CRA 19 Urban District of Crayford Annual Report OF THE Medical Officer of Health For the Year 1954 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 1954 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, J.P. Members : Councillors : Miss M. Barrand. H. E. Clark. J. Nokes. L. Riches. Councillors : Miss L. M. Rodgers. J. W. Taylor. Mrs. I. Walker. Mrs. E. White. Co-opted Members: Mrs. E. Fatharley. Mrs. E. Hayward. Mr. H. Spaull. Public Health Staff. Medical Officer of Health : John Landon, M.R.C.S., L.R.C.P., D.P.H. (Joint appointment with Boroughs of Bexley and Erith). Senior Sanitary Inspector : *†‡R. Milligan, Cert.R.San.I., M.S.I.A. District Sanitary Inspector: *†A. W. Kent, M.R.S.I., M.S.I.A. Chief Clerk: E. T Shutte. Shorthand Typist/Clerk : Mrs. M. H. Travis. Rodent Operator : W. McCulla. * Certificate for Inspection of Meat and other foods. † Shops Acts Inspector. ‡Rodent Officer. [ 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 1954. The assessment of the health of the District is based on a judicious mixture of knowledge and opinion. The former is represented by the vital statistics relating to births, deaths and infectious disease which are compiled in the Health Department and are collated by the General Register Office to allow for comparison with the country as a whole; the latter is based on personal observation and on information reaching the Department from doctors, sanitary inspectors, health visitors, voluntary organisations and the Press. In a highly developed modern community enjoying the benefits of over a 100 years of Public Health one can no longer be content to regard health as the mere absence of infectious or other recognisable disease, although this was the case during the many decades when the amelioration of the external environment was the main preoccupation of the Health Services. This is not to suggest that all the environmental hazards have been removed, and indeed this is far from being the case. It is true that we now have a pure water supply which has almost totally eliminated the diarrhoeal diseases, but we are still confronted with the perils of atmospheric pollution, of the chemical sophistication of much of our food and of a host of less obvious but equally insidious causes of loss of health, happiness and efficiency including those resulting from industrial mechanisation and sociological changes affecting work, recreation and personal objectives. In other words, the state of a modern civilised community must be judged far more from the viewpoint of its mental health than was considered necessary, or even possible, in earlier days. We have no statistics to measure the mental health of the people nor the amount of sub-normal health in general resulting in a departure from that functional "wholeness" which is the essence of health and, while it is true that such philosophical speculations may lead one into fields far removed from the [ 3 ] conventional activities of the older public health they are, nevertheless, an important part of the newer social medicine. It is necessary to point this out before proceeding to examine some of the statistical pointers to the health of the District. The birth rate for 1954 was 13.9 per thousand of the population compared with 14.6 per thousand in 1953, and represents the lowest birth rate ever recorded in the District. Thus the downward trend is still in evidence. The standardised birth rate, which allows for comparison with other parts of the country, is 13.3, but the rate is well below that for England and Wales which was 15.2 it looks as if we may have to regard a low birth rate as a permanent feature of our modern society. When this is coupled with a low death rate and a greater expectation of life, the result can only be an ageing population with the many social and industrial problems which that must bring. The death rate for the District fell still further to 8.06 per thousand of the estimated home population compared with 9.8 in 1953, and a rate of 11.3 per thousand for England and Wales. The two main causes of death, as in recent years, were diseases of the heart and blood vessels and cancer, the latter including 16 deaths from cancer of the lung. The prevention of cancer is one of the greatest public health tasks of the