AC 4412(3) CRAYFORD LIBRARY CRA 17 Urban District of Crayford Annual Report OF THE Medical Officer of Health For the Year 1952 BY JOHN LANDON M.R.C.S., L.R.C.P., D.P.H. Printed by Perry Son a Lack Ltd. (t.u.) Lowfield Works, Dartford Urban District of Crayford Annual Report OF THE Medical Officer of Health For the Year 1952 BY JOHN LANDON M.R.C.S., L.R.C.P., D.P.H. Printed by Perry Son & Lack Ltd. (T.U.) Lowfield Works, Dartford MEMBERS OF THE HEALTH COMMITTEE. Chairman: Councillor J. Kerr. Members: Councillors: W. A. Borrie, J.P. F. A. Gerrard. L. Riches. Mrs. E. M White. Councillors: H. E. Clark J. W. Howell. J. W. Taylor. S. J. Woolley. Co-opted Members: Mrs. L. Woolley, Mrs. I. Walker, Mrs. E. J. Borrie Public Health Staff. Medical Officer of Health : John Landon, M.R.C.S., L.R.C.P., D.P.H. Sanitary Inspectors: R. Milligan, Cert.RSan.L, M.S.I.A. A. W. Kent, M.R.S.I., M.S.I.A. Chief Clerk: Mrs. G. Mitchell Clerks: E. T. Shutte. Miss M. H. Millington. Rodent Operator: W. McCulla. [ 2 ] Crayford Urban District Council To the Chairman and Members of the Urban District Council. Mr. Chairman, Ladies and Gentlemen, I have the honour to present my Annual Report for the year 1952. The vital statistics of the Urban District were satisfactory but it should be remembered that they do not tell the full story in regard to the health of the area. To complete the picture we should, also, require morbidity statistics relating to the number of residents who, during the year, attended hospital, or their private doctors, who resorted to self medication or even failed to achieve that general level of wellbeing which is consistent with health. Such information is not available, but it is clear from indirect sources of information that the number of such persons was considerable. Nevertheless, the vital statistics as presented, in that they are capable of comparison with other districts and with events in previous years, may be accepted with guarded optimism. The birth rate during 1952 was 14.4 per 1,000 of the home population compared with 13.9 in 1951, and with a rate for England and Wales for 1952 of 15.3 per 1,000. The birth rate for the District corrected by the use of the Registrar General's comparability factor (0.93) which allows for comparisons with other areas, was 13.4. The death rate for the district, during 1952, was 9.11 per 1,000 of the home population compared with 9.56 per 1,000 in 1951, and with a 1952 rate for England and Wales of 11.3. The Crayford death rate for 1952 corrected by the comparability factor (1.21) for deaths was 11.2 per 1,000. The infant mortality rate for 1952 was 25 per 1,000 live births compared with 20.7 in 1951. The general death rate of infants under 1 year of age for England and Wales for 1952 was 27.6. Of the 10 infantile deaths occurring during 1952 in the Urban District, nine occurred in the neonatal period (within one month of birth) and were due to causes [ 3 ] not, at present, capable of control. The remaining death was due to broncho-pneumonia, a condition of high mortality among very young children but nowadays more amenable to treatment than a decade ago. There were, again, no maternal deaths in 1952 which reflects credit on the local midwifery services, bearing in mind the fact that there were 400 live births during the year in addition to 8 stillbirths. The incidence of infectious disease was again very low. with the exception of scarlet fever which is, nowadays, in most cases, a very mild disease which is treated at home except in those cases where housing conditions are bad or where there is some other special indication for the patient to be removed to hospital. No case of diphtheria was notified during the year and, in fact, only two cases of this disease have occurred since 1942. This is a very remarkable fact and should encourage parents to have their children immunised notwithstanding the present day absence of diphtheria. Two cases of paralytic poliomyelitis occurred during the year compared with a similar number in 1951, The behaviour of this disease is unpredictable and presents one of the chief epidemiological problems at the present time. The Clean Food Campaign made further progress during the year although there is nothing spectacular to report. The general public do not, perhaps, sufficiently recognise that effective official action is only possible with their co-operation and, although lip-service is often paid to the need for cleaner food production and handling, there is considerable public apathy in regard to film shows, lectures, and exhibitions. This is, however, a long term project in health education and the up-hill nature of the task does not make it in any way less worthwhile. The prevention of accidents in the home is likely to receive considerable attention in the coming year and will come to be regarded more and more as an integral part of preventive medicine. It is just as worthy to prevent the death of a child from burns as from diphtheria and there is, here, a fruitful field for the endeavours of the Health Department in collaboration with the voluntary organisations in the District. It is too little realised that, in the country as a whole, there are 5,000 to 6,000 fatalities every year from home accidents and that 20 per cent of the deaths occur in [ 4 1 children under the age of five years and about 60 per cent in old people and, further, that more children under 15 die from accidental causes in their homes than are killed in road accidents, I wish to thank the Members of the Health Committee for their support and encouragement, and the Senior Sanitary Inspector, Chief Clerk and all members of the Health Department for their sustained and valuable work during the year. I am, Your obedient servant, JOHN LANDON, Medical Officer of Health. