(Chisleburst & Sidcup Arban District Council. With the compliments Of the Medical Office of Health . Public Health Department, Council Offices, Sidcup Place. Sidcup, Kent. Spare 2 copies LIBRARY Urban District of CHISLEHURST AND SIDCUP REPORT For the Year 1938 on the Sanitary Conditions and Vital Statistics of the Urban District of Chislehurst and Sidcup by the Medical Officer of Health Together with the REPORT of the CHIEF SANITARY INSPECTOR Conbridge: Tonbridge Free Press, Ltd. 129 High 8treet. Tel, 18 chi io Urban District of CHISLEHURST AND SIDCUP REPORT For the Year 1938 on the Sanitary Conditions and Vital Statistics of the Urban District of Chislehurst and Sidcup by the Medical Officer of Health Together with the REPORT of the CHIEF SANITARY INSPECTOR Conbridgc: Tonbridge. Free Press, Ltd. 129 High Steet. Tel. 18 2 URBAN DISTRICT COUNCIL OF CHISLEHURST & SIDCUP HEALTH REPORT FOR 1938. Ladies and Gentlemen, I beg to submit my Annual Health Report for the year 1938, this being the fifth one presented by me as your Medical Officer of Health, but the sixteenth one I have had the pleasure to submit as Medical Officer of Health for the area concerned. From the point of view of Public Health the year 1938 may be considered as a fairly satisfactory one. The Population of the District as estimated by the RegistrarGeneral for mid-year .1938 is 61,750, as compared with 58,670 last year. The Birth Kate remained fairly stationery, being 16.8 per thousand of population in 1938 as compared with 16.9 in 1937. The Birth Rates for England and Wales were 15.1 in 1938 and 14.9 in 1937. The Death Rate continued to remain steady, being 8.5 per "thousand of population, as compared with 8.7 in 1937 and 8.3 in 1936. The Death Rates for England and Wales were 11.6 for 1938 and 12.7 for 1937. The Infant Mortality Rate was equal to 36 per thousand registered births. This compares very favourably with the Rates for the previous three years, these being 47, 53 and 43 per thousand births. The Infantile Mortality Rates for England and Wales were 53 for 1938, 58 for 1937, and 59 for 1936. From the point of view of incidence of Infectious Disease the year 1938 can be considered as a satisfactory one. Although the number of cases notified were somewhat larger than last year, the increase was chiefly due to a much larger number of cases of Measles being notified. In submitting this Report, I desire to take the opportunity of expressing my appreciation of the help and assistance I have received from the Council and all its Officers. I would also like to place on record the efficient and loyal services rendered by Mi*. Allen and all the members of the Public Health Department. I am, Ladies and Gentlemen, Your obedient Servant, P. N. CAVE, Medical Officer of Health. 3 URBAN DISTRICT COUNCIL OF CHISLEHURST & SIDCUP PUBLIC HEALTH COMMITTEE. Chairman : G. W. ALLEN, Esq. G. A. APPLETON, Esq. T. G. GALBRAITH, Esq, J.P. Lt.-Col. W. J. BIXL. C. E. GAMON, Esq., J.P. H. F. BRIDEL, Esq. C. E. NORRIS, Esq. W. BROWN, Esq. Miss M. K. PILLMAN. J. W. CRAY, Esq. T. RAMSBOTTOM, Esq. W. FULLER, Esq. A. W. SMITH, Esq. REPRESENTATIVES ON THE WEST KENT JOINT HOSPITAL BOARD. T. G. GALBRAITH, Esq., J.P. T. H. NASH, Esq. REPRESENTATIVES ON THE WEST KENT MAIN SEWERAGE BOARD. T. G. GALBRAITH, Esq., J.P. T. H. NASH, Esq. C. T. KNIGHT, Esq., J.P. STAFF. Medical Officer of Health: P. N. CAVE, M.A., M.D., M.R.C.S., LB.C.P, D.P.H. Chief Sanitary Inspector: A. V. B. ALLEN, M.R.S.I., M.R.I.P.H.H., M.S.I.A. District Sanitary Inspectors : J. AMES, C.R.S.I, (commenced duty may, 1938). D. H. LIVESEY, M.R.S.I., M.S.I.A. (left in 1938). J. C. KERMODE, C.R.S.I, (commenced duty August, 1938). E. R. RICHARD, A.R.S.I., M.S.I.A. S. H. G. STEVENS, M.I.S.E., A.R.S.I., M.S.I.A. (left in 1938). Health Visitor: Miss W. M. HUMPHRIES. Clerks: E. D. AUSTIN. G. WOOD. Shorthand Typist and Infectious Disease Clerk : Miss M. PETCHEY, 4 SECTION A.— STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 8,950 Registrar-General estimate of population, mid-1938 61.750 Population, 1931 (Census) 27,063 Number of occupied houses, December. 1938 17,350 Rateable Value, December, 1938 £534,382 Sum represented by a penny rate, December, 1938 £2,150 VITAL STATISTICS. Rate por 1,000 of estimated resident population. live births: Total. M. F. Legitimate 1.010 532 478 Illegitimate 28 13 15 Total 1,038 545 493 16.8 Rate per 1,000 (live and still) births. Stilbirths 27 11 16 27.3 Death Rate per 1,000 of estimated resident population. Deaths 526 291 235 8.5 Rate per 1,000 total (live and still) births. Deaths from puerperal causes: Deaths. Puerperal sepsis 2 1.877 Other puerperal causes - - Total 2 1.877 Death Rate of Infants under one year of age: All infants per 1,000 live births 36 Legitimate infants per 1,000 legitimate births 36 Illegitimate infants per 1,000 illegitimate live births 35 Deaths from Cancer (all ages) 92 Deaths from Measles (all ages) nil Deaths from Whooping Cough (all ages) nil Deaths from Diarrhoea (under 2 years of age) 4 SECTION B.—GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Laboratory Facilities: West Kent Joint Isolation Hospital, and Kent County Laboratory, Maidstone. Ambulance Facilities: For Infectious Disease: Four ambulances provided by the West Kent Joint Hospital Board. For general and accident cases: Two ambulances provided by Council, 5 Nursing' Facilities: Local District Nursing Associations. Clinics and Treatment Centres: Maternity and Child Welfare work is carried out by the Kent County Council. Immunising' Clinic (against Diphtheria) held once a week at the Council Offices. Hospitals, Public and Voluntary: Infectious Disease: West Kent Joint Isolation Hospital. General Hospitals (Voluntary) : Sidcup Cottage Hospital and Cray Valley Hospital. Midwifery and Maternity Services: Under the control of the Kent County Council. Institutional Provision for Mothers or Children: Under Kent County Council. Health Visitors: One employed by District Council. Four Health Visitors also employed by County Council. Infant Life Protection (under Part I of Children Act. 1908, as amended by Children and Young Persons Act, 1932): Under control of the Kent County Council. Orthopaedic Treatment: Under Kent County Council. Nursing' Homes Registration: The Medical Officer of the Local Supervising Authority is P. N. Cave, M. A., M. D., M. B. C. S., L.R.C.P., D.P.H. Action Taken during the year, and the arrangements made for the supervision of Maternity and Nursing Homes registered under the Act: Routine inspection by Health Visitor, and inspections by Medical Officer of Health as required. HEALTH REPORT FOR 1938. The Urban District of Chislehurst and Sidcup was constituted under the Kent County Review Order, 1934, and came into existence on the 1st April, 1934. It comprises the former Urban District of Sidcup and the former Urban District of Chislehurst with the exception of the Pettswood area, South of the old Chatham and Dover railway line (now part of the Southern Railway system), which was transferred to the newly constituted Urban District of Orpington. Also included in the Urban District are the old Rural Parishes of Mottingham, and North Cray, the greater part of St. Paul's Cray, and a small portion of St. Mary Cray and Orpington, all of which previously formed part of the Bromley Rural District. A small portion of the Borough of Bromley on the Western boundary of Chislehurst was also transferred to the Chislehurst and Sidcup Urban District. 