LONDON: made in great britain by harrison and sons limited by appointment to her majesty the queen printers, london, hayes (middx.)andhighwycombe City of Westminster REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1964 J. H. BRISCOE-SMITH, M.B., Ch.B., D.P.H. Medical Officer of Health WES 74 AC 4344 MET City of Westminster REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1964 J. H. BRISCOE-SMITH, M.B., Ch.B., D.P.H. Medical Officer of Health LONDON: made in great britain by harrison and sons limited by appointment to her majesty the queen printers, london, hayes (middx.) and high wycombE CONTENTS Page Aged Persons in need of Care and Attention 28 Animal Boarding Establishments Act, 1963 52 Area of the City 12 Assessment of Housing priorities on medical grounds 33 Atmospheric Pollution 47 Bacteriological Examinations 26 Basement Bakehouses 38 Births Births, Infant Deaths and Mortality Rates 14 Bodies, transportation of abroad53 British Red Cross Society 27 Burial or Cremation of the Dead 54 Catering establishments 39 Certificates of Disrepair 33 Clean Air Act, 1956 46 Cleansing of Persons 53 Clearance Areas 31 Club Registration Certificates 43 Common Lodging Houses 31 Coroner's Court and Mortuary 54 Day Club for handicapped old people 27 Deaths 12, 15 Disinfection and Disinfestation 53 Disposal of unsound food 43 Drainage 44 Dwelling Houses 37 Export Certificates 43 Factories Act, 196138, 56 Factories, Workplaces, Shops, Offices and other Premises 37 Factories, Defects and Nuisances 38 Food—Registration of Premises 42 „ —Inspection and Supervision 39 „ —Legal Proceedings 44 „ —Poisoning 22 „ —Sampling 41 „ —Shops and Food Premises 40 ,, —Unsound and Disposal of 43 Food and Drugs Act, 1955 39,42,43 Foodstuffs, Examination of 41 Furnaces, installation of 46 Page Handicapped old people, Day Club for 27 Health Education—Public hygiene 24 Holborn Borough Council, Mortuary accommodation for 55 House Purchase and Housing Act, 1959 33 Houses in multiple occupation 31 Houses, number of 12 Housing Act, 1964 32 Housing (Financial Provisions) Act, 1958 33 Housing Statistics 28 Ice Cream (Heat Treatment) Regulations, 1959 42 Ice Cream—Registration of premises 42 Ice Cream—Samples. 42 Infant Mortality 13 Infectious Diseases 20 Infectious Diseases—Notifications 22 International Certificates of Vaccination and Inoculation 25 Introduction 5 Justices' Licences 43 Land Charges Act, 1925 33 Legal Proceedings, 1964, Analysis of 44 Licensing Act, 1961 43 London County Council Divisional Health Committee, Division No. 2 8 London County Council (Drainage) Byelaws, 1934 44 Luncheon Clubs 27 Maternal Mortality . 12 Milk and Dairies (General) Regulations, 1959 42 Milk (Special Designation) Regulations, 1960-63 42 Milk Examinations 42 Milk Licences 42 Mobile Meals Service (" Meals on Wheels ") 27 Mortuary Accommodation 55 Neonatal Mortality 12 Notices 36,38,39 „ Statutory 36 Notifications of Infectious Disease 22 Nuisances 36,38,41 ,, Noise 45 Offices, Shops and Railway Premises Act, 1963 34 Offices, Workplaces, Shops, etc 37 Outworkers 38, 58 Overcrowding 31 Perinatal Mortality 12 Pet Animals Act, 1951 52 Pharmacy and Poisons Act, 1933 42 Poliomyelitis 22 Population 12 Prevention of Damage by Pests Act, 1949 44 Private Deep Wells51 Public Health Committee 8 Public Health Department staff' 9 (C3103) a2 Page Public Health Laboratory—Specimens submitted to 26 Public Health (London) Act, 1936 44 Public Hygiene 24 Public Swimming Baths 51 Puerperal Pyrexia 24 Rag Flock and other Filling Materials Act, 1951 45 Rateable Value12 Rats and Mice Repression 44 Rent Act, 1957 33 Rodents destroyed45 Samples, Food 41 Sanitary circumstances 35 Sequential Smoke Sampling 50 Sewerage and Sewage Disposal 44 Slaughter of Animals Act, 1933 52 Slaughterman's Licences 52 Slum Clearance 31 Smoke Abatement 46 Smoke Control Areas 46 Specimens submitted to Public Health Laboratory 26 Staff of the Public Health Department 9 Statistics and Social Conditions 12 Swimming Baths 51 Transportation of bodies abroad 53 Tuberculosis 26 Typhoid Fever 23 Unsound Food 43 Visiting of elderly persons 28 Water 51 Welfare of Old Persons 27 Wells 51 Westminster Old People's Welfare Association 27 Workplaces, Shops, etc 37 City of Westminster Health Department, City Hall, Telephone: TATe gallery 8070 Victoria Street, S.W.I. To the Right Worshipful The Mayor, Aldermen and Councillors of the City of Westminster. Mr. Mayor, Aldermen and Councillors, I have the honour to present for your consideration a Report on the health of the City of Westminster during the year 1964. This Report is the last in a long series to be submitted to the Council as one of the Metropolitan Boroughs. In 1900 the City of Westminster was formed by the amalgamation of five parishes; in 1965 the new City of Westminster has been formed by the amalgamation of three Metropolitan Boroughs. The Health Department of the new City Council is now responsible not only for the environmental health services formerly provided by the boroughs of Paddington, St. Marylebone and Westminster, but also for the personal health services previously provided in this area by the London County Council. The closing of the present era of London Government opens up a future of challenge and opportunity. I am confident that all the staff of the new Health Department will respond magnificently to the heavy tasks which lie ahead; and will ensure that the existing high standards of service to the public are not only maintained but expanded and improved wherever possible. In his Annual Report for 1901, the then Medical Officer of Health, Dr. Francis Allan, wrote of the amount of time which he and his staff had spent in reorganizing the work of the Health Department and in harmonizing the various systems in operation. The same can be said of 1964—65 when the staff of the Health Department, in addition to performing all their normal duties, have had to spend many hours in the far greater reorganization which has recently taken place. The various vital statistics for 1964 have been included in the Report and show minor changes compared with the previous year. In 1901 Dr. Allan remarked in his Report that "the year 1901 was a healthy one for children ..." In fact no fewer than 435 infants under one year of age died—a mortality rate of 126. In 1964 there were only 23 infant deaths—a rate of 22.59 per thousand live births. These figures speak for themselves and reflect the greatly improved services now available for mothers and children and the improved standards of living. 6 In regard to deaths at other age periods, the largest single causes of death in 1901 were tuberculosis and bronchitis. Thanks to the work undertaken during recent years in the early detection of tuberculosis, and the efficiency of modern drugs, tuberculosis is no longer a major cause of death. Today, the largest single cause of death is coronary disease and angina. In 1901 an epidemic of smallpox existed in this country and a total of 85 cases occurred in Westminster; 17 persons died, a mortality of 20 per cent. Now, due to many years of vaccination against this disease, smallpox is no longer rife in this country. Constant vigilance is, however, still necessary to ensure that no cases are imported from areas abroad where the disease is still prevalent, particularly in these times of high speed travel. At the beginning of this century, there were many cases of diphtheria in Westminster with 21 deaths; enteric or typhoid fever, with 20 deaths; and whooping cough with 48 deaths. It is now several years since there was a case of diphtheria in Westminster and in 1964 there were no deaths from any of these diseases in the area of the City. Some of this improvement must be attributed to advances which have been made in curative medicine, but much has been accomplished by preventive medicine combined with improved standards of living. Much progress has been made over the years in safeguarding the public food supplies. In the early 1900's there was much gross and deliberate adulteration of food; today this is rare. In 1901, the prevention of smoke engaged the earnest attention of the Public Health Committee. The year 1965 sees the completion of the City Council's programme for the declaration of Smoke Control Areas under the Clean Air Act; by July 1965, the whole of the area of the (old) City of Westminster was covered by operative Smoke Control Orders. This is no mean achievement when it is remembered that the Clean Air Act only came into operation in 1956. The wide and varied duties performed by the public health inspectors are dealt with in detail in the Report. Their work was undertaken with considerable difficulty during 1964, owing to the constant changes in staff and the general shortage of inspectors. At the end of the year no fewer than 10 posts of public health inspector were unfilled out of an establishment of twenty-six. This problem is not confined to Westminster, but is common throughout London, and it imposes strain on the remaining staff. Notwithstanding the difficulties of the past year, much good work has been undertaken by the staff of the Health Department in the many and varied duties which are set out in the Report. To all the members of the staff I express my sincere thanks for their unfailing support and loyalty; and to my colleagues in other Departments my appreciation of their co-operation and help. 7 Finally, Mr. Mayor, I would thank you, the Chairman and Members of the Public Health Committee, and all Members of the Council for the support, help and many kindnesses I have received during the past year. J. H. Briscoe-Smith Medical Officer of Health July, 1965 (3103) A3 8 PUBLIC HEALTH COMMITTEE The Mayor (ex-officio): Councillor B. Fitzgerald-Moore The Deputy Mayor (ex-officio): Councillor Leslie Farmiloe, M.C. Chairman : Councillor W. B. Clowes vice-chairman: Alderman Miss P. C. Paton Walsh Members : Councillor Dr. T. Anwyl-Davies, F.R.C.P. ,, T. Stirling Boyd „ Mrs. P. C. Butchers ,, The Countess of Dartmouth, L.C.C. ,, W. F. Davis „ Mrs. Paul Dean ,, R. L. Everest, F.R.I.C.S., F.I.Arb. „ Hugh G. Garside, M.A. „ Lady Hulbert, M.B., J.P. „ L. E. Johnson ,, R. V. Mares „ A. Sciver, B.Sc.