AC 4345 2. LIBRARY CHE 56 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 1958 68860 -1 - METROPOLITAN BOROUGH OF CHELSEA PUBLIC HEALTH AND BATHS COMMITTEE (at 31st December 1958.) Chairman: Councillor Tatton-Brown, J.S. Vice-Chairman: Councillor Paterson-Morgan, J.A. Alderman Shufeldt, Miss M.D. Councillor Gibbings, Miss Aimee. Councillor Birdwood, Vere Lady " Gough, A.E., T.D., " Budgett, F.G.P. " Hannay, J., M.Ch.S. " Buxton, Mrs. G.K. " Lyall, Miss M., M.B.E. " Cadogan, Lt.Col.The " Samuels, J.S. Rt. Hon. Earl, M.C.,D.L. " Wills, Dr. L. " Croslegh, M.C. " Woolford, J.E. Ex-Officio Members His Worship the Mayor (Alderman Basil Marsden-Smedley, O.B.E.,J.P.) The Deputy Mayor (Councillor A.J. Sims) - 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 1958.) Chelsea Association for Councillor Mrs. G.K. Buxton Moral Welfare Works: Chelsea Tuberculosis Councillor Mrs. G.K. Buxton Care Committee: Councillor Miss M. Lyall Chelsea Youth Committee: Councillor J.E. Woolford Family Welfare Association: Councillor Miss M. Lyall Invalid Children's Aid Councillor Miss M. Lyall Associations London County Council Councillor Mrs. G.K. Buxton Divisional Health Councillor Miss M. Lyall Committee (Division I): London County Council Councillor Mrs. G.K. Buxton Tuberculosis Care Committee (Division I): London and Home Counties Councillor J. Hannay Clean Air Advisory Council: National Society for Clean Councillor J. Hannay Airs: Councillor Miss M. Lyall Old People's Welfare Councillor J.S. Tatton-Brown Committee: Councillor J.A. Paterson-Morgan Third Feathers Club Committee: Councillor M.C. Croslegh Westminster and Chelsea Councillor Miss M. Lyall District Nursing Associations - 3 - STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December. 1958. Medical Officer of Health: J.H. WEIR, M.D.,B.S.,B.Hy.,D.P.H. Deputy Medical Officer of Health: Hastings E.A. CARSON, M.D.,M.B.,B.S., D.P.H. Chief Public Health Inspector? H. HOYLAND. Deputy Chief Public Health Inspector and Senior Housing Inspector: S. W. BARKER. Public Health Inspectors: H.F. LEACOCK, H.W. LUDLOW, A.J. WHITE, E.R. YOUNG. Women Public Health Inspectors: (Miss)A.C.C. KAY, (Miss) G.K. READER. Drainage Assistant: E. BOSLEY. Rodent Officers: J.F. COOKE, P. DRURY Public Health Inspectors' Assistant: F.G. RAWLINGSON. Chief Disinfector: L.H. BERRY. Disinfectors: F.W. HILL, R.J. WESTON. Cleansing Station Attendant: (Mrs.) J. LOBBAN. Chief Clerk: J.C. BRYANT. Clerical Officers: I.M. THOMSON, H.G. HAMILTON, L.A. POWELL, (Mrs.) W. BAAR, R.H. LITCHFIELD, P.M. MARGETTS. Social Worker: (Mrs.) O.M. BURKE. Public Analyst: Thos. McLACHLAN, A.C.G.F.C.,F.R.I.C. - 4 - METROPOLITAN BOROUGH OF CHELSEA. Public Health Department, Town Hall, TELEPHONE : King' s Road, FLAxman 8101 CHELSEA, S.W.3. June, 1959. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Your Worship, Ladies and Gentlemen, I have much pleasure in submitting my annual report on the health of the Borough of the year 1958. The mid-year population of Chelsea was estimated by the Registrar General to be 50,190, an aggregate which showed a decline of 410 as compared with 1957 when the figures were 50,600. Since 1950 the population has, generally speaking, decreased, and is now 2,300 below the estimated numbers for that particular year. The total number of live births registered was 742, and is a little in excess of the return for 1957 (738). The birth rate was 14.8 per 1,000 of the estimated population, which after the application of the "area comparability figure" gave a rate of 11.2. The number of deaths recorded in the year totalled 730, and is twenty below the figures for 1957 (750). The current death rate is 14.5 per 1,000 of the population, or when the "area comparability factor" is employed - 10.4. The use of "Area Comparability Factors" was adopted by the Registrar General because it is not possible for the populations of all areas to be similarly constituted as regards the proportions of their sex and age groups. Were this so, their crude death rates, (i.e. deaths per 1,000 of population) would be acceptable as valid comparative measures of the mortalities experienced by their populations. Such differences are well illustrated by (a) Chelsea with its large proportion of residents aged 65 years and over (74 per cent. of all deaths in 1958 occurred in this particular group) and (b) "new" towns which are mainly populated by persons of the lower age groups. To obtain the adjusted rates so far as Chelsea is concerned it is necessary to multiply the crude birth rate by 0.76 and crude death rate by 0.72. It is pleasing to record that no deaths have been recorded for four consecutive years as having been attributable to accidents or diseases associated with pregnancy or childbirth. Infant Mortality, however, showed an increase (24) as compared with 1957 (16). Further details will be found on page 14. Infectious Diseases notifications totalled 445, a fall of two hundred and thirty-seven as against six hundred and eighty-two received in 1957. This was mainly accounted for by the marked decrease of Measles cases which were 53 per cent of the previous year's return. - 5 - Whilst the figures concerning Food Poisoning were small, a more satisfactory picture emerges when comparing notifications received over the past 3 years : 1956 33 1957 13 1958 7 The Clean Air Act, 1956, is now fully in operation, and at the end of the year the declaration of a Smoke Control Area in the Church Ward was proposed, work in connection of which would be commenced early in the coming Spring. The Public Health Inspectors continued zealously to seek improvements in premises which are subject to the requirements of the Food Hygiene Regulations, and although much remains to be done, there is little doubt but that conditions in the catering trade are, with the co-operation of traders, beginning to evince signs of the constantly applied education in this sphere. During 1958, Mr. T. McLachlan, Analyst to the Council, carried out the examination of four hundred samples of Food and Drugs, and in twenty-one instances (5.2%) he reported the existence of adulteration, labelling inaccuracies, or misdescriptions. It was only necessary to resort to legal proceedings in one case, when the traders concerned were fined £10. 0s. 0d., with the imposition of £8. 8s. 0d. costs. With regard to three other cases upon which the Public Health Committee's instructions were sought, it was decided that circumstances did not call for the institution of legal proceedings. At the same time, however, the traders concerned were advised that a repetition of the offences would undoubtedly lead to more drastic action on the part of the Council. I am glad to have the opportunity of expressing my appreciation of the courtesy and support shown to me by the Chairman of the Public Health and Baths Committee and other members of the Council. The continued and friendly co-operation of all Chief Officers is a matter of much satisfaction, whilst I have to thank the members of my Department for their enthusiasm in carrying out their varied duties. I am, Madam Mayor, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health - 6 - METROPOLITAN BOROUGH OF CHELSEA ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1958 AREA OF THE BOROUGH; 659.6 acres GENERAL RATE: 17s. 4d in the £ (At 31st March, 1958) PRODUCT OF A PENNY RATE (GROSS) £7,386 RATEABLE VALUE OF BOROUGH AS AT 31st MARCH. 1958: £1,865,981 POPULATION: Registrar-General's estimate of the population of the Borough (mid-year 1958) 50,190 Density of population per acres 76.09 LIVE BIRTHS: Total M. F. Legitimate 644 337 307 Birth rate per 1,000 Illegitimate 98 50 48 of estimated 742 387 355 population 14.8 Adjustment of birth rate by area comparability factor 11.2 Birth rate for England and Wales - 16.4 STILL BIRTHS: Total M. F. Legitimate 16 10 6 Rate per ly000 Live Illegitimate 21 1 1 and Still Births 23.7 18 11 7 MATERNAL MORTALITY: No deaths associated with pregnancy or childbirth have occurred among Chelsea residents since 1954. DEATHS: Total M. F. 730 322 408 Death rate per 1,000 of estimated population 14.5 (Males 6.4: Females 8.1) Adjustment of death rate by area comparability factor 10.4 Death rate for England and Vales 11.7 - 7 - ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1958 (Continued) DEATHS AND DEATH RATES OF INFANTS UNDER ONE YEAR OF AGE : Total M. F. 24 15 9 All infants per 1,000 live births 32.3 Legitimate infants per 1,000 legitimate live births 31.1 Illegitimate infants per 1,000 illegitimate live births 40.8 DEATHS OF INFANTS UNDER FOUR WEEKS OF AGE : Total M. F. 20 15 5 Death rate of infants under four weeks of age per 1,000 live births 26.9 TUBERCULOSIS: Deaths from Pulmonary Tuberculosis 4 Deaths from Non-Pulmonary Tuberculosis 1 Death rate from Pulmonary Tuberculosis per 10.000 of estimad population 0.8 Death rate from Non-Pulmonary Tuberculosis per 10.000 of estimated population 0.2 - 7A- It will be seen that the illegitimate births number 98, representing 13.2% of the total live births registered. These may be compared with the statistics for London Administrative County and England and Wales, which are as follows:- Chelsea London England & Wales (in thousands) Year Births Illeg. % Births Illeg. % Births Illeg. % 1950 829 57 6.875 53,660 3752 7.0 697 35 5.1 1951 819 53 6.475 52,387 3597 6.9 677 32 4.8 1952 787 72 9.1 51,443 3607 7.0 673 32 4.8 1953 787 61 7.75 50,992 3645 7.1 684 32 4.7 1954 787 78 9.9 50,745 3615 7.1 673 31 4.7 1955 745 71 9.5 49,826 3827 7.7 667 31 4.7 1956 837 99 11.8 52,171 4434 8.5 700 33 5.0 1957 738 105 14.3 52,733 4686 8.9 723 34 4.7 1958 742 98 13.2 Not yet available A point of explanation is necessary in connection with the mortality rate among illegitimate infants. This is 40.8, and compares as follows with the rates for London Administrative County and England and Wales:- Chelsea London England & Wales Year I.M.R. Leg. M.R. Illg. M.R. I.M.R. Leg. M.R. Illg. M.R. I.M.R. Leg. M.R. Illg. M.R. 1950 25.3 23.3 52.6 25.75 24.81 38.33 29.6 29.1 39.4 1951 23.2 23.5 19.0 25.45 24.74 35.03 29.7 29.2 38.5 1952 20.3 16.8 55.5 23.06 22.30 33.27 27.6 27.2 34.9 1953 19.1 12.4 98.3 23.90 22.96 36.25 26.8 26.5 33.0 1954 26.6 22.6 64.1 20.63 19.86 30.71 25.4 25.1 32.0 1955 33.5 31.1 56.3 23.22 21.96 38.41 24.9 24.6 31.7 1956 25.1 23.0 40.4 21.20 20.89 24.58 23.7 23.5 28.7 1957 21.7 23.7 9.5 22.00 21.04 31.80 23.1 22.8 30.0 1958 32.3 31.1 40.8 Not yet available So far as Chelsea is concerned, the marked fluctuation in figures is related to the low numbers involved, which inevitably produce wide statistical variations. Regard must also be had to the unpredictable movements of these infants, many of whom are removed to areas outside Chelsea during the first year of life. - 8 - SUMMARY OF VITAL STATISTICS 1947 - 1958 (inclusive) Year Registrar-General's Estimate of Population BIRTHS DEATHS DEATHS UNDER ONE YEAR 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 11.1 23 26 - - 1950 52,490 829 15.8 638 12.2 21 25 - - 1951 52,430 819 15.6 686 13.1 19 23 - - 1952 52,140 787 15.1 669 12.8 16 20 - - 1953 52,150 787 15.1 694 13.3 15 19 3 3.7 1954 52,060 787 15.1 734 14.1 21 27 2 2.5 1955 51,450 745 14.5 825 16.0 25 34 - - 1956 51,070 837 16.4 815 16.0 21 25 - - 1957 50,600 738 14.6 750 14.8 16 22 - - 1958 50,190 742 14.8 730 14.5 24 32 - - Averages for the twelve years 1947-1958:- Births 808 Deaths 695 Deaths under one year of age 23 Maternal Deaths 0.51 + Totals arrived at after due allowance for inward and outward transfers. 9 DEATHS OF RESIDENTS DURING 1958. 