1 Borough of Lambeth PUBLIC HEALTH COMMITTEE (appointed by the Council on the 28th May, 1954). The Worshipful the Mayor of Lambeth (Councillor Major H.N.White, J.P.) (ex-officio) Aldermen: A. E. COTTON C. S. JORDAN W. LAVERICK Vice-Chairman Mrs. A. LOCKYER Councillors: A. J. COOKE C. GOLDBAUM Miss E. M. HICKMAN P. KINGS Mrs. M. MAROCK Chairman J. F. PLUM T. ROBINSON 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 98th Annual Report upon the health of the Borough of Lambeth. The health of the population has been satisfactory as will be seen from the statistics which appear in the report. The population has been estimated by the Registrar General to be nearly three thousand less than that of 1953 at 226,200. The birth rate is slightly higher at 14.33 and the death rate slightly lower at 10.26 per thousand population as adjusted by the comparability factor, both being lower than corresponding rates for the county and also lower than those for England and Wales as well. For the first time since 1938 new dwellings numbered more than a thousand completed in one year. The actual number was 1,124 compared with 790 in 1953 and 1,951 in 1938. The problem of the infirm aged is assuming larger proportions each year as the expectation of life increases with more and more elderly people becoming a burden to others. Plans to provide occupation for retired fit people are in hand and it is hoped that these will go some way to help to do what is urgently wanted. If old people can be found some work to do which is worth doing the two prime abjectives have been achieved first they show that they are stiLL useful to the community and not on the shelf, and secondly they are obliged to get about to follow their occupation which keeps them on their feet. I am again grateful to the members of the Council and especially to the Public Health Committee, to all the chief officers working as a team and especially to the staff of the Public Health Department. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, Medical Officer of Health. July 1955. 4 STAFF Of the PUBLIC HEALTH DEPARTMENT at 31st DECEMBER, 1954 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 Miss L. Baker, A.W. Bayley, Mrs.G.Hopkins, N.AJupp, E. F. Mannerson, Mrs.M. Rogers, 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) 5 SANITARY INSPECTORS continued (c) Housing Inspectors B. GOOD Cert. S.I.E. B. (Meat and other foods) P. J. HEFFIELD (Meat and other foods) (d) Rodent Officer S. F. HEAL (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, 1954-226,200 (229.000) Density-55.34 (56.02) persons per statute acre (inclusive of land and inland water, but exclusive of tidal water and foreshore). Births (corrected)-3,684 (3.649). Birth rate per 1,000 estimated resident population. *14.33 (14.02). Deaths (corrected)-2,298 (2.408). Death rate per 1,000 estimated resident population *10. 26 (10.62). Maternal mortality-(corrected) per 1,000 total births (live and still) 1.59(1.08) Infantile mortality 23.34 (25.49) Neonatal mortality 17.10 (15.89) Zymotic Death-rate (corrected) 0.04 (0.06) per 1,000 population total zymotic deaths 9 (13) Marriages - Marriage rate per 1,000 population 8.33 (7.97) Rateable Value at 1st April, 1954-£2,221,855 (£2,197,823). Sum represented by 1d. rate - £9,062 (£8,927). Comparable rates for England and Vales and London:- England and Wales London Birth rate 15.2 (15.5) 17.6 (17.5) Death rate 11.3 (11.4) 11.7 (12.5) Infantile mortality 25.5 (26.8) 22.5 (24.8) *As adjusted by comparability factor. 7 VITAL STATISTICS The population of the Borough of Lambeth at the mid year 1954 has been estimated by the Registrar-General to be 226,200 which is 2,800 less than the estimated population in 1953. The natural increase by births over deaths was 1,386. The following table shows the actual numbers and the percentages of deaths in various age groups from which it will be observed that 67.32% of all deaths occurred among those aged 65 years and older. Much is being done to help these elderly people from becoming a burden upon others as well as often a burden to themselves. Steps are being taken which it is much to be hoped will lead to the Metropolitan Borough Councils being responsible statutorily and directly for care which now is limited