FORTY-SIXTH Annual Report of the HEALTH AND SANITARY CONDITION of the East Barnet Valley Urban Sanitary District, for the year 1919, by W. H. ELAM, F.R.C.S., L.S.A. (Lond.), Medical Officer of Health to the Council, together with the ANN UAL REPORT of BERTRAM C. WATERS, A.M.I.Mun.E., C.R.S.I., Building Surveyor and Sanitary Inspector. Printed by E. S. Wheatley, Barnet (Tel. 654). 2 j£ast Barnet Dalles Tflrban District Council. LIST OF MEMBERS, 1918-1919. Chairmen— Mr. Councillor Amos Ford, J.P., C.C. [January—October). Mr. Councillor A. E. Passingham (November—December). Vice- Chairman— Mr. Councillor E. Smith. Members— ' Mr. Councillor R. A. Brown „ „ A. E. Ellett . „ ,, S. E. Frusher „ „ J. Humphreys J. Long „ „ A. E. Morgan „ „ Thomas F. P. Prentice „ „ W. Stutters, J. P. „ „ H. Walker, M.A. East Barnet Valley Urban District Council. ANNUAL REPORT of the Medical Officer of Health for the year 1919. To the Chairman and Members of the East Barnet Valley Urban District Council. Gentlemen, I have the honour of submitting to you the 46th Annual Report of matters relative to the vital statistics, health, and general sanitary conditions of the District, for the year 1919. Physical Features and General Character of the District. The Urban Sanitary District of East Barnet Valley is within the Administrative County of Hertford, being situate on the extreme southern portion of the county. Geographically, however the district is almost wholly surrounded by the County of Middlesex, the exception being the north western portion of the boundary, which adjoins the Urban Sanitary District of Barnet (Herts). The remaining districts adjoining the Council's area are all urban sanitary districts, situate within the County of Middlesex, viz.:—On the north, Enfield; on the south and south-east, Southgate; on the south-west, Friern Barnet. The District Council was formed in April 1894, to succeed the old Local Board. The District comprises the Parishes of East Barnet, Barnet Vale and Monken Hadley. As its name implies it lies on the side of a valley extending from Hadley in the north, to Brunswick Park, in the south. The principal portion of the District is divided by the main line of the Great Northern Railway from King's Cross to the north, while it is also bounded on the east and 4 west respectively by the main roads leading from London northwards through Southgate and Barnet. The general character of the District is residential; the area on the west of the railway has been conveniently planned, and consists principally of good class detached and semi-detached villa residences, the altitude varying from 200 to 400 feet above Ordnance Datum. The District forms a portion of a much wider area noted for the healthiness of its climate, and popularly known in and around the Metropolis as the "Northern Heights." On the east of the railwayare situate the older portions of the District, including the village of East Barnet, and Brunswick Park at the southern extremity, most of which is developed for a much smaller class of property, and is consequently more densely populated. The water supply is derived from deep wells and is of great purity though a little hard. The acreage area of the District is 2,644 acres. The number of houses is about 2,580, being the same as last year. The number of inhabitants at the beginning of the year was 12,500 and at the end as estimated by the number of Food Cards issued 14,000, being an increase of 1,500. This report reveals in many ways a more favourable condition of matters than the one for the previous year, viz.:—1918, as will be seen from the accompanying tables. The total number of deaths that occurred in the District was 24 less than the previous year, and the number of births registered 44 more than in 1918. In January and February, no deaths under two years of age were registered. The number of cases of tubercular disease notified was three less than in the previous year. No extraordinary case of illness such as smallpox, enteric fever, or spotted fever occurred. A case of suspected rabies in a dog was reported, but the examination of the brain and spinal cord, demonstrated the groundlessness of the suspicion. So far as is known, no case of infectious disease was brought into the neighbourhood, by returning soldiers and sailors. 5 There was no marked epidemic during the year, except that in the first three months Influenza prevailed, causing several deaths, and in the last three months Measles prevailed. It was not found necessary to close any of the County Council Schools. Sanitation. Much has been done to improve the general health conditions of the houses, but although some houses would have been condemned as unfit for habitation had it been possible to do so, no house was deemed absolutely unfit. A systematic inspection of the sanitary conditions of the houses in certain areas has been made. A thorough examination of the water cisterns as to the state of repair and cleanliness was carried out, and recommendations as to the future location of cisterns for drinking water, as also the desirability of obtaining drinking water direct from the main pipes, rather than from cisterns, will be made. The average number of occupants of each house at the commencement of the year was about 4.8, and at the end of the year about 5.4 for each house. This does not disclose any serious overcrowding, but in some areas an undoubted overcrowding exists, and in a few individual instances, the number of occupants in a house is such as to be a severe menace to health. Drainage and Sewerage. The District is sewered and drained on the separate system. The sewage is conveyed to an Irrigation Farm of 50 acres in area, at Brunswick Park, but before it is turned on to the land, it is passed through percolating filters. Samples of the effluent are occasionally taken by the Lee Conservancy Board, but no complaints have been received. The service water drainage is conveyed to Pymmes Brook. 