Urban District Council of FELTHAM Annual Report of the Medical Officer of Health for the year ending 31st December 1961 Feltham,Middx. July, 1962 FELTHAM URBAN DISTRICT COUNCIL PUBLIC HEALTH COMMITTEE Chairman: Mr. F. A. Watts Councillors: Mrs. W. E. Cox, Mrs. E. M. Woodall, Mr. A. G. Blight, Mr. H. T. Brown, Mr. T. W. McCarthy, Mr. A. J. Ogden, Mr. E. J. Pauling, Mr. W. R. Sands (Chairman of the Council), Mr. F. N. Saunders and Mr. A. J. Sheppard. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health (Part Time): W. Cormack, M.B., Ch.B., D.P.H. Chief Public Health Inspector: F. V. Bell, M.R.S.H., M.A.P.H.I. Public Health Inspectors: G. H. Green, M.A.P.H.I. J. W. Paine C. Willard, M.R.S.H., M.A.P.H.I. Student Public Health Inspector: K. M. Down Smoke Control Assistant: A. W. G. Wilcox Senior Clerk: Mrs. E. E. Hutchison Clerical Staff: Mrs. V. J. Park (Resigned 21.12.61) Miss P. Deuchar Rodent Operative: A. E. Gearing 2 Telephone: Public Health Department, Feltham 2281 and 3281 Council Offices, Feltham. July, 1962. To: The Chairman and Members of the Feltham Urban District Council. Mr. Chairman, Ladies and Gentlemen, I have pleasure in presenting for your consideration the Annual Report on the Health and Sanitation of your District for the year 1961. Total births of 921 give an adjusted Birth Rate of 17.7 per 1,000 of the population; this is again an increase on last year and compares favourably with the national rate of 17.4 for England and Wales. This is offset to some degree by an increase of 4.5 in the Infant Mortality Rate at 24.9 per 1,000 live births. Nineteen out of a total of twenty-one infant deaths occurred within a month of birth with once again, congenital malformations and prematurity as the main causes of death. An interesting point which leads on from the above is that although prematurity is one of the main causes of death in infant life, it is not always fatal. However, the premature child who survives may be damaged in other ways e.g. complete or partial deafness. The early diagnosis of this condition is now considered to be of such importance that any child known to have been subjected to any adverse prenatal or perenatal influence is now considered as being "at risk". The Local Health Authority in the district is now compiling "At risk" registers in order that this group of children may be followed up until positive evidence is obtained that the hearing is normal. The deaths in Feltham amounted to a total of 387 giving an adjusted mortality rate of 12.2 per 1,000 of the population which compares with a rate of 12.0 for England and Wales. Forty-nine per cent of deaths registered in the district were of people over seventy years of age with diseases of the heart and circulation as the main causes. The District had a relatively good year in respect of infectious diseases. This was only marred by the usual biennial rise in the incidence of measles with 782 notifications. There were no fatalities, but measles can produce a 3 "chesty child" and this plus the great disruption an epidemic of this type can produce in schools makes one wonder whether there is not a good case for yet another immunising vaccine. This may come to pass in the not too distant future. Dysentery, and Food Poisoning were made noteworthy by their absence from the District in 1961. Dare one say that the public are now becoming more hygiene conscious and that at long last we are now reaping the benefits of health education. I am afraid that time and the next few years' notifications alone will tell. The end of the year saw the completion of the adaptations and renovations carried out on the old mortuary in order to bring it up to be more in line with the recommendations given in the memorandum issued by the Ministry of Housing and Local Government on "The Planning of Mortuaries and Post-Mortem Accommodation". The old Mortuary fell short of these recommendations in many ways but thanks to the good work of Mr. Grimshaw, the District Engineer and his staff, the old building has been transformed into a really first class mortuary. The new building provides an autopsy room, doctor's suite, viewing and waiting facilities for relatives, and offices. All this, together with the provision of new equipment and furnishings gives the District a building, the general lay-out of which is much more convenient and the appearance of which is much more in keeping with the dignity and the importance of the service. I would like to take this opportunity of expressing my thanks to the Chairman and Members of the Public Health Committee for their interest and support during the year. At the same time I acknowledge with thanks the friendly co-operation of my colleagues in the other departments of the Council. Finally to Mr. F. V. Bell, the Chief Public Health Inspector and all members of the Health Department, my sincere thanks for their most willing and able assistance during the year. I am, Ladies and Gentlemen, Your obedient servant, W. CORMACK Medical Officer of Health. STATISTICS FOR THE AREA Area and Acreage (Bedfont, Feltham and Hanworth) 4,925 acres PoDulation 51 060 Number of inhabited dwellings 14,976 