4412(3) CRA 24 Urban District of Crayford ANNUAL REPORT of the Medical Officer of Health for the year 1959 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 1959 JOHN L A N D 0 N„ M.R.C.S. , L. R. C. P., D.P.H. MEMBERS OF THE HEALTH COMMITTEE Chairman Councillor J, Kerr Members Councillors: Councillors: Mrs, H.E. Gleed T. E. Sanders H L F Mitchell J. W. Taylor J,R Nokes Mrs. I. Walker Mrs. F M Pilbrow Mrs. EM White Co—opted Members Mrs. E. Fatharley Mr, D.J.James Miss 0. Perry 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) Telephone Number: Bexleyheath 2244 Chief Public Health Inspector: *#I A W Kent, M.R.S.H. , M.A.P.H.I. Chief Clerk E T Shutte District Public Health Inspectors H.G. Avril *J.H Grimston Shorthand Typist/Clerk Mrs. E M Tibbies Student Public Health Inspector A. Game General Assistant P.J. 0 Brien *Certificate for Inspector of Meat and other foods. #Shops Act Inspector I Rodent Officer 1. THE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH To The Chairman and Members of the Urban District Council of Crayford, Mr, Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1959 which is prepared on the lines set out in Circular 1/60 of the Ministry of Health. The Registrar General's estimate of the mid-year population of the Urban District is 30,600 (30,280 in 1958). On the basis of the statistical informa tion available, the health of the Urban District was well maintained. Although as I have indicated in the past, these figures give only a partial picture of the health situation of the area, they do present collectively a conspectus of the position which is at least objective and capable of comparison with other areas in the country as a whole. The environmental services operated by the Council under a wide range of health legislation are, of course, complementary to the Health and Welfare Services operated by the Kent County Council under the National Health Service Act, 1946 and the National Assistance Act, 1948, and comprise a wide range of personal health services vital to the health of every section of the community ~ the young, the old, the infirm and those who are physically or mentally handicapped. During the year the Council gave evidence before the Royal Commission on Local Government in Greater London and it is hoped the recommendations of the latter will achieve a degree of unification of all the health services in the area which is so much to be desired. The standardised death rate for 1959 was 9.87 per thousand of the home population compared with 11.6 for the whole of England and Wales. In 1958 the comparable death rate was 11.5, the practical point being that there were 36 fewer deaths during 1959 than in 1958. The standardised birth rate was 15.39 per thousand estimated home population compared with 16.5 per thousand for the country as a whole. Fifteen infant deaths occurred during the first year of life compared with eight during 1958. The infant mortality rate, therefore, rose to 30.24 per thousand live births as compared with 14.7 per thousand in the previous year. An examination of the causes of death, however, showed that nearly all the deaths were due to prematurity or congenital malformations and, broadly speaking, there was no question of any falling off in the standards of child care. These deaths, in other words, may be considered to have been due to causes outside the control of the health services. In regard to infectious disease, apart from the biennial measles epidemic which began in 1958 (266 cases) and continued into 1959 (228 cases), we had much to be thankful for. For the tenth year in succession no case of diphtheria occurred in the District but it is, however, essential that the public should be constantly reminded of the fact that diphtheria has only been contained by immunisation - it has not been abolished and its return as a killing disease 2. is quite likely, should the level of immunisation be allowed to fall to a sufficiently low level The duty of parents is plain. They should have their children immunised without fail at the age of eight to nine months with booster doses at five and ten years. It is estimated that, at present, about half the children under the age of fifteen years are at risk through non immunisation should the disease light up again in our midst. In my report