HAY 15 THIRTY-FIFTH ANNUAL REPORT (ABRIDGED) on the HEALTH of the URBAN DISTRICT OF HAYES AND HARLINGTON Middlesex J. STANLEY LLOYD, M.D., F.R.C.S.Edin. Medical Officer of Health 1939 THE URBAN DISTRICT COUNCIL OF HAYES AND HARLINGTON MEMBERS OF THE COUNCIL, 1959. Chairman: COUNCILLOR A.C. NICHOLS, J.P. Vice-Chairman: COUNCILLOR P.G. SOULSBY. COUNCILLORS: L. AYERST, F.C. BARNET'T, MRS. I.E. DOWNER, L.M. GRAVES, J. P., MRS. A.B. GREENHEAD, E.K. HARDING, E.G. HARTLEY, R.R.A. JOHNSON, A. OGDEN5 D. PAGE, G. PRATT, A. SIMPSON, W.R.F. SMART, G.H. STINTON, L. STRINGER, W. SUTCLIFPE, C. VIVEASH. PUBLIC HEALTH COMMITTEE, 1939. Chairman: COUNCILLOR L.M. GRAVES, J.P. COUNCILLORS: L. AYERST, MRa. A. B. GREENHEAD, E.G. HARTLEY, A.C. NICHOLS, J.P. (ex-officio), A. OGDEN, G. PRATT, A. SIMPSON, P.G. SOULSBY, L. STRINGER. « STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health: J. STANLEY LLOYD, M.D., F.R.C.S.Edin. Medical Officer in Charge of Diphtheria Immunisation Clinic, Hayes: GUY BOUSFIELD, M.D., B.S.Lond. Medical Officer in Charge of Diphtheria Immunisation Clinic, Harlington: G. HIGHFIELD-JONES, M.R.C.S.(Eng.), L.R.C.P.(Lond.)• Chief Sanitary Inspector, Inspector under the Shops Acts and Petroleum Inspector: RICHARD BILL, Cert.R.San.Inst, and Certified Meat Inspector. Deputy Chief Sanitary Inspector: LAURENCE BURKE. Additional Sanitary Inspectors: A.T. MATSON (joined H.M. Forces 9th December, 1939). R.S. NEWSOME (to 7th January, 1939). S.H.G. STEVENS (from 1st May, 1939). Additional Sanitary Inspector and Assistant Shops Inspector: S. GREENHEAD (from 20th June, 1939 - joined H.M. Forces 9th December, 1939). Temporary Additional Sanitary Inspector: E.G. DRAYSON (from 20th December, 1939). Temporary Meat Inspector: E.G. DRAYSON (to 19th December, 1939). Clerk and Temporary Assistant Shops Inspector: C.F. ALLARD (from 20th December, 1939). Clerks: C.F. ALLARD (to 19th December, 1939). S. GREENHEAD (to 19th June, 1939). F.E. POLLARD (from 8th August, 1939). SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (acres) 5,161 Population (Census 1931) 23,646 Population (Mid-year, 1939) Registrar-General's Estimate: Working Population Figure 51,370 Present estimated population at 3.4 persons per house 51,768 Number of inhabited houses end of 1939 15,226 Rateable value £362,186 Sum represented by a penny rate Gross £1,434 Net (Est.) £1,320 UNEMPLOYMENT - 1939. Males Females Total January 1,068 562 1,630 February 1,034 582 1,616 March 823 593 1,416 April 701 593 1,294 May 670 963 1,633 June 464 782 1,246 July 351 542 893 August 405 378 783 September 517 564 1,081 October 766 '727 1,493 November 758 667 1,425 December 826 616 1,442 3. AVERAGE UNEMPLOYMENT PER MONTH. 1939 1938 1937 Males 699 1,012 555 Females 631 650 288 1,330 1,662 843 1939 Male figures - decrease of approx. 31 per cent compared with 1938 figures. 1939 Female figures - decrease of approx. 3 per cent compared with 1938 figures. 1939 Total figures - decrease of approx. 