HAY 002 THE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, TO THE URBAN DISTRICT OF HAYES, FOR THE YEAR 1911. The Annual Report of the Medical Officer of Health of the Urban District of Hayes, for the Year 1911. To the Chairman and Members of the Hayes Urban District Council. Gentlemen, I have the honour to present the Annual Report of Health and Sanitary Condition of the Hayes Urban District for the year 1911. A. NATURAL AND SOCIAL CONDITIONS. Area 3311 acres; situated at from 85 to 169 feet above sea level; nearly flat; main road from London to Oxford passes practically along the highest portion of the District. South of this road subsoil gravel with water level in winter in many places very near the surface. North of this road practically subsoil clay; the District is mainly Agricultural, but the Southern position bordering the Great Western Railway and the Grand Junction Canal is Manufacturing. A large proportion of the population is of the mechanical or labouring classes. The manufacturing operations carried on are unlikely to have any effect on the public health. B. WATER SUPPLY. The water supply of the District is mainly from the Public Service of the Rickmansworth and Uxbridge Valley Water Company, whose mains cover the greater portion of the inhabited parts of the District. On several occasions complaints have been received by the Sanitary Officer and myself of a very unpleasant flavour found in the water; up to now we have been unable to obtain satisfactory samples of contaminated water; by the time complaints have reached the offices and samples could be taken in a proper manner the unpleasantness has passed off. It would much facilitate the action of the Officers of the Council if aggrieved persons would forward complaints to the offices of the Council immediately the flavour is noticed. There are still many dwellings which depend for their supply upon surface wells. RIVERS AND STREAMS. The only stream in the District is the River Crane, which is under the jurisdiction of the Middlesex County Council and so far as we are aware no pollution has taken place. 3 DRAINAGE AND SEWERAGE. The greater portion of the District is sewered, but the Hamlets of Yeading and Hayes Gate are as yet unprovided with sewers and arrangements are made by the Council for emptying cesspools when required; there has been an extension of 300 yards in the sewerage area during the year 1911; the number of houses and premises connected is 743: the number connected during the past year is 73. The condition of the sewers is not so satisfactory as could be desired owing to the infiltation of subsoil water; all house drains connected with the system are satisfactory, and have been passed by the Council's Surveyor. The method of disposal is biological on double contact bacteriological beds. Owing to the rapid development of Factories and Cottages in the Southern portion of the District the the quantity of sewerage has become more than can be satisfactorily dealt with by the existing plant. The Council is taking steps to increase the capacity of the disposal works. CLOSET ACCOMMODATION. All dwellings connected with the sewers are provided with water closets of approved pattern in accordance with the requirements of the Council; where there are no sewers, earth closets and privies are used. SCAVENGING. House refuse is removed by the Council from every house in the District once in every fortnight, and is carted to tips within the District. Many of the houses are unprovided with dust bins, and some complaints have been received by myself in reference to nuisance caused by their absence: I shall be glad if my Council can induce owners of property to provide sanitary dust bins. SANITARY INSPECTION OF DISTRICT. All adoptive Sanitary Acts, including the Public Health Acts; Amendment Act, 1890; Infectious Diseases Prevention Act, 1890; Model Regulations relating to Dairies, Cow Sheds and Milk Shops, are in force in the District. The Council has adopted new Bye Laws, but these have not yet received the sanction of the Local Government Board, and the old Bye Laws made by the Uxbridge Rural District Council in 1886 are still in force. The Sanitary Staff consists of one Sanitary Inspector who is also Surveyor. The number of premises visited by myself in connection with Infectious Diseases is 68. The number of premises visited by myself, largely in company of the Sanitary Inspector, in connection with sanitary matters is 46. PREMISES AND OCCUPATION WHICH CAN BE CONTROLLED BY BYE LAWS AND REGULATIONS. None in District. 