Forty-third Annual Report on the Health Urban District of Hayes and Harlington Middlesex J. STANLEY LLOYD, M.D., F.R.C.S.Edln. Medical Officer of Health 1947 THE URBAN DISTRICT OF HAYES AND HARLINGTON Members of the Council, 1947 Chairman: Councillor W. C. Mongor, J.P. Vice-Chairman: Councillor E. K. Harding Councillors: I. E. Barrett, H. Blackburn, P. J. Burke, S. G. Chilton, G. R. T. Clarke, F. W. Coleman, Mrs. B. F. Frost, L. M. Graves, J. P., H. R. Hann, H. B. Radley, N. L. Shakespeare, A. H. Smith, R. M. Smith, A. E. Stokes, F. Strong, R. Tabor, G. Triscott, M.B.E. Public Health Committee, 1947 Chairman: Councillor H. R. Hann Councillors: H. Blackburn, S. G. Chilton, R. M. Smith A. E. Stokes, F. Strong. 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—Resigned Appt. July), S. Greenhead, E. G. Drayson (Resigned Appt. July). Clerks: G. W. Sutherland (Resigned Appt. Jan.), F. E. Pollard, P. Rowley (Commenced October). Temporary Junior Shorthand Typists: B. Walby (Resigned Appt. Oct.), I. Sutcliffe (Resigned Appt. Oct.). Disinfector/Motor Driver: W. Cook. l MEDICAL OFFICER'S ANNUAL REPORT Public Health Department, Town Hall, Hayes, Middlesex. June, 1948. To the Chairman and Members of the Council, Mr. Chairman, Ladies and Gentlemen, I have the honour to present to you herewith the FortyThird Annual Report on the health of your Urban District. The overcrowding mentioned in my report last year has not been ameliorated to any great extent, and stiil stands as a major problem which will take time to solve. The continued rise in the birth-rate and fall in the death-rate are matters for congratulation, but this, however, tends to make the problem of overcrowding still more difficult. There has also been an influx of people into this town from other places, with the result that the population has reached the highest figure recorded. I regret that more use is not made of the immunisation against diphtheria offered free to all children and young persons. However, there was only one case of diphtheria in the area last year, and this was a child who had not been immunised; he recovered after a lengthy stay in hospital. Generally speaking, in spite of the difficulties and shortages left by the war, the health of this urban district is good. I should like to express my appreciation of the help given by members and officers of the Council, and would particularly mention the valuable services rendered by the Chief Sanitary Inspector, Mr. Richd. Bill. I have the honour to be, Your obsdient 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 1947) Registrar-General's Estimate: Working population figure 66,670 Number of Inhabited Houses as at 31st Dec. 1947 16,571 Rateable Value (Estimate) as at 31st Dec. 1947 £421,706 Product of a Penny Rate £1,650 EXTRACTS FROM VITAL STATISTICS OF THE YEAR Live Births— M. F. Total Birth Rate per 1,000 of the estimated resident population 21.35 Legitimate 669 690 1,359 Illegitimate 34 31 65 Stillbirths- Legitimate 8 12 20 Rate per 1,000 total (live and still) births 14.88 Illegitimate 1 — 1 Deaths 228 221 449 Death Rate per 1,C00 of the estimated resident population 673 Deaths from puerperal causes Nil Death Rate of Infants under one year of age:— All infants per 1,000 live births 35.11 Legitimate infants per 1,000 legitimate live births 34.58 Illegitimate infants per 1,000 illegitimate live births 30.76 M. F. Total Deaths from Cancer (all ages) 42 49 91 Deaths from Measles (all ages) — - — Deaths