MAL 13 Borough of Malden and Coobe Annual Report OF THE Medical Officer of Health AND THE Sanitary Inspector FOR THE YEAR ENDED DECEMBER 31st 1949 Printed by Raynes Park Press, Lambton Road, London, S.W.20. OFFICERS AND STAFF OF THE PUBLIC HEALTH DEPARTMENT James B. Morwood, MB., F.R.C.S.I., D.P.H. Medical Officer of Health. Henry Tunbridge, F.R.San.I., Chief Sanitary and Foods Inspector Douglas J. Hughes, C.R.S.I., Deputy Chief Sanitary Inspector. (Resigned 3/7/49). A. H. Newport, C.R.S.I., Sanitary Inspector. (Resigned 23/4/49). Stanley, J. T. Wood, M.R.San.I. Deputy Chief Sanitary Inspector. (Commenced 3/9/49). Leslie E. Bowskill, M.R.San.I., Sanitary Inspector. (Commenced 8/8/49). Bernard Ll. Prichard, Rodent Officer. Mrs. M. J. Butler, S.R.N., Public Health Nurse. Frederick W. W. Mitchell, Chief Clerk. Leslie S. Frazer, Mortuary Keeper, Disinfector, etc. Thomas Arnell, Junior. TEMPORARY. Mrs. A. Savage, Shorthand Typist. A. E. Wilson, Assistant to Rodent Officer. T. Clarkson, Assistant to Rodent Officer. PUBLIC ANALYST: Daniel D. Moir, M.Sc., F.R.I.C. Borough of Malden and Coombe ANNUAL REPORT of THE MEDICAL OFFICER OF HEALTH 1949 Public Health Department, Municipal Offices, New Malden. June, 1950. 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 which has been prepared in accordance with Ministry of Health Circular 2/50. The health of the district remains good and the vital statistics compare favourably with the country as a whole. During the year a great deal of work has been done by the department for the welfare of old people and there have been several cases in which it has been possible to provide adequate care and attention for old people in need of it. Consequently it has not been necessary to take any action under section 47 of the National Assistance Act, 1948, which provides for the compulsory removal to hospital of this type of case. A considerable amount of time has been spent on the inspection of premises where food is prepared or sold to ensure that the requirements of the Food and Drugs Act, 1938 are complied with and that a high standard of cleanliness is reached and maintained not only of the premises and utensils, but also of the persons engaged in these trades. There is every reason to believe that these visits with the advice given and suggestions made on the spot have been very well received and they have indicated, also, that the general hygienic standard, with few exceptions, is good. In conclusion I wish to thank members of the Council for their advice and support throughout the year and the staff for its keen co-operation. I am, Mr. Mayor, Aldermen and Councillors, Your obedient servant, J. B. MORWOOD, Medical Officer of Health. 2 STATISTICAL AND SOCIAL CONDITIONS OF THE AREA. Area 3,162 acres. Registrar-General's estimate of resident civilian population (mid-year, 1949) 44,580 Registrar-General's estimate of resident civilian and non-civilian population (mid-year, 1949) 44,620 VITAL STATISTICS. Total M. F. Live Births 548 277 271 (Legitimate) 269 264 (Illegitimate) 8 7 Stillbirths 19 8 11 Deaths 433 234 199 Birth rate per 1,000 of the estimated resident population 12.2 Rate per 1,000 total (live and still) births 33.5 Death rate per 1,000 of the estimated resident population 100 Deaths from puerperal causes:— Deaths. Rate per 1.000 Total (Live & Still) Births. Puerperal sepsis Nil Nil Other Maternal Causes Nil Nil Death rates of Infants under one year of age:— All Infants per 1,000 live births 25.5 Legitimate Infants per 1,000 legitimate live births 22.5 Illegitimate Infants per 1,000 illegitimate live births 133.3 Deaths from Cancer (all ages) 79 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) Nil Deaths from Diarrhoea (under 2 years of age) Nil BIRTHS. During the year 548 live births were registered, being 88 less than last year's total. The rate per thousand population was 12.3 compared with an average for England and Wales of 16.7. Of the total number 15 or 2.7 per cent were illegitimate. The birth rate was the lowest recorded since 1934. 3 DEATHS. During the year 433 deaths were registered, an increase of 29 compared with those recorded in 1948, the rate per thousand being 100 compared with an average of 11.7 for England and Wales. The infantile mortality rate was 25.5 per thousand live births, a low rate, comparing with the figure of 32 for England and Wales. For the fifth year in succession there were no deaths from maternal causes. CAUSES OF DEATH. M. F. Total Typhoid and paratyphoid fevers — — — Cerebro-spinal fever — — — Scarlet fever — — — Whooping cough — — — Diphtheria — — — Respiratory tuberculosis 8 6 14 Other forms of tuberculosis 1 — 1 Syphilitic diseases 2 1 3 Influenza 5 2 7 Measles — — — Acute poliomyelitis and polio-encephalitis — — — Acute infective encephalitis — — — Cancer 36 43 79 Diabetes 2 — 2 Intra-cranial vascular lesions 28 28 56 Heart diseases 69 52 121 Other circulatory diseases 12 9 21 Bronchitis 12 9 21 Pneumonia 6 8 14 Other respiratory diseases 4 3 7 Ulcer of stomach or duodenum 3 1 4 Diarrhoea (under 2 years) — — — Appendicitis 1 — 1 Other digestive diseases 7 7 14 Nephritis 5 5 10 Puerperal and post-abortive sepsis — — — Other maternal causes — — — Premature birth 4 1 5 Congenital malformations; birth injuries; infant diseases 5 5 10 Suicide 2 1 3 Road traffic accidents 4 — 4 Other violent causes 4 4 8 *A11 other causes 14 14 28 234 199 433 *Including one male aged 75 years, certified to have died from carditis due to or as a consequence of diphtheria in infancy. 