EBARO 10 AC4421(3)EAST BARNET SEVENTY-FIFTH ANNUAL REPORT of the HEALTH AND SANITARY CONDITION of the East Barnet Urban Sanitary District 1948 Cast Barnet Urban District Council. SEVENTY-FIFTH ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1948. To the Chairman and Members of the East Barnet Urban District Council. Ladies and Gentlemen, I have the honour to present to you my Report for the year 1948. Milk Supply. There are now only two farms in the district at which milk is produced and the milk from one of these farms is primarily for their own consumption, only a very small quantity indeed being sold to a dairy company. The great change in character of East Barnet during the past twenty odd years is reflected in the steady diminution of the number of farms, from some 10 to 2. It will be noticed from the report of the Chief Sanitary Inspector that the percentage of unsatisfactory milk samples continues to fall. Every care is taken to ensure that clean milk only is sold in this area, but this depends on constant vigilance and supervision, and even so the human factor occasionally fails. Water Supply. The water which is obtained from deep wells sunk into the chalk is supplied by the Barnet District Water Company. The Company have an up-to-date chemical and bacteriological laboratory in charge of which is a qualified chemist. During the year 1,389 examinations were made 99-71 per cent, being b. coli free in 100 c.c.'s. 1 Samples are also sent periodically to independent analysts in London for their examination and the following report is characteristic of such examinations:— 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." Twelve samples were also taken by us and submitted for examination. The reports were in every case satisfactory. Diphtheria Prophylaxis. Unfortunately I am not able to give the percentage figure of immunisation as the statistics are no longer available for individual urban districts. I do not, however, consider that our high percentage has fallen to any material extent, and on the whole it is fair to say that this measure of protection continues to commend general support. It may be of interest, on reflecting the general fall in number of cases of this deadly disease, to insert the following small table, which shows that 1948 was the first year since my term of office commenced that there have been no diphtheria notifications, despite an increase of population from 36,000 to 40,000. Number of Cases of Diphtheria Notified from 1941 to 1948. 1941 6 cases 1942 6 cases 1943 3 cases 1944 2 cases 1945 1 case 1946 2 cases 1947 3 cases 1948 Nil This must not be taken in any sense to mean that we can be satisfied with the present number of children immunised. The only safe position will be when 100 per cent, of children are immunised, and we have some way to go to achieve that figure. Scabies During the year some 45 cases and contacts have been treated. A steady decrease. Little persuasion is now needed to get people to undergo treatment and recurrences have been infinitesimal in number. 2 Infectious Diseases. During 1948 there was 1 case of Poliomyelitis notified— nevertheless it becomes apparent that this problem will be an increasing one, and the difficulty of tracing a source of infection becomes no less. The figures show little variation worthy of comment except perhaps to say that Measles tends to become more prominent each year. I regret that there is still considerable difficulty in obtaining supplies of convalescent measles serum for attenuation of the disease in suitable cases. Protective injection against Whooping Cough seems still to me to be of doubtful value, nor have I yet seen evidence to convince me otherwise. Tuberculosis. Figures compare closely with previous year. The housing problem is closely linked with the tuberculosis problem and I would wish that it were possible to give more priority in adequate accommodation to cases of tuberculosis. Here I would record my thanks to the Housing Officer for his co-operation with the Public Health Department in all matters. Finally, may I draw particular attention to the amount of work covered in the report of the Chief Sanitary Inspector, and express the opinion that in view of conditions generally, the number of nuisances and sanitary defects needing attention is likely to increase still further. The work of this department continues to increase both in amount and importance and I would like to express my most sincere thanks to the members of my staff for their untiring patience and perseverance throughout the year. Your obedient Servant, C. M. SCOTT, m.r.c.s. (eng.), l.r.c.p. (lond), Medical Officer of Health to the Council and Aj Assistant School Medical Officer. 