439(1) HES 48 1 NOV 1962 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE BOROUGH OF HESTON AND ISLEWORTH for the year 1961 A. ANDERSON, M.D., D.P.H., Medical Officer of Health. INDEX Page Accidents 8 Bakehouses 23 Births, live 7 Births, still 7 Blood Transfusion Service 31 Burials 30 Canal Boats 20 Clean Air . 17 Closet Accommodation 16 Common Lodging Houses 20 Deaths 8 Deaths, Age and Sex Distribution 34 & 35 Deaths, causes of 33 Disinfection 12 Disinfestation 20 Drainage and Sewerage 15 Factories, No. on Register Inspection and Defects, etc. 41 & 42 Factories, Workplaces, etc. 20 Family Planning Association 14 Fever Hospitals 12 Food and Drugs Sampling 24 Food Hygiene 26 Food Poisoning 12 Health Committee 3 Health Education 30 Health Services' provided by Other Authorities 12 Housing 27 Ice Cream 22 Infant Deaths according to Age and Cause 36 Infant Mortality 9 Infectious Diseases 10 Infectious Diseases, Age Distribution 37 Infectious Diseases, Notifications and Deaths. 38 Laboratory Service 12 Page Laundry Service. 31 Marriage Guidance Council 14 Maternal Mortality 9 Meat and other Pood Inspection 23 Medical Examinations of Staff 30 Meteorology 39 Milk 22 Municipal Restaurants and School Canteens 24 Noise Nuisances 20 Persons in need of care and attention 30 Pet Animals Act, 1951 22 Physical Characteristics 15 Public Cleansing 16 Public Mortuary 30 Rags, etc. Exchange of Articles for 17 Rag Flock and Other Pilling Materials Act, 1951 21 Rats and Mice Destruction 20 Rivers and Streams 16 Sanitary Circumstances 15 Sanitary Inspection 16 Shops Act, 1950, Section 38 21 Slaughter of Animals (Amendment) Act, 1954 23 Slaughterhouses, etc. 23 Staff 2 Statistics, General 7 Statistics, Vital 7 Statistics Vital, Summary of 32 Swimming Baths 21 Tents, vans and Caravans 20 Tuberculosis 11 Verminous Premises, Articles and Persons 22 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, P. A. P.H. I., M.R. S.H. 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 IW. Bowles, Cert, as P H.I. and M. I. J.K. Edson, Cert. asp.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.H. G. Canton, Cert, as P.H.I, and M.I. J.A.K. Garratt, Cert as P.H.I, and M.I (from 27.3.61) Pupil Public Health inspector: D.P. Seal (from 1.9.61) Rodent Officer: A Farrer Rodent Operatives A. L. Worthington J.D. Sorrell Mortuary Attendants, Disinfectors, Drain Testers, etc. : L. Wisdom S,G. Hanson (to 25 3. 61) A L. Walker (from 15.5.61) Administrative and clerical Staff: H.L. Law, A.R.S.H., MR.I.P.H.H. (part-time) D. S. Bates, A.R.S. H. C.J. C. Mail E.J. Hutchins F R. Money Mrs. M.E. Ponsford (to 4.5.61) Mrs. L. E. 0'Gorman Mrs J.A. Morgan (from 6.2.61) Miss V.A. Honess (from 8.8.61) 2 THE HEALTH COMMITTEE of HESTON AND ISLEWORTH BOROUGH COUNCIL to May, 1961 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 Inst.M.S.M. 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 from May, 1961 Councillor Mrs M. Hennig (Chairman) Councillor F G Raybaud (Vice-chairman) Alderman R.J. Barker, J.P (Mayor) Councillor A G. Cross, C.C. Alderman F.J. Jansen, M.Inst M.S.M. Councillor R.D. Flynn Alderman Mrs A B. Tolmon Councillor F.A Foster Councillor A A. Beck Councillor G A.M. Greenland Councillor Mrs E M Boxall Councillor Mrs. M. T. Roebuck Councillor Mrs E.M. Coleman Councillor P.B. Tuley 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 1961. The birth rate is the highest recorded since 1948, but is still well below the national rate. Just over 70 per cent, of these births occurred in hospital and the pressure on maternity beds continues to be high. The proportion of illegitimate births has shown a slow but persistent rise in recent years. The still birth rate was also higher than in 1960 The death rate shows little change from year to year and continues below the national level. Two-third's of the deaths occur in persons aged 65 years and over, and the chief causes are cancer and degenerative conditions associated with age. Of 'preventable' deaths, the largest group is still accidents, and if this loss is to be reduced, increasing care and vigilance in home and factory and on the road is needed Cancer of the lung still claims its victims in increasing numbers The Average annual deaths of Borough residents from cancer at three common sites is as under:- Stomach Breast Lungs 1947 - 1951 24 18 32 1952 - 1956 26 21 44 1957 - 1961 26 20 60 These local figures show the same trend as the national figures The recent report of the Royal College of Physicians has confirmed the previous evidence of the close association between cigarette smoking and cancer of the lung and the tobacco trade has produced no evidence to refute this. The consumption of tobacco, especially cigarettes, is rising steadily and is encouraged by an ever increasing advertising campaign Advertisements suggesting that cigarette smoking is a sign of manliness and contributes to glamour seemed to be aimed specifically at the young, in the hope of attracting them to the habit. There is evidence, however, that many children start cigarette smoking before they reach the 'romantic' age. It is necessary that school children and adolescents should be reminded continually of the risk associated with cigarette smoking and every effort made to counter the effect of the present widespread advertising of cigarettes. Established smoking habits are hard to break, and everything should be done to dissuade children from starting the habit. While the smoking of cigarettes remains socially acceptable, the young will follow the example of their elders. Adults must face up to their responsibilities in this matter The infant mortality rate showed an increase over the rate prevailing in recent years. This change was due almost wholly to a rise in the number of deaths occurring under one week of age. These early deaths constitute the hard core of infant mortality and their prevention is a problem facing all concerned Apart from the high prevalence of measles, the Borough was relatively free of infectious disease during the year. The number of infectious diseases against which some protection can be offered is increasing and now includes smallpox, diphtheria, whooping cough, tetanus, poliomyelitis and tuberculosis. There are indications that measles, influenza and the common cold may yet be added. The number of parents taking advantage of these protective measures for their children is disappointing. The number 4 of children protected against smallpox diphtheria whooping cough, tetanus and poliomyelitis before they reach the age of one year varies from year to year, but on the average is less than half of the number of children born in the year. This proportion is not high enough and parents should not be lulled into a false seribe of security It is advisable that a record should be readily available of the protective inoculations etc which have been given to any person. This applies especially to tetanus where a doctor may have to decide on the action to be taken against this risk in road casualties and other wounds Similarly it is important in an emergency to know if a patient is a diabetic or is taking drugs of the steroid group certificates of immunisation are issued and diabetics and patients on steroid drugs are usually given a card to carry with them at all times Experience has shown that such certificates and cards get mislaid and that parents memories about their children's inoculations are unreliable The problem is to devise a method whereby such information would be readily available at all times Tattooing has been suggested but there are many objections to this A metal disc to be worn round the neck or on the wrist might be the solution Agreed symbols could be used to indicate the items to be recorded and so get the maximum of information without making the disc of unacceptable size Water supply and sewage disposal occupy little space in the report The ease with which water is available and waste matters disposed of, tends to make the public forget the work done and continued to make this possible To obtain an adequate supply of water to purify it and to maintain a constant vigilance over it during storage and distribution is no mean task Equally the disposal of sewage and waste water calls for high technical skill and engineering ability Does the housewife realise as she gaily adds detergent in good measure to her washing water that such action results in considerable daily expenditure at the disposal works to control foam and that because of the interference of detergents with the purification method, the works have had to be enlarged at a cost of nearly a million pounds? in using detergents enough is better than too much