BOROUGH OF ERITH ANNUAL REPORT of the Medical Officer of Health For the year 1938 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 1958 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 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) Infant Mortality 11 (d) Deaths, Death Rate, Maternal Mortality Rate 12 (e) Summary of Vital Statistics for year 1958 13 (f) Vital Statistics of the whole District during 1958 and previous years 14 (g) Table showing Summary of Causes of Death during 1958 15 (h) Infant Mortality—Causes of death and table of comparison 16 (i) Comparison of Maternal Mortality Rate 17 B Prevalence of and control over Infectious and other Diseases 1. Notifications 18 (a) Age Distribution 19 (b) Ward Distribution 20 2. Tuberculosis (a) New cases notified during 1958 21 (b) Deaths 21 3. Diphtheria Immunisation 22 4. Vaccination against Smallpox 23 5. Vaccination against Poliomyelitis 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) The Clean Air Act, 1956 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 34 (k) Camping Sites 34 (1) Hop Pickers 34 (m) Rodent Control 34 (n) Pest Control 35 (o) Eradication of Bed Bugs 36 (p) Heating Appliances (Fireguards) Act 1952 and Regulations 1953 36 (q) Mosquito Control 36 (r) Agriculture (Safety, Health and Welfare Provisions) Act, 1956 36 6. Shops Act, 1950 37 7. Sanitary Accommodation at Offices 37 8. Street Trading 38 9. River Thames—Effluvia 38 10. The Storm of the Century 38 ii Section Page 11. Factories 40 (i) Inspections 40 (ii) Defects found 40 12. Housing 41 Houses in Clearance Areas and unnt houses elsewhere 41 (a) Houses demolished 41 (b) Unfit houses closed 41 (c) Unfit houses made fit and houses in 42 which defects were remedied (d) Housing statistics 42 13. The Rent Act, 1957 43 E Water Supply—Milk—Food and Drugs Act— Food Inspection 1. Water Supply 44 2. Milk Supply (a) Food and Drugs Act, 1955, Sec. 37 The Milk (Special Designations) (Specified Areas) Order, 1951 44 (b) The Milk (Special Designation) (Raw Milk) Regulations 1949 and 1954. The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949 to 1953 44 (c) Bacteriological examination of milk 44 (d) Designated milk licences 45 (e) Milk and Dairies Regulations 1949 45 (f) Ice Cream 45 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, 1954 49 (f) Disease of Animals (Waste Foods) Order 1957 49 4. Food and Drugs Act, 1955, Sections 2 and 91 50 5. Food Hygiene 51 The Food Hygiene Regulations, 1955 51 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 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 E. C. Pringle, J.P. (1957-1958). Mayor-Councillor A. H. Cross, J.P. (1958-1959). Deputy Mayor— Councillor C. Schofield, B.A. (1957—1958). Deputy Mayor— Councillor E. C. Pringle (1958-1959). Health Committee Chairman— Councillor E. C. Pringle. Members of Committee May 1957—May 1958 May 1958— May 1959 Aldermen W. F. Alford W. F. Alford E. Handy B Handy C. F. Morling Councillors Mrs. A. E. Bennett Mrs. A. E. Bennett F. Crow F. Crow Mrs. J. Sidders Mrs. M. M. Eccles E. E. Virrels Mrs. J. Sidders E.E. Virrels Ex-Officio Members Alderman G. W. H. Luck G. W. H. Luck Councillors C. Schofield, B.A. A. H. Cross, J.P. 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). 8, Brampton Road, Bexleyheath. (Telephone: Bexleyheath 2244). Chief Public Health Inspector L. E. King, M.R.S.H.j D.S.A.A., Certs: P.H.I.E.B., R.S.H., R.I.P.H. and H., Meat Inspector's Certificate, I.S.A.A. Public Health Inspectors P. R. Hickson, Cert. P.H.I.E.B., Meat Inspector's Certificate. 0. B Dodds, Cert. P.H.I.E.B. F. C. Shaw, Cert. P.H.I.E.B., R.I.P.H. & H., Meat Inspector's Certificate (Temporary). Student Public Health Inspectors: C. H. Ellis. K. E. Doubleday. Higher National Building Cert. Chief Clerk J- A. Sutherland. (Resigned 31.7.58). R. V. Hoad. (Appointed 1.10.58). Clerks Shorthand-typist:— Miss D. M. Williams Junior Clerk:— Miss P. M. Webster 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 1958, which is prepared on the lines suggested by the Minister of Health. The Registrar-General's estimate of the mid year population for the Borough is 45,880 compared with 46,010 in 1957. Generally speaking, on the basis of the statistical information available, the health of the Borough was well maintained. The standardised death rate was 12.91 per thousand of the home population compared with 11.7 for the whole of England and Wales. The birth rate at 14.65 per thousand remains considerably lower than that for the country as a whole (16.4). Thirteen infants died during the first year of life, giving an infant mortality rate of 19.35 per thousand live births. The infant mortality rate for England and Wales was 22.6 per thousand. Four deaths were associated with prematurity and congenital malformation, over which no significant degree of control is possible at present. Much research is, however, going on in regard to the possible influence of german measles and other virus infections which may affect the growing foetus during the early months of pregnancy. There was one maternal death, giving a maternal mortality rate per 1.000 total births of 1.49, compared with 0.44 per 1,000 for England and Wales. Deaths from tuberculosis numbered four as against six in 1957. Deaths due to malignant disease, in general, showed an increase over the previous year, and cancer of the lung caused 22 deaths, as against 21 in 1957. Deaths attributed to coronary disease numbered 76, compared with 61 in 1957, and 59 in 1956. For the ninth year in succession there has not been a single case of diphtheria in the Borough. There was one case of non-paralytic poliomyelitis during the year Thirty-five new cases of tuberculosis were notified during 1958 as against 53 during the previous year. The year under review was a measles year and a considerable epidemic commenced in July and continued to the end of March, 1959. During 1958, 614 cases were notified, and all cases were treated at home. Infectious diseases throughout the ages have shown a rise and fall in incidence due to many and complicated 5 factors which are not fully understood. This matter is, however of great significance from the administrative point of view as well as from the standpoint of the health of the community. As a result of the provision of pure water supplies in the middle of the 19th century the enteric and diarrhoeal diseases generally were largely overcome. Scarlet fever, which in the 19th