TC4376 Library CAM 57 METROPOLITAN BOROUGH OF CAMBERWELL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1962 H.D.CHALKE O.B.E. (Mil.) T.D., M. A., M.R.C.P., D.P.H. CAM 57 PUBLIC HEALTH DEPARTMENT, TOWN HALL, CAMBERWELL, S.E.5 October, 1963 To the Mayor, Aldermen and Councillors, of the Metropolitan Borough of Camberwell MR. MAYOR, ALDERMEN AND COUNCILLORS, I have much pleasure in presenting my Annual Report on the health of the Borough during 1962. There were no dramatic changes in the vital statistics. The birth rate increased from 19.3 to 20.2 per thousand population and the death rate fell by four points as compared with the previous year. The most significant variation was a reduction in the deaths from tuberculosis; these numbered only eight as compared with nineteen in 1961. The death rate of 0.05 is the lowest ever recorded in Camberwell. The Public Health Department has continued to expand its interests in community care, particularly in respect of the welfare of the elderly. The work of the Public Health Inspectors and the social workers in calling attention to unsuitable home conditions and arranging for their amelioration is of considerable value. Close liaison is maintained with the Council's Housing Department and with the Divisional Health Office of the L.C.C. 'Outside' activities include the continuation of parents groups in churches, and ties with such organisations as the Council on Alcoholism (of which the Medical Officer of Health is Chairman) and the Camberwell Samaritans (the Medical Officer of Health is a member of its Executive Committee). The Housing Act, 1961, and the regulations made thereunder in relation to houses in multiple occupation 1 opened up a wide sphere of activity for the Public Health Department by the new powers conferred upon local authorities to deal with squalid conditions in premises occupied by members of more than one family. The Offices, Shops and Railway Premises Act, 1963, will bring further increases in the work and responsibilities of the department when it becomes operative. It is regretted that this Report is later than usual in publication but the staff of my department has been subjected to extreme pressure during the past few months. In addition to the increased responsibilities referred to above, the very severe weather conditions at the beginning of this year gave rise to a multiplicity of complaints of environmental difficulties in which the department's assistance was sought; staff shortages and absences through sickness have also contributed to the general delay. I would like to take this opportunity of paying tribute to the loyal and diligent assistance I received from the staff of my department throughout the year, often in very trying circumstances. I would also like to express my thanks to the Members of the Council, the other Chief Officers and their staffs for the support and co-operation they have so willingly given. 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 1962 Chairman: Councillor H.G. Lamborn, L.C.C., M.R.S.H. Vice-Chairman: Councillor Mrs. R.E. Pritchard Members: Alderman G. S. Burden, B. Sc. (Econ.) Alderman Mrs. J. Burgess, J.P. Councillor Mrs. A. Blosse Mrs. E. S. Daymond G. A. Gilbert S.H. Gilbert Mrs. A. Inman Mrs. B.E. Knight F.E. Lee Mrs. M.U. Nelson C.T. Robinson Mrs. F. E. Sampson Mrs. M.M. Tarrant Miss D.M. Walker Ex-Officio: Councillor Edgar E. Reed, J.P., L.C.C. Mayor of Camberwell Councillor R.W. Brown, A.M.I.E.D., GRAD.I.E.E. Leader of the Council Councillor C.W. Baker, J.P., F.C.I. S. Leader of the Opposition Staff of the Public Health Department (As at 31.12. 62) Medical Officer of Health Medical Officer of Health H.D. Chalke, 0.B.E.(Mi1), T.D., M.A., M.R.C.P., M.R.C.S., D.P.H. Deputy Medical Officer of Health *Marjorie E. Watts, M.B., B.S., D.R.C.O.G., D.P.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. H. Attwater, a, c. Deputy Chief Public Health Inspector (vacant) Sampling Officer H.R. Weaver, a. Food Inspector D.V. Watkins, a. Smoke Control Inspector Technical Assistants A.G. O'Gilvie, a, c. J. Baillie R. Hewston T.W. Langley Public Health Inspectors F. Dray, a, c. E.C. George, a, c. J.E. Millway, a. F. Duggins, a. Miss J. Harris, b. J. Starr, a. G.A. Fraser,a. H.M. Hough, a. M. Stevenson, b. P. Frost, b. T. McCarthy, b. H. F. Williams, a. A. Gartside, D.P.A. A. a. C. H. Medland, a. (one vacancy) Student Public Health Inspectors A.J. Hughes W.E. Samuel M. Lawson (one vacancy) Infectious Disease Visitors Mrs. E.L.M. Falloon, S.R.N., Miss B.E. Brooks, S.R.N., R.F.N. Senior Clerk C. Burgess Clerical Staff P.A.S. Kirrage, D.M.A., Miss E.M. Lawrence A. Beare D. Danter Mrs. M. Findlay Miss J. Jakes W. Everett Mrs. A. D. Dormer F. Grace Miss B. Aslett Rodent Control (temp.) Rodent Officer W.H.G. Saunders, b. Rodent Investigator Mrs. M.J. Kenny Rodent Operators F.G. Hulbert, R. Humphreys, G. Marshall, Mrs. E.M. Lloyd Mrs. A. Grice (part-time) Disinfecting and Cleansing Station Foreman Disinfector R.T.J. Hodgson Stoker/Disinfector Apparatus Attendant E. Manning Disinfectors M. Concannon A.E. Kenny T.W.Whitfield J.E. Higgott Motor Driver H. King Cleansing Station Attendant Mrs. E.M. Norman *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. The Widening Sphere of Public Health Work Despite the fact that this is not a local health authority, the Public Health Department has wide interests in community care particularly in respect of the welfare of the elderly. A noticeable feature of the year's work of the Department has been the continued broadening of activities in the field of social medicine and the closer liaison, not only with other branches of the health service, but with voluntary bodies. The Church Parents' Group which was commenced in 1960 remains an active organisation, and there is continued evidence that projects of this kind are well worthwhile as filling an unmet need. The Department also works very closely with the Camberwell Council on Alcoholism, of which the Medical Officer of Health is Chairman. A great deal more needs to be known about the impact of drinking in individual and family life which is bound to have far reaching repercussions on the public health and investigations are already in hand with this aim in view. A bulletin on alcoholism is being prepared which will be issued at regular intervals: it is sent to general practitioners, hospital staffs, social workers and other interested persons, in many parts of the country and abroad. A close liaison is also maintained with the Camberwell Samaritans, a non-denominational venture formed to aid alcoholics, the sexually deviated, potential suicides and others whose needs do not seem to be met sufficiently by other statutory and voluntary agencies. Voluntary workers have been recruited and given training in both the mental and social aspects of the problem, and it has already been found that much can be done by attention to difficulties arising from housing, occupation and general community care. In these and other matters the Medical Officer of Health and his staff are finding great value in closer co-operation with the churches. The Public Health Department's activities are by no means restricted to environmental hygiene; indeed, environmental' and 'personal' hygiene are so closely linked that they are incapable of being separated, although there is still a tendency to do so in some quarters. The appointment of social workers in connection with the control of infectious diseases and the welfare of old people has proved of the utmost worth in making the work of the Department more comprehensive. It was soon found that the activities of these ladies was not specifically confined to old people and infectious diseases, but that there were many other fields in which their co operation with other agencies would prove fruitful. SANITARY CIRCUMSTANCES Water Supply Every dwelling house in the Borough is provided with a water supply direct from the mains of the Metropolitan Water Board, and no complaints were received concerning its quality or quantity. Drainage and Sewerage Two hundred and twenty-one applications were received for approval in respect of the drainage of new buildings or the reconstruction of existing drains. All the works were carried out under the supervision of the Public Health Inspectors. The reconstruction of sewers proceeded in accordance with the Council's programme and 4,674 lineal feet were relaid by the Borough Engineer and Surveyor's Department. Vacant Sites There is still a number of small vacant sites in the Borough which give rise to nuisances from time to time through the dumping' of refuse. Whenever offensive matter was found on any such land, the Borough Engineer and Surveyor was requested to arrange for its Prompt removal. The disposal of refuse and unwanted articles on such sites, including derelict motor cars, continued to give rise to a number of complaints. The Council's by-law relating to the deposit of refuse to the detriment of public amenities is difficult to enforce in the absence of evidence as to the identity of the culprits. Fencing of such land has, in many cases, proved to be of little avail since it is either rapidly demolished by vandals or refuse is thrown over it; nevertheless, it is the only alternative at present. It would seem that this problem will continue until the land is developed; in the meanwhile the costly process of clearing the refuse as it accumulates must continue. CLEAN AIR Smoke Control Areas During the year two further smoke control orders came into operation as follows:- Acres No. of Premises No. of Dwellings Date of Operation Smoke Control Order No. 2. 