CHISLEHURST AND SIDCUP URBAN DISTRICT COUNCIL. ANNUAL REPORT on the MEDICAL OFFICER OF HEALTH on the Health of the Urban District and the Work of the Health Department 1952 Printed by Bromley Office Supplies & Printing Co., Ltd. East Street, Bromley CHISLEHURST AND SIDCUP URBAN DISTRICT COUNCIL ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH on the Health of the Urban District and the Work of the Health Department 1952 3 CONTENTS. Page Members of the Health Committee 5 Staff 5 Prefatory Letter 6 Section A. Vital and Other Statistics and Social Conditions of the Area. Vital Statistics 10 Population 11 Births 11 Illegitimate Births 12 Stillbirths 12 Deaths 12 Maternal Mortality 12 Infantile Mortality 13 Unemployment 13 Open Air Recreational Amenities 13 Section B. General Provision of Health Services for the Area. Hospitals 16 Home Nursing Service 16 Health Visiting 17 Domiciliary Midwifery 17 Child Welfare Centres and Clinics 17 Day Nurseries 18 Domestic Help Service 18 Ambulance Facilities 19 Laboratory Service 19 Tuberculosis Care Committee 19 Medical Loan Depots 19 St. John Ambulance Brigade 19 Old People's Welfare Committee 20 British Red Cross Society 20 Section C. Sanitary and Environmental Circumstances. Water Supply 22 Rivers and Streams 25 Drainage and Sewerage 25 Cesspools 25 Swimming Baths 25 Section D. Factories, Outworkers, Etc. Factories 28 Sanitary Inspection of the Area 28 Smoke Abatement 29 Shops Act 29 Petroleum Acts 29 Rodent Control 30 Verminous Conditions and Uncleanliness 31 Pet Animals Act, 1951 31 4 Page Section E. Housing. New Houses 34 Rehousing 34 Moveable Dwellings 35 Section F. Inspection and Supervision of Food. Food Sampling 38 Food Preparing Places 40 Unsound Food 41 Slaughterhouses 42 Piggeries 42 Milk 42 Ice Cream 42 Section G. Infectious Diseases. Smallpox 44 Vaccination 44 Anterior Poliomyelitis 44 Scarlet Fever 44 Diphtheria 44 Diphtheria Immunisation 45 Paratyphoid 45 Puerperal Pyrexia 45 Ophthalmia Neonatorum 45 Measles 45 Whooping Cough 45 Tuberculosis 46 Food Poisoning 46 Dysentery 46 General 46 Section H. Other Services. Nursing Homes 48 Public Conveniences 48 National Assistance Act, 1948 48 Public Mortuary 48 APPENDIX—STATISTICAL TABLES. Table I.—Summary of Statistics 51 „ II.—Causes of Death 52 „ III.—Sanitary Inspection of the Area 53 „ IV.—Factories Acts 54 „ V.—Tuberculosis—New Cases and Mortality 1952 56 „ VI.—Tuberculosis Rates 57 „ VII.—Infant Mortality 1952 58 ,, VIII.—Notifiable Infectious Diseases, Sex and Age Distribution 59 5 PUBLIC HEALTH COMMITTEE. Chairman : G. C. ODLING, Esq. Vice-chairman : P. A. SHAW, Esq. Chairman of the Council. P. M. Anderson, Esq. Miss M. H. Bird. F. C. Carter, Esq. Mrs. F. J. Daubney. L. J. Green, Esq. Vice-Chairman of the Council. Mrs. R. A. Joyce. E. J. Reader, Esq. Mrs. E. V. Wallace. E. W. White, Esq. W. Williams, Esq. C. E. Wiltshire, Esq. STAFF OF THE HEALTH DEPARTMENT as at 31st December, 1952. Medical Officer of Health : K. E TAPPER, o.b.e., g.m., m.b., ch.b., d.p.h. Deputy Medical Officer of Health : H. B. C. CARTER-LOCKE, m.b., b.s., m.r.c.s., l.r.c.p., d.p.h. Chief Sanitary and Shops Act Inspector : A. V. B. ALLEN, m.r.s.i., m.r.i.p.h.h., m.s.i.a. Deputy Chief Sanitary and Shops Act Inspector : J. C. KERMODE, c.r.s.i., m.s.i.a. District Sanitary Inspectors : E. C. BERWICK, c.r.s.i., m.s.i.a. J. W. P. HARRIS, c.r.s.i., m.s.i.a. D. M. SKINNER, m.s.i.a. CLERICAL STAFF. W. J. WATLING. MISS C. DEVONSHIRE. MRS. E. K. LAW (Temp. 31st December, 1952). OUTDOOR STAFF. T. BACK (Disinfector, Mortuary Keeper, Drain Clearer and General Handyman). J. DAVIS (Assistant to Mr. Back) E. ELLIS (Rodent Operative). 6 To the Chairman and Members of the Chislehurst and Sidcup Urban District Council. Mr. Chairman, Ladies and Gentlemen, The Report for 1952 follows the directions of the Ministry of Health under Circular 2/53 and takes the form of previous years' reports. If statistics seem to be the dominant feature it is because statistics are useful for comparison with previous years and also that they give some indication of the progress or retardation of Public Health so far as it affects Chislehurst and Sidcup. A death rate of 8.7, a birth rate of 15.1, an infantile mortality rate of 19.5 when taken in comparison with the rates of England and Wales indicate that the state of health is good. As is well known such comparisons are only true if one is comparing like with like, viz., a population of equal age groups. It is known that the child population of Chislehurst and Sidcup is comparably higher than that of its neighbours and because there has during recent years, been a remarkable reduction in the killing diseases of childhood, it follows that from these two facts alone the death rate should be a low one. There were in fact only 11 deaths in children between the ages of one and fifteen, whereas in children under one year of age there were 25 deaths. Infectious Disease as a cause of death in 1952 was negligible. There were no deaths from Diphtheria, Scarlet Fever, Whooping Cough or from Measles—a very different picture from that of a few years back. There were 2 deaths from Meningococcal Meningitis, 2 from Influenza and 1 from Infantile Paralysis. There were 17 deaths from Tuberculosis of the Lungs and 21 deaths from Cancer of the Lungs. As Cancer of the Lung is not a notifiable disease our knowledge of its incidence is dependent upon death returns which for the country as a whole show a big increase in the past 20 years. Whether this big increase can be ascribed to improved diagnosis entirely is possible but unlikely. The fact that we seem to be relatively free from the scourge in these parts (our rate being .26 per 1,000 population compared with .59 for England and Wales) may be due to the fact that we are fortunate to be living in a district where there is plenty of fresh air, sunlight, open space and absence of gross atmospheric pollution, but the actual part played by these factors in the causation of this disease has not yet been satisfactorily determined, nor to my mind, has the role of tobacco as the villain of the piece yet been factually determined. To pass on to the other subject namely pulmonary tuberculosis, here we can draw a much more cheerful picture, for in Chislehurst and Sidcup the death rate from this disease has been reduced from 0.55 per thousand population in 1948 to 0.26 in 1952. 7 This is a triumph of preventive medicine combined with curative medicine for there can be little doubt that these satisfactory figures are due to improved early diagnosis by means, of mass X-ray facilities, the examination of contracts and new and more effective therapeutic agents. By such means the time of treatment is severely cut, more beds are available more quickly for urgent cases and the economic strain on both the family of the unfortunate victim and on the State at large is greatly reduced with corresponding advantages to everybody concerned. But how slow we are to see the advantages of prevention over the more dramatic success obtained by what sometimes appears a miraculous cure. The concentrated effort during the past few years, for improvement in the handling of food, is showing a good return if we are to judge by the absence of any outbreak of food poisoning. At the end of the year, an enquiry was made into the extent and condition of cesspool drainage throughout the widespread district, there being 482 premises not connected to main drainage. Sewerage schemes are under active consideration, being held up by the financial restrictions placed on capital expenditure. The problem of caravan encampments is one that has received for many years, and is now receiving, the active attention of the Committee of the Council. Such encampments are an anxiety to those whose work lies in Public Health and social welfare, but being largely a " floating" population cannot be considered as a strictly parochial matter, nor even perhaps as a County problem only, but one for which there will eventually have to be formulated a national policy. The Annual Report is my opportunity for once again thanking the Members of the Council for their support and continued interest in the work of the Department. I should also like to express my gratitude to all my fellow officers for their ever willing co-operation, especially to the Chief Sanitary Inspector, Mr. Allen and the rest of the staff of the Public Health Department, whose devotion to duty lightens my burden to no small extent. At the time of writing this report Mr. Allen has unfortunately been laid low by illness but we hope that ere long he will be restored to health. I am, Your obedient Servant, K. E. TAPPER, JUNE, 1953. Medical Officer of Health. SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. 