AC 4342 Library HOL 61 The Metropolitan Borough of Holborn REPORT OF THE MEDICAL OFFICER of HEALTH FOR THE YEAR 1963 R. D. DEWAR, B.Sc., M.B., Ch.B., D.P.H. The Metropolitan Borough of Holborn REPORT OF THE MEDICAL OFFICER of HEALTH FOR THE YEAR 1963 R. D. DEWAR, B.Sc., M.B., Ch.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 38 Section 6.—-Inspection and Supervision of Food 41 Section 7.—Tuberculosis 48 3 INDEX PAGES Aged and Infirm Persons 36 Altitude 9 Ambulance facilities 11 Area of Borough 9 Atmospheric pollution 30 Bacteriological examinations- Ice cream 45 Infectious disease 23 Milk 43 Births- Notification of 13 Rates 13 Registered live 13 Registered still 13 Burial of the dead 36 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 35 Disinfestation 36 Drainage 29 Dysentery 20 Emergency Bed Service 12 Erysipelas 20 Factories 38 Factories Act, 1961—Notices 26 Food & Drugs Act, 1955— Notices served 41 Work carried out 42 Food & Food Premises— Bakehouses 26 Ice cream 45 Milk supply 42 Unsound food condemned, Table 47 Food poisoning 20 Food sampling 46 PAGES General rate 9 Highways, area of 9 Hospitals in the Borough 11 Housing— Houses let in lodgings 27, 33 Notices 26 Overcrowding 33 Underground rooms 32 Ice cream— Registration of premises 45 Bacteriological examination 44 Chemical samples 46 Ice Cream (Heat Treatment, etc.) Regulations, 1959— 45 Infantile mortality— Causes, and age distribution 17 Rate 14, 16 Causes since 1953 17 Infectious Diseases- Bacteriological examinations 23 Notifiable 19 Non-notifiable 21 Summary of notifications, 1963 22 Comparative figures for years 1934-1963 24, 25 Inspections by Public Health Inspectors 26,41 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 44 Chemical samples 43 Distributors on register 42 Licences granted 44 Registrations 42 National Assistance Act, 1948 36 Notices served 27, 41 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 39 Overcrowding 33 Penny rate, product of 9 Pharmacy and Poisons Act, 1933 32 Pneumonia 21 Poliomyelitis, Acute 21 Population 9 Prevention of Damage by Pests Act, 1949 34 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 32 Rat Extermination 34 Rateable value 9 Registered live births 13 Registered still births 13 Restaurants 41 Roads, length of 9 Rodent Control — Block Surveys 35 Complaints 34 General 35 Sewers 34 PAGES Sampling 46 Sanitary circumstances of the area 26 Scabies 21 Scarlet fever 21 Slum clearance 32 Smallpox 20 Smoke abatement 30 Soil 9 Statistics and general information 9 Statutory Notices 27 Still births 13 Tuberculosis— Deaths 10,18, 50 Notifications 48 Notifications and deaths since 1914 50 Summary of changes in register 49 Underground roomsz 32 Unsound food 47 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 1962/63 was Councillor F. Jaque, J.P., and in 1963/4 was Councillor H. Bright, M.A., M.I.H.V.E., J.P., The Deputy Mayor in 1962/63 was Alderman C. F. Burge, and in 1963/4 was Councillor Miss I. Simpson, B.Sc. 1962/63 1963/64 Chairman— Chairman— Alderman M. P. Greengross, O.B.E. Alderman M. P. Greengross, O.B.E. Vice-Chairman— Vice-Chairman— Councillor I. W. Galbraith. Councillor I. W. Galbraith. Councillor J. A. Barker. „ Mrs. L. A. Brown. „ P. D. Carroll. „ E. A. J. Clark. „ Mrs. L. J. Coleman. „ E. G. Cracknell. „ A. S. Davis. „ Mrs. A. G. Finn. „ Mrs. B. M. Grass. „ Mrs. R. Howe. „ W. P. McGowan. „ Miss E. L. Martin. „ J. F. Robertson. „ G. A. Robinson. „ A. E. Shaw. „ Miss M. C. Smith. Councillor J. A. Barker. „ Mrs. L. A. Brown. „ E. A. J. Clark. „ Mrs. L. J. Coleman. „ E. G. Cracknell. „ A. S. Davis. „ Mrs. A. G. Finn. „ Mrs. B. M. Grass. „ Mrs. R. Howe. „ F. Jaque. „ Miss E. L. Martin. „ W. P. McGowan. „ W. Montgomery. „ J. F. Robertson. „ A. E. Shaw. „ J. Simpson. 6 STAFF The following was the staff of the Public Health Department during 1963. Medical Officer of Health: G. W. Piper, M.B., B.S., D.P.H. (to 3.8.63). R. D. Dewar, B.Sc., M.B.,Ch.B., D.P.H. (from 4.8.63). Public Analyst: 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: H. Parker, M.A.P.H.I., A.R.S.H. J. A. Hoare, M.A.P.H.I. L. T. J. Nash, M.A.P.H.I. Clerical Staff: R. R. Stent, (Senior Clerk). D. G. Marshall, (Senior Clerical Assistant). Miss I. J. Palk. Miss M. Field. J. J. Parker. M. J. Burrows (to 29.11.63). W. Wallis (from 2.9.63). Disinfecting Station and Cleansing Station Staff: F. A. L. Russell, (Superintendent Disinfector and Plant Engineer) (to 27.2.63). J. W. Gardiner (Superintendent Disinfector) (from 28.2.63). N. J. Lyons. W. C. Razzell. Mrs. R. E. Nicholls. R. T. Thompson (to 29.3.63). A. O. Shokumbi (from 17.4.63). A. P. Olive (from 18.4.63). Rodent Operative: J. W. Maloney. Social Welfare Officers: Mrs. E. M. Barralet (to 30.9.63). Miss R. P. Begg (from 25.10.63). Miss M. Sivyer (from 8.10.63). Assistant Social Welfare Officer: Mrs. P. M. D. Coole (Part-time) (to 26.10.63) 7 Public Health Department, Town Hall, High Holborn, W.C.I. September, 1964. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Holborn, Your Worship, Ladies and Gentlemen, I am pleased to present the Annual Report on the health and sanitary circumstances of the Borough for 1963. For the greater part of the year Dr. G. W. Piper was the Medical Officer of Health and the Report is consequently the record of the work which was largely done under his direction. The Registrar General's estimate of population for 1963 is 20,700. This is the first time since 1932 that Holborn's population figure has shewn a natural increase, although the figure of 60 is probably too small to have any real significance as yet. The birth rate is the highest for the last five years, but this is offset to a certain extent by the death rate which is the third highest for the last twelve years. As has been stated in these reports before however, the rates are calculated from such relatively small figures that variations from year to year mean very little. The main causes of death fell within the usual present day pattern with diseases of the heart and circulatory system being the commonest, and cancer the next most