MAL 4 LIBRARY Borough of Melden and Coombe. Annual Report OF THE Medical Officer of Health AND THE Sanitary Inspector FOR THE YEAR ENDED DECEMBER 31st 1940 Printed by J. B. Blackmore & Co. Ltd., 85, Merton High Street, S.W.19. Borough of Maiden and Coombe ANNUAL REPORT of the Health and Sanitary Conditions for the Year 1940 JAMES FANNING, M.D., B.S. (Lond.), M.R.C.S., L.R.C.P., D.P.H., Medical Officer of Health. HENRY TUNBRIDGE, M.R.San.I., Sanitary Inspector. 2 OFFICERS AND STAFF OF THE PUBLIC HEALTH DEPARTMENT. James Fanning, M.D., B.S. (Lond.), M.R.C.S., L.R.C.P., D.P.H Medical Officer of Health. Henry Tunbridge, M.R.San.I. Chief Sanitary and Foods Inspector. Certificates of the Royal Sanitary Institute as Sanitary Inspector and Inspector of Meat and Other Foods. Certificates in Building Construction and Drawing. Douglas J. Hughes, C.R.San.I., Sanitary Inspector. †A. H. Newport, M.S.I.A., Sanitary Inspector. Certificates of the Royal Sanitary Institute and Sanitary Inspectors Examination Joint Board. Certificates of Royal Sanitary Institute as Inspectors of Meat and Other Foods. Arthur 0. Scott. Assistant Rat Officer. Oliver Elliott, General Assistant and Mortuary Keeper. Frederick W. W. Mitchell, Clerk. On Active Service. 3 Borough of Melden and Coombe. ANNUAL REPORT of THE MEDICAL OFFICER OF HEALTH 1940 Public Health Department. Municipal Offices, New Malden. August, 1941. To the Mayor, Aldermen and Councillors of the Borough of Malden and Coombe. Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1940 which has been prepared on the lines indicated in the Ministry of Health Circular 2314. It was hardly to be expected that all vital statistics would show the same progress under war conditions that they did in times of peace and this deterioration is reflected in the general death rate and in the tuberculosis figures. The first complete year of war has produced a bi,rth rate of 14.5 per thousand compared with 15.4 in the previous year and a death rate of 12.6 compared with a previous figure of 9.3. There has been no significant change in the mortality rate for mothers and young children. The infectious disease statistics, with the exception of those relating to tuberculosis, were on the whole very satisfactory. A particularly heavy strain was placed on the Department in the latter months of the year as a result of intensified war activities and I am exceedingly grateful 4 to every member of the staff of the department who gave their services unstintingly under the able guidance of Mr. Tunbridge, the Senior Sanitary Inspector. The amount of individual work done will never be fully known except to myself and in most cases could only have been endured by a strong sense of duty to the community. I am, Mr. Mayor. Aldermen and Councillors. Your obedient Servant. JAMES FANNING, Medical Officer of Health. 5 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area 3,162 acres. Registrar General's estimate of resident. population (mid-year 1940) 38,360 VITAL STATISTICS. Total. M. F. Live births 560 308 252 Birth rate per 1,000 of the estimated resident population 14.5 (legitimate) 300 247 (illegitimate) 8 5 Stillbirths 14 10 4 Rate per 1,000 total (live and still) births 25.0 Deaths 444 220 224 Death rate per 1,000 of the estimated resident population Crude 11.5 Corrected 12.6 Deaths from puerperal causes:— Deaths. Rate per 1,000 Total (Live & Still) Births. Puerperal Sepsis l 1.7 Death rates of Infants under one year of age:— All Infants per 1,000 live births 43.7 Legitimate Infants per 1,000 legitimate live births 39.2 Illegitimate Infants per 1,000 illegitimate live births 214.3 Deaths from Cancer (all ages) 60 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea (under 2 years of age) Nil 6 BIRTHS. During the year 560 live births were registered, this being 55 less than last year's total. The rate per 1,000 was 14.5 compared with an average of 14.6 for England and Wales. Of the total number 13 or 2.3 per cent, were illegitimate. DEATHS. During the year 444 deaths were registered, being 92 more than in 1939. Two hundred and sixteen deaths were registered in the district and two hundred and twenty-eight in institutions and other districts. The death rate per 1,000 population was 12.6 compared with the average of 14.3 for England and Wales. This marked increase over the rate for recent years is mainly accounted for by a larger number