Ac 439(3) FRI 41 FRIERN BARNET URBAN DISTRICT COUNCIL ANNUAL REPORT of the Medical Officer of Health for the Year 1963 JANET R.CAMPBELL, M.B.,Ch.B.,D P H„ Medical Officer of Health friern basnet urban district council. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1963. JANET R. CAMPBELL M.B., Ch.B.,D.P.H, Medical Officer of Health. Public Health Department, Town Hall, Friern Barnet, Middlesex. Mr. Chairman, Ladies and Gentlemen, I have the honour to present the Annual Report for the year 1963* The vital statistics for 1963 followed closely the satisfactory figures of last year. The Birth Rate, with 376 live births, was 14.5 per 1,000 of population. The Death Rate was 12.1, slightly higher than last year's figures of 11.0 but lower than that for the country as a whole - 12.2. It is very satisfactory to state again this year that there were no maternal deaths, the last such death occurring in 1947 16 years ago. The Infantile Mortality Rate, i.e. the number of infants who died during the first year of life per 1,000 live births was 21.3 as against 22.9 last year. Two trends referred to in last year's report, a rising birth rate and an increase in the illegitimate birth rate are again evidenced this year as is shown in the following tables: Birth Rate Illegitimate Birth Rate as %of total live births. 1959 13.4 1959 4.36 1960 13.8 1960 5.08 1961 14.1 1961 5.7 1962 13.8 1962 7.1 1963 14.5 1963 7.7 The number of infectious diseases notified during 1963 was 379 as against 60 last year. This was accounted for largely by a similar rise in the number of cases of measles. The infectious sickness rate was 13.4 compared with 2.1 during 1962. No cases of poliomyelitis were notified during the year, the last occurring 6 years ago, and it is now 8 years since we had a case of diphtheria. -1- Notifications of whooping cough were 23. The pattern of health problems developing today driven home the importance of Health Education as a vital part of local authority Health Services. Two important factors in health education are: (a) Impact on young people - and this must involve co-operation between parents, teachers and medical staff and (b) Timing. (a) There have recently been produced some excellent films on smoking and on sex education, and several of our Head Teachers have expressed a wish that we should show these films to the schools. As a preliminary to this, meetings have been arranged with parents and staff. This affords the parents particularly, an opportunity of seeing the films and of discussing the appropriateness of their use in the schools concerned. Obviously if the parents have full knowledge of the instruction being given in school they will be in a much stronger position to add their influence to that of the teachers and the medical staff, and I hope that a greater measure of success may be achieved. (b) The advantage gained by timing in Health education was illustrated when, during the recent Aberdeen typhoid epidemic every school in Friern Barnet, secondary, junior and infants, was visited by a Medical Officer, Health Visitor or Public Health Inspector and a very brief but very downright talk given on the method of spread of thphoid fever, which is the same as that in dysentery and poliomyelitis. The importance of proper hand-washing after visiting the toilet and before eating and preparing food was driven home. In every case the children showed a lively interest and the school staff were not only welcoming but very appreciative. nt the same time a display of posters, leaflets etc., was staged in the Town Hall. -2- I need hardly emphasise the increasing amount of work falling upon the Public Health Inspectors particularly in the field of smoke control and housing, but it has been a good year of work, thanks to the willing effort of all concerned. With the coming merger of the personal and environmental health services in the Borough of Bernet the close and friendly co-operation of the staffs of the Urban District and the County Area is particularly fortunate. Especially is this so in regard to the care of the aged and in health education. To the great sorrow of his staff and, I am sure, of the Council, Dr. Harvey, after a year's sick leave resigned his appointment in October. His interest, however, in the staff and in the work of the Council still continues. On Dr. Harvey's retirement Dr. Mary Douglas was appointed as my Deputy and I should like to thank her warmly for the generous help she has given me. My grateful thanks are due also to the Chief Public Health Inspector, Mr. W. Jackaman, to Mr. J. Wilson and indeed every member of the Public Health Department. I feel I must also acknowledge with thanks the very friendly co-operation I have received from the other Chief Officers. In conclusion, I would once again thank the Council, particularly the Chairman and Members of the Public Health Committee for their unfailing courtesy and support. I am, Mr.Chairman, Ladies