AC 439(1) 1 Dr. ??? 2 Library HES 46 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE BOROUGH OF HESTON AND ISLEWORTH for the year 1959 A. ANDERSON, M.D., D.P.H., Medical Officer of Health. INDEX Page Accidents 7 Bakehouses 20 Births, live 6 Births, still 6 Blood Transfusion Service 27 Burials 27 Canal Boats 17 Clean Air 16 Closet Accommodation 14 Common Lodging Houses 17 Deaths 7 Deaths, Age and Sex Distribution 30 & 31 Deaths, causes of 29 Disinfection 10 Disinfestation 17 Drainage and Sewerage 14 Factories, No. on Register Inspection and Defects, etc. 38 Factories, Workplaces, etc. 17 Family Planning Association 13 Fever Hospitals 10 Food and Drugs Sampling 21 Food Hygiene 22 Food Poisoning 10 Health Committee 3 Health Education 27 Health Services provided by Other Authorities 11 Housing 23 Ice Cream 19 Infant Deaths according to Age and Cause 32 Infant Mortality 8 Infectious Diseases 8 Infectious Diseases, Age Distribution 33 Infectious Diseases, Notifications and Deaths 34 Laboratory Service 10 Page Laundry Service 27 Marriage Guidance Council 13 Maternal Mortality 8 Meat and Other Pood Inspection 20 Medical Examinations of Staff 27 Meteorology 36 Milk 19 Municipal Restaurants and School Canteens 21 Noise Nuisances 17 Persons in need of care and attention 27 Pet Animals Act, 1951 19 Physical Characteristics 13 Public Cleansing 15 Public Mortuary 27 Rags, etc. Exchange of Articles for 16 Rag Flock and Other Filling Materials Act, 1951 18 Rats and Mice Destruction 18 Rivers and Streams 14 Sanitary Circumstances 13 Sanitary Inspection 15 Shops Act, 1950, Section 38 18 Slaughter of Animals (Amendment) Act, 1954 20 Slaughterhouses, etc. 20 Staff 2 Statistics, Certain Vital, County of Middlesex 35 Statistics, General 6 Statistics, Vital 6 Statistics Vital, Summary of 28 Swimming Baths 18 Tents, Vans and Caravans 16 Tuberculosis 9 Verminous Premises, Articles and Persons 19 Water Supply 14 Wind Direction 37 1 STAFF Medical Officer of Health: A. Anderson, M. D., D.P.H. Deputy Medical Officer of Health: E.N. Christie, M. B., Ch. B., D.P.H. Chief Public Health Inspector. A. B. Hauldren, Cert. as P.H.I. and M.I. (to 31.1.59) K.J. Smith, Cert. as P.H.I. and M.I. (from 1.2.59) Deputy Chief Public Health Inspector: K.J. Smith, Cert. as P.H.I. and M.I. (to 31.1.59) S. H. G. Stevens, Cert. as P. H. I., M.I. and S. E. (from 1.2.59) 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. (to 31.1.59) J.A. Dawson, Cert. as P.H.I. and M.I. W. Bowles, Cert. as P.H.I. and M.I. J. K. Edson, Cert. as P.H. I., M.I. and San. Science. D. G. Martin, Cert as P.H.I. and M.I. F. W. Goldsmith, Cert. as P.H.I. and M.I. F.R. Brackfield, Cert. as P.H.I. and M.I. (from 6.7.59) Rodent Officer: A. Farrer Rodent Operatives: R. Ashurst A. L. Worthington Mortuary Attendants, Disinfectors, Drain Testers, etc.: L. Woodhead L. Wisdom Clerks: B.W. Kilby, Cert. as P.H.I. and M.I. (Part time) (to 30.9.59) H. Law, (Part time) (from 1.10.59) D.S. Bates (Senior Clerk) C.J.C. Mail E.J. Hutchins F. R. Money Mrs. M. E. Ponsford Mrs. L. E. 0' Gorman 2 THE HEALTH COMMITTEE of HESTON AND ISLEWORTH BOROUGH COUNCIL to May, 1959 Alderman F.J. Jansen (Chairman) Councillor Mrs. R. New (Vice-Chairman) Alderman A.J. Fielder, J.P. (Mayor) Alderman V. C. Denton, D. L., J. P., F. C. I.S. Alderman Mrs. A. B. Tolmon Councillor A.J. Beach Councillor Mrs. E. M. Coleman Councillor A. G. Cross, C.C. Councillor R.D. Flynn Councillor Mrs. M. Hennig Councillor Mrs. V.G.A. Secker Councillor F.J. Shercliff Councillor I.J. Thomas Councillor J.B. Webb from May, 1959 Alderman F.J. Jansen (Chairman) Councillor A.J. Beach (Vice-Chairman) Councillor Mrs. R. New, J.P. (Mayor) Alderman Mrs. A. B. Tolmon Councillor Mrs. E.M. Boxall Councillor A.G. Cross, C.C. Councillor R.D. Flynn Councillor F.A. Foster Councillor Mrs. M. Hennig Councillor E.H.F. Osbon Councillor Mrs. M.T. Roebuck Councillor I.J. Thomas Councillor D.J. Tippins Councillor J.B. Webb 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 1959. The general arrangement of the items is as in previous years. The Borough birth rate continues well below the national rate and among the lowest in the 26 Middlesex districts. The still birth and infant mortality rates, however, maintain their position at lower levels than the County and national rates. The Borough death rate has shown little change in recent years and is closely comparable with the County and national rates. Cancer and degenerative heart disease are still the most frequent causes of death. Deaths from cancer of the lung increase steadily and so does the consumption of cigarettes. Propaganda against cigarette smoking seems to make no progress against the concentrated trade advertisements and until the smoking of cigarettes is as socially unacceptable as the chewing of tobacco, youth will continue to accept the risk. The expected increased incidence of measles occurred. There was also a considerable increase in the notifications of scarlet fever. The disease continued to be mild, but watch must be maintained as this disease in the past has increased in virulence after years of slight severity. While the newer drugs have done much to reduce the incidence and severity of respiratory infection, the position in regard to gastro-intestinal infections is far from satisfactory. Poliomyelitis is now known to be initially a bowel infection, dysentery continues unabated, food poisoning is still prevalent and apart from notified cases, information reaches the Department of many cases of gastro-enteritis, and most of these are probably of infective origin. The commonest mode of spread of intestinal infection is by contaminated hands and a great improvement in personal hygiene is needed. Washing of the hands after use of the toilet and before preparing food must become a regular habit by all, and facilities for such washing must be made available everywhere. The absence of diphtheria, poliomyelitis, etc. may give rise to a false sense of security. Recent small outbreaks of diphtheria and poliomyelitis elsewhere in the country have shown that the risk is ever present. During the year there were 1,275 live births, but only the following numbers of children under the age of one year were protected - smallpox, 759: diphtheria, 897; whooping cough 813; poliomyelitis, 478. These proportions are not high enough to give community protection, and parents should give serious consideration to this matter. Much time throughout the year has been devoted to action in regard to the Clean Air Act. Smoke Control Order No. 1 was confirmed by the Minister on 23rd June, while Smoke Control Order No, 2 was submitted in December to the Minister for confirmation. The reaction to Smoke Control Orders has generally been helpful and co-operative though there has been some expression of opinion that factories and railways should be tackled first, that adequate supplies of smokeless fuels are not available and that domestic smoke is of little importance. It must be known to many that factories are increasingly changing over to oil fuel and that great strides are being made in the replacement of steam traction by electric or diesel locomotion on the railways. There are adequate supplies of coke though the quantity of other smokeless fuels available is still limited. Delivery delays occur, as with raw coal, in the winter months. Consumers should build up a stock as far as is possible during the summer. Because of the greater bulk of smokeless fuel storage difficulties may arise and retailers could help greatly by agreeing to deliver in small quantities. The following facts about domestic smoke should be noted; (1) Smoke is unburned coal and consists of a mixture of carbon, tar and hydrocarbons. Domestic smoke, produced as it is as relatively low temperatures contains much more tar and hydrocarbons than industrial smoke; (2) for 4 every 100 lbs. of coal burned in an open domestic fire, some 3. 