939 (1) Library HES 47 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE BOROUGH OF HESTON AND ISLEWORTH for the year I960 A. ANDERSON, M.D., D.P.H., Medical Officer of Health. INDEX Page Accidents 8 Bakehouses 22 Births, live 7 Births, still 7 Blood Transfusion Service 30 Burials 30 Canal Boats 19 Clean Air 17 Closet Accommodation 16 Common Lodging Houses 19 Deaths 8 Deaths. Age and Sex Distribution 33 & 34 Deaths causes of 32 Disinfection 11 Disinfestation 19 Drainage and Sewerage 15 Factories, No. on Register Inspection and Defects, etc. 41 Factories, Workplaces, etc. 19 Family Planning Association 14 Fever Hospitals 11 Food and Drugs Sampling 23 Food Hygiene 25 Food Poisoning 12 Health Committee 3 Health Education 30 Health Services provided by Other Authorities 12 Housing 26 Ice Cream 22 Infant Deaths according to Age and Cause 35 Infant Mortality 9 Infectious Diseases 9 Infectious Diseases, Age Distribution 36 Infectious Diseases, Notifications and Deaths 37 Laboratory Service 11 Page Laundry Service 30 Marriage Guidance Council 14 Maternal Mortality 9 Meat and Other Pood Inspection 23 Medical Examinations of Staff 30 Meteorology 39 Milk 21 Municipal Restaurants and School Canteens 23 Noise Nuisances 20 Persons in need of care and attention 30 Pet Animals Act, 1951 21 Physical Characteristics 14 Public Cleansing 16 Public Mortuary 30 Rags, etc. Exchange of Articles for 17 Rag Flock and Other Filling Materials Act, 1951 21 Rats and Mice Destruction 20 Rivers and Streams 16 Sanitary Circumstances 14 Sanitary Inspection 16 Shops Act, 1950, Section 38 20 Slaughter of Animals (Amendment) Act, 1954 22 Slaughterhouses, etc. 22 Staff 2 Statistics, Certain Vital, County of Middlesex 38 Statistics, General 7 Statistics, Vital 7 Statistics Vital, Summary of 31 Swimming Baths 21 Tents, Vans and Caravans 19 Tuberculosis 10 Verminous Premises, Articles and Persons 21 Water Supply 15 Wind Direction 40 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: K.J. Smith, Cert. as P.H.I. and M.I. Deputy Chief Public Health Inspector: S.H.G. Stevens, Cert. as P.H.I., M.I. and S.E. District Public Health Inspectors: G. Latimer, Cert. as P.H.I. and M.I. 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. (to 24.4.60) F.H.G. Canton, Cert. as P.H.I. and M.I. (from 4.7.60) Rodent Officer: A. Farrer. Rodent Operatives: R. Ashurst (to 30.6.60) A.L. Worthington J.D. Sorrell (from 20.6.60) Mortuary Attendants, Disinfectors, Drain Testers, etc.: L. Woodhead (to 8.10.60) L. Wisdom S. G. Hanson (from 31.10.60) Clerks: H.L. Law, A R.S.H. , M.R. I.P.H.H. (part time) D.S. Bates (Senior Clerk) C.J.C. Mail E.J. Hutchins F.R. Money Mrs. M.E. Ponsford Mrs. L.E. O'Gorman 2 THE HEALTH COMMITTEE of HESTON AND ISLEWORTH BOROUGH COUNCIL to May, 1960 Alderman F J. Jansen (Chairman) Councillor A.J Beach (Vice-chairman) Councillor Mrs. R. New, J.P. (Mayor) Councillor Mrs. M. Hennig Alderman Mrs. A.B. Tolmon Councillor E.H.F. Osbon Councillor Mrs. E.M. Boxall Councillor Mrs. M.T. Roebuck Councillor A.G. Cross, C.C. Councillor I.J. Thomas Councillor R D. Flynn Councillor D.J. Tippins Councillor F.A. Foster Councillor J.B. Webb from May, 1960 Councillor Mrs. M. Hennig (Chairman) Councillor F.G. Raybaud (Vice Chairman) Councillor K.F. Hughes, B.A., J.P (Mayor) Councillor F.A. Foster Alderman F.J Jansen, M.S.M.A. Councillor A.H. Nixon Alderman Mrs. A B. Tolmon Councillor Mrs. M.T. Roebuck Councillor Mrs. E.M. Boxall Councillor W.J.M Spencer Councillor A.G. Cross, C.C. Councillor I.J. Thomas Councillor R.D. Flynn Councillor D.J. Tippins 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 1960. The population of the Borough has shown no change over the last 10 years. During these years, just over 3,000 new houses were erected in the Borough, so their contribution must have been chiefly in relieving adverse housing conditions. The birth rate is the highest recorded since 1949, but is still well below the national rate. There was an increase in illegitimate births and still births during the year and the infant mortality rate rose slightly. All these changes were small and well within the normal variations to be expected from year to year. The death rate shows little change and continues at slightly below the national level. Two-thirds of the deaths in the Borough now occur in persons aged 65 years and over. The main causes of death are cancer and degenerative conditions associated with increasing age. In males the lungs continue to be the main site of fatal cancer, In 1951-55 the average annual deaths from suicide were 7, but in the last five years, the number has risen to an average of 13. The death rate from tuberculosis is the lowest in the Borough records. Of 'preventable' deaths, the largest group is now that due to accidents. The public seems to accept death and mutilation from accidents in the home and on the road without perturbation but panics on the occurrence of a few cases of poliomyelitis in the ten years 1951-60, one Borough resident died from poliomyelitis while 321 died as a result of accidents! While motor vehicles increasingly jam our roads, manufacturers struggle to raise the 'cruising speed', and too many drivers try to maintain it. Drugs left lying about, a kettle of boiling water, an unguarded fire, a loose stair rod, etc. will do more damage to children than all the infectious diseases. Accidents will not happen unless the environment is favourable and herein is the greatest prospect of prevention on the road and in the home and factory. Children should be protected, but it is equally important that they should be educated as to the dangers. Most accidents need not happen. The Borough was relatively free of infectious disease - only dysentery and whooping cough being more prevalent than in 1959. In general, it may be said that today gastro-intestinal infections - dysentery, food poisoning, etc. are the main source of anxiety. Apart from notified cases, one hears only too often of persons or families suffering from diarrhoea and sickness. Investigation takes up much time and requires the full co-operation of the victims and contacts in supplying specimens of faeces. In the absence of bacteriological evidence a decision as to the cause of the gastro enteritis presents many difficulties, especially where food poisoning has been suspected. Where a group of cases occur in school, factory or household the presumptive evidence may be strong, but the single isolated case is a real problem in diagnosis. This is specially so where there is only one victim among a group who have all consumed the same food. Gastro enteritis may be due to dietary indiscretion, be part of any upper respiratory or other infection, or caused by organisms not usually associated with food poisoning, but there still remain many cases where the cause of the illness remains in doubt. Deaths from gastro intestinal infections are uncommon but only prompt notification of cases, preferably by telephone, will give the opportunity of getting samples of suspected food and faecal specimens during the acute phase of the illness and thus improve the chances of finding the cause. Much time and effort was devoted during the year to work under the Clean Air Act. The atmosphere has always been subject to pollution from the decay of animal and 4 vegetable matter and natural radiation Smoke followed man's discovery of the use of fire and the more he huddled together the greater the pollution of the atmosphere around him. This pollution grew enormously with the use of coal and the development of industry and now other fuels and artificial radiation provide additional sources. Pollution may be visible or hidden and while attention is still being given to gaseous pollution the main drive is towards the elimination of particulate pollution, namely, smoke The fact that the problem of gaseous pollution is still unsolved is no excuse for failure to tackle the problem of smoke, grit, etc. There are still people who belittle the part played by the domestic fire, but if the domestic fire is so innocent, why are the records of solid deposit and sulphur dioxide almost twice as high in the winter months as in the summer months. The public response to our efforts has been good The burning of solid smokeless fuels requires a different technique and this has to be learned The number of brands of