1 Nr 6' Naua 5B. AC.4376 2/Pitrary CAM 53 Metropolitan Borough of Camberwell REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1958 H.D. CHALKE, O.B.E. (Mil.) T.D., M.A., M.R.C.P., D.P.H. Printed by MERRITT & HATCHER LTD. B London. CAM 53 Public Health Department, Town Hall, CAMBERWELL, S.E.5. August, 1959 To the Mayor, Aldermen and Councillors, of the Metropolitan Borough of Camberwell. Mr. Mayor, Aldermen and Councillors, I have the honour to present to you my Annual Report for the year 1958. The vital statistics did not alter materially; the population, as estimated by the Registrar-General at mid-year, was 177,300 which was a reduction of 400 as compared with the estimate twelve months previously. The birth rate rose by four points to 17.0 per thousand of the population, but there was an increase in the death rate from 10.6 to 11.5. The number of infant deaths, however, fell to 65, which is equivalent to 21.5 per thousand live births, and there was only one maternal death. The number of notifications of infectious diseases fell from 3,677 to 1,238, but this was due to the fact that 1958 was not an epidemic year for measles, the notifications of which totalled 668 as compared with 2,866 the previous year. There were nine cases of poliomyelitis, one of whom died. It is to be hoped that the campaign for vaccination against this disease will eventually have such successful results as that for diphtheria immunisation—no notifications of the latter disease were received during 1958. As in previous years there were many notifications of food poisoning, but as is generally the case it was seldom found possible to trace the source of infection. In general, the public health was maintained at a satisfactory level. Among the main activities of the Public Health Department during the year were the surveys of the properties in the Council's proposed smoke control area comprising 1,025 acres in the south, and of all industrial and domestic heating plants in the Borough with an output of 55,000 B.T.U.'s or more; the latter project was completed during the early part of the year. The important question of home accidents also came under review and is mentioned in the body of this Report, but the danger of accidental coal gas poisoning (which was the subject of an investigation referred to in last year's Report) was exemplified by the death of an old lady from this cause. A Coroner's inquiry revealed that the deceased was blind and had apparently attempted to light the gas-stove with an electric gas lighter which had an exhausted battery; her disability prevented her from noticing that the gas had failed to ignite, with fatal results. Complaints of nuisances from insects have steadily diminished since the advent of the new contact insecticides, of which DDT was the first. There have, however, been cases in which small insects (tyrophagus) from trees proved troublesome to the occupiers of houses near-by. With the co-operation of the Parks & Open Spaces Section of the Borough Engineer and Surveyor's Department, these infestations were eradicated. Considerable attention was given to the health education activities of the Public Health Department during the year. In addition to the increased number of talks, demonstrations, film shows, etc., which are referred to in this Report, students from Cambridge University and the University of London Institute of Education visited Camberwell and were shown something of the varied public health activities; many of these students were from abroad. There were also other visitors from foreign countries, who were mainly interested in the services for the care and welfare of the aged. Unfortunately, the work of the Department suffered throughout the whole year from the handicap of being unable to recruit a full establishment of Public Health Inspectors. One of the four vacancies which existed at the beginning of the year was filled when one of the Council's student inspectors qualified at midyear, but this advantage was off-set soon afterwards by the sad and sudden death of Mr. M. L. Malins, one of the Housing Inspectors. Towards the end of the year, the Council decided to increase the number of trainee inspectors from two to four. I should like to take this opportunity of thanking the members of the Council and the other Chief Officers and their staffs for their valuable co-operation and support during the year, and to express my appreciation for the loyal and efficient service rendered by' the staff of the Public Health Department. I am, Mr. Mayor, Aldermen and Councillors, Your obedient Servant, H. D. CHALKE Medical Officer of Health. PUBLIC HEALTH COMMITTEE. Constitution at the end of 1958. Chairman : Councillor H.G. Lamborn, L.C.C., M.R.S.H. Vice-Chairman : Councillor mrs. M. V. Goldwin Members: Alderman Mrs. J. Burgess. Councillor Mrs. B.E. Knight. „ E.W. Easdown. „ A.T. Lambert. „ J. V. I. Evans, M.Sc., Ph.D. „ Mrs. A. E. Pritchard. Councillor D. H. Bowyer, B.Sc., F.A.C.C.A. „ E. W. T. Pruce. „ G.Brown. „ F.Robbins. „ Mrs. A.L. Crossman, J.P. „ Mrs. F.E.Sampson. „ Mrs. E.S. Daymond. „ Miss J.D.F.Styles. „ F.A.Fairhead. „ Mrs. E.Thorpe. „ S.H.Gilbert. „ Miss D.M.Walker. ,, H.H. Guichard. „ E.A.Wright. K.C. Harland. Ex-Officio: Councillor F. A. Goldwin J.P. Mayor of Camberwell. Alderman G.S. Burden, B.Sc. (Econ.) Leader of the Council. Alderman C.W. Baker, J.P., F.C.I.S. Leader of the Opposition. Staff of the Public Health Department. (As at 31.12.58) Medical Officer of Health: H.D. Chalke, O.B.E.(Mil.), T.D., M.A., M.R.C.P. M.R.C.S., D.P.H. Deputy Medical Officer of Health: *R.W. Watton, M.B., B.S., D.P.H., D.C.H. Public Analyst: D.F.H. Button, A.R.C.S., F.R.I.C. Chief Administrative Assistant: S.A. Cranfield. Chief Public Health Inspector: L.W. Burrell. a Housing Inspectors: H.W. Leonard. a (One vacancy) Sampling Officer —Food and Drugs Act, etc.: H.R. Weaver. a Food Inspector: D. V. Watkins. a Smoke Inspectors: F. Dray. a, c A.G. O'Gilvie. a, c Public Health Inspectors: H.Attwater. a H.M. Hough. a F.Duggins. a C. H. Medland. a G.A. Fraser.a J. E. Millway. a A Gartside, D.P.A. a R. Sheppard. b E.C. George. a H.F. Williams. a (Three vacancies) Student Public Health Inspectors: M. McSweeney. (Three vacancies) Senior Clerk: A.J. Carly. Clerical Staff: C.Burgess. Mrs. M. Findlay. D. Danter. Mrs. A.D. Dormer. P.A.S. Kirrage. A.Beare. Miss E.M.Lawrence. P.Frost. W. Everett. Rodent Control Staff: Rodent Officer W.H.G. Saunders. b Rodent Investigator Mrs. M.J.Kenny. Rodent Operators C. Green (Working Foreman), F.G. Hulbert, P.Collins, R.Humphreys. Bait Preparer Mrs A. Grice. Disinfecting and Cleansing Station: Superintendent Disinfector A.Thomas. Stoker/Disinfector Apparatus Atten dant B. Russell. Disinfectors R.T.J. Hodgson, E. Manning, A.E. Kenny, J.Butterfield (Temp.). Motor Driver H. King. Cleansing Station Attendant Mrs. E.E.Doe. * Also Assistant Medical Officer, London County Council, Division 7. (a) Certificate Sanitary Inspectors Examination Joint Board and Meat and Other Foods Certificate. (b) Certificate Sanitary Inspectors Examination Joint Board. (c) Royal Society of Health Smoke Inspectors Certificate. ACCIDENTS IN THE HOME. In my last annual report reference was made to a scheme which was commenced in July 1957 whereby details of all home accidents treated at St. Giles' and Dulwich Hospitals were reported to me (thanks to the co-operation of the Camberwell Hospitals Management Committee). When this scheme had been in operation for one year, the information was analysed and a comprehensive report on the findings was submitted to the Council, and subsequently published in the medical press ("The Medical Officer",24th April,1959). Particulars have continued to be provided by these Hospitals and the report submitted to the Council has been amplified to include an analysis of the accidents reported up to the end of March 1959. Results Table I summarises the return during the period 1st July, 1957, to 31st March, 1959 (a period of one year and nine months). Table I HOME ACCIDENTS BY AGE GROUPS AND SEX Age Group Male Female Total Percentage of Total 0-5 212 141 353 28 157 6-15 87 70 13 16-65 143 539 396 43 65+ 30 168 198 16 Total 472 775 1247 100 Percentage of Total 62 38 100 Most of the accidents occur in the 16-65 age group, with a marked preponderance of females. Over the age of 65, the excess of female over male accidents is greater still. The smallest number of accidents is found between the ages of 6 and 15 and no sex differential is shown. The figures are further broken down in Tables I (a) and (I) (b). Table I (a) Accidents in the Home. BREAKDOWN OF THE AGE GROUP 15 YEARS-65 YEARS Age Group Male Female Total 46 22 16-20 68 204 21-45 80 284 46-65 146 41 187 539 Total 143 396 Table I (b) Accidents in the Home AGE GROUPS OVER 65 Age Group Male Female Total 1 31 65 30 70 9 52 43 75 9 39 48 9 80 33 42 85 - 10 10 90 2 13 15 Total 30 168 198 Table I (a) shows that in the group 15 to 65 years more than half the accidents occur in the middle period of life, i.e., between 21 and 45; 72 per cent, of these in women. Young people from 15 to 20 are far less liable. These results confirm the view that the housewife has a high occupational risk of minor accidents. As is to be expected,after 65 (Table I (b)) there is a relative increase in the number and seriousness of accidents and the female proportion is greater than would be expected from the numbers at risk. Accidents in old people are closely linked with increasing frailty and disability and those living alone are particularly prone. Lack of attention to foot defects also predisposes to falls. The Nature of the accidents Table II gives the type of accidents in age and sex groups. Falls make up nearly half the total. Falls on slippery floors increase in number as age advances and once more women are the chief victims. The stairs are a particular hazard to young and middle-aged housewives. As was to be expected very young boys hurt themselves from falls more often than girls; the stairs prove a risk to them also. Cuts formed the second largest group; the housewife being mainly affected. Carving knives, tins, bottles and wood choppers were the chief agents. Chopping wood causes accidents at all ages, one unfortunate father severing a child's digit whilst