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 4 — — — — 1 2 1 2. Tuberculosis , other 1 — — — — — 1 — 3. Syphilitic disease 2 — — — — — — 2 4. Diphtheria — — — — — — — — 5. Whooping Cough — — — — — — — — 6. Meningococcal Infections — — — — — — — — 7. Poliomyelitis, acute — — — — — — — — 8. Measles 1 — 1 — — — — — 9. Infective and parasitic diseases 2 1 — — 1 — — — 10. Malignant neoplasm, stomach 21 — — — — 1 6 14 11. Malignant neoplasm, lung, bronchus 28 — — — — 3 7 18 12. Malignant neoplasm, breast 18 — — — — 2 6 10 13. Malignant neoplasm, uterus 3 — — — — 1 2 — 14. Malignant and lymphatic neoplasms, other 66 — — — — 2 18 46 15. Leukaemia, aleukaemia 2 — — 1 — — — 1 16. Diabetes 7 — — — — — 2 5 17. Vascular lesions of nervous system 98 — — — — — 10 88 18. Coronary disease, angina 89 — — — — 2 17 70 19. Hypertension with heart disease 15 — — — — — — 15 20. Heart disease, other 92 — — — — 3 4 85 21. Circulatory disease, other 50 — — — — — 7 43 22. Influenza 7 — — — — — 1 6 23. Pneumonia 37 1 — — — — 8 28 24. Bronchitis 47 — — — — — 5 42 Carried forward 590 2 1 1 1 15 96 474 10 DEATHS OF RESIDENTS DURING 1958 (Continued) 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 Brought forward 590 2 1 1 1 15 96 474 25. Respiratory system, other disease of 6 — — — — — 1 5 26. Ulcer of stomach and duodenum 7 — — — — — 1 6 27. Gastritis,enteritis and diarrhoea 3 — — — — — — 3 28. Nephritis and nephrosis 3 — — — — — 1 2 29. Hyperhplasia of prostate 3 — — — — — — 3 30. Pregnancy, childbirth, abortion — — — — — — — — 31. Congenital malformations 7 3 1 — 2 — — 1 32. Other defined and ill-defined diseases 73 18 — — 2 2 15 36 33. Motor vehicle accidents 6 — — — 2 1 1 2 34. All other accidents 16 1 1 — — 3 1 10 35. Suicide 16 — — — 1 4 9 2 36. Homicide — — — — — — — — TOTALS 730 24 3 1 3 25 125 544 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 1958 730 24 3.28 544 74.52 11 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 shown on the preceding pages. Coding Percentage 1954 1955 1956 1957 1958 Average for five years (1) 1.23 0.97 0.12 0.27 0.55 0.63 (2) - 0.12 - - 0.14 0.51 (3) 0.14 0.48 0.49 0.40 0.27 0.36 (4) - - - - - - (5) - - - - - - (6) - - - 0.13 - 0.03 (7) - 0.24 - - - 0.05 (8) - - - 0.13 0.14 0.05 (9) 0.60 0.36 0.12 0.40 0.27 0.35 (10 ) 3.00 1.94 2.21 2.27 2.88 2.46 (11) 3.70 3.51 3.81 2.93 3.84 3.56 (12) 1.40 1.57 2.60 1.73 2.46 1.95 (13) 0.82 0.61 0.86 1.07 0.41 0.75 (14) 10.00 10.93 9.96 9.07 9.04 9.80 (15) 0.41 0.36 0.61 0.40 0.28 0.41 (16) 1.10 0.97 0.73 0.27 0.96 0.81 (17) 13.00 11.88 13.41 14.52 13.42 13.25 (18) 12.12 11.64 10.60 9.73 12.20 11.24 (19) 3.54 1.94 2.21 2.80 2.05 2.51 (20) 11.20 12.73 14.51 15.20 12.60 13.25 (21) 8.30 10.10 8.36 10.13 6.85 8.75 (22) - 0.24 - 0.93 0.96 0.43 (23) 5.70 6.42 7.75 7.20 5.07 6.43 (24) 4.40 4.61 4.80 4.93 6.44 5.04 (25) 0.82 0.40 1.23 0.80 0.82 0.81 (26) 0.70 1.60 1.35 1.07 0.96 1.14 (27) 0.41 0.73 - 0.53 0.41 0.42 (28) 1.09 0.97 0.37 0.70 0.41 0.71 (29) 0.82 0.40 0.61 0.40 0.41 0.53 (30) 0.30 - - - - 0.06 (31) 0.54 0.73 0.86 0.80 0.96 0.78 (32) 8.04 8.85 9.47 6.80 10.00 8.63 (33) 1.60 1.21 0.61 0.93 0.82 1.04 (34) 3.40 2.30 1.48 1.87 2.19 2.25 (35) 1.23 1.21 0.86 1.50 2.19 1.39 (36) 0.14 - 0.24 0.13 - 0.10 12 CANCER OF THE LUNG AND BRONCHUS Twenty-eight deaths (Males 22 and Females 6) from this cause were recorded as compared with twenty-two (Males 16 and Females 6) in 1957. The following table briefly gives details of the deaths of Chelsea residents during the years 1950 to 1958 (inclusive):- Year Males Females Totals Percentage of deaths registered 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 1958 22 6 28 4.0 Totals 181 47 228 31.5 Averages 20.1 5.2 25.3 3.9 Over the period shown above 79.4% of the deaths were in respect of males, whilst 20.6% concerned females, i.e. 4 males to 1 female. However the real significance of the increase for the country as a whole can be properly gauged from the following summary of deaths during each year from 1950 until the present times:- Year England and Wales Cancer of the Lung and Bronchus Number of deaths registered Increase over preceding year 1950 12,241 1,266 1951 13,247 1,006 1952 14,218 971 1953 15,132 914 1954 16,331 1,119 1955 17,271 940 1956 18,185 914 1957 19,118 933 1958 19,809 691 Despite evidence submitted by the Medical Research Council to the Ministry of Health and their acceptance thereof, it seems obvious that health education has not made the desired impact on the minds of the 13 populace, and until a realisation of the dangers attendant upon heavy cigarette smoking has led to a sense of health security there is no reason to expect that lung cancer will decrease., It must also be appreciated that nowadays the expectation of life is lengthening, and therefore people who a few decades ago died whilst in middle-age groups now survive to become victims of a disease which is normally associated with advancing years. It would therefore be reasonable to believe that with the excessive cigarette smoking now the rule a long period of increased lung cancer mortality is to be expected. Even if constant warnings to the public were heeded in a very definite way, many years would have to elapse before abstention from smoking was reflected in death returns. 14 INFANT MORTALITY It will be seen that the number of deaths (24) under this heading has risen sharply as compared with 1957 when the total was 16. In 1956 the aggregate was 21. Of the deaths now under review, eighty-three per cent had not attained to an age of four weeks, and mortality was attributed to the following causes:- Males Females Asphyxia - 1 Atelectasis 1 1 Haemorrhage, Cerebral 1 - Malformations, Congenital 4 3 Prematurity 7 2 Pneumonia 1 2 Septicaemia 1 - During the ten years 1925 to 1934, 465 infants under the age of one year died, thus giving an annual average of 46.5 for that period. In the years 1949 to 1958, deaths aggregated 201, or an annual average of 20.1. It will be observed that the number of deaths under this particular heading increased as compared with 1957, due mainly to the incidence of prematurity which was returned as nine as against five in the previous year. It will be noted that almost 71 per cent. of total deaths recorded occurred before the age of one week. It must also be borne in mind that the numbers of deaths in this connection appear to present unrealistic rates. The actual periods at which mortality was recorded are as follows:- Under 1 week Under 4 weeks 4 weeks to 3 months 3 to 6 months 6 to 12 months Total under 1 year Males 12 3 - - - 15 Females 5 - 1 2 1 9 17 3 1 2 1 24 15 INFANT MORTALITY RATES - ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year of age per 1,000 live births. Country 1951 1952 1953 1954 1955 1956 1957 Average for 7 years ENGLAND & WALES 30 28 27 25 35 24 23 27.4 SWEDEN 21 20 19 19 17 17 17 18.6 NEW ZEALAND 23 22 20 22 22 19 20 21.1 NETHERLANDS 25 23 22 21 20 19 17 21.0 AUSTRALIA 25 24 23 22 22 22 21 22.7 DENMARK 29 29 27 27 25 25 23 26.4 UNITED STATES OF AMERICA 29 29 28 27 27 26 26 27.4 SCOTLAND 37 35 38 31 30 28 29 32.6 REPUBLIC OF EIRE 45 41 39 38 37 36 33 38.4 FRANCE 51 46 42 a 39 36 34 41.3 ITALY 67 64 59 53 49 48 50 55.7 The above table has been prepared from information made available by the Registrar-General. 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 Hospital, Fulham Road, S.W.3. Chest Diseases Chelsea Hospital for Women, Dovehouse Street, S.W.3. General Granard House, 98, Dovehouse Street, S.W.3. (Part of Royal Marsden Hospital) Malignant Disease Royal Marsden Hospital, Fulham Road, S.W.3. Malignant Disease Royal Hospital, Royal Hospital Road, S.W.3. Home for Pensioners St. Luke's Hospital, Sydney Street, S.W.3. Chronic Sick St. Stephen's Hospital, Fulham Road, S.W.3. General Victoria Hospital for Children, Tite Street, S.W.3. Children's Diseases NURSING HOMES Belgravia-Chelsea Nursing Home, 39, Royal Avenue, S.W.3. Private 17 MATERNITY. CHILD WELFARE AND OTHER SERVICES The London County Council is responsible for the day-to-day administration of these services, with the assistance of the Medical Officers of Health for the Boroughs of Chelsea, Fulham, Hammersmith and Kensington. Division 1 of the County Council comprises the above Boroughs, and Dr. B.E.A. Sharpe, Divisional Medical Officer, has kindly supplied the following information:- WELFARE CENTRES Attendances at Ante-natal and Post-natal Sessions 1,505 Attendances at Infant Welfare Sessions 7,063 HEALTH VISITING Number of visits carried out by Health Visitors:- Expectant mothers: First Visits 328 Total Visits 756 Children under 1 year: First Visits (including visits paid to Premature Infants) 713 Total visits 2,523 Children between 1 and 2 years: Total visits 1,558 Children between 2 and 5 years: Total visits 2,257 Still Births: Total visits 16 School Children: Total visits 96 Care of Old People: Total visits 14 Care of other People: Total visits 21 Miscellaneous: Total visits 645 Unsuccessful: Total visits 1,443 No. of children under 5 visited during the year 1,657 No. of households visited during the year 1,341 Foster Mothers: Number of registered foster mothers 4 Number of children fostered 1 18 MATERNITY. CHILD WELFARE & OTHER SERVICES (Continued) Diphtheria Immunisation: Number of children who completed a primary course of injections 429 Number of children who completed reinforcing injections 431 Vaccination: Number of children vaccinated at Violet Melchett Infant Welfare Centre 370 Details of the facilities available at the Violet Melchett Infant Welfare Centre, Flood Street, S.W.3. are as follows:- CLINICS Ante-natal & Post-natal: Monday p.m. and Friday a.m. (by appointment) Relaxation & Ante-natal Exercises: Wednesday: 12 noon to 1 p.m. Friday: 2 p.m. to 3 p.m. Mothercraft Classes with Demonstrations & Films: Friday at 3 p.m. Infant Welfare: Tuesday & Thursday: 2 to 4 p.m. Wednesday: 10.30 a.m. to 12 noon at the Community Centre. 358, King's Road, S.W.10. Test Feeds arranged as required. Vaccination against Smallpox (from 2 months onwards) Wednesday at 10.30 a.m. by appointment. Immunisation against Diphtheria, Whooping Cough and Tetanus (from 3 months onwards) Tuesday at 10 a.m. Special Toddlers': By appointment on the first Thursday in each month. Dental Clinic (for children only) Monday 9.30 a.m. (by appointment) 19 MATERNITY. CHILD WELFARE & OTHER SERVICES (Continued) Health Visitors are available at the Centre for interview daily from 9 a.m. to 10.15 a.m. and from 4.30 p.m. to 5 p.m. and during these times may be contacted by telephone (FLAxman 8387) A Welfare Foods Department, whereat National Dried Milk, Orange Juice, and Cod Liver Oil may be obtained functions at the above Centre from 9.15 a.m. to 12.30 p.m. and 1.30 p.m. to 4.45 p.m. (Monday to Friday); 9.15 a.m. to 12 noon (Saturday) "PART III" ACCOMMODATION A local authority is required, under Section 21 of the National Assistance Act, 1948, to provide- (a) residential accommodation for persons who by reason of age, inifrmity or any other circumstances are in need of care and attention which is not available to them; and (b) temporary accommodation for persons who are in urgent need thereof, being need arising in circumstances which could not reasonably have been foreseen, or in such circumstances as the authority may in any particular case determine. One institution-"King's Mead", Dovehouse Street is maintained by the London County Council in the Borough as "Part III" accommodation, and they are, in this particular respect, "the local authority". It was considered essential to arrange for the reception of 22 persons in such accommodation during 1958, and in all cases admissions were made at "King's Mead". Recourse to legal action was, happily, only necessary in one instance to enforce removal as indicated in Section 47 of the Act, as amended by the National Assistance (Amendment) Act, 1951. However, in a number of cases, transfers were only effected after considerable persuasion. The London County Council assumes responsibility for the safe custody of the belongings of persons accommodated, thus removing any grounds for anxiety. Reasonable notice is always given to the County authorities of impending removals. 