AC 4345 1 Mr. Omarta Div 5B 2 Library CHE 52 Metropolitan Borough of Chelsea Annual Report of the Medical Officer of Health J. H. WEIR, M.D., B.S., B.Hy., D.P.H. for the year 1954 -1 - METROPOLITAN BOROUGH OF CHELSEA PUBLIC HEALTH AND BATHS COMMITTEE Chairman: Councillor Lyall, Miss M. M.B.E. V ice-Chairman: Councillor Duncan, Lt.-Col. R.G. C.I.E., M.V.0., O.B.E. Councillor Acland, Miss K. O.B.E. " Baxter, Mrs. M. " Beier, E.W. " Bifield, W.C. M.M. " Budgett, F.G.P. " Buxton, Mrs. G.K. Councillor Gough, A.E. " Hannay, J. M.Ch.S. " Henry, Mrs. A.F. " Molloy, Miss P.D.J. " Tatton-Brown, J.S. " Woolford, J.E. Ex-Officio Members His Worship the Mayor (Councillor Guy Edmiston, F.C.I.B., J.P.) The Deputy Mayor (Councillor Capt. C. Towns end) - 2 - Representation by Members of the Public Health and Baths Committee on outside Committees and other Organisations concered with Public Heaith work. Chelsea Cancer Committee: Councillor Mrs. G.K. Buxton Chelaea Tuberculosis Care Committees Councillor Mrs„ G„K. Buxton Councillor Miss M. Lyall Councillor Miss M. Lyall Invalid Children's Aid Associations Councillor Miss M. Lyall London County Council Divisional Health Committer (Division 1): Councillor Miss M. lyall London Country Council Divisional Tuberculosis Care Committee: Councillor Mrs. G.K, Buxton (Division 1) London and Home Counties Smoke Abatement Advisory Council: Councillor J. Hannay National Smoke Abatement Society: Councillor J. Hannay Councillor Miss M. Lyall Old People's Welfare Committee: Councillor Lt.-Col. R.C. Duncan Councillor Miss M. Lyall Third Feathers Club Committee: Councillor Lt.Col. R.C. Duncan Westminster and Chelsea District Nuraing Associations Councillor Miss M. Lyall - 3 - STAFF OF PUBLIC HEALTH DEPARTMENT at 31st December, 1954. Medical Officer of Health: Deputy Medical Officer of Health: Chief Sanitary Inspector: Deputy Chief Sanitary Inspector and Senior Housing Inspector: Sanitary Inspectors: Women Sanitary Inspectors: Sanitary Inspectors' Assistant: Drainage Assistant: Rodent Officers: Chief Disinfector: Disinfectors Cleansing Station Attendant: J.H. WEIER, M.D., B.S., B.Hy., D.P.H. W.C. TURNER, M.D., B.S., D.P.H., D.I.H. H. HYLAND S.W. BARKER J.T. HEALY H.F. LEACOCK H.W. LUDLOW a.j. white e.r. YOUNG (Miss) a.c.c. kay (Miss) G.K. reader F.G. RAWLINGSON E. BOSLEY J.F. COOke P. DRURY L.H. BERRY F.W. HILL R.J. WESTON (Mrs.) J. LOBBAN Chief Clerk: Clerical Officers: Social Worker: J.C. BRYANT I.M. THOMS0N H.G. HAMILTON L.A. P0WELL (Mrs.) W. BAAR R.H. LITCHFIELD P.M. MARGETTS (Mrs.) O.M. BUrKE Public Analyst: Thos. McLACHLAN, A.C.G.F.C., F.R.I.C. - 4 - METROPOLITAN BOROUGH OF CHELSEA Public Health Department, Town Hall, King's Road, CHELSEA, S.W.3. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Your Worship, My Lord, Ladies and Gentlemen, It is with pleasure that I submit my annual report for the year 1954. The inclusion of graphs and tables continues, thus clearly indicating the trends in various aspects of Public Health. The population of the Borough has been estimated by the RegistrarGeneral to be 52,060, as compared with 52,150 and 52,140 in 1953 and 1952 respectively. A decrease of 90 is apparent since 1953, but the variations in population returns show that the present figures exceed by over a thousand the estimate for 1947, the first year of normal conditions following World War II. Military personnel stationed in the Borough continue to be looked upon as residents, but there is no current Information available as to their numbers. The last estimate made in this particular connection was in 1951, when the total was 150. Births. The number of Live Births allocated to Chelsea was 787, and the Birth Rate was 15.1. By a remarkable coincidence the foregoing figures have been constant for the past three years. 401 Males and 386 Females were born in 19541 the relevant figures for 1953 were 423 and 386. Whilst "Chelsea" births remained unchanged, those for England and Wales (682,007) decreased by 8,795 to 673s212. Deaths. 734 residents died either within or without the Borough. In the latter case they were duly transferred to this authority by the RegistrarGeneral. The number of deaths increased by 40 as compared with 1953 (694) and the Death Rate rose by 0.8 per 1,000 of the population. However, it is most significant to record that almost three-quarters (547) of registered Chelsea deaths were of persons aged 65 years and over, a proportion never before attained. To provide for adjustments of sex and age components of any one area as compared with England and Wales as a whole, it has been found necessary to establish "Area Comparability Pastors," by which means a practical statistical basis can be found for both Birth and Death Rates. The results of these calculations can be seen on Page 6. Maternal Mortality. Two deaths were attributed to accidents or diseases associated with pregnancy or childbirth. In 1953 there were three deaths from such causes, but prior to that no deaths under this heading had occurred after 1946. The annual average number of deaths during the past fifteen years has been 1.066. Infectious Diseases. Five hundred and forty-nine notifications were received during the year, as compared with 1,232 in 1953. The great reduction is entirely due to Measles, Whooping Cough, and Sonne Dysentery which fell by 445, 164 and 59 respectively, as compared with 1953. A case of Diphtheria was last notified to the Department in 1949. - 5 - Infant Morta lity. The number of deaths of infants under one year of age was twenty-one, as compared with 15 in 1953. The infant death rate was, therefore, 26.6. Reference to this subject will be found on Page 12. Despite this "set-back", the following table is worthy of consideration- Year Deaths under 1 year of age No. o births registered Rate per 1.000 registered births 1900 333 2,245 148 1910 141 1,376 102 1920 73 1,392 52 1930 32 799 4-0 1940 15 428 4-0 1950 21 829 25 1951 19 819 23 1952 16 737 20 1953 15 787 19 1954 21 787 27 Since 1940, and until the year under review, there has been a tendency for the dramatic improvement apparent in the early decades of this century to decline. The rate must, however, be contemplated with the actual number of births and deaths registered. It is then chylous that a greater proportionate reduction in the number of deaths has occurred compared with the decline in births. Food Poisoning. Nineteen notifications were received during the year, a decrease of four as compared with 1953. Reference to investigations under this heading will be found, on Page 65. Food and Drugs. Four hundred samples were submitted to the Council's Analyst, Mr. T. MeLachlan, during 1954, and a comprehensive report of his work is included herein. Forty-one, or 10.2 per cent, were found to be adulterated; In thirteen instances "adulteration" was traced to labelling inaccuracies or misdescription. Food Hygiene is a section of this Department's work which receives unflagging attention, and the efforts of all concerned can be well realised from a study of this Report. Housing Conditions are another important feature of the year's work. It will be seen thai Underground Rooms have also received close attention. The Welfare of Old People is a problem which is steadily meeting with successful realisation, as will be seen from the section devoted to the variety of facilities readily available. There are now 1,093 persons on the register as coopered with 106 in 1950. I would like to take this opportunity of thanking the Chairman of Committees and individual members of the Council far the court say and consideration shown me, and for the keen attention given to the problems I have from time to time submitted to them. The friendly co-operation of all Chief Officers and their staffs, and the loyalty of my colleagues in the Public Health Department has done much, to make task a pleasant one. I am, Mr. Mayor, My Lord, Ladies and Gentlemen, Your obedient Servant, J.H. WEIR, Medical Officer of Health. 6 METROPOLITAN BOROUGH OF CHELSEA ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1954 AREA OF THE BOROUGH: GENERAL RATE: PRODUCT OF A PENNY RATE: RATEABLE VALUE OF BOROUGH AS AT 31ST MARCH: 659.6 acres 19s.6d. in tbe £. (1954-55) £5,227. £1,306,330. POPULATION: Registrar-General's estimate of the population of the Borough (mid-year, 1954) 52,060 LIVE BIRTHS: Total M. F. Legitimate 709 357 352 Birth rate per 1,000 of Illegitimate 78 44 34 estimated population 15.1 787 401 386 Adjustment of birth rate by area comparability factor 11.3 STILL BIRTHS: 13 6 7 Rate per 1,000 (live and still births) 16.2 DEATHS: 734 351 383 Death rate per 1,000 of estimated population 14.1 (Males: 6.7; Females: 7.4) Adjustment of death rate by area comparability faster 12.4 EXCESS OF REGISTERED BIRTHS OVER DEATHS: 53 (Males 50 : Females 3) MATERNAL MORTALITY RATE: 2.5 (Two deaths associated with pregnancy or childbirth occurred amongst Chelsea residents during the year.) DEATH RATES OF INFANTS UNDER ONE YEAR OF AGE: All infant per 1,000 live births 26.6 Legitimate infants per 1,000 legitimate live births 22.6 Illegitimate infants per 1,000 illegitimate live births 64.1 DEATHS FROM TUBERCULOSIS: Pulmonary 9 Other forms — Death rate per 1,000 of estimated population:- Pulmonary Tuberculosis: 0.17 -7- SUMMARY OF VITAL STATISTICS 1940-1954. (inclusive) Year Registrar-General's Estimate of Population BIRTHS DEATHS DEATHS UNDER ONE YEAR MATERNAL DEATHS No. + Rate No. + Rate No. + Rate No. + Rate 1940 38,700 428 11.0 851 22.0 15 40 3 7.8 1941 26,470 306 11.6 600 22.7 9 38 - - 1942 27,430 342 12.5 502 18.3 17 50 1 2.8 1943 30,330 459 15.1 554 18.3 32 70 1 2.1 1944 30,990 416 13.4 572 18.4 21 50 1 2.4 1945 35,310 557 15.8 536 15.2 25 45 4 6.9 1946 45,740 816 17.8 550 12.0 36 44 1 1.2 1947 51,000 868 19.0 611 12.0 43 44 - - 1948 50,890 883 17.4 597 11.7 35 40 - - 1949 51,990 875 16.8 588 11.1 23 26 - - 1950 52,490 829 15.8 638 12.2 21 25 - - 1951 52,430 819 15.6 686 13.1 19 23 - - 1952 52,140 787 15.1 669 12.8 16 20 - - 1953 52,150 787 15.1 694 13.3 15 19 3 3.7 1954 52,060 787 15.1 734 14.1 21 27 2 2.5 Averages for the seven years 1948-1954:- Births 824 Deaths 658 Deaths under one year of age 21 Maternal Deaths 0.7 Totals arrived at after due allowance for inward and outward transfers. -8- DEATHS OF RESIDENTS DURING 1954 AGE AT DEATH Causes of death At all Ages Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upward 1. Tuberculosis, respiratory 9 - - - - 3 - 6 2. Tuberculosis, other - - - - - - - - 3. Syphilitic disease 1 - - - - - - 1 4. Diphtheria — — — — — — — — 5. Whooping Cough — — — — — — — — 6. Meningococcal Infections - — — — — — — — 7. Poliomyelitis, acute — — — — — — — — 8. Measles — — — _ — — — — 9. Infective and parasitic diseases 4 1 — — 1 — 1 1 10. Malignant neoplasia, stomach 22 — — — — 1 5 16 11. Malignant plasm, lung, bronchas 27 — — — — 1 9 17 12. Malignant necplasm, breast 10 — — — — — 5 5 13. Malignant neoplasm, utsrus 6 — — — — 2 1 3 14. Malignant and lymphatic neoplasms, other 77 — — — — 5 14 58 15. Lsukaemis, alsukasuis 3 — — — — 1 1 1 16. Diabetes 8 — — — — — 2 6 17. Vascular lesions of nervous system 95 — — — — 3 9 83 18. Goronary disease angina 89 — — — — 2 18 69 19. Hypertension with heart disease 26 — — — — — — 26 20. Heart disease, other 82 — — — — 1 7 74 21. Circulatory disease, other 61 — — — — — 5 56 22. Influanza - — — — — — — — 23. Pneumonia 42 1 — — — — 3 38 24. Bronchitis 32 — — — — — 6 26 Carried forward 594 2 — — 1 19 86 486 -9- DEATHS OF RESIDENTS DURING 1954 (Continued) AGE AT DEATH Causes of death At all Ages Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Brought forward 594 2 - - 1 19 86 486 25. Respiratory system, other diseases of 6 - - - - - 4 2 26. Ulcer of stomach and duodenum 5 - - - - - 2 3 27. Gastritis, enteritis and diarrhœa 3 1 - - - - 1 1 28. Nephritis and nephrosis 8 - - - 1 1 1 5 29. Hyperplasia of prostate 6 - - - - - - 6 30. Pregnancy, childbirth, abortion 2 - - - - 2 - - 31. Congenital malformations 4 2 - - 1 1 - - 32. Other defined and ill-defined diseases 59 15 - 1 - 6 8 29 33. Motor vehicle accidents 12 - - 2 - 4 3 3 34. All other accidents 25 1 1 - 3 4 5 11 35. Suicide 9 — — — - 6 2 1 36. Homicide and operations of war 1 - - 1 - - - - TOTALS 734 21 1 4 6 43 112 547 The following summary gives an indication of the vast changes which have taken place in respect of deaths occurring in Chelsea (a) under one year of age, and (b) at 65 years and over:- Year Number of deaths Deaths under 1 year of age Percentage of total deaths Deaths at 65 years and over Percentage of total deaths 1900 1,737 333 19.17 442 25.44 1925 883 64 7.24 433 48.01 1950 638 21 3.29 434 68.02 1951 686 19 2.76 483 70.40 1952 669 16 2.39 470 70.25 1953 694 15 2.16 488 70.31 1954 734 21 2.86 547 74.52 It is of interest to note the tendency for the percentages of deaths in the particular age groups above to become stabilised. -10- ANALYSIS OF DEATHS The percentages of the total deaths (734) attributable to particular causes are set out below. It is proposed to incorporate this feature in the Report in future years, as it is felt that whatever the trends they will prove of interest. The figures in parentheses are to be read in association with those appearing in the main table of deaths appearing on the opposite page. Coding Percentage Coding Percentage Coding Percentage (1) 1.23 (13) 0.82 (25) 0.82 (2) - (14) 10.00 (26) 0.70 (3) 0.14 (15) 0.41 (27) 0.41 (4) — (16) 1.10 (28) 1.09 (5) — (17) 13.00 (29) 0.82 (6) — (18) 12.12 (30) 0.30 (7) — (19) 3.54 (31) 0.54 (8) — (20) 11.20 (32) 8.04 (9) 0.60 (21) 8.30 (33) 1.60 (10) 3.00 (22) — (34) 3.40 (11) 3.70 (23) 5.70 (35) 1.23 (12) 1.40 (24) 4.40 (36) 0.14 So far as cancer of the lung is concerned the number of deaths from this particular cause during the past five years were as follows:- 1950 22 1951 16 1952 33 1953 20 1954 27 It will be recalled that