LIBRARY €&Afci2j Cast jiarnet ^Htfaan Bfetrict Counttl SEVENTY-SEVENTH ANNUAL REPORT of the Medical Officer of Health for the year 1950 by C. M. SCOTT, M.R.C.S. (Eng.), L.R.C.P. (Lond.). Medical Officer of Health to the Council together with the ANNUAL REPORT of E. HOUGHTON, Cert. R. San. Inst., Certificated Food Inspector, Chief Sanitary Inspector. teT&° East Barnet Urban District Council SEVENTY-SEVENTH ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1950. To the Chairman and Members of the East Barnet Urban District Council Mrs. Jackson and Gentlemen, I have the honour to present to you my Report for the year 1950. Milk Supply The report of the Chief Sanitary Inspector reveals a most pleasing state of affairs, in that all samples taken during the year proved to be satisfactory, for the first time in our records. I agree entirely that the main reason for this has been that practically all milk retailed in the district is now pasteurised, but some of the credit for the result must be given to the policy of frequent sampling and checking on the handling of the milk. The human factor still remains and the need for constant vigilance and supervision is as great as ever. 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 1,663 examinations were made, 98-9 per cent, being B. coli free in 100 ml. 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 reaction. 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 For the third year in succession we have been fortunate in that no cases of Diphtheria have been notified. Although still needing advertising, immunisation is now generally accepted by parents, but some unfortunate publicity questioning the desirability of immunisation during poliomyelitis periods has probably lessened the number of children who would otherwise have been protected. Scabies No cases of Scabies were notified, and as I commented last year, Scabies has now become once again an uncommon disease in this district. Infectious Diseases During 1950 there were 8 cases of Poliomyelitis notified, unfortunately with one death. The "Polio, season" seems now to be a regular occurrence, and as people become more conscious of the incidence of this disease, we can look forward to earlier recognition, and so to an amelioration of the results. Measles and Whooping Cough were again prevalent and there was a mild Chicken Pox epidemic. Pneumonia figures remain fairly constant, as does my conviction that by no means all the cases are notified and that the figures underestimate the incidence of the disease. Old Age It may seem at first sight inappropriate to comment on this condition, but each year it becomes increasingly apparent that more attention will have to be given to alleviating some of the troubles, coincident, in many cases, with increasing age. Old folk living on their own are often a problem, needing careful and kindly handling if they are to avoid becoming a nuisance to themselves 2 and to their neighbours. The County Council's "Meals on Wheels" scheme has proved a great benefit in many cases, and I know that the welfare of the old folk holds a permanent position in the social and charitable work of the district. Tuberculosis I would again comment on the close link between the Tuberculosis problem and the Housing problem. The waiting period before cases accepted as suitable for Sanatorium treatment can be admitted appears to be lessening, and perhaps it may not be many years before the waiting period is eliminated altogether. Rodent Control It will be noticed that rat infestation has increased, and it is needing increased work to cope with this problem. Food Bye-laws The new Bye-laws will be a great help in the campaign for clean food and the co-operation of food traders has been good. The mass of detailed work covered by the Chief Sanitary Inspector's report is worthy of close attention. Finally, may I once again record my opinion that in these days of pure water supply, adequate drainage, clean milk, and control of the handling, wrapping and sale of foodstuffs, the pillars of Public Health support a well worth while edifice with one weak prop—lack of adequate housing. This, of course, is a National problem, and in our department we can only insist on remedying of defects in existing old houses. I would hope that the time may come when the Council will earmark a few houses out of each new estate for the rehousing of those at present living in properties which should be condemned. My most sincere thanks to all members of my staff for their usual 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. 