20 WELFARE OF OLD PEOPLE The proportion of elderly persons in the population is steadily growing, thus calling for greater efforts by local authorities and voluntary organisations for the provision of domiciliary services. In Chelsea, the Old People's Welfare Committee is keenly concerned with the fostering of services which, in many cases, elderly people consider should be in existence. The Committee also places much importance in the running of activities by those who are participants. This results in their gaining a sense of achievement which would most certainly not have been attainable a few decades back, when elderly people felt that they could only "look forward" to a condition of stagnation; nowadays it is realised that a happier and more active life may be enjoyed. The importance of regular visiting is fully realised, and much satisfaction is gained by recipients from the knowledge that they are not merely "on the books" of the local Old People's Welfare Committee. At the close of the year 1,111 persons were on the registers of the Public Health Department. The circumstances and conditions peculiar to each aged person are under constant investigation by the Council's Officers, and they have found that despite ill-health in many cases the old people are happy if they can remain at home, and at the same time be aware that every effort is being made to ensure their comfort. The Borough Council makes a grant of £450 yearly to the Chelsea Old People's Welfare Committee, which is representative of and coordinates the activities of voluntary organisations working in this sphere of public service. It is 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 13,474 meals were delivered, or an average weekly supply of 259. In 1957 the respective figures were 12,450 and 239. It. is quite certain that this service is greatly appreciated, as it is known that a high percentage of those now enjoying hot meals would consume what would be considered as "make do" meals. Chiropody. 137 persons were recommended for the service provided by two qualified chiropodists, and the number of treatments given totalled 483. This facility is in great demand, and there is a waiting list for treatment. Holidays. Pleasant holidays either at the sea or in the country were enjoyed by 74 persons. The majority stayed at homes controlled by the Women's Holiday Fund and others had a restful stay at the Lloyd Thomas Home of Rest, "Highgate. In the latter case, transport was provided to take them to and from their homes, and quite frequently escorts travelled to and from railway stations. 21 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, but the happy relationship between the Council's officers and hospital authorities brought about the admission of 105 men and women during the year. It is pleasing to record that the patient efforts of hospital rehabilitation departments have resulted in people returning to their homes ready to live normal lives again. Institutional care became necessary for 22 persons, most of whom settled down quite readily to a communal life. However, it must be stressed that a change of environment frequently entails considerable effort and tact. The Women's Voluntary Services and other kind donors have continued to dispense much needed clothing to recommended cases, and 266 persons were helped in this manner during the year as compared with 248 in 1957. Many people are found to be in enfeebled condition , and therefore unable to properly look after themselves. In such cases, personal cleansing is arranged. At the same time rooms are cleansed and superfluous items disposed of. The Council's Social Worker made 1,812 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 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. Christmas Dinners. Through the kindness of voluntary subscribers and a working committee, sufficient funds were secured to provide 500 housebound and lonely old folk with a three-course Xmas dinner, a miniature bottle of brandy, sweets, biscuits, and "a shilling for the gas". The entire distribution was carried out on Christmas Eve. A laundry service has been inaugurated by the Council with the valued co-operation of Fulham Borough Council. Soiled linen is collected twice weekly from the homes of incontinent 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 31 persons have so benefited, and some 6,604 pounds of bedding, etc., have been laundered. As a form of preventive medicine and to increase sociability amongst old people, Old Time Dancing Classes have been commenced and run 22 as a London County Council Dancing Class with the services of a fully qualified teacher and pianist supplied and paid for by the London County Council. Classes are held one afternoon a week and a fee of l/6d per term is paid by each old person who attends. This class commenced with the permitted minimum of 16 members, but in 18 months the membership has increased to 50, and all members say they feel great benefit from dancing. ACCIDENTS IN THE HOME Deaths attributable to such causes in England and Wales are now known to exceed 6,000 annually. Of this total, it is estimated that burns and scalds accounted for some 700 (or approximately 11.6/6 of the deaths recorded). Detailed information as to the number of non-fatal cases is not available, but it is reasonable to assume that not less than 50,000 persons present themselves for hospital treatment each year following accidents in their homes. The greater percentage of this suffering is undoubtedly due to the non-observance of elementary safety precautions, allied, to a certain extent, and where burns and scalds are occasioned, by inadequacies in the construction of certain types of goods on the market. Although this great wastage of life, and/or the permanent or temporary nature of handicaps which have to be contended with are constantly brought to the notice of the general public, it is regrettable to record that no diminution in the relevant figures established can be reported. Posters, leaflets, brochures, &c., are available from a variety of sources, including the Ministry of Health, the Royal Society for the Prevention of Accidents, the Central Council of Health Education, the National Baby Welfare Council, and the British Standards Institution, whilst the Borough Council prominently displays precautionary propaganda. 23 BOROUGH CREMATION SERVICE In October 1957, the Borough Council entered into an agreement with the General Cemetery Company whereby a reduced standard charge of four guineas would apply for each Chelsea resident in respect of whom cremation was carried out at the Kensal Green Crematorium, and in thirty-three instances the required arrangements were effected. It is apparent that national approval for cremation is steadily strengthening, due, to a certain extent, to the elimination of the understandable distress attendant upon interments as well as the indifferent weather conditions which frequently have to be contended with. A perusal of the following table will show that since 1951 the number of crematoria established in the country has more than doubled. In 1946, 50, 160 (8.9% of the total annual deaths) expressed a wish to be cremated, whilst the figures for 1958 were 180,075 and 30.6% respectively. 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 22.26 1955 82 141,353 579,907 24.37 1956 108 153,238 583,202 26.27 1957 117 163,358 575,946 28.36 1958 121 180,075 588,892 30.58 24 SPASTIC CHILDREN A non-resident treatment centre was established at 61, Cheyne Walk, Chelsea, in 1955 under the aegis of No. 4 (Chelsea) Group Hospital Management Committee, and during the past year it has continued to widen its experience, and at the same time expand. The Centre now takes cases whether adult or child, from many hospitals both inside and outside . the territory of the Regional Hospital Board for this area. The pattern of examination and investigation has remained much the same, though in addition to formal neurological and psychological assessment, audiometric and ophthalmological examinations are now being carried out on every case referred, and in most cases an orthopaedic opinion is also sought. Examinations have been made upon some two hundred and fifty cases, and the current number of children attending classes regularly is sixty-five, of whom thirty-eight attend daily either in the two classrooms or an assessment class. Inevitably a fairly high proportion of the children referred is unsuitable for admission because of age, distance, or mental defect, and, as might have been expected, the small Assessment Unit recently established to ascertain the special facilities for certain patients has tended to accumulate cases with such severe physical and mental disabilities that they are plainly ineducable. A nursery school which is recognised by the London County Council as a special school as well as a hospital school, has an upper age limit of seven. Expansion has taken place into the second floor of No. 61, Cheyne Walk, (the old Cheyne Hospital), so that the Centre now occupies half of this floor, the whole of the ground floor, its own classrooms in the garden, and the whole of No. 62, Cheyne Walk. A most valuable facility has been provided by the Friends of the Centre in No. 63, Cheyne Walk, now rebuilt, which now serves as a hostel for children who would otherwise live too far away to attend daily. These children are thus able to live in the hostel from Monday to Friday weekly. In addition, a mother and child from afar can be accommodated for several weeks while assessment is being carried out. This service is provided at relatively small cost to the parents, and is available to children from any county. 25 PUBLIC MORTUARY FACILITIES The Borough Council has not maintained premises of this nature for a considerable period, having entered into an agreement with Hammersmith Borough Council whereby excellent facilities are available at their Mortuary in Fulham Palace Road, W.6. During 1958, one hundred and fifteen post-mortems in respect of Chelsea residents were performed. MEDICAL EXAMINATIONS Seventy-four examinations of persons proposing to enter the Council's service, and who would be eligible to benefit from the authority's superannuation scheme, were completed. In only one instance was it necessary to reject an application for employment, whilst in three instances employees who had been working in a temporary capacity for some time, could not be accepted for superannuable service owing to the unsatisfactory assessments made at examinations. MASS RADIOGRAPHY Whilst the number of deaths from tuberculosis has fallen from 21,993 in 1948 to 4,449 in 1957, every need continues to be borne in campaigning against this scourge. It is not generally appreciated that on an average eighty-five deaths occur every week throughout the year from this particular disease, and much of the loss of life, or long illness and consequent suffering, would have been avoided if people had taken advantage of simple steps in the early stages of this disease. Facilities are readily available throughout the year from Monday to Friday in each week, except when public holidays occur, at Centres within easy reach of this area. It is also understood that a Mobile X-Ray Unit will be attending for approximately two weeks early in the Spring of 1959. Publicity will be directed to this facility in due course. 