ORP 2 ORPINGTON URBAN DISTRICT COUNCIL REPORT For the Year 1938 on the Sanitary Conditions and Vital Statistics of the Urban District of Orpington by the Medical Officer of Health. Together with REPORT of the CHIEF SANITARY INSPECTOR. Bromley: THE BROMLEY PRINTING CO., BROMLEY, KENT. URBAN DISTRICT COUNCIL OF ORPINGTON. Public Health Committee. Chairman: P. ~VV. H. Twyman, Esq. Vice-Chairman: J. R. Guthrie, Esq. Lt.-Col. K. M. Kirkhope, c.i.e.G. T. May, Esq. F. J. Bell, Esq. C. L. Bruce, Esq. C. S. Hammarton, Esq. H. J. Lester, Esq., f.s.a.a. F. W. Moore, Esq., j.p., f.c.a. A. L. Priest, Esq., j.p. J. H. B. Rich, Esq. W. J. Tarry, Esq. Representatives on the West Kent Main Sewerage Board: C. L. Bruce, Esq. A. L. Priest, Esq., j.p. Representatives on the West Kent Joint Hospital Board: C. L. Bruce, Esq. A. L. Priest, Esq., j.p. STAFF: Medical Officer of Health: P. N. Cave, m.a., m.d., m.r.c.s., l."r.c.p., d.p.h. Sanitary Inspectors: J. A. Capon, c.h.s.i., m.s.i.a. (Chief Sanitary Inspector and Cleansing Superintendent). F. C. Crowe, m.r.s.i., mjs.i.a. (Deputy Chief Sanitary Inspector, Housing Inspector and Inspector under the Shop Acts). W. T. Weedy, c.r.s.i., m.s.i.a. (Senior District Sanitary Inspector and Inspector under the Shop Acts). D. H. llvesey, m.r.s.i., m.s.i.a. (District Sanitary Inspector). It. Taylor, c.r.s.i., m.s.i.a. (District Sanitary Inspector). Health Visitor: Miss L. Tate. Clerk and Shorthand Typist: Miss M. E. Stimson, 2 URBAN DISTRICT COUNCIL OF ORPINGTON. Health Report for 1938. Gentlemen, I beg to submit to you my Annual. Healtli Report for the year 1938, this being the fifth one presented by me as your Medical Officer of Health, but the sixteenth one in respect of the area concerned. The population of the District as estimated by the Registrar-General for mid-year 1938 is 46,320, which is an increase of 2,710 on the corresponding figure for mid-year 1937. From the point of view of Public Health the year has been a satisfactory one. There was an increase in the Birth Rate, viz., 19.3 per thousand of population, as compared with 18.0 last year. The Birth Rates for England and Wales were 15.1 in 1938 and 14.9 in 1937. The Death Rate showed a decrease as compared with the last two years, viz., 8.3 in 1938, as against 8.6 in 1937 and 10.3 in 1936. The Death Rates for England and Wales were 11.6 in 1938 and 12.4 in 1937. A very large decrease in the Infantile Mortality Rate took place, the rate for 1938 being 28 per thousand registered births, as compared with 52 last year and 64 in 1936. The Infantile Mortality Rates for England and Wales were 53 for 1938, 58 for 1937 and 59 for 1936. From the point of view of incidence of Infectious Disease the year was a satisfactory one. Although the number of notifications received were somewhat in excess of those received during the previous year, the increase was almost entirely due to the greater number of cases of Measles notified. I again desire to place on record my thanks for the assistance I have received from, the Council and its Officers. In particular, I would especially desire to express my appreciation of the services so loyally and efficiently rendered by the staff of the Public Health Department. I am, Gentlemen, Your obedient Servant, P. N. CAVE, Medical Officer of Health, 3 SECTION A.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 20,842 Population, Census, 1931 43,610 Registrar-General's estimate of population, mid-1938 46,320 Number of occupied houses, 1937 13,635 Number of occupied houses, December, 1938 14,734 Rateable Value of District, December, 1938 £431,397 Sum represented by a penny rate, December, 1938 £1,625 SECTION B.