and makes for personal and municipal economy The Department continued to give much time and effort to work in connection with Smoke control Areas As each Smoke Control Order is made preliminary work on the next area starts and so it is hoped to maintain a steady programme till the whole of the Borough is covered The public affected by the Orders made to date have been co-operative but are confused at times by the multiplicity of names under which solid smokeless fuels are marketed These fuels are of three categories - (a) suitable for any open fire (b) suitable for approved types of open fire and (c) suitable for closed stoves and hot water boilers and customers should seek advice from the retailer of appliances or from their fuel merchant Plans of new industrial buildings have to be studied in relation to the Clean Air Act We want chimney stacks high enough to secure adequate dispersal and dilution of smoke and/or flue gases If this means a stack protruding well ahove the building objections mostly on aesthetic grounds, are sometimes made but health considerations must come first Much continues to be heard about black smoke from diesel engines It is right that effort should be made to reduce this to a minimum but it should be remembered that the petrol engine, with much of its fuel only partly combusted is a more serious health hazard than the diesel engine. Throughout the year attention was given to unfit houses ancj the general maintenance of housing standards The use made of improvement grants is disappointing There are still many houses lacking the amenities covered by the grants and their improvement would be a solid contribution to better housing conditions if these grants are to be really effective landlords must be prepared to spend money and tenants to give up a room for conversion to a bathroom and to pay the permitted increase in rent on completion of the work Improvements in lay-out design and equipment in food shops are apparent to all. They are making their contribution to food hygiene but must be reinforced by the individual action of all food handlers The failure to rinse milk bottles is a typical example of indifference to the elementary principles of food hygiene Investigations by the milk trade have shown that the worst offenders in order of incidence, in this respect are (a) schools (b) building sites and other casual consumers (c) canteens, etc. and shops and (d) housewives 5 Health education is part of the day-to-day work of a Health Department. Though talks, posters, pamphlets etc. are used, most is done by person to person education and persuasion. It is necessary to stick to what is known, to avoid distortion or disregard of the facts and to admit that there are gaps in our knowledge The continuous suggestion by commercial advertisers that their pills and potions, special foods and fancies, 'energy boosters', 'easers of nervous tension', etc are essential for healthy living must be opposed. Health is won by a way of life and not by a bottle of medicine'. Throughout the year my staff have given generously of their time and talents To the Council for their support and encouragement and to my colleagues in other Departments for their help and co-operation, I would like to record my sincere thanks I remain, Your obedient Servant, A. ANDERSON, Medical Officer of Health 6 GENERAL STATISTICS Year - 1961 Area in acres 7,261 population (Registrar-General s estimate) 102,580 Number of habitable premises (rate books). 30,921 Number of houses erected during year 79 Rateable Value of Borough £2,302,633 Sum represented by a penny rate £9,460 Live Births - male 730 Live Births - female 678 Birth rate per 1,000 population 13.7 Birth rate per 1,000 population (Rigland and wales) 17.4 Stillbirths - male . 11 Stillbirths - female 16 Stillbirths rate per 1 000 (live and still) births 18.8 Deaths - male - . . 604 Deaths - female 522 Death rate per 1,000 population 11.0 Death rate per 1,000 population (England and wales) 12.0 Infant Mortality rate 24.9 Infant Mortality rate (England and Wales) 21.4 Neo-natal Mortality rate 19.2 Perinatal Mortality rate . 26.2 Maternal Mortality rate . 0.7 Maternal Mortality rate (England and Wales) 0.34 VITAL STATISTICS POPULATION The Registrar-General s mid-year estimate of the population of the Borough for the year is 102 580 RATEABIf VALUE The Rateable value of the Borough for 1961 was £2,302,633 and the sum represented by a penny rate was £9 460 INHABITATFD HOUSES According to the rate books the number of habitable houses, flats and, shops with living accommodation at the end of the year was 30,921. LIVE BIRTHS The number of live births in 1961 was 1,408 as compared with 1 376 in I960 The birth rate was 13 7 per 1 000 population. The birth rate will vary apart from other causes according to the age and sex distribution of the population and to permit of a true comparison with other areas, the Registrar- General supplies for each local sanitary authority what is called the area comparability factor When this is applied to the Borough birth rate the result is 13.7 as compared with the birth rate of 17 4 per 1 000 population for England and Wales. The number of illegitimate births was 69 as compared with 60 in 1960. The proportion tff 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 1961 4.9 Of the total live and still births 1 027 occurred in hospital. STILLBIRTHS The number of stillbirths in 1961 was 27 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 1961 27 18. 8 DEATHS. The deaths of residents of the Borough during 1961 were 1,126 (604 male, 522 female). This represents a death rate for the Borough of 11.0 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 11.6 as compared with a death rate of 12.0 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 274 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 1961 Under 1 year 21.8 2.4 2.2 3.1 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 1.0 25 - 64 years 30.8 31. 6 28.8 28.1 65 years and over . 31.5 64. 3 67.5 67.3 The chief causes of death were heart and circulatory diseases; cancer; bronchitis and pneumonia; cerebral haemorrhage. In females 56 per cent, of deaths occurred at age 75 years and over as compared with 30 per cent in males. The Secretary of the Road Safety Committee informs me that during 1961 there were in the Borough 834 road accidents which resulted in 19 deaths, serious injury to 173 persons and slight injury to 823 persons. The number of deaths from motor vehicle and other accidents in Borough residents during the last ten years is shown below:- Year Motor Vehicle Accidents Age in years Other Accidents Age in years 0-4 5-14 15-64 65 + All ages 0-4 5-14 15-64 65 4 All ages 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 1961 - 1 10 8 19 1 1 4 7 13 Total 2 9 78 60 149 5 2 57 110 174 8 It should be noted that 40 per cent of these road deaths occurred in persons aged 65 years and over as compared with 63 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 1961 there were 35 deaths of children under the age of 1 year This represents an infant mortality rate per 1,000 live births of 24.9 as compared with 21 4 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 1961 1,408 35 25 These infant deaths can be viewed more closely by looking at the rates according to age at death - Total infant mortality rate per 1,000 live births (deaths under 1 year) 24.9 Neo-natal mortality rate per 1,000 live births (deaths under 4 weeks) 19.2 Early neo-natal mortality rate per 1,000 live births (deaths under 1 week) 17,8 These rates show the concentration of infant deaths into the early weeks of life This year 70 per cent of these deaths occurred before the baby had reached the age of one week Methods of prevention of congenital malformations, prematurity and associated conditions are still being sought The infant mortality rate of illegitimate infants was 29.0 compared with 24.9 for legitimate infants On medical grounds alone, any increase in illegitimate births is to be deplored It is thought that the same factors are probably in operation in relation to stillbirths and early infant deaths, and that it is a natter of degree or chance whether the child dies before or soon after birth This loss of infant life can be expressed collectively in what is called the perinatal mortality rate (stillbirths and deaths under 1 week combined per 1,000 total live and still births). For 1961 the Borough perinatal mortality rate was 36.2 MATERNAL MORTALITY One death was 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 9 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 - - - 1961 - 0.7 0.7 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, tuberculosis 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 varies to any great extent from year to year Persons travelling overseas may be required to produce evidence of recent vaccination against smallpox or inoculation against yellow fever cholera and typhoid fever Such certificates require to be endorsed by the Medical Officer of Health, and during the year 707 were so endorsed, INCIDENCE OF NOTIFIABLE DISEASE The number of cases notified during the year is shown in Table VI and the trend of infectious diseases during the last 20 years in Table VII SMALLPOX No case of smallpox occurred in the Borough during 1961. 