so doing. It is well known that fatalities from burns and scalds occur most often in young children and old people. These results demonstrate that the risk to the middle-aged is no less, although, for obvious reasons, the severity is generally diminished. It is gratifying to note that burns from unprotected fires are now far less frequent than formerly; the provision of fireguards and intensive propaganda may be responsible. Tea drinking— upsetting the teapot, kettle or tea cup—is again shown to be a dangerous procedure in the careless household, to the housewife as well as to the young and old. Table II DETAILS OF HOME ACCIDENTS 0-5 6-15 16-65 65 Total Grand Total M. F. M. F. M. F. M. F. M. F. r r (1) Falls On slippery/polished floor, mats. etc. - 29 4 - - - 42 11 7 71 82 6 12 51 118 Stairs 17 6 21 72 7 28 169 Against obstructions/ fixtures 35 13 10 6 4 8 23 2 13 2 58 23 - - 31 29 Whilst playing 26 5 6 - - 60 Out of bed 8 7 1 - - 6 3 6 12 19 31 20 9 2 2 1 18 1 14 24 67 Off chair/table 43 4 4 11 10 On/with door 5 3 1 2 2 - 21 4 3 1 - - 3 1 Off ladder - - - - 5 3 6 30 5 36 19 71 No cause given 5 - 90 Sub-total 42 138 94 63 27 25 171 22 185 397 582 (2) Cuts. 5 2 8 4 46 2 1 53 On kitchen appliances, knives, etc. 33 18 86 On glass (bottles/windows) 5 5 11 18 29 1 5 38 50 14 88 Tools: including sewing machines) 3 2 3 2 16 1 2 23 28 22 51 Playing 9 8 3 4 2 - - - 14 12 26 1 10 9 2 1 22 36 Other 6 3 4 14 Sub-total 28 20 32 22 64 106 6 9 130 157 287 6-15 16-65 65+ Total Grand Total 0-5 M. F. M. F. M. F. M. F. F. M. 1 Se(3) Burns/Scalds. 1 . ' 18 27 9 10 3 2 1 On unprotected fires 3 1 6 34 52 - 93 147 From liquids 21 13 12 7 8 54 6 3 2 2 12 1 10 21 31 Hot kitchen appliances 5 Other 1 1 1 - 10 6 - 1 12 8 20 225 50 31 25 72 1 11 94 131 18 17 Sub-total (4) Swallowing. Foreign bodies - 1 2 - - 5 9 3 - 10 15 8 1 - - 3 11 Poisonous liquids 2 - - - 8 8 5 - 2 1 3 - 2 9 12 21 Tablets Sub-total 25 - 2 2 - 27 20 47 6 2 10 (5) Electric shocks/ Burns - 1 1 - 2 1 - - 3 2 5 (6) Coal Gas Poisoning - - - 1 3 2 2 - 2 5 - 1 (7) Miscellaneous Defective window sash - - 12 - 17 2 1 1 - 4 1 18 3 6 1 10 13 Falling objects 3 - 13 - 8 - 1 15 3 3 20 2 27 38 65 Other 96 Sub-total 15 9 4 6 1 7 31 16 38 65 212 Total 141 87 70 143 396 168 472 1247 30 775 In one in every ten of the child casualties, foreign bodies, poisonous liquids or tablets had been swallowed. Prompt treatment prevented any fatalities, but in one or two cases there was doubt as to whether anything dangerous had in fact been ingested. The preventive lesson was learned notwithstanding. There is a heterogeneous list of swallowed materials —nails, glass, coal, methylated spirit, bleach, rat-poison, disinfectant, perfume and, of course, aspirin tablets. Structural defects which were easily remediable contributed to some of the injuries to housewives; broken sash cords caused 12 out of a total of 18 such accidents. Discussion The figures from this survey in Camberwell are in general agreement with previous studies. Falls accounted for 46.7 per cent, of all home accidents, cuts for 23 per cent. and thermal agents, burns and scalds for 18 per cent. Notification has proved of the greatest value in the control of communicable diseases, and it is increasingly evident that fact finding must also be an essential preliminary to the institution of preventive measures against many other problems of public health importance. Accidents in the home fall into this category. The mortality figures which are generally available give an incomplete picture, for minor accidents greatly exceed major ones and the age and sex grouping is different. Reporting by hospitals and general practitioners gives fuller and more detailed information, which serves as the basis for enquiry and correction. It is necessary also to know what is happening locally since social and environmental circumstances influence the type and incidence of these injuries. Most of the less serious accidents occur between the ages of 20 and 60 and housewives are specially liable. Many of these accidents can be classed as ordinary domestic hazards which are unavoidable; but in others there are personal or physical factors, the correction of which may prevent the occurrence of more serious or fatal injuries subsequently. The individual approach has advantages over the pamphlet, poster and lecture, and in this form of propaganda the public health inspector and health visitor have particular responsibilities. Both have a part to play, not only when they visit households in which accidents have occurred, but during their routine visits before accidents have happened. Each having established a liaison with the local gas board officials, should be on the look-out for defective appliances and also for structural defects such as broken window-cords and worn staircases or floors. The health visitor was able to give sound advice to numbers of housewives who figured in the present series, and the public health inspector initiated action to correct defects in many houses. The following defects were the subject of routine sanitary notices served during 1958: — Repair stoves, fireplaces and coppers 126 Repair windows, sashlines, sills, etc. 292 Repair flooring, stairs, doors, etc. 240 Provide sufficient light and ventilation 12 Provide or repair yard paving 32 There is a correlation between unsuitable housing and accidents. Overcrowding in small, badly-lit rooms, with unsatisfactory cocking arrangements, increases the risk, but unfortunately the housing shortage makes corrective action difficult. It is in these houses that carefulness and tidiness are so essential. The housewife who is out at work during the day and is tired when she gets home has a high accident potential. The disabled and frail, most of whom (but not all) are above pensionable age, need help and supervision and also early detection and treatment of their disabilities. Mention has already been made of the value of simple chiropody; the impairment of the sense of smell in old people should always be borne in mind when gas is used for cooking and heating. Many of the accidents among this group could have been prevented by removal to better rooms on ground floor level, or by alterations to existing accommodation. Unfortunately, in the aged and handicapped, accidents are generally severe and the preliminary injury of a minor nature, which calls attention to the need for preventive action, is not met so commonly. The routine reporting of accidents to the Medical Officer of Health is a most useful measure, but, in addition, information about unsatisfactory homes should be obtained from other agencies, both voluntary and statutory, particularly from social workers and others who gain entry to the homes. Other sources from which useful details have been obtained are the numerous applications for rehousing priority on medical grounds and for certificates of disrepair, and reports by smoke inspectors in connection with smoke control area visits. Conclusion The prevention of home accidents has now become an important part of the work of the Public Health Department. From the information available it appears that accidents requiring hospital treatment are on the increase. The graph on page 11 gives the number of cases reported by hospitals in the area in three-monthly periods since the investigation began. Whilst improved reporting may be partly responsible, the large increases shown after June, 1958, are not entirely accounted for in this way. Information about minor accidents is still scanty, but there is no doubt that for every death there is a large number of non-fatal accidents, and for every non-fatal accident there is a still larger number of minor ones in which medical treatment is not sought. This matter is now being investigated and the co-operation of the public is being sought in completing a questionnaire. It is hoped that this will supply valuable information. The success of preventive measures demands full and accurate information of accidents, and it is only by the co-operation of everyone concerned that this can be obtained. No. of Accidents in 3-monthly periods. NUISANCE FROM NOISE This is an age of noise and in conjunction with speed it has an influence on the tension and unrest which is characteristic of our times. Publicity has been given to the excessive noise from aircraft, especially since the development of the "jet," and there is greater noise on the roads with the increase of mechanical transport. Although of far less intensity, noises from factory machinery can be most annoying, particularly where work is carried on at night and at the weekend. The "whine" or "hum"is especially irritating, and is a sound to which people do not easily become conditioned. It is not surprising, therefore, that complaints about noises are on the increase. Although in some cases complaints seem to have little foundation, there are many instances where they appear to be fully justified. Investigations are made, and very often visits are paid at night or on Saturdays or Sundays. In all cases consultations take place with the management of the factory implicated, and considerable goodwill and co-operation has always been obtained. In a number of cases, extensive works have been carried out in an endeavour to abate the nuisance, but unfortunately it is rarely possible to completely eliminate the noise of machinery. The following list gives some of the major complaints of noise nuisances received during 1958 together with the action taken. Nature of complaint 1. Noise from mechanical Hoist 2. Noise from mechanical saw. 3. Noise from factory machinery 4. Noise from a room upstairs in a private house. Action taken and result Following representations to the management the hoist was overhauled and the noise thereby considerably reduced. No further complaint has been received. Investigation revealed that the noise was not excessive or unreasonable. Premises are being kept under constant observation. Alterations carried out to plant to reduce the noise. Still under observation. Investigation revealed that this was a disagreement between two tenants in the same house. No action called for by Council. Action taken and result Nature of complaint 5. Noise from factory machinery. 6. Noise at night from factory ventilating plant. 