hay 19 library Fortieth 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 1944 THE URBAN DISTRICT COUNCIL OF HAYES AND HARLINGTON MEMBERS OF THE COUNCIL, 1944 Chairman: COUNCILLOR W. R. F. SMART, J.P. Vice-Chairman: COUNCILLOR L. STRINGER Councillors: L. Ayerst, P. J. Burke, A. J. Cole, L.M. Graves, J.P., Mrs. A. B. Greenhead, E. K. Harding, A. N. Hartley, W. C. Laing, A. C. Nichols A. Ogden, D. Page, J.P., G. Pratt, A. Simpson, P. G. Soulsby W. Sutcliffe, A. P. Taylor, W. H. Turner. PUBLIC HEALTH COMMITTEE, 1944 Chairman: Councillor L. M. Graves, J.P. Councillors: L. Ayerst, Mrs. A. B. Greenhead, E. K. Harding, G. Pratt, A. Simpson, A. P. Taylor. 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 Mary L. Lloyd, M.A., M.B., Ch.B., D.P.H. Chief Sanitary Inspector, Inspector under the Shops Acts, and Petroleum Inspector: Richard Bill, Cert.R.San.Inst., and Certified Meat Inspector Sanitary Inspectors: A. T. Matson S. Greenhead Now in H.M. Forces E. G. Drayson S. H. G. Stevens C. F. Allard (Resigned 30.11.44) Clerks: F. E. Pollard S. George P. Rowley 1 Medical Officer's Annual Report Public Health Department, Town Hall, Hayes, Middlesex. August, 1945. To the Chairman and Members of the Urban District Council of Hayes and Harlington. Mr. Chairman, Madam and Gentlemen, I have the honour to present to you the fortieth Annual Report on the health of your Urban District. As in the case of the previous five Annual Reports, this is abridged in accordance with the instructions of the Ministry of Health. In spite of five years of war, with its attendant restrictions in food and recreation, gross overcrowding of the population, deficient ventilation of the houses consequent on the black-out, and long working hours, the health of this district has not appreciably deteriorated. There has, however, been an increase in the incidence of tuberculosis, although it is probable that part of this increase is due to the more efficient methods of early diagnosis which have resulted from mass radiography. The most urgent matter affecting public health at the present moment is undoubtedly overcrowding. The great shortage of houses is due partly to destruction by enemy action, but chiefly to the fact that there has been an increase in the population of about 15,000 since 1938. The most outstanding feature in the matter of the incidence of infectious disease is the startling reduction in diphtheria. During 1944 there was no death from diphtheria. Six cases were notified, none of which had been immunised. It will thus be seen that the free immunisation of children against diphtheria, begun here in 1935, has been of the greatest benefit to the district, as with the severe overcrowding from which the population has suffered, it might have been expected that such a disease might have spread rapidly and have been responsible for many deaths. During the war, owing to the fact that several of the members of the staff have joined His Majesty's Forces, the work of the Department has been carried on with some difficulty. I should like to thank the members and officers of the Council and also the County Medical Officer and his staff for the help which they have always been so ready to give my Department. I have the honour to be, Your obedient servant, J. STANLEY LLOYD, Medical Officer of Health. 3 SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (acres) 5,161 Population (census 1931) 23,646 Population (Mid-year) (1944), RegistrarGeneral's Estimate: Working Population Figure 59,020 Number of inhabited houses as at 31st December, 1944 15,498 Rateable Value (Estimate) £404,442 Product of a penny rate £1,642 5s. 2d. UNEMPLOYMENT, 1944 Particulars not available. Extracts from Vital Statistics of the Year Total M. F. Live Births— Birth Rate per 1,000 of the estimated resident population 20.78 Legitimate 1,146 593 553 Illegitimate 81 43 38 [ Stillbirths 29 17 12 Rate per 1,000 total (live and still) births 21.28 Deaths 468 237 231 Death Rate per 1,000 of the estimated resident population 7.92 Deaths from puerperal causes:— Rate per 1,000 total (live and still) births Deaths Puerperal sepsis — 0.00 Other puerperal causes 1 0.79 Total 1 0.79 Death rate of infants under one year of age.:— All infants per 1,000 live births 37.43 Legitimate infants per 1,000. legitimate live births 