AC 439 (1) BRENTFORD Chiswick 1 In O h zar Dr B BRE 23 2 Library Borough of Brentford and Chicwick ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1955 ; BOROUGH OF BRENTFORD AND CHISWICK ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1955 MARGARET A. GLASS, B.Sc., M.B., Ch. B.(Glas.), D.P.H.(Cantab.), Medical Officer of Health BOROUGH OF BRENTFORD AND CHISWICK PUBLIC HEALTH COMMITTEE Alderman Mrs, A.J Burden, J P Chairman Alderman F. S. Brierley Councillor Mrs, M. Charlton " R. S„ Howard, O.B.E. " M.J„ Digby Councillor T. R Baldwin " Mrs, A, Godfrey " AH Bulmer " L H, Maynard " Ho L. Chambers " A„ Russell Councillor Mrs. M G, Saint Ex-Officio: Alderman R,L„ Avery, J.P. J„ Connor Councillor T.J. Crispin STAFF - PUBLIC HEALTH DEPARTMENT Medical Officer of Health Margaret A, Glass, B Sc., Ml, Ch B, (Glasgow), D.P H (Cantab). Chief Sanitary Inspector, Shops 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 Shops 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, (resigned 31 10.55). Administrative Assistant R.P. Hill. Senior Clerk S.W. Trowbridge. Clerks N.J Rogers. Mrs, M M. Bishop. Shorthand Typist Mrs. V I Merrifield. Junior Clerk D.H. Vousden. Disinfector/Rodent Operative C, Clark. Rodent Operative 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 28th 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. There was a fall in the death rate, a fall in the birth rate, and the infant mortality rate was the lowest ever recorded in the Borough, There were no maternal deaths and no deaths from diphtheria or poliomyelitis - on the other hand a rise in the number of deaths from coronary disease would seem to indicate that the stress of modern conditions and increasing lack of care in nutrition evidenced by the growing use of prepacked ready prepared, refrigerated and dehydrated foods is taking its toll of the adult community. There were fewer deaths, as a result of motor vehicle accidents of Brentford and Chiswick citizens,, and there were fewer deaths caused by motor vehicle accidents within the Borough Although there was a rise in the total number of infectious disease notifications this was entirely due to the increase in measles of a comparatively mild type and a rise in the number of whooping cough cases The scarlet fever figure was nearly halved There was no outbreak of dysentery or food poisoning, a few scattered cases occurring Although eleven cases of poliomyelitis were notified, five only of these suffered some paralysis of whom two recovered completely and three were continuing to make good progress at the end of the year. The fact that the figures for immunisation against diphtheria and vaccination against small pox are still falling gives rise for concern, especially when it can be estimated that the protection of children under 15 would appear now to have fallen below the safety margin which has always been estimated at 75% of the total child population immunised If parents could realise that there were still four deaths from diphtheria in the Greater London area during 1955 it might bring home to them the risks they are running with the lives of their children. Although the figures for notifications of tuberculosis did not show the same considerable drop as in 1954, there was no increase in the number of cases. There were, however, three more deaths For the first time it is possible to state at the end of a year that no person known to be in need of admission to hospital or sanatorium for the treatment of tuberculosis was required to go on a waiting list because of the lack of bed space 7 In accordance with the directive in the Housing Repairs and Rents Act, 1954, a survey was made of the slums in the Borough and a report made to the Minister of Housing and Local Government. The problem of demolishing unfit houses, though not a vast one in this Borough as in other parts of the country, is still a very difficult one as for every family whose house is demolished another house must be found, so that with a limited programme of house building due to shortage of land, the needs of families on the housing waiting list, perhaps living in overcrowded conditions though not in slums, must be balanced against the needs of the families who are to be rendered homeless by demolition of slums: nevertheless as will be seen from the report, progress was made during the year with the implementation of the slum clearance programme. The observations on atmospheric pollution at both ends of the Borough which have been continuous now for a number of years gave an indication that in 1955 the amount of atmospheric pollution within the Borough had increased. Individual offenders in this respect were kept under observation and major improvements in two industrial premises were carried out, yet the figures continued to be less satisfactory than in 1954, An increased amount of information concerning the Welfare Services carried on by both statutory and voluntary bodies within the Borough has been collected and is included in this report. It is particularly interesting to be able to report the popularity of the Meals on Wheels Service. This success unfortunately brings in its train difficulties with regard to the supplying of all who need the service and it was necessary to report that the waiting list was growing very large by the end of the year. Noteworthy also was the opening of a club which old people could if they wished use daily and which offered bright premises, refreshments, social occasions and individual advice and help. This should be an important piece of preventive health work as it may overcome the feelings of loneliness and uselessness which often lead to deterioration in the minds and bodies of people who have retired from an active life but have been unable to organise their leisure. 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 County Welfare 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 the Invalid Kitchens of London the local Medical Practitioners, the Manager of the local Labour Exchange, and Chief Officers of the Council In conclusion I should like to thank the Chief Sanitary Inspector and all the members of the Public Health Department Staff for the good work they do, not only in assisting in the preparation of this Report, but at all times. I am. Your Worship, Ladies and Gentlemen, Your obedient Servant, Margreat a. Glass Medical Officer of Health 8 STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH, 1955 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 1955) 58,750 Number of Inhabited Houses according to Rate Book 15,655 Rateable Value at 1.4.1955 £728,146 Sum produced by 1d Rate £2,950 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 In the Borough of Brentford and Chiswick the eastern half is mainly residential with a certain number of industrial buildings of the smaller type interspersed throughout, while in the western half there is a highly industrialised section chiefly situated along the Great West Road 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 to the total area of the Borough is approximately 25% a very reasonable proportion for an urban 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 dwellings vary from flatted houses and cottages to large detached residences in their own surrounding grounds. The amount of slum property is not considerable and progress is now being made with the demolition of houses which are no longer fit for human habitation. The rehousing of the tenants in council houses, details concerning assessment of slum dwellings, demolition and the building of new houses are supplied later in this Report. In the 1954 Annual Report it was possible to state that the number of known cases of overcrowding had diminished, and this can again be said in the present Report, although the number of new houses built by the Council during the year was somewhat less than in 1954 9 An interesting piece of information which was kindly supplied by the Manager of the local Labour Exchange is that at the end of December. 1955, there were 71 men and 44 women unemployed in the Borough as compared with 137 men and 71 women unemployed in the same week of December, 1954. Most of these were actually unemployed because they were changing work and the unemployment was only intermediate and short term For most of the year there were approximately 1,000 jobs vacant at any given time. 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 Meadow Sports Ground 25.7 Embankment Promenade 12.5 Future Embankment Promenade 15.3 10,4 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 1955 69,358 Average number per day 231 Maximum number using baths on one day 495 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 1955 97,516 Average number per day 629 Maximum number using baths on one day 4,163 The total attendance figures at the swimming baths increased by approximately 40% during 1955 after showing an increase the previous year The wonderful weather throughout the summer of 1955 accounts, no doubt, for the large increase in the figure for attendances at the open air pools, but it is pleasing to note that the attendances at the indoor swimming baths were also maintained on a high level. 10 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 Other Facilities in the Borough for Open Air Recreation Privately owned open spaces and sports grounds 111.71 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 Clifden Road, Brentford, the Council maintains premises containing 21 slipper baths comprising: 8 first class (male) 4 first class (female) 6 second class (male) 3 second class (female) Total number using baths 24,779 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) In addition, 2 hip baths (1 male and 1 female) particularly for the use of elderly persons were installed on 21.9.55. Total number using' baths 42,063 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 1955, 1,884 persons took advantage of the service. 11 HEALTH SERVICES PROVIDED BY OTHER AUTHORITIES North West Metropolitan Regional Hospital Board South West Middlesex Hospital Management Committee. Brentford Hospital, Chiswick Maternity Hospital and Clayponds Hospital are situated within the Borough and are administered by the South West Middlesex Hospital Management Committee under the provisions of the National Health Service Act, 1946, Brentford Hospital is a cottage type hospital staffed by general practitioners and visiting consultants and has 33 beds dealing with general medical and surgical cases, Chiswick Maternity Hospital which is an integral part of the West Middlesex Hospital has 66 maternity beds and 55 maternity cots. Clayponds Hospital has 104 staffed beds and is classified as dealing with orthopaedic, chronic, general medical and surgical cases, It is just within the Borough and is integrated with the King Edward Memorial Hospital at Ealing, The majority of the patients admitted to Clayponds come through the King Edward Memorial Hospital and the remaining patients are admitted through the West Middlesex and Central Middlesex Hospitals, A considerable number of Brentford and Chiswick people receive their Hospital treatment at the West Middlesex Hospital, Isleworth, and the majority of cases of infectious disease requiring hospital isolation are admitted to the South Middlesex Hospital, Isleworth. Chest Clinic patients residing on the north side of the Borough attend the Ealing Chest Clinic for their examinations, X-rays and out-patient treatment, and the patients from the remaining area of the Borough attend the Hounslow Chest Clinic, which is administered by the Staines Group Hospital Management Committee, County Council of Middlesex The County Council of Middlesex is the Local Health Authority under the National Health Service Act, 1946, and provides the following services in the Borough:- (a) Care of Mothers and Young Children Brentford:- Ante-Natal Clinics and Post-Natal Clinics Tuesday mornings 9.30 to 12 a.m. Infant Welfare Clinics Wednesday and Thursday afternoons 2 to 4 p.m. Diphtheria and Whooping Cough Immunisation and Vaccination Clinics Alternate Friday afternoons 2 to 4. 30 p.m. Day Nursery Portsdown House The Butts, Brentford. 