AC 4413(1) THE HEALTH OF THE ROYAL BOROUGH OF KINGSTON UPON THAMES I964 THE ANNUAL REPORT of The Medical Officer of Health and the Chief Public Health Inspector PUBLIC HEALTH DEPARTMENT, KINGSTON UPON THAMES. JUNE, 1965 THE HEALTH OF THE ROYAL BOROUGH OF KINGSTON UPON THAMES 1964 THE ANNUAL REPORT of The Medical Officer of Health and the Chief Public Health Inspector PUBLIC HEALTH DEPARTMENT, KINGSTON UPON THAMES. JUNE, 1965 ANNUAL REPORT. 196 4 TABLE OP CONTENTS Page Preface i ,ii ,iii ,iv Population i Births i Deaths i Infant Mortality Rate = 1960 - 1964 - Rate per 1,000 live births ii Causes of Death ii Infectious Disease iii Diphtheria iii Pood Poisoning iii Housing and Rehousing iii Staff iv Constitution of Public Health Committee 1 Staff of Public Health Department 1 SECTION A Statistics and Social Conditions (1) General Statistics 2 (2) Social Conditions 2,3 (3) Extract from Vital Statistics of the Year 3 (a) Live Births 4 (b) Stillbirths 4 (c) Total Live and Stillbirths 4 (d) Deaths 4 (i) Death Rate 4 (ii)Infant Deaths 4 (iii) Maternal Deaths 4 (e) Maternal Mortality Rate 4 Infant Mortality Rate 1960/1964 5 Quinquennial Infant Mortality Rate 5 Causes of Death of Children under 1 year 6 (iv) Deaths from Other Causes 7 Introduction to Tables on Vital Statistics 7 Page Table I - Extract from Vital Statistics for the years 1960/1964 8 Table II - Comparison of Vital Statistics 1935/1964 9 Table III - Causes of Death 10 SECTION B General Provisions of Health Services. (1) (i) Laboratory Facilities 11 (ii) Hospitals:- (a) Infectious Diseases 11 (b) Smallpox 11 (c) General 12 (2) Health Services Provided by other Authorities:- Surrey County Council - Health Department 12,13,14 Surrey County Council - Education Department 14,15 Surrey County Council - Welfare Department 15 Surrey County Council - Social & Geriatric Services 16 Surrey County Council - Children's Department 16 Surrey Executive Council 16 (3) National Assistance Act, 1948 National Assistance (Amendment) Act, 1951 17 SECTION C Sanitary Circumstances (l) Water Supply 18 (2) Drainage and Sewerage 18 (3) Rivers and Streams 18 (4) Closet Accommodation 18 (5) Public Cleansing 18,19 (6) Sanitary Inspection of the Area 19,20 (7) Shops 20 (8) Factories Act, 1937 21,22 (9) Camping Sites 22 (10) Atmospheric Pollution 22,23,24, 25,26,27, 28,29,30, 31,32 (11) Swimming Baths and Pools 33 (12) Eradication of Bed Bugs 33 (13) Complaints 33 (14) Rodent and Insect Pest Control 34,35 Page SECTION D Housing General 36 Statistical Statements, 1964 37,38 SECTION B. Inspection and Supervision of Food (a) Milk Supply 38 (b) Bacteriological Examination of Milk 39 (c) Ice Cream 39,40 (d) Meat and Other foods 40,41 (e) Food Hygiene 41,42,43 Food Hygiene Regulations 1955 44 Food and Drugs Act, 1955 44,45 Tabulated Statement of Samples Submitted to the Public Analyst during 1964 45,46,47 Foods subject of complaint 47,48,49, 50,51,52 Merchandise Marks Act, 1926 52 SECTION F. Infectious Diseases Notifiable Diseases 53 Table 17 Notifiable Diseases during 1964 54 Table V Comparative Statement of Notifications of Certain Infectious Diseases 55 Whooping Cough 56 Enteric Fever (Typhoid or Paratyphoid) 56 Measles 56 Ophthalmia Neonatorum 56 Puerperal Pyrexia 56,57 Smallpox 57 Scarlet Fever 58 Poliomyelitis 58 Dysentery 58,59 Tuberculosis 59,60 Table VI & Graph- Notified oases and Deaths from Tuberculosis in 1964 61,62 (i) TELEPHONE NO: PUBLIC HEALTH DEPARTMENT, KINGSTON 2121. GUILDHALL, KINGSTON-UPON-THAMES. JUNE, I965. TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE ROYAL BOROUGH OF KINGSTON-UPON-THAMES. ANNUAL REPORT. 1964. 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 1964. As in previous years the report follows the general lines indicated by the Minister of Health, and is in accordance with Circular 1/65. Population - The Registrar General's estimated mid 1964 home population figure is given as 36,230 (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 1964 is 711 and compares with 664 for 1963. The crude birth rate is 19.6 per 1,000 population compared with 18.4 for 1963. Deaths - The number of deaths recorded in 1964 is 443 compared with 479 for 1963. This makes a crude death rate of 12.5 as compared with 13.3 for 1963. The excess of births over deaths was 268 compared with 185 for the previous year. The number of infant deaths (under 1 year of age) in 1964 is 12 which gives an Infant Mortality rate per 1,000 live births of 16.9. The corresponding figures for 1963 were 9 infant deaths and an Infant Mortality rate of 13.5. The following table shows the rate for the five years 1960 to 1964. (ii) INFANT MORTALITY RATE 1960 1961 1962 1963 1964 Total No. Deaths 6 10 18 9 12 RATE PER 1,000 LIVE BIRTHS 10.4 15.6 29.3 13.5 16.9 Causes of Death - Main conditions causing death during 1964 were:- 1964 1963 Heart Disease 124 152 Cancer 99 77 Vascular Lesions of the Nervous System 60 64 National attention has been drawn in recent years to the general increase in the number of deaths attributable to lung cancer and its possible association with cigarette smoking. 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. 1960 1961 1962 1963 1964 Total Total Total Total Total Deaths from cancer of the lung and bronchus 23 21 29 26 33 M F M F M F M F M F 20 3 19 2 24 5 20 6 26 7 (iii) Infectious Disease - The number of infectious disease notifications received in 1964 was 128 compared with 506 in 1963, a difference of 378 which is mainly accounted for by the notification of 276 less cases of measles than in 1963. Active protection of the child population against diphtheria, whooping cough, tetanus, smallpox, tuberculosis and poliomyelitis was continued at a good pace. Diphtheria - For the seventeenth year in succession no cases of diphtheria occurred in Kingston. Continued freedom from any illness creates a complacency in the minds of the people but this must be combated particularly in regard to diphtheria which is always likely to reappear, and will do so if protective immunisation of children is not kept up to a high level. Parents are constantly encouraged to take full advantage of the immunisation service provided, particularly the initial protection given in a child's first year of life. Intensive campaigns are also 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. Food Poisoning - It is pleasing to record that whilst there are so many restaurants, cafes and food shops in the town, no cases of food poisoning were reported which could be attributed to such premises. Four sporadic cases of food poisoning occurred during the year, and there was a total absence of outbreaks. No particular food or vehicle of infection was implicated, I am pleased to report that the constant hard work of the inspectors on food handling is being rewarded by the maintenance by the proprietors of a high standard of food hygiene in the town„ Housing and Rehousing - We are glad to note the progress in new homes for the people by completed schemes and others commenced in 1964, There is still a constant need for further housing and particularly one would mention young people setting up for the first time. The old people also require further provision of specially designed dwellings where they can be assisted in case of emergency. An additional point on provision is that many old people are in under-occupied Corporation houses and if they could be provided with suitable accommodation and persuaded to move, accommodation would quickly become available for others. (iv) Staff - Details of the staff of the Public Health Department are set out on Page 1. I am indebted to Mr.G.C. Smith, Chief Public Health Inspector, with special reference to Sections C - E, for assistance in compiling the report. I record also my thanks for the support and encouragement I have received in my present work, to The Worshipful The Mayor, 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 Public Health Committee for the Municipal Year 1964/65. Councillor Miss Tapping (Chairman) Councillor Baker " Parrish (Vice-Chairman) " Ormiston " Lees (Mayor) " Judge " Marshall (Deputy Mayor) " Mace Alderman Pyke " Barker " Miss Alexander " Montgomery " Guymer STAFF OF THE PUBLIC HEALTH DEPARTMENT AS AT 31st DECEMBER. 1964. Medical Officer of Health: J.W. STARKEY, M.B., Ch.B. (Edin.), D.P.H. Deputy Medical Officer of Health: W.H. KINSTRIE, M.B., Ch.B. (Edin.),D.P.H. Chief Public Health Inspector: G.C. SMITH, F.R.S.H., M.A.P.H.I. (a)(b) Senior Additional Public Health Inspector: L. BURROWS, M.A.P.H.I. (a)(b) Additional Public Health Inspectors: S.W. SIMPSON-SCOTT, M.A.P.H.I. (a)(b) K. APPLETON, A.R.S.H., M.A.P.H.I. (a)( b) Pupil Public Health Inspector: A.R. WEST Chief Administrative Assistant: M. FRANKELL, D.M.A.,A.C.C.S.,L.M.R.S.H.(Resigned 19.1.64). Technical Officer - Smoke Control Areas: W.A. HUCKIN (Died 20.12.64). Clerical Staff: MISS C.L. FOISTER. MISS M.W. FILBEE. I.D. REID. MISS E.HANCOCK. Pest Control Officer: F.W. STAGG, A.R.I.P.H.H. Rodent Operatives and General Assistants: G.H. LOCKE. F.J. PERRY. (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 1,408 Total Population (including Service personnel) 36,230 Number of inhabited houses (approx.) 