Ac.439(3) Urban District Council of FELTHAM Annual Report of the Medical Officer of Health for the year ending 31st December 1957 Feltham, Middx. July, 1958 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 Public Health Inspector F. V. BELL, M.R.S.H., M.A.P.H.I. Additional Public Health Inspectors: J. SMITH F. W. GOLDSMITH, M.A.P.H.I. (Resigned 2.12.57) G. H. GREEN, M.A.P.H.I. 2 Council Offices, Feltham. July, 1958. Mr. Chairman, Ladies and Gentlemen, I beg to present my Annual Report on the Health and Sanitation of your District for the year 1957. 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 was 50,000. This was a small increase compared with the 1956 figure of 49,230. The day population is increased by people working at the various factories and shops, but a large number of residents work outside the district, particularly in London. Only a very small number continue to work in agriculture. The product of a penny rate is £3,660.13.1 Rateable Value £885,691 Number of inhabited dwellings 13,844 Number of new dwellings erected 357 VITAL STATISTICS Births Live Births Total Male Female Legitimate 797 392 405 Illegitimate 18 13 5 Total 815 405 410 Still Births Total Male Female Legitimate 19 7 12 Illegitimate 1 — 1 Total 20 7 13 Birth Rate per 1,000 of the estimated home population- Crude Birth Rate 16.3 (1956 16.7 ) Comparability Factor 0.97 (1956 0.97) Adjusted Birth Rate 15.81 (1956 16.19) Still Birth Rate per 1,000 total births (live and still) 23.95 (1956 14.38) Still Birth Rate per 1,000 of the estimated home lation 0.4 (1956 0.24) 3 Deaths Total 350 Male 190 Female 160 Death Rate per 1,000 of the estimated home population— Crude Death Rate 7.0 (1956 6.6 ) Comparability Factor 1.59 (1956 1.60) Adjusted Death Rate 11.13 (1956 10.5 ) Death Rate from pulmonary tuberculosis 0.02 (1956 0.06) Death Rate from cancer 1.52 (1956 1.32) Maternal Mortality (Heading 30 of the Registrar-General's Short List.) Rate per 1,000 total Deaths, (live and still) births No. 30. Pregnancy, Childbirth Abortion — (1956 — Infant Mortality Death Rates of Infants under one year of age— All infants per 1,000 live births (16) 19.63 (1956 21.89) Legitimate infants per 1,000 legitimate live births (16) 20.07 (1956 20.12) Illegitimate infants per 1,000 illegitimate live births (-) (1956 74.07) Death Rates of Infants under four weeks of age— All infants per 1,000 live births (13) 15.95 (1956 18.24) Legitimate infants per 1,000 legitimate live births (13) 16.31 (1956 16.35) Illegitimate infants per 1,000 illegitimate live births (-) (1956 74.07) Deaths from gastritis, enteritis and diarrhoea: infants under two years (-) Rate per 1,000 live births (1956 —) Birth and Death Rates for England and Wales, 1957 Birth Rate 16.1 Still Birth Rate (per 1,000 live and still births) 22.4 Death Rate 11.5 Deaths under one year of age 23.0 Deaths under four weeks of age 16.5 Maternal causes, excluding abortion 0.39 Due to abortion 0.08 Total maternal mortality 0.47 4 Table of Birth and Death Rates for previous 10 years Year * Birth Rate Crude Adjusted * Death Rate Crude Adjusted † Still Birth Rate † Maternal Death Rate † Infant Under Death Rate Under 1 yr. 4 wks. 1956 16.7 16.19 6.6 10.5 14.38 nil 21.89 18.24 1955 16.0 15.84 7.1 10.5 13.87 nil 15.34 7.67 1954 15.76 15.60 5.87 8.68 15.54 1.29 17.10 13.15 1953 16.41 16.24 7.49 11.08 15.28 2.54 24.57 18.11 1952 16.98 16.47 6.22 8.77 18.61 nil 20.22 13.9 1951 15.76 15.28 7.03 9.91 15.19 nil 18.23 11.22 1950 15.52 15.05 7.11 10.02 20.20 1.43 25.03 — 1949 16.93 - 7.76 10.86 29.41 nil 28.92 - 1948 20.10 - 7.05 - 19.76 nil 26.09 — 1947 21.78 - 7.94 — 14.78 nil 51.96 — *Rate per †Rate per †Rate per 1,000 estimated home population. 1,000 total births. 