AC 4413 (1) II Library mc'd 9.7.63 KIN 36 THE HEALTH OF THE ROYAL BOROUGH OF KINGSTON-UPON-THAMES 1962 THE ANNUAL REPORT of The Medical Officer of Health and the Chief Public Health Inspector PUBLIC HEALTH DEPARTMENT, GUILDHALL, KINGSTON-UPON-THAMES. JUNE, 1963 THE HEALTH OF THE ROYAL BOROUGH OF KINGSTON-UPON-THAMES 1962 THE ANNUAL REPORT of The Medical Officer of Health and the Chief Public Health Inspector PUBLIC HEALTH DEPARTMENT, GUILDHALL, KINGSTON-UPON-THAMES. JUNE, 1963 ANNUAL REPORT 1962 TABLE OF CONTENTS page Preface i,ii,iii,iv,v. Population i Births i Deaths i Infant Mortality Rate - 1958/1962 - Rate per 1,000 live births ii Causes of Death ii Infectious Disease iii Diphtheria iii Housing and rehousing iii,iv. Food Poisoning iv Infective Hepatitis iv Cigarette Smoking iv,v. Staff v Constitution of Public Health Committee 1 Staff of Public Health Department 1 SECTION A Statistics and Social Conditions (1) Ceneral Statistics 2 (2) Social Conditions 2,3,A. (3) Extracts from Vital Statistics of the Year 4 (a) Live Births 5 (b) Stillbirths 5 (c) Total Live and Stillbirths 5 (d) Deaths 5 (i) Death Rate 5 (ii) Infant Deaths 5 (iii) Maternal Deaths 5 (e) Maternal Mortality Rate 5 Infant Mortality Rate 1938/1962 6 Quinquennial Infant Mortality Rate 6 Causes of Death of Children under 1 year 7 (iv) Deaths from Other Causes 8 Introduction to Tables on Vital Statistics 8 Page. Table I - Extract from Vital Statistics for the years 1958/1962 9 Table II - Comparison of Vital Statistics 1933/1962 . 10 Table III - Causes of Death 11 SECTION B general Provisions of Health Services (1) (i) Laboratory Facilities 12 (ii) Hospitalst:- (a) Infectious Diseases 12 (b) Smallpox 12 (c) general 13 (2) Health Services provided by other Authorities: Surrey County Council - Health Department 13,14,15. Surrey County Council - Education Department 15 Surrey County Council - Welfare Department 16 Surrey County Council - Social & Geriatric Services 17 Surrey County Council - Children's Department 17 Surrey Executive Council 18 (3) National Assistance Act, 1948 National Assistance (Amendment) Act, 1951 ) SECTION C Sanitary Circumstances (1) Water Supply 20 (2) Drainage and Sewerage 20 (3) Rivers and Stream 20 (4) Closet Accommodation 20 (5) Public Cleansing 21 (6) Sanitary Inspection of the Area 21,22 (7) Shops 22 (8) Factories Act, 1937 22,23,5,24. (9) Camping Sites 24 (10) Atmospheric Pollution 24,25,26, 27,28,29, 30,31,32, 33,34 (11) Swimming Baths and Pools 35 (12) Eradication of Bed Bugs 35 (13) Complaints 35 (14) Rodent and Insect Pest Control 36,37 Page SECTION D Housing General Statistical Statement, 1962 39 SECTION E Inspection and Supervision of Food (a) Milk Supply 40 (b) Designated Milks 40 (c) Bacteriological Examination of Milk 41 (d) Ice C ream 41,42 (e) Meat and Other Foods 42,43 (f) 43,44,45 Food Hygiene Regulations 1955 45 Food and Drugs Act 45 Tabulated Statement of Samples Submitted to the Public Analyst during 1962 46,47 Foods subject of complaint 48,49,50 Merchandise Marks Act„ 1926 50 SECTION F Infections Diseases Notifiable Diseases 51 Table IV Notifiable Diseases during 1962 52 Table V Comparative Statement of Notifications of certain Infectious Diseases 53 Whooping Cough 54 Enteric Fever (Typhoid or Paratyphoid) 54 Measles 54 Ophthalmia Neonatorum 54 Puerperal Pyrexia 54,55 Smallpox 55,56 Scarlet Fever 56 Poli 56 Dysentery 57 Tuberculosis 57, 58,59 Table VI & Graph - Notified cases and Deaths from Tuberculosis in 1962 60,6l (i) TELEPHONE NO: KINGSTON 2121. PUBLIC HEALTH DEPARTMENT, GUILDHALL , KINGSTON-UPON-THAMES. JUNE, 1963. TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE ROYAL BOROUGH OF KINGSTON-UPON-THAMES. ANNUAL REPORT, 1962. Mr. Mayor, Ladies and Gentlemen, I have the honour to present the Annual Report on the public health and social conditions of the Borough for 1962. As in previous years the report follows the general lines indicated by the Minister of Health, and is in accordance with Circular l/63. Population - The Registrar General's estimated mid 1962 home population figure is given as 35,990 (resident population figure - used for calculation of the statistical data in this report). The estimated day population is about 300,000 persons who enter the town, for business, education, and recreation purposes,, This influences the volume of work and responsibility of the Corporation. Births - The number of live births for 1962 is 614 and compares with 639 for 1961. The crude birth rate is 17.0 per 1,000 population compared with 17.1 for 1961. Deaths - The number of deaths recorded in 1962 is 463 compared with 462 for 1961. This makes a crude death rate of 12.8 as compared with 12.8 for 1961. The excess of births over deaths was 151 compared with 177 for the previous year. The number of infant deaths (under 1 year of age) in 1962 is 18 which gives an Infant Mortality rate per 1,000 live births of 29.3. The corresponding figures for 1961 were 10 infant deaths and an Infant Mortality rate of 15.6. The following table shows the approximate average rate for the previous five years. (ii) INFANT MORTALITY RATE 1958 1959 1960 1961 1962 Total No. Deaths 8 13 6 10 18 RATE PER l,000 LIVE BIRTHS 14.9 23.0 10.4 15.6 29.3 No maternal deaths (i.e. from pregnancy, childbirth, abortion) were recorded out of a total of 622 live and stillbirths. Causes of Death - Main conditions causing death during 1962 weres:- 1962 1961 Heart Disease 143 133 Cancer 94 112 Vascular Lesions of the Nervous System. 54 55 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. 1958 1959 1960 1961 1962 Deaths from cancer of the lung and bronchus Total Total Total Total Total 25 26 23 21 29 M F M F M F M F M F 23 2 23 3 20 3 19 2 24 5 (iii) Infectious Disease - The number of infectious disease notifications received in 1962 was 81, as compared with 560 in 196l, a difference of 479,, which is accounted for by a decrease in the eases of measles and puerperal pyrexia throughout the year. Active protection of the child population against diphtheria, whooping cough, tetanus smallpox, tuberculosis and poliomyelitis was continued at a good pace. Diphtheria - For the fifteenth yeas in succession no cases of diphtheria occurred in Kingston, Outbreaks of the disease occurred in unimmunised children in seme areas which only emphasized the importance of keeping the child population as highly immunised as possible and particularly for initial protection to be given in their first year. Parents are constantly encouraged to take full advantage of the immunisation service provided and intensive campaigns are carried out to immunise the school and pre-school population against this disease, This is done under my direction as Medical Officer of Health as well as Divisional Medical Officer for North Central Division of Surrey, at the Surrey County Council Clinics and by General Medical Practitioners, Housing and Rehousing - The provision of housing accommodation has proceeded throughout the year. It is felt necessary to reiterate that substantial measures must be taken in an endeavour to meet existing housing requirements as well as those of a possible increased population. During 1962, the Corporation provided 11 housing units comprising 7 single and 4 double bed-sitting rooms. Two houses, 94 flats and 1 bungalow were built by private enterprise giving a total of 109 housing units in Kingston during the year. The Minister of Housing and Local Government announced a massive national drive to speed slum clearance;, modernise obsolescent houses and build many more new houses (Circular No, 42/62), It is desired to "accelerate the progress of most of the elements of the housing programme and to keep up the pace until the housing of the entire nation is decent." It is again emphasized that there is a need to secure complete slum clearance, also building for old people and those who are living in overcrowded squalid conditions though not in unfit houses, and who cannot rehouse themselves by their own efforts. An increased provision of suitable Mousing accommodation is a most important service for old people. As increasing proportion of local authority housing is of this type, but there is considerable leeway to be made up. There is no doubt that many of the elderly are greatly handicapped by remaining in dwellings that are too big for (iv) their needs, or, beyond their physical capabilities to manage, Old people prefer to spend their last years in a house of their own among their own possessions and memories; their own community of relatives and friends; but the provision of suitably designed and equipped homes enables the old person to retain his independence for longer than before. Food Poisoning - In spite of the very large number of eating places and food shops in Kingston, no cases of food poisoning occurred during 1962 which could be attributed to lack of hygiene in the trade. Eight cases of infection in very young children by known food poisoning organisms were reported during the year. The pattern of spread, concerned three separate families affecting with one exception, young children and those of school age, The single adult case was that of a man aged 55 years who was taken ill during a business visit to Carlisle and reported as having salmonella bredeney infection. Infective Hepatitis - During the year twelve cases of Infective Hepatitis (Infectious Jaundice) occurred in the northern part of Kingston, Infective Hepatitis is not a notifiable disease so that there may have been a few more eases elsewhere. The incubation period is 4/6 weeks which makes it difficult to find the source of infection for every case. However, it was possible to establish the source in most of the cases. The infection was transferred from one member of the family to another in some instances and in others from contact with neighbours. There is no obvious reason why there should have been a slight increase in the numbers which normally occur in the summer months. It is not usually a serious illness and the only special measures that are necessary are good hygiene in the home. Cigarette Smoking - Lung Cancer - Health Education - The determination of the Government to break down public apathy to the relationship of smoking and lung cancer was established when in October two mini-vans were bought and equipped for use by the Central Council of Health Education as mobile information units. These mobile units have been specially designed to meet the needs of a long-term campaign by local authorities throughout the country to inform the public about the dangers to health involved in smoking. The cost of the units and equipment is met by a special grant from the Ministry of Health. (v) Each unit consists of a white mini-van descriptively sloganned and tearing the name of the town visited. The equipment includes film and filmstrip projectors, tape recorders, films and exhibition material, together with posters and leaflets on the subject. The units are manned by four young university graduates. all non-smokers,, Each has been specially trained and briefed to deliver talks on the subject of smoking and health and is expert in the use of visual aids. These activities are directed particularly to young people in schools and youth clubs, and they work in close liaison with Medical Officers of Healthy and Education Departments. A specimen day's programme includes talks to classes in primary and secondary schools, at ante-natal clinics and mothers' clubs, training colleges for teachers, etc. Evening sessions also include youth clubs, evening institutes, parent/teacher associations, W.V.S., Red Cross Branches, etc. Mobile unit visits were arranged for Kingston. Staff - Details of the staff of the Public Health Department are set out on Page l. I am indebted to Mr„ &.C. Smithy Chief Public Health Inspector, with special reference to Sections C - E, and Mr. M. Frankell. Chief Administrative Assistant, for assistance in compiling the report. I am also pleased to record my thanks for the support and encouragement I have received in my work, to The Worshipful The May or, Aldermen and Councillors and to the Chairman of the Public Health Committee. I also acknowledge my gratitude for the hard work and loyal support of the staff of the Public Health Department, and the co-operation of Dr. W.H. Kinstrie, Deputy Medical Officer of Health, and of my fellow Chief Officers. I have the honour to be, Your obedient Servant, J.W. STARKEY, Medical Officer of Health. 