—VITAL STATISTICS. Total. M. F. Birth Rate per 1,000 of estimated population. Live births J Legitimate 865 442 423 Illegitimate 33 21 12 19.3 Total Births 898 463 435 Rate per 1,000 (live and still) births. Stillbirths 25 15 10 27.07 Death Rate per 1,000 of estimated population. Deaths 388 216 172 8.3 Deaths. Rate per 1,000 total (live and still) births. Deaths from puerperal causes: Puerperal Sepsis - - Other puerperal causes 3 3.25 Total 3 3.25 Death Rate of Infants under one year of age:— All infants per 1,000 live births 28 Legitimate infants per 1,000 legitimate live births 26 Illegitimate infants per 1,000 illegitimate live births 90 Deaths from Cancer (all ages) 57 Deaths from Measles (all ages) Nil. Deaths from Whooping Cough (all ages) Nil. Deaths from Diarrhoea (imder 2 years of age) 6 4 PUBLIC HEALTH DEPARTMENT. During the year a re-organization of the Sanitary Inspectors' section of the Public Health Department took place, and the Inspectorial Staff and their duties are now as follows:— J. A. Capon, Chief Sanitary Inspector and Cleansing Superintendent. F. C. Crowe, Deputy Chief Sanitary Inspector, Housing Inspector, and Inspector under the Shop Acts. W. T. Weedy, Senior District Sanitary Inspector and Inspector under the Shop Acts. D. H. LlVESEY, District Sanitary Inspector. II. Taylor, District Sanitary Inspector. The Urban District has been divided into three areas, with an Inspector in charge of each. No. I District—Senior District Inspector W. T. Weedy. Comprising Crofton, Knoll, and St. Mary Cray Wards. Extent, 4076.4 acres. Estimated Population mid-1938, 20,140. No. 2 District—District Inspector R. Taylor. Comprising Goddington, Chelsfield, Green Street Green, and Knockliolt Wards. Extent, 7355.2 acres. Estimated Population mid-1938, 12,340. No. 3 District—District Inspector D. H. Livesey. Comprising Farnborough, Leaves Green, Downe, Biggin Hill, and Cudliam Wards. Extent, 8810.0 acres. Estimated Population mid-1938, 7,840. 5 VITAL STATISTICS. BIRTHS. During1 the year 898 Births were registered as belonging to the District, of which number 463 were males and 435 were females. This is equal to an Annual Birth Kate of 19.3 per thousand of population, as compared with 18.0 last year. The Birth Rate for England and Wales was 15.1 in 1938 and 14.9 in 1937. The number of Births registered as being illegitimate was 33, of which 21 were males and 12 were females. There were also 25 stillbirths; 15 males and 10 females. DEATHS. The number of Deaths registered during the year as belonging to the District was 388 (216 males and 172 females). This number includes those deaths which, although occurring outside belonged to this District, but excludes deaths occurring inside the District, but belonging to other Districts. The Death Rate for the year was equal to 8.3 per thousand of population, as against 8.6 last year, The Death Rate in England and Wales was 11.6 in 1938 and 12.4 in 1937. The diseases claiming the largest number of deaths were: Heart disease, 118; Cancer, 57; Circulation diseases 23 and Pulmonary Tuberculosis, 21. The following Table shows the diseases having the greatest influence on the Death Rate for the past five years:— Year Heart Disease Cancer Cerebral Haemorrhage Bronchitis Pneumonia Pulmonary Tuberculosis 1934 (9 months) 46 31 18 2 6 11 1935 108 39 17 5 21 19 1936 98 61 16 9 31 15 1937 101 50 12 8 26 19 1938 118 57 12 8 17 21 6 INFANTILE MORTALITY. Tlie number of deaths registered as occurring in infants under one year of age was 26 (14 males and 12 females). Of these, 23 were legitimate and 3 were illegitimate. The Infantile Mortality Rate was equal to 28 per thousand births, as compared with 52 last year. The Infantile Mortality Rate for England and Wales was 53, and for 1937, 58, DEATHS AT DIFFERENT AGES. Deaths in Children between One and Five Years.