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 794 children under the age of one year were vaccinated in 1961 as compared with 734 in 1960 Modern travel is such that the risk of importing smallpox is ever present SCARLET FEVER This disease was less prevalent - 29 cases notified as compared with 70 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 1961 was 482 as compared with 1,021 in 1960 ERYSIPELAS No notification of this disease was received. PNEUMONIA Notifications of pneumonia were 17 as compared with 18 in 1960. Of the total pneumonia deaths 65 per cent occurred at age 65 and over. MENINGOCOCCAL INFECTION Two cases were notified during the year. ACUTE ENCEPHALITIS. One notification was received and the patient made a good recovery Encephalitis is known to occur as a complication of other infectious diseases, and three such cases were notified during 1961 POLIOMYELITIS One case occurred during the year 10 Inoculation against poliomyelitis was continued during the year and 2,584 persons were given two injections of vaccine During the year third injections were given to 2, 047 persons TYPHOID FEVER No case of typhoid fever was notified during the year. PARATYPHOID FEVER No notification was received during the year DYSENTERY. This disease shows great variations in prevalence from year to year and from place to place. During the year only 14 cases were notified. The infection in all cases but one was of the Sonne type and the illness was mild in practically every case The source of infection in the one Flexner type case was not traced 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 46 notifications of pulmonary tuberculosis, and 9 notifications of non-pulmonary tuberculosis were received Persons continue to be certified as dying from tuberculosis who have not been notified during life, but it is hoped that with the improved facilities for diagnosis and treatment now available, any reluctance to seek investigation and treatment will disappear The trend of the Borough death rate from tuberculosis is shown below:- Tuberculosis Death Rate per 100,000 population Pulmonary Non-pulmonary Total 1930 1934 67.5 11.5 78.9 193 5 - 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 1961 10.7 0.0 10.7 A permanent mass X-ray unit has been established at west Middlesex Hospital and is open to the public without appointment During the year 804 children were inoculated with B C G vaccine as a protection against tuberculosis OPHTHAU1IA NEONATORUM No case was notified during the year PUERPERAL FYREXIA During the year 122 cases were notified as compared with 90 cases in 1960 No woman died from puerperal or post-abortion sepsis and none of the infections was severe All the cases except one arose in hospital MEASLES This was a year of measles prevalence and 1 437 cases were notified as compared with 30 in 1960 WHOOPING COUGH There were 14 cases of whooping cough notified as compared ffith 199 cases in 1960 Facilities for immunisation against this disease are available, and 407 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 overseas INFLUENZA Influenza caused 7 deaths as compared with 2 deaths in 1960 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 275. Chicken Pox 82 German Measles 24 11 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, 169 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 12 rooms and 2 lots of bedding were disinfected and 6 lots destroyed Seven 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 1961 was 352. The number of specimens sent to the laboratory is governed largely by the incidence of gastro-intestinal illnesses. FOOD POISONING During 1961 notifications of the occurrence of food poisoning in 26 persons were received, but after investigation only 8 were accepted as food poisoning In no case was the infecting organism isolated No death was associated with food poisoning During the year salmonella infection, not food borne, was found in 5 persons HEALTH SERVICES PROVIDED BY OTHER AUTHORITIES NORTH-WEST METROPOLITAN REGIONAL HOSPITAL BOARD. Two general hospitals (West Middlesex 1 150 beds and Hounslow 81 beds) and one fever hospital (South Middlesex, 140 beds) are situated in the Borough Part of the accommodation in the fever hospital is used for other cases The west Middlesex and South Middlesex Hospitals are controlled by the South West Middlesex Hospital Management Committee, while Hounslow Hospital and the chest Clinic are the responsibility of the Staines Group Hospital Management Committee The Regional Hospital Board provides the specialist services of the hospitals and for domiciliary consultations MIDDLESEX COUNTY COUNCIL - HEALTH DEPARTMENT. The County Council is the Local Health Authority under, the National Health Service Act, 1946. The following services are provided in the Borough - (a) Ante-natal and post-natal clinics Monday and Wednesday mornings 92 Bath Road Hounslow Thursday afternoon Busch Corner isleworth Tuesday and Thursday afternoons New Heston Road Thursday afternoon (b) Infant Welfare Clinics Tuesday, Wednesday, Thursday 92. Bath Road. Hounslow 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) By appointment New Heston Road ) (d) Artificial Sunlight Clinics (winter months) 92, Bath Road, Hounslow Tuesday and Friday afternoons Busch Corner Isleworth Tuesday and Friday afternoons 12 (e) Dental Clinics 92, Bath Road, Hounslow ) Monday to Friday daily and Busch Corner, Isleworth ) Saturday mornings (f) Day Nurseries, Approved accommodation Nantly House, Lampton Road 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. (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, lyingin. 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. (1) Ambulance Service Provision is made for the conveyance of sick, accident and emergency cases. Accident and emergency ambulances are stationed at the Fire Station, Isleworth and the new Ambulance Depot in Mogden Lane, isleworth The sick removal service operates from the new Ambulance Depot in Mogden Lane only (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 when required. (c) dental inspection of pupils. (d) ascertainment of handicapped pupils in need of special education. 13 (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 Pusch Corner isleworth Monday morning New Heston Road Friday morning (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 accomodation 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.I. FAMILY PLANNING ASSOCIATION This voluntary organisation holds sessions at 92, Bath Road, Hounslow, on Monday Tuesday and Thursday evenings About 3,000 patients attended during 1961. MARRIAGE GUIDANCE COUNCIL The Borough Council makes a contribution to the Thames Valley Marriage Guidance Council and enquiries should be made to Mrs. MM. Jolliffe, 25 Paradise Road,. Richmond 14 SANITARY CIRCUMSTANCES PHYSICAL CHARACTERISTICS. The Borough has an area of 7,261 acres and lies in the Thames Bailey 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 acres Church Meadow, Bath Road 9.20 acres Children's Playground, Sutton Lane 0.60 acres Kingsle.v Road Playing Field 0.95 acres Greenhams Land, London Road 14.75 acres St. John's Gardens, Isleworth 5.73 acres Riverside walk Isleworth 0.75 acres Children's Playground, Northcote Avenue 0.85 acres Playground, London Road 1.84 acres Bowling Green, Jersey Gardens 0.59 acres Isleworth Promenade 1.0 acres Heston Park 14.29 acres Lampton Park 24.20 acres Beaversfield Park 9.77 acres Inwood Park 10.25 acres Redlees Park 16.47 acres Jersey Gardens 7.87 acres Football Ground, Denbigh Road 3.70 acres Midsummer Children's Playground 1.52 acres 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 Compaav 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 - Supplies provided or reinstated 19 Cisterns cleansed, repaired, etc 4 Service pipes or taps repaired 5 Following a complaint, one sample of water was submitted to chemical and bacteriological analysis and was found to be satisfactory. DRAINAGE AND SEWERAGE The drainage and sewerage of almost