HOL62 (LONDON BOROUGH OF CAMDEN REPORT ON THE HEALTH OF THE METROPOLITAN BOROUGH OF HOLBQRN 1964 R. D. DEWAR, B.Sc., M.B., Ch.B., D.P.H. Associate Medical Officer of Health. LONDON BOROUGH OF CAMDEN REPORT ON THE HEALTH OF THE METROPOLITAN BOROUGH OF HOLBORN 1964 R. D. DEWAR, B.Sc., M.B., Ch.B., D.P.H. Associate Medical Officer of Health. 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 1 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 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 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 Food & Food Premises— Bakehouses 26 Ice cream 45 Milk supply 41 Unsound food condemned, Table 47 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 1954 17 Infectious Diseases- Bacteriological examinations 23 Notifiable 19 Non-notifiable 21 Summary of notifications, 1964 22 Comparative figures for years 1935-1964 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 20 Milk- Bacteriological examinations 44 Chemical samples 43 Distributors on register 41 Licences granted 44 Registrations 41 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 20 Poliomyelitis, Acute 20 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 34 Complaints 34 General 35 Sewers 34 PAGES Sampling 45 Sanitary circumstances of the area 26 Scabies 20 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 rooms 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 were ex-officio members of all Standing Committees of the Council. The Mayor in 1963/64 was Councillor H. Bright, M.A., M.I.H.V.E., J.P., and in 1964/65 was Alderman A. F. Judd, J.P. The Deputy Mayor in 1963/64 was Councillor Miss I. Simpson, and in 1964/65 was Councillor Miss C. E. Clayson. 1963/64 1964/65 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. Councillor J. A. Barker. „ Mrs. L. A. Brown. „ Mrs. L. A. Brown. E. A. J. Clark. „ E. A. J. Clark. „ Mrs. L. J. Coleman. „ Mrs. L. J. Coleman. „ E. G. Cracknell. „ A. S. Davis. „ A. S. Davis. „ Mrs. A. G. Finn. „ Mrs. A. G. Finn. „ J. Garforth-Bles. „ Mrs. B. M. Grass. „ Mrs. B. M. Grass. „ Mrs. R. Howe. „ P. A. Hayward. „ F. Jaque. „ Mrs. R. Howe. „ Miss E. L. Martin. „ F. Jaque. „ W. P. McGowan. „ Miss E. L. Martin. „ W. Montgomery. „ W. P. McGowan. „ J. F. Robertson. „ W. Montgomery. „ A. E. Shaw. „ J. F. Robertson. „ J. Simpson. „ A. E. Shaw. 6 STAFF The following was the staff of the Public Health Department during 1964. Medical Officer of Health: R. D. Dewar, B.Sc., M.B., Ch.B., D.P.H. Public Analyst: J. H. E. Marshall, M.A., F.R.I.C. Chief Clerk: A. E. Hobbs. Senior Public Health Inspectors: J. H. R. Crabtree, M.R.S.H., F.A.P.H.I., R.P. H. D. Bailey, F.A.P.H.I. Public Health Inspectors: H. Parker, M.A.P.H.I., A.R.S.H. J. A. Hoare, M.A.P.H.I. (to 30.4.64) 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. W. Wallis (to 20.8.64). K. Dixon (from 17.2.64). M. Regan (from 13.7.64). J. D. Bennett (from 31.8.64). Disinfecting Station and Cleansing Station Staff: J. W. Gardiner (Superintendent Disinfector) N. J. Lyons. W. C. Razzell. Mrs. R. E. Nicholls. A. O. Shokumbi (to 14.8.64). A. P. Olive. Rodent Operative: J. W. Maloney. Social Welfare Officers: Miss R. P. Begg Miss M. Sivyer (to 11.9.64). Technical Assistants: M. C. Walker (from 1.6.64 to 27.12.64). D. V. Wilmer (from 1.6.64). 7 Bidborough House, 38/50 Bidborough Street, London, W.C.I. August, 1965. To the Mayor, Aldermen and Councillors of the London Borough of Camden, Your Worship, Ladies and Gentlemen, This is the last Annual Report on the health of the Metropolitan Borough of Holborn which since 1st April 1965 has been incorporated in the new London Borough of Camden. The report is presented in a similar form to that of recent years so that statistical comparisons may be made easily. It is difficult to find any single figure which can be taken as an indication of the health of an area but some figures may be given as an indication of progress (or otherwise) during the past 30 years. 1934 1964 Population 36,000 20,430 Birthrate per 1,000 population 9.49 8.27 Infantile mortality per 1,000 live births 71.2 53.25* Cases of Diphtheria 74 Nil Cases of Whooping Cough 65 1 Cases of Tuberculosis 89 15 Deaths from Tuberculosis 32 1 *Children who died in Great Ormond Street Children's Hospital and who are normally resident outside England and Wales are attributed to Holborn so that the figure is artificially high. Whilst the figures for infectious diseases in particular are very gratifying not all diseases have responded in the same way. Thirty years ago the classification of diseases was somewhat different and the actual number of cases of cancer of the lung are not recorded but during the past 15 years the number of deaths from this disease has increased by more than 50%. Progress in other aspects of environmental health can be less easily expressed but those people who are familiar with the area will appreciate the improvements which have taken place in housing, in conditions of work and in the services provided, particularly those for the old people. I would like to thank the Chairman of the Public Health Committee, Alderman M. P. Greengross, O.B.E. and the Members of the Committee for their kindness, advice and assistance at all times. My thanks are also due to the other Chief Officers and their staffs for their ready help and to the staff of the Public Health Department for their efficient and loyal service. 