Number of new dwellings erected 358 The product of a penny rate £4,870 The rateable value £1,165,781 VITAL STATISTICS LIVE BIRTHS Total Male Female Legitimate 867 450 417 Illegitimate 54 26 28 Total 921 476 445 Live Birth Rate per 1,000 of estimated home population 18.03 Adjusted Live Birth Rate 17.66 Illegitimate live births per cent of total live births 5.86 STILL BIRTHS Total Male Female Legitimate 10 5 5 Illegitimate 1 - 1 Total 11 5 6 Still Birth Rate per 1,000 total (live and still) births 11.8 Total Live and Still Births 932 INFANT DEATHS (under 1 year of age) Total Male Female Legitimate 22 11 11 Illegitimate 1 - 1 Total 23 11 12 Infant Mortality Rate per 1,000 live births 24.97 Legitimate Infant Mortality Rate per 1,000 legitimate live births 25.37 Illegitimate Infant Mortality Rate per 1,000 illegitimate live births 18.52 NEO-NATAL DEATHS (under four weeks of age) Total Male Female Legitimate 19 9 10 Illegitimate — — — Total 19 9 10 Neo-Natal Mortalitv Rate per 1,000 live birth ... 20.63 Early Neo-Natal Mortality Rate (first week) per live births 1,000 16.3 Perinatal Mortality Rate per 1,000 live and still births 27.9 Maternal Deaths (including abortion) Maternal Mortality Rate per 1,000 total live and 1 still births •• 1.07 5 Birth and Death Rates for England and Wales, 1961 Birth Rate 17.4 Still Birth Rate (per 1,000 live and still births) 18.7 Death Rate 12.0 Deaths under one year of age 21.4 Deaths under four weeks of age 15.5 Maternal causes, excluding abortion 0.27 Due to abortion 0.07 Total maternal mortality 0.33 Table of Birth and Death Rates for previous 10 years * * t t t Infant Death Rate Birth Rate Death Rate Still Birth Maternal Under Under Year Crude Adjusted Crude Adjusted Rate Deaths 1 yr. 4 wks. 1960 17.9 17.2 7.2 11.5 18.9 nil 18.2 12.8 1959 15.6 15.0 8.6 13.5 11.05 nil 24.8 19.9 1958 16.6 16.1 7.4 11.7 10.55 nil 21.32 16.58 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 * Rate per 1,000 estimated home population. †Rate per 1,000 total births. ‡Rate per 1,000 live births. Table I Causes of Death Male Female Total 1. Tuberculosis—Respiratory 1 — 1 2. Tuberculosis—Other — — — 3. Syphilitic disease 2 — 2 4. Diphtheria — — — 5. Whooping Cough — — — 6. Meningococcal infection — 1 1 7. Acute poliomyelitis — — — 8. Measles — — — 9. Other infective and parasitic diseases 10. Malignant neoplasm, stomach 11 6 17 11. Malignant neoplasm, lung, bronchus 19 5 24 12. Malignant neoplasm, breast — 4 4 13. Malignant neoplasm, uterus — 1 1 6 14. Other malignant and lymphatic neoplasms 23 17 40 15. Leukaemia, aleukaemia 1 — 1 16. Diabetes 2 — 2 17. Vascular lesions of nervous system 12 31 43 18. Coronary disease, angina 48 32 80 19. Hypertension with heart disease 4 4 8 20. Other heart disease 16 30 46 21. Other circulatory disease 6 13 19 22. Influenza 1 1 2 23. Pneumonia 7 12 19 24. Bronchitis 17 1 18 25. Other diseases of respiratory system 2 2 4 26. Ulcer of stomach and duodenum — — — 27. Gastritis, enteritis and diarrhoea — 2 2 28. Nephritis and nephrosis 2 1 3 29. Hyperplasia of prostate 1 — 1 30. Pregnancy, childbirth and abortion 1 1 31. Congenital malformations 1 4 5 32. Other defined and ill-defined diseases 13 16 29 33. Motor vehicles, accidents 3 3 6 34. All other accidents 3 3 6 35. Suicide — 2 2 36. Homicide and operations of war — — — 195 192 387 Table II Notifiable Diseases other than Tuberculosis Corrected Admitted to Total Death Disease Notifications Hospital Diphtheria — — — Measles 782 16 — Whooping Cough 9 2 — Acute Primary or Influenzal Pneumonia — — — Scarlet Fever 14 1 — Ac. Encephalitis — — — Puerperal Pyrexia 1 1 — Ophthalmia Neonatorum — — — Erysipelas 2 1 — Poliomyelitis (Paralytic) 1 1 — Poliomyelitis (Non-Paralytic) . — — — Typhoid and Paratyphoid — — — Malaria — — — Dysentery 1 1 — Food Poisoning 2 — — Meningococcal infection 1 1 1 Smallpox — — — Table III Acute Poliomyelitis Age Periods Ophthalmia Neonatorum Scarlet Fever Measles Whooping Cough Paralytic NonParalytic Under 1 year — — 31 — — — 1-2 years — — 178 2 — — 3-4 years — 4 205 3 — — 5-9 years — 7 358 3 1 — 10-14 years — 2 5 1 — — 15-24 years — 1 3 — — — 25 and over — —- 2 — — — Age unknown Total — 14 782 9 1 — Age Periods Dysentery Food Meningococcal Poisoning infection pneumonia Erysipelas Under 5 years — 1 1 — — 5-14 years — 1 — — — 15-44 years 1 — — — — 45-64 years — — — — I 65 and over — — — — I Age unknown Total 1 2 1 — 2 Table IV Tuberculosis New Cases Deaths Age Periods Respiratory NonRespiratory Respiratory NonRespiratory Under 5 years 3 — — — 5-14 years 1 — — — 15-24 years 4 — — — 25-44 years 3 2 — — 45-64 years 8 — — — Over 65 years 1 1 1 — Total 20 3 1 — GENERAL HEALTH MATTERS, INCLUDING INFECTIOUS DISEASE CONTROL Tuberculosis Twenty cases of respiratory tuberculosis and three cases of non-respiratory tuberculosis were notified during the year. There was one death from respiratory tuberculosis and this occurred in the over 65 years age group. Twenty per cent of the cases occurred in children up to the age of fourteen years. These are usually cases of Primary Tuberculosis which normally respond very quickly to treatment. Nevertheless the notification of such