the whole of the Borough is arranged on the separate system and forms part of the west Middlesex Sewage Scheme A few houses on the outskirts of the Borough drain to cesspools. The following work was carried out during 1961 - Drains exposed for examination 70 Drains unstopped, repaired, etc. 127 Waste pipes repaired, trapped, etc. 18 Soil pipes repaired, etc. 3 Ventilation shafts repaired, etc. 8 Fresh Air Inlets repaired, etc. 3 Rainwater Pipes disconnected from soil drains 3 Gully traps inserted or repaired 24 Disconnecting traps inserted or repaired 10 Disconnecting and inspection chambers provided 12 Disconnecting and inspection chambers repaired, etc. 38 Drains constructed or repaired 28 15 Total length (ft.) of drain pipes laid - (a) 4" 298 (b) 6" 4 (c) 9" Drain tests applied 73 Other works executed 13 Cesspools emptied or repaired 1 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 Extensions to the Mogden Disposal works are nearing completion. RIVERS AND STREAMS. No complaint of pollution was made to the Health Department during 1961 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 Rorough has a pail or chemical closet The following works were carried out during the year:- Water closets constructed or rebuilt 3 Water closets where walls cleansed 12 Water closets fitted with new flushing apparatus 17 Water closets repaired or improved 23 New pans or pedestals provided 21 Water closets blockages unstopped 6 Urinals constructed, rebuilt or repaired 2 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 32 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:- 1957 1958 1959 1960 1961 Paper (tons) 994 1,045 1,069 1,364 1,379 Scrap metal (tons) 26 31 48 27 13 Textiles (tons) 10 3 5 53 50 Batteries - - - 43 - Total income £8,102 £8,564 £8,364 £13,268 £11,326 SANITARY INSPECTION OF THF 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 . 754 Number of premises at which nuisance, etc. were located 542 Number of premises where nuisances abated or defects remedied:- (a) by owners or occupiers 183 (b) by Council in default 4 (c) public sewers repaired by Council 51 (d) public sewers cleared and cleansed by Council 183 16 Informal notices issued 228 Written reminders issued 234 Statutory notices served 47 Total number of inspections and re-inspections 17,684 Inspections of piggeries 13 Inspections of stables 34 Inspections of urinals 54 Sinks provided or repaired 12 Roofs repaired 78 Gutters repaired or renewed 81 Brickwork sills, etc. repaired or renewed 141 Premises provided with damp-proof courses 2 Yards and forecourts paved or drained 14 External painting 6 Rooms stripped, cleansed and redecorated 115 Floors walls and ceilings repaired or renewed 256 Rooms in which ventilation provided or improved 14 Windows repaired or renewed 160 Doors and other woodwork repaired or renewed 92 Staircases replaced or repaired 6 Handrails or balusters repaired or renewed 2 Grates provided or repaired 35 Washing coppers provided or repaired 2 Instances where ventilation under floor provided or improved 6 Food stores provided or repaired 5 Domestic cleansing enforced 2 Verminous condition abated 5 Improper keeping of animals abated 5 Offensive accumulations removed 76 Other repairs carried out or nuisances abated 75 Visits re infectious diseases, etc. 305 Pigstyes repaired 1 Complaints continue to be received of nuisance caused by pigeons. The Public Health Act, 1961 now gives a local authority power 'to take steps for the purpose of abating or mitigating any nuisance, annoyance or damage caused by the congregation in any built-up area of house doves or pigeons or of starlings or sparrows'. The seizure and destruction of any birds must be carried out humanely and any action taken must not contravene the Protection of Birds Act, 1954 Action taken at nine sites in the Borough resulted in the destruction of 204 pigeons, but while food is liberally provided by the public there is little prospect of keeping the numbers down. FXCHANGF OF ARTICLFS FOR RAGS, ETC. Under the Public Health Act, 1961, 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 116 smoke observations and paid many visits to premises in regard to which complaints of smoke nuisance had been received Six notices were served under section 30 of the Clean Air Act. 1956 The Council has co-operated with the Department of Scientific and Industrial Research since 1951 by measuring atmospheric pollution in the Borough and forwarding monthly returns The original apparatus gave monthly measurements of solid deposits and sulphur pollution The instruments were installed on the roofs of the Health Department, Heath House and the isleworth Telephone Exchange. The average monthly records of pollution given by these instruments were as follows.- Deposit (tons per sq. mile) Sulphur (Mgms. S03 per day per 100 sq. cm.) 1951 12.2 0.72 1952 11.2 0.87 17  Deposit (tons per sq. mile) Sulphur (Mgtns. S03 per day per 100 sq. cm.) 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 1958 9.3 1.41 1959 9.9 1.42 1960 8.6 1.41 1961 (Jan. to July) 6.6 1.28 These figures indicate a downward trend in particulate pollution, but no improvement in sulphur pollution. A serious defect in these records was that they refer to conditions well above street level and that monthly intervals did not facilitate detailed analysis of the factors influencing pollution. On the advice of the Department of Scientific and Industrial Research, the original instruments were changed to a new type giving daily records of smoke and sulphur dioxide. The new instruments were installed at the Health Department, Heston Clinic, isleworth Clinic and Harlequin Avenue Air from a height not exceeding 15 feet is sucked continuously into the apparatus and every 24 hours the amount of smoke and sulphur pollution is recorded. Daily readings from the new apparatus started in September and the monthly average, highest daily reading and lowest daily reading are shown in the table on page 19. No real comparison can be made with the previous records but the point to be noted is the wide range of pollution that can occur. To date the indications are that these wide variations are linked to meteorological conditions. Work continued on the Council's programme of Smoke Control Orders. Orders No. 3 and No 4 were made by the Council on 27th June and 28th November and preliminary work for Orders no 5 and no. 6 was in hand at the end of the year. Progress to 31st December 1961 on smoke control areas is shown in the following table:- Smoke Control Area No. 1 No. 2 No. 3 No. 4 Council resolution 25.11.58 7. 12.59 27.6.61 28 11.61 Ministry enquiry 7.4.59 14.4.60 Ministry confirmation 25.6.59 15. 8. 60 31.10.61 Date of operation 1. 10.60 1.10.61 1.10.62 Acres 186 130 335 200 Total dwellings 1,602 1,060 804 1,141 Council houses 418 5 682 182 Estimated number of dwellings ranking for grant 1,370 911 739 979 Number of dwellings where estimates of cost of sations or adaptations were approved for grant 1,144 454 No. of claims for grant checked and approved for payment 1,050 313 Gross cost to 31.12.61 £14,105 £5,470 Nature of works carried out - (a) new appliances 956 400 (b) adaptation of existing appliances 443 115 (c) gas or electric points provided 688 263 18 RESULTS OF DAILY VOLUMETRIC MEASUREMENTS OF ATMOSPHERIC POLLUTION Smoke (Micrograms per cub. metre): Sulphur Dioxide (Micrograms per cub. metre.) MONTH HEALTH DEPARTMENT HESTON CLINIC ISLEWORTH CLINIC HARLEQUIN AVENUE Smoke S.O.2 Smoke S.O.2 Smoke S.O.2 Smoke S. O. 2 m. a. h.d. r. l.d. r. m. a. h.d. r. l.d. r. m. a. h.d. r. l.d. r. m. a. h.d. r. l.d. r. m. a. h.d. r. l.d. r. m. a. h.d. r. l.d. r. m. a. h.d. r. l.d. r. m. a. h. d. r. l.d. r. SEPTEMBER 33 120 10 63 200 21 38 130 10 62 197 3 33 90 10 70 233 23 83 220 10 88 246 23 OCTOBER 74 200 10 110 371 17 66 180 10 85 343 14 65 180 10 115 375 36 83 210 30 116 414 40 NOVEMBER 143 410 20 234 803 62 130 350 20 175 759 31 123 300 20 207 729 74 135 340 30 202 717 54 DECEMBER 412 930 30 439 1052 109 270 690 30 283 755 40 310 750 30 411 1021 80 288 640 40 462 1144 94 m. a. - monthly average. h.d.r. - highest daily reading. l.d.r. - lowest daily reading. 19 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. Seven other sites are occupied by one or more caravans. During the year, the inspectors made 468 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 Caravan Sites and Control of Development Act, 1960, five site licences were issued for a limited period, and two licences for unlimited periods. 