of deaths from violence, respiratory tuberculosis, and bronchitis. Apart from war conditions it is possible that exceptionally severe weather conditions in the early part of the yea,r may have influenced the death rate from respiratory conditions. The infantile mortality rate was 43.7 per 1,000 live births and compares with 55.0 for the average of England and Wales. Three deaths occurred in illegitimate children under one year of age. The death rate among illegitimate children in their first year remains unduly high. CAUSES OF DEATH. M. F. Total. Typhoid and paratyphoid fevers - - - Cerebro-spinal fever 1 1 2 Scarlet fever - - - Whooping cough - - - Diphtheria - - - Respiratory tuberculosis 12 14 26 Other forms of tuberculosis 1 - 1 Syphilitic diseases 5 1 6 Influenza 4 6 10 7  M. F. Total Measles — - - Acute polio-myelitis and polioencephalitis - - - Acute encephalitis lethargica - - - Cancer 29 31 60 Diabetes - - - Intra-cranial vascular lesions 10 12 22 Heart disease 41 48 89 Other circulatory diseases 7 13 20 Bronchitis 15 10 25 Pneumonia 6 10 16 Other respiratory diseases 1 2 3 Ulcer of stomach and duodenum 4 2 6 Diarrhoea (under 2 years) - - - Appendicitis 3 2 5 Other digestive diseases 3 6 9 Nephritis 1 - 1 Puerperal or post-abortive sepsis - 1 1 Other maternal causes - - - Premature birth 4 3 7 Congenital malformations; birth injury; infant diseases 6 8 14 Suicide 3 - 3 Road traffic accidents 7 1 8 Other violent causes 39 34 73 All other causes 18 19 37 All causes 220 224 444 DEATHS. AGE GROUPS. Under 1 1-5 5-15 15-25 25-35 35-45 45-55 55-65 65-80 80 & over Total Males 12 4 6 6 10 20 22 50 67 23 220 Females 12 2 4 8 10 16 21 31 89 31 224 Totals 24 6 10 14 20 36 43 81 156 54 444 8 STATEMENT SHOWING WHERE DEATHS OCCURRED. In District. Kingston County Hospital. Kingston Victoria Hospital. Tolworth Isolation Hospital. London & other Hospitals. Wimbledon Hospital. Other Districts. Total. 216 110 8 1 50 1 58 444 INFANTILE MORTALITY. Number of deaths occurring in infants under one year of age luring the past five years:— 1936 (22 Legitimate None Illegitimate) 22 1937 (21 „ None „ ) 21 1938 (18 „ 2 „ ) 20 1939 (12 „ 12 „ ) 24 1940 (21 „ 3 „ ) 24 Average for past five years—22. CAUSES OF DEATH OF INFANTS UNDER ONE YEAR OF AGE. Prematurity 7 Congenital diseases, Malformations 8 Infant diseases 6 Regurgitation of stomach contents into air passage 1 Broncho pneumonia 1 Violence 1 SUMMARY OF BIRTH, INFANTILE MORTALITY AND DEATH RATES FOR THE PAST FIVE YEARS. Year. Births. Infantile Mortality. Deaths. 1936 14.6 43.6 9.6 1937 15.1 37.1 9.2 1938 16.7 30.8 8.2 1939 15.4 39.0 9.3 1940 14.5 43.7 12.6 Average for past 5 years 15.2 38.8 9.8 9 MORTUARY. Twenty-four bodies were brought to the Mortuary and a post mortem examination was made on twenty-three. H.M. Coroner for the district held inquests in ten instances and the following verdicts were returned:— Natural causes 6 Accidental 1 Suicide 2 Misadventure 1 RAINFALL. Table showing rainfall in the district during 1940, taken at the Sewage Disposal Works, California Road, New Maiden:— January 2.56 inches. February 1.39 „ March 3.12 „ April 1.67 „ May 1.16 „ June 0.58 „ July 3.07 „ August 0.17 „ September 1.30 „ October 1.94 „ November 6.51 „ December 0.99 „ Total 24.46 „ Compared with the figures for the previous year this is an decrease of 1.50 inches. Average yearly rainfall (for past five years) 23.98. 10 NOTIFICATIONS OF INFECTIOUS DISEASES, 1940. DISEASES AGE GROUPS Totals Under 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-35 35-45 45-65 Over 65 Diphtheria 5 — — — 1 — 1 — — 3 — — — Erysipelas 2 — — — — — — — — — 1 1 — Pneumonia 18 — 1 1 1 — 4 — 3 2 2 4 — Puerperal Pyrexia 2 — — — — — — — — 2 — — — Scarlet Fever 46 — 1 2 2 3 27 4 3 3 — 1 — Ophthalmia Neonatorum — — — — — — — — — — — — — Typhoid (including Paratyphoid) 5 — — — — — 1 — — — 1 3 — Cerebro spinal Meningitis 15 — — — — 2 1 2 4 4 1 1 — Measles 409 9 28 30 41 74 205 9 5 5 3 — — Whooping Cough 13 — 5 1 1 2 3 1 — — — — — Totals 515 9 35 34 46 81 242 16 15 19 8 10 — DISEASES WARDS Totals Coombe Dickerage Mount Cambridge Norbiton Park Central Burlington Malden St. James Diphtheria 5 — — — — — — — 5 — Erysipelas 2 1 — — — — — — 1 — Pneumonia 18 2 2 1 1 2 1 4 5 — Puerperal Pyrexia 2 — — — — 1 — — 1 — Scarlet Fever 46 7 14 8 1 1 1 1 11 2 Ophthalmia Neonatorum — — — — — — — — — — Typhoid (including Paratyphoid) 5 — 3 — — — — 