and Gentlemen, Your obedient Servant, Janet R. Campbell. Medical Officer of Health. -3- PUBLIC HEALTH COMMITTEE. at 31st, December 1963. Cr. S. P. Esom M.I.H.I. (Chairman) Cr. J. 0. Blake (Vice-Chairman) Cr. K. J. Norman (Chairman of the Council) Cr. D. Plasket Marshall, F.R.I.B.S. (Vice-Chairman of the Council) Cr. L. F. Bannister Cr. E. C. George Cr. G. H. Flesher F.I.O.B. Cr. R. F. Pugh, J.P. Cr. M. Shaw PUBLIC HEALTH STaFF Medical Officer of Health Janet R. Campbell M.B.,Ch.B.,D.P.H. Deputy Medical Officer of Health Mary C. Douglas M.B.,Ch.B.,D.P.H. Chief Public Health Inspector V.R. Jackaman Deputy Chief Public Health Inspector R.N. Hedges D.M.A, Public Health Inspector V.C. Quin Technical Assistant F.G, Saunders Chief Clerk J. Wilson Secretary/Typist Miss E. M. Glasscock Rodent Operative E.T. Crawshaw -4- STATISTICS OF THE AREa. Area (in acres) 1,340 Population (Registrar General's estimate 1963) 28,330 (District - 26,200) (Friern Hospital 2,130) Number of inhabitated houses 8,394 Rateable Value (31st. December 1963) £1,046947 Sum represented by a penny rate £5,225 EXTRACTS FROM VITAL STATISTICS. LIVE BIRTHS. MALE. FEMALE. TOTAL. (Legitimate) 182 167 349 (Illegitimate ) 10 17 27 Total 192 184 376 PERCENTAGE OF ILLEGITIMATE LIVE BIRTHS OF TOTAL LIVE BIRTHS 7.7% BIRTH RATE (Live births per 1000 population) 14.5 STILL BIRTHS MALE. FEMaLE. TOTAL. (Legitimate) 5 4 9 (Illegitimate) 1 - 1 Total 6 4 10 STILL BIRTH RATS (per 1000 total live and still births) 25.9 TOTAL births 386 -5- INFANT DEATHS, (under 1 year of age) MALE. FEMALE. TOTAL. (Legitimate) 4 3 7 (Illegitimate) - 1 1 Total 4 4 8 INFANT DEATH RATE (per 1000 live births) 21.3 INFANT DEATH RATE (per 1000 legitimate births) 22.9 INFANT DEATH RATE (per 1000 illegitimate births) 37.0 NEO-NATAL DEATH RATE (under 4 weeks per 1000 live births) 18.6 EARLY NEO-NATAL DEATH RATE (under 1 week per 1000 live births) 15.9 PERINATAL DEATH RATE (stillbirths and deaths under 1 week per 1000 total live and still births) 41.6 MATERNAL DEATHS (excluding abortion) 0.0 MATERNAL DEATH RATE (including abortions per 1000 births live and still) 0.0 DEATHS. MALE. FEMALE. TOTAL. District 155 139 294 Friern Hospital 88 145 233 Total 243 284 527 DEATH RATE (per 1000 population) 12.1 -6- BIRTHS. The number of births assigned to the district was 376, giving a Birth Rate of 13.3 per 1000 of the population. The correcting factor for age and sex distribution so far as Friern Barnet is concerned is 1.09 so that the rate for comparative purposes was 14.5. The corresponding Birth-Rate for England and Wales was 18.2. Birth and Birth-Rates for the past five years have been:- Year. No.of Births. Birth-Rates. Friern Barnet. England & Wales.  1959 344 13.4 16.5 I960 354 13.8 17.1 1961 358 14.1 17 .4 1962 349 13.8 18.0 1963 376 14.5 18.2 MORTALITY. General Mortality and Death_Rate. There were 527 deaths during the year. Of these 233 occurred in Friern Hospital and 294 in the district. This provides an un-corrected Death-Rate of 18.6 per 1000 for the total population, and 11.2 per 1000 for the district excluding Friern Hospital. The correcting factor for age and sex distribution is O.65 providing a Death-Rate for comparative purposes of 12.1. The corresponding rate for England and Wales was 12.2. The Deaths and Death-Rates for the past five years have been:- Year. No. of Deaths. Death-Rates. Friern Barnet. England & Wales  1959 425 10.5 11.6 I960 373 9.5 11.5 1961 466 11.3 12.0 1962 445 11.0 11.9 1963 527 12.1 12.2 -7- Mortality of Persons over the age of 65. 389 deaths, or 73.8% of the total deaths during the year occurred in persons over the age of 65 years. Of these 242 were over the age of 75. There was a rise of 65 in the deaths from diseases of the heart and circulatory system. The deaths from cancer of the lung however, showed a very welcome drop from 20 to 16 and those from bronchitis also from 33 to 28. Infant Mortality. There were 8 deaths of infants under 1 year of age. This gives an infant death rate of 21.3 per 1,000 live births as compared with 8 deaths and a rate of 22.9 in the preceeding year. The infant mortality rate for England and Wales in 1963 was 20.9. Of the 8 infants who died in Friern Barnet during 1963, 7 died under four weeks, and 6 failed to survive one week. These very early deaths now constitute the hard core of all infant deaths and are under the most careful scrutiny. Ten stillbirths, 9 legitimate and 1 illegitimate were accredited to the District for 1963. This is equal to a death rate of 25.9 (live and still births) the corresponding figures for 1962 being 5 stillbirths with a rate of 14.1. No maternal deaths ware reported during the year. GENERAL PROVISION OF HEALTH SERVICES. Care of the Aged. The increasing number of elderly people in the community entails a constant increase in the scope and size of the problem relating to the aged. Much of the time and thought of the Medical Officer of Health is spent