15 AC 4374 28 SEP 1963 LEW 49 METROPOLITAN BOROUGH OF LEWISHAM THE PUBLIC HEALTH OF LEWISHAM Report of the Medical Officer of Health for the Year 1961 E. H. R. Smithard, MBE, MD, DPH London: e. g. Berryman & Sons, Ltd., Blackheath Road, s.e.10 METROPOLITAN BOROUGH OF LEWISHAM Report OF THE Medical Officer of Health for the Year 1961 E. H. R. Smithard, MBE, MD, DPH CONTENTS Page Staff 2 Introduction 3 Vital Statistics 6 General Provision of Health Services 18 Sanitary Circumstances of the Area 37 Housing 43 Inspection and Supervision of Food 49 Infectious Diseases 56 Appendix A — Statutory Instruments 66 „ B — Legal Proceedings 67 „ C — Special Reports to Health Committee 68 “ The chief function of the Medical Officer of Health is to safeguard the health of the area for which he acts by such means as are at his disposal..” “ He should endeavour to acquire an accurate knowledge of the influences, social, environmental and industrial, which may operate prejudicially to health in the area.. " While he has special duties for the prevention of infectious diseases, all morbid conditions contributing to a high sickness rate or mortality in the area from these or other causes should be studied with a view to their prevention or control." —from the Ministry of Health Memorandum on the duties of MOHs 2 STAFF as at 31/12/61 Medical Officer of Health E. H. R. Smithard, mbe, md, bs, mrcs, lrcp, dph Senior Public Health Inspector Deputy Senior Public Health Inspector A. J. Phillips (a) (6) J. R. Craven (a) (6) Group Public Health Inspectors H. Tolson (a) (b) (Food) R. C. Brittain (a) (b) (Housing) Assistant Group Housing Inspector *R. Mahoney (a) (6) (District) J. W. Bevan (a) (b) (c) District Inspectors Divisional Food Inspector *G. L. Belshaw (a) (b) H. W. Ellery (a) (6) *K. G. C. Burt (a) (b) (c) *L. J. Cleverly (a) (b) *C. L. Connor (a) (6) *R. L. Davis (a) (b) *G. E. Fallows (a) (b) *E. A. Howard (a) (b) A. Lakeland (a) *D. G. Oliver (a) (b) (c) A. J. Thrussell (a) *K. R. Wagener (a) (b) *T. E. R. Ware (a) (6) (a) Public Health Inspector's certificate. (b) Meat and Other Foods certificate. (c) Smoke Inspector's certificate. *With responsibility for certain food work. Women Health Officers Warden Mrs. A. Carins, srn, rfn Mrs. M. L. Shorten Mrs. L. Champness, srn, rfn Mrs. M. M. Couloon, srn, qn Principal Clerk E. W. Cheesman Clerical Staff Student public health inspectors S. Burridge, (senior clerk) J. T. Smith C. R. Coleman G. Matthews Mrs. D. J. Handford J. A. McMahon Miss D. Cashman A. C. Tyrrell Miss M. E. HinchclifF Mrs. M. G. James Mrs. H. I. Barnes Miss F. E. Smith Coroner's Court and Mortuary W. C. Spear, officer-in-charge Disinfecting Station, Pest Control, etc. J. G. Beale, superintendent R. A. Sharman, foreman rodent Foreman Disinfector operative Disinfectors ... ... 9 Rodent operatives 3 Bathing attendants ... 1 Rodent/fly operatives 2 Drain testers 2 Public Analyst J. H. Shelton, fric Bacteriologists E. H. Bailey, mrcs, lrcp, and A. J. H. Tomlinson, mb, BChir, of the Public Health Laboratory Service. 3 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lewisham. Mr. Mayor, Ladies and Gentlemen, I submit my report for the health department for the year 1961. Vital statistics The Registrar General's estimate of the population in midyear 1961, on which the rates in this report are based, was 220,910, a decrease of 390 on the previous year's estimate. The preliminary report of the census of 1961 showed that the population at the census was 221,590. The crude birth rate for 1961 at 16.9 again shows an increase (it was 16.2 in the previous year) and was the highest since 1949. The adjusted birth rate brings this down slightly to 16.3. The crude death rate at 11.7 is slightly higher than the 11.3 of the previous year, while the adjusted death rate (allowing for age and sex distribution of the population) is almost the same. The infant mortality rate at 19.8 is higher than the 18.9 of 1960 ; it appears to be stuck around this figure. The infant mortality rate can be divided into three parts, the early neonatal rate (under one week of age), the rest of the neonatal rate (up to one month of age) and the rest of the first year rate (that is from one month to twelve months). These rates were respectively 11.8, 1.8 and 6.2. The stillbirth rate at 18.9 was also slightly higher. The male infant rates this year were very little different from the female rates except for stillbirths. The various comparative figures of this century are shown in table 10. Infectious disease other than tuberculosis The total number of notifications received (including 123 for tuberculosis) was 4820 which is over three times the number for the previous year. This again reflects the two-year periodicity of measles, cases of which went up from 262 to 4278. Dysentery cases dropped sharply from 367 to 96 and these were mainly from school outbreaks. They were of a mild type. Food poisoning cases were, at 26, a little below the average, although it is likely that many such cases are not reported. There were 62 notifications of pneumonia,"almost double those of the previous year, indicating the presence of an influenza outbreak at the beginning of the year. There were no cases of poliomyelitis and it seems reasonably certain that vaccination has been a considerable factor here. It is essential that all children and young adults should for their own wellbeing and for the peace of mind of their relatives be protected against poliomyelitis. The three or perhaps four injections has tended to put some people off, but a vaccine which can be taken by mouth is now available and therefore there can be no real excuse at all for parents failing to get their child protected. Tuberculosis The number of new notifications again decreased, though slightly. The total was 123 giving a notification rate of 56 per 100,000 population, a low record. The death rate from pulmonary tuberculosis increased to 8 per 100,000 population, compared with 9 for the County of London as a whole. 4 Clean air Considerable progress was made in the establishment of smoke control areas whether through survey or by the making of Orders or in administrative and technical work necessary for the payment of grant. More details are given in section B of the report, together with a reference to the telescoping of the smoke control programme. It is now hoped that it may be possible to make the last Order affecting the borough in 1965 instead of in 1968 as previously programmed. Various alterations were made in our scheme for the measurement of atmospheric pollution, the Borough Council working in as far as possible with the national survey which is coordinated by the Department of Scientific and Industrial Research. Details are found in the body of the report, together with some new charts showing local pollution. Old people Three additional clubs applied for grant aid and altogether 19 clubs or organisations were in receipt of grants from the Council. Details are shown in Section B. The grant is reviewed each year and perhaps the chief factor in an upward revision is an indication (by the atmosphere of the club and particularly by the expansion of numbers and existing facilities and by the institution of new facilities) that the club is increasing its activities or comfort for its members. The number of old people on the club registers of the grant-aided clubs was much the same as during the previous year. An interesting new feature of the work of the department was the setting up of facilities for the welfare of old people at premises—The Saville in Lewisham High Street—which were bought and converted by the Borough Council. At these premises by the end of the year were three flourishing afternoon clubs, two morning handicraft classes, and a well-equipped kitchen loaned to LOPWA for the provision of meals. Day sessions for the handicapped will be started as soon as transport is available. The special King Edward Hospital Fund committee mentioned in my last two reports continued during the year. The detailed survey of a considerable proportion of the old people of the borough has been completed but the report is still under consideration. Home Safety The Public Health committee have regular reports on home safety matters, and the quarterly home safety bulletin which is got out by the department continues to be issued. The ability of London boroughs to do some home safety work was increased by the Home Safety Act 1961 so that all parts of the country have been given the specific power to contribute to voluntary organisations doing home safety work in their areas. Housing Act 1961 Housing remains a root cause of difficulty and dissatisfaction for a considerable number of families—whether waiting in the hope of new premises, or whether merely putting up with substandard and unpleasantly crowded premises. There is no doubt that many more houses each year are occupied by two, three or several families, though 5 the position in Lewisham is probably a good bit better than in some more central boroughs. We welcome therefore the passing of the Housing Act 1961 which gives several additional powers for dealing with multi-occupation and with squalid conditions, more particularly by management orders, by requiring additional facilities, or by limiting the number of persons who can live in a house having regard to the facilities already there. The Act did not come fully into operation until nearly the middle of 1962. Staff The sudden death of Mr. D. J. Allen, who had been our public analyst for only a short time, robbed us of the services of a keen young colleague. To fill the vacancy Mr. J. H. Shelton, F.R.I.C., was appointed and we look forward to many years of helpful cooperation in this field. The pupil public health inspectors' scheme continues though there is still a little difficulty in recruitment due to the desirability of candidates having passed the necessary preliminary examination, and of course from competing interests in other professions and industry. One pupil qualified. With the help of the Council's post-entry training scheme Mr. Thrussell, a public health inspector who had been trained here, obtained the Meat and Other Foods certificate. In ending the introduction to this report I wish to express my thanks to the Public Health Department Staff for their work during the year, and more particularly for the heavy additional work they have got through under the Clean Air programme, and for the difficulties they continue to surmount in this extremely important subject. My thanks are also due to the Public Health Committee for their support and guidance in the work done. The Public Health Committee during the year was constituted as follows : Alderman A. A. Hawkins (Chairman) Councillor E. F. Inch (Vice-Chairman) Councillor L. H. Moody, J.P. (The Mayor) Alderman C. S. E. Fox Councillors Mrs. R. K. Bartlett, J. V. Braund, Mrs. N. L. Bunce, Mrs. D. I. Cox (Deputy Mayor), J. Donovan, P. E. J. Forward, F. S. Gander, B.Sc. (Hons.) Eng., F. W. T. Hibbert, Mrs. D. Hurren, Mrs. G. M. M. Land, Mrs. J. Marsh, Mrs. D. E. New and A. J. Pinnegar. 6 SECTION A —VITAL STATISTICS NOTE—The principal figures for the previous year are italicised in brackets. Area The aiea of the borough is 7,015 acres. Public open space comprises 652 acres. Population Census 1961 (preliminary report) 221,590 The Registrar-General's estimate of the home population at midyear 1961 was 220,910. (This includes members of the armed forces stationed in the area). Rateable value Rateable value of the borough at April 1, 1961 £3,183,300 Estimated net product of a penny rate 1961/2 £12,875 Estimated number of separately assessed dwellings at April 1, 1961 65,330 Births (adjusted for inward and outward transfers) Total Livebirths 3,740 Males Females Total Legitimate 1,772 1,665 3,437 (3,348) Illegitimate 134 169 303 (235) Totals 1,906 1,834 3,740 (3,583) Crude birth rate per 1,000 of the estimated population 16.9 (16.2) Adjusted birth rate for comparative purposes (Area comparability factor = 0.96) ... ... 16.3 (15.4) Birth rate for England and Wales ... ... 17.4 (17.1) Adjusted birth rate for London Administrative County 16.8 (16.0) Stillbirths Total (41 males and 31 females) 72 (63) Rate per 1,000 live and stillbirths) 18.9 (17.3) (males 21.1 (20.4): females 16.6 (14.0)) Deaths Total (1,333 males, 1,253 females) 2,586 (2,510) Crude death rate per 1,000 population 11.7 (11.3) Adjusted death rate 11.2 (11.3) (Area comparability factor = 0.96) Death rate for England and Wales ... 12.0 (11.5) „ „„ London Administrative County... 11.4 (11.2) Infant mortality Infant deaths (all deaths of liveborn children under one year) Males Females Total Legitimate 33 32 65 (60) Illegitimate 6 3 9 (8) Total 39 35 74 (68) 7 Rates : 1. All infants per thousand livebirths 19.8 (18.9) 2. Legitimate infants per thousand legitimate livebirths 18.9 (17.9) 3. Illegitimate infants per thousand illegitimate livebirths . 29.7 (34.0) 4. Male infants per thousand male livebirths 20.5 (25.3) 5. Female infants per thousand female livebirths 19.1 (12.5) Neonatal deaths (under 4 weeks of age) 51 (48) Neonatal death rates :— Males, per 1,000 male livebirths 13.1 Females, per 1,000 female livebirths 14.2 All infants, per 1,000 livebirths 13.6 (13.1) Early neonatal deaths (under 1 week of age) 44 (39) Males, per thousand male livebirths 12.1 Females, per thousand female livebirths 11.5 All infants per thousand livebirths 11.8 (10.9) Perinatal mortality (deaths under 1 week plus stillbirths) 116 (102) Males, per thousand live and still male births 32.9 Females, per thousand live and still female births 27.9 All infants, per thousand live and stillbirths 30.4 (28.0) Reproductive wastage—(Stillbirths plus all infant deaths) 146 (131) Males, per 1,000 live and still male births ... 41.1 Females, per 1,000 live and still female births 35.4 All infants, per 1,000 live and still births ... 38.3 (35.9) Maternal deaths Maternal deaths 1 (Nil) Maternal mortality rate per thousand live and still births 0.3 (—) Other special causes of death Measles 1 (—) Whooping-cough — (—) Gastroenteritis (infants) — (—) Tuberculosis (all forms) 19 (77) Motor vehicle accidents 29 (28) Suicide 31 (33) Respiratory diseases (other than tuberculosis) (Code Nos. 22-25) 379 (294) Cancer (Code Nos. 10-15) 481 (539) Heart and circulation diseases (Code Nos. 17-21) 1,311 (1,156) Comparative statistics for the year 1961 Table 1 Birth rate Death rate (per 1,000 population) (adjusted) Infant mortality rate (per 1,000 livebirths) Live births (adjusted) Still births Lewisham 16.3 18.9 11.2 19.8 England and Wales 17.4 18.7 12.0 21.4 London Administrative County 16.8 18.3 11.4 21.5 8 Causes of death at different periods The following table shows the causes of and Table Code No. Causes of death Nett deaths at the subjoined ages of " residents " whether occurring within or without the borough MALES Total perrson (i.e include table opp.) All ages Under I yr. 