AC4413(1) KlN25 Royal Borough of Kingston-upon-Chames ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH AND CHIEF SANITARY INSPECTOR GUILDHALL. KINGSTON-UPON-THAMES SEPTEMBER, 1952 Royal Brough of Kingston-upon-Chames ANNUAL REPORT 1951 OF THE MEDICAL OFFICER OF HEALTH AND CHIEF SANITARY INSPECTOR GUILDHALL, KINGSTON-UPON-THAMES SEPTEMBER, 1952 ANNUAL REPORT 19 5 1 TABLE OF CQNTENTS Preface Page Staff of the 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) Still Births 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 3, 4 & 5 (iv) Other deaths 5 Table I - Extracts from Vital Statistics for years 1947 - 1951 inclusive 6 Table II - Comparison of vital Statistics 1922-1951 7 Table III - Birth Rates, Civilian Death Rates, and Case Rates for certain Infectious Diseases in the year 1951 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 National Assistance (Amendment) Act, 1951 11 SECTION C Sanitary Clrcumstances Introduction 12 - 15 (l) Water Supply 16 (2) Drainage and Sewerage 16 (3) Rivers and Streams 16 (4) Closet Accommodation 16 (5) Public Cleansing 17 (6) Sanitary Inspection of the Area 17 (7) Shops and Offices 18 (8) Factories Act, 1937 18, 19 (9) Camping Sites 19 Page (10) Atmospheric Pollution and Smoke Abatement 20-26 Chart I - Histagram for showing the data for Stations "A" "B" and "C" 25 (11) Swimming Baths and Pools 26 (12) Eradication of Bed Bugs 27 (13) Complaints 27 (14) Rodent and Insect Pest Control 28, 29 SECTION D Housing General 29, 30 SECTION E Inspection and Supervision of Food (a) Milk Supply 30 (b) Designated Milks 31 (c) Bacteriological Examination of Milk 31 (d) Ice Cream - Bacteriological Examination 31, 32 (e) Meat and Other Poods 32 Tabulated list of Condemned Foodstuffs 33 (f) Food Hygiene 33 Food and Drugs Act, 1938 34 Tabulated Statement of Samples Submitted to the Public Analyst during 1951 tables S1 and S.2 34-36 Merchandise Marks Act, 1926 36 Conclusion 37 SECTION F Infectious Diseases Notifiable Diseases 38 Table V - Notifiable Diseases during 1951 39 Table VI - Comparative Statement of Notifications of Certain Infectious Diseases 40 Scarlet Fever 40 Diphtheria 40 Table VII - Comparative Statement of Diphtheria Immunisation during the years 1949, 1950 and 1951 41 Poliomyelitis 42 Acute Infective Encephalitis 42 Enteric Fever (Typhoid and Paratyphoid) 42 Measles 42 Ophthalmia Neonatorum 42 Puerperal Pyrexia 42 Food Poisoning 43 Tuberculosis 43 Table VIII - Notified Cases and Deaths from Tuberculosis in 1951 44 Scabies 45 Infestation by Head Lice 46 PREFACE TO THE MAYOR, ALDERMEN AND COUNCILLORS OP THE ROYAL BOROUGH OP KINGSTON-UPON-THAMES. ANNUAL REPORT. 1951 Mr. Mayor, Ladies and Gentlemen, I have the honour to present the Annual Report on the public health and sanitary circumstances of the Borough for 1951. It follows the same pattern as that for 1950 and gives information on essential matters affecting the Public Health,, Population - The fifteenth census of the population of England and Wales was taken in April, 1951, an interval of twenty years after the previous census. The total population figure for Kingston at the date of the 1951 census was 40,168 (18,430 males: 21,738 females). This showed an increase of 0.9% in the intercensal period 193l/951. the population at the previous census being 39,825 persons. It is also interesting to note that at the 1921 census the population was 39,514 and that from that date until now the figure has increased by only 654 persons in thirty years. It must be remembered that these census figures only relate to the resident population, and do not represent the large day population of the town. The population figure shown in this report under "General Statistics"16 the estimated mid 1951 total of 39,920 and it has been used in the compilation of the statistical data now presented. Infectious Disease - In general the health of the people has been good. The number of infectious diseases notified in 1951 was higher than in 1950, but this was almost entirely due to a greatly increased incidence of measles and whooping cough. A reduction in the number of cases of scarlet fever and poliomyelitis is recorded. Once again, for the fourth 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 1951 some 59% of the children born between 1st. July 1950 and 30th. June 1951 have been vaccinated. Births - The number of live births for 1951 is 574, and compares with 619 for 1950. The Birth Rate if 14.39 per 1,000 of the population, compared with 14.76 for 1950. Deaths - The number of deaths recorded in 1951 is 556 compared with 491 for 1950. This makes a Death Rate of 13.93 for 1951 compared with 11.73 for 1950. The excess of births over deaths was 18 compared with 128 for the previous year. This reflects to some extent the fact that whereas the older people stay in their existing homes for the remainder of their lives, many of the younger, child producing population, are being rehoused elsewhere outside the Borough. The number of deaths of infants under 1 year of age in 1951 is 14, which gives an Infant Mortality Rate, per 1,000 live births of 24.39 compared with 19 infant deaths and a rate of 30.69 for 1950. The Causes of Death - The main conditions causing death as recorded in the table for 1951 are Heart Disease - 173; Cancer - 80; and Vascular Lesions of the Nervous System - 68. Housing - The insistent need for additional housing accommodation continues to be a problem occupying much energy and attention of the Council. During the year under review a contribution to the public health was made by the completion of sixty one housing units, 80% of which had to be constructed outside the Borough. As each year passes the need mentioned in my last Report for modified housing for elderly people who can maintain themselves in comparative independence increases in urgency. I wish to record my appreciation of the help given me by my colleagues in all departments and especially of the public health department. In particular I must make mention of Mr. H.T. Perry, O.B.E., Chief Sanitary Inspector. This Report deals with the year 1951, which is the last full year of Mr. Perry's service, and by the time it is published Mr. Perry will have entered his retirement. He is to be congratulated on completing an unusually long period of thirty-four years service with the Corporation during which time many and far reaching changes affecting the public health of Kingston have taken place. With our thanks to him for the part he has played in this we add our good wishes that he enjoy a long and happy retirement. I respectfully acknowledge the 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 tbs honour to be, Your obedient Servant, J.W. STARKEY. Medical Officer of Health. 1 19 5 1 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: J.W. STARKEY, M.B., Ch.B. (Edin.) D.P.H. Chief Sanitary Inspector: H.T. PERRY, O.B.E., F.S.I.A. (a) (b) Administrative Officer: 4 F.D. HARVEY, M.R. San. I. (a) (b) Additional Sanitary Inspectors: A. CLEGG, M.R. San. I. (a) (b) J.B. FACER, A.R. San. I. (a) (b) N.L.G. TUBB, D.P.A. (Lond.) M.R. San. I. (a) (b) ¥.H. DUNS TAN, M.R. San„ I. (a) (b) Junior Sanitary Inspector: (vacancy) Assistant Rodent Officer: F.W. STAGO Clerical Staff During 1951: M.E.POWELL, D.PeA. (Lond.) MISS C.L. FOISTER MISS V.E. NEELD MRS. B.M. HILL MISS J,A„ DILLIWAY (Resigned 30.3.51) A.R. ASTON (Called for National Service 9.3.50) L.A. PALMER (Resigned 30.12.51) Go N0RTHW00D T.J. MITCHELL (Appointed 8.1.51 - Temporary Vice A.R. ASTON, H.M.F.) (a) Certificate as Sanitary Inspector. (b) Certificate as Meat and Foods Inspector, Subject to a sharing arrangement with Surrey County Council. 2 SECTION A . STATISTICS MP SOCIAL CONDITIONS 1, General Staxisties. Area in Acres 1,390 Total Population (including Service personnel) 39,920 Number of inhabited houses (approx.) ll,509 Rateable Value - General Rate £558?217 Siraa represented by Penny Rate £ 2,279 2. Social Conditions. Mr, P,R. Smith, the Manager of the local Employment Exchange has kindly provided the following information regarding employment in Kingston and the surrounding districts. "Unemployment during 1951 was lower, over the whole year, than at any time since 1946. At its highest in late January, when 834 persons - approximately 1% of the estimated insured population - were registered, it fell to its lowest level of 353 in July, rising again to 640 just before Christmas. "The little long term unemployment which existed was almost entirely limited to elderly unfit work people; some 70 registered disabled persons were registered as unemployed at all times during the year. "There was no change in the industries in the area except that the aircraft industry and many engineering firms became heavily committed to the rearmament programme and there was a constant demand for skilled engineers which it was not possible to meet. Skilled building trade operatives were also in great demand for the greater part of the year; there was seasonal slackness in the decorating side of the building trade during the winter months. "The demand for women for factories showed a marked falling off towards the end of the year. Vacancies filled during the year by the Kingston Employment Exchange in the area Kingston, Maiden, Surbiton, Teddington, The Hamptons totalled 5,591 men and 2,735 women." 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 535281 254 Illegitimate 39 21 18 574 302 272 Birth Rate (Registrar General) per 1,000 population 14,39 (b) Still Births - Total Male Female Legitimate 11 5 6 I11egitimate 2 1 1 15 6 7 Rate per 1,000 total (live and still) births 22.16 (c) Deaths - Total Male Female 556 277 279 (i) Death Rate (Registrar General) per 1,000 populationo 13, 93 (ii) Maternal Death Rate (deaths caused byPregnancy, Childbirth, Abortion), Mo. of Deaths Rate per 1,000 total (live and still) births. 1 l.70 (iii) Infant Death Rate (deaths of all infants under one year of age) rotal No. of Deaths Rate per 1,000 live births 14 24.39 Legitimate Infants Rate per 1,000 legitimate No. of Deaths live births 10 18.69 Illegitimate Infants Rate per 1,000 illegitimate No, of Deaths live births 4 102,56 All infants under 4 weeks of age (included in above) Total No. of Deaths Rate per 1,000 live births 12 20.91 Legitimate Infants Rate per 1.000 legitimate No. of Deaths live births. 8 14.95 Illegitimate Infants Rate per l,000 illegitimate No. of Deaths live births 4 102.56 4 The approximate infant mortality rate for 1951 and the rates since 1946 are shown for purposes of comparison. 