to financial assistance to voluntary organisations. Infantile mortality has been reduced by a better knowledge of the nursing and feeding requirements of mothers and babies but the problem with the elderly is not the same, children eat what they are given and their day works to a time table. Adults eat and drink what they choose and as much or little as they want or can obtain. They suit their day and mode of life to their own time table with the result that most elderly people suffer later on for their lack of care for themselves in the past. All agesI 0-1 1-5 5-15 15-25 25-45 45-65 I 65-75 75 & over 2298 86 10 4 14 90 547 668 879 100% 3.74 0.44 0.17 0.61 3.92 23.80 29.07 38.25 The principal causes of death were heart disease 687 (717) or 29.89 per cent. (29.78) of the total deaths, cancer 445 (426) or 19.3 6 per cent (17. 69), andinfluenza, bronchitis and pneumonia, three causes of death largely dependent upon the weather, were the cause of 290 (409) deaths or 12.62 (16.99) per cent. During the year the number of live births corrected by inward or outward transfers was 3,684, giving a corrected birth rate of 16.29 compared with 15.93 in 1953, an increase of 0.36 per 1,000 population. These rates have not been adjusted. Deaths from tuberculosis of the lungs continue to fall with better knowledge of treatment but much less improvement is noticeable in the incidence. The number of deaths in 1948,six years ago was 135 and new cases 369; the corresponding numbers for 1954 were 41 and 369 new cases. The disease is attacking 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 1954 M F 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 92 22 Age Groups Respiratory Tuberculosis Neoplasms of the Lung or Bronchus/###] 1950 1951 1952 1953 1954 1950 1951 1952 1953 1954 Hales - 0 - 1 1 - 1 5 - - 15 - 2 - - - - - - - - - 25 - 16 26 13 5 3 4 5 2 4 4 45 - 23 37 20 18 10 52 55 49 39 51 65 - 9 10 10 9 10 23 29 21 22 27 75 - 2 3 1 4 1 8 8 3 8 10 TOTAL MALES 52 76 44 38 24 87 97 75 73 92 FEMALES - 0 - 1 1 - - 5 - - 15 - 6 1 2 1 - - - - - - 25 - 16 9 4 3 3 1 2 2 3 4 45 - 11 5 8 - 4 2 8 11 6 11 65 - 3 4 - 3 3 5 2 7 9 6 75 - - 1 2 - - 3 6 6 5 1 TOTAL FEMALES 36 20 16 8 10 11 18 26 23 22 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 six deaths during the year 1.59 pur 1.000 live and still births. Last year there were four deaths CAUSES OF AND AGES AT DEATH (CORRECTED) DURING 1954 MORTALITY 10.16 (10.52) 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 2 5 and under 45 years 45 and under 65 years 65 and unde 75 years 75 and upwards MALE FEMALE 1. Tuberculosis, Respirators M - - - - 3 10 10 i 24 F - - - - 3 4 3 - 10 2. Tuberculosis, other M _ _ _ - _ 4 - 1 5 F - - - - - 1 1 - 2 3. Syphilitic disease M - - - - - 3 4 - 7 F - - - - - 3 4 1 8 4- Diphtheria M - - - - - - - - - F - - - - - - -- - - 5. Whooping Cough M 1 - - - - - - - 1 F. - - - - - - - - - 6. Meningococcal Infectious M - - - - - - - - - b - 1 - - - - - - 1 7. Acute Poliomyelitis M - - - - - - - - - F - - 1 - - - - - 1 8. Measles M - - - - - - - - - F - - - - - - - - - 9. Other infective and parasitic diseases M 1 - _ - 1 - _ _ 2 F - - - - 3 - 2 1 6 10. Malignant Neoplasm,Stomach M - - - - - 8 11 4 23 F - - - - 1 7 10 12 30 11. Malignant Neoplasm, Lung Br onchus M - - - - 4 51 27 10 92 F - - - - 4 11 6 1 22 12. Malignant Neoplasm, Breast M - - - - - - - - - - F - - - - 2 13 8 8 31 9 CAUSES OF DEATH AGES (both sexes) TOTALS Under 1 year 1 and under 5 years 5 and under 15 years IS 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 6 4 4 15 Other malignant and lymphatic neoplasm M 1 - - 2 4 43 51 21 122 F - 1 1 1 6 29 33 32 103 15. Leukaemia, aleukaemia M - - - - 1 1 - - 2 F - - - - - 2 3 - 5 16. Diabetes M _ - - - - 1 2 3 6 F - - - - - - 6 4 10 Vascular lesions of nervous system M - - - - 4 26 34 57 121 F - - - - - 29 49 81 159 18. Coronary Disease,angina M - - _ - 9 59 65 48 181 F - - - - 1 19 42 57 119 19. Hypertension with heart disease M - - - - - 4 15 10 29 F - - - - - 3 8 21 32 20. Other heart diseases M - - - - 6 17 34 65 122 F - - - - 4 28 35 137 204 21. Other circulatory diseases M - - - - 2 18 21 18 59 F - - - - 1 10 19 34 64 22. Influenza M - - - - 2 2 - 2 6 F - - - - - - 1 3 4 23. Pneumonia M 2 2 - - - 11 14 31 60 F 6 1 - - 1 5 9 