ERI 32 BOROUGH OF ERITH ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1952 BY JOHN LANDON M.R.C.S., L.R.C.P., D.P.H. BOROUGH OF ERITH ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1952 BY JOHN LANDON M.R.C.S., L.R.C.P., D.P.H. Printed by Freame, Manning & Co., Ltd. Lewi sham, S.E. 13 Arrangement of Report Section Page A Statistics and Social Conditions of the Area 1. Physical Situation and Amenities 7 2. Comparative Rainfall 7 3. Unemployment Figures and Comments 8 4. Statistics 8 (a) General 8 (b) Births, Birth Rate, Still Births, Still Birth Rates 9 (c) Deaths, Death Rate, Maternal Mortality Rate 9 (d) Infant Mortality 10 (e) Summary of Vital Statistics for year 1952 11 (f) Vital Statistics of whole District during 1952 and previous years 12 (g) Table Showing Summary of Causes of Death during 1952 13 (h) Comparison of Maternal Mortality Rate 14 (i) Infant Mortality—Causes of death and table of comparison 14 B Prevalence of and Control over Infectious and other Diseases 1. Notifications 16 (a) Food Poisoning 17 (b) Dysentery 18 (c) Scarlet Fever 19 (d) Age Distribution 20 (e) Ward Distribution 21 2. Tuberculosis 22 (a) New cases notified during 1952 22 (b) Deaths 22 (c) Quarterly statements for year 1952 23 (d) Mass Radiography 24 3. Diphtheria Immunisation 25 4. Smallpox 26 (a) Vaccination 26 C General Provision of Health Services for the Area 1. General Hospital Facilities 27 2. Infectious Disease Hospitals 27 3. Tuberculosis Treatment and Hospital Accommodation 27 4. Venereal Diseases 27 i Section Page 5. Ambulance Service 27 6. School Clinics 27 7. Maternity and Child Welfare Centres 28 8. Maternity Home 28 9. Private Nursing Homes 28 10. Day Nursery 28 11. Laboratory Facilities 28 12. Mortuary 29 13. Disinfection Services 29 14. Welfare of Old People 29 15. National Assistance Act, 1948, (Burials) Section 50 30 D Sanitary Circumstances of the Area 1. Refuse Collection and Disposal 31 (a) Costs 31 (b) Details of Refuse Collection Vehicles and Staff 31 (c) Details of Tonnage 32 2. Trade Refuse 32 3. Salvage 32 4. Public Conveniences 32 5. Sanitary Inspection of the Area 33 (a) Visits by Sanitary Inspectors 33 (b) Premises visited and results of such visits 33 (c) Summary of Nuisances and defects remedied during the year 33 (d) Closet accommodation and cesspools 34 (e) Smoke Abatement 34 (f) Swimming Baths and Pools 34 (g) Camping Sites 35 (h) Hop Pickers 35 (i) Eradication of Bed Bugs 35 (j) Mosquito Control 36 (k) Rodent Control 36 (l) Pest Control 36 (m) Offensive Trades 36 (n) Rag Flock Act 37 (o) Pet Animals Act, 1951 37 (p) Merchandise Marks Act, 1926 37 6. Factories 37 (i) Inspections 37 (ii) Defects Found 38 7. Shops Acts 1950 38 ii Section Page 8. Sanitary Accommodation at Offices 38 9. Atmospheric Pollution 39 10. Effluvia from River Thames 39 11. Housing 40 (a) Inspection of Dwelling Houses during the year 40 (b) Remedy of Defects during the year 40 12. Rent and Mortgage Interest (Restriction) Act, 1939 42 13. Legal Proceedings 43 E Water Supply — Milk and Food and Drugs 1. Water Supply 44 2. (a) Dairies and Milk Stores 44 (b) Bacteriological examination of Milk 44 (c) Biological testing of Milk 44 (d) Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, etc. 45 (e) Designated Milk 45 (f) Milk and Dairies Regulations, 1949, Article 26 (1) 45 (g) Ice Cream 45 3. Meat and Food Inspection 46 4. Slaughter of Animals Act, 1933 46 5; Slaughterhouses—Section 57, Food and Drugs Act, 1938 46 6. Food and Drugs Act, 1938, Sections 3 and 68, Routine Sampling 47 7. Food Hygiene—Food Traders' Guild 48 F General 1. Members of Committee 2 2. Staff of Public Health Department 3 3. Introductory remarks of Medical Officer of Health 4 4. National Assistance Act, 1948, Sec. 47 48 5. Legislation in force 49 iii 2 F (1) BOROUGH OF ERITH Mayor :—Alderman C. F. Morling, J.P. (1951-1952) Mayor :—Alderman Mrs. L. F. Christian J.P. (1952-1953) Deputy Mayor :—Alderman Mrs. L. F. Christian, J.P. (1951-1952) Deputy Mayor :—Alderman C. F. Morling, J.P. (1952-1953) Health Committee Chairman :—Alderman Mrs. L. F. Christian, J.P. Members of Committee May 1951—May 1952 May 1952—May 1953 Councillors W. F. Alford A. H. Cross J. F. L. Gates Mrs. H. A. Jerome Miss M. E. Odell C. Schofield E. Taylor T. G. Tuffee Ex-Officio Members W. F. Alford W. Boast J. F. L. Gates Mrs. H. A. Jerome Miss M. E. Odell E. C. Pringle C. Schofield Mrs. C. Thomas Ex-Officio Members Aldermen C. F. Morling, J.P. C. F. Morling, J.P. G. W. H. Luck G. W. H. Luck 3 F (2) PUBLIC HEALTH DEPARTMENT STAFF Medical Officer of Health John Landon, M.R.C.S., L.R.C.P., D.P.H. (Acts also as Medical Officer of Health for the Borough of Bexley and the Urban District of Crayford). Senior Sanitary Inspector L. E. King, M.R.San.I., D.S.A.A., Cert.S.J.E.B., Meat Inspector's Certificate. Sanitary Inspectors J. Hacker, M.R.San.I., Cert.S.I.E.B., Meat Inspector's Certificate (Resigned 31.8.52) N. E. Broom. Cert.S.I.E.B. P. R. Hickson, Cert.S.I.E.B., Meat Inspector's Certificate). C. H. Sargent, Cert.S.I.E.B., Meat Inspector's Certificate (Appointed 1.10.52) Chief Clerk J. A. Sutherland Clerks Shorthand-typist:— Mrs. G. Green Junior Clerk:— J. W. Tiptaft (Joined H.M. Forces 8.4.52) Miss V. D. I. White (Appointed 26.5.52) 4 To the Mayor, Aldermen and Councillors of the Borough of Erith Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report for the year, 1952. The vital statistics of the Borough, the only instrument at our disposal for measuring the health of the population, may be regarded as satisfactory. The birth rate during 1952 was 14.83 per 1,000 of the home population, compared with 15.00 in 1951 and with a 1952 rate for England and Wales of 15.3. After correction by the comparability factor supplied by the Registrar General, the birth rate for Erith, in 1952, was 14.09. The death rate for the Borough for 1952 was 10.85 compared with 11.6 in 1951 and the rate corrected for comparison with other areas was 11.6 compared with 12.4 in 1951. The infant mortality rate was 29.3 per 1,000 live births compared with 34.8 in 1951, the rate for the country as a whole during 1952 being 27.6. The lowest rate ever achieved in the Borough was 20 in 1950 and it is wise to interpret these results with restraint owing to the small numbers involved. Nevertheless, there has been, allowing for inevitable fluctuations, continuous improvement in the infant mortality rate over the past 50 years. Erith was mentioned in the last three quarterly returns of the Registrar General in 1911 as being one of the towns which had low infant mortality rates but the rate for Erith during that year was 69.93 and the rate for the 136 smaller towns in general was 133.0 per 1,000. These comparisons reveal the extent of improvement in living conditions during the past half century and are in part, also, a reflection of the impact of health services and health education. The optimistic picture presented by these figures does not take into account the fact that we have no morbidity statistics relating specifically to the Borough, so that we do not know how many people had, during the year, to attend hospital, or 5 their private doctors, to resort to self-medication or who failed to achieve that degree of functional efficiency which is the essence of health ; but there is reason to believe that the number was considerable. Infectious disease was of low incidence with the exception of scarlet fever which has lost much of its past virulence and is not now regarded as a major scourge as it was 20 years ago. For the third year in succession no case of diphtheria was notified in the Borough. Four cases of paralytic poliomyelitis, with one death, occurred as compared with no case in 1951. The incidence of this disease is unpredictable but there is no doubt that it will provide one of the main epidemiological problems during the next few years. The Clean Food Campaign made further progress during the year although there is nothing spectacular to report. The general public do not, perhaps, sufficiently recognise that effective official action is only possible with their co-operation and although lip-service is often paid to the need for cleaner food production and handling, there is considerable public apathy in regard to film shows, lectures and exhibitions. This is, however, a long term project in health education and the up-hill nature of the task does not make it in any way less worthwhile. Reference should be made to the body of the Report for details