1 Borough of Lambeth PUBLIC HEALTH COMMITTEE (appointed by the Council on the 20th May, 1953). *** The Worshipful the Mayor of Lambeth (Alderman W.R. KNIGHT, J.P.) ( ex-officio) Aldermen: A. E. COTTON C. S. JORDAN W. LAVERICK Chairman Councillors: E. ALLISON (appointed 24.6.53) A. J. COOKE P. KINGS Mrs. M. MAROCK ice-Chairman T. MERCER S. H. OBORNE J. F. PLUM N. STAGG C. E. UPTON *** 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 97th Annual Report upon the health of the Borough of Lambeth. The general health of the population has been excellent. The death rate is under 11 per thousand, the infantile mortality under 26 per thousand live births and the birth rate almost 16, all figures indicative of a thriving, healthy community. With the expectation of life for a boy at birth today of 67.06 years and of a girl of 72.35 years the proportion of the population over 65 is increasing and is likely to do so for many years to come. The effect of the postwar social legislation however together with the generally difficult housing conditions have combined to lessen the sense of responsibility of the younger generations for their old parents who instead of receiving the loving care of their children are left more and more to their own resources. It is here that Old Peoples clubs are carrying on such useful and successful work. The legislation precludes the Council from taking any direct share in their work as they may only give financial help to Old Peoples Associations in specified circumstances. There is no doubt whatever that a direct responsibility placed upon the Council would lead to much improvement. The care of the aged ought to be a parochial responsibility making use of the intimate local knowledge of the local council and of their officers and not as at present leaving the burden to be shared by voluntary organisations with the County Council. The old people themselves are often to blame for much discomfort as many still look upon help under the National Assistance Act, 1948 as a form of public charity to be eschewed at all costs. Their difficulties in not maintaining direct contact with advice and help from children is just one more aspect of the problem created by the lack of houses. During the year 790 new houses and flats were built compared with 233 and 317 in the two previous years and 1951 houses and flats in 1938, but families in need still number many thousands. The improvement in the prospects of sanitary inspectors to obtain a reasonable reward for their responsibilities will, it is hoped lead to more entrants into their ranks which are at the moment, far too few to offset retirement and wastage from sickness, etc. The Council are fortunate to have a full complement of inspectors. I am grateful to all members of the Council and especially to the Public Health Committee for their recognition of difficulties and the help so readily accorded, to all the chief officers of the Council for their never failing assistance and especially to the staff of the Public Health department for their unswerving loyalty and devotion to duty. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, A.G.G.Thompson July, 1954 Medical Officer of Health 4 STAFF of the PUBLIC HEALTH DEPARTMENT at 31st DECEMBER, 1953. 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., F. R. I. C., Ph. C. CHIEF ADMINISTRATIVE ASSISTANT H. P. WRIGHT CLERICAL STAFF A. W. Bayley, M. A. East, Mrs. G. Hopkins, N, A. Jupp, E, F, Mannerson, Mrs. J. Rose, Miss E. Yelverton SANITARY INSPECTORS (a) District Inspectors S. G. FORD Cert. S. I. E. B. (Meat and other foods) J. BOWERS ,, (Meat and other foods and smoke) S. G. STARLING ,, (Meat and other foods) D. J. HUGGINS ,, (Meat and other foods) J. SMITH ,, (Meat and other foods) A. I. BELL R. NEWTON ,, (Meat and other foods) R. G. CUTLER E. E. MORGAN ,, (Meat and other foods) H. F. BRYAN J. B. SAINSBURY 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. F. 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 21 Wards. Population - estimated, 1953 - 229,000 (230,200) Density - 56.02 (56.32) persons per statute acre (inclusive of land and inland water, but exclusive of tidal water and foreshore). Births (corrected) - 3,649 (3,626). Birth rate per 1,000 estimated resident population. *15.93 (14.49). Deaths (corrected) - 2,408 (2,824). Death rate per 1,000 estimated resident population *10.62 (12.27) Maternal mortality (corrected) per 1,000 total births (live and still) 1.08 (2. 