Urban District Council of FELTHAM Annual Report OF THE Medical Officer of Health for the year ending 31st December, 1947. Feltham, Middx. July, 1948. 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: F. V. BELL, M.R.San.I., M.S.I.A., F.R.S.A. Additional Sanitary Inspectors: A. W. KENT, A.R.San.I., M.S.I.A. (Resigned 6.8.47.) G. E. CORAM, M.R.San.I., M.S.I.A. (Resigned 30.6.47.) J. SMITH, A.R.San.I., M.S.I.A. (Appointed 1.12.47.) 3 Council Offices, Feltham. July, 1948. Madam Chairman, and Gentlemen, I beg to present my Annual Report on the Health and Sanitation of your District for the year 1947. 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 39,760 (1947). This is an increase, compared with the 1946 figure of 38,740. 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 £1,099 12s. Id. All classes of inhabited houses 10,090 Working-class dwellings 5,157 New working-class dwellings erected 98 Total number of new houses erected 148 Vital Statistics. Live Births— Total Male Female Legitimate 827 440 387 Illegitimate 39 18 21 Total 866 458 408 Birth rate per 1,000 of the estimated resident population— 21.78 (1946 20.26) Still Births Legitimate 12 4 8 Illegitimate 1 1 — Total 13 5 8 Rate per 1,000 total births (live and still)—14.78 (1946 16.29) Rate per 1,000 of the estimated resident population—0.32 (1946 0.33) 4 Deaths Total Male Female 315 165 150 Death rate per 1,000 of the estimated resident population— 7.94 (1946 7.96) Deaths from Puerperal causes— (Headings 29 and 30 of the Registrar-General's Short List) Deaths (Rate per 1,000 total (live and still) births No. 29 Puerperal and PostAbortion Sepsis — — (1946 — ) No. 30 Other Maternal causes — (1946 1.25) Total — (1946 1.25) Death rates of Infants under one year of age All infants per 1,000 live births (45) 51.96 (1946 33.12) Legitimate infants per 1,000 legitimate live births (44) 53.20 (1946 32.12) Illegitimate infants per 1,000 illegitimate live births (1) 25.64 (1946 52.63) Total Rate per 1,000 of estimated population Deaths from Cancer (all ages) 53 1.33 (1946 1.21) Deaths from Measles (all ages) 1 0.25 (1946 — ) Deaths from Whooping Cough (all ages) 2 0.50 (1946 0.02) Rate per 1,000 live births Deaths from Diarrhoea (under two years) 7 8.08 (1946 2.54) Birth and Death rates for England and Wales, 1947 Birth rate 20.5 Still Birth rate 0.50 Death rate 12.0 Deaths under one year of age 41.0 Deaths from Diarrhoea and Enteritis (under two years of age) 5.8 Maternal Mortality—England and Wales, 1947— Abortion with Sepsis 0.10 Abortion without Sepsis 0.06 Puerperal Infections 0.16 Other 0.85 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 2 5. Diphtheria — — — 6. Tuberculosis of the respiratory system 14 6 20 7. Other forms of tuberculosis 2 — 2 8. Syphilitic disease — — — 9. Influenza 2 1 3 10. Measles 1 — 1 11. Acute poliomyelitis and polioencephalitis — — — 12. Acute infectious encephalitis — — — 13. Cancer of buccal cavity and eosophagus (M) Uterus (F) 2 3 5 14. Cancer of stomach and duodenum 9 5 14 15. Cancer of breast — 4 4 16. Cancer of all other sites 20 10 30 17. Diabetes 1 1 2 18. Intra-cranial vascular lesions 5 19 24 19. Heart disease 34 41 75 20. Other diseases of the circulatory system 2 4 6 21. Bronchitis 12 5 17 22. Pneumonia 12 9 21 23. Other respiratory diseases 2 1 3 24. Ulceration of the stomach or duodenum 6 3 9 25. Diarrhoea (under two years of age) 4 3 7 26. Appendicitis — 1 1 27. Other digestive diseases 4 3 7 28. Nephritis 2 1 3 29. Puerperal and post-abortive sepsis — — — 6  Male Female Total 30. Other maternal causes — — — 31. Premature birth 4 5 9 32. Congenital malformations, birth injury, infantile disease 9 7 16 33. Suicide 1 2 3 34. Road traffic accidents — 1 1 35. Other violent causes 4 3 7 36. All other causes 12 11 23 165 150 315 Notifiable Diseases other than Tuberculosis. Disease Total Nos. Notified Admitted to Hospital Deaths Diphtheria 4 4 — Measles 75 16 1 Whooping Cough 18 11 2 Pneumonia 4 2 21 Scarlet Fever 12 9 — Cerebro-spinal Fever 4 4 — Puerperal Pyrexia — — — Ophthalmia Neonatorium — — — Erysipelas 3 2 — Poliomyelitis 2 2 — Polioencephalitis — — — Enteric and Typhoid Fever 1 1 — Malaria 1 — Age Periods Scarlet Fever Diphtheria Encephalitis Puer. Py. Erysipelas Pneu. monia Measles whooping Cough Cerebrospinal Fever Under 1 yr. 1 — — — — 2 7 2 — 1—3 years 1 — — — — — 11 10 3 3—5„ — — — — — — 27 5 1 5—10 „ 5 1 — — 1 — 30 1 — 10—15„ 4 2 — — — — — — — 15—25 „ — 1 — — — 1 — — — Over 25 „ 1 — — — 2 1 — — — Total 12 4 — — 3 4 75 18 4 Ophthalmia Neonatorium Notified — Cases treated at home — Cases treated in hospital — Vision unimpaired — Total blindness — Death — 7 Tuberculosis. New Cases Deaths Age Periods Respiratory Non. Respiratory Respiratory NonRespiratory M F M F M F M F Under 1 yr. 1 — — — — — — — 1— 5 Years — 1 — — — — — — 5—15 „ 3 5 1 — — — 1 — 15—25 „ 4 13 — 1 — — — — 25—35 „ 8 10 — 3 — 5 — — 35—45 „ 5 3 — 1 4 1 — — 45—65 ,, 13 2 1 — 8 — — — Over 65 ,, 1 — — — 2 — 1 — Total 35 34 2 5 14 6 2 — Tuberculosis. Notifications of new cases of tuberculosis are almost the same as for 1946, the figure being 76 as compared with 74, deaths from this cause are exactly the same as in 1946. The overcrowded conditions under which many people are living, resulting from the acute shortage of houses is almost certainly helping to keep the numbers of new notifications at a comparatively high figure, but it must also be remembered that a number of these cases are mild ones which have been detected at an early stage by the use of mass radiography. The adequate housing of persons suffering from active pulmonary tuberculosis and their families is essential if increases in new cases of this disease are to be prevented. Maternal Mortality. It is gratifying to report that there have been no cases of maternal mortality during the year. 