35 57 24. Bronchitis M 2 1 - - 1 33 32 48 117 F 2 1 - - - 5 12 26 46 23. Other diseases of respiratory system M - - - - - 4 9 5 18 F 1 - - - - 2 4 6 13 24. Ulcer of stomach and duodenum M - - - - - 5 9 6 20 F - - - - - 7 1 3 11 25. Gastritis, enteritis and diarrhoea M - - - - 1 - 1 1 3 F 2 - - - 1 - 1 1 5 28. Nephritis and nephrosis M _ _ _ 1 2 3 2 2 10 F - - - - 1 4 3 - 8 29. Hyperplasis of prostate M - - - - - _ 10 9 19 F - - - - - - - - - Pregnancy, childbirth, 30. abortion. F - - - 2 4 - - - 6 31. Congenital malformation M 9 - - - 1 - - - 10 F 7 1 - 1 1 - - - 10 Other defined and 32. illdefined diseases M 29 1 - 5 2 19 13 16 84 F 22 - 1 - 4 12 25 33 97 33. Motor Vehicles accidents M - 1 - - 2 2 - 3 8 F - - - - - 5 1 1 7 7 34.All other accidents M 1 - - 1 2 7 5 3 19 F - - 1 1 - 2 5 10 19 35. Suicide M _ _ - - 4 8 3 1 16 F - - - - 1 1 1 3 6 36. Homicide and operations of war M _ _ - - - 1 - - 1 F - - - - - - - - - 12 Birth-Rates, Civilian Death-Rates, Analysis of Mortality and Case Rates for certain Infectious Diseases in the Year 1954 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 15.2 16.8 15.4 17.6 16.29 Still Births 23.4 25.6 22.4 19.7 22.03 DEATHS: All causes 11.3 12.1 11.3 11.7 10.16 Pneumonia 0.48 0.50 0.49 0.49 0.52 Whooping Cough 0.00 0. 00 0.00 0.00 0.00 Diphtheria 0.00 0. 00 0.00 - - Influenza 0.05 0.04 0.05 0.02 0.04 Acute Poliomyelitis 0.00 0.00 0.00 0.00 0.00 Rates per 1.000 Live Births Deaths under 1 year of age 25.5 29.2 23.8 22.5 23.34 Deaths from Diarrhoea and Enteritis under 2 years of age 0.8 0.9 0.5 0.4 0. 54 A dash (-) signifies that there were no deaths. *Rates per 1,000 total live and still births. 13 SANITARY CIRCUMSTANCES OF THE AREA Sanitary Inspectors. Total number of inspections 13,119 Total number of reinspections 20,531 Total number of intimation notices served 2,791 Total number of nuisance notices served 1,579 Women Sanitary Inspectors Total number of visits and inspections (factories workplaces, infectious disease, etc.) 1,920 Total number of revisits 401 Total number of intimation notices served 51 Total number of nuisance notices served Workshops in which defects were found 5 Restaurants 42 Old and Infirm persons living in insanitary conditions 4 The cost of repairs particularly to old property remains a serious problem both for owners and for the Council who themselves carry out the necessary work when a Court Order is ignored, collecting rents to recoup themselves and registering a charge upon the property. At the end of the year there were 90 cases outstanding from which some £6,486 was owing while in 23 others the estimated cost of works approved but not completed was £2,237. It was anticipated that the opportunity of obtaining higher rent envisaged by the Housing Repairs and Rents Act 1954 would be seized by large numbers of owners of property and that the publicity given to the grants obtainable under the Housing Act 1949 would lead to a spate of applications. In fact the numbers applying were remarkably few. Details will be found elsewhere in the report. SCABIES AND VERMINOUS PERSONS Cleansing Centre A total of 323 persons were treated at the cleansing station and given 428 treatments, compared with 321 persons treated in the previous year. The number of cases of scabies notified, 48, compares with 30 in 1953, 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 person in need of care and protection 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 29 cases, of whom 19 were males. 10 were females. All were Lambeth cases. The net cost to the Council was £ 143 17s. 5d. THE PREVENTION OF DAMAGE BY PESTS During the year 1954, 727 complaints have been investigated. Of these, 551 were found to be brown (common) rats, 1 black (ship) rat, 128 mice, and 47 were found to be not justified: 927 baitings were carried out and in 87 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 914 Revisits 1,082 Notices served 8 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 were effectively combatted. The usual offenders were wood boring beetles,psocids, ants, cockroaches, drug store beetles, carpet beetles, clothes moths, and weevils. REHOUSING AND OVERCROWDING 2057 cases have been investigated with the following results:- LONDON COUNTY COUNCIL- Cases