1946 1947 1948 1949 1950 1951 Kingston-uponThames 29 22 23 20 30 24 England & Wales 43 41 34 32 30 29 London Area 41 37 31 29 26 26 It will be 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 1951 in the Borough before reaching the age of one year, together with the cause of death and ages:- Age Total Deaths Aspiration - pneumonia Obstructed labour (persistent occipito posterior). Forceps delivery. Bronchitis Congenital atelectasis Erythroblastosis Foetalis Prematurity Cerebral compression - tentorial tear - maternal diabetes. Broncho-pneumonia Asphyxia due to inhalation of mucous and liquor amnii into trachea and bronchi. Congenital heart disease 0-24 hours 5 - - 1 1 3 - - - - 24 hrs. — 1 mth. 7 1 - 1 - 2 1 1 1 - 1 mth. - 1 yr. 2 - 1 - - - - - - 1 Totals 14 1 1 2 1 5 1 1 1 1 5 The infant deaths recorded during the year numbered 14 which gives an Infant Mortality Rate of 24.39. This is an encouraging figure but should be capable of farther reduction. A study of the causes of these 14 deaths, however, does not reveal any which might have been prevented. (iv) Other Deaths. No. of Deaths Deaths from Cancer (all ages) 80 Deaths from Measles (all ages) 1 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 1947, 1948, and 1949, have been converted, as far as possible, to the new classifications. Extracts from Vital Statistics for Years 1947-1951 inclusive. TABLE I LIVE BIRTHS 1947 1948 1949 1950 1951 Total M. F. Total M. F. Total M. F. Total M. F. Total M. F. Legitimate 838 432 406 677 345 332 679 344 335 578 279 299 535 281 254 Illegitimate 32 20 12 45 21 24 50 23 27 41 19 22 33 21 18 870 452 418 722 366 356 729 367 362 619 298 321 574 302 272 Birth Rate (R.G) per 1,000 pop. 21.53 17.73 17.96 14.76 14.39 STILL BIRTHS Legitimate 14 6 8 16 7 9 8 5 3 9 4 5 11 5 6 Illegitimate 1 - 1 - — - 2 - 2 2 1 1 2 1 1 15 6 9 16 7 9 10 5 5 11 5 6 13 6 7 Rate per 1,000 (live and still births) 16.95 21.62 13.53 17.46 22.16 DEATHS 495 228 267 455 227 228 500 250 250 491 215 276 556 277 279 Death rate (R.G) per 1,000 pop. 12.13 11.17 12.32 11.73 13.93 7 Comparison of Vital Statistics 1922-1951 TABLE II Year Estimated Population Live Births Birth Rate per 1,000 population Deaths Death rate per l,000 population Infantile Mortality Rate per 1,000 Live Births Kingston upon Thames England and Wales London Area 1922 39940 692 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 35970 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 16.6 474 13.6 48 46 6l 1945 35760 593 16.6 505 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 1951 39920 574 14.4 556 13.9 24 29 26 8 TABLE III Birth-rates, Death-rates, and Case-rates for certain infectious diseases in the Year 1951. 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 Rates per 1,000 Home Population Births Live Births 15.5 17.3 16.7 17.8 14.4 Still Births 0.36 0.45 0.38 0.37 0.33 Deaths All Causes 12.5 13.4 12.5 13.1 13.9 Typhoid and Paratyphoid 0.00 0.00 0.00 - 0.00 Whooping Cough 0.01 O.Ol 0.01 0.01 0.00 Diphtheria 0.00 0.00 0.00 0.00 0.00 Tuberculosis 0.31 0.37 0.39 0.38 0.33 Influenza 0.38 O.36 0.38 0.23 0.27 Smallpox 0.00 0.00 0.00 - 0.00 Acute Poliomyelitis (incl. Polioencephalitis) 0.00 0.01 0.01 0.00 0.00 Pneumonia 0.6l 0.65 0.63 0.61 1.05 Notifications (Corrected) Typhoid Fever 0.00 0.00 0.00 0.01 0.00 Paratyphoid Fever 0.02 0.03 0.02 0.01 0.00 Meningococcal infection 0.03 0.O4 0.03 0.03 0.00 Scarlet Fever l.ll 1.20 1.20 1.10 0.93 Whooping Cough 3.87 3.62 4.00 3.11 5.56 Diphtheria 0.02 0.02 0.03 0.01 0.00 Erysipelas 0.14 0.15 0.12 0.15 0.02 Smallpox 0.00 0.00 0.00 - 0.00 Measles 14.07 13.93 14.82 14.64 11.10 Pneumonia 0.99 1.04 0.96 0.72 0.10 Acute Poliomyelitis (including polioencephalitis) Paralytic 0.03 0.03 0.03 0.02 0.00 Non-Paralytic 0.02 0.02 0.03 0.02 0.00 Food Poisoning 0.13 0.15 0.08 0.23 0.13 Deaths. Rates per 1,000 Live Births All Causes under 1 year of age 29.6(a) 33.9 27.6 26.4 24.3 Enteritis and diarrhoea under 2 years of age 1.4 1.6 1.0 0.7 1.7 Notifications Rates per l,000 Total (Live and Still Births) (Corrected) Puerperal Pyrexia and Fever 10.66 13.77 8.08 14.90 23.85 (a) Per 1,000 related live births. 9 TABLE IV Causes of Death Registrar General's Tables 1947 1948 1949 1950 1951 M F M F M F M F M F All Causes 228 267 227 228 250 250 215 276 277 279 tuberculosis, respiratory 10 7 13 9 4 6 7 5 7 5 Tuberculosis, other 3 1 1 1 1 - — - - 1 Syphilitic disease 4 4 2 2 5 2 2 - 2 2 Diphtheria - - - - - — - - - - Whooping Cough - - - - - - - - - - Meningococcal infections - - - - 1 - - - - - Acute Poliomyelitis - - 1 - 1 2 - - - - Measles - - - - 1 - — - - 1 Other infective and parasitic diseases - - - - - - 1 1 - 1 Malignant neoplasm, stomach 5 8 10 8 10 5 8 5 11 5 Malignant neoplasm, lung, bronchus * - - - - - - 8 3 8 2 Malignant neoplasm, uterus * - - - - - - - 7 - 1 Malignant neoplasm, breast - 13 - 7 - 13 - 10 - 10 Other malignant and lymphatic neoplasms * - - - - - - 20 17 19 24 Leukaemia, aleukaemia * - - - - - - - 2 3 - Diabetes - 1 1 - - 2 2 1 2 1 Vascular lesions of nervous system 30 26 19 25 18 29 18 47 29 39 Coronary disease, angina) 31 23 46 25 Hypertension with heart disease 71 84 60 75 66 81 8 12 11 14 Other heart disease 21 41 36 41 Other circulatory disease 15 21 7 11 11 20 14 18 18 18 Influenza * - - - — - — - 4 2 9 Pneumonia 10 12 11 8 12 16 10 11 16 26 Bronchitis 13 14 10 5 23 10 11 11 24 5 Other diseases of respiratory system 3 2 6 4 5 3 3 3 3 Ulcer of stomach and duodenum 2 1 5 2 4 1 4 2 7 6 Gastritis, enteritis, and diarrhoea 1 2 - - 1 - - 1 1 - Nephritis and nephrosis 1 4 3 1 4 3 3 - 1 2 Hyperplasia of prostate * - - - - - - 7 - 4 - Pregnancy, childbirth, abortion - 1 - 1 - - - 4 - 1 Congenital malformations 1 8 4 3 6 4 3 2 2 1 Other defined and illdefined diseases * - - - - - - 22 31 14 27 Motor vehicle accidents 1 - 4 1 1 2 1 - 2 - All other accidents 1 2 6 8 4 5 5 12 6 5 Suicide 4 5 5 2 3 5 3 3 3 Homicide and operations war * - - - - - - 1 - - 1 st Separate figures not avilable for years 1947 - 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, where changes during the year have been recorded. (ii) Laboratory Facilities. During 1951 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 by the Clinical Research Association, and samples under the Food and Drugs Acts are submitted to the Public Analyst. (iii) Ambulance Facilities. Ambulance facilities are provided by the Surrey County Council 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. Patients are admitted directly to Tolworth Isolation Hospital, 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 36 infectious disease cases were sent to hospital for treatment, or diagnosis, as follows, A further 40 cases (of Puerperal Pyrexia) were treated in Kingston Hospital, having been notified from there. To Tolworth Isolation Hospital 27 Grove Hospital, Tooting 3 Kingston Hospital 43* Cuddington Hospital 1 Thames Ditton Hospital 1 Queen Mary's Hospital, Carshalton 1 *This number includes 40 cases of Puerperal Pyrexia already in Kingston Hospital and notified as Puerperal Pyrexia from there. 11 (b) Smallpox. No cases occurred in the Borough during the year. Arrangements are in existence whereby the first cases that may occur are to be admitted to the Joyce Green Hospital, Dartford, Kent, after consultation with a named smallpox consultant. This hospital is always standing by to receive any such cases within a defined area, which includes Kingston, and the above arrangements are adequate to cover any initial emergency action. (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). This is a large comprehensive General Hospital with a full range of general and special departments. It has also a busy and highly organised Out-Patient Department fully supported to meet all surgical, medical, and psychological emergencies. 2• National Assistance Act, 1948. National Assistance (Amendment) Act. 1951. Under Section 47 of the 1948 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. The 1951 Act enables local authorities to deal more expeditiously with such persons by facilitating an initial removal, for a period not exceeding three weeks, during which time arrangements may be made under the earlier Act for more prolonged removal, should that be required. It was necessary to have removed to Hospital without delay an elderly lady (84) living alone, who being aged, infirm, physically incapacitated, and living in insanitary conditions, was unable to devote to herself, and was not receiving from other persons, proper care and attention. A certificate was issued by the Medical Officer of Health and another registered medical practitioner, a Court Order obtained, and the removal effected. This action was taken under the National Assistance (Amendment) Act, 1951, and the Order made was valid for a period not exceeding three weeks. Subsequently the Town Council authorised application to the Court for a further Order, for a period not exceeding three months, under the 1948 Act. This extra action was not necessary, the old lady remaining in hospital as a voluntary chronic sick patient after the period of her compulsory removal had expired. A number of geriatric cases were referred to the Medical Officer during the year, and suitable advice and action was arranged in each. A close working co-operation now exists between the Physician Superintendent of Kingston Hospital, the Divisional Welfare Officer, the local doctors, and your Medical Officer. This has facilitated the gaining of hospital beds for a few of the more needy cases. Use is also made of powers to ensure that homes are kept in a good state of repair, and to deal with the cleansing of verminous persons and effects. The Sanitary Inspectors carry out unremitting work in this direction, and every reported case of an aged person living in unsatisfactory conditions receives full investigation. 