4 DEATHS. AGE GROUPS. Under 1 1-5 5-15 15-25 25-35 35-45 45-55 55-65 65-80 80 & over Totals Males 8 1 4 3 2 11 30 37 94 44 234 Females 6 2 1 5 2 12 18 29 72 52 199 Totals 14 3 5 8 4 23 48 66 166 96 433 STATEMENT SHOWING WHERE DEATHS OCCURRED. In District. Kingston Hospital. Other Surrey Hospitals. London and other Hospitals. Tolworth Hospital. Other Districts. 255 54 63 37 2 22 INFANTILE MORTALITY. Number of deaths occurring in infants under one year of age during the past five years :— 1945 (22 Legitimate. 4 Illegitimate) 26 1946 (14 „ 1 „ ) 15 1947 (19 „ None „ ) 19 1948 (15 „ 1 „ ) 16 1949 (12 „ 2 „ ) 14 CAUSES OF DEATH OF INFANTS UNDER ONE YEAR OF AGE. Prematurity 5 Birth injury 1 Congenital malformation 5 Asphyxia (accidental) 2 Other diseases of infancy 1 9 hours; 17 hours ; 2 days; 3 days; 4 days. 5 hours. 4 hours; 6 hours ; 3 days; 5 days; 2 months. 1 month ; 2 months. 3 days 5 SUMMARY OF BIRTH, INFANTILE MORTALITY AND DEATH RATES FOR THE PAST SIX YEARS. Year. Births. Infantile Mortality. Deaths. 1944 18.0 29.7 9.1 1945 16.7 40.8 9.2 1946 17.5 19.8 8.5 1947 17.2 24.8 10.1 1948 14.2 25.1 9.0 1949 12.3 25.5 10.0 MORTUARY. Forty-five bodies were brought to the Mortuary and postmortem examinations were made on each. H.M. Coroner for the district held inquests in six instances and the following verdicts were returned :— Accidental 3 Suicide 1 Misadventure 1 Natural causes 1 RAINFALL, 1949. Table showing rainfall in the district during 1949, taken at the Sewage Disposal Works, California Road, New Maiden. Inches January 1.17 February 1.00 March 0.86 April 1.62 May 2.19 June 0.57 July 1.66 August 1.44 September 0.27 October 4.76 November 1.99 December 1.20 18.73 Decrease on previous year 2.25 inches. Average for past 5 years 21.20 inches. 6 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality and Case rates for certain Infectious diseases in the year 1949. Provisional figures based on Weekly and Quarterly Returns. England and Wales 126 C.Bs. and Great Towns Including London 148 Smaller Towns Resident Pop. 25,000— 50,000 1931 Census London Adm. County England and Wales 126 C.Bs. and Great Towns Including London 148 Smaller Towns Resident Pop. 25,000— 50,000 1931 Census London Adm. County Rates per 1,000 Civilian Population. Rates per 1,000 Live Births. Live Births 16.7† 18.7 18.0 18.5 Deaths under 1 year of age 32* 37 30 29 Still Births 0.39† 0.47 0.40 0.37 Deaths:— All Causes 11.7† 12.5 11.6 12.2 Deaths from Diarrhœa and Enteritis under 2 years of age 3.0 3.8 2.4 1.7 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 Pneumonia 0.51 0.56 0.49 0.59 Whooping Cough 0.01 0.02 0.01 0.01 Diphtheria 0.00 0.00 0.00 0.00 Influenza 0.15 0.15 0.14 0.11 Small-pox 0.00 0.00 - Tuberculosis 0.45 0.52 0.42 0.52 Rates per 1,000 Total Births (Live and Still). Ac. Poliomyelitis & Polioencephalitis 0.01 0.02 0.02 0.01 Notilications:— Notification:— Typhoid Fever 0.01 0.01 0.01 0.01 Puerperal Fever and Pyrexia ) 6.31 8.14 5.30 6.82 Paratyphoid Fever 0.01 0.02 0.01 0.01 Cerebro Spinal Fever 0.02 0.03 0.02 0.02 Scarlet Fever 1.63 1.72 1.83 1.46 Whooping Cough 2.39 2.44 2.39 1.70 Maternal Mortality in England and Wales Diphtheria 0.04 0.05 0.04 0.07 Erysipelas 0.19 0 20 0.19 0.17 Small-pox 0.00 0.00 0.00 0.00 Measles 8.95 8.91 9.18 8.54 Abortion with Sepsis 0.11 Pneumonia 0.80 0.91 0.65 0.55 Abortion without Sepsis 0.05 Ac. Poliomyelitis 0.13 0.12 0.12 0.18 Ac. Polioencephalitis 0.01 0.01 0.02 0.01 Puerperal Infections 0.11 Food Poisoning 0.14 0.16 0.14 0.19 Other Maternal Causes 0.71 †Rates per 1,000 Total Population. *Per 1,000 Related Live Births. 7 NOTIFICATION OF INFECTIOUS DISEASES, 1949. DISEASES Totals Under 1 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-25 25-35 35-45 45-65 65 and over. Measles 503 9 43 50 78 62 247 5 2 2 2 3 — — Whooping Cough 94 6 9 18 14 12 33 — — — — 1 1 — Scarlet Fever 68 — 1 — 4 5 40 17 1 — — — — — Pneumonia 27 1 — 4 — 2 5 1 — — — 3 5 6 Erysipelas 6 — — — — — — — — — — — 5 1 Paratyphoid 1 — — — —. — — — — — 1 — — — Poliomyelitis 3 — — — — — 1 — 1 — 1 — — — Dysentery 1 — — — — — — — — — — 1 — — Totals 703 16 53 72 96 81 326 23 4 2 4 8 11 7 DISEASES WARDS Totals Coombe Dickerage Mount Cambridge Norbiton Park Burlington Maiden Green St. James Maiden Manor Measles 503 65 101 36 25 78 49 33 60 56 Whooping Cough 94 17 28 7 8 10 2 4 10 8 Scarlet Fever 68 7 11 9 3 10 8 7 10 3 Pneumonia 27 2 6 2 3 3 3 2 4 2 Erysipelas 6 — — — 1 1 1 — — 3 Paratyphoid 1 — — — — — — — 1 — Poliomyelitis 3 — — 1 1 — — 1 — — Dysentery 1 1 — — — — — — — — Totals 703 92 146 55 41 102 63 47 85 72 8 PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. SCARLET FEVER. The number of cases of scarlet fever notified during the year was comparatively low, a total of sixty-eight, giving an incident rate of 1.52 per thousand population. This compares with a rate of 1.63 for England and Wales. The great majority of cases were very mild and no fatalities occurred. Twenty-seven cases were treated at home and fortyone removed to hospital. There were no 'return' cases. DIPHTHERIA. For the second year in succession and the third occasion since records were available, the district was completely free from this disease, the last case having been notified in April, 1947. Immunisation against diphtheria progresses smoothly and the great majority of parents are now accepting it as a matter of course. It is now being recommended at the age of seven months. When done so early it is probably advisable to give a third dose twelve months later. Under the present scheme children are given the opportunity of receiving a re-inforcing dose at intervals of 3—5 years up to school leaving age. Under the National Health Service Act all medical practitioners providing general medical services in the area have been given an opportunity to provide services in the scheme of diphtheria immunisation. This has resulted in a number of children being done otherwise than at schools or clinics. The following statistics refer to immunisation carried out during the year:— Number of children completing treatment during the year (pre-school, 525, school, 99) ... 