solid smokeless fuels offered to the public causes some confusion, and retailers should advise customers as to the type of grate or stove for which each fuel is suitable It is difficult adequately to convey in mere figures a picture of the vast amount of detailed investigation called for in connection with this work, much of it novel, so far as the Public Health Inspectors are concerned, involving financial as well as technical considerations. It is gratifying to note that the creation of a suitable system of records and the additional field work has been accomplished with a minimum of disturbance to the routine work of the department. The emission of black smoke from diesel engined vehicles arouses public outcry at times. This smoke occurs only where the engine is not well maintained or where excess fuel is used in an effort to obtain additional power. Under the Motor Vehicles (Construction and use) Regulations, 1955 the use of vehicles 'emitting fumes which could cause damage to property, or injury or danger to any person' is prohibited, but in relation to a moving vehicle this is a difficult offence to prove in law. It is hoped that legislation may be introduced to prohibit the misuse of the excess fuel device It should be remembered that all oil and petrol driven vehicles contribute to gaseous pollution even when used at maximum efficiency. The Noise Abatement Act came into operation during the year. The provisions of the Act are much the same as those already in operation in the Borough under the Middlesex County Council Acts. Noise is a purely subjective sensation and individuals vary markedly in their sensitivity. Much noise nuisance is caused by inconsiderate behaviour noisy motor cycles, loud wireless sets, banging car doors, etc. Noise which is not noticed under normal conditions may, by reason of time and circumstances, become intolerable. Again the noise itself may not be the disturbing factor, but merely something that triggers off another sensation e.g. fear of a crash when an aeroplane passes overhead at a relatively low altitude. Man has a great capacity for adaptation. Some people pass the day happily with the wireless on from morning till night, and many children seem to be able to do homework against almost any background of noise. There is no doubt, however, that noise generally is disturbing and all should endeavour to reduce it to a minimum. The Act does not apply to noise or vibration caused by aircraft and for noise occurring in association with a trade or business it is still a defence to prove that the best practicable means have been taken for preventing the noise The abatement of noise from plant and machinery is a difficult technical Problem and only too often no solution is reasonably available. The day to day work of maintaining and improving houses and of ensuring food hygiene continued It is pleasing to note the increasing use of improvement grants to Provide modern amenities in houses. The Public Health Inspectors can give only a limited time to food hygiene and the general public should give support by ceasing to patronize establishments where conditions are in any way below standard- The number of unrinsed milk bottles left out for the milkman to collect raises doubts as to the standards of food hygiene practised in many homes The excavation of the burial ground at Holy Trinity Church and the re-internment of the human remains in an approved burial ground were supervised by the Department All concerned in this co-operated and no special difficulties arose 5 This report contains many items which are merely a repetition of what has been noted in previous reports. The work has to go on year after year to hold on to what has been gained and to try to safeguard the future. New responsibilities have come and my staff have been most helpful in weaving them into the ever developing pattern of day-to-day duties To the Council for their support and encouragement, and to my colleagues in other Departments, I would like to record my sincere thanks. I remain, Your obedient Servant, A. ANDERSON, Medical Officer of Health 6 GENERAL STATISTICS Year - 1960 Area in acres 7,261 Population (Registrar-General's estimate) 105,270 Number of habitable premises (rate books) 31,220 Number of houses erected during year 201 Rateable Value of Borough £2,273,030 Sum represented by a penny rate £9,365 Live Births - male 683 Live Births - female 693 Birth rate per 1,000 population 13.1 Birth rate per 1,000 population (England and Wales) 17.1 Stillbirths - male 10 Stillbirths female 14 Stillbirths rate per 1,000 (live and still) births 17.1 Deaths male 549 Deaths female 538 Death rate per 1,000 population 10.3 Death rate per 1,000 population (England and Wales) 11.5 Infant Mortality rate 18.2 Infant Mortality rate (England and Wales) 21.7 Maternal Mortality rate 0.0 Maternal Mortality rate (England and Wales) 0.39 VITAL STATISTICS POPULATION. The Registrar-General's mid-year estimate of the population of the Borough for the year is 105,270. RATEABLE VALUE. The rateable value of the Borough for 1960 was £2,273,030 and the sum represented by a penny rate was £9,365. INHABITATED HOUSES. According to the rate books the number of habitable houses, flats and shops with living accommodation at the end of the year was 31,220. 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 1960 was 1,376 as compared with 1,275 in 1959. The birth rate was 13.1 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 Registrar General supplies for each local sanitary authority what is called the area comparability factor. When this is applied to the Borough birth rate, the result os 13.1 as compared with the birth rate of 17.1 per 1,000 population for England and Wales. The number of illegitimate births was 60 as compared with 54 in 1959. The pro Portion 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 1945-49 5.1 1930-34 3.2 1950-54 4.0 1935-39 2.9 1955-59 3.8 1940-44 4.6 1960 4.4 Of the total live and still births, 981 occurred in hospital. STILLBIRTHS. The number of stillbirths in 1960 was 24. The proportion of stillbirths per 1,000 total (live and still) births in recent years is shown below:- 7 No. of Stillbirths Rate per 1,000 total births 1930 - 34 214 31.2 1935 - 39 224 29.4 1940 - 44 200 27.7 1945 - 49 198 23.8 1950 - 54 129 20.6 1955 - 59 94 14.8 1960 24 17.1 DEATHS. The deaths of residents of the Borough during 1960 were 1,087 (549 male, 538 female). This represents a death rate for the Borough of 10.3 per 1,000 population. The deaths in any area are influenced by the sex and age distribution of the population, and to permit of a true comparison, the Registrar-General calculates for each local sanitary authority area what is called an area comparability factor. When this is applied to the above Borough rate, the result is 11.1 as compared with a death rate of 11.5 per 1,000 population for England and Wales. The Registrar-General has classified the deaths registered during the year, and the details are given in Tables II, III and IV. The cause of death was certified by the Coroner in 233 cases. A progressive change is taking place in the percentage age distribution of deaths, and this is shown in the following table:- 1910-14 1950-54 1955-59 1960 Under 1 year 21.8 2.4 2.2 2.3 1-4 years 8.4 0.5 0.3 0.2 5-14 years 3.8 0.4 0.4 0.3 15 - 24 years 3.7 0.8 0.8 0.5 25 - 64 years 30.8 31.6 28.8 28.3 65 years and over 31.5 64.3 67.5 68.4 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 50 per cent. of deaths occurred at age 75 years and over as compared with 36 per cent. in males. The Secretary of the Road Safety Committee informs me that during 1960 there were 813 road accidents which resulted in 14 deaths, serious injury to 175 persons and slight injury to 833 persons. All these figures show little change from the corresponding figures for 1959. 