AC 4345 CHE 58 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 1960 1 METROPOLITAN BOROUGH OF CHELSEA PUBLIC HEALTH AND BATHS COMMITTEE (at 31st December, 1960) Chairman: Councillor J.S. Tatton-Brown Vice-Chairmans: Councillor J.A, Peterson-Morgan, F.L.A.S., M.R.S.H., J.P. Councillor Mrs. E.C. Blackett, Councillor Miss Aimee Gibbings M.A. " Mrs. Co Mallet " J. Elliott Brooks " M. Nadin " Mrs. G.K. Buxton Alderman Miss M„D„ Shufeldt " J.C. Corder, F.R.I.C.S. Councillor A. H. Stevenson " H. Denman " Dr. Lucy Wills Ex-Officio Members The Worshipful the Mayor (Councillor Miss Katharine Acland, O.B.E., T.D., J.P. ) The Deputy Mayor (Alderman R.A. Lygon, B.A.) 2 Borough Representation on outside Committees and other Organisations concerned with Public Health work. (At 31st December. 1960.) Chelsea Deanery Councillor Mrs. G.K. Buxton Moral Welfare Associations: Chelsea Tuberculosis Councillor Mrs. G.K. Buxton Care Committees: London County Council Councillor Mrs. G.K. Buxton Divisional Health Councillor Dr. A.J. Glyn Committee (Division I): London County Council Councillor Mrs. G.K. Buxton Divisional Tuberculosis Care Committee (Division I): London and Home Counties Councillor J.S. Tatton-Brown Clean Air Advisory Chief Public Health Inspector Councils: National Society for Councillor Mrs. G.K. Buxton Clean Air: Councillor J.S. Tatton-Brown Old People's Welfare The Worshipful the Mayor, Committee: (Councillor Miss Katharine Acland, O.B.E., T.D., J.P.) The Deputy Mayor, (Alderman R.A.Lygon, B.A.) Councillor J.A. Paterson-Morgan Councillor J.S. Tatton-Brown Councillor J. Elliott Brooks Councillor Miss Elisabeth Stockwell. 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December, 1960. Medical Officer of Healths: J.H.WEIR, M.D., B.S., B.Hy., D.P.H. Deputy Medical Officer of Healths: Hastings E.A. CARSON, M.D., B.S., D.P.H. (resigned 28.8.1960) D. J. SHEERBOOM, M.B., B.S., D,P.H. (commenced duty 1.10.1960) Chief Public Health Inspectors: H. HOYLAND. Deputy Chief Public Health Inspector and Senior Housing Inspectors: S.W. BARKER, Public Health Inspectors: H.F. LEACOCK. T.W. CAMSEY. (commenced duty 1.10,1960) A .J. WHITE. E.R. YOUNG. H.W. LUDLOW (resigned 1,5,1960) Women Public Health Inspectors: (Miss) A.C.C. KAY. (Miss) G.K. READER, Drainage Assistants: E. BOSLEY, Rodent Officers: J.F. COOKE. P. DRURY. Public Health Inspectors' Assistants: F.G. RAWLINGSON. Chief Disinfectors: L.H. BERRY (retired 13,7.1960) F.W. HILL (commenced duty 14.7.1960) Disinfectors: R.J. WESTON. Cleansing Station Attendants: (Mrs.) J. LOBBAN. Chief Clerks: J.C. BRYANT. Clerical Officers: I.M. THOMSON. H.G. HAMILTON. L.A. POWELL. (Mrs.) W. BAAR, P.M. MARGETTS. P.D. GRAINGER, Social Workers: (Mrs.) O.M. BURKE. Public Analysts: Thos. McLACHLAN, A.C.G.F.C., F,R.I.C. M.I. Biol. 4 METROPOLITAN BOROUGH OF CHELSEA TELEPHONE: Public Health Department, FLAxman 8101 Town Hall, King's Road, CHELSEA, S.W.3. July, 1961 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Your Worship, Ladies and Gentlemen, I have the honour to present my Annual Report on the health and environmental circumstances of the Borough during the year 1960. It was estimated by the Registrar-General that the mid-year population was 4.9,140, or 380 less than the total for 1959 (49,520) thus continuing the decline which has been apparent since 1950. During the year 697 live births were recorded, giving a birth rate of 14.2 per 1,000 of the population. In the preceding year there were 722 live births which represented a birth rate of 14.6. For the current year the employment of an "area comparability factor" gave a birth rate of 10.8. During the same period 729 deaths were registered, thus indicating a death rate of 14.8 per 1,000 of the populationo In 1959 there were 726 deaths representing a death rate of 14.7. The application of an "area comparability factor" showed the current death rate to be 11.5, a return identical to that of England and Wales as a whole. In common with the past 6 years, none of the deaths recorded were associated with pregnancy or childbirth. Infant mortality was at the same level as in 1959• The "area comparability factor" is a means of making allowance for the differing age and sex distribution of different populations. After the application of this factor, the corrected rate more accurately depicts the comparison with other areas number of infectious disease notifications received in the Public Health Department totalled 216, as compared with 613 in 1959, a decline of 397. This pleasing state of affairs was wholly attributable to the small incidence of cases of Measles. Four-hundred samples of Food and Drugs were submitted to Mr. T. McLachlan, Public Analyst to this authority. In only ten instances (2½%) was it found that adulteration or labelling inaccuracies had occurred. All instances were thoroughly investigated and appropriate action taken. Details of the work carried out during the year are incorporated in this Report. 5 Food premises throughout the area continued to be subjected to regular inspections to ensure compliance with the requirements of the Food Hygiene Regulations. The Council, on 16th November last, agreed to seek the consent of the Minister of Housing and Local Government to the making of a detailed survey of the Hans Town Ward with a view to its establishment as a Smoke Control Area. This is a further step to the ultimate object of extending Smoke Control to the whole of the Borough. In submitting my Annual Report I would like to take the opportunity of expressing my appreciation of the interest and support received from all Members of the Council. I am particularly grateful for the help and co-operation which has always been forthcoming from the Chairman and Members of the Public Health Committee, as well as the Chief Officers and members of other departments., In conclusion I wish to express my gratitude to all members of the Public Health Department for their valued assistance throughout the year. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, Medical Officej^-tfr Health. 6 METROPOLITAN BOROUGH OF CHELSEA Annual Report of the Medical Officer of Health for the year 1960, Area of the Borough: 659.6 acres General Rates: 17s.4d. in the £ (at 31st March 1960) Product of a Penny Rate (gross) £7,867 Rateable value of Borough as at 31st March, 1960 £1,948,869 Populations Registrar-General's estimate of the population of the Borough (mid-year 1960). 49,140 Density of population per acres: 74.58 Live Births: Total Male Female Legitimate 599 293 306 Birth rate per 1,000 Illegitimate 98 42 56 of estimated 697 335 362 populations 14.2 Adjustment of birth rate by area comparability factor 10.8 Birth rate for England and Wales - 17.1 Still Birthss Total Male Female Legitimate 12 5 7 Rate per l,000 live Illegitimate 2 2 1 and still births 21.1 15 2 Maternal Mortality: No deaths associated with pregnancy or childbirth have occurred among Chelsea residents since 1954. Deaths: Total Male Female 729 318 411 Death rate par 1,000 of estimated population 14.8 (males 6.43 females 8.4) Adjustment of death rate by area comparability factor 11.5 Death rate for England and Wales -11.5 7 Annual Report of the Medical Officer of Health for the year 1960 (continued) Deaths and death rates of Infants under One year of age: Total Male Female 12 7 5 All infants per 1,000 live births 17.2 Legitimate infants per 1,000 legitimate live births 20.0 Illegitimate infants per 1,000 illegitimate live births NIL Deaths of Infants under four weeks of age Total Male Female 9 6 3 Deaths rate of infants under four weeks of age per 1,000 live births 12.9 TUBERCULOSIS: Deaths from Pulmonary Tuberculosis 2 Deaths from non-Pulmonary Tuberculosis Nil Death rate from Pulmonary Tuberculosis per 10,000 of estimated population 0.4 8 It will be seen that the illegitimate births number 93 representing 14.1% of the total live births registered:- Chelsea London England & Wales (in thousands) Year Births 111eg. % Births Illeg. % Births Illeg. % 1950 829 57 6.875 53,660 3,752 7.0 697 35 5.1 1951 819 53 6.475 52,387 3,597 6.9 677 32 4.8 1952 787 72 9.1 51,443 3,607 7.0 673 32 4.8 1953 787 61 7.75 50,992 3,645 7.1 684 32 4.7 1954 787 78 9.9 50,745 3,615 7.1 673 31 4.7 1955 745 71 9.5 49,826 3,827 7.7 667 31 4.7 1956 837 99 11.8 52,171 4,434 8.5 700 33 5.0 1957 738 105 14.3 52,733 4,686 8.9 723 34 4.7 1958 742 98 13.2 54,152 5,343 9.9 740 36 4.9 1959 722 92 12.7 55,191 5,765 10.4 748 38 5.1 1960 697 98 14.1 Not yet available The mortality rate among legitimate and illegitimate infants can be compared as follows with those for London Administrative County and England and Wales:- Chelsea London England & Wales Year I.M.R. Leg. M.R. Illeg. M.R. I.M.R. Leg. M.R. Illeg. M.R. I.M.R. Leg. M.R. Illeg. 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 27o6 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 22.00 22.07 26.39 23.5 22.0 28.0 1959 16.6 15.9 21.7 22.4 22.00 26.19 22.0 22.0 27.0 1960 17.2 20.0 NIL Not yet available 9 SUMMARY OF VITAL STATISTICS 1947-1960 (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 - - 1959 49,520 722 14.6 726 14.7 12 16 - - I960 49,140 697 14.2 729 14.8 12 17 - - Averages for the fourteen years 1342-1960:- Births 794 Deaths 699 Deaths under one year of age 21.6 Maternal Deaths 0.36 * Totals arrived at after due allowance for inward and outward transfers. 10 DEATHS OF RESIDENTS DURING 1960. Causes of Death At all ages Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards 1. Tuberculosis, respiratory 2 - - - - 1 - 1 2. Tuberculosis, other - - - -- - - - - 3. Syphilitic disease 3 - - - - - 1 2 4. Diphtheria - - - - - - - - 5. Whooping-Cough - - - - - - - - 6. Meningococcal infections - - - - - - - - 7. Acute Poliomyelitis - - - - - - - - 8. Measles - - - - - - - 9. Other infective and parasitic diseases 5 - - - 1 - - 4 10. Malignant neoplasm stomach 20 , „ - - - 9 11 11. Malignant neoplasm lung, bronchus 30 - - - - - 12 18 12. Malignant neoplasm breast 16 - - - - 2 4 10 13. Malignant neoplasm uterus 9 - - - - - 5 4 14. Other malignant and lymphatic neoplasms 82 - - - 1 5 32 44 15. Leukaemla and Aleukaemia 6 - - - 1 - 1 4 16. Diabetes 2 - - - - - 1 1 17. Vascular lesions of nervous system 93 - - - - - 10 83 18. Coronary disease angina 113 - - - - 4 22 87 19. Hypertension with heart disease 10 - - - - - 2 8 20. Other heart diseases 112 - - - 1 2 9 100 21. Other circulatory diseases 41 - - - - - 5 36 22. Influenza 2 - - • - - - 2 23. Pneumonia 27 1 - - - - 8 32 24. Bronchitis 27 - - ■ - - 5 22 Carried forward 614 1 - - 4 14 126 469 11 DEATHS OF RESIDENTS DURING 1960. Causes of Death At all ages Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Carried forward 614 1 — — 4 14 126 469 25. Other diseases of respiratory system 8 — — — — 1 — 7 26, Ulcer of stomach and duodenum 5 — — — — — 1 4 27. Gastritis, enteritis and diarrhoea 4 — — — — — — 4 28. Nephritis and nephrosis 2 — _ — — — 1 1 29. Hyperplasia of prostate 4 _ — — — — — 4 30. Pregnancy, childbirth, abortion — — — — — — — — 31. Congenital malformations 6 2 1 1 1 — 1 — 32. Other defined and ill-defined diseases 43 9 2 — — 2 3 27 33. Motor vehicle accidents 9 — — — 2 3 — 4 34. All other accidents 16 — — — 1 4 1 10 35. Suicide 18 — — — 1 4 12 1 36. Homicide — — — — — — — — TOTALS 729 12 3 1 9 28 145 531 From an examination of the following summary it will be apparent that deaths in particular age groups have tended to become stabilised, particularly having regard to the figures which applied in the first quarter of this century. Dramatic variations will, it is hoped, no longer be the rule. Year No. of Deaths Deaths under 1 yr. 