Library AC 4421(3) EAST BARM EBAR 14 East Barnet Urban District Council SEVENTY-NINTH ANNUAL REPORT of the Medical Officer of Health for the year 1952 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 W. K. PICKUP, M.R.San.I. Chief Sanitary Inspector East Barnet Urban District Council SEVENTY-NINTH ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1952. To the Chairman and Members of the East Barnet Urban District Council I have the honour to present to you my Report for the year 1952. Milk Supply The report of the Chief Sanitary Inspector again shows that all samples taken during the year were found to be satisfactory. This is the third year in succession that we have had no bad sample. and reflects credit on all concerned in the handling of this foods The need for constant vigilance and supervision remains and the policy of periodic sampling continues necessary. It is still too common a sight to see milk bottles left standing on the doorstep at houses sometimes in brilliant sunlight for hours after delivery has been made by the roundsman, and in this aspect it is the public who need further education. Water Supply The water which is obtained from deep wells sunk into the chalk is supplied by the Barnet District Water Company. The 1 Company have an up-to-date chemical and bacteriological laboratory in charge of which is a qualified chemist. During the year 1,654 examinations were made, 98.6 per cent. being B. coli free in 100 ml. Samples are also sent periodically to independent analysts in London for their examination and the following report is characteristic of such examinations:— 'This sample is clear and bright in appearance, neutral in reaction and free from iron and other metals. The water is hard in character but not to an excessive degree, and it contains no excess of salinity or mineral constituents in solution. It is of very satisfactory organic quality and of the highest standard of bacterial purity. “These results are consistent with 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 fifth year in succession we have been fortunate in that no cases of Diphtheria have been notified, but the statement should not in the slightest degree be taken as lessening the need for continuing the policy of advertising the real protection given by immunisation. There is a distinct fear that the very absence of this disease may itself breed a slackening of the immunisation rate with disastrous results. I would like to pay a tribute to the unceasing propaganda of the Health Visitors, which has gone far in producing the present position. No apology is needed for repeating the previous paragraph from the last Annual Report as it stands, for there can be very few aspects of preventive medicine which have paid so handsome a dividend in so short a time as has immunisation. There are, however, faint signs that the immunisation rate is not being fully maintained: slight though these signs may be, they constitute nevertheless a real warning. 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 1952 there was one case of Poliomyelitis notified. 2 During the year Measles declined, also Whooping Cough, and in general the year was a light one so far as infectious diseases were concerned. Inoculation against Whooping Cough appears to be showing an increase in popularity and vaccines of increased efficiency are now available. It appears likely that within a few years a considerably greater protection will be available against the trials of this complaint. Food Byelaws The Clean Food Bye-Laws are working well, and it is fair to say that there is a growing consciousness of the necessity of these on the part both of the shopkeeper and of the public. Goodwill and persuasion have proved effective in the vast majority of cases. Housing This remains perhaps the greatest problem this district has to face, and I make no apology for re-stating my opinion that there is a considerable number of houses which are well substandard. Little by little some of the worst are being satisfactorily dealt with, but a considerable area needs clearing and re-planning, though there appears no probability of this being done in any appreciable period of time. Vital Statistics The population of the district is now static and near saturation point. The vital statistics compare favourably with those for England and Wales and show remarkably little variation from last year. My most sincere thanks to all members of my staff for their usual untiring patience and perseverance throughout the year. 