Royal Borough of Kingston-upon-Thames ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1954 GUILDHALL, KINGSTON-UPON-THAMES JUNE, 1955 Royal Borough of Kingston-upon-Thames ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1954 GUILDHALL, KINGSTON-UPON-THAMES JUNE. 1955 ANNUAL REPORT 1 9 54 TABLE OF CONTENTS Preface Page Constitution of the Public Health Committee 1 Staff of the Public Health Department.1 SECTION A Statistics and Social Conditions (1) General Statistics 2 (2) Social Conditions 2, 3 (3) Extracts from Vital Statistics of the Year:- (a) Live Births3 (b) Still Births 3 (c) Deaths - Total4 (i) Death Rate - Total 4 (ii) Maternal Death Rate4 (iii) Infant Death Rate - Quinquennial Infant Mortality Rate - Causes of Death of Children under one year 4, 5 (iv) Deaths from Other Causes6 Introduction to Tables on Vital Statistics. 6 Table I - Extracts from Vital Statistics for years 1950 - 1954 inclusive 7 Table II - Comparison of Vital Statistics 1925 - 1954 8 Table III - Birth Rates,, Death Rates in the year 1954 9 Table IV - Causes of Death. 10 SECTION B General Provisions of Health Services (1) (i) Public Health Offlcers11 (ii) Laboratory Facilities 11 (iii) Ambulance facilities11 (iv) Hospitals:- (a) Infectious Diseases11 (b ) Smallpox 12 (c) General 12 (2) National Assistance Act,1948 12 National Assistance (Amendment) Act, 195112 SECTION C Sanitary Circumstances (l) Water Supply 13 (2) Drainage and Sewerage 13 (3)Rivers and Streams 13 (4) Closet Accommodation13 (5) Public Cleansing14 (6) Sanitary Inspection of the Area14,15 (7) Shops 15 (8) Factories Act, 193715,16 (9) Camping Sites 17 Page (10 )Atmospheric Pollution 17,18,19 (11)Swimming Baths and Pools20 (12)Eradication of Bed Bugs 20 (13)Complaints20 (l4)Rodent and Insect Pest Control 20,21,22 (13 )Rag Flock Act 22 SECTION D Housing General 22,23,24 SECTION E Inspection and Supervision of Food (a)Mi1k Supply 24 ( b )Designated Milks 24 (c) Bacteriological Examination of Milk 25 (d)Ice Cream 25 (e) Meat and other Foods 25,26,27 (f) Food Hygiene27 Food and Durgs Act, 1938 27,28 Tabulated Statement of Samples Submitted to the Public Anslyst during 1954 28,29 Merchandise Marks Act,1926 29 SECTION F Infectious Diseases Notifiable Diseases 30 Table V - Notifiable Diseases during 1954 31 Table VI-Comparative Statement of Notifications of Certain Infectious Diseases 32 Scarlet Fever 32 Diphtheria 33 Poliomyelitis 33 Acute Infective Encephalitis 33 Enteric Fever (Typhoid and Paratyphoid) 33 Measles 33 Whooping Cough 33 Ophthalmia Neonstorum 34 Puerperal Pyrexia 34 Food Poisoning 34 Tuberculosis 34,35,37 Table VII-Notified Cases and Deaths from Tuberculosis in 1954 36 Scabies 37 Infestation by Head Lice 37 PREFACE TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE ROYAL BOROUGH OF KINGSTON-UPON-THAMES. ANNUAL REPORT . 1954. 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 1954. The Report follows a similar pattern to that for previous years, gives information on essential matters affecting the Public Health, and is in accordance with Ministry of Health Circulars 42/51, and 1/54. I am indebted to Mr. G.C. Smith, Senior Sanitary Inspector, and Mr. M.E. Powell, Chief Clerk, for much help in drafting and compiling the Report. Population - The estimated mid 1954 home population given by the Registrar General is 39,l60 an estimated decrease of 780 persons compared with 1953. This figure is the resident night population, and has been used for the calculation of the statistical data now presented. The actual day population has been estimated to be about 300,000 persons who congregate in the town for business, education, entertainment and recreation purposes. This is a special feature of the town and influences the volume of work and responsibility of the Public Health Department. Attention was drawn in the 1953 Report to the facts and figures published by the Registrar General and based on the 1951 Census. The most significant figure was that concerning the density of population, which for Kingston was 28.5 persons per acre (Canbury Ward 24.5: Hill Ward 33.7: Norbiton Ward 35.6: and Town Ward 24.6). This is a far higher density than for any other town in Surrey (e.g. Croydon 19.7: Wimbledon 18,1: Maiden 14.4: Surblton 12.9: Richmond 10.2). For the purposes of further comparison enquiries were made to the General Register Office for information regarding the density of population in other towns, with a population figure approximately the same as Kingston. I am very grateful for the assistance given by the General Register Office and for producing a list of 26 towns with populations from 35,000 to 45,000, and with varying densities of population, the highest of which was 15.3 persons per acre. There are changing circumstances in the population of the Borough which is to some extent a dormitory town. The level of resident population has remained remarkably constant however over the past 30 years. At the three Censuses in 1921, 1931, 1951 the respective populations were 39,514, 39,825, 40,172. At the time of the latter Census there were 1,158 females to each 1,000 males, 39% of the population were single, 52% married and 9% widowed or divorced; 68% of the population were in the age group 15-64, and 13% were aged 65 and over. There is every reason to suppose that the percentage concerning the group 65 and over has appreciably increased up to date and will continue to do so. Infectious Disease - In general the health of the people has been good. The number of infectious disease notifications received in 1954 was six higher than in 1953, and this was due to an increased incidence of measles and puerperal pyrexia. A reduction in the number of cases of scarlet fever is again recorded, and there has been a dramatic drop in the number of cases of whooping cough with the lowest figure since notification commenced in 1940. Once again, for the seventh year in succession, no case of diphtheria was 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 by the end of 1954 some 69% of the children born between 1st July 1953 and 30th June 195k have been vaccinated. Births - The number of live births for 1954 is 534 and compares with 609 for 1953 The Birth Rate is 13.64 per 1,000 of the population, compared with 15.25 for 1953. Deaths - The number of deaths recorded in 1954 is 450 compared with 465 for 1953. This makes a Death Rate of 11.49 for 1954 compared with 11.64 for 1953. The excess of births over deaths was 84 compared with 144 for the previous year. The number of deaths of infants under 1 year of age in 1954 is 11, which gives an Infant Mortality Rate per 1,000 live births of 20.60. The corresponding figures for 1953 were 15 infant deaths and an Infant Mortality Rate of 24.63. The Causes of Death - The main conditions causing death as recorded in the table for 1954 are Heart Disease 130; Cancer - 72; and Vascular Lesions of the Nervous System - 66. National attention has been drawn of late to the general increase in the number of deaths attributable to cancer of the lung, and the following table shows the relevant figures for the past five years in respect of Kingston residents. The Registrar General couples cancer of the lung with cancer of the bronchus in his abbreviated list of causes of death, but this does not detract from the interest of the figures shown below. 