future and may well be, in part, wrapped up with a Clean Air policy as fore-shadowed by the Beaver Report. Since we are mortal and must die of something, the best we can hope for is that life should come quietly and peacefully to an end without the intervention of any preventable catastrophe in which category at least some forms of cancer probably fall. The infant mortality rate for 1954, that is the number of children dying in the first year of life for every thousand live births, was 10.1 per thousand against 24.5 per thousand in 1953. This is the lowest rate ever recorded in Crayford. but what is even more important is that the overall trend of infant mortality is favourable and there are bound to be annual variations which are to some extent due to the small numbers with which we are dealing. Although there were 399 total births during the year, there were no maternal deaths. This is a fine record and speaks well for the obstetrical services in the area and for the standard of ante-natal care available for the expectant mother. [ 4 ] The incidence of infectious disease was again very low. Once again no case of diphtheria occurred but it is still very necessary that mothers should not fail to have their children immunised as only thus can a continued freedom from this disease be ensured. Two paralytic cases of poliomyelitis occurred in the District compared with none in the previous year. The number of cases of tuberculosis during 1954 was 39 compared with 45 during 1953. The number of deaths, however, was only 4 as against 11 in 1953. A comparison of notifications and deaths over the past 10 years is in keeping with the national tendency for deaths from this disease to decrease at a greater rate than notifications. In other words, the curative services are tending to outstrip the preventive services and very much more needs to be done to track down the infectious cases within the community and to lessen the chances of infection of susceptible persons. During the year a survey was commenced in accordance with Section 1 of the Housing Repairs and Rents Act, 1954, to ascertain how many houses would require to be demolished within the next five years and it was found that the number of obviously unfit houses was relatively small as was to be expected in an area in which so much housing development took place between the two wars. The demolition of these houses will not, necessarily, be followed by 100% replacement on the cleared sites as some of these may be considered unsuitable for new houses. The rehousing of these tenants may, therefore, be a matter of some difficulty but it is hoped that the rate of demolition will be such as to allow for the assimilation of such families into the Council's rehousing programme in general. The Clean Food Campaign continued to make real, if not spectacular progress, and at the time of writing 156 plaques have been awarded by the Bexley, Erith and Crayford Clean Food Traders' Guild. Far more could, no doubt, be achieved if the necessary staff were available, and, indeed, this applies to Health Education in general. A good case could be made for the appointment of a Health Education Officer to serve an area sufficiently large to provide sufficient scope for activity. The work of the Bexley, Erith and Crayford Home Safety Committee is gaining momentum and will, undoubtedly, increase the scope of its activities in the near future. Our thanks are due to the Woolwich and Dartford Hospital [ 5 ] Management Committees for providing statistics of home accidents treated at hospital over the past year. These emphasise the need for the instruction of the public in the causes of these accidents and the methods by which they may be prevented. The Old Peoples' Welfare Committee, now on a voluntary basis but sponsored originally by the Crayford Urban District Council, has done excellent work in alleviating the lot of many old people by friendly help, by assistance in kind when necessary, by making arrangements for inexpensive holidays and in other ways. Their work to some extent coordinates and is complementary to that of the many old peoples' organisations in the District providing clubs and other recreational facilities. The work of these voluntary organisations is invaluable to the old people in