FEL 15 AC439(3)FELAMM Urban District Council of FELTHAW Annual Report OF THE Medical Officer of Health for the year ending 31st December. 1952 Feltham, Mlddx. July, 1953. 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.L, 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., M.S.I.A. (Resigned 21.6.52) A. J. MADDOCKS, M.S.I.A. (appointed 1.10.52 2 Council Offices, Feltham. July, 1953. Mr. Chairman, Ladies and Gentlemen, I beg to present my Annual Report on the Health and Sanitation of your District for the year 1952. 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 46,560. This is an increase compared with the 1951 figure of 45,230. 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 £1,429 2s. 7d Rateable Value £346,600 Number of inhabited dwellings 12,200 Number of new houses erected 424 VITAL STATISTICS Births Live Births Total Male Female Legitimate 756 380 376 Illegitimate 35 17 18 Total 791 397 394 Birth Rate per 1,000 of the estimated home population16.98 (1951 15.76). Comparability Factor 0.97. Adjusted Birth Rate—16.47. Still Births Total Male Female Legitimate 14 9 5 Illegitimate 1 — 1 Total 15 9 6 Rate per 1,000 total births (live and still)—18.61 (1951 15.19) Rate per 1,000 of the estimated home population0.32 (1951 0.24) 3 Deaths Total 290 Male 172 Female 118. Death Rate per 1,000 of the estimated home population— 6.22 (1951 7.03). Comparability Factor 1.41. Adjusted Death Rate 8.77. Maternal Mortality (Heading 30 of the Registrar-General's Short List) Deaths. Rate per 1,000 total (live and still) births No. 30. Pregnancy, Childbirth Abortion — — (1951 —) Total — — (1951 —) INFANT MORTALITY Death rates of Infants under one year of age— All infants per 1,000 live births (16) 20.22 (1951 18.23) Legitimate infants per 1.000 legitimate live births (16) 21.16 (1951 17.36) Illegitimate infants per 1,000 illegitimate live births (—) — (1951 45.45) Death rates .of Infants under four weeks of age— All infants per 1,000 live births (11) 13.906 (1951 11.22) Legitimate infants per 1,000 legitimate live births (11) 14 14.55 (19.51 11.57) Illegitimate infants per 1,000 illegimate live births (0) —— (1951 — ) Rate per 1,000 live births Deaths from Diarrhoea (under two years 1) 1.26 Birth and Death Rates for England and Wales, 1952:— Birth rate 15.3 Still Birth rate 0.35 Death rate 11.3 Deaths under one year of age 27.6 Deaths from Diarrhoea and Enteritis (under two years of age) 1.1 Maternal Mortality—England and Wales, 1952:— Sepsis of pregnancy, childbirth and the puerperium 0.09 Abortion with toxaemia 0.02 Other Toxaemias of pregnancy and the puerperium 0.21 Haemorrhage of pregnancy and childbirth 0.09 Abortion without mention of sepsis or toxaemia 0.04 Abortion with sepsis 0.07 Other complications of pregnancy. childbirth and the puerperium 0.20 4 Causes of Death Male Female Total 1. Tuberculosis—Respiratory 4 — 4 2. —Other — — — 3. Syphilitic disease — 1 1 4. Diphtheria — — — 5. Whooping Cough — — — 6. Meningococcal infections — — — 7. Acute poliomyelitis — — — 8. Measies — — — 9. Other infective and parasitic diseases — — — 10. Malignant neoplasm, stomach 4 2 6 11. Malignant neoplasm, lung, bronchus 8 2 10 12. Malignant neoplasm, breast — 6 6 13. Malignant neoplasm, uterus — 2 2 14. Other malignant and lymphatic neoplasms 15 14 29 15. Leukaemia, aleukaemia 1 — 1 16. Diabetes 1 — 1 17. Vascular lesions of nervous system 12 21 33 18. Coronary disease, angina 22 4 26 19. Hypertension with heart disease 4 4 8 20. Other heart disease 22 18 40 21. Other circulatory disease 8 8 16 22. Influenza 1 1 2 23. Pneumonia 15 11 26 24. Bronchitis 15 6 21 25. Other diseases of respiratory system 1 — 1 26. Ulcer of stomach and duodenum 3 2 5 27. Gastritis, enteritis and diarrhoea 2 — 2 28. Nephritis and nephrosis 2 4 6 29. Hyperplasia of prostate 2 — 2 30. Pregnancy, childbirth and abortion — — — 31. Congenital malformations 2 1 3 32. Other defined and ill-defined diseases 14 7 21 33. Motor Vehicles, accidents 4 1 5 34. All other accidents 8 2 10 35. Suicide 2 1 3 36. Homicide and operations of war — — — 172 118 290 5 Notifiable Diseases other than Tuberculosis Disease Total Nos. Notified Admitted to Hospital Deaths Diphtheria — — — Measles 392 11 — Whooping Cough 48 6 — Pneumonia ... 