4412(1) (II) 1 Mr Ohora Di 5B 2 Library ERI 36 BOROUGH OF ERITH ANNUAL REPORT of the Medical Officer of Health For the year 1956 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 1956 by JOHN LANDON, M.R.C.S., L.R.C.P., D.P.H. Section Page A Statistics and Social Conditions of the Area 1. Physical Situation and Amenities 8 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 (d) Infant Mortality 12 (e) Summary of Vital Statistics for year 1956 13 (f) Vital Statistics of the whole District during 1956 and previous years 14 (g) Table showing Summary of Causes of Death during 1956 15 (h) Infant Mortality—Causes of death and table of comparison (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 1956 21 (b) Deaths 21 3. Diphtheria Immunisation 22 4. Vaccination against Smallpox 23 C General Provision of Health Services for the Area 1- General Hospital Facilities 24 2. Infectious Disease Hospitals 24 3. Tuberculosis Treatment and Hospital Accommodation 24 4. Venereal Diseases 24 5. Ambulance Service 24 6. School Clinics 24 7. Maternity and Child Welfare Centres 25 8. Maternity Home 25 9. Private Nursing Homes 25 i Section Page 10. Laboratory Facilities 25 11. Mortuary 26 12. Disinfection Services 26 13. Welfare of Old People 26 14. National Assistance Act, 1948, Section 50 (Burials) 26 D Sanitary Circumstances of the Area 1. Refuse Collection and Disposal 27 (a) Costs 27 (b) Details of Refuse Collection Vehicles and staff 27 (c) Details of tonnage 28 2. Trade Refuse 28 3. Salvage 28 4. Public Conveniences 29 5. Sanitary Inspection of the Area 29 (a) Visits by Public Health Inspectors 29 (b) Premises visited and results of such visits 30 (c) Summary of Nuisances abated and defects remedied during the year 30 (d) Drainage, Closet accommodation and Cesspools 30 (e) Atmospheric Pollution 31 (f) Smoke Abatement 32 (g) Swimming Baths and Pools 32 (h) Offensive Trades 33 (i) Rag Flock and Other Filling Materials Act, 1951 33 (j) Pet Animals Act, 1951 33 (k) Camping Sites 33 (1) Hop Pickers 33 (m)Rodent Control 33 (n) Pest Control 34 (o) Eradication of Bed Bugs 34 (p) Heating Appliances (Fireguards) Act 1952 and Regulations 1953 35 (q) Mosquito Control 35 6. Shops Act, 1950 35 7. Sanitary Accommodation at Offices 35 8- Street Trading 36 9. River Thames—Effluvia 36 10. Factories 37 (i) Inspections 37 (ii) Defects found 38 ii Section Page 11. Housing 39 Houses in Clearance Areas and unlit houses elsewhere 39 (a) Houses demolished 39 (b) Unfit houses closed 39 (c) Unfit houses made fit and houses in which detects were remedied 40 (d) Housing statistics 40 (e) Housing repairs and Rents Act, 1954, Section 1, Circular 55/54 40 12. Rent and Mortgage Interest tions) Act, 1939 41 E Water Supply—Milk—Food and Drugs Act— Food Inspection 1. Water Supply 42 2. Milk Supply 42 (a) Food and Drugs Act, 1955, Sec. 37 The Milk (Special Designations) (Specified Areas) Order, 1951 42 (b) The Milk (Special Designation) (Raw Milk) Regulations 1949 and 1954The Milk (Special Designation) (Pasteurised and Sterilised milk) Regulations 1949 to 1953 42 (c) Bacteriological examination of milk 43 (d) Designated milk licences 43 (e) Milk and Dairies Regulations 1949 Dairies and Milkshops 43 (f) Ice Cream 43 3. Meat and Food Inspection 44 (a) Slaughterhouses 44 (b) Other Foods 46 (c) Disposal of unsound meat 46 (d) Slaughter of Animals (Amendment) Act, 1954 46 (e) Swine Fever Order, 1938, Articles 2 and 14 46 4. Food and Drugs Act, 1955. Sections 2 and 91 47 5. Food Hygiene 48 (a) Food and Drugs Act, 1955, The Food Hygiene Regulations 1955 48 (b) Erith, Bexley and Crayford Clean Food Traders Guild 49 iii Section Page 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 49 5. Children and Young Persons Act, 1933, as amended by Education Acts 1944-1948 49 6. Legal Proceedings 50 7. Legislation in Force and Bye-Laws, etc. 50 IV 2 F (1) BOROUGH OF ERITH Mayor—Councillor Mrs. H. A. Jerome, B.E.M., J.P. (1955-1956) Mayor—Councillor C. Schofield, B.A., J.P. (1956-1957). Deputy Mayor:—Councillor W. Boast (1955-1956) Deputy Mayor—Councillor Mrs. H. A. Jerome, B.E.M. (1956-1957), Health Committee Chairman:-—Alderman Mrs. L. F. Christian, J P. Members of Committee May 1955—May 1956 May 1956—May 1957 Aldermen W. F. Alford W. F. Alford C. F. Morling C. F. Morling Councillors E. Handy Mrs. A. E. Bennett Miss M. E. Odell, M.A., J.P. Mrs. M. S. Dalton E- Taylor E. Handy E. E. Virrels Mrs. J. Sidders Mrs. A. E. Bennett E. E. Virrels Ex-Officio Members Ex-Officio Members Alderman G. W. H. Luck G. W. H. Luck Councillors Mrs. H. A. Jerome, B.E.M., C. Schofield, B.A., J.P. J.P. Mrs. H. A. Jerome, B.E.M. W. Boast 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). Chief Public Health Inspector L. E. King, M.R.S.H., D.S.A.A., Certs. S.I.E.B., R.S.H., R.I.P.H. & H., Meat Inspector's Certificate. Public Health Inspectors P R- Hickson, Cert. S.I E.B., Meat Inspector's Certificate. F. C. Shaw, Cert. S.I.E.B., Meat Inspector's Certificate. San.Science. Cert. R.I.P.H. & H. (Temporary). R. F. Griffiths, Cert. S.I.E.B. (Appointed 23.1.56). C. H. Ellis, Student Public Health Inspector. Chief Clerk J- A. Sutherland. Clerks Shorthand-typist:— Miss D. M. Williams Junior Clerk:— Miss G. P Trenfield 4 To the Mayor, Aldermen and Councillors of the Borough of Erith Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1956. From the standpoint of the customary vital statistics, the health of the Borough has been well maintained. The infant mortality rate for 1956 was 12.35 per thousand live births compared with 20.41 per thousand in 1955. This is the lowest rate ever recorded in the Borough. An analysis of these figures shows that five deaths occurred during the first month of life (neo-natal deaths), the causes of which were associated with prematurity and congenital malformation, over which no significant degree of control is possible at present. One of the three deaths occurring after the fourth week was due to meningeal infection which may have been preventable; the other two were due to prematurity and subarachnoid haemorrhage respectively, neither of which is closely connected with environmental conditions. There were again no maternal deaths during the year, and indeed no maternal death has occurred in the Borough for the fourth year in succession. This is a fine record and speaks well for the obstetrical services in the area and for the standard of ante-natal care available for the expectant mother. The vital statistics are fully sent out on pages 11-14 together with comparisons for each year in the past decade. In legard to infectious disease, poliomyelitis constitutes the main challenge at the present time and little is known as to the conditions which determine whether any particular year will experience a heavy or mild incidence. In the present state of knowledge, the most direct way of eliminating cases or, alternatively, of preventing serious paralysis, is the vaccination of as many individuals as possible, and it must be borne in mind that, although children must be given priority, 3 age groups in the population are susceptible and it may well have to be extended to adults as well. This, obviously, would introduce problems of the supply of vaccine and, also or medical and nursing manpower to cope with the large scale of operations required. In Erith, registered children in the age group of two to nine years were inoculated during 1956 under arrangements made by the Local Health Authority and 256 children received two injections and 29 received one injection. These facilities are now being extended to include children between the ages of one and two years. 