AC4347 LIBRARY HAM 43 Metropolitan Borough of Hammersmith ft ANNUAL REPORT of the Medical Officer of Health with STATISTICAL SUPPLEMENT for the Year , 1951 by F. M. DAY, M.R.C.S., L.R.C.P., D.T.M., D.P.H. METROPOLITAN BOROUGH OF HAMMERSMITH Health Committee At 31st December, 1951 Councillor E. O'K. Finn (Mrs.), M.B.E. (Chairman) „ A. R. Mingaye (Vice-Chairman) Alderman R. J. Buckingham, L.C.C. .Councillor A. Belsham „ J. M. Chambon (Mrs.), M.A. „ E. H. Freeman J. Leach, V.C., F.C.I.S. „ A. Martin „ S. Mountier „ E. O. Russell „ E. C. Woods (Miss) „ E. A. Worne Ex officio: The Worshipful the Mayor (Councillor W. H. Brind, J.P.) CONTENTS Page Introduction 1 Staff of the Public Health Dept. 2 Section A.—Social Conditions of the Borough and Statistics 3-5 Section B.—Prevalence and Control over Infectious Diseases 6-8 Section C.—Housing 9-11 Section D.—Inspection and Supervision of Food 12-18 Section E.—Sanitary Administration 19-21 Section F.—Sanitary Circumstances of the Borough 22-25 Section G.—General Provision of Health Services in the Borough 26-31 Statistical Supplement—List of Tables 33-51 1 Town Hall, Hammersmith, W.6. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hammersmith. Mr. Mayor, Ladies and Gentlemen, I have much pleasure in presenting to you my Annual Report for 1951. It is not an exaggeration to record here that our Borough continues to enjoy a standard of health so high that there is little in the way of new outbreaks of disease which need emphasis. Infectious diseases remained low in incidence and no large outbreak of poliomyelitis occurred. Eight cases were notified to me during the year. Tuberculosis shows little sign of reducing its incidence and the total number of cases in Hammersmith was 1,852. Amongst non-infectious diseases, cancer of the lung further increased, almost entirely amongst middle-aged men. Deaths from this cause in men between the ages of 45 and 65 were more than double those resulting from tuberculosis of the lung and deaths in all age groups have more than trebled during the last 10 years from malignant diseases of the lungs. The activities of the Hammersmith Clean Food Traders' Guild and of the Hammersmith Old People's Welfare Association continued at high pressure and a great deal of very good work was done by each of these two voluntary bodies. The happy liaison between the Health Department and the medical and lay staff of the London County Council Divisional Offices continues to facilitate their public health duties, and we have been much assisted by the arrangement whereby key staff of the County Council work from offices in the Hammersmith Health Department. I have been much helped in my work by having available the services of two part-time assistants and this scheme, fostered by the good offices of the Council and its Establishment and Health Committees, has proved a great success in filling the gap caused by no longer having a full-time Deputy Medical Officer of Health. In conclusion, I would like to record my appreciation and thanks to the Mayor, Aldermen and Councillors and, in particular, to the Chairman and Members of the Health Committee, for their assistance and help in the various problems which arose, and to express to the staff my thanks for their valuable work and loyal co-operation throughout the year. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, F. M. DAY, Medical Officer of Health. 2 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December, 1951 Medical Officer of Health: F. M. Day, M.R.C.S., L.R.C.P., D.T.M., D.P.H. Assistant Medical Officers of Health {Part-Time): W. K. Calwell, M.D., D.p.H. C. M. Brebner, B.Sc., M.B., Ch.B., D.C.H. Administrative Officer: P. W. Pottier Clerical: J. C. Turner (1st Assistant) W. Robinson T. J. Hares Mrs. F. Lawford Mrs. D. Kelley D. Haynes (Temporary) Miss S. A. Clee E. Baines (Temporary) Miss I. E. Waller Miss J. Wood (Temporary) (M.O.H.'s Secretary) Senior Sanitary Inspector: W. Rigby Sanitary Inspectors: P. T. Bayes (Deputy Senior) J. E. Davies J. C. Hopkins E. W. Pike E. J. Nether C. E. Mallett G. G. Gardiner C. R. Southgate A. N. Ross J. Beagle Miss E. M. Cross Food and Drugs Inspectors: J. Collier W. J. Godden Mortuary Keeper: D. A. Mackay Medicinal Baths Superintendent: F. G. Baldwin, S.R.N. Public Analyst: F. W. Edwards, F.R.I.C., F.C.S. 3 SECTION A SOCIAL CONDITIONS OF THE BOROUGH AND STATISTICS Hammersmith is the most westerly Borough in the County of London. It has an area of 2,282.5 acres and is bounded on the north by the Borough of Willesden, on the south by the River Thames, on the east by the Boroughs of Kensington and Fulham, and on the west by the Boroughs of Acton and Chiswick. Under the control of the Council and within the Borough are 20.94 acres of public gardens and open spaces. The London County Council similarly controls 253.36 acres of public open spaces. In addition to the five pre-war housing estates, many post-war dwellings, consisting of 1, 2, 3 and 4 bedroomed flats, have been erected by the Borough Council on various sites in the Borough. Under the control of the London County Council are also six housing estates. The total length of roads in the Borough is 67 miles. There are many industries, most of which are situated in our northern extremity. When local authorities were asked to undertake activities in connection with the Festival of Britain, the Council decided to proceed with the laying out of the land now forming Furnivall Gardens (south of the Town Hall and adjoining the riverfront). As a further contribution to the Festival of Britain, the Council conceived the idea of securing the provision of a Pier adjoining Furnivall Gardens. The scheme was finally approved and arrangements were made for the actual work of construction to be carried out by the Port of London Authority. The official opening of the Gardens and Pier was performed by The Worshipful The Mayor of Hammersmith (Alderman F. L. Hewett, J.P.), on the 5th May, 1951. Parking space is available nearby and combined with the nearness of the Pier to Hammersmith Broadway, a pivotal and interchange point for very many public service transport routes, large numbers of the public can avail themselves of this new facility for river passenger traffic. The opening of Furnivall Gardens means more than just the provision of a green oasis in a built-up residential area. It celebrates the completion of yet another stage in the Council's plans for the re-development of the Hammersmith riverfront. 4 Vital Statistics (a) Population The census of the population of the Borough in 1901 was 112,239. By the 1911 census it had increased to 121,521. The census of 1921 showed the population to be 130,295 and by the 1931 census it had increased to 135,521. No census of the population was undertaken during the war years but the one taken during the year under review shows the population to be 119,317. It will be seen, therefore, that during the last half-century the population of Hammersmith has only increased by 7,078 but since the 1931 census there has been a decrease of 16,204. No epidemic resulting in high mortality occurred during the year, and the natural increase in population resulting from an excess of births over deaths has been maintained. (b) Marriages The number of marriages registered during the year was 1,220, this being a reduction of 31 as compared with the previous year. (c) Births The corrected number of births for the year supplied by the Registrar-General was 1,874. On the estimated population, i.e., 118,300, this represents an annual rate of 15.8 births per thousand persons living as compared with 16.6 the previous year. (d) Deaths During the year 1,605 deaths were registered. Adding 401 deaths of residents of this Borough transferred by the Registrar-General as having occurred in various parts of England, and deducting 494 deaths of non-residents and 15 transferable deaths which occurred, the corrected number of deaths of residents was 1,497 (795 males, 702 females). On the estimated population, i.e., 118,300, the corrected number of deaths of residents was equal to an annual rate of 12.6 deaths per 1,000 persons living, as compared with the previous year's rate of 10.8, which was the lowest on record. In the Statistical Supplement will be found a chart showing the proportion of deaths from the principal causes, from which will be seen that diseases affecting the heart and important blood vessels come first and cancer occupies third place— lung conditions having taken second place. 5 (e) Infant Mortality The number of deaths of infants under one year of age during the year was 41 giving an annual mortality rate per 1,000 live births of 22. This compares with the record rate of 17 for last year. (/) Maternal Mortality Only one maternal death occurred during the year as against one for the previous year, resulting in a death rate of 0.52 per 1,000 live and still-births. 