12 Chiswick:- Ante-Natal Clinics and Post-Natal Clinics Tuesday and Thursday mornings 9,30 to 12 a m. Infant Welfare Clinics Tuesday, Wednesday, Thursday and Friday afternoons 2 to 4 p, m. Diphtheria and Whooping Cough Immunisation and Vaccination Clinics Monday afternoons 2 to 4.30 p.m. Priority Dental Service for expectant and nursing mothers and children under school age. (h) 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). (c) Home Nursing and Nursing Equipment: Home Nurses are employed to undertake the nursing of persons in their own homes. (This work was formerly undertaken by "District Nurses"). Where nursing equipment is required for use in the home, it is available on loan through the British Red Cross Society. Number and classification of patients visited by the Home Nurses in the Borough during the year are as follows:- Type of case Under 5 years 5 - 64 years 65 years and over Total Grand Total M F M F M F M F Medical 11 7 174 266 180 331 365 604 969 Surgical 7 - 14 22 16 14 37 36 73 Infectious Disease - 1 1 4 - - 1 5 6 Tuberculosis - - 25 24 2 1 27 25 52 Maternal Complications - - - 6 - - - 6 6 Others - - - 2 1 - 1 2 3 TOTALS 18 8 214 324 199 346 431 678 1,109 13 (d ) 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 are carried out by general practitioners who participate in the County Council's scheme (e) Mental Health Service: The County Mental Health Service deals with persons suffering from mental deficiency or mental illness, There is a Divisional Office at the County Offices Great West Road„ Brentford (EALing I801), 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 fourth Tuesday of each month from 2 to 4 p.m. ({) School Health Service: The County Council is also the authority responsible for providing the school health service under the provisions of the Education Act, Medical inspection and dental inspection of school children is arranged by the County Council through the Divisional Executive. Medical and dental treatment is provided by the County Council in the Borough at the following clinics:- Minor Ailment Clinic (Chiswick) Monday to Saturday 9 to 10 a.m. Monday 9.30 to 12 a.m. with doctor., Minor Ailment Clinic (Brentford) Monday to Saturday 9 to 10 am Thursday 9.30 to 12 a. m. with doctor. Orthopaedic Treatment Clinic (Brentford) With Surgeon - every first and third Monday in each month from 2 to 4 p.m. Ophthalmic Clinic (Brentford) Tuesday and Friday 9.30 to 12 a.m. Physiotherapy Treatment Clinic (Brentford) Monday Wednesday and Thursday 9 a.m. to 4.30 p.m. Speech Clinic (Brentford) Wednesday 9 a.m. to 12 a.m. 1.30 to 4 30 p.m Speech Clinic (Chiswick) Tuesday 9 a.m. to 12 a.m. 1.30 to 4.30 p.m. Thursday 1.30 to 4.30 p.m. 14 Dental Clinic (Brentford and Chiswick) By appointment Ultra-Violet Light Treatment Clinic Monday and Thursday 9 to 10 a.m. (Brentford) (Winter months only) (g ) 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„ (h ) 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., (i) 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 aged or a child not over compulsory school age, is provided under the County Council's scheme, (j ) Ambulance Service The County Ambulance Service is provided for the removal to hospital„ where necessary, of accident and sickness cases, This service is combined with the County Fire Service. (k) Chiropody Service: Old Age Pensioners are referred to private chiropodists. An assessment scheme is in operation. Number of persons treated during the year - 137 (including 29 new cases) Total attendances at Chiropodists - 771 Queen Charlotte's & Chelsea Hospitals Board Midwives are employed for attendance on women in their homes in the Borough as midwives or as maternity nurses during childbirth. 15 VITAL STATISTICS, 1955 Live Births Total Male Female Legitimate 728 371 357 Birth Rate per 1,000 of the estimated resident population- 13.41 Illegitimate 60 36 24 TOTAL 788 407 381 Stillbirths Total Male Female Legitimate 16 10 6 Rate per 1,000 total (live and still) Births -22.33 Illegitimate 2 - 2 TOTAL 18 10 8 Deaths Total Male Female 641 315 326 Death Rate per 1,000 of the estimated resident population- 10.91 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 10 5 5 Illegitimate - - - TOTAL 10 5 5 16 Deaths and Death Rate A fall in the death rate occurred in 1955, the figure for this year being 10.91 as compared with 11.17 in 1954. This however was not the lowest death rate recorded in the Borough, since in 1953 the figure was 10.16, When the totals of deaths are studied it can be seen that this fall occurred only amongst males, there being a very slight increase in the total number of female deaths. The principal causes of death were:- 1955 1954 19 53 1952 Circulatory Disease 206 205 173 217 Heart Disease 96 98 100 113 Cancer 136 159 119 128 Prom this it will be seen that there was a considerable reduction in the numbers dying from cancer, but a rise of one in the deaths from circulatory diseases, Included in the figure of 206 for circulatory diseases is one for coronary disease, and this in 1955 amounted to 98, as compared with 80 for the previous year (see Table I on page 57), How much of the incidence of coronary disease could be eliminated by a slower pace of living is still a matter for medical research, but the fact that one-third of these deaths occur between the ages of 40 and 65 in the late middle of life, when possibly older people, particularly during their working hours,, may be trying to carry out much more than they are physically able to do, is noteworthy and to be taken into account. Also it might be noteworthy that this figure for coronary disease rose so steeply during a year when weather temperatures remained very high for a long period of the summer. The distribution of cancer deaths in sites and ages is shown below, and it can be seen from these figures that the number of deaths from lung cancer is slightly lower than in the previous year and that there is a very high increase in the number of cancer patients dying from intestinal forms of the disease, The widespread incidence of chronic constipation and the irritation caused to the intestinal tissues from this condition may be of importance with regard to this figure. Statistics concerning constipation are of course non-existent but every medical practitioner is aware that this has become a very inportant feature of modern life, and there seems little doubt that the use of refrigerated, dehydrated and other types of unnatural foodstuffs have played a part in the formation of this habit with its concomitant evil, the need for taking constant irritant 1axative or purgative drugs. Site of Primary Growth Male Female 19 55 1954 1955 1954 Stomach 12 14 9 11 Lung, Bronchus 29 30 5 6 Breast - - 12 15 Uterus - - 3 2 Intestinal 13 1 15 5 Prostate 2 10 - - Bladder 3 1 1 2 Brain 2 - 4 1 Other 14 28 12 32 Totals 75 84 61 74 17 Age Groups Male Female 1955 1954 1955 1954 Between 10 15 years 1 - - - " 15-20 1 1 - - " 20-25 - - - - " 25 - 30 " - 1 1 1 " 30-35 " - - - 1 " 35 - 40 " - 3 - - " 40-45 " 4 5 5 4 " 45-50 " 3 4 1 2 " 50-55 " 7 6 3 4 " 55-60 5 12 7 11 " 60-65 " 6 11 7 11 " 65-70 " 18 11 4 8 " 70-75 11 13 14 14 " 75-80 " 12 10 7 8 " 80 - 85 " 4 5 5 4 " 85 - 90 " 3 2 5 4 " 90 - 95 " - - 2 2 Totals 75 84 61 74 There were no maternal deaths The fall in the number of deaths from tuberculosis did not occur again during 1955 there being a slight increase from 4 the previous year to 7 in 1955. 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 1955 5 2 7 The total number of deaths from violent causes since 1950 is as follows 1955 1954 1953 1952 1951 1950 27 27 17 21 23 28 Five residents died through involvement in road accidents The ages at death of these cases were:- Males 28, 6 Females 74, 64, 48. 3 of these died as a result of accidents within the Borough In all, 5 persons, including residents of other places died as a result of road accidents occurring in Brentford and Chiswick 1 motor-cyclist, 2 pedal cyclists and 2 pedestrians. Each of these accidents occurred on a different main road of the Borough. 18 Death Rate of all infants per 1,000 live births 12.69 Death Rate of all legitimate infants per 1,000 legitimate live births 13.74 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 (all ages) 136 Deaths from Tuberculosis (all ages) 7 The local Death Rate, 10.91, is lower that the figure of 11.7, 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. Birth Rate The Birth Rate showed a slight fall from 13 57 in 1954 to 13.41 in 1955 This compares with a National Birth Rate figure of 15,0. INFANT MORTALITY During 1955, the number of births recorded was 788: 728 legitimate and 60 illegitimate. There were 10 deaths of infants under 1 year of age, as compared with 21 in 1954, giving an infant mortality rate of 12 69 for 1955, the lowest infant mortality rate ever recorded in the Borough, The local figure compares with an infant mortality rate of 24 9 for England and Wales. The graph on page 20 shows the progress of Infant Mortality since the beginning of the century. The number of premature infants born in 1955 was 56, including premature stillbirths, Of the 47 premature infants born alive, 4 were born at home, of whom 3 survived to the end of one month. 43 were born in hospital, of whom 37 survived to the end of one month. The percentage of premature infants to total births (live and still) is 6.9 This figure has been rising gradually as can be seen by the following figures:- 1950 1951 1952 1953 1954 1955 3.3 4.5 5.6 4.9 6.0 6.9 Causes of infants deaths are shown in Table II on page 58. 19 GRAPH "A" GRAPH SHOWING INFANTILE MORTALITY RATES DURING THE PERIOD 1900 - 1955 20 MATERNAL MORTALITY AND MORBIDITY Deaths from Puerperal Causes:- Puerperal Sepsis Nil Other Causes Nil 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 1946 - 3 1947 - 1 1948 - - 1949 - - 1950 - - 1951 - - 1952 - 1 1953 - - 1954 - - 1955 - - During the year 6 cases of puerperal pyrexia were notified, as compared with 3 in 1954. Two 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". 21 PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES 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 15,534 Secondary Modern Schools. 4,650 20,184 Number of children requiring treatment 131 Number of children in respect of whom cleansing notices were issued 87 Number of children cleansed by Local Health Authority 37 There was an increase of 529 in the total number of cleanliness inspections but a decrease in the number of children who had become infested with head lice, from 144 in 1954 to 131 in 1955. Although this figure is less for the year, the findings are still not to be considered very satisfactory since the number requiring compulsory cleansing rose from 29 to 37 after rising in the previous year also. By arrangement with the Medical Officer of Health of Hammersmith, persons requiring cleansing because of infestation with scabies or vermin, can be treated at the Hammersmith Cleansing Station. During 1955, five persons were referred for cleansing, all for verminous infestation, Four of these cases were cleared quickly, but one, who lived in an Institution, was found to be repeatedly re-infested, and required cleansing on five separate occasions. This is the largest number of persons in the Borough for many years to require treatment for verminous infestation. INFECTIOUS DISEASE In the year 1955, there was a marked increase in the incidence of infectious disease. This was due solely to the rise in measles notifications. Measles is a disease showing a marked biennial fluctuation and the current year was the year of the crest 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. 