Urban District Council of FELTHAM Annual Report OF THE Medical Officer of Health for the year ending 31st December, 1946. Feltham, Middx. June, 1947. Urban District Council of Feltham Public Health Department Medical Officer of Health (part time) : F. H. WOODS, M.R.C.S., L.R.C.P. Chief Sanitary Inspector : R. J. ROWDON, C.R.S.I., M.S.I.A. (retired 24.1.46) F. V. RELL, M.R.San.I., M.S.I.A., F.R.S.A. (Appointed 25.1.46) Additional Sanitary Inspectors : A. W. KENT, A.R.San.I., M.S.I.A. R. B. GIRLING, C.R.S.I., M.S.I.A. (Appointed 1.4.46, Resigned 20.7.46) G.E. GORAM, M.R.San.I., M.S.I.A. (Appointed 1.11.46) 3 Council Offices, Feltham. June, 1947. Madam Chairman, Ladies and Gentlemen, I beg to present my Annual Report on the Health and Sanitation of your District for the year 1946. The District is divided into three Wards: Bedfont, Feltham and Hanworth, with a total acreage of 4,925. The population as estimated by the Registrar General is 38,740 (mid. 1946). This is an increase, the 1945 figure being 35,670. The day population is increased by people working at the various factories and shops. A small number continue to work at agriculture. The sum represented by a penny rate is £1,125 10 1.17d. All classes of inhabited houses 10,322 Working-class dwellings 9,608 New working-class dwellings erected 216 Total number of new houses erected 226 Vital Statistics. Live Births— Total Male Female Legitimate 747 398 349 Illegitimate 38 20 18 Total 785 418 367 Birth rate per 1,000 of the estimated resident population— 20.26 (1945 19.20). Still Births Legitimate 12 6 6 Illegitimate 1 — 1 Total 13 6 7 Rate per 1,000 total births (live and still)—16.29 (1945 11.49) Rate per 1,000 of the estimated resident population—0.33 (1945 0.22) 4 Deaths Total Male Female 309 156 153 Death rate per 1,000 of the estimated resident population— 7.96 (1945 8.94) Deaths from Puerperal causes— (Headings 29 and 30 of1 the Registrar-General's Short List) (Rate per 1,000 total Deaths ' (live and still) births No. 29 Puerperal and Abortion Sepsis — — (1945 — ) No. 30 Other Maternal causes 1 1.25 (1945 — ) Total 1 1.25 (1945 — ) Death rates of Infants under one year of age All infants per 1,000 live births (26) 33.12 (1945 55.23) Legitimate infants per 1,000 legitimate live births (24) 32.12 (1945 55.98) Illegitimate infants per 1,000 illegitimate live births (2) 52.63 (1945 44.44) Total Rate per 1,000 of estimated population Deaths from Cancer (all ages) 47 1.21 (1945 1.71) Deaths from Measles (all ages) — — (1945 .028) Deaths from Whooping Cough (all ages) 1 0.02 (1945 — ) Rate per 1.000 live births Deaths from Diarrhoea (under two years) 2 2.54 (1945 8.71) Birth and Death rates for England and \Vales, 1946— Birth rate 19.1 Still Birth Rate 0.53 Death rate 11.5 Deaths under one year of age 43.0 Deaths from Diarrhoea and Enteritis (under two years of age) 4.4 Maternal Mortality—England and Wales, 1946— Abortion with Sepsis 0.13 Abortion without Sepsis 0.06 Puerperal Infections 0.18 Other 1.06 5 Causes of Death in your Area. Male Female Total 1. Typhoid and paratyphoid fevers — — — 2. Cerebro-spinal fever — — — 3. Scarlet fever — — — 4. Whooping cough — 1 1 5. Diphtheria — 1 1 6. Tuberculosis of the respiratory system 7 11 18 7. Other forms of tuberculosis 2 2 4 8. Syphilitic disease — 1 1 9. Influenza 2 4 6 10. Measles — — — 11. Acute poliomyelitis and polioencephalitis — — — 12. Acute infectious encephalitis — — — 13. Cancer of buccal cavity and eosophagus (M) Uterus (F) 1 4 5 14. Cancer of stomach and duodenum 4 5 9 15. Cancer of breast — 3 3 16. Cancer of all other sites 19 11 30 17. Diabetes — 2 2 18. Intra - cranial vascular lesions 11 14 25 19. Heart disease 50 39 89 20. Other diseases of the circulatory system 3 7 10 21. Bronchitis 11 6 17 22. Pneumonia 7 5 12 23. Other respiratory diseases 2 2 4 24. Ulceration of the stomach or duodenum 4 1 5 25. Diarrhoea (under two years of age) 1 1 2 26. Appendicitis — 2 2 27. Other digestive diseases 2 1 3 28. Nephritis 2. — 2 6  Male Female Total 29. Puerperal and postabortive sepsis — — — 30. Other maternal causes — 1 1 31. Premature birth 4 4 8 32. Congenital malformations, birth injury, infantile disease 5 6 11 33. Suicide 1 2 3 34. Road traffic accidents 4 — 4 35. Other violent causes 3 7 10 36. All other causes 11 10 21 156 153 309 Notifiable Diseases other than Tuberculosis. Disease Total Nos. Notified Admitted to Hospital Deaths Diphtheria 2 1 1 Measles 2 1 — Whooping Cough 6 1 1 Pneumonia — — 12 Scarlet Fever. 