6 Scavenging. The house refuse is collected weekly by the Council's own staff and conveyed to the tip at Brunswick Park. The provision of a refuse destructor, will have to receive the consideration of the Council, in the near future. Industries and Occupations. The industries carried on within the district are on the increase, the factories of Messrs. Carr & Sons, also Messrs. Tylor & Co., at Brunswick Park, being considerably enlarged. Also a new factory is now in course of construction at the north end of Cromer Road. The factories and workshops in the District including laundries and bakeries, number 123. These are periodically inspected, and the condition of employment found generally satisfactory, and no special circumstance exists which is prejudicial to public health. Housing Accommodation. The Council are at present erecting 56 working men's houses on Nickell's field, East Barnet, which are expected to be completed and ready for occupation about October next, and further houses are contemplated later. It is hoped that this will tend to minimise the present shortage of houses. General Inspection. The work under this heading appears in the Sanitary Inspector's Report. 7 Bakehouses, etc. The bakehouses and slaughter houses have been periodically inspected and on the whole have been found to be in good order. Milk. The importance of a full supply of wholesale and pure milk, has been constantly under observation, and to this end the cow sheds, dairies, and milk shops have been constantly under supervision. Samples of milk have been examined as to purity, presence of dirt, foreign matter and tubercle bacilli. The further milk is conveyed from its source of production to its place of distribution, the greater the possibilities of contamination. Specimens examined from two farmers in the district were of excellent quality. Although there was some shortage of the milk supply during the year, the supply being approximately equal to 3 pints, per week for each individual, it was found possible to obtain an extra quantity for the children and sick, who were certified as requiring it. Births. The number of births registered was 203: 103 males and 100 females, given a birth rate of 14.3 per 1,000. Of these 6 males and 7 females were illegitimate. There were no deaths registered as being due to premature birth. Deaths. The number of deaths registered was 140: 65 males and 75 females, giving a death rate of 10.3 per 1,000. There were only seven deaths under seven years of age. Violence was the cause of five deaths, three occurring outside the district and two in the district. There was no case of suicide and only two inquests were held. 8 Tubercular disease was the cause of death in 14 instances. The accompanying table gives fuller particulars of causes of death and ages at which same occurred. It may be noted that there was no death from infantile Diarrhoea, that there were only seven deaths under seven years and one under one year. Tuberculosis. The number of deaths occurring from tuberculosis was 14, and of these seven were from disease in the lungs, five males and two females. The number of notification certificates of tubercular disease received was 20. During the year there were 36 people receiving treatment, dispensary, sanatorium, or institutional, four are reported as apparently cured, ten much improved or disease quiescent, and sixteen in a stationary condition. In September and October four separate carcases and viscera of cows were examined by the request of the butchers at slaughter houses, and being found extensively infected with tuberculosis, were condemned as unfit for food and destroyed. Each of these animals was purchased in Barnet Market. The danger of diseased animals infecting others in the cow sheds, and through the fa;ces in the grazing pastures, is great. It is desirable that the Tuberculosis Order of 1913, should be restored. Bacteriological Examinations. These are gfforded by the Council in all cases of infectious disease when required by Medical Practitioners. They are carried out by the Clinical Research Association. Fifty-six such examinations were made during the past year. Infectious Diseases. This is one of the most important matters of the Report, referring as it does to more or less preventable disease, and to the conditions and circumstances causing, or favouring the outbreak and spread of infectious disease. All infectious diseases were required to be notified and each separate case occurring in any house was also 9 required to be notified. Only by complete notification