FEL 14 LIBRARY AZ 439(3) FELTHAM Urban District Council of FELTHAM Annual Report OF THE Medical Officer of Health for the year ending 31st December, 1951 Feltham, Middx. September, 1952 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. Additional Sanitary Inspectors: J. SMITH, A.R.San.L, M.S.I.A. K. R. ENDERBY K. T. JOLLEY, A.M.I.S.E., A.R.San.I., M.S.I.A (Appointed 31-12-51). 3 Council Offices, Feltham September, 1952. Mr. Chairman, Mrs. Williams and Gentlemen, I beg to present my Annual Report on the Health and Sanitation of your District for the year 1951. The District is divided into three Wards: Bedfont, Feltham and Hanworth, with a total acreage of 4,925. The Home population (mid-year) as estimated by the Registrar General is 45,230. This is an increase compared with the 1950 figure of 43,730. 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 £1,356.31373. Rateable Value £328.934 Number of inhabited houses 11,639 Number of new houses erected 406 VITAL STATISTICS Births Live Births— Total Male Female Legitimate 691 379 312 Illegitimate 22 10 12 Total 713 389 324 Birth Rate per 1,000 of the estimated home population— 15.76 (1950 15.52). Comparability Factor 0.97. Still Births— Total Male Female Legitimate 11 7 4 Illegitimate — - — Total 11 7 4 Rate per 1,000 total births (live and still)—15.19 (1950 20.20). Rate per 1,000 of the estimated home population— 0.24 (1950 0.32). 4 Deaths Total 318 Male 165 Female. 153 Death Rate per 1,000 of the estimated home population— 7.03 (1950 7.11). Comparability Factor 1.41. Maternal Mortality (Heading 30 of the Registrar-General's Short List) Deaths. Rate per 1,000 (live and still) total births No. 30. Pregnancy, Childbirth, Abortion - — (1950 1.43 Total — — (1950 1.43) INFANT MORTALITY Death rates of Infants under one year of ageAll infants per 1,000 live births (13) 18.23 (1950 25.03) Legitimate infants per 1,000 legitimate live births (12) 17.36 (1950 24.46) Illegitimate infants per 1,000 illegitimate live births (1) 45.45 (1950 40.0 ) Death rates of Infants under four weeks of age All infants per 1,000 live births (8) 11.22 Legitimate infants per 1,000 legitimate live births (8) 11.57 Illegitimate infants per 1,000 illegitimate live births Nil. Rate per 1,000 live births Deaths from Diarrhoea (under two years) — Birth and Death Rates for England and Wales, 1950:— Birth rate 15.5 Still Birth rate 0.36 Death rate 12.5 Deaths under one year of age 29.6 Deaths from Diarrhoea and Enteritis (under two years of age) 1.4 Maternal Mortality—England and Wales, 1951:— Sepsis of pregnancy childbirth and the puerperium 0.10 (Abortion with toxaemia 0.00 (Other toxaemias of pregnancy and the puerperium 0.24 Haemorrhage of pregnancy and childbirth 0.13 Abortion without mention of sepsis or toxaemia 0.05 Abortion with sepsis 0.09 Other complications of pregnancy, childbirth and the puerperium 0.18 5 Causes of Death Male Female Total 1. Tuberculosis—Respiratory 6 12 18 2. „ —Other — — — 3. Syphilitic disease — — — 4. Diphtheria — — — 5. Whooping Cough — — — 6. Meningococcal infections — — — 7. Acute poliomyelitis — — — 8. Measles — — — 9. Other infective and parasitic diseases 1 - 1 10. Malignant neoplasm, stomach 7 6 13 11. Malignant neoplasm, lung, bronchus 11 1 12 12. Malignant neoplasm, breast — 4 4 13. Malignant neoplasm, uterus 4 4 14. Other malignant and lymphatic neoplasms 16 10 26 15. Leukaemia, aleukaemia — 1 1 16. Diabetes 3 2 5 17. Vascular lesions of nervous system 14 22 36 18. Coronary disease, angina 21 15 36 19. Hypertension with heart disease 6 3 9 20. Other heart disease 22 27 49 21. Other circulatory disease 4 6 10 22. Influenza 1 2 3 23. Pneumonia 12 6 18 24. Bronchitis 7 7 14 25. Other diseases of respiratory system 2 — 2 26. Ulcer of stomach and duodenum 6 1 7 27. Gastritis, enteritis and diarrhoea — — — 28. Nephritis and nephrosis 1 2 3 29. Hyperplasia of prostate 1 — 1 30. Pregnancy, childbirth and abortion — — — 31. Congenital malformations 2 1 3 32. Other defined and ill-defined diseases 11 12 23 33. Motor Vehicles accidents 5 3 8 34. All other accidents 5 5 10 35. Suicide 1 1 2 36. Homicide and operations of war — — — 165 153 318 6 Notifiable Diseases other than Tuberculosis Disease Total Nos Notified Admitted