FORTY-FIFTH ANNUAL REPORT on the HEALTH of the Urban District of HAYES & HARLINGTON Middlesex J. STANLEY LLOYD, M.D., F.R.C.S.Edin. Medical Officer of Health 1949 THE URBAN DISTRICT OF HAYES AND HARLINGTON Members of the Council, 1949 Chairman : Councillor A. H. Smith, J.P. Vice-Chairman : Councillor G. Triscott, M.B.E. Councillors: Mrs. R. E. Beard, A. J. C. Beck, R. Bristowe, P. J. Burke, H. C. Burnett, S. G. Chilton, G. R. T. Clarke, F. W. Coleman, B. E. Cooper, J. H. Dawson, Mrs. B. F. Frost, H. R. Hann, E. K. Harding, J. H. W. Johnson, W. C. Mongor, H. B. Radley, N. L. Shakespeare, A. Smith, R. M. Smith, F. Strong, H. T. Walker. Public Health Committee, 1949 Chairman : Councillor H. R. Hann. Councillors : Mrs. R. E. Beard, H. C. Burnett, B. E. Cooper, R. M. Smith, F. Strong. Staff of the Public Health Department Medical Officer of Health : J. Stanley Lloyd, M.D., F.R.C.S., Edin. 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 : Sydney Greenhead Additional Sanitary Inspectors : P. M. Ennis, R. Finn, E. A. Williams Rodent Control Officer : W. K. Tonkin Clerks : F. E. Pollard (resigned 19/5/49) P. Bailey C. F. Shervill (commenced 23/5/49) 1 MEDICAL OFFICER'S ANNUAL REPORT Public Health Department, Town Hall, Hayes, Middlesex. August, 1950 To the Chairman and Members of the Council, Mr. Chairman, Ladies and Gentlemen, I have the honour of presenting to you the Forty-Fifth Annual Report on the health of the Urban District of Hayes and Harlington. You will observe that the death-rate is still very low at 7.35 per 1,000 inhabitants. We have also been fortunate in avoiding major epidemics, there being no death from diphtheria nor scarletfever, and only one from poliomyelitis ; but the number of deaths from tuberculosis has, unhappily, risen from 21 to 27. The civilian population of the town has increased by 320 to 65,980 which is 5,980 above that recommended in the Abercrombie report; but even to provide adequate accommodation for 60,000 persons it will be necessary to continue building for some time to come. The health of this Urban District continues to be good. 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) 5,171 Population (census 1931) 22,969 Population (mid-year 1949) Registrar General's Estimate : Civilian Population Figure 65,980 Number of Inhabited Houses as at 31st December, 1949 17,087 Rateable Value (estimated) as at 31st December, 1949 £424,774 Product of a Penny Rate £1,702 18s. 10.608d. EXTRACTS FROM VITAL STATISTICS OF THE YEAR Live Births— M. F. Total Birth Rate per 1,000 of the 1,095 estimated resident popula45) tion 17.27 & Legitimate 565 530 Illegitimate 18 27 Stillbirths— Legitimate 10 7 17 Rate per 1,000 total (live and — still) births ... 14.9 Illegitimate — — Deaths 267 218 485 Death Rate 7.35 Nil Deaths from puerperal causes Death Rate of Infants under one year of age :— (a) All infants per 1,000 live births 42.98 (b) Legitimate infants per 1,000 legitimate live births 42.92 (c) Illegitimate infants per 1,000 illegitimate live births 44.4 M. F. Total Deaths from Cancer 47 39 86 „ „ Measles — 1 1 „ „ Whooping Cough — - — „ „ Diarrhoea (under 2 years of age) 5 1 6 „ „ Tuberculosis of respiratory system 15 10 25 „ „ Tuberculosis—other forms 2 — 2 „ Heart Disease 58 54 112 „ „ Bronchitis 20 6 26 „ „ Pneumonia (all forms) 25 15 40 3 BIRTH RATES, CIVILIAN DEATH RATES, ANALYSIS OF MORTALITY, MATERNAL MORTALITY AND CASE RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1949 PROVISIONAL FIGURES BASED ON QUARTERLY RETURNS England and Wales 126 County Boroughs and Great Towns including London I48 .Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 Census) I.ondon Administrative County Hayes and Harlington Rates per 1,000 civilian population Births— Live Births 16.7(a) 18.7 18.0 18.5 17.28 Still Births 0.39(a) 0.47 0.40 0.37 0.25 Deaths— All Causes 11.7(a) 12.5 11.6 12.2 7.35 Typhoid and typhoid 0.00 0.00 0.00 0.00 — Whooping Cough . . 