1,000 live births. Causes of Death Male Female Total 1. Tuberculosis—Respiratory — 1 1 2. Tuberculosis—Other — — — 3. Syphilitic disease — — — 4. Diphtheria — — — 5. Whooping cough — — — 6. Meningococcal infection — — — 7. Acute poliomyelitis — — — 8. Measles — — 9. Other infective and parasitic diseases — — — 10. Malignant neoplasm, stomach 4 2 6 11. Malignant neoplasm, lung, bronchus 24 1 25 12. Malignant neoplasm, breast — 7 7 13. Malignant neoplasm, uterus — 1 1 14. Other malignant and lymphatic neoplasms 21 16 37 15. Leukaemia, aleukaemia — 1 1 16. Diabetes — 1 1 17. Vascular lesions of nervous system 17 21 38 18. Coronary disease, angina 27 14 41 19. Hypertension with heart disease 8 7 15 20. Other heart disease 21 38 59 21. Other circulatory disease 3 5 8 22. Influenza 1 1 2 23. Pneumonia 10 10 20 24. Bronchitis 13 5 18 25. Other diseases of respiratory system 1 1 2 5 Male Female Total 26. Ulcer of stomach and duodenum 3 — 3 27. Gastritis, enteritis and diarrhoea 2 — 2 28. Nephritis and nephrosis 1 1 2 29. Hyperplasia of prostate 1 — 1 30. Pregnancy, childbirth and abortion — — — 31. Congenital malformations 2 3 5 32. Other defined and ill-defined diseases 20 16 36 33. Motor Vehicles, accidents 2 3 5 34. All other accidents 5 3 8 35. Suicide 4 2 6 36. Homicide and operations of war 190 160 350 Notifiable Diseases other than Tuberculosis Disease Corrected Notifications Admitted to Hospital Total Deaths Diphtheria — — — Measles 614 31 — Whooping Cough 16 - — Ac. Pneumonia 10 4 20 Scarlet Fever 13 3 — Ac. Encephalitis — — — Puerperal Pyrexia — — — Ophthalmia Neonatorum — — — Erysipelas 3 2 — Poliomyelitis (Paralytic) 2 2 — Poliomyelitis (Non-paralytic) 1 1 — Enteric or Typhoid Fever — — — Paratyphoid fevers — — — Malaria — — — Dysentery 9 6 — Food Poisoning 9 1 — Meningococcal infection 1 1 — Smallpox — — — Age Periods Ophthalmia Neonatorum Scarlet Fever Measles Whooping Cough Acute Poliomyelitis non- Paralytic Paralytic Under 1 year — — 11 2 — — 1—2 years — 2 131 5 I — 3—4 years — 2 161 7 — 1 5—9 years — 8 288 2 I — 10—14 years — 1 12 — — — 15—24 years — — 6 — — — 25 and over — — 2 — — — Age unknown — — 3 — — — Total — 13 614 16 2 1 6 Age Periods Dysentery Food Poisoning Meningococcal Infection Pneumonia Erysipelas Under 5 years 3 — — 1 — 5—14 years 4 1 — 1 — 15—44 years 1 5 — 5 — 45—64 years — 3 1 2 1 65 and over 1 — — — 2 Age unknown — — — 1 — Total 9 9 1 10 3 Tuberculosis Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M F M F M F M F Under 5 years 1 — - - - - - - 5—14 years — 2 1 1 — — — — 15—24 years 6 1 - - - - - - 25—44 years 9 2 1 1 — — — — 45—-64 years 4 1 - - - - - - Over 65 years 2 2 — - — 1 — — Total 22 8 2 2 — 1 — — Tuberculosis Only one death from tuberculosis occurred during the year and the number of new cases notified was approximately the same as the previous year. Maternal Mortality There were no maternal deaths during the year. Persons in Need of Care and Attention It was not found necessary to take action under the National Assistance Acts in respect of persons requiring care and attention. In certain cases arrangements were made with the Area Medical Officer of Health for the assistance of Home Helps. Housing Since house building recommenced in 1946 this Authority has built 2,055 dwellings and 987 private dwellings have been erected. In addition 150 temporary bungalows were erected. A start has now been made to replace these with permanent housing accommodation. There was still a demand for houses, mostly from young couples who were sharing accommodation with parents. Difficulties of finance and shortage of building land made it increasingly difficult for the Council to deal with this need. 7 Diphtheria Immunisation Facilities for immunisation against diphtheria are provided by the Middlesex County Council at their clinics or through the local medical practitioners. 498 children completed full courses of primary immunisation and 457 received re-inforcing injections against diphtheria (63 and 267), whooping cough (7 and 60) or both (428 and 130). The Department has co-operated with the Area Medical Officer of the County with regard to the publicity campaigns which have been undertaken. Poliomyelitis Vaccination Vaccination against poliomyelitis was undertaken by the Middlesex County Council at their three clinics in the area. I am advised by the Area Medical Officer of Health that during the year 1,724 children completed vaccination at the three clinics, these with the 252 