624 Number of children receiving re-inforcing doses 923 Of the above, 169 were immunised and 23 given re-inforcing doses by private practitioners. Special efforts are made to encourage mothers to bring their babies for immunisation in those cases where persuasion by the health visitor has failed. A note is made of every child aged ten months and older who has not been immunised and 9 the parents of these babies are circularised in regard to the importance of immunisation against diphtheria. In many cases this personally addressed circular succeeds where other methods of encouragement have failed. In previous reports, details have been given showing the rapid decline in the number of notifications and deaths from diphtheria since the immunisation campaign got under way in 1941. The following table shows the total number of corrected notifications and deaths for England and Wales during the five years 1944-1948 :— Year Deaths Cases 1944 934 23,199 1945 722 18,596 1946 472 11,896 1947 244 5,609 1948 156 3,575 When it is realised that for the 10 year period 1931/40 the average annual number of cases notified and deaths were 55,000 and 2,800 respectively the value of immunisation will be readily appreciated. VACCINATIONS. Vaccination against smallpox is not now compulsory, the Vaccination Acts 1867 to 1907 having been repealed by the National Health Service Act, 1946. As with diphtheria immunisation all medical practitioners providing general medical services in the area are given an opportunity to provide service for carrying out vaccinations. During the year the following were performed :— Vaccinations 292 Revaccinations 84 Total 376 Of the above, two hundred and forty-one were vaccinated or revaccinated by private practitioners. One hundred and forty-four of the persons vaccinated were under 1 year of age. 10 ACUTE POLIOMYELITIS. Three cases of acute poliomyelitis were notified during the year, two in the persons of females aged 24 and 13 years respectively and one male aged 17 years. All recovered from the acute stage of the disease but afterwards suffered in varying degree from resultant paralysis. MEASLES. In the past epidemics of measles have occurred biennially, but this seems to have changed so that they are now taking place more or less every year. Five hundred and three cases were notified, being one hundred and seventeen more than the previous year. Ten cases were removed to hospital and no deaths occurred. Prophylactic serum for contacts was supplied to all doctors who made application. WHOOPING COUGH. The number of cases of whooping cough notified was ninety-four. Six cases were removed to hospital. No deaths occurred. PARATYPHOID FEVER. One case of paratyphoid fever was reported. This was a young married woman who was taken ill whilst away on her honeymoon. Detailed enquiries failed to trace the source of infection although they indicated that the disease was contracted outside this district. SCABIES. The scheme for the treatment of Scabies, referred to in previous reports continued successfully although the number of cases coming to notice is gradually diminishing. During 1949, sixty persons received treatment. Of these, thirty-five showed definite lesions, the remainder being contacts in the same family. 11 VERMINOUS CONDITIONS. Fifty persons, mostly school children, were treated for headlice during the year. No case of body louse infestation came under notice. FOOD POISONING. There were no outbreaks of food poisoning reported during the year. CASE RATES PER 1,000 POPULATION FOR CERTAIN INFECTIOUS DISEASES. England and Wales Borough of Maiden and Coombe Scarlet fever 1.63 1.52 Diphtheria 0.04 NIL Typhoid fever 0.01 NIL Paratyphoid fever 0.01 0.02 Cerebro-spinal fever 0.02 NIL Measles 8.95 11.2 Whooping cough 2.39 2.10 *Puerperal pyrexia 6.31 NIL *per 1,000 total births (i.e. live and stillbirths). CASES REMOVED TO TOLWORTH ISOLATION HOSPITAL. Scarlet fever 40 Scarlet fever (not confirmed) 2 Pneumonia 4 Diphtheria (not confirmed) 1 Measles 8 Whooping cough 6 Chicken pox 1 Infective hepatitis 2 Cerebro-spinal fever (not confirmed) 1 Mumps 8 Meningitis with convulsions 1 Meningitis (not confirmed) 1 Erysipelas 1 Dysentery, Diarrhoea, etc. 2 Paratyphoid fever 1 Acute poliomyelitis 2 Erythema 1 Total 82 12 CASES ADMITTED TO HOSPITALS OTHER THAN TOLWORTH. Scarlet fever 1 Measles 2 Acute poliomyelitis 1 Mumps 1 Dysentery (not confirmed) 1 Total 6 NUMBER OF NOTIFICATIONS RECEIVED YEARLY FOR THE PAST SIX YEARS. 