11,812 Rateable Value - General Rate (1.4.64) £3,449,834 Sum represented by Penny Rate (year 1964/65) £13,560 Total number of assessments 15,291 " " " domestic dwellings 11,854 " " " shops with dwellings and public houses 343 " " " premises classified as industrial entertainment, public utility, educational and miscellaneous 574 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, Mr. E. Morgan, has kindly provided the following information regarding employment in Kingston and Diatrict:- "At the end of 1963 there were 509 men and 88 women unemployed, but after the first quarter of the year these figures decreased and unemployment during the year was slightly lower than it had been during 1963. In December 1964 there were 442 men and 59 women unemployed, the total of 501 representing less than 1% of the working population in the Employment Exchange area. This compared favourably with the national percentage of 1.6. During the year there were a number of redundancies in firms in the area for a variety of reasons, but in every case the workers who lost their employment were able to find suitable work quite readily, either by their own efforts or through the Employment Exchange. Whenever possible such persons were interviewed by Exchange staff at their places of employment before their notices expired to reduce to a minimum the risk of unemployment. Employment opportunities in the area were in fact so plentiful that at the end of 1964 there were 842 vacancies notified as outstanding for men compared with 609 a year earlier. There was also a considerable and persistent demand for women. 3 The diversity of industry is such that the area can continue to remain prosperous and maintain a reasonable balance in spite of difficulties in particular sectors. During the year the Employment Exchange placed 3,325 men and 1,129 women in work locally and 154 men and 39 women in other districts, this being an increase over the total figure for 1963, Of all those placed 77 men and 49 women were persons already in employment who were for a number of reasons seeking a change, while 191 men and 23 women were disabled. A further 25 key workers employed by a firm at New Maiden, some of whom lived in Kingston, were assisted under the Ministry's Transfer of Labour Schemes to move their households to the Isle of Wight where they were required to train local labour at the Company's new factory. In 1964, 56 ex-Regular service men (other ranks) sought help in their resettlement into civilian employment. Of these 25 were placed in employment and 8 were accepted for courses for vocational training to fit them for specific occupations in civilian life. There was little change in the labour force in the local aircraft industry during the year. Following the change of Government in October the aircraft industry became the subject of special review, but by the end of 1964 nothing definite had been decided. The overall picture is happily one of continuing full employment. Of those unemployed a good proportion are people over 60 who have retired from their normal employment, and for these openings are certainly few. There is always some turnover of labour taking place, but, in common with most of South-East England, a general labour scarcity prevails." 3. Extract 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 factor is unity). The comparability factors for Kingston-upon-Thames are Births 1.00, Deaths 0.89. The birth and death rates in respect of the town are shown overleaf and for the purpose of providing some comparison the rates for England and Wales are also shown. 4 VITAL STATISTICS Male Female Total Total 1964 1963 (a") Live Births - Legitimate 339 307 646 (614) Illegitimate 42 23 65 ( 50) 381 330 711 (664) Live Birth Rate per 1,000 population 19.6 (18.4) Adjusted Birth Rate 19.6 (18.4) England and Wales Live Birth Rate 18.4 (18.2) Illegitimate Live Births per cent of total Live Births 9.1 (7.5) Male Female Total Total 1964 1963 (b) Stillbirths - Legitimate 1 6 7 (2) Illegitimate - - - (1) 1 6 7 (3) Rate per l,000 total Live and Stillbirths 9.7 ( 4.5) England and Wales Stillbirths Rate 16.3 (17.3) Male Female Total Total 1964 1963 (c) Total Live and Stillbirths - Legitimate 340 313 653 (616) Illegitimate 42 23 65 ( 51) 382 336 718 (667) Male Female Total Total 1964 1953 (d) Deaths - 213 230 443 479 (i) Death Rate per 1,000 population 12.5 (13.3) Adjusted Death Rate 11.1 (11.8) England and Wales Death Rate 11.3 (12.2) * (ii) Infant Deaths - Total No. of Deaths 12 (9) Infant Mortality Rate per 1,000 Live Births 16.9 (13.5) Infant Mortality Rate per 1,000 Live Births - Legitimate 15.5 (10.5) Illegitimate 1.4 ( 3.0) Infant Mortality Rate for England and Wales 20.0 (20.9) ** Neo Natal Mortality Rate per 1,000 Live Births 15.5 (10.5) (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. 5 The approximate Infant Mortality Rate for 1964 and the rates since 1960 are shown for purposes of comparison. 1960 1961 1962 1963 1964 Kingston-upon-Thames 10 16 29 13 17 England and Wales 22 21 21 20 20 It will be seen from the following figures that since the war ended the Quinquennial Infant Mortality Rate was more than halved by 1950, and has since dropped even further. 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 King3tonupon-Thames infants who died during 1964 before reaching the age of one year, together with the cause of death. 9 INFANT DEATHS AGE TOTAL Asphyxia due to inhalation of maternal secretions and suckling. Asphyxia. Prematurity. Atelectasis. Respiratory failure. Congestive cardiac failure. Anencephaly. Intussusception. Septicaemia due to acute suppurative otitis media. 0-24 Hours 9 1 1 3 1 1 1 1 - - 24 Hours - 1 Mth. 1 - - 1 - - - - - - 1 Month - 1 Yr. 2 - - - - - - - 1 1 Totals 12 1 1 4 1 1 1 1 1 1 7 (iv) DEATHS FROM OTHER CAUSES IN 1964 NO. OF DEATHS Heart Disease 124 Cancer 99 Vascular Lesions of the Nervous System 60 Circulatory Disease other than Heart 31 Bronchitis 27 Pneumonia 18 Influenza 2 The following Tables I, II, III summarise certain vital statistics. Table I shows the figures for live births, stillbirths, and deaths for the years 1960 - 1964 inclusive. The figures in Table II are the Registrar General's estimates for successive years since 1935. 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 Kingston-upon-Thames and England and Wales. The trend of the estimated population figure is to remain below 40,000. 8 EXTRACT FROM VITAL STATISTICS FOR YEARS 1960-1964 INCLUSIVE. TABLE I. 1960 1961 1962 1963 1964 Total M. F. Total M. F. Total M. F. Total M. F. Total M. F. LIVE BIRTHS Legitimate 545 269 276 596 286 310 564 272 292 614 310 304 646 339 307 Illegitimate 33 21 12 43 26 17 50 25 25 50 26 24 65 42 23 578 290 288 639 312 327 614 297 317 664 336 328 711 381 330 Birth rate(R.G.) per 1,000 pop. 15.1 17.1 17.0 18.4 19.6 STILLBIRTHS Legitimate 7 3 4 10 6 4 6 2 4 2 1 1 7 1 6 Illegitimate 1 1 - - - - 2 - 2 1 - 1 - - - 8 4 4 10 6 4 8 2 6 3 1 2 7 1 6 Rate per 1,000 (live and stillbirths) 13.5 15.6 13.0 4.5 9.7 DEATHS 432 223 209 462 243 219 463 237 226 479 222 257 443 213 230 Death rate(R.G.) per 1,000 pop. 11.2 12.8 12.8 13.3 12.5 9 COMPARISON OF VITAL STATISTICS 1955 - 1964. TABLE II. Year Estimated Population Live Births Birth Rate per 1,000 Population Deaths Death Rate per 1,000 Population Infantile Mortality Rate per 1,000 live births Kingston upon Thames England and Wales 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 122 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 1955 39070 543 13.9 424 10.9 15 25 1956 38790 550 14.2 442 11.4 24 24 1957 38590 548 14.2 432 11.2 13 23 1958 38800 536 13.8 434 11.2 15 22 1959 38590 564 14.5 416 10.8 23 22 1960 38630 578 15.1 432 11.2 10 22 1961 35990 639 17.1 462 12.8 16 21 1962 35990 614 17 0 463 12.8 29 21 1963 36050 664 18.4 479 13.3 13 20 1964 36230 711 19.6 443 12.5 17 20 10 CAUSES OF DEATH - REGISTRAR GENERAL'S TABLES, TABLE III. All Causes 1960 1961 1962 1963 1964 M F M F M F M F M F 223 209 248 223 237 226 222 257 213 230 Tuberculosis, respiratory 3 - 2 - 1 1 3 1 1 1 Tuberculosis, other - - - - - - - 1 1 - Syphilitic disease - - 1 - - - - - - - Diphtheria - - - - - - - - - - Whooping Cough - - - - - - - - - - Meningococcal Infections - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - Measles, - - - 1 - - - - - - Other infective and parasitic diseases - - - - - - 2 - - - Malignant neoplasm, stomach 4 1 7 10 4 1 5 1 4 5 Malignant neoplasm,lung, bronchus 20 3 19 2 24 5 20 6 26 7 Malignant neoplasm, uterus - 1 - 4 - 7 - 1 - - Malignant neoplasm, breast - 11 - 12 - 9 - 3 1 11 Other malignant and lymphatic neoplasms 30 28 32 26 23 19 22 19 15 30 Leukaemia, aleukaemia 1 1 - 2 2 - 3 4 1 3 Diabetes 1 - 2 1 _ 2 - 5 - l Vascular lesions of the nervous system 21 32 24 31 24 30 22 42 12 48 Coronary disease, angina 51 38 60 32 47 38 52 35 49 38 Hypertension with heart disease 5 4 7 4 3 5 6 9 7 3 Other heart disease 20 27 9 21 22 28 15 35 6 21 Other circulatory disease 11 14 13 20 13 13 10 21 13 18 Influenza - - 1 3 1 6 1 2 1 1 Pneumonia 14 13 11 13 17 15 10 25 9 9 Bronchitis 14 2 20 9 18 9 10 6 26 1 Other diseases of respiratory system. - - 8 _ 1 - 2 1 2 2 Ulcer of stomach and duodenum 1 - 3 3 4 1 5 2 1 1 Gastritis, enteritis, and diarrhoea 2 2 2 1 - 2 2 1 - 1 Nephritis and nephrosis 1 1 2 - - - - 2 2 1 Hyperplasia of prostate 2 - 1 - 2 - 2 - 3 - Pregnancy, childbirth, abortion - - - - - - - - - - Congenital malformations - 2 2 2 2 1 2 5 1 1 Other defined and ill-defined diseases 10 21 15 20 15 25 17 22 17 19 Motor vehicle accidents 5 3 2 2 6 3 4 1 7 3 All other accidents 4 2 3 3 4 1 4 5 2 2 Suicide 3 3 2 1 4 5 3 2 6 3 11 SECTION B. GENERAL PROVISIONS OF HEALTH SERVICES 1. (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 and other foods 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.l. (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, Seventeen cases of infectious disease were treated in hospital during the year, but 15 of these had already been notified from Kingston Hospital and related to puerperal pyrexia. To Kingston Hospital 15 To Tolworth Hospital 2 (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). 