12 ANNUAL REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1951 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 1951. It is the thirty-third such Report I have been privileged to submit to your Corporation. It is my valedictory statement and for this reason I may be permitted to write a little more than is customary in this introduction. Much water has flowed under Kingston Bridge since I was appointed your sanitary inspector 34 years ago. Looking back over those eventful years perhaps I would like to refer to a few matters which I feel are worthy of recollection. My predecessor apparently confined himself, during his twenty-five years service, to the abatement of such nuisances as arose from choked drains, accumulations of manure, etc. I recall very clearly his daily peregrinations around the town accompanied by an assistant who carried a bucket which contained so-called disinfectant powder. This powder was sprinkled around in the evil smelling back yards and urinals which abounded at the time. It had the temporary effect of smothering the smell, and it had the advantage of economy, as the powder was mainly brickdust to which some pine or other similar fluid had been added. It seemed to satisfy quite a few people and not least certain prominent local folk who were in the habit of sending periodically for a supply of this powder to "disinfect" their ashpits. (galvanised dustbins were then extremely rare). That my predecessor must have devoted some time to house repairs is almost certain, but it must have been little in extent. No records of any such inspections or indeed of any other work carried out over the previous quarter of a century were made available to me. Kingston had passed through what might have been described as a dark age. How much lighter it became in the subsequent years I leave to those to assess who were knowledgeable of the past and who may have been interested lookers-on over the course of the years. In those days the houses in St. Peter's Road, then known as Asylum Road, were let off room by room and each to a separate family. They were farmed out by the leaseholder mainly to Italian landlords who paid a rent of about 12s. weekly for each house, In turn these astute people let the rooms at rents which produced for them very handsome profits. The Italians lived in the road and were always on the spot each week to collect the rents, which was something the real owner had seldom succeeded in doing. xhis Italian colony had settled in Asylum Road when it was removed from what was known as "The Back Streets" near Kingston Bridge. Their other source of livelihood was the sale of ice-cream in Summer and roast chestnuts in Winter. Both of these commodities were prepared and stored in the houses; so were their gaudy vehicles and the animals which drew them housed on their premises, and it was a common sight to see the hind part of donkey disappearing through the front door on its way to a shed in the back yard. 13 Despite what I have written these Italian folk were much cleaner in their own rooms than most of their nomadic tenants. They were law-abiding thrifty folk, honest in business and apart from the rentals charged they were probably better landlords than the actual owners. My recollections of Asylum Road remind me of one of the biggest social changes which has taken place, hardly noticed by most folk, during the past few decades. I refer to bed-bugs and other similar vermin. Gradually, almost imperceptibly, an improvement took place and whereas it was once a common occurrence to find houses heavily infested with bugs and fleas, and persons, less frequently, with lice, it is now as rare as it was once so common. Inspection of houses under such conditions res a very unpleasant duty. The bugs had a way of dropping on to unsuspecting persons who stood in the doorways of bedrooms, and fleas seemed to welcome a change of host. My experiences of these various types of vermin are many, but the details are too unsavoury for repetition here. The work of health education (which is nothing new to sanitary inspectors, for thev have practised it in the course of their duties over many years) is doubtless responsible to a considerable degree for the remarkable improvement. The other main cause is the improvement in the general standard of living which has been equally spectacular except in the eyes of those people who persist in referring to the "good old days". It has been my lot to work amongst the people (of all classes) for the past 45 years, and I have no hesitation whatever in saying that for the labouring or working classes, as they were then known, they were not good days. In the matter of house drainage there was much to do in Kingston thirty years ago. There was no systematic supervision over, and testing of, new drainage systems. Indeed one seldom was informed of proposed works and the first intimation of drainage works was the builder's truck outside a house and the usual pipes and impedimenta associated with such work. Owners of property were reluctant to seek the help of the sanitary inspector for fear of being called upon to expend large sums of money on what they regarded as unnecessary refinements. Gradually this feeling was removed. Owners found that they were actually protected against the wiles of the ignorant jobbing man if the assistance of the sanitary inspector was sought at the outset. Not always was the result so satisfactory. I remember the occasion when a large house on Kingston Hill had to be redrained. The owner was advised to use methods which would have prevented fracture of the pipes in the event of drought causing shrinkage of the heavy clay sub-soil. The extra cost involved might have been about 8% of the cost of the works. The advice was not acted upon and a few years later, when the owner died and the estate had to be sold, the new owner required the executors to reconstruct the whole of the system under the terms of the contract for sale. In the intervening years there had occurred one of the long periods of drought. It was not only the private owner who showed reluctance to bring about improvements. It is on record that in several parts of the town sites of groups of houses were periodically subjected to floodin from foul water sewers which were laid under the private ground. The condition of these houses had to be seen to be realised. The ground around some of the houses was soaked with sewage and the atmosphere was foetid. Heavy boots and leggings (before the use of rubber boots) were essential before one could walk over the gardens. Apparently it was considered an impracticable task to remove the basic causes of the flooding and that was the reply I received when the matter was first reported. That it was a heavy task I had no doubt, but I declined to believe that it was an impossible one. The reader need not be wearied with all the details. Suffice it to say that eventually I was given authority to try to remedy these very insanitary conditions. 14 I believe there was a fear that the proposed action would involve the Corporation in considerable expense. The task proved by no manner of means an easy one. All the owners concerned were brought together and the necessary plans were prepared and laid before them. Patience and persistence brought their reward and the first area lying between the two arms of Washington Road, Norbiton, was in due course freed from this constant threat of flooding. A similar case in Elm Crescent which involved properties also in Canbury Park Road and Cowleaze Road was later dealt with in the same manner. All this work was completed without expenditure by the Corporation. I recall with pleasure the comments of the then Chairman of the Sanitary and Drainage Committee and the relief and obvious pleasure shown by the tenants of the houses. But all the difficulties which confronted a new-comer to Kingston in those early years were not limited to housing and sanitation in the popular sense. Many moons before my appointment here I had heard stories in the London Markets of the ease with which unfit meat could be disposed of in Kingston. I thought they were wildly exaggerated - until after I took up my appointment. I found that there had been no inspection of meat by the department except when the condition of the food was so bad that the butcher concerned had no alternative but to surrender it for destruction. No meat had been known to have been condemned as the result of postmortem inspections at the slaughterhouses which numbered eight or more at that time. Indeed, the occupier of one slaughtering establishment gave as his reason for refusing me admission that he had occupied the place for fifteen years and during that time no sanitary inspector, or other officer, had sought to inspect the place or his meat: In the face of strong opposition from a section of the trade it required quite a considerable amount of determination if I were to have any hope of success. I recall one very highly respected Alderman of the Corporation expressing profound concern when he realised that several tons of diseased meat had been found on various premises in the town over a period of less than one year. He wondered what had happened to similar quantities of unfit meat in previous years. The files and records contain details of much activity which limitation of space prevents inclusion here. It is true to say that today Kingston possesses a reputation second to none in the matter of disease-free foods. Whilst on this subject of food, I feel that I might with appropriate reserve, express my pleasure, which I am sure is shared by all, that this town has been spared the ordeal of a serious outbreak of food poisoning during the period of my service. Long may such a state of affairs continue. An achievement such as this is not the result of efforts by an individual. It is due in great measure to the work of educating the public and the food traders over a long number of years in this almost hackneyed subject of clean and safe food handling. It is work that has been continued without break over the past thirty years. Today we are reaping the reward and the state of the food shops in this town has received favourable mention in the national press. I am grateful to the managements and staffs of all food shops for their ready cooperation without which this town could not have reached so high a standard. Much of what has been written above will be new to the majority of the present Corporation. I crave the indulgence of those members to whom the facts were already known. The scope of the duties of the modern sanitary inspector is so wide and much of the work is of such an unspectacular character that it is not surprising that the public generally remains unaware of what is done to create and maintain a healthy environment. Of necessity many of the duties are carried out quietly and unobtrusively. l5 It is only when unfortunately something occurs which interferes with the comfort and amenities of the people, that the services rendered by the sanitary inspectors are realised and appreciated. I trust the comments I have made in this brief review and the following Report on the work of 1951 will prove of interest to your Corporation and to others who may read them. Yours faithfully, HAROLD T. PERRY. Chief Sanitary Inspector. Guildhall, Kingston-upon-Thames. September, 1952. 