ERI 33 BOROUGH OF ERITH ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1953 BY JOHN LANDON M.R.C.S., L.R.C.P., D.P.H. 68013 BOROUGH OF ERITH ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1953 BY JOHN LANDON M.R.C.S., L.R.C.P., D.P.H. Printed by Freame, Manning & Co., Ltd. Lewisham, S.E.13 Arrangement of Report Section Page A Statistics and Social Conditions of the Area 1. Physical Situation and Amenities 9 2. Comparative Rainfall 9 3. Unemployment Figures and Comments 10 4. Statistics 10 (a) General 10 (b) Births, Birth Rate, Still Births, Still Birth Rates 11 (c) Deaths, Death Rate, Maternal Mortality Rate 11 (d) Infant Mortality 12 (e) Summary of Vital Statistics for year 1953 13 (f) Vital Statistics of whole District during 1953 and previous years 14 (g) Table Showing Summary of Causes of Death during 1953 15 (h) Infant Mortality—Causes of death and table of comparison 16 (i) Comparison of Maternal Mortality Rate 17 B Prevalence of and Control over Infectious and other Diseases 1. Notifications 18 (a) Age Distribution 19 (b) Ward Distribution 20 2. Tuberculosis 21 (a) New cases notified during 1953 21 (b) Deaths 21 (c) Quarterly statements for year 1953 22 3. Diphtheria Immunisation 23 4. Vaccination against Smallpox 24 C General Provision of Health Services for the Area 1. General Hospital Facilities 25 2. Infectious Disease Hospitals 25 3. Tuberculosis Treatment and Hospital Accommodation 25 4. Venereal Diseases 25 5. Ambulance Service 25 6. School Clinics 25 7. Maternity and Child Welfare Centres 26 i Section Page 8. Maternity Home 26 9. Private Nursing Homes 26 10. Laboratory Facilities 26 11. Mortuary 27 12. Disinfection Services 27 13. Welfare of Old People 27 14. National Assistance Act, 1948, (Burials) Section 50 27 D Sanitary Circumstances of the Area 1. Refuse Collection and Disposal 28 (a) Costs 28 (b) Details of Refuse Collection Vehicles and Staff 28 (c) Details of Tonnage 29 2. Trade Refuse 29 3. Salvage 29 4. Public Conveniences 29 5. Sanitary Inspection of the Area 30 (a) Visits by Sanitary Inspectors 30 (b) Premises visited and results of such visits 30 (c) Summary of Nuisances and defects remedied during the year 30 (d) Closet accommodation and cesspools 31 (e) Smoke Abatement 31 (f) Swimming Baths and Pools 31 (g) Offensive Trades 32 (h) Rag Flock Act 32 (i) Pet Animals Act, 1951 32 (j) Heating Appliances (Fireguards) Act, 1952 32 (k) Camping Sites 33 (1) Hop Pickers 33 (m) Mosquito Control 33 (n) Rodent Control 33 (0) Pest Control 34 (p) Burial Act, 1857, Section 25 34 (q) Eradication of Bed Bugs 34 6. Factories 35 (1) Inspections 35 (ii) Defects Found 35 7. Shops Acts 1950 36 8. Sanitary Accommodation at Offices 36 9. Flooding of Belvedere and Abbey Wood 36 ii Section Page 10. Effluvia from River Thames 37 11. Atmospheric Pollution 38 12. Housing 38 (a) Inspection of Dwelling Houses during the year 38 (b) Remedy of Defects during the year 39 13. Legal Proceedings 40 14. Rent and Mortgage Interest (Restriction) Act, 1939 41 E Water Supply — Milk, Food and Drugs Act — Food Inspection 1. Water Supply 42 2. (a) Dairies and Milk Stores 42 (b) Bacteriological examination of Milk 42 (c) Biological testing of Milk 43 (d) Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, etc. 43 (e) Designated Milk 43 (f) Ice Cream 43 3. Meat and Food Inspection 44 4. Slaughter of Animals Act, 1933 44 5. Food and Drugs Act, 1938, Sections 3 and 68, Routine Samplings 44 6. Clean Food Campaign 46 (a) Premises 46 (b) Disposal of unsound Foodstuffs 47 (c) Food Hygiene—Food Traders'Guild 47 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 48 iii 2 F (1) BOROUGH OF ERITH Mayor:—Alderman Mrs. L. F. Christian J.P. (1952-1953) Mayor:—Councillor E. Handy, J.P. (1953-1954) Deputy Mayor:—Alderman C. F. Morling, J.P. (1952-1953) Deputy Mayor:—Alderman Mrs. L. F. Christian, J.P. (1953-1954) Health Committee Chairman:—Alderman Mrs. L. F. Christian, J.P. Members of Committee May 1952—May 1953 May 1953—May 1954 Alderman C. F. Morling Councillors W. F. Alford W. F. Alford W. Boast W. Boast J. F. L. Gates J. F. L. Gates Mrs. H. A. Jerome Mrs. H. A. Jerome Miss M. E. Odell Miss M. E. Odell E. C. Pringle E. C. Pringle C. Schofield Mrs. C. Thomas Mrs. C. Thomas Ex-Officio Members Ex-Officio Members Councillor E. Handy Aldermen C. F. Morling, 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.I.E.B., Meat Inspector's Certificate. Sanitary Inspectors 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 Chief Clerk J. A. Sutherland Clerks Shorthand-typist:— Mrs. G. Green Junior Clerk Miss V. D. I. White (Resigned 11.9.53) Miss C. W. Gamble (Appointed 12.10.53) 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 1953. The vital statistics of the Borough indicate once again that, according to this limited yardstick, the health of the Borough can be considered satisfactory. The customary warning must however be given that these figures should be accepted with guarded optimism as they give only a part, albeit an important one, of the total health situation of a population numbering nearly 46,000. The birth rate for 1953 was 14.63 per 1,000 of the population, the lowest ever recorded in the Borough, compared with 14.83 in 1952. The birth rate for 1953, after correction by the comparability factor supplied by the Registrar General (1.00) was 14.63. The uncorrected birth rate for England and Wales was 15.5 so it will be seen that, once again, the birth rate for the Borough was below that of the country as a whole. The death rate for 1953, at 10.88 per 1,000 of the whole population, was a little higher than the rate for 1952 which was 10.85 per 1,000. After correction by the comparability factor for deaths (1.09), the rate was 11.86 and the uncorrected death rate for England and Wales for 1953 was 11.4. Cancer was again second, after diseases of the heart and blood vessels, among the chief causes of death. The infant mortality rate for 1953 at 32.79 per 1,000 live births showed an increase on the rate for 1952 namely, 29.3 per 1,000 live births. The rate for the country as a whole was 26.8 per 1,000 related births, so that this increase in the Erith rate is a cause of some concern although the rate for 1951 was even higher at 34.8 and I have often warned against placing too much reliance on annual figures, but to have regard for the figures over a period in view of the small numbers 5 concerned. The figures for 1954 will have to be watched rather carefully. Of the 22 infantile deaths in the Borough, at least 7 were due to causes which were, probably, preventable, namely pneumonia due to various causes, but it is not wise to be too dogmatic in this matter when there are so many unknown factors. Infectious diseases when judged by the standards of 25 years ago, were very low. Measles headed the list with 381 cases, whooping cough followed with 167, scarlet fever with 111, the latter disease being generally speaking of low virulence. There is