1950 1951 1952 1953 1954 M F M F M F M F M F 6 3 8 2 10 1 13 2 16 2 Deaths from Cancer of the lung and bronchus Total 11 Total 10 Total 11 Total 15 Total 18 Housing - During 1954 the Corporation completed 56 housing units, but all of these had to be constructed outside the Borough. A further 45 units were erected byprivate enterprise. The Borough is almost completely built up, and an indication of the density of the resident population has already been mentioned. The question of dealing with obsolete houses claims immediate attention. The time has come for the demolition of those dwellings which are incapable at reasonable cost of being made fit, and it will be necessary to prepare and submit to the Ministry of Housing and Local Government a plan for the clearance of unfit properties and for rehousing the occupants. Staff - In May 1954 the removal to other premises was finally completed in respect of the North Central Divisional staff of the Surrey County Council. Since July 1948, when the National Health Service Act 1946 came into operation, accommodation has been provided in the Guildhall for the administrative headquarters of this Division, for which your Medical Officer is the Divisional Medical Officer. With the transfer of the new Divisional Headquarters to the Health Centre, Grange Road, Kingston, finally completed it has been possible to provide adequate accommodation for the Public Health Department staff in the Guildhall. Further, the arrangement by which some officers were shared between the Surrey County Council and the Kingston Borough Council has ceased, and all members of the Public Health Department staff are now 100% in the service of the Corporation. I gladly record my thanks for the support and encouragement to me in my work, to His Worship the Mayor, Aldermen and Councillors. I specially record my appreciation of the understanding and help given by the Chairman of the Public Health Committee at all times to the Department. I also wish to acknowledge the hard work and loyal support of the staff of the Public Health Department, and the unfailing co-operation and advice of my fellow Chief Officers. I have the honour to be, Your obedient Servant, J.W. STARKEY. Medical Officer of Health. \ 1954 ROYAL BOROUGH OF KINGSTON-UPON-THAMES The Public Health Committee is responsible for the consideration of all questions affecting the health of the inhabitants of the Borough over which the Town Council mayhave jurisdiction. During the Municipal Year 1954-55 the Public Health Committee was constituted as follows:- Alderman oldfield.(Chairman) Councillor Guymer. " Digby. (Vice-Chairman) " Judge. " Lines. (Mayor) "Marshall . " Canham. (Ex-Mayor) " Mitchell. " McDonald. " Parker. " Knowlden. " Richards. Councillor Farrer. " Wakeford. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health; J.W. STARKEY, M.B., Ch.B. (Edln.)D.P.H. Senior Sanitary Inspector: G.C. SMITH, M.R.San.I., M.S.I.A. (a) (b) Additional Sanitary Inspectors: A. CLEGG, M.R.San.I. (a) (b) J.B. FACER, A.R.San.I. (Resigned l6.2.54.)(a) (b) H.W. GILES, M.R.San.I. (a) (b) L.A. PALMER, M.R.San.I. (Appointed l.4.54. (a) (b) Junior Sanitary Inspector: (vacancy) Chief Clerk: M.E. POWELL, D.P.A. (Lond.) Clerical Staff: MISS C.L. FOISTER, M.I.P.S. MRS. B.M. HILL. ø MISS V.E. NEELD. (Transferred wholetime to Surrey County Council from 1.4.54.) G. NORTHWOOD. (Called for National Service 31.12.52.) V.L. LERIGO. A.G. BELL. Assistant Rodent Officer: F.W. STAGG. (a) Certificate as Sanitary Inspector. (b) Certificate as Meat and Foods Inspector. ø Subject to a sharing arrangement with the Surrey County Council 2 SECTION A STATISTICS AND SOCIAL CONDITIONS 1. General Statistics. Area in Acres 1,390 Total Population (including Service personnel) 39,160 Number of inhabited houses (approx,) 11,651 Rateable Value - General Rate £587,605 Sum represented by Penny Rate £ 2,388 The total number of hereditaments is 14,004 of which 80% are domestic dwellings providing 51% of the gross Rateable Value of the town. The largest proportion of houses and flats fall within the £20-£30 Rateable Value group i.e. 44% 30% have a Rateable Value less than £20, and 26% a Rateable Value above £30. There are 2,207 commercial premises in the town being 16% of the total hereditaments and providing 30% of the gross Rateable Value. The remaining premises totalling 517 are classified as industrial, entertainment, public utility, educational and miscellaneous.These provide 4% of the total and produce 19% of the total Rateable Value. Acknowledgment is due to Alderman McDonald, Chairman of Finance Committee and Mr. A.R. Norris, F.I .M.T.A. Borough Treasurer, for the above information which has been obtained from the Abstract of Accounts for the year ended 31st March 1954. 2. Social Conditions. The town of Kingeton-upon-Thames is a compact commercial community bounded on the west by the River Thames, on the north by Richmond Park and adjacent at the south-west to Hampton Court Park with only the river intervening. Although largely a market town, there is an important industrial activity mainly in Aircraft and Engineerings Some 40,000 persons live in the Borough, a proportion of whom travel to London for business purposes and who are accommodated in the more residential parts of the town. Some excellent blocks of flats built by the Corporation and privately help to house this section of the community. An outstanding factor influencing the social conditions is the fact of full employment and 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. "I am happy to be able to say again that the employment position in the area is excellent and was throughout the whole of 1954, except for a short period in February when a spell of very cold weather brought the building trade to a standstill. Unemployment was low throughout the year and in the period immediately before Christmas it was as low as at any time since the War.At the beginning of the year there were 503 men and 217 women registered as unemployed but these figures had fallen to 245 men and 103 women at the end of 3 December; something less than 0.5% of our estimated working population. Broadly speaking long tern unemployment can be said to be confined to elderly persons or those suffering some physical disability. There was an unsatisfied demand for skilled labour of all types during the year and the demand is still growing; 6,100 men and 2,700 women were placed in employment in the Employment Exchange area during the year. The greatest demand on available manpower has been from aircraft, engineering and building industries. There are always vacancies for women in retail distribution, in offices and factories hut the main demand is for domestic workers in private households and institutions". 3. Extracts from Vital Statistics of the Year. The crude birth and death rates for local areas cannot properly he compared by reason of the fact that the populations on which they are based may be of widely differing sex and age constitutions. Consequently the Registrar General provides a comparability factor for each area. When the crude rate of any area is multiplied by this factor an adjusted rate is produced which can be used to compare with the adjusted rate of any other area, or with the crude death rate for England and Wales as a whole (where the comparability factor is unity). The comparability factors for Kingston are Births .95, Deaths .86, The birth and death rates in respect of the town are shown below and for the purpose of providing some comparison the Rates for England and Wales are also shown. It will be noticed that the rates for Kingston are lower than for the country as a whole. No comment need be made regarding the death rate but a comparatively low birth rate causes some concern. The number of live births recorded for 1954 in Kingston is the lowest it has been for 13 years and it should be borne in mind, when considering the birth rate, that, as has been mentioned in a previous report, there is a tendency for the younger child-producing families to be rehoused by the Corporation in houses which have been built in adjoining sanitary districts. This is a consequence of the physical features of the town and its lack of new building space, and to some extent tends to leave a population with a diminished birth rate. (a) Live Births - Total Male Female Legitimate 498 246 252 Illegitimate 36 22 14 534 268 266 Birth Rate per l,000 population (Crude Birth Rate) 13.64 Adjusted Birth Rate 13.0 England and Wales Birth Rate 15.2 (b) Still Births - Total Male Female Legitimate 13 4 9 Illegitmake 2 1 1 15 5 10 Rate per 1,000 total (live and still) births 29.14 4 (c) Deaths - Total Male Female 450 206 244 (1) Death Rate per 1,000 population (Crude Death Rate) 11 .49 Adjusted Death Rate 9.9 England and Wales Death Rate 11.3 (ii) Maternal Death Rate (deaths caused by pregnancy, childbirth, abortion). No. of Deaths Rate per l,000 total (live and still) births Nil Nil England and Wales Rate 0.69 (iii) Infant Death Rate (deaths of all infants under one year of age). Total No. of Deaths Rate per 1,000 live births 11 20.60 England and Wales Rate 25.5 No of Deaths Legitimate Infants Rate per l,000 legitimate live births 11 22.08 No. of Deaths Illegitimate Infants Rate per 1,000 illegitimate live births Nil Nil All infants under 4 weeks of age (included in above). Total No. of Deaths Rate per 1,000 live births 7 13.11 England and Wales Rate 17.7 No. of Deaths Legitimate Infants Rate per 1,000 legitimate live births 7 14.05 No. of Deaths Illegitimate Infants Rate per 1,000 illegitimate live births Nil Nil 5 The approximate infant mortality rate for 1954 and the rates since 1949 are shown for purposes of comparison. 