Urban District Council of CHISLEHURST. REPORT For the Year 1925 on the Sanitary Conditions and Vital Statistics of the Chislehurst Urban District By the MEDICAL OFFICER OF HEALTH Together with the Report of the Sanitary Inspector. CHI 8 Urban District Council of Chislehurst. HEALTH REPORT FOR 1925. Ladies and Gentlemen, I have the honour of submitting my Annual Report for the year 1925, being the third one presented by me as your Medical Officer. The estimated population for the year 1925 is 9,173, as compared with estimated populations of 9,081 and 8,957 for 1924 and 1925, and an actual population of 8,981 at the census in 1921. The birth-rate for the District was 16.2 per thousand of estimated population, as compared with 18.3 for England and Wales. The birth-rate for 1924 was 13.1 as compared with 19.8 for England and Wales. The corrected death-rate was 10.9 per thousand of population, as against 12.2 for England and Wales. The death-rate for 1924 was 7.5 as compared with 12.2 for England and Wales. The Infantile Mortality Rate was 53 per thousand registered births, as compared with 75 for England and Wales. In 1924 it was 16 as compared with 75 for England and Wales. The year 1925 again proved to be a most satisfactory one from the point of view of Infectious Disease, no epidemic of any consequence arising. I again desire to express my hearty thanks to the Council and their Officers for the help and consideration they have shown me in carrying out my duties. I should like to place on record my appreciation of the assistance rendered by Mr. W. G. Powell and Mr. J. A. Capon. I am, Ladies and Gentlemen, Your obedient Servant, P. N. CAVE, Medical Officer of Health. 2 Urban District of Chislehurst. PUBLIC HEALTH COMMITTEE. Mr. A. A. Bone, Chairman. Mrs. Field Mr. F. J. F. Edlmann, D.S.O., J.P. Miss S. L. Tiarks Mr. J. Kerfoot Mr. A. G. Clement Mr. A. J. A. Oldendorff Dr. G. W. Davis Mr. T. J. Robins REPRESENTATIVE ON THE WEST KENT MAIN SEWERAGE BOARD. Mr. F. J. F. Edlmann, D.S.O., J.P. REPRESENTATIVE ON THE BROMLEY & BECKENHAM JOINT HOSPITAL BOARD. Mr. F. J. F. Edlmann, D.S.O., J.P. STAFF. Medical Officer of Health. P. N. Cave, M.A., M.D., M.R.C.S., L.R.C.P., D.P.H. Sanitary Inspector and Road Surveyor. W. G. Powell, Assoc. & Cert. R.S.I. Assistant to Sanitary Inspector and Road Surveyor. I. A. Capon, Cert. R.S.I., Cert. S.I.E.Bd. 3 HEALTH REPORT FOR 1925. The Urban District of Chislehurst, which was formed in 1900, was previously contained within the Rural District of Bromley. The area of the District is 2,791 acres The population at the time of the Census of 1921 was 8,981, while for 1925 it is estimated at 9,173. For 1924 it was estimated at 9,081 and for 1923 at 8,957. The number of occupied houses within the District is 1,989, the number of persons per house being equal to 4.6. The Rateable value of the District is .£84,248, the sum represented by a penny rate being .£305. In tabular form recent figures of the population of the Urban District are:— 1921 (Census) 1922 (Estimated) 1923 (Estimated) 1924 (Estimated) 1925 (Estimated) 8,981 8,930 8,957 9,081 9.173 4 Occupations by Sex. Males. Females. Fishermen ... ... Agricultural occupations 398 27 Mining and quarrying occupations 2 Makers of coke, lime, cement, etc. 5 3 Makers of bricks, pottery, glass 3 ... Workers in chemicals, paints, etc. 5 1 Metal workers 188 3 Workers in precious metals 1 1 Electrical apparatus makers, fitters 26 2 Makers of watches, etc. 12 ... Workers in skins, leather goods makers 4 ... Textile workers 20 15 Makers of textile goods, articles of dress 22 65 Makers of foods, drinks and tobacco 40 2 Workers in wood, etc. 93 2 Paper makers, printers, etc. 72 17 builders, bricklayers, etc. 109 1 Painters and decorators 83 2 Workers in other materials ... ... Workers in mixed and undefined materials 15 2 Persons in gas, water, electricity supply 7 ... Transport workers 236 5 Commercial and financial occupations 347 105 Public administration and defence 336 9 Professional occupations 147 171 Persons employed in entertainments, etc. 14 5 Persons employed in personal service 122 1045 Clerks, draughtsmen, typists, etc. 142 114 Warehousemen, etc. 30 ... Stationary engine drivers, etc. 7 ... All other occupations 198 8 Total occupied 2684 1605 Unoccupied and retired. 