for 1958 I reported that there had been no case of poliomye litis and expressed the hope that the mass immunisation of children and young persons might result in the gradual overcoming of this disease. Whilst over optimism would be out of place, it is recorded with satisfaction that no case of poliomyelitis occurred during 1959. As in the case of diphtheria, parents and young adults must ensure that the younger section of the population is kept at a high level of vaccination against this disease It is authoritatively accepted that the effectiveness of the vaccine now used exceeds 90% for those persons receiving three or more doses of the vaccine. Tuberculosis is generally recognised to be a waning disease and it is at this stage in the natural history of a disease that most effective measures towards its eradication can be taken. The number of new cases of tuberculosis notified during 1959 was 11, compared with 21 cases in 1958 and 17 in 1957. In view of this obvious reservoir of infection the Councils of Crayford Bexley and Erith, in conjunction with the South East London Mass Radiography Service, in the latter part of 1959, set up the necessary machinery to carry out a concentrated mass radiography survey in the area of the three Authorities in the summer of 1960. A full account of this survey will be given in the report for 1960 but it can be said, at the time of writing, that approximately 43,000 persons were X-rayed as part of this campaign. Added to the fact that a large number of residents in this area have, in addition, been X-rayed in nearby London, where they work, it is safe to assume that the special measures which have been taken may have made a significant contribution towards a reduction of mortality from tuberculosis This is, however, only one aspect of the measures against tuberculosis. The vaccination of older school children (thirteen years and over) the constant search for unsuspected cases through the tracing of contacts of known sources of infection and, as far as the housing situation will allow, the amelioration of living conditions of tuberculous families, have an equally important part to play. During 1959 there were 17 deaths from cancer of the lung compared with 13 deaths in 1958 and 15 in 1957. Approximately half the cases occurred in persons between the ages of 45 and 65 years of age and this mortality in the prime of life is particularly deplorable at a time when the expectation of life in general is said to be increasing There are no signs that recent publicity relating to the association between heavy cigarette smoking and this form of cancer, which is regarded by responsible authorities as proved has resulted in any significant reduction of the smoking habit, 3. Deaths from coronary heart diseases numbered 51 (compared with 50, 42 and 35 in the three preceding years). Here again, the majority of these deaths occurred in the fifth and sixth decades of life, men being far more affected than women During 1959 the Health Committee gave consideration to Ministry of Housing and Local Government Circular 57/59 which set out the proposed division of responsibility between the various central departments concerned with the control of radioactivity. It is clear that the Government are of the opinion that little active part will be played by the local authorities in the oversight, in their own areas, of hazards arising from this source. Nevertheless,, it is hardly to be expected that local authorities will not feel that they are bound to consider with some anxiety the environmental hazards which may affect their districts and, notwithstanding the complexity of the subject, they may well turn to their medical officers of health to interpret any local developments in this field. The training of appropriate members of public health staffs is, therefore, a matter of great importance. This has been recognised by the Veale Committee which reported in February, 1960. In 1958, the Council decided to implement section 11 of the Clean Air Act, 1956 relating to smoke control areas and, following a pilot survey of the area in question (that part of Slade Green north east of the railway line) and the receipt of provisional approval of the Council's proposals by the Minister of Housing and Local Government, arrangements were made for the detailed survey of the area which is nearing its completion at the time of writing. The work of the Bexley, Erith and Crayford Home Safety Committee continued during the year and now that their funds are being supplemented by a grant from the Local Health Authority this work will be extended in the future. 