Ac 439 (1) HES 51 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE BOROUGH OF HESTON AND ISLEWORTH for the year 1964 A. ANDERSON, M.D., D.P.H., Medical Officer of Health. INDEX Page Accidents 7 Bakehouses 22 Births, live 6 Births, still 6 Blood Transfusion Service 28 Burials 27 Canal Boats 16 Clean Air 16 Closet Accommodation 14 Common Lodging Houses 16 Deaths 7 Deaths, Age and Sex Distribution 31 & 32 Deaths, causes of 30 Disinfection 10 Disinfestation 19 Drainage and Sewerage 14 Factories, No. on Register Inspection and Defects, etc. 38 & 39 Factories Workplaces, etc. 16 Family Planning Association 13 Fever Hospitals 10 Food and Drugs Sampling 23 Food Hygiene 23 Food Poisoning 11 Health Committee 3 Health Education 28 Health Services provided by Other Authorities 11 Housing 24 Ice Cream 22 Infant Deaths according to Age and Cause 33 Infant Mortality 8 Infectious Diseases 9 Infectious Diseases, Age Distribution 34 Infectious Diseases, Notifications and Deaths 35 Laboratory Service 11 Page Laundry Service 28 Marriage Guidance Council 13 Maternal Mortality 8 Meat and Other Food Inspection 22 Medical Examinations of Staff 28 Meteorology 36 Milk 21 Municipal Restaurants and School Canteens 23 Noise Nuisances 19 Offices, Shops and Railway Premises Act, 1963. 20 Persons in need of care and attention 28 Pet Animals Act, 1951 21 Physical Characteristics 13 Public Cleansing 15 Public Mortuary 28 Rags, etc. Exchange of Articles for 16 Rag Flock and Other Filling Materials Act, 1951 21 Rats and Mice Destruction 19 Rivers and Streams 14 Sanitary Circumstances 13 Sanitary Inspection 15 Shops Act, 1950, Section 38 20 Slaughter of Animals (Amendment) Act, 1954 22 Slaughterhouses, etc. 22 Staff 2 Statistics, General 6 Statistics, Vital 6 Statistics Vital, Summary of 29 Swimming Baths 21 Tents, Vans and caravans 16 Tuberculosis 10 Verminous Premises, Articles and Persons 21 Water Supply 14 Wind Direction 37 1 STAFF Medical Officer of Health: A. Anderson, M.D. D.P.H. Deputy Medical Officer of Health E.N. Christie, M.B., Ch. B., D.P.H. Chief Public Health Inspector: K.J. Smith, F.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. W. Bowles, Cert. as P.H.I. and M I. D.G. Martin Cert as P.H.I. and M.I. F.W. Goldsmith, Cert. as P.H.I. and M.I. J.A.K. Garratt, Cert. as P.H.I.. and M.I. D.A. McLaren, Cert. as P.H.I. and M.I. M. Hall, Cert. as P.H.I. and M.I. A.G. Babbage Cert. as P.H.I. and M.I. (to 29.11.64.) G.W. Marsland, Cert. as P.H.I. and M.I. (from 16.3.64.) Rodent Officer: A. Farrer Rodent Operatives: A.L. Worthington J.D. Sorrell Disinfectors, Drain Tester, etc: L. Wisdom (to 20.3.64.) M.S. North (to 3.2.64.) P. Morgan (from 24 2.64.) T. Clark (from 20.4.64.) Administrative and Clerical Staff H.L. Law, A.R.S.H M R I.PH H. (part-time) D. S. Bates L.M. R.S.H. C.J.C. Mail E.J. Hutchins F.R. Money Mrs. J.A. Morgan Miss. V. A. Honess Miss ML. Dalston (from 17.2.64.) Mrs. L-E. O'Gorman(part-time) 2 THE HEALTH COMMITTEE o f HESTON AND ISLEWORTH BOROUGH COUNCIL to May, 1964 Councillor R.D. Flynn (Chairman). Councillor Mrs. V.G.A. Seeker J.P. (Vice-Chairman). Alderman P. J. Jansen, J. P., M. Inst. M. S. M. (Mayor) Alderman Mrs. A. B. Tolmon Alderman J.A. Pope (from 24.9 63.) Councillor H. Candeland. M.Eng. Councillor Mrs. E. M. Coleman, J. P. Councillor A. G. Cross, C. C. Councillor P. A. Foster (to 16.9 63) Councillor G.A. M. Greenland Councillor Mrs. M. Hennig Councillor F.H. P. Hobbs Councillor G. McKay Councillor D. B. Wheatley Councillor A. White. from May, 1964. Councillor R. D. Flynn (Chairman). Councillor Mrs. V.G.A. Seeker J.P. (Vice-Chairman). Alderman J. A. Pope, J. P. (Mayor) Alderman F.J. Jansen, M. Inst. M. S. M. Alderman Mrs. A. B. Tolmon Councillor W.R. Boyce Councillor H. Candeland, M.Eng. Councillor Mrs. E. M. Coleman, J. P. Councillor A. G. Cross, C. C. Councillor G.A.M. Greenland Councillor Mrs. M. Hennig Councillor F.H. P. Hobbs Councillor G. McKay Councillor A. White. 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 on the health and sanitary circumstances of the Borough of Heston and Isleworth for the year 1964. The report has been prepared on the lines suggested by the Ministry of Health and for convenience the larger statistical tables are grouped together at the end of the Report. The birth rate shows no change but continues below the national rate. The number of illegitimate births showed a further rise but the still-birth rate was the lowest in the Borough records. The death rate was a little lower than in the previous year but the principal causes of death were unchanged There were nine fewer deaths from cancer of the lungs but variations from year to year are to be expected. While a reduction in any year is welcome it is the trend over a period of years which gives the truer picture. Deaths from tuberculosis were the lowest on record and all were in persons aged 65 years and over - a marked change from the earlier part of the century. The low infant mortality rate of last year was not maintained. Most of the deaths occurred in the first few weeks of life and this hard core of infant deaths remains a challenge to all concerned. Apart from some increase in Scarlet fever, the Borough was comparatively free of infectious diseases during the year. It should be noted that more than half of the new cases of tuberculosis notified were in persons aged 45 years and over. Contrary to the position years ago, persons in the second half of life rather than adolescents and young adults are those who may be etransmitting infection. Chronic cough in this older group should not be dismissed as due to smoking or bronchitis, and the possibility of tuberculosis should always be considered. It continues to be a matter of regret that the proportion of children whose parents present them for protection against infectious diseases is too low. The picture of parents yelling for 'someone' to do 'something' should an outbreak arise is always in the mind of the Department. The rainfall during the year was low - 21.0 inches compared with an average of 24.46 inches in the previous five years. While a low rainfall may be welcome from some points of view it should be remembered that rain is the source of our water supply and that a dry year may be followed by restrictions in the use of water. Steady progress has been maintained in the implementation of the Clean Air Act and nine Smoke Control Orders are now in operation. The widening of the range of approved appliances has provided more alternatives to the open fire. The availability of smokeless fuels for open fires is in some doubt and people are encouraged to install other appliances. Such appliances are more costly than open fires, and in future Smoke Control Orders the expenditure on grants may be higher. Attention to unfit houses continued throughout the year. Many houses, previously owned for investment purposes and let to tenants, have in recent years become owner occupied. Considerable effort and enterprise has been shown by the new owners, in minor repair, improvement and decoration which may temporarily hide the more serious structural faults but does little to extend the remaining useful life of such dwellings. As yet houses in multiple occupation are not a serious problem in the Borough, Constant watch is kept for this type of premises and, where necessary, action taken to secure that the amenities available are adequate for the number of persons in the house. In this type of house the occupants tend to change frequently and repeated visits, often outside usual working hours, may be necessary. 