5 lbs. of smoke gets into the atmosphere as compared with about 8 ozs. from factory furnaces; (3) the total annual weight of domestic smoke is much in excess of that from industrial sources; (4) industrial smoke is evenly spread over the year whereas domestic smoke is concentrated into the winter months when atmospheric pollution is most dangerous; (5) industrial smoke, usually emitted at a high level, has a greater chance of dispersal whereas low level domestic smoke readily becomes concentrated in certain weather conditions; (6) of the grime found in every town, it is the sticky tarry domestic smoke deposit that is most difficult to remove. There is still the problem of pollution of the atmosphere by sulphur dioxide which is produced in the burning of almost all fuels. While this problem awaits solution, it is no excuse for delaying the abolition of smoke. In any case, the open fire burning raw coal not only creates the worst kind of smoke, but because of its low thermal efficiency, emits more sulphur dioxide per unit of useful heat than any other fuel. To rid the atmosphere of smoke will require the full co-operation of industry and householders. Industry will have to develop new methods and technique, while the householder will have to learn to use smokeless fuels. The gardener will have to exchange the bonfire for the compost heap, while shopkeepers and other traders will have to dispose of containers, packages, etc. by methods other than burning, prom the health and economic aspects, clean air is most desirable and is worth some effort and adjustment by all. Throughout the year attention has been given to unfit houses. By informal action every effort is made to secure repair and improvement, but if these fail, the provisions of the Housing Acts must apply. In other words the Council has to take action to get the house repaired, closed or demolished as the case may be even while shortage of alternative accommodation continues. There is also the problem of the house which, though structurally sound, lacks modern amenities. The 1951 census showed that, in the Borough. 18 per cent of families in single occupation of houses lacked some, or all, of the following amenities:- piped water supply, cooking stove, kitchen sink, water closet and fixed bath. As restriction of space is putting a limit on the number of new houses that can be provided, consideration has been given in recent years to measures which might improve the condition of existing houses. Legislation has been introduced which permits local authorities to loan money to meet the cost of repairs and to make grants towards the cost of improving houses. During the years 1955-59, the Council has given loans towards the repair of 49 houses and made grants for the improvement of 107 houses. Much more needs to be done and owners of old but sound houses should study carefully the booklet 'New Grants for Better Houses' issued by the Ministry of Housing and Local Government. Pood hygiene is now more a matter of personal hygiene and food handling than of food premises. In recent years, there have been great improvements in the construction and equipment of food premises and the change must be apparent to all. There is no shortage of food and customers can exercise discrimination in their patronage of shops. They could do much to set standards, but the more hygienicallyminded shop staffs are only too often disappointed by the ignorance of, or indifference to, food hygiene shown by their customers. A busy year has been tackled steadily by my staff, and their industry has ensured smooth running of the Department. To the Council for their support and encouragement and to my colleagues in other Departments, I would like to record my thanks. I remain, Your obedient Servant, A. ANDERSON, Medical Officer of Health. 5 GENERAL STATISTICS Year - 1959 Area in acres 7,261 Population (Registrar-General's estimate) 105,000 Number of habitable premises (rate books) 31,045 Number of houses erected during year 326 Rateable Value of Borough £2,239,336 Sum represented by a penny rate £9,260 Live Births-male 657 Live Births-female 618 Birth rate per 1,000 population 12.1 Birth rate per 1,000 population (England and Wales) 16.5 Stillbirths-male 11 Stillbirths-female 7 Stillbirths rate per 1,000 (live and still) births 13.9 Deaths-male 590 Deaths-female 557 Death rate per 1,000 population 10.9 Death rate per 1,000 population (England and Wales) 11.6 Infant Mortality rate 16.5 Infant Mortality rate (England and Wales) 22.0 Maternal Mortality rate 0.8 Maternal Mortality rate (England and Wales) 0.4 VITAL STATISTICS POPULATION. The Registrar-General's mid-year estimate of the population of the Borough for the year 1959 is 105,000. RATEABLE VALUE. The rateable value of the Borough for 1959 was £2,239,336 and the sum represented by a penny rate was £9,260. INHABITED HOUSES. According to the rate books the number of habitable houses, flats and shops with living accommodation at the end of the year was 31,045. In relation to the estimated population, this yields an average of approximately 3.4 persons per house. LIVE BIRTHS. The number of live births in 1959 was 1,275 as compared with 1,264 in 1958. The birth rate was 12.1 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 RegistrarGeneral 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 12.1 as compared with the birth rate of 16.5 per 1,000 population for England and Wales. The number of illegitimate births was 54 as compared with 45 in 1958. 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 3.9 1950-54 4.0 1930-34 3.2 1955 4.2 1935-39 2.9 1956 3.3 1940-44 4.6 1957 3.6 1945-49 5. 1 1958 3.6 1959 4.2 Of the total live and still births, 70% occurred in hospital. STILLBIRTHS. The number of stillbirths in 1959 was 18. 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 6  No. of Stillbirths Rate per 1,000 total births 1945-49 198 23.8 1950-54 129 20.6 1955 20 16.9 1956 24 19.1 1957 15 11.4 1958 17 13.3 1959 18 13.9 This loss of potential lives remains a problem and until more is known of the causes little further improvement can be expected. DEATHS. The deaths of residents of the Borough during 1959 were 1,147 (590 male, 557 female). This represents a death rate for the Borough of 10.9 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. 1 as compared with a death rate of 11.6 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 248 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 1959 Under 1 year 21.8 5.3 2.4 1.8 1-4 years 8.4 0.8 0.5 0.5 5-14 years 3.8 2.1 0.4 0.4 15 - 24 years 3.7 2.1 0.8 0.7 25 - 64 years 30.8 33.0 31.6 27.3 65 years and over 31.5 56.7 64.3 69.3 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 diseases; cerebral haemorrhage; cancer; bronchitis and pneumonia. In females 53.5 per cent of deaths occured at age 75 years and over as compared with 34.4 per cent in males. The Secretary of the Road Safety Committee informs me that during 1959 there were 813 road accidents which resulted in 15 deaths, serious injury to 158 persons and slight injury to 758 persons. All these figures show little change from the corresponding figures for 1958. 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 Age in years Other Accidents Age in years 0-4 5-14 15-64 65 + All ages 0-4 5-14 15-64 65 + All ages 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 1958 1 2 10 4 17 - - 7 9 16 1959 - 1 5 8 14 1 - . 7 8 16 Total 4 10 74 57 145 6 3 57 123 189 It should be noted that 39.3 per cent of these road deaths occurred in persons aged 65 years and over as compared with 65.1 per cent for the same age group in deaths from other accidents. 7 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 1959 there were 21 deaths of children under the age of 1 year. This represents an infant mortality rate per 1,000 live births of 16.5 as compared with 22. 