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 1959 726 12 1.65 541 74.52 I960 729 12 1.65 531 72.84 12 ANALYSIS OF DEATHS The percentages of the total deaths attributable to particular causes during the past five 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 1956 1957 1958 1959 1960 Average for 5 years (1) 0.12 0.27 0.55 0.41 0.27 0.32 (2) — -— 0.14 —- -— 0.03 (3) 0.49 0.40 0.27 0.14 0.41 0.34 (4) — — — — -— — (5) —- — — —- —- —- (6) — 0.13 — — —- 0.03 (7) — — — — —- —- (8) — 0.13 0.14 — —- 0.05 (9) 0.12 0.40 0.27 0.14 0.68 0.32 (10) 2.21 2.27 2.88 1.51 2.74 2.32 (11) 3.81 2.93 3.84 4.94 4.11 3.93 (12) 2.60 1.73 2.46 2.20 2.19 2.24 (13) 0.86 1.07 0.41 0.69 1.23 0.85 (14) 9.96 9.07 9.04 8.13 11.25 9.49 (15) 0.61 0.40 0.28 0.83 0.82 0.59 (16) 0.73 0.27 0.96 0.14 0.27 0.47 (17) 13 .41 14.52 13.42 11.16 12.76 13.01 (18) 10.60 9.73 12.20 14.19 15.50 12.44 (19) 2.21 2.80 2.05 2.20 1.37 2.12 (20) 14.51 15.20 12.60 13.77 15.36 14.29 (21) 8.36 10.13 6.85 8.13 5.62 7.82 (22) — 0.92 0.96 3.03 0.27 1.04 (23) 7.75 7.20 5.07 9.23 5.62 6.97 (24) 4.80 4.93 6.44 4.13 3.70 4.80 (25) 1.23 0.80 0.82 0.69 1.10 0.93 (26) 1.35 1.07 0.96 0.83 0.68 0.98 (27) —— 0.53 0.41 0.28 0.55 0.35 (28) 0.37 0.70 0.41 0.55 0.27 0.46 (29) 0.61 0.40 0.41 0.55 0.55 0.50 (30) — — — — — -— (31) 0.86 0.80 0.96 1.38 0.82 0.96 (32) 9.47 6.80 10.00 6.34 5.90 7.70 (33) 0.61 0.93 0.82 0.69 1.23 0.86 (34) 1.48 1.87 2.19 2.34 2.19 2.01 (35) 0.86 1.50 2.19 1.24 2.47 1.65 (36) 0.24 0.13 — 0.14 "— 0.10 13 CANCER OF THE LUNG AND BRONCHUS Thirty deaths (Males 25 and Females 5) from this cause were recorded, as compared with thirty-six in 1959. The following table briefly gives details of the deaths of Chelsea residents during the years 1951 to 1960 (inclusive), and whilst over such a short period it is not clear that abstinence from the habit of "smoking" results in more satisfactory returns in respect to deaths, it would appear obvious that morbidity is steadily increasing from this cause. Year Males Females Totals Percentage of Deaths Registered 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 1959 31 5 36 4.9 1960 25 5 30 4.2 Averages 21.9 5.3 27.2 3.7 It is apparent, however, that deaths approximately occur annually in the ratio of four males to one female. The real significance of the increase of England and Males can be properly gauged from the following summary of deaths during each year from 1951 until the end of 1960:- Year England and Wales Cancer of the Lung and Bronchus Number of Deaths Registered Increase over preceding year 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 1959 21,063 1,254 1960 21,992 929 14 INFANT MORTALITY During the year the number of deaths registered was twelve, the same as in 1959. Of this total, nine had not attained the age of four weeks. Four hundred and sixty-five infants under the age of one year, died in the period 1925 to 1934, giving an annual average of 46.5, whilst during the years 1951 to 1960 deaths aggregated 181 and presented an annual average of 18.1. It is of interest to indicate that deaths from this cause totalled twelve, as in the preceding year. This was mainly due to the fact that there were only two instances of prematurity, as against nine in 1958. Mortality was attributed to the following causes:- Males Females Congenital malformations -- 1 Respiratory failure 1 - Cerebral vascular accident 1 - Asphyxia - 1 Prematurity 2 - Atelectasis 1 1 Intestinal obstruction 1 - Diabetes 1 - Cerebral atrophy - 1 Broncho-pneumonia - 1 The actual periods at which mortality was recorded are as follows:- Males Under 1 week Under 4 weeks 4 weeks to 3 months 3 to 6 months 6 to 12 months Total under 1 year 5 1 - - 1 7 Females 3 - 1 - 1 5 15 INFANT MORTALITY RATES ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year of age per 1,000 live births. Country 1953 1954 1955 1956 1957 1958 1959 Average for 7 years England & Wales 27 25 35 24 23 22 22 25.4 Sweden 19 19 17 17 17 15 15 17.0 Netherlands 22 21 20 19 17 17 17 19.0 New Zealand 20 22 22 19 20 19 20 20.2 Australia 23 22 22 22 21 20 22 21.7 Denmark 27 27 25 25 23 22 22 24.4 United States of America 28 27 27 26 26 27 26 26.7 Scotland 38 31 30 28 29 28 28 30.2 Republic of Eire 39 38 37 36 33 35 32 35.7 France 42 4L 39 36 34 31 30 36.1 Italy 59 53 49 48 50 48 45 50.3 The above table has been prepared from information made available by the Registrar-General. 16 HQSPITALS AND NURSING HOMES Excellent facilities for both general and special hospital treatment are available in the Borough, as will be seen from the following lists- HOSPITALS TYPE OF INSTITUTION Brompton Hospital, Fulham Road, S.W.3. Cheat 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 Diseases Royal Marsden Hospital, Fulham Road, S.W.3. Malignant Diseases 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.10. General Spastic Children, The Centre for 61, Cheyne Walk, S.W.3. Treatment and research of cerebral palsy in the very young children 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 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 relating to Chelseas:- WELFARE CENTRES Attendances at Ante-natal and Post-natal Sessions 1,396 Attendances at Infant Welfare Sessions 6,818 HEALTH VISITING Number of visits carried out by Health Visitors:- Expectant mothers: First Visits 293 Total Visits .... 763 Children under 1 years: First Visits (including visits paid to Premature Infants) 641 Total Visits ... 2,431 Children between 1 and 2 years: Total Visits ... 1,404 Children between 2 and 5 years: Total Visits ... 2,319 Still Births: Total Visits ... 9 School Children: Total Visits ... 98 Care of Old Peoples: Total Visits ... 20 Care of Other Peoples: Total Visits ... 28 Miscellaneous: Total Visits ... 266 Unsuccessful: Total Visits ... 1,260 No. of children under 5 visited during the year ... 1,945 No. of households visited during the year ... 1,324 Foster Mothers: Number of registered foster mothers 4 Number of children fostered 3 18 MATERNITY, CHILD WELFARE & OTHER SERVICES (Continued) Diphtheria Immunisations: Number of children who completed a primary course of injections 460 Number of children receiving reinforcing injections 502 Vaccinations: Number of children vaccinated at Violet Melchett Infant Welfare Centre 266 Details of the facilities available at the Violet Melchett Infant Welfare Centre, Flood Street, S.W.3., are as follows:- CLINICS Ante-natal and Post-natal: Monday p.m. (by appointment) Relaxation & Ante-natal Exercises: Wednesdays 12 noon to 1 p.m. Fridays 2 p„m to 3 p.m. Mothercraft Classes with Demonstrations & Films: Friday at 3 p.m. Infant Welfare: Tuesday & Thursdays 2 to 4 p.m. Wednesdays 10.30 a.m. to 12 noon, at the Community Centre, 385. King's Read, S.W.10. Test Feeds arranged as required Vaccination against Smallpox Immunisation against Diphtheria,, Whooping Cough, Tetanus and Polio 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 1.30 p.m. to 4.45 p.m. Monday, Tuesday and Thursday; Friday 9 a.m. to 12.30 p.m. closed on 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, infirmity 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 great 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 11 persons in such accommodation during 1960, and all but 2 of these admissions were made at "King' s Mead". In a number of the cases concerned, transfers were only effected after considerable persuasion. - 20 - WELFARE OF OLD PEOPLE. The investigation of the circumstances and living conditions of each old person is undertaken by the Borough Council's officers. Every effort is made to ensure their well-being, with due appreciation of the fact that in most instances they prefer to remain in familiar surroundings. The importance of regular visiting is fully realised and greatly appreciated by the beneficiaries. At the close of the year 1,149 persons were on the registers of the Public Health Department. The Borough Council makes a grant of £4.50 yearly to the Chelsea Old People's Welfare Committee, which is representative of and co-ordinates the activities of voluntary organisations working in this sphere of public service. It is obviously impossible to refer to all the facilities offered, but the following list illustrates 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. During the year 12,971 meals were delivered, or an average weekly supply of 249. In 1959 the respective figures were 13,048 and 250. The delivery of hot meals at a regular hour was welcomed by recipients. Chiropody. 124 persons were recommended for this service provided by two qualified chiropodists, and the number of treatments given totalled 505. A clinic has now been opened entirely for the use of old age pensioners at the Chelsea Community Centre. It is staffed by students from the London County Council's main chiropody clinic in Chelsea. This clinic is very popular and during the year 492 persons received attention, involving 1,928 treatments. Holidays. The continuance of this scheme provided 116 persons with holidays at the sea or in the country. The majority stayed at homes controlled by the Women's Holiday Fund, and in a number of cases, escorts were provided to take people to and from railway stations. Married couples were accommodated at various seaside resorts early or late in the summer at special reduced rates for pensioners offered by the Hotel and Boarding Associations. 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 who are housebound by their disabilities. The Society also provided 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 happy relationships have been maintained between the Council's officers and hospital authorities from whom willing co-operation and assistance has been received. 