414 2647 Total occupied and unoccupied 3098 4252 5 VITAL STATISTICS. Births. The number of Births registered as belonging to the District occurring during the year was 149 (81 males and 68 females), as against 126 last year. The Birth Rate for the year is equal to 16.2 per thousand of population, as against 13.1 last year. The Birth Rate in England and Wales was 18.3; and for 1924, 18.8. The number of illegitimate births registered was 2. This gives an illegitimate birth rate of 1.3 per cent. of total births. Deaths. During the year 100 deaths were registered as belonging to the District (39 males and 61 females). This number includes the deaths of residents who died outside the District, but excludes the deaths of those who, though dying within the District, belonged to other Districts. The Death Rate for the year was equal to 10.9 per thousand of population, as against 7.5 last year. The rate for England and Wales was 12-2 and 12-2 respectively. The three diseases claiming the largest number of deaths were: Heart disease 18, Cancer 12, and Bronchitis 6. In 1924 the three diseases giving rise to the greatest mortality were Heart disease 13, Cancer 9, and Bronchitis 6. MORTALITY AT DIFFERENT ACES. Infantile Mortality.—Eight deaths were registered as occurring in infants under one year of age. This gives an Infantile Mortality Rate of 53 per thousand registered births, as against 16 last year. The rates in England and Wales were 75 and 75 respectively. Deaths of Children between the Ages of 1 and 5 Years.— During the year 3 deaths were registered as occurring in children between the ages of 1 and five years. This is equal to 3.0 per cent. of total deaths. Deaths Occurring in Persons over 65 Years of Age.— 58 deaths were registered as occurring in persons over the age of 65 years. This gives a death rate of 58.0 per cent. of total deaths. 6 Causes of Deaths The deaths in 1925 included:— Pulmonary Tuberculosis 4 Bronchitis 9 Other Tuberculous Diseases 2 Heart Disease 18 Cancer 12 Influenza 1 Nephritis 2 Pneumonia 4 Zymotic Death Rate. The Zymotic Death Rate is a term commonly applied to the rates of deaths from the seven principal Zymotic complaints:— Small Pox, Scarlet Fever, Measles, Diphtheria, Whooping Cough, Diarrhoea, and "Fever," which latter term includes Typhus, Typhoid (or Enteric) and Paratyphoid Fever. Two deaths were registered as occurring from these complaints during the year, giving a Zymotic death rate of 0.2 per 1000 of population. Pulmonary Tuberculosis. Four deaths were registered as occurring from Tuberculosis of the Lungs (Consumption or "Phthisis"). This is equal to a death rate of 0.4 per thousand of population. Other Respiratory Diseases. During the year 14 deaths were registered from other diseases of the respiratory system. This gives a death rate of 1.5 per thousand of population. Cancer. The number of deaths registered as occurring from Cancer ("Malignant Disease") was 12, giving a death rate of 1.3 per thousand of population. Influenza. One death was registered as occurring from Influenza, the death rate being 0.1 per thousand of population. Analysis of Death Rates. Year. All Causes. Seven principal zymotic complaints Pulmonary Tuberculosis Other Respiratory Diseases. Cancer. Influenza. Number of Deaths. 1925 100 2 4 14 12 1 1924 69 nil 4 7 9 1 Death rate per 1000 of population. 1925 10.9 0.2 0.4 1.5 1.3 0.1 1924 7.5 nil 0.4 * 0.7 0.9 0.1 7 Birth Rate, Death-Rate, and Analysis of Mortality during the year 1925. BIRTHRATE PER 1,000 TOTAL POPULATION Annual Death-rate per 1,000 Population. Rate per 1,000 Births All Causes Enteric Fever Small-pox Measles Scarlet j Fever Whooping Cough Diphtheria Influenza j Violence Diarrhoea and Enteritis (under Two-years). Total Deaths under one year England and Wales 18.3 12.2 0.01 0.00 0.13 0.03 0.15 0.07 0.32 0.47 8.4 75 105 County Boroughs and Great Towns, including London 18.8 12.2 0.01 0.00 0.17 0.03 0.18 0.09 0.30 0.43 10.8 79 157 Smaller Towns (1921 adjusted Populations 20,000—50,000) 18.3 11.2 0.01 0.00 0.15 0.02 0.14 0.06 0.31 0.38 7.6 74 London 18.0 11.7 0.01 0.00 0.08 0.02 0.19 0.11 0.23 0.46 10.6 67 Chislehurst Urban District 16.2 10.9 0.00 0.00 0.00 0.00 0.10 0.10 0.10 0.32 0.00 53 8 INFECTIOUS DISEASE. The year has been an exceedingly satisfactory one from the point of view of incidence of Infectious Disease, no epidemic of any consequence arising; and compares very favourably even with the low figures of 1924. During the year 19 Certificates of Notification of Infectious Disease were received, which comprised:- Scarlet Fever 13 Encephalitis Lethargica 1 Diphtheria 2 Acute Poliomyelitis Nil Typhoid Fever Nil Cerebro-spinal Fever Nil Puerperal Fever Nil Erysipelas 1 Pneumonia 1 Malaria 1 Ophthalmia Neonatorum Nil The following Table shows the number of cases notified during the past six years. 