vaccinated in 1956 make a total of 1,976 children who have been protected. Taking Health Area No. 10 as a whole 9,392 children had completed courses of innoculation by 31st December, 1957 and another 10,600 were awaiting immunisation. Water Analysis 1. The Bedfont and Feltham Wards (9,734 dwellings) of the District were supplied by the South West Suburban Water Company and the Hanworth Ward (approximately 3,500 dwellings) by the Metropolitan Water Board. The water supplied to this area by the South West Suburban Water Company was taken by the Company from the Metropolitan Water Board. The water was derived from the River Thames, purified in the storage reservoirs at Littleton, Staines and Walton, and filtered and chlorinated at the Hampton Works. A contact period of over an hour was given at the works for the completion of chlorination. The water supply was satisfactory both as regards quantity and quality. 2. Samples for bacteriological examination (801) and chemical analysis (236) were taken by the Metropolitan Water Board at all stages of purification at least five times each week. Sixteen raw water and one hundred and seven treated water samples were taken by the South West Suburban Water Company. In addition six samples were taken by my department. 8 Average Results of Analyses of Metropolitan Water Board Supply. (Milligrammes per litre). Water filtered and chlorinated at Hampton Works. Chemical Ammonia Nitrogen 0.020 Albuminoid Nitrogen 0.076 Oxidised Nitrogen (Nitrate) 3.9 Chlorides as C1 29 Oxygen abs. from Permanganate 4 hours at 27°C. 1.20 Turbidity in terms of Silica 0.4 Colour m.m. brown 2 ft. tube Burgess's Tintometer 12 Hardness total 260 Hardness (Non-carbonate) 58 pH Value 7.9 Conductivity 550 Bacteriological Plate counts (average per ml.) Colonies counted on agar at 37°C. (20—24 hours) 3.7 Colonies counted on agar at 22°C. (3 days) — Coliform Test (Percentage of samples negative per 100 ml.) Coliform 99.50 B.Coli 99.75 Typical Analysis of South West S.W. Co., Supply (Parts per million.) Chemical Appearance Bright with very few particles. (Microscopic mineral particles) Turbidity Less than 3 Colour 5 Odour Nil pH 7.7 Free Carbon Dioxide 7 Electric Conductivity 510 Total Solids 340 Chlorine present as Chloride 28 Alkalinity as Calcium Carbonate 195 Hardness: Total 255 (Carbonate 195; Non-Carbonate 60) Nitrate Nitrogen 4.7 Nitrite Nitrogen absent Ammoniacal Nitrogen 0.000 Albuminoid Nitrogen 0.044 Oxygen absorbed 0.80 Residual Chlorine 0.08 Metals absent 9 Bacteriological Number of Colonies developing ) 1 day at 37°C. 2 days at 37°C. 3 days at 20°C. on Agar ) 2 per ml. 4 per ml. 5 per ml. Present in Absent from Probable number Presumptive Coli- aerogenes Reaction— 100 ml. 0per 100 ml. Bact. coli. (Type 1)— 100 ml. 0per 100 ml. C1. welchii Reaction 100 ml. 10 ml. 0per 100ml. 3. The water supplied had no plumbo solvent action but samples were tested for presence of metals. 4. No action was required in respect of contamination of the water. All water was chlorinated before distribution and all new and repaired mains were chlorinated before being restored to use. 5. With the exception of one or two outlying cottages, all the houses in the area were supplied from the public water mains. Only two cottages were supplied by a common standpipe, they had previously been condemned, and at the end of the year the occupiers were rehoused. Food Poisoning Nine unrelated cases of food poisoning were notified during the year. Investigations were made in all cases and twenty-four other cases were ascertained including a number at an old persons home who were affected with staph, aureus. The sources of infection were not ascertained due to lateness of information or other causes. Establishments for Massage and Special Treatment One establishment was licensed under Sections 355-357 of the Middlesex County Council Act, 1944. 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 Mr. Bell and the staff of the department for their able and willing assistance. F. H. WOODS, Medical Officer of Health. 