16 SANITARY CIRCUMSTANCES. Section C. 1. WATER SUPPLY. The town's water supply is provided by the Metropolitan Water Board who maintain constant supervision over the purity of the supply. At the end of 1950 there was only one house in the Borough known to be dependent upon a well for the supply of water for domestic purposes. During the year unsatisfactory bacteriological and chemical samples were obtained from this well supply, and at the end of the year, negotiations were taking place with the owner/occupier for the provision of a supply from the Water Board's mains. (Note - Since the end of the year your Committee very kindly gave special attention to this case which presented special difficulties. As the result, your Corporation decided to provide the house with a supply of water from the Board's mains.) Well water is used for industrial purposes at certain factories in the town. 2. DRAINAGE AND SEWERAGE. I am informed by the Borough Surveyor that the position regarding disposal of sewage remains as last year, namely, that the sewage from the Borough is pumped across the river into a sewer in the Teddington area, for treatment at the Mogden Disposal Works of the West Middlesex Main Drainage Board. This arrangement is, of course, a temporary one pending completion of the Hogsmill Valley Joint Sewerage Board's scheme for the construction of new sewage disposal works. 3. RIVERS AND STREAMS. The River Thames forms the Western boundary of the Borough and this river is under the control of the Thames Conservancy Board. The Hogsmill River, a tributary of the Thames, flows through the Borough. A section of the improvement scheme prepared by the Surrey County Council for straightening the line of the Hogsmill was completed during the year. Motor launches and houseboats on the Thames continued to provide living accommodation for many families. It does not seem likely that there will be any decrease in the numbers of folk making use of this kind of dwelling until more houses become available. Even so, life on river craft will always prove attractive to some people, and continued use of the limited mooring accommodation may be expected. 4. CLOSET ACCOMMODATION. All closets in connection with dwelling houses in the Borough are on the water carriage system. 17 5. PUBLIC CLEANSING, The Borough Surveyor is responsible for the collection, and disposal of house and trade refuse. He states that the disposal methods of burning and controlled tipping continued during January and February. On March 1st, 1951 an experimental scheme was commenced of controlled tipping into a worked-out gravel pit situate at Thorpe, in the area of the Egham Urban District Council. Refuse from this Borough and the adjoining Boroughs of Maiden & Coombe and Surbiton is transported by road to the gravel pit at Thorpe in large vehicles from a central loading point at the Kingston Refuse Destructor, Villiers Road. Approximately 10,000 tons of refuse per annum is sent from this Borough. Any excess refuse is disposed of by controlled tipping. The Corporation's refuse destructor has not operated since 1st March, 1951. During the year no complaints were received in respect of any refuse tip in the Borough. 6. SANITARY INSPECTION OF THE AREA,, The following is a tabulated list of visits and inspections which totalled 7,228:- House inspection, defects, etc., 635 Drainage 755 Reinspections and Works in Progress 3,322 Factories 352 Outworkers 31 Dairies etc. 45 Food premises 1,245 I.D.Enquiries 75 Theatres 8 Verminous premises 50 Rodent control 154 Shops Act 258 Schools ................... ........ 40 Markets 86 Miscellaneous 172 7,228 NOTICES SERVED. Informal. (a) Verbal 517 (b) Written Statutory. (a) Housing Acts Nil (b) Public Health Acts Nil NOTICES COMPLIED WITH. Informal. (a) Verbal 441 (b) Written Statutory, (a) Housing Acts Nil (b) Public Health Acts Nil 18 7. SHOPS AND OFFICES. The Shops Act, 1950 which came into operation on the 1st October, 1950, has become the main Statute controlling the arrangements for the health and welfare of shop workers. Working conditions in the majority of shops are kept up to a satisfactory standard. When change of occupier takes place or when structural alterations are proposed, the provisions of the Shops Act, 1950 are borne in mind during discussions with managements or owners. The Sanitary Inspectors are also responsible for the administration of the law relating to shop hours, including early closing and Sunday trading. Contraventions of the law have been observed in a few cases. The informal action taken proved successful. It is, however, necessary to maintain constant observation to ensure compliance with the law. This is essential in the interests of the traders themselves in order to maintain fair conditions for all. It is equally important from the Shop Assistants point of view particularly in respect of hours of work and the welfare conditions. There has, as yet, been no general inspection of office accommodation in the Borough. Individual premises are inspected as occasion demands. The general standard of offices in the town is reasonably good, and the time required for a more detailed examination can be employed more usefully in other directions. 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. 1. INSPECTIONS. Premises No. on Register Number of Inspections Written Notices Prosecutions Factories in which Sees.1,2,3,4 & 6 are enforced by the Corporation. 76 72 1 - Factories not included above in which Sec.7 is enforced by Corpn. 281 270 7 - Other premises excluding outworkers 6 10 - - 19 2. CASES IN WHICH DEFECTS WERE FOUND, Particulars No. of cases in which defects found Found Remedied Referred So. of Prosecutions To H.M. Inspector By H.M. Inspector. Want of cleanliness 1 1 - - - Overcrowding - - - - - Unreasonable Temperature. 1 1 - 1 - Inadequate Ventilation 1 1 1 - - Sanitary Conveniences (a) Insufficient 2 2 - 1 - (b) Unsuitable or defective 4 4 - 1 - (c) No ventilated space or 10bby - - - - - (d) Lighting (absence of) 2 1 - 1 - Others i 2 2 - - - PART VIII OF THE ACT. Outwork. Nature of Work No. of Outworkers. Wearing Apparel Making etc. 6 Brass and brass articles 31 Cardboard Boxes 1 38 9. CAMPING SITES. At the end of 1950, caravans, to the occupiers of which licences had "been issued, were stationed, at the following sites: Site of Nos. 22 and 23, Gordon Road (demolished houses) Rear of No. 222, Park Road. In March 1951 the licence in respect of the site in Gordon Road was withdrawn by the Corporation owing to non-compliance with the conditions laid down at the time the application was granted in September, 1950. In November 1951 an application was made by another person to station a caravan on the same site, and approval was given, subject to the same conditions as before. The land, however, had not been used as a caravan site by the end of the year. In addition to the above-mentioned licences, occupiers of caravans were also licensed to station them at the following additional sites:- 20 Rear of Nos. 10/13, Market Place, and Adjoining No. 38, Chestnut Road, When applications for licences are received there is complete co-operation with the Town Planning Authority from whom separate permission must be obtained before the sites may be used. 10. ATMOSPHERIC POLLUTION AND SMOKE ABATEMENT. There is a tendency in some quarters to discountenance the real importance of this subject. Why this course is taken it is difficult to say, more especially in view of the considered opinion of medical authorities as, for example, Dr.Peter Kerley, C.V.O.,C.B.E. In an address to a London audience he made it perfectly clear that in his opinion there is a direct relationship between atmospheric pollution and disease of the lung. There is ample evidence of the higher incidence of certain diseases in industrial areas compared with rural areas. Apart however, from that aspect of the subject, surely no well-informed person can justifiably decry this work, which aims at a cleaner, more comfortable, environment, It may be said that Greater London would soon become far less desirable as a residential area if all the efforts now being made to reduce atmospheric pollution were to cease. Smoke knows no atmospheric boundary. That which is produced in the industrial part of the East End may obliterate the sunshine in the skies of this less industrialised area if the wind is in the right quarter. Indeed this is known to occur from time to time and what a dismal picture is then presented. The Corporation of Kingston-upon-Thames is to be congratulated for the support it has given to the work of smoke abatement in the past years and for the interest which continues to be shown. In submitting this Report it should be noted that reference is made, for comparison purposes, to data covering periods other than the year 1 951. During 1951 no marked improvement was noted in the quality of the available coal either for industrial or for domestic use. It varied considerably from time to time but seldom rose above what could be described as a desirable average quality. In connection with industrial undertakings, the continued shortage of steel, and the rising costs, to say nothing about transport delays, did not tend to expedite the work of replacing steam raising plant or the supply and replacement of grit arrester equipment. But smoke abatement does not depend entirely on such matters. Attention has been directed frequently to the question of proper stoking. Unskilled stoking is an expensive way to raise steam. Not only may the consumption of fuel be raised by as much as 15% above what is necessary for the purpose, but the amount of grit and smoke will almost certainly be proportionately higher. Hence a well trained efficient stoker is an essential member of the staff. 