ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE BOROUGH OF HESTON AND ISLEWORTH for the year 1957 A. ANDERSON, M.D., D.P.H., Medical Officer of Health. INDEX PAGE Accidents 7 Bakehouses 21 Births, Live 6 Births, Still 6 Blood Transfusion Service 27 Burials 27 Canal Boats 18 Closet Accommodation 14 Common Lodging Houses 18 Deaths 7 Deaths, Age and Sex Distribution 30 & 31 Deaths, Causes of 29 Disinfection 10 Disinfestation 18 Drainage and Sewerage 13 Factories, No. on Register, Inspections and Defects, etc. 38 Factories, Workplaces, etc. 18 Family Planning Association 12 Fever Hospitals 10 Food and Drugs Sampling 21 Food Hygiene 23 Food Poisoning 10 Health Committee 3 Health Education 27 Health Services provided by Other Authorities 10 Housing 23 Ice Cream 20 Infant Deaths according to Age and Cause 32 Infant Mortality 7 Infectious Diseases 8 Infectious Diseases, Age Distribution 33 Infectious Diseases, Notifications and Deaths 34 Laboratory Service 10 laundry Service 27 Marriage Guidance Council 12 PAGE Maternal Mortality 8 Meat and Other Food Inspection 21 Medical Examinations of Staff 27 Meteorology 36 Milk 20 Municipal Restaurants and School Canteens 21 Noise Nuisances 19 Persons in need of care and attention 27 Pet Animals Act, 1951 20 Physical Characteristics 13 Public Cleansing 14 Public Mortuary 27 Rags, etc. Exchange of Articles for 15 Rag Flock and Other Filling Materials Act, 1951 19 Rats and Mice Destruction 19 Rivers and Streams 14 Sanitary Circumstances 13 Sanitary Inspection 14 Shops Act, 1950, Section 38 19 Slaughter of Animals (Amendment) Act, 1954 21 Slaughterhouses, etc. 21 Smoke Abatement 15 Staff 2 Statistics, Certain Vital, County of Middlesex 35 Statistics General 6 Statistics Vital 6 Statistics Vital, Summary of 28 Swimming Baths 19 Tents, Vans and Caravans 18 Tuberculosis 9 Verminous Premises, Articles and Persons 20 Water Supply 13 Wind Direction 37 1 STAFF Medical Officer of Health A. Anderson, M D. D. P H Deputy Medical Officer of Health E N Christie MB., Ch.B , D.P.H. Chief Public Health Inspector A B Hauldren, Cert as P. H I. and M. I. Deputy Chief Public Health Inspector K.J Smith. Cert as P H I and M.I. District Public Health Inspectors G. Latimer, Cert. as P H.I. and M.I. S H G Stevens, Cert, as P.H I., M I. and S.E. J. A Dawson, Cert. as P H.I. and M I W Bowles, Cert as P.H.I. and M I. P. G T Woods, Cert as P. H. I and M.I. (to 31.5.57) J K Edson, Cert as P.H.I., M I. and San. Science. D. G Martin, Cert. as P.H.I. and M.I. P W Goldsmith, Cert as P.H.I. and M.I. (from 1.12.57) Rodent Officer A Parrer Rodent Operatives R Ashurst M. L. Worthington Mortuary Attendants Disinfectors, Drain Testers, etc. F S J Allaway L R Smith (to 11 9 57) L Woodhead (from 16 9 57) Clerks B W Kilby Cert as P H I and M I. (Part time) Mrs L R Butler. Cert as P.H I D.S. Bates E.J. Hutchins Mrs. N.N. Vaughan Mrs L E 0' Gorman Mrs M E Ponsford (from 1.1.57) 2 THE HEALTH COMMITTEE of HESTON AND ISLEWORTH BOROUGH COUNCIL to May, 1957 Councillor Mrs. M. Hennig (Chairman) Councillor F. A. Raybaud (Vice-Chairman) Councillor R. G. Dunnett, J. P. (Mayor) Alderman J.E. Dillingham. Alderman Mrs. A. B. Tolmon. Councillor W. H. Bolster, B. Com. Sc. Councillor Mrs. E. M. Coleman Councillor A. G. Cross Councillor C.E. Maryon Davis. Councillor E. T. Harding. M.S.R. Councillor F.J. Jansen. Councillor Mrs. R. New. Councillor A. H. Nixon Councillor N.V. Wright. from May, 1957 Councillor Mrs. M. Hennig (Chairman) Councillor E. T. Harding, M. S. R., (Vice-Chairman) Councillor F. E. Kinsey, J. P. (Mayor) Councillor Mrs. E. M. Coleman Alderman F. J. Jansen Councillor A.G. Cross. Alderman Mrs. A. B. Tolmon Councillor A. J. Fielder, J. P. Councillor D. B. Andrews Councillor Mrs. R. New. Councillor A. J. Beach Councillor A. H. Nixon. Councillor W.H. Bolster, B. Com. Sc. Councillor N. V. Wright. 3 PUBLIC HEALTH DEPARTMENT, 92, BATH ROAD, HOUNSLOW. To the Mayor, Aldermen and Councillors of the Borough of Heston and Isleworth. Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1957. The report has been prepared on the lines suggested by the Ministry of Health and the larger statistical tables have been grouped together at the end of the report. Some variation in the figures from year to year must be expected. Attention should be given, not only to the records of any one year, but to the trends shown over a period of years. The birth rate, though the highest recorded since 1949, was still well below the national rate. The local death rate was only slightly lower than the national rate. The chief causes of death were again cancer and degenerative diseases of the circulatory system. Evidence continues to accumulate on the association of cigarette smoking with cancer of the lung. No doubt people who have been smoking cigarettes for many years think that it is too late to stop, but there are now indications that cancer of the lung is less prevalent in those who have ceased to smoke cigarettes. The great problem is how to discourage the young from starting cigarette smoking. it is difficult to see how health department propaganda can ever compete against the flood of trade advertisements, and therefore it is to be hoped that parents, and all associated with youth, will remember that example is more potent than precept. The causes of degenerative diseases of the circulatory system are still obscure. There are indications that consumption of fat, stress, obesity, active or sedentary occupation, etc., may play a part, but as yet no clear indication of preventive measures has appeared Accidental deaths were slightly less than in 1956, but 68 per cent of them occurred in persons aged 65 years and over. The special proneness of the aged to accidents especially falls, should be kept in mind by all who have any responsibility for their care. Burning accidents are still to frequent. The basic cause of these in young children and the aged is, in most cases, the unguarded fire. The use of pyjamas instead of nightdresses reduces this risk. Fabrics conforming to the B,S.I. specification of safety are now on the market, but unfortunately these 'non-flam- materials are expensive. Unless there is evidence of public demand, manufacturers will hesitate to put such materials on the market. The still birth rate was the lowest in the Borough records, but the infant mortality rate was disappointingly high. The deaths from pneumonia and haemorrhagic disease might be considered as preventable, but though methods of diagnosis and treatment are improving they are not always effective. For the fourth year in succession no mother died from conditions associated with pregnancy and childbirth. The incidence of infectious disease generally was low throughout the year. The epidemic of 'Asian' influenza reached the Borough towards the end of October. Fortunately it was of short duration and not very virulent. The attendance at schools fell to low levels, but it was not possible to assess how much this was due to the disease itself or to precautionary keeping of children at home. The numbers of children vaccinated against smallpox and inoculated against diphtheria and whooping cough were smaller than in 1956 There has been no smallpox in the Borough since 1930, no death from whooping cough since 1947 and no case of diphtheria since 1950, so propaganda to prevent parents acquiring a false sense of security is difficult. During the year a start was made in the protection of children against poliomyelitis. The response of parents to this offer of protection was smaller than expected, and the progress of the scheme was severely handicapped by difficulties in the production of the vaccine. Deaths from tuberculosis were the lowest in the Borough records. The public health inspectors continued their efforts to raise the standard of food hygiene. The Food Hygiene Regulations, by providing an enforceable standard, have proved of value and the response of the trade in remedying contraventions has been good. The incidence of notified food poisoning was small but the potential dangers are ever present. Improvements in premises alone will not give safety and the most important factor is good hygienic habits by persons engaged in handling food. It is right that the public should demand high standards in food premises, but it should not be a one-way traffic. Customers must apply the same standards to themselves and education on food and personal hygiene should begin in the home. Attention continued to be given to unfit houses and the Borough's first Clearance Order (25 houses) was made. A considerable volume of work had to be undertaken in regard to 'certificates of disrepair' arising out of new housing legislation. The delay in the rehousing of the occupants of houses declared unfit by the Council is a matter of some concern. 4 The passing of the Clean Air Act drew attention to the problem of atmospheric pollution. Preliminary work on a proposed Smoke Control Area has been carried out. Though the Borough does not suffer from atmospheric pollution to the same extent as industrial areas, the records kept by the Department during the last six years show that there is room for considerable improvement. When considering the cost to be met by the Government, the Borough Council and the householder in implementing the Clean Air Act, the extent of the present damage to health, buildings and fabrics should be remembered. The volume of official and voluntary work on the care of the aged and chronic sick grows, but deficiencies remain. A serious problem is that of firming accommodation for such as have reached the last stages of their illness or senscence. Neither the home nursing nor the home help services can meet the need of day and night care, and there is a limit to what relatives and neighbours, if available, can do but they have to struggle on as there seldom is a hospital or institution bed available. When appeals for help are made to the Department the feeling of frustration at not being able to do anything is deepened by admiration of the unselfish devotion of others in most distressing circumstances. People prefer to believe that illness is something imposed from without rather than something generated from within. External influences play their part but it should be remembered that many people are ill, because they have not learned how to live within their incomes, with their families, with their neighbours, with their workmates, with their environment and with themselves. The answer to this loss of wellbeing is not the National Health Service as 'the fault is not in our stars but in ourselves'. Information from many sources has been incorporated in this report and I would like to thank all who have contributed. The co-operation of all other Departments and the loyal assistance of my staff have been sources of pleasure throughout the year. To the Council for their encouragement and support, my thanks are sincere. I remain, Your obedient servant, A. ANDERSON. Medical Officer of Health. 