10 CHIEF PUBLIC HEALTH INSPECTOR'S REPORT Housing—Demolition and Closure Action within the framework of the Council's programme for dealing with unfit houses was continued, details of which are given below. The rate of progress was slower due to the reduced building programme as it was not considered advisable to condemn houses too far in advance of the Council's ability to rehouse the occupiers. In connection with this rehousing it was decided to include in current building projects some provision for persons living on their own, a class which is always represented in any group of cottages condemned. The advent of the new Rent Act, with its increased rents, will also increase house valuations and it was hoped that as a result it would be possible, once the Act was fully in operation, to deal with some of the unfit houses by way of repair instead of demolition. From 1946 until the end of 1957, 227 houses had been dealt with as follows:— Demolition Orders made 197 Agreements entered into with owners to "close" or repair or Closing Orders made 30 Houses demolished as a result of formal or informal action 176 Persons who have been displaced 613 Action taken during 1957 is as follows:— Housing Act, 1957 Houses reported to Public Health Committee as being unfit 45 Demolition Orders made 8 Closing Orders made 1 Houses demolished as a result of formal or informal procedure under Section 17 (1) 23 Houses closed under Sections 16 (4), 17 (1), and 35 (1) 0 11 Houses closed under Sections 17 (3) and 26 0 Parts of buildings closed under Section 18 0 Houses in respect of which agreements entered into with owners to repair 11 Total number of persons displaced 99 Housing—Repairs Defects in dwelling-houses continued to receive attention and repairs were carried out as far as possible. The result of the action taken is summarised below. As mentioned elsewhere it was hoped that the effect of the Rent Act upon rents, and consequently valuations, would enable more to be done by way of repair to the older houses which cannot be demolished. These houses, however, will still be sub-standard insofar that they will not provide the amenities expected today. In two cases the owners failed to comply with the requirements of notices served under Section 93 of the Public Health Act, 1936. Complaints were made to the Magistrates and orders were made for the execution of the works within twenty-eight days. In addition a fine of £2 with 15/- costs was imposed in one case and 5/- costs in the other. Informal Action Number of unfit or defective houses rendered fit during the period as a result of informal action by the local authority 120 Action under Statutory Powers Number of houses reported to Public Health Committee with a view to service of statutory notices 20 Number of statutory notices served ... 12 Public Health Acts Number of houses in which defects were remedied after service of formal notices:— (a) by owners 8 (b) by local authority in default of owners 0 12 Housing Act, 1957 Number of houses made fit after service of formal notices (Sections 9 and 16):— (a) by owners 0 (b) by local authority in default of owners 2 Rent Act, 1957—Certificates of Disrepair This Act came into operation on the 6th July, 1957, and replaced the provisions of the Housing Repairs and Rents Act, 1954, with regard to certificates of disrepair. No applications for certificates of disrepair were received under the old Act but two applications, one of which was refused, were received for the revocation of certificates of disrepair. Under the new Act the following applications were received and dealt with as shown:— No. of applications for certificates 35 No. of decisions not to issue certificates 13 No. of certificates issued 17 No. of undertakings given by landlords to remedy defects 13 No. of undertakings refused by local authority 0 No. of applications for cancellation of certificates 0 Overcrowding Little statutory overcrowding came to the notice of the department. Such cases as were found were reported to the Public Health Committee and where considered necessary were referred to the Housing Committee for special