5 Tuberculosis is a disease which from a national point of view is diminishing both in incidence and mortality and, by a combination of B.C.G. vaccination, mass radiography and modern medical and surgical treatment combined with the close supervision of infective cases within the community, it is likely that the risks from this disease could be reduced in the next quarter of a century to a very considerable degree. In the Borough of Erith a study of the figures for notifications and deaths over the past 20 years shows that while deaths have fallen considerably, notifications of new cases have tended to increase, but vthis is, no doubt, due to better methods of ascertainment, e.g. by Mass Miniature Radiography. It cannot be stressed too often that tuberculosis when associated with a serious degree of overcrowding and the presence of susceptible children, is a hazard which must constantly be borne in mind. During 1956, a small outbreak of paratyphoid B infection was experienced in the Borough of Bexley, two cases occurring also in this Borough and four cases in the Urban District of Crayford. The outbreak was considered to have been due to Chinese frozen liquid egg used in a bakery. Cancer of the lung, which has attracted much attention in recent years because of its apparent association, inter alia, with smoking, caused 17 deaths in the Borough in 1956 compared with 18 in 1955. There is no cause, here, for complacency as statistics show that, taking the country as a whole, the mortality from this disease continues to rise. In my1 1955 Report I stated that, " In the circumstances it seems reasonable to advise young people not to take up smoking and, in the case of heavy smokers of middle age, to say that published data indicate that there may be some diminution in risk to those who give up smoking after many years of addiction." I think this is a warning which deserves to be repeated in view of the evidence, on good authority, that smoking among late schoolagers in many parts of the country is by no means inconsiderable. With the passing of the Clean Air Act, 1956, the preyention of atmospheric pollution received its main legislative impetus, although one should not minimise the long term nature of the project which the Act envisages and the difficult technical problems which are involved. Locally, of course, the main emphasis will no doubt be on the establishment and gradual expansion of smoke Control areas and the need to work in close collaboration with neighbouring authorities. The industrial nature of Erith raises the Problem of preventing air pollution from factory premises but it wi'l also be recalled that about 50 per cent of atmosoheric pollution results from the domestic hearth and much foresight wi'l be 6 called for in the installation, in housing estates, of heating appliances capable of burning smokeless fuels. The availability of the latter is an important aspect which is, no doubt, receiving the attention both of the Government and the various agencies concerned with their production. The implementation of the Clean Air Act also raises problems of staffing and it has not yet been decided whether the public health inspectors will be called upon to undertake, not only the considerable task of detection of smoke nuisances (which they already exercise as a Public Health Act function), but also the function of examining and reporting upon existing heating appliances in the home and advising on the types of installations by which they should be replaced. The problem of health education of the public in connection with the declaration of smokeless zones is another matter which introduces the problem of staffing, and, indeed, this applies to health education in general. In my 1954 report I stated that " A good case could be made for the appointment of a Health Education Officer to serve the Borough or such wider area as appeared to be indicated," and I am becoming more than ever convinced that such a development may be necessary. A comprehensive policy of health education is a fairly costly matter and one of the main difficulties is the fact that health education is regarded in governmental circles as a matter for the Local Health Authority (The Kent County Council) under Section 28 of the National Health Serice Act, 1946 dealing with Prevention of Illness Care and After Care, and it is often forgotten that county districts also have a responsibility for this matter under Section 179 of the Public Health Act of 1936. This dichotomy of function is a real stumbling block from the point of view of instituting a full programme of health education in the Borough. The need to disseminate accurate information on personal hygiene, on the prevention of accidents in the home and on the principles of healthy living in general, as well as on the nature and meaning of health, is becoming one of the most important aspects of health administration. This is dictated, not only by the needs of the individual, but by the need, also, for economy in the use of the National Health Service, the cost of which has been rising from year to year. Among the environmental problems which remain. the most important is, undoubtedly, the lack of adequate housing, particularly for young married couples and for the aged, and this in spite of great strides which have been made in recenyears by the housing authority. I wish to acknowledge tne sympathetic treatment by the Council of many tuberculous families who have been rehoused during the year in the interests of the prevention of spread of this disease. 7 The work of the Bexley, Erith and Crayford Home Safety Committee continued with the task of spreading information in regard to causes and prevention of accidents in the home. The Rotary Club of Bexley, during the year, presented an exhibition stand to this Committee which is being used to disseminate propaganda in the form of leaflets and posters over the area. The stand was made by the Staff and boys of the Westwood County Secondary School and our thanks are due both to the Rotary Club and the School for their help. The future of the health services in the Borough is, clearly linked up with the three recent White Papers dealing with the reorganisation of Local Government, particularly with the White Paper of May, 1957. on Functions of County Councils and County District Councils in England and Wales. While the population of Erith is somewhat below the figure of 60,000 required for automatic delegation, the past record of the Borough in regard to the administration of health services (including the school health service) is such that it is reasonable to suppose that an application for delegation might well be successful. There can be little doubt that the type of delegation foreshadowed in the White Paper would provide a more truly local service for the inhabitants of the Borough without loss of efficiency and there is reason to believe that economies in administration would allow the services to be carried on without increased cost. I have, previously, drawn attention to the fact that the Council has made representations to the Minister of Agriculture Fisheries and Food that Local Authorities should be permitted to make charges for meat inspection. This is an important matter in view of the fact that Erith has two private slaughterhouses which lay a heavy burden of responsibility for meat inspection on the Public Health Inspectors. I am happy to record that in accordance with Circular FSH. 2/57 the Ministry have now approved a scheme for the reimbursement of authorities like Erith who have the supervision of slaughterhouses providing meat, not only for local consumption but for many areas outside the Borough boundaries, which will ensure that at least part of the cost of meat inspection will be refunded. In conclusion I wish to thank the Chairman and Memersof the Health Committee for their support and encouragement, and the Chief Public Health Inspector. Chief Clerk and all members of the Health Department for their excellent service during the year. I am, Your obedient servant. JOHN LANDON, Medical Officer of Health. 