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 2,698.71 Population (Registrar General's estimate mid-year 1952) 27,760 Number of inhabited houses 8,147 Rateable Value £180,730 Sum represented by a penny rate £738 Live Births. Total M. F. Legitimate 386 191 195 Illegitimate 14 6 8 400 197 203 Birth rate per 1,000 of the estimated home population 14.4. General birth rate for England and Wales 15.3. Stillbirths. Total M. F. Legitimate 8 4 4 Illegitimate — — — 8 4 4 Rate per 1,000 total (live and still) births 19.6. [ 5 ] Total M. F. Deaths. 253 145 108 Death rate per 1,000 of the estimated resident population 9.11 General death rate for England and Wales 11.3. The Birth Rate and Death Rate for Crayford compares favourably with that for other parts of the Country. The RegistrarGeneral has supplied comparability factors for 1952. The standardised Birth Rate which allows for comparison with other parts of the Country is 13.4 and the standardised Death Rate is 11.2. Maternal Deaths:— There were no Maternal Deaths in 1952. Deaths of Infants under one year of age:— Deaths of Infants under one year of age Total M. F. 10 7 3 Rate per 1,000 live births (Crayford) 25. Rate per 1,000 legitimate live births 25.9. General death rate of infants under 1 year of age for England and Wales 27.6. Deaths from Various Causes. Malignant Neoplasm (all ages) 54 Measles (all ages) — Whooping Cough (all ages) — Diarrhoea (under 2 years of age) — [ 6 ] [ 7 ] Vital Statistics during 1952 and previous years. Year Population LIVE BIRTHS DEATHS INFANT DEATHS No. RATE No. RATE No. RATE C.U.D.C. C.U.D.C. Eng. & W. C.U.D.C. C.U.D.C. Eng. & W. C.U.D.C. C.U.D.C. Eng. & W. 1939* 25,200 458 18.26 15 194 9.4 12.1 16 35.4 50 1940* 23,770 428 18 14.6 256 13.8 14.3 16 38.9 55 1941* 22,380 347 15.5 14.2 227 10.1 12.9 20 59.7 59 1942 22,840 441 19.3 15.8 193 8.5 11.6 20 45.3 49 1943 22,850 431 18.9 16.5 223 9.8 12.1 18 41.8 49 1944 21,910 507 23.1 17.6 243 11.1 11.6 21 41.4 46 1945 23,030 432 18.8 16.1 170 7.4 11.4 10 23.1 46 1946 25,780 566 22 19.1 249 9.7 11.5 21 37 43 1947 26,610 583 22 20.5 271 10.2 12 21 36 41 1948 27,190 501 18.4 17.9 205 7.5 10.8 10 19.9 34 1949 27,520 492 17.9 16.7 221 8.03 11.7 13 26.4 32 1950 27,750 434 15.6 15.8 219 7.89 11.6 12 27.6 29.8 1951 27,820 387 13.9 15.5 266 9.56 12.5 8 20.7 29.6 1952 27,760 400 14.4 15.3 253 9.11 11.3 10 25 27.6 * Instructions were issued by the Registrar General for these particular years, giving certain alternative figures for calculation of these statistics. SUMMARY OF VITAL STATISTICS, 1952. England and Wales 160 County Boro's and Great Towns (including London) 160 Smaller Towns (Resident Population) 25,000 to 50.000 at 1951 Census London Administrative County Urban District of Crayford Rates per 1,00 Home Population BIRTHS. Live Births 15.3 16.9 15.5 17.6 14.4 Still Births 0.35 22.6(a) 0.43 24.6(a) 0.36 23.0(a) 0.34 19.2(a) 0.28 19.6(a) DEATHS. All Causes 11.3 12.1 11.2 12.6 9.11 Typhoid and paratyphoid 0.00 0.00 0.00 — — Whooping Cough 0.00 0.00 0.00 0.00 0.00 Diphtheria 0.00 0.00 0.00 0.00 0.00 Tuberculosis 0.24 0.28 0.22 0.31 0.11 Influenza 0.04 0.04 0.04 0.05 0.11 Smallpox 0.00 — — — — Acute Poliomyelitis (including Polioencephalitis) 0.01 0.01 0.00 0.01 0.00 Pneumonia 0.47 0.52 0.43 0.58 0.11 NOTIFICATIONS. (Corrected). Typhoid Fever 0.00 0.00 0.00 0.00 0.00 Paratyphoid Fever Meningoccocal 0.02 0.02 0.03 0.01 0.04 fection 0.03 0.03 0.03 0.02 0.04 Scarlet Fever 1.53 1.75 1.58 1.56 3.56 Whooping Cough 2.61 2.74 2.57 1.66 3.31 Diphtheria 0.01 0.01 0.03 0.01 0.00 Erysipelas 0.14 0.15 0.12 0.14 0.25 Smallpox 0.00 0.00 0.00 — — Measles 8.86 10.11 8.49 9.23 12.86 Pneumonia 0.72 0.80 0.62 0.57 0.61 Acute Poliomyelitis (Including Polioencephalitis) Paralytic 0.06 0.06 0.06 0.06 0.07 Non-paralytic 0.03 0.03 0.02 0.03 0.00 Food Poisoning 0.13 0.16 0.11 0.18 0.00 Puerperal Pyrexia 17.87(a) 23.94(a) 10.22(a) 30.77(a) 12.2(a) Rate per 1,000 Live Births DEATHS. All causes under 1 year of age 27.6(b) 31.2 25.8 23.8 25.0 Enteritis and diarrhoea under 2 years of age 1.1 1.3 0.5 0.7 0.00 (a) Per 1,000 total (Live and Still) Births. (b) Per 1,000 related Live Births. [ 8 ] Maternal Mortality in England and Wales. Intermediate List of No. and cause No. of deaths Rates per 1,000 Total (Live & Still) Births Rates per Million Women aged 15-44 A115. Sepsis