1949 1950 1951 1952 1953 1954 Kingston-upon-Thames 20 30 24 24 24 20 England and Wales 32 30 29 27 26 25 It will be seen from the following figures that since the war ended the Quinquennial Infant Mortality Bate 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 in age groups of Kingston children who died during 1954 in the Borough before reaching the age of one year, together with the cause of death;- Age Total Death Acute Bronchitis Meningitis Tentorial tear Prematurity Atelectasis Broncho Pneumonia Asphyxia Neonatorum Congenital heart disease Hydrocephalus and Spina Bifida 0 - 24 hours 2 — — 1 — — — 1 — — 24hrs. - 1 mth, 5 — 1 — 3 1 — — — — 1 mth. - 1 yr. 4 1 — — _ — 1 — 1 1 Totals 11 1 1 1 3 1 1 1 1 1 (iv) Deaths from Other Causes. NO. of Deaths Deaths from Heart Disease 130 Deaths from Cancer 72 Deaths from Vascular Lesions of the Nervous System 66 Deaths from Circulatory Disease other than Heart 37 Deaths from Bronchitis 24 Deaths from Pneumonia 23 Deaths from Influenza 2 The following tables I, II, III, IV summarise certain vital statistics. Table I shows the figures for live births, still births, and deaths for the years 1950 - 1954 inclusive , It is noted that the number of births is the lowest since 1941 and that the number of deaths is the lowest since 1939. The number of stillbirths is high and shows a figure twice as high for females as for males. The figures in Table II are the Registrar General's estimates for successive years since 1925. They give the population, number of live births, birth rate per l,000 population, number of deaths, the death rate per 1,000 populations, and also the infant mortality rate per 1,000 live births of Kingston-upon-Thames and England and Wales. The trend of the population figure is to remain at about 40,000. Table III is largely self-explanatory and compares certain birth and death rates in England and Wales, 160 large towns, 160 small towns and Kingston-Upon-Thames. Discussion of the number of notifications of infectious disease received during 1954 in Kingston-upon-Thames appears later in this report in Section P. 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 end Causes of Death. Extract from Vital Statistics for Years 1950 - 1954 inclusive., TABLE I. LIVE BIRTHS Legitimate Illegitimate 1950 1951 1952 1953 1954 Total M. F. Total M. F. Total M. F. Total M F. Total M F. 576 41 279 19 299 22 535 39 281 21 254 18 531 45 283 22 248 23 564 45 290 24 274 21 498 36 246 22 252 14 619 298 321 574 302 272 576 305 271 609 314 295 534 268 266 Birth rate (R.G) per 1,000 pop. 14.76 14.39 l4.40 15.25 13.64 STILL BIRTHS Legitimate Illegitimate 9 4 5 11 5 6 17 4 13 18 12 6 13 4 9 2 1 1 2 1 1 - - - 1 1 - 2 1 1 11 5 6 13 6 7 17 4 13 19 13 6 15 5 10 Rate per 19000 (live and still births) 17.46 22.16 28.63 30.25 29.14 DEATHS 491 215 276 556 277 279 499 254 245 465 240 225 450 206 244 Death rate (R. G.) per 1,000 pop. 11.73 13.93 12.48 11.64 11.49 8 Comparison of Vital Statistics 1925 - 1954 TABLE II Year Estimated Population Live Births Birth fiat© per 1,000 Population Deaths Death fiat© per 1,00Q Population Infantile Mortality Rate per 1,000 live births Kingston upon Thames England and Wales 1925 40220 599 14.9 454 11.1 73 75 1926 39479 619 15.5 466 11.7 74 70 1927 39330 517 13.1 486 12.4 37 69 1928 39330 560 14.2 475 12.1 69 65 1929 38760 556 14.3 517 13.4 56 74 1930 38760 553 14.3 423 11.0 43 60 1931 39052 489 12.6 493 12.8 57 66 1932 38250 450 11.8 480 12.5 60 65 1933 38690 470 12.2 464 12.0 59 64 1934 38270 470 12.3 422 11.0 45 59 1935 39030 510 13.0 482 12.3 57 57 1936 39880 573 14.4 502 12.6 52 59 1937 39850 539 13.5 540 13.6 52 58 1938 39790 528 13.2 468 11.8 43 53 1939 39970 533 13.3 450 11.4 28 50 1940 37430 519 13.9 659 17.6 55 55 1941 35970 520 14.5 525 14.6 57 59 1942 36090 551 15.3 491 13.6 63 49 1943 35900 637 17.8 500 13.9 48 49 1944 34780 578 16.6 474 13.6 48 46 1945 35760 593 16.6 505 14.1 43 46 1946 39670 794 20.0 460 11.6 29 43 1947 40780 870 21.3 495 12.1 22 41 1948 40780 722 17.7 455 11.2 23 34 1949 40660 729 17.9 500 12.3 20 32 1950 41950 619 14.8 492 11.7 30 30 1951 39920 574 14.4 556 13.9 24 29 1952 39990 576 14.4 499 12.5 24 27 1953 39940 609 15.3 465 11.6 24 26 1954 39160 534 13.6 450 11.5 20 25 9 TABLE III Birth-rates, Death-rates for all causes and for certain causes and groups in the Year 1954. Provisional figures based on Quarterly Returns of the Registrar General. England and Wales 160 C.Bs. and Great Towns including London 160 smaller Towns Resident Pop.25,000 -50,000 at 1951 Census Kingston upon Thames Rates per 15,000 Home Po pulation Births Live Births 15.2 16.8 15.4 13.6 Still Births 24.0 (a) 25.6 (a) 22.4 (a) 29.l Deaths All Causes 11.3 12.l 11.3 9.9 Whooping Cough 0.01 O.0l 0.01 O.OO Diphtheria 0.00 0.00 O.OO O.OO Influenza 0.l9 0.17 0.19 0.05 Acute Poliomyelitis (including encephalitis) 0.01 0.01 0.02 O.OO Pneumonia 1.93 2.01 1.97 O.59 Tuberculosis Respiratory 0.l6 — — O.O8 Tuberculosis Other 0.02 - — 0.02 Cancer of the Lung and Bronchus 0.37 - - 046 Cancer, Other l.67 — - l.83 Maternal Causes (including Abortion] Infant Deaths 0.69(a) - — O.OO (under 1 year) 25.5 29.1 23.8 20.6 Enteritis and diarrhoea under 2 years of age 0.8 0.9 0.5 O.OO (a) Per 1 ,000 Total ( live and stil l) Births 10 TABLE IV Causes of Death Registrar General8s Tables All Causes 1950 1951 1952 1953 1954 M F M F M F M F M F 215 276 277 279 254 245 240 225 206 244 Tuberculosis, respiratory 7 5 7 5 7 2 5 3 - 3 Tuberculosisi, other - — — 1 — 2 — 1 1 1 Syphilitic disease 2 — 2 2 1 2 — 1 - - Diphtheia — — - — — — 1 — — — Whooping Cough,ooooooooooo — - - - - - — _ — Meningococcal infections — — — - - — - — — — Acute poliomyelitis — - — — — — — - — - Measxes — — - 1 — — 1 - — - Other infective and parasitic cliseases 1 1 - 1 - 1 - 2 - 1 Malignant neoplasm, stomach 8 5 11 5 7 4 4 4 2 3 Malignant neoplasm,lung bronchus 8 3 8 2 10 1 13 2 16 2 Malignant neoplasm, Uterus - 7 - 1 - 2 - 3 - 1 Malignant neoplasm,breast — 10 - 10 — 7 — 10 - 6 Other malignant and lymphatic neoplasms 20 17 19 24 29 20 25 34 22 20 Leukaemia, aleukaemia - 2 3 - 1 - 1 2 - 1 Diabetes 2 1 2 1 - 4 - 2 1 1 Vascular lesions of the nervous system 18 47 29 39 27 39 26 35 21 45 Coronary disease, ang ina, 31 23 46 25 29 31 43 18 34 28 Hypertension with heart disease 8 12 11 14 12 3 4 8 6 10 Other heart disease 21 41 36 41 28 37 16 31 18 34 Other circulatory disease 14 18 18 18 16 20 22 11 17 20 Influenza - 4 2 9 2 3 4 7 1 1 Pneumonia 10 11 16 26 14 10 11 10 9 14 BronohitiS 11 11 24 5 29 19 16 15 15 9 Other diseases of respiratory system 3 3 3 3 5 1 4 4 2 7 Ulcer of stomach and duodenum 4 2 7 6 3 1 6 - 3 1 Gastritis enteritis and diarrhoea - 1 1 - 1 - 2 2 - 3 Nephritis and nephresis 3 — 1 2 3 4 5 — 4 2 Hyperplasia of prostate 7 = 4 - 2 -=> 8 - 5 — Pregnancy;, Childbirth, Abortion - 4 - 1 - - - - - - Congenital malformations 3 2 2 1 5 - 2 - 4 1 Other defined and illdefined diseases 22 31 14 27 15 22 14 18 16 21 Motor vehicle accidentg 1 - 2 - 3 — 3 - 4 — All other accidents. 5 12 6 5 3 6 3 - 3 4 suicide 5 3 3 3 2 4 1 2 1 5 Homicide and operations Of. War 1 - - 1 - - - - 1 1 11 SECTION B GENERAL PROVISIONS OP 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 1954 "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 West Metropolitan Regional Hospital Board. In addition, the Ministry of Health Laboratory at Epsom is available for consultations and, if an occasion should arise, for help in the investigation of any important outbreaks of disease. There are also occasions on which special use is made of the services of the Public Analyst in chemical sampling which may become necessary in the interests of public health. Bacteriological examinations of milk are undertaken by the Ministry of Health Laboratory, Epsom, and samples under the Pood and Drugs Acts are submitted to the Public Analyst Mr. D.D. Moir, at the Analytical Laboratory, Southwark Street, S.E.l. (iii) Ambulance Paci1ities. The ambulance service for Kingston and the surrounding area is provided by the Surrey County Council from their new fully equipped control station at New Maiden (MAL.1173). A system of radio control is now used and greater efficiency and economy have been effected by this innovation. (iv) Hospitals. (a) Infectious Diseases. The South West 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 Physician Superintendent of Kingston Hospital. During the year 107 infectious disease cases were treated in hospital, but 97 of these were notified from hospital in the first instance. To Tolworth Isolation Hospital 9 Kingston Hospital 97 * Hospital for Tropical Diseases 1 ** x 96 Notified from hospital xx Notified from hospital. 