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 188 438 335 511 269 863 413 810 47 659 22 Poliomyelitis 11 notifications of poliomyelitis were received during the year, and 5 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 9 years still shows some residual paralysis of right leg,, the condition must be considered as stationary. Cases notified in 1950: CASE A- An adult male patient - condition stationary. Wears an instrument to control his drop foot, and suffers from circulatory disturbances, such as chilblains. Otherwise he is fit to continue his work as a lorry driver. CASE B- An adult female patient - partial paralysis of left biceps - very little limitation of power and movement Condition appears to be stationary. CASE C- A boy now 14 years of age = paralysis of right leg -• still partial paralysis. Condition appears to be stationary. Cases notified in 1951: No paralytic poliomyelitis occurred in 1951. Cases notified in 1952: CASE D- A boy now 8 years of age - severe case - paralysis of both upper and lower limbs. Now shows slight weakness of the right leg and some wasting of the muscles of the right thumb, but making some progress still with little limitation of power and movement. CASE H- A boy now 4 years of age - paralysis of left arm and shoulder, Some wasting of the muscles remains, but slight progress continues. CASE J- Adult female - paralysis of both arms and spine. Fully recovered Cases notified in 1953? CASE L- Adult male who left the district, but who was practically fully recovered in 1954. Cases notified in 1954: CASE M- Girl now aged 9 years - paralysis of right leg - condition improving. Still some slight weakness. CASE 0- Boy now aged 12 years - bulbar poliomyelitis. Slight weakness of palate remained, now fully recovered. Cases notified in 1955: CASE P- Girl aged 5 years - paralysis of right leg. Discharged from hospital with paralysis remaining. Has attended Hammersmith Hospital for physiotherapy. No calipers or special boots required, and making some progress continually - now back at school. 23 CASE Q-Boy aged 10 years - paralysis of chest muscles and of limbs. Respirator case. Left with much weakness in limbs and back. Transferred to Heatherwood Hospital, Ascot for orthopaedic treatment. Making good progress. CASE R- Boy aged 4 years - paralysis of both legs Had physiotherapy at Heatherwood Hospital, Ascot. Has completely recovered though still under observation. CASE S-Female aged 18 years - paralysis of palate and left shoulder, right sterno-mastoid left hip and left thigh. Having physiotherapy at West Middlesex Hospital Condition improving CASE T-Adult male - paralysis of right arm and leg Fully recovered with complete power and movement, although still under observation. Confirmed cases Died Still making progress Condition stationary Fully recovered 1949 4 - - 1 3 1950 9 - - 3 6 1951 - - - - - 1952 9 2 2 - 5 1953 6 1 1 * - 4 1954 3 - 1 - 2 1955 5 - 3 - 2 * Now left district. It can be seen from these figures that of 36 confirmed cases of paralytic poliomyelitis occurring during the past 7 years, 22 have made a complete recovery with full power and normal movement of all muscles. Smallpox During the year five contacts of suspected smallpox cases were notified to this Department from various sources. The contacts were followed up, but no sickness developed. Vaccination against Smallpox The following information regarding vaccinations against smallpox carried out in the Borough during 1955 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 IS & Over vaccinated for first time 375 5 12 10 36 438 re-vaccinated - 1 5 10 87 103 Total 375 6 17 20 123 541 Total number of first vaccinations:- 1951 1952 1953 1954 1955 298 373 548 487 438 It will be noted that 375 children under 1 year of age were vaccinated out of 788 born during the year, i.e, 47.5%. This is a slight decrease from last year when the figure was 50%, The figure for 1953 was 55%, Scarlet Fever A Considerable fall in the number of cases of scarlet "fever, is to be seen, the figures being 48 in 1955, as compared with 95 in 1954, 24 cases were admitted to hospital and the disease did not appear to be.severe in type. In 3 instances a second case occurred in the household in which a previous case had been notified. Diphtheria One case of diphtheria was notified during the year, but was subsequently not confirmed. The last confirmed case of diphtheria in the Borough was in 1948. Information concerning immunisation against diphtheria in the Borough during 1955 has been supplied by the County Medical Officer, and is as follows:- Number of children who Age Total Under 1 1 2-4 5-14 completed a full course of primary immunisation 332 95 27 9 463 received reinforcing injections - - 183 167 350 -25- Number of children at 31 12 55 who had completed a course of diphtheria immunisation at any time before that date (i.e„ at any time since 1.1.41). Age at 31. 12. 55. i.e. born in year Under 1 1955 1-4 1954 - 51 5 - 9 1950- 46 10 - 14 1945 - 41 Total under 15 Last complete course of injectionsiwhether primary or booster) A, 1951 - 55 89 1 956 2,601 545 5,191 B, 1950 or earlier - - 936 2,182 3.118 The figures for immunisation against diphtheria are still falling The number of primary immunisations in 1955 was 463 as compared with 583 in 1954 and was 671 in 1953 It is considered that in order to prevent the risk of diphtheria again becoming a danger in the event of a case occurring the proportion of schoolchildren who should be immunised should be not less than 75%„ Figures for the number of children under 15 estimated to be living in Brentford and Chiswick at the present time are not made available by the Registrar General but taking the figure at the 1951 Census as a rough guide, i.e. a population of 11,418 children under 15 the percentage 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 is roughly 72,8 On these calculations although they are approximate only, there is reason for concern that the community protection against diphtheria is below the safety margin. It is disturbing however to note that the number of children who receive a booster dose, i„e, the dose given just before school entry to reinforce the effects of the primary immunisation., keeps to a fairly low level, although it has not fallen during the past year, being 350 in each year, A reminder that diphtheria is still a dangerous and even deadly disease occurred during 1955, for in Middlesex there was one death from this cause, in London two, and in Essex one. Following these incidents there was a great increase in the number of parents bringing their children for immunisation in the districts concerned, but if a real outbreak had occurred this would have been too late to benefit the non-immunised children, In the whole of England and Wales there were nine fatal cases of diphtheria as compared with six in 1954, Whooping Cough 50 cases of whooping cough occurred in 1955,, No deaths occurred from Whooping Cough Dysentery and Food Poisoning There was no serious outbreak of dysentery or food poisoning during the year Eight cases of gastro- enteritis were notified as food poisoning They were all single cases,, The organism identified in four of these cases was Salmonella typhi-murium and the infection had been caused by personal contact during the course of a large outbreak of food poisoning due to Salmonella -26- typhi-murium in a factory in a neighbouring Borough In the other four cases no causal agent or infecting organism could be traced Twelve persons were notified as suffering from dysentery, of these two were not confirmed Ten were found to be suffering from bacteriological dysentery, in nine instances the organism being confirmed as Shigella sonnei Tuberculosis Although the figure for notifications of tuberculosis was in total identical with that for the previous year, i, e, 94, there was a fall in the number of pulmonary cases notified, from 90 in 1954 to 85 in 1955, A slight rise has occurred in the number of deaths from this disease, 7 persons having died from tuberculosis during 1955 as compared with 4 in 1954 It will be seen from Table IX that there have been no deaths from non respiratory tuberculosis since 1952. The figures, in spite of the slight rise in the number of deaths, seem to show a slow steady improvement in the situation with regard to pulmonary tuberculosis as a whole* Prom the note attached to Table VIII it will be seen that one death from tuberculosis occurred in a non notified case Although this is the first time that only one of these non-notified deaths has been observed (in previous years this number has been greater), it is not good to find that a patient can still carry active tuberculosis till the time of his death without it having been discovered. It is hoped that the widespread use of the Mass X~ray service will gradually eliminate this possibility since one undiscovered case of tuber-culosis can do a very great deal of damage amongst friends and relations and even casual contacts Facilities for diagnosis and treatment of pulmonary tuberculosis as well as prevention and after care are provided by the Hounslow Chest Clinic, and home visiting is carried out by Health Visitors attached to this Clinic, They are also responsible for the examination of contacts and for the B C G inoculation for the prevention of tuberculosis B C G inoculation is now offered to all the Mantoux negative, L e, susceptible, contacts of newly discovered tuberculosis cases: 42 residing in this Borough were inoculated during 1955, A prominent part in the treatment is played by domiciliary chemo-therapy (i.e. treatment with suitable drugs or injections given at home) on the recom mendation of the Chest Physician with the aid of the Home Nurses (formerly District Nurses) provided by the Middlesex County Council Apart from institutional treatment provided by the local Hospital Management Committees of the North West Metropolitan Regional Hospital Board in General Hospitals and in Chest Hospitals, there is also a Middlesex County Council Hostel for chronic ambulant male tuberculous patients. It was stated in the Annual Report for 1954 that the admission waiting list for hospital or sanatorium treatment was falling and indeed had reached the figure of 29, It is particularly pleasing to be able now to report that at the end of 1955 there was no waiting list for hospital or sanatorium treatment, and the modest hope expressed in the 1954 Report that the day might be reached when there would be more institutional beds for this disease than patients to fill them, seems to have been fulfilled in a very short time Facilities for convalescence, rehabilitation and training are provided by the Middlesex County Council and the North West Metropolitan Regional Hospital Board. The social side of the treatment and prevention of pulmonary tuberculosis is dealt with by the Welfare Department of the Hounslow Chest Clinic -27- Tuberculosis Vaccines Clinical Trial A report concerning this piece of research, which has been in progress during the last few years, has now been received Young people from Brentford and Chiswick took part in this trial The results have been so satisfactory that B.C.G. (Bacillus Calmette-Guerin) vaccination must now be considered a useful feature of preventive medicine, The details of the report sent by Dr, Pollock of the Medical Research Council' are as follows "During the last few years the Medical Research Council have been engaged in an extensive investigation to determine whether two tuberculosis vaccines are sufficiently valuable to be used on a mass scale in this country for the prevention of tuberculosis 22 North London boroughs, (including Brentford and Chiswick), and also areas in the Midlands and the North of England are taking part„ The vaccines used in the investigation are B.C,G. vaccine which was introduced more than 30 years ago, and a more recent introduction Vole vaccine Although B, C. G vaccine has been used for many years in Scandinavian and other countries, it has been difficult to assess its value Death rates from tuberculosis have been reduced in countries where the vaccine has been widely used, but this decline has been influenced by such things as better housing, better nutrition, and advances in the treatment of tuberculosis. Also, equally good results in the prevention of tuberculosis appear to have been achieved in some communities where the vaccine was not widely used. Thus,, to assess the contribution which the vaccine would make to the prevention of tuberculosis it has been necessary to undertake a clinical trial Between September, 1950, and December, 1952, school