FEL 25 Urban District Council of FELTHAM Annual Report of the Medical Officer of Health for the year ending 31st December 1962 Feltham, Middx. July, 1963 ??? 439 (3) FELTHAM URBAN DISTRICT COUNCIL PUBLIC HEALTH COMMITTEE Chairman: Mr. F. A. Watts Councillors: Mrs. W. E. Cox, Mr. G. A. Gatehouse (Chairman of the Council), Mrs. M. E. Nixon, Mr. T. W. McCarthy, Mr. A. J. Ogden, Mr. E. J. Pauling, Mr. W. R. Sands, Mr. F. N. Saunders, Mr. M. P. Slattery, Mr. D. L. Smith. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health (Part Time): W. Cormack, M.B., Ch.B., D.P.H. (resigned November, 1962) L. A. Matheson, M.B., Ch.B., D.P.H., D.C.H., M.M.S.A. (appointed November, 1962) 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. (resigned 30th April, 1962) D. M. Henderson (Appointed 1st November, 1962) Student Public Health Inspector: K. M. Down Smoke Control Assistant A. W. G. Wilcox Senior Clerk: Mrs. E. E. Hutchison Clerical Staff: Miss A. Isitt (Appointed 1st January 1962, Resigned 1st June, 1962) Miss M. Snelling (Appointed 22nd July, 1962, Resigned 20th Nov. 1962) Mrs. P. M. Mills (Appointed 3rd December, 1962) Miss P. Deuchar (Resigned 16th April, 1962) Miss J. Hodges (Appointed 24th April, 1962) Rodent Operative: A. E. Gearing 2 Telephone: Feltham 2281 and 2381 Public Health Department, Council Offices, Feltham. July, 1963. 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 1962. During the year there were nineteen infant deaths under one year of age of which sixteen occurred under four weeks of age. The greatest single cause, according to the death certificates, was prematurity where eight children died under one week old, four in the first day. Other causes were pneumonia, congenital malformations and pulmonary haemorrhage. The later cases in the first year were still attributable to congenital malformations but three children died of pneumonia and one of birth trauma. One baby died in the first day due to a rhesus incompatibility factor; this is now quite a rare cause. The infant mortality rate for this district is slightly less than that for England and Wales. In April the attention of the Council was drawn by the then Medical Officer of Health, Dr. Cormack, to the relationship between smoking and health. He told the Council that the report published by the Royal College of Physicians entitled "Smoking and Health" stressed that cigarette smoking is a cause of lung cancer and bronchitis and probably contributes to the development of coronary heart disease and various other less common diseases. It also delays healing of gastric and duodenal ulcers. The chance of dying in the next ten years for a man aged thirty-five, who is a heavy cigarette smoker, is one in twenty-three, whereas the risk for a non-smoker is only one in ninety. A careful examination has been made of the causes of death under the classification 'malignant diseases of the lungs' when it was found that twenty-eight males and one female died in 1962 of this cause. Five years ago there were twentyfive deaths from this cause, ten years ago there were ten only and even last year five fewer deaths from this cause were reported than for the period now under review. 3 Not only is it most desirable to decrease the amount of cigarette smoking by the population, most especially the younger section of the community, but the abolition of smoke in the air that we breath is of the very greatest importance. To this end the Council declared the third smoke control area during 1962. This is part of a well formulated policy whereby the whole of the Feltham Urban District will be entirely free from smoke by 1969. It is gratifying to know that there were no deaths due to pregnancy, childbirth or abortion. An increasing cause of death is unfortunately attributable to suicide of which there were no less than six—this is more than has been reported for fifteen years except in 1957 when a similar number occurred. No cases of diptheria occurred in the district during the year and it is now twelve years since a case was notified. During 1962 Dr. Cormack was appointed as Medical Officer of Health to the district of Harrow and I succeeded him in November, 1962. I should like to thank the Chairman and the members of the Public Health Committee and the staff of the Public Health Department, particularly Mr. F. V. Bell the Chief Public Health Inspector, for their welcome to me on the staff and the help I have had from the Council and the department. I am, Ladies and Gentlemen, Your obedient servant, LOUISE A. MATHESON