more and more evidence that the great problem of the future will be the control of the virus infections. There were, for instance, 2 paralytic and 3 non-paralytic cases of poliomyelitis which is now, unfortunately, an annual visitant and may, in fact, be regarded as endemic in this country. There is, however, at the present time, a somewhat greater hope of controlling this disease by immunisation although vaccination against poliomyelitis is still very much in the experimental stage. It may be some years yet before a vaccine can be produced in a sufficiently reliable form to produce the necessary resistance to the virus of this disease. The welfare of old people continues to take up a considerable amount of the time of the department. The notification of an old person living alone, often in very bad conditions, may be an emergency requiring immediate attention. It is often a serious problem to decide which is the best action to be taken. Admission to hospital sometimes provides a temporary respite to the difficulties of old persons but still leaves the problem of what is going to happen when they are ready for discharge. A tribute is due to those volunteers from many sources who are prepared to clean up the home and receive the old person on return from hospital. Recognition must also be given to the Woolwich Group Hospital Management Committee who are very co-operative in this matter. Often, however, in spite of all the contra-indications it is in the interests of the old person to be kept at home, however deplorable this may be and to apply to the fullest extent the social remedies which are available. In this connection the Home Help Service is invaluable. Many old people ask for no more than to be allowed to keep their independence and their old homes and, wherever possible, this must be respected. The work of the Old Peoples' Welfare Committee and the "good neighbours " of whom there are so many, often make it possible for this solution to be applied. 6 I have many times reported to the Health Committee that, although the death rate from tuberculosis has been falling rapidly during recent years, due to great improvements in medical treatment, the notification rate has not on the whole shown a similar reduction. This may be due in part to better means of ascertainment, notably by means of Miniature Mass Radiography, but I have suggested from time to time that an attack on the problem of tuberculosis from all possible angles, preventive and curative, is necessary if the disease is to be finally conquered. The Minister of Health has now prepared a memorandum which accompanied Circular No. 8/54 in which he " indicates a need for intensifying various preventive measures and reviews the value of existing measures to bring the disease under control." Among the suggested remedies are greater efforts to discover the source of a new case, the supervision of contacts, the extension of the use of B.C.G. Vaccine, and the more selective use of Mass Miniature Radiography. It will be seen, therefore, that the implementation of this scheme requires the closest co-operation between Chest Clinics, the Local Health Authority, the general practitioners and the Local Authorities, the latter being concerned mainly as housing authorities and as the authority responsible, in an important measure, for the local control of infectious disease. The task is one of the most arduous thrown on the health services for many years but it is the only sure way of getting rid of tuberculosis in the foreseeable future. The need for the collaboration of a large number of medical and social workers is called for and the effect on our own health department would be considerable. It is to be hoped that, in the coming years, this joint action will be forthcoming. Another impending development is the new housing legislation which is at present foreshadowed in the Housing Repairs and Rents Bill at present before Parliament. While the provision of new housing has proceeded apace, the older houses have tended to deteriorate during the war and since and the new Bill is, in part, concerned with slum clearance and the patching up of sub-standard houses and the improvement and conversion of older properties with a view to extending their life while further new houses are provided. Generally speaking there are no slums in the Borough in the accepted sense of the word but there is a manageable number of obsolescent houses which are ripe for demolition and could be tackled within the next ten years. These could be demolished as individual unfit houses or as small clearance schemes and, particularly in the former case, the problem of rehousing the 7 occupants is one of great difficulty. Frequently they are occupied by old persons living on their old age pension and the transfer to a more hygienic new house or flat is often overshadowed by the fear of higher rents and the possible reduction of expenditure on food and other essentials although help from the National Assistance Board may well offset the greater part of any additional expenditure. The Food and Drugs (Amendment) Bill at present before Parliament may also place further responsibilities on the Health Department in that it foreshadows the extension of registration to classes of premises not covered at present by Section 14 of the Food and Drugs Act, 1938. The Bexley, Erith and Crayford Clean Food Guild has continued its work during the year and at present 112 plaques have been awarded. The co-operation of many of the multiple firms has been obtained and this long term essay in health education, stimulated perhaps by the impending Food and Drugs (Amendment) Act will help to provide that higher standard of food hygiene which we all desire. During the year a Clean Food Week was held which culminated in an address and demonstration by the Deputy Medical Director of the Central Council for Health Education and was followed by a film show and discussion. The newly formed Bexley, Erith and Crayford Home Safety Committee promises to become an active instrument for the reduction of accidents in the home and is, in fact, complementary in its function to the Bexley, Erith and Crayford Road Safety Committee. The Minister of Housing and Local Government has given his approval to the making of a grant by each of the constituent authorities so that the Committee has, financially speaking, got off to a flying start. The collection of reliable statistics of home accidents is proceeding favourably and in the near future activities will be undertaken to draw the attention of the public, by propaganda methods, to the preventable nature of home accidents which, as is now well known, greatly exceed the number of accidents on the roads. The serious flooding which occurred on the 31st January, raised many health problems entailing supervision and I set out below a list of some of the duties undertaken by the Department:— 1. Medical supervision of Rest Centres, i.e., supervision of the health of individual persons and the removal 8 to hospital of cases of acute infections with a view to preventing the spread of disease. 