6 AREA AND POPULATION. The District has an area of 8.950 acres, the Rateable Value is £534,382, and the sum represented by a penny rate is £2,150. The population as estimated by the Registrar-General for mid-year 1938 was 61,750, as compared with 58,670 last year. VITAL STATISTICS. BIRTHS. During the year 1.038 Births were registered as belonging to the District, of which number 545 were males and 493 were females. This is equal to a Birth Rate of 16.8 per thousand of population, as compared with 16.9 last year. The Birth Rates for England and Wales were 15.1 for 1938 and 14.9 for 1937. The number of Births registered as being illegitimate was 28, of which 13 were males and 15 were females. There were also 27 stillbirths, 11 males and 16 females. DEATHS. The number of Deaths registered during the year as belonging to this District was 526 (291 males and 235 females), as compared with 515 last year. This number includes those deaths which, although occurring outside, belonged to this District, but excludes deaths occurring inside but belonging to other districts. The Death Rate for the year was equal to 8.5 per thousand of population, as compared with 8.7 last year. The Death Rates for England and Wales were 11.6 for 1938 and 12.7 for 1937. The diseases claiming the largest number of deaths were: Heart Disease 135, Cancer 92, Pulmonary Tuberculosis 32, and Pneumonia 31. The following Table shows the diseases having the greatest influence on the Death Rate for the past five years: Year Heart Disease Cancer Cerebral Haemorrhage Bronchitis Pneumonia Pulmonary Tuberculosis 1934 (9 months) 96 56 14 6 22 22 1935 117 57 28 5 28 26 1936 101 69 14 9 22 26 1937 120 71 20 10 38 29 1938 135 92 16 8 31 32 7 INFANTILE MORTALITY. During the year 38 Deaths were registered as occurring in Infants under one year of age (19 males and 19 females). Of these there were 37 legitimate and one illegitimate children. The Infantile Mortality Rate was equal to 36 per thousand registered births, as compared with 47 last year. The Infantile Mortality Rate for England and Wales was 53 for 193S and 58 for 1937. DEATHS AT DIFFERENT AGES. Deaths in Children Between One and Five Years.— During tho year 9 deaths were registered as occurring in children between the ages of 1 and 5 years. This is equal to a Death Rate of 0.14 per thousand of population. Deaths in Persons of 65 Years and Over.— The number of deaths occurring in persons of 65 years and over was 243. This is equal to a Death Rate of 3.9 per thousand of population and comprises 46.1 per cent, of total deaths. CAUSES OF DEATHS. The Deaths registered during 1938 included: Diphtheria 3 Influenza 2 Pulmonary Tuberculosis 32 Other Tuberculous Diseases 7 Cancer 92 Cerebral Haemorrhage 16 Heart Disea.se 135 Bronchitis 8 Pneumonia 31 Septic Ulcer 10 Diarrhoea (under 2 years) 4 Appendicitis 5 Nephritis 17 Congenital Debility, Premature Births, etc 21 Suicide 5 Other Violence . 17 8 VITAL STATISTICS. The following Table shows a comparison of the main features in the Vital Statistics for the District during the past five years: Years 1934 1935 1936 1937 1938 Population 44,200 47,692 54,300 58,670 61,750 No. of Births registered 671 808 862 995 1,038 Birth Rate 16.7 16.9 158 16.9 16.8 No. of Deaths Registered 347 419 455 515 526 Death Rate 8.6 8.7 83 8.7 8.5 Infantile Mortality Rate 46 43 53 47 36 ZYMOTIC DEATH RATE. The Zymotic Death Rate is a term commonly applied to the rate of deaths from the seven principal zymotic complaints, viz.: Smallpox, Measles, Scarlet Fever, Diphtheria. Whooping Cough, Diarrhoea, and "Fever." which latter includes Typhus, Typhoid (or Enteric) and Paratyphoid Fevers. During the year 9 deaths 'occurred from these complaints, the Zymotic Death Rate being 0.14 per thousand of population. 9 PULMONARY TUBERCULOSIS. The deaths occurring from Pulmonary Tuberculosis (Consumption or Phthisis) numbered 32. This is equal to a Death Rate of 0.51 per thousand of population. OTHER RESPIRATORY DISEASES. The deaths from other diseases of the respiratory system numbered 44. This gives a Death Rate of 0.71 per thousand of population. CANCER. The number of deaths from Cancer (malignant disease) was 92. The Death Rate from Cancer was 1.48 per thousand of population. INFLUENZA. During the year 2 deaths occurred from Influenza, the Death Rate being 0.03 per thousand of population. ANALYSIS OF DEATH RATES. All causes Seven principal Zymotic complaints Pulmonary Tuberculosis Other respiratory complaints Cancer Influenza Number of Deaths 526 9 32 44 92 2 Death Rate per 1000 8.5 0.14 0.51 0.71 1.48 0.03 10 A comparison between the Vital Statistics for the District and those for England and Wales is shown by the subjoined Table: 1934 1935 1936 1937 1938 Chislehurst and Sidcup Urban District England and Wales Chislehurst and Sidcup Urban District Eneland and Wales Chislehurst and Sidcup Urban District England and Wales Chislehurst and Sidcup Urban District England and Wales Chislehurst and Sidcup Urban District England and Wales Birth Rate 16.7 14.8 16.9 14.7 15.8 14.8 16. 9 14 .9 16..8 15.1 Death Rate 8.6 11.8 8.7 11.8 8.3 12.1 8.7 12.4 8.5 11.6 Infantile Mortality Rate 46 59 43 57 53 59 47 58 36 55 11 BIRTH RATES, DEATH RATES, ANALYSIS OF MORTALITY, MATERNAL DEATH RATES, AND CASE-RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1938. England and Wales 126 County Bora's. and Great Towns including London 148 Smaller Towns Resident Populations 25,000 to 50,000, 1931 Census London Administrative County Chislehurst and Sidcup Urban District] BIRTHS: Rates per 1,000 Population Live 15.1 15.0 15.4 13.4 16.8 Still 0.60 0.65 0.60 0.48 0.43 DEATHS: All Causes 11.6 11.7 11.0 11.4 8.5 Typhoid and Paratyphoid Fevers 0.00 0.00 0.00 0.00 0.00 Smallpox 0.00 000 Measlea 0.04 0.00 0.08 0.06 0.00 Scarlet Fever 0.01 0.01 0.01 0 01 0.00 Whooping Cough 0.03 0.03 0.02 0.03 0.00 Diphtheria 0.07 0.07 0.06 0.05 0.01 Influenza 0.11 0.10 0.11 0 06 0.03 NOTIFICATIONS: Smallpox 000 0.00 0.00 ... ... Scarlet Fever 2.41 2.60 2 58 2.05 2.26 Diphtheria 1.58 1.85 1 S3 1.90 1.23 Enteric Fever 0.03 0.03 0.04 0.05 0.8 Erysipelas 0.40 0.46 0.39 0.46 0.21 Pneumonia 1.10 1.28 0.98 0.9 053 Rates per 1000 Live Births Deaths under one year of age 53 57 51 57 36 Deaths from Diarrhoea and Enteritis under two years of age 6.5 7.8 3.6 13.1 3.85 MATERNAL MORTALITY: Puerperal Sepsis 0.89 | Not available. 1.92 Others 2.13 Total 3.08 1.92 Rates per 1,000 Total Births (i.e. Live and Still MATERNAL MORTALITY: Puerperal Sepsis 0.86 Not available. 187 Others 2.11 Total 2.97 1.87 NOTIFICATIONS: Puerperal Fever 14.42 18.08 12.51 3.53 18.14 Puerperal Pyrexia 15.46 12 INFECTIOUS DISEASE. The year 1938 was a fairly satisfactory one from the point of view of incidence of Infectious Disease, the number of notifications received (excluding Tuberculosis) being 1,129, as compared with 396 in 1937. The increase was chiefly due to the number of cases of Measles notified, there being 807 more notifications of this complaint than in the previous year. The following Table shows the number of cases of each disease notified during the year: Scarlet Fever 140 Diphtheria 75 Typhoid Fever 5 Erysipelas 15 Pneumonia 33 Puerperal Pyrexia 14 Ophthalmia Neonatorum 2 Dysentery 11 Acute Poliomyelitis 1 Malaria 1 Measles 831 Reference to Table 1 in the Appendix will show: 1.—Cases notified at various ages. 2.—Total number of cases removed to hospital. 3.—Number of Deaths registered. 13 The monthly incidence of Infectious Disease was as follows: Disease Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec.  