Public Health Dept. REPORTS COLLECTION COPY KIN 24 ??? Royal Borough of Kingston-upon-Thames ANNUAL REPORT 1950 OF THE t Medical Officer of Health AND Chief Sanitary Inspector GUILDHALL, KINGSTON-UPON-THAMES SEPTEMBER 1951 Royal Boraugh of Kingston-upon-Thames ANNUAL REPORT 1950 OF THE Medical Officer of Health AND Chief Sanitary Inspector GUILDHALL. KINGSTON-UPON-THAMES SEPTEMBER 1951 ANNUAL REPORT 19 5 0 TABLE OF CONTENTS. Preface Page. Staff of Public Health Department 1 SECTION A. Statistics and Social Conditions. (1) General Statistics 2 (2) Social Conditions 2 (3) Extracts from Vital Statistics of the Year:- (a) Live Births 3 (b) Stillbirths 3 (c) Deaths - Total 3 (i) Death Rate - Total 3 (ii) Maternal Death Rate 3 (iii) Infant Death Rate - Quinquennial Infant Mortality Rate - Causes of death of children under one year of age 3,4 & 5 (iv) Other Deaths 5 Table I - Extracts from Vital Statistics for years 1946 - 1950 inclusive 6 Table II - Comparison of Vital Statistics 1921 - 1950 7 Table III - Birth Rates, Civilian Death Rates, and Case Rates for certain Infectious Diseases, in the year 1950 8 Table IV - Causes of Death 9 SECTION B. General Provisions of Health Services. (1) (i) Public Health Officers 10 (ii) Laboratory Facilities 10 (iii) Ambulance Facilities 10 (iv) Hospitals (a) Infectious Diseases 10 (b) Smallpox 11 (c) General 11 (2) National Assistance Act, 1948 11 SECTION C. Sanitary Circumstances. Introduction 12 (1) Water Supply 13 (2) Drainage and Sewerage 13 (3) Rivers and Streams 13 (4) Closet Accommodation 14 (5) Public Cleansing 14 (6) Sanitary Inspection of the Area 14 Page. (7) Shops and Offices 15 (8) Factories Act, 1937 15, 16. (9) Camping Sites 17 (10) Atmospheric Pollution and Smoke Abatement 17 Pictorial Graph showing Atmospheric Pollution 1950 18 Tabulated Statements of Deposit of Solids, Wind Direction and Rainfall 19, 20. (11) Swimming Baths and Pools 20 (12) Eradication of Bed Bugs 20 (13) Complaints 21 (14) Rodent and Insect Pest Control 21,22 & 23. SECTION D. Housing. General 23, 24 SECTION E. Inspection and Supervision of Food. (a) Milk Supply 25 (b) Designated Milks 25 (c) Bacteriological Examination of Milk 25 (d) Ice Cream - Bacteriological Examination 26 (e) Meat and Other Foods 26 Tabulated list of Condemned Foodstuffs 27, 28. (f) Food Hygiene 29 Food and Drugs Act, 1938 29 Tabulated Statement of Samples Submitted to the Public Analyst during 1950 30 SECTION F. Infectious Diseases. Notifiable Diseases 32 Table V - Notifiable Diseases during 1950 33 Table VI - Comparative Statement of Notifications of Certain Infectious Diseases 34 Scarlet Fever 34 Diphtheria 34 Table VII - Comparative Statement of Diphtheria Immunisation during the years 1948, 1949 & 1950 35 Poliomyelitis 36 Polioencephalitis 36 Enteric Fever (Typhoid and Paratyphoid) 36 Measles 36 Ophthalmia Neonatorum 36 Puerperal Pyrexia 36 Food Poisoning 37 Tuber culosis 37 Table VIII - Notified Cases, and deaths from Tuberculosis in 1950 38 Scabies 39 Infestation by Head Lice 40 PREFACE TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE ROYAL BOROUGH OF KINGSTON-UPON-THAMES. ANNUAL REPORT, 1950 Ur. Mayor, Ladies and Gentlemen, I have the honour to present the Annual Report for 1950. It follows the same pattern as that for 1949, and gives information on essential matters affecting the Public Health. Population - A new and slightly increased figure of 41,950 for 1950, as against 40,660 for 1949, was given by the Registrar General and has been used for the calculation of the vital statistics. This is the resident night population, and is but a small fraction of the large day population, estimated to be about three hundred thousand, which concentrates in the town for business, education, entertainment, and recreation,. Infectious Diseases - In general the health of the people has been good. There was a substantial drop in the number of infectious diseases notified during the year, due to a much reduced figure for measles. Reduction in the number of cases of scarlet fever and of poliomyelitis is also recorded. Once again, for the third year in succession, no cases of diphtheria were notified, and further progress was made in the active immunisation and protection of the child population against this deadly and disabling disease. Vaccination against Smallpox - is voluntary and a calculation shows that in 1950 some 62% of the children born between 1st. July 1949, and 30th. June 1950, have been vaccinated. Last year this figure was 51% and the increase is partly due to a larger number of vaccinations by general medical practitioners. Births - The number of live births for 1950 is 619, and compares with 729 for 1949. The Birth Rate is 14.76 per 1,000 of the population, compared with 17.96 for 1949° Deaths - The number of deaths recorded in 1950 is 491, compared with 5.00 for 1949. This makes a Death Rate of 11.73 for 1950, compared with 12.32 for 1949. The excess of births over deaths was 128 compared with 229 for the previous year. The number of deaths of infants under 1 year of age in 1950 is 19, which gives an Infant Mortality Rate, per 1,000 live births, of 30.69, compared with 15 infant deaths, and a Rate of 20.31 for 1949, The Causes of Death - The main conditions causing death as recorded in the Table for 1950, are Heart Disease - 136; Cancer - 78; and Vascular Lesions of the Nervous System - 65. Housing - The strong demand for housing accommodation continues, and nearly all the points mentioned in recent reports hold good, with equal emphasis, today. During the year the Corporation built 168 new flats and 56 houses, outside the Borough for Kingston people, and private enterprise contributed some 20 new homes; in addition six private building licences were transferred to enable qualified applicants to build their own houses in other districts. A need exists for dwellings specially suited for elderly persons, where they could more easily maintain their separate existence so long as health and strength remain to them. I acknowledge the continued help received in my work from my colleagues in all departments, and particularly the untiring efforts of the staff of the Public Health Department. I respectfully acknowledge the continued support and encouragement of the Chairman and Members of the Public Health Committee and the Worshipful the Mayor, Members and Aldermen of the Council. I have the honour to be, Your obedient Servant, J. V. SIARKEY. Medical Officer of Health. September, 1951. 1 1950 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Healths J. W. STARKEY, M.B., Ch.B. (Edin.) D.P.H. Chief Sanitary Inspectors H.T. PERRY, O.B.E., F.S.I.A. (a) (b) Administrative Officers ø F.D. HARVEY, M.R. San. I„ (a) (b) Additional Sanitary Inspectorss A, CLEGG-, MoRo San. I. (a) (b) J.B. FACER, A.R. San. I. (a) (b) N.L.G. TUBB, M.R. San. I. (a) (b) * W.H. DUNSTAN, M.R, San. I. (a) (b) * (Appointed 1.5.50) Junior Sanitary Inspectors (vacancy) Assistant Rodent Officer; F.W. STAGS Clerical Staff as at 31st. December, 1950: M.E. POWELL, DcP.A. MISS C.L. FOISTER ø MISS V.E. NEELD MRS. B.M. HILL MISS J.A. DILLIWAY A.R. ASTON (Called for National Service 9.3.50) L.A. PALMER G. NORTHWOOD (Appointed 16.1.50) C. HART (Appointed 13.3.50 - Temporary Vice A.R. Aston, H.M.F.) (a) Certificate as Sanitary Inspector, (b) Certificate at Meat and Foods Inspector. ø Subject to a sharing arrangement with Surrey County Council. SECTION A. STATISTICS AND SOCIAL CONDITIONS. 1. General Statistics. Area in Acres 1,390 Total Population (including Service personnel) 41,950 Number of inhabited houses (approx.) 11,430 Rateable Value - General Rate £557,537 Sum represented by Penny Rate £ 2,267 2. Social Conditions, Mr.P.RoSmithy the Manager of the local Employment Exchange has kindly provided the following information regarding employment in Kingston and the surrounding districts. "Unemployment, even allowing for its seasonal variations, did not at any time during the year exceed 1% of the estimated insured population; it was at its height in January and its lowest in July for both men and women. There were approximately 150 registered disabled persons on the Unemployed Registers throughout the year and the little long term unemployment which existed affected these and those fit, but elderly, workers who together formed the hardcore of unemployment. Some 200 workpeople were unemployed during October as a direct result of the dispute in the Printing Trade., There was no change in the industries in the area during 1950, except that towards the end of the year there were signs of expansion in the aircraft industry. There was a very large and constant demand for skilled engineers' machinists which it was impossible to meet. There was difficulty too in meeting the constant demand for women for laundries and factories. Some firms were arranging part-time evening shifts 6 p.m. to 10 p.m. for women who were unable to leave their homes during the day. We are indebted to the Manager of the Local Employment Exchange for this encouraging information, and for the fact that the people of Kingston are spared the anxiety of unemployment. Housing accommodation has been greatly enhanced by the building of several blocks of flats, both within the Borough and nearby. 