1 — 1 Cerebro spinal Meningitis 15 2 2 1 2 — 1 1 1 5 Measles 409 35 84 49 24 53 31 48 26 59 Whooping Cough 13 3 — — — — — 2 4 4 Totals 515 50 105 59 28 57 34 57 54 71 11 PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. SCARLET FEVER. The incidence of scarlet fever was fairly light, fortysix cases being notified, a rate of 1.19 per 1,000 population. Forty-four cases were treated in hospital and two cases at home. In addition four suspected cases were admitted to hospital where it was later decided that the illness was not scarlet fever. Only one instance of "return case" infection occurred. DIPHTHERIA. The diphtheria incidence was 0.13 per 1,000 population, only five cases being notified, all of which were treated in hospital. Three of the cases occurred in one family and two in another, and the infection was known to have been imported from outside the district in both instances. None of the patients had been immunised. Three further cases were removed to hospital for observation but proved not to be diphtheria. The following statistics refer to immunisation carried out during the year:— Number of cases completing treatment during the year (pre-school children 96, school children 93) 189 Number of cases treated by private doctors under the Council's scheme 21 Number of Schick tests performed 109 Total number of attendances at Clinic 513 CEREBRO SPINAL MENINGITIS. The year was characterised by a generalised epidemic of meningococcal meningitis, and fifteen cases in all occurred in the district. Two of these cases were fatal. The comparatively low mortality is probably a tribute to the new methods of chemical therapy. There was no definite linking up between the various cases. 12 ENTERIC FEVER. There were five cases of enteric group infection. Three of these were typhoid, and two paratyphoid B. Of the former group two occurred in a mental hospital where a typhoid carrier was found, and one occurred in a sewage worker. One of the paratyphoid B cases linked up with a food infection in another district, and in the other case the origin of the infection was not discovered. All cases made a good recovery. MEASLES. An epidemic of measles appeared in the middle of May, reached a peak in July, and slowly declined towards the end of the year. Adult measles serum was prepared as in previous epidemic years and use was made of it in twenty-two cases. The lateness of the appearance of the epidemic may have partly accounted for the general mildness of the cases. CASE RATES PER 1,000 POPULATION FOR CERTAIN INFECTIOUS DISEASES. England and Wales. Borough of Maiden & Coombe. Smallpox 0.00 0.00 Scarlet fever 1.63 1.19 Diphtheria 1.16 0.13 Enteric fever 0.07 0.13 Erysipelas 0.33 0.05 Puerperal pyrexia 11.96 3.55 *Per 1,000 total births (i.e., live and stillbirths). 13 TUBERCULOSIS. Age Periods NEW CASES DEATHS Respiratory Non-Respiratory Respiratory Non-Respiratory Male Female Male Female Male Female Male Female 0 — — — — — — — — 1 — — — 1 — — — — 5 — 1 — — — — — — 15 7 6 1 2 2 5 — — 25 6 6 3 — 2 5 — — 35 7 2 — — 5 — — — 45 3 — — — | 1 2 — — 55 3 1 — — 2 2 1 — 65 & upwards — 1 — — — — — — Totals 26 17 4 3 12 14 1 — Notification of tuberculosis was, on the whole, satisfactory. Cases which die unnotified are usually those of an obscure character where ante-mortem diagnosis is difficult or impossible. There was one such case during the year. The facilities for chest X-ray examination offered by arrangement with the Kingston Victoria Hospital were made use of in five cases. At the end of the year the following number of cases were shown to be suffering from the disease and living in the district, an increase of four cases compared with the previous year:— Pulmonary. Non-Pulmonary. Males 85 22 Females 69 22 CASES OF INFECTIOUS DISEASES REMOVED TO TOLWORTH ISOLATION HOSPITAL. Scarlet Fever 44 Suspected Scarlet Fever 4 Diphtheria 5 Suspected Diphtheria 3 Cerebro-spinal Meningitis 12 Suspected Cerebro-spinal Meningitis 4 Para-typhoid 2 Measles 9 14 Pneumonia 6 German Measles 7 Whooping Cough 1 Chicken-pox and Impetigo 1 Erysipelas 1 Suspected Erysipelas 1 Enteritis 1 Otitis media 1 102 CASES REMOVED TO HOSPITALS OTHER THAN TOLWORTH. Cerebro-spinal Meningitis 3 Typhoid or Para-typhoid 3 Puerperal Pyrexia 1 7 NUMBER OF NOTIFICATIONS RECEIVED YEARLY FOR THE PAST SIX YEARS. 