common with lung cancer predominating. Holborn's infant death rate of 52.52 per 1000 live births was as usual high compared with London and the rest of England, but this is always so, due to the fact that deaths at the Hospital for Sick Children, of children residing outside England and Wales are for statistical purposes credited to Holborn. There have been no maternal deaths in Holborn since 1953. Following an outbreak of typhoid fever at Zermatt in Switzerland a nurse working at a hospital in the Borough and who had been on holiday at Zermatt at the time, contracted the disease and was removed to an isolation hospital. Patients in the ward where she had worked were kept under surveillance, and Medical Officers of Health of areas to which patients had been discharged were also notified, and those patients too were kept under surveillance. There were no cases of diphtheria or poliomyelitis during the year. Two cases of food poisoning were notified, both occurring at a hospital in the Borough. Notifications of new cases of tuberculosis, although slightly higher than last year were still within the trend of a fall in numbers over the last ten years. In March the Council's new minibus was put into service for the transport of aged and handicapped persons. A suitable room in the Bathing Centre was equipped as a chiropody clinic for old people and sessions are held there twice a week, patients being taken to and from the clinic by minibus for one session. The Chiropodist also carries out domiciliary treatment for the housebound elderly. The new chiropody arrangements are very much appreciated by the old people. With the transfer of functions to the new Borough of Camden on 1st April, 1965, this will probably be the last Annual Report by a Holborn Medical Officer of Health and it might be an opportune moment to compare statistics from the first Annual Report of the Borough's Medical Officer of Health with those of its last. In 1900 Holborn's population was 64,990, and in 1963, 20,700. The death rate was 22.4 compared with 12.17 in 1963, the birth rate 27.2 compared with 11.01, and the infant 8 mortality rate 128 compared with 52.5. In 1900 there were 123 cases of diphtheria with 13 deaths, 194 of scarlet fever with 7 deaths, 55 cases of typhoid fever with 9 deaths, 89 cases of erysipelas, and 193 deaths from tuberculosis. Although there was no smallpox that year, there were 211 cases with 30 deaths the following year and yet a greater number in 1902. There were 32 common lodging houses in the Borough, and now only 2, and 27 underground bakehouses of which none remained in 1963. One interesting heading is "Smoke Abatement" with the information that" the smoke shafts of the Borough were frequently kept under observation and 13 intimation notices served." It would seem therefore that smoke abatement is not such a modern idea after all. I am sure that Dr. Piper would wish me to express his thanks to the Members of the Council and particularly to the Chairman and Members of the Public Health Committee for their help and encouragement, to the other Chief Officers and their staffs for their co-operation and assistance and to the staff of the Public Health Department for their loyal and diligent service. I am indeed grateful that this assistance and encouragement has been extended to me also. I am, Your obedient Servant, R. D. DEWAR, 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 (1961) census 22,008 Population (Registrar-General's mid-1963 estimate) 20,700 Number of persons per acre (estimated average) 51 Number of dwelling houses, flats and other residences 5,847 Rateable Value £10,899,996 Product of penny rate, approximately £44,700 General rate for the year 6s. 11d. 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 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 1962 59 394 453 20,640 21.95 1963 56 384 440 20,700 21.23 Summary of Vital Statistics Live Births 228 Birth-rate (per 1,000 estimated population) 11.01 Deaths, all ages 252 Death-rate (per 1,000 estimated population) 12.17 Infant deaths 12 Infant death-rate (per 1,000 live births) 52.52 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 58 Cancer death-rate (per 1,000 estimated population) 2.80 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 51 French Hospital, Shaftesbury Avenue, W.C.2 Temple Bar 5025-6 Teaching Hospital 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 Very urgent illness in the home (provided a RHGent 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 1963. Population The civilian population, as estimated by the Registrar-General, Mid-1963 was 20,700. 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 108 91 199 9.61 873 Illegitimate 15 14 29 1.40 127 Total Live Births 123 105 228 11.01 — Comparable figures tor 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 2 4 17.24 Illegitimate — 1 1 4.31 Total Stillbirths 2 3 5 21.55 Notification of Births The following figures for Holborn for 1963 have been supplied by the Divisional Medical Officer of the London County Council:— M. F. Total Live Births 123 114 237 Stillbirths 2 3 5 Total Births Notified 125 117 242 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 12.17 121 131 252 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 1963. Age Groups 0-1 1- 5- 15- 25- 45- 65- 75- TOTALS Males 7 1 2 1 8 42 28 32 121 Females 5 1 2 2 5 30 31 55 131 TOTALS 12 2 4 3 13 72 59 87 252 % of Total 4.76 .79 1.59 1.19 5.16 28.57 23.42 34.52 100 Average age at death in Holborn during 1963 was 62.40 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 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 6L14 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 1962 20,640 190 9.21 270 13.08 13 68.41 1963 20,700 228 11.01 252 12.17 12 52.52 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 - - - - - - - - - - 2 - - - - - 2 — 2 2. Tuberculosis, other - - - - - - - - - - - - - - - - - - - 3. Syphilitic disease - - - - - - - - - - - - - - 1 1 1 1 2 4. Diphtheria - - - - - - - - - - - - - - - - - - - 5. Whooping cough - - - - - - - - - - - - - - - - - - - 6. Meningococcal infections - - - - - - - - - - - - - - - - - - - 7. Acute poliomyelitis - - - - - - - - - - - - - - - - - - - 8. Measles - - - - - - - - - - - - - - - - - - - 9. Other infective and parasitic diseases - - - - - - - - 1 - - 1 - - - - 1 1 2 10. Malignant neoplasm, stomach - - - - - - - - - - 1 - 1 - - 1 2 1 3 11. Malignant neoplasm, lung, bronchus - - - - - - - - - 1 8 1 3 2 13 2 15 12. Malignant neoplasm, breast — — — — — — — — — 1 — 7 — 2 — — — 10 10 13. Malignant neoplasm, uterus — — — — — — — — — 1 — 1 — 1 — 1 — 4 4 14. Other malignant and lymphatic neoplasms - - - - - - - 2 2 5 5 3 3 3 3 13 13 26 15. Leukaemia, aleukaemia - - - - - - - - - - - - - - - - - - - 16. Diabetes - - - - - - - - - - 2 - - - - 1 2 1 3 17. Vascular lesions of nervous system - - - - - - - - - - - - 1 3 3 8 4 11 15 18. Coronary disease, angina - - - - - - - - 1 1 6 5 6 10 6 9 19 25 44 19. Hypertension with heart disease - - - - - - - - - - - - - - - - - - 1 20. Other heart disease - - 1 - - - - - - - 2 2 3 4 3 5 9 11 20 21. Other circulatory disease - - - - - - - - - - 1 1 2 2 2 5 5 8 13 22. Influenza - - - - - - - - - - - - - - - - - - - 23. Pneumonia — 1 - - - - - - - - 2 3 1 — 5 10 8 14 22 24. Bronchitis - - - - - - - - - - 4 1 3 3 4 1 11 5 16 25. Other diseases of respiratory system - - - - - 1 - - - - - - - 1 1 1 2 3 26. Ulcer of stomach and duodenum - - - - - - - - - - - - 1 - - - 1 — 1 27. Gastritis, enteritis and diarrhoea - - - - - - - - - - - - - - - - - - - 28. Nephritis and nephrosis — — — — — — — — 1 — 1 — — — — — 2 — 2 29. Hyperplasia of prostate - - - - - - - - - - - - - - 1 - 1 - 1 30. Pregnancy, childbirth, abortion - - - - - - - - - - - - - - - - - - - 31. Congenital malformations 4 3 — 1 1 1 - - - - - - - - - 1 5 6 11 32. Other defined and ill-defined diseases 3 1 - - 1 - - - 1 1 5 2 3 1 7 13 12 25 33.Motor vehicle accidents - - - - - - - - - - - - - - - - - - - 34. All other accidents — — — — 1 — 1 1 1 1 1 — 2 4 4 8 35. Suicide — — — — — — — 1 2 — _ — — — 3 — 3 36. Homicide and operations of war - - - - - - - - - - - - - - - - - - - 7 5 1 1 2 2 1 2 8 5 42 30 28 31 32 55 121 131 252 16 Death Rate of Infants under One Year of Age No. Holborn London England and Wales All infants 12 Rate per 1,000 live births 52.52 24.2 20.9 Legitimate infants 12 Rate per 1,000 legitimate live births 60.30 Illegitimate infants Nil Rate per 1,000 illegitimate live births - Neo-natal deaths (first four weeks) 6 Rate per 1,000 live births 26.32 — — 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 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 1962 68.1 80.2 — 1963 52.5 60.3 — 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. Bronchopneumonia — — — — 1 1 — — — — 1 31. Congenital malformations— Congenital heart disease — — 1 — — 1 2 2 — — 5 Congenital cystic lungs - - - - - - - 1 - - 1 Myelomeningocele - - - - - - - 1 - - 1 32. Other defined and ill defined diseases— Cerebral haemorrhage - - 1 - - 1 - - - - 1 Prematurity 2 1 - - - 3 - - - - 3 Six of the twelve infant deaths recorded above were of infants domiciled outside England and Wales. Seven infants died as a result of congenital malformations. Of the six "Holborn infants" three died of prematurity, one of pneumonia, one of cerebral haemorrhage, and one 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 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 5. Whooping Cough 1 - - - - - - - - - - 9. Other infective and parasitic diseases - - - - - - - - - - - 20. Other heart disease - - - - - - - - - - - 23. Pneumonia - - - - - 1 1 2 2 1 1 24. Bronchitis - - - - - - - - - - - 27. Gastritis, enteritis and diarrhoea 1 - - - - - - - - 2 — 31. Congenital malformations 2 1 5 6 4 4 10 8 5 6 7 32. Other defined and ill-defined diseases _ 7 2 6 5 1 3 6 3 4 4 34. All other accidents - - - 1 - - - - - - - 4 8 7 13 9 6 14 16 10 13 12 18 Deaths from Tuberculosis — All Ages No. of Deaths Death Rate per 1,000 estimated population Pulmonary 2 10 Other forms Nil — Comparable figures for preceding 10 years:— Year No. of Deaths Rate per 1,000 estimated population 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 1962 4 .19 1963 2 .10 A Table for the years 1948-1963 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 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 1962 2 1 10 3 3 13 1963 2 — 13 2 2 15 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 (including Paratyphoid) Public Health (London) Act, 1936—Sections 192 and 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 (Primary and Influenzal) Public Health (Infectious Diseases) Regulations, 1953. 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 (Including Paratyphoid) Public Health (London) Act, 1936—Sections 192 and 304. 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 192 cases of infectious disease were notified, of which 33 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 1934-1963 are also shown (see Table No. 7, pages 24 and 25). No cases of Diphtheria, Erysipelas, Malaria, Ophthalmia Neonatorum, Poliomyelitis, Puerperal Pyrexia or Smallpox were notified during the year. Dysentery Seven cases were notified and three of them were removed to hospital. Enteric Fever One case of enteric fever was notified. The patient, a nurse at a hospital in the Borough, had been on holiday to Zermatt in Switzerland at the time an outbreak had occurred there. She was removed to an infectious disease hospital, and patients in the ward where she had worked were kept under surveillance. Medical Officers of Health of areas to which patients from her ward had been discharged were also notified and those patients too were kept under surveillance. Encephalitis (Acute) One case of post infectious encephalitis following primary vaccination was notified and was removed to hospital. The patient, a member of an Australian Rugby League team touring this country had been vaccinated in Australia just prior to leaving by plane. Food Poisoning Two cases were notified from a hospital in the Borough. Neither were Holborn residents. Meningococcal Infection Three cases were notified and were removed to hospital. 