FRI 22 Library FRIERN BARNET URBAN' DISTRICT COUNCIL. annual report OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1 9 4 4 . W. W. MILLEN. M.B.Ch.B. MEDICAL OFFICER OF HEALTH. Friman Barnet Urban district Council Public Health Department TOWN HALL, N.ll. 6th. September 1945. To the Chairman and Gentlemen of the Friern Barnet Urban District Council. Gentlemen, This report is again delayed this year on account of war time conditions. We are still working extended hours with a skeleton temporary staff, and the technical and administrative work fells on one Sanitary Tnsnector, truly a whole time occupation. The report covers the period January 1st. 1944, to December 31st. 1944 inclusive, and will follow the usual abbreviated form in accordance with Circular 10/44 issued in February 1944. There is no evidence that the health of the district has deterioriated; in fact, some indications are rather the other way, especially is this so in the case of the children of school age. Regular employment of the parents, with school meals nicely served, have undoubtedly improved their nutritional standard, and the contrast between the children of the early 1930's and to-day is most marked. Our deathrate is back again to the low pre-war figures; the birthrate continues above the pre-war average, and the infant mortality rate is the lowest yet recorded. There were no deaths due to childbirth, nor were there any notifications of puerperal pyrexia. Housing conditions have deteriorated, and there is considerable overcrowding, which only the provision of more houses will alleviate, and housing is and will be for some years the No. 1. Public Health problem. The district suffered two rather severe incidents from flying bombs, which strained the housing accommodation to the utmost; but the difficulties were overcome, and the displaced families were housed in such houses as were vacant, and had been requisitioned and retained for that purpose. In both these indidcnts, it was the small and fully occupied houses that received the worst damage. From the end of July to the first week in September, the evacuation of mothers and children took place. Your sanitary inspector acted as registrar and liasion officer, and Drs. Stephen and Campbell gave me valuable assistance in the medical examinations. 783 mothers and children were officially evacuated, and all records were kept in the Public Health Dept. In addition the records of the re-housing, office show that 1408 persons were evacuated to billets found by themselves, and un-connocted with the official parties. The whole scheme worked smoothly, and was an out-standing example of team work, carried out with enthusiasm by willing workers from all departmentS, who gave up their leisure time to make the evacuation the undoubted success it proved to be. The usual sanitary services, such as water supply, sewerage and sewage disposal, have been maintained, and some of the sprinkler oxidysing filters were improved, as they had not been giving effluents up to their pre-war standard. ThB W.v.S. continued their salvage work, and the collection of kitchen waste was speeded up and improved. The bins for this purpose have received periodical clcansing, and although -1- We receive complaints about them, I feel that- such complaints are mainly due to thoughtless action on the part of the public, in not replacing the covers after depositing the salvage in the bins. The bins and bone boxes are not ornaments to the localities where they are situated, but I do not think they are detrimental to public h.alth, and so long as their contents are required to ease the strain on