BOROUGH OF ERITH ANNUAL REPORT of the Medical Officer of Health For the year 1957 by JOHN LANDON, M.R.C.S., L.R.C.P., D.P.H. 4412(1) 1.503 2 Library ER137 BOROUGH OF ERITH ANNUAL REPORT of the Medical Officer of Health For the year 1957 by JOHN LANDON, M.R.C.S., L.R.C.P., D.P.H. ARRANGEMENT OF REPORT Section Page A Statistics and Social Conditions of the Area 1. Physical Situation and Amenities 10 2. Comparative Rainfall 11 3. Unemployment Figures and Comments 12 4. Statistics 12 (a) General 12 (b) Births, Birth Rate, Still Births, Still Birth Rates 13 (c) Deaths, Death Rate, Maternal Mortality Rate 13 (d) Infant Mortality 14 (e) Summary of Vital Statistics for year 1957 15 (f) Vital Statistics of the whole District during 1957 and previous years 16 (g) Table showing Summary of Causes of Death during 1957 17 (h) Infant Mortality—Causes of death and table of comparison 18 (i) Comparison of Maternal Mortality Rate 19 4B Prevalence of and control over Infectious and other Diseases 1. Notifications 20 (a) Age Distribution 21 (b) Ward Distribution 22 2. Tuberculosis (a) New cases notified during 1957 23 (b) Deaths 23 3. Diphtheria Immunisation 24 4. Vaccination against Smallpox 5. Vaccination against Poliomyelitis C General Provision of Health Services for the Area 1. General Hospital Facilities 26 2. Infectious Disease Hospitals 26 3. Tuberculosis Treatment and Hospital 26 Accommodation26 4. Venereal Diseases 26 5. Ambulance Service 26 6. School Clinics 26 7. Maternity and Child Welfare Centres 27 8. Maternity Home 27 9. Private Nursing Homes 27 i D Sanitary Circumstances of the Area 1. Refuse Collection and Disposal 29 (a) Costs 29 (b) Details of Refuse Collection Vehicles and staff 29 (c) Details of tonnage 30 2. Trade Refuse 30 3. Salvage 30 4. Public Conveniences 31 5. Sanitary Inspection of the Area 31 (a) Visits by Public Health Inspectors 31 (b) Premises visited and results of such visits 32 (c) Summary of Nuisances abated and defects remedied during the year 32 (d) Drainage, Closet accommodation and Cesspools 32 (e) Atmospheric Pollution 33 (f) Smoke Abatement 33 (g) Swimming Baths and Pools 34 (h) Offensive Trades 35 (i) Rag Flock and Other Filling Materials Act, 1951 35 (j) Pet Animals Act, 1951 36 (k) Camping Sites 36 (l) Hop Pickers 36 (m) Rodent Control 36 (n) Pest Control 37 (o) Eradication of Bed Bugs 38 (p) Heating Appliances (Fireguards) 38 Act 1952 and Regulations 1953 (q) Mosquito Control 38 6. Shops Act, 1950 38 7. Sanitary Accommodation at Offices 39 8. Street Trading 39 9. River Thames- Effuvia 40 10. Factories 41 (i) Inspections 41 (ii) Defects found 41 ii Section Page 10. Laboratory Facilities 27 11. Mortuary 28 12. Disinfection Services 28 13. Welfare of Old People 28 14. National Assistance Act, 1948, Section 50 (Burials) 28 Section Page 11. Housing 42 Houses in Clearance Areas and unht houses elsewhere 42 (a) Houses demolished 42 (b) Unfit houses closed 42 (c) Unfit houses made fit and houses in which defects were remedied 43 (d) Housing statistics 43 12. Rent and Mortgage Interest tions) Act, 1939 43 13. The Rent Act, 1957 44 E Water Supply—Milk—Food and Drugs Act— Food Inspection 1. Water Supply 45 2. Milk Supply 45 (a) Food and Drugs Act, 1955, Sec. 37 The Milk (Special Designations) (Specified Areas) Order, 1951 45 (b) The Milk (Special Designation) (Raw Milk) Regulations 1949 and 1954. The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949 to 1953 45 (c) Bacteriological examination of milk 45 (d) Designated milk licences 46 (e) Milk and Dairies Regulations 1949 46 (f) Ice Cream 46 3. Meat and Food Inspection 46 (a) Slaughterhouses 46 (b) Exchequer Grants towards cost of Meat Inspection 48 (c) Other Foods 48 (d) Disposal of unsound meat 48 (e) Slaughter of Animals (Amendment) Act, 195448 (f) Swine Fever Order, 1938, Articles 2 and 14 48 4. Food and Drugs Act, 1955, Sections 2 and 91 49 5. Food Hygiene 50 The Food Hygiene Regulations, 1955 50 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. (a) National Assistance Act, 1948, Sec. 47 51 (b) National Assistance Act, 1948, Sec. 50 51 5. Burial Act 1857, Sec. 25 52 6. Legal Proceedings 52 7. Legislation in Force and Bye-Laws, etc. 52 iv 2 F (1) BOROUGH OF ERITH Mayor—Councillor C. Schofield, B.A., J.P. (1956-1957). Mayor—Councillor E. C. Pringle, J.P. (1957-1958). Deputy Mayor—Councillor Mrs. H. A. Jerome, B.E.M. (1956-1957). Deputy Mayor—Councillor C. Schofield, B.A. (1957—1958). Health Committee Chairman: —Alderman Mrs. L. F. Rosser, J.P. Members of Committee May 1956—May 1957 May 1957—May 1958 Aldermen W. F. Alford W. F. Alford C. F. Morling E. Handy C. F. Morling Councillors Mrs. A. E. Bennett Mrs. A. E. Bennett Mrs. M. S. Dalton F. Crow E. Handy Mrs. J. Sidders Mrs. J. Sidders E. E. Virrels E. E. Virrels Ex-Officio Members Ex-Officio Members Alderman G. W. H. Luck G. W. H. Luck Councillors C. Schofield, B.A., J.P. E. C. Pringle, J.P. Mrs. H. A. Jerome, B.E M., C. Schofield, B.A. 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. (Resigned 10.2.57). 0. B. Dodds, Cert. S.I.E.B. (Appointed 6.5.57). C. H. Ellis, Student Public Health Inspector. K. E. Doubleday, Student Public Health Inspector. (Appointed 4.3.57). Chief Clerk J- A. Sutherland. Clerks Shorthand-typist:— Miss D. M. Williams Junior Clerk:— Miss G. P. Trenfield (Resigned 7.4.57) Miss P. M. Webster (Appointed 29.4.57) 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 1957. As in previous years, in attempting to assess the health of the Borough it is necessary to consider the vital statistics for the area. The infant mortality rate for 1957 was 18.05 per 1,000 live births, compared with 12.35 in 1956 and a rate for England and Wales of 23.1. In the past four years this rate, which is a sensitive index of social conditions, has been consistently lower than the rate for England and Wales and is a matter for satisfaction. There was one maternal death giving a maternal mortality rate of 1.47 per 1,000 total live and stillbirths. This was the first maternal death in the Borough since 1952. For the eighth year there has not been a case of diphtheria in the Borough. The standardized birth rate was 14.45 per 1,000 of the population compared with a rate of 16.1 per 1,000 for England and Wales whilst the standardised death rate is 11.73 compared with 11.5 for the country as a whole. There is nothing in these figures to warrant either concern or undue complacency. When one observes the great changes wrought in our civilisation by the industrial, social, educational and scientific developments of the past 50 years and their profound influence on our whole way of life, one cannot help feeling that the yardsticks used in the past to measure the health of a community need to be interpreted with great caution. Designed as they originally were for conditions of widespread povety and disease and the absence of medical care they served, in bygone years, not only as a measure of environmental hazards but, also, as a spur to their amelioration. Nowadays, however, having overcome the gross hazards of environment we can turn our attention to the more insidious and subtle ones which remain, as well as to the new hazards which are constantly arising as a result of the application of scientific developments as, for example, in the field of nuclear physics. A good example of the subjection of present-day vital statistics to the high power of the microscope is afforded by the study of infant mortality where the emphasis has shifted from the main causes of death during the first year of life (which at one time were gastro-enteritis and broncho- 5 pneumonia) to deaths during the neo-natal period (the first four weeks of life, the commonest causes of death being congenital