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 32 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 IX Inspection of (a) Factories - mechanical power 278 (b) Factories - non-mechanical power 20 (c) Other premises 26 (d) outworkers' premises 60 Defects remedied 9 At the end of the year the number of outworkers registered with the Department was 250 and the trades on which they were engaged are shown in Table ix. DISINFERTATION. 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, 50 rooms were treated, while 88 W8sp nests were destroyed, 8 premises cleared of cockroaches, 4 cleared of ants and 14 of other insects. Treatment of ponds and tanks to prevent the breeding of mosquitoes was carried out as necessary 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. NOISE NUISANCE The sources of noises which were the subject of complaint to the Department during the year were - Factories, industrial premises, etc. 8 Private woodworking machinery 2 Private wireless sets 2 Band practice 1 Barking dog 1 Domestic poultry 4 Vehicles 1 General noise of occupants of houses 2 In all cases, investigation showed some justification for the complaint. With the co-operation of the persons concerned the nuisance was remedied or abated except in one case where the remedy had to await the cessation of the work RATS AND MICE DESTRUCTION, ETC. The Prevention of Damage by Pests Act, 1949 20 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 orivate 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:- 1957 1958 1959 1960 1961 Complaints received 629 676 803 652 846 Block inspections 89 93 95 120 107 Individual inspections and re-inspect ions 4,441 4,631 5,183 5,516 5, 634 Other Visits 645 720 663 693 551 Premises treated - (a) By occupier 16 18 31 26 20 (b) By local authority 1,052 1,191 1,318 1,145 1,314 Test baiting and, where necessary, treatment is carried out to sewers, watercourses, tips, etc. Destruction of part of the rat population by chemical or other poisoning may increase the food supply and improve the chances of survival of the remainder Eradication requires environmental conditions which hinder survival, i.e no food and no shelter and occupiers of premises should bear this in mind SHOPS ACT, 1950, SECTION 38 Shops require to be reasonably ventilated, heated and lighted, end there should be suitable and sufficient sanitary and washing facilities for the persons employed therein In this connection 2 inspections were made during the year No certificate of exemption re provision of sanitary accommodation was granted RAG FLOCK AND OTHER PILLING 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, one premises in the Borough is registered and the public Health Inspectors made 2 visits of inspection SHIMMING 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 1961 177,146 235,243 197,421 Maximum number of persons using swimming bath on any one day 844 1,995 1,203 No of private baths - male 15 - 11 female 9 - 11 No of persons using private baths during 1961 35,476 - 21,646 21 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. On request, one house and its contents were treated for verminous infestation VERMINOUS PERSONS. Two verminous persons were cleansed under the provisions of Section 85 of the Public Health Act, 1936 During the year 4 children in attendance at schools in the Borough were found to be verminous and because of the failure of parents to take necessary action 2 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 8 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 38 inspections were made at dairies and retail purveyors' premises. The Milk (Special Designation) (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 complaints were received of dirty milk bottles In two cases a warning letter was sent. ICE CREAM Under the Pood and Drugs Act, premises used for the sale or the manufacture for the purpose of sale, of ice-cream, or the storage of ice-cream intended for sale must be registered. This does not apply to premises used primarily as a club, hotel, inn or restaurant and only to a theatre, cinematograph theatre, music hall or concert hall if the ice-cream is manufactured on the premises The number of premises registered at the end of the year was 254 The ice-Cream (Heat Treatment, etc.) Regulations require all ice-cream except complete cold-mix powders, to be heat treated with a view to killing any pathogenic organisms which may be present and lay down the temperatures at which mixtures are to be kept before and after heat treatment - these temperatures are such as to discourage bacterial growth. The Regulations also require that ice-cream shall be protected from dirt, dust or other contamination The enforcement of these Regulations calls for regular and persistent supervision of premises, plant and methods of manufacturing and handling. During the year, 81 inspections of registered premises were carried out. The following results were obtained from the bacteriological examination of samples:- Satisfactory Doubtful Unsatisfactory Ice-cream 55 4 6 The percentage of doubtful and unsatisfactory samples was 15.0 as compared with 17.1 in I960. All the unsatisfactory samples were associated with one producer making ice-cream at premises outside the Borough The local authority concerned took the necessary action. 22 BAKEHOUSES There are 18 bakehouses in the Borough and 61 visits of inspection were made during the year. SLAUGHTERHOUSES There is no public abattoir, private slaughterhouse or knacker's yard operating in the Borough. SLAUGHTER OF ANIMALS (AMENDMENT) ACT, 1954 No application for a licence under the provisions of the Act, has been received. INSPECTION OF MEAT AND OTHER FOODS. In addition to those mentioned elsewhere in this report, other food premises in the Borough and the number of inspections are listed below:- Number Inspections Butchers Shops 74 324 Cafes, canteens, Clubs, etc. 219 348 Fish Shops 25 172 Greengrocers 83 228 Grocery and Provision 180 337 Hotels, Public Houses, etc. 88 29 Manufacturers, Packers etc. 15 1 Confectioners, sweets 144 78 flour 21 36 A further 82 inspections were made of vehicles in which food was being conveyed, or from which food was being sold At retail premises 5 878 lbs. and 1,503 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 In connection with complaints about, or notification of the presence of unsound food, 136 special inspections were made The following foods were brought to the Department because the purchasers were not satisfied that they were fit for human consumption:- Article Number Article Number Flaked Rice 1 Pastry 1 Creamed Rice 1 Apple Pie 1 Pork Chop 1 Cream 2 Steak 1 Marmalade 1 Steak and Kidney Pie 1 Chocolate Bars 3 Mutton 1 Bread 6 Chicken 2 Chocolate Eclairs 1 Bacon 1 Crumpets 1 Pish and Chips 1 Soup 1 Dried Fruit 2 Honey 1 Tinned Peaches 1 Flour 1 Potatoes 1 Margarine 1 The complaints were not substantiated in 23 cases Two official warnings were issued and proceedings in other cases resulted in fines and costs amounting to £56 6s 0d Premises used for 'the preparation or manufacture of sausages or potted, pressed, Pickled or preserved food for sale' are required under the Pood 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 32 hawkers were on the register (greengrocery, 21; fish, 6; ice-cream, 5) and 32 inspections of their vehicles and wares were carried out. 23 MUNICIPAL RESTAURANTS AND SCHOOL CANTEENS. There is no municipal restaurant in the Borough but during the year the 23 school canteens provided 1,499,533 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 1961 has been supplied by the Public Control Department of Middlesex County council:- Article Total Samples Procured Unsatisfactory Milk, new 57 - Milk, various 66 - Butter 19 - Cakes and Bread 11 - Margarine 7 - Cream 15 - Drugs 5 - Fish and Fish Products 12 - Fruit: Fresh, Canned, etc. 42 - Ice-Cream 38 - Preserves 3 - Sausages 7 - Meat, Liver and Meat Products 36 - Soft Drinks and Fruit Juices 5 1 Spirits 19 - Sweets and Chocolate 8 - Vegetables 16 - Vinegar 29 1 Miscellaneous 16 - Total 411 2 SOFT DRINKS An imported canned vitaminised apple juice was found to be deficient in vitamin 'C' A second sample of the same product procured a short while afterwards was found to be correct and no further action was taken in respect of the original sample. NON-BREVFD CONDIMENT. A sample of non-brewed condiment purchased at a retail shop was deficient in acetic acid. The deficiency was found to be due to an error in dilution by the shop manager who had compounded the article from a strong solution of acid An official caution was sent to the seller Merchandise Marks Acts, 1887 - 1953 Inspections are carried out under the above Acts to ensure that the requirements of the various Marking Orders relating to the indication of origin of imported foodstuffs are applied, inspections were made at 333 premises and a total of 998 displays were examined. Minor breaches of the Orders were dealt with by verbal warnings. Eight more serious infringements were found and these were dealt with as indicated below A firm of butchers who sold Argentine beef as 'English' and who described as 'Loin of Lamb' a mixture of 'Best End of Neck and Loin' were prosecuted and fined £4 and were ordered to pay £4 4s Od towards the costs. A greengrocer who exposed for sale Canary Island potatoes falsely described as 'Jersey* was prosecuted and fined £2 with £2 2s Od towards the costs. Another greengrocer who labelled Cyprus grapefruit as 'jaffas' was also fined £2 with £2 2s Od costs. A letter of caution was sent to the manufacturer of a bleach who packed his product in various wine bottles which, in addition to the bleach label, bore the names of wines and the trade marks of wine merchants. 