4 Progress continues to be made in the design and equipment of food shops and premises. The number of individual cases or outbreaks of food poisoning notified varies from year to year but one is constantly hearing of families or groups suffering from diarrhoea and vomiting. When such information reaches the Department it is usually too late for bacteriological investigation to be of any value, but it is difficult to avoid the conclusion that many of these illnesses are due to food poisoning. Improvements in shops, kitchens, stores etc. are not enough and must be supplemented by high standards of food and personal hygiene by all who handle food. Complaints of the fouling of footpaths and grass verges by dogs show no reduction. Admittedly dogs need exercise, but one suspects only too often that dogs are taken out to avoid fouling the owners' gardens. Litter, on the streets and every unfenced open space, is still plentiful and the temporary improvement following the passing of the Litter Act seems to be falling off. Cigarette packets, sweet and food wrappings, etc. may be discarded thoughtlessly, but wornout furniture, mattresses, water tanks, etc. are deposited wilfully. The Council has provided many litter bins, but such expenditure can only be effective if it is supported wholeheartedly by the public. Bulky items present a special problem and the Council may have to consider providing facilities for their removal. The Offices, Shops and Railway Premises Act, 1963 became largely operative during the year. The Public Health Inspectors have had to make themselves familiar with the many Orders, Regulations and Circulars issued to date and a start has been made on the general inspection of registered premises. These initial inspections have to cover many aspects of health and welfare and cannot be hurried. If they are to be done without detriment to the other duties of the inspectors, I anticipate it will take some three to five years to complete them, especially as there is ground for suspicion that all eligible premises have not been registered. The Borough has had a particularly troublesome year with itinerant caravan dwellers on the western fringe. The number of caravans has increased and the occupants seem to be largely engaged in collecting scrap metal. Any road verge or open space on which they settle is soon covered with discarded metal and rubbish of all sorts, and the sanitary conditions are never satisfactory. The occupants of the caravans are far from susceptible to advice or suggestion and on occasion very firm measures have had to be taken to secure the removal of the caravans. Much thought has been given to this problem, but no solution is to hand. In my Report for 1963 I made some observations on work done in the Borough by Middlesex County Council acting as Local Health Authority, but here I have confined myself to matters dealt with by the Borough Council acting as Local Sanitary Authority. Both of these duties and responsibilities now rest with the Borough of Hounslow. It is hoped that the foundations laid by the predecessors of the new Borough will enable an enlightened and comprehensive local health service to grow and develop. To my colleagues in other Departments for their co-operation, to the Council for its support and encouragement and to the staff for their loyal service I would like to express my sincere thanks. I remain, Your obedient Servant, A. ANDERSON, Medical Officer of Health. 5 GENERAL STATISTICS Year - 1964 Area in acres 7,261 Population (Registrar-General's estimate) 100,910 Number of habitable premises (rate books) 31,467 Number of houses erected during year 438 Rateable value of Borough £6,923,378 Sum represented by a penny rate £28,460 Live Births - male 773 Live Births - female 704 Birth rate per 1,000 population 14.6 Birth rate per 1.000 population (England and Wales) 18.4 Stillbirths - male 5 Stillbirths - female 8 Stillbirths rate per 1,000 (live and still) births 8.7 Deaths - male 616 Deaths - female 494 Death rate per 1,000 population 11.0 Djeath rate per 1,000 population (England and Wales) 11,3 Infant Mortality rate 19.0 Infant Mortality rate (England and Wales) 20,0 Neo-natal Mortality rate 16.2 Perinatal Mortality rate 22.1 Maternal Mortality rate 0.0 VITAL STATISTICS. POPULATION. The Registrar-General's mid-year estimate of the population of the Borough for the year is 100,910. RATEABIE VALUE. The Rateable Value of the Borough for 1964 was £6,923,378 and the sum represented by a penny rate was £28,460. INHABITATED HOUSES. According to the rate books the number of habitable houses, flats and shops with living accommodation at the end of the year was 31,467. LIVE BIRTHS. The number of live births in 1964 was 1,477 as compared with 1,487 in 1963. The birth rate was 14 6 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:w,ith 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 14.9 as compared with the birth rate of 18.4 per 1,000 population for England and Wales. The number of illegitimate births was 107 as compared with 104 in 1963. The proportion of live births which were illegitimate, expressed as a percentage of the total live births, is shown below for recent years:- 1925 - 29 3 9 1955 - 59 3.8 1930 - 34 3.2 1960 4.4 1935 - 39 2.9 1961 4.9 1940-44 4.6 1962 6.3 19145 - 49 5.1 1963 7.0 1950 - 54 4.0 1964 7.2 Of the total live and still births, 70% occurred in hospital. STILLBIRTHS. The number of stillbirths in 1964 was 13. The proportion of still-births per 1 000 total (live and still) births in recent years is shown below:- 6  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 1962 23 16.0 1963 21 13.9 1964 13 8.7 This still-birth rate is the lowest in the Borough records. DEATHS. The deaths of residents of the Borough during 1964 were 1,110 (616 male, 494 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 11.1 as compared with a death rate of 11.3 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 Corpner in 283 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 1964 Under 1 year 21.8 2.4 2.2 2.5 1-4 years 8.4 0.5 0.3 0.3 5-14 years 3.8 0.5 0.4 0.8 15 - 24 years 3. 7 0.8 0.8 0.4 25 - 64 years 30.8 31.6 28.8 26.8 65 years and over 31.5 64.3 67.5 69.2 The chief causes of death were heart and circulatory diseases; cancer; bronchitis and pneumonia; cerebral haemorrhage. In females 52 per cent. of deaths occurred at 75 years and over as compared with 32 per cent. in males. The number of deaths from motor vehicle and other accidents in Borough residents during the last ten years is shown below:- Motor Vehicle Accidents Age in years Other Accidents Age in years Year 0-4 5-14 15-64 65 + All ages 0-4 5-14 15-64 65 All +ages 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 1962 1 - 6 3 10 - 2 10 11 23 1963 - 1 10 4 15 1 - 9 13 23 1964 - 2 6 6 14 - 1 4 8 13 Total 3 10 79 55 147 5 5 63 102 175 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. 7 INFANT MORTALITY. During 1964 there were 28 deaths of children under the age of 1 year. This represents an infant mortality rate per 1,000 live births of 19. 0 as compared with 20.0 for England and Wales. The causes of infant deaths are shown in Table V. In the following table, the change in the local infant mortality rate over 5 year periods from 1898 is shown:- No. of live births. No. of deaths under 1 year. Infant Mortality rate. 1898 - 1902 4,369 698 160 1903 - 1907 5,264 665 126 1908 - 1912 5,383 590 110 1913 - 1917 4,661 461 99 1918 - 1922 4,326 327 76 1923 - 1927 4,333 271 63 1928 - 1932 6,055 318 53 1933 - 1937 7,121 313 44 1938 - 1942 6,912 393 57 1943 - 1947 8,210 345 42 1948 - 1952 6,680 146 22 1953 - 1957 6,157 134 22 1958 - 1962 6,740 131 18 1963 1,487 17 11 1964 1,477 28 20 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) 20.0 Neo-natal mortality rate per 1,000 live births (deaths under 4 weeks) 16.2 Early neo-natal mortality rate per 1,000 live births (deaths under 1 week) 13.5 In other words 86 per cent of these deaths occurred before the babies reached the age of four weeks. It is thought that the same factors are probably in operation in relation to stillbirths and early infant deaths and that it is a matter 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 1964 the Borough perinatal mortality rate was 22.1 as compared with 19.1 in 1963. MATERNAL MORTALITY. No 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 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 1962 - - - 1963 - - - 1964 - 8 INFECTIOUS DISEASE. Notification to the Medical Officer of Health is the essential preliminary to control of infectious disease. The diseases required by statute to be notified are smallpox, cholera, diptherra, roembrapous 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, 1,225 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 1964. 