21 Measles One hundred and thirty cases were notified and one was removed to hospital. Pneumonia (Acute Primary and Acute Influenzal) Four cases of acute primary pneumonia were notified, and two were removed to hospital. Scabies Three cases were notified, and were treated at home. Scarlet Fever Three cases were notified, and were treated at home. Tuberculosis See page 48. Whooping Cough Fifteen cases were notified during the year. Other Diseases coming to the notice of the Department Disease No. of Cases No. removed to Hospital Chicken pox 56 18 Enteritis and gastro-enteritis 6 5 German measles 11 5 Glandular fever 3 3 Pyrexia unknown origin 1 1 Hepatitis 3 3 Influenza 2 2 Mumps 29 7 Shingles 1 — Tonsillitis 1 - 22 TABLE No. 6 Summary of Infectious Disease Notifications 1963. (Corrected) Age Groups Disease Under 1 1—2 2-3 3—4 4—3 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 1 - - — — — 1 - — — 1 1 — 1 - 2 — — — - — - 3 4 7 Encephalitis - - - - - - - - - - - - - - 1 - - - - - - - 1 - 1 Enteric Fever - - - - - - - - - - - - - - - 1 - - - - - - - 1 1 Erysipelas - - - - - - - - - - - - - - - - - - - - - - - - - Food Poisoning - - 1 - - - - - - - - - - 1 - - - - - - - 1 1 2 Malaria - - - - - - - - - - - - - - - - - - - - - - - - - Measles — 6 16 6 5 10 7 3 8 11 30 22 - 3 1 2 - - - - - - 67 63 130 Meningococcal Infection 2 1 - - - - - - - - - - - - - - - - - - - - 2 1 3 Ophthalmia Neonatorum - - - - - - - - - - - - - - - - - - - - - - - - - Pneumonia - - 1 - - - - - - - - - - - - - - - 2 - 1 - 4 - 4 Poliomyelitis - - - - - - - - - - - - - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - - - - - - - - - - - - - - - - - - - Scabies - - - - - - - - - - - - - - 2 - - - 1 - - - 3 — 3 Scarlet Fever - - - - 1 - - - 1 - 1 - - - - - - - - - - - 3 — 3 Tuberculosis (Pulmonary) - - - - - - - - - - - - - - 1 — 5 2 8 1 4 1 18 4 22 Tuberculosis (NonPulmonary) - - - - - - - - - - - - - - - - - 1 - - - - - 1 1 Whooping Cough — — 1 — — - — 1 1 — 5 6 — 1 - — - - — — — — 7 8 15 Totals 3 7 19 6 6 10 8 4 10 11 37 29 - 6 5 5 5 3 11 1 5 1 109 83 192 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 139 specimens were submitted for examination with the following results:— Disease Positive Negative Total Diphtheria — 1 1 (Nasal and throat swabs) Dysentery (Faecal swabs) 5 99 104 Food Poisoning (Faecal swabs) 3 16 19 Typhoid (Faecal swabs) — 11 11 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. Four certificates were issued during the year, all to persons working in the catering industry. Three were contacts of a typhoid carrier, and the fourth a contact of a case of dysentery. 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 710 certificates of persons travelling abroad were authenticated by the Department. Of these 534 were in respect of smallpox, 114 for cholera, 44 for typhoid, 10 for yellow fever, and 8 for poliomyelitis. Diphtheria Immunisation During the year 372 Holborn children completed the primary course of immunisation against diphtheria, and 326 received boosting doses. TABLE No. 7 Comparative Figures of Infectious Disease for the last 30 years Disease 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 1962 1963 (Population) 36,000 35,400 34,850 34,600 34,350 30,660 23,470 17,160 16,580 17,240 18,020 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 20,640 20,700 Diphtheria (including Membranous Croup) 74 93 60 76 49 19 7 14 17 17 5 11 12 3 2 1 2 — — — — — — — 1 2 — — — — Dysentery 2 6 6 10 10 — — — — 2 13 2 6 — 4 — 2 34 9 8 34 4 7 16 30 28 41 2 7 7 Encephalitis Lethargica 1 1 — — — 2 — — — — — 1 — — — — — — — 1 — — — — — — — — 1 1 Enteric Fever 3 2 2 — — 1 1 3 1 6 1 — 1 1 1 — 1 — 2 1 2 — — 4 — — 1 Erysipelas 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 — — 3 5 2 — — — — — — 1 — 1 2 3 1 2 1 4 2 12 1 2 11 19 6 4 2 2 Malaria 1 3 2 3 — 1 — — — 1 — — — — — — 1 1 — 1 1 — — — 1 — 1 Measles Notifiable as from 9th September, 193 8. — 8 39 34 58 219 33 103 107 157 87 170 137 254 133 195 37 172 71 99 56 139 38 122 22 130 Meningococcal Infection 1 1 2 1 1 3 7 7 1 1 — 1 2 2 — — — — — 2 1 2 2 1 — 4 1 1 3 Ophthalmia Neonatorum 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) 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 2 4 Polio-encephalitis Acute _ — — — — — — — — — — 1 1 — — — — — — — — — — — — — 1 — Poliomyelitis Acute _ — — — — — — — — — — 1 — 5 1 2 2 — 6 17 3 12 6 11 4 2 2 1 2 *Puerperal Fever 3 4 2 4 — — — 1 2 2 2 2 — 1 1 * * * * * * * * * * * * * * * Puerperal Pyrexia 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, 1 943. 54 99 125 106 43 16 4 3 4 3 6 1 5 5 1 3 2 5 1 5 3 Scarlet Fever 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 1 3 Smallpox — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Tuberculosis Pulmonary 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 15 22 Tuberculosis, Non-Pulmonary 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 1 1 Whooping Cough 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 2 15 412 379 365 322 296 278 161 194 242 456 280 364 392 348 268 269 311 406 261 366 133 258 157 184 148 243 128 170 62 193 *Ceased to be notifiable as from 30th July, 1948. 