10 SECTION A. VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA. The area of the Urban District is 8,957 acres. Registrar General's estimate of total population (mid-year) 1952 85,130 Number of valuation assessments of habitable premises at 31st March, 1953 23,069 Number of valuation assessments of habitable premises at the close of the year 1952, in respect of: — (a) Houses 21,847 (b) Flats 1,696 (c) Farmhouses 17 (d) Public Houses (including Beerhouses) 21 Rateable Value (estimated) at 31st March, 1953 £707,309 Product of a Penny Rate for the year ending 31st March, 1953 £2,845 Vital Statistics. Live Births. Total Male Female Legitimate 1,237 653 584 Birth Rate 15.1 per 1,000 total population. Illegitimate 45 23 22 1,282 676 606 Stillbirths. Total Male Female Legitimate 33 17 16 Stillbirth Rate 0.39 per 1,000 total population, and 25.1 per 1,000 (live and still) births. Illegitimate — — — — — — 33 17 16 Deaths. Total Male Female Death Rale 8.7 per 1,000 total population. 739 376 363 Deaths from Puerperal Causes. Pregnancy, childbirth and abortion 2 Maternal Mortality Rate 1.52 per 1,000 (live & still) births. Deaths of Infants under 1 year of age. Total Male Female Legitimate 25 9 16 Infant Mortality Rate 19.5 per 1,000 live births. Illegitimate — — — 25 9 16 11 Death Rates of Infants under 1 year of age. All Infants per 1,000 live births 19.5 Legitimate Infants per 1,000 live legitimate births 19.5 Illegitimate Infants per 1,000 live illegitimate births — Comparative statistics for year 1952. Birth rate (per 1,000 population) Death rate (per 1,000 population) Infant mortality rate (per 1,000 live births) Live Births Still Births Chislehurst and Sidcup 15.1 0.38 8.7 19.5 England and Wales 15.3 0.35 11.3 27.6* London Administrative County 17.6 0.34 12.6 23.8 * Per 1,000 related live births. POPULATION. The Registrar General's estimate of the total population (Civilian and Non-Civilian) of the Urban District, mid-year 1952. is 85,130. This population figure gives a density of 9.5 persons to the acre. The decrease over the year 1951, is 20. The 1952 return shows that the excess of births over deaths was 543. BIRTHS. The Birth Rate for 1952 is 15.1 per 1,000 total population, which compares favourably with the rate of 15.3 for England and Wales and 16.9 for the 160 large towns, including London. There were 1,282 live births registered during the year, of which 676 were males and 606 females. Comparative rates during the past ten years are as follow :— Year. Chislehurst & Sidcup. England & Wales. 1943 17.8 16 5 1944 20.0 17.6 1945 17.5 16.1 1946 20.8 19.1 1947 20.9 20.5 1948 16.4 17.9 1949 15.8 16.7 1950 15.0 15.8 1951 16.1 15.5 1952 15.1 15.3 The average yearly Birth Rate during the past ten years was 17.5 Chislehurst and Sidcup and 17.1 England and Wales. 12 Illegitimate Births. The illegitimate birth rate (per 1,000 live and still births) for 1952, is 34.2. Stillbirths. The total number of stillbirths allocated to the Urban District during the year was 33, which gives a stillbirth rate of 25.1 per 1,000 live and still births, and a rate of 0.39 per 1,000 total population. DEATHS. The Death Rate for the year 1952, is 8.7 per 1,000 total population. Of the 739 deaths occurring, 376 were males and 363 females. The following details show the age at death :— Age. Total. M. F. Under 1 9 16 1, under 5 4 2 5, under 15 4 1 15, under 25 2 4 25, under 45 26 18 45, under 65 117 67 65, under 75 91 88 75 and over 123 167 376 363 Grand Total 739 The main causes of death in the Urban District were :— Cancer 127 Congenital Causes 10 Heart Disease 377 Infectious Diseases 4 Influenza 2 Respiratory Diseases (non-T.B.) 72 Tuberculosis 22 Other 125 During the year there were 8 deaths from suicide, 4 from motor vehicle accidents and 10 from other accidents. Maternal Mortality. There were 2 maternal deaths in the Urban District during 1952, giving a rate of 1.52 per 1,000 total births. 13 Infantile Mortality. Twenty-five infants died in the Urban District during 1952 before reaching their first birthday, giving an Infant Mortality Rate for the year of 19.5 per 1,000 live 'births. Thirteen died during their first four weeks of life, 11 of which were within the first week. The average rate for the past ten years is 24.9. UNEMPLOYMENT. I am indebted to the Manager of the Local Employment Exchange for the following information :— " Unemployment, while more than the preceding year, was not large, and was due in some part to redundancies in other areas. Local firms have ceased their expansion, but in the main have held their ground. Some loss of orders was due to restriction by the Dominions on imports. The fit and not too elderly have usually been able to find work easily." OPEN AIR RECREATIONAL AMENITIES. Public Recreation Grounds, Gardens, etc. Some 392.42 acres of land have been secured or reserved for pulblic recreational purposes within the Urban District. Commons. The Chislehurst and St. Paul's Cray Commons have an area of approximately 165 acres and are administered by a Board of Conservators. Location. Acreage. Description. Abbeyhill P'ark 6.84 Part allotments. Belmont Lane Open Space 5.59 Part allotments. Beverley Avenue 1.64 Open space. Chalk Wood and Mount Misery 69.21 Open space. Chislehurst Recreation Ground and Whytes Woodland 15.02 Open space with 4 tennis courts, 1 football pitch and 1 cricket pitch and children's playground. Church Lane Recreation Ground 2.25 Open space. Footscray Common .70 Open space. Footscray Recreation Ground 6.80 Open space and part allotments. Hollyoak Wood Park 11.61 Open space and part allotments. King George's Field 11.10 Open space with 3 football pitches, 2 cricket pitches and 2 concrete cricket practice pitches and children's playground. 14 Location. Acreage. Description. Lamorbcy Park: — (1) The Glade 10.63 Open space. (2) Land fronting Burnt Oak Lane 2.00 Open space. (3) Land leased 12.42 Open space. Longlands Recreation Ground 6.00 Open space with 1 football pitch. Mottingham Sports Ground 30.00 Open space with 2 tennis courts, 8 football pitches, 6 cricket pitches, 1 hockey pitch and 3 concrete cricket practice pitches (mobile canteen summer). Mottingham Recreation Ground 5.89 Open space — children's playground. Old Farm Park 11.78 Open space and part allotments. Parish Wood 6.73 Open space. Penhill Park 17.10 Open space with 4 football pitches and 3 cricket pitches and children's playground. River Cray Reservation: — (1) North Cray Place Farm 29.60 Used for agricultural purposes. (2) Footscray Meadows 49.32 Open space and agricultural purposes. St. Paul's Cray Recreation Ground 6.20 Open space with children's playground. Sidcup Place 25.31 Open space with 1 football pitch, 1 cricket pitch and 1 putting green, 4 tennis courts, walled garden and children's playground. Stable Meadow Sports Ground 29.60 Open space with 2 football pitches and 1 cricket pitch. The Oval 1.66 Open space. Walden Recreation Ground 4.60 Open space with 1 football pitch. Waring Park 13.06 Open space with 4 tennis courts, 2 cricket pitches, 1 putting green, 2 netball pitches and 1 concrete cricket practice pitch and children's playground. Willersley Park 5.59 Open space with 4 tennis courts. 