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and under 75 75 and over Totals, all causes 1333 39 7 4 12 49 348 364 510 2586 1 Tuberculosis, respiratory 16 - — — 2 6 4 4 18 2 Tuberculosis, other forms 1 - — — — - 1 — — 1 3 Syphilitic diseases 3 - - - - - 1 1 1 4 4 Diphtheria - - - - - - - - - -- 5 Whooping cough - - - - - - - - - -— 6 Meningococcal infections. - - - - - - - - - -- 7 Acute poliomyelitis - - - - - - - - - —- 8 Measles - - - - - - - - - 1 9 Other infective and parasitic diseases 3 - - - - - 3 - - 7 10 Malignant neoplasms, stomach 42 - - - - 2 19 12 9 69 11 Malignant neoplasms, lung and bronchus 119 - - - - 4 58 40 17 134 12 Malignant neoplasms, breast — - — — — — — — — 46 13 Malignant neoplasms, uterus - - - - - - - - - 14 14 Other malignant and lymphatic neoplasms 104 - - - 1 6 33 33 31 208 15 Leukaemia, aleukaemia 6 - 1 — — 3 1 — 1 10 16 Diabetes 4 - — — — 1 — 1 2 26 17 Vascular lesions of nervous system 140 - - 2 21 47 70 317 18 Coronary disease, angina 284 — - — — 7 98 91 88 492 19 Hypertension with heart disease 18 - - - - - 2 8 8 49 20 Other heart disease 118 — - — — 2 15 13 88 330 21 Other circulatory disease 51 - - - - - 7 17 27 123 22 Influenza 12 - - - - - 2 4 6 19 23 Pneumonia 74 8 - — — 1 10 10 45 142 24 Bronchitis 138 3 - — — — 24 53 58 193 25 Other diseases of respiratory system 13 _ _ 1 2 3 7 25 26 Ulcers of stomach and duodenum 19 - - - - 2 6 5 6 29 27 Gastritis, enteritis and diarrhoea 1 - - 1 - - - - - 6 28 Nephritis and nephrosis 8 — - - — 1 3 — 4 17 29 Hyperplasia of prostate 11 - - - - - 1 3 7 11 30 Pregnancy, childbirth, abortion - - - - - - - - - 1 31 Congenital malformations 14 4 4 1 — — 4 1 — 26 32 Other defined and ill defined causes 76 23 1 - 1 1 18 10 22 168 33 Motor vehicle accidents 18 - 1 1 5 6 1 2 2 29 34 All other accidents 22 1 - 1 4 3 3 3 7 38 35 Suicides 17 — — — 1 5 8 3 — 31 36 Homicide and operations of war 1 - - - - - 1 - - 2 9 of life during the year 1961 ages at death during the calendar year 1961 :— 2 Code No. Causes of death Nett deaths at the subjoined ages of " residents " whether occurring within or without the borough FEMALES Total persons (i.e.. incl. table op p.) All ages Under 1 yr. 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and under 75 75 and over Totals all causes 1253 35 1 2 6 29 193 295 692 2586 1 Tuberculosis, respiratory 2 _ - - - - - 1 1 18 2 Tuberculosis, other forms - - - - - - - - - 1 3 Syphilitic disease 1 - - - - - - - 1 4 4 Diphtheria - - - - - - - - - - 5 Whooping cough - - - - - - - - - - 6 Meningococcal infections - - - - - - - - - - 7 Acute poliomyelitis - - - - - - - - - - Measles 1 — — 1 — — - — — 1 9 Other infective and parasitic diseases 4 - - _ 1 1 2 7 10 Malignant neoplasms, stomach 27 - - - - - 11 9 7 69 11 Malignant neoplasms, lung and bronchus 15 - - - - 2 6 4 3 134 12 Malignant neoplasms, breast 46 - — — — 5 21 10 10 46 13 Malignant neoplasms, uterus 14 - — — — 1 4 4 5 14 14 Other malignant and lymphatic neoplasms 104 - - 1 2 7 34 30 30 208 15 Leukaemia, aleukaemia 4 - - - - - 1 2 1 10 16 Diabetes 22 - - - - - 1 13 8 26 17 Vascular lesions of nervous system 177 - - - - 1 23 47 106 317 18 Coronary disease, angina. 208 - - - - - 24 63 121 492 19 Hypertension with heart disease 31 - - - - - 4 4 23 49 20 Other heart disease 212 - — — — 1 19 28 164 330 21 Other circulatory disease 72 - — — — 1 7 16 48 123 22 Influenza 7 - - - - - 1 — 6 19 23 Pneumonia 68 4 1 — — 2 1 16 44 142 24 Bronchitis 55 2 — — 1 — 6 12 34 193 25 Other diseases of respiratory system 12 - - - - - 2 3 7 25 26 Ulcer of stomach and duodenum 10 - - - - - 4 2 4 29 27 Gastritis, enteritis and diarrhoea 5 - - - - - - 2 3 6 28 Nephritis and nephrosis. 9 - - - - - 2 3 4 17 29 Hyperplasia of prostate - - - - - - - - - 11 30 Pregnancy, childbirth, abortion 1 - - - - 1 - - - 1 31 Congenital malformations 12 10 — — — 1 — 1 — 26 32 Other defined and ill defined causes 92 19 - - 1 2 11 20 39 168 33 Motor vehicle accidents 11 — — — 1 2 3 — 5 29 34 All other accidents 16 — — 1 1 1 1 12 38 35 Suicides 14 1 6 4 3 31 36 Homicide and operations of war 1 - - - - - - - 1 2 10 Deaths under 1 year of age Table 3 Cause of death Sex Under 1 day 1-6 days 1 week 2 weeks 3 weeks Total under 4 wks. 1-2 mths. 3-5 mths. 6-8 mths. 9-11 mths. Total 1-11 mths. Total under 1 yr Diseases of ear and mastoid process M - - - - - - - - - - - - F - - - - - - - 1 - - 1 1 Pneumonia M - - - 1 - 1 2 3 1 1 7 fi F - 1 - - 1 2 - 2 - - 2 4 Bronchitis M - - - - - - 1 2 - - 3 3 F — — - - - - 1 1 - - 2 2 Spina-bifida and meningocele M - - - - - - - - - - - - F - - - - - - - - - 1 1 1 Congenital malformations of heart M _ 1 - _ _ 1 _ _ _ _ _ 1 F 1 2 1 - 1 S - 1 - - 1 6 Other congenital malformations M 2 _ _ _ _ 2 _ 1 _ - 1 3 F - 2 - - - 2 1 - - - 1 3 Injury at birth M 4 _ - - _ 4 _ _ _ _ - 4 F - 1 - - - 1 - - - - - 1 Post-natal asphyxia and atelectasis M 5 1 _ _ 6 _ _ _ _ _ 6 F 4 - - - - 4 - - - - 4 Pemphigus and seps is of new born M - - _ _ 1 1 - - _ _ - 1 F — - 1 - - 1 - - - - - 1 Haemolytic disease of newborn M - 1 - - 1 _ - - - 1 F 1 1 - - 2 - ~ - - - 2 Immaturity M 7 _ _ _ __ 7 _ 7 F 4 2 - - 1 7 - - - - - 7 Lack of care of new born M 1 _ - - - 1 - - - - - 1 F - - - - - - - - - - - - All other causes M 1 _ _ _ 1 1 2 _ - 3 4 F 2 - " - - 2 - - - 1 1 3 TOTALS M 20 3 _ 1 1 25 4 8 1 1 14 39 F 12 9 2 - 3 26 2 5 - 2 9 35 GRAND TOTAL 32 12 2 1 4 51 6 13 1 3 23 74 23 infants (14 male and 9 female) thus died between the age of one month and one year compared with 20 in the previous year and 18 the year before that. 14 of the 23 were from pneumonia and bronchitis, 3 were from congenital malformations and there was one each through 2 other causes, with 4 being undefined. There was an increase of 3 in the number of deaths under 4 weeks of age, the greatest incidences being in immaturity with 14 deaths (1 more than last year), and post-natal asphyxia and atelectasis with 10 deaths (4 more than last year). 11 The social class, related to cause of death, was as follows :— Table 4 Code No. Cause of death Male Female 1 II Ill /V V Total 1 II Ill IV V Total Tuberculosis, respiratory _ 2 10 2 2 16 _ 1 1 — 2 2 Tuberculosis, other forms _ 1 1 _ 3 Syphilitic disease - — — 3 — 3 - — — 1 — 1 4 Diphtheria — - - - - - - - - - - - 5 Whooping cough _ - - - - - - - - - - - 6 Meningococcal infections _ - - - - - - - - - - - 7 Acute poliomyelitis - - - - - - - - - - - - Measles - - - - - - - 1 - - - 1 9 Other infective and parasitic diseases - - - - - - - - 2 1 - 3 10 Malignant neoplasm, stomach - 5 27 9 1 52 - 6 13 6 — 25 11 Malignant neoplasm, lung, bronchus 2 15 63 26 11 117 2 1 9 1 2 15 12 Malignant neoplasm, breast - — — — — — 1 - 21 5 4 39 13 Malignant neoplasm, uterus - - -— - - - - 3 5 1 2 11 14 Other malignant and lymphatic neoplasms 2 19 52 19 8 100 5 15 61 13 3 97 15 Leukaemia, aleukaemia 2 2 5 2 — 11 - — 4 — — 4 16 Diabetes - 2 2 — — 4 - 4 12 2 4 22 17 Vascular lesions of nervous system 4 22 81 14 25 146 4 48 96 20 9 177 18 Coronary disease, angina 3 45 162 22 17 249 - 34 80 24 9 147 19 Hypertension with heart disease 1 12 19 7 __ 39 3 10 35 10 3 61 20 Other heart disease 3 28 64 15 11 121 8 31 109 38 20 206 21 Other circulatory disease 1 6 33 9 2 51 - 10 43 15 4 72 22 Influenza _ 2 1 3 _ 2 4 2 8 23 Pneumonia 2 19 36 9 13 79 1 13 36 15 6 71 24 Bronchitis 5 15 75 25 18 138 1 28 8 4 49 25 Other diseases of respiratory system - 1 11 1 2 15 1 1 8 _ - 10 26 Ulcer of stomach and duodenum _ 3 11 3 2 19 _ 1 7 1 1 10 27 Gastritis, enteritis and diarrhoea - - - 1 - 1 - 1 3 1 5 28 Nephritis and nephrosis 2 1 5 - 8 2 5 1 1 9 29 Hyperplasia of prostate - - 7 3 1 11 - - - - - - 30 Pregnancy, childbirth, abortion _ — — _ — 1 — — 1 31 Congenital malformations 2 1 9 2 — 14 - 3 8 1 — 12 32 Other defined and ill defined diseases 3 10 46 13 3 75 3 12 47 12 12 86 33 Motor vehicle accidents - - 12 2 4 18 - 9 2 - 11 34 All other accidents _ 12 8 2 22 _ 2 6 4 3 15 35 Suicides 1 1 7 6 2 17 3 3 6 2 — 14 36 Homicide and operations of war Totals 33- 1 210 752 201 125 1 1321 1 33 219 657 188 88 1 1185 Percentage 3 16 57 15 9 100 3 19 55 16 7 100 No social class assessed - — — — — 9 - — — — — 59 There are various discrepancies between the above table and table 2, owing to different methods of assessment, and for comparative purposes therefore it is safer to group the causes of death which are linked together. Thus code numbers 10 to 15 may be regarded as all different kinds of cancer, while numbers 17 to 21 are all diseases of the heart and circulation. Similarly 22 to 25 are best grouped together. 12 Certain statistics have thus been extracted from the last table and grouped in this way. They are shown in the following table which also includes the percentage of each social class for each disease or group of diseases. The percentages should be compared with those in table 4 for all deaths, but for certain groups it will be realised that the numbers are too small for comparison year by year. Table 5 Grouped deaths in social class Code Nos. Group Male Female 1 II III IV V Total 1 II III IV V Total 10-15 No. Cancers % 6 41 147 56 20 270 8 33 113 26 11 191 2 15 55 21 7 100 4 17 59 14 6 100 17-21 Heart and circulation No % 12 113 359 67 55 606 15 133 363 107 45 663 2 19 59 II 9 100 2 20 55 16 7 100 22-25 No Lung, not TB or cancer % 7 35 124 35 34 235 3 24 76 25 10 138 3 IS 53 IS 14 100 2 18 55 18 7 100 33- 34 Accidents No % 24 10 6 40 2 15 6 3 26 — 60 25 18 100 — 8 58 23 II 100 35 Suicides No % 1 1 7 6 2 17 3 3 6 2 _ 14 6 6 41 35 12 100 21 21 43 IS 100 Social class in relation to infant statistics The following table shows the social classification in relation to registered births, registered infant deaths, notified stillbirths and notified premature births, an extra line being added to each group to indicate the percentage. Apart from the registered births the figures are too small to be significant; the percentages in the category of registered births can be compared with those for the registered deaths shown in table 4. Table 6 Social classification Total Not classifiable 1 II III IV V No Registered birth s % 124 673 2168 438 236 3639 101 3 18 60 12 7 100 No Registered stillbirths % 1 3 36 10 7 57 15 2 5 63 18 12 100 No Registered infant deaths % 1 7 58 7 1 74 / 10 78 10 / 100 No Notified premature births % 4 28 141 32 21 226 45 2 12 63 14 9 100 13 Local sickness The Regional Medical Officer of the Ministry of National Insurance kindly sends a weekly return indicating the first certificates of sickness benefit received in the local offices. The areas served by these local offices are in the main coterminous with postal districts of London and do not coincide with borough boundaries. Lewisham is served by four offices, "Lewisham." "Downham," "Eltham," and "Norwood," but as only a very small portion of the borough comes within the purview of the last two, it is felt that a better representation of the trend of sickness within the borough is given by quoting only the combined figures for "Lewisham," and "Downham". Table 7 Morbidity shown in insurance certificates Weekly average for period ending "Lewisham & Downham" Weekly average for period ending "Lewisham & Downham" January 24 1005 August 8 425 February 21 1506 September 5 468 March 21 686 October 3 573 April 18 547 746 May 16 605 November 28 777 June 13 516 December 26 749 July 11 481 Weekly average for the year 1961 699 „ 1960 633 FIRST APPLICATIONS FOR SICKNESS BENEFIT Dotted lines—Maximum and Minimum 1951—61 Continuous line—1961 14 The year cannot be regarded as abnormal. A peak occurred however at the beginning of the year, and during the middle part the graph line ran at or near the maximum for the previous ten years. Though remaining steady towards the end of the year it was considerably below past peaks of that period. Coronary disease Active research continues, particularly with regard to the dietary factor, although it is still true to say that results have not yet reached the stage when dogmatic advice can be given with regard to specific articles of dietary. Nevertheless, for those adults who are prepared to alter their dietary regime on a likely possibility rather than a scientific probability, advice which could be given at this stage would amount to this : eat sparingly, cut down fats particularly, look askance at foodstuff's with a high cholesterol content—brains, egg yolk, kidneys, butter—prefer vegetable and fish oil to animal fat, and take regular exercise. This is simple advice, easy to follow, and unlikely to do any harm ; and it is advice which quite possibly might do a lot of good. There are, almost inevitably, "savings" and "provisos" even to these simple rules but the only one of note here is in relation to vegetable fat: coconut oil is under some suspicion, while peanut oil is probably advantageous. For cooking and frying purposes there are now excellent vegetable oils on the market, and there are also evaporated milks where the butter fat has been replaced by vegetable fat. An interesting development was the making of the Skimmed Milk with Non-Milk Fat Regulations 1960, which came into force in September, 1961. These, amongst other things, require any label which carries a claim in relation to coronary disease to bear also a statement of the kind and amount of fat used. Various brands are mentioned by name. Table 8 Heart and circulation mortality Year (a) Deaths from Total heart and circulation (all ages) (e) Age group 45-65 Total deaths in borough (h) Percentage Coronary diseases (b) Other heart diseases* (c) Other circulatory diseases† (d) Total (f) Coronary diseases (g) (e) of (h) (i) (f) of (h) (j) (g) of (h) (k) 1928 357 97 454 115 _ 1993 23 5.8 ? 1933 516 117 633 162 - 2271 28 7.1 ? 1938 659 139 798 178 _ 2403 33 7.4 ? 1943 583 64 647 129 _ 2359 27 5.5 ? 1948 696 63 759 155 _ 2253 34 6.9 ? 1953 775 113 888 140 _ 2502 35 5.6 - 1958 770 109 879 150 - 2433 36 6.2 - 1952 327 537 86 950 180 89 2580 37 7.0 3.5 3 331 444 113 888 140 84 2502 35 5.6 3.4 4 358 387 113 858 176 99 2231 38 7.9 4.4 5 329 464 115 908 148 94 2423 37 6.1 3.9 6 385 421 113 919 149 84 2513 37 5.9 3.3 7 379 369 107 855 160 100 2433 35 6.2 4.1 8 407 363 109 879 150 99 2433 36 6.2 4.1 9 470 360 118 948 161 110 2617 36 6.2 4.2 1960 364 321 113 798 149 102 2510 32 5.9 4.'l 1 492 375 123 990 176 122 2586 38 6.8 4.7 ? means figure not available, *R.G. Code Nos. 19 and 20. †RG- Code No. 21. 15 Lung cancer Table 9 Year (a) MALE FEMALE All cancer deaths (b) Lung cancer deaths (c) (c)as % of (b) (d) All cancer deaths (e) Lung cancer deaths (f) (f) as % of (e)  1952 246 77 31 238 9 4 1953 237 83 35 215 13 6 1954 238 76 32 192 13 7 1955 303 102 3 4 226 19 8 1956 259 96 37 226 12 5 1957 267 101 38 229 21 9 1958 271 114 42 201 21 10 1959 297 118 40 235 22 9 1960 315 145 46 254 17 7 1961 271 104 38 210 15 7 Nationally, the upward trend still continues, for men at least, and for all age groups over 45. Locally however there was a pause in the upward trend, the number of lung cancer deaths in males falling from 145 to 104. This I fear is merely due to the play of statistics, and the figures for the early part of 1962 show no diminution. The Royal College of Physicians issued a report on tobacco and health early in 1962, and extended comment was made on this in our Home Safety Bulletin. In view of the urgency of the matter, particularly in relation to adolescents, I repeat some extracts from the Bulletin : "For many years medical officers of health have underlined the association of cigarette smoking with lung cancer (in this borough advice on this has been given over at least the last 10 years), but unfortunately with no obvious effect on the amount of tobacco consumed, while at the same time the lung cancer rate has steadily increased. Advice to stop smoking, certainly of cigarettes, to lessen the risk from lung cancer, chronic bronchitis, and certain heart diseases, has now been given by such an influential body as the Royal College of Physicians, and so the gist of their advice is modestly repeated here: SAVE YOUR HEALTH, YOUR FAMILY, YOUR POCKET... by giving up smoking. That is what it really amounts to. If you are wavering on the brink of giving it up, do now take the plunge, but even if you have not the inclination or will-power for that, please get out of the unhealthy social habit of offering cigarettes on so many occasions to your friends. (Keep them, if you have to, for your enemies!) Remember that: lung cancer may not show itself for 20 years or more ; it is almost invariably fatal ; it attacks younger age-groups than most other cancers ; 20,000 men died of it last year in this country; it appears to be one of the very few cancers which is mainly preventable ; evidence of its connection with cigarette smoking is overwhelming. Also remember that cigarette smoking can cause, or make worse, chronic bronchitis, certain types of heart disease, some stomach ulcers. A word for the middle-aged smoker: Statistics show that your safety chances improve with every year you give up smoking. Long-term comfort: With all the research going on now there is a probability that sooner or later the disease-causing factors in smoking will be identified and eliminated. The younger person therefore if he gives up now because it is dangerous, can comfort himself with the thought that in one, five, perhaps ten years' time, he will be able to smoke without danger to himself, other than to his pocket." 