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, 733 children under the age of two years were vaccinated in 1964. Modern travel is such that the risk of importing smallpox is ever present. SCARLET FEVER. This disease was more prevalent - 52 cases notified as compared with 13 in the previous year. This disease continued to be mild in character. DIPHTHERIA. The Borough's freedom from diptheria was maintained during the year. The number of children under the age of one year who were immunised during 1964 was 450 as compared with 469 in 1963. ERYSIPELAS. Nine notifications of this disease were received and one patient died. PNEUMONIA. Notifications of pneumonia were 11 as compared with 18 in 1963. Of the total pneumonia deaths, 80 per cent occurred at age 65 and over. MENINGOCOCCAL INFECTION. One case was notified during the year. ACUTE ENCEPHALITIS. Three notifications were received during the year. POLIOMYELITIS. No case was notified during the year. Inoculation against poliomyelitis was continued during the year. Three doses of oral vaccine were given to 1,365 persons, one dose following two injections to 6 persons, 2 injections to 34 persons and third injection to 31 persons. TYPHOID FEVER. No case of typhoid fever was notified during the year. PARATYPHOID FEVER. One notification was received during the year and the infection appeared to have been contracted ahfoad. DYSENTERY. This disease shows great variations in prevalence from year to year and from place to place. During the year 9 cases were notified. The infection in all cases was of the Sonne type and the illness was mild in practically every case. The mildness of the illness is such that medical advice is not always sought, and unless the disease is kept constantly in mind, cases are likely to be missed. 9 TUBERCULOSIS. During the year 37 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 79.0 1935 - 1939 62.3 8.2 70.5 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 1962 3.9 1. 0 4.9 1963 6.8 0.1 6.9 1964 2.0 1.0 3.0 This is the lowest tuberculosis death rate in the Borough records. A permanent mass X-ray unit has been established at West Middlesex Hospital and is open to the public without appointment. During the year 626 children were inoculated with B. C. G. vaccine as a protection against tuberculosis. OPHTHALMIA NEONATORUM. No case was notified during the year. PUERPERAL PYREXIA, During the year 87 cases were notified as compared with 127 cases in 1963. No woman died from puerperal or post-abortion sepsis and none of the infections was severe. All the cases occurred in hospital. MEASLES. This was not a year of measles prevalence and 331 cases were notified as compared with 886 in 1963. WHOOPING COUGH. There were 52 cases of whooping cough notified as compared with 59 cases in 1963. Facilities for immunisation against this disease are available, and 383 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. Two cases of malaria were notified during the year arid the patients had recently returned from overseas. INFLUENZA. Influenza caused no death as compared with 4 deaths in 1963. MUMPS, CHICKENPOX, 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 195, Chickenpox 263, and German Measles 12. TETANUS. Protection is provided against this disease and during the year 445 babies were imnunised. 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, 147 patients from the Borough were admitted to these hospitals. Clase 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 11 rooms and 4 lots of bedding were disinfected and 5 lots destroyed, Seven lots of clothing were disinfected before being sent abroad. 10 LABORATORY. Most of the bacteriological work is done in the laboratory of the National Public Health Laboratory Service. The 'number of specimens examined during 1964 was 277. The number of specimens Sent to the laboratory is governed largely by the incidence of gastro-intestinal illnesses. POOD POISONING. During 1964 notifications of the occurrence of food poisoning in 10 persons were received, but after investigation only 8 were accepted as food poisoning. In two cases the infecting organisms were isolated. No death was associated with food poisoning. During the year salmonella infection, not food borne, was found in 2 persons. In October notice was received of an outbreak of suspected food poisoning at a local factory. Investigation showed that 61 persons had been affected and that the organism concerned was Clostridium welchii. The evidence pointed to stewed beef as the vehicle of infection. 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 morning and Thursday 92 Bath Road, Hounslow. afternoon Busch Corner, Isleworth Tuesday afternoon 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 afternoon Busch Corner, Isleworth Tuesday and Friday afternoon (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. 11 (g) Midwifery Service Certified midwives are employed for attendance at domiciliary confinements. Gas and 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, lying in and 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 amergency ambulances are stationed at the Fire Station Isleworth and the Ambulance Depot in Mogden Lane, Isleworth. The sick removal service operates from the Ambulance Depot in Mogden Lane only. (m) Mental Health This service provides for the ascertainment of cases of mental ill-health 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. (n) Chiropody Sessions are held at the Hounslow and Isleworth clinics and domiciliary visits arranged as necessary. The County Council makes a contribution to chiropody services provided for the aged by voluntary organisations. 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. 12 (d) ascertainment of handicapped pupils in need of special education. (e) treatment clinics as under:- (i) Minor ailments 92, Bath Road, Hounslow Monday to Friday mornings Busch Corner, Isleworth Monday to Friday mornings New Heston Road Monday to Friday mornings (ii) Medical consultation 92, Bath Road, Hounslow Friday morning Busch 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 noons; Thursday morning (vii) Dental Clinic (viii) Artificial Sunlight Clinic (ix) Immunisation Clinic see under Health Department (x) Child Guidance Clinic Old Town School, Hounslow, by appointment. (xi) Speech Therapy by appointment. MIDDLESEX COUNTY COUNCIL - WELFARE DEPARTMENT. This service is concerned with the welfare of aged, physically and mentally infirm, blind and partially sighted, deaf and dumb, epileptic and crippled persons and the provision of temporary accommodation for persons in urgent need thereof. 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. MIDDLESEX EXECUTIVE COUNCIL. This body is responsible for the provision under the National Health Service Act, of the general practitioner, dental (other than Local Health Authority provision for expectant and nursing mothers, young children and school children) pharmaceutical and supplementary ophthalmic services. The headquarters of the Council is at North West House, 119, Marylebone Road, N.W.1. FAMILY PLANNING ASSOCIATION - This voluntary organisation holds sessions at 92, Bath Road, Hounslow, on Monday, Tuesday and Thursday evenings. Just over 6,000 patients attended during 1964. MARRIAGE GUIDANCE COUNCIL. The Borough Council makes a contribution to the Thames Valley Marriage Guidance Council, and enquiries should be made to Mrs. M. M. Jolliffe, 25, Paradise Road, Richmond. SANITARY CIRCUMSTANCES. PHYSICAL CHARACTERISTICS. The Borough has an area of 7,261 acres and lies in the Thames Valley on the North bank of the river. From the river, the land rises slowly until at North Hyde it is about 100 feet above sea level. The sub-soil consists of 'drift gravels' and lying on them in placese are patches of clay. 13 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 Kingsley 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 1.00 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 Company. There are in the Borough 41 shallow and 3 artesian wells serving 37 premises. The following work in connection with water supplies was carried out during the year:- Supplies provided or reinstated 19 Cisterns cleansed, repaired, etc. 3 Service pipes or taps repaired 7 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 1964:- Drains exposed for examination 359 Drains unstopped, repaired etc. 208 Waste Pipes repaired trapped, etc. 11 Soil pipes repaired, etc. 2 Fresh Air Inlets repaired, etc. 2 Gully traps inserted or repaired 7 Disconnecting traps inserted or repaired 4 Disconnecting and inspection chambers provided 3 Disconnecting and inspection chambers repaired, etc. 24 Drains constructed or repaired 12 Total length (ft.) of drain pipes laid - (a) 4" 149 (b) 6" - Drain tests applied 64 Other works executed 7 While the Borough is responsible for the local sewerage of its own district the duty of the disposal of sewage is the responsibility of the Middlesex County Council, whose West Middlesex Drainage Undertaking has been