during December 1952, a particularly dense and persistent smoke fog was experienced, whilst fog conditions were somewhat above normal in 1950. -11 - INFANT MORTALITY The deaths of twenty-one infants under the age of one year were recorded during 1954, representing a death rate of 26.6 per 1,000 live births, as compared with 19.1 and 20.3 in 1953 and 1952 respectively. Fifty-seven per cent of the deaths occurred under four weeks of age. The causes of deaths were attributed to:- Males Females Atelectasis 1 — Gastre-enteritis 1 - Inattention at birth 1 - Malformat ions, Congenital 4 1 Marasmis 1 — Pneumonia 3 1 Prematurity 5 1 Otitis Media 1 - Unascertained 1 - The following table shows the particular periods at which death took place:- Under 4 weeks 4 weeks to 3 months 3 to 6 months 6 to 12 months Total under 1 year Males 10 2 5 1 18 Females 2 - 1 - 3 Totals: 12 2 6 1 21 It has to be recorded that for the first time since 1948, infant deaths have failed to decrease, but such occurrences must, unfortunately, be anticipated from time to time. During the ten years 1925 to 1934, 465 infants under one year of age died, giving an annual average of 46.5 and in the period 1945 to 1954, 254 deaths occurred representing an annual figure of 25.4. The disappointing return for this year once again illustrates that satisfaction with "good returns" must not be taken as a matter of course. On the following page will be found a table giving details of Infant mortality in England and Wales as a whole, and a number of other countries. - 12 - INFANT MORTALITY RATES-ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year of age per 1,000 live births Country 1948 1949 1950 1951 1952 1953 Average for six years ENGLAND & WALES 34 32 30 30 28 27 30.1 SCOTLAND 45 41 39 37 35 38 39.1 AUSTRALIA 28 25 24 25 24 23 24.8 CANADA 44 43 41 38 38 35 38.1 DENMARK 35 34 31 29 29 27 30.8 FRANCE 51 61 52 51 46 42 50.5 irish republic 49 59 45 45 41 39 46.3 ITALY 70 74 64 67 64 59 66.3 NETHERLANDS 29 27 25 25 23 22 25.2 new zealand 22 24 23 23 22 20 22.3 SWEDEN 23 23 20 21 20 19 21.0 united states OF AMERICA 32 31 29 29 29 28 29.7 The above table has been prepared from information made available by the Registrar-General. - 13 - SPASTIC CHILDREN In April, 1955, the Chelsea Hospital Management Committee will be opening an out-patient centre for the diagnosis and treatment of cerebral palsied children under five years of age at Cheyne Hospital, Cheyne Walk, Chelsea. The centre is primarily a medical establishment, but by arrangement with the London County Council, educational facilities will be provided. Children who are educable will attend in the mornings and receive treatment and schooling throughout the day, whilst other children will attend for treatment by appointment. Parents wishing to avail themselves of facilities available should apply to the Secretary of the Centre fop Spastic Children, 61, Cheyne Walk, S.W.3. Cerebral palsy, which produces what is known as the "spastic child", has been the subject of recent research. Such a condition arises from an injury to the brain before, during, or after birth, and may render it difficult for a child to either stand, walk, speak, or use its hands. Until lately this problem has been one difficult to cope with in view of the fact that little was known about it, so that children so affected were deemed to be mentally defective, the tragic implications of which can be well realised when considering the fact that their intelligence is, in the majority of cases, quite normal. The centre has come into being as a result of generous contributions from the King Edward's Hospital Fund for London, City Parochial Charities, the William Johnston Yapp Trust, and many other public-spirited persons. A capital outlay of £15,000 was needed to found this pioneer project. It is hoped to include details of the work of the centre in later reports. - 14 - ATMOSPHERIC POLLUTION The Borough is reasonably free from serious nuisance from smoke within its own boundaries, whilst considerable improvements have been effected in the administrative area as a result of co-operative action between officers of the Public Health Department and those who have, in the past, contributed to the pollution of the atmosphere. A survey of industrial premises in which steam raising and central heating plants were operated was made during the year, and in the great majority of cases it was ascertained that solid smokeless fuels were employed. Without doubt the predominant source of atmospheric pollution throughout the metropolitan area is the domestic fireplace, and it is essential that local authorities be given the power, under town planning procedure, to secure the installation of new heating and cooking appliances of approved patterns, and to ensure that adequate and suitable supplies of solid smokeless fuels should be available at all times. During 1954, 55 observations were made in respect of nuisances arising at premises situate in or adjacent to the Borough, and occasionally reports are received of excessive smoke emitted by river craft passing Chelsea. It has been found that when the existence of nuisances has been substantiated, the operators of industrial plants concerned have taken every possible step to remedy conditions. As regards river craft, complaints have been referred to the Port of London Authority who have been most helpful in approaching the companies whose vessels have been found to be blameworthy. The Council, in conjunction with other Metropolitan Boroughs and the Department of Scientific and Industrial Research, has established stations for the investigation of atmospheric pollution, and data resulting from the examination of matter collected in an atmospheric deposit gauge, and the concentration of sulphur dioxide and smoke, are regularly forwarded to the Department of Scientific and Industrial Research. -15- SANITARY ADMINSTRATION OF TH EBOROUGH SUMMARY OF WORK PERFORMED BY THE SANITARY ISPECTIORS DURING THE YEAR 1954. Number of complaints received during the year 954 INSPECTIONS AND RE-VISITS DWELLINGS: Inspections alter complaint. 3,939 Inspections after Infectious Diseases 338 House-to-House inspections 1,780 Underground Rooms 195 Overcrowding and "Permitted Numbers" 197 Visits to obtain information re Housing applications 159 Inspection of Council flats re presence of vermin 109 Other visits 26 6,753 FOOD PREMISES: Butchers 176 Horseflesh Dealers 21 Fishmongers and Fish Friers 63 General Provision and Delicatessen Shops 170 Dairies and General Stores retailing Milk 203 Ice Cream Vendors (Premises, Stalls, Vehicles, etc.) 289 Ice Cream Manufasrturers 39 Bakehouses and Underground. Bakehouses 136 Street Stalls and Barrows 64 Food Delivery Vehicles 7 Food Factories (Mechanical) other than Bakehouses 18 Hotels, Restaurants and Dining Rooms 664 Premises in connection with Unsound Food 476 Premises in connection with sampling of Food and Drugs 125 Other Food Premises 104 2,555 FACTORIES AND OUTWORKERS Factories-other than Food Factories (Mechanical) 288 Factories—other than Food Factories (Non-Mechanical) 628 Outworkers 34 Other visits (not classified) 3 387 DRAINAGE: Drains tested: (a) by water 233 (b) by smoke 124 (c) by air 69 Drains traced by colour 18 444 Carried forward: 10,139 -16 - SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1954. Brought forwards 10,139 INSPECTIONS AND RE-VISITS (Continued) MISCELLANEOUS Public Conveniences and Hotel Conveniences accessible from the street 6 Conveniences in Cinemas, Theatres, Hotels, etc. 4 Stables and manure pits 3 Animals, poultry and birds 7 Open spaces, highways, allotments, fairgrounds, etc. 82 Office premises 16 Marine Stores and Second-hand Dealers 2 Premises registered under Pharmacy & Poisons Act, 1933 50 Premises to enforce requirements of Shops Act. 71 Visits re progress of voluntary works 3,793 Visits to offices of Owners, Agents, Builders, etc. 259 Smoke onservations 55 Food Poisoning 28 Fumigation of furniture and effects 11 Visits to Aged and Infirm Persons 194 Visits to Verminous Persons 13 Premises other than dwellings after Infectious Diseases. 1 Premises under Pet Animals Act, 1951 12 Visits for Atmospheric Pollution recording 247 Premises under Rag Flock and Other Filling Materials Act, 1950 14 Premises in connection with Merchandise Marks Act 2 Visits to premises resulting in "no access" 1,969 Other visits 918 7,757 TOTAL: 17,896 - 17 - WORKS SUPERV ISED BY THE SANITARY INSPECTORS. FACTORIES ACT 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LCNDON) ACT, 1936 FOOD & DRUGS ACT, 1938 TOTAL N. V. N. V. N. V. N. V. CLEANSING Rooms Walls & Ceilings cleansed and redecorated - 1 66 - 104 16 - 5 192 Passages & Staircases: Walls & Ceilings cleansed and redecorated - 1 25 - 21 4 1 - 52 Yard & Area Walls cleansed and redecorated - - 1 - - - - 1 2 Booms and Contants cleansed by occupiers - -- - - 1 - - - 1 Rooms where Food is manufactured stored or sold. - - - - - - 5 38 43 Miscellaneous — 1 - - 1 — — 2 4 GENERAL IMPROVEMENTS AND REPAIRS: Roofs - _ 35 — 119 6 - — 160 Eaves, Gutters - - 9 - 56 - - - 65 Rain-water pipes - - 9 - 9 - - - 18 Yard and Areas Pavings - - 16 - 7 - _ _ 23 Walls rendered or repaired — - 30 - 4 - - — 34 Rooms: Wall & Ceiling plaster - 1 84 — 214 24 1 1 325 Passages St Staircase as Wall and Celling plaster - 31 - 34 4 _ 1 70 Floors — 1 26 - 29 1 3 2 62 Site concrete provided - - - 18 - - - - 18 Subfloor ventilation provided - - - 3 - - — - 3 Stair Treads, Banister & Balustrades 1 - 31 - 10 1 — - 43 Window and Door Frames, fittings and gash cords 1 - 240 - 82 12 - _ 335 Dampness remedied - - 43 64 347 43 - - 497 Horizontal damp proof course provided - - 5 11 - - - _ 16 Vertical damp proof course provided __ - - 11 - - - 11 — Fireplaces & Fire-ranges repaired - - 61 - 48 7 - - 116 Washing Coppetrs repaired - "" 12 - 1 - - a- 13 Carried forward 2 5 724 107 1067 118 10 50 2103 - 18 - WQRKS SUPERISED BY THE SANITARY INSPECTORS (Continued) FACTORIES ACT 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LCNDON) ACT, 1936 FOOD & DRUGS ACT, 1938 TOTAL ? N. V. N. V. N. V. N. v. Brought forward 2 5 724 107 1087 118 10 50 2103 GENERAL IMPROVEMENTS AND REPAIRS (Continued) Natural Ventilation provided or improved _ 1 23 64 11 9 — - 106 Chimneys and Flues — — 26 — 5 1 - — 32 Natural Lighting provided or improved - - 12 45 — 2 - — 59 Obstruction to Natural Lighting removed - - - 6 - - - - 6 Height of Boom increased - - - 1 - - - - 1 Area adjoining Boom improved or provided - - - 16 - - - - 16 Miscellaneous - - 5 - 33 7 - 1 46 DRAINGE: Total Reconstructions - - - - - 6 — — 6 Partial Reconstructions, repairs or alterations - - - - - 9 - _ 9 Frontage Drains Reconstructed _ _ _ _ 22 1 — 1 24 Obstructions cleared - 1 2 3 17 4 - - 27 Inspection Chambers provided. - - _ _ 1 33 - 2 36 Inspection Chamber covers renewed - - - - 9 1 - - 10 Interceptors provided - - - - - 8 - 1 9 Soil & Ventilation Stacks provided or reconstructed - 1 1 - - 25 - 1 28 Soil & Ventilation Stacks repaired - - 2 - 9 - - - 11 Waste & Ventilation Stacks provided or reconstructed - 1 5 - 6 38 - 1 51 Waste & Ventilation Stacks repaired - - - - 2 - - - 2 Anti-Syphonage Stacks provided or reconstructed _ _ _ - _ 21 - 1 22 Fresh Air Inlets provided — — — — 1 4 — — 5 Fresh Air Inlets repaired or renewed — — 1 — 10 1 — — 12 Carried forward 2 9 801 242 1213 288 10 58 2623 - 19 - WORKS SUPERVISED BY THE SANITARY INSPECTORS (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1938 TOTAL N. V. N. V. N. V. N. V. Brought forward 2 9 801 242 1213 288 10 58 2623 DRAINAGES (Continued) Single Sinks provided - 2 3 - 4 90 1 4 104 Single Sinks renewed — 1 3 — 3 — — — 7 Baths provided - - - - - 117 - - 117 Wash-hand basins provided. — 2 — - - 113 - 4 119 Miscellaneous. — 4 8 1 29 55 - 1 98 SANITARY CONVENIENCES. Additional Water Closets provided — 4 - - 1 99 - 1 105 Water Closet pans renewed. - - 1 - 6 3 - — 10 Water Waste preventors renewed or repaired - - 3 3 18 4 - - 28 Water Waste Preventers provided - 4 - - 1 99 - 1 105 Roofs repaired or renewed. — — 5 — 1 3 - 1 10 Floors repaired or renewed - _ 1 - 4 - - - 5 Walls & Ceiling plaster cleansed, repaired or redecorated. 