century and early part of this century was one of the main killing diseases, is, nowadays, a disease of little importance. Smallpox has been largely overcome by stringent supervision at sea and air ports- and by the instrument of vaccination, although the possibility of an epidemic is always present, so that the greatest vigilance is necessary at all times. The last great epidemic of diphtheria occurred in the early 1930's and was thought to be due, largely, to an increase in the virulence of the diphtheria organism. The introduction of mass immunisation in the middle of the 1930's, together with great improvements in environmental and personal health have, practically, abolished this disease, although small outbreaks of virulent type do occur from time to time in different areas. The need to keep the level of immunisation of children at a high level has often been stressed. It is, of course, possible that any deterioration in environmental conditions resulting, for example, from war conditions or other calamity, might bring all or any of these diseases back in an enhanced form. Nowadays the main hazard is due to the virus diseases, of which poliomyelitis is the best known example. There are reasonable grounds, however, for optimism that the mass immunisation of the young population may, before long, in some way alter the relationship between the virus and the human organism, but it is too early yet to say whether one can look forward with confidence to the early abolition of this disease. The antibiotics and chemo-therapeutic drugs have shorn measles of most of its terrors due, largely, to preventing the serious complications, such as bronchopneumonia, which was the main cause of death in years gone by. Much discussion is taking place at the present time as to whether the present system of notification of infectious diseases which is founded, largely, on experience gained during the last half-century, does not need to be drastically overhauled. The notification of measles, which came into operation in 1940 when environmental conditions were seriously affected by the war, is regarded by many as being unnecessary at the present time in view of the fact that 6 little, if any, action is taken following the receipt of notifications by general practitioners. The cost of this notification is quite considerable and there is no commensurate return from the health point of view. Scarlet fever is another disease the notification of which could, perhaps, temporarily be discontinued. It is hoped that in the future the whole position of notification of infectious disease will be rationalised in the light of present day needs. During the year poliomyelitis vaccination was vigorously carried out by the Local Health Authority ,and details of the numbers vaccinated are given on page 23. During 1958 the Council decided to explore the possibility of implementing section II of the Clean Air Act, 1956, relating to smoke control areas, and a pilot survey was undertaken 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. A further pilot survey, on a different type of area was carried out during 1959. The Health Committe have been much exercised in the course of their deliberations by the lack of assurance that adequate supplies of smokeless fuels, other than coke, will be available and have not been too happy that, in the main, authorities will have to rely on coke as the main source of smokeless fuel for some years to come. In 1956, the South East London Mass Radiography Service issued a report on the operation of the service in a report entitled "No Time for Complacency" and although no hard and fast conclusions could be drawn from this in regard to the incidence of pulmonary tuberculosis in this area, it was evident that a sufficient reservoir of infection was present to raise the question of the advisability of carrying out a concentrated mass radiography survey. The Councils of Erith, Bexley and Crayford have now appointed a joint committee to carry out such a survey in the Spring of 1960, and a great deal of preparatory work will be necessary in the Autumn of 1959. A house to house visitation will need to be made which, in the case of Erith, alone, may mean as many as 13,000 visits with proportionate numbers for the remaining two areas. Tuberculosis is a waning disease and it is hoped that this concentrated attack will contribute towards its final eradication. 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 7 in the home. It is hoped that this work may be greatly increased in the future, although this would entail a larger expenditure than has been possible in the past. Both the Local Authority and the Local Health Authority have the power to make grants for this purpose. The Fabrics (Misdescription) Regulations of 1959 are to be welcomed in this connection in that they prescribe new standards of non-inflammability for textile fabrics, to which the Fabrics (Misdescription) Act of 1913 applies, namely, textile fabrics to which is attributed the quality of non-inflammability or safety from fire, or any degree of that quality. The Act places the responsibility on the Local Authority, who have been considering how the stringent British Standards tests prescribed by the Regulations could best be carried out. It is likely that they are too complicated to be carried out in the Health Department and the Council are considering the possibility of submitting samples of fabrics to one or other of the testing houses, recommended by the Board of Trade, who would be prepared to undertake such work on behalf of Local Authorities. The future of the health services in this area is closely linked up with work of the Royal Commission on Local Government in the Greater London area. The present separation, in the Borough, of the environmental from the personal health services is an artificial one, and I think one may look forward with some confidence to an improvement in the position in years to come. In conclusion I wish to thank the Chairman and Members 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 the good work which they have done during the year. I am, Your obedient servant, JOHN LANDON Medical Officer of Health. 