8 I am sure that the progress which has been achieved will be continued and accelerated within the new London Borough of Camden, with its enlarged powers and responsibilities and that the staff transferred from Holborn will always strive to achieve this object. I am, Your obedient servant, R. D. DEWAR, Associate Medical Officer of Health. 9 SECTION 1. General Information and Statistical Summary. General Holborn, with an area of 405 acres, was 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) 22½feet London Clay 63½feet 2. Grays Inn Made Soil 7 feet Gravel 9½ feet 3. Lincoln's Inn London Clay 40½ feet Made Soil 13 feet Gravel 5 feet London Clay 113 feet 4. Bernard Street Made Soil 10 feet Sand and Gravel ll½ 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-1964 estimate) 20,430 Number of persons per acre (estimated average) 51 Number of dwelling houses, flats and other residences 6,081 Rateable Value £12,102,478 Product of penny rate, approximately £48,450 General rate for the year 7s. 2d. 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 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 1964 66 313 379 20,430 18.50 Summary of Vital Statistics Live Births 169 Birth-rate (per 1,000 estimated population) 8.27 Deaths, all ages 214 Death-rate (per 1,000 estimated population) 10.47 Infant deaths 9 Infant death-rate (per 1,000 live births) 53.25 Maternal deaths Nil Maternal death rate (per 1,000 live births) Nil (per 1,000 live and still births) Nil Tuberculosis deaths 1 Tuberculosis death-rate (per 1,000 estimated population) .05 Cancer deaths 31 Cancer death-rate (per 1,000 estimated population) 1.52 Maternity and Child Welfare Centres Province of Natal Centre, Guilford Place Telephone CHAncery 9401 Chest Clinic University College Hospital, Huntley Street, W.C.1 Telephone EUSton 5050 Day Nurseries Kingsway Creche (Voluntary Day Nursery), Telephone 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, was 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 Waterloo 6000 in a hospital or maternity home)— Gentral6301 Very urgent illness in the home (provided a Regent 4000 medical practitioner certifies that the case Reliance 3622 is urgent and arrangements have been made New Cross2645 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 1964. Population The civilian population, as estimated by the Registrar-General, Mid-1964 was 20,430. Comparable estimates for preceding years are set out on page 14. STATISTICS FOR THE YEAR 1964. Population The civilian population, as estimated by the Registrar-General, Mid-1964 was 20,430 Comparable estimates for preceding years are set out on page 14. Registered Live Births Proportion per 1,000 Registered Live Births M. F. Total Rate per 1,000 Estimated Population Legitimate 73 68 141 6.90 834 Illegitimate 16 12 28 1.37 166 Total Live Births 89 80 169 8.27 — Comparable figures for preceding 30 years are set out on page 14. Registered Still Births M. F. Total Rate per 1,000 Live and Still Births Legitimate 2 1 3 17.75 Illegitimate — — — — Total Stillbirths 2 1 3 17.75 Notification of Births The following figures for Holborn for 1964 have been supplied by the Divisional Medical Officer of the London County Council:— M F.  Live Births 96 80 176 Stillbirths 1 1 2 Total Births Notified 97 81 178 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. 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 1964. Age Groups 0-1 1- 5- 15- 25- 45- 65- 75- TOTALS Males 4 1 3 1 8 43 33 23 116 Females 5 2 3 3 5 18 21 41 98 TOTALS 9 3 6 4 13 61 54 64 214 % of Total 4.22 1.41 2.81 1.87 6.08 28.48 25.23 29.90 100 Average age at death in Holborn during 1964 was 61.75 years. Deaths—All Ages M. F. Total Rate per 1,000 Estimated Population 116 98 214 10.47 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 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 1962 20,640 190 9.21 270 13.08 13 68.41 1963 20,700 228 11.01 252 12.17 12 52.52 1964 20,430 169 8.27 214 10.47 9 53.25 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. Trberculosis, other - - - - - - - - - - - - - - - - - - 3. Syphilitic disease - - - - - - - - - - - - - 1 - 1 — 1 1 4. Diphtheria - - - - - - - - - - - - - - - - - - - 5. Whooping cough - - - - - - - - - - - - - - - - - - - 6. Meningococcal infections - - - - - - - - - - - - - - - - - - - 7. Acute poliomyelitis - - - - - - - - - - - - - - - - - - - 8. Measles — — — — — — — — — — — — — — — — — — — 9. Other infective and parasitic diseases - - - - - - - - - - - - - - - - - - - 10. Malignant neoplasm, stomach — — — — — — — — — — 1 — 1 2 — 1 2 3 5 11. Malignant neoplasm, lung, bronchus - - - - - - - - 1 _ 6 2 6 3 1 - 14 5 19 12. Malignant neoplasm, breast - - - - - - - - - - - - - - - 1 — 5 5 13. Malignant neoplasm, uterus - - - - - - - - - - - - 1 — 1 — 2 2 14. Other malignant and lymphatic neoplasms 1 - - - - - - - - 2 9 4 4 2 2 5 16 13 29 15. Leukaemia, aleukaemia - - -- - - - - - - - - - - - - - - - - 16. Diabetes — _ — — - — — — 17. Vascular lesions of nervous system _ _ _ - - - - - - 3 - - 1 1 9 4 10 14 18. Coronary disease, angina - - - - - - - - 2 1 12 4 8 2 5 7 27 14 41 19. Hypertension with heart disease - - - - - - - - - 1 - - - - 2 1 2 3 20. Other heart disease — — — — — — — — — 2 3 3 4 4 7 9 16 21. Other circulatory disease — — — — — — — — 3 1 1 2 4 3 7 22. Influenza - - - - - - - - - - - - - - - — 23. Pneumonia — — — — — — — — . _ 2 2 1 4 3 6 9 24. Bronchitis — — — — - - - - - - 2 3 2 6 1 11 3 14 25. Other diseases of respiratory system -- - - - - - - - - - 2 - - - - - 2 - 2 26. Ulcer of stomach and duodenum — — — — — — — — 1 - 1 1 2 1 3 27. Gastritis, enteritis and diarrhoea - - - - - - - - - - - - - - - - - - - 28. Nephritis and nephrosis - - - - - - - - - - 1- - - - - - 1 — 1 29. Hyperplasia of prostate - - - - - - - - - - - - - - - - - - - 30. Pregnancy, childbirth, abortion - - - - - - - - - - - - - - - - - - - 31. Congenital malformations 2 3 1 1 1 1 — — 1 — 5 5 10 32. Other defined and ill-defined diseases 1 2 - 1 1 1 - 1 3 2 3 1 2 1 1 1 11 10 21 33. Motor vehicle accidents — — _ — — — _ 1 1 1 34. All other accidents — - 1 1 1 1 __ - 1 _ - 2 2 4 5 9 35. Suicide — — — 1 - - - - __ - - 1 1 36. Homicide and operations of war - - - - - - - - - - - - - - - - - - - 4 5 1 2 3 3 1 3 8 5 43 18 33 21 23 41 116 98 214 16 Death Rate of Infants under One Year of Age No. Holborn London England and Wales All infants 9 Rate per 1,000 live births 53.52 21.2 19.9 Legitimate infants 8 Rate per 1,000 legitimate live births 56.74 Illegitimate infants 1 Rate per 1,000 illegitimate live births 35.72 Neo-natal deaths (first four weeks) 3 Rate per 1,000 live births 17.75 — — 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 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 — 1964 53.3 56.7 35.72 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 1954. 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 14. Other malignant and lymphatic neoplasms - - - - - - - 1 - - 1 31. Congenital malformations Congenital heart disease — — — — — — 2 — — - 2 Encephalocele 1 — — — — 1 1 — — - 2 Rectal atresia - - - - - - - - - 1 1 32. Other defined and ill-defined diseases Bilateral atelactosis — — — — 1 1 — — — - 1 Prematurity 1 - - - - 1 - - - - 1 Birth trauma - - - - - - - 1 - - 1 Seven of the nine infant deaths recorded above were of infants domiciled outside England and Wales. Five infants died as a result of congenital malformations. Of the two "Holborn infants" one died of prematurity and one of encephalocele. 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 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 5. Whooping Cough _ 9. Other infective and parasitic diseases - - - - - - - - - - - 14. Other malignant and lymphatic neoplasms - - - - - - - - - - 1 20. Other heart disease — — — — — — — 23. Pneumonia — — — 1 1 2 2 1 1 24. Bronchitis 27. Gastritis, enteritis and diarrhoea — — — — 2 31. Congenital malformations 1 5 6 4 4 10 8 5 6 7 5 32. Other defined and ill-defined diseases 7 2 6 5 1 3 6 3 4 4 3 34. All other accidents - - 1 - - - - - - - - 8 7 13 9 6 14 16 10 13 12 9 18 Deaths from Tuberculosis—All Ages No. of Deaths Rate per 1,000 estimated population Pulmonary 1 .05 Other forms Nil — Comparable figures for preceding 10 years:— Rate per 1,000 estimated population Year No. of Deaths 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 1964 1 .05 A Table for the years 1948-1964 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 1964 1 — 14 5 1 19 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 Cholera Continued Fever Diphtheria Dysentery Encephalitis, Acute Enteric Fever (including Paratyphoid) Erysipelas Food Poisoning Leprosy† Malaria Measles Membranous Croup Meningococcal Infection Ophthalmia Neonatorum* Plague Pneumonia (Primary and Influenzal) Poliomyelitis, Acute Puerperal Pyrexia Public Health (Infectious Diseases) Regulations, 1953 and 1960. Public Health (London) Act, 1936—Sections 192 and 304. Do. Do. Public Health (Infectious Diseases) Regulations, 1953. Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. Public Health (London) Act, 1936—Sections 192 and 304. Do. Food and Drugs Act, 1955—Section 26. Public Health (Leprosy) Regulations, 1951. Public Health (Infectious Diseases) Regulations, 1953. County of London (Measles and Whooping Cough) Regulations, 1938 to 1948. Public Health (London) Act, 1936—Sections 192 and 304. L.C.C. Order dated 27.2.1912 and Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1939. L.C.C. Order dated 2.11.1910 and Public Health (Ophthalmia Neonatorum) Regulations, 1926 to 1937. Local Government Board Order, 1900. Public Health (Infectious Diseases) Regulations, 1953. L.C.C. Order dated 27.2.1912 and Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. 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 Relapsing Fever Scabies Scarlet Fever Smallpox Tuberculosis Typhoid Fever (Including Paratyphoid) Typhus Fever Whooping Cough Authority for Notification Public Health (London) Act, 1936—Sections 192 and 304. County of London (Scabies) Regulations, 1943. Public Health (London) Act, 1936—Sections 192 and 304. Do. Public Health (Tuberculosis) Regulations, 1952. Public Health (London) Act, 1936—Sections 192 and 304. Do. 