26 SECTION 4. Sanitary Circumstances. Visits made by the Public Health Inspectors during 1963. Public Health (London) Act, 1936 Number of Inspections Dwelling Houses 292 Houses Let in Lodgings 37 Common Lodging Houses 4 Offices 41 Rag and Bone Shops 8 Drainage Work and Testing 3,618 Noise Nuisance Visits 70 Other Inspections 808 Re-inspections of above 2,167 Housing Act, 1961 Number of Inspections Houses 145 Underground Rooms 53 Overcrowding Visits 35 Re-inspections of above 15 Factories Acts, 1961 Number of Inspections Power Factories 115 Re-inspections of above 30 Non-Power Factories 4 Re-inspections of above — Outworkers' Rooms 2 Re-inspections of above 6 Electrical Stations and Sites of Building Operations 128 Outworkers' Registers 2 Food and Drugs Act, 1955 Number of Inspections Dairies and Milk Shops 9 Ice Cream manufacture — Ice Cream sale and storage 60 Restaurants and Kitchens 629 Bakehouses 31 Butchers' Shops 44 Fish Shops 13 Fried Fish Shops 10 Other Food Shops 180 Market Streets 64 Licensed Premises 130 Sampling 272 Unsound Food 75 Re-inspections of above 212 27 Number of Inspections Clean Air Act, 1956 Smoke Observations 284 Inspections 22 Re-inspections of above 2 Visits 691 Smoke Control Area Visits 242 „ „ „ Inspections 614 „ „ „ Re-inspections 5 „ — No Entry 131 Miscellaneous Inspections Merchandise Marks Acts 4 Pharmacy and Poisons Acts 3 Prevention of Damage by Pests Act, 1949 109 Shops Act, 1950 31 Hairdressers and Barbers 121 Other Inspections 22 Re-inspections of above 4 Visits, etc., re Infectious Disease 135 Aged and Infirm Persons 21 Verminous Persons 4 No Entry 663 Other Visits 399 Total 12,816 Notices Served Public Health (London) Act, 1936 Intimation Notices 171 Dwelling Houses 160 Houses Let in Lodgings 6 Shops 1 Others 4 Statutory Notices 71 Dwelling Houses 67 Houses Let in Lodgings 4 Food and Drugs Act, 1955 4 Bakehouse 1 Licensed Premises 1 Food Shop 1 Premises and Stalls 1 Factories Act, 1961 1 Power Factory 1 Clean Air Act, 1956 21 Adaptation of Fireplaces 21 Shops Act, 1950 1 Baker 1 L.C.C. (General Purposes) Act, 1955 1 Dwelling House 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 1 Cisterns, cleansed, repaired or renewed — Service pipes repaired 4 Waterclosets Compartments cleansed and/or repaired 83 Water supplied, flushing cistern repaired 36 New W.C. pan provided 20 Ventilation improved or provided 52 Additional accommodation provided — Urinals cleansed and/or repaired — Unstopped 1 Drainage Soil pipes, repaired, renewed or ventilated 19 Rainwater pipes, repaired or renewed 4 Drains unstopped or cleansed 1 Drains repaired or relaid 2 New manhole covers provided — Sinks Defective sinks renewed 9 Waste pipes repaired, renewed or unstopped 14 Yards, Areas and Washhouses Cleansed 2 Drained or drains unstopped 2 Paved or paving repaired 8 Houses and Workshops, etc. Rooms cleansed or repaired 106 Passages and staircases cleansed or repaired 8 Ventilation improved 120 Dampness Roofs repaired 23 Gutters repaired 33 Other works to prevent dampness 66 Ashbins Provided, repaired, etc 1 Various Accumulations of refuse removed 10 Improper keeping of animals remedied — Noise nuisance abated — Dust nuisance abated — Emission of black smoke abated — During the year 510 complaints were received in respect of the following nuisances:— Artificial lighting, absence of, on common staircase - Aged and infirm persons 1 Animals improperly kept 7 Dampness 17 Dilapidations and disrepair 23 Drains, choked or defective 18 Dust — Dustbin accommodation inadequate or unsuitable 2 Food premises, unsatisfactory conditions in 10 Floors defective — Noise 24 Overcrowding 7 Obnoxious smells 42 Refuse, accumulations of 22 Rodent infestation 141 Roofs, defective 14 Smoke 38 Unsound food 25 Vermin 38 Ventilation inadequate 1 W.C. accommodation inadequate, dirty or defective 35 Miscellaneous 18 Water supply, burst pipes 8 Water supply, inadequate 17 Water supply, impure 2 29 Complaints 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. Two complaints of impure water were received. In one case the Metropolitan Water Board collected a sample, which on analysis proved to be satisfactory. In the second case it was found that the condition of the water was due to stagnation in long lengths of piping in the building together with warming of the water by local conditions, and infrequent draw-off. Samples of water drawn after flushing the tap were found to be satisfactory. Drainage During the year 3,618 inspections were made by the Public Health Inspectors in connection with drainage work; 121 applications for approval of proposed drainage work were submitted together with the necessary plans, and 109 Combined Drainage Orders were made. 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 1963, 4 notifications were received concerning the proposed discharge of trade effluents. In 3 cases notices of proposed conditions were issued by this Council and no counter proposals were received. In the remaining case premises concerned were connected to the London County Council sewers, and the notification was dealt with by that authority. Clean Air Act, 1956 During the year 38 complaints were received regarding smoke emissions and 284 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 1963 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 Apparatus out of order 6.28 February 0.24 3.4 13.80 8.39 22.25 9.23 March 2.05 3.8 23.27 4.66 27.93 5.66 April 0.55 3.8 8.25 5.20 13.45 4.60 May 1.62 4.1 16.54 5.70 22.24 1.60 June Apparatus out of order 2.32 July 0.87 4.5 10.00 5.00 15.00 2.38 August 2.40 4.4 11.17 7.72 18.89 2.04 September 1.62 4.2 9.73 6.24 15.97 2.78 October 1.42 4.1 9.35 8.45 17.80 3.86 November 3.74 4.0 12.34 4.86 17.20 5.81 December 0.59 3.8 12.92 7.48 20.40 5.88 Total 15.10 — 127.37 64.70 191.13 52.44 Monthly Average 1.51 4.0 12.74 6.47 19.11 4.37 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 Apparatus out of order February 8.73 5.31 14.04 March 14.72 2.95 17.67 April 5.22 3.29 8.51 May 10.47 3.61 14.08 June Apparatus out of order July 6.33 3.16 9.49 August 7.07 4.89 11.96 September 6.16 3.95 10.11 October 5.92 5.35 11.27 November 7.81 3.08 10.89 December 8.18 4.73 12.91 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 1963:— 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 224 673 56 February 154 294 83 March 89 175 48 April 125 256 56 Apparatus not in use May 67 115 39 June 82 140 41 July 45 81 5 August 65 117 33 55 111 27 September 84 184 46 79 114 24 October 139 247 87 95 213 30 November 143 496 51 127 239 41 December 176 276 98 200 281 113 32 Installation of New Furnaces In fourteen 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 Since 1st December, 1962, when the last Holborn Smoke Control Order became operative the whole of the Borough has been a smoke control area. During the year two hundred and one applications for grant were approved in connection with the adaptation of fireplaces, the total cost