malformations and prematurity) and, latterly, to the perinatal period in which the deaths during the first week of life are studied alongside with stillbirths. This highlights the combined effects of toxaemia of pregnancy and prematurity and, in a few cases, obstetrical difficulties and it will be seen on analysis of the figures that the perinatal mortality during 1957 was 33.8 per 1,000 related births. It is, indeed, remarkable that of the 12 Erith babies on whom the infant mortality rate is based, no less than 8 died within the first week of life. It is clear that a closer study needs, now, to be made of the causes of toxaemia and of the significance of maternal infections in early pregnancy (particularly german measles and, possibly, other virus diseases as well) in relation both to prematurity and congenital malformations. The fall in deaths during the perinatal period has not kept pace over the past 25 years with the fall in infant mortality generally and further improvement in the infant mortality rate depends on further research on these lines as well as on the maintenance of satisfactory conditions of living and levels of child care generally. The number of deaths from cancer of the lung during 1957 was 21 as against 17 in 1956 and 18 in 1955. The fact that there is an association between smoking and cancer of the lung has received very wide publicity and is now, I think, accepted by most reasonable people. There is no evidence, however, that this has had much effect on the smoking habits of people in general although one does meet individuals, here and there, who have given up cigarette smoking as a direct result of this newly-gained knowledge. It appears that the general attitude among the majority of smokers is a fatalistic acceptance of the risk; which can only mean that the smoking habit may fulfil a deep physical and psychological need in the stressful world in which we live. It is good to learn, therefore, that attempts are being made, by selective cultivation of particular varieties of tobacco leaf and by other means, to reduce the carcinogenic substances in tobacco and I believe that some progress is being made in this respect. Further research is also required into the causes of heavy cigarette smoking. I have given a number of talks on this subject to senior schoolchildren in a neighbouring district and have been impressed by the grasp shown by mem in regard to the hazard of lung cancer in relation to smoking. Nevertheless, although they received the information in a responsible way, one could not help feeling that The remoteness of the risk in point of time tended to reduce its impact for, to a boy or girl of 15, to talk of what may 6 happen in 30 or 40 years time is somewhat akin to a voyage into eternity. However, this particular form of health education must continue, and teachers as well as doctors and health visitors have their responsibilities, particularly when one bears in mind the seductive advertisements on television and in the Press which are designed to inculcate, in the adolescent mind, the impression that smoking is a sign of emancipation and growing up and a stepping-stone to social ease and acceptance. In considering lung diseases in general and perhaps chronic bronchitis in particular, one must not forget that the abatement of atmospheric pollution is one of the most important tasks facing both central and local government at the present time. In a way this problem is comparable in its complexity with the cleaning up of urban water supplies in the 19th century and just as important. The Clean Air Act, 1956 grants, among its many provisions, permissive powers to local authorities to declare smoke control areas in which only smokeless fuels will be burnt in suitable boilers and domestic heating appliances. In Erith a beginning has been made, the Council having authorised a pilot survey to be carried out in a selected area with a view to obtaining reliable information as to the cost of replacing unsuitable appliances and adapting others to make them capable of burning smokeless fuels. It took over 50 years to provide a clean and safe water supply to the great towns thus ridding the population of such diseases as cholera, typhoid and dysentery. By sustained and determined action in regard to clean air one may similarly see, in years to come, a reduction in lung diseases which are responsible for so much mortality and illhealth as well as the removal, from the atmosphere, of pollution which causes much unnecessary work for the harassed housewife and does untold damage to vegetation and the fabric of buildings. We have, now installed in the Health Department, a volumetric apparatus for the daily estimation of sulphur dioxide (one of the most lethal constituents of smoke) and figures are being collected which will serve as a guide to future action in regard to smoke abatement. It is unfortunate, to say the least of it, that the time when the prevention of atmospheric pollution is becoming a matter of major policy should coincide with the introduction of yet another serious hazard; this time from nuclear and allied radiation resulting from the peaceful uses of atomic energy in industry including the use of x-rays and of radioactive isotopes and from international efforts to build 7 up the "atomic deterrent." The addition of these radiations to those occurring naturally from certain heavy elements in the earth's crust and from cosmic rays reaching us from outer space may one day, and before long, induce a level of radioactivity in our surroundings harmful to the maintenance of health and, by causing undesirable genetic mutations, constitute a threat to future generations. Indeed, one can forsee the time when the Geiger counter will become as important a piece of public health equipment as the sampling bottle or deposit gauge is today. During the year steady progress was made in regard to the implementation of the Food Hygiene Regulations, 1955. Much work and constant vigilance is necessary to ensure that satisfactory standards of production and handling of food are not only achieved but, also, maintained. Even when cleanliness, repair of food premises, the supply of wash hand basins, hot and cold water and facilities for washing food and equipment are of a satisfactory standard, real cleanliness depends, ultimately, on the acceptance by food handlers, both management and staff, of a personal responsibility to the public; and we cannot say that this is invariably the case. During the year, 1965 inspections of food and food preparing premises were carried out by the Public Health Inspectors and improvements were carried out or defects remedied under the Regulations at 33 premises. Six premises were dealt with for infestation by rats and mice. During the year the Housing Act, 1957 and the Rent Act, 1957 came into operation. The former was largely a consolidating Act, while the latter in that it aimed, among other things, at the preservation of the structure of existing houses, placed a good deal of extra work on the Chief Public Health Inspector and his colleagues, particularly in connection with certificates of disrepair. Steady progress has been made during the year in the clearance of unfit houses within the framework of the five year plan submitted to the Ministry of Housing and Local Government in 1955. The work of the Bexley, Erith and Crayford Home Safety Committee continued during the year, with steady propaganda in the interests of the reduction of accidents in the home, chiefly through falls and burns and scalds. Officially this responsibility lies with the Local Health Authority under Section 28 of the National Health Service Act, 1948. In practice, the