of food poisoning which occurred in the Borough during the year. During the year under review, the nuisance caused by effluvia from the River Thames was not so marked as during the previous year and reference is made on Page 39 to the steps which are being taken by the Port of London Authority and the London County Council both in regard to the investigation of the basic causes of this nuisance and to the best means of remedying it. The Erith Old People's Welfare Committee continued to do good work and in fact increased its scope and usefulness. Funds have been collected from voluntary sources and arrangements are already made to send 22 necessitous old people to the seaside for a week's holiday free of all cost to them. The work of the district liaison officers is strenuous and much good work has been done in this field. The prevention of accidents in the home is likely to receive considerable attention in the forthcoming year and will come 6 to be regarded, more and more, as an integral part of preventive medicine. It is just as worthy to prevent the death of a child from burns as from diphtheria and there is, here, a fruitful field for the endeavours of the Health Department in collaboration with the voluntary organisations in the Borough. It is too little realised that, in the country as a whole, there are 5,000 to 6,000 fatalities every year from home accidents and that 20 per cent, of the deaths occur in children under five years and about 60 per cent, in old people and, further, that more children under 15 years of age die from accidental causes in their homes than are killed in road accidents. I wish to thank the Chairman and members of the Health Committee for their support and encouragement and the Senior Sanitary Inspector, the Chief Clerk and all members of the Health Department for their excellent work during the year. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, JOHN LANDON Medical Officer of Health. 7 Annual Report 1952 SECTION A:—STATISTICS AND SOCIAL CONDITIONS OF THE AREA A (I) Physical Situation and Amenities Erith is situated in the north west corner of Kent, and is bounded on the North-East by the River Thames, to which it has a frontage of about 4 miles; on the West by the Metropolitan Borough of Woolwich and the Borough of Bexley, and on the South by the Borough of Bexley, and the Urban District of Crayford. In spite of continuous industrial expansion, the Borough still retains in many places an urban aspect and views from the many vantage points in the district afford evidence of its undulating nature and the tree endowed districts of Abbey Wood and Belvedere. The shopping facilities in the Borough are excellent and a copious and pure supply of water is maintained by the Metropolitan Water Board. The chief industries are light and heavy engineering, edible oil refining, chemical works, coal shipping and lighterage, the production of building materials, i.e., stoneware, plasterboard, asbestos, and of radio equipment. A (2) Comparative Rainfall 1951 Inches 1952 Inches January 2.03 2.15 February 5.92 1.04 March 2.49 2.56 April 2.68 0.99 May 2.27 1.33 June 1.27 1.06 July 2.51 0.75 August 2.64 2.32 September 2.25 3.28 October 0.80 2.36 November 3.66 3.90 December 2.01 2.08 Total 30.53 Total 23.82 8 A (3) Unemployment Figures and Comments With the co-operation of the Manager of Erith Employment Exchange, to whom I am indebted for the necessary information, it is once again possible to give definite figures with regard to the state of unemployment in the district, as shown in the following table. Erith and District Unemployment Figures 1939—1952 Month and year Males Females Total 18 and over Under 18 18 and over Under 18 December, 1939 373 31 299 48 751 December, 1940 75 3 255 37 370 December, 1941 39 17 44 17 117 December, 1942 38 1 39 5 83 December, 1943 27 1 6 5 39 December, 1944 31 — 6 3 40 December, 1945 91 1 133 1 226 December, 1946 177 12 58 13 260 December, 1947 131 4 94 5 234 December, 1948 208 7 129 2 346 December, 1949 111 8 153 3 275 December, 1950 114 3 122 1 240 December, 1951 82 1 103 3 189 December, 1952 134 1 82 2 219 Unemployment in Erith throughout 1952, though higher than in 1951, still remained at a low level, and at the end of the year was still only 1.3% of the total working population. A (4) STATISTICS A (4)a General Area (i) Including River:—4,607 acres. Area (ii) Excluding River:—3,859 acres Population figure supplied by Registrar General:— Estimated mid-year Home Population—46,070 Density of population i.e. No. of persons per acre (Based on (ii) above) :—11.9 No. of inhabited houses at 31st December, 1952:— (Excluding houses with shops and houses with Public Houses assessed as single heraditaments) 12,437 Rateable value at 31st December, 1952:—£354,104 Sum produced by a penny rate, 1952:— (Estimated product for 1952/53) £1,443. 9 EXTRACTS FROM VITAL STATISTICS FOR YEAR 1952. A(4)b Births Male Female Total Live Births Legitimate 310 345 655 Illegitimate 13 15 28 323 360 683 Live Birth rate per 1,000 Home Population (Registrar General's Figure):—14.83 Birth rate corrected for comparison with other areas:— 14.09 Comparability factor supplied by Registrar General:— 0.95. Live birth rate, England and Wales:—15.3 Corresponding rate for the Borough of Erith for year 1951:—15.00 Male Female Total Still Births Legitimate 10 5 15 Illegitimate — — — 10 5 15 Still Birth rate per 1,000 total births:—21.49 Still Birth rate per 1,000 Home population:—0.33 Still Birth rate per 1,000 Home population, England and Wales 0.35 A (4)c Deaths Male :—253 Female :—247 Total:—500 Death rate per 1,000 Home population:—10.85 Death rate corrected for comparison with other areas:— 11.6. (Comparability Factor supplied by Registrar General):— 1.07. Corresponding rate for 1951:—11.6 Death rate per 1,000 Home population, England and Wales (1952) 11.3 Number of women dying in, or in consequence of, childbirth:—1 Maternal Mortality Rate per 1,000 total births:—1.43 Comparative figure for England and Wales:—0.72 10 A (4)d Infant Mortality Deaths of infants under 1 year of age:— Male Female Total Legitimate 10 8 18 Illegitimate 1 1 2 11 9 20 Death rate of infants under 1 year of age per 1,000 live births:—29.3 Death rate of infants under 1 year of age per 1,000 live births, England and Wales:—27.6 Deaths of infants under 4 weeks of age:— Male Female Total Legitimate 5 3 8 Illegitimate 1 1 2 6 4 10 Death rate of infants under 4 weeks of age per 1,000 live births:—14.6 Total number of deaths from:— 1951 1952 Measles (All ages) 1 0 Whooping Cough 1 0 11 A (4)e Summary of Vital Statistics for the Year 1952 England and Wales 160 County Boro's & Great towns including London 160 smaller towns (Resident population 25,00050,000 at 1951 census) London Administrative County Borough of Erith Births:— Rates per 1,000 Home Population Live births 15.3 16.9 15.5 17.6 14.09 Still births 0.35 0.43 0.36 0.34 0.33 22.6(a) 24.6(a) 23.0(a) 19.2(a) 21.5(a) Deaths:— All causes 11.3 12.1 11.2 12.6 11.6 Typhoid and Para-Typhoid 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.00 0.00 0.00 0.00 0.00 Diphtheria 0.00 0.00 0.00 0.00 0.00 Tuberculosis 0.24 0.28 0.22 0.31 0.28 Influenza 0.04 0.04 0.04 0.05 0.07 Smallpox 0.00 0.00 0.00 0.00 0.00 Acute Poliomyelitis (including Polioencephalitis) 0.01 0.01 0.00 0.01 0.02 Pneumonia 0.47 0.52 0.43 0.58 0.41 Deaths:— Rates per 1,000 Live Births All causes under 1 year of age 27.6(b) 31.2 25.8 23.8 27.6 Enteritis and diarrhoea under 2 years of age 1.1 1.3 0.5 0.7 0.00 Notifications:— (Corrected) Rates per 1,000 Home Population. Typhoid Fever 0.00 0.00 0.00 0.00 0.00 Para-Typhoid Fever 0.02 0.02 0.03 0.01 0.00 Meningococcal Infection 0.03 0.03 0.03 0.02 0.04 Scarlet Fever 1.53 1 .75 1.58 1.56 3.47 Whooping Cough 2.61 2.74 2.57 1.66 4.58 Diphtheria 0.01 0.01 0.03 0.01 0.00 Erysipelas 0.14 0.15 0.12 0.14 0.15 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 8.86 10.11 8.49 9.23 7.16 Pneumonia 0.72 0.80 0.62 0.57 0.76 Acute Poliomyelitis (including Polioencephalitis) Paralytic 0.06 0.06 0.06 0.06 0.09 Non-Paralytic 0.03 0.03 0.02 0.03 0.00 Food Poisoning 0.13 0.16 0.11 0.18 0.11 Puerperal Pyrexia 17.87(a) 23.94(a) 10.22(a) 30.77(a) 2.84(a) (a) Per 1,000 Total (Live and Still) Births. (b) Per 1,000 Related Live Births. 