1925 1924 1923 1922 1921 1920 Scarlet Fever 13 13 13 56 26 22 Diphtheria 2 - 10 7 15 29 Enteric Fever - 2 — 2 10 1 Puerperal Fever — 1 - — — — Erysipalas 1 2 3 1 1 4 Pneumonia 1 9 9 3 1 2 Ophthalmia Neonatorum — 1 - 1 2 — Encephalitis Lethargica 1 - - - — - Acute Poliomyelitis - - - - — — Cerebro-spinal Fever - - - - - - Malaria 1 - - - - - Chicken Pox - 12 24 - — — Total 19 40 60 70 55 58 Scarlet Fever.—A similar number of cases of Scarlet Fever were notified as occurred last year, viz., 13. Twelve cases were removed to the Isolation Hospital. There were no deaths from this complaint. The monthly incidence of the cases of Scarlet Fever was : Jan. Feb. Mar. Apl. May June July Aug. Sept. Oct. Nov. Dec. 3 2 1 2 1 1 1 ... 1 1 ... ... The age incidence was : Under 1 year 1—2 2—3 3—4 4-5 5—10 1 1 1 6 10—15 15—20 20—35 35—45 45—65 65 and over 3 ... 1... ... ... ... 9 Diphtheria.—Two cases of this disease occurred during the year, both of which were removed to Hospital. Typhoid Fever.—No cases of Typhoid Fever were notified. Puerperal Fever. No case of Puerperal Fever was notified. Pneumonia.—During the year 1 case of Pneumonia was notified, as against 9 the previous year. Ophthalmia Neonatorum.—No case was notified. Malaria.—One case was notified as occurring in a male aged 22 years. Encephalitis Lethargica.—One case was notified in April, the patient being a female aged 9 years. 10 Monthly Incidence of Infectious Disease. Disease. Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. TOTAL. Scarlet Fever. 3 2 1 2 1 1 l ... 1 1 ... ... 13 Diphtheria. ... ... ... 1 ... ... ... ... ... ... ... 1 2 Erysipelas. ... 1 ... ... ... ... ... ... ... ... ... ... 1 Pneumonia. ... ... ... ... ... ... ... ... ... ... 1 ... 1 Encephalitus Lethargia ... ... ... 1 ... ... ... ... ... ... ... ... 1 Malaria. ... 1 ... ... ... ... ... ... ... ... ... ... 1 TOTALS 3 4 1 4 1 1 l 1 1 1 1 19 11 Reference to Table I. in the Appendix will show:— 1. Total cases notified at ages. 2. Number of cases removed to Hospital. 3. Deaths from each complaint. Tuberculosis.—During the year 23 new cases of Tuberculosis were notified, of which 18 were Pulmonary and 5 were other forms of Tuberculosis. The following Table shows the number of cases notified and the number of deaths registered since the complaint became notifiable:— Cases. Deaths. 1913 (11 months) 23 11 1914 11 5 1915 18 4 1916 9 10 1917 7 5 1918 11 10 1919 12 3 1920 10 0 1921 9 0 1922 6 4 1923 4 1 1924 11 6 1925 23 6 Death Rates from Tuberculosis. Years. Pulmonary. NonPulmonary. TOTAL. Per thousand of population 1925 0.4 0.2 0.6 1924 0.4 0.2 0.6 Per cent of total deaths. 1925 4.0 2.0 6.0 1924 5.8 2.9 8.7 12 The following table shows the total cases notified at together with the deaths registered. ages, Age Periods. New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M F M F M F M F Under 1 ... ... ... ... ... ... ... ... 1 and under 5 ... ... ... ... ... ... 2 ... 5 „ „ 10 ... ... ... 1 ... ... ... ... 10 „ „ 15 ... ... ... ... ... ... ... ... 15 „ „ 20 ... 1 ... ... ... ... ... ... 20 „ „ 25 2 1 ... ... ... ... ... ... 25 „ „ 35 1 3 ... ... ... ... ... ... 35 „ „ 45 2 1 ... 2 1 1 ... ... 45 „ „ 55 4 ... 2 ... 1 ... ... ... 55 „ 65 1 2 ... ... 1 ... ... ... 65 and upwards ... ... ... ... ... ... ... ... TOTALS 10 8 2 3 3 1 2 ... The provision of sanitorium and dispensary treatment is under the control of the Kent County Council. During the year 3 patients received sanatorium treatment, 10 received dispensary treatment, and 12 received dispensary supervision. Public Health (Tuberculosis) Regulations, 1924. The above Regulations came into force on the 1st January, 1925, requiring, inter alia, that a quarterly return should be made to the County Medical Officer of Health of all cases of Tuberculosis, whether pulmonary or non-pulmonary, at the end of each quarter. Existing cases in the event of cure, removal from the district or death are deleted from the Register, and the new cases added on as notifications are received. 13 The accurate compilation of these Returns involved extra work for the Public Health Department, and this was allotted by the Council to Mr. Powell and Mr. Capon. The necessary work has been most efficiently performed. The figures submitted to the County Medical Officer of Health at the end of each quarter of 1925, are as follows:— Pulmonary. Non-Pulmonary. M F Total. M F Total. 31st March 21 13 34 3 3 6 30th June 23 13 36 3 4 7 30th September 22 14 36 3 6 9 31st December 22 11 33 3 6 9 Non-Notifiable Diseases. The mortality from non-notifiable diseases such as Measles Whooping Cough, Diarrhoea and Enteritis (under 2 years), and Influenza, has been extremely low, only two deaths having occurred; one from Influenza and one from Whooping Cough. Other Diseases. Heart Disease. Deaths from Diseases of the Heart numbered 18, giving a death rate of 1.9 per thousand of population as compared with 1.4 in 1924. Acute and Chronic Nephritis.