1 ROYAL BOROUGH OF KINGSTON-UPON-THAMES PUBLIC HEALTH DEPARTMENT Pablic Health Committee for the Municipal Year 1962/63. Alderman Councillor " " Alderman " Councillor Knowlden (Chairman) Parrish (Vice-Ghairman) Hooker (Mayor) Misa Tapping (Ex-Mayor) McDonald Miss Alexander Mrs. Cope Councillor Croll " Eades " Grummett " Kimber " Marshall " Mrs. Thomas STAFF OF THE PUBLIC HEALTH DEPARTMENT AS AT 31st DECEMBER. 1962. Medical Officer of Healths J.W. STARKEY, M.B, Ch.B. (Edin.). D.P.H. Deputy Medical Officer of Healths W.H. K1NSTRIE, M.B. Ch.B. (Edin.),D.P.H. Chief Public Health Inspectors G.C. SMITH, F.R.S.H., M.P.H.J. (a) (b) Senior Additional Public Health Inspectors L. BURROWS. M.A.P.H.I. (a) (b) Additional Public Health Inspectors: S.W. SIMPSON-SCOTT. (a) (b) K. APPLETON A.R.S.H. MA.P.H.I. (a) (b) Junior Public Health Inspectors (vacant) Chief Administrative Assistants M. FRANKELL, D.M.A., A.C.C.S., L.M.R.S.H. Technical Officer - Smoke Control Areas; W.A. HUCKIN. Clerical Staffs MISS C.L. FOISTER, MISS M.W. FILBEE, I.D. REID (appointed 24.4.62), A, HEDGES (appointed 12.2.62). MISS Jo MARTIN (resigned 4.3.62). Pest Control Officer; F.W. STAG, A.R.I.P.H.H. Rodent Operatives: G.H. LOCKE. F.J. PERRY. Disinfector/Driver: D. WILKINSON (resigned 3.8.62). (a) Certificate as Public Health Inspector. (b) Certificate as Meat and Other Foods Inspector 2 SECTION A STATISTICS AND SOCIAL CONDITIONS 1. General Statistics. Area in Acres 400 Total Population (including Service personnel) 35,990 Number of inhabited houses (approx) 11,860 Rateable Value - General Rate (l.4.62) £1,180,417 Sum represented by Penny Rate (year 1962/63) £ 4,780 Total number of hereditament 14,809 Domestic dwellings 80% of total hereditaments Commerical dwellings 18% of total hereditaments Number of premises classified as industrial, entertainment, public utility, educational and miscellaneous 462 2. Social Conditions. Kingston-upon-Thames is a Royal and Ancient Borough situated upon the south bank of the River Thames, within the County of Surrey and the Greater London area. Although it is renowned as a prosperous market town and for its extensive shopping centre, which provides the main economic function, there is also important industrial activity in Aircraft and Engineering. Kingston is not only a centre for education and recreation, but is a "commuting" area for business people travelling daily to and from London. The social conditions are influenced by the trend of the high level of employment which exists in the town and the Manager of the local Employment Exchange, Miss M. Bond, has kindly provided the following information regarding employment in Kingston and Districts:- "At the end of 1961 I reported that unemployment during the year had been slightly higher on average than in 1960 This trend unfortunately continued throughout 1962. In December 1961 there were 400 men and 91 women unemployed but by the end of 1962 these totals had risen to 705 and 129, the total of 834 representing 1% of the working population in the Employment Exchange area. When compared with the national percentage of 2.5 the local percentage was small but nevertheless gave cause for some concern. The diversity of industry in the Employment Exchange area is such that if one section is experiencing difficulties other sections are prosperous and a reasonable balance is usually maintained, During 1962, however, there appeared to be a general air of caution and engagements of labour through the Exchange were 342 fewer than in the previous year. With rising unemployment figures it is a natural corollary that demands for labour should fall and this is evident in 3 the fact that at the end of 1962 there were only 302 vacancies notified as outstanding for men compared with 531 at the same time last year. The majority of these were for workers with a high degree of skill or specialised experience. It was some little consolation to know that in the case of women demands were higher towards the end of the year, and from September onwards there were more vacancies available for women than for men. It is not surprising in view of the fewer employment opportunities for men that considerably fewer were found work during the year. The Exchange placed 3,188 men in local work and 127 in work in other Exchange areas, The higher demands for women enabled 1,076 to be found work locally and 80 in other districts, representing an increase of 41 over the figures for 1961, Of all those placed 12 men and 53 women were persons already in employment who were, for a number of reasons, seeking a change, while 204 men and 49 women were disabled. Most of these placings were in jobs within daily travelling distance of Kingston but two of the men were applicants on Local Authority Housing Lists for whom it was possible to find work in new and expanded towns. In the absence of suitably qualified persons on housing lists four vacancies in new or expanded towns were filled by the submission of other registrants. As part of the employment service 26 key workers employed by a Surbiton firmg, some of whom lived in Kingston, were assisted under the Ministry's Transfer of Labour Schemes to move their households to Plymouth where they were required to train local labour at the Company' s new factory. The number of ex-Regular service men who sought help in their resettlement into civilian employment was 40 in 1962 compared with 34 in 1961. Of these 15 were placed and 4 were accepted for courses of vocational training to fit them for specific occupations in civilian life. The disappointing downward trend in employment during 1962 appeared to be felt in most manufacturing industries and was due to a variety of causes, There was a general tendency to caution as a result of the Common Market negotiations and many firms reported a reduction in orders, In general the workers discharged were in the semi-skilled and unskilled categories and were more difficult to place in other work because of their lack of skill and qualifications. Where redundancies occurred arrangements were made wherever possible to register workers before they were discharged so that efforts to place them in alternative employment could be made without delay and before their notices expired. In most cases workers received severance payments based on length of service which helped in some degree to mitigate hardship where unemployment ensued. 4 In the aircraft industry the industrial picture was on the whole not so gloomy as the general picture. The decision to proceed with the manufacture of nine P1127 vertical take-off and landing aircraft produced increasing demands for skilled workers in specialised occupations. Recruitment of such workers was undertaken from all parts of the country and several workers coming to work in the Kingston area were paid allowances towards the cost of their lodgings under the Ministry of Labour Transfer Schemes. The retail trade in Kingston continued at a prosperous level and many firms introduced self-service facilities. There is always a high unsatisfied demand for women shop assistants and self-service arrangements do much to overcome the shortage. It is perhaps unwise to attempt to make any predictions about the employment position for 1963. It is probable that unemployment registers will be at a generally higher level than for some years past but I think it is safe to say that if there is a general improvement in the national economic position then Kingston, because of the diversity of its industry, will have a large share in any such improvement." 3. Extracts from Vital Statistics of the Year. The crude birth and death rates for local areas cannot properly be compared by reason of the fact that the population 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 rate for England and Wales as a whole (where the comparability faster is unity). The comparability factors for Kingston-upon-Thames are Births 1.00; Deaths 0.88. The birth and death rates in respect of the town are shown over-leaf and for the purpose of providing some comparison the rates for England and Wales are also shown. 5 VITAL STATISTICS Male Female Total 1211 Total 1961 (a) Live Births- Legitimate 272 292 564 (596) Illegitimate 25 25 50 (43) 297 517 614 (639) Live Birth Rate per 1,000 population. 17.0 (17.1) Adjusted Birth Rate. 17.0 (16.8) 3rd. Wales Live Birth Rate. 18.0 (17.4) Illegitimate Live Births per cent of total Live Births. 8.8 (7.2) Male Female Total 1962 Total 1961 (b) Stillbirths- Legitimate 2 4 6 (10) Illegitimate _ 2 2 (-) 2 6 8 (10) Rate per 1,000 total Live and Stillbirths 13.0 (15.6) England and Wales Stillbirth Rate. 18.1 (18.7) Male Female Total 1962 Total 1961 (c) Total Live and Stillbirths- Legitimate 274 296 570 (606) Illegitimate 25 27 52 (43) 299 323 622 (649) Male Female Total 1962 Total 1961 (d) Deaths- 237 226 463 (462) (i) Death Rate per 1,000 population. 12.8 (12.8) Adjusted Death Rate 11.3 (11.3) England and wales Death Rate 11.9 (12.0) * (ii) Infant Deaths Total No. of Deaths 18 (10) Infant Mortality Rate per 1,000 Live Births 29.3 (15.6) Infant Mortality Rate per 1,000 Live Births- Legitimate 22.8 (16.8) Illegifeimate 6.5 (Nil) Infant Mortality Rat® for England and Wales 21.4 (21.4) ** Neo Natal Mortality Rats per 1,000 Live Births 21.1 (14.1) (iii) Maternal. Deaths (including abortion) total Nil (Nil) (e)Maternal Mortality Rate per 1,000 Live and Stillbirths. Nil (Nil) * Under 1 year of age. ** Under 4 weeks of age. 6 The approximate Infant Mortality Rate for 1962 and the rates since 1958 are shown for purposes of comparison. 