LIBRARY EBAR 6 East Urban District Council. SEVENTY-FIRST ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1994 To Chairman and Members of the East Barnet Urban District Council. Gentlemen, I have the honour to present to you my Report for the year 1944. Milk Supply. There are now only three farms in the district at which milk is produced and the milk at two of these farms is primarily for consumption by their own households, only a very small quantity indeed being sold to a dairy company. Due allowance must be made for the fact that under war conditions it is very difficult to exact the high standard of cleanliness to which we have become accustomed, but taking all circumstances into consideration the proportion of unsatisfactory milk is small, and it is worth while noting that the percentage of unsatisfactory samples continues to decrease each year. Water Supply. The water which is obtained from deep wells sunk into the chalk is supplied by the Barnet District Gas and Water Company. The Company have an up-to-date chemical and bacteriological laboratory in charge of a fully qualified chemist. During the year 1530 examinations were made 96.3 per cent, being b. coli free in 100 c.c.'s. Samples are also sent periodically to independent analysts in London for their examination and the following report is characteristic of such examinations :— 2 " This is a clear and bright water free from odour and taste and neutral in re-action. It is hard in character, free from metals and contains no excess of saline matter. Both organically and bacteriologically the water is of a high degree of purity and is a pure and wholesome water suitable for public supply purposes." 12 samples were also taken by us and submitted for examination. The reports were in every case satisfactory. Diphtheria Prophylaxis. The position remains reasonably satisfactory. A careful estimate of numbers immunised showed 72% in the under 5 group and 72% in the 5-15 year group. Health. Visitors have been actively engaged in propaganda and the number of positive refusals to accept this treatment are gratifyingly small. The birthday card scheme promises good results in the under 5 group and we may anticipate a steady rise in the percentage immunised in this group. The district has shared in the country wide decrease in Diphtheria, which position is, in my opinion, mainly attributable to the immunisation campaign. Efforts are continuing to increase the number immunised and I am not satisfied that we have yet reached the total that could, and should, be protected. Scabies. Once again the co-operation of Civil Defence personnel must be gratefully acknowledged. During the year some 303 cases and contacts have been treated. Little persuasion is now needed to get people to undergo treatment and recurrences have been infinitesimal in number. Although this report refers to 1944 it is now appropriate to refer to the valuable services rendered to the Public Health of this district by Civil Defence personnel, as by the time this report is printed Civil Defence will have officially stood down. Mention has already been made of the work done in connection with Scabies, where the clinic has been staffed entirely by volunteers from the First Aid Post personnel. Another outstanding example to which the attention of the Council has recently been drawn is the Ambulance Service, during the whole of the war years worked entirely by Civil Defence personnel. It should be recorded that never has the district been so well served with Ambulance services, and this fact is recognised by the written and spoken thanks of those residents who have had occasion to use the Service. The number dealt with in 1944 was 794, and 3 maternity cases have been successfully dealt with during transit in the ambulance. 