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, 1952, 40,780. Rateable Value (at 31st December, 1952), £405,774. Product of a penny rate for 1952-53, £1,658. Vital Statistics Total M. F. Live Births. Legitimate 467 246 221 Illegitimate 12 5 7 Birth rate per 1,000 of the estimated resident population 11.7 (The birth rate for England and Wales was 15.3) Stillbirths 11 9 2 Rate per 1,000 (live and still) births 22.9 Total M. F. Deaths 378 194 184 Death rate per 1,000 of the estimated resident population 9.3 (The death rate for England and Wales was 11.3) There were no deaths from puerperal causes. Death rate of Infants under one year of age:— All Infants per 1,000 live births 14 Legitimate Infants per 1,000 Legitimate live births 15 Illegitimate Infants per 1,000 Illegitimate live births Deaths from Cancer (all ages) 73 „ „ Measles (all ages) 0 „ „ Whooping Cough (all ages) 0 Birth Rate There were 479 births (12 illegitimate) during the year. The birth rate is 11.7 per 1,000 of the estimated resident population, as compared with 12.1 last year. The births last year numbered 492 including 21 illegitimate. Death Rate There were 378 deaths (371 last year), giving a rate of 9.3. Infantile Death Rate There were 7 deaths of children under one year as compared with 10 last year, a death rate per 1,000 live births of 14.6. Last year the figure was 20.3 and for 1950 17.4. For England and Wales the rate was 27.6 for 1952, and 29.6 for 1951. 4 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 I. 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 1952. 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 1952 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 100 1 .... 6 9 31 42 8 2 1 .... .... .... Chicken Pox 131 1 10 26 53 34 5 2 .... .... .... .... .... Whooping Cough 66 7 3 7 10 18 19 2 .... .... .... .... .... .... Measles 235 3 7 85 123 12 4 1 .... .... .... .... .... .... Pneumonia 21 .... .... .... .... 1 2 2 .... .... 1 8 7 .... Dysentery 2 .... .... .... .... .... 1 .... .... .... 1 .... .... .... Puerperal Pyrexia 2 .... .... .... .... .... .... .... .... 2 .... .... ........ .... Poliomyelitis 1 .... .... .... .... .... 1 .... .... .... .... .... .... .... Totals 558 11 11 108 168 115 103 18 4 3 2 8 7 .... 5 TABLE II Causes of, and Ages at, Death during the year 1952 CAUSES OF DEATH. All Ages. Under 1 year. 1—2 yeais. 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 73 ... ... ... ... ... 2 18 53 68 Heart Disease 109 1 .... .... .... 1 6 26 75 47 Arterio-Sclerosis 2 .... .... .... .... .... .... .... 2 2 Coronary Thrombosis 38 .... .... .... .... .... 2 14 22 30 Cerebral Thrombosis 27 .... .... .... .... .... .... 9 18 15 Cerebral Haemorrhage 20 1 .... .... .... .... .... 8 11 19 Cerebral Tumour 6 .... .... .... 2 ....• 1 1 2 6 Pneumonia 15 1 .... .... .... .... .... 2 12 15 Bronchitis 19 .... 1 1 .... .... 1 1 15 10 Tuberculosis 8 .... .... .... .... .... 2 4 2 6 Pulmonary Embolism 5 .... .... .... .... .... .... 3 2 5 Pulmonary Oedema 1 .... .... .... .... .... .... .... 1 1 Premature Birth 2 2 .... .... .... .... .... .... .... 2 Ruptured Cerebral Vein 1 1 .... .... .... .... .... .... .... 1 Meningitis 2 .... .... .... 1 .... .... 1 .... 2 Influenza 2 .... .... .... .... .... .... 1 1 .... Uraemia 13 .... .... .... .... .... 1 3 9 10 Gastric Ulcer 2 .... .... .... .... .... .... .... 2 2 Peritonitis 6 .... .... .... .... .... 1 1 4 6 Nephritis 2 .... .... .... .... .... .... 1 1 .... Diabetes 1 .... .... .... .... .... .... .... 1 .... Haemorrhage from Varicose Vein (shock) 2 .... .... .... .... .... .... 1 1 2 Acute Pancreatitis 1 .... .... .... .... .... .... .... 1 1 Pernicious Anaemia 1 .... .... .... .... .... .... .... 1 1 Ulcerative Colitis 1 .... .... .... .... .... .... .... 1 1 Intestinal Obstruction 2 1 .... .... .... .... .... 1 ....• 2 Accident 13 .... .... 1 1 .... 4 2 5 7 Suicide 4 .... .... .... .... .... 1 2 1 ........ Total 378 7 1 2 4 1 21 99 243 261 TABLE III Infantile Mortality, 1952 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.J 1—3 months. 3—6 months. | 6—9 months. 1 9—12 months.(???) Total under 1 year. Premature Birth 2 .... .... .... 2 .... .... .... .... 2 Cerebral Haemorrhage .... .... .... .... .... 1 .... .... .... 1 Ruptured Cerebral Vein 1 .... .... .... 1 .... .... .... .... 1 Intestinal Obstruction .... .... .... .... .... 1 .... .... .... 