the area. In conclusion, I wish to thank the Chairman and 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 devoted service 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 1954) 28,150 Number of inhabited houses 8,796 Rateable Value £198,143 Sum represented by a penny rate £812 Live Births. Total M. F Legitimate 378 184 194 Illegitimate 16 10 6 394 194 200 Birth rate per 1,000 of the estimated home population 13.9. General birth rate for England and Wales 15.2. [ 6 ] Stillbirths. Total .M. F. Legitimate 5 1 4 Illegitimate — — — 5 1 4 Rate per 1,000 total (live and still) births 15.03. Total M. F. Deaths 227 119 108 Death rate per 1,000 of the estimated resident population 8.06. 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 Registrar General has supplied comparability factors for 1954. The standardised Birth Rate which allows for comparison with other parts of the Country is 13.3 and the standardised Death Rate is 9.67. Maternal Deaths :— There were no Maternal Deaths in 1954. Deaths of Infants under one year of age:— Total M. F. Legitimate 4 2 2 Illegitimate — — — 4 2 2 Rate per 1,000 live births (Crayford) 10.15. Rate per 1,000 legitimate live births 10.05. General death rate of infants under 1 year of age for England and Wales 25.5. Deaths from Various Causes. Malignant Neoplasm (all ages) 50 Measles (all ages) — Whooping Cough (all ages) — Diarrhoea (under 2 years of age) 1 [ 7 ] [ 8 ] Vital Statistics during 1954 and previous years. Year Population LIVE BIRTHS DEATHS INFANT DEATHS No. C.U.D.C. RATE No. C.U.D.C. RATE No RATE C.U.D.C. Eng. & W. 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 21,190 507 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 1953 27,820 407 14.6 15.5 273 9.8 11.4 10 24.5 26.8 1954 28,150 394 13.9 15.2 227 8.06 11.3 4 10.1 25.5 * Instructions were issued by the Registrar General for these particular years, giving certain alternative figures for calculation of these statistics. SUMMARY OF VITAL STATISTICS. England & Wales Crayford U.D.C. Rates per 1,000 Home Population BIRTHS. Live Births 15.2 13.9 Stillbirths 0.36 .17 23.4(a) 15.03(a) DEATHS. All Causes 11.3 8.06 Typhoid and paratyphoid 0.00 — Whooping Cough 0.00 — Diphtheria 0.00 — Tuberculosis 0.18 .17 Influenza 0.05 — Smallpox — — Acute Poliomyelitis (including Polioencephalitis) 0.00 — Pneumonia 0.48 .21 NOTIFICATIONS (Corrected) Typhoid Fever 0.00 — Paratyphoid Fever 0.01 — Meningococcal Infection 0.03 .03 Scarlet Fever 0.97 .67 Whooping Cough 2.39 8.4 Diphtheria 0.00 — Erysipelas 0.12 .07 Smallpox — — Measles 3.32 .27 Pneumonia 0.60 .67 Acute Poliomyelitis (including Polioencephalitis) Paralytic 0.03 .07 Non-paralytic 0.01 .03 Food Poisoning 0.20 .03 Puerperal Pyrexia 17.74(a) 27.5(a) Rates per 1,00 0 Live Births deaths. All causes under 1 year of age 25.5(b) 10.15(b) Enteritis and diarrhoea under 2 years of age .8 — (a) Per 1,000 total (Live and Still) Births. (b) Per 1,000 related Live Births. [ 9 ] MATERNAL MORTALITY. England & Wales Crayford U.D.C. Rates per 1,000 Total Live and Still Births MATERNAL MORTALITY. Maternal causes excluding abortion 0.58 Due to abortion 0.11 — Total maternal mortality 0.69 — [ 10 ] Table showing Summary of Causes of Death Registered during the year ended 31st December, 1954. CAUSE OF DEATH Male Female 1. Tuberculosis, respiratory 3 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 1 1 10. Malignant neoplasm, stomach 6 2 11. Malignant neoplasm, lung bronchus 14 2 12. Malignant neoplasm, breast — 4 13. Malignant neoplasm uterus — 3 14. Other malignant and lymphatic neoplasm 7 12 15. Leukaemia, aleukaemia 2 — 16. Diabetes — 3 17. Vascular lesions of nervous system 8 22 18. Coronary disease, angina 21 6 19. Hypertension with heart disease 6 6 20. Other heart disease 14 20 21. Other circulatory disease 6 4 22. Influenza — — 23. Pneumonia 3 3 24. Bronchitis 8 5 25. Other diseases of respiratory system 1 — 26. Ulcer of stomach and duodenum 2 1 27. Gastritis, enteritis and diarrhoea — 2 28. Nephritis and nephrosis — — 29. Hyperplasia of prostate 4 — 30. Pregnancy, childbirth, abortion — — 31. Congenital malformations — 2 32. Other defined and ill-defined diseases 5 8 33. Motor vehicle accidents 2 — 34. All other accidents — 1 35. Suicide 6 — 36. Homicide and operations of war — — ALL CAUSES TOTAL 119 108 [ 11 ] Births. The 394 live births notified showed a decrease of 13 compared with last year's figure. The birth rate per 1,000 of the population is 13.9 against 14.6 last year. The birth rate for England and Wales was 15.2. Deaths. This year we recorded 227 deaths out of a population of 28,150 representing a death rate of 8.06 against 9.8 in 1953. The death rate for England and Wales was 11.3. Infant Deaths. During the year 4 infants died before reaching the age of one year There were 10 in 1953. Rate of Infant Deaths under one year per 1,000 live births was 10.1 as against 24.5 last year. That of England and Wales was 25.5. [ 12 ] [ 13 ] Analysis of the causes of Death of Infants at various ages under one year. Cause of Death as Ceriified 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 — Congenital Abnormality of spinal cord 1 1 Atelactasis 1 1 1 3 TOTAL 1 1 2 4 During 1954, 4 infants died before reaching the age of one year, and all of these occurred in the neonatal period (within one month of birth). DISINFECTION SERVICE. A Joint Scheme is in existence 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. The Mortuary at Bexley is being jointly used by the Boroughs of Bexley and Erith and the Urban District of Crayford. In 1954, 122 cases were dealt with, out of which 114 post mortems and 22 inquests were conducted. 17 were from Crayford and from this latter figure 16 post mortems and 4 inquests were conducted. LABORATORY FACILITIES. The following specimens were sent to the County Laboratory from the District during 1954. Swabs 1 Sputa 63 Faeces 8 Bacteriological Examinations of Milk 29 Ice Creams 40 Water (drinking) 17 Swimming Bath Waters 9 Miscellaneous examinations 258 425 PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES AND OTHER DISEASES. Scarlet Fever. During the year 19 cases were notified. Of these 3 cases were isolated in hospital. The number of cases notified in 1953 was 36. [ 4 ] Diphtheria. There were no cases notified in 1954. Paratyphoid or Typhoid Fever. No cases were notified during the year. Puerperal Pyrexia. Eleven cases were notified during the year. Ten cases were from the Russell Stoneham Hospital. One case was removed to the Brook Hospital, one to the West Hill Hospital and one to Joyce Green Hospital. Meningococcal Infection. One case was notified during the year, the same as in 1953. Food Poisoning. One case was notified during the year. Measles. The number of cases notified in 1954 was 8. One case was removed to Joyce Green Hospital. The number of cases notified in 1953 was 174. Whooping Cough. 238 cases were notified during the year. The number of cases notified in 1953 was 41. Acute Poliomyelitis. There were three cases notified in 1954. Two of these were Paralytic cases and treated in hospital. Ophthalmia Neonatorum. No cases were notified during the year. Dysentery. No case was notified during the year. One case was notified in 1953. [ 15 ] Notifiable Diseases (other than Tuberculosis) during the year. Diseases Total cases notified Cases admitted to hospital Deaths Small Pox Scarlet Fever 19 3 — Diphtheria — — — Enteric or Typhoid Fever — — — Paratyphoid Fever — — — Puerperal Pyrexia 11 3 — Pneumonia 19 13 — Erysipelas 2 — — Meningococcal Infection 1 1 — Measles 8 1 — Whooping Cough 228 — — Ophthalmia Neonatorum — — — Dysentery — — — Scabies — — — Poliomyelitis (Paralytic) 2 2 — Poliomyelitis (Non-paralytic) 1 — — Encephalitis — — — Food Poisoning 1 — — TOTALS 292 23 — [ 16 ] [ 17 ] 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 10 8 1 _ 1 1 — — — 19 26 2 1 — — — — 3 2 1 — — 30 34 2 1 — — — — 5 4 7 — — 32 43 1 – 1 — — — 10 2 1 — — 11 11 – – – – – – 15 – – – – 1 – – – – – – – 25 and over — — — — 2 1 — – 1 — 1 — Age unknown — — — — — — — – — — — — Total (All Ages) 9 10 – – 105 123 5 3 2 – 1 – Enteric or Typhoid Fevers Paratyphoid Fever Ac. Pneumonia Dysentery Meningococcal Infection Ac. encephalitis lethargica M F M F M F M F M F M F Under 5 Years _ – – 2 1 – – – 1 – – 5 — — — — 3 1 – – – – – – 15 — — — — 3 2 – – – – – – 45 — — — — 1 1 – – – – – – 65 and over — — — — 1 4 – – – – – – Age unknown – – – – – – – – – – – – Total (All Ages) – – – – 10 9 – – – 1 – – [ 18 ] Age Groups—continued Erysipelas Smallpox Food Poisoning M F M F M F M F Puerperal pyrexia — 11 0 — — — — — — Ophthalmia neonatorum Scabies 5 — — — — — — 15 1 — — — — — 45 — 1 — — — — 65 and over — — — — — — Age unknown — — — — — 1 Total (All Ages) 1 1 — — — 1 [ 19 ] Immunisation against Diphtheria and Vaccination against Smallpox, 1954. 