392.42 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 16 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. I have again sub-divided the services into services rendered by the Council, the Hospital Boards, the County Council under Part III of the National Health Service Act, 1946, and Voluntary Services. 1. Public Health services rendered by the Council. The major services of the Public Health Department, to which detailed reference is made under the various sections of this report, are as follow :— Enquiries into complaints and abatement of nuisances. Infectious Diseases (Prevention and Notification). Inspection of Food and Food Premises. Inspection and Examination of Water and Milk Supplies. Inspection of Shops and Factories. Housing. Inspection of Nursing Homes. Rodent Control. Atmospheric Pollution. Public Mortuary. Health Education and all matters covered by the general heading of Sanitary and Environmental Services. A complete summary of the work of the Health Department will be found in the Tables at the end of this report. 2. Services rendered by the Hospital Boards. There are three hospitals in Chislehurst and Sidcup : Queen Mary's Hospital with 350 staffed beds (possible 510) ; Cray Valley Hospital with 35 beds ; Sidcup Cottage Hospital with 13 beds, giving a total of 398 beds staffed and available for use. These hospitals form part of the Sidcup and Swanley Hospital Group of the South East London Region. There are 14 maternity beds in the Cray Valley Hospital. In addition to these hospitals, six blocks of Grove Park Hospital lie within the area of the Urban District. In these six blocks there are 291 beds which are reserved for use of patients suffering from tuberculosis. This is part of the Woolwich Hospital Group. 3. Services rendered by the County Council. Home Nursing Service. There are nine Home Nurses operating in the area. Home Nursing is provided on medical certification only, and is free. 17 It is a very valuable service, especially at a time when there are long waiting lists for hospital admission. Health Visiting. Nine Health Visitors, two School Nurses and one Tuberculosis Health Visitor are employed by the County Council on work within the Urban District. The Health Visitors attend Welfare Centres, Clinics in connection with immunisation against diphtheria and vaccination against smallpox, etc., and carry out home visiting in respect of Child Life Protection, After Care, etc. Midwifery (Domiciliary). Nine midwives are engaged whole-time in domiciliary midwifery in the area. The services of the midwives are engaged direct by the patient or through the patient's private doctor, and the midwives act either as midwives or maternity nurses. The County Council is the supervising Authority under the National Health Service Act, 1946. Child Welfare Centres. CHISLEHURST: The Willows, Red Hill Tuesday & Thursday Test Feeds, Tuesday p.m. FOOTSCRAY: W. Smith Memorial Hall Tuesday p.m. MOTTINGHAM: Kimmeridge Road Mondav & Wednesday Tues. (non-doctor's session) p.m. p.m. NORTH CRAY: Social Club, NorthCray Road 1st. 3rd & 5th Friday p.m. SIDCUP: The Oval, Sherwood Park Avenue Tues., Wed. & Fri. p.m. Congregational Church Hall Monday & Wednesday p.m. Ante-Natal Clinics. CHISLEHURST: The Willows, Red Hill Wednesday p.m. MOTTINGHAM: Kimmeridge Road Monday & Wednesday a.m. SIDCUP: The Oval, Sherwood Park Avenue Tuesday & Friday a.m. Congregational Church Hall Wednesday Thursday a.m. p.m. Women's Welfare Clinics. CHISLEHURST: The Willows, Red Hill Tuesday (Once a month from end of May, 1953) a.m. MOTTINGHAM: Kimmeridge Road 1st Thursday p.m. SIDCUP: The Oval, Sherwood Park Avenue 1st & 3rd Thursdays a.m. Congregational Church Hall 3rd Thursday a.m. 18 Post-Natal Exercises. MOTTINGHAM: Kimmeridge Road SIDCUP: Days Lane Junior School Hall Friday 8-9 p.m. Wednesday 1.15 p.m. Ante-Natal Exercises. MOTTINGHAM: Kimmeridge Road SIDCUP: The Oval, Sherwood Park Avenue Thursday 2-3 p.m. Thursday 2.30 p.m. Minor Ailment Clinics (Schools). CHISLEHURST: The Willows, Red Hill Mon., Wed., Fri. & Sat 9-10 a.m. MOTTINGHAM: Kimmeridge Road SIDCUP: 10, Station Road Tues., Thurs. & Fri. 9-10 a.m. (No doctor) 2nd & 4th Saturday a.m. (Doctor's sessions) Thursday a.m. Dental Clinics. CHISLEHURST: The Willows, Red Hill Thurs. & Fri. by appointment MOTTINGHAM: Kimmeridge Road SIDCUP: 10, Station Road Monday all day Monday to Friday a.m. & p.m. Saturday a.m. Immunisation and Vaccination. SIDCUP: Child Welfare Centres At all sessions. Thursday a.m. 10, Station Road Asthma Clinic. CHISLEHURST: The Willows, Red Hill Thursday a.m. Ophthalmic Clinic. CHISLEHURST: The Willows, Red Hill Monday a.m. Day Nurseries. There are no Day Nurseries in operation in the area. Sidcup Hill Day Nursery having been closed by the County Council during 1952. Domestic Help Service. Applications for this service are made direct to the District Organiser, 2, Alma Road, Sidcup. Demands for this service are still high, especially for cases of illness in the home and for old people. Provision is also made for domestic help during a home confinement. Details of the service which was provided during the year 1952, are given below :— Maternity 119 Tuberculosis 64 Aged 187 Others 201 There were 125 part-time workers employed in the area during the year, 19 Ambulance Facilities. There is an ambulance depot at the Council Offices, Main Road, Sidcup, where there are seven ambulances and three sitting-case cars. Sitting-case cars are provided for out-patients on medical certification. Laboratory Service. The Kent County Council provide a Laboratory service for the whole of the County through their Laboratory at Maidstone. Details of Food and Drugs samples and other specimens, etc., which were sent during the year 1952. appear later in this report. Venereal Diseases. Patients are referred either to the London Hospitals or one of the established centres in the County. No centre is provided within the Urban District for the treatment of these diseases. 4. Services rendered by Voluntary Associations. Medical Loan Depots. A full range of nursing requisites is available at the Medical Loan Depots. Applications for loan of such equipment for Chislehurst and Sidcup inhabitants should be made to :— Applications for loan of such equipment for Chislehurst and Sidcup inhabitants should be made to :— The Manor House Hall, Sidcup Green Tuesdays 3—4 p.m. Thursdays 7—8 p.m. 56, Woodside Avenue, Chislehurst Mondays 3—4 p.m. Thursdays 6.30—8 p.m. 51, Framlingham Crescent, Mottingham Wednesdays 6—7 p.m. Chislehurst and Sidcup Tuberculosis Care Committee. This is a voluntary Committee which has been in existence since 1938, is very active in its functions and is doing very useful work in helping people suffering from tuberculosis and their families. The main functions of this Committee are to provide financial and clothing assistance where necessary, and diversional therapy and social visiting. During the past year 114 families came under the supervision of the Committee, 10 of them being new cases. The St. John Ambulance Brigade. The objects of the Brigade are to afford holders of first-aid certificates from the St. John Ambulance Association opportunities of meeting