1 Congenital Heart Disease .... 1 .... .... 1 .... .... .... .... 1 Broncho-Pneumonia .... .... .... .... .... 1 .... .... .... 1 Totals 3 1 .... .... 4 3 .... .... .... 7 TABLE IV. Tuberculosis. New Cases and Mortality during Year 1952. AGE PERIODS. NEW CASES. DEATHS. Respiratory. Non Respiratory. Respiratory. Non Respiratory. M. F. M. F. M. F. M. F. 0— ........ ........ ........ ........ ........ ........ ........ ........ 1— 1 ........ ........ ........ ........ ........ ........ ........ 5— 3 ........ 2 ........ ........ ........ ........ ........ 15— 2 1 1 ........ ........ ........ ........ ........ 25— 4 3 1 1 ........ 1 ........ ........ 35— 5 3 ........ 2 1 1 ........ ........ 45— 3 2 ........ 1 1 ........ ........ ........ 55— 2 2 ........ ........ 1 2 ........ ........ 65 and over ........ ........ ........ ........ 1 ........ ........ ........ Totals 20 11 4 5 4 4 ........ 7 East Barnet Urban District Council ANNUAL REPORT of the CHIEF SANITARY INSPECTOR FOR THE YEAR 1952 To the Chairman and Members of the East Barnet Urban District Council The following is a brief report on the sanitary inspection of the area during the year. The following list shows the number of visits and inspections made during the year, subdivided into the main categories:— 1951 1952 Nuisances and Sanitary Defects 5,134 5,290 Infectious Diseases 264 269 Observations of Factory Chimneys 54 46 Dilapidated Dustbins 24 24 Brooks and Streams 11 30 Verminous Premises 28 31 Premises (Infestation by Insects) 51 163 Premises (Rat and Mouse Infestation) 3,814 3,092 Houses (Housing Act, 1936, Part 2) 79 82 Houses (Permitted Numbers and Overcrowding) 22 39 Houses (Applicants for Houses—Special Cases) 8 124 Restaurants, Snack Bars, etc. 481 297 Fish Shops 88 89 Butchers' Shops 266 263 Bakehouses 86 55 Ice Cream Premises (including visits for sampling) 244 204 Other Food Shops and Premises 827 889 Food Inspections - 102 Under the Milk (Special Designations) Regulations (including visits for sampling) 212 205 Factories 279 257 Carried forward 11,972 11,551 8  1951 1952 Brought forward 11,972 11,551 Outworkers 128 325 Schools 75 80 Shops re Shops Act 293 374 Entertainments Acts - 35 Hairdressers' and Barbers' Premises (under Byelaws) 10 23 Caravan Sites 12 8 Totals 12,490 12,396 Number of Notices Served during the Year 1951 1952 Informal Notices 203 149 Statutory Notices 32 28 The result of the service of these Notices was as follows:— Preliminary Notices Statutory Notices 1951 1952 1951 1952 Complied with 174 116 22 19 Work in progress or in hand at the end of year 5 12 2 2 Not yet complied with 24 21 8 7 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 Roofs repaired and made weathertight 48 Rain water gutters and pipes cleaned, repaired or renewed 29 Interior walls repaired or replastered 20 Ceilings repaired or replastered 12 Walls and ceilings cleansed and distempered 20 Exterior brickwork repaired or repointed 10 Damp walls remedied 26 Stairs or staircases repaired 8 Broken sash cords renewed 10 Window frames repaired 10 Kitchen ranges repaired or renewed 5 Fireplaces repaired 4 Doors and frames, etc., repaired or renewed 10 Floors and skirting boards repaired or relaid 20 Scullery sinks renewed 6 Waste pipes repaired or renewed 8 Defective window sills repaired 4 9 No. of Houses Dilapidated dustbins renewed 10 Verminous premises fumigated, etc. 8 Choked drains cleared 66 Defective vent soil pipes repaired 8 Broken inspection chamber covers replaced 15 Drains repaired or relaid 10 W.C.'s, fittings repaired or renewed 21 Cisterns repaired or renewed. 5 Water pipes repaired 5 Accumulation of refuse removed 10 Nuisances arising from the keeping of animals, poultry, etc., remedied 12 Exterior paving repaired or relaid 3 Chimney pots and flues repaired 10 Insufficient water supply remedied 6 Defective covers to water tanks replaced 2 Lavatory basins renewed 8 Defective skylights repaired 1 Cement rendering renewed 9 Gulley kerbs renewed 8 Housing Act, 1936—Demolition and Closing Orders At the beginning of the year 1952 the position regarding the outstanding demolition orders was that there were six orders operative. The following is a list of these orders with the dates on which they were served:— 75, Church Hill Road Notice served January, 1936 77, Church Hill Road „ 1936 107, Leicester Road „ November, 1949 27, Dury Road „ „ February, 1952 54, Edward Road „ „ „ 1952 14. warwick cottages „ November 1949 In the