 17 in 1953, giving an infant mortality rate of 26,15 for 1954. an increase on the figure for 1953. i.e. 19.95. The local figure compares with an Infant Mortality Rate of 25.5 for England and Wales. The graph on page 21 shows the progress of Infant Mortality since the beginning of the century. The number of premature infants born in 1954 was 49, including premature stillbirths. Of the 44 premature infants born alive, 1 was born at home and survived to the end of one month 43 were born in hospital, of whom 35 survived to the end of one month. The percentage of premature infants to total births (live and still) is 6.0. This figure has been rising gradually as can be seen by the following figures:- 1950 1951 1952 1953 1954 3.3 4 5 5.6 4.9 6.0 Causes of infants deaths are shown in Table II on page 23. -20- -21- TABLE I PARTICULARS OF DEATHS AS SUPPLIED BY THE REGISTRAR - GENERAL FOR THE YEAR 1954 Cause of Death Males Females A11 Causes 34 2 319 1. Tuberculosis, respiratory 3 1 2. Tuberculosis, other - - 3. Syphilitic Disease 1 1 4. Diphtheria - - 5. Whooping Cough - - 6. Meningococcal Infections - - 7. Acute Poliomyelitis - - 8. Measles - - 9. Other infective and Parasitic Diseases 1 1 10. Malignant Neoplasm, stomach 15 11 11. Malignant Neoplasm, lung, bronchus 30 6 12. Malignant Neoplasm, breast - 15 13. Malignant Neoplasm, uterus - 2 14. Other Malignant and lymphatic neoplasms 40 40 15. Leukaemia, aleukaemia. 2 1 16. Diabetes 1 5 17 Vascular lesions of the nervous system. 41 55 18. Coronary disease, angina 46 34 19. Hypertension with heart disease 5 4 20. Other heart disease 38 51 21. Other circulatory disease 5 24 22. Inf1uenza 1 - 23. Pneumonia 6 11 24 Bronchitis 32 12 25. Other diseases of respiratory system 2 1 26. Ulcer of stomach and duodenum 6 2 27. Gastritis enteritis and diarrhoea 1 2 28. Nephritis and Nephrosis 3 - 29. Hyperplasia of prostate 6 - 30 Pregnancy, childbirth, abortion - - 31 Congenital malformations 4 3 32 Other defined and ill defined diseases. 33 30 33 Motor vehicle accidents 6 1 34. All other accidents 7 3 35. Suicide 7 3 36. Homicide and operations of war - - ALL CAUSES 342 319 -22- TABLE II INFANTILE MORTALITY DURING THE YEAR 1954 Net deaths from stated causes at various ages under one year Under l day 1day 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 - - - - - - - - - - - - - - - - - - - - - - Measles. - - - - - - - - - - - - - - - - - - - - - - Scarlet Fever. - - - - - - - - - - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - - - - - - - - - - Diphtheria or Croup - - - - - - - - - - - - - - - - - - - - - - Erysipelas - - - - - - - - - - - - - - - - - - - - - - Tuberculous Meningitis - - - - - - - - - - - - - - - - - - - - - - Abdominal Tuberculosis - - - - - - - - - - - - - - - - - - - - - - Other Tuberculosis Diseases - - - - - - - - - - - - - - - - - - - - - - Meningitis (non-T.B.) - - - - - - - - - - - - - - - - - - - - - 1 Convulsions - - - - - - - - - - - - - - - - - - - - - - Laryngitis - - - - - - - - - - - - - - - - - - - - - - Bronchitis - - - - - - - - - - - - - - - - - - - - - - Pneumonia (all forms) - - - - - - - 1 - - - 1 1 - - - - - - - - 3 Diarrhoea - - - - - - - - - - - - - - - - - - - - - - Enteritis - - - - - - - - - - - - - - - - - - - - - - Gastritis - - - - - - - - - - - - - - - - - - - - - - Rickets - -. - - - - - - - - - - - - - - - - - - - - Suffocation - - - - - - - - - - - - - - - - - - - - - - Injury at Birth 3 - - - - - - - - - - - - - - - - - - - - 3 Atelectasis 1 - - - - - - - - - - - - - - - - - - - - 1 Congenital Malformation 1 - - - - - _ 1 1 - 1 - - - - 1 - - - - 1 6 Premature Birth 5 2 - - - - - - - - - - - - - - - - - - - 7 Atrophy, Debility and Marasmus - - - - - - - - - - - - - - - - - - - - - - Pemphigus Neonatorum - - - - - - - - - - - - - - - - - - - - - - Smallpox - - - - - - - - - - - - - - - - - - - - - - Other Causes - - - - - - - - - - - - - - - - - - - - - - TOTALS 10 2 - - - - - 2 1 - 1 1 1 1 - 1 - - - - 1 21 -23- TABLE III MATERNAL MORTALITY AND 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 1945 - - 1946 - 3 1947 - 1 1948 - - 1949 - - 1950 - - 1951 - - 1952 - 1 1953 - - 1954 - " During the year 3 cases of puerperal pyrexia were notified, as compared with 18 in 1953. One of these did not belong to the Borough but had been admitted from another area 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 100.4 degrees Fahrenheit (38 degrees Centigrade) or more has occurred within fourteen days after childbirth or miscarriage". -24- PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. TABLE IV NOTIFIABLE DISEASES DURING THE YEARS 1953 AND 1954 Disease Total cases notified Cases admitted to hospital Total Deaths 1954 1953 1954 1953 19S4 1953 Scarlet Fever 95 65 29 32 - - Whooping Cough 9 141 1 10 - 1 Measles 47 810 1 17 - - Pneumonia (notifiable) 18† 43 6† 7 17‡ 24‡ Dysentery 12† 11 3† 5 - - Typhoid 1 - 1 - 1 - Puerperal Pyrexia 3 18 - 18 - - Erysipelas 9 3 1 1 - - Meningococcal Infection 1 2 1 2 - - Food Poisoning 4 23 2 - - - Ophthalmia Neonatorum 3 1 2 1 - - Malaria 1 1 1 1 - - Acute Poliomyelitis Paralytic 4† 3 4† 3 - 1 Non-Paralytic - 3 - 3 - - Diphtheria - - - - - - TOTALS 207 1124 52 100 18 26 * In addition, one case was subsequently not confirmed. †Includes one case subsequently not confirmed. ‡Includes deaths from non-notifiable pneumonia. TABLE V OPHTHALMIA NEONATORUM Cases Notified Cases treated at home Cases treated in hospital Vision unimpaired Vision impaired Total blindness Deaths 3 2 1 3 - - - •25- TABLE VI AGES OF CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1994 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 95 - - 5 8 10 66 6 - - - - - Whooping Cough 9 1 1 1 - 1 5 - - - - - - Measles 47 9 12 6 4 3 9 2 - 2 - - - Pneumonia 18† 1 - - 1 - 3 - - 1 - 6 6 Ac. Poliomyelitis:Paralytic 4† - - - - - 1 1 - 1 - 1 - Non-Paralytic - - - - - - - - - - - - - Meningococcal Infection 1 - 1 - - - - - - - - - » Dysentery 12† 2 2 2 - 3 2 - - - 1 - - Puerperal Pyrexia 3 - - - - - - - 3 - - - Erysipelas 9 - - - - - - - - - 2 3 4 Food Poisoning 4 - 1 - - - 1 - 1 1 - - - Ophthalmia Neonatorum 3 3 - - - - - - - - - - - Malaria 1 - - - - - - - - 1 - - - Typhoid 1 - - - - - - - - - 1 - † Includes one case subsequently not confirmed. -26 TABLE VII CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1954 CLASSIFIED IN WARDS Disease Number of Cases Notified Brentford West Brentford Central Brentford East Bedford Park Chiswick Park Grove Park Gunnersbury Old Chiswick Turnham Green Total Cases Scarlet Fever 17 18 9 2 17 12 6 9 5 95 Whooping Cough. 2 - 1 1 - - 1 3 1 9 Measles 8 5 5 2 4 12 4 2 5 47 Pneumonia 11 1 1 2 1 1 - 1 - 18† Acute Poliomyelitis Paralytic - - 1 - 1 1 1 - - 4† Non Paralytic. - - - - - - - - - - Meningococcal Infection - - - - - - - - 1 1 Dysentery - - - 4 4 1 - 3 - 12† Puerperal Pyrexia - - - 1 - 1 1 - 3 Erysipelas 3 - 1 - - 2 2 - 1 9 Food Poisoning 1 - - 1 1 1 - - 4 Ophthalmia Neonatorum. - - - 1 2 - - - - 3 Tuberculosis:- Respiratory 14 6 5 12 5 10 11 16 11 90 Non Respiratory - 1 - - - - 1 1 1 4 Malaria - - 1 - - - - - - 1 Typhoid - - - - 1 - - - - 1 † Includes one case subsequently not confirmed. -27- 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 15,476 Secondary Modern Schools 4,379 19,655 Number of children requiring treatment 144 Number of children in respect of whom cleansing notices were issued 79 Number of children cleansed by Local Health Authority 29 There was an increase of 823 in the total number of cleanliness inspections and an increase in the number of children who had become infested with head lice, from 118 in 1953 to 144 in 1954. The number of children found on inspection during 1954 to be in need of cleansing from infestation with vermin is unsatisfactory as there is a considerable rise over