from Whooping Cough (all ages) — - — Deaths from Diarrhoea (under 2 years of age) 3 3 6 Deaths from Tuberculosis of respiratory system 15 14 29 Deaths from Tuberculosis—other forms (all ages) - - - Deaths from Heart Disease (all age3) 39 3{ 78 Deaths from Bronchitis (all ages) 13 1( 23 Deaths from Pneumonia—all forms (all ages) 22 1J 37 3 BIRTH RATES, CIVILIAN DEATH RATES, ANALYSIS OF MORTALITY, MATERNAL MORTALITY AND CASE RATES FOR CERTAIN INFECTIOUS DISEASE IN THE YEAR 1947. PROVISIONAL FIGURES BASED ON WEEKLY AND QUARTERLY RETURNS England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Resident Population , 25.000 to 50,000 at 1931 Census London Administrative County Hayes and Harlington Births:— Rates per 1,000 Civilian Population Live 20.5* 23.3 22.2 22.7 21.35 Still 0.50* 0.62 0.54 0.49 0.31 Deaths:— All causes 12.0* 13.0 11.9 12.8 6.73 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 — Scarlet Fever 0.00 0.00 0.00 0.00 — Whooping Cough 0.02 0.03 0.02 0.02 — Diphtheria 0.01 0.01 0.01 0.01 — Influenza 0.09 0.09 0.08 0.08 0.04 Smallpox 0.00 0.00 0.00 — — Measles 0.01 0.02 0.02 0.01 — Notifications:— Typhoid Fever 0.01 0.01 0.00 0.01 0.01 Paratyphoid Fever 0.01 0.01 0.01 0.01 0.01 Cerebro-spinal Fever 0.05 0.06 0.05 0.05 0.05 Scarlet Fever 1.37 1.54 1.37 1.31 0.62 Whooping Cough 2.22 2.41 2.02 2.80 2.65 Diphtheria 0.13 0.15 0.14 0.14 0 01 Erysipelas 0.19 0.21 0.18 0.22 0.04 Smallpox 0.00 0.00 0.01 0.00 — Measles 9.41 9.13 9.58 5.29 9 83 Pneumonia 0.79 0.89 0.68 0.64 0.53 Rates per 1,000 Live Births Deaths under 1 year of age 41 47 36 37 35.11 Deaths from diarrhoea and enteritis under 2 years of age 5.8 8.0 3.7 4.8 4.21 Rates per 1,000 Total (Live and Still) Births Maternal Mortality Abortion with sepsis 0.10 1 Abortion without sepsis 0.06 Figures not available - Puerperal infections 0.16 — Others 0.85 1.38 Totals 1.17 1.38 Notifications:— Puerperal Fever and Puerperal Pyrexia 7.16 8.99 6.27 6.94 11.76 . * Rates per 1,000 Total Population. A dash (—) signifies that there were no deaths. 4 CAUSES OF DEATH DURING 1947 Cause of death Male Female All causes 228 221 1. Typhoid and Paratyphoid Fevers — — 2. Ceretaro-spinal Fever — 1 3. Scarlet Fever — — 4. Whooping Cough — 5. Diphtheria — 6. Tuberculosis of Respiratory System 15 14 7. Other forms of Tuberculosis — — 8. Syphilitic diseases — — 8. Influenza 2 1 10. Measles — — 11. Acute Poliomyelitis and Polioencephalitis — 1 12.—Acute infantile Encephalitis - - 13. Cancer of buccal cavity and oesophagus (M) and uterus (F) 4 6 14. Cancer of stomach and duodenum 7 6 15. Cancer of breast — 12 16. Cancer of all other sites 31 25 17. Diabetes — 3 18. Intra-cranial vascular lesions 20 19 19. Heart disease 39 39 20. Other diseases of circulatory system 9 12 21. Bronchitis 13 10 22. Pneumonia (all forms) 22 15 23. Other respiratory diseases 5 2 24. Ulcer of stomach and duodenum 5 2 25. Diarrhoea (under 2 years of age) 3 3 26. Appendicitis 1 2 27. Other-digestive diseases 6 6 28. Nephritis 6 3 29. Puerperal and Postabortive sepsis — - 30. Other maternal causes - 2 31. Premature Birth 3 4 32. Congenital Malformations, Birth Injuries, Infantile Diseases 8 11 33. Suicide - 1 34. Road traffic accidents 3 3 35. other violent causes 11 3 36. All other causes 15 15 Deaths of infants Legitimate 25 22 Illegitimate 1 1 Total 26 23 Live Births Legitimate 669 690 Illegitimate 34 31 Total 703 721 Stillbirths Legitimate 8 12 Illegitimate 1 — Total 9 12 I Population (mid-year): 66.670 5 SECTION