10 General statistics from 1901 Table 10 Year Population Death rate * % dying under age 45 % dying under age 65 Birth rate * Premature birth rate ‡ Maternal death rate † Stillbirth rate † Neonatal death rate ** One month to one year death rate (12)-(10) ** Infant mortality rate ♦ ♦ Reproductive wastage rate (9)+(12) Pulmonary tuberculosis Tuberculosis (a/1 forms) Notif. rate† Death rate† % notif. rate under 15 (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) 1901 127,495 13.0 - 74 26 - 3.9 - - - 128 - - 93 - 1902 132,432 13 .7 74 26 4.3 122 106 — 1903 136,405 11.1 72 26 2.5 92 78 — 1904 140,401 12.0 70 26 3.6 122 - - 84 — 1905 144,420 11.7 67 25 2.8 30 63 93 - 87 — 1906 148,463 12.0 72 23 2.0 30 83 113 - - 80 — 1907 152,532 11.5 67 24 2.5 34 56 90 - 90 — 1908 156,627 11.0 68 23 1.4 30 57 87 - 85 — 1909 160,749 10.4 63 22 - 2.0 - 35 40 75 - - 78 — 1910 164,899 9.7 — 65 21 — 2 .6 — 29 50 79 — - 55 — 1911 161,677 11.4 46 68 21 2.3 31 73 104 - 64 — 1912 165,249 10. 5 39 63 20 - 2.8 - 30 39 69 - 208 68 II 1913 168,822 10.7 43 65 20 - 2.6 - 28 48 76 - 188 73 25 1914 169,211 10.9 40 62 19 3.3 27 46 73 - 138 77 18 1915 164,438 12.9 36 61 19 4.0 30 49 79 - 154 90 26 1916 11.9 18 75 - — 102 — 1917 11.8 15 87 ,— 112 — 1918 — 13 .2 — — 14 - — - — — 66 - — 106 — 1919 174,750 11.4 35 59 17 - 3.1 - 28 32 60 - 179 86 22 1920 174,698 10.8 38 59 23 — 3.8 - 32 30 62 - 160 73 22 1921 175,800 10.5 34 58 19 - 2.6 - 23 31 54 - 135 81 18 1922 176,600 11.1 31 57 18 2.5 26 28 54 - 154 74 16 1923 182,400 10.1 31 56 18 - 3.6 - 20 23 43 - 154 76 17 1924 184,900 10.5 29 56 16 3.6 23 24 47 - 149 68 22 1925 185,600 10 .3 30 56 16 1.6 23 32 55 - 142 63 15 1926 187,800 10.0 29 54 15 - 2.1 18 22 40 158 71 17 1927 188,600 11.0 28 S3 15 - 2.1 - 35 21 46 - 157 92 12 1928 199.300 10. 0 29 54 15 - 2.3 - 22 30 52 - 168 77 15 1929 207.900 11.5 27 52 16 - 5.3 - - 44 142 74 13 1930 I 207,900 9.7 28 53 15 - 0 .9 37 — — 42 79 154 76 12 17 Table 10-continued (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) 1931 220,800 10.2 26 52 14 - 4.9 31 25 24 49 80 132 69 14 1932 221,500 10.2 26 49 13 - 3.4 32 31 23 54 86 123 59 II 1933 221,100 10.2 22 50 12 — 2.6 31 21 18 39 70 125 68 9 1934 222,180 10.1 23 50 12 — 1.5 36 21 22 43 79 129 58 14 1935 223,000 10.0 23 47 12 4.3 35 24 19 43 78 126 58 13 1936 224,000 10.9 23 48 13 — 2.0 37 23 32 55 92 131 62 12 1937 226,000 10.9 20 47 13 — 1.3 39 18 29 47 86 156 59 12 1938 229,000 10.5 23 49 14 2.1 26 — 47 73 116 61 12 1939 220,300 10.8 — — 14 — 2 .9 34 — — 42 76 111 64 12 1940 192,540 15.8 22 50 15 — 1.0 24 — — 45 69 111 67 II 1941 148,150 14..3 22 48 14 1.9 29 34 63 176 93 10 1942 161,800 12.0 18 44 17 - 3.2 37 37 74 175 73 15 1943 168,530 13 .9 20 45 19 3.1 25 42 67 194 76 14 1944 163,320 14.8 21 49 19 1.0 22 — — 40 62 196 79 II 1945 171,280 12.1 20 43 18 1.9 18 - 34 52 179 71 13 1946 207^410 10.6 17 43 22 1.1 21 33 54 193 53 15 1947 221,170 11.9 17 42 22 1.0 21 33 54 166 55 12 1948 226,100 9 .9 16 41 19 — 0.5 15 15 13 28 43 198 43 16 1949 227,700 10.2 II 35 17 — 0.3 16 13 6 19 35 146 40 12 1950 228,300 10 .6 II 35 15 — 0.6 15 19 7 26 40 158 29 13 1951 227,200 11.2 10 34 15 67 0.3 16 17 8 25 41 117 26 15 1952 227,100 11.4 9 32 14 86 0.3 18 16 6 22 40 117 15 8 1953 225,800 11.1 9 29 14 75 0.3 23 16 6 22 45 136 19 14 1954 224,200 10.0 8 31 14 60 Nil 14 13 8 21 35 102 16 10 1955 223,400 10.8 7 28 14 69 0.9 18 11 6 17 35 114 10 5 1956 222,100 113 6 27 14 59 Nil 19 16 3 19 38 88 13 II 1957 220,900 11.0 8 32 15 65 0.6 18 12 4 16 33 100 14 10 1958 221,000 11.0 8 29 15 78 Nil 18 19 5 24 42 98 8 II 1959 221,000 11.8 7 28 16 75 0.8 18 13 5 18 36 56 5 8 1960 221,300 11.3 8 28 16 69 Nil 17 13 6 19 36 54 5 10 1961 220,910 11.7 7 28 17 72 0.3 19 14 6 20 39 51 8 9 •per 1,000 population, ‡per 1,000 notified livebirths. **per 1,000 registered livebirths. tper 1,000 registered live and stillbirths. ††per 100,000 population. — means figure not available. SECTION B — GENERAL PROVISION OF HEALTH SERVICES Disinfection and personal cleansing Details of the work carried out during the year are as follows :— Disinfecting Station Table 11 West North South Total Disinfection Premises visited 44 59 32 135 Rooms disinfected 109 166 76 351 Articles disinfected 1260 1770 511 3541 Disinfestation Premises visited 32 28 18 78 Rooms disinfested 106 103 49 258 Articles disinfested 44 42 33 119 Articles treated Beds 23 26 14 63 Mattresses 83 95 53 231 Bolsters 16 18 16 50 Pillows 132 113 58 303 Cushions 6 5 14 25 Quilts 23 16 24 63 Blankets 180 381 89 650 Sheets 65 85 35 185 Household articles 395 332 138 865 Wearing apparel 331 741 103 1225 Total articles 1304 1812 544 3660 Articles received from the cleansing station 895 895 Articles received from the Coroner's court — 1059 1059 Public library books treated after infection 99 141 98 338 Private library books treated after infection 6 2 - 8 Articles treated under the Public Health (London) Act s.122 16738 22809 15340 54887 Treatments for verminous conditions and for scabies were as follow: — Verminous conditions Table 12 1st Cleansing 2nd Cleansing 3rd Cleansing 4th Cleansing Children under 5 9 2 School children 37 1 Adults 9 — - — TOTALS 55 3 - - 18 19 Scabies Table 12—continued Cases Contacts Treatments Children under 5 5 10 School children 22 — 39 Adults 19 — 33 TOTALS 46 — 82 London County Council (General Powers) Act, 1953 Section 43 of the above Act states that, on receipt of a report from the medical officer of health or a sanitary inspector that any aged person within their district is verminous or is for any other reason in need of cleansing in order to prevent injury or the danger of injury and is so enfeebled that he is unable to avail himself of any facilities for cleansing himself provided by the authority or to cleanse himself properly, the sanitary authority may on application or with the consent of that person (but not otherwise) cause him to be cleansed free of charge at the place where he resides or at any other suitable place. The authority is enabled to make such arrangements and provide any apparatus required to exercise these powers. 6 persons received treatment during the year. Anti-fly and anti-mosquito campaign The campaign was held from May 1 to September 30, and Mr. Craven, the deputy senior inspector, who is in charge of this anti-pest work, reports:—"327 sites, grass' verges and rear entrances were visited on two occasions each and necessary treatment carried out by spraying or the use of powder. Material collected or destroyed on the sites consisted of 38 mattresses and a large quantity of miscellaneous articles such as carpets, linoleum, furniture and rags. Most of this rubbish was taken to the Molesworth Street depot for removal with the household refuse because of the difficulty of destroying it on the site when wet. On a few occasions, however, when the material was reasonably dry it was destroyed by burning". The cooperation of the Borough Engineer's department was again available for the treatment of dustbins with a powder supplied by the health department. Approximately 4½ tons of powder containing gammexane was applied to dustbins at the time of refuse collection. This could well be increased with advantage. One stable and two piggeries and certain plots of land known to be particularly bad as rubbish tips were treated as special sites and visited regularly, special attention being paid to the manure receptacles at the stable and piggeries. Throughout the campaign frequent visits were paid to Lewisham Hospital to spray the refuse containers and the site of the kitchen waste bins. Spraying of the dustchutes and openings at both this Council's and the LCC's blocks of flats was carried out. Similar treatment was given in one block of privately owned flats. The caretakers of this Council's flats were provided with sprayers, insecticide liquid and powder, for use in connection with the containers at the base of the chutes, particularly following emptying, and for the sites of any waste bins. 20 In addition treatment by spraying was carried out in 27 houses by staff from the disinfecting station following complaints from the householders concerned. In a number of cases a supply of insecticide containing 5% DDT was also left with the householders for use in their own sprayers. Health education During the year the food inspectors during the course of their routine inspections of foodshops took the opportunities offered to put over items of health education to the occupiers, and on occasion to the food handlers. A large number of posters were obtained from central agencies in connection with health education generally and more particularly perhaps with environmental hygiene and home safety. The quarterly Bulletin on home safety continued to be distributed to some 500 organisations in the borough. In the course of the year six lectures or talks were delivered by the Health Department staff, two of these to students of a technical institute, one to older schoolgirls, one to a Boy Scout group, one to a group of estate agents, and one to members of a large grocery concern. Public Mortuary and Coroner's Court The premises are situated in Ladywell Road and comprise a court room, witness room, coroner's office, caretaker's apartments and mortuary. Statistics are as under :—- Table 13 Month Bodies received from Institutions Others Post-mortem examinations Inquests held Lewisham residents Others January 40 44 57 27 11 February 43 29 47 25 11 March 39 30 39 30 12 April 43 32 37 38 12 May 41 29 36 34 6 June 38 22 34 26 11 July 29 36 39 26 8 August 29 21 27 23 11 September 26 32 35 23 11 October 46 24 46 24 16 November 32 33 40 25 11 December 35 49 51 33 7 TOTALS 441 381 488 334 127 Rodent control A section, consisting from May to September of a foreman and three operatives and from October to April of the foreman and five operatives, is maintained for the purpose of repressing rat infestation, and this section is supervised by the senior public health inspector. 21 In his report on rodent control work during 1961, Mr. Phillips, the senior public health inspector, states:— “The number of rat and mice complaints showed an increase over the previous year. Mouse infestation increased in houses in multiple occupation where insufficient care and lack of proper storage of food exists. Baiting, normally with warfarin, was reasonably satisfactory but would have had greater success had there been no other food supply. Several infestations were dealt with in shops where more careful storage of food would have obviated this trouble. Rat infestation also was higher during the year in spite of a successful treatment of the sewers in the beginning of the year with sodium fluoracetate and later with sodium fluoracetamide. A considerable number of the infestations was traced to defective drains which were put in order after action by the public health inspectors under section 40 of the Public Health (London) Act, 1936. Many of the complaints, however, were due to the scattering of food by the general public, particularly in parks and other open spaces. Many of the complaints pointed to rivers, and the baiting of rivers was carried out as in previous years." The undermentioned table gives a summary of the work on the rivers and ditches, prebait being laid on 3/4 days :— Table 14 Location Base points River Ravensbourne 478 River Quaggy 106 River Pool 51 Ditches 35 For the past two years continuous baiting of manholes has been undertaken by a permanent rodent control gang, and after some 4,000 manholes had been baited four times over a period slightly longer than a year a complete pre-baiting and poisoning control was exercised to ascertain the result. Under the old system of undertaking rodent control twice a year the position was becoming static and some 27% poison takes were being recorded from the number of manholes baited. The pre-bait and poison check which was undertaken in 1961 showed quite encouraging results, recording a total of poison takes of 22½%. Continuous baiting is once again being undertaken, the rodent control men having nearly completed the second phase. Prevention of Damage by Pests Act, 1949 A copy of the report covering the calendar year 1961 submitted to the Minister of Agriculture, Fisheries and Food, as required by the provisions of the above Act, is appended :— 22 Table 15 Type of property Local authority Dwelling houses (including council houses) All other (including business premises) Total Agricultural Properties in borough 137 65,330 10,633 76,100 Properties inspected as a result of :— (a) notification 21 1,609 159 1,789 — (b) survey 2 489 21 512 — (c) otherwise 2 62 3 67 — Total inspections (including reinspections) 26 2,356 185 2,567 _ Properties inspected which were found to be infested by :— (a) Rats — major — — — — — (b) — minor 15 1,018 100 1,133 — (c) Mice—major — — — — — (d) —minor 4 340 42 386 — Infested properties treated 19 1,340 133 1,492 - Total treatments (including retreatments) S3 2,288 347 2,688 — "Block" control schemes carried out Nil Laboratory facilities The following summary relates to the work carried out by the public health laboratory on behalf of the council during 1961. The smaller number of faecal specimens indicates the decrease of " sonne " infection in the borough; on the other hand typhimurium positives increased from 8 to 23. Table 16 Specimens Number Remarks Faeces 409 Negative 39 Shigella sonnei 39 „ boydii 1 „ newcastle 23 Salmonella typhimurium 3 „ brandenburg 2 „ enteritidis 1 ,, unidentified Group B 3 CI. welchii 1 Bact. coli, type 0 55 Urine 26 Routine Swabs, from nose, throat etc. 279 Negative Sputum 8 Film and culture 2 Negative Cough plate 1 H. pertussis 1 Negative Tap water 2 Food 6 Pigeon carcases 3 Negative for salmonella typhimurium Soil 1 Total specimens 812 23 Swimming baths There are 4 public swimming baths in the borough, in addition to a few club and school swimming baths. The public swimming baths are shown in the table, together with the laboratory tests taken during the vear. Table 17 Bath Tests Variation of chlorine (p.p.m.) Chlorine Bact. Ladywell 2 0.50 Forest Hill North 2 — 0.85—0.90 Forest Hill South 2 — 0.75—1.50 Downham 8 — 0.60—1.80 Bellingham (openair) 3 — 0.30—1.80 The water used for these baths is supplied by the Metropolitan Water Board and is sterilised by the breakpoint chlorination method, sodium carbonate and sodium metaphosphate being used to control acidity and to keep the pH above 7.2. Colorimetric tests for free chlorine and pH value are also made at the baths at 9 a.m., 1 p.m. and 6 p.m. on weekdays and at 9 a.m. and 1 p.m. on Sundays, the results being recorded on log sheets kept for the purpose. The aim is to achieve a circulation of water every four hours, although it is rather more prolonged than this at the openair baths. National Assistance Act, 1948 — section 50 During the year the Council accepted responsibility for the burial of 5 persons, at a net cost to the Council of £22. National Assistance Act, 1948—section 47 Possible cases were investigated during the year and in one of them it was necessary to apply for an order for compulsory removal. This was granted. Dog excreta nuisances No proceedings were taken during the year, although complaints were received of the condition of certain roads and paths. Where a complaint is received it is the practice to exhibit a byelaw notice at a convenient site nearby. Drainage work During the year 158 plans were submitted to the public health inspectors for examination and approval. Water supply The Director of Water Examination of the Metropolitan Water Board states that the water supply to the Borough is well water derived from the Darenth, Deptford, Bexley and Wilmington wells together with River Thames derived filtered' water. Bacteriological analyses are made by the M.W.B. alt least five times a week and in the case of the River Thames source the water is analysed at all stages of purification. None of the supplies is plumbo-solvent. All new and repaired mains are chlorinated before being restored to use and samples are collected for analyses to establish that the quality of the water in them is up to the standard normally supplied. During 1961 a length of 155 yards of new 21-inch main was laid in Lewisham for the improvement of the supply, and also 1,139 yards of smaller mains for local supply purposes. Tables 18 and 19 give the average results of the chemical and bacteriological analyses of the various supplies for 1961. 