2. Supervision of the general hygiene and sanitation of the Rest Centres. 3. Establishing standards, from the point of view of area per person, of accommodation in Rest Centres. 4. Supervision of old people and expectant mothers. 5. Sampling of water supplies to ensure that no contamination by sewage had taken place. 6. Supervision of sanitary arrangements at the caravan site in Lessness Abbey Woods including arrangements for sewage disposal. 7. Inspection of houses, caravans and shacks in the flooded areas and advice to the Local Authority as to their suitability for human habitation. 8. Arrangements where necessary for the drying of bedding, etc. 9. Meetings, conferences, etc., in connection with the numerous problems involved, etc. Further information on the floods is contained in the report of the Senior Sanitary Inspector. Attention is also drawn to the report of the Senior Sanitary Inspector on effluvia from the river Thames which varies in intensity according to temperature and wind direction and no doubt to many other factors which may not be completely understood. It is hoped that the action both taken and contemplated by the London County Council during the next few years will rid the Borough of a serious nuisance. In conclusion, I wish to thank the 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 devotion to duty at all times of the year. I am, Your obedient servant, JOHN LANDON, Medical Officer of Health. 9 Annual Report 1953 SECTION A:—STATISTICS AND SOCIAL CONDITIONS OF THE AREA A (1) 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 Belvedere and Abbey Wood. The shopping facilities in the Borough are excellent, and a copious supply of pure water is maintained by the Metropolitan Water Board. The chief industries are light engineering, edible oil refining, chemical works, coal shipping and lighterage, and the production of building materials, i.e., stoneware, plasterboard, asbestos, and of radio equipment. A (2) Comparative Rainfall 1952 Inches 1953 Inches January 2.15 0.99 February 1.04 1.29 March 2.56 0.34 April 0.99 2.13 May 1.33 1.47 June 1.06 1.24 July 0.75 3.29 August 2.32 1.37 September 3.28 2.97 October 2.36 3.23 November 3.90 0.88 December 2.08 0.78 Total 23.82 Total 19.98 10 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—1953 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 December, 1953 101 6 91 9 207 The figures reveal a slight decrease in the number of men unemployed but a slight increase in the number of women unemployed. Unemployment still remains at a low level and at about the same percentage of the working population, viz. 1.3%. 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—45,860 Density of population i.e. No. of persons per acre (Based on (ii) above):—11.9 No. of inhabited houses at 31st December, 1953:— (Excluding houses with shops and houses with Public Houses assessed as single heraditaments)—12,679 Rateable value at 31st December, 1953:—£362,442 Sum produced by a penny rate, 1953:— (Estimated product for 1953/4)—£1,450. 11 EXTRACTS FROM VITAL STATISTICS FOR YEAR 1953. A(4)b Births Male Female Total Live Births Legitimate 338 309 647 Illegitimate 13 11 24 351 320 671 Live Birth rate per 1,000 Home Population (Registrar General's Figure):—14.63 Birth rate corrected for comparison with other areas 14.63 Comparability factor supplied by Registrar General 1.00. Live birth rate. Enaland and Wales:—15.5 Corresponding rate for the Borough of Erith for year 1952 14.83 Still Births Male Female Total Legitimate 6 8 14 Illegitimate — — — — — — 6 8 14 Still Birth rate per 1,000 total births:—20.44 Still Birth rate per 1,000 Home population:—0.31 Still Birth rate per 1,000 Home population, England and Wales:—0.35 A (4)c Deaths Male:—293 Female:—206 Total:—499 Death rate per 1,000 Home population:—10.88 Death rate corrected for comparison with other areas 11.86. (Comparability Factor supplied by Registrar General) 1.09. Corresponding rate for 1952:—10.85 Death rate per 1,000 Home population, England and Wales (1953) 11.4 Number of women dying in, or in consequence of, childbirth:—Nil Maternal Mortality Rate per 1,000 total births:—0.00 Comparative figure for England and Wales:—0.76 12 A (4)d Infant Mortality Deaths of infants under 1 year of age:- Male Female Total Legitimate 10 10 20 Illegitimate 1 1 2 11 11 22 Death rate of infants under 1 year of age per 1,000 live births:-32.79 Death rate of infants under 1 year of age per 1,000 live births, England and Wales :—26.8 Deaths of infants under 4 weeks of age :— Male Female Total Legitimate 8 6 14 Illegitimate 1 1 2 9 7 16 Death rate of infants under 4 weeks of age per 1,000 live births 23.84 Total number of deaths from :— 1952 1951 Measles (All ages) — — Whooping Cough — — 13 A (4)e Summary of Vital Statistics for the Year 1953 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 15.5 17.0 15.7 17.5 14.63 Still births 0.35 0.43 0.34 0.38 0.31 Deaths :— 22.4(a) 24.8(a) 21.4(a) 21.0(a) 20.44(a) All causes 11.4 12.2 11.3 12.5 10.88 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.01 0.01 0.00 0.00 0.00 Diphtheria 0.00 0.00 0.00 0.00 0.00 Tuberculosis 0.20 0.24 0.19 0.24 0.24 Influenza 0.16 0.15 0.17 0.15 0.35 Smallpox 0.00 0.00 0.00 0.00 0.00 Acute Poliomyelitis (including Polioencephalitis) 0.01 0.01 0.01 0.01 0.00 Pneumonia 0.55 0.59 0.52 0.64 0.55 Notifications :— (Corrected) Typhoid Fever 0.00 0.00 0.00 0.01 0.00 Paratyphoid Fever 0.01 0.01 0.01 0.01 0.00 Meningococcal Infection 0.03 0.04 0.03 0.03 0.02 Scarlet Fever 1.39 1.50 1.44 1.02 2.42 Whooping Cough 3.58 3.72 3.38 3.30 3.64 Diphtheria 0.01 0.01 0.01 0.00 0.00 Erysipelas 0.14 0.14 0.13 0.12 0.13 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 12.36 11.27 12.32 8.09 8.31 Pneumonia 0.84 0.92 0.76 0.73 1.18 Acute Poliomyelitis (including Polioencephalitis) Paralytic 0.07 0.06 0.06 0.07 0.04 Non-Paralytic 0.04 0.03 0.04 0.03 0.07 Food Poisoning 0.24 0.25 0.24 0.38 0.00 Puerperal Pyrexia 18.23(a) 24.33(a) 12.46(a) 28.61(a) 0.00 Deaths :— Rates per 1,000 Live Births All causes under 1 year of age 26.8(b) 30.8 24.3 24.3 32.79 Enteritis and diarrhoea under 2 years of age 1.1 1.3 0.9 1.1 1.49 (a) Per 1,000 Total (Live and Still) Births. (b) Per 1,000 Related Live Births. 