5 GENERAL STATISTICS Year 1957 Area in acres 7,218 Population (Registrar-General's estimate) 105,100 Number of habitable premises (rate books) 30,285 Number of houses erected during year 441 Rateable Value of Borough £1,977,413 Sum represented by a penny rate £7,900 Live Births - male 654 Live Births - female 651 Birth rate per 1,000 population 12 3 Birth rate per 1,000 population (England and Wales) 16 1 Stillbirths - male 8 Stillbirths - female 7 Stillbirths rate per 1,000 (live and still) births 11.4 Deaths - male 548 Deaths - female 534 Death rate per 1,000 population 10.3 Death rate per 1,000 population (England and Wales-) 11.5 Infant Mortality rate 23.0 Infant Mortality rate (England and Wales) 23.0 Maternal Mortality rate 0.0 Maternal Mortality rate (England and Wales) 0.5 VITAL STATISTICS POPULATION The Registrar General's mid-year estimate of the population of the Borough for the year 1957 1s 105 100 RATEABLE VALUE The rateable value of the Borough for 1957 was £1,977 413 and the sum represented by a penny rate was £7 900 INHABITATED HOUSES According to the rate books the number of habitable houses, flats and shops with living accommodation at the end of the year was 30 285 In relation to the estimated population this yields an average of approximately 3 5 persons per house LIVE BIRTHS The number of live births in 1957 was 1,305 as compared with 1,235 in 1956 The birth rate was 12 3 per 1,000 population The birth rate will vary, apart from other causes according to the age and sex distribution of the population, and to permit of a true comparison with other areas the Registrar-General supplies for each local sanitary authority what is called the area comparability factor When this is applied to the Borough birth rate the result is 12.2 as compared with the birth rate of 16.1 per 1,000 population for England and Wales The number of illegitimate births was 47 as compared with 41 in 1956 The proportion of live births which were illegitimate expressed as a percentage of the total live births is shown below for recent years. - 1925-29 1930-34 1935-39 1940-44 3.9 3.2 2.9 4.6 1945-49 1950-54 1955 1956 1957 5.1 4.0 4.2 3.3 3.6 The majority of births continue to occur in hospital STILLBIRTHS The number of stillbirths in 1957 was 15 The proportion of stillbirths per 1,000 total (live and still) births in recent years is shown below:- No of Stillbirths Rate per 1,000 total births 1930-34 214 31.2 1935-39 224 29.4 1940-44 200 27.7 1945-49 198 23.8 1950 -54 129 20.6 1955 20 16.9 1956 24 19.1 1957 15 11.4 This loss of potential lives remains a problem and until more is known of the causes little further improvement can be expected 6 DEATHS. The deaths of residents of the Borough during 1957 were 1,082 (548 male, 534 female). This represents a death rate for the Borough of 10.3 per 1,000 population. The deaths in any area are influenced by the sex and age distribution of the population, and to permit of a true comparison, the Registrar-General calculates for each local sanitary authority area what is called an area comparability factor. When this is applied to the above Borough rate, the result is 11.0 as compared with a death rate of 11.5 per 1,000 population for England and Wales, The Registrar-General has classified the deaths registered during the year, and the details are given in Tables II, III and IV The cause of death was certified by the Coroner in 241 cases. A progressive change is taking place in the percentage age distribution of deaths and this is shown in the following table ] 1910-14 1945-49 1950-54 1956 1957 Under 1 year 21.8 5.3 2.4 1.9 2.8 1-4 years 8.4 0.8 0.5 0.4 0.2 5-14 years 3.8 2.1 0.4 0.5 0.2 15-24 years 3.7 2.1 0.8 0.5 0.6 25-64 years 30.8 33.0 31.6 29.4 30.0 65 years and over 31.5 56.7 64.3 67.3 66.2 The chief causes of death in males were heart and circulatory diseases; cancer; bronchitis and pneumonia; cerebral haemorrhage. In females the chief causes of death were heart and circulatory disease; cerebral haemorrhage; cancer; bronchitis and pneumonia. The Secretary of the Road Safety Committee informs me that during 1957 there were 627 road accidents which resulted in 12 deaths, serious injury to 159 persons and slight injury to 601 persons. The number of deaths from motor vehicle and other accidents in Borough residents during the last ten years is shown below:- Year Motor Vehicle Accidents Other Accidents Age in years Age in years 0-4 5-14 15-64 65+ All ages 0-4 5-14 15-64 65+ All ages 1948 - - 8 2 10 2 2 10 14 28 1949 1 2 6 5 14 2 - 9 8 19 1950 2 3 8 7 20 2 1 6 17 26 1951 - - 9 3 12 - 1 4 13 18 1952 - 1 3 7 11 - - 3 12 15 1953 - - 9 8 17 - - 5 15 20 1954 - 1 9 3 13 1 - 9 13 23 1955 - - 7 7 14 - 1 4 13 18 1956 - 2 9 6 17 - - 11 8 19 1957 1 - 5 4 10 2 - 1 15 18 Total 4 9 73 52 138 9 5 62 128 204 Care and attention in the home, in the factory and on the roads is essential and the special proneness to accidents of the aged should be remembered. INFANT MORTALITY. - During 1957 there were 30 deaths of children under the age of 1 year. This represents an infant mortality rate per 1,000 live births of 23.0 as compared with 23.0 for England and Wales. The causes of infant deaths are showr in Table V. In the following table, the change in the local infant mortality rate over 5 year periods from 1898 is shown:- No. of live births No. of deaths under 1 year Infant Mortality Rate 1898-1902 4,369 698 160 1903-1907 5,264 665 126 1908-1912 5,383 590 110 1913-1917 4,661 461 99 1918-1922 4,326 327 76 1923-1927 4,333 271 63 1928-1932 6,055 318 53 1933-1937 7,121 313 44 1938-1942 6,912 393 57 1943-1947 8,210 345 42 1948-1952 6,680 146 22 7  No of live births No. of deaths under 1 year Infant Mortality Rate 1953 1,268 23 18 1954 1,185 31 26 1955 1,164 28 24 1956 1,235 22 18 1957 1,305 30 23 The hard core of infant deaths is due to congenital malformations, prematurity and associated conditions and most of these deaths occur before the age of one week. Continued effort is needed from all concerned to improve antenatal care, management of labour and the nurture of young babies. MATERNAL MORTALITY - No death occurred due to causes associated with pregnancy and childbirth. Maternal deaths are usually divided into those due to septic infection and those due to diseases and other conditions associated with pregnancy and labour, and the local trend of deaths from these two causes is shown below:- Maternal deaths per 1,000 total (live and still births) Sepsis Other Causes Total 1930-34 2.6 1.7 4.4 1935-39 1.0 2.1 3.1 1940-44 0.7 1.2 1.9 1945-49 0.2 1.2 1.4 1950-54 - 0.3 0.3 1955 - - - 1956 - - - 1957 - - - INFECTIOUS DISEASE Notification to the Medical Officer of Health is the essential preliminary to control of infectious disease. The diseases required by statute to be notified:smallpox, cholera, diphtheria, membranous croup, erysipelas, scarlet fever, typhus fever, typhoid fever, paratyphoid fever, relapsing fever, plague, poliomyelitis, tuberculosis, malaria, dysentery, puerperal pyrexia, ophthalmia neonatorum, acute primary pneumonia, acute influenzal pneumonia, whooping cough, measles, acute encephalitis,meningococcal infection and food poisoning. It is known that all cases are not notified, but there are no grounds for suspecting that the level of notification varies to any great extent from year to year. Persons travelling overseas may be required to produce evidence of recent vaccination against smallpox or inoculation against yellow fever, cholera and typhoid fever Such certificates require to be endorsed by the Medical Officer of Health and during the year 739 were so endorsed. INCIDENCE OF NOTIFIABLE DISEASE - The number of cases notified during the year is shown in Table VI and the trend of infectious diseases during the last 20 years in Table VII. SMALLPOX - No case of smallpox occurred in the Borough during 1957. Persons arriving in the Borough from parts of the world where smallpox is prevalent, are kept under observation till any chance of their developing the disease is over. Freedom from smallpox has resulted in a neglect of infant vaccination. According to the returns 492 children under the age of one year were vaccinated in 1957 as compared with 570 in 1956. Modern travel is such that the risk of importing smallpox is ever present. SCARLET FEVER - The continuing mildness of this disease is tending to make parents, and possibly doctors careless about home isolation and other measures to prevent the spread of infection Of the 36 cases which occurred during the year, 7 were admitted to hospital No death from this disease has occurred in the Borough since 1937. DIPHTHERIA'- The Borough s freedom from diphtheria was maintained during the year. The number of children under the age of one year who were immunised during 1957 was 553 as compared with 699 in 1956. ERYSIPELAS - The number of notifications was 8, but no death was due to this disease. PNEUMONIA - Notifications of pneumonia were 39 as compared with 27 in 1956. Of the total pneumonia deaths 81 per cent, occurred at age 65 and over. MENINGOCOCCAL INFECTION - One case was notified during the year. 8 EPIDEMIC ENCEPHALITIS - Two notifications were received during the year. The patients were admitted to hospital and recovered. POST-INFECTIVE ENCEPHALITIS - Encephalitis is known to occur as a complication of other infectious diseases, but no such case was notified during 1957 POLIOMYELITIS - During the year 2 cases were notified. Both showed paralysis. One recovered fully and the other is continuing treatment as an out-patient. Inoculation against poliomyelitis was continued during the year and 2,636 children were given two injections of vaccine. At the end of the year a fair number of children have also had the first injection. Experience has shown that reactions, local or general, to these inoculations are comparatively rare TYPHOID FEVER - No case of typhoid fever was notified during the year. PARATYPHOID FEVER - No notification was received during the year. DYSENTERY - This disease shows great variations in prevalence from year to year and from place to place During the year, 7 cases were notified, as compared with 22 in 1956 The infection in all cases was of the Sonne type and the illness was mild in practically every case. The mildness of the illness is such that medical advice is not always sought, and unless the disease is kept constantly in mind, cases are likely to be missed. In all cases of diarrhoea in children and on the least suspicion in adults, a specimen of faeces should be sent for bacteriological investigation. Only by such vigilance will this disease be kept under some degree of control. TUBERCULOSIS - During the year 67 notifications of pulmonary tuberculosis, and 15 notifications of non-pulmonary terberculosis were received Persons continue to be certified as dying from tuberculosis who have not been notified during life, but it is hoped that with the improved facilities for diagnosis and treatment now available, any reluctance to seek investigation and treatment will disappear. The trend of the Borough death rate from tuberculosis is shown below:- Tuberculosis Death Rate per 100.000 population Pulmonary Non-pulmonary Total 1930-34 67.5 11.5 78.9 1935-39 52 3 8.2 60 4 1940-44 55.8 7.4 63.2 1945-49 39.1 6.7 45.8 1950-54 18.9 1.1 20.0 1955 13.3 1.0 14.2 1956 10.5 0.9 11.4 1957 6.9 - 6.9 A permanent mass X-ray unit has been established at West Middlesex Hospital and is open to the public without appointment. In 1906 Calmette and Guerin began to cultivate a particular strain of tubercle bacillus and, in due course, claimed that an injection of this strain would stimulate the body defence against tuberculosis without producing the disease in those inoculated. This strain is now known as Bacillus Calmette Guerin (B.C.G.) and especially since the war, has been used extensively in many parts of the world. Very conflicting evidence as to its value has been submitted, so in 1950 the Tuberculosis Research Unit of the Medical Research Council started an investigation of the preventive value of this vaccine. Those taking part in the trial were all volunteers from pupils in their last year at secondary modern schools, and Heston and Isleworth was one of the participating districts. Over 50,000 children