6 SECTION B PREVALENCE AND CONTROL OVER INFECTIOUS DISEASES Infectious Diseases There were, omitting tuberculosis, 2,606 cases of infectious disease notified in the Borough during the year. 274 cases were removed to isolation hospitals. Of this number, however, 67 were subsequently returned home as they were found not to be suffering from the disease suspected. Thus, the corrected number of cases of infectious disease for the year was 2,539 as against 1,479 for the previous year. This increase was mainly due to the measles epidemic which periodically affects the total annual number of notifications. Fourteen cases of diphtheria were notified but only one case was confirmed and it is very pleasing to record that no death from this disease has occurred in the Borough during the past seven years. This is a record for the present century, if not for any previous similar period during which diphtheria has been recognised as a separate disease. During recent years great strides have been made in protecting children against diphtheria, and this service, free of charge, is carried out at clinics which are held regularly at the Infant Welfare Centres. To assist correct diagnosis the Council has made arrangements for the examination of specimens from patients sent in by doctors in doubtful or suspicious cases of diphtheria, typhoid fever, tuberculosis, etc. This service is carried out at the West London Hospital and is referred to later in the Report. Tuberculosis The number of new cases notified during the year was 208 as against 187 for the previous year. 27 more pulmonary cases were notified than last year, but there was a decrease of 6 in the non-pulmonary cases. It is to be regretted that the expected post-war drop in the incidence of this disease has not been maintained. The total number of cases on the Register of Notifications at the end of the year was 1,852 as compared with 1,779 in the previous year. Since the immediate pre-war period when the total was 859, the number of cases in the Borough has steadily increased to the figure mentioned above. Although high priority is given by the housing authorities in rehousing tuberculous persons, the acute housing shortage results in inevitable delay in obtaining satisfactory homes, at the right rent, for the tuberculous and their families. The number of deaths from tuberculosis was 44, as compared with 39 for the previous year, which was the lowest number ever recorded here. 7 Food Poisoning Thirty-two cases occurred. There were no deaths. In one case Bacillus Aertrycke was isolated as the responsible organism. Causal organisms were not isolated in the remaining cases. Foods alleged to have been involved included tinned peas, meat pie, sausages, tinned meat roll, tinned pork luncheon meat and duck eggs. Medicinal Baths The Medicinal Baths in Scotts Road, Shepherds Bush, provide for the treatment of scabies, impetigo, and the cleansing of verminous persons, etc. The figures showing the numbers dealt with during the year will be found on reference to the table in the Statistical Supplement. Although there has been a slight fall in the incidence of scabies, as compared with last year, there has been an increase in the verminous conditions requiring treatment at the Medicinal Baths. Disinfection of bedding, linen, etc., of infectious disease case at Hammersmith Medicinal Baths. 8 Return of disinfected bedding to home of case. The County Council continue to use this centre for the treatment of school children and special attention has been given to head infestations at the Welfare Centres and at the Day Nurseries. Advice has also been given as to the best methods of eradication and of preventing recurrence. Infested school children, together with their contacts of pre-school age, have been followed up in the home. Facilities for cleansing at the Medicinal Baths have been made available in all cases. The mobile team, which is available for dealing with homes that require spraying and other treatment, was again actively engaged, and during the year 279 premises were sprayed for vermin (613 rooms) and 146 premises for infectious disease (254 rooms). Particulars of bedding and articles of clothing, etc. collected from premises and removed to the Medicinal Baths for disinfection purposes during the year are summarized in a table in the Statistical Supplement. 9 SECTION C HOUSING Rehousing Applications for rehousing by the Borough Council are made to the Housing Department, 218, Goldhawk Road, Shepherd's Bush, W.12. Requests are received from the Housing Estates Manager asking for inspections to be made with a view to ascertaining whether a family is living in overcrowded conditions. Enquiries are then made by the Sanitary Inspectors and, if a family is found to be living in such conditions, overcrowding is duly certified. In many cases the request is accompanied by medical certificates supporting the family's application on medical grounds, and careful consideration is given that recommendations are made only for the most urgent cases, having regard to the nature of the illness, the condition of the premises and the amenities available. Applications for rehousing by the London County Council are made to that body, and requests are received from them via the Housing Estates Manager, for similar enquiries to be made. In cases where there is medical evidence the Medical Officer of Health to the London County Council is responsible for allocating priorities on health grounds. Reports are also asked for and supplied in regard to existing overcrowding and sanitary condition of premises. 445 enquiries regarding rehousing were received in the Department during the year. 243 families were found upon investigation to be living in overcrowded conditions, and particulars of this overcrowding were passed to the Housing Department for transmission to the London County Council. 37 cases were recommended for rehousing on grounds of health, tuberculosis, inadequate hygienic facilities for the proper care of babies and young children and many other serious conditions. In addition to the above, a recommendation for rehousing of a special character was made to the Borough Council's Housing Department in cases where the applicant represented a recently married family who were expecting a baby, or where there were young children already living in unhygienic surroundings which I considered inadequate to maintain the high level of health which is so important in the family unit in its early stages. These applications are most important as health deficiencies are probable without housing improvement. In spite of their many difficult responsibilities the Housing Department have agreed to accept these recommendations and 10 do the best they can in each case. During the year 8 such recommendations were made to the Housing Estates Manager. The remainder of the cases were found to be living in circumstances which were not considered sufficiently necessitous to recommend. Although the construction of new homes by the Borough Council and the London County Council continued, the number of families on the Council's waiting list at the end of the year was 7,456. The following table shows:— 1. Number of families rehoused by the Borough Council in new flats since the war 541 2. Number of families rehoused by the Borough Council in rebuilt houses since the war 30 3. Number of families rehoused by the Borough Council in prefabricated dwellings since the war 80 4. Number of Borough Council licensees living in requisitioned properties at the end of the year 1,737 I am informed by the Director of Housing and Valuer of the London County Council that since the 1st July, 1945, 1,378 families living in this Borough have been accommodated by the County Council and, in addition, 955 of the Council's tenants resident in Hammersmith have been transferred to other accommodation making a total of 2,333 families rehoused by the senior authority. Overcrowding (Section 61) Section 61 of the Housing Act, 1936, provides that a local authority may, on the application of the occupier or intending occupier of a dwelling house in their district, grant him a licence authorising him to permit such number of persons in excess of the permitted number as may be specified in the licence to sleep in the house. During the year four such licences were granted, the grounds generally speaking being natural increase in the number of tenants. Slum Clearance During the year it was announced that the Minister of Local Government and Planning had agreed to Slum Clearance Schemes being undertaken in the County of London by the County Council and the Metropolitan Borough Councils on the basis of approximately 3,000 houses per year for the next five years. The Borough Council announced its intention to designate Latimer Mews as a Clearance Area on my recommendation. Other particulars relating to housing will be found on reference to the table in the Statistical Supplement. 