AC 4342 sibiory HOL 58 The Metropolitan Borough of Holborn REPORT OF THE MEDICAL OFFICER of HEALTH FOR THE YEAR 1960 G. W. PIPER, M.B., D.P.H. The Metropolitan Borough of Holborn REPORT OF THE MEDICAL OFFICER of HEALTH FOR THE YEAR 1960 G. W. PIPER, M.B., D.P.H. CONTENTS Introduction 7 Section 1.—General Information and Statistical Summary 9 Section 2.—Births and Deaths 13 Section 3.—Infectious Diseases 19 Section 4.—Sanitary Circumstances 26 Section 5.—Factories 39 Section 6.—Inspection and Supervision of Food 42 Section 7.—Tuberculosis 50 3 INDEX PAGES Aged and Infirm Persons 37 Altitude 9 Ambulance facilities 11 Area of Borough 9 Atmospheric pollution 30 Bacteriological examinations— Ice cream 46 Infectious disease 23 Milk 44 Births— Notification of 13 Rates 13 Registered live 13 Registered still 13 Burial of the dead 37 Cancer 18 Chest Clinic 10 Committee, members of 5 Common Lodging Houses 26 Complaints 29 Day Nurseries 10 Deaths— Classification with age distribution 15 Infantile by causes, and age distribution 17 Number and rate, all ages 14 Puerperal 16 Rate, infants under 1 year of age 16 From tuberculosis 18 Diphtheria 20 Diphtheria immunisation 23 Disinfection 36 Disinfestation 37 Drainage 29 Dysentery 20 Emergency Bed Service 12 Erysipelas 20 Factories 39 Factories Act, 1937-1959—Notices 26 Food & Drugs Act, 1955— Notices served 42 Work carried out 43 Food & Food Premises— Bakehouses 26 Ice cream 46 Milk supply 43 Unsound food condemned, Table 49 Food poisoning 20 Food sampling 47 PAGES General rate 9 Highways, area of 9 Hospitals in the Borough 11 Housing— Houses let in lodgings 27, 34 Notices 26 Overcrowding 34 Underground rooms 33 Ice cream— Registration of premises 46 Bacteriological examination 45 Chemical samples 47 Ice Cream (Heat Treatment, etc.) Regulations, 1959— 46 Infantile mortality— Causes, and age distribution 17 Rate 14, 16 Causes since 1950 17 Infectious Diseases— Bacteriological examinations 23 Notifiable 19 Non-notifiable 21 Summary of notifications, 1960 22 Comparative figures for years 1931-1960 24, 25 Inspections by Public Health Inspectors 26, 42 Licensed premises 46 Live births 13,14 Malaria 19 Marriages 10 Marriage rate 10 Maternal Mortality 10, 16 Maternity and Child Welfare Centres 10 Measles 21 Milk- Bacteriological examinations 45 Chemical samples 44 Distributors on register 43 Licences granted 45 Registrations 43 National Assistance Act, 1948 37 Notices served 27, 42 Notifiable diseases, list of 19 Notifications of births 13 Notifications of infectious diseases, summary 22 Nuisances remedied 28 Nurseries, day 10 4 INDEX—continued. PAGES Outworkers 40 Overcrowding 34 Penny rate, product of 9 Pharmacy and Poisons Act, 1933 33 Pneumonia 21 Poliomyelitis, Acute 21 Population 9 Prevention of Damage by Pests Act, 1949 35 Public Health Committee, members of 5 Public Health Inspectors' visits 26 Public Health (London) Act, 1936— Notices served 27 Work carried out 28 Puerperal Pyrexia 20 Rag Flock and Other Filling Materials Act, 1951 33 Rat Extermination 35 Rateable value 9 Registered live births 13 Registered still births 13 Restaurants 42 Roads, length of 9 Rodent Control— Block Surveys 36 Complaints 35 General 35 Sewers 36 PAGES Sampling 47 Sanitary circumstances of the area 26 Scabies 21 Scarlet fever 21 Slum clearance 33 Smallpox 20 Smoke abatement 30 Soil 9 Statistics and general information 9 Statutory Notices 27 Still births 13 Tuberculosis— Deaths 10, 18, 52 Notifications 50 Notifications and deaths since 1910 52 Summary of changes in register 51 Underground rooms 33 Unsound food 49 Vital statistics 10, 14 Water supply 29 Whooping cough 21 5 The Metropolitan Borough of Holborn PUBLIC HEALTH COMMITTEE The Mayor and Deputy Mayor are ex-officio members of all Standing Committees of the Council. The Mayor in 1959/60 was Councillor A. F. Judd, J.P., and in 1960/61 was Alderman M. P. Greengross, O.B.E., J.P. The Deputy Mayor in 1959/60 was Councillor S. Jaque, and in 1960/61 was Councillor A. F. Judd. 1959/60 Chairman— Councillor S. Jaque (Deputy Mayor). Vice — Chairman— Councillor Mrs. L. J. Coleman. A.R.S.H. Councillor J. W. Bowden. „ Mrs. L. A. Brown „ E. A. J. Clark. „ J. Clark. „ E. G. Cracknell. „ M. Critchley, M.D., F.R.C.P. „ A. G. Feen. „ Mrs. A. G. Finn. Alderman M. P. Greengross, O.B.E., J.P. Councillor H. T. Haddow, L.D.S. „ T. E. C. Harris. „ Mrs. L. G. Jayne. M.H.C.I. C. D. B. Tutt, M.H.C.I. 1960/61 Chairman— Councillor S. Jaque (Deputy Mayor). Vice — Chairman— Councillor Mrs. L. J. Coleman, A.R.S.H. Councillor Mrs. L. A. Brown. „ E. A. J. Clark. „ J. Clark. „ E. G. Cracknell. „ M. Critchley, M.D., F.R.C.P. „ C. H. Davies. „ Mrs. A. G. Finn. „ T. E. C. Harris. „ F. Jaque. „ Mrs. L. G. Jayne. „ Miss M. C. Smith. C. D. B. Tutt, M.H.C.I. 6 STAFF The following was the staff of the Public Health Department during 1960. Medical Officer of Health: G. W. Piper, M.B., B.S., D.P.H. (from 17.6.60). J. A. Struthers, M.D., M.R.C.P., D.P.H. (to 16.6.60). Deputy Medical Officer of Health: G. W. Piper, M.B., B.S., D.P.H. (to 16.6.60). Public Analyst: (Part time) C. H. Wordsworth, B.Sc., F.R.I.C. Deputy Public Analyst: (Part Time) J. H. E. Marshall, M.A., F.R.I.C. Chief Clerk: A. E. Hobbs. Senior Public Health Inspectors: H. D. Bailey, F.A.P.H.I. J. H. R. Crabtree, M.R.S.H., F.A.P.H.I., R.P. Public Health Inspectors: L. T. J. Nash, M.A.P.H.I. (to 31.12.60). H. Parker, M.A.P.H.I., A.R.S.H. J. A. Hoare, M.A.P.H.I. Technical Assistant (Temporary) W. E. Malthouse Clerical Staff: R. R. Stent, (Senior Clerk). D. G. Marshall, (Senior Clerical Assistant). Miss I. J. Palk. Miss M. Field. B. O'Halloran. J. J. Parker. Disinfecting Station and Cleansing Station Staff: F. A. L. Russell, (Superintendent Disinfector and Plant Engineer). J. W. Gardiner, (Deputy Superintendent Disinfector). N. J. Lyons. W. C. Razzell. S. F. Harris. Mrs. R. E. Nicholls. Rodent Operatives: A. Baldwin (to 23.6.60). J. W. Maloney. Social Worker: Mrs. E. M.Barralet. Assistant Social Worker: Mrs. P. M. D. Coole (Part-time). 7 Public Health Department. Town Hall, High Holborn, W.C.I. June, 1961 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Holborn. Your Worship, Ladies and Gentlemen, Herewith I beg to present a report upon the health and sanitary conditions of the Borough for the year 1960. In June Dr. Struthers retired as Medical Officer of Health, having given literally a lifetime of service to Holborn. He took office in 1934, but for the previous eleven years he had been medical officer to the tuberculosis dispensary. Paradoxically this quarter of a century which has been among the most troubled in our history, has also witnessed an outstanding improvement in the public health. Dr. Struthers with his intimate knowledge of the borough and its people, kept Holborn in the van of this advance. Indications of the changing circumstances of the borough are given in the statistics recorded year by year in the Medical Officer's Annual Report. In 1934 the recorded population was 36,000. By 1960 this figure had fallen by some 40% to 21,000 yet the number of inhabited houses fell by only 5%. In 1934 the birth rate was 8.58 per thousand of the resident population and in 1939 it fell to the unprecedented low figure of 6.85. After a big rise in the immediate post-war years, the rate is settling and in 1960 was 9.86. The infant mortality rate is usually a sensitive indicator of the well being of the community. In Holborn, however, this is vitiated by the fact that infants with grave conditions come from all over the world to the Hospital for Sick Children. Inevitably some few of them fail to recover and the deaths of those who are domiciled outside England and Wales are " credited " to Holborn. Thus the infant mortality rate of 77.29 per thousand live births for Holborn for 1960, which appears to compare unfavourably with the rate of 21.6 for the whole of London is calculated from the deaths of sixteen infants, only six of whom were truly resident in the borough. The crude death rate which, for 1960 was 12.71 per thousand of the population, has shown little significant variation over the years. Taking into account the increasing proportion of elderly people in the population however, it is evident that there has been (except during the war years) a real decline in mortality. Diseases of the heart and circulatory system remain the most frequent causes of death, although within this group coronary artery disease has become more common. In 1960 only one person in Holborn died of tuberculosis (32 persons did so in 1934). The death rate from cancer, however, has nearly doubled during the same period, and the increase in cancer of the lung is particularly alarming. In 1960 this disease was responsible for one-third of all cancer deaths. Bronchitis, " the English disease," also causes twice as many deaths now as it did twentyfive years ago. These diseases offer a new challenge to preventive medicine. Changes have also occurred in the prevalence of infectious disease. The number of new cases of tuberculosis notified has fallen to less than half of the 1934 figure, but there is much to be done before this disease ceases to be a public health problem. The decline in the incidence of diphtheria has been dramatic. In 1934 there were 74 cases with four deaths; in 1960 no cases were notified. Outbreaks of the disease which occur from time to time demonstrate, however, the continuing need for children to be effectively immunised. The incidence of poliomyelitis has fluctuated greatly since it first assumed epidemic proportions in this country in 1947. The greatest number of cases experienced in Holborn in any one year was 17 in 1953. In 1960 two cases were notified. Vaccination confers very considerable protection against this disease, and is now freely available to everyone under the age of forty. Food poisoning and dysentery have become more prevalent since the war because more people now have meals in restaurants and canteens. Only a small proportion of cases receive medical attention or are notified. By regular inspection and supervision of 8 all types of food premises it is possible to eliminate conditions favourable to the spread of infection. The control of these diseases, however, depends on the proper education of food handlers and this is much more difficult to achieve. The body of this report contains no reference to venereal