0 for England and Wales. The causes of infant deaths are shown 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 1953-1957 6,157 134 22 1958 1,264 21 17 1959 1,275 21 17 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 ante-natal care, management of labour and the nurture of young babies. MATERNAL MORTALITY. One 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 1930-1934 2.6 1.7 4.4 1935-1939 1.0 2.1 3.1 1940-1944 0.7 1.2 1.9 1945-1949 0.2 1.2 1.4 1950-1954 - 0.3 0.3 1955 - - - 1956 - - - 1957 - - - 1958 - - - 1959 - 0.8 0.8 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 594 were so endorsed. 8 INCIDENCE OF NOTIFIABLE DISEASE. The number of cases notified during the year is shown in fable 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 1959. 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. According to the returns 759 children under the age of one year were vaccinated in 1959 as compared with 832 in 1958. Modern travel is such that the risk of importing smallpox is ever present. SCARLET FEVER. This disease was much more prevalent - 235 as compared with 62 in the previous year. This increase was general throughout the country but fortunately here, the disease continued to be mild in character. 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 1959 was 897 as compared with 900 in 1958. ERYSIPELAS. The number of notifications was 7 but no death was due to this disease. PNEUMONIA. Notifications of pneumonia were 47 as compared with 45 in 1958. Of the total pneumonia deaths 87 per cent. occurred at age 65 and over. MENINGOCOCCAL INFECTION. Three cases were notified during the year and one, aged 67 years, died. ACUTE ENCEPHALITIS. One notification was received and the patient made a good recovery. POST-INFECTIVE ENCEPHALITIS. Encephalitis is known to occur as a complication of other infectious diseases, but no such case was notified during 1959. POLIOMYELITIS. Though several patients were admitted to hospital as suspected poliomyelitis, in only one case was the diagnosis confirmed. The patient died soon after admission but laboratory investigation revealed poliomyelitis virus, type I. Inoculation against poliomyelitis was continued during the year, and 8,213 children, 717 adolescents and 648 expectant mothers were given two injections of vaccine. During the year third injections were given to 12,049 children, 549 expectant mothers and 416 others. Experience has shown that reactions, local or general, to these inoculations are comparatively rate. 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 42 cases were notified, as compared with 15 in 1958. 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. TUBERCULOSIS. During the year 53 notifications of pulmonary tuberculosis, and 3 notifications of non-pulmonary tuberculosis 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 - 1934 67. 5 11.5 78.9 1935 - 1939 52.3 8. 2 60.4 9  Tuberculosis Death Rate per 100,000 population Pulmonary Non-pulmonary Total 1940-1944 55.8 7.4 63.2 1945-1949 39.1 6.7 45.8 1950-1954 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 1958 4.8 - 4.8 1959 6.7 - 6.7 A permanent mass X-ray unit has been established at West Middlesex Hospital and is open to the public without appointment. During the year 236 children were inoculated with B.C.G. vaccine as a protection against tuberculosis. OPHTHALMIA NEONATORUM No case was notified but from a hospital report it was learned that a baby admitted because of prematurity developed an eye infection which did not respond to treatment and was only cleared up finally by the removal of the right eye. PUERPERAL PYREXIA, During the year 118 cases were notified as compared with 70 cases in 1958. No woman died from puerperal or post-abortion sepsis and none of the infections was severe. MEASLES This was a year of measles prevalence and 1,007 cases were notified as compared with 275 in 1958. WHOOPING COUGH. There were 46 cases of whooping cough notified as compared with 44 cases in 1958. Facilities for immunisation against this disease are available, and 813 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. Influenza was prevalent in the early part of the year and caused 37 deaths as compared with 7 deaths in 1958. Of these deaths, 80 per cent occurred in persons aged 65 years and over. 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 140, Chicken pox 132 and German Measles, 15. 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, 222 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. During the year six lots of bedding were disinfected and 2 lots destroyed. Nine lots of clothing were disinfected before being sent abroad. 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 1959 was 588. FOOD POISONING. During 1959 notifications of the occurrence of food poisoning in 50 persons were received, but after investigation only 23 were accepted as food poisoning. In 9 cases the infecting organism was isolated, In a further 22 persons, Salmonella organisms were found though there was no evidence of food-borne infection. No death was associated with food poisoning. 10 An outbreak of diarrhoea and sickness, affecting 26 pupils and 3 teachers in a school, was fully investigated and though the cause of the outbreak was not discovered, no connection with the school meals was found. 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 situated 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 of the hospitals and for domiciliary consultations. 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 (b) Infant Welfare Clinics 92, Bath Road, Hounslow. Busch Corner, Isleworth New Heston Road Cranford (Holy Angel's Church Hall, Bath Road) Monday and Wednesday mornings Thursday afternoon. Tuesday and Thursday afternoons Thursday afternoon Tuesday, Wednesday, Thursday and Friday afternoons Monday and Wednesday afternoons Monday, Tuesday and Wednesday afternoons Friday afternoon (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 Tuesday and Friday afternoons Busch Corner, Isleworth 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 domiciliary 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. 11 (i) Health Visitors Health Visitors who also act as School Nurses are employed in clinics and home visiting. Their 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. (l) 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 illhealth and mental deficiency, the statutory supervision-and guardianship of mental defectives living in the community, and the provision of aftercare for persons who have undergone treatment for mental illness. The office of 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, Bath Road, Hounslow Busch Corner, Isleworth New Heston Road daily-mornings daily-mornings daily-mornings (ii) Medical consultation 92, Bath Road, Hounslow Busch Corner, Isleworth New Heston Road Tuesday and Friday mornings Monday and Wednesday mornings Friday morning (iii) Eye Clinic 92, Bath Road, Hounslow Busch Corner, Isleworth Monday and Wednesday afternoons, Monday morning Thursday morning (iv) Allergy Clinic 92, Bath Road, Hounslow. Monday afternoons (v) Orthopaedic Clinic 92, Bath Road, Hounslow. 2nd Monday afternoon in month (vi) Physiotherapy 92, Bath Road, Hounslow. Wednesday and Thursday afternoons, Thursday morning 12 (vii) Dental Clinic (viii) Artifical Sunlight Clinic (ix) Immunisation Clinic) see under Health Department. (x) Child Guidance Clinic Old Town School, Hounslow, b.v appointment. (xi) Speech Therapy 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 EXECUTIVE 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.l. 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 1959. 