children in their last term at Secondary Modern Schools were invited to take part in this clinical trial. Those who joined were X-rayed and skin tested, and a proportion of the selected susceptible children were given either B C. G. Vaccine or Vole Vaccine. Approximately 60,000 young people joined the scheme, of whom roughly 100 came from Brentford and Chiswick Since then,it has been essential to keep in touch with the participants to determine if the vaccines were preventing the disease. This has been done by postal enquiries home visits by Health Visitors and regular X-rays In addition much assistance has been given by the chest clinics and hospitals in the areas concerned. The follow-up has so far been very successful. Over 80% of the postal forms have been returned, and more than 95% of the homes regularly visited. Approximately 75% of the young people have taken advantage of the regular X-rays. As a result of this intensive follow-up the investigation has already shown that both vaccines confer a substantial degree of protection in adolescents at least for four years after being given. It is now likely that tuberculosis vaccination will soon be offered to all young people in their final term at school in Britain, and that tuberculosis in young people will be considerably reduced as a result. The investigation is being continued and it is hoped to find out by continuing to keep in touch with the participants how long protection from the vaccine now lasts, as well as other information which will help to prevent tuberculosis. The co-operation of all concerned has been an important feature of the investi ^.tion, It is hoped to continue this co-operation during the next few years " -28- GRAPH "B" GRAPH OF CASES NOTIFIED AND DEATHS FROM TUBERCULOSIS DURING THE PERIOD 1935 - 1955 HOUSING CONDITIONS OF CASES OF TUBERCULOSIS NOTIFIED DURING 1955 The housing conditions of 86 of the 94 new cases of tuberculosis were found to be as follows: - 84 patients lived in sufficiently satisfactory housing accommodation, 36 in flats, 23 in houses, 23 in lodgings or furnished rooms, 1 in an institution and 1 in a prefabricated house. In 2 cases there was overcrowding,, The housing particulars of 8 cases were not obtainable either because of removal of patients to other districts or because of resistance of patients to home visiting, 14 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 one house, 1 of them being submitted in 1955 38 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 1954 3 1 1953 7 - 1952 1 1 1951 3 1 1950 3 2 FOOD CONTROL NUMBER AND TYPE OF FOOD PREMISES IN THE BOROUGH Bakers and Confectioners 23 Butchers 39 Club Canteens 30 Confectioners (Sweets) 85 Cafes, Restaurants, Dining Rooms & Snack Bars 143 Factory and Staff Canteens . 63 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 Total 660 -30- REGISTERED PREMISES Ice Cream During the year 46 samples were taken for bacteriological examination. The results of these examinations are as follows Grade I 19 Grade II 3 Grade III 10 Grade IV 3 Not Graded 7 3 Lollycreams were examined, 2 were satisfactory and 1 doubtful. In addition to the above, 1 Strawberry Puree was examined and found satisfactory. No cases occurred during the year of ice cream being in such poor bacteriological condition as to necessitate the stoppage of sale, but the results obtained from this year's sampling suggest that vigilance is still required to maintain the purity of the ice cream supplied for public consumption. The sampling results in 1955 are not so satisfactory as in 1954, and it was found necessary to pay several visits to one premises to suggest possible improvements in the methods of handling and distribution in order to obtain purer samples. The reason that a certain number of the specimens are reported as nongraded is usually because grading of coloured ice cream and chocolate ice cream by the methylene blue test is not a very reliable one. The result of the bacteriological plate count combined with knowledge of the nature of the organisms found in these particular types of ice cream preparations is the basis from which deductions can be drawn, The total number of samples tested by the laboratory during the year was rather low, This was because we had been asked to reduce the number to a minimum whilst alteration work was being carried out at the laboratory premises in Ealing, and although the laboratory staff were prepared always to deal with special samples in the case of emergency requirements, we were expected to reduce the number of routine samples,, Pour new premises were registered during the year in accordance with Section 14, Pood & 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 174 Manufacture and Sale 4 Storage only 1 179 -31- Preserved Foods The total number of premises registered in connection with the manufacture and/or preparation of preserved foods under Section 14 of the Food & Drugs Act, 1938, is 41 shown as under:- 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 183. CATERING ESTABLISHMENTS Thirty-three visits were made to catering establishments during the year and in no case was it necessary to serve a notice, FOOD COMPLAINTS During the year 10 cases concerning food alleged to be unsound were received in the Department. Eight cases were substantiated, the details of which are as follows:- Complaint Action taken Foreign matter in loaf Warning letter Bristle in butter Warning letter Foreign matter in milk bottle Warning letter Mouldy pie Court action - £5 fine and £3, 3s. Od. costs Mouldy wrapped loaf Warning letter Grub or maggot in block of chocolate Warning letter Hair in biscuit Warning letter Maggats in packet of currants Warning letter FOOD SAMPLING Food & 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:- -32- Article Total Samples Unsatisfactory Procured Milk 45 - Butter 16 - Cakes 5 - Cheese 4 - Cooked Meats 2 - Cream 10 1 Currants 1 1 Drugs 21 - Pish 9 - Flour 1 - Fruit Drink 1 - Fruit Juice 1 - Ground Nut Oil 1 - Ice Cream 10 2 Lard 1 - Liver 4 - Marzipan 2 - Minced Meat 3 - Onion and Parsley Sauce 2 - Peas 1 - Sausage Meat 1 - Sweets 1 - Tomato Ketchup 1 - Victoria Plums 5 - Vinegar 3 - White Pepper 1 - Wines and Spirits 17 - Totals 169 4 The total number of samples taken was down from 193 in 1954 to 169 in 1955, but the finding of only 4 unsatisfactory samples was the lowest yet recorded The following are the details from the Chief Officer's report on the unsatisfactory samples:- "Cream. This was a sample described as "Imitation Whipped Cream made with pure Butter", The sample was found to contain only a small amount of butterfat and a letter of caution was sent to the manufacturers. Currants. This fruit contained maggot's and the matter was dealt with by a warning letter from the Brentford & Chiswick Council (see page 32). Ice Cream. Two samples of ice cream, procured from the same vendor, were found to be deficient in fat, A caution was issued, Merchandise Marks Acts, 1887 - 1926 116 inspections of shops were undertaken to ensure that the Marking Orders relating to certain imported foodstuffs made under the Merchandise Marks Act, 1926 were complied with, 686 separate displays of meat, apples, tomatoes, poultry, dried fruit were examined. Verbal cautions were given in respect of minor infringements not being found so serious as to warrant more stringent action. -33- The Labelling of Food Order, 1953 This Order requires that in general pre-packed foods shall bear on the label a clear statement of the designation of the food and, in the case of compound foods, the ingredients,, It also requires that the name and address of the packer or labeller appears At 51 premises 262 articles of pre-packed food were examined, No proceedings were taken but in respect of infringements found see paragraph "False or Misleading Descriptions" below. False or Misleading Descriptions In addition to the foregoing activities which arise specifically from inspections in Brentford and Chiswick, a considerable amount of work has been done for the benefit of all districts of Middlesex equally in scrutinising advertisements and the labels of pre-packed foods and correcting false or misleading descriptions or errors in statement of composition found therein. Corrective action during the year in question included biscuits, confectionery spirits, sausages in brine, cereals, fruit squashes, margarine, ginger wine imitation cream, liver puree,, iced lollies, cheese spreads, tinned fruit and vegetables. Special Designated Milk No licences are issued by Middlesex County Council in respect of Dealers/ Pasteurisers or Dealers/Sterilisers in Brentford and Chiswick, Two samples of special designated milk were taken from roundsmen in the Borough during the year and submitted to examination, They proved satisfactory," MEAT AND OTHER FOODS During the year under review a total of 6 pigs were slaughtered in the Borough. These were all slaughtered under Licences issued by the Ministry of Food, were inspected at the time of slaughter and were all found to be in good condition and passed fit for human consumption, (Table XII) No beasts or sheep were slaughtered in the Borough during the year FOOD CONDEMNED DURING THE YEAR, 1955 Fruit and Vegetables tons Fish 17 stone Meat and Bacon 11½ cwts Perishable Goods 12 cwts Tinned Foods 3,390 tins There was an abnormal rise in the amount of fruit and vegetables requiring to be condemned the figures having risen from less than 1 ton in 1954 to 8 tons in 1955, The chief items in this large figure, are one of tons of tomatoes,, and one of 4% tons of apples and pears These were imported foodstuffs and the reason for their poor state on delivery was that there was delay in the docks owing to strike conditions prevailing there, -34- SLAUGHTERHOUSES Number on the Register (including one Knacker's Yard) 2 Contravention of Bye-laws Slaughter of Animals Acts 1933 to 1954, Number of Licences to Slaughter Animals issued during the year:- New Licences Renewed Licences 3 MILK During 1955, the following licences were issued under the Regulations mentioned:- Milk (Special Designation)(Pasteurised & Sterilised Milk) Regulations, 1949 to 1953., Dealer's Licences 54 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 9 Contraventions of Pood & 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 control 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 maintenance of good sanitation and the avoidance of nuisances, and also to ascertain that the market is free from rodent infestation 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 -35- HEALTH EDUCATION The work of educating the public in the matters of health, hygiene, and sensible living continued normally throughout the year,, There were no massive campaigns on any particular subject,, but on every occasion when members of the staff visited factories houses or catering establishments canteens or food shops, a few words on some special item of hygiene would be spoken, and each talk to youth groups voluntary associations church meetings etc was treated as an opportunity for health propaganda Film strips were used in combination with talks and in addition poster publicity was used in sequence during the year, fresh posters being displayed on the subject topical to the appropriate season , A conference was held in London by the National Association for the Prevention of Tuberculosis during the year, and speakers from all parts of the world took part in this, It was felt that preventive measures had played a great part in the decline in tuberculosis, reduction of which seems to be going on in all parts of the world where preventive measures are well carried out, The only places where tuberculosis is still a disease increasing in intensity and severity appear to be where the population is backward or preventive measures are made difficult because of overcrowding or the sheer mechanical difficulty of obtaining proper sanitation and where the Mass X Ray unit as a means of diagnosis has not yet been developed. Of the preventive measures it was considered that not least among them was the continuous health education of the public, in personal hygiene and the