GREF 11 1911. GREENFORD URBAN DISTRICT COUNCIL. Annual Report of GEORGE HOPE, d.p.h., l.r.c.p.. m.r.c.s. and l.s.a. (London). Medical officer of health. London: Francis A. Perry, Printer, 4, Kirchen Road, West Ealing, W. 1912. 1911 GREENFORD Urban District Council. CENSUS. 1901 1911 Area in Acres 3,041 3,041 Inhabited Houses 162 222 Total Tenements 179 222 Population 819 1,064 Population per House 5.05 4.7 Population per Acre 0.27 0.34 Inhabited Houses per Acre 0.05 0.07 7 I have personally made visits to 16 premises and 4 visits of reinspection. Premises and Occupations which can be Controlled by Bye-law or Regulations. We have no lodging houses nor cellar dwellings in the District, and the only offensive trade is that of a bone boiler and tallow melter, carried on by Messrs. Hornett, Foster & Co. This was fully referred to in my last Annual Report. Complaints are still received from time to time of obnoxious odours from these works. With an offensive trade of this description being carried on there is certain to be cause of complaint, but whilst the Company are doing all they can to minimise these offensive odours, the Council cannot take further steps, considering the comparatively isolated position of the building and the absence of illness in the immediate neighbourhood. At the same time I advise frequent visits from the Sanitary Inspector to see that the bye-laws which you adopted especially to deal with this business, are being rigidly observed. The experience the Council have had with this instance of an offensive trade should make them cautious in granting their permission to the commencement of another. The Surveyor mentioned in his report to the Works Committee on November 20th that he had received a letter from Messrs. Cleaver, saying that a firm of soap makers and perfumers wish to establish a factory at Park Royal, and asking if there are any restrictions. He properly replied that the trade was an offensive one, and would require the sanction of the Council. Schools. There is only one Public Elementary School in the District, and this is under the supervision of the Education Committee of the Middlesex County Council. There has been no serious outbreak of illness amongst the scholars during the year. On the 20th April, however, I received notification of 4 cases of measles at Perivale (this disease being compul- 8 sorily notifiable in this District). Perivale, being comparatively isolated from the other hamlets, the children from which attend the same school. I communicated with Dr. Young, the County and School Medical Officer, and he agreed with my suggestion that children from this part of the District should be excluded. This was done, and there were no cases supervening at the school. Food. Milk Supply. The conditions referred to under this heading in my last Annual Report remain the same. I have not received any complaints of nuisances, nor illness of an infectious nature on any of the premises from whence milk is supplied, and there has been no question as to the wholesomeness of the milk produced within or imported into the District. Other Foods. Most of the food consumed is purchased in the surrounding Districts, there being only a few small local shops. The Sale of Food and Drugs Act is administered by the Middlesex County Council. There are no bakehouses in the District. The few shops consist of general grocery and provision stores, and two butchers. In connection with one of the latter, there is a slaughter house, which was referred to fully in my last Annual Report. Several complaints were made about the insanitary condition of these premises, so much so, that when a renewal of the licence (which was only granted by the Council for twelve months) was asked for, the Sanitary Committee, at their meeting on April 12th, recommended to the Council that the application for the licence could net be entertained until the premises were put in a better condition. It was accordingly refused by the Council at their meeting on April 9 24th, but was subsequently (on May 29th) granted on condition that no nuisance should be created. In December an application was made, asking the Council to transfer this slaughter house licence to a new building which was proposed to be erected, but the application was refused. Housing. The housing accommodation of the District is at present satisfactory. The houses or cottages are dotted about in groups, with plenty of space, back and front. There ate no "back-to-back" houses, alleys, or slums. Consequently it was not necessary to make any inspections under and for the purposes of sec. 17 of the Act of 1909. Any insanitary conditions found were mostly due to the want of personal cleanliness in the occupants themselves. Any other have been remedied as required by notice from the Sanitary Inspector. The supervision over the erection of new houses has been very carefully carried out by your Surveyor as is shewn by his reports from time to time as to the attempt in several instances to deviate from the original plan of the building submitted and approved of by the Council, and the refusal of the Council on several occasions to pass plans for buildings contravening the bye-law on the subject made in 1901. Town Planning. The Council at their meeting on July 3rd resolved that the Town