24 23 — Cerebro-spinal Fever 1 1 — Puerperal Pyrexia — — — Ophthalmia Neonatorium 1 1 — Erysipelas 2 1 — Poliom yelitis — — — Polioencephalitis 1 1 — Age Periods Scarlet Fever Diphtheria Encephalitis Puer. Py. Eryipelas Pneumonia Measles Whooping Cough CerebroSpinal Fever Under 1 yr. — — — — — — — l 1 1—3 years — — — — — — 2 1 — 3—5 „ 5 — — — — — — 1 — 5—10 „ 6 — 1 — — — — l — 10—15 „ 9 — — — — — — l — 15—25 „ 3 1 — — — — — — — Over 25„ 1 1 — — 2 — — 1 — Total 24 2 1 — 2 — 2 6 1 Ophthalmia Neonatorum Notified 1 Cases treated at home — Cases treated in hospital 1 Vision unimpaired 1 Total blindness — Death — 7 Tuberculosis. New Cases Deaths Age Periods Respiratory NonRespiratory Respiratory Non- Respiratory M. F M F M F M F Under 1 yr – – – – – – – – 1—5 years — — 1 2 — 1 1 — 5—15 „ 3 3 1 2 — — 1 — 15—25 „ 10 8 1 1 1 2 — — 25—35 „ 7 11 — 2 2 5 — — 35—45 „ 4 5 1 2 — 1 — — 45—65 „ 7 2 – — 4 2 — 1 Over 65 „ 1 — — — — — — — Total 32 29 4 9 7 11 2 2 Tuberculosis. Notifications of new cases of tuberculosis show an increase of approximately ten per cent, deaths from this cause are also higher than in 1945. The overcrowded conditions under which many people are living, resulting from the acute shortage of houses has almost certainly helped to bring about this unsatisfactory condition. The adequate housing of persons suffering from active pulmonary tuberculosis and their families is essential if further increases in new cases of this disease are to be prevented. Housing. There is still a considerable amount of overcrowding in the district, three and even four families having to live in a single house. These families are mostly young couples, living often with their parents and in many cases trying to raise a young family under most difficult and trying conditions. There are many instances of these mothers having their babies at home, because of shortage of maternity beds, under conditions of overcrowding which would once have been considered intolerable. The need for houses is extremely urgent. Diphtheria Immunisation. Two clinic sessions a week are held at the Public Health Department, Feltham, The Institute, Bedfont, or The Village Hall, Hanworth, and in addition facilities are available at the Maternity and Child Welfare Clinics of the County Council. The day nurseries and St. Anthony's Home have been visited regularly. 8 During the summer months a propaganda campaign was undertaken in connection with the national campaign organised by the Ministry of Health. Advertisements were inserted in the local press, films and slides shown at cinemas, posters and handbills were distributed throughout the district at doctor's surgeries, chemists' shops, public notice boards, etc, but the results were disappointing. It is a sad reflection, that a death from diphtheria is far more effective in bringing children for immunisation. A Birthday card has been sent to each child living in the district on its first birthday for the past three years, and the County Council Health Visitors give special attention to the question of immunisation when visiting. From the commencement of the year the Middlesex County Council, as the Welfare Authority, became primarily responsible for the immunisation of children under 5 years of age. The number of children immunised during 1946 and the estimated percentage of the child population immunised up to 31st December, 1946, are as follows:— Under 5 years. 5—14 years inclusive. 869 391 40.05 % 77.88% 250 children received reinforcing injections during 1946. Scabies Clinic. Facilities continue to be available at the Public Health Department for the treatment of scabies. I am glad to say, however, that there has been a gradual decline in the number of cases. Factories. A number of factories in the area have been inspected by the Sanitary Inspectors and action has been taken in several instances which has resulted in improvements to the existing sanitary accommodation or the provision of new or additional accommodation. This work is often delayed by the necessity of obtaining licences and 1. The Bedfont and Feltham Wards of the District are supplied by the South West Suburban Water Co. and the Hanworth Ward by the Metropolitan Water Board. The water supply has been satisfactory both as regards quantity and quality, although concern has been expressed at the results of some of the chemical analyses, the bacteriological results have been satisfactory due to effective chlorination. 