local voluntary committee, closely 8 linked with district Health Department and the local Council is in a far better strategic position to increase the public awareness of a problem, the magnitude of which, both as regards morbity and mortality exceeds that of accidents on the roads. During 1957 one case of paralytic poliomyelitis was notified in the Borough. The number of children resident in the Borough who received a course of two injections against this disease, under arrangements made by the Local Health Authority, was 1,115. The extension of vaccination to all children of school age and possibly, in due course, to members of the public generally may, it is hoped, in years to come, considerably reduce the ill-effects of this annual visitation. Although, broadly speaking, the incidence of pulmonary tuberculosis is on the wane, there is evidence to show that much still remains to be done in the abolition of this incapacitating and killing disease. The chronic open case in the community and the undiagnosed case, often in middleaged and elderly people, remain two potent sources of infection. The main spearheads in the attack against this disease are the unremitting tracing of sources of infection, the protection of contacts and young children by B.C.G. inoculation and a more intensive search for new cases by means of mass miniature radiography. During the latter part of the year influenza of the Asian type reached epidemic proportions in the Borough, this being part of a world epidemic. Although widespread, the disease did not reach the severity which had been anticipated and most cases were of a relatively mild type, necessitating a few days in bed followed by a short period of convalesence. Much absenteeism resulted in factories and in schools from this cause in the area. No deaths were recorded as due to influenza during the year. So much for these objective factors for which figures are available, but this is by no means the whole story. There are no statistics by which we can study the health of the individual and of the community in the sense of happy and successful living as integrated members of society which is the essence of true health. It is, I think, true that, despite the great advances in clinical medicine over the past 40 years and the operation of the National Health Service for 10 years, there has been no reduction in the total incidence of disease although the pattern of disease has changed. The 9 old-fashioned epidemics have been largely brought under control but have been largely offset by the increase in the incidence of the so-called psychosomatic diseases such as coronary thrombosis, peptic ulcer, certain forms of cancer, the psychoneuroses and by the new endemics, accidents on the roads and in the home. Most disturbing of all is the great increase in the last few decades, of mental ill-health as shown by the high proportion of hospital beds taken up by the mentally sick. The causes of this social malaise are very complex and have their roots in the rapid changes which our society has undergone in recent years. Prevention and cure of disease is not enough to ensure true health in a modern society. The promotion of health by a consciouslydirected policy based, not only on the causes of disease, but on the causes of health remains, as always, the greatest challenge to statesmanship at the present time. In conclusion I wish to thank the Chairman and Meniere of 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 devoted service during the year. I am, Your obedient servant, JOHN LANDON, Medical Officer of Health. 10 Annual Report 1957 SECTION A:—STATISTICS AND SOCIAL CONDITIONS OF THE AREA A (1) Physical Situation and Amenities Erith occupies a riparian position in north-west Kent, being 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. Shopping facilities are advantageously situated, and a copious supply of pure water 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, production of 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 by autumn, the all-concrete jetty which projects 550 feet into the River Thames was completed. The construction of the new electricity generating station has steadily progressed since 1954, and is expected to be completed by 1961, although it is anticipated that the plant will be producing 480 mega-watts for the national grid by 1958. The new Royal Alfred Seamen's Home at Belvedere is now in course of erection, and completion is expected by the end of 1958. Lower Belvedere Re-development scheme is now visibly expanding, many new buildings being erected in an area which was made derelict by enemy action. The long established method of loading Erith pit sand for export at the Ballast Wharf by means of horse-drawn 11 bogeys has been superseded by employing motor vehicles, from the wells of which the sand cargo is transferred to conveyor belt with a terminal discharge direct into the ship's hold. A (2) Comparative Rainfall 1956 1957 Month. Inches. Month. Inches. January 3.09 January 1.07 February 42 February 2.55 March 1.08 March 0.89 April 1.55 April 0.16 May 73 May 0.95 June 1.57 June 0.76 July 5.45 July 2.98 August 3.09 August 2.74 September 2.04 September 2.35 October 1.39 October 1.39 November 62 November 3.19 December 2.45 December 1.67 23.48 total 20.70 12 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 1942—1957. Month and Year Males Females Total 18 and over Under 18 18 and over Under 18 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 December, 1954 52 3 74 10 139 December, 1955 38 - 43 - 81 December, 1956 53 - 41 - 94 December, 1957 113 7 52 6 178 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, 1957:— (Excluding houses with shops and houses with Public Houses assessed as single hereditaments)—13,148. Rateable value at 31st December, 1957:—£710,529. Sum produced by a penny rate, 1957:— (Product for 1957/58):—£2,770. Rate in the £ at 31st December, 1957:—18s. 4d. 13 EXTRACTS FROM VITAL STATISTICS FOR YEAR 1957. A (4)b Births Male Female Total Live Births Legitimate 337 309 646 Illegitimate 13 6 19 350 315 665 Live Birth rate per 1,000 Home Population (Registrar General's Figure). 14.45. Birth rate corrected for comparison with other areas:— 14.45. Comparability factor supplied by Registrar General:— 1.00. Live Birth rate, England and Wales:—16.1. Corresponding rate for the Borough of Erith for year 1956:—14.08. Male Female Total Still Births Legitimate 11 4 15 Illigitimate 11 4 15 Still Birth rate per 1,000 total births:—22.06. Still Birth rate per 1,000 total births, England and Wales:—22.5. Still Birth Rate per 1,000 Home Population:—0.33. Still Birth rate per 1,000 Home population, England and Wales:—0.37. A (4)c Deaths Male:—260 Female:—205 Total:—465. Death rate per 1,000 Home Population:—10.11. Death rate corrected for comparison with other areas:— 11.73. Comparability Factor supplied by Registrar General: — 1.16 Corresponding rate 1956:—10.08. Death rate per 1,000 Home population, England and Wales:—11.5. Number of women dying in, or in consequence of, childbirth:—One. Maternal Mortality Rate per 1,000 total births:—1.47. Comparative figure for England and Wales:—0.47. 