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 their excellent service during the year. I am, Your obedient Servant, JOHN LANDON Medical Officer of Health 4. STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 2,698 71 Population (Registrar General's estimate mid-year 1959) 30, 600 Number of inhabited houses 9,402 Rateable Value £470,476 Sum represented by a penny rate £1,900 Live Births Total M F Legitimate 485 241 244 Illegitimate 11 7 4 496 248 248 Birth rate per 1,000 of the estimated home population-16.2 Illegitimate live births per cent of total live births-2.26% General birth rate for England and Wales-16.5 Stillbirths Total M P Legitimate 5 3 2 Illegitimate 1 1 6 4 2 Rate per 1.000 total (live and still) births-11.95 Total M F Deaths 229 126 103 Death rate per 1,000 of the estimated resident population-7.48 General death rate for England and Wales-11.6 5. 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 1959 The standardised Birth Rate which allows for comparison with other parts of the country is 15.39 and the standardised Death Rate is 9.87. Maternal Deaths There were no maternal deaths in 1959. Deaths of infants under one year of age Total M F Legitimate 14 8 6 Illegitimate 1 - 1 15 8 7 Rate per l,000 live births (Crayford) - 30.24 Rate per 1,000 legitimate live births - 30.93 Neo Natal mortality rate per 1,000 live births - 20.16 Early Neo Natal mortality rate per 1,000 live births-1815 Perinatal mortality rate per 1,000 total (live and still) births-29,88 General death rate of infants under 1 year of age for England and Wales-22.2 Deaths from Various Causes Malignant Neoplasm (all ages) 52 Measles (all ages) — Whooping Cough (all ages) — Diarrhoea (under 2 years of age — 6. 7. Vital Statistics during 1959 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.D.D.C. C.D.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 1959 30,600 496 16.2 16.5 229 7.48 11.6 15 30.2 22.2 *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 and Wal es Cray ford U.D.C. Rates per 1 000 Home Population Births Live Births 16.5 16.2 Stillbirths ( 0.35 ( 0.19 ( 21.0 (a) ( 11.95 (a) Deaths All causes 11.6 7.48 Typhoid and Paratyphoid 0.00 - Whooping Cough 0.00 - Diphtheria — - Tuberculosis 0.09 - Influenza 0.18 0.09 Smallpox — - Acute Poliomyelitis (including Polioencephalitis) 0.00 — Pneumonia 0.61 .05 Notificatious (Corrected) Typhoid Fever 0.00 - Paratyphoid Fever 0.01 - Meningococcal Infection 0.02 - Scarlet Fever 1.05 0.39 Whooping Cough 0.73 1.01 Diphtheria 0.00 - Erysipelas 0.07 0.07 Smallpox 0.00 - Measles 11.88 7.45 Pneumonia 0.59 0.03 Acute Poliomyelitis (including Polioencephalitis) Paralytic 0.02 Non paralytic 0.01 - Food Poisoning 0.22 0.03 Puerperal Pyrexia 13.9 (a) 17.9 (a) 8  Engl and and Wales Crayford U.D.C. Rates per l,000 Live Births Deaths All causes under 1 year of age 22.2 (b) 30.2 (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 and Wal es Crayford U. D. C. Rates per 1,000 Total Live and Still Births Maternal Mortality Maternal causes excluding abortion 0.32 — Due to abortion 0„ 06 —- Total maternal mortality 0.38 — 9. Table showing Summary of Causes of Death Registered during the year ended 31st December, 1959 Cause of Death Male Female 1. Tuberculosis, respiratory — — 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 3 2 11. Malignant neoplasm, lung and bronchus 12 5 12. Malignant neoplasm, breast — 4 13. Malignant neoplasm, uterus — 2 14. Other malignant and lymphatic neoplasm 14 9 15. Leukaemia, aleukaemia 1 — 16. Diabetes — 1 17. Vascular lesions of nervous system 8 18 18. Coronary disease, angina 39 12 19. Hypertension with heart disease 2 3 20. Other heart disease 5 14 21. Other circulatory disease 3 5 22. Influenza — 3 23. Pneumonia 8 7 24. Bronchitis 8 4 25. Other diseases of respiratory system 2 — 26. Ulcer of stomach and duodenum 2 1 27. Gastritis, enteritis and diarrhoea — — 28. Nephritis and nephrosis — — 29. Hyperplasia of prostate — — 30. Pregnancy, childbirth, abortion — — 31. Congenital malformations 4 1 32. Other defined and ill-defined diseases 9 10 33. Motor vehicle accidents 2 1 34. All other accidents — — 35. Suicide 4 1 36. Homicide and operations of war — — All Causes Total 126 103 10. 