8 Annual Report 1956 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. The shopping facilities are advantageously situated having regard to the disposition of the six wards in the Borough, and there is a copious supply of pure water which is provided and maintained by the Metropolitan Water Board. The chief industries are light engineering, edible oil refining, manufacture of chemicals, coal shipping and lighterage, and the production of building materials e g stoneware drain pipes and asbestos components. Manufacture of television and radio equipment, and toys, are also well established industries. Industrial expansion has continued throughout the year, and the site of the new Belvedere Power Station is being fully developed. At the eastern end of the river, the construction of the new jetty at the coal discharging wharf proceeds, and the replacement of the existing coal screening plant is under review. During the year, a new public convenience for men and women was erected at Colyers Lane, the commissioning being a joint project of the Erith Borough Council and that of the Urban District of Crayford. The erection of a biscuit warehouse of some 20.000 sq. feet floor area on Belvedere Marshes was completed in February. The ancillary depot garages a fleet of 30 delivery vans by which the whole of the London area is served. The proposed new Retired Seamen's Home of the Roy3' Alfred Merchant Seamens Society is at blue print stage Accommodation will provide for 80 retired merchant seamen who at present occupy an old house. As the four storey blocK 9 to be erected is approximately on a north/south axis, all cabins will enjoy a period of sunshine. The upper floors will have extensive views over the Thames Estuary. A (2) Comparative Rainfall 1955 1956 Month. Inches. Month. Inches. January 3.15 January 3.09 February 1.68 February .42 March 0.95 March 1.08 April 0.24 April 1.55 May 3.91 May .73 June 1.36 June 1.57 July . 0.09 July 5.45 August 0.90 August 3.09 September 2.86 September 2.04 October 3.71 October 1.39 November . 0.55 November .62 December 1.68 December 2.45 Total 21.08 23.48 During the heavy rainfalls occasioned by thunderstorms during July, surface water sewers became surcharged and there was flooding in some thoroughfares. Some ground floors of houses in the low lying districts were inundated. 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 1941—1956. Month and Year Males Females Total 18 and over Under 18 18 and over Under 18 December, 1941 39 17 44 17 117 December, 1942 38 1 39 5 83 December, 1943 27 1 6 5 39 December, 1944 31 — 0 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 December, 1954 52 3 74 10 139 December, 1955 38 — 43 — 81 December, 1956 53 — 41 — 94 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—46,010. Density of population, i.e. No. of persons per acre (Based on (ii) above):—11.9. No. of inhabited houses at 31st December, 1956:— (Excluding houses with shops and houses with Public Houses assessed as single hereditaments)—13,075. Rateable value at 31st December, 1956:— £725,940. Sum produced by a penny rate, 1956:— (Estimated product for 1956/57):—£2,981. Rate in the £ at 31st December, 1956:—16s. 9d. 11 EXTRACTS FROM VITAL STATISTICS FOR YEAR 1956. A (4)b Births Male Female Total Live Births Legitimate 305 321 626 Illegitimate 13 9 22 318 330 648 Live Birth rate per 1,000 Home Population (Registrar General's Figure). 14.08. Birth rate corrected for comparison with other areas:— 14.08. ^Comparability factor supplied by Registrar General:— Live birth rate, England and Wales:—15.6. Corresponding rate for the Borough of Erith for year 1955: 13.86. Male Female Total Still Births Legitimate 5 4 9 Illegitimate 1 — 1 6 4 10 Still Birth rate per 1,000 total births:—15.20. Still Birth rate per 1,000 total births, England and Wales:—23.0. Still Birth rate per 1,000 Home population:—0.22. Still Birth rate per 1,000 Home population, England and Wales:—0.37. A (4)c Deaths Male:— 261 Female:— 203 Total:— 464. Death rate per 1,000 Home population:— 10.08. Death rate corrected for comparison with other areas:— 11.79 Comparability Factor supplied by Registrar General — 1.17 Corresponding rate 1955:— 9.58. Death rate per 1,000 Home population, England and Wales:—11.7. Number of women dying in, or in consequence of, child- birth:- Nil Maternal Mortality Rate per 1,000 total births:— Nil. Comparative figure for England and Wales:— 0.56. 12 A (4)d Infant Mortality Deaths of infants under 1 year of age: — Male Female Total Legitimate 6 — 6 Illegitimate — 2 2 6 2 8 Death rate of infants under 1 year of age per 1,000 live births:—12.35. Death rate of infants under 1 year of age per 1,000 live births, England and Wales:—23.8. Deaths of infants under 4 weeks of age:— Male Female Total Legitimate 5 — 5 Illegitimate — — — 5 — 5 Death rate of infants under 4 weeks of age per 1,000 live births:—7.72. Death rate of infants under 4 weeks of age per 1,000 live births, England and Wales:—16.9. Total Number of deaths from:— 1956 1955 Measles (All ages) — Whooping Cough — — 13 A (4)e Summary of Vital Statistics for the year 1956. England and Wales Borough of Erith Births: — Rates per 1,000 Home Population Live births 15.6 14.08 Still births 0.37 0.22 23.0(a) 15.20(a) Deaths:— All causes 11.7 10.08 Typhoid and Paratyphoid 0.00 — Whooping Cough 0.00 — Diphtheria 0.00 — Tuberculosis 0.12 0.09 Influenza 0.06 0.04 Smallpox — — Acute Poliomyelitis (including Polio-encephalitis) 0.00 Pneumonia 0.52 0.46 Notifications: — (Corrected) Typhoid Fever 0.00 — Paratyphoid Fever 0.01 0.04 Meningococcal Infection 0.03 0.02 Scarlet Fever 0.74 0.57 Whooping Cough 2.07 2.61 Diphtheria 0.00 — Erysipelas 0.10 0.07 Smallpox — Measles 3.59 0.57 Pneumonia 0.57 0.46 Acute Poliomyelitis (including Polio-encephalitis) Paralytic 0.04 0.02 Non-Paralytic 0.03 0.07 Food Poisoning 0.25 0.02 Puerperal Pyrexia 16.31(a) Deaths:— Rates per 1,000 live births All causes under 1 year of age 23.8(b) 12.35 Enteritis and diarrhoea under 2 years of age 0.51 — (a) Per 1,000 Total (Live and Still) Births. (b) Per 1,000 Related Live Births. 14 A (4)f Vital Statistics of Whole District—1947—1956. 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 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 19 23.9 (Corrected) 10.75 1950 46,850 701 14.96 478 10.2 14 20.0 (Corrected) (Corrected) 14.21 11.0 1951 46,010 690 15.00 533 11.6 24 34.8 (Corrected) (Corrected) 14.25 12.4 1952 46,070 683 14.83 500 10.85 20 29.3 (Corrected) (Corrected) 14.09 11.6 1953 45,860 671 14.63 499 10.88 22 32.79 (Corrected) (Corrected) 14.63 11.86 1954 45,950 621 13.51 455 9.9 12 19.32 (Corrected) (Corrected) 13.51 10.79 1955 45,950 637 13.86 440 9.58 13 20.41 (Corrected) (Corrected) 13.86 10.44 1956 46,010 648 14.08 464 10.08 8 12.35 (Corrected) (Corrected) 14.08 11.79 15 A (4)g Table showing Summary of Causes of Death during the year ended 31st December, 1956. Cause of Death Males Females Total 1 Tuberculosis, Respiratory 4 — 4 2 Tuberculosis, Other forms - - 1 3 Syphilitic diseases 1 - - 4 Diphtheria — - - 5 Whooping Cough — - - 6 Meningococcal Infections — - - 7 Acute Poliomyelitis - - - 8 Measles — - - 9 Other infective and parasitic 1 - 1 diseases 10 Malignant neoplasm, stomach 8 7 15 11 Malignant neoplasm, lung, bronchus 14 3 17 12 Malignant neoplasm, breast — 8 8 13 Malignant neoplasm, uterus — 4 4 14 Other malignant and lymphatic neoplasms 22 26 48 15 Leukaemia, Aleukaemia 2 1 3 16 Diabetes 1 5 6 17 Vascular lesions of nervous system 39 19 58 18 Coronary disease angina 41 18 59 19 Hypertension with heart disease 6 5 11 20 Other heart diseases 36 46 82 21 Other crirculatory disease 14 9 23 22 Influenza 1 1 2 23 Pneumonia 10 11 21 24 Bronchitis 26 11 37 25 Other diseases of respiratory system - — - 26 Ulcer of stomach and duodenum 8 2 10 27 Gastritis, enteritis and diarrhoea — 2 2 Nephritis and Nephrosis — 1 1 Hyperplasia of prostate 5 - 5 30 Pregnancy, Childbirth and abortion - - - 31 Congenital Malformations — - — Other defined and ill-defined diseases 16 20 36 33 Motor vehicle accidents 1 — 1 34 All other accidents 4 — 4 35 Suicide 1 4 5 36 Homicide and operations of war - - - Total all causes 261 203 464 16 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 Atelectasis 1 1 Prematurity 3 1 1 5 Subarachnoid haemorrhage 1 1 Suppurative meningitis 1 1 Totals ... 