1 BOROUGH OP LAMBETH Public Health Committee (appointed by the Council on the 23rd May, 1952), THE WORSHIPFUL THE MAYOR OP LAMBETH (Alderman H.W.Wallace, C. B. E., J.P. , M. P.) ex-officio ALDERMEN: Mrs. E. S. BARNES, J.P. G. K. RETTIE COUNCILLORS: Dr. J. BRAND Mrs. M. D. BROWNETT T. CLEASBY Mrs. B. M. GRANTHAM E. E. HARRIS Miss K. L. JENNER W. LAVEKICK Chairman Mrs. M. MAROCK P. R. NICE Mrs. J. ROBINSON Vice-Chairman 3 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lambeth. Your Worship, Ladies and Gentlemen, I have the honour to present to you the 96th Annual Report upon the health of the Borough of Lambeth. The general health of the population has again been phenomenally good except for the results of the disastrous smoke pall which enveloped the whole metropolis and beyond around th e weekend 13th/14th December. The deaths in London from influenza bronchi tis and pneumoni a shot up from 123 to 896 for the week ending December 13th and did not fall to the highest weekly figure of the previous winter, 182, until the second week in March. For the ten weeks succeeding the smoke pall, the number of deaths never fell below the 300 level except once, and for four of them the average was 527. Many of these deaths were directly caused by the incomplete combustion products of coal largely that used on the domestic hearth which as a rule wastes at least 80% of the coal used upon it. The unwashed combustion products from factory plants contain large volumes of sulphur fumes which play havoc with the lungs of elderly people as readily as they eat into the stone of our public buildings. There is nothing whatever to prevent a similar tragedy befalling the people of Lambeth in the coming winter, and not necessarily upon one occasion only. The mortality from infectious diseases has again been on a small scale despite the measles epidemic which was well under weigh by June, diminished considerably during the school holidays in August and then, contrary to expectations, carried on right through the winter and following spring. Whooping cough, so much more to be dreaded for infants than measles, never assumed epidemic proportions but every week throughout the year from 5 to 20 and more cases were notified. Diphtheria was not notified once. The loss of sanitary inspectors attracted by better pay elsewhere and the lack of answers to advertisements offering grades I-IV made it necessary to follow the lead of other authorities and to advertise up to grade V. This achieved the object and there are now no vacancies, nevertheless there were one or two districts which were without an inspector for many months and which were covered By the inspectors of adjoining districts, a circumstance which is wholly unsatisfactory. I am grateful for the consideration and understanding of difficulties accorded to me by the Public Health Committee, for the help and cordial co operation of all the Chief Officers of the Council and especially to the staff of the Public Health Department. July, 1953. Medical Officer of Health 4 STAFF of the PUBLIC HEALTH DEPARTMENT at 31st DECEMBER, 1952. MEDICAL OFFICER OF HEALTH A. G. G. THOMPSON, M. A. , M. D., B.C. (Cantab.)., D.P.H. PUBLIC ANALYST (part-time) J. E. WOODHEAD, B. Sc. , P. R. I. C. , Ph. C. CHIEF ADMINISTRATIVE ASSISTANT H. P. WRIGHT CLERICAL STAFF A. W. Bay ley, M. A. East, Mrs. G. Hopkins, N.Jupp, E. F.Mannerson, Mrs. J. Rose, Miss E.Yelverton SANITARY INSPECTORS (a) District Inspectors S. G. FORD Cert. S. I.E. a (Meat and other foods) J. BOWERS ,, (Meat and other foods and smoke) S. G. STARLING ,, (Meat and other foods) D. T. EVANS ,, J. SMITH ,, (Meat and other foods) E. E. MORGAN ,, (Meat and other foods) R. NEWTON ,, (Meat and other foods) R. G. CUTLER ,, A. FRENCH ,,(Meat and other foods) H. F. BRYAN ,, J. B. SAINS BURY ,, A. E. WHITE ,, (Meat and other foods) (b) Food Inspectors S. BRADLEY ,, (Meat and other foods) C. W. IDLE ,, (Meat and other foods) (c) Housing Inspectors B. GOOD ,, (Meat and other foods) F. J. HEFFIELD ,, (Meat and other foods) 5 SANITARY INSPECTORS - continued (d) Rodent Officer S. P. HEAL Cert. S.I.E.B. (Meat and other foods) (e) Women Inspectors Miss L. E. AUGER, Cert. S.I.E.B., S.C.M., H.V.Cert. Miss A. F. CROMBIE, ,, ,, ,, Disinfecting Station Wanless Road, Loughborough Junction, S. E. 5. Superintendent: L. BRANN GENERAL ASSISTANTS J. Leeson W.Deamer (Assistant Rodent Officer) L.Whiston (Rodent Operative) 6 STATISTICS AND SOCIAL CONDITIONS Summary of Vital and Mortal Statistics, etc (The comparable figures for the previous year appear in brackets) Area of Borough- 4087.5 Statute acres (inclusive of land and inland water, but exclusive of tidal water and foreshore), divided into 4 Registration Sub-Districts, 3 Parliamentary Constituencies, and 12 