2. Bacteriological and chemical analyses are made by the supply companies, seventy-two by the South West Suburban Water Company and by the Metropolitan Water Board 662 from the Hampton Works and 819 from Kempton Park Works. In addition, samples of each supply were taken quarterly by my department. There is an arrangement between my Council and the Councils of the following districts : Hayes and Harlington Windsor Egham Bagshot Easthampstead by which the water supplied by the South West Suburban Water Company to the combined districts is sampled twenty-five times a year on a rota. Average Results of Analyses of Metropolitan Water Board Supply. (Parts per million.) Ammoniacal Nitrogen Albuminoid Nitrogen Oxidised Nitrogen Chlorides as CI. Oxygen abs. from Permanganate 3 hours at 80° F. Hampton .131 .080 2.9 26.4 1.33 Kempton Park .127 .098 2.8 26.2 1.38 Turbidity in terrms of Silica Colour m.m. brown 2ft tube Burgess's Tintometer Hardness Total Hampton 0.7 21 257 Kempton Park 0.9 22 259 Hardness (Permanent) pH Value Conductivity Hampton 80 7.8 475 Kempton Park 77 7.9 475 Bacteriological Results No. of Samples Colony Count on agar at 37°C BACT. COLI TEST Negative per 100 ml. Bact coli per 100 ml. Hampton 662 16.9 97.4 .060 Kempton Park 819 19.1 99.0 .016 Typical Analysis of South West S.W. Co. Supply. (Parts per 100,000.) 1. Chemical. Total solids (dried at 120°C.) 32.0 Combined chlorine (as Cl) 3.3 equivalent to Sodium Chloride (NaCl) 5.5 Nitric nitrogen (Nitrates) 0.34 Nitrous nitrogen (Nitrites) faint trace present Ammoniacal nitrogen 0.0074 Albuminoid nitrogen 0.0134 Oxygen absorbed in 4 hours at 27°C 0.120 Lead or Copper Nil Temporary hardness (equivalent to CaCO3) 21.0 Permanent hardness ( „ „ „ ) 4.0 Total hardness ( „ „ „) 25.0 2. Bacteriological. The average number of organisms producing visible colonies on agar plates, at 20°—22°C. for three days 9 per millilitre At 37°C. for two days 14 per millilitre Faecal B.coli not found in 100 ml Probable number of coliform bacilli present equals none per 100 ml. Streptococci not found in 30 ml. Cl. welchii (spores) present in 25 ml. 3. The water supplied has no plumbo-solvent action but samples are tested for presence of metals. 4. No action has been required in respect of contamination of the water. 5. With the exception of a very few outlying cottages (which are likely to be scheduled for demolition when the housing position permits) all the houses in the area are supplied from the public water mains. All dwellinghouses are supplied direct. 9 by the general shortage of building materials and labour. Water Supply. F. H. WOODS, Medical Officer of Health. 10 CHIEF SANITARY INSPECTOR'S REPORT Council Offices, Feltham, Middlesex. June, 1947. To Dr. F. H. Woods, M.R.C.S., L.R.C.P., Medical Officer of Health, Sir, I beg to present a report upon the work of the department which I administer. The housing position is the cause of many bad cases of overcrowding which have been visited. Many people living under overcrowded conditions solicit the aid of the department in advancing their applications to the Council for rehousing. These cases are visited and, if considered necessary, are reported for consideration by the Housing Committee. Unfortunately, there are cases where much inconvenience and unhappiness is caused by the occupation of a house by more than one family, but where there is no illegal overcrowding, and one feels that some of these people will have to tolerate such conditions for a considerable time. Applicants for rehousing have been visited by the Sanitary Inspectors before interview by the Housing Committee, and I am hopeful that these fact-finding inspections have helped the Committee to assess those applicants with the greatest need. The urgent necessity of providing new houses also affects our efforts in connection with the repair of dwelling-houses. It is necessary to concentrate upon the most urgent defects, other works, necessary though they often are, have to be deferred. This position is not satisfactory, but is unavoidable. Some of the older houses present problems. There is only one real course of action and that is demolition; but as there are no replacements available for the occupiers, efforts have to be made to keep these worn-out houses habitable. 