4 SCHOOLS. There are three Public Elementary Schools in the District. Hayes Council School, Clayton Road; Dr. Triplett's School, Hayes Town; and Yeading Elementary School. All are supplied by water from the Company's Mains: the two former are connected to the Council's Sewers, and in the third the best arrangements for disposal of sewerage are in existence that can be made. The general sanitary condition is good. The Medical Examination of School Children is provided by the Middlesex County Council, and cases of Infectious Diseases coming to the knowledge of the Head Masters or Mistresses are at once notified to the Medical Officer of Health. FOOD. (A) MILK SUPPLY. On the whole the milk produced within the District is of excellent quality. The Dairies, Cow Sheds and Milk Shops are regularly inspected and are generally in a satisfactory condition. No samples of milk for analysis have been taken by the Officers of the Council: there are no arrangements in force for the inspection of milking Cows for evidence of tuberculosis. (B) OTHER FOODS. No necessity has arisen for action to be taken in the case of unsound food. Some unsound fish was destroyed. No cases of diseased meat have occurred. The condition of Bakehouses is generally good, and the condition of Slaughter Houses excellent. (C) SALE OF FOOD AND DRUGS ACTS. No action has been taken or needed. HOUSING. The housing accommodation for the industrial classes in the District is markedly insufficient, and there are many Cottages occupied which in my opinion are quite unfit for human habitation. The Council has already acquired land, and will shortly erect about 50 Cottages to enable it to house the families it will be necessary to disturb in dealing with these unhealthy dwellings; and about 60 houses suitable for habitation by the working classes are yearly erected by private enterprise. (D) PREVALENCE OF, AND CONTROL OVER ACUTE INFECTIOUS DISEASES. Five cases of Diphtheria, and Membranous croup were reported during the year: in four of these the sanitary arrangements were either in an improper or neglected condition and the necessary alterations and attentions were insisted on, and carried out—in one case no sanitary defect could be found and the source could not be traced, this case was removed to the Isolation Hospital. 5 Three cases of Scarlet fever were reported, the source of infection could not be traced. In two of these cases the sanitary arrangements were good, in the third not satisfactory. A severe epidemic of Measles was prevalent in the months of February, March, April and May:— in each case notified by Masters or Mistresses of schools—the premises were visited and instructions as to the attendance of other children at school given in accordance with the regulations of the Local Government Board. (F) FREVALENCE OF AND CONTROL OYER TUBERCULOSIS. One case of Tuberculosis was notified under the regulations of 1908. The case is visited generally twice a week and all precautions taken. Four casus were notified under the Regulations of 1911, their homes were visited and instructions given to prevent spread of the disease. Eight deaths were registered from pulmonary tuberculosis being one-eighth of the total deaths at all ages. No system of notification or control was in force during the year and no Hospital accommodation for cases of pulmonary tuberculosis, other than that afforded at the Workhouse Infirmary, is in existence. (F) INVESTIGATION OF OTHER DISEASE. I am of opinion that a great improvement in the general health of the District will be apparent as soon as the Council is able to close the numerous unhealthy dwellings therein: many of these are very damp with insufficieutly ventilated bedrooms and in a dirty condition, and I can assert from personal knowledge that the most severe and fatal cases of Measles, Diarrhoea and Rheumatic Endocarditis occur in those unhealthy cottages. (G) MEANS FOR PREVENTING MORTALITY IN CHILDBIRTH AND IN INFANCY. The Notification of Births Acts, 1907, is not adopted, but I am strongly of opinion Infant and Childhood mortality would be largely reduced if the Council would appoint a properly qualified female health officer to visit the Mothers and advise them as to the management of their Children, the care of their homes and the storage of their food to prevent contamination by dust and flies. In conclusion I wish to record my sincere thanks to Mr. D. C. Fidler, your Sanitary Inspector, for his valuable and ready assistance at all times in the performance of my numerous duties as Custodian of the Public Health of the District. I am, Gentlemen, Yours faithfully, E. J. PARROTT. 