3 2 2 1 8 Of the 8 infant deaths, 7 died in hospital and 1 died in its own home. Coroner's Postmortem examination was carried out in 1 case. No inquests were held. 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 1946-56. 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 1954 12 19.32 25.5 1955 20 20.41 24.9 1956 8 12.35 23.8 A (4)i Comparison of Maternal Mortality Rates Year Maternal Deaths Live Births Still Births Maternal Mor ality Rate per 1,000 total Births 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 I 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 - 1954 — 621 19 - 1955 — 637 15 - 1956 — 648 10 - 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 21 5 - Acute - - litis (Paralytic) 1 1 — (Non-Paralytic) 3 3 — Dysentery 3 1 — Erysipelas 3 1 — Food Poisoning 1 1 — Measles 26 — — Meningococcal Infection 1 1 — Paratyphoid Fever 2 2 — Scarlet Fever 26 2 — Whooping Cough 120 — — Total 207 17 — 19 B (l)a Age Distribution The following table shows the age distribution of confirmed cases of Infectious Disease notified during the year Under 1 year Age Groups Totals Disease 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 - - - 1 - - 1 - - - 2 - 2 1 6 1 4 3 - - 21 Acute Poliomyelitis (Paralvtic). - - - - - - 1 - - - - - - - - - - - - - 1 Acute Poliomyelitis (Non-Paralytic) 1 - - - - - - - 1 - - 1 - - - - - - - - 3 Dysentery - - - 1 - - - - - - 1 - - - 1 - - - - 3 Erysipelas — — — — — — — — — — - — 1 1 - 1 — — — — 3 Food poisoning - - - - - - - - - - - - - - - - - - - - 1 Measles - 9 - 4 9 2 8 5 1 - 1 1 - - - - - - - - 26 Meningococcal Infection - - - - - 1 - - - - - - - - - - - - - - 1 Paratyphoid - - - - - - 1 - - - - 1 - - - - - - - - 2 Scarlet Fever — - 1 — 1 3 9 5 4 1 — 1 1 - - - - - - - 20 Whooping Cough 6 4 12 17 12 22 22 20 4 - - - 1 - - - - - - - 120 Totals 7 6 13 22 16 28 42 30 10 1 3 5 5 2 6 4 4 3 — — 207 20 B 1(b) WARD DISTRIBUTION Number of cases of Infectious Disease confirmed in each ward in the Borough. Disease Ward Total Town Old Church Belvedere N'th Heath Abbey Wood Bostall Acute Pneumonia - 8 5 2 2 4 21 Acute Poliomyelitis (Paralytic) - 1 — — — — 1 Acute Poliomyelitis (Non-paralytic) - - 1 - 2 - 3 Dysentery 1 - — 1 — 1 3 Erysipelas — 1 — 1 — 1 3 Food Poisoning 1 — — — — 1 Measles 1 — 17 1 6 1 26 Meningococcal Infection — — 1 — — — 1 Paratyphoid 1 — — — — 1 2 Scarlet Fever 4 13 1 2 3 3 26 Tuberculosis (Respiratory) 14 14 11 7 7 11 64 Tuberculosis (Non-Respiratory) — — 1 1 — 2 4 Whooping Cough 23 12 39 19 19 8 120 T otals 45 49 76 34 39 32 275 21 B (2) Tuberculosis B (2) a. New Cases notified for the first time during 1956 Age Respiratorv Non -Respiratory Total M F M F 0— - - - - - 1— - - - - - 5— 1 - — — 1 10— 1 1 — — 2 15— 3 4 1 — 8 20— 1 3 — — 4 25— 5 4 — 1 10 35— 8 5 1 1 15 45— 7 3 — — 10 55— 8 4 — — 12 65 & over 5 1 — — 6 Totals 39 25 2 2 68 In addition to the above cases 6 males and 5 females suffering from respiratory tuberculosis and 1 male and 2 females suffering from non-respiratory tuberculosis were transferred into the district from other areas. One male and two females (respiratory) were transferred back into the district, and 3 males and 2 females (respiratory) and 1 male (non-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 M F Total M F Total M F Total 4 — 4 - - - 4 - 4 22 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, 1956, and are given below. 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 1956 Year of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations Year of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations 1956 Under 1 year of age 61 — 19511947 5—9 years of age 66 922 1955 1 year of age 318 — 1946— 1942 10—14 years of age 9 224 1954 2 years of age 73 — - - - 1953 3 years of age 11 2 - - - 1952 4 years of age 12 26 - - - Total 475 28 - 75 1146 23 Table B:—Number of children resident in the Borough of Erith under the age of 15 years on 31st December, 1956, who had completed a course of Immunisation at any time since 1st January, 1942. 0 - 4 years 5-14 years Year of Birth Number considered to be immunised Year of Birth Number considered to be immunised 1956 61 1951 520 1955 329 1950 593 1954 375 1949 720 1953 434 1948 615 1952 500 1947 729 1946 645 1945 553 1944 559 1943 535 1942 558 Total 1,699 Total 6,027 B (4) Vaccination Against Smallpox Age at 31st December, 1956 Under 1 year 1—4 years 5—14 years 15 or over Total Number vaccinated 219 183 9 22 433 Number re-vaccinated — 9 10 46 65 24 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 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. J. B King, District Officer, Kent County Council, County District Offices. Queen Street, Erith, telephone Erith 4747/8, or the Ambulance Station, Town Hall, Erith, telephone Erith 3603. C (6) School Clinics Hainault, Lesney Park Road. Minor Ailments, Refraction, Dental. Bedonwell Hill. Minor Ailments, Dental, Orthopaedic * St. Augustine's Hall. 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. 25 C (7) Maternity and Child Welfare Centres Hainault, Lesney Park Road. Ante-Natal Sessions:— Mondays 9 a.m.—11 a.m. Wednesdays 9 a.m.—11 a.m. Child Welfare Sessions:— Mondays 1.30 p.m.—4 p.m. Thursdays 1.30 p.m.—4 p.m. Belvedere Public Hall. Child Welfare Sessions:— Tuesdays 2.0 p.m.—4 p.m. Thursdays 2.0 p.m.—4 p.m. St. Augustine's Hall. Ante-Natal Sessions:— Wednesdays 10 a.m.—12 noon. Fridays 9 a.m.—11.30 a.m. 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.—11.30 a.m. Ante-Natal Exercises:— Wednesdays 9.30 a.m. (by appointment). Child Welfare Sessions:— Tuesdays 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. Ormonde 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, Preston Hall, British Legion Village, Maidstone, Kent. 26 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 139 bodies, and post-mortem examinations were carried out in 138 cases. 20 inquests were held. 47 bodies were from the Erith area, and post-mortem examinations were carried out in 46 cases. There were 8 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 Erith Old People's Welfare Committee continued its work throughout the year and much was accomplished in the way of visiting and the provision of good neighbourly services. The holiday scheme continued. A dinner and entertainment was arranged for 40 pensioners who were alone for Christmas. The Committee is proceeding with plans for providing housing accommodation for lone old people. C (14) National Assistance Act, 1948, Section 50 (Burials) During the year under review it was necessary for the Council to carry out two burials under the provisions of the above Act. Case No. 1. Deceased, a Lithuanian, was 45 years of age. had no known relatives, and died in the premises in which he lodged. Case No. 2. Deceased was a male, aged 82, who died in his home. He was a widower, and although relatives were traced they were unable to bear the cost of burial. 27 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 16,800 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 12 3½ Cost per ton of disposing of refuse 16 9 Nett cost per 1,000 population per annum 461 6 8 The following tables show: — 1Details of the refuse collection vehicles and staff2 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 „ „ J S. & D. Freighter 12 „ „ 1 Scammel Lorry 5 „ „ 1 Morris Utility Van 5 cwts. 6 Trailers They are operated by:— 1 Foreman " Driver Loaders 9 Loaders and Sorters 28 D (l)c Table 2 Month Tonnage Tons Cwts. January, 1956 867 6 February, 1956 762 10 March, 1956 773 15 April, 1956 749 6 May, 1956 708 10 June, 1956 625 5 July, 1956 618 7 August, 1956 641 4 September, 1956 617 10 October, 1956 783 18 November, 1956 795 4 December, 1956 722 4 Total 8,664 19 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 Service in 1956 produced a revenue of £719 Is. 2d. D (3) Salvage Tonnage collected: Income: T. C. Q. Lbs. £ s. d. 1,201 5 2 23 7,557 9 2 29 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. 