3 3 27 - 35 5 1 3 77 Natural Ventilation provided or improved - - 13 _ 7 23 - - 43 Natural or Artificial Light provided or improved. - - 1 - - - - - 1 Ventilated Lobby provided. - - 1 am 1 1 - - 3 Miscellansous. - - 13 - 19 3 - 1 36 WATER SUPPLY: Supplies provided to Tenements. — - 23 - 13 - - - 36 Taps supplied on main for drinking purposes - - 23 - 13 - - - 36 Burst. Pipes repaired. - - — — 4 2 - — 6 Cisterns cleansed, covered or repaired. - - - 6 - - - 6 Carried forward 5 29 926 246 1378 905 12 74 3575 - 20 - WORKS SUPERVISED BY THE SANITARY INSPECTOR (Continued) FACTORIES ACT 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1938 TOTAL N. V. N. V. N. V. N. V. Brought forward 5 29 926 246 1378 905 12 74 3575 MISCELLANEOUS SERVICES PROVIDED: Staff Rest & Changing rooms - - - - - - - 1 1 Constant Hot Water - 2 - - - - - 7 9 Food Cupboards provided - - 58 - - - - - 58 Food Cupboards - Ventilation provided — — 6 — — - — — 6 Covered Display & Counter Screens provided - - - - - - 21 _ 21 MISCELLANEOUS NUISANCES ABATED .ARISING FRQM: Animals or Birds - - — — 1 - _ - 1 Offensive accumulations on open land and bomb sites. - - - - 11 1 - - 12 Obstruction from Light and Air - — — - 1 — - — 1 GRAND TOTALS 5 31 990 246 1391 906 33 82 3684 N = Work carried out under Notice. V = Voluntary works. - 21- INSPECTION, PROCEEDINGS, etc. Total number of houses in the Borough 16,267 (approx) PUBLIC HEALTH LONDON) ACT. 1936 Number of houses inspected on account of complaints or illness 1,188 Number of statutory notices served 129 Number of houses repaired or nuisances remedied 468 HOUSING ACT. 1936 Number of houses inspected - housed to-house (Housing Consolidated Regulations, 1925) 58 Number of houses included by representations by the Medical Qffiser of Health under Section 25 of Housing Act, 1936 Nil Number of houses demolished following representation by Medical Qfficer of Health under Section 25 of Housing Act. 1936 Nil Number of houses repaired under Sections 9 and 10 of Housing Act. 1936:- (a) by owners 30 (b) by local authority in default of owners Nil Number of houses demolished:- (a) in pursuance of orders under Section 11 of the Housing Act, 1936 4 (b) voluntarily Nil Number of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) 1 Number of Closing Orders determined (i.e., houses made fit) Nil OVERCROWDING (HOUSING ACT. 1936) Number of families found to be living in overcrowded conditions 17 Number of overcrowded families who have obtained alternative assommodation 19 Number of houses greeted by the Borough Council during the year 70 UNDERGROUND BOOMS Number occupied but unfit Nil Number closed or modified occupation approved Nil HOUSES LET IN LODGINGS Number of inspections (see above) — Number of prosecutions Nil Number of complaints remedied under the bye-laws (not included under any other heading) 18 - 22 - DETAILS OF NOTICES SERVED DURING THE YEAR UNDER VARIOUS ACTS 1. FACTORIES ACT. 1937 Health-General Provisions 3 2. FOOD AND DRUGS ACT. 1938 Section 13 - Defects at Foal Premises 8 3. HOUSING ACT, 1936 (a) Section 9 - Repair of Insanitary Houses 55 (b) Byelaws - As to Lodging Houses for the Working Glasses 24 79 4. PUBLIC HEALTH (LONDON ACT. 1936 (a) Intimation. (Arising out of this item, 99 Nuisance Notices were served) 371 (b) Section 40 - Drainage 11 (e) Section 184 - Food Storage 19 5. SHOPS ACT. 1950 Section 38 -Porvision of suitable sanitary conveniences and ventilation Nil 6. PERVENTION OF DAMAGE By PESTS ACT, 1949 Section 4- Destruction of mice Nil TOTAL 491 Five hundred and twalve notices were complied with during the year of which four hundred and fifty-four were served under the Public Health (London) Act, 1936. HENT AND MORTGAGE INTEREST RESTRICTIONS ACTS One certificate was issued in accordanse with the provisions of the above Acts. HOUSING REPAIRS AND RENTS ACT. 1954. Three Certificates of Disrepair ware issued in accordance with the provisions of the above Act. - 23 - APPLICATIONS FOR RE-HOUSING To assist the Council's Property Manager in arriving at a just consideration of the merits of each application received a "pointing" system was evolved, and became effective in May, 1953. As applicable, points were awarded under the following headings:- Sub-standard accommodations Ill-health (excepting Tuberculosis); Tuberculosis; Overcrowding; and Other circumstances. During the year, 121 applications were referred to the Public Health Department. 94 originated from Chelsea residents, and the remainder from applicants living in other areas. Each case was investigated - 77 in connection with ill-health, including Tuberculosis, and 44 in respect of sub-standard accommodation. Since May, 1953, the position is as follows:- Applicants re-housed by the Borough Council 64 Applicants re-housed by the London County Council 12 Applicants re-housed by other authorities 1 Applicants who secured alternative accommodation by their own effects 12 89 Of this total, 66 of the cases re-eccommodated had been dealt with under the heading of "ill-health". The policy of co-operative examination of each housing application under the headings mentioned is proving to be mutually satisfying by virtue of the accelerated period of enquiry and subsequent re-settlement. HOUSING ACT. 1936 PART IV - OVERCROWDING. New cases investigated recorded 17 Number of families involved 17 Number of persons involved 106 Cases relieved by:- (a) Rehousing Authorities 9 (b) Informal or formal procedure 10 Such action resulted in 100 persons being adequately housed. At the end of the year, 46 families ware living in overcrowded conditions and every endeavour is being made to bring about an abatement of such conditions. - 24 - HOUSING AST. 1936. Repair of properties (Sections 9 and 10). Under Section 9 of the Housing Act, 1936, a local authority if satisfied that a house is in any respect unfit for human habitation, shall, unless satisfied that it is not capable at reasonable expense of being rendered fit, serve upon the person having control of the house a notice requiring him within a reasonable time to execute the works specified in the notice. In determining whether a house can be rendered fit for human habitation at a reasonable expense, regard shall be had to the estimated cost of the works necessary to render it so fit and the value which it is estimated the house will have when the works are completed. The local authority are allowed under section 10 of the Act to carry out the work themselves if the notice has not been complied with, and the expenses incurred by the local authority in executing such works are recoverable from the persons having control of the house. During the year 55 notices were served under Section 9 and 30 properties were repaired by owners after service of notices. No properties were repaired by the Council under Section 10 in default of owners. Demolition and Closing Orders (Sections 11 end 12). No demolition orders were made during the year, but 4 houses were demolished in pursuance of orders made in previous years and one house was the subject of a closing order under Section 12. The following table shows the total number of unfit houses dealt with under Sections 11 and 12 of the Housing Act, 1936, since 1949:- Year Houses Families Displaced 1949 45 56 1950 6 5 1951 - - 1952 10 5 1953 3 1 1954 3 2 TOTAL 67 69 - 25 - WORKS SUPERVISED BY THE SANITARY INSPECTORS (Continued) Housing Acts 1936 - 1954. Imorovements to Underground Rooms. Dampness remedied 64 Horizontal damp proof course provided 16 Vertical damp proof course provided 11 Site concrete provided 18 Subfloor ventilation provided 3 Permanent ventilation provided 40 Natural lighting improved 57 Ventilation improved 44 Obstruction to natural lighting removed 6 Height of room increased 1 Area to adjoining room improved or provided 16 TOTAL 276 These figures hare been included in previous pages under works supervised by the Sanitary Inspectors under the heading "Housing Act, 1936". - 26 - FACTORIES ACT. 1937 Under Section 128 of the above Act, a Medical Officer of Health is required to report annually as to the administration of Factories, Workshops, and Workplaces In his district. The following three tables indicate the work carried out by the Sanitary Inspectors during the year. 1. INSPECTION OF FACTORIES. WORKSHOPS. AND WORKPLACES. Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted (1) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authoritiess:- 65 67 1 - (2) Factories not included in (l) in which Section 7 is enforced by the Local Authority:- 251 306 2 - (3) Other Premises in which Section + 7 is enforced by the Local Authoritys:- - - - - TOTALS 316 373 3 - Note:- Outworkers' premises are not included in (3) above. + i.e., Electrical Stations - Section 103(1), Institutions (Section 104) and sites of Building Operations and Works of Engineering Construction (Sections 107 and 108). - 27 - FACTORIES ACT. 1937 (Continued) 2. CASES IN WHICH DEFECTS WERE FOUND. Particulars Number of cases in which Defects were found Number of Cases in which prosecutions were Instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (Section l) 7 5 - 1 - Overcrowding (Section 2) - - - - - Unreasonable temperature (Section 3) - - - - - Inadequate ventilation (Section 4) - - - - - Ineffective drainage of floors (Section 6) - - - - - Sanitary Conveniences (Section 7) (a) Insufficient - - - - - (b) Unsuitable or defective 5 2 - 1 - (c) Net separate for secces 1 - - - - Other offences against the Act (not including offenses relating to Outwork) 24 - 24 - - TOTALS 37 7 24 2 - - 28 - FACTORIES ACT. 1937 (Continued) OUTWORK (Sections 110 and 111) Nature of Work No. of Outworkers in August List required by Section 110 (1)(c) No. of Cases of default in sending List to the Council No. of Prosecutions for failure to supply Lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing Apparel, Making etc. 16 - - - - - Furniture and upholstery 1 - - _ - - Curtains and furniture hangings 2 - - - - - Jewelry, repairing, etc. 1 - _ - - - Lampshades 8 - - — — - TOTALS 28 - - - - - - 29 - LEGAL PROCEEDINGS The institution of legal proceedings, under the Public Health (London) Act, 1936, was necessary in six instances. Brief details of results of hearings are set out below. Premises Offense Result of Proceedings 3, Tetcott Road Non-compliance with Abatement Order. Penalty Summons Defendant fined £3.l6s.0d. Council awarded £1. 1s.0d. costs. 1, Glebe Place Non-compliance with Abatement Order. Penalty Summons Defendant fined £11.7s.6d. Council awarded £2.2s.0d. costs. 3, Tetcott Road Non-compliance with Abatement Order. Penalty Summons Defendant fined £4.18s.0d. Council awarded 4s.0d. Costs. 1, Glebe Place Non-compliance with Abatement Order. Penalty Summons — Defendant fined £10.10s.0d. Council awarded £2.2s.0d. Costs. 184, Lots Road Non-Compliance with Statutory Notice. Abatement Order made for the work to be completed within seven days. l, Glebe Place Non-compliance with Abatement Order. Penalty Summons Defendant fined £8.8s.0d. Council awarded £2.2s.0d. Cost. - 30 - NATIONAL ASSISTANCE ACT, 1948. BURIAL OF THE DEAD (Section 50 of above Act) The provisions of this Act require a local authority to arrange for the burial or cremation of the body of any person in respect of whom no other suitable action can be taken. This duty has been so delegated since 5th July, 1948, at which time the National Health Service Act of 1946 became operative. For approximately the first nine months, the Public Health Department dealt with all interments of the nature indicated above, whether death occurred in local hospitals or the homes of residents. The application of Section 50 of the Act was, however, reconsidered by the Minister of Health in March, 1949, and as a result it was decided that Hospital Committees and Boards should arrange and pay for the burial and cremation of patients dying in hospitals under the following circumstances:- (a) Relatives nob being traced; (b) Relatives being traced, but who were not, immediately before a patient's death, liable for his (or her) maintenance under Section 42(l) of the Act, and are not willing to undertake the arrangement of burial or cremation; and (c) Relatives not being able to obtain a death grant under the National Insurance Act, 1946, and unable to accept responsibility for burial or cremation expenses. Thus a direct financial burden on the local authority was greatly minimised as will be apparent from the following brief summary:- Year Interments arranged by Borough Council 1948 (approximately 6 months) 43 1949 25 1950 9 1951 10 1952 9 1953 12 1954 4 The local authority deals with such cases as may be referred to them by hospitals when liable relatives fail to accept their responsibilities, whilst necessary arrangements are always made in respect of persons dying in their own homes when exhaustive enquiries have established the non-existence of next-of-kin. No cremations have, during the years set out above, been carried out by the Council. Whilst it may be that investigations definitely point to the non-existence of any surviving relatives, there is always the remote possibility that at some future date a member of the deceased's family will pursue enquiries* with the result that the Council might be challenged as to the action taken in this respect. - 31 - Under the Second Schedule of Bart II of the National Insurance Act, 1946, appear details of Death Grants payable subject, of course, to the fulfilment of certain provisions, and the fact that either the deceased person or a legally liable relative has made a qualifying number of contributions to National Insurance. A grant is obtainable when the deceased person was at the time of death:- Grant (a) under the age of three years £ 6 (b) between three and six years £ 10 (c) between six and eighteen years £ 15 (d) over the age of eighteen years £ 20 A grant cannot be secured in the case of a man born before 5th July, 1883, or a woman before 5th July, 1888. A further exception is made in the case of a child under the age of ten years who was barn before 5th July, 1948. Grants as indicated above may only be paid in full to liable relatives; a local authority whilst assuming the role of a "liable relative" will only receive three-fifths of an applicable grant, as stipulated by the National Insurance (Death Grant) Regulations, 1949. - 32 - PUBLIC MORTUARY FACILITIES. For some years now no mortuary premises have existed in the Borough; fortunately however excellent facilities are available, under an agreement with Hammersmith Borough Council, at their Mortuary in Fulham Palace Road, W.6 (Telephones RIVerside 1813) which is also adjacent to the Coroner's Court for this area. During 1954 two hundred and seventeen Post Mortems without Inquests and fifty-three Post Mortems with Inquests were carried out in respect of Chelsea residents. MEDICAL EXAMINATIONS During the year, fifty-five examinations were carried out to ascertain whether persons appointed to fill positions in the Council's employment were fit for admission to the authority's superannuation scheme. As a result of the examinations 51 proved successful; 2 were deferred for re-examination; and 2 proved unacceptable for superannuation purposes. WATER SUPPLY The provision of water for both commercial and domestic users is made by the Metropolitan Water Board. During the year, two complaints regarding the unsatisfactory condition of water supplies were received. In the first instance, the complainant decided to have the supply, subject to the Metropolitan Water Board's permissions direct from the rising main, and in the second, approach was made to the owners of a large block of flats to have the storage tanks cleansed. Thirty-one samples of water were taken at the Council's Public Baths, and in every instance a satisfactory report was received,, As a result of investigation by the Council's Sanitary Inspectors, the following provisions were made:- Supplies to tenements 36 Taps on main for drinking purposes 36 Burst Pipes repaired 6 Cisterns cleansed, covered or repaired 6 - 33 - DISINFECTION AND DISINFESTATION The following is a summary of the work carried out by the staff of the Council's Disinfecting and Cleansing Station, 9a, Lots Road, Chelsea, during the past three years. (a) SCABIES 1952 1953 1954 Treatmenta were carried out as follows!