439 (B) 1) Mr. o'mata 5b 2) libaray Urban District Council of FELTHAM Annual Report of the Medical Officer of Health for the year ending 31st December 1958 Feltham, Middx. September, 1959 Feltham Urban District Council PUBLIC HEALTH COMMITTEE Chairman: Mr. W. R. Sands Councillors: Mrs. F. M. Haines, Mrs. L. M. Woodall, Mr. H. A. Battersby, Mr. W. F. Hobbs, Mr. H. Nixon, Mr. A. J. Ogden, Mr. A. E. Parfitt, J.P. (Chairman of the Council), Mr. A. J. Sheppard, Mr. F. A. Watts, Mr. E. Williams. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health (part time): F. H. Woods, M.R.C.S., L.R.C.P. (Retired March, 1959) W. Cormack, M.B.Ch.B., D.P.H. (Appointed July, 1959) Chief Public Health Inspector: F. V. Bell, M.R.S.H., M.A.P.H.I. Public Health Inspectors: J. Smith (Resigned 2/3/58) G. H. Green, M.A.P.H.I. J. W. Paine (Appointed 7/7/58) C. Willard, M.R.S.H., M.A.P.H.I. (Appointed 1/7/58) Senior Clerk: D. W. Tomlin Clerical Staff: Mrs. E. E. Hutchison Miss P. Deuchar Rodent Operative: T. O. Williams 2 Telephone: Public Health Department, Feltham 2281 and 3281 Council Offices, Feltham. August, 1959. To: The Chairman and Members of the Feltham Urban District Council. Mr. Chairman, Ladies and Gentlemen, I beg to present the Annual Report on the Health and Sanitation of your District for the year 1958. In this, my first report, I am pleased to say that the health of the district remains good and the vital statistics compare favourably with those of the country as a whole. This is actually a report on the health of your district and a record of the work carried out in your Health Department during the last year in office of Dr. F. H. Woods, who retired from your service in March, 1959. He was in office as Medical Officer of Health for the past 35 years and I am sure you will agree, is to be congratulated on a job well done. I sincerely hope that he will now enjoy a long and happy retirement. I trust that as your new Medical Officer of Health, I shall be able to carry on Dr. Woods' good work and I shall certainly do my best to maintain the high standard set by him. I am certain that the help and co-operation which I already have experienced of Mr. Bell, the Chief Public Health Inspector, and his staff will be of the greatest value to me in my task. I would also like to place on record my appreciation of the warm welcome I received from the Chairman and Members of the Public Health Committee on my appointment and acknowledge with thanks the friendly co-operation and help of my colleagues in the other departments of the Council. I am, Ladies and Gentlemen, Your obedient servant, W. CORMACK, Medical Officer of Health. 3 STATISTICS FOR THE AREA Area and Acreage (Bedfont, Feltham and Hanworth) 4,925 acres Population 50,780 Number of inhabited dwellings 14,124 Number of new dwellings erected 352 The product of the penny rate is £3,600.19.11 The rateable value is £897,680 VITAL STATISTICS LIVE BIRTHS Total Male Female Legitimate 810 422 388 Illegitimate 34 12 22 Total 844 434 410 Live Birth Rate per 1,000 of estimated home population 16.6 Adjusted Live Birth Rate 16.1 STILL BIRTHS Total Male Female Legitimate 9 7 2 Illegitimate — — — Total 9 7 2 Still Birth Rate per 1,000 total (live and still) births 10.55 Total Live and Still Births 853 INFANT DEATHS (under 1 year of age) Total Male Female Legitimate 17 9 8 Illegitimate 1 1 — Total 18 10 8 Infant Mortality Rate per 1,000 live births 21.32 Legitimate Infant Mortality Rate per 1,000 legitimate live births 20.98 Illegitimate Infant Mortality Rate per 1,000 illegitimate live births 29.41 NEO-NATAL DEATHS (under four weeks of age) Total Male Female Legitimate 13 6 7 Illegitimate 1 1 — Total 14 7 7 Neo-Natal Mortality Rate per 1,000 live births 16.58 Early Neo-Natal Mortality Rate (first week) per 1,000 live births 16.58 Perinatal Mortality Rate per 1,000 live and still births 0.027 Illegitimate live births per cent. of total live births 4.03 Maternal Deaths (excluding abortion) nil Maternal Mortality Rate (including abortion) per 1,000 total births nil 4 DEATHS Male 217 Female 158 Total 375 Death Rate per 1,000 of the estimated home population— Crude Death Rate 7.4 Comparability Factor 1.58 Adjusted Death Rate 11.7 Death Rate from pulmonary tuberculosis 0.02 Death Rate from cancer 1.4 Birth and Death Rates for England and Wales, 1958 Birth Rate 16.4 Still Birth Rate (per 1,000 live and still births) 21.6 Death Rate 11.7 Deaths under one year of age 22.6 Deaths under four weeks of age 16.2 Maternal causes, excluding