24 hours—day and night West Street, Erith, Male and Female. 6 30 a.m.—11.0 p.m. Station Road, Belvedere, Male and Female. 24 hours—day and night Heron Hill, Belvedere, Male 24 hours—day and night Woolwich Road, Belvedere, Female 6.30 a.m.—11.0 p.m. High Street, Erith, Male and Female 6.40 a.m.—11.0 p m. *Colyers Lane, Northumberland Heath, Male and Female. 24 hours—day and night. *The Colyers Lane Male and Female Conveniences were opened on 31st July, 1956 and are jointly owned by the Crayford Urban District Council and Erith Borough Council, but are maintained and staffed entirely by Erith Borough Council 1 am indebted to the Chief Public Health Inspector for the following information: — D (5) Sanitary Inspection of the Area D (5)a Visits by Public Health Inspectors The total number of visits was 9,615 Notices served: Formal 28: Informal 227: 255 Complaints received and investigated 1,221 Number of disinfections 75 30 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 35 51 6 6 Bakehouses 9 21 3 3 Dairies 5 19 2 2 Butchers' shops 33 171 9 9 Fish friers 12 38 5 5 Slaughterhouses 2 520 4 4 Factories 150 96 18 18 Outworkers 60 60 Food factories 4 10 2 2 Pet shops 5 13 1 1 Rag flock dealers 2 7 1 1 D (5)c Summary of Nuisances abated and defects remedied during the year Drains repaired 18 New vent shafts 6 Dampness remedied 77 Floors repaired 22 Plasters repaired 45 Eaves gutters repaired 36 Firegrates renewed 14 Windows made to open 47 Roofs made watertight 66 Yard pavings repaired 4 New W.C. pans 20 New sinks 36 Sink waste pipes repaired 38 W.C. cisterns repaired 15 Water supply provided Dustbins provided 35 New W.Cs. provided Miscellaneous 52 D (5)d Drainage, Closet accommodation and Cesspools The water carriage system has been practically universal in the Borough for many years, and sewerage is disposed <« at the outfall vested in the West Kent Sewerage Board. Corporation sewers have been extended to take the drainage of recently developed housing estates. Of cesspools, 19 are known to exist, and these are subject to cleansing service maintained in accordance with the resolution of the Council dated 10th March, 1942. During the year two cesspools have been abandoned, and the drains connected to Corporation sewers. 31 D (5)e Atmospheric Pollution Results of Analysis (a) The Erith Borough Council is represented on the Thameside Advisory Committee for the Abatement of Atmospheric Pollution. In this connection a deposit gauge and a lead peroxide gauge is in position at the grounds of the Royal Alfred Institution, and the analysis of the contents of these gauges for 1956 is as follows: Month Rain in inches Insoluble deposit Tons per sq. mile Soluble deposit Tons per sq mile Total Solids Tons per sq. mile Calcium Tons per sq. mile Sulphur mg/100 sq cms/day January. 2.81 7.40 7.60 15.0 1.73 3.56 February .............Gauge disturbed -No analysis ............. 3.28 March 1.02 14.73 15.97 30.70 3.47 2.00 April 1.27 13.85 11.41 25.26 2.50 1.68 May June 0.52 9.25 5.50 14.75 0.97 1.40 2.07 9.38 4.34 13.72 0.60 1.00 July ............. Gauge broken —No analysis 12.20 7.87 20.07 ............. 0.93 August September 4.08 1.20 0.77 2.07 7.70 9.46 17.16 2.01 0.88 October November 1.11 9.13 8.05 17.18 1.58 2.15 0.63 10.52 7.58 18.10 1.34 3.48 December 2.32 11.61 8.05 19.66 1.28 2.23 0>) The smog of January 1956. During the fog which covered many parts of the country between 4th and 7th January, measurements of air pollution were organised by the Fuel Research Station of D.S.I.R. in L«ndon, and also in Birmingham, Manchester, Leeds, Salford, and Sheffield. The concentration of various pollutants varied considerably from hour to hour and from point tc point due to fluctuations in meteorological conditions and amounts of emission from Chimneys in the areas. The concentrations of smoke and sulphur ranged from very small Mounts to two or three times the overall average figures 'nr the period of the smog. In the London area, the smoke c°ntent of the atmosphere averaged about 90 per cent, and ttle sulphur dioxide content about 70 per cent of those horded during the great smog of 1952, or three or four the normal for that time of the year. In addition to the f'Wer degree of pollution, the smog was of considerably porter duration than that of 1952. It was duly recorded 'jat the average amounts of smoke and sulphur dioxide in llle air of the other towns were similar to those in London. 32 D (5)f Smoke Abatement During the year, many visits have been made at the boiler-houses in the various factories with a view of reducing smoke output to the minimum. In one instance an F.R.S. smoke eliminator door has been installed whilst in another, a Pratt Daniel water sprayed dust arrester has been overhauled. In the latter case, a marked improvement has been effected at the foundry in question. The Clean Air Act received Royal Assent on 5th July 1956. D (5)g Swimming Baths and Pools (.1) The Council's open air bath is situated in Stonewood Road and comprises one pool of 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 bath is a mechanical laundry which launders on behalf of various undertakings in the locality and which include the Corporation's Catering Dept., Works Dept., the County Health and Education Depts., and the Hainault Maternity Home. During the year, 76,892 articles were dealt with. Attendances at the Swimming Baths for 1956. Swimming pool Slipper baths Schools: During term 10,990 Schools: During holidays 1,623 Youth Clubs 6,860 Total 19,473 Total 16,604 1955 21,933 1955 15,785 (2) A childrens' paddling pool of 60,000 gallons capacity is situated within the Belvedere recreation ground at Woolwich Road, and this is a popular rendezvous during the summer months. The pool is regularly emptied and cleansed during the period it is in use and is methodically dosed with chloros. A successful model power boat regatta sponsored by a local model engineering society was held at this site in May. 33 D (5)h Offensive Trades Other than 12 fish frying establishments, there are no scheduled offensive trades under Section 107 of the Public Health Act 1936. Fish frying was declared to be an offensive trade on the 17th March 1939, and bye-laws were made accordingly. All the businesses are well conducted and the frying apparatus is of modern and approved pattern. D (5)i 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 Dremises 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 Act provides for the inspection of premises and the sampling of rag flock. In this regard, several visits were made, and two samples were submitted to the Prescribed Analyst, with satisfactory results. D (5)j Pet Animals Act 1951 This Act contains welfare provisions with a view to securing humane conditions at premises where pet animals are sold. Of this type of shop, 5 now exist, 2 being discontinued during the year. The five licensed premises are well conducted, and one complaint regarding the tethering of puppies was unconfirmed. All the premises have been visited by an officer of the R S.P.C.A. during the year. D (5)k Camping Sites There are no summer camping sites within the Borough. At the end of the year, no licences were operative under Section 269, Public Health Act 1956. The area has been free from indiscriminate caravan squatters during the year. D (5)1 Hop pickers There are no hop fields in the district. D (5)m Rodent control Two full time operatives are employed on rodent control in accordance with the provisions of Circular N.S.I9. During the year, the district has been