Scarlet Fever 17 8 18 14 3 17 10 10 8 9 20 6 140 Diphtheria. G 5 3 2 10 3 10 10 4 4 11 8 76 Typhoid Fever — 1 — 1 1 — - - - - 1 5 Erysipelas. 2 — 2 1 4 1 - 1 - 1 3 — 15 Pneumonia 3 4 8 5 2 1 2 1 i 5 - 33 Puerperal Pyrexia 1 — — — 2 1 — 1 2 2 14 Ophthalmia Neonatorum — — — — — — i — - - - 1 2 Dysentery 1 1 4 — — 2 i 1 1 — 11 Acute Polio-myelitis — — — — — - - - 1 1 Malaria — — 1 - — - - - - - - - 1 Measles 18 97 376 175 98 37 23 4 1 1 — 1 831 TOTALS 48 116 412 198 120 62 47 27 21 17 41 20 1129 14 he following Table shows the number of cases of Infectious Disease notified during the past five years: 1934 6 months 1935 1936 1937 1938 Scarlet Fever 132 193 162 207 140 Diphtheria 24 60 29 55 76 Typhoid Fever 2 3 7 5 ErysipelaR 8 22 16 14 15 Puerperal Fever 1 3 3 4 Puerperal Pyrexia 2 5 7 7 14 Ophthalmia Neonatorum 1 ... 1 ... 2 2 Acute Poliomyelitis 1 ... ... 4 1 Cerebro spinal Fever ... ... ... 1 ... Pneumonia 11 30 21 49 33 Malaria ... 1 ... 1 Dysentery ... ... ... 22 11 Measles 38 745 24 831 TOTALS 181 356 983 396 1129 SMALLPOX. No cases of Smallpox were notified as occurring in this District during the year. SCARLET FEVER. A decrease took place in the number of cases of Scarlet Fever notified, there being 140 cases as compared with 207 last year and 162 in 1936. One hundred and twelve cases were removed to the Isolation Hospital. No deaths were registered from this disease during the year. The age incidence of the disease was: 0-5 5-10 10-15 15-20 20 and over 20 80 16 17 1 15 DIPHTHERIA. An increase in the number of cases of Diphtheria notified took place, viz. 76 as compared with 55 last year. Seventy-one cases were removed to the Isolation Hospital. Three deaths were registered. The age incidence was: 0-5 5-10 10-15 15-20 20 and over 24 38 5 4 3 The Council has made arrangements, free of charge, for the examination of swabs from cases, or suspected cases of Diphtheria, and during the year 524 such examinations have been made. A Clinic has been established by the Council for the immunisation of children against Diphtheria. Particidars of this will be found on another page. TYPHOID LEVER. Five eases of Typhoid Fever were notified, as compared with 7 last year. Two cases were removed to hospital. No deaths were registered from this complaint during the year. ERYSIPELAS. Fifteen cases were notified, as compared with 14 last year. PUERPERAL PYREXIA. Fourteen cases of Puerperal Pyrexia were notified. OPHTHALMIA NEONATORUM. Two cases were notified, this being the same number as last year. ACUTE POLIOMYELITIS. One case was notified as against 4 last year. PNEUMONIA. During the year 33 cases of Pneumonia were notified, this being 16 less than last year. The number of deaths registered as occurring from Pneumonia (all forms) was 31. 16 DYSENTERY. Eleven cases of Dysentery were notified. MEASLES. First cases of Measles were made compulsorily notifiable by the Chislehurst and Sidcup (Measles) Regulations, dated the 15th April, 1935, which came into force on the 15th May, 1935. During the year 831 eases of Measles were notified, as compared with 24 last year and 745 in 1936. Arrangements are made for home nursing of eases of Measles, when required, and for the removal to hospital of such cases where the condition of the patient renders it desirable. During the year 3 cases were removed to the Isolation Hospital. I am pleased to report that again this year no deaths were registered as occurring from Measles. TUBERCULOSIS. The number of new cases of Tuberculosis notified during the year was 40, as compared with 60 last year. The 40 new cases comprised: Males Females Total Pulmonary 20 12 32 Non-Pulmonary 7 1 8 Total 27 13 40 The number of deaths registered during the year was 39, viz.: Males Females Total Pulmonary 21 11 32 Non-Pulmonary 4 3 7 Total 25 14 39 Treatment for cases of Tuberculosis is carried out by the Kent County council. and during the year the following number of cases from this District have received treatment: Number of persons receiving sanatorium treatment 71 Number of persons receiving dispensary treatment 12 Dispensary supervision only 176 17 The following Table shows the number of new cases of Tuberculosis notified during the year, together with the deaths at various age-periods: Age Periods. New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M F M F M. F M F Under 1 year ... ... ... ... ... ... 1 1 1 and under 5 ... 1 ... ... ... 1 ... ... 5 ,, 10 ... ... ... ... ... ... ... ... 10 ,, 15 ... ... ... ... ... ... ... ... 15 ,, 20 2 4 2 ... ... 1 ... 1 20 ,, 25 1 2 ... 1 3 1 ... ... 25 ,, 35 10 4 1 ... 0 5 ... 1 35 ,, 45 5 1 ... ... 7 1 ... ... 45 ,, 55 ... ... ... ... 3 ... ... ... 55 ,, 65 2 ... ... ... 2 1 ... ... 65 and over ... ... ... ... ... 1 ... ... TOTALS 20 12 7 1 21 11 4 3 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. These Regulations, which came into force on the 1st January, 1931, require, inter alia, that a weekly Return of ali notified cases shall he sent to the County Medical Officer of Health; also that every Medical Officer of Health shall furnish the County Medical Officer of Health with a quarterly return and a statement showing: (a) The number of cases of Tuberculosis on his register at the commencement of each quarter; (b) The number of cases notified to him for the first time during the quarter; (c) The number of cases removed from the register in a preceding quarter which have been restored to the register, giving the name and address of each case and the reason for the restoration; (d) The number of cases added to the register during the quarter which have been brought to his knowledge other than by notification; 18 (e) The number of eases removed from his register during the quarter, giving the name of each case and the reason for removal; (f) The number of cases remaining on the register at the end of the quarter. Previously a large part of this statement was required under (ho Public Health (Tuberculosis) Regulations. 1924. The following Table shows the number of cases on the register at the end of each quarter since the District was eon stituted: Quarter ending Pulmonary Non-Pulmonary Total M. F. M. F. 1934 30th June 79 67 34 33 213 30th Sept. 86 72 37 33 228 31st Dec. 63 42 31 19 115 1935 31st Mar. 56 40 28 20 144 30th June 53 39 26 20 138 30th Sept. 49 47 25 19 140 31 st Dec. 55 53 26 19 153 1936 31st Mar 68 62 31 19 180 30th June 76 61 33 18 188 30th Sept. 85 64 36 20 205 31st Dec. 95 68 40 23 226 1937 31st Mar. 101 74 40 25 240 30th June 109 81 39 25 254 30th Sept. 104 85 42 25 256 31st Dec. 109 96 43 25 273 1938 31st Mar. 107 97 46 29 279 30th June 116 104 51 29 300 30th Sept. 114 107 51 27 299 31st Dec. 114 104 50 28 296 PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. No action was required during the period under review in respect of tuberculous employees in the milk trade. PUBLIC HEALTH ACT, 1936, SECTION 172. There was no need, during 1938, for the Council to take action with a. view to securing an Order of the Court for the compulsory removal to hospital of a case of Pulmonary Tuberculosis. DIPHTHERIA ANTI-TOXIN. A supply of Diphtheria Anti-toxin is kept for the use of Doctors practising in the District. This is supplied free on the certificate of the Medical Officer of Health that the circumstances of the ease render this desirable. In other cases the cost price is charged. 