Planning Committee, consisting of the whole Council be hereby re-appointed. Many meetings of this Committee have been held throughout the year. At the meeting on August 8th it was resolved to recommend that the Council should, after two months, consider the application of the Local Government Board for permission to prepare a Town Planning Scheme for the whole or certain parts of the district. This was agreed to at the Council meeting on September 5th and the neighbouring 10 Districts were asked to co-operate in the matter. At the meeting of the Committee held on November 16th it was resolved that the whole of Greenford and Perivale parishes be included in the scheme, and it was agreed that the width of "through roads" should be fixed at not less than 60 feet, recently reduced to 50 feet. New roads, shown on the Surveyor's map, were provisionally agreed upon. The Committee is still persevering in their arduous work preparatory to applying to the Local Government Board for permission to prepare a scheme. Workshops, Work-places, etc. By referring to the Special Form of the Home Office attached to this Report, it will be seen that we have very little to do under this heading, most of the duties being under the supervision of the Inspector of Factories I may mention, however, that during the month of April, an outbreak of lead poisoning occurred at the Purex Lead Works. These cases were not notified to the Home Office as they should have been by the medical attendants, and subsequent to a visit of an inspector several notifications were sent to me under the misapprehension that the notification was to be made as in the case of an ordinary scheduled infectious disease. I believe there are very few general medical practitioners aware of this provision in the Factory and Workshop Act. In this case neither the medical attendant at the factory nor the factory surgeon appeared to do so, as they both sent the notification to me. The Home Office subsequently took legal action in the matter. C.—Sanitary Administration of the District. 1.—The Sanitary Inpector is also Surveyor and Rate Collector. As Inpector he has chiefly been engaged in attending to complaints of nuisances such as are generally found in rural districts, e.g., the pollution of water courses and ditches, offensive pig sties, the inspection of cow sheds, etc. 11 All the notices he has served for the abatement of nuisances have been complied with, without having recourse to legal proceedings, and he has seldom had to call in my assistance. 2.—We have 110 hospital for cases of acute infectious diseases or tuberculosis, but arrangements have been made for the reception of the former into the Ealing Isolation Hospital. The charge, however, is very high, viz., two and a half guineas per patient per week; and as regards the latter (tuberculosis) I understand that arrangements are being made, which wilt be completed by about next April, for the reception of suitable cases into the conjoint Small Pox Hospital at South Mimms. 3.—No action has been taken under local or adoptive acts. The following is a list of the latter in force in the District, with the Bye-laws made by the Council:— 12 Adoptive Acts, Bye-Laws and Regulations in Force. Infectious Diseases (Prevention; Act, 890, —Adopted in 1902. Public Health Act Amendment Act, 1890. fart III. — Ditto 1900. Housingof the Working Classes Act, 1890, Partlll.—Ditto 1903. The Public Health Act Amendment Act, 1907, has not been adopted. Common Lodging Houses No Bye-laws. Slaughter Houses do. do. Cleansing,&c., and removal of Refuse —Bye-laws made in 1901. Houses let in Lodgings Tents, Vans, Sheds, &c. Hop-Pickers' Lodgings Fruit,&c., Pickers'Lodgings No Bye-Laws. Public Mortuaries Public Cemeteries Public Lodging Houses Prevention of Nuisances —Bye-Laws made in 1901. Keeping Animals —Included in Bye- Laws as to Nuisances. Offensive Trades —Bye-Laws made in 1906. New Streets and Buildings —Ditto. 1901. Removal of Offensive Matters and House Refuse Public Conveniences Public Baths and Washhouses Swimming Baths Open Spaces No Bye-Laws Markets Buildings, Limited Powers Communications between Drains and Sewers Removal of Patients Management of P.M. Room Dairies, Cowsheds and Milkshops —Regulations made 1900. 13 4.—The chemical and bacteriological work is carried out by the Clinical Research Association, of which the Council is a member. None has been required during the year, except for the analysis of a sample of water of which complaint was made and already referred to. D.