AC. 4342 HOL 50 The Metropolitan Borough of Holborn REPORT OF THE MEDICAL OFFICER of HEALTH FOR THE YEAR 1961 G. W. PIPER, M.B., D.P.H. The Metropolitan Borough of Holborn REPORT OF THE MEDICAL OFFICER of HEALTH FOR THE YEAR 1961 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 IN D E X—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 1960/61 was Alderman M. P. Greengross, O.B.E., J.P., and in 1961/62 was Councillor H. Gould, F.C.A., J.P. The Deputy Mayor in 1960/61 was Councillor A. F. Judd, and in 1961/62 was Alderman Mrs. L. J. Coleman, A.R.S.H. 1960/61 1961/62 Chairman— Chairman- Councillor S. Jaque (Deputy Mayor). Alderman M. P. Greengross, O.B.E., J.P. Vice-Chairman— Vice-Chairman— Councillor Mrs. L. J. Coleman, A.R.S.H. Councillor I. W. Galbraith. Councillor Mrs. L. A. Brown. Councillor J. A. Barker. ,, E. A. J. Clark. „ P. M. Best. ,, J. Clark. „ J. Clark. „ E. G. Cracknell. „ E. G. Cracknell. „ M. Critchley, M.D., F.R.C.P. „ M. Critchley, M.D., „ C. H. Davies. F.R.C.P. „ Mrs. A. G. Finn. „ C. H. Davies. „ T. E. C. Harris. „ Mrs. A. G. Finn. „ F. Jaque. „ H. T. Haddow, L.D.S. „ Mrs. L. G. Jayne. „ W. J. Holmes. „ Miss M. C. Smith. „ F. Jaque. „ C. D. B. Tutt, M.H.C.I. „ S. Jaque. „ Mrs, L. G. Jayne, 6 STAFF The following was the staff of the Public Health Department during 1961. Medical Officer of Health: G. W. Piper, M.B., B.S., D.P.H. Public Analyst: (Part time) J. H. E. Marshall, M.A., F.R.I.C. (from 5.12.61) C. H. Wordsworth, B.Sc., F.R.I.C. (Died 1.6.61) Deputy Public Analyst: (Part Time) J. H. E. Marshall, M.A., F.R.I.C. (to 1.6.61) 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: 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 K. Wooster (from 27.3.61 to 22.10.61) Clerical Staff: R. R. Stent, (Senior Clerk). D. G. Marshall, (Senior Clerical Assistant). Miss I. J. Palk. Miss M. Field. B.O'Halloran (to 24.6.61) J. J. Parker. M. J. Burrows (from 30.10.61) 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 Operative: 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. September, 1962. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Holborn, Your Worship, Ladies and Gentlemen, The preliminary report on the census shows the population of the borough as 21,596. Thus during the last ten years, the number of Holborn residents has decreased by 13%. At the same time the redevelopment of commercial premises has continued to augment the amount of office accommodation in the borough. Consequently the daytime population, whose numbers are not exactly known, must be assumed to have increased. The Offices Act, 1961 enabled the Home Secretary to make regulations for the better provision for health, welfare and safety in offices. So far no regulations have been made, and we have few powers to regulate the conditions under which a great number of people work. The birth and death rates recorded in this report differ little from those of recent years. Statistics culled from such a relatively small population as that of Holborn are subject to chance fluctuations and must be interpreted with caution. The reduction to five in the number of deaths from lung cancer is one such chance occurrence. Diseases of the heart and circulatory system, particularly coronary disease, continue to be the commonest causes of death. The mortality from lung cancer however, is particularly regrettable since much of it is attributable to cigarette smoking, which was until recently regarded as an innocent pleasure. In spite of the speed and density of traffic in the borough only one Holborn resident died as a result of a motor accident. There were three deaths from accidents in the home, one from barbiturate poisoning, one from coal gas poisoning, and one by electrocution. As was to be expected there were many cases of measles during the year. Nowadays this disease does not constitute a very serious threat to the lives of healthy children in this country and only in exceptional circumstances is it deemed necessary to offer specific protection against it. Towards the end of the year an epidemic of German measles began. This is a mild illness which is not notifiable and the exact extent of the epidemic is therefore unknown. However it has become common knowledge that women who suffer this complaint during the first three months of pregnancy run an increased risk of bearing a deformed child. Accordingly many requests for advice were received. Twenty-three new cases of tuberculosis were notified during the year. This is a considerable reduction from the figures for years gone by, but there is no ground for complacency. Four of the patients were domestic servants, three were engaged in the catering trade and two were nurses. By the nature of their occupation, people in these groups merit special supervision and protection. In recognition of this, the Mass X-Ray Unit of the North-West Metropolitan Regional Hospital Board organised a special survey of the employees in the hotel and catering trades to be carried out early in 1962. Only one case of poliomyelitis was notified. We have reason to be cautiously optimistic about the control of this disease, the more so since oral (Sabin type) vaccine is now available. There was no serious outbreak of dysentery, nor of food poisoning during the year, but the number of notified cases, almost certainly under-estimates the true incidence of these diseases. Once again there was no case of diphtheria. During the whole of the year there was a vacancy in the establishment of public health inspectors, and as a result the routine inspection of premises in the borough was somewhat curtailed. Routine inspections are unexciting and often apparently unproductive, 8 They are, however, essential in maintaining standards and in securing constant attention to the needs of the public health. The same may be said of food sampling. The overwhelming majority of samples are reported by the Borough Analyst to be genuine, but I am certain that continued sampling is necessary to maintain this happy state of affairs. Work on the smoke control programme was, with the help of an additional technical