12 (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. Acre Road Clinic. 204, Acre Road (Kingston 5812) Monday and Thursday afternoons. (c) Dental Clinics. Health Centre Tuesdays, Wednesdays and Thursdays, Acre Road Clinic Daily by appointment (except Saturday) (d) Immunisation and Vaccination Clinics. Health Centre Acre Road Clinic Thursday forenoon, Friday forenoon. 13 (e) Day Nursery, 53-55, Canbury Park Road. Approved accommodation 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 midwives 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 owing 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", 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' Departments, Kingston Hospital,, Wolverton Avenue,, Kingston-upon-Thames. Among other things the County 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. 14 (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 sohool 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 servicess:- (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 Road Clinic. Friday forenoon. (ii) Medical Consultation. Health Centre. Monday forenoon. Acre Road Clinic. Friday forenoon. (iii) Eye Clinic. Acre Road Clinic. Tuesday forenoon 15 (iv) Dental Clinic. (See under Health) Immunisation Clinic. ( Department ) (v) Child Guidance Clinic. Cases referred to clinic at "Roselands", Kingston Road, New Maiden. (vi) Speech Therapy. Health Centre. Monday all day Acre Road Clinic. Thursday all day. Welfare Department. This service is concerned with the welfare of:- 1. Aged persons. 2. Physically and mentally infirm. 3. Blind and partially sighted. 4. Deaf and dumb, 5. Epileptic and crippled persons. 6. The provision of temporary accommodation for persons in need thereof. The address of the Welfare Officer for the Borough is 35, Coombe Road, Kingston-upon-Thames (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 blind, partially sighted and deaf and dumb. The voluntary Association for Surrey Disabled acts as the Council's agents, but certain services are, howevers provided by the Council direct.They are as follows A. Occupational therapy, B. Training and Rehabilitation, C. Hostel accommodation and workshop facilities,, D. Adaptations to Homes - In approved cases 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 Department, County Hall, Kingston-upon-Thames, (Kingston 1050, Ext. 324). 16 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 by visits to Clubs,, Recreational activities are provided by 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 the home and assesses the need and urgency for a short stay in one of the appropriate hospitals. The family doctor is usually the person who first seeks assistance from the Home Help Supervisor, but all enquiries on behalf of needy old people may be made to Divisional Health Headquarters, Health Centre, Grange Road;, Kingston-upon-Thames, (Kingston 7261). The County Welfare Committee provides considerable services for the aged. These include different types of residential accommodation and many domioilliary and advisory services. The County Council also makes grants to voluntary organisations 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 care of the County Council, supervision of foster children, child neglect, etc. The children's Officer for the Borough works from the County Hall, Penrhyn Road, Kingston-upon-Thames. Surrey Executive Council. This body is responsible for the provision under the National Health Service Act, 1946, of the general practitioner, dental (other than Local Authority provision for expectant and nursing mothers, young children), pharmaceutical and supplementary ophthalmic services. The Headquarters of the Council is at 187, Swell Road, Surbiton, Surrey (Elmbridge 5722). 17 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 Summary Jurisdiction for an Order for removal and detention in a suitable hospital or other place of persons who:- (A) Are suffering from grave chronic disease, or being aged, infirm or physically incapacitated are living in insanitary conditions; and (B) Are unable to devote to themselves, and are not receiving from other persons, proper care and attention. 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 cases 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. 18 SUCTION C. SANITARY CIRCUMSTANCES 1.WATER SUPPLY. The Town 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, but is not used as a domestic supply, all the houses in the town being provided with a main water supply. Well water was also used for cooling and bottle washing at a dairy which closed down on the last day of February. During the first two months of the year four 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 treatment. 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. 5.PUBLIC CLEANSING. The Borough Surveyor 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. 19 The refuse from this Borough, 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 14,588 tons of refuse were sent from this Borough in 1964. 6. SANITARY INSPECTION OP THE AREA. The following is a tabulated list of visits and inspections made by the Public Health Inspectors which totalled 11,340 compared with 10,789 for 1963. House inspections, defects, etc. 477 Drainage 724 Factories 159 Outworkers 3 Atmospheric Pollution 25 4 Dairies, milk shops, etc., 156 Pood Premises 1,315 Restaurants and Cafes 464 Infectious disease enquiries 267 Verminous premises 50 Rodent Control 18 Shops Act 211 Schools 26 Housing Act 78 Markets 631 Public sanitary conveniences 87 Fireguards 42 Merchandise Marks Act 255 Interviews 350 Noise complaints visits 133 Offices 53 Miscellaneous 1,381 Smoke Control Inspections 2,119 Smoke Control Revisits 650 Total number of visits & inspections . 9,903 Reinspections & Works in Progress. 1,437 11,340 Disused drains. Section 19 of the Public Health Act, 1961 requires demolition contractors or other persons responsible to seal off drains which become disused or unnecessary as a result of drainage or demolition works. During the year it was necessary to trace and supervise the sealing of seven drains consequent upon the demolition of buildings. 20 It is important to ensure that the requirements of this Section of the Act are properly observed in order to avoid future trouble from rat infestation and other nuisances. NOTICES SERVED. Informal,, (a) Verbal 123 (b) Written 204 Statutory. (a) Housing Acts — (b) Public Health Acts 13 (c) Clean Air Act 4 NOTICES COMPLIED WITH„ Informal. (a) Verbal 373 (b) Written Statutory. ( a) Housing Act s - (b) Public Health Aacts 16 (c) Clean Air Act 2 7. SHOPS. There are some 890 shops in the Borough and inspections are made with regard to those provisions of the Shops Act, 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 closing and Sunday trading. 21 8. FACTORIES ACT. 1961. The following are the particulars required to be furnished to the Ministry of Labour and National Service respecting matters dealt with by the Corporation under Parts I and VIII of the Factories Act. PART I OF THE ACT. 1. INSPECTIONS. Premises No. on Register Number of Inspections Written Notices Prosecutions Factories in which Sec. 1, 2,3,4 & 6 are enforced by the Corporation 32 9 1 - Factories not included above in which Sec„ 7 is enforced by the Corporation 250 146 2 - Other premises excluding Outworkers 4 4 2 - 2. CASES IN WHICH DEFECTS WERE FOUND, No. of cases in which defects found Found Remedied To H.M. Inspector By HoMo Inspector No. of Prosecutions Want of cleanliness 2 2 - - - Overcrowding - - - - - Unreasonable temperature - - - - - Ineffective drainage of floors - - - - - Sanitary Conveniences - - - - - (a) Insufficient - - - - - (b) Unsuitable or defective 3 3 - - (c) Not separate for sexes - - - - - Others - - - - - 22 PART VIII 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. Nature of Work No. of Outworkers Wearing apparel - making etc. 5 Lampshades 7 12 9. CAMPING SITES. There are no camping sites within the Borough. 