Wards. The Parliamentary Constituencies and Registration Sub-Districts have been adjusted so that they and the Wards are co-terminous. Population- estimated, 1952 - 230 , 200 ( 229,100). Density- 56.32 (56.05) persons per statute acre (inclusive of land and inland water, but exclusive of tidal water and foreshore). Births (corrected)- 3,626 (3,829). Birth rate per 1,000 estimated resident population. *14.49 (15.40). Deaths (corrected)- 2, 824 ( 2,94 7). Death rate per 1,000 estimated resident population *12.27 (12.86). Maternal mortality (corrected) per 1,000 total births (live and still) 2.17 (.51). Infantile mortality 25.37 (25.07). Neonatal mortality 17.93 (16.19). Zymotic Death-rate (corrected)- 0.01 (0.03) per 1,000 population (total zymotic deaths 2 (6). Marriages - Marriage rate per 1,000 population 8.16 (8.75). Rateable Value at 1st April, 195 2 - £2,188, 134 (£2, 168,264). Sum represented by 1d. rate - £8,919 (£8,806). Comparable rates for England and Wales and London:- England and Wales London Birth rate 15.3 (15.5) 17.6 (17.8) Death rate 11.3 (12.5) 12.6 (13.1) Infantile mortality 27.6 (29.6) 23.8 (26.4) Puerperal causes 0.72 (0.79) not available *As adjusted by comparability factor. 7 VITAL STATISTICS The population of the Borough of Lambeth at the mid year 1952 has been estimated by the Registrar- General to be 230,200 which is 1,100 more than the estimated population in 1951. The natural increase By births over deaths was 802. The following table shows the actual numbers and the percentages of deaths in various age groups and no less than 39.73% of all deaths were in the age group 75 years and over. The ageing of the population, the increasing proportion of retired non-earning people to be supported by the younger workers becomes more apparent each year. It becomes therefore, correspondingly important to maintain not only the health of the aged but also their capacity to look after themselves. They must be entirely dependent upon the younger generations to produce the goods which pensions enable them to purchase but so far as possible they should not in addition be dependent upon the services of people who would be more usefully employed upon production. One important means of keeping the aged active is one by which they can get the services of a chiropodist at a cost which does not eat too much into the pension. The Borough Council are barred by statute from spending money directly upon such a service but the Council can make gran ts to the Lambeth Old People's Association for the purpose. It was hoped that it might be possible for the Association to set up three clinics each of two sessions a week, one at each end and the third in the centre of the Borough, but unfortunately it proved impossible to arrange for more than the one in the centre which has been domiciled in the Town Hall until accommodation was found on the Brixton District Nursing Association premises. It is hoped that enough financial assistance will be forthcoming 1 ater to start the two other clinics, perhaps next year. Meanwhile the association through its 23 clubs is doing invaluable work in maintaining the self reliance and physical abilities of scores of old people. All Ages 0-1 1-5 5-15 15-25 25-45 45-65 65-75 75 & over 2.824 92 12 11 18 141 668 760 1122 100% 3.26 0.43 0.39 0.64 4.99 23.65 26.91 39.73 The principal causes of death were heart disease 877(911) or 31.06 per cent. (30.91) of the total deaths, cancer 497(523) or 17.60 per cent. (17.75), and influenza, bronchitis and pneumonia, three causes of death largely dependent upon the weather, were the cause of 4 28 (501) deaths or 15. 16 per cent. (17.0) During the year the number of live births corrected by inward and outward transfers was 3,626, giving a corrected birth rate of 15.75 compared with 16.71 in 195.1, a decrease of 0.96 per 1,000 population. Deaths from cancer of the lungs have fallen this year to below the numbers in 1949. There is however nothing to indicate that this is other than a temporary remission. On the other hand deaths from tuberculosis of the lungs continue to fall with modern treatment and no doubt this will lead to like reduction in the 8 incidence which otherwise might have to wait upon better housing conditions before there was any substantial decline. Neoplasms of the lung and bronchus 1946 1947 1948 1949 1950 1951 1952 M F M F M F M F M F M F M F 57 13 59 19 58 23 77 31 87 11 97 18 75 26 Age Groups Respiratory Tuberculosis Neoplasms of the Lung or Bronchus 1950 1951 1952 1950 1951 1952 MALES- 0- 1- 5- 15- 2 - - - - - 25- 16 26 13 4 5 2 45- 23 37 20 52 55 49 65- 9 10 10 23 29 21 75- 2 3 1 8 8 3 TOTAL MALES 52 76 44 87 97 75 FEMALES- 0- 1- 5- 15- 6 1 2 - - - 25- 16 9 4 1 2 2 45- 11 5 8 2 8 11 65- 3 4 - 5 2 7 75- - 1 2 3 6 6 TOTAL FEMALES 36 20 16 11 18 26 MATERNAL MORTALITY The maternal mortality is expressed as the number of deaths attributed to puerperal and post-abortive sepsis and other maternal causes for each 1,000 births. There were eight deaths during the year. 2.17 per 1000 live and still births. Last year there were only two deaths. co MORTALITY 12.27 (12.86) CAUSES OF DEATH AGES (both sexes) TOTALS Under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and under 75 years 75 and upwards MALE FEMALE 1. Tuberculosis, Respiratory M _ _ _ _ 13 20 10 1 44 F _ _ _ 2 4 8 _ 2 16 2. Tuberculosis, other M _ _ _ _ 1 _ 1 _ 2 F _ 1 _ _ 1 _ 1 _ 3 3. Syphilitic disease M _ _ _ _ _ 5 10 4 19 F _ _ _ _ _ 2 _ . 