method of the transference of the disease, It was said by more than one speaker that health education, as part of the treatment of a patient discovered to be positive, was so effective that very often the infectious case of tuberculosis was very much less likely to infect a member of his family or member of the public with any germs of his, because cleanliness and personal hygiene had become part of his daily life and automatic, HOME ACCIDENTS In 1955, 16 persons died from accidental causes other than motor vehicle injuries, and, while it is not known what proportion of these were preventable, it can be assumed that quite a large number of them were, This figure for accidental deaths is higher than in 1954 and it can be assumed that for the number of persons who died as a result of injury caused by accident there would be a very much higher proportion of persons who suffered accidents ofamajor character and a still higher proportion of minor accidents, A few cases of Home Accident occurrence were notified to the Department during the year and the details of these are as follows - Adult Female, aged 35 years - Scald to forearm due to steam. Girl, aged 3½ years - Poisoned by drinking disinfectant. Adult Female aged 35 years - Cuts and bruises caused by the breaking and falling of a clothes pulley Adult Female, aged 25 years - Fall due to tripping over badly laid linoleum, -36- Boy, ages 4½ months Burns on fingers from grasping hot iron„ Girl, aged 1½ years - Severe burns pulled kettle of boiling water over herself. Girl, aged 1 year Fractured skull from fall. Girl, aged 4 years - Scald of hand; pulled kettle of boiling water on herself, Girl, aged 1 year - Scald; pulled cup of hot milk over hersel f. In each of these instances the accident would have been easily preventable as the secondary cause was obviously carelessness or haste. There is no question of faulty equipment or unavoidable faults to be seen amongst these cases, and it seems that propaganda for home safety must be directed and very steadily maintained to warn against the carelessness of the adult human being especially when responsible for the safety of young children WELFARE OLD PEOPLE During 1955, 18 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 the 18 cases are as follows:- Removed to Hospital 5 Removed to Old People's Home . 2 Remained at home with Home Help assistance and meals 1 Remained at home with meals only 3 Remained at home with district nursing assistance 1 Remained at home - no help required 3 Remained at home - refused all help although help desirable 1 Died at home 2 During the year a total of 284 aged persons or aged chronic sick persons in the Borough received help from the Home Help Service, and the Home Nurses dealt with 545 old people out of a total of 1,109 cases. These figures compare with 264 aged persons receiving help from the Home Help Service in 1954, and 483 old persons being visited by the Nurses out of a total of 1,060 cases. As has been noted already on page 11, during the year a special provision for old persons was made at the Public Baths in Chiswick by the provision of two hip baths. -37- Total number of persons admitted to old people's homes during 1955 was 22 19 to County Council Homes 3 to Homes provided by Voluntary Organisations Chiropody A service was maintained throughout the year by the Middlesex County Council whereby old people could have their foot defects treated at reduced cost or free of charge. Figures of the numbers taking advantage of this Service can be found on page 15, Old Folks Friendship Club This is a specially built club house opened in April, 1955, for the use of old age pensioners living in Brentford and Chiswick as a social and recreational centre. The club is open Monday to Friday, and there is a full-time organiser in attendance. The old people are enrolled as members at their first attendance, membership costs only one penny per week, and there are about 400 names on the register. The members can visit for rest room or reading room facilities, or just to meet their friends and talk, but many social occasions are provided for them in the way of concerts, whist drives, etc. A television set is installed in the lounge, and a radiogram in the concert hall. Light refreshments are available morning and afternoon Through this club the members are also able to obtain information about the special services at reduced rates which are available within the Borough for them, such as laundry,shoe repairs and hairdressing, and they can be given advice on any difficulties that occur in their private lives. This is the only club premises open daily for the use of old age pensioners but there are 9 clubs meeting in different parts of the Borough once a week to which mobile old age pensioners become attached as members for social and recreational purposes. Slipper Baths Under the scheme for the provision at the reduced rates (2d, per bath) of slipper baths for old people at the Public Baths Establishments, 1,926 baths were taken in Chiswick and 671 in Brentford, These figures show again a slight increase over those for the previous year. Meals on Wheels The new service of meals provided by the Invalid Kitchens of London has proved immensely useful and very popular. These meals are provided on 5 days per week and special diets can be arranged for, i.e. in the case of old people suffering from gastric ulcers, diabetes, etc. The cost of the meal to the old age pensioner receiving it is tenpence and this is supplemented by a grant from the Borough Council to cover part of the remainder of the cost of the meal, overheads and transport are provided by the Invalid Kitchens of London itself by means of funds raised by voluntary effort. Persons in need of this service and eligible for it were brought to the notice of the staff of the Public Health Department and a certificate signed by the Medical Officer of Health for those who were to be authorised to receive the -38- meals. Unfortunately the number of genuinely needy cases found Increased rapidly as the service became known The main reasons for the need are incapacity following ill-health or hospital treatment lack of cooking facilities, and for old people living alone with the genuine risk of starvation by abstention from food of sufficient nourishing quality. The result was that the waiting list began to grow and by the end of the year amounted to over forty persons. During the year 10,296 meals were provided for 67 old people GENERAL The Superintendent of the local St John's Ambulance Association and the Divisional Director of the British Red Cross Society have kindly supplied information concerning their welfare work in the Borough, St. John's Ambulance Brigade (1) Attendance at sports meetings, public gatherings and entertainments to render first aid if required, (2) Conveyance of patients by ambulance to supplement the County Ambulance facilities. (3) Maintenance of Comforts Depot from which supplies of medical equipment can be issued on loan, (4) The provision of instructors for classes in first aid and home nursing to Civil Defence volunteers, adult and youth groups, (5) Voluntary aid in hospital wards, male and female,, (6) Provision of nursing attendants for meetings and outings of old persons organised by the various Old People's Associations (7) Courses of lectures on first aid to factory staffs and local factory fire brigade personnel, British Red Cross Society (1) The arrangement of sessions for the taking of blood for the transfusion service, and the provision of volunteer assistants during the periods of the blood transfusion service operations, (2) Ambulance transport for the sick to supplement the County Ambulance facilities, (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 Clinic cases. -39- (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,, and to give regular blanket baths to the sick and nursing, (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. WELFARE OF THE BLIND AND PARTIALLY SIGHTED The County Council provides Welfare Services for the blind and partially sighted under the National Assistance Act, 1948 There are resident in the Borough 99 registered blind persons and 26 registered partially sighted persons Three of these are undergoing courses of training, and fourteen are in employment. The majority of the blind however, are not available for, or not capable of, training and employment owing to age or infirmity or for some other reason The County Council's Home Teacher of the Blind carries out regular domiciliary visiting, and the object of the service is to enable every blind person to lead as full and active a life as this handicap allows„ The Home Teacher's duties include the rehabilitation in their own homes of the newly blind, helping them to regain their independence and mobility in the house and neighbourhood and to perform the common daily tasks such as dressing etc, and simple household duties She also teaches Braille and Moon methods of reading to those who wish to learn, and 13 blind residents in the Borough are members of the National Library for the Blind, which Organisation receives financial support from the County Council. A handcraft classisheld fortnightly at the Area Welfare Office, 14a,Sutton Court Road, Chiswick,, and this is attended by about twelve persons. A weekly class in ballroom old time dancing is held in Ealing, and is attended by some of the blind residents of the Borough, The County Council works in close touch with Voluntary Organisations, including the Club for the Blind which meets fortnightly at the Christ Church Hall, Turnham Green, and the Middlesex Association for the Blind, who maintain a Holiday Home at Littlehampton and two Residential Homes as well as assisting financially, and by way of gifts individual necessitous blind persons -40 - WELFARE OF HANDICAPPED PERSONS OTHER THAN BLIND The Welfare Department is also responsible for operating, under the National Assistance Act, 1948,, schemes for the welfare of handicapped persons other than blind These include the deaf and dumb hard of hearing and the generally handicapped (cripples, etc.). Services to the deaf and dumb and the hard of hearing are provided by appropriate voluntary organisations, to whom the County Council makes grants in aid A Welfare Visitor for other persons who are substantially and permanently handicapped is employed in the Borough and she works under the direction of the Area Welfare Officer. She visits disabled persons in their own homes, the aim being to assist them to obtain such facilities as may be beneficial to them and available from statutory or voluntary sources, The help afforded from one source or the other or sometimes from a combination of both may enable the person to take part in social activities, to attend a handcraft class,, or, as may be necessary to obtain suitable appliances, or certain alterations and adaptations to houses (e, g, ramps for invalid chair cases, or handrails), or to take a needed ho liday, Advice and guidance on personal problems is given and membership of a voluntary organisation catering for the particular handicap may be facilitated. Residents of the Borough needing the County Welfare Services referred to should apply to the Area Welfare Officer, Mr. H. S. Wright at the Local County Offices Great West Road, Brentford ATMOSPHERIC POLLUTION The two stations set up for the measurement of smoke and sulphur dioxide in the atmosphere by the volumetric method, continued to function throughout the year. 