2) Library CRA 23 Urban District of Crayford ANNUAL REPORT of the Medical Officer of Health For the Year 1958 JOHN LANDON M.R.C.S L.R.C.P.D.P.H. Urban District of Crayford ANNUAL REPORT of the Medical Officer of Health For the Year 1958 JOHN LANDON M.R.C.S., L.R.C.P.,D.P.H. MEMBERS OF THE HEALTH COMMITTEE Chairman: Councillor J. Kerr Members: Councillors: Councillors: Mrs. F.M. Pilbrow J.W. Taylor N.E. Killick Mrs. H.E. Gleed G.C. Smith Mrs. E. White Mrs. I. Walker P.J.E. Boss Co-opted Members: Mrs. E. Patharley Mr. D.J. James Miss 0. Perry PUBLIC HEALTH STAPF 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) Telephone number Bexleyheath 2244 Chief Public Health Inspector: *† * A.W. Kent, M.R.S.H., M.A.P.H.I. District Public Health Inspectors: * E.J. Day, A.R.S.H., M.A.P.H.I. (resigned 18.11.58.) H.G. Avril (appointed 1.9.58.) Student Public Health Inspector: A. Game (appointed 27.11.58.) Chief Clerk: E.T. Shutte Shorthand Typist/Clerk: Mrs. E.M. Tibbies Rodent Operator: W. McCulla * Certificate for Inspection of Meat and other foods. Shops Act Inspector. * Rodent Officer. 1. To the Chairman and Members of the Crayford Urban District Council Mr. Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1958 which is prepared on the lines suggested by the Minister of Health. The Registrar-General's estimate of the mid year population for the Urban District is 30,280 compared with 29,980 in 1957. Generallyspeaking, on the basis of the statistical information available, the health of the Urban District was well maintained. The standardised death rate was 11.5 per thousand of the home population compared with 11.7 for the whole of England and Wales. The birth rate at 17.03 per thousand compares favourably with that for the country as a whole (16.4). Eight infants died during the first year of life giving an infant mortality rate of 14.7 per thousand live births, which is the lowest rate recorded in the District since 1954, when the rate was 10.1. The infant mortality rate for England and Wales was 22.6 per thousand. As in previous years, a substantial proportion of the deaths were associated with prematurity and congenital malformation, over which no significant degree of control is possible at present. Much research is, however, going on in regard to the possible influence of german measles and other virus illnesses as they affect the growing foetus during the early months of pregnancy. There were no maternal deaths due to childbirth. Deaths from tuberculosis numbered 3 as against 1 in 1957Deaths due to malignant disease, in general, showed a slight decrease over the previous year and cancer of the lung caused 13 deaths compared with 15 in 1957. Deaths attributed to coronary disease numbered 50 compared with 42 in 1957 and 45 in 1956. For the ninth year in succession there has not been a single case of diphtheria in the Urban District. There were no cases of poliomyelitis during the year. Twenty-one new cases of tuberculosis were notified during 1958 as against seventeen during the previous year. The year under review was a measles year and a considerable epidemic commenced in September and continued into the early summer of 1959. During 1958 267 cases were notified but only one case was treated in hospital. Infectious diseases throughout the ages have shown a rise and fall in incidence due to many and complicated factors which are not fully understood. This matter is, however, of great significance from the administrative point of view as well as from the standpoint of the health of the community. As a result of the provision of pure water supplies in the middle of the 19th century, the enteric and diarrhoeal diseases generally were largely overcome. Scarlet fever, which in the 19th century and early part of this century was one of the main killing diseases, is, nowadays, a disease of little importance. Smallpox has been largely overcome by stringent supervision at sea and air ports and 2. by the instrument of vaccination, although the possibility of an epidemic is always present, so that the greatest vigilance is necessary at all times. The last great epidemic of diphtheria occurred in the early 1930s and was thought to be due, largely, to an increase in the virulence of the diphtheria organism. The introduction of mass immunisation in the middle of the 1930s together with great improvements in environmental and personal hygiene have, practically, abolished this disease, although small outbreaks of virulent type do occur from time to time in different areas. The need to keep the level of immunisation