diseases since they are not notifiable. There are signs that the incidence of these diseases is increasing. Dr. Nevill Mascal, Physician in charge of the Endell Street Clinic of St. Pauls Hospital, reported in a letter to the British Medical Journal that the number of new patients found at the clinic to be suffering from early syphilis was more than two-and-a-half times greater in 1960 than in 1959. It should be known that although the treatment of these diseases has been facilitated by modern drugs they are still very serious conditions which can have the gravest consequences. Reviewing the work of the Public Health Inspectors over the years one observes that they now need to serve many fewer notices to achieve their ends. To an increasing extent these officers are regarded by all sections of the public as advisers rather than law enforcement officers. During the year, work on the smoke control programme proceeded satisfactorily. Two smoke control orders came into operation and the survey of the fourth area was completed. There are no really large industrial furnaces in Holborn, but considerable annoyance is sometimes caused because of the close proximity of residential commercial and industrial premises to each other. In February the Council declared a clearance area in respect of eight houses in Mount Pleasant. After a public enquiry in November this was confirmed by the Minister of Housing and Local Government. The slum clearance programme for the next five years, which has been agreed with the County Council, includes some 56 dwellings. On Page 53 there is an account of the staff medical examinations performed during the year. The object of these examinations is to ascertain, so far as possible, whether the person examined is physically capable of performing the duties of his post efficiently and without danger to the health and safety of himself, his colleagues and the public. If anyone is found to be in need of treatment he is appropriately advised. A recommendation that an applicant is fit for employment does not, however, signify that he is thought to be "a first class life." Quite clearly some grades are largely filled by persons who are physically incapable of more exacting work. In July the Council decided that the welfare service for old people which had operated successfully under the Town Clerk's supervision for more than two years should be brought under the administrative control of the Medical Officer of Health, and within the purview of the Public Health Committee. Some account of the work of the Social Workers is therefore given on Page 53. The Welfare State is a complicated structure and has many loopholes which are filled by innumerable voluntary bodies, both local and national. Today's old people began life in an era of horse transport, when the needy could turn only to the poor law or to private charity. They are confused by the speed and complexity of modern life. Many lead solitary lives and have no one with whom to discuss their problems. The Social Workers are able to help in two ways. In an emergency (sickness or accident for example) they can mobilise all the statutory and voluntary resources needed. Secondly, they encourage and assist old people to a life as full and as varied as possible. In this way it is hoped to prevent the mental and social deterioration that sometimes unfortunately occurs in old age. It is a pleasure to record my gratitude to the Public Health Committee, and in particular to its Chairman, for the help and consideration they have given me during my novitiate. My fellow chief officers have been an unfailing source of advice and support for which I am indebted. I must also thank the members of the public health department, for their tireless work throughout the year. The department works as a team, and the results of this co-operative effort are recorded in the following pages. I am, Your obedient Servant, G. W. PIPER, Medical Officer of Health, 9 SECTION 1. General Information and Statistical Summary. General Holborn, with an area of 405 acres, is the smallest of the Metropolitan Boroughs. It is about 1¼ miles long, extending from Tottenham Court Road in the West to Farringdon Road in the East, and averages about half a mile in width. Soil.—Most of the Borough is covered with Taplow Gravel to a depth of between 10 and 20 feet overlaying London Clay which varies in thickness from about 40 - 60 feet in the North of the Borough to about 80 - 100 feet in the South. In the North East corner there is a small area of London Clay without gravel cover, and in the extreme South East the London Clay is covered with brickearth. There is a deposit of alluvium in the valley of the old Fleet River in the extreme East of the Borough. Typical Sections are:— 1. Tottenham Court Road Drift (i.e. including Taplow Gravels) 22½ feet London Clay 63½ feet 2.Grays Inn Made Soil 7 feet Gravel 9½ feet London Clay 40½ feet 3.Lincoln's Inn Made Soil 13 feet Gravel 5 feet London Clay 113 feet 4.Bernard Street Made Soil 10 feet Sand and Gravel 11½ feet London Clay 46 feet Altitude.—The altitude varies from 40 feet above Ordnance datum in Farringdon Road in the East, to 92 feet above Ordnance datum in Torrington Place in the North West corner. In the South in Lincoln's Inn Fields the figure is 68 feet. Area of borough highways excluding footpaths 46 acres approx. Total length of roads about 25 miles Population (1951) census 24,806 Population (Registrar-General's mid-1960 estimate) 21,000 Number of persons per acre (estimated average) 52 Number of dwelling houses, flats and other residences 6,016 Rateable Value £3,934,771 Product of penny rate, approximately £16,000 General rate for the year 15s, 8d. in the £ 10 TABLE No. 1 Marriages The following table shows the number of marriages which have taken place in the Borough during the last 10 years, and the marriage rates for those years:— Year C. of E. R.C., Chapels and Supt. Registrar's Office Total Marriages Estimated Population Marriage Rate per 1,000 Population 1951 51 301 352 24,540 14.34 1952 54 257 311 23,950 12.99 1953 64 307 371 23,710 15.65 1954 53 345 398 23,340 17.05 1955 51 366 417 23,060 18.08 1956 75 387 462 22,640 20.40 1957 73 425 498 22,230 22.40 1958 68 374 442 21,870 20.20 1959 56 380 436 21,370 20.40 1960 66 380 446 21,000 21.24 Summary of Vital Statistics Live Births 207 Birth-rate (per 1,000 estimated population) 9.86 Deaths, all ages 267 Death-rate (per 1,000 estimated population) 12.71 Infant deaths 16 Infant death-rate (per 1,000 live births) 77.29 Maternal deaths Nil Maternal death rate (per 1,000 live births) Nil (per 1,000 live and still births) Nil Tuberculosis deaths 1 Tuberculosis death-rate (per 1,000 estimated population) .05 Cancer deaths 48 Cancer death-rate (per 1,000 estimated population) 2.29 Maternity and Child Welfare Centres Province of Natal Centre, Guilford Place Chest Clinic University College Hospital, Huntley Street, W.C.I Day Nurseries Kingsway Creche (Voluntary Day Nursery), Kingsway Hall, Kingsway, W.C.2 Telephone CHAncery 9401 Telephone EUSton 5050 Telephone HOLborn 5676 11 Hospitals in the Borough Name and Address of Hospital Telephone No. Type of Hospital Number of Beds Hospital for Sick Children, Great Ormond Street, W.C.1 Holborn 9200 Special Teaching Hospital 325 The Royal London Homoeopathic Hospital, Great Ormond Street, W.C.1. Terminus 3091 Group 22, N.W. Regional Hospital Board 183 The National Hospital, Queen Square, W.C.1. Terminus 7721 Special Teaching Hospital 229 Moorfields Eye Hospital, High Holborn, W.C.1 Temple Bar 6611 With Moorfields and Central Eye Hospital, Special Teaching Hospital 100 St. Paul's Hospital, Endell Street, W.C.2 Temple Bar 9611 With St. Peter's Hospital, Henrietta Street—Special Teaching Hospital 48 French Hospital, Shaftesbury Avenue, W.C.2 Temple Bar 5025-6 Voluntary Hospital 63 Italian Hospital, Queen Square, W.C.1 Holborn 6191 Voluntary Hospital 53 Ambulance Facilities The London County Council, as Local Health Authority, is responsible under Section 27 of the National Health Service Act, 1946, for the provision of ambulance facilities within the Administrative County of London. The Home Service Ambulance Department (Order of St. John of Jerusalem and British Red Cross Society) and the Hospital Car Service act as agents of the County Council in supplying some of the ambulance and car transport provided under the Act. The Headquarters of the London Ambulance Service are at The County Hall, Westminster Bridge, S.E.I. Ambulances may be summoned as follows:— (1) Accidents— Sudden illness in the streets, public places or places of employment. (Note—For sudden illness in the home a doctor, not an ambulance, should be summoned.) Dial " 999 " (or follow the instructions given on the telephone instrument) and ask for— "AMBULANCE." (2) Maternity patients (who have booked a bed in a hospital or maternity home)— Very urgent illness in the home (provided a medical practitioner certifies that the case is urgent and arrangements have been made with a hospital for the patient's admission). Telephone— WATerloo 6000 CENtral 6301 REGent 4000 RELiance 3622 or NEW Cross 2645 12 (3) Illness, infectious disease, etc.— Normally the hospital to which the patient is to be admitted will summon the ambulance, if one is necessary, by telephoning WATerloo 3311 This applies also to patients being discharged from hospital or attending there as out-patients. Emergency Bed Service (King Edward's Hospital Fund for London) The Emergency Bed Service was founded in 1938 to assist general practitioners in finding beds for acute emergency cases. Since the 5th July, 1948, the Service, working in close co-operation with the Ambulance Service, has acted as agent for the four Metropolitan Regional Hospital Boards for the admission of all types of cases except mental and tuberculous. The Central Office of the Emergency Bed Service is at 28, London Bridge Street, S.E.I, (Telephone HOP 7181). 