- ADULTS (Male) Cases 4 2 Nil Treatments 4 3 Nil ADULTS (Female) Cases 5 3 16 Treatments 7 7 20 Children Cases 3 1 13 Treatments 6 4 21 (In addition to the figures shown above 38 children attending L.C.C. schools ware given 38 treatments.) (b) VERMINOUS CONDITIONS Details of work in this connection are set out belows- ADULTS (Male) Cases 6 2 Nil Treatments 6 2 Nil ADULTS (Female) Cases 388 465 407 Treatments 388 465 407 Childress Cases 277 304 284 Treatments 277 304 284 (295 treatments were given to L.C.C. schoolchildren.) DISINFECTION OF ROOMS AND CONTENTS AFTER INFECTIOUS DISEASE. 1952 1953 1954 Number of Rooms Disinfected 337 220 112 Number of Articles Diginfected 4,373 6,138 3,334 Diainfection of Rooms and Contents: Number of Rooms Disinfected 511 480 198 Number of Articles Disinfected 1,307 1,615 772 Miacellansous Disinfection Number of Rooms Disinfected 242 322 390 Number of Articles Disinfected 1,572 2,370 2,320 - 34 - PET ANIMALS ACT, 1951 The Pst Animals Act,, 1951, which came into operation on the 1st April, 1952, provides for a system of licensing and inspection by local authorities of pet shops, the main purpose being the enforcement of the Protection of Animals Acts in their application to the business of selling pets. Under Section 1 of the Act, no person may keep a pet shop unless he obtains a licence from the local authority on payment of a fee not exceeding Ten Shillings. In deciding whether to grant a licence, the local authority is required to have regard to the need for securing that there will be provided accommodation suitable as regards size, temperature, lighting, ventilation and cleanliness; that there will be an adequate supply of suitable food and drink; that the animals will not be sold at too early an ages; that all reasonable precautions will be taken to prevent the spread of infectious diseases; and that appropriate steps will be taken in ease of fire or other emergency. The local authority has, however, a discretion to withhold a licence on other grounds, and is given power to specify in the licence such conditions as they think necessary or expedient in a particular case. Any person aggrieved by the refusal of the local authority to grant such a licence or by the conditions imposed in the licence may appeal to a court of summary jurisdiction. During the year three persons were licensed to keep pet shops in the borough and in each case a fee of ten shillings was paid. DESTRUCTION OF PIGEONS Complaints are occasionally received of nuisances caused by pigeons. The Council does not employ an officer to deal with such a matter; reference is generally made to a firm specialising in the trapping and despatching of these birds, and no charge whatsoever falls on the local authority. During the year some 800 pigeons were caught, and with the exception of seven which ware traced to their owners, they were all humanely destroyed. Under Section 123 of the Public Health (London) Act, 1936, a local authority is empowered to take steps to reduce the numbers of pigeons in its area to a reasonable level, and to abate nuisances arising from concentrations of these birds. - 35 - PHARMACY AND POISONS ACT. 1933 The provisions of the Act and the Poisons Rules relating to the retailing of poisons specified in Part II of the Poisons List were administered throughout the year. The number of listed sellers placedon the Council's register was 50. (47 retentions and 3 new applications). All applications are investigated to ensure that records are properly maintained, labelling efficiently performed, storage accommodation adequate and that sales are made only by employees nominated on the application forms. In every instance it was found that the requirements of the Act and Poisons Rules were being complied with, whilst subsequent enquiries revealed that all concerned were well aware of their responsibilities in such matters. As a general rule the poisons retailed were insecticides, rodent exterminants, hair dyes, and household ammonia. Applications for inclusion and/or retention in the Council's register are considered by the Public Health Committee each Springe When approval has been, exparessed to applications, appropriate entries are made for a period of twelve months (1st May to 30th April). RAG FLOCK AND OTHER FILLING MATERILS ACT, 1951 The Rag Flock and Other Filling Materials Act, 1951, came into force on 1st November., 1951, and brought about the repeal of:- The Rag Flock Acts of 1911 and 1928, and Section. 136 of the Public Health (London) Act, 1936. The new Act. represents a consolidation of the 1911 and 1928 Acts, and extends control to a large number of filling materials in order to ensure the cleanliness of same. Eleven premises in the Borough, used for upholstering and similar processes, have been registered since the Act came into force and in each ease a fee of £1. 0s. 0d. was received. - 36 - RODENT CONTROL The Prevention of Damage by Pests Act, 1949, which became operative on 31st March, 1950, is more advantageous to a local authority in dealing with rodents than the Rats and Mice Destruction. Act, 1919. which has been repealed. The new Act empowers a local authority to take all practicable measures to rid its area of rats and mice. Under the provisions of the Rats and Mice Destruction Act, 1919, the primary duty for the eradication of these particular pests rested upon the individual occupier. With the advent of this new legislation, an occupier is guilty of an offense if he fails to destroy rodents, or use his best endeavours to prevent infestation. There has always been co-operative action between owners, occupiers and the local authority in this Barough. Details of work carried out in this connection during the year are as follows 1- Treatment of Bisiness and Private Premises. Business Presses Private Premises Number of visits made 475 2,389 Number of infestations found 39 290 Number of treatments undertaken 33 263 Number of pre-baits laid 1,759 Number of poison baits laid 577 Number of complaints received 341 2. Sewer Maintenance Treatments. No. of prebaits laid No. of poisan baits laid Estimated kill No. 1 Treatmant 960 342 2,075 No. 2 Treatment 754 336 2,546 - 37 - WELFARE OF OLD PEOPLE At the close of the year, 1,093 persons were on the registers of the Public Health Department, an increase of 6l over 1953, after due allowance for removal to other areas, and the inexorable march of the years. In investigating the circumstances and conditions peculiar to each aged person, the Council's Officers at all times exercise commendable tact, and fully appreciate that despite ill-health in many cases, people are perfectly contented if they can remain in familiar surroundings, and at the same time be aware that every effort will be made to ensure their well-being. The Borough Council makes a grant of £450 yearly to the Chelsea Old People's Welfare Committee, which is representative of and co-ordinates the activities of voluntary organisations working in this sphere of public service# It is obviously impossible to refer to all the facilities offered, but the following matters will illustrate the variety of assistance available for the well-being of those in need:— Provision of Hot Meals. This service is efficiently administered by the Women's Voluntary Services from Monday to Thursday in each week, and during the year 10,028 meals were delivered, or an average weekly supply of 193. (The figures for 1953 were 10.302 and 198 respectively). The receipt of hot meals at a regular hour was welcomed by all concerned. Late in the year, the London County Council closed down their restaurant in Cadogan Gardens - at which address the meals were cooked - and it was necessary, without delay, to secure alternative facilities. Subsequently arrangements were concluded with a local caterer, and meals are supplied at l/8 per head. Since the changeover an increase in applications for this facility has been apparent. Chiropody. 117 persons were recommended for the services of two qualified chiropodists, as compared with 97 and 86 in the two preceding years. The number of treatments given totalled 432, a total in excess of previous years. The increasing demand for this indispensable facility has resulted in application to the Old People's Welfare Committee for an additional half day to be set aside monthly, which has enabled a farther sixty persons to be dealt with, and at the game time markedly reduced the waiting list. Holidays. The continuance of this scheme resulted in 73 persons having pleasant stays either at the sea or in the country. In seventeen instances financial help was given by the Old People's Welfare Committee to persons considered to be in special need, and only a charge of £1 per person for a two-weeks holiday was involved. The remaining 56 stayed at holiday homes controlled by the Women's Holiday Fund. In some instances, transport was provided to convey people to and from holiday centres, and quite frequently escorts travelled to and from railway stations. All holidays were arranged by the Social Worker. Library and Shopping Facilities continue to be maintained by the British Red Cross Society, and the weekly visits by their officers are eagerly awaited by those whose disabilities prevent them getting out and about. This Society also provides escorts, when necessary, to accompany persons attending hospital for treatment. Shopping facilities are provided by the Women's Voluntary Services. - 38 - Difficulty in securing hospital accommodation for the chronic sick continues, but the happy relationship between the Council's officers and hospital authorities brought about the admission of fifty-six men and women during the year. It is pleasing to record that the patient efforts of hospital rehabilitation departments have resulted in people returning to their homes ready to live normal lives again. Institutional care became necessary for eighteen persons, most of whom settled down quite readily to a communal life. However, it must be stressed that a change of environment frequently entails considerable effort and tact. The Women's Voluntary Services and other kind donors have continued to dispense much needed clothing to recommended cases, and 229 persons were helped in this manner during the year, as compared with 177 in 1953. The National Assistance Board also gives every sympathy to parsons in distress, and makes grants which ensure the securing of essential items. Many people are found to be in enfeebled conditions, and therefore unable to properly look after themselves. In such cases, personal cleansing is arranged. At the same time rooms are cleansed and superfluous items disposed of. The Council's Social Worker made 2,491 visits to cases an the Council's registers. In a considerable number of cases visits were made to people whilst they were in hospital,. It must be pointed out that very many visits are of a protracted nature, and lead to the making of a variety of enquiries, the completing of which cannot be duly recognised in this report. Christmas Dinners. Through the kindness of voluntary subscribers and a working committee, sufficient funds were secured to provide 320 housebound and lonely old people with a three-course Xmas dinner, a miniature bottle of brandy, sweets, biscuits, and "a shilling for the gas" The entire distribution was carried out on Christmas Eve. In addition, four hundred and fifty food parcels were received from America, and collected from the Town Hall. A local boot-repairer is now carrying out boot asd shoe repairs to the extent of twenty-five pairs monthly. The charge for this work is subject to a reduction of twopence in the shilling from normal costs, and this publicspirited action is taken full advantage of. In conclusion, I would express my sincere thanks to the British Red Cross Society, the Women's Voluntary Services, local voluntary organisations, and the many private residents who have contributed in no small measure to the successful pursuit of the maximum of happiness and freedom from care. 39 HOSPITALS AND NURSING HOMES Excellent facilities for both general and special hospital treatment are available in the Borough, as will be seen from the following lists:- HOSPITALS TYPE OF INSTITUTION Brompton Hospital, Fulham Road, S.W.3. Chest Diseases Chelsea Hospital for Women, General Dovehouse Street, S.W.3. Granard House, 98, Dovehouse Street, Malignant Disease S.W.3. (Part of Royal Marsden Hospital) Royal Marsden Hospital, Fulham Road, S.W.3. Malignant Disease Royal Hospital, Royal Hospital Road, S.W.3. Home for Pensioners St. George's Home, Milman's Street, S.W.3. Tuberculosis St. Luke's Hospital, Sydney Street, S.W.3. Chronic Sick St. Stephen's Hospital, Fulham Road, S.W.3. General Victoria Hospital for Children, Tite Street, Children's Diseases S.W.3. NURSING HOMES Royal Avenue Nursing Home, Private 39, Royal Avenue, S.W.3. Wilbraham Nursing Home Private 3, wilbraham Place, S.W.1. 