12 ("b) Smallpox. No cases occurred in the Borough during the year. Arrangements are in existence whereby any case of smallpox or suspected smallpox can "be transported "by the London County Council Ambulance Service to special isolation. (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 busy and highly organised Out-Patient Departments fully supported to meet all surgical, medical, and psychological emergencies. 2. National Assistance Act 1948. National Assistance (Amendment) Acta 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 suitable premises, persons in need of care and attention. The 1951 Act enables local authorities to deal more speedily with very urgent cases by initial removal, for a period not exceeding three weeks. It was not necessary to use these powers in respect of any person resident within the Borough during 1954. The problems associated with aged persons do not diminish, and a number of geriatric cases came to the notice of the Public Health Department during the year. All necessary help and advice was given in each individual case, and everything done to improve the conditions found upon inspection. The close co-operation between the Physician Superintendent of Kingston Hospital, the Welfare Officer, local Doctors and your Medical Officer of Health, mentioned in my last report9 continues. During the year a Geriatrician was appointed to the medical staff at Kingston Hospital and this welcome addition t© the team will assist 10, the solution of some of the pressing problems which occur in connection with aged persons in need of medical attention. 13 SECTION C SANITARY CIRCUMSTANCES. 1. WATER SUPPLY. The town'a water supply is provided by the Metropolitan Water Board who maintain constant supervision over the purity and adequacy of the supply. Well water is used for industrial purposes at certain factories in the town. 2. DRAINAGE AND SEWERAGE* The position regarding disposal of sewage remains the same as for last year. naraely that the sewage from the Borough is pumped across the river into a sewer in the Teddington area9 for treatment at the Mogden Disposal Works of the West Middlesex Main Drainage Boardu This arrangement is a temporary one pending completion of the Hogsmill Valley Joint Sewerage Board's works which is now in course of construction® 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® The chemical and bacteriological condition of the stream is very unsatisfactory. This is due to lack of natural dilution for the sewage effluent carried in its flow. In the 1953 Report reference was made to investigations in respect of the entry of foul water into a surface water sewer which discharged into the Hogsmill Rivered Testsp by the use of tracing materials. were carried out to the drainage systems of ninety-five houses thought to have connections to this sewer. In one instance the W.CS. of the house were found to be discharging into the surface water sewer and in a further ten cases sinks baths and wash basins had been wrongly connected to the surface water system. In all the cases referred to above. after due notice9 the fittings were properly discharged into the foul water sewer. The above emphasises the need for due notice to be given to the Department of intention to connect sanitary fittings to drainage systems® U. CLOSET ACCOMMODATION. All closets in connection with dwelling houses in the Borough are on the water carriage system® 14 5. PUBLIC CLEANSING. The Borough Surveyor Is responsible for the collection and disposal of house and trade refuse® He states that the disposal method of tipping into a worked out gravel pit situated at Thorpe. Egham. was completed at the end of May. Since that date refuse from this Borough and the Borough of Surbiton has been transported by road to a dry gravel pit at West Drayton. Middlesex. in large vehicles from the central loading point situated at the Kingston Refuse Destructor. Villiers Road. Maiden and Ctoora.be Borough Council who also tipped refuse at the Egham tip have. since the 1st June. 1954$. disposed of their refuse at their Blagdon Road tip and will rejoin the scheme when this has been filled® The new loading bay will be operating in 1955. and is intended to reduce to a minimum nuisance arising from the loading of refuse.. Approximately l4.200 tons of refuse per annum is sent from this Borough. A small quantity of suitable trade refuse. together with road sweepings and scarified material. is disposed of by controlled tipping in the old bed of the Hogsmill River. The Corporation. refuse destructor has not operated sine. 1st March 1951. During the year no complaints were received in respect of any refuse tip in the Borough. 6. SANITARY INSPECTION OP THE AREA. The following is a tabulated list of visits and inspections which totalled 8.6l3 as compared with 7.199 for 1953:- 1954 1953. House inspections - defects. etC 528 44.5 Drainage 560 503 Factories 268 429 Outworkers 18 11 Atmospheric Pollution 131 144 Dairies. milk shops. etc. 165 121 Pood Premisea 1.096 l.344 Restaurants and cafes 451 364 Infectious disease enquiries 131 145 Theatres and Cinemas 6 9 Verminous Premises 57 42 Rodent Control 75 111 ShOpS ACt 421 456 Schools 16 43 Honsin. Act 173 9 Markets 330 286 Miscellaneous 1.104 l.059 5. 530 5.524 Reinspections and works in progress 3.083 1.675 8.6l3 7.199 NOTICES SERVEDe Informalo (a) Verbal 134 (b) Written 424 Statutory. (a) Housing Acts - (b) Public Health Acts 16 NOTICES COMPLIED WITH. Informal. (a) Varbal 477 (b) Written Statutory. (Q. Housing Acts (b) Public Health Acts 8 1. INSPECTIONS. Premises No. on Register Numb ear of Inspections Written Notices Prosecutions- Factories in which Secs.l.2.3.4 & 6 are enforced by the Corporation 79 44 8 - Factories not ineluded above in which Sec.7 is enforced by Corpz. 281 202 16 - Other premises eluding outworkers 9 18 1 - 18 7. SHOPS. There are 895 shops in the Borough and inspections are made with regard to the provisions of the Shops Act. 1950 which are concerned with sanitary accommodation. washing facilities.. heating. lighting and ventilation. Where plans are submitted of new construction or alteration to shop premises. due consideration is given to ensure that the proposals comply with the provisions of the statute. The Sanitary Inspectors are also responsible for the administration of the law relating to shop hours. including early closing and Sunday trading. A total of 421 inspections were made during the year and 20 notices were served: eleven of these referred to sanitary arrangements as defined in Section 38. The remainder were in respect of the exhibition of notices and the sale from mixed shops of groceries. etc. on the early closing day or on Sunday. 8. FACTORIES ACTo 1957. 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 OP THE ACT. 16 2. CASES IN WHICH DEFECTS WERE POUND. Particulars. No.of cases in which defects found found Remedied Referred No. of Prosecutions To H.M. Inspector By H.M. Inspector Want of cleanliness 7 5 - 3 - Over-crowding - - - - - Unreasonable Temperature -CO - — - — Inadequate Ventilation 1 - - - • Ineffective drainage of floors - - — - - Sanitary Conveniences - (a) Insufficient 1 1 — — ■» (b) Unsuitable or defective 15 14 - - — (c) No ventilated space or lobby - ao - - ~ (d) Lighting (absence of) ea — — - — Others 1 1 1 - - PART VIII OP THE ACT. Outwork - This relates to certain work which is done in dwelling houses. Nature of Wosik No. of Outworkers Wearing Apparel Making etc. 2 Brass & Bras® Articles 14 Puses 3 Lampshades 4 Cardboard Boxes 1 24 22 9. CAMPING SITES„ There are no camping sites within the Borough and no licences to station caravans in accordance with Section 269 of the Public Health Act. 1936. were issued during the year. 10. ATMOSPHERIC POLLUTION. Twenty-one complaints were received with regard to smoke or grit emission and ten observations were taken. A total of 131 visits were made to "boiler installations situated in industrial or institutional premises. There is a progressive improvement in Kingston with regard to the emission of smoke from the industrial installations in the town. This is due. in great measure. to the educative work of the Department over many years. and the co-operation of the firms concerned. Conversion from coal to oil turning has taken place in a laundry which had previously "been the source of nuisance from smoke and grit. The conversion was completed in January and throughout the year the plant functioned very well. Reference is due to