10. ATMOSPHERIC POLLUTION. Clean Air Act, 1956 - Smoke Control Area. Smoke Control Order No. 4 became operative on the 1st October, 1964, covering an area of approximately 141 acres bounded by Portsmouth Road, The Bittoms, Grove Crescent, Grove Lane, Lingfield Avenue and Uxbridge Road. The number of premises affected is as follows - Domestic 1,151 Commercial 71 Industrial 3 Other 24 In September, the Minister of Housing and Local Government confirmed the making of the No. 5 Smoke Control Order, the operative date being 1st October, 1965, covering an area of approximately 160 acres bounded by Areas 1, 2 and 4 via Bonner Hill Road to the Municipal Boundary with Maiden & Coombe. The number of premises affected is as follows - Domestic 1,219 Commercial 56 Industrial 5 Other 15 23 During the year survey work was started in Area No. 6 which covers approximately 56 acres and includes over l,205 dwellings and commercial premises in the south west part of the town. This will be enclosed by Areas 2, 3 and 5 and the Municipal Boundary with Maiden & Coombe. By the end of the year the area covered by Smoke Control Orders made or confirmed comprised some 615 of the Borough's l,408 acres,, The rate of progress depends upon the production of approved appliances and the availability of labour for fixing, bearing in mind that the neighbouring boroughs also are proceeding with similar smoke control programme So It is essential also that there should be an adequate supply of alternative smokeless fuels particularly in view of the demands which vary as the changing trends in domestic heating make themselves apparent. At the present time there is a marked preference for gas room heaters and the sales of these appliances have increased remarkably in recent years. There has been a similar interest in openable stoves which will burn coke satisfactorily and are capable of providing a limited amount of central heating. Smoke Nuisance. Twenty-six complaints were received in respect of smoke nuisance, eleven 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 will burn quickly with a minimum of smoke. Three complaints referred to Kingston Hospital where from time to time soot emission is excessive. The difficulty here lies in the inherent obsolete layout of the plant and the means whereby the boilers are connected to the chimney. This was designed and constructed for the use of natural draught with solid fuel boilers at relatively low efficiency. The replacement of the present installation by a new boiler house is the answer to the problem. It is hoped that this work, which has been delayed on a number of occasions, will soon be commencedo Demolitions and building sites where rubbish was being burned were the subject of four complaints,, Other premises concerned were a garage, a restaurant and a factory where metal hardening is carried out and a building site where excessive smoke was being emitted by a diesel engined compressor. 24 The four remaining complaints were domestic in character, and advice was given in these cases. Chimney Heights. The Ministry of Housing and Local Government' s Memorandum on Chimney Heights has proved useful during the year in securing higher chimneys than originally proposed in two instances. In the case of he new boiler plant at Kingston Hospital, a height of 120 ft. was provided for in the original design,, A calculation based on the Memorandum indicated that this height would probably be insufficient. The Hospital Authorities were advised to arrange for wind tunnel tests to be made on a model of the new buildings. The National Physical Laboratory, who carried out the tests recommended a chimney height of 140 ft. and a modification of the chimney top to prevent "down-wash" of fumes. It is probable that these recommendations will be accepted,, In the other case obsolescent plant was to be replaced by three modern oil fired boilers with independent insulated steel stacks. Calculations showed that each stack would need to be almost as high as the existing brick stack which was to be demolished. The boiler engineers decided to retain the brick stack and fit an auxiliary oil burner at the foot of the stack to prevent condensation difficulties under light operating conditions. Section 10 of the Clean Air Act, which gives Local Authorities power to reject the plans of new buildings if the chimneys are not sufficiently high, unfortunately expressly excludes from its application residences, shops and offices. This omission is particularly important in this Borough where factory chimneys are rarely constructed but new blocks of shops and offices are very common. Central heating boilers in such blocks are often oil-fired, with chimneys terminating a few inches above a flat roof. Sulphur dioxide emissions in such circumstances are likely to give rise to nuisances in upper storeys of the building and in nearby buildings due to "down-wash" of fumes caused by air currents flowing over the top and down the sides of the building,, In order to safeguard the health of office workers and other occupants of tall buildings, this problem will need to be given careful attention, particularly in view of the imminent redevelopment of the town centre. Architects should seriously consider how the standards laid down in the memorandum can be achieved. In view of the likelihood of heights above roof line of twenty feet and more being required, the design of the chimney must obviously be considered at an early stage. It is without question that health must always take precedence over visual amenity, but it is hoped that architects will accept the challenge and design chimneys which are acceptable in appearance. 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 25 conditions on the state of the atmosphere. The following tables and graphs indicate the results obtained., Smoke and sulphur dioxide are expressed in microgrammes per cubic metre. Results obtained from the Volumetric Instrument at the Guildhall. Month Smoke S02 Monthly Average Highest Value Lowest Value Monthly Average Highe st Value Lowe st Value January 206 690 22 279 767 57 February 170 535 33 221 538 55 March 83 211 13 179 379 54 April 47 300 4 104 409 25 May 25 62 3 73 188 6 June 28 64 6 67 267 2 July 17 38 6 73 162 24 August 21 63 6 47 155 12 September 31 92 3 83 240 18 October 92 192 8 164 345 30 November 80 296 8 172 323 24 December 116 492 0 215 684 18 26 Smoke and Sulphur Dioxide, 1964. Results obtained from the Volumetric Instrument at Guildhall. 27 Tiffin Girls' School,, This instrument, during term time, is operated by the pupils. The co-operation of the Headmistress, the staff and pupils in this work is greatly appreciated. The following are the results obtained:- Month Smoke So2 Monthly Average Highest Value Lowest Value Monthly Average Highest Value Lowest Value January 205 682 28 290 770 58 February 154 528 32 237 484 55 March 88 298 16 174 439 64 April 45 172 7 98 357 23 May 23 57 3 82 458 13 June 21 69 8 72 246 26 July 17 38 3 38 85 0 August 19 47 7 52 92 20 September 33 124 7 74 257 13 October 116 240 8 169 420 33 November 97 288 16 211 697 42 December 119 500 4 235 633 64 28 Smoke and Sulphur Dioxide. 1964. Results obtained from the Volumetric Instrument at Tiffin Garish School. 29 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 Canbury Gardens and Tiffin Girls' School. They are, for the purposes of this report, referred to as 'A' and 'B' 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 sources towards the recording stations. CANBURY GARDENS - Station 'A'. 1964 Deposit in Tons per sq. mile Wind Direction Rainfall in Inches Insoluble Solids Soluble Solids Total Solids No. of Ob servations No. of times S .E. -.S.W. January 8.94 5.54 14.48 23 8 0.71 February 13.90 5.11 19.01 20 7 0.83 March 6.43 6.30 12.73 21 6 3.03 April 14.11 5.05 19.16 20 9 3.23 May 17.54 8.91 26.45 21 14 1.81 June 5.58 8.66 14.24 22 13 4.77 July 16.18 4.33 20.51 23 15 1.30 August 11.55 5.19 16.74 19 10 1.38 September 14.87 4.33 19.20 21 12 0.55 October 17.34 7.01 24.35 18 7 1.32 November 11.85 9.48 21.33 21 13 1.46 December 11.51 5.45 16.96 18 8 1.36 Totals 149.80 75.36 225.16 21.75 Average 1964 12.48 6.28 8.76 1.81 Average 1963 11.98 6.92 18.90 1.66 30 TIFFIN GIRLS' SCHOOL - Station 'B'. 1964 Deposit in Tons per sq. mile Wind Direction Rainfall in Inches Insoluble Solids Soluble Solids Total Solids No. of Observations No. of times S.E.-S.W. January 3.32 4.28 7.60 23 8 0.63 February 5.08 5.44 10.52 20 7 0.83 March 4.32 7.83 12.15 21 6 3.03 April 8.13 4.78 12.91 20 9 3.07 Hay 6.00 6.44 12.44 21 14 1.85 June 4.31 7.70 12.01 22 13 3.68 July 6.71 3.58 10.29 23 15 1.73 August 4.98 3.57 8.55 19 10 1.38 September 5.38 3.05 8.43 21 12 0.51 October 4.98 5.67 10.65 18 7 1.25 November 3.65 4.08 7.73 21 13 1.38 December 6.01 6.17 12.18 18 8 1.49 Totals 62.87 62.59 125.46 20.83 Average 1964 5.24 5.21 10.45 1.73 Average 1963 5.12 4.57 9.69 1.67 31 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 1950 22.l7 13.92 14.98 (6/12) 5.27 (6/12) 1951 22 .19 14.34 12.47 5.22 1952 19.12 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 19.00 12.51 8.95 4.34 1958 15.86 (11/12) 9.22 (11/12) 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 (11/12) 20.03 (11/12) 12.69 (11/12) 6.79 (11/12) 1962 20.63 13.01 12.13 6.40 1963 18.90 11.97 9.69 5.11 1964 18.76 12.48 10.45 5.24 32 Total Solids –Tons par Square Mile. 33 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 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 eleven premises were disinfested: one of which was a house under the control of the Corporation. 