dealing with such problems. The members of the Old People's Welfare Committee continue to give generously of their time and effort in this service. Arrangements are in hand for the setting up of the Elderly Persons Advice Clinic to be held at the Old People's Centre beside the Town Hall. This should start to function within the next few weeks, and I feel sure will be a very welcome addition to our health services. -8- Laundry Service for Sick Aged Persons. In February 1963, in conjunction with the Wood Green Borough Council, the Council agreed to participate in a joint scheme for providing a service for the laundering of bedclothes belonging to aged and incontinent persons. The service commenced in May. The whole of the work is done at the laundry attached to the Wood Green Borough Council's Swimming Bath in Western Road. N.22. I am pleased to report that the arrangements made have worked admirably, that the service provided has been a success, and, furthermore, that I am satisfied it has supplied the solution to a very difficult problem. In the Chiropody Service also there is some progress to report. We have obtained the additional services of a part-time Chiropodist on the area staff and are now able to hold 3 sessions of Chiropody at Holly Park Clinic. Additional time has also been made available for home treatment. Hospitals. The hospital admission of general and surgical cases appears to present no problem, nor does the admission of infectious cases to Coppetts wood Hospital. Hospital admission, however, of maternity bed accommodation is now under review. Laboratory facilities. As in previous years, the Central Public Health Laboratory Service has been of the greatest assistance to us, not only the Central Laboratory at Colindale, but also the Laboratory at Coppetts Wood Hospital. I gratefully acknowledge the assistance afforded throughout the year, and the close co-operation which has continued for so many years between the Public Health Department and the Laboratory Service. -9- Summary of the work carried out at the Public Health Laboratories for the year: Throat and nose swabs 8 Faeces 292 Sputum 3 Ice cream 49 Milk 96 Pet Food 3 Pilchards 1 Minced meat 33 National Assistance Act 1948. Section 50. Burial or cremation of the dead. Action was necessary in one case under this section during 1963. PREVALENCE AND CONTROL OF INFECTIOUS DISEASES. From the table of infectious diseases set out on Page 28 it will be seen that 379 cases of infectious diseases were notified during the year, as against 60 in 1962. The Infectious Sickness Rate for the year was therefore 13.4 as compared with 2.7 for the previous year. The increase in the number of infectious diseases was due to the fact that 1963 was a 'measles year'. The following table sets out the infectious diseases notified during 1963, as compared with those received during 1962. 1962. 1963.  Measles 27 314 Pertussis 6 23 Scarlet Fever 2 11 Pneumonia - 4 Dysentery 5 7 Food Poisoning 3 6 Tuberculosis 15 12 Erysipelas 1 2 Puerperal Pyrexia 1 — 60 379 From the table set out above the following facts emerge:-10- 1. Scarlet Fever. notifications totalled eleven in 1963 an increase of 9 the 1962 figures which were exceptionally low. 2. Diphtheria the last case of diphtheria notified was 8 years ago and it is 17 years since this was a cause of death. 3. Measles notifications increased from 27 in 1962 to 314 in 1963) this was to be expected as 1963 was a "measles year". 4. Pertussis notifications were 23 this year, 17 more than in 1962. 5. Notifications of food poisoning and dysentery increased from a combined total of 8 in 1962 to 13 in 1963. 6. No cases of poliomyelitis were notified. 7. Twelve cases of tuberculosis were notified during 1963, three less than in 1962. Five of the cases were from Friern Hospital. 8. International certificates. The number of certificates of successful vaccination or re-vaccination brought to the department for authentication by parsons proceeding overseas was 200. Immunisation and Vaccination in the control of Infectious Disease. I wish especially to mention a recent service made available in Friern Barnet whereby Tetanus Immunisation has been offered to the outdoor staff employed by the Council. (Although this strictly belongs to the 1964 report I make no apology for mentioning it here). Absence of immunity to Tetanus carries with it two hazards. The first, death from Tetanus, may occur when the infection is not even suspected, e.g., from the prick of a rose thorn. The much commoner hazard however is severe reaction and shock from the giving of Anti-Tetanus Serum, particularly if this is repeated. Certain employments more than others carry with them the risk of Tetanus wound infection and any injury under these conditions will demand tne giving of anti-tetanus serum. The only means of avoiding both the danger of conteacting tetanus and the danger of serum reaction is by -11- Tetanus