15 1 26 Scarlet Fever 26 11 — Cerebro-spinal Fever — — — Puerperal Pyrexia — — — Ophthalmia Neonatorum — — — Erysipelas 1 — — Poliomyelitis (Paralytic) 1 1 — „ (Non-paralytic) — — — Polioencephalitis — — — Enteric or Typhoid Fever 1 1 — Malaria — — — Dysentery 9 1 — Food Poisoning 4 — — Age Periods Ophthalmia Neonatorum Scarlet Fever Diphtheria Measles Whooping Cough Cerebrc Spinal Fever Acute Poliomyelitis 'paralytic NonParalytic Under 1 yr. — — — 18 8 — — — 1—2 yrs. — — — 87 12 — — — 3—4 yrs. — 5 — 119 10 — — — 5—9 yrs. — 19 — 152 17 — — — 10—14 yrs. — 1 — 11 1 — — — 15—24 yrs. — 1 — 2 — — 1 — 25 and over — — — 2 — — — — Age unknown — — 1 — — — — Total — 26 — 392 48 — 1 — Age Periods Malaria Dysentery - Encepalitis Food Poisoning Puerperal pyrexia Erysipelas Pneumonia Under 5 years — 5 —. 2 — — I 5—14 yrs. — 4 — 1 — — 2 15—44 yrs. — — — 1 — 1 5 45—64 yrs. — — — — — — 5 65 and over — — — — — — 2 Age unknown — — — — — — — Total — 9 — 4 — 1 15 6 Ophthalmia Neonatorum Notified — Cases treated at home — Cases treated in hospital — Vision unimpaired — 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. 1 1 1 – – – – – 5—15 „ 7 4 – – – – – – 15—25 „ 16 7 – – – – – – 25-35 „ 9 11 — 1 — — — — 35—15 „ 5 3 — 1 1 — – — 45—65 11 2 — — 2 — — — Over 65 „ 1 2 — 1 — — — Total 50 30 1 2 4 — — — Tuberculosis Notifications of new cases of tuberculosis have increased, the figures being 83 for 1952 and 38 for 1951, deaths from this cause show a decrease, the figure being 4 as compared with 18. 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 paid further visits to the district in March when 1,596 people attended, resulting in further investigations in 13 cases, and again in July, when 2,737 people employed at London Airport attended, many of whom would live in this area 7 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 past six 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. There is a need for still more houses although in the post-war years the Housing Committee have built 1,277 permanent houses and 150 temporary bungalows. This is a magnificent achievement which will bear comparison with that of any other authority of similar size. Quality has not been sacrificed to the need for numbers, and the Committee is to be congratulated upon the fine houses which have been provided, both for their pleasing appearance and layout and the amenities afforded. 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. The department has co-operated with regard to giving publicity to the need for immunisation and vaccination. 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 the Company from the Metropolitan Water Board. The water is derived from the River Thames purified in the storage reservoirs at Littleton, Staines and Walton, and is filtered and chlorinated at the Hampton Works. A contact period of over an hour is given at the works for the completion of chlorination. The water supplv has been satisfactory both as regards quantity and quality. 8 2. Samples for bacteriological examination and chemical analysis are taken by the Metropolitan Water Board at all stages of purification at least five times each week. Weekly samples have been taken by the South West Suburban Water Co. In addition five samples were taken by my department. Average Results of Analyses of Metropolitan Water Board Supply. (Parts per million.) Water filtered and chlorinated at Hampton Works : No. of Samples 245 Ammoniacal Nitrogen 0.022 Abuminoid Nitrogen 0.088 Oxidised Nitrogen (Nitrate) 4.0 Chlorides as C1 24.0 Oxygen abs. from Permanganate 3 hours at 80°F 1.09 Turbidity in terms of Silica 0.2 Colour m.m. brown 2ft. tube Burgess's Tintometer 13 Hardness Total 259 Hardness (Non-Carbonate) 62 pH Value 7.9 Phosphate A.S. P.O. 1114 0.28 Silica as S102 10 Conductivity 475 Bacteriological Results No. of Samples 775 Colony Count on agar at 37°C (20-24 hours) 7.0 BACT. COLI TEST Percentage of samples negative per 100 ml. 99.9 Bact. Coli per 100 ml. 0.004 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 CI.) 2.6 equivalent to Sodium Chloride (NaCl) 