13. COMPLAINTS. The number of complaints received from the general public during the year was 515 compared with 588 for the previous year. The following is a brief list of causes for complaints received during 1964:- Accumulations 19 Animals 10 Dampness 20 Drains and sanitary arrangements 151 Foods 53 General Housing Defects 52 Insects and Pests 21 Offensive Odours 33 Noise 23 Overcrowding 2 Rodents 86 Smoke 26 Water 3 Others 16 515 34 14. RODENT AND INSECT PEST CONTROL. The work of rodent and insect pest control has continued as in former years and a prompt and efficient service was provided to both householders and business concerns. Twenty vertical block control schemes were carried out together with three treatments for sewer control. During the year 11 drainage systems defects were found which had been the cause of rat infestation. Infestations relating to dwellings are often traced to accumulations of rubbish in back gardens. The service provided by the Corporation whereby discarded furniture and household chattels are removed should receive wider publicity. These articles would not then provide harbourage for rodents in back gardens and the service may be the means whereby a reduction could be effected in indiscriminate dumping of unwanted furniture and household goods on waste land and open spaces. The pest control service provided on a contract basis to the industrial and commercial interests in the town is appreciated and an effective 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 Food. During the year instructions and demonstrations were given to 96 colonial students and field officers. We on our part readily acknowledge the co-operation of the officers of the Ministry, particularly with regard to identification of unusual insects. 35 Rodent Control - Statistical Statement 1964. Local Authority Property Dwelling Houses Business & Factory Premises Totals No„ of properties inspected as a result of notification – 71 15 86 No. of properties inspected in the course of surveys 8 156 135 299 Totals 8 227 150 385 Premises infested Rats 8 98 28 134 Mice – 15 54 69 Totals 8 113 82 203 Total inspections including reinspections 127 678 2,071 2,876 No,, of 'block' or 'vertical' control schemes 1 8 11 20 No. of poison baits deposited 145 237 905 1,287 36 HOUSING. Daring the year two applications for Certificates of Disrepair under the Rent Act, 1957 were made as compared with five in 1963. A Clearance Order was made in respect of Nos 18/38 (even) Acre Road and Closing Orders were made in respect of – Nos. 2a and 12a, Alexandra Road = Basement Flats. No. 45 Beaufort: Road = Basement Front & Back Rooms. No. 13, Gloucester Road = Basement Flat. No. 1, Queen's Road = Basement. No. 63æ, Richmond Road = Whole of premises. No. 2, St. James Road = Two floors above furniture store. No. 31 & 33, St. James Road = Basement front & back rooms. No. 38. Tudor Road =Ground, first and top floor rooms. 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 75 2. 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 9 3. Number of house, the defects of which were remedied in consequence of informal action by the Local Authority or its officers 176 4. Number of representations made to the Local Authority with a view to— (a) The serving of notices requiring the execution of works 21 (b) The making of demolition or closing orders (Number of houses involved) 9 5. Number of formal notices served requiring the execution of works 12 6. Number of houses which were rendered fit after the service of formal notices 16 7. Number of demolition or closing orders made 10 8. Number of houses in respect of which an under– taking was accepted under sub-section 4 of Section 16 of the Housing Act. 1957 – 9. Number of houses demolished – 37 Housing - Statistical Statement. 1964. Total number of permanent dwellings erected by the Corporation since March 1924 to 31st December. 1964. Houses and Bungalows (including 930 outside Borough) 1167 Flats (including 372 outside Borough) 988 Bed-sitting room Units of Accommodation for Old People 65 One bedroom Plats for Old People 8 Total number of temporary dwellings erected up to 51st December. 1964o Still remaining Arcon 132 126 Aluminium 70 23 2-year Huts 113 Nil 315 149 Number of dwellings erected by private enterprise during 1964 Houses 15 Flats 11 With regard to Corporation housings, the following scheme which was reported as being in progress during 1963 was completed during 1964:- 8 one=bedroom flats for old people and 16 three-bedroom flats Acre Road It is hoped that the nine two–bedroom flats in Palace Road mentioned in the 1963 Report will be completed early in 1965. 38 The following schemes were commenced during 1964 and it is anticipated that they will all be completed in 1965:- 35 two-bedroom maisonettes Block 'D' Acre Road 12 one-bedroom flats for Old People 28 two-bedroom flats 12 three-bedroom flats Anglesea /Palace Roads 8 three-bedroom houses "Chessington Hall" 8 one-bedsitting room units for Old People ( Conversion of ( No, 56 Gibbon Road, SECTION E. INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply. All milk supplies in the town are brought in from outside sources, there being no milch herds in the Borough, All 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-Thames forms part of Specified Area No.l. 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, The following table shows the number and types of licences in force during 1964, under the provisions of the Milk (Special Designations) Regulations 1960 and 1963, These Regulations prescribe that the licences shall cover a five year period and all are dealer's licences to sell prepacked milk. Type of Licence Number Pasteurised Milk 15 Sterilised Milk 2 Pasteurised and Sterilised Milk 5 Pasteurised and Tuberculin Tested Milk 5 Pasteurised, Sterilised and Tuberculin Tested Milk 3 Untreated Milk 2 39 (b) Bacteriological Examination of Milk. During the year 96 samples of milk were sent to the Public Health Laboratory at Epsom, and the following is a tabulated statement of the resuits:- Phosphatase Test Methylene Blue Test Pass Fail Pass Fail Void T.T .Pasteurised 37 1 37 1 – Pasteurised 41 – 33 6 2 Tuberculin Tested — – 13 1 3 78 1 83 8 5 All the samples of pasteurised milk but one 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 70º F. during the period of the test. Eight samples failed this test, of these, seven were from milk dispensers used in cafes and snack bars. The sampling of milk from these sources revealed that cleansing of the fittings was not being carried out- satisfactorily. As a result of action taken by the department, proper cleansing routines were established. (c) 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, etc. where 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. The following table shows the results of examination in respect of 66 samples submitted to the Ministry of Health Public Health Laboratory at Epsom during 1964. 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. 40  GRADE I II III IV Total Ice Cream 56 8 1 1 66 (d) 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. 3,641 Ovine „ 6 85 Porcine „ 1,663 Total raw meat 5,989 Raw Fish Decomposition 143 Poultry, Game, etc. „ 1,030 Canned Goods Meat & Meat Products Fruit Jam Vegetables Milk Soup Fish & Fish Paste ) Punctured, blown, damaged or decomposition 685 3,257 274 267 182 49 154 Others 95 4,963 Cont/d 41 Cont/n Article of Food Reason for Action Weights lbs. lbs. Other Foods condemned for various reasons. Confectionery 4 Fruit 12 Pickles 2 Sausages 197 Meat 355 Vegetables 64 Others 229 863 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. (e) Food Hygiene. Recent developments in food retailing have reintroduced hazards which had previously been eliminated,, For instance, the creation of a demand for soft ice cream has been one of the means whereby effective control of production has been removed from the relatively safe conditions of the factory to the ice cream vehicle, thus each selling point for this product becomes a place of manufacture with the consequent risk of contamination being increased. The introduction in cafes of refrigerated dispensing units for milk has also created a problem. These appliances owing to their form of construction are required to be dismantled;, thoroughly cleansed and sterilised daily if they are to provide a safe source of milk supply. It is not suggested that this cleansing is beyond the capability of the staff employed in such premises, but if this is to be done properly, it necessitates detailed instruction and as in many cafes the turnover of staff is very frequent, it is not easy to ensure that the instructions are passed on and the correct procedure maintained,, A more recent development in this sphere is the cooking of meat pies on the retailer's premises. Meat pies with a cooked filling in raw pastry are distributed in a hard frozen condition,, They are thawed out as required in the shop and cooked rapidly in a rotating oven having a transparent case to enable the prospective customer to observe the progress of the cooking. The finished product has an appetizing appearance, 42 but unless care is taken to allow adequate time for the thawing and cooking processes;, food poisoning bacteria may remain in the interior of the pie. A