Library Mal 16 Borough of Malden and Coombe Annual Report OF THE Medical Officer of Health AND THE Sanitary Inspector FOR THE YEAR ENDED 31st DECEMBER 1952 OFFICERS AND STAFF OF THE PUBLIC HEALTH DEPARTMENT James B. Morwood, M.B., F.R.C.S.I., D.P.H., Medical Officer of Health. Henry Tunbridge, F.R.San.I., Chief Sanitary and Foods Inspector. Stanley J. T. Wood, M.R.San.I., Deputy Chief Sanitary Inspector. Leslie E. Bowskill, M.R.San.I., Sanitary Inspector. Mrs. M. J. Butler, S.R.N., Public Health Nurse. Bernard Ll. Prichard, Rodent Officer. Frederick W. W. Mitchell, Chief Clerk. Leslie S. Fraser, Mortuary Keeper, Disinfector, etc. Thomas Arnell, Junior, (Resigned July). Ian Wilson (Appointed July). TEMPORARY. Mrs. A. Savage, Shorthand Typist. A. E. Wilson, Assistant to Rodent Officer. T. Clarkson, Assistant to Rodent Officer. B. Jeffery, Junior, (Joined H.M. Forces, June). PUBLIC ANALYST: Daniel D. Moir, M.Sc., F.R.I.C. Borough of Malden and Coombe ANNUAL REPORT of THE MEDICAL OFFICER OF HEALTH 1952 Public Health Department, Municipal Offices, New Malden. July, 1953. 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 1952 which has been prepared in accordance with Ministry of Health Circular 42/51. The health of the district remains good and the vital statistics compare favourably with those of the country as a whole. The immunisation campaign against whooping cough, which was commenced in the Borough in February, 1951, was intensified in August, 1952 when the County scheme for the whole of Surrey was implemented. Not only have the results been promising, but in addition this campaign has had a beneficial effect on the diphtheria immunisation campaign. This is the last report of Mr. Tunbridge, the Chief Sanitary Inspector, who has retired after 33 years service with this Council. As with my predecessors, he has worked in the closest harmony with me and I wish him a long and happy retirement. In conclusion I should like to thank the Chairman and members of the Public Health Committee for their helpful cooperation and the staff of the department for the efficiency with which they have carried out their duties. I am, Mr. Mayor, Aldermen and Councillors, Your obedient servant, J. B. MORWOOD, Medical Officer of Health. Borough of Malden and Coombe With the Medical Office of Health's Compliments Municipal Office, Malden Road, New Malden Surrey Telephone No.; MALden 2424 2 STATISTICAL AND SOCIAL CONDITIONS OF THE AREA. Area 3,162 acres. Population—Census 1951 45,559 Population—Registrar-General's estimate (midyear) 1952 45,390 VITAL STATISTICS. Total M. F. Live Births 522 288 234 Birth rate per 1,000 of (Legitimate) 278 229 the estimated resident (Illegitimate) 10 5 population 11.0* Stillbirths 8 6 2 Stillbirth rate per 1,000 total (live and still births) 15.1 Deaths 446 232 214 Death rate per 1,000 of the estimated resident population 10.1* * Corrected. Deaths from puerperal causes:— Rate per 1,000 Deaths. Total (Live & Still) Births. Puerperal sepsis Nil — Other Maternal Causes 1 1-9 Death rates of Infants under one year of age:— All Infants per 1,000 live births 17.2 Legitimate Infants per 1,000 legitimate live births 15.8 Illegitimate Infants per 1,000 illegitimate live births 66.6 Deaths from Cancer 90 Deaths from Measles Nil Deaths from Whooping cough Nil BIRTHS. During the year 522 live births were registered, being 6 more than last year's total. The rate per thousand population was 11.0 comparing with an average for England and Wales of 15.3. Of the total number 15 or 2.8 per cent were illegitimate. 3 DEATHS. During the year 446 deaths were registered, a decrease of 1 compared with those recorded in 1951, the rate per thousand being 10.1 compared with an average of 11.3 for England and Wales. The infantile mortality rate was 17.2 per thousand, an exceptionally low rate, comparing with the figure of 27.6 for England and Wales. One death occurred from maternal causes. CAUSES OF DEATH. M. F. Total Typhoid and paratyphoid fevers - - - Meningococcal infections 1 - 1 Scarlet fever - - - Whooping cough - - - Diphtheria - - - Respiratory tuberculosis 8 1 9 Other forms of tuberculosis - 1 1 Syphilitic diseases - 1 1 Measles - - - Acute poliomyelitis 1 1 2 Acute infective encephalitis - - - Other infective and parasitic diseases 2 1 3 Cancer 50 40 90 Leukaemia, aleukaemia 2 1 3 Diabetes 1 - 1 Vascular lesions of nervous system 22 37 59 Coronary disease, angina 51 26 77 Hypertension with heart disease 3 4 7 Other heart diseases 22 32 54 Other circulatory diseases 7 13 20 Influenza 3 2 5 Pneumonia 7 10 17 Bronchitis 17 11 28 Other diseases of respiratory system 2 2 4 Ulcer of stomach or duodenum 3 1 4 Gastritis, enteritis and diarrhoea - 1 1 Nephritis and nephrosis 2 1 3 Hyperplasia of prostate 7 - 7 Pregnancy, childbirth, abortion - 1 1 Congenital malformations 6 2 8 Other defined or ill-defined diseases 7 20 27 Motor vehicle accidents 1 1 2 All other accidents 4 - 4 Suicide 2 4 6 Homicide and operations of war. 1 - 1 232 214 446 4 DEATHS STATEMENT SHOWING WHERE DEATHS OCCURRED. In District. Kingston Hospital. Other Surrey Hospitals. London and other Hospitals. Other Districts. 260 64 69 28 25 AGE GROUPS. Under 1 1-4 5-14 15-24 25-34 35-44 • 45-54 55-64 65-79 80 & over Totals Males 7 3 1 1 2 7 20 52 99 40 232 Females 2 - 2 - 3 7 16 36 94 54 214 Totals 9 3 3 1 5 14 36 88 193 94 446 INFANTILE MORTALITY. Number of deaths occurring in infants under one year of age during the past five years:— 1948 (15 Legitimate. 1 Illegitimate) 16 1949 (12 2 ”) 14 1950 ( 8 1 ”) 9 1951 ( 8 Nil. ”) 8 1952 ( 8 1 ”) 9 CAUSES OF DEATH OF INFANTS UNDER ONE YEAR OF AGE. Congenital heart 1 week. 1 month. 3 months. Congenital cerebral atrophy 1 month. Spina bifida 1 week. Broncho pneumonia 1 month. Accidental 5 months. Subarachnoid haemorrhage 3 months. 5 SUMMARY OF BIRTH, INFANTILE MORTALITY AND DEATH RATES FOR THE PAST SIX YEARS. Year. Births. Infantile Mortality. Deaths. 