—Three deaths occurred in children between the ages of one and five years. This is equal to a Death Rate of 0.06 per thousand of population. Deaths in Persons of 65 Years and Over.—The number of deaths registered as occurring in persons of 65 years and over was 212.. This is equal to a Deatli Rate of 4.5 per thousand of population, and comprises 54.6 per cent, of total deaths. CAUSES OF DEATHS. The Deaths registered during the year included:— Diphtheria 2 Heart Diseases 118 Influenza 5 Bronchitis 8 Pulmonary Tuberculosis 21 Pnuemonia 17 Other Tuberculous Diseases 3 Nephritis 6 Congenital Debility, etc. 7 Cancer 57 Suicide 5 Cerebral Haemorrhage 12 Accident 18 VITAL STATISTICS—PRINCIPAL FEATURES. The following Table shows a comparison of the main features in Vital Statistics for the District during the past five years:— 1934 (9 months) 1935 1936 1937 1938  Population 33,420 36,620 39,900 43,610 46,320 No. of births registered 430 668 763 786 898 Birth Rate 17.1 18.2 19.1 18.0 19.3 No. of Deaths registered 217 349 413 378 388 Death Rate 8.6 9.5 10.3 8.6 8.3 Infantile Mortality Rate 32 47 64 52 28 7 Birtli-iates, Death-rates, Analysis of Mortality, Maternal Death-rates, and Case-rates for certain Infectious Diseases in the year 1938. England and Wales, London, 126 Great Towns and 148 Smaller Towns. England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Resident Populations 25,000 to 50,000 at L931 Census) London Administrative County Orpington Urban District Rates per 1,000 Population Births:— Live 15.1 15.0 15.4 13.4 19.3 Still 0.60 0.65 0.60 0.48 0.32 Deaths:— All causes 11.6 11.7 11.0 11.4 8.3 Typhoid and Paratyphoid fevers 0.00 0.00 0.00 0.00 0.00 Small no* 0.00 - 0.00 - 0.00 Measles 0.04 0.05 0.03 0.06 o'.oo Scarlet Fever 0.01 0.01 0.01 0.01 0.00 Whooping Cough 0.03 0.03 0.02 0.03 0.00 Diphtheria 0.07 0.07 0.06 0.05 0.04 Influenza 0.11 0.10 0.11 0.06 0.10 Notifications:— Smallpox 0.00 0.00 0.00 — — Scarlet Fever 2.41 2.60 2.58 2.05 1.66 Diphtheria 1.58 1.85 1.53 1.90 0 47 Enteric Fever 0.03 0.03 0.04 0.05 0 15 Erysipelas 0.40 0.46 0.39 0.46 0.57 Pneumonia 1.10 1.28 0.98 0.98 0.66 Rates per 1,000 Live Births Deaths under 1 year of age 53 57 51 57 28 Deaths from Diarrhœa and Enteritis under 2 years of age 5.5 7.8 3.6 13.1 6.68 Maternal Mortality:— Puerperal Sepsis 0.89 Not available — Others ... 2.19 3.34 Total 3 08 3.34 Rates per 1,000 Total Births (i.e. Live and Still) Maternal Mortality:— Puerperal Sepsis 0.86 Not available - Others 2.11 3.25 Total 2 97 3.25 Notifications:— Puerperal Fever 14.42 18.08 12.51 3.53 19.50 Puerperal pyrexia 15.46 8 ZYMOTIC DEATH RATE. The Zymotic Death Bate is a term commonly applied to the rate of deaths from the seven principal zymotic complaints, viz., Small Pox, Measles, Scarlet Fever, Diphtheria, WhoopingCough, Diarrhoea and " Fever," which latter includes Typhus, Typhoid (or Enteric) and Paratyphoid Fevers. During the year 8 deaths occurred from these complaints, the Zymotic Death Eate being 0.17 per thousand of population. PULMONAEY TTJBEECULOSIS. The deaths occurring from Pulmonary Tuberculosis (Consumption or Phthisis) numbered 21. This is equal to a Death Eate of 0.45 per thousand of population. OTHEE EESPIEATOEY DISEASES. The deaths from other diseases of the respiratory system numbered 23. This gives a Death Eate of 0.49 per thousand of population. CANCEE. The number of deaths from Cancer (malignant disease) was 57. The Death Eate from Cancer was 1.25 per thousand of population. INFLUENZA. During the year 5 deaths occurred from Influenza, the Death Eate being 0.10 per thousand of population. ANALYSIS OF DEATH BATES. All Causes Seven Principal Zymotic Complaints Pulmonary Tuberculosis Other Respiratory Complaints Cancer Influenza Number of Deaths 388 8 21 23 57 5 Death Rate per 1000 of population 8.3 0.17 0.45 0.49 1.25 0.10 A comparison between the Vital Statistics for the District and those for England and Wales is shown by the subjoined Table. 