7. Noise at night from Hairdressers' drying apparatus. 8. Noise from building work at rear of a bakehouse. 9. Noise from machinery in builders' workshop. 10. Noise and vibration from laundry machinery. This was a repetition of a complaint made some months previously when at the request of the Public Health Department, the proprietors of the factory carried out alterations to reduce the noise. Since all reasonable steps were being taken and the noise was not considered to be excessive, no further action was possible. Representations to the management resulted in the repositioning of certain fans and the installation of silencing units. No further complaints have been received. Representations to the management resulted in the insulation of the party wall to the adjoining dwelling house and the resiting of the dryers. In addition the attention of the L.C.C. was drawn to this matter in view of the possible contravention of the Closing Hours clauses of the Shops Act 1950. No further complaint has been received. The co-operation of the management was sought to eliminate any unnecessary noise, but some noise was inevitable whilst the building works were in progress. When these are completed there should be no further cause for complaint. Following representations by the Public Health Department the workshop wall adjoining the dwelling house and the workshop ceiling was insulated; the machine area was also insulated. The management made application under the Town Planning Acts for permission to erect a workshop on land away from the dwelling houses to which the machinery could be transferred; this was refused. Meanwhile the continuance of the noise is giving rise to considerable disturbance to the occupants of the adjoining property. Full co-operation of the management has been obtained and steps are being taken to minimise the nuisance. This matter is still under observation. Section 66 of the London County Council (General Powers) Act,1937, states that ".... a noise nuisance shall be deemed to exist where any person makes or continues or causes to be made or continued any excessive or unreasonable or unnecessary noise which is injurious or dangerous to health". It also provides that it shall be a good defence for the person charged to show that he has used the best practicable means of preventing or mitigating the nuisance having regard to the cost and to other relevant circumstances. Whilst it may not be difficult to establish in certain cases that a noise is "injurious or dangerous to health," it is far more difficult to conclude that it is " excessive or unreasonable or unnecessary " and that "the best practicable means of preventing or mitigating the nuisance" have not been taken. It may well be that the time has come for additional legislation on this subject. Nuisances from noise are of increasing importance nowadays, and there is no doubt that they can constitute a very real menace to the public health. Apart from physical ill-effects to the hearing apparatus, the annoyance may result in lack of sleep and considerable mental anxiety. Whilst due regard must be paid to the inconvenience caused to the public, where factories are already established and authorised under the Town Planning Acts in built-up areas, and all practicable means are taken by the managements to reduce the noise, it is extremely difficult to take statutory action. It is unfortunate that in so many of these complaints one has eventually to inform the complainants that nothing more can be done by the Public Health Department, but that the only remaining course is for not less than three householders or occupiers within hearing of the noise to take action through the civil courts. The practice of seeking the goodwill and co-operation of the factory management has generally produced good results, and only in the event of an obstructive or apathetic attitude on the part of the person or persons responsible for the noise nuisance would it appear that legal proceedings may be justified. There is a more recent series of complaints in connection with the breaking-up of old cars on the many pieces of unfenced waste land which were formerly the site of war-damaged property, and the running of motor engines of vehicles parked near private dwellings late at night or in the early morning. CLEAN AIR Smoke Control Area At the beginning of the year the Council made a successful application to the Minister of Housing and Local Government for approval in principle to the establishment of a Control Area of 1,025 acres in the southern end of the Borough. The detailed survey of this area continued throughout the year and at the end of December was nearing completion. It is anticipated that a Smoke Control Order in respect of this Area, which is one of the largest proposed smoke control areas in the country, will become operative on the 1st October, 1960. Dark Smoke (Permitted Periods) Regulations, 1958 These Regulations, which were made by the Minister under the provisions of Section 1 (2) of the Clean Air Act, 1950, came into operation on the Ist June, 1958. They prohibit the continuous emission of dark smoke from any chimney, caused otherwise than by soot-blowing, for a period exceeding four minutes; or the emission of black smoke for more than two minutes in the aggregate in any period of 30 minutes. " Black Smoke" is defined by the Regulations as smoke which, if compared in the appropriate manner with the Ringelmann Chart, would appear to be as dark or darker than shade four on the chart. New Furnaces Under Section 3 of the Clean Air Act, 1950, application may be made to the local authority for prior approval to the installation of a furnace. Two such applications were received during the year, and as the Council were satisfied that the plans and specifications were for furnaces which were capable of being operated continuously without emitting smoke when burning fuel of a type for which the furnaces were designed approval was given in each case. Industrial Survey This survey of all the industrial and domestic heating plants in the Borough with an output of 55,000 B.T.U.'s or over was completed in the early part of the year and revealed the following information: — Industrial Visits 258 Domestic Visits (Boilers and furnaces over 55,000 B.T.U.s output) 399 Other visits, including revisits, complaints, observations 1,106 Total visits 1,763 No. of Boilers inspected 783 No. of furnaces 1,022 No. of incinerators 145 Fuel consumption for boilers and furnaces as above: Tons per annum Number using Coal Oil Gas Waste Coke Electricity 10,091 Industrial 14,481 5,028 43 2 8 4,933 5,573 49 6 Domestic 10,087 - 10,601 19,414 20,178 92 14 Totals 2 Grand Total Fuel Tonnage 50,193 Coal Coke Oil Gas Electricity Waste 107 - 4 Furnaces fired mechan- ically 185 49 2 Total number of furnaces fired mechanically 347 Total number of furnaces fired by hand 669 Total 1,016 Summary of Other Information: Smoke Density Meters provided 7 Smoke Density Meter/Recorders provided 3 Grit arresters provided, (existing) 4 Grit arresters provided, (new) 3 Smoke stats (mechanical) on oil fired furnaces 50 C.O.2 Meters and/or Recorders provided 11 Draught gauges provided 10 Cupolas inspected (Metal smelting works, coke-fire d, cool air blast) 1 Diesel generators (booster) 1 Diesel engined pumps (M.W.B.) 4 Stokers—Certificated 3 Ex Royal Navy 4 Ex Merchant Marine 3 Engineers, in charge of 10 Fishmongers, smoke holes or smoking cabinets 12 Sausage manufacturers, ditto 2 Gas fired stoves or stoving ovens 5 16 Gas Oil Coal Coke Electricity Bakers' Oven Furnaces fired by 36 17 19 8 1 Total 81 Measurement of Atmospheric Pollution There are four instruments in use in the Borough for calculating the amount of atmospheric pollution; a Deposit Gauge and Lead Peroxide instrument which are sited on the roof of the Queen's Road Centre, and two Volumetric instruments —one at the Town Hall and one at the Lordship Lane Infant Welfare Centre, 475 Lordship Lane. The information obtained from these instruments is furnished monthly to the Department of Scientific and Industrial Research, and the annual figures for 1958 are shown in graph form on pages 38-41, in the statistical appendix to this Report. It will be interesting to see what effect the operation of the Clean Air Act and Dark Smoke Regulations may have on these figures during the next few years—particularly where Smoke Control Orders become operative. Clean Air Exhibition In order to supplement the intensive health education activities which continued with undiminished vigour throughout the year, a Clean Air Exhibition was established at the Friends' Meeting House, Highshore Road, Rye Lane, S.E.15, from 24th September to Ist October inclusive. This Exhibition, which was opened by His Worship the Mayor, Councillor Frederick A. Goldwin, J.P., appeared to be quite successful. It was visited by more than 1,000 members of the public who showed considerable interest in the campaign for clean air. The co-operation of the Coal Utilization Council, the London Electricity Board, the South Eastern Gas Board and the Fuel Research Station of the Department of Scientific & Industrial Research was most valuable and much appreciated. One of the Council's Smoke Inspectors was in attendance all the time the Exhibition was open to give information and advice to the public who made full use of this service. SANITARY CIRCUMSTANCES Water Supply Every dwelling house in the Borough is provided with a direct water supply from the mains of the Metropolitan Water Board, and no complaints were received during the year as to its purity. Bombed sites These "scars of war" continued to give rise to complaints of nuisances resulting from the dumping of rubbish as well as their improper use as playgrounds by children and their general unsightliness. They were, however, kept under close surveillance, and when necessary arrangements were made for the removal of any offensive refuse which might have constituted a danger to public health. It is hoped that this will be a decreasing cause for complaint as re-building takes place. It is extremely difficult to enforce the Council's Byelaw concerning the Deposit of Litter to the Detriment of Public Amenities, as it is not practicable to maintain a 24-hour supervision