to Hospital Deaths Diphtheria — — — Measles 510 19 — Whooping Cough 172 23 — Pneumonia 14 3 18 Scarlet Fever 18 8 — Cerebro-spinal Fever — — — Puerperal Pyrexia 2 1 — Ophthalmia Neonatorum 1 — — Erysipelas 3 3 — Poliomyelitis (Paralytic) 1 1 — „ (Non - paralytic) — — — Polioencephalitis 1 — — Enteric or Typhoid Fever — — — Malaria 1 1 — Dysentery 2 1 — Food Poisoning 1 - — Age Periods Ophthalmia Neonatorum Scarlet Fever Diphtheria Measles Whooping Cough Cerebr Spinal Fever Acute Poliomyelitis Paralytic NonParalytic Under 1 yr. 1 — — 27 17 — — — 1—2 yrs. — I — 133 40 — — — 3—4 yrs. — 5 — 152 34 — — — 5—9 yrs. — 10 — 184 81 — 1 — 10—14 yrs. — 2 — 9 — — — — 15—24 yrs. — — — 5 — — — — 25 and over - - - - - - - - Age unknown - - - - - - - — Total 1 18 — 510 172 — 1 — Age Periods Malaria Dysentery Encephalitis Food Poisoning Puerperal Pyrexia Erysipelas Pneumonia Under 5 years - - - - - - 6 5—14 yrs. — 2 1 — — — 2 15—44 yrs. 1 — — — 2 — 5 45—64 yrs. - - - - - 2 1 65 and over - - - - - 1 — Age unknown - — — 1 — — — Total 1 2 1 1 2 3 14 7 Ophthalmia Neonatorum Notified — 1 Cases treated at home — 1 Cases treated in hospital — — Vision unimpaired — 1 Total blindness — — Death — — Tuberculosis New Cases Deaths Age Periods Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 1 yr. - - - - - - - - 1— 5 yrs. — 2 - - - - - - 5—15 „ 1 — 1 — — — — — 15—25 „ 5 3 — 1 — 1 — — 25—35 „ 6 3 1 1 — 3 — —- 35—45 „ 5 2 — — — 6 — — 45—65 „ 4 1 — 2 4 2 — — Over 65 „ — — — — 2 — — — Total 21 11 2 4 6 12 — — Tuberculosis Notifications of new cases of tuberculosis have decreased, the figures being 38 for 1951 and 66 for 1950, deaths from this cause show an increase, the figure being 18 as compared with 11. It must be remembered that a number of these new cases are mild ones which have been detected at an early stage by the use of mass radiography. The Mass X-ray unit of the North West Metropolitan Regional Hospital Board visited the district at the Public Health Committee's invitation in the Autumn. The visit was extensively publicised and 4,623 people attended for X-ray. Of this number 3,267 came in factory or organised groups and 1,356 from the general public. As a result of these X-rays, 150 persons were recalled for large films to be taken, following which further investigations were required in 35 cases. 8 Maternal Mortality I am happy to report that there has been no maternal mortality during the year. There has only been one such death, in 1950, during the last five years. 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. The need for houses is still great, although the Housing Committee's programme of building has already provided 1023 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 Water Co. In addition one sample was taken by my department. 9 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 .019 Abuminoid Nitrogen .085 Oxidised Nitrogen (Nitrate) 4.1 Chlorides as Cl. 22.0 Oxygen abs. from Permanganate 3 hours at 80°F 1.21 Turbidity in terms of Silica 0.3 Colour m.m. brown 2ft. tube Burgess's Tintometer 15 Hardness Total 268 Hardness (Non-Carbonate) 63 pH Value 7.9 Phosphate AS. P.O. III4 0.32 Silica as. SIO2 11.0 Conductivity 450 Bacteriological Results No of Samples 766 Colony Count on agar at 37°C (20-24 hours) 19.0 BACT. COLI TEST Percentage of samples negative per 100 ml. 100.0 Bact. Coli per 100 ml. Nil. Typical Analysis of South West S.W. Co. Supply. (Parts per 100,000): Chemical Total solids (dried at 120°C.) 40.0 Combined chlorine (as Cl. 2.6 equivalent to Sodium Chloride (NaCl) 4.3 Nitric nitrogen (Nitrates) 0.44 Nitrous nitrogen (Nitrites) Nil. Ammoniacal nitrogen 0.0004 Albuminoid nitrogen 0.0078 Oxygen absorbed in 4 hours at 27°C. 0.080 Lead or Copper Nil. Temporary hardness (equivalent to CaC03) 20.0 Permanent hardness („ „ „) 8.0 Total hardness („ „ „) 28.0 10 Bacteriological Agar plate count, at 20-22°C, for three days=10 per ml. Agar plate count, at 37°C. for two days= 6 per ml. Faecal coli not found in 100 ml. Probable number of coliform bacilli = 100 per ml. Enterococci not found in 100 ml. Cl. welchii (spores) present in 10 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. 