consideration in connection with the provision of housing accommodation. Moveable Dwellings Public Health control of moveable dwellings in the area is effected by means of Section 345 of the Middlesex County Council Act, 1944 as amended by the 1950 Act and by byelaws. The consent of the Council is required to the placing or keeping 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 6 applications 13 for consent were received, 3 were refused and limited consents given in the other 3 cases. In one case an appeal was made to the Magistrate's Court against the Council s refusal. The Magistrates gave consent for 1 year and indicated that if a renewal was asked for they would require to know what further provision was proposed in respect of sanitary accommodation. Action was taken to secure the removal of 27 other moveable dwellings and the cessation of use of one caravan in respect of the use of which no consent had been given. It has been the Council's policy for many years not to allow the use of caravans in the area as permanent dwellings. There is no doubt that, but for this policy, which has been pursued effectively, there would now be a large population of caravan dwellers. A little trouble has been experienced with the wandering gypsy type of caravan dweller but much of the land upon which these people camped is no longer available. Shops All shops were 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. Two licences, one of which was a renewal, were issued to keep pet shops. Two shops were licensed to deal in game. The "late day" for the general closing hours of shops in the area was Friday, but shopkeepers remained free to fix their own half day closing subject to the provisions of the Shops Act. Most shops closed for half day on Wednesday. There was no evidence of shops remaining open after the closing hours, but a number of shops opened on Sundays and inspections were made in connection with the limited range of articles permitted to be sold on that day. Food Premises Regular inspections of all types of food premises were made, special attention and more frequent visits being made to catering establishments, premises registered under section 16 of the Food and Drugs Act, bakehouses and other places where food is actually prepared. 14 Efforts were continued to secure adequate protection for foodstuffs exposed for sale, but it is a never ending task and recent Court decisions have appeared to weaken the provisions of the Food Hygiene Regulations in this matter. In many cases at a Public Health Inspector's instigation traders provided glass display screens or cabinets and on subsequent visits it was found that packeted articles were behind the screen and open food was placed on top or otherwise unprotected. In this day and age surely all food should be protected and required to be kept free from all avoidable contamination, quite apart from whether a risk to health is involved. Three prosecutions were taken during the year. One concerned two dirty milk bottles and fines of £20 and £5 5s. 0d. costs were imposed. The second was in respect of an insect in a loaf of bread. In this case the Magistrates considered that there was an element of doubt that the presence of the insect was an unavoidable consequence of the process of preparation and dismissed the case. The third was in respect of contraventions of the Food and Drugs Act and the Food Hygiene Regulations and fines totalling £130 and £5 5s. Od. costs were inflicted. Food premises in the district consist of the following:— Catering establishments including factory canteens and school kitchens 122 Grocery and provision shops and "general stores" 67 Greengrocers' shops 37 Butchers' shops 28 Bakers' shops 15 Milk shops 8 Fishmongers' shops 15 Sweet and confectionery shops 62 Food Preparing Premises There were no new registrations during the year. The register contained the addresses of 31 premises which had been registered under the Act for the preservation, etc., of food as follows:— Premises used for the manufacture of sausages, pies, etc. 12 Premises used for the cooking