AC 439(3) HAYES+HARLINGTON HAY 20 Forty-first 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 1945 73687 THE URBAN DISTRICT COUNCIL OF HAYES AND HARLINGTON Members of the Council, 1945 Chairman: Councillor L. Stringer, J.P. Vice-Chairman: Councillor P. G. Soulsby. Councillors: L. Ayerst, A. H. Bailey, A. Basford, P. J. Burke, L. M. Graves, J.P., Mrs. A. B. Greenhead, E. K. Harding, A. N. Hartley, 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, 1945 Chairman: Councillor G. Pratt. Councillors: L. Ayerst, L. M. Graves, Mrs. A. B. Greenhead, E. K. Harding, A. Simpson, L. Stringer, 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 tinder the Shops Acts and Petroleum Inspector: Richard Bill, Cert.R.San.Inst, and Certified Meat Inspector. Sanitary Inspectors: A. T. Matson, S. Greenhead, E. G. Drayson (in H.M. Forces), S. H. G. Stevens, J. H. M. Jolliffe (commenced 10.4.45). Clerks: F. E. Pollard, S. George (in H.M. Forces), P. Rowley. l MEDICAL OFFICER'S ANNUAL REPORT Public Health Department, Town Hall, Hayes, Middlesex. August, 1946. To the Chairman and Members of the Urban District Council of Hayes and Harlington Mr. Chairman, Ladies and Gentlemen, I have the honour to present to you the Forty-first Annual Report on the health of your Urban District. As in the case of the previous six Annual Reports, this is abridged, in accordance with the instructions of the Ministry of Health. The year under review was notable as marking the end of the war, with consequent disbandment of the Civil Defence Services, the medical portion of which was under the supervision of this Department. Demobilisation of some of the men and women in the Forces and the return of people evacuated to safer areas during the bombing have contributed to making overcrowding a problem of the first order. In spite of this the health of the district has remained remarkably good, the only adverse feature being an increase in the number of cases of tuberculosis notified. This is due in part to the increase in early diagnosis made possible by an extensive use of radiography. It is satisfactory to note that there has been a slight decrease in the number of deaths from this disease. Immunisation against diphtheria has been carried on to the fullest extent possible. It is unfortunate that some people still disregard the opportunity afforded them by your Council, without cost to themselves, to have their children protected against this disease. There has again been no death during the year from diphtheria. In July, 1945, the permission for tipping to be allowed at the Yeading Refuse Dump having expired, the Minister of Health extended this permission to July, 1947. This was no doubt necessary under the circumstances, but it is to be hoped that this period will not be further extended, as a refuse dump of this size is most undesirable in a built-up area. I should like to express my appreciation of the help which is always readily given by the members and officers of the Council. I have the honour to be, Your obedient Servant, J. STANLEY LLOYD, Medical Officer of Health. 2 SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (acres) 5,161 Population (census 1931) 23,646 Population (mid-year 1945), Registrar-General's Estimate: Working Population Figure 60,660 Number of Inhabited Houses as at 31st December, 1945 15,907 Rateable Value (Estimate) £410,392 Product of a Penny Rate £1,684 EXTRACTS FROM VITAL STATISTICS OF THE YEAR. Total M. F. Live Births- Birth Rate per 1,000 of the estimated resident population 18.99 Legitimate 1,076 543 533 Illegitimate 76 39 37 Stillbirths— Rate per 1,000 total (live and still) births 17.90 Legitimate 20 11 9 Illegitimate 1 1 0 Deaths 432 231 201 Death Rate per 1,000 of the estimated resident population 