17). Infantile mortality 25.49 (25.37). Neonatal mortality 15.89 (17.93). Zymotic Death-rate (corrected) - 0.06(0.01) per 1,000 population total zymotic deaths 13 (2). Marriages - Marriage rate per 1,000 population 7.97 (8.16). Rateable Value at 1st April, 1953 - £2,197,823 (£2,188,134). Sum represented by 1d. rate - £8,927 (£8,919). Comparable rates for England and Wales and London:- England and Wales London Birth rate 15.5 (15.3) 17. 5 (17.6) Death rate 11.4 (11.3) 12. 5 (12.6) Infantile mortality 26.8 (27.6) 24.8 (23.8) Puerperal causes 0.76 (0.72) not available *As adjusted by comparability factor. 7 VITAL STATISTICS The population of the Borough of Lambeth at the mid year 1953 has been estimated by the Registrar-General to be 229,000 which is 1,000 less than the estimated population in 1952. The natural increase by births over deaths was 1,241. The following table shows the actual numbers and the percentages of deaths in various age groups and no less than 39.16% of all deaths were in the age group 75 years and over. With the increasing expectation of life the problem of the aged, how to care for them or rather how best to assist them to take care of themselves is becoming more difficult each year. The Council could do a great deal to improve the lot of old people who so often suffer from the neglect of their children, but the Council are barred by statute from doing anything except making donations to voluntary bodies. It was hoped that by the end of the year there would have been at least three chiropody clinics each holding two sessions a week but there is still only the one clinic. This is working to capacity so that newcomers can only be accepted on the comparatively rare occasions when vacancies occur, usually from death. It is so important that nothing should be left undone which will improve the mobility of the aging and corns and the like are known to be such a great hindrance to getting about. All Ages 0-1 1-5 5-15 15-25 25-45 45-65 65-75 75 & over 2408 93 15 10 18 118 559 652 943 100% 3.86 0.62 0.42 0.75 4.90 23.21 27.08 39.16 The principal causes of death were heart disease 717 (877) or 29.78 per cent. (31.06) of the total deaths, cancer 426 (497) or 17.69 per cent. (17.60), and influenza, bronchitis and pneumonia, three causes of death largely dependent upon the weather, were the cause of 409 (428) deaths or 16.99 (15.16) per cent. During the year the number of live births corrected by inward or outward transfers was 3,649, giving a corrected birth rate of 15.93 compared with 15.75 in 1952, an increase of 0.18 per 1,000 population. Deaths from cancer of the lungs have fallen this year again. Deaths from tuberculosis of the lungs continue to fall with modern treatment but much less improvement is noticeable in the incidence. The disease is attacking almost as many as ever. It is often forgotten that it is infectious and that overcrowding due to inadequate housing is a potent cause of spread. 8 Neoplasms of the lung and bronchus 1946 1947 1948 1949 1950 1951 1952 1953 M F 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 73 23 Age Groups Respiratory Tuberculosis Neoplasms of the Lung or Bronchus 1950 1951 1952 1953 1950 1951 1952 1953 MALES - 0 - 1 1 - 1 5 - - 15 - 2 - - - - - - - 25 - 16 26 13 5 4 5 2 4 45 - 23 37 20 18 52 55 49 39 65 - 9 10 10 9 23 29 21 22 75 - 2 3 1 4 8 8 3 8 TOTAL MALES 52 76 44 38 87 97 75 73 FEMALES - 0 - 1 1 - - 5 - - 15 - 6 1 2 1 - - - - 25 - 16 9 4 3 1 2 2 3 45 - 11 5 8 - 2 8 11 6 65 - 3 4 - 3 5 2 7 9 75 - - 1 2 - 3 6 6 5 TOTAL FEMALES 36 20 16 8 11 18 26 23 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 four deaths during the year, 1.08 per 1,000 live and still births. Last year there were eight deaths. MORTALITY 10.52 (12.27) 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 1 1 _ _ 5 18 9 4 38 F 1 - - 1 3 - 3 - 8 2. Tuberculosis, other M - 1 - - - - 1 - 2 F 1 - 1 - 1 2 - - 5 3. Syphilitic disease M - - - - - 4 5 - 9 F - - - - 1 - 2 1 4 4. Diphtheria M - - - - - - - - - F - - - - - - - - - 5. Whooping cough M _ - - - - - - - - F - - - - - - - - - 6. Meningococcal Infections M - - - - - - - - - 1 F 1 - - - - - - - 7. Acute Poliomyelitis M _ - - - - - - - - F - - - - - - - - - 8. Measles M - 1 - - - - - - 1 F - - - - - - - - - 9. Other infective and parasitic diseases M _ - - - 1 1 2 - 4 F - - - - - 1 - - 1 10. Malignant Neoplasm, Stomach M - - - - - 11 13 7 31 F - - - - 1 5 5 7 18 11. Malignant Neoplasm, Lung Bronchus M - - _ _ 4 39 22 8 73 F - - - - 3 6 9 5 23 12. Malignant