of children at a high level has often been stressed. It is, of course, possible that any deterioration in environmental conditions resulting, for example, from war conditions or other calamity might bring all or any of these diseases back in an enhanced form. Nowadays the main hazard is due to the virus diseases, of which poliomyelitis is the best known example. There are reasonable grounds, however, for optimism that the mass immunisation of the young population may, before long, in some way alter the relationship between the virus and the human organism, but it is too early, yet, to say whether one can look forward with confidence to the early abolition of this disease. The antibiotics and chemo-therapeutic drugs have shorn measles of most of its terrors due, largely, to preventing the serious complications such as broncho-pneumonia, which was the main cause of death in years gone by. Much discussion is taking place at the present time as to whether the present system of notification of infectious diseases, which is founded, largely, on experience gained during the last half-century, does not need to be drastically overhauled. The notification of measles, which came into operation in 1940 when environmental conditions were seriously affected by the war, is regarded by many as being unnecessary at the present time in view of the fact that little, if any, action is taken following the receipt of notifications by general practitioners. The cost of this notification is quite considerable and there is no commensurate return from the health point of view. Scarlet fever is another disease the notification of which could, perhaps, temporarily be discontinued. It is hoped that in the future the whole position of notification of infectious disease will be rationalised in the light of present day needs. During the year poliomyelitis vaccination was vigorously carried out by the Local Health Authority and details of the numbers vaccinated are given on page 17 . During 1958. the Council decided, in principle, to implement the provisions of Section 11 of the Clean Air Act, 1956 relating to smoke control areas and a pilot survey was carried out with a view to obtaining reliable information as to the cost of replacing unsuitable appliances and adapting others to make them capable of burning smokeless fuels. 3. The area suggested for the first smoke control area is that part of Slade Green north-east of the railway line and contains 983 properties; 595 being Council dwellings, 346 private dwellings, 10 shops constructed by the Council, 26 other shop premises, and 6 Church buildings and schools. The Health Committee have been much exercised in the course of their deliberations by the lack of assurance that adequate supplies of smokeless fuels other than coke will be available and have not been too happy that, in the main, authorities will have to rely on coke as the main source of smokeless fuel for some years to come. At the time of writing, application has been made to the Minister of Housing and Local Government for preliminary approval of the Council's proposals for their No. 1 Smoke Control Area, In due course, arrangements will be made for the maximum amount of publicity to be given in the area concerned, so that no resident affected by this Order, which it is proposed will come into operation in the Autumn of I960, will be without all the information which he may require. Publicity measures will include public meetings, exhibitions and the distribution of explanatoryleaflets. In 1956, the South East London Mass Radiography Service issued a report on the operation of the service in a report entitled "No Time for Complacency" and, although no hard and fast conclusions could be dram from this in regard to the incidence of pulmonary tuberculosis in this area, it was evident that a sufficient reservoir of infection was present to raise the question of the advisability of carrying out a concentrated mass radiography survey. The Councils of Crayford, Bexley and Erith have now appointed a joint committee to carry out such a survey in the Spring of 1960 and a great deal of preparatory work will be necessary in the Autumn of 1959. A house to house visitation will need to be made which may mean as many as 10,000 visits in the Urban District alone. Tuberculosis is a waning disease and it is hoped that this concentrated attack will contribute towards its final eradication. The work of the Bexley, Erith and Crayford Home Safety Committee continued during the year with steady propaganda in the interests of the