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). SANITARY CIRCUMSTANCES PHYSICAL CHARACTERISTICS. The Borough has an area of 7,261 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 40.29 acres Heston Fair Ground 9.38 " Church Meadow, Bath Road 9.20 " Children's Playground, Sutton Lane 0.60 " Kingsley Road Playing Field 0.95 " Greenhams Land, London Road 14.75 " St. John's Gardens, Isleworth 5.73 " Riverside Walk, Isleworth 0.75 " Children's Playground, Northcote Avenue 0.85 " Playground, London Road 1.84 " Bowling Green, Jersey Gardens 0.59 " Isleworth Promenade 1.0 " Heston Park 14.29 " Lampton Park 24.20 " Beaversfield Park 9.77 " Inwood Park 10.25 " Redlees Park 16.47 " Jersey Gardens 7.87 " Football Ground, Denbigh Road 3.70 " Midsummer Children's Playground 1.52 " 13 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 Suburban Water Company. There are in the Borough 43 shallow and 3 artesian wells serving 40 premises and of these 4 houses and 2 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 11 Cisterns cleansed, repaired, etc. 5 Service pipes or taps repaired 12 One sample, taken from tap over washbasin, was found to be satisfactory. 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 1959:- Drains exposed for examination 46 Drains unstopped, repaired etc. 216 Waste pipes repaired, trapped, etc. 24 Soil pipes repaired, etc. 6 Ventilation shafts repaired, etc. 13 Fresh Air inlets repaired etc. 12 Gully traps inserted or repaired 31 Disconnecting traps inserted or repaired 7 Disconnecting and inspection chambers provided 8 Disconnecting and inspection chambers repaired, etc. 85 Drains constructed or repaired 36 Total length (ft.) of drain pipes laid- (a) 4" 959 (b) 6" 2 (c) 9" Drain tests applied 146 Other works executed 20 Cesspools emptied or repaired 4 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, foaming at the works tends to occur. 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. RIVERS AND STREAMS. No complaint of pollution was made to the Health Department during 1959. 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 the odd house on the outskirts of the Borough has a pail or chemical closet. The following works were carried out during the year:- Water closets constructed or rebuilt 4 Ventilated lobbies provided 4 Water closets where walls cleansed 62 Water closets fitted with new flushing apparatus 29 New pans or pedestals provided 26 Water closets repaired or improved 55 Water closets blockages unstopped 16 Other closets provided or repaired 3 Other closets abolished 1 Urinals constructed, rebuilt or repaired 3 14 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 40 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:- 1955 1956 1957 1958 1959 Paper (tons) 897 1,082 994 1,045 1,069 Scrap metal (tons) 38 73 26 31 48 Textiles (tons) 34 13 10 3 5 Bottles, jars (tons) 4 2 — - - Total income £8,490 £9,414 £8,102 £8,564 £8,364 SANITARY INSPECTION OF THE BOROUGH. In addition to the work recorded in othe paragraphs of this Report, the Public Health Inspectors continue their general dutie of investigating complaints, abating nuisances and dealing with contraventions of th Public Health Acts. Not all complaints brought to the Health Department deal with matters on whic the Department is empowered to take action, and in such cases complainants are adr vised 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 1,494 Number of premises at which nuisance, etc. were located 713 Number of premises where nuisances abated or defects remedied:- (a) by owners or occupiers 426 (b) by Council in default 3 (c) public sewers repaired by Council 21 (d) public sewers cleared and cleansed by Council 158 Informal notices issued 302 Written reminders issued 369 Statutory notices served 104 Total number of inspections and re-inspections 18,593 Inspections of piggeries 12 Inspections of stables 6 Inspections of urinals 73 Sinks provided or repaired 18 Roofs repaired 113 Gutters repaired or renewed 93 Brickwork, sills, etc. repaired or renewed 261 Premises provided with damp-proof courses 11 Yards and forecourts paved or drained 23 External painting 32 Rooms stripped, cleansed and redecorated 146 Floors, walls and ceilings, repaired or renewed 480 Rooms in which ventilation provided or improved 4 Windows repaired or renewed 376 Doors and other woodwork repaired or renewed 150 Staircases replaced or repaired 9 Lighting to staircases provided or improved 3 Handrails or balusters repaired or renewed 12 Grates provided or repaired 69 Washing coppers provided or repaired 1 Instances where ventilation under floor provided or improved 16 Food stores provided or repaired 10 Domestic cleansing enforced 2 Verminous condition abated 23 15 Improper keeping of animals abated 2 Offensive accumulations removed 64 Other repairs carried out or nuisances abated 232 Visits re infectious diseases, etc. 874 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. CLEAN AIR During the year the Public Health Inspectors made 297 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:- Health Department Heath House Rainfall (inches) 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 1.89 12.59 2.30 2.09 9.59 1.88 February 0.08 10.64 1.94 0.08 11.42 2.05 March 2.05 13.48 2.30 1.58 10.74 1.34 April 2.01 10.61 1.38 2.25 9.36 1.36 May 0.71 7.94 0.87 0.48 13.61 1.00 June 0.39 7.43 0.84 0.59 9.43 0.92 July 1.65 8.52 0.86 1.26 6.49 0.51 August 0.88 3.46 0.25 1.02 4.73 0.50 September 0.04 5.51 1.02 0.04 10.74 1.35 October 1.77 12.25 1.49 1.89 11.82 1.71 November 2.29 10.23 2.10 2.40 10.71 2.40 December 3.23 11.74 1.88 3.62 14.42 1.65 Average 1.42 9.53 1.43 1.44 10.25 1.39 Average 1954-58 2.01 8. 78 1.01 1.97 9. 13 1.08 The Smoke Control Order made by the Council in November, 1958 was confirmed by the Ministry and comes into operation on 1st October, 1960. During the year a second Smoke Control Order was made by the Council and is awaiting confirmation by the Minister. 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 419 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 16 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 one year 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 31 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 345 (b) Factories - non-mechanical power 31 (c) Other premises 4 (d) Outworkers' premises 74 Defects remedied 22 At the end of the year the number of outworkers registered with the Department was 265, and the trades on which they were engaged were as follows:- Wearing Apparel 210 Lace, lace curtains and nets 2 Curtains and furniture hangings 13 Furniture and upholstery 2 Brass and brass articles 1 Artificial flowers 1 Carding, etc. of buttons, etc. 20 Stuffed toys 7 Cosaques, Christmas crackers, Christmas stockings, etc. 9 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, 57 rooms were treated, while 110 wasp nests were destroyed, 10 premises cleared of cockroaches, 2 cleared of ants, and 6 of other insects. Treatment of ponds and tanks to prevent the breeding of mosquitoes was carried out as necessary. 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 15 complaints of nuisance from noise were received. Nine were associated with factories or industrial premises, 3 with self-employed motor car workers and 3 with other premises. In most cases there appeared to be some justification for the complaint and, with the co-operation of the firms or persons concerned, the nuisance was either remedied or some abatement secured. 17 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 rodent operatives and checking results. A summary of the work done in recent years is shown below:- 1955 1956 1957 1958 1959 Complaints received 692 634 629 676 803 Block inspections 66 53 89 93 95 Individual inspections and re-inspections 4, 541 4, 162 4,441 4,631 5,183 Other visits 419 561 645 720 663 Premises treated- (a) By occupier 15 14 16 18 31 (b) By local authority 1,004 982 1,052 1,191 1,318 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 21 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 5 visits of inspection. 