11 Building Licences The arrangements existing for dealing with applications for building licences have continued in operation throughout the year. The Sanitary Inspectors have continued to investigate and report upon all applications. The number of applications received during the year was 790, and were dealt with as follows:— Recommended (with or without modification) 649 Work carried out free of licence 70 Subsequently cancelled by applicant 27 Referred to Ministry of Works 35 Not recommended 8 Referred to other Authorities 1 790 Landlord and Tenant (War Damage) (Amendment) Act, 1941 Applications for certificates of fitness for housing purposes are dealt with by the Senior Sanitary Inspector. No application was received during the year. 12 SECTION D INSPECTION AND SUPERVISION OF FOOD Food and Drugs Act, 1938 Meat and Other Foods Shops, stalls, vehicles and premises where food intended for human consumption is prepared, stored, etc., were subjected to routine inspection throughout the year. The number of visits made to this class of premises during 1951 totalled 3,725. At 50 of these premises unsatisfactory conditions constituting contraventions under Section 13 of the Food and Drugs Act, 1938, were found to exist and appropriate action was taken. Legal proceedings were taken in one case, and penalties and costs amounting to £5 6s. 0d. were imposed. Four seizures of unsound chocolate were made under Section 10 of the Act. In each case the chocolate was rendered unfit by the larvae of the cacao moth (Ephestia Elutella). Investigations were made into the source of the infestation and the matter reported to the Ministry of Agriculture and Fisheries. As distinct from the above, a large quantity of unsound foods which did not call for action under Section 10 of the Food and Drugs Act, 1938, was voluntarily surrendered. A considerable percentage of this consisted of imported tinned hams. These hams (average weight 14 lbs.) came mainly from Austria, Belgium, Denmark, France, Germany, Holland, Italy and Poland. It was generally found that the chief causes of unsoundness were due to (a) under cooking, (b) poor tin plate, (c) improper curing, (d) punctured and damaged tins. The source of most of these faults would appear to be economic factors governing production or inexperience in canning practice. Sampling 1,600 samples of food and drugs were submitted to the Public Analyst during the year for chemical analysis. Of this number, 2 informal samples and 1 formal sample were reported to be non-genuine. This represents only 0.18 per cent. and shows a further decrease in comparison with the low figure of 0.4 per cent. reported last year. Sampling of food for the purpose of identification has been continued and in the case of one sample of apples sold as Cox's Orange Pippins, identification showed them to be Charles Ross. In this instance, legal proceedings were taken, a plea of guilty was made, and three guineas costs were awarded against the vendor. A number of samples of shellfish sold from stalls and barrows in the Borough taken for bacteriological examination were found to be satisfactory. 13 Markets The three markets situate in the Borough at Bradmore Lane, Railway Approach and Norland Road have been visited frequently by the Inspectors. The large amount of foodstuffs sold in these markets was found to be of a satisfactory standard. Merchandise Marks Act, 1926 Regular inspections were carried out under this Act and, in two cases concerning the sale of imported tomatoes, legal proceedings were taken resulting in the imposition of fines and costs amounting to £5 10s. 0d. Ice Cream Fifteen premises were registered for the sale of ice cream during the year. At the end of 1951 the total number of registrations in compliance with Section 14 of the Act was 232. The Food and Drugs Inspectors made 259 visits to premises where ice cream is sold, stored, or manufactured. For some time past, there have been persistent demands by local authorities and the public for a chemical standard for ice cream. The trade has always been in favour of the introduction of such a standard, providing the necessary materials were available. Following an improvement in the supply of fats and milk powder, and acting on the recommendation of its Food Standards Committee, the Ministry of Food has made the Food Standards (Ice Cream) Order, 1951, prescribing minimum standards of composition for ice cream. The Order, which came into force in March, 1951, provides that ice cream must contain at least 5 per cent. fat, 10 per cent. sugar, and 7½ per cent. milk solids other than fat. For ice cream containing fruit, the content of non-fatty milk solids may be reduced, but the total content of fat, sugar and "milk solids not fat" must be at least 25 per cent., with minimum contents of 1½ per cent. fat, 10 per cent. sugar and 2 per cent. milk solids not fat. Since the consumption of meat and milk at the same meal is prohibited by Jewish Dietary law, a minimum standard of 10 per cent. fat and 14 per cent. sugar with no milk solids is prescribed for parev (Kosher) ice cream. The standard is not intended to apply to water ices sold as such or to "ice lollies". The Ministry has made it clear, however, that it regards the standard as an interim one which can be improved as supplies of ingredients become more plentiful. During the year 1951, 15 samples of ice cream were taken for chemical analysis. 1 sample was reported to be 32 per 14 cent. deficient in fat and 26.6 per cent. deficient in non-fatty solids. Legal proceedings were taken in this case and the vendor was fined £2 0s. 0d. with one guinea costs. In addition, 49 samples of ice cream were taken for bacteriological examination. The results of the methylene blue test are as follows:— 29 samples were within Grade 1 standard. 12 samples were within Grade 2 standard. 3 samples were within Grade 3 standard. 5 samples were within Grade 4 standard. Milk The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, and the Milk (Special Designation) (Raw Milk) Regulations, 1949, which became operative on the 1st October, 1949, re-enact with amendments the provisions of the Milk (Special Designations) Regulations, 1936/1948. Briefly, they require the licensing of traders selling sterilised milk in addition to those selling pasteurised and tuberculin tested milks. A person proposing to sell a special designation as laid down by the Regulations must apply to the licensing authority of the area in which the premises from which the milk is to be sold for a licence to use such designation. Where a distributor holding a Dealer's Licence in one area wishes to sell the same designation in another area the latter authority must issue a Dealer's Supplementary Licence authorising the use of such designation. The following table shows the number of licences issued under the above Regulations during the year. Dealer's (Pasteuriser's) Licence 3 Dealer's (Steriliser's) Licence 1 Dealer's (Bottling) Licence 1 Dealer's Licences Tuberculin Tested 57 Pasteurised 64 Sterilised 73 Dealer's Supplementary Licences Tuberculin Tested 13 Pasteurised 16 Sterilised 17 15 Milk Supplies At the close of the year 301 inspections of premises in the Borough used in connection with the processing and distribution of milk had been made by the Food and Drugs Inspectors. Generally, the premises were found satisfactory. In only 8 cases was it found necessary to send warning letters in respect of unsatisfactory conditions. The Milk and Dairies Regulations, 1949, control the registration of premises and provide for the protection of milk against contamination throughout its stages of production and sale. It was found that the most frequent contravention under these regulations related to the use of bottles from which all foreign matter had not been removed. It is an unfortunate fact that milk bottles lend themselves to many kinds of abuse. Because of their convenient shape and size they are at times used for purposes other than for which they were designed, e.g., the holding of paraffin, motor oil, paint, cement and flowers, etc. Occasionally, fly larvae, beetles, snails, etc. have been found in bottles of milk. In the cases where fly larvae are found, the residue of milk left in the bottles attracts these creatures. Sour milk attracts the vinegar fly, and invites her to oviposit. Bottles are frequently left on waste ground and building sites and when they eventually reach the milk depots many are so dirty that they have to be smashed or subjected to special treatment, even the most modern bottle washing plant being inadequate to deal with contamination of this description. I feel that the Regulations do not go far enough, for, although it is an offence for a distributor or dairy farmer to return empty milk bottles, etc., in a dirty condition, no similar restriction is imposed on the consumer. 