reduction of accidents in the home. It is hoped that this work may be greatly increased in the future, although this would entail a larger expenditure than has been possible in the past. Both the Local Authority and the Local Health Authority have the power to make grants for this purpose. The Fabrics (Misdescription) Regulations of 1959 are to be welcomed in this connection in that they prescribe new standards of noninflammability for textile fabrics, to which the Fabrics (Misdescription) Act of 1913 applies, namely, textile fabrics to which is attributed the quality of non-inflammability or safety from fire, or any degree of that quality. The Act places the responsibility on the local authority, who have been considering how the stringent British Standards tests prescribed by the Regulations could best be carried out. It is likely that they are too complicated to be carried out in the Health Department and the Council are considering the possibility of submitting samples of fabrics to one or other of the testing houses, recommended by the Board of Trade, who would be prepared to undertake such work on behalf of local authorities. 4. The future of the health services in this area are closelylinked up with work of the Royal Commission on Local Government in the Greater London Area. The present separation, in the Urban District, of the environmental from the personal health services is an artificial one and I think one may look forward with some confidence to an improvement in the position in years to come. In conclusion I wish to thank the Chairman and Members of the Health Committee for their support and encouragement and the Chief Public Health Inspector, Chief Clerk and all members of the Health Department for the good work which they have done during the year. I am, Your obedient Servant, JOHN LANDON Medical Officer of Health 5. STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,698.71 Population (Registrar-General's estimate mid-year 1958) 30,280 Number of inhabited houses 9,675 Rateable Value £395,757 Sum represented by a penny rate £1,575 LIVE BIRTHS Total M F Legitimate 528 285 243 Illegitimate 15 9 6 543 294 249 Birth rate per 1,000 of the estimated home population - 17.93 Illegitimate live births per cent of total live births - 2.76% General birth rate for England and Wales - 16.4 STILLBIRTHS Total M F Legitimate 10 6 4 Illegitimate - - - 10 6 4 Rate per 1,000 total (live and still) births - 18.1 Total M F DEATHS 265 159 106 Death rate per 1,000 of the estimated resident population - 8.75 General death rate for England and Wales - 11.7 6. 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 1958. The standardised Birth Rate which allows for comparison with other parts of the country is 17.03 and the standardised Death Rate is 11.5 Maternal Deaths:- There were no Maternal Deaths in 1958. Deaths of Infants under one year of age:- Total M F Legitimate 8 5 3 Illegitimate - - - 8 5 3 Rate per 1,000 live births (Crayford) - 14.7 Rate per 1,000 legitimate live births - 15.2 Neo Natal mortality rate per 1,000 live births - 12.88 General death rate of infants under 1 year of age for England and Wales - 22.6 DEATHS FROM VARIOUS CAUSES Malignant Neoplasm (all ages) 52 Measles (all ages) - Whooping Cough (all ages) - Diarrhoea (under 2 years of age) - 7. Vital Statistics during 1958 and previous years Year Populatior 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 21,190 507 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 1955 28,460 437 15.4 15. 220 7.7 11.7 8 18.3 24.9 1956 29,530 476 16.1 15.6 247 8.36 11.7 11 23.1 23.8 1957 29,980 499 16.6 16.1 285 9.5 11.5 17 34. 23.1 1958 30,280 543 17.93 16.4 265 8.75 11.7 8 14.7 15.2 * 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. BIRTHS Rates per 1,000 Home Population Live Births 16.4 17.93 Stillbirths 0.36 0.33 21.6 (a) 18.1 (a) DEATHS All causes 11.7 8.75 Typhoid and paratyphoid 0.00 - Whooping Cough 0.00 • Diphtheria 0.00 — Tuberculosis 0.11 0.09 Influenza 0.05 - Smallpox 0.00 - Acute Poliomyelitis (including Polioencephalitis) 0.00 - Pneumonia 0.55 0.5 NOTIFICATIONS (Corrected) Typhoid Fever 0.00 - Paratyphoid Fever 0.00 — Meningococcal Infection 0.02 0.03 Scarlet Fever 0.86 0.19 Whooping Cough 0.74 0.39 Diphtheria 0.00 - Erysipelas 0.07 0.03 Smallpox 0.00 - Measles 5.75 8.78 Pneumonia 0.49 0.06 Acute Poliomyelitis (including Polioencephalitis) Paralytic 0.03 - Non-paralytic 0.01 — Food Poisoning 0.20 0.06 Puerperal Pyrexia 14.26 (a) 19.89(a)  England & Wales Crayford U.D.C. Rates per 1,000 Live Births DEATHS All causes under 