FEL 12 Urban District Council of Feltham Public Health Department 1949 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. Additional Sanitary Inspectors: J. SMITH, A.R.San.I., M.S.I.A. R.C.ROGERS M.S.I.A. (Appointed 15.9.48 Resigned 20.6.49) K.R. ENDERBY (Appointed 10.10.49) 3 Council Offices, Feltham. July, 1950 Mr. Chairman, and Gentlemen, 1 beg to present my Annual Report on the Health and Sanitation of your District for the year 1949. 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: Civilian Population, 42,880; Total Population, 43,690. This is an increase compared with the 1948 figure of 41,940. The day population is increased by people working at the various factories and shops. A small number continue to work in agriculture. The sum represented by a penny rate is £1,189 17s. 9d. All classes of inhabited houses 10,923 Working-class dwellings 9,000 New working-class dwellings erected 228 Total number of new houses erected 266 Vital Statistics Live Births— Total Male Female Legitimate 692 348 344 Illegitimate 34 23 11 Total 726 371 355 Birth rate per 1,000 of the estimated civilian population— 16.93 (1948 20.10) Legitimate 20 12 8 Illegitimate 2 2 – Total 22 14 8 Rate per 1,000 total births (live and still)—29.41 (1948 19.76) Rate per 1,000 of the estimated civilian population —0.513 (1948 0.40) 4 Deaths— Total Male Female 333 176 157 Death rate per 1,000 of the estimated civilian population— 7.76 (1948,7.05) Deaths from Puerperal causes— (Headings 29 and 30 of the Registrar-General's Short List) Deaths (live and still) births Rate per 1,000 total No. 29. Puerperal and PostAbortion Sepsis (1948 Nil) No. 30. Other Maternal causes — — (1948 Nil) Total — — (1948 Nil) Death rates of Infants under one year of age— All infants per 1,000 live births (21) 28.92 (1948 26.09) Legitimate infants per 1,000 legitimate live births (20) 28.90 (1948 23.09) Illegitimate infants per 1,0*00 illegitimate live births (1) 29.41 (1948 65.21) Total Rate per 1,000 of estimated civilian population Deaths from Cancer (all ages) 70 1.63 (1948 1.09) Deaths from Measles (all ages) — — — Deaths from Whooping Cough (all ages) — — — Rate per 1,000 live births Deaths from Diarrhoea (under two years) — — — Birth and Death rates for England and Wales,1949:— Birth rate 16.7 Still Birth rate 0.39 Death rate 11.7 Deaths under one year of ago 32.0 Deaths from Diarrhoea and Enteritis (under two years of age) 3.0 Maternal Mortality—England and Wales,1949:— Abortion with Sepsis 0.11 Abortion without Sepsis 0.05 Puerperal infections 0.11 Other maternal causes 0.71 .98 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 9 5 14 7. Other forms of tuberculosis — 1 1 8. Syphilitic disease 2 — 2 9. Influenza — 1 1 10. Measles — — — 11. Acute poliomyelitis and polioencephalitis — — — 12. Acute infectious encephalitis — — — 13. Cancer of buccal cavity and eosophagus (M) Uterus (F) 2 5 7 14. Cancer of stomach and duodenum 7 — 7 15. Cancer of breast — 9 9 16. Cancer of all other sites 36 11 47 17. Diabetes — — — 18. Intra-cranial vascular lesions 16 23 39 19. Heart disease 37 42 79 20. Other diseases of the circulatory system 9 8 17 21. Bronchitis 14 8 22 22. Pneumonia 8 18 26 23. Other respiratory diseases 1 1 2 24. Ulceration of the stomach or duodenum 5 — 5 25. Diarrhoea (under two years of age) — — — 26. Appendicitis — — — 27. Other digestive diseases 4 — 4 28. Nephritis 2 5 7 29. Puerperal and post-abortive sepsis — — — 6  Male Female Total 30. Other maternal causes — — — 31. Premature birth 1 3 4 32. Congenital malformations, birth injury, infantile disease 5 6 11 33. Suicide — 1 1 34. Road traffic accidents — — — 35. Other violent causes 5 4 9 36. All other causes 12 6 18 176 157 333 Notifiable Diseases other than Tuberculosis Disease Total Nos. Notified Admitted to Hospital Deaths Diphtheria — — — Measles 265 40 — Whooping Cough 66 3 — Pneumonia — — 26 Scarlet Fever 57 24 — Cerebro-spinal Fever 1 1 1 Puerperal Pyrexia 2 1 — Ophthalmia Neonatorum 2 — — Erysipelas 1 — — Poliomyelitis 4 2 — Polioencephalitis — — — Enteric and Typhoid Fever 2 2 — Malaria — — — Age Periods Scarlet Fever Diphtheria Encephalitis Puer. Py. Erysipelas Pneumonia Measles Whooping Cough Cerebro Spinal Fever Ac. Polio Under 1yr — — — — — — 5 8 — — 1—3 years 4 — — — — — — 71 15 — — 3—5 ,, 14 — — — — — 87 20 — 2 5-10 ,, 31 — — — — — 99 23 1 2 10—15 ,, 5 — — — — — 1 — — — 15-25 ,, 1 — — — — — 1 — — — Over 25 ,, 2 — — 2 1 — 1 — — — Total 57 — — 2 1 — 265 66 1 4 7 Ophthalmia Neonatorum Notified 2 Cases treated at home 2 Cases treated in hospital — Vision unimpaired 2 Total blindness — Death — Tuberculosis New Cases Deaths Ago Periods Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 yr. 1 — — — — — — — 1—5 years 1 1 — — — — — — 5—15 „ 4 3 — 1 — — — 1 15—25 „ 12 6 1 — — — — — 25—35 „ 7 8 — — — — — — 35—45 „ 2 4 — — — 2 — — 45—65 „ 7 3 — — 1 1 — — Over 65 „ 1 — — — — — — — Total 35 25 1 1 1 3 — 1 Tuberculosis Notifications of new cases of tuberculosis have decreased, the figures being 62 for 1949 and 86 for 1948, deaths from this cause also show a decrease, the figure being 5; compared with 16. The overcrowded conditions under which many people are living, resulting from the 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. 8 Maternal Mortality It is gratifying to report that there have been no cases of maternal mortality during the year. This is the third year during which there have been no maternal deaths. Housing There are still very many families sharing accommodation or living in one or two rooms. 