Overcrowding 42 Illness 142 Insanitary conditions 462 LAMBETH BOROUGH COUNCIL- Health (Medical Certificates) 652 Insanitary Conditions 161 Inquiries from other Authorities 60 During this period the L.C.C. have rehoused 538 15 INSPECTION AND SUPERVISION OF FOOD 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, 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, 171 were of milk, one 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 Calves Foot Jelly 1 Cream canned 20 Egg dried 1 Finger swabs 2 Ice Cream and Ice Cream Mix 155 Ice Cream Churns 2 Ice Lolly 2 Mallow Russe 1 Peanut Butter 1 Skimmed Milk Powder 1 Total 186 •These articles were suspected to have caused food poisoning. In February a press report stated that a certain brand of canned cream had been found, in Birmingham, to be infected with typhoid organisms. In addition to this report a broadcast by the B.B.C. urged the public who were in possession of this particular brand of cream not to consume it but to take it to the office of the local authority. In consequence of this appeal 65 tins were brought to the Town Hall and as a result of information given by the purchasers an embargo was placed on all known stocks of this cream in the possession of retailers. 17 samples were taken and submitted to the Public Health Laboratory Service for examination and no organisms capable of causing illness were isolated. It was eventually established that the manufacturers of the cream had cooled the batch of tins by water from a polluted well, and that the culprit tin in Birmingham had been imperfectly sealed allowing water to leak into the tin. As a precautionary measure, on the advice of the Ministry of Health, all tins of this brand of cream in the Borough were surrendered by retailers and destroyed. The public who had surrendered their tins were all financially reimbursed. 16 Milk Type of Test Samples No.passing No. failing to No.procured test pass test Methylene Blue 165 165 Nil Phosphatase 167 167 Nil 2. Inspection of Food (i) At the Slaughterhouse. No animals were slaughtered here during the year. Two 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 38 tons 18 cwts. 0 qrs. 19¾ lbs. 87 complaints about food were received. 62 of these were justified and a list of them is set out below. 1. Unsound Chicken 31. Dirty Milk Bottle 2. Metal and string in Sugar 32. Mouldy Bread Almonds. 33. Piece of Mortar in Milk 3. Pineapple, misleading label. 34. Maggots in Lamb and Rabbit 4. Cork, dust in medicine 35. Insect in Bread 5. Foil in Cheese 36. Mouldy Chocolate Cream Roll. 6. Apricots tough *37. Mouldy Apple Pie 7. Mouldy Apple Tart 38. Fungal Hyphae in Lemonade 8. Mould in Lime Juice Cordial *39. Nail in Chocolate Crunch 9. Metal in Canned Milk 40. Ants in Jam & Cream Puff 10. Rag in Bread 41. Mouldy Bread 11. Glass in cheese roll. 42. Lime deposit in Crisp bread 12. Unsound jellied eels 43. Cake ingredients insufficiently 13. Cigarette end in Bread mixed. 14. Wool, cotton and hair in Milk 44. Mouldy Pork Pie 15. Maggots in Chocolate 45. Yeast mixed with dust in *16. Foreign body in Buttered Roll Cream Soda. 17. Screw in Scone 46. Unsound Kidney *18. Cigarette end in Bread 47. Unsound Pork Pies 19. Mouldy meat pudding 48. Unsound Ham 20. Mineral oil and particles of 49. Unsound Lamb. iron in bread. 50. Glass in Milk 21. Nail in Cake 51. Insects in Bread 22. Mouldy meat pies 52. Maggots in Dried Fruit 23. Mineral oil, carbonaceous 53. Unsound eggs matter and particles of iron 54. String in Bread in Bread 55. Maggots in Toffees *24. Dirty Bread 56. Damaged Milk Bottle 25. Cigarette end in Bread. 57. Unsound Sweets 26. Mouldy Cornish Pasty 58. Insects in Drinking Chocolate. 27. Unsound salt pork 59. Unsound Walnuts 28. Wire in bread 60. Unsound Goose 29. Insect in Meat Pie 61. Hair in Piccalilli 30. Mice excreta in Flour 62. Unsound Chicken 17 Legal proceedings were instituted in the under-mentioned cases, with the results showm:- 16. Foreign body in Buttered Roll Fined £4 0 0 £2 2 0 costs. 18. Cigarette end in Bread Fined £5 0 0 £2 2 0 costs. 24. Dirty Bread Fined £4 0 0 £2 2 0 costs. 37. Mouldy Apple Pie Fined £3 0 0 no costs 39. Nail in Chocolate Crunch Fined £5 0 0 £2 2 0 costs. 