3 3. Extracts from Vital Statistics of the Year. (a) Live Births - Total Male Female Legitimate. 279 299 Illegitimate 41 19 22 619 228 321 Birth Rate (Registrar General) per 1,000 population 14.76 (b) Still Births - Total Male Female Legitimate. 4 5 Illegitimate 2 1 1 11 6 Rate per 1,000 total (live and still) births 17.46 (c) Deaths - Total Male Female 491 215 276 (i) Death Rate (Registrar General) per 1,000 pop. 11.73 (ii) Maternal Death Rate (deaths caused by Pregnancy, Childbirth, Abortion). No. of Deaths Rate per 1.000 total (live and still) births 4 6.35 (iii) Infant Death Rate (deaths of all infants under one year of age) Total No. of Deaths Rate per 1.000 live births 19 30.69 Legitimate Infants No., of Deaths Rate per 1.000 legitimate live births 17 29.41 Illegitimate Infants No. of Deaths Rate per 1,000 illegitimate live births 2 48.78 All infants under 4 weeks of ace (included in above) Total No. of Deaths Rate per 1,000 live births 13 21.00 Legitimate Infants No. of Deaths Rate per 1,000 legitimate live births. 12 20.76 Illegitimate Infants No. of Deaths Rate per 1.000 illegitimate live births 1 24.39 4 The approximate infant mortality rate for 1950 and the rates since 1945 are shown for purposes of comparison. 1945 1946 1947 1948 1949 1950 Kingston-uponThames 43 29 22 23 20 30 England & Wales 46 43 41 34 32 30 London Area 53 41 37 31 29 26 It will he seen, from the following figures, that since the war ended, the Quinquennial Infant Mortality Rate has been more than halved. Period Infant Mortality Rate. 1921 - 1925 69 1926 - 1930 56 1931 - 1935 56 1936 - 1940 46 1941 - 1945 52 1946 - 1950 25 The following are the numbers of Kingston Children who died during 1950 in the Borough before reaching the age of one year, together with the cause of death and ages- Age Total Deaths Hypostatic pneumonia spina bifida An63SGephaly - prematurity Gonp^nital atelectasis Gastro Enteritis Erythroblastosis Foetalis Prematurity iSubdural haemorrhage birth injury Infective hepatitis Asphyxia by overlaying Bronch Pneumonia Broncho Pneumonia,Myelocele Asphyxia by inhalation of stomach contents Asphyxia by inhalation of vomit at operation Superior Longitudinal sinus thrombosis, It.lateral sinus thrombosis, otitis media, broncho pneumonia 0-24 hours 4 - 1 1 - - 2 – - – – - - - - 24hrs. -lmth. 9 1 - - 1 1 3 1 _ - - 1 1 - - 1mth.1 year 6 - - - - - — _ 1 1 1 - 1 1 1 Totals 19 1 1 1 1 1 5 1 1 1 1 1 2 1 1 5 The infant deaths, numbering 19, are regretfullyhigher than previous years, and contain some which must be classified as preventable,, Considering them in three groups, four deaths occurred in the first group 0-24 hours, all of which were from conditions which could not be classified as preventableo With regard to the second group 24 hours to 1 month, nine deaths took place, most of them in the first week of life in spite of due care. Of the six deaths in the third group, one month to one year, in three cases no indication is offered that they might have been prevented, but in the remaining three in that group, namely "Asphyxia due to overlaying" at the age of 2 months: "Asphyxia due to the inhalation of stomach contents" at home at the age of 4 months: (both of which were recorded as accidental deaths), and the third one "Broncho Pneumonia" at the age of ten months: all leave a strong impression that they might have been preventable. The result of this large number of deaths of children under 12 months, during 1950, and the considerable drop in the number of births in the same period (i.e. from 729 births in 1949 to 619 in 1950) is that the infant mortality rate is artificially high at 30.69, when compared with 15 deaths and a rate of 20.58 for 1949. (iv) Other Deaths. No. of Deaths Deaths from Cancer (all ages) 78 Deaths from Measles (all ages) — Deaths from Whooping Cough (all ages) – Deaths from Gastritis, Enteritis, and Diarrhoea (under 2 years). 1 The following tables (I) (II) (III) (IV) summarise certain vital statistics. The figures in Table (II) are the Registrar General's estimates. The causes of deaths shown in Table (IV) are now in accordance with the 36 headings based on the Abbreviated List of the International Statistical Classification of Diseases, Injuries and Causes of Death. These differ from the headings used in previous years, and, in order to provide comparative figures the causes of death used for 1946, 1947, 1948, and 1949, have been converted, as far as possible, to the new classifications,. Extracts from Vital Statistics for Years 1946 - 1950 inclusive. TABLE I LIVE BIRTHS. 1946 1947 1948 1949 1950 Total M. F. Total M. F. Total M. F. Total M. F. Total M. F. Legitimate 738 367 371 838 432 406 677 345 332 679 344 335 578 279 299 Illegitimate 56 14 22 32 20 12 45 21 24 50 23 27 41 19 22 794 401 393 870 452 418 722 366 356 729 367 362 619 298 321 Birth Rate (R.G) per l000 pop. 20.02 21.33 17.73 17.96 14.76 STILL BIRTHS. Legitimate 24 13 11 14 6 8 16 7 9 8 5 3 9 4 5 Illegitimate 5 2 3 1 – 1 – – — 2 2 2 1 1 29 15 14 15 6 9 16 7 9 10 5 5 11 5 6 Rate per 1000 (live and still births) 35.24 16.95 21.62 13.53 17.46 DEATHS 460 236 224 495 228 267 455 227 228 500 250 250 491 215 276 Death rate (R.G) Per 1,000 pop. 11.60 12.13 11.17 12.32 11.73 7 TABLE II Comparison of Vital Statistics 1921 - 1950. Year Estimated Population Live Births Birth Rate per 1,000 population Deaths Death rate per 1,000 population Infantile Mortality Rate per 1,000 Live Births Kingston upon Thames England and Vales London Area 1921 39520 799 20.2 457 11.5 60 83 80 1922 39940 698 17.5 515 12.9 61 77 74 1923 40320 706 17.5 416 10.3 73 69 60 1924 40430 642 15.9 502 12.5 76 75 69 1925 40220 599 14.9 454 11.1 73 75 67 1926 39479 619 15.5 466 11.7 74 70 64 1927 39330 517 13.1 486 12.4 37 69 59 1928 39330 560 14.2 475 12.1 69 65 67 1929 38760 556 14.3 517 13.4 56 74 70 1930 38760 553 14.3 423 11.0 43 60 59 1931 39052 489 12.6 493 12.8 57 66 65 1932 38250 450 11.8 480 12.5 60 65 66 1933 38690 470 12.2 464 12.0 59 64 59 1934 38270 470 12.3 422 11.0 45 59 67 1935 39030 510 13.0 482 12.3 57 57 58 1936 39880 573 14.4 502 12.6 52 59 66 1937 39850 539 13.5 540 13.6 52 58 60 1938 39790 528 13.2 468 11.8 43 53 57 1939 39970 533 13.3 450 11.4 28 50 48 1940 37430 519 13.9 659 17.6 55 55 50 1941 3597Q 520 14.5 525 14.6 57 59 68 1942 36090 551 15.3 491 13.6 63 49 60 1943 35900 637 17.8 500 13.9 48 49 58 1944 34780 578 1606 474 13.6 48 46 61 1945 35760 593 1606 505 14.1 43 46 53 1946 39670 794 20.0 460 11.6 29 43 41 1947 40780 870 21.3 495 12.1 22 41 37 1948 40780 722 17.7 455 11.2 23 34 31 1949 40660 729 17.9 500 12.3 20 32 29 1950 41950 619 14.8 492 11.7 30 30 26 8 TABLE III Birth-rates, Death rates, and Case-rates for certain infectious diseases, in the Year, 1950, Provisional figures based on Quarterly Returns. England and Wales 126 C.Bs. and Great Towns including London 148 Smaller towns Resident Pop.25,000 -50,000 at 1931 Census London Adm. County Kingston upon Thames. Births Rates per 1,000 Home population. Live Births 15«8 17.6 16.7 17.8 14.8 Still Births 0.37 0.45 0.38 0.36 0.26 Deaths All Causes 11.6 12.3 11.6 11.8 11.7 Typhoid and paratyphoid 0.00 OoOO 0.00 0.00 0.00 Whooping Cough 0.01 0.01 0.01 0.01 0. 00 Diphtheria 0. 00 0.00 0. 00 0.00 0.00 Tuberculosis 0*36 0.2+2 0.33 0.39 0.29 Influenza 0.10 0.09 0.10 O.07 0.09 Smallpox - - - - - Acute Poliomyelitis (including polioencephalitis) 0.02 0.02 0.02 0.01 0. 00 Pneumonia 0.46 0.49 0.45 0.48 0.50 Notifications. (Corrected) Typhoid Fever 0. 00 0.00 0.00 0.01 0.00 Paratyphoid fever 0.01 0.01 0. 01 0.01 0. 00 Meningococcal infection 0.03 0.03 0.02 0.03 0. 00 Scarlet fever 1.50 1.56 1.61 1.23 1.26 Whooping Cough 3-60 3.97 3.15 3.21 0.97 Diphtheria 0.02 0.03 0.02 0.03 0.00 Erysipelas 0.17 0.19 0.16 0.17 0.07 Smallpox 0.00 O.00 - - Measles 8.39 8.76 8.36 6.57 3.15 Pneumonia 0.70 0.77 0.61 0.50 0.38 Acute poliomyelitis (including polioencephalitis) Paralytic 0.13 0.12 0.11 0.08 0.05 Non-paralytic 0.05 0.05 0.06 0.05 0.05 Food poisoning 0.17 0.16 0.14 0.25 0.02 Deaths. Rates per 1,000 Live Births All causes under 1 year of age Enteritis and diarrhoea under 2 29.8(a) 33.8 29.4 26.3 30.69 years of age 1.9 2.2 1.6 1.0 lt6 Notifications Rates per ls000 Total (Live and Still Births) (Corrected) Puerperal fever and Pyrexia 5.81 7.43 4.33 6.03 12.69 (A) Per 1,000 related live births. 