can a true conception of these important diseases be obtained, and the necessary steps taken to prevent and deal with them. Every case of infectious disease is as much as possible, isolated and the contact cases segregated. All children from an infected house are excluded from school, and all public places, until quite free from possible infection, and no person from an infected house is permitted to return to duty until free from infection: in the cases of Diphtheria, a bacteriological verification of freedom from the bacillus is insisted upon. All contact cases are notified to the Sanitary Districts concerned where necessary. There is a reasonable prospect of attaining success in stamping out these affections or diminishing their frequency of occurrence as is the case in some infectious diseases. Every care has been taken to detect "carriers" and in two or three cases a bacteriological examination of the throat and nose revealed the presence of the Diphtheria bacillus without there being any clinical sign of Diphtheria. The possibility that lice and fleas may convey infectious disease has been considered as well as all sources of infection. The number of notification certificates received during the year was 254, being made up largely by cases of Measles, 84 ; German Measles ; 28, Chicken Pox, 52 ; and Diphtheria, 31. The Diphtheria cases occurred mostly in the later months of the year, and coincident with widely prevailing colds and sore throats. Scarlet Fever was also most prevalent at the end of the year, and at the same time there was a great number of cases in the surrounding Districts. The following table gives some evidence of the atmospheric conditions prevailing, but it must be noted that these conditions affect not the immediate health of the people but a subsequent period:— 10  Mean Sunshine per day; hours. Rainfall. Inches. Number of days on which Rain fell. Notification Certificates received. Deaths January 0.39 4-3 21 8 13 February 1.43 3-T 12 4 26 March 313 4.04 21 19 18 April 4.07 3-2 l6 19 17 May 8.29 0.6 6 17 10 June 7.63 i-5 7 17 5 July 3.52 1.9 12 30 12 August 7.39 2.67 II 15 8 September 5.13 1.4 II 11 8 October 3.74 0.62 8 9 5 November 1.8 2.25 17 57 9 December 0.97 4.5 21 54 9 Schools. The Schools in the District were visited and the sanitary condition examined. Some defects were noted and will receive remedial attention. Instructions were given to the Head Masters as to ventilation, and the importance of cleanliness. For the most part the children appeared healthy and well cared for. Food Restrictions. Restrictions of Cream, Butter and Sugar continue to have a deleterious influence on the healthy nutrition of the community ; vegetable oils and fats cannot be an effective substitute for animal fats. Fortunately an extra quantity of these foods were supplied in necessitous cases. Great and valuable assistance has been given by the Sanitary Inspector in obtaining the very marked improvement in the sanitary condition of the houses in the District. 11 The maternity and child welfare scheme and the District nurses, have given significant help to the sick and weak. I would like to record my obligations to Mr. H. York, District Surveyor and Mr. B. C. Waters, Sanitary Inspector, for the help afforded me, and to express to the Chairmen and Members of the Council my sincere appreciation of the courtesy and consideration constantly manifested towards me during the three years that I have acted as Medical Officer. W. H. ELAM, F.R.C.S., L.S.A.(LonA), Medical Officer of Health. 12 BARNET UNION. Return of Certificates of Vaccination and Statutory Declarations of Objection to Vaccination relating to the Urban District of East Barnet Valley received by the Vaccination Officer during the year ending 31st December, 1919. Number. Certificates of successful vaccination of children under the age of 14 years 85 Statutory Declarations of Conscientious objections to vaccination 90 The above return does not include re-vaccinations or primary Vaccinations of persons above the age of 14 years, no reliable figures relating thereto being available. S. M. BALDOCK, Vaccination Officer. 19th April, 1920. 13 TABLE 1. Vital Statistics of Whole District during 1919 and Previous Years. Name of District.—EAST BARNET VALLEY. 1.—Year. 2.—Population estimated to Middle of each Year. Births. Total Deaths registered in the Transferable Deaths. Nett Deaths belonging to the District. 3.— Uncorrected Number. Nett. 8.—Of NonResidents registered in District. 9.—Of Residents not registered in the District. Under 1 Year of Age At all Ages. 4.— Number. 5.—Rate. 6. — Number. 7.—Rate. 10.—Number. 11.— Rate per 1,000 Nett Births. 12.—Number. 13.—Rate. 1909 12963 277 21.5 119 9.2 16 20 72 135 10.4 1910 13240 272 20.5 83 6.3 13 12 44 96 7.25 1911 12400 261 21 85 7 14 18 68.5 94 7.6 1912 12600 225 230 18.2 102 8.1 1 23 15 65 124 9.8 1913 12300 224 228 18.5 107 8.7 1 25 12 52.7 132 10.7 1914 12380 231 233 18.9 78 6.3 1 24 7 34.3 101 8.1 1919 13250 203 15.3 105 7.7 4 35 1 4.9 140 10.3 Area of District in acres (land and inland water) 2,636. Total population at all ages 12,400) „ Total families or separate occupiers 2,538 at Census of 1911. TABLE II.