together for ambulance and nursing practice, with the object of combining individual efforts for the public advantage ; to render first-aid to the sick and injured on public occasions, with the sanction of the police and other authorities, 20 and to maintain in readiness for such duty a body of trained men and women. Chislehurst and Sidcup Old People's Welfare Committee. Abstract from Secretary's Annual Report:— " This year it has not been necessary to open any new Clubs, since, in the previous year, we achieved our object of establishing a Club in each Ward of the Urban District. A meeting place has. therefore, been provided within reach of most of the elderly residents of the area. There are now 1,000 old people attending twelve Clubs each week and many of the members belong to two or three Clubs. Membership has continued to increase and several Clubs have had to limit their numbers." British Red Cross Society. The Chislehurst and Sidcup division of the British Red Cross Society has detachments at Chislehurst, Sidcup (2), Mottingham. and also at Petts Wood and Orpington (serving the St. Paul's Cray L.C.C. Estate), with cadet units and associate groups. The Divisional Office is at Hornbrook House, High Street, Chislehurst. The Objects of the Society are the care of the sick and wounded in peace and war, the improvement of health, the prevention of disease and the mitigation of suffering. In addition to first-aid duties and regular auxiliary nursing in the hospitals of the neighbourhood, the men and women of the Society's detachments are engaged in a number of local welfare activities which include the Hospital Library Service, diversional therapy for the home-bound, home visiting of the sick, hospital needlework and hopfield dispensaries. A first-aid hut is open at Ruxley Corner. Footscray, on Sundays and Public holidays during the summer, and four depots are operated at all times for the loan of invalid and sick-room equipment. Personnel assist in staffing at local clinics and at the periodical blood transfusion sessions. The division is responsible for the recruitment and initial instruction of untrained volunteers for the National Hospital Service Reserve, and undertake the basic first-aid training of volunteers for the Civil Defence Corps. Membership of the adult detachments is open to men and women between the ages of sixteen and sixty-five. SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES. 22 SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES. Water Supply. I am indebted to the Clerk, and the Director of Water Examination, Metropolitan Water Board, for the following information on the supply of water to the Urban District during the year 1952 :— " The supply to the district of Chislehurst and Sidcup has been adequate at all times in 1952 and is derived from the following seven wells : Orpington, North Orpington, Shortlands, Eynsford, Bexley, Wilmington and Darenth, together with Thames-derived filtered water via Shortlands pumping station. Bacteriological analyses of samples of water at the various stages of purification of these sources of supply are made at least five times a week and consistently satisfactory results have been obtained. Chemical analyses of the samples are also made at frequent intervals. All supplies are treated with chlorine on the works, but any excess remaining after a period of contact is removed completely or reduced to an amount that will not be perceptible to consumers. Tanks have been installed at North Orpington, Orpington, Bexley, Shortlands and Wilmington to ensure an adequate period of contact of chlorine with the water ; tanks at other well stations are planned or are in the course of construction. All new and repaired mains are disinfected with chlorine before being restored to supply and samples of water from them are analysed to establish that it is up to the normal standard of quality expected in the distribution system. None of the supplies is plumbo-solvent. We have no information with regard to the proportion of the total number of dwelling houses and population in Chislehurst and Sidcup which are supplied from each of the above-mentioned sources. All the houses are supplied directly and not by means of stand-pipes. Appended are the results of chemical and bacteriological analyses of the various supplies to Chislehurst and Sidcup during 1952." 23 Average Results of the Chemical and Bacteriological Examination of the Water Supply to Chislehurst and Sidcup during 1952. Parts per Million (unless otherwise stated) Orpington Well North Orpington Well Shortlands Well Eynsford Well Bexley Well Wilmington Well Darenth Well Thames derived filtered water Number of samples 4 4 4 4 5 8 2 1,714 Ammoniacal Nitrogen 0.004 0.010 0.007 0.004 0.011 0.013 0.013 0.027 Albuminoid Nitrogen 0.03.5 0.035 0.025 0.033 0.037 0.026 0.025 0.093 Oxidised Nitrogen—Nitrite — — — — — — — — Oxidised Nitrogen—Nitrate 6.9 4.9 5.4 4.3 6.2 7.3 5.3 3.7 Chlorides as CI. 15.4 13.9 18.6 14.9 16.1 19.5 14.8 24.6 Oxygen abs. from Permanganate 3 hrs. at 27° C. 0.05 0.05 0.19 0.09 0.07 0.12 0.08 1.05 Turbidity in terms of Silica — — — — — — — 0.2 Colour, M.M. brown 2 ft. tube, Burgess's Tintometer 2 0 0 0 0 0 0 12 Hardness (Total) 284 267 282 266 282 291 254 256 Hardness Non-carbonate 43 36 61 41 50 54 29 62 pH Value 7.3 7.3 7.4 7.3 7.3 7.2 7.3 7.8 Magnesium 2.6 2.5 5.8 3.2 3.6 3.7 4.0 5.5 Silica as Si02 12 14 16 14 17 19 14 10 Fluorides F 0.03 0.04 0.05 0.04 0.05 0.06 0.03 — Oxygen Saturation % — — — — — — — — B.O.D. 5 days at 65°F — — — — — — — — Conductivity 450 425 450 450 475 475 425 475 BACTERIOLOGICAL RESULTS. Orpington Well North Orpington Well Shortlands Well Eynsford Well Bexley Well Wilmington Well Darenth Well Thames derived filtered water Number of samples Plate Count (Average per millilitre) Colonies counted on 253 252 273 380 261 255 251 3,430 Agar— 22° C. (3 days) 896.5 37.0 5.7 344.3 10.9 33.3 1.2 - 37° C. (20.24 hrs.) 35.0 3.3 0.5 1.8 0.6 1.2 0.1 17.5 Bact. coli test— Percentage of samples negative in 100 ml. 100.0 100.0 100.0 100.0 100.0 100.0 99.6 99.8 Average number of Bact. coli per 100 ml. — — — — — — 0.004 0.005 to 25 Rivers and Streams. Thirteen inspections have been carried out by the Inspectors. No improvements or constructional works have been carried out during 1952. Drainage and Sewerage. The West Kent Main Sewerage Board is the responsible Authority in North West Kent. Twenty yards of 9" Surface Water Sewer were taken up and replaced by twenty yards of 12" stoneware pipes. No new sewers were constructed by the Council. Three-eighths of a mile of new sewer on the L.C.C. Estate, St. Paul's Cray, was taken over during the year. Cesspools. Four hundred and eighty-two premises are without main drainage. The Local Authority make no direct arrangements for the emptying of cesspools, this task being undertaken by private arrangement with a Gravesend firm. So far as is known only 118 of these cesspools receive adequate attention. Three new premises with cesspool drainage were erected during 1952. Swimming Baths. There is one small private swimming pool in the district to which the public are admitted. Two samples of the water were taken during the year, both being satisfactory. SECTION D. FACTORIES, OUTWORKERS, SMOKE ABATEMENT, SHOPS ACT, RODENT CONTROL AND VERMINOUS CONDITIONS AND UNCLEANLINESS. 