the previous year's figure. It is also observed that the number of cleansing notices required was almost double that for the previous year and the number of children compulsorily cleansed had also risen though to a less considerable extent. In comparing these figures with those received for the County as a whole, it is not very pleasing to note that the general average rate of vermin infestation for the County is -44%, a decrease since last year, while in Brentford and Chiswick the percentage is .73, an increase over last year's figure. One of the main difficulties in dealing with this problem is that very often infestation is carried on in a household because adult members of the family are infested and there is no legal authority for any one to insist on an inspection of adult contacts of infested school children. During the year one application was received for the cleansing of a person suffering from scabies The treatment was carried out at Hammersmith Cleansing Station by arrangement with the Medical Officer of Health of Hammersmith. INFECTIOUS DISEASE In the year 1954 there was an extremely lowincidence of infectious disease. This was principally due to the fall in measles notifications. Measles is a disease showing a marked biennial fluctuation and the current year was the year of the trough of the wave. The up and down nature of this disease can be observed from the following table of notifications of this disease during the past ten years 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 525 188 438 335 511 269 863 413 810 47 -28- Other noteworthy figures from Table IV are the drop in whooping cough notifications, the lower incidence of pneumonia, and the excellent figures for puerperal pyrexia and food poisoning. Less satisfactory is a figure showing some rise in the scarlet fever incidence. Typhoid During July, 1954, when a few cases of typhoid fever had occurred in the Borough of Fulham, we were notified that a case suffering from typhoid fever and belonging to this Borough had been admitted to the infectious disease hospital in that area This patient was so ill on admission to hospital, that it was very difficult to obtain any information with regard to the possible source of infection, and unfortunately she died without becoming really able to make herself understood. Enquiries made from the immediate contacts of the case did not elicit any further information, and the follow-up of contacts and the bacteriological examination of specimens from them resulted in the information that no carrier of this infection was numbered among them. Poliomyelitis 4 notifications of poliomyelitis were received during the year and 3 cases were confirmed as paralytic poliomyelitis. Up to date information regarding these cases and those poliomyelitis cases noted in previous years as still showing residual paralysis is as follows. Case notified in 1949 This patient, now a girl of 8 years, still shows some residual paralysis of right leg. 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 - partial paralysis of left biceps operation in 1953 gave good movement of elbow and forearm. Shoulder joint out of action. Condition stationary, but patient is married and has been delivered safely of a child weighing 7 lbs 1 oz. without any abnormality before, during, or after the confinement. CASE C - A boy now 13 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 7 years - severe case - paralysis of both upper and lower limbs. Slight weakness of right leg and limitation of muscular development of calf, Some wasting of muscles of right thumb, but power good. Has Physiotherapy -29- CASE H - Child now aged 3 years - paralysis left arm and shoulder. Still requires physiotherapy for partial paralysis. CASE J Adult female - paralysis both arms and spine. Recovered except for slight weakness of upper arms. Cases notified in 1953: CASE K - Adult female - partial paralysis right leg. Fully recovered. CASE L - Adult male - paralysis right side of neck, right arm and forearm, right leg and thigh. Condition was much improved, has now left district. Cases noti fied in 1954: CASE M - Girl aged 8 years - paralysis of right leg - some residual foot drop and partial paralysis of quadriceps Having physiotherapy, CASE N - Adult female - Full recovery. CASE 0 - Boy aged 11 years - bulbar poliomyelitis - slight weakness of palate remaining. Con firmed cases Died Still making progress Condition stationary Fully recovered 1949 4 - - 3 3 1950 9 - - 6 6 1951 - - - - - 1952 9 2 3 - 4 1953 6 1 1 - 4 1954 3 - 2 - 1 It can be seen from these figures that of 31 confirmed cases of paralytic poliomyelitis occurring during the past 6 years, 18 have made a complete recovery with full power and normal movement of all muscles. -30- SmalIpox No cases or contacts of smallpox were notified during the year. Vaccination against Smallpox The following information regarding vaccinations against smallpox carried out in the Borough during 1954 has been supplied by the County Medical Officer. Number of persons who during the year were:- Age groups Total Under 1 1 2 - 4 5 - 14 15 £ Over vaccinated for first time 400 17 19 20 31 487 re-vaccinated - - 3 6 128 137 Total 400 17 22 26 159 624 Total number of first vaccinations:- 1951 1952 1953 1954 298 373 548 487 It will be noted that 400 children under 1 year of age were vaccinated out of 803 born during the year i.e. approximately 50%. This is a slight decrease from last year when the figure was 55%. It is disappointing to note that the vaccination figures,which were showing an improvement in 1953, have decreased, especially since the major amount of the decrease is in the infants of under 2 years of age. Vaccination of infants under 1 year of age has dropped from 469 in 1953 to 400 in 1954, and in the 1 year age group from 33 to 17. This may be due to the fact that no major campaign for health education on the subject of the dangers of smallpox was carried out in 1954. Scarlet Fever A rise in the number of notifications of scarlet fever is to be seen, the figures being 95 in 1954 as compared with 65 in 1953. 29 cases were admitted to hospital and the disease did not appear to be severe in type. A secondary case, i.e a patient developing the infection subsequent to the first case occurring in the same household, occurred in only one instance, the first patient having been nursed at home, and the second developing the infection twenty-two days later. -31- 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 in the Borough during 1054 has been supplied by the County ,Medical Officer and is as follows. - Number of children who Age Total Under 1 1 2 3 4 5 - 9 10 -14 completed a full course of primary immunisation 356 152 22 13 19 19 2 583 received reinforcing injections - - - 1 200 145 4 350 Number of children at 31.12 54 who had completed a course of diphtheria immunisation at any time before that date (i.e. at any time since 1. 1. 40) Age at 31. 