a case is the signal for the start of much detective work by the staffs of the various bodies charged with the care of the public health. The object of the search is the infected adult who has been the source of infection. The search is very intensive and can even entail the skin testing and X-raying of large numbers of school children and teachers should the case occur in a child attending school. More 7 8 often than not the results are negative but this procedure just serves to illustrate the use of another "Weapon" in the fight against tuberculosis. Diphtheria and Whooping Cough No cases of diphtheria occurred in the district during the year and it is now 11 years since a case was notified. There were nine cases of whooping cough with three requiring admission to hospital. This is a decided improvement on the figures for the previous year. The three in one vaccine affording protection against Diphtheria, Whooping Cough and Tetanus in three injections is now in widespread use. This, plus the protection now available against Poliomyelitis, should go a long way to protect the rising generation from these diseases. The important thing, however, is to try and keep this immunity at a high level by ensuring that every child has its periodic "booster" innoculations. Acute Poliomyelitis One case of Paralytic Poliomyelitis occurred in the District last year and but for the fact that the patient had received three anti-poliomyelitis injections I am sure the outcome would have been fatal. I am happy to report that the patient made a full recovery with no residual paralysis. Immunisation with the Salk type vaccine continued during the year in the priority groups and later the overforty group was included. Immunisation for the latter group was made available through the general practitioner service. Towards the end of the year preliminary information on the Sabin Oral poliomyelitis vaccine was received and no doubt this will be issued for general use in 1962. Food Poisoning Only two cases of food poisoning were notified during the year. This is highly satisfactory and it is to be hoped will be the pattern for many years to come. As I have already stated in my introductory remarks this improvement may be due to the effects of health education which has been put over to the public through the media of radio, television, popular press, magazine articles, lectures, posters and last but not least the personal efforts of Health Department staffs throughout the country. 9 Dysentery One case of dysentery was notified during 1961, compared with forty-four cases the previous year. It is hoped this improvement will be maintained. However, it should be noted that Dysentery is a disease in which it is practically impossible to draw conclusions about trends from year to year. The main reasons for this are either (i) notification of cases on clinical grounds alone without bacteriological confirmation or (ii) during an epidemic the nonnotification of all the cases occurring in a particular household. Maternal Mortality There was one maternal death during the year. This was due to toxaemia which developed about the twentyeighth week of pregnancy in a young woman who had only recently moved into the district. Health Education Health Education is very much a personal affair and seems to have a much greater impact when treated on an individual basis rather than on the group. The inspectors always make use of the individual approach when the opportunity presents itself during the follow-up of infectious diseases etc. in the home. Full use was also made during the year of pamphlets and posters issued from time to time by the Ministry of Health. The Department also co-operated fully with any request from the Area Medical Officer to display health education material. 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. During the year my attention was brought to the case of an elderly gentleman who was living in deplorable circumstances in some old property scheduled for demolition. These old people are usually very unco-operative and suspicious of any offers of help and assistance made to them—this old man was no exception! However, after several visits with the Chief Public Health Inspector and the Area Welfare Officer we managed to persuade him to accept a vacancy in one of the County Council's Old Peoples' Homes and no action under Section 47 was required. I may add that this is the usual pattern in dealing with this type of case. Every effort is made to solve the problem using the Home Help Service, the Home Nursing Service, 10 the help provided by Voluntary Bodies etc., and only invoking action under Section 47 as a last resort when everything else has failed. Housing Progress was maintained during the year in the clearance of unfit houses and in the building of many new Council and private dwellings. Several new Council housing schemes were completed incorporating for the first time large blocks of flats. This usually brings some problems mainly due to tenants not being used to "flat" life. However, people usually adapt themselves fairly quickly and I am sure the amenities and good living conditions