Neoplasm, Breast M - - - - - - - - - F - - - - 4 14 10 4 32 6 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 - - - - 3 10 2 1 16 14. Other malignant and lymphatic neoplasm M - - 1 3 4 34 40 28 110 F 1 1 - 2 7 32 27 41 111 15. Leukaemia, aleukaemia M - 1 1 _ _ 3 1 1 7 F - 1 - - 1 2 - 1 5 16. Diabetes M - - - - _ 1 1 1 3 F - - - - - 1 4 6 11 17. Vascular lesions of nervous system M - - - _ 5 19 35 36 95 F - - - - 6 32 34 77 149 18. Coronary Disease, angina M - - - - 7 60 61 44 172 F - - - - 1 18 43 51 113 19. Hypertension with heart disease M - - - - - 9 10 6 25 F - - - - 2 1 9 17 29 20. Other heart disease M - - - 1 7 18 27 97 150 F - - - - 3 27 40 158 228 21. Other circulatory disease M - - - - 1 9 16 28 54 F - - - - - 12 17 35 64 22. Influenza M 1 - - - 2 4 4 7 18 F - - - 1 - 5 7 12 25 23. Pneumonia M 4 1 - _ _ 15 17 31 68 F 4 - - - - 9 16 31 60 24. Bronchitis M 4 1 - - 1 45 53 47 151 F 2 l - - 2 8 22 52 87 25.Other diseases of respiratory system M - - - 1 2 _ 8 2 13 F 1 - 1 - 3 1 2 3 11 26. Ulcer of stomach and duodenum M - - - - 1 9 9 7 26 F - - - - - 3 4 6 13 27.Gastritis, enteritis and diarrhoea M 2 l - - - _ _ 1 4 F 3 - - - 1 - 2 2 8 28. Nephritis and nephrosis M 1 - - - 3 3 4 1 12 F - - - 1 3 4 2 2 12 29. Hyperplasis of prostate M - - - - - 1 5 5 11 30. Pregnancy, childbirth, abortion F - - - 1 3 - - - 4 31. Congenital malformation M 6 l 2 _ _ 1 - - 10 F 3 2 - - 2 2 1 1 11 32.Other defined and illdefined diseases M 35 1 - 2 4 13 12 19 86 F 19 - 1 1 6 27 18 32 104 33. Motor vehicle accidents M - - 1 1 2 4 3 1 12 F - - 1 - - - - - 1 34. All other accidents M 1 1 1 2 6 7 6 4 28 F 2 - - 1 2 2 2 11 20 35. Suicide M - - - - 3 5 4 1 13 F - - - - - 2 3 1 6 36. Homicide and operations of war M _ _ - - 2 - - 2 F - - - - - - - - - 93 15 10 18 118 559 652 943 1228 1180 10 11 12 Birth-Rates, Civilian Death-Bates, Analysis of Mortality, and Case Rates for certain Infectious Diseases in the Year 1953. 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 15.5 17.0 15.7 17.5 15.93 Still Births (0.35 0.43 0.34 0.38 0.28 (22.4** 24.8** 21.4** 21.0** 16.97** DEATHs: All causes 11.4 12.2 11.3 12.5 10.52 Typhoid and paratyphoid 0.00 0.00 - - - Pneumonia 0.55 0.59 0.52 0.64 0.56 Whooping Cough 0.01 0.01 0.00 0.00 - Diphtheria 0.00 0.00 0.00 - - Influenza 0.16 0.15 0.17 0.15 0.19 Smallpox 0.00 0.00 0.00 - - Tuberculosis 0.20 0.24 0.19 0.24 0.23 Acute Poliomyelitis and Polioencephalitis 0.01 0.01 0.01 0.01 - Rates per 1,000 Live Births Deaths under 1 year of age 26.8# 30.8 24.3 24.8 25.49 Deaths from Diarrhoea and Enteritis under 2 years of age 1.1 1.3 0.9 1.1 1.64 * 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 Sanitary Inspectors. Total number of Inspections 14,009 Total number of reinspections 23,875 Total number of intimation notices served 2,972 Total number of nuisance notices served 1,639 Women Sanitary Inspectors. Total number of visits and inspections (factories workplaces, infectious disease, etc.) 1,975 Total number of revisits 378 Total number of intimation notices served 61 Total number of nuisance notices served 1 Workshops in which defects were found 12 Restaurants 47 Old and Infirm persons living in insanitary conditions 7 The cost of repairs looms heavier than ever upon the unfortunate owner of aging property. Care is taken to limit as far as possible the work entailed by sanitary notices but the burden is out of proportion to the rent paid and still more to the net income received by the owner. 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 65 cases outstanding from which some £5,054 was owing while in 21 others the estimated cost of works approved but not completed was £1,895. SCABIES AND VERMINOUS PERSONS Cleansing Centre. A total of 321 persons were treated at the cleansing station and given 390 treatments, compared with 343 persons treated in the previous year. The number of cases of scabies notified, 30, compares with 36 in 1952, 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. In no case was it necessary to apply for an order for the compulsory removal of any aged person to an institution. 14 Section 50. Burial or Cremation of the Dead. Arrangements were made during the year for the burial of 40 cases, of whom 16 were males, 24 were females. All were Lambeth cases. The net cost to the Council was £244. 