12.54 i,e born in year Under 1 1 2 3 4 5 - 9 1014 Total under 15 1954 1953 1952 1951 1950 1945 9 1940-4 Last complete course of injections(whether primary or booster) A. 1950 - 54 99 462 529 525 624 2,354 288 4,881 B. 1949 or earlier - - - - - 1,125 2,362 3,487 The figures for immunisation against diphtheria are. like the vaccination figures, less satisfactory than in 1953. There has been a decrease in the number of primary immunisations the total for 1954 being 583, as compared with 671 in 1953 The immunisation state of all children under 15 years of age remains roughly the same, and there is a slight rise in the proportion of children of school age, who have at some time in their lives received a full course of immunisation against diphtheria, and who have therefore reasonable protection against one of the hazards of school life, especially if the primary immunisation has been reinforced with a booster dose given just before school entry Approximately 79% of the school children are so protected. -32- Whooping Cough Only 9 notifications of whooping cough were received in 1954, a very low figure for this disease No deaths occurred from whooping cough. Dysentery and Food Poisoning There was no serious outbreak of dysentery or food poisoning during the year. Pour cases of gastro-intestinal disturbance were notified to the Department as food poisoning. They were all single cases. Salmonella typhi-murium was identified as the agent in one case, but in no other instance was any food poisoning organism identified. Malaria There was one case of benign tertian malaria, contracted by a service man in Korea. He was removed to hospital for treatment and no secondary cases occurred. 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 - 21 21 Scarlet Fever - swabs 1 7 8 Dysentery - faeces 14 52 66 Paratyphoid - faeces - 1 1 Typhoid - faeces - 3 3 Tuberculosis - sputa - 2 2 Totals 15 86 101 -33- TUBERCULOSIS - 1954 TABLE IX Age Groups New Cases Deaths Hespiratory SonRespiratory Respiratory NonRespiratory Male Female Male Female Male Female Male Female Under 1 year - 1 - - - - - - 1 - 5 years 2 1 - - ~ - - - 5-15 " 1 1 - - - - - - 15 - 25 " 10 18 2 - - - - 25 - 35 " 12 8 - 1 - - - - 35 - 45 " 11 3 - - 1 - - - 45 - 55 " 7 3 - 1 1 - - - 55 - 65 " 7 1 - - - - - - 65 years and over 3 1 - - 1 1 - - Totals 53 37 - 4 3 1 - - Of the 4 recorded deaths 2 were previously notified as cases of Tuberculosis, 2 had not been so notified. In addition, 4 patients already notified as tuberculosis died from other causes. TABLE X TABLE OF TUBERCULOSIS CASES IN YEARS Year Sew Cases Total Deaths Respiratory NonRespiratory Respiratory NonRespiratory Total M F M F M F M F 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 1.950 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 1953 75 41 3 7 126 8 1 - - 9 1954 53 37 - 4 94 3 1 - - 4 -34- GRAPH "B" GRAPH OF CASES NOTIFIED AND DEATHS FROM TUBERCULOSIS DURING THE PERIOP 1934 - 1954 Notified Cases of Tuberculosis Deaths from Tuberculosis -35- The total number of cases on the Tuberculosis Register at the end of 1954 was 765, viz. , pulmonary 702, non-pulmonary 63. TABLE XI - Tuberculosis Register - As at 31.12.54 Pulmonary Non-Pulmonary Total M F M F M F (a) Number of Cases on Register at commencement of year 382 281 22 41 404 322 (b) Number of Cases notified for the first time during year under Regulations 46 32 - 4 46 36 (c) Cases restored to Register during year 3 4 - - 3 4 (d) Cases added to Register otherwise than by notification under Regulations:-. (i) Transferred from other districts 7 5 - - 7 5 (ii) Non-notified deaths - - - - - - (e) Number of Cases removed from Register during year 35 23 1 3 36 26 (f) Number of Cases remaining on Register at end of year 403 299 21 42 424 341 Cases removed from the Register shown under (e) are accounted for as follows: - Found not to he T.B, Recovered Lost sight of Removed to another area Died at home Died at San at orium or other Institution Total M F M F M F M F M F M F M F PULMONARY 1 - 1 1 3 3 24 18 2 1 4 - 35 23 NO - PULMONARY - - - 1 - - 1 2 - - - - 1 3 -36- 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 years 1952 and 1953. TABLE XII Occupations 1954 1953 1952 M F M F H F Outdoor (Transport 2 - 2 - 2 _ Occupations (Other 7 - 9 - 8 - Indoor (Heavy Manual 3 - 1 . - - Occupations (Light Manual 13 2 18 2 11 7 (Clerical or ( Sedentary 11 10 15 6 18 12 (Other 3 - 7 1 3 1 Housewife and Domestic - 15 - 22 - 18 School child 1 2 4 2 2 1 Shop Assistant - 3 2 1 2 2 Under School Age 2 2 3 2 4 - Occupation Unknown 11 7 18 11 9 7 Totals 53 41 79 47 59 48 The fall in the number of deaths from tuberculosis is very gratifying indeed. For the first time, in 3953, this number came into the single figure category, and in 3 954 the number of deaths attributed to tuberculosis was the lowest on record. It will be seen from Table X how sensational the fall in the number of deaths due to tuberculosis has been over the last 20 years. Less satisfactory is the figure for notifications, although this again dropped considerably during .3954. This considerable fall in deaths from tuberculosis, combined with a much smaller fall in the incidence of notification of the disease, is to be observed all over the country, and indeed is reported from all parts of the Commonwealth. It seems reasonable to deduce from these figures that much earlier discovery of the disease combined with new methods of treatment, both by surgery and by drugs, and new methods of prevention, such as vaccination of contacts with B.C. G., are all having an effect at last on one of the greatest plagues that still affect this country. 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. B. C. G. inoculation is now offered to all the Mantoux negative, i.e. susceptible, contacts of newly discovered tuberculosis cases; 68 residing in this Borough were inoculated during 1954. A prominent part in treatment is played by domiciliary chemo-therapy with the aid of the "Home Nurses" (formerly District Nurses) provided by the Middlesex County Council. -37- Apart from institutional treatment provided by the local Hospital Management Committees and by the North West Metropolitan Regional Hospital Board in General Hospitals end in Chest Hospitals, there is also a Middlesex County Council Hostel for chronic ambulant male tuberculous patients. It is interesting to find that the number of persons waiting at the end of 1954 for hospital or sanatorium admission was only 29. This figure has been failing very rapidly in the past few years, and has indeed fallen during the twelve months from 77 on the waiting list in December, 1953. It seems that a modest hope can be entertained that the day is not far off when the satisfactory position will be attained of having more institution beds than patients to fill them. Facilities for convalescence, rehabilitation and training are providedby 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 1954 The housing conditions of 75 of the 94 new cases of tuberculosis were found to be as follows:- 72 patients lived in sufficiently satisfactory housing accommodation, 24 in flats, 18 in houses, 25 in lodgings or furnished rooms 3 in institutions, and 2 in prefabricated houses. In 1 case the housing was dilapidated and in 2 cases there was overcrowding The housing particulars of 19 cases were not obtainable either because of removal of patients to other districts or because of resistance of patients to home visiting. 21 new notifications came from homes already returning one or more cases of tuberculosis None of these came from houses classed as unsatisfactory or dilapidated There have been 4 notifications of tuberculosis from an institution 2 of them being submitted in 1954. 