230 2,310 2,183 1.9.62 Smoke Control Order No. 3. 352 3,786 3,637 1.11.62 With the 1,025 acres already covered by Smoke Control Order No. 1 this brought the smoke-controlled acreage of the Borough to 1,607 (about one third of the total acreage) and involved 9,055 premises. In March 1962 the Public Health Committee approved a programme of smoke control areas which will cover the remainder of the Borough by 1968; this is as follows:- Year S.C. Orders Acres Estimated number of premises. Estimated number of dwellings. Area No. 4 60 1,800 1,700 1962 3,500 3,350 Area No. 5 146 1963 Area No. 6 262 4,000 3,900 Area No. 7 578 3,500 3,300 1964 Area No. 8 258 4,500 4,000 Area No. 9 261 4,500 4,000 1965 4,300 4,000 Area No. 10 215 3,400 3,000 Area No. 11 124 1966 Area No. 12 174 3,750 3,500 Area No. 13 268 4,000 3,500 1967 4,800 4,200 Area No. 14 202 4,000 3,500 Area No. 15 148 1968 Area No. 16 182 3,900 3,500 It may be necessary to exempt from these Orders certain groups of properties which are included in proposed slum clearance or development schemes and this was taken into consideration when preparing estimates of the number of premises and dwellings for the above programme. The Committee also agreed that smoke control orders should be made as soon as possible in respect of those post-war housing estates which are already equipped with approved heating appliances and would, therefore, require only minor works of adaptation such as the installation of gas ignition. Towards the end of the year Smoke Control Orders were made in respect of Area No. 4 and also for an area including the Sceaux Gardens Estate which was designated Area No. 4A. These orders will become operative on 1st October, 1963. Dark Smoke (Permitted Periods) Regulations, 1958 Two instances were reported of contravention of these Regulations. In one the Committee directed that a cautionary letter should be sent to the offender and in the other, legal proceedings were authorised which resulted in a fine for £15 with £5 5s. 0d. costs. The latter firm had previously been fined for a similar offence. Fumes from Diesel-engined vehicles Pollution of the atmosphere by fumes and smoke from the exhausts of vehicles has been given attention by the officers of the Public Health Department. Several instances were reported of black smoke being emitted by diesel-engined lorries, and letters were addressed to the owners of the vehicles concerned giving details of the incident and seeking their co-operation in preventing a recurrence. In every case the firms in question replied expressing their gratitude for drawing their attention to the matter and stating that remedial action was being taken. HOUSING Houses in Multiple Occupation New legislation came into operation during the year which gave local authorities new and greatly strengthened powers to deal with squalid living conditions in houses in multiple occupation. The Housing (Management of Houses in Multiple Occupation) Regulations, 1962, made by the Minister of Housing and Local Government under the provisions of Section 13 of the Housing Act, 1961 lay down a code of management which the local authority may apply to any house occupied by members of more than one family, or, in appropriate cases, to a block of tenements. In general they require managers of such premises to ensure the good order, repair and cleanliness of means of water supply and drainage; heating installations; rooms and certain installations in common use; halls, staircases, passageways etc; windows and other means of ventilation; means of escape in case of fire; common outbuildings, yards, gardens etc. They are also required to ensure that refuse is satisfactorily dealt with and that accommodation is in good repair when they let it. They have obligations to protect tenants from injury resulting from structural conditions. Under Part III managers have responsibilities with regard to the display of certain documents (including a copy of the regulations) for the information of the tenants and the provision of certain information on request, to the local authority. The occupants are obliged to ensure that the manager can effectively carry out his duties, and the local authority is required to keep a register of managers and other relevant information. The Regulations were accompanied by a Circular which points out that the powers conferred by the new legislation are designed to deal primarily with the worst type of multi-occupied house where nothing less than strong action would be likely to achieve results. At the same time the Minister relies on local authorities to make quite clear to the people concerned what it is that the regulations require, to ensure the satisfactory management of these houses and to give them every opportunity to put matters right before resorting to the new penalty provision. The Circular also suggests that wherever possible the local authority's aim should be, by discussion with the owners, to achieve in suitable houses a thoroughgoing conversion at standards which will attract an improvement grant and where owners are willing to carry out conversion on this scale, to make grants and to accept any necessary rehousing of families who would need alternative accommodation. Whilst the Regulations relate mainly to the management of houses in multiple occupation, Section 15 of the Housing Act 1961, empowers local authorities to require the execution of works to ensure adequate natural and artificial lighting, ventilation, water supply, personal washing facilities, drainage and sanitary conveniences, facilities for the storage, preparation and cooking of food and for the disposal of waste water, or installations for space heating or for the use of space heating appliances, having regard to the number of individuals or households, or both, accommodated for the time being on the premises. During the year action was taken in respect of twenty-three premises in the Borough, details of which are given in the statistical appendix to this report. Slum Clearance The following Clearance Areas were declared in accordance with the five-year programme for 1961/65 agreed between this Council and the London County Council. No. of persons to be displaced Date of Declaration No. of dwelling houses Area Rosemary Road No.1 20.3.62 4 8 Garnies Street No.1 25.9.62 8 34 Sedgmoor Place 4.12.62 3 7 This brings the total number of houses represented to sixty-three out of the 127 included in the programme for action by this Council. References to Rent Tribunals The Immigrants Advisory Committee drew attention to the problem of extortionate rents charged for furnished accommodation and suggested to the Metropolitan Boroughs' Standing Joint Committee that it should be the general practice for local authorities to refer to Rent Tribunals such cases as came to their knowledge through the public health inspectorate. The Public Health Committee gave consideration to this matter and decided to instruct the Public Health Inspectors to report details of excessive rents for furnished accommodation which came to their notice in the normal course of their duties in order that the Finance Committee may decide whether or not they should