AC 4345 1 5B 2 Library CHE 55 Metropolitan Borough of Chelsea AnnuaI Report of the Medical Officer of Health J. H. WEIR, M.D., B.S., B.Hy., D.P.H. for the year 1957 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 1957 - 1 - METROPOLITAN BOROUGH OF CHELSEA PUBLIC HEALTH AND BATHS COMMITTEE (at 31st December 1957 Chairman: Vice-Chairman: Councillor Lyall, Miss M., M.B.E. Councillor tat toon-brown, J. S. Councillor Birdwood, Vere Lady " Budgett, F. G. P. " Buxton, Mrs., G. K. " Croslegh, M. C. " Gibbings, Miss Aimee Councillor Gough, A.E ., T.D. " Hannay, J., M. Ch. S. " Paterson-Morgan, J»A. " Samuels, J.S. " Wills, Dr. L. " Woolford, J. E. Ex-Offlcio Members His Worship the Mayor (Alderman Basil Marsden- Smedley, O.B.E.,J.P.) The Deputy Mayor (Councillor A. J. Slms.) 2 Representation by Members of the Public Health and Baths Committee on outside Committees and other Organisations concerned with Public Health work(at 31st December 1957) Chelsea Association for Moral Welfare Works Councillor Mrs. G. K. Buxton Chelsea Tuberculosis Care Committee : Councillor Mrs„ G. K. Buxton Councillor Miss M. Lyall Chelsea Youth Committee: Family Welfare Associations Invalid Children's Aid Associations Councillor J. E. Woolford Councillor Miss M. Lyall Councillor Miss M. Lyall London County Council Divisional Health Committee (Division I): Councillor Mrs. G. K. Buxton Councillor Miss M. Lyall Committee (Division 1): Councillor Mrs. G. K. Buxton London and Home Counties Smoke Abatement Advisory Committees Councillor J. Hannay Rational Smoke Abatement Councillor Jo Hannay Councillor Miss M0 Lyall Old People's Welfare Committees Councillor J. S. Tat ton-Brown Councillor Miss M, Lyall Committees Councillor M. C. Croslegh Westminster and Chelsea District Nursing Councillor Miss M. Lyall 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 3lst December1957, Medical Officer of Healths Deputy Medical Officer of Healths Chief Public Health Inspectors Deputy Chief Public Health Inspector and Senior Housing Inspectors J.H. WEIR, M.D.j ,B.S.,B.Hy.,D.P.H. Hastings E.A. CARSON, M.D.,M.B.,B.S.,D.P.H. Ho HOYLAND. Public Health Inspectorss S. W. BARKER. H.F. LEACOCK., H.W. LUDLOW, A.J. WHITE j, E.R. YOUNGl Women Public Health Inspectors (Miss) A.C.C. KAY, (Miss) G.K. READER, Drainage Assistants Rodent Officers: E. BOSLEY. J. F. COOKE, P. DRURY Public Health Inspectors,1 Assistants F. G. RAWLINGSON. L. H. BERRY. Chief Disinfectors Disinfectors: F.W. HILL, R.J. WESTON. Cleansing Station Attendants (Mrs.) J. LOBBAN. Chief Clerks Clerical Officers: \ JoC. BRYANTo I. M. THCMSON, H.G. HAMILTON , L. A. POWELL, (Mrs.) W. BAAR9 R.H. LITCHFIELD, P. M. MARGETTSo Social Workers (Mrs.) O. M. BURKE. Public Analysts Thos . M. LACHLAN, 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. July, 1958. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea.. Your Worship, My Lord, Ladies and Gentlemen, I have much pleasure in presenting my annual report for the year ended 31st December, 1957. The population of the Borough continues to decline, the RegistrarGeneral's estimate (for mid-year) being 50,600 - 470 less than in 1956 (51,070). The number of births registered was 738, 99 fewer than in 1956, the comparative rates being 14.6 and 16.4 Deaths of Chelsea residents totalled 750, 65 less than in the preceding year (815), and presenting a rate of 14.8. Infant Mortality again declined, sixteen deaths under the age of one year being recorded, the rate of 21.7 comparing with 25.1 in 1956. It is also pleasing to report that no deaths were attributed to causes associated with pregnancy or childbirth. Infectious Diseases notifications received totalled 682, and were 181 below the aggregate of 1956 (863). It is particularly gratifying to note that Sonne Dysentery cases fell from 346 to 70, a ratio of five to one when comparing the last two years. Measles sufferers, however, rose from 183 to 406. A more satisfactory position is revealed in connection with Food Poisoning, only thirteen cases being_ brought to the notice of the Public Health Department. In 1956, eighty-five notifications were investigated. Every opportunity is taken by the Council's Public Health Inspectors to advance hygienic conditions in food manufacturing and retailing premises, hotels, restaurants, &c., whilst the general public is constantly reminded that it must co-operate in securing the best possible standards. The scope of the Clean Air Act, 1956, is now widening, further provisions having become operative since my previous report, and serious consideration is being given to the inception of a smoke control area, Mr. T. McLachlan, the Public Analyst, examined four hundred samples of Food and Drugs during the year, and advised that in twenty-eight instances (7.0%) adulteration, labelling inaccuracies, or misdescriptions, 5 had been found. Approach to producers and retailers ensured that such offences were not repeated. As is customary, a section of this Report is devoted to the work of the Public Analyst. I should like to record my appreciation of the support received from the Chairman of the Public Health and Baths Committee, and other members of the Council. I also gratefully acknowledge the friendly co-operation extended to me by the Town Clerk and Chief Officers of other departments. To all the members of the Public Health Department I extend my sincere thanks for their loyalty during the year. 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 1957_ AREA OF THE BOROUGH s 659.6 acres GENERAL RATE: 14s.4d in the £ (At 31st March, 1957) PRODUCT OF A PENNY RATE (GROSS) £8,347 RATEABLE VALUE OF BO ROUGH AS AT 31st March, 1957: £2,073,195 POPULATIONS Registrar-General's estimate of the population of the Borough (aid-year 1957) 50,600 Density of population per acres 76.71 LIVE BIRTHS: Total M F. Legitimate 633 332 301 Birth rate per 1,000 of estimated population 14.6 Illegitimate 105 55 50 718 387 351 Adjustment of birth rate by area comparability factor 11.1 STILL BIRTHS: 9 6 3 Rate per 1,000 (live and still births) 12.0 DEATHS s 750 345 405 Death rate per 1,000 of estimated population (Males 6.8 : Females S.0) 14.8 Adjustment of death rate by area comparability factor 10.2 MATERNAL MORTALITY 3 For the third consecutive year no deaths associated with pregnancy or childbirth occurred amongst Chelsea residents. DiiiTH RATES OF INFANTS UNDER ONE YEAR OF AGE : All infants per 1,000 live births 21.7 Legitimate infants per 1,000 legitimate live births 23.7 Illegitimate infants per 1,000 illegitimate live births 9.5 DEATHS FROM TUBERCULOSIS: Pulmonary 2 Other forms Nil Death rates per 1,000 of estimated populations Pulmonary Tuberculosis 0.039 Other forms of Tuberculosis Nil 7 SUMMARY OF VITAL STATISTICS 1947 - 1957 (inclusive) Year Registrar-General's Estimate of Population BIRTHS DEATHS DEATHS ONE Y UNDER EAR MATERNAL DEATHS No. Rate No. Rate No. Rate No. Rate 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.l 23 26 - - 1950 52,490 829 15.8 638 12.2 21 25 - - 1951 52,430 819 15.6 686 13.1 19 23 _ a 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 1955 51,450 745 14.5 825 16.0 25 34 - = 1956 51,070 837 16.4 815 16.0 21 25 c=> = 1957 50,600 738 14.6 750 14.8 16 22 . . Averages for the eleven years 1947 - 1957;- Births 814 Deaths 691 Deaths under one year of age 23 Maternal Deaths 0.45 † Totals arrived at after due allowance for inward and outward transfers. 8 DEATHS OF RESIDENTS DURING 1957„ Causes of Death At all ages Under 1 yr. 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards 1.Tuberculosis, respiratory 2 - - - - 2 - - 2.Tuberculosis, other - -- -- -- - - -, - 3 syphilitic disease 3 - - - - - - 3 4..Diphtheria - - - - - - • - 5«Whooping Cough - - - - - — - — 6 .Meningococcal Infections 1 - 1 - - - - - 7.Poliomyelitis, acute - - - - - - .- - 8»Measles 1 - 1 - - - - - 9..Infective and parasitic disease® 3 - - - - - 1 2 10.Malignant neoplasm, stomach 17 - - - - - 3 14 11.Malignant neoplasm, lung, bronchus 22 - - - - 10 12 12 .Malignant neoplasm, breast 13 _-- - - - 1 5 7 13»Malignant neoplasm„ uterus 8 - - - - 2 3 3 14. .Malignant and lymphatic neoplasms, - - - - - - - - other 68 — - - -> 3 22 43 15 .Leukaemia, aleukaemia 3 - - - - _ - 3 16.Diabetes 2 - - - — - 1 1 17.Vascular lesions of nervous system 109 - - - - .- 9 100 18.Coronary disease, angina 73 - - - - 2 21 50 19.Hypertension with heart disease 21 - - - - - 2 19 2O. Heart disease, other 114 - - - - 1 5 108 21.Circulatory disease, other 76 - - - - 1 6 69 22.Influenza 7 — _ - — - 1 6 23.Pneumonia 54 - — 1 — 1 5 47 24.Bronchitis 37 - - - - 1 6 30 Carried forward 634 - 2 1 - 14 100 517 9 DEATHS OF RESIDENTS DURING 1957 (Continued) Causes of Death At all ages Under 1 yr. 1 and under 5 5 and under 15 j15 and under 25 25 and under 45 45 and under 65 65 and upwards Brought forward 634 <=> 2 1 14 100 517 25 .Respiratory system, other disease of 6 2 4 26.Ulcer of stomach and duodenum 8 ess G=J 1 7 27.Gastritis ^enteritis and diarrhoea 4 sr> 1 1 2 28 .Nephritis and nephrosis 5 1 2 1 1 29,Hyperplasia of prostate 3 CD CSS OB 3 30. Pregnancy,childbirth, abortion _ _ 31 .Congenital malformations 6 3 1 1 ' 1 32.Other defined and ill-defined diseases 51 10 3 10 28 33 .Motor vehicle accidents 7 1 3 3 34.A11 other accidents 14 2 1 4 7 35 .Suicide 11 => e=> 1 4 4 2 36,Homicide 1 1 o c=> = - - TOTALS 750 16 2 2 3 29 123 575 Consideration of the following table clearly indicates the increase in longevity of residents during the first half of this century. [###Year No. 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 1955 825 25 3.03 617 74.78 1956 815 21 2.58 643 78.89 1957 750 16 2.13 575 76.66 10 ANALYSIS OF DEATHS The percentages of the total deaths attributable to particular causes during the past four years are set out below. The figures in parentheses are to be read in association with those appearing in the main table of deaths shewn on the preceding pages. Percentage Coding 1954 1955 1956 1957 Average for four years (1) 1,23 0.97 0.12 0,27 0.64 (2) . 0.12 — = 0.03 (3) 0.14 0,48 0,49 0.4C 0.38 (4) _ - _ - _ (5) . - <= - - (6) . - - 0.13 Qo03 (7) . 