of the work amount to £3,333 9s. 5d. of which £1,000 0s. l0d. was borne by the Council, £1,333 7s. 9d. by the Exchequer and £1,000 0s. l0d. by the applicants. Pharmacy and Poisons Act, 1933 This Act, the Poisons Rules, 1963, and the Poisons List Order, 1952/63, 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 1963, 33 applications were received for retention on this Council's list. Two applications were received for entry on the list. Rag Flock and Other Filling Materials Act, 1951 This Act and the Regulations of 1961, 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 1963. Slum Clearance Houses included in clearance areas 15 Houses included in clearance areas and demolished 8 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 1 Parts of buildings made the subject of closing orders 3 Parts of buildings closed by undertaking Nil Underground rooms made the subject of closing orders 3 Underground rooms closed by undertaking Nil Closing orders determined Nil No. of flats erected by the Council during the year 48 33 Note: The number of underground rooms which do not comply with the relevant Regulations, but which are occupied for human habitation, is 434. Houses Let in Lodgings Number in Borough 258 Inspections made 37 Overcrowding On the 1st January, 1963, 125 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 11 cases, overcrowding was abated during the year as follows:— Families rehoused by the Holborn Borough Council 3 Families rehoused by the London County Council 2 Accommodation found by other means 6 During the year 35 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 Nil (2) Number of decisions not to issue certificates Nil (3) Number of decisions to issue certificates Nil (a) in respect of some but not all defects Nil (b) in respect of all defects Nil (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 Nil Applications for Cancellation of Certificates (7) Applications by landlords to Local Authority for cancellation of certificates Nil (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 34 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, 1963 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 15 5,975 — 7,363 13,353 II. Numberof properties inspected (a) - 72 69 141 as a result (a) of notification (b) (b) - — — — — survey, or (c) otherwise (c) - 43 — 45 88 III. Total inspections carried out including re-inspections — 214 — 175 389 IV. Number of properties (under II) found to be infested by:— (a) Rats Major — - Minor† 14 —_ 14 28 (b) Mice Major 1 _ 3 4 Minor† — 32 — 27 59 V. Number of infested properties (under IV) treated by the Local Authority — 47 43 90 VI. Total treatments carried out —including re-treatments — 325 — 213 538 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 1963, 141 complaints of rat or mice infestation were received and investigated. 35 The following table shows the work carried out during the year arising from the complaints received. Total Business premises inspected 114 Dwelling houses inspected 115 Local authority premises inspected — Business premises treated 43 Dwelling houses treated 47 Local authority premises treated — Business premises, inspection visits 175 Business premises, treatment visits 213 Dwelling houses, inspection visits 214 Dwelling houses, treatment visits 325 Local authority, inspection visits — Local authority, treatment visits — Total visits 927 Estimated kill (rattus norvegicus) 137 Bodies recovered (rattus norvegicus) 47 Estimated kill (rattus rattus) 7 Bodies recovered (rattus rattus) 1 Estimated kill (mice) 536 Bodies recovered (mice) 160 Baiting of Sewers During the year a third treatment of the sewers, by direct poisoning using 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 6 Number of rooms disinfected after other infectious diseases 24 Total number of rooms disinfected after infectious disease 30 Number of articles of bedding and clothing disinfected after tuberculosis 128 Number of articles of bedding and clothing disinfected after other infectious diseases 1,081 Total number of articles disinfected after infectious disease 1,209 Number of articles disinfected for export 68,000 Number of books disinfected after infectious disease 198 36 Disinfestation Number of rooms disinfested of vermin 105 Number of articles of bedding and clothing disinfested of vermin 2,270 Summary of 3,479 articles of bedding and clothing dealt with during the year:— Mattresses 116 Pillows 182 Pillow Cases 119 Bolsters 10 Bolster Cases 10 Blankets 348 Sheets 193 Household 1,565 Clothing 835 Other Bedding 101 Cleansing Number of persons treated for scabies 21 Number of persons treated for head lice 1 Number of persons treated for body lice 43 Number of persons treated for crab lice 14 Number of persons cleansed 265 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. In only one instance during the year was action necessary under the above provision. The case in question concerned an old man aged 75 years who was living alone in insanitary conditions and was suffering from the effects of self-neglect and malnutrition. He was removed to hospital and died there one month later. Visits also 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. 