CAM 30 LIBRARY METROPOLITAN BOROUGH OF CAMBERWELL ANNUAL (ABRIDGED) REPORT OF THE MEDICAL OFFICER OF HEALTH, H.W. BARNES, M.B., B.Ch., D.P.H., for the year 1941. Public Health Department, Town Hall, Camberwell, S.E.5. 15th December, 1942. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Camberwell. Mr. Mayor, Aldermen and Councillors, The following report does not attempt more than the provision of statistical information of the Department's principal activities during the year 1941, and its appearance in an abridged form is in accordance with the request of the Ministry of Health. The health of the Borough remained surprisingly good and the expectation that the intensive night bombing in the early months of the year with all the accompanying discomforts of irregular and disturbed sleep in domestic or public air raid shelters would leave its mark on the general health of the people was completely confounded. There is only slight variation to be noted in the birth and death rate figures for 1941 in relation to. the figures for 1940, and for comparative purposes the vital and mortal rates are shown for the past four years:- Birthrate 13.97 13.85 15.90 15.60 Death rate 12.27 12.43 19.13 19.90 1938. 1959. 1940. 1941. The interruption of the normal work of the Public Health Department which occurred in the early days of the Mar by the transference of many of the staff for duties in connection with Civil Defence, Evacuation, Billeting of the Homeless, Rest Centres supervision, and sanitary supervision of public air raid shelters, did not continue to the same extent during 1941. When these services became properly organised and staffs recruited for their operation, the Sanitary Inspectors for example were able "to devote more time to the normal duties of their appointments; the inspection and initiation of repairs to war damaged properties, however, claiming most of their attention during the period under review. In the early part of the year the Council decided to regroup the Infant Welfare Centre districts of the Borough which resulted in the work being directed from five Centres instead of eleven. These arrangements were approved by the Ministry of Health. Following my usual custom I wish to acknowledge the loyal and unstinted service which the Staff of the Public Health Department rendered to the public, the Council, and to myself during the year; I also desire to thank the Members of the Council for their unfailing consideration and courtesy they have at all times extended to me in the discharge of my duties as Medical Officer of Health. Your obedient Servant, H. W. Barnes, MEDICAL OFFICER OF HEALTH. CAM 30 SUMMARY OF STATISTICS 1. FOR THE YEAR 1941. Area of the Borough in acres 4,480 Population (estimated resident population) 127,570 Population (Census 1931) 251,294 Number of live births - 1,990 for birth rate for infant & maternal mortality rates 1,496 Birth rate 15.60 Number of deaths 2,541 Death rate 19.90 Infantile Deaths under 1 year 88 Infantile deaths per 1,000 births 58.70 Maternal Deaths of women from or accidents associated with childbirth 10 Maternal death rate (per 1,000 live births 6.68 (per 1,000 total births 6.52 Deaths from phthisis 145 Phthisis death rate 1.01 Deaths from all forms of tuberculosis 167 Tuberculosis death rate 1.03 DEATHS, CAUSES OP, AND AGES AT, DURING THE YEAR 1941 Causes of Death Sex All ages 0- 1- 5- 15- 45- 65- All causes M. 1375 52 17 21 196 416 673 268 F. 1166 36 12 14 191 645 Typhoid and paratyphoid fevers M. - - - - - - - F. - - - - - - - Cerebro-spinal