38.31 Illegitimate infants per 1,000 illegitimate live births 24.69 M. F. Total Deaths from Cancer (all ages) 31 41 72 Deaths from Measles (all ages) — 1 1 Deaths from Whooping Cough (all ages) — 2 2 Deaths from Diarrhoea (under 2 years of age) 6 2 8 Deaths from Tubeiculosis of resp. system (all ages) 17 14 31 Deaths from Tuberculosis (other forms) (all ages) 2 3 5 Deaths from Heart Disease (all ages) 45 39 84 Deaths from Bronchitis (all ages) 15 7 22 Deaths from Pneumonia (all forms) (all ages) 17 11 28 4 CAUSES OF DEATH DURING 1944 Causes of Death Male Female All Causes 237 231 1. Typhoid and paratyphoid fevers — — 2. Cerebro-spinal fever — — 3. Scarlet fever — 1 4. Whooping cough — 2 5. Diphtheria — — 6. Tuberculosis of respiratory system 17 14 7. Other forms of tuberculosis 2 3 8. Syphilitic diseases 1 1 9. Influenza — 2 10. Measles — 1 11. Ac. polio-myelitis and polio-encephalitis — — 12. Ac. infantile encephalitis — 1 13. Cancer of buccal cavity and oesophagus (M), uterus (F) 2 3 14. Cancer of stomach and duodenum 2 7 15. Cancer of breast — 10 16. Cancer of all other sites 27 21 17. Diabetes 2 2 18. Intra-cranial vascular lesions 15 20 19. Heart disease 45 39 20. Other diseases of circulatory system 4 15 21. Bronchitis 15 7 Pneumonia (all forms) 17 11 23. Other respiratory diseases 1 2 24. Ulcer of stomach and duodenum 5 1 25. Diarrhoea (under 2 years of age) 6 2 26. Appendicitis 1 — 27. Other digestive diseases 6 7 28. Nephritis 4 3 29. Puerperal and post-abortive sepsis — - 30. Other maternal causes — 1 31. Premature birth 9 5 32. Congenital malformations, birth injuries, infantile diseases 6 5 33. Suicide 1 1 34. Road traffic accidents 7 1 35. Other violent causes 23 31 36. All other causes 19 12 Deaths of infants Total 30 l6 Legitimate 29 15 Illegitimate 1 1 Live births Total 636 591 Legitimate 593 553 Illegitimate 43 38 Stillbirths Total 17 12 Legitimate 16 12 Illegitimate 1 — Population (Mid-year) 59,020 5 BIRTH-RATE, CIVILIAN DEATH-RATES, ANALYSIS OF MORTALITY, MATERNAL MORTALITY, AND CASERATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1944 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 Births:— Rates per 1,000 C ivilian Population Live 17.6 20.3 20.9 15.0 20.78 Still 0.50 0.64 0.61 0.42 0.49 Deaths:— All causes 11.6 13.7 12.4 15.7 7.9 Typhoid and paratyphoid 0.00 0.00 0.00 0.00 0.00 Scarlet fever 0.00 0.00 0.00 0.00 0.01 Whooping cough 0.03 0.03 0.02 0.04 0.03 Diphtheria 0.02 0.03 0.03 0.01 0.00 Influenza 0.12 0.10 0.11 0.08 0.03 Smallpox 0.00 - - - 0.00 Measles 0.01 0.01 0.01 0.00 0.01 Notifications:— Typhoid fever 0.01 0.01 0.01 0.01 0.00 Paratyphoid fever 0.01 0.00 0.01 0.01 0.00 Cerebro-spinal fever 0.05 0.06 0.04 0.06 0.01 Scarlet fever 2.40 2.41 2.67 1.57 2.73 Whooping cough 2.49 2.49 2.29 2.90 3.37 Diphtheria 0.58 0.67 0.69 0.31 0.10 Erysipelas 0.29 0.32 0.28 0.37 0.13 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 4.16 4.51 3.94 2.98 3.56 Pneumonia 0.97 1.3 0.82 0.93 0.49 Rates per 1,000 Live Births Deaths under 1 year of age 46 52 44 61 37 Deaths from Diarrhoea and Enteritis under 2 years of age 4.8 7.3 4.4 10.1 6.5 Rates per 1,000 Total Births (i.e., Live and Still) Maternal Mortality (excluding Abortion):— Puerperal sepsis 0.28 Not available o.oo Others 1.25 0.00 Total 1.53 o.oo Notifications:— Puerperal fever Puerperal pyrexi 10.34 13.13 9.25 3.61 14.14 0.78 SECTION B GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA Similar to previous years. 6 SECTION C SANITARY CIRCUMSTANCES OF THE AREA Water.—Two samples taken from the supplies of the Rickmansworth and Uxbridge Valley Water Company were examined and found to be fit for drinking purposes, together with twenty-six samples of the South West Suburban Water Company's supply taken by this Authority and five neighbouring authorities. Three samples were taken from the Wood End Park Estate's supply which were regarded as being safe for drinking purposes. Drainage and Sewerage Rivers and Streams No important changes Closet Accommodation from last year. Public Cleansing SANITARY INSPECTION OF THE AREA 1.—Complaints During the year 467 complaints were received with respect to the following matters, viz. Choked and defective drains 75 Insanitary or dilapidated condition of houses and premises 178 Offensive accumulations or deposits 15 Cesspools overflowing 1 Rats 91 Other nuisances 107 Total 467 2.