2 4. Diphtheria M _ _ _ _ _ _ _ _ _ F _ _ _ _ _ _ _ _ _ 5. Whooping Cough M _ _ _ _ _ _ _ _ _ F _ _ _ _ _ _ _ _ _ 6. Meningococcal Infections M _ _ _ _ _ _ _ _ _ F 1 _ _ _ _ _ _ _ 1 7. Acute Poliomyelitis M 1 _ _ 1 _ _ _ _ 2 F _ _ _ _ 1 _ _ _ 1 8. Measles M _ _ _ _ _ _ _ _ _ F _ _ _ _ _ _ _ _ _ 9. Other infective and parasitic diseases M 1 _ _ _ _ _ 1 _ 2 F _ _ 1 _ _ _ 1 _ 2 0. Malignant Neoplasm, Stomach M _ _ _ 1 3 13 10 7 34 F _ _ _ _ 1 6 13 4 24 1. Malignant Neoplasm, Lung Bronchus M _ _ _ _ 2 49 21 3 75 F _ _ _ _ 2 11 7 6 26 12. Malignant Neoplasm, Breast M _ _ _ _ _ _ _ _ _ F _ _ _ _ 5 16 8 12 41 10 11 CAUSES OF DEATH AGES (both sexes) TOTALS Under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and under 75 years 75 and upwards MALE FEMALE 13. Malignant neoplasm,Uterus F _ _ _ _ 1 12 7 5 25 14. Other malignant and lymphatic neoplasm M _ 2 2 _ 16 37 52 48 157 F 1 _ _ _ 13 29 25 37 105 15. Leukaemia, aleukaemia M _ 1 1 _ _ 2 1 _ 5 F _ _ _ _ 2 1 _ 2 5 16. Diabetes M _ _ _ _ _ _ 2 _ 2 F _ _ _ _ _ 1 6 6 13 17. Vascular lesions of nervous system M _ 1 _ _ 3 25 35 53 117 F _ _ _ 1 2 41 50 90 184 18. Coronary Disease, angina M _ _ _ _ 5 93 71 42 211 F _ _ _ 1 1 17 44 49 112 19. Hypertension with heart disease M _ _ _ _ _ 10 16 11 37 F _ _ _ _ _ _ 18 29 47 20. Other heart disease M _ _ _ _ 3 26 45 117 191 F _ _ _ 1 3 29 49 197 279 21. Other circulatory disease M _ _ _ _ 1 13 27 33 74 F _ _ _ _ 3 7 16 47 73 22. Influenza M _ _ _ _ _ 5 3 4 12 F _ _ _ _ 1 2 3 3 9 23. Pneumonia M 5 _ _ _ 1 13 21 27 67 F 6 1 1 1 _ 9 15 49 82 24. Bronchitis M 2 _ _ _ _ 49 61 50 162 F 1 _ _ _ 2 16 27 50 96 25. Other diseases of respiratory system M _ _ _ _ 2 9 5 6 22 F _ _ _ _ _ 1 2 2 5 26. Ulcer of stomach and duodenum M _ _ _ _ 1 10 5 5 21 F _ _ _ _ _ 4 4 4 12 27. Gastritis, enteritis and diarrhoea M _ _ _ 1 _ 1 1 _ 3 F 2 _ _ _ 1 3 3 2 11 28. Nephritis and nephrosis M _ _ _ _ 4 2 4 1 11 F _ _ _ _ 1 4 3 4 12 29. Hyperplasis of prostate M _ _ _ _ _ 2 9 16 27 F _ _ _ _ _ _ _ _ _ 30. Pregnancy, childbirth, abortion F _ _ _ _ 8 _ _ _ 8 31. Congenital malformation M 4 1 _ _ 2 2 _ _ 9 F 6 _ _ 1 1 _ _ _ 8 32. Other defined and illdefined diseases M 41 1 2 4 8 24 21 24 125 F 17 1 2 2 8 20 22 47 119 33. Motor vehicle accidents M _ 1 _ _ 2 1 _ _ 4 F _ _ _ _ 1 _ _ _ 1 34. All other accidents M 1 2 2 2 4 6 1 8 26 F 1 _ _ _ 2 _ 2 14 19 35. Suicide M _ _ _ _ 4 7 _ 1 12 F _ _ _ _ 1 5 1 _ 7 36. Homicide and operations of war M 1 _ _ _ 1 _ _ _ 2 F 1 _ _ _ _ _ _ _ 1 92 12 11 18 141 668 760 1122 1475 1349 12 BIRTH-RATES, CIVILIAN DEATH-RATES, ANALYSIS OF MORTALITY, AND CASE RATES FOR CERTAIN INFECTIOUS DISEASES IN TOE YEAR 1952. Provisional Figures based on Weekly and Quarterly Returns England and Wales 160 C. Bs. and Great Towns including London 160 Smaller Towns Resident Population 25,000 to 50,000 at 1951 Census London Administrative County Lambeth * Rates per 1,000 population Live Births 15.3 16. 9 15.5 17.6 15.75 Still Births 0.35 0.43 0.36 0.34 0.29 22.6** 24.6** 23.0** 19.2** 18.14** DEATHS: All causes 11.3 12.1 11.2 12.6 12.27 Typhoid and paratyphoid 0.00 0.00 0.00 - - Pneumonia 0.47 0.52 0.43 0.58 0.65 Whooping Cough 0.00 0.00 0.00 0.00 - Diphtheria 0.00 0.00 0.00 0.00 - Influenza 0.04 0.04 0.04 0.05 0. 09 Smallpox 0.00 - - - - Tuberculosis 0.24 0.28 0.22 0.31 0.28 Acute Poliomyelitis and Polioencephalitis 0.01 0.01 0.00 0.01 0.01 Rates per 1,000 Live Births Deaths under 1 year of age 27.6# 31.2 25.8 23.8 25.37 Deaths from Diarrhoea and Enteritis under 2 years of age 1.1 1.3 0.5 0.7 0.55 *A dash (-) signifies that there were no deaths. **Rates per 1,000 total live and still births. #Per 1,000 related births. 