42 cases were inward transfers from other districts and therefore, had not developed their illness while resident in Brentford and Chiswick. The position regarding cases living in unsatisfactory or overcrowded conditions, outstanding from previous years, is as follows:- Year Cases No where Conditions improved 1953 8 1 1952 1 - 1951 3 - 1950 3 - -38- MASS X - RAY During 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, and the use of the small hall at the Town Hall was granted free of charge for this purpose. Preliminary propaganda by means of press, poster and leaflet publicity brought a very good response The following Table shows the findings of the survey as compared with those obtained on the occasion of the previous visit in 1952. Year No. X-Rayed No. of Active Cases of Pulmonary Tuberculosis Hate per thousand 1954 11,725 29 2.5 (4,461) (10) (2.2) 1952 9,472 35 3.7 (-) (-) (-) The figures in brackets refer to residents of the Borough, and are included in the total numbers X-rayed. Unfortunately such figures for 1952 are not avail able. There was an improvement in the proportion of active cases found to the total attending for X-ray but this figure is still higher than for other parts of Middlesex. FOOD CONTROL NUMBER AND TYPE OF FOOD PREMISES IN THE BOROUGH Bakers and Confectioners 23 Butchers 39 Confectioners (Sweets) 85 Cafes, Restaurants, Dining Rooms & Snack Bars 136 Factory and Works Canteens 76 Fishmongers 19 Greengrocers and Fruiterers 57 Grocers and Provisions and General Stores 108 Ice Cream Manufacturers 4 Public Houses and Off Licences 74 School Canteens 15 -39- REGISTERED PREMISES Ice Cream During the year 71 samples were taken for bacteriological examination The results of these examinations are as follows:- Grade I 67 Grade II - Grade III 3 Grade IV 1 These results show that 94% of the samples taken were Grade I, as compared with 93% Grade I in 1953, thus showing that the standard achieved in 1953 is being maintained No cases occurred during the year of ice cream being in such poor bacteriological condition as to necessitate the stoppage of sale. Seven new premises were registered during the year in accordance with Section 14 Food & Drugs Act, 1938, for the sale of ice cream. The total number of ice cream premises on the register at the end of the year was as under:- Sale only 170 Manufacture and Sale 4 Storage only 1 175 Preserved Foods The total number of premises registered in connection with the manufacture and/or preparation of preserved foods under Section 14 of the Pood & Drugs Act, 1938 is 41 shorn asunder:- Sausage Manufacture 11 Sausages and pickled meat 28 Cooking of ham and other meats 2 Total 41 The total number of inspections of registered food premises made during the year was 241 CATERING ESTABLISHMENTS Thirty-seven visits were made to catering establishments during the year and in one case only was it necessary to serve a notice. The necessary work was subsequently carried out. -40- FOOD COMPLAINTS During the year 14 cases concerning food alleged to be unsound were received in the Department. Three cases were substantiated, the details of which are as follows:- Complaint Action taken Deposit in milk bottle Warning letter Metal rivet in fruit loaf Warning letter Mouldy wrapped loaf Warning letter POOD SAMPLING Pood & Drugs Act, 1938 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:- Article Total Samples Procured Unsatisfactory Milk 58 - Acetic acid 1 - Butter 9 - Cakes 10 1 Cooked Meats 2 - Cornflour 1 - Cream 8 - Drugs 6 - Dried Fruit 1 - Fish 4 - Fish Paste and cakes 3 - Flour 3 - Ice Cream 12 2 Iced Lolly 1 - Liver 5 2 Margarine 3 - Marzipan 1 - Meat Paste 1 - Minced Meat 1 - Mincemeat 1 - Mint Sauce in Vinegar 1 - Non-Brewed Condiment 5 1 Oranges 5 - Pickled Onions 3 - Sausages and Sausage Meat 10 1 Soup 1 - Suet 3 - Sweets 1 - Tomato Ketchup 2 - Victoria Plums 8 1 Vinegar 11 5 Wines and Spirits 12 - Total 193 13 -41- The total number of samples taken shows a considerable decrease from last year's figure of 300 and the number of unsatisfactory samples decreased from 14. The following is an extract from the Chief Officer's report on the unsatisfactory samples:- ''Cakes. This was a sample of cake described as "Chocolate Roll" which was found to be deficient in dry fat free cocoa and therefore should not have been called Chocolate roll. The firm was prosecuted and fined £15.0.0d. and ordered to pay £3 17 0d, costs, The Manager of the firm was also prosecuted for aiding and abetting in this offence and was fined £2.0.0d. Ice Cream, Two informal samples of ice cream, both obtained from the same vendor were found to be deficient in fat, A formal follow- up sample proved to be genuine and no further action was taken. Liver. Two samples, sold as "Lamb s Liver", were found to be pig's liver. Proceedings were instituted against both firms. In one case the summons was dismissed, no costs being allowed: in the other case a fine of £2.0.0d. was imposed and the firm ordered to pay £1.1.0d. costs. Non brewed Condiment. This was found to be a sample of non-brewed condiment deficient in acetic acid - see comments on vinegar, below. Sausages etc A tin of "Cocktail Sausages in Brine" was purchased from a firm of retail grocers. It was found that the sausages were contaminated by metallic tin and unfit fox human consumption. This was the last tin of these sausages in the firm's possession, and had been in stock for some considerable time. An official caution was issued. Victoria Plum., This was a tin of plums sold as "Victoria Plums" but upon examination found to be Ponds Seedlings. The firm of retail grocers who sold and described them as "Victoria Plums" was prosecuted and fined £10 0 0d. and ordered to pay £5. 5. 0d costs. Vinegar,, The five unsatisfactory vinegar samples were sold in all by two retailers. Two samples purchased from the same retailer as the Non-brewed Condiment mentioned above and associated with that purchase were found to be non brewed condiment deficient in acetic acid The retailer was prosecuted and fined £1.0.0d. and ordered to pay £2.2.0d. costs. In the other case, three samples from the same retailer were found to be non brewed condiment. An official caution was issued. Merchandise Marks Act, 1926 Imported Food Orders. During the year 180 premises were visited and 695 displays of meat, apples, tomatoes poultry dried fruit, and salmon were examined. three cases arose of misdescription and failing to mark imported food with the country of origin The first case concerned displays of Italian pears and Plums which were falsely described as "Empire", and of Australian apples not marked with the country of origin. The retailer was fined a total of £4.0.0d and ordered to pay £2.2.0d costs in respect of the misdescription, and an official caution was issued in respect of the apples. Proceedings were authorised against a second retailer for displaying New Zealand apples not marked with the country of origin. He was fined £2.0.0d. and ordered to pay £1.1.0d. costs, The third case was of display -42- ing New Zeal and and South African apples not marked with the countries of origin, and the retailer was fined £2.0.0d. , no costs being allowed. Labelling of Food Order, 1953. 93 premises were visited and 661 different articles examined. No infringements of substance arose. The Defence (Sale of Food) Regulations. 1943. Investigations under the above Regulations resulted in the following cases. Two firms of greengrocers falsely described potatoes other than King Edwards as "King Edwards". Official cautions were issued, and also to the Manager of one of the firms for aiding and abetting in this offence. Tinned Pershore plums were found, falsely described as "Victorias". The firm of retail grocers was prosecuted and fined £10.0.0d. andordered to pay £5 5.0d. costs. A greengrocer displayed White Winter Pearmain apples under the false description of "Newtowns" He was prosecuted and fined £2.0.0d, and ordered to pay £3.3.0d. costs," HEAT AND OTHER FOODS During the year under review a total of 46 pigs were slaughtered in the Borough These were all slaughtered under Licences issued by the Ministry of Pood were inspected at the time of slaughter and, with one exception, 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. TABLE XIII Carcases Inspected and Condemned: Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed (if known) - - - - 46 Number inspected - - - - 46 All diseases except Tuberculosis Whole carcase condemned - - - - - Carcases of which some part or organ was condemned - - - - - Percentage of the number inspected affected