—Inspection of District Number of houses and premises inspected (ordinary) 1,150 „ „ houses inspected and particulars recorded (Housing Act, 1936) 4 „ „ houses and premises re-inspected 1,186 „ „ miscellaneous visits 529 „ „ food inspections 282 „ „ visits to slaughter-houses 40 „ „ „ „ dairies, cowsheds and milk-shops 24 „ „ „ „ bakehouses and factories 45 „ „ „ re water supplies 17 „ „ „ „ cases of infectious disease 269 „ „ petroleum stores 4 „ „ inspections of tents, vans and sheds 10 „ „ verminous premises inspected 116 „ „ premises disinfected 158 „ „ inspections under the Shops Acts 139 „ „ „ the Housing Act, 1936 : (overcrowding) 42 „ „ public urinals inspected 5 7 3.—Notices Served Served Complied with Out- standing Informal notices 123 115 8 Statutory notices— Section 75, Public Health Act, 1936 4 1 3 Section 93, Public Health Act, 1936 7 7 - Section 39, Public Health Act, 1936 1 1 - Part I, Factories' Act, 1937 4 — 4 4.—Summary of Sanitary Improvements Carried Out Drainage Number of drains examined, exposed, etc.— Drainage systems reconstructed 1 Defective drains unstopped, repaired, etc 57 Manholes built, altered or repaired — Fresh air inlets fixed or repaired — Glazed sinks provided — Cesspools repaired — Water-Closets Defective flushing cisterns renewed or repaired 9 New pans provided 3 W.C. apartments repaired, cleansed, etc 15 Urinals reconstructed or repaired — Privies and pail-closets converted to W.C.'s — General Repairs, etc. Roofs repaired and made weatherproof 8 Eaves-gutters, repaired or renewed 5 Damp walls 're-pointed or rendered damp-proof 4 Defective brickwork of external walls repaired 1 Defective brickwork and plaster work of internal walls repaired 5 Defective wood floors repaired 2 Defective stairs repaired — Handrails provided - Lighting and ventilation increased 2 Defective tile, brick or concrete floors repaired — Defective doors repaired — Defective ceilings repaired 9 Defective windows repaired, made to open or renewed 2 Rooms cleansed 9 Defective stoves, coppers, etc., repaired 8 Sink waste pipes trapped or repaired 16 Insufficient water supply increased 1 8 Defective yard pavings repaired 3 Offensive accumulations removed 11 New dustbins provided 30 Food stores provided — Lighting, etc., of food stores improved - Defective cold water storage cisterns 10 THE FACTORIES ACT, 1937 Forty-five inspections of factories with and without mechanical power have been made during the year. There are eighty-six factories with mechanical power and four factories without mechanical power on the register, classified as under:— Factories with Mechanical Power Aircraft 4 Joinery 3 Bakers 8 Mineral waters 1 Building materials 1 Motor repairs 3 Boot repairs 8 Munitions 2 Caravans 1 Oil blending 2 Cheese 1 Oil drum cleaning 1 Chemical engineers 1 Paint 1 Cocoa 1 Pianos 1 Crisps 1 Printing 4 Cardboard 1 Radio 3 Electric transformers 1 Rubber 1 Engineering 22 Sawmills 1 Fire extinguishers 1 Slab partitions 1 Firelighters 1 Tarmacadam 1 Furniture 2 Valet services 1 Glazed tiles 1 Wire 2 Ink 1 Wood block floors 1 Jams 1 Factories without Mechanical Power Baker 1 Smith 1 Motor repairers 2 1.—Inspections Premises Number of Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 45 8 - Factories without mechanical power — — — Other premises under the Act (including work of building and engineering construction but not including outworker's premises) - - - Total 45 8 — 9 2. Defects Found Particulars Number of Defects Found Remedied Nuisances under the Public Health Acts:— Want of cleanliness 1 1 Want of ventilation 3 3 Overcrowding — — Want of drainage of floors — — Other nuisances 4 3 Sanitary accommodation Insufficient 3 1 Unsuitable or defective 10 10 Not separate for sexes — — Offences under the Factories Act:— Other offences — — Total 21 18 OFFENSIVE TRADES There are three establishments carrying on the offensive trade of fat extracting. SECTION D HOUSING 1.—Inspection of Dwelling-Houses during the Year (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,154 (b) Number of inspections made for the purpose 2,340 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 Nil (b) Number of inspections made for the purpose Nil (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (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 Nil 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 85 10 3.