Medical Officer of Health 4 STATISTICS FOR THE AREA Area and Acreage (Bedfont, Feltham and Hanworth) 4,925 acres Population 51,710 Number of inhabited dwellings 15,337 Number of new dwellings erected 484 The product of a penny rate £5,034/10/- The rateable value £1,237,173 VITAL STATISTICS LIVE BIRTHS Total Male Female Legitimate 954 478 476 Illegitimate 40 22 18 Total 994 500 494 Live Birth Rate per 1,000 of estimated home population 19.22 Adjusted Live Birth Rate 18.83 Illegitimate live births per cent of total live births 4.02 STILL BIRTHS Total Male Female Legitimate 14 9 5 Illegitimate — — — Total 14 9 5 Still Birth Kate per 1,000 total (live and still) births Total Live and Still Births 13.88 1008 INFANT DEATHS (under 1 year of age) Total Male Female Legitimate 18 11 7 Illegitimate ... 1 1 0 Total ... 19 12 7 Infant Mortality Rate per 1,000 live births 19.11 Legitimate Infant Mortality Rate per 1,000 legitimate live births 18.86 Illegitimate Infant Mortality Rate per 1,000 illegitimate live births 25.00 NEO-NATAL DEATHS (under four weeks of age) Total Male Female Legitimate 16 10 6 Illegitimate — — — Total 16 10 6 Neo-Natal Mortality Rate per 1,000 live births 16.09 Early Neo-Natal Mortality Rate (first week) per 1,000 live births 12.07 Perinatal Mortality Rate per 1,000 live and still births 25.79 Maternal Deaths (including abortion) nil Maternal Mortality Rate per 1,000 total live and still births nil 5 DEATHS Male 232 Female 191 Total 423 Death Rate per 1,000 of the estimated home population— Crude Death Rate 8.18 Comparability Factor 1.61 Adjusted Death Rate 13.16 Death Rate from pulmonary tuberculosis 0.03 Death Rate from Cancer 1.7 Birth and Death Rates for England and Wales, 1961 Birth Rate 18.0 Still Birth Rate (per 1,000 live and still births) 18.1 Death Rate 11.9 Deaths under one year of age 21.4 Deaths under four weeks of age 15.1 Maternal causes, excluding abortion 0.28 Due to abortion 0.07 Total maternal mortality 0.35 Table of Birth and Death Rates for previous 10 years Year * Birth Rate * Death Rate † Still Birth Rate † Maternal Deaths ‡ Infant Death Rate Under 1 yr. Under 4 wks. Crude Adjusted Crude Adjusted 1961 18.03 17.66 7.6 12.16 11.8 1.07 24.97 20.63 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 * 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 2. Tuberculosis—Other 2 — 2 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 7 5 12 11. Malignant neoplasm, lung, bronchus 28 1 29 12. Malignant neoplasm, breast 1 4 5 13. Malignant neoplasm, uterus — 6 6 6 14. Other malignant and lymphatic neoplasms 23 16 39 15. Leukaemia, aleukaemia 3 — 3 16. Diabetes — 3 3 17. Vascular lesions of nervous system 14 30 44 18. Coronary disease, angina 49 32 81 19. Hypertension with heart disease 6 8 14 20. Other heart disease 12 26 38 21. Other circulatory disease 10 10 20 22. Influenza — 2 2 23. Pneumonia 8 7 15 24. Bronchitis 26 8 34 25. Other diseases of respiratory system 4 3 7 26. Ulcer of stomach and duodenum 3 — 3 27. Gastritis, enteritis and diarrhoea 1 1 2 28. Nephritis and nephrosis 1 1 2 29. Hyperplasia of prostate — — — 30. Pregnancy, childbirth and abortion — — — 31. Congenital malformations 2 1 3 32. Other defined and ill-defined diseases 15 18 33 33. Motor vehicles, accidents 5 4 9 34. All other accidents 6 3 9 35. Suicide 5 1 6 36. Homicide and operation of war — — — 232 191 423 Notifiable Diseases other than Tuberculosis Table II Disease Corrected Notifications Admitted to Hospital Total Deaths Diphtheria — — — Measles 25 3 —... Whooping Cough 2 — — Acute Primary or Influenzal Pneumonia 4 3 — Scarlet Fever 22 2 — Ac. Encephalitis — — — Puerperal Pyrexia 1 1 — Ophthalmia Neonatorum — — — Erysipelas 1 1 — Poliomyelitis (Paralytic) — — — Poliomyelitis (Non-Paralytic) — — — Typhoid and Paratyphoid — — — Malaria — — — Dysentery 4 1 — Food Poisoning 24 — — Meningococcal infection 1 1 — Smallpox — — — 7 Table III Age Periods Ophthalmia Neonatorum Scarlet Fever Measles Whooping Cough Acute Poliomyelitis Paralytic NonParalytic Under 1 year — — — — — — 1-2 years — 3 12 2 — — 3-4 years — 4 6 — — — 5-9 years — 13 6 — — — 10-14 years — — — — — — 15-24 years — 2 — — — — 25 and over — — 1 — — — Age unknown — — — — — — Total — 22 25 2 — — Dysentary Food Poisoning Meningococcal infection Pneumonia Erysipealas Puerperal Pyrexia Under 5 years 3 — — — — — 5-14 years 1 2 — 1 — — 15-44 years — — 1 3 — 1 45-64 years — — — — 1 — 65 and over — — — — — — Age unknown — — — — — — Total 4 2 1 4 1 1 Table IV Tuberculosis Age Periods New cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory Under 5 years — — — — 5-14 years 1 — — — 15-24 years — — — — 25-44 years 2 — — — 45-64 years 4 2 1 2 Over 65 years — — 1 — Total 7 2 2 2 GENERAL HEALTH MATTERS, INCLUDING INFECTIOUS DISEASE CONTROL Tuberculosis Seven cases of respiratory tuberculosis and two cases of non-respiratory tuberculosis were notified during the year, one of the pulmonary cases being a child of under fourteen years of age. There were two deaths from respiratory tuberculosis, one of which was in the over 65 years age group. Diphtheria, Whooping Cough, Tetanus and Poliomyelitis No cases of diphtheria occurred in the district during the year and it is now 12 years since a case was notified. There were no cases of paralytic poliomyelitis, and only two of whooping cough. 8 The three in one vaccine affording protection against Diphtheria, Whooping Cough and Tetanus in three injections is now in widespread use. During 1962, the use of Salk type immunizing material was discontinued by the Health Authority. Instead Sabin type oral protection was substituted. This certainly won the approval of the younger patients and their mothers. A better protection is considered to be achieved in addition. Through the Health Authority, constant vigilance is kept upon school children upon entry and subsequently, to ensure that they receive "booster" protection for Diphtheria, Tetanus and Poliomyelitis. Maternal Mortality I am glad to say there were no maternal deaths this year. Health Education During routine and other visits the public health inspectors endeavoured to further the cause of health education, particularly with food handlers. Posters and pamphlets are d stributed to selected premises and publicly displayed from time to time and the department co-operated with any request from the Area Medical Officer to display health education material. National Assistance Acts—Persons in Need of Care and Attention. The living conditions of one or two elderly persons came to the attention of the department during the year. The services of the Area Health Authority were sought as required and it was not found necessary to take formal action. Housing The Council's building programme continues apace and more dwellings were provided than in recent years. By the end of the year 2,877 post war houses had been completed. More and more of the dwellings being built are flats and during the year the decision was taken to build the first multi-storey block. It was noticeable that opinions were gradually changing and flats becoming more acceptable to a larger number of people. 9 Smallpox In January cases of smallpox occurred in persons arriving by air in this country from Pakistan. These cases arrived at London Airport, part of which is in this Urban District. A large number of families living in Feltham are employed in various capacities at the Airport and the local population became very smallpox vaccination minded. During the first six months of 1962 whilst the population was so alerted, 4,804 adults received primary vaccination and 12,909 were revaccinated, 3,377 children of school age were vaccinated 3,778 revaccinated and 3,313 pre-school age children were vaccinated and 423 revaccinated. Fortunately no case of smallpox actually occurred in this district. Maternity and Child Welfare and School Health Services The District forms part of Middlesex County Council Health Area 10. The health authority provide numerous sessions for ante-natal 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 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. The Middlesex County Council provide 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 forty-seven. These consisted of twenty-seven for fitness for admissions to the Council's Sick Pay Scheme, fifteen for Superannuation purposes and five for aged employees' fitness to continue working. 10 Sewerage The vast majority of premises in the district are drained to the public sewers which in turn discharge to the deep sewers of the West Middlesex Main Drainage Department, the sewage being dealt with at the Mogden Works by that Department. During the year the Engineer and Surveyor constructed 750 yards of 9" sewer in Hatton Road, eliminating a small pumping station and providing main drainage for a number of premises served by cesspools. He now has in hand plans for a new sewer to serve the High Street area, at present being redeveloped. 