abortion 0.35 Due to abortion 0.08 Total maternal mortality 0.43 Table of Birth and Death Rates for previous 10 years Year * Birth Crude Adjusted * Death Rate Crude Adjusted † Still Birth Rate † Maternal Death ‡ Infant Under 1 yr. Death Rate Under 4 weeks 1957 16.3 15.81 7.0 11.13 23.95 nil 19.63 15.95 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 — * Rale per 1,000 estimated home population. † Rate per 1,000 total births, ‡ Rate per 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 1 1 2 10. Malignant neoplasm, stomach 7 5 12 11. Malignant neoplasm, lung, bronchus 23 2 25 12. Malignant neoplasm, breast — 6 6 13. Malignant neoplasm, uterus — 4 4 14. Other malignant and lymphatic neoplasms 17 9 26 15. Leukaemia, aleukaemia 3 1 4 16. Diabetes — 1 1 5  Male Female Total 17. Vascular lesions of nervous system 19 30 49 18. Coronary disease, angina 44 22 66 19. Hypertension with heart disease 5 8 13 20. Other heart disease 16 25 41 21. Other circulatory disease 6 6 12 22. Influenza — 2 2 23. Pneumonia 9 7 16 24. Bronchitis 20 4 24 25. Other diseases of respiratory system 3 1 4 26. Ulcer of stomach and duodenum 5 — 5 27. Gastritis, enteritis and diarrhoea — 1 1 28. Nephritis and nephrosis 1 1 2 29. Hyperplasia of prostate 1 — 1 30. Pregnancy, childbirth and abortion — — - 31. Congenital malformations 3 1 4 32. Other defined and ill-defined diseases 18 13 31 33. Motor vehicles, accidents 8 1 9 34. All other accidents 6 11 35. Suicide 2 1 3 36. Homicide and operations of war — — — 217 158 375 Notifiable Diseases other than Tuberculosis Disease Corrected Notifications Admitted to Hospital Total Deaths Diphtheria — — — Measles 111 4 — Whooping Cough 6 — — Acute Primary or Influenzal Pneumonia 2 1 Scarlet Fever 33 9 — Ac. Encephalitis — — — Puerperal Pyrexia 1 — — Ophthalmia Neonatorum — — — Erysipelas 2 2 — Poliomyelitis (Paralytic) — — — Poliomyelitis (Non-Paralytic) 1 1 — Typhoid and Paratyphoid — — — Malaria 1 1 — Dysentery 7 1 — Food Poisoning 18 8 1 Meningococcal infection 1 1 — Smallpox — — — Age Periods Ophthalmia Neonatorum Scarlet Fever Measles Whooping Cough Acute Poliomyelitis Paralytic nonParalytic Under 1 year - - 3 1 — — 1-2 years - 2 39 — — — 3-4 years - 5 24 2 — 1 5-9 years - 22 41 3 — — 10-14 years - 3 2 — — — 15-24 years - 1 2 — — — 25 and over - — — — — — Age unknown - — — — — — Total 33 111 6 — 1 6 GENERAL HEALTH MATTERS, INCLUDING INFECTIOUS DISEASE CONTROL Tuberculosis There was one death from tuberculosis during the year and 30 new cases were notified. Eight of these new cases occurred in the age group 15-24 years. This indicates the vulnerability of the young adult to this disease and it is hoped that the B.C.G. vaccination against tuberculosis now offered to senior school pupils through the school health service will help to reduce this high incidence. Mass X-Ray Unit 5A visited the district from the 5th to the 27th May, 1958, and, working in nine sites, X-rayed a total of 6,762 persons. Men Women Total Attendances 4,015 2,747 6,762 Out of this number thirty-eight people were referred to chest clinics for further investigation. From these, there were eight cases of active pulmonary tuberculosis and four cases of bronchial carcinoma. Diphtheria No cases occurred in the district during the year and, as before, the Middlesex County Council at their clinics in the district, together with the local general practitioners, continued the immunising campaign against the disease. Age Periods Dysentery Food Poisoning Meningococcal infection Pneumonia Erysipelas Under 5 years 1 6 1 1 — 5-14 years 3 1 — — — 15-44 years 1 6 — 1 1 45-64 years 2 2 — — — 65 and over — 3 — — 1 Age unknown — — — — — Total 7 18 1 2 2 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 1 1 — — — — — — 15-24 years 5 3 — — — — — — 25-44 years 5 7 — — — — — — 45-64 years 7 — — — — — — — Over 65 years — — — — — 1 — — Total 18 12 — — — 1 — — 7 667 children completed full courses of primary immunisation and 640 received re-inforcing injections against diphtheria. Whooping Cough The number of cases notified was six, as compared with sixteen for the previous year. Due to the complications that can accrue from this infection it is essential that children are protected by immunisation as early as possible in their life. 589 children received full courses of primary immunisation and 382 received re-inforcing injections against the disease. Acute Poliomyelitis One case of non-paralytic poliomyelitis occurred during the year. Vaccination against the disease was