12 Year Population Figure according to Registrar General No. of Live Births according to Registrar General Live Birth Rate per 1,000 population No. of Deaths according to Registrar General Death rate per 1,000 Population No. of Deaths of infants under 1 year of age Infant Mortality Rate per 1,000 live births A (4)f Vital Statistics of Whole District daring 1952 and previous years 1938 39,800 634 15.87 390 9.8 34 53.62 1939 41,870 721 17.22 452 10.98 31 44.28 1940 40,210 721 17.8 486 12.08 24 37.17 1941 36,520 606 16.8 473 17.00 23 37.95 1942 37,340 734 19.6 415 11.10 26 45 .4 1943 37,890 822 21.6 439 11 .58 35 42.57 1944 36,780 895 24.3 463 12.50 44 49.16 1945 38,270 732 19.13 451 11.78 29 39.61 1946 42,900 958 22.30 446 10.40 31 32.3 1947 44,350 1,006 22.6 493 11.1 34 33.7 1948 46,250 877 18.96 458 9.9 20 22.8 1949 46,730 795 17.00* 465 9.95* 19 23.9 (Civilian) 46,770 (Total) (Corrected) 10.75 1950 46,850 701 14.96 478 10.2 14 20.0 (Home Population) (Corrected) 14.21 (Corrected) 11.0 1951 46,010 690 15.00 533 11.6 24 34.8 (Home Population) (Corrected) 14.25 (Corrected) 12.4 1952 46,070 683 14.83 500 10.85 20 29.3 (Home Population) (Corrected) 14.09 (Corrected) 11.6 *Per 1,000 Home Population. 13 A (4)g Table showing Summary of Causes of Death during the year ended 31st December, 1952 Cause of Death Males Females Total 1 Tuberculosis, Respiratory 8 4 12 2 Tuberculosis, Other forms — 1 1 3 Syphilitic diseases 2 — 2 4 Diphtheria — — — 5 Whooping Cough — — — 6 Meningococcal Infections — — — 7 Acute Poliomyelitis 1 — 1 8 Measles — — — 9 Other infective and parasitic diseases — 1 1 10 Malignant neoplasm, stomach 7 6 13 11 Malignant neoplasm, lung, bronchus 12 4 16 12 Malignant neoplasm, breast — 7 7 13 Malignant neoplasm, uterus — 5 5 14 Other malignant and lymphatic neoplasms 26 23 49 15 Leukaemia, Aleukaemia 1 1 2 16 Diabetes — 3 3 17 Vascular lesions of nervous system 25 27 52 18 Coronary disease, angina 36 29 65 19 Hypertension with heart disease 4 6 10 20 Other heart diseases 50 63 113 21 Other circulatory diseases 5 11 16 22 Influenza 2 1 3 23 Pneumonia 10 9 19 24 Bronchitis 17 8 25 25 Other diseases of respiratory system 3 2 5 26 Ulcer of stomach and duodenum 2 — 2 27 Gastritis, enteritis and diarrhoea 1 — 1 28 Nephritis and Nephrosis 6 3 9 29 Hyperplasia of prostate 7 — 7 30 Pregnancy, Childbirth and abortion — 1 1 31 Congenital Malformations 2 4 6 32 Other defined and ill-defined diseases 18 19 37 33 Motor vehicle accidents — 2 2 34 All other accidents 3 2 5 35 Suicide 5 5 10 36 Homicide and operations of war — — — Total all causes 253 247 500 14 A (4)h Comparison of Maternal Mortality Rate Yearly Maternal Mortality rates are given Year Maternal Deaths Live Births Still Births Maternal Mortality Rate per 1,000 total Births 1921 3 735 11 4.0 1922 3 644 22 4.5 1923 1 623 14 1.57 1924 1 558 13 1.75 1925 — 602 9 — 1926 3 546 9 5.4 1927 1 532 — 1.88 1928 3 513 — 5.84 1929 1 547 11 1.82 1930 2 488 17 3.96 1931 — 492 7 — 1932 2 475 13 4.2 1933 1 492 10 2.03 1934 1 481 17 1.96 1935 2 525 19 3.67 1936 1 510 18 1.96 1937 1 605 20 1.52 1938 3 634 22 4.57 1939 3 721 24 4.28 1940 1 721 24 1.38 1941 1 606 23 1.65 1942 2 734 28 2.6 1943 3 822 21 3.65 1944 2 895 18 2.2 1945 — 732 17 — 1946 — 958 23 — 1947 1 1,006 27 0.9 1948 2 877 12 2.25 1949 1 795 13 1.24 1950 — 701 15 — 1951 1 690 15 1.42 1952 1 683 15 1.43 A (4) i. Infant Mortality 20 infants died before reaching 1 year of age giving an infant mortaliiy rate of 29-3 per 1,000 live births. The comparable figure for the whole of the country is 27.6. Of the 20 children who died, 10 died before reaching the age of one month, giving a neo-natal mortality rate of 14.6 per 1,000 live births. 16 died in hospital and the remaining 4 in their own homes. Coroner's Postmortem examinations, without inquests, were carried out in 6 cases. Analysis of the causes of death and of the age at death reveals the following figures:— 15 Cause of death as certified under 1 day 1 day 2 days 3 days 4 days 5 days 6 days 7-14 days 14-21 days 21-28 days 28 days - 2 months 2 months 3 months 4 months 5 months 6 months 7 months 8 months 9 months 10 months 11-12 months Total deaths under 1 year Atelectasis 1 1 1 1 4 Atresia of the Jejunum (Congenital) 1 1 Birth Debility 1 1 Cardiac Failure and Fits 1 1 Congenital Heart Disease 1 1 Inanition 1 1 Inhalation Pneumonia 1 1 Pneumonia 2 1 1 4 Prematurity 1 1 1 3 Renal Acidosis 1 1 Toxaemia 1 1 2 Totals 2 4 1 — 1 1 — — 1 — 3 2 1 — — 1 1 — — 1 1 20 16 Below is given a table showing the Infant Mortality rates and actual number of infant deaths for Erith at five yearly intervals 1920-1945 and for the years 1946, 1947, 1948, 1949, 1950, 1951 and 1952. Year Erith England and Wales (Infant Mortality Rate) No. of Inf. Deaths Infant Mortality Rate 1920 50 60.5 83 1925 34 56.48 75 1930 32 65.6 60 1935 21 40.00 39 1940 24 37.17 55 1945 29 39.61 46 1946 31 32.3 43 1947 34 33.7 41 1948 20 22.8 34 1949 19 23.9 32 1950 14 20.0 29.8 1951 24 34.8 29.6 1952 20 29.3 27.6 SECTION B.—PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES B (1) Notifications. Disease Total No. of cases notified Cases admitted to infectious disease hospital Total No. of Deaths among notified cases Acute Pneumonia 35 12 - Acute Poliomyelitis (Paralytic) 4 4 1 Dysentery 5 - - Erysipelas 7 2 — Food Poisoning 5 4 — Gastro Enteritis 1 1 1 Malaria 1 1 - Measles 330 4 - Meningococcal infection 2 2 - Puerperal Pyrexia 2 2 - Ophthalmia Neonatorum 1 1 - Scarlet Fever 160 62 - Whooping Cough 211 - - Total 764 95 2 One case notified as Poliomyelitis was subsequently rediagnosed on admission to hospital, as Pharyngitis and Bronchitis, and another case similarly notified proved, on admission to hospital, not to be Poliomyelitis. One case notified as Meningococcal Infection was subsequently rediagnosed on admission to hospital as Glandular Fever. 17 B (1)a Food Poisoning A small outbreak of food poisoning occurred in the Borough during the year under review, the circumstances being as follows: The first case occurred in a man aged 61. An investigation was immediately carried out and a specimen was forwarded to the Public Health Laboratory at Maidstone. The result of the examination of this specimen revealed the presence of Salmonella typhi-murium (aertrycke) organisms. When the Sanitary Inspector called for a further specimen, he was informed that the patient had suddenly been taken violently ill and had been removed to hospital, where he had, subsequently, died. A post mortem examination was carried out, and the cause of death was given as uraemia. Within a few days of this unfortunate occurence, I was notified from hospital of a case of gastro-enteritis which had occurred in a child aged 4, who was living only three houses away from the above-mentioned case. Almost immediately afterwards information was received that this patient had, also, died. A further exhaustive investigation was carried out with particular emphasis on locating a common source of infection. It was not found possible to link the two cases in any way. Very shortly after the admission of this patient, his mother and younger brother were removed to hospital, also, with a diagnosis of gastroenteritis, but these two cases had proved much milder. In the meantime, a specimen taken in hospital from the deceased child had revealed the presence of salmonella typhi-murium organisms. During the investigations, it was discovered that a son of the original case of food poisoning, who had worked with his father, but resided in a neighbouring borough, had been admitted to hospital as a case of suspected dysentery. Information was received from the hospital concerned that a similar food poisoning organism had been isolated from a specimen taken from this man. Enquiries made by the 18 neighbouring borough concerned also failed to trace any source of infection. Even though, from the enquiries made, it seemed evident that there could be no connection between the two families concerned in this outbreak, arrangements were made for the phage typing of the organisms isolated. The Pathologist reported, in due course, that the two families concerned were infected with different Phage types of S. typhi-murium, indicating that there was no connection between the two series of cases. All contacts were kept under supervision, and no further cases were reported. A report of the outbreak was prepared and submitted to the Ministry of Health in accordance with Memo. 188/Med. of May, 1949. B (l)b Dysentery Of the five notified cases of dysentery, four occurred in one family. It was reported by their doctor that three members of this family actually had symptoms of dysentery. Investigations were carried out and specimens from each of the occupants were sent to the bacteriological laboratory for examination. The results of these tests revealed that each member of the family had been infected with Shigella dysentery organisms. The source of infection was obscure but a number of possibilities were investigated. Enquiries showed that the father was the proprietor of a cafe in a London area, and with the co-operation of the Medical Officer of Health it was agreed that this man should be excluded from handling food but allowed to attend work in a supervisory capacity only, until three consecutive negative specimens were obtained from him. A series of specimens was taken from all members of the family until several consecutive negative results were obtained. 