3. Clean Food Campaign (i) The number of food premises by type of business in the area is as follows:- Greengrocers and fruiterers 172 Fish shops, wet, dry and fried 91 Bakers 109 Butchers 157 Restaurants 231 (ii) The number of premises registered under section 14 Food and Drugs Act, 1938, and Milk and Dairies Regulations 1949. Ice Cream 511 Sausages and potted processed etc. meat. 157 Registered milk distributors 269 (iii) Number of inspections of food premises 2,198 (tv) Education 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 378 applications for membership of which 36 were not proceeded with or withdrawn for one reason or another. 285 have been approved and accepted and 367 certificates (one for each shop) have been issued. Of these 76 have been surrendered as the premises have changed hands but 36 of the newcomers have been accepted for membership and are included in the 285 mentioned above. The number of badges issued is 844, 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 1581 taken only 50 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 are included in the food condemned or surrendered, for which unsound food certificates were issued. Quantity examined Quantity condemned Confectionery TONS. CWTS. QRS. TONS. CWTS. QRS. 17 _ _ 11 12 2 Sweet Fat 2 _ _ 19 2 Cake Mixture 5 1 5 1 Jelly Crystals 4 2 4 2 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 196 76 15 4 1 1949 99 22 27 29 21 5. Food Poisoning There have been 154 cases of food poisoning notified during the year. 120 of these cases occurred as an outbreak in Lambeth Hospital. The outbreak was among the medical and nursing staff of the Lambeth Hospital, some 120 in all being affected out of 200. The symptoms of acute abd aminal pain and diarrhoea occurred on an average of six hours after dinner at 8.0 p.m.on the 27th April. All recovered, symptoms subsiding in 24 hours and many were such mild cases that they carried on with their duties. All those taken ill had eaten the chicken course which was responsible for the outbreak. The chickens were cooked the day before, allowed to cool and were put in the refrigerator. About mid day on the 27th April the chickens were carved and put on plates and stored at room temperature on a shelf in a room next to the kitchen until 7.0 p.m. The remains of the chickens including the bones were used for making gravy just before the meal. The remaining items in the menu,grapefruit. cauliflower, potatoes, white sauce and bread sauce, were eliminated as probable causes. Unfortunately all the food was consumed and nothing was left for bacteriological examination so that there is no absolute confirmation of the cause. The quick onset and recovery indicate a toxin as the likely cause, most probably the toxin of a coagulase positive staphylococcus aureus. Examination of the 19 kitchen staff appeared to show that the birds were probably contaminated during trussing and before delivery to the hospital. All food particularly meats, jellies, sauces and gravies should be kept in a refrigerator where dangerous organisms if present are unable to multiply and it would seem that the lack of sufficient refrigerating space is partly at least responsible as well as the temporary kitchen arrangements which are inadequate The rebuilding of the war damaged kitchen is long overdue.These points have been taken up with the hospital authority who are aware that the conditions obtaining in the hospital kitchen would not be tolerated for one moment if existing elsewhere in the borough. Since this outbreak the refrigerator space has been increased but the lack of ordinary facilities for the clean preparation of food and the washing up of utensils places a continuous strain upon the kitchen staff and upon the administration. The kitchen was damaged by enemy action and was patched up in 1944. There has been little improvement since then. It is understood that despite the most urgent appeals to have the kitchen rebuilt this most necessary work has again been postponed. The remaining 34 cases were notified throughout the year and were not connected with each other. 6.Slaughterhouses There was no licensed slaughterhouse being used in the district during the year. SMOKE EMISSION During the year 21 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. 