of fish 10 Premises used for the cooking of bacon 9 15 Hawkers of Foodstuffs. Under the provisions of Section 11 of the Middlesex County Council Act, 1950, persons selling foodstuffs from any vehicle, etc., who are not the occupiers of an open shop for the sale of foodstuffs, require to be registered with the local authority and the foodstores at which the foodstuffs intended for sale are stored are also required to be registered. Most of the registered hawkers dealt in fruit and vegetables in respect of the sale of which the enforceable requirements are not very onerous so that a good deal of attention had to be given to these food traders to try to ensure a reasonable hygienic standard in their methods and storage arrangements. Three new hawkers of foodstuffs and two foodstores were registered. Street Traders Persons wishing to trade from a fixed site in any public street are required to hold a licence under Sections 320 and 321 of the Middlesex County Council Act, 1944, and issued by the local authority. There was only one street trader in the area whose licence to sell fruit and vegetables was renewed during the year. Slaughter-Houses One of the slaughter-houses was not used at all and at the other, which was principally used for the slaughter of horses, the amount was considerably reduced. There did not appear to be a demand for slaughtering facilities. Number of slaughter-houses licensed 2 Number of slaughtermen licensed 10 Knackers Yard There was one licensed knackers yard which was used to only a very limited extent. 16 INSPECTION AND SUPERVISION OF FOOD Carcases and Offal inspected at slaughter-houses and condemned in whole or in part Cattle Excluding Cows Cows Calves Sheep and Lambs Pigs Horses No. killed (if known) — — — — 4 33 No. inspected — — — — 4 33 All diseases except Tuberculosis and Cysticerci Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned - - - - - 6 Percentage of the number inspected infected with disease other than tuberculosis and cysticerci - - - - - 19.8 Tuberculosis only Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned - - - - - - Percentage of the number inspected affected with tuberculosis - - - - - - Cysticercosis Carcases of which some part or organ was condemned - - - - - - Carcases submitted to treatment by refrigeration - - - - - - Generalised and totally condemned - - - - - - 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 — — — — 17 Part Carcases and Organs— Beasts Calves Sheef Pigs Tuberculosis — — — — Other condition 909 lbs. — — — In addition, the following amounts of other foodstuffs were found to be unfit for human consumption:— Fish ... ... ... 588 lbs. Sugar ... ... ... 14 lbs. Tomatoes ... ... ... 5 lbs. Fruit Pie Fillings ... ... ... 7 lbs. Margarine... ... ... ... 3 lbs. Butter ... ... ... 6 lbs. Ham ... ... ... 40 lbs. Cheese ... ... ... 97 lbs. Steak and kidney pies ... ... ... 6 Sausages ... ... ... 56 lbs. Prawns ... ... ... 20 lbs. Peppermint Creams ... ... ... 14 lbs. Jam ... ... ... 7 lbs. Orange Squash ... ... ... 13 botts. Lemon Squash ... ... ... 7 botts. Dates ... ... ... 70 lbs. Tinned Foodstuffs: Fruit ... ... ... 372 lbs. Vegetables ... ... ... 32 lbs. Soup ... ... ... 6 tins Meat ... ... ... 336 lbs. Fish ... ... ... 5 lbs. Milk ... ... ... 15 tins Cream ... ... ... 1 tin Spaghetti ... ... ... 1 tin Eggs ... ... ... 14 lbs. Chicken ... ... ... 4 lbs. Ham ... ... ... 51 lbs. Bacon ... ... ... 14 lbs. Disposal of Condemned Food Where possible condemned foodstuffs are sent to a waste products factory where they are processed for non-edible purposes. Foodstuffs which are not suitable for such disposal are buried at the Council's refuse tip. Food and Drugs Act, 1955—Food and Drugs Authority The Middlesex County Council is the Food and Drugs Authority for the district. 