1958 1959 1960 1961 1962 Kingston-upon-Thames 15 22 11 16 29 England and Wales 22 22 22 21 21 A considerable upward trend in the number of deaths among very young infants was recorded during the early part of 1962. The causes were attributable to prematurity and atelectasis. QUINQUENNIAL INFANT MORTALITY RATE Years Infant Mortality Rate 1926-1930 56 1931-1935 56 1936-1940 46 1941-1945 52 1946-1950 25 1951-1955 21 1956-1960 17 The following table gives the numbers in age groups of Kingstonupon-Thames children who died during 1962 before reaching the age of one year, together with the cause of death. 7 INFANT DEATHS AGS TOTAL Prematurity Atelectasis Acute Suppurative Bronchitis Acute Suppurative Otitis Media Bronoho Pneumonia Influenzal Pneumonia Multiple Pulmonary Infarcts Cardiac Failure Hydrocephalus Erythroblastosis with Keraioterus 0-24 Hours 6 3 3 — – – - – – – – 24 Hrs. -1 Mth 7 3 - – – 1 – 1 1 - 1 1 Mth -1 Yr. 5 – – 1 1 1 1 – – 1 – Totals 18 6 3 1 1 2 1 1 1 1 1 8 (iv) DEATHS FROM OTHER CAUSES IN 1962. NO OF DEATHS. Heart Disease 143 Cancer 92 Vascular Lesions of the Nervous System 54 Circulatory Disease other than Heart 26 Bronchitis 27 Pneumonia 35 Influenza 7 The following Tables I, II, III summarise certain vital statistics. Table I shows the figures for live births, stillbirths, and deaths for the years 1958-1962 inclusive. The figures in Table II are the Registrar General's estimates for successive years since 1933. They give the population,, number of live births, birth rate per 1,000 population, number of deaths, and death rate per 1,000 population and also the infant mortality rate per 1,000 live births of Kingaton-upon-Thames and England and Walesa. The trend of the estimated population figure is to remain below 40,000. 6 EXTRACT FROM VITAL STATISTICS FOR YEARS 1958-1962 INCLUSIVE. TABLE I. 1958 1959 i960 1961 1962 Total M. F. Total M. F. Total M. F. Total M. F. Total M. F. LIVE BIRTHS Legitimate 506 244 262 536 273 263 545 269 276 596 286 310 564 272 292 Illegitimate 30 17 13 28 17 11 53 21 12 43 26 17 50 25 25 536 261 275 564 290 274 578 290 288 639 312 327 614 297 317 Birth rate(R.G.) per 1,000 pop 13.8 14.5 15.1 17.1 17.0 STILLBIRTHS Legitimate 14 8 6 4 1 3 7 3 4 10 6 4 6 2 4 Illegitimate 1 1 – - - - 1 1 – - - - 2 - 2 15 9 6 4 1 3 8 4 4 10 6 4 8 2 6 Rate per l,000 (live and stillbirths) 27.2 6.1 13.5 15.6 13.0 DEATHS 434 228 206 416 200 216 432 223 209 462 243 219 463 237 226 Death rate(R.G.) per l.000 pop. 11.2 10.8 11.2 12.8 12.8 10 COMPARISON OP VITAL STATISTICS 1953-1962. TABLE II. Year Estimated Papulation Live Births Birth Rate per 1,000 Population Deaths Death Rate per 15,000 Population Infantile Mortality Rate per 1,000 live births Kingston upon Thames England and Wales 1933 38690 470 12.2 464 10.46 59 64 1934 38270 470 12.3 422 11.42 45 59 1935 39030 510 13.0 482 12.82 57 57 1936 39880 573 14.4 502 10.14 52 59 1937 39850 539 13.5 540 11.16 52 58 1938 39790 528 13.2 468 10.44 12.29 43 53 1939 39970 533 13.3 450 10.23 28 50 1940 37430 519 13.9 659 10.16 55 55 1941 35970 520 14.5 525 10.76 57 59 1942 36090 551 15.3 491 10.94 10.84 63 49 1943 359OO 637 17.8 500 9.86 48 49 1944 34780 578 16.6 474 11.61 48 46 1945 35760 593 16.6 505 10.16 43 46 1946 39670 794 20.0 460 11.32 10.41 29 43 1947 40780 870 21.3 495 12.12 22 41 1948 40780 722 17.7 455 13.23 23 34 1949 W3660 729 17.9 500 12.38 20 32 1950 41950 619 14.8 492 10.83 10.44 30 30 1951 39920 574 14.4 556 10.97 24 29 1952 3999O 576 14.4 499 12.04 24 27 1953 39940 609 15.3 465 11.04 24 26 1954 39160 534 13.6 450 11.04 20 25 1955 3907© 543 13.9 424 10.10 15 25 1956 38790 550 14.2 442 11.31 24 24 1957 38590 548 14.2 432 8.56 13 23 1958 388OO 536 13.8 434 9.95 15 22 1959 38590 564 14.5 416 10.98 22 22 1960 38630 578 15.l 432 10.29 11 22 1961 35990 639 17.l 462 11.00 16 21 1962 3599® 614 17.0 463 10.47 11.14 28 21 11 CAUSES OF DEATH - REGISTRAR GENERAL'S TABLES„ TABLE III. 1958 1959 1960 1961 1962 M F M F M F M F M F All Causes 228 206 200 216 223 209 248 223 237 226 Tuberculosis, respiratory 2 - 1 2 3 — 2 – 1 1 Tuberculosis, other 1 2 – — – — – – – – Syphilitic diseases – – 1 1 – — 1 – – – Diphtheria – – – – – – – – – – Whooping Cough – – – – – – – – – – Meningococcal Infections – – – 1 – – – – – – Acute Poliomyelitis – – – – – – – – – – Measles – – – – – – – 1 – – Other infective and parasitic diseases – 2 – 1 – – – – – – Malignant neoplasm,stomach 9 5 2 11 4 1 7 10 4 1 Malignant neoplasm,lung,bronchus, 23 2 23 3 20 3 19 2 24 5 Malignant neoplasm,uterus – 6 – 1 – 1 – 4 – 7 Malignant neoplasm,breast – 5 – 11 – 11 – 12 – 9 Other malignant and lymphatic neoplasms 20 21 29 19 30 28 32 26 23 19 Leukaemia, aleukaemia – 1 1 2 1 1 – 2 2 — Diabetes 3 1 1 2 1 – 2 1 – 2 Vascular lesions of the nervous system, 19 42 22 32 21 32 24 31 24 30 Coronary disease, angina 49 32 35 21 51 38 60 32 47 38 Hypertension with heart diseases 9 4 1 10 5 4 7 4 3 5 Other heart diseases 20 33 12 26 20 27 9 21 22 28 Other circulatory disease 19 13 9 9 11 14 13 20 13 13 Influenza – 1 6 6 – – 1 3 1 6 Pneuaemia. 10 6 9 17 14 3 11 13 17 15 Bronchitis 19 5 14 6 14 2 20 9 18 9 Other diseases of respiratory 2 6 2 1 – – 8 – 1 – Ulcer of stomach and duodenum – – 4 1 1 - 3 3 4 1 GastritiS, enteritis, and diarrhoea – 1 – – 2 2 2 1 – 2 Nephritis and nephrosis – – 1 3 1 1 2 - - - Hyperplasia of prostate 1 - 2 – 2 – 1 - 2 - Pregnancy, childbirth, abortion, – – – – – – – – – – Congenital malformations 1 1 1 1 – 2 2 2 2 1 Other defined and ill-defined diseases 12 10 12 23 10 21 15 20 15 25 Motor vehicle accidents 4 – 4 1 5 3 2 2 6 3 All other accidents 3 5 5 4 4 2 3 3 4 1 Suicide 2 2 3 1 3 3 2 1 4 5 Homicide and operations of war – – – – – – – – – – 12 SECTION B. GENERAL PROVISIONS OF HEALTH SERVICES l. (i) Laboratory Facilities. Bacteriological examinations are carried out by Dr. D.S. Murray at the Laboratory, 37, Coombe Road, Kingston, as part of a pathological service administered by the South West Metropolitan Regional Hospital Board. The Ministry of Health Public Health Laboratory at Epsom is available for consultations and for help in the investigation of any important outbreaks of disease. On occasions special use is made of the services of the Public Analyst in chemical sampling which may become necessary in the interests of public health. Samples of milk for bacteriological examination are submitted to the Public Health Laboratory, Epsom, and samples under the Food and Drugs Acts to the Public Analyst, Mr. D.D. Moir, at the Analytical Laboratory, Southwark Street, S.E.1. (ii) Hospitals. (a) Infectious Diseases. The provision of beds for cases of infectious disease is the responsibility of the South West Metropolitan Regional Hospital Board,, Patients are admitted direct to Tolworth Isolation Hospital, which is under the direction of the Physician Superintendent of Kingston Hospital. Thirtynine eases of infectious disease were treated in hospital during the year but 38 of these had already been notified from Kingston Hospital and related to puerperal pyrexiae To Kingston Hospital 39. (b) Smallpox Arrangements exist whereby cases of smallpox or suspected smallpox can be transported by the London County Council Ambulance Service to special isolation. (Telephone-Whitehall 2177, or Waterloo 3311). 15 (c) General Kingston Hospital, Wolverton Avenue, Kingston-upon-Thames, (Telephone-Kingston 5692), is the main General Hospital situated in the Borough and is a large comprehensive hospital with a full range of general and special departments, and has highly organised out-patient departments fully supported to meet all surgical, medical, and psychological emergencies. 2. Health Services provided by other Authorities. The Medical Officer of Health is the Divisional Medical Officer responsible for the personal health services in the North Central Division administered by the Surrey County Council. Surrey County Council-Health Department. The County Council is the Local Health Authority under the National Health Service Act, 1946, and provides the following services in the Boroughs:- (a) Ante-natal and Post-natal Clinics Health Centre, Grange Road Wednesday afternoon. (b) Infant Welfare Clinics Health Centre (Kingston 726l) Tuesday and Friday afternoons. Thursday afternoon. (Toddlers) Acre Road Clinic, Monday and Thursday 204, Acre Road, (Kingston 5812). afternoons. (e) Dental Clinics Health Centre. Daily,(except Sat.) Acre Read Clinic. Daily by appointment. (except Saturday) (d) Immunisation and Vaccination Clinics. Health Centre. Thursday afternoon. Acre Road Clinic. Friday forenoon. 14 (e) Day Nursery. 53-55 Canbury Park Road Approved dation 46 places. This day nursery admits children aged 0-5 years and a small Charge is made for the care of the children. (f) Midwifery Service Certified midwifes are employed for attendance as midwives or maternity nurses at domiciliary confinements. (g) Home Nursing Home Nursing is undertaken by nurses of the Queen's Institute of District Nursing. Nursing equipment required for use in the home can be supplied on loan through the British Red Cross Society at the B.R.C.S.,H.Q., 73, Penrhyn Road, Kingston-upon-Thames, Kingston 5072). (h) Health Visitors. Health Visitors also act as school nurses working in the clinics and do home visiting. Their work is largely educational and social, defined in the Act as "giving advice as to the care of young children, persons suffering from illness, and expectant and nursing mothers, and as to the measures necessary to prevent the spread of infection. (i) Home Helps. Home Helps are employed to provide domestic help for households "where such help is required ©wing to the presence of any person who is ill, lying-in, an expectant mother, mentally defective, aged, or a child not over compulsory school age age." A charge is usually made for this service but in assessing what the charge should be consideration is given to the means of the persons concerned. (j) Prevention of Illness, Care and After-Care. The care and after-care of tuberculous persons is dealt with by the Care Almoner at the Chest Clinic, Out-Patients" Department, Kingston Hospital, Wolverton Avenue, Kingston-upon-Thames. Among other things, the Counts Council scheme provides for the admission of persons, not in need of medical or nursing care, to recuperative holiday homes and for this a charge is made according to the persons' circumstances. 15 (k) Mental Health. Under the Mental Health Act, 1959, Local Health Authorities are required to provide the following services concerning the after-care of patients discharged from mental hospitals:- 1. Residential accommodation. 2. Occupational and/or Training Centres. 3. Mental Welfare Officers. 4. Guardianships. 5. Necessary ancillary or supplementary services. 