11. Analysis of the Causes of Death of Infants at Various Ages under One Year Causes of Death DAYS MONTHS Total Under as Certified 0 1 2 3 4 5 6 7 14 21 28 2 3 4 5 6 7 8 9 10 11 One Year Prematurity 2 1 2 5 Congenital Malformation 1 1 1 1 1 5 Haemolytic Disease of Newborn 1 1 Intestinal Obstruction 1 1 Acute Tracheo—Bronchitis 1 1 2 Unascertainable (body found abandoned) 1 1 TOTALS 1 3 2 1 1 1 3 1 1 1 15 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 1959 141 cases were dealt with, out of which 139 post mortems and 23 inquests were conducted 20 were from Crayford and from this latter figure 20 post mortems and 2 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 12 cases were notified The number of cases notified in 1958 was 6. Diphtheria There were no cases notified in 1959 Paratyphoid or Typhoid Fever No cases were notified during the year Puerperal Pyrexia Nine cases were notified during the year Meningococcal Infection No cases were notified during the year, Food Poisoning One case was notified during the year 12. Measles The number of cases notified in 1959 was 228, The number of cases notified in 1958 was 266. Whooping Cough 31 cases were notified during the year. The number of cases notified in 1958 was 12. Acute Poliomyelitis There were no cases notified in 1959, Ophthalmia Neonatorum No cases were notified during the year. Dysentery One case was notified during the year. Notifiable Diseases (other than Tuberculosis) during the year Diseases Total Cases notified Cases admitted to hospital Deaths Smallpox - - - Scarlet Fever 12 - - Diphtheria - - - Enteric or Typhoid Fever - - - Paratyphoid Fever - - - Puerperal Pyrexia 9 - - Pneumonia 1 - - Erysipelas 2 - - Meningococcal Infection - - - Measles 228 1 - Whooping Cough 31 - - Ophthalmia Neonatorum - - - Dysentery 1 - - Poliomyelitis (Paralytic) - - - Poliomyelitis (Non Paralytic) - - - Encephalitis - - - Food Poisoning 1 1 - Totals 285 2 - 13. 14 Age Groups Under One Year Scarlet Fever Diphtheria Whooping Cough Measles (excluding rubella) Acute Poliomyelitis Paralytic Non-paralytic M F M F M F M F M F M F - - - - - - 3 3 - - - «= 1 - - - - - 1 14 12 - - - - 2 - 1 - - 3 1 18 13 - - - - 3 - - - - 3 2 15 13 - - - - 4 - - - - 3 1 15 23 - - - - 5-9 2 7 - - 7 8 54 44 - - - - 10 - 14 1 1 - - - - 1 - - - - - 15 - 24 - - - - - 1 - - - - - - 25 and over - - - - - 1 - - - - - Total (all ages) 3 9 - - 16 15 120 108 - - - - Under 5 Years Enteric or Typhoid Fevers Paratyphoid Fever Acute Pneumonia Dysentery Meningococcal 1nfection Acute Encephalitis Lethargia M F M F M F M F M F M F - - - - - - - 1 - - - - 5 - - - - - - 1 - - - - - 15 - - - - 1 - - - - - - - 45 - - - - - - - - - - - - 65 and over - - - - - - - - - - - - Total (all ages) - - - - 1 - 1 1 - - - - Age Groups (contd ) Erysipelas Smal1 pox Food Poisoning M F M F M F 0 - - - - - - 5 - - - - 1 - 15 - 1 - - - - 45 1 - - - - - 65 and over - - - - - - Total (all ages) 1 1 - - 1 - M F Puerperal Pyrexia - 9 Ophthalmia Neonatorum 15 Poliomyelitis Vaccination 1959 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, 1959:- Year of Birth 1959 1958 1957 1956 1955 1951 1953 1952 1951 1950 1919 1948 1947 1946 1945 1944 1943 Before Others Total 1943 Given second injections 72 357 80 57 57 52 64 54 50 65 53 52 76 50 24 55 195 1124 163 2700 Given third injections - 212 274 221 213 203 228 200 204 219 216 228 262 265 212 270 127 513 97 4164 Immunisation against Diphtheria 1959 The following is a return of the number of children resident in the Crayford area under the age of 15 years on 31st December, 1959 who had completed a course of immunisation at any time before that date (i.e. at any time since 1st January, 1945) Year of B i rth 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 Total Last complete course of injections (whether primary or booster) 1955-1959 45 213 160 117 173 420 107 227 236 344 318 313 299 289 73 3334 1954 or earlier 333 323 259 237 356 146 93 84 118 17 - - - - - 1966 16 Immunisation and Vaccination Set out below are the diphtheria immunisation, whooping-cough immunisation and smallpox vaccination figures for 1959 based