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 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 46,770 795 17.00 465 9.95 (Corrected) 19 23.9 10.75 1950 46,850 701 14.96 (Corrected) 478 10.2 (Corrected) 14 20.0 14.21 11.0 1951 46,010 690 15.00 (Corrected) 533 11.6 (Corrected) 24 34.8 14.25 12.4 1952 46,070 683 14.83 500 10.85 20 29.3 (Corrected) 14.09 (Corrected) 11.6 1953 45,860 671 14.63 (Corrected) 499 10.88 (Corrected) 22 32.79 14.63 11.86 A (4)f Vital Statistics of Whole District—1944—1953 14 15 A (4)g Table showing Summary of Causes of Death during the year ended 31st December, 1953 Cause of Death Males Females Total 1 Tuberculosis, Respiratory 8 2 10 2 Tuberculosis, Other forms — 1 1 3 Syphilitic diseases 1 — 1 4 Diphtheria — — — 5 Whooping Cough — — — 6 Meningococcal Infections — 1 1 7 Acute Poliomyelilis — — — 8 Measles — — — 9 Other infective and parasitic diseases 1 — 1 10 Malignant neoplasm, stomach 7 5 12 11 Malignant neoplasm, lung, bronchus 12 4 16 12 Malignant neoplasm, breast — 13 13 13 Malignant neoplasm, uterus — 3 3 14 Other malignant and lymphatic neoplasms 25 15 40 15 Leukaemia, Aleukaemia — 2 2 16 Diabetes — 2 2 17 Vascular lesions of nervous system 29 27 56 18 Coronary disease, angina 42 12 54 19 Hypertension with heart disease 8 11 19 20 Other heart diseases 47 42 89 21 Other circulatory diseases 14 14 28 22 Influenza 10 6 16 23 Pneumonia 19 6 25 24 Bronchitis 23 8 31 25 Other diseases of respiratory system 5 2 7 26 Ulcer of stomach and duodenum 5 1 6 27 Gastritis, enteritis and diarrhoea 2 — 2 28 Nephritis and Nephrosis 1 4 5 29 Hyperplasia of prostate 2 — 2 30 Pregnancy, Childbirth and abortion — — — 31 Congenital Malformations 4 2 6 32 Other defined and ill-defined diseases 22 15 37 33 Motor vehicle accidents 1 1 2 34 All other accidents 3 2 5 35 Suicide 2 5 7 36 Homicide and operations of war — — — Total all causes 293 206 499 A (4)h Infant Mortality—Causes of death and table of comparison 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 Anoxia 1 1 Atelectasis 1 1 Asphyxia Neonatorum 1 2 Acute Meningococcal Septicaemia 1 1 Congenital Malformation 1 1 Hydrocephalus 1 1 Inhalation Pneumonia Intracranial 1 1 Haemorrhage 1 1 Miliary Tuberculosis 1 1 Prematurity 1 1 3 Peritonitis 1 1 Pneumonia 1 2 1 1 1 1 7 Spina Bifida 1 1 Totals 5 2 — 2 — 1 1 3 2 — — 1 1 — — — 1 1 — 1 1 22 Of the 22 infant deaths, 19 died in hospital, 2 died in their own homes and 1 was found dead in a park. Coroner's Postmortem examinations were carried out in 10 cases with an inquest on 1 of them. 16 17 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 yearly from 1946-1953. 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 1953 22 32.79 26.8 A (4)i Comparison of Maternal Mortality Rates Year Maternal Deaths Live Births Still Births Maternal Mortality Rate per 1,000 total Births 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 1953 - 671 14 — 18 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 54 31 2 Acute Poliomyelitis (Paralytic) 3 3 — Acute Poliomyelitis (Non-Paralytic) 6 6 — Acute Encephalitis (Infective) 1 1 — Diphtheria 1 1 — Erysipelas 6 2 — Malaria 2 2 — Measles 381 3 — Meningococcal infection 1 1 - Ophthalmia Neonatorum 4 2 - Scarlet Fever 111 20 - Whooping Cough. 167 1 - Total 737 73 2 3 cases notified as acute poliomyelitis non-paralytic, were subsequently rediagnosed as follows :— 1 as acute poliomyelitis paralytic 1 as acute meningo encephalitis 1 as non-infectious. 1 case of acute poliomyelitis was rediagnosed as acute primary pneumonia, and 1 case was rediagnosed as noninfectious. The case notified as diphtheria proved not to be so. 19 B (l)a Age Distribution The following table shows the age distribution of confirmed cases of Infectious Disease notified during the year Disease Age Groups Totals under 1 year 1-2 3-4 5-9 10-14 15-24 25-44 45-64 65 & over Age not known M F M F M F M F M F M F M F M F M F M F Acute Pneumonia 4 1 7 1 1 1 8 1 - 1 1 3 4 6 5 3 3 4 — — 54 Acute Poliomyelitis (Paralytic) - - - - - - 1 - - - - 1 - - - - - - - - 2 Acute Poliomyelitis (Non-Paralytic) - - - - - - 1 1 - - - - 1 - - - - - - - 3 Acute Encephalitis (Infective) - - - - - - 1 - - - - - - - - - - - - - 1 Erysipelas - - - - - - - - 1 - - - 1 — 1 2 1 — — — 6 Malaria - - — - - - - - - - 1 - - - — — - - 1 - 2 Measles 9 9 36 46 44 45 96 77 4 1 3 4 2 3 - - - - - 2 381 Meningococcal Infection - - - - - - 1 - - - - - - - - - - - - - 1 Ophthalmia Neonatorum 2 2 - - - - - - - - - - - - - - - - - - 4 Scarlet Fever — — 2 4 13 10 42 32 2 3 1 2 - - - - - - - - 111 Whooping Cough 3 5 12 21 23 28 33 35 — 2 — — — 2 — 1 - - 1 1 167 Totals 18 17 57 72 81 84 183 146 7 7 6 10 8 11 6 6 4 4 2 3 732 B (l)b WARD DISTRIBUTION Number of cases of Infectious Disease confirmed in each ward in the Borough. Disease Ward Total Town Old Church Belvedere North Heath Abbey Wood Bostall Acute Pneumonia 12 11 5 13 6 7 54 Acute Poliomyelitis (Paralytic) — 1 — — — 1 2 Acute Poliomyelitis (Non-Paralytic) - 1 - 2 - 1 3 Acute Encephalitis (Infective) — 1 — — — — 1 Erysipelas — 1 3 — — 2 6 Malaria — — 1 — — 1 2 Measles 80 74 45 88 34 60 381 Meningococcal Infection — — — — — 1 1 Ophthalmia Neonatorum 1 — 1 1 1 — 4 Scarlet Fever 22 15 15 23 8 28 111 Whooping Cough 17 15 21 37 22 55 167 Totals 132 118 91 164 71 156 732 20 21 B (2) Tuberculosis B (2)a New Cases notified for the first time during 1953 Age Respiratory Non-Respiratory Total M F M F 0— — — — — — 1— 1 2 — — 3 5— 1 2 1 — 4 10— 2 — — — 2 15— 2 6 — — 8 20— 4 2 — — 6 25— 12 10 - 1 23 35— 6 6 — — 12 45— 6 3 1 — 10 55— 2 — — — 2 65 & over 2 — — — 2 Totals 38 31 2 1 72 In addition to the above cases, 8 females and 2 males suffering from Respiratory Tuberculosis, and 1 male suffering from Non-Respiratory Tuberculosis, were transferred into the district from other areas, 2 males (Respiratory) were restored to the register as re-activated, and 1 male and 1 female (Respiratory) were notified other than officially. 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 2 10 — 1 1 8 3 11 B (2)c Quarterlyl Statements for the Year 1953 Tuberculosis 1st Quarter 2nd Quarter 3rd Quarter . 4th Quarter M F Total M F Total M F Total M F  Respiratory Tuberculosis Number on register at commencement of Quarter 300 216 516 302 225 527 305 224 529 312 228 540 New notifications during Quarter 8 9 17 13 4 17 9 9 18 7 9 16 Cases removed, which have been restored 2 1 3 - - - - - - - 1 1 Cases added other than by formal notification - 2 2 1 1 2 2 4 6 1 1 2 Cases removed from register during Quarter 8 3 11 11 6 17 4 9 13 4 2 6 Cases remaining on register at end of Quarter 302 225 527 305 224 529 312 228 540 316 237 553 Non-Respiratory Tuberculosis Number on register at commencement of Quarter 42 40 82 43 41 84 44 40 84 43 38 81 New notifications during Quarter — 1 1 1 — 1 — — — 1 — 1 Cases removed, which have been restored - - - - - - - - - - - Cases added other than by formal notification 1 - 1 - - - - - - - - Cases removed from register during Quarter - - - - 1 1 1 2 3 - 1 1 Cases remaining on register at end of Quarter 43 41 84 44 40 84 43 38 81 44 37 81 Total of Respiratory and Non- Respiratory Cases on Register at end of Quarter 345 266 611 349 264 613 355 366 621 360 274 634 Respiratory: Non-Respiratory: Total Number of cases left on the register at end of 1953 is as follows :—316 males 237 females 44 males 37 females 634 22 23 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, 1953, 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 1953 Year