1944 1945 1946 1947 1948 1949 Scarlet fever 98 25 44 49 33 68 Diphtheria — 10 5 3 — — Typhoid fever — — — 2 — — Paratyphoid fever — — — — 1 1 Erysipelas 9 5 7 8 3 6 Pneumonia 12 14 15 18 22 27 Encephalitis lethargica — — — — — — Puerperal pyrexia — 4 2 4 1 — Cerebro-spinal fever 2 2 1 2 — — Acute poliomyelitis — — 2 5 — 3 Ophthalmia neonatorum — — — — — — Dysentery 9 53 2 — — 1 Malaria 34 28 — — 1 — Measles 22 589 152 240 386 503 Whooping cough 44 43 75 39 267 94 Tuberculosis (all forms) 36 44 52 42 63 41 TUBERCULOSIS, 1949. Age Periods NEW CASES DEATHS Respiratory Non-Respiratory Respiratory Non-Respiratory Male Female Male Female Male Female Male Female 0 — — — — — — — — i 1 — — — — — — — 5 2 2 1 1 — — 1 — 15 7 8 — — — 4 — — 25 2 5 — — 1 — — — 35 2 3 1 — 2 — — — 45 2 — — 1 1 — — — 55 1 — — — 3 1 — — 65 & upwards 2 — — — 1 1 — — Totals 19 18 2 2 8 6 1 — 13 The sharp rise in the number of notifications of new cases of pulmonary tuberculosis during 1948 was not maintained, twenty-two fewer cases being reported in the year under review. The mortality rate, although slightly higher than that for the previous year, was again only one-third of the high peak registered in 1941. The following table shows the trend of tuberculosis since 1938. TUBERCULOSIS 1938 - 1949. NEW CASES DEATHS Year Estimated Population No. Pulmonary Rate per 1,000 Population No. Non-Pulmonary Rate per 1,000 Population No. Pulmonary Rate per 1,000 Population No. Non-Pulmonary Rate per 1,000 Population 1938 38,820 29 0.74 8 0.20 10 0.25 1 0.02 1939 39,630 31 0.78 7 0.17 14 0.35 — — 1940 38,360 43 1.12 7 0.18 26 0.67 1 0.02 1941 33,920 45 1.32 8 0.23 31 0.91 5 0.14 1942 37,070 51 1.37 12 0.32* 21 0.56 3 0.08 1943 37,750 35 0.92 9 0.23 15 0.39 — — 1944 35,840 27 0.75 9 0.25 15 0.41 — — 1945 38.080 37 0.97 7 0.18 13 0.34 4 0.10 1946 43,160 40 0.92 12 0.27 14 0.32 — — 1947 44,450 31 0.69 11 0.24 14 0.31 4 0.09 1948 44,490 59 1.32 4 0.09 13 0.29 1 0.02 1949 44,580 37 0.83 4 0.09 14 0.31 1 0.02 Notification of tuberculosis was, on the whole, satisfactory. There was only one case during the year which did not come to light until after death. At the end of the year the following numbers of cases were shown to be suffering from the disease and living in the district, the total remaining the same as that for the previous year. Pulmonary NonPulmonary Males 147 23 Females 95 28 14 WORK OF PUBLIC NURSE. The following is a record of certain aspects of the work done by the nurse to the public health department during the year:— Home visits in connection with infectious diseases (measles, whooping cough, etc.) 917 Attendances at diphtheria immunisation clinics 34 Visits for treatment of scabies 107 Visits for treatment of head lice 267 Visits in connection with other matters, (home helps, old people, etc.) 672 15 SANITARY ADMINISTRATION. ANNUAL REPORT of THE SANITARY INSPECTOR 1949 Public Health Department, Municipal Offices, New Malden. To the Mayor, Aldermen and Councillors of the Borough of Maiden and Coombe, Ladies and Gentlemen, I have the honour and pleasure to submit my thirtieth Annual Report of work done and matters of interest concerning the Sanitary Department. Having been appointed sanitary inspector of the then Urban District Council in November, 1919, I have now completed 30 years in your service and a total of 42 years in the public health service. This is a long period and tempts me to engage in retrospection, which however, if at all, should be done otherwise than through the medium of this report. 1 may, however, be permitted to say that during this period which includes the difficult years of the great war, I have always maintained the happiest relations with the constantly changing Council and with my brother officers including especially the three medical officers of health with whom I have had the privilege of working. The year under review has been somewhat difficult, mainly due to changes of staff. Both my deputy and junior inspector resigned to take up other appointments and for a period this left me with a depleted staff. Before they went a drive was commenced to make detailed inspections of all food premises and, where defects or deficiences were found, to get these remedied. The new inspectors have continued this good work with vigour and at the end of the year the survey was nearing completion. The Council decided to adopt the new model 16 bye-laws regarding the handling, wrapping and delivery of food and sale of food in the open air. These will come into force early in the new year (1950). Prior to this, however, carefully prepared codes of standards and of conduct by employees had already been sent out to all food preparing premises and the reaction of the proprietors, I am glad to say, was most satisfactory. Cleanliness in food production and handling has been the focus of much attention by the public recently and rightly so, and so far as this district is concerned I feel confident in stating that, whilst individual cases may be found falling below a reasonable standard, the management and workers in the majority of instances recognise their duty to their customers and endeavour to reach a high standard of hygienic efficiency. For the purpose of abating nuisances or executing repairs to houses the following notices were served:— Preliminary 195 Abatement 116 Informal (dustbin only) 7 Formal (dustbin only) 6 In addition twenty-two informal notices were given under the Food and Drugs Act, two under the Meat Regulations and one under the Shops Act. It was necessary to apply to the Courts in fifteen instances. These referred to the following:— Public Health Act, 1936. Section 92 (1) (a). Premises in such a state as to be a nuisance. Nuisance Orders made 8 Applications withdrawn, work having been completed before hearing 7 In only one instance was it necessary to supply a dustbin to a house and charge the owner, where he had failed to comply with a notice. WATER SUPPLY. The whole of the Area is supplied by the Metropolitan Water Board and the supply has been satisfactory both as regards quantity and quality. In view of the