with disease other than Tuberculosis - - - - - Tuberculosis only: Whole carcase condemned - - - - - Carcase of which some part or organ was condemned - - - - 1 Percentage of the number inspected affected with Tuberculosis. - - - - 2.1 -43- FOOD CONDEMNED PUKING THE YEAR, 1954 Fruit and Vegetables 2,139 lbs Fish 52 stone Meat 28 cwt Perishable Goods 9.72 cwt Tinned Foods 6,616 tins SLAUGHTERHOUSES Number on the Register (including one Knacker's Yard) 2 Contravention of Bye-laws - Slaughter of Animals Act, 1933. (vide Livestock (Restriction on Slaughter) Order, 1940) Number of Licences to Slaughter Animals issued during the year New Licences 2 Renewed Licences 1 MILK During 1954, the following licences were issued under the Regulations mentioned:- Milk (Special Designation) (Pasteurised & Sterilised Milk) Regulations 1949 to 1953. Dealer's Licences 53 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. - BRENTFORD MARKET This is a very large wholesale market for the sale of fruit, vegetables and flowers and covers an area of some 13 acres. It is under the contrel of the Borough Council and there are 450 holdings with 150 tenants. It has a Corporation staff of 16 members and roughly 1,500 vehicles pass through the market every day. Frequent visits are paid by the Sanitary Inspectors to confirm the main tenance of good sanitation and the avoidance of nuisances, and also to ascertain that the market is free from rodent infestation. -44- 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 reckoned to be unfit for human consumption. Sanitary facilities were increased during the year because of the growth of this market, and a new sanitary block was provided during the year containing 4 water closets, 7 urinal stalls and 3 wash basins with hot and cold water, HEALTH EDUCATION Work in the education of the public in physical, mental and environmental hygiene was continuous throughout the year. This education was carried on unceasingly by person to person talks by the staff of the Public Health Department to members of the public, to groups or associations, to employers and employees in their places of business. It is believed that these personal conversations are more memorable than the other forms of education which can be used, but these, however, were not neglected, as leaflets and posters were used from time to time on topical subjects. For instance, during the winter months the emphasis was laid more on prevention of colds and Influenza and on personal cleanliness, while in summer more stress was laid on the importance of careful handling of food, the need for fresh air, sleep, and exercise, and all the year round the topic of proper nutrition was kept well in the foreground. At the beginning of the year a request was made by the Education Officer and the School Meals Organiser for some assistance with the education in hygiene of the canteen workers in the school canteens. Arrangements were made whereby all the canteen workers were gathered together on a single occasion and at that meeting the Medical Officer of Health gave a general talk on hygienic handling of food. The talk was accompanied by the projection of a filmstrip in colour prepared by the Medical Officer of Health of Ealing and was followed by a discussion when many interesting points were raised by the canteen staffs. Following this meeting the District Sanitary Inspectors visited the school canteens so that the preliminary talk could be followed up by an explanation of its application to the particular premises in which staff were working. All this education produces no tangible result, there is nothing that can be claimed as being the direct result of work on health education, but the real evidence that the work is having its effect is in the absence of preventable illness. While we cannot show by statistics that the general health of the population is better in any one year than it was in the previous year, the indications of lowered rates for death tuberculosis, and infectious disease and freedom from epidemics of foodborne diseases are good signs that attention is being paid to the rules of health. HOME ACCIDENTS A scheme for the notification of Home Accidents whereby hospital officers, general practitioners and other health workers would send in a form of notification when an accident occurring at home came to their notice, has not been effective in practice. Although occasional notifications have been received they have been few in number, and since during 1954, 13 persons died from accidental causes other than motor vehicle injuries, it can be assumed that a very much higher proportion received injuries that were not fatal, for instance 6 reports were received from Health Visitors concerning accidents occurring to young infants, details of which are as follows:- Female, aged 3 months - Fractured skull, caused by fall from mother' s arms while being bathed. -45- Male, aged 4½ years - Fractured right fore-arm caused by fall from chair. Male, aged 16 months - Multiple cuts on face, requiring stitches, caused by fall from cot which broke glass containing water. Male, aged 2& years - Burns caused by fall into fire after accidental push. Female, aged 1 year Scalds to thighs and buttocks caused by hot water tap turned on infant in bath by another child. Female, aged 4 years - Scalds on right thigh and right upper arm caused by splashes from hot water bottle. Of the deaths from accidents 2 occurred in children under 7 years of age. Five persons over 80 years of age died following falls in which limbs were fractured There is no doubt that a great number of falls of old people are occasioned by the fact that houses are not sufficiently equipped with hand rails or other aids to assist people who are elderly or infirm. WELFARE OLD PEOPLE During 1954 eighteen 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 Details of progress of the eighteen cases are as follows: Removed to Hospital 5 Awaiting admission to Old People's Home 2 Removed to Old People' s Home 1 Remained at home 9 Died at home 1 With regard to the 9 cases remaining at home, 2 were provided with home help assistance, 2 with meals and 3 with special comforts. During the year a total of 264 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 forold people at the Public Baths Establishments 1,838 baths were taken in Chiswick and 590 in Brentford. These figures show again a slight increase over those for the previous year. -46- Heals 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 discontinued at the end of January, 1954, when this service was taken over by the Invalid Kitchens of London, Negotiations between the Borough Council, the Old Folks Fund Committee and the Invalid Kitchens of London Association resulted in an agreement whereby the Association was prepared to provide a van to carry meals daily to the old and chronic sick of Brentford & Chiswick on an understanding that every effort would be made to keep the numbers large enough to use the van to capacity. The Borough Council was to pay a grant for every meal supplied so that the cost of each meal would be kept down to 10d. It was also thought desirable that since the ratepayers' money was involved a certificate of sickness should be obtained for each applicant and all the application forms were to be signed by the Medical Officer of Health,, There was no need to worry about keeping up the number of meals as in a very short time the number of applicants far exceeded the capacity of the van, and there has been, of necessity, a waiting list since shortly after the scheme came into operation. The meals are of good quality and can be varied according to individual needs as every day in addition to the ordinary meals prepared, there is a menu of light dishes suitable for special classes of invalids. From February to December, 9,266 meals were provided for 99 old persons. The recipients were not always willing to accept meals every day and they were quite at liberty to ask for meals to be supplied on single days or on two or three occasions each week. 