—Two deaths were registered from Nephritis, as against 3 last year. This is equal to a death rate of 0.2 per thonsand of population. Preventive Measures.—When a notification of a case of infectious disease is received, a visit is at once paid and full particulars obtained. I am always glad to see any doubtful case of infectious disease, in consultation with the Doctor in charge, and I have much pleasure in recording the help I have received in this respect from Doctors practicing in the area, most particularly in connection with cases arising in schools. This is, I feel sure, of great assistance in dealing with the incidence of Infectious Disease. When an outbreak of Infectious Disease arises amongst scholars attending any school—whether a Private School or a Public Elementary School or Secondary School—particular attention is given to any possible factors which may be tending to cause the spread of the disease. Convalescent cases after return from Hospital are visited; and, should circumstances arise rendering it advisable, are kept under further observation. 14 Disinfection.—No apparatus is available in the District for steam disinfection of infected articles of bedding, clothing, etc. Rooms are fumigated and sprayed after cases of notifiable Infectious Disease ; and also after cases of non-notifiable Infectious Disease, on the request of a Medical Practitioner. I consider disinfection desirable after fatal cases of Cancer, particularly where this is associated with open sores, and this is always available when required. During the year arrangements have been made with the Sidcup Urban District Council for the use of their Steam Disinfector when required. Laboratory Work. During the year 52 specimens have been examined, as under. Total. Positive. Negative. Swabs for Diphtheria 36 1 35 Sputa for Tubercle 16 4 12 Widals for Typhoid Fever Nil. Nil. Nil. TOTALS. 52 5 47 Drainage. The West Kent Main Sewerage Board's sewers receive the whole of the sewerage from this District, with the exception of five water-closets which are drained to cesspools and two privy middens. Water Supply. The whole of the District is supplied with water fram the mains of the Metropolitan Water Board, with the exception of six premises which obtain water from deep wells. House Refuse. The collection of house refuse is under the control of the Council. A weekly collection is made, and the refuse is disposed of by dumping. 15 HOUSING. There is a real need for more houses in the Urban District, there being at present a number of cases of more or less severe overcrowding. Steps are being taken by the Council to meet this requirement. The following table shows the number of private families occupying the following number of rooms (Census, 1921). Number of Persons in private family. Dumber of private families occupying the following number of rooms. 1 2 3 4 5 6-7 8-9 10 and over. 1 9 12 6 14 16 6 2 2 2 1 29 23 104 61 63 13 11 3 1 10 15 108 80 97 42 11 4 1 8 17 105 103 92 46 28 5 ... 3 5 54 63 72 26 19 6 ... 3 5 37 59 50 13 25 7 ... ... 5 18 37 39 21 21 8 ... ... ... 15 20 8 12 23 9 ... ... ... 3 11 8 1 14 10 ... ... ... 4 7 6 3 11 11 ... ... ... ... 2 5 6 12 ... ... ... ... 1 1 1 4 13 ... ... ... 2 ... ... ... 3 14 ... ... ... ... ... ... ... ... 15 and over ... ... ... ... ... ... ... 2 HOUSING STATISTICS FOR THE YEAR. Number of new houses erected during the year:— (a) Total (including numbers given separately under (b) 26 (b) With State assistance under the Housing Acts: (i) By the Local Authority Nil (ii) By other bodies or persons Nil 1.—Unfit Dwelling Houses. Inspection. Total number of houses inspected for housing detects (under Public Health and Housing Acts) 493 16 (2) Number of dwelling houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing Consolidation Regulations, 1925 Nil (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation .. Nil (4) Number of dwelling houses (including those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation Nil 2.— Remedy of Defects Without Service of Formal Notices. Number of defective dwelling houses rendered fit in consequence of the Local Authority or their Officers 105 3. Action under Statutory Powers. A.— Proceedings under Section 3 of the Housing Act, 1925. (1) Number of dwelling houses of which notices were served requiring repairs Nil (2) Number of dwelling houses which were rendered fit after service of formal notice:— (a) By Owners Nil (b) By Local Authority in default of owners Nil (3) Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil B.