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 and the water was derived from the River Thames. The SouthWest Suburban Water Company treated the water at their Staines works and 35 raw water and 614 treated water samples were taken for bacteriological and chemical analysis. A typical analysis is given in table I. Twenty-seven of the treated samples contained coliform bacteria in minimal numbers and two of these presumptive positive samples were found to contain E. Coli. As several of these samples were from service reservoirs, sterilisation was carried out as a precaution although actual contamination was thought to be extremely unlikely, and this sterilisation is now repeated at regular intervals. The Metropolitan Water Board stored the raw water in their Thames Valley reservoirs and filtered and chlorinated it at the Hampton, Ashford Common, Hanworth Road and Kempton Park Works. Samples were taken at each of the works including 1,121 at Hampton. Details of the average results obtained are given in table II. The water supply was satisfactory both as regards to quantity and quality and it had no plumbo-solvent action. Four check samples were taken by the department. All houses in the area were supplied direct from the water mains. I Typical Analysis of South-West Suburban Water Company's Supply (Parts per million) Appearance Clear and bright Turbidity Nil Colour 4 Odour Nil 11 pH 7.5 Free Carbon Dioxide 11 Electric Conductivity 580 Total Solids 400 Chlorine present as Chloride 36 Alkalinity as Calcium Carbonate 190 Hardness: Total 285 (Carbonate 190; Non-Carbonate 95) Nitrate Nitrogen 5.9 Nitrite Nitrogen absent Ammoniacal Nitrogen 0.000 Albuminoid Nitrogen 0.060 Oxygen Absorbed 1.2 Residual Chlorine 0.02 Metals Iron, Zinc, Copper and Lead: absent Bacteriological No. of Colonies developing on Agar 1 day at 37°C 0 per ml. 2 days at 37°C. 0 per ml. 3 days at 20°C. 1 per ml. Present in Absent from Probable number Presumptive Coliaerogenes Reaction —ml. 100 ml. 0 per 100 ml. Bact. coli (type 1) —ml. 100 ml. 0 per 100 ml. Cl Welchii Reaction 100 ml. 10 ml. II Average Results of Analyses of Metropolitan Water Board Supply (Hampton Works) (Milligrammes per litre) Chemical Ammonia Nitrogen 0.040 Albuminoid Nitrogen 0.078 Oxidised Nitrogen (Nitrate) 4.0 Chlorides as Cl 31 Oxygen abs. from Permanganate 4 hrs. at 27°C. 1.12 Turbidity units 0.3 Colour m.m. brown 2 ft. tube Burgess's Tintometer 12 Hardness (Total) 264 Hardness (non carbonate) 58 pH Value 7.8 Phosphate as PO4 1.2 Silicate as SiO2 9 Sulphate as SO4 61 Fluoride as F 0.25 Magnesium as Mg 6 Surface Active Material as Manoxol 0.12 Electrical Conductivity (micromhos) 550 Bacteriological Agar Plate Count (per ml.) 20-24 hrs. at 37 C. 11.9 Coliform count (percentage of samples negative in 100 ml.) 99.91 E.coli count (percentage of samples negative in 100 ml.) 100.0 12 CHIEF PUBLIC HEALTH INSPECTOR'S REPORT Housing—Demolition and Closure The clearance of unfit houses continued and with the declaring as clearance areas of Railway Terrace, The Clumps and Sydney Road/Bedfont Lane, all the houses in the programme were being dealt with, although by the end of the year, many were still occupied. Consideration was given to the future programme, when it was decided that a further fifty houses, in addition, should be dealt with in the two years ending in December, 1964. Progress during the year is summarised as follows: Houses reported to Public Health Committee as being unfit 69 Demolition Orders made 6 Closing Orders made 1 No. of houses in Clearance Areas declared 62 No. of houses in Clearance Orders or Compulsory Purchase Orders 67 Houses demolished as a result of formal or informal procedure under Section 17(1) 31 Houses in clearance areas demolished 6 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 or demolish 1 Total number of persons displaced 112 From 1946 until the end of 1962, 355 houses have been dealt with as follows:— Demolition Orders made 254 Agreements entered into with owners to "close" or repair or Closing Orders made 39 Houses demolished as a result of formal or informal action including those in clearance area 312 Houses in four Clearance Areas declared 91 Persons who have been displaced 971 Housing Repairs House-to-house inspections of the older houses were continued as far as possible and action taken to remedy defects found. This work is not very satisfying on present standards; a fit house still falls far short of satisfactory accommodation. An increasing number of the older houses 13 are becoming owner/occupied and it is the Council's policy that these should not normally be inspected. There was still a shortage