- Prevalence of and Control over Acute Infectious Diseases. We have not had a single case of compulsorily notifiable disease in the District other than the cases of measles which is notifiable, and has already been pointed out under the heading of Schools. We have not had a case of scarlet fever or diphtheria notified since 1907. Non-notifiable disease causing exclusion from school has been reported to me by the schoolmaster in a few cases, chiefly ringworm. The treatment of these cases is left to the parents. There is no district or other nurse or health visitor to attend to these cases. An insurance policy is taken out annually by the Council against the occurrence of small pox in theDistrict, the premium being £20 0s. 6d. (including stamp duty). Vaccination. As Public Vaccinator for the District I vaccinated only 4 children during the year. The number of exemptions has greatly increased, and soon, at the present rate, there will be no vaccinations till there is a scare of small pox. E. Prevalence of and Control over Tuberculosis. Only two cases of Pulmonary Tuberculosis were reported during the year, one which proved fatal was notified from the Brentford Union Infirmary, an inmate of this institution for seme time previous to notification, and the other was notified from the Victoria Park Hospital and has since 14 been admitted to University College Hospital. This case was carefully watched and explicit instructions were given to the friends as to the means of avoiding infection. At the Council Meeting on May 29th the Clerk reported that he had received from the Local Government Board a Provisional Order authorising (subject to restriction) the use of the Middlesex Districts Joint Small Pox Hospital for cases of Pulmonary Tuberculosis. F.—Investigation of other Diseases. Plague. The prevention of this disease has again occupied your Council, not that there has been any special cause for alarm, but the destruction of rats, of which there are many, infesting the various outhouses connected with farm buildings, has been deemed advisable, so the Council discussed the question of providing more Virus for this purpose, and the Clerk was instructed to write to the Local Government Board as to whether they would sanction the purchase of Virus, the reply being that it was for the Council to consider whether the case of the District came within the general order of the Board of November 10th, 1910. G.—Means of Preventing Mortality in Child-birth and in Infancy. The Midwives' Act, 1902, is administered for the District by the Middlesex County Council. There are not any registered midwives residing in the District. The Notification of Births Act, 1907. has not been adopted and there is no District Nurse or Lady Health Visitor. H.—Vital Statistics of the District. (Tables i.-iv.) These tables have been considerably altered from those of previous years, owing to the Registrar General's decision to publish from the commencement of 1911 statistics for 15 administrative, instead of, as hitherto, for registration (or Poor Law) areas. The death of residents dying in other Districts, as well as those of non-residents registered therein, and the births occurring in workhouses and lying-in hospitals have been, and will in future be, allocated to their proper districts, in the case of births to the area in which the parents reside. Population. According to the Preliminary Census Report for 1911 the population was— Greenford Ward 521 Greenford Green Ward 322 Perivale 95 West Twyford 126 Total 1064 an increase of 245 on that of the Census of 1901 (which was 819). This figure at the Census of 1891 was 660. Your Surveyor reports to nie that there are at present the following number of occupied houses in the District:— Greenford 201 Perivale 18 West Twyford 13 Total 232 The only institution for the reception of the sick is that carried on by the Alexian Brothers at Twyford Abbey, where there is accommodation for the reception of sixty infirm, aged, and convalescent gentlemen. There were four deaths of inmates of this Home during the year, one occurring outside the District, viz., in the Middlesex County Asylum, Wandsworth. This latter death has teen allocated by the Registrar General to this District though strictly speaking these inmates are not residents. In only one case has the death been allocated to the proper District, viz., Brixton. 1 Births. There were 26 Births, viz., 10 boys and 16 girls, in the District during the year, and none have been credited by the Registrar as having occurred in institutions outside our area. None of the births were illegitimate. Taking the population as enumerated at the Census, 1911, as 1,064, this gives a birth rate of 24.4 per 1,000, of the population. The average number of Births for the past five years is 24.2. A return of the Births registered is sent to me monthly by the Sub-Registrar. They were located as follows:— Boys. Girls. Total Greenford 9 8 17 Greenford Green 1 6 7 Perivale 0 1 1 West Twyford 0 1 1 Totals 10 16 26 Deaths. There were 12 Deaths registered in the District, and 6 transferred by the Registrar, of residents having died elsewhere. Of the 12 Deaths that occurred and were registered in this area, two belonged to other Districts, viz., one a boy, 14 years old, of 13, Fernhurst Road, Fulham, who was accidentally drowned in the Grand J unction Canal, and another a young man, 19 years of age, who died in Twyford Abbey Home, from epilepsy, whose previous residence is given by the Sub-Registrar as 31, Torrens Road, Brixton. The Registrar General, however, has only transferred one death, which is not specified in the return I have received. I have already referred to this matter in mentioning the Home for infirm people at Twyford Abbey. 