28 SECTION D. FACTORIES, OUTWORKERS, SMOKE ABATEMENT, SHOPS ACT, RODENT CONTROL AND VERMINOUS CONDITIONS AND UNCLEANLINESS. Factories Acts, 1937 and 1948. A total of 430 inspections and re-inspections were made during the year, and 66 nuisances and defects were found. There were 66 nuisances and defects remedied during 1952—this figure included those nuisances which were outstanding from the previous year. Table IV in the Appendix is a copy of the return made to the Ministry of Labour and National Service for the year 1952. Sanitary Inspection of the Area. Tables III and IV give details of the varied duties involved in Sanitary inspection of the area as carried out by the Sanitary Inspectors. The following are the aggregate totals under the respective headings:— Total No. of Inspections and Visits Total No. of Defects and Nuisances found Housing 4,186 1,470 Infectious Diseases 358 — Food Premises 1,909 231 Factories, Outworkers, etc 430 66 Sampling Visits 407 — Piggeries 165 27 Trade Premises (various) 149 24 Rodent Control 1,087 358 Miscellaneous 1,209 76 Total 9,900 2,252 Notices issued :— Preliminary: Housing 228 Food Premises 65 Factories, etc 19 Trade Premises 11 Rodent Control 4 Miscellaneous — 327 Statutory 7 Total 334 Food Condemnation Certificates issued 735 29 Smoke Abatement. Seventy-five inspections and re-inspections were made by the Inspectors. Three nuisances were found and at the end of the year 3 had been remedied. Shops Act, 1950. One hundred and twelve visits were made and 24 defects and contraventions were found, 24 of these were remedied by the end of the year. There are 699 shops in the district. Action taken by the inspectors resulted in the improvement of sanitary accommodation at seven premises and in a further eight cases washing facilities were brought up to standard. In six shops it was found that records required by the Shops Act, 1950, were not being kept and appropriate action was taken. In one case contravention of the Sunday trading restrictions was brought to the notice of the shopkeeper. No Closing Orders were made for shops in the district. The days of Early Closing generally observed are :— Wednesdays—Chislehurst, the Oval, Sidcup and (Part of) L.C.C. St. Paul's Cray Estate. Thursdays—Remainder of the district. Petroleum Acts. (Mr. A. V. B. Allen is the Inspector appointed under the above Acts. Fifty-three licences were issued to store Petroleum Spirit, Petroleum Mixtures, and nil for Carbide of Calcium. The total storage capacity licensed during the year was :— Bulk storage—91,100 gallons. Can storage—1,610 gallons. Carbide of Calcium—Nil. Can storage includes Petroleum Mixtures and Thinners. Twenty-four visits of inspection were made in connection with this work. A number of the new flame-proof electrically operated pumps have been installed in lieu of the old pattern and the electrical wiring carried out in accordance with the Home Office Regulations. 30 Rodent Control. In the early part of the year a test was carried out of sewer manholes in the district. Of those tested, 13% showed evidence of infestation. In June, and again in December, routine maintenance treatments were carried out. On the latter occasion only eight out of the sixty-eight manholes showed any sign of infestation. Prevention of Damage by Pests Act, 1949. Local Authority Dwelling Houses Agricultural All other (including business premises) Total (1) (2) (3) (4) (5) I. Total number of properties in Local Authority's District 66 23.000 200 1,025 24.291 II. Number of properties inspected by the Local Authority during 1952 as a result of: (a) Notification 17 318 7 55 397 (b) Survey or otherwise 22 403 6 52 483 III. Number of properties inspected (see Section II) which were found to be infested by rats: Major Minor 13 456 7 50 526 IV. Number of properties inspected (see Section II) which were found to be seriously infested by mice - - - - - V. Number of infested properties (see Sections III and IV) treated by the Local Authority 10 364 4 54 432 VI. Number of notices served under Section 4: (1) Treatment — — — — — (2) Structural Works (i.e., proofing) - - VII. Number of cases in which default action was taken by the Local Authority following the issue of a notice under Section 4 VIII. Legal Proceedings (see under) — — — — — IX. Number of " block" control schemes carried out 37 VIII. Where legal proceedings have been instituted toy the Local Authority brief particulars should be given. 31 Verminous Conditions and Uncleanliness. Seventy-two visits to premises by Sanitary Inspectors related to eradication of bugs, dirty conditions and disinfestations. Thirty nuisances were found during the year and 30 were abated (including those carried over from the previous year). Pet Animals Act, 1951. The aibove Act, to regulate the sale of pet animals, came into force on the 1st April, 1952. Licences in respect of six premises were issued during the year. SECTION E. HOUSING. 34 SECTION E. HOUSING. New Houses. There were 39 new houses completed during the year. In addition 7 buildings were converted into living accommodation and 11 existing houses into flats. Four war-destroyed houses rebuilt. Other Authorities' Development. London County Council. Flats and Maisonettes, St. Paul's Cray = 49 Flats, Avery Hill 30 New Shops and Offices. Private development 2 L.C.C. St. Paul's Cray Estate 42 New Factory and Workshop Premises. New Factory and Workshop Premises 13 During the year the following Huts were dealt with :— Nissen Huts, Mottingham 12 removed. Seco 2-year Huts, Valley Road 2 removed. 21 awaiting removal. Rehousing. The following information has been supplied by the Housing Manager :— Prior to During 1952. 1952. I. (a) Number of " permanent" dwellings built by Local Authority 799 256 (to) Number of prefabricated dwellings built by Local Authority 275 (c) Number of dwellings requisitioned by Local Authority 235 218 (d) Number of halfway Houses 6 6 II. (a) Number of families occupying I (a) 799 256 (to) Number of families occupying I (b) 275 275 (c) Number of families occupying I (c) 387 361 (d) Number of families occupying I (d) 28 34 III. Total number of families rehoused during 1952 in (a), (b) and (c): — (a) 289 (b) 32 (c) 106 427 Note.—The figure of 427 lettings includes 34 transfers from huts which had to be demolished to permit the building of permanent houses and 143 transfers from various types of Council controlled properties. 35 IV. Total number of families on waiting list at 28th February, 1953: — Couples 673 Families requiring 2 bedrooms 739 Families requiring 3 bedrooms 484 Families requiring 3 or more bedrooms 47 Old Age Pensioners 42 1,985 Cases not yet pointed, September, 1952, to February, 1953 305 Families in requisitioned premises and huts 367 Cases passed and not yet housed, including refusals of accommodation 71 743 2,728 Moveable Dwellings. Four hundred and twenty-six visits were made to the moveable dwellings in the district. There are 8 sites, as under :— No. of Approx. No. families, of persons. (i) Old Brickfield, Church Road, Footscray 8 27 (ii) Twydens Meadow, Cray Road, Footscray 1 3 (iii) Chalk Pit, Ruxley 35 139 (iv) Corke's Meadow, Leesons Hill, St. Paul's Cray 93 384 (v) 168, Blackfen Road, Sidcup 1 3 (vi) Beaverwood Farm, Perry Street, Chislehurst ... 