19 ISOLATION HOSPITAL. For Isolation Hospital purposes this District is served by the West Kent Joint Hospital. This hospital is administered by the West Kent Joint Hospital Board, and serves the Boroughs of Bromley and Beckenham, and the Urban Districts of Chislehurst and Sidcup and Orpington. Four motor ambulances -have been provided by the Board for the removal of cases. Cases of Smallpox are also removed to the West Kent Joint Smallpox Hospital, maintained by the West Kent Joint Hospital Board, on a separate site from the ordinary Infectious Disease Hospital. LABORATORY WORK. The Kent County Laboratory at Maidstone carries out the bacteriological work in connection with this District, and during the year the following number of specimens have been examined there: Positive. Negative Total. Swabs for Diphtheria 13 63 76 Sputa for Tubercle 68 158 226 Swabs for Haemolytic Streptococci 7 42 49 Faeces for Sonne bacillus 2 23 25 Blood for Typhoid 3 3 6 Totals 93 289 382 In addition to the above, emergency swabs are examined at the West Kent Joint Hospital, the number of such examinations during the year being: Positive Negative Total Swabs for Diphtheria 44 404 448 Swabs for Haemolytic Streptococci 7 13 20 Totals 51 . 468 20 DIPHTHERIA IMMUNISATION. The Council has established a Diphtheria Immunisation Clinic, and sessions have been held during the year at the Council Offices, Sidcup Place, Sidcup. The following is a statement of the work carried out during the year: Number of .sessions held 51 New crises: Number found susceptible 211 Number found not susceptible 18 Total 229 Number found not susceptible 163 Number found susceptible (re-immunised) 6 Total 169 Subsequent attendances 806 Total attendances 1,204 The Health Visitor paid 49 visits in connection with cases attending this Clinic. DRAINAGE. Practically the whole of the District is drained to the public sewers. Sewage outfall facilities are provided by the West Kent Joint Sewerage Board. During the year the following new sewers were laid: Approximately 2.44 miles of new sewers. Approximately 1.15 miles of surface water sewer. The approximate number of each type of closet in use at the end of the year was: Water closets draining into sewers 19,439 Water closets draining into cesspools 322 Earth closets or privy middens 5 Pail closets 53 SANITARY STATISTICS. No. of Houses connected to the sewer No. of Houses not connected to sewers No. of Houses not provided with a piped water supply No. of wells still in use for purpose of domestic supply 19439 380 24 22 SANITARY CONVENIENCES. W.C.'s Pan or Pail Closets Midden Privies and for Earth Closets Ashpits separate from Midden Privi9s Cesspools No. of No. of houses into 19439 53 5 Nil 258 322 21 WATER SUPPLY. The District is supplied with water by the mains of the Metropolitan Water Board. With the exception of about 24 premises, which obtain their water from wells, the whole of the District has a main supply. During the year approximately 3.17 miles of new mains were laid. One hundred and two samples of water were chemically examined during the year, of which 96 were found to be satisfactory. Suitable action was taken in the case of unsatisfactory samples. HOUSE REFUSE COLLECTION AND DISPOSAL. A weekly collection of house refuse is undertaken by the Council under the supervision of the Public Health Department. The refuse is deposited in a tip which has been opened during the year near Hockenden. The question of the erection of a refuse disposal plant has been under consideration. Tenders have been received for this work, but are now held in abeyance owing to negotiations for the erection of a refuse pulverising and separation plant. The Council does not undertake the cleansing of cesspools or earth closets. The contents are disposed of by the occupants on their land, or the work is undertaken by contractors. HOUSING. 1.—Inspection of Dwelling-houses during the Year. (1) (a) Total number of houses inspected for housing defects (under Public Health or Housing Acts) 1.017 (b) Number of inspections made for the purpose 4,191 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 240 (b) Number of inspections made for the purpose 2,154 (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 (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 227 2.—Remedy of Defects during the Year without service of 'Formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 431 22 3.—Action under Statutory Powers during the Year. (a) Proceedings, under Sections 9, 10 and 16 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which notices were served requiring repairs nil (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners nil (b) By Local Authority in default of owners 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 6 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 6 (b) By Local Authority in default of owners nil (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which Demolition Orders were made nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders nil (d) Proceedings under Section 12 of the Housing Act, 1936: (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit nil 4.— Housing Act, 1936. Part IV, Overcrowding. (a) (1) Number of dwelling-houses overcrowded at end of year 12 (2) Number of families dwelling therein 12 (3) Number of persons dwelling therein 101 (b) Number of new cases of overcrowding reported during the year 8 (c) (1) Number of cases of overcrowding relieved during the year 19 (2) Number of persons concerned in such cases 209 (d) Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding nil Number of new houses erected during the year:— By the Local Authority 46 By other persons 943 houses and 303 flats 23 MATERNITY AND CHILD WELFARE. The Kent County Council carries out the Maternity and Child Welfare work in this District. Health Visiting is undertaken by Nurses Lyle, Dobson, Bowman, Brammer, Rothera and Walsh. The following Maternity and Child Welfare Centres have been established in this District:— Chislehurst: The Willows.— Sessions held every Thursday afternoon. The Medical Officer in charge is Dr. Tallent, and Mrs. Brammer is the Health Visitor. The total attendances were 3,143. Foots Cray: Memorial Parish Hall.— Sessions held on alternate Tuesday afternoons. The Medical Officer in charge is Dr. Geddes, and Miss Rothera is the Health Visitor. The total attendances were 1,064. Mottingham: St. Edward's Hall. St. Kevern's Road.— Sessions held first, third and fifth Monday in each month. Dr. Power is the Medical Officer in charge, and Miss Brammer is the Health Visitor. The total attendances were 6,498. Sidcup: Baptist Church Hall. Day's Lane.— Sessions are held on each Tuesday, Wednesday and Friday afternoon. Dr. Simpson is the Medical Officer in charge, and Miss Lyle is the Health Visitor. The total attendances were 15,795. Sidcup: Congregational Hall. Station Road.— Sessions held each Thursday afternoon. Dr. C. J. M. Geddes is the Medical Officer, and Miss Rothera is the Health Visitor. The total attendances were 4,885. Ante-natal Clinics are held as follows:— Chislehurst: The Willows.— Sessions held first and third Wednesdays at 2.0 p. m. Dr. Simpson is the Medical Officer. Mottingham: St. Edward's Hall.— Sessions held on alternate Tuesdays at 10.0 a. m. Dr. Simpson is the Medical Officer in charge. Sidcup: Baptist Church Hall. Day's Lane.— Sessions held on each Friday morning at 10.0 a.m. Dr. C. J. M. Geddes is the Medical Officer in charge. 