over these sites. Even where fences enclose the land refuse is often thrown over them and they are very quickly damaged or broken down by children. The sites in Crown Street, which have been acquired by the London County Council for housing development purposes, have been particularly troublesome, since they are used almost daily by "totters" for the sorting of their "wares" and the disposal of unsaleable material; frequently these itinerant traders light bonfires on the sites, the smoke from which gives rise to serious nuisances. Representations have been made to the London County Council on many occasions, as the result of which some of the sites have been fenced. Nevertheless, the removal of accumulations of offensive refuse is frequently necessary, and it would seem that these recurrent nuisances are likely to continue until building on the land commences. Static Water Tanks No complaints were received during the year of nuisances arising from static water tanks. This was, no doubt, due to the vigilance of the public health staff. During the warmer weather the rain water which collected in the tanks was sprayed as a routine measure to prevent the breeding of mosquitoes, as a result no mosquito larvae were found. When necessary the Fire Brigade was requested to pump the water from the tanks and the Borough Engineer & Surveyor then arranged for the removal of any accumulations of refuse. In this way nuisances were prevented and the public health safeguarded. Rodent Control The scheme which was put into operation in July 1957 for the treatment of sewers at three-monthly intervals with block bait containing "Warfarin" was continued throughout the year. Since 1949, there has been a progressive reduction in the number of complaints of rat infestations received at the Public Health Department, and the fall in the figure for 1958 (962 against 1,205 the previous year) is most encouraging. It would appear that the improved methods of sewer treatment were largely responsible for this substantial reduction, because surface treatment was curtailed considerably throughout the year owing to shortage of staff caused by absences through sickness and injury. In August of the year under review, a Circular was received from the Ministry of Agriculture, Fisheries and Food drawing attention to the advantages of carrying out rodent control treatment in sewers by the use of sodium fluoracetate in four directpoisoning treatments per year. Sodium fluoracetate (commonly known as "1080") is a particularly deadly poison to which there is no known antidote, and its sale to a representative of a local authority for use as a rodenticide is only permitted on production of a prescribed certificate signed by the Medical Officer of Health. It is extremely important, therefore, that every precaution should be taken in handling this dangerous substance. Experiment in Camberwell has shown, however, that with proper control at the bait-preparing depot, the mixing and preparation of baits containing sodium fluoracetate can be carried out safely. Their successful application in the sewers, however, presented a difficult problem which the Rodent Officer solved by devising a bait which is made in a patented block form and sealed in a paper packet. This method obviates any danger by avoiding the necessity for the operator to handle or come into direct contact with the bait in any way. A record is kept of all baits made and issued from the depot, and the operator is required to account for all baits used on his record sheet, returning any unused baits to the Depot the same day, where they are kept in locked containers. At the end of the year a meeting took place between Officers of the Ministry and this Council, following which a letter was received indicating the Ministry's approval to a scheme for disinfestation of the sewers by the use of block baits containing sodium fluoracetate during the ensuing twelve months. "Single Stack" Drainage In July 1958 the Public Health Committee gave consideration to an application for permission to use the single stack system of drainage on a conversion scheme. The L.C.C. Drainage Byelaws make no provision for this system although it has been permitted outside London for some time. The London County Council indicated, however, that they are satisfied that the system operates satisfactorily provided the installations are properly designed, and that they would raise no objection in principle where a local sanitary authority was prepared to permit such a system, subject to compliance with certain, conditions. In fact, both the County Council and this Council have used the system successfully in a number of housing schemes. In the circumstances, and until such time as the byelaws are revised, the Committee decided to permit the use of the single stack system in Camberwell subject to the usual form of application being submitted; compliance with the design rules recommended by the Budding Research Section of the Department of Scientific and Industrial Research, and the Council being indemnified against any consequences arising from the works not being in accordance with the byelaws. Artificial Lighting of Common Staircases The Byelaws adopted by the Council at the end of 195 7, were approved by the Minister and came into operation on the 1st April, 1958. Briefly, the Byelaws require that the occupier of every tenement house to which these byelaws apply, and the owner of every block of flats shall provide adequate artificial lighting for all common staircases: (a) From half an hour before sunset to midnight. (b) For one hour before sunrise during the months of October, November, December, January, February and March, and (c) At other times as and when necessary if adqeuate means of natural lighting are not provided. It did not become necessary for any statutory action to be taken during the year to enforce compliance with these byelaws. HEALTH EDUCATION The scope of health education is widening; there have been increases in the number of talks, demonstrations and publicity material. A recent innovation has been the inclusion of a short article on a health topic in the Supplement to the Council's Diary of Local Events "Camberwell Calling." Subjects already dealt with have included "Clean Air," "Clean Food" and "Accidents in the Home." These appear to have been much appreciated by the public; indeed one article was reproduced in a local Church magazine Pamphlets and Posters It is a matter for consideration as to whether the educational value of the ordinary pamphlet and poster is commensurate with the expenditure involved in producing, displaying and distributing this material. The reactions of the public to this form of health education are being sought by means of a public opinion poll in an endeavour to find out the amount of notice that is taken of them and their educational value. In any case, the principle of concentrating on one particular topic at a time is undoubtedly more effective than the simultaneous display of posters on varying health subjects. The co-operation of the Public Libraries has been most useful in issuing booklets and bookmarks, which are, in fact, taken by the public in very considerable numbers. Several hundred booklets on the subject of "Clean Air" have already been distributed through this channel. Talks During the year talks have been given by the Medical Officer of Health and members of his staff to schools, mothers' clubs, women's and men's co-operative guilds, scoutmasters groups and other organisations. The main topics were General Health, Clean Air, Clean Food, Accident Prevention and the Health Education of Youth. These talks were supplemented by sound films, film strips, flannelgraphs and other visual aids. Opportunities have also been made available for talks in a number of schools, followed by visits by groups of selected children to the Public Health Department, the Council's Disinfecting Station and so on. The greatest effort must be expended o young people, but before doing so, Youth must be educated. Every opportunity has been taken to talk to such groups, but there is a great deal more to be done. The whole question of the training of Youth Leaders is one of increasing importance; there is a very urgent need for recruiting more people to undertake these vitally important and onerous tasks and giving them a background training in health and social matters. It was very gratifying to see the enthusiasm of the large group of Scoutmasters, Girl Guide, Brownie and Wolf Cub Leaders when they were addressed by Officers of the Public Health Department on such topics as good habit formation, cigarette smoking, health consciousness and the responsibility of the individual to the community. Whilst films, film strips and flannelgraphs are valuable, the group discussion is of particular importance. The long lecture is outmoded and our policy now is to substitute a short address with visual aids followed by group discussion. Exhibitions Health exhibitions, whilst no doubt of considerable interest to those who visit them, are necessarily of short duration and are expensive to establish. It is frequently difficult, too, to find a suitable and conveniently situated building in which to hold them. One wonders, also, whether the large static exhibition is visited in sufficient numbers by those for whom it is intended, or whether it only "preaches to the converted." Small portable single-topic exhibits which can be taken from place to place and shown for short periods in various parts of the area are probably more effective. They have the added advantage that they can be stored more easily for future use. Such exhibits have been made use of by the Public Health Department for displays in the Town Hall, Public Libraries and, by arrangement with the London County Council Divisional Office, at certain Welfare Centres in the Borough. General Whatever efforts are made in this direction, they will be most rewarding when they are directed at children and young people. Finally, those who have personal contact with the public —public health inspectors, health visitors, social workers and voluntary and official domiciliary visitors —can have the greatest impact on the health consciousness of the community. HOUSING New Houses The