B GENERAL PROVISIONS OF HEALTH SERVICES FOR THE AREA (a) HOSPITALS: Cottage Hospital, Grange Road, Hayes. Cottage Hospital, Sipson Lane, Harlington. County Hospital, Hillingdon. Joint Isolation Hospital, Kingston Lane, Uxbridge. (b) AMBULANCE SERVICE: A motor ambulance is provided by the Council for the conveyance of non-infectious, accident and maternity cases to hospital. For the conveyance of infectious cases an ambulance is provided by the Uxbridge Joint Isolation Hospital. (c) TUBERCULOSIS: Provision is made by the Middlesex County Council for treating cases of Tuberculosis at South Mimms Hospital, Harefield County Sanatorium and other places, the Tuberculosis Dispensary being situated at the Local County Offices, High Street, Uxbridge. (d) CHILD WELFARE CLINICS ETC. The Middlesex County Council also administers the numerous Maternity and Child Welfare Clinics in the district, which are open frequently and which are at the disposal of all residents free of cost. In addition, the County Council maintains a staff of midwives, all of whom reside within the Urban District. SECTION C SANITARY CIRCUMSTANCES OF THE AREA Water.—The Rickmansworth and Uxbridge Valley Water Co. supplies the greater part of the water in this district, the remainder coming from the South West Suburban Water Co. The supplies have been satisfactory, both in quality and quantity. Chemical and bacteriological examinations of the water obtained from taps have been regularly made by the Clinical Research Association The number of samples obtained was as follows:— Rickmansworth and Uxbridge Valley Water Co. 6 South West Suburban Water Co 26 (By H. and H. U.D.C., 4, by Other Authorities 22.) The samples were in every case considered safe for drinking purposes.' 6 SANITARY INSPECTION OF THE AREA 1.—Complaints During the year 792 complaints were received with respect to the following matters, viz:— Choked and defective drains 151 Insanitary or dilapidated condition of houses and premises 412 Offensive accumulations or deposits 22 Cesspools overflowing — Other nuisances 204 Rats (all complaints received transmitted to Rodent Control Officer.) 2.—Inspection of the District Number of houses and premises inspected (ordinary) 1,939 „ „ „ „ „ re-inspected 935 „ ,, miscellaneous visits 351 „ „ food inspections 318 „ „ visits to slaughterhouses 13 „ „ „ dairies, cowsheds and milk-shops 11 .. „ bakehouses and factories 61 ,, ,, „ re cases of infectious disease 82 ,, „ „ petroleum stores 76 „ ,, inspections of tents, vans and sheds 95 „ „ verminous premises inspected 43 ,, „ premises disinfected 97 ,, ,, ispections under the Shops Acts 62 ,, ,, ,, Housing Act, 1936 (Overcrowding) 555 Total 4,668 3.—Notices Served Served Complied with Outstanding Informal notices 567 470 97 Statutory notices:— Section 93, Public Health Act, 1936 16 16 - Section 56, Public Health Act, 1936 2 2 - 7 THE FACTORIES ACT, 1937 Sixty-one inspections of factories, with and without mechanical power, have been made during the year. There are one hundred and nineteen factories with mechanical power and five factories without mechanical power on the register, classified as under: Factories With Mechanical Power: Aircraft 1 Motor repairs 9 Bakers 11 Munitions 1 Building Materials 2 Oil blending 1 Boot repairs 12 Plastics 1 Caravans 1 Potato crisps 1 Carbon products 1 Printing 5 Cheese 1 Radio o Chemical engineers 1 Refrigerator repairs 1 Cocoa and chocolates 1 Repair of agricultural Coil winding 1 implements 1 Domestic appliances 1 Rubber 1 Electric transformers 1 Sausages 1 Engineering 37 Saw mills 1 Fire extinguishers 1 Slab partitions 3 Firelighters 1 Sports equipment 1 Furniture 3 Tarmacadam 1 Glazed tiles 2 Upholstery repairs 1 Jams 1 Valet services 1 Joinery 4 Wire 1 Lighting shades 1 Wood block floors 1 Mineral water 1 Factories Without Mechanical Power: Cigarette lighters 1 Smith "L Motor repairs 1 Stove enameling 1 Oil blending 1 1.