undertaken by the local general practitioners and also by the Middlesex County Council at their three clinics in the area. The age limit of the scheme was raised during the year to include all persons up to 26 years, all expectant mothers and certain people in priority groups. I am advised by the Area Medical Officer that 6,750 in the above groups have now completed a full course of vaccination and these, with the 1,976 children vaccinated during 1956 and 1957, make a total of 8,726 who have been protected against the disease. Poliovirus Survey in Normal Children In conjunction with the other Sanitary districts in Middlesex, this district co-operated with the Central Public Health Laboratory at Colindale in carrying out a survey to get an indication of the proportion of normal children carrying poliomyelitis virus and to relate the carrier rate to the number of notified cases. Your Public Health Inspectors collected 86 specimens from children under five years of age in this district. Small Pox Vaccination Number of primary vaccinations 552 Number of re-vaccinations 58 Food Poisoning Eighteen unrelated cases of food poisoning were notified during the year. Investigations were made in all cases and seven other cases were ascertained. In spite of these full investigations it was not possible to ascertain any specific source of infection in any of the cases. 8 Maternal Mortality There were no maternal deaths during the year. National Assistance Act, 1948—Section 47 It was not found necessary to take action under the National Assistance Act in respect of persons requiring care and attention. In certain cases arrangements were made with the Area Medical Officer for the assistance of Home Helps. Housing Since house building recommenced in 1946 this Authority has built 2,095 dwellings and 1,325 private dwellings have been erected. 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. Maternity and Child Welfare and School Health Services This district forms part of Health Area 10, Middlesex County Council, who provide numerous sessions for antenatal and post-natal care, child welfare, immunisation and school health services at the following clinics:— Cardinal Road, Feltham. Grove Crescent, Hanworth. Imperial Road, Bedfont. Establishments for Massage and Special Treatment One establishment was licensed under Sections 355-357 of the Middlesex County Council Act, 1944. Water Analysis The Bedfont and Feltham Wards of the District were supplied by the South-West Suburban Water Company and the Hanworth Ward 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 Thames Valley Works. The water supply was satisfactory both as regards quantity and quality. Samples for bacteriological and chemical examination were taken by the Metropolitan Water Board at all stages of purification at least five times each week and 13 raw water 9 and 139 treated water samples were taken by the South-West Suburban Water Company. In addition, four samples were taken by my department. Average Results of Analyses of Metropolitan Water Board Supply. (Milligrammes per litre.) Chemical Ammonia iNitrogen 0.027 Albuminoid Nitrogen 0.077 Oxidised Nitrogen (Nitrate) 4.2 Chlorides as C1 26 Oxygen abs. from Permanganate 4 hours at 27°C 1.26 Turbidity in terms of Silica 0.3 Colour m.m. brown 2ft. Tube Burgess's Tintometer 12 Hardness total 270 Hardness (non-carbonate) 66 pH Value 7.9 Phosphate as P04 0.85 Silicate as SiO2 9 Sulphate as S04 58 Fluoride as F 0.15 Magnesium as Mg 5 Electrical Conductivity (gemmhos) 550 Bacteriological Plate counts (average per ml.) Colonies counted on agar at 37°C (20-24 hours) 9.7 Colonies counted on agar at 22°C (3 days) — Coliform count (percentage of samples negative per 100 ml.) 99.07 Escherichia count (percentage of samples negative in 100 ml.) 99.88 Typical Analysis of South-West S. W. Co., Supply. (Parts per million.) Appearance Bright with a few particles Turbidity Less than 3 Colour 8 Odour Nil pH 8.2 Free Carbon Dioxide absent Electric Conductivity 540 Total Solids 360 Chlorine present as Chloride 28 Alkalinity as Calcium Carbonate 210 Hardness: Total 265 (Carbonate 210: Non-Carbonate 551 Nitrate Nitrogen 2.2 Nitrite Nitrogen absent Ammoniacal Nitrogen 0.000 Albuminoid Nitrogen 0.063 Oxygen absorbed 1.4 Residual Chlorine 0.05 Metals absent 10 Bacteriological Number of Colonies developing 1 day at 37° C. 2 days at 37° C. 3 days at 20° C. on Agar 75 per ml. 80 per ml. 22 per ml. Present in Absent from Probable number Presumptive aerogcnes Reaction — 100 ml. 0 per 100 ml. Bact. coli. (Type 1) — 100 ml. 0 per 100 ml. C1. welchii Reaction — 100ml. The water supplied had no plumbo-solvent action but samples were tested for presence of metals. 