Council completed the building of 214 new dwellings during the year, and 990 new houses and flats were in the course of erection at the end of December. Housing applications The scheme of co-operation with the Housing Department, whereby housing applications supported by medical certificates were referred to the Medical Officer of Health for consideration as to the award of priority points on medical grounds, was continued throughout the year. The number of such cases dealt with was 302; these are summarised in the following table showing the medical conditions and degrees of priority recommended. MEDICAL PRIORITIES FOR REHOUSING 1958 Category 1. Category 2. Category 3. Category 4. G.P's Recomm. M.O.H's Recomm. G.P's Recomm. M.O.H's Recomm. G.P's Recomm. M.O.H's Recomm. G.P.'s Recomm. M.O.H's* Recomm. Medical Condition - 1 12 12 14 13 22 22 Tuberculosis Bronchitis and/or Asthma 7 3 17 15 13 9 3 12 Other respiratory conditions 3 3 6 5 11 11 1 2 Rheumatic conditions Heart conditions 4 1 8 6 7 9 2 4 5 5 10 10 3 2 1 1 Physical disabilities (bad legs etc.) - - 6 6 2 2 - - Nervous disorders 13 2 24 21 22 15 8 28 Other medical conditions 15 9 36 40 23 19 4 10 *In addition, there were four instances where, although no medical category was recommended, an exchange to ground floor accommodation was advised. In 18 instances where the applicants sought priority on grounds of tuberculosis in a member of the family, it was found that the patient was not, in fact, on the tuberculosis register. There were 51 cases where the provision of ground floor accommodation was recommended, and in six cases it was reported that conditions were aggravated by friction between tenants in the same house. Twenty-one applicants who had been recommended for priority consideration on medical grounds were provided with alternative accommodation by the Council during the year; of these, eight were rehoused within three months of the recommendation, two within six months, and the remaining 11 a year or more afterwards. Overcrowding Only 51 cases of overcrowding came to the notice of the Public Health Department during the year (as compared with 74 in 1957), and the usual notifications were sent to the Housing Departments of both the L.C.C. and the Borough Council in support of housing applications by the affected families. Twenty-six overcrowded families were rehoused during the year; 19 by the London County Council and seven by the Borough Council. Certificates of Disrepair The number of applications received during the year for Certificates of Disrepair under the provisions of the Rent Act, 1957, was three less than the number received during the preceding six months, i.e., from the date of operation of the Act (6th July, 1957) to the end of that year. There was, however, a considerable increase in the number of Certificates issued, but many of these were in respect of applications received the previous year. The demand for the Council's assistance in these matters had diminished considerably by December 1958, and the following table gives details of the Department's activities in this matter since the Act became operative: 1957 1958 Total (from 6.7.57) No. of applications for Certificates of Disrepair 414 411 825 o. of undertakings received from Landlords 220 284 504 No. of Certificates of Disrepair issued ... 105 157 262 No. of Certificates of Disrepair refused 3 6 9 No. of Certificates of Disrepair cancelled 16 75 91 Slum Clearance Two further clearance areas in the current five-year programme (1956-60) were declared during the year: Area Date of declaration No. of dwelling Houses No. of persons to be displaced Old James Street 8.1.58 37 11 22.10.58 13 Royal Oak Place 41 This leaves only three more areas to complete the present programme and attention is already being given to the preparation of the proposed slum clearance activities for the five years— 1961 - 65. OCCUPATIONAL HEALTH It is, perhaps, not usually appreciated that the Medical Officer of Health has an important role in respect of the health of the Council's staff. His duties include general supervision of the health of the employees; examination of all staff on entry to the permanent establishment, and of temporary employees for admission to the Sickness Pay Scheme; and the investigation of extended sickness absences. During the year 246 temporary employees were medically examined, of whom 209 were found to be of a standard of fitness which enabled them to be recommended for appointment to the permanent staff or for entry into the Sickness Pay Scheme. It is worthy of note that in the second category there was a preponderance of applicants in the older age groups. It is gratifying to find that it is possible to continue to employ a number of men over the statutory retiring age of 65 years. In every case a chest X-ray examination was carried out. Abnormalities were found in 19 cases representing 7.7 per cent. of the persons examined. Apart from the essential place of chest radiography in routine medical examinations, this procedure is a useful adjunct to the national scheme for protection against tuberculosis and other chest diseases in the public. Sickness absences of Official Staff For the first six months of the year sickness absences exceeding three days among the official staff were recorded; the results are given in the following table: ANALYSIS OF STAFF SICKNESS (OFFICERS) EXCEEDING 3 DAYS Dept. Total Staff No. of staff absent Average Monthly Sickness rate Monthly Average Feb. Mar. Apr. May. June Jan. 95 A. 9 18 6 1 5 8 8.2% 7.8 3.6% B. 100 6 7 - 2 3 4 3.6 C. 32 3 7 1 - 1 1 2.2 6.9% 5.9% D. 73 6 10 4 3 2 1 4.3 E. 90 9 12 6 5 7 11 8.3 9.2% F. 64 8 5 2 3 3 2 3.8 5.9% TOTAL 59 19 14 21 27 30.2 6.6% 454 41 REPORT OF CONSULTANT PHYSICIAN CAMBERWELL CHEST CLINIC During the year, 15,146 units of X-ray work were carried out. Of this total 7,350 new cases had X-ray examination, and as a result 2,247 new patients had a full clinical examination. It will be seen from the table that there has been an appreciable increase in the work in this department since 1956. The increase in work has no doubt come about in part because of the service we are able to give to general practitioners. It is possible to X-ray a patient and send the report to the general practitioner all in the same day, and those patients that need to be seen for clinical examination are given an appointment within a few days. Unfortunately, this service to general practitioners is getting increasingly difficult to maintain with the present small medical and clinical staff. There has been a gratifying decrease in the number of patients with tuberculosis who attended either for the first time or for regular supervision, but this decrease has not led to any easing of the work of the department, since many more patients with pulmonary and cardiopulmonary symptoms are referred to us for advice and treatment. The number of new cases added to the register was 185, of which five were non-respiratory cases. This total is considerably less than the previous year when the figures were 343 and 15 respectively. Only eight cases came in from other areas but nearly the same number as the previous year, i.e., 87 cases on the register moved out of Camberwell. Twenty-six patients whose names had been on the register died and 32 deaths were directly attributable to tuberculosis. Nine hundred and fifty-four persons were examined as contacts for the first time during the year. B.C.G. vaccination was given to 1,150 children, 649 of these being contacts and children who were not vaccinated by the B.C.G. teams at school, and 501 babies born in the maternity department in St. Giles' Hospital. 1956 1957 1958 Cases on Register 1,886 1,771 1,698 Attendances 10,860 10,460 11,815 New cases 5,918 6,164 7,530 X-rays 10,953 11,763 15,146 Patients examined during 1958 for the first time by: (a) Complete examination 2,247 (b) X-ray only 5,283 During the winter months 86 patients with chronic bronchitis took part in the Influenza Vaccine Trials organised by the Medical Research Council. These trials were run on the same lines as those carried out in the previous year when a similar number of Camberwell patients was included. Although the national figures have not been particularly conclusive when analysed in the most critical way, there was hardly a patient who did not maintain that at least subjectively he felt considerably better for the vaccine. Fortunately, there was not a great deal of very bad weather or periods of smog during the year under review, and although the influenza outbreak produced severe and debilitating symptoms, the infection never reached the epidemic proportions of the previous year. The work of the Health Visitors continues to be of the utmost importance and in all, 3,821 successful visits were made. Although the tuberculosis health visiting entails calling on fewer patients, the amount of work involved in assisting and advising the tuberculous households has increased, and so too has the time that the Lady Almoner is able to devote to her interviews. However, in the cases of both the Health Visitors and the Lady Almoner, the scope of their work has widened and now includes supervision of families where there are Mantoux positive children and many elderly chronic bronchitics. The work of these two social departments is more than ever necessary nowadays and their complementary nature must never be overlooked. We wish to extend to the Divisional Medical Officer of the London County Council and her staff, Dr. Chalke and his staff of the Borough Health Offices, the District Nursing Organisations and the London County Council Ambulance Service, our appreciation for their help and co-operation during the year. KENNETH MARSH, Consultant Physician. Chest Department, St. Giles' Hospital, S.E.5. ANNUAL REPORT OF THE CAMBERWELL TUBERCULOSIS CARE COMMITTEE FOR THE YEAR 1958 The Committee continued its work as in other years which included financial and other assistance to patients, and generally meeting their needs where circumstances necessitated action, raising of funds by voluntary subscriptions through the Christmas Seal Sale, references to other Bodies and organisations, and the occupational therapy class. As before, most of the cases which the Committee