be referred to the Rent Tribunal. Priorities for Rehousing The scheme which was put into operation in 1955 (described in the Annual Report for 1959 page 27) has been continued. It has greatly facilitated the arrangements for medical rehousing and has been most acceptable to general practitioners who are enabled to obtain an accurate picture of the housing conditions from a public health angle before giving their recommendation. The scheme has been adopted by a number of authorities in different parts of the country. The number of applications supported by medical certificates which were referred to the Medical Officer of Health during the year numbered 232. This was a slight reduction on the figure for 1961 which was 252. The following table shows the medical conditions and the recommendations made in each category. Medical Condition Category 1 Category 2 Category 3 Category 4 Tuberculosis 2 4 7 - Bronchitis and/ or Asthma 7 14 16 4 Other respiratory conditions - 6 2 - Heart conditions 3 4 6 2 Physical disabilities (bad legs, etc.) 1 - 3 3 Nervous disorders 9 2 10 29 Rheumatic conditions 2 1 12 8 Other Medical conditions 19 9 28 19 The percentage of patients recommended on account of 'nervous disorders' rose from 18% in 1961 to over 21% last year. The bronchitis and asthma cases numbered about the same, but in recent years there has been a marked fall in the number of tuberculosis patients applying for rehousing; last year they represented less than 6% of the total medical cases. There were 73 recommendations for ground floor accommodation. Alternative accommodation was provided during the year for 93 families whose applications had been recommended for priority on medical grounds. CARE OF THE ELDERLY The appointment by the Council of social visitors for old people has proved to be of inestimable value. They have established an excellent liaison with other statutory and voluntary organisations such as the London County Council, the Camberwell Old People's Welfare Association, the U.G.S., and the local hospitals, particularly the Geriatric Unit at St.Francis Hospital. The co-operation with hospitals is exceptionally useful in that the Visitors are able to provide information relating to the social background of old people admitted as in-patients. Similarly, the hospitals notify the Visitors of the impending discharge of old people to their own homes in order that all the necessary services may be arranged in good time - home help, meals-on-wheels and so on. This co-ordination goes a long way towards the avoidance of overlapping or duplication, but at the same time ensures that no patients are deprived of any assistance they may require. Information of other elderly folk is received from many sources, including relatives and neighbours. A comprehensive register of old people in need of community care is gradually being built up and at the end of the year contained information of nearly one thousand old people. These are visited as often as is necessary, according to their circumstances, needs and wishes. Many lonely old folk have come to regard the Council's visitors as friends and look forward to their visits. Much loneliness has been ameliorated by persuading them to join Old People's Clubs and on many occasions the Visitors have taken them in their own cars and introduced them at such clubs. 'Breaking the ice' in this way has been of great benefit to many who have thus found a new interest in life and made new friends among others with whom they have much in common. Home Bathing This is a service which fulfils a real need and is appreciated by the recipients. The cleansing station attendant who visits the old people's homes to assist them to have a bath is looked upon as a friend and is gratefully welcomed. Requests for this service are usually received from hospitals and district nursing associations, but the consent of the person's own doctor is always sought before providing bathing assistance at home. During 1962, 23 cases received this service which involved 123 visits, but by the end of the year the demand was increasing rapidly. Cleansing of Soiled Linen In cases where old people are incontinent and there is no other person available in the house to undertake the cleansing and washing of soiled bed linen and clothing, arrangements are made for this to be collected and treated at the Council's Disinfecting and Cleansing Station. Normally, this service is provided twice weekly for each patient. Fifty-four cases were dealt with during the year which involved the washing of 12,224 articles. Employment Scheme for the Elderly The Centre set up at Cambridge House in 1960 continued to operate most successfully throughout the year. Members were referred by the Camberwell Old People's Welfare Association, general practitioners, hospitals, old peoples' Clubs and the Council's visitors. At the end of the year 54 persons were attending in two sessions. The membership is, of course, constantly changing. Some leave to take up full-time or part-time employment, others have ceased to attend for health reasons or because the journey from their home is becoming too much for them, and, inevitably, some members die. The Meals Club at the Centre is a popular and attractive feature and there is no doubt that the members benefit from a regular and well-cooked hot midday meal, particularly during the cold weather. The Council's Visitors maintain a close liaison with the Organiser and when members fail to attend for several days without known reason, arrangements are made for them to be visited to see if they are in need of assistance of any kind. The activities of the Centre received considerable publicity during the year which included an article and photographs in the Press and a recorded broadcast in the B.B.C. Home Service programme. In addition, British Movietone News have made a film of the workroom activities. Compulsory Removal It was fortunately only necessary to take action in one case for the compulsory removal to hospital of an aged person under the provisions of the National Assistance (Amendment) Act, 1951. This was an elderly woman in need of attention who refused to enter hospital voluntarily. She was taken to St.Francis' Hospital on a Court Order where she responded well to treatment and was subsequently discharged. With the assistance of a home help, the 'Meals-on-Wheels' and district nursing services she is still being well cared for in her own home. HEALTH EDUCATION The Medical Officer of Health and his staff continued to make use of every possible medium for disseminating information on matters affecting health, including posters, pamphlets, bookmarks, films and film strips, flannelgraphs and exhibitions. Among the bodies to whom talks, film shows and demonstrations were given during the year were a number of schools, youth organisations such as Scout Groups, women's leagues, women's fellowships, the League of Co-operators, and old people's clubs. In addition, arrangements were made, as in previous years, for small parties of school children to visit the Town Hall and the Disinfecting and Cleansing Station. Many distinguished persons from overseas also visited the Public Health Department to see different aspects of the work; they included doctors from Yugoslavia, Canada, the United States, Japan, Sweden, India and France. Research An enquiry into the public response to various methods of health education was carried out in 1959, the results of which were published in the Annual Report for that year. A further enquiry was completed during the year under review. A random sample of households in the Borough was selected and the householder asked to complete a questionnaire. Questionnaires were also sent to selected schools. A preliminary analysis of the results reveals some interesting information. Out of 339 households, there were only 49 without television sets and of the remainder 270 had sets capable of receiving both B.B.C. and I.T.V. programmes. One hundred and fifty-two responders stated they regularly viewed popular serials about doctors and hospitals and other similar programmes. What impressed them most about these programmes were 'realism' (22), 'interesting - catches imagination' (23), and 'instructiveness' (20). A large proportion of the people expressed a desire to see more television programmes on health matters, including general health, biology, child care, sex, mental illness and the work of doctors and surgeons. Two hundred and fifty admitted watching programmes which advertise drugs, medicines and patent foods and 120 stated they read similar advertisements in newspapers and magazines. A comprehensive analysis of the results of this investigation is being prepared and will be published in due course. Pupils at a Girls' Secondary School and a large mixed comprehensive school completed a similar questionnaire which also enquired into the smoking habits of the students. At the Girls' Secondary School 54 students out of 151 admitted to smoking cigarettes. Of these 34% smoked only occasionally; 43% smoked up to five cigarettes daily, 17% between six and ten and 6% more than ten. At the comprehensive school, 1,045 questionnaires were completed by pupils, 230 of whom smoked cigarettes. The following table shows the number of cigarettes which these boys and girls stated they smoked daily. 