8 Annual Report 1958 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 the town 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, the manufacture of chemicals, coal shipping and lighterage, production of stoneware drain pipes and asbestos components. Deep sea cables continue to be manufactured in the town, likewise television and radio equipment, and toys. Industrial expansion has continued throughout the year, the new all-concrete jetty which projects 550 feet into the River Thames providing much additional berthing accommodation for colliers. By the end of 1958, the erection of the new £60,000 coal screening plant at Garden Wharf had progressed considerably, and it is anticipated that the improved method of screening will be in operation by the Spring of 1959. Every effort has been made to install modern equipment which will mitigate the emission of coal dust. The new Royal Alfred Seamen's Home at Belvedere is now rapidly approaching the stage of completion. Extensive construction works comprising the extension of the L.C.C.'s Southern Sewerage outfall, and the building 9 of the new electricity generating station are operating on the riverside marsh area at the west end of the town. The electricity station is expected to be completed by 1961. Lower Belevedere Re-development scheme has made considerable progress, and many of the newly erected flats and business premises are now occupied. A (2) Comparative Rainfall 1957 1958 Month. Inches. Month. Inches. January 1.07 January 1.82 February 2.55 February 2.02 March 0.89 March 1.04 April 0.16 April 1.68 May 0.95 May 1.73 June 0.76 June 4.75 July 2.98 July 1.86 August 2.74 August 4.08 September 2.35 September 5.18 October 1.39 October 2.52 November 3.19 November 1.61 December 1.67 December 2.50 Total 20.70 30.79 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 1942—1958. 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 I 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 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 December, 1958 222 12 120 3 357 A (4) STATISTICS A (4)a General Area (i) Including River:—4,607 acres. Area (ii) excluding River:—3,859 acres. Population figure supplied by Registrar General: — Estimated mid-year Home Population—45,880. Density of population, i.e. No. of persons per acre (Based on (ii) above):—11.9. No. of inhabited houses at 31st December, 1958. (Excluding houses with shops and houses with Public Houses assessed as single hereditaments)—13,360. Rateable value at 31st December, 1958, £720,511. Sum produced by a penny rate, 1958, (Product for 1958/59): £3,007. Rate in the £ at 31st December, 1958:—18s. 4d. 11 EXTRACTS FROM VITAL STATISTICS FOR YEAR 1958 A (4)b Births Male Female Total Live Births Legitimate 337 316 653 Illegitimate 7 12 19 344 328 672 Live Birth rate per 1,000 Home Population (Registrar General's Figure). 14.65. Birth rate corrected for comparison with other areas:— 14.65. Comparability factor supplied by Registrar General:— 1.00. Live Birth rate, England and Wales:—16.4. Corresponding rate for the Borough of Erith for year 1957:—14.45. Male Female Total Still Births Legitimate 5 8 13 Illegitimate 5 8 13 Still Birth rate per 1,000 total births:—18.98. Still Birth rate per 1,000 total births, England and Wales:—21.6. Still Birth rate per 1,000 Home Population:—0.28. Still Birth rate per 1.000 Home Population, England and Wales:—0.36. Male Female Total Total live and still births 349 336 685 A (4)c Infant Mortality Deaths of infants under 1 year of age: — Male Female Total Legitimate 8 5 13 Illegitimate - 8 5 13 12 Death rate of Infants under one year of age, per 1,000 live births:— 19.35. Rate per 1,000 live births, England and Wales:—22.6. Rate per 1,000 legitimate live births:—19.91. Rate per 1,000 illegitimate live births:—Nil. Deaths of infants under 4 weeks of age:— Male Female Total Legitimate 6 4 10 Illegitimate - - 6 4 10 Death rate of infants under 4 weeks of age per 1,000 live births:—14.88. Death rate of infants under 4 weeks of age per 1,000 live births England and Wales:—16.2. Illegitimate live births per cent of total live births:— 2.83. A (4)d Deaths Maternal Deaths. Number of women dying in, or in consequence of, childbirth:—1. Maternal Mortality Rate per 1,000 total births:—1.49. Comparative figure for England and Wales:—0.44. Deaths all Causes. Male: - 282 Female: - -224 Total: —506. Death rate per 1,000 Home Population: —11.03. Death Rate corrected for comparison with other areas.—12.91. Comparability Factor supplied by Registrar General:— 1.17. Corresponding rate 1957:—10.11. Death rate per 1,000 Home population, England and Wales:—11.7. 1958 1957 Total number of deaths from: — Measles (All ages) - Whooping Cough - - 13 A (4)e Summary of Vital Statistics for the year 1958 England and Wales Borough of Erith Births:— Rates per 1,000 Home Population Live births 16.4 14.65 Still births 0.36 21.6(a) 0.28 18.98(a) Deaths:— All causes 11.7 11.03 Typhoid and Paratyphoid 0.00 - Whooping Cough 0.00 - Diphtheria 0.00 - Tuberculosis 0.11 0.09 Influenza 0.05 0.04 Smallpox 0.00 - Acute Poliomyelitis (including Polio-encephalitis) 0.00 - Pneumonia 0.55 0.54 Notifications:— (Corrected) Typhoid Fever 0.00 - Paratyphoid Fever 0.00 - Meningococcal Infection 0.02 0.02 Scarlet Fever 0.86 0.28 Whooping Cough 0.74 0.50 Diphtheria 0.00 - Erysipelas 0.07 0.04 Smallpox 0.00 - Measles 5.75 13.38 Pneumonia 0.49 0.24 Acute Poliomyelitis (including Polio-encephalitis) Paralytic 0.03 - Non-Paralytic 0.01 0.02 Food Poisoning 0.20 - Puerperal Pyrexia 14.26(a) 16.06(a) Deaths: — Rates per 1,000 live births All causes under I year of age 22.6 19.35 Enteritis and diarrhoea under 2 years of age 0.44 - (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—1948-1958 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) 11.73 12 18.05 1958 45.880 672 14.65 (Corrected) 14.65 14.65 506 11.03 (Corrected) 12.91 13 19.35 14 15 A (4)g Table showing Summary of Causes of Death during the year ended 31st December, 1958 Cause of Death Males Females Total 1 Tuberculosis, Respiratory 4 - 4 2 Tuberculosis, Other forms - - - 3 Syphilitic diseases - 1 1 4 Diphtheria - - - 5 Whooping Cough - - - 6 Meningococcal Infection - - - 7 Acute Poliomyelitis - - - 8 Measles - - - 9 Other infective and parasitic diseases 1 1 2 10 Malignant neoplasm, stomach 7 6 13 11 Malignant neoplasm, lung, bronchus 20 2 22 12 Malignant neoplasm, breast - 8 8 13 Malignant neoplasm, uterus - 4 4 14 Other malignant and lymphatic neoplasms 40 24 64 15 Leukaemia, Aleukaemia 2 3 5 16 Diabetes 1 2 3 17 Vascular lesions of nervous system 25 26 51 18 Coronary disease, angina 45 31 76 19 Hypertension with heart disease 11 8 19 20 Other heart