20 per cent compared with 1933 figures. EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total M. F. (Birth Rate per 1,000 of (the estimated resident (population Live Births Legitimate 1,137 578 559 Illegitimate 46 24 22 (23.0 Stillbirths 33 14 19 (Rate per 1,000 total (live (and still) births 27.1 Deaths 376 210 166 (Death Rate per 1,000 of (the estimated resident (population 7.32 The Areal Comparability Factor for adjusting the local death rate to that for the whole country after taking into consideration age and sex is the same as last year, namely 1.36. The adjusted death rate is, therefore, 10.Oi Deaths from puerperal causes Deaths. Rate per 1,000 total (live and still) births. Puerperal sepsis 1 0.825 Other puerperal causes 1 0.825 Total 2 1.65 Death rate of infants under one year of age - All infants per 1,000 live births 56.8 Legitimate infants per 1,000 legitimate live births 53.8 Illegitimate infants per 1,000 illegitimate livo births 130.4 M. P. Total Deaths from Cancer (all ages) 22 27 49 Deaths 'from Measles (all ages) 0 0 0 Deaths from Whooping Cough (all ages) 0 2 2 Deaths from Diarrhoea (under 2 years of age) 8 3 11 4. CAUSES OF DEATH DURING 1939. Causes of Death. Males. Females. All Causes 210 166 1. Typhoid and Paratyphoid Fevers – – 2. Measles – – 3. Scarlet Fever – 1 4. Whooping Cough – 2 5. Diphtheria 1 2 6. Influenza 4 2 7. Encephalitis lethargica — – 8. Cerebro-spinal Fever — – 9. Tuberculosis of respiratory system 8 10 10. Other tuberculous diseases 1 3 11. Syphilis 1 — 12. General paralysis of the insane, tabes dorsalis — — 13. Cancer, malignant disease 22 27 14. Diabetes 2 2 15. Cerebral haemorrhage, etc. 4 4 16. Heart disease 52 36 17. Aneurysm 4 2 18. Other circulatory diseases 6 12 19. Bronchitis 5 - 20. Pneumonia (all forms) 22 14 21. Other respiratory diseases 2 1 22. Peptic ulcer 3 1 23. Diarrhoea (under 2 years of age) 8 3 24. Appendicitis 3 5 25. Cirrhosis of liver 1 - 26. Other diseases of liver, etc. 2 — 27. Other digestive diseases 1 2 28. Acute and chronic nephritis 7 2 29. Puerperal sepsis - 1 30. Other puerperal causes — 1 31. Congenital debility, premature birth, malformations, etc. 17 17 32. Senility 1 1 33. Suicide 1 — 34. Other violence 17 5 35. Other defined diseases 15 9 36. Causes ill-defined or unknown - - Diarrhoea (2 years and over) - 1 Deaths of Infants 38 29 under 1 year (Legitimate 35 26 (illegitimate 3 3 (Total 602 581 Live Births (Legitimate 578 559 (Illegitimate 24 22 (Total 14 19 Stillbirths (Legitimate 13 19 (illegitimate 1 — Population (Mid-Year) 51,370 (Figures furnished by the Registrar-General). 5. BIRTH-RATES , DEATH-RATES, ANALYSIS OF MORTALITY, MATERNAL DEATH-RATES, AND CASE-RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1939. England and Wales, London, 126 Great Towns and 148 Smaller 'Towns. (Provisional Figures based on Weekly and Quarterly Returns.) • England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 Census) London Administrative County Hayes and Harlington Rates per 1,000 Population BIRTHS:- Live 15.0 14.8 15. 6 12.3 23.0 Still 0.59 0.59 0.57 0.44 0.64 DEATHS:- All Causes 12.1 12.0 11.2 11.9 10.0 Typhoid and Paratyphoid fevers 0.00 0.00 0.00 0.00 0.00 Smallpox — — — — — Measles 0.01 0.01 0.01 0.00 0.00 Scarlet fever • 0.01 0.00 0.00 0.00 0.02 Whooping cough 0.03 0.03 0.02 0.03 0.04 Diphtheria 0.05 0.05 0.04 0.02 0.06 Influenza 0.21 0.19 0.20 0.18 0.12 NOTIFICATIONS:- Smallpox 0.00 — - – 0.00 Scarlet fever 1.89 1.96 1.78 1.53 1.28 Diphtheria 1.14 1.21 1.16 0.98 0.62 Enteric fever 0.04 0.03 0.04 0.03 0.02 Erysipelas 0.34 0.40 0.31 0.37 0.08 Pneumonia 1.02 1.21 0.89 0.99 0.45 Rates per 1,000 Live Births Deaths under 1 year of age 50 53 40 48 57 Deaths from Diarrhœa and Enteritis under 2 years of age 4.6 6.3 3.0 8.2 9. 