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 62 cases of infectious disease were notified, of which 23 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 1935-1964 are also shown (see Table No. 7, pages 24 and 25). No cases of Diphtheria, Enteric Fever, Encephalitis (Acute), Food Poisoning, Meningoccal Infection, Malaria, Ophthalmia Neonatorum, Poliomyelitis, Puerperal Pyrexia or Smallpox were notified during the year. Dysentery Four cases were notified and all of them were removed to hospital. Erysipelas Two cases were notified and were treated at home. Measles Thirty-three cases were notified. Pneumonia (Acute Primary and Acute Influenzal) Two cases of acute primary pneumonia were notified, and one was removed to hospital. Scabies Two cases were notified, and one was removed to hospital. 21 Scarlet Fever Three cases were notified, one was removed to hospital. Tuberculosis See page 48. Whooping Cough One case was notified during the year. Other Diseases coming to the notice of the Department Disease No. of Cases No. removed to Hospital Chicken pox 73 9 Enteritis and gastro-enteritis 7 5 German measles 4 2 Glandular fever — — Pyrexia unknown origin — — Hepatitis 1 1 Influenza 1 — Mumps 21 8 Shingles — — Tonsillitis 1 — 22 TABLE No. 6 Summary of Infectious Disease Notifications 1964. (Corrected) Age Groups Disease Under 1 1—2 2—3 3—4 4—5 5—10 10—15 15—25 25—45 45—«5 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 - - - - - - - - - 2 - - - - - 1 - - - - - 4 4 Encephalitis - - - - - - - - - - - - - - - - -- - - - - - - - - Enteric Fever - - - - - - - - - - - - - - -- - - - - - - - - - - Erysipelas - - - - - - - - - - - - - - - - - - - 1 - 1 - 2 2 Food Poisoning - - - - - - - - - - - - - - - - - - - - - - - - - Malaria - - - - - - - - - - - - - - - - - - - - - - - - - Measles 1 - 4 1 3 2 2 2 6 2 7 2 1 - - - - - - - - - 24 9 33 Meningococcal Infection - - - - - - - - - - - - - - - - - - - - - - - - - Ophthalmia Neonatorum - - - - - - - - - - - - - - - - - - - - - - - - - Pneumonia - - - - - - - - - - - - - - - - - - 1 - - 1 1 1 2 Poliomyelitis - - - - - - - - - - - - - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - - - - - - - - - - - - - - - - - - - Scabies - - - - - - - - - - - - - - - - 1 - - 1 - - 1 1 2 Scarlet Fever - 1 - - - - - - - - 1 1 - - - - - - - - - - 1 2 3 Tuberculosis (Pulmonary) - - - - - - - - - - - - 1 - 1 3 1 1 5 - 2 — 10 4 14 Tuberculosis (NonPulmonary) - - - - - - - - - - - - - - - - - - - 1 - - - 1 1 Whooping Cough - - 1 - - - - - - - - - - - - - - - - - - - 1 - 1 Totals 1 2 5 1 3 2 2 2 6 2 8 5 2 - 1 I 31 2 2 6 3 2 2 38 24 62 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.1, and by the Public Health Laboratory Service at County Hall. During the year 49 specimens were submitted for examination with the following results:— Disease Positive Negative Total Diphtheria (Nasal and throat swabs) — 6 6 Dysentery (Faecal swabs) — 21 21 Food Poisoning (Faecal swaps) — 16 16 Typhoid (Faecal swabs) — 5 5 Other pathogenic organisms — 1 1 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. One certificate was issued during the year to a person working in the catering industry, who had been a contact of a typhoid carrier. 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 713 certificates of persons travelling abroad were authenticated by the Department. Of these 542 were in respect of smallpox, 127 for cholera, 36 for typhoid, 8 for yellow fever. 24 25 TABLE No. 7 Comparative Figures of Infectious Disease for the last 30 years Disease 1935 1936 1937 1938 i 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 1964 (Population) 35,400 34,850 34,600 34,350 30,660 23,470 17,160 16,580 17,240 18,020 18,680 21,190 | 23,46* 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 20,430 Diphtheria (including Membranous Croup) 93 60 76 49 19 7 14 17 17 5 11 12 3 2 1 2 - - - - - - - 1 2 - - - - - Dysentery 6 6 10 10 — — — — 2 13 2 6 — 4 — 2 34 9 8 34 4 7 16 30 28 41 2 7 7 4 Encephalitis Lethargica 1 - - - 2 - - - - - 1 - - - - - - - 1 - - - - - - - 1 1 — Enteric Fever 2 2 — — 1 1 3 1 6 1 — 1 1 1 — 1 — 2 1 2 — — 4 — — — — — 1 — Erysipelas 18 19 10 15 13 12 3 7 3 8 3 4 8 6 5 3 1 2 1 1 1 — — 1 2 — 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 3 2 3 — 1 - - - 1 - - - - - - 1 1 — 1 1 — — — 1 — — — 1 — — Measles Notifiable as from 9th Se ptemb er, 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 33 Meningococcal Infection 1 2 1 1 3 7 7 1 1 — 1 2 2 - - - - - 2 1 2 2 1 — 4 1 — 1 3 — Ophthalmia Neonatorum 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) 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 2 Polio-encephalitis Acute - - - - - - - - - - - 1 1 - - - - - - - - - - - - - - - - - Poliomyelitis Acute - - - - - - - - - - 1 — 5 1 2 2 — 6 17 3 12 6 11 4 2 2 1 2 — — Puerperal Fever 4 2 4 — — — 1 2 2 2 2 — 1 1 * * * * * * * * * * * * * * * * Puerperal Pyrexia 4 3 2 2 3 3 2 7 3 1 4 5 5 2 4 2 3 1 - - - - - - - - - - - - Scabies Notifiable as from 1st Au gust, 1 943. 54 99 125 106 43 16 4 3 4 3 6 1 5 5 1 3 2 5 1 5 3 2 Scarlet Fever 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 3 Smallpox - - - - - - - - - - - - - - - - - - - - - - - - - - - - Tuberculosis Pulmonary 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 14 Tuberculosis, Non-Pulmonary 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 1 Whooping Cough 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 1 379 365 322 296 278 161 194 242 456 280 364 392 348 268 269 311 406 261 366 133 258 157 184 148 243 128 170 62 193 62 *Ceased to be notifiable as from 30th July, 1948. 