of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations Year of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations 1953 Under 1 year of age 54 — 19481944 5-9 years of age 58 503 1952 1 year of age 389 — 19431939 10-14 years of age 38 433 1951 2 years of age 33 — 1950 3 years of age 7 — 1949 4 years of age 12 33 Total 495 33 96 936 24 Table B:—Number of children resident in the Borough of Erith under the age of 15 years on 31st December 1953, who had completed a course of Immunisation at any time since 1st January, 1939 Year of Birth 0-4 years 5 -14 years Number considered to be immunised Year of Birth Number considered to be immunised 1953 54 1948 683 1952 444 1947 831 1951 458 1946 687 1950 486 1945 652 1949 598 1944 614 1943 530 1942 619 1941 537 1940 504 1939 521 Total 2,040 Total 6,178 B (4) Vaccination Against Smallpox Age at 31st December 1953 Under 1 year 1-4 years 5-14 years 15 or over Total Number vaccinated 193 138 9 12 352 Number re-vaccinated — 1 7 33 41 25 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. †This clinic removed to St. Augustine's Hall, St. Augustine's Road, Belvedere, early in 1954. 26 C (7) Maternity and Child Welfare Centres Hainault, Lesnev 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) Laboratory Facilities Examination of pathological specimens and other laboratory work for the district is undertaken by the Public Health Laboratories, County Hall, Maidstone. †This clinic removed to St. Augustine's Hall, St. Augustine's Road, Belvedere, early in 1954. 27 C (11) Mortuary An up to date mortuary exists with refrigeration for 6 bodies 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. During the year the mortuary accommodated 158 bodies and post-mortem examinations were carried out in 156 cases. 31 inquests were held. 54 bodies were from the Erith area, and postmortem examinations were carried out in all cases. There were 10 inquests. C (12) 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 (13) Welfare of Old People The work of the Erith Old People's Welfare Committee continued throughout the year and much good work was done in visiting and provision of good neighbourly services. In addition it has been possible in certain cases of extreme difficulty to arrange assistance in cash or kind. During the year the Committee arranged a week's holiday by the sea for a coach load of needy old age pensioners. This scheme has been followed up and several coach loads will be sent during 1954. In an endeavour to revive an old custom, namely an annual dinner for needy old folks, the Committee arranged a Christmas dinner and entertainment for 200 old people on Boxing Day and this proved most successful. C (14) National Assistance Act, 1948, Section 50 (Burials) During the year it was necessary for the Council to carry out one burial under the provisions of the above Act. This case, an unidentified newly born male child was found in a brown paper wrapping in a quiet lane in the Borough. The body was taken to the mortuary and enquiries were made by the police in an endeavour to trace the mother or other person responsible, but without success. 28 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 16,000 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 (l)a Costs £ s. d. Cost per ton of collecting refuse 1 8 11 Cost per ton of disposing of refuse 15 8 Net cost per 1,000 population per annum 421 17 4 The following tables show :— 1. Details of the refuse collection vehicles and staff. 2. Details of the tonnage dealt with during the year. D (l)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 Morris Utility Van 5 cwt. 5 Trailers They are operated by :— 1 Foreman 11 Driver Loaders 1 Loaders and Sorters 29 D (l)c Table 2 Month Tonnage Tons Cwts. January, 1953 1,029 16 February, „ 857 14 March, „ 898 15 April, „ 835 2 May, „ 731 14 June, „ 687 16 July, 610 14 August, „ 541 5 September, „ 613 13 October, „ 765 11 November, „ 799 1 December, „ 782 16 Total 9,153 17 D (2) Trade Refuse Trade Refuse is collected from factories and shops by arrangements with the proprietors, an agreed charge being made. This section of the Refuse Services continues to increase and in 1953 produced a revenue of £584 15s. 3d. D (3) Salvage Tonnage collected: Income : T. C. Q. lbs. £ s. d. 855 3 2 8 5,075 6 0 D (4) 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. 30 D (5) Sanitary Inspection of the Area D (5)a Visits by Sanitary Inspectors The total number of visits of all kinds was 9,441 Notices served 371 : Formal 39 : Informal 332. Number of dwellings and other premises disinfected 198 Complaints received and investigated 1,635 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 Milkshops 27 81 1 1 Bakehouses 10 41 8 8 Dairies 5 29 3 3 Butchers' shops 33 367 14 14 Fish friers 14 83 6 6 Slaughter houses 4 — — — Factories 157 193 23 23 Outworkers 109 87 - - Food factories 4 29 3 3 Pet shops 6 27 1 1 Rag flock dealers 2 10 - — D (5)c Summary of Nuisances and defects remedied during the year Other than those enumerated in the above tabulations :— Roofs made watertight. 61 Dampness remedied 90 Eaves repaired 49 Floors repaired 29 Plasters renewed 87 New W.Cs 16 New W.C. pans 12 Cisterns repaired 16 New sinks 27 Sink wastes repaired 21 Firegiates repaired 10 Drains repaired 48 Water supplies provided 7 Windows made to open 48 Coppers repaired 3 Yard pavings renewed 4 Dustbins provided 51 Accumulations removed 16 Choked drains cleared 125 Miscellaneous 35 Houses demolished :— By formal action 0 By informal action 2 Demolition orders made 1 31 D (5)d Closet Accommodation and Cesspools Though the water carriage system has been universal in the Borough for many years, 19 cesspools are known to exist and these are subject to a cleansing service monthly by resolution of the Council dated 10th March, 1942. The cesspools requiring this service are in obscure positions which thus necessitates the covering of considerable distances both for pumping and conveying to the point of discharge. In two instances, cesspools have been abandoned, and the drains connected to Corporation sewers. D (5)e Smoke Abatement Action taken with regard to smoke and grit emission has resulted in the following improvement. (a) One hand fired furnace has been fitted with a smoke eliminator door. (b) At a coal discharge wharf on the east side of the Borough, a series of sprinklers has been installed with a view to consolidating coal dust during the process of screening. 