14 A (4)d Infant Mortality Deaths of infants under 1 year of age:— Male Female Total Legitimate 4 7 11 Illegitimate - 1 1 4 8 12 Death rate of infants under 1 year of age per 1,001 live births:-18.05. Death rate of infants under 1 year of age per 1,000 live births, England and Wales:—23.1. Deaths of infants under 4 weeks of age:— Male Female Total Legimate 2 7 9 Illegitimate - 1 1 2 8 10 Death rate of infants under 4 weeks of age per 1,000 live births:—15.04. Death rale of infants under 4 weeks of age per 1,000 live births, England and Wales:—16.5. Total Number of deaths from:— 1957 1956 Measles (All ages) - - Whooping Cough - 15 A (4)e Summary of Vital Statistics for the year 1957. England and Wales Borough of Erith Births: — Rates per 1,000 Home Population Live births 16.1 14.45 Still births 0.37 0.33 22.4(a) 22.06(a) Deaths: — All causes 11.5 10.11 Typhoid and Paratyphoid 0.00 - Whooping Cough 0.00 - Diphtheria 0.00 - Tuberculosis 0.11 0.13 Influenza 0.15 - Smallpox 0.00 - Acute Poliomyelitis (includ ing Polio-encephalitis) 0.01 - Pneumonia 0.52 0.46 Notifications: — (Corrected) Typhoid Fever 0.00 - Paratyphoid Fever 0.01 - Meningococcal Infection 0.02 - Scarlet Fever 0.66 0.24 Whooping Cough 1.89 3.43 Diphtheria 0.00 - Erysipelas 0.08 0.11 Smallpox 0.00 - Measles 14.11 13.30 Pneumonia 0.73 0.80 Acute Poliomyelitis (including Polio-encephalitis) Paralytic 0.07 0.02 Non-Paralytic 0.04 - Food Poisoning 0.20 0.04 Puerperal Pyrexia 16.00(a) 10.29(a) Deaths: — Rates per 1,000 live births All causes under 1 year of age 23.1 18.05 Enteritis and diarrhoea under 2 years of age 0.50 - (a) Per 1,000 Total (Live and Still) 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 A (4)f Vital Statistics of Whole District—1948—1957. 1948 46,250 877 18.96 458 9.9 20 22.8 1949 46,770 795 17.00 465 9.95 (Corrected) 10.75 19 23.9 1950 46,850 701 14.96 (Corrected) 14.21 478 10.2 (Corrected) 11.0 14 20.0 1951 46,010 690 15.00 (Corrected) 14.25 533 11.6 (Corrected) 12.4 24 34.8 1952 46,070 683 14.83 (Corrected) 14.09 500 10.85 (Corrected) 11.6 20 29.3 1953 45,860 671 14.63 (Corrected) 14.63 499 10.88 (Corrected) 11.86 22 32.79 1954 45,950 621 13.51 (Corrected) 13.51 455 9.9 (Corrected) 10.79 12 19.32 1955 45,950 637 13.86 (Corrected) 13.86 440 9.58 (Corrected) 10.44 13 20.41 1956 46,010 648 14.08 (Corrected) 14.08 464 10.08 (Corrected) 11.79 8 12.35 1957 46,010 665 14.45 (Corrected 14.45 465 10.11 (Corrected 12 18.05 16 17 A (4)g Table showing Summary of Causes of Death during the year ended 31st December, 1957. Cause of Death Males Females Total 1 Tuberculosis, Respiratory 4 1 5 2 Tuberculosis, Other forms - 1 1 3 Syphilitic diseases - - - 4 Diphtheria - - - 5 Whooping Cough - - - 6 Meningococcal Infection - - - 7 Acute Poliomyelitis - - - 8 Measles - - - 9 Other infective and parasitic diseases - 2 2 10 Malignant neoplasm, stomach 10 4 14 11 Malignant neoplasm, lung, bronchus 18 3 21 12 Malignant neoplasm, breast - 8 8 13 Malignant neoplasm, uterus - 5 5 14 Other malignant and lymphatic neoplasms 19 20 39 15 Leukaemia, Aleukaemia 1 3 4 16 Diabetes 1 4 5 17 Vascular lesions of nervous system 31 28 59 18 Coronary disease angina 42 19 61 19 Hypertension with heart disease 11 12 23 20 Other heart diseases 31 38 69 21 Other circulatory diseases 12 8 20 22 Influenza - - - 23 Pneumonia 9 12 21 24 Bronchitis 23 6 29 25 Other diseases of respiratory system 1 - 1 26 Ulcer of stomach and duodenum 2 4 6 27 Gastritis, enteritis and diarrhoea 1 - 1 28 Nephritis and Nephrosis 2 - 2 29 Hyperplasia of prostate 7 - 7 30 Pregnancy, Childbirth and abortion - 1 1 31 Congenital Malformations 9 1 10 32 Other defined and ill-defined diseases 15 20 35 33 Motor vehicle accidents 2 - 2 34 All other accidents 4 4 8 35 Suicide 4 1 5 36 Homicide and operations of war 1 - 1 Total all causes 260 205 465 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 2 Atresia of jejunum and pelvic colon 1 1 Congenital Heart Disease 1 1 2 Emphysema 1 1 Orbital Cellulitis 1 1 Prematurity 3 3 Pulmonary Atelectasis 1 1 Spina Bifida 1 1 Totals 5 2 1 1 1 1 1 12 All 12 infant deaths occurred in hospital. Coroner's Postmortem examinations were carried out in 3 cases. No inquests were held. 18 19 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 1946-57. 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 1957 12 18.05 23.1 A (4)i Comparison of Maternal Mortality Rates Year Maternal Deaths Live Births Still Births Maternal Mortality 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 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 - 1954 - 621 19 - 1955 - 637 15 - 1956 -- 648 10 - 1957 1 665 15 1.47 20 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 37 14 2 Acute Poliomye litis (Paralytic) 1 1 - Dysentery 1 1 - Erysipelas 5 2 - Food Poisoning 2 - - Measles 612 1 - Puerperal Pyrexia 7 7 - Scarlet Fever 11 - - Whooping Cough 158 2 - Total 834 28 2 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 Under 1 year 1—2 3—4 5—9 10—14 15—24 25—44 45—64 65 & over Age not known Totals M F M F M F M F M F M F M F M F M F M F Acute Pneumonia - 1 2 1 - 1 1 2 - 1 1 1 7 1 7 1 8 2 - - 37 Acute Poliomyelitis (Paralytic) - - - - - - - - - - 1 - - - - - - - - - 1 Dysentery - - 1 - - - - - - - - - - - - - - - - - l Erysipelas - - - - - - - - - - - - 1 - 3 - - 1 - - 5 Food poisoning - - - - - - - - - - - - 1 1 - - - - - - 2 Measles 6 3 56 49 72 85 149 183 1 5 - - 1 2 - - - - - - 612 Puerperal Pyrexia - - - - - - - - - - - 2 - 4 - - - - - 1 7 Scarlet Fever - - - - - - 3 7 1 - - - - - - - - - - - 11 Whooping Cough 2 4 15 24 20 17 24 44 2 1 - 1 1 - - 1 - - 1 1 158 Totals 8 8 74 74 92 103 177 236 4 7 2 4 11 8 10 2 8 3 1 2 834 21 22 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 5 13 4 3 7 5 37 Acute Poliomyelitis (Paralytic) - - - - - 1 1 Dysentery - - 1 - - - 1 Erysipelas - 1 1 - 2 1 5 Food Poisoning - - - - 1 1 2 Measles 124 97 121 117 53 100 612 Puerperal Pyrexia 7 - - - - - 1 Scarlet Fever 1 3 - 1 3 3 11 Tuberculosis (Respiratory) 6 7 12 13 6 7 51 Tuberculosis (Non-Respiratory] - 1 1 - - - 2 Whooping Cough 24 24 28 29 27 26 158 Totals 167 146 168 163 99 144 887 23 B (2) Tuberculosis B (2) a. New Cases notified for the first time during 1957. Age Respiratory Non-Respiratory Total M F M F 0— - - - - - 5— 4 1 - - 5 10— 1 1 - - 2 15— 1 - - - 1 20— 1 2 - - 3 25— 7 5 1 - 13 35— 4 1 - - 5 45— 14 - 1 - 15 55— 2 2 - - 4 65 & over 4 1 - - 5 Totals 38 13 2 - 53 In addition to the above cases 6 males and 9 females suffering from respiratory tuberculosis were transferred into the district from other areas. One female (respiratory) was transferred back into the district, one female (respiratory) was notified as reactivated and one male and one 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 M F Total M F Total M F Total 4 1 5 - 1 1 4 2 6 24 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, 1957, 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 1957. Year of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations Year of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations 1957 Under 1 year of age 57 - 1952— 1948 5—9 years of age 47 285 1956 1 year of age 324 - 1947— 1943 10—14 years of age 9 20 1955 2 years of age 55 - 1954 3 years of age 22 1 1953 4 years of age 14 10 Total 472 11 56 305 25 Table B:—Number of children resident in the Borough of Erith under the age of 15 years on 31st December, 1957, who had completed a course of Immunisation at any time since 1st January, 1943. 0 - 4 years 5-14 years Year of Birth Number considered to be immunised Year of Birth Number considered to be immunised 1957 57 1952 550 1956 385 1951 534 1955 384 1950 605 1954 398 1949 724 1953 451 1948 625 1947 734 1946 651 1945 554 1944 559 1943 535 Total 1,675 Total 6,071 B (4) Vaccination Against Smallpox Age at 31st December, 1957 Under 1 year l-4 years 5—14 years 15 or over Total Number vaccinated 184 183 16 26 409 Number re-vaccinated - 3 7 32 42 B (5) Vaccination Against Poliomyelitis. The following table gives the numbers of children resident in the Borough, with year of birth, who received a course of two injections against poliomyelitis during the year ended 31st December, 1957: — 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 Total 185 260 225 221 71 61 50 42 - - - 1,115 26 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. 