throughout the country took part in the trial and they are still being followed up. School leavers were selected because the greatest risk of contact with known or unsuspected cases of tuberculosis occurs after leaving the relatively sheltered school environment. This research has shown Quite clearly that susceptible school leavers inoculated with B.C G. are much less likely to develop pulmonary tuberculosis, and the County Council decided to offer this protection to all school leavers. The protection takes some time to develop, so the practice is to skin-test all 13 year-old pupils, whose parents consent and to inoculate those found to have no protection. During the year 1,731 children were inoculated under this Scheme. OPTHALMIA NEONATORUM- One case was reported but no damage to sight resulted. PUERPERAL PYREXIA - During the year 98 cases were notified as compared with 69 cases in 1956. No woman died from puerperal or post-abortion sepsis. MEASLES - This disease was more prevalent - 804 cases as compared with 244 in 1956 9 WHOOPING COUGH - The notifications of whooping cough, 74, were fewer than in 1956. Facilities for immunisation against this disease are available, and 518 were inoculated. The condition is most fatal in young babies, and protection should be provided before the child is six months old. There is evidence that, with the improvement in the vaccine, the protection, if not complete, does mitigate the severity of the attack. MALARIA - No case of malaria was notified during the year. INFLUENZA - This disease caused 9 deaths as compared with 4 in 1956. A fairly widespread epidemic occurred in October. The disease was of the 'Asian' type which had spread across the world from the Far East. On the whole, the attacks were mild but a large proportion of school children were victims. In some schools the attendance fell below 50 per cent. MUMPS, CHICKEN POX, GERMAN MEASLES - These diseases are not notifiable, but cases are brought to the notice of the Department through schools, health visitors, etc. During the year, the following cases were recorded: Mumps, 121; Chicken pox, 153 and German measles, 12. FEVER HOSPITALS - The Borough is served by the South Middlesex Infectious Diseases Hospital, but on occasion, accommodation in other fever hospitals of the North West Metropolitan Regional Hospital Board is used. During the year, 160 patients from the Borough were admitted to these hospitals. Close contact is maintained between the hospitals and the Health Department, so that any necessary action can be taken. DISINFECTION - The disinfection of bedding etc., is done at the South Middlesex Infectious Diseases Hospital, while the disinfection of homes is carried out by the disinfectors on the Health Department staff. In 1946, after considering a report on the subject, the Council decided to stop terminal disinfection of rooms and bedding 'except in cases of smallpox or where the Medical Officer of Health considers such disinfection to be advisable.' During the year four rooms were disinfected and 5 lots of bedding destroyed. LABORATORY - Certain routine bacteriological work is done in the laboratory at the Health Department. When more detailed investigation is required, specimens are sent to the National Public Health Laboratory Service. The number of specimens examined during 1957 was 129. FOOD POISONING - During 1957 notifications of the occurrence of food poisoning in 25 persons were received, and during the course of our investigations and from other sources, a further 2 cases were discovered. A summary of the cases is given below:- Cases of Food Poisoning 1st Quarter 10(8) 2nd Quarter 3(3) 3rd Quarter 10(10) 4th Quarter 4(4) Total 27(25) Outbreaks due to identified agents Total outbreaks 2(2) Total cases. 10(8) Outbreaks of undiscovered cause Total outbreaks 2(2) Total 4 cases. (4) Single cases Agent identified unknown cause Total cases Nil 13(13) 13(13) () notified under Section 26 of the Food and Drugs Act, 1955 The majority were single cases. The largest number affected in any one outbreak was 7 and this was associated with a Works canteen. HEALTH SERVICES PROVIDED BY OTHER AUTHORITIES NORTH-WEST METROPOLITAN REGIONAL HOSPITAL BOARD - Two general hospitals (West Middlesex, 1,150 beds and Hounslow, 81 beds) and one fever hospital (South Middlesex, 140 beds) are situate in the Borough. Part of the accommodation in the fever hospital is used for other cases. The West Middlesex and South Middlesex Hospitals are controlled by the South West Middlesex Hospital Management Committee, while Hounslow Hospital and the Chest Clinic are the responsibility of the Staines Group Hospital Management Committee. The Regional Hospital Board provides the specialist services for the hospitals and for domiciliary consultations. 10 MIDDLESEX COUNTY COUNCIL - HEALTH DEPARTMENT - The County Council is the Local Health Authority under the National Health Service Act, 1946. The following services are provided in the Borough:- (a) Ante-natal and post-natal clinics 92, Bath Road, Hounslow. Busch Corner, Isleworth New Heston Road Monday and Wednesday mornings Thursday afternoon Tuesday and Thursday afternoons Thursday afternoon (b) Infant Welfare clinics 92, Bath Road, Hounslow Busch Corner, Isleworth New Heston Road Cranford Memorial Hall Tuesday, Wednesday, Thursday and Friday afternoons Monday and Wednesday afternoons Monday, Tuesday and Wednesday afternoons Monday and Friday afternoons (c) Immunisation and vaccination clinics 92, Bath Road Hounslow) Busch Corner Isleworth) New Heston Road ) By appointment (d) Artificial Sunlight clinics (winter months) 92, Bath Road, Hounslow Busch Corner, Isleworth Tuesday and Friday afternoons Tuesday and Friday afternoons (e) Dental clinics 92, Bath Road, Hounslow ) Busch Corner Isleworth ) Monday to Friday daily and Saturday mornings. (f) Day nurseries Nantly House, Lampton Road Approved accommodation 54 children This day nursery admits children 0-5 years and a charge is made for the care of the children. (g) Midwifery Service Certified midwives are employed for attendance as midwives or maternity nurses at domicilary confinements. Gas and air analgesia is available. Maternity outfits are supplied free for home confinements. (h) Home Nursing. Male and female nurses are employed as 'district' nurses. Where nursing equipment is required for use in the home, arrangements have been made for this to be supplied on loan through the British Red Cross Society at 78, Lampton Road, Hounslow. (i) Health Visitors. Health Visitors who also act as School Nurses are employed in clinics and home visiting. There work is largely educational and social, and is defined in the Act as giving advice as to the care of young children, persons suffering from illness and expectant and nursing mothers, and as to the measures necessary to prevent the spread of infection'. (j) Domestic Helps. Home helps are employed to provide domestic help for households 'where such help is required owing to the presence of any person who is ill, lying-in, an expectant mother, mentally defective, aged, or a child not over compulsory school age'. A charge is made for this service and in assessing this, regard is had to the means of the person concerned. (k) Prevention of Illness, Care and After-care. The care and after-care of tuberculous persons is dealt with by the Welfare Officer at the Chest Clinic Among other things, the County Council scheme provides for the admission of persons, not in need of medical or nursing care, to recuperative holiday homes and for this a charge is made according to the person's circumstances. (1) Ambulance Service. Provision is made for the conveyance of sick, accident and emergency cases, and the service is organised in association with the Fire Service. The accident and emergency service is stationed at the Fire Station, Isleworth, and the sick removal service at West Middlesex Hospital. (m) Mental Health. This service provides for the ascertainment of cases of mental ill-health and mental deficiency, the statutory supervision and guardianship of mental defectives living in the community, and the provision of after-care for persons who have undergone treatment for mental illness. The office of 11 the Mental Welfare (Duly Authorised) Officer for the Borough is at County Offices, Great West Road, Brentford. MIDDLESEX COUNTY COUNCIL - EDUCATION DEPARTMENT - The School Health Service is staffed by the County Health Department and provides the following services:- (a) routine medical inspection of pupils (b) cleanliness surveys of pupils (c) dental inspection of pupils (d) ascertainment of handicapped pupils in need of special education (e) treatment clinics as under:(i) Minor ailments 92, Path Road, Hounslow Busch Corner, Isleworth New Heston Road Cranford Junior School (ii) Medical consultation 92, Bath Road, Hounslow Busch Corner, Isleworth New Heston Road Cranford Junior School (iii) Eye Clinic 92, Bath Road, Hounslow Busch Corner, Isleworth (iv) Allergy Clinic 92, Rath Road, Hounslow (v) Orthopaedic Clinic 92, Bath Road, Hounslow (vi) Physiotherapy 92, Bath Road, Hounslow (vii) Dental Clinic (viii) Artificial Sunlight Clinic (ix) Immunisation Clinic (x) Child Guidance Clinic (xi) Speech therapy daily - mornings daily - mornings daily - mornings Tuesday and Friday mornings Tuesday, Wednesday and Friday mornings Monday and Wednesday mornings Friday morning. Tuesday (fortnightly) - morning Monday and Wednesday afternoons Monday morning Tuesday morning Monday afternoons 1st. Thursday afternoon Wednesday and Thursday afternoons Thursday morning. (see under Health Department) Old Town School, Hounslow, by appointment. by appointment MIDDLESEX COUNTY COUNCIL - WELFARE DEPARTMENT - This service is concerned with the welfare of aged, physically and mentally infirm, blind and partially sighted, deaf and dumb, epileptic and crippled persons and the provision of temporary accommodation for persons in urgent need thereof. The address of the Welfare Officer for the Borough is County Offices, Great West Road, Brentford. MIDDLESEX COUNTY COUNCIL - CHILDREN'S DEPARTMENT - This Department deals with children taken into or committed to the care of the County Council, supervision of foster children, adoption, child neglect, etc. The Children's Officer for the Borough works from County Offices, Great West Road, Brentford. MIDDLESEX EXFCUTIW COUNCIL - This body is responsible for the provision under the National Health Service Act, of the general practitioner, dental (other than Local Health Authority provision for expectant and nursing mothers, young children and school children) pharmaceutical and supplementary ophthalmic services. The headquarters of the Council is at North West House, 119, Marylebone Road, N.W.1. FAMILY PLANNING ASSOCIATION -This voluntary organisation holds sessions at 92, Bath Road, Hounslow, on Monday, Tuesday and Thursday evenings Some 3,000 patients attended during 1957. MARRIAGE GUIDANCE COUNCIL - The Borough Council makes a contribution to the Richmond Marriage Guidance Council, and enquiries should be made to Mrs Hoyland, 100, Sandy Lane, Teddington, (KIN. 8227) 12 SANITARY CIRCUMSTANCES PHYSICAL CHARACTERISTICS - The Borough has an area of 7,218 acres and lies In the Thames Valley on the north bank of the river. From the river, the land rises slowly until at North Hyde it is about 100 feet above sea level. The subsoil consists of 'drift gravels' and lying on them in places are patches of clay. The following open spaces are laid out and controlled by the Borough Council:- Park Farm and Avenue House, Cranford Heston Fair Ground Church Meadow, Bath Road Children's Playground, Sutton Lane Kingsley Road Playing Field Greenhams Land, London Road St John's Gardens, Isleworth Riverside Walk, Isleworth Children's Playground, Northcote Avenue Playground, London Road Bowling Green, Jersey Gardens Isleworth Promenade Heston Park Lampton Park Beaversfield Park Inwood Park Redlees Park Jersey Gardens Football Ground, Denbigh Road Midsummer Children's Playground 40.29 acres 9.38 " 9.20 " 0.60 " 0.95 " 14.75 " 5.73 " 0. 