of pregnancy, childbirth and the puerperium 61 0.09 A116. Abortion with toxaemia 13 0.02 1 Other toxaemias of pregnancy and the puerperium 147 0.21 A117. Haemorrhage of pregnancy and childbirth 59 009 A118. Abortion without mention of sepsis or toxaemia 31 0.04 3 A119. Abortion with sepsis 47 0.07 5 A120. Other complications of pregnancy, childbirth and the puerperium 138 0.20 [ 9 ] Table showing Summary of Causes of Death registered during the year ended 31st December, 1952. CAUSES OF DEATH Male Female 1. Tuberculosis, respiratory 2 1 2. Tuberculosis, other — — 3. Syphilitic disease — — 4. Diphtheria — — 5. Whooping Cough — — 6. Meningococcal Infections — — 7. Acute Poliomyelitis — — 8. Measles — — 9. Other infective and parasitic diseases — — 10. Malignant neoplasm, stomach 7 2 11. Malignant neoplasm, lung bronchus 10 2 12. Malignant neoplasm, breast — 4 13. Malignant neoplasm, uterus — 3 14. Other malignant & lymphatic neoplasm 14 12 15. Leukaemia, aleukaemia 1 — 16. Diabetes 1 4 17. Vascular lesions of nervous system 8 18 18. Coronary disease, angina 23 15 19. Hypertension with heart disease 1 3 20. Other heart disease 33 19 21. Other circulatory disease 5 2 22. Influenza 1 2 23. Pneumonia 2 1 24. Bronchitis 11 4 25. Other diseases of respiratory system 1 2 26. Ulcer of stomach and doudenum 5 — 27. Gastritis, enteritis and diarrhoea — — 28. Nephritis and nephrosis 2 2 29. Hyperplasia of prostate 2 1 30. Pregnancy, childbirth, abortion — — 31. Congenital malformations 1 2 32. Other defined and ill-defined diseases 12 8 33. Motor vehicle accidents 1 — 34. All other accidents — 1 35. Suicidc 2 1 36. Homicide and operations of war — — All causes Total 145 108 [ 10 ] Births. The 400 live births notified showed an increase of 30 compared with last year's figure. The birth rate per 1,000 of the population is 14.4 as against 13.9 last year. The birth rate for England and Wales was 15.3. Deaths. This year we recorded 253 deaths out of a population of 27,760 representing a death rate of 9.11 against 9.56 in 1951. The death rate for England and Wales was 11.3. Infant Deaths. During the year 10 infants died before reaching the age of one year. There were 8 in 1951. Rate of Infant Deaths under one year per 1,000 live births was 25 as against 20.7 last year. That of England and Wales was 27.6. [ 12 ] Analysis of the causes of Death of Infants at various ages under one year. Causes of Death as Certified DAYS MONTHS * Total under 1 Year 0 — 1 — 2 3 — 4 — 5 - 6 — 7 - 14 - 21 - 28 — 2 — 3 — 4 - 5 — 6 — 7 — 8 — 9 — 10 — 11 - Erythroblastosis 1 1 Broncho Pneumonia 1 1 Anancephaly 1 1 Atelactasis 2 2 Prematurity 2 1 3 Foetal Malformation 1 1 Haemolytic Anaemia 1 1 TOTAL 3 4 1 1 1 10 * During 1952, 10 infants died before reaching the age of one year, of these 9, that is 90% occurred in the neonatal period (within one month of birth), the corresponding figure for 1951 was 50%. PUBLIC CLEANSING. A Joint Scheme is in existance with the Bexley Borough Council for the disinfection of bedding following cases of infectious diseases, tuberculosis and cancer, and for the disinfestation of bedding of verminous persons. In the case of tuberculosis, the service is carried out free of cost. MORTUARY. With reference to the Bexley Mortuary now being used jointly by Crayford, Erith and Bexley, adaptations were completed and the Mortuary opened on the 22nd February, 1952. Previous to the opening, from the 1st January to the 22nd February, 1952, 16 bodies were dealt with at the Crayford Mortuary from the three districts. From the 22nd February to the 31st December, 1952, 126 cases have been dealt with, out of which 123 post mortems and 16 inquests were conducted. 19 of these were from the Crayford area. One inquest was conducted. LABORATORY FACILITIES. The following specimens were sent to the County Laboratory from the District during 1952. Swabs 4 Sputa 72 Faeces 27 Ice Creams 41 Waters (Drinking) 16 Swimming Bath Waters 15 Bacteriological Examinations of Milk 23 Miscellaneous examinations 414 612 PREVALENCE OF AND CONTROL OF INFECTIOUS DISEASES AND OTHER DISEASES. Scarlet Fever. During the year 99 cases were notified. Of these 36 cases were isolated in hospital. The number of cases notified in 1951 was 35. [ 13 ] Diphtheria. There were no cases notified in 1952. Enteric or Typhoid Fever. No cases were notified during the year Puerperal Pyrexia. Five cases were notified during the year. Two more than the previous year's figure. All the cases were from the Russell Stoneham Hospital. One case was removed to Brook Hospital. Meningococcal Infection. One case was notified during the year, the same as in 1951. Food Poisoning. No cases were notified during the year. One case was notified in 1951- Measles. The number of cases notified in 1952 was 357. One caSe was removed to Joyce Green Hospital. The number of cases notified in 1951 was 682. Whooping Cough. 92 cases notified during the year. One case was removed to Joyce Green Hospital. Cases notified in 1951 was 134. Acute Poliomyelitis. 