assistant, further accelerated during the year, and the sixth and last smoke control order was made by the Council in December. By the 1st December, 1962, the borough will be the first to have become entirely covered by smoke control orders. The effects are not yet apparent in the measurements made by our smoke recording instruments. The general absence of smoke from chimneys in a smoke control area however, makes the occasional miscreant the more obvious. The majority of smoke emissions are of short duration and result from mechanical failures. In July, 1961, I submitted a representation that three houses in Eagle Street were unfit for human habitation. It is understood that consultations with the owners of the property have taken place, but so far no order has been made by the Council. The general standard of housing in the borough is better than in many other parts of London, but there is a relatively small number of dwellings which were considered unfit many years ago, and with the agreement of the County Council they are scheduled to be dealt with by 1965. In October the Council made new Underground Room Regulations. Their effect is substantially the same as that of the old regulations, but more lattitude is allowed in the means of achieving the desired ends. During the early part of the year the department designed displays for the Home Safety Exhibition organised by the Road and Home Safety Committee. The stands received favourable comment and were subsequently loaned to other authorities. The number of old people on the register kept by the department increased during the year. In getting to know old people in the borough we rely entirely on information given informally by old people themselves, and by other persons interested in their welfare. The closest possible liaison is kept with voluntary workers in the borough, and with the health visitors of the County Council. The social workers visits are greatly appreciated by the old people, many of whom are assisted thereby to retain their independence. In June, the administration of the old people's holiday scheme (which is run by the Old People's Welfare Committee, with a grant from the Borough Council) was transferred to the department. Over the past several years the establishment of clerical officers in the department has quite properly been decreased. As a result of recent additions to the duties of the department however, the number of staff is now barely adequate. It goes without saying that the work of the clerical sections is essential to the smooth running of the department, and that the senior officers are required to bring specialist knowledge of public health to the performance of their duties. Clerical and technical officers together form a team which, I am pleased to say, functions efficiently and harmoniously. I am happy to place on record my gratitude to the Public Health Committee and particularly its Chairman, for their interest and encouragement, and at times their forbearance. I would thank also my fellow chief officers for their help and support. By no means least my thanks are due to the staff of the department who have worked conscientiously and efficiently throughout the year, with the results that 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 1½ 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 11I½ 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 (1961) census (provisional figure) 21,596 Population (Registrar-General's mid-1961 estimate) 20,520 Number of persons per acre (estimated average) 51 Number of dwelling houses, flats and other residences 6,107 Rateable Value £4,112,840 Product of penny rate, approximately £16,000 General rate for the year 16s. l0d. 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 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 1961 67 408 475 20,520 23.15 Summary of Vital Statistics Live Births 216 Birth-rate (per 1,000 estimated population) 10.53 Deaths, all ages 243 Death-rate (per 1,000 estimated population) 11.84 Infant deaths 10 Infant death-rate (per 1,000 live births) 46.29 Maternal deaths Nil Maternal death rate (per 1,000 live births) Nil (per 1,000 live and still births) Nil Tuberculosis deaths 2 Tuberculosis death-rate (per 1,000 estimated population) 10 Cancer deaths 54 Cancer death-rate (per 1,000 estimated population) 2.63 Maternity and Child Welfare Centres Telephone Province of Natal Centre, Guilford Place CHAncery 9401 Chest Clinic Telephone University College Hospital, Huntley Street, W.C.I EUSton 5050 Day Nurseries Telephone Kingsway Creche (Voluntary Day Nursery), Kingsway Hall, Kingsway, W.C,2 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 342 The Royal London Homoeopathic Hospital, Great Ormond Street, W.C.1 Terminus 3091 Group 22, N.W. Regional Hospital Board 180 The National Hospital, Queen Square, W.C.1. Terminus 3611 Special Teaching Hospital 200 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 51 French Hospital, Shaftesbury Avenue, W.C.2 Temple Bar 5025-6 Voluntary Hospital 57 Italian Hospital, Queen Square, W.C.1 Holborn 6191 Voluntary Hospital 54 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— Dial "999" (or follow the Sudden illness in the streets, public places or instructions given on the places of employment. (Note—For sudden telephone instrument) illness in the home a doctor, not an ambu- and ask for— lance, should be summoned.) "AMBULANCE" (2) Maternity patients (who have booked a bed Telephone in a hospital or maternity home)— WATerloo 6000 CENtral 6301 Very urgent illness in the home (provided a REGent 4000 medical practitioner certifies that the case RELiance 3622 or is urgent and arrangements have been made NEW Cross 2645 with a hospital for the patient's admission). 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 1961. Population The civilian population, as estimated by the Registrar-General, Mid-1961 was 20,520. 