in full operation since 1936. During the second half of the year an offensive smell from the works was very prevalent in a considerable area around the works. The long period of dry hot weather was undoubtedly a contributory factor. By the end of the year, the position had greatly improved and it is to be hoped that the measures taken at the works will prevent a recurrence. RIVERS AND STREAMS No complaint of pollution was made to the Health Department during 1964. CLOSET ACCOMMODATION. The closet accommodation of the Borough consists almost wholly of water closets connected to the sewers. A few water closets drain to cesspools, and the odd house on the outskirts of the Borough has a pail or chemical closet. The following works were carried out during the year:- 14 Water closets where walls cleansed 9 Water closets fitted with new flushing apparatus 11 Water closets repaired or improved 14 New pans or pedestals provided 11 Water closets blockages unstopped 5 Urinals constructed, rebuilt or repaired 2 Ventilated lobbies provided 3 Cesspool cleansed 1 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, 7 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:- 1960 1961 1962 1963 1964 Paper (tons) 1, 364 1,379 1,101 1,119 933 Scrap metal (tons) 27 13 7 14 5 Textiles (tons) 53 50 43 39 42 Batteries 43 - - - - Total income £13,268 £11,326 £9,410 £9,311 £9,000 SANITARY INSPECTION OP THE BOROUGH. In addition to the work recorded in other paragraphs of this Report, the Public Health Inspectors continued their general duties of investigating complaints, abating nuisances and dealing with contraventions of the Public Health Acts. Not all complaints brought to the Health Department deal with matters on which the Department is empowered to take action, and in such cases complainants are advised as far as is known, how and where the matter may receive attention. Some particulars of the work done are shown below:- Number of complaints received 803 Number of premises at which nuisance etc. were located 823 Number of premises where nuisances abated or defects remedied:- (a) by owners or occupiers 206 (b) by Council in default - (c) public sewers repaired by Council 68 (d) public sewers cleared and cleansed by Council 311 Informal notices issued 175 Written reminders issued 186 Statutory notices served 100 Total number of inspections and re-inspections 20,673 Inspections of urinals 10 Premises licensed for public entertainment 41 Visits re infectious diseases, etc. 333 Sinks provided or repaired 11 Roofs repaired 61 Gutters repaired or renewed 40 Brickwork, sills, etc. repaired or renewed 53 Premises provided with damp-proof courses 4 Yards and forecourts paved or drained 6 External painting 22 Rooms, stripped, cleansed and redecorated 46 Floors, walls and ceilings repaired or renewed 103 Windows repaired or renewed 71 Doors and other woodwork repaired or renewed 18 Staircases replaced or repaired 1 Grates provided or repaired 7 Instances where ventilation under floor provided or improved 6 Food stores provided or repaired 5 Verminous condition abated 6 Offensive accumulations removed 78 Other repairs carried out or nuisances abated 33 Stables repaired 1 15 Complaints continue to be received of nuisance caused by pigeons. The Public Health Act. 1961 new 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 29 sites in the Borough resulted in the destruction of 620 pigeons, but while food is liberally provided by the public, there is little prospect of keeping the numbers down. EXCHANGE OP ARTICLES FOR RAGS Under the Public Health Act, 1961, it is an offence for any Reason 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 34 smoke observations and paid many visits to premises in regard to which complaints of smoke nuisance had been received. Three notices were served under Section 30 of the Clean Air Act, 1956. The Council continues to co operate with the Department of Scientific and Industrial Research by measuring atmospheric pollution in the Borough and forwarding monthly returns. The monthly average, highest daily reading and lowest daily reading are shown in the table on page 17. 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 and progress to 31st December, 1964 is shown in the table. See table on Page 18 Enquiries continue to be received about the burning of garden rubbish in Smoke Control Areas, The position is that smoke or smell from bonfires, if a nuisance to the inhabitants of the neighbourhood is a statutory nuisance liable to be dealt with under the Public Health Acts whether or not the bonfire is in a Smoke Control Area, It follows that care should be taken never to light a bonfire when conditions are such that the smoke may cause nuisance to occupants of adjoining properties. Materials should be dried before burning so that the bonfire burns briskly rather than smouldering for prolonged periods. Wherever possible garden rubbish should be disposed of by composting. 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 154 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, two site licences were issued for a limited period and another was renewed. 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 18 inspections during the year. FACTORIES, WORK PLACES, 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 on page 19 and in Table IX. 16 ??? Smoke (Micrograms per cu. metre): Sulphur Dioxide (Micrograms per cu. metre) 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. b. 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. January 187 488 28 40 301 14 196 604 40 218 786 56 215 664 40 403 1012 97 231 616 44 396 923 140 February 176 440 20 143 262 30 154 508 32 196 427 90 180 556 16 323 642 106 164 476 56 306 609 131 March 88 212 32 134 422 58 103 252 32 209 578 63 96 232 36 348 866 151 121 308 40 309 834 146 April 82 580 8 65 104 37 53 189 17 98 306 43 - Machine breakdown - 65 225 25 179 598 66 May 28 66 2 49 182 23 27 64 12 85 242 37 - Machine breakdown - 39 66 12 99 199 38 June 34 79 8 45 135 23 24 54 12 61 216 32 - Machine breakdown - 38 78 22 59 105 42 July 23 49 7 40 61 23 18 41 4 63 115 27 22 88 7 60 120 27 31 61 18 90 212 47 August 30 120 10 36 62 16 23 80 4 61 125 27 30 100 9 58 144 20 40 93 16 73 138 32 September 41 130 5 64 206 28 26 62 7 73 222 28 34 119 11 87 233 33 52 133 20 111 366 51 October 42 345 16 106 199 43 122 356 15 127 246 49 101 256 23 143 329 53 133 376 26 214 456 74 November 132 600 36 117 362 54 75 196 28 105 363 38 111 384 24 206 723 86 101 296 32 215 736 85 December 148 576 20 162 436 41 152 444 28 165 405 46 155 536 24 303 846 123 172 584 24 310 1052 70 m. a. - monthly average. h. d. r. - highest daily reading. l. d. r. - lowest daily reading. SMOKE CONTROL AREAS No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. Council resolution 25.11.58 7.12.59 27.6.61. 28.11.61. 27.3.62. 25.9.62. 30.4.63. 29.10.63. 28.7.64. Ministry enquiry 7.4.59. 14.4.60. - - - - - - - Ministry confirmation 25.6.59. 15.8.60. 31.10.61. 23.3.62 15.6.62. 27.12.62. 17.7.63. 21.1.64. 5.11.64. Date of operation 1.10.60. 1.9.61. 1.10.62. 1.10.62. 1.10.63. 1.10.63. 1.10.64. 1.10.64. 1.10.65. Acres 186 130 335 200 100 365 140 135 220 Total dwellings 1,602 1,060 804 1,141 880 987 1,082 780 1,138 Council houses 418 5 682 182 - 379 79 2 9 Estimated number of dwellings ranking for grant 1,370 911 739 979 773 766 1,039 732 872 Number of dwellings where estimates of cost of conversion or adaptation were approved 1,147 561 646 593 441 654 492 441 6 Number of claims for grant checked and approved for payment 1,062 517 561 621 394 162 327 201 - Gross cost to 31.12.64. £14,336 £8,700 £5,274 £12,537 £10,368 £3,047 £7,881 £6,764 - Nature of works carried out:- (a) new appliances 974 632 421 789 524 222 500 265 - (b) adaptation of existing appliances 445 200 106 193 120 39 51 39 - (c) gas or electric kindling provided 757 399 466 630 435 95 169 123 - Inspection of (a) Factories - mechanical power 278 (b) Factories - non-mechanical power 11 (c) Other premises 18 (d) Outworkers' premises 47 Defects remedied 8 At the end of the year the number of outworkers registered with the Department was 196 and the trades on which they were engaged are shown in Table IX. DISINFESTATION. The Health Department deals with bug and other infestations in houses and other premises, and for this purpose D.D.T. and other insecticides are used. During the year 42 rooms were treated, while 99 wasp nests were destroyed, 7 premises cleared of cockroaches, 6 