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 supplied with water from standpipes is approximately 70. Food Poisoning Only one case of food poisoning has been notified 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 11 CHIEF SANITARY INSPECTOR'S REPORT Housing The programme for dealing with unfit houses has proceeded steadily and during the year thirty one houses were represented to the Public Health Committee and nine demolition orders made. Proceedings in respect of the other representations had not been finalised by the end of the year, but demolition orders have since been made. A total of thirty-two demolition orders had been made under the programme by the end of 1951 and the rehousing of the occupants and demolition of the houses was proceeding satisfactorily. In rehousing the occupants every endeavour was made to provide them with accommodation, satisfactory to themselves both as regards situation, size and cost. Some difficulty was found in rehousing certain people, for instance, elderly widows or spiders whose means were often very limited and who had an aversion to leaving the almost immediate neighbourhood of their old abode. The repair of premises "in such a state as to be a nuisance" or "not reasonably fit" has proceeded as far as possible and in two instances works have been carried out in the owners default under the Housing Act, 1936, but the operation of the repair sections of this Act in respect of the older properties became increasingly difficult. Due to the increased cost of repairs and the stabilising of rents at pre-war levels, it can now almost be regarded as a maxim that to deal fully with any pre 1914 cottage or smaller type house under the Housing Act, 1936, unless it is in an exceptionally good condition, the operation of the "reasonable cost" clause will prevent the service of repair notices. Despite the large building programme which the Housing Committee carried through, the need for more houses was still apparent. Applicants still sought the department's help to hasten their rehousing and many applicants were living in unsatisfactory conditions, as were other unfortunate people who for one reason or another appeared to be unable to qualify for inclusion on any 12 housing authorities list, but the gross conditions of over crowding which were often found a few years ago, were rarely met with. The sanitary inspectors continued to visit all housing applicants before they were interviewed by the Housing Committee. Moveable Dwellings The preliminary report of the 1951 Census was issued during the year, and as the population of the district as published is over 20,000 the provisions of section 345 of the Middlesex County Council Act 1944 as amended by the Middlesex County Council Act 1950 came into force. These provisions give much better control over moveable dwellings and require the authority's consent subject to certain exceptions before a moveable dwelling may be occupied or stationed on any land. Without recourse to legal proceedings two small but unsatisfactory colonies of moveable dwellings upon the extremities of the London Airport were cleared. Much less trouble was experienced with the wandering gypsy. In previous years the department has pursued a policy of persuading owners to make their land inaccessible to gypsies' caravans and this, together with the closing of land by building activity in the area appears to have borne fruit. Shops The views of the shopkeepers and their staffs was sought with regard to the fixing of a "late day" for the district. After considering the replies received the Authority made an order naming Friday as the late day for the purposes of the Shops Act, 1950, and this order came into force on the 2nd July 1951. It was decided not to make an order in respect of the half-day closing. Shopkeepers remain free to fix their own day subject to the provisions of the Shops Act. 13 Food Premises A big effort was made to expand the regular visiting of all food premises and in fact all premises subject to routine inspection by the department. The registers of all these premises have been brought up to date by checking all available records as well as by street to street inspection and it is now thought that all premises in which the department has a special interest are known. The belief