improvement works carried out at a "busy factory in Richmond Road. It had previously been reported that the obsolete boilers had been replaced. and a new system of flues had been constructed and connected to the main chimneystack in which was incorporated a grit arrester® It is now reported that the firing of the boilers has been converted from coal to oil fuel with considerable success. The conversion has brought about an amazing improvement both with regard to smoke and grit emission and the condition of the boiler house and the surrounding landr previously used for coal storage and the dumping of ash and clinker. The installation is a model of its kind. and provides tangible evidence of what can be achieved in increased efficiency with large fuel-burning installation. With regard to the recording of atmospheric pollution in Kingston. three standard deposit gauges are maintained by the Corporation and were located after consultation with the Department of Scientific Research. The gauges are placed in Canbury Gardens. at Tiffin Girls" School and the Cemetery. Bonner Hill Road. and are p for the purposes of report. referred to as "A". "B" and respectively. The following tables give the results of analysis together with rainfall and wind readings. The figures are from observations made to show the effect when the prevailing wind was blowing from industrial works towards the recording stations. CANBURY GARDENS - Station "A". 1954 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 6o37 4.94 11.31 93 21 1.12 February 21.l0 9.88 30.98 84 36 2.12 March 15.10 5.21 20.31 93 49 2.30 April 4.61 2.64 7.25 90 12 0.27 May 17.14 8.02 25.16 93 34 2.29 June 14.26 7.04 21.30 90 47 4.09 July 14.12 4.84 18.96 93 31 2.88 August 12.97 4.23 17.20 93 56 2.84 September 9.79 4.20 13.99 90 60 2.15 October 9.85 6. 64 16.49 93 54 2.05 November 14.02 8.33 22.35 90 38 3.78 December 8.13 10.90 19.03 93 59 1.83 Totals 147.46 76.87 224.33 - - 27.72 Average 1954 12.29 6.41 18.70 - - 2.31 Average 1953 11.98 5.60 17.58 - - 1.69 TIFFIN GIRLS, SCHOOL - Station 'B'. 1954 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 3.94 4.41 8.35 93 21 1.00 ?ebruary 9.66 7.34 17.00 84 36 1.95 March 6.94 5.38 12.32 93 49 2.08 April 3.32 3.05 6.37 90 12 0.26 May 8.46 9.13 17.59 93 34 1.81 June 4.85 6.31 11.16 90 47 4.06 July 4.02 4.38 8.40 93 31 2.82 August 2.l6 3.85 6.01 93 56 2.76 September 4.31 3.45 7.76 90 60 2.05 October 2.29 3.95 6.24 93 54 2.04 November 3.05 7.40 10.45 90 38 3.18 December 2.59 8.36 10.95 93 59 1.44 Totals 55.59 67.01 122.60 - - 25.45 Average 1954 4.63 5.58 10.21 no — 2.12 Average 1953 4.59 5.73 10.32 - - 1.57 18 19 CEMETERY - Station 'C'. 1954 Deposit in Tons per sqe mile Wind Direction Rainfall in Inches Insoluble Solids Soluble Solids Total Solids No.of Observations No. of Times WNW - NNW January 3.94 4.41 8.35 93 4 1.00 February 8.35 4.28 12.63 84 - 1.94 March 7.29 5.l4 12.43 93 7 2.05 April 3.74 3.15 6.89 90 12 0.35 May 8.65 7.79 16.44 93 22 2.62 June 6.10 8.68 14.78 90 33 4.47 July 5.67 4.47 10.14 93 19 2.74 August 2.75 5.43 8.18 93 7 3.15 September 2.32 4.11 6.43 90 3 2.12 October 2.35 3.6l 5.96 93 10 2.00 November 2.62 6.16 8.78 90 12 3.42 December 2.32 6.73 9.05 93 2 1.62 Totals 56.10 63.96 120.06 - - 27.48 Average 1954 4.67 5.33 10.00 - - 2.29 Average 1953 4.77 5.18 9.95 - - 2.05  Station A Station B Station G 1954 1954 1954 ¼ Total Cumulative ¼ Total Cumulative ' ¼ Total Comalative First Quarter 62.60 62.60 37.67 37.67 33.41 33.41 Second Quarter 53.71 116.31 35.12 72.79 38.11 71.52 Third Quarter 50.15 166.46 22.17 94.96 24.75 96.27 Fourth Quarter 57.87 224.33 27.64 122.60 23.79 120.60 GJSNERAL. Station A. Station B. Station C. Total Deposit 224.33 122.60 120.06 Average Monthly Deposit 18.70 10.21 10.00 Total Rainfall 27.72 25.45 27.48 Average Rainfall 2.31 2.12 2.29 20 11. SWIMMING BATHS AND POOLS. (a) Public - The Corporation swimming baths are situate in Denmark Road and comprise two pools, one of which is in use throughout the year, whilst the other is used for swimming during the summer months and in the winter season is converted for use as a hall for concertSg, dancing, etc. The pools are equipped with pressure filters capable of treating the water of both pools every 3½ hours during bathing periods, In hot weather the filters are working continuously day and night. Chlorination is marginal and the residual quantity is maintained at the deep end of the baths with a maximum of 0.6 parts per million available chlorine. (b) Private - There are no privately owned swimming baths or pools open to the public in the Borough. 12. ERADICATION OF BED BUGS. During the year 30 premises were disinfested. Of these premises ten were properties under the control of the Corporation. Although the number of premises treated was greater than in the previous year, the figure is below the average for the years since 1939. 13. COMPLAINTS. The number of complaints received from the general public during the year was 548 compared with 625 for the previous year. The highest number of complaints was 920 in 1947. With the exception of last year, the numbers since 1947 have declined steadily. The following is a brief tabulated list of causes for complaints received during 1954:- Sanitary Defects 136 Rodent 164 Defective Ashbins 6 Drains and Sanitary Arrangements 104 Overcrowing 5 Food 33 Nuisance from Smoke 21 Defective Yards and Paving 4 Insect Pests 25 Accumulaitions 19 Water Supply 16 Others 15 548 14• RODENT AND INSECT PEST CONTROL. During 1954 no legal action was required under the provisions of the Prevention of Damage by Pests Act, 1949. This is an indication of the co-operation received from householders and business people. Although the figures in the statistical report compare favourably with the previous year, the work in the field was rendered more difficult by illness and changes in staff. As mentioned in previous reports, many rat infestations are traceable to defective drains, and, more rarely, to faults in sewers. During the year 39 defects of drainage systems ware revealed during rodent control investigation, 21 and of this number 22 were found to be the cause of the infestation. With regard to the sewerage system, it was considered necessary to carry out baiting of 36 additional manholes and poisoning at 11 where it was thought that there may have been some association with a surface infestation nearby. It is again necessary to emphasize the conditions which generally bring about infestation, namely, the badly constructed poultry houses, which are not rat proof and the indiscriminate feeding of wild birds, particularly when more food is put out than the birds can possibly consume. Shelter is also afforded to rodents by accumulations of junk and rubbishp much of which if not hoarded, can be disposed of by normal refuse collecting. Householders in a closely built-up town like Kingston should make every effort to keep gardens and yards clear of materials that provide harbourage to rats. The following statistical statement gives details of the work done during the year. Rodent Control - Statistical Statements 1954. Private Dwellings and Corporation Property. Rats. Mice. Total. No. of complaints received in office 119 32 151 " " premises inspected as a result 464 " " " found to be infested 229 40 269 " " separate infestations treated 261 23 284 " " visits for treatment and re- inspections 1518 46 1564 " " premises treated by occupier or other agency - 17 17 " " " inspected on routine survey Approx. 