cleared of ants and 4 of other insects. Treatment of ponds and tanks to prevent the breeding of mosquitoes was carried out as necessary. NOISE NUISANCE. The sources of noises which were the subject of complaint to the Department during the year were :- Motel 1 Private houses 2 Factories and industrial premises 6 Cafe 1 Bowling centre 2 Bridge construction 1 Barking dog 1 Motor cycles on waste Land 1 Laundry premises 1 In most cases, investigation showed some justification for the complaint. With the co-operation of the persons concerned the nuisances were remedied or reduced. RATS AND MICE DESTRUCTION, ETC. The Prevention of Damage by Pests Act, 1949 places the responsibility on the Council 'to keep their area as far as practicable free from rats and mice' and occupiers of premises are required to give notice when they have knowledge that rats and mice are present in substantial numbers. It is obligatory on the Council to recover the expenses reasonably incurred in taking steps for the destruction of rats and mice on business premises, but permissive as far as the cost of treating private dwellings is concerned. The Council has decided to make no charge for the treatment of private dwelling-houses unless there is failure on the part of the owner or occupier to co-operate in preventing infestation. The Council employs a Rodent Officer who is responsible for systematic inspection, planning of treatment, supervising the work of the rodent operatives and checking results. A summary of the work done in recent years is shown below:- 1960 1961 1962 1963 1964 Complaints received 652 846 693 828 852 Block inspections 120 107 88 127 110 Individual inspections and reinspections 5,516 5,634 5,766 4, 818 4,820 Other Visits 693 551 142 798 564 Premises treated - (a) By occupier 26 20 - - - (b) By local authority 1,145 314 1,236 1,307 1,314 Test baiting and where necessary, treatment is carried out to sewers, water-courses, 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. 19 SHOPS ACT 1950 SECTION 38 Shops require to be reasonably ventilated, heated and lighted and there should be suitable and sufficient sanitary and washing facilities for the persons employed therein. In this connection 12 inspections were made during the year. Notices were served in regard to un suitable sanitary facilities found in two strops. No certificate of exemption re provision of aanitary accommodation was granted. OFFICES, SHOPS AND RAILWAY PREMISES ACT 1963. The Act was parsed in 1963 and since then the following Orders and Regulations have been made The Notification of Employment of Persons Order, 1964. The Offices, Shops and Railway Premises Forms Order, 1964. The Offices, Shops and Railway Premises Act, 1963. (Modification of Section 29) Regulations, 1964. The Offices, Shops and Railway Premises Act, 1963. (Exemption No.1) Order 1964. The Washing Facilities Regulations, 1964. The Sanitary Conveniences Regulations, 1964. The Offices, Shops and Railway Premises First Aid Order, 1964. The Prescribed Dangerous Machines Order, 1964. The Offices Shops and Railway Premises Act, 1963, (Commencement No.1.) Order, 1964. The Offices Shops and Railway Premises Act, 1963. (Commencement No. 2.) Order, 1964. The Offices Shops and Railway Premises Act, 1963. (Exemption No.2.) Order 1964. The Offices Shops and Railway Premises Annual Reports Order, 1964. The Offices and Shops in Factories (First Aid) Regulations, 1964. The Offices at Building Operations etc. (First Aid) Regulations. 1964. The Offices in Electrical Stations (First Aid) Regulations, 1964. In addition to the above Orders and Regulations, twelve Circulars and fourteen supplementary Circulars have been issued by the Minister of Labour. As and from 1st May 1964 employers of persons and employers intending to employ persons working in any office shop or railway premises are required to give notice to the Council or Factory Inspector on the prescribed form. At the end of the year the following premises were on the register Offices 215 Retail Shops 426 Wholesale Shops, Warehouses 22 Catering establishments open to the public, canteens 51 Fuel Storage Depots 2 These numbers are in some cases lower than might be expected and it is probable that it has not been fully realised that the employment of even one person for more than 21 hours per week calls for registration. According to the returns received, 8 867 (4,456 male, 4,411 female) persons are employed in these premises. So far no application for exemption in regard to any of the provisions of the Act has been granted. Employers are required to notify the Council, on a prescribed form of accidents to employees occurring in offices, shops and railway premises and at 31st December, 1964 notification of eight such accidents had been received. It is not considered necessary that all notified accidents should be investigated but a decision must be made in each case. The purpose of investigation is to find out if a breach of the Act has been committed, and to improve standards of accident prevention. All the eight accidents notified were investigated and suitable advice given. The Council is required to appoint inspectors for the enforcement of the Act. So far the work arising from the Act has been done by the Health Department and any inspections carried out by the Public Health Inspectors. During the year a total of 715 visits were made. Most of these were of a preliminary and advisory nature but 138 visits were made to premises after their registration, It is advisable that, as soon as possible after registration, a visit of general inspection should be made. Such general inspection would be in relation to such matters as cleanliness; overcrowding; temperature ventilation; lighting; sanitary conveniences; washing facilities; drinking water 20 accommodation for clothing; sitting facilities; condition of floors, passages and stairs; fencing of machinery; first aid equipment, etc. Many of the Regulations and Orders were not issued till late in the year, so full general inspections could not be started till November, and only 15 such inspections had been completed by the end of the year. The Inspectors will also have to be on the watch for premises which have not been registered. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951. This Act is designed to ensure that filling materials used in upholstery, etc. comply with prescribed conditions of cleanliness. Premises using filling materials have to be registered and premises where rag flock is manufactured or stored have to be licensed. It is an offence to sell articles containing unclean materials. Certain records have to be kept on registered and licensed premises and authorised officers of a local authority have powers to enter, inspect and take samples. Under this Act, two premises in the Borough are registered and the Public Health Inspectors made 4 visits of inspection. SWIMMING BATHS. Three swimming baths are provided by the Council. The size and extent of usage of the three municipal baths are shown below:- HOUNSLOW HE3T0N ISLEWORTH Area of bath major 75' x 30' 100' x 48' 100' x 48' minor 50' x 25' - - Capacity of bath (gallons) major 71,000 200, 000 200,000 minor 36, 000 - - Total number of persons using swimming bath in 1964 148,356 196,245 214,187 Maximum number of persons using swimming bath on any one day 875 2,021 1,526 Number of private baths - Male 15 - 11 Female 9 - 11 Number of persons using private baths during 1964 29,149 17,914 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 8 samples of baths water, and two from a paddling pool were taken. All were satisfactory. VERMINOUS PREMISES AND ARTICLES. On request, 15 houses and 3 lots of bedding, etc. were treated for verminous infestation. VERMINOUS PERSONS. One verminous person was cleansed under the provisions of Section 85 of the Public Health Act, 1936. During the year 52 children in attendance at schools in the Borough were found to be verminous and because of the failure of parents to take necessary action 4 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 12 visits of inspection were made during the year. INSECTION AND SUPERVISION OF FOOD MILK. At the end of the year, there were 53 distributors registered under the Milk and Dairies Regulations. During the year 28 inspections were made at dairies and retail purveyors' premises. 