6 TABLE 1. VITAL STATISTICS OF WHOLE DISTRICT DURING 1911 & PREVIOUS YEARS. Year. Population estimated to Middle of the Year. Births. Total Deaths Registered in the District. Transferable Deaths.‡ Nett Deaths belonging to the District. Uncorrected Number. Nett. of Nonresidents registered in the District. † of Residents not registered in the District. † Under 1 Year of Age. At all Ages. Number. * Rate. Number. * Rate per 1,000 Nett Births. Number. * Rate. Number. † Rate. 1911. 4300 125 130 30.232 G2 14.418 per 1000 4 6 17 130.709 per 1000 64 14.883 per 1000 Area of District in acres (exclusive of area covered \ by water) 3284 At Total Population at all ages 4261 Census Number of Inhabited Houses 887 of 1911 Average number of persons per house 4.8 7 TABLE .II. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1911. Notifiable Disease. NUMBER OF CASES NOTIFIED. total cases Removed to hospital. At all Ages. At Ages—Years. Under 1. 1 to 5. 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Diphtheria (including Membranous croup 5 1 4 5 Erysipelas 2 1 1 0 Scarlet fever 3 2 1 3 Phthisis Under Tuberculosis Regulations, 1908 1 0 Under Tuberculosis Regulations, 1911 Others 4 1 1 2 0 Totals 15 1 2 2 6 2 — 1 8 Isolation Hospital— Uxbridge Con-Joint Hospital, Hillingdon, Uxbridge. Total available beds 33, and 2 observation beds. Number of Diseases that can be concurrently treated, 2 besides Small Pox, i.e. Scarlet Fever and Diphtheria. Small Pox Hospital, Yeading, Hayes, accommodation ample. 8 TABLE III. CAUSES OF, AND AGES AT DEATH DURING THE YEAR 1911. Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the District (a). Total Deaths whether of "Residents" or "Non-Residents" in the District (a) All ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 All causes Certified (c) 64 17 4 4 3 3 4 10 19 64 Uncertified Measles 5 2 1 2 5 Whooping Cough 1 1 1 Diphtheria and Croup 3 1 1 1 3 Phthisis (Pulmonary Tuberculosis) 8 1 3 3 1 8 Tuberculous Meningitis 2 2 2 Cancer, malignant disease 6 3 3 6 Bronchitis 2 1 1 2 Broncho-Pneumonia 1 1 1 Pneumonia (all other forms) 2 2 2 Other diseases of Respiratory organs 1 1 1 Diarrhœa and Enteritis 3 3 3 Nephritis and Bright's Disease 1 1 1 Puerperal Fever Other accidents and diseases of Pregnancy and Parturition 1 1 1 Congenital Debility and Malformation, including Premature Birth 7 7 7 Violent Deaths, excluding Suicide 2 1 1 2 Other Defined Diseases 12 1 1 5 5 12 Diseases ill-defined or unknown 7 7 17 4 4 3 3 4 10 19 64 9 TABLE IV. INFANTILE MORTALITY DURING THE YEAR 1911. Nett Deaths from stated causes at various ages under 1 year of age. Cause of Death Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 1 month. 1-3 months. 3-6 month?. 6-9 months. 9-12 months. Total Deaths under 1 year. All Causes Certified Uncertified Measles 2 2 Diphtheria and Croup 1 1 Whooping-cough 1 1 Diarrhœa 2 1 3 Other Tuberculous Diseases 1 1 Premature birth 4 1 5 Atrophy, Debility, and Marasmus 1 1 2 Bronchitis 1 1 Pneumonia (all forms) 1 1 4 1 1 3 3 3 2 17 Births in the year: legitimate 125; illegitimate 5. Deaths in the year: legitimate infants 15; illegitimate infants 2. 10 FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 24 1 Workshops (Including Workshop Laundry) 16 Total 40 1 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Sanitary accommodation insufficient 1 Laundry about to be closed. unsuitable or defective not separate for sexes Total 1 11 3.—HOME WORK. None in District. 4.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. Number. Important classes of workshops, such as workshop bakehouses may be enumerated here. Bakehouses 4 Workshops 7 Total number of workshops on Register 11 5.—OTHER MATTERS. None. 12 SANITARY WORK, 1911. No. 1. Enumerate (1) Adoptive Acts, (2) Bye-laws, in force in District. Particulars as to Staff employed in Sanitary Department, specify if Inspectors are engaged in any other duties, and if so what. Inspections. Action taken. (Other than under H. and T.P. Act). Dwelling Houses and Action under H. and T.P. Act, 1909. Houses let in lodgings. Tenement Houses. Common Lodging Houses. All the Adoptive Sanitary Acts, including the Public Health Acts Amendment Act, 1890; Infectious Diseases Prevention Act, 1890; Model Regulations relating to Dairies, Cow Sheds and Milkshops. One Sanitary Inspector who is also Surveyor. Number of premises Inspected on Complaint. Number of premises Inspected in connection with Infectious Diseases. Number of premises under periodical Inspection. Houses Inspected from Houseto-House (H. and T.P. Act). Total Number of Inspections and Re-inspections made. Cautionary or Intimation Notice Given. Statutory Orders