3 Area and Rateable Value The area of the district is 2,644 acres. Registrar-General's estimate of resident population, 1950, 40,690. Rateable Value (at 31st December, 1950), £396,396. Product of a penny rate for 1950-51, £1,601. Vital Statistics Total M. F. Live Births. Legitimate 505 247 258 Illegitimate 11 8 3 Birth rate per 1,000 of the estimated resident population 12.6 (The birth rate for England and Wales was 15-8) Stillbirths 4 1 3 Rate per 1,000 (live and still) births 7*6 Total M. F. Deaths 372 180 192 Death rate per 1,000 of the estimated resident population 9.1 (The death rate for England and Wales was 11.6) There were no deaths from puerperal causes. Death rate of Infants under one year of age:— All Infants per 1,000 live births 17.4 Legitimate Infants per 1,000 Legitimate live births 15.8 Illegitimate Infants per 1,000 Illegitimate live births 90.9 Deaths from Cancer (all ages) 86 „ „ Measles (all ages) 1 „ „ Whoopine Cough (all ages) 1 Birth Rate There were 516 births (11 illegitimate) during the year. The birth rate is 12.6 per 1,000 of the estimated resident population, as compared with 13.4 last year. The births last year numbered 547, including 20 illegitimate. Death Rate There were 372 deaths (363 last year), giving a rate of 9.1 compared with 8-9 last year. Infantile Death Rate There were 9 deaths of children under one year as compared with 6 last year, a death rate per 1,000 live births ot 17.4. Last year the figure was 10.9 and for 1948, 14.6. For England and Wales the rate was 29.8 for 1950 and 32 for 1949. 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 advantage 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 1950. In every case thorough disinfection of the premises, etc., is carried out as soon as the patient has been removed. TABLE I Notification of Infectious Disease (other than Tuberculosis) received during the year 1950 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 71 .... 2 5 10 15 29 6 2 2 .... .... .... .... Chicken Pox 237 5 2 19 22 31 130 26 .... 2 .... .... .... .... Whooping Cough 372 18 29 31 92 184 11 1 1 5 .... .... .... 1 Measles 348 7 20 22 51 60 179 7 .... 2 .... .... .... 1 Pneumonia 26 2 2 1 3 3 6 .... .... 5 .... 2 2 .... Erysipelas 4 .... .... .... .... .... .... .... .... 1 .... 1 2 .... Dysentery 2 .... .... .... .... .... .... .... .... 1 1 .... .... .... Poliomyelitis 8 .... .... .... 1 .... 3 2 .... 2 .... .... .... 1 Totals 1068 32 55 78 179 293 358 42 3 20 1 3 4 3 5 TABLE II Causes of, and Ages at, Death during the year 1950 CAUSES OF DEATH. All Ages. Undsr 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 86 .... .... .... .... .... 3 15 68 60 Heart Disease 107 1 .... .... .... 1 6 34 65 72 Arterio-Sclerosis 7 .... .... .... .... .... .... 1 6 7 Coronary Thrombosis 17 .... .... .... .... .... 1 8 8 10 Cerebral Thrombosis 14 .... .... .... .... .... 1 3 10 6 Cerebral Haemorrhage 29 2 .... .... .... .... .... 2 25 8 T.B. Meningitis 1 .... .... 1 .... .... .... .... .... 1 Cerebral Tumour 1 .... .... .... .... .... .... 1 .... 1 Poliomyelitis 1 .... .... .... 1 .... .... .... .... 1 Measles 1 .... .... 1 .... .... .... .... .... 1 Whooping Cough 1 .... 1 .... .... .... .... .... .... 1 Pneumonia 14 1 .... 1 .... .... 1 1 10 14 Bronchitis 16 .... .... .... .... .... 2 6 8 7 Influenza 1 .... .... .... .... .... .... 1 .... .... Tuberculosis 17 .... .... .... .... 1 6 5 5 9 Premature Birth 2 2 .... .... .... .... .... .... .... 2 Erythroblastosis foetatis 1 1 .... .... .... .... .... .... .... 1 Acute Leukaemia 1 1 .... .... .... .... .... .... .... 1 Asphyxia Pallida 1 1 .... .... .... .... .... .... .... 1 Lymphatic Leukaemia 2 .... .... .... .... .... .... 1 Uraemia 10 .... .... .... .... .... 1 4 5 4 Nephritis 7 .... .... .... .... .... .... 2 5 3 Diabetes Mellitis 3 .... .... .... .... .... 1 2 3 Pernicious Anaemia ? .... .... .... .... .... .... 1 1 1 Gangrene of Leg 1 .... .... .... .... .... .... .... 1 1 Encephalitis 1 .... .... .... .... .... .... 1 .... 1 Malignant Peritonitis 1 .... .... .... .... .... .... 1 .... 1 Addisons Disease 2 .... .... .... .... .... .... 1 1 ........ Operative Collapse 1 .... .... .... .... .... 1 .... .... 