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, -47- British Bed 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, W. 4., open on Mondays and Wednesdays from 7.30 to 8.30 p.m. Emergency contact can be made with Miss Wallace- telephone No. Chiswick 2353. (4) Occupational therapy for the disabled ex-Service pensioners and for Chest CIinic 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 convalescents. 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 months when the apparatus at the Chiswick station was being overhauled, (see Table XIV, Page 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 XIV. These recordings 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. -48- It will be noted from the graphs that there were the usual high peaks of pollution by smoke in early spring and at the end of the year, It is noteworthy however that these are very much lower than in 1953, and that the average pollution by both smoke and sulphur compounds is less for the whole year at the Brentford station, the averages for smoke being 0.1510 milligrarames per cubic metre in 1953, and 0.0783 in 1954 and for sulphur dioxide, 0 0713 volumes per million volumes of air in 1953, an do 0.0455 in 1954; a very satisfactory reduction. This same result was not obtained at the Chiswick station where the averages for the two years varied little. It can be seen by the graphs of comparison between our two local stations and the average figures for the stations in Leeds, a highly industrial town, and Central London, that although throughout the year the amount of pollution of the air is much less locally than in those places the difference is not so marked as in similar graphs in former Annual Reports, the figures for the two outside authorities having improved to a remarkable extent during 1954. Smoke Complaints Investigations were made into fourteen cases in which it was alleged that atmospheric pollution was taking place. As a result of these investigations 92 visits or observations of premises were made and improvements were noted. In the Annual Report for 1953 it was mentioned that the Inspector of Alkali etc. Works of the Ministry of Housing and Local Government had visited the Brentford Gas Works at the request of the Public Health Department.: This Inspector again visited the Works in the year under review and reported that alterations were taking place or were contemplated with a view to further imrovement being obtained,, 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. January 0.143 0.128 0.279 0.350 0.062 0.067 0.146 0.161 February 0.119 0.125 0.303 0.421 0.070 0.074 0.148 0.201 March 0.156 0.142 0.245 0.399 0.063 0.077 0.121 0.172 April 0.109 0.126 0.186 0.385 0.059 0.080 0.101 0.159 May 0.062 0.103 0.114 0.230 0.030 0.054 0.064 0.120 June 0.054 0.055 0.038 0.134 0.030 0.034 0.016 0.070 July 0.064 0.046 0.042 0.127 0.013 0.027 0.054 0.060 August 0.117 0.107 0.052 0.217 0.032 0.052 0.020 0.089 September 0.112 *- 0.106 *- 0.030 *- 0.030 *- October 0.068 *- 0.035 *- 0.024 *- 0.049 *- November 0.197 0.092 0.428 0.234 0.073 0.042 0.116 0.076 December 0.210 0.236 0.583 0.489 0.058 0.079 0.109 0.157 APPARATUS NOT WORKING 49 GRAPH "C" VARIATION IN AVERAGE MONTHLY CONCENTRATIONS OF SMOKE AND SULPHUR DIOXIDE IN BRENTFORD AND CHISWICK DURING 1954 50 GRAPH "D" COMPARISON OF CONCENTRATIONS OF SMOKE IN THE AIR AT BRENTFORD, CHIS1ICK, CENTRAL LONDON, LEEDS AND LERWICK 51 SANITARY CIRCUMSTANCES OF THE AREA Inspections The total number of inspections and re-inspections made by the Sanitary Inspectors during the year was 6,122. The following is a summary of these inspections:- Inspect ions Reinspections Atmospheric Pollution Stations 298 - Bakehouses 6 9 Complaints 798 - Complaints- following up inspections - 2,307 Caravans, House-boats, etc. 2 36 Catering Establishments 36 11 Drainage work 135 404 Factories- with mechanical power 67 21 Factories- without mechanical power 12 2 Food premises (excluding catering establishments) 148 19 Food premises- Inspection of unsound food 319 - Houses- Housing Acts 475 - Houses- Rehousing applications 12 - Houses- Overcrowding 49 - Ice Cream Vendors 146 - Infectious Disease enquiries 158 - Milk Vendors 10 - Rats and Mice 90 48 Shops- Shops Act Inspections 88 10 Slaughterhouses 31 - Smoke observations 97 11 Vermin, insects, etc. 23 - Miscellaneous 203 41 3,203 2,919 Action taken other than Housing Act, 1936 Cautionary or Intimation Notices served 495 Statutory Notices issued (under Public Health Acts) 21 Number of summonses served 4 Number of Certificates under Rents etc. (Restrictions) Acts issued to tenants 1 Number of Clearance Certificates issued to Owners - 52 The following list shows the number of defects remedied during the year as a result of notices served:- Brickwork, repaired 26 Choked drains, unstopped 43 Chimney stacks and flues, repaired and made good 22 Ceilings, repaired and made good 160 Doors and frames, repaired 15 Dustbins, supplied 24 Dampness in walls, remedied 228 Fresh air inlets and interceptor caps etc., provided 15 Firegrates; cooking stoves, repaired or renewed 91 Floors, joists and staircases repaired or renewed 123 Gutterings repaired or renewed or cleaned out 66 Inspection covers and frames renewed 10 Leaky roofs and skylights repaired 227 Piaster to walls, repaired and made good 182 Rainwater pipes, repaired or renewed 23 Soil pipe ventilators, repaired or renewed 4 Sinks replaced 5 Seats to W.C's, repaired or renewed 8 Waste water preventors, repaired or renewed 6 Walls and ceilings, cleansed or redecorated 84 Waste pipes, repaired or renewed 29 Window frames, sash cords, sills, repaired or renewed 189 W.C s replaced 68 Yard Paving, repaired and made good 4 Miscellaneous items 40 TOTAL 1,692 In addition, the following drainage works were carried out during the year under the supervision of the Public Health Department:- Drains tested (smoke) 18 New soil pipe ventilators fixed 2 New interceptors fixed 4 New surface water and soil gullies fixed 3 New manholes constructed 5 Manholes reconstructed or repaired 1 Whole of drainage system relaid (soil) 4 Soil drainage connections repaired or relaid 15 Soil main drains repaired or relaid 8 Surface water main drains repaired or relaid 3 New W.C's provided and fixed 9 New sinks provided and fixed 4 Drain ventilators fixed 1 New sewer connections 2 53 All houses In the Borough are provided with water closets, and, with the exception of a small percentage, all drain into the sewers. 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 SCHOOL SANITATION In the early part of 1954 a survey of the sanitation in all the schools in the Borough which had been begun the previous year was completed. Out of the 27 schools in the Borough; 18 were found to be completely satis factory as regards sanitary conveniences and washing facilities and up to the standards of the School Premises Regulations. In the remaining 9 schools the deficiencies found were reported to the Public Health Committee and details of the findings passed to the Education Officer from whom a report was later received concerning the proposals with regard to these various defects,, It was found that in 5 of the schools provision had already been made for improvement of the washing or sanitary facilities whichever were deficient, and for one other school it was likely that the overcrowded conditions would be relieved in a reasonable time by the provision of a new school.. Further reports are awaited but the overall position is better than in most parts of the country as the number of very old schools is extremely small, only four of them having been built before 1900. Two new primary school shave already been opened within the Borough, while work is in progress for the provision of considerable extensions to two of the secondary schools. WATER SUPPLY AND WATER SERVICES The whole of the district is supplied by the Metropolitan Water Board mains. There are two well sin 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 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 Metro politan 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. 