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. - 21 - Institutional care became necessary for 11 persons, all of whom settled down quite readily to a communal life. The Women's Voluntary Services and other kind donors have continued to dispense much needed clothing to recommended cases,, and 239 persons were so helped in this manner during the year, as compared with 24.1 in 1959. The National Assistance Board also gives every sympathy to persons in distress, and makes grants which ensure the securing of essential items. A few people are found to be in enfeebled condition, and therefore unable to look after themselves properly. In such cases, personal cleansing is arranged. At the same time rooms are cleansed and superfluous items disposed of. 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 34 persons have so benefited, and some 6,928 pounds of bedding, etc., laundered. Christmas Dinners. Through the kindness of voluntary subscribers and a working committee, sufficient funds were secured to provide 528 housebound and lonely old folk with a Christmas parcel containing sweets, biscuits, chocolate, sugar, cake, tea and a miniature bottle of brandy. Voluntary helpers carried out the distribution of the parcels during Christmas week. In addition to this number it is known that over 200 other pensioners received some form of parcel or gift. Old-Time Dancing Classes were held on one afternoon each week with the services of a fully qualified teacher and pianist supplied and paid for by the London County Council. A fee of l/6d. per term is paid by each old person who attends. Membership of the class is now over 60 and all members thoroughly enjoy themselves and at the same time derive great benefit from dancing. The Council's Social Worker made 1,944 visits to cases on the Council's registers. In a number of cases, visits were made to people whilst they were in hospital. Many visits were of a protracted nature, and led to the making of a variety of enquiries, the completing of which cannot be easily classified in a statistical report. Outings. During the year, outings were arranged to the country through the kindness of various Women's Institutes and the Chelsea Rotarians. These opportunities are mainly confined to non-club members as the clubs have their own facilities during the year. The Welfare Officer makes every effort to ensure that only the lonely or those who seldom go out are invited, and on all occasions tea and entertainment is provided. - 22 - BOROUGH CREMATION SERVICE The Borough Council, in October 1957, 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,. During 1960 these arrangements were made in respect of twenty-six persons. In Great Britain the total number of cremations recorded last year was 204,034, an increase of over 13,000 in the figures for 1959. The total for 1960 represented 34.71% of the recorded deaths as compared with 32.30% for the preceding year. It will be obvious from the following table that since 1952 the number of crematoria has considerably more than doubled, whilst since records were first maintained cremations have quadrupled. The Progress of Cremation in Great Britain Year No. of Crematoria No. of Cremations Percentage of Deaths 1946 58 50,160 8.90 1947 58 61,160 10.47 1948 58 64,290 12.10 1949 58 79,607 13.86 1950 58 89,557 15.63 1951 59 107,161 17.43 1952 63 107,699 19.27 1953 68 116,728 20.76 1954 74 125,521 22.29 1955 82 141,353 24.37 1956 99 153,238 26.27 1957 108 163,368 23.36 1958 120 180,075 30.58 1959 131 190,819 32.30 1960 148 204,034 34.71 - 23 - CENTRE FCR SPASTIC CHILDREN. The Centre for Spastic Children was established at 61, Cheyne Walk in 1955, for the treatment and research of cerebral palsy in the very young child. It is part of the Chelsea and Kensington Hospital Group and has access to any facilities which may be required in the other hospitals in the group. About 65 children attend regularly for treatment at the centre, either as out-patients, attending two or three days a week with their mothers, or as full day patients, when they spend the days in one of the two nursery classes or in the assessment unit, receiving daily therapy as required. The classes are recognised by the London County Council as a Special School and an outstanding feature of the centre is this combination of educational and medical care, the emphasis being on the latter. A loop induction system has been installed in each class-room and in the garden, so that children with hearing losses or defects, may have an opportunity to be included with the normal hearing children in group activities. A teacher of the deaf also takes these children for individual tuition daily, and every child who is accepted for treatment at the centre is given a full audiometric test. An electroencephalographic department forms part of the routine work of the centre every patient being tested by the recordist as part of the initial examination. The provision by the Association of Friends of the hostel for the weekly boarding of children from a distance or from difficult homes, and for a mother and child for a period of assessment and advice, has continued to be a valuable asset to the centre and is in constant use. The provision of a therapeutic pool is under consideration and it is hoped to start pool therapy for the children by the summer of 1961. Suitable children are accepted for treatment at the centre as out-patients as soon after birth as cerebral palsy is diagnosed, and may continue to receive treatment up to the age of seven, or longer if necessary. Children are considered for admission to the classes from the age of 2 up to the age of 7 years. - 24 - MEDICAL EXAMINATIONS A total of 45 medical examinations were carried out during the year 1960 on members and prospective members of the staff. One person was found to be unfit. NATIONAL ASSISTANCE ACT. 1948. Section 50 of the National Assistance Act, 1948, places responsibility upon a local authority to arrange the burial or cremation of any person in respect of whom no other suitable arrangements can be made. The Borough Council does not, however, arrange for cremations to be carried out. In some instances it has not always been possible to trace any surviving relatives, although every conceivable line of enquiry has been pursued, but there is always the possibility that a member of the deceased's family might ultimately be contacted, and who would not express approval to cremation having been performed. During the year it was necessary to arrange three interments as follows- Males Females (Aged) 79 years 87 years 72 years PUBLIC MORTUARY FACILITIES A public mortuary has not been in existence within the Borough for some years. An agreement has been effected with the Hammersmith Borough Council whereby excellent facilities are available at their mortuary in Fulham Palace Road. During 1960, two hundred and fifty-seven post-mortems were carried out in respect of Chelsea residents. - 25 - MASS RADIOGRAPHY The Central Mass X-Ray Centre at the Western Hospital, Seagrave Road, Fulham, S.W.6. is open without appointment, every Wednesday between 2.00 p.m. and 4 p.m., and from 5.00 p.m. to 7 p.m. It was not possible to have a Mass X-Ray Centre functioning at the Chenil Galleries, King's Road, Chelsea, during the past year. A mobile unit made visits to three undertakings in the Borough and made its annual visit to the Chelsea Polytechnic. On the above occasions 1,782 examinees presented themselves. Further, male employees of one firm in Chelsea, and over two hundred men drawn from offices and work places in this area co-operated in a special service for persons over 45 years of age, when volunteers are X-Rayed six-monthly in a pilot research survey by which an attempt is made to diagnose lung cancer in its early stages. It is hoped to repeat these visits during 1961, and to arrange the attendance of Mobile Units in various parts of the Borough. - 26 - SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF THE WORK PERFORMED BY THE PUBLIC HEALTH INSPECTORS DURING THE YEAR 1960. Number of complaints received during the year 607 INSPECTIONS AND RE-VISITS DWELLINGS: Inspections after complaints 2,127 Inspections after infectious disease 449 House-to-House inspections 9 Underground Rooms 184 Overcrowding and "Permitted Numbers 69 Other Visits 46 2,884 FOOD PREMISES: Butchers 314 Fishmongers and Fish Friers 87 General Provision Shops 66 Dairies 208 Ice Cream Vendors 239 Ice Cream Manufacturers 5 Bakehouses 43 Street Stalls and Barrows 93 Food Factories (Mechanical) 12 Hotels, Restaurants and Dining Rooms 1,134 Premises in connection with unsound food 105 Premises in connection with food sampling 144 Other food premises 158 2,608 FACTORIES AND OUTWORKERS: Factories other than Food Factories (Mechanical) 239 Factories other than Food Factories (Non-mechanical) 74 Outworkers 5 Other Visits 3 321 DRAINAGE: Drains tested: (a) by water 535 (b) by smoke 33 (c) by air 147 715 Carried forward 6,528 - 27 - SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF THE WORK PERFORMED BY THE PUBLIC HealthINSPECTORS DURING THE YEAR I960 Brought forward 6,528 INSPECTIONS AND RE-VISITS (Continued) MISCELLANEOUS: Animals, Poultry and Birds 11 Open Spaces and Highways 57 Ofiice Premises . 