40 "PART III" ACCOMMODATION A local authority is required, under Section 21 of the National Assistance Act, 1948, to provide- (a) residential accommodation for persons who by reason of age, infirmity or any other circumstances are in need of care and attention which is not available to them; and (b) temporary accomodation for persons who are in urgent need thereof, being need arising in circumstances which could not reasonably have been foreseen, or in such other circumstances as the authority may in any particular case determine. Two institutions - "King's Mead", Dovehouse Street, and 367, Fulham Road-are maintained by the London County Council in the Borough as "Part III" accommodation, and they are, in this particular respect, "the local authority". It was considered essential to arrange for the reception of 18 persons in such accommodation during 1954, and in all cases admissions were made at "King's Mead". Recourse to legal action was, happily, only necessary in one instance to enforce removal as indicated in Section 47 of the Act, as amended by the National Assistance (Amendment) Act, 1951. However, in a number of cases, transfers were only effected after considerable persuasion. The London County Council assumes responsibility for the safe custody of the belongings of persons accommodated, thus removing any grounds for anxiety. Reasonable notice is always given to the County authorities of impending removals. 41 MATERNITY AND CHILD WELFARE SERVICES The following information has been kindly provided by Dr. V.I. Russell, Medical Officer for Division 1 of the London County Council (which comprises the Boroughs of Chelsea, Falham, Hammersmith and Kensington). This particular section of Public Health work has been the concern of the County Council since 5th July, 1948. In the day-to-day administration of Maternity and Child Welfare services, the Divisional Medical Officer receives the assistance of the Madical Officers of Health to the Boroughs forming Division I. WELFARE CENTRES Attendances at Ante-natal and Post.natal Sessions 1,346 Attendances at Infant Welfare Sessions 8,975 HEALTH VISITING Number of visits carried out by Health Visitors in respect of:- Premature infants: First visits 7 Re-visits 21 Children under 1 years: First visits 801 Re-visits 2,461 Children under 1 year: First visits 97 Re-visits 1,198 Children between 1 year: First visits 102 Re-visits 2,011 Expectant mothers: First visits 435 Re-visits 225 Stillbirths: First visits 7 Re-visits 2 Infections disease: First visits 42 Re-visits 12 Follow-up of hospital patients: First visits 28 Re-visits 16 Care of old people: First visits 1 Re-visits 4 Other after-care: First visits 2 Re-visits 1 Miscellaneous 547 Unsuccessful 1,812 TOTAL: 9,835 42 MATERNITY AND CHILD WELFARE SERVICES (Ccntinued) Number of children visited during the year 2,670 Number of households iuvolved 2,046 Foster Mothers: Number of registered foster mothers 8 Number of children fostered 15 Diphtheria Immunisations: Number of children who completed a primary course of injections 677 Number of children who received reinforcing injections 657 Vaccinations: Number of children vaccinated at the Violet Melchett Infant Welfare Centre 440 It is of great interest to note that the figures for Diphtheria Immunisation are greatly in excess of those for 1953, as can be seen from the following brief tables:- Year Primary Injections Reinforcing Injections 1954 677 657 1953 461 277 Increases: 216 380 Percentages: 46 137 Having regard to the fact that public concern in preventive measures is usually aroused only when the incidence of a particular disease is high, it is all the more satisfying to learn of such an encouraging response to a much publicised service under the present circumstances. 43 BYELAWS FOR THE PROTECTION OF FOOD The requirements of these Byelaws were vigorously applied by the Council's Food Inspectors. Occupiers of twenty-one food premises received written or verbal notices referring to inadequate methods for protecting food such as sandwiches, cakes, cheeses, meats, etc., from contamination when on display. The majority of shopkeepers have co-operated promptly, and have fitted glass counter screens or transparent dish covers. In some instances, only cellophane covers have been provided, but a transfer to a more permanent, and hygienic, fitment is gradually taking place. Regular observation is maintained on snack bars, public houses and restaurants at which contamination easily occurs. Food delivery vans are frequently inspected, with the result that a number of firms have been cautioned for unsatisfactory methods of delivery. Suggestions have been made, and well-received, for the utmost care in the protection and handling of food. The thirty-six fruit and vegetable shops in Chelsea now display goods at a reasonable height from the ground, thus lessening the risk of spoiling. In some instances it has been found that notices stressing the importance of washing hands after the use of staff water-closet compartments are not affixed. These omissions were immediately rectified. Whenever practicable, it is suggested that a wash-hand basin should be fitted in toilet compartments, and very little difficulty is experienced in securing such a provision. When shopkeepers are installing new equipment, they are always advised as to its siting, so that when cleansing is necessary both appliances and their immediate surroundings can be properly dealt with. Whilst it is felt that good standards of hygiene are being maintained, food premises continue to receive unrelaxed attention. Educsational work to obviate shortcomings in the handling, wrapping and displaying of food is carried out, and no chance of securing a "change-over" to the use of modern equipment is missed. 44 INSPECTION AND SUPERVISION OF FOOD As required by current legislation, registers are maintained of all persons carrying on trades connected with the manufacture, storage and sale of food. From time to time letters and notes in connection with the "Handling, Wrapping and Delivery of Food are circulated to traders and their staffs, and generally speaking, this action was much appreciated. The following summary gives details of the types of businesses receiving the attention of the Public Health Department:- Bakehouses 7 Butchers 29 Dairies and Milk Shops 46 Food Factories 3 Fried Fish Premises 3 Fruit and Vegetable Retailers. 36 General Provision Merchants 55 Industrial Canteens 7 + Miscellaneous Premises 32 Public Houses and Hotels 48 Restaurants 144 Wet Fish Retailers 9 Wet and Fried Fish Retailer 1 + Off-licences and bottling stores, cake shops, and sweet shops. As required under Section 14 of the Food and Drugs Act, 1938, or other local acts, the registrations of 101 premises for the storage and sale of Ice Cream, and 40 premises for the sale of Preserved Foods, are effective. 45 PUBLIC HEALTH EDUCATION CLEM HANDLING OF FOOD As has already been stated, the vigilance and initiative of the Council's Sanitary Inspectors has brought about a steadily improving standard of hygiene in food premises, and now, on the whole, conditions are being maintained at a very satisfactory level. The majority of food handlers are becoming increasingly aware of their personal responsibility for the maintenance of health and the prevention of disease, and now that facilities have been made available at their places of work, through the willing co-operation of managements, the improvement in standards is progressing. The public at large, however, still have a duty to perform in drawing to the attention of both shopkeepers and officers of the Public Health Department any disgusting or dirty food handling habits or practices witnessed in shops and restaurants. There are in Chelsea a number of large hospitals and other institutions, and occasional outbreaks of food poisoning in these establishments draw attention to the considerable resident population at risk. It was, therefore, decided to undertake a series of lectures to the catering, kitchen and foodhandling staffs of these establishments. Originally it had been intended to give the lectures at the places of employment, but owing to the small numbers of persons separately available at any given time, it was found that this would have led to excessive repetition. However, thanks to the willing co-operation of the No. 4 (Chelsea) Group Management Committee in placing a suitable hall and other facilities at St. Luke's Hospital at our disposal, it was possible to bring all the persons to a central point. The course of training consisted of lectures given by the Medical Officer of Health and other members of the Public Health Department, and the showing of five films on the subject of the "Clean Handling of Food". It was followed by an examination under the auspices of the St. John Ambulance Association. Some fifty-four persons took the course and were suecessful in passing the examination. The same course was repeated for the benefit of the local division of the St. John Ambulance Brigade at their headquarters. This successful experiment in co-operation between the local authority and other bodies, (which included the Chelsea Hospital for Women, the Royal Marsden Hospital, the Brompton Hospital, the hospitals comprising the No. 4 (Chelsea) Group, the Victoria Hospital for Children, and the Hans Crescent Hostel for Foreign Students run jointly by the Colonial Office and the British Council) was much appreciated by all participants. 46 BACTERIOLOGICAL EXAMINATION During the year, sixty-six examinations were carried out for bacteriological findings, details of which are set out in the following summary:- Article Reported upon as Total Satisfactory Unsatisfactory Cheese 1 - 1 Cornish Pastie 1 - 1 Cream 3 10 13 Fruit Lolly 1 - 1 Milk, Cows 14 - 14 Minced Meat 1 - 1 Peas 1 - 1 Potato 1 - 1 Prunes 1 - 1 Semolina 1 - 1 Water 31 - 31 56 10 66 Reference to seventy-two samples of Ice Cream will be found on Page 47. 47 ICE CREAM Seventy-two samples of Ice Cream were submitted to the Public Health Laboratory Service for "Methylene Blue" tests, with the following results:- Grade I 22 Grade II 23 Grade III 17 Grade IV 10 72 Grading 1952 1953 1954 No. of samples Percentage of total No. of samples Percentage of total No. of samples Percentage of total I 24 70.6 32 62.7 22 30.4 II 5 14.8 8 15.6 23 32.0 III 1 2.9 6 11.8 17 23.6 IV 4 11.7 5 9.9 10 14.0 TOTALS 34 100.0 51 100.0 72 100.0 Traders whose products have been adversely reported upon are notified of the findings, whilst Madical Of ficers of Health are advised similarly concerning Ice Cream manufactured in their areas. Ice Cream which received chemical examination by the Public Analyst is commented upon in the section. devcted to "Food and Drugs" commencing on Page 51. 48 MILK SUPPLY Under the Milk and Dairies Regulations, 1949 to 1954, a local authority is required to keep a register of all persons carrying on the trade of milk distributor, and of all premises used as dairies (other than dairy farms) in their district, and to remove from the register the name of any person who ceases to trade as a milk distributer, and of any premise which ceases to be used as a dairy premise. On the 31st December, 1954, entries in the register were as follows:- (a) Number of registered distributors with premises in the Borough 37 (b) Number of registered distributors other than those included in (a) above 16 (c) Number of premises in the Borough registered as dairies 1 (d) Number of premises in the Borough, other than dairies, from which milk is distributed 45 During the year, 105 applications were received, and principal licences were granted under the Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954, and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953, authorising the use of special designations in relation to milk sold at or from premises within the Borough,, 41 supplementary licences were granted in respect of milk sold by retail within the Borough from 16 premises not situate in the area of this authority. Details of licences granted were as follows:- Type of Licence Tuberculin Tested Pasteurised Sterilised Totals Principal 30 39 36 105 Supplementary 13 14 14 41 All retailers selling milk within the Borough have been licensed to use special designations in accordance with the provisions of the Milk (Special Designations) (Specified Areas) Order, 1951, which came into force on 1st October, 1951, for the whole of the County of London. 