13 SANITARY CIRCUMSTANCES OF THE AREA Solitary Inspectors. Total number of inspections 13,790 Total number of reinspections 26,344 Total number of intimation notices served 3,691 Total number of nuisance notices served 1,888 Women Sanitary Inspectors. Total number of visits and inspections (factories workplaces, infectious disease, etc.) 2,263 Total number of revisits 422 Total number of intimation notices served 81 Total number of nuisance notices served Workshops in which defects were found 81 The relaxation of restrictions upon repairs has to some extant relieved property owners but the mounting burden of costs of all kinds upon a fixed rent quite out of touch with realities continues to impose great hardships. The Council where Court Orders are ignored themselves step in and carry out the repairs collecting the rents to recoup themselves and registering a charge upon the property. At the end of the year there were 66 cases outstanding from which some £5459 was owing while in 6 others the estimated cost of works approved but not completed was £511. SCABIES AND VERMINOUS PERSONS Cleansing Centre. A total of 343 persons were treated at the cleansing station and given 410 treatments, compared with 249 persons treated in the previous year. The number of cases of scabies notified, 36, compares with 43 in 1951, 40 in 1950, 68 in 1949, 125 in 1948, 310 in 1947, 758 in 1946 and 851 in 1945. More settled conditions of life and modern treatments have both conduced to this end. NATIONAL ASSISTANCE ACTS, 1948 and 1951 Section 47. Removal to suitable premises of persons in need of care and attention. It was necessary in one case to apply to the Court for the compulsory removal of one old woman and her detention in hospital for three months. She was incontinent and so caused considerable nuisance to other people in the house as she was otherwise in good health, active and capable of looking after herself. The object behind the application was to get her in to hospital where a simple appliance could be fitted to make her life much more comfortable. Unfortunately she was impervious to pleadings promises and threats and left hospital triumphantly at the end of her compulsory stay in the same condition as when she was admitted. This is quite a remarkable victory for upwards of four score years. 14 Section 50. Burial or Cremation of the Dead. Arrangements were made during the year for the burial of 33 cases, of whom 22 were males, 11 were females. All were Lambeth cases. The net cost to the Council was £167. THE PREVENTION OF DAMAGE BY PESTS During the year 1952, 811 complaints have been investigated. Of these, 583 were found to be brown (common) rats, 8 black (ship) rats, 153 mice, and 67 were found to be not justified; 953 baitings were carried out, and in 70 cases defective or disused drains were found to be the cause of infestations and were dealt with by the Borough Engineer and the Sanitary Inspectors. No major infestations have come to light during the year. There has been a further reduction in the number of black rat infestations, and in no case has the infestation been of a serious character. Inspections 1, 106 Revisits 980 Notices served 10 Once again, two separate sewer treatments with poison have been carried out by the Borough Engineer's department during the year in conjunction with the rodent officer and his staff. There are every year a number of complaints of the presence of many arthropods, mainly insects, and during the year, ants, clothes moths, cockroaches, steam flies, drugs tore beetles, various weevils,' woodboring beetles, mites and many others were the occasion of nuisances to ratepayers. REHOUSING AND OVERCROWDING 2,718 cases were examined and reports sent to the County Council with copies to the Borough Council's rehousing department. Of this number, 65 Orange forms (overcrowding) were forwarded to the County Council and 164 preferential forms on medical grounds. For the Council's housing department priority recommendations numbered 51, and no preference 69. Information upon 66 cases was forwarded to other districts. Cases not overcrowded and without need for preference numbered 533, deferred cases for which no immediate grounds for giving preference was possible were 346. Points on the Council's scheme were recommended in 981 cases where the application was reinforced with a medical certificate. Consultation with the family doctor is often required in order to elucidate the exact need. The 196 remaining cases were those in which no change in circumstances was discovered on revisiting. As a result of these activities the County Council rehoused during the year 82 Orange form and 165 preferential cases. 15 INSPECTION AND SUPERVISION OP POOD This part of the report deals with the work carried out by the Food Inspectors under the Food and Drugs Act, 1938, the Public Health (Meat) Regulations, 1924, the Milk (Special Designation) Regulations, 1949 and 1950, and the Ice Cream (Heat Treatment, etc. ) Regulations, 1947. I. Sampling of Food and Drugs. (a) For Chemical analysis. Number procured formally 200 Number procured informally 1,735 Of the 200 formal samples, 168 were of milk, 4 of which were adulterated (representing 2.38 per cent, of the number of formal milk samples procured). 