3 Premises re Pharmacy and Poisons 49 Premises to enforce requirement of Shops Act 339 Premises re Voluntary Works 5,755 Visits to owners, agents and builders' offices 256 Smoke Observations 130 Food Poisoning 2 Visits to aged and infirm persons 122 Premises under Pet Animals Act, 1951 5 Atmospheric Pollution Recording 283 Visits resulting in "No access" 566 Other visits 1,345 Visits in connection with the Clean Air Act, 1956 1,731 Premises under Rag Flock Act, 1950 10 Inspections after Infectious Disease (other than dwellings) 3 Visits to Verminous Persons 2 10,676 Total 17,204 - 28 - WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS FACTORIES ACT, 1937 SHOPS ACT, 1950 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD AND DRUGS ATC, 1955 TOTAL CLEANSING: N. V. N. V. N. V. N. V. Rooms: Walls & Ceilings cleansed & rede c orated 2 –– 8 – – – – – 10 Passages & Staircases: Ceilings cleansed & redecorated – – – – – – 2 – 2 Rooms where Food is manufactured, stored or sold – – 2 1 – – 19 13 35 GENERAL IMPROVEMENTS AND REPAIRS: Roofs: – – – – 51 3 – – 54 Eaves, Gutters – – – – 24 – – – 24 Rain-water pipes – – – – 18 – – – 18 Yard and Area: Pavings – – – – 3 – – – 3 Walls rendered or repaired 1 – – – 10 – – – 11 Rooms: Wall & Ceiling plaster – – 1 2 70 – 3 – 76 Passages & Staircases: Wall and Ceiling plaster – – – – 23 – – – 23 Floors – – – – 15 2 4 2 23 Stair Treads, Banisters & Balustrades – – – – 10 – – – 10 Window & Door Frames, fittings & sash cords 1 – 2 – 120 4 – – 127 Dampness remedied – – – – 135 – – – 135 Fireplaces & Fire-ranges repaired – – – – 10 – – – 10 Natural Ventilation provided or improved 2 – – – – 1 – – 3 Chimneys and Flues – – – – 3 – – – 3 Miscellaneous – – – – 6 – 2 – 8 Carried forward 6 – 13 3 498 10 30 15 575 - 29 - WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937 SHOPS ACTp 1950 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1955 TOTAL N. V. No V. N. V. N. Vo Brought forward 6 – 13 3 498 10 30 15 575 DRAINAGE: Total Reconstructions – 1 – – – 18 – – 19 Partial Reconstructions, repairs or alterations – – – – – 14 – 1 15 Frontage Drains Reconstructed – – – – 5 2 1 – 8 Obstructions cleared – – 1 2 29 6 – – 38 Inspection Chambers provided – – – 1 – 41 1 – 43 Inspection Chamber covers renewed – – – – 3 – – – 3 Interceptors provided – – – – – 18 – – 18 Soil & Ventilation Stacks provided or reconstructed 2 2 – – 2 81 – – 87 Soil & Ventilation Stacks repaired – – 1 – 4 – – – 5 Waste & Ventilation Stacks provided or reconstructed 2 2 – – 2 73 – 1 80 Waste & Ventilation Stacks repaired 1 – – – 1 – – – 2 Fresh Air Inlets provided – – – – – 24 1 – 25 Fresh Air Inlets repaired or renewed – – – – 5 2 – – 7 Single Sinks provided 1 – – 6 – 219 4 3 233 Single Sinks renewed – – – – 1 – 4 – 5 Double Sinks provided – – – – – – 2 1 3 Baths provided – – – – – 259 – – 259 Wash-hand basins provided 2 9 9 10 – 204 – 7 241 Wash-hand basins renewed – – 1 – – – 4 – 5 Waste Pipes cleared of obstructions or repaired – – – – 1 – – – 1 Untrapped waste pipes provided with traps – – – – 2 – 1 – 3 Miscellaneous 2 – 1 – 8 – 2 – 13 Carried forward 16 14 26 22 561 971 50 28 1688 - 30 - WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937 SHOPS ACT, 1950 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1955 TOTAL N. V. N. V. N. V. N. V. Brought forward 16 14 26 22 561 971 50 28 1688 SANITARY CONVENIENCES: Additional Water Closets provided 2 14 – 3 – 294 1 10 329 Water Closet pans renewed 1 – 1 – 2 1 – – 5 Water Closet pans cleansed – – – 1 2 – – 1 4 Water Waste preventers renewed or repaired – – – – 12 – – – 12 Water Waste preventers provided 2 14 – 8 – 294 1 10 329 Urinals repaired – 1 – 1 – – – 1 3 Roofs repaired or renewed 1 – – – 1 – – 1 3 Floors repaired or renewed – – – – 3 – – – 3 Walls & Ceiling plaster cleansed, repaired or redecorated 8 – 2 2 6 – – 1 19 Natural Ventilation provided or improved 2 – – – – – – – 2 Natural or Artificial Light provided or improved 4 1 2 – – – 1 – 8 Ventilated Lobby provided – – – – 2 – – 1 3 Miscellaneous – – – 1 – – 2 – 3 WATER SUPPLY: Supplies provided to Tenements – – – –– 2 – – – 2 Taps supplied on main for drinking purposes – – – – – – –– – – Burst Pipes repaired – – – – 6 – – – 6 Cisterns cleansed, covered or repaired – – – – – 1 – –– 1 Carried forward 36 44 31 43 597 1561 55 53 2420 - 31- WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937 SHOPS ACT, 1950 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1955 TOTAL N. V. N. V. N. V. N. V. Brought forward 36 44 31 43 597 1561 55 53 2420 MISCELLANEOUS SERVICES PROVIDED: Soap and Towels for staff – – 1 – – – – – 1 Staff Rest & Changing rooms – – – – – – 1 – 1 Constant Hot Water – – – – – – 1 2 3 Bins, refuse – – – – 4 – – 1 5 Covered Display and Counter Screens provided –– – – – – – 4 2 6 MISCELLANEOUS NUISANCES ABATED, ARISING FROM: Offensive accumulations on open land and bomb sites – – – – 6 7 – – 13 GRAND TOTALS 36 44 32 43 607 1568 61 58 2449 N = Work carried out under notice V = Voluntary Works - 32 - INSPECTIONS, PROCEEDINGS. ETC. Total number of houses in the Borough 16,441 (approx.) PUBLIC HEALTH (LONDON) ACT. 1936. Number of houses inspected on account of complaints or illness 1,106 Number of statutory notices served 42 Number of intimation notices served 121 Number of houses repaired or nuisances remedied 126 LEGAL PROCEEDINGS - PUBLIC HEALTH (LONDON) ACT. 1936. The institution of legal proceedings under the Public Health (London) Act, 1936, was necessary in one instance details of which are set out below:- Premises 8, Luna Street Offence Non-compliance with Statutory Notice. Result of Proceedings Abatement Order made for the work to be completed within twenty-eight days. Council awarded £1. 1s. 0d. costs. - 33 - 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. This complaint was referred to the Board who took samples of water from the tap, results of which showed that the water was of satisfactory hygienic quality and fit for human consumption. As a result of investigation by the Council's Public Health Inspectors the following provisions were made:- Supplies to tenements 2 Burst pipes repaired 6 Cisterns cleansed, covered or repaired 1 PUBLIC BATHS AND SWIMMING POOLS These facilities are available at premises situate in Chelsea Manor Street, adjacent to the Town Hall. They consist of two swimming pools - one 100' x 30' holding 100,000 gallons of water, and the other 97' x 27' holding 90,000 gallons of water, and personal baths. The supply of water is obtained from a deep well situated beneath the baths and is treated by chlorination and continuous filtration. During the day the water is changed every 4 hours. Thirty-one samples of water were taken from baths, pools and sources of supply, for bacteriological examination. Of this total, one sample was adversely reported upon because of its high plate count. From investigation it appears that this was due to the cleaning of the filters. A further sample was taken and this was found to be satisfactory. - 34 - DETAILS OF NOTICES SERVED DURING THE YEAR 1. PUBLIC HEALTH (LONDON) ACT. 1936 (a) Intimation 120 (b) Nuisance Notices 33 (c) Section 40 - Drainage 4 L.C.C. (General Powers) Act. 1954 Section 12 - Provision of dustbins - Intimations 1 L.C.C. (General Powers) Act. 1955 Section 25 - Stopped up drains 5 2. FACTORIES ACT. 1937 Health - general provisions 2 3. FOOD AND DRUGS ACT. 1955 Defects at food premises 38 4. SHOPS ACT. 1950 Provision of suitable sanitary conveniences and ventilation 11 5. CLEAN AIR ACT. 1956 Adaptation of fireplaces in private dwellings 23 TOTAL 242 DETAILS OF NOTICES COMPLIED DURING THE YEAR One hundred and eighty-four notices were complied with during the year oi which one hundred and twenty-four were served under the Public Health (London) Act, 1936. RENT ACT. 1957 During the year no applications were received or certificates issued in accordance with the provisions of the above Act. - 35 - HOUSING ACT, 1957 - PART IV - OVERCROWDING New cases investigated and recorded 3 Number of families involved 3 Number of persons involved 19 Cases relieved by:- (a) Rehousing Authorities NIL (b) Informal or formal procedure 4 Such action resulted in 19 persons being adequately housed. Cases on register at 31st December, 1960 25 Number of persons involved 153 APPLICATIONS FOR RE-HOUSING To assist the Council's Property Manager in arriving at a just consideration of the merits of each application received a "pointing" system was evolved, and became effective in May, 1953. As applicable, points were awarded under the following headings:- Sub-standard accommodation; Ill—health (excepting Tuberculosis); Tuberculosis; Overcrowding; and Other circumstances. During the year, 5 applications were referred to the Public Health Department, 4 originated from Chelsea residents and the remaining one from an applicant living in another area. Each case was investigated3 in connection with ill-health including tuberculosis, and 2 in respect of sub-standard accommodation, bringing the total number of cases since May, 1953, to 334 residents and 95 non-residents. The cases of 15 licensees in requisitioned premises and 5 tenants in Council premises were also referred to this Department during the year for an opinion or pointing on medical grounds. A total of 340 such cases have been dealt with since 1955. - 36 - FACTORIES ACT. 1937c 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 Public Health Inspectors during the year*- 1. INSPECTIONS OF FACTORIES. WORKSHOPS AND WORKPLACES. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (l) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities: 67 74 – – (2) Factories not included in (1) in which Section 7 is enforced by Local Authorities: 216 251 2 – (3) Other premises in which Section 7 is enforced by Local Authorities X 43 43 – – TOTALS 326 368 2 – NOTE:- Outworkers' premises are not included in (3) above. x 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 To H.M. Inspector By H.M. Inspector Want of Cleanliness (Section l) – 2 – – – Overcrowding (Section 2) – – – – – Unreasonable Temperature (Section 3) – 1 – – – Inadequate Ventilation (Section 4) – – – – – Ineffective drainage of floors (Section 6) – – – – – Sanitary Conveniences (Section 7) (a) Insufficient – – – – – (b) Unsuitable or defective 9 14 – 3 – (c) Not separate for sexes – – – – – Other offences against the Act (not including Outworkers) – – – – – TOTAL 9 17 – 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 (1)(c) No. of Cases of default in sending List to the Council No. of Prosecutions for failure to supply Lists No. of instances of work in unwholesome premises Notices served Prosecu tions Wearing Apparel making etc. 8 – – – – – Household Linen – – – – – – Curtains and furniture hangings 3 – – – – – Furniture and Upholstery – –– – – – – Stuffed Toys 1 – – – – – Lampshades – – – – – – Jewellery 1 – – – – – TOTALS 13 – – – – – - 39 - FOOD HYGIENE Since the introduction of the Food Hygiene Regulations, 1955, considerable progress has been made in structural improvements in food premises. A large number of food shops and restaurant kitchens have been completely reconstructed following notices from the Public Health Inspectors and, in addition, other shopkeepers and restaurant proprietors have voluntarily modernised their premises and in nearly all cases have sought and accepted the advice of the Inspectors before the alterations started. An increasing number of provision shops are following the modern trend of self-service, and although this method ensures that almost all goods are wrapped and the majority displayed under refrigeration, special attention has now to be paid to the preparation rooms where the foodstuffs are weighed and packed. This has sometimes meant requests for additional washing facilities to be provided within or adjacent to the preparation room so that persons handling unwrapped butter, cheese and cooked meats can be encouraged to wash after opening tins, packing-cases and cartons. With the advent of automatic food and milk vending machines and conversions to self-service stores, the pattern of the food