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 All ages Other Accidents Age in years All ages 0-4 5-14 15-64 65 + 0-4 5-14 15-64 65 + 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 1960 - 1 11 5 17 - - 6 10 16 Total 2 8 77 55 142 4 2 57 116 179 8 It should be noted that 39 per cent. of these road deaths occurred in persons aged 65 years and over as compared with 65 per cent for the same age group in deaths from other accidents, 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 1960 there were 25 deaths of children under the age of 1 year, This represents an infant mortality rate per 1,000 live births of 18.2 as compared with 21.7 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 1960 1,376 25 18 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 No death occurred due to causes associated with pregnancy and childbirth. Maternal deaths are usually divided into those due to septic infection and those due to diseases and other conditions associated with pregnancy and labour, and the local trend of deaths from these two causes is shown below:- Maternal deaths per 1,000 total (live and still births) Sepsis Other Causes Total 1930 - 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 - 1959 - 0.2 0.2 1960 - - - 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 are smallpox cholera, diphtheria, membranous croup erysipelas, scarlet fever typhus fever, typhoid fever, paratyphoid fever, relapsing fever, plague, poliomyelitis, tuberulosis, malaria, dysentery, puerperal pyrexia, ophthalmia neonatorum, acute primary pneumonia acute influenzal pneumonia, whooping cough, measles, acute encephalitis, meningococcal infection, anthrax and food poisoning. It is known that all cases are not notified, but there are no grounds for suspecting that the level of notification various to any great 9 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 648 were so endorsed. INCIDENCE OP NOTIFIABLE DISEASE The number of cases notified during the year is shown in Table VI and the trend of infectious diseases during the last 20 years in Table VII. SMALLPOX No case of smallpox occurred in the Borough during 1960. 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 734 children under the age of one year were vaccinated in 1960 as compared with 759 in 1959. Modern travel is such that the risk of importing smallpox is ever present. SCARLET FEVER. This disease was much less prevalent - 70 cases notified as compared with 235 in the previous year. This 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 1960 was 1,021 as compared with 897 in 1959. ERYSIPELAS. The number of notifications was 8 but no death was due to this disease. PNEUMONIA Notifications of pneumonia were 18 as compared with 47 in 1959. Of the total pneumonia deaths 72 per cent occurred at age 65 and over. MENINGOCOCCAL INFECTION One case was notified during the year. 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 1960. POLIOMYELITIS. No case occurred during the year. Inoculation against poliomyelitis was continued during the year, and 4,446 persons were given two injections of vaccine. During the year third injections were given to 7,716 persons Experience has shown that reactions, local or general, to these inoculations are comparatively rare. TYPHOID FEVER No case of typhoid fever was notified during the year. PARATYPHOID FEVER One notification was received during the year. The patient, not a Borough resident was in West Middlesex Hospital at the time of diagnosis. DYSENTERY. This disease shows great variations in prevalence from year to year and from place to place. During the year 126 cases were notified, as compared with 42 in 1959. A group of 32 cases occurred in a hostel for homeless families. 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 48 notifications of pulmonary tuberculosis, and 6 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 10 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 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 - 1959 8.4 0.3 8.7 1960 3.8 0.0 3.8 A permanent mass X-ray unit has been established at West Middlesex Hospital and is open to the public without appointment. During the year 847 children were inoculated with B.C.G. vaccine as a protection against tuberculosis. OPHTHALMIA NEONATORUM. One case was notified from a hospital. PUERPERAL PYREXIA. During the year 90 cases were notified as compared with 118 cases in 1959. No woman died from puerperal or post-abortion sepsis and none of the infections were severe. MEASLES. This was not a year of measles prevalence and 30 cases were notified as compared with 1,007 in 1959. WHOOPING COUGH. There were 199 cases of whooping cough notified as compared with 46 cases in 1959. Facilities for immunisation against this disease are available, and 929 babies 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 the protection, if not complete, does mitigate the severity of the attack. MALARIA. One case of malaria was notified during the year and the patient had recently returned from Africa, INFLUENZA. Influenza caused only 2 deaths as compared with 37 deaths in 1959. 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 242. Chicken pox 277 and German Measles 6. 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, 153 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. in cases of smallpox is done at the South Middlesex Infectious Diseases Hospital, while the disinfection of homes, and bedding in other cases, is carried out by the disinfectors on the Health Department staff. During the year five lots of bedding were disinfected and 2 lots destroyed, Eleven 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 1960 was 1,270. The number of specimens sent to the laboratory is governed largely by the incidence of gastro-intestinal illnesses. 11 POOD POISONING. During 1960 notifications of the occurrence of food poisoning in 121 persons were received, but after investigation only 31 were accepted as food poisoning, In 9 cases the infecting organism was isolated. No death was associated with food poisoning. HEALTH SERVICES PROVIDED BY OTHER AUTHORITIES NORTH-WEST METROPOLITAN REGIONAL HOSPITAL BOARD. Two general hospital (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 DEPARTNENT. 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. Monday and Wednesday mornings Thursday afternoon. Busch Corner Isleworth Tuesday and Thursday afternoons New Heston Road Thursday afternoon (b) Infant Welfare Clinics 92, Bath Road, Hounslow. Tuesday Wednesday, Thursday and Friday afternoons Busch Corner, Isleworth Monday and Wednesday afternoons New Heston Road Monday, Tuesday and Wednesday afternoons Cranford (Holy Angel" s Church Hall, Bath Road) 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, air and trilene analgesia is available. Maternity outfits are supplied free for home confinements. 12 (h) Home Nursing Male and female nurses are employed as 'district' nurses. Where nursing equipment is required for use in the home, arrangements have been made for this to be supplied on loan through the British Red Cross Society at 78, Lampton Road, Hounslow. (i) Health Visitors Health Visitors who also act as School Nurses are employed in clinics and home visiting. 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 Help 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 disordered, 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. 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 disorder, the statutory supervision and guardianship of mentally disordered persons living in the community, and the provision of after-care 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) periodic 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 daily - mornings Busch Corner, Isleworth daily - mornings New Heston Road daily - mornings (ii) Medical consultation 92, Bath Road, Hounslow Friday morning Busch Corner, Isleworth Monday morning New Heston Road Friday morning 13 (iii) Eye Clinic 92 Bath Road, Hounslow Monday and Wednesday afternoons, Monday morning Busch Corner. Isleworth Thursday morning (iv) Allergy Clinic 92, Bath Road, Hounslow Friday afternoon (v) Orthopaedic Clinic 92, Bath Road, Hounslow 2nd Monday afternoon in month (vi) Physiotherapy 92, Bath Road, Hounslow Wednesday and Thursday afternoons, Thursday morning (vii) Dental Clinic (viii) Artificial Sunlight Clinic see under Health Department (ix) Immunisation Clinic (x) Child Guidance Clinic Old Town School, Hounslow, by 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.1. FAMILY PLANNING ASSOCIATION. This voluntary organisation holds sessions at 92, Bath Road, Hounslow, on Monday, Tuesday and Thursday evenings. Some 3.000 patients attended during 1960 MARRIAGE GUIDANCE COUNCIL. The Borough Council makes a contribution to the Thames Valley Marriage Guidance Council, and enquiries should be made to Mrs. M. M. Jolliffe, 25, Paradise Road, Richmond. 