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 is to be found in Table XIII at the end of the book, and in Graph 'C' which has been prepared from these figures. As will be seen, for most of the year the Chiswick results both for smoke and sulphur dioxide pollution appear slightly higher than those for Brentford Since the station at Brentford is in a more highly industrialised section of the Borough than the Chiswick station, these results seemed to indicate an extra source of pollution might be looked for in Chiswick This might have been due to the fact that as this station is nearer ground level there could be additional pollution from the street during the periods of high wind and when passing traffic stirred up street dust in dry weather, The Public Health Committee agreed therefore, that a third station should be set up at second floor level in the Council buildings, and this was done, Readings were only taken from the month of August, and therefore figures for a complete year will not be available for this Report, It may be menticned, however that the first readings from the new station did not seem to justify the theory that street dust might be -41- responsible for this increase, as they still showed a higher degree of atmospheric pollution than at Brentford, A possibility is that this third station being sited with high blocks of flats on two sides, there may be a certain amount of down drift from the smoke stacks of these dwellings, which spoils the figures. The figures all over the Borough are disappointing for 1955, the high peaks in the winter being higher than during 1954 both for Brentford and for Chiswick, and the lowest levels reached in the summer period when domestic fires are little used were not nearly so good as in 1954. It was a fine hot summer, and there is no doubt that during the months of June, July and August, domestic fires must have been very limited, and therefore the findings at the stations must have been almost entirely due to industrial smoke and sulphur dioxide. It is noteworthy that on the 20th January. 1955, the highest figures yet recorded in the Borough were obtained for smoke in both Brentford and Chiswick. The day was dry, not foggy, with a south easterly wind, although there was some mist on the previous night. In order to obtain more detailed information on 'smog' (smoke and fog) occurrences, plans were made for the Fuel Research Station of the Department of Scientific and Industrial Research to be supplied with figures of two-hourly readings during any such period, The imminence of smoke and fog is reported to this Department from the Fuel Research Station at Greenwich, and following the receipt of this information, the apparatus is modified so that two-hourly readings can be taken. During 1955,, this plan was operated during the period 30th November - 1st December. 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, In 1954 it was reported that the Inspector of Alkali etc. Works of the Ministry of Housing and Local Government had following a visit in 1953, at the request of the Public Health Department again visited the Brentford Gas Works. During the year under review this Inspector again visited the Works and reported that certain plants had been overhauled or replaced by that of a more modern design. During the year 85 visits or observations were made in connection with 28 cases in which it was alleged that atmospheric pollution was taking place. Work was carried out where necessary, and advice on stoking methods given occasionally. One factory showed improvement after an extensive flue cleaning operation, and another factory converted from solid fuel to oil burning during the year. GUILTY CHIMNEYS A public meeting was arranged at which several speeches were made by The Worshipful the Mayor (Alderman R. L. Avery, J. P.) the Chairman of the Public Health Committee (Alderman Mrs. A. J. Burden), the Medical Officer of Health and the Chief Sanitary Inspector on atmospheric pollution and other health subjects. The film "Guilty Chimneys" was shown, and in addition, several films on other health topics. The meeting was attended by nearly 200 people, and much interest was shown in the matters discussed. -42- GRAPH "C" VARIATION IN AVERAGE MONTHLY CONCENTRATIONS OF SMOKE AND SULPHUR DIOXIDE IN BRENTFORD AND CHISWICK DURING 1955 -43- GRAPH "D" COMPARISON OF CONCENTRATIONS OF SMOKE IN THE AIR AT BRENTFORD, CHISWICK, CENTRAL LONDON, LEEDS AND LERWICK -44- SANITARY CIRCUMSTANCES OF THE AREA Inspections The total number of inspections and re-inspections made by the Sanitary Inspectors during the year was 6,100 The following is a summary of these inspections Inspections Reinspectins Atmospheric Pollution Stations 284 - Bakehouses 13 - Complaints 1,241 - Complaints - following up inspections - 2,199 Caravans, House-boats, etc 2 40 Catering Establishments 26 7 Drainage work. 247 447 Factories - with mechanical power. 30 36 Factories without mechanical power 2 - Food premises (excluding catering establishments) 50 37 Food premises - Inspection of unsound food 221 13 Houses - Housing Acts 183 181 Houses - Rehousing applications 13 2 Houses - Overcrowding 24 4 Ice Cream Vendors 65 26 Infectious Disease enquiries 126 28 Milk Vendors 5 1 Rats and Mice 98 85 Shops - Shops Act Inspections 22 22 Slaughterhouses 12 2 Smoke observations 85 - Vermin, insects, etc 40 10 Miscellaneous 131 40 2, 920 3,180 Action taken other than Housing Act, 1936 Cautionary or Intimation Notices served 372 Statutory Notices issued (under Public Health Acts) 69 Number of summonses served . 2 Number of Disrepair Certificates issued under the Housing Repairs and Rents Act 1954 10 Number of Revocation Certificates issued 2 -45- The following list shows the number of defects remedied during the year as a result of notices served:- Brickwork, repaired. 18 Choked drains,, unstopped 53 Chimney stacks and flues, repaired and made good 15 Ceilings, repaired and made good 98 Doors and frames, repaired 15 Dustbins, supplied 14 Dampness in walls, remedied 200 Fresh air inlets and interceptor caps etc, provided 23 Firegrates, cooking stoves, repaired or renewed 71 Floors, joists and staircases repaired or renewed 81 Gutterings repaired or renewed or cleaned out 38 Inspection covers and frames renewed 15 Leaky roofs and skylights repaired 163 Plaster to walls, repaired and made good 158 Rainwater pipes, repaired or renewed 11 Soil pipe ventilators, repaired or renewed 6 Sinks replaced - Seats to W.C. s, repaired or renewed 8 Waste water preventers, repaired or renewed - Walls and ceilings, cleansed or redecorated 7 Waste pipes, repaired or renewed 15 Window frames, sash cords, sills, repaired or renewed 141 W. Csreplaced 41 Yard Paving, repaired and made good 5 Miscellaneous items 25 TOTAL 1,221 In addition, the following drainage works were carried out during the year under the supervision of the Public Health Department:- Drains tested (smoke) 37 New soil pipe ventilators fixed 2 New interceptors fixed 1 New surface water and soil gullies fixed 2 New manholes constructed 4 Manholes reconstructed or repaired 5 Soil drainage connections repaired or relaid 29 Soil main drains repaired or, relaid 10 New W. C. s provided and fixed 17 New sinks provided and fixed. 4 New sewer connections 1 New manhole covers fixed 4 New surface water lengths fixed 1 Baths installed (new) 2 Lavatory Basins installed (new) 2 Drain ventilators fixed 1 -46- All houses in the Borough are provided with water closets, and all drain into sewers with the exception of four premises two situate in open spaces and one railway station signal box which have cesspools and one boathouse which has a septic tank Arrangements for the regular clearing of these are made with the Borough Engineer's Department of the Council. Enquiries-Outstanding Sanitary Notices During the year 820 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 Annual Report for 1954, the results of a survey of the sanitary facilities in the schools of the Borough were reported, the majority of schools being found to be up to standard or higher but improvements being required in a few. During 1955, in one of the Junior Schools reported to be deficient in sanitary and washing facilities hot water and additional wash-basins were provided in the boys' and girls' cloakrooms. At a Grammar School and a Secondary Modern Boys' School the sanitary facilities in the newly built additions became available for the use of the pupils during the year bringing these schools into a highly satisfactory condition with regard to sanitation Other minor improvements were made in an Infants" School and a further Secondary Modern School, Large improvement schemes are well under way for two of the combined Infants' and Junior Schools which were considered not to be entirely satisfactory, and it is hoped that complete new sanitary blocks will be built reasonably soon for these schools WATER SUPPLY AND WATER SERVICES The whole of the district is supplied by the Metropolitan Water Board mains. There are two wells in the Borough and the following is the position with regard to these wells:- (i) Mr, A. Knapp. 21 Grove Park Gardens - well working but used for washing purposes only Drinking water is obtained direct from mains (ii) Green's Boathouse, Riverside Lands - well working but used for washing purposes only, Drinking water is obtained direct from mains, The mains water supply is satisfactory both in quality and quantity and reports of the bacteriological and chemical analyses carried out by the Metropolitan Water Board are issued from time to time, REFUSE COLLECTION Refuse is collected once per week from each house in the Borough and is disposed of by collecting freighters to a Controlled Tip outside the Borough, -47- HOUSING HOUSING REPAIRS AND RENTS ACT, 1954 In the Annual Report for 1954, it was stated that a preliminary survey had been started in the Borough on the inspection of houses for designation as slums under the slum clearance provisions of the Housing Repairs and Rents Act, 1954., This survey was completed early in 1955, and the following is an extract from the return submitted to the Minister of Housing and Local Government as required by Section 1 of the Act, which sets out the number of houses in the district which appear to be unfit for human habitation and liable to demolition 1„ Total number of permanent houses in the area 15,654 2, Estimated number of houses unfit 659 Action to be taken in first 5 years Number of houses to be demolished:- (a) Individual houses 41 (b) Houses in Clearance Areas 395 Total houses to be demolished 436 (c) Number of houses to be retained for temporary accommodation . 223 The above figures show that 4.2% of the number of houses in the borough are estimated to be unfit. It is interesting to record that from the summary of returns submitted by local authorities throughout England and Wales, 2½% of the houses in the London County Council area were estimated to be unfit, and 6½% in the whole of England and Wales. 10 applications for Certificates of Disrepair under the above Act were made during the year and 10 certificates were issued 3 applications were received from owners for the revocation of Certificates of Disrepair 2 were granted and 1 refused Grants for Improvements and Conversions The Borough Engineer and Surveyor has supplied the following information regarding works carried out by owners for the improvement or conversion of houses and to whom grants have been authorised by the Council in accordance with the provisions of the Housing Repairs and Rents Act 1954. Property Improvement or Conversion 51, New Road, Brentford Extension to premises to form a bathroom 69, Wavendon Avenue, Chiswick. Conversion into two flats. 16, Pyrmont Road, Chiswick. Conversion of third bedroom into bathroom. 23, Sutherland Road, Chiswick. ditto 27, Sutherland Road, Chiswick. ditto 50, Duke Road, Chiswick. ditto 33, Swanscombe Road. Chiswick. ditto -48- Property Improvement or Conversion 138, Devonshire Road, Chiswick. Conversion of third bedroom into bathroom. 23, Eastbourne Road, Brentford,. ditto 35, Swanscombe Road Chiswick Forming new bathroom by raising on scullery. 