2 samples of butter, 1 of ammoniated tincture of quinine, 2 of sal volatile, 1 of white pepper and 1 of non-brewed condiment also were adulterated. Two samples were the subject of legal proceedings, particulars of which are set out below. Sample No. Subject of Nature of Offence Fines Costs Prosecution £ s d £ s d 127 White Pepper Containing 25% 2 - - 2 2 - Wheat Flour 128 Non-brewed Deficient 7% 2 - - 4 4 - condiment Acetic Acid (b) For bacteriological and other examinations. The following shows the number and types of samples submitted for bacteriological and other examinations:- Bacteriological Examinations Ice Cream and Ice Cream Mix 186 Chocolate Lolly 5 *Milk 1 Vomit 1 Finger Nail Swabs 4 *Fancy Cake 1 *Eclair 1 * Sausage 1 *Blancmange 1 *Roast Lamb 1 Faeces 5 *Lamb Chop 1 *Veal and Ham Loaf 1 Brawn 2 Stewed Steak, Canned 2 Total 213 *These articles were suspected to have caused food poisoning but no organisms likely to cause food poisoning were isolated, 16 Milk Type of Test Samples No. procured No. passing test No. failing to pass test Methylene Blue 77 76 1 Phosphatase 77 77 nil 2. Inspection of Food. (i) At the Slaughterhouse: No animals were slaughtered here during the year. Six pigs were slaughtered privately elsewhere in the presence of the food inspector and 1 head weighing 12 lbs was condemned. (ii) shops, stores and factories: Large quantities of food of all varieties were inspected and as a result the following weight of food was surrendered as unfit for human consumption and unsound food certificates were issued 44 tons 18 cwts. 2 qrs. 233/4 lbs. 65 complaints about food were received. 39 of these were justified and a list of them is set out below: 1. Button in milk. 2. Beetle in canned fruit. 3. Oil stain in bread. 4. Mouse excrement in bread. 5. Dirty condition of buns. 6. Wire in bread. 7. Foreign matter in bread. 8. Mould in meat pie. 9. Dirty condition of bread. 10.Screw in currant bread. 11.Dirty condition of bread, rolls. 12. Metal in bread. 13. Wire in bun. 14. Tobacco shreds in bread. 15. Insectin bread. 16. Hair in dried milk. 17. Insect in oread. 18. String in bread. 19. Farthing in bread. 20. Wire in bread. 21. Dirty milk bottle. 22. Dirty milk bottle. 23. Maggots in biscuits. 24. Foreign matter in bread. 25. Foreign matter in custard powder. 26. Mould in meat pie. 27. Wire in cake. 28. Bread 'Ropey' . 29. Mould in pork pie. 30. Maggots in nut chocolate. 3 1. Black particles in marmalade. 32. Foreign matter in beef sausage. 33. Mould in pork pie. 34. Foreign matter in cream bun. 35. Pin in cake. 36. Nail in ham roll. 37. Foreign matter in bread 38. Tobacco in crumpets. 39. Luncheon meat contaminated by flies. Legal proceedings were instituted in the under mentioned cases, with the results shown: 11. Dirty condition of bread rolls Fined £2 - £2. 2s. costs. 14. Tobacco shreds in bread Fined £2 - £2. 2s. costs. 24. Foreign matter in bread Fined £2 - £2. 2s. costs. 17 3. Clean Food Campaign. The Lambeth Clean Food Association has again increased its membership and whereas this was originally limited to the retail traders, the doors have now been opened to the wholesale trade and manufacturers. Since its inception there have been 331 applications for membership of which 36 were not proceeded with or withdrawn for one reason or another. 234 have been approved and accepted and 308 certificates (one for each shop) have been issued. Of these 55 have been surrendered as the premises have changed hands but 20 of the newcomers have been accepted for membership and are included in the 308 mentioned above. The number of badges issued is 668, these being worn by those serving the public whether members or employees of members. The practice of taking finger swabs serves as a reminder to wash hands before handling unwrapped food for sale. Of the 1043 taken only 31 have been found to be contaminated with faecal coli. There are no figures for comparison with conditions of say twenty years ago but it is safe to say that standards are far higher today. Qualification for membership consists of two principal requirements, first that the premises shall comply with the statutory retirements and by 1aws and second that the applicant and employees agree to maintain scrupulous cleanliness of person, of clothing and of utensils. The first insures that the facilities for cleanliness are available for use and the second the promise that they shall be properly and efficiently used. 4. Ice Cream Samples (Methylene Blue Test). Year No. of Samples Grade I Grade II Grade III Grade IV 1952 179 148 25 5 1 1951 96 76 15 4 1 1949 99 22 27 29 21 5. Food Poisoning. There have been 49 cases of food poisoning notified during the year, none of which were found to