1935 1936 1937 1938 1939 1940 Scarlet Fever 35 45 39 68 96 46 Diphtheria 22 21 22 22 6 5 Enteric Fever (including Para-typhoid) — — 4 2 1 5 Erysipelas 4 6 4 6 11 2 Pneumonia 10 16 19 24 24 18 Encephalitis Lethargica — — — — — — Puerperal Fever 1 — — — — — Puerperal Pyrexia 2 6 3 12 9 2 Cerebro-Spinal Fever — — — 1 — 15 Acute Poliomyelitis 3 — 1 1 — — Ophthalmia Neonatorum — — 2 — 1 — Dysentery 10 — 12 2 — — Malaria — — — — — — *Measles — — — — — 409 *Whooping Cough — — — — — 13 Tuberculosis (all forms) 42 36 46 37 38 49 *Notifiable since November, 1939. 15 GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. Laboratory Facilities. The cost of bacteriological investigations required by medical practitioners in diphtheria, enteric fever, tuberculosis and certain other special cases is defrayed by the Council. The bulk of this work is carried out by the Pathologist at Kingston Victoria Hospital. The following table shows the number of examinations during the past year:— Disease. Results. Totals. Positive. Negative. Tuberculosis Sputa 11 41 52 Scarlet Fever Swabs — 4 4 Diphtheria Swabs — 110 110 Cerebro-Spinal Meningitis Swabs 6 90 96 Typhoid and Paratyphoid Faeces — 9 9 do. Blood 1 4 5 do. Urine — 1 1 Other Swab — 1 1 Totals 18 260 278 In addition one specimen of tinned salmon and one of butter were submitted for examination with negative results. A number of samples of milk were submitted for bacterial count or the presence of tuberculosis, details of which will be found in the report of the Sanitary Inspector. There has been no change in the general provision of health services as recorded in my annual report for 1938. 16 SANITARY ADMINISTRATION. ANNUAL REPORT OP THE SANITARY INSPECTOR 1940 Public Health Department, Municipal Offices, New Malden. To The Mayor, Aldermen and Councillors. Ladies and Gentlemen, I have the pleasure to submit my twenty-first annual report of work accomplished and matters of interest concerning the Sanitary Department. Once again, in view of the exceptional circumstances, this will necessarily be greatly curtailed. Many items which usually appear will be omitted altogether. For the purpose of abating nuisances, destruction of rats, and executing repairs to render houses fit for human habitation, the following notices were served:— Preliminary. Formal. Notices served 93 18 Complied 80 16 Remaining outstanding 13 2 It was not necessary to institute legal proceedings for the abatement of nuisances or other sanitary matters. 17 INFECTIOUS DISEASES. The following number of rooms were disinfected for the under-mentioned causes:— Scarlet Fever 41 Diphtheria 7 Tuberculosis 31 Vermin— Houses 11 Rooms 19 Enteric Fever 3 Puerperal Pyrexia 4 Cerebro spinal Fever 19 Other 9 144 None of the Public Elementary Schools were disinfected during the year owing to the War and curtailed holidays. Two hundred and two books from the Public Library and Schools were disinfected for various reasons. Twelve loads of bedding were removed for steam disinfection and five for destruction. In addition to the above, various public shelters, warden's posts, furniture from war damaged houses, bedding, etc., have been disinfected or disinfested. SANITARY CIRCUMSTANCES OF THE AREA. WATER SUPPLY. The drinking water for the district is supplied by the Metropolitan Water Board and consists of Thames derived stored water, filtered and terminally chlorinated. A number of complaints were received of "taste" but in every instance this was found to be due to extra precautions being taken, due either to abnormal weather or to conditions produced as a consequence of the War. 18 CLOSET ACCOMMODATION. Practically all the houses in the district Rave water closets connected with the main sewage system. Only in a few isolated instances are earth closets known to exist. PUBLIC CLEANSING. House refuse is collected from houses in mechanically driven freighters and disposed of by burning at the Council's destructor at California Road, or by controlled tipping on adjacent land. The very few cesspools are emptied and cleansed by owners as and when required. Movable ashbins, with few exceptions, are general throughout the district. As earth closets and privies are practically nonexistent, there are no special arrangements for the disposal of the contents thereof. SMOKE ABATEMENT. I am glad to state that the emission of grit from a boiler chimney of a factory in the district, which has given trouble for a number of years, now appears to have