11.0. THE PREVENTION OF DAMAGE BY PESTS During the year 1953, 747 complaints have been investigated. Of these, 553 were found to be brown (common) rats, 2 black (ship) rats, 134 mice, and 58 were found to be not justified; 934 baitings were carried out, and in 79 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 941 Revisits 1,005 Notices served 16 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 were many complaints during the year of insect infestations which with much help from Mr. A. McKenny Hughes, British Museum (Natural History), were effectively combatted. The usual offenders, wood boring beetles, psocids, ants, cockroaches, drug store beetles, carpet beetles, clothes moths, weevils and the like were joined in the autumn by kelp flies. These presumably were blown by autumn gales from the rotting seaweed which storms had cast up in great quantity on the south coast beaches. There were two infestations one in the degreasing section of an engineering works and the other in an establishment where the only attraction was the scent of the liquid soap in the lavatories. REHOUSING AND OVERCROWDING 2,386 cases were examined and reports sent to the County Council with copies to the Borough Council's rehousing department. Of this number 29 Orange forms (overcrowding) were forwarded to the County Council and 124 preferential forms on medical grounds. For the Council's housing department priority recommendations numbered 41, and no preference 95. Information upon 45 cases was forwarded to other districts. Cases not overcrowded and without need for preference numbered 333, deferred cases for which no immediate grounds for giving preference was possible were 137. Points on the Council's scheme were recommended in 1,035 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 117 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 84 Orange form and 346 preferential cases. 15 INSPECTION AND SUPERVISION OF FOOD This part of the report deals with the work carried out by the Food Inspectors under the Pood and Drugs Act, 1938, the Public Health (Meat) Regulations, 1924, and the Milk (Special Designation) Regulations, 1949 and 1950, and the Ice Cream (Heat Treatment, etc.) Regulations, 1947. 1. Sampling of Food and Drugs. (a) For Chemical analysis Number procured formally 200 Number procured informally 1,300 Of the 200 formal samples, 167 were of milk. For the first time it can be recorded that no sample was found to be adulterated. (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 155 Ice Lolly 6 Ice Cream Wrapping Paper 1 Swab used in Ice Cream manufacture 1 Liquid Egg 4 *Lambs Heart 2 *Sausages 1 Bread 1 *Pork Pie 1 Desiccated Coconut 6 Coconut Fruit Jelly 1 Sweetened Flour 1 Bottle of Milk 1 Total 181 * These articles were suspected to have caused food poisoning but no organisms likely to cause food poisoning were isolated, a faecal strain of B.Coli was however isolated from the heart. The rapid onset of symptoms after the sausages suggested that the poisoning was due to pre-formed toxin. No pathogenic organisms were found in the pork pie. Milk Type of Test Samples No. procured No. passing test No. failing to pass test Methylene Blue 153 153 Nil Phosphatase 152 152 Nil 16. 2. Inspection of Pood. (i) At the Slaughterhous: No animals were slaughtered here during the year. Six pigs were slaughtered privately elsewhere in the presence of the food inspector. (ii) At 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 41 tons 19 cwts. 3 qrs. 11¼ lbs. 75 complaints about food were received. 54 of these were Justified and a list of them is set out below: 1. Grease in bread. 28. Ply in medicine. 2. Stone in bun. 29. Foreign matter in medicine. 3. Grease in swiss roll. 30. Foreign matter in bread. 4. Metal hook in sausage roll. 31. Mouldy apple turnover. 5. Filth and fibres in cheese 32. Mouldy cream sandwich. tart. 33. Mouldy cheese slice. 6. Hair in mince tart. 34. Glass in milk. 7. String in bread. 35. Foreign matter in bread. 8. Insect in jam. 36. Mouldy bread. 9. Foreign body in sweets. 37. Mouldy meat pie. 10. Metal in bread roll. 38. Mouldy pork pies. 11. Cockroach in bread. 39. Foreign matter in bread, 12. Metal in mince tart. 40. Maggots in almonds. 13. Wire in biscuits. 41. Paper in milk. 14. Foreign matter in ice cream 42. Dirt and vegetable debris cone. in milk 15. Foreign matter in bread. 43. Dirt, part of insect and 16. Grease in bread. fibres in bread. 17. Dust particles in foil milk 44. Mouldy cheese. bottle top. 45. Unusual flavour of 18. Ebonite in lemonade. marmalade. 19. Fibres and dust particles in 46. Fibres, grit and sand in bread. bread. 20. Insect in linctus. 