11 A serious nuisance to the residents in one area of the district was caused by the contamination of the water in a disused gravel pit during tipping operations. Action was taken and the company concerned cooperated fully. After a number of methods had been experimented with it was found necessary to discharge many thousands of gallons, of water into the West Middlesex Main Drainage Board's sewers, the dilution of the remaining water and large scale aeration. This necessitated constructing a pumping main and several pumping and aeration plants, two of which had to be mounted on steel floats and launched upon the offending water. The nuisance was completely abated and arrangements made for the quick filling in of the pit by the large scale tipping of shelter rubble, etc. After statutory action had been taken, the use of a private sewerage disposal plant serving 128 dwellings, which had given rise to nuisances on a number of occasions, was discontinued and the effluent diverted to the Council's sewers. The supply of dustbins has much improved, enabling a speeding up of action taken under Section 75 of the Public Health Act, 1936, to be effected. Rodent destruction, in accordance with the methods advocated by the Ministry of Food, has been continued. The house refuse tip has been kept under observation, but no serious infestation has occurred. Nomad caravan dwellers have been a source of considerable trouble, as they have been to surrounding districts. The wholesale meat distribution depot No. 16, which has operated at Bedfont since the early days of the war, returned to Smithfield on the 16th March, 1946. The distribution of meat to this and adjoining areas continues through the depot at its new location. Fifty-seven samples were taken of graded milks, most of which were satisfactory. One or two odd samples failed, but it was usually possible to attribute this failure to some temporary fault. They were not due to consistently faulty methods. 12 A great deal of work is required in connection with premises where food is prepared, stored, etc., and as much time as possible is spent on this work, but it is, of necessity, limited by the number of inspectors available and the calls upon their time by the many other activities of the department. In concluding I should like to thank you, Sir, for the consideration you have shown me, and the members of the staff for their support in carrying out the work of the department. Summary of Sanitary Work and Improvements Eradication of Bed Bugs (1) The number of Council houses infested 11 The number of Council houses disinfested 11 The number of other houses infested 12 The number of other houses disinfested 12 The number of other premises disinfested 1 (2) The methods of disinfestation employed are the spraying with contact insecticides incorporating D.D.T., mainly '' Pyagra " or " Zaldecide " or the use of fumigants, such as " Cimex " or " Thermatox " fumigators. Occasionally fumigation with hydrogen cyanide gas is carried out. (3) The furniture, etc., of prospective Council house tenants is inspected before removal to the Council's houses and if necessary is treated for the eradication of bugs. (4) The work of disinfestation is carried out by the local authority except when hydrogen cyanide gas is used, when a contractor is employed. Infectious Disease The following number of premises have been disinfected after cases (or suspected cases) of infectious disease:— Tuberculosis 13 Scarlet Fever 21 Diphtheria 4 Cerebro Spinal Fever 3 Total 41 13 Milk (Special Designations) Regulations, 1936-1946 The number of persons licensed in the district to sell or bottle graded milks is as follows:— Tuberculin Tested 4 Accredited — Pasteurised 4 Supplementary Licences : — Tuberculin Tested 4 Accredited — Pasteurised 4 Inspection and Supervision of Food Carcases examined at Slaughter-houses and Butcher's Shops Beasts Calves Lambs Pigs Horses Number killed — 1 — 69 387 N umber inspected — 1 — 69 387 Diseases excluding Tuberculosis— Beasts Calves Lambs Pigs Horses Whole carcase condemned — 1 — — 3 Carcases of which some part or organ condemned — — — 2 76 Percentage affected with disease other than tuberculosis — 100.0 — 2.80 20.22 Tuberculosis only— Whole carcase condemned — — — — — Carcase of which some part or organ condemned — — — — — Percentage affected with tuberculosis — — — — — Meat Inspected at Distributing Depot No. 16— The following number of carcases have been examined after slaughter and removal to the depot:— Beasts Sheep Calves Pigs — — — 7 14 In addition a large number of carcases, quarters, parts of carcases and organs have been examined. The following has been declared unfit for human consumption : — Whole Carcases— Beasts Calves Sheep Bigs Tuberculosis — — — — Other Disease — — — 2 Part Carcases and Organs— Tuberculosis Nil Other Disease 11 cwts. 14 lbs. In addition the following amount of canned meat was found to be unfit for human consumption :— 1 ton 3 cwts. 30 lbs. FRANCIS V. BELL, Chief Sanitary Inspector.