1 Duodenal Ulcer 2 .... .... .... .... .... .... 1 1 2 Hodgkins Disease 2 .... .... .... .... .... .... 1 1 2 Asphyxia due to Epilepsy 1 .... .... .... .... .... 1 .... .... 1 Pulmonary Embolism 3 .... .... .... .... .... 1 2 .... .... Accident 9 .... .... 1 .... .... 1 1 6 7 Suicide 4 .... .... .... .... .... 2 2 .... .... Syphilis 3 .... .... .... .... .... 1 1 1 3 Total 372 9 1 4 1 2 31 97 227 234 6 TABLE III Infantile Mortality, 1950 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 2 .... .... .... 2 .... .... .... .... 2 Erythroblastosis foetatis 1 .... .... .... 1 .... .... .... .... 1 Cerebral haemorrhage 2 .... .... .... 2 .... .... .... .... 2 Asphyxia Pallida 1 .... .... .... 1 .... .... .... .... 1 Heart Disease 1 .... .... .... 1 .... .... .... .... 1 Broncho Pneumonia .... .... .... .... .... 1 .... .... .... 1 Acute Leukaemia .... .... .... .... .... 1 .... .... .... 1 Totals 7 .... .... .... 7 2 .... .... .... 9 TABLE IV. Tuberculosis. New Cases and Mortality during Year 1950. 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 1 ........ ........ ........ ........ 15— 1 3 ........ 1 ........ ........ ........ ........ 25— 4 5 ........ 1 ........ ........ ........ ........ 35— 8 2 ........ 1 1 ........ ........ 1 45— 11 3 ........ 1 4 1 ........ ........ 55— 6 ........ 1 ........ 5 ........ ........ ........ 65 and over 6 ........ 1 ........ 5 ........ ........ ........ Totals 36 14 4 5 15 1 1 1 7 Cast garnet Urban Ziistriit Council ANNUAL REPORT of the CHIEF SANITARY INSPECTOR FOR THE YEAR 1950 f To the Chairman and Members of the East Barnet Urban District Council. Mrs. Jackson and Gentlemen, I he 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:— 1949 1950 Nuisances and sanitary defects 6,033 5,267 Infectious Diseases '322 296 Restaurants, Snack Bars, etc. 216 297 Water Supply 59 12 Schools .. .. .. .. 58 63 Verminous Premises 58 29 Fish Shops 108 103 Butchers' Shops 164 208 Other Food Shops 233 463 Various Premises re rats 2,482 4,448 Visits in connection with Scabies cases 7 — Inspections for dilapidated dustbins 120 13 Inspections of Factories 159 277 Inspections of Outworkers' Premises 83 108 Inspections of Bakehouses 52 93 Inspections of Cowsheds and Dairies Under the Milk (Special Designations) Regulations, 12 30 1936—41, including visits for purchase of samples 88 202 Inspection of Dwelling Houses 42 172 Visits to Houses to ascertain permitted numbers .. 82 7 Inspections in Connection with Overcrowding 40 188 Visits to homes of applicants for Council Houses 138 7 Carried forward 10,556 12,283 8 1949 1950 Brought forward 10,556 12,283 Other Shops 167 201 Food Inspections 117 79 Inspections under the Bye-laws relating to Hairdressers and Barbers' Premises 15 12 Inspections of Brooks and Streams 10 9 Smoke observations and visits 14 44 Premises for sale of ice cream 42 264 Caravan sites 22 10 Total 10,943 12,902 Number of Notices Served during the Year 1949 1950 Informal Notices 208 260 Statutory Notices 16 33 The result of the service of these Notices was as follows:— Preliminary Notices. Statutory Notices. 1949 1950 1949 1950 Complied with 155 164 11 30 r Work in progress or in hand at at the end of year 15 25 1 1 Not yet complied with 38 71 4 2 Improvements effected as a result of Notiees served The following is a list of repairs executed or work done as a result of inspections made or notices served:— No. of Houses. Roofs repaired and made weathertight 63 Spouts and downspouts cleaned and repaired or renewed 51 Interior walls repaired or replastered 36 Ceilings repaired or replastered 38 Walls and ceilings cleansed and distempered 34 Exterior brickwork repaired or repointed 21 Damp walls remedied 37 Stairs or staircases repaired 7 Broken sash cords renewed 16 Window frames repaired 32 Kitchen ranges repaired or renewed 11 Fireplaces repaired 18 Doors repaired 17 Door steps repaired or replaced 7 Dilapidated washing coppers repaired 5 Floors repaired or relaid 28 9 No. of Houses. Scullery sinks renewed 8 Waste pipes repaired or renewed 11 Defective window sills repaired 5 Dilapidated dustbins renewed 19 Defective sub-floor ventilation remedied 5 Skirting boards repaired or replaced 4 Verminous premises fumigated, etc. 11 Choked drains cleared 123 Defective vent pipes repaired 7 Broken inspection chamber covers replaced 4 Drains repaired or relaid 22 W.C.'s, fittings repaired or