1 2 (vii) Opposite Glebe Cottage, Maidstone Rd.. Ruxley 1 2 (viii) Fair View, Cray Road, Footscray 3 4 The Old Brickfield, Church Road, Footscray, is owned by the Council, and all caravans stationed there are licensed. The Chalk Pit, Ruxley, is occupied by thirty-five families, most of which hold licences issued by the Council. This enables some control to be exercised. The site is little occupied during the summer months during which period the inhabitants are away fruit picking. Corke's Meadow, Leesons Hill, St. Paul's Cray continues to present a problem. The London County Council is desirous of acquiring the site for industrial purposes and the provision of alternative accommodation is being considered in conjunction with the Kent County Council. The encampment is unsatisfactory, but frequent inspections are made in order to control nuisance. SECTION F. INSPECTION AND SUPERVISION OF FOOD. 38 SECTION F. INSPECTION AND SUPERVISION OF FOOD. Food Sampling. During the year a total of 352 samples of food and drugs were taken. No formal action was taken by the Council, during the year 1952. under the Byelaws adopted under Section 15 of the Food and Drugs Act, 1938. Samples taken Result Remarks Formal. Informal. Genuine. Adulterated. Inferior Aspirin 2 — 2 — Baking powder 3 — 3 — — Barley crystals 1 — 1 — — Bread — 1 — — 1 See (a) Butter chocolate 1 — 1 — — Butter drops 1 — 1 — — Butter scotch 3 — — — Carnival macs — 1 1 — — Candied peel 1 — 1 — — Cheese spread (processed) 7 — 1 — 6 See (b) Chicken noodle soup 1 — 1 — Custard P'owder 1 — 1 — — Desiccated coconut 1 — 1 — — Diabetic orange squash 1 — 1 — — Dried whole egg — 1 1 — — Fish cakes 2 — Fish Paste 1 — 1 — — Foam crystals 1 — 1 — — Gelatine 1 — 1 — — Greengages (canned) — 1 — — 1 See (c) Ground almonds 1 — 1 — — Ground nutmeg 1 — 1 — — Honey wheat crunch — 1 1 — — Ice cream — 17 17 — — Ice lolly — 1 — — 1 See (d) Jelly crystals 2 — 2 — — Junket tablets 2 — 2 — — Lemonade powder & crystals 6 — 6 — — Lemon squash 1 — 1 — — Luncheon meat (canned) — 3 — 3 — See (e) Marshmallow creme 1 — 1 — — Mutton — 1 — — 1 See (f) Milk 6 18 24 — Milk bottle — 1 — 1 — See (g) Meat paste 1 — 1 — — Orange squash 2 — 2 — — Pastry mixture — 2 1 — 1 See (h) Pineapple 1 — 1 — — Pickled onions — 1 1 Pop corn 1 — 1 — — Refreshers — 1 — — 1 See (i) Rock lobster (canned) — 1 1 — — Sausages, beef 103 2 98 1 6 See (j) Sausagemeat, beef 7 — 6 1 See (k) Sausages, pork 91 5 81 3 12 See (I) 39 Sausagemeat, pork 5 — 5 — — Saccharin tablets 5 — 5 — — Salad cream 1 — 1 — — Skimmed milk powder 1 1 1 — 1 See (m) Snowcake — 1 — — 1 See n) Soft drink 2 — 2 — — Suet, beef 1 — 1 — — Sugar — 1 — — 1 See (o) Synthetic cream - 1 1 — — Tinned ham — 1 1 — — Tomato ketchup 1 — 1 — — Vinegar 17 1 17 — 1 See (P) White pepper 1 — 1 — — 288 64 309 8 35 Result. (a) Stain probably due to oil and grease lb) 1. Fat 18.0% (should contain not less than 20.0%) Moisture 57.9% 2. Fat .16.0%. Moisture 58.0% 3. Fat 19.3%. Moisture 57.0% 4. Fat 18.8%. Moisture 63.0% 5. Fat '18.9%. Moisture 58.4% 6. Fat 23.8%. Moisture 58.2% (c) Tin markedly blown: a hydrogen swell. Contents—tin 0.4 grains/lb. (d) Complaint of bitter taste, probably due -to excess of lime essence flavouring (e) 1. Swell 2. Slight swell 3. Blown (f) Slight evidence of incipient putrescence (g) Deposit consisted substantially of mineral matter of the nature of mortar (h) Moderately rancid (i) Damp and sticky condition (j) 1. Deficient 8.0% minimum amount of meat 2. Deficient 30% minimum amount of meat 3. Deficient 10.0% minimum amount of meat 4. Deficient 6.0% minimum amount of meat 5. Sulphite 190 parts per million (not declared) Action Taken. Seller warned. Matter taken up with Ministry of Food. Matter taken up with Ministry of Food. Matter taken up with Ministry of Food. Matter taken up with Ministry of Food. Matter taken up with Ministry of Food. Matter taken up with Ministry of Food. Withdrawn from sale. Manufacturers linformed. Consignment withdrawn from sale. Consignment withdrawn from sale. Consignment withdrawn from sale. Complainant and shopkeeper informed. Warning given. All supplies withdrawn from sale. Complainant informed. Warning given. Seller prosecuted. Discharged on payment of costs. Warning given. Further sample satisfactory. Warning given. Further sample satisfactory. Seller warned. 40 Result. 6. Meat 47% 7. Deficient 12% minimum amount of meat (k) Meat 146% (I) 1. Deficient 7.7% minimum amount of meat 2. Deficient 4.6% minimum amount of meat 3. Deficient 7.7% minimum amount of meat 4. Deficient 7.7% minimum amount of meat 5. Deficient 7.7% minimum amount of meat 6. Deficient 4.6% minimum ' amount of mea 7. Deficient 4.6% minimum amount of meat 8. One rodent hair found 9. Deficient 40% minimum amount of meat 10. Meat 58% 11. Sulphite 1,400 parts per million 12. Sulphite 100 parts per million (not declared) 13. Meat 62% 14. Deficient 32% minimum amount of meat 15. Deficient 15% minimum amount of meat (m) Unfit for use in making pudding (n) Contained partly carbonised insect fragments (o) Contained 0.23% common salt (p) Presence of added salt (0.98%) should be declared Action Taken. Seller warned. Further sample satisfactory. Seller warned. Further sample satisfactory. Seller warned. Further sample satisfactory. Warning given. Further sample satisfactory. Warning given. Further sample satisfactory. Warning given. Further sample satisfactory. Warning given. Further sample satisfactory. Warning given. Further sample satisfactory. Warning given. Further sample satisfactory. Warning given. Further sample satisfactory. Warning given. Seller prosecuted, fined £3 and £2 costs. Seller warned. Further sample satisfactory. Manufacturers warned. Further sample satisfactory. Seller warned. Further sample satisfactory. Seller warned. Further sample satisfactory. Seller prosecuted, fined £5 and £2 2s. costs. Manufacturers prosecuted, fined £20 and £10 10s. costs. Consignment withdrawn from sale. Manufacturers informed. Complainant informed. No action. Food Preparing Places. Three hundred and seventy-one visits were made to cafes, restaurants and canteens in the district, and 1,703 to other food preparing premises. There are approximately 168 premises in the area issued with a catering licence by the Ministry of Food, and these include 74 restaurants, cafes, public houses, fish friers, etc., 1 hotel, 28 staff canteens, 16 clubs, 27 day schools and nurseries, and 22 institutions (including hostels, residential schools and colleges, hospitals, nursing homes, orphanages, etc.). 41 Unsound Food. Five tons, one cwt., one qr., five lbs. of unsound food were surrendered as unfit for human consumption during the year, as shown below. Where possible this was utilised either for manufacturing purposes, animal food, or where this was impracticable, destroyed. Seven hundred and thirty-five Food Condemnation certificates were issued. Item. Condition. tons. cwts. qrs. lbs. Almond Filler Moulds 14 Bacon Decomposed 3 — Beef Bone taint & decomposed 11 3 8 Beef Abscess 7 Biscuits Moulds 5 2 1 Cake Moulds 1 13 Canned Asparagus Containers blown, punctured or perforated . 6 Canned Baby Food 1 Canned Beans " " " 6 Canned Coconut " " " 8 Canned Corn " " " 4 Canned Fish " " " 1 1 2 Canned Fish Paste " " " 1 Canned Fruit & Fruit Juice " " " 1 6 2 25 Canned Ham " " " 1 2 24 Canned Jam " " " 1 3 25 Canned Marmalade " " " 18 Canned Meat " " " 18 2 3 Canned Meat Pudding " " " 1 Canned Milk " " " 4 1 24 Canned Mincemeat " " " 1 Canned Paste " " " 8 Canned Peas " " " 1 14 Canned Pickles " " " 2 1 Canned Pork " " " 19 Canned Pudding " " " 2 Canned Soup " " " 2 3 Canned Spaghetti " " " 1 12 Canned Tomatoes " " " 18 Canned Vegetables " " " 12 1 16 Cereals Moulds, etc. 1 23 Cheese Decomposed 1 8 Dates Verminous 16 Fish Decomposed 4 21 Flour Contamination 3 Jam Fermentation 10 Jelly Contaminated 8 Meat Pie Decomposed 7 Mincemeat 7 Peas, Dried Out of condition 2 19 Pickles Fermentation 10 Pork Decomposed 1 21 Poultry 10 42 Prunes Fermentation 3 2 Pudding Mixture Verminous 12 Rabbits Decomposed 2 12 Sago Moulds 13 Sausages Decomposed 5 — 15 Spaghetti Contaminated 24 Tapioca Out of condition 13 5 1 1 5 Slaughterhouses. There were no applications received during the year for licences to slaughter animals under the Slaughter of Animals Act, 1933. There are no slaughterhouses in the district. Piggeries. There are 30 piggeries in the district, to which 165 visits were made. Twenty-seven defects were found and remedied. Milk. A total of 89 licences were granted under the Milk (Special Designation Pasteurised and Sterilised Milk) Regulations, 1949, and the (Milk (Special Designation) (Raw Milk) Regulations, 1949, as follow :— Pasteurised Dealers' Licences 16 Pasteurised Supplementary Licences 12 Sterilised Dealers' Licences 22 Sterilised Supplementary Licences 12 Tuberculin Tested Dealers' Licences 16 Tuberculin Tested Supplementary Licences 11 Twenty-four samples of pasteurised milk were taken, all of which were satisfactory. There are 16 dairies in the district to which 23 visits were made. Ice Cream. There are 145 premises registered for the storage and sale of ice cream in the area. Seventeen samples were taken for bacteriological examination. No pathogenic organisms were found to be present. The Methylene Blue tests resulted as follow, and continue to show an improvement in the results for the previous year. The method of sampling was varied and always carefully carried out. Grade I 54 Grade II 8 Grade III 6 Grade IV — SECTION G. INFECTIOUS DISEASES. 