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 93 100 193 9.41 893 Illegitimate 13 10 23 1.12 107 Total Live Births 106 110 216 10.53 — 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 1 4 5 22.62 Illegitimate — — — — Total Stillbirths 1 4 5 22.62 Notification of Births The following figures for Holborn for 1961 have been supplied by the Divisional Medical Officer of the London County Council:— M. F. Total Live Births 102 104 206 Stillbirths 1 2 3 Total Births Notified 103 106 209 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 1,000 139 104 243 Estimated Population 11.84 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 1961. Age Groups 0-1 1- 5- 15- 25- 45- 65- 75- TOTALS Males 5 2 5 6 50 37 34 139 Females 5 1 1 — 3 37 27 30 104 TOTALS 10 3 6 — 9 87 64 64 243 % of Total 4.12 1.23 2.47 — 3.70 35.80 26.34 26.34 100 Average age at death in Holborn during 1961 was 61.36 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 Rate per 1,000 net Live Births 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 1961 20,520 216 10.53 243 11.84 10 46.29 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 — — — — — 1 — — — — — - — — — — - 1 1 3. Syphilitic disease — — — — — — — — — — 1 — 1 — — — 2 - 2 4. Diphtheria - - - - - - - - - - - - - - - - - - - 5. Whooping cough - - - - - - - - - - - - - - - - - - - 6. Meningococcal infections - - - - - - - - - - - - - - - - - - - Acute poliomyelitis - - - - - - - - - - - - - - - - - - 8. Measles — — — — — — — — - — — - — - — - - - - 9. Other infective and parasitic diseases - - - - - - - - 1 1 - 1 1 - - - 2 2 4 10. Malignant neoplasm, stomach — — — — — — — — — — 3 3 — 1 — 2 3 6 9 11. Malignant neoplasm, lung, bronchus - - - - _ - - - - - 3 1 - - 1 - 4 1 5 12. Malignant neoplasm, breast — — — — — — — — — — 1 1 — 1 — 2 1 4 5 13. Malignant neoplasm, uterus - - - - - - - - - - - 2 - 2 - - - 4 4 14. Other malignant and lymphatic neoplasms - - - - 2 - - - - 2 7 9 4 1 5 1 18 13 31 15. Leukaemia, aleukaemia — — — — — — — — — — — 1 — — — — — 1 1 16. Diabetes — — — — — — — — — — — — — — — — — — — 17. Vascular lesions of nervous system — — — — — — — — — — 6 3 5 3 3 3 14 9 23 18. Coronary disease, angina — — — — — — — — 1 — 11 4 10 9 6 5 28 18 46 19. Hypertension with heart disease — — — — — — — — — — 1 — — — 1 2 2 2 4 20. Other heart disease — — — — — — — — — — 5 1 1 4 5 3 11 8 19 21. Other circulatory disease — — — — 1 — — — — — 2 1 2 1 4 2 9 4 13 22. Influenza — — — — — — — — — — — — 1 — — — 1 — 1 23. Pneumonia 2 — — — — — — — — — 4 — 4 1 3 6 13 7 20 24. Bronchitis — — — — — — — — — — 1 1 4 — 3 2 8 3 11 25. Other diseases of respiratory system — — — — — — — — — — — — — — — — — — — 26. Ulcer of stomach and duodenum — — — — — — — — — — — — — — — — — — — 27. Gastritis, enteritis and diarrhoea — — — — — — — — — — — 1 — — — — — 1 1 28. Nephritis and nephrosis — — — — — — — — 1 — 1 1 — — — — 2 1 3 29. Hyperplasia of prostate — — — — — — — — — — — — — — — — — — — 30. Pregnancy, childbirth, abortion — — — — — — — — — — — — — — — — — — — 31. Congenital malformations 3 2 2 — — — — — — — — — — — — — 5 2 7 32. Other defined and ill-defined diseases — 3 — 1 1 — — — — — 3 5 2 1 2 1 8 11 19 33. Motor vehicle accidents — — — — — — — — — — — — — 1 — — — 1 1 34. All other accidents — — — — 1 — — — — — — 1 1 1 — 1 2 3 5 35. Suicide — — — — — — 3 — 1 1 — 1 1 — 5 2 7 36. Homicide and operations of war — — — — — — — — — — — — — — — — — — — 5 5 2 1 5 1 — — 6 3 50 37 37 27 34 30 139 104 243 16 Death Rate of Infants under One Year of Age No. Holborn London England and Wales All infants 10 Rate per 1,000 live births 46.29 24.8 21.6 Legitimate infants 9 Rate per 1,000 legitimate live births 46.62 — — Illegitimate infants 1 Rate per 1,000 illegitimate live births 43.48 Neo-natal deaths (first four weeks) 5 Rate per 1,000 live births 23.15 — — 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 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 1961 46.3 46.6 43.5 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. Total Under[ 1 Year 23. Broncho pneumonia — 1 — — — 1 — 1 — — 2 31. Congenital malformations Congenital heart disease — — — — — — — 2 — — 2 Cerebral malformation — — — — — — 1 — — — 1 Encephalocoele — — — 1 — 1 — — — — 1 Hirschprungs disease — — — — — — 1 — — — 1 32. Other defined and ill-defined diseases Atelectasis 2 — — — — 2 — — — — 2 Pulmonary haemorrhage 1 — — — — 1 — — — — 1 Five of the infant deaths recorded above were of infants domiciled outside England and Wales. Four of these infants died as a result of congenital malformations. Of the five "Holborn infants" one died of pulmonary haemorrhage shortly after birth, two died on the first day as a result of atelectasis, one died of pneumonia at the age of three days and one died at three months as the result of congenital heart disease. 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 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 5. Whooping Cough - - 1 - - - - - - - - 9. Other infective and parasitic diseases — — — — — — — — — — — 20. Other heart disease - - - -. - - - - - - - 23. Pneumonia 1 1 2 2 24. Bronchitis - 1 — — — — — — — — — 27. Gastritis, enteritis and diarrhoea — — 1 — — — — — — — — 31. Congenital malformations 2 2 2 1 5 6 4 4 10 8 5 32. Other defined and ill-defined diseases 7 7 — 7 2 6 5 1 3 6 3 34. All other accidents 1 — — — — 1 — — — — — 10 10 4 8 7 13 9 6 14 16 10 18 Deaths from Tuberculosis—All Ages No. of Deaths Death Rate per 1,000 estimated population Pulmonary 1 .05 Other forms 1 .05 Comparable figures for preceding 10 years:— Year No. of Deaths Rate per 1,000 estimated population 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 1961 2 .10 A Table for the years 1946-1961 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 1946 9 4 6 1 13 7 1948 10 2 8 4 12 12 1950 7 3 10 2 10 12 1952 5 1 14 2 6 16 1954 4 1 9 5 5 14 1956 1 1 19 1 2 20 1958 3 — 10 2 3 12 1960 1 — 10 3 1 13 1961 1 — 4 1 1 5 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 while the numbers of deaths from malignant neoplasm of the lung or bronchus have increased. The Table shows the higher incidence in men for both diseases, and that over the last ten 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. 