170 " " poison baits deposited 798 Business and Factory Premises. NO. of complaints received in office 5 8 13 " " premises inspected^ including those under Service Agreement 223 " " premises in which slight infestations were found 32 111 143 " " visits for treatment and reinspections 1644 2013 3657 " " premises treated by occupier or other agency 11 " " poison baits deposited 2278 Sewerage System. No. of foul water manholes in system 810 " " " " " baited 214 No. in which bait was taken by rats 74 Summary. No. of complaints received 164 No. of premises inspected 857 No. of premises infested 412 No. of visits 5221 No. of premises treated by occupier or other agency 28 No. of poison baits deposited 3121 22 Insect Pest Centrol. Insect Pest Control and maintenance treatments with regard to cockroacbes, flies etc. are carried out by the Department in all types of premises. It should ue remembered that practically every foodstuff or material has its own particular pest, e.g., the bacon beetle, flour moth, cocoa moth and carpet beetle, to name only a few. Not many complaints are now received concerning insects which were once common pests, namely, bugs, fleas and lice; with regard to other insect pestsp the Department is often called upon, and is ready to give advice on the means of dealing with them. 15. RAG FLOCK ACT, 1951. There are in the Borough four premises registered under the provisions of the Act for upholstering or bedding manufacture. No samples of material were taken during 1954. SECTIOND HOUSING The Housing Repairs and Rents Act, 1954 was passed in July and came into force in August. The Act, among other things, contains provision, in certain circumstances, for the raising of rents, the increase in rent being contingent upon the premises being maintained in good repair. The main intention of the Act was to arrest, as far as possible, the deterioration which is taking place in the older type of property, due to the greatly increased cost of repair and maintenance. By the end of the year 56 applications had been received for Certificates of Disrepair; 54 of these related to cases where the landlords had applied for an increase of rente In all cases Certificates were granted. It is thereby implied that, whilst the owners had satisfied the expenditure testp the properties were not in sufficiently good repair to justify a rent increase, At the end of the year in only one ease had the necessary repairs been carried out, and the Certificate revoked. Mush of the improvement which is obvious in the "old controlled" houses is due to the fact that they are being purchased by the tenanta, or, where they become vacant, they are being sold for occupation by the owner. Action taken during the year under the provisions of the Housing Act was as followsg:- 23 NO. 1, Hawks Passage No. 9, Hudson Road NO. 215a, Richmond Road No. l1, Cowleaze Road No. 8, Denmark Road No. 3, Knight°s Park NO. 8, Vicarage Road No. 92, Hawks Road Demolished under Order made in 1953. Closing Orders made. Closing Orders made in respect of basements. Closing Order made in respect of attic room. Undertaking accepted that the house will not be used again for human habitation unless rendered fit to the satisfaction of the Corporation. Housing - Statistical Statement, 1954. The following information is supplied by the Borough Surveyor who indicates that 56 houses were built by the Corporation during the year. Total number of permanent dwellings erected by the Corporation since March 1924 to 31st December, 1954. Houses l,137 (Inc. 876 outside Borough) Flats 732 (lnc. 221 outside Borough) Total number of temporary dwellings erected up to 3lstDecember,1954. Arson 132 Aluminium 70 2 year Huts 113 315 Number of 2 year huts demolished during 1954 13 Number of dwellings erected by private enterprise during 1954. Houses 7 Plate 38 45 In accordance with Ministry of Health Circular 28/54 the following information in tabular form as required by Article 31 of the Housing (Consolidated) Regulations is included. (l) Number of houses inspected and recorded 70 (2) Number of houses whichp on inspection, were considered to be unfit for human habitation 4 (a) Parts of houses which8 on inspection, were considered to be unfit for human habitation 3 24 (3) Number of houses, the defects in which were remedied in consequence of informal action, by the Local Authority or its officers 206 (4) Number of representations made to the Local Authority with a view tos(a) The serving of notices requiring the execution of works - (b) The making of demolition or closing orders - (5) Number of fbraal notices served requiring the execution of works _ (6) Number of houses which were rendered fit after the service of formal notices — (7) Number of demolition or closing orders made 6 (8) Number of houses in respect of which an undertaking was accepted under subsection 3 of section 11 of the Housing Act, 1936 1 (9) Number of houses demolished 1 SECTIONE INSPECTION AND SUPERVISION OF FOOD. All milk supplies in the town are brought in from outside sourees, there being no milch herds in the Bcrough. All known sources of supply are regularly sampled. The quality generally has proved to be satisfactory. Under the provisions of the Milk (Special Designations) (Special Areas)Order, 1951, the Borough of Kingston forms part of Specified Area No. 1. By the provisions of the Order, it is an offence to sell in the Borough milk which is not either Pasteurised, Sterilised or Tuberculin Tested. The sale of raw undesignated milk is therefore entirely prohibited within the Boroughe (b) Designated Milks. The following table shows the number and type of licences issued by your Corporation during 1954, under the provisions of the Milk (Special Designations) Regulations. All the licences were in force at the end of the year. Pasteurised Sterilised Tuberculin Tested To Pasteurise 1 - - To Deal 11 11 6 Supplementary 10 7 10 25 (c) Bacteriological Examination of Milk. During the year 110 samples of milk were sent to the Fiblie Health Laboratory at Efcsom for examination. The total of 110 was made up as follows:- Pasteurised 105 (T.T.) Pasteurised 3 Sterilised 2 The Pasteurised Milk was submitted for the phosphatase and methylene blue tests and the Sterilised Milk for the turbidity test. With the exception of one sample of Pasteurised. Milk which failed to pass the Methylene Blue Test, all other samples passed the test to which they were submitted. (d) Ice Cream. The number of registered premises in the Borough upon which ice cream may be stored or from which it may be sold is 132. This figure includes six producers. In addition to these dealers and producers there are 38 other premises, such as restaurants, canteens, cinemas, etc. upon which ice cream is sold. These premises are not required to be registered. By far the greater part of the ice cream sold in the town is obtained from manufacturers whose premises are situate outside the Boroughe More than ever the production of ice cream is being Confined to the few large manufacturers. The following table shows the results of examinations in respect of 71 samples submitted to the Public Health Laboratory at Epsom during 1954. GRADE I XI III IV Total Ice Cream 46 11 5 7 71 In addition to the above, four iced lollies were submitted for bacteriological examination and all wers placed in Grade I. (e) Meat and Other Foods. (i) Until the end of meat rationing on the 5th July, the Ministry of Food 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 were made to the Meat Depot and routine inspections carried out. When the control of slaughtering ended, of the three slaughterhouses in the Borough which were in use in 1939, only one was in anything like its condition when last used in 1940. The owner of these premises, in accordance with the provisions of Section 57 of the Pood and Drugs Act, applied for a licence but the condition of the slaughterhouse was such that the Corporation refused to licence the premises. There are now, therefore, no premises in the Borough licensed for the slaughter of animals. 26 The meat trade have quickly reverted to the prewar manner of distribution, mainly through the Smithfield Market. A fair amount of home killed meat sold in Kingston is now coming from the new abattoir built by the Government at Guildford and now managed by the Guildford Corporation. It is pleasing to record that the return of the Meat Depot shops to their owners has brought about a remarkable improvement in the cleanliness of the premises. It is obvious that the various managements are taking a keen interest in maintaining a high standard. (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 to avoid unnecessary detail. The quantities involved are small in comparison with the amount of food which is handled in the town. Tabulated List of Condemned Foodstuffs showing causes for Condemnation and the weights. Article of Food. Reason for Action. lbs. Weight. lbS. Raw Meat Ovine. Decomposition 428 470 Disease 42 Bovine Decomposition 1479¼ 16131¾ Disease 130½ Contamination 4 Porcine Decomposition 82 Total quantity of Raw Meat 21651 Raw Fish Decomposition 290 Poultry Game, etc. Rabbits 290 344¾ Chicken 54¾ Canned Goods. Meat & Meat Products Punctured, 19531 3227¾ Fruit 711½ Jam Damaged, Blown, 152½ Vegetables 267 Milk Decompositions 107 Soup 2¼ Fish & Fish Past 19½ Others 14¼ Dried Fruit Infestation 60 Food in Glass Containers - Glass contamination, mould, deterioration. lO¾ Other foods condemned for various reasons - Flour 3 Cheese 24½ Confectionery 125 Shell Eggs 2560 (Number) 27 With regard to the disposal of this unsound