HAY 003 THE URBAN DISTRICT COUNCIL OF HAYES. Annual medical Report FOR THE YEAR 1913. BY EDWARD J. PARROTT, M.R.C.P. LRCP. MEDICAL OFFICER OF HEALTH. Lucy & Birch, Printers. Uxbridge. The Annual Report of the Medical Officer of Health of the Urban District of Hayes, for the Year ending December, 1913. To the Chairman and Members of the Hayes Urban District Council. Gentlemen, I have the honour to present the Annual Report of the Health and Sanitary Condition of the Urban District of Hayes for the year 1913. A.-NATURAL AND SOCIAL CONDITIONS. Area, 3311 acres, situated at from 85 to 169 feet above 6ea level. Rainfall 1913, 22.5 inches; surface somewhat flat. The main road from London to Oxford passes practically along the highest portion of the District. South of this road the subsoil is gravel with the water level in winter in many places very near the surface; north of this road the subsoil is generally clay. The District is mainly agricultural, but the southern portion bordering the Great Western Railway and Grand Junction Canal is manufacturing; this southern portion is developing very rapidly, new factories are in course of erection and housing accommodation for the employees is progressing; the Botwell House Estate is now being developed for building purposes. A large percentage of the population is of the mechanical or labouring classes. The District is divided into three Wards for Municipal Election purposes. Population last Census, 4,261; estimated population middle of 1913, 4,750. Amount of Poor Law Relief distributed during 1913, £251 19s. 2d. A small Cottage Hospital supported by voluntary contributions treats annually 20 to 25 patients. There is also a District Nurse supported by voluntary contributions, 4 B.—SANITARY CIRCUMSTANCES OF THE DISTRICT. The Water Supply of the District is mainly from the Public Service of the Rickmansworth and Uxbridge Valley Water Co., whose mains cover the greater portion of the inhabited parts of the District. During the year 1913 one complaint was received of unpleasantness in the water; the impurity consisted of oxide of iron (rust) and was not injurious to health, and the water was otherwise good drinking water. There are still some isolated dwellings which depend for their water upon surface wells. RIVERS AND STREAMS. The only stream in the District is the River Crane, which forms the western boundary of the District, and is under the jurisdiction of the Middlesex County Council, and so far as we are aware no pollution has taken place. DRAINAGE AND SEWERAGE. The major portion of the District is sewered, but the hamlets of Yeading and Hayes Gate are as yet unprovided wirh sewers, and arrangements are made by the Council for emptying cesspools when required. A scheme for the drainage of Yeading is contemplated by the Council. About 2,200 yards of sewers were laid in private streets during the year, and some 550 yards are under construction in the Cranford Lane, in the Parish of Harlington, to accommodate the houses fronting on that road and situate in the District of Hayes, and also to receive the sewage from Messrs. Sandow's new Factory. Two Sewage Ejector Stations are also under construction to raise the sewage from low lying estates. The new filters and other works at the Sewage Disposal Works have given satisfaction during the year, and the effluent has been satisfactory; no complaints have been received from the County Authority. The number of houses and premises connected to the sewers is 922. The number connected during the past year is 99. The number remaining unconnected is 176. There is still considerable infiltration of subsoil water on the line of sewers, but otherwise the condition is satisfactory. All house drains connected to the system are tested with water before being passed by the Surveyor to the Council. 