3 MATERNAL MORTALITY:- Puerperal Sepsis 0.77) (0.85 Others 2.16) Not available (0.85 Total 2.93) (1.70 Rates per 1,000 Total Births (i.e. Live and Still) MATERNAL MORTALITY:- Puerperal Sepsis 0.74) (0.825 Others 2.08) Jot available (0.825 Total 2.82) (1.65 NOTIFICATIONS:- Puerperal fever) 14.35 17.26 12.99 (3.31) \ 6.60 Puerperal pyrexia) (14.22) 6. SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Similar to previous years. SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. WATER.— Five samples taken from the supplier of the Rickmansworth and Uxbridge Valley Water Co. and the Wood End Park Estate were examined by the Clinical Research Association Ltd. and found to be fit for drinking. Twenty-two samples of the South West Suburban Water Co.'s supply taken by this authority and five neighbouring authorities were found to be fit for drinking. DRAINAGE AND SEWERAGE. ) ) RIVERS AND STREAMS. ) ) CLOSET ACCOMMODATION.) PUBLIC CLEANSING.) No important change from last year. SANITARY INSPECTION OF THE AREA. 1.- COMPLAINTS. During the year 247 complaints were received with respect to the following matters, viz.:- Choked and defective drains 33 Insanitary or dilapidated condition of houses and premises 147 Offensive accumulations or deposits 20 Cesspools overflowing 1 Rats 13 Other nuisances 33 Total 247 2. - INSPECTION OF DISTRICT. Number of houses and premises inspected (ordinary) 990 " " houses inspected and particulars recorded (Housing Act, 1936) 82 " " houses and premises re-inspected 1,904 " " miscellaneous visits 592 " " food inspections 2,452 " " visits to slaughter-houses 2,279 " " " " dairies, cowsheds and milk-shops 48 " " " " bakehouses and factories 102 " " " " re water supplies 10 " " " " cases of infectious disease 185 " " " " offensive trades 89 " " " " petroleum stores 50 " " smoke observations and visits to works 70 " " inspections of tents and vans 423 " " public urinals inspected 92 " " verminous premises inspected 48 " " premises disinfected 117 " " inspections under the Shops Acts 723 " " " (Housing Act, 1936; overcrowding) 1,468 " " " under the Food and Drugs Act 73 Total 11,797 3. - NOTICES SERVED. Served. Complied with. Outstanding. Informal notices 272 249 23 Statutory notices:- Section 75, Public Health Act, 1936 4 4 – Section 93, Public Health Act, 1936 8 6 2 Section 10, Shops Act, 1934 4 3 1 4. - SUMMARY OP SANITARY IMPROVEMENTS CARRIED OUT. Drainage. Number of drains examined, exposed, etc. 46 Drainage systems reconstructed 13 Defective drains unstopped, repaired, etc. 46 Manholes built, altered or repaired 3 Presh air inlets fixed or repaired 2 Glazed sinks provided 3 Cesspools repaired 1 Water Closets. Defective flushing cisterns renewed or repaired 11 New pans provided 10 W.C. apartments repaired, cleansed, etc. 19 Urinals reconstructed or repaired — Privies and pail-closets converted to W.C.'s — General Repairs, etc. Roofs repaired and made weatherproof 24 Eaves, gutters, repaired or renewed 16 Damp walls re-pointed or rendered damp-proof 84 Defective brickwork of external walls repaired 6 Defective brickwork and plaster work of internal walls repaired 15 Defective wood floors repaired 7 Defective stairs repaired 1 Handrails provided 2 Lighting and ventilation increased 6 Defective tile, brick or concrete floors repaired 4 Defective doors repaired 3 Defective ceilings repaired 27 Defective windows repaired, made to open or renewed 22 Rooms cleansed 65 Defective stoves, coppers, etc., repaired 10 Sink waste pipes trapped or repaired 11 Insufficient water supply increased 2 Defective yard