that these new flats provide must far outweigh any of the so-called drawbacks of flat life. Maternity and Chief Welfare and School Health Services The 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. In addition a mobile clinic providing child welfare services visits sites on the Sparrow Farm Estate, the Wigley Road Estate and in Lower Feltham. Establishments for Massage and Special Treatment One establishment was licensed under Sections 355-357 of the Middlesex County Council Act, 1944. During the year the Middlesex County Council started weekly chiropody sessions at their three clinics in the district. In the first instance priority is being given to the elderly people, the physically handicapped and nursing and expectant mothers. Medical Examination of Council Employees The total number of medical interviews and examinations carried out during the year was seventy-nine. These consisted of thirty-one for fitness for admission to the Council's Sick Pay Scheme, thirty-four for Superannuation purposes and fourteen for aged employees' fitness to continue working. Sewerage The vast majority of premises in the district are drained to the public sewers which in turn discharge to the West 11 Middlesex Main Drainage deep sewers. Several premises still have to make use of cesspools or pail closets and I sincerely hope it will not be long until all of these disappear and every house is connected to the public sewers. Works with this end in view are in progress at the present moment. 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 Hampton Works. The water supply was satisfactory both as regards quantity and quality. Samples for bacteriological and chemxal examination were taken by the Metropolitan Water Board at all stages of purification at least 5 times each week and 13 raw water and 416 treated water samples were taken by the South West Suburban Water Company. In addition 2 samples were taken by my department. Average Results of Analyses of MetropoBtan Water Board Supply (Milligrammes per litre) Chemical Ammonia Nitrogen 0.045 Albuminoid Nitrogen 0.080 Oxidised Nitrogen (Nitrate) 4.1 Chlorides as CI 26. Oxygen abs. from Permanganate 4 hrs. at 27°C 1.06 Turbidity units 0.2 Colour m.m. brown 2 ft. tube Burgess's Tintometer 13. Hardness (Total) 268. Hardness (non carbonate) 52. pH Value 7.9 Phosphate as PO4 0.95 Silicate as SiO2 9. Sulphate as SO4 50. Fluoride as F 0.20 Magnesium as Mg 6. Surface Active Material as Manoxol 0.11 Electrical Conductivity (micromhos) 525. Bacteriological Agar Plate Count (per ml.) 20-24 hrs. at 37 C. 11.7 Coliform count (percentage of samples negative in 100 ml.) 99.91 E.coli count (percentage of samples negative in 100 ml.) 100.0 Typical Analysis of South-West Suburban Water Company's Supply (Parts per million) Appearance Clear and bright Turbidity less than 0.5 Colour 7 Odour very faint "chlorinous" pH 7.3 Free Carbon Dioxide 18 Electric Conductivity 590 Dissolved Solids dried at 180°C Chlorine present as Chloride 30 Alkalinity as Calcium Carbonate 195 Hardness: Total 270 (Carbonate 195; Non-Carbonate 75) Nitrate Nitrogen 6.0 Nitrite Nitrogen absent Ammoniacal Nitrogen 0.000 Albuminoid Nitrogen 0.049 Oxygen Absorbed 0.70 Residual Chlorine 0.13 Metals absent Bacteriological No. of Colonies ldayat37°C. 2daysat37°C. 3daysat20°C. developing on Agar 1 per ml. 3 per ml. 1 per ml. Present in Absent from Probable number Presumptive Coli- aerogenes Reaction —ml. 100 ml. 0 per 100 ml. Bact. coli (Type 1) —ml. 100 ml. 0 per 100 ml. CI Welchii Reaction —ml. 100 ml. 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. All the houses in the area were supplied from the public water mains. 12 13 CHIEF PUBLIC HEALTH INSPECTOR'S REPORT Housing—Demolition and Closure The clearance of unfit houses continued in accordance with the Council's programme. Progress appeared to be slower as no demolition orders were made. The declaring of three clearance areas, embracing sixty-three unfit houses was under consideration and although not accomplished during the year was subsequently achieved. Better progress was made with clearing houses already the subject of demolition orders. Rehousing of the occupants of the Fern Grove Clearance Area was completed and most of the site cleared. Action taken during 1961 is as follows:— Houses reported to Public Health Committee as being unfit 9 Demolition Orders made — Closing Orders made 3 Houses demolished as a result of formal or informal procedure under Section 17 (1) 33 Houses in clearance area demolished 8 Houses closed under Sections 16 (4), 17 (1) and 35 (1) 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 76 From 1946 until the end of 1961, 285 houses have been dealt with as follows:— Demolition Orders made 248 Agreements entered into with owners to "close" or repair or Closing Orders made 37 Houses demolished as a result of formal or informal action including those in clearance area 275 Clearance areas declared 1 Persons who have been displaced 859 Housing Repairs House-to-house inspections of the older houses were continued and notices served where necessary to remedy defects. Quite a fair proportion of the houses