21 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). In other words no raw milk can be sold in the Borough. Five complaints were received with regard to milk bottles. In no case was formal action possible. ICE CREAM, Under the Food and Drugs Act, premises used for the sale or the manufacture for the purpose of sale, of ice cream, or the storage of icecream 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 249. 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, 123 inspections of registered premises were carried out. The following results were obtained from the bacteriological examination of samples:- Satisfactory Doubtful Unsatisfactory Ice-Cream 43 4 1 The percentage of doubtful and unsatisfactory samples was 10.4 as compared with 4 0 in 1963. BAKEHOUSES. There are 18 bakehouses in the Borough and 56 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 70 294 Cafes, Canteens, Clubs, etc. 230 520 Fish Shops 25 120 Greengrocers 82 254 Grocery and Provision 176 4 66 Hotels, Public Houses etc. 88 80 Manufacturers, Packets, etc. 15 3 Confectioners, sweets 143 87 Confectioners, flour 20 62 A further 73 inspections were made of vehicles in which food was being conveyed, or from which food was being sold. 22 At retail premises 5,842 lbs., 4,555 tins and 7,045 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, 452 special inspections were made. The following items of food were brought to the Department because the purchasers were not satisfied that they were fit for human consumption:- Article No. Sweets 1 Butter 2 Frozen Peas 1 Packet Soup 1 Fruit Cake 2 Cereal 1 Popcorn 1 Liquer Chocolate 1 Bread 8 Baby Food 1 Orange Barley Water 1 Frozen Chips 1 Beef Sausages 1 Tinned Salmon 3 Steak & Kidney Pie 3 Cooked Chicken 2 Article No. Chocolate Swiss Roll 1 Tinned Fruit 3 Bacon joint 1 Chopped Ham 1 Tinned mixed grill 1 Shrimps 1 Sausagemeat 1 Pork Pie 1 Pork Sausage 1 Tinned Pilchards 1 Liver 1 Tinned Ham 1 Stewed Steak 1 Cakes 1 Raisins 1 Tinned Tomatoes 1 The complaints were not substantiated in 24 cases. Two official warnings were issued and proceedings in other cases resulted in fines and costs amounting to £124. 13s. 0d. Premises used for 'the preparation or manufacture of sausages or potted, pressed, pickled or preserved food for sale' are required under the Food and Drugs Act, 1955, to be registered, and the end of the year 116 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 39 hawkers were on the register (greengrocery, 22; fish, 8; bread and cakes, 2;: ice-cream, 7) and 68 inspections of their vehicles and wares were carried out. MUNICIPAL RESTAURANTS AND SCHOOL CANTEENS. There is no municipal restaurant in the Borough, but during the year the 24 school canteens provided 1,646,240 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. This work was carried out in the Borough by the Public Control Department of Middlesex County Council. FOOD HYGIENE. The work of promoting sound standards of hygiene in food premises has been steadily pursued. As far as possible, the plans of all premises which will be associated with the preparation and sale of food are examined. In this way it is possible to influence the standard of premises and equipment and consultation on these matters is welcomed. Visits of inspection were paid with a view of securing 'clean food, handled by clean hands and transported, prepared and stored under clean conditions'. As a result of these visits contraventions of the Food Hygiene Regulations were found at 43 premises and were remedied at 83 premises during the year. Particulars of the contraventions found are given below:- 23 Contraventions of Food Hygiene Regulations. No. of Contraventions. Articles/Equipment not kept clean 3 Articles/Equipment not in good order 4 Pood so placed as to involve risk of contamination 12 Pood placed within 18" of the ground and not adequately protected 2 Personal cleanliness not observed 6 Water closets not kept clean and in efficient order 10 Insufficient lighting and ventilation of water closet 1 Absence of 'Wash your Hands' notice in water closets 1 Absence of suitable and sufficient wash-hand basins 9 Absence of hot water at a suitably controlled temperature over wash-hand basins 4 Absence of soap, nail brushes, clean towels, etc. near wash-hand basins 3 Absence of first aid materials 3 Absence of accommodation for clothing not worn during working hours 4 Absence of suitable and sufficient sinks for the washing of food and equipment 4 Absence of hot water at a suitably controlled temperature over sink 3 Absence of soap, clean cloths, etc. at sink 2 Walls, floors etc. not kept clean 23 Walls, floors, etc. not kept in good order 21 Covered receptacle for refuse not provided 4 Accumulations of refuse, etc. 3 Miscellaneous 4 126 There is a continuing need for vigilance in connection with unhygienic practices and personal habits among food handlers. HOUSING The numbers of new houses erected in the Borough in post-war years is shown below:- 1946-60 1961 1962 1963 1964 Heston and Isleworth B.C. 1,888 32 70 58 237 Brentford and Chiswick B.C. 62 - - - 48 Southpll B. C. 64 - - - - Middlesex County Council 7 12 - - - Ministry of Civil Aviation 77 - - - - Metropolitan Police 29 - - - - Prison Commissioners 18 - - - - War Department 34 - - - - British Waterways. - 1 - - - Private Enterprise- (a) new houses 1,476 34 107 74 153 (b) reconstructed after war destruction. 185 _ _ _ _ (c) housing association 429 - - 6 - (d) additional dwellings by conversion 3 - - - - 4,272 79 177 138 438 What action is to be taken concerning unfit houses is governed by the costs 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 defined the matters to be taken into consideration in assessing fitness for human habitation. 24 The action taken in insanitary and unfit dwelling houses during the year is summarised as follows:- 1. INSPECTION OF DWELLING-HOUSES DURING THE YEAR: (1) (a) Total number of dwelling houses inspected for housing defects (Under Public Health and Housing Acts) 538 (b) Number of inspections made for the purpose 956 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under Housing Regulations, 1925 and 1932 418 (b) Number of inspections made for the purpose 836 (3) (a) Number of dwelling-houses found to be in a state to dangerous or injurious to health as to be unfit for human habitation 31 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 200 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 59 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 reapirs (2) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) by Owner (b) by Local Authority in default of owners (b) Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which formal notices were served requiring defects to be remedied 21 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) by Owner 15 (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 4 (b) not to use 25 (2) Number of dwelling houses rendered fit in consequence of Undertakings given by Owners (3) Number of dwelling houses demolished which were subject to Closing Orders 2 (4) Number of dwelling-houses in respect of which Demolition Orders were made (5) Number of dwelling-houses demolished in pursuance of Demolition Orders 2 (6) Number of dwelling-houses in respect of which Closing Orders were made in lieu of Demolition Orders 3 (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 - (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 1 (12) Clearance Areas Linkfield Road (Nos 14 to 38) Clearance Order (13 Houses) Confirmed 3 7 63 The remaining families were rehoused by the Council by the 11th May 1964 New Heston Road (Nos 103 to 117) Clearance Order (8 houses) Confirmed 25 6 64 By the end of the year all the families had been rehoused 4 HOUSING ACT 1957 OVERCROWDING (1) (a) Number of dwellings overcrowded at the end of the year 23 (b) Number of families dwelling therein 33 (c) Number of persons dwelling therein 147 (2) Number of new cases of overcrowding reported during the year 7 (3) (a) Number of cases of overcrowding relieved during the year 3 (b) Number of persons concerned in such cases 19 (4) Particulars of any case in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding 5 OTHER MATTERS (1) Number of dwelling houses demolished voluntarily 26 (2) Number of dwelling houses demolished following issue of certificates of unfitness (3) Certificates of Disrepair Number of decisions not to issue certificates 26 Number of decisions to issue certificates - (a) in respect of some but not all defects 3 (b) in respect of all defects 3 Number of undertakings given by landlords to remedy defects (Form 'K' ) 4 Number of certificates issued 2 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 3 (4) At the end of the year, the following 13 houses, subject to Demolition or Closing Orders or to undertakings not to re-let till rendered fit were still occupied: Date of Closing Order Situation or Undertaking. 