case of the dwelling houses known as 75 and 77 Church Hill Road, these were Council-owned property and have been demolished during October and November of 1952. As can be seen from the above list, these demolition orders have been outstanding for a very considerable period, but unfortunately, owing to the war and the present re-housing conditions, it had not been practicable to take any further action. One of these premises fell vacant some time ago, and during 1952 arrangements were made for the re-housing of the other occupants. Immediately both houses became vacant the premises were completely demolished and the site cleared. During the period to which this report applies, 27, Dury Road, Hadley, has also been completely demolished and new premises 10 erected on the same site. This house will shortly be ready for occupation. The tenant of 54, Edward Road has now vacated these premises, and it is apparent that 14, Warwick Cottages will also shortly become vacant. The premises at 107, Leicester Road, are still occupied, and it appears that no action will be possible on these premises for some time. Last year it was reported that 7, Edward Grove, was unfit for human habitation and could not be repaired at a reasonable expense, and the Council had authorised service of the usual notice. The owner submitted to the Council an undertaking to carry out extensive repairs which was accepted. As the works shown on the undertaking have been carried out, the matter is now concluded. No new Closing or Demolition Orders were made during the year. Rodent Control One hundred and eighty-six complaints of rat and mouse infestations were received during the year. In order that these complaints could be efficiently dealt with, a total of 625 properties were visited, and 277 of these were found to be infested with rats or mice. All the infested properties were treated by the Rodent Operator. During the year a new poison, Warfarin, has been used in suitable cases with good results. This poison has the advantage in that rodents do not suffer from poison prejudice where it has been used, and it therefore allows the use of permanent baiting points where these are advantageous. In accordance with the requirements of the Rodent Control Branch of the Ministry of Agriculture, two treatments of the sewers were made. The first in January being a maintenance treatment and the second in July being the annual 10 per cent. test of the sewer manholes, followed by a treatment based on the results of the test. The maintenance treatment of the sewers which was carried out in January consisted of prebaiting 57 manholes with sausage rusk. These manholes being those which showed “takes" at previous treatments, with the addition of manholes in the immediate vicinity. Of the manholes prebaited, 16 showed "takes," these were subsequently poison-baited with sausage rusk and zinc phosphide. Two days after laying the poison it was found that in 8 cases the bait had been partially consumed. 11 During the annual 10 per cent. test of the sewer manholes in July, 152 manholes were baited with damp sausage rusk, and on an inspection made two days later in 12 cases the bait had been completely taken and in 2 cases partially taken. This test was followed by a treatment in which 69 manholes were prebaited consisting of those in which bait was partially or completely taken and those in the immediate vicinity. Twenty-seven of these manholes showed "takes," these being poison baited when 20 partial "takes" were found. There were no complete "takes" of poison bait. From the above results it is indicated that the sewers of the area are not seriously rat infested. Verminous Houses During the year 11 houses were found to be verminous. All of these premises were disinfested with liquid insecticide containing D.D.T. with satisfactory results. As far as is known there has been no recurrence of the infestation. 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 16 37 1 Factories in which mechanical power is used 91 220 6 Totals 107 257 7 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 4 4 _ _ Unsuitable or defective sanitary conveniences 1 1 _ _ Other offences (not including offences relating to home work) 4 4 _ _ 9 9 _ _ 12 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 8 Sterilised 12 The following Supplementary licences under principal licences granted by other authorities to sell milk from premises outside this area were also granted:— Tuberculin Tested 11 Pasteurised . 