visited were found to be owner-occupied and in such cases inspections were not made. It was not often necessary to recourse to formal action to enforce repairs. Delays which occurred seemed to be more often due to inability of builders to 14 cope with the amount of available work, rather than the reluctance of landlords to give them instructions. With plenty of available work, builders tend to deal with the most lucrative or congenial and works under notices are mostly not in these categories. The position was considered of persons, who, because of their urgent need for accommodation, had entered into agreements or leases, often at very high rents under which they were responsible for all repairs. When the Housing Bill was before Parliament the Council made representations to the Minister of Housing and Local Government and secured the help of the Member for Feltham to amend the Bill to give the protection it afforded to those who had entered into agreements of leases before the 16th February, 1961, the date provided, but without success. Informal Action Number of unfit or defective houses rendered fit during the period as a result of informal action by the local Authority 100 Action under Statutory Powers Number of houses reported to Public Health Committee with a view to service of formal notices ... 8 Number of formal notices served 6 Public Health Acts Number of houses in which defects were remedied after service of formal notices:— (a) by owners — (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 16 (b) by local authority in default of owners ... -— Notices Served and Repairs or Improvements Effected Informal Statutory Public Health and Housing Acts 214 6 Food and Drugs Act 299 Factories Act 34 Shops Act 63 Middlesex County Council Acts 5 Prevention of Damage by Pests Act ... 4 Clean Air Act 9 Others 2 15 Dwellings and Food Premises Elsewhere Rooms or contents cleansed 142 54 Sanitary accommodation cleansed 18 31 Walls or ceilings repaired 18 215 Floors repaired or improved 17 53 Windows, doors or woodwork repaired 4 314 Stoves, grates etc. repaired — 17 Ventilation improved 8 3 Lighting improved 3 — Food Stores provided or improved — 23 Sanitary accommodation repaired or improved 25 94 Washing facilities provided or improved ... 59 27 Water Supply or Services improved or repaired 12 14 Dampness remedied — 185 Damp-proof courses provided — 5 Roofs repaired or renewed 1 46 Guttering and rain water pipes repaired or renewed 2 68 Paving repaired or renewed 1 17 Chimney stacks, sills, thresholds, brickwork etc. repaired or renewed — 119 Drainage repaired or renewed 2 24 Drains cleansed 13 430 Dustbins provided or renewed 9 7 Nuisances from accumulations abated 40 22 Nuisances from keeping of animals abated 1 2 Nuisances from smoke, dust or odours abated 2 5 Nuisances from noise abated — 4 Defective equipment replaced 45 2 Handling or display of foodstuffs improved 51 2 House Purchase and Housing Act, 1959— Standard Improvement Grants This Act which came into operation in 1959 provides for the payment of grants of half the cost of providing standard amenities, subject to prescribed maxima, depending upon the amenities already existing. The standard amenities are (a) a fixed bath or shower in a bathroom; (b) a wash-hand basin; (c) a hot water supply; (d) a water closet in or contiguous to the dwelling; and (e) satisfactory facilities for storing food. During the year 41 applications were received and 38 were approved. The majority of the applications were from owner/occupiers. It is difficult to understand why more owner/occupiers and landlords of older property do not avail themselves of the opportunity to improve it at a reduced cost. Even at this stage the existence of such a scheme is not sufficiently known, and more direct publicity may be of assistance. A few people it is thought are deterred by the need for building byelaw and/or planning applications and the preparation of plans etc. 16 Rent Act, 1957—Certificates of Disrepair Applications for Certificates of Disrepair and for the cancellation thereof were received and dealt with as set out below. No. of applications for certificates 5 No. of decisions not to issue certificates 4 No. of certificates issued 1 No. of undertakings given by landlords to remedy defects 4 No. of undertakings refused by local authority — No. of applications for cancellation of certificates 4 No. of certificates cancelled 6 Overcrowding Two cases of overcrowding were found and reported to the Public Health Committee and two known cases of overcrowding were abated during the year. Moveable Dwellings Since the operation of the Caravan Sites and Control of Development Act, 1960 which is largely a planning measure and so far as the control of caravans is concerned supersedes the general public health control, the control of caravans has been exercised by the Engineer and Surveyor's Department. With the reduction in available "pulling on" sites the gipsy type caravan dweller has been far less apparent than at one time. Food Premises Regular inspections of all types of food premises were continued, more particular attention being given to premises