13 SECTION 2. Births and Deaths STATISTICS FOR THE YEAR 1960. Population The civilian population, as estimated by the Registrar-General, Mid-1960 was 21,000. Comparable estimates for preceding years are set out on page 14. Registered Live Births M. F. Total Rate per 1,000 Estimated Population Proportion per 1,000 Registered Live Births Legitimate 83 96 179 8.53 865 Illegitimate 18 10 28 1.33 135 Total Live Births 101 106 207 9.86 — Comparable figures for preceding 30 years are set out on page 14. Registered Still Births M. F. Total Rate per 1,000 Live and Still Births Legitimate 2 1 3 14.16 Illegitimate 2 — 2 9.43 Total Stillbirths 4 1 5 23.59 Notification of Births The following figures for Holborn for 1960 have been supplied by the Divisional Medical Officer of the London County Council:— M. F. Total Live Births 107 106 213 Stillbirths 4 2 6 Total Births Notified 111 108 219 The number of notified births in any year differs from the number of registered births owing to the difference in time allowed for notification and registration. Deaths—All Ages M. F. Total Rate per 1,000 Estimated Population 135 132 267 12.71 Comparable figures for preceding 30 years are set out on page 14. The following table shows the age and sex distribution of the total deaths (corrected) in Holborn during 1960. Age Groups 0-1 1- 5- 15- 25- 45- 65- 75- TOTALS Males 9 1 4 5 6 40 40 30 135 Females 7 3 3 3 4 32 25 55 132 TOTALS 16 4 7 8 10 72 65 85 267 % of Total 5.99 1.50 2.62 2.99 3.75 26.97 24.34 31.84 100 Average age at death in Holborn during 1960 was 60.20 years. 14 TABLE No. 2 Vital Statistics for the last 30 years Year Estimated Mid-Year Population Net Registered Live Births Net Deaths All Ages Under 1 Year of Age Number Rate per 1,000 Est'd. Population Number Rate per 1,000 Est'd. Population Number per 1,000 net Live Births 1931 34,470 352 10.55 492 14.3 26 73.9 1932 36,440 349 10.21 517 14.2 25 71.6 1933 36,050 342 9.57 486 13.5 24 70.2 1934 36,000 309 9.49 440 12.2 22 71.2 1935 35,400 271 8.58 420 12.7 24 88.6 1936 34,850 289 7.65 418 11.99 18 62.3 1937 34,600 280 8.29 410 11.85 22 78.6 1938 34,350 250 8.09 358 10.51 19 76.0 1939 30,660 229 7.28 378 12.33 14 61.14 1940 23,470 218 6.85 504 21.47 14 64.22 1941 17,160 191 9.29 432 25.17 9 47.12 1942 16,580 188 11.13 250 15.08 9 47.82 1943 17,240 252 11.34 305 17.69 13 51.59 1944 18,020 207 14.62 302 16.76 11 53.14 1945 18,680 244 11.49 296 15.85 17 69.67 1946 21,190 298 13.06 292 13.78 12 40.27 1947 23,460 338 14.06 295 12.57 12 35.50 1948 24,960 361 14.41 283 11.34 7 19.39 1949 25,490 325 14.46 284 11.14 12 36.92 1950 25,930 300 12.75 286 11.03 7 23.33 1951 24,540 284 11.57 304 12.39 10 35.22 1952 23,950 293 11.57 276 11.53 10 34.13 1953 23,710 275 12.24 273 11.52 4 14.55 1954 23,340 252 11.60 237 10.15 8 31.75 1955 23,060 248 10.80 240 10.41 7 27.67 1956 22,640 265 10.76 261 11.53 13 49.06 1957 22,230 251 11.70 264 11.88 9 35.85 1958 21,870 218 11.29 255 11.66 6 27.52 1959 21,370 215 9.97 251 11.74 14 65.12 1960 21,000 207 9.86 267 12.71 16 77.29 15 TABLE No. 3 Causes of, and Ages at, Death Classification according to the short list of causes of death adopted by the Registrar General in Form S.D.25. Causes of Death Net Deaths at the Subjoined Ages of "Residents," whether occurring within or without the District Under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and under 75 years 75 and over Totals All ages M F M F M F M F M F M F M F M F M F 1. Tuberculosis, respiratory - - - - - - - - - - - - 1 - - - 1 — 1 2. Tuberculosis, other - - - - - - - - - - - - - - - - - - - 3. Syphilitic disease - - - - - - - - - - - - - - - - - - - 4. Diphtheria - - - - - - - - - - - - - - - - - - - 5. Whooping cough - - - - - - - - - - - - - - - - - - - 6. Meningococcal infections - - - - - - - - - - - - - - - - - - - 7. Acute poliomyelitis - - - - - - - - - - - - - - - - - - - 8. Measles - - - - - - - - - - - - - - - - - - - 9. Other infective and parasitic diseases - - - - - - - - - - - - - - - - - - - 10. Malignant neoplasm, stomach - - - - - - - - - - - - 1 — 2 2 3 2 5 11. Malignant neoplasm, lung, bronchus - - - - - - - - - - 6 2 4 - - 1 10 3 13 12. Malignant neoplasm, breast — — — — — — — — — — — 2 — - — 1 — 3 3 13. Malignant neoplasm, uterus - - - - - - - - - - - 1 - 1 - - - 2 2 14. Other malignant and lymphatic neoplasms - - - 1 2 - - 1 1 2 3 6 3 2 1 3 10 15 25 15. Leukaemia, aleukaemia - - - - - 1 - - - - - - 1 - - - 1 1 2 16. Diabetes - - - - - - - - - - - - - - 1 - 1 - 1 17. Vascular lesions of nervous system - - - - - - - 1 1 - 4 4 2 4 6 9 13 18 31 18. Coronary disease, angina - - - - - - - - 1 — 13 4 11 5 6 8 31 17 48 19. Hypertension with heart disease - - - - - - - - - - - - - - 1 2 1 2 3 20. Other heart disease - - - - - - 1 - - - 2 4 5 2 5 8 13 14 27 21. Other circulatory disease - - - - - - - - - - 4 - - 3 1 6 5 9 14 22. Influenza - - - - - - - - - - - - - - - - - - - 23. Pneumonia 1 - - - - - - - - - 1 2 2 2 3 6 7 10 17 24. Bronchitis — 1 - - - - - - - - - - 6 2 1 1 7 4 11 25. Other diseases of respiratory system - - - - 1 - - - - - - - - - - - 1 - 1 26. Ulcer of stomach and duodenum - - - - - - - - - - - - - - 1 2 1 2 i 27. Gastritis, enteritis and diarrhoea - - - - - - - - - - - - 1 - - 1 1 1 2 28. Nephritis and nephrosis - - - - - - 2 - - - - - - 1 - - 2 1 3 29. Hyperplasia of prostate - - - - - - - - - - - - - - 1 - 1 - 1 30. Pregnancy, childbirth, abortion - - - - - - - - - - - - - - - - - - - 31. Congenital malformations 4 4 — 2 — 1 1 — — - — 1 — — — — 5 8 13 32. Other defined and ill-defined diseases 4 2 - - - 1 - - 2 2 4 3 3 2 - 3 13 13 26 33. Motor vehicle accidents — — — — — — — — — — 1 1 - - — - 1 1 2 34. All other accidents — — 1 — 1 - - - - - - - 1 1 - 1 3 2 5 35. Suicide — — — — — — — 1 1 — 2 2 - - - 1 3 4 7 36. Homicide and operations of war - - - - - - - - - - - - - - - - 1 — 1 9 7 1 3 4 3 5 3 6 4 40 32 41 25 29 55 135 132 267 16 Death Rate of Infants under One Year of Age No. Holborn London England and Wales All infants 16 Rate per 1,000 live births 77.29 21.6 21.7 Legitimate infants 12 Rate per 1,000 legitimate live births 67.04 - - Illegitimate infants 4 Rate per 1,000 illegitimate live births 142.9 - - Neo-natal deaths (first four weeks) 6 Rate per 1,000 live births 28.98 — — Three of the four deaths of illegitimate infants were due to prematurity or severe congenital abnormality. Rates for preceding 10 years:— Year All infants per 1,000 live births Legitimate per 1,000 legitimate live births Illegitimate per 1,000 illegitimate live births 1950 23.3 20.0 34.8 1951 35.2 30.8 83.3 1952 34.1 26.9 90.9 1953 14.6 16.7 - 1954 31.8 34.6 - 1955 27.7 32.7 - 1956 49.1 47.4 60.6 1957 35.9 35.4 40.0 1958 27.5 31.1 — 1959 65.1 70.7 32.3 1960 77.3 67.0 142.9 Deaths from Puerperal Causes (i.e., deaths classed by the Registrar-General to pregnancy or childbirth). No deaths from puerperal causes have been registered since 1953. 17 TABLE No. 4 Deaths of Infants under one year of age Causes of, and ages at, death Classification according to the short list of causes of death adopted by the Registrar General in Form S.D.25 Cause of Death AGE Under 1 Day. 1 Day to 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total Under 4 Weeks 4 Weeks to 3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Under 1 Year 23. Broncho pneumonia — — — — — — 2 — — — 2 31. Congenital malformations External hydrocephalus 1 - — — — 1 - 1 - - 2 Congenital heart disease — 1 — 1 1 3 2 — 1 — 6 32. Other defined and ill-defined diseases Prematurity 1 1 — — — 2 — — — — 2 Hypertrophy of suprarenals - - - - - - 1 - - - 1 Urinary infection - - - - - - 1 - - - 1 Fibrocystic disease of the pancreas - - - - - - - 1 - - 1 Haemorrhage G.I. tract and anoxia — — — — — — — 1 — — 1 Examination of the infant deaths of 1960 shows that four deaths occurred in the first week of life, one due to external hydrocephalus, one to congenital heart disease, and two to prematurity. Of the ten children dying between the age of one and three months, three had congenital heart disease. All but three of the sixteen infant deaths were caused by, or associated with prematurity or severe congenital abnormality. In the case of ten of the infants the home addresses were outside England and Wales. TABLE No. 5 Deaths of Infants under one year of age for preceding 10 years Classification according to the short list of causes of death adopted by the Registrar General in Form S.D.25 Cause of Death 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 5. Whooping Cough - - - 1 - - - - - - - 9. Other infective and parasitic diseases - - - - - - - - - - - 20. Other heart disease — - - - - - - - - - - 23. Pneumonia 2 - - - - - - - 1 1 2 24. Bronchitis — - 1 - - - - - - - - 27. Gastritis, enteritis and diarrhoea - - - 1 - - - - - - - 31. Congenital malformations 1 2 2 2 1 5 6 4 4 10 8 32. Other defined and ill-defined diseases 4 7 7 - 7 2 6 5 1 3 6 34. All other accidents — 1 — — — — 1 - — — — 7 10 10 4 8 7 13 9 6 14 16 18 Deaths from Tuberculosis—All Ages No. of Deaths Death Rate per 1,000 estimated population Pulmonary 1 .05 Other forms Nil — Comparable figures for preceding 10 years:— Year No. of Deaths Rate per 1,000 estimated population 1950 11 .42 1951 17 .69 1952 7 .29 1953 11 .46 1954 5 .21 1955 8 .35 1956 3 .13 1957 4 .18 1958 3 .14 1959 5 .23 1960 1 .05 A Table for the years 1951-1960 giving numbers of Holborn residents in whose cases the underlying cause of death was certified as pulmonary tuberculosis or malignant neoplasm of the lung or bronchus. Pulmonary Tuberculosis Malignant Neoplasms of Lung or Bronchus Totals Pulmonary Tuberculosis Malignant Neoplasms of Lung or Bronchus Male Female Male Female 1951 12 4 9 3 16 16 1952 5 1 14 2 6 16 1953 7 2 5 5 9 10 1954 4 1 9 5 5 14 1955 7 1 9 4 8 13 1956 1 1 19 1 2 20 1957 4 — 10 7 4 17 1958 3 — 10 2 3 12 1959 4 1 13 — 5 13 1960 1 — 10 3 1 13 This Table is included to compare by sexes the numbers of deaths from pulmonary tuberculosis with those from malignant neoplasm of the lung or bronchus. The numbers of both males or females who have died of pulmonary tuberculosis have declined during these last ten years. The numbers of deaths from malignant neoplasm of the lung or bronchus are of interest in view of trends shewn by national figures. The Table shows the higher incidence in men for both diseases, and that over the last nine years these neoplasms have produced a wastage of life greater than that of pulmonary tuberculosis. 