diseases 30 41 71 21 Other circulatory diseases 13 11 24 22 Influenza 2 - 2 23 Pneumonia 15 10 25 24 Bronchitis 23 11 34 25 Other diseases of respiratory system 4 1 5 26 Ulcer of stomach and duodenum 3 2 5 27 Gastritis, enteritis and diarrhoea - - - 28 Nephritis and Nephrosis 6 4 10 29 Hyperplasia of prostate 2 - 2 20 Pregnancy, Childbirth and abortion - 1 1 31 Congenital Malformations - 2 2 32 Other defined and ill-defined diseases 13 20 33 33 Motor vehicle accidents 4 1 5 34 All other accidents 6 4 10 35 Suicide 5 - 5 36 Homicide and operations of war - - - Total all causes 282 224 506 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 3 4 Acute Intestinal Obstruction 1 1 Bronchitis 1 1 2 Bronchopneumonia 1 1 2 Congenital Defects 1 1 2 Prematurity 2 2 Totals 3 3 1 2 1 1 1 1 13 12 of the 13 infant deaths occurred in hospital. Coroner's Postmortem examinations were carried out in 4 cases. No inquests were held. 16 17 Below is given a table showing the Infant Mortality rates and actual number of infant deaths for Erith at five yearly intervals 1920-1945 and yearly from 1946-1958. 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 1958 13 19.35 22.6 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 1958 1 672 13 1.49 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 11 - 1 Acute Poliomyelitis (Non-Paralytic) 1 1 - Erysipelas 2 - - Measles 614 - - Meningococcal Infection 1 1 - Puerperal Pyrexia 11 11 - Scarlet Fever 13 - - Whooping Cough 23 - - Total 676 13 1 B (l)a Age Distribution The following table shows the age distribution of confirmed cases of Infectious Disease (other than Tuberculosis) notified during the year. Disease Age Groups Under 1 year 1 2 3 4 5—9 10—14 15—24 25 & 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 - 1 - 5 4 - - 11 Acute Poliomyelitis (non-Paralytic) - - - - - - - - - - - - - - 1 - - - - - 1 Erysipelas - - - - - - - - - - - - - - 1 1 - - 2 Measles 12 6 24 31 35 39 49 38 38 36 153 146 1 2 i 2 - 1 - - 614 Meningococcal Infection - - - - - - - - - - - - - - - - - - - - 1 Puerperal Pyrexia - - - - - - - - - - - - - - - 5 - 6 - - 11 Scarlet Fever - - - - - - - - - 4 4 4 1 - - - - - - - 13 Whooping Cough - - 2 - 1 4 3 2 3 2 2 3 - 1 - - - - - - 23 Totals 12 6 26 31 36 43 52 40 42 42 159 153 3 3 3 7 6 12 - - 676 19 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 1 2 2 3 - 3 11 Acute Poliomyelitis (non-paralytic) - - - - - 1 1 Erysipelas - 2 - - - - 2 Measles 69 82 116 115 96 136 614 Meningococcal Infection - - - - 1 - 1 Puerperal Pyrexia 7 - - 2 1 1 11 Scarlet Fever - 4 2 2 1 4 13 Tuberculosis (Respiratory) 10 7 3 4 4 6 34 Tuberculosis (Non-Respiratory] - - - - - 1 1 Whooping Cough 6 1 6 7 1 2 23 Totals 93 98 129 133 104 154 711 21 B (2) Tuberculosis B(2)a New Cases notified for the first time during 1958. Age Respiratory Non-Respiratory Total M F M F Under 5 years - 1 - - 1 5—14 „ 1 1 - - 2 15—24 „ 1 1 - - 2 25-44 „ 9 6 1 - 10 45—64 „ 5 1 - - 6 65 & over 5 3 - - 8 Age unknown - - - - - Totals 21 13 1 - 35 In addition to the above cases 9 males and 8 females suffering from respiratory tuberculosis were transferred into the district from other areas. One female (respiratory) was transferred back into the district. 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, 1958, 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 1958. Year of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations Year of Birth Number Immunised Primary Inoculations Number given Reinforcing Inoculations 1958 Under 1 year of age 54 - 1953— 1949 5—9 years of age 18 237 1957 1 year of age 278 3 1948— 1944 10—14 years of age - 12 1956 2 years of age 30 1 1955 3 years of age 7 3 1954 4 years of age 5 20 Total 374 27 18 249 23 Table B:—Number of children resident in the Borough of Erith under the age of 15 years on 31st December, 1958, who had completed a course of Immunisation at any time since 1st January, 1944. 0 - 4 years 5-14 years Year of Birth Number considered to be immunised Year of Birth Number considered to be immunised 1958 54 1953 499 1957 338 1952 564 1956 415 1951 535 1955 392 1950 607 1954 408 1949 722 1948 625 1947 735 1946 652 1945 554 1944 560 Total 1,607 Total 6,053 B (4) Vaccination Against Smallpox Age at 31st December, 1958 Under 1 year 1-4 years 5—14 years 15 or over Total Number vaccinated 113 141 10 14 278 Number re-vaccinated - - 8 26 34 B (5) Vaccination Against Poliomyelitis. The following table gives the number of persons resident in the Borough, with year of birth, who received injections against poliomyelitis during the year ended 31st December, 1958: — Year of Birth Given two injections Given third injection Year of Birth Given two injections Given third injection 1958 89 - 1951 285 16 1957 356 11 1950 170 25 1956 435 64 1949 184 21 1955 395 52 1948 193 18 1954 319 36 1947 226 32 1953 353 32 1946 474 5 1952 348 20 1945 385 3 1944 411 5 Total 4623 340 Others 636 3 Total 5259 343 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 the Ambulance Station. Erith Road, Bexleyheath, telephone Crayford 21511. 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. 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. Congregational Hall, Belvedere. 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 Oifices, Bexley. During the year the mortuary accommodated 177 bodies, and post-mortem examinations were carried out in 175 cases 25 inquests were held. 75 bodies were from the Erith area, and post-mortem examinations were carried out in 75 cases. There were 13 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. Home visiting and good neighbourly services are one of the busiest but least publicised activities of the Committee. The holiday scheme was continued and 54 parcels were distributed at Christmas to needy old people who were prevented by ill health from attending a Christmas dinner and entertainment which was arranged for 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. Miss E.M.Y. Deceased was 66 years of age and died in a local nursing home. There were no known relatives and a death grant was not payable. Case No. 2. Mr. P.K. Deceased was aged 62 years and died at his lodgings in Erith. A death grant was received. Subsequently two persons were traced, residing in Eire, who claimed relationship with the deceased. 