2 cases were notified during the year. Both cases were treated in hospital, and were paralytic. There were no deaths. 2 cases were notified in 1951. Ophthalmia Neonatorim. No cases were notified during the year. Dysentery. Two cases were notified during the year. Four cases were notified in 1951. [ 14 ] Notifiable Diseases (other than Tuberculosis) during the year. Diseases Total cases notified Cases admitted to hospital Deaths Small Pox Scarlet Fever 99 36 — Diphtheria — — — Enteric or Typhoid Fever — — — Paratyphoid Fever 1 1 — Puerperal Pyrexia 5 1 — Pneumonia 17 11 3 Erysipelas 7 — — Meningococcal Infection 1 1 — Measles 357 1 — Whooping Cough 92 — — Ophthalmia Neonatorum — — — Dysentery 2 1 — Scabies — — — Poliomyelitis (Paralytic) 2 2 — Encephalitis — — — Food Poisoning — — — TOTALS 583 54 3 [ 15 ] [ 16 ] Age Groups. Scarlet Fever Diphtheria Whooping Cough Measles (excluding rubella) Ac. Poliomyelitis Paralytic Non Paralytic M F M F M F M F M F M F Under One Year — 1 — — 3 2 I 1 — — — — 1 3 6 — — 7 14 31 23 — — — — 3 15 6 — — 13 14 43 48 — — — — 5 31 28 — — 17 20 108 95 — — — — 10 1 3 — — — — 3 1 — 1 — — 15 2 1 — — — — — 1 1 — — — 25 and over 2 — — — — 1 2 — — — — Age unknown — — — — 1 — — — — — — — Total (All Ages) 54 45 — — 41 51 186 171 1 1 — — Enteric or Typhoid Fever Paratyphoid Fevers Ac. Pneumonia Dysentery Meningococcal Infection Ac. encephalitis lethargica M F M F M F M F M F M F Under 5 Years — — — — 3 4 — — — — — — 5 — — — 1 1 — 1 — — — — — 15 — — — — 3 1 — 1 — — — — 45 — — — — 2 — — 1 — — — 65 and over — — — — 1 2 — — — — — — Age unknown — — — — — — — — — — — — Total (All Ages) — — — 1 8 9 1 1 1 — — — [ 17 ] Age Groups—continued Erysipelas Smallpox Food Poisoning M F M F M F M F Puerperal pyrexia — 5 Ophthalmia neonatorum — — 0 — — — — — — Scabies — — 5 — — — — — — 15 1 — — — — — 45 3 1 — — — — 65 and over I 1 — — — — Age unknown — — — — — — Total (All Ages) 5 2 — — — — [ 18 ] Immunisation against Diphtheria and Vaccination against Smallpox, 1952. The following is a return received from the County Medical Officer of Health of (A) the number of children resident in the Crayford area who were immunised against Diphtheria and (B) the number of persons who were vaccinated against Smallpox during the year ended 31st December, 1952. (A) DIPHTHERIA IMMUNISATION. Year of Birth 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 Total Primary Inoculations 38 207 27 14 9 16 7 5 3 — 2 1 — — — 319 Re-inforcing Inoculations — — — 3 74 259 49 16 14 9 10 4 — — 2 440 (B) VACCINATION. Year of Birth 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 before 1938 Total Primary Vaccination 120 48 2 1 3 3 — — 2 — — 1 — — — 15 195 Re-Vaccination — — I 1 — 1 2 1 2 1 2 — — — — 38 49 The following is a return of the number of children resident in the Crayford area under the age of 15 years on 31st December, 1952, who had completed a course of immunisation at any time before that date (i.e. at any time since 1st January, 1938). Year of Birth 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 Total 143 257 391 241 281 271 526 626 399 411 412 364 315 243 38 4918 Tuberculosis. Age periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F 0 — — — — — — — — 1 — — — — — — — — 5 1 2 — — — 1 — — 15 6 4 — — — — — — —25 4 10 — — — — — — 35 3 2 1 2 — — — — 45 2 — — 1 — — — — 55 2 1 — 1 1 — — — 65 and upwards 1 — — — 1 — — — Totals 19 19 1 4 2 1 — — Chest Clinics. At West Hill Hospital, Dartford, and 65, Bexley Road, Erith. Housing Applicants. Special consideration is given to cases put forward by the Medical Officer of Health involving tuberculosis or other physical disability in the applicants' families and such cases are considered outside the normal points scheme. Cases investigated during the year—31. Applicants recommended for rehousing—6. No. of families granted houses on account of Tuberculosis—9. TUBERCULOSIS AFTER CARE. The Tuberculosis Care Committee, in association with the Kent Council of Social Service, has continued to function satisfactorily during the year. 39 families have been assistedPatients, and their dependents have been provided with clothing, relatives' fares have been paid to enable them to visit patients in sanatoria A holiday was arranged for the wife [ 19 ] and family of a patient after his removal to a sanatorium. A patient rehoused by the Council had her home furnished with the assistance of the County Committee. The cost of repairs to wireless sets has been paid and wireless licences purchased. The Committee has a radio set available for loaning to patients. Occupational Therapy is becoming generally recognised as an aid towards the recovery of patients. The Committee are fortunate in having as Occupational Therapist a teacher of Arts and Crafts from Crayford Manor House Community Centre. Also an advanced student from the same Centre as Assistant Occupational Therapist, both working in a voluntary capacity. Patients have been supplied with materials and also tools where necessary. A hand loom has been purchased and hand loom weaving is now one of the crafts available- The results of