44 SECTION G. INFECTIOUS DISEASES. Statistical details of notifiable infectious diseases are shown in Table VIII in the Appendix. There were no epidemics of a serious nature during the year 1952. Two thousand two hundred and eighteen cases of infectious diseases were notified. Vaccination. The County Medical Officer has furnished the following figures showing the number of persons who were vaccinated against smallpox during the year 1952. Year of Birth l 1 1 1 1 1 1 l 1 1 1 1 l 1 1 Before 1 Total 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 9 5 5 5 4 4 4 4 4 4 4 4 4 4 3 3 3 2 1 0 9 8 7 6 5 4 3 2 1 0 9 8 8 Primary Vaccination 481 347 25 13 19 12 6 6 5 3 1 7 3 2 3 52 985 ReVaccination — 1 1 5 5 3 7 9 2 5 3 1 2 6 2 194 246 Acute Anterior Poliomyelitis. Ten cases were notified during the year. Seven of these were Paralytic and three Nonparalytic. Eight were nursed in hospital. Months during which the cases were notified :— May—1, June—1, Aug.—2, Sept.—2, Oct.—1, Nov.—2, Dec—1 There was one death from this disease. Scarlet Fever. One hundred and fifty-two cases of Scarlet Fever were notified during the year, giving an attack rate of 1.8 per 1,000 population. Ninety-four of these cases were home nursed, and fifty-eight were removed to hospital. There were three " return " cases. There were no deaths from this disease recorded in the area. Diphtheria. No cases occurred in the Urban District during the year 1952. 45 Diphtheria Immunisation. This is a County Council service and I am indebted to the County Medical Officer for the following return of immunisation carried out during 1952. During the year a total of 1,461 children received Primary Inoculations and 1,328 Reinforcing Inoculations. (Figures for 1951 were 1,543 Primary and 2,109 Reinforcing Inoculations.) A total of 12,814 children under the age of fifteen years at 31st December, 1952 had completed a course of immunisation (i.e., at any time since 1st January, 1938). Typhoid Fever. One case of Paratyphoid was notified and was removed to hospital. This was an isolated case and no secondary cases occurred. Puerperal Pyrexia. Eleven cases, two of which were removed to hospital, were notified during 1952. This represents an attack rate of 8.4 per 1.000 total births. There was no mortality from this disease. Ophthalmia Neonatorum. Two cases, tooth of which were home nursed, were notified. In neither case was the vision impaired. Pemphigus Neonatorum. No cases were notified. Measles. One thousand three hundred and fifteen cases were notified in the Urban District during 1952, as against one thousand, eight hundred and twenty-four for 1951, giving an attack rate of 15.4 per 1,000 population. Ten of these cases were admitted to hospital and the remainder were home nursed. The distribution of the cases occurring was fairly even throughout the area. There were no deaths from this disease recorded in the district. Whooping Cough. Five hundred and thirty notifications of this disease were received during 1952, as against four hundred and forty-one during 1951, giving an attack rate of 6.2 per 1,000 population. Six of these cases were removed to hospital and remainder home nursed. 46 Tuberculosis. Recordings in the Register for the year ended 31st December, 1952, are as under :— Respiratory. Other Forms. Total No. M. F. M. F. of Cases. On Register at 1st Jan. 1952 590 602 56 59 1,307 New cases notified during 1952 50 31 3 2 86 Number of cases coming to knowledge after death 1 2 - - 3 Restored to Register 1 — — — 1 Inward Transfers 38 35 1 4 78 680 670 60 65 1,475 Deletions — deaths, removals, recoveries, etc. 45 41 1 3 90 Number of cases on Register at 31st Dec., 1952 635 629 59 62 1,385 Full details of the new cases and mortality during the year are shown in Table V of the Appendix. The number of new cases notified during the year showed a decrease of 8 over the corresponding figure for 1951. There were 90 deletions from the Register as against 29 for the year 1951. Food Poisoning. Thirteen cases were notified during the year. There were three outbreaks with a total of six cases, and seven single cases notified. With the exception of one single case, when the agent causing the upset was identified as salmonella typhi murium, it was not possible to ascertain the cause of the illness. Dysentery. The incidence of this disease dropped sharply during 1952, only fifteen cases being notified as against ninety-five for the previous year. Four of these cases were removed to hospital. Other Infectious Diseases notified during 1952 :— No. of cases. Removed to Hospital. Erysipelas 12 2 Cerebro-spinal fever 1 1 Meningococcal infection 1 1 Pneumonia (all forms) 66 12 SECTION H. OTHER SERVICES. 48 SECTION H. OTHER SERVICES. Nursing Homes. There are five fully equipped Nursing Homes in the district, as follow :— Number of Beds. Name and Address of Home. Maternity. Other. Total. " FallO'Wfield," Ashfield Lane, Chislehurst .... — 36 36 " Glenthorne," 24, Lower Camden, Chislehurst — 12 12 " Hadlow," 4, Hadlow Road, Sidcup .... .... 3 4 7 " Hatherley," 12, Hatherley Road, Sidcup .... — 9 9 " Redhill House," Redhill, Chislehurst .... — 7 7 3 68 71 The Nursing Homes were visited regularly throughout the year. No serious infringements of the Byelaws were found, and the service offered, in all cases, was up to the required standard. Public Conveniences. The Health Department was responsible for the cleansing of 13 Public Conveniences during the year, at St. Johns Road, Sidcup, Sidcup Place Park, Queens Head, Willersley Park, Tigers Head, Waring Park, West Chislehurst Sports Ground, The Glade, Lamorbey Park. Longlands Recreation Ground, St. Paul's Cray Recreation Ground, Mottingham Recreation Ground, King George's Playing Fields, Penhill Park. A further convenience is being constructed at Westwood Lane, Blackfen, and will be in use early in 1953. Public Mortuary. There were 137 bodies received in the Public Mortuary during the year. Inquests were held on 25 of these bodies. National Assistance Act, 1948. It has not been found necessary to deal with any person being aged and infirm and living in insanitary conditions and unable to devote to himself or receiving from other persons proper care and attention. In no case during the year was it necessary to grant financial assistance for the burial of bodies due to the absence of other suitable arrangements for their disposal. APPENDIX. STATISTICAL TABLES. 50 STATISTICAL TABLES, 1952. TABLE I.—Summary of Statistics. TABLE II.—Causes of Death, 1952. TABLE III.—Sanitary Inspection of the Area. TABLE IV.—Factories Acts, 1937 and 1948. TABLE V.—Tuberculosis—New Cases and Mortality, 1952. TABLE VI.—Tuberculosis Rates. TABLE VII.—Infant Mortality, 1952. TABLE VIII.