HA 421 Forty-second Annual Report 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 1946 THE URBAN DISTRICT COUNCIL OF HAYES & HARLINGTON Members of the Council, 1946 Chairman : Councillor P. J. Burke, J.P. Vice-Chairman : County Councillor W. Sutcliffe Councillors: L. Ayherst, I. E. Barrett, H. Blackburn, F. W. Coleman, Mrs. B. F. Frost, I,. M. Graves, J.P., Mrs. A. B. Greenhead, H. R. Hann, E. K. Harding, W. C. Monger, A. C Nichols, D. Page, J.P., A. H. Smith, P. G. Soulsby, A. E. Stokes, L. Stringer, G. Triscott, M.B.E. Public Health Committee, 1946 Chairman : Councillor H. R. Hann Councillors: L. Ayherst, I. E. Barrett, F. W. Coleman; Mrs. B. F. Frost, Mrs. A. B. Greenhead, P. G. Soulsby, A. E. Stokes. 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: S. H. G. Stevens, A. T. Matson (in H.M. Forces), J. H. M. Jolliffe (resigned October, 1946), S. Greenhead (returned from H.M. Forces, 1/3/46), E. G. Drayson (returned from H.M. Forces, 1/8/46). Clerks: G. W. Sutherland, P. Rowley (resigned, April 1946), F. E. Pollard (returned from H.M. Forces 1/11/46). Temporary Junior Shorthand Typists: B. Walby (Commenced 15/7/46), I. Sutcliffe (Commenced 19/8/46) Disinfector/Motor Driver : W. Cook. 1 MEDICAL OFFICER S ANNUAL REPORT Public Health Department, Town Hall, Hayes, Middlesex. June, 1947. To the Chairman and Members of the Urban District Council of Hayes and Harlington Mr. Chairman, Madam, and Gentlemen, I have the honour of presenting to you the Forty-second Annual Report on the health of your Urban District. The health of this Urban District continues to be satisfactory in spite of severe overcrowding of some of the population. The condition under which some people live is very bad indeed, whole families being confined to one room, without adequate facilities for cooking, washing, drying clothes, etc. The housing problem in Hayes is the most urgent matter requiring solution at the present time. The birth-rate continues to rise and is now just over 20 per thousand of population. The death-rate is low at 6.97 per thousand, while the infantile death-rate is the lowest ever reached in this town, being only 24.5 per thousand live births. Free immunisation against diphtheria is still not utilised to the extent it should be in this town. Nine causes with four deaths occurred during the year; in none of these cases, one of which was an adult, had the patient been immunised. Deaths from tuberculosis have dropped by about 30 per cent. from the 1945 figure while new cases notified have diminished by about 11 per cent. I should again like to express my appreciation of the help 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 1946) Registrar-General's Estimate: Working population figure 64,650 Number of Inhabited Houses as at 31st December, 1946 16,224 Rateable Value (Estimate) £415,519 Product of a Penny Rate £1,666 EXTRACTS FROM VITAL STATISTICS OF THE YEAR Total M. F. Live Births— Birth Rate per 1,000 of the estimated resident population 20.24 Legitimate 1,245 647 598 Illegitimate 63 29 34 Stillbirths— Legitimate 24 12 12 Rate per 1,000 total (live and still) births 18.01 Illegitimate - - - Deaths 451 238 213 Death Rate per 1,000 of the estimated resident population 6.97 Deaths from puerperal causes Nil Death Rate of Infants under one year of age:— All Infants per 1,000 live births 24.46 Legitimate Infants per 1,000 legitimate live births 24.09 Illegitimate Infants per 1,000 illegitimate live births 31.74 M. F. Total Deaths from Cancer (all ages) 28 47 75 Deaths from Measles (all ages) — — — Deaths from Whooping Cough (all ages) — 1 1 Deaths from Diarrhoea (under 2 years of age) — — — Deaths from Tuberculosis of respiratory system 19 6 25 Deaths from Tuberculosis (other forms) (all ages) — 2 2 Deaths from Heart Disease (all ages) 54 46 100 Deaths from Bronchitis (all ages) 13 9 22 Deaths from Pneumonia (all forms) (all ages) 16 13 29 3 BIRTH RATES, CIVILIAN DEATH RATES, ANALYSIS OF MORTALITY, MATERNAL MORTALITY AND CASE RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1946 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 19.1 22.2 21.3 