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.Perndale 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. 49 plans of new buildings and 59 plans of alteration to existing drains were deposited. In addition combined drainage was carried out in 20 20 cases. There were no 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. HOUSING REPAIRS AND RENTS ACT, 1934 This Act came into force on the 30th August, 1954. Certificates issued 198 .. refused 6 Applications withdrawn 5 Revocation certificates issued 10 DANGEROUS STRUCTURES Information was forwarded to the District Surveyor on 84 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, 46 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 269 licenses with 22 supplementary licenses and two Pasteurisers licenses. The number of persons entered or retained on the list under the Pharmacy and Poisons Act, 1933 (Section 21) Part II was 184. Rag Flock and other Filling Materials Act, 1951 Under the provisions of this Act no premises were registered during the year. 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 the premises and has greatly improved safety from fire and other calamities. Sixteen premises have been registered and are under supervision. EXHUMATIONS The Home Secretary issued licenses for the removal of one human remains from one grave to another grave in the district and one for cremation. The sanitary inspector was present on each occasion to see that the terms of the licenses were fulfilled and that no nuisance or danger to the public health was permitted. 21 STREET MARKETS Markets are held in The Cut, Lower Marsh, Lambeth Walk and Wilcox Road in the inner wards, and in the Popes Road, Electric Avenue and Brixton Station Road. All these are inspected regularly HOUSING REPAIR. MAINTENANCE AND SANITARY CONDITION OF HOUSES. SANITARY CONDITION OF HOUSES. Housing Act, 1936. Part-II Section 9. Surveys made during the year Nil .. but no action called for Nil Premises made fit after service of legal notices Nil ..by informal schedules Nil where works were outstanding on 31st Dec. Nil Service of legal notices during the year Nil Section 10. Nil. Section 11 and Section 11 as amended by Section 10 Local Government (Miscellaneous Provisions) Act, 1953. Representations (Demolition Orders) made during the year 20 Demolition Orders made (13), Undertakings accepted (3) 16 not made before 31st December 8 .. complied with 10 ,. .. not yet complied with 6 Premises stirveyed but not yet represented 13 .. .. but no action found to be necessary 25 Section 12. Representations made during the year 42 (a) Underground rooms (77). (b) Parts of buildings (18 rooms). FORMAL ACTION. Closing Orders made (10): Undertakings accepted (13) 23 .. .. not yet made 19 determined (-), complied with (12) 12 .. ..or undertakings not yet complied with 11 Premises made fit after representation Nil .. vacated or closed after representation Nil surveyed but not yet represented 9 INFORMAL ACTION. Premises made fit after informal action 9 (a) Underground rooms (19). (b) Parts of buildings (2 rooms). 22 Premises closed or vacated after informal action Nil where works are still outstanding after informal action 2 Premises surveyed but no action found necessary 38 (a) Underground rooms (72). (b) Parts of buildings (10 rooms). Drain tests made (chemical, smoke and water) Nil Total visits (revisits 872) 2,224 MINISTRY OF HEALTH TABLE 1. Inspection of Dwelling-Houses during the year. (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 9,328 (b) Number of inspections made for the purpose 21,311 (2) (a) Number of dwelling-houses (included under sub-head (1) above which was inspected and recorded under the Housing Consolidated Regulations Nil (b) Number of Inspections made for the purpose Nil (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 33 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 54 2. Remedy of defects during the year without service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 1,171 3. Action under Statutory Powers during the year. A. Proceedings under Sections, 9, 10 and 16 of the Housing Act, 1936. (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices- (a) By owners Nil (b) By Local Authority in default of owners Nil ** Total re-inspections during 1954. 