food, condemned meat is coloured with dye and collected by firms who specialise in the extracting of fat and manufacture of feeding meals. The canned goods and other foodstuffs are transported to the refuse destructor of a nearby Authority and are incinerated. (f) Food Hygiene. As reported previously, the work of providing and maintaining a clean food supply is one of continuous endeavour. The problems before us remain the same9 but only gradually can improvement be made. The stage has now been reached when the most important factor in food distribution and handling is the attitude of mind of the individual person. All who are employed in the food industry must realise the need for personal and general hygiene and be aware of the consequences of their actions. There is in the Borough a very good relationship between traders and the Public Health Department and this willing co-operation is much appreciated. During the year much work was done on maintenance and improvement of food premises, both with regard to structural repairs, the cleansing and painting of food rooms and shops, and provision of continuous hot water supply for washing purposes. The Sftnitary Inspectors spent much time on education in food hygiene by visits to food premises and by advice and discussion with the management and employees an essential duty in view of the constant and frequent changes which take place in the staffs. In accordance with the request of the Minister of Health the following is a tabulated statement of inspections made during the year to the various types of food premises. Food Premises. No. of Premises. No. of Visits Bakehouses 7 55 Dairies and Milk Shops 12 39 Butchers 46 105 Greengrocers and stalls 96 51 Public Houses 62 39 Fishmongers and stalls 24 62 Ice Cream Premises 132 81 Grocers & General Provisions 129 347 Restaurants and Cafes 105 451 Meat Destribution Depots 5 123 Visits to Food Premises re Condemnation of Unsound Food 178 618 1532 FOOD AND DRUGS ACT, 1938. Details of samples submitted to the Public Analyst during the year are given in the tabulated statement* The following are the results of action taken in respect of three samples which were the subject of adverse comment. 28 The Analyst, in reporting upon an iced lolly, stated that it could be more correctly labelled as an ice cream lolly. All the ingredients were not specified on the label as required by the Labelling of Pood Order, 1953. The manufacturer stated that this sample was one of a small batch distributed for market research purposes, and that in future, the product would be properly deseribed and labelled in accordance with the Act. In the case of a sample of mint sauce, this again was a case of technical infringement of the Labelling of Pood 0rder. The ingredients were not designated correctly or in proper order. The firm in question, upon being approached, undertook to print new labels for the product. In an excess of zeal the Manager of a local butcher's shop labelled some sausages "100% Pork Special". A sample submitted for examination confirmed that the sausages were of good quality, but obviously not 100% pork. The attention of the Company was drawn to the matter, and the necessary action was taken to ensure proper labelling in future. Tabulated Statement of Samples submitted to the Public Analyst during 1954. NO. Of Samples Genuine Formal Informal Formal Informal Arrowroot — 1 — 1 Baking Powder — 1 — 1 Beans & Grilled Sausage — 1 — 1 Blancmange — 1 — 1 Butter — 4 — 4 Cake (Battenburg) — 1 — 1 Cake Mix — 2 — 2 Castor Oil — 1 — 1 Cocoa — 1 — 1 Cheese Spread — 1 — 1 Cream (tinned) — 4 — 4 Creamola Crystals — 1 — 1 Desiccated Coconut — 1 — 1 Horseradish Relish — 1 — 1 Ice Cream — 8 — 8 Jam — 4 — 4 Jelly — 2 — 2 Lime Juice Cordial — 1 — 1 Liver Sausage — 1 — 1 Luncheon Sausage — 1 — 1 Lollies — 4 — 4 Mar gar to® — 3 — 3 Marmalade — 1 — 1 Meat Paste — 1 — 1 Milk — 46 — 46 Milk (Channel Isle) — 2 — 2 Mincemeat — 1 — 1 Mint Sauce — 1 — 1 Non-brewed Condiment — 1 — 1 Nutmeg (Ground) — 1 — 1 Peanut Butter — 1 — 1 Peel (cut) — 1 — 1 C/Fwd. — 101 — 101 29  No. of Samples Genuine Formal Informal Formal Informal B/Fwd. — 101 — 101 Pepper (Ground White) — 1 — 1 " (Flavoured Compound) — 1 — 1 Piccalilli — 1 — 1 Pickle (Thick) — 1 — 1 Pineapple in Syrup — 1 — 1 Pork Kidney (Braised) — 1 — 1 Prunes — 1 — 1 Pudding Mix — 1 — 1 Quinine, Phosphated — 1 — 1 Salad Cream — 1 — 1 Sausages 3 3 3 3 Sauce — 3 — 3 Suet (Shredded) — 5 — 5 Tea — 2 — 2 Tomato Ketchup — 2 — 2 " Soup — 1 — 1 Vinegar — 1 — 1 Total 3 128 3 128 MERCHANDISE MARKS ACT, 1926. Regular and frequent Inspections were made during the year with regard to the labelling and display of appropriate notices, in compliance with the Orders made under the above Act in respect of certain foodSe From time to time attention was drawn to infringementSg particularly in respect of tomatoes and apples, but it was not considered necessary to take any legal enforcement action. 30 SECTIONF 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 Para-typhoid) Food Poisoning Erysipelas Chickenpox Malaria Cholera Plague Typhus Fever Relapsing Fever Tuberculosis Leprosy is notifiable by General Medical Practitioners direct to the Chief Medical Officer of the Ministry of Health. In 1954 a total of 569 notifications of infectious disease was receivedj, compared with 563 in 1953. This slight increase is due only to a rise in the number of notifications of measles and puerperal pyrexia, and does not indicate an increase in infectious disease generally. The following table gives an analysis of the cases into age groups. 31 NOTIFIABLE DISEASES DURING 1954 TABLE V. CASES DEATHS Age Groups Age Groups Under 1 year 1-2 2-3 3-4 4-5 5-10 10 - 15 15 - 20 20 - 35 35 - 45 45 - 65 65 & over Total cases notified Cases admitted to Hosp. Under 1 year 1-2 2-3 3-4 4-5 5-10 10 - 15 15 - 20 20 - 35 35 - 45 45 - 65 65 & over Total Scarlet Fever - - 1 1 - 13 1 - - - - - 16 4 - - - - — - - - - - - - Nil Diphtheria — - - — - — - - - - - - - - - - - - - - - - - - - - Nil Enteric Fever including Para-typhoid - - - - - - - - - - - - - - - - - - - - - - - - - - Nil Acute Poliomyelitis: Paralytic - - - - - - - - - - - - - - - - - - - - - - - - - - Nil Non-paralytic — - - — - - - - — - - - - — - - - - - - - - - - - - Nil Acute Infective Encephalitis - - - - - 1 - - - - - - 1 1 - - - - - - - - - - - - Nil Meningococcal Infection - - — — - - - - - - - - - - - - - - - - - - - - - - Nil Puerperal Pyrexia - - - — - - - 10 80 6 - - 96 96 - - - - - - - - - - - - Nil Ophthalmia Neonatorum - - — - — - - - - - - - - - - - - - - - - - - - - - Nil Pneumonia - - - - 1 1 - 1 3 - 4 — 10 1 1 - - - - - - 1 - - 2 19 23 Erysipelas - - — — — - - - 2 - 1 - 3 1 - - - - - - - - - - - - Nil B. Dysenteria (Sonne) - - - 1 - - - - - - - - 1 1 - - - - - - - - - - - - Nil Measles 7 36 42 52 45 234 2 - — 1 - - 419 2 - - - - - - - - - - - - Nil Whooping Cough 3 3 4 3 2 5 - - 1 - - - 21 1 - - - - - - - - - - - - Nil Chickenpox - — - - - — — - - - - — - — - - - - - - - - - - - - Nil Food Poisoning - - - - - - - — 2 - — - 2 - - - - - - - - - — - - - Nil Totals 10 39 47 57 48 254 3 11 88 7 5 - 569 107 1 - - - - - - 1 - - 2 19 23 32 The following table gives a comparative statement of notifications of certain infectious diseases received during the last thirty years:- TABLE VI Year Scarlet Fever Puerperal Pyrexia Measles Whooping Cough Acute Infective Encephalitis Poliomyelitis Enteric Fever (including Para-typhoid) Diphtheria Ophthalmia Neonatorum 1925 213 4 - Not notifiable - - Not notifiable - 3 7 25 5 1926 82 4 — 2 7 27 2 1927 87 9 — 1 3 65 3 1928 135 9 — 1 7 152 4 1929 74 5 — — 1 113 3 1930 78 9 — — 5 100 2 1931 61 14 — 1 53 4 1932 56 13 — 2 1 47 1933 125 10 — 3 2 30 2 1934 40 5 — — 2 42 3 1935 54 8 — — 2 50 3 1936 67 19 — — 6 27 2 1937 51 32 — 2 1 21 3 1938 61 47 — 2 1 72 2 1939 69 66 — 1 1 19 3 1940 45 63 373 22 — 3 53 3 1941 54 37 331 271 — 1 7 15 — 1942 79 24 375 99 — — 8 3 1943 110 18 287 151 — 1 1 3 — 1944 49 15 33 73 — 1 — 7 2 1945 28 23 407 84 — 1 - 16 2 1946 34 41 283 67 — 2 1 8 1 1947 24 28 219 38 3 5 1 2 1 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 — — — — 1952 29 84 280 102 — 3 — — — 1953 21 80 302 126 — 5 — — — 1954 16 L 96 419 21 1 — — — — Scarlet Fever. Only sixteen cases of mild scarlet fever were notified, fourteen of which were of school age. No deaths occurred and no "return" cases. Only four of the cases notified were removed to an infectious diseases hospital for treatment and the remainder were treated at home. Attention has been drawn in previous reports to the significant fact that each year now shows a reduction in the number of cases of scarlet fever occurring, and the relatively small proportion of such cases which have to be treated in hospital. It is to be hoped that the figures for 1954 indicate a continuation of the tendency for this disease to become diminished in prevalence and severity. . 