24 Letters of caution were sent to the importers of three brands of canned whole chicken The labels on the cans were false in that the weight declared was not that of the chicken but the whole contents of the can and this declaration was so framed as to mislead a prospective purchaser In each case the weight of chicken was about half of the weight of the contents of the can. Safe Milk Thirty-four samples of raw milk were procured and tested for the presence of tubercle bacilli. All were satisfactory. From the 1st January, 1961 the County Council became the Licensing Authority for the issue of licences to dealers with premises within its area and 40 such licences were issued in respect of the sale of milk to which the special designations 'Pasteurised' , 'Sterilised" and Tuberculin tested' could be applied. The period for which these licences were granted has been extended from one year to five years sixtynine samples of milk were obtained to test that heat treatment and subsequent storage were properly carried out. All were satisfactory. The County Council continue to licence those premises at which milk is processed, three being issued in respect of plants in the borough. Thirty-five inspections of premises were made to ensure proper compliance with the Milk (Special Designation) Regulations, 1960. Twenty-four samples of washed bottles were taken as a check on the efficiency of the washing plant used for cleansing milk bottles All were satisfactory. The Labelling of Food Order, 1953 The Labelling of Food Order requires prepacked food to be marked with the name and address of the packer or labeller or to bear a registered trade mark; to be marked with its common or usual name and to bear a statement of ingredients if the food consists of more than one ingredient It also controls the manner in which the presence of vitamins and minerals is disclosed. In the borough of Heston and Isleworth a total of 190 premises were visited and 1,287 items of food were examined for compliance with the Order. Three infringements were disclosed in one case the ingredients were not declared on a packet of mixed cereals and pulses; in another, the ingredients were not declared on a flavoured milk; and in the third case there was an incorrect declaration of vitamin V content in respect of a soft drink All these infringements were dealt with by letters of caution to the manufacturers. Labelling & Advertising Infringements In addition to the detail given above, a considerable volume of work was done in the period under review in respect of nationally retailed articles of food Several manufacturers were required to designate the ingredients on labels of Instant Coffee As a result of a complaint of the taste of a soft drink, investigations made in my Department showed that there was phenolic contamination which arose from a chemical reaction between chlorinated water and the phenol formaldehyde stopper The manufacturer has modified the ingredients of this product to prevent the chemical reaction. The manufacturer of a non-alcoholic wine was challenged on the ground that the description was a contradiction in terms, and the label was amended to 'non-alcoholic beverage". The importer of a slimming food was challenged on claims made in advertising literature as to the Vitamin concentration, and the literature was corrected. A manufacturer's claim of slimming properties for Deducing perles* was challenged and the product withdrawn The claim relied on the presence of purgatives and bladder- wrack 25 The slimming claims made for a lemon juice in a television advertisement were modified after the manufacturer had been challenged as to the efficiency of the product as a slimming agent " 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 pood Hygiene Regulations were found at 37 premises and were remedied at 84 premises during the year. Some particulars of the contraventions found and remedied are given below:- ]Contraventions of Food Hygiene Regulations Found Remedied Articles/Equipment not kept clean 5 15 Articles/Equipment not in good order 5 34 Containers not protected from contamination 1 40 Food so placed as to involve risk of contamination 9 45 Food placed within 18" of ground and not adequately protected 1 25 Personal cleanliness not observed 2 2 Water closets not kept clean and in efficient order 9 13 Insufficient lighting and ventilation to water closets _ 12 Absence of "wash your hands' notice in water closets - 15 Inadequate cold water supply - 1 Absence of suitable and sufficient wash-hand basins - 13 Absence of hot water at a suitably controlled temperature over wash-hand basins 4 12 Absence of soap, nail brushes, clean towels, etc near wash-hand bas ins _ 10 Absence of first aid materials 3 9 Absence of accommodation for clothing not worn during working hours 3 16 Absence of suitable and sufficient sinks for the washing of food and equipment _ 5 Absence of hot water at a suitably controlled temperature over sink 2 11 Absence of soap, clean cloths etc. at sink _ 2 Absence of suitable and sufficient lighting in food rooms _ 3 Absence of suitable and sufficient ventilation in food rooms _ 5 Walls, floors, etc not kept clean. 24 93 Walls, floors, etc not kept in good order .. 18 34 Covered receptacle for refuse not provided 2 8 Accumulations of refuse, etc. 6 13 Specified foods not stored at prescribed temperature - 3 Miscellaneous 6 12 100 451 Again the number of contraventions of the pood Hygiene Regulations remedied is greater than number of new ones found during the year. In other words previously recorded contraventions continue to be remedied by comprehensive re-conditioning and improvement of food premises. There is a continuing need for vigilance in connection with unhygienic practices and personal habits among food handlers 26 HOUSING The numbers of new houses erected in the Borough in post-war years is shown below:- 1946-57 1958 1959 1960 1961 Heston and Isleworth B.C. 1,718 98 12 60 32 Brentford and Chiswick B.C. 56 6 - - - Southall B. C. 64 - - - - Middlesex County Council 5 - 1 1 12 Ministry of Civil Aviation 77 - - - - Metropolitan Police 29 - - - - Prison Commissioners 18 - - - - War Department - - 34 - - British Waterways - - - 1 Private Enterprise - (a) new bouses 889 168 279 140 34 (b) reconstructed after war destruction 185 - - - . (c) housing association 429 - - - - (d) additional dwellings by conversion 3 - - - - 3,473 272 326 201 79 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 habitat ion. The action taken in insanitary and unfit dwelling houses during the year is summarised as follows:- 1 INSPECTION OP DWELLING-HOUSFS DURING THE YEAR: (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health and Housing Acts) .. .. .. .. .. 132 (b) Number of inspections made for the purpose .. .. 193 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under Housing Regulations, 1925 and 1932 .. 64 (b) Number of inspections made for the purpose .. 125 (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 .. .. .. .. 49 (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 habitat ion .. . .. .. .. .. ,. 65 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 .. . . .. .. .. 