Immunisation. In those so protected injury calls for simply a small boost dose of toxoid and there is no need for administration of serum. Tetanus Immunisation was first made available through local health authorities in 1960, and since then has been offered each year to all our infants, pre-school and school children. Accordingly by now most young people up to the age of 18 have had the opportunity of this protection and have widely availed themselves of it. This, however, leaves almost the entire adult population unprotected, including certain groups particularly at risk. Such groups employed by local authorities include parks, building, roads, sewer and refuse collection and disposal staff. An effort is now being made in Friern Barnet to put matters right in this respect, and all such staff have been offered tetanus immunisation. There has been a very good initial response and it is hoped that it may be possible to continue this measure as a local authority service. The changing pattern of infectious disease over the last few years leaves no room for doubt as to the efficiency of immunisation as a means of control. It is interesting to consider the age range of our present population who are so protected from various infectious diseases. Smallpox. The population at all ages have had the opportunity of smallpox vaccination. The response of the adult population is directly related to any occurrence of smallpox in the vicinity. As regards the child population, however, fortunately the response is consistent and high. Every month, each Health Visitor records the vaccination state of all children currently reaching the age of 2. In the majority of cases a vaccination record card is available and, if not, a home visit is paid, so that records are accurate. In Friern Barnet the percentage of children at 2 years who have been successfully vaccinated has risen from 45% in 1955, when this method of follow-up was commenced, to 83% for 1963. Diphtheria. A very high percentage of the population from infancy to adults aged 38 to 40 years have received diphtheria immunisation. Diphtheria immunisation was carried out to some extent in the late 1930s, but it was in 1940 that a campaign was launched in Middlesex offering immunisation to all children up to school-leaving age. There was an immediate, massive response with soon afterwards a spectacular drop in the cases of diphtheria. -12- The response over the years has continued at a high level and the primary protection is continued with "boost" injections to maintain continuing immunity. It follows that, in our present population, adults up to the age of 38 to 40 come within the range of the protected group. In Friern Barnet during 1963, 92% of children reaching the age of 2 years had been immunised. This compares with a percentage of 85 in 1955. The system of follow-up used is the same as that in smallpox vaccination. Whoopirg Cough. Our main concern in this disease is to protect the very young in whom the condition can still be fatal. Immunisation is thus given over the first few years of life, but since in older children the disease tends to be mild, the regular immunisation of older groups is not considered necessary. Poliomyelitis. Polio vaccine was introduced in 1956 and led to a wide initial public response, which later fluctuated. Probably 80^ or more of young people up to the age of 24 years have been vaccinated against poliomyelitis. Older people up to the age of 50 years and over have also had the opportunity of this protection although the percentage in this group will be considerably lower. B.C.G. Vaccination against Tuberculosis. In 1957 B.C.G. vaccination was first offered to all school children aged 13 years i.e. prior to leaving school. This offer is made annually to all schools, both maintained and private schools, thus young people between the ages of 13 and 22 yeais have all had the opportunity of receiving B.C.G. vaccination in school, and in Friern Barnet between 60 and 70% have taken advantage of it. The consent rate in Friern Barnet for 1963 was 69.6%. Typhoid. A comparatively small percentage of the population are protected against Typhoid Fever. A growing number of our school children, however, are so protected prior to foreign travel and it may be that the general public will profit by their example and also seek this safeguard before travelling abroad. -13- SANITARY SERVICES. Summary of inspections of District. Visits in connection with complaints 44l Visits in connection with infectious disease 235 Visits to shops and other places where food is prepared, stored or sold 434 Visits to other shops 171 Visits to factories 89 Visits to petrol installations 127 Visits in connection with housing and the repair of dwelling houses 1945 Visits in connection with the Rent Act 10 Visits in connection with the Clean Air Act 2589 Visits in connection with rodent control 913 Appointments and special visits 326 Miscellaneous