1947 17.2 24.8 10.1 1948 14.2 25.1 9.0 1949 12.3 25.5 10.0 1950 11.9 16.9 8.7 1951 10.8 15.5 10.0 1952 11.0 17.2 10.1 MORTUARY. Forty bodies were brought to the Mortuary and a postmortem examination was performed on each. 6 Birth-rates, Death-rates, Analysis of Mortality, Maternal Mortality and Case-rates for Certain Infectious Diseases in the Year 1952. Provisional figures based on Quarterly Returns. England and Wales 160 County Boroughs and Great Towns (including London) 160 Smaller Towns London (Resident Pop. Administrative 25,000-50,000 County at 1951 Census) Births— Rate§ per 1,000 Home Population Live births 15.3 16.9 15.5 17.6 Still births 0.35 0.43 0.36 0.34 22.6* 24.6* 23.0* 19.2* Deaths— All Causes 11.3 12.1 11.2 12.6 Typhoid and paratyphoid 0.00 0.00 0.00 - Whooping cough 0.00 0.00 0.00 0.00 Diphtheria 0.00 0.00 0.00 0.00 Tuberculosis 0.24 0.28 0.22 0.31 Influenza 0.04 0.04 0.04 0.05 Smallpox 0.00 - - - Acute poliomyelitis (including polioencephalitis) 0.01 0.01 0.00 0.01 Pneumonia 0.47 0.52 0.43 0.58 Notifications (Corrected) Typhoid fever 0.00 0.00 0.00 0.00 Paratyphoid fever 0.02 0.02 0.03 0.01 Meningococcal infection 0.03 0.03 0.03 0.02 Scarlet fever 1.53 1.75 1.58 1.56 Whooping cough 2.61 2.74 2.57 1.66 Diphtheria 0.01 0.01 0.03 0.01 Erysipelas 0.14 0.15 0.12 0.14 Smallpox 0.00 0.00 0.00 - Measles 8.86 10.11 8.49 9.23 Pneumonia 0.72 0.80 0.62 0.57 Acute poliomyelitis (including polioencephalitis) Paralytic 0.06 0.06 0.06 0.06 Non-paralytic 0.03 0.03 0.02 0.03 Food poisoning 0.13 0.16 0.11 0.18 Puerperal pyrexia 17.87* 23.94* 10.22* 30.77* Deaths— Rate per 1,000 Live Births All causes under 1 year of age 27.6t 31.2 25.8 23.8 Enteritis and diarrhoea under 2 years of age 1.1 1.3 0.5 0.7 * Per 1,000 Total (Live and Still) Births. † Per 1,000 related live births. 7 Maternal Mortality in England and Wales. Intermediate List No. and cause Number of Deaths Rates per 1,000 Total (Live and Still) Births Rate per million women aged 15-44 A115 Sepsis of pregnancy, childbirth and the puerperium f Abortion with toxaemia 61 0.09 1 13 0.02 AI16 Other toxaemias of pregnancy and the puerperium 147 0.21 A117 Haemorrhage of pregnancy and childbirth 59 0.09 A118 Abortion without mention of sepsis or toxaemia 31 0.04 3 A119 Abortion with sepsis 47 0.07 5 A120 Other complications of pregnancy, childbirth and the puerperium 138 0.20 8 NOTIFICATION OF INFECTIOUS DISEASES, 1952. DISEASES Totals Under 1 1-2 3-4 5-9 10-14 15-24 25 and over Measles 244 7 38 56 134 3 2 4 Whooping cough 76 6 12 28 28 1 - 1 Scarlet fever 52 - 2 11 35 1 1 2 Pneumonia 15 - 2 - 2 1 8 Poliomyelitis Paralytic 11 1 1 2 3 1 1 2 Non-paralytic 3 - - 1 2 - - - Puerperal pyrexia 2 - - - - - 1 1 Dysentery 97 1 8 8 48 21 2 9 Food poisoning 9 - 1 - 3 - 1 4 Erysipelas 1 - - - - - - 1 Para-typhoid B. 1 - - - - - 1 - Totals 511 15 64 108 255 27 10 32 DISEASES Totals Coombe Dickerage Mount Cambridg WARDS Norbiton Park Burlington Malen Green St. James Malen Manor Measles 244 45 19 18 16 21 12 34 21 58 Whooping cough 76 10 22 8 3 12 8 2 8 3 Scarlet fever 52 3 4 5 6 17 5 5 Pneumonia 15 - 4 - 1 - 6 - 4 - Poliomyelitis Paralytic 11 4 2 - 1 2 1 - 1 - Non-paralytic 3 1 - - - 2 - - - - Puerperal pyrexia 2 - - 1 - - - - - 1 Dysentery 97 7 9 29 17 18 8 3 6 Food poisoning 9 - 2 - - 2 - 1 4 - Erysipelas 1 - - - - - - - - 1 Para-typhoid B. 1 - - - - - - 1 - - Totals 511 70 65 60 38 62 41 58 49 68 9 PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. SCARLET FEVER. The number of cases of scarlet fever notified during the year was fifty-two, giving an incidence rate of 1.14 per thousand population. This compares with a rate of 1.53 for England and Wales. All the cases were very mild and no fatalities occurred. Twenty-four cases were treated at home and twenty-eight removed to Hospital. DIPHTHERIA. For the fifth year in succession the district was completely free from this disease, the last case having been notified in April, 1947. Immunisation against diphtheria progresses smoothly and although the majority of parents are now accepting it as a matter of course there is a decline in the number being immunised. 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 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. The object of the campaign is to secure the immunisation of not less than seventy-five per cent of babies before their first birthday. 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. This has resulted in a number of children being immunised otherwise than at schools or clinics. The following statistics refer to immunisation carried out during the year:— Number of children immunised during the year (pre-school 395, school 58) 453 Number of children receiving reinforcing doses 671 Of the above 141 were immunised and 64 given reinforcing doses by Medical Practitioners. 10 The fear of diphtheria has declined among parents in a direct relation to the decline of the disease itself; the majority of parents of young children nowadays have never seen or heard of a case of diphtheria among their neighbours' children and are more afraid of illnesses they know than of the dangers of diphtheria. It cannot be said too often that "diphtheria still kills" and that elimination of this disease is conditional upon the maintenance of an adequate level of immunisation. In 1901, 10,000 persons died from diphtheria in England and Wales: In 1951 this had been reduced to 33. Since 1944 (when records of corrected notifications were first kept) notifications have fallen from over 23,000 in that year to a new low figure of 274 for the first 9 months of 1952. The following are (corrected) since 1944:— figures for deaths and notifications Year Deaths Corrected Notifications 1944 934 23,199 1945 722 18.596 1946 472 11,986 1947 244 5,609 1948 156 3,575 1949 84 1.890 1950 49 962 1951 33 664 1952 31* 274 (9 months only) * Provisional. From being one of the most serious causes of death of children in this country, diphtheria has now fallen to a position of numerical insignificance. It must not be allowed to revert. 