80 samples of Special Designated milk were submitted for the phosphatase, methylene blue and turbidity tests, the results of which are set out below:— Class of Milk No. Tested Phosphatase Test Meth. Blue Test Turbidity Test Passed Failed Passed Failed Passed Failed Pasteurised 49 49 — 49 — 1 — T.T. Pasteurised 16 16 — 16 — — — Tuberculin Tested 3 — — 3 — — — Sterilized 12 — — — — 12 — Total 80 65 — 68 — 12 — 16 In addition, 28 formal samples of milk were submitted to the Public Analyst for chemical analysis, all of which were reported as genuine. Public Health (Condensed Milk) Regulations, 1923/1948 These regulations provide standards for milk fat and milk solids of condensed milk and control the labelling of tins or other receptacles. During the year, 14 samples were submitted for examination to the Public Analyst and were reported genuine. Slaughterhouses In accordance with the Livestock (Restriction on Slaughtering Order), 1940, the two private slaughterhouses have not been used during the year, but the licences have been renewed by the occupiers. Hammersmith Clean Food Traders' Guild The Hammersmith Clean Food Traders' Guild continued to operate during the year. This Guild, which was formed in 1949 with the object of securing an improvement in the conditions under which foodstuffs are prepared and sold in the Borough, is controlled by a Committee consisting, mainly, of representatives of the various sections of the food trade, although the Health Committee has representation thereon. To qualify for membership a trader's premises must comply with all legal requirements and be approved by the Medical Officer of Health and the trader must give an undertaking that he will conform to a "Code of Practice" adopted by the Guild. In a number of respects the "Code of Practice" calls for a higher standard of hygiene than can be enforced under present legislation. The conditions of membership provide that reports shall be submitted to the Committee at least once a year in regard to each trader's premises. For this purpose special inspections were made by the Food and Drugs Inspectors and the Sanitary Inspectors, in addition to the routine inspections which they made of food shops and factories. The reports indicated that the standard required by the Guild was, generally, being well 17 maintained. In only a few instances was it necessary to call attention to a departure from the Code of Practice and in such cases the deviation was soon remedied. At the end of the year the membership of the Guild was 113. The propaganda commenced during the previous year was continued during the period under review. Talks on "Clean Food" were given to the employees of several traders and lectures were arranged for school children, women's institutes, Church guilds and other similar organisations. These talks were illustrated by film strips projected by a portable diascope which the lecturer took with him. Early in the year a "Brains Trust" was held in the Town Hall to which the general public were invited. The team of Food Inspector checking bottle washing plant at delivery end. 18 Examination of beef carcase by Food Inspector. experts, which included the Chairman of the Guild, the Chairman of the Health Committee, Mr. Morley Parry of the Ministry of Food and the Medical Officer of Health answered questions put to them from the audience ranging over a wide field and covering most aspects of Food Hygiene. In May, a Clean Food Exhibition was held in the Small Hall at the Town Hall. Exhibits provided by the Ministry of Food, the Ministry of Agriculture and Fisheries, the Central Council for Health Education, the Public Health Department and the Guild, illustrated the necessity for care in the handling of food, the dangers which might arise as the result of improper practices and the best methods to be adopted in the preparation, storage and exposure for sale. Food care in the home was also covered by exhibits. It is estimated that between 2,500 and 3,000 members of the general public visited the exhibition during the week that it was open. Each day visiting parties of children from the senior schools in the Borough, joined in specially designed demonstrations. 19 SECTION E SANITARY ADMINISTRATION Staff The inspectorate at the end of the year consisted of one Senior Sanitary Inspector, eleven district inspectors, two Food and Drugs Inspectors and one woman Sanitary Inspector, with vacancies for one permanent and two temporary inspectors. Exhumation and Re-interment of Bodies During the year twelve licences were granted by the Secretary of State for the exhumation and removal of bodies from graves in St. Mary's Catholic Cemetery, Harrow Road. Each of these was attended by the Sanitary Inspector for this area and in each case it was possible to certify that the removal was carried out in a proper manner. Increase of Rent and Mortgage Restrictions Act, 1920/39 During the year nine applications were received for certificates under the above Act and in five cases certificates were granted. This total includes four applications from owners, all of which were issued as the work specified had been completed satisfactorily. Coroner's Court and Public Mortuary An increase in the number of bodies admitted to the Public Mortuary and the number of post mortem examinations conducted, occurred during the year. There was, however, a decrease in the number of inquests held. The Mortuary was closed for four weeks during the month of August and during this period twenty-two bodies which normally would have been admitted were taken to the Kensington Mortuary, kindly made available to us by the Royal Borough. The Mortuary and Court were also used by the Boroughs of Fulham, Chelsea and Kensington. The Mortuary is equipped with a large refrigeration plant and this ensures a completely satisfactory standard of hygiene. An additional assistant Mortuary Keeper was appointed during the autumn and it is the intention that the work of the part-time cleaners shall be absorbed by the male staff. Furthermore, by staggering the staff's working hours, a more even distribution of attendants will be possible. 20 Rag Flock and Other Filling Materials Act, 1951 The above Act, which came into operation on the 1st November, 1951, makes it compulsory for premises where certain prescribed filling materials are used in any form of upholstery, including the stuffing or lining of bedding, toys, baby carriages, etc., to be registered with the local authority. It is also necessary for premises where rag flock is manufactured or stored to be licensed. The fee for registration is £1 0s. 0d. The regulations also provide that the occupiers of registered premises must keep records of all filling materials consigned to the premises to which the Act applies and of all second-hand articles containing such filling materials. The occupier of premises licensed for the manufacture of, or storage of rag flock must keep records of all rag flock consigned from those premises. All records must be properly kept, and must include appropriate details of the trade being carried on. An advertisement has been issued in the local Press drawing attention to the requirements of the Act regarding registration and licensing. Up to the end of the year eight certificates of registration of premises were granted. Pharmacy & Poisons Act, 1933, and Pharmacy and Medicines Act, 1941 The names and addresses of 109 retailers were entered on the Council's list of persons entitled to sell poisons under Part 2 of the Pharmacy and Poisons Act, 1933, and Pharmacy and Medicines Act, 1941. No action was necessary in respect of any offence under the Act. All have been inspected as to their suitability, method of storage and labelling, as required under the Act, and have been found satisfactory. Shops Act, 1950 Section 38, sub-section (2) of the Shops Act, 1950, provides that in every shop, not being a shop exempt from the provisions of this sub-section, there shall be provided and maintained suitable and sufficient sanitary conveniences available for the use of persons employed in or about the shop. 21 It is provided by sub-section (6) that a shop may be exempted from the provisions of sub-section (2) if there is in force a certificate exempting the shop therefrom granted by the Borough Council, whose duty it is to enforce the necessary provisions. A certificate may be granted by the Borough Council if they are satisfied that by reason of restricted accommodation or other such circumstances it is not practicable to provide such accommodation on the premises, and that alternative arrangements are conveniently available. During the year one such certificate was issued. In one case a certificate of exemption, which had previously been issued, was withdrawn. The Borough Council is also responsible for securing compliance with the provisions regarding heating and ventilation. 