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 18,500 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 17 l0¾ Cost per ton of disposing of refuse 17 3 Net cost per 1,000 population per annum 594 17 5 The following tables show: — 1 Details 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 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 28 D (l)c Table 2 Month Tonnage Tons Cwts. January, 1958 876 6 February, 1958 734 17 March, 1958 805 2 April, 1958 859 3 May, 1958 833 9 June, 1958 805 4 July, 1958 832 2 August, 1958 725 4 September, 1958 817 19 October, 1958 837 9 November, 1958 796 14 December, 1958 889 13 Total 9,813 1 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 £840 8s. 8d. in 1958. D (3) Salvage Tonnage collected: Income: T. C. Q. lbs. £ s. d. 1,223 6 1 20 6,804 3 9 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 6.45 a.m.—10.30 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 6.45 a.m.—10.30 p.m. High Street, Erith, Male and Female 6.45 a.m.—10.30 p.m. Colyers Lane, Male and Female. 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 9.229 Notices served: Formal 27; Informal 302: 329 Complaints received and investigated 1,256 Number of disinfections 85 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 36 59 6 6 Bakehouses 9 25 3 3 Dairies 5 28 4 4 Butchers' shops 34 198 11 11 Fish friers 10 41 8 8 Slaughterhouses 2 519 6 6 Factories 167 118 23 23 Outworkers 85 85 - - Food factories 4 19 2 2 Pet shops 4 37 1 1 Rag flock dealers 2 15 1 1 D (5)c Summary of Nuisances abated and defects remedied during the year Drains repaired 48 New W.C. pans 4 New W.C.'s provided 3 New sinks fixed 25 Water supplies provided 9 Dustbins renewed 38 W.C. cisterns repaired 11 Sink waste pipes renewed 6 Roofs made watertight 41 Dampness remedied 45 Fjoors repaired 21 Firegrates repaired 9 Plasters renewed 34 Windows made to open 19 Eaves gutters repaired 33 Yard pavings made good 10 Walls re-pointed 5 Offensive accumulations removed 8 Miscellaneous 39 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 of at the outfall vested in the West Kent Main Sewerage Board. Twenty seven cesspools are known to exist, and these are subject to cleansing service (Resolution of the Council dated 10th March, 1942). During the year, one cesspool was abandoned, the dwelling it served being subject to closing under the Housing Act. Corporation sewers have been extended to serve the newly developed housing estates. The increased number of cesspools is due to factory extensions on the Belvedere marsh area where no sewers exist. 31 D (5)e Atmospheric Pollution Results of Analysis (a) The Erith Borough Council is a constituent member of the Thameside Advisory Committee for the Abatement of AtmosDheric Pollution. Atmospheric Pollution. In this connection a deposit gauge and a lead peroxide gauge is in position at the ground of the Royal Alfred Institution, and the analysis of the contents of these gauges for 1958 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 Load peroxide gauge Sulphur mg/l00 sq ems/day January 1.16 10.34 6.95 17.29 1.07 3.04 February 1.76 8.37 5.84 14.21 0.87 2.39 March 1.02 9.71 7.45 17.16 1.24 2.12 April 1.61 9.58 4.23 13.81 0.74 1.41 May 1.85 7.69 5.30 12.99 0.94 0.70 June 5.15 8.67 8.05 16.72 1.61 0.88 July 1.70 6.33 5.10 11.43 0.94 0.70 August 3.87 5.15 5.77 10.92 0.81 0.55 September 5.90 9.97 12.08 22.05 2.28 1.35 October 3.44 5.41 6.31 11.72 1.21 1.52 November 0.44 4.39 6.51 10.90 1.31 3.02 December 2.55 11.97 7.51 19.48 1.14 2 35 Monthly average for 1958 14.89 1.18 1.67 Monthly average for 1957 15.68 1.25 1.56 Monthly average for 1950 37.75 5.17 No readings New York City,U.S. A. Monthly average for 1958 72.00 - - (b) In conformity with the request of the above mentioned Committee, a smoke filter and volumetric sulphur dioxide apparatus was installed in July, since which time daily readings have been made and results thereof recorded by the Public Health Inspectors. Appended below are particulars of the highest recorded figures for the period ended 31st December, 1958:-- Smoke: smog level. Sulphur Dioxide: smog level. 200 mgs per 100 cu. metres. 40 parts per 100 millions. 127.2 52.9 Reading 15.11.58. Reading 5.12.58 32 D(5)f The Clean Air Act 1956 The object of this Act is to abate pollution of the air to assist in which Local Authorities are enabled to create smoke control areas by means of Orders subject to confirmation by the Minister of Housing and Local Government. As yet, no Orders have been submitted to the Minister for approval but by the end of the year, a pilot survey of existing appliances in dwellings situated within a proposed area of 148 acres was well in progress, on completion of which, a report will be presented to the Local Authority. One visible result of the Clean Air Act is the reduction of the former voluminous smoke emission from factories, and at the local ceramic works the old-type kilns are being drastically improved, and the conversion to gas heating is being explored. (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 the 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, 80,249 articles were dealt with. Attendances at the Swimming Baths for 1958: Swimming pool Slipper baths Schools: During term 10,064 Schools: During holidays 2,600 Youth clubs 7,837 Total Total for 1958 20.501 for 1958 16,143 Total Total for 1957 22,646 for 1957 17.373 D (5)g Swimming Baths and Pools 33 (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 and is always well attended. D (5)h Offensive Trades Other than 10 fish frying establishments, there are no 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. Two samples were obtained during the year, a copy of one of which is as follows: — Tests. Results. Chlorine content 7 parts per 100,000 Oil content 2.4% Soap content 0.8% Soluble impurities (i) 1.3% (ii) 1.3% (iii) 1.4% Average 1.3% Remarks: Sample satisfactory. 30th May, 1958. 34 D (5)j Pet Animals Act 1951 This Act contains welfare provisions with regard to pet animals exposed or deposited for the purpose of sale. Of this type of shop, 4 exist and are subject to annual licensing. All these were found to be conducted in a satisfactory manner and in accordance with the statutory requirements Animal food with horseflesh content, of which a large quantity is sold from these premises, is marked "Horseflesh," D (5)k Camping Sites There are no camping sites in the Borough. During the year, one licence to station 10 caravans was issued by the Local Authority under Section 269 Public Health Act, 1936. 