visits 110 Total 7390 Summary of complaints received. Housing defects 98 Defective drainage 46 Offensive accummulations or smells 29 Insect pests 94 Rat or mouse infestations 126 Unsound food 9 Noise nuisance 1 Other complaints 19 Total 422 Notices served. Informal notices served 136 Statutory notices served 25 -14- Legal Proceedings. Proceedings under the Public Health Act 1936 and the Noise Abatement Act 1960 were taken against a householder in respect of noise nuisance arising from the keeping of dogs. On an undertaking being given to limit the number of dogs kept and to prevent any nuisance being caused the case was adjourned sine die. The matter was finally resolved when the owner of the dogs removed from the district. HOUSING. Inspection of dwellings during the year. 1. Number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 166 2. Number of dwelling houses which were inspected and recorded under the Housing (Consolidated) Regulations 1925 and 1932) 32 3. Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for habitation 10 Number of dwelling houses (exclusive of those referred to in 3 above) found not to be reasonably suitable for occupation 20 Remedy of defects during the year without the service of formal notice. Number of defective dwelling houses rendered fit as a consequence of informal action 129 Action under statutory powers during the year. (l) Proceedings under sections 9,10 and 16 of the Housing Act 1957. (a) Number of dwelling houses in respect of which notices were served requiring repairs 2 -15- (2) Proceedings under Public Health Act 1936. (a) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 22 (b) Number of dwelling houses in which defects were remedied after service of formal notices:- (l) By owners 21 (11) By Council in default of owners 1 (3) Proceedings under section 17 of the Housing Act 1957. (a) Number of dwelling houses in respect of which Demolition Orders were made or undertakings accepted - (b) Number of dwelling houses demolished 1 (c) Number of dwelling houses in respect of which Closing Orders were raaue - (d) Number of dwelling houses in respect of which Demolition Orders were determined, the dwellings having been rendered fit - (4) Proceedings under sections 42 and 43 of the Housing Act 1957. (a) Number of Clearance Areas declared - (b) Number of unfit dwellings included in Clearance Areas - (c) Number of unfit dwellings in Clearance Areas previously declared,demolished 20 Unfit houses. The Council's programme for the clearance and redevelopment of The avenue area was taken a stage further during the year when a compulsory purchase order was made in respect of the properties -16- included in the third phase of this scheme. This phase covered twenty-nine dwelling houses, four shops and a factory. A Public Inquiry was held and the compulsory purchase order was subsequently confirmed without modification. Twenty dwellings included in clearance areas previously declared were demolished during the year. Houses in multiple occupation. A limited survey in 1962 revealed nine instances of premises in multi-occupation. A more detailed enquiry during 1963 brought to notice a further thirteen cases and the indications are that these figures do not yet represent the full extent of this particular problem in Friern Barnet. Some control over conditions at such premises is provided by the Housing Act 1961 which enables local authorities to require landlords to provide services and facilities to meet the needs of the occupiers or to impose a limit on the number of persons accommodated. Use was made of these powers to obtain improvements in the living conditions of the tenants in the houses referred to and in three instances the multiple occupation of the premises ceased. Certificates of disrepair. Applications were received from the tenants of five dwellings for certificates of disrepair undei the provisions of the Rent Act 1957 and these were dealt with as follows:- (1) Applications received 5 (2) Certificates:- (a) approved in respect of all defects 2 (b) approved in respect of some defects 2 (c) refused 1 (3) Undertakings to remedy defects accepted 4 (4) Certificates of disrepair issued - -17- Improvement Grants. A number of enquiries were investigated in connection with the scheme for providing financial assistance to owners of older properties who wished to improve their houses and to provide the essential facilities such as a bathroom, hot water supply, internal W.C.