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 170 cases of infectious disease were notified, of which 16 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 1932-1961 are also shown (see Table No. 7, pages 24 and 25). No cases of Diphtheria, Enteric fever, Meningococcal infection, Malaria, Ophthalmia Neonatorum, Puerperal Pyrexia or Smallpox were notified during the year. Dysentery Two cases were notified and one was removed to hospital. Erysipelas Two cases were notified during the year. Food Poisoning Four cases were notified and three of them were removed to hospital. Encephalitis (Acute) One case was notified and was removed to hospital. 21 Measles One hundred and twenty-two cases were notified and eight were removed to hospital. Pneumonia (Acute Primary and Acute Influenzal) One case of acute primary pneumonia, and one case of acute influenzal pneumonia, were notified. The latter was removed to hospital. Poliomyelitis One case was notified from a hospital in the borough. The patient, who resided in another borough, had had one injection only of poliomyelitis vaccine two months before his illness. Scabies One case was notified, and was treated at home. Scarlet Fever Five cases were notified, and were treated at home. Tuberculosis See page 51. Whooping Cough Seven cases were notified, and two were removed to hospital. Other Diseases coming to the notice of the Department Disease No. of Cases No. removed to Hospital Abortion, septic 1 1 Chicken pox 29 19 Conjunctivitis 1 — Enteritis and gastro-enteritis 20 14 German measles 11 7 Glandular fever 3 3 Cervical adenitis 1 1 Papular urticaria 1 1 Impetigo 1 — Influenza 5 — Mumps 7 4 Tetanus 1 1 Tonsillitis 3 3 Upper respiratory tract infection 1 1 Gingivitis 1 1 Diarrhoea 3 2 22 TABLE No. 6 Summary of Infectious 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 Totil M F M F M F M F M F M F M M F M F M F M F M F Diphtheria - - - - - - - - - - - - - - - - - - - - - - - - - Dysentery - - - 1 - - 1 - - - - - - - - - - - - - - - 1 1 2 Encephalitis - - - - - - - - - - - - - - - 1 - - - - - - - 1 1 Enteric Fever - - - - - - - - - - - - - - - - - - - - - - - - - Erysipelas - - - - - - - - - - - - - - - - - - 1 - - 1 1 1 2 Food Poisoning 1 - - - - - - - - - - - - - - - - - - - - 1 3 4 Malaria - - - - - - - - - - - - - - - - - - - - - - - - - Measles 3 1 12 5 8 10 12 8 4 10 18 25 2 1 - 3 - - - - - - 59 63 122 Meningococcal Infection - - - - - - - - - - - - - - - - - - - - - - - - - Ophthalmia Neonatorum - - - - - - - - - - - - - - - - - - - - - - - - - Pneumonia - - - - - - - - - - - - - - - - - 1 - - - 1 — 2 2 Poliomyelitis - - - - - - - - - - - - - - - - - - - - - - 1 — 1 Puerperal Pyrexia - - - - - - - - - - - - - - - - - - - - - - - - - Scabies - - - - - - - - - - - - - - - - - - - - - - 1 — 1 Scarlet Fever - - - - - - - - 1 1 2 - - - - 1 - - - - - - 3 2 5 Tuberculosis (Pulmonary) - - - - - - - 1 - - 1 - - - 1 — 3 6 7 1 1 — 13 8 21 Tuberculosis (NonPulmonary) - - - - - - - - - - - - - - - 1 1 - - - - - 1 1 2 Whooping Cough — 1 — — 1 1 1 - 2 1 - — — — — - — — — — 3 4 7 Totals 4 1 13 6 8 11 14 10 5 14 22 25 2 1 3 61 4 8 8 2 1 2 84 86 174 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 78 specimens were submitted for examination with the following results:— Disease Positive Negative Total Diphtheria - 33 33 (Nasal and throat swabs) Dysentery (Faeces) - 1 1 (Faecal swabs) 1 30 31 Food Poisoning (Faecal swabs) 4 2 6 Streptococcus haemolyticus 1 5 6 Vincents organisms - 7 7 Other pathogenic organisms 5 - 5 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 521 certificates of persons travelling abroad were authenticated by the Department. Of these 374 were in respect of smallpox, 84 for cholera, 38 for typhoid, 21 for yellow fever, and 4 for poliomyelitis. Diphtheria Immunisation During the year 267 Holborn children completed the primary course of immunisation against diphtheria, and 353 received boosting doses. Poliomyelitis Immunisation During the year 238 second injections and 204 third injections were given to children under 5 years; 130 second injections and 79 third injections to persons between 5 and 18 years and 405 fourth injections to 5-12 year olds, 24 25 TABLE No. 7 Comparative Figures of Infectious Disease for the last 30 years Disease 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 1961 (Population) 36,440 36,050 36,000 35,400 34,850 34,600 34,350 30,660 23,470 17,160 16,580 17,240 1 8,020 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 20,520 Diphtheria (including Membranous Croup) 76 75 74 93 60 76 49 19 7 14 17 17 5 11 12 3 2 1 2 1 2 — — Dysentery 1 — 2 6 6 10 10 — — — — 2 13 2 6 4 — 2 34 9 8 34 4 7 16 30 28 41 2 Encephalitis Lethargica 1 1 1 1 — — — 2 — — — — — 1 — — — — — — — 1 — — — — — — - — Enteric Fever 4 1 3 2 2 — — 1 1 3 1 6 1 — 1 1 1 — 1 — 2 1 2 — — 4 — — — — Erysipelas 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 — 2 Food Poisoning Notifiable as from 12 th July, 1932 11 5 - - 3 5 2 - - - - - - 1 - 1 2 3 1 2 1 4 2 12 1 2 11 19 6 4 Malaria 1 1 1 3 2 3 - 1 - - - 1 - - - - - 1 1 - 1 1 - - - 1 - - - Measles Notifiable as from 9th September, 1938. — 8 39 34 58 219 33 103 107 157 87 170 137 254 133 195 37 172 71 99 56 139 38 122 Meningococcal Infection 1 3 1 1 2 1 1 3 7 7 1 1 — 1 2 2 2 1 2 2 1 — 4 1 — Ophthalmia Neonatorum 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) 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 2 Polio-encephalitis Acute - - - - - - - - - - - - - — 1 1 - - - - - - - - - - - - - 1 Poliomyelitis Acute 2 1 — 5 1 2 2 — 6 17 3 12 6 11 4 2 2 1 'Puerperal Fever 1 3 3 4 2 4 — — — 1 2 2 2 2 — 1 1 * * * ♦ * * * * * * • * * Puerperal Pyrexia 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 August, 1943. 54 99 125 106 43 16 4 3 4 3 6 1 5 5 1 3 2 5 1 Scarlet Fever 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 5 Smallpox 1 1 — Tuberculosis Pulmonary 73 50 83 68 77 66 71 64 44 47 45 51 41 59 55 47 39 42 39 45 46 48 32 40 33 32 25 27 18 21 Tuberculosis, Non-Pulmonary 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 2 Whooping Cough 108 23 65 99 76 60 53 71 7 42 48 38 30 11 43 23 74 5 90 33 32 62 6 1 22 6 3 4 9 7 408 335 412 379 365 322 296 278 161 194 242 456 280 364 392 348 268 269 311 406 261 366 133 258 157 184 148 243 128 170 *Ceased to be notifiable as from 30th July, 1948. 