where food was prepared. There have been undoubtedly, big improvements in food handling since the operation of the Food Hygiene Regulations, particularly with regard to wrapping and packaging, but standards still fall far short of what they should be. The public by and large however seem to be satisfied, or at least they do not make their disapproval known. It is very seldom a complaint is made to the department about the condition of food premises or the way food is handled. Six complaints were made with regard to foreign matter in food and two regarding dirty milk bottles. After investigation warnings were given to the companies concerned. Shops All shops were regularly inspected, the department administering the whole of the provisions of the Shops Act, 17 1950, the frequency of inspection depending upon the class of business carried on. Two licences including one renewal were issued to keep pet shops. The occupiers of 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 the half-day on Wednesdays. There was no evidence of shops remaining open after the closing hours. 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, but it appeared that generally the requirements of the Act were being observed. Food premises in the district consist of the following:— Catering establishments, including factory canteens and school kitchens 131 Grocery and provision shops and "general stores" 70 Greengrocers' shops 43 Butchers Shops 27 Bakers' shops 13 Milk shops 14 Fishmongers' shops 12 Sweet confectionery shops 54 Food Preparing Premises There were two new registrations during the year. The register contained the addresses of thirty-seven premises registered under the Act for the preservation, etc. of food as follows:— Premises used for the manufacture of sausages, pies, etc. 16 Premises used for the cooking of fish 12 Premises used for the cooking of bacon 9 Hawkers of Foodstuffs Under the provisions of Section 11 of the Middlesex County Council Act, 1950 persons selling foodstuffs from any vehicles 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 with the general use of closable motor 18 In addition, the following amounts of other foodstuffs were found to be unfit for human consumption:— Fish 168 lbs. Chicken 406 lbs. Sausages 10 lbs. Bacon 3 lbs. Confectionery 291 lbs. -do- 10 pkts. Cheese 2 lbs. Biscuits 2 pkts. Turkeys 838 lbs. Tinned Foodstuffs (75 turkeys) Meat 851 lbs. Fruit 309 lbs. vans, hawkers are more reluctant to provide one. Without a store it is inevitable that some sorting or preparation for sale of foodstuffs takes place in the highway which is undesirable. Moreover the lack of a foodstore may lead to food being kept in unsuitable places. Public Health Control over hawkers' activities is not very strong and is difficult of application but efforts were made to maintain a reasonable hygienic standard. Two new hawkers of foodstuffs were registered. Street Traders Persons wishing to trade from fixed sites in any public street are required to hold licences under Sections 320 and 321 of the Middlesex County Council Act, 1944. The licence of a street trader to sell fruit and vegetables in the district was renewed. One other application was refused. Slaughter-houses There are no slaughter-houses in the district. One slaughter-man's licence was renewed. In February 1960 the Council submitted to the Minister of Agriculture, Fisheries and Food a report upon slaughterhouse facilities, in accordance with the Slaughter-houses Act, 1958, and the Slaughter-house (Reports) Direction, 1959, which was accepted by the Minister. Knackers Yard There are now no knackers yards in the district. Inspection and Supervision of Food Carcase meat and offal was inspected at butchers' shops, catering establishments and elsewhere, including two pigs slaughtered by a pig breeder and the following was considered unfit for human consumption:— Beasts Calves Sheep Pigs Tuberculosis — — — — Other condition 3985 lbs. 23 lbs. 290 lbs. 382 lbs. Fish 9 lbs. Vegetables 17 lbs. Milk 2½ pts. Jam 10 lbs. Soup 4 tins. Pickle 10½ oz. Golden Syrup 2 lbs. Honey 2 lbs. Tomatoes lb. 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, for details of action taken in this district. Samples procured:— [ Total samples procured Unsatisfactory Article Milk (New) 135 5 Milk (Various) 43 9 Butter and Margarine 29 — Cream 21 — Drugs 4 — Fish and Fish Products 9 — Fruit 11 — Ice Cream 18 — Meat and Meat Products 25 — Sausages 4 — Soft drinks 2 — Spirits 4 — Vegetables 4 — Vinegar 19 2 Miscellaneous 5 1 (sauce) Total 333 17 With regard to the milk samples shown above as unsatisfactory these arose from a consignment from a Hampshire farmer which contained a small amount of added water and in respect of which a warning letter was sent, a small amount of added water in another single churn but which was an isolated instance and no action was necessary and eight instances of foreign matter being found in bottles of milk and in respect of which warnings were given. The unsatisfactory samples of vinegar concerned the sale of a diluted solution of acetic acid which was not properly described. The retailer concerned was cautioned. 