0.01 0.02 0.01 0.01 — Diphtheria 0.00 0.00 0.00 0.00 — Tuberculosis 0.45 0.52 0.42 0.52 0.41 Influenza 0.15 0.15 0.14 0.11 0.04 Smallpox 0.00 0.00 — — — Acute Poliomyelitis & Polioencephalitis 0.01 0.02 0.02 0.01 0.01 Pneumonia 0.51 0.56 0.49 0.59 0.60 Notifications— Typhoid Fever 0.01 0.01 0.01 0.01 — Paratyphoid Fever 0.01 0.02 0.01 0.01 0.01 Cerebro-spinal Fever 0.02 0.03 0.02 0.02 0.04 Scarlet Fever 1.63 1.72 1.83 1.46 1.30 Whooping Cough 2.39 2.44 2.39 1.70 1.75 Diphtheria 0.04 0.05 0.04 0.07 — Erysipelas 0.19 0.20 0.19 0.17 0.15 Smallpox 0.00 0.00 0.00 0.00 — Measles 8.95 8.91 9.18 8.54 4.66 Pneumonia 0.80 0.91 0.65 0.55 1.47 Acute Poliomyelitis 0.13 0.13 0.12 0.18 0.12 ,, Polioencephalitis 0.01 0.01 0.02 0.01 — Food Poisoning 0.14 0.16 0.14 0.19 0.04 Deaths— Rates per 1,000 Live Births All causes under 1 year of age Enteritis and Diarrhoea under 2 years of age 32(b) 37 30 29 42 3.0 3.8 2.4 1.7 5.2 Rates per 1,000 Total (Live and Still) Births Maternal Mortality Abortion with sepsis 0.11 — Abortion without sepsis 0.05 Figures not avail able. Puerperal infections 0.11 — Others 0.71 0.85 Notifications— Puerperal Fever and 1.72 Puerperal Pyrexia 6.31 8.14 5.30 6.82 (a) Rates per 1,000 Total Population. (6) Per 1,000 related live births. (A dash — signifies no deaths or no notifications). Comparability Factor for Hayes and Harlington—1.51. 4 CAUSES OF DEATH DURING 1949 Cause of Death Male Female All causes 267 218 1. Typhoid and Paratyphoid Fevers 2. Cerebro-spinal Fever — — 3. Scarlet Fever — 4. Whooping Cough — — 5. Diphtheria — — 6. Tuberculosis of Respiratory System 15 10 7. Other forms of Tuberculosis 2 — 8. Syphilitic diseases 2 — 9. Influenza 1 2 10. Measles 1 11. Acute Poliomyelitis and Polioencephalitis 1 — 12. Acute infantile Encephalitis — — 13. Cancer of buccal cavity and oesophagus (M) and uterus (F) 4 3 14. Cancer of stomach and duodenum 8 4 15. Cancer of breast — 12 16. Cancer of all other sites 35 20 17. Diabetes — 1 18. Intra-cranial vascular lesions 25 26 19. Heart diseases 58 54 20. Other diseases of circulatory system 5 7 21. Bronchitis 20 6 22. Pneumonia 25 15 23. Other respiratory diseases 6 3 24. Ulcer of stomach or duodenum 7 1 25. Diarrhoea under 2 years 5 1 26. Appendicitis 2 — 27. ()ther digestive diseases 2 8 28. Nephritis 1 1 29. Puerperal and post-abortive sepsis — 30. Other maternal causes - 1 31. Premature Birth 2 2 32. Congenital malformations, birth injuries, infantile diseases 10 17 33. Suicide 2 2 34. Road traffic accidents 3 1 35. Other violent causes 7 2 36. All other causes 19 18 Deaths of Infants : Legitimate 26 21 Illegitimate — 2 Total 26 23 Live Births : Legitimate 565 530 Illegitimate 18 27 Total 583 557 Stillbirths : Legitimate 10 7 Illegitimate — Total 10 7 Civilian population (mid-year) 65,980 Total population (mid-year) 5 66,030 SECTION B. GENERAL PROVISIONS OF HEALTH SERVICES FOR THE AREA (a) Hospitals. Hayes Cottage Hospital, Grange Road, Hayes. Harlington Cottage Hospital, Sipson Lane, Harlington. Hillingdon Hospital, near Uxbridge. St. John's Hospital, Kingston Lane, Uxbridge. (b) Ambulance Service. Motor ambulances are provided by the Middlesex County Council for the conveyance of all cases to hospital. (c) Tuberculosis. Provision is made by the Middlesex County Council for treating cases of tuberculosis at South Minims Hospital, Harefield Hospital, and other places ; the Tuberculosis Dispensary being at the Local County Offices, High Street, Uxbridge. (d) Child Welfare Clinic, etc. The Middlesex County Council also administers the numerous Maternity and Child Welfare Clinics in the district. These are open frequently and are at the disposal of all residents free of cost. SECTION C. SANITARY CIRCUMSTANCES OF THE AREA Water.—The Rickmansworth and Uxbridge Valley Water Company supplies the greater part of the water in the district, the remainder being supplied by the South West Suburban Water Company. Chemical and bacteriological examinations of the water have regularly been made by the Clinical Research Association and the Public Health Laboratory Service at Reading. The number of samples taken was as follows : Rickmansworth and Uxbridge Valley Water Co 24 South West Suburban Water Co 24 (4 by this authority, 20 by others) Private well 1 Bacteriological examination of a sample taken from the Wood End Park Estate's supply showed evidence of pollution. A further investigation proved that the contamination arose in the distribution tank on this estate. This was cleaned and treated by chlorination, with the result that all subsequent samples of water were found to be satisfactory. Examination of the remaining samples scheduled above showed them to be safe for drinking purposes. 