7.12 Deaths from Puerperal Causes Nil Death Rate of Infants under one year of age:— All infants per 1,000 live births 39.9 Legitimate infants per 1,000 live legitimate live births 40.9 Illegitimate infants per 1,000 live illegitimate live births 26.3 M. F. Total Deaths from Cancer (all ages) 39 40 79 Deaths from Measles (all ages) 1 2 3 Deaths from Whooping Cough (all ages) - — — Deaths from Diarrhœa (under 2 years of age) 1 1 2 Deaths from Tuberculosis of respiratory system (all ages) 16 12 28 Deaths from Tuberculosis (other forms) (all ages) 3 2 5 Deaths from Heart Disease (all ages) 46 30 76 Deaths from Bronchitis (all ages) 20 8 28 Deaths from Pneumonia (all forms) (all ages) 13 11 24 3 BIRTH RATES, CIVILIAN DEATH RATES, ANALYSIS OF MORTALITY, MATERNAL MORTALITY AND CASE RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1945 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 Civilian Population Births:— Live 16.1 19.1 19.2 15.7 18.99 Still 0.46 0.58 0.53 0.4 0.35 Deaths:— All causes 11.4 13.5 12.3 13.8 7.12 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 0.00 Scarlet Fever 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.02 0.02 0.01 0.02 0.00 Diphtheria 0.02 0.02 0.02 0.01 0.00 Influenza 0.08 0.07 0.07 0.07 0.05 Small-pox — — — — — Measles 0.02 0.02 0.02 0.01 0.05 Notifications:— Typhoid Fever 0.01 0.01 0.01 0.01 0.00 Paratyphoid Fever 0.01 0.00 0.01 0.00 0.01 Cerebro spinal Fever 0.05 0.05 0.05 0.06 0.05 Scarlet Fever 1.89 2.02 2.03 1.57 1.22 Whooping Cough 1.64 1.65 1.47 1.25 0.67 Diphtheria 0.46 0.52 0.56 0.31 0.13 Erysipelas 0.25 0.28 0.24 0.31 0.18 Small-pox 0.00 0.00 0.00 0.00 0.00 Measles 11.67 10.89 11.19 9.03 17.14 Pneumonia 0.87 1.03 0.72 0.78 0.3 Rates per 1,000 Live Births Deaths under 1 year of age 46 54 43 53 38.2 Deaths from Diarrhœa and Enteritis under 2 years of age 5.6 7.8 4.5 7.6 1.8 Rates per 1,000 Total Births (i.e., Live and Still) Maternal Mortality (excluding Abortion):— Puerperal Sepsis 0.25 Not available 0.00 Others 0.08 0.00 Total 0.33 0.00 Notifications:— Puerperal Fever and Puerperal Pyrexia 9.93 12.65 8.81 15.87 15.8 4 CAUSES OF DEATH DURING 1945. Cause of Death Male Female All Causes 231 201 1. Typhoid and Paratyphoid Fevers — — 2. Cerebro-spinal Fever 1 — 3. Scarlet Fever — — 4. Whooping Cough — — 5. Diphtheria — — 6. Tuberculosis of respiratory system 16 12 7. Other forms of Tuberculosis 3 2 8. Syphilitic Diseases 2 1 9. Influenza 1 2 10. Measles 1 2 11. Acute Poliomyelitis and Polioencephalitis 1 1 12. Acute Infantile Encephalitis 1 1 13. Cancer of buccal cavity and oesophagus (M.) and uterus (F.) 3 5 14. Cancer of stomach and duodenum 7 3 15. Cancer of breast — 10 16. Cancer of all other sites 29 22 17. Diabetes — 2 18. Intra-cranial Vascular Lesions 14 21 19. Heart Disease 46 30 20. Other Diseases of circulatory system 6 9 21. Bronchitis 20 8 22. Pneumonia (all forms) 13 11 23. Other Respiratory Diseases 2 3 24. Ulcer of stomach and duodenum 4 1 25. Diarrhœa (under 2 years of age) 1 1 26. Appendicitis — — 21. Other Digestive Diseases 7 7 28. Nephritis — 5 29. Puerperal and Post-abortive Sepsis — - 30. Other maternal causes — - 31. Premature Birth 12 7 32. Congenital Malformations, Birth Injuries, Infantile Diseases 6 8 33. Suicide 2 — 34. Road traffic accidents 6 — 35. Other violent causes 8 3 36. All other causes 19 24 Deaths of infants Total 26 18 Legitimate 23 17 Illegitimate 3 1 Live births Total 582 570 Legitimate 543 533 Illegitimate 39 37 Stillbirths Total 12 9 Legitimate 11 9 Illegitimate 1 Population (mid-year): 60,660 5 SECTION B GENERAL PROVISIONS OF HEALTH SERVICES FOR THE AREA Similar to previous years. SECTION C SANITARY CIRCUMSTANCES OF THE AREA Water.