(Lond.), F.R.I.C. „ L. F. Squires „ K. J. Taylor ,, Mrs. Brian Warren Members of the Council were appointed to: The London County Council Divisional Health Committee, Division No. 2 Alderman Miss P. C. Paton Walsh and Councillors Mrs. P. C. Butchers and Mrs. Paul Dean. 9 STAFF OF THE PUBLIC HEALTH DEPARTMENT (as at 31st December, 1964) Medical Officer of Health: J. H. Briscoe-Smith, M.B., Ch.B., D.P.H. Deputy Medical Officer of Health: Marjory A. Dawson, M.B., Ch.B., D.P.H. Public Analyst: (Part-time) T. McLachlan, A.C.G.F.C., F.R.I.C. Chief Public Health Inspector: W. G. J. Sutton, F.A.P.H.I. Chief Clerk: J. H. Gillett Deputy Chief Public Health Inspector: (and with special duties relating to Theatres, Cinemas and other places of entertainment), C. F. Brockett Public Health Inspectors: District: R. F. Stubbs (Senior Public Health Inspector—District) S. Shave F. E. Siddle (Inspector with special duties relating to Rodent Control and Disinfestation) F. Simmons W. G. Stivey A. J. Teare Offices, Shops and Railway Premises Act, 1963: Miss K. G. Reader (3103) A4 10 Housing : J. W. Baxter (Senior Public Health Inspector—Housing) E. M. Russell Food and Catering Establishments: P. A. Lloyd, O.B.E. (Senior Public Health Inspector—Food) W. O. A. Austin, M.B.E. W. H. Dunstan Atmospheric Pollution: J. J. Coveney (Senior Public Health Inspector—Smoke) G. A. Hunter (Ten public health inspector vacancies at 31.12.64) Technical Assistants: (Smoke Control Areas) R. H. Major P. Syrett Welfare Worker: Miss D. M. Rugg Public Health Inspector Students: P. E. Beeching J. C. Bray A. Miller T. C. Moore R. Pendreigh General Assistants to Public Health Inspectors: A. Jones A. Murkin 11 Clerical Staff: W. H. Smith (Senior Clerk) Miss P. Allen J. E. Atkinson R. L. Booker Miss B. Chew R. W. Easton W. F. C. King D. Levitton E. N. Metcalfe Miss L. E. Minors D. J. Myers L. J. Nunn Mrs. H. Russell B. SheridaD J. M. Shotbolt W. E. F. Simmons Miss D. V. Stothard E. A. Taylor Miss J. K. Velden Coroner's Court and Mortuary Superintendent: A. W. Nicholls 1st Mortician: W. H. Wilshire Mortuary Assistants: P. A. Burns R. Garlick Cleaner : Mrs. A. McEwan Rodent Control Rodent Officer: J. W. Brown Foreman: W. Weems Rodent Operatives : T. Izzard C. Ralph R. West 12 STATISTICS AND SOCIAL CONDITIONS Area (acres) 2,503.9 Population (Registrar General's Estimate, mid-year, 1964) 85,840 Population, Census, 1961 85,735 Number of private dwellings (Census, 1961) 30,801 Rateable Value (at 1st April, 1964) £69,840,971 Births Live Births (registered)— Total. Males. Females. Legitimate 865 440 425 Illegitimate 153 78 75 1,018 518 500 Birth rate per 1,000 of the estimated resident population 11.85 Area Comparability Factor—Births: 0.83 Birth rate (adjusted) 9.83 (Rate for England and Wales, 18.4) Number of stillbirths (males, 15; females, 8) 23 Rate of stillbirths per 1,000 (live and still) births 22.09 Total live and stillbirths 1,041 Illegitimate live births per cent. of total live births 15.03 Deaths Net deaths (males 498; females, 406) 904 Death-rate per 1,000 of the estimated resident population 10.53 Area Comparability Factor—Deaths: 1.0 Death rate (adjusted) 10.53 (Rate for England and Wales, 11.3) Deaths arising from pregnancy, childbirth, abortion 1 Rate per 1,000 total (live and still) births 0.96 Deaths of infants under 1 year (males, 12; females, 11) 23 Death-rate of infants under 1 year— All infants per 1,000 live births 22.59 Legitimate infants per 1,000 legitimate live births 21.96 Illegitimate infants per 1,000 illegitimate live births 26.14 Neo-natal mortality rate (deaths under 4 weeks per 1,000 total live births) 14.73 Early neo-natal mortality rate (deaths under 1 week per 1,000 total live births) 14.73 Perinatal mortality rate (stillbirths plus deaths under 1 week per 1,000 total live and stillbirths) 36.50 13 Infant Mortality Analysis of Infant Deaths, 1964 Cause of Death 1st week 2nd week 3rd week 4th week Total under 4 weeks 1-3 months 4-6 months 7-9 months 10-12 months Total under 1 year Legitimate Asphyxia — — — — — 4 — — — 4 Bilateral Pneumothorax 1 — — — 1 — — — — 1 Broncho Pneumonia — — — — — 1 — — — 1 Cerebral Anoxia 2 — — — 2 — — — — 2 Cyanotic Heart Disease — — — — — 1 — — — 1 Congenital Abnormalities 1 — — — 1 1 — — — 2 Congenital Heart Disease 1 — — — 1 — — — — 1 Dehydration due to GastroEnteritis — — — — — — 1 — — 1 Oesophageal Atresia 1 — — — 1 — — — — 1 Placental Insufficiency 1 — — — 1 — — —• — 1 Prematurity 3 — — — — — — — — — Respiratory Failure 1 — — — 1 — — — — 1 Illegitimate Atelectasis 1 — — — 1 — — — — 1 Prematurity 1 — — — 1 — — — — 1 Rupture of Tentorium Cerebri 1 — — — 1 — — — — 1 Tentorial Tear 1 — — — 1 — — — — 1 Totals 15 — — — 15 7 1 — — 23 14 Births, Infant Deaths and Mortality Rates All Infants. Legitimate. Illegitimate. Year Total Births Deaths Mortality Rate Births Deaths Mortality Rate Births Deaths Mortality Rate 1964 1,018 23 22.59 865 19 21.96 153 4 26.14 1963 1,089 25 22.95 929 21 22.60 160 4 25.00 1962 1,061 26 24.50 894 20 22.37 167 6 35.93 1961 1,011 23 22.74 888 17 19.14 123 6 48.78 1960 1,007 16 15.88 892 13 14.57 115 3 26.08 1959 956 19 19.87 854 18 21.07 102 1 9.80 1958 1,032 19 18.41 919 17 18.49 113 2 17.69 1957 1,056 23 21.78 949 16 16.85 107 7 65.42 1956 1,135 26 22.90 1,024 19 18.55 111 7 63.06 1953 1,223 32 26.16 1,080 24 22.22 143 8 55.94 1952 1,243 31 24.93 1,107 23 20.77 136 8 58.82 1951 1,235 42 34.00 1,110 35 31.53 125 7 56.00 1950 1,251 44 35.17 1,117 37 33.12 134 7 52.20 1949 1,246 42 33.70 1,110 38 33.30 136 4 36.80 1948 1,390 53 38.10 1,227 42 34.20 163 11 67.50 1947 1,594 53 33.20 1,427 42 29.40 167 11 65.90 1946 1,361 55 40.40 1,143 35 30.60 218 20 91.70 1945 936 67 71.50 728 41 60.40 208 26 110.60 15 (3103) Deaths 1964 Causes of Deaths in the City at different periods of life No. Cause of Death Sex Total All Ages Under 4 weeks 4 weeks and under 1 year Age in Years 1- 5- 15- 25- 35- 45- 55- 65- 75 and over 1 Tuberculosis, Respiratory M. 11 — — — — — 1 2 4 2 2 F. — — — — — — — — — — — — 2 Tuberculosis, Other M. 1 — — — — — — — — 1 — — F. 1 — — — — — — — — — — 1 3 Syphilitic Disease M. — — — — — — — — — — — — F. — — —|— — — — — — — — — 4 Diphtheria M. — — — — — — — — — — — — F. — — — — — — — — — — — — 5 Whooping Cough M. — — —— — — — — — — — — — F. — — — — — — — — — — — — 6 Meningococcal Infection M. — — — — — — — — — — — — F. — — — — — — — — — — — — 7 Acute Poliomyelitis M. — — — — — — — — — — — — F. — — — — — — — — — — — — A5 16 8 Measles M. — — — — — — — — — — — — F. — — — — — — — — — — — — 9 Other Infective and Parasitic Diseases M. — — — — — — — — — — — — F. — — — — — — — — — — — — 10 Malignant Neoplasm, Stomach M. 15 — — — — 1 — 1 4 5 1 3 F. 11 — — — — — — 1 2 1 4 3 11 Malignant Neoplasm, Lung, Bronchus M. 51 — — — — — — 2 4 21 17 7 F. 21 — — — — — — 3 3 6 4 5 12 Malignant Neoplasm, Breast M. 1 — — — — — — — — 1 — — F. 21 — — — — — 1 — 2 3 8 7 13 Malignant Neoplasm, Uterus F. 3 — — — — — — 1 1 — — 1 14 Other Malignant and Lymphatic Neoplasms M. 48 — — — — 2 — 1 7 16 13 9 F. 43 — — — — 1 — 3 2 7 12 18 15 Leukaemia, Aleukemia M. 1 — — — — 1 — — — — — — F. — — — — — — — — — — — — 16 Diabetes M. 2 — — — — — 1 — — — — 1 F. 4 — —— — — — — — — — 1 3 17 Vascular Lesions of Nervous System M. 28 — — — — — — 2 — 9 11 6 F. 62 — — — — — 1 — 1 7 14 39 17 No. Cause of Death Sex Total All Ages Under 4 weeks 4 weeks and under 1 year Age in Years 1- 5- 15- 25- 35- 45- 55- 65- 75 and over 18 Coronary Disease, Angina M. 131 — — — — — 1 2 16 46 45 21 F. 64 — — — — — — — 2 10 19 33 19 Hypertension, with Heart Disease M. 7 — — — — — — — 1 1 3 2 F. 4 — — — — — — — — — 2 2 20 Other Heart Disease M. 26 — — — — — 1 — 4 6 9 6 F. 37 — — — — — — — 1 6 8 22 21 Other Circulatory Disease M. 14 — — — — — — — 1 1 2 10 F. 27 — — — — — 1 — 1 3 4 18 22 Influenza M. — — — — — — — — — — — — F. 1 — — — — — — — — 1 — — 23 Pneumonia M. 25 — 1 — — — — 1 2 2 6 13 F. 15 — — — — — — — — 1 6 8 24 Bronchitis M. 28 — — — — — — 1 — 6 15 6 F. 7 — — — — — — — — 1 1 5 25 Other Diseases of the Respiratory System M. 8 — — — — — — — — 6 2 — F. 4 — — — — — — — — 3 — 1 (3103) a6 18 26 Ulcer of Stomach and Duodenum M. 4 — — — — — — — — 1 1 2 F. 2 — — — — — — — — — — 2 27 Gastritis, Enteritis and Diarrhoea M. 4 — 1 — — — — — 1 2 — — F. 2 — — — — — — — — — — 2 28 Nephritis and Nephrosis M. 6 — — — — 1 1 2 — — 1 1 F. 1 — — — — — — — — — — 1 29 Hyperplasia of Prostate M. 3 — — — — — — — — — 2 1 30 Pregnancy, Childbirth, Abortion F. 1 — — — — — — 1 — — — — 31 Congenital Malformations M. 4 — 1 2 — — — — — — 1 — F. 3 2 — — — — — — — 1 — — 32 Other Defined and Ill-Defined Diseases M. 37 7 1 — — — — 2 2 9 5 11 F. 41 6 — — I — 1 — 4 6 8 15 33 Motor Vehicle Accidents M. 3 — — — 1 — 2 — — — — — F. 2 — — — 1 1 — — — — — — 34 All other Accidents M. 21 — 1 1 — — — 4 3 4 3 5 F. 13 — 3 — — — — 2 2 — 1 5 35 Suicide M. 19 — — — — 1 4 6 1 5 — 2 F. 16 — — — — 1 1 3 5 3 1 2 No. Cause of Death Sex Total All Ages Under 4 weeks 4 weeks and under 1 year Age in Years 1- 5- 15- 25- 35- 45- 55- 65- 75 and over 36 Homicide and Operations of War M. — — — — — — — — — — — — F. — — — — — — — — — — — Total All Causes M. 498 7 5 3 1 6 10 25 48 146 139 108 F. 406 8 3 — 2 3 5 14 26 59 93 193 Grand Totals 904 15 8 3 3 9 15 39 74 205 232 301 19 20 Infectious Diseases The undermentioned conditions are compulsorily notifiable in Westminster:— Disease Authority for Notification Anthrax Public Health (Infectious Diseases) Amendment Regulations, 1960. Cholera Public Health (London) Act, 1936—Sections 192 and 304. Diphtheria Do. Dysentery Public Health (Infectious Diseases) Regulations, 1953. Encephalitis, Acute Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. Enteric Fever (includ- Public Health (London) Act, 1936—Sections ing Paratyphoid) 192 and 304. Erysipelas Do. Food Poisoning Food and Drugs Act, 1955—Section 26. Leprosy* Public Health (Leprosy) Regulations, 1951. Malaria Public Health (Infectious Diseases) Regulations, 1953. Measles County of London (Measles and Whooping Cough) Regulations, 1938 to 1948. Membranous Croup Public Health (London) Act, 1936—Sections 192 and 304. Meningococcal Infec- L.C.C. Order dated 27.2.1912 and Public tion Health (Acute Poliomyelitis, Acute phalitis and Meningococcal Infection) Regulations, 1949. Ophthalmia Neona- L.C.C. Order dated 2.11.1910 and Public torum Health (Ophthalmia Neonatorum) tions, 1926 to 1937. Plague Local Government Board Order, 1900. Pneumonia (Primary Public Health (Infectious Diseases) Regulaand Influenzal) tions, 1953. Poliomyelitis, Acute L.C.C. Order dated 27.2.1912 and Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. * Notifiable to the Chief Medical Officer, Ministry of Health. Notifiable to the County Medical Officer of Health for London. 