19 SECTION 3. Infectious Diseases. The undermentioned conditions are compulsorily notifiable in Holborn:— Diseases Authority for Notification Anthrax Public Health (Infectious Diseases) Regulations, 1953 and 1960. Cholera Public Health (London) Act, 1936—Sections 192 and 304. Continued Fever Do. Diphtheria Do. Dysentery . Public Health (Infectious Diseases) Regulations, 1953. Encephalitis, Acute Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. Enteric Fever Public Health (London) Act, 1936—Sections 192 and (including Paratyphoid) 304. Erysipelas Do. Food Poisoning Food and Drugs Act, 1955—Section 26. Glanders L.C.C. Order dated 23.3.1909 and Public Health (London) Act, 1936—Section 305. Hydrophobia Do. Leprosy † Public Health (Leprosy) Regulations, 1951. Malaria Public Health (Infectious Diseases) Regulations, 1953. Measles County of London (Measles and Whooping Cough) Regulations, 1938 to 1948. Membranous Croup Public Health (London) Act, 1936—Sections 192 and 304. Meningococcal Infection L.C.C. Order dated 27.2.1912 and Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1939. Ophthalmia Neonatorum* L.C.C. Order dated 2.11.1910 and Public Health (Ophthalmia Neonatorum) Regulations, 1926 to 1937. Plague Local Government Board Order, 1900. Pneumonia Public Health (Infectious Diseases) Regulations, 1953. (Primary and Influenzal) Poliomyelitis, Acute L.C.C. Order dated 27.2.1912 and Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. Puerperal Pyrexia Puerperal Pyrexia Regulations, 1951. *Notifiable to the County Medical Officer of Health for London. †Notifiable to the Chief Medical Officer, Ministry of Health. 20 Diseases Authority for Notification Relapsing Fever Public Health (London) Act, 1936—Sections 192 and 304. Scabies County of London (Scabies) Regulations, 1943. Scarlet Fever Public Health (London) Act, 1936—Sections 192 and 304. Smallpox Do. Tuberculosis Public Health (Tuberculosis) Regulations, 1952. Typhoid Fever Public Health (London) Act, 1936—Sections 192 and 304. (Including Paratyphoid) Typhus Fever Do. Whooping Cough County of London (Measles and Whooping Cough) Regulations, 1938 to 1948. For each of the above a fee of 2/6d. is payable by the Local Authority to the medical practitioner if the case occurs in his private practice, or 1/- if the case occurs in his practice as medical officer of a public body or institution. Notifications During the year 128 cases of infectious disease were notified, of which 45 were removed to hospital. These are tabulated in the age groups (see Table No. 6, page 22). Comparative figures of infectious disease for the years 1931-1960 are also shown (see Table No. 7, pages 24 and 25). No cases of Diphtheria, Enteric fever, Erysipelas, Malaria, Ophthalmia Neonatorum, Puerperal Pyrexia or Smallpox were notified during the year. Dysentery Forty-one cases were notified and nine were removed to hospital. Eight cases were the result of an outbreak of Shigella sonnei infection in the Kingsway Creche. Numerous swabs were taken and examined by the Public Health Laboratory, County Hall, the positive cases being excluded from the Creche under care of their own doctors until three consecutive negative specimens had been produced. Food Poisoning Six cases were notified and five of them were removed to hospital. In three of these cases the patient was not resident in Holborn. Ten members of the staff of an hotel were taken ill. Five of them were admitted to hospital where they were found to be suffering from food poisoning due to Salmonella Typhimurium. None of them were kitchen staff and no guests were reported to be affected. The source of infection is thought to have been a lamb stew served to some of the staff on the previous day. With the co-operation of the general practitioners involved it was possible to ensure that none of those affected returned to duty until they were free from infection. No secondary cases occurred. 21 Measles Thirty-eight cases were notified and six were removed to hospital. Meningococcal Infection One case was notified during the year and was removed to hospital. Pneumonia (Acute Primary and Acute Influenzal) Two cases of acute primary pneumonia were notified, and one was removed to hospital. There was also one notification of acute influenzal pneumonia, which was removed to hospital. Poliomyelitis Two cases were notified. One was a case of paralytic poliomyelitis in a boy of 2½ years who had not been immunised against the disease. He was admitted to hospital. The other case was that of a young man of 25 years who complained to his doctor of weakness and wasting of his leg. Although he gave no history of recent illness it was decided that he had had poliomyelitis. He continued at work. Scabies Five cases were notified, and were treated at home. Scarlet Fever Four cases were notified, and three of them were removed to hospital. Tuberculosis See page 51. Whooping Cough Nine cases were notified, one of which was removed to hospital. Other Diseases coming to the notice of the Department Disease No. of Cases No. removed to Hospital Chicken pox 77 6 Diarrhoea 1 — Gastro-enteritis 3 2 German measles 17 12 Glandular fever 4 4 Hepatitis 2 2 Mumps 41 7 Respiratory infection 2 2 Ringworm 1 — Tonsillitis 3 3 22 TABLE NO. 6 Summary of Infections Disease Notifications 1960. (Corrected) Age Groups Disease Under 1 1- -2 2- -3 3—4 4—5 5- -10 10—15 15- -25 25—45 45—65 65& over Totals Total M F M F M F M F M F M F M F M F M F M F M F M F Diphtheria - - - - - - - - - - - - - - - - - - - - - - - - - Dysentery 2 1 3 1 6 3 2 - 1 - 4 4 3 3 2 1 2 3 - - - - 25 16 41 Encephalitis - - - - - - - - - - - - - - - - - - - - - - - - - Enteric Fever - - - - - - - - - -- - - - - - - - - - - - - - - - Erysipelas - - - - - - - - - - - - - - - - - - - - - - - - - - Food Poisoning ... 2 — — — — — - — — — 1 — — — 1 — 1 — — 1 — — 5 1 6 Malaria - - - - - - - - - - - - - - - - - - - - - -- - - - Measles — 2 3 1 3 1 7 3 4 3 7 4 - - - - - - - - - - 24 14 38 Meningococcal Infection - - - - - - - - - - - - - - - - - - - - - - 1 1 Ophthalmia Neonatorum - - - - - - - - - - - - - - - -- - -- -- - - - Pneumonia. - - - - - - - - - - - - - - - - - - - - - 1 1 2 3 Poliomyelitis - - - - 1 - - - - - - - - - - - 1 - - - - - 2 — 2 Puerperal Pyrexia - - - - - - - - - - - - - - - - - - - - - - - - - Scabies - - - - - - - - - - - - 1 - 3 - - - 1 - - - 5 — 5 Scarlet Fever - - - - - - 2 - - 1 1 - - - - - - - - - - 3 1 4 Tu berculosis (Pulmonary) 1 - - - - - - - - - - - - 1 — 4 2 4 5 1 — 11 7 18 Tuberculosis (NonPulmonary) - - - - - - - - - - -- - - - -- - - - - - 1 1 Whooping Cough 1 1 — 1 — - 1 — 4 1 — — — — — — — — 6 3 9 Totals 6 4 7 3 10 4 12 3 S 4 17 10 4 3 ) 7 1 10 5 5 6 1 1 84 44 128 23 Bacteriological Examinations The Borough Council provides bacteriological confirmation of diagnosis free of charge in connection with certain diseases. This work is carried out by the Royal Institute of Public Health and Hygiene, 23 Queen Square, W.C.I, and by the Public Health Laboratory Service at County Hall. During the year 398 specimens were submitted for examination with the following results:— Disease Positive Negative Total Diphtheria (Nasal and throat swabs) — 22 22 Dysentery (Faeces) 27 59 86 (Faecal swabs) 50 207 257 Food Poisoning (Faeces) — 3 3 (Faecal swabs) 3 12 15 (Other specimens) — 5 5 Streptococcus haemolyticus 2 1 3 Vincents organisms — 3 3 Other pathogenic organisms 1 3 4 Infectious Disease Contacts Where a person is precluded from continuing at work by reason of being a carrier or having been in contact with infectious disease, benefits under the National Insurance Act, 1946, are paid only on production of a certificate from the Medical Officer of Health. It was not found necessary to issue any such certificate during the year. International Certificates of Vaccination The International Sanitary Regulations adopted by the Fourth World Health Assembly on 25th May, 1951, prescribe inter alia that International Certificates, to be valid, must bear an approved stamp which certifies that the signature of the vaccinator is that of a doctor. During the year 525 certificates of persons travelling abroad were authenticated by the Department. Of these 448 were in respect of smallpox, 47 for cholera, 24 for typhoid, 5 for yellow fever, and 1 for poliomyelitis. Diphtheria Immunisation During the year 289 Holborn children completed the primary course of immunisation against diphtheria, and 60 received boosting doses. 24 25 Table No. 7 Comparative Figures of Infectious Disease for the last 30 years Disease 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 (Population) 34,470 36,440 36,050 36,000 35,400 34,850 34,600 34,350 30,660 23,470 17,160 16,580 17,240 13,020 18,680 21,190 23,460 24,960 25,490 25,930| 24,540 23,950 23,710 23,340 23,060 22,640 22,230 21,870 21,370 21,000 Diphtheria (including Membranous Croup) 69 76 75 74 93 60 76 49 19 7 14 17 17 5 11 12 3 2 1 2 - - - - - - - 1 2 — Dysentery 2 1 — 2 6 6 10 10 — — — — 2 13 2 6 — 4 — 2 34 9 8 34 4 7 16 30 28 41 Encephalitis Lethargica — 1 1 1 1 — — — 2 — — — — — 1 — — — — — — — 1 — — — — — — — Enteric Fever 4 4 1 3 2 2 — — 1 1 3 1 6 1 — 1 1 1 — 1 — 2 1 2 — — 4 — — — Erysipelas 17 17 19 12 18 19 10 15 13 12 3 7 3 8 3 4 8 6 5 3 1 2 1 1 1 — — 1 2 — Food Poisoning Notifiable as from Malaria 12th 11 July, 1 5 1932. 1 1 3 3 2 5 3 2 1 - - - 1 - 1 1 2 3 1 1 2 1 1 4 1 2 1 12 1 2 11 1 19 6 Measles Notifiable as from 9th S eptem ber, 19 38. — 8 39 34 58 219 33 103 107 157 87 170 137 254 133 195 37 172 71 99 56 139 38 Meningococcal Infection 4 1 3 1 1 2 1 1 3 7 7 1 1 - 1 2 2 - - - - - 2 1 2 2 1 — 4 1 Ophthalmia Neonatorum 7 4 6 6 4 3 3 5 4 4 1 5 4 4 1 4 3 3 3 2 — 2 3 — 1 — — — 1 — Pneumonia (Acute primary & Acute-influenzal) 40 28 37 38 21 30 34 21 28 14 18 20 22 14 6 17 15 9 9 5 8 4 4 4 - 3 4 2 6 3 Polio-encephalitis Acute - - - - - - - - - - - - - — — 1 1 - - - - - - - - - - - - - Poliomyelitis Acute 1 2 - - - - - - - - - - - - 1 — 5 1 2 2 — 6 17 3 12 6 11 4 2 2 *Puerperal Fever 2 1 3 3 4 2 4 — — — 1 2 2 2 2 — 1 1 - - - - - - - - - - - - Puerperal Pyrexia 4 6 5 2 4 3 2 2 3 3 2 7 3 1 4 5 5 2 4 2 3 1 - - - - - - - - Scabies Notifiable as from 1st Au gust, 1 943. 54 99 125 106 43 16 4 3 4 3 6 1 5 5 1 3 2 5 Scarlet Fever 57 57 96 115 50 67 38 59 56 20 16 23 30 20 14 24 29 13 15 16 21 18 10 5 4 4 8 9 7 4 Smallpox 3 1 1 — — — — — — — — — — — - - - - - - - - - - - - - - - - Tuberculosis Pulmonary 80 73 50 83 68 77 66 71 64 44 47 45 51 11 59 55 47 39 42 39 45 46 48 32 40 33 32 25 27 18 Tuberculosis. Non-Pulmonary 8 16 9 6 5 13 10 8 5 3 6 8 3 9 9 5 4 8 6 5 — 2 3 4 4 3 — 2 — 1 Whooping Cough 44 108 23 65 99 76 60 53 71 7 42 48 38 10 11 43 23 74 5 90 33 32 62 6 1 22 6 3 4 9 342 408 335 412 379 365 322 296 278 161 194 242 456 210 364 392 348 268 269 311 406 261 366 133 258 157 184 148 243 128 *Ceased to be notifiable as from 30th July, 1948. 