transport, and the war effort generally, they should be retained. They are especially valuable in reducing the quantity of house refuse that has to be disposed of on the controlled tip. It is trade and kitchen waste that is largely responsible for the heat generated in a controlled refuse tip, and its elimination ia all to the good. Wo were again troubled with crickets on the tip in the summer months, but increased cover, the removal of herbage, and treatment by spraying, kept down their numbers, and by early autumn the tip was cleared of them. The working arrangement with our neighbours at Finchley for the joint use of a rat-catcher, has proved satisfactory, all complaints having been dealt with satisfactorily. There is no doubt that the rat is responsible for a great deal of damage to our food stuffs, and when conditions are favourable, he should be attacked and destroyed. On spotting the places from whence complaints were received on a large scale map, it became evident that the rats were survivors from the colonies formerly inhabiting the sites of pig farms, (now covered with good class houses), and that those houses where chickens were kept, were the attractions. Keepers of chickens would greatly assist-in keeping down the numbers of rats if they took the simple precaution of storing chicken feeding stuffs in securely fastened metal containers, The incidcnce of the common infectious diseases has been satisfactory. The numbor of notifications of Scarlet Fever is less than half those in 1913,, and in Measles, less than one third of those in 1943. On the other hand, Whooping Cough was up. There was also an increase in the notifications of Diphtheria, 13 against 10. Pulmonary Tuberculosis was less by 7 notifications, and other Tuberculosis is less by one notification. There was no Typhoid Fever notified throughout the year. Respiratory diseases were about average, there being 14 deaths from Bronchitis and 17 from Pneumonia, as agains; 33 in 1943. The incidence of scabies fell considerably during the year, and the clinic established at 10, Remington Avenue, proved its suitability and worth. I again thank the members of the Red Cross organisation for their good work in this connection. Dr. Stephen of the Middlesex schools medical service, has continued her good work at the diphtheria immunisation clinic. Tie percentage of immunised children to the child population is not so high here as in some other districts, of Middlesex. This may be accounted for by the fact that we do not count those as off. actually immunised until they show a satisfactory Schick test, and we have no means of knowing the number of children immunised by the general practitioners in their private practices. private practitioners have applied for supplies of A.P.T. and Schick tasting materials, and from the quantity issued, one must assume that it is used, and protects a considerable number of children, whose parents do not take advantage of the infant welfare and school medical services. The ambulance service has been maintained satisfactorily and full use mace of the facilities given by the W.V.S. "Voluntary Car Pool, for the use of 'chose people not ill enough to require an ambulance, but unable to travel to and from hospital by the public transport services. I attach the usual tables of 'statistics and express my thanks to my fellow officers and members of the Council, who have given me assistance throughout the year under review. I am, Gentlemen, Your obedient Servant, W.W. Mi11en. Medical Officer of Health. -3- NO.OF Dwelling HOUSES INSPECTED (scperate primary inspections only), (1). On Complaint 279. (2). On