4.3 Nitric Nitrogen (Nitrates) 0.44 9 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 (equivalent to CaC03) 8.0 Total hardness (equivalent to CaC03) 28.0 Bacteriological Agar plate count, at 20-22°C. for three days=10 per ml. Agar plate count, at 37°C. tor two days = 6 per ml. Faecal coli not found in 100 ml. Probable number of coliform bacilli = none per 100 ml. Enterococci not found in 100 ml. CI. welchii (spores) present in 10 ml. 3. The water supplied had 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 and all new and repaired mains are chlorinated before being restored to use. 5. With the exception of a very 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 Four cases of food poisoning have been notified during the year. Establishments for Massage and Special Treatment One establishment was licensed under Sections 355-357 of the Middlesex County Council Act, 1944. Conclusion 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 Mr. Bell and the staff of the department for their able and willing assistance. F. H. WOODS, Medical Officer of Health. 10 CHIEF SANITARY INSPECTOR'S REPORT Housing. The programme for dealing with unfit houses has proceeded steadily and during tne year five houses were represented to the Public Health Committee and twenty-three demolition orders made. A total of fif ty-five demolition orders had been made and nine undertakings accepted under the programme by the end of 1952 and the rehousing of the occunants and demolition of the houses was proceeding satisfactorily. In rehousing the occupants every endeavour was made to provide them with accommodation, satisfactory to themselvs both as regards situation, size and rent.. Houses demolished as a result of formal or informal action under Section 11 of the Housing Act, 1936 £3 Persons displaced as a result of these demolitions 75 Houses closed in pursuance of an undertaking given by the owners and still in force 2 Persons displaced 3 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 three 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 remained very 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. Number of unfit or defective houses rendered fit as a result of informal action under Public Health or Housing Acts 178 11 Number of houses in which defects were remedied after service of formal notices under Public Health Acts (a) By owners — (b) By local authority in default of owners — Number of houses in which defects were remedied after service of formal notices under Housing Act, 1936 (a) By owners 5 (b) By local authority in default of owners 3 Towards the end of the year the Public Health Committee authorised the making of a survey of the pre-1918 houses in the area. This survey was intended to reveal the conditions existing in those houses, the extent to which they are substandard and to help in determining those with regard to which action under the Housing Acts should first be taken. Despite the large building programme which the Housing Committee carried through, the need for more houses was still apparent, but the gross conditions of overcrowding 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 Public health control of moveable dwellings in the area is effected by means of Section 345 of the Middlesex County Council Act as amended by the 1950 Act and by byelaws. The consent of the Council is required to the stationing and use of any moveable dwelling used or intended to be used as the sole or principal means of habitation for more than three months in any year. During the year three applications for consent were received, limited consents being given in each case. Three other moveable dwellings were removed following informal action. Very little trouble was experienced with the wandering gypsy. In previous years the department has pursued a policy of persuading owners to make iheir land 12 inaccessible to gypsies' caravans and this, together with the closing of land by building activity in the area appears to have borne fruit. Shops All shops are regularly inspected, the department administering the whole of the provisions of the Shops Act, 1950, the frequency of inspection