FR126 FRIERN BARNET URBAN DISTRICT COUNCIL. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. FOR THE YEAR 1948. W.W.MILLEN, M.B., Ch.B. MEDICAL OFFICER OF HEALTH. FRIERN BARNET URBAN DISTRICT COUNCIL. Public Health Department, Town Hall. N. 11. August. 1949. The Chairman and Members of the Friern Barnet Urban District Council. Mr. Chairman, Ladies and Gentlemen, I have the honour to submit my report on the state of the public health and sanitary circumstances of the District for the year ending 31st. December, 1948. The Ministry of Health (Circular 3/49) again requires that this report shall be in abridged form, and it is therefore little more than a factual record of statistics. The year was satisfactory from the point of view of vital statistics. The death-rate showed another decrease, and although the birth-rate was lower than last year, the infantile mortality rate was the lowest for a number of years. The infectious sickness rate showed a sharp increase, but this was due to the fact that the number of cases of Measles and Whooping Cough were more than double than the previous year. There has been a small decrease in the number of new cases of Tuberculosis. Six cases of Polio-myelitis were notified, but no source of infection was traced, nor were any of the cases known contacts. The National Health Service Act which came into force during the year left the responsibility for Maternity and Child Welfare end the other personal Health Services with the County Council as the Local Health Authority, but indirectly placed a certain amount of additional work on the Department in dealing with numerous calls by the public for advice and information on the various services. 1 I would like to take this opportunity of expressing my thanks to the Chairman and members of the Public Health Committee for their consideration and support during the year under review. I should also like to record my appreciation of the services of the members of the Public Health Department for the manner in which they have carried out their duties which continue to increase in extent and importance. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient servant, W.W. MILLEN M.B., Ch.B. Medical Officer of Health. 2 PUBLIC HEALTH COMMITTEE. At 31st. December, 1948. Councillor A.C, Henry " H.R. Tar]ton " C.F. Simmonds J.P. " A. Richardson " E. Draper. " F. Foley. " R.P. Matthews. " Mrs. H.H. McCarthy. " A.C.S. Meynell. " Miss M. Richards, (Chairman) (Vice- Chairman) (Chairman of the Council) (Vice-chairman of the Council) PUBLIC HEALTH STAFF. Medical Officer of Health. Chief Sanitary Inspector. Sanitary Inspector. Sanitary Inspector. Assistant Assistant. Rodent Operative. W. W. Millen. M. B. CH. B. W. R. Jackaman. S. Caine. J.J. Wisdom. (Appointed 15.11.48) J. Wilson. Miss E. Glasscock. E.T. Crawshaw (Appointed 16.2.48). STATISTICS OF THE AREA. Area (in acres) 1341.2 Registrar General's estimate of population 28,620 (District - 26,570) (Friern Hospital - 2,050) Number of separate dwellings 7,563 Rateable Value (31.12.48) £282,664. Sum represented by a penny rate £1,145. 3 EXTRACTS FROM VITAL STATISTICS. Male. Female. Total. LIVE BIRTHS. (Legitimate) 185 168 353 (Illegitimate) 12 10 22 (Totals) 197 178 375 14.1 Male. Female. Total. STILL BIRTHS. (Legitimate) 5 3 8 (illegitimate) - - - (Totals) 5 3 8 STILL BIRTH PATE per 1000 Births (Live and Still) 21.3 Male. Female. Total. DEATHS. (From all causes and at ell ages) 116 116 232 DEATH RATE per 1000 of the estimated population 9.0 DEATHS OF WOMEN IN CHILDBIRTH. From Puerperal Sepsis 0 From other meternal causes 0 Total 0 DEATH RATE per 1000 Births (Live end Still) 0.0 DEATHS OF INFANTS (under 1 years of ego). Male. Female. Total. Legitimate 2 5 7 Illegitimate - - - Total 2 5 7 DEATH RATE OF INFANTS (under 1 year per 1000 Births) 19.0 DEATHS FROM MEASLES (all ages ) 0 DEATHS FROM WHOOPING COUGH (all ages) 0 DEATHS FROM DIARRHOEA (under 2 years of ago) 0 4 BIRTHS. The total of births during the year was 375, a decrease of 135 compared with the preceding year. Of these 197 were males and 168 females. The Birth-Rate for the year was 14.1 per 1000 of the population. The corresponding Birth-Rate for England and Wales was 17.9 and for London 20.1. Births and Birth-Rates for the past five years have been as follows:- No. of Births. Friern Bernet, Birth-Rates. England & Wales, London. 