26 SECTION 4. Sanitary Circumstances. Visits made by the Public Health Inspectors during 1961. Public Health (London) Act, 1936 Number of Inspections Dwelling Houses 223 Houses Let in Lodgings 29 Common Lodging Houses 3 Offices 30 Rag and Bone Shops 18 Drainage Work and Testing 3,927 Noise Nuisance Visits 58 Other Inspections 662 Re-inspections of above 481 Housing Acts, 1957—1961 Number of Inspections Houses 146 Underground Rooms 30 Overcrowding Visits 13 Re-inspections of above 30 Factories Acts, 1937—1961 Number of Inspections Power Factories 73 Re-inspections of above 23 Non-Power Factories 6 Re-inspections of above 3 Outworkers' Rooms — Electrical Stations and Sites of Building Operations 120 Outworkers' Registers 6 Food and Drugs Act, 1955 Number of Inspections Dairies and Milk Shops 7 Ice Cream manufacture - Ice Cream sale and storage 19 Restaurants and Kitchens 325 Bakehouses 6 Butchers' Shops 29 Fish Shops 4 Fried Fish Shops 5 Other Food Shops 121 Market Streets 53 Licensed Premises 55 Sampling 254 Unsound Food 108 Re-inspections of above 69 27 Clean Air Act, 1956 Number of Inspections Smoke Observations 210 Inspections 57 Re-inspections of above 14 Visits 641 Smoke Control Area Visits 547 „ „ „ Inspections 2,948 „ „ „ Re-inspections 166 ,, „ ,, — No Entry 1,826 Miscellaneous Inspections Merchandise Marks Acts 7 Pharmacy and Poisons Acts 3 Prevention of Damage by Pests Act, 1949 122 Shops Act, 1950 11 Hairdressers and Barbers 37 Other Inspections 6 Re-inspections of above 23 Visits, etc., re Infectious Disease 57 Aged and Infirm Persons 10 Verminous Persons — No Entry 302 Other Visits 111 Total 14,034 Notices Served Public Health (London) Act, 1936 Intimation Notices 46 Dwelling Houses 26 Houses Let in Lodgings 14 Power Factories 2 Others 4 Statutory Notices 6 Dwelling Houses 4 Houses Let in Lodgings 1 Others 1 Food and Drugs Act, 1955 2 Restaurants 2 Housing Acts, 1957—1961 Nil Factories Act, 1937—1961 Nil Clean Air Act, 1956 51 Adaptation of Fireplaces 51 L.C.C. (G.P.) Act, 1927—Byelaws 2 Sites 2 Byelaws as to Artificial Lighting of Common Staircases in Tenement Houses and Flats, 1958 1 Houses Let in Lodgings 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 Proper and sufficient supply provided 2 Cisterns, cleansed, repaired or renewed 1 Service pipes repaired 1 Waterclosets Compartments cleansed and/or repaired 5 Water supplied, flushing cistern repaired 1 New W.C. pan provided 1 Ventilation improved or provided — Additional accommodation provided 2 Drainage Soil pipes, repaired, renewed or ventilated 2 Rainwater pipes, repaired or renewed 2 Drains unstopped or cleansed 1 Drains repaired or relaid — New manhole covers provided — Sinks Defective sinks renewed - Waste pipes repaired, renewed or unstopped 2 Yards, Areas and Washhouses Cleansed 2 Drained or drains unstopped 1 Houses and Workshops, etc. Rooms cleansed or repaired 7 Passages and staircases cleansed or repaired 1 Ventilation improved 8 Dampness Roofs repaired 4 Gutters repaired 1 Other works to prevent dampness 14 Ashbins Provided, repaired, etc. — Various Accumulations of refuse removed 6 Improper keeping of animals remedied — Noise nuisance abated — Dust nuisance abated 2 29 Complaints During the year 611 complaints were received in respect of the following nuisances:— Artificial lighting, absence of, on common staircase 1 Aged and infirm persons 1 Animals improperly kept 6 Dampness 30 Dilapidations and disrepair 29 Drains, choked or defective 8 Dust 5 Dustbin accommodation inadequate or unsuitable 5 Food premises, unsatisfactory conditions in 14 Floors defective 1 Noise 29 Overcrowding 2 Obnoxious smells 73 Refuse, accumulations of 22 Rodent infestation 189 Roofs, defective 11 Smoke 58 Unsound food 34 Vermin 50 Ventilation inadequate 1 Water supply, burst pipes 2 W.C. accommodation inadequate, dirty or defective 22 Miscellaneous 17 Water supply, inadequate 1 Water supply, impure — 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. Drainage During the year 3,927 inspections were made by the Public Health Inspectors in connection with drainage work; 129 applications for approval of proposed drainage work were submitted together with the necessary plans, and 129 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 1961, 6 notifications were received concerning the proposed discharge of trade effluents. In 4 cases notices of proposed conditions were issued by this Council and no counter proposals were received. In the remaining two cases the premises concerned were connected to the London County Council's sewers, and the notifications were dealt with by that authority. Clean Air Act, 1956 During the year 58 complaints were received regarding smoke emissions and 210 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 1961 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 2.11 5.5 13.49 18.02 31.51 5.70 February 2.15 5.6 14.80 9.39 24.19 5.76 March 0.21 - 15.38 1.04 16.42 5.13 April 1.76 4.9 15.50 9.83 25.33 3.91 May 0.98 6.1 8.59 5.40 13.99 2.38 June 1.35 6.3 9.83 4.80 14.63 1.99 July 1.92 5.9 8.52 7.32 15.84 0.86 August 2.14 5.9 7.04 8.59 15.63 1.91 September 1.95 5.8 11.38 7.79 19.17 1.40 October 2.32 4.9 9.36 3.79 13.15 2.49 November 1.89 4.8 10.97 7.42 18.39 4.00 December 3.31 4.7 13.25 14.50 27.75 3.63 Total 22.09 — 138.11 97.89 236.00 39.16 Monthly Average 1.84 5.0 11.51 8.16 19.67 3.26 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 8.54 11.40 19.94 February 9.37 5.94 15.31 March 9.73 .66 10.39 April 9.81 6.22 16.03 May 5.44 3.42 8.86 June 6.22 3.04 9.26 July 5.39 4.63 10.02 August 4.45 5.44 9.89 September 7.20 4.93 12.13 October 5.92 2.40 8.83 November 6.93 4.70 11.63 December 8.38 9.18 17.56 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 1961:— Concentration of smoke—microgrammes 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 Value Highest Value Lowest Value January 27 66 16 30 58 15 February 30 59 16 25 49 8 March 40 81 17 30 82 11 April 114 180 70 148 230 100 May 6 12 1 8 16 4 June 7 10 4 9 13 4 July 6 12 4 6 13 4 August 6 10 3 8 16 4 September 8 14 5 11 17 6 October 12 27 5 Recordings temporarily discontinued November 20 51 5 December 25 57 5 32 Installation of New Furnaces In eleven 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 As from the 1st December, 1962, the whole of the Borough will have become a smoke control area, and Holborn will have been the first local authority to have achieved this distinction under the Clean Air Act, 1956. The Borough was dealt with in six areas as follows:— 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. 