considered were referred to it by the medical staff and health visitors of the Chest Clinic, the general practitioners, Almoners of hospitals, and various voluntary organisations. Included in the general work the Secretary gave 1,430 interviews. The table below indicates the number of cases assisted by the Committee during the year and the type of assistance provided: Pocket money while in hospital 21 Taxi fare 10 Lodgings and meals 19 Household removals and help with furnishings 8 Clothing 38 Wireless (repairs and licences) 5 Fares of relative to distant sanatoria 13 Loan of beds 10 Supply of sheets, blankets and other bedding 22 settlement of hire purchase arrears, payment of electricity and other outstanding accounts, installation of gas fire 6 Loan of dressing gowns 14 Pyjamas for those confined to bed or on admission to hospital 17 Supply of towels 9 In addition, following investigation by the Secretary into the circumstances of new patients reference was made to the National Assistance Board in 99 cases for financial or other help. The Committee again participated in the Christmas Seal Sale for 1957 to 1958 and the net sum received up to 31st March 1958, was £1,141 1s. 3d. We extend our thanks to all who made this result possible, for it is realised that this method of raising money is becoming more difficult each year. Early in the year the Committee provided an aquarium and tropical fish for the waiting room of the Chest Clinic. As this created such interest amongst the patients more fish of rarer types were later purchased and added to the tank. We are indebted to a former patient for his knowledgeable advice on the choice of fish and for his enthusiasm in so kindly looking after the tank once it became established. The Committee purchased an additional typewriter for the use of patients who wished to become typists when fit for work. This has proved very useful and helpful. In July it was decided that for a period of twelve months the scope of the work of the Committee should be enlarged to enable assistance to be given to former tuberculosis patients now suffering from diseases of the chest or of the heart, other than pulmonary tuberculosis. In the meantime no alteration will be made to the name of the Committee. The handicraft class continued to meet each Friday afternoon. During the first six months there were 20 students on the Roll. At the end of the year the Roll had decreased to 15—three students having left to commence work and two moved from the Borough. The Committee were able to arrange the usual summer and winter social events for the students. A day's outing was held at Southend during the summer and just prior to Christmas a visit to a theatre was followed by supper. The Worshipful the Mayor of Camberwell (Councillor F. Goldwin, J.P.) issued to the Committee a number of toys and books at Christmas time for the children of patients. These were distributed by the Secretary on behalf of the Committee. We appreciate and record our thanks to the voluntary associations in the Borough for their close co-operation. These include The British Red Cross Society, Family Welfare Association, Nursing Associations, Invalid Children's Aid Association, Rotary Club "Wireless for the Bedridden," Soldiers, Sailors and Air Force Families Association and the Women's Voluntary Services. The official bodies have continued their help and advice for which we thank them. We place on record our thanks to the Worshipful the Mayor of Camberwell (Councillor F. Goldwin, J.P.) Patron of the Christmas Seal Sale; Mrs. Lilian Reddeford, Organiser of the Seal Sale; Mr. H. Smith, Borough Treasurer, who is our Honorary Treasurer; and Mr. R. A. Hughes, our Honorary Auditor; and the Camberwell Borough Council for affording us accommodation for our meetings. We also thank Dr. H. D. Chalke, Medical Officer of Health of Camberwell, for including the Care Committee's Annual Report for 1957 in his Annual Report for the same year. AMY CROSSMAN, Chairman. J. M. LEONARD, Secretary. STATISTICAL APPENDIX. Summary of Statistics. for the year 1958. Area of the Borough 4,480 acres Greatest length 4¾ miles „ breadth 2½ miles „ height above Ordnance Datum (Sydenham Hill) 365 feet Population (Census April 1951) 179,777 „ (estimated by Registrar-General mid-1958) 177,300 Number of inhabitated houses (April 1958) 44,073 Rateable value (April 1958) £2,333,054 Sum represented by a penny rate (estimated) £9,280 Number of live births 3,021 Birthrate 17.0 Number of deaths 2,042 Death rate 11.5 Infantile Mortality:— Deaths under 1 year 65 Infant deaths per 1,000 live births 21.5 Maternal Mortality:— Deaths of women from diseases or accidents associated with childbirth 1 Maternal death rate per 1,000 total births 0.32 Deaths from Phthisis 30 Phthisis death rate 0.17 Deaths from all forms of Tuberculosis 32 Tuberculosis death rate 0.18 33 TABLE SHOWING CLASSIFIED CAUSES OF DEATHS IN AGE GROUPS IN CAMBERWELL DURING 1958 Causes of death. Sex. All Ages. 0- 1- 5- 15- 25- 45- 65- 75- M. 1,062 35 5 3 13 37 304 303 362 All causes 487 F. 980 30 6 5 31 168 251 2 - Tuberculosis, respiratory M. 20 - - 1 2 11 2 4 2 F. 10 - - 1 3 - 4 - Tuberculosis, other M. 1 - - 1 - - - - - 1 1 F. - - Syphilitic disease - - - - - - M. 4 - - - 2 - - 2 2 - 1 1 - F. - - - - Diphtheria M. - - - - - - - - - F. — - - - - - - Whooping Cough - - - M. - - - - - - - - F. - - - - - - - - - Meningococcal infections M. - - - - - - - - - - - — - - F. - - - - Acute poliomyelitis M. - - - - - - - - - - 1 - 1 _ - - F. - - Measles - - M. - - - - - - - - F. - - - - - - - - Other infective and parasitic diseases M. 1 - 2 - - 1 - - - - F. 1 - - - 1 - - Malignant neoplasm, stomach — M. 23 - 7 11 - - - - 5 Malignant neoplasm, lung, bronchus F. 17 - - - - - 1 10 6 - 95 - - - 2 51 M. 30 12 9 1 F. - - 2 4 2 Malignant neoplasm, breast - - M. - - - - - - - - - 19 12 7 F. 38 - - Malignant neoplasm, uterus - n F. - 14 - l> 7 1 - - 4 38 Other malignant and lymphtic neoplasms 5 M. 113 - - - - 32 38 1 F. 98 - 3 2 25 33 34 - Leukaemia, aleukemia M. 4 2 - - - - 1 - 1 12 F. 2 - 1 - - 2 4 3 Diabetes 3 - 1 2 M. - - - - - F. 9 2 - 3 - - - - - Vascular lesions of nervous system 85 - 3 14 38 M. 1 29 - - F. 147 - - 5 25 29 - - 78 M. - 77 Coronary disease, angina 185 - - - 5 60 43 F. 116 - 1 16 38 - - 61 - Hypertension with heart disease - 3 M. 20 - 10 7 - - - 2 8 F. 45 35 - - - - - M. - 11 17 Other heart disease 86 - - 3 55 - F. 121 - - - 2 14 21 84 - Other circulatory disease 49 - 14 15 M. - - - - 20 F. 65 11 38 - - 6 - — - M. 4 - - Influenza - - - 4 - - F. 3 - - 1 2 - - - - M. Pneumonia 67 - - - 1 1 14 14 32 F. 82 5 - 1 - 4 25 47 - Causes of death Sex. All Ages 0- 1- 5— 15- 25- 45- 65- 75- Bronchitis M. 126 2 - - - 1 33 40 50 F. 49 - - - - - 11 10 28 Other diseases of respiratory system M. 8 - - - - - 3 3 2 F. 5 - - - - - - 3 2 Ulcer of stomach and duodenum M. 20 - - - - 7 6 1 6 F. 3 - - - - - 2 1 - Gastritis, enteritis and diarrhoea M. 3 - - - - - 2 - 1 F. 5 - - - - - 3 1 1 Nephritis and nephrosis M. 7 - 1 - - 1 1 3 1 F. 5 - - - - 1 2 - 2 M. 22 - - - - - - 7 15 Hyperplasia of prostate Pregnancy, childbirth, abortion F. 1 - - - - 1 - - - Congenital malformations M. 10 8 1 1 - - - - - F. 11 7 - - - 3 - - 1 Other defined and ill-defined diseases M. 19 2 - 1 3 10 15 60 10 F. 75 17 1 1 1 2 11 14 28 Motor vehicle accidents M. 11 - - - - 1 5 - 2 2 1 F. 7 1 1 - 1 2 2 All other accidents M. 18 1 - 1 2 3 6 2 3 14 1 - - - - 1 - 12 F. Suicide M. 16 - - - 1 5 5 1 4 F. 13 - - - 1 4 1 6 1 Homicide and operations of war M. - - - - - - - - - F. 1 - - - - 1 - - - Births. Still Births Total Live Births M. F. M. F. M. F. 1433 1367 1463 1386 30 19 Legitimate 2 3 129 97 127 94 Illegitimate 32 22 1592 1483 1560 1461 Total 3021 54 3075 Medical Examinations carried out by the Medical Officer of Health or his Deputy. Officers for admission to the Permanent Establishment 27 Officers for admission to the Unestablished Staff 3 Employees for admission to Sick Pay Scheme 148 Employees for admission to Permanent Establishment 68 Employees absent from duty owing to sickness 469 Cremation Certificates. No. of cremations authorised during the year by the Medical Referee or his Deputy e . 2,010 Water Certificates. No. of Water Certificates issued 85 No. of dwellings concerned 356 Drainage and Sewerage. No. of drainage applications received 301 Length of new sewers constructed 658 ft. Length of sewers reconstructed 2,866 ft. No. of brick gullies replaced by pot gullies 97 No. of defective pot gullies renewed 17 Public Cleansing. Amount of house refuse collected 46,942 tons Amount of trade refuse collected 807 tons Examination of Water from the Council's Swimming Baths. Bacteriological examination Chemical examination No. of Samples No. Satis. No. of Samples No. Satis. 