—Proceedings under the Public Health Acts. (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied Nil (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) By owners Nil (b) By Local Authorities in default of owners Nil 17 C.— Proceedings under Sections 11, 14 and 15 of Housing Act, 1925. (1) Number of representations made with view to making of a Closing Order Nil (2) Number of dwelling houses in respect of which Closing Orders were made Nil (3) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling house having been rendered fit. Nil (4) Number of dwelling houses in which Demolition Orders were made Nil (5) Number of dwelling houses demolished in pursuance of Demolition Orders . Nil MATERNITY AND CHILD WELFARE. Maternity and Child Welfare work in this District is under the control of the Kent County Council. Two Health Visitors are employed in this District: Chislehurst Upper Nurse Eke Chislehurst Lower Nurse Staines A Maternity and Child Welfare Centre has been established at the Hornbrook Social Women's Institute, and sessions are held each Thursday afternoon at 2.30 p.m. The Medical Officer of the Centre is Dr. J. H. Tallent, who attends fortnightly, and the Health Visitor in charge is Nurse Eke. The average number of children attending per session is 13. SCHOOLS The Medical Inspection of school children is carried out by the Kent County Council. On no occasion was it found necessary to close a school owing to the prevalence of Infectious Disease amongst the scholars. REGULATED TRADES. Dairies, Cowsheds and Milkshops. —During the year 223 visits of inspection have been paid to the 13 premises registered as 18 Dairies, Cowsheds and Milkshops. Six premises have been cleansed. During the year two licences were granted under the Milk (Special Designation) Regulations. Slaughterhouses. —There were four Slaughterhouses in occupation during the year, two being registered and two licensed. 374 visits of inspection have been paid, and any matters needing attention have been dealt with. On one occasion only was a defect found. The number of Slaughterhouses in use at the following dates were: In 1920. In January, In December, 1925 1925 Registered 2 2 2 Licensed 2 2 2 Public Health (Meat) Regulations, 1924.—These Regulations came into force on the 1st April, 1925. The work involved by the provisions of this Order has been most efficiently carried out by Mr. Powell and Mr. Capon. During the period from the 1st April to the 31st December, 1925, the following number of animals were killed for human food in the slaughter-houses in the District. Upper District. Lower District. Total. Beasts 1 43 44 Calves — 24 24 Sheep 9 113 122 Pigs 24 234 258 Total 34 414 448 In all approximately 8 cwt. 16 lbs. of meat was found to be unfit for human food. Bakehouses. —Visits are paid to all Bakehouses within the District, and during the year 33 inspections have been made. The number of Bakehouses in the District is seven. 9 LEGAL PROCEEDINGS. On no occasion was it found necessary to institute legal proceedings to enforce the abatement of nuisances. SALE OF FOOD AND DRUGS ACTS. The administration of the Sale of Food and Drugs Acts is carried out by the Kent County Council. Quarterly reports on samples taken are submitted to the Council. AMBULANCE FACILITIES. For Infectious Cases.— Two motor ambulances are provided for the removal of Infectious Cases by the Bromley and Beckenham Joint Isolation Hospital Board. For Non-Infectious Cases. — Satisfactory arrangements have now been made for ambulance facilities to be available for general and accident cases. SUMMARY OF NURSING ARRANGEMENTS, HOSPITALS AND OTHER INSTITUTIONS AVAILABLE FOR THE DISTRICT. There is no General Hospital situated within the District, but cases are sent to the Sidcup Cottage Hospital and to the Cray Valley Hospital. Professional nursing is provided at home for general purpose, but not for Infectious Diseases. Infectious Diseases are admitted to the Bromley and Beckenham Joint Hospital, and provision has been made for Smallpox on a separate site. There is no institutional provision for unmarried mothers, illegitimate infants or homeless children. Midwives. Two midwives have given notice of intention to practice within the District. ADOPTIVE ACTS. The following Acts have been adopted for this District:— The Infectious Disease (Prevention) Act. Adopted in 1900. Public Health Acts Amendment Act, 1890. Public Health Acts Amendment Act, 1907:— Part 2. Streets and Buildings. Order made by Local Government Board on 29th May, 1909, and came into operation 16th July, 1909. 