21 Disease Authority for Notification Puerperal Pyrexia Puerperal Pyrexia Regulations, 1951. Relapsing Fever Public Health (London) Act, 1936—Sections 192 and 304. Scabies County of London (Scabies) Regulations, 1943. Scarlet Fever Public Health (London) Act, 1936—Sections 192 and 304. Smallpox Do. Tuberculosis Public Health (Tuberculosis) Regulations, 1952. Typhoid Fever (includ¬ing Paratyphoid) Public Health (London) Act, 1936—Sections 192 and 304. Typhus Fever Do. Whooping Cough County of London (Measles and Whooping Cough) Regulations, 1938 to 1948. For each of the above a fee of 2s. 6d. is payable by the Local Authority to the medical practitioner if the case occurs in his private practice, or 1s. if the case occurs in his practice as medical officer of a public body or institution. 22 Notifications of Infectious Disease Disease Notifications Removed to Hospital Diagnosis not Confirmed Diagnosis Established Diphtheria - - - - Dysentery 13 8 — 13 Erysipelas - - - - Food Poisoning 37 13 — 37 Measles 389 12 — 389 Ophthalmia Neonatorum 1 1 — 1 Pneumonia:— Acute Primary 1 — — 1 Influenzal - - - Paratyphoid Fever - - - Poliomyelitis:— Paralytic - - - - Non-Paralytic - - - - Puerperal Pyrexia 36 36 — 36 Scabies 15 — — 15 Scarlet Fever 5 1 — 5 Typhoid Fever - - - - Whooping Cough 14 — — 14 Poliomyelitis For the fourth consecutive year, no case of poliomyelitis occurred in Westminster. The number of corrected notifications of poliomyelitis, including polio-encephalitis, for each year since 1949 is given below. Immunisation against poliomyelitis began in 1956:— 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 29 13 1 10 9 4 15 7 5 1 1 1 — — — — Food Poisoning During the year 37 notifications were received of persons suffering from food poisoning. Nine were single cases; 19 others related to children attending a Day Nursery, whilst the remaining nine were involved in three family outbreaks. The incident involving 19 children occurred following lunch at a Day Nursery. The children concerned received hospital treatment. The symptoms were fairly severe in the initial stage but were of short duration. Staphylococcus aureus was found to be the causative organism, and was isolated from stool specimens and also from a tin used for containing macedoine vegetables, one of the ingredients of the meal. 23 Of the three family outbreaks one concerned a mother and two children, the causative agent of which was not discovered. In another, six persons had lunch at a private house; shortly afterwards four were taken ill and were removed to hospital. Prompt notification by the general practitioner enabled food specimens to be obtained by the public health inspector; laboratory examination revealed the presence of Staphylococcus aureus in a ham bone and phage typing indicated this to be associated with a food poisoning strain. The source of infection was not determined. In the third family outbreak a party of four, together with a friend, had a meal at home, following which three were taken ill at later intervals. Faecal specimens were positive for Salmonella typhimurium. Investigation did not reveal the source of infection and, other than emphasising the extreme care necessary to personal hygiene by all concerned, no further action could be taken. Typhoid Fever In May-June 1964 an outbreak of typhoid fever occurred in Aberdeen. Altogether 487 persons were admitted to hospital, of whom some 450 cases were confirmed as suffering from typhoid. The outbreak was thought to be associated with cold cooked meat purchased from one store in Aberdeen, where much of the trade was in corned beef. On 3rd June, 1964, a communication was received from the Chief Medical Officer of the Ministry of Health, giving details of markings on 6-lb. cans of corned beef which had been processed in South America during a certain, period when raw river water was stated to have been used for cooling the cans after treatment. The Ministry advised that all stocks of corned beef at food premises should be examined to ascertain whether they bore certain code marks which had been notified to local authorities, and that any such stocks found should be returned by the proprietors to their wholesale suppliers. Accordingly, all public health inspectors were immediately taken off their normal routine duties so that they could visit all food and catering establishments in Westminster, to advise the managements and to search for stocks of corned beef which might be contaminated. In addition a circular letter was sent to each such establishment giving details of the markings concerned. Subsequently, five further circulars were received from the Chief Medical Officer on the subject, with information of other markings on 6-lb. tins which might be suspect, and the inspectorate made further visits. In. all 6,656 circular letters were despatched to proprietors of food and catering establishments in the City, and some 3,500 visits were made to these establishments by the public health inspectors. During the course of these visits 190 cans of corned beef bearing the appropriate code mark(3103) a7 24 ings were found at 28 premises; they were immediately withdrawn from use and dealt with in accordance with the Ministry's advice. In Westminster, containing as it does such a large number of premises which deal in food for sale or service to the general public, the task which confronted the staff of the department was of immense proportions, but they performed these additional duties with very commendable expedition and efficiency. During this period many who had travelled to Westminster from Aberdeen, or had had contact with persons who lived there, voluntarily reported to the Public Health Department as a precautionary measure for advice. Where considered necessary, surveillance was maintained by officers of the Department. Happily, however, no case of typhoid fever occurred in Westminster. Public Hygiene In June, 1964, arising out of events in Aberdeen, the Public Health Committee felt that action was required to increase public awareness of the necessity for improved standards of hygiene. The Committee therefore approved the recommendations of the Medical Officer of Health that, in order to obtain the widest possible publicity, the following steps should be taken by the Public Health Department:— (i) The proprietors of all food premises in Westminster should be reminded of the requirements of the Food Hygiene (General) Regulations, 1960. A copy of a Guide to these Regulations published by the Central Council for Health Education was sent or handed to each proprietor. (ii) The owners and occupiers of all premises in Westminster to which the Offices, Shops and Railway Premises Act, 1963, applied were sent or handed a copy of the Guide to that Act published by the same body. (iii) With the concurrence of the Standing Committees concerned, posters were displayed at all Council premises, as had been done in previous health education campaigns. (iv) In order further to stimulate public interest, meetings were arranged between members and officers of the Council and representatives of the Westminster Chamber of Commerce, the various Street Associations, etc., with a view to discussing the requirements relating to food hygiene in all food and catering premises, offices, shops, etc., in Westminster. Puerperal Pyrexia Thirty-six notifications of puerperal pyrexia were received during 1964. All the cases occurred in hospitals; nineteen were in respect of persons normally resident in Westminster. 