27 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.mFridays 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. 28 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 145 bodies, and post-mortem examinations were carried out in 142 cases. 19 inquests were held. 40 bodies were from the Erith area, and post-mortem examinations were carried out in 39 cases. There were 7 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 during the year. Much was accomplished in visiting and the provision of good neighbourly services. The holiday scheme continued, parcels were issued at Christmas to lonely and needy old people, and a dinner and entertainment was arranged for 40 old people who would, otherwise, have been alone at this time. 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. Mrs. A. F. Deceased was 84 years of age and died in a local nursing home. The only relatives were an aged brother (a bedridden inmate of an old peoples home) and a nephew, neither of whom was a liable relative. Case No. 2. Mrs. J. J. Deceased was aged 90, and also died in a local nursing home. The only relative traced was a niece, who was not a liable relative. 29 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 17,500 are emptied weekly. The dustbins are provided and maintained by the owners of the properties concerned, the Council securing this by a local Act— The Erith Improvement Act, 1920. Disposal is effected by barging under contract, and these arrangements are still working very satisfactorily. D (l)a Costs £ s. d. Cost per ton of collecting refuse 1 16 3½ Cost per ton of disposing of refuse 17 0 Net cost per 1,000 population per annum 505 7 8 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 2 S. & D. Freighters 12 „ „ 2 S. & D. Freighters 9 „ „ 5 S. & D. Freighters 7 „ „ 1 Scammel Lorry 5 „ „ 1 Morris Utility Van 5 cwts. 6 Trailers They are operated by: — 1 Foreman 11 Driver Loaders 10 Loaders and Sorters November, 1957— three new S. & D. Freighters were purchased, two 9-yard vehicles, one 12-yard vehicle. Two of these were purchased for replacements and one to cater for new premises. 30 D (l)c Table 2 Month Tonnage Tons Cwts. January, 1957 918 11 February, 1957 721 6 March, 1957 746 3 April, 1957 739 10 May, 1957 804 3 June, 1957 631 0 July, 1957 662 0 August, 1957 657 1 September, 1957 657 8 October, 1957 748 3 November, 1957 740 16 December, 1957 741 19 Total 8,768 0 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 produced a revenue of £904 5s. 2d. in 1957. D (3) Salvage Tonnage collected'. Income: T. C. Q. lbs. £ s. d. 1,169 14 2 7 7,132 1 2 31 D (4) Public Conveniences Public Conveniences under the control of the Council are as under: — Site Walnut Tree Road, Male and Female. West Street, Erith, Male and Female Station Road, Belvedere, Male and Female. Heron Hill, Belvedere, Mate Woolwich Road, Belvedere, Female High Street, Erith, Male and Female Colyers Lane, Maie and Female. Hours of opening 24 hours—day and night 6.45 a.m.—10.30 p.m. 24 hours—day and night 24 hours—day and night 6.45 a.m.—10.30 p.m. 6.45 a.m.—10.30 p.m. 24 hours—day and night. I 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 8,568 Notices served: Formal 27: Informal 210: 237 Complaints received and investigated 1,323 Number of disinfections 98 32 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 57 5 5 Bakehouses 9 22 2 2 Dairies 5 21 3 3 Butchers' shops 33 187 10 10 Fish friers 11 39 6 6 Slaughterhouses 2 515 5 5 Factories 150 87 17 17 Outworkers 71 71 - - Food factories 4 15 2 2 Pet shops 4 17 1 1 Rag flock dealers 2 9 1 1 D (5)c Summary of Nuisances abated and defects remedied during the year Roofs repaired 34 Dampness remedied 41 Eaves repaired 34 Floors repaired 17 Plasters renewed 31 Windows made to open 21 Cisterns repaired 16 Yard pavings renewed 6 Water supply provided 7 Drains repaired 28 New sinks 29 Sink wastes repaired 21 W.C. pans renewed 15 New W.C's provided 3 Dustbins provided 31 Stoves repaired 5 Accumulations removed Miscellaneous 23 Houses demolished by informal action 12 D (5)d Drainage, Closet accommodation and Cesspools The water carriage system has predominated in the Borough for many years, and sewerage is disposed of at the outfall vested in the West Kent Main Sewerage Board. Of cesspools, 17 are known to exist, and these are subject to cleasing service by resolution of the Council dated 10th March, 1942. During the year, one cesspool has been abandoned, and the drains connected to Corporation sewers. Corporation sewers have been extended to serve the newly developed housing estates. 33 D (5)e Atmospheric Pollution Results of Analysis 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 1957 is as follows: Month Bain in inches Insoluble deposit Tons per eq. mile Soluble deposit Tons per sq mile Total Solids Tons per sq. mile Calcium Tons per sq. mile Sulphur mg/l 00 sq cms/day January 0.85 5.34 3.76 9.10 0.44 1.92 February 2.46 8.85 8.39 17.24 1.28 2.46 March 0.80 8.31 9.60 17.91 2.18 1.49 April 0.34 11.04 6.64 17.68 1.41 1.05 May 1.04 10.56 5.54 16.10 1.11 0.89 June 0.82 10.08 5.71 15.79 1.01 0.83 July 3.90 9.13 7.79 16.92 1.48 0.95 August 1.88 5.99 5.44 11.43 1.01 1.09 September 2.15 8.01 8.39 16.40 1.41 1.17 October 1.51 8.92 7.05 15.97 1.28 1.63 November 2.26 8.34 6.58 14.92 0.94 2.28 December 1.68 9.12 9.60 18.72 1.41 2.98 The Department's petrie dish investigation which was carried out in 1950 determined that total solids per square mile per month were approximately 37 tons, this figure being inclusive of a fall out approximately 5.1/6 tons of calcium on similar superficial area. By comparing these 1950 figures with those in the above monthly tabulation, it will be seen that the density of calcium deposits arising from County Kent and County Essex sources, are indicative of a considerable reduction for the year 1957. D (5)f Smoke Abatement The aim of the Clean Air Act, 1956 is to abate pollution of the air, for the purpose of which, Local Authorities are enabled to create smoke control areas by means of orders, which must however be confirmed by the Minister of Housing and Local Government before they become operative. A period of time elapses between the making of an order by a Local Authority, and its coming into operation. It is generally accepted at this stage that establishment of smoke control areas will be gradual, and 34 governed by the quantity of smokeless fuels available, and the rate at which appliances can be converted or replaced. During the year, the various ramifications of the Act have been reviewed by the appropriate Commitees of the Council, but as yet no smoke control area has been declared. It has however been resolved that: (1) The functions of the Council under sections 3, 10 and 24 be duly carried out by the Plans and Town Planning Committee and that the model bye-laws submitted by the Ministry of Housing and Local Government amending the 1953 bye-laws, be adopted. (2) That suitable advanced publicity for a future propaganda campaign should be inaugurated. (3) That the pressure to make available more smokeless fuels at reasonable prices be supported. Having regard to smoke control areas already operative in the Greater London area, it cannot be claimed that there has as yet, been any perceptible diminution of seasonal smog. Perhaps the ultimate objective will not be achieved until atmospheric pollution is dealt with as was raw milk in 1951 when the whole of the Greater London area was declared a "specified area" for designated milk only. In the scientific age, the prescribing of a like area in which the burning of raw coal is prohibited should not be too difficult a project having regard to all the