18 SWIMMING BATHS. Three swimming baths are provided by the Council. The size and extent of usage of the three municipal baths are shown below:- Hounslow Heston Isleworth Area of bath major 75'x30' 100'x48' 100'x48' minor 50'x25' - - Capacity of bath (gallons) major 71,000 200,000 200,000 minor 36,000 - - Total number of persons using swimming bath in 1959 160,448 233,353 187,681  Hounslow Heston Isleworth Maximum number of persons using swimming bath on any one day 1,158 2,225 1,731 No. of private baths male 15 - 11 female 9 - 11 No. of persons using private baths during 1959 38,666 24,184 The baths waters are treated by continuous filtration and breakpoint chlorination. While baths' staff do everything to maintain a 'safe' standard of bath water bathers could assist very materially by the observance of strict personal hygiene. During the year 7 samples of baths water and 2 from a paddling pool 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. One verminous person was cleansed under the provisions of Section 85 of the Public Health Act, 1936. During the year 41 children in attendance at schools in the Borough were found to be verminous and because of the failure of parents to take necessary action 16 of these children had to be cleansed by the School Health Department. 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 27 visits of inspection were made during the year. INSPECTION AND SUPERVISION OF FOOD MILK. At the end of the year, there were 40 distributors registered under the Milk and Dairies Regulations. During the year 84 inspections were made at dairies and retail purveyors' premises. Under the Milk (Special Designation) Regulations, 42 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'. Twelve samples of pasteurised milk were tested. The pasteurisation was found to be satisfactory in 9 and slightly unsatisfactory in 3. The attention of the firms concerned was drawn to these results. Seven complaints were received of dirty milk bottles, 2 of foreign matter in the milk and one of a metallic taste in the milk. Pour of the complaints were not substantiated, and in one case proceedings could not be taken as the complainant was unwilling to give evidence in Court. In two cases warning letters were sent and proceedings in the remaining three cases resulted in fines of £15 and costs of £5 5s Od. ICE CREAM. Under the Food 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 250. 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 19 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 methods of manufacturing and handling During the year, 65 inspections of registered premises were carried out. file following results were obtained from the bacteriological examination of samples:- Satisfactory Doubtful Unsatisfactory Ice-Cream 43 - 1 Water Ices or 'lollies' 9 Milk Ices 5 1 Rinse Water 2 - - The percentage of doubtful and unsatisfactory samples was 3. 5 as compared with 17.1 in 1958 and 13.3 in 1957. BAKEHOUSES. There are 20 bakehouses in the Borough and 72 visits of inspection were made during the year. SLAUGHTERHOUSES. There is no public abattoir, private slaughterhouse or knacker's yard operating in the Borough. SLAUGHTER OF 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 74 346 Cafes, Canteens, Clubs, etc. 191 365 Fish Shops 26 192 Greengrocers 84 98 Grocery and provision 183 273 Hotels, public houses, etc. 87 50 Manufacturers, packers, etc. 14 28 Confectioners, sweets 141 106 flour 23 60 At retail premises 5,495 lbs. and 1,832 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, 15; cakes, 5; chicken, 1; fish, 1; beef, 1; pork, 1; cheese spread, 1; meat pie, 2; corned beef, 1; eggs, 1; sugar, 1; horse radish sauce, 1; dried fruit salad, 1; fruit pie, 1; mandarin oranges, 1; pineapple juice, 1; and desiccated coconut, 1. The complaints were not substantiated in 20 cases, 2 official warnings were issued and proceedings in the other cases resulted in fines and costs amounting to £117 4s Od. A prosecution for exposing unsound food for sale resulted in fine and costs amounting to £12 2s Od. 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 30 20 hawkers were on the register (greengrocery 20, fish 6, ice-cream 4) and 45 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 1,327,264 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 1959 has been supplied by the Public Control Department of Middlesex County Council:- Article Total Samples Procured Unsatisfactory Milk (new) 87 56 Milk (various) 84 - Cakes and biscuits 5 - Cooked meat 10 - Coffee 5 - Cream 20 - Drugs 11 - Fish and Fish Products 25 1 Fruit - Fresh, Canned Dried 19 2 Glace Cherries 5 - Ice-Cream 34 - Jelly 4 - Liver 4 - Meat and Meat Products 32 - Preserves 9 - Sausages 7 - Spirits 6 - Sweets 6 - Vinegar 19 - Miscellaneous 25 - Total 417 59 MILK. Three consignments of new milk were delivered from a dairy farmer to a milk processing depot in your district and when sampled many of the churns contained milk which was slightly deficient both in milk fat and solids-not-fat. There was no evidence of added water. Another supplier delivered two consignments of which some churns contained milk deficient in solids-not-fat. Again this appeared to be due to seasonal diet deficiencies in the herd concerned, and subsequent sampling disclosed improved quality. FISH. An official caution was issued in the case of a retailer who displayed witches as lemon soles. The shop manager was prosecuted as the person responsible and fined £5 and 2 guineas costs. FRUIT. Two retailers were prosecuted for labelling and selling giant prune variety plums as Victoria plums. Each retailer was fined £2 on each of two summonses and 2 guineas costs. MERCHANDISE MARKS ACTS, 1887 - 1953. The majority of the inspection work carried out under the provisions of the above Acts relate to ensuring that the requirements of the various Marking Orders made under the provisions of the Act of 1926, and which relate to the marking with an indication of origin on certain imported foodstuffs when exposed for sale or sold, are complied with. Inspections were made at 278 different premises and 1,474 displays consisting of meat, apples, tomatoes, poultry, dried fruit, butter and bacon, were examined. Any infringements detected were of a minor nature, and were dealt with by verbal warnings. Two prosecutions were undertaken under the main Act in relation to the display of extra small eggs under the description 'small'. Fines of £2 and costs of 5 guineas were imposed in each case. LABELLING OF FOOD ORDER. 1953. This Order requires pre-packed food to be 21 marked with the name and address, or with the registered trade mark of the packer or labeller. It also requires such food to be labelled with its common or usual name (if any) and with the names of the ingredients of a compounded food. It also controls the manner in which the presence of vitamins and minerals is disclosed and prescribes specific labelling on certain foods. A total of 838 articles of prepacked food was examined at 171 premises, to ascertain whether the above requirements were complied with. Corrective action taken for infringements in the whole area of the County has equal effect within the Boroughs and in instances where incorrect labels were noted correction was obtained by representations to the packers or manufacturers. Continental packet goods marked only in the language of the country of origin were the most common types of infringement found under this heading. FALSE OR MISLEADING DESCRIPTIONS. As in previous years food advertisements and labels have been scrutinised for false or misleading statements and descriptions. Similarly County wide correction has equal effect in all boroughs, and corrective action was taken in respect of a 'seedless' fig bar containing seeds, dubious claims for slimming properties in lemon juice drinks, and extravagent claims for medical remedies. Misleading labels describing fruit syrups as fruit juices were also corrected. SPECIAL DESIGNATED MILK. During 1959 my Council issued to two Dealer's (Pasteuriser's) licences in respect of premises within your area where milk is processed, These premises were regularly inspected and compliance with statutory requirements was well maintained. 