26 SECTION 4. Sanitary Circumstances. Visits made by the Public Health Inspectors during 1964. Public Health (London) Act, 1936 Number of Inspections Dwelling Houses 327 Houses Let in Lodgings 91 Common Lodging Houses 1 Offices 22 Rag and Bone Shops 6 Drainage Work and Testing 3,165 Noise Nuisance Visits 151 Other Inspections 824 Re-inspections of above 1,385 Housing Act, 1961 Number of Inspections Houses 258 Underground Rooms 28 Overcrowding Visits 26 Re-inspections of above 16 Factories Acts, 1961 Number of Inspections Power Factories 82 Re-inspections of above 17 Non-Power Factories 5 Re-inspections of above 1 Outworkers' Rooms 5 Re-inspections of above — Electrical Stations and Sites of Building Operations 90 Outworkers' Registers 3 Food and Drugs Act, 1955 Number of Inspections Dairies and Milk Shops 3 Ice Cream manufacture — Ice Cream sale and storage 17 Restaurants and Kitchens 813 Bakehouses 23 Butchers' Shops 69 Fish Shops 19 Fried Fish Shops 3 Other Food Shops 266 Market Streets 65 Licensed Premises 115 Sampling 227 Unsound Food 90 Re-inspections of above 89 27  Number of Inspections Clean Air Act, 1956 Smoke Observations 282 Inspections 5 Re-inspections of above 1 Visits 279 Smoke Control Area Visits 64 „ „ „ Inspections 170 „ „ „ Re-inspections 9 „ — No Entry 56 Offices, Shops, Railway Premises Act, 1963 Inspections 920 Re-inspections 334 Miscellaneous Inspections Merchandise Marks Acts 1 Pharmacy and Poisons Acts 1 Prevention of Damage by Pests Act, 1949 117 Shops Act, 1950 10 Hairdressers and Barbers 100 Other Inspections 32 Re-inspections of above 6 Visits, etc., re Infectious Disease 88 Aged and Infirm Persons 18 Verminous Persons 4 No Entry 405 Other Visits 849 Total 12,055 Notices Served Public Health (London) Act, 1936 Intimation Notices 138 Dwelling Houses 123 Houses Let in Lodgings 9 Shops 4 Others 2 Statutory Notices 30 Dwelling Houses 27 Houses Let in Lodgings 1 Sites 2 Factories Act, 1961 8 Power Factory 8 Clean Air Act, 1956 4 Adaptation of Fireplaces 2 Sites 2 Housing Acts, 1957-1961 12 Dwelling House 1 Houses let in Lodgings 11 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 6 Cisterns, cleansed, repaired or renewed — Service pipes repaired 2 Waterclosets Compartments cleansed and/or repaired 51 Water supplied, flushing cistern repaired 16 New W.C. pan provided 8 Ventilation improved or provided 1 Additional accommodation provided — Urinals cleansed and/or repaired — Unstopped — Drainage Soil pipes, repaired, renewed or ventilated 4 Rainwater pipes, repaired or renewed 1 Drains unstopped or cleansed 2 Drains repaired or relaid 1 New manhole covers provided 1 Sinks Defective sinks renewed 2 Waste pipes repaired, renewed or unstopped 7 Yards, Areas and Washhouses Cleansed 1 Drained or drains unstopped 1 Paved or paving repaired 2 Houses and Workshops, etc. Rooms cleansed or repaired 56 Passages and staircases cleansed or repaired 10 Ventilation improved 12 Dampness Roofs repaired 1 Gutters repaired — Other works to prevent dampness 27 Ashbins Provided, repaired, etc. 1 Various Accumulations of refuse removed 7 Improper keeping of animals remedied — Noise nuisance abated 1 Dust nuisance abated 1 Emission of black smoke abated — 29 Complaints During the year 468 complaints were received in respect of the following nuisances:— Artificial lighting, absence of, on common staircase 1 Aged and infirm persons — Animals improperly kept 6 Dampness 19 Dilapidations and disrepair 14 Drains, choked or defective 10 Dust 8 Dustbin accommodation inadequate or unsuitable 7 Food premises, unsatisfactory conditions in 24 Floors defective — Noise 39 Overcrowding 5 Obnoxious smells 45 Refuse, accumulations of 16 Rodent infestation 127 Roofs, defective 3 Smoke 26 Unsound food 29 Vermin 46 Ventilation inadequate 2 W.C. accommodation inadequate, dirty or defective 24 Miscellaneous 15 Water supply, burst pipes — Water supply, inadequate — Water supply, impure 2 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 the bodies of two pigeons were found in the storage tank, and after removing them and cleaning the tank, the water was found to be satisfactory. Drainage During the year 3,165 inspections were made by the Public Health Inspectors in connection with drainage work; 114 applications for approval of proposed drainage work were submitted together with the necessary plans, and 115 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 1964, one notification was received concerning the proposed discharge of trade effluent. The 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 26 complaints were received regarding smoke emissions and 282 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 1964 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 0.75 3.4 9.66 9.39 19.05 6.85 February 0.39 3.7 11.20 11.50 22.70 5.65 March 2.88 3.6 13.79 12.86 26.65 5.94 April 2.92 3.6 8.35 7.79 16.14 4.26 May 2.56 3.8 12.08 6.51 18.59 2.92 June 2.88 3.6 5.40 3.53 8.93 2.18 July 1.42 5.7 7.65 4.76 12.41 2.50 August 1.26 5.8 7.85 3.79 11.64 1.76 September 0.35 6.1 8.69 5.03 13.72 2.88 October 1.14 3.8 11.68 3.82 15.50 5.24 November 1.14 3.5 9.39 7.65 17.04 7.18 December 1.22 3.5 9.80 9.23 19.03 3.66 Total 18.91 — 115.54 85.86 