26 SECTION 4. Sanitary Circumstances. Visits made by the Public Health Inspectors during 1960. Public Health (London) Act, 1936 Number of Inspections Dwelling Houses 240 Houses Let in Lodging 58 Common Lodging Houses 1 Offices 23 Rag and Bone Shops 19 Drainage Work and Testing 3,956 Noise Nuisance Visits 43 Other Inspections 690 Re-inspections of above 670 Housing Acts, 1957 and 1959 Number of Inspections Houses 102 Underground Rooms 32 Overcrowding Visits 23 Re-inspections of above 3 Factories Acts, 1937—1959 Number of Inspections Power Factories 83 Re-inspections of above 21 Non-Power Factories 7 Re-inspections of above 4 Outworkers' Rooms 5 Electrical Stations and Sites of Building Operations 144 Outworkers' Registers 1 Food and Drugs Act, 1955 Number of Inspections Dairies and Milk Shops 26 Ice Cream manufacture — Ice Cream sale and storage 13 Restaurants and Kitchens 561 Bakehouses 4 Butchers' Shops 23 Fish Shops 23 Fried Fish Shops 9 Other Food Shops 218 Market Streets 41 Licensed Premises 80 Sampling 344 Unsound Food 142 Re-inspections of above 99 27 Number of Inspections Clean Air Act, 1956 Smoke Observations 405 Inspections 52 Re-inspections of above 10 Visits 647 Smoke Control Area Visits 1,165 „ „ „ Inspections 2,374 „ „ „ Re-inspections 472 „ — No Entry 1,435 Miscellaneous Inspections Merchandise Marks Acts 11 Pharmacy and Poisons Acts 10 Prevention of Damage by Pests Act, 1949 149 Shops Act, 1950 31 Hairdressers and Barbers 62 Other Inspections 39 Re-inspections of above 31 Visits, etc., re Infectious Disease 81 Aged and Infirm Persons 52 Verminous Persons — No Entry 331 Other Visits 167 Total 15,232 Notices Served Public Health (London) Act, 1936 Intimation Notices 48 Dwelling Houses 28 Houses Let in Lodgings 13 Power Factories 1 Others 6 Statutory Notices 3 Houses Let in Lodgings 3 Food and Drugs Act, 1955 7 Restaurants 5 Butchers 2 Housing Acts, 1957 and 1959 Nil Factories Act, 1957 1 Power Factory 1 Clean Air Act, 1956 19 Adaptation of Fireplaces 19 Hairdressers and Barbers Byelaws, 1956 1 Hairdressing Salon ,, ,, ., ,, ,, ,, 1 28 Public Health (London) Act, 1936 Summary of work carried out in respect of nuisances found to exist in dwelling houses, houses let in lodgings, shops, factories, food premises, and on bombed sites: Water Supply Burst water service pipes repaired — Waterclosets Compartments cleansed and/or repaired 12 Water supplied, flushing cistern repaired 7 New W.C. pan provided 1 Ventilation improved or provided — Drainage Soil pipes, repaired, renewed or ventilated 4 Rainwater pipes, repaired or renewed 1 Drains unstopped or cleansed 6 Drains repaired or relaid — New manhole covers provided 1 Sinks Defective sinks renewed — Yards, Areas and Washhouses Drained or drains unstopped — Houses and Workshops, etc. Rooms cleansed or repaired 15 Passages and staircases cleansed or repaired 2 Ventilation improved 3 Dampness Roofs repaired 10 Gutters repaired — Other works to prevent dampness 10 Ashbins Provided, repaired, etc — Various Accumulations of refuse removed 3 Improper keeping of animals remedied 1 Noise nuisance abated 1 29 Complaints During the year 532 complaints were received in respect of the following nuisances:— Artificial lighting, absence of, on common staircase - Aged and infirm persons 1 Animals improperly kept 4 Dampness 22 Dilapidations and disrepair 22 Drains, choked or defective 17 Dust 4 Dustbin accommodation inadequate or unsuitable 1 Food premises, unsatisfactory conditions in 7 Noise 21 Overcrowding 3 Obnoxious smells 42 Refuse, accumulations of 20 Rodent infestation 182 Roofs, defective 16 Smoke 41 Unsound food 22 Vermin 61 Ventilation inadequate 2 Water supply, burst pipes — W.C. accommodation inadequate, dirty or defective 25 Miscellaneous 17 Water supply, inadequate 1 Water supply, impure 1 Water 1. Water for drinking and commercial purposes in this area is supplied by the Metropolitan Water Board and has been satisfactory both in quantity and quality. 2. There is a piped supply, and bacteriological examinations of the raw water are made by the Metropolitan Water Board, who also perform chemical analysis. 3. The water is not known to have any plumbo-solvent action. 4. No action has been necessary in respect of contamination. 5. All dwelling houses have a piped supply, and standpipes are normally used only in cases of emergency, such as repair of mains. One complaint of impure water was received. Upon investigation it was found that the condition of the water was due to the state of the internal pipes and fittings, and was remedied. Drainage During the year 3,956 inspections were made by the Public Health Inspectors in connection with drainage work; 137 applications for approval of proposed drainage work were submitted together with the necessary plans, and 117 Combined Drainage Orders were made. In 6 cases, consent was given to the carrying out of work on the single stack system of drainage. L.C.C. (General Powers) Act, 1953—Part II Discharge of trade effluent into sewers. Empowers the London County Council and Borough Councils to control the volume and content of new or modified effluents proposed to be discharged from trade premises into sewers. 30 During 1960, 2 notifications were received concerning the proposed discharge of trade effluents. In both cases notices of proposed conditions were issued by this Council and no counter proposals were received. Clean Air Act, 1956 During the year 41 complaints were received regarding smoke emissions and 405 observations were made. In most cases, it was found that the nuisance was caused by unsatisfactory stoking, and conditions were remedied following advice being given by the District Public Health Inspectors. The routine of making special observations from the roofs of four tall buildings was continued, and as in previous years these observations were helpful in checking the behaviour of boiler plant, especially in connection with plant installed in the many new buildings which have been erected. Most of the new installations however, are oil fired and consequently little trouble from smoke is experienced. Measurement of Deposited Matter and Sulphur Dioxide These forms of pollution are recorded each month by means of apparatus installed on the roof of the British Museum. The apparatus consists of a deposit gauge for collecting rainwater and deposited matter, and a lead peroxide instrument for recording the amount of sulphur dioxide in the atmosphere. The recordings obtained during 1960 were as follows:— Month Rainfall Monthly deposit—Tons per sq. mile Mg. of S03/day collected by 100 sq. cm. of Batch A Pb 02 inches pH value Insoluble matter Soluble matter Total solids January 1.56 5.5 7.92 10.60 18.52 3.76 February 1.76 4.8 8.49 9.13 17.62 2.35 March 1.78 4.8 12.64 16.67 29.31 5.00 April 0.66 6.3 5.54 9.16 14.70 3.73 May 1.61 4.8 9.69 17.18 26.87 2.73 June 1.62 5.5 8.65 8.42 17.07 2.41 July 3.39 4.8 6.78 8.51 15.29 1.50 August 2.56 4.8 7.11 11.95 19.06 1.81 September 4.40 5.4 9.63 9.83 19.46 3.38 October 5.25 6.1 12.54 22.27 34.81 3.09 November 3.57 5.8 5.54 13.66 19.20 6.05 December 1.85 5.7 18.72 11.61 30.33 2.82 Total 30.01 — 113.27 148.99 262.24 38.63 Monthly Average 2.50 5.4 9.44 12.42 21.85 3.22 31 The solid matter expressed in tons falling over the area of Holborn month by month was as follows:— Month Insoluble matter Soluble matter Total solids January 5.01 6.71 11.72 February 5.37 5.78 11.15 March 8.00 10.54 18.54 April 3.50 5.80 9.30 May 6.13 10.87 17.00 June 5.47 5.33 10.80 July 4.29 5.39 9.68 August 4.50 7.56 12.06 September 6.09 6.22 12.31 October 7.94 14.09 22.03 November 3.51 8.64 12.15 December 11.85 7.35 19.20 Daily Measurement of Suspended Matter The Council has apparatus for making daily estimations of smoke installed at the London School of Hygiene and Tropical Medicine, Keppel Street, and at the Royal Institute of Public Health and Hygiene, Queen Square. The apparatus consists mainly of an air pump which draws a known volume of air from outside and passes it through a white filter paper. The amount of smoke collected is estimated by comparing the stain on the paper with a calibrated scale of shades. The following recordings were obtained during 1960:— Concentration of smoke—milligrammes per cubic metre. Month London School of Hygiene and Tropical Medicine Royal Institute of Public Health and Hygiene Average Value Highest Value Lowest Value Average Highest Lowest Value Value Value January 0.31 0.96 0.16 0.36 1.16 0.08 February 0.29 0.64 0.08 0.39 0.80 0.22 March 0.18 0.34 0.08 0.17 0.29 0.04 April 0.22 0.48 0.09 0.19 0.31 0.11 May 0.15 0.34 0.07 0.14 0.31 0.03 June 0.08 0.16 0.06 0.14 0.27 0.11 July 0.07 0.17 0.04 0.08 0.17 0.04 August 0.09 0.16 0.06 Apparatus out of com mission September 0.60 0.99 0.04 October 0.26 0.55 0.15 0.32 0.50 0.24 November 0.27 0.36 0.15 0.28 0.48 0.23 December 0.32 0.67 0.11 0.40 0.63 0.11 32 Installation of New Furnaces In eight cases notice was received under subsection (3) of section 3 of the Clean Air Act, 1956 of a proposal to instal a furnace in the Borough, and in one case plans and specifications of a furnace were submitted to and approved by the Council as being deemed to comply with the provisions of subsection (1) of that section which requires that a new furnace shall be as far as practicable capable of being operated continuously without emitting smoke when burning fuel of a type for which the furnace was designed. Smoke Control Areas Holborn Smoke Control Area No. 1 This area is that portion of the Borough enclosed by the boundaries of the City of London and City of Westminster, and a line drawn westwards from the City of London boundary at Staple Inn, Holborn, along High Holborn to Kingsway, southward along Kingsway to Great Queen Street and along the southern side of Great Queen Street to the boundary with the City of Westminster. The Council made the Order in July, 1958; it was confirmed by the Minister of Housing and Local Government in October, 1958, and came into operation on 1st September, 1959. Four applications for grant were approved in connection with the adaptation of fireplaces in private dwellings within the area. The total cost of the work for which grants were approved amounted to £53 Os. 2d. of which £15 8s. Id. was borne by the Council, £21 4s. Od. by the Exchequer, and £15 8s. Id. by the applicants. Holborn Smoke Control Area No. 2 This area is the portion of the Borough enclosed by High Holborn, Gray's Inn Road, Theobalds Road, and Southampton Row, together with all land in the Borough south of a line between Gray's Inn Road and Farringdon Road running along Fox Court and Greville Street. The Council made the Order in November, 1959; it was confirmed by the Minister of Housing and Local Government in February, 1960; and came into operation on the 1st October, 1960. During the year twelve applications for grant were approved in connection with the adaptation of fireplaces in private dwellings within the area. The total cost of the work for which grants were approved amounted to £155 2s. 9d. of which £46 10s. 8d. was borne by the Council, £62 0s. lid. by the Exchequer, and £46 1 Is. 2d. by the applicants. Holborn Smoke Control Area No. 3 This area is enclosed by the following streets:—Kingsway, Southampton Row, Woburn Place, Tavistock Square, Byng Place, Torrington Place, Endell Street, Shelton Street, Drury Lane, and Great Queen Street. The Order was made by the Council on the 23rd March, 1960; it was confirmed by the Minister of Housing and Local Government in May, 1960, and came into operation on the 1st December, 1960. 