6. Care and training of school children of compulsory school age not considered suitable on medical grounds to attend any sort of school. The office of the Mental Welfare (Duly Authorised) Officer for the Borough is at 35, Coombe Road, Kingston-upon-Thames, (Kingston 3302). Surrey County Council - Education Department„ The School Health Service is staffed by the County Health Department and provides the following services:- (a) Routine medical inspection of pupils. (b) Cleanliness surveys of pupils. (c) Dental inspection of pupils. (d) Ascertainment of handicapped pupils in need of special education. Treatment Clinics (i) Minor Ailments. Health Centre. Monday forenoon Tuesdays to Fridays 9-10 a.m. Acre Read Glials. Friday forenoon. (ii) Medical Consultation. Health Centre. Monday forenoon. Acre Road Clinic. Friday forenoon. (iii) Eye Clinic. Health Centre Monday afternoon. 16 (iv) Dental Clinic, See under Health Immunisation Clinic. Department. (v) Child Guidance Clinic. Cases referred to clinic at "Roselands", Kingston Road, New Malden. (vi) Speech Therapy. Health Centre. Mondays & Thursdays by appointment. Welfare Department,, This service is eonerned with the welfare of:1. Aged persona. 2. Physically and mentally infirm. 3. Blind and partially sighted. 4. Deaf and dumb. 5. Epileptic and crippled persons. 60 The provision of temporary accommodation for persons in need thereof. The address of the Welfare Officer for the Borough is 35. Coombe Road, Kingston uponThames (Kingston 4402), In addition, the Surrey County Council implement a scheme for the provision of welfare services for handicapped persons under the National Assistance Act, 1948, other than for blinds, partially sighted and deaf and dumbo The voluntary Association for Surrey Disabled acts as the Council's agents, but certain services are,, however provided by the Counoil direct. They are as follows A. Occupational therapy. B. Training and Rehabilitation. C. Hostel accommodation and workshop facilities, D. Adaptations to Homes In approved eases the Council will assist handicapped persons in arranging for the carrying out of works of adaptation in their homes for their greater comfort and convenience, Further particulars are obtainable from the Handicapped Persons Section, County Health Departments, County Hall Kingstonupon-ThameS, (Kingston 1050, Ext. 326. - 17 Social and Geriatric Services, Social and Geriatric Services for old people are steadily developing and improving. Much is done for them by voluntary associations and many who are relatively fit in mind and body enjoy a fully active and interesting life enlivened fey visits to Clubs, Recreational activities are provided fey these voluntary associations. For those who are beginning to fail and require assistance to maintain themselves in their own homes all the resources of the Divisional Health Services are readily available and much assistance from home helps, district nurses and health visitors as well as from voluntary agencies is given. For those who are in need of more, such as medical or nursing care and who cannot maintain themselves in their own homes the specialised services of a physician, health visitors, and social workers are available from Kingston Hospital,, The main purpose of this arrangement is rehabilitation,, The social worker or the physician visits th® home and assesses the need and urgency for a short stay in on© of the appropriate hospitals. The family doctor is usually the person who first seeks assistance from the Home Help Supervisor, but all enquiries on feehalf of needy old people may fee mad© to Divisional Health Headquarters, Health Centre, Grange Road, Kingston-upon-Thames, (Kingston 726l). The County Welfare Committee provides considerable services for the aged. These include different types of residential accommodation and many domicilliary and advisory services. The County Council also makes grants to voluntary organ- isations towards initial expenses of buying and equipping properties, Children's Department. This Department is responsible for the welfare of children who have been deprived of a normal home life. It has important functions in connection with child life protection and adoption and deals with children taken into or committed to the ear® of the County Couneilj, supervision of foster children, child neglect;, etc. The Children's Officer for the Borough works from the County Hall, Penrhyn Road, Kingston-apon-Thames. 18 Surrey Executive Council. This body is responsible for the provision under the National Health Service Act, 194-6 , of the general practitioner, dental (other than Local Health Authority provision for expectant and nursing mothers, young children), pharmaceutical and supplementary ophthalmic services. The Headquarters of the Council is at 187, Ewell Road, Surbiton, Surrey, (Elmbridge 5722). 19 National Assistance Act, 1948. National Assistance (Amendment) Act, 1951. Under Section 47 of the 1948 Act power is given to the Councils of County Boroughs and County Districts to apply to a Court of Summai Jurisdiction for an Order for removal and detention in a suitable hospital or other place of persons whos- (A) Are suffering from grave chronic disease, or being aged, infirm or physically incapacitated are living in insanitary conditionsj and (B) Are unable to devote to themselves, and are not receiving from other persons, proper care and attention. The 1951 National Assistance (Amendment) Act enables local authorities to deal more speedily with very urgent cases by initial removal, for a period not exceeding 3 weeks. Although a number of eases were brought to the notice of the Public Health Department for investigation during the year it was possible to find a solution to each particular problem without resorting to compulsory methods. 20 SECTION C. SANITARY CIRCUMSTANCES 1. WATER SUPPLY. The town's water supply is provided by the Metropolitan Water Board who successfully maintain constant supervision over the purity and adequacy of the supply. Well water is used for industrial purposes at certain factories and a dairy, but is not used as a domestic supply, all the houses in the town being provided with a main water supply. In the case of the dairy, well water is used for cooling and bottle washing. During the year 29 samples from this source were submitted for examination all were reported to be satisfactory. 2. DRAINAGE AND SEWERAGE . The sewage from the Borough gravitates to the Corporation Pumping Station and is then pumped to the North Surrey Joint Sewage Board's Works for treatmento This is a modern plant and successfully provides very effective purification and disposal for the sewage of Epsom & Ewell, Surbiton, Maiden & Coombe, and Kingston-upon-Thames population. 3. RIVERS AND STREAMS. The River Thames forms the Western Boundary of the Borough and is under the control of the Thames Conservancy Board. The Hogsmill River, a tributary of the Thames, flows through the Borough. A considerable portion of the flow of this river comprises the effluent from the North Surrey Joint Sewage Board Works. 4. CLOSET ACCOMMODATION. All closets in connection with dwelling houses in the Borough are on the water carriage system. 21 5. PUBLIC CLEANSING. The Borough Surreyor is responsible for the collection and disposal of house and trade refuse. Disposal is carried out by tipping into a worked-out gravel pit provided by the haulage contractor. The refuse from this Botough, Surbiton and Maiden is transferred to large capacity road vehicles and transported to the tip by the contractor,. The refuse is weighed on a weighbridge and 13,114 tons of refuse were sent from this Borough in 1962. 6. SANITARY INSPECTION OF THE AEBA. The following is a tabulated list of visits and inspections made by the Public Health Inspectors which totalled 9,204 as compared with 7,500 for 196l. House inspections, defects, etc 398 Drainage 596 Factories 133 Outworkers 14 Atmospheric Pollution 257 Dairies, milk shops, etc. 156 Food Premises 905 Restaurants and cafes 347 Infectious disease enquiries 107 Cinemas 5 Verminous premises 19 Rodent 0ontrol 22 Shops Act 250 Schools 39 Housing 1 Markets 764 Public sanitary conveniences 84 Fireguards 47 Merchandise Marks Act 253 Interviews 473 Miscellaneous 1257 Smoke Control Inspections 631 Smoke Control Rein sits 779 Noise Coniplaint Visits 47 Reinspections and works in progress7614 1590 9204 22 NOTICES SERVED. Informal„ (a) verbal 94 (b) Written 191 Statutory. (a) Housing Acts - (b) Public Health Acts 20 (c) Clean Air Act 6 NOTICES COMPLIED WITH. Informal. (a) Verbal 285 (b) Written Statutory. Public Health Acts 25 7. SHOPS. There are some 900 shops in the Borough and inspections are made with regard to those provisions of the Shops Actj, 1950 which are concerned with sanitary accommodation, washing facilities, heating 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 Public Health Inspectors are also responsible for the administration of the law relating to shop hours, including early olosing and Sunday trading. 8, FACTORIES ACT, 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. 23 PART I OF THE ACT. 1. INSPECTIONS Premises No. on Register Number of' Inspections Written Notices Prosecutions Factories in which Sec. 1, 2,3,4 & 6 are enforced by the Corporation 35 5 2 - Factories not included above in which See,, 7 is enforced by the Corporation 238 117 - - Other premises excluding Outworkers - 10 - - 2. CASES IN WHICH DEFECTS WERE FOUND No„ of cases in which defects found Found Remedied To H.M. Inspec- tor By H.M. Inspee- tor No. of ProseCutions Want of cleanliness = - - - - Overcrowding - - - - = Unreasonable temperature - - - - - Inadequate ventilation 1 1 - - - Ineffective drainage of - - - - - floors - - - - - Sanitary Conveniences (a) Insufficient - - - - - (b) Unsuitable or defective 1 1 1 — - (c) Not separate for sexes - - - - - Others - - - - - 24 PART VITT OF THE ACT„ Outwork. The following table gives details of work which is carried on in private dwelling houses. The conditions obtaining have been found to be satisfactory. Noo of Nature of Work , Outworkers Making of wire brushes and pot scourers 10 Wearing apparel -making etc. 4 Brass & Brass- Articles 2 Doll's Clothes 1 Lampshades 1 18 9. CAMPING- SITES. There are no camping sites within the Borough. 10. ATMOSPHERIC P0LUJTI0N. Clean Air Act 1956 - Smoke Control Areas. Smoke Control Orders Nos„ 1 and 2 became operative on October 1st. 1962, covering an area of approximately 160 acres in the town centre and extending southwards from the railway to the junction of South Lane and Portsmouth Road, and from the river by way of The Bittoms, Penrhyn Road, Brook Street, Orchard Road, Fairfield South, Minerva Road and London Road to the railway. The number of premises affected is as follows - Domestic 914 Commercial 617 Industrial 22 Other 48 The Minister of Housing and Local Government confirmed the making of the No, 3 Smoke Control Order, the operative date being October 1st, 1963, covering an area of 135 acres bounded by Cambridge Road, London Road, Kingston Hill and the municipal boundary with Maiden & Coomb. 