75 " 0.85 " 1. 84 " 0.59 " 1.0 " 14.29 " 24.20 " 9.77 " 10.25 " 16.47 " 7.87 " 3.70 " 1.52 " WATER SUPPLY - The water supply of the Borough is derived almost wholly from the Metropolitan Water Board. A small portion of the Cranford area is supplied by the South-West Surburban Water Company. There are in the Borough 43 shallow and 3 artesian wells serving 40 premises and of these 4 houses and 1 business premises are without an alternative supply The following work in connection with water supplies was carried out during the year - Supplies provided or reinstated Cisterns cleansed repaired etc. Draw-off taps connected direct to main Service pipes or taps repaired 4 4 1 15 DRAINAGE AND SEWERAGE - The drainage and sewerage of almost the whole of the Borough is arranged on the separate system and forms part of the West Middlesex Sewage Scheme. A few houses on the outskirts of the Borough drain to cesspools. The following work was carried out during 1957: - Drains exposed for examination 85 Drains unstopped. repaired etc. 319 Waste pipes repaired trapped, etc. 18 Soil pipes repaired etc. 6 Ventilation shafts repaired, etc. 5 Rainwater pipes disconnected from drains 2 Gully traps inserted or repaired 25 Disconnecting traps inserted or repaired 2 Disconnecting and inspection chambers provided 24 Disconnecting and inspection chambers repaired, etc. 35 Drains constructed or repaired 22 Total length (ft) of drain pipes laid - (a) 4" 547 (b) 6" 25 Drain tests applied 98 Other works executed 10 Cesspools emptied or repaired 7 While the Borough is responsible for the local sewerage of its own district the duty of the disposal of sewage is the responsibility of the Middlesex County Council, whose West Middlesex Drainage Undertaking has been in full operation since 1936. In recent years the increasing use of synthetic detergents has given rise to difficulties at the disposal works. Apart from some interference with the purification process, parts of the works have at times been buried in foam. Research at the works has succeeded in overcoming the foam problem - at considerable annual cost and efforts are continuing to secure an effluent of the highest standard of purity. 13 RIVERS AND STREAMS - No complaint of pollution was made to the Health Department during 1957. CLOSET ACCOMMODATION - The closet accommodation of the Borough consists almost wholly of water closets connected to the sewers. A few water closets drain to cesspools, and several houses on the outskirts of the Borough have pail or chemical closets. The following works were carried out during the year:- Water closets constructed or rebuilt 5 Water closets provided in substitution for dry receptacles, etc. 3 Water closets where walls cleansed 40 Water closets fitted with new flushing apparatus 29 New pans or pedestals provided 30 Water closets repaired or improved 64 Water closets blockages unstopped 7 Other closets provided or repaired 3 Urinals constructed, rebuilt or repaired 11 Chemical closets abolished 4 PUBLIC CLEANSING - The cleansing of streets and collection and disposal of refuse are carried out under the control of the Borough Engineer. Refuse is disposed of by controlled tipping and the collection of house refuse is carried out weekly. Through the action of the Health Department 29 new dustbins were provided during the year. Salvage continues to be collected at the same time as refuse and is segregated before sale. The collection of kitchen waste was discontinued in January, 1954. The returns for the past five years are as follows:- 1953 1954 1955 1956 1957 Paper (tons) 986 1,000 897 1,082 994 Scrap metal (tons) 84 90 38 73 26 Textiles (tons) 41 27 34 13 10 Bottles, jars (tons) 11 17 4 2 - Cullet (tons) - 3 - - - Kitchen Waste (tons) 822 9 - - - Total income £11,440 £8, 705 £8,490 £9,414 £8,102 Throughout the Borough litter is to be found in our streets, parks and open spaces and ranges from discarded bus tickets to 'any old iron'. Whilst it has to be admitted that there may be difficulties in disposing of garden refuse and items that cannot be burned easily much of the unsightliness arising from litter is due to carelessness and lack of consideration. The Health Department can act only if the deposits are 'prejudicial to health or a nuisance' as defined in the Public Health Acts and this is seldom the case. SANITARY INSPECTION OF THE BOROUGH - In addition to the work recorded in other paragraphs of this Report, the Public Health Inspectors continued their general duties of investigating complaints, abating nuisances and dealing with contraventions of the Public Health Act. Not all complaints brought to the Health Department deal with matters on which the Department is empowered to take action, and in such cases complainants are advised as far as is known, how and where the matter may receive attention. Some particulars of the work done are shown below - Inspections following complaint 1,123 Number of premises at which nuisance, etc were located 840 Number of premises where defects were remedied (a) by owners or occupiers 867 (b) by Council in default 14 (c) public sewers repaired by Council 12 Informal notices issued 351 Written reminders issued 612 Statutory notices served 27 Total number of inspections and re-inspections 20,368 Inspections of piggeries 42 Inspections of stables 14 Inspections of urinals 201 Sinks provided or repaired 10 Roofs repaired 165 Gutters repaired or renewed 105 Brickwork, sills, etc , repaired or renewed 258 Premises provided with damp-proof courses 3 Sites covered with impervious material 1 Yards and forecourts paved or drained 13 External painting 24 Rooms stripped, cleansed and redecorated 389 14 Floors, walls and ceilings, repaired or renewed 506 Rooms in which ventilation provided or improved 4 Rooms in which lighting provided or improved 35 Windows repaired or renewed 288 Doors and other woodwork repaired or renewed 91 Staircases replaced or repaired 8 Lighting to staircase provided or improved 3 Handrails or balusters repaired or renewed 5 Grates provided or repaired 61 Instances where ventilation under floor provided or improved 3 Larders provided or repaired 6 Domestic cleansing enforced 1 Improper keeping of animals abated 1 Offensive accumulations removed 55 Other repairs carried out or nuisances abated 226 Visits re infectious diseases, etc. 212 Complaints continue to be received of nuisance caused by pigeons. The department does what it can to assist and advise complainants, but it must be pointed out that the Council has no power to catch or destroy pigeons on private property or to spend money for such a purpose EXCHANGE OF ARTICLES FOR RAGS etc. - Under the Public Health Act, 1936, it is an offence for any person who collects or deals in rags etc., to sell or deliver, whether gratuitously or not any article whatsoever to a child under the age of 14 years in exchange for rags etc The Police notify the Council of any such contraventions coming to their notice SMOKE ABATEMENT - The emission of smoke grit and ash from a factory chimney may constitute a nuisance within the meaning of the Public Health Acts. During the year the Public Health Inspectors made 152 smoke observations and paid many visits to premises in regard to which complaints of smoke nuisance had been received. The Council co-operates with the Department of Scientific and Industrial Research by measuring atmospheric pollution in the Borough. Two sets of apparatus are in use, one on the roof of the Health Department in Bath Road, Hounslow, and the other on the roof of Heath House London Road Isleworth The detailed monthly analyses are forwarded for record and study to the Central Department, but the main features are recorded below - Rainfall (inches) Health Department Heath House Deposit (tons per sq mile) Sulphur (Mgms So3 per day per 100 sq. cm. ) Rainfall (inches) Deposit (tons per sq. mile) Sulphur (Mgms.So3 per day per 100 sq. cm.) January 1.50 9.04 1.50 1.42 9.52 1.05 February 2.84 8.62 1.28 2.68 7.91 1.14 March 0.95 8.04 0.85 0.95 8.44 0.74 April 0.20 11.74 0.58 0.24 13.20 0.66 May 0.95 6.81 0.52 0.99 8.21 0.54 June 0.71 9.75 0.72 0.59 10.34 0.84 July 3.70 7.05 0.61 3.51 7.97 0.69 August 3.51 9.34 0.68 3.63 10.88 0.77 September 2.44 7.94 0.59 2.29 8.41 0.70 October 3.27 11.53 0.68 3.27 12.80 1.51 November 0.87 11.29 2.21 0.95 14.53 2.69 December 1.58 13 38 2.39 1.65 14.83 2.43 Average 1.88 9.54 1.05 1.85 10.59 1.15 Average 1952-1956 1.89 9.13 0.92 1.87 9.47 1.00 The following table and Figures 1 and II show 1957 in comparison with the average for the previous five years 15 Figure I 16 Figure II 17 1952 - 56 1957 Total Deposit (tons per sq. mile) Sulphur (Mgms. So3 per day per 100 sq. cms. ) Total Deposit (tons per sq. mile) Sulphur (Mgms.So3 per day per 100 sq. cms.) January 11.2 1.5 9.3 1.3 February 11.0 1.4 8.3 1.2 March 11.4 1.2 8.2 0.8 April 9.2 0.8 12.5 0.6 May 9.2 0.7 7.5 0.5 June 8.1 0.5 10.1 0.8 July 6.9 0.4 7.5 0.7 August 6.2 0.4 10.1 0.7 September 7 9 0.5 8.2 0.6 October 9.0 1.1 12.2 1.1 November 8.9 1.3 12.9 2.5 December 10.5 1.7 14.2 2.0 TENTS, VANS AND CARAVANS - There are five sites in the Borough which have been used as caravan sites for many years. Some are occupied wholly or in part by persons, who use caravans for business in connection with a travelling circus, fair or stall. During the year, the inspectors made 1,449 visits of inspection because of the occupation of land by caravans. Trespass by caravans on road verges and unfenced land continues especially on the western outskirts of the Borough. The vagrant type who occupy these caravans deposit domestic refuse, litter of all kinds, waste water and faecal matter in the neighbourhood of the sites occupied. Much time and effort have been given in attempts to clear them from their usual camping sites but only too often within 24 hours they are back again. Under the provisions of the Middlesex County Council Acts one application for permission to place a caravan on a site in the Borough for a further period of twelve months was granted. COMMON LODGING HOUSES - There is no common lodging house in the Borough. CANAL BOATS - The Public Health Inspectors continued their duties as canal boat inspectors, and made 52 inspections during the year. FACTORIES, WORKPLACES etc - The Factories Act placed on the Council certain duties in regard to (a) outworkers; (b) employment of persons in unwholesome premises; (c) basement bakehouses; (d) provision of sanitary conveniences in all factories, and (e) cleanliness, over-crowding, ventilation and drainage of floors in the case of factories in which mechanical power is not used. A summary of the work done is given below and in Table X. Inspection of (a) Factories - mechanical power 567 (b) Factories - non-mechanical power 37 (c) Other premises 7 (d) Workplaces 7 (e) Outworkers' premises 104 Defects remedied 19 At the end of the year the number.of outworkers registered with the Department was 238 and the trades on which they were engaged were as follows:- Wearing apparel 202 Lace, lace curtains and nets 2 Curtains and furniture hangings 5 Furniture and upholstery 3 Brass and brass articles 1 Artificial flowers 1 Carding, etc., of buttons, etc. 16 Stuffed toys 6 Cosaques, Christmas crackers, Christmas stockings, etc. 2 DISINFESTATION - The Health Department deals with bug and other infestations in houses and other premises, and for this purpose D.D.T. and other insecticides are used. During the year, 38 rooms and 3 houses were treated, while 39 wasp nests were destroyed, 10 premises cleared of cockroaches, 2 cleared of ants, and 12 of other insects. Treatment of ponds and tanks to prevent the breeding of mosquitoes was carried out as necessary. 