24 HEALTH VISITOR. One full-time Health Visitor is employed by the Council and works under the supervision of the Medical Officer of Health. The following is a summary of the visits paid by her during the year:— Total number of visits paid 2,499 Visits re Measles 989 German Measles 12 Chicken-pox 158 Whooping Cough 55 Mumps 83 Tuberculosis: Primary 88 Revisits 615 Infectious Disease cases discharged from hospital 203 Infectious Disease, home cases 25 Nursing Homes 25 Ophthalmia Neonatorum 3 Puerperal Pyrexia 5 Impetigo and Scabies 18 Dysentery 34 Immunisation Clinic 49 Visits re Contacts with Infectious Disease: Diphtheria 69 Scarlet Fever 3 Typhoid Fever 2 Smallpox 5 Scabies 6 Visits re Maternity Homes, etc. 52 SCHOOLS. There are fifteen elementary and two secondary schools within the District. Medical Inspection.— The medical inspection of school children is under the control of the Kent County Council. Sanitary Accommodation.— Periodical inspection is made of the sanitary accommodation at the schools. School Closure.— The following school was closed during the year owing to a case of Scarlet Fever being in the school: St. Paul's Cray Infants' School, from 18th to 21st January. In addition, the following Certificates covering low attendances at school owing to the incidence of Infectious Disease were issued:— Chislehurst Annunciation Infants' Department : Whooping Cough, four weeks ending 18th March, 1938. Ditto: Whooping Cough and Measles, one week ending 25th March, 1938. Ditto: Measles and Chicken-pox, two weeks ending 8th July, 1938. Sidcup Black fen Council School, Infants' Department: Measles, one week ending 4th March, 1938. Sidcup Halfway Street Council School: Measles and Colds, one week ending 15th April, 1938. 25 MIDWIVES. The supervision of Midwives is under the control of the Kent County Council. The following Midwives have given Notice of Intention to Practice in this District:— Alcock, El., 171 Black fen Road, Sidcup. Cayzer, E. H., 57 Canterbury Avenue, Sidcup. Day, M., 16 Ingle by Way, Chislehurst. Easther, E. E., Sunny bank, Whitehorse Hill. Chislehurst. Evans, EL Ml, 23 Braundton Avenue, Lamorbey. Gibson, E. M., 22 Chalk Pit Avenue, St. Paul's Cray. Harris, L. E. P., 6 Cornwallis Avenue, New Eltham. Gibson, M. G. H., 14 Mainridge Road, Chislehurst. Hopkins, EL, 84 Wellington Avenue, Sidcup. Hyde, A. M., 63 Crombie Road, Sidcup. Jones, P. M., 3 Berwick Crescent, Day's Lane, Sidcup. Nugent, F. M., "Mottingdene," High Road, Mottingham. Russell, J. K., "Mottingdene," High Road, Mottingham. Smith, E. E., 117 Longlands Road, Sidcup. Watton, A., "Amhurst," Whitehorse Hill, Chislehurst. NURSING FACILITIES. The local Nursing Association provides the nursing facilities for this District. HOSPITALS. For Infectious Cases.— Cases of Infectious Disease are admitted to the West Kent Joint Hospital. General Cases.— The County Hospital, Farn borough (Public Assistance); the Sidcup Cottage Hospital; and the Cray Valley Hospital (Voluntary). AMBULANCES. For Infectious Disease.— The West Kent Joint Hospital Board have provided four motor ambulances for the removal of cases of Infectious Disease. For General and Accident Cases.— Two motor ambulances are provided by the Council for the removal of general and accident cases. NURSING AND MATERNITY HOMES. The powers under the Public Health Act, 1936, relating to Nursing Homes have been delegated to the District Council by the Kent County Council. There are seven premises registered in this District, two of which are maternity homes, three are both for maternity and general cases, and two for general cases only. The number of beds provided is 45, viz. 14 for maternity cases and 31 for other cases. 26 RIVERS AND STREAMS. Constant attention is paid to all watercourses within the District. The principal rivers are the River Quaggy (about 1,170 yards), the Cray (about 5,200 yards), and the Shuttle (about 2,800 yards) It was not found necessary to take any action during the year. LEGAL PROCEEDINGS. In no case was it found necessary to institute legal proceedings to enforce the abatement of a nuisance. REGULATED TRADES. DAIRIES AND COWSHEDS. There are 33 registered premises within the District, this being 4 more than last year. During the year 152 visits were paid, and in 22 instances defects were found. These were all remedied. MILK (SPECIAL DESIGNATIONS) ORDER, 1936. During the year the Council granted the following number of licences under the above Order: Tuberculin Tested 6 Ditto, supplemental 5 Pasteurised 16 Ditto, supplemental 2 MILK SUPPLY. During the year 152 visits were paid to the 33 dairies and cowsheds. Eighty-two samples of graded milk were submitted for examination, with the following results: Satisfactory. Unsatisfactory Tuberculin Tested 35 6 Pasteurised 27 2 Accredited 8 4 SLAUGHTERHOUSES. There are 5 Slaughterhouses within the District, of which 2 are registered and 3 are licensed. During the year 283 visits were paid, and on 28 occasions defects were found. These have since been remedied. PUBLIC HEALTH (MEAT) REGULATIONS. Under the above Regulations, which came into force on the 1st April, 1935, an opportunity is afforded for inspection of carcases of animals slaughtered for human consumption. 27 The following Table shows the work carried out during the year:— MEAT.— CARCASES INSPECTED AND CONDEMNED Cattle excluding Cows Cows Calves Sheep and Lambs Pigs (if known) Number of animals killed 112 6 42 1039 1445 Number of animals inspected 112 6 42 1039 1445 (All diseases except Tuberculosis) Whole carcases condemned ... ... ... ... ... Carcases of which some part or organ was condemned 2 1 ... 2 31 Percentage of the number inspected affected with diseases other than Tuberculosis 1.7 13.3 ... 2 2.4 Tuberculosis Only Whole carcases condemned ... ... ... ... 2 Carcases of which some part or organ was condemned 2 1 1 ... 65 Percentage of the number inspected affected with tuberculosis 1.7 13.3 2.3 ... 4.6 Fish Mutton Pork Beef The following amount of meat has been destroyed as being unfit for human consumption:— - - 1 1 Tons - - - 1 cwt. 1 - 2 3 qrs. 5 6 4 8 lb. 28 1.—INSPECTIONS for purposes of provision as to health. Including Inspections made by Sanitary Inspectors. premises Number of Inspections Written Notices. Occupiers Prosecuted. Factories with mechanical power 134 ... ... Factories without mechanical power 95 ... Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises ... ... ... Total 220 ... ... 2.—DEFECTS FOUND. PARTICULARS. (1) Number of Defects. No. of defects in respect of which prosecutions were instituted (5) Found. (2) Remedied. (3) Referred to H. M. Inspector. (4) Want of cleanliness 6 6 - - Overcrowding — - — — Unreasonable temperature — — - — Inadequate ventilation — - — - Ineffective drainage of floors. — — — — Sanitary convenience insufficient 1 1 — — unsuitable or defective 7 7 - — not separate for sexes — - - — Other offences Not including offences relating to Home Work or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Power) ordor,19'21, and re-enacted in the Third Schedule to the Factories Act, 1937) 5 5 - - Total 19 19 Nil Nil 29 BAKEHOUSES. There are 19 Bakehouses in the District, to which 37 visits have been paid. Thirty-seven defects were found, of which 22 have been remedied. PIGGERIES. There are 22 Piggeries in this District, this being 3 more than last year. During the year 80 visits were paid to these premises. OTHER FOOD PREPARING PLACES. There are 125 other premises in which food is prepared for human consumption. One hundred and ninety-three visits were paid to these premises during the year, and on 8 occasions defects were found. COMMON LODGING-HOUSES AND