of builders and owners often had difficulty in finding one to enable them to comply with notices. Owner/ occupiers waiting to carry out improvements also often experienced this difficulty. Informal Action Number of unfit or defective houses rendered fit during the period as a result of informal action by the local Authority 113 Action under Statutory Powers Number of houses reported to Public Health Committee with a view to service of formal notices 16 Number of formal notices served 12 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 6 Housing Act, 1957 Number of houses made fit after service of formal notices (Sections 9 and 16):— (a) by owners — (b) by local authority in default of owners — Notices Served and Repairs or Improvements Effected Informal Statutory Public Health and Housing Acts 156 26 Food and Drags Act 129 — Factories Act 18 — Shops Act 55 — Middlesex County Council Acts 7 — Prevention of Damage by Pests Act 6 — Clean Air Act 56 73 Others 1 — Food Premises Dwellings and Elsewhere Rooms or contents cleansed 117 22 Sanitary accommodation cleansed 12 13 Walls or ceilings repaired 22 120 Floors repaired or improved 12 50 Windows, doors or woodwork repaired 1 184 Stoves, grates etc. repaired — 14 Ventilation improved 5 2 Lighting improved — 1 Food Stores provided or improved — 32 Sanitary accommodation repaired or improved 27 82 14 Washing facilities provided or improved 37 18 Water Supply or Services improved or repaired 15 17 Dampness remedied — 153 Damp-proof courses provided — 1 Roofs repaired or renewed 2 49 Guttering and rain water pipes repaired or renewed 1 64 Paving repaired or renewed — 15 Chimney stacks, sills, thresholds, brickwork, etc. repaired or renewed — 116 Drainage repaired or renewed 2 44 Drains cleansed — 425 Dustbins provided or renewed 12 3 Nuisances from accumulations abated 34 21 Nuisances from keeping of animals abated — — Nuisances from smoke, dust or odours abated 4 37 Nuisances from noise abated — — Defective equipment replaced 29 — Handling or display of foodstuffs improved 121 5 Standard Improvement Grants The House Purchase and Housing Act, 1951, as amended by the) Housing Act, 1961, provides for the payment of grants of half the cost of installing the standard amenities, subject to prescribed maxima and 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) an internal water closet and (e) satisfactory facilities for storing food. During the year 25 applications were received and 24 were approved. In an effort to stimulate greater interest the Council authorised, as a pilot scheme, the circularising of the landlords, owner/occupiers and tenants of some three hundred of the older houses. This was at the end of the year. There was a little reaction, mostly favourable, from tenants and at the time of preparing this report, well into 1963, one or two landlords appeared to be preparing to undertake improvements, but progress is very slow. 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 1 No. of decisions not to issue certificates 1 No. of certificates issued — No. of undertakings given by landlords to remedy defects 1 15 No. of undertakings refused by local authority — No. of applications for cancellation of certificates 4 No. of certificates cancelled 4 Overcrowding One case of overcrowding was found and reported to the Public Health Committee and five 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. Two areas of land awaiting redevelopment were invaded by large colonies of caravan dwellers. The owners of the sites eventually had them evicted, but not before many complaints were made regarding the behaviour of the caravan dwellers. The sites were left in a deplorable condition, necessitating the removal of lorry loads of rubbish including several car bodies. Food Premises Inspections of all types of food premises were continued as regularly as possible more particular attention being given to premises where food was prepared. Constant vigilance is required in connection with food handling and display. The visits of the public health inspectors to individual premises had of necessity to be relatively short and infrequent and in so many cases the attitude of food handlers to the commodity they handled seemed careless, no doubt bred by familiarity. Display methods change and self service as applied to the smaller shops tended to bring less satisfactory methods of display. Action under food hygiene law is generally limited to those matters which are a risk to health, but surely the time has now corns when it