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. With the exception of two condemned but occupied cottages, all the houses in the area were supplied from the public water mains. 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. Towards the end of the year the Council declared a group of 29 houses in Fern Grove, Feltham, to be a clearance area. Appeals were lodged against ten demolition orders made upon the owner's failure to carry out an undertaking which he had previously given. The appeals were not determined during the year but subsequently the hearing of the appeals was adjourned upon the owner giving a new undertaking. Appeals against eight other demolition orders were withdrawn during the year. From 1946 until the end of 1958, 241 houses had been dealt with as follows:— Demolition Orders made 209* Agreements entered into with owners to "close" or repair or Closing Orders made 32 Houses demolished as a result of formal or informal action 204 Persons who have been displaced 661 11 Action taken during 1958 is as follows:— Houses reported to Public Health Committee as being unfit 11 Demolition Orders made 12* Closing Orders made 2 Houses demolished as a result of formal or informal procedure under Section 17 (1) 28 Houses closed under Sections 16 (4), 17 (1) and 35 (1) Houses closed under Sections 17 (3) and 26 Parts of buildings closed under Section 18 Houses in respect of which agreements, entered into with owners to repair Total number of persons displaced 48 * Including ten referred to in text above. Housing—Repairs Defects in dwelling-houses continued to receive attention and systematic house-to-house inspections were commenced. The position with regard to "reasonable cost" of repairs and the action to be taken was materially affected in some cases by the increased rents being paid with consequent higher valuations. Repairs were asked for instead of demolition being contemplated. One wondered, however, who, if anyone, was satisfied after repairs to the older properties were completed. Hardly the owners, who had to find the cost, and little more likely the tenants, for whose benefit the action was taken. Many considered them sub-standard still and lacking the amenities which they so much desired. Informal Action Number of unfit or defective houses rendered fit during the period as a result of informal action by the local authority 56 Action under Statutory Powers Number of houses reported to Public Health Committee with a view to service of formal notices 2 Number of formal notices served 1 12 Public Health Acts Number of houses in which defects were remedied after service of formal notices:— (a) by owners 2 (b) by local authority in default of owners Housing Act, 1957 Number of houses made fit after service of formal notices (Sections 9 and 16):— (a) by owners 4 (b) by local authority in default of owners Rent Act, 1957—Certificates of Disrepair Applications for Certificates of Disrepair and for the cancellation thereof were received as set out below, together with the action taken:— No. of applications for certificates 40 No. of decisions not to issue certificates 27 No. of certificates issued 18 No. of undertakings given by landlords to remedy defects 23 No. of undertakings refused by local authority 2 No. of applications for cancellation of certificates 14 No. of certificates cancelled 6 Overcrowding Ten cases of overcrowding were found and reported to the Public Health Committee. Most of the cases concerned housing applicants and they were referred to the Housing Committee for special consideration. Four known cases of overcrowding were abated during the year. Moveable Dwellings Public Health control of moveable dwellings in the area is effected by means of the Middlesex County Council Acts, 1944-1956 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. 13 It has been the Councils' policy for many years to deter the use of caravans in the area as permanent dwellings. During the year two applications for consent were received, both of which were refused. Action was taken which secured the removal of 45 other moveable dwellings and the cessation of use of one caravan in respect of the use of which no consent had been given. These figures include moveable dwellings occupied by the wandering gypsy type of caravan dweller, who gave some trouble from time to time. 