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 „ 14 Children's Playground, Sutton Lane 0.60 acres Kingsley Road Playing Field 0.95 „ Greenhams Lane, 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 „ 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 41 shallow and 3 artesian wells serving 37 premises and of these 1 house and 2 business premises are without an alternative supply. The following work in connection with water supplies was carried out during the year:- Draw-off taps connected to rising mains 2 Supplies provided or reinstated 14 Cisterns cleansed, repaired, etc. 5 Service pipes or taps repaired 11 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 1960:- Drains exposed for examination 80 Drains unstopped, repaired etc. 119 Waste pipes repaired, trapped, etc. 21 Soil pipes repaired, etc. 4 Ventilation shafts repaired, etc. 5 Fresh Air Inlets repaired etc. 8 Rainwater Pipes disconnected from soil drains 2 Gully traps inserted or repaired 20 Disconnecting traps inserted or repaired 20 Disconnecting and inspection chambers provided 9 Disconnecting and inspection chambers repaired, etc. 63 Drains constructed or repaired 32 Total length (ft.) of drain pipes laid - (a) 4" 392 (b) 6" 50 (c) 9" - Drain tests applied 98 Other works executed 20 Cesspools emptied or repaired 2 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 15 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 1960. 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 10 Water closets substituted for dry receptacles 2 Water closets where walls cleansed 29 Water closets fitted with new flushing apparatus 33 Water closets repaired or improved 27 New pans or pedestals provided 25 Water closets blockages unstopped 21 Other closets provided or repaired 2 Urinals constructed, rebuilt or repaired 3 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 33 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:- 1956 1957 1958 1959 1960 Paper (tons) 1,083 994 1,045 1,069 1,364 Scrap metal (tons) 73 26 31 48 27 Textiles (tons) 13 10 3 5 53 Bottles, jars (tons) 2 - - - - Batteries - - - - 43 Total income £9,414 £8,102 £8,564 £8,364 £13,268 SANITARY INSPECTION OP THE BOROUGH, In addition to the work recorded in other paragraphs of this Report, the Public Health Inspectors continued their general duties of investigating complaints, abating nuisances and dealing with contraventions of the Public Health Acts. Not all complaints brought to the Health Department deal with matters on which the Department is empowered to take action, and in such cases complainants are advised as far as is known,, how and where the matter may receive attention. Some particulars of the work done are shown below: Number of complaints received 634 Number of premises at which nuisance, etc. were located 686 Number of premises where nuisances abated or defects remedied:- (a) by owners or occupiers 337 (b) by Council in default 4 (c) public sewers repaired by Council 104 (d) public sewers cleared and cleansed by Council 155 Informal notices issued 307 Written reminders issued 302 Statutory notices served Total number of inspections and re-inspections 20,135 Inspections of piggeries 5 Inspections of stables 15 16 Inspections of urinals 20 Sinks provided or repaired 21 Roofs repaired 114 Gutters repaired or renewed 92 Brickwork, sills, etc. repaired or renewed 234 Premises provided with damp proof courses 22 Yards and forecourts paved or drained 17 External painting 15 Rooms stripped, cleansed and redecorated 170 Floors, walls and ceilings, repaired or renewed 423 Rooms in which ventilation provided or improved 31 Rooms in which lighting provided or improved 27 Windows repaired or renewed 310 Doors and other woodwork repaired or renewed 127 Staircases replaced or repaired 15 Lighting to staircases provided or improved 4 Handrails or balusters repaired or renewed 5 Grates provided or repaired 64 Washing Coppers provided or repaired 4 Instances where ventilation under floor provided or improved 19 Sites covered with impervious material 4 Food stores provided or repaired 11 Domestic cleansing enforced 4 Verminous condition abated 12 Improper keeping of animals abated 3 Offensive accumulations removed 65 Other repairs carried out or nuisances abated 142 Visits re infectious diseases, etc. 1,096 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 164 smoke observations and paid many visits to premises in regard to which complaints of smoke nuisance had been received, Eight notices were served under Section 30 of the Clean Air Act, 1956 The Council co-operates with the Department of Scientific and Industrial Research by measuring atmospheric pollution in the Borough. Two sets of apparatus have been in use since 1951, One on the roof of the Health Department in Bath Road, Hounslow, and the other on the roof of Heath House, London Road, Isleworth. A third set of apparatus was fitted on the roof of the Isleworth Telephone Exchange in October. 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. 72 10.37 2.45 1.69 10.98 1.70 February 1.89 9.34 2.28 1.93 12.40 1.28 March 1.69 15.47 2.16 1.62 13.44 2.04 April 0.51 8.01 1.19 0.55 10.78 1.10 17  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.) May 1.73 9.24 1.22 1.58 12.67 1.13 June 1.38 7.73 0.95 1.18 11.08 0.95 July 2.56 7.60 0.59 3.59 10.78 0.39 August 1.58 4.24 0.66 2.13 6.28 0.63 September 2.80 5.61 1.08 3.82 10.03 1.13 October 5.28 6.40 1.67 5.24 5.51 1.82 November 2. 17 6.09 1.88 3.59 8.11 1.49 December 1.89 7.60 2.00 2.52 8.31 1.94 Average 2. 1 8.14 1.51 2.45 10.11 1.3 Average 1955-59 1.85 9.13 1.1 1.81 9.65 1.16 For the months of October, November and December, the average results recorded on the apparatus on the roof of the Isleworth Telephone Exchange were: rainfall, 3.31 inches; deposit, 7,59 tons per sq. mile and sulphur, 1.92 milligrams SO3 per day per 100 sq. cm. The deposit gauges and lead peroxide apparatus have been in use at Heath House and the Health Department for 10 years and the average monthly results over that period are as under:- Deposit (tons per sq. mile) Sulphur (Mgms.SO3 per day per 100 sq. cm.) January 10.7 1.69 February 10.7 1.55 March 11.4 1.55 April 9.7 0.92 May 10.1 0.73 June 9.5 0.63 July 7.8 0.47 August 7.0 0.46 September 8.0 0.64 October 9.6 1.20 November 9.4 1.58 December 11.0 1.78 For both deposit and sulphur the results are lowest in the summer months when domestic solid fuel consumption is at its minimum. During the ten years the average monthly records of deposit and sulphur are given below. Deposit Sulphur 1951 12.3 0.72 1952 11.2 0.87 1953 9.1 1.13 1954 7.7 0.97 1955 8.5 0.90 1956 9.3 0 85 1957 10.1 1.10 18 Deposit Sulphur 1958 9.3 1.41 1959 9.9 1.42 1960 8.6 1.41 Variations from year to year are to be expected. The trend would appear to be towards a decrease in solids deposited and towards an increase in sulphur pollution. Smoke Control Order No. 1 came into operation on 1st October 1960 and Order No. 2 becomes operative on 1st September 1961. During the year 1,084 estimates of the cost of works of adaptation were checked and 922 claims for grant approved after inspection of the works of adaptation. TENTS VANS AND CARAVANS. There are six 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. Six other sites are occupied by single caravans. During the year the inspectors made 523 visits of inspection because of the occupation of land by caravans. Trespass by caravans on road verges and unfenced land continues especially on the western outskirts of the Borough. The vagrant type who occupy these caravans deposit domestic refuse, litter of all kinds, waste water and faecal matter in the neighbourhood of the sites occupied. Much time and effort have been given in attempts to clear them from their usual camping sites but only too often within 24 hours they are back again. Under the provisions of the Middlesex County Council Acts three applications for permission to place a caravan on a site in the Borough for a limited period were received and two were granted. Under the Caravan Sites and Control of Development Act 1960, one site licence was issued for a limited period, while applications in respect of five other sites were deferred pending the decision of the Town Planning Authority. 