retail business appears to be changing. During 1960, only two new food shops and one new restaurant were opened, and it has been noted that small family businesses continue to close down. In addition the occupiers of a number of small milk-shops which formerly provided a milk delivery service have now sold their milk-rounds to the larger combines. SHOPS ACT 1960. Health and Welfare Provisions In the past responsibility for enforcement of the section of the abovementioned Act dealing with the health and comfort of shop workers has been divided between the London County Council and the local Council, but as from 1st January, 1959, the London County Council's powers and duties in this respect were transferred to the Metropolitan Boroughs, making them responsible for the following: 1. Washing facilities 2. Sanitary conveniences 3. Lighting 4. Temperature 5. Facilities for taking meals Taking into consideration the extensive shopping frontages of Sloane Street, King's Road and Fulham Road,, these extra duties necessitated a considerable number of inspections and, in all 339 visits were made and 11 notices served. - 40- INSPECTION AND SUPERVISION OF FOOD Registers are maintained of all premises 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 detais of the type of businesses receiving the special attention of the Public Health Inspectors:- Bakehouses 6 Butchers 26 Horse-flesh butcher 1 Food Factories (flour mills, bottling stores, ice cream factory) 7 Milk Retailers (including dairies) 53 General provision merchants (not selling milk) 27 Fruit and vegetable retailers 28 Hotels and Public Houses Restaurants, Dining Rooms, Canteens ) 188 Fried fish premises 3 Wet fish retailers 9 Miscellaneous premises (Bread and cake shops, sweets and confectionery shops, ice cream store) 53 As required under Section 16 of the Food and Drugs Act, 1955, 123 premises are registered for the storage and sale of Ice Cream, and 30 premises for the sale of Preserved Food. - 41 - LEGAL PROCEEDINGS - Food and Drugs Act, 1955- During the year, ten complaints were received regarding the sale of foodstuffs not being of a satisfactory nature, but in each case the Public Health Committee directed that a warning letter be sent as the offences did not justify the institution of legal proceedings. BACTERIOLOGY During I960, 30 samples were submitted for examination to the Bacteriological Laboratory of the Public Health Service, London County Council. These consisted of - No. of Samples Ice Cream Water Milk Meat Sandwiches Bread Pudding Ice Lolly 32 31 14 1 1 1 80 One sample (meat sandwiches) was found to contain a growth of staphylococcus aureus, the cause of the food poisoning outbreak report on Page 6Q„ The ice cream samples submitted to the Laboratory gave the following results when subjected to the Methylene Blue tests:- Grade I: 18 Grade II: 10 Grade III: 1 Grade IV: 3 32 - 42 - MILK SUPPLY Under the Milk and Dairies (General) Regulations, 1959, 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, 1960, entries in the register were as follows:- (a) Number of registered distributors with premises in the Borough. 45 (b) Number of premises in the Borough, other than dairies from which milk is distributed 52 (c) Number of premises in the Borough registered as dairies 1 (d) Number of registered distributors other than those included in (a) above 16 During the year 148 applications were received, and principal licences were granted under the Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954, and the Milk (Special Designation) (Pasteurised and Sterilised) Milk Regulations, 1949 to 1953, authorising the use of special designations in relation to milk sold at, or from premises within the Borough. 55 supplementary licences were granted in respect of milk sold by retail within the Borough from 22 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 46 57 45 148 Supplementary 17 19 19 55 All retailers selling milk within the Borough have been licensed to use special designations in accordance with the provisions of Sections 37(l) and 41(1) of the Food and Drugs Act, 1955. - 43 - PET ANIMALS ACT. 1951. Two applications for the renewal of licences to keep Pet Shops in pursuance of Section 1 of the Pet Animals Act, 1951, were approved during the year. Regular inspections were carried out by the Public Health Inspectors to ensure that all animals were being cared for and maintained in accordance with the conditions specified in the licence,, RAG FLOCK AND OTHER FILLING MATERIALS ACT. 1951. Since the above-mentioned Act came into force on the 1st November, 1951, eleven premises used for upholstering and similar processes have been registered in pursuance of the provisions of Section 2 of the Act. During the year six premises were using filling materials to which this Act applies. Thirteen samples of various filling materials were submitted to the Research Laboratories for analysis and in each case the Analyst issued a satisfactory certificate. There are no premises in the Borough where rag flock is manufactured. PHARMACY AND POISONS ACT. 1933. The number of listed sellers of Part II Poisons, on the Council's Register was 46. All applications are investigated to ensure that records are properly maintained, labelling efficiently performed, storage accommodation adequate, and that sales are only made by employees nominated on the application forms. In every instance it vas 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 given, appropriate entries are made for a period of twelve months (1st May to 30th April.) - 44 - STREET TRADING - Licensed and Unlicensed Stall-holders. Traders are licensed annually to operate from established 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 licensees 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 while handling food has been considerably reduced as a result of the verbal and written warnings issued by the Public Health Inspectors throughout the year. 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 from licensed sites in this Borough is carried out as follows:- Fruit and vegetables l4 Refreshments (at coffee stalls) 3 Flowers 10 Newspapers 6 In addition there are 3 stalls which are sited on private forecourts. These are: Fruit and vegetables 1 Shellfish 1 Clothing 1 Ninety-three visits were made to stalls during the year. The institution of legal proceedings in respect of unsatisfactory conditions was not necessary. -45 - UNSOUND FOOD When it has been established that food is unfit for human consumption, it is surrendered to the Council's Public Health Inspectors, removed from the premises, and the necessary surrender certificates issued, the food being subsequently disposed of via the Council's refuse disposal service, after suitable treatment with liquid carbolic. Approximately 2,230 pounds of unsound or diseased food were surrendered to and destroyed by the Council's Public Health 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 1957 - I960 (inclusive) are set out in the following tables- UNSOUND FOOD SURRENDERED TO THE COUNCIL'S FOOD INSPECTORS DURING THE YEARS 1957 - I960 (INCLUSIVE). Commodity 1957 lbs. 1958 lbs. 1959 lbs. I960 lbs. Biscuits - - - 119 Cheese 33 44 46 16 Currants 102 - - 28 Fish, Tinned 11 - 114 32 Fish, Fresh - - 43 - Flour - - 80 200 Fruit, Tinned 482 421 380 208 Fruit, juices 46 31 46 30 Fruit, Fresh - - 120 36 Fruit, dried - 25 - - Ice Cream - - 99 - Meat, Fresh 853 815 281 294 Meat, Tinned 520 910 635 314 Milk, Tinned 28 - 30 20 Potatoes - 208 - - Preserves - Jams Marmalade, etc. 21 - 20 190 Rice - - - 112 Sausages 23 - - - Soups 16 16 30 55 Vegetables, Fresh - - - 448 Vegetables, Tinned 410 125 328 103 Aggregates of all foods condemned annually 2,661 2,780 2,290 2,230 Average for the four years - 2,490 lbs. 46 RODENT CONTROL - The Prevention of Damage by Pests Act, 1949.0 The following are details of work carried out during the year by the Rodent Officers in connection with the destruction of rats and mice? 1. Treatment of Business and Private Premises. Business Premises Private Premises Number of visits 533 3,020 Number of infestations found 43 270 Number of treatments undertaken 40 256 Number of pre-baits laid 2,398 Number of poison baits laid 718 Number of complaints received 330 2. Sewer Maintenance Treatments. No. of prebaits laid No. of poison baits laid No. 1 Treatment 1,355 421 No. 2 Treatment 1,180 281 There has been excellent co-operation from owners and occupiers of premises where treatments have been carried out. It is of interest to record that a large number of rat infestations have been traced to defective frontage drains, this being the section of drain between the interceptor and the sewer, and such iniestations have been completely eradicated on reconstruction or repair of the defective drain. -47- DISINFECTION AND DISINFESTATION SUMMARY OF WORK CARRIED OUT BY THE COUNCIL'S DISINFECTING STAFF DURING THE YEAR I960, 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 14 L.C.C. Schoolchildren 2 VERMINOUS CONDITIONS Adults 73 Children 19 L.C.C. Schoolchildren 16 DISINFECTION OF ROOMS AND CONTENTS. CLOTHING ETC. Number of Rooms Disinfected 204. Number of Articles Disinfected 2,355 DISINFESTATION OF ROOMS AND CONTENTS Number of Rooms Disinfested 304 Number of Articles Disinfested 1,507 - 48 - CLEAN AIR ACT, 1956 SMOKE CONTROL ORDERS THE CHELSEA (CHURCH WARD) SMOKE CONTROL ORDER, 19S9o The Council"a first Smoke Control Order (The Chelsea (Church Ward) Smoke Control Order, 1959) was confirmed, without modification, by the Minister of Housing and Local Government on the 26th January, I960, and became operative on the 1st November, 1960o The area covered by the Order comprises approximately 93 acres and is bounded on the north by the centre of Fulham Road9 on the eaat by the centres of Draycott Avenue, Whiteheads Grove and Markham Street, on the south by the centre of King's Road and on the west by the centre of Old Church Street. Included in the area are 3,948 domestic dwellings, 196 commercial premises and 14 industrial premises. Immediately after receipt of the Minister's confirmation, a circular letter was sent to all householders in the area where fireplaces required adaptation or replacement, notifying them accordingly, and advising as to the procedure for obtaining grant0 During the early months after the Order had been confirmed few applications for approval of proposed works were receivedo It was decided therefore, in late June, to circularise all householders, reminding them that in order to rank for grant works of adaptation or conversion must be approved and carried out before 1st November, 1960. This action brought about a considerable