&c., where these are lacking. Arising from these enquiries eleven applications for grant were received, compared with five in 1962, and of these ten were approved. INSPECTION AND SUPERVISION OF FOOD. Food premises. There are 139 premises in Friern Barnet where food is either stored, prepared for sale, or sold, and these are classified as follows:- Type. Number. Registered under Food and Drugs Act 1955* For sale of ice cream. For manufacture of sausages or preserved food. Bakers 9 1 - Butchers 13 - 9 Cafes and - - Restaurants 17 9 - Confectioners 30 29 - Fishmongers 6 1 - Greengrocers 21 3 - Grocers 39 30 11 Milkshops 4 4 — Total 139 77 20 There are also fourteen hawkers who carry on their trade from vehicles or stalls and who have been registered for this purpose under the provisions of the Middlesex County Council Act. -18- Requirements relating to the standard and cleanliness of food premises, the equipment used, and the hygienic handling of food, are contained in the Food Hygiene (General) Regulations. Four hundred and thirty four visits were made to premises in order to ensure that these regulations were being observed. In general the standard of hygiene was good and in those instances where defects or deficiencies were found the remedy was achieved without the need to take legal proceedings. Food inspection. There are no licensed slaughterhouses in Friern Barnet and most of the local meat supply comes from the London and other nearby meat markets. Samples of meat offered for sale in the butchers shops were taken for bacteriological examination and without exception these were found to be satisfactory. Of the various foodstuffs examined at local shops and stores the following were found to be unfit for human consumption, surrendered and disposed of by incineration or burial at the Council's Sewage Works:- Chicken 42 lbs. Pork 14 lbs. Liver 66 lbs. Fish 23 lbs. Tinned meat 13 tins Tinned fish 9 tins Tinned vegetables 49 tins Tinned fruit 277tins Tinned rice 7 tins Tinned milk 1 tin Tinned fruit juice 2 tins Frozen fish 4 packets Frozen vegetables 107 packets Frozen sponge 2 packets Nine complaints were receivedwhich concerned either the quality of food or the presence of some foreign material. All these complaints were investigated in detail and also discussed with the manufacturer or retailer of the foodstuff concerned with the object of ensuring that every precaution would be taken to prevent contamination of food. -19- Milk Supply. The milk supplied to Friern Barnet residents is either pasteurised, sterilised or tuberculin-tested. The nineteen registered distributors include the large dairy companies delivering milk daily and the occupiers of shops retailing small quantities of sterilised milk in association with some other business. There is one dairy in the district at which milk is pasteurised and bottled. Samples of the different grades of milk were taken regularly throughout the year. The one hundred and ninety-six samples which were sub, dtted for examination were all found to be satisfactory. No complaints were received as to the quality of the milk supplied. There were, however, three complaints of milk being supplied in dirty bottles. In each instance the investigation indicated that the bottles had been misused at some stage before being returned to the dairy company concerned. Ice cream. Seventy-seven, or rather more than half of all the food premises in the district are registered to sell ice cream. One person manufactures ice cream in accordance with the methods described in the Ice Cream (Heat Treatment) Regulations. Generally, however, the ice cream is obtained by the retailers from the nationally known manufacturers. Forty-nine samples of ice cream offered for sale were examined and all satisfied the standard test for bacterial cleanliness. FACTORIES AND SHOPS. Factories. The Council's functions under the Factories Act 1961 are concerned with such matters as cleanliness, overcrowding, temperature, ventilation and the drainage of floors in factories where no mechanical power is used, and with the provision of adequate sanitary conveniences in all factories. Except for the provision of sanitary facilities these matters are in the case of factories using mechanical power the responsibility of H.M. Inspectorate of Factories. -20- There are seventy-two factories in the district most of which are of the light industrial kind employing power in soem form or other. A few defects of a minor character were found during the year and were remedied without the need to take any proceedings under the Act. Inspection of factories. Premises. No. on Register. Inspections. Number of Written Notices. Occupiers Prosecuted. (l) Factories without mechanical power. 11 21 - - (2) Factories with mechanical power. 61 68 1 - (3) Other premises i.e. building or engineering works. - - - - Total. 72 89 1 - Defects found in factories. No. of cases in which defects were found. Particulars. fo'jt-d o Remedied. Drosecutions. Want of cleanliness. 4 4 - Sanitary conveniences unsuitable or defective. 5 5 - Other offences against the Act. 1 l - Total. 