24 Average results of the chemical and bacteriological examination of the water supply to the Borough of Lewisham for 1961 milligrams per litre (unless otherwise stated) (a) CHEMICAL Table 18 Description of the sample Ammonia nitrogen Albuminoid nitrogen Oxidised nitrogen (nitrate) Chlorides as CI. Oxygen abs. from permanganate (4 hrs. at 27°C) Hardness (total) Hardness (non. carbonate) PH value Electrical Conductivity (micromhos) Southern Group .041 .076 4.1 27 1.06 262 52 7.9 525 Deptford .028 .035 6.3 36 0.12 374 124 7.3 725 Bex ley .20 .043 5.9 17 0.14 292 48 7.2 550 Darenth .022 .033 4.5 17 0.08 270 28 7.2 500 Wilmington .023 .041 9.0 23 0.14 298 54 7.2 550 (b) BACTERIOLOGICAL Table 19 BEFORE TREATMENT (RAW WATER) AFTER TREATMENT (WATER PASSING INTO SUPPLY) Plate counts (average per ml.) Colonies counted on agar Coliform count Percentage samples neg. 100 ml. Plate counts (average per ml.) Colonies counted on agar Coliform count Percentage samples neg. 100 ml. 37° C. (20.24 hrs.) 22° C. (3 days) 37° C. (20.24 hrs.) 22 C. (3 days) Coliform E. Coli Coliform E. Coli Southern Group . . . . 10.0 . 99.84 99.89 Darenth well 38 95.58 99.12 0.1 718 100.00 100.0 Deptford 0.2 178 98.00 99.20 0.6 119 100.00 100.0 Wilmington No 2. Well 0.2 49 96.94 100.0 0.1 2 100.00 100.0 Bexley 1.4 147 10000 100.0 - 64 100.00 100.0 25 Atmospheric pollution Clean Air Act During 1961 four more areas were made the subject of Smoke Control Orders and particulars with regard to these are as follows: — Name No. 8 (Hazelbank) No. 9 (Northover) No. 10 (Blythe Hill) No. II (Algernon) Acreage 280 220 280 160 No. of industrial premises 3 1 3 15 No. of commercial premises 42 46 130 125 No. of dwellings 3,123 3,226 2,586 1,981 No. of other premises 7 12 14 7 Present annual tonnage of bituminous coal to be replaced 4,000 4,000 3,300 2,700 Likely additional fuel required annually :— (a) Electricity (BTUs) 450,000 450,000 350,000 650,000 (b) Gas (therms) 85,000 85,000 70,000 47,000 (c) Oil, etc. Nil Nil Nil Nil (d) Solid smokeless fuel (tons) 3,000 3,000 2,500 2,025 Existing appliances requiring replacement or adaptation :— (a) Open fires 3,626 3,611 3,366 2,624 (b) Open fires with boilers 313 10 225 63 (c) Combination grates without boilers 7 2 20 51 (d) Combination grates with boilers 8 9 6 (e) Washboilers 1 6 7 5 (f) Domestic boilers 161 25 132 113 (g) Other appliances (free standing stoves, etc.) 104 31 95 100 Total estimated cost of works £48,325 £37,152 £57,333 £42,630 Date :— Order made 1.2.61 1.3.61 27.9.61 27.9.61 Order confirmed 12.6.61 19.7.61 31.1.62 31.1.62 Order operative 1.7.62 1.9.62 1.10.62 1.11.62 The progressive total (when these Orders are operative) will be 2,910 acres covering 27,638 dwellings. Programme As a result of the experience gained in the first few areas of the borough it was decided to 'bring forward the target dates for the remaining proposed Smoke Control Orders. The programme is now shortened from 1968 to 1965. This will be a difficult task, but the advantages of smoke control, and its potential saving of money on such things as clothes, curtains, paint and the fabric of buildings, to say nothing of the unassessable though considerable benefit to individual and communal health, make the attempt to shorten the time schedule well worth while. At the end of December 1961, the position in relation to areas which have been or still are the subject of smoke control action was as follows: — 26 Table 20 Area No. and name No. of dwellings Date of operation Remarks 1 Ladywell 1,409 1.9.59 2 Southend 2,827 1.11.59 3 Brook dale 1,155 1.9.60 4 Penerley 3,367 1.10.60 5 Glenbow... 2,059 1.9.60 6 Lewisham Park 3,716 1.8.61 7 Sandhurst 2,187 1.8.61 8 Hazelbank 3,123 1,7.62 9 Northover 3,226 1.9.62 10 Blythe Hill 2,586 1.10.62 11 Algernon 1,981 1.11.62 12 Brockley 3,910† — Under survey 13 Manor 6,235† - Under survey approximate The above deals with approximately 38,000 dwellings out of an estimated total of 71,000. Measurement of atmospheric pollution Table 21, on pages 28 and 29, gives a record of the principal results from six stations, and also gives some indication of the sunshine, rainfall etc. during the year. Some of these latter data are not specific to the borough, having been obtained from a publication of the Meteorological Office, and relate to the nearest station which records the particular item concerned. During the year, as a result of consideration of a report by the Department of Scientific and Industrial Research submitted to all cooperating authorities, the committee decided to review their own programme of atmospheric pollution measurements. As a result it was decided to dispense at the end of the year with two deposit gauge stations (at Forest Hill Cricket club and at Brockman Rise) and with a smoke station (at Downham Depot), and to add sulphur measurements to smoke measurements at Valentine Court and Paragon Place. During the year also, at the specific request of the D.S.I.R.'s atmospheric pollution division, the committee decided to cooperate in a further national survey being carried out by that body, and as a result a smoke and sulphur measuring station was set up in Downham, at Pendragon school. This commenced operating in September, and the results for the part year were as follows : September October November December Smoke, daily average 26 38 149 248 „ maximum (& date) 64 (8) 83 (31) 636 (17) 730 (22) „minimum (& date) 5 (21) 8 (10) 41 (2) 32 (5) SO„ daily average 85 92 227 292 maximum (& date) 213 (1) 214 (30) 833 (17) 804 (22) „ minimum (& date) 23 (29) 19 (9) 64 (2) 64 (5) 27 The smoke and sulphur dioxide are both measured in microgrammes per cubic metre. Since the above constitutes a major change in recording, it is thought that a review of the previous years' records may be appropriate. Accordingly the charts on pages 30 and 31 have been got out. Those on page 30 show the smoke records over the past seven years—highest, lowest and 1961 figures of (a) the monthly average and of (b) the extreme recordings in periods (of maybe one, two, three, or perhaps more days) during those months. Commentary. It will be seen from the charts showing the monthly average (left hand side of the page) that smoke in 1961 was, apart from a bad December, as low as it has been in the last seven years. In the south (Downham depot) in fact, it was below the previous minimum for most of the first half of the year. With regard to the highest and lowest readings in the months (right hand side of the page) it will be seen that the lowest readings are in the main the lowest for the seven years, while the highest readings (with the exception of November and December) are well within the previous highest for those years. In other words 1961, except for November and December, was a reasonably satisfactory year for smoke pollution in spite of the poor weather. The cold spell in December, however, blotted the copybook. The charts on page 31 show the deposit gauge records over the past nine years, and the highest, lowest and 1961 monthly figures for insoluble deposit, soluble deposit, and for sulphur. Commentary. It will be seen that with regard to insoluble deposit (mainly, grit, smuts, dust) Pool Allotments shows high maxima but quite satisfactory minima ; the 1961 line was mediumly placed. Verdant Lane shows lesser maxima, slightly lower minima, and, for 1961, again a medium amount. Wearside Road has an intermediate position with regard to maxima, and a low position for minima, the 1961 line being again medium. The Brockman Rise graph has more interest : it deals only with results over 3 years, but the 1961 figures show that for many of the months of 1961 the insoluble deposit was below the previous minima. December was exceptional. The gauge was placed in an area which became smoke-controlled in 1959. With regard to soluble deposits (a measure more of general pollution) there is not so much difference between the maxima and minima, nor between the various stations. Brockman Rise again however shows the lowest pollution for 1961, except again for the bad month of December. On the amount of sulphur deposited (which is some indication of the degree of general smoke and house congestion in the neighbourhood) the summer 'trough' is always obvious. Pool Allotments was quite satisfactory in 1961 and, in relation to previous years, so was Wearside Road. Brockman Rise again, except for the early part of the year, was low, but on the whole no lower than Verdant Lane. 28 Atmospheric Conditions Table January February March April May Temperature— Mean maximum1 °C 6.6 10.2 13.1 14.4 16.1 Mean minimum1 ... ... °C 2.8 6.1 4.4 7.8 8.3 Mean1 °C 4.7 8.1 8.7 11.1 12.2 Diff. from average1 nC -0.1 + 3.2 +2.0 + 1.8 -0.3 Highest maximum1 °C 10 16 20 20 24 Lowest minimum2 °C —2 —3 0 5 4 Rainfall— Total2 in. 1. 96 1 .85 0. 04 1.69 1.73 Percent of average1 IIS 139 9 III 52 Sunshine1 Daily mean hrs. 1 .73 2.36 5 53 3.39 7 .50 Percent of average I2S 110 152 68 119 Wind' NE/E/SE % 29 19 9 39 21 s/sw/w % S4 75 73 44 40 NW/N/Calm % 17 6 18 17 39 Atmospheric pollution— West Division3 : Water insol. matter tpm Water sol. matter tpm 9.94 3 .71 8 .98 5.41 7.37 2.92 10.34 6 .14 12.07 525 Sulphur 1.94 2.07 1 .54 1.22 0.78 3.0 Smoke, daily average 16.0 9.0 15.0 6.5 „ maximum 35.0 19.0 28.0 11.0 60 (date) (12.13) (23.24) (8.9) (18.19) (11-12) „ minimum 4.0 3.0 5.0 2.0 20 (date) (31) (31.1) (30) (20.21) (2-8) Mnrth Division4 ' . . Water insol. matter tpm 9 .74 6.56 9.60 11.42 10.78 Water sol. matter ... tpm 4 .31 6.63 3 .28 7.45 55.28 Sulphur 3.25 2.74 2.76 2.01 1.79 Smoke, daily average 12.0 9.0 12.0 5.5 3.0 „ maximum 37.0 20.0 26.0 13. 0 7.0 (12) (date) (12) (4) (8) (18) \ 1.0 minimum 6.0 5.0 5.0 (date) (29.30) (7) (30) (21.22) (2) Smith Division0 JUULII Wlr IjIWII . Water insol. matter tpm 11 .04 8.30 7.64 10.16 9 51 4..23 Water sol. matter tpm 3.75 6.08 3.53 5.6 0.95 Sulphur 1.07 1.11 1.11 0.76 U. 2.0 Smoke, daily average 7.0 6.0 7.0 4.0 4.0 lt maximum 29.0 13.0 17.0 7.0 4.0 (date) (12) (23) (8) (18) (25) NIL minimum 3.0 3.0 2.0 1.0 (date) (6) (9) (30) (20.21) (4) Weather summary Changeable Very mild, moist Mild, very dry Mild, dull and moist Dry, late frosts Notes : 'Kew ; ;Lewisham ; 'Valentine Court for smoke, Pool allotments for others, tpm : tons per square mile per month ; †as trioxide in mg per 100 sq. cms. per day 29 n 1961 21 June July August September October November December Average or actual (as applic.) 21.0 21.3 20.7 19 7 15 .0 9.5 6.3 14. 5 11.4 13.0 13.5 12.9 9.0 5.3 2.2 8.1 16.2 17.1 17.1 16 3 12.0 7.4 4.3 11.4 +0.5 —0.7 —0. 2 + 1.4 + 1.1 + 0.2 .0.8 + 0 7 29 34 30 27 21 16 14 34 (Jul. 2) 9 11 11 9 3 1 —4 —4 (Dec. 27) 1.30 0.83 0.20 1.69 3.19 2.52 2.60 17 6 81 49 103 117 86 81 I57 92 8.05 6.55 5.38 4.34 3.97 2.11 1 75 4.4 115 102 89 93 128 123 136 113 11 10 13 21 15 30 26 20 63 64 70 56 65 41 37 57 26 26 17 23 20 29 38 23 10.47 7.48 9. 83 7.65 6.95 11.22 9 66 9.33 5.52 2.91 3.78 5.25 6.13 6.88 801 5.16 0.57 0.63 0.73 0.82 0.78 1.75 2.00 1.24 2.0 2.0 1.3 3.0 5 .4 19.0 28 9.2 5.0 4.0 2.0 4.0 13.0 49.0 64 - (3-5) (6-7) (1-2) (2.4) (28-30) (16-17) (21.22) - 10 1.0 NIL 1.0 2.0 1.0 5.0 (8-9) (8-9) (26-28) (1) (7-11) (18-20) (5.6) — 8.07 6.30 - 5.39 6.90 9.25 8.12 8.38 4.68 2.78 - 5.97 7.71 8.91 9.37 6.03 1.25 1 05 0.97 1.26 1.59 2.73 3.42 2.07 2.0 1.7 1.4 2.3 3.4 13.0 23 7.4 7.0 3.0 2.0 6.0 9.0 38.0 81 - (2) (1) (1.3) (9) (31) (17) (22) 1.0 1.0 NIL 1.0 10 4.0 14.0 - (8) (4) (4) (12-13) (6.11) (14) (12) — 8.48 10.00 6.93 4.94 6.75 7.55 10.02 8.44 4.01 3.04 3.75 5.58 6.91 7.76 7.37 5.14 0.50 0.40 0.46 0.41 0.56 1.81 2 .28 0.95 2.0 1.5+ 1.1 1.8 2.5 11.0 28 6.2 3.0 3.0 2.0 3.0 6.0 44.0 73 - (2.5) (6) (2) (5) (28.30) (17) (21.22) - 1.0 1.0 2 / NIL 1.01 NIL 2.0 3 0 - (1) (4) (4) (1) (10) (2) (5) — Sunny, hirly dry Cloudy and cool; dry Cool and changeable Mild and changeable Changeable, fairly mild Sunny; mainly dry Cold, wet but sunny place for smoke, Wear side Road for others ; 'Downham Depot for smoke, Verdant Lane for others • mg per 100 cub. metres. 30 31 32 Home safety As a result of pressure by the Metropolitan Boroughs' Standing Joint Committee a clause was included in the LCC (General Powers) Bill of 1957 (which subsequently became an Act) under which metropolitan boroughs were given powers to deal to some extent with home safety. S.82 of the 1957 Act allows a borough council "for the purpose of promoting safety in the home and for encouraging the taking of proper precautions in preventing the occurrence of accidents therein" to make arrangements for the dissemination in the borough of information and advice relating to such matters. In 1961 the Home Safety Act was passed which repeals and re-enacts the above powers, and allows contributions to be made to voluntary committees and organisations carrying out home safety work. Before and after the passing of the Act, the Health department had arranged or carried out certain propaganda or educational efforts in connection with home safety. For example, home safety films have been shown to old people's clubs; various posters, leaflets and pamphlets have been displayed or made available to the public; the council subscribes to the Royal Society for the Prevention of Accidents, home safety section; health department leaflets have been printed and displayed; various suggestions have been made for home safety in the provision of housing; statistics on accidents in the home are collected or sought from hospitals. Furthermore a quarterly bulletin is issued to local clubs, organisations, doctors and dentists, so that it can be available to club members, those attending surgeries, and so on. Some 500 copies of each issue are distributed. The collection of home accident statistics is to some extent a longterm process and it is only by obtaining the knowledge and studying it and analysing it that one has a chance of showing different groups of accidents which may be more preventable than other groups, or certain localities which appear to be more accident-prone than others. It would of course be on those that any work of the department would be particularly brought to bear. It has been found impracticable to gather the necessary statistics, 'but some of a limited nature, based on County Council ambulance removals for 1961. are as follows: Table 22 Accidents Quarter of year Total 1st 2nd 3rd 4th 1961 1960 Total for London 2061 1995 2056 2319 8431 7947 Total for Div. 7 (Lewisham and Camberwell) 260 233 258 277 1028 980 Rate per 10,000 population London 6.5 6.2 6.4 7.3 26.5 24.9 Div. 7 6 .6 5.9 6.5 7.0 26.0 24.7 Falls total 1554 1539 1582 1781 6456 6140 on stairs 302 263 251 303 1119 1221 tripping 213 252 176 279 920 838 in garden 33 77 76 41 227 251 Knifelike wounds 69 78 105 85 337 321 Gassing 68 13 17 67 165 137 Burns and scalds 134 87 112 164 497 431 Poisoning (including foreign objects) 80 95 78 85 338 318 33 It will be seen that there are no separate figures for Lewisham, but based on the first four lines the approximate numbers for Lewisham, (below the horizontal line in the table) would be about one-sixteenth of those shown. It must be emphasised that these are only accidents sufficiently serious to require removal to hospital by ambulance. Old people General comments on the problems connected with the care of old people are made in the introduction