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 8 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, although the Housing Committee's programme of building is now well under way and houses are becoming available in increasing numbers. Diphtheria Immunisation. Two clinic sessions a week are held at the Public Health Department, Feltham, Public Hall, Bedfont, or the Village Hall, Hanworth, and in addition facilities are available at the Maternity and Child Welfare Clinics of the County Council who are now primarily responsible for the immunisation of children under 5 years of age. The day nurseries and St. Anthony's Home have been visited regularly. The Birthday card scheme by which each child receives a card on its first birthday has been continued and the County Council's Health Visitors give special attention to the encouragement of mothers to bring their babies for immunisation. 475 children received reinforcing injections during 1947. 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 great decline in the number of cases. Water Analysis. 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 The number of children immunised during 1947 and the estimated percentage of the child population immunised up to 31st December, 1947, are as follows:— Under 5 years 5—14 years inclusive. 605 311 43% 79.15% 9 Board. The water supplied by the South West Suburban Water Co. is taken by that Company from the Metropolitan Water Board. The water supply has been satisfactory both as regards quantity and quality. 2. Samples for bacteriological examination and chemical analysis are taken five times each week by the Metropolitan Water Board of the raw and treated water, and seven check samples have been taken in Feltham by the South West Suburban Water Co. In addition, ten samples were taken 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.) No. of Samples 252 Ammoniacal Nitrogen 0.173 Albuminoid Nitrogen 0.076 Oxidised Nitrogen (Nitrate) 3.1 Chlorides as CI. 24.3 Oxygen abs from Permanganate 3 hours at 80°F 1.08 Turbidity in terms of Silica 0.7 Colour m.m. brown 2ft. tube Burgess's Tintometer 19 Hardness Total 245 Hardness (Permanent) 70 pH Value 7.7 Conductivity 450 Bacteriological Results No. of Samples 1080 Colony Count on agar at 37°C 18.5 BACT. COLI TEST Percentage of samples negative per 100 ml. 99.1 Bact coli per 100 ml. 0.013 10 Typical Analysis of South West S.W. Go. Supply (Parts per million.) Chemical Appearance: Clear and bright. Turbidity (Silica Scale) Nil Colour (Hazen) Faint yellow brown on the alkaline side 11 Odour Nil Refection pH of neutrality 7.9 Free Carbon Dioxide 3 Electric Conductivity at 20°C 475 Total Solids, dried at 180°C 320 Chlorine in Chlorides 22 Alkalinity as Calcium Carbonate 195 Hardness: Total 275 Carbonate (Temporary) 195 Non-carbonate (Permanent) 80 Nitrogen in Nitrates 3.8 Nitrogen in Nitrites Absent Free Ammonia 0.088 Oxygen absorbed in 4 hrs at 27°C 1.60 Albuminoid Ammonia 0.056 Free Chlorine Reaction 0.32 Metals: Iron: Less than 0.03 Other metals Absent Bacteriological Number of Colonies developing on Agar per e.c. 1 day at 37°C 2 days at 37°C 3 days at 37°C qr ml. in 17 24 9 Presumptive Coliform Reaction Absent from 100 ml. Bact. coli. Absent from 100 ml. CI. welchii Reaction Present in 100ml. Absent from 10 ml. This sample is clear and bright in appearance, practically neutral in reaction and free from metals apart from a negligible trace of iron. The water is hard in character but not to an excessive degree and it contains 11 no excess of salinity or mineral constituents in solution. It shows only a trace of colour and is of satisfactory organic and bacterial purity. These results are consistent with a wholesome water suitable for drinking and domestic purposes. 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 few outlying cottages (some of 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. Only a very limited number of houses are supplied by standpipe, the vast majority being supplied direct. Conclusion. In conclusion I should like to thank the members of the Committee for the support which they have given me during the year and also to thank Mr. Bell and the staff of the department for their able and willing assistance. F. H. WOODS, Medical Officer of Health 12 CHIEF SANITARY INSPECTOR'S REPORT Council Offices, Feltham, Middlesex. July, 1948. To Dr. F. 11. 