1-5 16-20 Total smokers No. of cigarettes daily 6-10 11-15 7 1 155 75 40 2 Boys Girls 97 60 11 2 Totals 8 230 157 52 13 This is the school which set up its own anti-smoking society (referred to on page 20) and some intensive propaganda has since been carried out there. A further enquiry is now being conducted to ascertain whether this has resulted in a reduction in the consumption of cigarettes by the pupils. Camberwell Council on Alcoholism This voluntary organisation was set up about the middle of the year. The Medical Officer of Health is its Chairman. It came into being as a result of suggestions from many quarters and the support given at a meeting attended by people in different walks of life. Its objects are to find out more about the impact of alcohol on the community, and by joint effort, to help in the solution of some of its problems, and to help the alcoholic. It aims, therefore, not only to bring people together for discussion, but to go on to the stage of positive discussion and positive action. During its early months it has concentrated its efforts on a study of the homeless alcoholic - the man who 'sleeps rough' and drinks surgical spirit. A detailed scheme has been drawn up for a hostel where such men can be cared for and treated; all that is now needed is financial backing. The work of the Council on Alcoholism is linked closely with that of the Camberwell Samaritans through joint membership, and it is believed that there will soon be integration of effort. It is intended to publish a Bulletin periodically which will be distributed to doctors, hospital staff, social workers and others interested in this important subject. SMOKING AND HEALTH Since the publication of the Report on Smoking by the Royal College of Physicians, propaganda on this subject has been intensified. Posters have been displayed on the Council s notice boards throughout the Borough, bookmarks and pamphlets issued to libraries and schools, and lectures given to youth organisations and community groups. General practitioners were asked to co-operate by displaying posters and making pamphlets available in their surgery waiting rooms: the managements of industrial concerns were approached and asked if they would be prepared to exhibit posters and distribute pamphlets to their employees. A number of favourable replies were received and large numbers of posters and pamphlets were distributed in this way. Press conferences resulted in publicity in the local Press and the information sheet 'Camberwell Calling' has also been used to comment on this subject. At the instigation of the Ministry of Health two Mobile Anti-smoking Units were set up by the Central Council for Health Education. These Units were staffed by trained lecturers and equipped with a film projector and screens, film strips, flannelgraphs, blackboard, easel and tape-recorder as well as supplementary educational material such as posters and leaflets. One of these Units was secured by this Council from the 8th to the 26th October (inclusive); this was its first engagement after the inauguration by the Minister of Health. A comprehensive programme was arranged during which it visited many schools, youth organisations and community groups in the Borough. This proved to be a very worthwhile project and its visit to a large mixed Comprehensive School in this Borough was followed by the establishment by the students of an Anti-Smoking Society which now has nearly 600 members. The Medical Officer of Health arranges panels of speakers - including doctors and sporting personalities - from time to time to address the boys and girls. The Chairman of the Anti-Smoking Committee (a scholar of fifteen) broadcasts to the school periodically. It was suggested that the members of the Society should wear a lapel badge and a prize was offered for the best design. Through the 'Family Doctor' magazine badges are now available free of charge but the scholars have asked that they should pay for them. It is hoped that other schools will form similar societies and accept badges for their members. Every effort is being made to prevent enthusiasm from waning. Anti-Smoking Centre In collaboration with Maudsley Hospital the Medical Officer of Health arranged for an anti-Smoking Centre to be set up in the Public Health Department, The sessions which commenced on 21st November 1962, were held at lunch-time and after 5 p.m. on Wednesday of each week. Individual counselling and treatment were given by a psychiatrist following the completion of a personality assessment questionnaire. Each person was asked to attend weekly for four weeks, and this was followed up by a monthly postal enquiry for three months. All applicants were required to provide a note from their own doctor consenting to their attendance. Following a broadcast on the B.B.C. programme 'Woman's Hour' in which the Medical Officer of Health, the Psychiatrist, the Vicar of Camberwell and two persons attending the 'Clinic' took part, a large number of applications for treatment were received, and continue to be received from a wide area. In due course, an analysis will be made of the results, but an interim assessment of 30 persons, who had completed the course revealed the following information. No. who had ceased to smoke : 14 (46.7%) No. who had reduced their cigarette consumption by more than half 5 (16.7%) No. who had reduced by less than half 2 (6.6%) No. who had failed to stop or reduce smoking 9 (30.0%) These figures were very encouraging and it is hoped that a later more comprehensive analysis will prove the experiment to be well worthwhile. The Council have since assumed responsibility for this project as part of their health education activities. Recently, arrangements have been made for group therapy courses to be conducted bya general practitioner who has volunteered his services for this purpose. The response from the public for appointments continues and there is still a long waiting list for appointments. INFECTIOUS DISEASES Bacillary Dysentery In the early spring of 1962 there was a small outbreak of sonne dysentery among certain primary school children, their pre-school siblings and their parents. The outbreak was confined mainly to pupils of one school, with a few contact cases at a neighbouring school and a Sunday School. The school sanitary accommodation and kitchen facilities were visited by the Public Health Inspector. These quarters were all in good order and clean, so that the spread of the infection could again be attributed to poor personal hygiene and mainly to the fact that the only adequate washing facilities were situated within the school, which gave little encouragement to the children to cleanse their hands after visiting the external lavatories. Home visits were made by the Council's Visitors, so that families could be informed individually about transmission and prevention of infection. The outbreak was finally controlled after 118 cases had been notified, mainly in the five to ten year age groups. Measles In accordance with the usual bi-ennial incidence of measles, this was the year in which notifications of the disease were expected to be lower than in 1961. In fact, only 337 cases were notified (2741 during 1961), again mainly in the five to ten year age group. Measles claims its largest number of victims during the early years of school life. Vaccination against this disease will no doubt be available in the near future. Food Poisoning There were fewer