been cured. Last year I reported that the War had had the effect temporarily of delaying the installation of the necessary apparatus. This was, however, received later and since it has been working a notable improvement has resulted. Complaints which previously had been unceasing, stopped completely and observations have indicated that the trouble, if not entirely cured, has been reduced to a minimum. RATS AND MICE DESTRUCTION. The importance of this work, especially during war time, cannot be over estimated and the Assistant Rat Officer has had his time fully occupied during the year. 19 The increase in the number of poultry keepers has had to be carefully watched and in many cases advice has been given regarding the rat proofing of runs, both before and after construction. Anderson and public air raid shelters, pig and rabbit keeping, houses left empty, demolished houses and allotments have all contributed their own problems. For some years the interest of the public in this work has been carefully fostered and the success which has attended our efforts has been greatly due to this. It is obvious that without the co-operation of the public the Rat Officer's work would be rendered ineffective. Consequently one of his main objects in each individual case is always to encourage householders over as wide an area as possible to combine in taking active steps in the destruction of these rodents. This necessarily takes up much time, but I am convinced it is time well spent. The charges made for his services when he carries out work of actual destruction are kept as low as possible. This encourages the public to make use of his services, while high charges would tend to have the opposite effect. Our policy is to lead rather than force and I am sure it is the better. FOOD AND DRUGS ACT, 1938. During the year 114 samples were submitted to the Public Analyst for analysis. Of these 19 were formal and 95 informal samples. They comprised the following:— Informal Formal Milk 20 15 Sausages 9 2 Jam 4 — Margarine 3 — Currants 6 — Sultanas 2 — Plain Flour 8 1 Self raising Flour 1 — 20 Tapioca 2 — Rice 5 — Egg Powder 3 — Pepper 1 — Lard 2 — Batter 3 — Compound Lard 1 — Dripping 3 — Cocoa 4 — Tea 3 — Coffee 4 — Dried Apricots 2 — Prunes 1 — Vinegar 3 — Whiskey 1 — Rum 1 — Gin 1 — Mustard (Dry) 1 — „ (Liquid) 1 — Cheese — 1 95 19 Combined total—114 In addition one sample of bleach ointment and one of sausage skins were submitted for analysis. One informal sample of milk was certified to contain 2 per cent, of added water and this led to the taking of 13 formal samples in course of delivery from the producers to the retailer. Six churns from one producer were sampled and seven from another. The results of the analyses in regard to these samples were as follow:— No. 102 Deficient in solids other than milk fat, the deficiency corresponding to the presence of 2% of added water. No. 103 No. 104 No. 106 No. 107 No. 105 Genuine. do. do. do. do. 11% added water. 5% added water. 2% added water. 3% added water. 21 Deficient in solids other than milk fat, the deficiency corresponding to the presence of 10% of added water. No. 108 No. 109 No. 110 No. 111 No. 112 No. 113 No. 114 do. do. do. do. do. do. 20°o added water. 8% added water. 8% added water. 6% added water. 9% added water. 13% added water. Proceedings were instituted in respect of samples Nos. 103 and 104 of the first batch, the defendant being fined £1 on each count with £8 costs, and in respect of samples Nos. 108-9-10-11-12-13 and 14 of the second batch, the defendant in this case being fined £1 on each count with £20 costs. HOUSING ACT, 1936. OVERCROWDING. There is nothing to report in regard to overcrowding during the past year. Applications to be supplied with the permitted numbers for houses continued to be received and this necessitated visits to and the measurement of 24 houses. FOOD SUPPLY. As far as possible, watch is kept on premises where foodstuffs are prepared or sold, which includes slaughterhouses, butchers' and fishmongers' shops, bake-houses, dairies, cowsheds, etc. The following foodstuffs were found to be unfit for food and destroyed:— Tinned Ham 52 lbs. Carcase of Pork 124 „ Carcase of Lamb 20 „ Pork 68 „ Bacon 44½ „ Ham 34¾ „ Beef 96 „ Lamb 14½„ Oxtails and Hearts 28 „ Sweetbreads 4½ „ Fish 25 stone Shrimps 2½ gallons. 