large number of 17 routine bacteriological and chemical examinations carried out by the Water Examination Department of the Board it was not considered necessary to make any special local tests. All dwelling houses in the area are supplied by public water mains direct to the houses. INFECTIOUS DISEASES. The following number of rooms were disinfected for the undermentioned causes:— Scarlet fever 26 Tuberculosis 29 Vermin (including fleas) 25 Other 5 A number of books from the public library and schools were also disinfected as far as practicable for a variety of reasons. Sixteen loads of bedding were removed for steam disinfection or destruction. Routine disinfection after Scarlet Fever is not now carried out and is only done in those cases where a request is made. Instead a bottle of disinfectant is left and advice given as to the best method to be employed in dealing with the bedroom used by the patient. It is now well known that the incidence of this disease is not affected by failure to do ordinary fumigation. Efforts are made, however, to ensure that disinfection is carried out after death or where patients suffering from pulmonary tuberculosis move. There are, however, difficulties in ensuring that this is always done. Disinfection is often declined but in these cases it is generally found that adequate measures have already been taken. FOOD AND DRUGS ACT, 1938. During the year 147 samples were submitted to the Public Analyst for analysis. These comprised the following:— ARTICLES ANALYSED Adulterated or below standard. Formal Informal Total Formal Informal Total Aspirin — 2 2 — — — Butter — 2 2 — — — Boracic ointment — 1 1 — — — Baking powder — 2 2 — — — Beer 2 — 2 — — — Black pudding 2 — 2 — — — 18 ARTICLES ANALYSED Adulterated or below standard. Formal Informal Total Formal Informal Total Chutney — 2 2 — — — Cinnamon — 1 1 — — — Cocoa — 2 2 — 1 1 Custard powder — 1 1 — — — Curry powder — 2 2 — — — Coffee and chicory essence — 1 1 — — — Cheese — 1 1 — — — Coffee — 1 1 — — — Custard mix — 1 1 — — — Crushed apple (tin) — 1 1 — — — Fish paste — 1 1 — — — Flour — 2 2 — — — Ground ginger — 2 2 — — — Gin 1 — 1 — — — Gelatine — 1 1 — — — Horseradish sauce — 1 1 — — — Honey 1 — 1 — — — Jam — 5 5 — — — Jell-tina — 1 1 — — — Lard — 2 2 — — — Lobster paste — 1 1 — — — Liver sausage 1 — 1 — — — Lemonade powder — 1 1 — — — Lime juice cordial 1 — 1 — — — Milk 35 29 64 2 1 3 M ustard — 2 2 — — — Margarine — 2 2 — — Marmalade — 1 1 — — — Meat paste — 2 2 — — — Orange wine 1 — 1 — — — Pineapple flavouring — 1 1 — — — Pickles — 1 1 — — — Pepper (white) — 3 3 — — — Rum 1 — 1 — — — Salad Cream — 2 2 — — — Sausage meat 7 — 7 — — — Saccharin 1 1 2 — — — Sulphur ointment — 1 1 — — — Sweets 2 — 2 — — — Sauce — 1 1 — — — Sponge cake mixture — 1 1 — — — Tea — 1 1 — — — Tomato ketchup — 1 1 — — — Vinegar wine 1 — 1 — — — Vinegar malt 1 — 1 1 — 1 Vinegar non-brewed 1 — 1 — — — Vegetables (tin) — 1 1 — — — Whiskey 2 — 2 — — — Totals 60 87 147 3 2 5 Notes in regard to samples shown as adulterated or below standard. Milk. The informal sample shown as below standard was followed by several formal samples which all proved genuine. One of the formal samples was the subject of careful consideration by the Committee, but in view of special circumstances and of a 19 recommendation by the Public Analyst a prosecution was not instituted. The second formal sample shown to be below standard was one taken at the place of delivery and revealed a very slight deficiency in solids not fat. The fat content was well above the permitted minimum and the freezing test did not indicate the presence of added water. Except that the wholesalers attention was drawn to this incident, no further action was taken beyond obtaining a number of follow-up samples which all proved genuine. Cocoa. This was a minor labelling matter only, the cocoa itself being entirely satisfactory. Malt Vinegar. One sample of malt vinegar contained 0.9% of salt. Salt is not a natural ingredient of malt vinegar and the analyst had, therefore, no alternative but to report adversely on this sample. In view of the fact that the Ministry of Food gave certain manufacturers of malt vinegar a special temporary dispensation to add, without declaration, a small quantity of salt to help preserve the vinegar, no further action was taken. MILK. During the year one Act of Parliament and three new sets of Regulations affecting milk came into force. To attempt even to summarise these within the space of this report would be difficult and I can only, therefore, give a few notes regarding them. All came into operation on the 1st October, 1949. The Milk (Special Designations) Act is described as an Act to render compulsory the use of special designations on sales of milk by retail in specified areas; to enact certain provisions ancillary thereto as to the use of such designations and to amend certain enactments in relation to such designations. Section 1 of the Act states that the use of a special designation shall be obligatory for the purpose of all sales of milk by retail for human consumption where the place of sale is a "specified area". The Minister of Food is given power under Section 5 at any time to make an order declaring any area to be a "specified area". It will be seen, therefore that in such an area the status of designated milk will be completely altered from an article which a dairyman may sell or not as he likes into one which he must sell and it alone. The Milk and Dairies Regulations, 1949 re-enact, with amendments, similar Regulations 1926—1943 