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. There is always the possibility that a member of a deceased person's family might be contacted, although searching enquiries have proved fruitless over a long period, only for him or her to express disapproval if cremation had been performed. During the year the assistance of the Borough Council was enlisted in three instances, and concerned three women aged 68, 76 and 85 years respectively. 26 METEOROLOGY-1958 Set out below are brief details of temperatures, rainfalls, and sunshine during the year, which are based upon recordings made at Kew Observatory and provided by the Director of the Meteorological Office. Quarter Daily Temperature of the Air Total Rainfall (inches) Total Sunshine (hours) Average of Highest Average of Lowest Average of Mean March 45.9 36.0 41.2 4.98 221.6 June 60.2 46.0 52.1 7.89 510.1 September 68.8 55.5 61.7 9.16 491.6 December 51.7 43.0 47.6 6.95 174.6 TOTALS: 28.98 1397.9 Rainfall and Sunshipe recorded during the June and September quarters of the past four 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 1958 June Quarter 7.89 510.1 September Quarter 9.16 17.05 491.6 1011.7 Recent summers have been noteworthy both for the excessive rainfalls and the below average hours of sunshine. Precipitation has been most marked in the last three September quarters. - 27 - SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF THE WORK PERFORMED BY THE PUBLIC HEALTH INSPECTORS DURING THE YEAR 1958. Number of complaints received during the year 763 INSPECTIONS AND RE-VISITS DWELLINGS: Inspections after complaints 3,092 Inspections after Infectious Diseases 652 House-to-House inspections 1,638 Underground Rooms 53 Overcrowding and "Permitted Numbers" 211 Other Visits 21 5,667 FOOD PREMISES : Butchers 281 Fishmongers and Fish Friers 29 General Provision Shops 64 Dairies 203 Ice Cream Vendors (Premises, Stalls, Vehicles) 210 Ice Cream Manufacturers 7 Bakehouses 99 Street Stalls and Barrows 70 Food Factories (Mechanical) other than Bakehouses 21 Hotels, Restaurants and Dining Rooms 935 Premises in connection with Unsound Food 154 Premises in connection with Food Sampling 132 Other Food Premises 40 2,245 FACTORIES AND OUTWORKERS: Factories other than Food Factories (Mechanical) 296 Factories other than Food Factories (Non-Mechanical) 72 Outworkers 14 382 DRAINAGE: Drains tested: (a) by water 674 (b) by smoke 70 (c) by air 146 890 Carried Forward 9,184 _ 28 - SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF THE WORK PERFORMED BY THE PUBLIC HEALTH INSPECTORS DURING THE YEAR 1958 Brought Forward 9,184 INSPECTIONS AND RE-VISITS (Continued) MISCELLANEOUS Animals, Poultry, and Birds 13 Open Spaces, and Highways 49 Office Premises 8 Marine Stores and Second-hand Dealers 3 Premises re Pharmacy and Poisons 51 Premises to enforce requirements of Shops Act 76 Premises re Voluntary Works 5,077 Visits to Owners, Agents and Builders Offices 258 Smoke Observations 238 Food Poisoning 13 Visits to aged and infirm persons 99 Premises under Pet Animals Act, 1951 11 Atmospheric Pollution Recording 175 Visits resulting in "No access" 1,103 Other visits 1,14.8 Clean Air 122 8,444 17,628 - 29 - 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 — — 50 — 5 — 16 26 97 Passages & Staircases: Walls & ceilings cleansed and redecorated — — 14 — — — 4 — 18 Yard & Area Walls cleansed and colour-washed — — 2 — — — — — 2 Verminous Rooms disinfested — _ 4 — — — — — 4 Rooms where Food is manufactured, stored or sold — — — — — — 26 10 36 Miscellaneous — — — — — — 1 — 1 GENERAL IMPROVEMENTS AND REPAIRS: Roofs — — 19 — 79 3 — — 101 Eaves, Gutters — — 7 — 11 — — — 18 Rain-water pipes 1 — 8 — 29 — — — 38 Yard and Area; — — — — — — Pavings — — 14 — 3 — — — 17 Walls rendered or repaired — 13 — 31 — — — 44 Rooms: Wall & Ceiling plaster 1 1 46 _ 173 — 5 226 Passages & Staircases: Wall & Ceiling plaster — — 16 — 40 — 1 — 57 Floors — — 8 — 43 — 7 — 58 Stair Treads, Banisters& Balustrades — — 10 — 33 1 44 Window and Door Frames, fittings and sash cords 2 — 102 — 261 — 1 — 366 Dampness remedied — — 36 — 312 — — — 348 Vertical damp proof course provided — — 4 — — — — — 4 Fireplaces & Fire-ranges repaired — — 19 — 37 — — 56 Washing Coppers repaired — — 1 — — — — — l Natural Ventilation provided or improved — — — — 1 — — 1 2 Chimneys and Flues — — 3 3 — _ — 6 Natural Lighting provided or improved — — 9 — — — _ — 9 Miscellaneous — — 3 — 52 — — — 55 Carried forward 4 1 388 — 1113 3 61 38 1608 - 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 4 1 388 — 1113 3 61 38 1608 DRAINAGE : Total Reconstructions — — — — — 15 — — 15 Partial Reconstructions, repairs or alterations — 1 2 — 3 13 — 19 Frontage Drains Reconstructed — - - — 26 6 — — 32 Obstructions cleared - - - - 26 10 — — 36 Inspection Chambers provided - 2 — — 1 55 — 1 59 Inspection Chambers covers renewed - - 1 — 9 — — _ 10 Interceptors provided — — - - 1 29 — _ 30 Soil & Ventilation Stacks provided or reconstructed — 1 — — 3 104 — 1 109 Soil & Ventilation Stacks repaired - — - - 8 - — — 8 Waste & Ventilation Stacks provided or reconstructed — — — _ — 98 — — 98 Waste & Ventilation Stacks repaired — — — — 2 — — — 2 Anti-Syphonage Stacks provided or reconstructed — — — — 1 5 — — 6 Fresh Air Inlets provided - - - - — 20 — _ 20 Fresh Air Inlets repaired or renewed 1 — 3 _ 30 _ — — 34 ■ Single Sinks provided - — - - - 386 3 5 394 Single Sinks renewed - - 1 - 3 - 2 - 6 Baths provided - - - - — 414 — - 414 Wash-hand basins provided — 2 - - — 440 8 10 460 Wash-hand basins renewed — — - - 1 — - 1 2 Waste Pipes cleared of obstructions or repaired — _ — — 1 — — — 1 Miscellaneous — — 4 — 12 8 — — 24 Carried forward 5 7 399 — 1240 1606 74 56 3387 - 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 Brought forward N. V. N. V. N. V. N. V. 5 7 399 - 124.0 1606 74 56 3387 SANITARY CONVENIENCES: Additional Water Closets provided 3 — — 426 9 438 Water Closet pans renewed 1 — 1 — 9 — — — 11 Water Closet pans cleansed 2 — — — — — — — 2 Water Waste preventers renewed or repaired — — — — 17 — — — 17 Water Waste preventers provided — 3 _ — — 426 — 9 438 Roofs repaired or renewed — — 3 _ 4 — — — 7 Floors repaired or renewed — — — — 1 — — _ 1 Walls & Ceiling plaster cleansed, repaired or redecorated 7 2 18 — 31 — 3 2 63 Natural Ventilation provided or improved 9 1 — — — — — — 10 Natural or Artificial Light provided or improved 1 2 — — — — — — 3 Ventilated Lobby provided — — — — — 2 _ 2 Miscellaneous 7 2 5 — 16 — — — 30 WATER SUPPLY: Supplies provided to Tenements — — 12 — 1 — — — 13 Supplies re-connected — — — — 7 10 — — 17 Taps supplied on main for drinking purposes — — 12 — — — — — 12 Burst Pipes repaired — — — — 6 _ — — 6 Cisterns cleansed, covered or repaired — — — — 6 — — — 6 Carried forward 32 20 450 - 1338 2468 79 76 4463 - 32 - 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. 32 20 450 — 1338 2468 79 76 4463 MISCELLANEOUS SERVICES PROVIDED: Soap and Towels for staff — — — — — — 2 — 2 Constant Hot Water — — — — — — 12 6 18 Bins, refuse — — — — 9 — — — 9 Food Cupboards provided — — 1 — — — — — 1 Covered Display & Counter Screens provided — — — — — — 3 — 3 MISCELLANEOUS NUISANCES ABATED. ARISING FROM; Offensive accumulations on open land and bomb sites — — — — 6 2 — — 8 Emissions of Smoke and Grit — — — — — 6 — — 6 GRAND TOTALS 32 20 451 — 1353 2476 96 82 4510 N = Work carried out under Notice. V - Voluntary Works, - 33 - INSPECTIONS. PROCEEDINGS,, ETC.. Total number of houses in the Borough 15,920 (approx.) PUBLIC HEALTH (LONDON) ACT. 1936. Number of houses inspected on account of complaints or illness 1,249 Number of statutory notices served 113 Number of houses repaired or nuisances remedied 293 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 42 of the Housing Act, 1957 Nil Number of houses demolished following representation by the Medical Officer of Health under Section 42 of the Housing Ac t, 1957 000 000 000 o o. 00. ... N il Number of houses repaired under Sections 9 and 10 of the Housing Act, 1957s- (a) by owners 13 (b) by local authority in default of owners 1 Number of houses demolisheds- (a) in pursuance of orders under Section 17 of the Housing Act, 1957 4 (b) voluntarily Nil 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 1 Number of overcrowded families who have obtained alternative accommodation 4 Number of houses erected by the Borough Council during the year 21 UNDERGROUND ROCMS Number found to be unfit Nil Number rendered fit for human habitation Nil Number closed by Closing Orders Nil - 34 - DETAILS OF NOTICES SERVED DURING THE YEAR 1. PUBLIC HEALTH (LONDON) ACT. 1936 (s) Intimation 278 (b) Nuisance Notices 94 (c) Section 40 ~ Drainage 18 L.C.C. (General Powers) Act. 1954 (a) Section 12 - Provision of dustbins - Intimations 12 (b) Section 12 - Provision of dustbins - Statutory Notices 4 L.C.C. (General Powers) Act. 1955 Section 25 - Stopped up drains 1 2. FACTORIES ACT. 1937 Health - general provisions 20 3. FOOD AND DRUGS ACT. 1955 Defects at food premises 33 4. SHOPS ACT. 1950 Provision of suitable sanitary conveniences and ventilation 3 TOTAL 463 DBTAIE8 <y SOTICES COMPLIED WITH DURING THE YEAR Three hundred and eighty-three notices were complied with during the year, of which three hundred and sixteen were served under the Public Health (London) Act, 1936. - 35 - HOUSING ACT. 1957 - PART IV - OVERCROWDING New cases investigated and recorded 1 Number of families involved 1 Number of persons involved 6 Cases relieved by:- (a) Rehousing Authorities Nil (b) Informal or formal procedure 4 Such action resulted in 30 persons being adequately housed. At the end of the year, 25 families (involving 122 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 one complaint regarding the unsatisfactory condition of the water supply was received. A visit was made by the District Public Health Inspector, but in his opinion the fault lay with the occupiers who were using the supply from a tank instead of the main supply and also for having dirty anti-splash spouts on the taps. These faults were corrected and no further complaint was received. As a result of investigation by the Council's Public Health Inspectors the following provisions were made:- Supplies to tenements 13 Taps on main for drinking purposes 12 Cisterns cleansed, covered or repaired 6 Burst pipes repaired 6 PUBLIC BATHS AND SWIMMING POOLS These facilities are available at premises situate in Chelsea Manor Street, adjacent to the Town Hall. During the year 34 samples of water were taken from baths, pools and sources of supply, for bacteriological examination, and apart from a breakdown of the chlorination plant in the early simmer which resulted in an adverse report being received, water was found to be in a satisfactory condition. - 36 - 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 1. INSPECTION OF FACTORIES. WORKSHOPS AND WORKPLACES: Premises Number on Register Number of Inspections Written Notices Occupiers Prosecute (1) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities: 74 54 3 – (2) Factories not included in (l) in which Section 7 is enforced by Local Authorities : ? 236 323 17 – (3) Other premises in which Section 7 is enforced by Local Authorities : ? – – – – TOTALS 310 377 20 – NOTE:- Outworkers' premises are not included in (3) above. ? i.e. Electrical Stations - Section 103 (l), Institutions - Section 104, and sites of Building Operations and Works of Engineering Construction - Sections 107 and 108. - 37 - FACTORIES ACT, 1937 (Continued) 2. CASES IN WHICH DEFECTS WERE FOUND Particulars Number of cases in which Defects were found Prosecutions Found Remedied Referred By H,M. Inspectors By H.M. Inspector Want of Cleanliness (Section l) - - - - - Overcrowding (Section 2) - - - - - Unreasonable Temperature (Section 3) - - - - - Inadequate Ventilation (Section 4.) - - - - - Ineffective drainage of floors (Section 6) - - - - - Sanitary Conveniences (Section 7): (a) Insufficient 1 - - 1 - (b) Unsuitable or defective 19 11 - 2 - (c) Not separate for sexes - - — — Other offences against the Act (not including Outworkers) - - - - - TOTAL 20 11 - 3 - - 38 - FACTORIES ACT, 1937 (Continued) OUTWORK Sections 110 and 111 Nature of Work No. of Outworkers in August List as required by Section 110 (l)(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. 