9 TABLE IV Causes of Death Registrar General's Tables 1946 1947 1948 1949 1950 M F M F M F M F M F All Causes 236 224 228 267 227 228 250 250 215 276 Tuberculosis, respiratory 6 4 10 7 13 9 4 6 7 5 Tuberculosis, other 3 3 1 1 1 1 — — — Syphilitic diseases 3 1 4 4 2 2 5 2 2 - Diphtheria — — — — — — — — — — Whooping Cough — — _ - — - — — — — Meningococcal infections 1 1 - — — — 1 — — — Acute Poliomyelitis — — — — 1 1 2 — — Measles — — — — — 1 — _ — Other infective and parasitic diseases - - - - - - - - 1 1 Malignant neoplasm, 4 7 5 8 10 8 10 5 8 5 Malignant neoplasm, lung, bronchus - - - - - - - - 8 3 Malignant neoplasm, uteris - - - - - - - - - 7 Malignant neoplasm,breast - 8 — 13 — 7 -0 13 — 10 Other malignant and lymphatic neoplasms - - - - - - - - 20 17 Leukaemia, aleukaemia - - - - - - - - 2 Diabetes 3 1 - 1 1 - — 2 2 1 Vascular lesions of nervous system 24 31 30 26 19 25 18 29 18 47 Coronary disease, angina Hypertension with heart 31 23 65 6 4 71 84 60 75 66 81 8 12 Other heart disease 21 41 Other circulatory disease Influenza 9 18 15 21 7 11 11 20 14 18 4 Pneumonia 16 9 10 12 11 8 12 16 10 11 Bronchitis. 14 8 13 14 10 5 23 10 11 11 Other diseases of ratory system 2 1 3 2 6 4 5 3 3 Ulcer of stomach and duodenum 8 2 2 1 5 2 4 1 4 2 Gastritis, enteritis, and diarrhoea - 2 1 2 - - 1 - - 1 Nephritis and nephrosis 1 6 1 4 3 1 4 3 3 Hyperplasia of prostate 7 Pregnancy, childbirth, abortion 2 __ 1 1 4 Congenital malformations 8 2 1 8 4 3 6 4 3 2 Other defined and illdefined diseases - - - - - - - - 22 31 Motor vehicle accidents All other accidents 2 1 1 6 1 1 2 4 6 1 8 1 4 2 5 1 5 12 Suicide 4 2 4 - 5 5 ? 3 5 3 Homicide and operations of war - - - - - - - 1 - * Separate figures not available for years 1946 - 1949 inclusive owing to different classifications in use during those years. 10 SECTION B General Provisions of Health Services 1. (i) Public Health Officers The staff of the Public Health Department is as shown in the preface to the report. Changes of staff during the year have been recorded in the preface. (ii) Laboratory Facilities. During 1950 bacteriological examinations were carried out by Dr. D.S. Murray at the Laboratory, 37 Coombe Road, as part of a pathological service administered by the South Western Metropolitan Regional Hospital Board. In addition, the Ministry of Health Laboratory at Epsom is available for consultations and, if an occasion should arise, for the investigation of any important outbreaks of disease. The presence of the laboratory in Kingston Hospital is of great value in helping to identify and control outbreaks of infection when they occur. This service, throughout the year is gratefully acknowledged. Bacteriological examinations of milk are also undertaken by the Ministry of Health Laboratory, Epsom, and samples under the Pood and Drugs Acts are submitted to the Public Analyst. (iii) Ambulance Facilities. Ambulance facilities are now provided by Surrey Ambulance Service. (iv) Hospitals (a) Infectious Diseases. The South Western Metropolitan Regional Hospital Board is responsible for the provision of beds for cases of infectious disease. Such patients are admitted directly to Tolworth Isolation Hospital whenever possible, which is under the direction of the Medical Superintendent of Kingston Hospital. On occasions, when beds are not available, admittance is arranged with the South Middlesex Hospital, and in the event of beds not being available there, the removal is put into the hands of the South Western Branch of the Emergency Bed Service which operates in conjunction with the Local Authorities and Hospital Boards. During the year 44 infectious disease c»ses were sent to hospital for treatment, or diagnosis, as follows To Tolworth Isolation Hospital 27 South Middlesex Hospital 7 Grove Hospital, Tooting 2 Kingston Hospital 7 Wandle Valley Hospital 1 11 (b) Smallpox. Arrangements were in existence for some years whereby the first cases of smallpox could be admitted to the special Smallpox Hospital at Clandon, Surrey These arrangements have now been superseded by a Regional Hospital Board provision for first cases to be admitted to Joyce Green Hospital, Dartford, Kent, after consultation with a named smallpox consultant. No cases occurred in the Borough during the year. (c) General. The main General Hospital situated in the Borough available for the district is the Kingston Hospital, Wolverton Avenue, Kingston-upon-Thames (telephone KINgston 5692). 2„ National Assistance Act, l948. Under Section 47 of this Act, a Local Authority is empowered to apply to a Court of Summary Jurisdiction, to have removed to a suitable premises, persons in need of care and attention. It was not necessary for your Medical Officer to issue a certificate to the effect that any person in the Borough should be so removed. The number of geriatric cases referred to the Medical Officer was considerably smaller than last year, and suitable action was taken in each® 12 ANNUAL REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1950. To the Mayor, Aldermen and Councillors, of the Royal Borough of Kingston-upon-Thames. Mr. Mayor, Ladies and Gentlemen, I have the honour to present for your consideration the Annual Report on the work of your sanitary inspectors for the year 1950 It is the thirty-second such Report I have been privileged to submit to your Corporation,, It is very brief in character and does little more than outline facts. The Report is divided into three parts - Sanitary Circumstances; Housing Inspection and Supervision of Pood. In the first part of the Report particular mention is made of Atmospheric Pollution and Rodent and Insect Pest Control. A special report upon Atmospheric Pollution was submitted to your Corporation in November, 1950. This report covered the period from June 1949 to June 1950 at which latter date two further standard deposit gauges were installed in the borough. The report was comprehensive in character^ but in order to avoid unnecessary repetition, it has not been included in this annual statement. Data which will be provided by observations to be made during the next few years will prove valuable, but at this stage conclusions cannot be formed with any close accuracy. The need for a complete housing survey and the subsequent demolition of worn-out cottages,, with the construction of new units as collateral activity is referred to in the Housing Section. A tour of urbanised rural areas in proximity to large towns, and of other parts of this country, reveals the rapid increase in the number of caravan dwellings. Kingston, however, has no available camping sites for large groups of caravans, otherwise the position would be different. There are a few caravans stationed in the town9 but these temporary homes are not a satisfactory substitute for permanent housing units. In the third section the supervision of the food supply is briefly reviewed and attention is directed to the small quantity of food condemned as the result of disease compared with the amount which is rendered unfit for consumption by reason of spoilage or decomposition - much of which is avoidable. I trust this Report will prove of interest to your Corporation and others who may read it. Yours faithfully, HAROLD T. PERRY. Chief Sanitary Inspector. Guildhall, Kingston-upon-Thames. Septembe r, 1951- 13 SANITARY CIRCUMSTANCES. Section C. io WATER SUPPLY. The Metropolitan Water Board is responsible for the supply of water in the Borough. The service provided by the Board is excellent in all respects, and during 1950 no action was necessary on the part of the Corporation. The Board exercises day-by-day routine control over the supply which is maintained at a high standard of purity. At the end of the year 1949 there were only two houses in the borough known to be entirely dependent upon wells for their supply of water for domestic purposes. During 1950, the owner of one of the houses accepted the advice offered and late in the year he gave instructions for a water supply to be laid on to his house from the Metropolitan Water Board's mains. Thus only one house dependent upon a well remained on the records at the end of 1950. In this case samples of the water examined have proved satisfactory. Well water is used for industrial purposes in two premises in the borough. 2. DRAINAGE AND SEWERAGE. The arrangement whereby sewage from the Borough is pumped over from the pumping station in Down Hall Road into a sewer of the West Middlesex Main Drainage Board at Teddington, for ultimate treatment at the Mogden Disposal Works, continued during the year. Work on the preparation of the scheme for the new disposal works for the Hogsmill Valley Joint Sewerage Board, was continued by the Board's consulting engineers during the year. 3. RIVERS AND STREAMS. Apart from the River Thames which forms the Western boundary of the town, and which is controlled by the Thames Conservancy Board, the only other water course in the borough is the Hogsmill River. This tributary enters the Thames a little South of Kingston Bridge, It is fed by a spring situate at Ewell and receives effluent from sewage works. An Improvement Scheme for the Hogsmill River has been prepared by the Surrey County Council. The object of the scheme is to assist drainage of the water shed by straightening the course of the river. Work on a portion of the scheme was commenced during the year under review but was not completed during 1950. The improved section extends from Athelstan Bridge in Villiers Road across land owned by the Corporation in an Easterly direction to the borough boundary. The use of river craft for housing accommodation has been continued, and there is no reduction in the number habitually used throughout the year. It is understood that available mooring sites are very limited in number so it is unlikely that any considerable increase in the use of boats for human habitation can take place in the future in the Kingston Reach. 