and affect administration so far as this district is concerned but little. The principal changes are consequent on the provisions of the Food and Drugs (Milk and Dairies) Act, 1944 and the Agriculture (Miscellaneous Provisions) Act, 1949. As, however, there are now no dairy farms in this district these do not affect our local administration. There are a number of minor changes in the Regulations relating to buildings, the cleansing of vessels and utensils and the distribution of milk and its protection against contamination and infection with disease. In particular 20 sion is made for modern practices in dairying, the use of mechanical refrigeration for cooling and the use of approved chemical agents for the cleansing of appliances. The Milk (Special Designation) Regulations, 1936—1938 are now replaced with two sets of Regulations, one regarding pasteurised and sterilised milks and the second in reference to raw milk. They re-enact, with amendments, the previous Regulations and, as will be seen, provide for the legal recognition of an additional designation, viz: "Sterilised" milk. This is described as milk which, after having been filtered or clarified and homogenised, has been heated to above 212°F. for long enough to comply with a particular test. During the year the following licences were issued under the Milk (Special Designations) Orders:— Dealers Tuberculin tested 5 Pasteurised 6 Pasteuriser's 1 Sterilised 8 Supplementary. Tuberculin tested 7 Pasteurised 7 Sterilised 8 One hundred and thirteen samples of milk were submitted for examples by the phosphatase and ninety-five by the methylene blue tests. The phosphatase test determines whether or not the milk has been adequately heat treated and failure to pass the methylene blue indicates that the milk may not be of good keeping quality. The greater importance must be attached to the phosphatase test as correct heat treatment or pasteurisation reasonably ensures that all pathological organisms have been eliminated. Three failures to pass this test were recorded out of one hundred and thirteen examined. Ten samples failed to pass the methylene blue test. Most of these occurred during hot weather when it is recognised that milk kept at an atmospheric shade temperature of above 65°F. will not remain sweet for any lengthy period. Even with efficient pasteurisation and correct handling, milk may be expected to sour quickly if kept at a shade temperature exceeding 65°F; the rapidity of the deterioration increasing quickly with a rise of temperature. Consequently this necessitates additional precautions being adopted by the householder, such as scalding, as soon as the milk is delivered. 21 FOOD SUPPLY. As far as possible, watch is kept on premises where foodstuffs are prepared or sold, which includes slaughterhouses, butchers' and fishmongers' shops, bakehouses, dairies, etc. No animals were killed for sale in local slaughterhouses during the year. The following unfit foodstuffs were voluntarily surrendered and destroyed or handed over for salvage Evaporated or Condensed Milk 192 tins Jam and Marmalade 37 tins Beans 28 tins Tinned Vegetables 85 tins Brawn 7 tins Salad Cream 31 bottles Tinned Fruit 42 tins Beef Loaf, Luncheon Meat, etc. 20 tins Soup 29 tins Coffee ½ lb. Figs 164 lbs. Meat and Vegetable Stew 3 tins Malted Milk 1 bottle Fish 82 tins Toffees 4 packets Wet Fish 160 stone Lamb 59 lbs. Stewing Steak 19½ lbs. Pickles 28 jars Dried Egg 1 tin Spaghetti 4 tins Meat and Fish Paste 4 jars Cheese 7 lbs. Barley Flakes 16 lbs. Eggs 69 Danish Pork 1 tin Bacon 1 tin Potted Meat 2 tins Beef 42 lbs. Mutton 20 lbs. Calves Head 12½ lbs. Corned Beef 1 tin A number of complaints regarding foodstuffs were received during the year, some of which are worth recording. (1) A piece of cheese (Canadian) when cut was found to contain a piece of glass. The glass was embedded well in the interior and, apparently, introduced during manufacture abroad. (2) A complaint was received that some iced cakes purchased locally were thought to contain mice 'dirts'. The cakes were sent to the Public Analyst who, however, reported that what was thought to be the offending substance were numerous pieces of brown or blackish matter which proved to consist of finely chopped raisins or similar dried fruit. There was no abnormal dirt or other foreign matter. 22 (3) A loaf of bread which had a large beetle embedded in the bottom surface was the subject of another complaint. A prosecution was instituted in this case, the summons being dismissed under the Probation of Offenders Act on payment of £2 2s. Od. costs. (4) A fruit cake was the subject of a further prosecution. In this case it contained a cricket and the summons was again dismissed under the Probation of Offenders Act on payment of £3 3s. Od. costs. (5) A third prosecution was instituted regarding a loaf of bread in which was embedded a label which had obviously become detached from a sack of flour. In this case a fine of £20 was imposed with £5 5s. Od. costs. I may be permitted to add that in each of the three foregoing instances the articles in question were prepared in bakehouses outside this area. (6) A sliced loaf of bread was brought to me and examination disclosed a dark-grey to black discolouration concentrated in streaks near but not on the surface. The conclusions of the Public Analyst was that the streaks were due to a deposit of tiny particles of carbon and that it was likely that the particles were introduced by contamination with some machine or plant lubricant. A warning was