33 Diphtheria. No cases of diphtheria were notified, for the seventh successive year. Intensive work was continued to immunise the school and pre-school population against diphtheria and it is intended to continue with a vigorous immunisation campaign. This is necessary to prevent any possible diminishing of public interest in this service, occasioned by seven years freedom from the diseases, and the complacency which may result. Immunisation is just as necessary in the absence of diphtheria as when it occurs. Poliomyelitis. No cases occurred during 1954, and the welcome freedom from this disease may have been due, in part at least, to the lack of hot dry periods during the summer. Some cases occurred in neighbouring districts, however, but there is no evidence that any infection was spread to Kingston residents. Acute Infective Encephalitis, One case occurred during 1954 in a boy aged 7½ years, who was treated in Kingston Hospital. The illness was severe and followed an attack of mumps. A complete recovery was made. Enteric Fever (Typhoid or Paratyphoid). No cases of typhoid or paratyphoid B were notified during 1954. This is the seventh successive year in which no cases of typhoid or paratyphoid fever were notified. Measles. There were 419 cases of measles notified during 1954 (compared with 302 in 1955, and 280 in 1952), of whom two only were removed to hospital. Generally speaking the illness was of a mild type with little by way of complications. The 5-10 year age group contained the largest number of notifications (234) the majority of the remainder being spread over the 1-5 year age group (175) with only 10 at other ages. Whooping Cough. There were only 21 cases of whooping cough notified during 1954, as compared with 126 in 1953, and 102 in 1952. This very low incidence of the disease, which Is considered to be one of the most serious of childhood illnesses is very encouraging, and the figure is the smallest ever recorded in Kingston. Vaccination against whooping cough has proceeded for two full years, and it is usually performed as a combined process with diphtheria immunisation. Every effort will be made in company with the medical practitioners to maintain a high degree of immunity in all the school, and under school age, children of Kingston. 34 Ophthalmia Neonatorum. No cases were notified during 1954. This is the seventh successive year in which no cases of ophthalmia neonatorum have been notified. Puerperal Pyrexia. Ninety six cases were notified during 1954, all of which occurred in patients in Kingston Hospital., An analysis is shown below, together with figures for the years 1950 - 1953 for purposes of comparison. Twenty-seven of the cases were Kingston residents. Cases 1950 1951 1952 1953 1954 (a) TotaL notified 23 41 84 80 96 (b) Number included in (a) of (i) Kingston residents 8 14 23 15 27 (ii) Extra district residents 15 27 61 65 69 (c) Number included in (a) notified from Kingston Hospital 21 40 82 78 96 (d) Number included in (a) notified by private doctors 2 1 2 2 - (e) Number of cases included in (d) removed to hospital other than those included in (c) - - - - - Food Poisoning. Only two notifications of food poisoning were received during 1954, compared with four in 1953. These were both mild isolated cases. The fullest investigations were made in each hut it was not possible to prove that any particular foods had caused the illness. Faeces specimens were taken, and salmonella organisms were isolated, but all other specimens were found to be negative for pathogenic organisms, and no spread of infection occurred. Food poisoning was strongly suspected in the occurrence of a quick, sharp incident of illness appearing among 89 persons of a firm in Kingston. The persons concerned represented a proportion of the employees of the firm in question who had taken meals in their staff canteen. The Public Health Department was notified immediately the illness became known and it was possible at once to deal with the outbreak which was of a mild nature and quickly resolved itself. The incident was reported fully to the Ministry of Healths, and suggestions, which it is thought will minimise the risk of a further incident of this nature, were made to the firm, Tuberculosis. Cases of tuberculosis are dealt with by the South West Metropolitan Regional Hospital Boards and by the Surrey County Council. Your Medical Officer and the Chest Physician and his staff work closely together and with the Surrey County Council. Each case notified is visited by an officer of the Public Health Department, and all contacts are X-rayed and advised by the Chest Physician. The efficiency of notification is good and there have been no cases of wilful neglect or refusal to notify. 35 The following table shows comparative figures of notified cases and deaths for the years 1944 to 1954 (inclusive):- Year Canes Notified Deaths Respiratory Non-Respiratory Total Respiratory Non-Respiratory Total 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 1952 43 2 45 9 2 11 1953 37 5 42 8 1 9 1954 26 4 30 3 1 4 1950 1951 1952 1953 1954 1 : 6 1 : 3 1 : 2 1 : 5 1 : 4 Thirty notifications of Tuberculosis were received during 1954? and twenty six of these were in respect of pulmonary cases. The total number of cases notified is considerably lower than in any of the ten preceding years. This fact is especially encouraging when it is borne in mind that Kingston was visited for 5 weeks during 1954 by the Regional Hospital Board Mass Radiography Unite A total of 7,118 persons were X-rayed, and 6 cases of active tuberculosis, 279 cases of inactive tuberculosis, and 15 cases for further investigation were discovered. (These figures do not necessarily relate to Kingston residents only). The number of deaths from tuberculosis during 1954 was only 14, and this figure is substantially lower than for previous years. This trend is being experienced throughout the country, but it is evident that although deaths from tuberculosis have been decreasing rapidly there has not been a decrease at a comparable rate in the number of notification of new cases. The number of new cases occurring, however, is steadily diminishing;, and provided there is no major economic or social upset this trend will be likely to continue. During 1954 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 Committee, whose field of work is coincidental with the North Central Division. The Medical Officer of Health is Chairman of the Care Committee and considerable assistance has been given to patients. There is no doubt that this body is fulfilling its function of helping towards the rehabilitation of tuberculous patients. (Note - An analysis of the total notified cases during 1954 in age groups is shown on the following page). The ratio of non-notified cases to total deaths for 1954 and the preceding four years is as follows:- OS NOTIFIED CASES OF. AND DEATHS FROM, TUBERCULOSIS IN 1954 TABLE VII 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 2 3 1 2 13 — — — — — — — — — — F — — — 1 5 3 2 1 — 13 — — — — — 2 — — 1 3 Total — — 1 2 9 5 5 2 2 26 — — — — — 2 — — 1 3 (b) Non-respiratory M — — 1 — — — — — _ 1 — — — — — 1 — — — 1 F — — — — 1 1 — — 1 3 — — — — — — — — — — Total — — 1 — 1 1 — — 1 4 — — — — — 1 — — — 1 37 During 1954, 115 families were helped, the form of help being extra nourishment, clothing, money grants for removals, bedding, fares, pocket money, etc., and a total of £975 was expended from the funds of the Committee on this work. Scabies. Owing to the very few cases occurring and requiring attention the Corporation Cleansing Treatment Station has been closed. Any cases referred by a General Medical Practitioner are given a supply of treatment cream together with printed instructions for home self-treatment. This system has proved to be quite satisfactory for dealing with the occasional minor infections which occur. INFESTATION BY HEAD LICE. Daring 1954 there was no evidence of special incidence of infestation by head lice. D.D.T. preparations were used in addition to the usual cleansing by water and soft soap or shampoo® It was not necessary to take any statutory action for infestation by head lice during the year.