21 In a somewhat similar way the thoughtless housewife may burn coal uneconomically. There are so many appliances available for the efficient burning of coal in domestic fires that there is really little excuse for the old fashioned method to be continued. Yet the placing of large lumps of coal on a low fire inevitably results in the formation of smoke and, regrettably, it remains a common error. The sooty smoke from the ordinary open domestic fire is a far greater menace than the gases from an industrial chimney. It is also far more wasteful, as such a fire is only up to about 25% efficient from a heating point of view, and, in addition, the soot which is produced contains valuable ingredients which are wasted. Under present difficult economic circumstances, it is essentia that all those who are in a position to assist in the reduction of atmospheric pollution should work steadily and constantly to this end. No opportunity must be lost of making the public conscious of the wastage and its attendant evil results. Standard Gauges for Measuring Deposited Matter, It should be remembered that, although standard deposit gauges are a useful means of measuring atmospheric pollution, it may be dangerous and even misleading to draw firm conclusions from the readings until the data available covers a period of at least five years. This period is necessary in order to smooth out fluctuations due to weather changes (rain, wind speed and direction) and small exceptional variations in the sources of pollution. When such a period has elapsed, it, should be possible to assess the seasonal trend and to form a more accurate estimate of the true average deposit for the Borough. In the following paragraphs references to Stations "A" "B" and "C" refer to sites of standard deposit gauges installed and maintained by the Corporation. It was pointed out in the Annual Report for 1950 that although Stations "A" and "B" lie in the same wind sector and have only slightly varying average rain-falls, viz, 2.69" and 2.48", the average deposit varied considerably - 22.19 tons compared with 12.47 tons, This fact emphasizes three points:- (a.) The deposit of insoluble solids (grit and ash, etc.) decreases rapidly with increased distances from the source. (b) The influence of wind speed on the distance over which the deposit is air-borne. (c) The known fact that deposit is less in quantity in a given area in an open space than in one closely surrounded by trees or buildings of varying height. In the last Annual Report mention was made that the British Electricity Authority had set up several stations within the Borough, but that sufficient data from the observations made at these stations was not available. Details are available now for the 10 months January/October, 1951, and they afford valuable additional information by which to assess the general position. The monthly averages for these stations show results which were to be expected, having regard to their positions in relation to, their respective distances from, the main sources of pollution. That the main area of origin of pollution is that which extends northward from the railway and which includes the Electricity Works and the Gas Works is confirmed by a reasonable interpretation of the data. It also appears to show, at least to some degree, the rain-fall and wind direction have a direct influence upon the amount of recorded deposit. Firm conclusions, however, must not be react until a longer period of observations has been completed. 22 It; is interesting to note that none of the B.E.A stations gave an average amount of deposit higher than the Corporation's Station "A"; three gave an average amount higher than Stations "B" and "C"; and one gave an average less than that of Station either "A" "B" or "C". The monthly average total solids deposited during 1951 for Station "A" was 22.19 tons - an increase over the average for 1950 of only 0.03 tons, but an increase of 1.79 tons over the figure for 1949. CANBURY GARDENS - Station "A" 1951 Deposit in Ions per sq. mile Wind Direction Rainfall in Inches Insoluble Solids Soluble Solids Total Solids No. of Observations No. of times SE - SW January 14.7 12.8 27.5* 93 42 3.09* February 25.3 15.9 41.2* 84 51 5.68* March 14.3 8.5 22.8* 93 21 2.99* April 15.1 7.6 22.7* 90 27 2.64* May 13.4 4.0 17.4 93 20 1.72 June 14.6 4.2 18.8 90 27 0.86 July 13.8 7.6 21.4 93 27 1.08 August 16.0 7.3 23.3* 93 67 2.81* September 14.8 6.9 21.7 90 49 2.66* October 9.79 3.25 13.04 93 60 0.78 November 10.77 10.77 21.54 90 49 5.94* December 9.55 5.42 14.97 93 60 2.09 Totals 172.11 94.24 266.35 32.34 Average 1951 14.34 7.85 22.19 2.695 Average 1950 13.92 8.24 22.16 2.14 * Above monthly averages of rainfall and deposit. Station "A" Comparative Table - Years 1949. 1950. and 1951 Deposit in Tons per sq. Mile Q 1949 1950 1951 Quarterly Total Cumulative Total Quarterly Total Cumulative Total Quarterly Total Cumulative Total 1st 47.52 47.52 58.81 58.81 91.5 91.5 2nd 64.65 112.17 61.99 120.80 58.9 150.4 3rd 62.03 174.10 73.20 194.00 66.4 216.8 4th 70.77 244.87 72.00 266.00 49.55 266.35 Rain ins. 19.05 25.70 32.34 23 The foregoing tables show the details for this station together with comparisons for the preceding two years. It may be noted that the total solids deposited for the year 1950 compared with 1951 vary by less than half a ton. The respective quarterly totals for the two years varied considerably, there being a heavy increase in the first quarter of 1951, probably due to the abnormally high rain-fall of 5.68" in February 1951. The middle two quarters show only slight variation.. In the last quarter of 1951 there was a heavy reduction compared with the corresponding quarter of 1950 viz:- 49.55 tons against 72.00 tons, a decrease all the more surprising in view of the fact that the rain-fall in November, 1951 was the heaviest monthly rain-fall (5.94") recorded since observations began. The following table covers three specific months and is included to demonstrate how unwise it may be to draw definite conclusions from isolated monthly data. Deposit Rain Wind Reading Applicable November 1950 21.40 5.20 27 February 1951 41.20 5.68 51 November 1951 21.54 5.94 49 The deposit at station "A" for February 1951 was the second highest ever recorded, being 41.20 tons per square mile. There was no simple explanation for this abnormally high deposit. Throughout the year the deposit of insoluble solids exceeded the deposit of soluble solids, the respective totals for the year being in the ratio of about 2 to 1. This was to be expected in view of the proximity of this station to potential sources of heavy pollution. TIFFIN GIRLS' SCHOOL - Station "B". 1951 Deposit in Tons per sq. mile Wind Direction Rainfall in Inches Insoluble Solids Soluble Solids Total Solids No. of Observations No. of times S.E.-S.W. January 4.9 8.6 13.5* 93 42 2.83* February 5.8 11.6 17.4* 84 51 4.97* March 5.9 8.4 14.3* 93 21 2.72* April 7.8 6.5 14.3* 90 27 2.52* May 5.8 6.9 12.7* 93 20 1.90 June 6.8 5.1 11.9 90 27 0.86 July 6.6 7*3 13.9* 93 27 1.09 August 3.5 7.2 10.7 93 67 2.52* September 4.1 60 6 10.7 90 49 2.57* October 5.24 4.25 9.49 93 60 0.72 November 3.45 8. 63 12.08 90 49 5.13* December 2.75 5.87 8.62 93 60 1.89 Totals 62.64 86.95 149.59 29.72 Average 1951 5.22 7.24 12.47 2.48 Average JulDec.1951 4.27 6.64 10.91 2.32 Average JulDec.1950 5.27 9.71 14.98 2.28 * Above monthly averages of rainfall and deposit. 24 Station "B". Q. 1951 Quarterly 'Total. Cumulative Total 1st 45.2 45.2 2nd 38.9 84.l 3rd 35.3 119.4 4-th 30.19 149.59 This station was established in July 1950 and true comparison can be made only for the periods July/December in the two years 1950 and 1951. The year 1951 shows a considerable reduction in the monthly average deposit, although the rain-fall and wind readings varied little compared with the figures for 1950. At this station the deposit of soluble solids exceeds that of insoluble solids for 9 months of the year, the totals being in the ratio of 7 to 5 - a reversal of the relationship at station "A". This again was expected9 in view of the position of the gauge on the roof of a building in a large open area. CEMETERY - Station "C". 1951 Deposit in Tons per sq. mile Wind Direction Rainfall in Inches Insoluble Solids Soluble Solids Total Solids No. of Observations NO. of times SE - SW. January 3.2 6.6 9.8 93 31 2.82* February 5.1 7.9 13.0* 84 8 5.2 8* March 7.0 6.3 13.3* 93 22 2.71* April 8.1 5.1 13.2* 90 18 2.48 May 7.4 6.4 13.8* 93 8 1.91 June 7.5 5.8 13.3* 90 16 0.89 July 7.8 6.6 14.4* 93 51 1.15 August 4.0 7.4 11.4 93 20 2.84* September 5.2 9.3 14.5* 90 10 2.77* October 5.80 4.15 9*95 93 15 0.72 November 3.57 7.51 11.08 90 9 5.28* December 2.34 4.30 6.64 93 10 1.86 Totals 67.01 77.36 144.37 30.71 Average 1951 5.58 6.44 12. 03 2.56 Average JulDeC.1951 4.78 6.58 11.33 2.64 Average JulDec.1950 5.57 8.77 14.34 2.33 * Above monthly averages of rainfall and deposit. ATMOSPHERIC POLLUTION 1951* CHART I 25 26 Station "C". Q. 1951 Quarterly Total Cumulative Total 1st 36.1 36.1 2nd 40.3 76.4 3rd 40.3 116.7 4th 27.67 144.37 As in the case of station "B", this gauge also was installed in July 1950 and so comparison can he made only between the half-years July/December in 1950 and 1951. Again 1951 shows an increased deposit over 1950: the rain-fall and wind readings showed little variation. The wind readings applicable to this station are those between W. and N.N.W. and these are always considerably less in number than the appropriate readings for stations "A" and "B", which are affected by other wind directions. It seems reasonable to infer that the increase in total deposit at this station during the second and third quarters of 1951 was due, in some measure, to the building operations at the Crematorium. There is less difference between the amount of soluble and the insoluble solids (77.36 tons:67.01 tons) than at either station "A" or "B". GENERAL. For stations "A", "B" and "C" the summarised figures for 1951 are:- A B C Total Deposit 266.35 tons 149.59 tons 144.37 tons Monthly average deposit 22.19" 12.49" 12.03" Total Rainfall 32.34 ins. 29.72 ins. 30.71 ins. Monthly average rainfall 2.69" 2.48" 2.56" Chart I is a histagram showing the data for stations "A", "B" and "C" during 1951. 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 during the winter season it was converted for use as a hall for concerts, dances, balls, etc. (b) Private. There are no privately owned swimming baths or pools open to the public in the Borough. 