notification ofinfectious disease 55. (3). Re Tuberculosis 2. Visits to foodshops 53. " " dairies and milkshops 6. re Shops Act " to Factories and Workshops 2. " re Petroleum Act 3. " for Disinsection 51. " re Housing Act " re Disinfestetion and to Verminous premises 14. " re Rat Infestation 407. Appointments and Special visits 296. Re-inspections and visits to works in progress 364. Attendance at Court (Petty Sessions & County Court 2. Visits re attendance at Scabies Clinic 20. visits on technical matters for Re-housing Office 139. Visits re casualties due to enemy action 49. Visits re Government Evacuation 109. 1356. Total visits and inspections for 1943 1625. " " " " " 1942 1431. " " " " " 1941 1684. " " " " " 1940 2726. HOUSING STATISTICS. 1. Inspection of Dwelling-houses during the year:- 1.(a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts 206. (b) Number of inspections made for the purpose 301. 2. Number of dwelling-houses found not to be in all respects reasonably fit for human habitation.... 117. 2. Remedy of defects without service of formal noticer- Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers ill. 3. Action under Statutory Powers:A.Proceedings under sections 9, 10 & 16 of the Housing Act 1936:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs 1. (2) Number of dwelling-houses which were rendered fit after service of formal notices 1. (a) By owners 1. (b) By local authority in default of owners 0. B. Proceedings under Public Health Acts:- (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 6. (2) Number of dwelling-houses in which defects were remedied after service of formal notice (a) By owners 6 (b) By Local Authority in default of ownors 0. -4- The following is a summary of the sanitary improvements and defects remedied during the year:- Water. store cisterns proved, repaired, cleansed or covers provided 2. Fittings-and services repaired 12. Drainage. Drains cleared or repaired 17 Inspection chambers cleansed, repaired etc. 1 Soj1 and vent pipes repaired 2 Now sink wastes pipes provided 2 Sink wastes repaired 1 W.C. W.C. pans and traps fixed 8 W.C. pans and traps repaired 1 W.C. seats, doors windows,floors renewed Walls cleansed and distempered 1 Ceilings cleansed and distempered 1 Flushing cisterns provided 5 Flushing cisterns repaired or regulated 9 Floors. Floors repaired 3 Roofs. Stripped and renewed 2 Repaired 31 Gutters & downspouts renewed or repaired 14 Cleansing. Walls repaired, cleansed or distempered 11 Ceilings repaired or renewed 13 New ceilings Windows. Sashes and frames repaired or renewed 5 Cills repaired or renewed 1 Sashcords provided (number of houses) 1 Brickwork. Damp-proof courses provided 1 Brickwork repaired 2 Chimney stacks rebuilt or repaired Dampness in walls remedied 2 Walls re-pointed or rendered Refuse. Dustbins provided 85 Accummuiation of refuse removed 3 General. New ranges and grates provided Ranges and grates repaired Other defects (unclassified) 1 Verminous rooms cleansed 1 240 -5— INSPECTION AND SUPERVISION OF FOOD. Milk. The following licences were issued under the Milk (special Designations) Order, 1936; Pasteurised 10 Accredited Grade A (Tuberculin Tested) 6 Pasteuriser's 1 Heat and other foods. The following foodstuffs were surrendered as unfit for human consumption. 30¼ lbs. Tinned Pork & Luncheon Meat. 336 lbs. Boneless Beef. 12½ lbs. Bacon Trimmings. 3 Tins Stewed Steak. 32 Tins pilchards. 8 Tins Salmon. 6 Tins Sardines. 7 Tins Herrings. 3 Tins Mackerel. 10 Tins Soup. 8 Tins Beans. 40 Tins Evaporated Milk. 7 Tins Condensed MiIk. 5 Tins Plums. 1 Jar Bramble Jelly. 5 lbs. Tinned Jam, 12 lbs. Cheese cuttings, 27 cwts Potatoes. 