47. Staple in cake. 21. Mouldy pork pie. 48. Mouldy fruit pie. 22. Maggots in nut chocolate. 49. Ferric iron in cereal. 23 - ditto - 50. Insect in eccles cake. 24. Metal in milk. 51. Unfit leg of lamb. 25. Mouldy fruit pies. 52. Mouldy fish paste. 26. Cement and sand in milk. 53. Bandage in bread. 27. Skin and hair of animal in 54. String in bread. sausages. Legal proceedings were instituted in the under-mentioned cases, with the results shown: 23. Maggots in nut chocolate Fined 10/- - 10/6 costs. 25. Mouldy fruit pie Fined 10/- - 10/6 costs. 32. Mouldy cream sandwich Withdrawn. 17 3. Clean Food Campaign The following additional information asked for in circular 1/54 dated 12.1.54 from the Ministry of Health is unavoidably less detailed than it might have been had it been known at the beginning of 1953 that more was required. (i) The number of food premises by type of business Greengrocers and fruiterers 165 Pish shops, wet, dry and fried 89 Bakers 114 Butchers 154 Restaurants 253 (ii) The number of premises registered under section 14 Pood and Drugs Act, 1938. Ice Cream 650 Sausages and potted processed etc. meat 154 Registered milk distributors 86 (iii) Number of inspections of food premises 2426 (iv) Educational Activities, etc. 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 365 applications for membership of which 40 were not proceeded with or withdrawn for one reason or another. 271 have been approved and accepted and 352 certificates (one for each shop) have been issued. Of these 69 have been surrendered as the premises have changed hands but 33 of the newcomers have been accepted for membership and are included in the 352 mentioned above. The number of badges issued is 805, 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 1334 taken only 36 have been found to be contaminated with faecal coli. There are no figures for comparison with conditions of 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 requirements and bylaws 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. 18 (v) The method of disposal of condemned food. All condemned animal products are sent to firms specialising in the making of glues and other like commodities. Such vegetable waste as is suitable is converted into pig food under the Council's scheme. (vi) Details of the few stocks or consignments of food specially examined have not been kept. The quantities are included in the food condemned or surrendered, for which unsound food certificates were issued. 4. Ice Cream Samples (Methylene Blue Test). Year No. of samples Grade I Grade II Grade III Grade IV 1953 149 123 20 6 - 1952 179 148 25 5 1 1951 96 76 15 4 1 1949 99 22 27 29 21 5. Pood Poisoning. There have been 133 cases of food poisoning notified during the year. 70 of these cases occurred as an outbreak in an old peoples' home where 3½ hours after a breakfast of brawn everyone of the 70 cases was taken ill with vomiting and diarrhoea within a few minutes of each other. In a few cases there was temporary collapse but all recovered within a few hours although six stayed in bed the next day. An anal swab from each of these six contained Staphylococcus aureus. None of the brawn was left and all dishes were washed so that it was not possible to obtain any sample for examination. The brawn was the one common article in the breakfast menu eaten by everybody taken ill. The two staff who cooked and served the breakfast were both free from pathogenic organisms so that it is presumed that the brawn was infected before it reached the home. Those responsible could not be traced as it passed through many hands. The remaining 63 cases were notified throughout the year and were not connected with each other. 6. Slaughterhouses There was no 1icensed slaughterhouse being used in the district during the year. SMOKE EMISSION During the year 26 complaints were received of nuisance from smoke from factory shafts which were satisfactorily handled without recourse to more than the intimation notice and by word of mouth. Sulpher gases would appear likely to cause a greater nuisance as time goes on since diesel and crude oil are used as fuels both for moving as well as stationery engines where it is replacing coal to a greater extent every year.These crude oils too contain a higher proportion of sulpher than coal. 19 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. 