14 4. CLOSET ACCOMMODATION. All the closets in connection with dwelling houses in the borough are on the water carriage system,, 5. PUBLIC CLEANSINGo The collection and disposal of house and trade refuse is the responsibility of the Borough Surveyor who states that the disposal methods of burning and tipping have continued during the year. Salvaged material recovered monthly was approximately 67-tons (including waste food suitable for pig feeding) The Corporation is under 'irection'to collect waste food which is conveyed to Twickenham for conversion into pigfoodc Despite efforts which have been made to ensure satisfactory sanitary conditions at collecting points in the streets, complaints from nearby residents continued to be received,, The bins are often upset and the contents strewn over footpaths and roadway. It remains an urgent necessity for all available waste food to be salvaged but the need for a more hygienic system than the one in use is equally essential. The individual collecting pail system which was tried out in a small area of the town has not been extended. It is pleasing to note that no nuisance arose during the year from insects at the tip face, and* although the eradication of insects such as crickets is never an easy matter, it would appear that the steps taken in past years have proved completely successful. 6. SANITARY INSPECTION OF THE AREA. The following is a tabulated list of visits and inspections which totalled 8,58 compared with 7,52 the previous year:- Houses, etc 785 Drainage 996 Reinspections and Works in Progress 3902 Factories 258 Outworkers 26 Dairies, etc. 22 Food Premises 1372 I.D.Enquiries 124 Theatres 7 Verminous Premises 57 Rodent Control 91 Shops Act 335 Schools 5 Visits re Well Water Supplies 2 Housing Inspections (Consolidated Housing Regulations) 184 Housing Act 27 Markets 52 Miscellaneous 13 8,258 15 NOTICES SERVED. Informal, (a) Verbal 537 (b) Written Statutory. (a) Housing Acts (b) Public Health Acts 5 NOTICES COMPLIED WITH. Informal "TaT Verbal (b) Written 454 Statutory,, (a) if Housing Acts - (b) Public Health Acts 6 7. SHOPS AND OFFICES. The Shops Act, 1934,he Statute which controlled the arrangements for the health and welfare of shop workers was repealed during 1950 by the Shops Act 1950. This latter Act is a consolidating measure which was long overdue. There were nine Acts relating specifically to shops and to shop assistants and other persons employed in or about the business of shops. This mass of legislation was extremely complicated and difficult to administer. For the time being however the law has not been amended, but the fact that the many provisions of the law have been brought within the scope of one Act will lighten the task of administration considerably. The Shops Act, 1950 came into operation on 1st October 1950. During the years opportunity was taken to keep under review the welfare sections of the law and also to ensure that the law relating to Sunday closing was observed.The latter duty is not an easy one to carry out, but it is necessary to do so if only to ensure that one trader does not take an unfair advantage of his fellow shopkeepers, by trading outside permitted hours. Offices are brought within certain of the provisions of the Shops Act. The general standard of office accommodation in the borough is reasonably good. 8.FACTORIES ACT,1937 The following are the particulars required to be furnished to the Ministry of Labour and National Service respecting matters dealt with by the Corporation under Parts I and VIII of the Factories Act. PART I OF THE ACT 16 1. INSPECTIONS Premises No. on Register Number of Inspections Written Notices Prosecutions . Factories in which Sees.1,2, 3,4- & 6 are enforced byCorporation 83 46 4 - Factories not included above in which Sec.7 is enforced byCo rporation 289 196 17 - Other premises excluding outworkers. 18 16 2. CASES IN WHICH DEFECTS WERE FOUND. Particulars No. of cases in which defects found. • Found Remedied Referred by H.M. Inspector No. of Prosecutions Want of cleanliness - - - - Overcrowding _ - - Unreasonable Temperature — — — — Sanitary conveniences (a) Insufficient 5 3 5 - (b) Unsuitable or defective 5 3 2 - (c) No ventilated space or lobby 1 1 1 - (d) Lighting (absence of) 5 4 5 - Others 2 1 2 - PART VIII OF THE ACT Outwork. Nature of Work No. of Out-workers. Wearing apparel Making, etc. 5 Brass and brass articles 22 Letter files 1 Lampshades 1 Total 29 17 9. CAMPING SITES. During the year licences were issued for the placing of caravans at the following sites (a) Land in Crescent Roado (b) Site of NoSo 22 and 23 Gordon Road (Demolished Houses). (c) Rear of No. 222 Park Roado By the end of the year the land in Crescent Road had ceased to be used for the purpose, but each of the other sites was in useQ Licences in all three cases were issued only after it had been ascertained that no objection would be raised under the Town Planning Act to the stationing of caravans on the sites. 10. ATMOSPHERIC POLLUTION AND SMOKE ABATEMENT,, Taking the year as a whole it is doubtful if any improvement in the quality of fuel supplied to local industrial undertakings occurred during 1950, and constant vigilance and advice was necessary in order to minimise the amount of smoke and grit emitted to the atmosphere,, Considerable difficulties and delay were encountered in obtaining replacements for steam raising plant and grit arrester installations,, Improvement in the standard of firing and maintenance of furnaces and boilers would in all probability be achieved if sufficient experienced stokers were available, or if more of the present employees would attend classes of instruct tion organised at Technical Colleges. Employers should give careful consideration to ways and means of encouraging employees to become skilled stokers,, The observations of atmospheric pollution, from the gauge in Canbury Gardens, showed that during 195° there was an increase over 1 949 in the aggregate amount of deposited matter - 266 tons as against 245.97 tons - a monthly average of 22.165 tons compared with 20.5 tons, (after making due allowance for the month of August 1949 when the apparatus was out of commission). As from February, 1950, both chimney stacks of the Power Station were in use, and this fact may explain to some degree, the increase referred to above (particularly in the third quarter). The rainfall recorded showed a large increase over 1949; 25.70 ins. as compared with 19-05 ins. and the effects of this on the recorded deposit cannot be overlooked. Tables A and B following show the records obtained at the Canbury Gardens station. On 1st July, 1950 observations commenced on two other sites, namely, Tiffin Girls" School and the Cemetery. As might be expected, the pollution recorded at each of these two sites is less than that at Canbury Gardens. The difference in recordings between Canbury Gardens and Tiffin Girls' School is interesting and worthy of notice. Both stations lie in the same sector from the main sources ATMOSPHERIC POLLUTION 1950 (CANBURY GARDENS) Graph showing Monthly Deposit of Total Solids & Insoluble solids In Tons per Sq.Mile & Rainfall in Inches. 19 of pollution, and are affected by the same winds,, They vary only in their respective distance from the sources of pollution. The two new sites have been in operation only for six raonthSo There is as yet insufficient data upon which to base comparisons or detailed comment,, Tables C. and Do following give details of the recordings at these stations for the period July - December, 1950. In December, 1950, publication commenced of recordings from 5 other sites, set up (within the Borough) by the British Electricity Authority,, The data afforded should prove valuable in due course when the general position is reviwed TABLE A. CANBURY GARDENS Deposit in Tons per Sq. mile. Wind Direction. Rainfall in inches. Insoluble Solids Soluble Solids Total Sol- ids. No. of observations. No. of times wind from SEo to SWo January 10.40 6.94 17.34 93 29 0.89 February 15.20 9.55 24.75 84 58 3.68 March 11. 61 5.11 16.72 93 45 0.70 April 15.00 5.99 20.99 90 16 1.68 May 13.70 6,00 19.70 93 17 1.77 June 14.50 60 80 21.30 90 42 2.05 July 16.50 10.20 26.70 93 57 3.33 August 15.50 5.90 21.40 93 64 1.66 September 13.80 11.30 25.10 90 49 2.88 October 14.90 4.30 19.20 93 46 0.32 November 12.70 8.70 21.40 90 27 5.20 December 13.30 18.10 31.40 93 14 1. 