1944 382 17.6 17.6 15.0 1945 366 14.2 16.1 15.7 1946 491 18.9 19.1 21.5 1947 510 19.0 20.5 22.7 1948 375 14.1 17.9 20.1 DEATHS. The total number of deaths during the year was 232, being 32 less than in the preceding year. Of these 116 were males and 116 females. 146 deaths or 60% were of persons above the ago of 65. The chief causes of death at all ages were Heart Disease 85, and Connor 46. The Death-Rate was 9.0 per 1000 of the population, compared with a Death-Rate for England & Wales of 10.8, and for London, 11,6. The Deaths and Death-Rates for the past five years have been:- No. of Deaths. Friern Bernet. Death-Rates. England & Wales. London. 1944 274 10.6 11.6 15.7 1945 233 9.4 11.4 13.8 1946 261 10.0 11.5 12.7 1947 264 9. 9 12.0 12.8 1948 232 9.0 10.8 11.6 There were 7 deaths of infants under 1 year of ago, giving an Infantile Death-Rote of 19 per 1000 births, compared with 19 deaths and a rate of 37 in 1947. The comparative rates for England & Wales and for London were 34 and 31. Of the 7 infant deaths 5 occurred during the first week of life, and 3 of these were due to prematurity. 5 SANITARY SERVICES. SANITARY INSPECTIONS. Visits to promises on complaint 648 Visits in connection with infectious disease 64 Visits to shops and places where food is prepared,stored or sold 145 Visits to dairies and milkshops 22 Visits to factories 48 Visits to petroleum installations 25 Visits under the Housing Act for appointments and special visits and to works in progress 2518 Visits re infestation and disinfestation of verminous premises 4 Visits for the purpose of rodent control 84 Visits to Piggeries 63 Attendances at Court 1 3622 Visits by Rodent Operative in connection with Rodent Control 1291 Total 4913 SERVICE OF NOTICES. Total number of informal notices served 401 Total number of informal notices complied with 319 Total number of statutory notices served 35 Total number of statutory notices complied with 19 6 The following is a summary of the sanitary improvements and defects remedied during the year as a result of action by the Public Health Department:- Water. Store cisterns provided, repaired cleansed, or covers provided 16 Fittings and services repaired 23 Drainage. Drains cleared or repaired 23 Inspection chambers reconstructed or repaired 2 Inspection covers provided 2 Soil and vent pipes provided or repaired 5 New sinks provided 2 Sink waste-traps provided or repaired 19 W. C's. W.C. pens and traps fixed 20 W.C. pens end traps repaired 6 W.C. seats, doors, windows, floors renewed or repaired 6 Walls cleansed, and distempered 6 Ceilings cleansed and distempered 5 Flushing cisterns provided 2 Flushing cisterns repaired or regulated 25 Floors. Floors renewed or repaired 32 Roofs. Stripped and renewed 5 Roofs repaired 146 Gutters end down spouting renewed or repaired 71 Cleansing. Walls repaired, cleansed and redecorated 220 Ceilings renewed or repaired 205 Windows. Sashes and frames renewed or repaired 101 Sills renewed or repaired 66 Sashcords provided (number of houses) 27 Brickwork. Damp-proof courses provided 1 Brickwork repaired 15 Chimney stacks rebuilt or repaired 11 Walls re-pointed or rendered 42 Woodwork. Doors renewed, repaired or re-hung 15 Staircases repaired 2 Yards. Yard paving repaired or renewed 4 Refuse. Dustbins provided 28 Accummulations of refuse removed 2 General. New ranges and grates provided 13 Ranges or grates repaired 29 Wash boilers repaired or renewed. 