33 During the year nineteen applications for grant were approved in connection with the adaptation of fireplaces in private dwellings within the area. The total cost of the work for which grants were approved amounted to £163 10s. 3d. of which £49 1s. 1d. was borne by the Council, £65 7s. lOd. by the Exchequer and £49 Is. 4d. by the applicants. Holborn Smoke Control Area No. 4 In October, 1960, the Council approved in principle a proposal to establish a smoke control area in that portion of the Borough enclosed by the boundary line separating Holborn and St. Pancras and a line commencing from the boundary at Woburn Place running south-east along Woburn Place and Southampton Row to Theobalds Road, along Theobalds Road to Gray's Inn Road, and then northerly along Gray's Inn Road to meet the boundary with St. Pancras. In January, 1961, provisional approval of this proposal was received from the Minister of Housing and Local Government. Pharmacy and Poisons Act, 1933 This Act, the Poisons Rules, 1960, and the Poisons List Order, 1952/60, regulate the sale of poisons, and every local authority is required to keep a list of persons who are entitled to sell poisons included in Part II of the Poisons List. During the year 1960, 33 applications were received for retention on this Council's list. Four applications were received for entry on the list. Rag Flock and Other Filling Materials Act, 1951 This Act and the Regulations of 1951, require the registration of premises where specified filling materials are used in connection with certain upholstering and filling processes, and require premises used for the manufacture or storage of rag flock to be licensed. Four premises in the Borough are registered under the Act, but no premises are licensed for the manufacture or storage of rag flock. Housing Acts 1957 and 1959 The following is a summary of action under the above Acts during the year 1960. Slum Clearance Houses included in clearance areas 8 Houses included in clearance areas and demolished Nil Houses repaired as a result of action under Sees. 9 and 10 Nil Houses made the subject of demolition orders Nil Houses demolished as a result of demolition orders Nil Houses made the subject of closing orders Nil Parts of buildings made the subject of closing orders Nil Parts of buildings closed by undertaking Nil Underground rooms made the subject of closing orders 5 Underground rooms closed by undertaking Nil Closing orders determined Nil No. of flats erected by the Council during the year 142 34 Note: The number of underground rooms which do not comply with the relevant Regulations, but which are occupied for human habitation, is 443. Houses Let in Lodgings Number in Borough 266 Inspections made 58 Overcrowding On the 1st January, 1960, 130 families were known to be living in overcrowded conditions. During the year a further 4 families were found to be living in overcrowded conditions. In 7 cases, overcrowding was abated during the year as follows:— Families rehoused by the Holborn Borough Council 3 Families rehoused by the London County Council 1 Accommodation found by other means 3 During the year 23 visits were made by the Public Health Inspectors in connection with conditions of overcrowding. In cases where overcrowding is abated, a warning letter is sent to the owner of the premises drawing attention to the relevant provisions of the Housing Acts. Rent Act, 1957 The following particulars were supplied to the Minister of Housing and Local Government in accordance with Circular No. 32/57 dated 6th June, 1957:— Applications for Certificates of Disrepair (1) Number of applications for certificates 1 (2) Number of decisions not to issue certificates Nil (3) Number of decisions to issue certificates 1 (a) in respect of some but not all defects 1 (b) in respect of all defects Nil (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 1 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule Nil (6) Number of certificates issued Nil Applications for Cancellation of Certificates (7) Applications by landlords to Local Authority for cancellation of tificatesNil (8) Objections by tenants to cancellation of certificates Nil (9) Decisions by Local Authority to cancel in spite of tenant's objection Nil (10) Certificates cancelled by Local Authority Nil 35 Rodent Control Prevention of Damage by Pests Act, 1949 This Act lays a duty upon a local authority to see that their district is kept free from rats and mice. It empowers them to carry out inspections and to require owners and occupiers to keep their land and premises free from infestation. Occupiers are required to give notification in writing of infestation by rats or mice to the local authority. Report for 12 months ended 31st December, 1960 The following particulars were supplied to the Minister of Agriculture and Fisheries in accordance with Circular POP/1961/2 dated 3rd February, 1961:— Type of Property Local Authority Dwelling Houses Agricultural All other (including Business and Industrial) Total 1. Total number of properties in Local Authority's District 13 6,016 — 7,309 13,338 II. Number of properties inspected as a result (a) of notification (b) survey, or (c) otherwise (a) 2 86 — 94 182 b) 1 119 — 664 784 (c) - 30 — 37 67 III. Total inspections carried out including re-inspections 18 823 1,254 2,095 IV. Number of properties (under II) found to be infested by:— (a) Rats Major* — — — — — Minor† — 31 19 50 (b) Mice Major* 7 7 Minor† 2 39 — 46 87 V. Number of infested properties (under IV) treated by the Local Authority 2 70 — 65 137 VI. Number of notices served under Section 4— (1) Treatment — — — — — (2) Structural works (i.e. Proofing) VII. Number of cases in which default action was taken by Local Authority following issue of notice under Section 4 — — — — — VIII. Legal Proceedings — — — — — IX. Number of " block" control schemes carried out 16 " blocks " surveyed. * "Major " includes properties with an estimated population exceeding 20 rats or mice, † "Minor " includes properties with an estimated population not exceeding 20 rats or mice. During 1960, 182 complaints of rat or mice infestation were received and investigated. 36 The following table shows the work carried out during the year arising from the complaints received, and in connection with 16 blocks which were surveyed. Complaint Block Survey Total Business premises inspected 131 664 795 Dwelling houses inspected 116 119 235 Local authority premises inspected 2 1 3 Business premises treated 65 — 65 Dwelling houses treated 70 — 70 Local authority premises treated 1 1 2 Business premises, inspection visits 185 683 868 Business premises, treatment visits 386 — 386 Dwelling houses, inspection visits 195 120 315 Dwelling houses, treatment visits 508 — 508 Local authority, inspection visits 4 — 4 Local authority, treatment visits 8 6 14 Total visits 1,286 809 2,095 Estimated kill (rattus norvegicus) 184 184 Bodies recovered (rattus norvegicus) 81 — 81 Estimated kill (rattus rattus) 14 — 14 Bodies recovered (rattus rattus) 4 — 4 Estimated kill (mice) 782 12 794 Bodies recovered (mice) 213 4 217 Disinfecting Station The arrangement whereby Holborn undertakes to carry out all disinfecting, disinfestation and cleansing work for the City of Westminster continued during the year. The figures below relate to work done for Holborn only. Disinfection Number of rooms disinfected after tuberculosis 3 Number of rooms disinfected after other infectious diseases 89 Total number of rooms disinfected after infectious disease 92 Number of articles of bedding and clothing disinfected after tuberculosis 234 Number of articles of bedding and clothing disinfected after other infectious diseases 2,539 Total number of articles disinfected after infectious disease 2,773 Number of books disinfected after infectious disease 103 Baiting of Sewers Two treatments were carried out during the year, the results of which are shewn below. In both treatments sausage rusk plus 2½% zinc phosphide was used. Treatment No. of Manholes No. of bodies found No. Date Baited Showing pre-bait take Total poison take 1 April, 1960 240 211 186 187 2 October, 1960 249 212 197 192 37 Disinfestation Number of rooms disinfested of vermin 202 Number of articles of bedding and clothing disinfested of vermin 3,513 Summary of 6,286 articles of bedding and clothing dealt with during the year:— Mattresses 162 Pillows 319 Pillow Cases 120 Bolsters 37 Bolster Cases 24 Blankets 314 Sheets 192 Household 4,681 Clothing 360 Other Bedding 77 Cleansing Number of persons treated for scabies 19 Number of persons treated for head lice 1 Number of persons treated for body lice 24 Number of persons treated for crab lice 36 Number of persons cleansed 12 Aged Persons The National Assistance Acts, 1948 and 1951, provide that, where certified by the Medical Officer of Health to be necessary for the purpose of securing the proper 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, a local authority may apply to a court of summary jurisdiction for an order to secure the removal of such aged and infirm persons. There were no cases arising during the year which called for action under the above Acts by the Public Health Department, but visits were made in connection with the voluntary removal of aged and infirm persons living alone, to hospitals or other places and in connection with the provision for such persons of home nursing and home help facilities. Burial of the Dead Section 50 of the National Assistance Act, 1948, places upon the Borough Council the responsibility of causing to be buried or cremated the body of any person who has died in the area, or been found dead in the area, in any case where it appears that no suitable arrangements for the disposal of the body are otherwise likely to be made. Such cases are those of persons who die in poor circumstances, and, with few exceptions, have no known relatives. Hospital Management Committees and Boards of Governors of Teaching Hospitals have been asked by the Minister to exercise their powers to arrange and pay for the burial or cremation of such persons dying in hospital. This Circular does not apply to voluntary hospitals, of which there are two in the Borough, namely the French Hospital, Shaftesbury Avenue, and the Italian Hospital, Queen Square. 