improvement in the number of applications submitted and by the end of the year approvals had been issued in respect of 1419 dwellings concerning 1564 appliances, which represented 73% of the total fireplaces requiring adaptation or replacemento In addition to the works approved by the Council, there were some 53 dwellings where the occupiers had not applied for grant-aid, having carried out the necessary works at their own expense or provided alternative means of heating by supplying portable oil or electric appliances. In accordance with the provisions of Section 12(2) of the Clean Air Act, 1956, 28 notices were served requiring works of adaptation to fireplaces which were considered reasonably necessary to avoid contravention of the provisions of Section 11 of the Act. THE CHELSEA (HANS TOWN WARD) SMOKE CONTROL AREA. The Council, at its meeting on the 16th November, I960, agreed in principle to make Hans Town Ward its second Smoke Control Area, and the Town Clerk was authorised to supply the Minister of Housing and Local Government with all necessary particulars of the Council's proposals, in order to obtain his consent to a detailed survey of the Ward being undertaken. Hans Town Ward covers approximately 110.6 acres, accommodating approximately 8,620 persons,, and contains 3,294 domestic dwellings (including 320 Council dwellings), 366 commercial premises, 10 industrial premises,4 schools, educational and cultural establishments, 6 Crown -49 - properties and 3 churches and religious establishments. The area is bounded on the north-west by the centres of Walton Street, Walton Place, Basil Street, Hooper's Court, Brompton Road and Knightsbridge; on the east by the centres of William Street, the east carriageway of Lowndes Square, Lowndes Street, the west carriageway of Chesham Place, Che sham Street, Eaton Place and West Eaton Place} on the south by tte centres of Ellis Street, Cadogan Gardens and Cadogan Street; and on the south-west by the centre of Draycott Avenue. (A map of the Ward appears on page 50). Subject to receiving the Minister's early consent to the carrying out of a detailed house-to-house survey in the area, it is anticipated that the survey will be completed in time to enable the required information to be submitted to the Council at its meeting in October or November, 1961. The Order will than be made by the Council and submitted to the Minister for confiimation. In the event of the Order being confirmed by January, 1962 it will come into operation on the 1st November, 1962. CLEAN AIR ACT. 1956 HANS TOWN WARD SMOKE CONTROL AREA THE CHELSEA (lIANS TOWN WARD) SMOKE CONTROL AREA The Area is bounded on the north-west by the centres of Walton Street, Walton Place, Basil Street, Hooper's Court, Brompton Road and Knightsbridge; on the east by the centres of William Street, the east carriageway of Lowndes Square, Lowndes Street, the west carriageway of Chesham Place, Chesham Street, Eaton Place and West Eaton Place; on the south by the centres of Ellis Street, Cadogan Gardens and Cadogan Street; and on the south-west by the centre of Draycott Avenue. - 51 - ATMOSPHERIC POLLUTION RECORDING The Council maintain two measurement and recording stations. The readings are submitted to the Department of Scientific and Industrial Research, who issue monthly bulletins indicating the national picture as regards atmospheric pollution. The stations are situated at the Chelsea Polytechnic, Manresa Road, and the 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 air. The deposited matter is collected at the end of each month and forwarded to The Royal Institute of Public Health and Hygiene for analysis. The following tables show the results obtained from this station during the yearr- Month I960 Days Exposed Ra infall (ins.) Total Deposits for perioc in tons per sq. mile 1 Deposits per day in tons per sq. mile (average) Soluble soluble Total Soluble soluble Total January 32 1.37 7.68 9.99 17.67 .240 .312 .552 February 28 1.62 7.33 10.59 17.92 .617 .378 .640 March 30 1.53 11.30 10.92 22.22 .376 .364 .740 April 32 0.52 5.39 10.79 16.19 .168 .337 .505 May 30 1.54 11.28 11.11 22.39 .376 .373 .746 June 30 • 0.98 6.63 12.29 18.92 .221 .496 .630 July 32 3.40 5.06 11.67 16.73 .158 .364 .522 August 30 3.73 6.75 9.43 16.18 .225 .314 .539 September 29 3.51 7.15 8.70 15.85 .246 .300 .563 October 32 5.12 8.94 11.13 20.07 .279 .347 .627 November 30 3.20 10.24 10.18 20.42 .341 .339 .680 December 29 1.89 5.25 11.74 16.99 .171] .450 .634 Totals 364 28.a 93.00 , 128.54 221.55 - 52 - Estimation of Atmospheric Sulphur Milligrams of Sulphur Trioxide per Day. Month Days Exposed Chelsea Polytechnic January 32 5.02 February 28 4.99 March 30 4.75 April 32 2.54 May 30 2.69 June 30 2.05 July 32 1.79 August 30 1.45 September 29 2.28 October 32 3.25 November 30 3.70 December 29 4.27 Average for year: 3.23 Chenil Galleries This station measures the amount of smoke suspended in the air and the sulphur dioxide content of tne 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. 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. - 53 - Atmospheric Pollution Recording (Continued) The following table shows the results obtained from this station during the year t- VOLUMETRIC ANALYSIS - SMOKE AND S02 Month Average daily total Smoke mg/100 ml S02 p.p.100 m. January 40 16.7 February 34 13.5 March 27 17.2 April 13 9.4 May 12 7.6 June 13 5.8 July 5 4.8 August 7 4.6 September 16 6.5 October 18 10.6 November 25 9.5 December 33 13.6 t EPIDEMIOLOGY Incidence and Notification of Infectious Disease - 54 - The undermentioned diseases are notifiable to the Medical Officer of Health by general practitionerss- Anthrax Cholera Continued Fever Diphtheria Dysentery Encephalitis, Acute Enteric (Typhoid or Paratyphoid) Fever Erysipelas Food Poisoning (or Suspected Food Poisoning) Glanders Hydrophobia Leprosy Malaria Measles Membranous Croup Meningococcal Infection Ophthalmia Neonatorum Pla gue Pneumonia, Acute Influenzal Pneumonia, Acute Primary Poliomyelitis, Acute Puerperal Pyrexia Relapsing Fever Scabies Scarlatina or Scarlet Fever Smallpox Tuberculosis Typhus Fever Whooping Cough - 55 - 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 (Boydii type 2) - - - - 2 1 14 17 Dysentery (Flexner) - - - 1 - - - 1 Dysentery (Sonne) 1 17 15 2 13 2 - 50 Erysipelas - - - - 2 - 1 3 Food Poisoning - - 9 3 2 1 - 15 Measles 1 6 7 1 - - - 15 Meningococcal Infection - 2 - - - 1 - 3 Pneumonia: AcoInfluenzal - - - - - 1 3 4 AcoPrimary - - - — — 1 1 2 Poliomyelitis s Paralytic - - - - 1 - _ 1 Non-paralytic - - - - - - - - Puerperal Pyrexia - - - 11 8 - - 19 Scabies - - - 1 2 - - 3 Scarlet Fever - 6 12 1 1 - - 20 Whooping Cough 3 28 30 - - - 1 62 TOTALS 5 59 73 20 31 7 21 216 - 56 - SUMMARY OF NOTIFICATIONS QF INFECTIOUS DISEASES RECEIVED DURING THE YEARS 1956 - I960 (inclusive} Disease 1956 1957 1958 1959 I960 ge for five years Dysentery 349 71 111 62 69 132.4 Erysipelas 5 3 1 1 3 2.6 Food Poisoning 85 13 7 5 15 25 Measles 183 406 217 416 15 247.4 Meningococcal Infection 3 1 1 2 3 2 Pneumonia: Ac.Influenzal 12 19 4 9 4 9.6 Ac.Primary 24 24 11 9 2 14 Poliomyelitis Paralytic 8 3 3 2 1 3.4 Non-paralytic 6 - - 1 - 1.4 Puerperal Pyrexia 63 31 46 36 19 39 Scabies 15 8 6 6 3 7.6 Scarlet Fever 38 34 16 31 20 27.8 Typhpid Fever - - 2 - - 0.4 Whooping Cough 72 69 20 33 62 51.2 - 57 - DIPHTHERIA No notifications were received during the year. Two cases were confirmed in 1955, being the only cases since 1949. whilst there have been no deaths for fifteen years. Immunisation has played a major part towards the present excellent positions 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. DYSENTERY During 1960, sixty-nine notifications were submitted as compared with 62 in 1959, and 111 in 1958. MEASLES Fifteen notifications of measles were received during 1960, as compared with 416 and 217 in 1959 and 1958 respectively. POLIOMYELITIS One notification of poliomyelitis was received, and was of a paralytic type. This case concerned an American businessman who had returned to this country from abroad two weeks previously, and was ill the week prior to notification, which was at the time thought to be influenza. Partial paralysis of the left arm developed and the diagnosis of acute poliomyelitis was confirmed by a neurologist. He was nursed at home and made a very satisfactory recovery. 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 it is now available to everyone over the age of six months,, In view of the decrease in the number of cases since 1956, it is hoped that every unvaccinated person will make a special effort to avail themselves of this service. Details of vaccination centres can always be obtained from this department,, for persons under 4.0 years of age. SCARLET FEVER Twenty notifications of scarlet fever were received in the Public Health Department during 1960, as compared with 31 in 1959. - 58 - SMALLPOX No case of smallpox has been notified to this 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 one contact who resided in the Borough. He was vaccinated by another authority before returning home, when it was arranged with his employer for him to remain indoors for the Last seven days of the surveillance period. He received a medical check each day and remained perfectly well. 