—Inspections: Premises Number of Inspections Written Notices Occupiers Prosecuted 58 6 - Factories without mechanical power 3 1 — Other premises under the Act (including work of building and engineering construction but not including out-workers' premises) - - - Total 61 7 — 8 2.—Defects Found Particulars Number of defects Pound Remedied Nuisances under the Public Health Acts:— Want of cleanliness 2 2 Want of ventilation 1 1 Overcrowding — — Want of drainage of floors — — Other nuisances — — Sanitary accommodation Insufficient 12 in hand Unsuitable or defective 3 3 Not separate for sexes - — offences under the Factories Act — — Total 18 6 OFFENSIVE TRADES There are no establishments carrying on offensive trades. SECTION D HOUSING During the year 1947 the following houses and prefabricated bungalows were completed. Permanent houses 418 Temporary bungalows 36 Houses rebuilt after destruction by enemy action 24 Houses rendered habitable after serious damage by enemy action 2 Adaptation of unoccupied buildings 1 1.—Inspection of Houses During the Year (1) (a) Total number of dwelling-houses spected for housing defects (under the Public Health or Housing Acts 1,939 (b) Number of inspections made for the purpose 2,004 (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 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 subhead) 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 dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 253 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 16 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 16 (b) By Local Authority in default of owners Nil (c) Partly complied with but not yet complete 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 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 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) Order 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 Licence Supplementary Tuberculin tested 6 4 Pasteurised 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 slaughterhouse in the district. (c) Other Foods The following foods (other than fresh meat) were condemned during the year 1947:— Bacon 11 tins Fruit (Tinned) 87 tins Beans 180 tins Geese 12 Beetroot 4 tins Jams and Preserves 82 tins Bitter orange pulp 400 lbs. Lard 31 lbs. Buns 24 Loaves 143 Butter 9¼ lbs. Macaroni 56 lbs. Cakes 4 Margarine ¾ lb. Carrots 84 tins Meat and Vegetables 75 tins Cheese trimmings 33 lbs. Milk (Condensed) 28 tins Chocolate 32 b"TS Milk (Dried) 11 tins Coffee 14 bls. Milk (Evaporated) 471 tins Cofectionery 70½ lbs. Mustard 3 tins Cornflakes 1 pkt. Oats 476 lbs. Damsons 7.354 lbs. Oxo 144 cbs. Dough 17 lbs. Peas 521 tns Egg (Dried) 19 pkts. Pickles 68 jars Eggs (Frozen) 394 lbs. Potatoes 52 tins Eggs (Shell) 551 Puddings (Mixed) 10 tins Egg (Yolk) 760 lbs. Sausages 18 tins Fish (Canned) 357 tins Soup 50 tins Pish (Fresh) 97½ st. Spaghetti 6 tins Fish (Shell) 2 st. Spinach 9 tins Pish paste 6 jars Sugar 5 lbs. Flour 42 lbs. Syrup 1 tin Emit juices 44 tins Tea 15¾ lbs. Vermicelli 56 lbs. 11 SECTION F PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES 1.