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 were renewed to keep pet shops. The occupier of one shop renewed his licence 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. Efforts were continued to secure adequate protection for foodstuffs exposed for sale, but it was a hard task to maintain the ground already won. The impact of the self-service stores encouraged other traders to modify their methods so as to provide some degree of self-service. In some cases it was felt that the standard of food hygiene suffered as a consequence. Such partial changeovers often resulted in the use of display units in a way for which they were not designed. Subsequent criticisms tended to be resented a little by traders who had neglected to seek the department's views before buying expensive equipment. 14 The wholehearted co-operation of many food handlers for a proposal for improving food hygiene is only available if at the same time they think it will improve business. This is understandable to a point, but surely it is time that all measures to prevent the avoidable risk of contamination of food should not have to be so weighed in the balance. One would have thought that the possibility of contamination of our food would have been so abhorrent to the public that legislation would have required its prohibition whether there was a risk of injury to health or not. Proceedings were taken against the occupier of a catering establishment in respect of offences against the Food Hygiene Regulations, 1955 (Regulations 6, 16, 18 and 23), and fines totalling £45 were imposed. Food premises in the district consist of the following: Catering establishments, including factory canteens and school kitchens 120 Grocery and provision shops and "general stores" 68 Greengrocers' shops 38 Butchers' shops 28 Bakers' shops 14 Milk shops 8 Fishmongers' shops 14 Sweet and confectionery shops 64 Food Preparing Premises Two premises were registered during the year. One for the manufacture of sausages and the other for the cooking of fish. One registered food business was discontinued. The register contained the addresses of 32 premises registered under the Act for the preservation, etc., of food as follows:— Premises used for the manufacture of sausages, pies, etc. 13 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 open shops for the sale of foodstuffs, are required to be registered with the local authority and any foodstores at which the foodstuffs intended for sale are stored are also required to be registered. There is no requirement that hawkers shall have a food store and many stated that they did not need or have one. It was suspected that in some cases foodstuffs were kept over from day to day and how they were stored was a matter for conjecture. Action was only possible if such storage could be discovered. There was even less public health control over hawkers' activities than over foodshops, but efforts were made to maintain a reasonable hygienic standard. Three new hawkers of foodstuffs were registered. Street Traders Persons wishing to trade from fixed sites in any publicstreet are required to hold a licence under Sections 320 and 321 of the Middlesex County Council Act, 1944. There was only one street trader in the area whose licence to sell fruit and vegetables was renewed during the year. Slaughter-Houses One new licence was granted in respect of premises formerly used as a slaughter-house. One of the two existing slaughter-houses was not used at all and the other was only used on three occasions. Slaughtering in the area has almost ceased and there would not appear to be a demand for further facilities. Number of slaughter-houses licensed 3 Number of slaughtermen licensed 7 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) — — — — 10 5 No. inspected — — — — 10 5 All diseases except Tuberculosis and Cysticerci Whole carcases condemned — — — — — — Carcases of which some part or organ was condemned — — — — 1 2 Percentage of the number inspected infected with disease other than tuberculosis and cysticerci — — — — 10 40 Tuberculosis only Whole carcases condemned — — — — — — Carcases of which some part or organ was condemned — — — — 2 — Percentage of the number inspected infected with tuberculosis — — — — 20 — Cysticercosis Carcases of which some part or organ was condemned — — — — — — Carcases submitted to treatment by refrigeration — — — — — — Generalised and totally condemned — — — — — — Meat and other Foods Inspected Carcase