humanitarian benefits which would result therefrom. Improvements to factory equipment in the area include the installation of three chain grate stokers, and recording instruments. D (5)g Swimming Baths and Pools (T) 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, 77,832 articles were dealt with. 35 Attendances at the Swimming Baths for 1957: Swimming pool Slipper baths Schools: During term 12,037 17,373 Schools: During holidays 2,371 Youth clubs 8,238 Total Total for 1957 22,646 for 1957 17,373 Total Total for 1956 19,473 for 1956 16,604 (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 methodically dosed with chloros. A successful model power boat regatta sponsored by a local model engineering society is held at this site. D (5)h Offensive Trades Other than 11 fish frying establishments, there are no other scheduled offensive trades under Section 107 of the Public Health Act 1936 in the Borough. Fish frying was declared to be an offensive trade on 17th March, 1939, and bye-laws were made accordingly. All the fish frying businesses are well conducted and the frying apparatus at each 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 applies to manufacturers' and dealers' premises. Whilst there are no manufacturers in the Borough, two premises exist where filling materials are utilised, and which accordingly are registered with the Local Authority. Apart from the incumbent duties of licensing and registration, the Act provides for inspection, and the sampling of rag flock. 36 A typical Prescribed Analysts' Report is as follows: — Tests. Results. Chlorine content 10 parts per 100,000 Oil content 1.0% Soap content 0.8% Soluble impurities (i) 1.2% (ii) 1.2% (iii) 1.1% Average 1.2% Remarks: Sample satisfactory. D (5)j Pet Animals Act 1951 There are 4 pet animals shops in the Borough, and trading seems to have expanded during the year. All the premises are well conducted and no contraventions of welfare provisions which aim at securing humane conditions at shops where animals are sold, were located. In one instance however, it was proposed to sell caged birds from a greengrocer's shop, but pursuant to informal action, the project was abandoned. "Economics of Domestic Pets" published by P. and E.P., reveals that of British household pets, 6,000,000 are cage birds, 5,200,000 are cats and 3,700,000 are dogs. The total cost of foods for cats and dogs is estimated at more than £40 million per year. D (5)k Camping Sites There are no camping sites in the Borough. No licences under Section 269 Public Health Act 1936 were issued during the year, and none whatever are operative. During the year, the area has been free from indiscriminate caravan squatters. D (5)1 Hop pickers There are no hop fields in the district. D (5)m Rodent control (A) Two full time operatives are employed on rodent control in accordance with the provisions of Circular N.S.19. No major infestations have occurred during the year and all complaints arising from industrial and private sources have been appropriately dealt with. 37 In accordance with established practice, maintenance treatments were carried out on Corporation sewers in March and September when Warfarin poisoning based on 1, 4, 8, technique was markedly successful. The Prevention of Damage by Pests (application to Shipping) Order 1951 applies to the many wharfs, jetties and dry slipways in the riparian Borough, and by way of implementation, the following visits were made: — Lighters 73 Refuse barges 18 Coastwise vessels 20 Tugs 27 Dredgers 5 Tankers 2 Total 145 No marine infestations were located. (B) Rattus Rattus. Progress report on elimination measures undertaken against ship rat was submitted to the Ministry of Agriculture, Fisheries and Food in July, 1957. Since 1951, when known reservoirs of infestation numbered five, such locations have been reduced to one, and this site is subject to constant and concentrated control. Reduction in incidence of infestations is attributed to the following: — 1. (a) Reconstruction, and (b) Demolition of certain industrial premises including wharfs which formerly provided reservoirs, and (c) satisfactory rat-proofing, (d) Methodical rat destruction co-incided with the foregoing. 2 Change of user of premises and change of industry. 3- Re-inforcement and concreting of the river bank. 4. Berthed vessels at wharfs being the subject of de-ratisation certificates. D (5)n Pest control. For matters which are outside the scope of the Public Health Act, practical assistance of the Department's outdoor service is available to occupiers. In this regard, many private drains and sewers have been cleared, and insect infestations dealt with. Wasps were more than usually active during The summer, and 10 nests were destroyed. 38 The Department's outdoor service includes dealing with clothing for export to Italy, which now has to be suitably disinfected. The income arising from this outdoor service amounted to £41 5s. Od. which is inclusive of cost of insecticides etc. used and apportionment charge of the operative's time. 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 7 Corporation houses 1 With a view to obtaining good control, occupiers are encouraged to reveal any infestation, when every assistance is given to eradicate the pests. D (5)p Heating Appliances (Fireguards) Act 1952 and Regulations 1953 It is now found that most heating appliances sold in shops are guaranteed to comply with the requirements of the Regulations. The probe test was applied to 148 fitments deposited at various shops, and all were found to be satisfactory. Appliances which are repaired or overhauled at electricians' shops are not, on completion, enforced by law to comply with the prescribed safety factor. This appears to be an outstanding deficiency in the Regulations. Special attention is devoted to appliances which are sold in second-hand establishments. D (5)q Mosquito Control The ditches which intersect the Belvedere marsh area were kept under constant review during the year. Many of the watercourses were treated with larvicide, thus maintaining good control. No complaints were received during the year. D (6) Shops Act 1950 (a) The following Closing Orders are in operation in the area: — Erith Weekly Half holiday (No. 1) Order, dated 17th February, 1913. Closing hour: Thursday 1 p.m. 39 Erith Hairdressers and Barbers Shops Closing Order. Dated 11th March, 1947. Closing Hour: Every evening 7 p.m. (b) No partial exemption Orders with regard to Sunday trading provided for by Section 48 of the Shops Act 1950 exist. (c) The majority of unmixed trade shops in the Borough close at 5.30 p.m. to 6 p.m. (d) New legislation, the object of which was to amend and consolidate various obscure aspects of the Shops Act 1950 was wholly abandoned by the Legislature in May 1957. Thus the Act of 1950 remains the applicable Statute which requires that "shops must be closed for the serving of customers after a specified hour." It had been hoped that a clarified interpretation of this operative enactment would have been decided in Parliament during the passage of the Shops Bill, but in the absence of new Statute, it would appear that a case at law may be necessary to solve the question whether radio and television dealers' premises utilised for evening demonstrations are open for the serving of customers. (e) No legal proceedings were instituted during the year. In one instance, informal action resulted in the selling of cigarettes from a private dwelling being discontinued. (f) The application of the provisions of Section 38 of the Shops Act 1950 resulted in the following improvements: Heating facilities provided or renewed 7 Washing facilities 3 Lighting improved 5 Sanitary conveniences 6 Seats provided 9 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 rapidly developing industrial area were provided with suitable and sufficient sanitary conveniences. Various improvements have been effected in sanitary accommodation already existing at office premises. D (8) Street Trading There is no established street trading in the Borough, there being only two mobile stalls sited in the shopping area. No nuisances have been detected at this source. 