on record cards received: Year of Birth Diphtheria Immun i sat ion Smal1 pox Vaccination Whooping-cough Immunisation Primary Reinforcing Primary Revaccination Primary 1959 73 - 175 - 195 1958 231 - 150 - 172 1957 49 - 1 - 26 1956 15 2 2 - 7 1955 7 38 4 - 3 1954 9 152 - 2 3 1953 3 49 1 - 4 1952 4 13 - 1 1 1951 1 4 - - 3 1950 2 12 - 1 1 1949 - 4 1 - - 1948 1 3 1 - - 1947 - 5 1 - - 1946 - 1 - - - 1945 - - 1 - - Before 1945 - - 7 15 - Total 395 283 344 19 415 17 Tuberculosis Age Periods New Cases Deaths Resp i ratory Non-Respi ratory Respi ratory Non-Respi ratory M F M F M F M F Under 5 years _ _ _ - - _ _ 5 - 1 - 1 - - - - 15 - - - - - - ~ 25 2 - 1 1 - - - - 45 4 - - - - - - - 65 and over - 1 - - - - - - Totals 6 2 1 2 - - - - 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 - 14 Applicants recommended for rehousing - 3 No of families granted houses on account of tuberculosis - 2 Other reasons - 6 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 9 including 3 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. 18 The total result of the local Christmas Seals Sale, including the mail sale, as reported by the Organiser to the Annual General Meeting, amounted to £73 10s.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 place an increasing demand on the services of the Health Department and the Crayford Old People's 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 People" s Homes where this has been possible. The Visiting Service carried out by the Crayford Old People" s 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 People"s 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 authorityto 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 It was necessary to arrange three burials under this section during the year. 19 CHIEF PUBLIC HEALTH INSPECTOR'S REPORT To The Chairman and Members of the Urban District Council of Crayford. Mr, Chairman, Ladies and Gentlemen, I have the honour to present my Annual Report for the year 1959 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 722 inspections were carried out, 141 of which were to premises registered under Section 16 of the Pood and Drugs Act, 1955 Fifty¬seven informal notices were served under the Food Hygiene Regulations, 1955,and in thirty¬three cases repairs or improvements to premises have been effected The number of food premises in the area is as follows Bakers 4; Butchers 18 Grocers 56 Greengrocers 20; Confectioners 27 Fishmongers 8; Cafes, Canteens, etc 35; Public Houses 19; Off Licences 3; Clubs 12; Other premises 29. Under Section 16 of the Food and Drugs Act, 1955, 63 premises are registered for the storage and sale of Ice Cream and 37 for the manufacture or preparation of preserved food intended for sale. Complaints The following complaints were received and dealt with during the year Luncheon Meat. The sale of a tin of luncheon meat affected with mould and in an advanced state of decomposition resulted in the suppliers being fined £15 with £2 2s. costs awarded to the Council Cornish Pasty. The presence of mould in a Cornish Pasty led the Council to institute legal proceedings against the suppliers resulting in a fine of £10 with £2 2s costs awarded to the Council. Milk Supplies. Legal proceedings were instituted against the suppliers in the case of a bottle of milk which was delivered not in a thoroughly clean state as required by the Milk and Dairies (General) Regulations, A fine of £3 was imposed. Fruit Pie. Examination of a fruit pie revealed the presence of what appeared to be part of a pair of nail scissors. The matter was taken up with the suppliers who were proceeded against. A fine of £20 was imposed with £4 4s, costs awarded to the Council. 