15 _ - _ _ _ Household Linen - - - - _ _ Curtains and furniture hangings 3 - - - _ _ Furniture and Upholstery - - - - - _ Stuffed Toys _ - - _ _ ~ Lamp, shades 5 - _ _ _ _ TOTALS 23 _ _ _ _ _ - 39 - FOOD HYGIENE Steady progress continues to be made in the field of clean food handling and its attendant practices. it may well be deemed that the provision of well-constructed kitchens, store rooms, refrigeration plant and adequate display coverings automatically ensures reasonable hygienic standards, but it remains constantly necessary to allow for human failings, and it is essential to maintain unceasing propaganda and vigilance so that foodstuffs are always fresh and of the quality demanded by the purchaser. It is fortunate that the present-day shopkeeper is, generally speaking, very co-operative as well as being aware of his responsibility to the general public. On the subject of service great difficulty arises from the fact that employees at catering premises are constantly changing. It has to be regretfully recorded that a not insignificant proportion of persons so employed possess widely differing views as to efficiency in the carrying out of their duties. It must also be admitted that slackness is all too often fostered by customers who although appreciating that the service they receive may, on occasions, be slipshod, fail to remonstrate when suffering at the hands of food handlers. Unless they can be relied upon to be consistent in their interpretation of clean food-handling rules they must be prepared to accept some measure of responsibility for nonobservance. Whilst they fail to display an attitude of public-spiritedness they are making the task of public health officers unnecessarily arduous. Customers are always encouraged to ventilate their grievances at the Public Health Department to ensure that improvements are speedily effected. They should most certainly report any instances of smoking or spitting during the course of sales, and can themselves show concern for the aims of hygiene by refraining from taking pets with them on shopping expeditions. The local authority also experiences much investigation and enquiry when it is proposed to adapt premises which are, for example, to be used as a snack-bar when the accommodation was previously used for confectionery. In both cases the handling of consumable goods arises, but the alterations and adaptations are very often of no mean nature. In arriving at providing adequate facilities one has to bear in mind that the operator may be called upon to bear expenditure which may be more than was anticipated. At the same time it will be duly appreciated that a reasonable living has to be secured from the business, and it is reasonable to expect that completion of the required works must be spread over a little time. It is not unknown that once premises have been thoroughly adapted, the operator may not proceed, and an application may be received from another person or persons in connection with a very different type of catering, a procedure which leads to considerable work on the part of the authority's officers. What may appear to be unnecessary is, of course, all part of the continuance of clean food handling. -40- 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, storage, 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 7 Butchers 26 Milk Retailers (including Dairies) 51 Food Factories 5 Fried Fish Premises 3 Fruit and Vegetable Retailers 32 General Provision Merchants 42 Hotels and Public Houses 52 Restaurants, Dining Rooms, Canteens, etc. 151 Wet Fish Retailers 10 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 124 premises for the storage and sale of Ice Cream, and 35 premises for the sale of Preserved Food, is operative. - 41 - BACTERIOLOGY Apart from samples of ice cream, which are dealt with separately below, 35 samples of food and water were submitted for bacteriological examination during 1958. All were found wholesome save one, consisting of meat taken from a canteen, which was found to contain a heavy growth of Clostridium welchii, the cause of an outbreak of food poisoning at a local telephone exchange. Ice Cream. Results obtained on the 20 samples of ice cream taken during the year were as follows:- Grade I: 13 Grade II: 2 Grade III: 4 Grade IV: 1 20 LEGAL PROCEEDINGS During the year a number of complaints were received regarding the sale of foodstuffs not being of a satisfactory nature, but in only one instance was it deemed necessary to proceed. Section 2 of the Food and Drugs Act, 1955 was invoked as it allows that a person who sells any food or drug which is not of the nature, substance, or quality demanded by the purchaser shall be guilty of an offence. The particular item of food was a steak and kidney pie which was found to be in a mouldy condition. The case was heard at Park Petty Sessions on 15th July, 1958, and the defendants were found guilty of the offence as indicated above. A fine of £10. 0s. 0d. was imposed, and costs totalling £8. 8s. Od. were granted. - 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 to be used as dairy premises. On the 31st December, 1958, entries in the register were as follows:- (a) Number of registered distributors with premises 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 121 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 1953, authorising the use of special designations in relation to milk sold at, or from premises within the Borough. 61 supplementary licences were granted in respect of milk sold by retail within the Borough from 24 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 44 40 121 Supplementary 19 21 21 61 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 three licences were applied for and granted 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 51. 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 the 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. As a general rule the poisons retailed were insecticides, rodent exterminants, hair dyes, and household ammonia. Applications for inclusion and/or retention in the Council's register are) considered by the Public Health 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 - STREET TRADING Traders are annually licensed to operate from longestablished sites in the Borough in accordance with the provisions of Part IV of the London County Council (General Powers) Act, 1947, and providing requirements are fully observed, licences are renewed on receipt of applications. A number of licencees are concerned with the retailing of food, and in such instances the Council's Public Health Inspectors are particularly attentive to the conditions prevailing at storage accommodation, whilst steps are taken to ensure that all equipment is hygienically maintained. The practice of smoking during the handling of food has always been frowned upon, and traders are frequently reminded of the distaste with which members of the public regard such an occurrence. It is desirable that food displays should not be sited too near pavement surfaces, and it is stressed, under the Food Hygiene Regulations, 1955, that the permitted minimum height of such displays is 18" from ground level. Street trading in this Borough is carried out as follows:- Fruit and vegetables 14 Refreshments (at coffee stalls) 3 Flowers 10 Newspapers 6 Ninety-nine visits were made to sites during the year. The institution of legal proceedings in respect of unsatisfactory conditions was not necessary. -45- RODENT CONTROL The Prevention of Damage by Pests Act, 1949, which became operative on 31st March, 1950, is more advantageous to a local authority in dealing with rodents than the Rats and Mice Destruction Act, 1919, which was 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, whereas, with the present 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, ocoupiers 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 305 2,869 Number of infestations found 46 265 Number of treatments undertaken 34 256 Number of pre-baits laid 2,046 Number of poison baits laid 664 Number of complaints received 317 2. Sewer Maintenance Treatments. No. of prebaits laid No. of poison baits laid No. 1 Treatment 1,264 400 No. 2 Treatment 1,064 254 - 46 - UNSOUND FOOD When it has been established that food is unsound, it is surrendered to the Council's officers, removed from the premises, and the necessary certificates issued. The food is subsequentlydisposed of via the Council's refuse disposal service, but prior to such action it is treated with carbolic acid. Approximately 2,780 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 19551958 (inclusive) are set out in the following tables- UNSOUND FOOD SURRENDERED TO THE COUNCIL'S FOOD INSPECTORS DURING THE YEARS 1955 - 1958 (INCLUSIVE) Commodity 1955 lbs 1956 lbs 1957 lbs 1958 lbs Cake _ _ 37 Cheese 137 86 33 44 Currants — - 102 - Egg, dried 180 - - - Fish, Tinned - 66 11 — Fish, Fresh 173 - - - Fruit, Tinned 517 829 482 421 Fruit, juices - 60 46 31 Fruit, Fresh 2,353 - - - Fruit, dried — - - 25 Meat, Fresh 3,490 1,287 853 815 Meat, Tinned 714 310 520 910 Milk, Tinned - 33 28 - Potatoes - - - 208 Preserves - Jams, Marmalade, etc. 92 45 21 - Sausages 72 - 23 - "Soups 304 - 16 16 Vegetables 639 214 410 125 Aggregates of all foods condemned annually 8,926 3,296 2,661 2,780 Average for the four year - 4,415 lbs. -47- DISINFECTION AND DISINFESTATION SUMMARY OF THE WORK CARRIED OUT BY THE COUNCIL'S DISINFECTING STAFF DURING THE YEAR 1958. Under an arrangement with the London County Council, schoolchildren are treated at the Cleansing Station for Scabies and Verminous conditions. SCABIES CASES TREATED Chelsea Residents 5 L.C.C. Schoolchildren 15 VERMINOUS CONDITIONS. Adults 212 Children 103 L.C.C. 138 DISINFECTION OF ROOMS AND CONTENTS. CLOTHING ETC. Number of Rooms Disinfected 376 Number of Articles Disinfected 3,067 PISINFESTATION OF ROOMS AND CONTENTS Number of Rooms Disinfested 319 Number of Articles Disinfested 1,012 -48- 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 15 Number of decisions not to issue certificates Nil Number of decisions to issue certificates 16 in respect of some but not all defects 12 in respect of all defects 4 Number of undertakings given by landlords under paragraph 5 of the First Schedule 12 Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule Nil Number of Certificates issued 4 Applications by landlords to Local Authority for cancellation of certificates 6 Objections by tenants to cancellation of certificates 2 Decisions by Local Authority to cancel in spite of tenants' objection 1 Certificates cancelled by Local Authority 5 49 CONFERENCES The Borough Council was represented at the undermentioned Conferences during the years:- 1. The Royal Society of Health Annual Congress held at Eastbourne from the 28th April to 2nd May. 2. The Public Health Inspectors' Association held at Blackpool from 16th to 19th September. 3. The National Society for Clean Air Annual Conference at Llandudno, from 1st to 3rd October. There is no doubt but that attendances at Conferences of these types are most advantageous to the officers privileged to participate. Problems, either local or national, are fully ventilated, and much valuable data is acquired for the consideration of a variety of public health matters. It must also be stressed that the opportunities of informally discussing points of interest prove extremely interesting and educative. 