free from any major infestation, but many complaints were received from industrial and private sources, each of which was visited, treated where necessary and an appropriate charge made for 34 In accordance with the established practice, maintenance treatments were carried out on Corporation sewers during March and September. The Prevention of Damage by Pests (Application to Shipping) Order 1951 applies to the many wharfs, jetties, and dry docks in the Borough and by way of implementation, the following visits and inspections were made:— Coastwise vessels 27 Barges 81 Tugs 31 Dredgers 1 Repair vessels 2 Total 142 No marine infestations were located. D (5)n Pest control—General sanitation (a) During the year, many requests were received to deal with infestations by wasps, beetles, bees, silverfish, ants, etc., and each complaint received individual attention. The necessary destruction was carried out at a charge inclusive of cost of insecticides and apportionment charge of the operative's time. The income arising from this service amounted to £35 7s. Od. (b) A suspected Colorado Beetle which was submitted for identification was found to be a Summer Chafer. (c) In the early part of of the summer, it was found that a huge quantity of sewerage screenings was being deposited by the L.C.C. on land leased by that Authority and situated on the Belvedere Marsh. Prompt pest control action at this site prevented what could easily have been a considerable nuisance, and as a result of statutory action, the practice of dumping sewerage screenings in the Erith Borough area was discontinued. After incineration, the residual deposits were removed and dug into the land, and this site some 4,200 square yards in size is now free from offensive accumulations. D (5)o Eradication of Bed Bugs Vermin infestations continue to decrease and the number of dwelling houses treated during the year was as follows:— Privately owned houses 9 Corporation houses 1 With a view to obtaining good control, occupiers are encouraged to reveal any infestation, when every assistance is given to cope with the menace of infestation. 35 D (5)p Heating Appliances (Fireguards) Act 1952 and Regulations 1953 These Regulations have been in force since 1st October 1954, and it is now found that most fitments sold in shops are guaranteed to comply with the requirements of the regulations. During the year, many visits were made to retailers premises and the probe test was applied to 106 heating appliances. All were found to be satisfactory. Special attention is devoted to heating fitments and appliances which are sold in second-hand furniture shops. D (5)q Mosquito Control The erection of dwellinghouses in the Belvedere Marsh area together with further industrial expansion in the ditchintersected lowland necessitated keeping the marshland under constant review. In this regard many of the watercourses were treated with larvicide, and a good control was maintained. D (6) Shops Act 1950 (a) Requirements regarding statutory closing hours were generally complied with by shop-keepers during the year, and no action was necessary in the Magistrates' Court. In one instance however, it was found that a shop-keeper persistently closed his shop at 1 p.m. on Tuesdays instead of Thursdays. Implementation of the statute effected the requisite reversion. The local County bird show was held on a Saturday and not on Sunday as formerly, in which case it was not necessary to implement sections 47, 58 and fifth schedule which refers to the sale of merchandise. (b) Improvements in connection with the health and comfort provisions were as follows:— Heating facilities provided 2 Washing facilities 3 Closet accommodation 5 Seats provided 6 D (7) Sanitary Accommodation at Offices In accordance with the requirements of Section 46 of the Public Health Act 1936, all new offices provided in the developing industrial area were provided with suitable and sufficient closet accommodation. Various improvements have been effected at existing factory office premises. 36 D (8) Street Trading The established street trading which was so prevalent a few years ago has now practically ceased to exist, and only two stalls of the mobile type are sited in the shopping area. No nuisances have been detected at this source. D (9) River Thames—Effluvia Effluvia from this source were not so discernible during the summer months, probably due to the abnormal rainfall and low atmospheric temperatures which prevailed. In June it was announced that the London County Council were to construct sewage treatment works as an extension to the Southern Outfall at Crossness, Erith. The new project is said to be capable of treating to an adequate standard, the whole of the flow from that part of London County which lies to the south of the River Thames, and has a population of about 1,600,000. The existing tanks and some of the more modern pumping plant will continue to deal with storm water when the new works have been completed. Sewage is now delivered to the outfall works by two low level sewers and one high level sewer, each of 11 feet 6 inches diameter. These are not sufficiently high for sewage to gravitate through the treatment works to the Thames at all states of the tide, and a new electric sewage pumping station will therefore be installed. Before pumping, the whole of the flow arriving at the works will be screened by six low level and four high level mechanical screens. The detritus will be extracted by dredger pump and used for reclamation of low lying marsh land. The 16 primary sedimentation tanks, capable of treating up to twice the average dry weather flow, will be of the rectangular type, arranged for de-sludging by travelling scraper, followed by surface aeration units incorporating the latest modifications in machinery and fed so as to permit stepped aeration and re-aeration of activated sludge. They will discharge to 32 circular final sedimentation tanks of 113 feet diameter provided with sludging mechanisms. The sedimentation and aeration units will be divided into two groups of separate plants capable of individual operation: between will be a general sludge pumping station for dealing with raw and activated sludge, and incorporating the main control room. The 16,-80 feet diameter primary digestion tanks will each have a floating gasholder roof and a heating and circulating unit and there will be 8 circular secondary digestion tanks of 120 feet diameter. The sludge will be cooled before secondary digestion to save heat and facilitate de-watering, and after digestion it will be gravitated to sludge ships for 37 disposal at sea. It is estimated that 1¼ million cubic feet of gas per day will be produced by the digestion process and utilized for production of power for use at the works. In addition there will be a reclamation scheme for the improvement of the river front, and new offices, scientific laboratories and other buildings, the estimated cost of the whole scheme being £9,750,000. Work is expected to be completed in seven years' time. In November, at the Public Works and Municipal Services Congress, it was estimated that of 22 sewage works, effluents from which discharge direct into the Thames Estuary, the major source of pollution was attributed to the effluent from the Northern Outfall of the L.C.C. at Barking, Essex. Until 1955 (when the first part of a very large scheme of extensions was put into operation), for many years, the daily discharge from these works was 1,50 million gallons of settled sewage, as well as 40 million gallons of effluent from an activated sludge plant. In the Erith area two miles to the east and downstream, a further 100 million gallons of settled sludge enters daily from the L.C.C. Southern Outfall. From 1949 to 1954. the average B.O.D. of the final mixed effluent from the Northern Outfall has been calculated to be 240 parts per million, and the effluent from Southern Outfall 184 p.p.m. During the same period the estimated B.O.D. load from these two sources was 290 tons per day of which three quarters came from the Northern Outfall. The calculations presented above, demonstrate to the full, the magnitude of the problem relative to the cleansing of the River Thames in the Erith area. D (10) Factories (1) Inspections for the purpose of provisions as to health are detailed below: — Premises Number of Inspections Written Notices Owners Prosecuted 150 Factories on Register 96 10 - 6 Other premises under the Act including building and engineering construction but not including outworkers. 