25 Puerperal pyrexia is defined as any febrile condition occurring in a woman in whom a temperature of 100.4º F. or more has occurred within fourteen days after childbirth or miscarriage. The following table shows an analysis of the causes of pyrexia in the cases notified in 1964: Cause Number of cases Respiratory infection 1 Genital tract infection 8 Influenza 2 Urinary infection 2 Urinary tract infection 1 Pyelonephritis 1 Chest infection following L.S.C.S 1 Haemolytic streptococcal infection of genital tract 1 Unknown 19 International Certificates of Vaccination and Inoculation Arrangements continued during the year for the authentication by the Medical Officer of Health of International Certificates of Vaccination and Inoculation completed by medical practitioners in Westminster. These certificates are required by passengers proceeding abroad from this country and the purpose of the authentication is to provide proof to those health authorities abroad who desire it that the signature of the person issuing the certificate is that of a registered medical practitioner. Three thousand, six hundred and sixteen such certificates were authenticated in 1964, compared with 16,206 in 1962 and 3.083 in 1963. The Medical Officer of Health also issues, on request and in appropriate circumstances, certificates to the effect that no cases of smallpox have occurred in the district during the preceding two weeks. These certificates are sought by persons proceeding to the United States of America who do not wish to submit to vaccination. It is understood that the United States immigration authorities reserve the right to place such persons under surveillance notwithstanding the production of such a certificate. Sixty-one of these certificates were issued during 1964, compared with 36 in the previous year. (3103) a8 26 Specimens Submitted to the Public Health Laboratory Nature of Specimen Number Positive Findings Examined Nasal and Throat Swabs 179 Haemolytic streptococci 50 Bact. coli 0127 1 Staphylococcus aureus 5 Monilia 5 Pneumococci and Staphylococcus aureus 1 Vincent's organisms 2 Faeces 265 Salmonella typhimurium 5 Salmonella thompson 1 Salmonella hartford 1 Salmonella blockley 1 Salmonella brandenburg 2 Salmonella flexneri type lb 1 Shigella Sonnei 18 Shigella flexneri type 2a 1 Ova of Ascaris lumbricoides and Trichuris trichuria 1 Giardia lambia 1 CI. Welchii 1 Urine 20 Rectal swab 3 Gum swab 1 Blood 4 Mouth swab 1 Tuberculosis Age Periods New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under 5 years 1 — — — — — — — 5 to 15 years — — — — — — — — 15 to 25 years 2 1 1 — — — — — 25 to 45 years 18 2 — 2 1 — — — 45 to 65 years 15 — — — 6 — 1 — 65 to 75 years 2 2 — — 2 — — — 75 and over 1 — 1 — 2 — — 1 39 5 2 2 11 — 1 1 27 New cases Source of Information Pulmonary Non-Pulmonary M. F. M. F. Primary notifications 39 5 2 2 Transfers from other areas 20 2 — — Non-notified deaths — — — — Posthumous notifications 2 — — — Welfare of Old Persons During 1964 the Westminster Old People's Welfare Association continued its activities in the City for the general welfare of old people. These activities included the organisation of fourteen Darby and Joan Clubs in various parts of Westminster; a chiropody service; holidays at seaside resorts and summer outings; Christmas parties and the distribution of gift parcels at Christmas time; special outings for handicapped old people and a Day Club for handicapped elderly persons at Sherborne House at which luncheons cooked on the premises are served daily. The City Council makes an annual grant to the funds of the Association under powers contained in the National Assistance Act, 1948. Throughout the year the Westminster Division of the British Red Cross Society continued the service established in Westminster in 1946 for the delivery of hot midday meals to the homes of old people who are themselves unable to prepare meals at home. The City Council makes an annual grant to the Society for this purpose and also provides the necessary transport. The Society also operates a luncheon club for the elderly on two days per week in accommodation provided by the City Council in Monck Street. The invaluable service rendered to old people in Westminster by the Old People's Welfare Association and the local Division of the British Red Cross Society is much appreciated by all concerned. The following table shows the total number of meals supplied by all the above sources to elderly persons in Westminster during 1964, with comparative figures for 1963:— 1964 1963 westminster Old People's Welfare Association — luncheon club (five days per week) 7,489 5,414 Delivered by the Mobile Meals Service (British Red Cross Society) 24,437 21,910 British Red Cross Society luncheon club (two days per week) 2,488 2,604 Total 34,414 29,928 28 V isiting of Elderly Persons During the year, the social worker of the Westminster Old People's Welfare Association continued to assist in the welfare visiting of old people, the salary and expenses of this officer being reimbursed by the City Council by way of grant to the Association under Section 136 of the Local Government Act, 1948. In April, 1964, the City Council agreed that a Welfare Worker should be appointed to the staff of the Public Health Department for duties connected with the welfare of old people in Westminster. This officer commenced duty in September, 1964, and between then and the end of the year undertook 375 visits to elderly persons in the City. In addition, there were occasions when a visit by a medical officer or public health inspector was required, because of their specialist knowledge or statutory powers; a total of 472 such visits were made during the year. Aged Persons in Need of Care and Attention Under the provisions of the National Assistance Acts, a Medical Officer of Health is empowered to apply to the Courts for an order for the compulsory removal to a hospital or other suitable place, of persons who are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions and unable to devote to themselves, and are not receiving from others, proper care and attention. Several cases of this kind were investigated by the medical officers during 1964 but in only one instance was it found necessary to resort to these compulsory powers. In this case, the patient was an old man of some 90 years living alone in one room on the ground floor of a house at the rear of a second-hand furniture shop, his room being cluttered with unsold furniture, books and ornaments. All offers of assistance were refused and as his condition was obviously deteriorating the necessary action had to be taken to remove him compulsorily to hospital. He died within a few days of admission, the cause of death being broncho-pneumonia. Housing Statistics 1. Inspection of Dwelling-houses during the year (1) (a) Number of initial inspections of dwelling-houses for housing defects (under Public Health or Housing Acts) 4,172 (6) Number of reinspections 4,803 (2) (a) Number of dwelling-houses which were examined in the course of "house-to-house" inspection and recorded under the Housing Consolidated Regulations, 1925 37 (6) Number of reinspections 88 29 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 24 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 35 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 109 3. Action under Statutory Powers during the year A.—Proceedings under Sections 9, 10 and 12 of the Housing Act, 1957 (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— (а) By owners Nil (b) By Local Authority in default of owners Nil B. Proceedings under Public Health Acts (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 35 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) By owners 34 (b) By Local Authority in default of owners 1 C.—Proceedings under Sections 16, 17 and 23 of the Housing Act, 1957 (1) Number of dwelling-houses represented for demolition Nil (2) Number of dwelling-houses in respect of which Demolition Orders were made Nil (3) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (4) Number of dwelling-houses in respect of which Closing Orders were made Nil D.—Proceedings under Sections 18 and 27 of the Housing Act, 1957 (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 24 (68 rooms) (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 11 (24 rooms) 30 4. Paris of buildings unfit for human habitation A. —Formal action in respect of parts of buildings unfit for human habitation (1) (a) Number of basements represented for closure 22 (54 rooms) (b) Number of Closing Orders made in respect of underground rooms 21 (55 rooms) (c) Number of undertakings accepted in lieu of Closing Orders in respect of underground rooms Nil (2) (a) Number of other parts of buildings represented for closure 2 (4 rooms) (6) Number of Closing Orders made in respect of other parts of buildings 3 (13 rooms) (c) Number of undertakings accepted in lieu of Closing Orders in respect of other parts of buildings 1 (11 rooms) (3) (a) Number of specifications submitted in respect of proposed works to parts of buildings subject to Closing Orders 13 (b) Number of specifications approved 13 (4) (a) Number of Closing Orders determined, in respect of ground rooms 11 (24 rooms) (b) Number of Closing Orders determined in respect of other parts of buildings Nil (5) (a) Number of applications made for modification of Closing Orders to permit approved use 14 (40 rooms) (6) Number of applications approved 14 (40 rooms) (6) (a) Number of cancellations of Closing Orders (premises demolished) 22 (b) Number of cancellations of Undertakings (premises demolished) Nil B.—Informal action in respect of parts of buildings unfit for human habitation (1) Number of instances of informal action inititiated to secure requirements of the Housing Acts and Regulations made thereunder— (a) In respect of underground rooms 16 (b) In respect of other parts of buildings 104 31 C.