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 33 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 438 (b) Factories -non mechanical power 23 (c) Other premises 207 (d) Outworkers' premises 55 Defects remedied 16 At the end of the year the number of outworkers registered with the Department was 273 and the trades on which they were engaged are shown in Table X. 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, 58 rooms were treated, while 89 wasp nests were destroyed, 35 premises cleared of cockroaches 5 cleared of ants, and 5 of other insects. Treatment of ponds and tanks to prevent the breeding of mosquitoes was carried out as necessary. 19 It is pleasing to record that in the Borough bug infestations have become a rarity, and activity in this sphere is now concerned more with the extermination of other insects, notably dermestids, which are not necessarily associated with dirty conditions, 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 nuisanc 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 factor 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 complaints of nuisance from noise were received in respect of 15 premises. All but one were associated with factories or industrial 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, 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 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:- 1956 1957 1958 1959 1960 Complaints received 634 629 676 803 652 Block inspections 53 89 93 95 120 Individual inspections and re-inspections 4,162 4,441 4,631 5,183 5,516 Other Visits 561 645 720 663 693 Premises treated - (a) By occupier 14 16 18 31 26 (b) By local authority 982 1,052 1,191 1,318 1,145 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 whichhinder 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 24 inspections were made during the year. No certificate of exemption re provision of sanitary accommodation was granted, 20 RAG FLOCK AND OTHER FILLING MATERIALS ACT 1951 This Act is designed to ensure that filling materials used in upholstery, etc. comply with prescribed conditions of cleanliness. Premises using filling materials have to be registered and premises where rag flock is manufactured or stored have to be licensed. It is an offence to sell articles containing unclean materials. Certain records have to be kept on registered and licensed premises and authorised officers of a local authority have powers to enter, inspect and take samples. Under this Act five premises in the Borough have been registered and the Public Health Inspectors made 6 visits of inspection. 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' x 30' 100' x 48' 100' x 48' minor 50 x 25' - - Capacity of bath major 71,000 200,000 200,000 (gallons) minor 36,000 - - Total number of persons using swimming bath in 1960 160,464 237,886 187,780 Maximum number of persons using swimming bath on any one day 1,766 1,755 1,519 No. of private baths -male 15 - 11 female 9 - 11 No. of persons using private baths during 1960 37,368 - 23,745 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 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 Four verminous persons were cleansed under the provisions of Section 85 of the Public Health Act, 1936 During the year 55 children in attendance at schools in the Borough were found to be verminous and because of the failure of parents to take necessary action 21 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 7 premises in the Borough have been licensed and 47 visits of inspection were made during the year. INSPECTION AND SUPERVISION OF FOOD MILK. At the end of the year, there were 43 distributors registered under the Milk and Dairies Regulations, During the year 53 inspections were made at dairies and retail purveyors' premises. Under the Milk (Special Designation) Regulations, 44 licences for the sale of tuberculin tested' milk, 49 for the sale of 'pasteurised' milk, and 50 for the sale of 'sterilised milk were issued. 21 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'. Eleven samples of pasteurised milk were tested. The pasteurisation was found to be satisfactory in 9 and slightly unsatisfactory in 2, The attention of the firms concerned was drawn to these results. Two complaints were received of dirty milk bottles. In one case a warning letter was sent and in the other, proceedings resulted in an absolute discharge but costs of six guineas were awarded to the Council. 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 244, The Ic-Cream (Heat Treatment, etc.) Regulations require all ice cream except complete cold-mix powders, to be heat treated with a view to killing any pathogenic organisms which may be present and lay down the temperatures at which mixtures are to be kept before and after heat treatment - these temperatures are such as to discourage bacterial growth. The Regulations also require that ice-cream shall be protected from dirt, dust or other contamination. The enforcement of these Regulations calls for regular and persistent supervision of premises plant and methods of manufacturing and handling. During the year, 65 inspections of registered premises were carried out. The following results were obtained from the bacteriological examination of samples:- Satisfactory Doubtful Unsatisfactory Ice-Cream 34 4 12 Water Ices or 'lollies' 11 - - Milk Ices 3 - - Rinse Water 1 1 - The percentage of doubtful and unsatisfactory samples was 25.0 as compared with 3.5 in 1959 and 17.1 in 1958. All the unsatisfactory samples were associated with one producer and most were obtained during the investigation of the plant and process. Later samples were satisfactory. BAKEHOUSES. There are 18 bakehouses in the Borough and 57 visits of inspection were made during the year SLAUGHTERHOUSES. There is no public abattoir private slaughterhouse or knacker s yard operating in the Borough. During the year, in accordance with Section 3 of the Slaughterhouses Act, 1958. and the Slaughterhouse (Reports) Direction 1959, the Borough Council submitted to the Minister of Agriculture, Fisheries & Food, a report on the present and possible future requirements for slaughterhouse facilities in the Borough. The Report indicated that, after exhaustive inquiry and consultations with interested parties the Borough Council were satisfied that the provision of slaughterhouse facilities in the Borough is not necessary. The Report was accepted unconditionally by the Minister. SLAUGHTER OF ANIMALS (AMENDMENT) ACT, 1954. No application for a licence, under the provisions of the Act has been received. 22 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 75 451 Cafes Canteens Clubs etc. 213 549 Fish Shops 25 176 Greengrocers 82 129 Grocery and provision 182 346 Hotels public houses, etc, 87 26 Manufacturers packers etc 14 23 Confectioners sweets 145 73 flour 21 36 At retail premises 4 680 lbs. and 1,310 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 5; cakes, 2; chicken, 1; fish, 3; mutton 1; pork pie, 1; cheese spread, 1; meat pie, 1; steak fillets, 1; sausages, 1; smoked bacon, 1; egg and tomato roll, 1; dripping, 1; frozen peas, 2; cereal 2; tomatoes 1; grapefruit, 1; plums 1; toffe apple, 1; popcorn, 1 and portion of a school dinner 1. The complaints were not substantiated in 23 cases, 2 official warnings were issued and proceedings in the other cases resulted in fines and costs amounting to £37 14s 0d 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 108 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 28 hawkers were on the register (greengrocery 20 fish 4, icecream 4) and 29 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 22 school canteens provided 1,458,734 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 i960 has been supplied by the Public Control Department of Middlesex County Council:- Article Total Samples Procured Unsatisfactory Milk, new 111 10 Milk various 72 - Butter and Margarine 40 - Cakes 5 1 Cheese 5 - Cream 34 - Drugs 21 - Fish and Fish Products 30 1 Fruit, Fresh. Canned, etc. 18 - Ice-Cream 31 - carried forward 367 12 23 Articles Total Samples Procured Unsatisfactory brought forward 367 12 Jelly 9 - Meat, Liver and Meat Products 72 - Soft Drinks 5 - Spirits 4 - Sweets 4 - Vegetables: Fresh and Canned .. 