18 NOISE NUISANCE - In the Middlesex County Council Act a noise nuisance is deemed to exist 'where any person makes or continues or causes to be made or continued any excessive or unreasonable or unnecessary noise which is injurious or dangerous to health'. Further, it is a good defence for the person charged to show 'that he has used the best practicable means of preventing or mitigating the nuisance, having regard to the cost and to other relevant circumstances.' Most complaints of noise nuisance arise in connection with industrial processes carried on in factories situated close to houses. From the above definition it will be seen that many factors have to be taken into consideration in judging whether or not a noise is a nuisance within the meaning of the Act, though there may be no doubt about the annoyance to residents in the neighbourhood of the factory concerned. During the year 14 complaints of nuisance from noise were received. Thirteen were associated with factories but the other was not confirmed In most cases there appeared to be some justification for the complaint and, with the co-operation of the users of the factories, considerable reduction in noise was achieved. RATS AND MICE DESTRUCTION, etc. - The Prevention of Damage by Pests Act, 1949, places the responsibility on the Council 'to keep their area as far as practicable, free from rats and mice' and occupiers of premises are required to give notice when they have knowledge that rats and mice are present in substantial numbers It is obligatory on the Council to recover the expenses reasonably incurred in taking steps for the destruction of rats and mice on business premises, but permissive as far as the cost of treating private dwellings is concerned The Council has decided to make no charge for the treatment of private dwelling-houses unless there is failure on the part of the owner or occupier to co-operate in preventing infestation. The Ministry of Agriculture and Fisheries may make to local authorities a grant equal to one half of the expenditure incurred in the performance of their duties under the Act so far as such expenditure has not been recovered. The Council employs a Rodent Officer who is responsible for systematic inspection, planning of treatment, supervising the work of the roden operatives and checking results. A summary of the work done in recent years is shown below:- 1953 1954 1955 1956 1957 Complaints received 527 533 692 634 629 Block inspections 46 43 66 53 89 Individual inspections and re-inspections 4,970 4,381 4,541 4,162 4,441 Other visits 654 503 419 561 645 Premises treated - (a) By occupier 7 18 15 14 16 (b) By local authority 930 883 1,004 982 1,052 Test baiting and where necessary, treatment is carried out to sewers, watercourses, tips, etc. Destruction of part of the rat population by chemical or other poisoning may increase the food supply and improve the chances of survival of the remainder. Eradication requires environmental conditions which hinder survival, i.e., no food and no shelter and occupiers of premises should bear this in mind. SHOPS ACT, 1950, SECTION 38 - Shops require to be reasonably ventilated, heated and lighted, and there should be suitable and sufficient sanitary and washing facilities for the persons employed therein. In this connection 3 inspections were made during the year No certificate of exemption re provision of sanitary accommodation was granted. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 - This Act is designed to ensure that filling materials used in upholstery, etc., comply with prescribed conditions of cleanliness Premises using filling materials have to be registered and premises where rag flock is manufactured or stored have to be licensed. It is an offence to sell articles containing unclean materials. Certain records have to be kept on registered and licensed premises and authorised officers of a local authority have Powers to enter, inspect and take samples. Under this Act, five premises in the Borough have been registered and the Public Health Inspectors made 6 visits of Inspec- t.i on SWIMMING BATHS - Three swimming baths are provided by the Council. The size and extent of useage of the three municipal baths are shown below:- Hounslow Heston Isleworth Area of bath maj or 75' x 30' 100' x 48' 100' x 48' minor 50' x 25' - - Capacity of bath (gallons) major 71,000 200,000 200,000 minor 36,000 - - 19 Hounslow Heston Isleworth Total number of persons using swimming bath in 1957 129,431 192,557 155,357 Maximum number of persons using swimming bath on any one day 1,720 2,002 1,327 No. of slipper baths Male 15 - 11 Female 9 - 11 Mo. of persons using slipper baths during 1957 40,805 . 24,291 The baths waters are treated by continuous filtration and breakpoint chlorination. While baths' staff do everything to maintain a 'safe' standard of bath water the bathers could assist very materially by the observance of strict personal hygiene. During the year 8 samples of baths water were taken and all were found to be satisfactory. VERMINOUS PREMISES AND ARTICLES - No action had to be taken under Sections 83 and 84 of the Public Health Act, 1936. VERMINOUS PERSONS - No verminous person was cleansed under the provisions of Section 85 of the Public Health Act, 1936. During the year 136 children in attendance at schools in the Borough were found to be verminous and because of the failure of parents to take necessary action 38 of these children had to be cleansed by the School Health Department. Louse infestation is much too prevalent and is due solely to lack of personal cleanliness. The problem of the persistently verminous children or family is a difficult one and is usually not one of uncleanliness alone. PET ANIMALS ACT 1951 - This Act is designed to regulate the sale of pet animals and the main provision is that no person shall keep a pet shop except under the authority of a licence granted in accordance with the provisions of the Act. Under the provisions of this Act 8 premises in the Borough have been licensed and 14 visits of inspection were made during the year. MILK - At the end of the year, 12 dairies were registered under the Milk and Dairies Regulations. During the year, 69 inspections were made at dairies and retail purveyors' premises. Under the Milk (Special Designation) Regulations, 41 licences for the sale of 'tuberculin tested' milk, 45 for the sale of 'pasteurised' milk, and 53 for the sale of 'sterilised' milk were issued. The Milk (Special Designations) (Special Areas) Order, 1951, came into operation on 1st October.. 1951 This Order defined the County of Middlesex as an area in which the use of a special designation becomes obligatory for the purpose of all sales of milk by retail for human consumption (other than a catering sale). The special designations permitted are 'sterilised', 'pasteurised' and tuberculin tested'. Complaints of milk being supplied in dirty bottles continue to be received. The number is very small in relation to the large issue to the public. The consumer can help by the hygienic care of the bottles which should never be used for any other purpose than to hold milk. After use, they should be well rinsed in cold water to remove any milk residue. In regard to dirty milk bottles, one warning letter was issued and there were two prosecutions, resulting in fines and costs amounting to £14 7s Od. ICE CREAM - Under the Pood and Drugs Act, 'premises used for the sale or the manufacture for the purpose of sale, of ice-cream, or the storage of ice-cream intended for sale' must be registered. This does not apply to premises used primarily as a club, hotel, inn or restaurant and only to a theatre, cinematograph theatre, music hall or concert hall if the ice-cream is manufactured on the premises The number of premises registered at the end of the year was 230. The Ice-Cream (Heat Treatment, etc.) Regulations require all ice-cream except complete cold-mix powders, to be heat treated with a view to killing any pathogenic organisms which may be present and lay down the temperatures at which mixtures are to be kept before and after heat treatment - these temperatures are such as to discourage bacterial growth The Regulations also require that ice cream shall be protected from dirt, dust or other contamination. The enforcement of these Regulations calls for regular and persistent supervision of premises, plant and method of manufacturing and handling- INSFECTION AND SUPERVISION OF FOOD 20 During the year, 119 inspections of registered premises were carried out. The following results were obtained from the bacteriological examination of samples:- Satisfactory Doubtful Unsatisfactory Ice-Cream 43 7 1 Water Ices or 'lollies' 15 - 1 Milk Ices 14 2 - Rinse Water 1 - 1 The percentage of doubtful and unsatisfactory samples was 13.3 as compared with 31.2 in 1956. BAKEHOUSES - There are 20 bakehouses in the Borough and 133 visits of inspection were made during the year. SLAUGHTERHOUSES, etc. - There is no public abattoir, private slaughterhouse or knacker's yard operating in the Borough SLAUGHTER OP ANIMALS (AMENDMENT) ACT, 1954 - No application for a licence, under the provisions of the Act, has been received. INSPECTION OF MEAT AND OTHER FOODS - In addition to those mentioned elsewhere in this report, other food premises in the Borough and the number of inspections are listed below:- Number Inspections Butchers Shops 73 466 Cafes, Canteens, Clubs, etc. 160 675 Fish Shops 27 207 Greengrocers 87 291 Grocery and provision 187 659 Hotels, public houses, etc. 98 181 Manufacturers, packers, etc. 13 61 Confectioners sweets 140 173 - flour 22 158 At retail premises 4,185 lbs. and 2,597 tins or packets of unsound food were seized by, or surrendered, to the Public Health Inspectors These unsound foods were deposited on the Council's refuse tip and immediately and adequately covered by refuse or other material. The following foods were brought to the Department because the purchasers, were not satisfied that they were fit for human consumption - bread, 9; cakes, 2; potatoes, 2, tinned fish. 2 black pudding, 1; sausage, 1; chocolate-coated biscuits, 1; fish sticks, 1 meat pie, 1; meat, 1; marzipan substitute, 1; jam, 1; haricot beans, 1; sausage roll, 1. The complaints were not substantiated in 18 cases 4 official warnings were issued; proceedings in 2 cases resulted in fines and costs amounting to £10 4s 0d; and one case was dismissed on grounds that summonses were not in the form required. Premises used for 'the preparation or manufacture of sausages or potted, pressed, Pickled or preserved food for sale' are required under the Food and Drugs Act, 1955, to be registered, and at the end of the year 104 such premises were registered. Under Section 11 of the Middlesex County Council Act, 1950, hawkers of food and their storage premises require to be registered. At the end of the year 42 hawkers were on the register (greengrocery, 29; fish, 8; ice-cream 5) and 90 inspections of their vehicles and wares were carried out. MUNICIPAL RESTAURANTS AND SCHOOL CANTEENS - There is no municipal restaurant in the Borough, but during the year the 20 school canteens provided 1,312,356 meals. By the provision of new schools and the replacement of school canteens established during the war, the facilities for meals at schools are being improved. FOOD AND DRUGS SAMPLING - The following information on the work done in the Borough during 1957 has been supplied by the Public Control Department of Middlesex County Council:- ARTICLE TOTAL SAMPLES PROCURED. UNSATISFACTORY Milk, new 65 7 Milk, various 65 – Butter 9 – Ale 2 – Cakes 6 – carried forward 147 7 21 NEW MILK - The 7 unsatisfactory samples were all deficient in milk fat. Two of these were procured from different farmers and in each case other samples of new milk taken from the same consignments were satisfactory. The remaining 5 unsatisfactory samples were all from one farmer; the farmer's attention was drawn to this result by letter and the Milk Marketing Board was also informed in order that it could tender technical advice to the farmer as to how an improvement could be secured. CHEESE - In two instances a compound article was sold under the description 'Cheese' whereas the article should properly have been called 'cheese spread'. Both of these were imported foods and letters were addressed to the importers concerned requiring suitable amendments to the respective labels to be effected. The other three unsatisfactory samples of cheese were also imported produce. In each case the label bore a statement of the percentage fat content, but it was in such a form as to mislead a purchaser into thinking that the stated percentage of milk fat was a percentage on the weight of the whole cheese whereas it was a statement of the percentage on the total dried matter in the cheese. In these cases also letters were sent to the importers concerned requesting suitable modification of the labels. FRUIT JUICE - One sample sold as 'lime-juice' was found to be lime juice cordial and another sample sold as 'cherry juice' was cherry syrup. In each case the manufacturer was informed of the inaccurate description and was requested to make suitable modification to these labels SAUSAGES - Two samples of sausages were found to contain a preservative, sulphur dioxide, although its presence was not disclosed as required by The Public Health (Preservatives, etc., in Pood) Regulations, 1925-1953. In each case the amount present would have been permitted had this disclosure been made. An official caution was sent to each trader. MERCHANDISE MARKS ACTS, 1887-1926 - 213 inspections of shops were undertaken to ensure that the Marking Orders relating to certain imported foodstuffs made under the Merchandise Marks Act, 1926, were complied with. 548 separate displays of meat, apples, tomatoes, dried fruit, butter and bacon were examined. No serious infringement was disclosed and verbal cautions,were given in respect of those minor infringements which were detected. THE LABELLING OF FOOD ORDER, 1953 - At 238 premises 2,065 articles of prepacked food were examined to see that they bore a label which gave a clear statement of the designation of the food and, in the case of compound foods, the ingredients, also the name and address of the packer or labeller. No infringements of this Order were detected. SPECIAL DESIGNATED MILK - During the year in question two licences were issued by my Council in respect of the use of the special designation 'pasteurised' for milk processed within your area. Each premise was regularly inspected and compliance with the requirements of the Act and of the appropriate Regulations was maintained in each case 111 samples of pasteurised milk were taken, all of which were certified as being satisfactory. SAFE MILK - In addition to the foregoing, 38 samples of raw milk were procured within your Borough and submitted to test for the presence of tubercle bacilli. None was found contaminated. 22 ARTICLE TOTAL SAMPLES PROCURED. UNSATISFACTORY brought forward 147 7 Cheese 12 5 Cream 14 - Drugs 17 - Fish and fish products 21 - Fruit (fresh and canned) 26 - Fruit Juice 4 2 Ice Cream 2 - Jelly 4 - Liver 6 - Margarine 3 - Meat and meat products 10 - Miscellaneous 18 - Non-brewed condiment 2 - Peas (canned) 5 - Preserves 8 - Sausages, etc. 13 2 Spirits 4 - Sweets 5 - Vinegar 16 - 337 16 POOD HYGIENE - The work of promoting sound standards of hygiene in food premises has been steadily pursued. As far as possible, the plans of all premises which will be associated with the preparation and sale of food are examined. In this way it is possible to influence the standard of premises and equipment and consultation on these matters is welcomed. Visits of inspection were paid with a view of securing 'clean food, handled by clean hands and transported, prepared and stored under clean conditions', As a result of these visits contraventions of the Pood Hygiene Regulations were found at 73 premises and were remedied at 216 premises during the year. Many of the conditions remedied had been discovered during the latter half of 1956 when a special effort was made to draw the attention of the food trade to the Regulations. Some particulars of the contraventions found and remedied are given below:- Contraventions of Pood Hygiene Regulations Found Remedied Articles/Equipment not kept clean 20 102 Articles/Equipment not in good order 20 104 Containers not protected from contamination 12 60 Pood so placed as to involve risk of contamination 14 72 Pood placed within 18" of ground and not adequately protected 5 14 Personal cleanliness not observed 2 16 Improper wrapping materials used — 3 Inadequate trapping of drain inlets — 1 Water Closets not kept clean and in efficient order 14 48 Insufficient lighting and ventilation to water closets 10 53 Absence of 'Wash your hands' notices in water closets 30 120 Inadequate cold water supply — 1 Absence of suitable and sufficient wash-hand basins 38 86 Absence of hot water at a suitably controlled temperature over wash-hand basins 33 107 Absence of soap, nail brushes, clean towels etc., near wash-hand basins 12 42 Absence of first aid materials 21 81 Absence of accommodation for clothing not worn during working hours 6 54 Absence of suitable and sufficient sinks for the washing of food and equipment 7 67 • Absence of hot water at a suitably controlled temperature over sink 15 70 Absence of soap, clean clothes etc., at sink. 1 7 Absence of suitable and sufficient lighting in food rooms. 4 15 Absence of suitable and sufficient ventilation in food rooms 6 17 Walls, floors etc., not kept clean. 44 182 Walls, floors etc., not kept in good order. 46 187 Covered receptacle for" refuse not provided 1 1 Accumulations of refuse etc. 3 12 Specified foods not stored at prescribed temperature 2 9 Miscellaneous 6 12 TOTALS 377 1,543 HOUSING The numbers of new houses erected in the Borough in recent years is shown below: - 1946-53 1954 1955 1956 1957 Heston and Isleworth B.C. 1,280 23 217 20 178 Brentford and Chiswick B.C. 34 – – 22 – Southall B.C. 64 – – – – Middlesex County Council 4 – 1 – – Ministry of Civil Aviation 77 – – – – Metropolitan Police 18 – 11 – – Prison Commissioners – 8 10 – – carried forward 1,477 31 239 42 178 23  1946-53 1954 1955 1956 1957 brought forward 1,477 31 239 42 178 Private enterprise - (a) new houses 189 76 219 172 233 (b) reconstructed after war destruction 185 _ _ _ _ (c) housing associations 190 111 39 59 30 (d) additional dwellings by conversion 3 _ _ _ _ 2,044 218 497 273 441 What action is to be taken concerning unfit houses is governed by the cost of the necessary works. Unless the house 'is capable at reasonable expense of being rendered fit' action must be in the direction of closing or demolition. 'Reasonable expense' has never been defined and with restrictions on rents and the high cost of repairs, its interpretation is far from easy, but the Housing Act, 1957 has now defined the matters to be taken into consideration in assessing fitness for human habitation. The action taken in insanitary and unfit dwelling houses during the year is summarised in the following return which has been submitted to the Ministry of Housing and Local Government:- 1. INSPECTION OF DWELLING-HOUSES DURING THE YEAR (1) (a) Total number of dwelling-houses inspected for housing defects (Under Public Health and Housing Acts): 241 (b) Number of inspections made for the purpose: 278 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under Housing Regulations, 1925 and 1932: 48 (b) Number of inspections made for the purpose: 85 (3) (a) Number of dwelling-houses found to be in a state so dangerous or Injurious to health as to be unfit for human habitation: 32 (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 145 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 75 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: 11 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) by Owners: 3 (b) by Local Authority in default of owners: 12 (b) Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 9 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) by Owners: 2 (b) by Local Authority in default of owners (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: 15 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders: 9 (3) Number of dwelling-houses rendered fit in consequence of Undertakings given by Owner: 3 24 (4) Number of dwelling-houses in respect of which undertakings from owners accepted, not to relet houses for human habitation: 3 (5) Number of dwelling-houses demolished in pursuance of undertakings: 3 (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: (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit: 1 (e) Proceedings under section 155 of the Housing Act, 1936: Number of prosecutions taken for letting, attempting to let, occupying or permitting to occupy houses ordered to be closed: 1 (f) Housing Act, 1949, and Local Government (Miscellaneous Provisions) Act, 1953; (1) Demolition Orders Quashed: (g) Local Government (Miscellaneous Provisions) Act, 1953: (1) Demolition Orders determined and Closing Orders substituted: (2) Closing Orders made under section 10 (1): 1 (3) Number of dwelling-houses demolished; 4. HOUSING ACT, 1936 - OVERCROWDING (1) (a) Number of dwellings overcrowded at the end of the year: 34 (b) Number of families dwelling therein: 56 (c) Number of persons dwelling therein 245 (2) Number of new cases of overcrowding reported during the year 6 (3) (a) Number of cases of overcrowding relieved during the year: 10 (b) Number of persons concerned in such cases: 89 (4) Particulars of any case in which dwelling-houses have again become over-crowded after the Local Authority have taken steps for the abatement of overcrowding: 5. OTHER MATTERS. (1) Number of dwelling-houses demolished voluntarily: 5 (2) Certificates of Disrepair: The Rent Act, 1957, came into operation in July and applications for Certificates of Disrepair began to come in during September. The procedure for dealing with applications under the new Act is much more complicated than under the 1954 Act and entails considerably more work in the Department both by the Inspectors and the clerical staff. By the end of the year eighty-five applications for Certificates of Disrepair had been received and had been dealt with as follows:- Number of decisions not to issue certificates Nil Number of decisions to issue certificates - (a) in respect of some but not all defects 56 (b) in respect of all defects 27 Number of undertakings given by landlords to remedy defects (Form 'K') * 39 Number of Certificates issued 33 Number of applications by landlords to Local Authority for cancellation of Certificates 5 25 (3) At the end of the year, the following 53 houses, subject to Demolition or Closing Orders or to undertakings not to re-let till rendered fit, were still occupied:- Situation Date of Demolition Order or Undertaking. 