22 In addition various quantities of food were dealt with consequent on damage by enemy action. There now remain only two slaughterhouses in the district. These have not been used at all during the year. SHOPS ACTS. The whole of these Acts are administered by my Department, which include the hours of closing, weekly half-holidays, time worked, Sunday trading and the provisions relating to sanitary conveniences, lighting, heating, etc. There appears to have been no instance of intentional evasion. ERADICATION OF BED BUGS. During the year the following number of houses were found to be infested with bed bugs:— Infested. Disifested. (a) Council houses 11 11 do. (rooms) 17 17 (b) Other houses (rooms) 2 2 The methods employed for freeing infested Council houses are completely to remove all picture rails, skirtings and mouldings which are first thoroughly sprayed with insecticide (Zaldecide). Wallpaper is stripped where loose and a floorboard taken up in each room. The place is then sealed up and left for 24 or 48 hours under gas (Cimex). On opening, the walls are cleansed and any defects repaired. Before reinstating, the woodwork is cleansed and the back thoroughly soaked with creosote. The place is then redecorated and the walls distempered, not papered. The work of disinfestation at Council houses is carried out by our own staff under my supervision and not by outside contractors. HCN has not been used. When these houses are occupied detailed advice is given by supplying disinfectant to cleanse bedsteads, pictures, etc. 23 Every house becoming vacant on the Corporation Estates is carefully inspected before reletting. In this way a number were found to be affected, to a varying degree and dealt with. Advice has also been given to a number of house owners, and several houses have been treated by outside contractors without notice from my department. HCN is known to have been used in two or three cases. DAIRIES, COWSHEDS AND MILKSHOPS. Only one cowshed is now in use in the district. This is in a very poor condition structurally, but is not, however, used for cows in milk. Nearly all the milk is pasteurised before delivery to the consumer but is not sold labelled as such. During the year the following licences were issued under the Milk (Special Designations) Orders Dealers. Tuberculin tested 8 Pasteurised 8 Pasteurisers licences 1 Supplementary. Tuberculin tested 5 Pasteurised 3 Seven samples of milk were submitted for examination and in six instances they were also examined for the presence of tubercle bacilli (animal experiment). In one instance a high count was recorded. This was immediately followed up. In the tests for the presence of tubercle bacilli negative results were returned in each case. Nine samples were submitted of milk pasteurised locally and in six satisfactory results were obtained. 24 All three samples of pasteurised milk which failed to pass the phosphatase test were taken from the same plant. The trouble was found to be a defect in the recording thermometer. AIR RAID PRECAUTIONS. In common with other Departments of the Council a very considerable amount of time has had, unfortunately, to be given to this work. When the War is brought to a successful conclusion a full report may then be given of these activities and no more, therefore, need be stated at this juncture. It may be stated, however, with some pride that the ordinary work of the department, although curtailed, has gone on in all its essential details and whilst some minor routine matters have had to be abandoned, all those necessary for the maintenance of good sanitation and public health have been kept at a high level. I am, Mr. Mayor, Aldermen and Councillors, Your obedient Servant, HENRY TUNBRIDGE, Sanitary Inspector. 25 FACTORIES. INSPECTIONS. Premises. Number of Inspections Written Notices Occupiers. Prosecuted (1) (2) (3) (4) Factories with mechanical power 14 2 - Factories without mechanical power 20 2 - Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) 7 - - Total 41 4 - DEFECTS FOUND. Particulars Number of Defects : Number of Defects Number of defects in respect of which Prosecutions were instituted Found I Remedied Referred to H.M. Inspector (1) (2) (3) (4) (5) Sanitary Conveniences (S. 7)— Insufficient — — — — Dirty 2 2 — — Unsuitable or defective — — — — Insufficient artificial lighting 2 2 — — Not separate for sexes — — — — No intervening ventilated space — — — — Other offences 1 1 — — Total 5 5 — —