FELL 11 FELTHAM Urban District Council of FELTHAM Annual Report OF THE Medical Officer of Health for the year ending 31st December, 1948 Feltham, Middx. July, 1949. 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: J. SMITH, A.R.San.I., M.S.I.A. W. G. THURGOOD (Appointed 5.1.48, Resigned 1.5.48) R. C. ROGERS, M.S.I.A. (Appointed 15.9.48) 3 Council Offices, Feltham. July, 1949 Madam Chairman, and Gentlemen, I beg to present my Annual Report on the Health and Sanitation of your District for the year 1948. 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 41,940 (1948). This is an increase compared with the 1947 figurd of 39,760. 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 £1,152 5s. 4d. All classes of inhabited houses 10,683 Working-class dwellings 8,772 New working-class dwellings erected 515 Total number of new houses erected 546 Vital Statistics Live Births— Total Male Female Legitimate 797 400 397 Illegitimate 46 23 23 Total 843 423 420 Birth rate per 1,000 of the estimated resident population— 20.10 (1947 21.78) Still Births— Legitimate 17 9 8 Illegitimate — — — Total 17 9 8 Rate per 1,000 total births (live and still)—19.76 (1947 14.78) Rate per 1,000 of the estimated resident population—0.40 (1947 0.32) The sum represented by a penny rate is £1,152 5s. 4d. All classes of inhabited houses 10,683 Working-class dwellings 8,772 New working-class dwellings erected 515 Total number of new houses erected 546 4 Deaths Total Male Female 296 146 150 Death rate per 1,000 of the estimated resident population— 7.05 (1947 7.94) 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 - - (1947 Nil) No. 30. Other Maternal causes — — (1497 Nil) Total — — (1947 Nil) Birth and Death rates for England and Wales, 1948 Birth rate 17.9 Still Birth rate 0.42 Death rate 10.8 Deaths under one year of age 34.0 Deaths from Diarrhoea and Enteritis (under two years of age) 3.3 Maternal Mortality—England and Wales, 1948:— Abortion with Sepsis 0.11 Abortion without Sepsis 0.05 Puerperal Infections 0.13 Other 0.73 Death rates of Infants under one year of age All infants per 1,000 live births (22) 26.09 (1947 51.96) Legitimate infants per 1,000 legitimate live births (19) 23.09 (1947 53.20) Illegitimate infants per 1,000 illegitimate live births (3) 65.21 (1947 25.64) Total Rate per 1,000 of estimated population Deaths from Cancer (all ages) 46 1.09 (1947 1.33) Deaths from Measles (all ages) — — (1947 0.25) Deaths from Whooping Cough (all ages) — — (1947 0.50) Rate per 1,000 live births Deaths from Diarrhoea (under two years) - - (1947 8.08) 5 Causes of Death in your Area Male Female Total 1. Typhoid and paratyphoid fevers - - - 2. Cerebro-spinal fever 1 — 1 3. Scarlet fever — — — 4. Whooping cough — — — 5. Diphtheria — — — 6. Tuberculosis of the respiratory system 7 7 14 7. Other forms of tuberculosis 1 1 2 8. Syphilitic disease — 1 1 9. Influenza 3 1 4 10. Measles — — — 11. Acute poliomyelitis and polioencephalitis - 1 1 12. Acute infectious encephalitis - - - 13. Cancer of buccal cavity and eosophagus (M) Uterus (F) 1 3 4 14. Cancer of stomach and duodenum 7 3 10 15. Cancer of breast — 4 4 16. Cancer of all other sites 18 10 28 17. Diabetes 1 — 1 18. Intra-cranial vascular lesions 17 20 37 19. Heart disease 33 50 83 20. Other diseases of the circulatory system 8 6 14 21. Bronchitis 4 7 11 22. Pneumonia 8 10 18 23. Other respiratory diseases 2 2 4 24. Ulceration of the stomach or duodenum 2 - 2 25. Diarrhoea (under two years of age) - - - 26. Appendicitis 1 — 1 27. Other digestive diseases 4 2 6 28. Nephritis 2 3 5 29. Puerperal and post-abortive sepsis — — — 6 [ Male Female Total 30. Other maternal causes ... — — — 31. Premature birth — 1 1 32. Congenital malformations, birth injury, infantile disease 7 5 12 33. Suicide 6 1 7 34. Road traffic accidents 1 1 2 35. Other violent causes 5 3 8 36. All other causes 7 8 15 146 150 296 Notifiable Diseases other than Tuberculosis Disease Total Nos Notified Admitted to Hospital Deaths Diphtheria 3 3 — Measles 114 18 — Whooping Cough 92 3 — Pneumonia 3 3 18 Scarlet Fever 21 12 — Cerebro-spinal Fever 2 1 1 Puerperal Pyrexia 3 1 — Ophthalmia Neonatorium — — — Erysipelas 5 4 — Poliomyelitis — — — Polioencephalitis — — — Enteric and Typhoid Fever — — — Malaria — — — CerbroSpinal Fever Age Periods Scarlet Fever Diphtheria Encephalitis Puer. Py. Erysipelas Pneu. monia Meales Whooping Cough Under 1 yr - - - - - 1 4 7 1 1—3 years 2 1 - - - - 31 30 - 3—5 „ 8 1 - - - - 29 31 - 5-10 „ 9 1 - — - 2 49 23 - 10—15 „ 1 - - - - - - - 1 15—25 „ 1 - - - 3 - 1 - - Over 25 „ - - - — 2 — — 1 — Total 21 3 3 5 3 114 92 2 Ophthalmia Neonatorium Notified - Cases treated at home — Cases treated in hospital — Vision unimpaired — Total blindness — Death — 7 Tuberculosis New Cases Deaths Age Periods Respitary Non- Respiratory Respiratory Non- Respiratory Under 1 yr. M F M F M F M F 1 — — — — — — — 1— 5 years — — 1 — — - 1 — 5—15 „ 5 2 1 3 - — — 1 15—25 „ 16 18 1 1 — — — — 25—35 „ 5 10 - 2 2 4 — — 35—45 „ 6 6 1 - 1 2 — — 45—65 „ 3 — 1 2 2 1 — — Over 65 „ 1 — — — 2 — — — Total 37 36 5 8 7 7 1 1 Tuberculosis Notifications of new cases of tuberculosis have increased, the figures being 86 for 1948 and 76 for 1947, deaths from this cause however show a decrease, the figure being 16 as compared with 22. 