5 Verminous rooms cleansed 2 Other defects (unclassified) remedied 28 7 WATER SUPPLY. The water supply of the district is provided by the Barnet District Gas & Water Company and has been satisfactory in both quality and quantity. All houses in the district are provided with a piped supply, and there have been no complaints of unsatisfactory or insufficient supply. Bacteriological and chemical examinations of the water were carried out at regular intervals, and the following is characteristic of reports received:- "This is a very satisfactory water. It is clear and bright in appearance and of the highest standard of bacterial purity, indicative of a pure and wholesome water suitable for the purpose of a public supply". RATS AND MICE (DESTRUCTION) ACT. 1919. During the year 375 private and business promises were visited and investigated for infestation by rats, and treatment was carried out in 209 instances. In addition public undertakings such as the Sewage Works, Refuse tip, Depots and Parks and other open spaces were regularly visited and treatment carried out whenever necessary. The second and third maintenance treatments of the district sewers were carried out during the year, and as a result the number of manholes showing infestation has been reduced to 8. These treatments suggest that the extent of rat infestation in the sowers is slight. INSPECTION AND SUPERVISION OF FOOD. MILK SUPPLY. The following licences wore issued under the Milk (Special Designations) Regulations 1936/46:- Pasteuriser's. 1 Dealer's. Pasteurised 3 Tuberculin Tested 1 Supplementary. Pasteurised 6 Tuberculin Tested 5 Numerous samples of milk supplied in the district were taken. In the case of one source of supply a series of samples failed to satisfy the prescribed tests. The circumstances were fully investigated and the matter taken up with the retailer concerned. As a result of this action subsequent samples were satisfactory. 8 MEAT AND OTHER FOODS. Frequent visits were paid to butchers', fishmongers', grocers' and bakers' shops, and other food premises. A large quantity of food was examined of which the following was condemned as unfit for human consumption:- Beef 40 lbs. Mutton 20 lbs. Offal 20 lbs. Bacon 24 lbs. Fish 1050 lbs. Sugar 28 lbs. Jam/Marmalade 21 lbs. Fruit 93 lbs. Vegetables 94 lbs. Dried Eggs 22 lbs. Corned Beef/Mutton 220 lbs. Tinned Milk 402 tins. " Vegetables 343 tins. " Meat 103 tins. " Fish 104 tins. " Fruit 121 tins. " Bacon 25 tins. " Soup 5 tins. " Fruit Juice 25 tins. " Fish Paste 7 tins. INFECTIOUS DISEASE. NOTIFICATIONS. 539 cases of infectious disease were notified during the year,(details of which are set out in Table 1), and is the highest figure for some years. This may be attributed to a sharp rise in the number of cases of Measles and Whooping Cough (309 and 120 respectively), in each case more than twice the number notified during 1947. The incidence of Diphtheria continued exceptionally low 3 cases. One case, that of a girl aged 6 years, who was taken ill whilst on holiday with her parents, proved fatal. This patient had not been immunised. Six cases of Polio-myelitis were notified during the year - two girls aged 5 and 8 years - two boys aged 7 and 12 years - two adults (females aged 19 and 28 years). All made a good recovery, the two adults and the boy aged 7 being the only cases requiring orthopaedic treatment. There was a slight decrease in the number of new Tuberculosis cases - 30, compared with 37 during 1947. In addition 7 persons took up residence in the district who had previously been notified as suffering from the disease. IMMUNISATION AGAINST DIPHTHERIA. During the year 314 children were immunised at the Clinics against Diphtheria. In addition, 111 children, on reaching school age, were given a re-inforcing dose. SCABIES. Only 7 cases were notified during the year, 5 being treated at the Isolation Hospital, the other 2 being supplied with the medicament for homo treatment. 9 REPORT OF MEDICAL OFFICER REQUIRED BY SECTION 128 (3) OF THE FACTORIES ACT, 1937. 1. Inspections for purpose of provisions as to health. Number of Number on Register. Inspections, Written notices. Occupiers Prosecuted. (1) Factories in which Sees.1,2,3,4 & 6 are to be enforced by Local Authorities. 15 19 2 - (2) Factories not included in (1) in which Sec. 7 is enforced by the Local Authority. 