3 Apart from these two main items Civil Defence personnel have given valuable help in Minor Ailment and other clinics, Day Nurseries and Oakdene Medical Rest Centre. It can be truly said that any help desired by the Public Health Authorities has always been most rapidly forthcoming from Civil Defence, and this has undoutedly quickened the civic sense in Public Health work. The Joint War Organisation of St. John and British Red Cross has been responsible for the greater part of the staffing of Oakdene Medical Rest Centre, and in so doing have made a great contribution. This is perhaps not the place to comment on the work done at Oakdene except to say that it has helped a considerable number of bombed out people. Members of the Joint War Organisation based on First Aid Posts have at all times cheerfully carried out various duties required of them by my department. The Volunteer Car Pool organised and run by the Women's Voluntary Service has been of the greatest assistance in the transport of the sick and infirm, and the service they have performed will be impossible to replace without a continuance on some lines of voluntary help. Medical Practitioners in the district responded en masse to such calls for aid as were made upon them for Civil Defence purposes, and when incidents occurred, doctors invariably arrived amongst the earliest helpers, frequently without waiting to be called. The Wellhouse Hospital responded magnificently to the work of treating air raid casualties, and gave most valuable aid to the community, due in no small measure to the ever present interest and co-operation of the Medical Superintendent. In conclusion I would like to mention the work involved in the recruiting and training to a high degree of efficiency of a Food Decontamination Squad, formed entirely by volunteers for this work. This organisation although happily never needed for the purposes for which it was reserved, caused considerable extra work on the part of the Chief Sanitary Inspector. I have the honour to be, Gentlemen, Your obedient Servant, C. M. SCOTT, m.r.c.s. (Eng.), l.r.c.p. (Lond.), Medical Officer of Health to the Council and A Assistant School Medical Officer. 4 Area and Rateable Value. The area of the district is 2,644 acres. Registrar-General's estimate of resident population, 1944, 34,610. Rateable Value (at 31st December, 1944), £385,558. Estimated product of a penny rate for 1944, £1,540. Vital Statistics. Total. M. F. Live Births. Legitimate 688 332 356 Illegitimate 20 14 6 Birth rate per 1,000 of the estimated resident population 20.45 (The birth rate for England and Wales was 17.6). Stillbirths9 6 3 Rate per 1,000 (live and still) births 12.5 Total. M. F. Deaths377 200 177 Death rate per 1,000 of the estimated resident population 10.8 (The death rate for England and Wales was 11.6). There were no deaths from puerperal sepsis or other puerperal causes. Death Rate of Infants under one year of age :— All Infants per 1,000 live births 35.3 Legitimate Infants per 1,000 Legitimate live births 33.4 Illegitimate Infants per 1,000 Illegitimate live births 100.0 Deaths from Cancer (all ages) 79 ,, Measles (all ages) 0 ,, Whooping Cough (all ages) 2 ,, Diarrhoea (under 2 years of age) 1 Infantile Death Rate. There were 25 deaths of children under one year as compared with 17 last year, a death rate per 1,000 live births of 35.3. Last year the figure was 25.7 and for 1942, 33.3. For England and Wales the rate was 46. Prevalence of, and Control over, Infectious Diseases. With the exception of Mumps, all cases of infectious disease are now notifiable in the area, and particulars of those cases notified are given in Table 1. With regard to Diphtheria, every facility for prompt diagnosis and treatment is placed at the disposal of local doctors, swabs for examinations of throat, etc., and a supply of antitoxin are kept in readiness at the Town Hall. In addition, the Council has now given facilities for the supply of immunising serum. 