46 inspections were made and 122 samples of designated milk were taken, all of which were certified as being satisfactory. SAFE MILK. In addition to the foregoing, 59 samples of raw milk were procured within your borough and submitted to test for the presence of tubercle bacilli. None was found contaminated." FOOD 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 Food Hygiene Regulations were found at 21 premises and were remedied at 59 premises during the year. Some particulars of the contraventions found and remedied are given below, and it is of interest to note that the number of new contraventions found is decreasing:- Contraventions of Food Hygiene Regulations Found Remedied Articles/Equipment not kept clean 2 38 Articles/Equipment not in good order 5 28 Containers not protected from contamination 2 40 Food so placed as to involve risk of contamination 6 46 Food placed within 18" of ground and not adequately protected - 28 Personal cleanliness not observed 2 3 Improper wrapping materials used - 1 Inadequate trapping of drain inlets - 1 Water closets not kept clean and in efficient order 4 11 Insufficient lighting and ventilation to water closets 1 5 Absence of 'Wash your hands' notice in water closets 1 14 Inadequate cold water supply - 2 Absence of suitable and sufficient washhand basins - 7 Absence of hot water at a suitably controlled temperature over wash-hand basins - 7 22 Contraventions of Food Hygiene Regulations Found Remedied Absence of soap, nail brushes, clean towels, etc. near wash-hand basins 1 19 Absence of first aid materials 2 4 Absence of accommodation for clothing not worn during working hours 2 10 Absence of suitable and sufficient sinks for the washing of food and equipment - 5 Absence of hot water at a suitably controlled temperature over sink 2 4 Absence of soap, clean cloths etc. at sink - 5 Absence of suitable and sufficient lighting in food rooms 1 3 Absence of suitable and sufficient ventilation in food rooms - - Walls, floors, etc. not kept clean 10 84 Walls, floors etc. not kept in good order 9 41 Covered receptacle for refuse not provided 1 11 Accumulations of refuse, etc. 1 29 Specified foods not stored at prescribed temperature 1 Miscellaneous 1 8 Totals 54 459 HOUSING The numbers of new houses erected in the Borough in recent years is shown below:- 1946-55 1956 1957 1958 1959 Heston and Isleworth B.C. 1,520 20 178 98 12 Brentford and Chiswick B. C. 34 22 - 6 - Southall B. C. 64 - - - - Middlesex County Council 5 - - - 1 Ministry of civil Aviation 77 - - - - Metropolitan Police 29 - - - - Prison Commissioners 18 - - - - War Department - - - - 34 Private Enterprise- (a) new houses 484 172 233 168 279 (b) reconstructed after war destruction 185 - - - - (c) housing associations 340 59 30 - - (d) additional dwellings by conversion 3 - - - - 2,759 273 441 272 326 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; - 23 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) 156 (b) Number of inspections made for the purpose 165 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under Housing Regulations, 1925 and 1932 11 (b) Number of inspections made for the purpose 22 (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 10 (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 114 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 130 3. ACTION UNDER STATUTORY POWERS DURING THE YEAR: (a) Proceedings under sections 9, 10 and 12 of the Housing Act, 1957: (1) Number of dwelling-houses in respect of which notices were served requiring repairs 6 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) by Owner - (b) by Local Authority in default of owners 3 (b) Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which formal notices were served requiring defects to be remedied 2 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) by Owner 2 (b) by Owner after Court had made a Nuisance Order 2 (c) by Local Authority in default of owners - (c) Proceedings under sections 16, 17, 18, 24, 27, 28 and 43 of the Housing Act, 1957:- (1) Number of dwelling-houses in respect of which Undertakings from Owners accepted to render houses fit or not to re-let for human habitation: (a) To render fit 5 (b) Not to use - (2) Number of dwelling-houses rendered fit in consequence of Undertakings given by owners 2 (3) Number of dwelling-houses demolished which were subject to Undertakings not to use - (4) Number of dwelling-houses in respect of which Demolition Orders were made - 24 (c) Proceedings under sections 16, 17, 18, 24, 27, 28 and 43 of the Housing Act, 1957 (contd.): (5) Number of dwelling-houses demolished in pursuance of Demolition Orders 10 (6) Number of dwelling-houses in respect of which Closing Orders were made in lieu of Demolition Orders 1 (7) Number of dwelling-houses in respect of which Closing Orders were revoked and Demolition Orders substituted - (8) Number of Demolition Orders revoked 2 (9) Number of Closing Orders determined, the premises having been rendered fit - (10) Number of Closing Orders made in respect of (a) any part of a building 2 (a) any underground room - (11) Number of Closing Orders determined in respect of any part of a building rendered fit - (12) Clearance Area (Pears Road): (a) Number of dwelling-houses subject to a confirmed Compulsory Purchase Order 18 (b) Number of dwelling-houses purchased by Agreement 13 4. HOUSING ACT, 1957 - OVERCROWDING: (1) (a) Number of dwellings overcrowded at the end of the year 31 (b) Number of families dwelling therein 49 (c) Number of persons dwelling therein: 213 (2) Number of new cases of overcrowding reported during the year 11 (3) (a) Number of cases of overcrowding relieved during the year 6 (b) Number of persons concerned in such cases 20 (4) Particulars of any case in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding - 5. OTHER MATTERS: (1) Number of dwelling-houses demolished voluntarily 26 (2) Certificates of Disrepair: Number of decisions not to issue certificates Number of decisions to issue certificates - (a) in respect of some but not all defects 15 (b) in respect of all defects 9 Number of undertakings given by landlords to remedy defects (Form "K") 12 Number of certificates issued 12 Number of applications by landlords to Local Authority for cancellation of certificates 14 Number of objections by tenants to cancellation of certificates 7 Number of certificates cancelled 9 25 (3) At the end of the year, the following 38 houses, subject to Demolition or Closing Orders or to undertakings not to re-let till rendered fit were still occupied:- Date of Demolition Situation Order or Undertaking 14, Brickfield Yard 25.10.38 18, do. 25.10.38 3, Park Cottages 28.12.38 4, do. 28.12.38 11, Tivoli Road 28. 2.39 13, do. 28. 2.39 159, Martindale Road 25. 7.50 165, do. 25. 7.50 169, do. 30. 9.52 10, Ivy Road 28. 6.55 4, Algar Road 26. 7.55 180, Linkfield Road 28. 2.56 184, do. 28. 2.56 175, Spring Grove Road 28. 2.56 38, Haliburton Road 29. 5.56 308, North Hyde Lane 27.11.56 21, Whitton Road 24. 9.57 811, Bath Road 26.11.57 813, do. 26.11.57 817, do. 26.11.57 819, do. 26.11.57 1, Derby Road 26.11. 57 41, Grove Road 26.11.57 47, do. 26.11.57 1, Vine Place 25. 3.58 3, do. 25. 3.58 83, Whitton Road 27. 5.58 9, Hanworth Terrace 28.10. 58 61, Staines Road 28.10.58 63, do. 28.10.58 319, Wellington Road 28.10.58 67, (part) Wellington Road 25.11.58 1, Bakers Cottages, Hayes Road, Southall 27. 