fever M. 3 - - - 2 1 - 1 - - 1 - F. - - Scarlet Fever M. - - - - - - - - - - - F. - - - Whooping cough M. 2 2 - - - - - F. 3 1 - - 2 - Diphtheria - M. 1 - 1 - - - - F. 2 - 1 1 - - - Tuberculosis of respiratory system M. 89 - 41 39 7 2 - F. 56 - - - 46 6 4 Other forms of tuberculosis M. 12 1 2 1 6 2 - 10 1 1 6 1 1 F. - Syphilitic diseases M. 12 - - 1 8 3 - F. 3 - - - 1 1 1 Influenza M. 10 1 1 - 2 4 2 F. 6 - - - 2 4 - Measles M. 1 - 1 - - - - 1 F. 1 - - - - - Acute Polio-myelitis and polio-encephalitis. M. - - - - - - - F. - - - - - - - Ac: inf: enceph: M. - - - - 1 - 1 F. - - 1 - - 1 - 12 Cancer of buc: cav:& oesoph:(M) uterus (F) M. 25 - - - 1 12 F. 17 - - 1 8 8 - 20 Cancer of stomach & Duodenum M. 38 - 1 2 15 - F. - - - 12 7 19 - Cancer of breast M. 1 - - - 1 - - F. 35 - - 6 19 10 - Cancer of all other sites M. 112 1 1 10 41 59 - F. - 7 21 39 87 - - Diabetes M. 4 - - - 1 - 3 - - 4 6 F. 10 - - Intracranial vascular lesions 62 - - - - 27 35 M. F. - 2 27 58 87 - - DEATHS, CAUSES OF, AND AGES AT, DURING THE YEAR 1941. 2. Causes of Death Sex All Ages 0 - 1 - 5 - 15 - 45 - 65 - M. 368 - Heart disease - - 8 69 291 373 - 1 18 46 298 F. - Other Dis: of cire: system M. 25 - 1 8 16 - - F. 12 - - 2 10 - - Bronchitis M. 117 1 1 - 2 44 69 F. - 22 56 81 1 2 - Pneumonia M. 89 7 1 30 39 5 7 F. 4 8 33 54 5 4 - Other resp: diseases M. 16 - - 1 3 7 5 F. 9 - - 3 6 - - 14 Ulcer of stomach or duodenum M. 28 - - 5 9 - F. 8 - - - 1 4 3 Diarrhoea under 2 years - - M. 7 7 - - - F. 3 3 - - - - - Appendicitis M. 1 - - 1 - - - 2 F. 7 - 1 1 2 1 Other digestive diseases M. 27 1 - 3 9 14 - F. 20 - 1 - 11 8 - Nephritis 22 - - 5 6 11 K. - 3 7 F. 18 - - 8 - Puer: and post-abort: sepsis - - - - - M. - - F. 5 - - - 5 - - Other maternal causes M. - - - - - - - p. - 5 - - 5 - - Premature birth M. 13 13 - - - - - F. 10 10 - - - - -- Con: Mal: birth, inj: Infant: dis: M. 16 14 - - 2 - - F. 11 11 - - - - - Suicide M. 11 - - 2 3 6 - - 1 F. - 2 1 4 - Road Traffic acc: M. 11 - 2 1 5 3 - - - 2 2 2 F. 6 - 75 Other violent causes M. 170 3 4 12 57 19 64 F. 152 2 2 7 40 37 All other causes M. 81 2 1 13 12 53 - F. 3 1 14 18 44 80 - INFECTIOUS DISEASES SUMMARY OF NOTIFICATIONS RECEIVED. Found to be not suffering from the disease No.of cases notified. Treated in Hospital Diphtheria and Croup 114 113 4 Scarlet Fever 82 70 7 Measles 655 118 - Whooping Cough 317 76 - Enteric Fever & Para-typhoid 16 16 2 Pneumonia (Acute Influenzal 20 8 - (Acute Primary 39 22 - Erysipelas 38 25 - Cerebro-spinal Meningitis 33 33 12 Polio-Myelitis 1 1 - Dysentery 4 4 1 Ophthalmia Neonatorum 5 2 - 7 7 Puerperal Fever - Puerperal Pyrexia 11 11 - Totals 1,342 506 26 DISINFECTING STATION -RETURN OF WORK. Rooms disinfected Lots of bedding disinfected Total Visits Notified Irffectious Diseases 428 196 533 Other Diseases 195 140 393 Miscellaneous 5 36 368 A.R.P Disinfecting and washing 36 301 1065 1317 Scabies 520 732 Vermin 736 275 654 Total all cases 1701 2032 3997 Number of articles disinfected by steam 44,394 „ „ „ „ by formalin 6,037 „ „ books disinfected 99 Beds and Mattresses destroyed 311 Miscellaneous goods destroyed 359 T. C. qr. lb. Weight of Unsound foods destroyed 13 6 0 19¼ „ „ old and verminous furniture etc., destroved 3 14 3 6 „ „ dead animals destroyed - 1 0 0 CLEANSING STATION. Persons cleansed. Adults Number of attendances Scabies Vermin Males Females Males Females 427 357 20 8 Children 2,390 2,598 429 1,140 IfUMBLR OF BACTERIOLOGICAL EXALTATIONS 1941. Swabs for diphtheria 500 Sputa for tubercle 697 Faeces for Typhoid-paratyphoid group 7 