17 The average number of Deaths registered in the district during the past five years is 13.2 as against 12 this year(1911) Last year there were 19 deaths registered in the District. Eight of these occurred at the Twyford Abbey Home of Rest, and two were of other persons, also non-residents in the District, making ten that were deducted before adding the deaths of residents that occurred elsewhere, which were 6 (the same as now). This year, however, the number to be deducted is only 2 as already explained; hence the difference in the death rate, although the rate for the total deaths registered in the District is only 11.2, as against 15.9 last year. The nett. rate is 15.0 as against 12.6 last year. The deaths registered in the District were distributed as follows:— Males. Females. Total Greenford 1 4 5 Greenford Green 2 2 4 Perivale 0 0 0 West Twyford 3 0 3 Total 6 6 12 The ages at death can be seen by referring to Table III. It will be noticed that seven of the deaths occurred in people over 65 years of age; also that 4 met with violent deaths, two being drowned in the Grand Junction Canal, one being suffocated on a barge, whilst unloading at Hunt & Kennard's Wharf, and a child that was suffocated by food being lodged in its windpipe. Infantile Mortality. The number of deaths of infants under 12 months old is 2 ; the average for the past five years is 2.4. The infantile death rate—that is, the proportion of deaths to those born during the year—is 76.9 per 1,000 births. 18 That none of the 26 babies born in the District succumbed to the very fatal infantile diarrhoea that was so prevalent during the hot summer and continued into the late autumn is good testimony of the care taken of them. No doubt those infants reaped the advantage of plenty of freshair andsurvived, whereas those in neighbouring crowded districts were dying in appalling numbers every week, especially during the month of August, a circular on this subject being issued by the Local Government Board, dated 18th August, 1911. We had only one death from epidemic diarrhoea. This was of a child, twelve months old. I am, Gentlemen, Your obedient servant, GEORGE HOPE. TABLE 1 Vital Statistics of Whole District during 1911 and Previous Year. NAME OF DISTRICT, GREENFORD URBAN. Year Population estimated to Middle of each Year. Births. Total Deaths Register District Transferable Deaths. Net Deaths belonging to the District. Under 1 Year of Age At all Ages. Uncorrected Number. Number Rate. Number. Rate of Nonresidents registered in the District. of Residents not registered in the District. Number Rate per 1000 Net Births. Number. Rate. 1. 2. 3 4 5 6. 7 8. 9 10 11 12. 13. 1906 1200 19 19 15.8 15 14.1 2 2 3 157.8 15 14.1 1907 1050 22 22 20.9 8 7.6 0 4 2 45.4 12 11.4 1908 1074 31 31 28.8 13 12.0 2 6 3 96.7 17 . 15.8 1909 1086 21 21 19.3 11 10.12 0 3 3 14 2.8 14 12.8 1910 1188 28 8 23.5 19 15.9 10 6 1 35.7 15 12.6 1911 1064 26 26 24.4 12 11.2 2 6 2 76.9 16 15.0 Area of District in acres 3041. Total population at all ages 1064. Number of inhabited houses 22 0 Average number of persons per house 4.7 20 TABLE 2. Cases of Infectious Disease notified during the Year 1911 Notifiable Disease. At all Ages. at Ages. Years Under 1 to 5. 5 to 15 15 to 25. 25 to 45. 45 & up wards. Small-pox Cholera Diphtheria (including membranous croup) Erysipelas Scarlet fever Typhus fever Enteric fever Relapsing fever Continued fever Puerperal fever Plague Phthisis Under Tuberculosis Regs. 1908 1 1 Under Tubercul osis Regs. 1911. Others 1 1 Totals 2 2 Isolation Hospital.—Arrangment made with Ealing Borough Council for Scarlet Fever and Diphtheria. South Minuns for Small-pox. 21 TABLE 3 Causes of, and ages at, Death during Year 1911. Causes of Death. Deaths of the subjoined ages of "Residents'' whether occurring within or without the District Total Death whether of "Residents" or "Non-Residents" in Institutions in the District. All ages. Under 1 year. 1 and under 2 2 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upward All causes, Certified 16 2 1 1 3 2 7 3 Enteric Fever Small-pox Measles Scarlet fever Whooping-cough Diphtheria and Croup Influenza Erysipelas Cerebro-Spinal Fever Phthisis (Pulmonary Tuberculosis 1 1 Tuberculosis Other tuberculous diseases Rheumatic Fever Cancer, malignant disease Bronchitis Broncho Pneumonia Pneumonia (all other forms) Other diseases of Res piratory organs Diarrhoea and Enteritis 1 1 Appendicitis and Typhlitis 1 1 Alcoholism Cirrhosis of liver Nephritis and Bright's Disease Puerperal fever Other accidents and Diseases of Pregnancy and Parturi tion Congenital Debility and Malformation, including Premature birth 1 1 Violent Death, excluding Suicide 4 1 1 1 1 Suicides Senile Decay 3 3 2 Heart Disease 1 1 Other Defines Diseases 4 1 2 1 1 Diseases ill-defined or unknown 16 2 1 1 3 2 7 3 TABLE 4 Infant Mortality. Nctt Death from stated Causes at various Ages under One Year of age. CAUSE OF DEATH. Under 1 Week. . 1-2 Weeks. 2-3 Week 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total under 1 year. All Causes. Certified 1 1 1 2 Uncertified Small-pox Chicken-pox Measles Scarlet Fever Diphtheria and Croup Whooping Cough Diarrhœa Tuberculous Meningitis Abdominal Tuberculosis (b) Other Tuberculous Diseases Congenital Malformatio Premature Birth 1 1 1 Enteritis, Muco-enteritis Premature Births Atrophy, Debility, Marasmurs Atelectasis 1 Injury at Birth Erysipelas Syphilis Rickets Meningitis not Tuberculous Convulsions Gastritis Laryngitis Branchitis Pneumonia (all forms) Suffocation, overlying Other causes 1 1 1 1 1 2 Nctt Births in the year—26, Nett Death® in the year—2. All Legitimate.