3 Area and Rateable Value. The area of the district is 2,644 acres. Registrar-General's estimate of resident population, 1948, 39,840. Rateable Value (at 31st December, 1948), £387,851. Product of a penny rate for 1948-49, £1,599. Vital Statistics. Total. M. F. Live Births. Legitimate 591 .. 293 298 Illegitimate 22 .. 12 10 Birth rate per 1,000 of the estimated resident population 15.3 (The birth rate for England and Wales was 17.9). Stillbirths 9 .. 4 5 Rate per 1,000 (live and still) births 18.5 Total. M. F. Deaths 364 180 184 Death rate per 1,000 of the estimated resident population 9.1 (The death rate for England and Wales was 10.8.) There were no deaths from puerperal causes. Death rate of Infants under one year of age:— All Infants per 1,000 live births 14.6 Legitimate Infants per 1,000 Legitimate live births 13.5 Illegitimate Infants per 1,000 Illegitimate live births 45.4 Deaths from Cancer (all ages) 71 „ Measles (all ages) 1 „ Whooping Cough (all ages) 0 ,, Diarrhoea (under 2 years of age) 1 Birth Rate. There were 613 births (22 illegitimate) during the year. The birth rate is 15-3 per 1,000 of the estimated resident population, as compared with 17-3 last year. The births last year numbered 698, including 24 illegitimate. Death Rate. There were 364 deaths (356 last year), giving a rate of 91 compared with 8-8 last year. Infantile Death Rate. There were 9 deaths of children under one year as compared with 21 last year, a death rate per 1,000 live births of 14-6. Last year the figure was 30-0 and for 1946 36-6. For England and Wales the rate was 34 for 1948 and 43 for 1947. 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. 4 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 gives facilities for the supply of immunising serum. Similar facilities for bacteriological diagnosis are available in cases of Tuberculosis and other Infectious Diseases and full advantake is taken of them. 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 1948. 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 Diseases (other than Tuberculosis) received during the year 1948. DISEASES. 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. Total Deaths. Diphtheria — .... .... .... .... .... .... .... .... .... .... .... .... .... Scarlet Fever 43 .... .... 3 8 14 7 6 3 2 .... .... .... 1 Chicken Pox 54 .... .... 2 8 17 21 3 2 1 .... .... .... .... Whooping Cough 404 24 22 22 66 77 167 12 4 10 .... .... .... .... Measles 408 14 39 41 83 99 116 11 2 3 .... .... .... 1 Erysipelas 6 .... .... .... .... .... .... .... 1 .... .... 4 1 .... Pneumonia 19 1 .... .... 1 2 .... 2 .... 2 6 3 2 .... Dysentery 2 .... .... .... .... 2 .... .... .... .... .... .... .... .... Poliomyelitis 1 .... .... .... .... .... .... .... 1 .... .... .... .... .... Puerperal Pyrexia 2 .... .... .... .... .... .... .... .... 2 .... .... .... .... Ophthalmia Neonatorum 1 1 .... .... .... .... .... .... .... .... .... .... .... .... Totals 940 40 61 68 166 211 311 34 13 20 6 7 3 2 5 TABLE II. Causes of, and Ages at, Death during the year 1948. CAUSES OF DEATH. All Ages. Under 1 year. 1—2 years. 2—5 years. 5—15 years. 15—25 years. 25—45 years. 45—65 years. 65 and over. Total No. of Deaths in Public Institutions in the District. Cancer 71 .... .... .... .... .... 2 1 17 52 36 Heart Disease 122 .... .... .... .... .... 2 24 96 90 Arterio Sclerosis 6 .... .... .... .... .... 1 1 1 4 6 Coronary Thrombosis 70 .... .... .... .... .... ? 10 8 14 Cerebral Thrombosis 11 .... .... .... .... .... .... 2 9 10 Cerebral Haemorrhage 15 1 .... .... .... .... 2 12 9 Pneumonia 12 2 .... .... .... .... 3 4 12 Bronchitis 19 .... .... .... .... .... 4 4 11 9 Tuberculosis 10 .... .... .... 1 1 5 3 .... 8 Pulmonary Oedema 4 .... .... .... .... .... .... 2 2 3 Pulmonary Embolism 3 .... .... .... .... .... .... 1 2 2 Tubercular Meningitis 2 .... .... .... 1 1 .... .... .... 2 Premature Birth 1 1 .... .... .... .... .... .... .... 1 Atelectasis 2 2 .... .... .... .... .... .... .... 