0.24 - 0,06 (8) — - - 0.13 0.03 (9) 0.60 0.36 0,12 0,40 0.37 (10) 3.00 1.94 2.21 2,27 2.35 (11) 3.70 3.51 3.81 2.93 3.49 (12) 1.40 1.57 2.60 1.73 1.82 (13) 0.82 0.61 0.86 1.07 0.84 (14) 10.00 10.93 9.96 9.07 10.00 (15) 0.41 0.36 0.61 0.40 0.44 (16) 1.10 0.97 0.73 0.27 0.77 (17) 13.00 11.88 13.41 14.53 13.20 (18) 12.12 11.64 10.60 9.73 11.02 (19) 3.54 1.94 2.21 2.80 2.62 (20) 11.20 12.73 14.51 15.20 13.41 (21) 8.30 10.10 8.36 10.13 9.22 (22) — 0.24 0.93 0.29 (23) 5.70 6.42 7.75 7.20 6.77 (24) 4.40 4.61 4.80 4.93 4.68 (25) 0.82 0.40 1.23 0.80 0.81 (26) 0.70 1.60 1.35 1.07 1.18 (27) 0.41 0.73 - 0.53 0.42 (28) 1.09 0.97 0.37 0.70 0.78 (29) 0.82 0.40 0.61 0.40 0.56 (30) 0,30 - - — 0.07 (3D 0,54 0.73 0.86 0.80 0.73 (32) 8.04 8.85 9.47 6.80 8.29 (33) 1.60 1.21 0.61 0.93 1.09 (34) 3.40 2.30 1.48 1.87 2.26 (35) 1.23 1.21 0.86 1.50 1.20 (36) 0.14 - 0.24 0.13 0.13 11 ANGER OF THE LUNG AMD BRONCHUS During 1957, deaths of residents from the above cause numbered 22 (Males 16 and Females 6) as compared with 31 (Males 25 and Females 6) in the preceding year, and showed a decrease of nine, The national aspect is, however, quite different as will be seen from the following table Cancer of the Lupg and Bronchus Number of Deaths registered Death rates per million of the population Tear Males Females Total Males Females 1957 16,430 2,688 19,118 759 116 1956 15,615 2,570 18,185 726 111 815 118 933 Advances 33 5 Investigation into the association of tobacco smoking and lung cancer has been in progress for over five years, and it seems clear that a higher mortality rate can be expected in - (a) Smokers rather than in non-smokers 3 (b) Heavy rather than in light smokers ; (c) Cigarette smokers rather than in pipe smokers 5 and (d) Those who continued to smoke as compared with persons who discontinued the practice. No reduction in the number of deaths resulting from cancer in other sites of the body has resulted to compensate for the rise in lung cancer mortality. Despite the manifold difficulties encountered in the continuing investigations, it is apparent that the habit of smoking cannot be definitely dissociated from the steadily advancing mortality figures for lung cancer, neither is it felt that the increasing proportion of aged persons is more than an incidental contribution. In the last ten years the death rate for this particular cause, both among men and women, has risen at all ages from early middle life onwards. The general consensus of opinion supports the belief that Bmoking is the primary reason for the dramatic rise in the number of lung cancer deaths, and whilst it would be unrealistic to imagine that cigarette smoking can, or should, be forbiddens every opportunity must be taken to encourage 12 an abatement of this practice. Adolescents in particular should be subjected to intensive propaganda against ever commencing to smoke, but even if such a campaign bore successful results it would be many years before such education was apparent in mortality returns , The following table gives in detail the number of deaths of residents during the years 1950 to 1957 (inclusive): Year Males Females Totals Percentage of deaths reelstared 1950 18 4 22 3.4 1951 16 - 16 2.3 1952 27 6 33 5.0 1953 16 4 20 2.9 1954 20 7 27 3.7 1955 21 8 29 3.5 1956 25 6 31 3.8 1957 16 6 22 2.9 159 41 200 27.5 Averages; 19.9 5.1 25.0 3.4 During the period under review it will be observed that the ratio of mortality is one woman to every four men. 13 INFANT MORTALITY Sixteen infants under the age of one year died during 1957, as compared with twenty-one and twenty-five in 1956 and 1955 respectively, Eighty-one per cento of the deaths now under review occurred before the age of four weeks was attained. Deaths were attributable to - Males Females Asphyxia 2 2 Atelectasis 1 2 Haemorrhage, Cerebral 1 - Malformations, Congenital 3 - Prematurity 1 4 It will be noted that the number of infant deaths has again declined. During the ten years 1925 to 1934, 465 infants under one year of age died, giving an annual average of 46.5, whilst in the period 1948 to 1957, 212 deaths occurred - an annual average of 21.2. Deaths from "Prematurity" accounted for thirty-one per cent. of total registered (16). The actual periods at which deaths occurred were as follows:- Under 4 4 weeks to 3 to 6 months 6 to 12 montha Total under Males 7 1 - - 8 Females 6 1 1 - 8 Totals : 13 2 1 - 16 14 INFANT MORTALITY RATES - ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year of age per 1000 live births. Country 1951 1952 1953 1954 1955 1956 Average for six years ENGLAND & WALES 30 28 27 25 35 24 26.5 SWEDEN 21 20 19 19 17 17 18.8 NEW ZEALAND 23 22 20 22 22 19 21.3 NETHERLANDS 25 23 22 21 20 19 21.7 AUSTRALIA 25 24 23 22 22 22 23.0 DENMARK 29 29 27 27 25 25 27.0 UNITED STATES OF AMERICA 29 29 28 27 27 26 27.7 SCOTLAND 37 35 38 31 30 28 33.1 CANADA 38 38 35 32 31 25 33.1 REPUBLIC OF IRELAND 45 a 39 38 37 36 39.3 FRANCE 51 46 42 a 39 36 42.5 ITALY 67 64 59 53 49 48 56.7 The above table has been prepared from information made available by the Registrar-General. - 15 - NATIONAL ASSISTANCE ACT, 1948. Section 50 of the above Act places responsibility upon a local authority to arrange the burial or cremation of any person in respect of whom no other suitable arrangements can be made. The Borough Council does not, however, arrange for cremations to be carried out. In certain instances it has not been possible to trace any surviving relatives, but it is possible that a member of the deceased's family might ultimately be contacted and who would not express approval to cremation having been performed. The National Insurance Act, 1946, provides that under certain circumstances, death grants may be obtained as follows:- (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 Grants as indicated above were only payable to liable relatives ; a local authority whilst assuming the role of a "liable relative" did not receive reimbursement in fully but was granted three-fifths of one of the above-mentioned sums, a stipulation included in the National Insurance (Death Grant) Regulations, 1949. This procedures in one or two instances, resulted in the Borough Council being unable to clear expenditure involved in interments. In the coming year, however, a local authority will be entitled to recover the full death grants applying. During 1957, it was necessary to arrange the following interments: (Aged) 17 64 69 69 Years (Aged) 2 weeks 71 years 86 years and one stillborn female child. - 16 - 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 list: HOSPITALS TYPE OF INSTITUTION Brompton Hospitals Fulham Road, S.W.3. Chest Diseases Chelsea Hospital for Women, Dovehouse Streets S.W.3. General Granard House, 98, Dovehouse Streets S.W.3. (Part of Royal Marsden Hospital) Malignant Disease Royal Marsden Hospitals Fulham Road, S.W.3. Malignant Disease Royal Hospital, Royal Hospital Road, S.W.3. Home for Pensioners St. Luke's Hospital, Sydney Streets S.W.3. Chronic Sick Sto Stephen's Hospital, Fulham Road, S.W.3. General Victoria Hospital for Children, Tite Street, S.W.3. Children's Diseases NURSING HOMES Royal Avenue Nursing Homes 39, Royal Avenue, S.W.3. Private - 17 - MATERNITY AND CHILD WELFARE SERVICES Responsibility for the day-to-day administration of the above services rests with the London County Councils with the assistance of the Medical Officers of Health for the Boroughs of Chelsea, Fulham, Hammersmith and Kensington. Division I of the County Council comprises the above Boroughs, and information relevant to Chelsea has been kindly supplied by Dr. B.2.A. Sharpen Divisional Medical Officer. WELFARE CENTRES Attendances at Ante-natal and Post-natal Sessions 1,404 Attendances at Infant Welfare Sessions 8,261 HEALTH VISITING Number of visits carried out by Health Visitors:- Expectant mothers: First visits 357 885 Total visits Children under 1 year: First visits (including visits paid to Premature Infants) 607 2,967 Total visits Children between 1 and 2 years: Total visits 1,783 2 and 5 years: Total visits 2,622 Still Births: Total visits 12 School Children: Total visits 137 Care of old People: Total visits 51 Miscellaneous: Total visits 832 Unsuccessful: Total visits 1,204 No. of children under 5 visited during the year 2,934 No. of households visited during the year 2,117 Foster Mothers: Number of registered foster mothers 6 Number of children fostered 8 - 13 - MATERNITY AND CHILD WELFARE SERVICES (Continued) Diphtheria Immunisations Number of children who completed a primary course of injections 651 Number of children who completed reinforcing injections 609 Vaccinations: Number of children vaccinated at the Violet Melchett Infant Welfare Centre 380 Child Population: The Registrar-General's estimates of the child population of the Borough during the years 1956 and 1957 were as follows:- 1956 1957 790 Under 1 year 760 2,550 1 to 4 years 2,640 4,300 5 to 14 years 3,900 7,640 7,300 indicating a decline of 340. DIPHTHERIA IMMUNISATION During the year, as will be seen from the table set out below, parents maintained an interest in the advantage to be gained by recourse to this facility, despite the fact that once again no cases of Diphtheria were notified to the Public Health Department. Year Primary Injections Reinforcing 1954 677 657 1955 513 375 1956 645 595 1957 651 609 - 19 - "PART III" ACCOMMODATION The Council is empowered by Section 47 of the National Assistance Act, 1948, as amended by the National Assistance (Amendment) Act, 1951,to make applications for Court Orders for the removal to hospitals or institutions, persons who are physically incapacitated by reason of age or infirmity, who are living in insanitary conditions and need care and attention. The London County Council maintain two institutions in the Borough of Chelsea - (a) 367, Fulham Road (adjacent to St. Stephen's Hospital), and (b) "King's Mead", Dovehouse Street. During the year it was found necessary for eleven persons to be accommodated at "King's Mead", but in every case voluntary transfer was accomplished. The possessions of those concerned were, of course, in the safe keeping of the County authorities. It is pleasing to report excellent and amicable arrangements have long existed between institutional authorities and members of the Public Health Department whereby admissions are speedily completed. - 20 - SPASTIC CHILDREN Early in the Spring of 1955, a non-resident treatment centre (which has now been recognised as a Special School) was established at 61, Cheyne Walk, S.W.3., under the aegis of No. 4 (Chelsea) Group Hospital Management Committee. The Centre is possessed of the most up-to-date equipment and is proving of considerable assistance in connection with cases referred to it by hospitals in south-western districts. Although the age-group of children upon which the Centre is concentrating is between 0 and 5 years, the London County Council have expressed approval, in certain instances, to the continuance of treatment until the age of seven years. Children capable of benefiting from the facilities provided are taken on for full treatment, and they attend daily from 9.30 a.m. to 4 p.m. Very young children, and those with severe mental defect are accepted for physiotherapy only as out-patients. From experience gained it became essential to establish an Assessment Unit to ascertain the special facilities required for certain patients, and this unit deals with ten severely handicapped children. Others who are both deaf and afflicted with cerebral palsy are under the care of a teacher of the deaf, and receive individual and group training. Such facilities are also extended to neighbouring hospitals and general practitioners in the area. It is hoped that during 1958 it will be possible to provide residential accommodation for one or two mothers and their children. Later the Hospital Management Committee intend to make available a similar facility for some six children as weekly boarders. During the year, 197 children were screened, and the latest information indicates that 37 school patients were presenting themselves daily for treatment, in addition to 17 out-patients who attended for treatment only. 21 WELFARE OF OLD PEOPLE At the close of the year, 1076 persons were on the registers of the Public Health Department. 