11 Sterilised 10 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:— Result of Examination. (a) Methylene blue. (b) Turbidity (c) Phosphatase. T.T. Pasteurised 16 (a) and (c) Satisfactory T.T. Farm Bottled 23 (a) ” Pasteurised 30 {a) and (c) ” Homogenised Past. 13 (a) and (c) ” Sterilised 14 (b) ” A copy of the report of each sample was supplied to the retailer or dairy proprietor. For the last three years no sample of milk has been found to be unsatisfactory. This shows considerable improvement as in 1941 33 per cent. of the samples obtained were unsatisfactory. These results are undoubtedly due to the improved conditions under which milk is handled and the increased care taken by persons employed in the trade. As mentioned by the Medical Officer of Health, the greatest danger as far as milk is concerned is after the retailer has delivered it to the consumer. Ice Cream Three applications were received for the registration of premises for the sale of ice cream. The premises being satisfactory, all three applications were granted. Ninety-six samples were obtained and submitted for bacteriological examination, with the following results:— Provisional grade 1 92 „ „ 2 4 „ „ 3 0 „ „ 4 0 96 13 It will be noted from the above figures that only 4 Grade 2 samples were obtained and that no samples of a lower grade were found. This shows that the conditions in which the ice cream is being made and kept are reaching a very high standard, not only on the part of the manufacturers, but also in the retail premises Every endeavour will be made to ensure that this high standard is maintained. There is only one person who manufactures ice cream in.the district, and in this case it is occasional and of very small quantities. The other retailers purchase the ice cream in bulk from the large manufacturers. Meat and Other Food Inspection The requirements of the Public Health (Meat) Regulations, 1924, have been carried out as regards all premises on which meat is sold for human consumption. The inspection of food (other than meat) is carried out as necessary. The co-operation between retailers of food and this office is extremely good and no difficulties have been experienced during the inspection of meat and other foods. The following is a list of the foods surrendered as unfit for human consumption during the year:— cwts. lbs. Beef 12 30 Mutton - 27 Pork - 40 Fish 1 91 Currants - 8 Cheese -- 2 Sugar - 26 Tea 1 15 Butter - 7 Margarine -- 12 Tins 10 40 Total 26 74 Inspection of Premises on which Food is Sold or Prepared for Sale Frequent inspections are made of all restaurants, snack bars, canteens and food shops and other premises on which food is prepared or exposed for sale. During these inspections particular attention is paid to the general cleanliness of the premises and equipment and also to the methods of handling and care of the various foods. 14 During the year 1,904 inspections were made for this purpose, and although the number of improvements shown on the following list is very considerably less than the previous year, the standard demanded of these type of premises is very high. During 1951 the Clean Food Byelaws came into force, and in consequence a large number of improvements to bring the premises to the standard required were made. As the majority of these were the installation of additional equipment, they would effect a permanent improvement and consequently would not be repeated. During 1952 several premises have installed modern refrigerating equipment of their own initiative, and during the inspections advice is fequently asked and given regarding improvements in the handlir g and storage of food. In general, it is found that close personal contact with the proprietors of food premises is resulting in a higher level of hygiene and an increased interest in the improved methods of handling foods. The following list of improvements are those which have been effected in food premises after the service of Preliminary Notices on the persons responsible:— No. of Shops. Notices to wash hands on or near sanitary conveniences 2 Dirty walls and ceilings cleansed 4 Defective W.C. fittings repaired or renewed 2 Provision of adequate sanitary accommodation 1 Other minor improvements 4 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. W. K. PICKUP, Chief Sanitary Inspector. 15 WILL C. JONES : : Printer : : 62, East Barnet Rd., New Barnet, Herts.