—Cases of Infectious Disease notified during the Year 1919. EAST BARNET VALLEY URBAN DISTRICT. Notifiable Disease. Number of Cases Notified. Total Cases notified in each Locality. Total Cases removed to Hosp'I. At all Ages. Under 1. 1 to 5. 5 to 15. 15 to 25. n 25 to 45. 45 to 65. 65 and upwards. 1.—East Barnet. 2.—Barnet Vale. 3.—Monken Hadley. 4.—Brunswick Park. Small Pox ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Cholera (C) Plague (P) ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Diphtheria (including Membranous Croup) 31 ...... 8 20 1 2 ...... ...... 27 3 ...... 1 24 Erysipelas 3 ...... ...... 2 ...... ...... 1 ...... 2 1 ...... ...... 1 Scarlet Fever 16 ...... 3 11 2 ...... ...... ...... 5 2 3 6 15 Typhus Fever ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Enteric Fever ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Fever Relapsing (R) Continued (C) ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Puerperal Fever ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Cerebro-spinal Meningitis ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Poliomyelitis 1 ...... 1 ...... ...... ...... ...... ...... ...... ...... ...... 1 ...... Ophthalmia Neonatorum ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Pulmonary Tuberculosis 18 ...... ...... 1 6 7 3 1 11 4 2 1 ...... Other forms of Tuberculosis 2 ...... ...... 1 ...... 1 ...... ...... 2 ...... ...... ...... ...... Chicken Pox 52 1 14 36 1 ...... ...... ...... 13 23 1 15 ...... *Pneumonia 15 ...... 1 ...... 2 7 3 2 9 3 ...... 3 ...... Polioencephalitis ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Encephalitis Lethargica ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Trench Fever ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Dysentry ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Malaria 1 ...... ...... ...... ...... 1 ...... ...... ...... 1 ...... ...... ...... Measles 84 ...... 12 62 8 2 ...... ...... 27 55 1 1 ...... German Measles 28 ...... 6 10 11 1 ...... ...... 6 19 ...... 3 ...... Whooping Cough 3 1 1 1 ...... ...... ...... ...... 3 ...... ...... 1 ...... Totals 254 2 46 144 31 21 7 3 105 111 7 31 40 Isolation Hospital. —Barnet Isolation Hospital, Mays Lane, Barnet. Total available beds 16; number of Diseases that can be concurrently treated, 3. *Nearly all the cases of Pneumonia were preceded by Influenza. TABLE III. Causes of, and Ages at Death during Year 1919. EAST BARNET VALLEY URBAN DISTRICT. Causes of Death. Net Deaths at the subjoined ages of Residents whether occurring within or without the District. Total Deaths in Public Institutions in the District. All Ages. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Enteric Fever ...... ... ... ... ... ... ... ... ... ...... Small Pox ...... ... ... ... ... ... ... ... ... ...... Measles ...... ... ... ... ... ... ... ... ... ...... Scarlet Fever ...... ... ... ... ... ... ... ... ... ...... Whooping Cough ...... ... ... ... ... ... ... ... ... ...... Diphtheria and Croup 1 ... ... 1 ... ... ... ... ... ...... Influenza ...... ... ... ... ... ... ... ... ... ...... 1 ... ... ... ... ... ... 1 ... ...... Phthisis (Pulmonary Tuberculosis) 10 ... ... ... ... ... 6 4 ... ...... Tuberculous Meningitis 2 ... ... ... 1 1 ... ... ... ...... Other Tuberculous Diseases 2 ... ... 1 1 ... ... ... ...... Cancer, Malignant Disease 12 ... ... ... ... ... ... 5 7 ...... Rheumatic Fever ...... ... ... ... ... ... ... ... ... ...... Meningitis ...... ... ... ... ... ... ... ... ... ...... Organic Heart Disease 16 1 ... ... ... ... 3 2 10 ...... 9 ... 1 ... ... ... 1 ... 7 ...... Pneumonia (all forms) 21 ... ... 3 ... 3 7 6 2 ...... Other Diseases of Respiratory Organs 4 ... ... ... ... ... 2 1 1 ...... Diarrhoea and Enteritis 1 ... ... ... ... ... ... ... 1 ...... Appendicitis and Typhlitis 2 ... ... ... ... ... 1 ... 1 ...... 1 ... ... ... ... ... ... 1 ... ...... ...... ... ... ... ... ... ... ... ... ...... Nephitis and Bright's Disease 5 ... ... ... ... ... 1 3 1 ...... Puerperal Fever ...... ... ... ... ... ... ... ... ... Accidents& Diseasesof Pregnancy& Parturition ...... ... ... ... ... ... ... ... ... ...... Congenital Debilityand Malformation, including Premature Birth ...... ... ... ... ... ... ... ... ... ...... Violent Deaths, excluding Suicide 4 ... ... ... 1 ... ... 3 ... ...... Suicide ...... ... ... ... ... ... ... ... ... ...... Other defined Diseases 49 ... ... ... 1 ... 4 14 30 ...... Diseases ill-defined or unknown ...... ... ... ... ... ... ... ... ... ...... Totals 140 1 1 5 3 5 25 40 60 ...... No Death occurred directly from Influenza but occurred from its sequelæ. 16 TABLE IV. EAST BARNET VALLEY URBAN DISTRICT. Infant Mortality. 1919.—Nett Deaths from stated causes at various Ages under 1 Year of age. Cause of Death. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. ot. und. 4 w'ks. 1-3 months. 3-6 months. 6-9 months. 9-1.2 months. Tot. und. 1 year. Small Pox ... ... ... ... ... ... ... ... ... ... Chicken Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... Pneumonia (all forms) ... ... ... ... ... ... ... ... ... ... Diarrhœa ... ... ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... ... ... ... ... ... Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... ... ... ... ... ... ... ... ... ... Congenital Malformations 1 ... ... ... 