57 plans of new buildings and 58 plans of alteration to existing drains were deposited. In addition combined drainage was carried out in 16 cases of which 2 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 9 certificates enabling the statutory tenant to withhold a portion of the rent and for the issue of 7 determining certificates to cancel corresponding enabling certificates previously issued. DANGEROUS STRUCTURES Information was forwarded to the District Surveyor on 88 occasions during the year of the presence of structures which were considered to be dangerous to life or limb. REGISTRATIONS Under the Milk and Dairies Regulations, 1949, 86 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 258 licences with 21 supplementary licences and two Pasteurisers licences. The number of persons entered or retained on the list under the Pharmacy and Poisons Act, 1933 (Section 21) Part II was 203. Rag Flock and Other Filling Materials Act, 1951 Under the provisions of this Act 1 premises were registered during the year. 20 Pet Animals Act, 1951. Under the provisions of this Act, 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 insure that they enjoy a reasonably comfortable existence while on tne premises and has greatly improved safety from fire and other calamities. Nineteen premises have been registered and are under supervision. EXHUMATIONS The Home Secretary issued licences for the removal of seven human remains from graves to other graves or vaults in the district. The sanitary inspector was present on every occasion to see that the terms of the licences were fulfilled and that no nuisance or danger to the public health was permitted. STREET MARKETS Markets are held in The Cut, Lower Marsh, Lambeth Walk and Wilcox Road in the inner wards, and in Popes Road, Electric Avenue and Brixton Station Road. All these are inspected regularly. HOUSING ACT, 1936 and 1949 The work carried out under the Acts during the year presented a considerable increase beyond any previous post war years. 128 detailed inspections of premises were made. (a) Closing Orders. Closing Orders after representation were made on three premises while an informal undertaking was given in respect of one other property not to relet until rendered fit to the satisfaction of the Council. Closing Orders previously made were determined in respect of two basement rooms which have now been made fit for habitation and in one other case the Closing Order has been varied for modified use of the basement. Other premises were inspected in respect of underground rooms or parts of buildings, but in which no action could justifiably be taken. (b) Demolition Orders. Eight Demolition Orders were made after representation of the premises and two formal undertakings were given by owners in lieu of orders being made. Three premises were demolished during the year after formal undertakings had been given and twenty nine others arising from 21 (c) Clearance areas A Clearance Order Involving nineteen premises made in 1952 to which no objections were raised with the Ministry of Housing and Local Government has been confirmed by the Minister during the year. Another Clearance Order Involving six premises was made this year to which no objections were raised. (d) Housing Act, 1949 (Advances) Seventeen premises were inspected in respect of applications for advances for improvement of houses and flats under the Housing Act, 1949. In two cases advances were justified and granted by the Council. Housing Acts, 1936 & 1949 Tabulated results Premises Represent- - Order Pinal Action and ation Remarks Demoli tions 96. 98, 100, 102, 104 Black Prince Road 12.1.53 4.12.53 Orders appealed against 30. 12. 53. Appeal dismissed with costs. 106 Black Prince Rd. 12.1.53 16.1.53 U/T in lieu of Demolition Order 74,76 Broadwall 10. 1.49 8. 12.53 Still standing. 48 Hatfields 6.7.53 14.9.53 Still standing. 9 PREMISES (a) As a resul t of Orders 106, Black Prince Rd. 12.1.53 U/T 16.2.53 Demolished Oct. 1953. 49 Lower Marsh 3.1.38 U/T 28.2.38 Demolished Sep. 1953. 2a Coral Street 3.1.38 U/T 28.2.38 Demolished Sep. 1953. 3 PREMISES (b) 124 Black Prince Rd Unofficial action Demolished 1954 (lncl.cottage at rear) 44 Chryssell Road 109-117 (odd) Cowley Rd 40 Gipsy Road 35 Harleyford Road 280 Hillingdon Street 32 Kempsford Road 6 Layham Cottages 22 Premises Represent- Order Final Action and atlon Remarks (b) continued 22a Lothian Road 43 Lowden Road 15,16,17 Mawbey Street 16 Melbourne Square 79 Monkton Street 11 Renfrew Road 118-120 Vassall Road 293 Wandsworth Road 27, 29 Wilcox Road 19,52,78 Wincott Street 29 PREMISES Closing Order (other than U/R) 316 Clapham Road 5.10.53 17. 