Milks 28 Bath waters 4 Well waters 6 Miscellaneous specimens 9 Total 1251 VACCINATION 1941. No. of names received in birth lists 928 Certificates of Successful Vaccination received 546 „ „ Postponement received 2 „ „ Insusceptibility received 3 Statutory Declarations of Objection received 301 3. MATERNITY AND CHILD WELFARE. Infant Welfare Centres - Clinic Attendances etc, 1941. Attendances of Children (i) Under 1 year 14,842 (ii) Between 1 & 5 years 6,503 Miscellaneous attendances 2,612 Total attendances 23,957 Analysis of Attendances- Doctors' Consultations 9,846 Seen by Health Visitor 11,499 Health Visitors - Record of Visits, 1941. Visits to Expectant Mothers 1,351 „ „ Post-natal Mothers 1,116 No. of Births reported in the Area 1,127 Visits to Children- (i) Under 1 year 8,047 (ii) Between 1 and 5 years 14,229 Total 22,276 Miscellaneous Visits 4,649 Total Visits 30,519 Ancillary Services. In 103 instances the services of a Home Help were provided for mothers, either before, during or after confinement. In 5 cases expectant or nursing mothers were provided with dental treatment. The District Nursing Associations paid a total of 2131 visits to 161 approved cases under the Council's. Domiciliary Nursing Scheme. A total of 62 patients benefitted under the Council's Treatment of Minor Ailments Scheme. FOOD AND DRUGS. FORMAL AND INFIRMAL SAMPLES SUBMITTED FOR ANALYSISYEAR ENDED 31. 12. 41. Number examined Number adulterated etc. Percentage of adulteration. Formal Informal Total Formal Total Formal Informal Informal 32 127 743 875 31 63 25.19 4.14 COMPOSITION OF MILK SAMPLES. 90 formal and 211 informal samples of milk were taken during the year and fifteen formal samples and eleven informal samples were found not to conform with requirements. 4. MILK ADULTERATION. Fifteen formal samples were reported against the percentage of adulteration being 15.30. Of these fifteen samples one was deficient in milk fat and fourteen contained extraneous water. No infringements of the MERCHANDISE MARKS ACT were recorded during the year or of the various orders under the AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT 1928. BACTERIOLOGICAL EXAMINATION OF MILK. Number of samples submitted for examination- Pasteurised milk 27 Tuberculin tested 1 All graded milks complied with the standards laid down in the Milk (Special Designations) Order, 1936. EXAMINATION OF MILK FOR THE PRESENCE OF TUBERCLE BACILLI. Five Samples of raw milk were examined by means of the animal test for the presence of tubercle bacillus, with negative results. BAKEHOUSES. The number of bakehouses on the register at the end of the year was 68 overground and 29 underground. SUMMARY OF INSPECTION. Street Markets Inspections 2078 FOOD PLACES- Inspections: Bakehouses 112 Fish Curers Premises 81 Fried Fish Shops 154 Ice Cream Premises 331 Restaurants and Eating Houses 224 SANITARY INSPECTION. No. of complaints received 1516 Inspections under Shops Act, 1934 386 „ „ Pharmacy and Poisons Act, 1933 174 „ of Milkahops 516 Factories Act, 1937:- No. of inspections of Factories 221 „ „ „ „ Outworkers' Premises 219 Intimations served 7 No. of Intimations., P.H. (London) Act, 1936 1105 „ „ Statutory Notices 141 „ „ Reinspections (all Enactments) 10140 Total number of visits 15326 5. TUBERCULOSIS. 