is held that regular visiting by the sanitary inspectors will in the long run achieve the best and most lasting improvement in the hygiene of food premises. Already many improvements have been carried out, but still much remains to be done. With a view to enabling more frequent visits to be paid to premises subject to routine inspection the Public Health Committee recommended the appointment of an additional sanitary inspector. An officer was appointed but as he did not commence duty until the 31st December, the benefits of the additional staff will not be felt until 1952. The Public Health Committee again considered the advisability of promoting a clean food guild but after investigating the position, including the experience of other Authorities who have set up such guilds, it was decided not to proceed on such a course but to rely upon the present methods. INSPECTION AND SUPERVISION OF FOOD Carcases examined at Slaughter-houses Beasts Calves Lambs Pigs Horses Goats No. killed — — — 46 508 31 No. Inspected — — — 46 508 31 Diseases excluding Tuberculosis Beasts Calves Lambs Pigs Horses Goats Whole carcase condemned — — — — — — Carcases of which some part or organ condemned - - - 5 138 1 Percentage affected with disease other than tuberculosis - - - 10.87 27.17 3.23 14 Tuberculosis only Beasts Calves Lambs Pigs Horses Goats Whole carcase condemned - - - - - - Carcases of which some part or organ condemned - - - - - - Percentage 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:— Whole Carcases— Beasts Calves Sheep Pigs Tuberculosis — — — - Other condition — — — — Part Carcases and Organs— Tuberculosis — — — — In addition, the following amounts of other foodstuffs were found to be unfit for human consumption:— Fish 1 cwt. 86 lbs. Sausage Meat 8 lbs. Rabbits 7 Corn Flakes 3 lbs. Ovaltine 2 lbs. Jam 14 lbs. Coffee 8 lbs. Bacon 2 lbs. Cheese 1 lb Pickles 1 lb. Tinned Foodstuffs: — Meat 9 cwt. 48 lbs. Fish 46 lbs. Fruit 97 lbs. Vegetables 2 cwt. 47 lbs. Milk 1 cwt. 62 lbs. Soup 14 lbs. Pudding 1 lb. 15 Milk (Special Designation), (Raw Milk) and Pasteurised and (Sterilised Milk) Regulations, 1949 The number of licences granted to sell graded milks is as follows:— Tuberculin Tested 8 Accredited — Pasteurised 8 Sterilised 9 Supplementary Licences:— Tuberculin Tested 12 Accredited — Pasteurised 13 Sterilised 12 51 samples of graded milks were taken and submitted to the Public Health Laboratory Service at Epsom. Of these three samples of pasteurised milk failed the methylene blue test. Ice Cream 55 samples of ice cream were taken and submitted to the Public Health Laboratory Service at Epsom. These samples were graded as follows:— Provisional Grades 1 1 &2 3 4 Samples taken (Total 55) 42 53 2 — % of total samples 76.36 96.36 3.63 — No. in which Coliforms present in 1/10 ml. 11 5 1 — % in which Coliforms present 26.19 9.43 50.0 — No. in which Faecal B. Coli present — 1 — — % in which Faecal B. Coli present — 1.88 — — These results show a continuation of the improvement noted in the previous report. The fact that over ninety-six per cent of all samples fell within grades I and II compared with eighty-four per cent in 1950 and fifty-six per cent in 1949, indicates, I think, that there has undoubtedly been a 16 big improvement in the bacteriological quality of ice cream. The only detraction is the higher percentage of grade I samples containing coliforms. These satisfactory results are due to several factors. Firstly, a much larger proportion of the ice cream retailed in Feltham is supplied by the well known reputable manufacturers with a consequent reduction in the previous large number of less reliable manufacturers This change over has been partly due to the greater "sales appeal" of certain well known ice creams and partly due to the desire of many retailers to sell an ice cream, which, when sampled, would give a result satisfactory to this department. Most retailers are anxious to sell a satisfactory product, and many have been very concerned in previous years at their inability to find a supplier whose ice cream would give consistently good results. As soon as the supply situation permitted they changed to a reliable source. Secondly, partly due to the activities of this