—Contravention of Closing Orders (1) Number of contraventions of Closing Orders reported Nil (2) Number of legal proceedings instituted Nil 5. Housing Act, 1957—Part IV—Overcrowding (1) Number of new cases of overcrowding reported during the year 10 (2) Number of cases of overcrowding relieved during the year 3 Slum Clearance Clearance Areas In pursuance of the City Council's slum clearance programme 1961-65, I made representations during 1964 for dealing with the following premises:— (i) one building comprising 19 dwellings, viz.:—St. Anne's Buildings, St. Anne's Court, W.1 (0-056 acre); (ii) seven houses, viz.:—Nos. 1 to 7 (consecutive and inclusive), St. Anne's Court, W.1 (0-092 acre); and (iii) six houses, viz.:—Nos. 1 to 6 (consecutive and inclusive), Richmond Buildings, W.1 (0.137 acre). The City Council at its meeting on 21st May, 1964, passed a resolution declaring the three areas to be clearance areas, and Members were informed that a further report would be submitted dealing with the steps to be taken to secure the demolition of the buildings. The Housing Act, 1957, provides that an order authorising the compulsory purchase of land comprised in a clearance area shall be submitted to the Minister of Housing and Local Government within six months after the date of the resolution declaring the area to be a clearance area. In the case of the areas referred to above, however, and at the City Council's request, the Minister authorised an extension of the statutory period by six months expiring 20th May, 1965. Housing Acts, 1961 and 1964- Houses in Multiple Occupation Owing to the continued shortage of public health inspectors, only a small amount of progress could be made during 1964 in connection with the survey of houses in multiple occupation, and the implementation of the provisions of the Housing Acts, 1961 and 1964. Common Lodging Houses There are two common lodging houses for men in the City, licensed by the City Council under the Public Health (London) Act, 1936. These common lodging houses have accommodation for 716 and 565 men lodgers respectively. Nine visits were made by the public health inspectors to the lodging houses during the year. 32 At one of these lodging houses the washing and bathing facilities were greatly improved during 1964 by the installation of several shower baths, foot baths and lavatory basins. Housing Act, 1964 This Act, which came into force on the 16th August, 1964, sets up a new body to assist housing societies to provide housing accommodation; conveys powers and duties on local authorities to compel the carrying out of works for the improvement of dwellings which are without all or any of the standard amenities; amends the law relating to the giving of financial assistance for the improvement of housing accommodation; makes further provision as to the powers and duties of local authorities as respects houses let in lodgings or occupied by more than one family; amends the provisions of the Clean Air Act, 1956, relating to the making of contributions to expenditure incurred in the adaptation of fireplaces in private dwellings, and amends in other respects the law relating to housing. The Sections of the Act are arranged in five Parts. The purpose of Parts II and III is to secure that within the next 10 years most of the 2,000,000 or so improvable homes in England and Wales which lack amenities and which still have a reasonable life, are provided with hot water, a fixed bath or shower, a wash-hand basin, an inside lavatory and a proper food store—the five "standard" amenities. Part I deals with assistance for housing societies providing housing accommodation. Part II enables local authorities to compel owners to improve tenanted dwellings in improvement areas and tenement blocks; and elsewhere at the request of the tenant. Improvement areas are defined as being areas containing dwellings lacking one or more of the standard amenities where at least one half are so constructed that it is practicable to improve them to the full standard, and thereafter be fit for human habitation for a period of not less than 15 years. The provisions of Part III of the Act are designed to make grants more attractive and thus encourage more owner-occupiers and landlords to improve their dwellings. The provisions of Part IV of the Act, which strengthen and extend powers given in the Housing Act, 1961, to deal with squalid living conditions in houses in multiple occupation, fall into three main groups:— (i) increases powers to obtain information requisite to the exercise of control under Part II of the Housing Act, 1961, and strengthen their powers of enforcement; (ii) introduces safeguards against eviction of tenants in a multi-occupied house after a local authority has made a compulsory purchase order under the Housing Acts; and 33 (iii) provides an entirely new "Control Order" power to take over the control and management of a multi-occupied house summarily if the living conditions are so bad that immediate intervention by the local authority, rather than the more protracted process of requiring the proprietor to ameliorate the conditions, is necessary for the protection of the residents' safety, welfare or health. The Sections in Part V of the Act deal with miscellaneous and general provisions concerning financial matters, amendments of the Clean Air Act, 1956, relating to dwellings, and minor amendments of the Housing Acts. Housing (Financial Provisions) Act, 1958 House Purchase and Housing Act, 1959 Housing Act, 1961 During 1964, a total of 38 applications for loans and/or grants under the above Acts were received by the Council, relating to the acquisition, conversion and/or improvement of 127 dwellings. Altogether, 205 visits were made by the public health inspectors in connection with these applications. Rent Act, 1957—Certificates of Disrepair No applications for Certificates of Disrepair were received during 1964. One certificate was issued as to the remedying of defects specified in a landlord's undertaking to remedy defects. This related to a Certificate of Disrepair issued in 1963. Land Charges Act, 1925 The number of enquiries dealt with and. reported upon during 1964 was 3,152. The enquiries concerned outstanding statutory or informal notices, combined drainage orders, smoke control orders, applications for decontrol under the Rent Restrictions Acts, and certificates of disrepair. Additional questions appeared on many of the search forms, mainly in regard to any proposals for dealing with properties by means of clearance or redevelopment under the Housing Acts, restrictions on the use of underground rooms, and the suitability of premises for specific purposes such as catering establishments and workrooms. Assessment of Housing Priorities on Medical Grounds During the year, 126 applications for rehousing on medical grounds were examined, and recommendations were made for the guidance of the Housing Committee. 34 In each case the precise medical condition and resultant disability were determined (frequently necessitating communication with the family doctor or with the hospital attended). Investigations concerning the present housing circumstances of the applicants were made by the public health inspectors. Their detailed reports included a reference to the extent and nature of existing premises, and its adequacy for the number of persons accommodated; the sanitary and structural conditions; the risk of infection; and the existence of inconveniences, such as stairs, which might be prejudicial to the patient. On this information an assessment was made of the degree of priority merited on medical grounds. The Offices, Shops and Railway Premises Act, 1963 This Act received the Royal Assent on 31st July, 1963. Provisions relating to registration of premises came into operation on 1st May, 1964, but the majority of the provisions operated from 1st August, 1964. In certain instances statutory regulations made by the Government came into force during 1965. The Act contains provisions for securing the health, safety and welfare of persons employed in offices, shops and railway premises. The duty of enforcing the Act has been placed on local authorities in regard to the majority of the provisions, on fire authorities (in London the London County Council) in relation to fire precautions and upon H.M. Inspector of Factories in respect of the remaining provisions. In certain types of premises such as Crown Properties, Fire and Police, Education, and premises occupied by local authorities, the provisions will be dealt with by the Factory Inspector. The Council's duties under the Act were referred to the Public Health Committee and in January, 1963, the establishment of the Public Health Department was increased by four posts of public health inspector to help undertake inspections necessitated by this Act. Unfortunately, it was not possible during 1964 to fill all four posts and for much of the year only two public health inspectors could be spared for this new work. The clerical establishment was increased by one post of administrative assistant and one shorthand typist to undertake work entailed by the many thousands of registration forms received. The Act contains the following general requirements for dealing with conditions in offices, shops and railway premises: Cleanliness Overcrowding Temperature Ventilation Lighting Sanitary conveniences Washing facilities 35 Drinking water Accommodation for clothing Seating arrangements Seats for sedentary workers Eating facilities Floors, passages and stairs Fencing of exposed parts of machinery Cleaning of machinery Training and supervision of persons working at dangerous machines Prohibition of heavy work First aid Penalisation of dangerous acts and interference with equipment Dangerous conditions and practices Information for employees During 1964, 8,254 applications for registration were received; a total of 4,790 visits were made by the public health inspectors to all types of office premises, including 461 visits for specific purposes under the Offices, Shops and Railway Premises Act. Sanitary Circumstances Duties performed by the Public Health Inspectors The following statistics relate to the work of the public health inspectors during 1964:— Dwelling Houses Reasons for initial inspections:- I nspeclions