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 wellbeing. 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 Friday in each week, and during the year, 12,450 meals were delivered, or an average weekly supply of 239. In 1956 the respective figures were 12,570 and 241. The receipt of hot meals at a regular hour was welcomed by all concerned. Chiropody. 133 persons were recommended for the services provided by two qualified chiropodists, as compared with 130 and 138 in the two preceding years. This facility is in great demand and there has been, for some time, a waiting list for treatment. Holidays. The continuance of this scheme resulted in 70 persons having pleasant stays either at the sea or in the country. The majority stayed at homes controlled by the Women's Holiday Fund, whilst others had one or two weeks at the Lloyd Thomas Home of Rest at Highgate. In some instances, transport was provided to convey people to and from holiday centres, and quite frequently escorts travelled to and from railway stations. Library and Shopping Facilities, continued 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. Difficulty in securing hospital accommodation for the chronic sick continues, whilst the happy relationship between the Council's officers and hospital authorities brought about the admission of 104 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. - 22 - Institutional care became necessary for 11 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 tact and effort. The Women's Voluntary Services and other kind donors have continued to dispense much needed clothing to recommended cases, and 246 persons were so helped in this manner during the year as compared with 308 in 1956. The National Assistance Board also gives every sympathy to persons 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 superflous items disposed of. A local boot-repairer is now carrying out boot and 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 public-spirited action is taken full advantage of. At the beginning of November, 1955, a laundry service for incontinent persons was inaugurated by the Council with the valued co-operation of Fulham Borough Council, Soiled linen is collected twice weekly from the homes of these unfortunate persons and delivered to Fulham's disinfecting station where it is laundered and later collected for return to those using the scheme. During the year 23 persons had so benefited, and some 3,308 pounds of bedding, etc,, had been laundered. The Council's Social Worker made 1,990 visits to cases on 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. - 23 - PUBLIC MORTUARY FACILITIES The Borough Council has not maintained mortuary premises for many years. An agreements however, exists with Hammersmith Borough Council whereby excellent facilities are available at their Mortuary in Fulham Palace Road, W.6. During the year, one hundred and fifty-five PostMortems without Inquests, and forty-three Postmortems with Inquests were performed in respect of Chelsea residents. MEDICAL EXAMINATIONS Sixty-two examinations occurred in respect of persons proposing to enter the Council's employments and subsequently enjoying the benefit of the authority's superannuation scheme# In all cases satisfactory reports were submitted to the Borough Treasurer,, One examination was made on behalf of a provincial authority involving the transfer of an employee, and two officers were examined owing to their indifferent health. MASS RADIOGRAPHY Tuberculosis of the lungs is an infectious diseases and can be contracted from someone who is already afflicted. Great advances have, in recent years, been made in combatting the disease. Facilities for the detection of unsuspected Tuberculosis of the lungs are available throughout the year from Mondays to Fridays in each week-, except when a particular day coincides with a public holidays at Centres within easy travelling distance of Chelsea. It is also anticipated that a Mobile X-Ray Unit will visit the Borough during the coming summer. Shortly before Christmas a similar Unit was operated at the Chelsea Community Centre, 385, King's Road, when three hundred and sixty-six persons submitted themselves for examination. In only two instances was it necessary for more detailed examinations to be made,, resulting in the persons concerned being referred to their own doctors for conditions other than of a tuberculous mature. - 24 - The following table gives brief details of temperatures, rainfall and sunshine recorded during the year, and has been compiled from information supplied by the Director of the Meteorological Office, based on data obtained at Kew Observatory. Quarter Daily Temperature of the Air Total Rainfall (inches) Total Sunshine (hours) Average of Highest Average of Lowest Average of Mean March 50.2° 40.8° 45.5° 5.90 227.5 June 62.1° 46.3° 54.2° 2.28 674.9 September 67.9° ° 55.0 61.4° 9.52 444.7 December 51.4° 41.8° 46.6° 6.04 210.2 TOTALS: 23.74 1557.3 Rainfall and Sunshine recorded during the June and September quarters of the past three years: Rainfall (inches) Totals Sunshine (hours) Totals 1955 June Quarter 6.24 587.3 September Quarter 2.87 9.11 601.9 1189.2 1956 June Quarter 3.02 549.7 September Quarter 11.61 14.63 438.9 988.6 1957 June Quarter 2.28 674.9 September Quarter 9.52 11.80 444.7 1119.6 It will be apparent that the recognised "holiday" months of the past two years have been very disappointing, due to the excessive rainfalls and reduced sunshine obtaining in the September quarters. - 25 - CREMATION SERVICE In October of this year, an agreement was concluded with the General Cemetery Company whereby cremation facilities became available at West London Crematorium, Kensal Green, for persons who, at the time of death, resided or were normally resident in the Borough of Chelsea. At this time it is not possible to comment upon public reaction to this scheme, but the publicity which is maintained will, it is hoped, eventually impress upon everyone the benefits accruing from cremation. Cremation is considered to be more hygienic than earth burial, as well as more convenient for relatives and mourners, whilst its adoption obviously results in the conservation of land which is urgently needed for housing, agriculture and industrial use. The following extract from the official journal of the Cremation Movement is indicative of the trend of thought in this respect,, Progress of Cremation Year No. of Crematoria No. of Cremations No. of Deaths Percentage of deaths 1946 58 50,160 556,695 8.90 1947 58 61,160 583,813 10.47 1948 58 64,288 531,247 12.12 1949 58 79,607 574,319 13.86 1950 58 89,557 574,309 15.59 1951 59 107,161 614,718 17.43 1952 63 107,699 558,790 19.27 1953 68 116,728 562,303 20.76 1954 74 125,521 563,128 22.36 1955 82 141,353 579,907 24.37 1956 108 153,238 583,202 26.27 1957 117 163,358 575,946 28.36 - 26- SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF THE WORK PERFORMED BY THE PUBLIC HEALTH INSPECTORS DURING THE YEAR 1957. Number of complaints received during the year 807 INSPECTIONS AND RE-VISITS DWELLINGS: Inspections after complaints 3,464 5,559 Inspections after Infectious Diseases 985 House-to-House inspections 798 Underground Rooms 98 Overcrowding and "Permitted Numbers" 206 Other Visits 8 FOOD PREMISES: Butchers 256 1,835 Fishmongers and Fish Friers 47 General Provision Shops 11 Dairies 226 Ice Cream Vendors (Premises, Stalls, Vehicles) 247 Ice Cream Manufacturers 12 Bakehouses 87 Street Stalls and Barrows 123 Food Factories (Mechanical) other than Bakehouses 31 Hotels, Restaurants, and Dining Rooms 493 Premises in connection with Unsound Food 154 Premises in connection with Food Sampling. 109 Other Food Premises 39 FACTORIES AND OUTWORKERS: Factories other than Food Factories (Mechanical) 207 274 Factories other than Food Factories (Non-Mechanical) 49 Outworkers 18 Other visits (not classified) - DRAINAGE: Drains tested: (a) by water 605 855 (b) by smoke 147 (c) by air 103 Carried Forward: 8,523 - 27 - SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF THE WORK PERFORMED BY THE PUBLIC HEALTH INSPECTORS Brought forward INSPECTIONS AND RE-VISITS (Continued) 8,523 MISCELLANEOUS Animal, Poultry, and Birds 33 Open Spaces, and Highways 67 Office Premises 10 Marine Stores and Second-hand Dealers 5 Premises re Pharmacy and Poisons 49 Premises to enforce requirements of Shops Act 10 Premises re Voluntary Works 4,874 Visits to Owners, Agents and Builders Offices 269 Smoke observations 57 Food Poisoning 14 Visits to aged and infirm persons 168 Premises under Pet Animals Act, 1951 9 Atmospheric Pollution Recording 331 Visits resulting in "No access" 1,273 Other Visits 1,470 8,639 17,162 28 WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS FACTORIES ACT, 1937 HOUSING ACT, 1957 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1955 TOTAL N. V. N. V. N. V. N. V. CLEANSING: Rooms: Walls & ceilings cleansed and redecorated - - 39 - - - 5 - 44 Passages & Staircases: Walls & ceilings cleansed and redacorated - - 5 - - - - - 5 Yard and area walls cleansed and colour-washed - - - - - - 1 - 1 Rooms and Contents cleansed by occupiers - - - - 1 - - - 1 Verminous rooms disinfested - - 1 - - - - - 1 Rooms where Food is manufactured, stored or sold - - - - - - 23 - 23 GENERAL IMPROVEMENTS AND REPAIRS Roofs - - 44 - 61 15 - - 120 Eaves, Gutters - - 16 - 15 5 - - 36 Rain-water pipes - - 22 - 14 - - - 37 Yard and Area: Pavings - - 17 - 3 39 - - 59 Walls rendered or repaired - - 28 - 5 - - - 33 Rooms: Wall and Ceiling plaster 1 - 193 - 94 - 6 - 338 Passages & Staircases: Wall and Ceiling plaster - - 46 - 8 - - - 54 Floors - - 12 - 12 45 9 1 79 Stair Treads, Bannisters & Balustrades - - 15 - 1 - - - 16 Window and Door Frames, fittings and sash cords - 1 278 - 52 3 - - 334 Dampness remedied 1 - 118 - 130 46 - - 295 Horizontal damp proof course provided - - 2 - - - - - 2 Vertical damp proof course provided - - 3 - - - - - 3 Fireplaces & Fire-ranges repaired - - 41 - 7 - - - 48 Natural Ventilation provided or improved - - 21 - 3 2 - - 26 Chimneys and Flues - - 17 - 3 - - - 20 Natural Lighting provided or improved - - 5 - - 40 - - 45 Carried forward 2 2 923 - 409 239 44 1 1620 -29- WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1957 PUBLIC HEALTH (LONDON) ACT, 1936 food & drugs ACT, 1955 total Brought forward N. v. n. V. N. v. n. v. 1620 2 2 923 - 409 239 44 1 GENERAL IMPROVEMENTS AND REPAIRS (Continued) Subfloor ventilation provided CSS - 6 - - 6 Miscellaneous - 1 23 • 10 41 - - 75 DRAINAGE: Total Reconstructions - - - - - 26 - - 26 Partial Reconstructions, repairs or alterations - - - - - 15 - - 15 Frontage Drains Reconstructed - - - - 8 5 3 - 16 Obstructions cleared - - 1 - 17 23 - 1 42 Inspection Chambers provided - 2 - - - 80 - - 82 Inspection Chamber covers renewed - - - - 3 2 - - 5 Interceptors provided - 1 - - - 31 - - 32 Soil & Ventilation Stacks provided or reconstructed - - - - - 112 - - 112 Soil & Ventilation Stacks repaired - - - - - 1 - - 1 Waste & Ventilation Stacks provided or reconstructed - - 2 - - 110 - - 112 Waste & Ventilation Stacks repaired - - 1 - 2 - - - 3 Fresh Air Inlets provided - - - - - 22 - - 22 Fresh Air Inlets repaired or renewed - - 3 - 15 5 - - 23 Single Sinks provided - 3 1 - - 438 9 3 454 Double Sinks provided - - - - - - 1 1 2 Baths provided - - - - - 464 - - 464 Wash-hand basins provided - - - - - 506 10 5 521 Miscellaneous - 2 4 - 22 14 2 - 44 Carried forward 2 11 964 - 486 2134 69 11 3677 - 30 - WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1957 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1955 TOTAL N. V. N. V. N. V. N. V. Brought forward 2 11 964 - 486 2134 69 11 3677 SANITARY CONVENIENCES: Additional Water Closets provided - 7 - - - 491 - 3 501 Water Closet pans renewed - 1 4 - 2 3 1 4 15 Water Closet pans cleansed 2 - - - - - 1 - 3 Water Waste preventers renewed or repaired - - 2 - 28 - 1 - 31 Water Waste preventers provided - 7 - - - 491 - 3 501 Roofs repaired or renewed - - 5 - - - - - 5 Walls & Ceiling plaster cleansed repaired or redecorated 2 - 20 - 6 - 6 - 34 Natural Ventilation provided or improved - - 19 - - 12 - - 31 Natural or Artificial Light provided or improved 1 - 3 - - - 3 - 7 Ventilated Lobby provided 1 - - - - 8 1 1 11 Miscellaneous - - 11 - 2 2 1 - 16 WATER SUPPLY: Supplies provided to Tenements - - - - 1 1 - - 45 Supplies re-connected - - - - 1 2 - - 3 Taps supplied on main for drinking purposes - - - - 1 - - - 44 Burst Pipes repaired 1 - - - 2 4 - - 7 Cisterns cleansed, covered or repaired - - - - 3 - - - 3 MISCELLANEOUS SERVICES PROVIDED: Soap and Towels for staff - - - - - - 1 - 1 Constant Hot Water - - - - - - 25 1 26 Bins, refuse 1 - - - 28 6 - - 35 Food Cupboards provided - - 49 - - 2 2 - 53 Carried forward 10 26 1163 - 560 3156 111 23 5049 - 31 - WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1957 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1955 TOTAL N. V. N. V. N. V. N. V. Brought forward 10 26 1163 - 560 3156 111 23 5049 MISCELLANEOUS SERVICES PROVIDED (Continued) Food Cupboards - Ventilation provided - - 9 - - - - - 9 Covered Display and Counter Screens provided - - - - - - 16 1 17 MISCELLANEOUS NUISANCES ABATED, ARISING FROM: Offensive accumulations on open land and boob sites - - - - 7 7 - - K GRAND TOTALS 10 26 1172 - 567 3163 127 24 5089 N = Work carried out under Notice. V = Voluntary Works. - 32 - INSPECTIONS, PROCEEDINGS,, ETC Total number of houses in the Borough 15,720 (approxo) PUBLIC HEALTH (LONDON) ACT, 1936 Number of houses inspected on account of complaints or illness 1,603 Number of statutory notices served 68 Number of houses repaired or nuisances remedied 285 HOUSING ACT, 1957 Number of houses inspected - house-to-house (Housing Consolidated Regulations, 1925) Nil Number of houses included by representations by the Medical Officer of Health under Section 4.2 of the Housing Act, 1957 Nil Number of houses demolished following representation by the Medical Officer of Health under Section 42 of the Housing Act, 1957 Nil Number of houses repaired under Sections 9 and 10 of the Housing Act, 1957:- (a) by owners 53 (b) by local authority in default of owners Nil Number of houses demolished:- (a.) in pursuance of orders under Section 17 of the Housing Acta 1957 Nil (b) voluntarily 14 Number of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) Nil Number of Closing Orders determined (i.e. houses made fit) Nil OVERCROWDING (HOUSING ACT, 1957) Number of families found to be living in overcrowded conditions 6 Number of overcrowded families who have obtained alternative accommodation 19 Number of houses erected by the Borough Council during the year 16 UNDERGROUND ROOMS Number found to be unfit Nil Number rendered fit for human habitation Nil Number closed by Closing Orders Nil - 33 - DETAILS OF NOTICES SERVED DURING THE YEAR l. HOUSING ACT, 1957 Section 9 - Repair of insanitary houses NIL 2. PUBLIC HEALTH (LONDON) ACT, 1936 (a) Intimation 252 (b) Nuisance Notices 57 (c) Section 40 — Drainage 11 L.C.C. (General Powers) Act, 1954 (a) Section 12 - Provision of Dustbins - Intimation 19 (b) Section 12 - Provision of Dustbins - Statutory Notices 3 L.C.C. (General Pgwejp) Act, 1955 Section 25 - Stopped up drains 3 3. FACTORIES ACT, 1937 Health - general provisions 4 4. FOOD AND DRUGS ACT, 1955 Defects at food premises 45 5. SHOPS ACT, 1950 Provision of suitable sanitary conveniences and ventilation 1 TOTAL 395 Four hundred and sixty-three notices were complied with during the year of which three hundred and thirty-two were served under the Public Health (London) Act, 1936. HOUSING REPAIRS AMD RENTS ACT, 1954 - RENT ACT, 1957 Four Certificates of Disrepair and three Certificates of Revocation were issued in accordance with the provisions of the above Acts. - 34 - HOUSING ACT, 1957 - PART IV - OVERCROWDING New cases investigated and recorded 6 Number of families involved 6 Number of persons involved 33 Cases relieved by:- (a) Rehousing Authorities 1 (b) Informal or formal procedure 18 Such action resulted in 98 persons being adequately housed. At the end of the year, 28 families (involving 163 persons) were living in overcrowded conditions and every endeavour is being made to bring about an abatement of such conditions. 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 the water supply were received. In both cases samples of the water were taken from the tap, results of which showed that the water was of satisfactory hygienic quality and fit for human consumption. 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 Public Health Inspectors, the following provisions were made Supplies to tenements 45 Taps on main for drinking purposes 44 Cisterns cleansed, covered or repaired 3 - 35 - 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 Public Health Inspectors during the years 8= 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 Authorities:- 75 49 - - (2) Factories not included in (l) in which Section 7 is enforced by the Local Authorities §=> 238 207 4 - (3) Other premises in which Section + 7 is enforced by Local Authorities:- - - - - TOTALS 313 256 4 - 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. - 36 - FACTORIES ACT, 1937 (Continued) 2. CASES IN WHICH DEFECTS WERE FOUND Particulars Number of cases in which Defects were found Prosecutions Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (Section l) 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 4 2 - - - (c)Not separate for sexes - - - - - Other offences against the Act (not including Outworkers) 2 1 - - - TOTAL 7 3 - - - 37 FACTORIES ACT, 1937 (Continued) OUTWORK Nature of Work No. of Outworkers in August List as 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 Prosecu tions Wearing Apparel making etc. 13 - - - - - Household Linen - - - - - - Curtains and furniture hangings - - - - - - Furniture and upholstery - - - - - - Stuffed toys - - - - - - Lampshades 5 - - - - - TOTALS 18 • - - - - - - 38 - 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 Offence Result of Proceedings 2, Callow Street Non-compliance with Statutory Notice Abatement Order made for the work to be completed within 28 days. Council awarded £2. 2s, 0d. costs. 21, Jubilee Place Non-compliance with Statutory Notice Abatement Order made for the work to be completed within 7 days. Council awarded £2. 2s. Od. costs. 21, Jubilee Place Non-compliance with Abatement Order Penalty Summons Defendant fined £3. 7s. 0d., with £2. 2s.0d. costs. Council paid £2.6s.0d. costs. 22, Ives Street Non-compliance with Statutory Notice Abatement Order made for the work to be completed within 7 days. Council awarded £l. ls. 0d. costs. 24, Ives Street Non-compliance with Statutory Notice Absolute Discharge requirements of Notice having been complied with at time of hearing. Council awarded £l.ls.0d. costs. 21, Jubilee Place Non-compliance with Abatement Order Penalty Summons - NOT SERVED. "To Let" Board at premises. Defendant believed to have gone away. - 39 - BACTERIOLOGICAL EXAMINATIONS During 1957, samples submitted for bacteriological examination totalled 59 (apart from ice cream samples, dealt with separately below). All 59 Samples were found to be satisfactory, the details of which are as follows:- Article Prawns 1 Mussels 1 Milk Pasteurised 22 Tuberculin tested 3 Sterilised 1 26 Water 31 59. Ice Cream 62 samples of Ice Cream were submitted to the Public Health Laboratory Service and tested by the Methylene Blue method. Results were as follows:- Grade I 29 Grade II 19 Grade III 8 Grade IV 6 62 Grade 1955 1956 1957 No. of Samples % of Total No. of Samples % of Total No. of Samples % of Total. I 3 37.5 23 28.8 29 47 II 3 37.5 29 36.2 19 30 III 1 12.5 13 16.2 8 13 IV 1 12.5 15 18.8 6 10 TOTALS 8 100.0 80 100.0 62 100.0 There has been a marked increase in the percentage of samples returned as Grades I and II as compared with 1956. -40- FOOD HYGIENE The improvement of Food Hygiene standards is a task earnestly pursued by the Council's officers, and the implementation of the Food Hygiene Regulations, 1955? has undoubtedly brought about an advance in the general standard of food handling in association with hygienic conditions in premises used for food preparation and disposal,. There are approximately four hundred and fifty businesses concerned with the preparation and/or sale of food located in this Borough, and they are subjected to constant inspection to ensure that the said Regulations are adhered to„ Briefly this legislation requires that (1) Food premises, stalls, etc,,, are to be maintained in a cleanly condition, a need which, of course, covers apparatus and equipment; (2) Food must at all times be hygienically handled; (3) Persons employed in trades dealing with foodstuffs must be cleanly clothed. Should it be found that any of them are sufferers from or carriers of certain infections, immediate action will be taken to remove them from such.duties until they are pronounced fit to resume their occupationsg and (4) The construction of food premises, the repair and maintenance of food premises,, stalls, vehicles;, etc,,, and the facilities to be provided; shall be of a consistently high standard,, In general, traders have been quick to co-operate with the Council; officers, and conditions ruling are very satisfactory,, Operators of food premises appreciate the advantage of providing a service which is both clean and attractive,, A duty also rests upon consumers, and they should, without hesitation, remonstrate when they meet with an assistant who is smoking, has dirty or nicotine-stained hands, or possesses the objectionable habit of licking his