5 Similar facilities for bacteriological diagnosis are available in cases of Tuberculosis and other Infectious Diseases and full advantage is taken of them. During the year, reports on the following swabs sent for bacteriological examination were received :— Swabs taken from suspected cases of Diphtheria, Positive, 2 Negative, 36. In all infectious cases where patients are removed to isolation or special hospitals, the patient's home is visited and disinfection thoroughly carried out. Smallpox. No cases of this disease were notified during the year. Tuberculosis. A table is given showing new cases and mortality during 1944. Whenever possible, all cases of Pulmonary Tuberculosis likely to benefit are sent to the County Sanatorium at Ware. In every case thorough disinfection of the premises, etc., is carried out as soon as the patient has been removed. TABLE I. Notifications of Infectious Disease (other than Tuberculosis) received during the year 1944. CAUSES. Total Cases Notified. Under 1 year. 1—2 years. 2—3 years. 3—4 years. 4—5 years- 5—10 years. 10—15 years. 15—20 years. 20—35 years. 35—45 years. 45—65 years. 65 and over. Cases admitted to Hospital. Total Deaths. Scarlet Fever 73 ...... 4 ...... 12 25 21 10 ...... 1 ...... ...... ...... 54 ...... Diphtheria 2 ...... ...... 1 ...... ...... ...... 1 ...... ...... ...... ...... ...... 2 ...... Chicken Pox 212 7 12 11 11 19 107 33 8 3 1 ...... ...... ...... ...... Whooping Cough 136 11 15 41 30 33 ...... 6 ...... ...... ...... ...... ...... 1 2 Measles 69 5 6 7 13 14 14 5 ...... 5 ...... ...... ...... 6 ...... Pneumonia 16 ...... ...... ...... ...... ...... 1 ...... 1 3 2 5 4 2 ...... Erysipelas 6 ...... ...... ...... ...... ...... ...... ...... ...... 1 1 3 1 1 ...... Puerperal Pyrexia 1 ...... ...... ...... ...... ...... ...... ...... ...... 1 ...... ...... ...... ...... ...... Dysentry 2 ...... ...... ...... ...... ...... ...... ...... ...... 2 ...... ...... ...... ...... ...... Total 517 23 37 60 66 91 143 55 9 16 4 8 5 66 2 TABLE II. Causes of, and Ages at, Death during the year 1944. causes Net Deaths at the subjoined ages of Residents whether occurring within or without the District. All Ages. Under 1 year. 1 to 2 years. 2 to 5 years. 5 to 15 years. 15 to 25 years. 25 to 45 years. 45 to 65 years. 65 and over. Total Deaths in Public Institutions in the District. Cancer 79 ...... ...... ...... ...... ...... 3 31 45 31 Heart Disease 89 2 ...... ...... 1 ...... 8 33 45 44 Arterio Sclerosis 6 ...... ...... ...... ...... ...... 1 ...... 5 2 Coronary Thrombosis 12 ...... ...... ...... ...... ...... ...... 3 9 3 Cerebral Thrombosis 16 ...... ...... ...... ...... ...... ...... 3 13 3 Cerebral Haemorrhage 12 ...... ...... ...... ...... 1 ...... 2 9 5 Cerebral Embolism 2 ...... ...... ...... ...... ...... 1 1 ...... 1 Hemiplegia 2 ...... ...... ...... ...... ...... ...... 2 ...... Subdural Haemorrhage 2 1 ...... ...... ...... ...... ...... 1 ...... 1 Aneurysm of Abdominal Aorta 2 ...... ...... ...... ...... ...... ...... ...... 2 2 Maglignant Hypertension 1 ...... ...... ...... ...... ...... 1 ...... ...... 1 Cerebral Tumour 1 ...... ...... ...... ...... ...... 1 ...... ...... 1 T.B. Meningitis 1 ...... ...... ...... 1 ...... ...... ...... ...... 1 Tuberculosis 18 ...... ...... ...... 2 7 2 2 5 4 Haemoptysis 1 ...... ...... ...... ...... ...... ...... ...... 1 ...... Pneumonia 22 6 ...... ...... 2 ...... 6 3 5 12 Bronchitis 9 1 ...... ...... ...... ...... 3 1 4 6 Whooping Cough 2 2 ...... ...... ...... ...... ...... ...... ...... ...... Acute Pulmonary Oedema 2 ...... ...... ...... ...... ...... ...... ...... 2 ...... Pulmonary Embolism 1 ...... ...... ...... ...... ...... ...... 1 ...... ...... Influenza 4 ...... ...... ...... ...... ...... ...... 