201.40 51.02 Monthly Average 1.58 4.2 9.63 7.15 16.78 4.25 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 6.12 5.94 12.06 February 7.09 7.27 14.36 March 8.73 8.14 16.87 April 5.28 4.93 10.21 May 7.65 4.12 11.77 June 3.42 2.23 5.65 July 4.84 3.01 7.85 August 4.97 2.40 7.37 September 5.50 3.18 8.68 October 7.39 2.42 9.81 November 5.94 4.84 10.78 December 6.20 5.84 12.04 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 1964:— 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 t Value January 245 577 74 230 481 113 February 231 422 104 214 389 101 March 117 364 43 135 251 63 April 124 333 65 96 330 52 May 61 117 32 62 111 27 June 67 146 42 63 120 36 July 64 98 42 62 93 36 August 66 125 30 64 121 35 September 73 139 25 67 140 38 October 153 341 36 151 291 51 November 172 436 47 Apparatus out of order December 221 709 71 224 686 57 32 Installation of New Furnaces In four 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. 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 twenty-eight applications for grant were approved in connection with the adaptation of fireplaces, the total cost of the work amounting to £1,545 16s. 1 Id. of which £463 15s. Id. was borne by the Council, £618 6s. 9d. by the Exchequer and £463 15s. Id. 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 1964, 32 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 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 1964. 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 Nil Parts of buildings closed by undertaking Nil Underground rooms made the subject of closing orders 2 Underground rooms closed by undertaking Nil Closing orders determined Nil No. of flats erected by the Council during the year 33 33 Note: The number of underground rooms which do not comply with the relevant Regulations, but which are occupied for human habitation, is 432. Houses Let in Lodgings Number in Borough 258 Inspections made 91 Overcrowding On the 1st January, 1964, 116 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 one case, overcrowding was abated during the year as follows:— Families rehoused by the Holborn Borough Council 1 Families rehoused by the London County Council Nil Accommodation found by other means Nil During the year 26 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, 1964 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 5,996 7,237 13,248 II. Number of properties inspected (a) 7 49 — 71 127 as a result (a) of notification (b) (b) - survey, or (c) otherwise (c) 2 43 — 23 68 III. Total inspections carried out including re-inspections 14 289 163 466 IV. Number of properties (under II) found to be infested by:— (a) Rats {Major* - - - - - {Minor† 11 11 22 {Major* - - - 5 5 (b) Mice {Minor† 5 17 — 34 56 V. Number of infested properties (under IV) treated by the Local Authority 6 31 48 85 VI. Total treatments carried out —including re-treatments 36 207 227 470 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" contro 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 1964, 106 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 94 Dwelling houses inspected 92 Local authority premises inspected 9 Business premises treated 48 Dwelling houses treated 31 Local authority premises treated 6 Business premises, inspection visits 163 Business premises, treatment visits 227 Dwelling houses, inspection visits 289 Dwelling houses, treatment visits 207 Local authority, inspection visits 14 Local authority, treatment visits 36 Total visits 936 Estimated kill (rattus norvegicus) 130 Bodies recovered (rattus norvegicus) 49 Estimated kill (rattus rattus) 2 Bodies recovered (rattus rattus) — Estimated kill (mice) 521 Bodies recovered (mice) 154 Baiting of Sewers During the year a fourth treatment of the sewers, by direct poisoning using fluoracetamide (1081) was commenced. Disinfecting Station The arrangement whereby Holborn undertook 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 4 Number of rooms disinfected after other infectious diseases 29 Total number of rooms disinfected after infectious disease 33 Number of articles of bedding and clothing disinfected after tuberculosis 51 Number of articles of bedding and clothing disinfected after other infectious diseases 711 Total number of articles disinfected after infectious disease 762 Number of articles disinfected for export 27,000 Number of books disinfected after infectious disease 130 36 Disinfestation Number of rooms disinfested of vermin 88 Number of articles of bedding and clothing disinfested of vermin 1,221 Summary of 1,983 articles of bedding and clothing dealt with during the year:— Mattresses 98 Pillows 155 Pillow Cases 116 Bolsters — Bolster Cases — Blankets 275 Sheets 184 Household 914 Clothing 154 Other Bedding 87 Cleansing Number of persons treated for scabies 15 Number of persons treated for head lice — Number of persons treated for body lice 37 Number of persons treated for crab lice 24 Number of persons cleansed 308 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. During the year it was necessary to take action under the above provisions in the case of two elderly sisters. One, of rather low intelligence, was looked after by the other, and when the latter fell ill their condition deteriorated to the extent that it became necessary to have them both removed to hospital. 