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 services for carrying out vaccinations. During the year the following were performed:— Vaccinations 414 Revaccinations 153 Total 567 11 Of the above, three hundred and sixty-six individuals were vaccinated or revaccinated by private practitioners. Three hundred and ten of the persons vaccinated were under one year of age. ACUTE POLIOMYELITIS. Fourteen cases of acute poliomyelitis were notified during the year, eleven as paralytic and three as non-paralytic. This is the largest number ever occurring in one year. Two deaths resulted, a boy of six years and a married woman. There was only one instance where a second case occurred in the same household, but contrary to experience in previous years, the cause of some of the cases was traced to contact with other known cases. MEASLES. The number of cases of measles notified (244) was much lower than in 1951. Six cases were removed to hospital. No deaths occurred. Prophylactic serum for contacts, etc., was supplied to all doctors on application. WHOOPING COUGH. The number of cases of whooping cough notified was 76. No cases were removed to hospital and no deaths occurred. The immunisation campaign against whooping cough which was commenced in the Borough in February, 1951 was intensified in August, 1952 when the County Scheme for the whole of Surrey was implemented. Whooping cough is one of the most serious diseases of childhood and mothers appreciate the facilities for immunisation which are available. Fortunately the whooping cough immunisation campaign has had a beneficial effect on the diphtheria immunisation campaign because the prophylactic material most commonly used gives combined protection against both whooping cough and diphtheria. It is to be hoped that whooping cough immunisation will prove as effective as immunisation against diphtheria. Details of the number of children immunised against whooping cough during the year, are as follows:— Primary immunisations carried out by medical officer of health 257 12 Primary immunisations carried out by medical practitioners 69 Children receiving reinforcing doses by medical officer of health 28 Children receiving reinforcing doses by medical practitioners 5 DYSENTERY. An outbreak of mild sonne dysentery, mostly affecting children, occurred at the commencement of the year and caused a great deal of work. Ninety-seven cases were notified, but in the course of investigations fifty-one symptomless carriers were also found. A number of schools was implicated. Over 1,300 specimens of faeces were obtained and taken to the Public Health Laboratory at Epsom. The age groups of the persons affected were:— 0-4 26 5-14 96 15 and over 26 Total 148 The outbreak which commenced in the middle of January was practically over at the begining of May. No deaths occurred. SCABIES AND VERMINOUS CONDITIONS. Necessary action in reference to the conditions noted above has been very limited and calls for no special comment. FOOD POISONING. Nine cases of food poisoning occurred in the district during the year. These comprised two family outbreaks involving five persons due to staphylococci and typhi-murium respectively; one outbreak involving two persons the cause of which was unidentified and two single cases due to staphylococcus aureus and bacillus typhi-murium respectively. 13 CASE RATES PER 1,000 POPULATION FOR CERTAIN INFECTIOUS DISEASES. England and Wales Borough of Malden and Coombe Scarlet fever 1.53 1.14 Diphtheria 0.01 0.00 Typhoid fever 0.00 0.00 Paratyphoid fever 0.02 0.02 Measles 8.86 5.37 Whooping cough 2.61 1.67 *Puerperal pyrexia 17.87 3.77 * per 1,000 total births (i.e. live and stillbirths). *CASES REMOVED TO TOLWORTH ISOLATION HOSPITAL. Scarlet fever 22 Scarlet fever (not confirmed) 1 Poliomyelitis 9 Poliomyelitis (not confirmed) 4 Measles 5 Chicken pox 3 German measles 2 Para-typhoid 1 Pneumonia 2 Gastro-enteritis 3 Diarrhoea (non-infective) 1 Impetigo 1 Total 54 CASES ADMITTED TO HOSPITALS OTHER THAN TOLWORTH. Scarlet fever 6 Poliomyelitis 3 Poliomyelitis (not confirmed) 1 Mumps 1 Measles 1 Typhi-murium carrier 1 Chicken pox 1 Erysipelas 1 Total 15 *Not including cases of tuberculosis and certain other noninfectious illness. 14 NUMBER OF NOTIFICATIONS RECEIVED YEARLY FOR THE PAST SIX YEARS. 1947 1948 1949 1950 1951 1952 Scarlet fever 49 33 68 76 32 52 Diphtheria 3 - - - - - Typhoid fever 2 - - - - - Paratyphoid fever - 1 1 - - 1 Erysipelas 8 3 6 1 3 1 Pneumonia 18 22 27 21 27 15 Encephalitis lethargica - - - - - - Puerperal pyrexia 4 1 - 4 4 2 Meningococcal infection 2 - - 1 - - Acute poliomyelitis 5 - 3 10 1 14 Ophthalmia neonatorum - - - - - - Dysentery - - 1 20 26 97 Malaria - 1 - - - - Measles 240 386 503 171 807 244 Whooping cough 39 267 94 79 206 76 Tuberculosis (all forms) 42 63 41 35 36 47 TUBERCULOSIS 1952. Age Periods NEW CASES DEATHS Respiratory Non-Respiratory Respiratory Non-Respiratory Male Female Male Female Male Female Male Female 0 - - - - - - - - 1 - - l - l - - - 5 l 2 - - - - - - 15 5 6 - 1 - - - - 25 7 1 1 - - - - - 35 3 5 - - 2 - - - 45 5 1 l 1 1 - - - 55 3 2 - - 3 - - 1 65 & upwards - 1 - - 1 - - - Totals 24 18 3 2 8 - - 1 The cases of pulmonary tuberculosis notified (42) showed a sharp rise over those for 1951 (30). 15 TUBERCULOSIS 1938 - 1952. Year NEW CASES DEATHS Estimated Population Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary No. Rate per 1,000 Population No. Rate per 1,000 Population No. Rate per 1,000 Population No. 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 1950 44,830 30 0.67 5 0.11 6 0.13 1 0.02 1951 45,640 30 0.65 6 0.10 9 0.19 2 0.04 1952 45,390 42 0.92 5 0.11 8 0.17 1 0.02 Notification of tuberculosis was, on the whole, satisfactory. There were three cases 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 being sixteen more than that for the previous year. Non- Pulmonary Pulmonary Males 144 17 Females 106 23 WORK OF THE PUBLIC HEALTH 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 and whooping cough 458 Sonne dysentery (including visits to laboratory) 423 Attendances at diphtheria immunisation sessions 16 Visits for treatment of head lice 14 Visits in regard to old people 518 Poliomyelitis survey 237 Whooping cough survey 389 Miscellaneous 98 16 SANITARY ADMINISTRATION. ANNUAL REPORT of THE CHIEF SANITARY INSPECTOR 1952 Public Health Department, Municipal Offices, New Malden. July, 1953. To the Mayor, Aldermen and Councillors of the Borough of Malden and Coombe, Ladies and Gentlemen, I have the honour and pleasure to submit my thirty-third Annual Report of work done and matters of interest concerning the Sanitary Department. I remarked in my introduction to last year's annual report how increasingly difficult it becomes, as the years go by, to produce a report which, whilst retaining certain essential features and being, as it should be, of an informative character, does not become too repetitive. The constantly changing