20' Part 3. Sanitary Provisions. „ 4. Infectious Disease. ,, 5. Common Lodging Houses. ,, 7. Police (part of sec. 81). Order made by Home Office on 2nd April, 1909. „ 8. Fire Brigades. „ 9. Sky signs. Sanction for the adoption of Section 51 of the above Act (relating to powers to declare a business to be an offensive trade) was given under an Order of the 28th May 1909. The list of offensive trades as coming under the Order, which was confirmed by the Local Government Board, is: Blood-dryer, Tanner, Leatherdresser, Fat-melter or Fat-extractor, Glue-maker, Size-maker, Gutscraper, and Fish-fryer. Public Health Act, 1925. The adoptive provisions except Part V. BYE-LAWS AND REGULATIONS. Slaughter-houses. New Streets and Buildings. Decent lodging and accommodation of persons engaged in hop picking, and picking of fruit and vegetables. Prevention of keeping swine so as to be injurious to health. Drainage to existing buildings. Management of Cemetery. Mode of construction and laying out of drains, and their connection to the sewer. Dairies Cowsheds and Milkshops Regulations. New Streets and Buildings. Drainage of existing Buildings. Adopted 7 th October, 1901, and confirmed 30th December, 1901. Adopted 2nd September, 1907, and confirmed 8th November, 1907. Adopted 7th October, 1907, and confirmed 28th November, 1907. Adopted 17th October, 1908, and confirmed 28th October, 1908. Adopted 2nd September, 1907, and confirmed 8th November, 1907. Adopted 20th January, 1913, and confirmed 18th March, 1913. Adopted 4th November, 1907. Adopted 8th June and came into force 12th August, 1903. Adopted or revised in 1925. 2 i FACTORIES AND WORKSHOP ACT. It will be seen from the subjoined list that there are now 12 factories and 49 workshops on the Register. All these are periodically visited and inspected, and due attention has been paid to maintaining them in such a condition as to comply with the requirements of the Act. During the year 98 visits ot inspection were paid, and in 12 instances nuisances or irregularities were found ; these were all remedied. Trade. Number of Factories Workshop Total Laundries 1 1 2 Cycle and Motor Works 1 6 7 Carriage Makers and Whee wrights - 1 1 Printers 2 — 2 Carpenters and Builders 3 16 18 Shoeing Forges — 3 3 Dressmakers and Tailors — 6 6 Upholsterers 1 3 4 Bakeries — 7 7 Harness Making — 1 1 Bootmaking and Repairing 1 2 3 Mineral Water Works 1 — 1 Organ Works 1 - 1 Electric Light Works 1 — 1 Basket Makers - 3 3 1 2 49 61 Delects Found. Nuisances under Public Health Acts Found Remedied Reported to H.M. Inspector No. of prosecut'ns Want of Cleanliness 6 6 — - Other nuisances 6 6 — - Outworkers. Number of Outworkers in the District 1 Summary. Total number of factories and workshops 61 22 1. Inspection of Factories, Workshops and Workplaces. premises (1) Number of Inspections (2) Written Notices (3) Prosecutions (4) Factories (Including Factory Laundries) 15 Nil Nil Workshops (Including Workshop Laundries) 83 Nil Nil Workplaces (Other than Outworkers' premises) Total 98 — — 2 Delects found in Factories, Workshops and Workplaces. PARTICULARS (1) Number of Defects Number of Prosecutions (5) Found (2) Remedied (3) Referred to H.M. Inspector (4) Nuisances under the Public Health Acts— Want of cleanliness 6 6 — ' — Want of ventilation Overcrowding Want of drainage of floors Other nuisances 6 6 — — Sanitary accommodation insufficient unsuitable or defective not separate for sexes Offences under the Factory and Workshop Acts— Illegal occupation of underground bakehouse (s. 101) Other offences (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921) Total 12 12 — — * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 23 Total number of Visits paid 98 Number of Defects found 12 Number of Preliminary Notices served 12 APPENDIX Area of District (acres) 2,791 Population (1925) Number of inhabited houses, 1921 1,860 Ditto 1924 1,981 Ditto 1925 1,989 Number of families or separate occupiers: Lower Chislehurst 783 Upper Chislehurst 1,105 1,888 Rateable Value £84,248 Sum represented by penny rate £305 EXTRACT FROM VITAL STATISTICS OF THE YEAR. Total Male Female Births. Legitimate 147 80 67 Illegitimate 2 1 1 Birth Rate 16.2 Deaths. 100 39 61 Death Rate 10.9 Number of women dying in, or in consequence of, childbirth:— From sepsis Nil From other causes 1 Deaths of infants under one year of age, per 1,000 births. Legitimate 47, Illegitimate 500, total 53. Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhœa (under 2 years) Nil 34 Table 1. Cases of Infectious Disease notified during the year 1925. Disease. Number of Cases Notified. Cases removed to Hospital Death At all Ages. at ages years. Under 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10tol5 15to20 20to35 35to45 45to65 65 and over Scarlet Fever 13 ... ... 