—Samples of water were taken from the three supplies serving this area, as follows:— Rickmansworth and Uxbridge Valley Water Co. 4 Wood End Park Estate water supply 13 South-West Suburban Water Company:— (a) By Hayes and Harlington U.D.C 4 (b) By other Authorities 20 All the above samples were found to be satisfactory for drinking purposes. In August, 1945, it was found that the water supplied to the Wood End Park Estate contained small worms. On examination these were proved to be aquatic worms of genus Nais. Although these worms were known to be harmless to human beings, if swallowed, it was, nevertheless, very desirable to get rid of them. Tests proved that the worms were not present in the water drawn from the Artesian well. Contamination, therefore, must have occurred either in the storage tank or in the distribution tank or in the mains. Extensive works were carried out to cleanse the tanks but the worms still appeared in the water drawn from the taps in the houses. It thus became obvious that the question of the mains and service pipes to the houses would have to be dealt with, but the shortage of men and materials has delayed completion of this task. Bacteriological examination of this water has been made on frequent occasions; the reports have been invariably satisfactory. 6 SANITARY INSPECTION OF THE AREA 1.—Complaints During the year 418 complaints were received with respect to the following matters, viz.:— Choked and defective drains 70 Insanitary or dilapidated condition of houses and premises 222 Offensive accumulations or deposits 20 Cesspools overflowing 1 Rats 1 Other nuisances 104 Total 418 2.—Inspection of District Number of houses and premises inspected (ordinary) 823 ,, „ houses inspected and particulars recorded (Housing Act, 1936) 2 „ ,, houses and premises re-inspected 627 ,, miscellaneous visits 1,053 ,, food inspections 244 ,, ,, visits to slaughter-houses 27 ,, ,, ,, ,, dairies, cowsheds and milk-shops 12 ,, ,, ,, ,, bakehouses and factories 62 ,, ,, „ re water supplies 1,337 ,, ,, ,, ,, cases of infectious disease 138 ,, ,, „ ,, petroleum stores 49 „ ,, inspections of tents, vans and sheds 16 ,, ,, verminous premises inspected 60 ,, „ premises disinfected 107 „ „ inspections under the Shops Acts 322 ,, „ the Housing Act, 1936 (overcrowding) 63 ,, „ public urinals inspected 6 3.—Notices Served Served Complied with Out-standing Informal notices 631 589 42 Statutory notices:— Section 75, Public Health Act, 1936 1 1 — Section 93, Public Health Act, 1936 4 3 1 Section 56, Public Health Act, 1936 10 — 10 7 THE FACTORIES ACT, 1937 Sixty-two 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 Saw mills 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 62 17 - Factories without mechanical power — — — Other premises under the Act (including work of building and engineering construction but not including outworkers' premises) - - - Total 62 17 — 8 2.—Defects Found Particulars Number of Defects Found Remedied Nuisances under the Public Health Acts:— Want of cleanliness 9 9 Want of ventilation — — Overcrowding — — Want of drainage of floors — — Other nuisances - - Sanitary accommodation Insufficient 6 6 Unsuitable or defective 2 2 Not separate for sexes — — Offences under the Factories Act:— Other offences — — Total 17 17 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) 823 (b) Number of inspections made for the purpose 934 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 2 (b) Number of inspections made for the purpose 3 (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 125 9 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 4 (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 Nil (c) Partly complied with, but not yet complete 1 (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 ground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or