27 12. ERADICATION OF BED BUGS. During the year 26 premises were disinfested, compared with 34 for the previous year. Nine Corporation controlled houses were dealt with by the Department during the year. The continued diminution of the number of premises found to he infested by the bed bug is a pleasing feature of the post-war period, 13, COMPLAINTS. The number of complaints received during the year under review was 636 - slightly fewer than in 1950, when 671 various complaints were recorded at the office. There was again a slight increase in the number of complaints regarding rats and mice. It is likely that this increase reflects the increasing co-operation between the public and the Department, The knowledge that rat and mouse infestations in connection with domestic premises are treated free of cost is becoming more widespread. Alleged overcrowding was the subject of complaint in nine instances compared with six during 1950. It is often found, however, that these complaints are ill—founded and are made in order to gain support for a request for Corporation owned accommodation. An inspection follows the receipt of every complaint and, in fact, in only three of the nine cases was there actual overcrowding. The standard for overcrowding is laid down by the Housing Acts, The "Permitted Number" i6 calculated on the number, and size, of the rooms in the house. Regard must be had to all living rooms as well as bedrooms a fact not always appreciated by the public. It may happen that children share a bedroom with their parents and this fact is often the basis of a complaint of alleged overcrowding. Full use must be made of all rooms whether or not they were originally intended for use as bedrooms. This standard of overcrowding is not easily defended' but it must remain the only legal standard until such time as the Housing Act is amended. These comments have been made because one often hears exaggerated statements regarding the extent of overcrowding in the Borough, In point of fact there is very little actual overcrowding, but there may be some discomfort and inconvenience by reason of the enforced use of rooms as both living and sleeping accommodation. The following is a brief tabulated list of causes for complaints received during 1951. Sanitary Defects 228 Rodent Infestation 180 Defective Ashbins 8 Drainage and Sanitary Arrangements 80 Overcrowding 9 Food (quality, soundness, etc.) 32 Smoke & Grit Emission 10 Miscellaneous 89 636 24. RODENT AND INSECT PEST CONTROL. The Prevention of Damage by Pests Act, 1949, which came into force on the 31st March, 1950, has now had its first complete year of working. Although the Act gave much wider powers to local authorities, there have been few prosecutions under the Act throughout Greater London, and none in this Borough, The happy and satisfactory relationship which exists between the traders and public on the one hand and the Department on the other has been maintained. It is this good feeling which makes any form of statutory action seldom necessary. There is complete liaison with local authorities in adjoining areas and also with private servicing companies holding a few local contracts. By constant survey and inspection every care is taken to prevent any serious build-up of rodent infestation. The protection from rodent contamination of foodstuffs is no light task and considerable time is taken up in advisory work of this nature. That it is successful is reflected in the rare incidence of rodent contamination as a cause for food condemnation in the town. A very careful and systematic control of rodent infestations in sewers is maintained. The experience gained during the years, has made it possible to locate infested sections of sewers with comparative accuracy, and the least possible expenditure of labour and materials. During 1951 approximately 300 sewer manholes were baited. During the course of the work, matters calling for further investigation and action came to light. For example the rodding eyes on 36 sewer connections were found to be without suitable caps, thus permitting free egress for rodents and sewer gas to the house drains. Quite often, evidence of the presence of rats is the first indication of a defect in the drainage system or in a near-by sewer. It is not unknown for the surveys to bring to light old sewer connections which had once been sealed off with pieces of wood which in the course of time had rotted aways thus leaving open doors for rodents. The assistance placed at the disposal of the local authorities by the Rodent Control section of the Ministry of Agriculture and Fisheries is much appreciated. The research laboratory is located at the Tolworth Department of the Ministry, and the staff there is always willing to give assistance and to consult with your officers if and when, difficulties arise. Rodent Control - Statistical Statement,1951. Private Dwellings. Rats Mice Total No, of complaints received in office 168 " " premises inspected as a result of these complaints 587 " "premises found to be infested 257 58 315 " " separate infestations treated 248 70 318 " " visits for treatment and reinspections 1751 192 1943 In addition, over 800 premises were inspected in connection, with routine surveys. 29 Rodent Control - Statistical Statement (Contd.) Business Premises. No. of complaints received in office 12 " " premises inspected, including those under service agreement 129 " " premises in which slight infestations were found 67 48 115 " " Visitors for treatment and reinspections 1330 2060 3390 SUMMARY No. of complaints received 180 " " premises inspected, approx. 1580 " " premises infested 430 " " visits for treatment and reinspections 5333 Insect Pest Control. The main portion of this work is in connection with food premises, which afford many opportunities for insects to harbour in corners and crevices of counters, shelves, etc. Less often infestations occur at private houses. The Department is always willing to assist occupiers with advice on the identity of strange insects which may be found on their premises and also on the best methods for the extermination of the pest So When an insect cannot be identified by the local department the aid of the Entomologist at the Natural History Museum is sought. He has never failed to supply the required information together with the best means of control, and all in the course of a post or two. The staff for insect pest control is the same as that for rodent control work. This system is economical in practice and it enables the best possible service to be made available for the public. HOUSING Section D The housing position remained much the same during 1951. The Corporation continued the building of new flats, the majority of which were erected outside the Borough, but there did not appear to be any noticeable diminution in the number of families seeking separate accommodation. Touching the matter of house repairs, the cost remained very high. In the case of houses subject to the early Rent Controls, the costs were such as to prohibit any substantial repairs being carried out. One can add nothing to what was written in previous Reports on this problem of repair of old houses. It is encouraging to note the increased interest in the matter which has been evinced in the national and technical press. It is to be hoped that some constructive action will be taken at a high level before it is too late to save some of the houses which are deteriorating so rapidly. 30 One cannot help feeling that the time has arrived when some at least of the new properties should be made available for occupants of old worn out houses. If this course were to be followed it should be possible to provide new accommodation on some of the cleared sites in the Borough. Such procedure would serve to remove the sense of frustration which is possessed by tenants of old properties who have had none of the modern conveniences and appliances provided for new-comers in the new houses. A gradual clearance of old houses could thus be accomplished. Housing - Statistical Statement - 1951. The following information has been supplied by the Borough Surveyor No. of Dwellings erected by private enterprise during 1951. Houses, New construction 5 War damage - rebuilt 1 By conversion of existing houses into flats.13 Total number of working class permanent dwellings erected by the Corporation since March 1924 to 51st. December 1951. New Construction. War Damaged. Houses 1035 4 (Inc. 774 outside Borough) Flats 576 3 (inc. 221 outside Bo rough) Total No. of temporary dwellings erected up to 51st.December. 1951 Arcon - 132 Aluminium - 70 2 year Huts - 126 328 No. of 2 year Huts demolished during-.1951. - 4 INSPECTION AND SUPERVISION OF FOOD Section E (a) Milk Supply. All milk supplies in the town are brought in from outside sources of supply, there being no milch herds in the. Borough. All known sources of supply are regularly sampled. the quality generally has proved to be satisfactory. So far as is known, all the milk supplied to Kingston residents is pasteurised, but. a small amount of untreated tuberculin tested milk is sold in the Borough. the rest of the raw milk which enters the Borough is pasteurised in local dairies before delivery to consumers. 31 There appears to be a tendency for an increase in the use of sterilised milk. This type of milk has not been in any considerable demand in Kingston during past years, but there were signs of an increasing demand towards the end of the year. On the 1st. October, 1951, the Milk (Special Designations) (Specified Areas) Order, 1951, came into force. The effect of this Order was to make it illegal in specified areas to sell, by retail for human consumption, any milk not tuberculin tested, or pasteurised, or sterilised. The Borough of Kingston formed part, of Specified Area No.1. (b) Designated Milks. The following table shows the number and type of licences issued by your Corporation during 1951, 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 e- - To Deal 5 7 5 Supplementary 8 9 5 (c) Bacteriological Examination of Milk, During the year 1951, 91 samples of milk were sent to the Public Health Laboratory at Epsom for examination. The total of 91 was made up as follows:- Pasteurised 68(++) T.T.(Pasteurised) 2l Sterilised 1 Ungraded Milk 1 ++ two of these samples failed the Methylene Blue Test. Four samples were found not to be properly pasteurised. These samples were taken from bulk supplies at the place of delivery under contract to a local Home. The matter was taken up with the Suppliers. Subsequent samples proved to be satisfactory. (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 112. In addition to these registered dealers, ice cream is sold on 38 other premises which do not require to be registered (restaurants, canteens, cinemas, etc.) The majority of retailers in the town obtain supplies of ice cream from producers whose premises are outside Kingston. 