the Christmas Seals Sale were most gratifying showing, after deduction of administrative expenses, an increase from £45 14s. 6d. in 1951 to £126 5s. 2d. in 1952. The County Organiser, Health Visitor, Chest Physican and District Officer have given invaluable service to the Committee. MASS RADIOGRAPHY. A Mass Radiography Survey was carried out by Dr. J. M. Morgan of the London Mass Radiography Unit in Crayford from the 7th to the 14th May, 1952. The total number radiographed was 507 men and 657 women. Analysis of abnormal large film showed probable significant new cases of pulmonary tuberculosis for further investigation—5 men and 6 women. WELFARE OF OLD PEOPLE. The Old People's Welfare Committee is now established and becoming more widely known in the District. Liaison Officers have been appointed on a Ward basis, whose duty it is to visit old people in their own homes and to report to the Committee cases of distress found in their respective areas. [ 20 ] The names and addresses of these Officers have been displayed in Public Libraries and this has proved of great value in being the means of co-ordinating the voluntary and statutory services in the area, able to deal with old peoples' personal difficulties. The National Old Peoples Welfare Committee had been asked to approach the Postmaster General for permission to display the names and addresses of these Officers in Post Offices. After discussing the question, the National Old People's Welfare Committee were of the opinion that it would be more useful if the names and addresses of Secretaries of Old People's Welfare Committees were displayed in this way, and agreed to approach the Postmaster General for the necessary permission- There are many old people who are very lonely and appreciate a visitor calling upon them, but there are also many who do not wish to be visited. They do, however, all appreciate knowing where to apply for help when it is needed. Many and varied are the tasks that have been carried out by the Liaison Officers and Visitors who are also members of the Committee, such as regular bathing and bed making for infirm patients, securing domestic help, chiropody, "Meals on Wheels" services, conveying non-ambulant old people by wheel chair to social functions, distributing clothing, letter writing and assisting them with their financial problems. Two of the visitors have on occasions performed the last offices at death. A case was brought to the notice of the Public Health Department of an old lady aged 86 years and her son aged 60 years, who had allowed their home to become extremely dirty and neglected. Their plight was only discovered when the son, who had previously been in regular work, was taken ill. He was found to be lying on a dirty bed with a broken old spring supported by a wooden box. The only bed clothing being dirty old coats. Although the Doctor had visited the old lady, no mention had been made of the son's illness until it was too late to do anything for him, except get him to hospital where he [ 21 ] died two days later. As no relative was available the Health Department made all the arrangements for the funeral and collected the assets due to the old lady in respect of her son. Co-ordination of Services:—The Health Department's Sanitary Inspectors cleared out the old beds and rubbish from the house, St. John's Ambulance Brigade and Nursing Division cleaned up the old lady and provided a bed and mattress, Women's Voluntary Services provided quilts, National Assistance Board blankets, British Legion groceries. Domestic Helps cleaned up the house, Neighbours assisted with the shopping and undertook to see the old lady safely to bed each night and to extinguish the gas. The old lady's physical condition is deteriorating and she is in need of constant attention, but steadfastly refuses to allow her name to go forward for entry into an Old Peoples Home. There are approximately 130 Council Bungalows available for old people in the district, and there are 20 more in the course of erection. A retired nurse gives attention to old people residing in the Council's bungalows in Russell Close. In addition there are two Darby & Joan Clubs functioning through the Women's Voluntary Service, which meet at Manor House Community Centre and for the Slade Green area at the Baptist Church, Elm Road, Slade Green. There are also three old age Pensioners Clubs in the District Close co-operation was maintained with the Kent County Council's District Officer, the National Assistance Board, the Women's Voluntary Service and the St. John's Ambulance Brigade and Nursing Division The Committee is affiliated to the North West Kent Old People's Welfare Committee. Domestic Help. The Kent County Council's Domestic Help Scheme has rendered invaluable assistance to old people. 