membership of the Council, however, renders some repetition unavoidable and I crave the indulgence of those to whom some or many of the facts may already be known. I might be tempted in this report, which is destined to be my last, to recall some of the worth recording incidents which have occurred during my career. But so many crowd to my mind that I find the greatest difficulty in making a selection and, at the same time, keeping this report within bounds so far as length is concerned. I think it would be best therefore, for me strictly to keep reminiscences at a minimum and to conclude my period of office in the same way as I have always endeavoured to do my work— quietly and unobstrusively. This does not prevent me however, from expressing a sense of pride in the efficient working of the department. I have served with three Medical Officers (Drs. Davison, Fanning and Morwood) and with each the happiest relations have been maintained. This 17 has resulted in good work being done, and gives special point to the following brief extracts from the latest report of the Chief Medical Officer of the Ministry of Health. "However much the scope of preventive medicine may be extended it should never be forgotten that this branch of medicine depends primarily on a sound foundation of environmental hygiene: and for this reason the medical officer of health must possess a firm grasp of all that relates to healthy environmental conditions. It must not be supposed that these can now be wholly left to other experts in the field of sanitary science; on the contrary the need for close co-operation between the health officer, his engineering colleagues and his indispensable co-workers the sanitary or public health officers, is as important as ever. There should be no working in isolation; And in a later paragraph dealing with environmental hygiene the following occurs— "Since environmental hygiene has been defined as the control of those factors in a man's physical environment which exercise or may exercise a deleterious effect on his physical, mental or social well-being the interest and responsibility of the medical officer of health in this field continue to be of fundamental importance Within the health department itself much depends in this connection on the invaluable services of the sanitary inspectors, or public health inspectors as they may now be more properly designated." Furthermore I have had the advantage in having a loyal and co-operative staff who, besides carrying out their normal and often dull and unspectacular routine duties, have always been ready to meet those urgent situations which inevitably arise in a department of this character. Of my voluntary work done on behalf of the general public I will say nothing except that it has been not inconsiderable and the expressions of thanks I have received from time to time both from individuals and the Council have been a source of great gratification to me. Finally it would have been impossible for me to have remained here happy in my work for such a long time, without the help, encouragement and backing of the Council and the cooperation of my brother officers. The year under review has been uneventful. No departmental changes have occurred and this allowed the work to proceed smoothly. Food matters again occurred a considerable proportion of the inspectors' time. I mentioned in my last report, the main causes of the increase in food poisoning notifications during the past few years and these 18 need not be repeated. The prevention of the great majority of food poisoning cases, however, is principally and simply a matter of scrupulous domestic and personal cleanliness and the avoidance, so far as one can, of made-up meat dishes. Were all meat consumed on the day it was cooked, outbreaks in institutions and associated with catering establishments would very soon cease. There is some gratification in being able to report that, although a few isolated cases have been reported, no outbreak of food poisoning has occurred in this district for some years. For the purpose of abating nuisances or executing repairs to houses the following notices were served :— Preliminary 144 Abatement 43 Informal (dustbin only) 13 Formal (dustbin only) 4 These figures do not include verbal notices often given in regard to minor matters. For the first time for a number of years it was not found necessary to apply to the Court for Nuisance Orders. In the case of one house and by agreement with the Owner, the Council, pursuant to section 275 of the Public Health Act, 1936, carried out the works necessary to comply with an Abatement Notice. Later, in accordance with section 291 (2) of the same Act and Order was made for the recovery of expenses by instalments. 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 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. 19 INFECTIOUS DISEASES. The following number of rooms were disinfected for the undermentioned causes:— Scarlet fever 3 Tuberculosis 27 Poliomyelitis 13 Paratyphoid 1 Vermin (including fleas) 39 Other 13 Eleven 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 instances where a special 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. FOOD & DRUGS ACT, 1938. This Council did not become a Food and Drugs Authority until October, 1939, the work having previously been carried out by the Surrey County Council. During the year 146 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 Almonds, ground — 1 1 — — — Aspirin tablets 1 — 1 — — — Baking powder — 1 1 — — — Butter — 3 3 — — — Beer 3 — 3 — — — Bacon 1 — 1 — — — Bread — 1 1 — — — Coffee & Chicory Ess. — 3 3 — — — Coffee extract — 1 1 — — — Coffee, powdered — 1 1 — — — Chocolate Roll 3 — 3 2 — 2 Cheese — 2 2 — — — Cooking fat — 2 2 — — — Cider 1 — 1 — — — Condiment, non-brewed 1 — 1 — — — 20 ARTICLES ANALYSED Adulterated or below standard. Formal Informal Total Formal Informal Total Confectionery - 2 2 - - - Cordials — 2 2 - - - Cornflower — 1 1 - - - Cherry wine 1 — 1 - - - Ginger, ground — 1 1 - — — Gelatine 1 - 1 - - - Glucose — 1 1 - - - Gin 2 - 2 - - - Honey — 1 1 - — — Ice-cream 6 8 14 - 1 1 Jelly Crystals — 1 1 - — — Jelly, table — 1 1 - — — Jam — 4 4 - — — Ketchup — 1 1 - — — Lard — 1 1 - — — Milk 36 18 54 - — — Milk (Channel Island) 3 — 3 - — — Milk, condensed — 2 2 - — — Margarine — 3 3 - — — Marmalade — 1 1 - — — Meringue powder — 1 1 - 1 1 Orange curd — 1 1 - — — Pepper, white — 1 1 - — — Rum 1 — 1 - — — Sausage, pork 4 — 4 - — — Sausage, beef 2 — 2 - — — Sausage meat 2 — 2 - — — Sponge mixture — 1 1 - — — Stuffing — 2 2 - — — Sherbert fountain — 1 1 - 1 1 Saccharin 1 — 1 - — — Sherry 1 — 1 - — — Throat tablets — 1 1 - — — Tea — 1 1 - — — Vinegar 2 — 2 - — — Vermouth 1 — 1 - — — Whiskey 1 — 1 - — — Totals 74 72 146 2 3 5 Notes in regard to samples shown as adulterated or below standard or otherwise. Milk. — It is satisfactory to note that none of the fifty-seven samples of milk was adversely reported upon. 21 Chocolate Roll. — These two samples contained only 0.3 and 0.1 per cent respectively of dry fat-free cocoa matter in the sponge whereas, in the opinion of the Public Analyst, they should have contained not less than 4.0 per cent. Proceedings were instituted in both cases the defendants being fined £5. 0s. 0d. and £2. 2s.0d. costs awarded to the Council in each. Meringue Powder. — This was adversely reported upon as regards labelling. The ingredients of this article included wheat starch, potato starch, cocoa and ethyl-methyl-cellulose, whereas they were described on the label as wheat amylum, processed farina, ethyl-methyl-cellulose, flavouring and colouring. In the opinion of the Public Analyst, "wheat amylum" and "processed farina" did not indicate to a prospective purchaser the true nature of the ingredients. Moreover the cocoa is a separate ingredient of this article and cannot be classified as flavouring or colouring. Correspondence with the makers disclosed that printing on recent bags had been altered to show wheat starch in the place of wheat amylum, and it would appear that the Ministry of Food had approved drafts of the label showing processed farina provided this ingredient was potato starch. As regards the cocoa, the makers were agreeable to cocoa being included on the label as an ingredient and not as merely as a flavouring. Sherbert Fountain. — This also was a matter of labelling, chiefly by reason of the fact that although the article contained cornflour it was not included in the list of ingredients printed on the packets. Attention was also drawn to the fact that the labels were nearly illegible. Correspondence with the makers produced the desired result. MILK. During the year the following licences were issued under the Milk (Special Designations) (Raw Milk) or the (Special Designations) (Pasteurised and Sterilised Milk) Regulations, 1949. Dealers Tuberculin tested 7 Pasteurised 8 Pasteuriser's 1 Sterilised 7 Supplementary. Tuberculin tested 8 Pasteurised 8 Sterilised 10 The difference between a dealers and a supplementary licence is that, if a dairyman has premises in a local government area where he retails milk he is issued with a dealers licence. Should he retail milk in another area he must obtain a supplementary licence from the Council of that area. 22 DETAILS OF MILK TESTING. ' Pasteurised' Passed Failed Total Phosphatase test (To determine whether or not the milk has been adequately heat treated) 179 5 184 Methylene blue test (To determine whether or not the milk is of good keeping quality) 182 2 184 ' Sterilised' Turbidity test (To determine whether or not the milk has been adequately sterilised) 19 - 19 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. Five failures occurred out of 184 examined. This test is a highly sensitive one and a failure will result if the milk has been heated to only 1½° lower than the correct temperature of 145°F (holder process), or held for twenty minutes at 145°F instead of thirty minutes. The addition of as little as a quart of raw milk in 100 gallons of pasteurised milk will produce an adverse result. Failures may result from any one of these three factors and inspection of the plant is necessary to ascertain what may be the offending cause. A slight failure by no means indicates that any tubercle bacilli which may have been in the milk before processing will not have been destroyed. The failure might be due to some small error in pasteurising technique, requiring adjustment, but not necessarily demonstrating inadequate treatment. Two samples only failed to pass the methylene blue test. These occurred during the hot weather, when it is recognised that milk kept at an atmospheric shade temperature of above 65°F., even if efficiently pasteurised, will not remain sweet for any lengthy period. Farm bottled (tuberculin tested) milk is not pasteurised and is retailed as it comes from the cow. In order to ensure, as far as possible that this does not contain any tubercle bacilli sixteen samples were taken and submitted for biological examination (animal experiment). These all gave negative results. 23 FOOD SUPPLY. As far as practicable watch is kept on premises where foodstuffs are prepared or sold, which includes butchers' and fishmongers' shops, bakehouses, dairies, restaurant kitchens, etc. Various sections of this report deal with foods and make it unnecessary to report more fully under this head. The following unfit foodstuffs were voluntarily surrendered and destroyed or handed over for salvage Fish, wet 336 lbs. Fish 13 tins Eggs 114 Fruit 285 tins Vegetables 144 tins Beans, baked 13 tins Tea 7 lbs. Sugar 4 lbs. Milk, condensed, evaporated, etc. 26 tins Dried fruit 120½ lbs. Confectionery 2 lbs. Irish chicken 13 lbs. Boiling fowls 4 Sponges, jam, etc., 56 Jam or marmalade 13 tins Soups, various 6 tins Luncheon meat 43 tins Potato, dried 1¾ lbs. Raisins 23 lbs. Braised steak 4 tins Jellies 4 Gammon, cooked 6 lbs. Ham, tinned 15 tins Mincement 6 tins Veal, jellied 47 lbs. Lemonade powder 1 lb. Chutney 66 tins Cake mixture 1 pkt. Oats and cereals 5 pkts. Flour 4 bags Soft roes 24 lbs. Sausages 17 tins Pork sausage 60 lbs. Pork butts 17 tins Beef 206 lbs. Pork 5 lbs. Mutton or lamb 136½ lbs. Mutton, cooked 176 lbs. Bacon 23 lbs. A number of complaints regarding foodstuffs was received during the year, some of which are worth recording :— (1) A tea cake was found to have some discolouration in the interior and, moreover, was alleged to have caused sickness and dizziness after being eaten. The Public Analyst, however, certified that the discolouration was of an entirely innocent nature and he could find nothing to account for the sickness. 