21.5 20.24 Still 0.53 0.67 0.59 0.54 0.37 Deaths:— All causes 11.5 12.7 11.7 12.7 6.97 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 0.02 0.02 0.01 Diphtheria 0.01 0.01 0.01 0.01 0.06 Influenza 0.15 0.13 0.14 0.12 0.04 Small-pox 0.00 0.00 0.00 0.00 0.00 Measles 0.00 0.01 0.00 0.01 0.00 Notifications:— Typhoid Fever 0.01 0.01 0.01 0.01 0.00 Paratyphoid Fever 0.02 0.02 0.01 0.01 0.00 Cerebro-spinal Fever 0.05 0.05 0.04 0.06 0.1 Scarlet Fever 1.38 1.51 1.33 1.42 0.83 Whooping Cough 2.28 2.48 2.05 2.22 2.78 Diphtheria 0.28 0.32 0.31 0.24 0.13 Erysipelas 0.22 0.25 0.22 0.27 0.12 Small-pox 0.00 0.00 0.00 0.00 0.00 Measles 3.92 4.73 3.70 7.35 1.5 Pneumonia 0.89 1.02 0.74 0.75 0.54 (Rates per 1,000 Live Births) Deaths under 1 year of age 43 46 37 41 24.46 Deaths from diarrhoea and enteritis under 2 years of age 4.4 6.1 2.8 4.2 0.000 (Rates per 1,000 Total Births (Live and Still) Maternal Mortality Abortion with sepsis 0.13 0.00 Abortion without sepsis 0.06 Figures not available 0.00 Puerperal infections 0.18 0.00 Others 1.06 1.57 Totals 1.43 1.57 Notifications:— Puerperal Fever and Puerperal Pyrexia 8.50 10.35 7.63 9.68 10.5 4 CAUSES OF DEATH DURING 1946 Cause of Death M ale Female All causes 238 213 1. Typhoid and Paratyphoid Fevers — — 2. Cerebro spinal Fever — — 3. Scarlet Fever — — 4. Whooping Cough — 1 5. Diphtheria 3 1 6. Tuberculosis of respiratory system 19 6 7. Other forms of Tuberculosis — 2 8. Syphilitic diseases 2 1 9. Influenza 1 2 10. Measles — — 11. Acute Poliomyelitis and Polioencephalitis... — — 12. Acute infantile Encephalitis — — 13. Cancer of buccal cavity and oesophagus (M.) and uterus (F.) 2 3 14. Cancer of stomach and duodenum 3 8 15. Cancer of breast — 9 16. Cancer of all other sites 23 27 17. Diabetes 1 1 18. Intra-cranial vascular lesions 24 26 19. Heart disease 54 46 20. Other diseases of circulatory system 15 16 21. Bronchitis 13 9 22. Pneumonia (all forms) 16 13 23. Other respiratory diseases 1 2 24 Ulcer of stomach and duodenum 3 — 25. Diarrhoea (under 2 years of age) — — 26. Appendicitis 2 1 27. Other Digestive Diseases 6 4 28. Nephritis 3 3 29. Puerperal and Post-abortive sepsis — — 30. Other maternal causes — 2 31. Premature Birth 6 3 32. Congenital Malformations, Birth Injuries, Infantile diseases 6 7 33. Suicide 4 — 34. Road traffic accidents 6 1 35. Other violent causes 6 1 36. All other causes 19 15 Deaths of infants Legitimate 17 13 Illegitimate 2 — Total 19 13 Live Births Legitimate 647 598 Illegitimate 29 34 Total 676 632 Stillbirths Legitimate 12 12 Illegitimate — — Total 12 12 Population (mid-year) : 64,650 5 SECTION B GENERAL PROVISIONS OF HEALTH SERVICES FOR THE AREA Similar to previous years. SECTION C SANITARY CIRCUMSTANCES OF THE AREA Water. -The bulk of the water used in Hayes and Harlington is obtained from the Rickmansworth and Uxbridge Valley Water Company. The South West Suburban Water Company supplies part of the Parish of Harlington, and the Wood End Park Estate, at the beginning of the year, obtained its water from its own Artesian well. On the 30th June, 1946, the Rickmansworth and Uxbridge Valley Water Company connected its mains with the water tower on the Wood End Park Estate and since then has supplied all the water to this estate. The small aquatic worms formerly found in the water obtained from the taps in the estate have now disappeared. Samples of water were taken from the three supplies serving this area and submitted to bacteriological examination. In some cases chemical examination was also made. The number of samples examined was as follows: Rickmansworth and Uxbridge Valley Water Company 3 Wood End Park Estate Water Supply 31 South-West Suburban Water Company: (a) By Hayes and Harlington U.D.C. 7 (ft) By other Authorities 21 All the samples taken were reported to be of good quality. 6 SANITARY INSPECTION OF THE AREA 1.- Complaints During the year 707 complaints were received with respect to the following matters, viz.:- Choked and defective drains 90 Insanitary or dilapidated condition of houses and premises 433 Offensive accumulations or deposits 25 Cesspools overflowing Nil Other nuisances 159 Rats (All complaints received transmitted to Rodent Control Officer). 