11.53 (2 rooms) 2 ROOMS Orders Determined NIL Closing Orders (U/R) 316 Clapham Road (3 rooms) 6 Mount Villas (2 rooms) 5 ROOMS Number closed or modified occupation approved 316 Clapham Road Closed 6 Mount Villas Closed 353 Brixton Road Modified use 8 ROOMS Closing Orders Determined 31 Bellefields Road Determined 24.12.53 38 Guildford Road Determined 29.12.53 2 PREMISES (c) Houses represented under Sec. 25 Represented Clearance Orders 75,77 Kennington Lane 14.1.52 Clearance Order confirmed 28.8.53 2,2a, and 3 to 9 (consec.) Lyric Place 14.1.52 ditto 1-15 (odd) Opal Street 14.1.52 ditto 2-7 (consec.) Waterworks Place 6.7.53 Clearance Order 6. 12.53 25 PREMISES Number of Houses demolished after Clearance Order NIL . (d) Number of premises inspected following applications for advances under the provisions of the Housing Act 1940. 281 and 283 Coldharbour Lane. 23 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 prosecuted (5) FACTORIES: With Mechanical power 623 373 20 - Without mechanical power 198 101 7 _ OTHER PREMISES under the Act (including works of building and engineering construction but not including outworkers' premises) 76 95 - TOTAL 897 569 27 - 2.-DEFECTS FOUND Particulars Number of Defects No.of defects in respect of which prosecutions were instituted Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S.1) 35 35 - 4 - Overcrowding (S.2) - - - - - Unreasonable Temperature (S.3) 1 1 1 1 - Inadequate ventilation (S.4) 1 1 - - - Ineffective drainage of floors (S.6) 3 3 - - - San it ary Conveniences (S.7) Insufficient 4 4 - 3 - Unsuitable or defective 16 16 - 7 - Not separate for sexes 2 2 - 1 - Other offences (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 2 2 1 1 - TOTAL 64 64 2 17 24 OUTWORK NATURE OF WORK No. on Register Notices served Prosecutions (1) (2) (3) (4) Wearing Apparel - Making, etc. 209 - - Cleaning and washing - - - Household linen 3 - Lace, lace curtains and nets - - - Curtains and furniture hangings 1 - - Furniture and upholstery 2 - - Electro-plate - - - File making - - - Brass and brass articles - - - Fur pulling - - - Cables and chains - - - Anchors and grapnels.. - - - Cart gear ... - - - Locks, latches and keys - - - Umbrellas, etc. 1 - - Artificial flowers 1 - - Nets, other than wire nets - - - Tents - - - Sacks - - - Racquet and tennis balls - - - Paper bags 4 - - Paper, etc., boxes 32 - - Brush making - - - Pea picking - - - Feather sorting - - - Carding, etc., of buttons, etc. 12 - - Stuffed toys 6 - - Basket making - - - Chocolates and sweetmeats - - - Cosaques, Christmas crackers, Christmas stockings, etc. 5 - - Textile weaving - - - Lampshades 61 - - TOTAL 337 - - 25 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 790 (233), Borough Council 211 others 579. 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, diphtheria 0, measles 1, 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 diphtheria it is no doubt expedient to satisfy the demand for immunisation against both diseases. If not there is a possibility that immunisation against diphtheria may be less diligently sought. Poliomyelitis Although 20 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 no deaths. In no instance was it possible to trace any contact with another case. 26 Tuberculosis Notifications received during the year ended 3lst December, 1953. Respiratory 318 (323) Non-respiratory 29 (34) Deaths certified 53 (65) The notifications per 1.000 population for the past ten years (1944-53) have been: 2.28, 2.24, 1.16, 1.68, 1.63, 2.01, 1.87, 1.86, 1.55, 1.52 Notifications received during the year ended 31st December, 1953. Scarlet Fever 173 (257) Diphtheria - (-) Erysipelas 15 (27) Puerperal Pyrexia 66 (73) Ophthalmia Neonatorum 4 (8) Measles 1303 (2.366) Whooping Cough 784 (305) Primary Pneumonia Influenzal Pneumonia 189 (125) Malaria (relapse) 11 (- ) ,, (indigenous) 2 (-) Dysentery 59 (38) Food Poisoning 130 (49) Scabies 30 (36) Typhoid 1 (-) Paratyphoid 1 (1) Polio-Myelitis (Paralytic) 13 (13) ,, (Non-Paralytic) 5 (5) Polioencephalitis - (-) Meningococcal Infection 7 (8) Encephalitis (Infectious) 1 (2) ,, (Post-Infective) 1 (1) 27 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 0.01 0.00 Paratyphoid Fever 0.01 0. 01 0.01 0.01 0. 00 Meningococcal Infection 0.03 0. 04 0. 03 0. 03 0.03 Scarlet Fever 1. 39 1. 50 1. 44 1. 02 0.76 Whooping Cough 3.58 3.72 3.38 3. 30 3. 42 Diphtheria 0.01 0.01 0.01 0.00 - Erysipelas 0. 14 0. 14 0. 13 0. 