fingers when wrapping up their purchases„ If improvement is not apparent, the circumstances should be brought to the attention of the local health authority, for it is in the interests of the community as a whole that such breaches of hygiene should be reported,. Similar action should be taken when departures from recognised hygienic practices are observed in restaurants, cafes, ets„ Public-spirited action in these respects will definitely result in the decreased incidence of foodpoisoning which is a matter of much concern,, On the other hand, the general public should play their part by refraining from coughing or sneezing, or smoking, over food displayed on counters, whilst they should certainly cease to take dogs into shops with them when making purchases. - 41 - INSPECTION AND SUPERVISION OF FOOD As required by current legislation;, registers are maintained of all persons engaged in carrying on trades connected with the manufacture, storagej and sale of food. Traders and their staffs are kept well informed of the latest methods adopted for the hygienic handling, wrapping and delivery of food, and the great majority are appreciative of such advice,, The following summary gives details of the type of businesses receiving the attention of the Public Health Department :- Bakehouses 6 Butchers 26 Milk Retailers (including Dairies) 51 Food Factories 5 Fried Fish Premises 3 Fruit and Vegetable Retailers 33 General Provision Merchants 42 Hotels and Public Houses 52 Restaurants, Dining Rooms, Canteens, etc. 193 Wet Fish Retailers 9 Wet and Dry Fish Retailers 1 Miscellaneous Premises 29 + Includes Off-Licences, Bottling Stores, Cake and Sweet Shops. As required under Section 16 of the Food and Drugs Act, 1955, or other local Acts, the registration of 123 premises for the storage and sale of Ice Cream, and 35 premises for the sale of Preserved Food is operative,. - 42 - 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 distributor, and of any premises which cease *-,o be used as a dairy premise0 On the 31St December, 1957, entries in the register were as follows:- (a) Number of registered distributors with premise in the Borough 42 (b) Number of registered distributors other than those included in (a) above 18 (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 50 During the year 122 applications were received, and principal licences were granted under the Milk (Special Designations) (Raw Milk) Regulations, 1949 to 1954$ and the Milk (Special Designation) (Pasteurised and Sterilised) Milk Regulations, 1949 to 1953s authorising the use of special designations in relation to milk sold at, or from premises within the Borough. 59 supplementary licences were granted in respect of milk sold by retail within the Borough from 18 premises not situated in the area of this authority. Details of licences granted were as follows:- Type of Licence Tuberculin Tested Pasteurised Sterilised Total Principal 37 43 42 122 Supplementary 19 20 20 59 All retailers selling milk within the Borough have been licenced 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. - 43- PET ANIMALS ACT, 1951 During the year five licences were applied for and gran ted, and in each case a fee of 10/- was paid. Regular inspections were carried out to ensure that all animals were being cared for and maintained in accordance with the conditions attaching to the licences. PHARMACY & 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 placed on the Council's register was 49. All applications are investigated to ensure that records are properly maintained, labelling efficiently performed, storage accommodation is adequate, and that sales are only made by employees nominated on application forms» In every instance it was found that the requirements of the Act and the Poisons Rules were being complied with, whilst it was apparent that all concerned were fully aware of their particular responsibilities 0 As a general rule the poisons retailed were insecticides, rodent exterainants, hair dyes, and household ammonias Applications for inclusion and/or retention in the Council's register are considered by the Public Health and Baths Committee each Spring, and when approval has been expressed, appropriate entries are made for a period of twelve months.(1st May to 30th April.) RAG FLOCK AND OTHER FILLING MATERIALS,ACT , 1951 Eleven premises in the Borough, used for upholstering and similar processes, have been registered since the Act came into force on 1st November, 1951. There are no premises in the Borough where rag flock is manufactured. - 44- 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 Rate 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 offence 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 Borough. Details of work carried out in this connection during the year are as follows:- 1. Treatment of Business and Private Premises. Business Premises Private Premises Number of visits 385 2,888 Number of infestations found 33 278 Number of treatments undertaken 28 272 Number of pre-baits laid 2,074 Number of poison baits laid 662 Number of complaints received 325 2. Sewer Maintenance Treatments. No. of prebaits laid No. of poison baits laid No. 1 Treatment 1,326 424 No. - Treatment 1,130 284 No. 3 Treatment 1,380 345 - 45- UNSOUND FOOD Whan 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 2,66l 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 contributed to the annual totals during the years 1954-1957 (inclusive) are set out in the following table:- UNSOUND FOOD SURRENDERED TO THE COUNCIL' S FOOD INSPECTORS DURING THE YEARS 1954 - 1957 (INCLUSIVE) Commodity 1954 lbs 1955 lbs 1956 lbs 1957 lbs Cheese 110 137 86 33 Currants - - - 102 Egg, dried - 180 - - Fish, Tinned - - 66 11 Fish, Fresh 200 173 - - Fruit, Tinned 929 517 829 482 Fruit, juices - - 60 46 Fruit, Fresh - 2,353 - - Meat, Fresh l,903 3,490 1,287 853 Meat, Tinned 1,027 714 310 520 Milk, Tinned 90 - 33 28 Preserves - Jams, Marmalade, etc. 74 92 45 21 Sausages 359 72 - 23 Soups 88 304 - 16 Vegetables 254 639 214 410 Aggregates of all foods condemned annually. 5,146 8,926 3,296 2,66l Average for the four years - 5,007 lbs. - 46 - SUMMARY QF WORK CARRIED OUT BY THE COUNCIL'S DISINFECTING STAFF DURING THE YEAR 1957,. Under an arrangement with the London County Council, schoolchildren are treated at the Cleansing Centre for Scabies and Verminous conditions. SCABIES CASES TREATED Chelsea Residents Nil L.C.G. School children 10 VERMINOUS CONDITIONS. Adults 282 Children 133 L.C.C. School Children 164 DISINFECTION OF ROOMS AND CONTENTS. Number of Rooms Disinfected 450 Number of Articles Disinfected 3,045 DISINFESTATION OF ROOMS AND CONTENTS. Number of Rooms Diainfested 268 Number of Articles Disinfested 1,318 - 47 - Early in the year, a report on Atmospheric Pollution was submitted to the Public Health and Baths Committee , and as a result it was resolved that the Committee reconmend that the Metropolitan Boroughs" Standing Joint Committee be informed (a) that the Council is prepared to consult with them with a view to considering the co-ordination of a smoke control area or areas with other local authorities, and (b) the Council considers that the London County Council should adept, as soon as possible, a building byelaw under Section 24 of the Clean Air Act, 1956. on the lines of the model issued by the Minister of Housing and Local Government. Atmospheric Pollution contributes vastly to reduced hours of sunshine and the creation of fog. The latter condition results in severe damage to buildings, works of art, &c. It is estimated that a loss of between 100 and 150 million pounds results each year from atmospheric pollution; in addition, the inefficient use of fuel entails a further annual wastage of five to ten million tons. The effects upon the health of the population must not be overlooked,, It will be recalled that in the London smog experience of 1952, some 4,000 deaths were directly attributed to this visitation, whilst increased morbidity was subsequently maintained for some time, Annual statistics show that in England and Wales,, Bronchitis accounts for 30,000 deaths in each year, and that Lung Cancer mortality has risen from approximately 11,000 in 1949 to more than 18,000 in 1956. From an economic aspect it must also be considered that 26 million working days are lost annually, due solely to the incidence of Bronchitis. Recording stations are maintained in this Borough, and data obtained is submitted to the Department of Scientific and Industrial Research each month for collation0 The following table shows the degree of pollution ruling in Chelsea, compared with that found in a country district and an industrial district during 1957o Chelsea Country Districts. Industrial District Daily total soluble and insoluble deposits (tons per square mile) Daily sulphur content in milligrams. SO3 0.611 0.240 0.760 3.29 0.54 1.95 - 48 - The Clean Air Act, 1956, is mainly concerned with the implementation of recommendations made by the Beaver Committee on Air Pollutions, and makes provisions under the following headings:- INDUSTRIAL (a) Prohibiting the emission of dark smoke from any chimney for periods longer than those to be specified in Regulations which will be duly operative; (b) Adoption of precautionary measures in the lighting-up of furnaces; (c) Maintenance of prearranged measures to combat creation of nuisances due to plant failure and/or non-availability of recommended fuel; (d) Emitting of dust and grit from furnaces to be minimised by the provision of dust and grit arrestors For this purpose a local authority is empowered to call for the installation of measuring and recording apparatus (e) Abatement of nuisances - Notice of nuisances must be given to responsible persons forthwith and confirmed in writing within forty-eight hours; and (f) New industrial buildings - Chimney heights must be adequate to prevent nuisances from smoke, grit, dust, or gases. DOMESTIC (i) With the consent of the Minister of Housing and Local Government, a local authority may establish Smoke Control areas in which the emission of smoke will be completely prohibited; (ii) A survey will then be initiated to ascertain the number and types of premises, existing boilers and fireplaces, types of fuel consumed, quantity of smokeless fuel required, number of fireplace adaptations and replacements necessary, and cost involved]; finally, the estimating of expenditure likely to fall upon a local authority. (iii) A scheme based upon findings of (b) above will be submitted to the Minister of Housing and Local Government for approval, and when an Order is granted, householders will be called upon to carry out fireplace adaptations to prevent future smoke emissions. A local authority will bear 70% of the cost involved, (40% of which can be recovered on application to the Exchequer), and householders will be responsible for 30% of expenditure in connection with adaptations. - 49 - RENT ACT. 1957. The above-mentioned Act came