2.—Inspection of the District Number of horses and premises inspected (ordinary) 1,464 „ „ „ inspected and particulars recorded (Housing Act, 1936) 3 „ „ „ and premises re-inspected 777 „ „ miscellaneous visits 664 „ „ food inspections 220 „ „ visits to slaughterhouses 15 „ „ „ „ dairies, cowsheds and milk-shops 4 „ „ „ „ bakehouses and factories 59 „ „ „ re water supplies 46 „ „ „ re cases of infectious disease 259 „ „ „ re petroleum stores 59 „ „ inspections of tents, vans and sheds 156 „ „ verminous premises inspected 22 „ ,, premises disinfected 116 ,, „ inspections under the Shops Acts 274 ,, „ „ ,, ,, Housing Act, 1936 (Overcrowding) 968 ,, „ public urinals inspected 2 Total 5.108 3.—Notices Served Served Complied with Out- standing Informal notices 420 321 99 statutory notices:— Section 75, Public Health Act, 1936 9 4 5 Section 93, Public Health Act, 1936 25 23 2 Section 39, Public Health Act, 1936 2 2 - Section 138, Public Health Act, 1936 1 1 - 7 THE FACTORIES ACT, 1937 Fifty-nine inspections of factories with and without mechanical power have been made during the year. There are one hundred factories with mechanical power and five factories without mechanical power on the register, classified as under : Factories with Mechanical Power Aircraft 3 Bakers 9 Building materials 1 Boot repairs 8 Caravans 1 Cheese 1 Chemical engineers 1 Cocoa and chocolates 1 Coil winding 1 Cardboard 1 Domestic appliances 1 Electric transformers 1 Engineering 29 Fire extinguishers 1 Firelighters 1 Furniture 3 Glazed tiles 1 Ink 1 Jams 1 Joinery 4 Mineral water 1 Motor repairs 7 Munitions 2 Oil blending 1 Oil drum cleaning 1 Pianos 1 Potato crisps 1 Printing 4 Radio 3 Refrigerator repairs 1 Repair of agricultural implements 1 Rubber 1 Saw mills 1 Slab partitions 1 Tarmacadam 1 Valet services 1 Wire 1 Wood block floors 1 Factories without Mechanical Power Motor repairs 2 Oil blending 1 Upholstery repairs 1 Smith 1 1.—Inspections Premises Number of Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 59 4 1 Factories without mechanical power — — — Other premises under the Act (including work of building and engineering construction but not including out-workers' premises — — — Total 59 4 1 8 2.—Defects Found Particulars Number of Defects Found Remedied Nuisances under the Public Health Acts:— Want of cleanliness 8 8 Want of ventilation — — Overcrowding — — Want of drainage of floors — — Other Nuisances 1 1 Sanitary accommodation Insufficient — — Unsuitable or defective — — Not separate for sexes — — Offences under the Factories Act 2 2 Total 11 11 OFFENSIVE TRADES There are two establishments carrying on the offensive trade of fat extracting. SECTION D HOUSING During 1946 the following houses and pre-fabricated bungalows were completed. Permanent houses 25 Temporary bungalows 188 Houses rebuilt after destruction by enemy action 7 House rendered habitable after serious damage by enemy action 1 In addition certain buildings were adapted to produce seven family units. 1.—Inspection of Houses during the Year (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,464 (b) Number of inspections made for the purpose 2,241 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 3 (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 9 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 105 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 25 (2) Number of dwelling-houses in which fects were remedied after service of formal notices:— (a) By owners 23 (b) By Local Authority in default of owners Nil (c) Partly complied with but not yet complete 2 (r) Proceedings under Sections 11 and 13 of the Housing Act, 1936:— (1) Number if 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 10 SECTION E INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply 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 pasteurise milk. The table below gives particulars of the other nineteen licences granted during the year. Designation Dealer's Licence Supplementary Licence Pasteurised 6 4 Tuberculin Tested 