54 HOUSING Housing Repairs and Rents Act, 1954 This Act which came into operation on the 30th August, 1954, directed every local authority to make a survey for the purpose of ascertaining how much slum clearance was necessary in its area. With the easing of post war difficulties it was desirable that the clearance of slums, which had been practically inhibited for 15 years, should be resumed in a thorough and systematic way. Houses were to be classified as to whether they were due for immediate demolition or whether demolition could without prejudice to health, be postponed for a limited number of years by means of improvements and repairs. In order to carry out this work the preliminary survey was started in the Borough at once and was nearing completion at the end of the year, 6 Certificates of Disrepair were issued under this Act during the period 30th August to 31st December, 1954. Hogarth Lane Re Development Area The four Compulsory Purchase Orders made during the year 1953, and involving 48 houses, were confirmed by the Minister of Housing and Local Government on the 6th May, 1954, with certain modifications in respect of three of the Orders. The re-development of the above area continues, and during the year under review, the following 47 houses in clearance areas, from which 119 persons were displaced and rehoused by the Council, were demolished:" 121-133 (odd numbers); 135a; 135-149 (odd numbers), Devonshire Road, 3-13 (consecutive numbers); 15 and 16, Devonshire Place, 18 24 (consecutive numbers); James Street, 13- 35 (odd l umbers) Wood Street. In addition to the above, the following 46 houses, from which 100 persons were displaced and rehoused by the Council, and which were acquired by the Council at site value without the need for declaring clearance areas, were also demolished during the year:- 15, 16, 17, Furze Street, . 16, 17, 18, James Street Yard, 13 17 (consecutive numbers), James Street, 20, 22, 24, and 4-14 (even numbers), Devonshire Street, 20-32 (even numbers). Wood Street, 5, 7, 9, 11 and 37 Wood Street, 13 and 14, .17 and 18, Devonshire Place, 109-119 (odd numbers) and 151-357 (odd numbers), Devonshire Road, The total number of houses demolished in this area during recent years is 135. Other properties in this area were demolished either as a result of enemy action or by Closing Orders made prior to the outbreak of the War in 1939, The number of flats to be built on the cleared site is 206, of which 62 were completed at the end of 1954. 55 Albany Road Re Development Area Official representations were made in July that the following houses were unfit for human habitation, and were declared Clearance Areas as under:- Albany Road (No, 1) Area 1-13 (consecutive numbers), and 14 (May Cottage), Caroline Place, end 5, Albany Road. Albany Road (No.2) Area 1-10 (consecutive numbers), Paradise Place, and 15 and l7(01iffe Cottages), Albany Road. Albany Road (No.3) Area 19a, Albany Road, and 3-8 (consecutive numbers), Mount Pleasant. The above houses were included in the under-mentioned Compulsory Purchase Orders, which were submitted to the Minister of Housing and Local Government for confirmation. No.1 Compulsory Purchase Order 1-12 (consecutive numbers), Catherine Row, and 15-18 (consecutive numbers), Caroline PI ace. Wo.2 Compulsory Purchase Order 11 and 12, Paradise Place. No. 3 Compulsory Purchase Order 1-12 (consecutive numbers), Sussex Place. The total number of houses to be demolished in this area is 64. A Public Enquiry was held in December to hear objections to the Orders, the result of the enquiry was still awaited at the end of 1954. Beaconsfield Terrace Re Development Area A Compulsory Purchase Order was made in respect of certain land at the above and confirmed on the 7th August, after the hearing of a Public Enquiry into the Order on the 27th May, 1953. A revised scheme to include the existing 7 houses in the road was made, and a Compulsory Purchase Order (No.2) submitted to the Minister in August, 1953. A hearing of an objection to the Order was held in December, 1953, and the Order confirmed in January, 1954. The total number of houses to be demolished in this area is 7. 56 Brentford High Street Re Development Scheme The following five properties were declared unfit for human habitation and not capable at reasonable expense of being rendered fit:- 198, 206, 301, 302 and 305, High Street. Two of these houses have been closed, and the families rehoused by the Council. The Ham Re-Development Area Official representations were made that the following houses were unfit for human habitation, and declared Clearance Areas, as under:- Church Alley Clearance Area 1, Church Alley: 1„ 2 and 3, Newbury Cottages, Church Alley;. 4, 5, 6, 7, 8 and 11, Church Alley; 25, The Ham, The Ham (No.l) Clearance Area 43-63 (odd numbers), The Ham. The total number of houses to be demolished in this area is 22. 14 of these houses have been closed, and the families rehoused by the Council. HOUSING STATISTICS 1. Inspection of Dwelling-houses during the year: (1) (a) Total number of dwelling-houses Inspected for housing defects (under Public Health or Housing Acts) 493 (b) Number of inspections made for the purpose 2,307 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidation Regulations 1925 Nil (b) Number of inspections made for the purpose Nil (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 55 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 431 57 2. Remedy of Defects during the year without service of formal Notices Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 492 3. Action under Statutory Powers during the year (a) Proceedings under Sections9, 10 and 16 of the Housing Act, 1936 (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices: (i) by owners Nil (ii) by local authority in default of owners Nil (b) Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 18 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (i) by owners 18 (ii) by local authority in default of owners 2 (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (d) Proceedings under Section 12 of the Housing Act, 1936: (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined,the tenement or room having been rendered fit Nil 4. Housing Act, 1936.,- Overcrowding: (a) (i) Number of dwellings known to be overcrowded at end of year 63 (ii) Number of families dwelling therein 75 (iii) Number of persons dwelling therein 321 (b) Number of new cases of overcrowding reported during the year 18 (c) (i) Number of cases of overcrowding relieved during the year 14 (ii) Number of persons concerned in such cases 82 (d) Particulars of any cases in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil 58 Statement of (a) Rebuilt (war damage) and (b) New Dwellings erected by the Borough Council and Private Enterprise during 1954 Permanent Housing Total Houses Flats Maisonettes Bungalows By Borough Council (a) Rebuilds - - - - - (b) New 2 81 57 - 140 By Private Enterprise TOTAL 140 (a) Rebuilds 1 - - - 1 {b) New 3 - - - 3 TOTAL 4 Statement of (a) 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,1954 