14, Brickfield Yard 25.10.38 18, Brickfield Yard 25.10 38 3, Park Cottages 28.12.38 4, Park Cottages 28.12.38 11, Tivoli Road 28. 2.39 13, Tivoli Road 28. 2.39 106, Linkfield Road 28. 3.39 98, Linkfield Road 28. 3.39 100, Linkfield Road 27. 6.39 122, New Heston Road 25. 7.39 124, New Heston Road 25. 7.39 159, Martindale Road 25. 7.50 165, Martindale Road 25. 7.50 67, Pears Road 29. 4.52 169, Martindale Road 30. 9.52 10, Ivy Road 28. 6.55 4, Algar Road 26. 7.55 1, Castle Place 29.12.55 180, Linkfield Road 28. 2.56 184, Linkfield Road 28. 2.56 173, Spring Grove Road 28. 2.56 175, Spring Grove Road 28. 2.56 38, Haliburton Road 29. 5.56 134, Hanworth Road 26. 6.56 136, Hanworth Road 26. 6.56 138, Hanworth Road 26. 6.56 140, Hanworth Road 26. 6.56 10 and 12, Barrack Road (jointly occupied) 31. 7.56 14, Barrack Road 31. 7.56 30, Park Road 30.10.56 304, North Hyde Lane 27.11.56 306, North Hyde Lane 27.11.56 308, North Hyde Lane 27.11.56 312, North Hyde Lane 27.11.56 316, North Hyde Lane 27.11.56 6, Prince Regent Road 30. 4.57 220, Linkfield Road 30. 7.57 21, Whitton Road 24. 9.57 25, Martindale Road 29.10.57 27, Martindale Road 29.10.57 807, Bath Road 26.11.57 809, Bath Road 26.11.57 811, Bath Road 26.11.57 813, Bath Road 26.11.57 815, Bath Road 26.11.57 817, Bath Road 26.11 57 819, Bath Road 26.11.57 1, Derby Road 26.11.57 41, Grove Road 26.11.57 43, Grove Road 26.11.57 45, Grove Road 26.11.57 47, Grove Road 26.11.57 49, Grove Road 26.11.57 All these houses are incapable of being made fit at a reasonable cost and in each case the owner has had full opportunity to submit to the Council any proposals for their retention and to object to the action taken by the Council. The Housing Department is kept informed of adverse housing conditions coming to the notice of the Health Department and assistance is giver in the assessment of applications for re-housing where priority on medical grounds is claimed. During the year the Council approved expenditure as under:- (a) advances of £421,295 under the Small Dwellings Acquisition Acts in relation to 313 houses. (b) improvement grants of £2,480 under section 20 of the Housing Act, 1949, in relation to 12 houses. (c) repairs loans of £760 under section 4 of the Housing Act, 1949, in relation to 3 houses. (d) Pepair costs of £1,131 under section 9 of the Housing Act, 1936, for work in default in relation to 7 houses. 26 GENERAL MATTERS BURIALS - Under Section 50 of the National Assistance Act, 1948, it is the duty of the Council to arrange the burial of any person who has died in the district, where it appears that there are no suitable arrangements for the disposal of the body. During 1957, two burials were arranged in accordance with this section. PUBLIC MORTUARY - The public mortuary is situated in the grounds of Holy Trinity Church. The premises are out-of-date and unsuitable for post-mortem examinations or the retention of a body for other than a very short time, so by arrangement with Acton Borough Council and the Coroner, bodies are taken direct to or transferred to Acton Mortuary. The Council pays a proportion of the cost of maintenance of the Acton Mortuary. MEDICAL EXAMINATION OP STAFF - For superannuation or other purposes 171 members of the Council's staff were referred to the Health Department for medical examination. HEALTH EDUCATION - Posters issued by the Central Council for Health Education continued to be displayed on the boards formerly used by the Empire Marketing Board. During the year, the Medical Officer of Health gave talks to several organisations in the Borough on various aspects of the health services. Though the work of the department is not primarily educational, the staff are fully aware of the opportunities given by their contact with the people for drawing attention to matters bearing on health and hygiene. Other Departments have co-operated by displaying health educational material. PERSONS IN NEED OF CARE AND ATTENTION - Section 47 of the National Assistance Act, 1948, places the responsibility on the Council of taking action to secure 'the necessary care and attention for persons who:- (a) are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention . Despite the growing interest of statutory and voluntary agencies in the welfare of the aged, cases come to the notice of the Department of neglected aged persons living in insanitary conditions. Such persons are usually most reluctant to accept assistance or to go to hospital or institution, but fortunately, in most cases, peaceful persuasion secures their co-operation in some degree and the necessary action can be taken. In no case was it necessary to seek authority to apply for an Order for compulsory removal to hospital or institution. LAUNDRY SERVICE - One of the problems in the care of aged and sick persons in their own homes is soiled clothing and bed linen. Where washing facilities are poor and the persons concerned neither have nor can afford assistance, the cleansing of clothing and bedding presents serious difficulty. In some cases, action under Section 84 of the Public Health Act, 1936, is the only solution and the Council has made arrangements with a laundry firm for the cleansing of articles where the Medical Officer of Health has issued the certificates required by the Act. The number of cases in which such action has been necessary is small, but the provision of these facilities has met a genuine need BLOOD TRANSFUSION SERVICE - Sessions for the collection of blood from donors were held as under:- BLOOD TRANSFUSION SERVICE - Sessions for the collection of blood from donors were held as under:- Hounslow Isleworth 5th, 6th and 7th January 31st March 27th, 28th and 29th April 21st July 17th, 18th and 19th August 10th November. 7th, 8th and 9th December. 27 TABLE 1 Summary of Vital Statistics 1898-1957 Estimated Civilian population (mid- year) Birth Rate per 1,000 population Death Rate per 1,000 popu1ation Infant Mortality Rate Deaths under 1yr. per 1, 000 1ive births Neo- natal Mortality Rate Deaths under 1mth. per 1, 000 1ive births Maternal Mortality Rate per 1, 000 1ive and still births Still Birth Rate per 1, 000 live and still births Tuberculosis Death Rate per 1, 000 population 1898 29, 185 28.0 16.0 173 – – – 1.4 1899 29, 607 31.4 17.8 155 – – – 2.2 1900 ' 30, 040 27.1 23.0 156 – – – 1.6 1901 30, 959 28.5 15.7 160 – – – 1.6 1902 31, 470 29.9 16.7 157 – – – 1.2 1903 31, 531 32.8 14.2 99 – – – 1.8 1904 32, 630 32.3 16.8 169 – – – 1.9 1905 33, 194 31.0 13.9 137 – – – 1.2 1906 33, 767 33.5 15.1 139 48 – – 1.3 1907 34, 351 33.0 14.2 88 30 – – 1.2 1908 34, 895 29.1 15.9 111 29 – – 1.3 1909 35,672 27.3 15.9 91 28 – – 1.6 1910 36 311 25.1 14.1 100 26 – – 1.3 1911 43, 684 23.9 13.6 162 43 – – 1.5 1912 45, 191 23.1 10.8 86 37 – – 0.4 1913 46. 749 24.0 11.7 103 34 – – 0.9 1914 48. 361 21.0 11.4 98 34 – – 1.2 1915 41 836 19.6 12.6 102 40 – – 1.6 1916 42, 000 20.1 12.6 77 30 – – 1.2 1917 40,000 16.6 14.9 117 47 – – 1.8 1918 43, 129 16.8 17.9 86 36 – – 1.8 1919 42, 020 16.8 11.6 99 62 – – 1.0 1920 43, 445 24.7 10.9 58 22 – – 1.0 1921 47, 290 20.0 11.3 69 40 – – 1.0 1922 47, 850 18.7 11.8 74 37 – – 1.0 1923 48, 030 17.5 9.8 55 26 – – 0. 9 1924 47, 700 17.7 10.8 61 27 – – 1.0 1925 48, 620 17.4 10.3 73 41 – – 0.7 1926 52, 110 17.4 9.1 56 25 – – 0.8 1927 55, 870 16.1 10.7 68 36 – – 1.0 1928 59, 730 17.1 9.9 56 27 – – 0.6 1929 63, 070 17.1 11.6 46 18 – – 0.8 1930 63,070 19.1 9.6 50 25 6.4 36 0.8 1931 76, 230 17.6 10.0 49 24 5.0 30 0.7 1932 81, 100 17.4 9.7 60 29 2.8 24 0.7 1933 84, 460 16.3 9.4 43 19 4.9 34 0.9 1934 87, 797 15.1 10.3 48 21 2.9 32 0.8 1935 90, 970 15.8 9.0 41 22 4.7 36 0.6 1936 95, 000 15.7 9.6 48 20 2.0 30 0.6 1937 99, 420 14.9 9.5 40 20 3.3 23 0.5 1938 101, 500 14.2 8.6 46 24 2.7 30 0.6 1939 101, 100 15.0 8.8 50 23 3.4 26 0.7 1940 97, 530 13.7 12.3 58 39 2.3 26 0.6 1941 93, 990 12.9 10.3 61 32 2.4 35 0.8 1942 95, 600 14.6 10.2 72 43 2.8 32 0.7 1943 95, 080 16.3 10.6 47 23 0.6 26 0.6 1944 92, 370 16.5 10.4 46 30 1.9 22 0.5 1945 95, 100 15.5 9.7 51 33 2.0 26 0.5 1946 104, 240 17.3 10.4 29 22 2.2 26 0.5 1947 106, 670 17.3 10.5 39 24 0.5 24 0.5 1948 106, 200 14.5 8.8 30 20 0.6 25 0.4 1949 106, 900 13.6 9.8 17 12 2.0 18 0.3 1950 107, 300 11.6 9.9 24 14 0.8 18 0.3 1951 106, 400 11.3 10.4 18 14 0.0 20 0.3 1952 105, 600 11.7 10.1 19 15 0.0 16 0.2 1953 105, 100 12.1 10.1 18 11 0.8 19 0.1 1954 105, 600 11.2 9.6 26 19 0.0 20 0.1 1955 105, 500 11.0 10.6 24 17 0.0 17 0.1 1956 105, 100 11.1 10.8 18 15 0.0 19 0.1 1957 105, 100 12.3 10.3 23 17 0.0 11 0.07 28 TABLE II. REGISTRAR GENERAL s RETURN OF CAUSES OF DEATH, 1957. Abridged List No. Cause of Death Male Female Total B. 1 Tuberculosis, respiratory 5 2 7 B. 2 Tuberculosis, other _ _ _ B. 8 Syphilitic disease 2 _ 2 B. 8 Diphtheria _ _ _ B. 9 Whooping Cough _ _ _ B. 10 Meningococcal Infections _ _ B. 12 Acute poliomyelitis _ _ _ B. 14 Measles _ _ _ B 4-7, 11 15- 17 Other Infective and parasitic diseases _ 1 1 B. 18 Malignant neoplasm, stomach 17 14 31 Malignant neoplasm, lungs 35 7 42 Malignant neoplasm, breast _ 19 19 Malignant neoplasm, uterus _ 5 5 Other malignant and lymphatic neoplasms 57 51 108 Leukaemia, aleukaemia 4 3 7 B. 20 Diabetes 2 1 3 B. 22 Vascular lesions of nervous system 54 100 154 B. 26 pt. Coronary disease, angina 120 73 193 B. 28 Hypertension with heart disease 13 19 32 B. 25 26pt. 27 Other heart disease 58 67 115 B. 29 46pt. Other circulatory disease 26 41 67 B. 30 Influen ta 6 3 9 B. 31 Pneumonia 31 33 64 B. 32 Bronchitis 31 19 60 B. 46pt. Other respiratory diseases 7 2 9 B. 33 Ulcer of stomach and duodenum 8 6 14 B. 36 43pt. Gastritis, enteritis, diarrhoea 1 1 2 B. 38 Nephritis and nephrosis 3 4 7 B. 39 Hyperplasia of prostate 3 _ 3 B. 40 Pregnancy, childbirth, abortion _ _ _ B. 41 Cogenital malformations 5 4 9 Residual Other defined and ill-defined diseases 42 44 86 B.E. 47 Motor vehicle accidents 5 5 10 B.E. 48 All other accidents 8 10 18 B.E. 49 Suicide 6 10 16 B.E. 60 Homicide and operations of war _ _ _ Total 548 534 1,082 29 TABLE III CAUSES OF DEATH (MALES) AT CERTAIN AGES. 1957 Under 1 1-4 5-14 15- 24 25-44 46-64 65-74 75-over Total Tuberculosis, respiratory _ — — _ 1 2 1 1 5 Tuberculosis, other _ _ — — _ _ _ — — Syphilitic disease _ _ _ _ _ 1 1 — 2 Diphtheria _ _ _ _ — _ _ _ — Whooping Cough _ _ _ _ _ _ _ _ _ Meningococcal infection _ _ _ _ _ _ _ _ — Acute Poliomyelitis _ _ _ _ _ _ _ _ _ Measles _ _ _ _ — _ _ _ _ Other infective & parasitic diseases — — — — — — — — — Cancer- stomach _ _ _ _ 1 10 2 4 17 lung _ — _ _ 1 17 14 3 35 breast _ _ _ _ _ _ _ _ _ uterus _ _ _ _ _ — _ _ _ other — _ 1 1 4 22 13 16 57 leukaemia _ _ 1 _ 2 1 _ _ 4 Diabetes _ _ _ _ _ _ 1 1 2 Cerebral Haemorrhage, etc. _ _ _ _ 2 14 21 17 54 Coronary disease, angina _ _ _ _ 1 53 36 30 120 Hypertension with heart disease _ _ _ _ _ 2 6 5 13 Other heart disease _ _ — _ 1 9 15 33 58 Other circulatory disease _ _ _ 2 _ 6 5 13 26 Influenza _ _ _ _ 1 1 1 3 6 Pneumonia 3 _ _ _ _ 4 9 15 31 Bronchitis _ _ _ _ 11 11 9 31 Other respiratory diseases _ — _ _ _ 4 2 1 7 Ulcer of stomach 4 duodenum _ _ _ _ _ 1 6 2 8 Gastritis enteritis, etc. _ _ _ _ _ _ _ 1 1 Nephritis and nephrosis _ _ _ _ 1 1 _ 1 3 Prostatic enlargement _ _ _ _ _ — 1 2 3 Pregnancy, childbirth, abortion — — — — — — — — — Congenital malformations 3 _ _ 1 — 1 _ _ 5 Other diseases 7 _ _ _ 3 7 11 14 42 Motor vehicle accidents _ 1 _ _ _ 1 1 2 5 All other accidents _ _ _ _ _ _ 3 5 8 Suicide _ _ _ _ 1 