25 The number of premise affected is as follows Doraestic 1,271 Commercial 110 Industrial 2 Other 7 During the year survey work was started in Area No, 4. which covers approximately 100 acres and includes over 1,000 dwellings and commercial premises in the southernmost part of the town, This will extend from Area N0. 1 south along the river and south-east along Denmark Road and Grove Lane to the municipal boundary with Surbitonc Smoke Nuisance0 Sixteen complaints were received in respect of smoke nuisance, ten of which referred to the burning of rubbish. This type of nuisance is sometimes created by the thoughtless action of persons who are unaware of the proper means of disposal, but on many occasions it is caused by a complete disregard of the rights and feelings of others who are subjected to considerable annoyance from smoke disagreeable fumes and ash, Much nuisance would be avoided if soft rubbish such as lawn mowings could be composted, As the soil in the area is mainly light, the addition of humus would help to enrich it, Tree trimmings and woody stems should be laid on a wire mesh rack and when dried, this material wi burn quickly with a minimum of smoke. Two complaints referred to the smoke nuisance from a dlesel driven compressor used by one of the public utility companies engaged on road works Upon representation to the proper quarter the appliance was withdrawn for servicing,, It is not infrequently that excessive smoke is seen to come from diesel engines in various types of vehicles and invariably the nuisance is due to lack of proper maintenance. A diesel engine properly maintained and used does not emit smoke in any quantity which could be considered to be objectionable. The four remaining complaints were domestic in character, and advice waa given in these cases. During the year the incinerator at a large store was entirely reconstructed and a washing system installed which effectively removes fly ash and much of the chemical oontent of the flue gases. This installation which was, in the main, designed by the engineering staff of the store, is probably one of the most advanced of its kiad in operation. 26 In the last Report reference was made to a. survey following complaints which had been received of excessive grit deposition alleged to be emanating from the Power Station. Due to the variable factors relating to plant operation and weather conditions, such surveys are often protracted and the results inconclusive. The snowfall on the 31st Decemberj, 196l, however. presented an opportunity to carry out a widespread survey of the Borough over a period of 43 hours between the end of the snowfall and the Collection of the samples. Specimens were taken by skimming a layer of snow from an area of a quarter of a square metre at seven different points in the Borough, The material collected was submitted to the Public Analyst, and the results were collated with the hourly wind readings during the period. The results of this survey can best be summarised in the concluding paragraphs of the Public Analyst' s report:- "In my opinion the collection of these deposits from the surface of the snow under the conditions obtaining at the time is of great importance as it eliminate pollution due to wind-borne dust from roads ground surfaces and roofs of houses. This is confirmed by the virtual absence of ordinary siliceous particles. The conclusion to be drawn from the magnitude of the deposit at Canbury Car Park as compared with the other sites chosen is inescapable. There can be little doubt also, that the pollution over the Kingston area derived from the power station is heaty and that particles of substantial size are carried for a considerable distance," These conclusions were reported to H,M,District Inspector of Alkali etc. Works and upon his approach to the authorities at the Power Station a full investigation was carried out which was followed by the adoption of improved methods both of operation and maintenance of the grit collecting equipment. It is reasonable to assume that the action taken at the Station is reflected in the improved figures reported from the deposit gauges and the absence of complaints by residents. As weather conditions also affect the results from deposit gauges„ it may be some years before the full effects ©an be ascertained. Recording of Atmospheric Pollution. Instruments are maintained on the Guildhall roof and at Tiffin Girls' School for the recording of smoke and sulphur dioxide by the volumetric method. The advantage of this method over the deposit gauge is that it is possible to obtain daily readings of pollution and to observe more closely the effects of weather conditions on the state of the atmosphere. The following tables and graphs indicate the results obtained, Steoke and sulphur dioxide are expressed in microgrammes per cubic metre. 27 Results obtained from Volumetric Instrument at the Guildhall. Month Smoke 502 Monthly Average Highest Value Lowest Value Monthly Average Highest Value Lowest Value January 100 708 8 152 1057 6 February 74 412 12 146 551 19 March 132 384 28 231 527 57 April (25 days) 43 144 4 106 439 37 May 27 120 4 66 213 13 June 15 47 2 45 278 13 July 19 56 3 49 191 6 August (27 days) 9 45 2 21 108 6 September 26 70 3 49 115 13 October 112 392 11 159 421 13 November 103 481 12 194 596 32 December 206 975 17 344 2144 39 28 Smoke and Sulphur Dioxide, 1962, Results obtained from the Volumetrie Instrument at Guildhall. 29 Tiffin Girls’ School, This instrument was installed in September, and during term time is operate by the pupils. The co-operation of the Headmistress the staff and pupils in this experiment is greatly appreciated. The following are the results obtaineds:- Month Smoke S02 Monthly Average Highest Value Lowest Value Monthly Average Highest Value Lowest Value August 55 204 16 27 145 6 September 112 324 16 44 76 17 October 108 448 16 149 509 45 November 149 519 40 174 550 38 December 220 912 33 297 1458 54 In addition to the instruments previously referred to„ the Corporation maintains two deposit gauges which were located, after consultation with the Department of Scientific and Industrial Research, in Caribury Gardens and Tiffin Girls' Sehoal respectively. They are, for the purposes of report. referred to as "A" and 'B' The following tables give the results of analysis, together with rain fall and wind readings„ The figures are from observations made to show the effects when the prevailing wind was blowing from industrial sources towards the recording stations. 30 Smoke and Sulphur Dioxide, 1962. Results obtained from the Volumetric Instrument at Tiffin Girls’ School. SMOKE-Mioregrammes per cu.m. so2 - Microgrammes per eu.m. 31 CANBURY GARDENS - Station ‘A. 1962 Deposit in Tons per sq. mile Wind Direction Rainfall in Inches Insoluble Solids Soluble Solids Total Solids No of 0bservations No. of limes S. E-S.W. January 26.79 11.92 38.71 26 14 3.19 February 11.69 5.07 16.76 23 6 0.63 March 9.87 5.59 15.46 27 6 1.30 April 8.8O 10.80 19.60 22 5 1.46 May 10.73 6.77 17.50 26 11 1.93 June 13.21 6.09 19.30 23 13 0.28 July 14.73 5.49 20.22 25 13 2.36 August 12.29 5.59 17.88 22 10 1.97 September 12.67 7.088 20.55 20 17 2.36 October 12.86 11.6l 24.47 23 13 2.48 November 9.89 60.98 l6.87 22 10 1.85 December 12.60 7.68 20.28 18 9 2.20 Totals 156.13 91.47 247.600 22.01 Average 1962 13.61 7.62 20.63 1.83 Average 1961 20.03 11.99 32.02 2.00 32 TIFFIN GIRLS SCHOOL - Station B. 1962 Deposit in Tons per sq. mile Wind Direction Rainfall in Inches Insoluble Solids Soluble Solids Total Solids No. off 0bservations No. of times S.E-S.W. January 17.93 7.ll 25.70 26 14 2.99 February 6.60 4.21 10.81 23 6 0.43 Marsh 4.55 4.48 9.03 27 6 1.30 April 3.58 6.87 10.45 22 5 1.46 Kay 4.48 5.97 10.45 26 11 1.85 June 6.44 3.78 10.22 23 13 0.20 July 9.86 5.94 15.80 25 13 2.40 August 2.52 3.65 6.l7 22 10 1.77 September 4.15 4.95 9.l0 20 17 2.40 October 4.61 6.07 10.68 23 13 2.25 November 3.39 7.07 10.46 22 10 1.81 December 8.70 8.09 16.79 18 9 2.01 Totals 76.81 68.85 145.66 20.87 Average 1962 6.40 5.73 12.13 1.74 Average 1961 6.79 5.89 12.68 1.90 33 The following additional table, illustrated with a graph, is of interest in showing the trend of atmospheric pollution over the years. Average Monthly Deposit - Tons per square mile. Year Station A. Canbury Gardens Station B. Tiffin Girls School Total Solids Insoluble Solids Total Solids Insoluble Solids 1949 20.41 12.04 - - 1950 22.17 13.92 14.98(6/12) 5.27(6/12) 1951 22.19 14.34 12.47 5.22 1952 19.l2 12.91 12.49 5.88 1953 17.58 11.98 10.32 4.59 1954 18.70 12.29 10.21 4.63 1955 15.85 10.77 9.13(11/12) 4.80(11/12) 1956 19.00 10.04 9.95 4.67 1957 19.08 12.51 8.95 4.34 1958 15.86(ll/l2) 9.22(13/12) 9.42 4.10 1959 19.75 13.62 11.51 6.40 1960 20.86 12.42 11.74 5.83 1961 32.02 20.03 12.69 6.79 1962 20.63 13.01 12.13 6.40 Total Solids - Tons per Square Mile, Caribury Gardens 34 35 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 concerts, dancing etc. The pools are equipped with pressure filters capable of treating the water of both pools every 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 BSD BU&S. During the year eleven premises were disinfestedo Five of these were houses under the control of the Corporation. 13. COMPLAINTS. The number of complaints received from the general public during the year was 364 compared with 456 for the previous year. The following is a brief list of causes for complaints received during 1962:- Accumulations 15 Ashbins 1.6 Caravans 2 Drains & Sanitary Arrangements 81 Food 23 General Housing Defects 49 Insects and Pests 24 Noise 11 Offensive Odours 16 Rodents 96 Overcrowding 1 Smoke l6 Water 7 Yard Paving 2 Others 5 364 36 14. RODENT AND INSECT PEST CONTROL. During the year under review„ the volume and character of the work has been similar to that of previous years„ Householders still provide harbourage for rodents in their gardens by hoarding old furniture. perambulators and other rubbish. The Corporation have provided a service for the removal of such articles - details given below„ The 54 vertical block control schemes yielded the usual proportion of sewer and other defects. During the year 17 such defects were responsible for rat infestations. Rodent control in sewers is now carried out more economically by treating more frequently known areas of persistent infeation in the system,, The percentage method previously used has, by experience, been preved to be unnecessary. The pest control service provided on a contract basis to the industrial and commercial interests in the town is appreciated and an efficient and readily available control has been maintained. The Authority’s service is held in esteem by the officers of the Ministry of Agriculture, Fisheries and Pood. Colonial students and field officers regularly spend part of their training in the Department. We on our part readily acknowledge the co-operation of the officers of the Ministry, particularly with regard to identification of unusual insects. (The Borough Surveyor’s Department arrange for the free collection of domestic rubbish, including perambulators, etc., provided reasonable notice is given, and the accumulation is not excessive„) 37 Rodent Control - Statistical Statement. 