12 0.07 Smallpox 0.00 0.00 0.00 - - Measles 12. 36 11. 27 12. 32 8. 09 5. 69 Pneumonia 0. 84 0. 92 0.76 0.73 0. 83 Poliomyelitis Paralytic 0.07 0.06 0.06 0.07 0.06 Non -do- 0.04 0.03 0. 04 0.03 0.02 Food Poisoning 0. 24 0. 25 0. 24 0. 38 0. 57 Rates per 1,000 Total Births (Live and Still):(a) Notifications:- Puerperal Pyrexia 18.23 24.33 12.46 28.61 17.78 28 MALARIA IN BRIXTON On the 11th July and 11th August notifications were received that a boy, aged 8 years, and a married woman, aged 27, living in adjoining houses in Brixton were suffering from malaria. Both patients were cases of indigenous malaria, and benign tertian malarial parasites had been found in blood, films. Careful search was made, on one occasion in conjunction with the Malarial Officer of the Medical Research Council (Mr. P. G. Shute, M.B.E.,F.R.E.S.), but no mosquitoes, either anopheles or culex, were found. The boy spent one day in the summer of 1951 on the Isle of Sheppey and the woman was in Nice in August, 1952. It is not considered at all likely that either contracted the disease while on holiday although faintly possible, but from the evidence available one or the other, probably both, contracted the disease in their homes. The boy was ill for nearly a month before admission to hospital when he had typical ague attacks and had enlarged spleen and liver. Blood smears were examined, the parasite found and he soon recovered with treatment. The woman had an attack of pneumonia just before the boy was first taken ill from which she completely recovered as shown by X-ray early in July. On the 1st August, however, she was taken ill again and later on admitted to hospital where a blood smear also showed benign tertian malarial parasites. Living next door to each other It would seem likely that both were Infected by mosquitoes which had bitten somebody recently returned from abroad who was still carrying malarial parasites. Neither had ever had a blood transfusion. It is not possible to contract malaria except from an infected mosquito or possibly a blood transfusion so that the mosquito was the object of search. A. Maculipennis was the mosquito on the marshes round London in past centuries which was responsible for the 'ague' then quite common. These obtain their blood feeds mainly from animals, such as pigs and cows, and overflow Into houses to bite human beings. There is no marsh land, static water supply or water butt which might form a breed site for A. Maculipennis nearby, nor for A. Bifurcatus, but the third English anopheline A. Plumbeus might be the culprit. This mosquito breeds In the hollows, forks and crevices in trees, in fact, anywhere in a tree where a tiny puddle of rain water can collect. They have been found in Hyde Park among many other places, and they have been shown to be excellent carriers of malarial parasites for therapeutic purposes when used for the treatment of other diseases so that this mosquito could well have been the cause. There are many trees large enough to contain small pools of water in the immediate neighbourhood of the area, but it is scarcely practicable to make a detailed investigation of every likely tree. The cases have therefore been classed as indigenous malaria of unknown origin. More cases may, of course, occur, but so far as is known these are the only two contracted in Lambeth for many years, and it may well be many more years before another case is notified. 29 DISINFECTING DEPARTMENT 2,981 rooms and 22,178 articles of bedding and clothing were disinfected during the year, among them being the rooms and articles used by the 371 cases of various forms of infectious disease taken to hospital; 187 certificates of disinfection were issued, and 87 library books dealt with from the 4,919 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. 379 houses were treated for bed bugs and in them 1,252 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. M 1165 Printed by Lambeth Borough Council 30 INDEX PAGE Births 12 Clean Food 17 Committee 1 Dangerous Structures 19 Deaths 9 Disinfection 29 Drainage Plans 19 Exhumation Orders 20 Factories 23 Food Inspection 15 Infectious Diseases 25 Malaria 28 Markets 20 Maternal Mortality 8 Mortality Analysis 12 National Assistance Act 13 Notifications 26 Offensive Trades 19 Orders 20 Outworkers 24 Overcrowding 14 Prevention of Damage by Pests 14 Registrations 19 Rent Restrictions Acts 19 Sanitary Circumstances 13 Scabies 13 Slaughterhouses 18 Smoke 18 Staff 4 Statistics 6 Tuberculosis 26 Water 25