1.59 2, (part) Bakers Cottages, Hayes Road, Southall 27. 1.59 35, (part) Whitton Road, Hounslow 28. 4.59 29, Algar Road, Isleworth 28. 7.59 16, Percy Road, Isleworth 28. 7.59 197, (part) Hanworth Road, Hounslow 29. 9.59 In addition, 16 houses in the Pears Road Clearance Area and 15 unfit houses in the ownership of the Council and purchased for redevelopment, were still occupied. 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 given 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 £552,877 under the Housing (Financial Provisions) Act, 1958 in relation to 347 houses. (b) improvement grants of £4,400 2s 6d under section 30 of the Housing (Financial Provisions) Act, 1958 in relation to 21 houses. 26 (c) repairs loans of £1,744 under section 43 of the Housing (Financial Provisions) Act, 1958 in relation to 9 houses. (d) repair costs of £265 16s Od under section 9 of the Housing Act, 1957, for work in default in relation to 4 houses. (e) standard grants of £1,030 under Section 4 of the House Purchase and Housing Act 1959 in relation to 8 houses. 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 1959 one burial was 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 examination or the retention of a body for other than a very short time, so by arrangement with the Coroner, bodies are taken direct to or transferred to Acton or Hampton Mortuaries. The Council pays a charge made for the use of these mortuaries. MEDICAL EXAMINATION OF STAFF. For superannuation or other purposes 176 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. 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:- Hounslow Isleworth 31st January 10th March 1st and 2nd February 20th September 20th, 21st and 22nd June 21st, 22nd and 23rd November 21st December 27 TABLE 1 Summary of Vital Statistics 1900-1959 Estimated Civi1ian population (mid- year) Birth Rate per 1,000 population Death Rate per 1,000 population Infant Mortality Rate Deaths under l yr. per 1,000 live births Neo-natal Mortality Rate Deaths under l mth. per 1,000 live births Maternal Mortality Rate per 1,000 live and still births Still Birth Rate per 1,000 live and still births Tuberculosis Death Rate per 1,000 population 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 12.5 102 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 52 - - 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 11.5 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 6.0 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 25 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 0.5 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 1958 105,100 12.0 10.6 17 13 0.0 13 0.05 1959 105,000 12.1 10.9 17 15 0.8 14 0.07 28 TABLE II REGISTRAR-GENERAL'S RETURN OF CAUSES OF DEATH, 1959 Abridged List No. Cause of Death Male Female Total B.1. Tuberculosis, respiratory 3 4 7 B.2. Tuberculosis, other - - - B.3. Syphilitic disease 1 - 1 B.8. Diphtheria - - - B.9. Whooping Cough - - - B.10. Meningococcal Infections 1 - 1 B.12. Acute Poliomyelitis 1 - 1 B.14. Measles - - - B. 4-7, 11 15-17 Other Infective and parasitic diseases - 2 2 B.18. Malignant neoplasm, stomach 17 14 31 Malignant neoplasm, lungs 59 9 68 Malignant neoplasm, breast - 17 17 Malignant neoplasm, uterus - 6 6 Other malignant and lymphatic neoplasms 55 50 105 Leukaemia, aleukaemia 6 5 11 B.20 Diabetes 1 3 4 B.22 Vascular Lesions of nervous system 44 80 124 B.26 pt. Coronary disease angina 121 60 181 B.28 Hypertension with heart disease 21 14 35 B.25 26 pt. 27 Other heart disease 57 76 127 B.29 46 pt. Other circulatory disease 20 45 65 B.30 Influenza 18 19 37 B.31 Pneumonia 25 36 61 B.32 Bronchitis 41 21 62 B.46 pt. Other respiratory diseases 6 5 11 B.33 Ulcer of stomach and duodenum 9 2 11 B.36 43 pt. Gastritis, enteritis, diarrhoea 3 3 6 B.38 Nephritis and nephrosis 1 2 3 B.39 Hyperplasia of prostate 5 - 5 B.40 Pregnancy, childbirth, abortion - 1 1 B.41 Congenital malformations 6 - 6 Residual Other defined and ill-defined diseases 52 63 115 B.E. 47 Motor vehicle accidents 9 5 14 B.E. 48 All other accidents 7 9 16 B.E. 49 Suicide 6 6 12 B.E. 50 Homicide and operations of war 1 - 1 Total 590 557 1,147 29 TABLE III CAUSES OF DEATH (MALES) AT CERTAIN AGES, 1959 under 1 1-4 5-14 15-24 25-44 45-64 65-74 75-over Total Tuberculosis, respiratory - - - - 1 1 1 - 3 Tuberculosis, other - - - - - - - - - Syphilitic disease - - - - - - 1 - 1 Diphtheria - - - - - - - - - Whooping Cough - - - - - - - - - Meningococcal Infection - - - - - - 1 - 1 Acute Poliomyelitis - - - - 1 - - - 1 Measles - - - - - - - - - Other Infective and parasitic diseases - - - - - - - - - Cancer -stomach - - - - - 9 4 4 17 lung - - - - 3 26 21 9 59 breast - - - - - - - - - uterus - - - - - - - - - other - - - 1 1 17 17 19 55 leukaemia - - - - 2 2 2 - 6 Diabetes - - - - - - - 1 1 Cerebral Haemorrhage, etc. - - - - - 9 19 16 44 Coronary disease , angina - - - - 3 55 36 27 121 Hypertension with heart disease - - - - - 2 8 11 21 Other heart disease - - - - 2 7 14 28 51 Other circulatory disease - - - - - 5 4 11 20 Influenza - - 1 - - 5 6 6 18 Pneumonia - 1 - - - 3 8 13 25 Bronchitis - - - - - 10 14 17 41 Other respiratory diseases - - - - - 2 2 2 6 Ulcer of stomach and duodenum - - - - - 4 2 3 9 Gastritis, enteritis, etc. - 1 - - - 1 - 1 3 Nephritis and nephrosis - - - - - - - 1 1 Prostatic enlargement - - - - - - - 5 5 Pregnancy, childbirth, abortion - - - - - - - - - Congenital malformations 4 - 1 - - 1 - - 6 Other diseases 9 1 1 - 2 6 8 25 52 Motor vehicle accidents - - 1 1 2 1 1 3 9 All other accidents - 1 - - 1 4 - 1 7 Suicide - - - - - 4 2 - 6 Homicide and war operations - 1 - - - - - - 1 Total 13 5 4 2 18 174 171 203 590 Percentage of Total 2.2 0.8 0.7 0.3 3.1 29.5 29.0 34.4 30 TABLE IV CAUSES OF DEATH (FEMALES) AT CERTAIN AGES, 1959 under 1 1-4 5-14 15-24 25-44 45-64 65-74 75-over Total Tuberculosis, respiratory - - - - - 2 - 2 4 Tuberculosis, other - - - - - - - - - Syphilitic disease - - - - - - - - - Diphtheria - - - - - - - - - Whooping Cough - - - - - - - - - Meningococcal Infection - - - - - - - - - Acute Poliomyelitis - - - - - - - - - Measles - - ~ - - - - - - Other infective and parasitic diseases - - - - - 2 - - 2 Cancer - stomach - - - - 2 4 3 5 14 lung - - - - - 4 4 1 9 breast - - - - 3 10 1 3 17 uterus - - - - - 1 3 2 6 other - 1 - 1 2 17 13 16 50 leukaemia - - 1 - 1 1 - 2 5 Diabetes - - - - - - 2 1 3 Cerebral haemorrhage, etc. - - - 1 1 12 15 51 80 Coronary disease, angina - - - - - 9 18 33 60 Hypertension with heart disease - - - - - - 7 7 14 Other heart disease - - - - 1 10 11 54 76 Other circulatory disease - - - - - 10 9 26 45 Influenza - - - - 2 - 6 11 19 Pneumonia 2 - - - - 2 6 26 36 Bronchitis - - - 1 - 1 7 12 21 Other respiratory diseases - - - - - - 2 3 5 Ulcer of stomach and duodenum - - - - - 1 - 1 2 Gastritis, enteritis, etc. - - - - - - 1 2 3 Nephritis and nephrosis - - - - - 2 - - 2 Prostatic enlargement - - - - - - - - - Pregnancy, childbirth, abortion - - - 1 - - - - 1 Congenital malformation - - - - - - - - - Other disease 6 - - - 1 14 9 33 63 Motor vehicle accidents - - - 1 - - 1 3 5 All other accidents - - - - - 2 3 4 9 Suicide - - - 1 2 2 1 - 6 Homicide and war operations - - - - - - - - - Total 8 1 1 6 15 106 122 298 557 Percentage of Total 1.4 0.2 0.2 1.1 2.7 19.0 21.8 53.5 31 TABLE V INFANTS' DEATHS ACCORDING TO AGE AND CAUSE, 1959 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 - - - - - - - - 2 Haemolytic Disease 1 1 - - - - - - - - - - - - - - - - - - - 2 Atelectasis and birth asphyxia 3 - - 1 - - - - - - - - - - - - - - - - - 4 Congenital malformations 2 - - - - - - - - 1 - 1 - - - - - - - - - 4 Prematurity 5 1 1 - - - - 1 - - - - - - - - - - - - - 8 Volvulus - - - - 1 - - - - - - - - - - - - - - - - 1 Total 12 2 1 1 1 - - 1 - 1 - 1 1 - - - - - - - - 21 32 TABLE VI INFECTIOUS DISEASES, AGE DISTRIBUTION - 1959 Disease Total under 1 yr. 1 yr. 2 yrs. 