54 Total 167.11 98.89 266.00 25.70 Average 13.925 8.24 22.165 2.14 TABLE B. CANBURY GARDENS. Deposit (Tons per Sq.Mile) 1949 1950 Quarterly Total Cumulative Total Quarterly Total Cumulative Total 1st 47.52 47.52 58.81 58.81 2nd 64.65 112.17 61.99 120.80 3rd 62.03 174.10 73.20 194.00 4th 70.77 244.87 72.00 266.00 20 TABLE C. CEMETERY Deposit in Tons per sq.mile Rainfall in Inches. Insoluble Solids. Soluble Solids Total Solids July 6.00 13.70 19.70 3.24 August 5.90 9.70 15.60 1.56 September 4.80 9.50 14.30 2.71 October 5.00 4.60 9.60 0.30 November 6.90 9.30 16.20 4.77 December 4.80 5.80 10.60 1.42 Total 33.40 52.60 86.00 14.00 Average 5.57 8.77 14.34 2.33 TABLE D. TIFFIN GIRLS' SCHOOL. Deposit in Tons per sq. mile. Rainfall Insoluble Solids. Soluble Solids Total Solids in Inches July 6.70 13.40 20.10 3.27 August 3.60 9.40 13.00 1.51 September 6.20 19.70 25.90 2.35 October 4.30 3.70 8.00 0.30 November 4.20 6.80 11.00 4.75 December 6.60 5.30 11.90 1.51 Total 31.60 58.30 89.90 13.69 Average 5.27 9.71 14.98 2.28 11. SWIMMING BATHS AND POOLS. (a) Public. The Corporation baths are situate in Denmark Road and comprise two pools, one of which was in use throughout the year, whilst the other was used for swimming during the summer months and for the winter months was converted for use as a hall for concerts, dancing, balls, etc. (b) Private. There are no privately owned swimming baths or pools open to the public in the borough. 12. ERADICATION OF BED BUGS. During the year 34 premises were disinfested, compared with a figure of 51 for the previous year. Fourteen Corporation controlled houses were dealt with by the Department during the year. 21 13. COMPLAINTS. There was a fall in the number of complaints received during the year 1950, viz; 671 compared with 781 the previous year. There were increases under only two headings, rodent infestation and non-removal of house refuse. In the case of the rats and mice, the increase reflects the continued co-operation of householders who now do not incur any risk of a charge for services rendered, by disclosing the presence of rodents on their premises. Furthermore, this co-operation is valuable from another point of view. Not infrequently, the presence of rats indicates structural defects in buildings or in connection with drainage systems, and the investigation by the department which follows immediately upon the receipt of complaints, may bring to light conditions which might otherwise have remained undiscovered. The reduction in the number of complaints regarding food (quality, soundness, etc.) was welcome, 30 compared with 43 in 1949. This figure of 30 or 4.4% of the total number of complaints received is reasonably low when one realises the immense amount of foodstuffs which is handled and sold within the borough. The following is a brief tabulated list of causes for complaints received during 1950:- Sanitary Defects 253 Rodents 158 vermin Infestation 41 Non-removal of Refuse 17 Defective Ashbins 9 Drains and Sanitary Arrangements 109 Overcrowding 6 Food (Quality, Soundness, etc.) 30 Nuisance from smoke 16 Miscellaneous 32 671 14. RODENT AND INSECT PEST CONTROL. The Prevention of Damage by Pests Act, 1949, came into force on 31st March 1950. Administration of this Act is vested in the Minister of Agriculture and Fisheries and Local Authorities are entrusted with the duty of carrying out many of its provisions. The Act replaced the Rats and Mice Destruction Act of 1919, which had many inherent weaknesses. The new Act appears to have received a general welcome. It affords considerable support to local authorities in their efforts to combat pests, and the fact that there are means to enforce compliance with the requirements of the Act, is no doubt the reason why it has not yet been necessary to implement the statutory powers contained in the Act. A good deal of humour is directed towards this work of rat extermination by those who may not realise the valuable nature of the work. The material damage that one or two rats are capable of causing in business premises needs to be seen to be believed. The contamination of foodstuffs and the consequent danger of food poisoning in those who consume the food should now be well known. But there is also the effect on the minds of women and children who are quite often thoroughly scared by the presence of rats or mice, and this 22 fear is not the exclusive possession of women and children, for men, who have been regarded as 'strong' have been known to re-act with equal speed to the presence of one rat. It is routine practice in all investigations of rodent infestation to check up on possible drainage or sewer defects. Frequently, the cause of the infestation is found to be the misplacement of the cap which should seal the 'rodding arm' of intercepting traps on the drainage system, thus allowing rodents to pass from the sewer into the house drain, or vice versa. It was the recurring infestations by rats around a block of new flats which first revealed the existence of defects in the drainage system® Further investigations showed these defects to be serious in extent. The borough is completely free of any major infestation by rodents. With the day-by-day system of visiting and inspection it is virtually impossible for a minor infestation to develop and to assume serious proportions. In fact, many of the visits made have as their object confirmation of the absence of rodents, In this way, business houses have at their disposal an organisation which ensures, so far as it is possible to do so, freedom from any large scale infestations. Much good work of a research character has been carried out by Central Departments into the habits of the rodent population, and more especially with regard to the use of sewers and drains by rodents. One of the first of such investigations was carried out in Kingston some years ago jointly with this Corporation. The Ministry of Agriculture and Fisheries is continuing this valuable work and their officers are always ready to consult with, and to advise local authorities. In pursuance of the programme for sewer treatment, the work was continued throughout 1950. Approximately 400 sewer manholes were baited with good results. There can be little doubt that in an old borough such as Kingston, many old disused drains remain underground. These conduits afford ready means of transit for rats where the pipes have not been properly sealed off, and the open ends of the pipes are frequently found to be connected with rat runs on the ground surface. Any defects which may be found in sewers or manholes during the course of the work are reported to the Borough Surveyor for attention. Rodent Control-Statistical Statement-1950. Private Dwellings. Rats Mice Total No© of complaints received in office 150 " " premises inspected as a result of these complaints 599 " " premises found to be infested 201 45 246 " " separate infestations treated 226 47 273 " " visits for treatment and reinspections 1589 156 1745 In addition, over 1000 premises were inspected in connection with routine surveys 23 Business Premises. Rats Mice Total No. of complaints received in office 8 " " premises inspected, including those under service agreement 183 " " premises in which slight infestations were found 94 44 138 " " visits for treatment & reinspections 2567 1055 3622 SUMMARY. No. of complaints received 158 " " premises inspected, approx. 1800 " " " infested 384 " " visits for treatment and reinspections 5367 Insect Pest Control. The arrangement whereby insect pest work is carried out by the same staff as that employed on rodent control continued with success during 1950. It is an economical system which provides a better and more efficient service than would be possible with two separate staffs. Advice is given to private householders as well as traders regarding the identity of insects found on their premises. When some strange insect cannot be recognised, the aid of the Entomologist at the Natural History Museum is sought, and he very readily gives th© necessary information together with advice on the best means of control. Apart from the occasional cases of aged folk living alone who are unable to look after themselves properly (and such unfortunate cases are almost certain to recur from time to time) there is a definite reduction in the number of verminous houses discovered now, compared with a decade ago. HOUSING Section D. There was little change to record in the general housing situation in the Borough during 1950. In previous Reports the need for a Housing Survey has been stressed and this necessity is even greater now. There is no need to repeat the reasons why such a survey should be made. but it can be said that a true picture of the housing situation throughout the country cannot be produced without some such review on a national basis© Despite the efforts of the Corporation in the way of building new habitations, the shortage of housing accommodation does not seem to become any less. At the same time, there is no evidence of any considerable overcrowding of individual houses in the borough. Many older types of houses which were constructed to accommodate one family only are now housing two or more families, but, unsatisfactory as this may be from certain points of view, it does not follow that the houses are over-crowded. The most important present need is the demolition of the worn-out small cottage type of houses, which are devoid of modern amenities such as are being provided in the new houses erected by the Corporations, and the replacement of these unfit and decrepit houses by new units. 