Complaints 605 House to House (by Housing Inspectors) 37 Routine 1,452 Smoke Control Areas 345 Infectious Disease 74 Underground Rooms 52 Housing circumstances 126 Applications for Loans and Grants 127 Drainage 417 Rodent Control 890 Miscellaneous 84 4,209 36 Included in the above totals are:— Houses in multiple occupation 212 Council properties 144 Aged and infirm persons 91 Common Lodging Houses 9 4,891 re-inspections were made following the above inspections. A further 381 visits were made by the medical officers. Notices served Public Health (London) Act, 1936 34 L.C.C. (Drainage) Byelaws 1 Prevention of Damage by Pests Act 1 36 Statutory Notices 6 Nuisances, defective and unsatisfactory conditions found:- Defective, dirty internally 16 Damp 69 Defective drainage 19 Defective roofs 15 Water closets:— Insufficient ventilation, light 3 Defective or dirty 10 Water supply:— Insufficient 2 Supply, absence of in upper floors 2 Cisterns dirty 1 Smells 33 Rubbish 21 Animals 5 Verminous 26 Cockroaches 9 37 Inspection of Factories. Workplaces, Shops, Offices and Other Premises (other than food premises) Total Number of Visits Factories—Power 135 Factories—Non-power 16 Workplaces, etc. 2,748 Offices 4,790 Shops (other than food) 550 8,239 Reasons for initial inspections:— Complaints 646 Routine 930 Infectious Disease 36 Drainage 585 Rodent Control 401 Smoke Control 565 Miscellaneous 58 3,221 Re-inspections 5,018 Types of premises inspected:— Places of public entertainment 52 Wearing apparel 140 Furriers 3 Garages, motor tyres and rubberworks 59 Boots and shoes and other leather goods 17 Jewellers, precious and other metal-workers 22 Hairdressers 59 Laundries an d dry cleaners 11 Printers and publishers 23 Warehouses and packers 25 Shops (other than food) 550 Photographers, film renters 19 Electricity sub-stations 1 Opticians 1 Florists 4 Offices 4,790 Various (schools, hospitals, halls, building sites, etc.) 2,463 8,239 38 Notices Served Factories Power Factories, Non- power Workplaces, Offices, Shops, etc. Total Public Health (London) Act, 1936 - - 1 1 Factories Act, 1961 14 — - 14 Noise Abatement Act, 1960 — — 1 1 14 — 2 16 Nuisances, Defective and Unsatisfactory Conditions Found Factories Power Factories Nonpower Workplaces, Offices, Shops, etc. Defective, dirty, internally — — 3 Damp — — 11 Inadequate imderfloor ventilation — — — Defective drainage — — 10 Sanitary accommodation:— Insufficient 2 — - Insufficient ventilation and light 8 — 1 Defective or dirty 22 — 2 Not separate for sexes 2 — 3 Unsuitable 5 .— —- No indicating notices on doors of water-closets 5 1 Other nuisances — — 4 Temperature — — 1 Want of ventilation — — 1 Cockroaches — — 3 Verminous — — 2 Factories Act, 1961 Section 70—Basement Bakehouses There are three basement bakehouses in Westminster in respect of which Certificates of Suitability are in force. Section 133—Outworkers Number of outworkers (includes 1,941 living in areas outside the City 2,823 (See Appendix II to this Report) 39 Food and Drugs Act, 1955 Inspections of all types of food premises Reasons for initial inspections Complaints 428 Routine 2,872 Infectious Disease 44 Drainage 75 Rodent Control 134 New catering proposals 172 3.725 2,798 reinspections were made following the above inspections. Catering Establishments At the end of the year, particulars of 3,007 catering establishments were in the register. Summary of inspections:— Hotels, restaurants, clubs 3,246 Cafes, teashops, etc. 651 Staff Canteens 70 Public Houses 347 4,314 Notices served Public Health (London) Act, 1936 2 Food Hygiene (General) Regulations, 1960 117 Noise Abatement Act, 1960 1 L.C.C. (Drainage) Bye-laws 5 L.C.C. (Water-closet) Bye-laws 5 130 Nuisances, defective and unsatisfactory conditions found:— Dirty, dilapidated internally 79 Defective internally 13 Defective drainage 6 Defective floors 60 Preparation tables and equipment worn and insanitary 49 Food storage accommodation inadequate and unsuitable 20 Vegetable preparation and washing up facilities worn and insanitary 41 Ventilation insufficient 25 Lighting 1 Staff washing facilities insufficient and unsuitable 12 Staff changing rooms insufficient and unsuitable 5 Fuel, rubbish and other extraneous materials in food preparation rooms 10 40 Water Closets:— Insufficient 2 Insufficient ventilation and light 16 Defective 15 Dirty and dilapidated 22 Not separate for sexes 3 Suitable notices not displayed on doors of water-closets 2 Smoking in catering premises 1 Cockroaches 2 Food Shops and Food Premises (Other than Catering Establishments) Types of businesses and summary of inspections:— Inspections Bakehouses (underground included) 32 Dairies and milkshops 63 Ice cream premises 45 Meat shops 156 Stalls 195 Confectioners 94 Fruit and greengrocery 490 Provision shops 592 Fish and poultry 111 Other Food Premises 431 2,209 Included in the above totals are 56 visits of enquiry in relation to food poisoning outbreaks. Other Food Premises:— Under this heading are included: (1) Off licences. (2) Food factories. (3) Bonded warehouses. (4) Chemists' shops. (5) Visits made in connection with applications for entry on the List of Persons entitled to sell poisons included in Part II of the Poisons List. (6) Visits of enquiry regarding adulterated samples. Notices served Food Hygiene (General) Regulations, 1960 21 Food and Drugs Act, 1955 1 22 41 Nuisances and defective conditions found:— Dirty and dilapidated internally 9 Defective internally 11 Defective externally 1 Defective floors 1 Preparation tables and equipment worn and insanitary 4 Food storage accommodation inadequate and unsuitable 3 Vegetable preparation and washing up facilities worn and insanitary 3 Fuel, rubbish and other extraneous materials in food preparation rooms 1 Lighting 1 Staff washing facilities insufficient and unsuitable 4 Water Closets:— Defective 1 Dirty and dilapidated 2 No indicating notices 3 Visits for the Purpose of Obtaining Samples and Inspecting Foodstuffs Sampling Inspection of Food Confectioners 11 66 Dairies and milkshops 58 70 Fish and poultry 12 98 Fruit and greengrocery — 457 Ice cream premises 37 38 Meat shops and stalls 4 298 Other food premises 68 286 Provision shops 79 533 Cafes, teashops, etc. 6 188 Hotels, restaurants, clubs, etc. 20 493 Staff canteens 3 62 Public houses 30 85 328 2,674 Food Sampling During the year 1,540 samples were submitted to the City Council's Public Analyst for chemical analysis. Of this number 80 were reported upon adversely, representing a percentage of 5.2. Appropriate action was taken, where necessary, in respect of these samples. 42 Pharmacy and Poisons Act, 1933 Persons entitled to sell poisons included in Part II of the Poisons List numbered 103 at 31st December, 1964. Milk and Dairies (General) Regulations, 1959 At the 31st December, 1964, the following were entered in the Council's Register of Dairies and Distributors of Milk:— Distributors of milk with premises registered as dairies 5 Distributors of milk with premises not registered as dairies 140 Milk (Special Designation) Regulations, 1960-63 During the year seventeen applications were received from newly registered Distributors of Milk for Dealer's (Pre-Packed) Milk Licences for the use of one or more of the designations "Pasteurised," "Sterilised" or "Tuberculin Tested". The latter designation as from the 1st October, 1964, was replaced by the designation "Untreated", and eighteen applications for its use were received. The licence permits the sale of milk both inside as well as outside the area of the licensing authority. Examination of Milk During the year eighteen samples of milk were submitted for methylene blue and phosphatase tests. The phosphatase tests of all samples were satisfactory. Food and Drugs Act, 1955—Section 16 Registration of premises in connection with the manufacture, sale or storage of ice cream. Two hundred and eighty premises are registered for the manufacture and/or sale and/or storage of ice cream. Registration of premises used for the preparation or manufacture of preserved foods. Sixty-seven premises are registered for the preparation or manufacture of preserved foods. Ice Cream (Heat Treatment) Regulations, 1959 During the year, 55 samples of ice cream were submitted for examination by the methylene blue test, and were classified in the following provisional grades as recommended by the Ministry of Health:— Grade No. of samples 1 32 2 10 3 9 4 4 43 Food and Drugs Act, 1955—Section 8 The following table shows the amount of food surrendered as unfit for human consumption during the year:– Amount surrendered Tons Cwts. Lbs. Canned meat and fish 2 18 38 Canned fruit and vegetables 13 12 89 Meat 1 13 7 Fish — 17 92 Fruit and vegetables 186 11 101 Confectionery — — 45 Fats — 4 32 Cereals 5 11 29 Bottled and packeted foods — 19 14 Frozen foods 2 10 66 Miscellaneous — 7 72 215 7 25 Method of disposal of condemned food Food condemned or voluntarily surrendered to the public health inspectors is disposed of by depositing in the Council's refuse barges at the Central Depot at Gatliff Road, S.W.I. Foodstuffs disposed of at this depot are removed by barge for land reclamation by controlled tipping at Pitsea. No recovery or diversion of any goods takes place at the central tipping site. Export Certificates Applications for Certificates of Export received in the Public Health Department during the year in respect of foodstuffs which consignors wished to despatch abroad numbered 41. Licensing Act, 1961 During the year the following applications were received:— Club Registration Certificates New applications 19 Variations 3 Renewals 119 Justices' Licences Applications (including re-grants) 90 It was not found necessary to lodge formal objection in