notifications of food poisoning during 1962 - surprisingly, these occurred mainly during the winter and spring months. Diphtheria and Poliomyelitis During 1962, there were no cases of these diseases within the Borough. Smallpox There were no cases of smallpox in Camberwell during 1962. Consultations were requested by local medical practitioners in several suspected cases, but these were mainly coloured immigrants suffering from chicken pox. Surveillance was necessary in the cases of two residents who had travelled from an area in which there was a small epidemic of smallpox. Venereal Diseases During the past five years the increase in the incidence of venereal diseases has caused much concern to medical and social workers. Valuable information is supplied regularly to the Public Health Department from two hospitals which serve this Borough stating the numbers of Camberwell residents attending their V.D. Clinics for the first time in each month. These figures do not, of course, represent the true cases of infection, since a recent survey by the British Medical Association indicates that 20% of all venereal diseases are treated outside hospitals and clinics. Also a certain number of first attenders are those who have taken risks and are anxious lest they have become infected, and those who have the abnormal and excessive fears which these diseases sometimes induce. With these exceptions in mind the table on page 25 indicates that there was a slight increase in the number of cases attending during 1962, particularly during July, August and September. The figures unfortunately, follow the national pattern. Committees have been set up by the British Medical Association and the Central Council for Health Education to investigate the causes of the increasing numbers of young people infected and the sexual habits of young people generally. It has been suggested that the extensive socioeconomic changes of the past decade with high wage packets for young people and the constant menace of the hydrogen bomb have produced the worst effects of war and peace. It is perhaps true that young people have never been exposed to so much sexual stimulation and propaganda and, in many cases, so little religious teaching and example in their own homes - the places which should be the most important sources of training for citizenship. Parents and young people must be helped to understand the perils of these infections - to the sufferer himself and to the nation generally. Immigration and the social unheaval which this entails has been mentioned as a further cause for the increase in gonorrhoea, but investigation in London showed that of 368 male immigrants attending a clinic, only 15 had become infected before arrival in this country and that some of these had acquired the disease in other countries on their journey to Britain. Another series of patients showed that 50% of male cases were immigrants and 50% were men normally resident in Britain, while in women, 17% were immigrants and 83% were women of this country. Social work must be directed to ensure that lonely young men with no home ties are persuaded to interests other than the company of promiscuous women. There i s need also for more united action between doctors, the churches and social agencies, and it is gratifying to record that this is now coming into being more rapidly than formerly, with promising results in this and other fields of health promotion. VENERAL DISEASES First attendances of Camberwell residents at the V. D. Clinics at St. Thomas's and King' s College Hospitals, 1962. Month Immigrants Others Totals Male Female Male Female Male Female January 13 11 6 30 19 19 13 8 4 2 February 17 10 6 20 5 8 13 March 26 2 1 April 2 1 3 3 3 - - May 5 5 3 25 13 5 June 9 30 22 19 20 July 14 15 39 29 35 21 14 August 4 56 18 30 11 16 September 8 41 24 23 6 16 October 4 39 10 24 20 November 12 1 44 13 20 December 8 9 1 29 9 124 Totals 64 175 233 111 357 REPORT OF CONSULTANT PHYSICIAN CAMBERWELL CHEST CLINIC During 1962, there was some falling-off of the work in this department and this was especially noticeable in the case of B.C.G. vaccination against tuberculosis of the infants born in the maternity department of the hospital. There was a smallpox scare from January to May, and during this time B.C.G. vaccination was not carried out because it was felt that smallpox vaccination was of more importance. Furthermore, many mothers demanded the smallpox vaccination which was a complete reversal of the usual practice. In fact, 458, compared with 696, newly-born infants were vaccinated; 724 were vaccinated as contacts or schoolchildren who did not receive vaccination from the B.C.G. team on its visit to their school. During the year, 13,458 units of X-ray work were carried out and there were 9,809 out-patients attendances Seven thousand two hundred new cases were X-rayed and a total of 1,658 new patientshad full clinical examinations. One hundred and seventy patients were admitted to St. Giles' Hospital for treatment and 73 to neighbouring hospitals. Patients with tuberculosis admitted to sanatoria for treatment numbered 101. It is encouraging to note that the number of cases on the tuberculosis register fell from 987 to 945 - further details of newly notified cases appear on page 44 in the Appendix of this Report. There was a very low death rate from tuberculosis - 6 men and 2 women, compared with 17 men and 3 women in 1961. The very cold winter also played a part in reducing the number of patients seen and even when the weather improved, it was gratifying to note that many of the bronchitics who had been attending regularly over a number of years, were at last beginning to follow our advice and stay at home during the bad weather. The incidence of pneumonia among these bronchitics was not alarmingly high. A number were admitted to hospital with concommitant heart failure and such a state of affairs is likely to become more common as more bronchitics continue to survive into the older age groups. Treatment of a chronic bronchitic patient with secondary heart failure strains a general practitioner's reserve of time and energy very considerably, and it is not surprising therefore, that many are admitted to hospital. During the year the number of acute social problems associated with difficult and anti-social patients with tuberculosis was fortunately not very high. Six patients, all after a period of treatment, were found to be excreting tubercle bacilli resistant to one of the three standard drugs and three unfortunate patients had organisms resistant to all three drugs. These latter patients have very extensive disease and they are a considerable cause for anxiety in case they should infect others with their resistant organisms. The Central Register mentioned in the 1961 Report, which was established in June, 1962, has very fortunately not become very large. The Health Visitors were able to make 2,618 visits during the year, which is highly commendable in view of the climatic conditions, and their work is of very great value. The Department has had very considerable help from Dr. Mower White and her staff and from Dr. Chalke, Medical Officer of Health. The London County Council Ambulance Service has always been as helpful as possible and we are greatly indebted to the Camberwell District Nursing and Ran yard Nursing organisations for their continued help. KENNETH MARSH, Consultant Physician. Chest Department, St. Giles' Hospital. STATISTICAL APPENDIX Summary of Statistics for the year 1962. 