24 When this progress may be possible is not at all clear, but it should not be long delayed. In the meantime the struggle to maintain these old houses continues. With ever rising building repair costs and static controlled rents, many of them at the 1914 standard, it is a source of continuous financial embarrassment to landlords to try to carry out even urgent works. The very difficult conditions under which some owners exist is well known to your sanitary inspectors, who labour under a sense of frustration in their efforts to improve housing conditions,, It should be remembered that repair notices which are served upon owners at the present time usually include only essential repair works. Even when these notices are complied with, in many cases it would not be possible to issue a certificate of fitness, within the standards of the Housing Acts. The costs of the additional works which would be required for this purpose and to bring the houses up to By-law standard would be completely uneconomic. It has not been unknown for an owner to offer to give away a house because of the financial burden of maintaining it in reasonable condition. Housing-Statistical Statement-1950. The following information has been supplied by the Borough Surveyor:- No. of Dwellings erected by private enterprise during 1950. Houses. New construction - 11 War Damaged - 5 Total number of working class permanent dwellings erected by the Corporation since March 1924 to 31st December, 1950. New Construction War Damaged. Houses 1035 (Inc.774 outside Borough). 4 Flats- 515 (Inc. 172 outside Borough) 3 Total No. of temporary dwellings erected up to 51st December. 1950. Arcon - 132 Aluminium - 70 2 year Huts - 126 Total 328 No. of 2 year Huts demolished during 1950. 6 25 INSPECTION AND SUPERVISION OF FOOD. Section E. (a) Milk Supply. There are no milch herds in the borough and all milk has to be brought into the town,, The supply is satisfactory, from the point of view of quality as well as quantity. With the exception of a very small quantity of T.T. milk delivered in a small area and a bulk supply which is brought in to a dairy to be pasteurised, the whole of the supply of milk in the town is heat treated. The value of publicity has shown itself in the improvement which has taken place in the matter of returned milk bottles. The average housewife complies with the request of the dairyman to rinse and cleanse the milk bottle before returning it to the roundsman or shop. It would be a great advantage to the dairymen as well as to the consumers if bottles from Canteens, catering establishments and more especially, schools, could be returned in a clean condition. It is not good training for children who will in due course be called upon to manage their own homes, to be shown so bad an example as can be seen day after day when bottles are collected from school. Bottles are returned in varying condition-some part filled, many still containing straws, and few, if any, rinsed. (b) Designated Milks0 The following table shows the number and type of licences issued by your Corporation during 1950, under the provisions of the Milk (Special Designations) Regulations. All the licences were in force at the end of the year. Tuberculin Tested & TT.Pasteurised. Pasteurised Sterilised To Pasteurise 1 - - To Deal 5 8 3 Supplementary 7 7 5 (c) Bacteriological Examination of Milk. During the year 1950. 88 samples of milk were sent to the Public Health Laboratory at Epsom for examination,, The total of 88 was made up as follows:- Pasteurised 62 T.T.(Pasteurised) 19 Sterilised 1 T.T.(Certified) 2 Ungraded Milk 4 Two samples failed to pass the Phosphatase test; one failed the Methylene Blue test; one ungraded milk failed to pass the Coliform test. 26 (d) Ice Cream. There are 12 Producers of Ice Cream with premises in the borough. The number of Registered Premises upon which ice cream may be stored or from which it may be sold is 102. In addition to these registered dealers, ice cream is sold on 32 other premises which do not require to be registered(restaurants, canteens, cinemas, etc.). The great majority of the retailers in the town obtain their ice cream from producers whose premises are outside Kingstoh. There are 28 such producers who sell either directly or through retailer agents. Bacteriological Examinations. There was a slight increase in the number of samples sent to the Public Health Laboratory during 1950-157 compared with 145 sent during the previous year. The samples were placed in the provisional Grades as set out below:- GRADE I II III IV Total Ice Cream 80 42 26 7 155 Delikrema 2 - - - 2 82 42 26 7 157 It will be seen that just over half the total number of samples fell into Grade I. Grades I and II together accounted for over 66% of the samples. There seems to be a definite increase in the proportion of wrapped ice cream sold. The summer of 1950 was a wet one, and one might have expected the amount of ice cream sold to be less than in the previous year. No evidence of any serious diminution was noted. (e) Meat and Other Foods. (i) Slaughterhouses. There are no licensed slaughterhouses in the borough. (ii) Meat Depot. The Depot in Wood Street continues to be the distributing centre for meat destined for Kingston and the surrounding districts of Esher, Surbiton, Wimbledon, Richmond, Maiden & Coombe, and Barnes. Daily visits are made to the Depot and it is satisfactory to be able to record the cordial relations which exist between the Department and the Manager and his Staff at the Depot. The transport of meat to and from the Depot has been a cause for much disquiet. The Ministry of Food does not accept responsibility directly for the transport arrangements, which are in the hands of a separate organisation. When more than usually unsatisfactory conditions were observed, representations were made to the Transport Organisation, and a temporary improvement would be noted. These requests for cleaner and more suitable means of transport have been repeated on several occasions, but no permanent improvement was observed by the end of the year. 27 (iii) Foodstuffs condemned as unfit. The following tabulated statement shows the amounts of various foods which were condemned during the year and the causes for the condemnation. The list is very much condensed so as to avoid unnecessary detail. Tabulated List of Condemned Foodstuffs showing cause for Condemnation and the Weights. Article of Food. Reasons for Action. Weight lbs. Raw Meat. Bovine Decomposition 1,209½ Disease 124½ Contamination 10 1,344 Ovine Decomposit ion 122¾ Disease 56 Contamination ¾ 179½ Porcine Decomposition 3½ 3½ Caprine Decomposition 126½ 126½ Total Weight Raw Meat 1.653? Raw Fish. Decomposition 1,602 Poultry, Game, etc. Decomposition Chickens 52¼ Ducks Geese 30 Rabbits (Imported) 993 1,075¼ Fresh Fruit Tomatoes Decomposition 2,510 Dried Fruit Currants Insect Infestation 50 Dates 98¼ Prunes 29¾ 178 Canned Goods. Meat Damaged, pictured, 908£ Fish blown, decomposition,. U3i Vegetables and Soup 616# Fruit & jam 7 ,883i Milk 223^ Other 1 9 081+ 10,759? Food in Glass Containers. Sauces, Pickles, Paste, etc Glass contamina- 118½ Fruit tion, Mould, 50½ Preserves Deterioration. 10¾ Beverages l¼ 181 Packet Foodstuffs. Miscellaneous Contamination 62 Insect Infestation 2 64 Total C/Fo 18,023¼ 28 Article of Food. Reasons for Action. Weight, lbs. B/Fwd. 18,023¼ Cheese and Fat. Cheese 21 334¾ Fat Decomposition 2¾ Flour & fat (mixed) 311 Sausages. Decomposition 24 Sweets Contamination 2 Totals- 18,384 lbs. Shell Eggs. 10,876 (Number) It is worthy of note that only 180½ lbs. of raw meat were condemned because of diseased condition. The remainder of the 1653½ lbs. was rendered unfit by reason of contamination or decomposition. This weight of meat may not represent many rations compared with the total issue, but it is a matter for extreme regret that any such unnecessary wastage of human food should occur. The same comment applies to the fish and to a greater degree to the several tons of canned foods which were found to be unfit. The responsibility for this wastage, much of which is avoidable, cannot be placed in any one quarter. There are many factors which have to be considered, but this should not be accepted as a reason, or excuse, for laissez-faireism. It is far from pleasant to realise that nearly 11,000 shell eggs were destroyed during the year. This figure does not take into account all those which were sold and which were found to be unfit by customers. It frequently happens that customers, for one reason or another, fail to take the offending egg back to the retailer who sold it. It must be understood that the retailer cannot choose the eggs for his shop. He has to accept those allocated to him in exactly the same way as the butcher has to accept his allocation of meat. Eggs do not usually become decomposed within a week or two. At one time they used to be considered as 'new-laid' if not more than one month old. Some of those which were condemned must have seen many months come and go, but others were likely to have been kept under bad conditions for a shorter period. There is room for a complete investigation into the whole question of food wastage. 