depending upon the class of business carried on. Arising out of these inspections certificates of exemption from the provision on the premises of sanitary accommodation were granted in two cases and of washing accommodation in one case. Satisfactory alternative arrangements were made in each case. Licences for the keeping of pet shops were granted in two instances. The "late day" for the general closing hours of shops in the area is Friday, but shopkeepers remain free to fix their own half day closing subject to the provision of the Shops Act. Food Premises All types of food premises were being regularly inspected. It was intended that catering establishments and food preparing premises registered under Section 14 of the Food and Drugs Act should be inspected once a month although this frequency has not yet been achieved. It is believed that regular inspection which has already done a lot of good will in the long run give the best and most lasting results and will raise the standard of hygiene at all food premises. The essential thing about any method employed with this object in view, is in my opinion, that it must be continuous. Publicity campaigns have their uses, But unless backed up by a continuous level of effort, the results are apt to be very temporary. Legal proceedings were instituted in respect of a greengrocer's shop for failure to provide a supply of hot water, but the summons was withdrawn when satisfactory provision was made before the date of hearing. 13 The occupier of a grocers' shop was summoned for failing to protect food from contamination and was fined £15. Four premises were registered under Section 14 of the Food and Drugs Act, 1938, as premises where food was to be preserved. Eight hawkers of foodstuffs were registered in accordance with the provisions of Section 11 of the Middlesex, County Council Act, 1950. Three Street Traders' Licences were issued under Sections 320 and 321 of the Middlesex County Council Act, 1944. INSPECTION AND SUPERVISION OF FOOD No. of slaughter-houses licensed 4 No. of slaughter-men licensed 12 Carcases examined at Slaughter-houses Beasts Calves Lambs Pigs Horses Goats No. killed — — — 61 363 — No. Inspected — — — 61 362 — Diseases excluding Tuberculosis Beasts Calves Lambs Pigs Horses Goats Whole carcase condemned — — — — — — Carcases of which some part or organ condemned — — — 5 97 — Percentage affected with disease other than tuberculosis — — — 8.19 26.79 — 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. 14 The following has been declared unfit for human consumption :— Whole Carcases— Beasts Calves Sheep Pigs Tuberculosis — — — — Other condition — — 2 1 Part Carcases and Organs— Tuberculosis — — — — Other condition 58ilb. 7ilb. 18|lb. 401b. In addition, the following amounts of other foodstuff were found to be unfit for human consumption Fish 2 cwt. 90 lbs. Fruit 3 cwt. 83 lbs. Pearl Barley 60 lbs. Oats 1 lb. Prepared Cereals 5 lbs. Rice 7 lbs. Dried Eggs 14 lbs. Milk Powder 1 cwt. Butter 19 lbs. Bacon 56½lbs. Cheese 64 lbs. Pork Pies 24 Sausages 25 lbs. Lard 28 lbs. Flour 1 cwt. 81½ lbs. Margarine 96 lbs. Chocolates 4 lbs. Rabbits 87½lbs. Jam 4½ lbs. Pickles 4 lbs. Tinned Foodstuffs : Fruit 2 cwt. 59 lbs. Vegetables 1 cwt. 95 lbs. Soup 13½ lbs. Meat 6 cwt. 29½ lbs. 15 Chicken 4 lbs. Fish 25 lbs. Pudding 2 lbs. Milk 35 tins Milk (Special Designations), (Raw Milk) and (Pasteurised and Sterilised Milk) Regulations, 1949 The number of licences granted to sell graded milks is as follows:— Tuberculin Tested 9 Accredited — Pasteurised 9 Sterilised 20 Supplementary Licences:— Tuberculin Tested 11 Accredited — Pasteurised 12 Sterilised 12 14 Samples of graded milks were taken and submitted to the Public Health Laboratory Service at Epsom. All of these samples were satisfactory. Ten new milk distributors were registered during the year. These were mainly shopkeepers who wished to sell sterilized milk in sealed bottles. 