3 1 2 Premature Birth 5 5 ...... ...... ...... ...... ...... ...... ...... 3 Congenital Atelectasis 1 1 ...... ...... ...... ...... ...... ...... ...... ...... Uraemia 5 ...... ...... ...... ...... ...... ...... 1 4 1 Acute Gastro Enteritis 3 3 ...... ...... ...... ...... ...... ...... ...... 3 Haematemesis 1 1 ...... ...... ...... ...... ...... ...... ...... 1 Convulsions 1 ...... 1 ...... ...... ...... ...... ...... ...... ...... Nephritis 13 ...... ...... ...... ...... ...... 1 8 4 ...... Hypernephroma 1 ...... ...... ...... ...... ...... ...... ...... 1 ...... Perforaed Gastric Ulcer 1 ...... ...... ...... ...... ...... ...... 1 1 Acute Intestinal Obstruction 4 ...... ...... ...... ...... ...... ...... 2 2 4 Paralytic Ileus 1 ...... ...... ...... ...... ...... ...... ...... 1 ...... Perforated Appendix 2 ...... ...... ...... ...... ...... ...... 2 ...... 2 Chronic Pancreatitis 1 ...... ...... ...... ...... ...... 1 ...... ...... ...... Bantis Disease 1 ...... ...... ...... ...... ...... ...... ...... 1 ...... Lymphatic Leukaemia 2 ...... ...... ...... ...... ...... ...... ...... 2 ...... Diabetes 3 ...... ...... ...... ...... ...... ...... 1 2 2 Strangulated Hernia (op.) 1 1 1 Post Operative Shock 2 ...... ...... ...... ...... 1 ...... ...... 1 1 Gangrene 2 ...... ...... ...... ...... ...... ...... ...... 2 ...... Barbitutate Poisoning 1 ...... ...... ...... ...... ...... ...... 1 ...... ...... Toxaemia 1 ...... ...... ...... ...... ...... ...... ...... 1 1 Adenoma of Prostate 2 ...... ...... ...... ...... ...... ...... ...... 2 1 Typhoid Fever 2 ...... ...... ...... ...... ...... 1 1 ...... 2 Obstetric Shock (op.) 1 ...... ...... ...... ...... ...... 1 ...... ...... 1 Asphyxia 5 2 ...... ...... ...... 1 2 ...... ...... 3 Misadventure (Inquest— Inattention at Birth) 1 1 ...... ...... ...... ...... ...... ...... ...... ...... Senility 5 ...... ...... ...... ...... ...... ...... ...... 5 2 Burns and Shock 1 ...... ...... ...... 1 ...... ...... ...... ...... 1 Accident 3 ...... ...... ...... ...... 1 1 1 ...... 1 Suicide 4 ...... ...... ...... ...... 2 ...... ...... 2 ...... Due to War Operations 15 ...... ...... ...... ...... ...... 4 5 6 3 Syphilis 2 ...... ...... ...... ...... ...... ...... 1 1 2 Totals 377 25 1 ...... 7 13 37 107 187 155 6 7 TABLE III. Infantile Mortality, 1944. Net Deaths from stated causes at various ages under 1 year. CAUSES OF DEATH. Under 1 week. 1—2 weeks. 2—3 weeks. 3—4 weeks. Total under 4 weeks. 1—3 months. 3—6 months. 6—9 months. 9—12 months. Total under 1 year. Premature Birth 5 ...... ...... ...... 5 ...... ...... ...... ...... 5 Misadventure (Inquest— Inattention at Birth) 1 ...... ...... ...... 1 ...... ...... ...... ...... 1 Congenital Heart Disease 1 ...... ...... ...... 1 1 ...... ...... ...... 2 Whooping Cough ...... ...... ...... ...... ...... 1 1 ...... ...... 2 Broncho Pneumonia ...... ...... ...... ...... ...... 1 2 2 2 7 Acute Gastro Enteritis ...... ...... ...... 1 1 1 1 ...... ...... 3 Congenital Atelactasis 1 ...... ...... ...... 1 ...... ...... ...... ...... 1 Subdural Haemorrhage 1 ...... ...... ...... 1 ...... ...... ...... ...... 1 Haematemesis 1 ...... ...... ...... 1 ...... ...... ...... ...... 1 Asphyxia 1 ...... ...... ...... 1 ...... ...... 1 ...... 2 Totals 11 — — 1 12 4 4 3 2 25 TABLE IV. Tuberculosis. New Cases and Mortality during 1944. AGE PERIODS. NEW CASES. DEATHS. Respiratory. Non-Respiratory. Respiratory. Non-Respiratory. M. F. M. F. M. F. M. F. 0— ...... ...... ...... ...... ...... ...... ...... ...... 1— ...... 1 1 1 ...... ...... ...... ...... 5— 1 3 ...... 1 1 ...... 1 ...... 15— 13 10 1 1 1 2 ...... ...... 25— 10 9 ...... 1 2 2 ...... ...... 35— 9 2 1 3 2 ...... ...... 45— 5 2 ...... ...... 1 ...... ...... ...... 55- 2 1 1 ...... 1 ...... ...... ...... 65 and over 4 ...... ...... ...... 