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 Catering Department, Works Department, the County Health and Education Departments, and the "Hainault" Maternity Home. During the year 83,806 articles were dealt with. Attendances at Public Bath for 1954 Swimming pool Slipper Baths Schools' During term 9,699 13,737 Schools' During holidays 1,835 Youth clubs 3,861 Total 15,395 Total 13,737 32 (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 Offensive Trades Fish frying was declared to be an offensive trade in this area on 17th March, 1939 and bye-laws were made accordingly. Other than 14 fried fish premises, no statutory offensive trades which are enumerated in Section 107 of the Public Health Act 1936 exist. D (5)h Rag Flock and Other Filling Materials Act, 1951 This Act is designed to secure that clean filling materials are used in the upholstery trade, and whilst there are no manufacturing premises subject to licensing in the Borough, two premises exist where filling materials are utilised and which are registered by the Local Authority. Apart from the incumbent duties of licensing and registration, the operation of this Act includes the inspection of premises and the sampling of rag flock. In this regard, several visits were made to registered and other premises and two samples submitted to the Prescribed Analyst were reported upon satisfactorily. D (5)i Pet Animals Act, 1951 There are 6 pet animal shops in the Borough and these are subject to annual licensing. All the premises are conducted in a satisfactory manner and in accordance with the statutory requirements. D (5)j Heating Appliances (Fireguards) Act 1952 Regulations made under the above Act came into operation on 1st October and this statute requires that fireguards must be fitted to the domestic type of gas fires, electric fires and oil heaters and on which the absence of such an approved guard would be a contributory factor to the menace of injury by burning. The Regulations prescribe the requisite standards of construction, fitting of guards, and the tests to be employed in determining whether or not the guards comply with the approved standards. Heating appliances, other than imported fitments, manufactured prior to the date of the commencement 33 of the Regulations and not fitted with the approved guards may be retailed until September 1954. Testing technique will embrace (1) Proximity of heating filament by use of probe, (2) Strength of guard by application of weight, (3) Demonstration of ignition hazards by use of fabric material. D (5)k Camping Sites There are no summer camping sites in the Borough, though 2 sites exist which are subject to licensing by the Local Authority. One application to station a caravan on certain land was refused during the year. D (5)1 Hop Pickers There are no hop fields within the district. D (5)m Mosquito Control Having regard to the extensive flooding of marsh land in February special precautionary measures were taken to preclude any possibility of nuisance during the summer months. In this regard the many water courses in the Belvedere Marsh area were treated with an approved larvicide, and this was wholly successful. D (5)n Rodent Control Two operatives are employed on rodent control in accordance with the provisions of circular N.S. 19, and during the year Corporation sewers were effectively treated for sewer rats when 310 manholes were baited. As in previous years, each complaint of rodents in private or industrial premises was investigated, and an appropriate charge made for destruction. For the purposes of the Prevention of Damage by Pests (Application to Shipping) Order 1951, vessels which are not sea going ships are regarded as land provided for by the Prevention of Damage by Pests Act, 1949, and accordingly, many inspections have been made at the various wharfs in the Borough as follows:— Coastwise vessels 47 Tugs 17 Barges 89 153 No sea-borne infestation was located. 34 D (5)o Pest Control Destruction of ants and wasps nests, beetles, silverfish, crickets etc., are carried out at a cost inclusive of the cost of materials with an apportionment charge on the operative's time. The charges made in connection with this service amounted to £33 9s. 8d. Following the location of 2 insects in timber at a local factory, the specimens were duly submitted to the Forest Products Research Laboratory, Department of Scientific and Industrial Research where they were identified as Longhorn beetles (Ergates Spiculatus), a type peculiar to softwoods from the Pacific coast of North America. These beetles do not breed in Britain and there is no danger of emerging beetles attacking associated timbers. The management of the firm was informed accordingly. D (5)p Burial Act, 1857. Section 25 In accordance with the prescribed requirements of the Home Secretary's licence, one re-interment was supervised during the year. D (5)q Eradication of Bed Bugs All cases of vermin-infested dwellings which came to the notice of the Sanitary inspectors during the year were appropriately dealt with and it is gratifying to record that the instances are appreciably reducing. The number of dwelling houses treated are as follows:— Privately owned houses 6 Corporation houses 6 With a view to obtaining good control, occupiers are encouraged to reveal any infestation, when every assistance is given to cope with the menace. 35 D (6) Factories (1) Inspections for the purpose of provisions as to health are detailed below:— Premises Number of Inspections Written Notices Occupiers Prosecuted 151 Factories on Register 172 14 - 6 Other premises under the Act (including building and engineering construction but not including outworkers' premises) 21 2 - 157 Total 193 16 - (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 9 9 - - Washing facilities 2 2 — — Drainage of floors 1 1 — — Sanitary conveniences: (a) Insufficient 5 5 - - (b) Unsuitable 3 3 - - Other offences against the Act (not including offences relating to outworkers) 3 3 - - Total 23 23 — — 36 D (7) Shops Act, 1950 The following improvements were effected with regard to health and comfort provisions:— Shops cleansed 7 New floors 2 New W.C.’s 5 Washing facilities 3 17 D (8) Sanitary Accommodation at Offices Two offices were found to be without the requisite closet accommodation in consequence of which Section 46 Public Health Act 1936 was implemented when 4 additional conveniences, together with adequate washing facilities were provided. D (9) Flooding of Belvedere and Abbey Wood The unexpected high tide flooding during the night of January 31st, resulted in an area equivalent to one third of the acreage of the Borough being submerged to depths varying from 3 to 6 feet. The initial survey which immediately followed the evacuation of families to rest centres showed that some 300 dwellings and the caravan encampment, were inundated, and that several factories, business premises, and small holdings were similarly affected, and it was at once apparent that the whole resources of the sanitary services would be fully taxed in dealing with such an unexpected and unprecedented combination of adverse circumstances. It was therefore imperative that a highly effective system of sanitary organisation should be instituted and maintained throughout the emergency in order to cope with the question of saturated dwellings, ineffective drainage, spoilage of food, and the possibilities of contamination