4 Duke's Avenue, Chiswick, Conversion of ground floor into self- contained flat HOUSING ACT, 1936 Hogarth Lane Re-development Area The re-development of this area continues and during the year under review 20 flats were built by the Council, making a total of 82 now erected on this site. Albany Road Re-development Area The three Compulsory Purchase Orders involving 64 houses on this site and mentioned in the Annual Report for 1954, were confirmed by the Minister of Housing and Local Government on the 24th June, 1955, with certain modifications. During the year, official representations were made in respect of 42 houses which were considered to be unfit for human habitation and the following were declared Clearance Areas:- The Ham (No.1) Clearance Area, 1955 Nos, 31, 33, 35, 37, 39 and 41 The Ham, Brentford. The occupants from two of these houses were rehoused by the Council at the end of the year and the houses closed The total number of persons to be displaced from these properties is 23, The Ham (No.2) Clearance Area, 1955 Nos. 40 and 42 The Ham, Brentford, Both of these houses were demolished in September, 1955 and the 6 persons displaced were rehoused by the Council. Old Spring Gardens (No,1) Clearance Area, 1955 Nos. 1 and 3 New Spring Gardens, Brentford, and Nos, 7, 8, 9, 10, 11, 12, 13, 14, and 15 Old Spring Gardens, Brentford. The occupants from 6 of these houses, involving 22 persons, were rehoused by the Council at the end of the year and the houses closed. Old Spring Gardens (No.2) Clearance Area, 1955 Nos. 1, 2 and 3 Old Spring Gardens, Brentford. Twelve persons from these houses were rehoused by the Council during the year and the houses were demolished in November 1955 -49- Chiswick Common Road Clearance Area, 1955 Nos. 21, 22, 23, 24, 25 26, 27 and 28 Chiswick Common Road, The number of persons to be displaced from these houses is 16. Walnut Tree Road Clearance Area, 1955 Nos. 12, 13, 14, 15, 16, 17, 18, 19, 20. 21 and 22 Walnut Tree Road, Brentford These properties were also included in a Compulsory Purchase Order which was confirmed by the Minister of Housing and Local Government on the 14th September, 1955 with modifications The Order was modified by the exclusion therefrom of Nos. 12 and 13 which are already owned by the Council,, and the exclusion from both the Order and the Clearance Area of the passage-way between Nos, 22 and 23 Walnut Tree Road The number of persons to be displaced from these houses is 35, of which 12 persons (3 families) were rehoused by the Council at the end of the year Individual houses - Section 11, Housing Act, 1936 Nos, 1 2, 3, 4 5 6 7 and 8 Haywood Terrace, Chiswick, The above houses,, included in the Council's slum clearance programme, were considered to be unfit for human habitation and not capable at a reasonable expense of being rendered so fit. The Council intend to acquire and "patch" these properties as provided for by section 3 of the Housing Repairs and Rents Act, 1954, Nos, 44, 46, 48, 50 and 52 The Ham, Brentford The above unfit houses, suitable for inclusion in a Clearance Area, were acquired by the Middlesex County Council and were demolished in May, 1955, The occupants (4 families - comprising 16 persons) were rehoused during 1954 by this Council with the consent of the Ministry of Housing and Local Government During the year the under-mentioned 25 unfit houses in Clearance Areas were demolished, and the occupants rehoused by the Council, The number of persons so displaced was 93, Church Alley, Brentford, Nos, 1, 4, 5, 6, 7, 8 and 11 Church Alley and Nos. 1, 2 and 3 Newbury Cottages, Brentford,, The Ham, Brentford, Nos, 25, 43, 45, 47 and 49 and Nos 40, 42, 44, 46, 48, 50 and 52 The Ham, Brentford. Old Spring Gardens, Brentford Nos. 1, 2 and 3 Old Spring Gardens, Brentford, -50- 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) 828 (b) Number of inspections made for the purpose 2,044 (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 31 (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 325 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 424 3. Action under Statutory Powers during the year: (a) Proceedings under Sections 9, 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 56 (2) Number 6f dwelling-houses in' which' defects were remedied after service of formal notices (i) by owners 32 (ii) by local authority in default of owners Nil (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 -51- (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. - vercrowding: (a) (i) Number of dwelling-houses known to be overcrowded at end of year 51 (ii) Number of families dwelling therein 66 (iii) Number of persons dwelling therein 301 (b) Number of new cases of overcrowding reported during the year 17 (c) (i) Number of cases of overcrowding relieved during the year 32 (ii) Number of persons concerned in such cases 166 (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 Statement of (a) Rebuilt (war damage) and (b) New Dwellings erected by the Borough Council and Private Enterprise during 1955 Permanent Housing Houses Flats Maisonettes Bungalows Tota By Borough Council (a) Rebuilds - - - - - (b) New 4 16 4 8 32 TOTAL 32 By Private Enterprise (a) Rebuilds - - - - - (b) New 3 6 - 1 10 TOTAL 10 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,1955 Permanent Housing Houses Flats Maisonettes Bungalows Total By Borough Council (a) Rebuilds 23 11 2 - 36 (b) New 129 430 165 27 751 TOTAL 787 By Private Enterprise (a) Rebuilds 116 135 15 2 268 (b) New 14 26 - 2 42 TOTAL 310 Temporaiy Housing Houses Flats Maisonettes Bungalows Total By Borough Council (a) Rebuilds - - - - (b) New - - 150 150 TOTAL 150 It should be noted that the Borough Council1' s figures include a number of dwellings on the Syon Estate Isleworth which is in the adjoining Borough of Heston and Isleworth, Modernisation of Council Houses It was decided that in Council houses supplied only by gas„ electricity would be provided for lighting purposes and heating where required, and this work was being carried on throughout the year in individual properties, A plan was also prepared, for 196 Council houses to provide for replacement of old fashioned cooking ranges by open fireplaces, retaining the existing hot water services. For 220 houses with no separate hot water facilities, plans were made for the cooking ranges to be replaced by open fireplaces, and for either complete hot water installations or alternatively back boilers to existing open fireplaces. Overcrowding Twenty-six cases of alleged overcrowding were investigated by the Department staff during the year, Of these, seventeen were found to be statutorily overcrowded, and were accordingly notified to the Housing Department for consideration by the Housing Committee It will be seen from the Housing Statistics on -53- page 52 that thirty-two cases of overcrowding were relieved during the year. This is a higher figure than in 1954, when the number was 14. Overcrowding is relieved in various ways, by private arrangements made by the families concerned, by Council rehousing, or by Cbuncil nomination under the Industrial Selection Scheme for housing in New Towns, Since New Town housing for Brentford and Chiswick residents has become available, one hundred and seven families have obtained housing in this way, four at Basildon, thirty-one at Bracknell, eighteen at Crawley, seven at Harlow, twenty-seven at Hemel Hempstead, sixteen at Stevenage, and four at Welwyn and Hatfield. These figures are up to December, 1954, In 1955, seventeen families were nominated and rehoused in New Town accommodation under the Industrial Selection Scheme. These families were not necessarily all living in overcrowded conditions, as the obtaining of New Town housing is not so much dependent on the housing conditions of the families concerned, as on the ability of the head of the family to find work in the New Town, but in the majority of cases, overcrowding was probably the reason for the wish of the families to transfer away from the Borough, DISINFECTION Premises disinfected: Ordinary notifiable diseases 46 Tuberculosis 5 Cancer 19 Other diseases 2 Premises treated for vermin 13 Premises treated for other pests (wasps, moths, ants and beetles) 11 An arrangement is in force whereby the South West Middlesex Hospital Management Committee undertakes to carry out emergency disinfection of vermin infested or smallpox-infected clothing and bedding on demand. MISCELLANEOUS RODENT CONTROL During the year 2,718 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 301 Factories 15 Shops 20 Schools 9 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, and the following shows the number of manholes found to be infested. -54 - Date Manholes found to be infested January, 1955 56 June, 1955 31 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 purpose of the above Act, in pursuance of the provisions of Section 2 thereof, ESTABLI SHMENTS FOR MASSAGE AND SPECIAL TREATMENT Eight establishments were inspected 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 1 Massage and Electrical Treatment 2 Chiropody and Electrical Treatment 1 FREE WASHING FACILITIES IN PUBLIC CONVENIENCES Facilities for free handwashing are available in Kew Bridge (Ladies') Kew Bridge (Men s), High Road (Men's) and Turnham Green (Ladies') Public Conveniences, paper hand towels and liquid soap in tilting dispensers being available in each, During 1955, 7,400 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 7,800 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, 150 linen towels were supplied for use, -55- RIVER POLLUTION Reports continued to be received at regular intervals from the Officers of Middlesex County Council regarding the condition of the River Brent. Samples were taken at points along the stream from Wembley to Brentford High Street; the two sampling points in the Borough being at Gallows Bridge and Brentford High Street. The results of sampling in 1955 seemed to show some deterioration. This was not great however, and may have been attributable in part to the smallness of the rainfall during the year. The samples taken in April and August particularly, were during very fine dry spells, when the river must have been at a very low level. No new sources of pollution were discovered during the year, and no action was required to be taken against persons using the River Brent for unauthorised discharge of sewage or trade effluents. 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 93 Other boats 406 -56- STATISTICAL TABLES TABLE I PARTICULARS OF DEATHS AS SUPPLIED BY THE REGISTRAR - GENERAL FOR THE YEAR 1955 Cause of Death Males Females All Causes 315 326 1, Tuberculosis, respiratory 5 2 2. Tuberculosis, other - - 3. Syphilitic Disease 3 1 4. Diphtheria - - 5. Whooping Cough - - 6. Meningococcal Infections - - 7. Acute Poliomyelitis - - 8, Measles - - 9 Other infective and Parasitic Diseases 1 3 10 Malignant Neoplasm, stomach 12 9 11 Malignant Neoplasm, lung, bronchus 29 5 12. Malignant Neoplasm, breast . - 12 13. Malignant Neoplasm, uterus . - 3 14. Other Malignant and lymphatic neoplasms 34 32 15. Leukaemia, aleukaemia 1 2 16. Diabetes . 2 1 17. Vascular lesions of the nervous system 28 49 18. Coronary disease, angina 56 42 19. Hypertension with heart disease 11 15 20 Other heart disease 22 48 21. Other circulatory disease . 