5 Camberwell Front Swimming Bath 5 5 5 12 12 Camberwell Rear Swimming Bath Dulwich First Class Swimming Bath 12 12 6 6 6 Dulwich First Class Swimming Bath 6 12 Dulwich Second Class Swimming Bath 12 12 12 35 35 35 Total 35 In addition, water from the Swimming Bath at Mary Datchelor Girls' School, Camberwell Grove, was chemically and bacteriologically examined on four occasions. All the samples were satisfactory. Rag Flock and other Filling Materials Act, 1951. No. of Samples examined Type of Material No. Satisfactory Rag flock (loose) 4 4 Rag flock (layered) 8 6 3 Woollen mixture felt 3 1 1 Sized cotton felt Cotton felt 3 3 Algerian fibre 2 2 Coir fibre 4 4 1 1 Fibre (pad) 2 2 Cotton millpuffs 28 Totals 26 Two samples of layered rag flock forming part of composite pads were found not to be satisfactory. These composite pads are made up of coir fibre needled on to a hessian backing and the coir pad is then covered with tissue paper and a layer of rag flock needled on. The pads are used in the furniture upholstery trade. One sample just failed the soluble impurities test, the permitted maximum being 1.8 per cent. and the actual test figure being 1.9 per cent. The other sample failed both the soluble impurities test and the test for chlorine content, the soluble impurities figure being 2.0 per cent. and the chlorine content 200 parts per million (permitted maximum 30 parts per million). The matter was reported to the Public Health Committee. Having regard to the fact that the failure of the tests in the layered flock may have been caused by salt from the coir fibre impregnating the flock during manufacture of the composite pads, the Medical Officer of Health for the area in which the place of manufacture was situated, was informed accordingly; samples were taken at the factory and found to be satisfactory. In the circumstances the Committee decided to take no action. Offensive Trades. Type of business. No. on Register. Skin dressers 4 Soap boilers 1 5 Total Pet Animals Act, 1952. No. of licences issued Nil No. of licences renewed 11 11 Total No. of pet shops licensed Pharmacy and Poisons Act, 1933. No. of applications received for registration 18 No. of applications received for renewal of registration 169 London County Council (General Powers) Act, 1954. No. of hairdressers and barbers premises registered 132 ATMOSPHERIC POLLUTION 1958 Total Solids Deposited—Tons per Square Mile. ------------- = Solids Deposited — = Rainfall Apparatus installed at Queen's Road Health Centre. ATMOSPHERIC POLLUTION 1958 Estimation of Sulphur by Lead Peroxide Method. Apparatus installed at Queen's Road Health Centre. Milligrams of SO 3 Fixed Per Day Per 100 Sq. Cms. ATMOSPHERIC POLLUTION 1958 Average Concentration of Smoke in Milligrams per Cubic Metre. Average Concentration of Sulphur Dioxide in Parts per Million Volumes of Air. Apparatus installed at Town Hall. ------- = Solids Deposited - = Rainfall ATMOSPHERIC POLLUTION 1958 Average Concentration of Smoke in Milligrams per Cubic Metre. Average Concentration of Sulphur Dioxide in parts per Million Volumes of Air. Apparatus installed at 475 Lordship Lane - = Smoke ----- = Sulphur Dioxide Sanitary Inspection of the Area. No. of complaints received 3,196 Summary of Work carried out during the year 1958. Inspections:— Nuisance inspections 3,372 Offensive trades 52 Smoke observations 38 it m .» Drainage, new and existing 5,912 Overcrowding 446 Factories and workplaces 906 Outworkers' premises 425 Rag dealers 78 Infections and other diseases 348 Verminous premises and persons 104 Aged and infirm persons 190 Common lodging houses 17 Conveniences, public and private 277 Heating appliances (Fireguards) Act, 1952 51 Rent Act, 1957 1,224 Shops Act 917 Hairdressers and barbers 162 Voluntary work 128 Inspections not defined 837 Re-inspections 13,706 Total inspections 29,190 Works supervised:— ni J Tests applied to drains (existing premises) 314 Drains found defective 119 Drains totally reconstructed 27 Drains repaired or partially reconstructed 217 Tests applied to drains (new buildings) 3,093 Drains constructed 737 Total works supervised 4,507 Description of Sanitary Improvements ordered during the year:— Cleanse and repair walls and ceilings 353 Repair roofs, gutterings, etc. 776 Abate dampness 1,058 Repair stoves, fireplaces and coppers 126 Repair windows, sashlines, sills, etc. 292 Repair flooring, stairs, doors, etc. 240 Provide sufficient light and ventilation 12 Provide dustbin 104 Remove offensive matter 28 Provide or repair yard paving 32 Provide or render accessible water supply 14 Cleanse, cover or render accessible water cistern 4 Repair water pipes and fittings 41 Clear premises of vermin 2 Cleanse or repair water closets and flushing apparatus 186 Repair or clear defective or obstructed drains 66 Repair soil pipes, waste pipes, sinks, etc 88 Abate nuisances caused by animals improperly kept 2 Miscellaneous... 27 Total repairs and improvements ordered 3,451 SUMMARY OF NOTICES SERVED, 1958. Intimations, Public Health (London) Act, 1936. Byelaws, etc. 1,555 Statutory notices, Public Health (London) Act, 1936. Byelaws, etc. 843 London County Council (General Powers) Act, 1955 134 Public Health (London) Act, 1936 (Part II) 43 Section 4, Housing Act, 1936 and Sec. 8, Housing Act, 1957. 15 Clean Air Act, 1956 4 No. of Summonses issued 86 Factories Acts, 1937 - 1948. 1.—INSPECTIONS, 1958. Number on Register. Number of Premises. Inspections. Written Notices. Occupiers prosecuted. Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 266 42 - - Factories not included above in which Section 7 is enforced by the Local Authority 1,048 193 - 6 - Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 24 2* - 237 6 1,338 - Totals *Figures for visits to building sites not available. 2.—CASES IN WHICH DEFECTS WERE FOUND, 1958. No. of cases in which defects were Number of cases in which prosecutions were instituted Found. Remedied. Referred Particulars. To H.M. Inspector. By H.M. Inspector. Want of cleanliness - 1 - 1 - - - Overcrowding - - - Unreasonable temperature Inadequate ventilation - - - - - - - - - - - Ineffective drainage of floors - - - - Sanitary conveniences— I I (a) insufficient - - - - - (b) unsuitable or defective 3 5 - 2 - (c) not separate for sexes - - - - - Other offences against the Act (not including offences relating to outwork) - - - - - Total 3 6 - - 3 43 Summary of Outworkers classified by trades. Artificial flowers 5 Novelties 30 Brushes 1 Paper bags 2 Cardboard boxes 108 Toys 14 Card lacing 71 Umbrellas 1 Curtains, etc 1 Wearing apparel 663 Lampshades 123 Total 1,019 Summary of work of the Rodent Control Staff. No. of complaints received 962 No. of inspections 4,462 No. of operators' calls 7,707 No. of private premises baited 1,175 No. of business premises baited 133 No. of baits laid 6,536 No. of drains tested 23 No. of positive drain test results ... 5 Vermin and Scabies. ATTENDANCES AT CLEANSING STATION. Vermin. Scabies. Male. Female. Total. Male. Female. Total. 30 57 28 27 14 42 Adults Children 103 133 287 390 46 24 70 447 74 38 112 314 Total Disinfection. RETURN OF WORK CARRIED OUT BY DISINFECTING STAFF. Other Diseases. Miscellaneous. Vermin. Total All Cases. Notified Infectious Diseases. 25 4 1,526 1,774 Rooms disinfected Lots of bedding disinfected 219 12 29 82 59 182 Total visits 297 33 2,441 787 3,558 Number of articles disinfected by steam 2,140 Number of articles disinfected by formalin 369 Number of books disinfected 128 Number of towels washed 4,644 Number of soiled articles washed 6,376 Number of overalls washed 504 Number of covering sheets washed 439 Beds and mattresses destroyed 395 Miscellaneous articles destroyed 1,159 Weight of:— Tons Cwls. Qtrs. Lbs. Unsound foods destroyed 24 11 0 24¼ Hospital bedding, etc., disinfected 2 7 2 0 Old clothing, lino, paper etc., destroyed 2 7 0 14 Furniture and effects destroyed 23 15 2 0 Dead animals destroyed — 17 3 0 Hospital dressings etc., destroyed — 13 0 0 45 HOUSING. Record of work of Housing Inspectors, 1958. Inspections Re-inspections Total Clearance areas 58 120 178 304 39 343 Individual unfit houses Section 9 7 108 115 Section 16 Underground rooms and parts of premises Section 18 230 99 329 1 - 1 Requisitioned Property 762 Total 966 204 Housing Statistics, 1958. 1. Inspection of Dwelling Houses during the Year: — (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Act) 3,981 (b) Number of inspections made for the purpose 18,410 (c) Number of dwelling-houses found not to be in all respects reasonably fit for human habitation 3,870 2. Remedy of defects during the year without service of Formal Notices: — Number of dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers —Public Health (London) Act and Housing Act 268 3. Action under Statutory Powers during the year: — (a) Proceedings under Public Health (London) Act: — (1) Number of dwelling-houses in respect of which statutory notices were served requiring defects to be remedied 843 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: — (a) By owners 1,723 (b) By local Authority in default of owners 4 (b) Proceedings under Housing Act, 1957: — (1) Number of houses made fit after service of formal notices (Sections 9, 16 and 18) (a) By owners 22 (b) By local Authority in default of owners 3 (2) Houses demolished as a result of formal or informal procedure under Section 17 (3) Houses closed in pursuance of an undertaking given by the owners under Section 16 and still in force (4) Parts of buildings closed by Closing Orders (Section 18):— (a) Underground rooms (6) Other rooms 41 (5) Undertakings not to use parts of buildings for human habitation accepted:— (a) Underground rooms - (b) Other rooms — (6) Houses demolished under Section 42 2 (c) Proceedings under Housing Act, 1957:— (1) Closing Orders made under Section 17 (3) nil (2) Demolition Orders determined and Closing Orders substituted under Section 26 nil (3) Closing Orders made under Section 17(1) 1 (4) Closing Orders determined 3 (5) Closing Orders revoked and Demolition Orders made nil Certificates of Disrepair No. of applications for Certificates of Disrepair 411 No of Undertakings received from landlords 284 No. of Certificates of Disrepair issued 157 No. of Certificates of Disrepair refused 6 No. of Certificates of Disrepair cancelled 75 Overcrowding. No. of cases of overcrowding found 51 No. of overcrowded families rehoused:— By Borough Council 7 By London County Council 19 47 INFECTIOUS DISEASES, 1958 SUMMARY OF NOTIFICATIONS RECEIVED AND DEATHS FROM THESE CAUSES AMONG NOTIFIED CASES Disease. No. of Notifications. Treated in Hospital. Found not to be suffering from the Disease. Deaths of Notified Cases. Age Distribution of Notifications Under 1. 1 to 2. 2 to 3. 3 to 4. 4 to 5. 5 to 10. 10 to 15. 15 to 20. 20 to 35. 35 to 45. 45 to 65. 