4 - Vinegar 23 - Miscellaneous 20 1 (Bread) Total 508 13 MILK. From samples taken from a milk processing depot in your district, ten proved to be slightly deficient in butter fat and solids-not-fat. There was no evidence of added water, and the average butter fat and solids-not-fat content on whole consignments proved to be satisfactory. Subsequent sampling disclosed improved quality. CAKES. A sample of "Jam and Cream Sponge' was procured and on analysis it was found to contain imitation cream. Legal proceedings were instituted, and a fine of £2 0s 0d on each of two summonses was imposed, together with costs of five guineas, FISH. The examination of a purchase of three pieces of 'Smoked Haddock' showed that one piece was in fact 'Whiting'. A caution was issued to the Manager of the shop. BREAD. A complaint was received from an Old People's Home that a loaf of bread delivered to the Home had been pecked by birds. It was thought that the pecking took place at the bakery and an official caution was issued MERCHANDISE MARKS ACTS. 1887-1953. The majority of the inspectors' 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 of certain imported foodstuffs when exposed for sale or sold, are complied with. Inspections were made at 338 different premises and 2,019 displays, consisting of meat apples, tomatoes, poultry, butter, margarine, dried fruit, bacon salmon and lard were examined Any infringements detected were of a minor nature and were dealt with by verbal warnings. LABELLING OF FOOD ORDER, 1953. This Order requires pre packed food to be marked with the name and address, or with the registered trade mark of the packer or labeller, and 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 1,080 articles of prepacked food was examined at 216 premises to ascertain whether the above requirements were complied with Corrective active 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. FALSE OR MISLEADING DESCRIPTIONS Food advertisements and labels have con tinued to be scrutinised for false or misleading statements and descriptions Similarly County wide correction has equal effect in all Boroughs and corrective action was taken where a fruit content was suggested for sweets, oranges falsely described as seedless, and cheese spread labelled as 'Cream Cheese8. Misleading labels describing such articles as 'Butter Cream Fancies' and 'Creamed Rice' which contained imitation cream were also corrected. SPECIAL DESIGNATED MILK During 1960 my Council issued two Dealers (Pasteuriser's) Licences in respect of premises within your area where milk is produced Thirty-nine inspections were made to these premises and ninety six samples of 24 designated milk were taken One sample failed the Methylene Blue test but subsequent sampling from the same premises proved to be satisfactory, SAFE MILK In addition to the foregoing 73 samples of raw milk were procured within your Borough and submitted to test for the presence of tubercle bacilli. One sample taken in December was found to be slightly contaminated The Public Health Department for the area in which the milk was produced was notified and investigations are continuing. 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 43 premises and were remedied at 53 premises during the year Some particu lars 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 8 30 Articles/Equipment not in good order 9 27 Containers not protected from contamination 2 43 Food so placed as to involve risk of contamination 1 56 Food placed within 18' of ground and not adequately protected 1 37 Personal cleanliness not observed 2 2 Improper wrapping materials used - - Inadequate trapping of drain inlets 1 - Water Closets not kept clean and in efficient order 9 12 Insufficient lighting and ventilation to water closets - 16 Absence of "Wash your hands notice in water closets - 26 Inadequate cold water supply - - Absence of suitable and sufficient wash hand basins 2 13 Absence of hot water at a suitably controlled temperature over wash hand basins Absence of soap nail brushes, clean towels, etc. 3 16 near wash hand basins 2 18 Absence of first aid materials Absence of accommodation for clothing not worn 2 11 during working hours 3 15 Absence of suitable and sufficient sinks for the washing of food and equipment 3 9 Absence of hot water at a suitably controlled temperature over sink 2 9 Absence of soap clean cloths etc. at sink 1 3 Absence of suitable and sufficient lighting in food rooms - 5 Absence of suitable and sufficient ventilation in food rooms - 6 Walls, floons etc not kept clean 16 114 Walls floors, etc, not kept in good order 12 58 Covered receptacle for refuse not provided - 33 Accumulations of refuse, etc. 2 31 Specified foods not stored at prescribed temperature 1 14 Miscellaneous 8 17 Totals 90 621 25 HOUSING The numbers of new houses erected in the Borough in recent years is shown below 1946-56 1957 1958 1959 1960 Heston and Isleworth B.C. 1,540 178 98 12 60 Brentford and Chiswick B.C. 56 - 6 - - Southall B.C. 64 - - - - Middlesex County Council 5 - - 1 1 Ministry 0f Civil Aviation 77 - - - Metropolitan Police 29 - - Prison Commissioners 18 - - - - War Department - - - 34 - Private Enterprise - (a) new houses 656 233 168 279 140 (b) reconstructed after war destruction 185 - - - - (c) housing associations 399 30 - - - (d) additional dwellings by conversion 3 - - - - 3,032 441 272 326 201 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 as follows;- 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) 145 (b) Number of inspections made for the purpose 173 (2) (a) Number of dwelling houses (included under sub head (1) above) which were inspected and recorded under Housing Regulations 1925 and 1932 37 (b) Number of inspections made for the purpose 74 (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 24 (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 68 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 79 26 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 formal notices were served requiring repairs 8 (2) Number of dwelling houses which were rendered fit after service of formal notices (a) by Owner 5 (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 10 (2) Number of dwelling houses in which defects were remedied after service of formal notices (a) by Owner 3 (b) by Owner after Court had made a Nuisance Order - (c) by Local Authority in default of owners 1 (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 - (b) Not to use - (2) Number of dwelling houses rendered fit in con sequence of Undertakings given by Owners 1 (3) Number of dwelling houses demolished which were subject to Undertakings not to use 6 (4) Number of dwelling houses in respect of which Demolition Orders were made 2 (5) Number of dwelling houses demolished in pursuance of Demolition Orders 17 (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 1 (8) Number of Demolition Orders revoked 4 (9) Number of Closing Orders determined, the premises having been rendered fit 1 (10) Number of Closing Orders made in respect of (a) any part of a building - (b) any underground room - 27 (c) Proceedings under sections 16, 17, 18. 24, 27, 28 and 43 of the Housing Act, 1957 (Contd.) (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 purchased by Agreement 5 (b) Number of dwelling houses demolished 31 4. HOUSING ACT 1957 - OVERCROWDING: (1) (a) Number of dwellings overcrowded at the end of the year 40 (b) Number of families dwelling therein 56 (c) Number of persons dwelling therein 271 (2) Number of new cases of overcrowding reported during the year 11 (3) (a) Number of cases of overcrowding relieved during the year 3 (b) Number of persons concerned in such cases 18 (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 22 (2) Number of dwelling houses demolished following issue of certificate of unfitness 13 (3) 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 8 (b) in respect of all defects 2 Number of undertakings given by landlords to remedy defects (Form 'K') 6 Number of certificates issued 3 Number of applications by landlords to Local Authority for cancellation of certificates 2 Number of objections by tenants to cancellation of Certificates 1 Number of certificates cancelled 3 (4) At the end of the year, the following 33 houses, subject to Demolition or Closing Orders or to undertakings not to re-let till rendered fit were still unoccupied: 28 Situation Date of Demolition Order or Undertaking 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 38, Haliburton Road 29. 