19 B (1)c Scarlet Fever The number of notified cases of scarlet fever during 1952 showed a marked increase. The total number of cases notified during the year was 160, which is the highest number of notifications for scarlet fever received during any year since 1939 when the figure was 231. A table covering the 14 years 1939-1952 is set out below: It is interesting to note how the proportion of patients admitted to hospital has decreased in recent years. Year Number of cases % of notified cases admitted to hospital Notified Admitted to Hospital 1952 160 62 39% 1951 45 22 49% 1950 59 38 65% 1949 116 73 62% 1948 89 36 40% 1947 80 40 50% 1946 49 32 65% 1945 29 20 69% 1944 89 57 63% 1943 101 76 76% 1942 68 37 54% 1941 15 9 60% 1940 25 18 72% 1939 231 184 80% Home circumstances have a direct bearing on the number of patients admitted to hospital. The above table shows that in 1939 80% of cases were admitted and in 1952 only 39% of cases were admitted. It is unlikely that, generally speaking, home circumstances in the area have shown much improvement if any at all since 1939 due to the shortage of housing accommodation; the real explanation is that this disease has, in recent years, decreased in severity. B (1)d Age Distribution The following table shows the age distribution of cases of Infectious Disease notified during the year Disease Age Groups under 1 year 1-2 3-4 5-9 10-14 15-24 25-44 45-64 65 & over Age not known Totals M F M F M F M F M F M F M F M F M F M F Acute Pneumonia 2 2 - 1 - - 4 1 - 2 2 3 6 1 3 2 2 2 2 - 35 Acute Poliomyelitis (Paralytic) - - - - 1 - - - - - 1 - 2 - - - - - - - 4 Dysentery - - - - 1 - 1 - - - - - 1 1 — — — — 1 — 5 Erysipelas - - - - - - - - - - - - - 2 1 2 — 2 — — 7 Food Poisoning - - 2 - - - - - - - - - - 1 1 - - - - 1 5 Gastro Enteritis - - - - 1 - - - - - - - - - - - - - - - 1 Malaria - - - - 1 - - - - - - - - - - - - - - - 1 Measles 4 4 24 21 44 53 98 72 — 3 1 4 2 - - - - - - - 330 Meningococcal Infection - - - - 1 - - - - - - - - - 1 - - - - - 2 Puerperal Pyrexia - - - - - - - - - - - 2 - - - - - - - - 2 Ophthalmia Neonatorum - 1 - - - - - - - - - - - - - - - - - - 1 Scarlet Fever — — 5 3 12 14 54 56 5 10 - 1 - - - - - - - - 160 Whooping Cough 9 7 22 19 37 25 39 49 - 1 - - - 1 — — — — 2 — 211 Totals 15 14 53 44 97 92 196 178 5 16 5 10 11 6 6 4 2 4 5 1 764 20 B (1)e WARD DISTRIBUTION Number of cases of Infectious Disease notified in each ward in the Borough. Disease Ward Total Town Old Church Belvedere North Heath Abbey Wood Bostall Acute Pneumonia 4 9 6 7 3 6 35 Acute Poliomyelitis (Paralytic) — — — 2 — 2 4 Dysentery 1 — — — — 4 5 Erysipelas — 2 2 1 1 1 7 Food Poisoning 1 1 — — - 3 5 Gastro Enteritis — — — — — 1 1 Malaria 1 — — — — — 1 Measles 39 34 37 41 49 130 330 Meningococcal Infection 1 — 1 — — — 2 Puerperal Pyrexia — 1 — 1 — — 2 Ophthalmia Neonatorum — — — — 1 — 1 Scarlet Fever 43 19 23 17 13 45 160 Whooping Cough 48 30 28 40 49 16 211 Totals 138 96 97 109 116 208 764 21 22 B (2) Tuberculosis B (2)a New Cases notified for the first time during 1952 Age Respiratory Non-Respiratory Total M F M F 0— - - - - - 1— 2 1 - - 3 5— 4 2 2 1 9 10— 1 3 - - 4 15— 1 6 1 — 8 20— 5 7 - - 12 25— 16 11 - - 27 35— 7 3 - - 10 45— 6 1 - - 7 55— 4 3 - - 7 65 & over 5 1 - - 6 Totals 51 38 3 1 93 In addition to the above cases, 4 females and 6 males suffering from Respiratory Tuberculosis, and 1 female suffering from Non-Respiratory Tuberculosis, were transferred into the district from other areas. B (2)b Deaths According to the figures supplied by the Registrar General, the following is the number of deaths from Tuberculosis during the year. Tuberculosis of Respiratory system Other forms of Tuberculosis All forms of Tuberculosis Male Female Total Male Female Total Male Female Total 8 4 12 - 1 1 8 5 13 B (2)c Quarterly Statements for the Year 1952 Tuberculosis 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter M F Total M F Total M F Total M F Total Respiratory Tuberculosis Number on register at commencement of Quarter 283 195 478 284 195 479 284 200 484 296 210 506 New notifications during Quarter 8 5 13 13 9 22 20 14 34 6 7 13 Cases removed, which have been restored - - - - - - - - - 2 - 2 Cases added other than by formal notification 3 4 7 1 - 1 2 - 2 2 3 5 Cases removed from register during Quarter 10 9 19 14 4 18 10 4 14 6 4 10 Cases remaining on register at end of Quarter 284 195 479 284 200 484 296 210 506 300 216 516 Non-Respiratory Tuberculosis Number on register at commencement of Quarter 42 40 82 41 39 80 40 38 78 41 39 80 New notifications during Quarter - - - 1 - 1 1 - 1 1 1 2 Cases removed, which have been restored - - - - - - - - - - - - Cases added other than by formal notification - - - - - - - 1 1 - - - Cases removed from register during Quarter 1 1 2 2 1 3 - - - - - - Cases remaining on register at end of Quarter 41 39 80 40 38 78 41 39 80 42 40 82 Total of Respiratory and NonRespiratory Cases on Register at end of Quarter 325 234 559 324 238 562 337 249 586 342 256 598 Respiratory: Non-Respiratory: Total Number of cases left on the register at end of 1952 is as follows:—300 males 216 females 42 males 40 females 598 23 24 B (2)d Mass Radiography During the year a Mass Radiography Survey of the general public of Erith was carried out by the South East London Mass Radiography Unit. The following report was received from the Unit. Overall Analysis of Results of General Public Survey carried out at: Civil Defence Hall and Belvedere Public Hall, Erith, from 5th to 15th Februrary and 26th to 29 th February (inc.). Part I—Stages of Procedure. Men Women Total (a) Total radiographed 2,335 2,307 4,642 (b) Total recalled for large film 96 93 189 (c) Number normal on large film 31 40 71 (d) Number abnormal on large film 64 52 116 (e) Not yet attended for large film 1 1 2 Part II—Analysis of Abnormal Large Films. Men Women Total 1. Probably significant new cases of pulmorary tuberculosis for further investigation 18 14 32 2. Probably significant non-tuberculous cases for further investigation 3 2 5 3. Previously known tuberculous cases 10 7 17 4. Cardio-vascular lesions 2 5 7 5. Abnormalities requiring no action 30 24 54 6. Examination not yet completed 1 - 1 Comments by Director of Unit "The overall analysis shows the usual proportion of patients referred to the chest clinics and I do not feel that there is anything requiring comment." 25 B (3) Diphtheria Immunisation This service is administered by the Kent County Council. The latest figures supplied by the County Medical Officer show the position at December 31st, 1952, and are given below. It is interesting to note that no case of Diphtheria occurred in the Borough. Table A:—Number of children resident in the Borough of Erith who were given immunising injections during 1952 Year of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations Year of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations 1952 Under 1 year of age 55 — 19471943 5-9 years of age 87 594 1951 1 year of age 376 - 19421938 10-14 years of age 7 53 1950 2 years of age 44 — 1949 3 years of age 23 2 1948 4 years of age 21 39 Total 519 41 94 647 26 Table B:—Number of children resident in the Borough of Erith under the age of 15 years on 31st December 1952, who had completed a course of Immunisation at any time since 1st January, 1938 0-4 years 5-14 years Year of Birth Number considered to be immunised Year of Birth Number considered to be immunised 1952 55 1947 818 1951 425 1946 1,084 1950 479 1945 836 1949 559 1944 768 1948 596 1943 714 1942 697 1941 637 1940 604 1939 621 1938 379 Total 2,114 Total 7,158 B (4) Smallpox During the year under review information was received from the Medical Officer of a local firm that several of the firm's employees had been in contact with a smallpox contact. Enquiries revealed that these employees had been in contact with a representative of the Birmingham branch of the firm who had, while returning by air from South Africa, shared sleeping accommodation with a smallpox contact. As a precautionary measure these local employees were vaccinated and kept under observation, none developed any suspicious symptoms. B (4)a Vaccination Age at 31st December 1952 Under 1 year 1-4 years 5-14 years 15 or over Total Number vaccinated 175 106 12 18 311 Number re-vaccinated - 3 6 49 58 27 SECTION C.—GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA C (1) General Hospital Facilities Erith and District Hospital. This hospital is administered by the Regional Hospital Board. In addition, the services of the large General and Specialist Hospitals in London are readily accessible to residents in this area. C (2) Infectious Disease Cases—Hospital Accommodation Brook Hospital. River Hospitals, Joyce Green Any other Infectious Disease Hospital controlled by the South East Metropolitan Regional Hospital Board. C (3) Tuberculosis Treatment and Hospital Accommodation The South East Metropolitan Regional Hospital Board is responsible for sanatorium treatment and hospital accommodation. A dispensary is held weekly at 65, Bexley Road, Erith, by a whole-time Chest Physician. C (4) Venereal Diseases Venereal Disease Clinics for this area are provided and administered by the South East Metropolitan Regional Hospital Board. C (5) Ambulance Service This is provided by the Kent County Council, an ambulance being obtained through Mr. R. W. Griffin, District Officer, Kent County Council, 148, West Street, Erith, telephone Erith 4747/8 or the Ambulance Station, Council Offices, Erith, telephone Erith 3603. C (6) School Clinics Hainault, Lesney Park Road. Minor Ailments, Refraction, Dental. Bedonwell Hill, Minor Ailments, Dental, Orthopaedic.* Lessness Abbey. Minor Ailments. Erith and District Hospital. Ear, Nose and Throat. *These clinics are administered by the Health Committee of the County Council, or the Regional Hospital Board. 28 C (7) Maternity and Child Welfare Centres Hainault, Lesney Park Road. Ante-Natal Sessions:— Mondays 9 a.m.—12 noon. Child Welfare Sessions:— Mondays 1.45 p.m.—4 p.m. Thursdays 1.45 p.m.—4 p.m. Belvedere Public Hall. Child Welfare Sessions:— Tuesdays 1.45 p.m.—4 p.m. Thursdays 1.45 p.m.—4 p.m. Lessness Abbey. Ante-Natal Sessions:— Wednesdays 9 a.m.—12 noon. Fridays 9 a.m.—12 noon. Child Welfare Sessions:— Wednesdays 1.45 p.m.—4 p.m. Fridays 1.45 p.m.—4 p.m. Bedonwell Schools. Ante-Natal Sessions:— Thursdays 9 a.m.—12 noon. Ante-Natal Exercises;— Wednesdays 1.45 p.m.—4 p.m. Child Welfare Sessions:— Tuesdays 1.45 p.m.—4 p.m. Wednesdays 1.45 p.m.—4 p.m. Fridays 1.45 p.m.—4 p.m. C (8) Maternity Home Hainault, Lesney Park Road. The administration of this Home is carried out by the Woolwich Group Hospital Management Committee. C (9) Private Nursing Homes The undermentioned Homes are registered by the Erith Borough Council. The Eaves, 64, Picardy Road, Belvedere. Ormande House, 68, Picardy Road, Belvedere. C (10) Day Nursery Administered by the Kent County Council and located at Franks Park, this nursery was closed early in 1953. C (11) Laboratory Facilities Examination of pathological specimens and other laboratory work for the district is undertaken by the Public Health Laboratories, County Hall, Maidstone. 29 C (12) Mortuary An up-to-date mortuary with refrigeration for 6 bodies came into operation on the 23rd February, 1952, to serve the Boroughs of Erith and Bexley and the Urban District of Crayford. This building is situated at the rear of the Council Offices, Bexley. Prior to the opening of this building, the facilities of the Crayford mortuary were used for the three areas on 16 occasions. Since 23rd February, the new mortuary has accommodated a total of 126 bodies, of which 44 were from the Erith area. Post-mortem examinations were carried out in 123 cases, and 16 inquests were held. C(13) Disinfection and Disinfestation of Bedding, Clothing, etc. A joint arrangement is in existence with the Bexley Borough Council for the disinfection and disinfestation of bedding, clothing, etc. There is, also, a cleansing station for dealing with verminous persons. In the case of notifiable infectious disease, the service is carried out free of charge. It is also available to authorities who wish to make use of the facilities and in these cases a charge is made based on the cost of the work. C(14) Welfare of Old People The Erith Elderly People's Welfare Committee continued, during the early part of the year, its efforts to provide good neighbourly services in the borough, and much good work was done. However, there had been for some time, a feeling that there was scope for an organisation which would be able to cope with a wider field of service. In May, 1952, the Committee decided to take an important step in this direction, namely to affiliate to the North West Kent Council of Social Service through its Old People's Welfare Committee, with the backing of the National Old People's Welfare Committee. This meant that, in following closely the aims and objects of the parent body, funds could be raised to enable the committee to provide assistance in cash or kind where this was 30 found necessary. The committee also adopted the title “Erith Old People's Welfare Committee." In order to facilitate the attainment of these aims, the Committee appointed a Liaison Officer in each of the Borough's electoral Wards, with the object of forming teams of workers to cover the Ward, in order that the needs of the old people could be fully assessed. Such an organisation does, of course, require a great deal in the way of spade work, before practical results are obtained and towards the end of the year a widespread public appeal for funds was circulated, which had a moderate response. Close co-operation was maintained with officers in charge of local statutory services, as well as with all voluntary organisations in the Borough, and it is to be hoped that the coming months will show much progress in the fulfilment of the aims of the Committee. C(15) National Assistance Act, 1948, Section 50 (Burials) During the year 3 burials were carried out by the Council under the provisions of the above Act. Case No. 1 Deceased was a male, aged 83, had no known relatives and was a widower living alone in one room. His only source of income was his old age pension. No burial grant was payable as the man was born before the 5th July, 1883. Case No. 2 A woman aged 75 years, died in a local nursing home. Enquiries revealed that she had no known relatives or friends and was a spinster. No burial grant under the National Insurance Act was payable in this case. Case No. 3 A man aged 69 years, was found dead in a ditch within the borough. Enquiries made by the police revealed that this man's only relative was a brother who was living as a tramp, this man had been contacted but was not interested in making funeral arrangements in respect of his brother. No other relatives could be traced. As this man's date of birth fell before 5th July, 1883, no burial grant was payable in this instance. 31 SECTION D.—SANITARY CIRCUMSTANCES OF THE AREA I am indebted to the Borough Engineer and Surveyor for the following information relating to refuse collection and disposal. D (1) Refuse Collection and Disposal The method of storage is by means of sanitary dustbins, and some 15,500 are emptied weekly. The dustbins are provided and maintained by the owners of the properties concerned, the Council securing this by a local act—the Erith Improvement Act, 1920. Disposal is effected by barging under contract, and these arrangements are still working very satisfactorily. D (1)a Costs £ s. d. Cost per ton of collecting refuse 1 5 4 Cost per ton of disposing of refuse 15 8 Net cost per 1,000 population per annum 409 7 0 The following tables show:— 1. Details of the refuse collection vehicles and staff. 