of this report. The Council continued to make grants to organisations in the borough which are carrying out work for old people, whether by recreational facilities or by the provision of meals. A sum of £8,430 was eventually included in the annual estimates for the year 1961-62 for such organisations as accepted the Council's conditions and to assist any other such organisations as might be established during that year. Reports were made to the Public Health committee giving details of the work undertaken by the voluntary organisations and as a result grants were made as follows :— £ Lewisham Old People's Welfare Association 6,600 Lewisham Darby and Joan Club 420 St. Mark's Old Folks' Club 75 Hither Green Branch of the National Federation of Old Age Pensions Associations 68 St. Philip's Darby and Joan Club 30 The Over 60's Friendly Club 44 The Bellingham Community Association Darby and Joan Club 40 Lee Branch of the National Federation of Old Age Pensions Associations 44 Good Companions Club 18 St. Hilda's Seniors' Club 70 Blackheath Branch of the National Federation of Old Age Pensions Associations 24 September Club 34 Happy Old Folks' Club (St. Barnabas) 18 St. John's Over 60's Club 55 The Friendship Circle over 60's Club 50 Spring Hill Social Club, Darby and Joan Section 20 St. Barnabas Darby and Joan Club for Deaf and and Dumb 30 This left a sum of money available for new clubs which might qualify for grant, and three such clubs, the St. Cyprian's 61 Club (£45), The Saville Club (£115) and the Autumn Club (£36), were given the grants indicated for the part year. Additional grants were paid to nearly all the clubs as a help towards fares and towards the purchase of nutrients. It is hoped that such old people's organisations as can will not only provide the usual afternoon's recreation with a little tea, but will also make arrangements to provide lunch either on the day the club meets or another day. To this end the Lewisham Old People's Welfare Association is prepared to cooperate by conveying the meals in bulk from the kitchens, were they are obtained, to the luncheon club. 34 It has also been suggested to the clubs which do not already do it, that they might consider setting up handicraft classes for their members, this being thought to be in some ways a suitable alternative to the so-called "workshops for the elderly" which have been set up particularly in a few London boroughs. There are many difficulties with regard to starting such workshops in an outer London dormitory borough such as this, but these difficulties would not apply to handicraft classes and if the work turned out at such classes were good enough it would have saleable value of its own. Unfortunately most of the clubs found it impracticable to get sufficient of their members interested in the scheme to allow a qualified teacher to be obtained for them, but one or two clubs are still making efforts in this direction. The health department during the year continued to take a detailed interest in the work for old people generally and remained in the closest touch with the Lewisham Old People's Welfare Association (LOPWA), which Association has offices in the department. LOPWA is, so far as the borough council's work for old people's welfare is concerned, the main body in the area and has affiliated to it the various other bodies to which the Council makes grant. LOPWA is responsible for the meals-on-wheels service to housebound old people and to certain clubs, and during the year ended 31st March 1962, 38,269 meals were delivered. In addition the WVS delivered 6,066 in one area of the borough. The Saville The committee had for some time past been anxious to acquire premises which could be adapted for various services for old people, and even provide a comprehensive centre for such services. The search for premises however failed until the autumn of 1960 when a dance hall in Lewisham High Street, known as The Saville, came on the market. After inspection by officers and consideration by the committee the Council decided to purchase, and agreed terms were eventually reached. The premises comprised a large main hall with small stage, three other rooms on the ground floor and three rooms (including a bathroom) upstairs. There is a commodious cellar. Major alterations and decorations were made and the premises were officially opened by the Mayor, Councillor L. H. Moody, J.P., on October 7, 1961. Mrs. M. L. Shorten, appointed as Warden, had taken up her duties a little time previously. By the end of the year afternoon clubs, each with its own voluntary committee under the guidance of the Warden, had been opened on Wednesdays, Fridays, and Mondays. The two former became almost immediately "full" at about a membership of 80, and the Monday club was being built up. In addition two handicraft sections had been started, on Tuesday and Thursday mornings. All those attending the morning sessions or afternoon sessions are eligible to have lunch on the premises. Two of the ground-floor rooms of the premises were thrown into one and were fully equipped for the preparation of meals. This preparation is undertaken by LOPWA who have appointed a cook-manager and ancillary staff. Besides supplying the local club members, "mealson-wheels" are provided. The first meal service started on December 5, 1961. It is hoped to develop further the various activities at the premises, 35 for example, by sessions for the handicapped, but the premises are of course not purpose-built, and space is a limiting factor. The committee also intend to let the premises to outside organisations in the evenings, or at weekends, when they are not required for old people's welfare, and the terms and conditions of letting were under active consideration at the end of the year. There is no doubt that this pioneering effort in the interests of old people has got off to a successful start. The public health committee controls the premises, and a central voluntary committee, The Saville Club executive committee, was set up to receive grant from the Council, to make grants to the various sections, and generally to guide and coordinate (as a central body) the activities carried out at the premises for old people. The Council made an initial grant of £50 to the Club, and a maintenance grant of £65 for the remainder of the financial year. The voluntary committee consists of three members of the Public Health Committee (including the chairman, ex officio), a representative of LOPWA, a representative of the WVS, one representative from each of the individual clubs and sections using the premises, together with the medical officer of health, and the warden who acts as secretary. Appointments are for one year and cooption is permissible up to onethird of the basic members. Visiting of old people Three nurses (officially called Women Health Officers) are concerned with visiting old people and houses where there has been infectious disease. Their work for old people is tabulated as follows :— Table 23 W N S Total First visits 37 149 102 288 Futile visits 61 191 100 352 Revisits 479 1160 436 2075 Total 577 1500 638 2715 Facilities for the aged, generally The King Edward Hospital Fund committee set up to review the services for old people in this borough with a view to ascertaining whether any of such services should be strengthened or whether additional services were required, continued to meet during the year. Lewisham was chosen for two main reasons: first because although the services were in some respects (for example, a geriatric unit) less than in many other boroughs it was maintained by the hospital and other authorities that the old people were not prejudiced thereby; and secondly that Lewisham could be regarded as a fairly typical suburban area and that if anything was required here it might well be required elsewhere. 36 Besides representatives of the Fund, the committee includes representatives of the hospital management committee, the London County Council, local practitioners and LOPWA, and I represent the borough council. The committee decided to carry out a partial house-to-house survey of the borough through a government agency. After a pilot survey, in which the health department officers gave great help, the main survey was carried out in the late spring of 1961. Tabulated results were not available to the committee until the early part of 1962 and the committee hopes to issue its report during the current year. 37 SECTION C —SANITARY CIRCUMSTANCES OF THE AREA The following table gives a summary of the inspections, etc., carried out by the public health inspectors during the year:— Table 24 Reason for inspection West North South Total On complaint 549 504 231 1,284 House to house — 116 108 224 Improvement grants 110 110 50 270 Houses let in lodgings 10 6 — 16 Rent Acts 27 18 21 66 Other Housing Act visits 538 603 269 1,410 Notice from builder 584 291 178 1,053 Infectious diseases 12 5 6 23 Infestation 114 134 58 306 Factories, mechanical 42 48 56 146 Factories, non-mechanical 10 1 11 Outworkers ... ... 90 56 47 193 National Assistance Act, S47 4 4 2 10 Smoke observations 35 53 24 112 Clean air inspections 2,873 5,136 3,206 11,215 Keeping of animals 19 16 14 49 Water certificates 50 54 4 108 Fireguards 38 7 1 46 Crash helmets 20 1 21 Hairdressers 32 2 2 36 Pharmacy and poisons 59 41 7 107 Milk shops 47 18 42 107 Icecream premises 156 47 55 258 Restaurants and eating houses 103 50 131 284 Bakehouses 26 6 32 Other food shops 407 120 426 953 Other shops 11 20 8 39 Food inspections 102 95 914 1,111 Sampling 231 94 218 543 Markets and stalls 18 168 91 277 Slaughterhouses — 11 — 11 Futile visits 4,367 3,785 2,040 10,192 All other matters 1,415 1,346 941 3,702 Revisits 5,858 5,321 3,558 14,737 Total — all inspectors 17,957 18,287 12,708 48,952 Smoke abatement Observations 112 Intimations served — Complaints received 7 Statutory notices served — Legal proceedings — Convictions — 38 Summary of notices served Table 25 West North South Total Intimation notices :— Public Health (London) Act, 1936 176 217 120 513 Factories Act, 1937 — 7 3 10 Informal intimations under Housing Act, 1957 — 2 — 2 Total intimations 176 226 123 525 Statutory notices :— Public Health (London) Act, 1936 111 133 58 302 Factories Act, 1937 — 1 1 Clean Air Act, 1956* — 455 331 786 Housing Act, 1957 8 3 — 11 Byelaws 34 13 30 77 Total statutory notices 153 605 419 1177 ♦The vast majority of these were for late applications (those received later than a month before the Orders became operative) and were served to safeguard Ministry and Borough Council grant. Nuisances remedied Table 26 Nuisance West North South Total Wall and ceiling plaster repaired 138 208 36 382 Roofs repaired 45 55 30 130 Dampness remedied... 181 191 72 444 Brickwork repaired 5 47 6 58 Chimneys repaired 2 6 3 11 Drains cleared 20 28 1 49 Drains repaired 5 10 3 18 Drinking water cisterns repaired — — — — Dustbins supplied 8 1 — 9 Doors and door frames repaired or renewed 15 38 18 71 Flushing cisterns repaired, renewed or cleansed 12 21 2 35 Flush pipes repaired or renewed 2 — — 2 Firegrates, etc., repaired or renewed 5 36 11 52 Flooring repaired or renewed 37 96 16 149 Dry rot remedied 12 15 6 33 Gullies renewed, repaired or cleansed 9 9 3 21 Gutters repaired 36 48 18 102 Refuse cleared 1 5 1 7 Rainwater pipes repaired 12 12 6 30 Soil pipes repaired, ventilated or renewed 9 6 9 24 Sinks provided 7 12 6 25 Sashcords renewed 39 60 22 121 Water closets repaired or renewed 26 28 6 60 Walls and ceilings cleansed... 6 22 3 31 Windows and frames repaired or renewed 14 61 15 90 Water service pipes repaired or renewed, water supply restored 10 8 3 21 Yards and areas paved 2 17 4 23 Glazing 1 23 5 29 Painting 1 16 5 22 Other nuisances remedied 12 55 17 84 TOTALS 672 1134 327 2133 39 Heating Appliances (Fireguards) Act, 1952 The public health inspectors are authorised for the purposes of inspection and testing of heating appliances under the Act. 46 inspections were made during the year. During the year the Act was repealed and virtually re-enactcd by the Consumer Protection Act, 1961. Registration of hairdressers Under s.18 of the London County Council (General Powers) Act, 1954, no person may carry on the business of a hairdresser or barber on any premises in a borough unless he and those premises are registered by the borough council. Exceptions are for premises which are visited only by appointment with a customer, and for a person who in effect is doing hairdressing on his own premises part-time and who does not employ any other person to assist him. Registration in the first place is automatic on application, and a register is kept for the purpose. By the end of the year 158 persons were registered. Byelaws governing the conduct of these establishments, designed to ensure cleanliness of the person, equipment and premises, came into force on December 1, 1955. The standard of hygiene in those visited up to the end of the year was good. Pet Animals Act, 1951 During the year 20 premises were licensed as pet shops. In the main, the sale of pets at these premises consists of cage birds and tropical and coldwater fish. In general it has been found that pets are kept for sale under conditions which do not call for any particular comment and in no case has it been found necessary to attach special conditions to any licence which has been issued. A report by a veterinary surgeon was obtained in one case after complaints had been received. Water certificates Under the provisions of section 95 of the Public Health (London) Act, 1936, an occupied house without a proper and sufficient water supply is a nuisance and if a dwelling-house, is unfit for human habitation. Further it is not lawful to occupy a house as a dwellinghouse, subject to certain provisos, until the sanitary authority has certified that it has a proper and sufficient supply of water. Certificates were issued in respect of 152 premises and 9 blocks of flats certifying that under the provisions of the Public Health (London) Act, 1936, a proper and sufficient supply of water had been provided. Factories Section 7 of the Factories Act, 1937, requiring the provision of sufficient and suitable sanitary conveniences is enforced by the council in all factories, whether mechanical power is used in the factory or not. The provisions of sections, 1, 2, 3, 4 and 6 relating to cleanliness, overcrowding, the maintenance of a reasonable temperature, the securing of adequate ventilation of workrooms and the furnishing of adequate 40 means for draining floors where wet processes are carried on, are enforced by the council in factories in which mechanical power is not used. The provisions of section 7 are also applied to certain building operations and works of engineering construction, etc. A local authority is required to keep a register of factories with respect to which it is responsible for the enforcement of any of the provisions mentioned above. Close cooperation is maintained with HM Inspectors of Factories in that any defaults found by them during the course of their visits and for which it is the duty of the local authority to secure that remedial measures are taken, are notified to the health department. Similarly the public health inspectors notify HM Inspectors of any contraventions of the provisions of the Act which come within their jurisdiction. HM Inspectors also forward to the health department details relating to the establishment of new factories, the introduction of mechanical power and other information which may come to their notice and which appears to affect factories subject to the control of the local authority. Special attention is paid to factories which provide canteens. These factories are visited by the council's food inspectors and the opportunity is taken to discuss with the canteen staff the various requirements needed to maintain a good standard in food hygiene. The medical officer of health is required in his annual report to the local authority to report