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. Nineteen cases were notified during the year and all except one occurred in hospital. Twelve notifications referred to patients residing outside the Borough. Herewith is a brief summary of the actual causes of the above cases: 2 cases were due to genital tract infection, 8 to breast involvement, 4 urinary tract infection, 2 respiratory tract infection, 1 associated with Caesarean section, and causes not known - 2. Six cases were brought to the notice of this Department by other local authorities; these concerned Chelsea residents whose confinements took place in hospitals in their areas. WHOOPING COUGH Sixty-two cases were notified during the year against 33 in 1959. - 59 - FOOD POISONING Fifteen cases were notified as compared with 5 in 1959 and 7 in 19580 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 6 9 Nil Nil 15 CASES OTHERWISE ASCERTAINED. First Quarter Second Quarter Third Quarter Fourth Quarter Total 1 Nil Nil Nil 1 SYMPTOMLESS EXCRETERS First Quarter Second Quarter Third Quarter Fourth Quarter Total 1 Nil Nil Nil 1 FATAL CASES First Quarter Second Quarter Third Quarter Fourth Quarter Total Nil Nil Nil Nil Nil PARTICULARS OF OUTBREAKS No. of outbreaks No. 0: cases Total No. of cases Family outbreaks Other outbrea ks Notified Otherwise ascertained Sa lm onella saint paul 1 6 1 7 Staphylococci 0 1 9 — 9 (This outbreak concerned other authorities, bringing the total number of cases to 20, and of these 17 were notified,,) - 60- FOOD POISONING Other than family outbreaks (2) 1. Seven Cases and One Carrier Illness followed the Nurses' Christmas dinner at a local hospitalo Symptoms diarrhoea and vomiting, and at the time was thought to be gastric flu» Five nurses out of ten sitting at one table were ill within a few hours to six days after attending the dinner. Two mess waitresses (one living outside Chelsea) also had symptoms, while a mess orderly was found to be a symptomless excreter. Salmonella saint paul was isolated from all cases and the carrier,, All were excluded from carrying out their usual duties until cleared of the infection, but the organism was so persistent, that in three cases they had to be found alternative employment in the hospital, the last one being cleared four months after infection. There was no infection in the kitchen or wards, and mouse faeces found in the food store and sent to the laboratory were reported negative. Christmas dinner is the only time when all the nurses congregate together, and two of those affected lived out and did not normally take meals in the hospital. Probable origin of infection or contamination of food was a waitress in the Nurses' Mess who presumably contaminated food served to those affected at the Christmas dinner,, 2. Nine Cases During June, a party of army cadets from a grairmar school in the provinces came by coach to watch the Royal Tournament at Earl's Court, and during the performance a number of them were taken ill with suspected food poisoningo The party had been provided with luncheon packets which included meat sandwiches and pasties. Lunch was eaten on the coach at noon, and those affected commenced vomiting between 5 and 5.30 p.m., and some developed diarrhoea shortly afterwards. Most of them had recovered by 7 p.m. Nine of the boys were admitted to a general hospital in Chelsea and were notified to this Borcrugho These lads had abdominal pains and vomiting which were quite severe, but recovery was rapid. The remains of two parcels of sandwiches were recovered and sent to the Public Health Laboratory at County Hall where staphylococcus aureus was isolated in both cases, One faecal specimen taken at the hospital was negative. In all eighteen were affected in London and 2 adults at the school. - 61 - Origin and preparation of food causing illness was in the kitchen of the grammar school. A fresh beef joint was supplied to the school and cooked the same day. After cooling it was kept in the refrigerator overnight. The next day it was (in part) sliced up and served with gravy for a luncheon meal. The consumers of this meal remained fit. Most of the remainder of the joint was then minced, mixed with the remaining gravy from lunch and spread into sandwiches. The sandwiches were kept overnight on the shelf of the pantry and issued for use the following morning to the two locally notified cases and to thirty-four boys and staff visiting London that day. Probable origin of infection or contamination of food was the kitchen, contributory factors being unsatisfactory food storage arrangements on the night before the party came to London.. Although present, refrigeration accommodation was inadequate for the purpose on that occasion,. Results of laboratory investigation carried out at the school were as followss- Vomit Staphylococcus untypable isolated„ Faeces negative. Food Samples - Sliced cold beef - staphylococcus aureus isolated. Food Handlers - Negative with the exception of one handler - Nose swab - staphylococcus of a different type to the food samples was isolated. SALMONELLOSIS 8 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 Healtho 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) Brandenburg - - - 1 1 Infantis - - - 1 1 Typhimur ium - - - 5 5 Not specified - - - 1 1 - 62 - NOTIFICATIONS OF INFECTIOUS DISEASE BY WARDS North Stanley South Stanley Cheyne Church Hans Town Royal Hospital TOTALS Dysentery - - - - 1 - 1 Dysentery (Boydii type 2) - - - 17 - - 17 Dysentery (Flexner) - - - -- 1 - 1 Dysentery (Sonne) 4 3 20 18 2 3 50 Erysipelas - 1 - 2 - - 3 Food Poisoning 9 - - 6 1 - 15 Measles - 2 - 5 2 2 15 Men ingococca: Infection — - - 2 1 - 3 Pneumonia : Acute Influenzal 1 2 - - 1 - 4 Acute Primary - 1 -- 1 - - 2 Poliomyelitis : Paralytic - - - - 1 - 1 Non-paralytic - - - - - - - Puerperal Pyrexia 18 1 - - - - 19 Scabies -- 2 - 1 - - 3 Scarlet Fever 4 3 1 7 1 4 20 Whooping Cough 12 20 12 12 3 3 62 TOTALS 48 35 37 71 13 12 216 - 63 - TUBERCULOSIS 45 cases of Pulmonary Tuberculosis were notified during the year. These were made up of 25 primary notifications, 18 "inward transfers" and 2 from other sources,, There were also 3 non-pulmonary cases, 2 being primary notifications and one "inward transfer". The accompanying tables present details of cases at present on the Tuberculosis Register. VARIATIONS IN REGISTER DURING I960. (a) Number of cases remaining on register at 1st January, I960 PULMONARY NON-PULMONARY TOTAL CASES. M. F. M. F. 200 163 16 31 410 (b) Number of new cases notilied 20 7 - 2 29 (c) Inward Transfers 8 10 - 1 19 Removals (d) Outward Transfers 21 20 2 5 48 (e) Cases recovered 6 8 - 2 16 (f) Cases gone abroad 5 2 - 1 8 (g) Cases lost sight of 5 11 1 1 18 (h) Deaths 4 2 - - 6 (j) Cases remaining on the Register at 31st December, I960 187 137 13 25 362 - 64 - (A) NEW CASES OF TUBERCULOSIS I960 (B) DEATHS OF TUBERCULOSIS CASES I960 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 1 55 and under 65 years 65 and under 75 years 75 years and upwards TOTAL (all ages) 1 (A) NEW CASES Pulmonary M - - - - - - 5 2 5 5 - 3 - 20 Pulmonary F - 2 - - 1 - - 1 1 - 1 1 - 7 Non- Pulmonary M - - - - - - - - - - - - - Nil Non- Pulmonary F - - - - - 1 - 1 - - - - - 2 (B) DEATHS Pulmonary M - - - - - - - - 1 - 3 - 4 Pulmonary F - - - - - - - - 1 - 1 - - 2 Non- Pulmonary M - - - - - - - - - - - - - Nil Non- Pulmonary F - - - - - - - - - - - - - Nil - 65 - CHELSEA TUBERCULOSIS DISPENSARY. BROMPTGN HOSPITAL. S.W.3. 1957 1958 1959 1960 Population served by Dispensary 50,600 50,190 49,520 49,140 Number of notified cases in Borough at end of year 441 431 411 361 Number of these who at present do not attend Dispensary 96 96 92 185 Total attendances during year 1,594 1,453 1,526 1,278 Total new patients seen 190 168 164 180 Number of these who were contacts 91 80 72 92 Number of contacts found to be tuberculous 2 - 4 - Number of cases newly notified to Medical Officer of Health (i.e. excluding inward transfers) 51 52 39 29 Number of cases diagnosed as tuberculous (for the first time) at the Dispensary 20 26 25 5 Number of X-rays 1,250 1,140 1,041 925 Number of Patients who received "Special treatment" at home during the year 6 4 2 Number of Patients given B.C.G. 80 75 79 88 Number of home visits by medical staff 25 1 3 Number of visits paid by Dispensary Nurse 1,798 1,627 1,613 1,250 Number of Clinic Sessions per week 2 2 2 2 - 66 - ZYMOTIC DISEASES An examination of statistics provided by the Registrar-General for the year I960 showed that four deaths were attributable to "Gastritis, enteritis and diarrhoea," representing a death rate of 0,08 per 1,000 of the population. Formerly the term "zymotic" was applied to "epidemic or contagious" ailments but later became limited to such diseases as cholera, diarrhoea, diphtheria, measles, scarlet fever, smallpox, typhoid fever and typhus fever. Mortality from these infections has declined to a remarkable extent since the beginning of the century, a s will be seen from the following summary?- Year Number of dea ths 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 1959 2 I960 4 - 67 - BACTERIOLOGICAL EXAMINATIONS All bacteriological examinations are carried out at the Public Health Laboratory at County Hall under its Director, Dr. A.J.H. Tomlinson. No charge is made to the Council for these examinations and during the year 1610 were made as follows Throat/Nose Swabs Vincent's organisms found 1 Diphtheroids found 1 Haemolytic Streptococci found 12 Staphylococcus aureus found 1 Haemophilus pertussis found 1 Pneumococci found 1 Negative results 50 Faeces Shigella boydii type 2 found 20 Shigella sonnei found 97 Salmonella brandenburg found 4 Salmonella infantis found 1 Salmonella saint paul found 24 Salmonella typhimurium found 4 Pathogenic Bact. coli 026 found 4 Pathogenic Bact. coli 055 found 3 Pathogenic Bact. coli 0119 found 13 Giardia lamblia found 2 Trichuris trichiura found 1 Negative results 1362 Mouse Faeces Negative results 1 Meat Sandwiches Staphylococcus aureus found 2 54.0 faecal specimens which are included in the foregoing were arranged and collected by this Department with the approval and cooperation 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. ANNUAL REPORT of the PUBLIC ANALYST for the year ended 31st December, 19bO. 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, Ladies and Gentlemen, During the year I960, 4.00 samples of food were examined, 19 of which were taken formally and 381 informally,, Adverse comments were made against 10 samples and the incidence of adulteration or incorrect labelling may be classified as follows:- Number of samples examined. Number of samples adulterated. Milk 200 1 Other food 200 9 A sample of milk contained a few small pieces of bread and some bread crumbs, but from the condition of the milk and the bottle it was thought that the bottle had been through the cleansing machine. It was impossible to say how the crumbs had gained access, but they appeared to have entered the milk after bottling. A milk cocoa beverage contained 15.3 per cent of total solids, but only 1.36 per cent of total fat, including the fat present as cocoa butter. The quantity of separated milk was therefore greater than that of the full cream milk and the order of disclosure of the ingredients was incorrect. The packers later stated their attention had been drawn to the matter previously and agreed to amend the label accordingly when new bottles were obtained. The label of a Strawberry Milk Shake was considered incorrect in that it contained more artificial flavour than natural flavour. The word "Flavour" should be included in the description. A complaint was received concerning the condition of "new.laid" eggs purchased in Chelsea, and a fried egg and its shell and an unbroken egg were submitted for examination. The fried egg contained a large purple. brown body adjoining the yolk of the egg, which consisted of a chick embryo. An embryo of this size may develop within 2 to 3 days if a hen is allowed to sit on the egg. A slice of bread contained foreign matter which was found to consist