have been connected with any other case. 6. Slaughterhouses. There is only one licensed slaughterhouse in the district in which no slaughtering took place during the year. 18 SMOKE EMISSION During the year 15 complaints were received of nuisance from smoke from factory shafts, but the main cause of atmospheric pollution in Lambeth is the coalfire on the domestic hearth. Coal in the past in this country has been so plentiful and so cheap that it has been the custom to burn it to warm out homes in the most wasteful and uneconomic fashion as could well be devised and to build our houses with no particular care to prevent the escape of warmth as making bigger fires was cheaper. The resulting habits have made our city buildings and the air over them such as can be found nowhere else in the world. Conditions are not likely to improve while it is permissible to incorporate the same out of date heating arrangements in new buildings. OFFENSIVE TRADES Establishment Orders have been granted to two companies who carry on the offensive trades respectively of (a) fellmonger and (b) fatboiler. (a) Messrs. Gaston Morrell, Ferndale Road. (b) Messrs. Lepard, Wandsworth Road. These two orders are renewable annually. DRAINAGE PLANS All plans are registered with the Borough Engineer but the Sanitary Inspectors are responsible for seeing that the work is carried out in accordance with the drainage by-laws. 43 plans of new buildings and 108 plans of alteration to existing drains were deposited. In addition combined drainage was carried out in 13 cases of which 5 were cases of relaying defective combined drains for which no order had been made by the Council and no plans could be found, and which therefore were deemed to be sewers repairable by the Council. RENT AND MORTGAGE INTEREST RESTRICTIONS ACTS Applications were made accompanied by the statutory fee of one shilling for the issue of 20 certificates enabling the statutory tenant to withhold a portion of the rent and for the issue of 11 determining certificates to cancel corresponding enabling certificates previously issued. DANGEROUS STRUCTURES Information was forwarded to the District Surveyor on 145 occasions during the year of the presence of structures which were considered to be dangerous to life or limb. 19 REGISTRATIONS Under the Milk and Dairies Regulations. 1949, 35 distributors of milk were registered. Under the Milk (Special Designation) (Raw Milk) Regulations. 1949 and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, there were 209 registrations with 25 supplementary licences and two Pasteurisers licences. The number registered under the Pharmacy and Poisons Act, 1933 (Section 21) Part II was 216. Rag Flock and Other Filling Materials Act. 1951. Under the provisions of this Act 1 premises were registered during the year. Pet Animals Act, 1951. Under the provisions of this fact, which came into force on the 1st January 1952, no pet animals may be sold except from registered premises. The conditions in which animals, including birds, fish, reptiles, etc., must be kept If registration is granted insures that they enjoy a reasonably comfortable existence while on the premises and has greatly improved safety from fire and other calamities. The work of inspection for the purposes of the Act has been added to the duties of the sanitary inspectors. Twenty one premises have been registered and are under supervision. EXHUMATION ORDERS The Home Secretary issued three orders for the removal of human remains from one grave in the district to another. The sanitary inspector was present on every occasion to see that the terms of the orders were fulfilled and that no nuisance or danger to the public health was permitted. STREET MARKETS Markets are held in the The Cut, Lower Marsh, Lambeth Walk and Wilcox Road in the inner wards, and in Popes Road, Electric Avenue and Brixton Station Road. A11 these are inspected regularly. HOUSING ACT, 1936 and 1949. The work carried out under the Act during the year presented a considerable increase beyond any previous post war years except 1951, 110 detailed inspections of premises were made, arising out of which in 10 cases it was found necessary to take informal (7) or official (3) action to acquire the desired results. 