5 Stone Cod Fillets. 11 lbs. Dried Raisins. 4 lbs. Dried Figs. 19 lbs. Dried Peas. 45 lbs. Flour. 1ll lbs. Soya Flour. 23 Packets Yorkshire Pudding Mixture. 13 Packets Sponge Pudding Mixture. 15 Packets Cake Flour. 10 Packets Dried Eggs. 50 Shell Eggs. -6- TABLE 1. ANALYSIS. OF CASES OF NOTIFIABLE INFECTIOUS DISEASE NOTIFIED DURING THE YEAR ENDING. 31st. DECEMBER 1944. Disease. Number of cases notified. Cases in each Ward. No. removed to Hosp All. Un.l . 1-5 5-15 15-25 25-45 45-65 65 & 0. North. South Central Friern Hosp. Scarlet Fever. 47 - 7 31 5 3 1 - 20 11 16 - 25 Diphtheria. 12 - 3 3 3 3 - — 2 5 5 - 12 Pneumonia. 34 2 1 7 1 10 7 6 9 9 7 9 4 Measles. 76 4 28 44 — — - - 50 8 18 - - Whooping Cough. 134 17 68 47 — 2 - - 29 49 56 - 3 Erysipelas. 10 - - - 4 3 1 2 3 6 1 - 2 Sonne-dysentery. 1 1 - - — - — — - - 1 - 1 Pulmonary Tuberculosis. 27 - 1 1 3 13 3 1 9 6 12 - - Other Tuberculosis, 4 - 1 - - 3 - - 2 1 1 - - TOTALS. 345 24 109 133 21 37 12 9 124 95 117 9 47 TABLE 2. ANALYSIS OF THE CAUSES OF AND AGES AT DEATH DURING THE YEAH 1944, FOR THE WHOLE DISTRICT. Causes of Death, No Regd. At Ages Wards. Out Tran In Tran Me F. Nett deaths 0-1 1-2 2-5 5-15 15-25 25-45 45-65 65&0 N. s. C A. Apeident 5 - - 1 - - 2 5 7 5 5 2 r- 3 3 10 11 4 12 Appendicitis 1 - - - - - 1 1 - - - 1 1 1 1 2 - 1 Arterio-sclerosis 13 - - - - - - 2 21 10 1 6 6 6 10 14 9 17 Bronchitis 14 - - — - - 1 3 3 3 4 4 6 6 3 10 7 11 Brights disease 1 - - - - - - 1 - 1 - - - - - 1 1 Cancer 64 - - - - - 11 39 29 13 13 7 46 46 15 42 37 33 Cerebral-haemorrhage 23 - - - - — 3 11 29 10 3 17 3 3 20 21 22 55 Cirrhosis of liver 1 — — — — — - - 1 - — — 1 1 - 1 - - Congenital debility 3 11 — — — - - — - 2 6 3 — — 8 3 8 11 Diabetes 5 — - - - - 2 1 2 - — - 5 5 - 1 4 - Epilepsy 5 - — — - 3 2 - — — - 5 5 - 3 2 - General paralysis 2 - - — - - — 2 — — — 2 2 - - 2 - Heart Disease 98 - - - - 1 9 33 75 22 18 30 48 49 20 58 60 69 Ill-defined diseases 1 — — — — — — - 1 - - - 1 1 - - 1 - Mania — - — - - - 1 - - 1 - - - - 1 - 1 1 Meningitis 4 - — 1 - 1 — 3 - - — 1 4 4 1 4 1 1 Nephritis 13 - — - — — 1 4 11 2 2 1 11 11 3 15 1 5 Other defined diseases 29 1 - - - 4 4 14 17 5 3 7 25 24 11 24 16 16 Other Tubercular diseases 4 - - 1 - 1 3 1 - - 2 1 3 3 2 5 1 3 Pneumonia 36 1 — 1 — — 6 20 20 4 7 4 33 31 12 25 23 17 Senility 11 - — - — — — — 13 2 2 2 7 6 2 6 7 7 Suicide 2 — - — — — 2 1 1 - 1 2 1 1 2 3 1 3 Tuberculosis of Resp system 27 - - - - 6 14 12 4 3 5 5 23 23 9 28 8 13 War operations. 21 - 1 — 1 4 9 11 6 9 6 3 14 14 11 18 14 18 TOTALS 383 13 1 4 1 17 72 170 246 91 84 96 253 250 141 294 230 274 TABLE 3. ANALYSIS 0F CASES OF TUBERCULOSIS NOTIFIED DURING 1944, AND THE MORTALITY FROM THE SAME DISEASE OVER THE SAME PERIOD. AGES. HEW CASES Non-Pulmonary DEATHS Pulmonary. Pulmonary. Non-Pulmonary. Males. Females. Males. Females. Males. Femles. Males. Females. 0-1 - - - - - - 1-5 2 - 1 - - - - - 5-10 - - - - - - - - 10- 15 - - - - - - - - 15- 20 - - 1 - - — - 20-25 4 - 2 - 2 - - - 25- 35 2 - 4 3 3 - - - 35- 45 1 1 2 - 2 - 2 - 45- 55 - - - - 1 - - - 55- 65 3 - - - - - - 65 & Over - - - - 1 - 1 - TOTALS. 12 1 10 3 9 - 3 - TABLE 4. INFANTILE MORTALITY. NETT DEATHS FROM STATED CAUSES AT VARIOUS AGES UNDER 1 YEAR OF AGS 1944 Under 1 week. 1-2 weeks. 1 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and, under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total under 1 year. All causes :Certified.- 8 2 1 - 11 1 1 - - 13 Un- certified. - - - - - - - - - - Congenital defects. 1 - - - 1 1 - - - 2 Haemorrhagic disease - 1 - - 1 - - - - 1 Other defined diseases. - - 1 - 1 - - - - 1 Prematurity 9 1 - - 8 — - - - 8 Pneumonia. - - - - - - - - 1