2 Gastro Enteritis 1 1 .... .... .... .... .... .... .... 1 Haemolytic Jaundice 2 2 .... .... .... .... .... .... .... 2 Peritonitis 2 .... .... .... .... .... 1 1 .... 2 Intestinal Obstruction 3 .... .... .... .... .... 1 .... 2 3 Duodenal Ulcer 4 .... .... .... .... .... 1 2 1 4 Pyelitis 2 .... .... .... .... .... 1 .... 1 2 Nephritis 9 .... .... .... .... .... .... 4 3 8 Uraemia 8 .... .... .... .... .... 1 3 4 5 Cachexia 4 .... .... .... .... .... .... 1 3 2 Hypertensive Encephalopathy 2 .... .... .... .... .... .... .... 2 .... Myelogenous Leukaemia 1 .... .... .... .... .... 1 .... .... 1 Paralysis Agitans 2 .... .... .... .... .... .... .... 1 2 Sarcoma of Ribs 1 .... .... .... 1 .... .... .... .... 1 Aplastic Anaemia 2 .... .... .... .... 1 .... 1 .... 1 Scarlet Fever 1 .... .... .... 1 .... .... .... .... 1 Measles 1 .... 1 .... .... .... .... .... .... .... Cerebral Tumour 3 .... .... .... .... .... 1 .... .... 3 Diabetes Mellitus 2 .... .... .... .... .... .... 1 1 2 Syphilis 2 .... .... .... .... .... 1 1 .... 2 Accident 10 .... .... .... .... .... 3 2 .... 7 Suicide 4 .... .... .... .... .... 2 1 1 3 Total 364 9 1 4 3 34 90 223 256 6 TABLE III. Infantile Mortality, 1948. 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 1 .... 1 .... .... .... .... 1 Haemolytic Jaundice 2 .... .... .... 2 .... .... .... .... 2 Cerebral Haemorrhage .... 1 .... .... 1 .... .... .... .... 1 Broncho Pneumonia .... .... .... .... .... .... 1 .... 1 2 Gastro-Enteritis .... .... .... .... .... .... 1 .... .... 1 Atelectasis 2 .... .... .... 2 .... .... .... .... 2 Totals 5 1 .... .... 6 .... 2 .... 1 9 TABLE IV. Tuberculosis. New Cases and Mortality during Year 1948. AGE PERIODS. NEW CASES. DEATHS. Respiratory. Non- Respiratory. Respiratory. Non Respiratory. M. F. M. F. M. F. M. F. 0— ....... ....... ....... ....... ....... ....... ....... ....... 1— ....... 1 ....... 1 ....... ....... ....... ....... 5— ....... 5 1 1 ....... ....... ....... 1 15— 6 5 ....... 3 ....... ....... ....... 1 25— 9 8 1 1 2 ....... ....... 35— 8 4 ....... 2 2 ....... ....... ....... 45— 7 2 ....... ....... ....... 2 ....... ....... 55— 2 1 ....... ....... 1 ....... ....... ....... 65 and over 2 ....... ....... ....... ....... ....... ....... ....... Totals 34 26 2 7 4 4 ....... 2 7 Cast Barnet Urban district Council. ANNUAL REPORT of the CHIEF SANITARY INSPECTOR FOR THE YEAR 1948. To the Chairman and Members of the East Barnet Urban District Council. Ladies and 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:— 1947 1948 Nuisances and sanitary defects 5,923 5,800 Infectious Diseases 197 201 Restaurants, Snack Bars, etc. 114 85 Water Supply 48 44 Schools 54 70 Verminous Premises 59 43 Fish Shops 68 116 Butchers' Shops 122 150 Other Food Shops 249 110 Various Premises re rats 2,083 2,110 Visits in connection with Scabies cases 7 3 Inspections for dilapidated dustbins 160 38 Inspections of Factories 202 215 Inspections of Outworkers' Premises 33 71 Inspections of Bakehouses 37 39 Inspections of Cowsheds and Dairies 74 30 Under the Milk (Special Designations) Regulations, 1936—41, including visits for purchase of samples 119 83 Inspection of Dwelling Houses 26 20 Visits to Houses to ascertain permitted numbers 62 61 Inspections in Connection with Overcrowding 106 57 Visits to homes of applicants for Council Houses 502 99 Carried forward 10,245 9,445 9 1947 1948 Brought forward 10,245 9,445 Other Shops 108 77 Food Inspections 327 191 Inspections under the Byelaws relating to Hairdressers' and Barbers' Premises 18 16 Inspections of Brooks and Streams 22 12 Smoke observations and visits 32 11 Premises for sale of ice cream — 27 Caravan sites — 32 Total 10,752 9,811 There was a decrease in the number of inspections as compared with last year of 941. This was due to the absence through illness of one of the Sanitary Inspectors who was away from duty for three months, and to the decrease in the number of visits to the homes of applicants for Council houses from 502 to 99, this work having been transferred to the Housing Department. Number of Notices Served during the Year. 1947 1948 Informal Notices 469 264 Statutory Notices 70 33 The result of the service of these Notices was as follows:— Preliminary Notices. Statutory Notices. 1947 1948 1947 1948 Complied with 375 232 • • 55 29 Work in progress or in hand at the end of year 30 11 .. 