22 SECTION F SANITARY CIRCUMSTANCES OF THE BOROUGH Water Supply The Metropolitan Water Board is responsible for the water supply of the Borough and no complaints with regard to the condition of the water were received during the year. 171 certificates were granted under Section 95(2) of the Public Health (London) Act, 1936, with regard to newly erected houses and flats having a proper and sufficient water supply. Public Cleansing The Borough Engineer and Surveyor, who is responsible for supervising the collection, removal and disposal of refuse, has kindly furnished the following information with regard to this service. Tons Amount of house refuse collected—House Refuse 25,015 during year 1951 (including—Salvage 594 salvage and kitchen waste) —Kitchen Waste 3,620 29,229 Method of disposal By barge from Hammersmith to Mucking (River Thames). Controlled tipping at Mucking on reclaimed land. By Contractor. Frequency of collection House refuse collected weekly. (Trade refuse by arrangement, as required.) Drainage The bye-laws made by the London County Council under the Metropolis Management Acts with regard to drainage, and also those under the Public Health (London) Act relating to water closets, etc., are enforced by the Council. During the year 119 drainage plans (17 combined drainage). were submitted and approved, and a total of 1,594 inspections were made in connection with supervision of drainage works. In three cases drainage work was carried out under Section 40 of the Public Health (London) Act, 1936, by the Borough Engineer and Surveyor's Department, in default of the owner. 23 Dustbins By Section 105 of the Public Health (London) Act, 1936, if any house is without a sufficient ashpit (dustbin) the Council may serve a notice on the owner or occupier requiring him to make such provision, and the notice may include direction as to the number, material, size and construction of the dustbins to be provided. Prior to 1st August, an appeal against the service of the notice could be made to the London County Council. Two such appeals were made and in each case the decision of the Appeals Committee of the County Council upheld the action of the Borough Council. With the coming into force of the London County Council (General Powers) Act, 1951, on the 1st August, the appeal tribunal was altered from the London County Council to a Court of Summary Jurisdiction. No appeals were made to the Court. Sanitary Inspection The sanitary conditions of the Borough were subject to routine inspection and investigations were made into all complaints received. Particulars of visits made by the Sanitary Inspectors during the year, the numbers of preliminary and statutory notices served and complied with, and proceedings instituted, will be found on reference to the table in the Statistical Supplement. Owing to the resignation of two inspectors during the year the house-to-house inspection programme has, unfortunately, been held up. 368 inspections were made and 135 notices served for defects found in the house-to-house programme during the year. Advertisements have been issued for the appointment of one permanent and two temporary sanitary inspectors and as soon as the appointments are made this programme will be resumed. Factories During the year 56 notices were served relating to insanitary conditions found to exist during the inspection of factories in the Borough and 45 notices were complied with. In the Statistical Supplement will be found a table which has been prepared in accordance with the form prescribed by the Minister of Labour and National Service on the administration of the Factories Act, 1937, dealing with factories (mechanical and non-mechanical) and outwork. 24 Rodent Control Prevention of Damage by Pests Act, 1949 Under Part 1 of the above Act the Council now has a primary duty to ensure that, as far as is practicable, its area is kept free from Rats and Mice. Whenever, therefore, premises are visited for any reason, an inspection or enquiries are made by the Sanitary Inspectors as to rodent infestation, in addition to following up complaints of Rodents. This accounts for the increase in the number of premises inspected for Rats and Mice and resulted in 20 rat and 96 mice infestations being discovered. These were mostly of a minor character, but the early action no doubt prevented many becoming major infestations. Under the Act, failure by Occupiers to give notice of infestations in "Substantial Numbers" renders them liable, on summary conviction, to a fine of £5. No cases were discovered which warranted legal action being taken, and I feel that the continuance of the present drive will bring greater co-operation from the public towards Rodent Control. The number of complaints (440) is less than in 1950 (451), but 550 premises were treated as against 453 in 1950 because of the infestations "discovered". No "ship" (Black) rat infestation has been found in the Borough. Rat infestations have decreased from 404 to 324. Mice infestations have increased from 137 to 226. The number of mice infestations in large buildings have increased. Individually this type of treatment presents greater difficulty than the more straightforward rat infestations. Frequently rat infestations have come from defective drainage. To enable more efficient smoke testing of drains, a "long distance" drain stopper, specially designed in the Department, now makes it possible to test many drain connections to sewers which could not otherwise be tested because the sewer was less than three feet in diameter. The use of this "stopper" also reduced the need to employ sewermen in some other cases. Notwithstanding this, sewermen have had to be used on many more occasions than hitherto, and this accounts for the increase in the charges made by the Borough Engineer to Rodent Control. The sewer system has been poison-baited twice during 1951 by the Borough Engineer's Department in accordance with the requirements of the Ministry of Agriculture and Fisheries. 25 Approximately £200 was received for the treatment of 100 business premises by the Council's Rodent Operatives. 13 Notices were served under the above Act, and of these 11 were complied with by the owner or occupier. In the remaining 2 instances the work was carried out by the Council in default and the cost thereof charged to the owners. 134 Notices were served under the Public Health (London) Act for defective drains, etc., causing rat infestations. A new Rodenticide, "Warfarin", has been approved and should make a valuable addition to our list of poisons. From the foregoing it is fair to say that Rodent infestation in the Borough is well under control. The Ministry of Agriculture now require detailed records of all work done under the Act, and the following summary shows the main figures required. Summary Number Premises inspected: Dwellings, 1,082. Business, 869 1,951 Complaints of Rats and Mice 410 Premises infested by Rats: Dwellings, 252. Business, 72 324 Premises infested by Mice: Dwellings, 192. Business, 34 226 Properties treated 550 Statutory Notices served 13 Prosecutions Nil Inspections and Re-inspections by Sanitary Inspectors re Rodent Control 3,120 26 SECTION G GENERAL PROVISION OF HEALTH SERVICES IN THE BOROUGH Laboratory Facilities The chemical analysis of food is carried out by the Public Analyst at the City of Westminster Depot, Monck Street, W.l. The food and drugs part of the Council's bacteriological examinations are dealt with at the Public Health Laboratory, Colindale, and the Borough Council have arranged for the convenience of local doctors and their patients that various bacteriological investigations are made at the West London Hospital. Our work at this laboratory includes the examination of throat swabs and intestinal specimens, etc., and the service is of much benefit in view of its immediate availability. Throat swabs and faeces outfits are supplied free on application to the Public Health Department to all medical practitioners practising in the Borough. Ambulance Facilities The London County Council is responsible under the National Health Service Act, 1946, for the provision of ambulance facilities within the administrative County of London. Hospitals The undermentioned hospitals are situated in Hammersmith:— Hammersmith Hospital, Ducane Road, W.l2. Queen Charlotte's Maternity Hospital, Goldhawk Road, W.6. Royal Masonic Hospital, Ravenscourt Park, W.6. West London Hospital, Hammersmith Road, W.6. Hammersmith Hospital and West London Hospital are designated as teaching hospitals and together with St. Mark's Hospital, Chelsea, are under the control of a joint board of governors. The Royal Masonic Hospital is a private hospital and Queen Charlotte's is a maternity hospital with its own board of governors. It is one of the largest of its kind in the country. 27 The Hammersmith Chest Clinic established at Hammersmith Hospital continued to function during the year, and sessions are held regularly at the following times:— Monday mornings 9 a.m. evenings 5 p.m. (contacts). 