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, in some cases two or three 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 8 ditions. 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 well under way and houses are becoming available in increasing numbers. Diphtheria Immunisation Responsibility for carrying out diphtheria immunisation passed to the Middlesex County Council on the 5th July, 1948, in accordance with the provisions of the National Health Service Act. By arrangement with the Area Medical Officer of Health, this Authority's immunisation clinics were continued until the end of the year when all arrangements for diphtheria immunisation were taken over by the Area Medical Officer. Whooping Cough Immunisation In February, 1948, the Public Health Committee decided with the consent of the Minister of Health to undertake the immunisation of children against whooping cough. This was carried out in conjunction with the diphtheria immunisation clinic and in many cases by use of a combined vaccine. This service was proving popular with the public and 348 children had completed a course of immunisation by the end of the vear when the service was passed over with the diphtheria immunisation to the County Council, the Area Medical Officer having agreed to carry on with the whooping cough immunisation. Scabies Clinic The number of cases of scabies referred to the department declined to such an extent that the Public Health Committee were able to dispense with the clinic. Arrangements have, however, been made for treating verminous cases, should the need arise. 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 Board. The 9 water supplied to this area 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 water and the treated water at all stages of purification, and weekly samples have been taken by the South West Suburban Water Co. In addition, eight 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 twentyfive times a year on a rota. Average Results of Analyses of Metropolitan Water Board Supply. (Parts per million.) Hampton Kempton Park No. of Samples 250 250 Ammoniacal Nitrogen 097 .056 Albuminoid Nitrogen 080 .091 Oxidised Nitrogen (Nitrate) 3.8 3.6 Chlorides as Cl. 27.5 27.3 Oxygen abs. from Permanganate 3 hours at 80°F 96 1.03 Turbidity in terms of Silica 5 .4 Colour m.m. brown 2 ft. tube Burgess's Tintometer 16 16 Hardness Total 248 257 Hardness (Permanent) 71 71 pH Value 7.7 7.9 Conductivity 475 475 Bacteriological Results No. of Samples 1065 954 Colony Count on agar at 37°C 4.7 18.5 BACT. COLI TEST Percentage of samples negative per 100 ml. 100 100 Bact. coli per 100 ml. Nil Nil 10 Typical Analysis of South West S.W. Co. Supply. (Parts per million.) Chemical Appearance : Clear and bright. Turbidity (Silica Scale) Nil Colour (Hazen) Faint yellow brown on the alkaline side 10 Odour Nil Reaction pH of neutrality 7.7 Free Carbon Dioxide 6 Electric Conductivity at 20°C 550 Total Solids, dried at 180°C 370 Chlorine in Chlorides 27 Alkalinity as Calcium Carbonate 205 Hardness: Total 280 Carbonate (Temporary) 205 Non-carbonate (Permanent) 75 Nitrogen in Nitrates 4.4 Nitrogen in Nitrites Absent Free Ammonia 0.016 Oxygen absorbed in 4 hrs. at 27°C 1.1 Albubinoid Ammonia 0.084 Residual Chlorine Absent Metals Absent Bacteriological Number of Colonies developing on Agar per c.c. 1 day at 37°C 2 days at 37°C 3 days at 20°C or ml. in 4 7 2 Presumptive Coliform Reaction Absent from 100 ml. Bact. coli Absent from 100 ml. CI. welchii Reaction Present in 100 ml. Absent from 10 ml. This sample is clear and bright in appearance, has a .eaction on the alkaline side of neutrality and is free from metals. The water is hard in character but its hardness and its content of mineral and saline constituents in solution are not excessive. It is of satisfactory organic quality and of a high standard of bacterial purity. These results are indicative of a water which is pure and wholesome in character and suitable for drinking and domestic purposes. 11 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. All water is chlorinated before distribution. 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 standpipes common to two or more houses, the vast majority being supplied direct. Food Poisoning No cases of food poisoning have been notified to me during the year. 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 June, 1949 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. Staffing difficulties have not been so severe as in 1947, although we were one sanitary inspector short for several months and with two changes of personnel during the year conditions were not as settled as one could wish for the continuous development and improvement of the department's services. The housing shortage is the cause of many cases of overcrowding which have been visited. Many people living under over-crowded 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 over-crowding. 