73 families between the ages of 70 and 90 years have received this assistance during the year. [ 22 ] INSPECTION AND SUPERVISION OF FOOD. Mincemeat. A strong warning letter was sent to a manufacturer of mincemeat consequent to a piece of glass being found in a jar of that product. Semolina. A consignment of semolina was withdrawn from use owing to it being infested with active mites. Beans- Complaint was lodged regarding the presence of foreign matter in a tin of baked beans in tomato sauce. This was ascertained to be metal swarf and the matter taken up with the manufacturers. Meat. A portion of the spinal column of an ox was submitted for examination, but autolysis proved to be too far advanced to allow accurate histological examination. Lamb. A portion of lamb stated to have been the cause of illness in a family, was submitted to the County Pathologist who reported that no pathogenic organisms were isolated. Cheesecakes- Complaint was made by a local restaurant proprietor regarding an unpleasant taste of cheesecakes. Enquiries instituted with the manufacturers established the fact that the taste was due to the presence of a bacterial growth known in the trade as "Rope". The consignment was immediately withdrawn from sale. Banana Curd. Another complaint was made regarding an unpleasant taste in banana curd and this was ascertained to be due to an excess of "banana" flavour in the mixture. The Makers were notified. [ 23 ] Bread. A slice of bread was alleged to contain mouse droppings, but on reference to the analyst these were found to be mould spores, the probable origin of which was dirty dough. Investigation was made at the Bakery and the cause traced to grease from a chain becoming liquidated during hot weather and coming into contact with pieces of dough. The Company issued instructions for regular cleaning of all machinery, and no further trouble was experienced. Warning letters were sent to two manufacturers regardinsects found in bread. In one case the grub was identified as the larva of a beetle—Tenebroides mauritanicus (Cadelle) and in the other—a cochroach. In the latter case the Ministry of Agriculture and Fisheries, Pest Officer, were informed of the matter. Peeled shrimps. Complaints regarding the palatability of shrimps led to the submission for examination of a quantity of these tinned peeled shrimps. Although cultures remained sterile, the tin content was high and rendered the consignment unfit for use and was therefore destroyed. Milk. A strong letter of warning was sent to a dairy after investigation of a complaint regarding a piece of glass contained in a bottle of milk. Ice Cream- One vendor was discovered selling ice cream from unregistrated and unsuitable premises. A subsequent application for registration made by the dealer was refused on the grounds of unsuitability of the premises Milk. Licences granted by the Council under the Milk (Special Designations) (Pasteurised and Sterilised Milk) Regulations, 1949 and 1950. Supplementary:— Tuberculin Tested, 6. Pasteurised, 7. Sterilised, 8. Dealers:— Tuberculin Tested, 4. Pasteurised, 4. Sterilized, 14- [ 24 ] Meat and Other Foods. The following articles were found during the year to be unfit for human consumption. Beef 121½ lbs. Tinned Luncheon Meat 79 lbs. Pork 518½ lbs. Sausage Meat 78 lbs. Tinned Vegetables 68 lbs. Mutton 58 lbs. Tinned Baked Beans 19½ lbs. Lamb 328 lbs. Rabbits (24) 48 lbs. Jam and Marmalade 28 lbs. Offal 44 lbs. Eggs 352 Fruit and Fruit Juices 154½ lbs. Bacon 128½ lbs. Cheese 27½ lbs. Tinned Jellied Veal 14 lbs. Sultanas 32 lbs. Prunes 114 lbs. Tinned Stewed Steak 10 lbs. Flour 39 lbs. Fish 91 lbs. Tinned Soups 5½ lbs. Semolina 59 lbs. Tinned Peeled Shrimps 21 Tins Tinned Fish 7½ lbs. Tinned Pork 38½ lbs. Meat Paste 2 Jars Tinned Ham 122½ lbs. Tinned Milk 23 Tins Tinned Sausages 2½ lbs. Miscellaneous Articles 12 In addition to the above, 3 quarters of beef, 1 lamb and 1 pig carcase considered unfit for ration issue was returned to the Meat Depot for regrading and re-allocation to manufacturers. 1 box of butter was also returned to the wholesalers for salvage. 15 pigs were slaughtered during the year, all carcases being passed as fit for human consumption with the exception of two livers affected with cirrhosis. Keeping of Pigs. An application to keep pigs on land adjoining children's playing fields was refused. The applicant appealed against the decision and a local enquiry was arranged in conjunction with the Ministry concerned, but the application was withdrawn before the appeal was heard. [ 25 ] FOOD AND DRUGS ACT, 1938. Details of Samples taken by the County Sampling Officer within the Urban District of Crayford during the year ended 31st December, 1952. Article. No. Aspirin B.P. 2 Aspro 1 Baby Cream 1 Bi-carbonate of Soda 1 Butter Mixture 1 Butterscotch 1 Castor Sugar 1 Cephos 1 Cheese 1 Cherry Cough Balsam 1 Concentrated Beef Soup 1 Dried Milk Powder 1 Extract of Malt with Cod Liver Oil 1 Fancy Crabmeat 1 Flaked Tapioca 1 Gin 1 Glycerine, Lemon and Ipecac. Mixture 1 Golden Butter Mints 1 Golden Sweet Tobacco 1 Hard Herring Roes 1 Ice Cream 2 Iodised Table Salt 1 Iodised Throat Tablets 1 Kilkof 1 Lard 1 Laxative Syrup of Figs 1 Liniment 1 C/fd. 9 Article. No. B/f. 29 Liquid Paraffin B.P. 1 Luncheon Meat 1 Lung Syrup 2 McLean Stomach Powder 