40 D (9) River Thames— Effluvia In August, when Metropolitan Authorities publicised the dangers arising from bathing in the river, the pollution of the Thames received the particular attention of the Institution of Public Health Engineers on whose behalf it was stated that no other capital city in the world has allowed such disgraceful conditions to operate for so many years. The present London sewage disposal system allows for the discharging of about 300 million gallons per day of virtually crude sewage into the river, and it sometimes takes a fortnight before this is washed out to sea. In the meantime, the tidal piston carries it upstream and back again, the time taken travelling backwards and forwards, depending on the amount of fresh water coming over Teddington weir. Much of the crude sewage settles, and the bed of the river becomes a vast mass of deposited sludge. Then, as secondary decomposition begins, the black and effluvial sewerage sludge rises to the surface, releasing its bubbles of marsh gas which are visually apparent. The scientific adviser to the London County Council affirms that there is definite evidence that the pollution load on the River Thames has been appreciably reduced, and it is anticipated that, as new sections of outfall plant come into service, a substantial contribution to this end will be achieved. New Sedimentation tanks at Northern Outfall are said to produce evidence that the reduced loading has prevented more serious deterioration. The summer quarter July to September with its normally reduced rainfall and higher air temperature is the critical period, and in 1955, warm weather, coupled with the heated discharges into the river, resulted in the highest temperatures yet to be recorded from Kew to Gravesend. During 1957, river effluvia, though intermittent, was extremely penetrative and objectionable to residents in all parts of the Borough. Unfortunately, the worst conditions invariably co-incide with the advent of good weather, and each year, an olfactory improvement becomes the object of hope. As yet, that hope has not been realised, and it would appear that there is a long way to go before it is. 41 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 87 7 - 7 Other premises under the Act including building and engineering construction but not including outworkers premises 9 2 - 157 96 9 - (2) Defects found: — Particulars Number of defects No. of defects in repect of which Prosecutions were instituted. Found Remedied Referred to H.M.F.I. Want of cleanliness 3 3 - - Ineffective drainage of floors 1 1 - - Sanitary conveniences; Insufficient 2 7 - - Unsuitable 7 7 - - Other offences against the Act but not including outworkers 4 4 - - Total 17 17 - - 42 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 33 99 33 Informal 12 48 19 D(ll)b. Unfit houses Number closed. (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 buildings closed under Section 12, Housing Act 1936 - - - 43 D(ll)c. Unfit houses made fit and houses in which defects were remedied. By Owner By Local Authority (8) After informal action by Local Authority 114 - (9) After formal notice under (a) P.H.As. 27 - (b) Housing Act 1936 - - (10) Under Section 5, Housing Repairs and Rents Act 1954 1 - D(ll)d Housing statistics Number of permanent houses constructed in the Borough in 1957: — By the Council 86 houses: 12 flats By private enterprise 51 houses: 8 flats Total 137 houses: 20 flats Total number of permanent houses built and owned by the Council 1,374 Total number of flats built and owned by the Council 288 Total number of prefabricated temporary houses in the Borough 200 D(12) Rent and Mortgage Interest (Restrictions) Act 1939. (a) During the year, the Chief Public Health Inspector dealt with 42 applications for assistance regarding standard rents and extortionate payments, and appended below is a summary of the improvements which were effected:— (a) Rent reduced from £1 Is. 3d. to 18s. 3d. per week. (b) Rent reduced from £1 10s. 3d. to £1 9s. 3d., and £2 14s. 0d. returned to tenant. (c) Rent reduced from 19s. 6½d. to 12s. 0½d. (d) Rent reduced from £2 2s. 0d. to £1 9s. 9½d. 44 (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 (13) The Rent Act 1957. This Act received Royal Assent on 6th June, and came into operation on 6th July, 1957, the legislation proving to be just as confusing as the obsolete statute which the new Act sought to amend. Amongst other enactments, the 1957 Act provides thai tenancies of £40 rateable value or under within the Metropolitan Police Area remain controlled, whilst those of over £40 are de-controlled. In the latter category are the following types of property: — 1. Houses completed after 30th August, 1954. 2. Houses with rateable value of over £40 in Metropolitan Police District on 7th November, 1956. 3. Owner-occupied houses which become subject to a tenancy after 6th July, 1957. 4. Houses, irrespective of rateable value factor, subject to a new tenancy after 6th July, 1957. For houses remaining within control, rent increases generally, are permitted to a limit equivalent to twice gross value, and to effect the carrying out of repairs pursuant to rent increase, a complicated procedure exists whereby the tenant can obtain a certificate of disrepair from the Local Authority. With a view to publicising the essential provisions of the Act, various leaflets were exhibited, and handbills were at the disposal of enquirers. In addition, an evening bureau was opened at the Town Hall, so that the necessary information could be obtained. By the end of the year, 32 applications had been received for certificates of disrepair, in connection with which 6 were granted. 45 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. Twenty-four samples drawn from various points in the district have been forwarded to the appropriate Laboratory for bacteriological examination, with satisfactory results. E (2) Milk supply E(2)a Food and Drugs Act 1955. Section 37. The Milk (Special Designations) (Specified areas) Order 1951. In pursuance of the above Order which came into operation on 1st October, 1951, all milk retailed in the Borough is specially designated. 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 heated. There are no pasteurising plants and milk bottling establishments situated within the Borough. 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 23 Tuberculin tested (pasteurised) 4 Sterilised 0 27 All the samples satisfied the methylene blue, and phosphatase tests. 46 E (2)d Designated milk licences The following table indicates the number of licences issued for 1957: — Dealers licences Supplementary licences Tuberculin tested 9 Tuberculin tested 8 Sterilised 37 Sterilised 8 Pasteurised 15 Pasteurised 8 61 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 11 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). 12 Samples were obtained and forwarded for bacteriological examination with the following results:— Grade 1 7 Grade 2 5 E (3) Meat and Food Inspection E (3)a Slaughterhouses Slaughtering which formerly took place at the two private slaughterhouses daily, in the evenings of at least three days and on every Sunday, has now been extended to Saturdays, and this accounts for the increased number of inspections shown in the prescribed form table. In this regard, the incumbent duties of meat inspection are taxing the manpower resources of the Department to the full, and it is considered that this exacting situation will continue until the irregular times and hours of slaughtering are stabilised. 