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 seventeen 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 £225 19s. lid. of which £67 16s. 0d. was borne by the Council, £90 7s. 11d. by the Exchequer, and £67 16s. 0d. 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 in 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. During the year ninety-seven 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 £1,236 14s. 3d. of which £371 0s. 3d. was borne by the Council, £494 13s. 9d. by the Exchequer and £371 0s. 3d. by the applicants. Holborn Smoke Control Area No. 4 This area is 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. The Order was made by the Council in February, 1961; it was confirmed by the Minister of Housing and Local Government in May, 1961, and came into operation on the 1st December, 1961. 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 £252 6s. 7d. of which £75 14s. Od. was borne by the Council, £100 18s. 7d. by the Exchequer and £75 14s. 0d. by the applicant. Holborn Smoke Control Area No. 5 This area is the portion of the Borough in the north-east abutting on St. Pancras and Finsbury, and is separated from the remainder of Holborn by a line running south from the St. Pancras boundary at Elm Street down Gray's Inn Road to Fox Court, then east along Fox Court and Greville Street, reaching the Finsbury boundary at Farringdon Road. The Council made the Order in November, 1961: it was confirmed by the Minister of Housing and Local Government in March, 1962, and will come into operation on the 1st November, 1962. Holborn Smoke Control Area No. 6 This final area is the portion of the Borough in the south-west enclosed by a line commencing at the junction of Tottenham Court Road and Great Russell Street travelling southerly along Tottenham Court Road and Charing Cross Road to Cambridge Circus; then south-east along West Street; north-east along Shelton Street to Endell Street; northerly along Endell Street meeting Shaftesbury Avenue and along Bloomsbury Street to Great Russell Street; and finally west along Great Russell Street to the junction with Tottenham Court Road. The Council made the Order in December, 1961; it was confirmed by the Minister of Housing and Local Government in April, 1962, and will come into operation on the 1st December, 1962. 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 1961, 35 applications were received for retention on this Council's list. One application was 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—1961 The following is a summary of action under the above Acts during the year 1961. Slum Clearance Houses included in clearance areas Nil 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 2 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 21 34 Note: The number of underground rooms which do not comply with the relevant Regulations, but which are occupied for human habitation, is 441. Houses Let in Lodgings Number in Borough 266 Inspections made 29 Overcrowding On the 1st January, 1961, 127 families were known to be living in overcrowded conditions. During the year a further 2 families were found to be living in overcrowded conditions. In 3 cases, overcrowding was abated during the year as follows:— Families rehoused by the Holborn Borough Council 2 Families rehoused by the London County Council Accommodation found by other means 1 During the year 13 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 Nil (b) in respect of all defects 1 (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule Nil (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule Nil (6) Number of certificates issued 1 Applications for Cancellation of Certificates (7) Applications by landlords to Local Authority for cancellation of certificates 1 (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 1 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, 1961 The following particulars were supplied to the Minister of Agriculture and Fisheries:— 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 6,105 - 7,280 13,398 II. Number of properties inspected as a result (a) of notification (b) survey, or (c) otherwise (a) 1 88 100 189 \ / (b) - - - - V / (c) - 1 - 48 59 III. Total inspections carried out including re-inspections - 109 - 198 307 IV. Number of properties (under II) found to be infested by:— (a) Rats {Major* - 2 - 1 3 {Minor† 1 31 - 24 56 (b) Mice {Major* 1 1 {Minor† - 39 — 50 89 V. Number of infested properties (under IV) treated by the Local Authority 1 72 - 69 142 VI. Total treatments carried out —Including re-treatments 7 508 - 376 891 VII. Number of notices served under Section 4— (1) Treatment - (2) Structural works (i.e. Proofing) - - - - VIII. Number of cases in which default action was taken by Local Authority following issue of notice under Section 4 - - - - - IX. Legal Proceedings - - -— - - X. Number of " block" control schemes carried out Nil *" 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 1961, 189 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. Total Business premises inspected 148 Dwelling houses inspected 99 Local authority premises inspected 1 Business premises treated 69 Dwelling houses treated 72 Local authority premises treated 1 Business premises, inspection visit 198 Business premises, treatment visits 376 Dwelling houses, inspection visits 109 Dwelling houses, treatment visits 508 Local authority, inspection visits — Local authority, treatment visits 7 Total visits 1,198 Estimated kill (rattus norvegicus) 332 Bodies recovered (rattus norvegicus) 123 Estimated kill (rattus rattus) 3 Bodies recovered (rattus rattus) 1 Estimated kill (mice) 791 Bodies recovered (mice) 273 Baiting of Sewers During the year a treatment of the sewers, by direct poisoning using sodium fluoracetamide (1081) was commenced. 