10 10 - -21- Outwork. Occupiers of factories engaged in carrying out certain classes of work are required to send to the Council, twice each year, lists of the persons who are employed by them as outworkers. This information enables control to be exercised over work which might otherwise be carried out in unsatisfactory premises or in conditions likely to lead to the spread of infection. Notification was received of 60 outworkers who were engaged in the following occupations:- Making wearing apparel 36 Making artificial flowers 3 Box making 15 Brush making 3 Carding buttons 2 Making lampshades 1 It was not necessary to restrict outwork in any instance. Shops. There are some 313 shops in Friern Barnet. The Shops Act 1950 is administered by the Council and deals with such matters as hours of closing, the early closing day, Sunday trading, the employment of young persons, and the comfort and welfare of shop assistants. One hundred and seventy-one inspections were made in administering the various provisions of the Act. No serious defects or infringements were observed and those matters which needed attention were remedied without the necessity for formal action under the Act. The Offices, Shops and Railway Premises Act 1963 was introduced during the year and will come into operation during 1964. The purpose of this Act is to secure the health, safety and welfare of employees in offices, shops and certain railway premises. For office workers the new provisions will be the first of their kind, for shop employees the existing protection given by the Shops Act will be extended. The new legislation will deal with a wide range of matters including cleanliness, overcrowding, room temperature, ventilation, lighting, toilet facilities, safety provisions, first aid facilities and fire precautions. -22- WATER SUPPLY. Friern Barnet's water supply is provided by the Lee Valley Water Company, except for a small part of the South Ward which is supplied from the mains of the Metropolitan Water Board. All the houses in the district have an internal supply. The supply has been adequate and no complaints were received concerning its quality. The reports on samples shewed that it was of a high standard of bacterial purity and suitable for public supply purposes. The water is hard and has no plumbo-solvent action. PEST CONTROL. Complaints relating to rats or mice received during the year totalled one hundred and twenty-six. The actual number of rat infestations found in investigating these complaints and during other routine inspections throughout the district was seventy-nine. These figures are similar to those recorded last year and, accepted as an indication of the extent of rat infestation, are encouraging, since they are considerably lower than at any previous time. The treatments to clear up infestation at private dwellings are carried out without charge to the occupiers, but where business premises are involved a charge based on the labour ana material used is made. Two treatments of the district sewers were undertaken, a routine control measure followed since 1947. The results of these treatments suggested that the level of infestation in the sewers had risen very slightly. The number of premises cleared of mice during the year was twenty. There were a number of requests for advice and aid to deal with various insect pests, the most numerous being in respect of wasps nests, of which eighty-four were destroyed. -23- CLEAN AIR. Orders in respect of Smoke Control Areas Nos.3 and k were confirmed by the Minister of Housing and Local Government in January and March and came into force on 1st. October. These Orders brought a further 1429 dwellings under smoke control. A complete survey of premises before making an Order is now no longer necessary and was not found to be possible in the case of Area No. 4: estimates were prepared after a sample survey and found to be reasonably accurate. Personal contact with all occupiers is, however, of immense value in securing their co-operation as well as making it possible to offer advice on alternative means of heating their homes where this is required, and this was achieved before the Order came into force. Smoke and sulphur dioxide measurements were continued at the Town Hall measuring station and a pictorial representation of the results is shewn overleaf. The results are much as before shewing heaviest pollution during the winter months when domestic fires are in use and discharging smoke and sulphur dioxide at a low level. Readings taken in a smoke control area would, undoubtedly shew a substantial reduction in the smoke figures and it is indeed unfortunate that no measuring apparatus is sited in such an area. Our readings are sent every month to the Warren Springs Laboratory of the Department of Scientific and Industrial Research for use in the national survey of atmospheric pollution and are distributed to every other co-operating body in the United Kingdom. -24- -25- MISCELLANEOUS Storage of petroleum spirit and mixtures. Twenty-three licences were granted to store a total quantity of 52,030 gallons of petroleum spirit or mixtures, of which 51,l80 gallons were kept in underground tanks each holding 500 gallons or more, and 230 gallons in smaller containers. The licences imposed conditions for the safe-keeping of petrol which conform with those recommended by the Home Office. One hundred and twenty-seven visits were made to the petroleum stores to ensure that the conditions attached to the licences were complied with. Local land charges registration enquiries. Information was supplied in respect of 777 enquiries relating to properties in Friern Barnet. -26- APPENDIX 1. (a) Letters to Doctors. Letters on the following subjects were circulated to Friern Barnet practitioners in 1963, some under signature of Medical Officer of Health, others either as Area Medical Gfficer or District School Medical Officer. 