1 1 1 6 3 ... 1 ... ... ... 12 ... Diphtheria 2 ... ... ... ... ... 1 ... ... 1 ... ... ... 2 1 Erysipelas 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Pneumonia 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... 4 Malaria 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... Encephalitis Lethargica 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Totals . 19 ... ... 1 1 2 8 4 — 3 — - - 14 5 25 Table II. Deaths occurring during 1925. Males. Females. Total. Enteric Fever ... ... ... Small Fox ... ... ... Measles ... ... ... Scarlet Fever ... ... ... Whooping Cough ... 1 1 Diphtheria ... 1 1 Influenza 1 ... 1 Encephalitis Lethargica ... ... ... Meningococcal Meningitis ... ... ... Tuberculosis of Respiratory system 3 1 4 Other Tuberculosis Diseases 2 2 Cancer, malignant disease 4 8 12 Rheumatic Fever ... ... ... Diabetes ... ... ... Cerebral haemorrhage, etc. 2 7 "9 Heart Disease 6 12 18 Arterio Sclerosis 2 4 6 Bronchitis 2 7 9 Pneumonia (all forms) 2 2 4 Other respiratory diseases ... 1 1 Ulcer of stomach or duodenum ... ... ... Diarrhoea, etc. (under 2 years) ... ... ... Appendicitis and typhlitis ... 1 1 Cirrhosis of Liver ... ... ... Acute and chronic nephritis 1 1 2 Puerperal sepsis ... ... ... Other accidents and diseases of pregnancy and parturition ... 1 1 Congenital debility and malformation, premature birth 4 1 5 Suicide ... ... ... Other deaths from violence 3 ... 3 Other defined diseases 7 13 20 Causes ill-defined or unknown ... ... ... Totals 39 61 100 26 Chislehurst Urban District Council. Annual Report of Sanitary Inspector for the year ended December, 1925. Gentlemen, I beg to present to you my Annual Report for the year 1925. Visits.—The number of visits and re-visits made to various premises during the year in connection with sanitary and health matters has been 6,570, and 271 nuisances deemed fit to enumerate have been discovered and dealt with. Complaints.—There were 24 complaints received during the year, showing an increase of 7 on the previous year. These were as follows :— Delay in the removal of house refuse 2 Insufficient sanitary accommodation 1 Defective water-closet t Dampness and defective condition of houses 5 Rats infesting premises 3 Accumulation of refuse 1 Nuisance from smoky chimneys 2 Absence of dust-bin 1 Animals so kept as to be a nuisance 1 Smells from house refuse dumps 4 Smell from piggery 1 Absence of water supply to W.C. 1 Obstruction of sewage drains 1 All the complaints were thoroughly investigated, and where just cause for complaint was found, the nuisance was abated. Disinfection.—The number of houses disinfected during the year was 23, consisting of about 35 rooms. The walls and bedding were sprayed with an Equifex Spray Pump, the solution employed being Formic Aldrhyde as a 5 per cent. solution. The clothing of the patients, bed linen, etc. were disinfected in a 1 in 40 solution of Izal, and the rooms fumigated by formalin tumigators in tabloid form. 27 Ashpit Accommodation. 46 premises were provided with properly covered galvanized iron receptacles for house refuse during the year, being an increase of 11 over the previous year. Temporary Shelters for Fruit Pickers.—The temporary shelters for fruit pickers, etc. at Town Court and Thongs Farm were inspected periodically. Shelters at both farms were occupied for a portion of the year, and various works have been carried out to the structures, cleansing, etc. Slaughter-Houses. — Two registered and two licensed slaughter-houses were occupied during the year, one of each being within the Upper and Lower Districts respectively. One licensed slaughter-house in Lower Chislehurst is regularly used by a butcher resident outside your District, and the licensed slaughter-house is also occasionally used by a person other than the occupier for killing purposes. These premises have been regularly inspected during the year, and various small matters, such as accumulation of refuse, offal, etc. have been attended to, and the periodical cleansing of the premises has been carried out in accordance with the Regulations. Public Health (Meat) Regulations, 1924.—A large amount of additional work has been put upon this Department by these Regulations, necessitating considerable overtime being put in since April, the date the Regulations came into force. The greater part of the killing in this District is carried out in Lower Chislehurst by a butcher residing in New Eltham, and killing operations are usually carried on well into the evening. The following have been killed since April last:— Upper Dist. Lower Dist. Total. Beasts 1 43 44 Calves — 24 24 Sheep 9 113 122 Pigs 24 234 258 34 414 448 The beast killed in Upper Chislehurst was an emergency slaughter at Red Hill Farm. In this case a foreign body had penetrated the heart of the animal previous to slaughter. The meat was in good condition. 