1962. Local Authority Property Dwelling Houses Business & factory premises Totals No. of properties inspected as a result of notification 2 73 18 93 No. of properties Inspected in the course of surveys 7 172 154 333 Totals 9 245 172 426 Premises infested Rats 1 64 34 99 Mice Nill 31 56 87 Totals 1 95 90 186 Total inspections including reinspeetions 242 659 2,420 3,321 No. of "block" or "vertical" control schemes 3 19 32 54 No. of poison baits deposited 659 287 1,196 2,142 38 SECTION D. HOUSING During the year one application for a Certificate of Disrepair under the Rent Act, 1957 was made, as compared with nine in 196l. With regard to statutory action under the provisions of the Housing Act 1957, Closing Orders were made in respect of No„ 31, Elm Road and the upper part of No. 49, Eden Street. During the year the following premises were demolished in compliance with Clearance Orders previously made - NoS. 77a/99, Park Road and Nos. 17/21b, Brook Street. 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. 1. Number of houses inspected and recorded 31 Number of houses which, on inspection, were considered to be unfit for human habitation 1 (a) Parts of houses which, on inspection, were considered to be unfit for human habitation 1 3. Number of houses, the defects of which were remedied in consequence of informal action by the Local Authority or its officers 144 4. Number of representations made to the Local Authority with a view to:- (a) the serving of notices requiring the execution of works 30 (b) the making of demolition or closing orders (number of houses involved) 2 5. Number of formal notices served requiring the execution of works 26 6. Number of houses which were rendered fit after the service of formal notices 16 7. Number of demolition or closing orders made 1 8. Number of houses in respect of which an undertaking was accepted under sub-seotion 4 of section 16 of the Housing Act 1957 - 9. Number of houses demolished 17 39 Housing - Statistical Statements, 1962. Total, number of permanent dwellings erected by the Corporation since Marsh 1924 to 31st December, 1962. Houses and Bungalows 1,150 (lnc. 876 outside Borough) Flats 940 (ins. 326 outside Borough) Units of accommodation for OId people 11 Total number of temporary dwellings erected up to 31st December,, 1962. Still remaining Arson 132 127 Aluminium 70 27 2-year huts 113 Nil "515 154 Number of dwellings erected by private enterprise during 1962. House 2 Flats and Maisonettes 94 Bungalows 1 97 With regard to Corporation housing, an extension. was made to No 22, Gloucester Road, thereby providing. eleven units suitable for occupation by old people. Work proceeded during the year on the undermentioned sites, and upon completion, the housing units enumerated will be provided„ Acre Road 93 Penrhyn Road 32 No, 33, Gloucester Road 19 old people’s bsd-sitting rooms, 1 warden's flat. Park Road 10 old people’s bed-sitting rooms, 1 warden's fiat. 40 SECTION E. INSPECTION AND SUPERVISION OF F00D. (a) Milk Supply. All milk supplies in the town are brought in from outside sources, there being no milch herds in the Borough. 111 known sources of supply are regularly sampled. The quality generally has proved to be satisfactory throughout the year. Under the provisions of the Milk (Special Designations) (Special Areas) Order 1951, the Borough of Kingston-upon-Thamea 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 Borough. (b) designated Milks. The following table shows the number and types of licences in force during 1962 under the provisions of the Milk (Special Designations) Regulations 1960. These Regulations prescribe that the licences shall cover a five-year period, and with the exception of one pasteuriser's licence, all are dealer’s licences to sell prepacked milk. Type of Licence Number Pasteurised milk 10 Sterilised " 4 Tuberculin Tested Milk 1 Pasteurised & Sterilised Milk 4 Pasteurised & Tuberculin Tested Milk 3 Pasteurised, Sterilised and Tuberculin Tested Milk 6 To Pasteurise 1 29 41 (c) Bacteriological Examination of Milk. During the year 108 samples of milk were sent to the Public Health Laboratory at Epsom, and the following is a tabulated statement of the results:- Phosphatase Test Methylene Blue Test Pass Pass Pail Void T.T.Pasteurised 61 55 — 6 Pasteurised 32 29 — 3 Tuberculin Tested — 12 2 1 93 96 2 10 All the samples of Pasteurised Milk passed the phosphatase test which indicates that the milk has been properly pasteurised. The methylene blue test is a measure of the bacteriological condition of the milk and in accordance with the standard set by the Milk (Special Designations) Regulations 1960, this test is void if the atmospheric shade temperature exceeds 700 F. during the period of the test. The two samples of Tuberculin Tested Milk which failed the test were from the same source. Appropriate follow-up action is being taken. (d) Ice Cream. The number of registered premises in the Borough in which ice cream may be stored or from which it may be sold is 173. This figure also includes five producers,, In addition to these dealers and producers, there are other premises, such as restaurants, canteens, cinemas, ete. 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 Borough. 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 79 samples submitted to the Ministry of Health Public Health Laboratory at Epsom during 1962. Owing to the numerous factors governing the hygienic quality of ice cream, undue attention is not paid to the bacteriological results on any single sample. Those which are placed within Grades I and II are considered to be satisfactory, and those within Grades III and IV not so. Adequate follow-up action is taken where samples fall within the latter grades. 42 Of the 79 samples taken, 57 were from the producers in the town and the remainder from the retailers. The results are considered to be most satisfactory and indicate a good standard of hygiene. GRADE I II III IV Total Ice Cream 70 3 2 4 79 (e) Meat and Other Foods. (i) There are no slaughterhouses in the Borough. The supply of meat for the town arrives from Smithfield and through the local wholesale shops. A certain amount of home killed meat also comes from the modern abattoir at Guildford. (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 quantities involved are small in comparison with the amount of food which is handled in the town. The list is very much condensed to avoid unnecessary detail. Tabulated list of Condemned Foodstuffs showing causes for condemnation and the weights. Article of Food Reason for Action Weights Raw Meat lbs. lbs. Bovine Decomposition etc. 2,244½ Ovine ,, 7943/4 Porcine ,, 4993/4 Total - raw meat 3,539 Raw Fish Decomposition 86 Poultry, Game, ete. ,, 53 ... continued overleaf. 43 Condemned Foodstuffs - Tabulated list cont/d. Article of Food Reason for Action Weights. Canned Goods lbs. lbs. Meat & Meat Products 6363/4 Fruit Punctured, blown, 1,7481/4 Jam 141/4 Vegetables damaged or 2603/4 Milk decomposition. 29 Soup 141/4 Fish & Fish Paste 691/4 Others 381 3,153½ Other Foods condemned for various reasons. Fruit 2681/4 Jam 2 Cheese 653/4 Confectionery 14 Others 14 364 Unsound food is turned into a condition from which recovery is impossible and placed in vehicles for conveyance to a tip. Where this method of disposal would be unsatisfactory, arrangements can be made for incineration at the refuse destructor of the Merton and Morden Urban District Council. (f) Food Hygiene. The normal routine inspection of food premises was carried on throughout the year. Generally speaking it was found that a very satisfactory standard of food hygiene was being maintained. In the few instances where slackness or structural defects were encountered, appropriate action was taken. The active co-operation of proprietors and managers is almost invariably given to the Public Health Inspectors who, on their part, seek to give assistance by advice and encouragement„ The modernisation and structural improvement of food premises is still being voluntarily undertaken by both large and small firms, in many eases prompted by the increased prepacking of foodstuffs and the continuing preference of the public for the self-service type of shop. New restaurants and cafes are opened from time to time and appear to flourish, indicating an unsatisfied demand for meals and snacks in the better class of establishment. As in the past, whin plans and proposals are submitted for the alteration of existing, or the establishment of new, businesses, every effort is made to ensure that the premises will comply with the Regulations in the first instance. This is a service which is appreciated by the proprietors. 44 A distinct improvement in the hygienic conditions at many food shops and restaurants is being achieved by the use of the paper sack system of refuse collection. Proprietors have been quick to realise the advantages of this system, particularly where storage space is limited or access by the refuse collection service is difficult. The sacks are supplied by the Corporation at cost price and a suitable paper sack holder can be obtained from the makers for about the price of an ordinary refuse bin. The following tabulated statement shows the nature of the defects for which Notices were served during the years- PART IV Defects Requiring Notices Complied Sanitary Conveniences Lack of "Wash your Hands Notices" 3 3 Fittings cleansed, repaired or extended 8 10 Walls and ceilings cleansed 4 5 Lighting Provided 2 2 Floors repaired or cleansed 1 1 Ventilation provided 1 1 Sinks. Renewed or repaired, also draining boards 4 3 Washing facilities for Staff. Absence of, defective, inadequate hand basins 4 2 Absence of hot water 4 3 " " cold water 3 2 Provision of Towels, soap, nailbrushes 3 2 Repairs to Food Rooms Walls and ceilings cleansed or repaired 14 14 Additional ventilation required 1 1 Floors repaired 5 3 Other structural repairs 1 1 Protection of Food against Contamination Food to be kept 18" off ground 1 1 Covers provided for food 2 2 Others 6 5 Uncleanliness. Kitchens and Equipment 3 5 Delivery Vans 1 1 Floors 1 1 C/Fwd. 72 68 .. continued overleaf 45 Food Hygiene - Tabulated Statement cont/d. PART IV Defects Requiring Notices Complied B/Fwd. 72 68 Dustbins Provision of, or racks 7 7 General Repairs 1 3 Cleansing General 3 4 Others 2 4 Total 85 86 Food Hygiene Regulations 1955. In accordance with the request of the Minister of Health the following is a tabulated statement of inspections made during the year of the various types of food premises. Food Premises No. of Premises Visits Bakehouses and bakers' shops 25 41 Dairies and milk shops 25 45 Butchers 40 118 Greengrocers and fruiterers 89 111 Public houses (a) Providing restaurant services 17 48 (b) Not providing restaurant services 41 Fishmongers and stalls 16 39 Ice Cream premises registered 173 111 Grocers and general provisions 132 206 Restaurants and cafes 69 347 Kitchens and canteens (including factory, school and shop) 35 Wholesale meat distribution depots 6 79 Visits to food premises re unsound food 141 Open market, food stalls, barrows 764 668 2,050 FOOD AND DRUGS ACT. 1955. During the year, 78 samples were submitted to the Public Analyst in accordance with the provisions of the Food and Drugs Act, 1955 and the Labelling of Food Order and other relevant Orders and Regulations. 