16 Complaints received of infestations numbered 142, and these together with cases discovered by members of the staff involved the inspection of 932 premises. Rat infestations were found at 116 premises and mice infestations at 52 premises. Of these 123 treatments were undertaken by the department, the remaining 45 being carried out by the 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 and supervision is given to ensure that the treatment is effective. In conjunction with the Ministry of Agriculture and Fisheries, Infestation Division, a survey of the whole of the Longford River and properties adjoining was undertaken. Due to lack of co-operation on the part of a small number of the occupiers of infested premises, statutory notices under Section 6 of the Prevention of Damage by Pests Act, 1949, had to be served, but the success of the treatment was assured. A subsequent treatment and survey of the river banks has shown that the rats have been almost completely eliminated. Arrangements were made with the Middlesex County Council for this department to carry out any rodent control works necessary on the portions of the Duke of Northumberland's River and the River Crane in this area. Rag Flock and Other Filling Materials Act, 1951. One establishment whereat filling materials were used was registered. Disinfestation Twenty-three premises were found to be infested with bed bugs and were disinfested : Council houses infested 5 Other houses infested 18 The method of disinfestation normally employed was spraying with contact insecticides incorporating 17 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. Disinfestation was carried out for the eradication of the following vermin :— Lice 1 case, cockroaches 2 cases, fleas 3 cases, mosquitoes 1 case. In addition 21 wasps' nests were destroyed. Infectious Disease—Disinfection The following numbers of premises have been disinfected after cases (or suspected cases) of infectious disease :— Tuberculosis 27 Scarlet Fever 2.5 Poliomyelitis 1 Other Diseases 2 Cancer 1 Total 56 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 Registe; 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 20 23 1 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 164 360 12 — (iii) Other Dremises in which Section 7 is enforced by the 18 Local Authority (excluding outworkers' premises) 6 10 — — Total 190 393 13 — 2. Cases in which defects were found :— Number of cases in which defects were found Referred Particulars Fc Found Remedied To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) 3 3 — — Overcrowding (S.2) — — — — Unreasonable temporature (S.3) 1 1 — — Inadequate ventilation (S.4) — — Ineffective drainage of floors (S.6) — — — — Sanitary conveniences (S.7) (a) Insufficient 5 5 — 1 (b) Unsuitable or defective 14 14 — — (c) Not separate for sexes 1 1 — — Other offences against the Act (not including offences relating to Outwork) 5 5 — — Total 29 29 — 1 Part VIII of the Act Outwork (sections 110 and 111) No. of outworkers included in August list:— Working in the making etc., cleaning and washing of wearing apparel 29 Summary of Sanitary Work No. of premises inspected on complaint 842 No. of primary inspections 1,128 No. of Inspections made Housing Insp. (Hsg. Regs.) 24 Housing Re-inspections 399 Other re-inspections 3,901 Infectious Diseases 17 19 Council Houses 46 Moveable Dwellings 42 Bakehouses 66 Slaughterhouses (excl. re-Slaughtering) 6 Knackers Yards 2 Dairies and Milkshops 40 Offensive Trades 1 Shops (Shops Acts) 537 Hawkers of Foodstuffs Premises 103 Ice Cream Premises 83 Food Preparing Premises (exc. Catering ments) 216 Catering Establishments 187 Butchers' Shops 65 Other Food Shops 322 Power Factories 360 Non-Power Factories 23 Other Factories 10 Piggeries 6 San. Accomm. at Licensed or Public Premises 109 Hairdressers and Barbers Establishments 21 Rodent Control 1.948 Defence Regulations 123 Housing Applications 376 Measurements under Housing Act 367 Smoke Observation 19 Food Inspection—Meat 268 „ „ —Fish 6 „ „ —Other commodities 97 Milk Sampling 5 Street Trading 30 Tipping of refuse 35 Inspection of Food Vehicles 231 Inspections under Rag Flock Act 15 Inspections under Pet Animals Act 4 Miscellaneous 13 Total 12,093 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 staff for their support in carrying out the work of the department. FRANCIS V. BELL, Chief Sanitary Inspector.