20 Cheesecake and Jam Doughnut. The complaint in respect of these articles was that they were unpalatable and further that this was due to "taint from paraffin or disinfectant". The general shop where the articles were sold from was visited and the storage of the various commodities ascertained to be satisfactory. No paraffin or phenols were detected when the articles were submitted for examination. Breads Pour complaints regarding foreign matter were received. In two cases the "dirt" complained of was stated to be a trivial amount of bakery char and in the third it was ascertained to be slightly contaminated with highly refined mineral oil used for lubrication of the breadmaking machinery, These three complaints were taken up with the suppliers but no further action was considered necessary. In the fourth instance, however, the foreign matter was identified as part of a metal slicing blade and legal proceedings were instituted against the bakery concerned and subsequently a fine of £5 was imposed with £2 2s. costs awarded to the Council. Chocolates. Complaint was received regarding the condition of a quantity of chocolates. The matter was taken up with the manufacturers and the remainder of the particular batch withdrawn from sale. Flour. Black specks in a bag of flour were ascertained to be not harmful and it was felt the matter did not warrant further action. Sausages. A package of sausages formed the basis of a complaint alleging that they were unsound, As, unfortunately, part of the wrapper and the manufacturer3 s code slip had been destroyed it was difficult to establish how long these sausages had been kept. The matter was, however, brought to the notice of the manufacturer. Meat and Other Foods. The following articles were found during the year to be unfit for human consumption lbs. ozs. lbs. ozs. Beef 7 15 Tinned Pork 8 0 Lamb 44 0 Tinned Fruit 95 13½ Pig's Head 11 4 Tinned Fruit Juice 1 4 Offal 39 5 Tinned Vegetables 10 6 Sausages 3 8 Tinned Soup 3 15½ Ham 99 15 Tinned Ham 324 15 Chicken 29 0 Tinned Chicken 4 10 Corned Beef 139 8 Tinned Braised Steak and Kidney 7 Luncheon Meat 48 4½ Tinned Meat Loaf 2 2½ Bacon 129 0 Tinned Steak 3 6 Jellied Veal 76 0 Tinned Milk 9 8 Chocolates 2 8 Tinned Fish 9 11½ Butter 53 0 Tinned Jam 4 0 Steak and Kidney Pie 4 0 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, after sterilisation, 21 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 13 Sterilised 31 18 samples of milk were submitted to the County Laboratory as follows: Tuberculin Tested Pasteurised 6 Pasteurised 8 Sterilised 4 All satisfied the prescribed tests. ICE CREAM (HEAT TREATMENT) REGULATIONS, 1947 1952 There are now no manufacturers of ice cream in the area. 44 samples of ice cream submitted for examination during the year were graded as follows: Grade I 30 Grade II 13 Grade III 1 Grade IV - 22 FOOD AMD DRUGS ACT 1955 Details of samples taken by the County Sampling Officers within the Urban District of Crayford during the year ended 31st December. 1959: Article No, Article No. A.P.C. Tablets B.P.C. 1 B/f 37 Apple Charlotte 1 Lemon Flavouring 1 Apricots (dried) 1 Menthol and Wintergreen 1 Apricot Nectar 1 Military Pickle 1 Aspirin B. P. 1 Milk 24 Bakewell Tart Mixture 1 Milk Chocolate with centre containing liqueur 1 Beer Braised Steaks 1 Minced Beef 1 Butter Mint Sauce 1 Cheese (White Stilton) 1 Mixed Fruit and Nuts 1 Cheese Spreads (assorted) 1 Moche Rum Creme 1 Children's Cough and Cold Mixture 1 Mouthwash 1 Chocolate Squeez 1 Oil of Juniper Berry 1 Condensed Milk 1 Orange Cornflour 1 Pate de Foie 1 Cream (double) 1 Potted Salmon with Butter 1 Cream (single) 1 Raspberries (canned) 1 Creamed Rice Milk Pudding 1 Rum 1 Double Antiseptic Soap 1 Rum and Butter flavoured Toffees 1 Dried Green Peas 1 Sausages (beef) 1 Dusting Powder 1 Sausages (pork) 1 Easter Egg (milk chocolate) 1 Soup (condensed) 1 Easter Egg (plain chocolate) 1 Special High Protein Cereal 1 Egg and Milk flavoured Toffees 1 Steak and Kidney Pie Essence of Chicory and Coffee 1 Table Jelly 1 Eye Drops 1 Talcum Powder (mildly medicated) 1 Eye Ointment 1 Tea 1 Flour (self raising) 1 Tomatoes (canned) 1 Gin 1 Tomato Ketchup Ginger Beer (brewed) 1 Vegetable Laxative Tablets 1 Ice Cream 3 Vita Wheat Crispbread 1 Lard 2 Whisky 2 C/F. 37 Total 95 23 Summary Milks 24 Drugs 12 Spirits 4 Other samples 55 95 All the fore going samples were genuine with the exception of the following: Sample of Analysis Action Taken Braised Steaks Description "Braised Steaks" unsatisfactory Label amended to read "Braised Steaks with Gravy and Diced Carrots" Mixed Fruit and Nuts - As the anlysis disclosed 66% peanuts and 34% sultanas, the suppliers were requested to label them "Nuts and Sultanas" Egg and Milk Flavoured Toffees Label designs indicated the presence of milk and butter. Rum and Butter Flavoured Toffees Labels amended. CLEAN AIR ACT, 1956 Having completed the initial survey for the proposed Smoke