29 (f) Food Hygiene. No effort was spared during the year 1950 to maintain the high standard of food premises in the borough. Your Corporation did not remain passive in the matter of 'clean food' until it became a popular demand and a frequent subject for headlines in the press. During the war years a reduction in the standard was inevitable, but immediately after cessation of hostilities, a review of all food premises was made. Many improvements were suggested to traders in respect of structural matters, and instruction was given to food handlers and staffs whenever opportunities presented themselves. A tactful reference to a careless act at the time it occurs, and an explanation given as to why it should not be repeated, is usually much more effective than the most erudite lecture delivered away from the place of employment. The spirit of co-operation which was evident from the commencement of the review, and which has since been maintained, between the traders, their staffs and the sanitary inspectors, has been a predominant feature. Without this mutual understanding, it is doubtful whether the high reputation for clean food shops which the borough enjoys, could have been achieved, let alone maintained. The Clean Pood By-laws, which deal with the handling, wrapping and delivery of food, came into force in this Borough during the year. These By-laws contain wide powers regarding food establishments, vehicles and persons engaged in food handling. They apply to food shops and vehicles in private ownership and equally to market stalls and barrows. The application of the By-laws to the market stalls was under consideration at the end of the year under review,. FOOD AND DRUGS ACT, 1938. Adulteration. One hundred and thirty samples were submitted to the Public Analyst during 1950, The tabular statement on the following page gives the number and type of the samples. The table also shows that adulteration of foodstuffs is found less frequently nowadays, compared with a few years ago. For example, only one sample of milk proved to be below the presumptive standard. In this case a small percentage of added water was detected. Follow-up samples taken from the same source proved to be genuine. In the case of the bread, the analysis was made in order to determine the nature of foreign matter found in a loaf. Although very disagreeable in appearance, it proved to be nothing more than a small piece of grease (probably from a machine bearing) mixed with nine times its weight of dough. 30 Tabulated Statement of Samples taken during 1950. Article NO.Of Samples. Genuine Not Genuine Remarks Formal Informal Formal Informal Formal Informal Milk 7 54 7 53 - 1 Sample 9558.16% solids not fat & 40% added water. Beef Sausage - 10 - 10 - - Custard Pdr. - 2 - 2 - Meat Paste - 3 - 3 - - Plum Jam - 2 - 2 - - Sausage Meat - 2 - 2 - - Pork Sausage - 4 - 4 - - Meat Pie - 1 - 1 - - Dessert Pdr. - 1 - 1 - - Macaroni - 1 - 1 - - Kipper Snacks - 1 - 1 - - Ice Cream - 14 - 14 - - Carrot Soup - 1 - 1 - - Spaghetti - 1 - 1 - - Raising Pdr. - 1 - 1 - - Pepper Substitute - 1 - 1 - - Tomato Soup - 1 - 1 - - Beef Suet - 1 - 1 - - Coffee Essence - 1 - 1 - - Castor Oil - 1 - 1 - - Cornflour - 2 - 2 - - Cake Plour Mix. - 1 - 1 - - Malt Vinegar - 2 - 2 - - Semolina Mix. - 1 - 1 - - Mussels (Tinned) - 1 - 1 - - Potato Crisps - 5 - 5 - - Aspirin — 1 - 1 - - Fruit Drinks - 3 - 3 - - Brandy - 1 - 1 - - Corned Beef - 1 - 1 - - Bread - 1 - - 1 Sample 1062 1/10 grease and 9/l0 cooking dough. Delikrema - 1 — 1 - — Totals 7 123 7 121 - 2 31 CONCLUSION. It only remains once again to express ray sincere thanks to the Chairman of the Public Health Committee, Alderman Dr.E.H.R.O1ldfield, and the Members of the Committee and the Corporation generally, for their continued encouragement and support; my thanks are offered also to my fellow officers for their cooperation and to all my colleagues, without whose unremitting efforts this record of a year's work could not have been compiled. HAROLD To PERRY. Chief Sanitary Inspector. 32 SECTION F. PREVALENCE OF. AND CONTROL OVER. INFECTIOUS AND OTHER DISEASES The following infectious diseases are notifiable to the Medical Officer of Health of the Borough:- Scarlet Fever Whooping Cough Diphtheria (including Membranous Croup) Measles (excluding Rubella) Acute Pneumonia (primary or influenzal) Meningococcal Infection Acute Poliomyelitis - paralytic " " - non-paralytic Acute Encephalitis - infective " " - post infectious Dysentery Ophthalmia Neonatorum Puerperal Pyrexia Smallpox Para-typhoid Fevers Enteric or Typhoid Fever (excluding Paratyphoid) Food Poisoning Erysipelas Chickenpox Malaria Cholera Plague Typhus Fever Relapsing Fever Tuberculosis (x Acute Poliomyelitis includes Acute Polioencephalitis) In 1950 a total of 272 notifications of infectious disease was received, compared with 699 in 1949. This decrease is due chiefly to the drop in the number of cases of measles, but a general improvement over last year is apparent in respect of all notifiable diseases with the exception of Non-Pulmonary Tuberculosis, which shows 11 cases notified as against 6 for the previous year. The following table gives an analysis of the cases into age groups. 33 NOTIFIABLE DISEASES DURING 1950 TABLE V CASES DEATHS Age Groups Age Groups Under 1 year 1-2 2-3 3 - 4 4-5 5-10 10 - 15 15 - 20 20 - 35 135 - 45 45 - 65 65 & over Total cases notified Cases admitted to Hosp. Under 1 year 1-2 2-3 3-4 4-5 5 - 10 10 - 15 15 - 20 20 - 35 35 - 45 45 - 65 65 & over Total Scarlet Fever - 1 2 9 - 28 8 1 1 1 - - 51 33 - - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - - - - - - - - - - - - - - - - Enteric Fever including Paratyphoid - - - - - - - - - - - - - - - - - - - - - - - - - - - Acute Poliomyelitis:- Paralytic - - 1 - - 1 - - - - - - 2 1 - - - - - - - - - - - - - Non-Paralytic - - 1 - 1 - - - - - - - 2 2 - - - - - - - - - - - - - Acute Infective Encephalitis - - - - - - - - - - - - - - - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - 3 17 3 - - 23 21 - - - - - - - - - - - - - Ophthalmia Neonatorum - - - - - - - - - - - - - - - - - - - - - - - - - - - Cerebro-Spinal Fever - - - - - - - - - - - - - - - - - - - - - - - - - - - Pneumonia - 2 - - - 1 - - 2 2 2 7 16 3 2 - - - - - 1 - - - 4 14 21 Erysipelas - - - - - - - - 1 1 1 - 3 2 - - - - - - - - - - - - - B.Dysenteria(Sonne) - - - - - - - - - - - - - - - - - - - - - - - - - - - Measles - 8 12 25 17 67 2 1 - - - - 132 2 - - - - - - - - - - - - - Whooping Cough 2 10 6 7 2 13 - - - - - 1 41 1 - - - - - - - - - - - - - Chickenpox - - - - - - - 1 - - - - 1 - - - - - - - - - - - - - - Food Poisoning - - - - - - - - - - - - 1 - - - - - - - - - - - - - - TOTALS 2 21 22 41 20 110 10 6 21 8 3 8 272 65 2 - - - - - 1 - - - 4 14 21 34 The following table gives a comparative statement of notifications received during the last thirty years, in respect of certain infectious diseases:- TABLE VI Year Enteric Fever ('Including Para-typhoid) Scarlet Fever Diphtheria Puerperal Pyrexia Ophthalmia Neonatorum Measles Whooping Cough Acute Infective Encephalitis Poliomyelitis 1921 4 302 79 1 6 - Not notifiable until 1940- - Not notifiable until 1940 - - 1 1922 1 238 74 1 6 — — 1923 1 118 17 2 5 — — 1924 6 143 20 — 4 - 1 1925 7 213 25 4 5 - 3 1926 7 82 27 4 2 - 2 1927 3 87 65 9 3 - 1 1928 7 135 152 9 4 - 1 1929 1 74 113 5 3 - - 1930 5 78 100 9 2 - - 1931 1 61 53 14 4 — — 1932 1 56 47 13 - 2 1933 2 125 30 10 2 - 3 1934 2 40 42 5 3 - - 1935 2 54 50 8 3 - - 1936 6 67 27 19 2 - - 1937 1 51 21 32 3 — 2 1938 1 61 72 47 2 - 2 1939 1 69 19 66 3 - 1 1940 3 45 53 63 3 373 22 - - 1941 7 54 15 37 - 331 271 - 1 1942 — 79 8 24 3 375 99 — - 1943 1 110 3 18 - 287 151 - 1 1944 — 49 7 15 2 33 73 — 1 1945 — 28 16 23 2 407 84 — 1 1946 1 34 8 41 1 283 67 - 2 1947 1 24 2 28 1 219 38 3 5 1948 — 34 — 30 - 197 200 - 3 1949 - 73 - 29 - 483 81 3 7 1950 — 51 - 23 — 132 41 — 4 Scarlet Fever. Fifty-one cases of mild scarlet fever were notified, forty-seven of which were of school age. No deaths occurred and no "return" cases. Thirty-three of the cases notified were removed to an infectious diseases hospital for treatment and the remainder were treated at home. Diphtheria No cases of diphtheria were notified, for the third successive year. Intensive work was continued to immunise the school and preschool population against diphtheria, and the table on the following page shows the stage reached by the end of 1950. It is intended to continue with a vigorous immunisation campaign to prevent any possible diminishing of public interest in this service, occasioned by three years freedom from the disease,and the complacency which may result. immunisation is just as necessary in the absence of diphtheria as when it occurs. 