24 (2) A complaint was made alleging that a loaf of bread sold under a proprietory name was not, in fact. so. The loaf was submitted to the Public Analyst who was able to certify it to be genuine. (3) A loaf of brown bread was brought to me and a complaint lodged alleging that after eating a portion, a burning sensation in the throat was experienced by two persons. The Public Analyst could find no abnormal constituent or impurity and certified the bread to be wholesome and fit for consumption. (4) The bottom three slices of a packet of sliced bread was found to have a quantity of woollen rhaterial adhering and a complaint was made to me in consequence. Proceedings were instituted in this case and the defendants were fined £5. 0s. 0d. with £3. 3s. 0d. costs. (5) A 1s. 6d. family block of ice-cream was found to contain a piece of metal. There was a number of factors which raised doubts as to where the metal had pierced the carton and got inside the ice-cream, and the Public Health Committee decided that warnings should be given to both manufacturer and seller. (6) The purchaser of a bun complained to me in regard to the presence of a piece of wire in the interior. Proceedings were instituted in this case and the defendants were fined £5. 0s. Od. with £3. 3s. 0d. costs. (7) A complaint was made that a loaf of bread was found after purchase to have some foreign matter, thought to be cigarette ash. on the crust. The Public Analyst found, however, that the dust was not tobacco ash but consisted of a mixture of flour and ordinary miscellaneous dirt including cotton and other fibres, dark siliceous particles and coal and coke dust. There was no contamination in the interior except where it could have been introduced from the outside during cutting of the loaf. A warning was given. (8) A milk bottle was found to contain some adherent deposit in the interior. This was no doubt some cement which had hardened. The Bottle was submitted to the Public Health Laboratory and their certificate stated, "No pathogenic organisms were found". It was clear, therefore, that the purity of the milk was unaffected and a warning was given. (9) Some small pieces of glass were found in a bottle of milk and the purchaser complained of this. The matter was very thoroughly investigated and the committee decided not to prosecute but to issue a warning in this case. (10) The purchaser of a bun found that it had a sour bitter taste and then noticed it was soiled. He thereupon brought it to me. The bun was then in three portions, one being partly buttered, one unbuffered and one partly masticated. They were all sent to the Public Analyst who found that the trouble was due to the presence of a black mould. The presence of this mould would account for a sour bitter taste, but there was no reason to suppose it would be injurious to health. Proceedings were instituted in this case, the defendant being fined £8. 0s. 0d. with £2. 2s. 0d. costs. (11) A loaf of bread was found to contain a nail. Proceedings were instituted in this case and the defendants were fined £5. 0s. 0d. with £3. 13s. 6d. costs. ICE CREAM. Seventy-six samples were submitted for testing by the methylene blue method and, of these, seventy-one reached grades I or II standards. Five were placed in grade III and none in the 25 low category of grade IV. The results can be said to be very gratifying As I have previously explained the methylene blue 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 grades I or II give reasonable grounds to indicate defects in manufacture or handling requiring further investigation. The certificate giving the results of testing has the following note appended :— "Owing to the numerous factors governing the hygienic quality of ice-cream it is unwise to pay too much attention to the bacteriological results of any single sample. Judgement should be based rather on a series of samples. It is suggested over a six monthly period 50 per cent of vendors samples should fall into grade 1, 80 per cent into grades I or II, not more than 20 per cent into grade III and none into grade IV". The following table shows the results of samples taken since 1947 and it will be seen that those for the past two years are well within the limits indicated in the above note. Year Total Samples Taken Grades I or II. % Grade III. % Grade 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 1950 85 81 95.3 4 4.7 Nil. — 1951 79 74 93.7 5 6.3 Nil. — 1952 76 71 93.4 5 6.6 Nil. — It may be noted that all five samples placed in Grade III were manufactured outside this Borough. The firms concerned and the Health Departments of the Councils in whose area the icecream was made were notified and subsequent samples proved satisfactory. Ice-cream generally must now contain not less than 5% fat, 10% sugar and 1½% milk solids other than fat, although some variations in this standard are permitted where ice-cream contains fruit or, because of the Jewish dietary law, is sold as Parev (Kosher) Ice. A number of samples were taken during the year, details of which will be found in the table giving a list of food and drugs samples analysed (pages 19 and 20). MERCHANDISE MARKS ACT. By reason of the fact that the Council appoints an analyst for the purposes of the Food and Drugs Acts, 1938 and 1944, they may execute any of the provisions of the Merchandise Marks Act 26 other than those relating to importation, so far as relates to any foodstuff to which an Order in Council under the Act applies. These are administered by my department. As much of the work can be done whilst visits are being made for other purposes, it does not entail a great deal of time. The Act requires that an indication of origin is given in the case of certain imported goods. During the War the Ministry of Food exercised emergency powers to suspend the Marking Orders relating to eggs, bacon, butter, dried fruit, meat and poultry and, by Directions made in May, 1950 these suspensions were continued (except for eggs) until 31st May, 1951. A few cases were found where foreign apples or tomatoes were not labelled as such and verbal warnings were given. SMOKE ABATEMENT. This is not a district where there is a large number of factory chimneys and it is not long before I hear about