—Notifiable Infectious Diseases — Sex and Age Distribution. 51 TABLE I. SUMMARY OF STATISTICS, 1952. Population (mid-year 1952, per Registrar General) 85,130 Birth Rate 15.1 Death Rate 8.7 Maternal Mortality Rate (per 1,000 live and still births) 1.52 Infant Mortality Rate (per 1,000 live births) 19.5 Number of Births (live) 1,282 Number of Stillbirths 33 Number of Deaths 739 Number of Maternal Deaths 2 Number of Infant Deaths (under 1 year) 25 Death Rate of Respiratory Diseases (incl. Influenza but not Tuberculosis) 0.87 Death Rate of Tuberculosis 0.26 Death Rate of Cancer 1.49 Death Rate of Zymotic Diseases 0.05 Notifications of Infectious Diseases 2,218 Scarlet Fever 152 Diphtheria Nil Poliomyelitis 10 Typhoid Fever 1 Puerperal Pyrexia 11 Pneumonia 66 Tuberculosis (new cases) 86 Number of Deaths from Infectious Diseases 4 Number of Deaths from Diarrhoea (under 2 years of age) Nil Number of Visits by Sanitary Inspectors 9,900 52 TABLE II. CAUSES OF DEATH, 1952. Male. Female. Total 1. Tuberculosis—Respiratory 7 10 17 2. „ —Other 2 3 5 3. Syphilitic diseases 4 1 5 4. Diphtheria — — — 5. Whooping Cough — — — 6. Meningococcal Infection — 2 2 7. Acute Poliomyelitis 1 — 1 8. Measles — — — 9. Other infective and parasitic diseases 1 — 1 10. Malignant neoplasm stomach 14 8 22 11. Malignant neoplasm, lung bronchus 17 4 21 12. Malignant neoplasm, breast — 14 14 13. Malignant neoplasm, uterus — 5 5 14. Other malignant and lymphatic neoplasms 38 27 65 15. Leukaemia, aleukaemia 4 4 8 16. Diabetes 3 4 7 17. Vascular lesions of nervous system 43 60 103 18. Coronary disease, angina 59 42 101 19. Hypertension with heart disease 10 6 16 20. Other heart disease 43 74 117 21. Other circulatory disease 19 21 40 22. Influenza 1 1 2 23. Pneumonia 15 12 27 24. Bronchitis 26 12 38 25. Other diseases of the respiratory system 7 — 7 26. Ulcer of stomach or duodenum 7 1 8 27. Gastritis, enteritis and diarrhoea 1 2 3 28. Nephritis and nephrosis 6 1 7 29. Hyperplasia of prostate 4 — 4 30. Pregnancy, childbirth, abortion — 2 2 31. Congenital malformation 4 6 10 32. Other defined and ill-defined diseases 27 32 59 33. Motor vehicle accidents 3 1 4 34. All other accidents 8 2 10 35. Suicide 2 6 8 36 Homicide and operations of war — — — All causes 376 363 739 53 TABLE III. SANITARY INSPECTION OF THE AREA. 1. Inspections—General. A total of 9,900 inspections were made during the year, as under :— Dwelling houses (Public Health Acts) 4,114 Dwelling houses (Housing Acts) 72 Bakers and bakehouses 190 Butchers 218 Cafes, restaurants and canteens 371 Dairies 23 Fishmongers 152 Greengrocers 170 Grocers 379 Piggeries 165 Ice Cream premises 242 Visits re sampling 407 Other food preparing premises „ ., „ „ (Clean Food Campaign) 63 101 Factories with mechanical power 54 Factories without mechanical power 309 Premises re rats and mice infestation 1,087 Visits re infectious diseases 355 Visits re infectious diseases (tuberculosis) 3 Moveable dwellings 426 Pickers huts — Visits in connection with smoke abatement 75 Shops 112 Visits re unsound food 304 Rivers and streams 13 Miscellaneous 495 9,900 2. Complaints. A total of 1,050 complaints were received and investigated and, where necessary, appropriate remedial action was taken. Summary of complaints received :— General sanitary defects 246 Keeping of animals 7 Offensive accumulations 81 Verminous premises 30 Drainage 266 Water supply 7 Rats and mice 313 Overcrowding 12 Food 30 Dustbins 19 Smoke 7 Miscellaneous 32 1,050 TABLE IV. FACTORIES ACTS, 1937 and 1948. Part I. 1. Inspections for Purposes of Provisions as to Health. Premises. Number on Register. Number of Inspections. Written Notices. Occupiers Prosecuted. (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorites 12 54 2 – (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 163 309 15 (iii) Other Premises in which Section 7 is enforced by the Local Authority * (excluding outworkers premises) 5 67 Total 180 430 17 — 54 * Electrical Stations (Section 103) (i). Institutions (Section 104) and sites of Building Operations and Works of Engineering Construction (Section 107 and 108). TABLE IV. (cont.). 2. Cases in which defects were found. Particulars. Number of Cases in which defects were found. Number of cases in which prosecutions were instituted. Found. Remedied. Referred To H.M. Inspector. By H.M. Inspector. Want of Cleanliness (S.l.) 5 5 — 1 Overcrowding (S.2.) — — — — — Unreasonable temperature (S.3.) 1 1 — — — Inadequate ventilation (S.4.) — — — — — Ineffective drainage to floors (S.6.) — — — — — Sanitary Conveniences (S.7.):— — — — — — (a) insufficient 12 12 — 2 — (b) unsuitable or defective 28 28 — 1 — ic) not separate for sexes 5 5 — 1 — Other offences against the Act (not including offences relating to outwork) 15 15 11 1 — Total 66 66 11 6 — 55 TABLE V. TUBERCULOSIS. New Cases and Mortality during the year 1952. Age Groups. New cases notified or otherwise revealed. (* Not including Inward Transfers.) Deaths. Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary. M. F. M. F. M. F. M. F. Under 5 — — 1 1 — — — — 5 - 14 2 — — — — — — — 15-44 35 30 2 1 4 6 — — 45 - 64 12 3 — — 1 2 — — 65 & over 2 — — — 1 — — 1 Inward Transfers 51 33 3 2 6 8 — 1 38 35 1 4 — — — — TOTALS 89 68 4 6 — — — — 56 TABLE VI. TUBERCULOSIS IN CHISLEHURST AND SIDCUP. (as corrected by Inward and Outward Transfers) Year Ending Population of Chislehurst and Sidc-up Urban District Notifications Number of Cases on Register Pulm. Non-Pulm. Pulm. Non-Pulm. Total Number of yearly increase Number per 1,000 pop. M F M F Dec. 1942 60,400 73 12 191 128 54 43 416 19 6.8 1943 60,130 77 15 200 140 51 45 436 20 7.1 1944 57,470 81 6 194 177 51 42 464 28 8.9 1945 59,170 58 13 201 194 56 47 498 34 8.4 1946 67,870 78 15 231 217 61 51 560 62 8.2 1947 70,580 81 3 253 241 58 51 603 43 8.5 1948 72,750 114 5 308 301 60 51 720 117 9.8 1949 73,510 86 9 399 395 64 55 913 193 12.4 1950 80,040 94 5 583 587 73 66 1,309 396 16.3 1951 85,150 89 9 590 602 56 59 1,307 (minus 2) 15.3 1952 85,130 72 6 635 629 59 62 1,385 78 16.3 57 TABLE VII. INFANT MORTALITY, 1952. (Compiled locally from Registrar's Death Returns.) CAUSES OF DEATH. Under 1 week. 1 and under 2 weeks. 2 and under 3 weeks. 3 and under 4 weeks. Total under 4 weeks. 1 month and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total deaths under 1 year. Atelectasis 2 — — – 2 – — – — 2 Malformation – — — – – — – — — — Prematurity 5 1 — — 6 — — — 6 Bronchopneumonia 2 — – 1 2 5 — 2 1 10 Other causes 2 — — 1 3 2 — — 2 7 TOTALS 11 1 — 1 13 7 1 2 3 25 58 TABLE VIII. NOTIFIABLE INFECTIOUS DISEASES, 1952. Sex and Age Distribution. Disease Totals Under 1 1—2 3—4 5—9 10—14 15—24 25 and over Age Unknown M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Scarlet Fever 83 69 1 1 3 1 13 13 56 43 4 5 3 2 2 3 1 1 Whooping Cough 258 272 21 28 67 62 67 86 92 80 1 3 — 1 3 9 7 3 Poliomyelitis (Paralytic) 3 4 — — — 1 — 2 1 1 1 — — — 1 — — — Poliomyelitis (Non-Paralytic) — 3 — — — — — — — 2 — 1 — — — — — — Measles 698 617 24 14 104 Ill 156 150 385 321 16 13 8 1 2 6 3 1 Diphtheria —• — — — — — — — — — — — — — — — — — 1042 965 46 43 174 175 236 251 534 447 22 22 11 4 8 18 11 5 Under 5 5—14 15—44 45—64 65 and over Age Unknown M. F. M. F. M. F. M. F. M. F. M. F. Acute Pneumonia 34 32 5 4 12 7 5 6 7 5 5 10 Dysentery 7 8 — 5 5 1 1 2 — — I — — — Erysipelas 6 6 — — 2 1 1 2 1 3 2 — — — Cerebro Spinal Fever 1 1 — — 1 1 — — — — — — — — Puerperal Pyrexia — 11 — — — — — 11 — — — — — — Typhoid & Para-Typhoid Fever — 1 — — — — — 1 — — — — — — Food Poisoning 9 4 — — 1 1 3 2 3 1 2 — — — Ophthalmia Neonatorum 1 1 1 1 — — — — — — — — — Tuberculosis (Pulmonary) 51 33 — — 2 — 35 30 12 3 2 — — —. Tuberculosis (Non-Pulmonary) o O 2 1 1 — — 2 1 — — — — — — 112 99 7 11 23 11 47 55 23 12 12 10 — — 1154 1064 59