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 1961) 175,304 " (Estimated by Registrar-General mid/1962) 173,720 Number of inhabitated houses (April 1962) 45,239 Rateable value (April 1962) £2,590,599 Sum represented by a penny rate (Estimated) £10,450 Number of live births 3,504 Birth rate 20.2 Number of deaths 1,982 Death rate 11.4 Infantile Mortality:- Deaths under 1 year 84 Infant deaths per 1,000 live births 23.9 Maternal Mortality:- Deaths of women from diseases or accidents associated with childbirth 2 Maternal death rate per 1,000 total births 0.5 Deaths from Pulmonary Tuberculosis 8 Death rate 0.05 Deaths from cancer of lung and bronchus 126 Death rate 0.7 Deaths from all forms of cancer 417 Death rate 2.4 TABLE SHOWING CLASSIFIED CAUSES OF DEATHS IN AGE GROUPS IN CAMBERWELL DURING 1962 1- 5- 15- 25- 45- All ages Causes of death Sex 0- 65- 75- All causes M 999 49 6 5 13 47 321 239 319 F 983 35 1 1 5 34 155 218 534 Tuberculosis,respiratory M 6 - - - - 2 2 2 - - - F 2 - 1 1 - - - Tuberculosis, other M - - - - - - - - - F - - - - - - Syphilitic disease - - - - 1 M 2 - - - 1 - - F - - - - 1 1 - Diphtheria - - M - - - - - - - - - - - F - - - - - - - Whooping Cough - M - - - - - - - - - -- - - - F - Meningococcal infections - - - 1 - - M 1 - - - - - F - - - - - - - - Acute poliomyelitis - M - - - - - - - - - F - - - - - - - Measles - - - M - - - - - - - - F - - - - - - - - - Other infective and parasitic disease M - - 2 - 2 - - - - - - F - - - - - - - Malignant neoplasm, stomach M 23 - 9 8 - - 2 4 - 34 - - - 16 F 2 7 9 - Malignant neoplasm,lung, bronchus M 112 30 - - - 1 66 15 - F 14 - - - 4 8 2 - - Malignant neoplasm, breast M - - - - - - - - - F - 29 13 9 7 - - - - Malignant neoplasm, uterus F 16 - 6 6 1 3 - - - Other malignant and lymphatic neoplasms M 96 2 6 - - 38 29 21 - F 93 1 1 3 26 21 41 Leukaemia, aleukaemia - - M 4 1 1 1 1 - - - - F 11 1 3 4 3 - - - - Diabetes 2 M - 1 1 - - - - - F 6 1 - 2 - 3 - - - Vascular lesions of nervous system M 77 1 2 15 18 41 - - - F 127 2 16 30 - 79 - - - 207 - 13 49 Coronary disease,angina M 82 63 - - - F 164 - 20 46 98 - - - - Hypertension with heart disease M 26 9 10 7 - - - - - F 16 5 10 - - - 1 - - Other heart diseases M 67 1 17 1 20 28 - - - F 100 3 14 16 67 - - - - Other circulatory disease M 43 12 8 23 - - - - - F 68 11 4 10 43 - - - - Influenza M - - - - - - - - - F 4 1 1 - 2 - - - - Causes of death Sex All ages 0- 1- 5- 15- 25- 45- 65- 75- Pneumonia M 68 5 2 1 8 11 41 - - F 6 100 4 16 74 - - - - M Bronchitis 101 1 1 2 22 35 40 - - F 53 1 5 13 34 - - - - Other diseases of respiratory system M 11 4 3 4 - - - - - F 6 3 1 2 - - - - - Ulcer of stomach and duodenum M 11 5 2 4 - - - - - F 4 1 2 1 - - - - - Gastritis,enteritis and diarrhoea M 6 2 3 1 - - - - - F 4 3 1 - - - - - - Nephritis and nephrosis M 5 2 1 2 - - - - - F 6 1 1 1 2 1 - - - Hyperplasia of prostate Pregnancy, childbirth, abortion M 7 6 - - - - 1 - - F 2 1 1 - - - - - - Congenital malformations M 17 15 1 1 - - - - - F 4 3 1 - - - - - - Other defined and illdefined diseases M 57 25 2 2 10 6 11 1 - F 22 10 84 4 16 32 - - - Motor vehicle accidents M 14 - 1 3 4 6 - - - F 6 1 2 2 - 1 - - - All other accidents 4 M 17 1 2 4 3 3 - - F - 13 1 1 1 10 - - - Suicide M 16 5 5 4 2 - - - - F 1 15 4 8 2 - - - - Homicide and operations of war M 1 1 - - - - - - - F 1 - 1 - - - - - - Births Legitimate Illegitimate Live Births Still Births Total M F M F M F 1,560 1,497 28 21 1,588 1,518 227 220 9 4 236 224 1,787 1,717 37 25 1,824 1,742 Total 3,566 3,504 62 Medical Examinations carried out by the Medical Officer of Health or his Deputy Officers for admission to the Permanent Establishment 59 Officers for admission to the Unestablished Staff 8 Employees for admission to Sick Pay Scheme 179 Employees for admission to Permanent Establishment 41 Employees absent from duty owing to sickness 608* * In addition, 685 who were requested to attend failed to do so. Cremation Certificates No.of cremations authorised during the year by the Medical Referee or his Deputy 2,120 Water Certificates No.of Water Certificates issued 99 No.of dwellings concerned 680 Drainage and Sewerage No.of drainage applications received 221 Length of sewers reconstructed 4,674, ft. No.of brick gullies replaced by pot gullies 97 No.of defective pot gullies renewed 3 No. of new pot gullies installed 3 Public Cleansing Amount of house refuse collected 42,878 tons Amount of trade refuse collected 1,140 tons Examination of Water from the Council's Swimming Baths Bacteriological examination Chemical examination No.of Samples No. Satis. No. of Samples No. Satis. Camberwell Front Swimming Bath 5 5 5 5 Camberwell Rear Swimming Bath 11 11 11 11 Dulwich First Class Swimming Bath 5 5 5 5 Dulwich Second Class Swimming Bath 12 12 12 12 Total 33 33 33 33 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 No. Satisfactory Type of Material 12 Woollen mixture felt 16 2 2 Used jute wadding 6 6 New cotton felt 1 1 Sized cotton wadding 1 1 Cotton millpuffs 1 1 Kapok 1 1 Coir fibre 2 2 Coir fibre pad Totals 30 26 Four samples of woollen mixture felt failed to meet the requirements of the Rag Flock and Other Filling Materials Regulations, 1961, in respect of the chlorine content. Under the Regulations the maximum permitted chlorine content of woollen mixture felt should not exceed 30 parts per 100,000. The four samples in question gave readings of 65, 34, 32 and 34 parts per 100,000. These samples were taken from stocks delivered by one manufacturer. The matter was reported to the Public Health Committee and a cautionary letter was sent to the firm. Further samples have since been taken and found to be satisfactory. Offensive Trades Type of Business No. on Register Skin dressers 3 Soap boilers 1 Total 4 Pet Animals Act, 1952 No. of licences issued 3 No. of licences renewed 10 Total No. of pet shops licensed 11* *Two discontinued during the year Pharmacy and Poisons Act, 1933 No. of applications received for registration 11 No. of applications received for renewal of registration 143 London County Council (General Powers) Act, 1954 No. of hairdressers and barbers premises registered 141 ATMOSPHERIC POLLUTION, 19 62 Average Concentration of Smoke in Micrograms Per Cubic Metre. Apparatus installed at Town Hall and 475 Lordship Lane ATMOSPHERIC POLLUTION, 19 62 Average Concentration of Sulphur Dioxide in Micrograms Per Cubic Metre. Apparatus installed at Town Hall and 475 Lordship Lane Sanitary Inspection of the Area No. of complaints received 3,011 Summary of work carried out during the year 1962 Inspections:- Nuisance inspections 3,430 Offensive trades 14 Smoke observations 255 Drainage, new and existing 10,152 Overcrowding 571 Factories and workplaces 1,354 Outworkers premises 455 Rag dealers 99 Infectious and other diseases 37 Verminous premises and persons 139 Aged and infirm persons 155 Common lodging houses 54 Conveniences, public and private 411 Consumer Protection Act 347 Rent Act, 1957 107 Shops Act 1,929 Hairdressers and barbers 422 Voluntary work 107 Inspections not defined 1,351 Re-inspections 11,492 Total inspections 32,901 Works supervised:- Tests applied to drains (existing premises) 1,456 Drains found defective 325 Drains totally reconstructed 8 Drains repaired or partially reconstructed 560 Tests applied to drains (new buildings) 3,602 Drains constructed 2,669 Total works supervised 8,620 Description of sanitary improvements ordered during the year:- Cleanse and repair walls and ceilings 260 Repair roofs, gutterings, etc. 359 Abate dampness 536 Repair stoves, fireplaces and coppers 55 Repair windows, sashlines, sills, etc. 218 Repair flooring, stairs, doors, etc. 168 Provide sufficient light and ventilation 3 Provide dustbin 39 Remove offensive matter 34 Provide or repair yard paving 14 Provide or render accessible water supply 4 Cleanse, cover or render accessible water cistern 5 Repair water pipes and fittings 21 Clear premises of vermin Cleanse or repair water closets and flushing apparatus 107 Repair or clear defective or obstructed drains 24 Repair soil pipes, waste pipes, sinks, etc. 40 Abate nuisances caused by animals improperly kept 2 Miscellaneous 87 Total repairs and improvements ordered 1,969 Smoke Control - Return of Work Visits in connection with smoke complaints 313 Smoke observations 255 Atmospheric pollution readings 405 Smoke Control Areas - Inspections 3,595 Other Visits 1,456 Industrial premises inspections 146 Total 6,170 SUMMARY OF NOTICES SERVED, 1962 Intimations, Public Health (London) Act, 1936 Byelaws, etc. 858 Statutory Notices, Public Health (London) Act, 1936 Byelaws, etc. 433 London County Council (General Powers) Act, 1955 406 Public Health (London) Act, 1936 (Part II) 51 Section 8, Housing Act, 1957 32 No. of Summonses issued 70 Factories Act, 1961 1. INSPECTIONS, 1962 Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted Factories in which Sections 1,2,3,4 and 6 are to be enforced by Local Authorities - - 342 196 Factories not included above in which Section 7 is enforced by the Local Authority 809 38 930 - Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 14 - - 14 1,286 1,019 - 38 Totals 2. CASES IN WHICH DEFECTS WERE FOUND, 1962 No.of cases in which defects were Number of cases in which prosecutions were instituted Found Remedied Referred Particulars To H.M. In. spector