6 p.m. (refill). Tuesday mornings 9 a.m. afternoons 2 p.m. (refill). Wednesday afternoons 2 p.m. (children—tests). Thursday mornings 9 a.m. afternoons 2 p.m. (refill). Friday mornings 9 a.m. afternoons 2 p.m. (children). All new patients should bring a letter of introduction from their family doctor. Personal Health Services These services, as distinct from the environmental health service for which the Metropolitan Boroughs continue to be responsible, became the responsibility of the London County Council on the 5th July, 1948. For this purpose, Metropolitan Boroughs form nine divisions, and Hammersmith, together with the boroughs of Chelsea, Fulham and Kensington, comprises Division 1. The offices of Division 1 are at 129 Fulham Palace Road, W.6. Dr. Violet I. Russell, the Divisional Medical Officer, is responsible for the administration of the services. The day-today administration is carried out by the Medical Officer of Health in each of the Boroughs. Very happy relations continued to exist between the staffs of the County Council and the Borough Council, and this pleasing state of affairs is reflected in the first rate standard of service provided for the public. The following is a list of the various clinics:— Ante-natal Clinics 1/3 Milson Road Monday 1.30 p.m. Tuesday 9.30 a.m. Friday 9.30 a.m. 48 Glenthorne Road Monday 6p.m. Tuesday 1.30 p.m. Thursday 9.30 a.m. Friday 1.30 p.m. Becklow Gardens Monday 1.30p.m. Tuesday 9.30 a.m. Thursday 9.30 a.m., 1.30 p.m., 6 p.m. 28 The Curve, Westway Monday 9.30 a.m. Wednesday 9.30 a.m., 1.30 p.m. The Library, College Park Tuesday 1.30 p.m. Infant Welfare Centres 1/3 Milson Road Wednesday 9.30a.m. Thursday 9.30 a.m., 1.30 p.m. Friday 1.30 p.m. 48 Glenthorne Road Tuesday 1.30p.m. Wednesday 1.30 p.m. Thursday 1.30 p.m. Friday 9.30 a.m. Becklow Gardens Tuesday 1.30p.m. Wednesday 9.30 a.m., 1.30 p.m. Friday 9.30 a.m., 1.30 p.m. The Curve, Westway Monday 1.30 p.m. Thursday 9.30 a.m., 1.30 p.m. Friday 1.30 p.m. The Library, College Park Friday 9.30 a.m. Physiotherapy (Massage and Light) 48 Glenthorne Road Monday 1.30 p.m. Tuesday 9.30 a.m., 1.30 p.m. Wednesday 1.30 p.m. Thursday 9.30 a.m., 1.30 p.m. Friday 1.30 p.m. Diphtheria Immunisation 1/3 Milson Road Tuesday 1.30 p.m. 48 Glenthorne Road Wednesday 9.30a.m. Becklow Gardens Thursday 9.30 a.m. The Curve, Westway Tuesday 9.30 a.m. The Library, College Park Friday 9.30 a.m. Vaccination 1/3 Milson Road Tuesday 1.30p.m. 48 Glenthorne Road Wednesday 9.30 a.m. The Curve, Westway Tuesday 9.30 a.m. Chiropody 48 Glenthorne Road Tuesday 2 p.m. Wednesday 2 p.m. Thursday 2 p.m. During the year dried milk and other nutrients have been issued from the Maternity and Child Welfare Centres. In addition, the Ministry of Food has been responsible for National Dried Milk, Concentrated Orange Juice and Cod Liver Oil in accordance with their recognised scale of charges. 29 The County Council also maintain the following four Day Nurseries, which are available for children up to five years of age:— Brook Green Day Nursery. Dalling Road Day Nursery. Latimer Road Day Nursery. Uxbridge Road Day Nursery. Each is open on Mondays to Fridays from 7.30 a.m. to 5.30 p.m. and the charge for children received into them is 2s. 0d. per day. Domestic Help Service This service, also administered by the County Council, employs ten full-time and sixty-two part-time helpers and maintained its good and valuable work during the year. Its local headquarters are in the Public Health Department in the Town Hall. No. of cases in which help was provided:— Maternity 44 Tuberculosis 66 Other 647 1,259 visits were made to various homes by the organiser. International Certificates of Vaccination and Inoculation Arrangements continued during the year for the authentication by the Medical Officer of Health of certificates of vaccination and inoculation in the international form. These certificates are required by passengers proceeding abroad from this country and the purpose of the authentication is to provide proof to health authorities abroad that the signature of the person issuing the certificate is that of a registered medical practitioner. National Assistance Act, 1948 (a) Removal to suitable premises of persons in need of care and attention Section 47 of the above Act provides that a local authority shall be responsible for the removal to suitable premises of persons who are suffering from grave chronic disease or being aged, infirm or physically incapacitated, who are living in insanitary conditions and who are unable to devote to themselves and are not receiving from other persons, proper care and attention. It was not found necessary to apply to the Court for an Order under this section. 30 It was necessary, however, to apply to the Court on two occasions for an extension of Court Orders. 63 other cases, all elderly persons, alleged to be living without proper care and attention were reported, but in no case was it found necessary to take legal action to enforce removal to hospital. It was possible, however, to arrange the voluntary admission of five cases to hospital and three cases to an institution. One case was referred to the Duly Authorised Officer of the London County Council. Other amenities were provided for all the remaining cases reported, and included provision of nursing by the District Nursing Association, Home Help, visits by the Welfare Organiser of the Hammersmith Old People's Welfare Association, provision of invalid meals, arrangements for voluntary help, etc. (b) Burial or Cremation of the Dead It is provided that the local authority shall arrange burial or cremation in the case of any person who has died or been found dead in the Borough, in any case where it appears to the authority that no suitable funeral arrangements have been or are being made. The Council may recover from the estate of the deceased person or from any person who, for the purpose of this Act, was liable to maintain the deceased person immediately before his death, expenses incurred for the burial or cremation. During the year twenty-five burials have been carried out in Hammersmith at a total cost of £267 2s. 0d. Hammersmith Old Peoples' Welfare Association Progress during the year was very great indeed. As an index of activity, the grants made by the Council indicate the degree of expansion attained. The Association, which was formed in August, 1950, incurred its first expenditure in December, 1950. For the period December, 1950, to March, 1951, a grant of £712 was made by the Council. For the financial year 1951/2 a grant of £2,500 was made and, at the time of writing (early 1952) provision has been made for this amount to be increased to £3,000 for the year 1952/3. 31 Up to the end of the year, approximately 500 cases were on the records of the Association, and at the time of writing it is estimated that the number of persons on the register has increased to 700. The Association's sphere of activity embraces seaside holidays, two luncheon clubs, domiciliary meals to the needy, and social visitation on a very large scale. It is fully expected that the expansion that has already taken place will be followed during the next few years by further expansion and the numbers on the register will undoubtedly continue to increase. Medical Examination of Council's Staff I have been responsible for reporting to the Establishment Committee on various of the authorities' officers and servants. Examinations take place on entry to the service, during sick leave and illness and in 1951 247 examinations were made. STATISTICAL SUPPLEMENT TO ANNUAL REPORT FOR YEAR 1951 33 GENERAL STATISTICS—1951 Area 2,282.5 acres Population (1950) (estimated) 119,200 „ (1951) ( „ ) 118,300 „ „ Census (1901) 112,239 „ „ (1911) 121,521 „ „ (1921) 130,295 „ „ (1931) 135,521 „ „ (1951) 119,317 Natural increase, i.e., excess of births over deaths 377 Marriages registered 1,220 Rateable value (April, 1951) £1,231,073 Sum represented by a penny rate (April, 1951) £5,040 EXTRACT FROM VITAL STATISTICS—1951 Total M. F. Live Births Legitimate 1,739 891 848 (Birth Rate per 1,000 estimated resident population=15.8 Illegitimate 135 64 71 Stillbirths 40 22 18 Rate per 1,000 total (live and still) births=20.9 Deaths 1,497 795 702 Death Rate per 1,000 estimated average population=12.6 Deaths from maternal causes- Deaths Rate per 1,000 total (live and still) births Pregnancy, childbirth, abortion 1 0.52 Total 1 0.52 Death Rate of Infants under one year of age:— All Infants per 1,000 live births 22 Legitimate Infants per 1,000 legitimate live births 21.27 Illegitimate Infants per 1,000 illegitimate live births 29.62 Deaths from Cancer (all ages) 254 ,, ,, Measles (all ages) — ,, ,, Whooping Cough (all ages) 1 34 INCIDENCE OF CANCER DURING THE PAST 10 YEARS Year Population Deaths Rate per 1,000 1942 89,370 204 2.2 1943 92,050 206 2.2 1944 89,190 200 2.2 1945 96,100 207 2.1 1946 111,860 226 2.0 1947 117,280 253 2.1 1948 115,800 254 2.1 1949 118,440 238 2.0 1950 119,200 258 2.1 1951 118,300 254 