47 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 877 126 885 1786 34933 - Number inspected 877 126 885 1786 34933 - 411 diseases except Tuberculosis and Cysticerci. Whole carcases condemned - 1 3 - 74 - Carcases of which some part or organ was condemned 158 30 4 25 1873 - Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 18.02% 24.60% 0.79% 1.40% 5.57% - Tuberculosis only. Whole carcases condemned 2 6 1 - 11 - Carcases of which some part or organ was condemned 28 13 - - 136 - Percentage of the number inspected affected with Tuberculosis 3.42% 15.08% 0.11% - 0.42% - cysticercosis. Carcases of which some part or organ was condemned - - - - - - Carcases submitted to treatment by refrigeration - - - - - - Generalised and totally condemned - 1 - - - - Total weight of meat diseased and unfit, and consequently destroyed—11 tons 17 cwts. 1 qr. 4lbs. 48 E (3)b Exchequer grants towards cost of Meat Inspection. Circular F.S.H. 2/57 dated 11th April, 1957 announced that the appropriate Minister had decided to offer a contribution to Local Authorities' costs of meat inspection. The object of the grant is to assist those Local Authorities on which the cost of inspecting meat in slaughterhouses, imposes an unduly heavy burden because much of the meat inspected is not for local consumption. Proportionate grant therefore is now applicable for the units of "export meat" this being meat which is in excess of the Local Authority's datum figure i.e. a calculation of units representative of meat consumed in the Local Authority's area. For the purpose of calculating export meat and datum figure units respectively, one beast is regarded as 10 units, one calf or one pig as 3 units, and one sheep as 2 units. The necessary returns have been prepared for presentation to the Ministry concerned. E (3)c Other Foods. (1) Considerable time and attention has been devoted to the inspection of food in shops and stores, etc., as a result of which a total of 15 cwts. 2 qrs. 9 lbs. were confiscated as being unfit for human consumption. (2) 11 cwts. 0 qrs. and 26 lbs. of imported ground nuts were found to be unfit for human consumption and were duly processed and de-greased at the local Oil works. E (3)d 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 after being stained with naphthaline green. The residue of unsound food is disposed of with town's refuse. E (3)e Slaughter of Animals (Amendment) Act, 1954. Humane slaughtering of all animals in accordance with the above Statute prevails throughout the Borough. The number of slaughtermen's licences issued is 14. E (3)f Swine Fever Order 1938. Articles 2 and 14. Certain piggeries were declared by the Ministry of Agriculture, Fisheries and Food to be infected places. The requisite precautionary measures were taken. 49 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 1 19 20 Cream - 2 2 Condensed milk - 1 1 Evaporated milk - 2 2 Ice-cream - 4 4 Butter - 2 2 Margarine - 4 4 Cooking fat - 2 2 Bread 2 2 4 Biscuits - 1 1 Cake Mixture - 2 2 Baking Powder - 2 2 Spices and Herbs - 6 6 Pickles and sauces - 3 3 Fish - 5 5 Dressed crab 1 2 3 Fish and meat pastes . - 5 5 Minced chicken - 1 1 Meat pie - 1 1 Luncheon meat 1 1 2 Pate de foie - 1 1 Shredded beef suet - 1 1 Gelatine - 1 1 Beverages and drinks 1 8 9 Condiments - 4 4 Preserves - 3 3 Ground almonds - 2 2 Lemon Juice - 1 1 Flavouring essences - 4 4 Confectionery & puddings - 6 6 Table jellies - 2 2 Soups - 3 3 Candied Peel - 1 1 Dried fruit - 1 1 Baked beans - 1 1 Split peas - 1 1 Pea flour - 1 1 Cheese spread - I 1 Olive oil - 1 1 Bicarbonate of soda - 1 1 Tartaric acid - 1 1 Drugs - 2 2 6 114 120 50 Remarks on unsatisfactory samples'.— Milk, the subject of a complaint, was found to contain a safety pin and a warning letter was sent to the vendor. Ginger beer containing a slimy mould growth.—Action pending. Luncheon meat containing 61% meat was regarded as inferior, as was sample of dressed crab which contained 88% crab meat. Two bread loaves were reported as containing small quantities of extraneous matter, subsequent to which improvements have been carried out at the bakeries concerned. The milk samples had an average fat content of 3.6% and 8.71% SNF. The ice-cream samples had an average fat content of 12.1% and 11.2% SNF. E(5) Food Hygiene. The Food Hygiene Regulations 1955. (1) The methodical implementation of these Regulations continues to show good results, and many improvements which c.ould not be obtained by enforcement under previous legislation, have been effected. The main items dealt with have been the provision of sufficient sinks for washing food and equipment, together with washing facilities for staff, with hot and cold water supplies in both cases, provision of protective screening for food, the making available of cloakroom facilities for staff clothing, and the provision of first aid equipment. In a few instances, difficulty has been experienced in convincing traders of the necessity of providing separate sinks and washhand basins having regard to the fact that one fitment only fulfilled the requirements of previous legislation, but no cases of non-compliance have been met with. All licensed premises now have constant hot and cold water supplies serving bars, and in the town shopping centre reconstruction of various premises has included the renewal of shop fronts, which has enhanced considerably the appearance of these business premises. The attainment of the best possible standards undoubtedly makes all the requisite planning and subsequent reconstruction well worth while, having regard always to an increasingly hygiene-minded public which is attracted to clean food practice. 51 The new self service supermarket in the town centre is a typically good example of what can be achieved by planning the re-construction of existing premises, hygienically. This pattern is worthy of adoption at other food premises. No certificates of exemption under Regulation 31 have been issued during the year. (2) Number of food premases in Borough, (a) Registered under Statute. No. of visits. Butchers .33 187 Bakehouses 9 22 Fishfriers 11 39 Food factories 4 15 Ice-cream dealers 126 291 Ice-cream manufacturers 5 24 Slaughterhouses 2 515 (b) Food premises not subject to registration. Fishmongers 13 36 Cafes 25 162 Grocers 79 184 Greengrocers and Fruiterers 40 131 Confectioners 50 81 Milk purveyors premises 35 57 (c) Premises registered under Milk and Dairies Regulations 1949-1954. Dairies 5 21 Pasteurising plants and bottling establishments 0 0 F (4) National Assistance Act 1948. F (4)a 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. F (4)b Section 50. Following the deaths in Regional Group Hospitals of persons domiciled in the Borough, visits to dwellings in company with Group Hospital Management Committee officers, in two instances, resulted in considerable sums of money being located. This was duly paid in to the Treasury Solicitors. 52 F (5) Burial Act 1857. Section 25. In accordance with the prescribed requirements of the Home Secretary's licence, one re-interment at Erith Cemetery was supervised during the year. F(6) Legal Proceedings. Statute. Offence. Penalty. Sec. 154 Public Health Act Exchanging toys £3. 1936. for rags. Sec. 154 Public Health Act Exchanging toys £3. 1936. for rags. 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 1950 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