detailed investigation into the operation of these machines in local shops was carried out during the year,, It was found that large steak and kidney pies were difficult to render safe by cooking owing to the time needed for heat to reach the centre of the meat mass. Following recommendations made to retailers, large pies are no longer sold and a revised routine is now used for small goods. As in the past, when 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. The use of paper sacks in food shops and restaurants has been encouraged with a consequent improvement in hygienic conditions. Proprietors appreciate the advantages of the system, particularly when 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 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 following tabulated statement shows the nature of the defects for which Notices were served during the year:- PART IV Defects Requiring Notices Complied Sanitary Conveniences. Lack of "Wash your Hands" Notices 11 14 Fittings cleansed, repaired or extended 4 12 Walls and ceilings cleansed 4 8 Ventilation provided 2 4 Lighting Provided 1 – Sinks. Renewed or repaired, also draining boards 2 2 C/Fwd. 24 40 Cont/d. 43 Cont/n. Defects Requiring Notices Complied Washing Facilities for Staff B/Fwd. 24 40 Absence of, defective, inadequate hand basins 4 2 Absence of hot water 4 5 " " cold water 1 3 Provision of Towels, soap and nailbrushes 8 6 Absence of, or defective, water heaters 3 6 Repairs to Pood Rooms. Walls and ceilings cleansed or repaired 14 14 Floors repaired 8 12 Other structural repairs 7 5 Protection of Food against Contamination Food to be kept 18 off ground 2 2 Covers provided for food 1 3 Others 9 10 Uncleanliness. Kitchens and Equipment 11 4 Insects 1 — Food Stores 1 2 Preparation Rooms 1 1 Dustbins. Insufficient 2 1 Cleansed and/or repaired 1 - General Repairs. 8 9 Cleansing-General. 9 13 First Aid Kit 2 3 Defective Roofing 2 2 Defective Drainage 5 4 129 149 44 Food Hygiene Regulations, 1955 In accordance with the request of the Minister of Healthy, 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 69 Dairies and Milk Shops 24 47 Butchers 40 217 Greengrocers and Fruiterers 89 56 Public Mouses (a) Providing restaurant services 17 78 (b) Not providing restaurant services 41 Fishmongers and Stalls 16 65 Ice Cream Premises registered 173 114 Grocers and General Provisions 132 301 Restaurants and Cafes 69 464 Kitchens and Canteens (including factory, school and shop) 35 Wholesale meat distribution depots 6 135 Visits to food premises re unsound food 211 Open Market, Food Stalls, Barrows 631 667 2,388 FOOD AND DRUGS ACT, 1955. The tabulated statement overleaf gives details of the 103 samples which were submitted during the year 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. Six samples were the subject of adverse comment and three of these related to contraventions of the Labelling of Food Order,, In all Cases new or amended labels were produced. The sample of shrimps was contaminated with a number of tiny black carbonaceous particles. Three of the shrimps had developed a circular area of discoloration caused by a dark colour diffusing out from a particle in the centre. This appeared to be an isolated case as follow-up samples proved to be without blemish. 45 The sample of white bread was contaminated with poppy seed but as this is a common article used in bakeries at the present time it was not thought that any further action was necessary, other than to warn the baker to take effective precautions to prevent the seeds becoming embedded in the crust of loaves. Action in the case of the remaining sample which was a pork pie affected with a type of penicillin mould growth, culminated in legal proceedings, the vendor was fined £20 with £5 costs. Tabulated Statement of Samples submitted to the Public Analyst during 1964. Commodity No. of Samples Genuine Not Genuine or otherwise irregular Formal Informal Formal Informal Formal Informal Anchovy Paste – 1 – 1 – – Apple Pie Pilling – 1 – 1 – – Apple Sauce – 1 – 1 – – Apricots in Sorbitol Syrup — 1 – 1 – – Apricots in Syrup — 1 – 1 – — Aspirin Tablets – 1 — 1 – – Batter Mix – 2 – 2 – – Beefburgers – 1 – 1 – – Beef Dinner – 1 – 1 – – Beef Milano (Shack Meal) – 1 – 1 – – Beef Roma (Snack Meal) – 1 – 1 – – Braised Sliced Pork Kidneys – 1 – 1 – – Cheese Dressing Mix – 1 – – – 1 Cherry Pie Pilling – 1 – 1 – – Chicken Supreme – 1 – 1 – – Christmas Pudding – 1 – 1 – – Cod Roe – 1 – 1 – – Condensed Milk – 1 – 1 – – Crab Spread with Butter – 1 – 1 – – Cream (Dairy) – 1 — 1 – – Cream (Danish) – 1 – 1 – – Cream (Double Devon) – 1 – 1 – – Cream (Pure Jersey) – 1 – 1 – – Cream of Tartar – 1 – 1 – – Currants – 1 – 1 – – Curry Powder – 2 – 2 – – Cut Mixed Peel – 1 – 1 – – Demarara Sugar – 1 – 1 – – C/Fwd. – 30 – 29 – 1 46 Commodity No, off Samples Genuine Not Genuine or otherwise irregular Formal Informal Formal Informal Formal Informal B/Fwd. – 30 – 29 – 1 Dessert (instant) – 1 – 1 – – Dried Fruit Mix – 1 – 1 – – Drinking Chocolate – 1 – 1 – – Fruti-Fort – 1 – 1 – – Halibut Liver Oil Capsules – 1 – 1 – – Ham & Chicken Roll – 2 – 1 – 1 Ham & Tongue Spread – 1 – 1 – – Hamburger Steak 1 – 1 – – – Herring Roe (Soft) – 1 – 1 – – Hot Dog Sausages – 1 – 1 – – Iron Tonic Tablet (Vitaminised) – 1 – 1 – – Jelly – 1 – 1 – – Lemonade Crystals – 1 – 1 – – Lemon Flavour – 1 – 1 – – Lemon Pie Filling- – 1 – 1 – – Linotus – 1 – 1 – – London Grill (Snack Meal) – 1 – 1 – – Marmalade – 1 – 1 – – Marmalade (Orange Jelly) – 1 – 1 – – Mentholated Balsam – 1 – 1 – – Milk – 13 – 13 – – Milk Shake Syrup (Strawberry) – 1 – l – – Onions (instant Dried) – 1 – 1 – – Orange Drink – 1 – l – – Peaches in Heavy Syrup – 1 – 1 – – Peach Pie Filling – 1 – l – – Pearl Barley – 1 – l – – Pickle – 1 – l – – Pimentos (Sweet Red) – 1 – 1 – – Pork Pie – 1 – – – 1 Potted Beef with Butter – 1 – 1 – – Raisins (Seeded) – 1 – l – – Raisins (Seedless) – 1 – l – – Raisins (Stoned) – 1 – 1 – – Ravioli in Rich Tomato Sauce – 1 – l – – Rice (Ground) – 1 – l – – Rice (Long Grain) – 1 – 1 – – Rice Pudding – 2 – 2 – – Roast Beef in Gravy – 1 – 1 – – Sage and Onion Stuffing — 1 — 1 – – C/Fwd. 1 83 1 80 – 3 47 Commodity No. of Samples Genuine Not Genuine or otherwise Formal Informal Formal Informal. Formal Informal B/Fwd. 1 83 1 80 – 3 Salmon (Red) – 1 – 1 – – Savoury Minced Steak – 1 – 1 – – Shrimp Salad – 1 – 1 – – Shrimps (Peeled) – 1 – – – 1 Soya Beans in Tomato Sauce – 1 – 1 – – Spaghetti Bolognese – 1 – 1 – – Steak & Kidney Pie – 1 – 1 – – Strawberries in Syrup – 1 – 1 – – Strawberries (Selected Dessert)' – 1 – – – 2 Sugar (Soft Brown) – 1 – 1 – – Tapioca (Seed Pearl) – 1 – 1 – – Tomatoes (Italian Peeled) – 1 – 1 – – Tomato Juice (instant Pure) – 1 – 1 – – Tuna – 2 – 2 – – Tuna in Pure Edible Oil – 1 – 1 – – Vegetable and Turkey Dinner – 1 – 1 – – Welsh Rarebit – 1 – 1 – – White Bread 1 – – – 1 – 2 101 1 96 1 5 Other Foods which were the subject of Complaint. Joint of Pork. The dark spots on this joint were caused by the rupture of small blood vessels which occasionally occurs at the time of slaughter. Jar of Dressed Crab. The manufacturers apologised for the inclusion of shell in the article and promised to take greater care in their checking procedure. Nail in Walnut Cake,, The manufacturers had been worried for some time about the possibility of a nail entering this product, due to the way in which some of the ingredients were packed. With this in mind, they had just previously installed a metal detector at some considerable cost and gave assurances that the occurrence would not be repeated. Quality of Hamburger Steak. The complainant alleged that there was no particle of meat in the small portion she ate. Formal samples were taken at the restaurant and analysed but were found to be genuine. It seemed obvious that proper mixing of the ingredients was not being carried out,, and the proprietor was advised accordingly., 48 Foreign Matter in White Loaf. The matter was identified as edible oil used for lubricating the bakery machinery. The Bakers promised to keep a stricter check at the point where the trouble occurred,, Chicken. Complainant alleged that the chicken he had bought was not chicken but seme inferior meat. Upon inspection,, the meat was found to be genuine. Foreign Body in Orange Marmalade. The body was found to be a piece of wood that had presumably come from one of the wooden vats used for manufacturing the orange pulp. The manufacturers stated that the introduction of stainless steel vats which was imminent would rule out the possibility of a repetition. Tinned Rhubarb, The tin had corroded internally and upon examination of tins of the same product it was found that internal corrosion had commenced in some of them. The whole of the stock was therefore surrendered for destruction,, Vacuum Packed Bacon. This was alleged to have been out of condition but was discarded before an examination could be made. An inspection of the wrapper, however, revealed that the expiry date had been rubbed out, while the price mark was left untouched,, The wrapper was therefore submitted for laboratory inspection which shewed that the original date of manufacture was some time prior to purchase. There were a number of likely explanations but none could be substantiated. The Manager of the store was advised to make more frequent inspections of all perishable goods in stock. Swigs Roll out of Condition. The roll was very much out of condition when purchased. The coding on the wrapper indicated that the roll wa3 made six weeks prior to purchase and delivered within four days. The Manager of the store had not ensured that proper stock rotation was being observed as he was under the impression that the manufacturers would accept responsibility for the freshness and display of their cakes. He was corrected on this and given advice on the proper method of stock rotation. Tin of Baked Beans. Claimed to have a bitter taste; upon inspection of the can, however, no damage could be found, the remaining beans were tasted and found to be quite normal. A second can, bearing the same code mark as the first, was opened, and again everything appeared to be satisfactory. The complaint was regarded as unfounded. Beef Sausages. Alleged to have been out of condition. Upon examination of these and the remaining stock it was considered that the complaint was completely unwarranted. 