18 The Public Control Department carry out the provisions of the Food and Drugs Act, 1938, operated by the County Council and I am indebted to the Chief Officer of that Department, Mr. J. A. O'Keefe, for the following details of action taken in this district:— Samples procured:— Article Total samples procured Unsatisfactory Milk (New) 34 2 Milk (various) 29 — Butter 4 — Cakes 6 — Cooked Meat 4 — Cream 6 — Drugs 4 — Fish and Fish Products 16 — Fruit (canned) 7 — Fruit (fresh) 2 — Fruit Squash, etc. 3 — Garden Peas 8 — Ice-Cream 2 — Margarine 2 — Meat and Meat Products 4 — Preserves 3 — Sausages 7 — Vinegar 15 1 Miscellaneous 15 — Totals 171 3 The two unsatisfactory milk samples were deficient in milk fat and solids-not-fat. Follow up samples from the same source were satisfactory. The unsatisfactory vinegar was found to be brewed condiment. An official caution was given. Forty-six inspections of shops were made in connection with the Merchandise Marks Acts 1887-1926. No serious infringements were disclosed, minor infringements were dealt with by verbal cautions. The labelling of Food Order, 1953, requires certain prepacked foods to bear on the label a clear statement of the designation of the food and in the case of compound foods, the ingredients. It also requires that the name and address 19 of the packer or labeller appears. Thirty-nine premises were visited but no infringement was detected. In addition advertisements and the labels of pre-packed foods were scrutinised to detect false or misleading descriptions. Corrective action was taken with regard to a number of commodities. One licence was issued to use the designation "pasteurised" in relation to milk processed in the area. The premises were inspected regularly and fifty-three samples taken. The premises and samples were satisfactory. Nine samples of raw milk were tested for tubercle bacilli but none was contaminated. Milk (Special Designations), (Raw Milk), (Pasteurised and Sterilised Milk) Regulations, 1949 Dealers licences were granted to sell graded milks as follows:— Tuberculin Tested 9 Pasteurised 9 Sterilised 21 Supplementary Licences: Tuberculin Tested 12 Pasteurised 12 Sterilised 13 Nine samples of graded milks were taken and submitted to the Public Health Laboratory Service at Epsom, all were satisfactory. There were twenty-five registered milk distributors and one dairy. Ice Cream Premises at which ice cream was sold continued to receive regular attention. There were no registered manufacturers of ice cream in the area. Five premises were registered, under Section 16 of the Food and Drugs Act, 1955, for the sale of ice cream. The Council continued to receive complaints with regard to the noise and disturbance caused by the various instruments used by mobile ice cream vendors to attract attention. The existing law did not appear to deal effectively with the matter and efforts were directed towards securing more effective legislation. 20 Clean Air The Clean Air Act came partly into operation on the 31st December, 1956, including provisions with regard to Smoke Control Areas, heights of new chimneys, installation of new furnaces and new building byelaws regarding heating and cooking appliances in new domestic buildings. The Council adopted the byelaw requiring domestic heating and cooking appliances in new buildings to be capable of burning smokeless fuel and it came into operation on the 1st November, 1957. Action was taken with regard to certain new buildings to ensure adequate chimney heights. Consideration was given to the establishment of a Smoke Control Area but no decision had been made at the end of the year. Rodent Control The control of rat and mice infestations in accordance with the methods advocated by the Ministry of Agriculture, Fisheries and Food was continued. The Council's refuse tip was kept under regular observation and any sign of rat activity dealt with immediately. The public sewers were test baited in the Autumn and were found to be free from infestation. The Ministry considered that further test baiting would not be necessary until 1960. During the twelve months ended on the 31st March, 1958, the complaints received of infestations numbered 174, and these together with cases discovered by members of the staff involved the inspection of 1,089 premises. Rat infestations were found at 188 premises and mice infestations at 51 premises. Of these 212 treatments were undertaken by the department, the remaining 27 being carried out by the occupiers. When treatments are carried out by this department on behalf of occupiers, a standard charge of five shillings is made in the case of private dwellings and the full cost of the treatment is recovered 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. 