23 B. Proceedings under Public Health Acts (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 1.579 (2) Number of dwelling-houses in which defects were remedied after service of formal notices- (a) By owners 1.722 (b) By Local Authority in default of owners 118 C. Proceedings under Sections 11 and 13 of the Housing Act. 1936 and Section 11 as amended by Section 10 Local Government (Miscellaneous Provisions) Act, 1953. (1) Number of dwelling-houses in respect of which Demolition Orders were made 20 (2) Number of dwelling-houses demolished in pursuance of Dem edition Orders 3 D. Proceedings under Section 12 of the Housing Act, 1936. (1) Number of separate tenements of underground rooms in respect of which Closing Orders were made 23 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil HOUSING ACT. 1949. Section 4. ADVANCES FOR INCREASING HOUSING ACCOMMODATION FORMAL APPLICATIONS RECEIVED AND INSPECTIONS MADE. WITH POSITION AT THE END OF 1954. Ballater Road 1 (Loan granted and work completed). Rommany Road 271 (Pending) Coldharbour Lane 281 and 283 (Application made and loans granted in 1953. Work now carried out and completed). Total 4 premises. 24 HOUSING ACT, 1949, Section 20, and HOUSING REPAIRS AND RENTS ACT, 1954, Section 16. IMPROVEMENT GRANTS PRELIMINARY INSPECTIONS Albert Square 5 Alexandra Drive 24 Bankton Road 5 Broxholm Road 48 (Withdrawn) Camberwell New Road 197 and 199 Chancellor Grove 24 Clapham Road 73 Cleaver Square 55 Coldharbour Lane 135b (Withdrawn) Cottage Grove 30 Croxted Road 127 Denmark Hill 97 (Withdrawn) Dodbrooke Road 5 Dorset Road 119 Elder Road 60 Pentiman Road Caron's Almshouses 1 to 7 consecutive. Ferndale Road 29 Gipsy Road 173 Hayter Road 38 (Withdrawn) Jelf Road 22 Josephine Avenue 13 Landor Road 122 Langley Lane 14 (Pilot Scheme) Leigham Court Road 227 Lingham Street 34 and 36 Lowden Road 184 Norwood Road 72 and 197 Off ley Road 3 9 Oval Mansions (Pilot Scheme) Palace Road 61 Portal Close 7 Prague Street 1,3,5,7.9,13,15,17,19, 2,4.10,12,14, and 16 (15 premises) Roxburgh Road 81 St. Clouds Road 21 St. Julians Farm Road 77 Santley Street 14 Shakespeare Road 225 to 293 and 297 to 303 (odd) (39 premises). Spenser Road 1(Turned down by Ministry on informal application). Stockwell Road 100 Thurlow Hill 42 Trinity Gardens 58 Trinity Rise 21 and Vicarage Victoria Crescent 16 Warham Street 61 Water Lane 66 25 Wilkinson Street 20 Wynne Terrace 5 Total 109 premises. FORMAL APPLICATIONS RECEIVED AND FULL INSPECTIONS AND REPORTS MADE WITH POSITION AT THE END OF 1954. Camberwell New Road Chancellor Grove Dorset Road Elder Road Fentiman Road Ferndale Road Landor Road Langley Lane Portal Close Prague Street Roxburgh Road St. Clouds Road Thurlow Hill Trinity Rise Victoria Crescent 197 and 199 (Pending) 24 (Pending) 119 (Pending) 60 (Pending Caron Almshouses 1 to 7 consecutive (Pending, subject to revision). 29 (Refused on account of work having been completed). 122 (Loan granted and work completed). 14 (Pilot scheme pending) 7 (Pending) 1,3,5,7,9,13,15,17,19, 2,4,10,12,14, and 16 (Pending). 81 (Turned down by Ministry) 21 (Withdrawn) 42 (Pendin} The Vicarage (Pending, subject to revision). 16 (Pending) Total 36 premises. HOUSING AND RELATED ACTS (Rehousing Sections) INSPECTIONS ARISING FROM REHOUSING 381 premises were inspected as a result of notifications received from the Directors of Housing of the Lambeth Borough Council and the London County Council of the rehousing or transfer of families to new or other properties. Appropriate formal or informal action was taken to prevent reoccupation of unsuitable accommodation in 43 cases by the making of Demolition or Closing Orders or by other suitable action 26 HOME OFFICE TABLE Factories, and other Premises. 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 632 458 9 ­ Without mechanical power 219 130 5 ­ OTHER PREMISES under the Act (including works of building and engineering construction but not including outworkers premises) 50 75 ­ ­ Total 901 663 14 ­ 2.