49 Apple Strudel. The Strudels were part of a meal consumed at a restaurant and were alleged to have a green discoloration on the inner filling. The proprietor stated that any green colour would probably be due to apple peel. Owing to the fact that the meal was entirely consumed;, the matter could be pursued no further. Crumpets affected with Mould Spots. The manufacturers were at a complete loss to explain why or how the mould had formed on their crumpets, as they were delivered to the retailers' premises on the same day that they were purchased. Maggots on Bacon Pieces. The maggots were found to be the larvae of bluebottles,, When inspected the retail premises proved to be clean and no sign of the presence of flies, either recent or past, was evident. The likeliest explanation was that the eggs were laid on the bacon before delivery to the shop. Foreign material in Superloaf. The matter was identified as small crumpled fragments of paper, on some of which were printed lines and figures. The discoloration of the bread appeared to be caused by the running of the ink. The manufacturers stated that the paper had been derived from a "divider dough sheet". The Manager and staff were warned to exercise greater care in the use of paper in the bakery, Madeira Cake, The cake was affected with bluish-green spots. The method of stock rotation, storage and sale at the retail premises proved to be good and the likeliest explanation for the condition of the cake was that it must have been cut and wrapped before it had properly cooled. Insect in Loaf, Insect was identified as the remains of a bee, which had presumably been introduced during the moulding and twisting of the dough. An inspection of the bakery was carried out and no trace of bees or wasps was detected. All windows that could be opened were covered by wire mesh, so it could only be assumed that the insect had gained access to the bakery unnoticed. Foreign Matter in Loaf, The matter was identified as a small piece of dough which was thought to have remained undetected in the mixer and become incorporated in the next batch of dough. The manufacturers gave assurances that steps would be taken to prevent a repetition. Tin of Stewed Steak, Upon examination, the hair-like particles were identified as fibres of jute and manilla, possibly from a small piece of string. This appeared to be an isolated case as the manufacturers' hygiene precautions were very stringent. 50 Tomato Juice. The complainant alleged that a foreign body lodged in his throat while drinking some of the juice. On investigation it was found that the internal lacquer lining had become detached from the can. All the stock, which was in a similar condition, was surrendered by the retailer and the matter was taken up with the importer. Jam Sandwich Cake. The cake was very much out of condition and investigations revealed that it had been delivered nearly three weeks prior to purchase. The retailers' method of stock rotation was unsatisfactory and he was advised on this and warned to take greater care in the future. Mould on Loaf. The bread had been manufactured two days prior to purchase. The complaint was not received until five days after purchase so it was not possible to determine when the mould spores developed,, Pork Luncheon Meat. The dark substance was identified as black hog bristle indicating that a portion of rind was inadvertently left on some meat. The manufacturers offered their apologies. Matter in unsliced Loaf . The matter was identified as a deposit of vegetable oil and charred dough which had presumably dislodged itself from a bread tin into a piece of dough contained in the loaf. Packet of Frozen Peas. There appeared to be a slight mould growth on the packet and on some of the peas. The peas should have been in perfect condition when purchased and it became obvious that a very serious fault in the method of stock rotation at the retail premises had occurred. The Manager was advised on this and warned to exercise much greater care in checking the rotation of all perishable foodstuffs. Mould on Brown Loaf. The loaf was in a sound condition when delivered to the retail premises but owing to a misunderstanding by an assistant with regard to the shelf life of the product, it was held for a longer period than usual. Maggot on Toffee. The maggot was identified as the larva stage of the dried fruit moth. Dried fruit is sometimes infested with this moth before entry into the country and despite rigid precautions, it is possible that one or two grubs may survive. It was thought that the grubs may have been introduced to the premises on some fruit confection and then migrated into the toffee wrapper in order to pupate. Glass in Marmalade. The glass was identified as not of the same nature as that which is associated with jam jars and in fact was clear glass. The manufacturers' bottling procedure and checking system appeared to be of a high standard and they were unable to account for the presence of the glass. 51 Beetle in Chocolate Nut Sundae. The sundae had a beetle embedded in it and on inspection of the retail premises it was found that there was an infestation of steam flies in a wooden cabinet which is used for serving the sundaes. The proprietor was given firm instructions to dismantle this cabinet regularly in order to execute proper cleansing and disinfestation. Drawing Pin in Danish Pastry. This seemed to be an isolated case of mischance as the bakery, upon examination, proved to be very clean and hygienic,, The staff were informed of the incident and advised to keep a greater scrutiny during production. Raisin Bran Flakes out of condition. It appeared that in this case the packet was sold some time after its shelf life had expired. The Manager of the store took the matter very seriously and gave strict instructions to make a close check on existing stocky and to see that no further lapses of stock rotation took place. Earwig in Pork Luncheon Meat. The manufacturers were at a complete loss to explain the presence of this insect and could only offer assurances that they would do all in their power to prevent a repetition. String in Sultana Cakes. The manufacturers could not explain the presence of the string and could only assume that the material, which was a sack tie, had somehow become attached at the moulding stage. Electronic detectors which were in use do not indicate the presence of this type of foreign body. Bristle in Healthvita. The bristle was identified as coming from one of the cleaning brushes used at the manufacturer's plant. They are endeavouring to find an improved type of brush from which the bristles are less easily detached. Muscatels out of Condition. These were confirmed to be old stock and the extensive white deposit on the raisins was fruit sugar,, A sign was displayed 'both on the shop window and beside the display warning customers of this. Foreign Matter in Milk Bottles. Three complaints were received and related respectively to a mouldy substance at the bottom of a bottle, reddish-brown matter subsequently identified as an iron rust stain, and sand and cement. In all eases the bottles had escaped scrutiny at the filling plant. It is fortunate, however, that the method of cleaning bottles prior to filling ensures that the bottles are sterile,, The presence of foreign matter is to be deprecated and the suppliers are anxious, as far as is practicable, to reduce the risk of such occurrences. 52 The remaining twelve cases of complaint related to a number of minor matters mainly concerned with alleged off flavours or food sold out of condition. Often in these cases the product is brought to the office some time after purchase when it is not possible to assess its condition at the time of sale, All such cases are. however, investigated, as on occasions these enquiries reveal faults in handling which require attention. It is cause for concern that seven of the cases reported above were occasioned by bad stock rotation, Whilst every case 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. Pood 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 under the above Act in respect of certain foods - mainly imported apples and tomatoes. Twelve warning notices were given, but it was not considered necessary to take any legal enforcement action. 