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 7 Number of rooms disinfected after other infectious diseases 58 Total number of rooms disinfected after infectious disease 65 Number of articles of bedding and clothing disinfected after tuberculosis 304 Number of articles of bedding and clothing disinfected after other infectious diseases 2,761 Total number of articles disinfected after infectious disease 3,065 Number of books disinfected after infectious disease 75 37 Disinfestation Number of rooms disinfested of vermin 160 Number of articles of bedding and clothing disinfested of vermin 3,137 Summary of 6,202 articles of bedding and clothing dealt with during the year:— Mattresses 149 Pillows 210 Pillow Cases 112 Bolsters 37 Bolster Cases 27 Blankets 412 Sheets 239 Household 4,688 Clothing 205 Other Bedding 123 Cleansing Number of persons treated for scabies 5 Number of persons treated for head lice - Number of persons treated for body lice 55 Number of persons treated for crab lice 20 Number of persons cleansed 75 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 hep 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 twenty-two cases were dealt with, at a total cost of £325 2s. 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 7 Hospitals or Doctors 4 Friends or Relatives of Deceased 11 New Legislation Home Safety Act, 1961 This Act which came into force on 18th May, 1961, enables county councils and metropolitan borough councils to promote safety in the home by publishing or making arrangements for otherwise giving information or advice relating to the prevention of accidents in the home or by making contributions to any non-profit making organisation concerned with safety in the home. Housing Act, 1961 This Act came into operation on the 24th November, 1961. It confers further powers on local authorities regarding houses let in lodgings or occupied by members of more than one family and houses or other buildings affected by clearance orders and demolition orders. Factories Act, 1961 This Act which came into operation on 1st April, 1962, consolidates the law relating to the safety, health and welfare of persons employed in factories. Public Health Act, 1961 This Act amends the provisions of the Public Health Act, 1936, which with the exception of one minor provision does not apply to London. Licensing Act, 1961 This Act became operative on 1st March, 1962, and provides for the objection to or cancellation of club registration certificates by local authorities. Legal Proceedings Nature of Offence Action taken Under Result Selling food not of the quality Food and Drugs Act, 1955. Fined £5 0s. 0d. demanded (nail in coconut Section 2. Council awarded rock cake) £2 2s. Od. costs Selling food not of the quality Food and Drugs Act, 1955. Fined £10 0s. 0d. demanded (cigarette end in Section 2. Council awarded cream slice) £4 12s. 2d. costs. 39 SECTION 5. Factories. Most of the provisions of the Factories Acts, 1937-1961, 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 1961 are as follows:— Number of visits to:— Factories with mechanical power 96 Factories without mechanical power 9 Outworkers registers 6 Outworkers' rooms Nil Electrical stations and sites of building operations 120 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 1. 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 176 9 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 610 96 - - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 40 120 - - Total 826 225 - - 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) - - - - - Overcrowding (S.2) 1 1 1 — — Unreasonable Temperature (S.3) — — — — — Inadequate Ventilation (S.4) — — — — — Ineffective Drainage of Floors (S.6) — — — — — Sanitary Conveniences (S.7)— (a) Insufficient — — — — — (b) Unsuitable or Defective 7 15 — 4 — (c) Not separate for Sexes 2 2 — — — Other offences against the Act (not including offences relating to Outwork) 14 3 11 .— — Total 24 21 12 4 — 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 207 — — — — — Cleaning and Washing 2 — — — — — Household Linen — — — — — Lace, Lace Curtains and Nets 4 - - - - - Artificial Flowers 8 — — - - Boxes etc. 1 — — — — — Cosaques, Christmas Crackers, Christmas Stockings, etc 52 — Total 274 - _ _ - — 41 Firms in the Borough employing outworkers 20 No. of outworkers on lists submitted 274 No. of outworkers referred to other Boroughs 263 No. of outworkers in Holborn employed by Holborn firms 11 No. of outworkers in Holborn employed by firms outside the Borough 33 Total number of outworkers in Holborn 44 Inspection of outworkers' premises Nil 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 1961:— Dairies and milk shops 7 Ice cream, sale or storage 19 Ice cream manufacture — Restaurants and kitchens 325 Bakehouses 6 Butchers' shops 29 Fish shops 4 Fried fish shops 5 Other food shops 121 Market streets 53 Licensed premises 55 Sampling 254 Unsound food 108 Re-inspections 69 Food and Drugs Act, 1955 Notices During 1961,2 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 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: Articles and equipment cleansed 1 Ventilation of food rooms improved 1 Food rooms repaired and put in good condition 1 Food rooms cleansed 5 Accumulation of refuse in food room removed 2 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 1961 Nil Dairies removed from register during 1961 Nil Dairies on register at end of 1961 1 Distributors registered during 1961 4 Distributors removed from register during 1961 3 Distributors on register at end of 1961 48 Inspections made by Inspectors during 1961 7 Formal milk samples taken and submitted for analysis 69 Informal milk samples taken and submitted for analysis 89 44 The following tables show the monthly variation of the chemical composition of the 158 