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, 1954. (A) DIPHTHERIA IMMUNISATION. Year of Birth 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 Total Primary Inoculations 42 209 18 5 8 9 5 2 2 2 — 1 — — 303 Re-inforcing Inoculations — — — — 50 196 31 8 14 23 22 54 2 — — 400 (B) VACCINATION. Before Year of Birth 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1940 Total Primary Vaccination 159 90 3 4 2 1 1 1 1 10 272 Re-Vaccination — — 1 — — 1 - 2 - 1 - - — — 1 23 29 The following is a return of the number of children resident in the Crayford area under the age of 15 years on 31st December, 1954, who had completed a course of immunisation at any time before that date (i.e., at any time since 1st January, 1940). Year of Birth 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 195' 1 Tatal Last complete course of injections (whether primary or booster) 1950—1954 31 33 95 l?1 140 778 346 401 368 446 337 765 75? 248 47 3,403 1949 or earlier 193 259 194 114 137 61 2 16 56 13 - - - - - 1.045 Tuberculosis. Age pei iods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 5 years 1 3 — 1 — — — — 5 — 2 — — — — — — 15 1 4 — — — 1 — — 25 11 4 — — — — — — 45 7 — 1 2 — — — 65 and over 2 1 — 1 1 — — — Totals 22 14 — 3 3 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—17. Applicants recommended for rehousing—Nil. No. of families granted houses on account of Tuberculosis—3. CRAYFORD TUBERCULOSIS CARE COMMITTEE. The Crayford Tuberculosis Care Committee in association with the Kent Council of Social Service has continued to function during the year. The number of cases assisted was 33. Clothing, coal supplies and fares to visit relatives in Sanatoria had once again formed the bulk of the assistance given by the Committee. This number was somewhat lower than last year and it is to be hoped that the decrease in the number of applications for assistance is a good sign. [ 20 ] Occupational Therapy continues to progress satisfactorily, and it was felt that this aspect of the Committee's work was well worthwhile. The result of the Christmas Seals Sale, after deduction of administrative expenses, amounted to £106 18s. 3d. The County Organiser, Health Visitor, Chest Physician and District Officer have given invaluable service to the Committee. MASS RADIOGRAPHY. A Mass Radiography Survey was carried out by the South East London Mass Radiography Unit in the Crayford Urban District from the 11th February to 3rd March, 1954. The total number radiographed was 1,318 men and 1,942 women. Analysis of abnormal large film showed probable significant new cases of pulmonary tuberculosis for further investigation—11 men and 10 women. WELFARE OF OLD PEOPLE. This has continued to provide an increasing demand on the services of the Health Department and the Crayford Old Peoples Welfare Committee during the year. Many cases brought to the notice of the Department by the Committee Visitors and otherwise discovered, have been visited by the Medical Officer of Health and Sanitary Inspectors. Arrangements have been made for entry into Old Peoples Homes where this has been possible. The Visiting Service carried out by the Crayford Old Peoples Welfare Committee has continued to flourish. Help has been given to the old folk with clothing and small home comforts, gifts of tea and sugar. Two wheelchairs, one purchased by the Committee and one donated to the Committee during the past year both for the purpose for loaning out to old people, have been used extensively. Many services have been rendered to elderly people and in this connection much assistance had been given by other Voluntary Organisations to the Old Peoples Welfare Committee. Last offices have been carried out by Visitors. Following the Committee's decision to operate a holiday scheme in conjunction with those at present operating in many coastal resorts, arrangements were made for some 63 [ 21 ] persons to spend a week at the seaside. In this particular instance the old folk paid for the cost of their accommodation (at