49 UNSOUND FOOD When it has been established that food is unsound, it is surrendered to the Council's Officers, removed from the premises, and the necessary certificates issued. The food is subsequently disposed of via the Council's refuse disposal service, but prior to such action it is treated with carbolic acid. Approximately 5,486 pounds of unsound or diseased food were surrendered to and destroyed by the Council's Food Inspectors during the year, and for the purpose of comparison details of the foods which have largely buted to the annual totals during the years 1951-1954 (inclusive) are set out in the following table:- UNSOUND FOOD SURRENDERED TO THE COUNCIL'S FOOD INSPECTORS DURING THE YEARS 1951-1954 (INCLUSIVE) Commodity 1951 lbs. 1952 1bs. 1953 lbs. 1954 1bs. Biscuits - - 505 - Bread - - 144 - Cereals — - 139 - Cheese — - - 110 Fish, Fresh 327 117 174 200 Fish, Tinned 402 88 - - Fruit , Tinned 2,184 1,723 2,157 929 Fruit, juices 165 98 - - Ham, Tinned 3,775 — - - Meat, Fresh - 1,326 1,621 1,903 Meat, Tinned 830 - 1,239 1,027 Milk, Tinned 241 95 - 90 Preserves, - Jams, Marmalade, etc. 77 123 182 74 Sausages 300 858 435 359 Soups 132 40 93 88 Vegetables 709 1,127 436 254 Aggregates of all foods condemed annually 9,788 8,192 7,640 5,146 Average for the four years - 7,690 1bs. 50 UNDERGROUND BAKEHCUSES In accordance with the provisions of Section 54 of the Factories Act, 1937, the Borough Council are required to arrange for the Inspection of all underground bakehouses every five years. In cases where the conditions in such premises are found to be satisfactory, the Council are empowered to issue certificates of suitability valid for so long as the bakehouses may otherwise lawfully be used. Such action does not, of course, prejudice the Council's power to revoke a certificate as a result of a subsequent examination. In cases where for reasons of construction, height, light, ventilation or any hygienic respect, the premises are nob adjudged satisfactory, the Council shall decline to renew the certificate and the occupier has a right of appeal to a court. The quinquennial inspection which took place in this Borough established that eight underground bakehouses existed, and at the end of the year the position was as follows:— Certificates of suitability issued 2 Necessary works in progress to secure issue of certificates of suitability 4 Underground bakehouses closed 2 ANNUAL REPORT of the PUBLIC ANALYST for the year ended 31st December, 1954. THOMS McIACHLAN, A.C.G.F.C., F.R.I.C. 51 To the Mayors Aldermen and Councillors of The Metropolitan Borough of Chelsea. Mr. Mayor, Ladies and Gentlemen, During the year 1954, 400 samples of foods and drugs were examined. Of these 197 were taken formally and 203 informally. The number adulterated was 41, or 10.2 per cent. The incidence of adulteration may be classified as follows:- Number of samples examined. Number and percentages incorrect. Compositional. Labelling. Milk 194 - - Other foods 205 28 (7%) 13 (3.2%) Drugs 1 - - No samples of milk examined during the year were found to be adulterated. An ice cream was very lumpy and contained only 3.8 per cent of fat. The Food Standards (Ice Cream) Order, 1953, requires ice cream to contain not less than 5 per cent of fat, and most ice cream at the present time contains about 10 per cent of fat. A sample of double cream contained only 47.6 per cent of fat, whereas double cream must contain not less than 48 per cent of fat. The cream was supplied to the packers by the North of Scotland Milk Marketing Board with a guarantee that all cream contains not less than 48 per cent of milk fat. Examination of a sample from store, (which was a year old) by the Board showed this to contain 48 per cent of butter fat, and the Board promised that all future supplies would be tested. Some Pure Devon Cream was a tinned cream containing only 23.3 per cent of milk fat. Your analyst considers that the term "Devon Cream" is synonymous with Clotted Cream which is a thick cream containing 48 per cent of milk fat. The packers claimed that as it is cream from Devon cows produced in Devonshire it must be Devon Cream and the Ministry of Food agreed with the packers. The fat of a sample of margarine gave a positive test for rancidity by the Kreis reaction. The manufacturers after testing the sample, agreed that it had an off-flavour and suggested that this might be due to an unusual instance of some unbalancing of ingredients. None of the ingredients,however, ought to have been rancid in the first place. A sample of cheese had an unpleasant flavour and contained 0.83 per cent of butyric acid as a result of fermentation. Two samples of Brie cheese were found to contain only 25.1 per cent and 37.2 per cent of fat respectively, calculated on the dry matter. Unless stated to the contrary Brie cheese must be either a full cream milk cheese, or a cheese made from milk the fat of which may have been adjusted to about 3.3 per cent. In either case the fat should be from 45 to 51 per cent, calculated on the dry matter. The suppliers suggested that the percentage of fat calculated on the dry basis decreases with age. This is contrary to general experience since the protein usually decomposes first and 52 therefore diminishes in quantity, thereby making the percentage of fat calculated on the dry matter increase. The shopkeepers did not think the cheese had been kept on their shelves for a long period. A portion of cooked chicken was examined on account of a metallic taste. The iron and lead contents were more or less normal. The flavour was found to be associated more with the fat than with the lean meat and the free fatty acids on the fat were very high, 5.2 per cent calculated as oleic acid. There was no doubt therefore that the flavour was caused through the rancidity of the fat, and your analyst considered that the chicken must have been kept for a long time in a refrigerator. Although the suppliers' expert adviser agreed with this, they themselves did not think the bird could have been kept by them for any appreciable length of time. A jar of Chicken in Chicken Jelly was submitted for examination because the purchaser complained about the appearance and taste. The appearance was considered to be satisfactory, but the product possessed a "kerosene" flavour associated more especially with the jelly than with the meat. The manufacturers stated that this was the first complaint of this nature they had had. The same purchaser also complained of the taste of some Calves Foot Jelly. This sample possessed a "gluey" flavour the jelly was limp and rather dark in colour. The product had been manufactured some five years previously when it may have been difficult for the manufacturers to obtain a good supply of bones. A sample of canned Pork Luncheon Meat contained only 80 per cent of meat and was therefore 11 per cent deficient in meat. The manufacturers stated that the recipe for this product included 90 per cent of pork, but later confirmed that the pack was manufactured in 1952 and did in fact only contain 80 per cent. A sample submitted as Chopped Ham contained 6 per cent of starch filler whereas chopped ham should contain no starch binding material. Although sold as chopped ham the sample was in fact obtained from a tin clearly labelled "Pork Luncheon Meat". Some minced meat contained pieces of fur and bristle, probably derived from the cheek of an ox, indicating careless handling in the slaughterhouse. A purchaser complained that a sample of Salami was rancid. This sample was therefore examined in parallel with several other varieties of salami. The results of the investigation showed that the free fatty acids on the fat of the complaint sample calculated as oleic acid, were 17 per cent and that this figure was only slightly higher than in the other samples. In view of the small size of the excess, however, your analyst considered that the disagreeable flavour was not due primarily to rancidity, but to lack of flavouring and spices. A sample of park sausage meat contained only 49 per cent of meat and was therefore 23 per cent deficient in this ingredient. Another sample of pork sausages contained only 53 per cent of meat and was therefore 18 per cent deficient. Pork sausages must contain not less than 65 per cent of meat. 53 A sample of canned Beef Soup contained only 2 per cent of protein. Beef Soup must contain not less than 2.5 per cent of protein and the sample was therefore 16 per cent deficient in protein. Two samples of soup powder were considered to be worthless. The weight of the contents of the packets, 22 gramme and 24 gramme respectively was declared to make 1 litre of soup, little more than sufficient material to colour and flavour the water. Unfortunately, it was found that the Ministry of Pood had approved these preparations some years ago. Some cooked solid packed apples were submitted because of a salty taste. The salt content was 0.85 per cent. Apples do not contain more than .01 per cent of salt. and salt should never be added to apples in cooking them. The packers explained that the apples were brined to preserve their colour and had been improperly washed. A Gourd (Squash) was submitted because it had an unpleasant flavour. The complaint was justified, but all true Gourds have a tendency to secrete the cathartic principle formerly believed to be colocynthin, but now known to be enslin, and in many varieties or Cucurbita and allied genera it is often elaborated to such an extent as to render them unwholesome or even poisonous. All the fruits from this particular plant would be contaminated. The Gouid submitted as a sample was very small and hopelessly unripe. A sample of Tomato Juice contained extraneous matter which your analyst considered to be diseased tomato skin. The manufacturers thought it to be scorched portions of tomato tissue as they had had similar trouble in 1953. A sample labelled Tomato Vitamin failed to give any declaration of vitamin content as required by the Labelling of Pood Order. Analysis showed it to be an ordinary sample of Tomato Puree, and the packers eventually agreed to amend the label by making it to read "Vitam", which is the Latin word for "life". Two samples of Fresh Grange Drink one concentrated and the other ready to drink were found to contain from 10 to 20 lbs. and 1.2 to 2.5 lbs. respectively of comminuted fresh orange per 10 gallons of drink, so that they contained less than the minimum quantity of comminuted fresh oranges required to be used by the Soft Drinks Order. They also contained only 5.8 mgs. and 0.4 mgs. respectively of vitamin C per fl. oz. of soft drink, and in your analyst's opinion this was insufficient to warrant the description "Fresh Orange Drink". Since the rejected portion of the oranges is often used for the manufacture of marmalade which also has to comply with a standard under the Pood Standards (Preserves) Order, it is difficult to see how one batch of oranges can supply essential fruit for two different products to comply with different Orders. It is, however, understood that the Food Standards (Soft Drinks) Order, may be amended. A sample submitted as Pig Coffee consisted entirely of ground roasted figs. No literature could be found giving any reference to the use of the word "coffee" in connection with figs for a preparation consisting of figs only. The Labelling of Food Order, part IV, 7(3), accepts the description "Viennese Coffee" for a mixture of 85 per cent coffee with 15 per cent of fig seasoning, but does not allow for Fig Coffee. The label of this product has now been amended to "Figcaf". 54 A sample of Groats contained 8 per cent of fat and of this fat the free acids were 70 per cent. The stock had been packed in 1947, before the manufacturers employed a system of steam-treatment to destroy lipase and thus prevent the development of rancidity. Three samples of bread were submitted because of complaints by members of the publics. Two of the samples were contaminated with gear oil from overhead shafting, and the third sample contained foreign matter which could not be positively identified. It appeared to consist of two portions one blackish and one whitish, both of vegetable origin, thus excluding the possibility of it being rodent excreta. It was thought to be a portion of a partially burnt currant or sultana and white dough, which had been folded into the loaf of bread. A number of samples were considered to bear incorrect or misleading labelso A sample consisting of comminuted walnut with vegetable fats was labelled as Walnut Vegetarian Butter. Your analyst considered that in accordance with the requirements of Section 33, 2(a) and (b) of the Food and Drugs Act, it should be labelled margarine, As the manufacturers wished to avoid registering the factory for the manufacture of margarine it was suggested that the word "Nutta" should be used. Some Cheese Wafers were incorrectly labelled as containing vegetable shortening and leavening. Vegetable shortening mast be described as vegetable fat, and leavening as sodium bicarbonate, together with the name of the acid material used. A sample composed of Indian lentils, salt, paprika, and edible oil was labelled with the constituents in the wrong order. The manufacturer agreed to amend the labels. Samples of Mayonnaise and Spiced Mayonnaise were also labelled with the disclosure of the ingredients in the wrong order. The products were manufactured in Germany and the manufacturers agreed to amand the labels. The label of a sample of Oriental salt gave no declaration of ingredients, but the product appeared to be composed of 93 per cent of salt and 7 per cent of capsicum. The label of a sample of "Creamed Cottage Cheese" was considered to be misleading, as the average person reads the word "cream" or "creamed" in conjunction with cheese as meaning a cream cheese. The disclosure of Ingredients compiled with the Labelling of Food Order, bat the statement that it was prepared from pasteurised skimmed milk, pasteurised dairy cream, and salt, was considered to be misleading. The fat in the sample was 4 per cent, or calculated on the dry matter only 18.74 per cent, and such a product could be prepared from a mixture of 3 parts of separated milk with two parts of ordinary milk and a little salt. At a conference held to discuss the labelling of this product the suggestion "Cottage Milk Curds" was put forward for consideration. 