5 The method of disposal is by sedimentation and subsequent treatment by percolating filters. CLOSET ACCOMMODATION. All dwellings conuected to 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 a few privies are in use. SCAVENGING. The house refuse is removed by the Council in proper sanitary covered carts from every house in the District once in each week, and is carted to a tip within the District. The Council has in force a new bye-law making the provision of a proper sanitary dust-bin for every house compulsory, and about 100 have been provided upon request. SANITARY INSPECTION OF THE DISTRICT. The number of premises visited by myself in connection with Infectious Disease is 34. The number of premises visited by myself largely in company with the Sanitary Inspector is 33. Inspections made by Sanitary Inspector: Upon complaint 3 In connection with Infectious Disease 20 Periodical 14 Total number of Inspections of all kinds 304 Statutory Orders issued - Informal Notices issued 79 Summonses served - PREMISES AND OCCUPATIONS WHICH CAN BE CONTROLLED BY BYE-LAWS. None in the District. 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. The Managers of Dr. Triplett's School have under consideration the provision of additional class room accommodation to meet the demands of increasing population. 6 All the Schools are supplied by the Water Company's mains; the two former are connected with the Council's sewers and at the third satisfactory arrangements for the disposal of sewage are in existence. The general sanitary condition is good, and the Managers of Dr. Triplett's School are hoping shortly to provide additional washing accommodation for boys. The medical examination of school children is provided by the Middlesex County Council, and cases of Infectious Disease coming to the knowledge of Head Masters and Head Mistresses are at once notified to your Medical Officer of Health and dealt with by him, but there is no provision for the treatment of other ailments pointed out by the Medical Examiners. FOOD. (A.) Milk Supply.—The milk produced within the District is of excellent quality. The Dairies, Cowsheds and Milkshops are regularly inspected by myself and your Sanitary Inspector, and all are in a most satisfactory condition. No samples of milk have been taken for analysis by the Officers of the Council. There are no arrangements iu force for the inspection of milking cows for evidence of Tuberculosis. (B) Other Foods.—No necessity has arisen for action to be taken in case of unsound food. The condition of Bakehouses is generally good, and the condition of Slaughter Houses excellent, with one exception. (C.) Sale of Food and Drugs Act.—No action has been taken. HOUSING. The housing accommcdation for the industrial classes in the District is undoubtedly insufficient, and there are still many cottages occupied which in my opinion are quite unfit for human habitation. Fifty-one cottages erected by the Council for the housing of families resident in unhealthy dwellings are now completed and occupied, and land has been acquired for the erection of 22 houses at Yeading for the same purpose. Thirty-one houses suitable for habitation by the industrial classes were erected during the year by private enterprise. The Council are about to acquire 14 acres of land at Botwell for the further erection of workmen's dwellings. The inspection of the District under Section 17 of the Housing, Town Planning, etc., Act, 1909, was delayed until the houses being built by the Council were completed, but in November 25 houses were inspected and the 7 report thereon submitted to the Council, but so far no action has been taken in the matter. Nineteen Closing Orders were issued relating to houses inspected in a previous year, but which had been allowed to remain occupied owing to lack of accommodation in the District, and three of these houses were demolished. C.—SANITARY ADMINISTRATION OF THE DISTRICT. The Sanitary Staff consists of one Sanitary Inspector, who is also the Surveyor. The Council are contemplating the separation of these offices. Ample accommodation exists at the Joint Isolation Hospital at Kingston Lane, Uxbridge, and the Small Pox Hospital at Yeading, for the reception and treatment of all cases of Infectious Disease, but only three varieties, viz., Small Pox, Scarlatina and Diphtheria. Typhus, Enteric, Puerpural and Cerebro-Spinal Fever are not received. D.