8 2 - 156 104 12 — 38 (2) Defects found: — Particulars Number of defects Found Remedied Referred to H.M.F.I. Prosecutions Want of cleanliness 2 2 - - Inadequate ventilation 2 2 - - Sanitary conveniences: Insufficient 6 6 - — Unsuitable 6 6 - — Other offences against the Act (not including offences relating to outworkers) 2 2 - - Total 18 18 — - 39 D (11) Housing Houses in clearance areas and unfit houses elsewhere. D(ll)a. Houses demolished. Houses demolished Displaced during year. Persons Families In Clearance Areas. (Housing Act 1936 and Housing Repairs and Rents Act, 1954) (1) Houses unfit for human habitation - - - (2) Houses included by reason of bad arrangements etc. - — — (3) Houses on land acquired under Section 27, Housing Act 1936 - — — Not in Clearance Areas. (4) As a result of formal or informal procedure under Section 11, Housing Act 1936 Formal 34 127 34 Informal 7 33 13 D(1 l)b. Unfit houses closed. Number (5) Under Section 11 Housing Act 1936 and Sections 10 (1) and 11 (2) Local Govt. (Misc. Prov.) Act 1953 - - - (6) Under Sections 3 (1) and 3 (2) Housing Act 1949 - - - (7) Parts of building closed under Section 12, Housing Act 1936 - - — 40 D(11)c. Unfit houses made fit and houses in which defects were remedied. By Owner By Local Authority (8) After informal action by Local Authority 157 — (9) After formal notice under (a) P.H.As. 28 — (b) Housing Act 1936 — — (10) Under Section 5, Housing Repairs and Rents Act 1954 — — D(ll)d Housing statistics Number of permanent houses constructed in 1956:— By the Council 62 plus 54 flats By private enterprise 52 plus 0 flats Total 114 plus 54 flats Total number of permanent houses built and owned by the Council 1,288 Total number of flats built and owned by the Council 276 Total number of prefabricated temporary houses in the Borough 200 D (11 )e Housing Repairs and Rents Act 1954. Section 1 Circular 55/54 Five years slum clearance programme—Progress Report, for 1956. Representations Demolition Orders etc. made. No. of houses demolished. No. of houses in scheme. (a) Privately owned 140 36 36 4 (b) Corporation properties. 80. 27 — 27 41 Houses outside 5 years programme Representations Demolition Orders etc. made. No. of houses demolished. By formal action 1956 4 4 — By formal action (prior to 1956) — — 3 By informal action - - 7 D(12) Rent and Mortgage Interest (Restrictions) Act 1939. (a) During the year, the Chief Public Health Inspector dealt with 91 applications for assistance regarding standard rents and extortionate payments. Appended below is a summary of the improvements which were effected:— (a) Rent reduced from 30s. to 14s. 9½d. (b) Rent reduced from 15s. to 12s. (c) Rent reduced from 16s. to 14s. (d) Rent reduced from 29s. to 27s. 6d. (e) Rent reduced from 15s. to 13s. 7d. and £7 7s. 4d. returned to the tenant. (f) Rent reduced from £2 1s. 2d. to £1 9s. 8d. (g) Rent reduced from 17s. 6d. to 15s. (h) Rent reduced from 17s. 6d. to 15s. (i) Rent reduced from 28s. 6d. to 27s. 6d. (b) Several applicants were referred to the Rents Tribunal under The Furnished Houses (Rent control) Act 1946, and the Landlord and Tenant (Rent control) Act 1949, with good results. (c) Two enquirers were introduced to the Poor Man's Lawyer. (d) Three owners were instructed to provide rent books to conform with the requirements of Section 6 of the Rents Act 1938. (e) One enquiry re ownership was referred to the Marriage Guidance Council. 42 SECTION E—WATER SUPPLY—MILK—FOOD AND DRUGS ACT—FOOD INSPECTION E (1) Water supply The Borough is served throughout by the Metropolitan Water Board, the water containing some 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 bacteriological examination, with satisfactory results. The former chemical accretion in water service pipes at Coronation Court and which was characterised by green and blue discolouration in kettles due to the deposition of calcium carbonate coloured by the small admixture of copper carbonate, now appears to be wholly neutralized. The copper carbonate content was attributed to the new lead, galvanised iron, and copper service pipes, and the gradual build up of calcium carbonate in the interior of the pipes seems to have mitigated the discolouration. Samples of water at this source now produce satisfactory results. E (2) Milk supply E(2)a Food and Drugs Act 1955. Section 37. The Milk (Special Designations) (Specified areas) Order 1951. By virtue of the above Order which came into operation on 1st October, 1951, all the milk supply is specially designated. During the summer, it was found that the overlapping caps on bottles utilised by one dairy company were so faintly franked that the appropriate designation was very difficult to discern. The matter was immediately brought to the notice of the company concerned as a result of which an improvement was effected with regard to the franking of designations on caps. E 2(b) The Milk (Special Designation) (Raw Milk) Regulations, 1949 and 1954. The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953. The designations applicable to milk sold in the Borough are limited to "Pasteurised," "Sterilised." and "Tuberculin Tested." Pasteurised milk must be bottled at the premises at which it is heat treated. There are no pasteurisers and milk bottling establishments situated in the Boroug 43 E (2)c Bacteriological examination of milk The following samples of designated milk from various sources and retailed in the Borough were obtained and submitted for examination: — Pasteurised 20 Tuberculin tested (pasteurised) 7 Sterilised 3 30 All the samples satisfied the methylene blue, phosphatase, and turbidity tests. E (2)d Designated milk licences The following table indicates the number of licences issued in 1956:— Dealers licences Supplementary licences Tuberculin tested 9 Tuberculin tested 8 Sterilised 34 Sterilised 8 Pasteurised 13 Pasteurised 8 56 24 E (2)e Milk and Dairies Regulations, 1949 Dairies and milkshops The register of dairies and milk stores records the following registration figures: — No. of registered distributors 10 No. of dairies 5 No of milkshops 35 No. of producers/retailers 0 Regular inspections have been made at the above. E (2)f Ice-Cream 126 premises in the Borough are registered for the sale of ice-cream. There are 5 active manufacturers of ice-cream (2 boil mix and 3 cold mix). 10 samples were obtained and forwarded for bacteriological examination with the following results:— Grade 1 7 Grade 2 3 44 E (3) Meat and Food Inspection E (3)a Slaughterhouses Whilst the two privately owned, licenced slaughterhouses are fully adequate to satisfy consumer demands for homekilled meat in Erith, only about 5 per cent of the animals slaughtered therein is sold in the local butchers' shops. The differential proportion is disposed of to Smithfield markets, and to butchers in other districts. Slaughtering takes place daily, in the evening of at least three days, and on every Sunday. Throughout the year, the constancy of slaughtering at irregular hours has been maintained, making considerable demands on Public Health Inspectors' time. Having regard to the many other duties which Inspectors have to perform, some prescribed limitation of slaughtering hours appears to be urgently necessary. New slaughterhouse bye-laws made under section 68 of the Food and Drugs Act 1955 are dated 29th November, 1956. 