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 dealing with old, obsolescent and worn out dwelling-houses. A start in a small way was made by the making of demolition orders in respect of eight cottages. The occupants were in process of being rehoused at the end of the year and 1949 will probably see the demolition of these unfit houses. 13 The position with regard to old houses is made more difficult by reason of the high cost of repairs. The question of "reasonable cost "having to be borne in mind, yet demolition on anything but a small scale is not practicable because of the need for finding new accommodation for the people displaced. Fifty-seven samples were taken of graded milks, fifty-two of which were satisfactory. Five samples failed the methylene blue test, three of the samples being tuberculin tested (pasteurised) milk retailed by one particular dairy. There had previously been trouble with this milk so arrangements were made for an alternative source of supply. Thirty-six samples of ice-cream were taken, the grading of which was as follows:— Group 1 Groups 1 and 2 Group 3 Group 4 54.83% 64.51% 25.8% 9.67% Five samples were of a type which could not be examined for grouping. With regard to the grouping of samples the position is a little better than the figures above show, because where an unsatisfactory sample was obtained the source of supply was concentrated upon for further samples, thus more than an average number of unsatisfactory samples was obtained. On the other hand it was found that a number of samples which had a good grouping also contained coliform organisms and could not therefore be considered satisfactory. There are no large manufacturers of ice-cream in the area, the majority of retailers purchase their ice-cream from outside sources and only a very small number make their own. 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. 14 Rodent destruction, in accordance with the methods advocated by the Ministry of Agriculture and Fisheries, 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 which revealed slight infestation of a section of the Hanworth sewers. This was dealt with and has now been cleared up completely. In September, 1948, the Council adopted the provisions of the Middlesex County Council Act, 1944, dealing with street trading in order to be in a position to exercise some control over what appeared to be a growing type of business. 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 11 The number of Council houses disinfested 11 The number of other houses infested 20 The number of other houses disinfested 20 The number of other premises disinfested (2) The methods of disinfestation employed are the spraying with contact insecticides incorporating D.D.T., mainly "Pyagra" or "Zaldecide." (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. Infectious Disease The following number of premises have been disinfected after cases (or suspected cases) of infectious disease:— Tuberculosis 43 Scarlet Fever 18 Diphtheria 5 Erysipelas 4 Total 70 Milk (Special Designations) Regulations, 1936—46 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 Kids No. killed - - - 81 1432 - - 3 No. Inspected — — — 81 1432 — — 3 Meat Inspected at Butcher's Shops A number of carcases, quarters, parts of carcases and organs have been examined. The following has been declared unfit for human consumption:— Diseases excluding Tuberculosis Beasts Calves Lambs Pigs Horses Donkeys Goat Whole carcase condemned - - - 1 7 - - Carcases of which some part or organ condemned - - - 10 727 - - Percentage affected with disease other than tuberculosis - - - 13.5 51.25 - - Tuberculosis only Whole carcase condemned - - - - - - - Carcases of which some part or organ condemned - - - - - - - Percentage affected with tubercu losis - - - - - - - 17 Whole Carcases— Beasts Calves Sheep Pigs T uberculosis — — — - Other Diseas. — — — — Part Carcases and Organs— Tuberculosis - - - - Other Disease 2 cwts. 31 lbs. — 5 cwts. 17 lbs. — In addition the following amount of canned meat was found to be unfit for human consumption:— 4 cwts. 4 lbs. 18 Annual Report of the Medical Officer of Health in Respect of the Year 1948 on the administration of the Factories Act, 1937 Part I of the Act 1. Inspections for purposes of provisions as to health (including inspections made by Sanitary Inspectors) : Premises Number on Register Inspections Number of Written Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 6 3 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 114 47 9 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) - - - - Total 120 50 9 — Part VIII of the Act Outwork (sections 110 and 111), nil. 2. Cases in which defects were found : Number of cases in which defects were founc Referred Particulars Found Remedied To H.M. Inspector By H.M Inspectoi Want of cleanliness (S.l) 3 3 — — Overcrowding (S.2) — — — — Unreasonable temperature (S.3) - - - - Inadequate ventilation (S.4) — — — — Ineffective drainage of floors (S.6) - - - - Sanitary Conveniences (S.7) (a) Insufficient 5 5 - - (b) Unsuitable or defective 6 6 - - (c) Not separate for sexes 1 1 — - Other offences against the Act (not including offences relating to Outwork) 1 1 - - Total 16 16 - -