By H.M. In. spector Want of cleanliness 5 - 1 - 5 - - Overcrowding - - - - - - Unreasonable temperature - - - - - - Inadequate ventilation - - - - - Ineffective drainage of floors - - - - Sanitary conveniences - - (a) insufficient - 28 - - (b) unsuitable or defective 29 4 (c) not separate for sexes 2 2 - - - Other offences against the Act (not including offences relating to outwork) 27 25 - - - Total 63 60 - 5 - Summary of Outworkers classified by Trades Artificial flowers 2 Cardboard boxes 40 Carding 16 Christmas stockings & crackers 8 Household linen 3 Jewellery 7 Lampshades 85 Wearing apparel 243 Total 404 Summary of work of the Rodent Control Staff No. of complaints received 1,144 No. of inspections 2,295 No. of Operators' calls 10,337 No. of private premises baited 1,358 No. of business premises baited 176 No. of baits laid 7,117 Vermin and Scabies ATTENDANCES AT CLEANSING STATION Vermin Scabies Total Male Female Total Male Female Adults Children 37 18 10 70 47 88 8 47 34 57 26 10 55 80 135 36 55 91 Total Disinfection RETURN OF WORK CARRIED OUT BY DISINFECTING STAFF Notified Infectious Diseases Other Diseases Miscellaneous Vermin Total all Cases 13 4 45 36 674 51 Rooms disinfected Lots of bedding disinfected 22 27 754 118 Total visits 29 16 3,126 383 3,554 Number of articles disinfected by steam1 ,695 Number of articles disinfected by formalin 895 Number of books disinfected 21 Number of towels washed 5,828 Number of soiled articles washed 12,224 Number of overalls washed 129 Number of covering sheets washed 97 Beds and mattresses destroyed 128 Miscellaneous articles destroyed 343 Weight of:- tons cwt. qtrs. lbs. Unsound foods destroyed 29 8 3 6¾ Unsound foods destroyed for Lambeth B.C. 15 16 0 16 Furniture and effects destroyed 63 19 0 0 Official documents 18 4 1 18 Dead animals destroyed - 9 2 0 Hospital dressings etc. destroyed - 8 3 0 Hospital bedding etc. disinfected - 7 0 0 Total 128 13 2 12¾ Bacteriological Reports on Samples of Swimming Bath Waters taken throughout the Year. Dulwich Baths First Class Bath Second Class Bath Probable No. of coliform bacilli MacConkey 48 hrs. 37°C colonies per 100 ml. Plate count yeastrel agar 24 hrs. 37°C. aerobically colonies per ml. Plate count yeastrel agar 24 hrs. 37ºC. aerobically colonies per ml. Probable No. of coliform bacilli MacConkey 48 hrs. 37°C colonies per 100 ml. January - - 1 0 February - - 1 0 March - - 0 0 April - - 0 0 May 4 0 0 0 June 1 0 0 0 July 0 0 1 0 August 1 0 0 0 September 0 4 0 1 October - - 1 0 - November - 6 0 December - - 0 0 Camberwell Baths Front Bath Rear Bath Plate count yeastrel agar 24 hrs. 37°C aerobically colonies per ml. Probable No. of coliform bacilli MacConkey 48 hrs. 37°C colonies per 100 ml. Plate count yeastrel agar 24 hrs. 37°C aerobically colonies per ml. Probable No. of coliform bacilli MacConkey 48 hrs. 37°C colonies per 100 ml. January - - 0 0 February - - 0 0 March - - 10 0 April - - 1 0 May 0 4 0 0 June 20 0 7 0 July 3 0 0 0 August 0 0 3 0 September 2 - 0 - October 1 0 - - November - - 0 0 December - 0 0 - HOUSING Record of work of Housing Inspector, 1962 Inspections Re-inspections Total 176 94 5 21 68 57 22 39 244 151 27 60 Clearance areas Individual unfit houses- Section 9 Section 16 Underground rooms and parts of premises Section 18 296 186 482 Total Housing Statistics, 1962 1.Inspection of Dwelling Houses during the Year:- (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Act) 3,727 (b) Number of inspections made for the purpose .. 15,107 (c) Number of dwelling-houses found not to be in all respects reasonably fit for human habitation 2,617 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 854 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 432 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) By owners 1,472 (b) By Local Authority in default of owners 2 (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 6 (b) By Local Authority in default of owners Nil (2) Houses demolished as a result of formal or informal procedure under Section 17 Nil (3) Houses closed in pursuance of an undertaking given by the owners under Section 16 and Still in force Nil (4) Parts of buildings closed by Closing Orders (Section 18):- (a) Underground rooms Nil (b) Other rooms 18 (5) Undertakings not to use parts of buildings for human habitation accepted:- (a) Underground rooms Nil (b) Other rooms Nil (5) Houses demolished under Section 42 24 (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 1 (3) Closing Orders made under Section 17(1) Nil (4) Closing Orders determined 3 (5) Closing Orders revoked and Demolition Orders made Nil (d) Houses in Multiple Occupation:- (1) No. of premises visited 23 (2) No. of premises at which conditions were remedied as a result of informal action 3 (3) No. of premises requiring formal action 16 (4) No. of Direction Orders made 4 (5) No. of Management Orders made Nil Certificates of Disrepair No. of applications for Certificates of Disrepair 55 No. of Undertakings received from landlords 41 No. of Certificates of Disrepair issued 9 No. of Certificates of Disrepair refused 3 No. of Certificates of Disrepair cancelled 15 INFECTIOUS DISEASES 1962. SUMMARY OF NOTIFICATIONS RECEIVED AND DEATHS FROM THESE CAUSES AMONG NOTIFIED CASES No. of Notifications Treated in Hospital u Age Distribution of Notifications £- Found not to be suffering from the disease Deaths of Notified Cases Disease 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 55 65 and upwards - 7 33 6 2 Scarlet Fever 57 1 3 6 - - - - - - - 52 13 6 2 8 5 16 2 Whooping Cough - - - - - - - - Poliomyelitis & Polioencephalitis - - - - - - - - - - - - - - - - 1 337 12 31 52 43 44 134 12 4 4 Measles - - - - - Diphtheria - - - - - - - - - - - - - - - - 1 3 Pneumonia Acute Influenzal 4 1 - - - - - - - - - - - - 5 2 17 12 36 3 - Acute Primary - - - - - - - - - 6 51 7 5 7 10 9 36 11 3 12 11 6 1 (1) Dysentery 118 - 1 Typhoid & Paratyphoid Fever 1 1 - - - - - - - - - - - - - 1 6 1 11 1 1 2 Erysipelas - - - - - - - - - - 4 2 2 1 (2) Meningococcal Infection 5 - - - - - - - - - - 27 130 21 1 (3) Puerperal Pyrexia 179 172 - - - - - - - - - - (4) Ophthalmia Neonatorum 7 6 7 - - - - - - - - - - - - - 5 1 2 14 - 1 1 4 - Scabies - - - - - - - 1 (5) Malaria 1 1 - - - - - - - - - - - - - 14 822 51 40 44 66 69 65 222 35 34 160 36 37 Totals 196 - ( 1) Includes 8 cases of Camberwell residents which occurred in hospitals outside the thorough. (2) Includes 1 case of a Camberwell resident which was diagnosed in a hospital outside the Borough. (3) Includes 61 cases of non-residents occurring in hospitals in Caraberwell, also 5 cases ot Lamberwell residents that occurred in hospitals outside the Borough. (4) Includes 3 cases of non-residents occurring in hospitals in Camberwell, also 2 cases of Camberwell residents that occurred in hospitals outside the Borough. (5) This was a case of a Camberwell resident which was diagnosed in a hospital outside the Borough. FOOD POISONING Annual Return of cases of Food Poisoning, 1962 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total (a) Food poisoning notifications (corrected) as returned to R.G. 14 10 1 1 26 (b) Cases otherwise ascertained - 1 3 1 5 (c) Symptomless excreters - - - - - (d) Fatal cases - - - - - 2. Particulars of outbreaks No. of outbreaks No. of cases Agent Total No. of cases Otherwise ascertained Family outbreaks Other outbreaks Notified Agent identified: I - —I - - 1 — - (a) Chemical poisons - (b) Salmonella 3 - 11 4 15 (c) Staphylococci (inc. toxin) - - - - - (d) Cl. Boculinum - - - - - (e) Cl. Welchii - - - - - (f) Other bacteria - - - - - Totals 3 - 11 4 15 Agent not identified - - - - - 3. Single cases Total No. of cases Agent No.of Cases Notified Otherwise ascertained - - r~ - Agent identified: (a) Chemical poisons (b) Salmonella Typhimurium Heidelberg - 1 1 1 1 - - 1 (c) Staphylococci (inc. toxin) - (d) Cl. Botulinum - - - - (e) Cl. Welchii - - (f) Other bacteria - - - Totals 1 1 2 Agent not identified - 14 14 Tuberculosis TABLE SHOWING SEX AND AGE DISTRIBUTION OF ALL PRIMARY NOTIFICATIONS AND DEATHS FROM TUBERCULOSIS DURING 1962 Deaths Notifications Nonpulmonary Pulmonary Nonpulmonary Age Periods Pulmonary Male Male Female Male Female Male Female Female - - - - 0 - 1 yr. 1 - - - - 3 2 - - - - 1 - 5 yr. - 1 - - 5 - 15 yr. 2 - - - - - 8 - - - 15 - 25 yr. 14 - - - 9 2 2 1 - 25 - 35 yr. 12 - - - 5 2 2 - 35 - 45 yr. 11 - 2 - 45 - 55 yr. 24 2 1 1 - - 1 - - 55 - 65 yr. 32 - - - - 3 4 1 65 and over 10 2 - - - 8 6 - Totals 107 30 7 2 - After correction for inward and outward transfers. TABLE SHOWING NOTIFICATIONS AND DEATHS, TOGETHER WITH THE ESTIMATED POPULATION DURING THE PAST FIVE YEARS Notification Rate per 1,000 Population Death Rate per 1,000 Population Estimated Population No. of Primary Notifications No.of Deaths Year 32 1958 177,300 193 1.1 0.18 14 0.08 1959 176,100 162 0.9 1.0 0.10 1960 175,020 183 18 165 0.9 20 0.12 1961 173,980 173,720 152 0.8 8 0.05 1962 RETURN OF VISITS - INFECTIOUS DISEASES AND OLD PERSONS Food Poisoning Dysentery Diphtheria Smallpox Other Diseases Poliomyelitis Scarlet Fever Scabies Aged and Infirm Persons Total Visits Miscellaneous Contacts Cases Contacts Contacts Contacts Cases Contacts Contacts Contacts Contacts Cases Cases Cases Cases Cases Cases - 20 37 14 1,409 417 2,351 72 4 315 20 2 - 27 10 - 3 1 - Food and Drugs Adulteration Summary of Samples obtained for examination. Number examined Number adulterated etc. Percentage of adulteration Formal Total Formal Informal Total Formal Informal Informal 423 480 903 5 15 1.18 2.08 10 Particulars of the adulterated samples and the action taken are set out on pages 47 and 48. Registered Purveyors of Milk Distributors of milk in the Borough 226 No.of pre-packed licences issued 226 Results of Tests Designation Methylene Blue Test Phosphatase Test Turbidity Test Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Pasteurised 101 - 101 — - - - 39 - Tuberculin tested pasteurised 39 - - Sterilised - - 21 - - - Samples of milk taken in course of delivery to Hospitals and Schools:- Methylene Blue Test Phosphatase Test Chemical Test Hospitals 38 38 38 Schools 57 57 62 All the above samples proved to be satisfactory. Ice Cream Summary of samples submitted for Methylene Blue Test and Chemical Examination. Methylene Blue Test Chemical Examination Satisfactory Unsatisfactory Grade I Grade II Grade III Grade IV - 45 19 9 12 56 Ice Lollies and Water Ices Summary of samples submitted for examination. Ice Lollies Bacteriological Examination Chemical Analysis Satisfactory Unsatisfactory Satisfactory Unsatisfactory 19 - - - Cream Lollies - - - 17 Assorted Lollies - 42 - - Water (Lemon) Ices 5 - - - PARTICULARS OF ADULTERATED SAMPLES 1962 Article Whether Formal or Informal Nature of Adulteration or Irregularity Observations Result of proceedings or other action taken Canned Cooking Butter Informal Rancid and contained excess free fatty acid Rancid and contained excess free fatty acid Rancid and contained excess free fatty acid See Formal Samples Nos. 49 and 50. Having regard to the fact that the butter complied with the statutory 16% limit for water content and was not adulterated, and taking into account the acidity, rancidity, and organoleptic character of the samples, it was considered that the criteria as regards palatability which might be held for table butter could not be applied unchanged to cooking butter, and, further, that this article of food could not be deemed to be unfit within the meaning of Section 8 of the Food and Drugs Act, 1955. See Formal Sample No. 75 — No action. Canned Cooking Butter Formal Formal Canned Cooking Butter Informal Contained 20% excess camphor Camphorated Oil Camphorated Oil Formal Contained 20% excess camphor - - Reported to Public Health Committee and cautionary letter sent Informal Lemon Juice Decomposed and fermenting Remaining stock surrendered and destroyed. - Formal Glace Pineapple Slightly contaminated with carbon particles Remaining stocks in this country withdrawn and returned to country of origin. - Article Glace Pineapple Orange Drink Whole Black Pepper Avorio Rice Bread Milk Malt Vinegar Borax B.P. Whether Formal or Informal Informal Informal Informal Informal Informal Informal Formal Informal Nature of Adulteration or Irregularity Slightly contaminated with carbon particles Deficient in sugar Contained excess extraneous matter Misleading label Contaminated with soiled dough and mineral oil. Slightly sour. 10% deficient in acetic acid. Effloresced. Observations See Formal Sample No. 154 Complaint sample: catering sale made to a member of a Bingo and Social Club. The provisions of the Soft Drinks Order, 1953, do not apply to such sales Matter taken up with wholesalers and packers: steps taken to rectify matter. Letters sent to retailer and wholesaler and importers. Steps taken by importers with exporters and packers to delete dietary claims to which exception had been taken. Complaint of contamination by rodent droppings not substantiated. Complaint of contamination not justified. - Remainder of stock withdrawn from sale. Result of proceedings or other action taken - No action. - - No action. No action. Reported to Public Health Committee and cautionary letter sent. - REGISTRATION OF FOOD PREMISES Premises registered under the provisions of Section 16 of the Food and Drugs Act, 1955, as at December 31st, 1962 Sale, manufacture and storage of ice cream 538 Preparation or manufacture of:- Potted, pressed, pickled or preserved meat 225 Potted, pickled or preserved fish 58 Potted, pickled or preserved other foods 35 Supervision of Food Premises Number of visits paid to each type of food premises by the Councils's Public Health Inspectors. Type of premises No. of Inspections Bakehouses 246 Bakers and Confectioners 595 Butchers 686 Cooked and Preserved Meat Shops 675 Dairies and Milkshops 556 Fishmongers and Shell Fish Vendors 481 Fish Fryers 340 Fish Curers 234 Food Factories 280 Ice Cream Vendors 583 Public Houses 477 Restaurants and Eating Houses 923 Street Markets 984 Street Traders Food Stores 82 Other Food Premises 1,805 Total 8,947 Unsound Food No. of condemnation Certificates issued 2,452 Particulars of Unsound Food Destroyed Description Weight Total Weight Tons Cwts. qtrs. lbs. Tons cwts. qtrs. Meat Sausages & cooked meats (Asstd.) 8 12 0 5½ 2 27½ Beef cuts - - Beef fillets 13¼ - - - Beef trimmings 6 - - 1 Ham (sliced) - - 1 8½ Gammon (cooked) 7½ - - - Lamb (carcase) 27 - - - Lamb (loin) 1 2 - - Ox livers 1 3 13 - Pigs knuckles 1 0 - - Pigs kidneys 13½ - - - Bacon (Asstd Pkts and pieces) 7 1 27¼ 9 3 2 - Poultry Turkeys 3 2 6 - Chickens 6¼ 3 2 - - - - Vegetables Potatoes 2 9 2 16 2 9 2 Fruit Peaches 5 2 24 - 2 0 6 0 Currants - - - Fish Skate wings 4 3 5 - Cod - - 3 0 Cod fillets 2 0 - - Dog fish 2 0 - - Fish fingers 1¼ 6 2 - - - - Tinned Foods Meat (Asstd) 2,348 tins 1 17 2 17½ Ham 201 tins 13 2 4¾ - Vegetables (Asstd) 6, 179 tins 2 19 3 9¾ Fruit (Asstd) 9,692 tins 0 2¼ 5 12 Milk (Cond. & Evap.) 876 tins 13¾ 6 1 - Rice (Creamed) 166 tins 1 1 24¼ - Cream 64 tins 1 5¼ - - Fish 1,507 tins 5 1 21½ - Jam (Asstd) 4 tins 18½ 11 16 3 - - - Miscellaneous Frosted foods (various), confectionery, pearl barley, tapioca, flour, pro. cheese, cheese cuttings, jams gherkins, pickles, sauces, chutney, marmalade, bottles of soft drinks, animal foods and various other foods 5 2 1 15¾ 5 2 1 Gross Weight 29 8 3 TABLE OF CONTENTS Page Clean Air 8 Care of the Elderly 14 Health Education 17 Housing 10 Infectious Diseases 22 Public Health Committee - Constitution 3 Report of the Consultant Chest Physician 26 Sanitary Circumstances 7 Smoking and Health 20 Staff of the Public Health Department 4 The Widening Sphere of Public Health Work 5 Venereal Diseases 23 INDEX TO STATISTICAL APPENDIX Atmospheric pollution - graphs 33-34 Births 30 Certificates of Disrepair 41 Deaths - Causes and Age Distribution 29-30 Disinfection 38 Drainage and Sewerage 31 Factories Acts 36-37 Food & Drugs Adulteration 45 Adulterated Samples Table 47-48 Food Inspector - Return of Work 49 Food Poisoning Food Premises - Registration and Supervision 49 Hairdressers and Barbers 32 Housing Inspector - Return of Work 40 Housing Statistics 40-41 Ice Cream and Lollies 46 Infectious Diseases 42 Infectious Diseases Visitors - Return of Work 44 Medical Examinations 30 Milk - Registered Purveyors 45 Results of Tests 45 Offensive Trades 32 Outworkers 37 INDEX TO STATISTICAL APPENDIX - continued Page Pet Animals Act 32 Pharmacy and Poisons Act 32 Public Cleansing 31 Rag Flock & Other Filling Materials 32 Rodent Control - Return of Work 37 Sanitary Inspection of the Area 35 Smoke Control - Return of Work 36 Statistics - Summary of 28 Swimming Bath Water - Examination of 31 & 39 Tuberculosis 44 Unsound Food Certificates 49 Unsound Food Destroyed 38 Vermin and Scabies (Attendances) 38 Water Certificates 31