5 4 No refusal or revocation of licences 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 8 Retail Purveyors of Milk with premises in the district 7 Retail Purveyors of Milk with premises outside the district 11 26 (b) meat There is no Ministry of Food slaughter-house in the district. (c) Other Foods The following foods (other than fresh meat) were condemned during the year 1946:- Batter mixture 120 pkts. Bacon 51 lbs. Baked beans 80 tins Biscuits 23 lbs. Bovril 1 jar Brawn 12 lbs. Cake mixture 30 lbs. Canned fish 294 tins Cereals 28½ lbs. Cheese 199 lbs. Cocoa 144 pkts. Dried fruit 365 lbs. Dried egg 1 pkt. Dried milk 3 tins Drinking chocolate 7 lbs. Egg yolk 2,250 lbs. Eggs (shell) 570 Evaporated milk 373 tins Fish cakes 74 lbs. Fresh fish 1,656 lbs. Horseradish and beetroot sauce 24 jars Jams and Preserves 36 lbs. Loaves (J quarter) 85 Macaroni 1 tin Macaroni cheese 2 tins Meat paste 3 jars Meat pies 19 Mustard 4 tins Pickles 6 jars Rissole mixture 20 lbs. Rollmops 13 jars Sausages (fresh) 18 lbs. Sauce 1 bot. Soup 28 tins Sugar confectionery 26 lbs. Suet ½ lb. Spaghetti 1 tin Sugar 44¼ lbs. Smoked fillets 17 jars Tinned fruit 20 tins Tinned vegetables 147 tins 11 Canned Meats Corned Beef 131½ lbs. Corned Mutton 3/4 lb. Luncheon meat (Spam, etc.) 7½ lbs. Meat and Vegetable 36 lbs. Ox Tongue 6 lbs. Pork Sausage meat 19¼ lbs. Potted meat 11 ozs. Steak and kidney 1 lb. Stewed steak 55 lb Sheep tongue 3/4 lb. Vienna sausages 5 lbs. SECTION F prevalence of and control over, infectious diseases Scabies.—Two clinics weekly are held at the Hayes Cottage Hospital for treatment of scabies and infestation with lice. The number of scabies cases in 1946 is about half of that for 1945. Only three cases of infestation with lice were reported. Diphtheria Immunisation Number of sessions 147 Number of prophylactics given 3052 Number of post-schicks and re-tests 132 Percentage of failure to immunise 5% Percentage successfully immunised 95% Notifiable Diseases (other than Tuberculosis) during the year, 1946 Diseases Total Cases Notified. Total Deaths Scarlet Fever 54 — Diphtheria 9 4 Pneumonia 35 29 (all forms) Cerebro-spinal fever 7 — Peurperal pyrexia 14 — Erysipelas 8 — Ophthalmia Neontorum — — Measles 97 — Whooping Cough 180 1 Dysentery 2 — Acute Poliomyelitis 1 — Malaria 2 — Poliencephalitis 1 — 12 ANALYSIS OF TOTAL CASES Diseases AT AGES Tender 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 4 3 37 2 — 2 2 — — Diphtheria — — 1 — — 5 2 — — — 1 — Pneumonia 1 — — — — 2 2 12 6 4 8 — Cerebro-spinal Fever 2 — — — — — 1 — 3 — — 1 Puerperal pyrexia — — — — — — — — 10 4 — — Erysipelas — — — — — 1 — — 3 1 3 — Ophthalmia Neonatorum — — — — — — — — — — — — Measles 4 9 25 13 19 22 5 — — — — — Whooping Cough 17 21 22 34 17 65 4 — — — — — Dysentery 2 — — — — — — — — — — — Acute Poliomyelitis — 1 — — — — — — — — — — Malaria — — — — — — — — 1 1 — — Polio-encephalitis — — — — — — 1 — — — — — 13 Tuberculosis New cases and mortality during 1946:— Age Periods New Cases Mortality Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. f. 0—1 — — 1 — — — — — 1—5 1 1 — 1 — — — — 5—15 3 2 1 5 1 — — 2 15—25 8 16 1 — 3 — — — 25—35 12 6 — 1 3 4 — — 35—45 10 6 — — 3 — — — 45—55 12 2 1 — 6 1 — — 55—65 6 3 — — 3 1 — — 65 and over — — — — — — — — Age unknown 1 — — — — — — — Totals 58 36 4 7 19 6 — 2 It has not been found necessary to take any action under the Public Health (Prevention of Tuberculosis) Regulations, 1925, relating to tuberculosis 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 fifteen persons (1 male and 14 females) during the year, the amount being:— 142 x 10 c.c. 40 unit (Protamine with zinc) 142 x 10 c.c. 40 unit Insulin. 39 x 10 c.c. 80 unit Insulin. 28 x 5 c.c. 80 unit (Protamine with zinc) Ambulance Service.—The ambulance and ambulance car provided by the Urban District Council are free to all residents in the area. The calls answered and total mileage during 1946, are set out below. Calls Mileage Austin Ambulance 1,681 15,650 Standard Ambulance Car 335 3,237 Totals 2,016 18,887 June, 1946. 14 Perry & Routlell Ltd. Printers & Stationers Uxbridge and Ealing