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. In March, ten per cent baiting with 2 oz. deposits of unpreserved sausage rusk was carried out in the Council's sewers when 102 manholes were tested. In no instances were test baits taken. Twenty fourth maintenance treatment associated with the foregoing, comprised the 1-4-8 day technique in 12 manholes when preserved 1 lb. pre-baits of oatmeal, sugar, oil, and 5% warfarin were laid. During the whole treatment, only two manholes showed any infestation as a result of which the Ministry of Agriculture, Fisheries, and Food, advised that no general sewer treatment be carried out in September. 35 The use of paranitrophenol preservative for rat baits has undoubtedly resulted in more effective treatment of sewers. Success would appear to be due to the fact that larger baits which have prolonged durability can be used with the object of ensuring concentrated feeding in the manholes. Furthermore, a more flexible programme is made possible. The use of Sodium Fluoracetate has not yet been adopted. (b) Prevention of Damage by Pests (Application to to Shipping) Order, 1951. This Order has been implemented at the various wharfs, jetties, and dry slipways in the Borough, for the purpose of which, the following visits and inspections were made:— Lighters 55 Refuse barges 17 Coastwise vessels 18 Tugs 21 Yachts 1 Total 112 No marine infestations were located. 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 6 nests were destroyed. The income arising from this outdoor service amounted to £50 6s. 0d., which is inclusive of cost of insecticides, etc., used, and apportionment charge of the operative's time. Wild rabbits affected with Myxomatosis were located in the Lessness Abbey Woods, the infestation being successfully dealt with. 36 D (5)o Eradication of Bed Bugs Bed bug infestations continue to decrease, the number of dwellings which were treated being as follows:— Privately owned houses 5 Corporation houses 6 With a view to obtaining good control, occupiers are encouraged to reveal any infestations, when every assistance is given to eradicate the pests. D (5)p Heating Appliances (Fireguards) Act 1952 and Regulations 1953 Almost without exception, it is found that heating appliances sold in shops are guaranteed to comply with the requirements of the Regulations. Routine visits were made to many vendors' premises and the probe test applied to 171 appliances, all of which complied with the statutory requirements. Special attention is devoted to appliances which are sold from second hand establishments. Though no safety factor is provided for in respect of existing appliances under repair, many electrical shops have been persuaded to include the safety factor along with the necessary repair work. D (5)q Mosquito Control The many ditches which intersect the Belvedere marsh area were, as usual, 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(5)r Agriculture (Safety, Health and Welfare Provisions) Act 1956. Section 3 and 5 of the above Act which place duties on Local Authorities in connection with the provision of sanitary conveniences at farms and similar premises, have, so far as is possible, been implemented. The requisite action includes enforcement of a suitable and sufficient number of conveniences, and their proper maintenance at all times. 37 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. 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) No legal proceedings were instituted during the year, but on four occasions it was found necessary to draw the attention of shopkeepers to the statutory provisions with regard to Sunday trading. (e) The application of the provisions of Section 38 of the Shops Act, 1950, resulted in the following improvements being effected: — Heating facilities provided or renewed 3 Washing facilities 3 Lighting improved 1 Seats provided 2 Sanitary conveniences 2 D (7) Sanitary Accommodation at Offices In accordance with the requirements of Section 46 of the Public Health Act 1936, all new offices constructed in the developing Belvedere area were provided with suitable and sufficient sanitary conveniences. Various improvements have been effected in sanitary accommodation already existing at office premises. 38 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. D (9) River Thames—Effluvia Effluvia from the River Thames were not so apparent during the summer months, probably due to the low atmospheric temperatures which prevailed. In May, the Parliametary Secretary to the Ministry of Works announced in the House of Commons that the Chemical Research Laboratory of the Department of Scientific and Industrial Research had developed a process for the production of sulphur from raw sludge to which calcium sulphate had been added. This had operated successfully at Beckton. The work had been undertaken in collaboration with the London County Council which was now considering the installation of a 100,000 gallon plant for full scale development trials. The process was not yet at a stage at which it should be recommended to all Local Authorities. Results of the tests at Beckton were awaited, but it had proved economical in the sense that the system removed a large amount of water, which meant that the amount to be carried away was about half the quantity it would otherwise be. This meant a great saving. In view of the chemical experiments which are taking place at the outfall works, it is considered necessary to keep river and associated atmospheric conditions constantly under review. D (10) The Storm of the Century. Tn the light of structural and other damage caused by unprecedented rainfall, the night of 5th September, 1958. is likely to be long remembered. It was at dusk that the storm approached the town from the west, and at its height 2.04 inches of rain fell—including 1.68 inches in 37 minutes. When it is remembered that one inch of rain on an acre's surface equals 101 tons in weight, it is not difficult to imagine what is likely to happen when such mass 39 weight travels at a speed of about three miles per hour, and cascades into low lying areas as it did on the night of 5th September. Resultant damage included the breaking of road surfaces, collapse of boundary walls, uprooting of trees and foliage, the deposit of debris of all kinds in the low lying areas. Flood access to dwellings was by way of doors, sub-floor ventilators and drains, flood level varying up to three feet, this being extremely unfortunate for householders because of the damage to floor coverings which happen to be one of the most costly of house furnishings. Within 24 hours, flood water had substantially seeped away, and it was at this stage that public health assistance was given to those distressed. This included the mass clearing of choked drain interceptors and gulleys, the methodical clearance of mud, liberal application of chloride of lime where necessary, aeration of dwellings by natural methods, and the salvaging of storm damaged food in shops. In these matters, the enthusiastic co-operation of the majority of occupiers with the public health service was much appreciated, and good team work achieved a rapid return to normal conditions. No incidence of infectious disease has been attributed to storm aftermath. 