HOUSES-LET-INLODGINGS. There are no Common Lodging-Houses nor Houses-Let-inLodgings within the District. FISH FRIERS. There are 12 premises in which fish frying is carried on. During the year 24 visits were paid, and on 9 occasions defects were found. These have since been remedied. FACTORIES AND WORKPLACES. There are 99 Factories in the District. During the year 229 visits were paid to these premises, and 19 defects were found and later remedied. A detailed list of the Factories remaining at the end of the year is found in the following Table:— Bakehouses 17 Breeze Block Manufacturers 2 Builders and Decorators 9 Boot Repairers 10 Brake Lining Manufacturers 1 Carpenters 4 Cycle Repairers 1 Electrical Station 1 Electrical Engineers 2 Grinders 1 Hairdressers 1 Ladies' Garments 2 Laundries 3 Machinist 1 Mason 1 Metal Workers 1 Mineral Water Manufacturers 1 Motor Engineers 20 Organ Works 1 Paper Mills 1 Paint Manufacturers 1 30 Piano Repairers 1 Printers 3 Radio Manufacturers 1 Saw Mills 1 Smiths 2 Surgical Instrument Makers 1 Surgical Rubber Manufacturers 1 Tailor 1 Upholsterers 4 Ventilation Engineers 1 Window Manufacturer 1 Woodcutter 1 Total 99 SUMMARY OF REGULATED TRADES. No. of Premises Visits Paid Defects Found Remedied Dairies. 29 152 32 22 Cowsheds. 4 Slaughterhouses Licensed 2 283 28 28 Registered 3 Bakehouses. 19 47 37 32 Piggeries 22 60 8 8 Other food preparing places 135 193 72 72 Factories. 99 229 19 19 Workplaces. - - - - Houses let in lodgings - - - - Common Lodging Houses — — - — Totals 313 964 196 181 SHOPS AND OFFICES. Inspection of shops within the District is carried out in order to enforce the provisions of the Shops Acts. In one case a shop was provided with additional ventilation, and two shops were provided with heating apparatus. In addition, an additional water-closet was provided in connection with a shop. Inspection has also been made of the Offices within the District. SWIMMING BATHS AND POOLS. There are no public swimming baths in the District. 31 There is a small private swimming pool which is open to the public. Samples of the water taken during the year proved to be satisfactory. SMOKE ABATEMENT. Observations for smoke nuisances are kept as required. ERADICATION OF BED BUGS. During the year 6 Council houses and 26 other premises were found to be infested with bed bugs. All of these premises were disinfested. The method employed is to strip the woodwork, seal the premises, and use a sulphurous spray and an insecticide fluid (Lawverside). The furniture of prospective tenants of Council houses is inspected, and where necessary, disinfestation is carried out, the bedding, etc., being steam disinfected. All Council houses are disinfested upon vacation of tenants. The work of disinfestation is carried out by the Council's workmen, the owner of the premises doing any structural work. Close observation is kept on all suspected tenants, and advice and leaflets are given to occupants of affected premises. CAMPING SITES. No sites were used for camping in this District during the year. MORTUARIES. The following cases were admitted to the Mortuary at Beaver wood Road, Chislehurst, during the year:— M. 38 years Tetanus—accidental. M. 71 „ Myocardial degeneration—natural causes. M. 64 „ Inquest adjourned indefinitely. M. 65 „ Drowning—suicide whilst of unsound mind. M. 51 „ Misadventure. M. 3 „ Accidental—strangulation. F. 78 „ Accidental—fractured skull. M. 53 „ Haemorrhage. M. 37 „ Myocardial degeneration. M. 65 „ Ruptured aorta. M. 62 „ Myocardial degeneration—cardiac failure. F. 50 „ Electrocution—suicide whilst of unsound mind. M. 48 „ Valvular disease of the heart. F. 28 „ Drowning—suicide whilst of unsound mind. M. 51 „ Coronary thrombosis. M. 52 „ Coal gas poisoning. M. 43 „ Cerebral haemorrhage. F. 7 weeks Cerebral congestion. F. 60' years Cerebral haemorrhage. F. 38 „ Heart failure—natural causes. M. 72 „ Heart failure. F. 74 „ Myocardial degeneration. M. 62 „ Cerebral hemorrhage. M. 78 „ Arterio-selerosis—senility. M. 79 „ Myocardial degeneration. M. 66 „ Aortic disease. M. 74 „ Myocardial degeneration. M. 72: „ Natural causes. 32 ADOPTIVE ACTS, ETC. The following is a list of Acts, etc., which have been adopted, together with the date of adoption:— Acts. The Public Health Acts Amendment Act, 1890, Parts II and in. Infectious Disease (Prevention) Act, 1890. Museums and Gymnasiums Act, 1891. Private Street Works Act, 1892. Local Government Act, 1894, Section 8 (1) (h) (i). * Public Health Acts Amendment Act, 1907, Parts 1I-VI inclusive, Part VII (Sections 81 and 86), Parts VIII and IX, and Part X (Section 95). Order of the Local Government Board, 24th December, 1909. * Public Health Act, 1925, Parts II-V inclusive. * Slaughter of Animals Act, 1933, Section 1. Local Government and Other Officers' Superannuation Act, 1922. Date of Adoption. Adopted 14th January, 1904, and came into force 1st March, 1904. Ditto. January, 1928. 25th July, 1902. 17th December, 1923. Order of the Local Government Board, 24th December, 1909. Order of the Secretary of State, 12th November, 1909. Confirmation Order dated 4th August, 1911, made by the Local Government Board declaring each of the following trades, viz.: Blood-dryer, Tanner, Leather-dresser, Fat-melter or Fat-extractor, Gluemaker, Size-maker, Gutscraper, and Fish Frier, to be an offensive trade. The Sections subject to the consent of the Ministry of Health came into force on the 1st March, 1926. By resolution dated 19th September, 1934, Section 1 of the Act was made to apply to Sheep, Ewes, Wethers, Rams and Lambs, and came into force on the 1st October, 1934. 1st October, 1938. * Certain provisions repealed by Public Health Act, 1936. 33 BYELAWS AND REGULATIONS. Byelaws with respect to New Streets and Buildings. Byelaws with respect to Drainage of Existing Buildings (Chislehurst). Byelaws with respect to Tents, Vans, Sheds, etc. Byelaws with respect to Pleasure Grounds (Waring Park and Long lands Recreation Ground). Byelaws with respect to Nuisances. Byelaws with respect to Smoke Abatement. Byelaws with respect to Nursing Homes. Byelaws with respect to Recreation Ground, St. Paul's Cray. Byelaws with respect to Accommodation of Persons engaged in Picking Hops, Fruit and Vegetables. Byelaws with respect to the Regulation of Advertisements (approved by the Council on the 20th October, 1937, and confirmed by the Secretary of State on the 25th May, 1938). Regulations with respect to Allotments. Regulations with respect to Mode of Construction and Laying of Drains. Regulations with respect to Compulsory Notification of Measles. Regulations with respect to Cemeteries. 34 TABLE I.—Cases of Infectious Disease notified during the year 1938. Disease. At all Ages. Number of Cases Notified. at ages—years. Total cases removed to Hospital. Deaths Under 1 year 1 and under 2 years 2 and under 3years 3 and under 4 years 4 and under 5 years 5 and under 10 years 10 and under 15 years 15 and under 20 years 20 and under 35 years 35 and under 45 years 45 and under 65 years 65 and over Scarlet Fever 140 ... 1 3 5 11 80 16 17 7 ... ... ... 112 ... Diphtheria 76 ... 1 6 5 12 38 5 4 ... 5 ... .... 71 3 Typhoid Fever 5 ... ... ... ... ... 1 1 ... 1 1 1 ... 2 ... Erysipelas 15 ... ... ... ... ... ... ... 1 3 3 5 3 ... ... Pneumonia 33 4 3 2 2 1 8 2 2 2 4 2 1 ... 31* Puerperal Pyrexia 14 ... ... ... ... ... ... ... ... 10 4 ... ... ... ... Ophthalmia Neonatorum 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery 11 ... ... 1 1 ... 1 2 ... 