9 DEATHS REGISTERED DURING THE YEAR 1938. Cause of Death Males Females Total Typhoid and paratyphoid — — — Measles — — — Scarlet fever — — — Whooping Cough — — — Diphtheria 1 1 2 Influenza 3 2 5 Encephalitis Lethargica — — — Cerebro-spinal Fever — — — Tuberculosis of respiratory system 13 8 21 Other Tuberculosis diseases 3 — 3 Syphilis 1 1 2 General paralysis of the insane (Tabes Dorsalis) — — — Cancer 27 30 57 Diabetes — 6 6 Cerebral haemorrhage 4 8 12 Heart disease 63 55 118 Aneurism 2 1 3 Other circulatory diseases 15 8 23 Bronchitis 5 3 8 Pneumonia (all forms) 14 3 17 Other respiratory diseases 2 1 3 Peptic ulcer 3 — 3 Diarrhoea (under 2 years) 4 2 6 Appendicitis — — — Cirrhosis of liver — 1 1 Other diseases of liver — — — Other digestive diseases 3 2 5 Acute and chronic Nephritis 6 — 6 Puerperal sepsis — — — Other Puerperal causes — 3 3 Congenital debility, premature birth, malformations 7 8 15 Senility 4 9 13 Suicide 1 4 5 Other violence 13 5 18 Other defined diseases 21 11 32 Other ill-defined diseases 1 — 1 Total 216 172 388 10  1934 1935 1936 1937 1938 Orpington Urban District England and Wales Orpington Urban District England and Wales Orpington Urban District England and Wales Orpington Urban District England and Wales Orpington Urban District England and Wales Birth Rate 17.1 14.8 18.2 14.7 19.1 14.8 18.0 14.9 19.3 15.1 Death Rate 8.6 11.8 9.5 11.7 10.3 12.1 8.6 12.4 8.3 11.6 Infantile Mortality rate 32 59 47 57 64 59 52 58 28 53 INFECTIOUS DISEASE. The year 1938 was a fairly satisfactory one from the point of view of incidence of Infectious Disease. Although the number of cases notified increased from 260 last year to 458 in 1938, this was in consequence of a larger number of cases of Measles being* notified. Excluding Measles there were 184 cases notified as compared with 191 last year. Details of the work carried out in connection with the Immunisation Clinic will be found on another page. The following t able shows the number of cases notified, together with the number removed to Hospital, and the number of deaths registered:— Disease Number Notified N umber Removed to Hospital Deaths Scarlet Fever 77 49 — Diphtheria 22 20 2 Enteric Fever 7 4 — Erysipelas 25 — — Pneumonia 26 — 17* Puerperal Pyrexia 18 — — Ophthalmia Neonatorum 2 — — Dysentery 2 — — Malaria 1 — — Acute Poliomyelitis 4 — — Measles 274 4 — TOTALS 458 77 19 *A11 forms. 11 Disease Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total The monthly incidence of Infectious Disease was:— Scarlet Fever 9 5 1 5 13 13 9 ... 1 11 5 5 77 Diphtheria 3 4 2 ... 1 3 1 1 4 ... 2 1 22 Typhoid Fever 2 1 1 ... ... 1 ... 2 ... ... ... ... 7 Erysipelas 3 3 8 1 1 4 ... 2 ... ... 1 2 25 Pneumonia 2 7 6 5 1 ... ... ... ... 2 ... 3 26 Puerperal Pyrexia 3 1 2 2 1 1 ... 2 2 2 2 ... 18 Ophthalmia Neonatorum ... ... 1 ... 1 ... ... ... ... ... ... ... 2 Dysentery ... ... ... 2 ... ... ... ... ... ... ... ... 2 Malaria ... ... ... ... ... 1 ... ... ... ... ... ... 1 Acute Poliomyelitis ... ... ... ... ... ... ... ... ... ... 4 ... 4 Measles 7 16 73 85 43 25 19 4 2 ... ... ... 274 Totals 29 37 94 100 61 48 29 11 9 15 14 11 458 12 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1938. Disease Number of cases notified Cases removed to Hospital Deaths At all ages At ages—years Under 1 year 1 and under 2 2 and under 3 3 and under 4 4 and under 5 5 and under 10 10 and under 15 15 and under 20 20 and under 35 35 and under 45 45 and under 65 65 and over Scarlet Fever 77 — 1 — 7 6 44 5 3 7 3 1 — 49 — Diphtheria 22 — — 1 — — 15 2 1 3 — — — 20 2 Typhoid Fever 7 — — — — — 1 — 1 2 — 3 — 4 — Erysipelas 25 — — — — — 2 1 3 3 3 8 5 — — Pneumonia 26 — 1 — 1 2 3 1 1 2 6 7 2 — 17* Puerperal Pyrexia 18 — — — — — — — — 18 — — — — — Ophthalmia Neonatorum 2 2 — — — — — — — — — — — — — Dysentery 2 — — — — — — — — — 2 — — — — Malaria 1 — — — — — — — — 1 — — — — — Acute Poliomyelitis 4 — — 1 1 — 1 1 — — — — — — — Measles 274 4 15 13 10 22 186 15 3 6 — — — 4 — TOTALS 458 6 17 15 19 30 252 25 12 42 14 19 7 77 19 *A11 forms of Pneumonia. 