ground 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 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 vear to produce pasteurised milk. The table below gives particulars of the other venty-two licences granted during the year:— Designation Dealer's Licence Supplementary Licence asteurised 8 4 Tuberculin Tested 6 4 No refusal or revocation of licences to retailers has been made. There are now twenty-six persons registered in accordance vith 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) Other Foods The following foods (ojther than meat) were condemned during the year 1945:— Evaporated milk 1,704 tins Cheese 16 lbs. Canned fish 282 „ Cocoa 200 ,, Baked beans 202 ,, Egg yolk 1,496 ,, Fruit pulp 667 „ Biscuits 786 ,, Vegetables 70 „ Sausages 7 ,, Soup 21 „ Cooked meats 2 ,, Fruit 10 „ Bacon 113 ,, ' aavy browning 99 bots. Poultry 78 „ Pickles 19 jars Fresh fish 934 ,, Soft drinks 3 bots. Sugar 44 ,, Meat paste 8 jars Fishcakes 13 ,, Coffee 2 bots. Tea 7 „ Sugar confectionery 152 lbs. Canned meats 1,211 ,, Dried fruit 205 „ Oranges 983 ,, Jams and preserves 132 „ Potatoes 4,480 ,, Cereals 162 ,, * Flour confectionery 12,000 ,, Flour 472 „ Eggs (shell) 1,121 Butter and margarine 215 ,, Pork pies 30 *Damaged by an aircraft flare. (d) Adulteration, etc. Particulars not available. 11 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. Scabies cases were treated by Benzyl Benzoate and disinfestation from lice was effected by the use of Lethane Oil, in both cases very successfully. 904 attendances were recorded during the year. Diphtheria Immunisation Number of sessions 189 Number of attendances 1,289 Number of prophylactics given 1,050 Number of post-Schicks 213 Number of re-tests 23 Percentage of failure to immunise 4-2 Percentage successfully immunised 95-8 Notifiable Diseases (other than Tuberculosis) during the Year, 1945 Diseases Total Cases Notified Total Deaths Scarlet Fever 74 — Diphtheria 6 — Pneumonia 18 24 (all forms) Cerebro-spinal Fever 3 1 Puerperal Pyrexia 17 — Erysipelas 11 — Ophthalmia Neonatorum 1 — Measles 826 — Whooping Cough 41 3 Dysentery 9 — Acute Poliomyelitis 2 2 12 13 ANALYSIS OF TOTAL CASES. Diseases 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 10 7 37 12 1 1 2 — — Diphtheria — — 2 — — 1 1 — 1 1 — — Pneumonia — 2 — 2 — 2 — — 2 2 5 3 Cerebro-spinal Fever 1 — — - — — — — 1 1 — — Puerperal Pyrexia - - - - - - - - 13 4 — — Erysipelas — — — — — — — — 6 1 2 2 Ophthalmia Neonatorum 1 - - - - - - - - - - - Measles 18 72 102 86 172 352 11 4 5 1 — — Whooping Cough 4 10 1 8 9 7 1 — — 1 — — Dysentery — 2 — 2 1 1 1 1 1 — — — Acute Poliomyelitis — 1 - - 1 - - - - - - - Tuberculosis New cases and mortality during 1945:— Age Periods New Cases Mortality Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. 0—1 - — 1 — - - 1 - 1—5 — 1 — — 1 — — — 5—15 7 — 1 2 1 — — 1 15—25 15 14 — 4 1 3 — 1 25—35 11 6 3 2 6 6 — — 35—45 19 9 1 — 7 2 — — 45—55 13 3 1 — 2 — — — 55—65 4 1 — — 4 — — — 65 and over 1 - - - - - - - Age unknown 2 2 - - - - - - Totals 72 36 7 8 22 11 1 2 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 the 4th January, 1943, free insulin has been supplied to nine persons (all female) during the year, the amount being:— 26 x 5 c.c. 20 unit insulin 85 x 10 c.c. 40 „ „ 100x10 c.c. 40 ,, „ (protamine with zinc) Ambulance Service.—The ambulance provided by the Urban District Council is free to all residents in the area. 1,409 calls were answered in 1945, the total mileage being 12,622. Civil Defence ambulances were used on occasions when the ambulance was out and also when it was temporarily laid up for repairs. In October a Standard 12 h.p. sitting case ambulance was put into commission by the Council. August, 1946. 14 KING AND HUTCHINGS, LTD. PRINTERS UXBRIDGB