10 Ivy Road, Hounslqw 28. 6.55. Shrewsbury Place, Upper Square, Isleworth 17.11.64. 38 Haliburton Road, Isleworth. 29. 5.56. 181 High Street, Cranford. 1. 6.64. 189 High Street, Cranford. 1. 6.64. 195 High Street, Cranford. 1. 6.64. 165 Martindale Road, Hounslow. 25. 7.50. 1 Woodfield Road, Cranford. 21.12.64. 3 Woodfield Road, Cranford. 21.12.64. 5 Woodfield Road, Cranford. 21.12.64. 7 Woodfield Road, Cranford. 21.12.64. 9 Woodfield Road, Cranford. 21.12.64. 11 Woodfield Road, Cranford. 21.12.64. All these houses are incapable of being made fit at a reasonable cost and in each case the owner has had full opportunity to submit to the Council any proposals for their retention and to object to the action taken by the Council. The Housing Department is kept informed of adverse housing conditions coming to the notice of the Health Department and assistance is given in the assessment of applications for re-housing where priority on medical grounds is claimed. During the year the Council approved expenditure as under:- (a) advances of £503,087 for house purchase under the Housing (Financial Provisions) Acts, 1958 and 1959 in relation to 171 houses. (b) improvement grants of £5,624 under section 30 of Housing (Firtancial Provisions) Act, 1958 in relation to 19 houses. (c) repairs loans of £5,672 under the Housing (Financial Provisions) Acts, 1958 and 1959 in relation to 21 houses. (d) standard grants of £1,920 under Section 4 of the House Purchase and Housing Act, 1959 in relation to 22 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 1964 two burials were arranged in accordance with this section. 27 PUBLIC MORTUARY. There is no public mortuary in the Borough. By arrangement with the Coroner, bodies are taken direct to Acton or Humpton Mortuaries. The Council pays a charge made for the use of these mortuaries. MEDICAL EXAMINATION OP STAFF. For superannuation or other purposes, 142 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 dnawing attention to matters bearing on health and hygiene. Other Departments have co-operated by displaying health educational material. The anti-smoking unit of the Central Council for Health Education spent 1 day in the Borough visiting secondary schools, 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 oare and attention". Despite the growing interest of statutory and voluntary agencies in the welfare of the aged, cases come to the notice of the Department of neglected aged persons living in insanitary conditions. Such persons are usually most reluctant to accept assistance or to go to hospital or institution, but fortunately, in most cases, peaceful persuasion secures their co-operation in some degree and the necessary action can be taken. In no case was it necessary to seek authority to apply for an Order for compulsory removal to hospital or institution. LAUNDRY SERVICE. One of the problems in the care of aged and sick persons in their own homes is soiled clothing and bed linen. Where washing facilities are poor and the persons concerned neither have nor can afford assistance, the cleansing of clothing and bedding presents serious difficulty. In some cases, action under Section 84 of the Public Health Act, 1936 is the only solution and the Council has made arrangements with a laundry firm for the cleansing of articles where the Medical Officer of Health has issued the certificates required by the Act. The number of cases participating in this service is increasing. BLOOD TRANSFUSION SERVICE Sessions for the collection of blood from donors were held as under: Hounslow 29th February, 1st and 2nd March 31st May. 25th, 26th and 27th July. 25th October. 19th, 20th and 21st December. Isleworth 19th January. 28th June. 13th December. 28 TABLE 1 Summary of vital Statistics 1905-1964 Estimated Civilian population (mid-year) Birth Rate per 1,000 popu1ation Death Rate per 1,000 population Infant Mortality Rate Deaths under 1 yr. per 1,000 live births Neo- natal Mortality Rate Deaths under 1 mth. per 1,000 1ive 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 1905 33,194 31.9 13.9 137 - - - 1.2 1906 33,767 33.5 15.1 139 48 - - 1.3 1907 34,851 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. ft 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 0.5 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 0.5 1947 106,670 17.3 10.5 39 24 0.5 24 0.5 1948 106,200 14.5 8.8 30 20 O.C 25 0.4 1949 106,900 13.6 9.8 17 12 2.0 18 0.3 1950 107,300 11.6 9.9 24 14 0.8 18 0.3 1951 106,400 11.3 10.4 18 14 0.0 20 0.3 1952 105,600 11.7 10.1 19 15 0.0 16 0.2 1953 105,100 12.1 10.1 18 11 0.8 19 0.1 1954 105,600 11.2 9.6 26 19 0. 0 20 0.1 1955 105,500 11.0 10.6 24 17 0.0 17 0.1 1956 105,100 11.1 10.8 18 15 0.0 19 0.1 1957 105,100 12.3 10.3 23 17 0.0 11 0.07 1968 105,100 12.0 10.6 17 13 0.0 13 0.05 1959 105,000 12.1 10.9 17 15 0.8 14 0.07 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 1962 102,680 13.8 10.9 21 18 0.0 16 0.05 1963 101,860 14.6 11.3 11 8 0.0 14 0.08 1964 100,910 14.6 11.0 19 16 0. 0 9 0.03 29 TABLE II REGISTRAR GENERAL'S RETURN OF CAUSES OF DEATH, 1964 Abridged List No. Cause of Death Male Female Total B.1. Tuberculosis, respiratory 2 - B.2. Tuberculosis, other - 1 - B.3. Syphilitic disease - - - 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 3 - - B. 18. Malignant neoplasm, stomach 16 6 2 Malignant neoplasm, lungs 52 6 5 Malignant neoplasm, breast - 21 2 Malignant Neoplasm, uterus - 3 Other malignant and lymphatic neoplasms 60 63 12 Leukaemia, aleukaemia 2 6 B.20. Diabetes 2 3 B.22. Vascular Lesions of nervous system 45 71 11 B.26. pt. Coronary disease, angina 164 77 24 B.28. Hypertension with heart disease 7 15 2 B.25. 26.pt. 27 Other heart disease 60 71 11 B.29. 46pt. Other circulatory disease 27 27 6 B.30. Influenza - - B.31. Pneumonia 38 27 6 B.32. Bronchitis 43 17 6 B.46. pt. Other respiratory diseases 11 2 1 B.33. Ulcer of stomach and duodenum 4 5 B.36. 43 pt. Gastritis, enteritis, diarrhæa 4 2 B.38. Nephritis and nephrosis 2 4 B.39. Hyperplasia of prostate 5 - B.40 Pregnancy, childbirth, abortion - - B.41. Congenital malformations 5 - Residual Other defined and ill-defined diseases 39 58 1 B.E.47. Motor vehicle accidents 12 2 1 B.E.48. All other accidents 8 5 1 B.E.49. Suicide 5 2 B.E.50. Homicide and operations of war - - Total 616 494 1,11 30 TABLE III. CAUSES OF DEATH (MALES) AT CERTAIN AGES, 1964. Under 1 1-4 5-14 15-24 25-44 45-64 65-74 75-over Total Tuberculosis, respiratory - - - - - - 2 - 2 Tuberculosis, other - - - - - - - - - Syphilitic disease - - - - - - - - - Diphtheria - - - - - - - - - Whooping Cough - - - - ~ - - - - Meningococcal Infection - - - - - - - - - Acute Poliomyelitis - - - - - - - - - Measles - - - - - - - - - Other Infective and parasitic disease - - - - 1 2 - - 3 Cancer - Stomach - - - - 1 5 6 4 16 Lung - - - - 2 23 20 7 52 Breast - - - - - - - - - Uterus - - - - - - - - - Other - - - 1 2 22 16 19 60 Leukaemia - - 1 - - - - 1 2 Diabetes - - - - - - 2 - 2 Cerebral Haemorrhage, etc. - - - 1 1 23 6 14 45 Coronary disease, angina - - - - 6 58 64 36 164 Hypertension with heart disease - - - - - 1 3 3 7 Other heart disease - - - - 1 7 11 41 60 Other circulatory disease - - - - - 7 11 9 27 Influenza .. .. - - - † - - - - - Pneumonia 1 2 - 1 - 4 8 22 38 Bronchitis - - - - - 14 14 15 43 Other respiratory disease - - - - 1 4 4 2 11 Ulcer of Stomach and duodenum - - - - - 1 1 2 4 Gastritis, enteritis, etc. - - - - - - 1 3 4 Nephritis and nephrosis - - - - - - - 2 2 Prostatic enlargement - - " - - - 2 3 5 Pregnancy, childbirth, abortion - - - - - - - -• - Congenital malformations 6 - - - - - - - 5 Other diseases 8 1 - - - 12 6 12 39 Motor vehicle accidence - - 2 1 2 3 2 2 12 All other accidents - - - - 2 1 2 3 8 Suicide - - - - 2 3 - - 5 Homicide and war operations - - - - - - - - — Total 14 3 3 4 21 190 181 200 616 Percentage of Total 2.3 0.5 0.5 0.6 3.4 30.8 29.4 32.5 31 TABLE IV. CAUSES OF DEATH (FEMALES) AT CERTAIN AGES, 1964 Under 1 1-4 5-14 16-24 25-44 46-64 65-74 75-over Total Tuberculosis, respiratory - - - - - - - - - Tuberculosis, other - - - - - - - 1 1 Syphilitic disease - - - - - - - - - Diphtheria - - - - - - - - - Whooping