into force on 6th July, 1957, and the following table shows the number of applications received. Number of applications for certificates 10 Number of decisions not to issue certificates Nil Number of decisions to issue certificates 9 in respect of some but not all defects 6 in respect of all defects 3 Number of undertakings given by landlords under paragraph 5 of the First Schedule 7 Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule Nil Number of Certificates issued 2 Applications by landlords to Local Authority for cancellation of certificates 1 Objections by tenants to cancellation of certificates 1 Decisions by Local Authority to cancel in spite of tenants' objection Nil Certificates cancelled by Local Authority Nil EPIDEMIOLOGY Incidence and Notification of Infectious Disease -50 - 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 TOTAL Dysentery - 1 - - - - - 1 Dysentery (Sonne) 7 33 12 10 7 1 - 70 Erysipelas - - - - - 3 - 3 Food Poisoning - 2 - 4 5 2 - 13 Measles 9 212 173 6 6 - - 406 Meningococcal Infection 1 - - - - - - 1 Pneumonia: Ac. Influenzal - - - 1 4 8 6 19 Ac. Primary 6 1 6 - 4 5 2 24 Poliomyelitis: Paralytic - - - - 3 - - 3 Non-Paralytic - - • - - - - - Puerperal Pyrexia - - - 11 20 - - 31 Scabies - 1 - 2 5 - 8 Scarlet Fever - 11 22 - 1 - - 34 Whooping Cough 6 37 24 1 - - 1 69 TOTALS 29 298 237 35 55 19 9 682 - 51 - SUMMARY OF NOTIFICATIONS OF INFECTIOUS DISEASES RECEIVED DURING THE YEARS 1953 - 1957 (inclusive) Diseases 1953 1954 1955 1956 1957 Average for five years Diphtheria - - 2 - - 0.4 Dysentery 260 196 216 349 71 218.4 Erysipelas 4 6 4 5 3 4.4 Food Poisoning 23 19 27 85 13 33.4 Malaria 1 - - - - 0.2 Measles 549 104 736 183 406 395.6 Meningococcal Infection 4 1 2 3 1 2.2 Ophthalmia Neonatorum 2 - 1 - - 0.6 Paratyphoid Fever 1 3 2 - - 1.2 Pneumonia: Ac. Influenzal 13 4 6 12 19 10.8 Ac. Primary 16 24 18 24 24 21.2 Poliomyelitis: Paralytic 2 1 2 8 3 3.2 Non-Paralytic 3 - 4 6 - 2.6 Puerperal Pyrexia 29 36 57 63 31 43.2 Scabies 19 34 12 15 8 17.6 Scarlet Fever 49 26 43 38 34 38 Typhoid Fever - 1 - - - 0.2 Whooping Cough 257 93 85 72 69 115.2 - 52 - DIPHTHERIA No notifications were received during the year. Two cases were confirmed in 1955, being the first cases since 1949. Only one death has occurred during the past eighteen 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 page 18 „ POLIOMYELITIS Four notifications of Poliomyelitis came to hand, and three were subsequently confirmedj all were of the paralytic type. All the cases were females, aged from 25 to 29 years, one being pregnant at the time. Fortunately all were reported to be making satisfactory progress. PUERPERAL PYREXIA Puerperal Pyrexia means a 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-one cases were notified during the year, all of which occurred in hospital. Twenty-three notifications referred to patients residing outside the Borough. The Puerperal Pyrexia (Amendment) Regulations, 1954, which came into operation on the 1st March, 1955, prescribed a form of certificate for notification of cases of puerperal pyrexia by medical practitioners. The new form requires the cause of the disease, if known, to be stated. Herewith is a brief summary of the actual causes in the above cases? 1 case was due to genital tract infection, 4 to breast involvement, 4 urinary tract infection, 1 respiratory tract infection, 1 kidney infection, and causes not known 20. Eleven 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. - 53 - SMALLPOX No case of Smallpox has 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 This Department was informed by the Ministry of Health early in May of this year that a German business man had been admitted to a hospital in Hamburg suffering from Smallpox after a brief visit to this country. He had left a hotel in Chelsea to fly to Germany on the morning of the day he was taken ill, and it was reported that possibly he was infectious at the time. A visit to the hotel revealed that the majority of the people resident at the time had left the Borotigh, and from information obtained from the hotel's register, the Ministry of Health were informed of those who had left the country and Medical Officers of Health of the authorities concerned where an address had been given in this country,, The hotel, and the staff which number seventy were kept wider surveillance for twenty-one days from the date the patient left. Fortunately there were no untoward developments„ DYSENTERY During 1957, seventy=one notifications were submitted as compared with 349 in 1956 and 216 in 1955o 65% of the sufferers were residents of an institution not controlled by this authority,, The premises were such that it was difficult to prevent the spread of infection mong the particular type of inraatee. Nevertheless the Borough Council has been at great pains to bring about the eradication of the incidence of dysentery,, MEASLES Four hundred and six notifications of Measles were received during 1957, as compared with 183 and 736 in 1956 and 1955 respectively,, WHOOPING COUGH Sixty-nine cases were notified during the year against 72 in 1956. SCARLET FEVER Thirty=four notifications of Scarlet Fever were received in the Public Health Department during 1957, as compared with 38 in 19560 - 54 - FOOD POISONING Thirteen cases were notified as compared with 85 in 1956 and 27 in 1955. 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 Healtho Notifications of the occurrence of Food Poisoning were received as follows:- First Quarter Second Quarter Third Quarter Fourth Quarter Total 4 Nil Nil 9 13 Outbreaks (other than family outbreaks) due to identified agents:- NIL Family Outbreaks due to identified agents:- Total Outbreaks 1 (Salm. typhl-murium 4) Total Cases: 4 Outbreaks (other than family outbreaks) of undiscovered causes:- Total Outbreaks 1 Total Cases: 9 Family Outbreaks of undiscovered causes:- NIL Single cases NIL - 55 - ZYMOTIC DISEASES An examination of statistics provided by the Registrar-General for the year 1957 showed that four deaths were attributable to "Gastritis, enteritis and diarrhoea", and one was from Measles, representing a death rate of 0.09 per 1,000 of the population. Currently, the term "Zymotic" is indicative of such diseases as cholera, diarrhoea, diphtheria, measles, scarlet fever, smallpox, typhoid fever and typhus fever, but at one time it was applied to a considerable number of diseases which were considered to be "epidemic, endemic, and contagious". Mortality from the causes outlined above has declined to a remarkable extent since the beginning of the century as will be seen from the following summary:- 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 1955 6 1956 - 1957 5 - 56 - NOTIFICATION OF INFECTIOUS DISEASE BY WARDS North Stanley South Stanley Cheyne Church Hans Town Royal Hospital TOTALS Dysentery - - - 1 - - 1 Dysentery (Sonne) 6 7 7 49 1 - 70 Erysipelas - - 1 2 - - 3 Food Poisoning - - - 13 - - 13 Measles 45 101 66 112 50 32 406 Meningococcal Infection - — — 1 - - 1 Pneumonia: Acute Influenzal 2 2 3 10 1 1 19 Acute Primary 8 4 7 1 2 2 24 Poliomyelitis: Paralytic 1 - - 1 - 1 3 Puerperal Pyrexia 31 - ■ - - - 31 Scabies 4 - 1 1 2 - 8 Scarlet Fever 1 5 14 8 3 3 34 Whooping Cough 8 16 7 21 7 10 69 TOTALS 106 135 106 220 66 49 682 - 57 - TUBERCULOSIS 87 cases of Pulmonary Tuberculosis were notified during the year. These were made up of 42 primary notifications, 34 "inward transfers", and 11 from other sources. There were also 8 non-pulmonary cases of which 5 were primary notifications, 2 from "inward transfers", and one from other sources. The accompanying tables present details of cases at present on the Tuberculosis Register. VARIATIONS IN REGISTER DURING 1957. PULMONARY NON-PULMONARY TOTAL CASES M. F. M. F. (a) Number of cases remaining on register at 1st January, 1957. 227 194 12 31 464 (b) Number of new cases notified. 31 14 2 4 51 (c) Number of cases restored to register. 5 3 - - 8 (d) Inward Transfers 20 14 1 1 36 Removals (e) Outward Transfers 52 35 1 3 91 (f) Cases recovered 2 3 - 2 7 (g) Cases gone abroad 2 2 - - 4 (h) Cases lost sight of 8 - 1 - 9 (i) Deaths 3 4 - - 7 (j) Cases remaining on the Register at 31st December, 1957. 216 181 13 31 441 - 58 - (A) NEW CASES OF TUBERCULOSIS 1957 (B) DEATHS OF TUBERCULOSIS CASES 1957 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 45 years 45 and under 55 years 55 and under 65 years 65 and under 75 years 75 years and upwards TOTAL (all ages) (A) NEW CASES Pulmonary M - - - - - - 4 5 8 9 3 1 1 31 Pulmonary F - - - - - 1 2 6 2 3 - - - 14 Non- Pulmonary M - - - - - - - - 1 - - 1 - 2 Non- Pulmonary F - - - - 1 - - 2 1 - - - - 4 (B) DEATHS Pulmonary M - - - - - - - - - 1 1 1 - 3 Pulmonary F - - - - - = - - - 3 - 1 - 4 Non- Pulmonary M - - - - - - - - - - - - - Nil Non- Pulmonary F - - - - - - - - - - - - - Nil 59 CHELSEA TUBERCULOSIS DISPENSARY, BRoMPTON HOSPITAL, S.W.3. 1954 1955 1956 1957 Population served by Dispensary 52,060 51,450 51,070 50,600 Number of notified cases in Borough at end of year 471 425 468 441 Number of these who at present do not attend Dispensary 164 102 115 96 Total attendances during year 2,208 2,080 1,984 1,594 Total new patients seen 404 242 149 190 Number of these who were contacts 173 220 106 91 Number of contacts found to be tuberculous 2 1 - 2 Number of cases newly notified to Medical Officer of Health (i.e. excluding inward transfers) 68 42 43 51 Number of cases diagnosed as tuberculous (for the first time) at the Dispensary during the year 13 7 18 20 Number of X-rays 1,889 l,578 1,417 1,250 Number of Patients who received "Special treatment" at home during the year 33 33 30 6 Number of Patients given 'B.C.G.' 52 54 65 80 Number of home visits by medical staff 32 31 50 25 Number of visits paid by Dispensary Nurse 2,382 2,135 2,027 1,798 Number of Clinic Sessions per week 2 2 2 2 60 BACTERIOLOGICAL EXAMINATIONS All bacteriological examinations are carried out at the Public Health Laboratory at County Hall under its Directory Dr. A.J.H. Tomlinson. No charge is made to the Council for these examinations and during the year 669 were made as follows:- Throat/Nose Swabs Haemolytie Streptococci found 21 Vincent's Angina found 1 Pneumococci found 1 Monilia found 6 Staph. Albus found 1 Coliform bacilli found 1 Normal throat flora found 5 Negative results 50 Ear Swabs Heavy growth of Proteus found 1 Abscess/Ulcer Swabs Negative results 2 Faeces Shigella sonnei found 96 Salmonella oranienberg found 1 Salmonella paratyphi B. found 1 Salmonella typhi-murium found 7 Pathogenic Bact. coli 0119 found 3 Pathogenic Bact. Coli 026 found 2 Monilia found 1 Negative results 467 Foodstuffs Negative results 2 The following specimens which are included in the above were arranged and collected by this Department with the approval and co-operation of local practitioners and school authorities: Throat/ Nose Swabs 16 and Faecal specimens 342. 