21 Arrangements were continued with the Middlesex County Council for the department to carry out any rodent control works necessary on the portions of the Duke of Northumberland's River and the River Crane in the area. Rag Flock and Other Filling Materials Act, 1951 There were three premises registered under this Act. Except at one of the premises, very little filling materials were used. Four inspections were made. Disinfestation One dwelling was found to be infested with bed bugs and was disinfested : Council houses infested 0 Other houses infested 1 Disinfestation with contact insecticides incorporating D.D.T. was carried out by the department. It was not found necessary to disinfest the furniture, etc., of prospective Council house tenants before removal to the Council's houses. Disinfestation for the eradication of the following vermin was carried out at the numbers of premises stated:— Cockroaches 4, fleas 1, woodworm 1, lice 1, silver fish 1, ants 2. In addition 22 wasps' nests were destroyed. Infectious Diseases—Disinfection The following numbers of premises have been disinfected after cases (or suspected cases) of infectious disease:-— Tuberculosis 2 Scarlet Fever 3 Poliomyelitis 1 22 Administration of the Factories Acts, 1937 and 1948 Part I of the Act 1. Inspections for purposes of provisions as to health. Premises Number on Register Inspections Number of Written Verbal Notices Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 19 27 - 2 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 198 550 3 40 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 15 54 - 1 - Total 232 631 3 43 — 2. Cases in which defects were found. Number of cases in which defects were found Particulars Found Referred Remedied To H.M. By H.M. Insspector Inspector Want of cleanliness (S.l) 2 1 — — Overcrowding (S.2) — — — — Unreasonable temperature (S.3) - - - - Inadequate ventilation (S.4) — - - — Ineffective drainage of floors (S.6) - - - - Sanitary conveniences (S7) (a) Insufficient — 2 - — (b) Unsuitable or defective 32 37 - - (c) Not separate for sexes 2 - - Other offences against the Act (not including offences relating to Outwork) 6 2 Total 40 44 — — 23 Part VIII of the Act Outwork (Sections 110 and 111). No notifications were received of outworkers employed by local manufacturers but there were 66 persons doing outwork for employers outside the area. 101 visits were made to outworkers' homes. Summary of Inspections Number of premises inspected on complaint 797 Number of inspections made:— Housing Insp. (Housing Regulations) 65 Housing re-inspections 931 Other re-inspections 2,162 Infectious Diseases and Food Poisoning 178 Council Houses 51 Moveable Dwellings 139 Bakehouses 52 Slaughter-houses (excluding re-Slaughtering) 5 Knackers Yards — Dairies and Milk Shops 32 Pet Animal Shops 10 Shops (Shop Acts) 1,274 Hawkers of Foodstuffs 84 Ice Cream Premises 91 Food Preparing Premises (excluding Catering Establishments) 117 Catering Establishments 683 Butchers' Shops 215 Fish Shops 98 Other Food Shops 771 Power Factories 550 Non-Power Factories 27 Other Factories 4 Outworkers' Premises 101 Workplaces and Offices 54 Piggeries 34 Licensed or Public Premises 233 Hairdressers and Barbers Establishments 50 Rodent Control 2,307 Defence Regulations 58 Housing Applications 172 Measurements under Housing Act 19 24 Smoke observations 54 Food Inspection—Meat 53 Food Inspection—Fish 11 Food Inspection—Other commodities 53 Milk and Water Sampling 21 Street Trading 96 Tipping of Refuse 25 Inspection of Food Vehicles 186 Inspection under Rag Flock Act 4 Re Disrepair Certificates 59 Miscellaneous 197 Total 12,123 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 Public Health Inspector.