1 year of age 22.6 (b) 14.7 (b) Enteritis and diarrhoea under 2 years of age 0.4 - (a) Per 1,000 total (Live and Still) Births (b) Per 1,000 Live Births MATERNAL MORTALITY England & Wales Crayford U.D.C. Rates per 1,000 Total Live and Still Births MATERNAL MORTALITY Maternal causes excluding abortion 0.35 - Due to abortion 0.08 - Total maternal mortality 0.43 - 10. Table showing Summary of Causes of Death Registered during the year ended 31st December, 1958 Cause 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 4 4 11. Malignant neoplasm, lung and bronchus 11 2 12. Malignant neoplasm, breast - 7 13. Malignant neoplasm, uterus - - 14. Other malignant and lymphatic neoplasm 11 13 15. Leukaemia, aleukaemia 1 3 16. Diabetes 2 1 17. Vascular lesions of nervous system 13 16 18. Coronary disease, angina 38 12 19. Hypertension with heart disease 3 3 20. Other heart disease 17 13 21. Other circulatory disease 4 1 22. Influenza - - 23. Pneumonia 12 4 24. Bronchitis 16 3 25. Other diseases of respiratory system 1 1 26. Ulcer of stomach and duodenum 1 1 27. Gastritis, enteritis and diarrhoea 1 1 28. Nephritis and nephrosis 1 3 29. Hyperplasia of prostate 5 - 30. Pregnancy, childbirth, abortion - - 31. Congenital malformations - 2 32. Other defined and ill-defined diseases 12 13 33. Motor vehicle accidents - - 34. All other accidents 3 - 35. Suicide 1 2 36. Homicide and operations of war - - ALL CAUSES TOTAL 159 106 11. 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 Pleurisy & Pneumonia 1 1 Prematurity 2 2 Atelectasis 1 1 2 Cerebral Harmorrhage 1 1 Anencephalus & Spina Bifida 1 1 Acute TracheoBronchitis 1 1 Totals 3 1 1 1 1 1 8 DISINFECTION SERVICE A joint scheme is in existence with the Bexley Borough Council for the disinfection of tedding 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 1958 177 cases were dealt with, out of which 175 post mortems and 25 inquests were conducted. 28 were from Crayford and from this latter figure 27 post mortems and 4 inquests were conducted. LABORATORY FACILITIES Pathological and bacteriological work for the area was carried out through the Public Health Laboratory Service. PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES AND OTHER DISEASES Scarlet Fever During the year 6 cases were notified. The number of cases notified in 1957 was 16. Diphtheria There were no cases notified in 1958. Paratyphoid or Typhoid Fever No cases were notified during the year. Puerperal Pyrexia Eleven cases were notified during the year. Meningococcal Infection One case was notified during the year, there were none in 1957. Food Poisoning Two cases were notified during the year. 13. Measles The number of cases notified in 1958 was 266. The number of cases notified in 1957 was 701. Whooping Cough 12 cases were notified during the year. The number of cases notified in 1957 was 122. Acute Poliomyelitis There were no cases notified in 1958 Ophthalmia Neonatorum No cases were notified during the year. Dysentery No cases were notified during the year. Notifiable diseases (other than Tuberculosis) during the year Diseases Total Cases notified Cases admitted to hospital Deaths Smallpox - - - Scarlet Fever 6 - - Diphtheria — — - Enteric or Typhoid Fever - — - Paratyphoid Fever — — - Puerperal Pyrexia 11 5 - Pneumonia 2 l - Erysipelas 1 1 - Meningococcal Infection 1 1 - Measles 266 1 - Whooping Cough 12 — — Ophthalmia Neonatorum — - - Dysentery - - - Poliomyelitis (Paralytic) - - - Poliomyelitis (Non-Paralytic) - — — Encephalitis - - - Food Poisoning 2 2 - Totals: 301 11 - 14. 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 Tnder One Year - - - - - 1 3 3 — — » — 1 - - - - 1 1 19 13 - - - - 2 - - - - 1 1 21 13 - - - - 3 - 1 - - 1 1 14 25 - - - - 4 1 - - - 1 2 11 8 - - - - 5 - 9 1 3 - - - 2 72 63 - - - - 10 - 14 - - - - - - - 1 - - - - 15 - 24 - - - - - - - - - - - - 25 and over - - - - - - - - - - - - Total (all ages) 2 4 - - 4 8 140 126 - - - - 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 - - - — - — — — 1 - - - 5 - - - - - - - - - - - - 15 - - - - 1 - - - - - - — 45 - - - - - - - - - - - - 65 and over - - - - 1 - - - - - - - Total (all ages) - - - - 2 - - - 1 - — - 16. Age Groups (continued) 0 Erysipelas Smallpox Food Poisoning M F M F M F M F 5 - _ - _ - _ Puerperal Pyrexia - 11 15 _ 1 - _ - _ 45 - _ - _ - _ Ophthalmia neonatorum - _ 65 and over _ — _ — _ 2 Total (all ages) 1 - 2 Poliomyelitis Vaccination, 1958 The following table gives the numbers of persons resident in the Crayford Urban District who received injections against poliomyelitis during the year ended 