28th. February-Smallpox Vaccination and Tetanus Immunisation. 29th. March-Dysentery Notifications. 9th. April-Collection of Laboratory Specimens. 11th. October-Vaccination and Immunisation Publicity Campaign. l6th. December-Collection of Laboratory Spesimens. (b) Medical Examinations. During 1963, 39 medical examinations were carried out in respect of the new entrants to the Council's service. In addition to these medical examinations a considerable number of medical reports were issued relating to employees absent from duty for more than a short period through sickness. These reports were obtained from the Family Doctor or from a Hospital Consultant. In this connection it is a pleasure to acknowledeg the courtesy and co-operation which I have invariably received from the General Practitioners in Friern Barnet. -27- TABLE 1. ANALYSIS OF CASES OF NOTIFIABLE INFECTIOUS DISEASES DISEASE NUMBER OF CA;5is NOTIFIED. All. Un.l. 1-5 5-15 15-25 25-45 45-65 65 & 0 Measles 314 7 154 150 1 2 - - Whooping- Cough 23 4 10 8 - - - 1 Scarlet- Fevor 11 - 2 8 l - - - Dysentery 7 - 2 - 3 2 - - Pneumonia 4 - - - - - 2 2 Erysipelas 2 - - - - 1 1 - Food Poisoning 6 - - l 2 2 1 - Tuberculosis ll - - - 2 5 4 - Other culosis 1 - - - 1 - - - Totals 379 11 168 167 10 1 12 8 3 -28- NOTIFIED DURING THE YEAR ENDING 31st. DECENBER 1963 CASES IN EACH WARD No.Removed to Hospital. North. South. Central. East. West. Friern Hospital. 98 32 73 26 85 - 4 9 10 2 - 2 - 1 4 2 1 2 2 1 2 1 3 1 - - - 1 - - - - 3 - 2 - - - - - 1 4 2 - - - - - 1 2 1 1 1 5 - - 1 - - - - - 121 50 80 | 30 90 8 7 -29- table 2. analysis of cases of tuberculosis notified during 1963 and the mortality from the disease over the same period. new cases. deaths. ages. pulmonary. non-pulmonary. pulmonary. non-pulmonary. m. f. m. f. m. f. m. f. 0-1 - - - - - - - - 1-5 - - - - - - - - 5-10 - - - - - - - - 10-15 - - - - - - - - 15-20 - 1 - 1 - - - - 20-25 2 - - - - - - - 25-35 1 - - - - - - - 35-45 2 1 - - - - - - 45-55 2 - - - 1 - - - 55-65 1 1 - - 1 - - - 65 & Over - - - - 2 - — — totals 8 3 - 1 4 - - - -30- TABLE 3. REGISTER OF TUBERCULOSIS. PULMONARY. NON-PULMONARY. TOTALS. Male. Female. Male. Female. Cases on Register at 1.1.63. 95 58 if 19 176 Cases notified for first time 1963 8 3 - 1 12 Other cases added to the Register 1963 6 3 - - 9 Cases removed from Register 1963 12 8 - - 20 Cases remaining on Register 1963 97 56 4 20 177 -31- TABLE 4 ANALYSIS OF THE CAUSES OF AND AGES AT DEATH CAUSES OF DEATH AT AGES 0 to 1 l to 2 2 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 to 75 75 and Over Accident - - - - 1 l 2 2 2 Bronchitis 1 - - - - - 9 14 4 Cancer - - - - - - 28 14 3 Congenitalmalformation 2 1 - - - - - - Diabetes - - - - - - - 2 2 Diseases of heart and circulatory system - - - - 1 4 52 83 161 Gastritis - - - - - — - - 1 Influenza - - - - - - 1 2 3 Leukaemia - - - 1 - - - - 1 Nephritis - - - - - - - 1 3 Other defined diseases 2 - - - - 2 6 12 5 Other respiratory diseases - - - - - - 4 2 - Pneumonia - - - - - 2 10 11 43 Prematurity 3 - - - - - - - - Senility - - - - - - - 2 12 Syphilitic disease - - - - - - - - 1 Suicide - - - - 1 2 3 1 - Tuberculosis(Resp) - - - - - - 2 1 1 Total 8 - 1 1 3 11 114 147 242 -32- DURING THE YEAR 1963 FOR THE WHOLE DISTRICT. Wards. Male. Fem. No. Reg. In Tran. Total. North. South. Cent. East. West. Friern Hosp. 1 1 1 - 2 3 5 3 3 5 8 2 4 6 1 6 9 24 4 14 14 28 10 14 6 2 7 6 22 23 14 31 45 - 2 — — 1 — 2 1 - 3 3 1 — - — — 3 3 1 3 1 4 39 34 32 18 - 134 131 170 212 89 301 l - ~ - - - - 1 - l 1 - — — - - 6 2 4 6 - 6 1 — - - — 1 — 2 l l 2 1 l 2 - - - - 4 1 3 4 l 2 3 2 6 13 11 16 14 13 27 1 1 _ 1 _ 1 2 _ 3 3 2 - 1 6 6 47 32 34 56 10 66 — — 3 - - - 2 1 - 3 3 4 - - - - 10 - 14 14 - 14 - — 1 - - - 1 - 1 - 1 2 — 1 2 1 1 3 4 5 2 7 1 3 - - - - 4 - 2 2 4 67 66 56 32 73 233 243 284 346 181 527 -33- TABLE 5. INFANTILE MORTALITY. NETT DEATHS FROM STATED CAUSES AT VARIOUS AGES UNDER 1 YEAR OF AGE 1963. 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. 7 - - - 7 1 - - - 8 Un- Certified. - - - - - - - - - - Asphyxia 1 - - - 1 - - - - 1 Bronchitis - - - - - 1 - - - 1 Congenital heart disease 1 - - - 1 - - - - 1 Congenital Malformation 1 - - - l - - - - 1 Other defined diseases 2 - - - 2 - - - - 2 Prematurity 2 - - - 2 - - - - 2 -34-