13 The following Table shows the number of cases notified during the past five years:— 1934 (9 months) 1935 1936 1937 1938 Scarlet Fever 86 63 193 73 77 Diphtheria 46 48 33 53 22 Enteric Fever — 1 3 4 7 Erysipelas 31 25 26 19 25 Puerperal Fever 2 4 3 4 — Puerperal Pyrexia 2 7 3 5 18 Ophthalmia Neonatorum 3 — 1 1 2 Acute Poliomyelitis 1 — — — 4 Pneumonia 15 22 25 27 26 Cerebro-spinal Meningitis — — 2 2 — Malaria — — 3 1 1 Dysentery — — — 2 2 Measles 104 59 831 69 274 TOTALS 290 229 1,123 260 458 SMALL POX. No cases of Small Pox were notified during the year in this District. SCARLET FEVER. There were four more cases of Scarlet Fever notified than last year, viz., 77 as against 73 last year, and 193 in 1936. Forty-nine cases were removed to the Isolation Hospital. No Deaths were registered as occurring from Scarlet Fever. 14 The age periods were:— Under 1 1 to 5 5 to 10 10 to 15 15 to 20 over 20 — 14 44 5 3 11 The monthly incidence was:— Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 9 5 1 5 13 13 9 — 1 11 5 5 DIPHTHEBIA. A decrease in the number of cases of Diphtheria notified took place, viz., 22 as against 53 last year. This is the lowest number of cases notified in any year since 1934. Twenty cases were removed to the Isolation Hospital. Two deaths were registered as occurring from this complaint during the year. The age periods were:— Under 1 1 to 5 5 to 10 10 to 15 15 to 20 over 20 — 1 15 2 1 3 The monthly incidence was:— Jan Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 3 4 2 — 1 3 1 1 4 — 2 1 The Immunisation Clinic, which was opened in May, 1929, has been in operation during the year. Details of the work carried out will be found on another page. The number of new cases attending during the year was 374. 15 The Council has made arrangements for the examination of swabs from cases, or suspected cases, of Diphtheria, and during the year 256 such examinations have been made. ENTERIC FEVER. During the year 7 cases of Enteric Fever were notified, as compared with 4 last year. Four cases were removed to the Isolation Hospital. No deaths occurred from this disease. PUERPERAL PYREXIA. During the year 18 cases of Puerperal Pyrexia were notified. This number includes cases which previously were notified as Puerperal Fever. OPHTHALMIA NEONATORUM. Two cases of Puerperal Fever were notified, this being one more than last year. No impairment of vision occurred in either case. POLIOMYELITIS. During the year 4 cases of Acute Poliomyelitis were notified, these being the first cases notified since 1934. DYSENTERY. Two cases were notified. PNEUMONIA. During the year 26 cases of Pneumonia were notified, this being one less than last year. During the year 17 deaths were registered from Pneumonia (all forms). MEASLES. Measles is a compulsorily notifiable disease in this District. During the year 274 cases were notified, as compared with 69 last year and 831 in 1936. Four cases were removed to the Isolation Hospital. No deaths were registered as occurring from Measles. 