Control Area at Slade Green, steps have been taken to complete the detailed survey necessary, subsequent to the provisional approval of the Council's proposals by the Minister of Housing and Local Government having been received. This survey is now virtually complete. HOUSING STATISTICS (1) Inspection of Dwelling Houses (1) Total number of dwellinghouses inspected for housing defects (under Public Health or Housing Acts) 1,187 Number of inspections made for that purpose 3,195 (2) Number of dwellinghouses (included under sub¬heading (1) (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 1 (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 .. 171 24 (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 80 (3) Action under statutory powers during the year Statutory Notices under Housing or Public Health Acts 5 Number of houses in which defects were remedied after serving of formal notices - (a) by owners 5 (b) by local authority in default of owners - Proceedings under Housing Act, 1957 - (a) Demolition Orders made under Section 17 1 (b) Clearance Area declared - Section 42 22 (c) Parts of buildings closed - (d) Houses closed 1 (e) Houses demolished: (i) as a result of formal or informal procedure under Section 17(1) 28 (ii) after purchase by Council 17 (1) 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 2,962 Number of houses built during the year - (a) by the local authority 113 (b) by other bodies or persons 69 Rent Act, 1957 During the year, 3 applications have been received for certificates of disrepair and certificates as to the remedying of defects which landlords have undertaken to remedy, 2 certificates of disrepair and 1 certificate as to remedying of defects have been issued. 25 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. The water from Crayford well station of the Metropolitan Water Board is normally very pure, even before treatment, but for the second time in recent years, this source suffered more or less serious contamination in the course of the year. This happened previously in 1950 when Number 3 well was seriously polluted by the overflow from a blocked sewer. On this second occasion inspection of the routine bacteriological culture tubes in the Water Examination Department of the Metropolitan Water Board for the sample taken on 2nd October, showed that Number 2 well had an Escherichia coli count of 16 and Number 3 had a coliform count of 2 per 100 ml. These waters are normally completely free of both organisms and their presence indicated that something was amiss. The tests showed that the water passing into supply after treatment was of the normal high standard but it was obviously necessary to watch the situation closely. Samples on the two successive days showed a further deterioration in the condition of the raw water and, although the water passing into supply was still unaffected, it was decided to close the station down as a precautionary measure. Inspection of the drains on the station did not reveal the source of the contamination and it was arranged that the Board's Drainage Inspector should co-operate with the Council's Public Health Inspector in investigating the sewers in the vicinity of the pumping station. It was ascertained that a sewer behind some shops on the other side of the road from the pumping station had been blocked and had overflowed into a nearby soakaway. The blockage was cleared on Monday 5th October. Number 2 well, which was the one most seriously affected, was pumped to waste in an endeavour to get rid of the pollution. Number 3 well gave no further evidence of contamination and was returned to supply. The bacteriological quality of Number 2 well slowly improved and it was returned to service on 5th November. 26 Water has been abstracted from the present site of the Metropolitan Water Board pumping station at Crayford since 1866 and until recently it has always been of unimpeachable quality. The pumping station is now, however, in the middle of a built¬up area and as the proximity of dwelling houses and sewers was thought to constitute a possible danger the station was given priority after the War for re¬building and the installation of adequate contact tank capacity. It is extremely fortunate that this was the case which ensured that no contaminated water was supplied to consumers. On the other hand the two instances when pollution has occurred emphasise the importance of the closest possible co-operation between the Sewage and Water Authorities in the area. Water Sampling The following samples were sent to the County Laboratory by the Council"s Public Health Inspector: (a) Wells (drinking water) Bacteriological - 14 (b) Swimming Pool, Bacteriological - 14 (c) Domestic Supplies, Bacteriological - 7 All samples forwarded have been reported satisfactory. 