specifically on the administration of, and furnish prescribed particulars with respect to, the matters under part I (factories) and part VIII (outworkers) which are administered by the local authority. Details follow :— Inspections Table 27 Premises Number on register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which sections 1, 2, 3, 4 and 6 are to be enforced by local authorities 54 11 - - (ii) Factories not included in (i) in which section 7 is enforced by the local authority 461 146 11 - (iil) Other premises in which section 7 is enforced by the local authority (excluding outworkers' premises) 28 28 — — TOTAL 543 185 11 — 41 Cases in which defects were found Table 28 Defects No. of defects cutions instituted Found Remedied Referred To HM Inspector By HM Inspector Want of cleanliness (S 1) 1 1 Overcrowding (S 2) — — — — - Unreasonable temperature (S 3) - - - - - Inadequate ventilation (S 4) — - — — - Ineffective drainage of floors (S 6) - _ - - - Sanitary conveniences (S 7) : (a) insufficient — - — — - (b) unsuitable or defective 1 3 — 2 - (c) not separate for sexes — — — — - Other offences against the Act (not including offences relating to outwork) 1 1 1 TOTAL 2 5 1 3 — Outworkers Under section 110 of the Factories Act, 1937 the occupier of every factory and every contractor employed by him must keep lists showing the names and addresses of all outworkers directly employed by him and of the places where they are employed, and must send to the district council in February and in August of each year, copies of those lists showing all outworkers so employed by him during the preceding six months. Section 111 of the same Act empowers the district council by notice in writing to the occupier of a factory or to any contractor employed by him to prohibit the employment of any persons as home workers in premises which the council regard as injurious or dangerous to health. The Home Work Order, 1911, specified the kinds of work to which these two sections apply. The types of work consist mainly of wearing apparel and textiles, the making of paper bags, boxes, brushes, baskets, artificial flowers, metal fittings, etc. The following is a list of occupations concerned: Trade Outworkers employed Clothing 164 Lampshades 3 Box making 11 Paper bags 1 Firework cases 1 Artificial jewellery 1 Cherry sticks 2 Artificial flowers 2 Soft furnishings 1 Stuffed toys 2 Wirework for deaf aids. 1 Millinery 3 Button making 1 193 42 It will be noted that none of the outworkers are employed in food. Outworking in food ceased to be legal in July, 1956 as a result of the Food Hygiene Regulations, 1955, onions and shrimps being temporary exceptions. The inspectors made 193 visits during the year which included some to places in which no work was being done at the time of the visit, although the outworkers were prepared to restart work when required. Reports were submitted to the Council setting out the position with regard to outworkers in the borough. No adverse comments were made. Rag Flock and Other Filling Materials Act, 1951 This Act came into force on November 1, 1951, and repealed the Rag Flock Acts, 1911 and 1928 and section 136 of the Public Health (London) Act, 1936. The Act is designed to secure the use of clean filling materials in upholstered articles and other articles which are stuffed or lined. Five premises are registered for the use of filling materials for upholstery purposes, one of these being also registered for storage. Samples of these materials proved satisfactory on examination. Destruction of pigeons The public, which still seems divided on whether pigeons should be destroyed or encouraged, provided bread and other food for the birds in different parts of the borough. The pigeons come to feed regularly during the day but their roosting places are not always easy to locate. Many complaints referred to woodpigeons, and damage to crops in gardens and allotments was reported. In April it was decided to advertise for a part-time pigeon catcher to be employed during the breeding season (normally March to the end of September). A few applications were received and the successful applicant commenced duties on 23 May. He puts in a monthly report, and by the end of the season (four months) he had reported that he had disposed of 883 pigeons, 117 eggs and 65 nests. In addition he had killed 16 rabbits and a fox. Sanitary work generally Mr. Phillips, the senior public health inspector, reports : "The total number of inspections shows a slight reduction on the previous year. The number of complaints was considerably less but the houseto-house figures were almost identical and no doubt helped to maintain the number of notices served at a similar level to 1960. The visits under the Housing Acts fell, due mainly to an unfortunate reduction in applications for improvement grants which if used on a wider scale could do a great deal to improve living standards in many houses in the Borough. The number of certificates applied for under the Rent Act continued the downward trend. This was also noticeable in the number of outworkers visited. A great deal of the inspectors' time has been taken up with the Clean Air Act. The survey of properties to be included in areas continued but many inspections were also carried out to advise on the necessary alterations of grates, to supervise the work in progress and finally to approve the alterations when completed. Observation of premises in smoke control areas was continued and accounted for a similar number of visits as last year. In all the areas it was found that the public was continuing to respond well to the requirements of the Clean Air Act." 43 SECTION D —HOUSING Building The following 207 new dwellings were completed by the Council during the year :— Greystead Road 65 Knapdale Close 40 Dacres Road ... 12 Elsinore Road 30 Springbank Road 2 Silverdale 52 Dacre Park 6 Families rehoused for first time During the year the following families were rehoused :— 1. By the Lewisham Borough Council:— (a) in permanent properties 279 (b) in temporary bungalows 7 286 2. By the London County Council (figures supplied by district offices) . 30 316 N.B. — Number of families where points had been awarded for bedroom deficiency, rehoused by the Lewisham Borough Council or the London County Council during the year . 235 Housing Act, 1957 Repair of houses (sections 9 and 10) During the year 2 informal and 11 formal notices were served. 8 properties were repaired by the owners after service of notices ; in no case was work done by the Council in default (section 10). Demolition Orders and Closing Orders (whole house) The following is a list of cases involving procedure for demolition orders or for complete closure of houses which originated in or were complied with during 1961, together with the present position of cases originating in previous years which had not been complied with at the end of 1960 44 Table 29 Properties Dwellings involved Present position 1 Slaithwaite Road 1 Demolition order made 3 Slaithwaite Road 1 Demolition order made 56 Summer Field Street 1 Closing order on whole house 371, 373 Stanstead Road 2 Demolition order made 375 Stanstead Road 1 Demolition order made 27 Taunton Road 1 Closing order on whole house 47 Molesworth Street 1 Closing order on whole house 56 Molesworth Street 1 Works completed Graham Cottage, Morden Lane 1 Offer of works accepted 64 Knowles Hill Crescent 1 Demolition order made 15 Claremont Terrace 1 Demolition order made 42 Oakcroft Road 1 Offer of works accepted 73 Mayow Road 1 Demolition order made 60 Knowles Hill Crescent 1 Notices served 62 Knowles Hill Crescent 1 Notices served 6 Drysdale Road 1 Closing order on whole house 51 Mount Pleasant Road 1 Works completed. Order determined. 8 Elthruda Road 1 Order determined 66 Knowles Hill Crescent 1 Demolition order made Closing Orders in respect of part of house Table 30 Properties Part of house Present position 21a Mount Pleasant Road Basement flat, 2 rooms and scullery Works completed 75 Summerfield Street Two rooms, scullery, w.c. Order made 36 Leyland Road Three rooms, scullery, wash-house, bathroom, in semi-basement Undertaking given that rooms will not be used for habitation 34 Morden Hill Two basement rooms Order made 96 Loampit Vale Ground floor back room, 2 rooms first floor Order made 65 Summerfield Street Two rooms and kitchen first floor Order made 269 Stanstead Road Two rooms in basement Notices served 85 Perry Vale Semi-basement rooms Notices served 31 Devonshire Road Two rooms and kitchen basement Notices served 45 Table 30—cont. Properties Part of house Present position 20 Elthruda Road Three rooms, scullery, w.c., in ground floor flat Order determined 7 Mayow Road Two rooms, scullery, boxroom and w.c. in basement Order made 154 Lewisham Road Two rooms and scullery in basement Order made 59 Summerfield Street Two rooms, scullery and w.c., in ground floor Order made 345 Baring Road Bedroom and living room in basement Order to be varied to allow rooms to be used for storage of furniture. 25 Mount Pleasant Road Two rooms, scullery and w.c., in semi-basement Order determined 20 Blackheath Grove Two rooms in basement Order determined 8 Holbeach Road Two rooms on first floor and rear room and scullery ground floor Order to be varied to permit rear portion of rooms to be used for storage of flowers 4 Somerset Gardens Two rooms and w.c., in basement Order determined 42 Manor Park Three rooms, scullery and w.c., in semi-basement Order determined 25 Devonshire Road Two rooms, scullery, passage,semi-basement Order determined 27 Devonshire Road Two rooms, scullery, passage, semi-basement Order determined 83a Perry Hill Two main rooms and scullery in basement Order determined 4 St. Germains Villas, Silk Mills Path Two basement rooms Order determined 46 Table 31 HOUSES IN CLEARANCE AREAS AND UNFIT HOUSES ELSEWHERE A —HOUSES DEMOLISHED Clearance areas (Housing Act, 1957) Houses Displaced Persons Families Houses unfit for human habitation 16 13 6 Houses included by reason of bad arrangement 6 18 5 Houses or land acquired under s.43 12 — - Not in clearance areas Formal or informal procedure under s. 17 (1) 14 21 8 Local authority houses certified unfit by medical officer of health — — — B —UNFIT HOUSES CLOSED (Housing Act, 1957) ss 16, 17 and 35 6 28 10 ss 17(3) and 26 - - - Parts of buildings closed under s.18 8 10 5 C —UNFIT HOUSES MADE FIT AND HOUSES IN WHICH DEFECTS WERE REMEDIED By owner By Local Authority After informal action by local authority ... 15 - After formal notice under Public Health Acts After formal notice under Housing Act, 1957 16 Under s.24 Housing Act, 1957 D — UNFIT HOUSES IN TEMPORARY USE (Housing Act, 1957) Houses Separate dwellings Retained for temporary accommodation under ss. 17, 46 and 48 Licensed for temporary occupation under ss. 34 or 53 — — E —PURCHASE OF HOUSES BY AGREEMENT Houses Occupants Houses in Clearance Areas other than those included in confirmed Clearance Orders or Compulsory Purchase Orders — — 47 Rent Act 1957 The following table shows the applications for certificates of disrepair dealt with during the year 1961, and for the whole period. Table 32 1961 1957-61 Applications for certificates 34 1091 Decisions not to issue certificates 1 21 Decisions to issue certificates (a) in respect of some but not all the defects 24 655 (b) in respect of all defects 14 388 Undertakings given by landlords to repair 22 501 Undertakings refused for special reasons — — Certificates of disrepair issued 21 520 Applications by landlords for cancellation of certificates 24 332 Objections by tenants to cancellation 7 112 Decisions to cancel in spite of tenants' objection 1 21 Certificates cancelled 22 235 House Purchase Loans 839 properties, a record number, were surveyed and' reported on by the inspectors during the year for house purchase loans made by the Council. In many of these cases schedules of work were agreed and the repairs supervised and approved in order to make the premises "in all respects fit for habitation" as required by s.43 of the Housing (Financial Provisions) Act 1958 under which loans are made. Discretionary Grants and Standard Grants Standard grants—given for the establishment of certain facilities otherwise lacking—are equivalent to 50 percent of the cost, with maxima of £25 for a bath or shower, £5 for a wash-hand basin, £75 for a hot water supply, £40 for a w.c. and £10 for a food store. The largest possible grant is therefore £155. These grants are made under the House Purchase and Housing Act, 1959, and during the year 59 applications were investigated and reported on. Discretionary grants are available for a wide range of improvements, including conversions to self-contained dwellings, to enable houses to be modernised and brought up to a " twelve point " standard. They are paid solely at the discretion of the Council, have a maximum of £400 for each dwelling, and are made under the Housing (Financial Provisions) Act, 1958. During the year 62 applications were investigated and reported on. Moveable dwellings During the year the overall position in London as far as homeless families were concerned became even more acute and in an effort to ameliorate this, the County Council decided to set up prefabricated moveable dwellings on various vacant sites. These dwellings will be connected to the main services (water, electricity and drainage) and they, and their surroundings will have to conform to regulations unofficially agreed between the metropolitan boroughs. No sites had been licensed in Lewisham by the end of the year, but it is expected that applications will be made in 1962. 48 On housing work generally, Mr. Brittain, the group housing inspector states: "An important feature of the year was the passing of the Housing Act 1961 which came into force in November and gives much wider powers than existed previously for dealing with houses in multiple occupation. Its provisions include powers to apply a code of management (specified in regulations) to ensure proper maintenance of such houses found to be in an unsatisfactory state, and to require additional amenities where necessary including personal washing facilities. The Act also amended the House Purchase and Housing Act 1959 so that, where improvements are made with the aid of a standard grant, the water closet must now wherever practicable be internal. This brings the two forms of grant into line with regard to this amenity. The interest in discretionary grants declined somewhat compared with 1960, especially during the last quarter of the year while, on the other hand, there was a small increase in the number of applications for standard grants. The latter form of grant enables the owner of a house which has some of the necessary amenities to obtain assistance in providing the remainder however small the cost, whereas the discretionary grant requires that the work shall cost at least £100. Both forms of grant require that any repairs that are necessary to make the house fit shall be carried out, the requirements being more stringent in the case of discretionary grants. The majority of applications come from owneroccupiers, but now that the permissible rent increase for improvements has been raised from 8% to 12½%, more owners of tenanted property may be encouraged to take advantage of the scheme. Although it was necessary to make demolition or closing orders on a number of properties, on the credit side 13 houses or parts of houses, subject to orders issued between 1953 and 1961, were made fit, so recovering useful units of accommodation.” 49 SECTION E— INSPECTION AND SUPERVISION OF FOOD MILK The Milk and Dairies (General) Regulations, 1959 These Regulations re-enacted with amendments the Milk and Dairies Regulations, 1949 to 1954. At the end of the year there were 120 persons registered for the distribution of milk from premises within the borough. There are no premises in the borough used as dairies. Milk (Special Designations) Licences Licences, to expire on December 31, 1965, were issued during the year as follows :— for sale of pasteurised milk ... 