- DEFECTS FOUND Particulars Number of Defects Referred by H. M. Inspector No.of defects in respect of which prosecutions were instituted Found Remedied Referred to H.M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S.1) 17 17 ­ 3 ­ Overcrowding(S.2 ­ ­ ­ ­ ­ Unreasonable Temperature(S.3) 1 1 ­ 1 ­ Inadequate ventilation(S.4) 1 1 ­ m ­ Ineffective drainage of floors(S.6) ­ ­ ­ ­ ­ Sanitary Conveniences (S.7) Insufficient 1 1 ­ 1 ­ Unsuitable or defective 12 12 ­ 1 ­ Not separate for ­ ­ ­ ­ ­ 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 1937, 1 1 1 1 Total 33 33 1 7 ­ 27 OUTWORK NATURE OF WORK No. on Register Notices served Prosecutions (1) (2) (3) (4) Wearing Apparel - ­ Making, etc 266 ­ ­ Cleaning and washing ­ ­ ­ Household linen ­ ­ ­ Lace, lace curtains and nets 1 ­ ­ Curtains and furniture hangings ­ ­ ­ Furniture and upholstery ­ ­ ­ Electro-plate ­ ­ File making ­ ­ ­ Fur pulling ­ ­ ­ Cables and chains ­ ­ ­ ­ ­ ­ Cart gear ­ ­ ­ Locks, latches and keys ­ ­ ­ 1 ­ ­ Artificial flowers 3 ­ ­ Nets, other than wire nets ­ ­ ­ ­ ­ ­ Sacks ­ ­ ­ Racquet and tennis balls ­ ­ ­ Paper bags 1 ­ ­ Paper, etc., boxes 30 ­ ­ Brush making ­ ­ ­ Pea Picking ­ ­ ­ Feather sorting ­ ­ ­ Carding, etc., of buttons, etc. 11 ­ ­ Stuffed toys 4 ­ ­ Basket making ­ ­ ­ Chocolates and sweetmeats ­ ­ ­ Cosaques, Christmas crackers, Christmas stockings, etc. 14 ­ ­ Textile weaving - ­ ­ Lampshades 119 ­ ­ Total 440 ­ ­ 28 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 1,124 (790), Borough Council 586 others 538. 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 0, and whooping cough 1. 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 possiblity that immunisation against diphtheria may be less diligently sought. Poliomyelitis Although 6 notifications were received only 5 were cases of poliomyelitis, the rate per 1,000 population being 0.02 all five were paralytic and there was one death. In no instance was it possible to trace any contact with another case. 29 Tuberculosis Notifications received during the year ended 31st December, 1954. Respiratory 352 (318) Non-respiratory 17 (29) Deaths certified 41 (53) The notifications per 1,000 population for the past ten years (1944-54) have been: 2.28, 2.24, 1. 16, 1.68, 1.63, 2.01. 1.87. 1.86, 1.55, 1.52. 1.63. During the Good Health Exhibition at the Town Hall in May 336 people were X rayed resulting in the discovery of two previously unknown cases of respiratory tuberculosis. Notifications received during the Year ended 31st December, 1954. Scarlet Fever 133 (173) Diphtheria - ( - ) Erysipelas 14 (15) Puerperal Pyrexia 148 (66) Ophthalmia Neonatorum 4 (4) Measles 482 (1303) Whooping Cough 321 (784) Primary Pneumonia 134 (189) Influenzal Pneumonia Mai aria (relapse) 2 (11) " (indigenous) - (2) Dysentery 84 (59) Food Poisoning 154 (130) Scabies 48 (30) Typhoid 1 (1) Polio-Myelitis (Paralytic) 4 (13) .. (Non-Paralytic) 2 (5) Polioencephalitis - (-) Meningococcal Infection 6 (7) Encephalitis (Infectious) - (1) (Post-Infective) - (1) 30 ENGLAND AND WALES LONDON ADMINISTRATIVE COUNTY LAMBETH Rates per 1,000 Population:- NOTIFICATIONS: Typhoid Fever Paratyphoid 0.01 0.01 0.01 Fever Meningococcal Infection 0.03 0.03 0.03 Scarlet Fever 0.96 0.73 0.59 Whooping Cough 2.39 1.40 1.42 Diphtheria 0.00 0.00 Measles 3.32 2.23 2.13 Pneumonia 0.60 0.45 0.59 Poliomyelitis Paralytic 0.03 0.02 0.02 Non -do- 0.01 0.01 0.01 Food Poisoning 0.20 0.32 0.68 31 DISINFECTING DEPARTMENT 2.633 rooms and 6,936 articles of bedding and clothing were disinfected during the year, among them being the rooms and articles used by the 352 cases of various forms of infectious disease taken to hospital; 135 certificates of disinfection were issued, and 69 library books dealt with from the 4,060 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. 286 houses were treated for bed bugs and in them 879 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 49 houses a second time. M 18 28 PRINTED BY LAMBETH BOROUGH COUNCIL.. 32 INDEX PAGE Births 12 Clean Food 17 Committee 1 Dangerous Structures 20 Deaths 26 Disinfection 31 Drainage Plans 19 Exhumation Orders 20 Factories 26 Food Inspection 15 Housing 21 Housing Repairs & Rents Act, 1954 20 Infectious Diseases 28 Markets 21 Maternal Mortality 8 Mortality Analysis 12 National Assistance Act 13 Notifications 29 Offensive Trades 19 Orders Outworkers 27 Overcrowding 14 Prevention of Damage by Pests 14 Registrations 20 Sanitary Circumstances 13 Scabies 13 Slaughterhouses 19 Smoke 19 Staff 4 Statistics 6 Tuberculosis 29 Water 28