of burnt starch, probably derived from a baking tin, which had worked its way just inside the loaf as it rose in the oven. A piece of rump steak was submitted because of a complaint that it was contaminated with insect eggs. Examination showed that frying oil for cooking had been poured onto the steak while frozen, and that minute globules of the solid stearin of the fat had frozen out as a result. -69- The sample was satisfactory. A can of corned beef contained what appeared to be a portion of a bluebottle, but part of the body was missing. The contamination must have taken place in the canning factory, probably in a machine. A steak and kidney pie contained areas of mould affecting the pie on the outside upper crust and the inside of the pie on the pastry and pastry/meat interface. The mould growth consisted of a Penicillium species and an unidentified mould of the Fusarium type. If the pie had been kept cold at least seven days would have been required for this stage of growth to be reached but if kept at normal temperature under the then weather conditions it could have been reached in four days. A sample of Pale Ale was contaminated with yeast and mould growth. This contamination sometimes occurs through the rubber gasket on the stopper not having been properly washed and although in this case the gasket appeared to be in good condition it had not been fitted properly onto the stopper. There was also a chip on the inside of the neck of the bottle. Adverse comment was made on two samples of soup powder. They were considered to be incorrectly labelled as, in your analyst's opinion, they should be labelled "Appetizer Soups" since the concentration of the prepared soups are only half that of corresponding canned soups, and the calorific value of the Lobster Bisk was only 72 calories per 250 mis., approximately half pint portion, while that of the Vegetable Soup was only 56 calories. One complaint concerned the condition of tinned Asparagus which possessed an unpleasant smell when heated. A portion of the cooked asparagus mixture was submitted and this had undergone some bacterial decomposition. The odour was unpleasant and a smear showed a massed mixed bacterial flora, but it was impossible to state whether this bacterial decomposition had occurred before or after opening the tin. Had the asparagus been bad in the can one would expect it to have been decomposed and it was not. Another complaint concerned a Dundee cake which was thought to be contaminated with paint. The foreign matter submitted was examined and consisted of pieces of burnt vegetable tissue. The bulk of this tissue contained starch and was evidently from a seed or nut, which could not be readily identified. It was a high oil containing nut, probably almond or walnut. Some ice lollies had made children feel ill, but examination revealed no excess of lead, zinc or arsenic. The dye was a permitted colour, and the pH was 3»17o Similar cases had been reported elsewhere, but no explanation could be found for the circumstances and the samples were reported as satisfactory. Some tomatoes were submitted because the complainant alleged that they were covered with a chemical powder which affected the taste -70- of the fruit. Examination showed the deposit to consist of fine particles of soil. During the year several other samples were submitted as complaints by members of the public, but were in fact satisfactory,, Food Legislation, The year brought little change in food legislation, although the Food Standards Committee issued two long reports, of which mention will be made later. The Food Hygiene (General) Regulations, I960, No, 1601, consolidated and amended the previous regulations. One amendment extends the regulations to cover the cleaning of food utensils and equipment, but it is remarkable that no regulations have yet been made to cover the material of which food handling utensils and equipment are made. Over many years attention has been drawn to the risk involved in using articles such as enamelware coated with antimony enamels and toasting prongs coated with lead, but it is still necessary to show that the food stored in or treated with this equipment has been contaminated before any action can be taken. The Milk (Special Designation) Regulations, I960, No. 1542, prescribe modifications of the existing Methylene blue test, provide a fresh Phosphatase test for pasteurised milk, and also provide a new test, the Glot-on-Boiling Test for tuberculin tested milk. The Skimmed Milk with Non.Milk Fat Regulations, 1960, No. 2331, cover fresh ground in food law inasmuch as they provide for the sale of milk, condensed milk, and dried milk, from which the original milk fat has been removed and replaced by other fats or oils. Fats and oils used for this exchange are generally of vegetable origin and are intended primarily for persons suffering from coronary disease, and the reconstituted milk products are not to be used for babies. The Regulations are unfortunate in that they "do not apply to any food intended at the time of sale for export from the United Kingdom", because certain foreign governments accept foods, which comply with the requirements of the British Food and Drugs Act to be admitted into their countries and accept the certificates either of any public analyst or of certain recognised public analysts to this effect. Any Regulations should, therefore, be so worded that they apply only to countries where there are no restrictions. Another unfortunate provision in these regulations is that the labelling requirements do not apply to .sales to catering or manufacturing businesses or to sales for immediate consumption. One would have thought that the casual consumer or eater.out is as much entitled to know what he is consuming as the purchaser buying a pre.packed food for use in the home. The Arsenic in Food (Amendment) Regulations, I960, increase the amount of arsenic in brewers' yeast to be used in manufacture from 2.0 to 5.0 parts per million when calculated on the dry matter, but make no other alteration to the existing regulations. The Report of the Departmental Committee on "Milk Composition in the United "Kingdom" occupies some 86 pages and makes 23 main recommendations, . 71 . which may be summarised as follows:- (a) Milk should continue to be sold as it comes from the cow except for separated and other grades, which must be clearly labelled; (b) Efforts should be made to improve the quality of milk both with regard to fat and solids.not.fat, though the committee is more concerned about the solids.not.fat than the fat contents (c) The presumptive minimum standards should in five or ten years time become minimum legal standards for sale to the consumer? (d) The Hortvet Freezing test should be made legal subject to certain provisosg (e) Differential payment schemes should be introduced according to the quality of the milks (f) Better provision should be made for the testing both of bulk and of individual cow milks. The Food Standards Committee Report on Bread and Flour occupies 19 pages and includes 24 general recommendations regarding flour and 10 regarding bread, but it also contains 51 pages of Appendices, The main provisions are that all flour required to be fortified at present should continue to be fortified for the present and that no change should be made in the quantities prescribed, that all sampling should be made at mills or docks, and that only certain bleaching and improving agents should be permitted. It is recommended that there should be a statutory list of ingredients permitted to be used in bread, that descriptions of "protein", "milk" and "Slimming" breads should be controlled, and that exaggerated claims for enrichment or energy.producing qualities of bread should be prohibited, I have the honour to be, Mr. Mayor, Ladies and Gentlemen; Your obedient servant, THOMAS McLACHLAN, A.C.G.F.Co, F.R.I.C., M.I,Biol, Public Analyst. . 72 . Article Taken Informally Taken Formally Total Analysed Adultera ted etc. Ale 1 1 1 Bread 1 1 1 Butter 18 18 Cake 1 1 Chicken in Jelly. 1 1 Confectionery 3 3 Conserve 1 1 Eggs 1 1 1 Fish, canned 4 4 Fish Paste 22 22 Fish Potted 8 8 Flour 3 3 Fruit Juice 5 5 Ice Cream 7 7 Ice Lolly 1 1 Jam 21 21 Jelly 2 2 Margarine 4 4 Marmalade 15 15 Meat 1 1 1 Meat, canned 1 1 Meat Paste 20 20 Meat Pie 1 1 1 Milk 200 200 1 Milk Beverage 1 1 1 Milk Shake Syrup 2 2 1 Soft Drinks 19 19 Soup Powder 2 2 2 Spirits . 19 19 Suet 2 2 Tomatoes 1 1 Turkey in Jelly 1 1 Vegetables, canned 1 1 Vinegar 8 8 Yoghourt 2 2 TOTALS 381 19 400 10 INDEX Subject, Page (s) Analyst, Public . Report of 68.72 Atmospheric Pollution . Recording Stations 51 . 53 Bacteriological Examinations 41 and 67 Baths and Swimming Pools 33 Births 6 Burials . Sect, 50, National Assistance Act, 1948, 24 Cancer of the Lung and Bronchus 13 Clean Air Act, 1956s. Church Ward Smoke Control Order 48 Hans Town Ward Smoke Control Area 48 . 50 Committee, Public Health and Bathss. Members 1 Representation elsewhere by Members 2 Cremation Service 22 Deaths 6.12 Diphtheria 57 Diphtheria Immunisation 18 Disinfection and Disinfestation 47 Dysentery 57 Epidemiology 54 . 62 Factories Act, 1937 36 . 38 Food and Drugs Act, 1955 41 Food* Hygiene 39 Inspection and Supervision 40 Poisoning 59 .. 61 Unsound 45 Hospitals 16 Housing Act, 1957 . Overcrowding 35 Housing . Applications for Re.housing 35 Infant Mortality 14 and 15 Infectious Diseases 54 . 62 Inspections and work carried out 26 . 32 Introduction 4 . 5 Legal Proceedings 32 Mass Radiography 25 Maternity and Child Welfare 17 . 19 Measles 57 Medical Examinations of Staff 24 Milk Supply 42 Mortuary Facilities 24 Subject Page (s) National Assistance Act, 1948 . Sect. 50, Burials 24 Notices, Service of 34 Old People, Welfare of 20 . 21 Overcrowding 35 Outworkers 38 Part III' Accommodation 19 Pet Animals Act, 1951 43 Pharmacy and Poisons Act, 1933 43 Poliomyelitis 57 Public Analyst . Report of 68 . 72 Public Health and Baths Committees. Members 1 Representation elsewhere by Members 2 Public Health Department . Staff of 3 Public Health Inspectors . Work of 26 . 32 Puerperal Pyrexia 58 Rag Flock and Other Filling Materials Act, 1951 43 Rent Act, 1957 34 Rodent Control 46 Scarlet Fever 57 Shops Act, 1950 39 Smallpox 58 Smoke Controls. Church Ward Smoke Control Order 48 Hans Town Ward Smoke Control Area 48.50 Spastic Children 23 Staffs. Medical Examinations of 24 Public Health Department 3 Statistics s. Births, Deaths, Stillbirths, Illegitimate Births, Population, etc. 6 . 9 Street Trading 44 Tuberculosis 63 . 65 Unsound Food 45 Vaccination 18 Water Supply 33 Welfare of Old People 20 . 21 Whooping Cough 58 Zymotic Diseases 66