40 D (11) Factories (1) Inspections for the purpose of provisions as to health are detailed below: — Premises Number of Inspections Written Notices Owners Prosecuted 158 Factories on Register 101 13 - 9 Other premises under the Act including building and engineering construction but not including outworkers premises 17 3 - 167 118 16 — (2) Defects found: — Particulars Number of defects Found Remedied Referred to H.M.F.I. No. of defects in repect of which Prosecutions were instituted. Want of cleanliness 2 2 - - Overcrowding — — — — Unreasonable temperature - - - - Inadequate ventilation - - - - Ineffective drainage of floors - - - - Sanitary conveniences: (a) Insufficient 3 3 - - (b) Unsuitable or defective 11 11 - - (c) Not separate for sexes - - - - Other offences against the Act (not including offences relating to Outwork) 7 7 — — Total 23 23 — — 41 D (12) Housing Houses in clearance areas and unfit houses elsewhere. D(12)a. Houses demolished. Houses demolished Displaced during year. Persons Families In Clearance Areas. (1) Houses unfit for human habitation - - - (2) Houses included by reason of bad arrangements etc. - - - (3) Houses on land acquired under Section 43 (2) Housing Act 1957 - - - Not in Clearance Areas. (4) As a result of formal or informal procedure under sec. 17 (1) Housing Act 1957 Formal 12 41 12 Informal 26 83 26 (5) Local Authority owned houses certified unfit by Medical Officer of Health 26 119 26 (6) Houses unfit for human habitation where action has been taken under local Acts - - - (7) Unfit houses included in Unfitness Orders - - - D(12)b. Unfit houses closed. Number (8) Under sees. 16 (4), 17 (1) and 35 (1) Housing Act 1957 6 29 6 (9) Under sees. 17 (3) and 26 Housing Act 1957 - - - (10) Parts of buildings closed under sec. 18 Housing Act 1957 — — - 42 D(12)c. Unfit houses made fit and houses in which defects were remedied. By Owner By Local Authority (11) After informal action by Local Authority 121 - (12) After formal notice under: (a) Public Health Acts 27 1 (b) Secs. 9 and 16 Housing Act 1957 - - (13) Under sec. 24 Housing Act 1957 - - D(12)d Housing statistics Number of permanent houses constructed in the Borough during 1958: — By the Council 2 houses: 160 flats By private enterprise 33 houses: 6 flats Total 35 houses: 166 flats Total number of permanent houses built and owned by the Council 1,376 Total number of flats built and owned by the Council 448 Total number of prefabricated temporary houses in the Borough 200 Crown Property at Woolwich Arsenal. Crossness, Bungalows Nos. 43-76. These 34 stone fabric bungalows of 1916 vintage, and occupied by Ministry of Supply security personnel, were all subject to informal housing action during the year, resulting from which all except one of the families were rehoused. At the end of the year, many of the bungalows had been demolished, and it is expected that the whole site will be cleared by 1959. Corporation Property. Nissen Huts at Nissen Way and Appian (Way. By the end of the year, 32 huts at Nissen Way, and 29 huts at Appian Way had been demolished subsequent to the rehousing of the 61 families. It is anticipated that the available sites will be utilised for building traditional properties. 43 Special Housing Circumstances. Having regard to the influx of residents from abroad into local housing accommodation, a sanitary inspection and overcrowding survey was carried out at all such dwellings when it was found that the majority of the responsible householders were co-operative and were acquiescent to public health essentials. Whilst the number of occupants is apt to be somewhat fluid, in the light of "permitted numbers," no gross overcrowding was located, neither were any major nuisances detected. It was however, necessary to insist on certain improvements being affected, and it is proposed to keep these dwellings and the associated housing conditions under review. D (13) The Rent Act 1957. Most of the enquiries by tenants regarding this Act relate to repairs, and the appropriate methods to be taken to obtain prompt rent reductions. In many cases it is found that action under the Public Health Act effects the requisite improvement much quicker than by the Rent Act alone, but for the most dilatory owner, a combination of both Acts often proves to be the most effective procedure. Action taken under the Rent Act, 1957, is enumerated below: — No. of applications for Certificates of Disrepair 45 No. of Certificates issued 27 No. of Revocations applied for 6 No. of Revocations granted 5 44 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 samples per month have been drawn from various domestic sources in the district and forwarded to the appropriate laboratory for bacteriological examination, all with satisfactory results. On investigation of complaints in the early part of the year, it was found that the "cloudy" condition of domestic supply was due to air having gained access to pipes via mains which had been opened up. No adverse effect was identified, clarification being rapidly effected. 