1 Meat Pie 1 Milk 21 Minced Beef 2 Mother Siegal's Digestive Syrup 1 Olive Oil B P. 1 Parrish's Chemical Food 1 Pepper Flavoured Condiment 1 Pickled Red Cabbage 1 Pork Sausage 1 Processed Peas 1 Rhubarb in Syrup 1 Rum 2 Saccharin 1 Self-raising Flour 1 Stewed Steak 4 Table Jelly 2 Talcum Powder 1 Tea 2 Tots 1 Vegetable Salad 1 Victoria Plums in Syrup 1 Vienna Sausages 1 Whisky 3 White Pepper 1 Total 87 [ 26 ] SUMMARY. Milks 21 Drugs 19 Spirits 6 Other samples 41 87 All the above samples were genuine with the exception of the following:— Sample of Analysis Action taken Butter Mixture Fat 3.1% of which not more than 1.3% is butter fat. Manufacturer cautioned. Minced Beef Fat 48.9% Protein 12.6% Moisture 38%,. Very fat indeed but just within the recorded figures for beef. Further sample taken and found to be genuine. BYELAWS UNDER SECTION 15 OF THE FOOD AND DRUGS ACT, 1938. Under this Section three traders were warned for contravening the Byelaws, but it was not found necessary to take statutory action. CLEAN FOOD CAMPAIGN. The work in connection with the Clean Food Campaign has now reached the stage when the membership plaques can be issued to those applicants whose premises and food handling methods comply with the standards laid out in the Codes of Practice. Altogether in Crayford 18 applications for membership were received during the year, 5 of which were registered for membership- It must be emphasised that the value of a Clean Food Campaign should not be judged entirely on the number of applications received or the number admitted to membership. If such was the case we would have to admit that unless there was a 100% membership, most Campaigns would have to be written off as failures. The main thing to remember is [ 27 ] that through its educational value and its psychological effect any campaign, regardless of membership numbers, is worth while because one learns from experience that, within the food trades, there is the desire and the will to improve standards, and although there are shop premises structurally unsuitable for the proper storage and handling of food, it is pleasing to note that many occupiers of such, by cleanliness in personal habits, refrigerated storage, covered display containers, etc, are carrying out to the best of their ability the message conveyed by clean food campaigners:—Geanliness in food handling. ATMOSPHERIC POLLUTION. For some years Crayford and its adjoining districts have been concerned at the excessive amount of atmospheric pollution caused by industrial plants in the surrounding neighbourhood, particularly that of cement dust As a result of an inaugural meeting of representatives of several districts held at Dartford in July of 1952, it was resolved to form "The Thameside Advisory Committee for the Abatement of Atmospheric Pollution". The objects of the Committee are as follows:— (a) The prevention and abatement of atmospheric pollution in the area from time to time covered by the Committee. (b) The collection, consideration and dissemination of information with regard to atmospheric pollution. (c) The stimulation of action by local authorities, Government Departments, industrial and commercial undertakings and factories, and others, to bring about the prevention and abatement of atmospheric pollution. / (d) The making of representations with regard to atmospheric pollution to local authorities, Government Departments, industrial and commercial undertakings and factories, and others. (e) To expend monies in connection with any purpose concerning atmospheric pollution and its prevention, or abatement or control. [ 28 ] Represented on the Committee are the following districts. Borough — Dartford. Urban Districts — Crayford, Northfleet and Swanscombe. Rural Districts — Dartford. The constitution of the Committee allows for the area of representation to be extended, and it is anticipated that in due course other districts in the area will seek representation on the Committee. The Control of Rodents and other Pests- During the year the following infestations were dealt with:— Rats 144, Mice 44. Wasps 10, Woodworm 12, Miscellaneous 3. HOUSING STATISTICS. (1) Inspection of Dwelling-Houses. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 288 Number of inspections made for that purpose 1751 (2) Number of dwelling-houses (included under sub-heading (1) above which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 14 Number of inspections made for that purpose 56 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 11 (4) Number of dwelling-houses (exclusive of those referred to under the preceding subheading) found not to be in all respects reasonably fit for human habitation 214 (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 Local Authority or their Officers 246 [ 29 ] (3) Action under Statutory Powers during the year. Statutory Notices under Housing or Public Health Acts 9 1 (3) Number of dwelling-houses in respect of which demolition orders were made - Number of dwelling-houses demolished in pursuance of demolition orders 5 By agreement with owner 2 Parts of buildings closed 3 Total number of houses owned by local authority Number of houses built during the year:— 1738 (a) by the Local Authority 58 (b) by other bodies or persons 18 (4) Housing Act, 1936, Part IV.