the specially reduced rates) and the Committee provided for the cost of transport and concession tickets. Close co-operation was maintained with the Kent County Council's District Officer, the National Assistance Board, the Women's Voluntary Service, the St. John Ambulance Brigade and Nursing Division and Red Cross. The Committee is affiliated to the North West Kent Old Peoples Welfare Committee. INSPECTION AND SUPERVISION OF FOOD. The inspection of food plays an important part in the activities of the Health Department, and regular visits are paid to all food premises, particular attention being paid to those premises where food is prepared for sale. In this connection a total of 756 inspections were carried out, 355 of which were to premises registered under Section 14 of the Food & Drugs Act, 1938. The number of food premises in the area is as follows:— Bakers 5; Grocers 49; Butchers 18; Fish Shops 9; Confectioners 19; Cafes and Canteens 27; Public Houses serving meals 5. Under Section 14 of the Food & Drugs Act, 1938, 60 premises are registered for the storage and sale of Ice Cream and 41 for the manufacture or preparation of preserved food intended for sale. The following complaints were received and dealt with during the year :— Bread. A complaint was received regarding foreign matter found in a loaf of bread. Upon investigation this proved to be insect lava and a warning letter was forwarded to the manufacturers. In another instance, a complaint was received regarding the condition of a loaf of bread. A portion of the bread was sent for examination and was found to contain charred vegetable oil from the outside of a baking tin. The matter was taken up with the suppliers and more stringent precautions demanded. [ 22 ] Milk. The condition of a milk bottle reported to have a dirty internal surface was investigated and taken up with the suppliers. It was ascertained that the bottle in question was a new one and the appearance of the internal surface was due to "manufacturer's dust". A warning letter was sent to the dairy concerned. Pork. On request pieces of pork were forwarded to the County Analyst to ascertain the reason for an unusual staining. This was due to blood. Cocoanut Squares. A complaint of the unpalatable nature of this product resulted in a sample being forwarded to the County Analyst, and his report was that rancidity had developed to such a degree as to render the article unfit for food. Only a small quantity was involved as it was from old stock, and this was withdrawn from sale and destroyed. Corned Beef. A complaint by a retailer concerning a piece of solder in a tin of corned beef was investigated. This proved to be an isolated case but nevertheless the matter was taken up with the distributors seeking their co-operation to prevent a recurrence of the matter. Meat and Other Foods. The following articles were found during the year to be unfit for human consumption :— Beef 53 lbs. Pork 23 lbs. Rabbit 60 lbs. Chicken 39 lbs. Offal 46 lbs. Dried Egg 9 lbs. Cheese 10½ lbs. Fish 84 lbs. Tinned Fish 7¾ lbs. Cooked Ham 33 lbs. Tinned Milk 6½ lbs. Tinned Luncheon Meat 20½lbs. Potted Meat ll½lbs. Sponge Mixture 33 lbs. Tinned Peas 5 lbs. Butter Beans 10½ lbs. Beetroot 7 lbs. Jam and Marmalade 6 ¼lbs Fruit and Fruit Juices 188½ lbs. Corned Beef 38½ lbs. Tinned Soup 19 lbs. Sauce 33½ lbs. Pickles 36½ lbs. Miscellaneous Articles 70½ lbs. [ 23 ] The bulk of the food condemned was unfit for salvage and had to be destroyed, but where possible, it is the practice to use condemned food for animal feeding. Slaughterhouses. There are no Government slaughterhouses in the area, but one existing slaughterhouse was used for cottagers pigs slaughtered under licence. 3 pigs were examined and all found to be fit for human consumption. Milk. Licences granted by the Council under the Milk (Special Designation) Regulations, 1949/1953. Supplementary :— Tuberculin Tested 8 Pasteurised 8 Sterilised 10 Dealers Tuberculin Tested 7 Pasteurised 7 Sterilised 29 29 samples of milk were submitted to the County Laboratory as follows :— Tuberculin Tested Pasteurised 8 Pasteurised 11 Sterilised 10 All satisfied the prescribed tests. ICE CREAM (HEAT TREATMENT) REGULATIONS 1947—1952. There is only one manufacturer of ice cream in the area, and as a complete cold mix is used, heat treatment is not necessary. 