31st December, 1958 J - Year of 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 Others Total Birth Given two injections 79 311 257 264 258 245 235 190 123 123 134 130 261 224 208 502 3544 Given third injection - 16 55 46 47 49 36 33 38 40 36 48 2 1 2 8 457 Immunisation against Diphtheria, 1958. The following is a return of the number of children resident in the Crayford area under the age of 15 years on 31st December, 1958, who had completed a course of immunisation at any time before that date (i.e. at any time since 1st January, 1944)* Year of 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 Total Birth Last complete course of injections (whether primary or booster) 1954-1958 84 70 228 163 147 327 469 108 217 308 323 304 297 250 58 3353 1953 or earlier 222 ?OS 30S 253 203 200. 92 90 91 16 - - - - - - - - - - 1774 Immunisation and Vaccination Set out below are the diphtheria immunisation, whooping-cough immunisation and smallpox vaccination figures for 1958 based on record cards received. Year of birth Diphtheria Immunisation Smallpox Vaccination Whooping-cough Immunisation Primary Reinforcing Primary Revaccination Primary 1958 58 - 164 - 177 1957 207 2 124 - 240 1956 24 - 2 - 39 1955 5 2 1 - 8 1954 3 38 1 - 9 1953 6 138 - 1 - 1952 3 16 1 - - 1951 - 7 - 1 - 1950 2 4 - 1 - 1949 - 10 - 1 - 1948 - 4 - - - 1947 - 3 1 1 - 1946 - 3 - - 1945 - 1 - - - 1944 - - 1 - - Before 1944 1 14 11 13 - Total 309 228 306 18 473 18. Tuberculosis Age Periods New Cases Deaths Respiratory M F NonRespiratory M F Respiratory M F NonRespiratory M F Under 5 years - — - - - - - - 5 - - - - - - - - 15 2 2 - 1 _ — — — 25 1 6 - - - - - - 45 7 1 _ _ 1 - - — 65 and over 1 - - - 1 - - - Totals: 11 9 - 1 2 - - Chest Clinics At V/est Hill Hospital, Dartford and 65, Bexley Road, Erith. Housing Applicants Special consideration is given to cases put forward by the Medieal 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 - 25 Applicants recommended for rehousing - 5 No. of families granted houses on account of Tuberculosis - 6 Other reasons - 5 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 13» including 7 new cases. Clothing, coal supplies and fares to visit relatives in Sanatoria had once again formed the bulk of the assistance given by the Committee. 19. The total result of the local Christmas Seals Sale, as reported by the Organiser to the Annual General Meeting, amounted to £94* 8s. 9d. The County Organiser, Health Visitor, Chest Physician and District Officer have given invaluable service to the Committee. WELFARE OF OLD PEOPLE This continued to provide an increasing demand on the services of the Health Department and the Crayford Old Peoples Welfare Committee. 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 Chief Public Health Inspector. 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 continues to flourish. Help is given to the old folk with clothing and small home comforts. Many services have been rendered to elderly people and much assistance is given by other Voluntary Organisations to the Old Peoples Welfare Committee. Last offices have been carried out by Visitors. Close co-operation is 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. NATIONAL ASSISTANCE ACT, 1948 Under Section 50 of the Act, it is the duty of the local authority to arrange for the burial or cremation of any person who has died in its area if it appears that no suitable arrangements for the disposal of the body can otherwise be made. During the year one body was dealt with by the Council under these provisions. 20. CHIEF PUBLIC HEALTH INSPECTOR'S REPORT 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 1958 which gives a general summary of the work carried out by the Public Health Inspectors during the year. INSPECTION AND SUPERVISION OF FOOD The inspection of food, as always, was very much to the fore. This important branch of Public Health work occupied its usual high quota of time spent by the Inspectors. In this connection a total of 684 inspections were carried out, 181 of which were to premises registered under Section 16 of the Food and Drugs Act, 1955* The number of food premises in the area is as follows Bakers 4» Butchers 16; Grocers 58; Greengrocers 19} Confectioners 26; Fishmongers 8; Cafes, Canteens, etc., 34; Public Houses 19; Off Licences 3; Clubs 12; Other premises 24. Under Section 16 of the Food & Drugs Act, 1955» 58 premises are registered for the storage and sale of Ice Cream and 30 for the manufacture or preparation of preserved food intended for sale. Complaints The following complaints were