— PREVALENCE AND CONTROL OVER ACUTE INFECTIOUS DISEASES. Three cases of Diphtheria, 63 per 1,000 of estimated population, were reported during the year; two were removed to the Isolation Hospital and the other case was satisfactorily treated at home. The source of infection was not traced. Fifteen cases of Scarlatina, 3.157 per 1,000 of estimated population, were reported; the source of original infection was not traced, but it appears to have been spread by infection acquired at school; one case which I saw with the School Medical Inspector was attending school in the desquamating stage. I would point out to parents that in every case in which a child develops a rash of any kind, it should be seen as soon as possible by a doctor, in order that a diagnosis of its nature may be made. Four cases of Erysipelas, .844 per 1,000 of the estimated population, were reported during the year. There has been a very considerable epidemic of Scarlet Fever throughout the country during the late summer and autumn. E.—PREVALENCE AND CONTROL OVER TUBERCULOSIS. (a.) In all primary notifications of Tuberculosis the patients are visited and oral and printed instructions as to self preservation and prevention of the infection of others are given. Spitting mugs are provided by the Council. 8 (b.) As the arrangements for the treatment of cases of Pulmonary Tuberculosis are under the management of the Tuberculosis Department of the Middlesex County Council, subsequent visits are not paid by the Medical Officer of Health, unless requested by the Tuberculosis Officer of that Authority. (c.) The arrangements for the detection of unrecognized cases of Tuberculosis associated with notified cases of the disease are under the direction of the Tuberculosis Officer of the Middlesex County Council. (d.) The arrangements made for utilizing the services of the Tuberculosis Officer or Nurses are as in (c.). (e) Disinfection is performed when necessary by the Officers of the Hayes Council. The arrangements made by the County Council of Middlesex for the visitation and treatment of cases of Pulmonary Tuberculosis (sanitorium and domiciliary) are working satisfactorily, and, I am of opinion, will in the future tend to produce a considerable diminution in the number of cases of this dire malady. F.—INVESTIGATION OF OTHER DISEASES. Owing to the nature of the subsoil Rheumatism in all its forms has been very prevalent. I am of opinion there has been considerable neglect on the part of some of the occupiers of land in allowing the ditches and watercourses to become silted up; many of the ditches by the sides of the roads are not properly attended to, which must contribute to the land becoming waterlogged and to increased dampness in dwellings, a fertile cause of Rheumatism and Tuberculosis. Once more I wish to express 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 duties as Custodian of the Public Health. I am, Gentlemen, Yours faithfully, EDWARD J. PARROTT. 9 TABLE I. VITAL STATISTICS OF WHOLE DISTRICT DURING 1913 & PREVIOUS YEARS. Name of District-URBAN DISTRICT OF HAYES, MIDDLESEX. 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. Under 1 Year of Age. At all Ages. of Nonresidents registered in the District. of Residents not registered in the District. Number. Rate. Number. Rate per 1,000 Nett Births. Number. Rate. Number. Rate. 1911. 4300 125 130 30.212 62 14.418 4 6 17 130.769 64 14.88 1912. 4500 106 108 24 48 10.66 4 11 9 83.3 55 12.22 1913. 4750 117 121 25.473 50 10.526 9 11 11 90.9 52 10.947 Area of District in acres 3284 Land (land and inland water) 27 Water 3.311 At Census of 1911 Total Population at all ages 4261 Number of Inhabited Houses 887 Average number of persons per house 4.8 10 TABLE II. CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 191 Name of District—URBAN DISTRICT OF HAYES, MIDDLESEX. 