—Poliomyelitis An epidemic of Acute Poliomyelitis and Polioencephalitis arose during 1947. Thirteen cases occurred in Hayes and Harlington with no deaths. There was one death attributed partly to Poliomyelitis from which the patient had suffered 10 years before. 2.—Scabies Fifty-seven males (adult) and eighty females and children were treated for scabies during the year, and only one case of infestation with lice was reported. The clinic is held at the Hayes Cottage Hospital, and is still open twice weekly for females and children, and when required for males (adult). 3.—Diphtheria Immunisation (Hayes Cottage Hospital) Number of sessions 40 Number of attendances 633 Number of prophylactics given 409 Number of post-schicks and re-tests 131 Number of post-schicks and re-tests NEG 94 Number of post-schicks and re-tests POS 1 In addition 2,618 prophylactic injections were given at the various clinics in the district under the control of the Middlesex County Council. The total number of children immunised up to the 31st December 1947 was 9,743 out of an estimated child population of 16,360 (approx. 60%). Notifiable Diseases (Other than Tuberculosis) During the Year 1947 Diseases Total Cases Notified Total Deaths Scarlet Fever 42 - Diphtheria 1 - Pneumonia 36 36 (all forms) Cerebrospinal Fever 4 1 Puerperal Pyrexia 17 — Erysipelas 3 — Ophthalmia Neonatorum 2 - Measles 658 - Whooping Cough 177 — Dysentery 1 — Acute Poliomyelitis 11 1 Malaria 2 1 Polioencephalitis 2 1 Enteric Fever 1 - Para-typhoid Fever 1 - Food Poisoning 35 — 12 ANALYSIS OF TOTAL CASES AT AGES Diseases Under 1 year 1-3 3-5 5-10 10-15 15-25 25 and over Age unknown Totals Scarlet Fever - 3 12 16 8 2 1 - 42 Whooping Cough 21 47 52 53 3 — — 1 177 Acute Poliomyelitis 2 — 2 2 2 1 2 — 11 Acute Polioencephalitis — — 1 1 — — — — 2 Measles 29 123 170 318 11 4 3 - 658 Diphtheria - — — 1 — — - — 1 AT AGES Diseases Under 5 5-15 15-45 4 5-65 65 and over Age unknown Totals Pneumonia 4 1 17 10 3 1 36 Dysentery — — 1 — — — 1 Smallpox — - - — - - - Acute Encephalitis Lethargica — — — — - — - Enteric Fever — - 1 — - - 1 Para-Typhoid Fever — — 1 — - — 1 Erysipelas — — 3 — - — 3 Cerebro-spinal Fever 2 2 — — — — 4 Diseases All ages Pueroeral Pyrexia 17 Ophthalmia Neonatorum 2 Malaria 2 Food Poisoning 35 13 Tuberculosis New cases and mortality during the year 1947:— Age Periods New cases Mortality Respiratory NonRespiratory Respiratory Non- Respiratory M. F. M. P. M. F. M. F. 0—1 - - 1 - - - - - 1—5 1 1 1 - - - - - 5—15 8 5 1 2 — 1 — — 15—25 16 15 1 — 2 3 — — 25—35 6 11 2 1 2 2 — — 35—45 9 2 — 1 4 5 — — 45—55 8 2 — 2 2 3 — — 55—65 5 — — — 5 — — — 65 and over 1 - - - - - - - Age unknown - - - - - - - - Totals 54 36 6 6 15 14 — — 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 com pulsory removal to hospital of persons suffering from tuber culosis. Insulin.—In accordance with Circular 2734 of the Ministry of Health, dated the 4th January, 1943, free insulin has been supplied to twenty-one persons (one male and twenty females) during the year, the amount being:— 178 x 10 c.c. 40 unit Insulin. 249 x 10 c.c. 40 unit Insulin P.Z. 23 x 10 c.c. 80 unit Insulin. 88 x 5 c.c. 80 unit Insulin P.Z. 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 1947, are set out below. Calls Mileage Austin Ambulance 1,573 15.119 Standard Ambulance Car 353 3,218 1,926 18,334 June, 1948. 14 Hayes Chronicle Ltd. 10 Grange Parade Hayes, Middx.