20 The last unsatisfactory sample was one of tomato relish which was found not to comply with the standard obtaining in this country. The importers subsequently made arrangements for the material to be relabelled so as not to offend the Standards Order. Inspections of 426 displays of food stuffs at 149 premises were made to ensure that the requirements of the Merchandise Marks Acts 1887 to 1953 were complied with. Minor breeches were dealt with by verbal warnings but in one case the manager of a butchers shop was prosecuted and fined in respect of a false trade description as to the weight of meat supplied. 208 items of food stuffs were examined at 68 premises in connection with the labelling of Food Order 1953 which requires pre-packed food to be marked with the name and address of the packer or labeller or to bear the registered trade mark together with its common or usual name and a statement of the ingredients. In addition to the above details a considerable volume of work was carried out which did not arise from samples procured in Feltham but which had the effect of protecting the residents in each of the county districts. The matters dealt with were in respect of nationally retailed articles of food. Several manufacturers were required to designate the ingredients on labels of Instant Coffee. Manufacturers were challenged with regard to the description of a nonalcoholic wine and slimming foods or agents. A complaint was investigated of phenolic contamination of soft drink and modifications to the labels of several products of canned chicken were secured where it was not apparent from the labels that the contents of the can were not solely chicken but chicken in jelly or broth. Twenty-five samples of raw milk were procured within the Feltham district and submitted to test for the presence of tubercle bacilli; all were satisfactory. Under the Milk (Special Designation) Regulations 1960 the County Council as Food and Drugs Authority are responsible for the issue of licences to dealers with premises within its area. Twenty-four licences were issued each valid for the new period of five years. Thirty six samples of milk were taken for test for proper heat treatment and subsequent storage, all were satisfactory. Twenty-two premises were visited and the licence of the dairy in Feltham where milk is pasteurised was renewed. 21 The Milk and Dairies (General) Regulations 1959 Seven new distributors were registered and at the end of the year the register contained details of thirty-three distributors of milk and one dairy. Complaints were received in respect of two milk bottles which were not clean. A warning was given in each case. Ice Cream Premises at which ice cream was sold continued to receive regular attention. There were no registered manufacturers of ice cream in this area. Five premises were registered, under Section 16 of the Food and Drugs Act, 1955, for the sale of ice cream and at the end of the year the register contained details of thirtyfive premises. Clean Air The Feltham Urban District (No. 1) Smoke Control Order came into operation on the 1st November, 1961. No. 1 Smoke Control Area covers 1,398 acres and included 2265 premises at the time of making the order. The 2110 dwellings has been increased by new building since. Of the private dwellings constructed before the 5th July, 1956 approximately 1,050 were known to require some adaptations or replacements. The Council extended the period during which applications for grant would be accepted and by the end of the year 682 applications had been approved. Where necessary statutory notices were served upon the owners of tenanted property requiring adaptations or replacements to enable the tenants to comply with the Smoke Control Order. In June 1961 the Feltham Urban District (No. 2) Smoke Control Order was made, but at the end of the year confirmation was still awaited. Residents in the proposed Smoke Control Areas are kept fully informed and in addition floats devoted to Clean Air were entered in the Feltham and Hanworth Carnival Processions. Two week-long visits to the district were made by the mobile exhibition of the Solid Smokeless Fuels Federation and our thanks are due to that association for its continued assistance. The Council decided to participate in the investigation of atmospheric pollution carried out by the Department of Scientific and Industrial Research and in consultation with the Warren Springs Laboratory of that Department set up volumetric measuring apparatus in the Public Health Department. 