Issued. Summonses Served. Convictions Obtained. Number of Houses dealt with under Sect. 15. Number of Houses found to be in a state Dangerous or Injurious to Health. Sect. 17. Number of Representations made by M.O.H. Sect. 17. N umber of Houses made Habitable without Closing Orders. Number of Closing Orders made by L.A. (Sect. 17.) Number of Houses Closed Voluntarily. Number of Closing Orders determined after Repairs (Sect. 17.) Number of Houses Demolished (а) by order of L.A. (Sect. 17.) (b) Voluntarily. Illegal Underground Rooms Vacated. Number Registered under ByeLaws. Number of Contraventions. Number Registered under ByeLaws. Number of Inspections made. Number of Contraventions. The Council have adopted New Bye-laws, hut these have not yet received the sanction of the L. G. B., and the Old Bye-laws made by the Uxbridge Rural District Council in 1860 are still in force. 1 11 16 73 651 19 2 — — 21 23 6 5 - 20 - (a) 13 - - — - - - (b) 2 This work has been stopped by the Council until they have built houses to accommodate Tenants who will be dislodged. Tenders have been received for the erection of 51 houses and the work will be commenced as soon as the L.G.B. have sanctioned the Loan. SANITARY WORK, 1911. No 2. ?bal Boats used as Dwellings. Movable Dwellings, Caravans, Tents, &c. Bakehouses. Slaughter-Houses. Cow-Sheds. Dairies and Milkshops. Unsound Food. Adulterated Food. Offensive Trades. Water Supply and Water Service. Acts. Number of Contraventions of c Regulations Number Observed during the Year. Number of Nuisances there-: from Abated Number Removed from District. Number in District. Contraventions of Factory Acts. Number on Register. I Number of Inspections made. Frequency of Inspection. 1 Contraventions of Bye-Laws. Number on Register. ■ Number of Inspections made. Frequency of Inspection. Contraventions of Regulations. Number of Milch Cows in District. Number on Register. Number of Inspections made. Frequency of Inspection. Contraventions of Regulations. Animals seized. Articles or Parcels seized. Animals condemned by Magistrate. Articles or Parcels condemned by Magistrate. Articles or Parcels surrendered. Samples taken (if any) by the District Local Authority. Found adulterated. Number of Premises in District. Number of Inspections made. Contraventions of Bye-Laws. Wells. Percentage of Houses supplied from Public Water Service. Cisterns. Draw-Taps placed on Mains. Percentage of Houses supplied on Constant System. Number of Samples obtained for analysis. New Sunk. Cleansed, Repaired, &c. Closed as polluted. New Provided. Cleansed, Repaired, Covered, &c. From Local Wells. From Public Supply. | Authority. 3 - - - 4 - 5 10 As often as may be considered necessary. 1 4 8 As often as may be considered necessary. Cannot say. 6 12 1 - - - - Case of Fish. - - - - - - 1 1 90 per cent. - - - All those connected to Public Service. 2 - SANITARY WORK, 1911. No. 3. Drainage and Sewerage of existing Buildings. Disinfection. Dust. Sundry Nuisances Abated. Remarks as to any other matters or in explanation of previous columns. Water Closets. Percentage of Houses provided with Water Closets. Drains. Cesspools. Percentage of Houses Draining into Sewers. Number of Water Closets substituted for Dry Receptacles. Repaired, Supplied with Water, or otherwise Improved. Examined, Tested. Exposed, etc. Unstopped, Repaired, Trapped &c. Waste Pipes, Rain Water Pipes Disconnected, Repaired, &c. New Soil Pipes or Ventilating Shafts fixed. Existing Soil Pipes or Ventilating Shafts Repaired. Disconnecting Traps or Chambers Inserted. Reconstructed. Rendered Inpervious, Emptied, Cleansed &c. Abolished, and Drain connected to Sewer. Rooms Disinfected. Rooms Stripped and Cleansed. Articles Disinfected or destroyed. New Bins provided. How frequently is dust removed from each Home ? Number of Complaints of NonRemoval received. Method of Disposal Overcrowding. Smoke. Accumulations of Refuse. Foul Ditches, Ponds, &c., and Stagnant Water. Foul Pigs and other Animals. Dampness. Yards repaved or repaired. Other Nuisances. Ordinary Infectious diseases. Phthisis. Ordinary infectious disease. Phthisis. Destructor. By Tipping. Other, state method. 12 139 This includes new ones. 85 per cent. 31 8 - - - - 7 - 2 80 per cent. 20 - - This work is done by the Joint Hospital Authority. - Bins are not provided by the Council. Fortnightly. Schools weekly. Two or three only. - Tipping. - - - - 5 31 Dead Dogs removed. - - - Practically no complaints as to nuisances have be received and few, if any, exist in the district apart from the insanitary houses which the Council are taking steps to abolish.