2.1 DEATHS FROM CARCINOMA OF LUNGS Year 0—25 —45 —65 —75 +75 Total 1941 M 10 1 11 F - — 2 3 — 5 Total — — 12 4 — 16 1946 M 6 30 5 1 42 F — — 2 2 — 4 Total - 6 32 7 1 46 1947 M 3 25 7 2 37 F - — 1 1 1 3 Total — 3 26 8 3 40 1948 M 1 19 8 4 32 F — 1 8 3 1 13 Total — 2 27 11 5 45 1949 M - 7 25 13 4 49 F — — 3 1 1 5 Total — 7 28 14 5 54 1950 M 4 28 10 3 45 F — 1 3 2 2 8 Total — 5 31 12 5 53 1951 M 1 33 11 3 48 F — 1 3 3 1 8 Total — 2 36 14 4 56 35 INCIDENCE OF PULMONARY TUBERCULOSIS AND NEOPLASMS OF THE LUNG Age Groups Pulmonary Tuberculosis Neoplasms of the Lung or Bronchus 1950 1951 1950 1951 MALES 0- — — — — 1 — — — — — 5— _ — — — 15— 2 1 — — 25— 3 4 4 1 45— 17 15 28 33 65— 4 11 10 11 75— 2 1 3 3 Total Males 28 32 45 48 FEMALES 0- - — - - 1- — — — - 5- — 1 — — 15— — 1 — — 25— 6 4 1 1 45— 3 1 3 3 65— — 1 2 3 75— 1 1 2 1 Total Females 10 9 8 8 36 VITAL STATISTICS OF WHOLE DISTRICT 1951 and Previous Years Year Population estimated to middle of each year Births Total Deaths Registered in the District Transferable Deaths Net Deaths belonging to the District Number Rate Number Rate of Non-residents registered in the District of Residents not registered in the District Under 1 Year of Age At all Ages Number Rate per 1,000 Net Births Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 1925 134,500 2,351 17.5 1,034 7.7 186 756 153 65 1,604 11.9 1926 134,400 2,188 16.3 1,174 8.7 195 556 144 66 1,535 11.4 1927 132,800 2,076 15.6 1,581 11.9 230 377 126 61 1,728 13.0 1928 136,300 2,258 16.6 1,449 10.6 222 326 156 69 1,553 11.4 1929 136,900 2,162 15.8 1,757 12.8 222 340 133 62 1,875 13.7 1930 136,900 2,173 15.9 1,387 10.1 219 436 140 64 1,604 11.7 1931 135,100 2,073 15.3 1,567 11.6 288 373 140 68 1,652 12.2 1932 133,700 1,940 14.5 1,465 10.9 294 543 129 66 1,714 12.8 1933 131,400 1,827 13.9 1,500 11.4 340 530 119 65 1,690 12.9 1934 129,170 1,783 13.8 1,359 10.5 346 655 137 77 1,668 12.9 1935 128,100 1,877 14.7 1,347 10.5 406 583 131 70 1,524 11.9 1936 127,700 1,922 15.1 1,399 10.9 441 639 116 60 1,597 12.5 1937 126,500 1,913 15.1 1,333 10.5 402 662 130 68 1,593 12.6 1938 125,100 1,874 15.0 1,340 10.7 450 522 117 62 1,412 11.3 *1939 B122,800 D116,200 1,829 14.9 1,311 11.2 362 442 77 43 1,391 12.0 1940 98,320 1,600 16.3 1,725 17.5 370 401 76 51 1,756 17.9 1941 84,880 1,405 16.5 1,315 15.4 351 364 52 41 1,328 15.6 1942 89,370 1,589 17.8 1,270 14.2 356 338 94 59 1,252 14.0 1943 92,050 1,768 19.2 1,278 13.9 365 387 102 58 1,300 14.1 1944 89,190 1,788 20.0 1,447 16.2 418 389 95 53 1,418 15.9 1945 96,100 1,742 18.1 1,464 15.2 423 267 78 45 1,308 13.6 1946 111,860 2,310 20.6 1,522 13.6 463 277 103 45 1,336 11.9 1947 117,280 2,559 21.8 1,570 13.3 472 271 97 38 1,369 11.6 1948 115,800 2,149 18.5 1,608 13.8 547 241 75 35 1,302 11.2 1949 118,440 1,971 16.6 1,532 12.9 545 322 55 28 1,309 11.0 1950 119,200 1,988 16.6 1,433 12.0 482 346 34 17 1,297 10.8 1951 118,300 1,739 15.8 1,605 14.4 509 401 41 22 1,497 12.6 * B=Birth-rate Population Figure. D =Death-rate Population Figure. 37 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1951 Cause of Death Sex 0— 1— 5— 15— 25— 45- 65— 75— Total all Ages 1. Tuberculosis, respiratory M - - - 1 4 15 11 1 32 F — — 1 1 4 1 1 1 9 2. Tuberculosis, other M — — — — — 1 — — 1 F - - - - - 1 — 1 2 3. Syphilitic disease M 1 3 2 6 F — — — 1 1 3 2 7 4. Diphtheria M — - - - - - - - - F - - - - - - - - - 5. Whooping cough M - - - - - - - - - F - 1 - - - - - - 1 6. Meningo-coccal infections M 2 - - - - - - - 2 F — 1 - - - - - - 1 7. Acute poliomyelitis M - - - - - - - - - F - - - - - - - - - 8. Measles M - - - - - - - - - F - - - - - - - - - 9. Other infective and parasitic diseases M - - - - - 1 — — 1 F - - - - - 1 — — 1 10. Malignant neoplasm, stomach M - - - - - 13 4 6 23 F — — — — 1 6 8 4 19 11. Malignant neoplasm, lung bronchus M — — — -— 1 33 11 3 48 F - — — — 1 3 3 1 8 12. Malignant neoplasm, breast M - - - - - - - - - F 4 6 6 16 13. Malignant neoplasm, uterus M — — — — — - — — — F — — 1 7 2 2 12 14. Other malignant and lymphatic neoplasms M 3 16 30 27 76 F — 2 — 3 18 12 17 52 15. Leukaemia, aleukaemia M — — 2 — 1 — — — 3 F - - - - - 2 — 2 4 16. Diabetes M - - - 1 — 1 F - - - - - - 2 2 4 17. Vascular lesions of nervous system M — 3 17 29 23 72 F 2 17 16 50 85 18. Coronary disease, angina M - - - - 3 45 34 12 94 F - - - - - 8 16 19 43 19. Hypertension with heart disease M - - - - - 5 9 7 21 F 5 6 15 26 20. Other heart disease M 3 7 31 58 99 F — — — — — 14 34 93 141 21. Other circulatory disease M - - - - - 1 6 9 16 F - - - - - 4 5 17 26 22. Influenza M - 2 4 3 9 F - - - - - 4 2 13 19 23. Pneumonia M 1 - - - 1 11 16 18 47 F 3 1 I - 4 6 11 15 41 24. Bronchitis M 1 - - - 4 33 32 28 98 F 2 1 2 5 20 41 71 25. Other diseases of respiratory system M 1 - 1 1 7 5 1 16 F - - 1 1 2 4 26. Ulcer of stomach and duodenum M — — — 2 5 10 3 20 F - - - 3 1 2 6 27. Gastritis, enteritis and diarrhoea M — 1 — — — 1 — 1 3 F 1 — 2 1 4 28. Nephritis and nephrosis M - - - - 2 3 5 2 12 F - - 1 - - 3 4 - 8 29. Hyperplasia of prostate M - 2 6 3 11 F - - - - - - - - - 30. Pregnancy, childbirth, abortion M - - - - - - - - - F - - - - 1 — — — 1 31. Congenital malformations M 3 2 1 1 2 1 — 10 F 6 - - - - 2 1 1 10 32. Other defined and illdefined diseases M 12 1 - - 2 9 11 6 41 F 9 - - — 9 15 8 19 60 33. Motor vehicle accidents M — 1 — 2 3 2 1 — 9 F - - - - - - 1 — 1 34. All other accidents M - - - 1 2 1 3 4 11 F - - - - - 2 2 11 15 35. Suicide M - 1 5 5 - 1 12 F - 2 2 — 1 5 36. Homicide and operations of war M — — — 1 — — — — 1 F — — — — — — — - - Total of all causes M 20 5 4 7 40 239 262 218 795 F 21 4 5 1 35 137 161 338 702 41 9 9 8 75 376 423 556 1497 38 39 INFANT MORTALITY—1951 and Previous Years Year Births Deaths of Infants Deaths of Infants per 1,000 births Average 1906-1913 3,000 359 117 1914-1923 2,639 230 88 1924-1933 2,145 141 66 1934 1,783 137 77 1935 1,877 131 70 1936 1,922 116 60 1937 1,913 130 68 1938 1,874 117 62 1939 1,829 77 43* 1940 1,600 76 51† 1941 1,405 52 41‡ 1942 1,589 94 59 1943 1,768 102 58 1944 1,788 95 53 1945 1,742 78 45 1946 2,310 103 45 1947 2,559 97 38 1948 2,149 75 35 1949 1,971 55 28 1950 1,988 34 17 1951 1,874 41 22 * Rate calculated on a birth figure supplied by the Registrar-General of 1,781. † Rate calculated on a birth figure supplied by the Registrar-General of 1,501. ‡ Rate calculated on a birth figure supplied by the Registrar-General of 1,253. 40 Net deaths of infants at various ages under one year of age Under 1 week 20 .1-2 weeks 3 2-3 weeks 1 3-4 weeks 1 4 weeks and under 3 months 4 3 months and under 6 months 9 6 months and under 9 months 1 9 months and under 1 year 2 Total deaths under 1 year 41 Net Births in the Year: Legitimate, 1,739; Illegitimate, 135. Net Deaths in the Year: Legitimate Infants, 37; Illegitimate Infants, 4 MATERNAL MORTALITY—1951 and Previous Years Year Number of Deaths Number of live Births Maternal Death Rate Pregnancy, childbirth, abortion Average 1924-1933 8 2,145 3.5 1934 9 1,783 5.0 1935 2 1,877 1.1 1936 3 1,922 1.6 1937 4 1,913 2.1 1938 2 1,874 1.1 1939 2 1,829 1.0 1940 — 1,600 — 1941 2 1,405 1.5* 1942 3† 1,589 1.9 1943 3 1,768 1.6 1944 2 1,788 1.08 1945 1 1,742 0.56 1946 7 2,310 2.94 1947 1 2,559 0.38 1948 1 2,149 0.45 1949 2 1,971 0.99 1950 1 1,988 0.49 1951 1 1,874 0.52 * Rate calculated on a (live and still) birth figure supplied by the Registrar-General of 1,289. † 1 death from puerperal sepsis not counted as "Maternal death." 41 ENVIRONMENTAL HEALTH SERVICES (A) SANITARY INSPECTION Cause of Inspection No. of Inspections No. of Notices served No. of Notices plied with Bakehouses 90 1 - Cancer 1 - - Complaints 4,197 2,241 2,194 Drainage 1,594 9 17 Factories (Mechanical) 593 37 26 Factories (Non-mechanical) 234 19 19 Food (other than Restaurants and Eating Houses) 2,279 8 1 House to House 368 135 262 Housing Act 243 4 13 Ice Cream Vendors 259 - — Infectious Diseases 359 8 8 Licences (Building) 988 2 3 Markets 198 — — Milk Vendors 301 1 — Outworkers 1,396 12 7 Pharmacy and Medicines Act 84 — — Public Urinals 3 — — Rag Flock Act 19 — — Rats and Mice 3,120 134 77 Re-Housing 816 59 49 Restaurants and Eating Houses 570 20 18 Scabies 1 - — Shops Act 140 8 8 Slaughterhouses — — — Smoke Observations 94 3 2 Miscellaneous 1,746 47 47 Re-visits 14,856 998 1,336 No Answer 4,518 — — 39,067 3,746 4,087 No. of Ineffective Visits 4,518 — — Total 34,549 3,746 4,087 During the year, 2,064 Statutory Notices were served and 2,001 complied with. (B) SUMMONSES—Proceedings instituted during the year Public Health (London) Act, 1936 326 Food and Drugs Act, 1938 11 Housing Act, 1936 2 Milk and Dairies Regulations, 1949 5 H.B.C. Byelaws 4 L.C.C. Byelaws 34 Merchandise Marks Act, 1926 2 42 (C) FACTORIES ACT, 1937 1 .—INSPECTIONS Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (i) Factories in which Seclions 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 78 234 19 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 539 593 37 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - Total 617 827 56 - 2.