5 1 Not yet complied with 64 21 • • 10 3 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:— No. of Houses. 1947 1948 Roofs repaired and made weathertight 136 110 Spouts and downspouts cleaned and repaired or renewed 89 75 Interior walls repaired or replastered 132 116 Ceilings repaired or replastered 123 121 Walls and ceilings cleansed and distempered 66 59 Exterior brickwork repaired or repointed 52 45 Damp walls remedied 106 75 Stairs or staircases repaired 6 15 10 No. of Houses. 1947 1948 Broken sash cords renewed 27 25 Window frames repaired 103 75 Kitchen ranges repaired or renewed 14 27 Fireplaces repaired 42 40 Doors repaired 38 44 Door steps repaired or replaced 14 21 Dilapidated washing coppers repaired 6 10 Floors repaired or relaid 59 45 Scullery sinks renewed 5 8 Waste pipes repaired or renewed 12 21 Defective window sills repaired 21 18 Dilapidated dustbins renewed 22 16 Defective sub-floor ventilation remedied 8 13 Skirting boards repaired or replaced 5 8 Verminous premises fumigated, etc. 24 16 Choked drains cleared 45 52 Defective vent pipes repaired 7 6 Broken inspection chamber covers replaced 8 10 Drains repaired or relaid 32 24 W.C.'s, fittings repaired or renewed 78 64 Storage cisterns cleansed 3 11 Cisterns repaired or renewed 22 26 Water supply re-instated after being cut off 14 16 Water pipes repaired 30 21 Accumulation of refuse removed 5 9 Nuisances arising from the keeping of animals, poultry, etc., remedied 9 8 Exterior paving repaired or relaid 10 8 Hot water systems repaired 12 7 Chimney pots and flues repaired 26 21 Insufficient water supply remedied 6 5 Defective covers to water tanks replaced 6 7 Lavatory basins renewed 7 7 Flearths repaired or renewed 4 6 Soil pipes repaired or renewed 4 8 Parapet walls repaired 4 3 Electric switches repaired or renewed 4 4 Defective skylights repaired 3 7 Fresh-air inlets to drains repaired 2 3 Cement rendering renewed 3 14 Gulley kerbs renewed — 9 Exterior balconies and steps repaired — 7 Defective pointing of exterior walls renewed — 13 Door porches repaired — 5 Damp-proof courses provided — 6 Site concrete provided — 4 11 There were no legal proceedings against property owners in 1948, but in one case it was necessary, where a statutory notice under section 9 of the Housing Act, 1936, had not been complied with, to execute the work in the owner's default. The cost of the works amounted to £94 2s. 6d., the owner agreeing to repay the amount by quarterly instalments of £10. Property Condemned as Unfit for Human Habitation. Six dwellings were reported as unfit for human habitation and incapable of repair at reasonable expense, in accordance with section 11 of the Housing Act, 1936. These were:— 155b, East Barnet Road Basement flat 87, Park Road Timber cottage 9, Somerset Road Lower flat 10, Lyonsdown Road Basement flat 25, Edward Road Detached cottage 3, Margaret Road Semi-detached cottage Only one of these was demolished, No. 25, Edward Road. A Demolition Order was made as the cost of repairs was estimated at £519 and the value of the house on completion of the repairs at £330. The house was duly demolished and the site cleared, the tenant and his family being rehoused in one of the new Council houses. Undertakings not to use the dwellings for human habitation were given by the owners of 155b, East Barnet Road, 87, Park Road, and 10, Lyonsdown Road. The basement flat at 155b, East Barnet Road is now used for business purposes (a storage depot for builders' materials), the cottage at 87, Park Road and the basement flat at 10, Lyonsdown Road are now vacant and closed by reason of the cost of reconditioning being prohibitive, the flat at 9, Somerset Road and the dwelling-house at 3, Margaret Road were reconditioned by the owners and sold with vacant possession, undertakings having previously been given by the owners to execute the necessary works. Since my appointment here 22 years ago a total of 57 dwellings have been reported upon and condemned as unfit for habitation. Forty-seven of these have been demolished, 4 have been reconditioned, 4 are closed, undertakings having been accepted not to use them for human habitation, and 2 are still occupied and , awaiting demolition. Rat Destruction. One hundred and two complaints of rat infestation were received (109 in 1947), 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 12 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. The annual 10 per cent, test of the sewer manholes, to ascertain the extent of rat infestation of the sewers, was again carried out at the request of the Ministry of Food. Test baits of sausage rusk were laid in 187 manholes and when inspected two days afterwards only 19 of the baits had disappeared. Pre-baiting as a preliminary to poison baiting was then undertaken in the sewers in the vicinity of those where the test baits had gone. This again resulted in only a few "takes"—13 out of 190 baited. These 13 manholes were then poison baited with the result that there were no complete "takes" and in 12 sewer manholes the poison baits were only partly consumed. These results were somewhat similar to those of last year and are a proof that rat infestation of the sewers is very slight. Full particulars were supplied to the Infestation Division of the Ministry of Agriculture. Verminous Houses. Eleven privately owned houses, three council houses and two requisitioned houses were found to be infested with insects. All were disinfested by stripping and burning wallpaper and spraying with "Zaldecide" or "Cooper's D.D.T." liquid insectide after loosening or removal of picture rails, skirting boards and architraves. Factory Inspections. FACTORIES ACT, 1937. Inspections for the purposes of provisions as to Health. Premises. No. on Register Number of Inspections. Written Notices. Factories without mechanical power 17 28 2 Factories in which mechanical power is used 89 187 14 Totals 106 215 16 CASES IN WHICH DEFECTS WHERE FOUND. Particulars Number of cases in which defects were found Referred Found Remedied. To H.M. Inspector. By H.M. Inspector. Want of cleanliness 6 6 - 2 Unreasonable temperature 1 1 - 1 Unsuitable or defective sanitary conveniences 10 10 - - Other offences (not including offences relating to home work) 4 4 - - 21 21 - 3 13 INSPECTION AND SUPERVISION OF FOOD Milk Supply. Number of Cowkeepers on the Register 2 „ Retailers 22 „ Registered Premises 8 „ Inspections 30 The following licences were granted to dealers to sell under the Milk (Special Designations) Regulations, 1936-43:— Tuberculin Tested 2 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 One hundred and three samples of milk were purchased and submitted for bacteriological examination to the Ministry of Health's Emergency Public Health Laboratory, at Hertford. The following is a summary of the results of the examinations:— Test applied:— No. of Samples Submitted. (a) Methylene blue. (b) b. coli. Result of Examination. (c) Phosphatase. Undesignated 6 (a) and (b) Satisfactory T.T. Pasteurised 23 (a) and (c) Satistactory T.T. Certified 11 (a) and (b) 3 Unsatisfactory Pasteurised 26 (a) and (c) Satisfactory Homogenised Past 16 (a) and (c) Satisfactory Sterilised 8 (a) and (c) 1 Unsatisfactory Channel Islands Pasteurised 13 (a) and (c) 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 for an investigation. The percentage of unsatisfactory samples was 3. The previous year it was 9 per cent., in 1946 6 per cent., in 1945, 10 per cent.; in 1944, 7 per cent.; in 1943, 9 per cent.; in 1942, 18 per cent.; and in 1941, 33 per cent. Ice Cream. Certificates of Registration were granted in respect of four premises for the sale of ice cream. Thirty-two visits of inspection were paid to registered premises, all of which were found satisfactory. 14 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 Cwt. Lbs. Fish 2 10 62¼ Poultry .. 3 78 Barley flakes .. 2 — Semolina .. 2 62¼ Biscuits .. 1 16 Beef .. 1 105½ Palm kernel oil .. 1 28 Lentils .. 1 — Sugar .. 1 32 Potatoes .. 50 Ox Kidney .. 3 Cheese .. 11½ Dried Peas .. 23 Sweets and chocolates .. 26 Pearl barley .. 19 Black Pudding .. 44 Figs .. 3½ Rolled oats .. ¼ Prawns .. 28 Rabbits .. 2 26 Batter flour .. 24 Prunes .. 3 Flour .. 37 Skimmed dried milk .. 56 Nuts .. 10 1092 tins, bottles, jars, etc., of various foodstuffs .. 14 15¾ Total 4 4 92¼ Total amount condemned last year, 3 tons, 9 cwts., 22¼ lbs. In conclusion, I wish to tender my thanks to the other officers of the Council and members of the staff for their assistance and co-operation throughout the year. Your obedient Servant, EDWARD HOUGHTON, A.R.San.I., Chief Sanitary Inspector. 15