should be possible to deal with an asthetically undesirable practice without having to prove an actual risk. Shops The department administered the whole of the provisions of the Shops Act, 1950, and all shops in the area were 16 visited, the frequency of inspection depending upon the class of business carried on. Two licences, both renewals, 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 appeared to be no desire on the part of shopkeepers to open after the closing hours; generally, of course, shops were closed well before. A number of shops opened on Sundays and periodical inspections were made in connection with the limited range of articles permitted to be sold! on that day with a view to ensuring so far as possible that 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 provisions shops and "general stores" 70 Greengrocer's Shops 39 Butchers Shops 26 Bakers' Shops 18 Milk Shops 13 Fishmongers' Shops 11 Sweet Confectionery Shops 51 Food Preparing Premises There were no new registration during the year. The register contained the addresses of thirty-seven premises registered under the Act for the preservations, 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 17 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 foodstuff intended for sale are stored, are also required to be registered, but there is no requirement that a hawker shall have a food store. Broadly the local authority may only refuse registration if the public health is likely to be endangered or the proposed storage premises are considered unsuitable. Public health control over hawkers' activities is not very effective but every endeavour is made to maintain a reasonable hygienic standard. Four 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. Slaughter-houses There are no slaughter-houses or knackers yards in the district. One slaughter-man's licence was renewed. In July 1960 the Minister of Agriculture, Fisheries and Food accepted the Council's slaughterhouse report and The Slaughter-houses (Hygiene) Regulations (Appointed Day No. 2.) Order, 1960 and the Slaughter of Animals (Prevention of Cruelty) Regulations (Appointed Day No. 2) Order, 1960, came into operation in the district on 1st October, 1960. Inspection and Supervision of Food Carcase meat and offal was inspected at butchers' shop, catering establishments and elsewhere, and 667 lbs. beef and 11 lbs. pork was considered unfit for human consumption and surrendered. In addition, the following amounts of other foodstuffs were found to be unfit for human consumption: Fish 196 lbs 18 Tinned Foodstuffs Meat 371 lbs. Fruit 304 lbs. Fish 2 lbs. Vegetables 94 lbs. Milk 5 pints. Jam 7 lbs. Seven complaints were made with regard to foreign matter in food and after investigation warnings were given to the companies concerned. Proceedings were taken under Section 8 of the Food and Drugs Act, 1955, with regard to unsound sausage rolls, when a conviction was obtained and a fine of £20 with 10 guineas costs imposed. 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 Mr. J. A. O'Keefe, O.B.E., the Chief Officer of the Public Control Department, for details of action taken in this district. Samples procured:— Article Total samples procured Unsatisfactory Milk (New) 72 2 Milk (Various) 8 2 Butter 23 Margarine 3 Cream 17 Cheese 3 Fish and Fish Products 5 Fruit (fresh and canned) 18 1 Ice Cream 20 Meat and Meat Products 25 Sausages 6 Soft drinks and fruit juices 2 Spirits 7 Preserves 5 Vinegar 16 Cakes and buscuits 4 Jelly 3 Liver 9 Miscellaneous 11 Total 257 5 19 The Officer comments on the unsatisfactory samples as follows:— "Milk Two samples of new milk taken at a dairy in your area were found to be deficient in milk fat. The churns were part of a large consignment, the bulked quality of which was satisfactory. No action was therefore possible. A verbal warning was given to the managers of two cafes who served milk deficient in milk fat, because it was found in each case that the milk was dispensed from a bottle which had not been shaken so as to mix the cream into the milk. Fruit A letter of caution was sent to a greengrocer who sold "Guyot" pears as "Williams". The pears are quite similar, and it was thought that he had made a genuine mistake in labelling." Examination of labelled displays of natural foods is made by experienced inspectors and formal samples are selectively procured, based on these examinations. During 1962 new regulations were introduced dealing with emulsifiers and stabilisers in food and with preservatives in food. There was also an amended food standard relating to table jellies. In the first case food additives are defined and their number limited and in the second the range of foods to which preservatives in limited quantities may be added, is extended. Inspections of 405 displays of food stuffs at 233 premises were made to ensure that the requirements of the Merchandise Marks Act, 1887 to 1953 were complied with. Minor infringements were dealt with by verbal warnings. 