Permanent Housing Total Houses Flats Maisonettes Bungalows By Borough Council (a) Rebuilds 23 11 2 - 36 (b) New 125 414 161 19 719 By Private Enterprise TOTAL 755 (a) Rebuilds 116 135 15 2 268 (b) New 11 20 - 1 32 TOTAL 300 Temporary Housing Total Houses Flats Maisonettes Bungalows 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 59 Overcrowding 46 cases of alleged overcrowding were investigated by the Department during the year. Of these 46 cases 18 were found to be Statutorily overcrowded and were accordingly notified to the Housing Department for consideration by the Housing Committee. DISINFECTION Premises disinfected: Ordinary notifiable diseases 70 Tuberculosis 4 Cancer 33 Other diseases 3 Premises treated for vermin 28 Premises treated for other pests (wasps, moths, ants and beetles) 16 An arrangement is in force whereby the South West Middlesex Hospital Management Committee undertakes to carry out emergency disinfection of vermin-infested or small pox-infected clothing and bedding on demand. MISCELLANEOUS FACTORIES ACT, 1937 TABLE XV Inspections: 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 by Local Authorities 121 12 - - (ii) Factories not included in (i) in which Section 7 is enforced by L, A 289 67 3 - (iii) Other premises in which Section 7 is enforced by L. A. (excluding outworkers premises). 22 - - - Totals 432 79 3 - 60 TABLE XVI 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) 1 - - 1 - Sanitary Conveniences (Sec, 7}:- (a) Insufficient - - - - - (b) Unsuitable or defective 11 8 - 11 - (c) Not separate for sexes - - - - - Totals 12 8 - 12 - TABLE XVII Outwork (Sections 110 and 211): 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 prosecutions for failure to supply list No. of instances of work in unwholesome premises Notices served Prosecutions Wearing Apparel Making etc. 46 - - - - - Cleaning and Washing - - - - - - Household Linen 2 - - - - - Artificial Flowers 5 - - - - - Paper Bags 2 - - - - - Cosaques, Christmas Crackers, Christmas Stockings etc. 1 - - - - - Stuffed Toys 9 - - - - - Lace, Lace Curtain and Nets 3 - - - - - Curtains and Furniture Hangings 1 - - - - - Totals 69 - - - - - 61 RODENT CONTROL During the year 2,831 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 254 Factories 15 Shops 22 Schools 13 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 months of January and June to July, 1954, and the following shows the number of manholes found to be infested. Date Manholes found to be infested January, 1954 66 June - July, 1954 62 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. PET ANIMALS ACT, 1951 This Act for the regulation of the sale of pet animals requires all premises in which animals are sold for pets to be licenced by the local authority. 3 licences were issued during the year. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 Three premises in the Borough are registered for the purposes of the above Act, in pursuance of the provisions of Section 2 thereof. 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. Purpose No. of Licences Massage only - Chiropody only 4 Massage and Chiropody - Massage, Chiropody and Electrical Treatment - Massage and Electrical Treatment 2 Chiropody and Electrical Treatment 1 62 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 available in each, During 1954, 5 400 paper towels were issued showing a much improved 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 7,582 of these towels were also used, In the one convenience in the Borough (Market Place Men s and Ladies ) where free washing facilities are not yet available, 174linen towels were supplied for use RIVER POLLUTION During the year reports were received regularly from the Officers of the Middlesex County Council regarding the condition of the River Brent, as ascertained from samples taken at two points, one near its entry into Brentford and Chiswick and one near its outfall into the River Thames On the whole the results were more satisfactory than during the previous year. In addition, when samples taken from the river indicated that particular sites were showing an increase of pollution the source was ascertained and action was taken by the Borough Council Officers in conjunction with those of the Middlesex County Council in order that the sources of offence should be abolished. Serious pollution in Workhouse Dock at the mouth of the river which had given cause for anxiety for some years was finally removed by the closing of this dock for residential purposes, and the removal of derelict barges and houseboats at times occupied by human beings was in progress at the close of the year. 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 406 63 Accidents, Home 45,46 Accidents, Road 19 Albany Road Re-Development Area 56 Allotments 11 Ambulance Service 16 Area of Borough 10 Atmospheric Pollution 48,49,50,51 Bakehouses 44 Baths and Washhouses 12,46 Beaconsfield Terrace Re-Development Area 56 Births and Birth Rate 17,20 Brentford High Street Re-Development Scheme 57 Brentford Market 44,45 British Red Cross Society 48 Canal Boats 63 Cancer 18,19,20 Care of mothers and children 13,16 Catering Establishments 40 Causes of Death 18,19,22 Chest Clinics 13 Chiropody 16 Circulatory Diseases 18 Clinics 13,15,16 Condemned Food 44 Death and Death Rate 17, 18, 19, 20 Defence (Sale of Food) Regulations, 1943 43 Diarrhoea 20 Diphtheria 32 Diphtheria Immunisation 15,32 Disinfection 60 Domestic Helps 16 Dysentery 33 Factories Act, 1937 60,61 Food and Drugs Act, 1938 41 Food Control 39 Food Hawkers 63 Food Poisoning 33 Food Premises 39 Food Sampling 41,42,43 Free Washing Facilities 63 Ham, The Re-Development Area 57 Health Education 45 Health Services provided by other Authorities 12, 13, 14, 15, 16 Health Visitors 14 Heart Disease 18 Hogarth Lane Re-Development Area 55 Home Helps 16 Home Nursing 14 Hospitals 12,13 Housing 10.55,56.57,58.59 Housing Repairs and Rents Act, 1954 55 Ice Cream Sampling 40 Infant Mortality 17,20,21,23 Infectious Disease 28 Infectious Disease, Ages of Cases 26 Infectious Disease. Classified in Wards 27 Infectious Disease, Prevalence and Control of 25 Isolation Hospital, Admissions 25 Labelling of Food Order, 1953 43 Laboratory Work 33 Malaria 33 Mass X-Ray 39 Massage and Special Treatment Establishments 62 Maternal Morbidity and Mortality 17,19,24 Meals on Wheels 47 Measles 20,28 Meat and Other Foods 43 Mental Health 15 Merchandise Marks Act, 1926 42 Midwifery Service 13 Milk Regulations 44 Notifiable Diseases 25 Old People 46 Ophthalmia Neonatorum 25 Outworkers 61 Overcrowding 10,58,60 Parks and Open Spaces 11, 12 Pet Animals Act, 1951 62 Poliomyelitis 29,30 Population 10 Premature Infants 20 Preserved Foods 40 Prevention of Illness, Care and After-care 16 Public Health Committee 3 Puerperal Pyrexia 24 64 Rag Flock, etc. Act, 1951 62 Rateable Value 10 Refuse Collection 54 River Pollution 63 Rodent Control 62 Sanitary Circumstances of the Area 52,53,54 Sanitary Services 54 Scarlet Fever 31 School Health 15 School Sanitation 54 Slaughterhouses 44 Slum Clearance 8,10,55,56,57 Smallpox 31 Smallpox Vaccinations 15,31 Smoke Pollution 49,50,51 St. John's Ambulance Brigade 47 Staff 5 Statistics and Social Conditions 10 Stillbirths 17 Street Trading 63 Swimming Baths 11 Tuberculosis 13,19 20,34,35,37,38 Tuberculosis, B. C. G. Inoculations 37 Tuberculosis - Cases in years 34 Tuberculosis, Hospital or Sanatorium Accommodation 38 Tuberculosis, Housing Conditions of Newly Notified Cases 38 Tuberculosis, Occupations of Newly Notified Cases 37 Tuberculosis Register 36 Typhoid 29 Unsound Food 41,44 Vermin and Scabies, Control of 28 Vital Statistics 17 Wards 10 Water Supply and Water Services 54 Welfare Old People 46 General 47 Wells 54 Whooping Cough 20, 33 65