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. 43 and 45; the former to comprise 32 dwellings and the latter 28 Old People's Dwellings with Community Room and Warden's Accommodation. Housing Scheme No. 42 (not yet commenced) will provide a further 263 dwellings. Report of Kent River Board River Cray- Weed growth cut and removed. Debris, in the form of bedsteads, bicycles, prams, tins and household refuse, removed from the river and carted to tip. it might be notedherethat the practice of using watercourses as a convenient resting place for debris is increasing. 27 River Wansunt. Weed growth cut and removed. Waterway under Crayford Road Bridge increased by handcasting bed of river. Marsh Dykes. Weed growth and debris removed. Closet Accommodation. Approximate number of premises containing each type of sanitary conveniences in the district - W.Cs. into drainage system, approximately 11,987 W. Cs. 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 defective 42 Drainage: (i) repaired 70 (ii) unstopped, etc.151 Refuse receptacles 69 Damp proof courses inserted 7 Roofs and rain water pipes 72 Chimney stacks and pots repaired or renewed 11 Fireplaces, grates and stoves repaired or improved 11 Floors, walls and ceilings repaired or renewed 120 Rooms cleansed 21 Baths, lavatory basins and sinks 30 Water supplies 16 Doors and other woodwork 37 Yard paving provided or renewed 9 Offensive accumulations removed 8 Improper keeping of animals abated 1 Other defects 211 28 Control of Rodents and other Pests 202 complaints in respect of rats and mice infestations were received and fully investigated. 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 26; Bugs 16; Miscellaneous 57. Total number of visits of all kinds paid by Inspectors during the year 8,388 Approximate number of rated premises in the area 10,338 Notices served - Statutory 5 Informal 330 Number of houses, etc. disinfected 7 Swimming Pool Period open from 9th May to 20th September. Number of bathers - 66,445 + 52 season tickets. This figures does not include school parties and clubs. Shops Act, A total number of 146 visits were made during the year. This figures includes Sunday and evening visits. Four Notices were served. Shops continue the practice of closing earlier than the statutory closing times but the smaller shopkeepers seem to prefer commencing business much earlier in the morning, whilst on the other hand the larger concerns are beginning to carry on business until a later time on specific days. No serious breach of the Act has been noted, Eradication of the Bed Bug. Particulars of the action taken in 1959 for the eradication of the Bed Bug were as follows: Infested Disinfested Number of - Council houses 16 16 Other houses - - 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). 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 10 20 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. 63 120 4 (iii) Other Premises in which Section 7 is enforced by Local Authority. (excluding outworkers premises) 12 12 1 - Total 85 152 5 - 30 2, Cases in which Defects were found. Particulars Number of Cases in which defects were found Number of Cases in which prosecutions were in¬stituted Found Remedied Referred to H. M. Inspector Referred by H.M„ Inspector (1) (2) (3) (4) (5) (6) Want of Cleanliness (S. 1) 1 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 9 5 - - (c) Not separate for sexes - - - - - Other offences (not including offences relating to outwork) 3 — — - - TOTAL 13 6 - - - 31 OUTWORK Part VIII of the Act Nature of Work Section 110 Section 111 1 No. of out-workers in August list required by Section 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. 16 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 1 - - - - I am, Your obedient Servant A. W. KENT Chief Public Health Inspector 32