38 During the year fifteen cases were dealt with, at a total cost of £217 12s. 6d. The total amount recovered during the year in respect of burials was £193 7s. 8d. The cases had come to the notice of the Public Health Department from the following sources:— Coroner's Officer 6 Hospitals or Doctors 5 Friends or Relatives of Deceased 3 Undertakers 1 New Legislation Noise Abatement Act, 1960 This Act which came into operation on the 27th November, 1960, amends the provisions of the London County Council (General Powers) Act, 1937 by substituting " noise which is a nuisance" for the words " noise which is injurious or dangerous to health," makes vibration as well as noise a statutory nuisance, and restricts the use of loudspeakers in a street. Skimmed Milk with Non-Milk Fat Regulations, 1960 These Regulations come into operation on 19th September, 1961, and impose requirements as to the labelling and advertising of certain "specified foods" which have the appearance of milk, condensed milk or dried milk and which contain skimmed milk and non-milk fat. Arsenic in Food (Amendment) Regulations, 1960 These amending Regulations came into operation on the 14th December, 1960, and increase from 2 to 5 parts per million the maximum amount of arsenic permitted in brewers yeast for use in the manufacture of yeast products. Factories (Cleanliness of Walls and Ceilings) Order, 1960 This Order prescribes the manner of painting and repainting inside walls and ceilings of factories and the intervals for repainting. Milk (Special Designation) Regulations, 1960 Came into operation on 1st October, 1960. They consolidate and re-enact with amendments the Milk (Special Designation) (Raw Milk) Regulations, 1949-1954, and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949-1953. The new Regulations provide that dealers licences which are issued for a period of five years, no longer restrict sales to the area of the licensing authority, and supplementary licences are therefore discontinued. Food Hygiene (General) Regulations, 1960 These Regulations consolidate and amend the Food Hygiene Regulations, 1955 to 1957, and extend the regulations to food businesses carried on from home-going ships and moored vessels. Offices Act, 1960 This Act comes into force on 1st January, 1962. The object of the Act is to provide for the health, welfare and safety of persons employed in offices and power is given to the Home Secretary to make regulations for this purpose. Oil Burners (Standards) Act, 1960 This Act came into operation on the 1st January, 1961. The object of the Act is to provide for minimum standards of efficiency and safety for oil heaters and power is given to the Home Secretary to make regulations for this purpose. Meat (Staining and Sterilisation) Regulations, 1960 These Regulations came into force on the 1st November, 1960, and require all butchers' meat and imported meat which is unfit for human consumption to be sterilised, and all knacker meat to be stained or sterilised before entering the chain of distribution. 39 SECTION 5. Factories. Most of the provisions of the Factories Acts, 1937-1959, are administered by the Ministry of Labour and National Service through H.M. Factory Inspectors. The Sanitary Authority is charged with the duty of enforcing the legislation as to sanitary accommodation in all factories in its area, and, in those factories where mechanical power is not used, legislation with regard to cleanliness, overcrowding, temperature, ventilation, and drainage of floors. All factories must have an adequate supply of drinking water from a public main or some other source approved in writing by the Council. Particulars of inspections and other work carried out during 1960 are as follows:— Number of visits to:— Factories with mechanical power 104 Factories without mechanical power 11 Outworkers registers 1 Outworkers' rooms 5 Electrical stations and sites of building operations 144 Factories Acts, 1937—1959 The following particulars are furnished in accordance with Section 128 (3) of the principal Act, with respect to matters under Part I and Part VIII:— Part I of the Act I. Inspections for purposes of provisions as to health. Premises No. 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 183 11 - - (II) Factories not included in (i) in which Section 7 is enforced by the Local Authority 709 104 1 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 36 144 — - Total 928 259 1 - 40 2. Cases in which defects were found. PARTICULARS Number of Cases in which Defects were Number of Cases in which Prosecutions were Instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (S.1) 1 1 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 20 17 — 5 (c) Not separate for Sexes 1 1 — 1 — Other offences against the Act (not including offences relating to Outwork) 4 3 1 1 — Total 26 22 1 7 — Part VIII of the Act Outworkers Section 110 of the Factories Act, 1937, requires that where, in certain specified industries, work is given by an employer or contractor to be done by workers outside his factory, lists containing the names and addresses of such workers must be forwarded to the Local Authority. Section 111 has the object of preventing such work being carried out in premises which are insanitary or in which infectious disease is present. The following table gives the number and type of such premises in the Borough, and the nature of the work carried out:— Type of Specified Work Section 110 Section 111 No. of Outworkers in August List required by Sect. 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 Wearing Apparel— Making, &c. 231 - - - - - Cleaning and Washing 1 — — — — — Household Linen 2 — — — — — Lace, Lace Curtains and Nets 3 - - - - - Artificial Flowers 1 — — — — - Cosaques, Christmas Crackers, Christmas Stockings, &c. 53 - — — — - Total 291 — — — — — 41 Firms in the Borough employing outworkers 23 No. of outworkers on lists submitted 291 No. of outworkers referred to other Boroughs 279 No. of outworkers in Holborn employed by Holborn firms 12 No. of outworkers in Holborn employed by firms outside the Borough 26 Total number of outworkers in Holborn 38 Inspection of outworkers' premises 5 Cases of notifiable disease occurring in such premises Nil 42 SECTION 6. Inspection and Supervision of Food. General All premises where food is prepared, stored or exposed for sale for human consumption are inspected, and the following is a record of the inspections made during 1960:— Dairies and milk shops 26 Ice cream, sale or storage 13 Ice cream manufacture — Restaurants and kitchens 561 Bakehouses 4 Butchers' shops 23 Fish shops 23 Fried fish shops 9 Other food shops 218 Market streets 41 Licensed premises 80 Sampling 344 Unsound food 142 Re-inspections 99 Food and Drugs Act, 1955 Notices During 1960, 7 notices were served on owners or occupiers of food premises, drawing attention to infringements of the Food Hygiene (General) Regulations, 1960. Details of the premises are as follows:— Restaurant 5 Butchers 2 43 The following is a summary of the work carried out during the year as a result of Notices served under the Food and Drugs Act, 1955, in respect of food premises: Premises or parts of premises put in sanitary condition — Articles and equipment put in good order, repair and condition — Notice provided in sanitary convenience re washing hands — Sanitary conveniences cleansed and put in efficient order 2 Persons handling food:— Wash-hand basins provided — Hot and cold water provided — Soap detergents, nail brushes and towels provided — Washing food and equipment:— Suitable and sufficient sinks provided — Sinks and other equipment cleansed and put in good order — Ventilation of food rooms improved 1 Food rooms repaired and put in good condition 6 Food rooms cleansed 2 Accumulation of refuse in food room removed — Registrations The Milk and Dairies Regulations require every Local Authority to keep a register of all persons carrying on the trade of distributor in their district and of all premises which are used as dairies. "Dairy" does not include a shop from which milk is supplied only in the properly closed and unopened vessels in which it is delivered to the shop, or other place in which milk is sold for consumption on the premises only. "Distributor" includes a purveyor of milk whether by wholesale or retail. Most distributors now sell milk in the bottles and cartons in which they receive it from the wholesaler, and consequently their premises are not required to be registered as dairies. Dairies registered during 1960 Nil Dairies removed from register during 1960 Nil Dairies on register at end of 1960 1 Distributors registered during 1960 6 Distributors removed from register during 1960 7 Distributors on register at end of 1960 72 Number of above distributors trading from premises outside Borough 25 Inspections made by Inspectors during 1960 26 Formal milk samples taken and submitted for analysis 79 Informal milk samples taken and submitted for analysis 89 44 The following tables show the monthly variation of the chemical composition of the 168 samples. Designated Milk Month Number of Samples examined Fat Per cent, average