46 Only one sample was the subject of adverse comment. The manufacturers were approached with regard to a contravention of the Labelling of Food Order, but it transpired that the sample taken was of old stock and that the packet now in use carried an amended form of label which complied with the Order. Tabulated Statement of Samples Submitted to the Public Analyst during 1962 Commodity No. of Samples Genuine Not Genuine or otherwise Formal Informal Formal Informal Formal Informal Almond Marzipan - 1 - 1 - - Apple Flakes - 1 - 1 - - Beetroot - 1 - 1 - - Biscuits - 3 - 3 - - Braised Sliced Pork Kidneys - 1 - 1 - - Caramel Wafers - 1 - 1 - - Cheese Flaps in Tomato Sauce - 1 - 1 - - Cheese Spread with Ham - 1 - 1 - - " " " Shrimps - 1 - 1 - - " " " Tomato - 1 - 1 - - Cheez Whiz - 1 - 1 - - Chicken & Veal Pie - 2 - 2 - - Chicken Meat Paste - 1 - 1 - - Chicken Supreme - 1 - 1 - - Chocolate Spread - 1 - 1 - - Coffee (French) - 1 - 1 - - Coffee & Chicory - 1 - 1 - - Coffee (instant) - 1 - 1 - - Crab Meat - 1 - 1 - - Currants - 1 - 1 - - Curried Beans with Sultanas - 1 - 1 - - Curried Chicken & Mushrooms - 1 - 1 - - Curry (Beef) - 1 - 1 - - Curry Sauce - 1 - 1 - - Dressed Lobster - 1 - 1 - - Fish Cakes - 2 - 2 - - Fish Paste - 1 - 1 - - Fish Steaks - 1 - 1 - - Flake Tapioca - 1 - 1 - - Flan with Jelly - 1 - 1 - - C/Fwd. - 34 - 34 - - 47 Food and Drugs Act - Samples .... continued Commodity No. of Samples Genuine Not Genuine or otherwise irregular Formal Informal Formal Informal Formal Informal B/Fwd. - 34 - 34 - - Frankfurter Sausages in Brine - 1 - 1 - - Fruit, Mixed - 1 - 1 - - Glace' Cherries - 1 - 1 - - Ground White Pepper - 1 - 1 - - Hamburger - 1 - 1 - - Horseradish (Creamed) - 1 - 1 - - Horseradish Sauce - 1 - 1 - - Instant Whip - 1 - 1 - - Jam - 2 - 2 - - Lemon Pie Pilling - 1 - 1 - - Linseed, liquorice & chlorodyne lozenges - 1 - 1 - - Milk - 6 - 6 - - " Evaporated - 1 - 1 - - Mint in Vinegar - 1 - 1 - - Mock Salmon Croquettes - 1 - 1 - - Mushrooms in Savoury Rice - 1 - 1 - - Mustard - 1 - 1 - - Ox Tongues - 1 - 1 - - Pate de Foie Troff??? - 1 - 1 - - Peas, dried - 1 - 1 - - " garden - 1 - 1 - - Pork, canned - 1 - 1 - - Pork Pie - 1 - 1 - - Ravioli in Tomato Sauce - 1 - 1 - - Raisins, seedless - 1 - 1 - - Rice, Whole - 1 - 1 - - Rilehoc Block - 1 - 1 - - Salmon (Canned) - 1 - 1 - - Steak with Gravy - 1 - 1 - - Steak & Kidney Pie - 2 - 2 - - Pudding - 1 - 1 - - Steak, Stewed with Gravy - 1 - 1 - - Steamed Pudding Mixture - 1 - - - 1 Strawberries in Syrup - 1 - 1 - - Sultanas - 1 - 1 - - Vanilla Flavouring - 1 - 1 - - Total - 77 - 76 - 1 48 Other Foods which were the subject of Complaint. Metal in Chicken Noodle Soup. The piece of metal proved to be solder from the side seam of the can body. The manufacturers were notified. Metal in Wheatmeal Loaf. This was found to be part of a cap to a can containing malt extract. The baker undertook to arrange for the caps to be removed from the cans before being taken into the bakery. Leg of Lamb. A musty smell was detected when carved. The matter was referred to an adjoining Borough where the joint was purchased. Glass in Wimpy Hamburger. Additional precautions were taken to protect the stock from possible contamination by foreign matter. Weetabix containing hard substance. The material complained of was found to be a normal constituent but its presence in the hard form was due to a manufacturing fault. Violet Discoloration in Roast Pork. The pig had been inoculated with anti-swine fever vaccine which incorporates a dye known as crystal violet. There would be no danger to health through consumption of meat9 but its presence is objectionable. Foreign Bodies in Loaf. These were found to be poppy seeds used for sprinkling on the outside of certain loaves. The presence of the seeds in the loaf was not normal and the baker undertook to ensure that these could not be incorporated in the dough. Mould Growth on Apple Strudels. It was not possible to trace the cause of mould growth. No fault could be found with the methods of distribution. storage and sale of either manufacturer or retailer. It was not possible to pursue the matter any further. Foreign Matter in Wrapped Loaf. This was identified as a piece of brown (i.e.wholemeal or wheatmeal) dough incorporated in a white loaf. This was a case for alteration in bakery routine. Pork Pie with Mould Growth. This appeared to be due to a failure in stock rotation. After due consideration, in this case a warning letter was sent to the vendor. 49 Pea in Bottle of Lemon Barley. A most unusual case. In the absence of a seal on the bottle9 it is not known at what stage the foreign body was introduced. Dirty Milk Bottles. Two cases were reported during the year. Both related to hard mineral substances adhering to the inner surfaces of the bottles. In both eases the sealing processes at the dairies rendered the bottles sterile and the contents were not, therefore, unfit for food. The dairies concerned were warned and they have undertaken to ensure stricter supervision in order to avoid a repetition. The public could co-operate to a greater extent by ensuring that milk bottles are not misused. Rubber Band in Butter. Investigation at the shop confirmed that the band was one used for semiring egg cartons. The Manager agreed to keep the box of bands in a position less likely to cause trouble, while the assistants were warned to exercise greater care. Alleged Contamination of Pine Oatmeal. The consignment was made in a hurry and due care was not exercised to ensure that the grinding stone was completely free from fibrous grain before a change to oat flour. The oatmeal, however, was not considered to be unfit for human consumption. Alleged foreign matter in Pork Luncheon Meat. This sample was submitted to the Public Analyst who reported that in his opinion the blemish in the pack was probably due to a little of the raw minced meat and cereal preparation having been left behind in the blender or other part of the plant, and that in the interval before a subsequent batch was put through it had been discoloured by oxidation and by absorption of iron. There was no evidence of decomposition of meat. The manufacturers were informed so that their attention could be directed to any fault which may have occurred during processing. Of the remaining six complaints, four referred to food sold out of conditions, one to a minor foreign body and the other to a fault in manufacture. Fewer complaints have been received which could be attributable to lack of care in stock rotation. It is to be hoped that retailers will continue to focus attention on this important aspect of the trade. In the present era of severe competition in the food trade it must surely be good business to ensure that foods are served as fresh as possible; the cause of clean and safe food will be advanced at the same time. 50 Whilst every ease of food contamination must be regarded as serious, the number of complaints are few in relation to the very large amount of food which passes through the shops in the town. Consideration must also be given to the number of transactions involved and the persons concerned in processing, packing and handling the food. Food traders and manufacturers are very sensitive to complaints and the trade in general co-operate fully in an effort to avoid any cause for repetition. 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 wider the above Act in respect of certain foods - mainly imported apples and tomatoes. Thirteen warning notices were given, but it was not sidered necessary to take any legal enforcement action. 51 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 Boroughs:- 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 Malaria Cholera Plague Typhus Fever Relapsing Fever Tuberculosis Anthrax Leprosy is notifiable by General Medical Practitioners direct to the Chief Medical Officer of the Ministry of Health, In 1962 a total of 81 notifications of infectious disease was received, and these are analysed and commented upon in the following tables and reports. 52 NOTIFIABLE DISEASES DURING- 1962. TABLE IV. 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 eases notified Cases admitted to hospital 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 Diphtheria - - - - - - - - - - - - - - - - - - - - - - - - - - - Scarlet Fever - - - 1 1 1 - 1 - - - - 4 - - - - - - - - - - - - - - Measles 1 3 3 2 2 5 - 2 - - 1 - 19 - - - - - - - - - - - - - - Whooping Cough - 2 - 1 - 2 - - - - - - 5 - - - - - - - - - - - - - - Acute Poliomyelitis: Paralytic - - - - - - - - - - - - - - - - - - - - - - - - - - - Non-paralytic - - - - - - - - - - - - - - - - - - - - - - - - - - - Acute Infective Encephalitis - - - - - - - - - - - - - - - - - - - - - - - - - - - Meningococcal Infection. - - - - - 1 - - - - - - 1 1 - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - 8 24 6 - - 38 38 - - - - - - - - - - - - - Dysentery 1 - - - 3 2 - - 1 1 - - 8 - - - - - - - - -- - - - - - Food Poisoning - - - 1 l - - - - - - - 2 - - - - - - - - - - - - - - Pneumonia - - - - - - - - - 1 3 - 4 - 3 - - - - - - - - - 4 25 32 Erysipelas - - - - - - - - - - - - - - - - - - - - - - - - - - - Ophthalmia Neonatorum - - - - - - - - - - - - - - - - - - - - - - - - - - - Totals 2 5 3 5 7 11 - 11 25 8 4 - 81 39 3 - - - - - - - - - 4 25 32 55 The following table gives a comparative statement of notifications of certain infectious diseases received during the last thirty years:- TABLE V. Year Scarlet Fever Measles * Whooping Cough * Puerperal pyrexia Poliomyelitis Acute Infective Encephalitis Diphtheria Ophthalmia Neonatorum Enteric Fever (including para-typhoid) 1933 125 - - 10 3 - 30 2 2 1934 40 - - 5 - - 42 3 2 1935 54 - - 8 - - 50 3 2 1936 67 - - 19 - - 27 2 6 1937 51 - - 32 2 - 21 3 1 1938 61 - - 47 2 - 72 2 1 1939 69 - - 66 1 - 19 3 1 1940 45 373 22 63 - - 53 3 3 1941 54 331 271 37 1 - 15 - 7 1942 79 375 99 24 - - 8 3 - 1943 110 287 151 18 1 - 3 - 1 1944 49 33 73 15 1 - 7 2 - 1945 28 407 84 23 1 - 16 2 - 1946 34 283 67 41 2 - 8 1 1 1947 24 219 38 28 5 3 2 1 1 1948 34 197 200 30 3 - - - - 1949 73 483 81 29 7 3 - - - 1950 51 132 41 23 4 - - - - 1951 37 443 222 41 - 1 - - - 1952 29 280 102 84 3 - - - - 1953 21 302 126 80 5 - - - - 1954 16 419 21 96 - 1 - - - 1955 11 170 17 72 10 1 - - - 1956 17 35 58 88 3 - - - - 1957 13 483 55 59 2 1 - - - 1958 11 200 9 60 - - - 1 - 1959 27 258 3 72 - - - - - 1960 11 8 11 89 - - - - - 1961 11 447 - 89 - - - - - 1962 4 19 5 38 - - - - - * Measles - Not notifiable until 1940. * Whooping Cough - Not notifiable until 1940. 