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 were 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 still urgent, although the Housing Committee's programme of building had already provided 636 permanent houses and 150 temporary bungalows by the end of the year. 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. Since the end of 1948 all arrangements for immunisation have been carried out by the County Council. 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 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 at least 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 9 Water Co. In addition seven 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.) Water filtered and chlorinated at Hampton Works: No of Samples 250 Ammoniacal Nitrogen .015 Albuminoid Nitrogen .087 Oxidised Nitrogen (Nitrate) 4.3 Chlorides as Cl. 27.4 Oxygen abs. from Permanganate 3 hours at 80°F 1.13 Turbidity in terms of Silica 0.4 Colour m.m. brown 2 ft. tube Burgess's Tintometer 14 Hardness Total 244 Hardness (Permanent) 71 pH Value 7.7 Conductivity 450 Bacteriological Results No. of Samples 980 Colony Count on agar at 37°C (20-24 hrs.) 7.5 BACT. COLI TEST Percentage of samples negative per 100 ml. 99.7 Bact. coli per 100 ml. .006 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 Albuminoid 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 3days at20°C or ml. in 4 7 2 Piesumptive Coliform Reaction Absent from 100 ml. Baet. coli. Absent from 100 ml. Cl. welchii R faction Present in 100ml. Absent from 10 ml. This sample is clear and bright in appearance, has a reaction 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 11 stituents 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 and character and 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. All water is chlorinated before distribution. 5. With the exception of a few outlying cottages, 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. Population in Feltham and Bedfont Wards supplied with water from standpipes approximately 220. The figure for Hanworth is not available. Food Poisoning Three cases of food poisoning have been notified to me during the year. Conclusin. In conclusion 1 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, 1950 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 difficulties of maintaining a full complement of staff have not been so pressing as in recent years, but there was a vacancy for a sanitary inspector which remained unfilled for several months. With a small staff the loss of one inspector's services for a month or two can seriously upset the routine of the department, particularly as efforts are being made to expand the work of the department under Sections 9 and 11 of the Housing Act, 1936, and there are other branches of the department's work which call for more attention. Problems arising from the housing shortage continue to occupy a predominant position despite the substantial number of new houses which the Council have already provided. Many people living under unsatisfactory conditions solicit the aid of the department with a view to being rehoused by the Council. These cases are investigated but unless they are already applicants to the Council and an investigation reveals conditions which may lead to an increase in the number of points allocated to them, there is little that can be done. Reports are submitted for consideration by the Housing Committee whenever it is thought they will serve a useful purpose. In many cases much inconvenience and unhappiness is caused by the occupation of a house by more than one family, but where there is no illegal 13 overcrowding or other circumstances which are not shared by very many of the Council's other applicants. All applicants for rehousing are visited by the sanitary inspector 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 for rehousing. The urgent need to house people who have no accommodation of their own has rather overshadowed the needs of persons occupying old, obsolescent and worn out houses, but as I mentioned in the Annual Report for 1948, demolition orders were made in respect of eight houses in that year and the occupants of these cottages have now all been rehoused and the cottages demolished and work has been commenced for dealing with a further thirty cottages in a similar manner. During the year a very limited survey was made of the houses likely to require Housing Act action and a report was made to the Public Health Committee with a view to obtaining a rough estimate of the position appertaining to the existing housing. The survey was however based principally on local knowledge and its usefulness is strictly limited. It was quite impossible to make a detailed survey with existing staff. One hundred and twenty-five samples of graded milks were taken and submitted to the Public Health Laboratory Service at Epsom. Of these seventeen failed, although in respect of six samples taken on one occasion the laboratory advised that the results should not be taken loo seriously in view of prevailing temperature; Of the seventeen failures, one was in respect of the phosphalase 3 test, the others the methylene blue test. The failures were distributed as follows:— Pasteurised Milk 8. *T.T. (Past.) Milk 3. South Devon (Past.) Milk 6. The