35 TABLE VII DIPHTHERIA IMMUNISATION, Comparative Statement for the Years 1948.1949. and 1950. (Provided by Dr.W.H.Kinstrie) Year of Birth. No. completely immunised. 1948 1949 1950 1950 - - 38 1949 - 43 474 1948 59 453 471 1947 557 602 578 1946 529 540 544 1945 419 423 482 1944 437 455 448 1943 422 423 420 1942 424 409 401 1941 387 384 380 1940 420 403 415 1939 390 384 379 1938 389 377 375 1937 385 379 374 1936 364 367 366 1935 321 322 1934 290 0-4 Age Group. Total number completely Immunised as at 31.12.1948 2001 Percentage 1948 - 62.4 as at 31.12.1949 2061 „ 1949 - 64.7 as at 31-12.1950 2105 „ 1950 - 65.0 5-15 Age Group., Total number completely Immunised as at 31.12.1948 3792 Percentage 1948 - 86.5 as at 31-12.1949 3903 „ 1949 - 88.0 as at 31-12.1950 4040 " 1950- 88.0 Record of Work done At Diphtheria Immunisation Clinics.. 1948 1949 1950 Total number of clinics held 98 97 98 Number completely Immunised 832 545 415 Number of Schick Tests 1294 1357 1172 Number of Positive Schick Tests and Re-inoculations 133 134 84 Total Attendances 3965 3791 3204 Average Attendances 40.5 40 32 36 Poliomyelitis, During the year four cases of poliomyelitis were notified, two being classified as slightly paralytic, and two as non-paralytic. All were mild cases, one being nursed at home, and no deaths were recorded. Two of the cases were notified early in the year in respect of a young brother and sister, who both completely recovered. The one case nursed at home was notified at the end of the year, and also made a satisfactory recovery. These facts indicate that, in spite of the fairly high prevalence of this disease throughout the country generally during the summer, Kingston was almost completely free of the infection. Polioencephalitis. Acute Polioencephalitis is now included under the heading of Acute Poliomyelitis and is no longer notified separately. Acute Infective Encephalitis. No cases were recorded during 1950. Enteric Fever (Typhoid or Paratyphoid). No cases of typhoid or paratyphoid B were notified during 1950. Measles. There were 132 cases of measles notified during 1950 (compared with 483 in 1949), of whom two only were removed to hospital. There were no deaths recorded in this group. The 5 - 10 year age group contained the largest number of notifications (67) the majority of the remainder being spread over the 1-5 year age period (62), and only 3 at other ages. Ophthalmia Neonatorum. No cases were notified during 1950. Puerperal Pyrexia. Twenty-three cases were notified during 1950 and an analysis is shown "below, together with figures for the years 1946 — 1949 for purposes of comparison. Only eight of the cases were Kingston residents,, and the total shows an improvement over last year. Cases 1946 1947 1948 1949 1950 (a) Total notified 41 28 30 29 23 (b) Number included in (a) of (i) Kingston residents 9 6 9 4 8 (ii) Extra District Residents 32 22 21 25 15 (c) Number included in (a) notified from Kingston County Hospital 39 27 29 28 21 (d) Number included in (a) notified by private doctors 2 1 1 1 2 (e) Number of cases included in (d) removed to hospital other than those included in(c) 2 - - - - 37 Food Poisoning. One case of food poisoning was notified during 1950. It was not possible to determine the cause of the illness, which did not take a severe course, the patient quickly recovering. No similar related cases occurred and investigation did not produce any evidence concerning the agent producing the symptoms upon which the diagnosis was based. Tuberculosis. Cases of tuberculosis are dealt with by the South Western Metropolitan Regional Hospital Board, and by the Surrey County Council. Good liaison exists between your Medical Officer and the Chest Physician, and his staff, and with the Surrey County Council. Each case notified is visited by an officer of the Public Health Department, and all contacts are advised to consult the Chest Physician. The efficiency of notification is good and there have been no cases of wilful neglect or refusal to notify. The following table shows comparative figures of notified cases and deaths for the years 1940 - 1950 (inclusive):- Year Cases Notified Deaths Respiratory Non Respiratory Total Respiratory Non Respiratory Total 1940 37 10 47 25 1 26 1941 44 9 53 19 3 22 1942 67 11 78 22 2 24 1943 63 8 71 25 1 26 1944 56 11 67 19 4 23 1945 41 12 53 19 7 26 1946 41 9 50 10 3 13 1947 43 3 46 17 4 21 1948 55 3 58 22 2 24 1949 40 6 46 10 1 11 1950 37 11 48 12 - 12 (Note - An analysis of the total notified cases during 1950 in age groups is shown on the following page) The ratio of non-notified cases to total deaths for 1950 and the preceding four years is as follows:- 1946 1947 1948 1949 1950 1 : 3 1:7 1: 24 1: 11 1:6 Daring 1950 no action became necessary under the Public Health (Prevention of Tuberculosis) Regulations, 1925, or Section 172 of the Public Health Act, 1936. Very close contact is maintained with the Kingston and District Tuberculosis Care Committee, whose field of work is coincidental with the North Central Division. The Medical Officer of Health is Chairman of the Care Committee and considerable assistance has been given to patients. There is no doubt that this body is fulfilling its function of helping towards the rehabilitation of patients. Tuberculosis is an infectious condition, and the treatment required to cure pulmonary tuberculosis involves a long period of rest. When the infection comes to the bread-winner it is a very serious matter for the family and puts a great 38 NOTIFIED CASES OF. AND DEATHS FROM. TUBERCULOSIS ^25°• TABLE VIII NEW CASES DEATHS Under 1 yeai 1-5 5-15 15 - 25 25 - 35 35 - 45 45 - 55 55 - 65 65 & over Total Under 1 year 1-5 5-15 15 - 25 25 - 35 35 - 45 45 - 55 55 - 65 65 & over Total Tuberculosis (a) Respiratory M. - - 1 5 6 2 5 4 1 24 - - - - - - 5 2 - 7 F. - - 2 5 5 - - - 1 13 - - - - - 1 2 - 2 5 Total - - 3 10 11 2 5 4 2 37 - - - - - 1 7 2 2 12 (b) Non-Respiratory M. - - 1 1 -. 1 - - - 3 - - - - - - - - - - F. - - 1 1 3 1 - 1 1 8 - - - - - - - - - - Total - - 2 2 3 2 - 1 1 11 - - - - - - - - - - 39 strain on the financial resources. There is also the necessity of preventing the spread of infection from the infected person to healthy members of the family circle. This requires isolation, nearly always at home, for long periods, throwing a further strain on already limited resources. the Kingston and District Tuberculosis Care Committee was formed for the purpose of encouraging and assisting sufferers from tuberculosis towards recovery. During 1950 171 families were helped, the form of help being extra nourishment, clothing, money grants for removals, bedding, fares, pocket money, correspondence courses, and miscellaneous items, and a total of £1,351 was expended from the funds of the Committee on this work. Scabies. During the year the scheme for treating cases and contacts of scabies continued to operate as described in previous reports. Arrangements exist for the treatment of scabies at the Cleansing Centre for school children, the cost being recharged to the Education Authority. Treatment of children under five and adults continues as a Borough Health Service. The Work was carried out on a sessional basis, at the Cleansing Station, Burton Road, by a part-time attendant working under the supervision of Health Visitors. The number of cases and contacts during 1950 showed a slight increase over 1949. but no special difficulties were encountered, and the incidence of scabies is at a satisfactorily low level. The following tables show the number of persons treated during the year 1950 and the five preceding years. Cases of Scabies and Contacts Treated Year No. Treated Total oases and contacts treated Cases _ Contacts 1945 341 251 592 1946 152 190 342 1947 108 88 196 1948 63 82 145 1949 27 18 45 1950 40 10 50 40 Analysis into Age Groups of Cases and Contacts Treated Year Males Females Under 5 Years 5 yrs. to 14 yrs. Over 14 Years Under 5 Years 5 yrs. to 14 yrs. Over 14 Years 1945 35 113 137 17 80 210 1946 23 48 77 19 69 106 1947 10 44 26 23 40 53 1948 12 33 25 14 18 43 1949 1 10 11 7 4 12 1950 3 7 14 5 9 12 INFESTATION BY HEAD LICE During 1950 there was no evidence of special incidence of infestation by head lice. D.D.T. preparations were used in addition to the usual cleansing by water and soft soap or shampoo. The measures described in previous reports are still in force and fulfil the terms of Circular 2831, Ministry of Health. It was not found necessary to take any statutory action for infestation by lice during the year.