respect of any application received during the year. 44 Analysis of Legal Proceedings, 1964 Fines Costs £ s. d. £ s. d. Food and Drugs Act, 1955 Selling food not of nature or quality demanded One conviction 15 0 0 7 7 0 Selling a bottle of milk containing foreign matter One conviction 20 0 0 10 10 0 Food Hygiene (General) Regulations Insanitary premises and equipment Six convictions 12 0 0 — In connection with the sale of " hot dogs " 53 convictions 135 0 0 26 10 0 £182 0 0 £44 7 0 Sewerage and Sewage Disposal The trunk sewers and sewage disposal in London are the responsibility of the London County Council; the local sewers, which discharge into the trunk sewers, are the responsibility of the City Council. All premises in Westminster are connected to the main drainage system, the sewage passing to disposal works maintained by the London County Council outside the City. The arrangements for Westminster would appear to be adequate; in 1964 there were no occasions on which heavy storms caused the sewers in the City to become surcharged and cause flooding. Public Health (London) Act, 1936 London County Council (Drainage) Byelaws, 1934 Drainage Drainage plans submitted 487 Combined drainage orders made 32 Prevention of Damage by Pests Act, 1949 Rats and Mice Repression Complaints received 317 Treatments undertaken 479 Inspections by Public Health Inspectors and Rodent Officer 2,282 Notices served — 45 Rodents destroyed Black Rats 482 Brown Rats 2,704 Mice 3,931 Rag Flock and Other Filling Materials Act, 1951 Under the provisions of this Act, various types of premises concerned with the upholstery trade or with the provision of materials for that trade must be registered or licensed with the local authority. At the end of the year, seven premises were on the register; one licence was issued for the use of premises for storage purposes. Noise Nuisance Complaints received 114 Investigations made 170 Notices served 2 During 1964, complaints were received of noise caused by the following:— Noise caused by: No. of complaints Machinery and vehicles of various types 64 Demolition or building operations 15 Clubs/cafes 15 Record players, juke boxes, dance bands, etc. 12 Other tenants 8 Two notices were served during the year, one relating to noise from a workshop and the second to noise emanating from catering premises. Fifteen complaints were received in regard to noise caused by demolition or building operations. In a built-up area, large scale demolition and building operations, such as those being undertaken at various sites in Westminster, must inevitably result in noise and annoyance being caused to residents of neighbouring dwellings, offices and shops. Although it was not necessary for statutory action to be taken during 1964 in regard to these matters, there were several occasions on which strong warnings had to be given to contractors, reminding them of their duty to carry out their operations with the minimum amount of noise and annoyance consistent with their activities. 46 Clean Air Act, 1956 Smoke Control Areas The City Council's programme for the declaration of Smoke Control Areas under the Clean Air Act, 1956, has now been completed. The final Smoke Control Order in respect of the Westminster (South) Area, came into operation on 1st July, 1965, and the whole of the area of the (old) City of Westminster is now covered by operative Smoke Control Orders. Installation of new furnaces Under Section 3 of the Clean Air Act, 1956, the installation, of all new furnaces except domestic furnaces of less than 55,000 British thermal units per hour capacity must be notified to the local authority. The purpose of the section is to ensure that new furnaces installed shall be capable, so far as is practicable, of being operated without emitting smoke. During 1964, 86 such notifications were received. Provision is also made in this section of the Act for proposals relating to the installation, of new furnaces to be submitted to the local authority for approval, and during 1964, 33 applications were approved. Since the Clean Air Act, 1956, came into operation on 1st January, 1956, up to the end of 1964, a total of 594 notifications have been received concerning the installation of new furnaces, of which 152 applications were submitted for approval. Smoke Abatement—Complaints Received and Observations Made 1956 1957 1958 1959 1960 1961 1962 1963 1964 Complaints received 87 41 67 58 53 41 54 63 40 Observations made 2,634 1,603 625 497 897 572 584 806 516 Notices issued— Preliminary 23 6 – 1 3 – – – – Statutory – – – 1 – – – – – 47 Atmospheric Pollution Investigation into the atmospheric pollution in the City was continued during the year at three sites, Mayfair, Pimlico and Charing Cross, where deposit gauges, which measure the deposited pollution, and lead peroxide cylinders, which measure the sulphur activity, are sited. The following table gives the results of the monthly analyses, and shows separately the amounts of insoluble and soluble constituents. Monthly deposits of impurities—tons per square mile Month 1964 Mayfair Pimlico Charing Cross Insol. Sol. Total Insol. Sol. Total. Insol. Sol. Total January 8.08 7.16 15.24 12.25 12.25 24.50 10.45 10.02 20.47 February 10.40 6.37 16.77 15.10 11.27 26.37 12.28 10.09 22.37 March 10.64 3.75 14.39 14.20 3.69 17.89 12.18 13.51 25.69 April 10.47 2.76 13.23 12.89 6.58 19.47 12.88 5.67 18.55 May 12.11 27.25 39.36 13.09 9.30 22.39 14.21 7.20 21.41 June 8.63 6.24 14.87 11.47 7.22 18.69 10.69 7.24 17.93 July * * * 8.59 3.29 11.88 8.07 3.98 12.05 August 7.16 29.26 36.42 9.33 4.90 14.23 9.03 4.15 13.18 September 6.55 7.37 13.92 8.56 2.75 11.31 6.67 3.25 9.92 October 7.88 7.37 15.25 14.20 7.18 21.38 11.45 8.00 19.45 November 6.82 8.46 15.28 8.76 10.27 19.03 8.83 10.36 19.19 December 7.16 8.90 16.06 13.36 8.46 21.82 10.79 14.17 24.96 * No readings available; apparatus accidentally damaged. 48 Estimation of sulphur activity by the lead peroxide method The cylinders for the estimation of sulphur activity are situated at Mount Street Gardens, Bessborough Street Clinic, and Alhambra House. The following table gives the degree of sulphation expressed in empirical units, viz., milligrams of sulphur trioxide per day per 100 square centimetres of standard lead peroxide exposed in the standard apparatus. Month S03 in milligrams per 100 sq. cms. per day Mayfair Pimlico Charing Cross January 1.68 3.39 3.31 February 2.03 1.95 1.98 March 2.18 2.23 1.16 April 2.87 4.74 4.26 May 2.01 2.84 2.83 June 1.44 1.85 2.04 July 1.13 1.97 1.94 August 1.20 1.71 1.70 September 1.72 2.21 2.77 October 4.14 3.21 5.22 November 4.79 5.06 5.56 December 5.39 6.57 6.62 Estimate of sulphur content by the volumetric method In 1929, the City Council was apprehensive of the possible danger to public health by the pollution of atmosphere likely to arise from the emission of flue gases from the large power stations which were to be erected in close proximity to the south western boundaries of the City— namely Battersea and Fulham. Accordingly, in 1930, an atmospheric pollution measuring apparatus was installed in Westminster, and the results obtained have been regularly reported to the Public Health Committee since that date. In 1960 the City Council felt that it would be useful if additional information were obtained concerning the pollution of the atmosphere, particularly in the Pimlico area. A further atmospheric pollution measuring apparatus was, therefore, purchased and installed in April, 1960, on the top of a block of flats in Churchill Gardens. 49 The results obtained from the two sites are as follows:— Month S02 micrograms per cubic metre Monck Street Churchill Gardens January 539 524 February 550 525 March 576 278 April 261 231 May 177 145 June 133 85 July 162 161 August 100 81 September 138 158 October 348 254 November 390 360 December 482 579 50 Smoke Average readings from apparatus sited at Monck Street, and Churchill Gardens. By means of this apparatus a measured volume of air is drawn through a filter paper which removes solid matter from it. The stain therebyproduced is compared with a standard, from which the amount of pollution is calculated. Month Micrograms per cubic metre Monck Street Churchill Gardens January 225.1 304.1 February 163.3 166.3 March 96.6 88.9 April 90.6 56.6 May 39.4 33.2 June 44.2 32.0 July 30.6 28.9 August 31.1 31.1 September 48.2 74.6 October 113.6 112.5 November 115.9 114.1 December 132.6 144.6 Sequential Smoke Sampling Apparatus As previously reported, the City Council is co-operating in the investigation being carried out by the Department of Scientific and Industrial Research into the relation between atmospheric pollution and respiratory diseases. During 1962, in order to provide the information required, the Council purchased and installed, at a cost of approximately £55, a sequential smoke sampling apparatus which examines and records at regular intervals the solid pollution in a measured quantity of air. The machine was put into use on a total of 36 days in 1964 during periods of fog or weather showing a fog tendency, as follows:— 51 Month, 1964 Days machine in use January 11 February 9 October 3 November 8 December 5 Where requested, the calculated readings from these samples were supplied to the Department of Scientific and Industrial Research. Water The resident population of 85,840 in some 30,800 dwellings receive water from the Metropolitan Water Board's mains or from deep wells. At 31st December, 1964, 75 deep wells were in use. From 68 of these wells the water is used for domestic purposes. Of the remainder, six are used for standby only and one in case of fire. During the year the use of one well situated at the Stag Brewery Site, Allington Street, S.W.I, was