—CASES IN WHICH DEFECTS WERE FOUND Particulars Number of Cases in which Defects were Found Number of Cases in which Prosecutions were Instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness 28 23 1 - - (S.l) Overcrowding (S.2) — — — — — Unreasonable Temperature (S.3) - - - - - Inadequate Ventilation (S.4) 4 4 - - - Ineffective Drainage of Floors (S.6) - - - - - Sanitary Conveniences (S.7)- - - - - - (a) Insufficient 5 2 - — - (b) Unsuitable or Defective 35 30 - - - (c) Not separate for Sexes 1 - - - - Other offences against the Act (not including offences relating to Out-work) - - 8 - - Total 73 59 9 — — 43 OUTWORK Nature of Work Section 110 Section 111 No. of Outworkers in August List required by Sect. 110 (1) (c) No. of Cases of Default in Sending Lists to the Council No. of Prosecutions for Failure to Supply Lists No. of Instances of Work in Unwholesome Premises Notices Served Prosecutions Wearing Apparel— Making, &c. 263 — — 5 5 — Curtains and Furniture Hangings 9 — — — — — Iron and Steel Cables and Chains 5 — — — — — Artificial Flowers 2 — — — — — Paper Bags 74 — — 3 3 — Feather Sorting 4 — — — — Carding, &c., of Buttons, &c. 22 — — — — Stuffed Toys 63 — — 2 2 — Cracker Bon-bon, Christmas Crackers, Christmas Stockings, &c. 171 — — 1 1 — Total 613 — - 11 11 — 44 (D) HOUSING 1. Total number of houses in the Borough, including flats, tenements, etc., separately assessed 25,750 (approx) Public Health (London) Act, 1936 2. No. of houses inspected on account of complaints or illness 4,197 3. Number of statutory notices served 2,064 4. Number of prosecutions 334 5. Number of houses repaired or nuisances remedied 2,194 Housing Act, 1936 6. Number of houses inspected—house-to-house (Housing Consolidated Regs. 1925) Nil 7. (a) Number of houses included in representations by the Borough Medical Officer under Sec. 25 of H.A., 1936 10 (b) Number of houses demolished following representations by Borough Medical Officer under Sec. 25 of H.A., 1936 Nil 8. Number of houses repaired under Sections 9 and 10 of H.A., 1936:— (a) By owners 3 (6) By L.A. in default of owners Nil 9. Number of houses demolished:— (a) In pursuance of orders under Sec. 11 of the Housing Act, 1936 Nil (6) Voluntarily Nil 10. Number of rooms on which Closing Orders were made (excluding underground rooms) Nil 11. Number of Closing Orders determined (excluding underground rooms) Nil Overcrowding (Housing Act, 1936) 12. Number of families living in overcrowded conditions 243 Number of overcrowded families who have obtained alternative accommodation 88 13. Number of dwellings erected by the Borough Council during year 73 (Flats) Underground Rooms 14. Number occupied but unfit Unknown Number closed or modified occupation approved 15 Number of Closing Orders 7 Number of Closing Orders determined 12 Houses Let in Lodgings 15. Number in Borough 9,600 (approx.) *Number of inspections — Number of prosecutions Nil †Number of complaints remedied under the Bye-laws (not included under any other heading) - * Included under item No. 2. †Included under item No. 5. 45 (E) UNSOUND FOOD CONDEMNED—1951 Baby Food 16 tins Bacon 29 lbs. Baked Beans 116 tins Beetroot 16 tins Biscuits 242 lbs. Blancmange Powder 31 packets Butter 1½ lbs. Cake 168 lbs. Carrots 30 tins Cheese 54 lbs. Chocolate and Sweets 52 lbs. Coffee 4 bottles Dried Eggs 6 tins Dried Fruit 115 lbs. Fish (tins) 132 tins Fish (lbs.) 245 lbs. Fruit (tins) 1,897 tins Fruit (pulp) 28 barrels Jam 94 lbs. Meat (tins) 2,078 tins Meat 2,139 lbs. Milk 527 tins Milk (Skimmed) 36 cwts. Peas 521 tins Pickles and Sauces 152 bottles Rabbits 869 lbs. Salad Cream 152 bottles Salt 216 packets Sausages 45 lbs. Soup 92 tins Spaghetti 17 tins Suet 7 lbs. Syrup 1 tin Tomatoes (tins) 378 tins Tomato Juice 3 tins Tomato Puree 58 lbs. Tongue (tins) 91 tins Turkeys 145 lbs. 46 PUBLIC MORTUARY—Bodies admitted, &c. Bodies admitted from the Borough:— By order of Coroner 247 By order of Police 7 On application of undertakers for -accommodation 19 273 Bodies admitted from other Boroughs:— Fulham 78 Chelsea 194 Kensington 17 - 289 Total bodies admitted 562 No. of P.-M. examinations conducted:— Hammersmith cases 253 Fulham 56 Chelsea 188 Kensington 17 Total P.-M.'s 514 No. of Inquests held:— Hammersmith cases 68 Fulham „ 34 Chelsea „ 34 Kensington „ 85 Total Inquests held 221 47 (A) INFECTIOUS DISEASES Diseases Notifications Total Cases Notified Cases Removed to Hospital Deaths Corrected Figures 0—1 year 1—2 years 2—5 years 5—15 years 15—25 years 25—45 years 45—65 years 65 + years Scarlet Fever - 7 35 75 - 5 - - 122 32 - 117 Whooping Cough 61 160 143 123 1 1 1 2 492 71 1 489 Acute Poliomyelitis (Par.) 1 — 8 4 3 2 1 — 19 19 — 5 Acute Poliomyelitis (Non. Par.) — — — 2 — — — — 2 2 2 Measles 66 371 1,099 25 10 11 — 1 1,583 44 1,581 1 Diphtheria — — 3 7 2 2 — — 14 14 Acute Pneumonia 5 5 25 12 5 18 27 16 113 4 88 112 Dysentery 4 7 28 31 4 16 5 3 98 52 88 Acute Encephalitis (Inf.) — — — — — 2 — - 2 2 1 Enteric or Typhoid Fever — —- - 1 — - — - 1 1 1 Paratyphoid Fever - — 3 2 — — — — 5 5 — 2 Erysipelas - — - - — 6 8 5 19 5 — 19 Meningococcal Infection - 1 3 5 2 — 2 — 13 13 3 1 Food Poisoning - — 9 10 3 8 4 34 5 32 Puerperal Pyrexia - - — — 13 17 — — 30 2 29 Ophthalmia Neonatorum 3 - — — — - — — 3 3 3 Scabies — - 4 20 9 16 6 1 56 —- — 56 Totals 140 551 1,360 317 52 104 54 28 2,606 274 92 2,539 48 (B) BACTERIOLOGICAL EXAMINATIONS Specimen Positive Negative Total Swabs for suspected cases of Diphtheria 299 299 Haemolytic Streptococci 22 82 104 Faeces 59 176 235 Vincents Organisms 10 38 48 Occult Blood — 1 1 Urine - 3 3 Blood Test - 1 1 91 600 691 49 (A) PART 1.—Summary of Notifications during the period from the 1st January, 1951, to the 31st December, 1951 Age Periods Formal Notifications Number of Primary Notifications of new cases of tuberculosis 0— 1— 2— 5— 10— 15— 20— 25— 35 45— 55- 65- 75- Total (all ages) Respiratory, Males - 2 4 5 2 10 14 22 14 16 15 9 1 114 Respiratory, Females — 1 4 5 3 13 18 20 8 5 2 — — 79 Non-Respiratory, Males — — 1 - 1 - 1 1 3 - - — — 7 Non-Respiratory, Females — — 2 2 2 2 — — - 8 PART II.— New Cases of Tuberculosis coming to the knowledge of the Medical Officer of Health during the above-mentioned period, otherwise than by Formal Notification Source of Information Number of cases in age Groups 0— 1— 2— 5— 10— 15— 20— 25— 35— 45— 55— 65— 75— Total Death Returns from Local Registrars Respiratory M - - - - - - - - - 2 1 3 — 6 (A) F - - - - - - - 1 - - - - - 1 (B) Non-Respiratory M - - - - - - - - - - - - - — (C) F - - - - - - - - - - - - 1 1 (D) Death Returns from Registrar-General (Transferable deaths) Respiratory M - - - - - - - 1 - - 1 - - 2 (A) F - - - - - - - - - - - -- — (B) Non-Respiratory M - - - - - - - - - - - - - — (C) F - - - - - - - - - - - 1 — 1 (D) Posthumous Notifications Respiratory M - - - - - - - - - - - - - — (A) F - - - - - - - - - - - - - — (B) Non-Respiratory M - - - - - - - - - - - - - — (C) F - - - - - -- - - - - - - - — (D) "Transfers" from Other Areas(excluding transf e r a b 1 e deaths) Respiratory M - - - - - 4 11 29 14 7 3 — — 68 (A) F - - — 2 2 1 11 14 3 4 — 1 — 38 (B) Non-Respiratory M — - — — - - 1 1 — — - — - 2 (C) F - 1 (D) Other Sources Respiratory M — — — — - — 1 — 1 - 1 — 3 (A) F - - -- - - - - - - - - - - — (B) Non-Respiratory M - - - - - - - - - - - - - — (C) F - - - - - - - - - - - - — (D) Totals (A) 79 (B) 39 (C) 2 (D) 3 50 (B) CASES NOTIFIED AND DEATHS—1951 and Previous Years Year No. of Cases notified No. of Deaths No. of Cases on Register of Notifications Pulmonary NonPulmonary Total 1932 183 45 228 156 1,128 1933 185 31 216 150 1,056 1934 184 31 215 124 1,070 1935 170 31 201 119 1,059 1936 156 40 196 116 1,063 1937 141 33 174 106 1,068 1938 155 37 192 87 859 1939 165 33 198 107 889 1940 143 24 167 118 813 1941 160 39 199 103 828 1942 169 31 200 104 963 1943 177 24 201 72 1,097 1944 192 22 214 93 1,184 1945 207 23 230 93 1,282 1946 188 23 211 85 1,487 1947 189 21 210 90 1,517 1948 167 20 187 76 1,599 1949 193 14 207 51 1,674 1950 166 21 187 39 1,779 1951 193 15 208 44 1,852 Average number of cases notified for the 10 years 1932-1941 (inclusive)—199. Average number of cases notified for the 10 years 1942-1951 (inclusive)—205. Average number of deaths for the 10 years 1932-1941 (inclusive)—119. Average number of deaths for the 10 years 1942-1951 (inclusive)—65. 51 MEDICINAL BATHS Cleansing of Verminous Persons School Children—Hammersmith Scabies 122 Verminous 1,053 Impetigo 7 School Children—Non-Hammersmith Nil. Children under Five Years—Hammersmith Scabies 33 Verminous 66 Children under Five Years—Non-Hammersmith Nil. Adults—Hammersmith Scabies 97 Verminous. 127 Other conditions 8 Adults—Non-Hammersmith Scabies 4 Verminous 2 Lodging-Houses Scabies 4 Verminous 157 DISINFECTION Beds 40 Mattresses 402 Pillows 354 Bolsters 21 Blankets 264 Sheets 125 Quilts 66 Curtains 3 Carpets 1 Articles of Clothing 273 Sundries 143 1,692 Rooms (including 613 verminous rooms) 867