—Overcrowding. Whilst it is known from the particulars supplied by housing applicants that overcrowding does exist it is impossible to state the extent of such overcrowding. SANITARY CIRCUMSTANCES OF THE AREA. Water. The Metropolitan Water Board is the supplying authority. The supply to the Crayford district is a mixture of water from Crayford, Dartford, Darenth, Wansunt and Wilmington wells. All the water is chlorinated on the works, but, any excess remaining after a period of contact is removed completely before the water is passed into supply. Bacteriological analyses are carried out at least five times per week for all supplies both before and after chlorination. All new and repaired mains are chlorinated before being restored to use and samples of water from them are tested to see that the quality conforms with that normally supplied before the main is passed for service. None of the supplies is plumbo-solvent. Water Sampling. The following samples were sent to the County Laboratory by the Council's Sanitary Inspectors. [ 30 ] Samples of water taken by the Department and forwarded to the County Laboratory for bacteriological examination have all been reported satisfactory except one. This was stored water and the tank was in need of cleansing. Samples forwarded after cleansing were reported satisfactory. (a) Wells (drinking water). Bacteriological 8. (b) Swimming Pool, Bacteriological 15. (c) Domestic Supplies, Bacteriological 6. Water Supply. Approximately 76 new houses were connected to existing water mains at Housing Schemes 22 and 31 (Slade Green), and privately built houses. Drainage and Sewerage. Approximately 76 new houses were connected to existing sewers at the above mentioned schemes, and private houses. Housing Plans. The building of houses is in progress at Scheme 37 (North End, Erith) and when completed the scheme will provide 286 living units. Rivers and Streams. The normal annual maintenance work was carried out on the ditches, water-ways and rivers, in the District. Closet Accommodation. Approximate number of premises containing each type of sanitary convenience in the district:— W.C's. into drainage system, approximately 10,000 W.C's. into Cesspools 16 Number of premises not connected to public water supplies 0 Refuse Collection. A seven day collection of refuse was maintained under the same system as previously. [ 31 ] Sanitary Inspection of the Area. No. in district No. of visits in 1952 No. of faults and defects found No. of faults and defects remedied Bakehouses 1 4 0 0 Milk Shops 2 51 0 0 Other food-preparing places, which are, as such, subject to inspection 54 618 4 3 Nuisances and defects remedied during the year (other than those enumerated in the previous tabulation). Overcrowding 2 Sanitary Accommodation : Defective 24 Drainage: (i) Repaired 93 (ii) Cleansed 328 Refuse Receptacles 28 Dampness 54 Roofs and Rain Water Pipes 65 Smoke Nuisances 3 Floors 213 Walls and Ceilings 302 Baths, Lavatory Basins and Sinks 5 Water Supplies 13 Doors and other woodwork 47 Windows and Ventilation 35 Accumulation of Refuse 7 Other works 23 Total number of visits of all kinds paid by Inspectors during the year 7863 Approximate number of rated premises in the area 8503 Notices served:— Statutory 10 Informal 217 Number of houses, etc., disinfected 78 Swimming Pool. Period open from the 10th May, to the 14th September. Number of bathers 36,092. This figure does not include School Parties and Clubs. [ 32 ] Shop Acts. Visits made during the year 234. Smoke Abatement No action taken. Eradication of the Bed Bug. Particulars of the action taken in 1952 for the eradication of the Bed Bug are as follows:— Number of Infested Disinfested Council Houses 12 12 Other Houses 4 4 Prescribed particulars on the administration of the Factories Act, 1937. 1. Inspections for purposes of provisions as to health (including inspections made by Sanitary 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 14 18 1 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 58 150 4 (iii) Other Premises in which Section 7 is enforced by Local Authority (excluding outworkers' premises) 13 19 — — TOTAL 85 187 5 — [ 33 ] 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 Inspector By H.M. (1) (2) (3) (4) (5) (6) Want of cleanliness (S. 1) — — — — — Overcrowding (S.2) Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7) (a) Insufficient — — — — — (b) Unsuitable or defective 4 3 — 2 — (c) Not separate for sexes — — — — — Other offences (not including offences relating to Outwork) 1 1 — — — TOTAL 5 4 — 2 — [ 34 ] (Sections 110 and 111). OUTWORK. Part VIII of the Act. Section 110 Section 111 Nature of Work No. of out-workers in August list required by Sect. 110 (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. Wearing Apparel, Making, etc. 11 — — — — — [ 35 ]