6 SANITARY INSPECTION OF THE AREA 1.—Complaints. During the year 748 complaints were received with respect to the following matters: Choked and defective drains 112 Insanitary or dilapidated conditions of houses or premises 320 Offensive accumulations or deposits 34 Defective dustbins 77 Verminous premises 13 Gypsies 18 Rat and mice infestations 81 Other nuisances 93 2.—Inspection of the District. Number of premises and houses inspected 932 „ „ „ re-inspected 2,025 „ inspections under Housing Consolidated Regulations 4 „ „ re overcrowding 578 „ re verminous premises 39 „ visits re infectious diseases 133 „ premises disinfected or disinfested 84 „ „ inspected re drainage 785 „ Shops Acts inspections 493 „ food inspections 316 „ inspections re ice cream premises: (manufacturers) 108 (dealers) 146 „ ice cream samples taken 93 „ inspections re dairies 11 „ „ slaughterhouses 8 „ „ other food premises 549 „ „ factories and workshops 93 „ observations re smoke or grit 52 „ petroleum stores inspected 78 „ inspections re tents, vans or sheds 279 „ public conveniences inspected 65 „ visits to controlled refuse tips 22 „ inspections re accumulations of refuse 140 „ „ piggeries and stables 71 „ miscellaneous visits 817 Total 7,921 7 3.—Notices Served. Complied Out- Served with standing Informal notices (written) 401 293 108 Statutory notices : Section 93, Public Health Act, 1936 19 12 7 75 16 14 2 45 2 2 — OFFENSIVE TRADES There is no establishment in the district carrying on an Offensive Trade. THE FACTORIES ACT, 1937 Ninety-three inspections of factories, with and without, mechanical power, have been made during the year. There are one hundred and fifty-three factories with mechanical power and three factories without mechanical power on the register, classified as under : Factories with mechanical power : Aircraft 2 Metal and rag sorting 1 Art reproductions 2 Mineral waters 1 Bakers 10 Motor repairs 15 Body and coach building 3 Music rolls 1 Boot repairs 14 Oil blending 2 Building materials 7 Optical lens grinding 1 lireeze block making 1 Plastics 1 Caravans 2 Potato crisps 1 Carbon products 1 Printing 6 Cheese 2 Radio 1 Chemical engineering 1 Refrigerator repairs 1 Cocoa and chocolate 1 Repair of agricultural implements 1 Cycle repairs 1 Clothing manufacturers 1 Rubber 1 Electrical apparatus 2 Refuse destructor 1 Electro platers 1 Sausages 2 Electric transformers 1 Slab partitions 1 Electric welding 3 Sports equipment 2 Engineering 43 Tarmacadam 1 Firelighters 1 Upholstery 1 Furniture 3 Valet services 1 Glazed tiles 1 Wire 1 Jams 1 Wood block floors 1 Joinery 4 Water ices 1 Factories without mechanical power : Oil blending 1 Photographs 1 Smith 1 8 Inspections. Premises Number of Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 86 1 — Factories without mechanical power 7 — — Other premises under the Act (including work of building and engineering construction but not including outworkers premises) - — — 93 1 — 1.—Inspection of houses during the year. (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 932 (b) Number of inspections made for the purpose 2,957 (2) (a) Number of dwelling houses which were spected and recorded under the Housing Consolidated Regulations, 1925 and 1932 1 (b) Number of inspections made for the purpose 4 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 1 (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 296 2.—Remedy of Defects during the Year, without the service of Formal Notices. Number of dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers 226 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: (i) By owners Nil (ii) By Local Authority in default of owners Nil Proceedings under Public Health Act, 1936 : (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 21 (2) Number of dwelling houses in which defects were remedied after service of formal notices: (i) by owners 14 (ii) by Local Authority in default of owners Nil (iii) partly complied with but not yet complete 7 10 (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 or Undertakings given 1 (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 SECTION E. INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply. One producer