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. Very considerable staffing difficulties have arisen during the year. For several months both the posts of Additional Sanitary Inspector were vacant and the staff was up to establishment for only six months of the year. With a small staff this naturally upsets the routine and I was not able to carry out the improvements which I had hoped to do. 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. In some cases much inconvenience and unhappiness is caused by the occupation of a house by more than one family, but where there is no illegal overcrowding. Applicants for rehousing have been visited 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 13 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. Forty-seven samples were taken of graded milks, most of which were satisfactory. A few samples failed the methylene blue test, but it was usually possible to attribute this failure to some temporary fault. A great deal of trouble was experienced due to the unsatisfactory keeping quality of the milk purveyed by one dairy company from outside the area and many complaints were received. Action was taken which resulted in considerable improvement. Forty-five samples of ice cream were taken, the grading of which was as follows:— Group 1. Groups 1 and 2. Group 3. 4. 23.7% 64.2% 31% 4.8% There are no large manufacturers in the area and most of the retailers purchase ready made ice cream. All ice cream premises were visited and advice given. Special attention was given where unsatisfactory samples were obtained, but there were no cases of consistently bad samples. 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. There is close co-operation with the Food Executive Officer of the Ministry of Food with regard to food premises in respect of which applications for new licences are under consideration. The supply of dustbins is now satisfactory, enabling a speeding up of action taken under Section 75 of the Public Health Act, 1936, to be effected. 14 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. In May a 10% test baiting of the sewers was undertaken and the sewers proved to be free from infestation. Nomad caravan dwellers have been a source of considerable trouble, as they have been to surrounding districts. 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. FRANCIS V. BELL, Chief Sanitary Inspector. 15 Summary of Sanitary Work and Improvements Eradication of Bed Bugs (1) The number of Council houses infested 7 The number of Council houses disinfested 7 The number of other houses infested 17 The number of other houses disinfested 17 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 31 Scarlet Fever 10 Diphtheria 9 Cerebro Spinal Fever 1 Poliomyelitis 0 Erysipelas 3 Pneumonia 2 Encephalitis Lethargica 1 Total 62 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 16 Supplementary Licences:— Tuberculin Tested 4 Accredited — Pasteurised 4 Inspection and Supervision of Food Carcases examined at Slaughter houses Beasts Calves Lambs Pigs Horses Donkeys Goats No. killed — — — 48 4272 66 2 No. inspected — — — 48 4263 66 2 Diseases excluding Tuberculosis— Beasts Calves Lambs Pigs Horses Donkeys Goats Whole carcase condemned — — — — 6 — — Carcases of which some part or organ condemned — — — 5 1203 45 1 Percen tage affected with disease other than tuberculosis — — — 10.41 28.16 68.18 50.0 Tuberculosis only— Whole carcase condemned — — — — — — — Carcases of which some part or organ condemned — — — — — — — Percen tage affected with tuberculosis — — — — — — — Meat Inspected at Butchers' Shops A number of carcases, quarters, parts of carcases and organs have been examined. The following has been declared unfit for human consumption:— 17 Whole Carcases— Beasts Calves Sheep Pigs Tuberculosis — — — — Other Disease — — — — Part Carcases and Organs— Tuberculosis 17 lbs. — — — Other Disease 1680 lbs. 163 lbs. 22 lbs. 29 lbs. In addition the following amount of canned meat was found to be unfit for human consumption:— 8 cwts. 12 lbs. 18 Annual Report of the Medical Officer of Health in Respect of the Year 1947 on the administration of the Factories Act, 1937 Part 1 of the Act 1. Inspections for purposes of provisions as to health (including inspections made by Sanitary Inspectors) Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 5 2 – – (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 110 53 3 – (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) – – – – Total 115 55 3 – 2. Gases in which defects were found Number of cases in which defects were found. Particulars Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) — — — — Overcrowding (S.2) — — — — Unreasonable temperature (8.3) — — — — Inadequate ventilation (S.4) — — — — Ineffective drainage of floors (S.6) — — — — Sanitary Conveniences (S.7 (a) Insufficient 2 2 — — (6) Unsuitable or defective 2 2 — — (c) Not separate for sexes — — — — Other offences against the Act (not including offences relating to Outwork) 1 1 — — Total 5 5 — — Part VIII of the Act Outwork (sections 110 and 111), nil.