10S „ sale of tuberculin tested milk ... 84 „ sale of sterilised milk 116 Examination of heat-treated milk 69 samples of pasteurised milk and 12 samples of tuberculin tested (pasteurised) milk were submitted for examination during the year and all were found to be satisfactory. Analysis of milk During the year under review, 42 samples of milk were submitted for examination to the public analyst by the Council's inspectors ; all were found to be genuine. The average composition of the samples is set out in the following table :— Table 33 Period Samples Average composition of sampl Percentage of es examined Milk fat Solids not fat Water First quarter 12 3 35 886 87 79 Second quarter 14 3-36 8-85 87-79 Third quarter 5 3-58 8 74 87-68 Fourth quarter 11 357 8-78 87-65 TOTALS 42 3-47 881 87-73 The legal standard is 3.0 percent milk fat and 8.5 percent solids not fat. 50 ICECREAM Food Standards (Icecream) Regulations 1959, Labelling of Food (Amendment) Regulations 1959 The composition and labelling of icecream was altered from April 1959, new regulations under the above headings coming into operation then. The 45 samples submitted to the public analyst were found to have the composition shown in the appended table :— Table 34 Period Samples Average percentage composition Fat Milk solidsnot fat Water First quarter 10 10-2 10-8 79 0 Second quarter 11 9 4 109 79-7 Third quarter 18 9-5 9-6 80-9 Fourth quarter 6 9-2 10 3 80S TOTALS 45 9 6 10-4 800 Grading Icecream is submitted to the Public Health Laboratory for bacteriological examination. The icecream is graded according to the time taken to decolorise a dye, methylene blue. The test is a provisional one and because of the many factors which govern the hygienic quality of icecream it is recommended officially that judgment should be based on a series of samples and that too much attention should not be paid to the result of an individual sample. It is suggested that over a six-monthly period, at least 50 percent of a vendor's samples should fall into grade 1, 80 percent into grades 1 or 2, not more than 20 percent into grade 3 and none into grade 4. During the year 99 samples of icecream were submitted for bacteriological examination with the following results :— Table 35 Grading Samples submitted °/ /o Grade 1 71 72 Grade II 11 II Grade III 9 9 Grade IV 8 8 TOTAL 99 100 In general, grades I and II are satisfactory, while grades III and IV may indicate some defect in manufacture, handling or storage. Such cases are followed up and advice is given. 51 FOOD GENERALLY Adulteration of food The number of samples taken during the year under the Food and Drugs Act was 576 ; of these, 28 were formal and 548 informal. After examination the public analyst reported that 1 of the formal samples and 19 of the informal samples were adulterated or below standard ; the percentage of adulteration amounted to 3.6 in the formal samples, 3.5 in the informal samples, and to 3.5 of all the samples submitted, compared with 2.4 in the previous year. Samples analysed Table 36 Articles Examined Adulterated Formal informal Total Formal Informal Total Beverages 1 29 30 - 4 4 Bread, biscuits, cake flour 2 21 23 - - - Colouring matter - 2 2 - 1 1 Drugs - 18 18 - - - Fats, cheese 1 53 54 - 1 1 Fish 2 14 16 - 1 1 Flavourings and condiments 1 116 117 - 1 1 Fruit, nuts - 30 30 - 1 1 Icecream 2 45 47 - - - Jams, pastes, etc. - 22 22 - - - Meats and preserved meats 1 56 57 - 3 3 Milk 9 42 51 1 1 2 Sausages 5 10 15 - - - Vegetables and cereals. - 39 39 - 4 4 Miscellaneous 4 51 55 - 2 2 TOTALS 28 548 576 1 19 20 Non-genuine samples Table 37 Article Formal or informal Adulteration or irregularity Action taken or result of proceedings Bubble gum Informal Contained non-permitted dyestuff Under consideration Candy beads Informal Contained non-permitted dyestuff ditto Lemon juice Informal Contained an excessive amount of lead Inside soldered seam of can showed considerable signs of attack from juice which may indicate that sample was of considerable age or that lacquer of can was fractured. No further action. 52 Table 37—cont. Article Formal or informal Adulteration or irregularity Action taken or result of proceedings Ground almonds Informal Deficient in almond oil and incorrectly labelled Formal sample to be taken. Milk Informal Deficient in fat Further sample taken and found to be satisfactory. Hot milk Formal Contained added water Legal proceedings instituted, but case withdrawn on a technicality Foam crystals Informal Ingredients contained saponin a potentially dangerous substance On advice taken some years ago, the minute quantity of saponin present need not be objected to Minced beef Informal Contained preservative Warning letter sent Minced beef Informal Contained preservative Warning letter sent Minced beef Informal Contained preservative Warning letter sent Buttered kipper fillets Informal Label did not bear list of ingredients Manufacturers asked to consider alteration of label Instant mashed potato Informal Statement on label incorrect Manufacturers' explanation accepted Glace cherries Informal Container bore no trade mark nor name of packer or labeller Unable to take formal sample-line discontinued Tomato Frizets Informal One Ingredient missed from declared list Manufacturers' explanation accepted Rum butter Informal Contained insufficient proof spirit to justify description No further stocks Tomato puree condensed Informal Misleading label Awaiting further information from public analyst Apple green colour Informal Sample wrongly labelled Accidental fixing of wrong label Italian tomato puree extra Informal Misleading label Awaiting further information from public analyst Golden ginger and rum flavour Informal Misleading label Manufacturer notified Port flavour Informal Misleading label Manufacturer notified 53 Other samples In addition to samples submitted to the public analyst or bacteriologist for routine sampling, the following were submitted for various reasons, but mainly because of complaints received or as a result of enquiries made into cases of food poisoning :— Sweet necklace Non-alcoholic drink Bubble gum (5) Limeade Bread (3) Lolly Steak & kidney pudding Milk bottle Stout Sausage Malted milk Corned beef Meringue Salami Corned sliced ham Cooked chicken with stuffing Coconut mallow creams Lettuce Shredded wheat Frozen egg white Chocolate coconut ice Sterilised cream Registration of food premises During the year the following were registered, the total (including previous registrations) being shown in the last column. Type 1961 Total Sale and storage of icecream 19 347 Manufacture of icecream - 4 Fish frying 1 32 Fish curing - 20 Preparation or manufacture of sausages - 74 Preparation or manufacture of potted, pressed, pickled or preserved food 9 146 Unsound food Approximately 14 tons of food were surrendered as unfit for human consumption. This was dealt with by the Council's food inspectors and consisted of meat, fruit pulp, fish, vegetables etc. Shops Act, 1950 — section 38 No certificates of exemption in respect of sanitary conveniences were issued during the year. Under s.38 of the Shops Act, 1950, we already had powers and duties with regard to ventilation, temperature and sanitary conveniences in shops. Under s.18 of the L.C.C. (General Powers) Act, 1958, additional powers and duties under s.38 came to us on 1 January 1959, and these were to do with lighting, with washing facilities and with facilities for the taking of meals. Details were set out in the 1959 annual report, exemption certificates were issued during the year. Food Hygiene Regulations, 1960 Regulations 15 and 16 require the provision of a water supply and wash hand basin on all food premises. No certificates of exemption were issued during the year. 54 Pharmacy and Poisons The names of 20 persons were entered on the Council's list of persons entitled to sell poisons in Part II of the poisons list and the names of 167 persons previously registered were retained on the register. 107 visits were paid by the food inspectors in connection with the granting and renewal of these licences. Slaughterhouses and slaughtermen There are no slaughterhouses in the Borough. 2 slaughtermen's licences were issued during the year. Offensive trades There are no offensive trades carried on in the borough. Continental Goods Depot, Hither Green A very large British Railways Depot for dealing with continental goods traffic is at Hither Green and was opened in October, 1960. The major part of the material passing through it is similar to that previously handled at Southwark. We are concerned insofar as unfit food may be present, in which case we have to ensure that it is either destroyed or not used for human consumption. It may be necessary to contact wholesalers and various local authorities if it is intended for distribution elsewhere. Although the proportion of unfit food is small (there was none last year) the large amount of material handled through the depot throws considerable extra work on the food inspectors concerned. Totals for the year are shown in the table :— Table 38 Country of origin Tonnage imported Amount unfit, and remarks Spain 87,255 - Italy 34,687 - France 27,445 - Belgium 699 - Yugoslavia 10,357 - Hungary 214 - Roumania 57 - Morocco 40 - Israel 202 - Algeria 4,189 - U.S.A 138 - Canary Islands 937 - Denmark 55 - Brazil 160 - Egypt 8 - Total 166,443 - 55 Food hygiene The Food Hygiene Regulations 1955, which at the time they were made marked a considerable advance in the control of the manufacture and sale of food products, were consolidated and amended by the Food Hygiene (General) Regulations 1960. One major change was that the person carrying on a food business is principally responsible for securing compliance with the regulations, but a manager or foreman is also required to take all reasonable steps to secure compliance by the food handlers under his control. In general the regulations lay down requirements in respect of 1 the cleanliness of premises, ships, stalls, vehicles, etc., used for the purposes of the food business and of apparatus and equipment used for those purposes ; 2 the hygienic handling of food ; 3 the cleanliness of persons engaged in the handling of food and of their clothing, and the action to be taken where they suffer from or are the carriers of certain infections liable to cause food poisoning ; 4 the construction of premises and ships used for the purposes of a food business and the repair and maintenance of such premises and ships and of stalls, vehicles, etc.; 5 sanitary conveniences and the provision of a water supply and washing facilities ; 6 the temperatures at which certain foods which are particularly liable to transmit disease are to be kept on catering premises. 56 SECTION F—PREVALENCE OF and CONTROL OVER INFECTIOUS AND OTHER DISEASES Notifiable Diseases The undermentioned diseases are notifiable by medical practitioners to the Medical Officer of Health :— Anthrax Plague Cholera Pneumonia, acute influenzal Diphtheria Pneumonia, acute primary Dysentery (bacillary or amoebic) Poliomyelitis, acute Encephalitis, acute Puerperal pyrexia Enteric fever Relapsing fever Erysipelas Scabies Food poisoning Scarlet fever Malaria Smallpox Measles Tuberculosis, all forms Membranous croup Typhoid fever, including paratyphoid Meningococcal infection Typhus fever Ophthalmia neonatorum Whooping cough Number of Notified Cases (corrected for revised diagnosis) during the year 1961 with comparative figures for the previous six years. Table 39 Diseases Cases notified 1961 1960 1959 1958 1957 1956 1955 Diphtheria - - - - - - 1 96 367 233 214 129 579 92 Dysentery 1 - - 1 2 2 - Encephalitis (acute) 2 - 6 4 2 3 1 Enteric or typhoid fever 14 20 16 13 15 20 26 Erysipelas 26 31 49 27 42 46 48 Food poisoning - 2 - - - - 1 Malaria 4278 262 2613 835 2728 206 3905 Meningococcal infection 5 8 3 3 4 9 4 Ophthalmia neonatorum - 1 1 1 2 2 4 Pneumonia 62 33 108 61 96 89 121 Poliomyelitis (acute) - 2 6 2 15 26 63 Puerperal pyrexia 46 78 48 59 93 57 92 Scabies 8 9 9 9 18 29 18 Scabies fever 94 172 303 210 143 188 158 Tuberculosis 123 134 143 236 247 212 271 Whooping cough 65 333 229 154 225 241 412 TOTALS 4820 1452 3767 1829 3761 1709 5217 57 Notifications of infectious diseases in 1961 showing sex and age groups Table 40 Diseases Under 1 1- 3- 5- 10- 15- 25- 45- 65 + Total M F M F M F M F M F M F M F M F M F M F Dysentery 2 3 13 13 4 4 10 2 3 6 4 10 3 10 5 3 1 45 51 Encephalitis - - - - - - - - 1 - - - - - - - - - 1 - Erysipelas - - - - - - - - - - - 1 - 4 - 5 2 2 2 12 Food poisoning 1 - 1 - 1 - 4 - - 1 4 2 2 6 2 - 1 1 16 10 Measles 57 58 516 511 539 555 971 959 40 35 11 13 5 8 - - - - 2139 2139 Meningococcal infection - 3 - - - - - - - - 2 - - - - - - - 2 3 Paratyphoid fever - - - - - - - - - - - - - - - - - - 1 1 Pneumonia 2 - - 1 - - 3 - 2 - 1 1 3 7 17 7 10 8 38 24 Puerperal pyrexia - - - - - - - - - 1 - 14 - 31 - - - - - 46 Scabies - - 2 - 1 1 1 - - 2 - - - 1 - - - - 4 4 Scarlet fever - - 5 3 7 8 29 31 4 3 4 - - - - - - - 49 45 Tuberculosis (respiratory) - - 1 1 - 1 1 4 1 - 11 10 19 15 26 8 12 3 71 42 Tuberculosis (non-respiratory) - - - - - - 1 1 - - - 1 2 2 2 1 - - 5 5 Whooping cough 4 5 1 6 7 16 10 15 1 - - - - - - - - - 23 42 Totals 66 69 539 535 559 585 1030 1012 53 48 37 53 34 84 52 24 26 14 2396 2424 58 Analysis of certain diseases in table 40 into divisional areas— Table 41 Disease Div. areas Under 1 1- 3- 5- 10- 15- 25- 45- 65+ Total Dysentery W 1 6 2 2 3 3 7 2 - 26 N 1 7 1 4 2 2 1 1 - 19 S 3 13 5 6 4 9 5 5 1 51 Total 5 26 8 12 9 14 13 8 1 96 Measles W 24 317 344 548 16 6 3 - - 1258 N 47 412 379 692 22 13 7 - - 1572 S 44 298 371 690 37 5 3 - - 1448 Total 115 1027 1094 1930 75 24 13 - - 4278 Pneumonia W 1 - - _ - - 3 6 4 14 N 1 1 - 1 - 2 2 6 10 23 S - - - 2 2 - 5 12 4 25 Total 2 1 - 3 2 2 10 24 18 62 Poliomyelitis W - - - - - - - - - - N - - - - - - - - - - S - - - - - - - - - - Total - - - - - - - - - - Scarlet fever W - 1 5 21 2 1 - _ - 30 N - 5 5 26 1 1 - - - 38 S - 2 5 13 4 2 - - - 26 Total - 8 15 60 7 4 - - - 94 Tuberculosis (respiratory) W - 1 1 - 1 4 10 10 5 32 N - 1 - 2 - 13 15 11 3 45 S - - - 3 - 4 9 13 7 36 Total - 2 1 5 1 21 34 34 15 113 Whooping cough W 3 3 7 8 1 - - - - 22 N 3 1 5 4 - - - - - 13 S 3 3 11 13 - - - - - 30 Total 9 7 23 25 1 - - - - 65 Infectious disease visiting The Council employs three infectious disease visitors whose duty it is to visit the homes of persons who are stated to be suffering from a notifiable infectious disease. All the infectious disease visitors are state registered nurses, and two are also registered fever nurses. The work they do is in addition to visits paid by the food inspectors to cases of food poisoning and by the district public health inspectors on certain other occasions. 59 The work of the infectious disease visitors as agents of the medical officer of health includes the investigation of home conditions, the giving of advice to patients and contacts, particularly where the patient is left at home, and in general the taking of such measures as may be necessary to combat the spread of infection. The following is a summary of the work in visiting infectious diseases carried out during the year which is in addition to the visits paid by the public health inspectors referred to in table 24 :— Table 42 W N S Total First visits 191 267 296 754 Futile visits 377 171 214 762 Revisits 143 124 190 457 Total 711 562 700 1973 Poliomyelitis In 1961 no case of poliomyelitis was notified—the first occasion of a NIL return since 1946. Dysentery The number of cases showed a marked decrease, being only onequarter of the previous year's total. The focus for local outbreaks is often the schools and the mildness of the type of dysentery conduces to spread as the child may go on attending school for the first day or two when likely to be most infective. The only real bar to the quick spread of the disease appears to be an extremely high hygienic standard from the very start in connection with all the apparatus of the water-closet and with hand washing ; and with immediate exclusion from school. Measles 1961 was an epidemic year, there being 4278 cases, some sixteen times the number of the previous year ; and probably the highest number on record. They were of mild degree, though one death was recorded from complications in an already weak child. Pneumonia The number of cases was 62—an increase on the previous year, but still very low. The absence of any influenza outbreak was probably responsible for this although it is likely that many cases of pneumonia are not formally notified. Scarlet fever There was again a decreased number of cases in 1961, the total being only a little more than half the previous year, which in itself was about half those in 1959. 