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 fifteen cases were dealt with, at a total cost of £216 7s. 6d. The total amount recovered during the year in respect of burials was £192 18s. 9d. The cases had come to the notice of the Public Health Department from the following sources:— Coroner's Officer 6 Friends or Relatives of Deceased 3 French Hospital 6 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 1964 are as follows:— Number of visits to:— Factories with mechanical power 99 Factories without mechanical power 6 Outworkers' registers 3 Outworkers' rooms 5 Electrical stations and sites of building operations 90 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 160 6 - - (II) Factories not included in (i) in which Section 7 is enforced by the Local Authority 614 99 8 - (iii) Other Premises In which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 30 90 — — Total 804 195 8 - 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) - - - - - Overcrowding (S.2) — — — — — Unreasonable Temperature (S.3) — — — — — Inadequate Ventilation (S.4) 1 — 1 — — Ineffective Drainage of Floors (S.6) — — — — — Sanitary Conveniences (S.7)— (a) Insufficient — — — — — (b) Unsuitable or Defective 41 35 3 4 — (c) Not separate for Sexes 1 1 — — — Other offences against the Act (not including offences relating to Outwork) 11 - 7 1 — Total 54 36 11 5 — Part Vffl 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 ot 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 192 — — — — — Cleaning and Washing 1 — — — — — Household Linen 4 — — — — — Curtains and Furniture Hangings 3 _ _ _ _ - Artificial Flowers 6 — — — — Boxes etc 4 — Cosaques, Christmas Crackers, Christmas Stockings, etc 56 _ — Total 266 — - — — — 40 Firms in the Borough employing outworkers 19 No. of outworkers on lists submitted 266 No. of outworkers referred to other Boroughs 260 No. of outworkers in Holborn employed by Holborn firms 6 No. of outworkers in Holborn employed by firms outside the Borough 20 Total number of outworkers in Holborn 26 Inspection of outworkers' premises 3 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 1964:— Dairies and milk shops 3 Ice cream, sale or storage 17 Ice cream manufacture - Restaurants and kitchens 813 Bakehouses 23 Butchers' shops 69 Fish shops 19 Fried fish shops 3 Other food shops 266 Market streets 65 Licensed premises 115 Sampling 227 Unsound food 90 Re-inspections 89 Food and Drugs Act, 1955 Notices During 1964, no notices were served on owners or occupiers of food premises. 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" 42 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 1964 Nil Dairies removed from register during 1964 Nil Dairies on register at end of 1964 Nil Distributors registered during 1964 3 Distributors removed from register during 1964 6 Distributors on register at end of 1964 48 Inspections made by Inspectors during 1964 3 Formal milk samples taken and submitted for analysis 18 Informal milk samples taken and submitted for analysis 120 The following tables show the monthly variation of the chemical composition of the 138 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 3.89 8.51 12.40 February 14 3.82 8.60 12.42 March 13 3.80 8.70 12.50 April 14 3.77 8.73 12.50 May 6 3.50 8.74 12.24 June 5 3.68 8.90 12.58 July 11 3.63 8.67 12.58 August 6 3.58 8.68 12.30 September 20 3.71 8.84 12.26 October 6 3.79 8.71 12.55 November 18 3.83 8.66 12.49 December 7 3.81 8.76 12.57 Whole year 134 3.73 8.71 12.44 Legal minimum — 3.00 8.50 11.50 43 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 1 4.60 8.88 13.48 March 2 4.68 9.07 13.75 April — — — — May — — — — June 1 4.38 9.21 13.59 July — — — — August — — — — September — — — — October — — — — November — — — — December — — — — Whole year 4 4.55 9.05 13.60 Legal minimum — 4.00 8.50 12.50 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) 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 1964 134 12.44 8.71 3.73 44 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 3 dealers licences were issued, details of which are as follows:— To sell Tuberculin Tested milk 2 To sell Pasteurised milk 3 To sell Sterilised milk 2 As from 1st October, 1964, the special designation "Tuberculin Tested" was replaced by "Untreated", and 13 premises were re-licensed for the new designation. Milk—Bacteriological Examination During the year, 88 samples of milk were submitted for bacteriological examination. 