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. ANNUAL REPORT of the PUBLIC ANALYST for the year ended 31st December, 1957« THOMAS McLACHLAN, A.C.G.F.C., F.R.I.C., M.I.Biol. 61 To the Mayor, Aldermen and Councillors of The Metropolitan Borough of Chelsea, Your Worship, My Lord, Ladies and Gentlemen, During the year 1957, 400 samples of food and drugs were examined, all of which were taken informally. Adverse comments were made against 28 samples and the incidence of adulteration or incorrect labelling may be classified as follows s- Number of samples examined. Number of samples adulterated. Milk 203 - Other foods 188 25 Drugs 9 3 One portion in a box of assorted cheese spreads was labelled "Pasteurized Process Cheese Spread with Sherry Wine", but no alcohol could be detected. The manufacturers stated that in general the percentage of alcohol in the cheese is very small as it evaporates during pasteurization. Only one small portion was examined originally and the manufacturers arranged for two further samples to be sent for examination, one fresh and one old stock. These samples showed 0.35 per cent of alcohol in the fresh sample and 0.72 per cent in the old sample. It was considered the print of the words "with Sherry Wine" on the label was too large and the manufacturers agreed to amend this when printing new labels. A sample of "Smoked" Cream Cheese was stated to contain 30 per cent "Fett i. T", the "i.T" being the German abbreviation for "calculated on the dry substance", but in accordance with the Labelling of Food Order the label must be in English. The cheese was found to contain 31.1 per cent of fat on the dry substance, but this was equivalent to only 11.5 per cent on the cheese as received, so that the cheese was really prepared from a slightly separated milk and not from cream at all. It is suggested that cream cheese should contain not more than 55 per cent of water and not less than 30 per cent of milk fat. Some "Cheese Fondue" was labelled on the front panel as "Gruyere Cheese Spread processed with White Wine and Kirsch, but the ingredients on a side panel were disclosed as "Swiss Gruyere Cheese, emulsifying salts and Spices". The two labels were contradictory, and the main label was misleading as no alcohol could be detected. The manufacturers stated that 2 per cent of proof spirit should have been detected, and that the statement on the label was that the cheese is "processed with white wine and Kirsch" so that it would be misleading to list them as ingredients. Your analyst does not agree because if Kirsch and White Wine leave a flavour and bouquet, it is impossible to escape from the fact that they are ingredients. 62 A pork luncheon meat contained only 74 per cent of meat and was therefore 17.8 per cent deficient in meat. It is understood from importers that no luncheon meat is coming into this country at the present time containing more than 75 per cent of meat. Importers and certain home manufacturers are hoping to standardise pork luncheon meat on a minumum meat content of 75 per cent of meat, but public analysts maintain that this should be not less than 90 per cent. Another sample of luncheon meat contained an added phosphate emulsifying agent which was not declared, In accordance with the requirements of the Labelling of Food Order every constituent, including emulsifying agents must be quoted on the label. The packers eventually agreed to amend their label to include "Emulsifying Salts". A sample of Danish braised ox liver was found to contain added nitrite without any notification on the label, but upon investigation it was found to be very old stock. A product sold as Beef and Ox Tongue consisted of a large number of shreds of beef and ox tongue suspended in jelly. It was considered that the description should be either "Beef and Ox Tongue in Jelly" or "Beef and Ox Tongue in Aspic". The manufacturers agreed to include the words "In Jelly" when new labels were printed. The name of a fish paste implied that it was prepared from some particular type of fish, but no particular fish was actually mentioned. This is a contravention of the Labelling of Food Order, which requires the paste either to be described by a name which includes that of the predominating fish used or to give a list of ingredients contained in the product. After considerable correspondence and discussion of the matter with the Association of Public Analysts and the Food Manufacturers. Federation, the manufacturers eventually amended the label. Canned tuna fillets in oil were also incorrectly labelled as they were described as "Tuna with Oil and Salt". According to the Labelling of Food Order, the oil should be defined as "Edible Oil". The manufacturers agreed to amend the label when ordering further supplies. The order of disclosure of the ingredients on the labels of a smoked rainbow trout savoury and a lobster mayonnaise implied that the fat present was essentially milk or butter fat, whereas with the smoked rainbow trout not more than three quarters of the fat was butter fat, and with the lobster mayonnaise only about one third of the fat was butter fat. It was also noticed that the label on the lobster mayonnaise was incorrect as the ingredients were given in two parts on separate corners of the label. The manufacturers are redesigning their labels. A cream of leek soup powder contained only 11.7 per cent of fat equivalent to 0.97 per cent of fat on the made up soup. A product sold as "Vegetable Oil for Cooking and Salad purposes" was found to consist of rape oil. Rape Oil is used to a large extent in India as an edible oil, but it is not generally considered suitable for use as a salad oil here. As it was a single oil and not a constituent of some 63 other food, the description must be that of the oil, i.e. rapeseed oil. As it was not so labelled it contravened the Labelling of Food Order,, As, however, only a small quantity of the oil had been imported and had proved an unsatisfactory line. the importer was taking no further supplies. The retailer agreed to remove from sale the remainder of his stock. A sample of mayonnaise sauce was considered to be incorrectly labelled as it contained more acid than should be present in a mayonnaise sauce. After discussion the manufacturers agreed to amend their label. The label of a tomato sauce listed the ingredients used in the wrong order,, The labelling of Food Order requires ingredients present in the largest quantity to be named first, and tomato puree was present in much larger quantity than butter fat, of which there was only a minute quantity. A can of granadillas contained a large number of completely inedible seeds, and was therefore reported as inferior. Granadilla fruit is in some ways similar to Pomegranates, and nobody in this country would wish to drink pomegranate juice full of its seeds. The packers claimed that the seeds were edible and were an integral part of the fruit and had been found to be acceptable to those who know this tropical fruit. They wrote that if they heard of any criticisms in England they would have to consider a special pack for the British housewife, but they did not consider this possible. A sample submitted as canned gooseberries consisted of cape gooseberries. The label of the can was ambiguous as it described the fruit on one panel as "Standard Golden Berries" and on another as "Finest South African Selected Gooseberries". The packers agreed to amend the label to "Cape Gooseberries". Some fresh lemon juice was found to contain only 6.0 milligrammes per 100 millilitres of ascorbic acid, whereas fresh lemons normally contain about 40 milligrammes of ascorbic acid per 100 millilitres. The best canned or bottled lemon juice usually contains between half and the full quantity of ascorbic acid. Two samples of drinking chocolate powder bore identical labels except that one bore the disclosure "Pure Cocoas and Sugar" and the other "Sugar and Pure Cocoas". One sample contained 57 per cent and the other 71 per cent of castor sugar. When made up according to the directions the drinks were insipid, The quantities of sugar were excessive and the sugar in drinking chocolate should, moreover, be icing sugar and not castor sugar, A home made lemon curd contained only 48.3 per cent of soluble solids whereas the Food Standards (Preserves) Order requires this figure to be not less than 65 per cent. The curd had crystallised where it had come into contact with the cellophane cover and the product was generally unsatisfactory. This was a typical case where it is unwise to try to manufacture in a home 64 kitchen food which is for sale to the public in general.instant chocolate icing was a very satisfactory product, but contained 252 parts per million of benzoic acid in contravention of the Preservatives Regulations. The importers reported that only a small quantity had been brought into the country and under the circumstances they would not import any more. A sample of Devon clotted cream toffee contained 11.3 per cent of total fat of which not more than 4 per consisted of butter fat. The label on the box showed the words "clotted cream" in the same sized print as "Toffee", and bore a large illustration of a bowlful of clotted cream, repeating underneath in large print the words "Containing real Devonshire Clotted Cream". These words were repeated on the side panel of the carton and created an ensemble which was misleading. A representative of the manufacturers came to sea your analyst to discuss the matter, and promised to consider the technical problems involved with his Board of Directors and Staff. Some glycerine and blackcurrant pastilles contained not more than 3.5 per cent of glycerine and not more than 10 per cent of fruit juice, but were advertised to be "Made from Glycerine and Blackcurrants". This was considered by your analyst to be misleading,, The expression "made from" implies that the pastilles are only a portion which has been extracted from glycerine and blackcurrants, Glycerine is made from vegetable or animal fat of which it is a portion but it would be illogical to say that vegetable or animal fats are made from glycerine. The label of a cough syrup called "Cherry Bark Cough Syrup" was considered to be misleading, as also was the colour of the syrup. The cherry type colour of this preparation was obtained by the use of an artificial dy. Cherry Bark Syrup on the other hand is more or less colourless and the quantity of this present in the sample was insignificant,, The preparation really contained as its active ingredient 0.38 per cent of liquid ipecacuanha and 0.75 per cent of liquid extract of squill, disclosed only in very small print. If a full dose, that is two teaspoonsful, were to be taken patients would obtain 8 per cent of the maximum dose or 32 per cent of the minimum dose of wild cherry. Without realising it they would also take the full -minimum dose of liquid extract of ipecacuanha and twice the minimum dose of extract of squill without realising it. A meeting between the manufacturers and your analyst was arranged but has not