pavings repaired 8 Offensive accumulations removed 36 New dustbins provided 55 Pood stores provided 2 Lighting, etc., of food stores improved 1 5. - SHOPS. ) 6. - CAMPING SITES. J 7. - SMOKE ABATEMENT. ) 8. - SWIMMING BATHS AND POOLS. ) 9. - ERADICATION OP BED BUGS. ) SCHOOLS. ) No important change from last year. 8. THE FACTORIES ACT, 1937. One hundred and two inspections of factories with and without mechanical power have been made. There are sixty-four factories with mechanical power and four factories without mechanical power on the register, classified as under:- Factories with mechanical power. Aircraft 1 Ink 1 Bakehouses 8 Jams 1 Bicycle repairs 1 Joinery 2 Boot repairs 7 Mineral waters 1 Builders' materials 1 Motor repairs 4 Caravans 1 Music rolls 1 Cheese 1 Oil blending 1 Chemical engineers 1 Paint 1 Cocoa, etc. 1 Pianos 1 Corrugated cardboard 1 Printing 3 Crisps 1 Radio 2 Electric transformers 1 Rubber 1 Engineering 10 Slab partitions 1 Fire extinguishers 1 Tar macadam 1 Firewood 1 Valet service 1 Furniture 2 Wire 1 Glazed tiles, etc. 1 Wood block floors 1 Factories without mechanical power. Bakehouse 1 Smith 1 Motor repairs 2 1. - INSPECTIONS. Premises Number of Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 99 6 ) ) Factories without mechanical power 3 2 Other Premises under the Act (including works of building and engineering construction but not including Outworkers' premises) ) Nil ) ) ) Total 102 8 2. - DEFECTS FOUND. » Particulars Number of Defects Found Remedied Nuisances under the Public Health Acts:- Want of cleanliness 5 5 Want of ventilation Nil Nil Overcrowding Nil Nil Want of drainage of floors Nil Nil Other nuisances 1 1 Sanitary accommodation (Insufficient 2 2 (Unsuitable or defective 4 4 (Not separate for sexes Nil Nil Offences under the Factories Act:- Other offences Nil Nil Total 12 12 9. OFFENSIVE TRADES. Sixteen fish friers and three fat extractors were licensed by the Council. Regular inspections have been made and the trades found to be conducted satisfactorily. SECTION D. HOUSING. 1. - INSPECTION OF DWELLING-HOUSES DURING THE YEAR. (l) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,072 (b) Number of inspections made for the purpose 2,976 (2) (a) Number of dwelling-houses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 82 (b) Number of inspections made for the purpose 240 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 19 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 53 2. - REMEDY OF DEFECTS DURING THE YEAR WITHOUT SERVICE OF FORMAL NOTICES. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 37 3. - ACTION UNDER STATUTORY POWERS DURING THE YEAR. (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:- (l) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices (a) By owners Nil (b) By local authority in default of owners .. Nil (b) Proceedings under Public Health Acts:- (1) Number of dwelling-houses in respect of which notices were served requring defects to be remedied 8 (2) Number of dwelling-houses in which defects were remedied after service of formal notices (a) By owners 6 (b) By local authority in default of owners .. Nil (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936:- (1) Number of dwelling-houses in respect of which Demolition Orders were made 3 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 3 (d) Proceedings under Section 12 of the Housing Act, 1936:- (l) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil 4. - HOUSING ACT, 1936 - PART IV. - OVERCROWDING. Particulars not available. 