2. Details of the tonnage dealt with during the year. D (1)b Table 1 Vehicle Capacity 2 Dennis lorries 12 cubic yards 6 S. & D. Freighters 7 „ „ 1 S. & D. Freighter 12 „ „ 1 Scammell Lorry 5 „ „ 1 Austin Van (Disposed of September, 1952) 1 Morris Van (Purchased September, 1952) 5 cwt. They are operated by:— 1 Foreman 11 Driver Loaders 7 Loaders and Sorters 32 D (1)c Table 2 Month Tonnage Tons Cwts. January, 1952 989 5 February, „ 880 8 March, „ 828 1 April, „ 796 7 May, „ 641 17 June, „ 512 10 July, „ 508 2 August, „ 516 12 September, „ 616 12 October, „ 825 12 November, „ 827 13 December, „ 914 15 Total 8,857 14 D (2) Trade Refuse Trade Refuse is collected from the shops by arrangements with the shopkeepers, an agreed charge being made. Due to increased costs of collection and disposal, the charges were increased by 20% from 1st April, 1952. The growth of this section of the Refuse Services continues and in 1952 produced a revenue of £481 7s. 4d. D (3) Salvage Tonnage collected Bottles Income T. C. Q. lbs. Gross Dozen £ s. d. 835 14 3 9 1 8½ 5,475 12 9 (D4) Public Conveniences Public Conveniences under the control of the Council are as under:— Site Hours of opening Walnut Tree Road, Male and Female 6.30 a.m.—Midnight West Street, Erith Male and Female 6.30 a.m.—11 p.m. Station Road, Belvedere Male and Female 24 hrs.—Day and Night Heron Hill, Male 24 hrs.—Day and Night Woolwich Road, Female 6.30 a.m.—11p.m. 33 D (5) Sanitary Inspection of the Area D (5)a Visits by Sanitary Inspectors The total number of visits of all kinds was 7,081 Notices served 325: Formal 34: Informal 291. Number of dwellings and other premises disinfected 265 Complaints received and investigated 1,480 D(5)b Premises Visited and Results of Such Visits Premises No. in district No. of visits No. of defects found No. of defects remedied Bakehouses 10 36 5 5 Dairies 5 27 3 3 Butchers' shops 33 187 11 11 Fish friers 14 61 6 6 Slaughter houses 4 - - - Factories 153 98 24 24 Outworkers 97 78 - - Food factories 4 18 3 3 Pet shops 6 16 1 1 Rag flock dealers 2 9 - - D (5)c Summary of Nuisances and defects remedied during the year Other than those enumerated in the above tabulations:- Roofs made watertight 103 Dampness remedied 132 Plasters renewed 81 Yard pavings repaired 15 Dustbins provided 55 Food premises cleansed 34 Rooms cleansed 4 New W.C. pans provided 12 New closets provided 13 New sinks installed 18 Drains repaired 49 Cisterns repaired 20 Drains cleared 128 Gutters, etc., repaired 50 Floors repaired 21 Coppers repaired 3 Water supplies provided 4 Windows made to open 56 Accumulations removed 18 W.C's repaired 10 Stoves and fireplaces repaired 22 Miscellaneous 34 Houses demolished:— By formal action 0 By informal action 8 Demolition orders made 3 34 Many requests were received from residents with regard to the clearing of branch drains, eradication of vermin, destruction of ants and wasps nests, etc. In each case the necessary service was provided with much beneficial result to the applicant. The charges made in connection with the above service amounted to £49 19s. 6d. D(5)d Closet accommodation and Cesspools The whole of the closet accommodation both in the older parts of the town and in the recently developed areas is identified with the water carriage system, there being only 22 known cesspools existing. Cesspools are emptied once a month free of charge by Council resolution of 10th March, 1942, and sewage contents are disposed of by discharging into the nearest sewer. The cesspools requiring the service of Council plant are scattered throughout the district, and in the majority of cases, necessitate the covering of considerable distances both for pumping out and conveying to the point of discharge. During the year, cesspools were emptied on 27 occasions. In one instance, a cesspool has been abandoned, and the drains connected to Corporation sewer. D(5)e Smoke Abatement Smoke and grit emission necessitated action being taken which resulted in the following improvements:— (a) Foundry. Apertures in walls effectively closed. (b) Coal screening plant. Hopper improved and canvas screen provided. D(5)f Swimming Baths and Pools (1) The Council's open air bath is situated in Stonewood Road and comprises one pool of some 55,000 gallons capacity which is now exclusively used by the Kent Education Committee during normal school hours, and local youth clubs during the evenings and on Saturday mornings. Water in the pool is heated to a temperature of 72 degrees Fahrenheit by low pressure steam heating and is sterilised by the chlorine process. There is a slipper establishment with accommodation for 16 males and 4 females. Adjacent to the public bath is a mechanical laundry which launders on behalf of various undertakings which include the Corporation's CateringDepartment. 35 Works Department, the County health and Education Departments and the Hainault Maternity Home. During the year, 126,510 articles were dealt with. Attendances at Public Bath for 1952 Swimming pool. Slipper Baths Schools: During term 11,235 16,081 bathers Schools: During holidays 1,899 Youth Clubs 7,642 Total 20,776 (2) A children's paddling pool of some 60,000 gallons capacity is situated within the Belvedere recreation ground at Woolwich Road. The pool is regularly emptied and cleansed, and during the summer months, is regularly and methodically dosed with chloros. D(5)g Camping Sites There are no summer camping sites within the Borough. There are however, 2 sites which are subject to licensing by the Local Authority under Section 269, Public Health Act, 1936. D(5)h Hop pickers There are no hop fields within the district. D(5)i Eradication of Bed Bugs During the year dwelling houses found to be infested with vermin and subsequently disinfested were as follows:— Privately owned houses 14 Corporation houses 2 Disinfestation of both privately owned and Corporation houses is carried out by an operative under the supervision of Sanitary Inspectors, presence of vermin being revealed either on complaint or when inspections are being carried out. With a view to good control, occupiers are encouraged to report infestations, when every assistance is given to cope with the menace. Close co-operation exists between the Housing Department and the Sanitary Inspectors, as a result of which successful disinfestation is promptly carried out, and in the case of transfers, it is sometimes necessary for the tenant to surrender certain household effects for destruction. 36 D(5)j Mosquito Control During the year, the usual appropriate precautionary measures were taken when the many water courses within the Borough were sprayed with larvicide. The 285 pig food salvage bins in the streets received the like attention. D(5)k Rodent Control Two operatives continue to be employed on rodent destruction in accordance with the terms of Circular N.S.19. As in previous years, Corporation sewers were effectively treated for sewer rats during the months of March and September when a total of 347 manholes were baited. The Prevention of Damage by Pests (Application to Shipping) Order which came into operation on 1st October, 1951 has been fully implemented during the year. This Order provides that the duties of Local Authorities in terms of Part I of the Prevention of Damage by Pests Act 1949 in relation to rats and mice on land, shall extend so as to include any vessel or craft in the area which is not a sea going ship, and accordingly the following inspections were made:— Coastwise vessels 49 Barges 54 Tugs 4 Dredgers 1 Total 108 D(5)l Pest Control Many requests were received during the year to effect the destruction of ants and wasps nests, beetles, silverfish, crickets, and in this regard the services of an operative are available, for which an appropriate charge is made. This includes the cost of materials used plus apportionment charge on operative's time devoted to the service. One suspected Colorado beetle was found to be Amphimallus (Chafer). D(5)m Offensive Trades In addition to the ordinary statutory offensive trades which are specified in Section 107 of the Public Health Act, 37 1936, fish frying was declared to be an offensive trade on 17th March, 1939 and bye-laws were made accordingly. Within the Borough, there are no offensive trades other than those of fish-frying, and of these premises, there are 14. D(5)n Rag Flock & Other Filling Materials Act, 1951. Whilst there are no manufacturing premises within the Borough subject to licensing by the Local Authority, two premises exist wherein filling materials are used, and which are registered by the Local Authority. Two samples from the above sources were forwarded to the prescribed Analyst during the year, with satisfactory results. D(5)o Pet Animals Act, 1951 There are 6 pet animal shops within the Borough, and all are registered and licenced under section 1 of the Act. In conformance with the statutory requirements, satisfactory conditions