37 During the year twenty-two cases were dealt with, at a total cost of £278 2s. 6d. The total amount recovered during the year in respect of burials was £370 13s. ld. The cases had come to the notice of the Public Health Department from the following sources:— Coroner's Officer 3 Friends or Relatives of Deceased 13 French Hospital 6 New Legislation Offices, Shops and Railway Premises Act, 1963 This Act, which comes into operation during 1964 requires the registration with a local authority of all offices, shops and railway premises within its area, and makes provision for securing the health, safety, and welfare of persons employed in such premises. Animal Boarding Establishment Act, 1963 This Act which came into force on 1st January, 1964, empowers local authorities to grant a licence to a person to keep a boarding establishment for animals subject to the compliance with such conditions as may be specified in the licence. The Ice-Cream (Heat Treatment, etc.) (Amendment) Regulations, 1963 These Regulations amend the Ice-Cream (Heat Treatment, etc.) Regulations, 1959 to allow the addition of sugar to sterilised or pasteurised mixtures used in the manufacture of ice-cream. The Meat Inspection Regulations, 1963 These Regulations which came into operation on 1st October, 1963, replace with amendments the Public Health (Meat) Regulations, 1924 to 1952. The main provisions require the inspection and marking prior to removal of carcases of animals slaughtered for human consumption. The Milk (Special Designation) Regulations, 1963 These Regulations re-enact with amendments the Milk (Special Designation Regulations, 1960. The only significant amendment relating to dealers licences is that on and after 1st October, 1964, "Untreated" replaces "Tuberculin Tested" as the special designation for raw milk. The Liquid Egg (Pasteurisation) Regulations, 1963 These Regulations which came into operation on 1st January, 1964, require the pasteurisation of liquid egg to be used in food intended for sale for human consumption, other than eggs broken out on the food manufacturer's premises and used within 24 hours. The Regulations prescribe the method of pasteurisation and the test to be satisfied. Soft Drinks Regulations, 1963 These Regulations re-enact the Food Standards (Soft Drinks) Order, 1953, with amend- ments concerning the composition and labelling of soft drinks. The Bread and Flour Regulations, 1963 These Regulations which come into operation on 1st September, 1964, prescribe requirements as to the composition, labelling, advertising, sale, and importation of bread and flour. The Public Health (Ships) (Amendment) Regulations, 1963 The Public Health (Aircraft) (Amendment) Regulations, 1963 These Regulations which came into operation on 1st August, 1963, amend the Public Health (Ships) Regulations, 1952 to 1961 and the public Health (Aircraft) Regulations, 1952 to 1961 and enable port health officers and aircraft health officers to require the production of International Certificates of Vaccination against smallpox. If a person has not a certificate he may be offered vaccination and may be placed under surveillance or in isolation. 38 SECTION 5. Factories. Most of the provisions of the Factories Act, 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 1963 are as follows:— Number of visits to:— Factories with mechanical power 145 Factories without mechanical power 4 Outworkers registers 2 Outworkers' rooms 8 Electrical stations and sites of building operations 128 Factories Act, 1961 The following particulars are furnished in accordance with Section 153 (1) 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 Inspections Number of Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 169 4 - - (II) Factories not included in (i) in which Section 7 is enforced by the Local Authority 635 145 1 - (lii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 32 128 — — Total 836 277 1 39 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) 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 24 21 — 9 — (c) Not separate for Sexes 1 1 — — — Other offences against the Act (not including offences relating to Outwork) 35 1 34 — — Total 62 24 35 9 — Part VIII of the Act Outworkers Section 133 of the Factories Act, 1961, 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 134 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 133 Section 134 No. of Outworkers in August List required by Sect. 133(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 202 — — — — — Cleaning and Washing 1 — — — — — Household Linen 3 — — — — — Lace, Lace Curtains and Nets 3 - - - - - Artificial Flowers 5 — — — — — Boxes etc. — — — — — — Cosaques, Christmas Crackers, Christmas Stockings, etc 58 — — — — Total 272 - — — — - 40 Firms in the Borough employing outworkers 18 No. of outworkers on lists submitted 272 No. of outworkers referred to other Boroughs 265 No. of outworkers in Holborn employed by Holborn firms 7 No. of outworkers in Holborn employed by firms outside the Borough 30 Total number of outworkers in Holborn 37 Inspection of outworkers' premises 2 Cases of notifiable disease occurring in such premises Nil 41 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 1963:— Dairies and milk shops 9 Ice cream, sale or storage 60 Ice cream manufacture — Restaurants and kitchens 629 Bakehouses 31 Butchers' shops 44 Fish shops 13 Fried fish shops 10 Other food shops 180 Market streets 64 Licensed premises 130 Sampling 272 Unsound food 75 Re-inspections 212 Food and Drugs Act, 1955 Notices During 1963, 4 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:— Bakehouse 1 Licensed Premises1 Food Shop1 Premises and Stalls1 42 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 7 Articles and equipment cleansed 1 Proper lighting and ventilation provided to sanitary conveniences 3 Sanitary conveniences cleansed and put in efficient order 6 Persons handling food:— Wash-hand basins provided 3 Hot and cold water provided 2 Soap, detergents, nail brushes and towels provided 2 Washing food and equipment— Suitable and sufficient sinks provided 1 Sinks and other equipment cleansed and put in good order 1 Ventilation of food rooms improved 3 Food rooms cleansed 4 Food rooms repaired and put in good condition 4 Adequate precautions taken in food room to prevent infestation by vermin 5 Accumulation of refuse in food room removed 1 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 1963 Nil Dairies removed from register during 1963 1 Dairies on register at end of 1963 Nil Distributors registered during 1963 6 Distributors removed from register during 1963 4 Distributors on register at end of 1963 51 Inspections made by Inspectors during 1963 9 Formal milk samples taken and submitted for analysis 69 Informal milk samples taken and submitted for analysis 92 43 The following tables show the monthly variation of the chemical composition of the 161 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 