received and dealt with during the jrear:- Salmon. Chicken & Turkey Cutlets. Complaint was made in respect to the condition of these cutlets which were alleged to be mouldy. Contact with the suppliers resulted in the immediate withdrawal from sale of the consignment. A warning letter was also sent expressing the serious concern of the Council for this incident. Milk. The advice of the Department was sought on the question of the quality of some milk. Samples submitted for examination, however, failed to indicate any abnormality in the quality or condition of the milk. 21. Bread. Two complaints of alleged foreign matter found in loaves of bread were received. In one case the "dark discolouration" complained of, under microscopical examination revealed only wheat structures, and therefore no further action was considered necessary. In the second case, the foreign matter was found to consist of a piece of cloth embedded in the loaf and, in this instance, legal proceedings were instituted resulting in a fine of £20 with £2. 2s. Od. costs awarded to the Council. Jam Tart. Small dark specks in a jam tart were alleged by a complainant to be cigarette ash. The report on the examination of the article stated that under the microscope the specks bore no resemblance to cigarette ash. Also in this particular case it was a little difficult to establish the fact that the specks had not got into the jam tart after sale. No further action, therefore, was considered necessary. Meat and Other Foods The following articles were found during the year to be unfit for human consumption:- lbs. ozs. lbs. ozs. Beef 81 8 Lard 7 8 Offal 66 0 Sugar 6 0 Chopped Pork 8 0 Margarine 14 8 Beef Chipolatas 2 8 Currants 5 0 Sausages 23 0 Tinned Sausages 6 10 Ham 83 15 Horseradish Relish 2 5 Corned Beef 108 12 Tinned Fruit 185 10 Frozen Rabbits 18 0 Tinned Fruit Juice 1 4 Chickens 203 0 Tinned Vegetables 715 1 Minced Beef Loaf 1 8 Tinned Snrrn 228 4 Luncheon Meat 35 2 Tinned Rice 2 15 Smoked Bacon 123 0 Tinned Meat & Gravy 1 15 Turkey Cutlets 17 0 Tinned Chicken 5 0 Chicken Cutlets 10 8 Tinned Spaghetti in Meat 98 0 Salmon Cutlets 12 0 Tinned Apricot Puddings 31 8 Jellied Veal 66 0 Tinned Beef Loaf 1 8 Dried Peas 13 8 Tinned Scotch Broth 2 0 Cocoa 24 4 Evaporated Milk 2 0 Self Raising Flour 12 0 Tinned Fish 58 4 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. 22. Food Hygiene Regulations. 1955 We axe indeed fortunate that, on the whole, shopkeepers in this District have been very co-operative with regard to the Food Hygiene Regulations, 1955. It is pleasing to note that many traders seek the Inspectors' advice when contemplating new or additional work to their premises. Consequently, no really serious breach of the Regulations has been observed. Generally speaking, local shops are well abreast of the times respecting the installation of refrigerated display cabinets and there appears to be an increase in the sale of frozen foods. As a result of regular visits to premises within the purview of the Regulations, 140 informal notices were served which represents a decided decrease on last year's figure of 196. These figures bear out the fact that such co-operation as previously mentioned is a distinct advantage. Slaughterhouses There are no slaughterhouses in the area. Milk Licences granted by the Council under the Milk (Special Designation) Regulations, 1949/1953«- Supplementary - Tuberculin Tested ... 12 Pasteurised 13 Sterilised 14 Dealers - Tuberculin Tested ... 8 Pasteurised 12 Sterilised 29 25 samples of milk were submitted to the County Laboratory as follows:- Tuberculin Tested Pasteurised 8 Pasteurised ... ... ... 13 Sterilised 4 All satisfied the prescribed tests. 23. ICE CREAM (HEAT TREATMENT) REGULATIONS, 1947-1952 There are now no manufacturers of ice cream in the area. 38 samples of ice cream submitted for examination during the year were graded as follows:- Grade I 31 Grade II 8 Grade III _ Grade IV _ In two instances advice was sought where refrigerators had broken down, and arrangements for the proper disposal of stock was made. FOOD AND DRUGS ACT, 1955 Details of samples taken by the County Sampling Officers within the Urban District of Crayford during the year ended 31st December, 1958:- Article No. Article No. Apricot Halves 1 B/fwd. 23 Baby Powder 1 Ginger Marmalade 1 Boned Chicken 1 Ground Almonds 1 Bourn Vita 1 Instant Piping 1 Bran Flakes 1 Instant Pudding 1 Bread, brown 1 Jelly 1 Bread, white 1 Lemon 1 Bronchial Balsam 1 Lemon Cheese 1 Butter 1 Liquid Paraffin 1 Buttered Cheese Spread 1 Maoprin 2 Calcinate