20 (a) Closing Orders. Closing Orders after representation were made on three premises while an informal undertaking was given in respect of one other property. Other premises were inspected in respect of Underground Rooms or Parts of Buildings, but in which no action was found justified. (b) Demolition Orders. Eight Demolition Orders were made during the year after representation, all of which were demolished. Six other premises were also demolished as the result of informal action. Two other premises were also inspected with a view to demolition, but were found not suitable for such action. (c) Underground Booms and Parts of Buildings made fit. Pour Underground Rooms or Parts of Buildings were made fit after Closing Orders or Undertakings had become operative. . (d) Clearance Areas. Two small clearance areas, involving nineteen (19) premises, inspected in 1951, were represented during the year 1952. These are still awaiting the Ministry's Inquiry. Seven other small areas were inspected during the year, but were not found suitable for action under Clearance Sections of the Housing Acts. (e) Housing Act, 1949 (Loan Sections). Some further survey work has been carried out under the above Sections of this Act in respect of facilities af forded for loans to private persons for improvement of housing accommodation. HOUSING ACT, 1936. Tabulated Results Paragraph Premises Representation Order Dates of Final Action (a) 353, Brixton Road 11. 2.52 12.5.52 14, Gordon Grove 14.1.52 16.6.52 21.7.52 Vacated 36, Victoria Cres. 10. 3. 52 12.5.52 40, Gipsy Road - Informal Undertaking 19.8.52 Two other premises were inspected in respect of underground Rooms or Parts of Buildings, But in which no action was found necessary. 21 Paragraph Premises Representat ion Order Dates of Final Action (b) 4, Ashmole Street 10.9.51 7.4.52 Demolished 29.9.52 78/80, Broadwall 5.1.49 No Orders Demolished 6. 5.52 146/148, 150, 154 & 156, Old South Lambeth Road 6.11.50 ” ” Demolished 1.8.52 3,5 & 7 Dugdale St. - Informal Action Demolished 30.1.52 280, Hillingdon St. - ” ” Demolished 19.3.52 22a, Lothian Road - ” ” Demolished 8.4.52 (b) 44, Guildford Road 3. 7. 39 Undertaking Made Fit 14.7.39 15.1. 52 4, Martell Road 10. 3. 47 Closing Order Made Pit 10.3. 47 3. 9. 52 1, Medwin Street 11. 2. 52 - Made Pit 9. 7. 52 10, , Shakespeare Road 2. 3. 36 Closing Order Made Pit 9.9.36 10.10. 52 (d) No. 1 Area 1/15 (odd), ) Opal Street 75/77, Kennington) 14.1.52 Awaiting Mininstry Lane ) inquiry No.2 Area 2/2a and 3/9 (cons.) Lyric Place 14.1.52 ,, HOUSING ACT, 1949. Section 4 - Loan (e) 15, Albert Square Subsequently dropped by applicant. 22 HOME OFFICE TABLE FACTORIES, AND OTHER PURPOSES. 1.- INSPECTIONS FOR PURPOSES OF PROVISIONS AS TO HEALTH Including inspections made by Sanitary Inspectors. Premises (1) Number on Register (2) Number of Inspections (3) Written Notices (4) Occupiers prosecute (5) FACTORIES: With Mechanical power 591 389 17 - Without mechanical power 196 116 6 - OTHER PREMISES under the Act (Including works of building and engineering construction but not including outworkers' premises) 98 147 1 - TOTAL 885 652 24 2.-DEFECTS FOUND Particulars (1) Number of Defects Referred by H.M. Inspector (5) No. of defect in respect of which prosecution were institute (6) Found (2) Remedied (3) Referred to H.M. Inspector (4) Want of cleanliness (S. 1) 25 23 1 3 - Overcrowding (S.2) 1 1 - - - Unreasonable Temperature (S. 3) 1 1 _ 1 - Inadequate ventilation (S. 4) 1 _ 1 - - Ineffective drainage of floors (S. 6) 1 1 _ - - Sanitary Conveniences (S. 7) Insufficient 6 5 - 3 - Unsuitable or defective 11 10 - 7 _ Not separate for sexes 1 1 - - _ Other offences 4 4 - - - (Not including offences relating to Home Work or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re-enacted in the Third Schedule to the Factories Act 1937) TOTAL 51 46 2 14 - 23 OUTWORK NATURE OP WORK (1) No. on Register (2) Notices served (3) Prosecutions (4) Wearing Apparel - Making, etc. 185 _ _ Cleaning and washing - - - Household linen - - - Lace, lace curtains and nets - - - Curtains and furniture hangings 1 - - Furniture and upholstery 1 - - Electro-plate - - - File making - - - Brass and brass articles - - - Fur pulling _ _ . Cables and chains - - - Anchors and grapnels - - - Cart gear - - ~ Locks, latches and keys - - - Umbrellas, etc. - - - Artificial flowers 1 - - Nets, other than wire nets - - Tents - - - Sacks - - - Racquet and tennis balls - -- - Paper, etc., boxes, paper bags 27 - - Brush making - - - Pea picking - - - Feather sorting - - - Carding, etc., of buttons, etc. 13 - - Stuffed toys 8 - - Basket making - - - Chocolates and sweetmeats - - - Cosaques, Christmas crackers. Christmas stockings, etc. 6 - - Textile weaving - - - Lampshades 45 - - Fancy articles, pin cushions, milk bottle covers, etc - - - Stringing cotton bags - - - Pot scourers - - - TOTAL 287 - - 24 WATER Section 95, Public Health (London) Act, 1936 The number of new dwellings for which applications were received for certificates that a proper and sufficient supply of water had been installed was 233 (317). Borough Council 78, others 155. The water supply for the area is provided almost entirely by the Metropolitan Water Board, but there are a few deep wells of which some supply water for purposes other than human consumption, while in a few cases the supply is used for potable purposes both for drinking on the premises as well as for the manufacture of beverages and for similar trade purposes. In these latter cases a comprehensive examination of the supply both bacteriological as well as chemical is made every three months at least, which is deemed sufficient for ample warning of any serious changes to be observed before there is danger to health. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES The mortality from infectious disease was again almost negligible scarlet fever 0, diptheria 0, measles 0, and whooping cough 0. Although immunisation against whooping cough is by no means certain, even with the best prophylactics now in use, because it is at present a more dangerous disease than diptheria it is no doubt expedient to satisfy the demand for immunisation against both diseases. If not there is a possibility that immunisation against diptheria may be less diligently sought. Poliomyelitis Although 19 notifications were received only 18 were confirmed cases of poliomyelitis, the rate per 1,000 population being 0.08. Five of them were non-paralytic and there were three deaths. In no instance was it possible to trace any contact with another case Puerperal pyrexia The number of cases increased to 73 from 51 last year. This increase has no significance at all being due to an alteration of the definition. The rise in temperature may be due to so many causes more often not connected with child birth, while the antibiotic and other remedies have eliminated almost entirely any fear of danger to life from the puerperal septicaemias which used to be the constant dread of those responsible for maternity and lying in homes and hospitals. The need for notification is now not so apparent as it was before the last war. 25 Tuberculosis Notifications received during the year ended 31st December, 1952. Respiratory 323 (396) Non-respiratory 34 (31) Deaths certified 65 (103) The notifications per 1,000 population for the past ten years (1943-52) have been 2.21, 2.28, 2.24, 1.16, 1.68. 1.63, 2.01, 1.87, 1.86, 1.55. Notifications received during the Year ended 31st December, 1952. Scarlet Fever 257 (235) Diphtheria - (5) Erysipelas 27 (21) Puerperal Pyrexia 73 (72) Ophthalmia Neonatorum 8 (11) Measles 2,366 (3.124) Whooping Cough 305 (608) Primary Pneumonia 125 (77) Influenzal Pneumonia Malaria (relapse) (1) Dysentery 38 (83) Food Poisoning 49 (47) Scabies 36 (43) Typhoid (1) Paratyphoid 1 (1) Paralytic 13 (6) Polio-Myelitis Non-Paralytic 5 (6) Polioencephalitis (1) Meningococcal Infection 8 (7) Encephalitis (Infectious) 2 (-) ,, (Post-Infective) 1 (-) 26 England and Wales 160 C. Bs. and Great Towns including London 160 Smaller Towns Resident Population, 25,00050,000 at 1951 census London Administrative County Lambeth Rates per 1,000 Population:- NOTIFICATIONS: Typhoid Fever 0.00 0.00 0.00 0.00 Paratyphoid Fever 0.02 0.02 0.03 0.01 0.00 Meningococcal Infection 0.03 0.03 0. 03 0. 02 0.03 Scarlet Fever 1.53 1.75 1.58 1.56 1.12 Whooping Cough 2.61 2.74 2.57 1.66 1.32 Diphtheria 0.01 0.01 0.03 0.01 - Erysipelas 0.14 0.15 0.12 0. 14 0.12 Smal1pox 0.00 0.00 0.00 - - Measles 8.86 10.11 8.49 9.23 10.28 Pneumonia 0.72 0.80 0.62 0.57 0.54 Poliomyelitis Paralytic 0.06 0.06 0.06 0.06 0.06 Non -do- 0.03 0.03 0.02 0.03 0.02 Food Poisoning 0.13 0.16 0.11 0.18 0.21 Rates per 1,000 Total Births (Live and Still):- (a) Notifications:- Puerperal Pyrexia 17.87 23.94 10.22 30.77 19.77 27 DISINFECTING DEPARTMENT 3,358 rooms and 4,687 articles of bedding and clothing were disinfected during the year, among them being the rooms and articles used by the 497 cases of various forms of infectious disease taken to hospital; 305 certificates of disinfection were issued, and 225 library books dealt with from the 5,107 premises visited during the year. The clean van was used regularly for the delivery of stores to the day nurseries and to the Welfare Centres. 520 houses were treated for bed bugs and in them 1,358 separate rooms were sprayed with Vermicine, a preparation of 5 per cent. D.D.T. with Pyrethrum as a 'Knock out'. It was necessary to treat 71 houses a second time. M669 Printed by Lambeth Borough Council 28 INDEX PAGE Births 12 Clean Food 17 Committee 1 Dangerous Structures 18 Deaths 9 Disinfection 27 Drainage Plans 18 Exhumation Orders 19 Factories 22 Food Inspection 15 Infectious Diseases 24 Markets 19 Maternal Mortality 8 Mortality Analysis 12 National Assistance Act 13 Notifications 25 Offensive Trades 13 Orders 19 Outworkers 23 Overcrowding 14 Prevention of Damage by Pests 14 Registrations 19 Rent Restrictions Acts 18 Sanitary Circumstances 13 Scabies 13 Slaughterhouses 17 Smoke 18 Staff 4 Statistics 6 Tuberculosis 25 Water 24