55 A sample of Smoked Rainbow Trout Paste was marked on the label on the lid of the jar as imported, whereas on the side of the jar it was described as "English Pate of Smoked Rainbow Trout". It therefore contravened the Merchandise Marks Act. The sample was part of a small batch intended for the American market, but having failed to be acceptable to the overseas buyer was permitted to be sold on the home market. The manufacturers agreed to amend the label for future manufacture. The label on a jar of Horseradish Sauce claimed that it was "free from all chemicals" and, at the same time, the presence of added acetic acid. Acetic acid is definitely a chemical and was held to be so in the High Court case regarding Artificial Vinegar. The manufacturers agreed to amend their label. A sample of Chocolate Spread was stated to contain "chocolate liquor", but there is no such commodity. Enquiry shewed that chocolate liquor was unsweetened chocolate couverture which had not been properly couched, and the manufacturers agreed to amend their label to include the words "Unsweetened Chocolate Couverture". A Meringue Powder was incorrectly stated to contain Ethyl-MethylCellulose. There is no such compound and the disclosure should have read "Ethyl - or Methyl - Cellulose". The sale of preparations of this type, however,shows how far modern progress has taken us from foods as originally prepared. Meringues used to be made from sugar and white of eggs, whereas methyl cellulose and ethyl cellulose possess no food value or flavour whatever. A Soup Flavouring was described as "a preparation of pure hydrolysed vegetable protein only", whereas the chief constituent was salt. The matter is being discussed with the manufacturers. Legislation during 1954. The most important piece of food and drug legislation passed during the year was undoubtedly the Food and Drags (Amendment) Act, 1954, which will not, however, come into force as such, but will be consolidated with the Food and Drugs Act, 1938, the Food and Drugs (Milk and Dairies) Act,1944, and the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950. When the Food and Drugs Act, 1938, was introduced it was intended merely to be a consolidating Act with a view to bringing the whole of Food and Drugs Administration to date, but the war prevented this and much piecemeal legislation has been passed under the description of Emergency Orders. Many writers have referred to the Amendment Act as a "Hygiene" Act, but it was more than this. It is doubtful whether any Government is sufficiently strong at the present time to bring in the wholesale legislation necessary to safeguard health, if it is realised that the British have passed from being a nation which eats freshly cooked food in the home or in small restaurants to one which consumes food cooked days or months before it is eaten and not always even kept in refrigerators or under sterile conditions far much of th® intervening periods. One of the main objects of the Act is to enable temporary legislation to be made permanent. This accounted for much of the delay in the passing of the Amendment Act and has retarded the introduction of the Consolidation 56 Act. The power of the Minister to make fresh orders has been greatly extended. From the public analyst's point of view legislation has become necessary in order to obtain efficient control over the large number of chemicals now being used as fertilisers, weed destroyers, insecticides, and fungicides, not to mention the use of anti-oxidants for the prevention of the oxidation of fats and vitamins, and even anti-biotics, which are now included as regular ingredients of animal foods. In the 1938 Act the definition of food Included "any substance intended for use in the preparation of food", but this does not appear to have been appreciated by most Local Authorities. The point is made much clearer in the new Act by enabling a sampling officer to take a sample of any food "or of any substance capable of being used in the preparation of food, which appears to him to be intended for sale - - etc." This provision enables articles such as enamelled jugs, pails, etc. to be sampled, if it is thought that they might be used for the preparation of food and one has to remember that the use of enamelled pails for the preparation of lemonade caused severe poisoning from antimony some years ago and that the Minister of Health published a special report about such enamels. Whilst the definition of food itself has been widened there is now an extended provision that if the public analyst certifies a food to be a food to which any particular regulations apply that food may be seized and condemned on the order of a magistrate. Similarly the Minister may now require manufacturers to produce evidence concerning the composition and chemical formulae of substances which it is proposed to add to foods. It will in future be unnecessary to prove that a label or advertisement is "otherwise" calculated to mislead. The Amendment Act permits the Minister to make regulations prohibiting the sale of milks of higher quality unless they conform to certain minimum standards—this will bring Channel Island and Devon milks under the control of the Food and Drugs Act, though it has not, so far, been made illegal to sell milk, containing less than 3.0 per cent of fat or less than 8.5 per cent of solids-not-fat. The definition of cream has been completely revised. In future three substances appearing to be cream may be solds:— genuine Cream, reconstituted cream, and imitation cream and, from the wording of the Act, it would appear that a cream bun mast contain genuine cream. Provision is made for the sampling officer to inform the manufacturer or packer of a food that it has been sampled, thus ensuring that the latter cannot be ignorant of the fact until, perhaps, proceedings may be commenced against them. Similarly with certain articles sealed in containers it is now unnecessary for the sampling officer to open them to divide the contents; it will be sufficient for him to buy three or multiples of three of the article and to separate the containers or articles. This provision would apply to such goods as whole fruit jam, medicaments containing volatile constituents, condensed milk, etc. Action may now be taken against proprietary medicaments, which have previously been protected from attack if they were supplied in response to a demand for the article. Various other fresh points have been introduced. A part time public analyst has been placed in the same category as any other officer of his Local Authority, when acting in his capacity as a public analyst. Similarly a public analyst may now pass to another public analyst a sample, which he is unable 57 to analyse personally. With the increase in cost of apparatus and the specialised knowledge required to be able to operate some of this apparatus this provision has become essential. From the point of view of the public analyst and of the Local Authority a most unfortunate insertion was made in the Act on the third Reading in the House of Commons and it has been impossible to have this removed. This is the clause relating to what has been christened as the "Bob-a-nob" certificate or the provision that the Local Authority must supply, any vendor of a sample who demands it with a copy of the public analyst's certificate on payment of a fee of one shilling. A public analyst can only report on a sample to the best of his ability and knowledge. It is sometimes impossible to detect the presence of some deleterious substance car the destruction of some essential constituent in a food without inside information or very specialised knowledge in a particular field. He may, therefore, occasionally report an adulterated product as satisfactory. During the late war it was a common practice for certain disreputable manufacturers to ask Local Authorities "whether samples had been reported as genuine by public analysts and to use such report when any adverse comments were made. There appears, moreover, to be nothing to prevent copies of these certificates being used for advertisement purposes. Care will have to be exercised in bringing into permanent legislation much of the temporary legislation now in force. Thus the new Act specified that "chewing gum" is a food, but the Mineral Oil in Food Order prohibits the presence of mere than 0.2 per cent of mineral hydrocarbons in foods, other than dried fruit, which may contain 0.5 per cent, and citrus fruit which may only contain 0.1 per cent. Chewing gum generally contains up to 4 per cent of one or other of the various paraffin wax hydrocarbon products. The Food Standards (Margarine) Order 1954, made it compulsory to add vitamin A and vitamin D to margarine and prescribed the method for the determination of vitamin A. The Food Standards (Soft Drinks) (Amendment) Order, 1954, permitted soft drinks to be made from fruit juice with or without added sugar and in concentrated or frozen form. During the year all ordinary control Orders relating to the rationing of manufacture or consumption of foods have been revoked leaving their manufacture and sale mere flexible. These revocations, unless controls are introduced under the new Food and Drugs Consolidation Act, may entail greater care before manufacturers are prosecuted or warned. A Report was issued by the Food Standards Committee on Antioxidants in foods and recommended that propyl, octyl, or dedecyl gallates or mixtures of these should be permitted up to 0.02 per cent in alible oils and fats and O.l per cent in essential (that is volatile flavouring) oils. Alternatively butylated hydroxyanisole should be permitted in quantities up to 0.02 and O.l per cent respectively. A fresh Report on lead was issued by the Food Standards Committee proposing that a general limit of 0.2 parts per million should be imposed on ready-to-drink beverages and 2.0 parts per million in other foods. Various 58 exceptions to these general limits are suggested and in certain cases, such as food colours and solid pectin, the quantities rise to 20 and 50 parts per million respectively. The Food Standards Committee issued a Report suggesting that ready-todrink beverages should not contain more than 5 parts per million of zinc and that other foods should not contain more than 50 parts per million, but that these limits should be exercised with discretion if it could be proved that the presence of the zinc is a natural occurrence. Although the Minister of Food has stated more than once in Parliament that he does not wish to fix a standard for the meat content of sausages, the Ministry issued a Circular showing the average meat content of pork sausages is greater than 65 per cent and of beef sausages greater than 50 per cent. The Ministry issued a Circular drawing the attention, of Looal Authorities to the use by certain exporters in other countries of thiourea as a fungicide to prevent deterioration in citrus fruits and that this was a contravention of the Public Health (Preservatives etc. in Food) Regulations. The Ministry issued a Circular which stated that cream soups should contain either not less than 2½ cent of butter fat, or not less than l½ per cent of butter fat and not less than 3 per cent of total edible fat, or not less than 3½ per cent of edible fat. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, THOMS McLCHIAN, A.C.G.F.C., F.R.I.C., Public Analyst. - 59 -  Takan Formally Adulterated Taken Informally Adulterated Total Samples Analysed Adulterated Sanana Whip 0 0 1 0 1 0 sans canned 1 0 0 0 1 0 Biscuits 0 0 1 1 1 1 Bread 0 0 4 3 4 3 butter walnut vegetarian 1 1 0 0 1 1 Sake Mixture 0 0 1 0 1 0 Cheese 11 2 3 2 14 4 Chicken 0 0 1 1 1 1 Chicken in Jelly 0 0 1 1 1 1 Chocolate Beverage 1 0 2 0 3 0 Chocolate Liquid 0 0 1 1 1 1 Cocktail Cracklings 0 0 1 0 1 0 Coffee 0 0 1 0 1 0 Coffee, debydrated 1 0 0 0 1 0 Coffee, Fig 0 0 1 1 1 1 Colour, Safron 1 0 0 0 1 0 confectioanery 3 0 1 0 4 0 Cooking Fat 1 0 0 0 1 0 Cream 1 1 4 1 5 2 Custard Powder 0 0 1 0 1 0 Dessert Powder 0 0 1 0 1 0 Fish, bottled 3 1 0 0 3 1 Fish Cakes 1 0 1 0 2 0 Fish Canned 3 0 5 0 8 0 Fish Paste 0 0 1 0 1 0 Fish Potted 1 0 0 0 1 0 Flavouring for Soups, etc. 0 0 2 1 2 1 Flour, pea 0 0 1 0 1 0 Flour, wholemeal 1 0 0 0 1 0 Fruit, canned 2 0 1 1 3 1 fruit Juice 3 0 2 0 5 0 Gluscose Powder 0 0 1 0 1 0 Gourd Squash 0 0 1 1 1 1 Gravy Powder 2 0 0 0 2 0 Groats Highh Protein Food 0 0 1 1 1 1 1 0 0 0 1 0 Ice Cream 0 0 5 1 5 1 Ice Cream Powder 0 0 1 0 1 0 Jam 0 0 1 0 1 0 Jelly, Calves Foot 0 0 1 1 1 1 Jelly Crystals 0 0 1 0 1 0 Lager 0 0 1 0 1 0 Lantils, salted 0 0 1 1 1 1 Carried forward 38 5 52 18 90 23 - 60 -  Taken Formally Adulrerated Taken Informelly Adulterated 1. !■ lit. " 1 J I Total samples Analysed Total Samples Adulterated Brought forward 38 5 52 18 90 23 Margarine 4 1 0 0 4 1 Marmalade 0 0 2 0 2 0 Marzipan 1 0 0 0 1 0 Meat, canned 7 1 7 2 14 3 Meat Pie 2 0 1 0 3 0 Meat Pudding 1 0 0 0 1 0 Meatless Steak 1 0 0 0 1 0 Meringue Powder 0 0 1 1 1 1 Milk 95 0 99 0 194 0 Milk, condensed 1 0 0 0 1 0 Nut Product 0 0 4 0 4 0 Olive Oil 1 0 0 0 1 0 Paprika 1 0 l 0 2 0 Pate de Foie Truffle 3 0 0 0 3 0 Peels, candied 1 0 0 0 1 0 Pickles 0 0 1 0 1 0 Pudding Mixtures 1 0 1 0 2 0 Pudding Xmas 0 0 1 0 1 0 Ravioli 1 0 0 0 1 0 Salad Cream 3 2 0 0 3 2 Salami 6 0 1 1 7 1 Salt, oriental 0 0 1 1 1 1 Sauce 4 0 3 1 7 1 Sausages 6 0 7 2 13 2 Soft Drinks 0 0 10 2 10 2 Soups 5 3 6 0 11 3 Spread, Savoury 2 0 0 0 2 0 Spread, chestnut 1 0 0 0 1 0 Sweetcorn 1 0 0 0 1 0 Sugar icing 0 0 1 0 1 0 Sugar tinted crystals 1 0 0 0 1 0 Suet 0 0 1 0 1 0 Tomato Juice 0 0 2 1 2 1 Tomato Vitamin 1 0 0 0 1 0 Vegetables bottled 1 0 0 0 1 0 Vegetables canned 0 0 1 0 1 0 Vegetables, dehydrated 4 0 0 0 4 0 Vegetable Juice 1 0 0 0 1 0 Vinegar Tarragon 1 0 0 0 1 0 Yeast Extract 1 0 0 0 1 0 Drugs-Throat Pastilles 1 0 0 0 1 0 TOTALS 197 12 203 29 400 41 EPIDEMIOLOGY Incidence and Notification of Infectious Disease - 61 - NOTIFICATIONS. The following table shows the total (corrected) number of cases of Infectious Diseases received during the year. Disease Under 1 year 1 and under 5 yrs. 5 and under 15 yrs. 15 and under 25 yrs. 25 and under 45 yrs. 45 and under 65 yrs. 65 yrs. and over TOTALS Continued Fever - - 1 - - - - 1 Dysentery - 1 - - 1 2 1 5 Dysentery (Amoebic) - - - - - 1 - 1 Dysentery (Flexner) - - - 1 - - - 1 Dysentery (Sonne) 16 97 44 10 20 1 1 189 Erysipelas - - - - 1 1 4 6 Food Poisoning - 4 2 2 6 4 1 19 Measles 8 51 43 1 1 - - 104 Meningococcal Infection - — 1 - - — - 1 Paratyphoid Fever 1 - 1 - — — 1 3 Pneumonia: Ac. Influenzal - - - 1 - 1 2 4 Ac. Primary 1 7 1 - 4 4 7 24 Paralytic 1 - - - - - - 1 Non-Paralytic - - - - - - - - Puerperal Pyrexia - - - 18 18 - - 36 Scabies 1 6 7 5 11 3 1 34 Scarlet Fever - 13 13 - - - - 26 Typhoid Fever 1 - - - - - - 1 Wooping Cough 9 53 31 - - - - 