yet taken place. An expectorant linctus had been satisfactorily prepared but disclosed "Invert Syrup" as an ingredient. There is no official invert syrup and therefore its composition must be declared. The manufacturers explained that the product had appeared on the home market in exceptional circumstances which were unlikely to recur. Some glucose tablets were labelled in such a manner as to imply the presence of vitamins when none were present and were considered to have a misleading label. The manufacturers stated that they would print on the label the words "Contains no Vitamins" but as this did not settle the matter 65 the manufacturers finally agreed to meet the wishes of your analyst. Legislation and Official Reports. The amount of fresh legislation and the number of official reports issued has again shown a decrease during the year. The Public Analysts Regulations have been re-issued in order to provide a new form of certificate to meet conditions resulting from the Food and Drugs Act, 1955. With the new Act it may be necessary for a public analysts if he is unable to carry out the whole of the work required. to pass a sample to the public analyst for some other area for examination.) This revised certificate provides at the same time for those cases where adverse comment may be mad# on a label, advertisement, or other matter, which may or may not be dependent on chemical analysis, but on which the public analyst is the most competent authority. The Colouring Matter in Food Regulations came into force in 1957 and revoked that part of the Preservatives, etc,, in Food Regulations relating to the addition of colours to foods, Although the regulations came into force on the 30th June, 1957, they do not come into effective operation in the current year as regards sale of food by retail. This was essential if a smooth flow from the manufacturer of food colours to the retail sale of foods was to be obtainedo The order therefore stipulated that the manufacturer of food colours or compounds for colouring and flavouring must comply with the order by the 30th September, 1957, whereas in general it may be stated that food sold by retail must comply with the requirements of the order by the 30th June, 1958. For over thirty years the Preservatives, etc0, in Food Regulations have provided a short list of colours, whose addition to food was forbidden. Many colours have been found to be suspect of causing cancer, and the new order permits the use of thirty organic chemical dyes together with a few more or less natural ones, which have been used over many years. It is hardly necessary to state that this order imposes much more work on the analyst for its efficient administration. The Pre-Packed Foods (Weights and Measures 3 Marking) Regulations were made under Sectiors 7 and 123 of the Food and Drugs Act, but are administered by Weights and Measures Authorities only and not by other Food Authorities. When there is a matter of the content of a particular food, mixed with other ingredients, one would have thought it better to handle the matter via the food inspector and the public analyst. Your analyst had submitted to him a tin marked to contain a definite weight of smoke salmon, but in which more oil (undeclared) was present than salmon, the declared weight being that of the total ingredients of the tin, Whilst this matter can be handled in other ways, one would have thought that this order would have been the simplest one. The Food Standards Committee issued a Report on a Standard for Icecream. Essentially this report proposes to maintain the present standards for ice cream with the prohibition of the use of saccharin and other artificial sweeteners, except in the case of ice cream made for diabetics, which could be suitably labelled. The Committee recommend, however, that 66 provision should be made for "dairy ice cream" of which the fat should be entirely milk fat, and "milk ice" made on the basis of the old fashioned hokey-pokey, which is essentially a custard-type ice with a milk fat content of not less than 2.5 per cent. The Food Standards Committee also issued a revised report on Fluorine, The previous report was issued in 1947 following the discovery of very large quantities of fluorine in phosphates used in baking powders resulting from the emergency conditions caused by the war. These circumstances have how disappeared and it is proposed to restrict drastically the quantities of fluorine permitted in acidic phosphates used for foods, in baking powders, and in flour products containing such phosphates. There is, however, a considerable delay between the issue of Reports by the Food Standards Committee and ensuing legislation,. Thus the following Reports have appeared:- Report on Antioxidants. The revised report appeared in 1954, but no legislation has followed so far. Now that the Colouring Matter in Food Order has removed colours from the orbit of the Public Health (Preservatives, etc. in Food) Regulations, the time is ripe for a fresh order. Second Report on Processed Cheese and Cheese Spread. This revised report appeared in 1956. Legislation is also required to control the descriptions of skimmed, partially skimmed, and so-called cream cheeses. Report on Emulsifying and Stabilising Agents. This report appeared in 1956. Reports have been issued on Arsenic (Revised Report, 1955), Copper (1956), Lead (Revised Report, 1954), Tin (1952), and Zinc (1954), but no further action has ensued although it is believed that an Order controlling the quantity of arsenic in food may not be long delayed. Looking to the future, Public Analysts are deeply concerned by the need to safeguard the public against the effects of radioactivity. The recent incident at Windscale brought the matter into prominence, but even before that a good deal of preliminary work had been done by Public Analysts. The task of monitoring pastures, crops, etc., in the vicinity of atomic installations is vested in the Ministry of Agriculture by the Atomic Energy Act, but the ultimate responsibility for the protection of the public must rest on the Public Analyst. Many foods are imported from abroad, from regions which may be affected by the "fall-out" from test explosions, or canned fish may come from seas into which radioactive effluents flow. Fish may concentrate radioactive elements up to two million times the amount in the sea water in which they live. As the complexity of the work has increased so has the equipment of the analyst's laboratory. The crude adulteration of the earlier years demanded only the simplest equipment, but the tasks of today require the use of complex physical instruments such as absorptioaseters, flame photometers, polarographs, etc. Without these instruments the determination of many essential factors, such as vitamins, would be impossible. - 67 As an example, your analyst has recently purchased a spectrophotometer which, with the ancillary equipment, cost over £850. Not many years ago a large laboratory could have been equipped for such a sum. The use of such equipments moreover, requires highly skilled staff. who are difficult to obtain when the demand for scientists exceeds the supply, and more lucrative fields are open to them. How the situation can best be handled is difficult to foresee, but it is one to which considerable thought must be given in the near future. I am, Mr, Mayor, My Lord, Ladies and Gentlemen, Your obedient Servant, THOMAS McLACLHUN, A.C.G.F.C., F.R.I.C.M.I.Biol. Public Analyst. 68 Taken Informally Total Analysed Adulterated etc. Baby Cereals 1 1 0 Batter Mix 1 1 0 Beef Aspic Jelly 1 1 0 Biscuits 4 4 0 Bread, continental 1 1 0 Cheese 9 9 2 Breakfast & Similar Foods 1 1 0 Chicken Galantine 1 1 0 Chicken, minced 1 1 0 Chocolate Beverage 4 4 2 Coffee Extract 2 2 0 Confectionery 10 10 2 Cream 3 3 0 Cream, soured 1 1 0 Cream, synthetic 1 1 0 Dessert Powder 1 1 0 Fish, bottled 2 2 2 Fish, canned 4 4 1 Fish Paste 1 1 1 Fruit, canned 3 3 2 Fruit, dried apricots 1 1 0 Fruit Juice 5 5 1 Fruit, pickled cranberries 1 1 0 Fruit Syrup 1 1 0 Fruit salad, diabetic 1 1 0 Gelatine 1 1 0 Glucose 1 1 0 Gravy Powder 1 1 0 Herbs 2 2 0 Honey 1 1 0 Horseradish cream 1 1 0 Horseradish, ground 1 1 0 Ice Cream 8 8 0 Ice Cream Mix 1 1 0 Icing Chocolate 1 1 1 Icing Fondant 1 1 0 Jam 66 0 Jelly with fruit 1 1 0 Jelly piping 1 1 0 Lemon curd 1 1 1 Marmalade 3 3 0 Marsipan 1 1 0 Meat Balls 1 1 0 Meat, canned 8 8 4 Meat Paste 1 1 0 Meat Pie 2 2 0 Milk 203 203 0 Carried forward 308 308 19 69 Taken Informally Total Analysed Adulterated, etc. Brought forward 308 308 19 Milk, condensed 2 2 0 Milk shake 1 1 0 Mincemeat 1 1 0 Mushrooms canned 1 1 0 Noodles with meat 1 1 0 Pate de Foie 2 2 0 Peels, mixed cut 1 1 0 Pickles 2 2 0 Pulses, dried peas 1 1 0 Puree , Blackcurrant 1 1 0 Puree, Spinach 1 1 0 Pudding, Xmas 1 1 0 Rice Pudding, canned 1 1 0 Salad Dressing 1 1 0 Sauce 6 6 2 Sausages 2 2 1 Sausage Rolls 1 1 0 Shortening 1 1 0 Sodium Bicarbonate 1 1 0 Soft Drinks 2 2 0 Soup, canned 2 2 1 Soup, Powder 14 14 0 Soup and vomit 1 1 0 Soup Tablet 2 2 0 Spices 7 7 0 Spread savoury and cheese 8 8 1 Sugar, Demerara 1 1 0 Tea 1 1 0 Tomatoes, canned 2 2 0 Tomato puree 1 1 0 Turkey, minced 2 2 0 Vanilla pods 1 1 0 Vegetables, canned 8 8 0 Vegetable Oil 1 1 1 Vinegar 1 1 0 Vinegar, wine 1 1 0 DRUGS: Adrenalin Cream 1 1 0 Cough Mixture 1 1 0 Cough Syrup 2 2 1 Epsom Salts 1 1 0 Expectorant Linctus 1 1 1 Glucose Tablets 1 1 1 Nerve Tablets 1 1 0 Rheumatism Tablets 1 1 0 TOTALS 400 400 28 INDEX Subject. Page (s) Aged and Infirm Persons, Welfare of 21 & 22 Analyst, Public - Report of 61- 69 Atmospheric Pollution 47 & 48 Bacteriological Examinations 39 & 60 Births 6 & 7 Child Welfare 17 & 18 Committee, Public Health & Baths: Members 1 Representation elsewhere by Members 2 Cremation Service 25 Deaths 6 - 12 Diphtheria Immunisation 18 Disinfection and Disinfestation 46 Factories 33 - 37 Food: Adulterated 61 - 69 Poisoning 54 Premises, Inspection and Supervision of 40 & 41 Unsound 45 Health Visiting 17 Hospitals 16 Housing 32 - 34 Ice Cream 39 Infant Mortality 6 & 7 13 & 14 Infectious Disease 50 - 60 Introduction 4 & 5 Iegal Proceedings 38 Mass Radiography 23 Maternity and Child Welfare Services 17 & 18 Maternal Mortality 6 & 7 Medical Examinations 23 Meteorology 24 Milk 42 Mortuary, Public 23 National Assistance Act, 1948: Burial 15 "Part III" Accommodation 19 Nursing Home 16 Subject. Page (s) Outworkers 37 Overcrowding 32 & 34 "Part III" Accommodation 19 Pet Animals Act, 1952 43 Poisons, Sale of 43 Population 6 & 7 Public Analyst, Report of 61 - 69 Public Health Inspectors, Work of 26 - 49 Radiography (Mass) 23 Rag Flock & Other Filling Materials Act, 1951 43 Rent Ac t, 1957 49 Rodent Control 44 Shops Act, 1950 33 Spastic Children 20 Staff of Public Health Department 3 Statistics, Vital 6 Stillbirths 6 Tuberculosis 6 57 - 59 Underground Rooms 32 Vaccination 18 Water Supply 34 Welfare Centre, Attendances at 17 Welfare of Aged and Infirm Persons 21 & 22 Zymotic Disease 55