Tablets 1 Magsilate Tablets 1 Calamine Lotion 1 Margarine 1 Concentrated Mint Sauce 1 Marzipan 1 Condensed Milk (sweetened) 1 Meat Pies 1 Cheshire Cheese 1 Medicated Shampoo 2 Cocoa 1 Medium Red Salmon 1 Creamed Potato Whirls 1 Milk 22 Cream Ices 1 Milk Chocolate Windsor Biscuits 1 Custard Powder 1 Mixed Peel 1 Dairy Cream Doughnuts 1 Nasal drops 1 Double Cream 1 Olive Oil 1 Draught Bass 1 Orange 1 Drinking Chocolate 1 Orange Squash 2 C/fwd. 23 C/fwd. 69 24. Article No. Article No. B/fwd. 69 B/fwd. 80 Elixir Gabail 1 Pickled Walnuts 1 Extra Cream caramels 1 Pure Lard 1 Extra Potency Yeast 1 Pork Luncheon Meat 1 Famel Syrup 1 Sausage, Beef 1 Fish Paste, Crab 1 Sausage Rolls 1 Flour, Vitbe 1 Strawberry Jsm 1 Frozen Lolly 1 Teabreak Snacks 1 Garden Peas 1 Tomato Soup 1 Gin 2 Whisky 1 Ginger Beer 1 White Absorbent Lint 1 C/fwd. 80 Total 91 Summary Milks 22 Drugs 15 Spirits ...... 3 Other Samples 51 91 All the above samples were genuine with the exception of the following: Sample of Analysis Action Taken Cocoa Contains added alkali equal to Now under consideration approximately 1.9$ potassium by the Ministry of carbonate} presence of which Agriculture, Fisheries should be declared. and Food. Pish Paste, Fish approximately 90i°» Colour Old stock. Permitted Crab Rhodamine B (not permitted). colour now used. 25. CLEAN AIR ACT. 1956 A considerable amount of the Inspectors time was taken uj? with the initial survey for the proposed Smoke control Area at Slade Green. The information obtained has provided much food for thought and there is no doubt that a lot of hard work will be necessary, and the full co-operation of all concerned will be needed, in order that this problem can be successfully solved. As a member of the Thames-Side Joint Committee for the Abatement of Atmospheric Pollution, my Council brought into operation during the year volumetric apparatus for the detection of Sulphur Dioxide in the atmosphere, and it is hoped that the daily readings obtained will play some useful part in the overall picture in North West Kent. HOUSING STATISTICS (1) Inspection of Dwelling Houses (1) Total number of dwellinghouses inspected for housing defects (under Public Health or Housing Acts) 969 Number of inspections made for that purpose 3,605 (2) Number of dwellinghouses (included under subheading (l) above) which were inspected and recorded under the Housing Consolidation Regulations — Number of inspections made for that purpose _ (3) Number of dwellinghouses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 14 (4) Number of dwellinghouses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 110 (2) Remedy of defects during the year without Service of formal Notices Number of defective dwellinghouses rendered fit in consequence of informal action by Local Authority or their Officers 103 26. (3) Action under Statutory Powers during the Year Statutory Notices unuer Housing or Public Health Acts 2 Number of houses in which defects were remedied after serving of formal notices (a) By owners ... ... ... 2 (b) By Local Authority in default of owners Proceedings under Housing Act, 1957s (a) Demolition Orders made under Section 17 14 (b) Parts of buildings closed _ (c) Houses closed 7 (d) Houses demolished (i) in pursuance of Demolition Orders _ (ii) by agreement with owner _ (iii) after purchase by Council 14 (4) Housing Act. 1957 - 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 2,808 Number of houses built during the year:- (a) by the Local Authority 192 (b) by other bodies or persons 35 Rent Act. 1957 Since the above Act came into force on the 6th July, 1957» 65 applications have been received for certificates of disrepair and certificates as to the remedying of defects which landlords have undertaken to remedy, 8 certificates of disrepair and 13 certificates as to remedying of defects have been issued. _ . 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 Public Health Inspectors (a) Wells (drinking water), Bacteriological - 38 (b) Swimming Pool, Bacteriological - 9 (c) Domestic Supplies, Bacteriological - 13 All samples forwarded have been reported satisfactory with the exception of 17 samples taken after a well had been ascertained to be contaminated by flooding of the surrounding land. Notwithstanding, the fact that the pollution eventually cleared, it was decided by the owners to instal a chlorination plant as an additional safeguard. Water Supply Normal mains extension to serve new development was carried out. Drainage and Sewerage Normal sewerage extension to serve new housing development. Housing Plans The building of houses is in progress at Schemes Nos. 40 and 44» the former to comprise 226 dwellings, and the latter 30 Old Peoples' Dwellings with Community Room and Warden's Accommodation. Housing Scheme No. 45 (not yet commenced) will provide a further 28 dwellings. REPORT OF KENT RIVER BOARD Rivers and Streams The following work was carried out within the Crayford Urban District:- R.Cray. Weed growth removed and rubbish cleared from Hall Place to Vitbe Mill. Accumulated gravel shoals removed below Hall Place. Middle River. Weed growth removed. 