76 27 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 5 (2) Number of dwelling-houses which were rendered 5th after service of formal notices: (a) by Owner 2 (b) by Local Authority in default of owners 2 (b) Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which formal notices were served requiring defects to be remedied 4 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) by Owner 4 (b) by Owner after court had made a Nuisance Order (c) by Local Authority in default of owners (c) Proceedings under sections 16, 17, 18, 24, 27, 28 and 43 of the Housing Act, 1957: (1) Number of dwelling-houses in respect of which Undertakings from Owners accepted to render houses fit or not to re-let for human habitation: (a) to render fit (b) not to use (2) Number of dwelling-houses rendered fit in consequence of Undertakings given by Owners (3) Number of dwelling-houses demolished which were subject to Undertakings not to use 5 (4) Number of dwelling-houses in respect of which Demolition Orders were made (5) Number of dwelling-houses demolished in pursuance of Demolition Orders (6) Number of dwelling-houses in respect of which Closing Orders were made in lieu of Demolition orders 1 (7) Number of dwelling-houses in respect of which Closing Orders were revoked and Demolition Orders substituted (8) Number of Demolition Orders revoked (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 (11) Number of closing Orders determined in respect of any part of a building rendered fit 4 HOUSING ACT, 1957 - OVERCROWDING (1) (a) Number of dwellings overcrowded at the end of the year .. .. .. .. .. ,. 31 (b) Number of families dwelling therein .. .. .. ..52 (c) Number of persons dwelling therein .. 220 (2) Number of new cases of overcrowding reported during the year .. .. .. .. .. .. .. 10 (3) (a) Number of cases of overcrowding relieved during the year .. .. .. .. .. .. .. 18 (b) Number of persons concerned in such cases .. .. .. 97 28 (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 15 (2) Number of dwelling-houses demolished following issue of certificates of unfitness 1 (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 6 (b) in respect of all defects. 3 Number of undertakings given by landlords to remedy defects (Form 'K' ) 7 Number of certificates issued 1 Number of applications by landlords to Local Authority for cancellation of certificates 2 Number of objections by tenants to cancellation of Certificates Number of certificates cancelled 2 (4) At the end of the year, the following 26 houses, subject to Demolition or Closing Orders or to undertakings not to re-let till rendered fit were still occupied: Situation Date of Demolition Order or Undertaking 3, Park Cottages 28.12.38 4, Park Cottages 28.12.38 11, Tivoli Road 28.2.39 13, Tivoli Road 28.2.39 159 Martindale Road 25.7.50 165, Martindale Road 25.7.50 169, Martindale Road 30.9.52 10, Ivy Road 28.6.55 4 Algar Road 26.7.55 184: Linkfield Road 28.2.56 38, Haliburton Road 29.5.56 811, Bath Road 26.11.57 817, Bath Rofld 26.11.57 1, Derby Road 26.11. 57 I, Vine Place 25.3.58 3, Vine Place 25.3.58 83, Whitton Road 27.5.58 9, Hanworth Terrace 28.10.58 67 (part) Wellington Road 25.11.58 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, Bath Road, Cranford 26.4.60 2, Derby Road, Hounslow 25.4.61 In addition, 7 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. 29 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 £808,960 for house purchase under the Housing (Financial Provisions) Act, 1958 in relation to 350 houses (b) improvement grants of £4,656 under section 30 of the Housing (Financial Provisions) Act, 1958 in relation to 20 houses. (c) repairs loans of £4,475 under section 43 of the Housing (Financial Provisions) Act, 1958 in relation to 18 houses. (d) repair costs of £49 15s Od under section 9 of the Housing Act, 1957, for work in default in relation to one house. (e) standard grants of £5,910 under Section 4 of the House Purchase and Housing Act, 1959 in relation to 55 houses GENERAL MATTERS BURIALS Under Section 50 of the National Assistance Act, 1948, it is the duty of the Council to arrange the burial of any person who has died in the district, where it appears that there are no suitable arrangements for the disposal of the body During 1961 one 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 OF STAFF. For superannuation or other purposes 179 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 Departments have co-operated by displaying health educational material. PERSONS IN NEED OF CARE AND ATTENTION Section 47 of the National Assistance Act, 1948, places the responsibility on the Council of taking action to secure the necessary care and attention for persons who:- (a) are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions, and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention: Despite the growing interest of statutory and voluntary agencies in the welfare of the aged, cases come to the notice of the Department of neglected aged persons living in insanitary conditions. Such persons are usually most reluctant to accept assistance or to go to hospital or institution, but fortunately, in most cases, -- peaceful persuasion secures their co-operation in some degree and the necessary action can be taken. In no case was it necessary to seek authority to apply for an Order for compulsory removal to hospital or institution LAUNDRY SERVICF 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 SFRVICE Sessions for the collection of blood from donors were held as under:- Hounslow Isleworth 14th, 15th and 16th January 4th June 5th March 8th October 27th, 28th and 29th May 23rd July 21st, 22nd and 23rd October 31 TABLE 1 Summary of Vital Statistics 1902-1961 Estimated Civilian population (mid- year) Birth Rate per 1,000 population Death Rate per 1,000 population Infant Mortality Rate Deaths under 1 yr. per 1,000 live births Neo- natal Mortality Rate Deaths under 1mth. 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 1902 31,470 29.9 16.7 157 - - - 1.2 1903 31,531 32.8 14.2 99 - - - 1.8 1904 32,630 32.3 16.8 169 - - - 1.9 1905 33,194 31.9 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 17.5 9.8 55 26 - . 0. 9 1924 47, 700 17.7 10.8 61 27 - - 1.0 1925 48, 620 17.4 10.3 73 41 - - 0. 7 1926 52, 110 17.4 9.1 56 25 - - 0. 8 1927 55, 870 16.1 10.7 68 36 - - 1.0 1928 59,730 17.1 9.9 56 27 - - 0.6 1929 63,070 17.1 11.5 46 18 - 0.8 1930 63,070 19.1 9.6 50 25 6.4 36 0.8 1931 76,230 17.6 10.0 49 24 5.0 30 0.7 1932 81,100 17.4 9.7 60 29 2.8 24 0. 7 1933 84,460 16.3 9.4 43 19 4.9 34 0.9 1934 87,797 15.1 10.3 48 21 2.9 32 0.8 1935 90,970 15.8 9.0 41 22 4.7 36 0.6 1936 95,000 15.7 9.6 48 20 2.0 30 0.6 1937 99,420 14.9 9.5 40 20 3.3 23 0.5 1938 101,500 14.2 8.6 46 24 2.7 30 0.6 1939 101,100 15.0 8.8 50 23 3.4 26 0.7 1940 97,530 13.7 12.3 58 39 2.3 25 0.6 1941 93,990 12.9 10.3 61 32 2.4 35 0.8 1942 95,600 14.6 10.2 72 43 2.8 32 0.7 1943 95,080 16.3 10.6 47 23 0.6 26 0.5 1944 92,370 16.5 10.4 46 30 1.9 22 0.6 1945 95,100 15.5 9.7 51 33 2.0 26 0.6 1946 104,240 17.3 10.4 29 22 2.2 26 0.6 1947 106,670 17.3 10.5 39 24 0.5 24 0.6 1948 106,200 14.5 8.8 30 20 0.6 25 0.4 1949 106,900 18.6 9.8 17 12 2.0 18 0.3 1950 107,300 11.6 9.9 24 14 0.8 18 0.3 1951 106,400 11.3 10.4 18 14 0.0 20 0.3 1952 105,600 11.7 10.1 19 15 0.0 16 0.2 1953 105,100 12.1 10.1 18 11 0.8 19 0.1 1954 105,600 11.2 9.6 26 19 0.0 20 0.1 1955 105,500 11.0 10.6 24 17 0.0 17 0,1 1956 105,100 11.1 10.8 18 15 0.0 19 0.1 1957 106,100 12.3 10.3 23 17 0.0 11 0.07 1958 105,100 12.0 10.6 17 13 0.0 13 0.05 1959 105,000 12.1 10.9 17 16 0.8 14 0.07 1960 105,270 13.1 10.3 18 13 0.0 17 0.04 1961 102,580 13.7 11.0 25 19 0.7 19 0.11 32 TABLE II REGISTRAR-GENERAL'S RETURN OF CAUSES OF DEATH, 1961 Abridged List No. Cause of Death Male Female Total B. 1 Tuberculosis, respiratory 8 3 11 B. 2 Tuberculosis, other - - - B. 3 Syphilitic disease 1 1 2 B. 8 Diphtheria - - - B. 9 Whooping Cough - - - B. 10 Meningococcal Infections - - - B. 12 Acute Poliomyelitis - - - B. 14 Measles - - - B. 4-7,11 15- 17 Other Infective and parasitic diseases - 2 2 B.18 Malignant neoplasm, stomach 16 8 24 Malignant neoplasm, lungs 56 9 65 Malignant neoplasm, breast - 20 20 Malignant neoplasm, uterus - 9 9 Other malignant and lymphatic neoplasms 63 43 106 Leukaemia, aleukaemia 5 2 7 B. 20 Diabetes 1 4 5 B. 22 Vascular Lesions of nervous system 49 76 125 B. 26 pt. Coronary disease, angina 141 71 212 B. 28 Hypertension with heart disease 7 13 20 B. 25 26 pt. 27 Other heart disease 58 79 137 B. 29 46 pt. Other circulatory disease 23 29 52 B.. 30 Influenza 3 4 7 B. 3i Pneumonia 40 37 77 B. 32 Bronchitis 33 22 55 B. 46 pt. Other respiratory diseases 8 2 10 B. 33 Ulcer of stomach and duodenum 9 2 11 B. 36 43 pt. Gastritis, enteritis, diarrhœa - 3 3 B. 38 Nephritis and nephrosis 4 3 7 B. 39 Hyperplasia of prostate 4 - 4 B. 40 Pregnancy, childbirth, abortion - 1 1 B. 4i Congenital malformations 3 7 10 Residual Other defined and ill-defined diseases 42 57 99 B.E. 47 Motor Vehicle accidents 12 7 19 B.E. 48 All other accidents 8 5 13 B.E. 49 Suicide 10 3 13 B.E. so Homicide and operations of war Total 604 522 1, 126 33 TABLE III CAUSES OF DEATH (MALES) AT CERTAIN AGES, 1961 under 1 1-4 5- 14 15- 24 26-44 45-64 65-74 75- over Total