renewed 32 Storage cisterns cleansed 6 Cisterns repaired or renewed 11 Water supply re-instated after being cut off 8 Water pipes repaired 11 Accumulation of refuse removed 12 Nuisances arising from the keeping of animals, poultry, etc., remedied 6 Exterior paving repaired or relaid 9 Hot water systems repaired 18 Chimney pots and flues repaired 13 Insufficient water supply remedied 6 Defective covers to water tanks replaced 8 Lavatory basins renewed 8 Hearths repaired or renewed 5 Soil pipes repaired or renewed 5 Parapet walls repaired 3 Defective skylights repaired 3 Fresh-air inlets to drains repaired 9 Cement rendering renewed 7 Gulley kerbs renewed 6 Exterior balconies and steps repaired 7 Door porches repaired 3 Damp-proof courses provided 2 Site concrete provided 2 Condemned Property The dwelling at No. 21, Henry Road, occupied as two flats, became vacant last March, the two families having been found accommodation on the Council's housing estate. The owners had instructed a firm of contractors to demolish the building in accordance with the requirements of the demolition order and arrangements have been made for demolition early in the new year. The basement flat at No. 7, Somerset Road, which was the subject of a Closing Order, also became vacant, the tenant having left the premises. This flat is now vacant and closed. 10 No. 56, Edward Road was reconditioned and sold by the owner to the present occupier. Rodent Control Three hundred and nine complaints of rat and mice infestations were received (215 in 1949). All were dealt with by the Rodent Operative. 517 dead rats and 71 dead mice were picked up after poisoning and trapping. Infestation of rats and mice at dwelling houses is dealt with free of charge. Owners or occupiers of business premises are charged with the cost of the work. The arrangement made with the Barnet Urban District Council for one rodent operative to serve the two districts, was terminated, and a separate operative has since been appointed for each district. The annual test of 10 per cent of the sewer manholes to ascertain the extent of rat infestation of the sewers was again undertaken in accordance with the requirements of the Rodent Control branch of the Ministry of Agriculture. Test baits of bread mash were laid in 167 manholes, and when inspected two days later there were 26 manholes where the bait had completely disappeared, and in 7 manholes part only of the bait had been consumed. A treatment of the sewers with bread mash and arsenious oxide was then undertaken with the result that there were 25 manholes where the poison baits had been completely or partly taken. These results indicated that rat infestation of the sewers had increased since the last treatment in 1949. Six months later a further treatment was carried out, 47 manholes being pre-baited with sausage rusk. Of this number there were 15 manholes where the bait was either completely or partly taken. Poison baits of sausage rusk and zinc phosphide were then laid in these manholes, and when inspected later it was found that there were no complete "takes," but in 13 manholes some portion of the poison bait had been consumed. Full particulars of these operations were supplied to the Infestation Division of the Ministry of Agriculture. National Assistance Act, 1948, Section 50, Burial or Cremation of the Dead One funeral of a destitute person was arranged under this Act at a cost of £8 12s. 6d. The order for the funeral was given to Messrs. E. Treeves Ltd., of Willesden, the interment being at the Great Northern London Cemetery. As there was an insurance policy for the sum of £10, the full cost of the funeral was recovered by the Treasurer from the insurance company. 11 Verminous Houses Nine privately owned houses, one council house and one requisitioned house were found to be infested with insects. All were disinfected by stripping and burning wallpaper and spraying with "Zaldecide" or "Cooper's D.D.T." liquid insecticide. Premises. No. on Register. Number of Inspections. Written Notices. Factories without mechanical power 21 46 4 Factories in which mechanical power is used 94 231 15 Totals 115 277 19 CASES IN WHICH DEFECTS WERE FOUND Particulars. Number of cases in which defects were found Found. Remedied. Referred To H.M. Inspector. By H.M. Inspector. Want of cleanliness 9 9 — 1 Unsuitable or defective sanitary conveniences 