2 1 1 5 Homicide and war operations — — — — — — — — — Total 13 1 2 4 19 170 160 179 548 Percentage of Total 2.4 0.2 0.4 0.7 3.5 31.0 29.2 32.6 30 TABLE IV CHASES OF DEATH (FEMALES) AT CERTAIN AGES, 1957 Under 1 1-4 5-14 15-24 26- 44 45-64 65-74 75-over Total Tuberculosis, respiratory – – – – – 1 1 – 2 Tuberculosis, other – – – – – – – – – Syphilitic disease – – – – – – – – – Diphtheria – – – – – – – – – Whooping cough – – – – – – – – – Meningococcal infection – – – – – – – – – Acute poliomyelitis – – – – – – – – – Measles – – – – – – – – – Other infective and parasitic diseases – – – – – – – 1 1 Cancer - stomach – – – – – 4 4 6 14 lung – – – – 1 4 2 – 7 breast – – – – 2 13 2 2 19 uterus – – – – – 2 2 1 5 other – – – – 2 21 11 17 51 leukaemia – – – – 1 1 – 1 3 Diabetes – – – – – – – 1 1 Cerebral haemorrhage, etc. – – – – 2 14 26 59 100 Coronary disease, angina – – – – – 11 26 37 73 Hypertension with heart disease – – – – – 4 6 9 19 Other heart disease – – – – – 9 8 40 57 Other circulatory disease – – – – – 10 7 24 41 Influenza – – – – – 1 1 1 3 Pneumonia 2 – – 1 – 2 4 24 33 Bronchitis – – – – – 6 5 8 19 Other respiratory diseases – – – – – _ _ 2 2 Dicer of stomach I duodenum – – – – – – 1 5 6 Gastritis, enteritis, etc. – – – – – – – 1 1 Nephritis and nephrosis – – – 1 1 1 – 1 4 Prostatic enlargement – – – – – – – – – Pregnancy, childbirth, abortion – – – – – – – – – Congenital malformation 2 – – – 1 1 – – 4 Other disease 11 1 – – 2 6 10 14 44 Motor vehicle accidents – – – – 2 2 – 1 5 All other accidents 2 – – – 1 – 1 6 10 Suicide – – – 1 2 3 4 – 10 Homicide and war operations – – – – – – – – – Total 17 1 – 8 17 116 119 261 634 Percentage of Total 3.2 0.2 – 0.6 3.2 21.7 22.3 48.8 31 TABLE V. INFANTS ' DEATHS ACCORDING TO ACE AND CAUSE, 1957. Cause of Death Age Total Days Months under 1 1 2 3 4 5 6 7-13 14- 20 21-28 1 2 3 4 5 6 7 8 9 10 11 Pneumonia 1 - 1 - - - - - 1 - 1 1 - - - - - - - - - 5 Birth Injuries 1 - - - - - - 1 - - - - - - - - - - - - - 2 Atelectasis & birth asphyxia 2 - 1 2 - - - - - - - - - - - - - - - - - 5 Congenital malformations 1 - 1 - - - - - 1 - 1 - 1 - - - - - - - - 5 Prematurity 3 1 - - 1 - - - - - - - - - - - - - - - - 5 Haemorrhagic disease 2 2 - - - - - - - - - - - - - - - - - - - 4 Accident - - - - - - - - - - 2 - - - - - - - - - - 2 Asthma - - - - - - - - - - - - 1 - - - - - - - - 1 Intestinal Obstruction - - - - - - - - - - - - 1 - - - - - - - - 1 TOTAL 10 3 3 2 1 - - 1 2 - 4 1 3 - - - - - - - - 30 TABLE VI INFECTIOUS DISEASES, AGE DISTRIBUTION - 1957 Disease Total Under l yr. 1 yr. 2 yrs. 3 yrs. 4 yrs. 5-9 yrs. 10-14 yrs. 15- 19 yrs. 20-34 yrs. 35-44 yrs. 45-64 yrs. 66 yrs. Cases admitted to hospital. Smallpox - - - - - - - - - - - - - - Typhoid Fever - - - - - - - - - - - - - - Para-Typhoid Fever - - - - - - - - - - - - - - Scarlet Fever 36 - 2 1 3 4 17 6 2 1 - - - 7 Diphtheria - - - - - - - - - - - - - - Erysipelas 8 - 1 - - - - - - 1 3 2 1 2 Puerperal Pyrexia 98 - - - - - - - 16 74 8 - - 98 Ophthalmia Neonatorum 1 1 - - - - - - - - - - - 1 Acute Encephalitis 2 - - - - - - 1 1 - - - - 2 Acute Poliomyelitis 2 - - - - - - - - 1 1 - - 2 Meningoccal Infection 2 - 1 - - - 1 - - - - - - 2 Pneumonia 39 2 - - 1 1 4 - 3 4 2 12 10 12 Dysentery 7 1 - 1 - 1 1 - - 2 - - 1 4 Measles 804 14 58 85 92 146 386 14 4 4 - 1 - 16 Whooping Cough 74 7 5 9 8 5 33 6 - 1 - - - 4 Food Poisoning 27 - - - - 1 2 - 2 8 6 8 - 10 Tubercnlosis:- Pulmonary 67 - 1 - - - 3 — 3 19 10 26 5 Non-Pulmonary 14 - - - - - 1 - 1 8 - 4 - Meninges 1 - - - - - - - - - - 1 - 34 NOTIFICATIONS AND DEATHS FROM CERTAIN INFECTIOUS DISEASES HESTON AND ISIEWORTH 1938 1957 TABIE VII Year Smallpox Scarlet Fever Diphtheria Erysipelas Pneumonia Meningococcal Infection Epidemic Encephalitis Poliomyelitis and Polioencephalitis Typhoid Fever Paratyphoid Fever Dysentery Measles Whoop ing Cough Influenza Tuberculosis Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases . Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths 1938 _ _ 314 _ 40 2 43 _ 159 36 8 5 1 _ 3 1 4 _ _ _ 2 _ _ 2 _ 1 Not Notifiable 6 113 58 1939 _ _ 175 _ 51 5 23 _ 142 35 6 _ _ 2 _ _ _ _ _ 1 _ _ _ _ 2 10 132 69 1940 _ _ 96 _ 73 5 35 1 200 57 43 6 1 2 1 _ 4 _ _ _ _ _ 1109 2 123 3 16 130 59 1941 _ _ 117 _ 37 3 20 _ 124 41 34 2 1 1 1 _ _ _ 30 _ _ 2 580 _ 286 1 9 174 78 1942 _ _ 190 _ 11 1 16 _ 72 67 12 1 _ _ _ _ 4 _ 1 _ 2 2 1085 2 243 4 3 202 70 1943 _ _ 280 _ 5 _ 21 _ 116 63 _ 1 _ 1 _ _ 1 _ _ _ _ _ 636 1 134 _ 16 190 49 1944 _ _ 130 _ 11 1 16 _ 50 59 3 2 _ 1 3 _ _ _ _ _ 22 _ 219 _ 171 3 5 184 44 1945 _ _ 124 _ 24 2 16 1 25 37 11 2 1 _ 7 _ _ _ _ _ 28 _ 1107 1 110 _ 3 157 52 1946 _ _ 67 _ 16 1 19 1 47 53 13 _ _ 1 1 1 1 _ _ _ 6 _ 170 _ 170 _ 16 217 56 1947 _ 62 _ 3 _ 19 _ 56 40 8 1 _ _ 43 5 _ _ _ _ _ 840 2 142 2 8 180 52 1948 _ _ 159 __ 2 _ 21 _ 41 42 2 _ _ 1 29 2 _ 3 _ 5 _ 571 _ 227 _ 5 168 43 1949 _ _ 138 _ _ _ 26 _ 52 53 2 1 _ 2 14 1 _ _ _ _ 2 _ 523 _ 173 _ 6 219 36 1950 _ _ 92 _ 1 _ 12 _ 64 30 _ _ _ _ 9 _ 3 _ 6 _ 6 _ 881 _ 206 _ 6 182 37 1951 _ _ 67 _ _ _ 12 _ 59 38 5 1 _ _ 4 _ 1 _ 1 _ 77 _ 790 1 220 _ 33 185 27 1952 _ _ 161 _ _ _ 19 1 58 51 5 1 _ _ 3 _ _ _ 7 _ 28 _ 10 27 _ 86 _ 4 168 19 1953 _ _ 161 _ _ _ 16 _ 78 48 1 _ _ _ 11 _ _ _ _ _ 13 _ 602 _ 291 _ 26 141 10 1954 _ _ 71 _ _ _ 17 _ 34 31 4 _ _ _ _ _ _ _ 1 _ 9 _ 38 _ 35 _ 2 88 12 1955 _ — 74 _ _ _ 17 _ 50 46 _ _ 1 _ 13 _ _ _ _ _ 131 _ 1568 _ 177 _ 4 67 14 1956 _ _ 67 _ _ _ 12 _ 27 60 1 _ 1 1 5 _ _ _ _ _ 22 _ 244 _ 96 _ 4 69 12 1957 _ _ 3? _ _ _ 8 _ 39 64 2 _ 2 _ 2 _ _ _ _ _ 7 _ 804 _ 74 _ 9 82 7 * Includes para typhoid fever to 19 39. 35 TABLE VIII. COUNTY COUNCIL OF MIDDLESEX CERTAIN VITAL STATISTICS FOR THE YEAR 1957. District Population mid- 1957 Birth rate per 1000 population Death rate per 1000 population Specific death rates per 1000 population Infant mortality per 1000 live births Maternal mortality per 1000 total births (a) Crude Adj usted Crude Adjusted Pulmonary Tuberculosi s (*) Cancer (a) Infant (a) Neo-natal (a) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Acton 65, 840 14.2 13.3 10.6 11.1 0.08 (5) 2.2 (148) 19.2 (18) 13.9 (13) -() Brentford & Chiswick 57, 700 13.8 13.0 10.9 11.0 0.07 (4) 2.3 (131) 16.3 (13) 13.8 (11) (-) Ealing 183, 600 14.5 13.9 10.3 11.2 0.11 (20) 2.2 (412) 17.6 (47) 10.9 (29) 0.74 (2) Edmonton 96, 530 12.9 12.6 9.8 11.1 0.04 (4) 2.1 (202) 13.6 (17) 12.0 (15) (-) Enfield 109, 200 13.4 13.4 10.9 9.9 0.07 (8) 2.2 (242) 10.3 (15) 6.8 (10) 2.01 (3) Feltham 50, 000 16.3 15.8 7.0 11.1 0.02 (1) 1.6 (76) 19.6 (16) 16.0 (13) (-) Finchley 69, 380 13.3 12.8 11.3 10.3 0.10 (7) 2.4 (168) 17.3 (16) 15.1 (14) 1.06 (1) Friern Barnet 28, 490 11.2 12.5 16.9 9.6 0.21 (6) 2.4 (69) 3.1 (1) 3.1 (1) (-) Harrow 216, 000 12.9 13.2 9.0 10.7 0.06 (12) 2.0 (425) 14.0 (39) 9.7 (27) 0.35 (1) Hayes & Harlington 67, 190 15.9 14.9 7.6 12.3 0.10 (7) 1.8 (118) 14.0 (15) 10.3 (11) (-) Hendon 152, 600 12.6 12.0 10.0 10.6 0.07 (11) 2.2 (330) 21.9 (42) 17.2 (33) (-) Heston t Isleworth 106, 100 12.4 12.3 10.3 11.0 0.07 (7) 2.0 (205) 23.0 (30) 17.6 (23) (-) Hornsey 96.890 16.2 16.1 11.6 10.2 0.07 (7) 2.3 (225) 17.2 (27) 15.3 (24) 0.62 (1) Potters Bar 20, 370 15.5 14.3 8.5 11.2 0.05 (1) 1.1 (23) 15.8 (6) 9.5 (3) (-) Ruislip- Northwood 75, 280 13.4 13.4 7.4 9.3 0.05 (4) 1.7 (128) 23.8 (24) 17.8 (18) (-) Southal1 53, 000 15.0 15.5 13.0 11.3 0.25 (13) 2.0 (108) 21.4 (17) 16.4 (13) (-) Southgate 71, 260 11.2 12.1 12.6 10.5 0.13 (9) 2.8 (202) 20.1 (16) 16.0 (12) (-) Staines 45, 770 18.4 17.1 7.9 10.0 0.09 (4) 1.3 (60) 14.3 (12) 8.3 (7) (-) Sunbury 27, 690 22.4 20.4 9.2 11.9 0.04 (1) 1.5 (41) 19.4 (12) 14.6 (9) (-) Tottenham 119, 300 13.9 13.5 11.0 11.8 0.08 (9) 2.4 ( 283) 25.3 (42) 20.5 (34) 1.18 (2) Twickenham 103, 600 12.9 13.3 10.8 10.4 0.08 (8) 2.2 (228) 16.6 (22) 12.0 (16) (-) Uxbridge 60, 780 17.1 16.6 9.1 12.0 0.10 (6) 1.7 (104; 21.1 (22) 15.4 (16) (-) Wembley 127, 500 11.4 11.4 9.2 10.9 0.05 (6) 2.0 (260) 18.5 (27) 14.4 (21) (-) Willesden 174, 100 16.5 16.2 9.7 11.2 0.07 (13) 2.3 (405) 16.7 (48) 11.8 (34) 0.68 (2) Wbod Green 49, 500 13,2 13.2 9.8 9.6 0.12 (6) 2.2 (107) 16.8 (11) 16.8 (11) (-) Yiewsley & West Drayton 23, 340 19.4 17.7 7.1 10.2 0.13 (3) 1.4 (33) 15.5 (7) 8.8 (4) 2.16 (1) COUNTY 2, 249,000 14.1 13,8 10.0 10.9 0.08 (182) 2.1 (4733) 17.7 (561) 13.3 (422) 0.40 (13) NOTE (a) Absolute numbers are given in parenthesis in addition to rates to afford valid comparison TABLE IX. (a) METEOROLOGY (Extracted from records supplied by Chief Engineer, Mogden Sewerage Wbrks). Week Ending Barometer Temperature (0F) Days with Rainfal 1 Total Rainfall (inches) Highest Lowest Max Min, Jan. 5th 30.04 29.28 57.0 31.0 7 0.69 12th 30.68 30.02 53.0 30.0 5 0.12 19th 30.71 30.03 44.0 33 0 4 0.07 26th 30.72 29.47 58.0 29.0 5 0,63 Feb. 2nd 30.39 29.60 56.0 37.0 7 0.64 9th 30.00 29.39 57.0 35.0 7 1.22 16th 29.99 28.74 55.0 28.0 6 0.78 23rd 29.99 29.40 48.0 28.0 5 0.45 Mar. 2nd 30.57 29.49 59.0 43.0 3 0.26 9th 30.07 29.43 61.0 30.0 6 0.25 16th 30.16 29.67 68.0 39.0 1 0.00 23rd 29.89 29.33 62.0 39.5 6 0.34 30th 30.17 29.67 53.0 36.0 4 0.44 Apr. 6th 30.37 29.98 68.0 41.0 1 0.00 13th 30.38 29.77 51.0 29.0 3 0.05 20th 30,29 30.01 65.0 37.0 3 0.13 27th 30.50 29.95 66.0 42.0 3 0. 16 May 4th 30.27 29.90 66.0 38.0 2 0.07 11th 30.27 29.51 65.0 33,0 6 0.51 18th 30.03 29.00 65.0 43.0 7 0.58 25th 30.35 29.94 65.0 39.0 4 0.03 June 1st 30.37 30.03 78.0 41.0 Nil 0.00 8th 30.10 29.57 80.0 44.0 5 0.09 15th 30.57 29.61 83.0 40.0 3 0.07 22nd 30.18 29.75 87.0 46.0 3 0.11 29th 30.24 29.83 93.0 46.0 1 0.11 July 6th 30.08 29.72 90.0 69.0 6 0.81 13th 30.07 29.55 80.0 49.0 5 0,82 20th 29.99 29.49 72.0 52.0 7 1.35 27th 30.09 29.62 76.0 53.0 5 0.43 Aug. 3rd 30.39 29.85 82.0 54.0 Nil 0.00 10th 30.16 29.04 80.0 57.0 5 0.86 17th 29.98 29.39 70.0 52.0 7 2.27 24th 30.17 29.45 75.0 46.0 3 0.06 31st 30.21 29.59 69.0 46.0 3 0.32 Sept. 7th 30.19 29.67 70.0 45.0 6 0.26 14th 30.13 29.30 68.0 43.0 7 0.69 21st 30.10 29.66 69.0 45.0 4 0.07 28th 30.34 29.64 71.0 43.0 5 1.38 Oct. 5 th 30.35 29.85 64.0 39.0 2 0.03 12th 30.30 29.94 66.0 44.0 1 0.02 19th 30.25 29.45 69.0 37,0 3 1.02 26th 30.09 29.60 65.0 38.0 5 0.13 Nov. 2nd 30.00 29.16 63.0 41,0 6 1.03 9th 30.02 28.68 57.0 36.0 4 1.33 16th 30.35 29.88 52.0 39.0 7 0.14 23rd 30.53 30.00 51.0 28.0 2 0.14 30th 30.52 30.31 54.0 32,0 Nil 0.00 Dec. 7th 30.48 29.18 56.0 25.0 4 0.21 14th 30,12 28.79 56.0 27.0 6 1.27 21st 30.35 29.77 56.0 22.0 5 0.11 28th 30. 32 29.45 50.0 34.0 5 0.15 36 TABLE IX. (b) WIND DIRECTION (Sum. of Daily Records, 62 weeks) N. 16 days N.N. E. 11 days N. E. 32 days E. N. E. 11 days E. 17 days E. S. E. 12 days S. E. 12 days S.& E. 9 days S. 12 days S. S. W. 14 days S. W. 44 days W. S. W. 36 days W. 20 days W.N.W. 14 days N. W. 22 days N.N.W. 11 days Calm 71 days 37 TABLE X FACTORIES ACTS, 1937 and 1948 PART I OF THE ACT 1. Inspections for purposes of provisions as to health made by Public Health Inspectors Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sections 1,2,3, 4 and 6 are to be enforced by Local Authorities 34 37 – – (ii) Factories not included in (l) in which Section 7 is enforced by the Local Authority 375 567 15 – (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 6 7 – – TOTAL 415 611 15 – 2. Cases in which Defects were found - Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M Inspector By RM Inspector Want of Cleanliness _ _ _ _ _ Overcrowding (Ex 2) _ _ _ _ _ Unreasonable temperature (S. 3. ) _ _ _ _ _ Inadequate ventilation (S, 4. ) _ _ _ _ _ Ineffective drainage of floors (&6) _ _ _ _ _ Sanitary Conveniences (S, 7) - (a) insufficient 2 2 _ 1 _ (b) unsuitable or defective 17 15 _ _ _ (c) not separate for sexes - 1 _ _ _ Other offences against the Act (not including offences relating to Outwork) 1 _ 1 _ _ TOTAL 20 18 1 1 _ 38