28. Stanham River. Weed growth removed and bed and banks handcast below Maiden Lane to relieve allotments from flood water. R. Wansunt. Weed growth removed and debris carted to tip from Crayford Road Bridge to Greyhound Stadium. Marsh Dykes. Some miles of marsh dykes have been cleared of weed growth. Closet Accommodation Approximate number of premises containing each type of sanitary convenience in the district W.C.'s into drainage system, approximately 11,805 W.C.'s into cesspools 20 Number of premises not connected to public water supplies Refuse Collection A seven day collection of refuse was maintained under the same system as previously. Nuisances and defects remedied during the year Sanitary Accommodation Floors, walls and ceilings defective 55 repaired or renewed 49 Drainage: Baths, lavatory basins (i) examined, exposed, and sinks 8 etc 325 Water supplies 10 (ii) repaired 71 Doors and other (iii) unstopped, ate. 125 woodwork 12 Refuse Receptacles 87 Windows, lighting and __ ventilation 64 Dampness 20 Roofs and rain water pipes ... 85 Offensive Accumulations removed 9 fireplaces, grates and Improper keeping of stoves repaired or animals abated 2 improved ... ... ... 7 Other defects 40 29. Prescribed Particulars on the Administration of the Factories Act, 1937 & 1948 1. Inspections for purposes of provisions as to Health (including inspections made by Public Health Inspectors). Number of Premises (1) Number on Register (2) 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 12 14 _ _ (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 67 81 12 (iii) Other Premises in which Section 7 is enforced by Local Authority, (excluding outworkers' premises) 14 16 _ _ Total 93 111 12 - 31 Control of Rodents and other Pests I46 complaints in respect of rats and mice infestations were received and fully investigated. In some instances defective drains and sewers could be attributed to such infestations and defects were traced and rectified. Twice during the year the foul water system was treated for rats and the results were most satisfactory. Other pest infestations dealt with were as follows Woodworm 23; Bugs 171 Miscellaneous 27. Total number of visits of all kinds paid by Inspectors during the year 8,269 Approximate number of rated premises in the area 9,670 Notices served Statutory 10 Informal 464 Number of houses, etc., disinfected 8 Swimming Pool Period open from 10th May to 4th September. Number of bathers - 32,160. This figure does not include school parties and clubs. Shops Act A total of 150 visits were made during the year. This figure includes Sunday and evening visits. It was noted that although many shops do not keep open until the statutory closing time, there has been a tendency on the part of the smaller shopkeepers to commence business much earlier in the morning. Advice regarding Sunday trading was sought on a number of occasions a marked increase in previous years. No special action of any kind was necessary. Eradication of the Bed Bug Particulars of the action taken in 1958 for the eradication of the Bed Bug are as follows Number of Infested Disinfested Council houses 14 14 Other houses 3 3 30. 2. Cases in which Defects were found Number of cases in which defects were found Number of cases in which prosecutions were instituted Particulars Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (s.i) _ - - - - Overcrowding (S.2) _ - - - - Unreasonable tempera ture (S.3) - - - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) _ _ _ _ _ Sanitary Conveniences (S.7) . (a) Insufficient - - - - - (b) Unsuitable or defective 18 15 - - - (c) Not separate for sexes - - _ _ _ Other offences (not including offences relating to Outwork) _ _ _ _ _ Total: 18 15 - - - 32. OUTWORK Part VIII of the Act Section 110 Section 111 Nature of Work No.of out-workers in August list required by Sect.110 (l) (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. 14 - - - - - I am, Your obedient Servant, A. W. KENT Chief Public Health Inspector 33.