65 and upwards - 2 1 Scarlet Fever 163 4 1 1 2 8 9 21 103 16 - - - 5 1 1 5 12 11 17 9 29 - - - Whooping Cough 98 5 - - - 2 (1) Poliomyelitis & Polio-encephalitis 9 1 - - - - 9 - 5 - - - 1 1 - 38 93 285 9 5 - 668 7 - 69 77 90 2 - Measles - - - - - - - - - Diphtheria - - - - - - - - - 9 - 2 1 1 2 2 1 Pneumonia Acute Influenzal 1 - - - - - - - 3 3 6 11 8 - 2 2 4 1 - 3 5 Acute Primary 40 - - 4 79 5 3 8 6 3 7 20 3 4 10 6 1 (2) Dysentery 7 - 1 1 1 - (3) Typhoid and Paratyphoid Fever 2 1 - - - - - - - - - - 5 - 1 - 2 2 10 - - - Erysipelas 3 - - - - - 1 3 - 1 - - - (4) Meningococcal Infection 3 - - - - - 1 - - 12 - 24 94 1 (5) Puerperal Pyrexia 131 128 - - - - - - - - - 12 - - 12 1 - - - - - - - - - (6) Ophthalmia Neonatorum — - 1 1 1 - 1 - 1 - 6 4 - Scabies 14 1 - - - 15 91 132 39 78 165 123 448 134 125 28 20 Totals 1,238 176 6 1 (1) In addition, 1 case of a Camberwell resident occurred in a hospital outside the Borough and was notified to the Medical Officer of Health for the area in which the hospital was situated. (2) In addition, 4 cases of Camberwell residents were diagnosed in hospitals outside the Borough. (3) In addition', 1 case of a Camberwell resident occurred in hospital outside the Borough. (4) Includes 2 cases of non-residents occurring in hospitals in this Borough, and in addition, 3 cases of Camberwell residents were diagnosed in hospitals outside the Borough. (5) Includes 46 cases of non-residents occurring in hospitals in this Borough, and in addition 11 cases of Camberwell residents were diagnosed in hospitals outside the Borough. (6) Includes 1 case of a non-resident which occurred in a hospital in this Borough. FOOD POISONING Annual Return of cases of Food Poisoning, 1958 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total 13 24 14 - (a) Food poisoning notifications (corrected) as returned to R.G. 20 71 1 - - - - - 1 (b) Cases otherwise ascertained (c) Symptomless excreters - - - (d) Fatal cases - - - - 2. Particulars of outbreaks. Agent Agent identified: (a) Chemical poisons (b) Salmonella: Typhimurium (c) Staphylococci (inc. toxin) (d) Cl. Botulinum (e) Cl. Welchii (f) Other bacteria Totals Agent not identified Otherwise Ascertained I - - - - - - - - No. of outbreaks No. of cases Total No. of cases Family outbreaks Other outbreaks Notified - - - - 1 - 2 - - - - 2 10 2 - - - - - - - - - - - - 1 - 2 4 - 10 3. Single cases Agent No. of cases Total No. of cases Notified Otherwise ascertained - Agent identified: (a) Chemical poisons I - - 1 (b) Salmonella: Typhimurium 5 6 1 (c) Staphylococci (inc. toxin) 1 - - (d) Cl. Botulinum - - (e) Cl. Welchii - - - - (f) Other bacteria 1 - 1 B. Coli - 1 1 Totals 7 8 - 52 52 Agent not identified MASS RADIOGRAPHY Summary of results of surveys carried out by the South East London Mass Radiography Units. (These figures were kindly provided by Dr. J. M. Morgan, Director of the M.R.U.) Part I General Analysis Men Women Total (a) Total X-rayed 7,552 7,797 15,349 (b) Total previously surveyed 4,486 4,152 8,638 (c) Total recalled for large film 345 376 721 (d) Number normal on large film 100 130 230 (e) Number abnormal on large film 245 244 489 (f) Not yet attended for large film — 2 2 Part II Analysis of Abnormal Large Films (1) Cases considered tuberculous and referred elsewhere (a) No further action required 4 2 6 (b) Occasional supervision only 12 9 21 (c) Requiring treatment 31 23 54 (d) Still under investigation — — — (e) Refused further investigation — — — (2) Non-tuberculous cases (a) Investigated 31 25 56 (b) Still under investigation — — — (3) Cardio vascular lesions 14 25 39 (4) Previously known tuberculous cases 16 14 30 (5) Abnormalities requiring no action 137 146 283 Tuberculosis. TABLE SHOWING SEX AND AGE DISTRIBUTION OF ALL PRIMARY NOTIFICATIONS AND DEATHS FROM TUBERCULOSIS DURING 1958 Age Periods. Notifications Deaths.† Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary. Male. - Female. Male. Female. Male. Female. Male. Female. - 0 - 1 yr. - - - - - - 1-5 „ 1 - 2 - - - - - - 5-15 „ 3 5 - 1 - - - 15-25 „ 14 18 1 1 1 1 - - 25-35 „ 16 18 4 2 - - - - - 13 12 2 4 2 35-45 „ - - 45-55 „ 24 5 1 4 2 - - - 6 - 7 1 55-65 „ 25 - - - 6 65 and over 12 7 - 4 1 1 - 71 9 1 108 20 10 Totals 1 5 † After correction for inward and outward transfers. TABLE SHOWING NOTIFICATIONS AND DEATHS, TOGETHER WITH THE ESTIMATED POPULATION DURING THE PAST FIVE YEARS. Year. Estimated Population. No. of Primary notifications. Notification Rate per 1,000 Population. No. of Deaths. Death Rate per 1,000 Population. 179,500 1954 364 2.0 26 0.14 1955 178,400 318 1.8 30 0.16 1956 177,800 330 1.8 25 0.13 1957 177,700 240 1.3 ? 0.14 1958 177,300 193 1.1 32 0.18 Food and Drugs Adulteration. Summary of Samples obtained for examination. Number examined. Number adulterated, etc. Percentage of adulteration. Informal. Formal. Informal. Total. Formal. Total. Informal. Formal. 400 - 500 900 - 1.2 6 6 Particulars of the adulterated samples and the action taken are set out on pages 54 and 55. Registered Purveyors of Milk. Dairies 24 Distributors of milk in the Borough 197 Distributors of milk dealing from premises outside the Borough 16 Special Designated Milk. Summary of Licences issued. Sterilised. Pasteurised. Tuberculin Tested. Type of Licence Dealers 216 97 89 Supplementary 27 25 25 243 222 114 Results of Tests. Methylene Blue Test Phosphatase Test Turbidity Test Designation Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Pasteurised 119 - 121 - - - - Tuberculin tested pasteurised - 50 - - - - - 49 - Sterilised - 41 Samples of milk taken in course of delivery to Hospitals and Schools. Methylene Blue Test Phosphatase Test Chemical Test Hospitals 34 34 34 Schools 61 61 65 All the above samples proved to be satisfactory. Ice Cream. Summary of samples submitted for Methylene Blue Test and Chemical Examination. Chemical Examination Methylene Blue Test Satisfactory Unsatisfactory Grade I Grade II Grade III Grade IV 54 16 10 10 41 Nil. Ice Lollies and Water Ices. Summary of samples submitted for examination. Bacteriological Examination Chemical Analysis Satisfactory Unsatisfactory Satisfactory Unsatisfactory - — - Ice Lollies 26 - Cream Lollies 22 - - - - Assorted Lollies 48 - Water (Lemon) Ices 16 9 - - 52 Margarine. Eight samples were examined for vitamin content and found to comply with the requirements of the Food Standards (Margarine) Order, 1954. Particulars Of Adulterated Samples. Nature of Adulteration or Irregularity Observations Result of Proceedings or other action taken Unsatisfactory label: word "compound" almost illegible. - Reported to Public Health Committee. Cautionary letter sent to manufacturers: amended label subsequently submitted to Council for approval. - Lead. 21 parts per million Arsenic 6 parts per million. Apples returned to wholesalers for washing and cleansing prior to retail sale. Sulphur dioxide 2,500 parts per million. Formal samples taken and found to be satisfactory. lauiuiv* Sulphur dioxide 150 parts per million. - Formal sample taken and found to be satisfactory. - Rancid. - Letters sent to retailer and manufacturer. Contaminated with petrol. - Reported to Public Health Committee: cautionary letters sent to retailer and bottlers. REGISTRATION OF FOOD PREMISES. Premises registered under the provisions of Section 16 of the Food and Drugs Act, 1955, as at December 31st, 1958. Sale, manufacture and storage of ice cream 5 507 Preparation or manufacture of:— Potted, pressed, pickled or preserved meat 205 Potted, pickled or preserved fish 63 Potted, pickled or preserved other foods 35 Supervision of Food Premises. Number of visits paid to each type of food premises by the Council's Public Health Inspectors. No. of Inspections Type of Premises Bakehouses 167 Bakers and Confectioners 399 Butchers 612 Cooked and Preserved Meat Shops 384 Dairies and Milkshops 345 Fishmongers and Shell Fish Vendors 341 Fish Fryers 206 Fish Curers 137 Food Factories 207 Ice Cream Vendors 431 Public Houses 376 Restaurants and Eating Houses 597 Street Markets 1,236 Street Traders Food Stores 118 Other food premises 867 Total 6,423 Unsound Food. No. of condemnation Certificates issued 2,258 Particulars of Unsound Food Destroyed Total Weight Weight Description Tons cwts. qtrs. lb. Tons cwts. qtrs. lb. Meat Beef 1 2 11 — 1 2 11 Brisket - - - 3¼ Pork — 11 2 27 Lamb — — — 1½ Veal — 3 0 19 Sausages (various) - — — 18 Liver (various) - - - 26 Pigs' kidneys - - - 10¼ Bacon (sliced) — 13 1 16¾ 1 10 1 20¾ Poultry Chickens (96) - 2 3 16½ - 2 3 16½ Fish Soles (frosted) - 3 0 14 Prawns — 2 0 6 Salmon — — — 5 Rock Salmon - 2 0 7 Skate - 1 3 14 Cod (fillets) - - 1 4 Mackerel - - 1 0 Plaice — — — 14 — 9 3 8 Fruit Currants - - 3 16 Pineapples - - 3 9 — 1 2 25 Canned Foods Meat (various) 1,826 tins 1 7 2 25¾ Ham 924 tins 4 17 2 19¾ Vegetables (Asstd.) 4,395 tins ... 2 8 3 0 Fruit (various) 6,339 tins 4 9 1 23 Milk (Evap. & Cond.) 3,060 tins 1 2 1 4½ Cream 27 tins - - - 9½ Fish 375 tins - 3 0 9¾ Jam (Asstd.) 28 tins - - 2 11½ Marmalade4tins - - - 18 14 9 3 9¼ Weight Total Weight Description Tons cwts. qtrs. lbs. Tons B ewts. qtrs. lbs. Miscellaneous Frozen foods (various), Confectionery, potatoes, flour, bread, biscuits, cheeses (various), tomato paste and puree, suet, salad cream, sauces, pickles (various), animal foods and other foods 7 16 2 0¾ 7 16 2 0¾ Gross Weight 24 11 0 24¼ Summary of Work of Food Inspector. Complaints received 44 Complaints found to be justified 25 Visits :— Bakers and Confectioners 23 Butchers 107 Fish curers 7 Fish fryers 14 Restaurants and eating houses 33 Street markets 1,006 Other food premises 392 Merchandise Marks Act 180 Inspections not defined 226 Re-inspections 39 39 •JCO Food surrendered 362 Foodstuffs certified for export 2 2 Food condemnation certificates issued 2.258 TABLE OF CONTENTS Page Accidents in the Home 5 Clean Air 15 Health Education 21 Housing 23 Nuisance from Noise 12 Occupational Health 26 Public Health Committee —constitution 3 Report of the Consultant Chest Physician 27 Report of the Tuberculosis Care Committee 29 Rodent Control 19 Sanitary Circumstances 18 Staff of the Public Health Department 4 INDEX TO STATISTICAL APPENDIX Atmospheric Pollution —graphs 38 - 41 Births 34 Certificates of Disrepair 47 Cremation Certificates 35 Deaths —Causes and Age Distribution 33 - 34 Disinfection 44 - 45 Drainage and Sewerage 35 Factories Acts 43 Food and Drugs Adulteration 51 Adulterated samples table 54 - 55 Food Inspectors—Return of Work 58 Food Poisoning 49 Food Premises —Registration and Supervision 56 Hairdressers and Barbers 37 Housing Inspectors—Return of Work 46 Housing Statistics 46 - 47 Ice Cream 52 Ice Lollies 52 Infectious Diseases 43 Margarine 53 Mass Radiography 59 Medical Examinations 34 Milk—Registered Purveyors 51 Special Designated 51 Results of Tests Offensive Trades 35 Outworkers 44 Overcrowding 47 Pet Animals Act 39 Pharmacy and Poisons Act 37 Index to Statistical Appendix—continued. Page Public Cleansing 35 Rag Flock and Other Filling Materials 36 Rodent Control—Return of Work 44 Sanitary Inspection of the Area 42-43 Scabies and Vermin (Attendances) 44 Statistics —Summary of 32 Swimming Bath Water —Examination of 35 Tuberculosis 50-51 Unsound Food Certificates 56 Unsound Food Destroyed 57-58 Vermin and Scabies (Attendances) 44 Water Certificates 35 R7/67