55 29 3 - (3) Other premises in which Sec.7 is enforced by the Local Authority. 6 - - - Total 76 48 5 - 2. Cases in which defects were found. No. of cases in which defects were found. Found. Remedied. Referred Prosecutions To H.M. Inspector. By H.M. Inspector. Went of cleanliness 5 5 - 1 - Sanitary conveniences (a) Unsuitable or defective 1 1 - 1 - Other offences 1 1 - 1 - Total 7 7 - 3 - Outworkers (Sections 110 end 111). Section 110. Section 111. No. of outworkers on lists received. No. of instances of work in unwholesome premises. Notices served. 28 - - 10 TABLE 1. ANALYSIS OF CASES OF NOTIFIABLE INFECTIOUS DISEASES NOTIFIED DURING THE YEAR ENDING 31st. DECEMBER. 1948. 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. Cent. East. West. Friern Hosp. Measles. 309 - 148 155 - 5 1 - 92 56 61 37 63 - 7 Whooping Cough. 120 9 70 40 - - 1 - 45 32 12 20 11 - 3 Scarlet Fever. 50 - 15 32 2 1 - - 14 7 9 5 15 - 17 Diphtheria. 3 - - 2 1 - - - - 1 2 - - - 3 Dysentery. 5 - - - - - 4 1 2 - - - - 3 1 Pneumonia. 13 - 4 1 - 2 3 3 6 - 2 2 1 2 - Polio-myelitis. 6 - - 4 1 1 - - 3 - - 2 1 - 6 Puerperal Pyrexia. 1 - - - - 1 - - - - - - 1 - 1 Erysipelas. 1 - - - - - - 1 1 - - - - - - Typhoid. 1 - - - - - 1 - 1 - - - - - 1 Pulm. Tuberculosis. 28 - 1 2 11 11 3 - 6 8 8 3 3 - - Other Tuberculosis. 2 - - - 1 11 1 - 1 1 - - - - TOTALS. 539 9 238 236 16 21 14 5 171 105 94 69 95 5 39 TABLE 2. ANALYSIS OF THE CAUSES OF AND AGES AT DEATH DURING THE YEAR 1948 FOR THE WHOLE DISTRICT. Cause of Death. No. Reg. In Trans At Ages Wards. M. F. Nett Deaths. 0-1 1-2 2-5 5-15 15-25 _ 25-45 45-65 65 & 0. N. S. C. E. W. Accident 1 1 - - - - - - 1 1 1 - 1 - - 1 1 2 Arterio -sclerosis. 5 3 - - - - - - 1 7 4 2 1 - 1 3 5 8 Cancer. 30 16 - - - - - 5 17 24 15 9 9 6 7 23 23 46 Cerebral-Haemorrhage 22 5 - - - - - - 5 22 15 4 3 - 5 10 17 27 Congenital-debility - 3 3 - - - - - - - 1 1 - - 1 1 2 3 Diabetes. - 2 - - - - - - 1 1 1 - - - 1 - 2 2 Diphtheria. - 1 - - - 1 - - - - - - 1 - - - 1 1 Gangrene. - 1 - - - - - - - 1 - - - - 1 - 1 1 Heart Disease. 63 22 1 - - - - 2 18 64 23 12 23 8 19 43 42 85 Meningitis. - 1 1 - - - - - - - - - - - 1 - 1 1 Misadventure. 1 1 - - - - - 1 - 1 - - 2 - - 2 - 2 Nephritis. 3 5 - - - - - 1 1 6 3 1 1 2 1 4 4 8 Other circulatory diseases. 1 1 - - - - - 1 - 1 2 - - - - 1 1 2 Other defined dis. 3 6 2 1 - - - 1 3 2 2 2 3 1 1 6 3 9 Other digestive dis. - 5 - - - - - 3 - 2 2 - 2 - 1 4 1 5 Other Respiratory diseases. 1 2 - - - - - 1 2 - 1 - 1 - 1 3 - 3 Pneumonia. 8 6 - 1 - - - 1 3 9 4 1 6 1 2 4 10 14 Suicide. 1 - - - - - - - - 1 - - - 1 - 1 - 1 Senility. - 2 - - - - - - - 2 - 1 1 - - 2 - 2 Tuberculosis.(Pulm) 9 1 - - - - 1 2 5 2 1 1 4 2 2 8 2 10 TOTALS. 148 84 7 2 - 1 1 18 57 146 75 34 58 21 44 116 116 232 TABLE 3. ANALYSIS OF CASES OF TUBERCULOSIS NOTIFIED DURING 1948. AND THE MORTALITY FROM THE SAME DISEASE OVER THE SAME PERIOD. AGES. NEW CASES. DEATHS. PULMONARY NON- PULMONARY. PULMONARY NON-PULMONARY. MALES . FEMALES. MALES. FEMALES. MALES. FEMALES. MALES. FEMALES. 0-1 - - - - -_ - - - 1-5 - 1 - - - - - - 5-10 - - - - - - - - 10- 15 1 1 - - - - - - 15- 20 1 2 - - - 1 - - 20- 25 6 2 - 1 - - - - 25- 35 2 8 - - - - - - 35- 45 1 - - - 2 1 - - 45- 55 1 - - 1 3 - - - 55- 55 1 1 - - 2 - - - 65 & Over. - - - - 1 - - - TOTALS 1 13 15 - 2 8 2 - - TABLE 4. REGISTER OF TUBERCULOSIS. PULMONARY. NON-PULMONARY. TOTALS. MALE. FEMALE. MALE. FEMALE. Cases on Register at 1.1.48. 95 54 10 18 177 Cases notified for first time 1948. 13 15 - 2 30 Other cases added to Register 1948. 5 1 - 1 7 Cases removed from Register 1948. 19 8 4 1 32 Cases remaining on Register 31.12.48. 94 62 6 20 182 TABLE 5. INFANTILE MORTALITY. NETT DEATHS FROM STATED CAUSES AT VARIOUS AGES UNDER 1 YEAR OF AGE. 1948. Under 1 week. 1-2 weeks. 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. 5 - - - 5 2 - - - 7 Un-Certified. - - - - - - - - - - Asphyxia. 1 - - - 1 - - - - 1 Atelectasis. 1 - - - 1 - - - - 1 Heart Disease. - - - - - 1 - - - 1 Meningitis. - - - - - 1 - - - 1 Prematurity. 3 - - - 3 - - - - 3