1 ... ... ... ... ... Premature Births ... ... ... ... ... ... ... ... ... ... Atroyhy, Debility and Marasmus ... ... ... ... ... ... ... ... ... ... Other Causes ... ... ... ... ... ... ... ... ... ... Totals 1 ... ... ... 1 ... ... ... ... ... Nett Births in the year Legitimate 190. Illegitimate 13. Nett Deaths in the year of Legitimate infants 1. Illegitimate infants 0, Annual Report of Medical Officer of Health for 1919. For the Urban District of East Barnet Valley, on the administration of the Factory and Workshop Act, 1901, in connection with Factories, Workshops, Workplaces and Homework. 1.—INSPECTION of FACTORIES, WORKSHOPS & WORKPLACES Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 26 9 — Workshops (Including Workshop Laundries) 120 13 — Workplaces 5 1 — Total 151 23 — 2.—DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars, Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts:— Want or cleanliness 18 18 Want of ventilation 2 2 Overcrowding 1 1 Want of Drainage of floors Other Defective drains 4 4 4 4 nuisances Animals kept Sanitary accommodation insufficient unsuitable or 1 defective 5 5 not separate for sexes Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) Breach of special sanitary requirements for bakehouses (SS. 97 to 100) Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report) Total 35 34 * Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshops Act, as remediable under the Public Health Acts, 18 3.-HOME WORK. Outworkers' Lists * (S. 107):— Lists received from other Councils:— Wearing Apparel—(!) making, &c. 13 Outworkers—Workmen 1 4.-REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. Number. Workshops 60 Domestic Workshops 30 Workshop Laundries 2 Domestic Laundries 3 Workshop Bakehouses 9 Workplaces 3 Total number of Workshops on Register 107 5.-OTHER MATTERS. Class. Nlumber. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. 133). Action taken in matters ' referred by H.M. In- Notified by H.M. Inspector spector as remediable 2 Health Acts, but not Reports (of action taken) undertheFactoryand sent to H.M. Inspector Workshop Act (S. 5) 2 Other Underground Bakehouses (S. 101):— Certificates granted during the year In use at the end of the year 3 * The Lists should be received twice in the year. The year's figures required in the Table are then obtained by adding together the two halfyearly totals. 19 East Barnet Valley Urban District Council. Sanitary Inspector's Report for the year 1919. Mr. Chairman and Gentlemen, I have the honour to present herewith my First Annual Report on the work of my department. I commenced duties on April 7th. 1919, and am pleased to be able to state that, in the majority of cases, an intimation to the owners of the existence of certain nuisances on specified premises, with a request to execute the remedial works, of which particulars are invariably given, has been sufficient to secure the abatement of the nuisances. Only in one instance has legal proceedings been resorted too, and in that case the defendant had been cautioned several times previously. Nine Statutory Notices have had to be served throughout the year, out of a total of 267 intimation notices and letters. Having regard to the amount of work carried out in the District, I consider the fact of there being so few Statutory Notices necessary, reflects the greatest credit upon the owners of property, and I appreciate very much the amount of work done that was held in abeyance during the period of the War, especially remembering the very greatly increased cost of material and labour at the present time. It should not be overlooked in considering this report that the War has seriously affected the financial resources of many Property Owners. The Council have given consideration to this and the systematic Inspections under the Housing and Town Planning Act, 1909, have been temporarily suspended, and the Committee has been given authority to exercise its discretion as to the postponement of works or extension of time in which to execute same. In most 20 instances the works have been carried out without undue delay, but the difficulty of procuring materials and labour has been the cause of works sometimes being held up. In two instances, Notices under Section 28 H. and T.P. Act, 1919, have been issued, giving the owners 28 days in which to carry out all necessary works, and in default, the Council themselves to do the work and charge the cost to the owners. In the case of the first Notice the mortgagees stepped in, and carried out the necessary works, and the second Notice has not yet expired. A Notice was also served under Section 36 of the Public Health Act, 1875, to provide flushing cisterns to the W.C's., giving the owner 28 days in which to carry out the work, or in default the Council to do so and charge the cost to the owner. This matter received attention by the owner. I received the instructions of the Council, to inspect Lancaster Road, especially in regard to the Sanitary Appliances and Water Cisterns, because of the recurring outbreaks of Infectious Fever in this road, and 70 houses have already been inspected. The water supply cisterns in the majority of the houses inspected required cleaning out, and the covers repaired, and several of the properties were