meat and offal was inspected at butchers' shops and catering establishments and the following was considered unfit for human consumption:— Beasts Calves Sheep Pigs Tuberculosis — — — — Other condition 982 lbs. — — — 17 In addition, the following amounts of were found to be unfit for human consumpt - Fish Sausages Cheese Ham Bacon Tinned Foodstuffs Meat 205 lbs. Fruit 91 lbs. Ham 47 lbs. Soup 1 tin Fish 1 lb. Vegetables 8 lbs. Milk 16 tins Salad Dressing 1 gallon Disposal of Condemned Food Where possible condemned foodstuffs were sent to a waste products factory, where they were processed for nonedible purposes. Foodstuffs which were not suitable for such disposal were 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 and I am indebted to the Chief Officer of the Public Control Department, Mr. J. A. O'Keefe, for details of action taken in this district. Samples procured: Article Total samples procured Unsatisfactory Milk (New) 15 — Milk (Various) 29 3 Butter 9 — Cakes 6 — Cooked Meat 2 — Cream 8 — Drugs 16 — Fish and Fish Products 6 — Fruit (canned) 9 — Fruit (dried) 4 — Fruit Squash 2 — Ice Cream 3 — Meat and Meat Products 5 — Preserves 6 — Sausages and Sausage Meat 10 2 Spirits 4 — Vinegar 19 — Miscellaneous 14 — Totals 167 5 18 Ins Two of the unsatisfactory milk samples concerned bottles which were not thoroughly clean and the other, milk which contained dust, mould spores and hyphae. In each case cautions were given. The two unsatisfactory samples of sausage contained preservative, within the permitted limits, but its presence had not been declared. Official cautions were given. Ninety-seven premises were inspected in connection with the Merchandise Marks Acts, 1887-1926. No infringements were detected. 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 of the packer or labeller appears. Forty-one premises were visited but no serious infringements were 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 sixty-five samples taken. The premises and samples were satisfactory. Ten samples of raw milk were tested for tubercle bacilli but none was contaminated. Milk (Special Designations), (Raw Milk), (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953. Dealers licences were granted to sell graded milks as follows:— Tuberculin Tested 7 Pasteurised 7 Sterilised 18 Supplementary Licences: Tuberculin Tested 13 Pasteurised 13 Sterilised 14 There were twenty-two distributors of milk and one dairy. The department co-operated with milk distributors in the area in a campaign to reduce the mis-usage of milk bottles by consumers and to ensure their prompt return to the roundsmen in a clean condition. One dairy reported some improvement. 19 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. Four premises were registered, under Section 16, of the Food and Drugs Act, 1955, for the sale of ice cream. The Council made representations to the Ministry of Agriculture, Fisheries and Food when draft regulations with regard to the ice cream were under consideration. It was considered that in the interests of the consumer the word "cream" should not be used in relation to ices which contained fat other than milk fat. However, the Food Standards (Ice Cream) Regulations, 1959, which were subsequently issued permit such use. The Council continued to receive complaints with regard to the noise and disturbance caused by the various instruments used by mobile ice cream vendors. Clean Air The remaining provisions of the Clean Air Act, 1956, came into operation on the 1st June. Further consideration was given to the establishment of a smoke control area, but a final decision was not made. It was agreed to support a proposed clean air co-ordinating committee embracing adjoining districts. A number of proposals with regard to new chimneys was considered, no difficulties were encountered where increased heights were asked for. 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 Councils' refuse tip was kept under regular observation and any sign of rat activity dealt with immediately. It was not considered necessary to test bait the public sewers. During the twelve months ended on the 31st March, 1959, the complaints received of infestations numbered 173, and these, together with cases discovered by members of the staff, involved the inspection of 1,322 premises. Rat infestations were found at 174 premises and' mice infestations at 49 premises. Of these 218 treatments were undertaken by the department, the remaining five being carried out by the occupiers. 