50 ATMOSPHERIC POLLUTION RECORDING The Clean Air Act 1956, became fully operative on the 1st of June, 1958, and is principally concerned with action to secure the use of (a) smokeless fuels and (b) efficient combustion apparatus. The existence of atmospheric pollution brings about many undesirable conditions. It results in a lessening of sunshine and promotes the formation of foggy conditions, which lead to corrosion of buildings, as well as damage to a wide variety of materials. It will be recalled that the London smog of 1952 was estimated to have caused the deaths of 4,000 people, mainly amongst those in the higher age groups. It will therefore be readily appreciated that atmospheric pollution acts insidiously, in that its effects are not appreciated until such time as works to preserve property become essential, when the physical well-being of the populace has to be maintained against this unwelcomed, and until now ???avoidable enemy. If these problems are not enough to contend with, there is the economic aspect which, it is estimated, results in the wastage of 5 to 10 million tons of fuel annually, whilst the direct and indirect cost of pollution may well be between £100 to £150 millions each year. To bring about an amelioration of these circumstances, industrial and domestic fuel burning is the subject of intensified education in the principles concerning the use of gas, electricity and a variety of smokeless fuels, and to foster the use of efficient combustion apparatus. The presence of smoke is undoubtedly due to the employment of unsuitable flues, inadequate furnace draught, careless or irregular firing, with the probable overloading of boilers, and the fact that plant and/or appliances have gone beyond their years of efficient service. This authority in common with many other co-operating bodies maintains recording stations, and the readings are submitted to the Department of Scientific and Industrial Research who assess the findings received and issue monthly bulletins indicating the national picture as regards atmospheric pollution. The Council maintains two stations in the borough for the measurement and recording of atmospheric pollution. They are situated at the following sitesi:- (1) Chelsea Polytechnic, Manresa Road. (2) Chenil Galleries, King's Road. Chelsea Polytechnic The apparatus situated on this station consists of a standard deposit gauge for collecting the amount of soluble and insoluble deposits, and a lead peroxide apparatus for measuring the sulphur content of the air0 The deposited matter is collected at the end of each month and forwarded to The Royal Institute of Public health and Hygiene for analysis. 51 The following tables show the results obtained from this station during the year. Month 1958 Days Exposed Rainfall (ins.) Total Deposits for period in tons per sq. mile Deposits per day in tons per sq.mile (average) Soluble Insoluble Total Soluble Insoluble Total  January 30 1.71 8.82 9.83 18.65 .294 .327 .621 February 28 l.89 8.70 11.38 20.08 .310 .406 .716 March 31 0.94 7.77 10.87 18.64 .250 .350 .600 April 31 1.61 6.99 6.91 13.90 .225 .222 .447 May 32 2.33 10.48 11.22 21.70 .327 .350 .677 June 29 4.42 10.30 10.26 20.56 .355 .353 .708 July 31 1.48 7.70 7.65 15.35 .248 .246 .495 August 31 3.32 10.94 8.31 19.25 .352 .268 .620 September 30 4.06 4.99 11.06 16.05 .166 .368 .534 October 30 2.27 7.91 11.27 19.19 .263 .375 .638 November 31 1.71 5.29 5.75 11.04 .170 .185 .355 December 31 2.64 8.57 16.13 24.70 .276 .520 .796 TOTALS: 365 28.38 98.46 120.64 219.11 Estimation of Atmospheric Sulphur Milligrams of Sulphur Trioxide per Day. Month Days Exposed Chelsea Polytechnic January 30 4.24 February 28 4.32 March 31 4.21 April 31 3.14 May 32 1.99 June 29 1.90 July 31 1.62 August 31 1.59 September 30 2.49 October 30 3.10 November 31 4.53 December 31 4.27 Average for Year 3.12 52 Chenil Galleries. This station measures the amount of smoke suspended in the air and the sulphur dioxide content of the atmosphere. The apparatus consists of a smoke filter and a hydrogen peroxide bubbler. Readings are taken daily by an officer of the Public Health Department and the results are averaged to produce figures for each month. Unfortunately this station did not commence operations until May 1958 so complete figures for the year are not available. All information obtained from these readings is forwarded to the Fuel Research Station for correlation with the results obtained from other sites throughout the country. Early in 1959, it is intended to open a programme for the establishment of Smoke Control Areas, beginning with the Church Ward, and closing with the North Stanley Ward in 1968. With the completion of all surveys and the obtaining of Smoke Control Orders it is anticipated that the whole of the Borough would be smokeless in approximately ten years. EPIDEMIOLOGY Incidence and Notification of Infectious Disease 53 The undermentioned diseases are notifiable to the Medical Officer of Health by general practitioners:- Anthrax Meningococcal Infection Cholera Ophthalmia Neonatorum Continued Fever Plague Diphtheria Pneumonia, Acute Influenzal Dysentery Pneumonia, Acute Primary Encephalitis, Acute Poliomyelitis, Acute Enteric (Typhoid or Puerperal Pyrexia Paratyphoid) Fever Erysipelas Relapsing Fever Food Poisoning (or Scabies Suspected Food Poisoning) Glanders Scarlatina or Scarlet Fever Hydrophobia Smallpox Leprosy Tuberculosis Malaria Typhus Fever Measles Whooping Cough Membranous Croup 54 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) 9 34 22 8 23 - 14 110 Erysipelas - - 1 - - - - 1 Food Poisoning - 3 1 - 3 - - 7 Measles 9 115 91 - 2 - - 217 Meningococcal Infection - 1 - - - - - 1 Pneumonia: Ac. Influenzal - - 1 - - 2 1 4 Ac. Primary 2 - 2 1 2 1 3 11 Poliomyelitis: Paralytic - - - - 3 - - 3 Non-paralytic - - - - - - - - Puerperal Pyrexia - - - 31 15 - - 46 Scabies - - 3 1 1 1 - 6 Scarlet Fever - 5 10 - - - 1 16 Typhoid Fever - - - - 1 1 - 2 Whooping Cough 1 8 11 - - - 20 TOTALS 21 167 142 41 50 5 19 445 55 SUMMARY OF NOTIFICATIONS OF INFECTIOUS DISEASES RECEIVED DURING THE YEARS 1954-1958 (inclusive) Disease 1954 1955 1956 1957 1958 Average for five years  Diphtheria - 2 - - - 0.4 Dysentery 196 216 349 71 111 188.6 Erysipelas 6 4 5 3 1 3.8 Food Poisoning 19 27 85 13 7 30.2 Measles 104 736 183 406 217 329.2 Meningococcal Infection 1 2 3 1 1 1.6 Ophthalmia Neonatorum - 1 - - - 0.2 Paratyphoid Fever 3 2 - - - 1 Pneumonia: Ac. Influenzal 4 6 12 19 4 9 Ac. Primary 24 18 24 24 11 20.2 Poliomyelitis: Paralytic 1 2 8 3 3 3.4 Non-Paralytic - 4 6 - - 2 Puerperal Pyrexia 36 57 63 31 46 46.6 Scabies 34 12 15 8 6 15 Scarlet Fever 26 43 38 34 16 31.4 Typhoid Fever 1 - - - 2 0.6 Whooping Cough 93 85 72 69 20 67.8 56 DYSENTERY During 1958, one hundred and eleven notifications were submitted as compared with 71 in 1957 and 34.9 in 1956. 63% of the sufferers were residents of an institution not controlled by this authority. The premises concerned were such that it was difficult to prevent the spread of infection among the particular type of inmates. Nevertheless the Borough Council has been at great pains to bring about the eradication of the incidence of dysentery. MEASLES Two hundred and seventeen notifications of Measles were received during 1958, as compared with 406 and 183 in 1957 and 1956 respectively. SCARIET FEVER Sixteen notifications of Scarlet Fever were received in the Public Health Department during 1958, as compared with 34 in 1957. TYPHOID FEVER There were two isolated cases of typhoid fever notified during the year. The first case was a young man of 27 years, who was admitted to hospital with a history of high fever (no gastro-intestinal symptoms), where typhoid fever was diagnosed and confirmed from blood cultures. He is making satisfactory progress and should be discharged early in the new year. The other case referred to a male, aged 46 years. He was taken ill and had a temperature of 100°, remaining in bed for four days with what appeared to be influenza. Malaise persisted, and he developed a swinging temperature after fourteen days, which continued for a few days, when he took to bed again. The patient was removed to hospital, and after investigation was notified as a case of typhoid fever, confirmed by blood culture and faeces specimens. After three weeks in hospital he was considered fit to be discharged although he was still excreting the organism. Toilet facilities and home conditions were excellent, and he was allowed home under the care of his private doctor and the hospital. This Department will make periodic visits until he is free from infection. Investigations to ascertain the source of infection in the above cases were still in progress at the end of the year. 57 DIPHTHERIA No notifications were received during the year. Two cases were confirmed in 1955, being the only cases since 1949, and there have been no deaths for thirteen 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. 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. Information was received during the year regarding four contacts who had travelled to addresses in the Borough, and all were given advice on the precautionary action they should take. POLIOMYELITIS Three notifications of poliomyelitis came to hand and all were subsequently confirmed as being of the paralytic type. All the cases were adult, one being over thirty and the other two over forty years of age. The two older persons were infected before returning from abroad, and all were reported to be making satisfactory progress. Vaccination against poliomyelitis was commenced by the London County Council in 1956, and was only available to children in certain age groups, but as the supply of vaccine improved, the Ministry of Health extended the programme and the following persons are now eligible:- All persons six months to 25 years of age. Expectant mothers. General medical practitioners and ambulance staff and the families of such persons. Staff of hospitals where poliomyelitis is treated during the infectious stage, and the families of such staff. Medical Officers of Health, Public Health Inspectors and Disinfectors. WHOOPING COUGH Only twenty cases were notified during the year against 69 in 1957. This followed the trend throughout the Country, where the number of cases notified showed a drop of over 60% compared with the previous year. 58 FOOD POISONING Seven cases were notified as compared with 13 in 1957 and 85 in 1956. A summary of all cases occurring during the year under review is set out in identical form to that supplied to the Ministry of Health. ANNUAL RETURN OF FOOD POISONING FOOD POISONING NOTIFICATIONS (CORRECTED) AS RETURNED TO REGISTRAR GENERAL. First Quarter Second Quarter Third Quarter Fourth Quarter Total Nil 3 3 1 7 CASES OTHERWISE ASCERTAINED. First Quarter Second Quarter Third Quarter Fourth Quarter Total Nil 1 26 Nil 27 FATAL CASES. First Quarter Second Quarter Third Quarter Fourth Quarter Total Nil Nil Nil Nil Nil PARTICULARS OF OUTBREAKS No. of outbreaks No. of cases Total No, of cases  Family outbreaks Other outbreaks Notified Otherwise ascertained Salmonella newport 2 - 6 1 7 Clostridium welchii - 1 - 26 26 SINGLE CASES No. of cases Total No. of cases  Notified Otherwise ascertained Salmonella typhimurium 1 - 1 59 FOOD POISONING Family Outbreaks (2) (1) Four Cases. The first outbreak involved a family of four persons - father, mother and their two daughters, aged 3 and 11 years. All had headaches and diarrhoea which was quite severe. Faecal specimens submitted for bacteriological examination were reported positive for