93 TOTALS 38 232 144 38 62 17 18 549 - 62 - SUMMRY OF NOTIFICATIONS OF INFECTIOUS DISEASES RECEIVED DURING THE YEARS 1950 - 1954 (inclusive) Disease 1950 1951 1952 1953 1954 Average for five years Dysentery 117 95 139 260 196 161.4 Erysipelas 6 7 5 4 6 5.6 Food Poisoning 122 13 10 23 19 37.4 Malaria - 1 - 1 - 0.4 Measles 318 669 355 549 104 399 Meningococcal Infection — 2 1 4 1 1.6 Paratyphoid Fever 1 3 1 1 3 1.8 Pneumonia: Ac. Influenzal 17 16 — 13 4 10 Ac. Primary 8 5 16 16 24 13.8 Poliomyelitis : Paralytic 1 - 12 2 1 3.2 Non-Paralytic 2 1 2 3 — 1.6 Puerperal Pyrexia 10 7 67 29 36 29.8 Scabies 10 8 6 19 34 15.4 Scarlet Fever 55 29 61 49 26 44 Typhoid - 1 - - 1 0.4 Whooping Cough 170 174 87 257 93 156.2 - 63 - SMALLPOX No case of Smallpox hag been notified to the Public Health Department as having occurred in the Borough since 1928, and there have been no deaths from this disease for over fifty years. Information was received during the year regarding eight contacts who had travelled to addresses in the Borough, and all were given advice on the precautionary action they should take. PUERPERAL PYREXIA Puerperal Pyrexia means any febrile condition in a woman in whom a temperature of 100.4° Fahrenheit (38° Centigrade) or more has occurred within fourteen days after childbirth or miscarriage. Thirty-six cases were notified during the year, of which only one case occurred at home, the remainder being in hospital. Thirty of the hospital notifications referred to patients normally residing outside the Borough. Ten other cases were brought to the notice of this Department by other Local Authorities; these concerned Chelsea residents whose confinements took place in hospitals situated in their areas. DIPHTHERIA. It is most gratifying to record that for the fifth year in succession no cases of Diphtheria occurred amongst residents in the Borough. Notifications received and confirmed during 1948 and 1949 were 2 and 1 respectively, and only one death has occurred during the past fifteen years. Immunisation has played a major part towards the present excellent position, nevertheless it is constantly necessary to publicise the efficacy of such a service. Details of services provided during the year will be found on the following page. -64 - DIPHTHRIA IMMUNISATON The campaign to secure immunisation against, diphtheria continues unabated. The work received a set-back in 1953 owing to the incidence of poliomyelitis during the summer months, which rendered it necessary to apply curtailment,, To illustrate this, notifications of poliomyelitis received in London during an identical period in July during the last three years are set out - Poliomyelitis cases notified in London Year Paralytic Non-Paralvtic Total 1952 4 2 6 1953 17 10 27 1954 4 2 6 With the relaxation of restrictions last year, good progress was made, as will be seen from the following table. The figures in parentheses show the corresponding returns for 1953. AGE at date of final injection (as regards A) or of Under 1 1 2 3 4 5 to 9 10 to 14 Total A. No. of children who completed a full course of Primary Immunisation in the authority's area (including temporary residents) during the year ended 31st December 1954. 256 176 87 30 19 107 2 677 (128) (164) (67) (14) (14) (74) (-) (461) B. No. of children who received a secondary (reinforcing) injection (i.e. subsequently to primary immunisation at an earlier age) during the year ended 31st December 1954. - - - 1 72 428 156 657 (-) (-) (1) (1) (41) (209) (26) (277) Diphtheria Immunisation work in this Borough is carried out by the London County Council at the Violet Melchett Infant Welfare Centre, Flood Walk, S.W.3. Further reference there to will be found on Page 42. - 65 - FOOD POISONING Nineteen cases were notified as compared with 23 in 1953 and 10 in 1952. A summary of all cases occurring during the year under review is set out below in identical form to that supplied to the Ministry of Health. ANNUAL REPORT OF FOOD POISONING NOTIFICATIONS Notifications of the occurrence of Food Poisoning were received as follows:- First Quarter Second Quarter Third Quarter Fourth Quarter Total 12 3 1 3 19 Outbreaks (other than family outbreaks) due to identified agents:NIL Family Outbreaks due to identified agents:- Total Outbreaks 1 (Salm. typhi-murium) Total Cases: 3 Outbreaks (other than family outbreaks) of undiscovered cause:- Total Outbreaks 2 Total Cases: 5 Family Outbreaks of undiscovered causes:- Total Outbreaks 1 Total Cases: 2 Single Cases:- Agent identified: 3 Unknown causes: 6 (Salmonella typhi-murium 3) Total Cases: 9 - 66 - POLIOMYELITIS Three notifications of Poliomyelitis same to hand, and only one of these was subsequently confirmed, this being a case of a paralytic type. In 1953 there were 5 confirmed cases, and In 1952 fourteen confirmed casesl. Twenty-six notifications of Scarlet Fever were received in the Public Health Department during 1954, as compared with 49 In 1953. WHOOPING COUGH Ninety-three cases were notified during the year as against 257 in 1953. A11 cases were under 15 years of age and there were no deaths. MEASLES One hundred and four notifications of Measles were received in the Public Health Department during 1954s, as compared with 549 and 355 in 1953 and 1952 respectively. Sixty-two of the cases were notified during the last two months of the year. DYSENTERY During 1954, one hundred and ninety-six notifications were submitted as compared with 260 in 1953 and 139 in 1952. It must again be stressed that over 80% (86%) of the sufferers were residents of institutions not controlled by this authority. The premises concerned were such that it was difficult to prevent the spread of Infection among the particular type of Inmates. Nevertheless the Borough Council has been, at great pains to bring about the eradication of the incidence of dysentery. -67- ZYMOTIC DISEASES During the year three deaths were classified as having occurred from "Gastritis, enteritis and diarrhœa", and the death rate for such causes 0.06 per 1,000 of the population. The term "Zymotic" was, in the past, applied to numerous diseases which were considered to be "epidemic, endemic, and contagious". However, in the light of existing conditions, it is applicable to such diseases as cholera, diarrhœa, diphtheria, measles, scarlet fever, smallpox, typhoid fever and typhus fever. The consideration of actual figures is preferable to that of rates, and the following summary gives a clear picture of the great advances of preventive medicine in its fight against zymotic diseases. Year Number of deaths 1900 219 1905 98 1910 66 1915 76 1920 41 1925 29 1930 22 1935 17 1940 1 1945 6 1950 3 — 68 — TUBERCULOSIS 92 cases of Pulmonary Tuberculosis were notified during the year. These were made up of 54 primary notifications, 31 "inward transfers*, 2 from Death Returns and 5 from other sources. There were also 9 nonpulmonary cases, all of which were primary notifications. The accompanying tables present details of cases at present an the Tuberculosis Register. VARIATIONS IN REGISTER DURING 1954. PULMONARY NON-PULMONARY TOTAL CASES M. F. M. F. (a) Number of cases remaining on register at 1st January, 1954 237 201 7 23 468 (b) Number of new cases notified 26 30 3 6 65 (c) Number of cases restored to register 2 2 - - 4 (d) Other cases added 16 16 - - 32 (e) Removals 38 56 1 3 98 (f) Cases remaining on Register at 31st December, 1954 243 193 9 26 471 -69- (A) NEW CASES OF TUBERCULOSIS 1954 (B) DEATHS OF TUBERCULOSIS CASES 1954 Under 1 year 1 and under 2 years 2 and under 5 years 5 and under 10 years 10 and under 15 years 15 and under 20 years 20 and under 25 years 25 and under 35 years 35 and under 4-5 years 45 and under 55 years 55 and under 65 years 65 and under 75 years 75 years and upwards TOTALS (all ages) (A) NEW CASES Pulmonary M - - - - - 2 5 4 5 2 1 6 1 26 Pulmonary F - - - - 2 2 5 6 5 5 2 2 1 30 Non- Pulmonary M - - 1 - - - 1 - - - 1 - - 3 Non- Pulmonary F - - - - - 1 - 3 - 2 - - - 6 (B) DEATHS Pulmonary M - - - - - - - - 2 - - 7 2 11 Pulmonary F - - - - - - - 2 2 - - - - 4 Non- Pulmonary M - - - - - - - - - - - - - Nil Non- Pulmonary F - - - - - - - - - - - - - Nil - 70 - CHELSEA TUBERCULOSIS DISPENSARY BROMPTON HOSPITAL, S.W.3. 1951 1952 1953 1954 Population served by Dispensary 52,490 52,140 52,150 52,060 Number of notified cases in Borough at end of year 411 429 440 471 Number of these who at the present do not attend Dispensary - - 156 164 Total attendances during year 1,834 2,123 1,899 2,208 Total new patients seen 389 504 526 404 Number of these who were contacts 170 252 285 173 Number of contacts found to be tuberculous 1 7 18 2 Number of cases newly notified to Medical Officer of Health (i.e., excluding inward transfers) 72 99 107 68 Number of cases diagnosed as tuberculous (for the first time) at the Dispensary during the year 24 25 39 13 Number of X-rays 1,301 1,373 1,464 1,889 Number of Patients who received refills during the year 47 35 20 19 Number of Patients who received "Special treatment'' at home during the year 12 30 42 33 Number of Patients given B.C.G. 15 11 12 52 Number of home visits by medical staff 31 48 53 32 Number of visits paid by Dispensary Nurse 2,436 2,297 2,529 2,382 Number of Clinic Sessions per week 2 2 2 2 - 71 - BACTERIOLOGICAL EXAMINATIONS All bacteriological examinations are carried out at the Public Health Laboratory at County Hall under its Director, Dr. A.J.H. Tomlinson. No charge is made to the Council for these examinations and during the year 385 were made as follows:- Throat/Nose Swabs Diphtheria Bacilli found Nil Friedlander's Bacilli and Strep. viridans found 1 Haemolytic Streptococci found 13 Coagulase positive Staphylococcus found 1 Monilia found 2 Vincent's angina found Nil Negative results 48 Eye Swabs Haemolytic Streptococci and Coagulase positive Staphylococcus found 1 Negative results Nil Faeces Shigella sonnei found 22 Salmonella typhi-murium found 8 Clostridium welchii found 6 Negative results 277 Foodstuffs Scanty gram positive cocci found 1 Faecal coli found 1 Negative results 4 The Public Health Department has an arrangement with Chelsea doctors whereby specimens left at the offices by 3 p.m. Mondays to Fridays, and 11 a.m. on Saturdays are delivered by hand to the Laboratories the same day. This service is used extensively. - 72 - MASS RADIOGRAPHY A Mass X-Ray Unit was established, for the first time, at the Community Centre, King's Road, as it was deemed advantageous to function from a point close to the World's End Area, particularly as a short and intensive campaign had been carried out there in 1953. facilities were available from the 1st to 11th November, 1954, and a total of 3,320 persons were X-rayed - 1721 men and 1599 women. One of the most satisfactory features was the fact 1,051 people (representing 31.6% of all who attended) had presented themselves for the first time at any Mass X-Ray Centre. A, good proportion of those who availed themselves of the facility were residents of the South Stanley Ward, where a houseto-house distribution of leaflets bad been made at an earlier date. The Centre was well supported by local firms and organisations who arranged for employees to come along during working hours, whilst the assistance of Churches, Voluntary Organisations, and the Warden of the Community Centre which contributed much to the publicity campaign, was greatly appreciated by the Mass X-Ray Service. Of those examined (3,320), thirteen (or 0.39% were found to have radiologically significant lesionsy and were referred to Chest Clinics. In addition ten persons (or 0.30%) had chest lesions, probably not of a tuberculous nature, but of sufficient seriousness to merit investigation at a Chest Hospital. In the preceding month a visit was made to Chelsea Polytechnic, Manresa Road, where 574 students and staff submitted themselves for X-Ray. Still earlier in the year, and at the request of the tendon County Council Divisional Health Office, a special visit was made to "Kingsmead" Hostel, Dovehouse Street, where 47 men and 149 women patients and residents were examined by the Mobile Unit. In five instances it was recommended that more comprehensive X-rays should be taken, but owing to the advanced age enfeebled condition of those concerned, the Medical Officer to the Hostel undertook to make the necessary arrangements with the authorities at a local hospital. It is anticipated that a Mobile X-Ray Unit will be visiting Chelsea late in 1955. INDEX Subject Page(s) Aged and Infirm Persons, Welfare of 37 & 38 Analyst, Public - Report of 51 - 60 Atmospheric Pollution 14 Bacteriological Examinations 46 & 71 Births 6 & 7 Bakehouses, Underground 50 Child Welfare 41 & 42 Committee, Public Health and Baths: Members 1 Representation elsewhere by Members 2 Deaths 6—10 Diphtheria Immunisation 42 & 64 Disinfection and Disinfestation 33 Factories Act, 1937 26 - 28 Food: Adulterated 51 - 60 Byelaws 43 Education 45 Hygiene 44 & 45 Poisoning 65 Unsound 49 Health Visiting 41 Hospitals 39 Housing 23 - 25 Ice Cream 47 Infant Mortality 6 & 7 11 & 12 Infectious Diseases 6l - 70 Introduction 4 & 5 Legal Proceedings 29 Mass Radiography 72 Maternal Mortality 6 & 7 Medical Examinations 32 Milk 48 Mortuaryj Public 32 National Assistance Act, 1948: Burials 30 & 31 "Part III" Accommodation 40 Nursing Homes 39 Subject Page(s) Outworkers 28 Overcrowding 23 'Part III' Accommodation 40 Pet Animals 34 Pigeons 34 Population 6 & 7 Poisons, Sale of 35 Public Analyst - Report of 51 - 60 Radiography, Mass 72 Rag Flock 35 Rodent Control 36 Sanitary Inspectors - Work of 15 - 29 Spastic Children 13 Staff of Public Health Department 3 Stillbirths 6 Tuberculosis 6,68-70 Underground Bakehouses 50 Underground Rooms 25 Vaccination 42 Vital Statistics 6-12 Water Supply 32 Welfare Centre, Attendances at 41 Welfare of Aged and Infirm Persons. 37&38 Zymotic Diseases 67