prevail at these shops which are now subject to regular inspection. D(5)p Merchandise Marks Act, 1926 One complaint was investigated regarding the sale of imported plums and attending misdescription of same. Due enquiry proved that the plums in question were Belle de Lauvains and Victorias, and that no contravention existed. D (6) Factories (1) Inspections for the purpose of provisions as to health are detailed below :— Premises Number of Inspections Written Notices Occupiers Prosecuted 150 Factories on Register 95 14 - 3 Other premises under the Act (including building works and engineering construction but not including outworkers' premises) 3 - - 153 Total 98 14 — 38 (2) Defects found Particulars Number of defects Number of defects in respect of which prosecutions were instituted Found Remedied Referred to H.M. F.I. Want of cleanliness 7 7 — - Inadequate ventilation 4 4 — — Drainage of floors 2 2 — — Sanitary conveniences: (a) Insufficient 8 8 - - (b) Unsuitable 2 2 — — Other offences against the Act (not including offences relating to outworkers) 1 1 - - Total 24 24 — — D(7) Shops Act, 1950 With regard to statutory hours of closing, it was necessary to issue 4 warnings to shop-keepers respecting closing of shops at the prescribed hour. In one instance a shopkeeper was prosecuted for selling articles contrary to the Erith Weekly Half Holiday (No. 1) Order and fined £2. In another case, the summons was dismissed. Infringements of health and comfort provisions were located in the following instances, and the necessary improvements were subsequently effected:— New lighting 2 Heating provided 4 Shops cleansed 6 Floors repaired 1 New sinks 4 New W.C. pans 1 D(8) Sanitary accommodation at Offices At one factory office it was found necessary to implement Section 46, Public Health Act, 1936, in consequence of which an additional convenience was provided for each of the sexes, together with adequate washing accommodation. 39 D(9) Atmospheric Pollution Cement Dust Deposits During February and March cement dust deposits were observed on roofs and foliage during a period of persistent east wind. Similar deposits were observed during the latter part of the winter and which co-incided with fog dispersal. Fortunately no observation records such heavy deposits as existed during the spring of 1949. D(10) River Thames—Effluvia Though no complaints were received during the year regarding objectionable odours arising from the above source, nevertheless, such odours were perceptible from time to time in the Town area. It is noted that the incidence of L.C.C. expenditure for projects at the two London sewer outfalls was scheduled at £100,000 for 1951-1952 whilst the following published report indicates the various aspects of research which is being undertaken by the Port of London Authority. "A model of the River Thames has been constructed by the Port of London Authority at the Royal Victoria Docks. It is one of the largest tidal models in the world. So far, two models have been constructed, the larger one being 400 feet long and the work has been carried out under the direction of Sir Claude Inglis, Director of Hydraulic Research in the Department of Scientific and Industrial Research. The Port of London Authority ordered the construction in their capacity of Port Authority responsible for the maintenance and improvement of the channels leading to the docks, and as conservators responsible for the purity and depth of the river. The models are primarily for the study of dredging problems of the river. Each year, the Authority have to remove nearly 3,000,000 cubic yards of silt from the docks and river at a cost in the region of £500,000. The Engineers and Experimenters working on the model will use it in their search for answers to a large number of problems which have been selected for consideration by the Port of London Authority. The first of these is the reduction of silt in Tilbury Tidal Basin. The removal of silt now costs the Authority £75,000 per annum. The second problem is the improvement of the channel through Halfway Reach, Barking and Gallions Reach, to the King George V entrance to the Royal Docks, and the third problem is the reduction of siltation in the Royal Docks themselves. 40 The Thames model will also be utilised when required to determine the periods of retention in the river of liquids discharged at various places and states of the tide. When Sir Joseph Bazalgette in 1874 built the London sewerage system to remedy the polluted state of the river, it was confidently stated that, if the outfall at Barking discharged on the falling tide, the sewage effluent would leave London, never to return. It is now known that discharges to the river travel up and down the channel, only slowly progressing towards the sea, and the Barking and Crossness outfalls flow continuously day and night. The aim of the Port of London Authority is to raise the standard of cleanliness of the river until it is able to purify the discharges made to it during their slow progress to the sea." D(11) Housing D(11)a Inspection of Dwelling Houses during the year. 1. (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 2,412 (b) Number of inspections made for the purpose 3,161 2. (a) Number of houses (included under sub-head (1) above) which were recorded and inspected under the Consolidated Housing Regulations 3 (b) Number of inspections made for the purpose 10 3. Number of houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 4. Number of houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 325 D(ll)b Remedy of defects during the year without service of Formal Notices Number of defective dwelling houses rendered fit in consequence of informal action by the local authority 318 41 Action under Statutory Powers during the year. (a) Proceedings under Sections 9 and 10 Housing Act, 1936 (1) No. of houses in respect of which Notices were served requiring repairs 0 (2) No. of houses which were rendered fit after service of formal notices (a) By owner 0 (b) By Local Authority 0 (b) Proceedings under the Public Health Act. (1) No. of houses in which Notices were served requiring defects to be remedied 34 (2) No. of houses in which defects were remedied after service of formal Notices (a) By owner 34 (b) By Local Authority 0 (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936. (1) No. of houses in respect of which demolition orders were made 3 (2) No. of houses demolished in pursuance of demolition orders 0 (d) Proceedings under Section 12 of the Housing Act, 1936 (1) No. of separate tenements or underground rooms in respect of which closing orders were made 0 (2) No. of separate tenements or underground rooms in respect of which closing orders were determined, the tenement or room having been made fit 0 Numbers 1, 2, 9, 10, 11, 12, 20 and 23 Crossness Cottages were demolished by informal action. The Demolition Orders referred to in (c) (1) above were made in respect to:— 187, 189 and 191, Lower Road, Belvedere. The acute problem of housing continues to give considerable anxiety, and I am indebted to the Borough Engineer and 42 the Housing Assistant for the following information on the subject:— Number of permanent houses constructed in 1952:— By the Council 51 plus 20 Flats By Private enterprise 36 Total 87 houses: 20 Flats. Total number of permanent Council houses in Borough 1,145 Flats 20 Total number of prefabricated temporary houses in Borough 250 Total number of requisitioned premises in Borough 202 Number of premises requisitioned in 1952 None Number of premises de-requisitioned in 1952 6 D(12) Rent and Mortgage Interest (Restriction) Act, 1939 The provisions regarding extortionate rents are administered by the Senior Sanitary Inspector, and during the year applications were made for advice and assistance. The maximum rent of houses brought under control by this Act is the rent payable at 2nd. September 1939, subject to certain permitted increases. Houses let for the first time after that date come within the purview of the Landlord and Tenant (Rent Control) Act, 1949 which Act provides for application to be made to the Rent Tribunal for the assessing of a reasonable rent. This Act also affords protection of tenants who share accommodation. Appended below is a summary of improvements effected under the Rents Restriction Act:— (a) Rent reduced from 18/6 to 15/5 per week and £16. 0. 