Salmonella newport, except in the case of the father who was negative, but as he experienced identical symptoms to those of the other members of the family and there was some delay in obtaining a specimen (which was submitted after receiving medical attention), this case was included in the outbreak. He was not notified. The food suspected of causing this outbreak was some pork chops purchased at a local butcher's, cooked and eaten at home. Owing to the lapse of time between onset of symptoms and notification, it was not possible to recover any remains of the meal in question. The staff of the butcher1 s shop were reported well and there was no history of illness. (2) Three Cases. This outbreak affected a mother, aged 32, and her daughters of 3½ and 2½ years. All experienced diarrhoea (not severe). Salmonella newport was isolated from faecal specimens submitted by the sufferers. Other members of the household were reported negative. The vehicle of infection was unknown, but twelve hours prior to onset of symptoms, the family had luncheon at a country public house whilst out motoring. Exact location of public house could not be ascertained. Father and baby aged 6 months were not affected. Other Outbreaks (l) It was reported to this office one morning that a number of the staff of a Telephone Exchange situated in the Borough were taken ill during the night with abdominal pains and diarrhoea not particularly severe. All had been able to go to work and they had all practically recovered by the afternoon. On investigation, it emerged that out of 48 at risk, 26 were suffering, apparently related to the canteen lunch served on the previous day. The symptoms commenced most commonly about 8-9 hours after the meal, and lasted about 20 hours. Enquiries seemed to indicate minced meat as the vehicle of infection, and bacteriological examination revealed it to be heavily contaminated with C1. welchii. Neither this organism nor organisms of the Salmonella or Shigella groups were isolated from any of the staff. Information was given that the meat was delivered during the morning, cooked in the afternnon, allowed to cool, kept overnight at atmospheric temperature, and reheated for lunch the following day. 60 The Treasury Medical Service were notified of this incident,, and their attention drawn to the dangerous practice of reheating meat cooked the previous day. A recommendation was also made for the provision of adequate refrigeration space. Single Cases (l) This referred to a female aged 31 (nursemaid). Symptoms were fever and diarrhoea. Salmonella typhimurium was isolated in this case. Specimens taken from household contacts proved negative. Source of the infection was not discovered, but could have been food contaminated by mice known to be infesting the premises. SALMONELLOSIS 10 cases of salmonella infection were brought to the notice of this Department during the past twelve months. These are cases which have symptoms, and although a food poisoning organism is isolated from the faecal specimens, food is not considered to be the vehicle of the infection, which is caused through case-to-case contact or by crossinfection. A summary of these cases is now supplied annually to the Ministry of Health as instructed in the revised memorandum on Food Poisoning. A copy of this year's return is submitted below. SALMONELLA INFECTION. NOT FOOD BORNE Salmonella (type) Outbreaks No. of cases Single Cases Total No. of cases (Outbreaks) and single cases)  Family Other (Outbreaks) Typhimurium 1 3 5 8 Kentucky - - - 1 1 Derby - - - 1 1 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. Forty-six cases were notified during the year, all of which occurred in hospital. Thirty-six notifications referred to patients residing outside the Borough. Herewith is a brief summary of the actual causes of the above casess 5 cases were due to genital tract infection, 8 to breast involvement, 6 urinary tract infection,9.respiratory tract infection, 1 kidney infection, 1 bladder infection, 2 associated with Caesarean section, and causes not known 14. Two 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. 61  NOTIFICATIONS OF INFECTIOU0S DISEAES BY WARDS North Stanley South Stanley Cheyne Church Hans Town Royal Hospital TOTALS  Dysentery 1 - - - - - 1 Dysentery (Sonne) 7 15 12 69 6 1 110 Erys ipelas 1 - - - - - 1 Food Poisoning - - 3 - 1 3 7 Measles 24 43 75 48 19 8 217 Meningococcal Infection - - 1 - - - 1 Pneumonia: Acute Influenzal 1 1 - 1 - 1 4 Acute Primary 2 - 2 3 1 3 11 Poliomyelitis: Paralytic 1 1 - - - 1 33 Puerperal Pyrexia 46 - - - - - 46 Scabies 3 1 1 1 - - 6 Scarlet Fever 4 6 2 1 3 - 16 Typhoid Fever - - - - 2 - 2 Whooping Cough - 9 5 4 - 2 20 TOTALS 90 76 101 127 32 19 445 62 TUBERCULOSIS 73 cases of Pulmonary Tuberculosis were notifed during the year. These were made up of 41 primary notifications, 23 "inward transfers", and 9 from other sources. There were also 9 non-pulmonary cases of which 7 were primary notifications, 1 from "inward transfers", and one from Death Returns. The accompanying tables present details of cases at present on the Tuberculosis Register. VARIATIONS IN REGISTER DURING 1958. PULM0NARY NON-PULMONARY TOTAL CASES  M. F. M. F. (a) Number of cases remaining on register at 1st January, 1958 216 181 13 31 441 (b) Number of new cases notified 34 10 4 4 52 (c) Number of cases restored to register 3 3 - - 6 (d) Inward Transfers 8 15 1 - 24 Removals (e) Outward Transfers 38 24 - 2 64 (f) Cases recovered 2 4 - - 6 (g) Cases gone abroad 2 2 - 1 5 (h) Cases lost sight of 5 4 1 - 10 (i) Deaths 3 2 1 1 7 (j) Cases remaining on the Register at 1st December, 1958 211 173 16 31 431 - 63 - (A) NEW CASES OF TUBERCULOSIS 1958 (B) DEATHS OF TUBERCULOSIS CASES 1958 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 - - - - - 2 4 7 3 6 7 3 2 34 Pulmonary F - - - - - - 1 2 3 1 1 1 1 10 Non- Pulmonary M - - - - - 2 — 1 - 1 - - - 4 Non- Pulmonary F - — - - - 1 - 2 - - 1 - - 4 (B) DEATHS Pulmonary M — 2 1 - 3 Pulmonary F - - - - - - - - 1 - - - 1 2 Non- Pulmonary M - - - - - - - - - - 1 - - 1 Non- Pulmonary F - - - - - - - - - - 1 - - 1 64 CHELSEA TUBERCULOSIS DISPENSARY, BROMPTON HOSPITAL. S.W.3. 1955 1956 1957 1958 Population served by Dispensary 51,450 51,070 50,600 50,190 Number of notified cases in Borough at end of year 425 468 441 431 Number of these who at present do not attend Dispensary 102 115 96 96 Total attendances during year 2,080 1,984 1,594 1,453 Total new patients seen 242 149 190 168 Number of these who were contacts 220 106 91 80 Number of contacts found to be tuberculous 1 - 2 - Number of cases newly notified to Medical Officer of Health (i.e. excluding inward transfers) 42 43 51 52 Number of cases diagnosed as tuberculous (for the first time) at the Dispensary 7 18 20 26 Number of X-rays 1,578 1,417 1,250 1,140 Number of Patients who received "Special treatment" at home during the year 33 30 6 4 Number of Patients given B.C.G. 54 65 80 75 Number of home visits by medical staff 31 50 25 1 Number of visits paid by Dispensary Nurse 2,135 2,027 1,798 1,627 Number of Clinic Sessions per week 2 2 2 2 65 ZYMOTIC DISEASES An examination of statistics provided by the Registrar-General for the year 1958 showed that three deaths were attributable to "Gastritis, enteritis and diarrhoea", and one was from Measles, representing a death rate of 0.07 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 1958 4 66 BACTERIOLOGICAL EXAMINATIONS All bacteriological examinations are carried out at the Public Health Laboratory at County Hall under it Director, Dr. A.J.H.Tomlinson. No charge is made to the Council for these examinations and during the year 1083 were made as follows:- Throat/Nose Swabs Haemolytic Streptococci found 13 Haemolytic Streptococci and Staphylococcus found 1 Haemolytic Streptococci and proteus found 1 Mixed growth of Haemolytic Streptococci and Pyocyaneus found 1 Vincent's angina and Staphylococcus aureus found 1 Pneumococci found 1 Monilia found 1 Staphylococcus albus found 1 Staphylococcus aureus found 1 Proteus found 1 Normal throat flora found 1 Negative results 58 Gum Swabs Negative results 1 Eve Swabs Staphylococcus albus found 1 Boil Swabs Staphylococcus albus found 1 Urine Mixed growth including coliform bacilli found 1 Occasional leucocytes and heavy growth of proteus found 1 Faeces Shigella sonnei found 170 Salmonella paratyphi B. found 1 Salmonella typhi-murium found 3 Salmonella newport found 13 Salmonella kentucky found 2 Pathogenic Bact. coli 0125 found 1 Pathogenic Bact. coli 0127 found 3 Threadworms found 1 Negative results 802 Foodstuffs Heavy growth of Cl. welchii found 1 67 494 faecal specimens which are included in the foregoing were arranged and collected by this Department with the approval and co-operation of local medical practitioners and school authorities. The Public Health Department has an arrangement with Chelsea Doctors whereby specimens left at the office 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. 3 ANNUAL REPORT of the PUBLIC ANALYST for the year ended 31st December, 1958. THOMAS McLACHLAN, A.C.G.F.C., F.R.I.C., M.I.Biol. 68 To the Mayor, Aldermen and Councillors of The Metropolitan Borough of Chelsea. Your Worship, My Lord, Ladies and Gentlemen, During the year 1958, 400 samples of food and drugs were examined, 18 of which were taken formally and 382 informally. Adverse comments were made against 21 samples and the incidence of adulteration or incorrect labelling may be classified as follows:- Number of samples examined. Number of samples adulterated. Milk 200 - Other foods 197 21 Drugs 3 - A sample of Yoghourt contained only 0.1 per cent of fat, and unless sold as a skimmed milk Yoghourt it must be prepared from full cream milk. The manufacturers agreed to amend the label to include the words "separated milk" in the description of the product. An egg was submitted for examination because on cooking the white was found to be red. Two unopened eggs submitted at the same time were found to be satisfactory, but the white of the egg about which complaint was made was full of bacilli which were believed to be Serratia marcescens. This is the bacterium responsible for forming red patches in bread. A product labelled as a "Milk Shake in a Straw" was considered to be incorrectly labelled, as milk had to be added and no milk was contained in the straw. It was considered that the description should be "Milk Shake Straws", or "Flavoured Straws for Milk Shakes". A loaf of bread contained numerous pieces of dark grey matter embedded in the bottom of the loaf, consisting of pieces of bread or bread crumbs from the tin in which the loaf had been baked, showing that the tin had not been cleaned before use. These dark fragments contained more oil than is normally present in bread and it was considered that the tin had been greased before use and that the oil or fat used for greasing had been readily absorbed into the dried bread crumbs. An imitation cream cake was received as a result of a complaint and was found to be mouldy between the surfaces of the pastry and of the imitation cream filling. The cake must have been manufactured for at least five days, and the conditions of manufacture must have been unsatisfactory. The cake was considered unfit for sale. A cheese spread stated to be prepared from "Cream Cheese base with Danish Blue Cheese" was found to contain 47.9 per cent of total solid matter and 2U per cent of fat, and therefore the cream cheese could not be the ingredient in largest proportion. The manufacturers 69 agreed to amend the label to read "Made from a Blue Cheese base". Samples of Cheese Spread and Buttered Cheese Spread were examined, and two of the Buttered Cheese Spreads were reported as inferior because they contained