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 3.58 8.66 12.24 February 10 3.52 8.65 12.17 March 10 3.46 8.60 12.06 April 13 3.37 8.64 12.01 May 12 3.44 8.70 12.14 June 11 3.33 8.70 12.03 July 14 3.46 8.66 12.12 August 7 3.53 8.68 12.21 September 11 3.54 8.64 12.18 October 10 3.66 8.67 12.33 November 13 3.70 8.75 12.45 December 10 3.68 8.68 12.36 Whole year 135 3.52 8.67 12.19 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 2 4.30 8.71 13.01 March 5 4.27 8.81 13.08 April — — — — May 2 4.23 8.95 13.18 June 3 4.25 8.92 13.17 July — — - August — — - - September 3 4.43 8.89 13.32 October 4 4.56 8.95 13.51 November — — - December 4 4.64 9.01 13.65 Whole year 23 4.36 8.89 13.27 Lega 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) Fat (average) 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 1961 135 12.19 8.67 3.52 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. During the year 51 dealers licences were issued, details of which are as follows:— To sell Tuberculin Tested milk 37 To sell Pasteurised milk 49 To sell Sterilised milk 36 Milk—Bacteriological Examination During the year, 102 samples of milk were submitted for bacteriological examination. 38 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, 1961, two sets of premises were registered for the manufacture, storage and sale of ice cream, in Holborn, and 132 premises were registered for storage and sale. During the year 10 applications were received and approved in respect of premises to be used for storage and sale of ice cream. One set of premises ceased to be used for the manufacture, storage and sale of ice cream, and two sets of premises ceased to be used for the storage and sale of ice cream, and were removed from the register. At the end of the year, there was one registration for manufacture, storage and sale, and 140 premises were registered for storage and sale. Ice Cream (Heat Treatment, Etc.) Regulations, 1959 During the year, 75 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 61 Grade 2 9 Grade 3 3 Grade 4 2 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 74 public houses in the Borough, and during the year 55 inspections were carried out. In addition, 37 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 482 samples of food and drugs were purchased and submitted to the Borough Analyst for chemical analysis during the year. 229 were formal samples and 253 were informal. Article Number of Samples purchased Baking Powder 1 Batter Mix 1 Beer 1 Bread 1 Butter 4 Cheese 7 Cocoa 1 Coffee 6 Condiments 14 Cooking Fat, Oil, Dripping and Suet 12 Cream, fresh and tinned 15 Curry Powder 2 Custard Powder 2 Desiccated Coconut 4 Drugs and Medical Preparations 3 Essences and Flavourings 12 Fish, fresh, tinned and preserved 21 Flour 6 Fruit, dried, tinned and fresh 4 Honey 2 Ice Cream 4 Jams and Preserves 10 Jellies 4 Lemon Juice 2 Maple Syrup 1 Margarine 6 Meat and Meat Preparations 39 Milk 158 Milk, Evaporated and Condensed 7 Milk Shake Ingredients 5 Oatmeal 2 Olive Oil 2 Puddings 3 Rice 9 Sandwich Spread 8 Sauces 12 48 Article Number of Samples purchased Skimmed milk powder 1 Soft Drinks and Cordials 17 Soups 10 Sweets and Confectionery 20 Tapioca 1 Tea 6 Tomato Juice, Paste, Puree and Ketchup 2 Vegetables, tinned and dried 21 Vitamin Tablets and Preparations 12 Yogurt 1 482 49 Unsound Food During the year 1961, the undermentioned unsound food was surrendered and destroyed or disposed of otherwise:— Commodity Tons Cwts. Qtrs. Lbs. MILK Fresh — — — — Tinned — — 2¾ FISH Fresh — — 3 1 Tinned — — 1 3¼ MEAT Fresh — — — 13½ Tinned 3 14 2 15 FRUIT Fresh - — — — Tinned 2 4 — 8½ VEGETABLES Fresh — 2 — 3¾ Tinned 7 4 1 ¼ OTHER FOOD 1 2 13¾ TOTAL 14 8 1 26¼ 50 SECTION 7. Tuberculosis. The following table gives the number of new cases of tuberculosis notified, and deaths during 1961 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— 2 years — — — — — — — — 2— 5 years — 1 — — — - — — 5—10 years 1 — — — — — — — 10—15 years — — - - — — — — 15—20 years — — — - — — — — 20—25 years 2 — — 1 — — — — 25—35 years — 6 — - — — — — 35—45 years 2 — — 1 — — — — 45—55 years 4 1 — — 1 — — — 55—65 years 3 — — — — — — — 65—75 years 2 1 — — 3 — — — 75 and over — — — — - - — — TOTAL 14 9 — 2 *4 - — — •Only one of these persons died of tuberculosis. 51 Summary of Changes in Tuberculosis Register During 1961 Pulmonary Non-Pulmonary Total M. F. M. F. Cases on Register at 31st December, 1960 136 110 4 11 261 Cases Added Primary notifications 14 9 — 2 25 Transferred from other districts 7 5 — 1 13 Restored to register 1 — — — 1 Totals 158 124 4 14 300 Cases Removed Moved to other district 13 6 — - 19 Recovered 2 4 — 6 Died 4 — — - 4 Lost trace of 3 2 — 1 6 Others — 2 — 1 3 Totals 22 14 — 2 38 Cases on Register at 31st December, 1961 136 110 4 12 262 52 Tuberculosis Notifications and Deaths for the last 50 years Notifications Rate per 1,000 Population Deaths Rate per 1,000 Population 1912 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 61 25 1.22 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 1961. No. of Examinations Results First examination 69 Fit for employment 85 Second examination 19 Decision deferred 9 Re-examinations of the above — Not fit for employment 3 By reason of age 3 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 7 examinations were made of 6 persons who had had long periods of sickness. In all cases the general practitioner was consulted. As a result of these deliberations, one person was considered to be "incapable of discharging the duties of their employment by reason of permanent ill health or infirmity of body." DISABLED DRIVERS. Seventy-five applications for exemption from parking meter charges were referred by the Borough Engineer for medical opinion, necessitating medical examinations in respect of 45 of these applicants. 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 331 Number known to be active or members of Clubs 392 Visited by other organisations 199 Total number registered 922 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. During the year 1,577 visits were made by the Social Workers.