found in a very dirty and dilapidated condition. The usual high standard of work has been insisted upon, so that the improvements are of a lasting character. The effect of same on the health and general convenience of the occupiers must be appreciable and the increase in the value of the premises dealt with is in many instances also considerable. Many properties have been dealt with during the year without even the issue of a Preliminary Notice. There are a variety of ways in which an Inspector becomes acquainted with conditions requiring attention, and there are also various methods of getting defects put right quickly and effectually. The choice of the best method in particular cases affords opportunity for the exercise of tact and discretion. Formal Notices are not always the most successful. It is often found that a courteous letter, or a personal interview, is much more appreciated and more effective than a purely official communication. 21 Summary of Statistics. I append to this report a summary of statistics relating to the sanitary work effected in the District, in the form prepared by the County Medical Officer of Health for co-ordinating the records throughout the County. The information desired has been supplied as fully as possible, but in some instances the items are not applicable to an Urban District. Public Health Legislation. The work of my department has proceeded along the usual lines during the year, and resolved itself into several main features, viz.:— (a) Inspecting houses in routine; (b) Inspecting premises on complaint, or for special purposes, as after infectious diseases; (c) Inspections for supervision of works in hand to comply with notices; (d) Inspections under Factory and Workshops Acts, Dairies, Cowsheds and Milkshop Regulations, Slaughter Houses, etc. For the information of the Council, and in accordance with the requirements of the Ministry of Health, I append hereto a table showing the defects found to exist on the properties inspected during the year:— Statistics of Inspections, Nuisances, etc. Number of Premises visited in house to house inspection, under the Public Health Acts 115 Number of Nuisances abated 518 „ Houses inspected from complaints received 89 „ Premises inspected after complaints, and no nuisance found 16 „ Visits in respect of illness 51 „ Visits in respect of disinfecting of rooms 70 „ Visits in respect of removal of bedding for disinfection 51 „ Visits for sundry purposes Numerous „ Preliminary notices, letters, and verbal instructions issued for the abatement of nuisances 267 „ Statutory notices issued 9 „ Visits to dairies, cowsheds, and milkshops 52 „ Visits to slaughterhouses 25 22 Remedial Works carried out. As the result of notices issued under the Public Health Acts the undermentioned works have been carried out during the year:— 1. Arrangements for Prevention of the Contamination of the Water Supply. Defects found:— Water cisterns defective 3 „ „ Dirty or inaccessible 31 „ „ Without covers 18 „ „ Covers defective or dilapidated 30 Houses without water supply, through defective supply pipes 11 2. Closet Accommodation. Defects found:— W.C. pans in foul condition 5 „ pans broken or otherwise defective 21 „ buildings structurally dilapidated or dirty 22 „ flushing cisterns defective 40 „ without flushing cisterns 5 J. Drainage. Defects found:— Drains in leaky condition 13 „ unventilated 1 „ without inspection chambers or same defective 6 „ communicating direct with sewer, without intercepting trap 3 „ choked, cleared and cleansed 21 Rain water pipes acting as ventilators to the drain, disconnected and made to discharge over properly trapped gullies 7 Defective soil and ventilating pipes repaired 47 Defective traps removed and proper traps substituted 12 Premises without sufficient lavatory accommodation; additional conveniences provided 1 Premises redrained 6 Cesspools constructed 2 23 4. Condition of Dwelling Houses in regard to Light, Free Circulation of Air, Dampness and Cleanliness. Defects found:— Light and ventilation insufficient, and windows dilapidated 25 Dwelling houses damp 29 Ceiling and walls of rooms cleansed 156 ,, „ „ repaired 96 Defective scullery sinks 9 „ sink waste pipes 8 Leaky and dilapidated roofs 53 Floors dilapidated and defective ventilation underneath 11 Defective staircases 13 5. Paving, Drainage and Sanitary Condition of Yards or Outhouses. Defects found:— Yards in dirty condition 17 „ without paving or drainage 5 „ with defective or insufficient paving 19 6. Arrangements for Deposit of Refuse and Ashes. Defects found:— Absence of dustbins, or dustbins so dilapidated as to be unfit for use 34 7. Existence of Rooms unfit for Human Habitation. Defects found:— Rooms unfit for habitation; throughly renovated 3 Houses unfit for habitation nil Houses overcrowded several 8. Defects in other matters:— Eaves gutters and rain water pipes in defective condition (Premises) 27 Animals improperly kept 8 Miscellaneous defects 47 Removals of manure numerous Accumulation of rubbish 3 Bedding cleansed 3 24 Water Supply. During the year numerous storage cisterns have been found situated over w.c.'s and coal houses, and often without any protection of the water supply from any foul air from the w.c. and dirt from