39 samples of ice cream submitted for examination during the year were graded as follows :— Grade I 36 Grade III 3 [ 24 ] FOOD AND DRUGS ACT, 1938—1950. Details of samples taken by the County Sampling Officer within the Urban District of Crayford during the year ended 31st December, 1954. Article. No. Article. No. Antacid Analgesic 1 B/fd. 31 Arrowroot 1 Ground Rice 1 Beef Sausages 1 Halibut Oil Capsules 1 Benzac 1 Iced Lolly Special 1 Best Bitter Beer 1 Juice of Real Lemons 1 Butter 1 Kompo 1 Butter Fishes 1 Laxative Vegetable 1 Buttered Chocolate 1 Lemon 1 Buttermint Lumps 1 Lyonzade 1 Butterscotch 1 Malt Vinegar 1 Cake Mix 1 Mild Beer 1 Cheese 1 Milk 21 Cheese Spread 1 Milk Caramels 1 Chiklet 1 Milk Powder 1 Cocoa 1 Mixed Jam and Frui Pudding 1 Coffee 1 Complevite 1 Nulacin 1 Concentrated Tomato Paste 1 Orange 1 Pile Herbs 1 Cooking Fat 1 Pure Orange Juice 1 Curiously Strong Raspberry Leaf Tea 1 permints 1 Reffell's Best Bitter Bee 1 Cut Mixed Peel 1 Rum 1 Danish Blue Cheese 1 Scotch Shortbread Mix ture 1 Devon Biscuits ing butter and eggs 1 Shredded Beef Suet 1 Double Cream 1 Single Cream 1 Edam Cheese 1 Sterilised Cream 1 Epsom Salts B.P. Stoned Dates 1 Essence of Coffee and and Chicory 1 Tea Veno's Lightning Cough Cure 1 Fruit Salts 1 Fynbred 1 Zinc and Castor Oi Cream B.P. 1 Golden Marzipan 1 C/fd. 31 82 [ 25 ] SUMMARY. Milks 21 Drugs 16 Spirits 4 Other samples 41 82 All the above samples were genuine with the exception of the following :— Sample of Analysis Action taken Butterscotch 2% butter fat Written caution issued Buttermint Lumps 3.6% butter fat. Should be 4.0% Written caution issued Butter Fishes 1.9% butter fat. Should be 4.0% Written caution issued Devon Biscuits containing butter and eggs Fat 22.5% includ ing 4.2% butter fat. Egg not detected. Is deficient in egg and possibly in butter Makers notified. Methods of manufacture checked. Further samples satis factory. Milk Caramels Fat 12.1% including not more than 1 % butter fat. Non fatty milk solids 4.0% Total milk solids 5% (Should be 10%) Under investigation Nulacin Magnesium trisilicate not more than 3 gr. per tablet (claim 3.5) Manufacturers notified. Necessary investigation being made. Scotch Shortbread mixture Wheat flour containing 21.2% sugar, etc. Shortbread contains much fat. This shortbread mixture contains none Manufacturers notified. Wording on carton will be amended. [ 26 ] ATMOSPHERIC POLLUTION. Crayford, like its immediate neighbours, is affected with more than one type of pollution viz:—from cement dust and from smoke. Whilst the problems of cement dust and industrial smoke can be minimised by proper methods of control it is difficult, without introducing smokeless zones, to control the emission of domestic smoke. With the ever increasing number of houses, the pollution of the atmosphere must increase. The Council have already embarked on schemes to instal modern fuel burning appliances in the older type of Council property, but I am afraid that is only part of the problem, and a modern fire will still emit too much smoke unless the householder is prepared to use smokeless fuel and sufficient supplies of such fuel are available. THE CONTROL OF RODENTS AND OTHER PESTS. During the year the following infestations were dealt with:— Rats 98; Mice 42; Wasps 16; Woodworm 10; Ants 16; Crickets 2; Beetles 2; Flies 5; Fleas 2. HOUSING STATISTICS. (1) Inspection of Dwelling Houses. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 208 Number of inspections made for that purpose 1499 (2) Number of dwelling-houses (included under sub-heading (1) above which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 7 Number of inspections made for that purpose 11 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 4 (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 162 [ 27 ] (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 140 (3) Action under Statutory Powers during the year. Statutory Notices under Housing or Public Health Acts 6 Number of houses in which defects were remedied after serving of formal notices :— (a) By Owners 6 (b) By Local Authority in default of Owners Nil Proceedings under Housing Act, 1936 :— (a) Demolition Orders made under Section 11 2 (b) Parts of buildings closed under Section 12 2 (c) Houses demolished (i) in pursuance of Demolition Orders (ii) by agreement with Owner ... 