Cough - - - - - - - - - Meningococcal Infection - - - - - - - - Acute Poliomyelitis - - - - - - - - - Measles - - - - - - - - - Other infective and parasitic diseases . . _ _ _ - _ _ Cancer - stomach - - - - - - 1 5 6 lung - - - - - - 5 1 6 breast - - - - 3 7 8 3 21 uterus - - - - - 2 1 - 3 other - - 3 - 4 21 21 14 63 leukaemia - - 2 - - 2 1 1 6 Diabetes - - - - 1 - 1 1 3 Cerebral Haemorrhage, etc. - - - - - 8 16 47 71 Coronary disease, angina - - - - - 7 31 39 77 Hypertension with heart disease - . _ - - - 5 10 15 Other heart disease - - - - 1 6 9 56 71 Other circulatory disease - - - - - 1 8 18 27 Influenza - - - - - - - - Pneumonia 2 - - - - - 6 19 27 Bronchitis - - - - - 4 4 9 17 Other respiratory diseases - - - - - - 1 1 2 Ulcer of stomach and duodenum - - - - - - 3 2 5 Gastritis, enteritis, etc. - - - - - - - z 2 Nephritis and nephrosis - - - - - - - 4 4 Prostatic enlargement - - - - - - - - - Pregnancy, childbirth, abortion _ _ - - - - - - - Congenital malformation - - - - - - - - - Other disease 12 - - 1 2 16 5 22 58 Motor vehicle accidents _ - - - - 1 1 2 All other accidents - - 1 - - 1 1 2 5 Suicide - - - - 1 1 - - 2 Homicide and war operations - - - ~ - - - - - Total 14 - 6 1 12 75 128 258 494 Percentage of Total 2.8 0.0 1.2 0.2 2.4 15.2 26.0 52.2 32 33 TABLE V. INFANTS' DEATHS ACCORDING TO AGE AND CAUSE, 1964. Cause of Death Age Total Days Months Under 1 1 2 3 4 5 6 7-13 14—20 21-28 1 2 3 4 5 6 7 8 9 10 11 Pneumonia - - - - - - v - - 1 1 - - - - - 1 - - - - 3 Birth Injury 2 2 1 - - - - - 1 - - - - - - - - - - - - 6 Atelectasis and birth asphyxia 3 2 1 - - - - 2 - - 1 - - - - - - - - - - 9 Congenital malformations 1 1 - 1 - - 1 - - - 1 - - - - - - - - - - 5 Prematurity 2 2 - - 1 - - - - - - - - - - - - - - - 5 Total 8 7 2 1 1 - 1 2 1 1 3 - - - - - 1 - - - - 28 34 TABLE VI. INFECTIOUS DISEASES, AGE DISTRIBUTION - 1964 Disease Total Under 1 yr. 1 yr. 2yrs. 3yrs. 4 yrs. 5-9 yrs. 10-14 yrs. 15-19 yrs. 20-34 yrs. 35-44 yrs. 46-64 yrs. 65 + yrs. Age unknown Cases Admitted to hospital Smallpox - - - - - - - - - - - - - - - Typhoid Fever - - - - - - - - - - - - - - - Para-Typhoid 1 - - - - - - - - 1 - - - - 1 Scarlet Fever 52 - - 2 2 11 32 4 1 - - - - - 2 Diphtheria - - - - - - - - - - - - - - - Erysipelas 9 - - - - - - - - 1 2 2 4 - 5 Puerperal Pyrexia 87 - - - - - - - 13 63 11 - - - 87 Ophthalmia Neonatorum - - - - - - - - - - - - - - - Acute Encechalitis 3 - - 1 - - 1 - - - - 1 - - 3 Acute Poliomyelitis - - - - - - - - - - - — - - - Meningococcal Infection 1 - 1 - - - - - - - - - - - 1 Pneumonia 11 - - 2 - 1 - - - - - 4 4 - 2 Malaria 2 - - - - 1 - 1 - - - - - - 2 Dysentery 9 - 2 - 1 1 1 1 1 - 2 - - - 5 Measles 331 16 47 47 43 54 114 7 2 1 - - 1 - 18 Whooping Cough 22 6 1 1 3 6 6 - - - - - - - 7 Food Poisoning 8 - - 1 - - - 1 1 4 - 1 - - 1 Tuberculosis:- Pulmonary 37 - - - 1 - - 1 3 9 4 17 2 - 8 Non Pulmonary 9 - - - - - - - 1 3 1 1 3 - 5 35 NOTIFICATIONS AND DEATHS FROM CERTAIN INFECTIOUS DISEASES HESTON AND ISLEWORTH 1945-1964 TABLE VII Year Smallpox Scarlet Fever Diphtheria Erysipelas Pneumonia Meningococcal Infection Epidemic Encephalitis Poliomyelitis and Polioencephali ti s Typhoid Fever Paratyphoid Fever Dysentery Measles Whooping Cough Influenza Tuberculosis Cases Deaths Cases Deaths Cases s 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 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 2 140 2 8 180 52 1948 - - 159 - 2 - 21 - 41 42 2 * - 1 29 2 - - 3 - 5 - 571 - 227 - 5 168 43 1949 - - 138 - - - 26 - 52 53 2 1 - 2 14 1 - - - - 2 - 523 - 173 - 6 219 36 1950 - - 92 - 1 - 12 - 64 30 - - - - 9 - 3 - 6 - 6 - 881 - 206 - 6 182 37 1951 - - 67 - - - 12 - 59 38 5 1 - - 4 - 1 - 1 - 77 - 790 1 220 - 33 185 27 1952 - - 161 - - - 19 1 58 51 5 1 - - 3 - - - 7 - 28 - 1027 - 86 - 4 168 19 1953 - - 161 - - - 16 - 78 48 1 - - - 11 - - - - - 13 - 602 - 291 - 26 141 10 1954 - - 71 - - - 17 - 34 31 4 - - - - - - - 1 - 9 - 38 - 35 - 2 88 12 1955 - - 74 - - - 17 - 50 46 - - 1 - 13 - - - - - 131 - 1568 - 177 - 4 67 14 1956 - - 67 - - - 12 - 27 60 1 - 1 1 5 - - - - - 22 - 244 _ 96 - 4 69 12 1957 - - 36 - - - 8 - 39 64 2 - 2 - 2 - - - - - 7 - 804 - 74 - 9 82 7 1958 - - 62 - - - 6 - 45 60 - - - - - - 1 - - - 15 - 275 - 44 - 7 81 5 1959 - - 235 - - - 7 - 47 61 3 1 1 - 1 1 - - - - 42 - 1007 - 46 - 37 56 7 1960 - - 70 - - - 8 - 18 46 1 1 1 - - - - - 1 - 126 - 30 - 199 1 2 54 4 1961 - - 29 - - - — - 17 77 2 - 4 2 1 - - - - - 14 - 1437 - 14 - 7 55 11 1962 - - 22 - - - 6 - 14 55 2 - 2 - - - 1 - - - 42 - 207 - 3 - 9 33 5 1963 - - 13 - - - 11 - 18 81 1 - - - - - - - - - 34 - 886 - 59 - 4 50 8 1964 - - 52 - - — 9 1 11 65 1 3 — - - - - 1 - 9 - 331 — 22 - - 46 3 METEOROLOGY (Extract from records supplied by the chief Engineer, Mogden Sewerage Works). Week Ending Barometer Temperature (C°) Days with Rainfall Total Rainfall (inches) Highest Lowest Max. Min, Jan 4th 30.42 29.74 11.5 1.0 4 0.04 11th 30.57 30.27 7.0 -2.0 2 0.01 18th 30.54 29.82 5.0 -4.0 4 0.11 25th 30.67 30.33 8.5 -4.0 5 0.06 Feb, 1st 30.50 29.63 12.5 1.5 4 0.32 8th 30.82 30.05 12.6 -4.5 2 0.04 16th 30.60 29.47 9.5 0.0 2 0.20 22nd 30.24 29.35 8.7 -2.5 4 0.13 29th 30.10 29.27 13.5 3.5 7 0.34 Mar. 7th 30.37 30.09 6.0 -1.5 3 0,03 14th 30.16 29.43 15.0 -1.5 3 1.17 21st 30.06 29.22 14.5 0.0 6 1.54 28th 30.12 29.37 12.5 2.0 3 0.58 Apr, 4th 29.85 29.50 7.0 1.0 6 0.33 11th 30.15 29.80 16.0 -1.0 2 - 18th 29.93 29.44 17.0 5.0 6 1.02 25th 30.29 29.33 17.0 5.0 6 1.31 May 2nd 30.23 29.52 21.0 6.0 6 0.64 9th 30.11 29.51 17.5 7.0 4 0.14 16th 30.40 29.82 25.0 5.0 3 0.02 23rd 30.15 29.77 25.0 6.0 6 0.74 30th 29.88 29.60 26.0 10.0 3 0.14 Jnne 6th 29.90 29.31 25.5 9.0 7 1.86 13th 30.16 29.60 26 0 9.5 4 0.98 20th 30.01 29.70 24.0 5.5 5 1.56 27th 30.20 29.87 25.6 7.5 2 - July 4th 30.28 29.99 25.0 9.0 1 - 11th 30.07 29.38 21.0 8.5 5 0.59 18th 30.21 29.66 28.0 11.0 5 0.26 25th 30.16 29.88 27.5 13.5 2 0.76 Aug. 1st 30.03 29.78 27.0 12.0 2 0.08 8th 30.10 29.60 27.0 9.0 3 0.06 15th 30.02 29.75 22.6 9.0 4 0.27 22nd 30.12 29.08 23.0 6.5 3 1.15 29th 30.36 29.77 29.5 6.5 3 0.18 Sept. 5 th 30.40 29.63 26.0 8.0 1 0.09 12th 30.16 29.70 26.0 8.0 1 - 19th 30.07 29.30 23.0 8.0 6 0.34 26th 30.30 29.80 24.5 3.0 1 0.02 Oct. 3rd 30.22 30.05 21.5 5.5 - - 10th 30.18 29.02 21.5 2.0 5 0.53 17th 30.36 29.10 15.0 -1.0 4 0.45 24th 30.40 29.37 15.5 1.0 2 0. 15 31st 30.37 30.00 15.5 4.5 2 0.03 Nov. 7 th 30.43 30.00 12.0 1.5 - - 14th 30.14 29.40 14.5 2.0 4 0.58 21st 30.26 29.40 15.0 5.0 5 0.64 28th 30.30 29.37 13.5 -1.0 1 0.01 Dec. 5 th 30.11 29.30 10.6 -4.5 6 0.46 12th 30.19 29.40 14.5 2.5 7 0.75 19th 30.24 29.39 8.0 -4.5 3 0.11 26th 30.24 29.92 6.5 -6.0 4 0.08 36 TABLE VIII (b) WIND DIRECTION (Sum. of Daily Records, 52 weeks) N. 16 days N. N. E 7 days N. E. 25 days E N. E 12 days E 16 days E S. E 7 days S. E . 10 days S.S.E 1 day S. 12 days s. s. w. 6 days s. w. 36 days w. S. w. 31 days w. 29 days W. K. W. 18 days N. W. 18 days N. N. W. 12 days Calm 106 days No record 2 days 37 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 Premi ses 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 11 - - (ii) Factories not included in (1) in which Section 7 is enforced by the Local Authority 389 278 9 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers1 premises) 13 18 1 - TOTAL 441 307 10 - 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 Refer red To EM Inspector By EM Inspector Want of Cleanliness - 1 - - - Overcrowding (S. 2. ) - - - - - Unreasonable temperature (S.3.) - - - - - Inadequate ventilation (S. 4) - - - - - Ineffective drainage of Floors (S. 6. ) - - - - _ Sanitary Conveniences (S. 7.) - - - - - (a) insufficient - 1 - - - (b) unsuitable or defective 10 6 - 2 - (c) not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) - - - - - TOTAL 10 8 - 2 - 38 TABLE IX (Continued) 3. Outwork - Part VIII of the Act. Nature of Work (1) Section 110 Section 111 No. of Outworkers in August list required by Section 110(1) (c) (2) No, of cases of defau1t in sending lists to the Counci1 (3) No. of prosecutions for failure to supply lists (4) No, of instances of work in unwholesome premises (5) Notices served (6) Prosecutions (7) Wearing) Making etc. apparel) Cleaning & Washing 154 - - - - - Lace, lace curtains and nets 2 - - - - - Curtains and furniture hangings 3 - - - - - Furniture and Upholstery 2 _ _ - - - Artificial flowers .. 5 - - - - - Carding, etc. of buttons, etc. 9 - - - - - Stuffed toys 18 - - - - - Cosaques, Christmas stockings, etc. 3 - - - - - TOTAL 196 - - - - - 39 ^ LIBRARY^'^ f; *2 AUG 1968 /3 \ # '%«L# *