22 Pollution of the atmosphere by smoke from dieselengined vehicles continued unabated, from observation in this district it seemed that a high proportion of such vehicles emitted smoke at some time. Instances where continuous emissions were observed, were brought to the attention of vehicle operators. In many cases co-operation was forthcoming and steps taken to improve the position, but why was it necessary to wait for someone to protest before taking action? It is felt that the quality of the routine maintenance may be at least partly to blame. Fortunately there are signs that the public are beginning to register objection to this nuisance. Noise Abatement The Noise Abatement Act, 1960 came into operation on the 27th November, 1960. It provides that noise or vibration which is a nuisance shall be a statutory nuisance for the purposes of the Public Health Act, 1936 and restricts the operation on highways etc. of loudspeakers. The use of loudspeakers by vendors of certain foodstuffs, for example, ice cream, is permitted, subject to conditions, between the hours of noon and seven o'clock in the evening. The Clerk to the Council took three successful prosecutions against ice cream vendors for contravening the Act's requirements. 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. It was not considered necessary to test bait the public sewers. Complaints received of infestations numbered 150 and these, together with cases discovered by members of the staff, involved the inspection of 899 premises. Rat infestations were found at 202 premises and mice infestations at 30 premises. 216 treatments were undertaken by the department, a further 16 being carried out by the occupiers. 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 treatment was recovered in the case of business premises. In certain cases of hardship the standard charge was waived. Where the occupiers elected to carry out the treatment themselves, advice and supervision was given to ensure that the treatment was effective. 23 Rag Flock and Other Filling Materials Act, 1951 Two premises were registered under this Act at the beginning of the year and two inspections were made. Very little filling material was used at either of them. Disinfestation One dwelling (Council owned) was treated for bed bugs, contact insecticide being used. It was not found necessary to disinfect for bed bugs, the furniture etc. of persons rehoused in the Council's dwellings. Other disinfestations for the eradication of pests were carried out as follows:— Fleas 1 Wasps 26 Cockroaches 3 Ants 2 Lice 1 Clover Mites 1 Infectious Disease—Disinfection It was not found necessary to carry out disinfection after infectious disease. Administration of the Factories Act, 1937 and 1959 Part 1 of the Act 1. Inspections for purposes of provisions as to health. Premises Number on Register Inspections Number of Written Verbal Occupiers Notices Notices Prosecuted (i) Factories in which Sections, 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 14 15 — — — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority ... 206 464 2 51 — (iii) Other premises in which Section 7 is enforced by the Local Authority excluding outworkers' premises 2 9 — — Total 222 488 2 51 — 2. Cases in which defects were found. Referred To H.M. By H.M. Particulars Found Rer nedied Inspector Inspector Want of cleanliness (S.l) ... — — — — Overcrowding (S.2) — — — — 24 Unreasonable temperature — — — — (S.3) — — — — Inadequate ventilation (S.4) 1 — — — Ineffective drainage of floors — — — — (S.6) — — — — Sanitary conveniences (S.7) (a) Insufficient — — — — (b) Unsuitable or defective 52 34 — — (c) Not separate for sexes — — — — Other offences against the — — — — Act (not including offences relating to Outwork) — — — — Total 53 34 — — Part VUI of the Act Outwork (Sections 110 and 111). No notifications were received of outworkers employed by local manufacturers but there were 61 persons doing outwork for employers outside the area. 202 visits were made to outworkers' homes. Summary of Inspections Number of premises inspected on complaint 518 Number of inspections made: — Housing inspections (Housing Regulations) 105 Housing re-inspections 2,718 Other re-inspections 1,736 Infectious Diseases and food poisoning 549 Council Houses 41 Moveable Dwellings 12 Bakehouses 26 Slaughter-houses (excluding re-slaughtering) — Knackers Yards — Dairies and Milk Shops 43 Pet Animal Shops 7 Shops (Shops Act) 1,098 Hawkers of Foodstuffs 93 Ice Cream Premises 98 Food Preparing Premises (excluding Catering 27 Establishments) Catering Establishments 663 Butchers' Shops 270 Fish Shops 80 Greengrocers' Shops 160 Grocery and Provision Shops 320 Sweet and Confectionery Shops 153 Bakers' Shops 53 Other Food Shops 26 Power Factories 464 Non-Power Factories 6 Other Factories 9 Outworkers' Premises 202 Workplaces and Offices 102 Piggeries 21 Licensed or Public Premises 196 Hairdressers' and Barbers' Establishments 64 25 Rodent Control 2,531 Defence Regulations 2 Housing applications 303 Measurements under Housing Act 8 Smoke Observations 255 Food Inspection—Meat 66 Food Inspection—Fish 7 Food Inspection—Other Commodities . 32 Milk and Water sampling 2 Street Trading 29 Tipping of Refuse 23 Inspection of Food Vehicles 200 Inspection under Rag Flock Act 2 Re Disrepair Certificates 27 Miscellaneous 266 Smoke Control Areas 3,309 Clean Air Act 1956, Sections 3 and 10 . 32 Standard Improvement Grants 166 Noise Abatement 26 Mortuary 6 Total 16,654 I should like to take this opportunity of thanking the Chairman and Members of the Public Health Committee and Dr. Cormack, the Medical Officer of Health, for the consideration shown to me and to express my thanks 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.