discontinued; this well had previously served Watney's Brewery. During 1964, 77 samples of water from wells in the City were submitted for examination; satisfactory reports were received of 60 bacteriological examinations and 17 chemical analyses. Public Swimming Baths (I am indebted to the Director of Public Cleansing for the following information.) The City Council has three public baths establishments at Buckingham Palace Road and Marshall Street (each having two swimming pools) and at Great Smith Street, where there is one pool. The water for each of these swimming pools is supplied by the Metropolitan Water Board and is continuously heated, filtered and chlorinated at a rate of 25,000-0,000 gallons per hour, the whole of the water of any one pool being filtered and chemically treated in four hours. Fully automatic chlorine residual controllers and recorders, which adjust the chlorine content of the water to the requirements of the bathing load, are in use at both the Buckingham Palace Road and Marshall Street Baths and were the first of their kind to be used in any public baths in Great Britain. Up to 31st August, 1963, an independent firm of analytical chemists took samples (without notice) of water from the swimming pools each fortnight. From 1st September, 1963, this work has been undertaken by the public health inspectors in the course of their routine duties. The 52 bacteriological examinations show that the water is maintained to a high standard of bacterial purity and is in every respect suitable for swimming purposes. A further swimming pool of 70,000 gallons, which is available to the public, is sited under a large block of flats within the City. The water is drawn from deep wells; continuous filtration through sand and chlorination is maintained during the time that the bath is in use, with a turnover of four hours. Ozone treatment plant is also available. Up to the end of August, 1963, an independent firm of analytical chemists took samples every week (without notice), but since 1st September, 1963, this work has been undertaken by the public health inspectors in the course of their normal duties. The results show that the water is maintained to a high bacterial and chemical standard. There is also the Lido in Hyde Park, which is under the control of H.M. Minister of Works. During 1964 a total of 244 samples of swimming bath water were examined. Pet Animals Act, 1951 Three licences were issued by the Council during the year in relation to premises subject to the provisions of this Act. Animal Boarding Establishments Act, 1963 This Act, which originated as a Private Member's Bill, came into operation on the 1st January, 1964. It provides for a system of annual licensing by local authorities (in London, the metropolitan borough councils and the City Corporation) of any establishment at which a business of providing accommodation for cats and dogs is carried on, and for the inspection by authorised officers of such establishments. The powers given by the Act are akin to those which the Council exercises under the Pet Animals Act, 1951, in respect of premises at which pet animals are sold. As the Council had delegated these latter powers to the Public Health Committee, it was decided to delegate to that Committee the exercise of its powers under the Animal Boarding Establishments Act, 1963. Slaughter of Animals Act, 1933—Slaughterman's Licences The Council during the year granted Slaughterman's licences to 23 men who had been accepted by the Royal Society for the Prevention of Cruelty to Animals to act as their inspectors in different parts of the country. These licences are required to be held by the pupils while undergoing training in humane slaughtering as part of the course for appointment as inspectors of the R.S.P.C.A. 53 Disinfection, Disinfestation and Cleansing of Persons— Arrangements with the Holborn Borough Council The arrangement between the City Council and the Holborn Borough Council whereby the latter undertook to carry out, on agreed terms, the work of disinfection, disinfestation and cleansing of persons, and the provision of the necessary transport therefor, continued. The arrangement came into operation on the 3rd September, 1956, and continued until 31st March, 1965. The following is a summary of the work carried out for Westminster during the year 1964:— Disinfection and Disinfestation Rooms Articles Articles Washed Books Disinfection 72 7,516 — 92 Disinfestation 282 2,875 — — Cleansing of Persons Treatments Scabies Head Lice Body Lice Men 25 — 362 Women 6 2 8 Children 5 — — Transportation of Bodies Abroad On occasion, when it is proposed to transport a body overseas for burial, the Medical Officer of Health of the district in which death has taken place is asked to provide a certificate to the effect that the deceased did not die from any infectious or contagious disease, and that no recent epidemic of dangerous infectious disease had occurred in the district. During 1964, eight such certificates were issued in respect of persons who had died in Westminster, and whose bodies were being transported abroad for burial. 54 Burial or Cremation of the Dead Under the provisions of Section 50 of the National Assistance Act, 1948, it is the duty of the City Council as a Sanitary Authority to cause to be buried or cremated the body of any person who has died or is found dead in the area, where no other arrangements have been made for the disposal of the body. The Council is empowered to recover the cost of burial from the estate of the deceased, and is eligible to receive payments in respect of the cost of such burial from death grants payable under the provisions of the National Insurance Act, 1946. Where persons without known relatives die in the City, it is frequently necessary not only to arrange for their burial, but to dispose of the contents of their homes. This is done in consultation with the Treasury Solicitor. Such action is necessary to enable the proceeds to be applied towards the cost of burial and also to avoid rent accruing and to release the accommodation for housing purposes as early as possible. During the year 51 burials were undertaken by the City Council in its Cemetery at Hanwell. The requests for the burials were received from the following sources:— H.M. Coroner 19 Relatives or friends of the deceased 18 Hospitals in the City 14 Coroner's Court and Mortuary During 1964, 284 bodies were received in the Mortuary on Coroner's Warrants, etc. One body was deposited to await burial. Number of Cases Inquest cases 87 Non-inquest cases 197 Post-mortem examinations held 276 Causes of death in the foregoing were as under:— Accidental drowning 1 Found drowned 4 Suicide by drowning — Suicide by other means 39 Accidents— Street 9 Domestic 8 Others 14 Natural causes 200 Misadventure 1 Murder — Miscellaneous causes 8 55 Mortuary Accommodation—Arrangements with Other Authorities Holborn Borough Council An arrangement exists between the City Council and the Holborn Borough Council whereby bodies from Holborn, which are not the concern of H.M. Coroner, can be accommodated at the City Council's Mortuary in Horseferry Road whilst awaiting burial. The arrangement came into operation in September, 1956; no bodies were received in the Mortuary from Holborn during 1964. 56 APPENDIX I FACTORIES ACT, 1961 Prescribed Particulars on the Administration of the Factories Act, 1961 Part I or the Act 1. Inspections for purposes of provisions as to health (including inspections made by public health inspectors). Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (1) (2) (3) (4) (5) (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 568 16 — — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,696 135 14 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 49 — — — Total 2,313 151 14 — 57 2. Cases in which Defects were found (If defects are discovered at the premises on two, three or more separate occasions they should be reckoned as two, three or more “cases ") 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 (1) (2) (3) (4) (5) (6) Want of cleanliness (S.I) 30 20 — 11 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) 1 — — — — Ineffective drainage of floors (S.6) — — — — Sanitary Conveniences (S.7) (a) Insufficient 3 1 — 1 — (6) Unsuitable or defective 15 12 — 7 — (c) Not separate for sexes 5 4 — 5 — Other offences against the Act (not including offences relating to Out-work) 32 29 — Total 86 66 — 24 — 58 APPENDIX II Part VIII of the Act Outwork (Sections 133 and 134) Nature of work Section 133 Section 134 No. of outworkers in August list required by Section 133 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) Wearing apparel— Making, etc 2,783 — — — — — Cleaning and washing — — — — — — Household linen 21 — — — — — Lace, lace curtains and nets — — — — — — Curtains and furniture hangings 19 — — — — — Furniture and upholstery — — — — — — Electro-plate — — — — — File making — — — — — — Brass and brass articles — — — — — — Fur pulling — — — — — — Iron and steel cables and chains — — — — — — Iron and steel anchors and grapnels Cart gear — — — — — — Locks, latches and keys — — — — — — Umbrellas, etc — — — — — — Artificial flowers — — — — — — Nets, other than wire nets — — — — — — Tents — — _ — — — Sacks — — — — — — Racquet and tennis balls — — — — — — Paper bags — — — — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper — — — — — — Brush making — — — — — — Pea picking — — — — — — Feather sorting — — — — — — Carding, etc., of buttons, etc. — — — — — — Stuffed toys — — — — — — Basket making — — — — — — Chocolates and sweetmeats — — — — — — Cosaques, Christmas stockings, etc. — — — — — — Textile weaving — — — — — — Lampshades — — — — — — Total 2,823 — — — — —