20 For treatments carried out by this department on behalf of occupiers, a standard charge of five shillings was made in the case of private dwellings and the full cost of the treatment was recovered in the case of business premises. Where the occupiers elected to carry out the treatment themselves, advice and supervision was given to ensure that the treatment was effective. 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 Northmberland's River and the River Crane in the area. Rag Flock and Other Filling Materials Act, 1951. Three premises were registered under this Act, but very little filling materials were used. Five inspections were made. Disinfestation Three Council and two other dwellings were found to be infested with bed bugs and were disinfested by the department with contact insecticides incorporating D.D.T. It was not found necessary to disinfest for bed bugs the furniture, etc., of prospective Council house tenants before removal to the Council's houses, but due to the increasing prevalence of "woodworm" infestations in the Council's houses the Engineer and Surveyor, who is responsible for the maintenance of these houses, found it necessary to obtain authorisation for the treatment of ingoing tenants' furniture where necessary. Other disinfestations for the eradication of pests were carried out as follows:— Cockroaches 1, fleas 1, woodworm 1, mosquitoes 1, clover mites 1, ants 2, wasps 6. The following number's of premises were disinfected after cases of infectious disease:— Tuberculosis 1 Scarlet Fever 3 21 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 Occupiers Prosecuted Written Notices Verbal Notices (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 17 14 - 1 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 202 479 21 23 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises). 5 7 - 5 - Total 224 500 21 29 — Part VIII of the Act Outwork (Sections 110 and 111). No notifications were received of outworkers employed by local manufacturers but there were 72 persons doing outwork for employers outside the area. 105 visits were made to outworkers' homes. 2. Cases in which defects were found. Particulars Number of cases in which defects were found Referred Found Remedied To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) — — — — Overcrowding (S.2) — — — — Unreasonable temperature (S.3) - - - - Inadequate ventilation (S.4) — — — — Ineffective drainage of floors (S.6) - - - - Sanitary conveniences (S.7) (a) Insufficient 1 — — — (b) Unsuitable or defective 44 28 — — (c) Not separate for sexes - 1 - - Other offences against the Act (not including offences relating to Outwork) 5 5 - - Total 50 34 — — 22 Summary of Inspections Number of premises inspected on complaint 858 Number of inspections made: — Housing inspections (Housing Regulations') 42 Housing re-inspections 726 Other re-inspections 1,355 Infectious Diseases and Food Poisoning 496 Council Houses 53 Moveable Dwellings 121 Bakehouses 30 Slaughter-houses (excluding re-slaughtering) 5 Knackers Yards 1 Dairies and Milk Shops 21 Pet Animal Shops 6 Shops (Shops Act) 761 Hawkers of Foodstuffs 84 Ice Cream Premises 65 Food Preparing Premises (excluding Catering Establishments) 77 Catering Establishments 474 Butchers' Shops 155 Fish Shops 66 Other Food Shops 531 Power Factories 479 Non-Power Factories 14 Other Factories 7 Outworkers' Premises 105 Workplaces and Offices 86 Piggeries 21 Licensed or Public Premises 167 Hairdressers and Barbers Establishments 65 Rodent Control 2.824 Defence Regulations 40 Housing Applications 220 Measurements under Housing Act 42 Smoke Observations 23 Food inspection—Meat 48 Food inspection—Fish 15 Food inspection—Other Commodities 29 Milk and Water Sampling 7 Street Trading 6 Tipping of Refuse 10 Inspection of Food Vehicles 115 Inspection under Rag Flock Act 5 Re Disrepair Certificates 130 Miscellaneous 231 Total 10,616 23 During the first half of the year the department was considerably handicapped by shortage of public health inspectors, only one out of the three additional inspectors remaining. From July, however, the full establishment was maintained. I should like to take this opportunity of thanking the Chairman and members of the Public Health Committee and Dr. Woods, the late Medical Officer of Health, for the consideration shown to me. I should like to express my thanks also to the members of the staff for their able assistance in carrying out the work of the department. FRANCIS V. BELL, Chief Public Health Inspector.