2 2 2 ... ... ... Acute Poliomyelitis 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Malaria 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... Measles 831 21 50 53 61 51 564 18 8 5 ... ... ... 3 ... Total 1129 27 55 65 74 75 093 44 32 31 19 10 4 188 34 * A11 forms of Pneumonia. 35 TABLE II.—Deaths Registered during the year 1938. Disease Males. Females. Total. Typhoid and Paratyphoid Fevers - - - Measles — Scarlet Fever — — — Whooping Cough — — — Diphtheria 3 — 3 Influenza — j 2 Encephalitis Letbargica - - — Cerebro-spinal Fever - — — Tuberculosis of respiratory system 21 11 32 Other tuberculous diseases 4 3 7 Syphilis 1 - 1 General Paralysis of the Insane, (Tabes Dorsalis) 4 - 4 Cancer 54 38 92 Diabetes 3 2 5 Cerebral haemorrhage, etc 6 10 10 Heart disease 78 57 135 Aneurism 4 — 4 Other circulatory diseases 19 20 39 Bronchitis 5 3 8 Pneumonia (all forms) 18 13 31 Other respiratory diseases 1 4 5 Peptic Ulcer 7 3 10 Diarrhoea, etc. (under 2 years) — 4 4 Appendicitis 3 2 5 Cirrhosis of the liver — - — Other diseases of the liver, etc. 2 1 3 Other digestive diseases 6 9 15 Acute and chronic Nephritis 6 11 17 Puerperal Sepsis — 2 2 Other Puerperal causes — Congenital debility, premature birth, malformations, etc. 12 9 21 Senility 2 5 7 Suicide 3 2 5 Other violence 8 9 17 Other defined diseases 20 15 35 Ill-defined or unknown 1 — 1 TOTALS 291 235 526 36 URBAN DISTRICT COUNCIL OF CHISLEHURST & SIDCUP REPORT OF THE CHIEF SANITARY AND SHOPS ACTS INSPECTOR For the Year ended 31st December, 1938. Mr. Chairman, Ladies and Gentlemen, I have the honour of submitting a Report on the Sanitary and Shops Acts inspection carried out in the District during the year ended 3]st December, 1938. 1. Inspections—General. A total of 6,431 inspections were made during the year as follow:— 2,037 to dwelling-houses (Public Health Acts) 2,154 „ do. (Housing Acts) 152 „ farms, dairies and cowsheds 283 „ slaughterhouses 60 „ piggeries 47 „ bakehouses 24 „ fish friers 193 „ other food preparing premises 134 „ factories 95 „ workshops 169 „ premises for rats and mice 232 „ cases of infectious disease 3 „ rivers and streams 9 „ vans and sheds 23 „ pickers' huts 45 „ smoke abatement 232 „ water supplies 532 „ shops 35 „ various 6,459 Total 2. Complaints. 353 complaints were received and investigated. Where necessary, appropriate action was taken. They were as follow : 149 re general sanitary defects 16 ,, keeping of animals 30 „ offensive accumulations 25 „ verminous premises 34 „ drainage 4 „ water supply 37 46 „ rats 2 „ overcrowding 2 „ smoke 1 „ food 1 „ insect pests 43 „ various 353 Total 3. Notices. 723 Informal Notices were served, drawing the attention of property owners and others to the existence of nuisances and requesting abatement. It was found necessary to serve 6 Statutory Notices under the Public Health Acts to secure the abatement of nuisances where Informal Notices had not received compliance. In no instance was it found necessary to resort to legal proceedings. 4. Nuisances Remedied during the year: Sanitary accommodation: Defective 23 Drainage: (i) Reconstructed 23 (ii) Repaired 50 (iii) Cleaned 98 (iv) Provided 1 Cesspools: Cleaned 18 Baths, lavatory basins and sinks 51 Yard paving 29 Floors 55 Sub-floor ventilators 17 Walls and ceilings redecorated 668 Walls and ceilings repaired 308 Dampness, roofs, walls and rainwater pipes 312 Verminous premises 32 Refuse receptacles 108 Water supplies 19 Offensive accumulations 7 Fruit pickers' huts 15 Rats 36 Smoke 1 Various 622 38 5. Housing. (i) Routine Inspections. 240 premises were inspected under the Housing Consolidated Regulations, 1932, as follow:— Address. No. of Premises Albany Road, Chislehurst 58 Park Road, Chislehurst 38 Whitehorse Hill, Chislehurst 75 Devonshire Road, Mottingham 22 Dorset Road, Mottingham 6 Mottingham Road, Mottingham 6 Portland Crescent, Mottingham 22 Portland Road, Mottingham 13 Total 240 2,154 visits were made to premises in connection with the Housing Acts. (ii) Clearance Areas. No clearance areas have been declared during the year under review. (iii) Individually Unfit Houses. No individually unfit houses have been declared during the year. (iv) Overcrowding. The position with regard to overcrowding at the end of the year under review is shown on the following Table:— 39 WARD July 1936 1st Jan. 1937 31st Dec. 1937 31st Dec. 1938 No. of cases Number of Cases No. of persons concerned Cases remedied during year Cases found during year Cases to end of year No. persons concerned Cases remedied during year Cases found during year Cases to end of year No. persons concerned Aged over 10 Aged Under 10 Aged over 10 Aged under 10 Aged over 10 Aged under 10 Lamorbey 12 13 77 28 9 2 6 41 14 2 2 6 38 14 Longlands 2 1 7 2 1 - - - - — 1 1 7 2 Birchwood — __ — — — - Mottingham 8 9 50 11 7 2 4 26 11 4 2 2 16 2 Chislehurst Commons 11 13 68 18 9 — 4 25 5 2 — 2 17 1 Frognal 5 5 38 10 3 3 5 38 15 8 3 — - — North Cray 2 2 7 1 1 - 4 4 - — — 1 4 — St. Pauls Cray 4 8 40 20 5 — 3 17 12 3 - - - — Totals 44 51 287 90 35 7 23 151 57 19 8 12 82 19 40 During the year approximately 93 premises were measured in consequence of requests for the "permitted number" from owners of premises. 6. Infectious Disease. 232 visits of enquiry were made to notified cases of infectious disease, mainly cases of diphtheria and scarlet fever. On the removal of a case to the Isolation Hospital, the release from quarantine (home cases) or in other necessary cases, disinfection was immediately carried out by spraying rooms and their contents with formalin, and the clothing and bedding was steam disinfected at the disinfecting station. Public Library books found in any premises in which infectious or contagious disease occurred were also disinfected by formalin vapour in a special metal chamber. Certain articles have also been destroved bv fire. The disinfections carried out during the year were as follows:— Sprayed. Fumigated. Steam Disinfected Destroyed. Booms Mattresses 252 121 179 289 24 Pillows 267 — 842 23 Bedclothes, Batches of 103 _ 140 9 Clothing, Batches of 99 — 124 3 Library Books _ 82 - — Cushions 7 - 41 12 Carpets 248 - - 4 7. Vermin (i) Bed Bugs. During the year 25 complaints were received of infestation of premises by bed bugs. The number of houses and/or their contents found to be infested was 32 (including 6 in the Council's possession). In suitable cases, and on the request of tenant and. owner, the disinfestation of the premises and contents were simultaneously carried out by the Department. In all other cases the premises were disinfested by the owners, and the contents by the tenants. In all necessary cases bedding was steam disinfested by the Department. The usual method of disinfestation insisted upon is to strip as much woodwork from walls, etc., as possible, seal the premises and use a sulphurous gas or spray with contact fluid. Close supervision was made of premises which had been disinfested, and tenants were given suitable advice and instruction on methods of prevention and destruction of vermin. (ii) Rats and Mice. 169 visits were made to premises in connection with rat infestation. 46 complaints were received and at 36 premises infestation was remedied. 