8d. returned to the tenant. (b) Several references were recommended to the Rents Tribunal under the Furnished Houses (Rent control) Act, 1946, and the Landlord and Tenant (Rent Control) Act, 1949, with satisfactory results. 43 D(13) Legal Proceedings Statute Offence Penalty Sec. 57 Food & Drugs Act, 1938 Using unlicensed premises as slaughterhouse. £5 0 0 Associated Ministry of Food proceedings £130 0 0 Erith Weekly Half Holiday (No. 1) Order Sale of prohibited articles. Dismissed. Sec. 10 Food & Drugs Act, 1938. Sale of dirty milk. Destruction order obtained. Milk & Dairies Regs 1949. Art 26 (1). Failure to cleanse milk bottle. £10 and £5 5 0 costs. Milk & Dairies Regs 1949. Art 26 (1). Failure to cleanse milk bottle. £10 and £5 5 0 costs. Erith Weekly Half Holiday (No. 1) Order. Sale of prohibited articles. £2 0 0 Sec. 154 Public Health Act 1936 Exchanging toys for rags. £1 10 0 44 SECTION E—WATER SUPPLY—MILK AND FOOD AND DRUGS, ETC. E(1) Water Supply The water supply in the district is supplied by the Metropolitan Water Board and though possessing a considerable degree of hardness (30.8 degrees), is palatable and of good quality. The supply is led direct into the premises served, no standpipes being known to exist, except on the Belvedere Marsh Encampment site where three standpipes are installed and maintained by the Council. Two monthly samples have been regularly obtained and submitted to the Kent County Council's Laboratory for examination, with satisfactory results. E (2)a Dairies and Milk stores The current register of dairies and milk stores records the following registration figures:— No. of registered distributors 8 No. of dairies 5 Regular inspections have been made throughout the year with a view to maintaining the high standard of cleanliness. E (2)b Bacteriological Examination of Milk The following samples of designated milk retailed within the Borough were obtained and submitted to the County Laboratory for examination:— Pasteurised 22 Tuberculin tested (Past) 6 Sterilised 3 Total 31 All were reported upon satisfactorily, such milk satisfying the methylene blue, phosphatase, and turbidity tests. E (2)c Biological Testing of Milk In addition to the samples enumerated above, two samples of milk were submitted to the County Laboratory for biological testing. No evidence of Tuberculosis was found to exist. 45 E (2)d Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950 The Milk (Special Designations) (Specified Areas) Order 1951 On 1st October, 1951, the above-mentioned Order came into operation within this administrative area, and since that date the whole of the milk supply within the Borough has been specially designated in conformance with the Statute. E (2)e Designated Milk The following table indicates the number of licences issued by the Local Authority in 1952 under (1) Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949, and (2) Milk (Special Designation) (Raw Milk) Regulations 1949, viz:— Dealers Pasteurised 9 Sterilised 22 Tuberculin tested 6 37 Supplementary: Pasteurised 7 Sterilised 8 Tuberculin tested 7 22 E(2)f Milk and Dairies Regulations, 1949 Article 26 (1) In two instances, proceedings were instituted against a registered Distributor for failure to cleanse milk bottles as required by the above Statute. Convictions resulted in the defendants being fined a total of £20 and £10 10s. 0d. costs. E(2)g Ice-Cream 23 Manufacturers of ice-cream are entered on the Register but only 8 operate (i.e. 2 boil mix and 6 cold mix). During the year 22 samples of ice-cream were procured and submitted to the Bacteriologist, examination results being as follows:— Grade 1 13 Grade 2 7 Grade 4 2 22 46 E(3) Meat and Food Inspection (a) Considerable time and attention has been devoted to the inspection of meat and other foods retailed in the Borough, and the following foodstuffs were confiscated as being unfit for human consumption:— Meat 1 ton. 0 cwt. 0 qrs. 21½ lbs. Meat 893 tins Fish 3 cwts. 2 qrs. 10 lbs. Fish 868 tins & 384 jars. Fruit 1 cwt. 1 qr. 14½ lbs. Fruit 1,085 tins. Vegetables 624 tins Milk 43 tins. Cereals 13 lbs. Preserves 3 qrs. 19 lbs. Coconut 1 qr. 2 lbs. Confectionery 11 lbs. Pudding mixture 68 packets. Eggs 20 Vinegar 33 bottles. Cheese 21½ lbs. Tea 1 qr. 2 lbs. Approximate total weight'—3 tons. 18 cwts. 0 qrs. 12 lbs. (b) One application was made to the Magistrates Court under Section 10 Food and Drugs Act, 1938 for a Destruction Order with regard to dirty milk. Such Order was granted. E(4) Slaughter of Animals Act, 1933 The above Act makes the use of mechanically operated instruments a statutory obligation. By resolution of the Council dated 23rd May, 1938, the provisions of Section 1 of the Act apply to sheep which are slaughtered in the district. E(5) Slaughterhouses.—Section 57, Food & Drugs Act, 1938 In one instance it was found that unlicensed premises were used as a slaughterhouse, in consequence of which proceedings were instituted, and the unauthorised user fined £5 for contravening the above Act. 47 E(6) Food and Drugs Act, 1938. Sections 3 and 68 The following samples were procured during the year and submitted to the Public Analyst with the following results:— Article Submitted Unsatisfactory Genuine No. of Samples Milk 1 22 23 Ice-cream — 3 3 Coffee — 1 1 Coffee & chicory essence — 1 1 Tea — 1 1 Pudding mixture — 1 1 Sponge mixture 1 2 3 Cake flour mixture — 4 4 Flour — 1 1 Batter mixture — 2 2 Bread crumbs — 1 1 Ground white pepper — 2 2 Ground nutmeg — 1 1 Ground ginger — 1 1 Curry powder — 1 1 Mustard — 2 2 Mixed spice — 2 2 Herbs — 1 1 Cloves — 1 1 Desiccated soup — 3 3 Meat soup — 1 1 Chicken noodle soup — 1 1 Macedoine — 1 1 Fish paste — 2 2 Meat paste — 1 1 Vinegar — 1 1 Non-brewed vinegar — 1 1 Garden mint in vinegar — 1 1 Sauce — 4 4 Horseradish & Vitacream — 1 1 Gravy thickness — 4 4 Custard powders — 4 4 Blanc mange powders — 2 2 Table creams — 1 1 Raspberry dessert — 1 1 Table jellies — 4 4 Table jelly crystals — 2 2 Sugared coconut — 1 1 Meringue powder 1 — 1 Chocake — 1 1 Jam — 1 1 Gelatine — 1 1 Lucozade 1 — 1 Bicarbonate of soda — 1 1 Borax — 1 1 Borax & Honey — 1 1 Aspro tablets - 1 1 48 Seidlitz powders — 2 2 Epsom salts — 2 2 Ammoniated tincture of quinine 1 — 1 Compound Thymol tablets 1 - 1 Total 4 99 103 Action taken. Milk—See under legal proceedings. Sponge Mixture—Stock withdrawn. Meringue powder—Irregular label—now standardised. Lucozade—Possible excessive preservative—Referred to Ministry of Food. The milk samples averaged a content of 3.54% fat and 8.8 % of solids, not fat. The ice-cream samples averaged a content of 11.6% fat and 36.4% total solids. E(7) Food Hygiene Bexley, Erith and Crayford Clean Food Traders' Guild The formulation of the various codes of practice having been completed by the end of 1951, invitations were sent to food traders with a view to their applying for membership of the Bexley, Erith and Crayford Clean Food Traders' Guild. Resulting from an intensive clean food campaign, 21 Erith traders are now members of the Guild, and this number of plaques has been issued. Many further applications are under review, and when certain minor structural and other improvements have been effected, there is every indication that the membership of local traders will be considerably increased. F(4) National Assistance Act, 1948. Section 47 The persons covered by the above section are those mentioned in sub-section 1 as follows:— Persons who:— (a) Are suffering from grave chronic disease, or, being aged, infirm, or physically incapacitated, are living in insanitary conditions, and (b) Are unable to devote to themselves, and are not receiving from other persons, proper care and attention. 49 As in previous years, close liaison has been maintained with the various voluntary and statutory organisations operating locally, whereby it has been possible to render some assistance to those to whom this Statute applies. It was not necessary during the year for such statutory action to be taken. F (5) Legislation in Force—Byelaws Tents, vans and sheds 28th Feb. 1928 Houses let in lodgings 27th Jan. 1930 Slaughterhouses 29th Feb. 1932 Libraries and Museums 15th June 1934 Nursing Homes 20th July 1934 Pleasure Grounds 4th Feb. 1936 Dogs fouling footpaths 22nd Feb. 1939 Fish Frying 9th May 1939 Building bye-laws 10th Aug. 1939 House refuse 17th Oct. 1939 Erith Cemetery 25th Oct. 1939 Public Baths 26th Oct. 1939 Prevention of Nuisances 23rd Apr. 1940 Good rule and government 1st Jan. 1941 Offensive trades 9th May, 1939 Deposit of litter 9th Jan. 1950 Clean food 19th July, 1950