3.82 8.80 12.62 February 12 3.71 8.76 12.47 March 11 3.74 8.66 12.40 April 13 3.68 8.67 12.35 May 10 3.55 8.56 12.11 June 12 3.45 8.66 12.11 July 11 3.64 8.67 12.31 August 11 3.84 8.70 12.54 September 12 3.90 8.66 12.56 October 10 4.00 8.80 12.80 November 11 3.90 8.62 12.52 December 12 4.01 8.67 12.68 Whole year 139 3.77 8.69 12.46 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 4.80 9.13 13.93 March 5 4.55 8.97 13.52 April — — — — May 4 4.36 8.94 13.30 June 1 4.25 9.10 13.35 July - - - - August 2 4.54 8.92 13.46 September 2 4.63 8.88 13.51 October — — — — November 3 4.88 9.04 13.92 December 3 4.70 8.95 13.65 Whole year 22 4.59 8.99 13.58 Legal minimum — 4.00 8.50 12.50 44 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) 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 1962 141 12.29 8.67 3.62 1963 139 12.46 8.69 3.77 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 6 dealers licences were issued, details of which are as follows:— To sell Tuberculin Tested milk 4 To sell Pasteurised milk 6 To sell Sterilised milk 2 Milk—Bacteriological Examination During the year, 97 samples of milk were submitted for bacteriological examination. 35 of these were from milk supplied to schools in the Borough and four to a Day Nursery. 45 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, 1963, one set of premises was registered for the manufacture, storage and sale of ice cream, in Holborn, and 142 premises were registered for storage and sale. During the year 3 applications were received and approved in respect of premises to be used for storage and sale of ice cream. 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 143 premises were registered for storage and sale. Ice Cream (Heat Treatment, Etc.) Regulations, 1959 During the year, 83 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 55 Grade 2 23 Grade 3 1 Grade 4 4 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 130 inspections were carried out. In addition, 51 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 Acts, 1953 and 1961. 46 Food Sampling. A total of 479 samples of food and drugs were purchased and submitted to the Borough Analyst for chemical analysis during the year. 264 were formal samples and 215 were informal. Article Number of Samples purchased Batter Mix 2 Bread 2 Butter 2 Cereals 2 Cheese 5 Cocoa 1 Coffee 6 Condiments 9 Cooking Fat, Oil, Dripping and Suet 15 Cream, fresh and tinned 8 Curry Powder 1 Custard Powder 1 Drugs and Medical Preparations 24 Essences and Flavourings 11 Fish, fresh, tinned and preserved 6 Flour 5 Fruit, dried, tinned and fresh 9 Herbs and Spices 6 Ice Cream 1 Jams and Preserves 12 Jellies 2 Margarine 2 Meat and Meat Preparations 50 Milk 161 Milk, Evaporated and Condensed 6 Olive Oil 4 Pearl Barley 1 Puddings 6 Rice 5 Sandwich Spread 1 Sauces 13 Soft Drinks and Cordials 30 Soups 11 Spaghetti 1 Sugar 4 Sweets and Confectionery 19 Tea 5 Vegetables, tinned and dried 17 Vitamin Tablets and Preparations 9 Wines and Spirits 1 Yoghurt 3 479 47 Unsound Food During the year 1963, the undermentioned unsound food was surrendered and destroyed or disposed of otherwise:— Commodity Tons Cwts. Qtrs. Lbs. MILK Fresh — — — — Tinned — — — 3 FISH Fresh — — 1 15 Tinned — 1 — — MEAT Fresh — — — 24 Tinned 3 14 1 20 FRUIT Fresh — — — 27 Tinned — 14 — — VEGETABLES Fresh — — — — Tinned 5 5 3 11 OTHER FOOD — 14 — 22 TOTAL 10 13 2 12 48 SECTION 7. Tuberculosis. The following table gives the number of new cases of tuberculosis notified, and deaths during 1963 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 — — — — — — — — 5-10 years — — — — — — — — 10-15 years — — - — — — — — 15-20 years — — — — — — — — 20-25 years 1 — — — — — — — 25-35 years 3 1 — 1 — — — — 35-45 years 2 1 — — — — — — 45-55 years 7 — — — — — — — 55-65 years 1 1 — — — 1 — — 65-75 years 2 1 — — 3 — — — 75 and over 2 — — — — - — — TOTAL 18 4 — 1 *3 *1 — — 3*Only two of these persons died of tuberculosis. 49 Summary of Changes in Tuberculosis Register During 1963 Pulmonary Non-Pulmonary Total M. F. M. F. Cases on Register at 31st December, 1962 115 86 4 5 210 Cases Added Primary notifications 18 4 — 1 23 Transferred from other districts 13 2 — — 15 Restored to register — — — — — Totals 146 92 4 6 248 Cases Removed Moved to other district 8 1 — 1 10 Recovered — 1 — — 1 Died 3 1 — — 4 Lost trace of 6 6 1 1 14 Others — — — — — Totals 17 9 1 2 29 Cases on Register at 31st December, 1963 129 83 3 4 219 50 Tuberculosis Notifications and Deaths for the last 50 years Notifications Rate per 1,000 Population Deaths Rate per 1,000 Population 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 62 16 .78 4 .19 63 23 1.11 2 .10 51 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 1963. No. of Examinations Results First examination 78 Fit for employment 102 Second examination 26 Decision deferred 5 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 16 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, three persons were considered to be "incapable of discharging the duties of their employment by reason of permanent ill health or infirmity of body." DISABLED DRIVERS. Fifty-four applications for exemption from parking meter charges were referred by the Borough Engineer for medical opinion, necessitating medical examinations in respect of 39 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:— 52 Number on visiting list 350 Number known to be active or members of Clubs 376 Visited by other organisations 176 Total number registered 902 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 1,489 home visits were made by the Social Workers, and 463 other visits or interviews on behalf of old people occurred. SERVICES ARRANGED FOR OLD PEOPLE As a result of their visits during the year the Social Workers arranged for the following services to be provided for old people in the Borough. Meals-on-Wheels and Luncheon Club 43 Home Help 68 National Assistance 12 Chiropody 55 Incontinent Laundry Service 23 Home Library Service 7 Bathing 21 Holidays 48 Other Services— radio, meter lowering, clothing &c. 113