32 Bacteriological Examinations. The following table shows the results of tests of 109 samples submitted to the Public Health Laboratory at Epsom during 1951. Grade I II III IV Total Ice Cream 64 33 9 3 109 The classification of the samples must be considered as satisfactory, over 60% falling within Grade I, and the number in Grades I and II together forming 89% of the total number of samples. Grades I and II are considered to be quite satisfactory. The sale of loose ice-cream in the open air has been discouraged, it being felt that contamination was more likely to -cake place when this type of ice-cream was sold. No exception is, of course, taken to the serving of loose ice-cream inside pranises, where facilities exist for the proper cleansing of the necessary utensils. It is found that most traders who sell ice-cream from 'mixed business' premises, prefer to market the ice-crean as a wrapped commodity, rather than to have the trouble inherent in the sale of ice-cream in cones, wafers, etc. The latter method makes the provision of sterilising equipment necessary and also the more frequent washing of the hands. (e) Meat and Other Foods. (i) There are no licensed slaughter-houses in the Borough. The Ministry of Pood Meat Depot in Wood Street continued as the distributing centre for meat sold in Kingston, Esher, Surbiton, Wimbledon, Richmond, Maiden & Coombe, and Barnes. Daily visits are made to the Meat Depot and routine inspections are carried out. Once again the conditions under which meat is transported remained a source of concern to the Local Authority during the year. As is known, the Ministry of Pood does not accept direct responsibility for the transport arrangements, the work being contracted out to transport firms and there is a large measure of variation in the suitability of the vans employed for the purpose. It was understood that further protests about the uncleanly condition in which meat is sometimes delivered to the retailers were made by the London Retail Meat Traders' Association. The Association requested that more adequate protection by way of clean wrappings around the meat should be provided until more suitable delivery vehicles are available. (ii) Foodstuffs condemned as unfit. The following tabulated statement shows the amounts of various foods which were condemned during the year and the causes for condemnation. the list is very much condensed so as to avoid unnecessary detail. The total amount of offal condemned during the year was 1,563 lbs. 33 Tabulated List of Condemned Foodstuffs showing cause for Condemnation and the Weights. Article of Food, Reasons for Action. Weight, lbs. Raw Meat Bovine Ovine Porcine Decomposition Disease Contaminat ion Decomposition Disease Contamination Decomposition Total weight Raw Meat 554½ 199¾ 77 651¾ 75½ 831¼ 657¼ 75 1563½ Raw Fish. Decomposition 703 Poultry, Game, etc. Geese Turkey Ducks Decomposition „ „ 171 14,316 3 14,490 Fresh Fruit Decomposition 756 Dried Fruit Insect Infestation 58 Canned Goods Meat ) Fish ) Vegetables & ) Soup ) Milk ) Fruit & Jams ) Others Damaged, punctured, blown, decomposition 6,302½ 245¼ 783¼ 15¾ 3,579 9½ 10,9340¼ * Food in Glass Containers, Sauces pickles paste, etc., Fruit Preserves Beverages ) Glass contamination, ) mould, deterioration. 38¼ 43¾ 114 3 199 Packet Foodstuffs, Cheese Fat Miscellaneous ) Contamination, Insect ) Infestation 100½ 39 453 592½ Sweets Contamination 1° 627 Shell Eggs 5,182 (Number) (f) Food Hygiene. The year 1951 saw a continuation of the efforts which have teen made more particularly in the post-war years further to improve the standard of cleanliness in restaurant and hotel kitchens,, It is pleasing to report that the spirit of cooperation which has manifested itself amongst Kingston traders since the Corporation "began to press for improvement in the condition of premises in 1945 continued throughout the year. 34 A big problem for the managements and proprietors of catering businesses was the frequent change which took place in personnel of kitchen staffs. These frequent changes make the maintenance of the high standard of hygiene more difficult than it would otherwise be as new staff has to be trained in the correct methods of food hygiene. the Sanitary Inspectors have, at all times, been willing to offer helpful advice on problems which have arisen in food establishments. During the year lectures and film shows were given by the Sanitary Inspectors to the staffs of certain food premises. It is believed that this method of disseminating infonnation assisted in making many of the persons concerned more aware of the important place they occupy in the team working for clean foodo. The Clean Pood Bye-Laws have proved a useful addition to food legislation. In particular the bye-law which requires foodstuffs to be protected from contamination by dust, dirt, flies, etc. and the Bye-Law which requires the name and address of the vendor to be legibly exhibited on stalls and vehicles have proved very helpful. 1951 was the first full year in which the Bye-Laws were in force in the Borough and they have proved of material assistance in the clean food campaign. FOOD AND DRUGS ACT. 1958 Adulteration - During the year 121 samples were submitted to the Public Analyst for examination. The following table (S1) shows the number and type of samples, also the number adulterated, or otherwise not genuine. Action taken in respect of the latter samples is shown in Table (S2) Table S.l. Tabulated Stasment of Samoles submitted to the Public Analyst during 1951 Commodity No .of Samples Gerruine Not Genuine Formal Informal For- Informal mal For- Informal mal Apple Puree - 1 - - - 1 Baking Powder - 1 - 1 - - Bread - 1 - - - 1 Confectionery - 1 - 1 - - Crisps, Potato — 2 — 2 - - Grape Juice — 1 - 1 — — Ice Cream — 11 — 11 — Jam (Plum) — 1 — 1 — — Jelly, Table — 1 — 1 — — Milk 14 45 1! 42 3 3 Milk (Channel Island) — 4 — 3 — 1 Paste, Meat — 1 — 1 — — Pepper (flavoured) — 1 — 1 — — Pepper, white _ 1 — 1 — — Salad Cream — 1 — 1 — — Sausage — 1 — — — 1 Sausage, Beef 8 4 — 3 1 1 Sausage, Liver — 1 — 1 — — Sausage Meat, Beef 5 — 5 — — — Sausage, Pork 7 3 5 3 2 — Sausages, Pork (Preserved) 2 — 2 — — — Soft Drink 2 — 2 — — — Vegetable Concentrate Tonic — . 1 — - — 1 Totals '38 83 32 74 6 9 35 Table S.2 Sample No. Formal Informal Commodity Nature of Adulteration Action Taken 1122 Milk Deficiency of 4% of non-fatty solids An informal sample followed by 2 formal samples as follow-up action, 1133 Milk Deficiency of 5% of fat. One of 2 formal follow-up samples. (Warning letter sent) 1149 1150 Milk Milk Deficiency of 7.6% of fat. Deficiency of 1.3% of fa. At request of wholesale dairy company twelve check samples obtained on delivery at dairy. Samples 1149 and 1150 formed part of one consignment in four churns, deficiency of milk fat in whole consignment being 2.33% Warning letter sent to producer concerned 1123 Milk Deficiency of 5% of fat. An informal sample of Channel Islands Milk, Follow-up sample proved satisfactory. 1172 Milk Deficiency of 2% of non-fatty solids There was no evidence of added water and, the fat content being 6.11%, no further action was deemed necessary. 1094 Beef Sausage Meat content, 10% deficient Formal follow-up sample (No.1107) reported genuine. 1109 Pork Sausage Meat content 29.23% deficient Reported to Ministry of Food for action under Meat Products & Canned Meat (Control & Max. Prices) Order, 1948 as am ended. Defendant fined £15 and 7 guineas costs. 1110 Beef Sausage Meat content 16% deficient Reported to Ministry of Food for action under Meat Products & Canned Meat (Control & Max. Prices) Orderj, 1948 as amended. Defendan t fined £10 and 7 guineas costs. Contd. 36 Sample No. Commodity Nature of Adulteration Action Taken Formal Informal 1111 Milk Deficiency of 1% of non-fatty solids. Follow-up sample (No. 1119) reported genuine 1116 Bread Contaminated by solid excreta of cat. Legal proceedings instituted. Two defendants, each fined £10. Costs 3 guineas. 1117 Apple Puree Contained high proportion of sandy matter, also tin. Stock sur rendered by retailer and destroyed. 1179 Beef Sausage Meat content deficient. Reported to Ministry of Food for action under Meat Products & Canned Meat (Control & Max.Prices) Order, 1948, as amended. Ministry issued warning letter to producer/retailer. 1198 Pork Sausage Meat content 30.76% deficient. Sample taken from canteen, following complaint of taste. Formal sample not obtained as source of supply to canteen was changed. Local authority in whose district the sausages were manufactured was informed of facts. 1095 Vegetable Concentrate Tonic Labelling offence Contents not declared in terms of Labelling of Pood Order, 1950• Attention of manufacturers was drawn to the requirements of the Labelling Order. MERCHANDISE MARKS ACT. 1926 The Marking Orders made under the above Act, with one or two exceptions, came into force again from the 25th. May, 1951. During the war, the Ministry of Pood had suspended the Marking Orders relating to certain rationed food stuffs. All traders concerned were circularised and given full information regarding their responsibilities. There was a gratifying response from the traders and up to the end of the year 1951 it had proved necessary to institute proceedings in only one case, viz:- for the non-labelling of imported tomatoes. CONCLUSION When re-reading the previous pages, including the introduction, my mind would persist in recalling the words of Kipling (The Piles, - The Five Nations), The following is an adapted and slightly amended extract:- "So they catch the eye in running through the files. For their epoch-marking actions see the files. Who remembers Thirty-odd-year old Septembers? Only sextons paid to dig among the files You must hack through much deposit Ere you know for sure when was it Tis a sure and sovereign balm Unto a philosophic calm, When you marvel at your lateness In apprehending facts so plain to others When your Imp of Blind Desire Bids you set the Thames afire, You'll remember men have done so - in the files You've a better chance to guess At the meaning of Success When you've seen it in perspective in the files. Nothing now remains but for the last time to express my sincere thanks to the Chairman of the Public Health Committee, Alderman Dr. E.H.R. Oldfield, and the Members of "Che Committee and the Corporation generally. My thanks are offered also to my fellow officers for their co-operation; and finally to all my colleagues in the Department, without whose unremitting efforts this brief record of a year's work could not have been compiled. HAROLD T. PERRY. Chief Sanitary Inspector. 