of the water supply. Having regard to the latter, it was arranged for the Metropolitan Water Board to take daily water samples in the submerged area, whilst the sanitary inspectors obtained a number of check samples as an added precaution. From the submerged small holdings, some 150 asphyxiated pigs were removed and disposed of whilst the more fortunate live animals were removed to suitable sites on dry land. On 13th February, flood level was visibly receding, this enabling the operation of mechanical drying plant by R.A.F. 37 personnel. At the same time, impacted sewerage in sewers was released, thus effecting a gradual clearance. On 20th February, it was possible to negotiate the made up roads on the caravan encampment when it was found that a considerable number of vans and structures had been completely demolished by a fast rising tide, and that future use for habitation was impossible. By the end of February a good proportion of saturated dwellings had been treated by mechancial drying and aeration, and it was possible to make a house-to-house inspection over the whole area, when chloride of lime and other appropriate disinfectants were applied to all sub-floor areas and to the interior of drains and public sewers. In the meantime, first aid repairs were carried out at the dwellings, this coinciding with the excavation and cropping of some miles of ditches by the Kent River Board. During the existence of the 6 rest centres, each was visited daily by the Medical Officer of Health and the Sanitary Inspectors and aerial disinfection carried out. A daily refuse collection service was also laid on which included the disposal of contents of improvised pail closets. During the summer, very close attention to detail was paid to this former flooded area. No outstanding nuisances were located and all the houses have been re-inhabited. D (10) River Thames—Effluvia From time to time, throughout the year, complaints have been received regarding the unpleasant odour emanating from the River Thames and even in the absence of high temperatures it was noted that the objectionable odours persisted especially after fog dispersal. Locally, it is considered extremely unfortunate that the menace cannot be combatted by a sanitary effort, for to attain a wholly desirable result, a change of procedure is indicated at the two outfall works vested in the L.C.C. Under the existing circumstances, the enamelled surfaces of household baths, and domestic and other brassware rapidly becomes discoloured. Paintwork likewise, substantially deteriorates. In a recently published report, it was stated that, with a view to the bringing of sludge from the sewerage works at Crossness and Barking Creek to the North Sea, a new twin screw sludge vessel of 1,560 tons capacity with a speed of 11 knots is being constructed by Lobnitz for the L.C.C. At the Local Enquiry on 17-18th December 1953 in connection with the proposed new L.E.B. generating station at Belvedere, evidence was duly given on behalf of the Erith 38 Corporation. On this occasion it was demonstrated that white lead acetate papers became dark brown on exposure of 30 hours duration, thus indicating that sulphuretted hydrogen gas was present in the Council Chamber, in which room the Enquiry was being held. D (11) Atmospheric Pollution Thames-side Advisory Committee for Abatement of Atmospheric Pollution On 1st August, one deposit gauge was assembled on behalf of the above Committee in the grounds of the Royal Alfred Institution situated at Belvedere, and since that date, monthly deposits within the gauge have been examined by the Public Analyst with the following results:— Month Rain in inches. Monthly Deposit. Insoluble deposit Tons per sq. mile. Soluble deposit Tons per sq. mile. Total solids. Tons per sq. mile. Calcium Tons per square mile. August 1.46 8.01 6.67 14.68 1.37 September 2.04 14.07 8.84 22.91 1.47 October 3.81 15.01 11.87 26.88 1.87 November 0.32 5.52 4.07 9.59 0.53 December 0.72 16.88 15.14 32.02 3.13 D (12) Housing D (12)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) 2,961 (b) Number of inspections made for the purpose 3,612 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 14 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 323 39 D (12)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 311 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 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 39 (2) No. of houses in which defects were remedied after service of formal Notices (a) By owner 39 (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 1 (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 The demolition order referred to in (c)(1) above was made in respect to Magazine Cottage, Thames Riverbank. The two dwellings Manor House Crossness, and Avenue Lodge South Road, were demolished by informal action. 40 I am indebted to the Borough Engineer and Surveyor and Housing Assistant for the following information regarding building activity in the Borough during the year:— Number of permanent houses constructed in 1953:— By the Council 55 plus 77 flats By private enterprise 113 Total 168:77 flats Total number of permanent Council houses in the Borough 1,196 Flats 97 Total number of prefabricated temporary houses in the Borough 250 Total number of requisitioned premises in the Borough 185 Number of premises requisitioned in 1953 Nil. Number of premises de-requisitioned in 1953 17 D (13) Legal Proceedings Statute Offence Penalty Sec. 3. Food & Drugs Mineral oil in bread. £30 0 0 Act, 1938. £15 15 0 costs. £ 3 3 0 Analyst's fee. Sec. 3. Food & Drugs Metal in sausage. £10 0 0 Act, 1938. £ 5 5 0 costs. £ 3 3 0 Analyst's fee. Sec. 47. Shops Act, 1950. Sunday Trading. 10/- Sec. 47. Shops Act, 1950 Sunday Trading. 10/- 41 D (14) Rent and Mortgage Interest (Restrictions) Act, 1939 The provisions regarding extortionate rents are administered by the Senior Sanitary Inspector, and during the year 77 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 this date come within the orbit of the Landlord and Tenant (Rent Control) Act, 1949, which Act provides for application to be made to a Rent Tribunal for the assessing of a reasonable rent. This Act also affords an umbrella of protection for tenants who share accommodation. Appended below is a summary of improvements effected under the Rent Restriction Act:— (a) Rent reduced from £1 6s. 7d. to £1 5s. Id. (b) Rent reduced from £1 10s. Od. to £1. (c) Rent reduced from £1 0s. Od. to 16/7. (d) Rent reduced from 12/3 to 8/6 and £1 10s. Od. extortionate rent returned to tenant. (e) 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 good results. 