1 (4) Action under Local Government (Miscellaneous Provisions) Act, 1953. Number of houses closed (5) 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. Total number of houses owned by local authority 2,235 Number of houses built during year :— (a) by the Local Authority 211 (b) by other bodies or persons 110 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. [ 28 ] 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. Samples of water taken by the Department and forwarded to the County Laboratory for examination have all been reported satisfactory. (a) Wells (drinking water), Bacteriological 8. (b) Swimming Pool, Bacteriogolical 9. (c) Domestic Supplies 9. Water Supply. Approximately 0.4 mile mains extension. Drainage and Sewerage. Normal sewerage extension to serve new housing development. Ellingham Estate surface water scheme—1,265 yards new sewer from 6" to 15" diameter. Housing Plans. The building of houses is in progress at Scheme No. 38 (Normandy Farm), and when completed the scheme will provide 102 living units. A further 274 dwellings are proposed on other schemes. REPORT OF KENT RTVER BOARD. Rivers and Streams. The Board's main dyke on Crayford Marsh, from Crayford Sluice to Russell Stoneham's ash tip, together with two dykes flowing into this "main" have been dredged with Mechanical Excavator. In all, a little over three miles of dykes have been treated in this manner. Normal weed clearance and removal of debris has been carried out in the river Cray from Vitbe Mills to the Crayford Urban District Council's boundary and also on the Stanham river and Middle river. [ 29 ] In spite of the abnormally wet summer and the winter's snow, no flooding has been experienced in the Crayford district. Closet Accommodation. Approximate number of premises containing each type of sanitary convenience in the district:— W.C's. into drainage system, approximately 10,880 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. Nuisances and defects remedied during the year. Overcrowding 3 Sanitary Accommodation : Defective 21 Drainage : (i) Repaired 44 (ii) Cleansed 290 Refuse Receptacles 35 Dampness 73 Roofs and Rain Water Pipes 55 Smoke Nuisances 2 Floors 41 Walls and Ceilings 27 Baths, Lavatory Basins and Sinks 11 Water Supplies 15 Doors and other woodwork 7 Windows and Ventilation 18 Accumulation of Refuse 10 Other works 30 Total number of visits of all kinds paid by Inspectors during the year 7705 Approximate number of rated premises in the area 9161 Notices served :— Statutory 6 Informal 170 Number of houses, etc., disinfected Swimming Pool. Period open from the 15th May to the 12th September. Number of bathers 21,061. This figure does not include School Parties and Clubs. Shop Acts. Visits made during the year 294. [ 30 ] Smoke Abatement. No action taken. Eradication of the Bed Bug. Particulars of the action taken in 1954 for the eradication of the Bed Bug are as follows :— Number of Infested Disinfested Council Houses 8 8 Other Houses 3 3 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 (0 Number on Register (2) Number of Inspections (3) Written notices (4) Occupiers prosecuted (5) (i) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 16 91 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 61 115 3 (iii) Other Premises in which Section 7 is enforced by Local Authority (excluding outworkers' premises) 20 58 2 - TOTAL 97 264 5 — [ 31 ] 2. Cases in which Defects were found. Partioulars (1) Number of cases in which defects were found Number of cai es in which prosecutions were instituted (6) Found (2) Remedied (3) Kef erred To H.M. Inspector (4) BvH M Inspector (5) Want of cleanliness (S.l) Overcrowding (S.2) Unreasonable temperature (S.3) — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7) (a) Insufficient 3 3 — 1 — (b) Unsuitable or defective 8 8 5 (c) Not separate for sexes — — — — — Other offences (not including offences relating to Outwork) — — — — — TOTAL 11 11 — 6 — [ 32 ] (Sections 110 and 111). OUTWORK. Part VIII of the Act Nature of Work Section 110 Section 111 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. 20 - - - - - Carding of buttons, etc. 2 — — [ 33 ]