185 items of food stuffs were examined at 56 premises in connection with the labelling of Food Order 1953 which required pre-packed food to be marked with the name and address of the packer or labeller or to be bear the registered trade mark together with its common or usual name and a statement of the ingredients. It also controls the manner in which the presence of vitamins and minerals is disclosed. 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 in the county. 20 The matters dealt with were in respect of nationally retailed articles of food. Action was taken with regard to the proper labelling of foods including pickles, canned peas and mixed vegetables and ice cream, also with regard to disclosing the foreign origin of honey and prepacked lamb chops. Other matters dealt with included the constituents and quality of so called cream cheese, and cake mixes, also meat products, breakfast cereals, cream, ice lollies and sweet confectionery. False or misleading labelling or advertising was challenged and alterations or withdrawals effected. Cautions were given with respect to preservatives in instant coffee and apricots. Forty inspections of premises where milk is pasteurised or sold were carried out and thirty five samples of milk taken to ascertain whether or not pasteurisation or sterilisation had been correctly performed. There were no failures. Twelve samples of raw milk were procured and tested for the presence of tubercle bacilli. All were satisfactory. The Milk and Dairies (General) Regulations, 1959 One new distributor was 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. There was one new registration 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 thirty-six premises. Clean Air The Feltham Urban District (No. 2) Smoke Control Order came in co-operation on the 1st October, 1962. Under the two Orders, 2025 acres are now smoke controlled and include 3,105 dwellings and 215 other premises. The Feltham Urban District (No. 3) Order was confirmed at the end of the year to come into operation on the 1st October, 1963. In approximately 60% of elligible cases, applications for 21 grant towards the cost of adaptations were made in the first smoke control area. This left some 400 houses and to ascertain the position a single visit was made to each. Access was obtained to 152 and in 150 of these it was found that some adaptation enabling the occupier to comply with the Order had been made, although no grant had been applied for. It was felt that this revealed a very satisfactory state of affairs. Residents in the proposed Smoke Control Areas are kept fully informed by visits to each house, by letters and by the visits of the mobile exhibition of the Solid Smokeless Fuels Federation, whose continued assistance I am glad to acknowledge. The smoke control programme was reviewed and accelerated so that approximately 1,500 dwellings will be included in areas each year and the whole district covered by 1969. The burning of waste materials at industrial premises can give rise to the production of a considerable amount of smoke and in order to control this the Council decided that Section 47 of the Middlesex County Council Act, 1961 should be operative in the district. It became available on the 1st day of December. Pollution of the atmosphere by smoke from dieselengined vehicles continues to increase, according to my observations. Very few of these vehicles, it would seem, are able to operate, particularly in the lower gears, without emitting some smoke. The activities of the Ministry of Transport Inspectors is very welcome, and it is hoped that this will be maintained and increased, but further steps are necessary to bring home to the operators of these vehicles their responsibilities to society. Neglect of these responsibilities should carry a far greater risk of punishment than it does today. Those who manufacture and service the fuel injection equipment for diesel engines in road vehicles should recognise their failings and try to do something about them. 