53 SECTION F PREVALENCE OF. AND CONTROL OVER. INFECTIOUS AND OTHER DISEASES The following infectious diseases are notifiable to the Medical Officer of Health of the Borough:- Scarlet Fever Whooping Cough Diphtheria (including Membranous Croup) Measles (excluding Rubella) Acute Pneumonia (Primary or Influenzal) Meningococcal Infection Acute Poliomyelitis - Paralytic " " - Non-Paralytic Acute Encephalitis - Infective " " - Post Infectious Dysentery Ophthalmia Neonatorum Puerperal Pyrexia Smallpox Para-Typhoid Fevers Enteric or Typhoid Fever (excluding 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 1964 a total of 128 notifications of infectious disease was received, and these are analysed and commented upon in the following tables and reports. 54 NOTIFIABLE DISEASES DURING 1964 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 cases 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 - - - - - 2 - 1 - - - - 3 - - - - - - - - - - - - - - Measles. - 5 8 10 13 35 1 - - 1 - - 73 - - - - - - - - - - - - - - Whooping Cough Acute Poliomyelitis: — 1 2 4 1 9 1 - — — - — 18 - - - - - - - - - - - - - - Paralytic - - - - - - - - - - - - - - - - - - - - - - - - - - — Non-paralytic Acute Infective — - - - - - - - - - - - - - - - - - - - - - - - - - - Encephalitis - - - - - - - - - - - - - - - - - - - - - - - - - - Meningococcal Infection - - - - - - - - - - - - - - - - - - - - - - - - - - - Puerperal Pyrexia. - - - - - - - 3 13 1 - • 17 15 - - - - - - - - - - - - - Dysentery - - - 1 - - - - - - l - 2 - - - - - - - - - - - - - - Food Poisoning - - - - - 1 - 1 - 2 - - 4 1 - - - - - - - - - - - - - Pneumonia - - - - - - - 1 - 3 5 - 9 - - - - - - - - - 1 - 3 14 18 Erysipelas - - - - - - - - - - 1 - 1 - - - - - - - - - - - - - - Ophthalmia Neonatorum - - - - - - -- - - - - - - - - - - - - - - - - - - - - Para-Typhoid Fever — - — — - - - - 1 - - — 1 1 - - - - - - - - - - - - - Totals - 6 10 15 14 47 2 6 14 7 7 - 128 17 - - - - - - - - 1 - 3 14 18 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) 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 l 1940 45 373 22 63 - - 53 3 3 1941 54 331 2'71 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 - - — - - 1963 12 404 13 37 - - - - 1 i 1964 3 73 18 17 - - - 1 *Measles - Hot notifiable until 1940. *Whooping Cough - Not notifiable until 1940. 56 Whocping Cough. There were 18 cases of whooping cough notified during 1964, comprising 8 pre-school children and 10 attending school. The number of cases notified for the years 1959-1964 are shown in the table below for the purposes of comparison. 1959 1960 1961 1962 1963 1964 3 11 _ 5 13 18 Immunisation against whooping cough is usually performed as a combined process with diphtheria immunisations, 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 Para-Typhoid). During 1964, one case of para-typhoid was notified. The patient, a male, was admitted to hospital for treatment, The blood culture tests at the laboratory at Colindale resulted in a diagnosis of phage type "BECCLES". The case had no connection in any way with the epidemic which occurred in Aberdeen during the year. The patient made a normal recovery, and the source of infection was not established. Measles , There were 73 cases of measles notified during 1964 compared with 404 in 1963. Generally speaking the illness was of a mild type with little by way of complications and all cases were nursed at home. There were 36 cases in the 0/5 age group, 35 in the 5/10 age group, and a further 2 isolated cases. Ophthalmia Neonatorum. No cases of ophthalmia neonatorum occurred during 1964. Puerperal Pyrexia. The maternity block at Kingston Hospital serves Kingston and a large surrounding area embracing a population of some 285,000 persons. During 1964, 2,036 deliveries took place in the hospital;, and inevitably some cases 57 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 100.4 F. or more has occurred within fourteen days after childbirth or miscarriage. During 1964, 17 cases were notified, 15 of whom were notified from Kingston Hospital;, of which 5 were Kingston residents, These figures compare with 37 and 8 respectively for 1963. An analysis for the years back to 1960 is shown below. Cases 1960 1961 1962 1963 1964 (a) Total notified 89 89 38 37 17 (b) Number included in (a) of (i) Kingston residents 19 24 9 9 7 (ii) Extra district residents (c) Number included in (a) notified 70 65 29 28 10 from Kingston Hospital 89 89 38 36 15 (d) Number included in (a) notified by private doctors - - - 1 2 (e) Number of cases included in (d) removed to hospital other than included in (c) - - - - Smallpox. There were no cases recorded in Kingston during 1964. Constant vigilance is however necessary and in particular surveillance has to be maintained over persons arriving from abroad particularly 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 connection, a large number of certificates issued by Kingston doctors are officially authenticated in the Public Health Department each year in accordance with regulations. During 1964s, vaccination of infants continued to be carried out at about the age of one year as recommended by the Ministry of Health. 58 Scarlet Fever,, Only three cases were notified in 1964, and occurred in children of school age, The infection was of a mild nature and all cases were treated at home. 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. Poliomyelitis. No cases of poliomyelitis have been notified in Kingston since 1957. Vaccination against poliomyelitis by the oral method was continued throughout the year. The bulk of the work in prevention of poliomyelitis by active immunisation of the population up to 40 years of age has now been completed,, The main groups which were immunised during 1964 were infants commencing at the age of six months, and school children and adults who had failed to attend for immunisation in previous years. Many of the young adults who have not so far been protected against poliomyelitis receive this protection when they later attend the clinics with their own children. Oral vaccine by mouth, not only provides protection but also prevents protected persons from harbouring poliomyelitis virus and spreading the disease to unprotected persons. This type of vaccine is of great value during an epidemic because it works quickly. The vaccine is available for the immunisation of everyone between six months and 40 years, and in addition for those who may be in contact with poliomyelitis as a result of their work. Dysentery (Sonne), Only two cases of dysentery were notified during 1964 compared with five during 1963. 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 59 informed of developments including up-to-date information as to drug sensitivity of organisms. An essential and important factor undertaken by the public 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 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. During 1964, seventeen cases were reported in Kingston, and of these 12 referred to lungs. The corresponding figure for 1963 was 14, of which 10 were lung cases. Whilst we can claim that fear and pessimism concerning tuberculosis have been largely removed from people's minds, and there is considerable satisfaction to be derived from the decline in the number of new cases, there are 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 therapeutio treatment, facilities for early detection of tuberculosis by public mass x-ray sessions and B.C.G. vaccination of school children will eventually bring the disease to the Point of eradication. The following table shows comparative figures of notified cases and deaths for the years 1955 to 1964 (inclusive) 60 Year Cases Notified Deaths Respiratory Non-Respiratory Total Respiratory Non-Respiratory Total 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 1963 10 4 14 4 1 5 1964 12 5 17 2 1 3 The efficiency of notification has been good and there is no reason to suspect refusal or neglect. 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. 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 1964, 104 families within the area covered by the Committee were helped in the form of grants for extra nourishment, clothing, fuel, removals, bedding,, fares, pocket-money, etc., end a total of £2,468. was expended from the funds of the Committee on this work. An analysis of the total notified cases during 1964 in age groups is shown on the next page, and the following graph depicts the numbers of new cases and deaths in respect of respiratory tuberculosis occurring for the past 15 years. 61 NOTIFIED CASES OF AND DEATHS FROM TUBERCULOSIS IN 1964. TABLE VI. NEW CASES DEATHS Under 1 Year 1 - 5 5-15 15 - 25 25 - 35 35 - 4-5 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 - - - - 2 1 — 2 2 7 - - - - - - - - 1 1 F - - 1 1 2 - - - 1 5 - - - - - 1 - - 1 Total - 1 1 4 1 - 2 3 12 - - - - - - 1 - 1 2 (b) Non-respiratory M - - - 2 - 1 - - - 3 - - - - - - 1 - - 1 F - - - 1 - - - 1 - 2 - - - - - - - - - - Total - - - 3 - 1 - 1 - 5 - - - - - - 1 - - 1 62 R2/68