5.56 811, Bath Road 26.11.57 817, do. 26.11.57 1, Derby Road 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, Southa 11 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. 7.59 197 (part) Hanworth Road, Hounslow .. 29. 9.59 810, Bath Road, Cranford 26. 4.60 812, do. 26. 4.60 52, Derby Road, Hounslow 25.10.60 In addition, 13 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 £680,155 under the Housing (Financial Provisions) Act, 1958 in relation to 343 houses. (b) improvement grants of £6,205 10s 0d under section 30 of the Housing (Financial Provisions) Act, 1958 in relation to 24 houses. (c) repairs loans of £3,250 under section 43 of the Housing (Financial Provisions) Act, 1958 in relation to 19 houses. (d) repair costs of £151 10s 0d under section 9 of the Housing Act, 1957. for work in default in relation to 4 houses (e) standard grants of £5,645 under Section 4 of the House Purchase and Housing Act, 1959 in relation to 52 houses. 29 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 1960 no burial was arranged in accordance with this section. PUBLIC MORTUARY. The public mortuary situated in the grounds of Holy Trinity Church, has been demolished. The premises were out-of-date and unsuitable for postmortem examination or the retention of a body for other than a very short time. By arrangement with the Coroner, bodies are taken direct to Acton or Hampton Mortuaries. The Council pays a charge made for the use of these mortuaries. MEDICAL EXAMINATION OP STAFF. For superannuation or other purposes 145 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 Chief Public Health Inspector engaged in similar activities, particularly in those parts of the Borough affected by Smoke Control Orders. 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 Department 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 participating in this service is increasing. BLOOD TRANSFUSION SERVICE. Sessions for the collection of blood from donors were held as under:- Hounslow Isleworth 9th, 10th and 11th April 27th, 28th and 29th August 7th February 26th June 13th August 18th December 30 TABLE 1 Summary of Vital Statistics 1901 1960 Estimated Civilian population (mid- year) Birth Rate per 1, 000 popu1ation Death Rate per 1, 000 popu1ation Infant Mortality Rate Deaths under lyr.per 1,000 1ive births Neo-natal Mortality Rate Deaths under lmth.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 1901 30, 959 28.6 16.7 160 - _ _ 1.6 1902 31, 470 29.9 16.7 167 - - - 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 31.9 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 17.6 9.8 56 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 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 5.0 30 0.7 1932 81, 100 17.4 9.7 60 29 2.8 24 0.7 1933 84, 460 16.3 9.4 43 19 4.9 34 0.9 1934 87, 797 16.1 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 16.7 9.6 48 20 2.0 30 0.6 1937 99, 420 14.9 9.6 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 0.6 1944 92, 370 16.5 10.4 46 30 1.9 22 0.6 1945 95, 100 15.6 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 1966 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 106, 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 1960 105, 270 13.1 10.3 18 13 0.0 17 0.04 31 TABLE II REGISTRAR-GENERAL'S RETURN OF CAUSES OF DEATH, 1960 Abridged List No. Cause of Death Male Female Total B. 1 Tuberculosis, respiratory 3 1 4 B. 2 Tuberculosis, other - - - B. 3 Syphilitic disease 2 - 2 B. 8 Diphtheria - - - B. 9 Whooping Cough 1 - 1 B. 10 Meningococcal Infections - 1 4 B. 12 Acute Poliomyelitis - - - B. 14 Measles - - - B. 4-7, 11 15-17 Other Infective and parasitic diseases . 1 1 B 18 Malignant neoplasm, stomach 14 10 24 Malignant neoplasm, lungs 53 10 63 Malignant neoplasm, breast - 18 18 Malignant neoplasm, uterus - 18 18 Other malignant and lymphatic neoplasms 58 49 107 Leukaemia, aleukaemia 3 3 6 B. 20 Diabetes 1 1 2 B. 22 Vascular Lesions of nervous system 42 94 136 B. 26 pt Coronary disease, angina 124 78 202 B. 28 Hypertension with heart disease 11 10 21 B. 25 26 pt. 27 Other heart disease 56 72 128 B. 29 46 pt. Other circulatory disease 20 32 52 B. 30 Influenza 1 1 2 B. 31 Pneumonia 21 25 46 B. 32 Bronchitis 46 18 64 B. 46 pt. Other respiratory diseases 6 2 7 B. 33 Ulcer of stomach and duodenum 8 3 11 B. 36 43 pt. Gastritis, enteritis, diarrhoea 1 2 3 B. 38 Nephritis and nephrosis 3 3 6 B. 39 Hyperplasia of prostate - - - B. 40 Pregnancy, childbirth, abortion - - - B. 41 Congenital malformations 4 7 11 Residual Other defined and ill-defined diseases 45 57 102 B. E. 47 Motor Vehicle accidents 12 5 17 B. E. 48 All other accidents 6 10 16 B. E. 49 Suicide 8 7 15 B. E. 50 Homicide and operations of war 1 - 1 Total 549 538 1,087 32 TABLE III CAUSES OF DEATH (MALES) AT CERTAIN AGES, 1960 under 1 1-4 5- 14 16-24 25- 44 46-64 65-74 75-over Total Tuberculosis, respiratory - - - - - 3 - - 3 Tuberculosis, other - - - - - - - - - Syphilitic disease - - - - 1 - - 1 2 Diphtheria - - - - - - - - - Whooping Cough 1 - - - - - - - 1 Meningococcal Infection - - - - - - - - - Acute Poliomyelitis - - - - - - - - - Measles - - - - - - - - - Other Infective and parasitic diseases - - - - - - - - - Cancer - stomach - - - - - 6 4 4 14 lung - - - - - 32 12 9 53 breast - - - - - - - - - uterus - - - - - - - - - other - - - - 3 16 21 18 58 leukaemia - - - - - 1 1 1 3 Diabetes - - - - - - - 1 1 Cerebral Haemorrhage, etc. - - - - 2 12 11 17 42 Coronary disease, angina - - - - 3 56 32 33 124 Hypertension with heart disease 3 3 5 11 Other heart disease - - - - 1 4 16 36 56 Other circulatory disease - - - - - 4 8 8 20 Influenza - - - - - - _ 1 1 Pneumonia 2 - - - - 2 6 11 21 Bronchitis - - - - - 9 16 21 46 Other respiratory diseases - - - - - 1 2 2 5 Ulcer of Stomach and duodenum - - - - - 2 3 3 8 Gastritis, enteritis, etc. - - - - - - - 1 1 Nephritis and nephrosis - - - - - 1 1 1 3 Prostatic enlargement - - - - - - - - - Pregnancy, childbirth, abortion - - - - - - - - - Congenital malformations 2 _ - - - 2 - _ 4 Other diseases 8 - - 1 - 4 12 20 45 Motor vehicle accidents _ _ 1 2 4 1 2 2 12 All other accidents - - _ 2 1 3 6 Suicide - - - - 2 3 3 _ 8 Homicide and war operations - - - 1 - - - - 1 Total 13 - 1 4 18 163 152 198 549 Percentage of Total 2.4 0.0 0.2 .0.7 3.3 29.7 27.7 36.0 33 TABLE IV CAUSES OF DEATH (FEMALES) AT CERTAIN AGES, 1960 under 1 1-4 5- 14 15- 24 25-44 45- 64 65-74 75-over Total Tuberculosis respiratory - - - _ _ _ - 1 1 Tuberculosis, other - - - - - - - - - Syphilitic disease - - - - - - - - - Diphtheria - - - - - - - - - Whooping Cough - - - - - - - - - Meningococcal Infection 1 - - - - - - - 1 Acute Poliomyelitis - - - - - - - - - Measles - - - - - - - - - Other infective and parasitic diseases - - - - _ _ 1 _ 1 Cancer - stomach - - - - - 2 5 3 10 lung - - - - 1 6 3 - 10 breast - - - - 1 11 3 3 18 uterus - - - - - 7 6 5 18 other - - - - 3 16 8 22 49 leukaemia - - - - - 1 1 1 3 Diabetes - - - - - - - 1 1 Cerebral haemorrhage, etc. - - - - 1 13 30 50 94 Coronary disease, angina - - - - 1 11 21 45 78 Hypertension with heart disease - - - _ _ 2 3 5 10 Other heart disease - - - - 1 6 15 50 72 Other circulatory disease - - - - 1 4 6 21 32 Influenza - - - - - - - 1 1 Pneumonia - 1 - - - 8 4 12 25 Bronchitis - - - - - 4 5 9 18 Other respiratory diseases - - - - 1 - 1 - 2 Ulcer of stomach and duodenum - - - - - _ 2 1 3 Gastritis, enteritis, etc. - - - - - - 1 1 2 Nephritis and nephrosis - - - - 1 2 - - 3 Prostatic enlargement - - - - - - - - - Pregnancy, childbirth, abortion - - - - - - - _ - Congenital malformation 3 1 1 - 1 1 - - 7 Other disease 8 - 1 - 2 9 7 30 57 Motor vehicle accidents - - - 2 1 1 1 - 5 All other accidents - - - - - 3 1 6 10 Suicide - - - - 1 4 1 1 7 Homicide and war operations - — — — — — - - - Total 12 2 2 2 16 111 125 268 538 Percentage of total 2.2 0.4 0.4 0.4 3.0 20.6 23,2 49.8 34 35 TABLE V INFANTS' DEATHS ACCORDING TO AGE AM) CAUSE, I960 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 Birth Injury 2 - - - - - - - - - - - - 1 - - - - - - - 3 Pneumonia - - - - - - - - - 1 - 1 - - - - - - - - - 2 Haemolytic Disease 1 - - - - - - - - - - - - - - - - - - - - 1 Atelectasis and birth asphyxia 3 - 1 1 - - - - - - - - - - - - - - - - - 5 Congenital malformations 1 - - 1 - - - - - 