28 One whole carcase, etc. of a beast was found to be so affected with Tuberculosis as to be unfit for food, and the same was voluntarily surrendered and destroyed. The following offal was found diseased or in such a condition as to be unfit for food. Voluntary surrender took place in all cases, and the articles were destroyed :— Beasts Lungs 6 Beasts Livers 5 Pigs Livers 4 Sheeps Livers 3 Sheeps Lungs 1 The approximate weight of the meat, etc. destroyed as above would be about 8cwt.161bs. Unsound Food. —No case, other than the foregoing, came to notice during the year. Dairies, Cowsheds and Milkshops.—The Dairies and Cowsheds have been periodically inspected during the year, and the required limewashing and cleansing carried out by the occupiers. Accumulations of manure and repairs have been dealt with at the various farms. House Refuse Removal.- A few cases of delay in the regular removal of house refuse was brought to notice, and on investigation it was found that the delay occurred owing to the workmen being unable to gain access to the premises, and the holidays also disorganised the regular times for removal. The staff employed in this work is three men and three boys, with three horses and carts, and with this labour the collection of the refuse can be considered as being very satisfactory. It has been necessary, however, on occasions to use the Steam Wagon to assist in the work. The shoot for the refuse from Upper Chislehurst is at the Whitehorse Hill Brickfields. The present shoot for Lower Chislehurst is on private premises adjoining Cray Road owned by Mr. E. J. Rose, payment being made for the use of this shoot. Food and Drugs.—The taking of samples for analysis is undertaken by the Kent County Council, and quarterly reports of their Inspector on samples taken by him and weights of coal checked have been submitted to you. 29 Housing (Inspection of District) Regulations. — No inspections were made during the year under these Regulations. Rents Restriction Act. —One inspection was carried out under these Regulations. Various defects were found at the premises, and these were remedied. Rats and Mice (Destruction) Act. -A few complaints were received as to rats infesting premises. These places were visited and the required steps taken to exterminate the vermin. A National Rat Week was held in November, and 500 circulars were printed and distributed throughout the district, drawing attention to the need of destruction of the vermin and giving information as to the preparation and use of poisons, etc. Steps have periodically been taken to destroy the vermin on the Council's properties in the District. The Official Rat Exterminator appointed by the Kent County Council is Mr. A. Funnel], of Banks Cottages, Perry Street, Chislehurst, who reports that during 1925 he was engaged at 35 premises in connection with the destruction of the vermin, and could account for 757 rats killed. From information it would appear that some 235 rats were killed on other premises. Summary of Work Carried Out. Number of houses cleansed and generally repaired. 40 Number of houses found with defective roofs, gutters, rainwater down pipes, yard paving, external brickwork, etc., causing dampness 29 Number of houses found with defective W.C. cisterns and other drainage appurtenances 14 Number of houses cleansed after the occurrence of infectious disease, etc. 23 Number of premises whereon offensive accumulations were found 3 Number of dairies, cowsheds, and slaughter-houses cleansed 15 Number of workshops cleansed, repaired, etc., after preliminary notice to the occupiers 12 30 Summary of Nuisances Discovered. Defective roofs 12 Dampness (caused by the want of or insufficient damp proof courses, defective eaves, gutters, rainwater down pipes, etc.) 41 Dirty walls and ceilings of rooms 88 Defective interior walls and ceilings 20 Defective exterior walls 3 Defective interior floors and paving 3 Defective exterior paving of yards and approaches 12 Defective drainage appurtenances (W.C. pans, gullies, sinks, sink wastes, etc.) 15 New dust-bins provided . 46 Verminous condition of house 1 Accumulations of offensive matter 3 Overcrowding (new cases) 5 Miscellaneous defects discovered (washing coppers, windows, doors, stoves, etc.) 22 I am, Gentlemen, Your obedient Servant, WM. GEO. POWELL, A.&C.R.S.I., Sanitary Inspector.