3 2 ...... ...... Totals 44 28 4 7 11 6 1 — East Barnet Urban District Council. ANNUAL REPORT of the CHIEF SANITARY INSPECTOR FOR THE YEAR 1944. To the Chairman and Members of the East Barnet Urban District Council. Gentlemen, The following is a brief report on the sanitary inspection of the area during the year. The number and nature of the inspections and visits were as follows :— Nuisances and sanitary defects 3,672 Infectious diseases 531 Restaurants, Snack Bars, etc. 33 Water Supply 62 Schools 77 Verminous Premises 228 Fish Shops 31 Butchers' Shops 88 Other Food Shops 245 Various Premises re rats 994 Visits in connection with Scabies cases 471 Inspections for dilapidated dustbins 833 Inspections of Factories 158 Inspections of Outworkers' Premises 168 Inspections of Bakehouses 31 Inspections of Cowsheds and Dairies 96 Under the Milk (Special Designations) Regulations, 1936-41 (including visits for purchase of samples) 128 Inspection of Dwelling Houses 226 Visits to Houses to ascertain permitted numbers 18 Inspections in connection with Overcrowding 86 Visits to homes of applicants for Council Houses 11 Carried forward 8,187 9 Brought forward 8,187 Other Shops 115 Food Inspections 132 Dwelling Houses re the Rent Restrictions Acts 32 Inspections under the Byelaws relating to Hairdressers' and Barbers' Premises 26 Inspections of A.R.P. Shelters 625 Inspections of Fire Guard Posts 16 Visits re Food Decontamination 165 Inspections of Brooks and Streams 65 Smoke Observations and visits 52 Total 9,415 Number of Notices Served during the Year. Informal Notices 362 Statutory Notices 25 The result of the service of these Notices was as follows :— Preliminary Notices. Statutory Notices. Complied with 313 . 24 Work in progress at end of year 14 — Not yet complied with 35 1 Improvements effected as a result of Notices served. The following is a list of repairs executed or work done as a result of inspections made or notices served :— Roofs repaired and made weathertight 33 Spouts and downspouts cleaned and repaired or renewed 39 Interior walls repaired or replastered 36 Ceilings repaired or replastered 38 Walls and ceilings cleansed and distempered 40 Exterior brickwork repaired or repointed 14 Damp walls remedied 35 Stairs or staircases repaired 2 Broken sash cords renewed 18 Window frames repaired 15 Kitchen ranges repaired or renewed 5 Fireplaces repaired 6 Doors repaired 5 Door steps repaired or replaced 3 Dilapidated washing coppers repaired 3 Floors repaired or relaid 17 Scullery sinks renewed 2 Waste pipes repaired or renewed 6 10 Defective window sills repaired 15 Dilapidated dustbins renewed 185 Defective sub-floor ventilation remedied 6 Skirting boards repaired or replaced 2 Verminous premises fumigated, etc. 30 Choked drains cleared 47 Defective vent pipes repaired 3 Broken inspection chamber covers replaced 3 Drains repaired or relaid 11 W.C.'s., fittings repaired or renewed 25 Storage cisterns cleansed 6 Cisterns repaired or renewed 5 Water supply re-installed after being cut off 6 Water pipes repaired 3 Accumulation of refuse removed 9 Nuisances arising from the keeping of animals, poultry, etc., remedied 5 Smoke nuisances remedied 4 Cases of overcrowding abated 2 Rat Destruction. One hundred and eleven complaints of rat infestation were received, all of which were investigated and advice given as to the best methods of dealing with them. All the premises affected were repeatedly visited until finally cleared of rats. Many cases were also visited by the staff of the County Pests Officer at our request, and I must again acknowledge the valuable assistance and cordial co-operation of Mr. Sharp and his staff. There were no heavy infestations and all could be classed as belonging to the " Minor Secondary " type. Verminous Houses. Thirty privately owned houses were found to be infested with bed bugs. All were disinfested by stripping and burning wallpaper where necessary and spraying with "Zaldecide" liquid insecticide after loosening or removal of picture rails, skirting boards and architraves, followed by sealing and fumigation by sulphur of the infested rooms. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. Number of Cowkeepers on the Register 3 ,, Retailers 17 ,, Registered Premises 10 ,, Inspections 96 11 The farms and dairies have been regularly inspected. A high standard of cleanliness has been maintained and the requirements of the Milk and Dairies Order, 1926, have been complied with. The following licences were granted to dealers to sell under the Milk (Special Designations) Regulations 1936-41 :— Tuberculin Tested 2 Accredited 1 Pasteurised 3 The following Supplementary licences under principal licences granted by other authorities to sell milk from premises outside this area were also granted :— Tuberculin Tested 8 Pasteurised 8 Accredited 1 One hundred and eight samples of milk were purchased and submitted for bacteriological examination to the Emergency Public Health Laboratory. The following is a summary of the results of the examinations :— Designation. No. of Samples submitted. Examined for (а) Plate Count (b) b. coli. (c) Methylene blue test. (d) Tubercle b. (e) Phosphatase test. Result of Examination. Raw 26 (b) and (c) Satisfactory. Tuberculin Tested 1 (b), (c) and (d) Satisfactory. „ „ 8 (b) and (c) Satisfactory. T.T. (Pasteurised) 1 (a), (b), (c), and (d) Satisfactory. „ „ 2 (a), (b), (c) and (e) Satisfactory. „ „ 4 (a) and (e) Satisfactory. „ „ 1 (a), (c) and (e) Satisfactory. T.T. (Certified) 6 (b) and (c) Satisfactory. Accredited 9 (b) and (c) 2 Unsatisfactory. Pasteurised 19 (a) and (e) 1 Unsatisfactory. „ „ 5 (a), (c) and (e) 2 Unsatisfactory. Homogenised 11 (b) and (c) 2 Unsatisfactory. Sterilized 3 (b) and (c) Satisfactory. Jersey and Guernsey 8 Ib) and (c) 1 Unsatisfactory. „ „ 3 (a) and (e) Satisfactory. „ „ 1 (a), (c) and (e) Satisfactory. A copy of the report of each sample was supplied to the retailer or dairy proprietor. In the case of unsatisfactory samples, visits were paid to the premises of the dairy concerned and investigations made into the cause of the unsatisfactory report, or if the premises were outside our area a letter was sent to the particular person or firm pointing out that the report was not satisfactory and asking 12 for their observations. It is very satisfactory to note that the number of unsatisfactory samples shows a decrease to 8 from 9 last year, or a reduction from 9% to 7% and compares with 18% in 1942, and 33% in 1941. Meat Inspection. The requirements of the Public Health (Meat) Regulations, 1924, have been duly observed as regards the butchers' shops in the district. Inspection of Other Foods. All restaurants, snack bars, fried fish shops and other places where food is prepared have been visited and their kitchens and cooking utensils inspected for cleanliness. Food Condemned as unfit for Human Consumption. Tons. cwts. lbs. Flour 2 16 63 Soya Flour 1 55 Self Raising Flour 12 Rolled Oats 8 Oatmeal • 1 80 Semolina 1 0 Spaghetti 78 Macaroni 5 Barley Flakes 1 0 Rice 5 Egg Powder 1½ Custard Powder 3 Split Peas 5 Biscuits 7 Dried Fruit 4 Raisins 63/4 Cheese 45½ Butter 10½ 119 Eggs 143/4 Tea 1 Coffee Extract 6 Bacon 40 Sausages 37 Pork Pies 3 Pork Sausage Meat 4 Pork 10 Boiled Sweets 5½ Carried forward 3 4 62½ 13 Tons. cwts. lbs. Brought forward 3 4 64¼ Almond Essence ½ Puddings 8 Sponge Mixture 6 Cured Ham 12½ Cauliflowers 2 0 Oranges 26 Skate 1 0 Witches 1 28 Cured Fillets 84 896 tins of various foodstuffs 8 63 Total Tons. 3 18 66½ In conclusion, I wish to tender my thanks to other members of the staff for their assistance and co-operation throughout the year. I am, Gentlemen, Your obedient Servant, EDWARD HOUGHTON, A.R.San.I., Chief Sanitary Inspector. ■ * * . . .