38 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 (Acute Poliomyelitis includes Acute Polioencephalitis) During the year Leprosy was made notifiable by General Medical Practitioners to the Chief Medical Officer of the Ministry of Health. In 1951 a total of 763 notifications of infectious disease was received, compared with 272 in 1950. This increase is due to greatly increased number of notifications of measles, and whooping cough, but a general improvement over last year is apparent in respect of other notifiable disease, such as scarlet feverj, pneumonia, and poliomyelitis, notifications of which were reduced in number. The following "table gives an analysis of the cases into age groups. NOTIFIABLE DISEASES DURING. 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 35 - 45 45 - 65 65 & over Total cases notified Cases admitted to Hosp. Under 1 year 1-2 2-3 3-4 4-5 / 4 5-10 10 - 15 15 - 20 20 - 35 35 - 45 45 - 65 65 & over Total Scarlet Fever - - 1 2 5 24 2 1 2 - - — 37 21 — — — — — — — — — — — — — Diphtheria — — — — — — — — — — — — — — — — — — — — — — — — — — — Enteric Fever including Paratyphoid — — — — — — — — — — — — — — — — — — — — — — — — — — — Acute Poliomyelitis: Paralytic. — — — — — — — — — — — — — — — — — — — — — — — — — — — Non-Paralytic — — — — — — — — — — — — — — — — — — — — — — — — — — — Acute Infective Encephalitis — — — — — — — — 1 — — — 1 1 — — — — — — — — — — — — — Meningococcal Infection 1 — — — — — — — — — — — 1 1 — — — — — — — — — — — — — Puerperal Pyrexia — — — — — — — 6 28 7 — — 41 40 — — — — — — — — — — — — — Ophthaimia Neonatorum — — — — — — — — — — — — — — — — — — — — — — — — — — — Pneumonia 1 — — — — — — — 1 1 — 1 4 2 — — — — — — — — — — 3 39 42 Erysipelas — — — — — — — — — _ 1 — 1 — — — — — — — — — — — — — B. Dysenteria(Sonne) 1 — — 1 — 1 1 — — — — — 4 3 — — — — — — — — — — — — — Measles 3 47 62 79 62 176 5 1 5 2 1 — 443 3 — — — — — — — — — 1 — — 1 Whooping Cough 9 25 32 33 34 83 3 1 2 — — — 222 — — — — CM • — 1 Chickenpox — 1 1 — — 2 — — — — — - 4 4 — — — — — — — — — — — — — Food poisoning — 1 — — — — — — — 1 3 — 5 1 — — — — — — — — — — — — — totals 15 74 96 11.5 101 286 11 9 39 11 5 1 763 76 - — — — — — — — — 1 3 39 43 39 40 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 1922 1 238 74 1 6 - Not notifiable until 194*-) - - Not notifiable until 1940 - - - 1923 1 118 17 2 5 - - 1924 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 1951 •• 37 41 - 443 222 1 - Scarlet Fever, Thirty seven cases of mild scarlet fever were notified, thirty four of which were of school age. No deaths occurred and no "return" cases. Twenty one of the cases notified were removed to an infectious diseases hospital for treatment and the remainder we re treated at home. Diphtheria. No cases of diphtheria were notified, for the fourth successive year. Intensive work was continued to immunise the school and Pre-school population against diphtheria, and the table on the following page shows the stage reached by the end of 1951- It is intended to continue with a vigorous immunisation campaign to prevent any possible diminishing of public interest in this service, occasioned four 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. 41 DIPHTHERIA IMMUNISATION TABLE VII Conmarative Statement for the Years 1949. 1950. and 1951. (Provided by Dr. W.H.Kinstrie) No. completely immunised Year of Birth 1949 1950 1951 1951 — - 35 1950 - 38 376 1949 43 474 539 1948 453 471 484 1947 602 578 575 1946 540 544 571 1945 423 482 503 1944 455 448 461 1943 423 420 503 1942 409 401 407 1941 384 380 382 1940 403 415 397 1939 384 379 409 1938 377 375 343 1937 379 374 359 1936 367 366 1935 322 0-4 Ace Group. Total number completely 2061 percentage 64.7 Immunised as at 31.12.1949 1949 as at 31.12.1950 2105 " 1950 65.0 as at 31.12.1951 2009 " 1951 65.5 5-15 Ace Group. Total number completely 1949 88.0 Immunised as at 31.12.1949 3903 percentage as at 31.12.1950 4040 „ 1950 88.0 as at 31.12.1951 4335 1951 98.0 Record of work done at Diphtheria Immunisation Clinics 194? 1950 1951 Total number of clinics held 97 98 96 Number completely immunised 545 415 363 Number of Schick Tests 1357 1172 1494 Number of Positive Schick Tests and Re-inoculations 134 84 82 Total Attendances 3791 3204 3681 Average Attendances 40 32 38 4 2 Poliomyelitis. No cases were recorded during 1951. Acute Infective Encephalitis. One case was recorded during 1951 in respect of a young woman. There is no history of preceding infection or of associated cases. Enteric Fever (Typhoid or Paratyphoid). No cases of typhoid or paratyphoid B were notified during 1951. This is the fourth successive year in which no cases of typhoid or paratyphoid fever were notified. Measles. There were 443 cases of measles notified during 1951 (compared with 132 in 1950), of whom three only were removed to hospital. Generally speaking the illness was of a mild type with little by way of complications, but in one exceptional case a fatal rare complication occurred in a woman aged 39 years. The 1-5 year age groups contained the largest number of notifications (250) the majority of the remainder being spread over the 5 - 10 year age period (176), and only 17 at other ages. Ophthalmia Neonatorum. No cases were notified during 1951. This is the fourth successive year in which we have had no cases of ophthalmia neonatorum notified. Puerperal Pyrexia. Forty-one cases were notified during 1951 and an analysis is shown below, together with figures for the years 1947 - 1950 for purposes of comparison. Fourteen of the cases were Kingston residents, and the total which shows an increase of 18 cases over 1950 reflects the effect of the Puerperal Pyrexia Regulations, 1951, which modify the definition of the disease. rhe result has been that some cases of temperature occurring in women after childbirth which would not, under earlier regulations, have been classified as puerperal pyrexia, now come within that heading and are notified as such. Your Medical Officer has been in consultation with the Physician Superintendent of Kingston Hospital, where 40 of the above patients were confined, and is able to affirm that the increased number of cases does not indicate a higher prevalence of the disease, or lack of suitable precaution. Cases 1947 1948 1949 1950 1951 28 30 29 23 41 (b) Number included in (a) of (i) Kingston residents 6 9 4 8 14 (ii) Extra District Residents 22 21 25 15 27 (c) Number included in (a) notified from Kingston 27 29 28 21 40 (d) Number included in (a) notified by private doctors 1 1 1 2 1 (e) Number of cases included in (d) removed to hospital other than those included in (c) - - - - - 43 Food Poisoning. A total of five cases of food poisoning was notified during 1951 compared with one case in 1950. In two of the cases, which were not connected with each other in any way, salmonella organisms were isolated from specimens of faeces. This type of organism is a common food poisoning agent, but the fullest enquiries did not reveal evidence implicating any particular food. The three remaining cases were in one household; here again no particular food could be traced as the source of infection, and all the laboratory tests undertaken on specimens of faeces from the patients were negative of any organism that could have caused the illnesses. Thus, although five cases were notified, it was not possible to verify a food as the cause. 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 1941 - 1951 (inclusive) Year Cases Notified Deaths Respiratory Non Respiratory Total Respiratory Non Respiratory Total 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 1951 38 9 47 12 1 13 (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 1951 and the preceding four years is as follows 1947 1948 1949 1950 1951 1; 7 1: 24 1: 11 1: 6 1: 3 The Regional Hospital Board Mass Radiography Unit visited Kingston during the year and was attended by 5,843 persons. A total of 18 cases of active pulmonary tuberculosis and 183 cases of inactive pulmonary tuberculosis were discovered, together with 193 non-tuberculous abnormalities. Since the mass radiography service is available to all the above figures do not all necessarily relate to Kingston residents, and no increase in the number of cases notified during 1951, as compared with 1950, occurred. 44 NOTIFIED CASES OP. AND DEATHS FRCM. TUBERCULOSIS IN 1951. TABLE VIII NEW CASES DEATHS Under 1 year 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 4 9 6 4 - 2 26 - - - 1 1 3 - - 2 7 F. - - - 4 3 2 1 1 1 12 - - - 2 - - - 3 - 5 Total - - 1 8 12 8 5 1 3 38 - - - 3 1 3 - 3 2 12 (b) Non-Respiratory M. - 1 1 - 1 - - - - 3 - - - - - - - - - - F. - - 1 3 - 1 1 - - 6 - - - 1 - - - - - 1 Total - 1 2 3 1 1 1 - - 9 - - - 1 - - - - - 1 45 During 1951 no action became necessary under the Public Health (Prevention of Tuberculosis) Regulations, 1925, or Section 172 of the Public Health Act, 1936. Very close co-operation is maintained with the Kingston and District Tuberculosis Care Committees, 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 tuberculous 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 to the bread-winner it is a very serious matter for the family and puts a great 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 1951 157 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 £1193 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 1951 showed a slight decrease over 1950, and no special difficulties were encountered. The incidence of scabies is at a satisfactorily low level. The following tables show the number of persons treated during the year 1951 and the six preceding years. Cases of Scabies and Contacts Treated. Year No. treated Total cases 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 1951 13 18 31 46 Analysis into Ace Groups of Cases and Contacts Treated Year Males Females Under 5 Years 5 yrs. to 15yrs. Over 15 Years Under 5 Years 5 yrs. to 15yrs. Over 15 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 1951 4 7 4 3 6 7 Infestation by head lice During 1951 there was no evidence of special incidence of infestation by head lice. D.D.I, preparations were used in addition to the usual cleansing by water and soft soap or shampoo. It was not found necessary to take any statutory action for infestation by lice during the year.