31 of these were from milk supplied to schools in the Borough and three to a Day Nursery 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, 1964, one set of premises was registered for the manufacture, storage and sale of ice cream, in Holborn, and 143 premises were registered for storage and sale. During the year one application was received and approved in respect of premises to be used for storage and sale of ice cream. At the end of the year, there was one registration for manufacture, storage and sale, and 144 premises were registered for storage and sale. 45 Ice Cream (Heat Treatment, Etc.) Regulations, 1959 During the year, 71 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 3 Grade 3 3 Grade 4 - Not graded owing to colouring 3 In addition a sample of ice lolly was submitted for bacteriological examination and was found to be satisfactory. In the case of samples falling within Grades 3 and 4, letters were sent to the vendors drawing their attention to the poor grading. In such cases where the ice cream was manufactured outside Holborn, details were also sent to the Medical Officers of Health of the areas concerned. Licensed Premises There are 72 public houses in the Borough, and during the year 115 inspections were carried out. In addition, 53 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. Food Sampling A total of 431 samples of food and drugs were purchased and submitted to the Borough Analyst for chemical analysis during the year. 27 were formal samples and 404 were informal. Article Number of Samples purchased Baking Powder 2 Batter Mix 1 Blancmange 1 Bread 2 Cereals 2 Cheese 6 46 Article Number of Samples purchased Coffee 3 Condiments 12 Cooking Fat, Oil, Dripping and Suet 8 Cream, fresh and tinned 3 Curry Mixture 3 Custard Powder 3 Drugs and Medical Preparations 36 Essences and Flavourings 15 Fish, fresh, tinned and preserved 7 Flour 3 Fruit, dried, tinned and fresh 16 Gravy Salt 2 Herbs and Spices 5 Jams and Preserves 4 Jellies 6 Macaroni 2 Margarine 4 Meat and Meat Preparations 38 Milk 138 Milk, Evaporated and Condensed 3 Olive Oil 1 Pearl Barley 2 Pickles 3 Puddings 1 Rennet 1 Rice 5 Sago 1 Sandwich Spread 3 Sauces 20 Soft Drinks and Cordials 16 Soups 6 Sugar 3 Sweets and Confectionery 13 Tea 2 Treacle 2 Vegetables, fresh, tinned and dried 17 Vitamin Tablets and Preparations 9 Yoghurt 1 431 47 Unsound Food During the year 1964, the undermentioned unsound food was surrendered and destroyed or disposed of otherwise:— Commodity Tons Cwts. Qtrs. Lbs. MILK Fresh — — — — Tinned — — — 8 FISH Fresh — 2 2 4 Tinned — — 1 — MEAT Fresh — 2 1 2 Tinned 3 14 2 15 FRUIT Fresh — — — — Tinned 2 9 1 22 VEGETABLES Fresh 1 19 2 — Tinned 5 18 3 17 OTHER FOOD 1 15 3 3 TOTAL 16 3 1 15 48 SECTION 7. Tuberculosis. The following table gives the number of new cases of tuberculosis notified, and deaths during 1964 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 1 — — — — — — — 15—20 years 1 — — — — 1 — — 20—25 years — 2 — — 1 — — — 25—35 years 1 2 — — 2 1 — — 35—45 years 2 — — 1 1 — — — 45—55 years 3 — — — — — — — 55—65 years — — — — 1 — — — 65—75 years 1 — — — — — — — 75 and over — — — — — — — — TOTAL 9 4 — 1 5* 2* — — •Only one of these persons died of tuberculosis. 49 Summary of Changes in Tuberculosis Register During 1964 Pulmonary Non-Pulmonary Total M. F. M. F. Cases on Register at 31st December, 1963 129 83 3 4 219 Cases Added Primary notifications 9 4 — 1 14 Transferred from other districts 5 2 — — 7 Restored to register — — — — — Totals 143 89 3 5 240 Cases Removed Moved to other district 23 6 — — 29 Recovered 7 4 — — 11 Died 3 1 — — 4 Lost trace of 13 6 — — 19 Others — 1 — — 1 Totals 46 18 — — 64 Cases on Register at 31st December, 1964 97 71 3 5 176 50 Tuberculosis Notifications and Deaths for the last 50 years Notifications Rate per 1,000 Population Deaths Rate per 1,000 Population 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 64 14 .68 1 .05 51 MEDICAL EXAMINATION OF STAFF Staff medical examinations were undertaken on the following occasions. (a) Entrants to the Established Staff. All persons appointed to the established staff were medically examined, unless they were already established local authority officers. In general, non-established staff were first examined as soon as it seems reasonably certain that they would remain in the Council's employ. They were examined again immediately prior to joining the establishment. (b) After sickness. Staff whose sick pay had expired were examined to evaluate the probability of their return to duty. A report was sent to the appropriate committee. (c) Age. Certain staff who wished to continue working after the normal age for retirement were examined to determine their fitness to do so. Motor drivers were 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 1964. No. of Examinations Results First examination 33 Fit for employment 43 Second examination 14 Decision deferred 7 By reason of age 3 A decision was deferred when further observation or investigation of an abnormality was desirable, or to enable the applicant to obtain treatment for a remediable defect. In addition 9 examinations were made of 8 persons who had had long periods of sickness. In all cases the general practitioner was consulted. As a result of these deliberations, two 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. Forty-six applications for exemption from parking meter charges were referred by the Borough Engineer for medical opinion, necessitating medical examinations in respect of 42 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 380 Number known to be active or members of Clubs 352 Visited by other organisations 162 Total number registered 894 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 2,083 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 44 Home Library Service 8 Home Help 50 Bathing 10 National Assistance 12 Holidays 72 Chiropody 66 Other Services— Incontinent Laundry Service 22 radio, meter lowering, clothing &c. 153 Printed by Thomasont Ltd., Cedar Prats, High Street, Hounslow, Middx.