one of them offending by issuing smoke or grit. During the year investigations have had to be made into several instances where trouble has occurred. I have found factory managers and employees in general are most anxious that no nuisance shall occur but circumstances sometimes arise when they are more or less helpless. The trouble at one factory which was still under close investigation at the end of the year was due to the fact that the fuel being used was waste products of the factory (wood shavings and chips, saw-dust, etc.). Special apparatus was installed but this did not altogether stop grit emission and, unless the stoker was constantly on the look-out, black smoke also. Experiments were being conducted to try and abate this nuisance. SHOPS ACT. I have little to report under this heading. One or two warnings regarding minor offences were given. During the year an Order in Council namely "the Shops (Revocation of Winter Closing Provisions) Order 1952, revoked such of the provisions of section 2 and 6 of the Shops Act, 1950, as prescribe the general closing hours of shops in winter; accordingly the general closing hours will now be the same throughout the year. 27 ERADICATION OF BED BUGS. During the year the following numbers of houses were found to be infested with bed bugs:— Infested Disinfested Council houses (rooms) 15 15 Other houses (rooms) 18 18 There is little doubt that the incidence of bed bug infestation is far less now than in the pre-war years. The use of D.D.T. and Gammaxane may have some bearing on this, whereby secondhand furniture, etc., so often the vehicle for introducing these vermin into houses can be effectively and more easily disinfested. RATS AND MICE DESTRUCTION. A very considerable change has taken place in our approach to this important subject since 1921 when, soon after I commenced my duties here, I persuaded the Council to get the Surrey County Council to delegate their powers under the old Rats and Mice (Destruction) Act, 1919. Year by year, with limited resources at our disposal, good work was done to keep the rat population of the district at a minimum. Regularly every November "Rat Weeks" were held when extraordinary efforts were made to focus public attention on the paramount importance of destroying rats. Thousands of circulars giving detailed methods of how best to go about poisoning or trapping rats, were distributed. This did not mean that for the remaining 51 weeks we remained quiescent. On the contrary, throughout the year we continued the good work of relying on our powers of persuasion to gain the co-operation that was so vitally necessary. In 1937 the work had so developed that I asked for and obtained the sanction of the Council to employ a man — full time — to assist me in this work. This marked a distinct advance and commenced what may be termed the second phase. We were now enabled, on request, to carry out the work of destroying rats ourselves and to make small charges for services rendered. More important still it allowed the work to be done more systematically and efficiently. I like to mention the foregoing because it does show that we were working hard and doing our best to tackle the rat problem long before the third and present phase which commenced during the last great war. The food shortage and the vital necessity for husbanding our resources in this respect led to the Government under emergency powers, to make the Infestation Order in 1943 and, shortly afterwards, a conference of all local authorities and other interested parties or organisations was called by the Minister 28 of Food to discuss a regional control scheme for the whole of the London area. (Similar regional schemes were set up throughout the country). This marked the real turning point in the methods employed to combat the rat menace. It was really the datum line for the change over from well-meant but rather haphazard individualistic action to efficient and strictly co-ordinated methods. Much could be written of this subject but our efforts in the past, often the subject of ridicule however well done, with the little or no assistance available, could not keep up with the breeding propensities of the rats. What is the position today ? We have now a Rodent Officer working under my general supervision with two operatives giving full-time service throughout the year. They use up-to-date methods and poisons, they are fully trained for their job and are enthusiastic inasmuch that they know their work is of importance. The utmost co-operation exists between the responsible government department and local authorities and between local authorities themselves. No longer is it a case of one local authority striving to keep its district free whilst an adjoining district does little or nothing. Occupiers of private dwelling houses, whilst not being relieved of their responsibility, are given a service without payment and freely take advantage of this offer. The days when one householder himself tries to rid his premises of rats whilst his neighbours do nothing has passed. Whenever a request for assistance is received an investigation is made at all the adjoining properties. The owners of business premises are required to pay for the services rendered, but a large proportion, in this district, are willing to pay annual charges to cover regular inspection by our staff and for treatment if and when required. Sewers in the district are test-baited annually to make sure they are not infested with rats. It has been proved that sewer infestation is often associated with trouble on the surface. Council depots, sewage disposal works, piggeries and open spaces all receive their share of attention. The work of rat destruction is now carried out on a well organised basis and is providing a service to ratepayers which I have every reason to believe is very much appreciated by the great majority. MISCELLANEOUS. During the year it became necessary to arrange for the funerals of three persons where no suitable arrangements for the disposal of the bodies had been made. This is a duty placed upon Local Authorities by Section 50 of the National Assistance Act, 1948. Only a small proportion of the expenses involved could be recovered. 