10. SECTION E. INSPECTION AND SUPERVISION OF POOD. (a) MILK SUPPLY. Samples of designated milks submitted to the bacteriologist during the year passed the prescribed tests. There is one producer in the district licensed by the County Council under the Milk (Special Designations) Orders for the production of accredited milk. Two milk dealers were licensed during the year to produce pasteurised milk. The table below gives particulars of the other thirty-six licenses granted during the year:- Designation Dealer's Licence Supplementary Licence Pasteurised 16 8 Tuberculin Tested 6 6 No refusal or revocation of licenses to retailers has been made. There are now thirty-two persons registered in accordance with the Milk and Dairies (Amendment) Act, 1922, (superseded by the Pood and Drugs Act, 1938, on the 1st October, 1939) as under:- Wholesale Traders or Producers of Milk 7 Retail Purveyors of Milk with premises in the district 12 Retail Purveyors of Milk whose premises are outside the district 13 Total 32 (b) MEAT. CARCASES EXAMINED AND MEAT CONDEMNED, 1939. Cattle Calves Sheep and Lambs Pigs Number killed 600 368 466 4,658 Number examined 600 368 466 4,658 ALL DISEASES EXCEPT TUBERCULOSIS Whole carcases condemned 5 - — 12 Carcases of which some part or organ was condemned 25 – 6 4 Percentage of the number inspected affected with disease other than tuberculosis 5.00 – 1.29 0.34 TUBERCULOSIS ONLY - Whole carcases condemned 4 — — 4 Carcases of which some part or organ was condemned 103 - — 79 Percentage of the number inspected affected with tuberculosis 17.83 — _ 1.78 11. SLAUGHTER-HOUSES. One registered slaughter-house, one permanently licensed and one annually licensed slaughter-house were discontinued during the year. Four applications were received for licensing of premises as slaughterhouses under the Food and Drugs Act, 1938. These premises will be licensed on completion of certain works of improvement. (c) ADULTERATION, ETC. Particulars not available. SECTION F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. DIPHTHERIA IMMUNISATION - The clinic held at Hayes Cottage Hospital was interrupted at the commencement of hostilities, hut was resumed in October. The clinic started at Harlington Cottage Hospital in January was discontinued at the end of July and was not resumed owing to lack of applications for immunisation and the fact that the hospital was converted into a first-aid post. HAYES COTTAGE HOSPITAL HARLINGTON COTTAGE HOSPITAL Number of sessions 38 26 Number of attendances 1,582 1,028 Number of certificates issued 350 132 Number of re-tests 369 151 Percentage of failure to immunise 4.15 12.58 Successfully immunised 95.85 87.42 NOTIFIABLE DISEASES(other than Tuberculosis) DURING THE YEAR, 1939. Disease Total Cases Notified Cases admitted to Hospital Total Deaths Scarlet fever 66 50 1 Diphtheria 32 29 3 Enteric fever 1 1 — Pneumonia 23 19 36 (all forms) Puerperal pyrexia 8 8 2 Erysipelas 4 2 — Cerebro-spinal fever 1 1 - Poliomyelitis 2 2 – Ophthalmia neonatorum 1 1 - Measles) from 23rd 4 — -) .. Whooping cough) October, 1939 1 — 2) all year ANALYSIS OF THE TOTAL CASES. At Ages Under 1 year 1 2 2 3 3 4 4 5 5 10 10 15 15 20 :20 35 35 45 45 65 65 and over Scarlet fever 2 2 3 4 8 34 4 5 2 1 1 - Diphtheria 1 2 2 1 4 10 6 3 3 — — — Enteric fever — — — — — — — — — — 1 — Pneumonia 1 - - - - - 1 4 8 2 6 1 Puerperal pyrexia — - - — — - - 1 7 — — — Erysipelas - - - - - - - 1 1 2 1 Cerebro-spinal fever — - — - 1 — — — - — - - Poliomyelitis - - - - - - - - 2 - - - Ophthalmia neonatorum 1 - — - - - — - - - - Measles ) from 23rd — 1 — 1 1 1 - - - - - - Whooping cough) October, 1939 - - 1 - - - - - - - - - 12. TUBERCULOSIS. New Cases and Mortality during 1939. Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M. F. " M. P. M. P. M. F. 0 - - — - - - - - 1 — 1 — — — — — 1 5 1 2 1 2 - — — X 1 15 7 5 4 1 1 4 — — 25 8 5 3 — 2 4 — — 35 7 — - — 3 1 1 1 45 1 2 — 1 1 — — — 55 3 2 — — 1 1 — 1 65 and upwards - - _ _ - — - — Total 27 17 8 4 8 10 1 3 The ratio of non-notified tuberculosis deaths to toal tuberculosis deaths is 50.0 per cent. No action has been taken under the Public Health (Prevention of Tuberculosis) Regulations, 1925, relating to tuberculous employees in the milk trade, nor under the Public Health Act, 1936, Section 172, for the compulsory removal to hospital of persons suffering from tuberculosis. (November» 1940.) -21- Temperature. Maximum 570 Normal 55.4° Minimum 45.5° Normal 52.69 Absolute Maximum 81° Absolute Minimum 23° Earth Temperature 1 ft. 52.2° " " 4 ft. 53.1° Miscellaneous. Rainfall 7.91 in. over normal Snow fell on 4 occasions Thunderstorms on 2 occasions Ground Frost on 43 occasions Wind at Gale Force on 2 occasions Warmest day August 20th - 81° Warmest night September 3rd - 63° Coldest day December 28th - 33° Coldest night December 30 th - 23° Relative Humidity morning 80% Relative Humidity night 83% Prevailing winds S.W. N.E. 14. SUMMARY OF PROVISION OF HEALTH SERVICES FOR THE AREA. (a) Laboratory facilities - (See special section) (b) .balance facilities - The service both for infectious and noninfectious cases is adequate for the district, (see Report for 1930) (c) Nursing in the Home - See special section - Maternity and Child Welfare. (See also Report for 1930) (d) Clinic and Treatment Centres - (See Special Sections) (See Report for 1930. (e) Hospitals - public and Voluntary - (See Special section.). (f) Medical services transferred from late Board of Guardians - (See Special section). (g) Mental Deficiency - (see Special Section). (h) Maternity and Child Welfare Services - (See Special Section). (i) Institutional provision for unmarried Mothers, Illegitinate Infants and Homeless children. (See Report for 1930). ( j ) Prevention of Blindness. The Corporation gives a substantial grant to the voluntary Society for the Blind, which is carrying out an ever increasing most admirable and beneficient work, e.g. maintenance of subsistence allowance up to 22/6 per week for each blind person, obtaining and keeping suitable work, general and special treatment in local hospitals and national institutions. By a declaration under the Local Government Act of 1929, the Voluntary Committee now deals with blind persons and sighted "dependents" requiring out-relief from the public Assistance Committee. The public Health Committee has also authorised the Honorary Medici Officer, Dr. Lowe, to complete the Special Medical Certificate of the Board of Education and the Ministry of Health in respect of all new case; (k) Rag, Flock Acts, 1911, 1922 - The amount of flock is comparatively small in amount", clean and used in re-making mattresses and general upholstery. The premises are all in a satisfactory condition and under the regular supervision of the Sanitary Inspectors,