1 - 2 - - - - - - - - - 5 Prematurity 3 - 2 - - - - 1 - 1 - - - - - - - - - - 7 Whooping Cough - - - - - - - - - - - 1 - - - - - - - - - 1 Meningococcal Infection - - - - - - - - - - - - - 1 - - - - - - - 1 Total 10 - 3 2 - - - - 1 2 1 4 - 2 - - - - - - - 25 36 TABLE VI INFECTIOUS DISEASES AGE DISTRIBUTION - 1960 Disease Total under 1 yr. 1 yr. 2 yrs. 3 yrs. 4 yrs. 6- 9 yrs. 10- 14 yrs. 15- 19 yrs. 20-34 yrs. 35-44 yrs. 45-64 yrs. 65 -f yrs. Age unknown Cases admitted to hospital Smallpox - - - - - - - - - - - - - - - Typhoid Fever - - - - - - - - - - - - - - - Para-Typhoid Fever 1 - - - - - - - - - - - 1 - 1 Scarlet Fever 70 2 2 5 6 6 34 13 1 1 - - - - 4 Diphtheria - - - - - - - - - - - - - - - Erysipelas 8 - - - - - - - - 1 - 4 3 - 2 Puerperal Pyrexia 90 - - - - - - 14 65 11 - - - 88 Ophthalmia Neonatorum 1 1 - - - - - - - - - - - - 1 Acute Encephalitis 1 - - - - - - 1 - - - - - - 1 Acute Poliomyelitis - - - - - - - - - - - - - - - Meningococcal Infection 1 1 - - - - - - - - - - - - 1 Pneumonia 18 - 1 - - - 3 - 1 - - 8 5 - 4 Malaria 1 - - - - - - - - - 1 - - - 1 Dysentery 126 6 7 5 5 9 34 13 5 21 3 7 - 11 19 Measles 30 2 7 6 4 2 9 - - - - - - - 1 Whooping Cough 199 11 20 20 23 22 86 15 1 1 - - - - 12 Food Poisoning 31 - 2 1 1 2 10 6 - 3 2 3 - 1 1 Tuberculosis:- Pulmonary 48 - - - - - 1 - 4 13 8 17 8 - 14 Non-Pulmonary 6 - - - - - - - - 2 1 2 1 - 3 37 NOTIFICATIONS AND DEATHS FROM CERTAIN INFECTIOUS DISEASES HESTON AMD ISLEWORTH 1941-1960 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 Case 8 Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Case 8 Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths 1941 - - 117 _ 37 3 20 _ 124 41 34 2 1 1 1 - 2 - 30 - - 2 580 - 286 1 Not Notifiable 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 1960 - — 70 - - — 8 - 18 46 1 1 1 — - - - - 1 - 126 - 30 - 199 1 2 54 4 CO 00 COUNTY COUNCIL OF MIDDLESEX CERTAIN VITAL STATISTICS FOR THE YEAR 1960 TABLE VIII District Estimated Population mid-1960 Live birth rate per 1000 population Death rate per 1000 population Specific death rates per 1000 population Infant mortality per 1000 live births Maternal mortality per 1000 total births Crude Adjusted Crude Adjusted Coronary disease,angina Cancer Infant Neo-natal (a) (a) (a) (a) (a) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Acton 64,550 16.8 16.0 10.7 10.9 2.0 (131) 2.4 (153) 24.9 (27) 18.5 (20) - (-) Brentford and Chiswick 57,070 15.8 15.0 10.4 10.4 2.0 (113) 2.1 (122) 11.1 (10) 10.0 (9) - (-) Ealing 183,390 15.0 14.6 11.2 12.0 2.0 (369) 2.4 (438) 16.0 (44) 14.5 (40) 0.36 (1) Edmonton 98,890 14.1 14.1 10.2 11.2 1.7 (161) 2.2 (202) 23.5 (31) 18.9 (25) - (-) Enfield 110,240 14.7 14.7 10.1 11.1 1.8 (201) 1.8 (203) 21.0 (34) 17.3 (28) - (- ) Feltham 52,290 17.9 17.2 7.2 11.4 1.3 (69) 1.6 (82) 18.2 (17) 12.8 (12) - (-) Finchley 68,980 15.3 14.7 10.7 9.6 2.3 (169) 2.1 (148) 13.3 (14) 10.5 (11) - (-) Friern Barnet 28,670 12.3 13.8 13.0 9.6 1.7 (48) 2.7 (77) 14.1 (5) 11.3 (4) - (-) Harrow 214,370 14.5 14.9 9.5 11.2 1.7 (358) 2.3 (493) 18.6 (58) 14.4 (46) 0.32 (1) Hayes and Harlington 69,400 16.4 15.4 7.3 11.8 1.3 (88) 1.6 (113) 21.1 (24) 17.6 (20) - (-) Hendon 151,850 12.9 12.4 10.6 11.1 2.0 (308) 2.4 (372) 21.9 (43) 16.8 (33) - (-) Heston and Isleworth 105,270 13.1 13.1 10.3 11.1 1.9 (202) 2.2 (230) 18.2 (25) 13.8 (19) - (-) Hornsey 96,570 19.6 18.4 11.5 10.2 2.5 (242) 2.5 (242) 19.0 (36) 14.2 (27) - (-) Potters Bar 23,140 17.1 15.2 8.1 11.3 1.8 (42) 1.3 (30) 20.2 (8) 15.2 (6) - (-) Ruislip and Northwood 75,470 14.3 14.3 8.1 10.1 1.6 (119) 1.7 (130) 19.5 (21) 15.8 (17) - (-) Southal1 53,150 15.4 16.0 13.2 12.1 2.9 (156) 2.2 (116) 17.1 (14) 14.7 (12) 1.21 (1) Southgate 69,880 13.5 14.7 13.3 11.0 2.9 (200) 2.7 (189) 14.8 (14) 9.5 (9) - (-) Staines 49,400 19.0 17.3 8.3 10.9 1.6 (76) 1.8 (87) 18.1 (17) 11.7 (11) 1.04 (1) Sunbury 31,600 23.6 20.8 10.5 12.2 1.4 (45) 2.2 (71) 20.1 (15) 13.4 (10) - (-) Tottenham 116,030 16.7 16.5 11.6 12.2 2.2 (255) 2.4 (276) 23.4 (45) 18.7 (36) 0.51 (1) Twickenham 103,450 13.9 14.3 11.9 11.4 2.2 (230) 2.4 (247) 13.2 (19) 12.5 (18) - (-) Oxbridge 64,620 17.2 15.5 9.2 11.6 1.8 (117) 2.0 (128) 23.4 (26) 18.0 (20) 0.88 (1) Wembley 126,120 13.1 13.2 8.9 10.2 1.8 (232) 2.3 (286) 13.3 (22) 9.1 (15) - (-) Willesden 172,430 20.9 19.4 9.7 10.8 1.9 (329) 2.2 (386) 15.0 (54) 11.1 (40) 0.27 (1) Wood Green 48,160 15.0 16.2 11.5 11.0 2.5 (118) 2.3 (113) 30.4 (22) 23.5 (17) - (-) Yiewsley and West Drayton 23,430 16.9 15.2 8.6 12.4 2.0 (47) 1.6 (37) 26.3 (10) 16.2 (6) - (-) 1 COUNTY (1960) 2,252,420 15.7 15.4 10.3 11.1 2.0 (4414) 2.2 (4971) 18.6 (655) 14.5 (510) 0.20 (7) 1 COUNTY (1959) 2,247,000 14.7 14.4 10.6 11.4 1.8 (4126) 2.2 (4939) 19.4 (640) 15.5 (513) 0.39 (13) NOTE (a) Absolute numbers are given in parenthesis in addition to rates to afford valid comparison. 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 30.02 29.00 54.0 38.0 7 0.66 9th 30.48 29.95 65.0 28.0 4 0.03 16th 30.27 29.79 45.0 25.0 5 0.12 23rd 30.09 29.20 55.0 30.0 7 0.94 30th 30.19 29.00 54.0 32.0 5 0.40 Feb 6th 30.64 29.51 62.0 29.0 5 0.24 13th 30.72 29.20 44.0 31.0 5 0.45 20th 29.66 29.13 49.0 25.0 6 0.37 27th 30.04 29.24 57.0 30.0 5 0.68 Mar. 5th 30.33 29.47 63.0 37.0 6 0.08 12th 30.13 29.16 40.0 36.0 5 0.93 19th 30.39 29.16 69.0 36.0 3 0.00 26th 30.39 29.62 57.0 35.0 - 0.00 Apr. 2nd 29.92 29.40 60.0 33.0 5 0.67 9th 29.93 29.36 64.0 43.0 6 0.24 16th 30.33 29.64 53.0 34.0 5 0.12 23rd 30.34 30.10 67.0 35.0 1 0.01 30th 30.29 30.00 63.0 35.0 5 0.06 May 7th 30.18 29.99 76.0 40.0 3 0.07 14th 29.99 29.44 75.0 58.0 4 0.72 21st 29.93 29.70 70.0 47.0 3 0.72 28th 30.31 29.75 73.0 44.0 1 0.04 June 4th 30.30 29.79 80.0 40.0 - 0.00 11th 30.05 29.61 84.0 49.0 7 0.66 18th 30.27 29.69 82.0 47.0 4 0.19 25th 30.20 29.83 81.0 62.0 4 0.38 July 2nd 30.28 29.93 80.0 47.0 2 0.00 9th 29.95 29.44 75.0 52.0 6 0.56 16th 29.93 29.40 72.0 51.0 7 1.30 23rd 30.12 29.49 72.0 40.0 6 0.82 30th 30.01 29.68 74.0 50.0 4 0.36 Aug 6th 29.97 29.80 74.0 50.0 3 0.04 13th 29.90 29.44 75.0 46.0 5 1.36 20th 29.91 29.47 71.0 46.0 4 0.10 27th 29.90 29.60 73.0 53.0 6 0.31 Sept. 3rd 29.96 29.57 71.0 49.0 7 1.78 10th 30.17 29.59 73.0 48.0 4 0.19 17th 30.12 29 16 76.0 40.0 3 0.93 24th 30.35 29.72 69.0 45.0 6 0.60 Oct. 1st 30.26 29.50 66.0 48.0 3 0.43 8th 29.72 29.14 68.0 50.0 6 1.71 16th 30.10 29.19 58.0 32.0 5 0 15 22nd 30.12 29 11 60.0 36.0 7 1.02 29th 29.63 29.18 62.0 46.0 7 1.56 Nov. 5th 29.79 28.82 64.0 38.0 7 1.74 12th 30.06 29.09 56.0 31.0 5 0.41 19th 29.83 29.32 55.0 34.0 7 0.77 26th 29.75 29 28 57.0 45.0 7 1.22 Dec. 3rd 30.02 29.13 47.0 32.0 7 0.86 10th 30.09 29.16 39.0 33.0 7 0.17 17th 30.26 29.72 45.0 31.0 6 0.02 24th 29.94 29.31 49.0 26.0 6 0.47 31st 29.80 29.23 50.0 30.0 6 0 63 39 TABLE IX (c) 1956 - 1960 Relative average frequency of wind direction Average number of calm days per annum - 70 40 TABLE IX (b) HIND DIRECTION (Sum. of Daily Records, 52 weeks) N. 29 days N.N.E. 10 days N.E. 28 days E.N.E. 10 days E. 30 days E.S.E. 8 days S.E. 19 days S.S.E. 2 days S. 16 days S.S.W. 13 days S.W. 66 days w.s.w. 24 days w. 45 days w.N.W. 6 days N.W. 12 days N.N.W. 9 days Calm 39 days 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 Inspectors. Premisea 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 33 23 - - (ii) Factories not included in (1) in which Section 7 is enforced by the Local Authority 399 438 11 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers premises) 8 207 2 - TOTAL 440 668 13 - 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 - - - - - (b) unsuitable or defective 13 13 - - - (c) not separate for sexes - 1 - - - Other offences against the Act (not including offences relating to Outwork) 1 2 1 - - TOTAL 14 16 1 - - 41 TABLE X (Continued) 3. OUTWORK - Part VIII of the Act. Nature of work Section 110 Section 111 No. of outworkers in August list required by Section 110(1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwho1e- some premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) Wearing) Making etc. , apparel) Cleaning ) and Washing 220 - - - - - Lace lace curtains and nets 2 - - - - - Curtains and furniture hangings 12 — - - - - Furniture and Upholstery 2 - - - - - Brass and brass articles 1 - - - - - Artificial flowers 1 - - - - - Carding, etc., of buttons, etc. 18 - - - - - Stuffed toys 8 - - - - - Cosaques, Christmas stockings, etc. 9 - - - - - TOTAL 273 - - - - - 42