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 22 tions, between the hours of noon and seven o'clock in the evening. Various noise complaints were investigated and dealt with informally. Some of the plant used by public works contractors is very noisy and is often in use for several days at the same place in a road to the annoyance of surrounding residents, but statutory undertakers are exempt from the operation of the Act. From enquiries made it would seem that there is as yet no really satisfactory way of quietening that worst of offenders, the pneumatic drill. 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 160 and these, together with cases discovered by members of the staff, involved the inspection of 958 premises. Rat infestations were found at 188 premises and mice infestations at 32 premises. 205 treatments were undertaken by the department, a further 20 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. Rag. Flock and Other Filling Materials Act, 1961 Two premises were registered under this Act at the beginning of the year and three inspections were made. Very little filling material was used at either of them. Disinfestation No infestation of bed bugs came to the department's knowledge during the year but disinfestations for the eradication of other pests were carried out as follows:— 23 Wasps 18 Cockroaches 3 Ants 4 Clover Mites 1 Crickets 1 Flies 1 Infectious Disease—Disinfection The disinfection of one premises was carried out following a case of tuberculosis. 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 Number of Inspections Written Notices Verbal Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3, 4, and 6 are to be enforced by Local Authorities 16 4 — 1 — (ii) Factories not included in (i) in which Sections 7 is enforced by the Local Authority 196 542 — 16 — (iii) Other premises in which Sections 7 is enforced by the Local Authority excluding outworkers' premises. 5 8 — 1 — Total 217 554 — 18 — 2. Cases in which defects were found. Particulars Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) — — — — Overcrowding (S.2) — — — — Unreasonable temperature (S.3) — — — — Inadequate ventilation (S.4) 1 1 — — Ineffective drainage of floors (S.6) — — — — Sanitary conveniences (S.7) (a) Insufficient — 1 — — (b) Unsuitable or defective 16 19 — — (c) Not separate for sexes 1 1 — — Other offences against the Act (not including offences relating to Outwork) — — — — 18 22 — — 24 Part VIII of the Act Outwork (Sections 110 and 111) No notifications were received of outworkers employed by local manufacturers but there were 43 persons doing outwork for employers outside the area. 116 visits were made to outworkers' homes. Summary of Inspections Number of premises inspected on complaint 551 Number of inspections made:— Housing inspections (Housing Regulations) 117 Housing re-inspections 1,463 Other re-inspections 1,964 Infectious Diseases and food poisoning 411 Council Houses 41 Moveable Dwellings 72 Bakehouses 25 Dairies and Milk Shops 30 Pet Animal Shops 8 Shops (Shops Act) 858 Hawkers of Foodstuffs 148 Ice Cream Premises 65 Food Preparing Premises (excluding Catering Establishments) 33 Catering Establishments 499 Butchers' Shops 218 Fish Shops 43 Greengrocers' Shops 112 Grocery and Provision Shops 295 Sweet and Confectionery Shops 104 Bakers' Shops 50 Other Food Shops 16 Power Factories 542 Non-Power Factories 4 Other Factories 8 Outworkers' Premises 116 Workplaces and Offices 78 Piggeries 9 Licensed or Public Premises 174 Hairdressers' and Barbers' Establishments 49 Rodent Control 2.710 Housing Applications 598 Measurements under Housing Act 21 Smoke Observations 99 Food inspection—Meat 46 Food inspection—Fish 4 Food inspection—Other Commodities 47 Milk and Water sampling 9 Street Trading 21 Tipping of Refuse 29 Inspection of Food Vehicles 105 Inspection under Rag Flock Act 3 Re Disrepair Certificates 24 Miscellaneous 183 Smoke Control Areas 3,428 25 Clean Air Act 1956, Sections 3 and 10 16 Standard Improvement Grants 160 Noise Abatement 108 Mortuary 26 TOTAL 15,189 The work of the department suffered to some extent by reason of a vacancy in the inspectorial staff. It took six months to obtain a replacement after one of the public health inspectors left and with a staff of three additional inspectors this represented one sixth of the total available time. I should like to take this opportunity of thanking the Chairman and Members of the Public Health Committee and Drs. W. Cormack and L. A. Matheson, the Medical Officers 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.