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 Smallpox .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. Diphtheria (including Membranous croup) 3 .. .. 2 1 .. .. .. 2 Erysipelas 4 .. 1 .. .. 1 2 .. 0 Scarlet fever 15 .. 6 8 1 .. .. .. 15 Typhus fever .. .. .. .. .. .. .. .. .. Enteric fever .. .. .. .. .. .. .. .. .. Relapsing fever .. .. .. .. .. .. .. .. .. Continued fever .. .. .. .. .. .. .. .. .. Puerperal fever .. .. .. .. .. .. .. .. .. Cerebrospinal Meningitis .. .. .. .. .. .. .... .. .. Poliomyelitis .. .. .. .. .. .. .. .. .. Pulmonary Tuberculosis 11 1 1 2 1 4 2 .. .. Other forms of Turberculosis 2 2 .. .. .. .. .. .. .. Totals 35 3 8 12 3 5 4 17 Isolation Hospital—Hospital for Small Pox, Yeading, Hayes. Joint Isolation Hospital, Kingston Lane, Hillingdon, 11 TABLE CAUSES OF, AND AGES AT DEATH DURING THE YEAR 1913. Name of District—URBAN DISTRICT OF HAYES, MIDDLESEX. 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) 51 10 .. .. .. .. .. .. .. 51 Uncertified 1 1 .. .. .. .. .. .. .. 1 Enteric Fever .. .. .. .. .. .. .. .. .. .. Small Pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. 1 .. .. .. .. .. 1 Diphtheria and Croup .. .. .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. 1 .. .. 1 Erysipelas .. .. .. .. .. .. .. .. .. .. Phthisis (Pulmonary Tuberculosis) .. .. .. .. .. 1 4 2 .. 7 Tuberculous Meningitis .. .. .. .. .. .. .. .. .. 1 Other Tuberculous Diseases .. .. .. .. .. .. .. 1 .. 1 Cancer, malignant disease .. .. .. .. .. .. .. 1 .. 1 Rheumatic Fever .. .. .. .. .. .. .. .. .. .. Meningitis .. .. .. .. .. .. 1 .. .. 1 Organic Heart Disease .. .. .. .. .. .. 1 .. 3 4 Bronchitis .. .. .. .. .. .. .. .. .. .. Pneumonia (all forms) .. 3 1 .. .. .. .. 1 2 7 Other diseases of Respirator organs .. .. .. .. .. .. .. .. 1 1 Diarrhoea and Enteritis .. 2 .. .. .. .. .. .. .. 2 Appendicitis and Typhlitis .. .. .. .. .. .. .. .. .. 1 Cirrhosis of Liver .. .. .. .. .. 1 1 .. .. 2 Alcoholism .. .. .. .. .. .. .. .. .. .. Nephritis and Bright's Disease .. .. .. .. .. .. 1 .. .. 1 Puerperal Fever .. .. .. .. .. .. .. .. .. .. Other accidents and diseases of Pregnancy and Parturition .. 1 .. .. .. .. .. .. .. 1 Congenital Debility and Malformation, including Premature Birth .. 3 .. .. .. .. .. .. .. 3 Violent Deaths, excluding Suicide .. .. .. .. .. .. .. .. 2 2 Suicide .. .. .. .. .. .. .. .. .. .. Other Defined Diseases .. 2 .. .. 3 .. .. 1 4 10 Diseases ill-defined or unknown .. .. .. .. .. .. .. 2 3 5 Total (Certified and Un-certified) 52 11 2 1 4 2 9 8 15 52 12 TABLE IV. INFANTILE MORTALITY DURING THE YEAR 1913. 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 months. 6-9 months. 9-12 months. Total Deaths under 1 year. All Causes Certified .. .. .. .. .. .. .. .. .. .. Uncertified .. .. .. .. .. .. .. .. .. .. Smallpox .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping-cough .. .. .. .. .. .. .. .. .. .. Diphtheria and Croup .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. .. .. .. .. .. .. .. .. Abdominal Tuberculosis .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. .. .. .. .. .. .. .. .. .. Convulsions .. .. .. .. .. .. .. .. 1 1 Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis .. .. .. .. .. .. .. .. .. .. Pneumonia (all forms) .. .. .. .. .. .. .. .. 2 3 Diarrhoea .. .. .. .. .. .. .. .. .. .. Enteritis .. .. .. .. .. .. .. .. .. 2 Gastritis .. .. .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. .. .. .. .. Rickets .. .. .. .. .. .. .. .. .. .. Suffocation, overlying .. .. .. .. .. .. .. .. .. .. Injury at Birth 1 .. .. .. 1 .. .. .. .. 1 Atelectasis .. .. .. .. .. .. .. .. .. .. Congenital Malformations .. .. .. .. .. .. .. .. .. .. Premature birth 2 .. .. .. .. .. .. .. .. 2 Atrophy, Debility, and Marasmus .. .. .. .. .. .. .. .. .. 1 Other causes .. .. .. .. .. .. .. .. 1 1 3 .. .. .. 3 .. 3 1 4 11 Births in the year: legitimate 115; illegitimate 6. Deaths in the year: legitimate infants 10; illegitimate infants 1. 