13 18 22. Influenza - 1 23, Pneumonia 8 16 24, Bronchitis 37 14 25, Other diseases of respiratory system 6 2 26. Ulcer of stomach and duodenum 4 4 27. Gastritis, enteritis and diarrhoea 1 1 28. Nephritis and Nephrosis 4 - 29. Hyperplasia of prostate 6 - 30. Pregnancy, childbirth, abortion - - 31. Congenital malformations 3 3 32. Other defined and ill-defined diseases 14 31 33, Motor vehicle accidents 2 3 34, All other accidents 8 8 35. Suicide 5 1 36. Homicide and operations of war - - ALL CAUSES 315 326 -57- TABLE II INFANTILE MORTALITY DURING THE YEAR 1955 Net deaths from stated causes at various ages under one year Under 1 day 1 day 2.days 3 days 4 days 5 days 6 days 7-14 days 14-21 days 21-28 days 1 - 2 mon ths 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 Tuberculous Di seases - - - - - - - - - - - - - - - - - - - - - - Meningitis (non-T.B.) - - - - - - - - - - - - - - - - - - - - - - Convulsions - - - - - - - - - - - - - - - - - - - - - - Laryngitis - - - - - - - - - - - - - - - - - - - - - - Bronchitis - - - - - - - - - - - - - - - - - - - - - - Pneumonia (all forms) - - - - - - - - - - - - - - - - - - - - - - Diarrhoea . - - - - - - - - - - - - - - - - - - - - - - Enteritis - - - - - - - - - - - - - - - - - - - - - - Gastritis - - - - - - - - - - - - - - - - - - - - - - Rickets - - - - - - - - - - - - - - - - - - - - - - Suffocation - - - - - - - - - - - - - - - - - - - - - - Injury at Birth - - - - - - - - - - - - - - - - - - - - - - Atelectasis 1 - - - - - 1 - - - - - - - - - - - - - 2 Congenital Mai formation 1 - - - - - - 1 - - - - - - 1 - - - - - 1 4 Premature Birth 1 1 - - - - 1 - - - - - - - - - - - - - - 3 Atrophy, Debility and Marasmus - - - - - - - - - - - - - - - - - - - - - - Pemphigus Neonatorum - - - - - - - - - - - - - - - - - - - - - - Smallpox - - - - - - - - - - - - - - - - - - - - - - Other Causes - - - - - 1 - - - - - - - - - - - - - - - 1 TOTALS 3 1 - - - 1 2 1 - - - - - - - - - - - - 1 10 -58- TABLE III NOTIFIABLE DISEASES DURING THE YEARS 1954 AND 1955 Disease Total cases notified Cases admitted to hospial Total Deaths 1955 1954 1955 1954 1955 1954  Scarlet Fever 52** 95 24 29 - - Whooping Cough 51† 9 4 1 - - Measles 659 47 16 1 - - Pneumonia (notifiable) 17 18† 7 6† 24† 17† Dysentery 12* 12+ 3 3† - - Typhoid - 1 - 1 - 1 Puerperal Pyrexia 6 3 2 - - - Erysipelas 8 9 2 1 - - Meningococcal Infection - 1 - 1 - - Food Poisoning 8+ 4 4 2 - - Ophthalmia Neonatorum 1 3 - 2 - - Malaria - 1 - 1 - - Acute Poliomyelitis Paralytic 61† 4+ 6 4† - - Non-Paralytic 5* - 5 - - - Diphtheria 1+ - 1 - - - Acute Encephalitis (In fective) 1 - - - - - TOTALS 827 207 74 52 24 18 †Includes one case subsequently not confirmed ‡Includes deaths from non-notifiable pneumonia Includes two cases subsequently not confirmed. ** Includes four cases subsequently not confirmed. TABLE IV OPHTHALMIA NEONATORUM Cases Notified Cases treated at home Cases' treated in hospital Vision unimpaired Vision impaired Total blindness Deaths 1 1 - 1 - - - -59- TABLE V AGES OF CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1955 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 52** - 1 1 5 10 31 4 - - - - - Whooping Cough 5lt 3 7 2 11 4 22 2 - - - - - Measles 659 14 54 54 65 94 357 13 1 5 1 - 1 Pneumonia 17 1 - - 1 - 1 - - - 3 7 4 Ac. Poliomyelitis: Paralytic 6† - - - - 1 1 1 1 2 - - - Non-Paralytic 5* - - - - 1 1 - - 3 - - - Diphtheria 1† - - - - - - - - - 1 - - Dysentery 12* 1 - 1 1 1 5 - - 2 - 1 - Puerperal Pyrexia 6 - - - - - - - - 6 - - - Erysipelas 8 - - - - - 1 - - - - 4 3 Food Poisoning 8† - - - - - - - - 4 - 2 2 Ophthalmia Neonatorum 1 1 - - - - - - - - - - - Acute Encephalitis (Infective) 1 - - - - - - - - - - 1 - † Includes one case subsequently not confirmed, * Includes two cases subsequently not confirmed, ** Includes four cases subsequently not confirmed, -60- TABLE VI CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1955 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 5 7 7 4 3 7 7 4 8 52** Whooping Cough. 5 2 3 - 7 12 12 5 5 51† Measles 121 68 117 29 77 34 69 39 105 659 Pneumonia 7 4 3 - 1 2 - - - 17 Acute Poliomyelitis:Paralytic 1 1 - 1 1 1 1 - - 6† Non-Paralytic 1 - - - 2 2 - - - 5* Diphtheria - - - - - - 1 - - 1+ Dysentery - - 1 4 - - - 6 1 12* Puerperal Pyrexia 1 - - 1 - - 1 2 1 6 Erysipelas - 2 2 - 2 1 - 1 - 8 Food Poisoning. 2 - 1 2 1 - 1 - 1 8† Ophthalmia Neonatorum - - - - - 1 - - - 1 Acute Encephalitis (Infective) - - 1 - - - - - - 1 Tuberculosis:Respiratory 4 11 7 6 5 2 19 14 17 85 Non-Respiratory - - - - 2 2 - 2 3 9 + Includes one case subsequently not confirmed. * Includes two cases subsequently not confirmed. ** Includes four cases subsequently not confirmed -61- TABLE VII LABORATORY WORK Nature of Specimen Result Positive Negative Total Diphtheria- swabs - 20 20 Scarlet Fever - swabs 9 14 23 Dysentery - faeces 18 84 102 Typhoid - faeces - 10 10 Food Poisoning faeces 6 13 19 Totals 33 141 174 TABLE VIII TUBERCULOSIS - 1955 Age Groups New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory Male Female Male Female Male Female Male Female Under 1 year - - - - - - - - 1-5 years 1 - - - - - - - 5-15” 1 2 - 1 - - - - 15 - 25 ” 8 14 1 - - - - - 25 - 35 " 14 10 2 2 - - - - 35 - 45 " 9 5 - 1 - 1 - - 45 - 55 " 9 3 - 1 1 - - - 55 - 65 " 3 1 1 - - 1 - - 65 years and over 4 1 - - 4 - — — Totals 49 36 4 5 5 2 - - Of the 7 recorded deaths, 6 were previously notified as cases of Tuberculosis, 1 had not been so notified. In addition, 3 patients already notified as tuberculosis died from other causes, -62- TABLE IX TUBERCULOSIS CASES IN YEARS Year New Cases Deaths Respiratory NonRespiratory Total Respiratory NonRespiratory Total M F M F M F M F 1935 46 47 3 5 101 21 15 5 1 42 1936 40 33 4 5 82 26 24 1 2 53 1937 38 46 9 9 102 22 13 1 3 39 1938 54 39 8 7 108 29 8 2 2 41 1939 36 33 9 7 85 18 18 2 3 41 1940 42 27 7 7 83 20 10 3 5 38 1941 52 25 3 3 83 23 12 5 2 42 1942 42 36 1 8 87 14 12 - 2 28 1943 52 29 3 5 89 25 11 - 1 37 1944 57 39 3 7 106 16 11 3 4 34 1945 46 41 9 6 102 18 11 1 2 32 1946 68 49 5 7 129 23 6 2 5 36 1947 62 36 4 4 106 30 8 - - 38 1948 61 47 1 6 115 18 16 2 3 39 1949 53 44 6 7 110 13 7 3 2 25 1950 59 39 4 6 108 19 13 1 1 34 1951 49 44 4 6 103 11 13 - 1 25 1952 58 43 1 5 107 9 4 - 2 15 1953 75 41 3 7 126 8 1 - - 9 1954 53 37 - 4 94 3 1 - ' - 4 1955 49 36 4 5 94 5 2 - - 7 -63- TABLE X TUBERCULOSIS REGISTER - AS AT 31.12.55 Pulmonary Non-Pulmonary Total M F M F M F (a) Number of Cases on Register at commencement of year 403 299 21 42 424 341 (b) Number of Cases notified for the first time during year under Regulations 29 20 2 3 31 23 (c) Cases restored to Register during year 5 5 - - 5 5 (d) Cases added to Register otherwise than by notification under Regulations (i) Transferred from other districts 19 15 2 2 21 17 (ii) Non-notified deaths 1 1 - - 1 1 (e) Number of Cases removed from Register during year 39 27 1 2 40 29 (f) Number of Cases remaining on Register at end of year 418 313 24 45 442 358 Cases removed from the Register shown under (e) are accounted for as follows:- Found not to be T.B. Recovered Lost sight of Removed to another area Died at home Died at Sanatorium or other Institution Total M F M F M F M F M F M F M F 1 - - - 1 PULMONARY 2 3 2 39 27 2 31 21 3 - - 1 - N0N°PULM0NARY - - 1 2 - - - 2 - - The total number of cases on the Tuberculosis Register at the end of 1955 was 800, viz,, pulmonary 731, non-pulmonary 69, -64- TABLE XI OCCUPATIONS OF CASES OF TUBERCULOSIS NOTIFIED DURING THE YEARS 1953 - 1955 Occupations 1955 1954 1953 M F M F M F Outdoor (Transport 2 - 2 - 2 - Occupations (Other 3 - 7 - 9 - Indoor (Heavy Manual 2 - 3 - 1 - Occupations (Light Manual (Clerical or 16 1 13 2 18 2 ( Sedentary 13 13 11 10 15 6 (Other 7 1 3 - 7 1 Housewife and Domestic - 20 - 15 - 22 Schoolchild 2 3 1 2 4 2 Shop Assistant 3 - - 3 2 1 Under School Age - - 2 2 3 2 Occupation Unknown 5 3 11 7 18 11 Totals 53 41 53 41 79 47 TABLE XII Carcases and Offal inspected and condemned in whole or in part during 1955 Cattle Ex cluding Cows Cows Calves Sheep & Lambs Pigs Horses Number killed (if known) - - - - 6 - Number inspected - - - - 6 - All diseases except Tuberculosis and Cysticerci Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned - - - - - - Percentage of the number in spected affected with disease other than tuberculosis and cysticerci - - - - - - Tuberculosis only: Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned - - - - - - Percentage of the number inspected affected with Tuberculosis - - - - - - Cysticercosis Carcases of which some part or organ was condemned - - - - - - Carcases submitted to treat ment by refrigeration - - - - - - Generalised and totally condemned - - - - - - -65- TABLE XIII ATMOSPHERIC POLLUTION RESULTS DURING 1955 Month Highest Daily Heading Monthly Average Sulphur Dioxide Smoke Sulphur Dioxide Smoke Bt fd. Chis. Btfd. Chis. Btfd. Chis. Btfd. Chis. Jan. 0.15 0.57 0.85 0.85 0.08 0.10 0.18 0.19 Feb. 0.13 0.18 0.25 0.39 0. 07 0.04 0.14 0.16 Mar. 0.31 0.32 0.47 0.45 0.10 0.08 0.15 0.15 Apr. 0.12 0.17 0.28 0.28 0.05 0.06 0.08 0.10 May 0.08 0.15 0.09 0.20 0.03 0.05 0.04 0.06 Jun. 0.12 0.24 0.11 0.29 0.04 0.06 0.04 0.07 Jul. 0.08 0.11 0.11 0.13 0.04 0.05 0.04 0.05 Aug. 0.12 0.14 0.18 0.14 0.04 0.05 0.05 0.05 Sep. 0.08 0.08 0.14 0.17 0.03 0.04 0.05 0.06 Oct. 0.13 0.17 0.32 0.34 0.06 0.07 0.12 0.15 Nov. 0.26 0.20 0.51 0.61 0.09 0.09 0.16 0.18 Dec. 0.19 0.30 0.37 0.60 0.06 0.10 0.16 0.21 TABLE XIV FACTORIES ACT. 1937 Inspections: Premises Number on Register Number of Inspections made Written Notices Occupiers Prosecuted (i) Factories in which Sees. 1, 2,3,4 & 6 are to be enforced by Local Authorities 117 1 - - (ii) Factories not included in (i) in which Section 7 is enforced by L.A. 290 33 2 - (iii) Other premises in which Section 7 is enforced by L. A. (excluding outworkers premises). 22 - - - Totals 429 34 2 - -66- TABLE XV FACTORIES ACT, 1937 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 Sanitary Conveniences (Sec. 7):(a) Insufficient 2 1 - 2 - (b) Unsuitable or defective 3 2 1 2 - Totals 5 3 1 4 - TABLE XVI FACTORIES ACT„ 1937 Outwork (Sections 110 and 111): Nature of Work Section 110 Section 111 No of out workers in Aug. list re qui red by Section 110 (l)(c) No of cases of default in sending lists to Counci1 No of prosecutions for failure to supply list No of instances of work in unwho1esome premises No tices served Prosecutions Wearing Apparel: Making etc. 24 - - - - - Furniture and Upholstery 1 - - - - - Artificial Flowers 5 - - - - - Cosaques, Christmas Crackers, Christmas Stockings etc 7 - - - - - Stuffed Toys 1 - - - - - Totals 38 - - - - - -67- INDEX Accidents, Home 36 Heart Disease 17 Accidents, Road 18 Home Helps 15 Allotments 10 Home Nursing 13 Ambulance Service 15 Hospitals 12 Area of Borough 9 Housing 48,49,50 Atmospheric Pollution 41,43,44,66 Housing Repairs and Rents Act, 1954 48 Bakehouses 35 Housing Statistics 51,52,53 Baths and Washhouses 11 38 Births and Birth Rate 16.19 Ice Cream Sampling 31,33 Blind Persons 40 Infant Mortality 16,19,20,58 Brentford Gas Works 42 Infectious Disease 22 35 Infectious Disease, Brentford Market 35 Ages of Cases 60 British Red Cross Society 39 Infectious Disease Classified in Wards . 61 Canal Boats 56 Infection Dusesase Cancer. 17 Prevalence and Control of 22 Care of mothers and children 12,15 Isolation Hospital, Admissions 59 Catering Establishments. 32 Causes of Death 17.18,57 Labelling of Food Order, 1953 34 Chest Clinics 12,27 laboratory Work 62 Chiropody 15,38 Massage and Special Treatment Circulatory Diseases 17 Establishments 55 Clearance Areas 49,50 Maternal Morbidity and Mortality 18,21 clinics 12,13,14 Meals on Wheels 38 Condemned Pood 34 Measles 19,22 Deaths and Death Rate 16,17,18,19 Meat and Other Foods 34,65 Diarrhoea 19 Mental Health 14 Diphtheria 25 Merchandise Marks Act, 1926 33 Diphtheria Immunisation .14,25,26 Midwifery Service 15 Disinfection 54 Milk Regulations 35 Domestic Helps 15 Notifiable Diseases 59 Dysentery 26,27 old People 38 Factories Act, 1937 66,67 Ophthalmia Neonatorum 59 Food and Drugs Act, 1938 32 Outworkers 67 Food Control 30 Overcrowding 9,52,53 Food Hawkers 56 Food Poisoning 26 Parks and Open Spaces l0, 11 Food Premises 30,31 Pet Animals Act, 1951 55 Food Sampling 32,33 Poliomyelitis 23,24 Free Washing Facilities 55 Population 9 Premature Infants 19 Handicapped Persons 41 Preserved Foods 32 Health Education 36,42 Prevention of Illness, Health Services provided by Care and After-Care 15 other Authorities 12,13,14,15 Health Visitors 13 Public Health Committee 3 -88- Puerperal Pyrexia 21 Tuberculosis, B, C, G. Inoculations 27,28 Rag Flock, etc, Act, 1951 55 Tuberculosis - Cases in years. 63 Rateable Value 9 Tuberculosis, Hospital or Sanatorium Accommodation 27 Redevelopment Areas 49 Tuberculosis, Housing Refuse Collection 47 Conditions of Newly River Pollution 56 Notified Cases 30 Rodent Control 54 Tuberculosis, Occupations of Newly Notified Cases 65 Sanitary Circumstances Tuberculosis Register 64 of the Area 45,46 Sanitary Services 47 Unfit Houses 48,51 Scarlet Fever 25 Unsound Food 32,34,65 School Health 14 Unemployment 10 School Sanitation 47 Slaughterhouses 35 Vermin and Scabies, Slum Clearance 9,49,50 Control of 22 Smallpox 25 vital Statistics . 16 Smallpox Vaccinations 14,25 Smoke Pollution 42,43,44 St. John's Ambulance Brigade 39 Wards 9 Staff 5 Water Supply and Water Statistics and Social Conditions 9 Services 47 Statistical Tables 57-67 Welfare: Old People 37 Stillblrths 16 Blind and Partially Sighted 40 Street Trading 56 General 39 Handicapped Persons 41 Swimming Baths 10 Wells 47 Tuberculosis 18,27 , 29,62 Whooping Cough 19,26 -69-