coal houses, etc. Action has been taken in all such cases, either for the removal of the cisterns to more suitable positions, or for the provision of new airtight ceilings to w.c.'s, and coal houses. As the number of cases of Infectious Disease in Lancaster Road was rather numerous and recurring, the Council instructed me to inspect the houses in this road, especially with regard to the water supply cisterns, drainage and general cleanliness. This road contains 159 houses and 70 were inspected by the end of the year, the inspection of the remainder is being proceeded with. I append a short summary of the principle defects found:- Number of houses inspected, and no defects found 9 Water supply cisterns dirty 19 „ „ „ without covers 7 „ cistern covers defective or dilapidated 14 W.C. pans defective and without water or insufficient water to flush same 14 W.C. compartments dirty 6 Drains defective, unventilated or insufficiently ventilated 19 Roofs leaky and houses damp 22 Rooms require cleansing 65 Drainage. During the year the drainage of 6 premises was reconstructed, while the partial reconstruction has also been carried out on 13 other premises. Twenty-six drains were smoke and chemically tested. The work has involved the laying approximately of 2,500 feet of glazed stoneware and iron pipes. 25 Factory and Workshops Act, 1901. Two large factories, one at Oakleigh Road, Brunswick Park and the other at Cromer Road, New Barnet are at present in course of erection. The Brunswick Park factory which is nearing completion has at present 422 employees. The factory at Cromer Road when completed is expected to accommodate 600 employees. Messrs. Carr's factory at Brunswick Park has 378 employees. The condition of the Factories and Workshops throughout the District was not quite up to the required standard of cleanliness, owing to little having been done during the period of the war, but an intimation to the occupiers in most cases has been sufficient to have the necessary remedial works carried out without undue delay. Outworkers. In accordance with the provisions of the Factory and Workshop Act, several lists of outworkers residing in this district have been received during the year, from persons employing homeworkers. These lists have mostly come through the office of the Corporation of London, and other Metropolitan Boroughs. The premises specified in these lists have been visited for the purpose of ascertaining the sanitary condition under which the work is done. In most cases defects were found but the remedial works have either been carried out, or are receiving attention. Bakehouses. Notices under Section 99 of the Factory and Workshop Act, 1901, were sent out to all occupiers of bakehouses throughout the district requiring them to thoroughly limewash their bakehouse premises twice a year, in May and November, and all the notices were complied with forthwith, no further action has been necessary. There are nine bakehouses in the district, three of which are underground. 26 Sale of Food and Drugs Act. This Act is administered in this Council's district through one of the Inspectors appointed by the County Council for that purpose. I have been supplied with the following information as to samples of articles of food taken for analysis from retailers within this Council's Area during the year 1919:— * Milk 13 Butter 3 Lard 2 Cocoa 1 Self-raising Flour 1 Total 20 * One of these was adulterated, being 6 % deficient in fat and the vendor was cautioned by the Clerk of the County Council. All the other samples were genuine. Dairies, Cowsheds, and Milk Shops. The number of these premises within the district is:— Dairies and Cowsheds 9 Milk Shops 6 Several visits were paid to these premises throughout the year, and verbal intimations to the occupiers that their premises required limewashing were complied with forthwith. The local dairymen and purveyors of milk appear to be plying their trade with due regard to the protection of the milk supply from contamination. Slaughter Houses. There are two licensed and two registered slaughter houses in the district and these are being maintained in a satisfactory manner. Verbal intimations to the occupiers that these premises required limewashing were complied with forthwith, and no further action has been necessary. 27 Offensive Trades. Steps have been taken under the provisions of the Public Health Act Amendment Act 1907, Sec. 51, Amending Sec. 12 of the Public Health Act, 1875, to include by Declaratory Order the trade of Fish Frier as an Offensive Trade and the Ministry of Health has issued an order to this effect. The order declaring the foregoing trade to be offensive has been advertised in the local newspaper and byelaws are being carefully drawn up regulating the carrying on of this trade. These byelaws when drafted will be submitted to the District Council and the Ministry of Health for approval. Manure Notices. Notices were circulated throughout the District during the summer months to have all manure removed from stables, etc., at least twice a week, in order to prevent the breeding of flies. The notices were complied with and the results satisfactory. Diseased and Unsound Food. The following is a list of unsound food that has been voluntarily surrendered and destroyed during the year:— 3 carcases of beef and offal Tuberculosis 2 forequarters of beef and offal ditto 1 sack of winkles Decomposed 1 box of dates ditto 99 pounds of bacon ditto 52 pounds of jam ditto 77 two pound jars and 141 one pound jars of marmalade were detected in a preliminary stage of decomposition (moulds growing on top of same) through not properly being sealed down, fermentation having taken place. The contents, to the depth of two inches were removed from the top of each jar and permission was given for the bulk to be returned to the makers to be reboiled. 