42 SECTION E—WATER SUPPLY—MILK—FOOD AND DRUGS ACT—FOOD INSPECTION E(l) Water Supply The water supply in the district is supplied by the Metropolitan Water Board and contains 30.8 degrees of hardness. Almost without exception, the supply is led direct into the premises served. Two monthly samples have been forwarded to the appropriate Laboratory for examination, with satisfactory results. E (2)a Dairies and Milk stores The 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 during 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 in the Borough were obtained and submitted to the County Laboratory for examination:— Pasteurised 26 Tuberculin tested (Pasteurised) 3 Sterilised 1 Total 30 All were reported upon satisfactorily, such milk satisfying the methylene blue, phosphatase, and turbidity tests. 43 E (2)c Biological Testing of Milk Two samples of milk were submitted to the County Laboratory for biological testing. No evidence of tuberculosis was found to exist. E (2)d Food and Drugs (Milk, Dairies, and Artificial Cream) Act, 1950. The Milk (Special Designations) (Specified Areas) Order, 1951 Since 1st October 1951 when the above named Order came into operation, the whole of the milk supply in the Borough is specially designated in accordance with the statute. E (2)e Designated Milk The following table indicates the number of licences issued in 1953 under (1) The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949/1953 and (2) The Milk (Special Designation) (Raw Milk) Regulations, 1949/1950, viz:— Dealers licences Supplementary licences Pasteurised 9 Pasteurised Sterilised 27 Sterilised 8 Tuberculin tested 6 Tuberculin tested 7 42 22 E (2)f Ice-Cream 109 premises in the Borough are registered for the sale of ice-cream. Of 23 manufacturers entered on the Register, only 8 are active (i.e. 2 boil mix and 6 cold mix). 18 samples were obtained and forwarded for bacteriological examination, results being as follows:— Grade 1 14 2 2 3 2 18 44 E (3) Meat and Food Inspection (a) Resulting from inspections at the various food premises in the Borough, the following were found to be unfit and subsequently destroyed:— Mea 293 tins Meat l,90 ¾ lbs. Fish 232 tins Fish100 lbs. Fruit 492 tins Vegetables 804 tins Milk 68 tins Preserves 152 lbs. Cheese 102 lbs. Cereals 44 ½ lbs. Fat 112 lbs. Frozen egg 84 lbs. Table jellies 106 Approximate total weight:—2 tons. 3 cwts. 1 qr. 6 lbs (b) One trader proposed to retail so called hot pies from an improvised moble vehicle, and owing to the unsatisfactory conditions prevailing, this practice was discouraged, and the project was consequently abandoned. E (4) Slaughter of Animals Act 1933 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 area, and makes the use of mechanically operated instruments a statutory obligation. E (5) Food and Drugs Act 1938, Sections 3 and 68 The following samples were procured during the year and submitted to the Public Analyst for the purpose of analysis, with the following results:— Article Unsatisfactory Genuine Number of samples Milk 1 19 20 Ice-cream - 9 9 Ice lolly - 1 1 Coffee extract - 1 1 Padding mixtures — 2 2 Cake mixtures - 3 3 Hour - 1 1 Bread loaves 3 - 3 Article Unsatisfactory Genuine Number of samples Mustard — 1 1 Ground ginger — 3 3 Ground cinnamon — 2 2 Mixed spice — 2 2 Mixed herbs — 2 2 Dried mint — 1 1 Soups 1 5 6 Shredded suet — 1 1 Fish paste — 3 3 Meat paste — 1 1 Sausage 1 — 1 Malt vinegar — 2 2 Sauces 1 3 4 Gravy thick — 1 1 Pea flour — 1 1 Custard powder — 2 2 Corn flour — 1 1 Arrowroot — 1 1 Raising powder — 2 2 Junkets — 1 1 Essence of rennet — 1 1 Table creams — 2 2 Table jelly — 2 2 Aspic jelly powder — 1 1 Dessert powder — 1 1 Honeycomb mould — 1 1 Tapioca flakes — 1 1 Tapioca dessert — 1 1 Rice 1 — 1 Pearl barley — 1 1 Jam — 1 1 Mincemeat — 1 1 Gelatine — 1 1 Chocolate biscuit — 1 1 Brandisnaps — 1 1 Ground almonds — 1 1 Sweet confectionary — 2 2 Flavouring essences — 2 2 Glucose with Vit. D. — 2 2 Cereal foods — 3 3 Milk powders — 4 4 Bicarbonate of Soda — 1 1 Saccharin tablets — 1 1 Syrup of figs — 1 1 Cough syrup — 1 1 Liquid paraffin — 1 1 Indigestion tablets — 1 1 Headache tablets — 4 4 Laxatives — 1 1 Total 8 112 120 45 46 Action taken on unsatisfactory samples : Channel Island Milk Repeat sample satisfactory. Bread loaf (1) Purveyor fined £30 0s. Od. and £18 18s. Od. costs, (sec. 3). (2) Warning letter sent on tion of Health Committee. (3) Action pending at end of year. Cream of Tomato soup Stock withdrawn from sale. Letter to supplier. Cooked sausage Purveyor fined £10 0s. Od. and £8 8s. Od. costs, (sec. 3). Tomato sauce Observations submitted by purveyor to Public Analyst. Rice Stocks withdrawn from sale. The milk samples had an average content of 3.45% fat and 8.80% solids not fat. The ice-cream samples had an average content of 10.56% fat, 13.12% sucrose, and 11.14% milk solids other than fat. Both the milk and ice-cream samples compare very favourably with their respective statutory standards. E (6) Clean Food Campaign E (6)a Premises There are 266 food premises in the area of the following types:- Fishmongers 17 Bakers 10 Cafes 33 Canteens 13 Butchers 33 Greengrocers 26 Grocers 57 Grocers and Confectioners 27 Grocer/Green grocer 5 Confectioners 36 Dairies 5 Food Factories 4 47 There are 180 registered food premises in the area as follows:— Food and Drugs Act, 1938, Section 14. Ice cream 109 Sausages and preserved food, etc. 66 Milk and Dairies Regulations, 1949. Dairies 5 There were 793 inspections carried out on registered food premises and where defects or improvements were found to be necessary ready co-operation was given by proprietors. E(6)b Disposal of unsound foodstuffs Whilst unfit tinned goods are destroyed with the bulk of the town's refuse, the remainder of unfit food and which is capable of salvage is disposed of by way of the Corporation's salvage scheme—this food being sent to the Woolwich Borough Concentrating plant for the purpose of manufacture into pig food. E (6)c Food Hygiene Erith, Bexley and Crayford Clean Food Traders' Guild Much time and attention has been given to the various aspects and activities of the above, and much progress has been made during the year both in regard to the stimulation of interest of food traders and to the associated improvement of premises where necessary. The public lecture and film show held on the 30th January 1953, was an unqualified success and aroused considerable interest. Resulting from a continuous clean food campaign, 32 Erith traders are now members of the Guild and recipients of the approved plaque, whilst another 13 food traders arc recommended for membership and awaiting approval by the Executive Committee. 48 F (4) National Assistance Act 1948, Section 47 Once again, it is gratifying to report that, in the course of sanitary inspections, it has been possible to assist some of those to whom the above statute applies. As in previous years, close liaison has been maintained with the various voluntary and statutory organisations which operate locally. In one instance, it was found necessary to take formal action. F (5) Legislation in Force—Byelaws, etc. Provision of Dustbins Erith Improvement Act 1920 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