issued. (7) A complaint was made that some buns were in a filthy condition when purchased. The appearance of these buns certainly gave rise to some misgivings but were, however, certified by the Public Analyst to be free from any objectionable dirt or filth, the trouble being due to another entirely innocent cause. (8) A somewhat peculiar circumstance was reported to me and proved of interest. A piece of jam sponge sandwich was alleged to have caused redness of the tongue and swelling and redness of the throat when eaten by a young boy. The symptons soon subsided. On examination the jam was noted to have turned, in parts, from its normal red colour to green. A sample was, therefore, sent to the Public Analyst for examination as to the possible presence of injurious substances. In brief his report disclosed that the discolouration was due to an alkaline condition of the sponge occasioned by the use of unbalanced raising ingredients. This lack of balance was probably due to inadequate mixing whereby a large local excess of carbonate of soda was present in one section of the cake which could have caused the symptoms described. The patchy nature of the green colour of the jam lent support to this theory. ICE CREAM. Sixty-three samples were submitted for testing by the methylene blue method and of these, fifty-four reached grades I and II standards. Eight were placed in Grade III and only one in Grade IV. Five of the samples contained faecal coli, strangely enough four of these being in Grades I and II. As has been previously explained, the test does not provide a guarantee of safety but it does serve as a simple and practical method of grading ice cream according to its degree of bacterial cleanliness and samples which consistently fail to reach 23 Grades I and II give reasonable grounds to indicate defects in manufacture or of handling calling for further investigation. One naturally would desire all samples to reach Grades I or II and results of those taken since 1947 when the test was first officially put into operation show progressive improvement as the following table indicates:— Total Samples Grades Grade Grade Year Taken I or II. % III. % IV. % 1947 29 13 44.8 13 44.8 3 10.4 1948 84 55 65.4 22 26.2 7 8.4 1949 63 54 85.7 8 12.7 1 1.6 In April a letter was received from the Ministry of Food stating that from November, 1948, additional quantities of sugar and, in certain cases, fats had been made available to ice cream manufacturers. To ensure that these materials were used to the best advantage manufacturers wishing to avail themselves of the additional supplies were required to sign an undertaking that their ice cream would have a minimum fat content of 2½%. This minimum does not constitute a legal standard, indeed it must not be interpreted even as meaning that this figure is regarded officially as a proper standard. Ten samples were obtained during the year and sent to the Public Analyst and copies of results were forwarded to the Ministry of Food, together with the names of the manufacturers. All exceeded the 2\%, the lowest containing 3.7% and the highest 10.7%. The possibility of prescribing a legal standard of composition for ice cream has been under consideration by the Food Standards Committee and until that Committee has reported to the Minister no action in this respect is contemplated. In my opinion it should be a requirement for barrows, vans, etc., from which ice cream is sold to be registered with the local authority in the same manner as premises. At present anyone can purchase ice cream from a wholesaler and sell it from a van, barrow or stall, the only obligation being that he must have his name and address legibly and conspicuously displayed on such van, stall or barrow. SMOKE ABATEMENT. I have little to report in regard to this subject. Hardly any complaints were received and laundry chimneys, which in previous years have given rise to the majority of complaints, appear to have caused little trouble. There is no doubt that improvements both in plant and fuel which have taken place 24 during the past few years, is now reflected in the fact that serious nuisance due to smoke emission from factory chimneys has become more rare. SHOPS ACTS. No intentional evasion of these Acts was discovered during the year. One or two instances were found where shops were being kept open beyond the permitted hours, the occupiers being unaware that a Defence Regulation is still in force limiting the hours of opening during the winter months. During the summer months normal hours of closing prescribed by the Shops (Hours of Closing Act) 1928 operate, but it is noticeable that the great majority of shops are closed at a much earlier hour than that permitted by the Act. ERADICATION OF BED BUGS. During the year the following number of houses were found to be infested with bed bugs:— Infested Disinfested (a) Council houses 3 3 Council houses (rooms) 12 12 (b) Other houses (rooms) 2 2 RATS AND MICE DESTRUCTION. This work has gone on uninterruptedly and the solid foundations laid in previous years have proved of the utmost value in maintaining a high state of efficiency. Although no scheme embracing the whole district was undertaken such as that of which I made a full report last year, nevertheless sewers, sewage disposal works, refuse tips, piggeries, allotments, business premises and private houses have all had their share of attention. A new Act called the Prevention of Damage by Pests Act, 1949 will come into operation on the 31st March, 1950 and the Rats and Mice (Destruction) Act, 1919 will then be repealed. This important measure will make it obligatory for all local authorities to take such steps as may be necessary to secure, so far as practicable, that their district is kept free from rats and mice and, in particular, from time to time to carry out such inspections as may be necessary for this purpose ; to destroy rats and mice on land of which they are the occupier and otherwise keep such land, as far as practicable, free from rats or mice and to enforce the duties of owners and occupiers of land under the provisions of the Act. 25 An occupier of land (which includes houses, buildings, etc.) will now be under a legal obligation to give the Local Authority notice in writing if it comes to his knowledge that rats or mice are living on or resorting to the land in substantial numbers. It may be mentioned here that no definition is given in the Act as to the meaning of 'substantial numbers'. Provision is made for the enforcement of rat destruction on infested land and in giving notice to the owner, occupier or both the Local Authority may specify the form of treatment to be given and also the work required to prevent reinfestation. To those Authorities who did not accept delegation of powers under the old Act this will mean making a commencement and building up a new organisation but to us, with an efficient staff already operating who have been doing this work for a number of years, it will have little affect except perhaps the strengthening of powers already possesed. Part 2 of the Act deals with the infestation of food and will be administered by the Ministry of Food, but power of delegation to Local Authorities is given, with the exception of making certain Regulations. MISCELLANEOUS. No application was received during the year to bury or cremate the body of a dead person in accordance with the provisions of section 50 of the National Assistance Act, 1948. Measures to prevent undue cricket infestation at the Corporation refuse tip in the Norbiton Potteries pit and at the depot, piggeries, etc., in California Road were successfully undertaken. Movements of tenants from Council property were far more frequent than in previous years since the War. In all cases which numbered forty-one the houses, on becoming vacant are carefully inspected for any signs of bed-bug infestation before reoccupation and, in those cases where evidence of infestation is discovered, appropriate steps are taken. Choked public sewers (combined drains) were cleared on one-hundred and sixty-two occasions by the department. In a few instances the assistance of sewermen from the Borough Engineer's department had to be obtained. Several complaints were received alleging excessive noise from factory premises. The Council has limited powers under the Maiden and Coombe Urban District Council Act to deal 26 with noise nuisance and no formal action was taken during the the year. It is not generally known and may perhaps be mentioned here that no complaint can be made to a Justice unless it is signed by not less than three householders within hearing of the noise nuisance complained of and, in the event of a prosecution, it is necessary to prove that the noise is injurious or dangerous to health and is capable of being prevented or mitigated having due regard to all the circumstances of the case. Furthermore if the noise is occasioned in the course of any trade or business it is a good defence that the best practicable means of preventing or mitigating it, having regard to cost have been adopted. The difficulties of sustaining a prosecution are clearly evident. Generally visits and tactful interviews have brought about desired improvements. The Council adopted the Byelaw prohibiting the sale of contraceptives from slot machines so placed that they can be used by persons who are in the street. Only one machine of this character was found to exist and this was converted for the sale of another article immediately after confirmation of the Byelaw. I am, Mr. Mayor, Aldermen and Councillors, Your obedient servant, HENRY TUNBRIDGE, Sanitary Inspector. 27 FACTORIES ACT, 1937 Prescribed particulars required by section 128 (3) in respect of matters under Part I and Part VIII of the Act which are administered by the District Council. PART I OF THE ACT. 1. INSPECTIONS. Number on Register Number of Inspections Written Notices Occupiers prosecuted Factories in which sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities. 15 12 — — Factories not included in (i) in which section 7 is enforced by Local Authorities. 87 58 3 – Other premises in which section 7 is enforced by the Local Authority. 7 7 — — Total 109 77 3 — 28 2. CASES IN WHICH DEFECTS WERE FOUND. Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness 1 1 — 1 — Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — Sanitary Conveniences: (a) Insufficient 2 — — 2 — (b) Unsuitable or defective — — — — (c) Not separate for sexes (absence of screening) — — — — — Other offences against the Act (not including offences relating to Outwork) — — 4 — — Total 3 1 4 3 — 29 PART VIII OF THE ACT. OUTWORK. No. of out-workers in August list req'd. by Sect. 110(I) (c) No. of cases of default in sending lists to the Council No Of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions The making of boxes or other receptacles or parts thereof made wholly or partially of paper 1 — — — — — Brush making 119 — — — — — Cleaning of wearing material 2 — — — — — File making 2 — — — — — Making of artificial flowers 2 — — — — — Total 126 – — — — —