department and to a general trend in that direction, a much larger proportion of the ice cream is sold wrapped. In all cases notification of the results of sampling was given to the manufacturer, the retailer and the Authority in whose district the ice cream was manufactured, and it was found that many manufacturers appreciated receiving good results as well as unsatisfactory ones. There were no manufacturers of ice cream in the area. Rodent Control Rodent destruction in accordance with the methods advocated by the Ministry of Agriculture and Fisheries was continued. The annual test baiting of the Council's sewers showed that the sewers were free from infestation. The Councils refuse tip is kept under observation and any signs of rat activity dealt with immediately. During the year 185 complaints or reports of rat or mice infestation were dealt with, involving visits to 874 premises, 91 treatments were carred out by this department and 61 by occupiers. When treatments are carried out by this department on behalf of the occupiers, a standard charge of five shillings is made in the case of private dwellings, and the full cost of the treatment in the case of business premises. Where the occupiers elect to carry out the treatment themselves, advice 17 and supervision is given to ensure that the treatment is effective. In no case has it been necessary to take statutory action in accordance with the Prevention of Damage by Pests Act, 1949. Disinfestation Nineteen premises were found to be infested with bed bugs and were disinfested: Council houses infested 7 Other houses infested 12 The method of disinfestation normally employed is spraying with contact insecticides incorporating D.D.T. and this work was carried out by the department. 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. The following numbers of premises have been disinfected after cases (or suspected cases) of infectious disease:— Tuberculosis 31 Scarlet Fever 16 Poliomyelitis 1 Other Diseases: 1 Cancer 1 Total 49 18 Administration of the Factories Acts, 1937 and 1948. Part 1 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 31 3 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 124 140 35 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 9 5 - - Total 139 176 38 - 2. Cases in which defects were found:— Number of cases in which defects were found Particulars Found Remedied Referred ToH.M. Inspector By H.M. Inspector Want of cleanliness (S.l) 11 11 — — Overcrowding (S.2) — — — — Unreasonable temperature (S.3) - - - - Inadequate ventilation (S.4) - — - — Ineffective drainage of floors (S.6) 2 2 - - Sanitary conveniences (S.7) (a) Insufficient 9 9 - - (b) Unsuitable or defective 20 20 - - (c) Not separate for sexes 1 1 - — Other offences against the Act (not including offences relating to Outwork) 15 15 - - Total 58 58 - — Part VIII of the Act Outwork (sections 110 and 111), nil. 19 Summary of Sanitary Work No of premises inspected on complaint 632 No. of primary inspections 827 No. of Inspections made:— Housing Insp. (Hsg. Regs.) 40 Housing Re-inspections 227 Other re-inspections 2808 Infectious Dis. 10 Council Houses 42 Moveable Dwellings 38 Bakehouses 27 Slaughterhouses (excl. re Slaughtering) 12 Knackers Yards 3 Dairies and Milkshops 35 Offensive Trades 1 Shops (Shops Acts) 383 Hawkers of Foodstuffs Premises 89 Ice Cream Premises 66 Food Preparing Premises (excl. Catering Establishments) 164 Catering Establishments 41 Butchers Shops 11 Other Food Shops 69 Power Factories 140 Non-Power Factories 31 Other Factories 5 Piggeries 3 San. Accomm. at Licensed or Public Premises 69 Hairdressers and Barbers Establishments 4 Rodent Control 1480 Defence Regulations 28 Housing Applications 416 Measurements under Housing Act 4 Smoke Observation 10 Food Inspection—Meat 275 „ „ —Fish 7 „ „ —Other commodities 80 Milk Sampling 22 Street Trading 11 Tipping of refuse 51 Miscellaneous 11 Total 7,550 20 Staff I should like to take this opportunity of thanking the Chairman and members of the Public Health Committee and the Medical Officer of Health, Dr. Woods for the consideration shown to me, and the members of the statf for their support in carrying out the work of the department. FRANCIS V. BELL, Chief Sanitary Inspector