—Action under Statutory Powers during the Year (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) 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 requiring defects to be remedied 12 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) By owners 3 (b) By Local Authority in default of owners 1 (c) Partly complied with, but not yet complete 8 (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 Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (d) Proceedings under Section 12 of the Housing Act, 1936:— (1) 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. 11 SECTION E INSPECTION AND SUPERVISION OF FOOD (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 twenty-two licences granted during the year:— Designation Dealer's Licence Supplementary Licence Pasteurised 8 4 Tuberculin Tested 6 4 No refusal or revocation of licenses to retailers has been made. There are now twenty-six persons registered in accordance with the Food and Drugs Act, 1938, as under:— Wholesale Traders or Producers of Milk 6 Retail Purveyors of Milk with premises in the district 9 Retail purveyors of Milk whose premises are outside the district 11 26 (b) Meat — There is no Ministry of Food slaughter-house in the district. (c) Adulteration, etc. Particulars not available. SECTION F PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES Scabies.—By arrangement with the Hayes Cottage Hospital, four clinics weekly have been held for treatment of scabies and infestation with lice. Members of the British Red Cross Society have very kindly volunteered to give their services at the clinic. In addition, the First Aid Post at Minet Clinic dealt with cases of scabies and lice arising in the population nearest to them. Scabies cases were treated by Benzyl Benzoate and disinfestation from lice was effected by the use of Lethane Oil, in both cases very successfully. 938 attendances were recorded during the year. 12 Diphtheria Immunisation Number of sessions 172 Number of attendances 1,357 Number of prophylactics given 920 Number of post-Schicks 184 Number of re-tests 26 Percentage of failure to immunise 4.2% Percentage successfully immunised 95.8% Notifiable Diseases (other than Tuberculosis) during the Year, 1944 Diseases Total Cases Notified Cases admitted to Hospital Total Deaths Scarlet Fever 161 127 1 Diphtheria 6 6 - Pneumonia 29 27 28 (all forms) Cerebro-spinal fever 1 1 — Puerperal pyrexia 1 1 — Erysipelas 8 3 — Ophthalmia neonatorum 4 4 — Measles 201 3 1 Whooping cough 199 3 2 Dysentery 2 2 — Acute poliomyelitis 1 1 - ANALYSIS OF TOTAL CASES Disease At ages Under 1 1 2 3 4 5 10 15 20 35 45 65 and year 2 3 4 5 10 15 20 35 45 65 over Scarlet fever 3 2 4 9 15 97 21 8 9 - 1 - Diphtheria — 1 — — 1 2 1 — 1 — — — Pneumonia — — 1 — 2 3 2 1 8 4 7 — Cerebro-spinal fever 1 - - - - - - - - - - - Puerperal pyrexia — - - - - - - - 1 - - - Erysipelas — — — — — 2 — 1 3 1 1 — Ophthalmia neonatorum 4 - - - - - - - - - - - Measles 6 11 10 14 10 115 21 5 6 — — — Whooping cough 18 25 30 20 24 66 4 — 2 — — — Dysentery 1 — — — — 1 — — — — — — Acute poliomyelitis - - - - - - 1 - - - - - 13 TUBERCULOSIS New Cases and Mortality during 1944 Age Periods New Cases Mortality Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. 0 - 1 — - - 1 - - 1 2 1 1 — — — 1 1 5 2 1 5 4 — — — 1 15 9 13 — 2 3 5 — — 25 9 11 1 1 2 5 — 1 35 14 1 2 2 5 2 1 — 45 4 3 — - 5 1 - - 55 6 — — — 4 — — — 65 and upwards — 1 - - - - - - T otal 46 32 9 9 19 14 2 3 The ratio of non-notified tuberculosis deaths to total tuberculosis deaths is 15.7 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. Insulin.—In accordance with Circular 2734 of the Ministry of Health, dated 4th January, 1943, free insulin has been supplied to nine persons (all female) during the year, the amount being:— 100x10 c.c. 40 Unit insulin 105xl0c.c. 40 ,, ,, (protamine with zinc) Ambulance Service.—The ambulance provided by the Urban District Council is free to all residents in the area. 1468 calls were made in 1944, total mileage being 12,836, making an average of 8.7 miles per call. The Civil Defence ambulances were used on occasions when the ambulance was out and also when it was temporarily laid up for repairs. August, 1945. 14