six failures referred to in previous paragraph were all in respect of the methylene blue test and there were two each from each grade. *Tuberculin tested 14 The failure in respect of the phosphatase test was attributable to a plant failure. The methylene blue failures were isolated ones except for the six mentioned previously and for a series of four samples of South Devon Milk taken from one company. In this particular case the very hot weather being experienced at the. time no doubt contributed to the failures. The milk was withdrawn from sale for a time, at any rate in this area. One hundred and forty-one samples of ice cream were taken, and were submitted to the Public Health Laboratory at Epsom. Three were of a type which could not be graded as a methylene blue reading was impossible due to colouring matter in the ice cream, but they were negative in coliforms. The other one hundred and thirty-eight were graded as follows:— PROVISIONAL GRADES TOTAL 1 1 & 2 3 4 138 50 78 37 23 Percentage of total samples 36.23 56.52 26.81 16.66 Number in which Coliforms present in 1/10 ml. 16 31 32 20 Percentage in which Coliforms present 32 39.74 86.48 86.95 Number in which faecal B. Coli present 1 4 12 3 Percentage in which faecal B. Coli. present 2 5.12 32.43 13.04 In addition nine samples of the water in which servers were kept were taken and of these four were satisfactory. The results of the samples taken cannot be regarded as representative of the ice cream sold in the area, as there was a tendency to concentrate upon the sources of unsatisfactory ice cream and to omit or many occasions those ice creams which experience had shown to be reliable. 15 In all cases notification of the results of sampling was given to the authority in whose district the icc cream was manufactured. 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 devoted to 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 respcct of which applications for new licences are under consideration. By arrangement with the Engineer and Surveyor to the Council, deposited plans of new works have been perused so that there has been an opportunity of making recommendations for the improvement of proposed new food premises. Rodent destruction, in accordance with the methods advocated by the Ministry of Agriculture and Fisheries, has been continued. The Council house refuse tip has . been kept under observation and small infestations have been dealt with as they occurred. Following the slight infestation of the Hanworth sewers in 1948, further testing was carried out and the sewers were declared to be free from rodent infestation. The activities of street traders and hawkers of foodstuffs have received a good deal of attention and in this connection the Council resolved that Section 16 of the Food and Drugs Act, 1938, should apply to all foodstuffs sold in the area from stalls, vehicles, etc. 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. 16 Summary of Sanitary Work and Improvements Eradication of Bed Bugs (1) The number of Council Houses infested 14 The number of Council houses disinfested 14 The number of other houses infested 14 The number of other houses disinfested 14 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 22 Scarlet Fever 45 Poliomyelitis 2 Total 69 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 Sterilised 4 Supplementary Licences:— Tuberculin Tested 6 Accredited — Pasteurised 7 Sterilised 5 17 Inspection and Supervision of Food Carcases examined at Slaughter-houses Beasts Calves Lambs Pigs Horses Donkeys Goats Kids No. killed — — — 97 530 — — 2 No. Inspected — — — 97 530 — — 2 Diseases excluding Tuberculosis Beasts Calves Lambs Pigs Horses Donkeys Goats Whole carcase condemned – – – 5 – – – Carcases of which some part or organ condemned – – – 10 239 – – Percentage affected with disease other than tuberculosis – – – 15.46 45.09 – – Tuberculosis only Whole carcase condemned – – – – – – – Carcases of which some part or organ condemned – – – 3 – – – Percentage affected with tuberculosis – – – 3.09 – – – 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:— Whole Carcases— Beasts Calves Sheep Pigs Tuberculosis — — — — Other Disease — — 1 — Part Carcases and Organs— Tuberculosis — — — — Other Disease 5 cwt. 12 lbs. — 1 cwt. 20 lbs. — 18 In addition, the following amount of canned meat was found to be unfit for human consumption:— 1 cwt. 32 lbs. 19 Annual Report of the Medical Officer of Health in Respect of the year 1949 on the administration of the Factories Act, 1937 Part I of the Act 1. Inspections for purposes of provisions as to heallli (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 1 — — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 124 38 2 — (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 9 1 — — Total 139 40 2 — 2. Cases in which defects weffe found: Particulars Number of eases in which defects were found Referred Found Remedied To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) 2 2 — 1 Overcrowding (S.2) — — — — Unreasonable temperature (S.3) — — — — Inadequate ventilation (S.4) — — — — Ineffective drainage of floors (S.6) — — — — Sanitary Conveniences (S.7) (a) Insufficient 1 1 — 1 (b) Unsuitable or defective 10 10 — 1 (c) Not separate for sexes — — — — Other offences against the Act (not including offences relating to Outwork) 3 3 — — Total 16 16 — 3 Part VIII of the Act Outwork (sections 110 and 111), nil.