45 The following table in prescribed form details the number of carcases inspected and condemned: — Carcases and offal inspected and condemned in whole or in part- Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Horses Number killed 511 119 855 1462 37363 — Number inspected 511 119 855 1462 37363 — All diseases except Tuberculosis and Cysticerci. Whole carcases condemned 1 1 3 2 58 - Carcases of which some part or organ was condemned 97 22 4 36 1678 - Percentage of the lumber inspected affected with disease other than tuberculosis and cysticerci 19.18% 19.33% 0.82% 2.60% 4.65% - Tuberculosis only. Whole carcases condemned 1 3 — — 9 — Carcases of which some part or organ was condemned 17 11 - - 194 - Percentage of the number inspected affected with Tuberculosis 3.52% 11.76% - - 0.54% - Cysticercosis. Carcases of which some part or organ was condemned - - - - - - Carcases submitted to treatment by refrigeration - - - - - - Generalised and totalby condemned - - - - - - Total weight of meat diseased and unfit 9 tons 12 cwts. qr. 13 lbs. 46 E (3)b Other Foods (1) Considerable time and attention has been devoted to the inspection of food in shops and stores, as a result of which 17 cwts, 3 qrs, and 23 lbs were confiscated as being unfit for human consumption. (2) 2,097 bags of imported ground nuts totalling 131 tons were rejected by the Port of London Health Aurthority at Surrey Commercial Docks by reason of damage by fire and water. The nuts in question were subsequently conditionally released to a warehouse in the Borough, subject to their being sorted under supervision. Resulting therefrom, 26 tons were passed for human consumption, whilst 105 tons were consigned for animal feeding and oil extraction. This procedure entailed numerous visits, and continued over a period of three months. E (3)c Disposal of Unsound Meat In accordance with the recommendations of the Ministry of Foods Circular 10/54 dated 20th June, 1954, meat rejected as unfit is safely disposed of by utilisation for trade purposes and animal feeding after being stained with naphthaline green. No departure from the approved practice has been observed. The residue of unsound food is disposed of with town's refuse. E (3)d Slaughter of Animals (Amendment) Act, 1954 Humane slaughtering of all animals in accordance with the above Statute prevails throughout the Borough. The number of slaughtermens' licences existing is 11. E(3)e Swine Fever Order 1938. Articles 2 and 14. During the year, certain piggeries and yard were declared by the Ministry of Agriculture and Fisheries to be an infected place in accordance with the above Statute. The requisite precautionary measures were taken. 47 E(4) Food and Drugs Act, 1955. Sections 2 and 91. The following samples were procured during the year and submitted to the Public Analyst for the purpose of analysis with results as follows: — Article Unsatisfactory Genuine No. of samples Milk - 24 24 Tinned cream — 1 1 Pea flower — 1 1 Currants — 1 1 Pork luncheon meat — 1 1 Meat paste — 1 1 Processed peas — 2 2 Condensed milk — 1 1 Bread loaf - 1 1 Teacake mixture — 1 1 Tapioca flakes — 1 1 Blanc mange powder — 1 1 Creamed rice — 1 1 Cornflour - 2 2 Table jelly - 3 3 Shredded beef suet - 2 2 Cheese spread - 2 2 Margarine - 3 3 Brown soup powder — 1 1 Sponge pudding mixture — 1 1 Custard Powder — 3 3 Macaroni — 1 I Oxtail soup — 1 1 self-raising flour — 1 1 Sago - 1 1 Powder glucose — 1 1 Oatmeal - 1 1 Cake mix - 1 1 Peanut butter - 1 1 Condiments - 21 21 Drugs - 7 7 Preserves - 8 8 Confectionery — 8 8 Beverages - 6 6 Fish - 6 6 Butter - 1 1 Lard — 1 1 — 120 120 The milk samples had an average fat content of 3.43%. 48 E(5) Food Hygiene. E(5)a Food and Drugs Act 1955. The Food Hygiene Regulations 1955. (1) The Regulations referred to above and made under sections 13 and 123 of the principal Act came into operation, save in so far as was otherwise expressly provided by any provision thereof, on 1st January 1956. The design of the Regulations is to strengthen the hands of local authorities in securing higher standards of food hygiene throughout the food and catering industries, and by replacing section 13 of the Food and Drugs Act 1938, add a number of new provisions in respect of hygienic handling of food and the construction and maintenance of premises, stalls, vehicles etc., where food is handled. Implementation of the Regulations necessitated every food premises in the Borough being inspected and enforcement has already produced a noticeable improvement in regard to standards aspects of both food hygiene and personal hygiene. In many instances, food premises are being structurally altered, whilst in others, complete reconstruction is taking place. Some food purveyors have discontinued the practice of selling open food, and the refrigeration of deposited foodstuffs is now becoming more the rule than the exception. No certificates of exemption under Regulation 31 have been issued during the year. (2) Number of food premises in Borough. (a) Registered under section 16 Food and Drugs Act 1955. No. of visits- Butchers (sausages and preserved foods) 33 171 Bakehouses 9 21 Fishfriers 12 Food factories 4 10 Ice-cream manufacturers 5 22 Ice-cream dealers 126 351 (b) Food premises not subject to registration. Fishmongers 13 34 Cafes 25 156 Grocers 78 191 Greengrocers and Fruiterers 40 124 Confectioners 50 92 49 (c) Premises registered under Milk and Dairies Regulations 1949-1954. Dairies 5 19 Pasteurising plants and bottling establishments 0 0 E(5)b Erith, Bexley and Crayford Clean Food Traders Guild. A total of 58 approved plaques has been issued to Erith food traders, and established educational activity has progressed. i e. posters have been displayed in factory canteens, and food kitchens at cafes. Appropriate displays were also made in the two public libraries. In addition, a clean food film of twenty minutes duration was shewn daily at an exhibition held in the town ward, and in the autumn, talks were given to each of two womens' organisations. All these sessions were sparsely attended, and there was very little evidence of a stimulated interest which propaganda of this kind is intended to promote. F (4) National Assistance Act 1948, Section 47 Sanitary conditions and the associated home circumstances of many aged persons have been kept under review, and where indicated, the necessary improvement has been effected. One case, a female, was removed to hospital under the provisions of the National Assistance (Amendment) Act, 1951. F(5) Children and Young Persons Act 1933 as amended by Education Acts 1944-1948. A boy under school leaving age was found to be employed at a shop in circumstances which appeared to be Contrary to the above statute, and the matter was referred to the appropriate department of the County Council. Compliance with the statute was subsequently effected. 50 F(6) Legal Proceedings. Statute. Offence. Penalty. Art 28. Good rule and government bye-laws 1941. (Proceedings by Metropolitan Police). Dog fouling footway. £1 Miscellaneous. Art 6. Good rule and government byelaws 1941. Noisy hawking. Warning to news vendor. F (7) Legislation in Force—Bye-laws, etc. Provision of Dustbins Erith Improvent Act 1920 Tents vans and sheds 28th Feb. 1928 Houses let-in-lodgings 27th Jan. 1930 Libraries and Museums 15th June 1934 Nursing homes 20th July 1934 Pleasure grounds 4th Feb. 1936 Fish frying 9th May 1939 House refuse 17th Oct. 1939 Erith Cemetery 25th Oct. 1939 Public baths 26th Oct. 1939 Prevention of nuisances 23rd April 1940 Good rule and government 1st Jan. 1941 Offensive trades 9th May 1939 Deposit of litter 9th Jan. 1950 Clean food 19th July 1953 Building bye-laws 7th Dec. 1953 Deposit of substances on highways 27th Oct. 1954 Slaughterhouses 29th Nov. 1956 Deposit of loose substances on highways 1st Mar. 1957