Solids Non-fat Per cent, average Total Solids Per cent, average January 14 3.40 8.58 11.98 February 11 3.42 8.57 11.99 March 12 3.38 8.65 12.03 April 14 3.41 8.68 12.09 May 10 3.28 8.67 11.95 June 11 3.42 8.67 12.09 July 18 3.38 8.62 12.00 August 7 3.44 8.70 12.14 September 12 3.51 8.67 12.18 October 12 3.66 8.76 12.42 November 11 3.76 8.81 12.57 December 13 3.77 8.76 12.53 Whole year 145 3.49 8.68 12.17 Legal minimum - 3.00 8.50 11.50 Channel Island and South Devon Milk Month Number of Samples examined Fat Per cent, average Solids Non-fat Per cent, average Total Solids Per cent, average January - - - - February 3 4.31 9.07 13.38 March 2 4.18 9.00 13.18 April — — - - May 4 4.06 9.06 13.12 June 3 4.17 8.94 13.11 July 1 4.25 8.71 12.96 August — — - - September 3 4.21 8.89 13.10 October 2 4.60 9.12 13.72 November - - - - December 5 4.63 9.01 13.64 Whole year 23 4.30 8.98 13.28 Legal minimum — 4.00 8.50 12.50 45 These figures approximate closely to those of the previous ten years, averages of which are tabulated below:— Designated Milk Year No. of Samples examined Total Solids (average) Non-fatty Solids (average) average) 1950 216 12.32 8.80 3.52 1951 217 12.35 8.83 3.52 1952 179 12.39 8.86 3.53 1953 175 12.18 8.69 3.49 1954 157 12.20 8.61 3.59 1955 164 12.19 8.65 3.54 1956 192 12.39 8.73 3.66 1957 160 12.48 8.80 3.68 1958 146 12.43 8.76 3.67 1959 143 12.26 8.69 3.57 1960 145 12.17 8.68 3.49 Milk (Special Designations) Regulations A person proposing to use a special designation authorised by the Regulations is required to apply to the licensing authority of the area in which the milk is to be sold, for a licence to use the designation. Upon being satisfied that the relevant provisions of the Regulations are complied with, a Licensing Authority grant a dealer's licence to a distributor in respect of each of his premises within their area from which the designated milk is to be sold. A licence is issued for a period of five years and permits the sale of designated milk outside as well as inside the area of the licensing authority (see p. 38). During the year 177 licences were issued, details of which are as follows:— Dealer's Licences Dealer's Supplementary Licences To sell Tuberculin Tested milk 31 22 To sell Pasteurised milk 44 22 To sell Sterilised milk 44 24 Milk—Bacteriological Examination During the year, 109 samples of milk were submitted for bacteriological examination. 42 of these were from milk supplied to schools in the Borough and four to a Day Nursery. 46 Registration of Premises used for the Manufacture, Storage or Sale of Ice Cream Premises used for the manufacture, storage or sale of ice cream are required by Section 16 of the Food and Drugs Act, 1955, to be registered by the local authority. On the 1st January, 1960, two sets of premises were registered for the manufacture, storage and sale of ice cream, in Holborn, and 128 premises were registered for storage and sale. During the year 4 applications were received and approved in respect of premises to be used for storage and sale of ice cream. At the end of the year, there were two registrations for manufacture, storage and sal e, and 132 premises were registered for storage and sale. Ice Cream (Heat Treatment, Etc.) Regulations, 1959 During the year, 61 samples of ice cream were submitted for examination by the Methylene Blue Test. The results in the grading suggested by the Ministry of Health were as follows:— Grade 1 51 Grade 2 5 Grade 3 2 Grade 4 3 In addition, 9 samples of ice lollies were submitted for bacteriological examination, and all of them were found to be satisfactory. In the case of samples falling within Grades 3 and 4, letters were sent to the vendors drawing their attention to the poor grading. In such cases where the ice cream was manufactured outside Holborn, details were also sent to the Medical Officers of Health of the areas concerned. Licensed Premises There are 75 public houses in the Borough, and during the year 80 inspections were carried out. In addition, 45 reports were submitted to the Licensing Justices, in respect of premises where application had been made for the grant, re-grant or transfer of a licence under the Licensing Act, 1953, 47 Food Sampling A total of 492 samples of food and drugs were purchased and submitted to the Borough Analyst for chemical analysis during the year. 258 were formal samples and 234 were informal. Article Number of Samples purchased Baking Powder 1 Batter Mix 1 Butter 5 Cake Mixture 1 Cheese 1 Coffee 7 Condiments 17 Cooking Fat, Oil, Dripping and Suet 11 Cream, fresh and tinned 8 Creamed coconut 1 Curry Powder 2 Custard Powder 2 Desiccated Coconut 2 Drugs and Medical Preparations 1 Essences and Flavourings 12 Fish, fresh, tinned and preserved 20 Flour 2 Fruit, dried, tinned and fresh 13 Gelatine 1 Honey 1 Ice Cream 8 Jams and Preserves 14 Jellies 3 Lemon Juice 4 Margarine 1 Meat and Meat Preparations 57 Milk 168 Milk, Evaporated and Condensed 6 Milk Shake Ingredients 1 Noodles 2 Olive Oil 5 Pearl Barley 1 Puddings 4 Rice 4 Salad Dressings 2 Sandwich Spread 3 48 Article Number of Samples purchased Sauces 13 Semolina 3 Soft Drinks and Cordials 12 Soups 5 Spices 6 Sugar 1 Sweets and Confectionery 18 Tapioca 2 Tea 4 Tomato Juice, Paste, Puree and Ketchup 4 Turkey 1 Vegetables, tinned and dried 18 Vitamin Tablets and Preparations 12 Wine 1 492 49 Unsound Food During the year 1960, the undermentioned unsound food was surrendered and destroyed or disposed of otherwise:— Commodity Tons Cwts. Qtrs. Lbs. MILK Fresh - - - - Tinned — — 1 26½ FISH Fresh - - 2 Tinned - - — 19½ MEAT Fresh - - 2 20¼ Tinned 2 1 3 21½ FRUIT Fresh Tinned 2 6 3 8½ VEGETABLES Fresh - - 3 - Tinned 2 2 3 15 OTHER FOOD 3 3 — 9¾ TOTAL 9 18 — 9¼ 50 SECTION 7. Tuberculosis. The following table gives the number of new cases of tuberculosis notified, and deaths during 1960 of persons notified as suffering from the disease:— Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. 0— 1 year 1 - - - - - - - 1— 2 years - - - - - - - - 2— 5 years - - - - - - - - 5—10 years - - - - - - - - 10—15 years - - - - - - - - 15—20 years - - - - - - - - 20—25 years 1 - - - - - - - 25—35 years 2 — 1 - - - - - 35—45 years 1 2 - - - - - - 45—55 years 4 3 — — 1 — — — 55—65 years 1 2 - - - - - - 65—75 years 1 — — — 3 — — — 75 and over - - - - - - - - TOTAL 11 7 1 — 4 — — — *Only one of these persons died of tuberculosis. 51 Summary of Changes in Tuberculosis Register During 1960 Pulmonary Non-Pulmonary M. F. M. F. Cases on Register at 31st December, 1959 137 117 3 12 269 Cases Added Primary notifications 11 7 1 - 19 Transferred from other districts 8 6 - - 14 Totals 156 130 4 12 302 Cases Removed Moved to other district 9 13 - - 22 Recovered 3 5 1 9 Died 4 - - - 4 Lost trace of 4 2 — - 6 Totals 20 20 — 1 41 Cases on Register at 31st December, 1960 136 110 4 11 261 52 Tuberculosis Notifications and Deaths for the last 50 years Notifications Rate per 1,000 Population Deaths Rate per 1,000 Population 1911 187 3.81 116 2.36 12 210 4.37 111 2.29 13 204 4.35 100 2.13 14 135 2.88 103 2.20 15 198 4.90 86 2.13 16 218 5.71 80 2.10 17 149 4.22 95 2.69 18 163 4.43 105 2.86 19 94 2.46 75 1.97 1920 123 3.10 55 1.39 21 117 2.69 48 1.10 22 82 1.91 51 1.19 23 60 1.38 48 1.11 24 87 2.01 54 1.25 25 74 1.71 54 1.25 26 92 2.13 35 .81 27 111 2.63 55 1.30 28 105 2.67 47 1.20 29 88 2.29 44 1.15 1930 86 2.24 43 1.12 31 88 2.55 38 1.10 32 89 2.44 38 1.04 33 59 1.64 29 .80 34 89 2.47 32 .89 35 73 2.06 30 .85 36 90 2.58 35 1.00 37 76 2.20 27 .78 38 79 2.30 32 .93 39 69 2.25 20 .65 1940 47 2.00 24 1.02 41 53 3.09 22 1.28 42 53 3.19 30 1.82 43 54 3.13 21 1.22 44 50 2.78 15 .83 45 68 3.64 16 .86 46 60 2.83 13 .61 47 51 2.17 18 .77 48 47 .88 13 .52 49 48 1.88 15 .59 1950 44 1.69 11 .42 51 45 1.83 17 .69 52 48 2.00 7 .29 53 51 2.15 11 .46 54 36 1.54 5 .21 55 45 1.95 8 .35 56 36 1.59 3 .13 57 32 1.44 4 .18 58 26 1.19 3 .14 59 27 1.26 5 .23 1960 19 0.90 1 .05 53 MEDICAL EXAMINATION OF STAFF Staff medical examinations are undertaken on the following occasions. (a) Entrants to the Established Staff. All persons appointed to the established staff are medically examined, unless they are already established local authority officers. In general, non-established staff are first examined as soon as it seems reasonably certain that they will remain in the Council's employ. They are examined again immediately prior to joining the establishment. (b) After sickness. Staff whose sick pay has expired are examined to evaluate the probability of their return to duty. A report is sent to the appropriate committee. (c) Age. Certain staff who wish to continue working after the normal age for retirement are examined to determine their fitness to do so. Motor drivers are examined at the ages of 55 years and 60 years and thereafter annually. The following table gives the numbers and results of examinations conducted during 1960. No. of Examinations Results First examination 59 Fit for employment 61 Second examination 12 Decision deferred 16 Re-examinations of the above 7 Not fit for employment 3 By reason of age 2 A decision is deferred when further observation or investigation of an abnormality is desirable, or to enable the applicant to obtain treatment for a remediable defect. In addition 14 examinations were made of 11 persons who had had long periods of sickness. In all cases the general practitioner was consulted. As a result of these deliberations, 5 persons were considered to be " incapable of discharging the duties of their employment by reason of permanent ill health or infirmity of body." OLD PEOPLE'S WELFARE The register of Elderly Holborn Residents which is kept consists of names supplied by persons and organisations interested in the welfare of the aged. It includes members of Old Peoples' Clubs and those who are visited by other organisations. The remainder are visited regularly by the Social Workers. The state of the register at the end of the year was:— Number on visiting list 256 Number known to be active or members of Clubs 387 Visited by other organisations 227 Total number registered 870 Old people who are fit and well are visited once a year to maintain contact and check the accuracy of the register. Less able people are visited quarterly or monthly. When special difficulties arise more frequent visits are needed. From July 1st to December 31st, 720 visits were made by the Social Workers.