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 18 Tuberculin tested (pasteurised) 4 Sterilised 3 25 All the samples satisfied the methylene blue, phosphatase and turbidity test. 45 E (2)d Designated milk licences The following table indicates the number of licences issued for 1958:— Dealers licences Supplementary licences Tuberculin tested 10 Tuberculin tested 8 Pasteurised 15 Pasteurised 8 Sterilised 36 Sterilised 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 36 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 6 Grade 2 2 Grade 3 1 Grade 4 1 46 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 regularly extended to Saturday mornings, and from the entries on the prescribed table, it will be seen that slaughtering is nothing less than formidable. As in previous years, a 100% inspection service has been given but it is most apparent that the incumbent duties of meat inspection are taxing the manpower resources of the Department to the full and is now equivalent to the whole time service of a Public Health Inspector. It was hoped that the Slaughterhouses Act, 1958, which came into operation on 1st August, 1958, would have made provision for regulating and stabilising hours of slaughtering. Unfortunately, however, no such amendment was made, and until this important matter is rigidly dealt with, an exacting situation which has to be coped with by Public Health Inspectors, will continue, at the same time prejudicing equally important public health work. 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 846 174 580 1813 37576 — Number inspected 846 174 586 1813 37576 — All diseases except Tuberculosis and Cysticerci. Whole carcases condemned — — — — 60 — Carcases of which some part or organ was condemned 134 26 2 51 1346 - Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 15.8% 14.9% 0.34% 2.8% 3.7% - Tuberculosis only. Whole carcases condemned — 2 — — 11 — Carcases of which some part or organ was condemned 9 5 - - 113 - Percentage of the number inspected affected w;th Tuberculosis 1.1% 4.0% - - 0.33% - Cysticercosis. Carcases of which some part or organ was condemned - - - - - - Carcases submitted to treatment by refrigeration - - - - - - Generalised and totally condemned — — — — — — Total weight of meat diseased and unfit, and consequently destroyed:— 8 tons, 1 cwt., lqr., 0 lbs. 48 E (3)b Exchequer grants towards cost of Meat Inspection. The Slaughterhouses (Meat Inspection Grant) Regulations, 1958, which came into operation on 2nd October, 1958, supersedes Circular 2/57 dated 11th April, 1957. No material change has resulted, and the Exchequer contribution remains identical with the former provision. The object of the grant is to assist those Local Authorities on which the costs of meat inspection in slaughterhouses imposes an unduly heavy burden because much of the meat is not for local consumption. In this regard, proportionate grant is 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 cattle beast is regarded as 10 inspection 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, (a) Considerable time and attention has been devoted to the inspection of food in shops and stores, as a result of which a total of 1 ton, 3 cwts., 1 qr., 11 lbs. was confiscated as being unfit for human consumption. (b) Lebanese apples which had been delivered to shops in the district were found to contain 1 to 10 p.p.rn. Arsenic and 6 to 30 p.p.m. lead as a result of which precautionary measures were put into operation. All the shops concerned were visited on which the fruit was withdrawn from sale and duly returned to the source of supply. E (3)d Disposal of Unsound Meat. In accordance with the recommendations of the Ministry of Food 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, inclusive of tinned goods is disposed of with town's refuse which is barged across the River Thames, and tipped in Essex. 49 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 instruments used are captive bolt pistol, and electrolethaler. The number of slaughtermen's licences issued is 14. E(3)f Diseases of Animals (Waste foods) Order 1957. Pursuant to powers delegated by the Kent County Council on 12th November, 1957, all the 15 waste food boiling plants were visited and inspected, subsequent to which 14 licences were duly issued. Particulars of all these premises, including the one considered to be unsatisfactory were forwarded to the County Council. 50 E(4) Food and Drugs Act, 1955. Sections 2 and 91. The following samples were procured during the yeai and submitted to the Public Analyst for the purpose of analysis with results as follows: — Article Unsatisfactory Genuine No. of samples Milk — 20 20 Butter 1 1 2 Margarine — 1 1 Cooking fat — 1 1 Shredded beef suet — 1 1 Preserves 1 4 5 Canned and dried fruit — 7 7 Flour — 2 2 Sugar for cakes — 1 1 Pepper — 2 2 Chicken spread — 2 2 Sauce — 8 8 Medicines — 8 8 Gravy powder — 2 2 Cream — 4 4 Peas — 3 3 Pork Roll — 1 1 Cake Mix — 1 1 Custard powder — 1 1 Spices and Herbs — 3 3 Jelly — 6 6 Cheese spread — 3 3 Chocolate spread — 1 1 Rice — 1 1 Ice Cream — 5 5 Beverages and drinks — 3 3 Fruit pies — 1 1 Fish and meat pastes — 3 3 Savoury stuffing — 1 i Honey spread — 1 1 Baking Powder — 1 1 Dessert Powder — 2 2 Mincemeat — 2 2 Christmas pudding — 2 2 Flavouring essence — 1 1 Non-brewed condiment — 1 1 Vinegar — 2 2 Casserole steak 1 — 1 Cochineal — 1 1 Evaporated milk — 3 3 Condensed milk - 4 4 3 117 120 Remarks on unsatisfactory samples: — Nail in Butter. Warning letter sent to retailer. Jam. 5% deficiency in fruit. Warning letter sent to retailer. Casserole steak. Deficiency in meat content—no standard—matter deferred. 51 E(5) Food Hygiene. The Food Hygiene Regulations 1955. (1) Since 1st January, 1956, when the above Regulations came into operation there has been a considerable improvement in regard to standards aspects of both food hygiene, and personal hygiene. Whilst many food premises have been completely re-conditioned, others are in the process of reconstruction with a view to improving the existing conditions. Some food purveyors have completely abandoned the former practice of selling open food and the storage of food in refrigerators prior to sale, 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 Statute. Mo. of premise. No. of visits. Butchers 34 198 Bakehouses 9 25 Fishfriers 10 41 Food factories 4 19 Ice-cream dealers ... 126 199 Ice-cream manufacturers 5 16 Slaughterhouses 2 519 (b) Food premises not subject to registration. Fishmongers 13 39 Cafes 25 181 Grocers 79 49 Greengrocers & Fruiterers 40 28 Confectioners 50 24 Milkshops 36 42 (c) Premises registered under Milk and Dairies Regulations 1949-1954. Dairies 5 28 Pasteurising plants & bottling establishments 0 0 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. 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. Art. 28. Good rule and governDog fouling footway. £1 ment Bye-laws 1941. Section 94 Public Health Act Disrepair of DwelNuisance Order 1936 ling-house issued by trates Court. 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