5 5 1 Other offences (not including offences relating to home work) 5 5 — — 19 19 — 2 INSPECTION AND SUPERVISION OF FOOD Milk Supply The following licences were granted to dealers to sell under the Milk (Special Designations) Regulations, 1936-1949:— Tuberculin Tested 6 Pasteurised 6 Sterilised 6 The following Supplementary licences under principal licences granted by other authorities to sell milk from premises outside this area were also granted:— Tuberculin Tested 9 Pasteurised 9 Sterilised 9 12 Ninety-six 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:— No. of Samples Submitted Test applied:— (a) Methylene blue. (b) Turbidity (c) Phosphatase. Result of Examination. Undesignated 3 (a) Satisfactory T.T. Pasteurised 18 (a) and (c) „ T.T. Certified 2 (a) „ Pasteurised 18 (a) and (c) „ Homogenised Past 10 (a) and (c) „ Sterilised 17 (b) „ Channel Islands Pasteurise 11 (a) and (c) „ Tuberculin Tested 3 (a) „ T.T. Farm Bottled 8 (a) „ South Devon Pasteurised 6 (a) and (c) „ A copy of the report of each sample was supplied to the retailer or dairy proprietor. The percentage of unsatisfactory samples was nil. The previous year it was 9 per cent.; in 1948, 3 per cent.; in 1947, 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. This is the first occasion on which I have been able to report all samples satisfactory and as having passed the prescribed tests. This is no doubt due to the fact that the coliform test—always a doubtful test—has been eliminated, and that nearly all the milk sold in this district is now heat treated. Ice Cream Seven applications were received for the registration of premises for the sale of ice cream. Six were granted and one refused on the grounds that the premises for which application was made were unsatisfactory. Two hundred and sixty-four visits were paid to registered premises. Eighty samples were obtained and submitted for bacteriological examination, with the following results:— Provisional grade 1 49 2 20 3 2 4 9 13 Sampling commenced in April. All the grade 3 and 4 samples were in the months of May and June. Further samples taken later gave much improved results, all subsequent samples being placed in Grades 1 or 2. There was only one retailer who manufactured ice cream and only on a very small scale and by the cold mix method. All the other retailers purchase their supplies from large manufacturers whose factories are situated in other districts. 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, canteens and other places where food is prepared have been visited and their kitchens and cooking utensils inspected for cleanliness. Bye-laws controlling the handling, wrapping and delivery of food and the sale of food in the open air came into operation on the 6th November, and during the two months of November and December, 137 food shops were inspected. As a result of these inspections and to comply with the bye-laws and the Foods & Drugs Acts, written or verbal requests were made to the proprietors or owners of shops for the following improvements:— No. of Shops. Notices to wash hands to be fixed on or near sanitary conveniences 65 Provision of a satisfactory hot-water supply 24 Limewashing or cleansing of walls and ceilings 12 Repairs to defective sanitary conveniences 6 Provision of clean towels . 4 Provision of wash bowls 3 Other structural repairs 3 Cleansing of floors 2 Provision of additional heating 2 Provision of a proper sink 1 Provision of electric light to sanitary conveniences 1 Thirty-three aluminium plaques of notice to wash hands were supplied to shop proprietors at a charge of 2s. each. The film "Fly About The House" was obtained on loan from the National Screen Service Ltd., and was shown at the Regal Cinema during the week commencing the 27th August by kind permission of Mr. Myers, the proprietor of the cinema. 14 Food Condemned as Unfit for Human Consumption Cwts. Lbs. Fish 3 — Chitterlings 2 76 Dried potato powder 80 Dates 74 Cod roe 70 Beef 67½ Rabbits 60 Swiss Rolls 60 Currants 50 Sausages 39½ Prunes 31 Dried peas 28 Cheese 17 Sweetened fat 14 Margarine 12 Bacon 7½ Junket powder 7 Christmas puddings 6 Lobsters 6 Figs 3 Pork pies 2 439 tins, bottles, jars, etc., of various foodstuffs 8 18 Total 19 56¾ 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, Chief Sanitary Inspector. 15 WILL C. JONES : : Printer : : 101, Leicester Road New Barnet, Herts.