13 SANITARY WORK FOR THE YEAR 1913. Inspections:— Totals. Number of Premises Inspected on Complaint 3 „ „ „ in connection with Infectious Diseases 20 Number of Premises under Periodical Inspection 14 Total Number of Inspections and Re-Inspections made 304 Notices:— Cautionary or Intimation Notices Given 79 Dwelling-Houses and Action under H. & T. P. Act, 1909. Number of Houses dealt with under Section 15 — Number of Houses found to be in a state Dangerous or Injurious to Health (Section 17) 18 Number of Representations made by M.O.H. — Number of Houses made habitable without Closing Order — Number of Closing Orders made by L.A. (Section 17) 19 Number of Houses closed voluntarily — Number of Closing Orders determined after repairs — Number of Houses demolished:— (a) by order of L.A. (Section 17) — (b) Voluntarily 3 Canal Boats used as Dwellings:— Number of Contraventions of Regulations none Number Registered. (This is not a registration Authority) Movable Dwellings, Caravans, Tents, &c. none Bakehouses:— Number in District 4 Contraventions of Factory Acts — Slaughter Houses:— Number on Register 5 Number of Inspections 16 Cowsheds Number on Register 3 Number of Inspections made 12 Number of Milch Cows in District about 84 14 SANITARY WORK FOR THE YEAR 1913—(continued). Dairies and Milkshops:— Totals. Number on Register 5 Number of Inspections made 12 Offensive Trades:— Number of Premises in District none Water Supply and Water Service:— Percentage of Houses supplied from Public Water Service 94 Percentage of Houses supplied on Constant System 94 Number of Samples obtained for Analysis from Local Wells 2 „ „ „ „ from Public Supply none Drainage and Sewerage of Existing Buildings:— Water Closets: Repaired, Supplied with Water, or otherwise Improved 6 Number of Water Closets substituted for dry Receptacles 12 Percentage of Houses supplied with Water Closets 90 Drains: Examined, Tested, Exposed, &c. 9 Unstopped, Repaired, Trapped, &c. 7 Reconstructed 14 Cesspools: Emptied, Cleansed, etc 5 Abolished, and Drains connected to Sewer 4 Percentage of Houses Draining into Sewers 85 Disinfection: Rooms Disinfected (a) Ordinary Infectious Diseases 22 (b) Phthisis 3 Dust:— New Bins Provided 100 How frequently is Dust Removed from each House?— Weekly. Number of Complaints of Non-Removal received none Method of Disposal By Tipping Sundry Nuisances Abated:— Accumulations of Refuse 4 Foul Ditches, Ponds, &c., and Stagnant Water 5 Other Nuisances 2 15 FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. I.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. No. of Inspections. No. of Written Notices. FACTORIES (Including Factory Laundries) 30 1 WORKSHOPS (Including Workshop Laundries) 11 1 WORKPLACES (Other than Outworkers' Premises included in Part 3 of this Report) - - Total 41 2 II.—DEFECTS FOUND. Nuisances under the Public Health Acts:— Found. Remedied. Want of Cleanliness — — Want of Ventilation — — Overcrowding — — Want of Drainage of Floors — — Other Nuisances — — Sanitary Accommodation: Insufficient Unsuitable or Defective — — Not Separate for Sexes — — Offences under the Factory and Workshop Act:— Illegal Occupation of Underground Bakehouse (s. 101) — — Breach of Special Sanitary Requirements for Bakehouses (s.s. 97 to 100) Other Offences — — (Excluding Offences relating to Outwork, which are included in Part 3 of this Report) - - Total — — 16 III.—HOME WORK. Number. Wearing Apparel (Making, &c.):— Lists received from Employers — IV.—REGISTERED WORKSHOPS. Number Workshops on the Register (s. 131) at the end of the year:— Bakehouses 4 Workshops 6 Total 10 V.—OTHER MATTERS. Number. Matters notified to H.M. Inspector of Factories: — Failure to affix Abstract of the Factory and Workshop Act (s. 133) — Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5):— Notified by H.M. Inspector — Reports (of action taken) sent to H.M. Inspector — Other — Underground Bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year—