was licensed by the Middlesex County Council during the year for the production of tuberculin tested milk. There were three milk dealers licensed to pasteurise milk and nineteen other licences issued, details of which are set out below : Designation Dealer's Licence Supplementary Licence Tuberculin Tested 5 4 Pasteurised 6 4 On 1st October, 1949, legislation was revised and some administrative amendments made, so that licences to pasteurise are no longer issued by this authority. The under-mentioned licences were issued in accordance with Regulations made under the Milk (Special Designations) Act, 1949 : Designation Dealer's Licence Supplementary Licence Tuberculin Tested 2 2 Pasteurised — 3 Sterilised 13 8 11 A register is maintained of Dairies and Milk Distributors (other than dairy farms and farmers) and the numbers shown on1 the register are: Milk Distributors 19 Dairies 9 (The premises of milk distributors who only retail milk in the sealed vessels in which they receive it, are not subject to registration). No refusal or revocation of licences has been made. (b) Meat. There is no Ministry of Food slaughterhouse in the district. 474¼ lbs. of imported meat were condemned during the year In addition, 103½ lbs. of canned corned beef or mutton and 146¼ lbs. of other canned meat were condemned. The following foods (other than meat) were also condemned during the year: The following foods (other than meat) were also condemnec during the year : Bacon 36 lbs. Jams 30i lbs. Cheese 113 lbs. Milk 234 tins Cereals 120 lbs. Pastry mix 4J cwt. Coffee ... 5£ lbs. Rabbit 6 tins Cooked meat 15J lbs. Salad cream 60 jars Eggs (shell) 557 Soup 87 tins Fish 230J stone Sugar confectionery 2254 lbs. Fruit (fresh) 8 lbs. Vegetables 192 tins Fruit (tinned) 46 tins All others 775 lbs. Fruit (pulp) 80 galls. SECTION F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES (a) General. Deaths from tuberculosis—these show an increase on last year, rising from 21 to 27. Poliomyelitis—there has been an increase in the number of cases on last year's figures, but the number of cases and of deaths (one death) is slightly less than the rate for the whole country. (b) Scabies. Six females and children were treated for scabies during the year, and 2 cases of infestation with head lice received treatment. Clinics are held on Thursday of each week at the Hayes Cottage Hospital. (c) Diphtheria Immunisation. This service is now undertaken by the Middlesex County Council at the Child Welfare Clinics in the district. 12 13 ANALYSIS OF TOTAL CASES AT AGES Disease Under 1 year 1-3 3-5 5-10 10-15 15-25 25 and over Age Unknown Totals Scarlet Fever 1 5 23 48 6 2 1 86 Whooping Cough 15 37 30 30 1 1 2 - 116 Acute Poliomyelitis — 2 — 1 — 2 3 - 8 Acute Polioencephalitis — — — — — — - — Measles 12 101 92 89 4 0 4 1 308 Diphtheria Disease AT AGES Under 5 years 5-15 15-45 45-65 65 and over Age Unknown Totals Acute Pneumonia 12 19 28 22 16 97 Dysentery — 2 — — — — 2 Smallpox — — — — — - — Acute Encephalitis Lethargica — — — — — - — Enteric Fever — — — — — - — Paratyphoid Fever — 1 — — — — 1 Erysipelas 2 — 2 5 1 — 10 Cerebro-spinal Fever 1 — 1 1 — — 3 Food Poisoning 1 - 2 - — - 3 Puerperal Pyrexia 2 (all ages) Ophthalmia Neonatorum 1 Notifiable Diseases (other than Tuberculosis) during the Year 1949 Disease Total Cases Notified Total Deaths Scarlet Fever 86 - Diphtheria - - Pneumonia 97 40 Cerebro-spiual Fever 3 - Puerperal Pyrexia 4 - Erysipelas 10 - Ophthalmia Neonatorum 1 - Measles 308 1 Whooping Cough 116 - Dysentery 2 - Acute Poliomyelitis 8 1 Malaria - - Polioencephalitis 1 - Enteric Fever - - Para-typhoid Fever 1 - Food Poisoning 3 - Smallpox - - Acute Encephalitis lethargica - - TUBERCULOSIS New cases and mortality during the year 1949 : Age Periods New Cases Mortality Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. o-1 - - - - - - - - 1-5 3 4 1 2 - - - - 5-15 14 5 2 1 - - 1 - 15-25 16 23 - 1 2 2 - — 25-35 19 13 - 4 — 3 1 — 35-45 7 4 - 3 4 2 — — 45-55 14 1 1 2 6 1 - — 55-65 4 — - — 3 1 — — 65 and over — 1 - — — 1 - — Age unknown - - - - - - - - Totals 77 51 4 13 15 10 2 - It has not been found necessary to take any action 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. August, 1950. 14 Perry & Routleff Ltd. Printers Uxbridge and Ealing