6. Public Health (Tuberculosis) Regulations, 1930 NEW CASES during 1941. There was a total of 315 new cases comprising 226 primary notifications of pulmonary tuberculosis and 25 non-pulmonary tuberculosis, 37 inward transfers, 10 posthumous notifications and 17 non-notified deaths obtained from the Registrar's returns. MORTALITY during 1941 There were 167 deaths from all forms of tuberculosis equal to a death rate of 1.31 per 1,000 of population (0.86 per 1,000 in 1940). Of these 145 were pulmonary cases and 22 non-pulmonary cases. NOTIFICATION REGISTER Deaths † New Cases * Age Periods Respiratory Non Respiratory Respiratory Non Respiratory M F M - F - M F M F 1 - - 1 - - 0 2 - 2 1 4 4 - 1 - 1 - - - 1 5 3 5 3 5 4 3 5 10 21 15 40 44 1 16 17 2 33 17 2 - 25 - 15 8 - 26 9 1 - 35 2 2 1 1 19 1 45 20 3 - - 1 20 4 55 14 1 - 2 1 7 4 - 1 5 2 65 and upwards Total 3 17 56 145 81 8 10 12 89 * Includes primary formal notifications and cases which came to the knowledge of the Medical Officer of Health from other sources. * After correction for Inward and Outward Transfers. The total number of cases on the Register at the end of the year was 1,943 i.e. 1,525 pulmonary, 418 non-pulmonary. The rate of non-notified deaths to the total deaths was 1 to 9.8 compared with 1 to 19 in 1940. No case of wilful neglect or refusal to notify cases on the party of medical practitioners occurred. No occasion arose during 1941 for any action under the Public Health (Prevention of Tuberculosis) Regulations 1925 or the Public Health Act 1936, Section 172. WORK of the TUBERCULOSIS DISPENSARY during 1941. Non-Pulmonary Total Diagnosis Pulmonary Adults Childres. Adults Children Grand Total Adults Children. M. F. M. F. M F. M. F. M. F. F. M. A - NewCaaea examined during the year (excluding contacts):- 72 5 2 126 - 3 47 44 2 3 5 - 69 (a) Definitely tuberculosis - - - - (b) Diagnosis not completed 11 - - 2 5 3 1 - - 12 14 388 - - - - - 218 144 (c)NOn-tuberoulous - - - 7. Pulmonary Total Non-Pulmonary Grand Total Adults children. Adults Children. Adults Children. M. F. M. F. M. F. M. F. M. F. M. F. B- Contacts examined during the year:- (a) Definitely tuberculous 15 18 2 2 1 - - - 16 2 2 18 38 (b) Diagnosis not Completed - - - - - - - - - - - - - (c) Non-tuberculous - - - - - - 86 88 12 19 205 - - C - Cases written off the Dispensary Register as:- 3 (a) Recovered 6 4 3 - 3 3 18 3 9 7 21 40 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) 29 35 621 317 240 D- Number of Gases on Dispensary Register on December 31st:— (a) Definitely tuberculous 612 489 6l 100 119 67 712 608 121 128 1569 56 65 (b) Diagnosis not completed - - - - - - 2 5 3 1 11 - - 1. Number of cases on Dispensary 2. Number of cases ferred from other areas Register on January Ist 1,61 V and cases returned after discharged under Head 3 in nrevio-us years. 94 3. Number of cases transferred 4, Cases written off during to other areas, cases not the year as Dead "(all desirous of further causes) 84 ance under the Scheme and 154 cases "lost sight of" 5. Number of attendances at the TN J _ 1 -»o • 6. Number of insured persons under domiciliary Dispensary (Including contacts) treatment on 31st December 5,774 310 8. Number of visits by 7 Number of consultations with 1 .♦ -1 ilia • m » Tberculosis Officers medical practitioners' (a) Personal 34 to homes (including 382 (b ) Other 2 .096 pergonal consultetions 9. Number of visits by Nurses 10. Number of:- (a) Specimens of sputum or Health Visitors to homes Specimens of sputum etc examined for Dispensary purposes 5,997 465 (b) X-ray examinations 1,289 made in connect.!on with dispensary vtorlz 11. Number of "recovered" cases 12, Number of " T.B. plus " restored to Dispensary cases on December 31st. Register, and Included in Register on December 31st. A (a) and A (b) above 532