60 Whooping cough After the relatively high number in 1960 the cases in 1961 fell to about one-fifth, 65 in all—probably a low record. Whooping cough is however a preventable disease, and attention is called to the desirability of young children being protected by immunisation, as whooping cough is in general the more serious the younger the child is. Whooping cough immunisation can be combined with diphtheria immunisation, thus reducing the number of injections the young child requires. Tuberculosis After the dramatic fall in 1959 the number of cases in 1960 dropped a little, and in 1961 they dropped a little further—from 134 to 123. 113 of these were pulmonary and were scattered evenly through the three divisions of the borough. The biggest number occurred in the age group 25-45 followed closely by the age group 45-65. As in previous years there were many more cases in males than in females as far as respiratory tuberculosis was concerned, there being 71 males (a decrease of 7) and 42 females (an increase of 1). With the drop in cases and the small increase in population the rate per 100,000 came down to 51, the lowest on record. The death rate, however, rose to 8 from 5. Table 43 Age periods New coses notified Respiratory Deaths Totals Respiratory NonRespiratory Totals NonRespiratory M F M F M F M F M F M F 0 - - - - - - - - - - - - 1 1 1 - - 1 1 - - - - - - 2 - 1 - - - 1 - - - - - - 5 1 4 1 1 2 5 - - - - - - 10 1 - - - 1 - - - - - - - 15 4 3 - - 4 3 - - - - - - 20 7 7 - 1 7 8 - - - - - - 25 10 6 1 - 11 6 2 - - - 2 - 35 9 9 1 2 10 11 - - - - - 45 12 4 2 1 14 5 6 - 1 - 7 - 55 14 4 - - 14 4 6 - - - - 65 7 2 - - 7 2 4 1 - - 4 1 75 + 5 1 - - 5 1 4 1 - - 4 1 71 42 5 5 76 47 16 2 1 - 17 2 61 Analysis of new cases of tuberculosis into divisional areas :— Table 44 Division Sex 0- /- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total West Respiratory M - - - - 1 - 1 4 1 3 4 3 - 17 F - 1 1 - - 2 1 4 1 2 1 1 1 15 Non-respiratory M - - - - - - - 1 - 1 - - - 2 F - - - - - - - - 1 1 - - - 2 North Respiratory M - 1 - - - 3 5 4 5 4 4 2 - 28 F - - - 2 - 1 4 1 5 - 3 1 - 17 Non-respiratory M - - - - - - - - - - 1 - - 1 F - - - 1 - - 1 - - - - - - 2 South Respiratory M - - 1 - 1 1 2 3 5 6 2 5 26 F - - - 2 - - 2 1 3 2 - - - 10 Non-respiratory M - - - 1 - - - - 1 - - - - 2 F - - - - - - - - 1 - - - - 1 Summary of statistics as to tuberculosis for the last ten years Table 45 Year Population New cases notified (all forms) (excluding inward transfers) Notif. rate per 100,000 pop. Deaths Death rate from resp. tuberculosis per 100,000 pop. All forms Respiratory Lewisham County of London 1952 227,100 307 135 42 35 15 28 1953 225,800 341 151 48 44 19 21 1954 224,200 256 114 38 36 16 18 1955 223,400 271 121 26 22 10 16 1956 222,100 212 95 29 29 13 13 1957 220,900 247 112 33 31 14 12 1958 221,000 236 107 19 18 8 12 1959 221,000 143 65 12 11 5 10 1960 221.300 134 61 11 10 5 7 1961 220,910 123 56 19 18 8 9 62 Tuberculosis — environmental conditions Case papers showing the environmental conditions of new patients attending the Lewisham Chest Clinic in 1961 have been analysed in 201 cases with the following results :— Table 46 Males Cases %* 105 52 Females 96 48 Social classification :— Class I - 0 Class II 18 11 Class III 92 59 Class IV 34 22 Class V 13 8 Not classifiable 44 - Rooms occupied :— 20 11 2 or more rooms per person 1—2 rooms per person 116 60 Less than 1 room per person 56 29 No information 9 - Accommodation :— Separate bed 66 33 Separate bedroom 47 23 Condition of premises occupied :— 78 Good 148 Fair 33 17 Poor 10 5 No information 10 - •Excluding cases not classified Food poisoning The cases last year formally notified again slightly decreased, from 31 to 26. Again I must point out that the number notified is probably incomplete as many cases are sufficiently mild as not to require the attendance of a doctor. The following tables are based on returns made to the Ministry of Health. (1) Food poisoning cases Table 47 Notifications (corrected) Cases otherwise ascertained Symptomless excreters Fatal cases 1st quarter 4 - - - 2nd quarter 3 - - - 3rd quarter 19 - - - 4th quarter 6 - - - Year 32 -— -— - 63 (2) Particulars of outbreaks Outbreaks Cases Total cases Family outbreaks Other outbreaks Notified Otherwise ascertained Agent identified - - - - - Agent not identified 1 - 2 - 2 (3) Single cases Notified Otherwise ascertaine Total cases Agent identified :— Salmonella group B „ typhimurium 3 - 3 8 - 8 Agent not identified 13 - 13 (4) Salmonella infections, not food-borne Nil Mass radiography unit I am indebted to the Director of the Unit for information of work done in the borough during 1961 on which the following table is based. Table 48 Patients Men Women Total General analysis X-rayed 2,304 1,990 4,294 Previously x-rayed 1,756 1,051 2,807 Reviewed 129 63 192 Abnormal after review 68 28 96 Analysis of abnormal films :— Cases considered tuberculous :— (a) no further action required - - - (b) occasional supervision only. 3 1 4 (c) requiring treatment 3 1 4 (d) still under investigation - - - (e) refused further investigation - - - Previously known tuberculous cases 7 3 10 Non-tuberculous cases :— (a) investigated 9 7 16 (b) still under investigation 1 - 1 Cardio-vascular lesions 5 3 8 No action required 40 13 53 64 Commenting on the year's work, Dr. J. M. Morgan, director of the South East London mass x-ray service, states "Out of the total of 4,294 examinations during the year, 865 were examined during the Downham survey and three cases were found, giving an incidence of 3.4 per thousand. The other case was found at Grove Park Hospital, during which survey 34 people were examined. Most of the surveys in 1961 were only small routine surveys, and no large scale public visits were done. Apart from regular six-monthly visits to Lewisham, Romer Avenue, and Catford Town Hall, and to Messrs. Elliotts, the other surveys took place at Glennifer Laundry, Chiltonian Ltd., Whitbread and Messrs. Robertsons ; Hither Green and Grove Park Hospitals ; and the Crofton Park and Downham public surveys." 65 I am indebted to the Divisional Medical Officer of the London County Council for the information on which the following table is based: — Immunisation against diphtheria ; whooping cough ; smallpox; poliomyelitis Table 49 Age at December 31, 1961 Under 1 1 2 3 4 5-9 10-14 Total under 15 Born in year 1961 1960 1959 1958 1957 1952-56 1947-51 (i) Diphtheria (induing combined and triple): Immunised during Immunised at enc year 1479 1770 306 217 154 644 362 4932 1479 3007 4422 2961 2486 14,074 14,042 42,471 Estimated mid-year population 16,700 31.300 48,000 (li) Whooping cough (including combined and triple):— Immunised during year 1474 1757 288 201 121 296 109 4,246 (iii) Vaccination. Vaccinated during the year (age at date of vaccination) Under 1 1-4 5-14 15 and over Total Primary 2,376 419 126 158 3,079 Revaccination... — 19 57 24 4 320 ('') Poliomyelitis 1st Injection 2nd Injection 3rd Injection 4th Injection (5-11 years only) Inoculated against Poliomyalitis 4,295 9,715 9, 628 8,599 Council Offices, E. H. R. SMITHARD Canadian Avenue, Medical Officer of Health S.E.6. 66 APPENDIX A Acts of Parliament, Statutory Instruments and Circulars issued by Government Departments with regard to the public health services, during the year 1961 :— Statutes London County Council (General Powers) Act 1960 Home Safety Act 1961 Rivers (Prevention of Pollution) Act 1961 Public Health Act 1961 The Consumer Protection Act 1961 Factories Act 1961 Housing Act 1961 River Ravensbourne etc., (Improvement and Flood Prevention) Act 1961 Statutory Instruments The Public Health (Aircraft) (Amendment) Regulations 1961 The Authorised Officers (Meat Inspection) Regulations 1961 The Labelling of Food (Amendment) Regulations 1961 The Importation of Carcases and Animal Products (Amendments) Orders 1961 The Rag Flock and Other Filling Materials Regulations 1961 The Poisons Rules 1961 The Poisons List Orders 1961 The Lead in Food Regulations 1961 The Alkali, etc Works Order 1961 Ministry of Health Circulars No. 1 Annual Reports of Medical Officers of Health for 1960 12 Services for old people—Cooperation between housing, local health and welfare authorities and voluntary organisations—joint circular 22 Food Hygiene. Codes of Practice. Poultry Dressing and Packing 31 Training Courses on Radiological Health and Safety 33 Public Health Act 1961 Ministry of Housing and Local Government Circulars No. 1 Clean Air Act, 1956—I Notification of provisional plans for establishing smoke control areas. II Amendments to appendix II of circular 28/60 10 Services for old people—Cooperation between housing, local health and welfare authorities and voluntary organisations—joint circular 12 Clean Air—Air Pollution—Measurement and Research 15 Rural Water Supplies and Sewerage Acts 1944-1955 Grants 20 Pollution of water by tipped refuse 28 Clean Air Act 1956—Selection of open fires for coke burning 31 Works of adaptation eligible for grants (electric firelighters) 33 The Rag Flock and Other Filling Materials Regulations 1961 39 Rivers (Prevention of Pollution) Act 1961 42 Clean Air Act, 1956—industrial furnaces 46 Public Health Act, 1961—I Building Regulations. II Trade Effluents. Ill Provisions derived from local Acts 67 Ministry of Agriculture, Fisheries and Food Circulars No. FSH 2 The Authorised Officers (Meat Inspection) Regulations 1961 3 Milk and Dairies (General) Regulations 1959 Approved chemical agents 4 The Labelling of Food (Amendment) Regulations 1961 6 Milk and Dairies (General) Regulations 1959 Approved chemical agents 8 Milk and Dairies (General) Regulations 1959 Approved chemical agents 9 The Lead in Food Regulations 1961 PDP 1 Prevention of Damage by Pests Act 1949 "Insect Pests in Food Stores— advisory leaflet" Home Office Circular No. 124 Home Safety Act 1961 General Register Office Circular No. MOH 3 Annual Reports of Medical Officers of Health 1960—Vital Statistics APPENDIX B Legal Proceedings, 1961 The following are details of legal proceedings during the year: — Nature of summons No. Total fines Total costs Remarks Public Health (London) Act 1936 £ s. £ s. Non-compliance with nuisance notices 16 33 0 13 13 2 summonses withdrawn (work completed); 10 abatement orders made; 1 summons withdrawn (action under Housing Acts) Food Hygiene Regulations 1955 Regulations 6 1 10 0 2 2 28 (1) (c) 1 5 0 - 28 (1) (a) 1 5 0 - 28 (1) (b) 1 5 0 - 26 (1) (b) 1 5 0 - Food Hygiene (General) Regulations 1960 Regulations 28 (1) (a) 7 26 0 4 4 28 (1) (b) 2 6 0 2 2 28 (1) (c) 1 5 0 1 1 9(e) 2 2 10 - 26 (1) 10 - Food and Drugs Act 1955 1 summons withdrawn 3 conditional discharges Sections 47 2 4 0 - 2 8 40 10 11 11 8 5 65 0 12 12 68 Nature of summons No. Total fines Total costs Remarks London County Council (General Powers) Acts Want of dustbin 1 £ s. £ s. 10 - Caravans on unlicensed sites 24 80 0 16 16 1 summons withdrawn (caravan had left site) 7 adjourned sine die (caravans had left site) Non-compliance with Byelaw notices Byelaw No. 10 12 3 2 0 - 2 summonses withdrawn 1 10 APPENDIX C List of special reports submitted to the Health Committee by the medical officer of health during 1961 :— January 10 Smoke Control Areas—Future programme February 7 Suggested use of Saville dance hall March 7 Meals-on-wheels May 30 Health Congress at Blackpool October 31 Clean Air Conference The Saville November 28 National Home Safety Conference The Saville—Use of the premises other than by sections of the Saville club 69 INDEX SUBJECT PAGE SUBJECT PAGE Acts, regulations and orders ... 66 Legal proceedings ... ... 67 Area of borough 6 LCC (General Powers) Act, Atmospheric conditions ... 25 1953 section 43 19 Births and birth rate 6 mass miniature radiography 63 Cancer of lung 15 Maternal deaths 7 Clean Air Act 25 Measles 59 Clearance areas 46 Milk analysis of 49 Continental Goods Depot 54 Milk and Dairies Regulations 49 Coronary disease 14 Mortuary and Coroner's Court 20 Deaths and death rate 6 Moveable dwellings 47 Deaths, cause of 8 National Assistance Act, 1948 s. 50 23 Discretionary grants and standard grants 47 S.47 23 Disinfection and personal Nuisances remedied 38 cleansing 18 Offensive trades 54 Dog nuisances 23 Old people 33 Drainage work 23 Outworkers. 41 Dysentery 59 Pet animals 39 Factories 39 Pharmacy and Poisons 54 Flies and mosquitos 19 Pigeons 42 Food, adulteration of 51 Pneumonia 59 Food inspection and supervision 49 Poliomyelitis 59 Food poisoning 62 Population 6 Food Hygiene Regulations, 53 Prevention of Damage by Pests 21 General statistics from 1901 16 Rag flock etc. 42 Hairdressers 39 Rateable value 6 Health education 20 Rent Act 47 Health Services,general Rodent control 20 provision of 18 Sampling 51 Heating appliances 39„ Sanitary circumstances of the Heattreated milk 49 area 37 Home safety 32 Scarlet fever 59 House purchase loans 47 Shops Act 53 Housing:— Sickness, local 13 Building 43 Slaughterhouses 54 Families rehoused 43 Smoke nuis.ances 37 Housing Act, 1957 39 Social medicine statistics 11 Housing Act, 1961 4 Staff 2 Icecream composition 50 Stillbirths 6 Icecream grading 50 Swimming baths 23 Immunisation 65 Tuberculosis 60 Infant mortality 6 Unsound food 53 Infant mortality Vaccoination 65 Infant mortality analysis 10 Vital statistics 6 Infectious diseases 56 Water certificate 39 Infectious desease visiting 58 Water supply 23 Laboratory facilities 22 Whooping cough 60 70 TABLES TABLE SUBJECT PAGE TABLE SUBJECT PAGE NO. Section A NO. Section D 1 Comparative statistics 7 29 Demolition orders 44 2 Causes of death by age 30 Closing orders 44 groups 8 3 Deaths under one year 10 31 Clearance areas 46 4 Deaths by social class 11 32 Rent Act 1957 47 5 Grouped causes of death by social class 12 6 Births, infants deaths, etc., Section E by social class 12 7 Morbidity 13 33 Analysis of milk 49 8 Heart and circulation 34 Icecream composition 50 mortality 14 35Icecream gradinig 50 35 Icecream grading 50 9 Lung cancer 15 10 General Statistics from 1901 16 36 Sample analysed 51 37 Adulterated samples 51 Section B 38 Continental Goods Depot 54 11 Disinfecting station 18 12 Verminous conditions, etc. 18 Section F 13 Public mortuary 20 14 Rodent control—treatment 39 Notified cases of infectious of rivers 21 diseases 56 15 Prevention of Damage by 40 Notifications of infectious Pests Act 22 diseases by age and sex 57 16 Laboratory facilities 22 41 Analysis of certain diseases 17 Swimming Baths 23 into divisional areas 58 18 Water, chemical samples 24 42 Infectious disease visiting 59 19 Water, Bacteriological 43 Tuberculosis notifications samples 24 and daths 60 20 Smoke Control Areas 26 44 Analysis of new cases of 21 Atmospheric conditions ... 28 tuberculosis into divi- 22 Accidents 32 sional areas 61 23 Old People's visits ... ... 35 45 Tuberculosis 1 0 year statistics 61 Section C 46 Tuberculosis — environ- 24 Sanitary inspection 37 mental conditions 62 25 Summary of notices 38 47 Food poisoning cases62 26 Nuisances remedied 38 48 Mass Radiography 63 27 Factory inspections ... 40 49 Immunisation against 28 Factory defects 41 infectious disease 65 CHARTS First applications for sickness benefit 1951-61 13 Smoke 1955 - 61 30 Deposited Matter 1953 - 61 31