3 yrs. 4 yrs. 6-9 yrs. 10-14 yrs. 16-19 yrs. 20-34 yrs. 35-44 yrs. 45-64 yrs. 65 yrs. Cases admitted to hospital Smallpox - - - - - - - - - - - - - - Typhoid Fever - - - - - - - - - - - - - - Para-Typhoid Fever - - - - - - - - - - - - - - Scarlet Fever 235 1 2 9 10 27 144 37 2 2 1 - - 23 Diphtheria - - - - - - - - - - - - - - Erysipelas 7 - - - - - - - - 4 2 - 4 2 Puerperal Pyrexia 118 - - - - - - - 12 86 20 - - 114 Ophthalmia Neonatorum - - - - - - - - - - - - - - Acute Encephalitis 1 - - 1 - - - - - - - - - 1 Acute Poliomyelitis 1 - - - - - - - - 1 - - - 1 Meningococcal Infection 3 - - - - - 1 - - 1 - - 1 3 Pneumonia 47 - - 2 - 2 3 1 2 2 2 15 17 15 Dysentery 42 - 2 3 1 1 19 6 - 5 3 2 - 7 Measles 1007 19 81 92 108 146 527 26 2 5 1 - - 26 Whooping Cough 46 6 6 8 4 3 14 5 - - - - - 4 Food Poisoning 23 - 1 1 1 - 1 2 - 7 2 5 3 10 Tuberculosis:- Pulmonary 53 - 1 - - 1 1 - 3 16 5 18 8 15 Non-Pulmonary 3 - - - - - 1 - — 1 1 - - 1 33 NOTIFICATIONS AND DEATHS FROM CERTAIN INFECTIOUS DISEASES HESTON AND ISLEWORTH 19401959 TABLE VII Year Smallpox Scarlet Fever Diphtheria Erysipelas Pneumonia Meningococcal Infection Epidemic Encephalitis Poliomyelitis and Polioencephalitis Typhoid Fever Paratyphoid Fever Dysentery Measles Whooping 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 1940 - - 96 - 73 5 35 1 200 57 43 6 1 2 1 - 4 - - - - - 1109 2 123 3 Not Notifiable 16 130 59 1941 - - 117 - 37 3 20 - 124 41 34 2 1 1 1 - 2 - 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 1 - - - - 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 - 1027 - 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 - - 36 - - - 8 - 39 64 2 - 2 - 2 - - - - - 7 - 804 - 74 - 9 82 7 1958 - - 62 - - - 6 - 45 60 - - - - - - 1 - - - 15 - 275 - 44 - 7 81 5 1959 - - 235 - - - 7 - 47 61 3 1 1 - 1 1 - - - - 42 - 1007 - 46 - 37 56 7 34 COUNTY COUNCIL OF MIDDLESEX CERTAIN VITAL STATISTICS FOR THE YEAR 1959. TABLE VIII District Estimated Population mid-1959 Live birth rate per 1000 population Death rate per 1000 population Specific death rates per 1000 population Infant mortality per 1000 1ive births Maternal mortality per 1000 total births Crude Adjusted Crude Adjusted Coronary disease, angina Cancer Infant Neo-natal (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Acton 64,800 16.0 15.2 11.6 11.8 2.1 (134) 2.1 (136) 19.2 (20) 17.3 (18) - (-) Brentford and Chiswick 56,970 14.3 13.6 10.5 10.5 1.8 (104) 2.1 (121) 27.1 (22) 22.2 (18) 1.21 (1) Ealing 182,700 14.7 14.3 10.8 11.7 1.9 (341) 2.2 (393) 16.7 (45) 12.6 (34) - (-) Edmonton 94,420 13.6 13.6 10.9 12.1 1.6 (152) 2.4 (231) 23.3 (30) 20.2 (26) - (-) Enfield 109,700 13.4 13.4 10.1 10.8 1.5 (167) 2.1 (227) 19.7 (29) 14.2 (21) 0.67 (1) Feltham 51,750 15.6 15.0 8.6 13.5 1.3 (69) 1.4 (71) 24.8 (20) 19.9 (16) - (-) Finchley 68,920 13.5 13.0 11.5 10.4 2.0 (136) 2.4 (164) 20.4 (19) 13.9 (13) - (-) Friern Barnet 28,660 12.0 13.4 14.8 10.5 2.0 (57) 2.3 (66) 43.6 (15) 40.7 (14) - (-) Harrow 213,700 13.7 14.1 9.7 11.4 1.8 (379) 2.1 (444) 15.0 (44) 11.6 (34) - (-) Hayes and Harlington 68,670 16.2 15.2 8.0 13.0 1.5 (104) 1.8 (122) 18.0 (20) 14.4 (16) 0.88 (1) Hendon 151,500 13.0 12.5 10.9 11.6 1.9 (286) 2.3 (347) 19.3 (38) 16.3 (32) 1.50 (3) Heston and Isleworth 105,000 12.1 12.1 10.9 11.1 1.7 (181) 2.2 (227) 16.5 (21) 14.1 (18) 0.77 (1) Hornsey 96,430 18.0 16.7 12.3 10.9 2.4 (227) 2.3 (225) 24.8 (43) 21.4 (37) - (-) Potters Bar 22,750 16.0 14.2 8.8 12.2 1.6 (37) 1.5 (34) 19.3 (7) 8.3 (3) - (-) Ruislip and Northwood 75,330 13.4 13.4 8.2 10.3 1.4 (106) 1.9 (143) 16.8 (17) 12.9 (13) 0.98 (1) Southall 52,900 14.0 14.6 12.1 11.4 2.2 (114) 2.1 (113) 22.9 (17) 17.5 (13) 1.33 (1) Southgate 70,680 12.0 13.0 13.3 10.9 2.5 (177) 3.0 (211) 15.3 (13) 12.9 (11) 1.15 (1) Staines 47,910 18.7 17.2 9.6 12.2 1.7 (82) 2.0 (97) 15.7 (14) 13.4 (12) - (-) Sunbury 29,710 19.4 17.3 10.7 12.3 1.3 (38) 2.3 (68) 17.3 (10) 12.1 (7) - (-) Tottenham 116,100 15.1 14.9 11.6 12.3 2.0 (227) 2.4 (280) 24.0 (42) 19.4 (34) 0.56 (1) Twiakenham 103,600 13.2 13.6 12.1 11.5 2.3 (237) 2.2 (229) 16.8 (23) 12.4 (17) - (-) Uxbridge 63,730 16.7 15.0 9.1 11.7 1.5 (93) 1.7 (110) 19.7 (21) 19.7 (21) 0.92 (1) Wembley 126,300 12.6 12.7 9.7 11.3 1.9 (237) 2.2 (278) 14.4 (23) 13.2 (21) - (-) Willesden 172,800 19.6 18.2 10.5 11.9 1.8 (303) 2.4 (420) 19.5 (66) 14.5 (49) - (-) Wood Green 48,520 14.1 14.2 12.4 11.9 2.1 (104) 2.9 (141) 20.5 (14) 14.7 (10) 1.43 (1) Yiewsley and West Drayton 23,450 18.8 16.9 7.4 10.7 1.4 (34) 1.7 (41) 18.1 (8) 13.6 (6) - (-) COUNTY 2,247,000 14.7 14.4 10.6 11.4 1.8 (4126) 2.2 (4939) 19.4 (641) 15.5 (514) 0.39 (13) NOTE: Absolute numbers are given in parenthesis in addition to rates to afford valid comparison. 35 TABLE IX(a) METEOROLOGY (Extract from records supplied by Chief Engineer, Mogden Sewerage Works) Week Ending Barometer Temperature (°F) Days with Rainfall Total Rainfall (inches) Highest Lowest Max. Min. Jan. 2nd 30.12 29.33 57.0 31.0 5 0.89 9th 29.96 29.43 50.0 27.0 5 0.78 17th 30.28 29.47 45.0 23.0 3 0.04 24th 30.48 28.82 53.0 30.0 6 0.69 31st 30.53 30.23 48.0 26.0 - 0.00 Feb. 7th 30.53 30.10 44.0 32.0 . 0.00 14th 30.74 30.20 43.0 33.0 1 0.00 2lst 30.83 30.22 57.0 28.0 4 0.06 28th 30.35 30.64 66.0 37.0 2 0.00 Mar, 7th 30.08 29.15 66.0 39.0 6 0.82 14th 30.22 29.27 58.0 34.0 4 0.25 21st 30.26 29.96 58.0 33.0 2 0.11 28th 30.25 29.55 61.0 34.0 5 0.07 Apr 4th 30.21 29.40 68.0 38.0 1 0.28 11th 29.91 29.14 56.0 37.0 6 0.61 18th 30.20 29.24 68.0 41.0 6 0.85 26th 30.32 29.72 51.0 40.0 3 0.41 May 2nd 30.16 29.39 58.0 38.0 3 0.42 9th 30.18 29.60 76.0 37.0 2 0.17 16th 30.30 29.51 81.0 46.0 1 0.01 23rd 30.21 29.00 72.0 46.0 4 0.46 30th 30.24 29.86 73.0 44.0 - 0.00 June 6th 30.26 29.74 76.0 45.0 5 0.19 13th 30.61 29.79 77.0 44.0 4 0.05 20th 30.60 29.87 82.0 49.0 - 0.00 27th 30.12 29.65 81.0 57.0 5 0.17 July 4th 30.17 29.62 86.0 52.0 4 0.21 11th 30.27 29.63 93.0 56.0 3 0.60 18th 30.14 29.67 83.0 48.0 2 0.00 25th 30.16 29.92 83.0 55.0 - 0.00 Aug. 1st 30.02 29.49 84.0 50.0 6 0.88 8th 30.08 29.80 82.0 53.0 1 0.07 15th 30.19 29.47 78.0 52.0 6 0.83 22nd 30.27 29.70 86.0 45.0 1 0.00 29th 30.33 30.04 85.0 48.0 - 0.00 Sept. 5th 30.22 30.06 74.0 48.0 - 0.00 12th 30.22 29.86 85.0 51.0 - 0.00 19th 30.23 29.90 77.0 50.0 - 0.00 26th 30.31 29.80 73.0 46.0 3 0.09 Oct. 3rd 30.37 30.02 80.0 41.0 1 0.00 10th 30.12 29.61 77.0 47.0 2 0.30 17th 30.15 29.01 69.0 47.0 4 0.19 24th 30.46 29.60 64.0 40.0 4 0.48 31st 30.13 28.55 50.0 35.0 6 0.91 Nov. 7th 30.27 29.93 39.0 29.0 4 0.09 14th 30.17 28.99 54.0 26.0 5 1.03 21st 30.14 29.19 61.0 31.0 5 0.75 28th 30.17 29.25 59.0 38.0 5 0.21 Dec. 5th 29.68 29.10 52.0 31.0 6 0.91 12th 30.19 28.96 41.0 32.0 5 0.42 19th 30.28 29.80 55.0 46.0 7 0.73 26th 29.92 28.89 46.0 34.0 7 0.98 36 TABLE IX (b) WIND DIRECTION (Sum. of Daily Records, 52 weeks) N. 14 days N. N. E. 10 days N. E. 22 days E. N. E. 21 days E. 33 days E. S. E. 5 days S. E. 9 days S. S. E. 7 days s. 25 days S.S.W. 15 days S.W. 42 days w.S.w. 22 days w. 35 days W. N. W. 14 days N.W. 21 days N. N. W. 7 days Calm 62 days 37 TABLE X FACTORIES ACT, 1937 and 1948 PART I OF THE ACT 1. Inspections for purposes of provisions as to health made by Public Health Inspecto 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 31 1 - (ii) Factories not included in (1) in which Section 7 is enforced by the Local Authority 381 345 23 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 6 4 - - TOTAL 421 380 24 - 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 H.M. Inspector Want of Cleanliness - - - - - Overcrowding (S. 2.) - - - - - Unreasonable temperature (S. 3.) - - - - - Inadequate ventilation (S. 4.) - - - - - Ineffective drainage of floors (S.6.) - - - - - Sanitary Conveniences (S. 7.) (a) insufficient 1 3 - - - (b) unsuitable or defective 22 18 - - - (c) not separate for sexes 1 1 - - - Other offences against the Act (not including offences relating to Outwork) 2 - 2 - - TOTAL 26 22 2 - - 38