41 41 8. Food Inspections. (i) Meat Inspections. During the year a total of 2.751 animals were killed in slaughterhouses in the District, and all the animals slaughtered were examined. The details of killings are as follow:— Beasts. Cow s. Calves. sheep and Lambs. Pigs. Animals slaughtered under "Regular Notice" (260 occasions) 112 6 42 1,039 1,445 Animals slaughtered under "Occasional Notice" (13 occasions) 11 - - 12 84 Total number examined 123 6 42 1,051 1,529 Total number rot examined - - - - — Total number slaughtered 123 6 42 1,051 1.529 (ii) Food: Diseased or Unsound. Disease. Weight. Weight. Tons cwt. qrs. lb. Ton CWt. qrs. lb. Beef: Tuberculosis 18 0 11 Cirrhosis 1 12 Actinomycosis 1 2 Abscess 1 0 Pyaemia 20 Distomatosis 14 Tumour 8 Unsound 2 1 25 1 1 3 8 Pork: Tuberculosis 13 2 6 Excema 5 0 0 Gangrene 2 21 Unsound 1 10 Pneumonia 1 0 Urticaria 20 Cysts 18 Cirrhosis 12 Oedema 8 Arthritis 6 Pericarditis 6 Peritonal abscess 5 Hepatis 4 1 0 2 4 Mutton: Unsound 4 Septic lungs 2 6 Fish: Unsound 1 5 1 5 Total 2 2 2 23 (iii) Slaughterhouses. There are 5 slaughterhouses within the District, situated as under:— Address. Occupier. Registered: High Street, Foots Cray J. S. Tompkins. Roval Parade, Chislehurst Lidstone Ltd. Licensed: High Street, Chislehurst B. Keith. Station Road, Sidcup Fewell & Co. High Street, Sidcup Chalk & Cox Ltd. 42 These premises have been closely inspected on 283 occasions and 28 defects which were found were remedied. (iv) Slaughter of Animals Act, 1933. (a) Slaughtering-. In accordance with the provisions of this Act and by reason of the adoption by the Council of Section 2 of the Act, all beasts, sheep and lambs slaughtered in the District have been killed with a mechanically operated instrument. All pigs have been similarly killed. (b) Slaughtermen. In accordance with the requirements of the Slaughter of Animals Act, 1933, five licences were issued to slaughtermen during the year. (v) Milk and Dairies. There are 33 dairies and cowsheds in the District. These premises have been given special attention and 152 visits were made. 22 defects were found, which were remedied. During the year 82 samples of Graded milk were taken as follow:— Grade of Milk. Satisfied test. Did not satisfy test. Tuberculin tested 35 6 Pasteurised 27 9 Accredited 8 4 (vi) Bakehouses. There are 14 factory bakehouses and 5 workshop bakehouses in the District, to which 37 visits were made. 37 defects were found, 32 of which were remedied during the year. (vii) Fish Frying. Fish frying is a declared Offensive Trade within the District. There are 12 premises in which fish frying is carried on, and 24 inspections have been made to these premises. Nine defects were found, all of which were remedied. 9. Factories, Workshops and Workplaces. 229 visits were made to the 65 factories, 34 workshops and no workplaces in the District, details of which are incorporated in the Annual Report of your Medical Officer of Health in the Home Office Form. 10. Piggeries. There are 22 piggeries in the District, to which 60 visits were made during the year. Eight defects were found and remedied. 11. Cesspools. As far as is known, there are 258 cesspools draining 322 premises in the District. Owners or occupiers of premises make private arrangements for emptying cesspools with a Maidstone firm. The charge made is £1 for the first 1,000 gallons, and 17s. 6d. for each subsequent 1,000 gallons of sewage emptied. During the year the drains of two premises were connected with the Council's sewers and the cesspools abolished. The large majority of the cesspools drain premises not within a reasonable distance of a sewer, and the few that drain premises within this distance were constructed prior to the laying of the sewer. These latter are closely watched, but nuisance therefrom has not arisen and consequent action was unnecessary. 43 12. Smoke Abatement. During the year the abatement of the emission of grit was effected at St. Pauls Cray by the installation of a grit arrestor at the works at St. Mary Cray. 13. Pickers' Huts. There are 6 camps of pickers' huts in the District, of which only 4 have been used during the year and to which 23 inspections were made. In consequence of inspection 15 defects were found and remedied after informal action. 14. Rivers and Streams. Three inspections were made to rivers and streams in the District, and no nuisance was found. 15. Shops Acts. During the year 532 inspections and observations were made of shops, and 144 Informal Notices were served in connection with the Acts. (i) Ventilation. In one shop it was found Accessary to require improvement to ventilation. (ii) Temperature. In two cases was it found necessary to require additional heating to be provided. (iii) Sanitary Conveniences. No Certificates of Exemption were granted to occupiers of shops. Additional sanitary accommodation was provided at one shop. (iv) Lighting. No action was found necessary in this respect. (v) Washing Facilities. No Certificates of Exemption were granted to occupiers of shops. In five shops proper washing facilities were provided. (vi) Facilities for Meals. In one shop accommodation was provided for the taking of meals. (vii) Closing. No Closing Orders have been made for shops in the District, but the days of Early Closing generally observed are: Thursdays—Sidcup High Street; Blackfen; Mottingham. Wednesdays—The Oval, Sidcup; Chislehurst; St. Paids Cray. (viii) Hours. In 24 instances offences respecting hours of employment were remedied after the attention of the shopkeepers had been drawn thereto. In no case was it found necessary to take formal action. (ix) Records. 238 shops were found not to be keeping, exhibiting, or providing the necessary Notices or Records, and in each case a letter was sent to the shopkeeper. (x) Sunday Trading. 44 One shopkeeper was prosecuted for the sale of nonpermitted transactions under the Shops (Sunday Trading Restriction) Act, 1936, and a fine of 10s. was imposed. 16. House Refuse Collection and Disposal. At the beginning of the year the refuse was collected from approximately 16,825 premises, and at the end of the year from 17,350 premises. (i) Vehicles. The vehicles in use during the year were as follow:— One 15 cubic yard Thorny croft. Three 12/15 cubic yard Thorny crofts. Two 7 cubic yard Thorny crofts. Two 30 cwt. Morris. The average length of haul throughout the District from point of disposal at the shoot at Hockenden is 2½ miles. (ii) Collection. Refuse is collected from ail premises once weekly. Collection is also made of trade refuse at a standard charge of 6d. per small bin and 9d. per large bin, and prepaid vouchers were used for this at the latter part of the year. (iv) Disposal. The scheme for the erection of a Separation and Incineration. Plant at Foots Cray was deferred pending the consideration of a Pulverising and Composting Plant. (v) Clothing. Every man is provided with clean overalls, smock, waterproof leggings, leather shoulder pad and leather gloves. (vi) Salvage. Paper, bottles, rags and metals are salvaged. The value of goods salvaged during the year was approximately £554. (vii) Cost of Service. The cost of the service for the year ending 31st April, 1938, was £14,450, and it is anticipated that the cost during the financial year ending 31st March. 1939, will be £11,084, as follow:— 1936-7 1937-8 1938-9 1939-40 £ £ £ £ Collection 9,142 12,600 9,418 8,757 Disposal 1,827 1,850 1,666 2,351 10,969 14,450 11,084 11,108 Tonnage (estimated) 12,132 12,500 12,525 12,550 Cost per ton: Collection 15/- 20/2 15/- 13/11 Cost per ton: Disposal 3/11 2/11 2/8 3/9 17. Conclusion. In conclusion I desire to place on record my appreciation of the assistance rendered by all members of the Department. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, A. V. B. ALLEN, Chief Sanitary and Shops Acts Inspector.