respectively 28.7 per cent and 29.3 per cent of fat, equivalent to 19 per cent and 19.6 per cent of fat in the original cheese. The label claimed 15 per cent of added butter, whereas the original cheese spread which was supposed to be the basis of the final product contained 22.3 per cent of milk fat. The manufacturers decided to increase the percentage of butter added to the original cheese. Gherkins and Onions in Vinegar wereexamined and found to contain 3.6 per cent of added salt not declared as an ingredient, and Pickled Olives were described only as "Pickled Green Olives", without any declaration of ingredients. The manufacturers agreed to amend the labels. Some canned Braised Pork Kidneys were satisfactory, but there was an interesting error in the disclosure of ingredients on the label, which read "Pork, Kidneys, Flour, Salt, Spices". The ingredients were "Pork Kidneys" etc., omitting the comma after the word "Pork". A soup sold as "Shark's Fin Soup" was stated to be prepared from "chicken, gelatine, fishj flavoured with soy extract, yeast extract, onions, carrots, spices, herbs, monosodium glutamate, garnished with Shark's Fin and parsley". The chief constituent was gelatine. It is difficult to believe that a garnish can be sufficient to give its name to the soup, and if the label complied with the Labelling of Food Order, it is seen that Shark's Fin was the ingredient in about the lowest quantity present. The Manufacturers stated that the soup was made from an authentic Chinese Recipe, but they did not quote the authority for the recipe, or the recipe itself, nor would it appear to comply with two recipes taken from reputable Chinese Cookery books in the possession of your analyst. Wads formed on the surface of a sample of wine vinegar consisted of zoogloeal masses of bacteria. The cork of the bottle leaked slightly enabling air to gain access to the vinegar with the result that bacteria in the vinegar continued to develop and form what is known as "Mother of Vinegar". A Beef Steak with Gravy contained only 62 per cent of total meat and was therefore 17 per cent deficient in meat. Beef Steak with Gravy must in your analyst's opinion contain not less than 75 per cent of meat. Two samples of Veal cutlets consisted of minced meat, with cereal filler and spices. A veal cutlet is a thin slice of veal meat, though this slice may be obtained from various parts of the carcase, and it was suggested that these samples should have been sold by a description such as "Veal Croquettes". The manufacturers agreed to call them "Continental Rissoles". 70 A Chicken Curry contained dark meat only with no intimation to the customer that white meat was absent. The white meat of poultry is always considered to be more delicate and it is richer in protein than the dark meat. It is also more expensive if purchased separately. The manufacturers eventually agreed to amend the wording of the ingredients to indicate that boneless leg meat was used. Two samples of Meat Pies were submitted for examination owing to complaints. They were mouldy and unfit for sale. Samples of Salmon with Mayonnaise and Pink Shrimp Savoury were not labelled in accordance with the requirements of the Labelling of Food Order. The ingredients were listed in five separate panels on this label and not in their order of precedence. The manufacturers had already promised to amend these labels, and it was found that they were the last of an old stock being used and that new ones were to be delivered in January, 1959. The year 1958 probably witnessed less fresh legislation for food and drug administration than any year since the outbreak of the 1939 war. The Public Health (Preservatives etc. in Food) Regulations. The most important changes affected the Preservatives Regulation. The Public Health (Preservatives etc. in Food) (Amendment) Regulations, 1958, and The Public Health (Preservatives etc. in Food) (Amendment No. 2) Regulations, 1958 permit the treatment of certain fruit with anti-mould agents. Fruit has for long caused trouble owing to its perishable nature and consequent attack by moulds between collection and consumption. With greater dependence on foreign imports and with the food laws of other countries permitting what are considered to be harmless quantities of preservatives on the skins of fruits this country has been more or less forced to cane into line. As a result the fruits named below may now contain the following added preservativess- Citrus fruits. Diphenyl not more than 100 parts per million, or orthophenylphenol not more than 70 parts per million or proportionate quantities of the two together. Orthophenylphenol in Apples, Pears, and Pineapples not more than 10 parts per million, Peaches not more than 20 parts per million, Melons not more than 125 parts per million, and foods made with any of these fruits may contain proportionate New Legislation. 71 quantities of these permitted preservatives, except that foods containing melon may not contain more than 10 parts of orthophenylphenol for every million parts of melon in the food. It is difficult to understand why melons are permitted to be treated with 125 parts per million of orthophenylphenol. The skin of melons, like that of the related squash families, is hard, and therefore more resistant to attack than that of many other fruits, but the melon is a very juicy fruit and many consumers of melon are apt to spoon up the juice from their plates, thereby consuming a large proportion of the preservative. It does not seem to have been realised, moreover, that the area of the skin of a fruit is proportional to the square of the radius, whereas the weight, or volume, is more or less proportional to the cube of the radius, so that the larger the fruit the less should be the quantity of preservative in parts per million required to cover the area of the skin. The Antioxidant in Food Regulations. 1958. These regulations provide for the sale and importation of certain foods, which contain propyl, octyl, and dodecyl gallates, butylated hydroxyanisole and butylated hydroxytoluene within certain limits. Essentially these regulations permit the addition of these compounds to anhydrous edible oils and fats, to vitamin oils and concentrates, to butter for manufacturing purposes, and to essential oils and their flavouring constituents. Since ingredients are allowed to contain antioxidants provision is made for the resultant foods to do so. With our present knowledge it is extremely difficult to determine the quantitiy of anti-oxidants in oils and the difficulty of doing so in prepared foods is much greater. There has been a considerable amount of discussion as to whether legislation should or should not be enacted before it is capable of being fully implemented, but if one were always to adopt the practice that legal requirements must follow the development erf scientific knowledge to enable their ready enforcement, food laws would lag even further behind than they do at the present time. It is generally found that science manages to catch up with legislation and public analysts owe much to the willing help received from their colleagues in industrial laboratories for information on some of these delicate matters. Labelling of Food (Amendment) Regulations. 1958. This amendment revokes Article 8 (d) of the Labelling of Food Order, so that alcoholic cocktails need no longer contain 4.0 per cent of Proof Spirit, but they will need to be labelled with the quantity of spirit which is present. Copper in Foods. The Ministers of Agriculture, Fisheries and Food, and of Health duly considered the Report of the Food Standards Committee and decided not to issue any fresh Regulation, but recommended limits, which they hope will be adopted. In general it has been found that recommendations of this type are accepted for enforcement purposes and are not disputed by trade interests. 72 Tea Examination. Greater vigilance is necessary regarding the purity of tea following the issue of Circular FSH 16/58, informing Local Authorities that E. M. Customs and Excise have discontinued sampling tea on importation for adulteration and unfitness, but it is not anticipated that this will cause any inconvenience to normal sampling and analysis. The Therapeutic Substances (Supply of Substances for Analysis) Regulations. 1958. These regulations came into force as the result of an oversight in the drafting of the Therapeutic Substances Act, 1956, and enabled public analysts and others likely to be responsible for testing products containing antibiotics, to obtain samples for control and for test. I am, Mr. Mayor, My Lord, Ladies and Gentlemen, Your obedient Servant, THOMAS McLACHLAH A.C.G.F.C. ,F.R, I.G.,M.J.Biol. Public Analyst. - 73 - Taken Informally Taken Formally Total Analysed Adulterated etc. Baby Food Bread, Breakfast Cereal Butter Cake Cheese Chicken Chopped in Jelly Chicken Curry, canned Colour, Saffron Confectionery Conserve Cooking Oil Corn Syrup Cream Curried Beans Curry Malayan Edible Fungi Eggs Fish Cake Fish, canned Fish paste Fish, potted Flour Fruit, canned Fruit, dried Gherkins and Onions in Vinegar Glucose Gravy Powder Hamburgers, canned Herbs Honey Ice Cream Jam Jelly Lemon Curd Macaroni product Margarine Marmalade Meat, Brawn Meat, canned Meat Paste Meat Pie Meat, Veal Cutlet Milk Milk Shake Powder Mushrooms, dried Olives, pickled Olive Oil Paprika Peel, candied Carried forward 1 1 1 12 1 2 1 1 1 2 2 1 1 1 1 1 1 1 1 6 5 3 3 1 3 1 1 1 1 2 1 5 16 1 2 1 5 8 1 5 5 2 2 200 1 1 1 1 1 1 320 1 1 1 12 1 2 1 1 1 2 2 1 1 1 1 1 1 1 1 6 5 3 3 1 3 1 1 1 1 2 1 5 16 1 2 1 5 8 1 5 5 2 2 200 1 1 1 1 1 1 320 1 1 1 1 1 2 2 2 1 1 13 - 74 - Taken Informally Taken Formally Total Analysed Adulterated etc. Brought forward Pickles Pulses, peas-dried Salmon with Mayonnaise Salt and added vegetables Sauce Sausages Sausages, Liver Savoury Meat Pancake Rolls Scotch Eggs Shrimp Savoury Soft Drinks Soup, canned Soup, jar Spirits Brandy Gin Rum Whisky Spread, cheese Spread, savoury Suet, shredded Sugar Sunflower Seed Oil Sweet Corn, canned Tomato Juice Tomato Paste .Jegetafel-e-'^aiad, canned Vinegar Yoghourt Drugs Calamine and Benadryl Cream Cod Liver Oil and Malt Linseed Compound TOTALS 320 2 1 1 1 1 3 3 1 1 1 8 2 1 7 1 3 2 1 1 2 1 1 6 8 1 1 1 382 4 5 5 4 18 320 2 1 1 1 1 3 3 1 1 1 8 2 1 4 5 5 4 7 1 3 2 1 1 2 1 1 6 8 1 1 1 400 13 1 1 1 3 1 1 21 INDEX Subject. Page (s) Accidents in the Homo 22 Analyst Public - Report of 68 - 74 Atmospheric Pollution 50-52 Bacteriological Examinations 41, 66 & 67 Baths and Swimming Pools 35 Cancer of the Lung and Bronchus 12 & 13 Committee, Public Health & Baths: Members 1 Representation elsewhere by Members 2 Conferences 49 Cremation Service 23 Deaths 6-13 Diphtheria 57 Diphtheria Immunisation 18 Disinfection and Disinfestation 47 Dysentery 56 Epidemiology 53-65 Factories Act, 1937 36— 38 Food Hygiene 39 & 40 Food Poisoning 58 — 60 Hospitals 16 Housing Act, 1957 35 Infant Mortality 14 & 15 Infectious Diseases 53-65 Introduction 4 & 5 Legal Proceedings 41 Maternity and Child Welfare17-19 Measles 56 Meteorology 26 Milk supply 42 Mortuary facilities 25 Nursery Homes 16 Old People, Welfare of 20-22 Outworkers 38 Subject. Page (s) "Part III" Accommodation 19 Pet Animals Act, 1931 43 Pharmacy & Poisons let, 1933 43 Poliomyelitis 57 Public Analyst - Report of 68-74 Public Health Inspectors - Work of 27-52 Puerperal Pyrexia 60 Rag Flock & Other Filling Materials Act, 1951 43 Rent Act, 1957 48 Rodent Control 45 Scarlet Fever 56 Shops Act, 1950 34 Spastic Children 24 Staff of Public Health Department 3 Statistics 6-8 Street Traders 44 Tuberculosis 62-64 Typhoid Fever 56 Underground Rooms 33 Unsound Food 46 Vaccination 18 Water Supply 35 Whooping Cough 57 Zymotic Diseases 65