29 The depot and pigstyes at California Road have been practically free from cricket infestation and only minor measures to control a small infestation at the refuse tip at Norbiton Potteries were called for. A more serious situation, however, arose at the Norbiton Potteries due to flooding of the pit and a potential nuisance existed for some time. Steps were taken for hard material and clay to be dumped by contractors over the areas where the standing water was shallow, thereby leaving one large deep pond which would be more convenient to deal with should it become offensive. I am sure this would have happened had not a most beneficial circumstance accidently arisen. A quantity of yellow coloured material was deposited at a number of points round the lake and soon the water turned a similar colour. At this time I was visiting daily anxiously watching for developments. The water, however, retaining its yellow colour remained completely inoffensive. I thought at this stage that something more should be known of what was going on and samples of the water and the material were sent to the Public Analyst. He found that the water was coloured yellow by the presence of chromate (as CrO3 ) 480 parts per million and that the yellow material on the bank consisted essentially of compounds of chromium in various degrees of oxidation. The effect of the presence of this chromate in the water, which has excellent oxidising and sterilizing properties, was to destroy much of the organic matter which normally accumulates in stagnant water of this nature and prevented the formation of objectionable odours. So long as the presence of this solid matter continues to act as a source of chromate the water will probably remain free from any of the troubles normally associated with stagnant water accumulating on or near the refuse tips. This was borne out by a series of samples of the water submitted for bacteriological examination, the water remaining consistently good. The bacteriologists remarks regarding this were — "Coliform bacilli only become viable when the water is diluted and it is likely, therefore, that the chromate is exerting an inhibiting action." This was certainly the position at the end of the year, but just how long the situation will remain so satisfactory I cannot say. Some urgent action may become necessary at any time during the summer months if the strength of the chromate in the water lessens so that its inhibiting action on bacteria breaks down. A thing that has puzzled me is why the pit has remained flooded when in years gone by, during summer, only a small deep pond remained. In my last Annual Report I made reference to the fact that during the past few years many requests have been received from householders for assistance in destroying wasps nests. During the 30 year under review 65 wasps nests and 1 hornets nest were destroyed. Again some requests were declined where the nests were found to be in positions not causing real inconvenience. Wasps are not entirely harmful, in fact it is known that they do much good and the indiscriminate destruction of nests should be avoided. The department also gave advice or assistance in dealing with bats, moles, beetles, slugs, ants and pigeons. By arrangement with the Surrey County Council the school kitchens and canteens (eight in number) were thoroughly sprayed at the appropriate time with D.D.T. solution as a deterent against insect infestation. Forty-one vacant council houses were inspected for any signs of bed bug infestation and where evidence was discovered (in two instances) appropriate steps were taken. Modern methods of treatment are far more simple and effective than those of a few years ago and cases of infestation are less frequently met with now than previously. One licence, of a limited character, was granted to station a moveable dwelling in the area. No application was received during the year for an Improvement Grant under the Housing Act, 1949, although several enquiries were made. Stoppages in public sewers (combined drains) were cleared by the department on two hundred and twenty-three occasions. In a few instances the assistance of sewermen from the Borough Engineer's department had to be obtained. 31 RAINFALL, 1952. Table showing rainfall in the district during 1952, taken at the Sewage Disposal Works, California Road, New Malden. Inches January 1.68 February 1.02 March 2.67 April 1.40 May 2.40 June 2.03 July 0.60 August 2.42 September 3.19 October 2.51 November 3.20 December 2.35 25.47 Decrease on previous year 4.81 inches Average for past five years 23.89 inches Conclusion. And now I take my final leave, regretfully perhaps after such a long time (46 years) spent in the public health service. Nevertheless it is not entirely devoid of some feeling of pleasure. That my work has earned the approbation of the Council has been demonstrated by the presentation to me, by the Mayor at my last Council meeting, of a testimonial couched in felicitous terms and bearing the seal of the Corporation. This and other kind messages in reference to my retirement received from citizens of this Borough, has given me infinite satisfaction and makes the ending of my career less of an ordeal than might have been expected. I am, Mr. Mayor, Aldermen and Councillors, Your obedient servant, HENRY TUNBRIDGE, Sanitary Inspector. 32 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 (i) Factories in which sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities. 14 15 2 — (ii) Factories not included in (i) in which section 7 is enforced by Local Authorities. 93 86 4 — (iii) Other premises in which section 7 is enforced by the Local Authority. 6 4 — — Total 113 105 6 — 33 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 2 2 — 1 — Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — — Sanitary Conveniences: (a) Insufficient 1 1 — 1 — (b) Unsuitable or defective 1 1 — — — (c) Not separate for sexes (absence of screening) — — — — — Other offences against the Act (not including offences relating to Outwork) 2 2 — — — Total 6 6 — 2 — 34 PART VIII OF THE ACT. OUTWORK. No. of out-workers in August list req'd. by Sect. iio(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 Brush making 17 — — — — — Making of wearing material 5 — — — — — File making 2 — — — — — Total 24 — — — — — Printed by Raynes Park Press, Lambton Road. London S.W.20