54 Whooping Cough There were 5 cases of whooping cough notified during 1962. The number of cases notified during the previous five years are given below. 1958 1959 1960 1961 1962 9 3 11 - 5 Immunisation against whooping cough is usually performed as a combined process with diphtheria immunisation, and practically 100% of the children being immunised for the first time receive "combined" material which affords protection against both these diseases, Enteric Fever (Typhoid or Paratyphoid), There were no cases of typhoid or paratyphoid "B" notified in Kingston during 1962 and this is the fifteenth successive year without notification of enteric fever„ Measleso There were 19 cases of measles notified during 1962 compared with 447 in 1961. 1962 was a non-epidemic year, but the beginning of the biennial epidemic which is expected to reach a peak in the early part of 1963, was evident from the increase in the number of notifications received in the last few weeks of the year, Ophthalmia Neonatorum, No cases of ophthalmia neonatorum occurred during 1962, Puerperal Pyrexia, The maternity block at Kingston Hospital serves Kingston and a large surrounding area embracing a population of some 285,000 persons, During 1962, l,88l deliveries took place in the hospital, and inevitably some eases of puerperal pyrexia occurred, all of which were notified to the Medical Officer of Health in accordance with the regulations which define the illness as a febrile condition occurring in a woman in whom a temperature of 100,40F, or more has occurred within fourteen days after childbirth or miscarriage, During 1962, 38 oases were notified from Kingston Hospital, 9 of which referred to Kingston residents, These figures compare with 89 and 24 respectively for 196l, 55 An analysis for the years back to 1958 is shown overleaf, Cases 1958 1959 1960 1961 1962 (aj Tatal notified, 60 72 89 89 38 (b) Number included in (a) of (i) Kingston residents, 18 24 19 24 9 (ii)Extra district residents, 42 48 70 65 29 (c) Number included in (a) notified from Kingston hospital, 60 70 89 89 38 (d) Number included in (a) notified by private doctors, - 2 - - - (e) Number of cases included in (d) removed to hospital other than included in (c) - - - - - Smallpox No eases were recorded in Kingston during 1962, A series of smallpox outbreaks did, however, occur in some Midland Towns, Wales, and London, The incidence of a number of smallpox cases occurring together tends to become more frightening than an isolated case and it became necessary as a result of the reaction of the people to the publicity given nationally to take steps to prevent a public rush for vaccination, and to restrict vaccination facilities t© priority groups, In Kingston this was done by providing special clinics for three main groups of persons i,e:- (1) Contact of cases or suspected eases, (2) Primary infant vaccination, (3) Persons who had not been vaccinated within the last year travelling to and from known areas where smallpox cases had been confirmed, This brings to the fore the importance of maintaining constant vigilance and in particular surveillance over persons arriving from abroad when they have come by air from countries where outbreaks have occurred, Most countries insist upon an International Certificate of Vaccination being produced before travellers are allowed to land, In this conneetion, a large number of certificates issued by Kingston doctors are officially authenticated in the Public Health Department each year in accordance with regulations, 56 Smallpox vaccination is voluntary and every effort is made to maintain a high immunity level in the population by vaccinating infants during their early months, This is carried out by general practitioners and at the Surrey County Council clinics, Vaccination and re-vaccination is available free for persons of all ages, Scarlet Fever, Four cases were notified during 1962, two of which were of school age, No serious cases or deaths were reported, As a streptococcal infection scarlet fever is always viewed as potentially dangerous, Modern drugs however, prove to be a good weapon, and the illness usually takes a mild form, Poliomyeliti s, No oases of poliomyelitis were notified in Kingston during 1962, Vaccination with Sabin oral vaccine was started in 1962 and has been increasingly used during the year, The vaccine given by mouth, not only provides protection but also prevents protected persons from harbouring natural dangerous poliomyelitis virus and spreading disease to unprotected persons. This type of vaccine is of great value during an epidemic because it works quickly. Oral vaccine is available for the immunisation of persons eligible under approved local health authority arrangements, i,e, "priority groups" namely those over six months and under 40 years of age and certain others at special risk, The following small groups are also included:- A, Hospital staff who come in contact with patients, B, Practising dental surgeons, dental students, dental hygienists, student hygienists and dental surgeons' chairside assistants, and their families, C, Practising nurses not working in hospitals (those working in hospitals are already eligible) and their families, D, Public health staff who may come in contact with poliomyelitis cases, and their families, E, Children and young persons bora on or after 1st January 1933, providing that in the ease of babies they have reached the age of 6 months, F, Expectant mothers, 57 Dysentery (Sonne), A total of 8 oases of dysentery were notified during 1962 compared with 7 during 1961, These notifications were all in respect of individuals or individual families, No outbreaks occurred during the year, Although the type of cases which occur are normally sporadic individual dysentery cases there is always an awareness that such infection can be widely spread by contagion from person to person, and that the illness can have a serious effect on babies and debilitated persons, Most of the notifications received concern children of school age and under, requiring treatment at home with appropriate segregation during the carrier stage either by exclusion from school or day nursery, No effort is spared to prevent the spread of the disease and there is close liaison with general medical practitioners who are kept fully informed of developments including up-to-date information as to drug sensitivity of organisms, An essential and important factor undertaken by the publie health inspectors is the opportunity to stress the necessity for personal hygiene, especially to those concerned with food handling and the care of young children. Every effort is also made to ensure that personal hygiene is intensified and adhered to during outbreaks. Furthermore, everything possible is done to prevent contact of individuals, in particular children, with persons outside the infected home until the whole family is free from infection, Measures such as these tend to decrease the spread of the disease and also act as an education in personal hygiene, Tuberculosis, In accordance with the national trend the number of new eases of tuberculosis notified continues to be satisfactorily low, In 1962 in Kingston 20 eases were reported, all of these referred to lungs, Compared with 1961, there appears to be very little change when there were 14. eases of which 13 referred to lungs, A total of 6,670 persons were x-rayed during a visit of the South West Metropolitan Regional Hospital Board X-Ray Unit in October and November, (3,030 males -3,640 females), A total of 5 cases (2 male - 3 female) of active pulmonary tuberculosis were discovered and referred for treatment or close clinical supervision, 58 Whilst we can claim that fear and pessimism, concerning tuberculosis has been largely removed from people's minds; that statistics show a declining death rate and a satisfactory reduction in the number of new cases there are, however,, many cases on the register receiving treatment and attention at the Chest Clinic, It is, therefore, necessary, to remember that breakdown and infectivity are continually possible in these cases, It is to be hoped that in due course continued effects of improved living conditions of the populace, continued advances in therapeutic treatment, facility for early detection of tuberculosis by public mass x-ray sessions and B,C,G, vaccination of school children will eventually bring this disease to the point of eradication, The following table shows comparative figures of notified cases and deaths for the years 1953 to 1962 (inclusive):- Year Cases Notified Deaths Respiratory Non-Respiratory Total Respiratory Non-Respiratory Total 1953 37 5 42 8 1 9 1954 26 4 30 3 1 4 1955 14 6 20 6 6 1956 25 2 27 2 - 2 1957 26 1 27 6 1 7 1958 16 2 18 2 3 5 1959 18 1 19 3 - 3 1960 13 1 14 3 - 3 1961 13 1 14 2 - 2 1962 20 - 20 2 - 2 The efficiency of notification has been good and there is no reason to suspect refusal or neglect to notify, Throughout the year no action became necessary under the Public Health (Prevention of Tuberculosis) Regulations 1925, or Section 172 of the Public Health Act, 1936, These regulations respectively relate to the restriction of tuberculosis sufferers from employment in the handling of milk, and the compulsory removal to hospital in certain circumstances of persons suffering from tuberculosis, 59 Considerable help is given to tuberculosis and other chest disease patients and their dependants by the Kingston and District Care Committee for Tuberculosis and Other Chest Diseases, During 1962, 106 families within the area covered by the Committee were helped in the form of grants for extra nourishment, clcthing, fuel, removals, beddings, fares, pocket-money, etc, and a total of £2,484, was expended from the funds of the Committee on this work, An analysis of the total notified cases during 1962 in age groups is shown on the next page, and the following graph depicts the numbers of new eases and deaths in respect of respiratory tuberculosis occurring for the past 15 years, 60 NOTIFIED CASES OF. AND DEATHS FROM. TUBERCULOSIS IN 1962, TABLE VI. 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 Tubereulosis (a) Respiratory M - - - 1 1 2 - 2 5 11 - - - - - - - - 1 1 F - - - 2 2 2 2 1 - 9 - - - - - - - - 1 1 Total - - - 3 3 4 2 3 5 20 - - - - - - - - 2 2 (b) Non-respiratory M - - - - - - — — — — - — — — - - - - - - F - - - - - - - - - - - - - - - - - - - - Total - - - - - - - - - - - - - - - - - - - - 61