Tuberculosis, respiratory - - - - - 3 2 3 8 Tuberculosis, other - - - - - - - - - Syphilitic disease - - - - - 1 - - - Diphtheria - - - - - - - - - Whooping Cough - - - - - - - - - Meningococcal Infection - - - - - - - - - Acute Poliomyelitis - - - - - - - - - Measles - - - - - - - - - Other Infective and parasitic diseases - - - - - - - - - Cancer - stomach - - - - - 3 9 4 16 lung - - - - 1 29 21 5 56 breast - - - - - - - - - uterus - - - - - - - - - other - - - 2 3 23 18 17 63 Leukaemia - - - - - 2 2 1 5 Diabetes - - - - - 1 - - 1 Cerebral Haemorrhage, etc. - - - 1 1 13 16 18 49 Coronary disease, angina - - - - 2 61 47 31 141 Hypertension with heart disease - - - - - 4 1 2 7 Other heart disease - - - 1 i 7 15 34 58 Other circulatory disease - - - - 1 5 6 11 23 Influenza - - - 1 - - 1 1 3 Pneumonia - 1 - - - 8 12 19 40 Bronchitis - - - - - 12 10 11 33 Other respiratory diseases - - - - - 2 5 1 8 Ulcer of Stomach and duodenum - - - - - 3 5 1 9 Gastritis, enteritis, etc. - - - - - - - - * Nephritis and nephrosis - - - - - 1 2 1 4 Prostatic enlargement - - - - - 1 2 1 4 Pregnancy, childbirth, abortion - - - - - - - - 3 Congenital malformations 3 - - - - - - - 3 Other diseases 14 - - 1 3 7 3 14 42 Motor vehicle accidents - - 1 1 3 2 3 2 12 All other accidents - 1 - I 3 - 2 1 8 Suicide - - - 1 3 3 3 - 10 Homicide and war operations - - - - - - - - - Total 17 2 1 9 21 191 185 178 604 Percentage of Total 2.8 0.3 0.2 1.5 3.5 31.6 30.6 29.5 34 TABLE IV CAUSES OF DEATH (FEMALES) AT CERTAIN AGES, 1961 under 1 1-4 5- 14 15- 24 25-44 45-64 65-74 75- over Total Tuberculosis, respiratory - - - - 3 - - - 3 Tuberculosis, other - - - - - - - - - Syphilitic disease - - - - - - - 1 1 Diphtheria - - - - - - - - - Whooping Cough - - - - - - - - - Meningococcal Infection - - - - - - - - - Acute Poliomyelitis - - - - - - - - - Measles - - - - - - - - - Other Infective and parasitic diseases - - . - - 1 - 1 2 Cancer - stomach - - - - 1 3 1 3 8 lung - - - - 2 4 2 1 9 breast - - - - 3 10 1 6 20 uterus - - - - - 7 1 1 9 other - - - - 2 15 15 11 43 leukaemia - - - - - 1 1 - 2 Diabetes - - - - - 1 - 3 4 Cerebral haemorrhage, etc. - - - - - 10 17 49 76 Coronary disease, angina - - - - 1 12 21 37 71 Hypertension with heart disease - - - - - 2 1 10 13 Other heart disease - - - - 1 4 12 62 79 Other circulatory disease - - - - - 2 6 21 29 Influenia - - - - - - 2 2 4 Pneumonia 5 - - - - 2 8 22 37 Bronchitis - - - - - 3 4 15 22 Other respiratory diseases - - - - - - 1 1 2 Ulcer of stomach and duodenum -- -- - - - - 1 1 2 Gastritis, enteritis, etc. - - - - - 1 1 1 3 Nephritis and nephrosis - - - - - 1 1 1 3 Prostatic enlargement - - - - - - - - - Pregnancy, childbirth, abortion - - - 1 - - - - 1 Congenital malformation 6 - - - - 1 - - 7 Other disease 7 - 2 - 1 6 5 36 57 Motor vehicle accidents - - - 1 1 2 - 3 7 All other accidents - - - - - 1 1 3 5 Suicide .. - - - - - 1 1 1 3 Homicide and war operations - - - - - - - - Total 18 - 2 2 15 90 103 292 522 Percentage of Total 3.5 0.0 0.4 0.4 2.9 17.2 19.7 55.9 35 TABLE V INFANTS DEATHS ACCORDING TO AGE AND CAUSE, 1961 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 - - 1 - - - - - - - - - - - - - - - - - - 1 Pneumonia - - - - - 1 - 1 - - 1 - 1 - - - - - - - 1 5 Hyaline Membrane Syndrome 1 1 1 2 - - - - - - - - - - - - - - - - - 5 Atelectasis and birth asphyxia .. 4 2 - 1 - - - - - - - - - - - - - - - - - 7 Congenital malformations 3 - - - - - 1 - - 1 - 1 1 1 - - - 1 - - - 9 Prematurity 1 2 - 1 - 1 - - - - - - - - - - - - - - - 5 Intrapulmonary haemorrhage 1 - - - - - - - - - - - - - - - - - - - - 1 Acute pneumonitis - - - - - - - - - - - 1 - - - - - - - - - 1 Cystic disease of pancreas - - - - - - - - - - - 1 - - - - - - - - - 1 Total 10 6 2 4 - 2 1 1 - 1 1 3 2 1 - - - 1 - - 1 36 36 INFECTIOUS DISEASES, AGE DISTRIBUTION - 1961 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 + yrs. Age unknown Cases admitted to hospital Smallpox - - - - - - - - - - - - - - - Typhoid Fever - - - - - - - - - - - - - - - Para- Typhoid - - - - - - - - - - - - - - - Scarlet Fever 29 - - 1 1 2 10 9 5 1 - - - - 2 Diphtheria - - - - - - - - - - - - - - - Erysipelas - - - - - - - - - - - - - - - Puerperal Pyrexia 122 - - - - - - 16 92 14 - - - 121 Ophthalmia Neonatorum - - - - - - - - - - - - - - - Acute Encephalitis 4 - - - - - 1 1 - 1 1 - - - 4 Acute Poliomyelitis 1 - - 1 - - - - - - - - - - 1 Meningococcal Infection 2 - - - - - - 1 1 - - - - - 2 Pneumonia 17 - - 1 - - 1 1 - 2 1 8 3 - 1 Malaria 1 - - - - - - - - 1 - - - - 1 Dysentery 14 - - 1 1 - 5 3 2 2 - - - - 4 Measles 1437 49 117 173 165 191 701 26 2 4 1 - - 8 19 Whooping Cough 14 3 1 1 2 4 2 1 - - - - - - - Food Poisoning 8 - - 1 1 - - - 4 1 1 - - - Tuberculosis:- Pulmonary 46 - - - - - - 1 1 13 6 16 9 - 10 Non-Pulmonary 9 - - - - 1 - - 1 5 1 2 - - 4 37 NOTIFICATIONS AND DEATHS FROM CERTAIN INFECTIOUS DISEASES HESTON AND ISLEWORTH 1942-1961 TABLE VI1 Year Smallpox Scarlet Fever Diphtheria Erysipelas Pneumonia Meningococcal Infection Epidemic Encephalitis Poliomyelitis and Polioencephalitis Typhoid Fever Paratyphoid Fever Dysentery Measles Whooping Cough Influenza Tuberculosis Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths 1942 – – 190 – 11 1 16 – 72 67 12 1 – – – – 4 – 1 – 2 2 1085 2 243 4 Not Notifiable 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 6 – – – – – 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 – – 236 – – – 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 7 54 4 1961 – – 29 – – – – – 17 77 2 – 4 2 1 – – – – – 14 – 1437 – 14 – 7 55 11 38 TABLE VIII(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. 7th 29.90 28.83 48.0 30.0 7 0.84 14th 30.59 29.33 50.0 28.0 4 0.34 21st 30.47 29.73 49.0 33.0 4 0.23 28th 30.10 29.27 52.0 30.0 4 0.39 Feb. 4th 29.88 29.17 53.0 34.0 7 1.06 11th 30.39 29.26 56.0 41.0 6 0.32 18th 30.57 30.02 66.0 37.0 4 - 25th 30.58 29.65 56.0 40.0 3 0.57 Mar. 4th 30.56 29.90 62.0 33.0 3 0.86 11th 30.56 30.10 65.0 34.0 - - 18th 30.30 29.86 73.0 35.0 1 0.10 25th 30.25 29.79 60.0 28.0 2 0.01 Apr. 1st 30.29 29.64 60.0 35.0 4 0.09 8th 30.06 29.33 66.0 41.0 5 0.73 15th 29.96 29.64 65.0 43.0 6 0.30 22nd 30.00 29.23 66.0 42.0 6 0.59 29th 29.89 29.28 66.0 40.0 5 0.34 May 6th 29.86 29.48 64.0 42.0 7 0.89 13th 30.44 29.84 76.0 41.0 1 - 20th 30, 25 29.83 66.0 43.0 - - 27th 30.09 29.83 66.0 36.0 1 0.03 June 3rd 30.03 29.52 73.0 38.0 2 0.15 10th 30.03 29.71 75.0 45.0 3 0.18 17th 30.01 29.44 73.0 46.0 3 0.99 24th 30.29 29.91 80.0 49.0 2 0.01 July 1st 30.27 29.64 92.0 48.0 2 0.11 8th 30.26 29.96 76.0 47.0 2 0.05 15th 29.98 29.17 77.0 49.0 5 0.84 22nd 30.13 29.60 74.0 61.0 2 0.04 29th 30.20 29.60 78.0 48.0 1 0.14 Aug. 5th 30.14 29.65 76.0 47.0 4 0.44 12th 30. 14 29.30 72.0 48.0 6 0.66 19th 30.14 29.67 74.0 48.0 6 0.29 26th 30. 15 29.68 74.0 54.0 4 0.93 Sept. 2nd 30.26 29.80 87.0 53.0 - - 9th 30.14 29.50 79.0 45.0 4 0.23 16th 30.00 29.46 78.0 50.0 7 1.34 23rd 30.15 29.77 79.0 52.0 3 0.25 30th 30.22 29.50 70.0 46.0 5 0.51 Oct. 7th 30.00 29.22 68.0 46.0 6 0.20 14th 30.36 29.37 71.0 41.0 - - 21st 30.17 29.24 69.0 42.0 5 0.34 28th 29.79 29.24 60.0 36.0 6 1.49 Nov. 4th 30.20 29.72 63.0 34.0 4 0.26 11th 30. 20 29.16 55.0 32.0 6 1.33 18th 30.13 29.60 51.0 39.0 3 0.06 25th 30.20 29.57 54.0 28.0 1 0.01 Dec. 2nd 29.85 29.14 57.0 31.0 6 0.61 9th 30.14 29.17 56.0 25.0 7 0.81 16th 30.50 29.29 59.0 30.0 4 0.58 23rd 30.66 29.79 46.0 23.0 3 - 30th 29.78 28.88 48.0 23.0 3 1.20 39 TABLE VIII(b) WIND DIRECTION (Sum. of Daily Records, 52 weeks) N 13 days N.N.E. 7 days N.E.L. 18 days E.N.E. 6 days E. 13 days E.S.E. 7 days S.E. 11 days S.S.E. 5 days S. 14 days S.S.W. 11 days S.W. 45 days W.S.W. 27 days W. 52 days W.N.W. 14 days N.W. 22 days N. N.W. 12 days Calm 82 days No record 6 days 40 TABLE IX FACTORIES ACT, 1937 to 1959. 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 39 20 – – (ii) Factories not included in (1) in which Section 7 is enforced by the Local Authority 406 278 7 – (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 8 26 – – TOTAL 453 324 7 – 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 5 8 - - - (c) not separate for sexes 2 1 - 1 - Other offences against the Act (not including offences relating to Outwork) - - - - - TOTAL 7 9 - 1 - 41 TABLE IX (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 unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) Wearing Making etc. apparel Cleaning & Washing 208 - - - - - Lace, lace curtains and nets 2 - - - - - Curtains and furniture hangings 5 - - - - - Furniture and Upholstery 4 - - - - - Brass and brass articles 1 - - - - - Artificial flowers 1 - - - - - Carding, etc. , of buttons, etc. 20 - - - - - Stuffed toys 7 - - - - - Cosaques, Christmas stockings, etc. 2 - - - - - TOTAL 250 - - - - - 42