28 The beef and bacon were removed to the Council's piggeries and boiled down as food for the pigs. The other unsound food was buried in lime by the owners in their gardens. Disinfection. The methods in use in this District are:— Rooms sprayed with 2% solution of Formic Aldehyde: bedding clothes, etc., removed (by arrangement with the Joint Hospital Authorities) for steam disinfection. A small disinfection hand pump was purchased by the Council in place of a large pump which was worn out. This greatly facilitates the work. All disinfection of rooms is carried out free of charge by the Council to the residents in the District, and the bedding, clothes, etc., after notifiable cases of fever and tuberculosis, steam disinfected by the Joint Hospital Authorities. The articles are collected, disinfected and returned free of charge. Owing to the increased cost of horse hire, labour, etc., the Joint Isolation Hospital Authorities have now made a charge of 17/6 per journey to residents in this district for the disinfection of bedding, clothes, etc., after all non-notifiable diseases. The Council recently gave instructions that disinfectant soap be purchased and supplies given free after all cases of infectious disease; also in other cases where supplies are thought to be desirable. This should greatly influence people to thoroughly cleanse their premises and so ward off any likelihood of recurring cases. Disinfection figures for the year are:— Rooms Disinfected. Houses from which bedding was removed. After Scarlet Fever 16 16 „ Diphtheria 31 31 „ Tuberculosis 6 4 „ Other Diseases 23 - 76 51 29 In conclusion I wish to express my indebtedness to the Chairmen and Members of the Council, for the support which has always been extended to me in carrying out the duties of my office which support is greatly appreciated. My thanks are also due to my fellow officials for their valuable assistance. I beg to remain, Gentlemen, Your obedient servant, BERTRAM C. WATERS, A.M.I.Mun.E., C.R.S.I., Sanitary Inspector. 30 Summary of Sanitary Work executed in 1919 The following particulars are supplied at the request of the County Medical Officer of Heath. The information desired has been given wherever possible, but in some instances the items are not applicable to the District:— INSPECTIONS. Houses:— Number of Premises Inspected. Number of visits paid. Houses inspected in routine 115 314 „ „ on complaint 89 170 „ „ for special enquiry 16 22 Visits re infectious disease 51 123 Common lodging houses inspected 1 7 Common yards, courts, and alleys inspected — - Schools:— Visits to 7 21 Trade Premises:— Bakehouses 9 28 Laundries 7 17 Cowsheds 9 23 Milkshops 6 29 Ice cream shops — — Food manufacturers — — Slaughterhouses 4 25 Markets — — Other factories 16 34 „ workshops and workplaces 93 113 Visits after serving notice — Numerous „ to works in progress — „ 31 REMEDIAL WORKS. Houses:— Houses disinfected 70 „ rooms cleansed 156 „ closed ... — „ demolished — „ in which overcrowding abated several Walls damp and defective, remedied 29 Roofs, guttering or spouting repaired 80 Windows made to open ... 25 Lighting improved Ventilation improved Drainage:— Water closets repaired and cleansed 27 „ „ provided with flushing cisterns 6 Cisterns and flushing apparatus repaired 40 Pipes disconnected; sink, lavatory, etc. 7 Sinks defective; new ones provided 9 New urinals constructed — Drains reconstructed 6 „ repaired 13 „ unstopped 21 „ tested by water (lengths) 49 „ „ „ smoke 11 ,, „ „ chemicals 15 Houses connected to sewer - Cesspools constructed 2 Water. Cisterns cleansed, repaired or covered 82 Yards. Yards paved, repaired or cleansed 41 Sanitary dust bins provided 34 Accumulations of manure removed numerous Schools disinfected - 32 Trade Premises:— Factories and workshops ventilation improved 2 „ „ „ w.c. accommodation defective 5 Workshops cleansed or limewashed 18 Bakehouses „ „ „ 9 Food:— Carcases condemned or partly so (tuberculosis) 4 Bacon (decomposed) 99 lbs. Winkles „ 1 sack Dates „ 1 box Jam „ 52 lbs. Marmalade, 295 lbs., in 1 lb. and 2 lb. jars (moulds and fermenting), two inches removed off the top of each jar and the bulk then allowed to be returned to the makers, to be re-boiled. Samples of food and drugs taken, 20: Milk 13 „ „ milk 13 Convictions for adulteration or otherwise — Various:— Cases in which infective bedding destroyed — Canal boats inspected; number of contraventions — Fruit pickers' huts inspected — Temporary or movable dwellings inspected — Birds and animals improperly kept; removed 8 Clerical and Le.sral Work:— Letters written numerous Notices served; Preliminary 60 „ „ Statutory 9 Summonses issued 1 Convictions 1