16 TUBERCULOSIS. During the year 37 new cases of Tuberculosis were notified, as compared with 54 last year. The 37 new cases comprised:— Males. Females. TOTAL Pulmonary 13 19 32 Non-Pulmonary 2 3 5 TOTAL 15 22 37 The number of deaths registered as occurring from Tuberculosis during the year was 24, viz.:— Males. Females. TOTAL. Pulmonary 33 8 21 Non-Pulmonary 3 — 3 TOTAL 16 8 24 The treatment for cases of Tuberculosis is carried out by the Kent County Council through the agency of their Tuberculosis Officers. Sanatorium and dispensary treatment is provided for both insured and uninsured persons, and during the year the following number of patients have received treatment. Number who received sanatorium treatment 45 Number who received dispensary treatment 7 Dispensary supervision only 104 The two Dispensaries available for this District are:— 2, Park Road, Bromley.—Wednesdays 1.30 to 3.30 p.m. and Fridays 5 to 6 p.m. Medical officer in charge: Dr. B, G. Edelston. 1, Westbury Road, Penge.—Wednesdays 5 to 6 p.m. and Fridays 1.30 to 3.30 p.m. Medical Officer in charge: Dr. T. P. Cole. 17 The following Table shows the number of new cases of Tuberculosis notified during the year, together with the number of deaths, at various age periods. Age Periods. New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M. F. M. F. M. F. M. F. Under 1 year ... ... ... ... ... ... 1 ... 1 and under 5 ... ... ... ... ... ... ... ... 5 and under 10 1 ... 1 1 1 ... ... ... 10 and under 15 ... ... ... 1 ... 1 2 ... 15 and under 20 ... 2 1 ... ... 1 ... ... 20 and under 25 1 3 ... 1 ... 1 ... ... 25 and under 35 6 10 ... ... 1 3 ... ... 35 and under 45 3 2 ... ... 5 2 ... ... 45 and under 55 2 2 ... ... 4 ... ... ... 55 and under 65 ... ... ... ... 2 ... ... ... 65 and upwards ... ... ... ... ... ... ... ... TOTALS 13 19 2 3 13 8 3 ... PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Tlie above Regulations, which came into force on the 1st January, 1931, require, inter alia, that a Weekly Return of all notified cases of Tuberculosis should be sent to the County Medical Officer of Health; and also that a quarterly statement should be sent by the Medical Officer of Health to the County Medical Officer of Health, showing:— (a) The number of cases on his register at the ment of each quarter; (b) The number of cases notified for the first time during the quarter; 18 (c) The number of cases which have been removed from the register in a preceding quarter, and which have been restored, giving the name and address of each case, and the reason for restoration; (d) The number of cases added to the register which have been brought to his knowledge other than by notification; (e) The number of cases removed from the register, giving the name and address of each case, and the reason for removal; (f) The number of cases remaining on the register at the end of the quarter. Previously most of these particulars were required under the Public Health Tuberculosis Regulations, 1924, and subjoined are the number on the register at the end of each quarter since the formation of the District:— Pulmonary Non-Pulmonary Totals M. F. M. F. 1934 30th June 62 60 17 25 164 30th Sept. 70 66 16 26 178 31st December 72 65 16 27 180 1935 31st March 73 68 16 27 184 30th June 73 68 16 27 184 30th Sept. 78 73 17 28 196 31st December 83 72 17 30 202 1936 31st March 83 81 17 33 214 30th June 89 85 19 35 228 30th Sept. 90 84 23 37 234 31st December 95 94 23 39 251 1937 31st March 96 96 25 39 256 30th June 100 101 31 40 272 30th Sept. 105 98 39 41 283 31st December 111 100 38 44 293 1938 31st March 109 105 38 44 296 30th June 115 111 39 45 310 30th Sept. 117 113 39 45 314 31st December 122 118 41 47 328 19 PUBLIC HEALTH ACT, 1936, SECTION 176. On no occasion during the year was it necessary for the Council to take steps to secure an Order for the compulsory removal to Hospital of a person suffering from Pulmonary Tuberculosis. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. No action was required during the year under the powers conferred by the above Regulations in respect of Tuberculosis employees in the milk trade. NON-NOTIFIABLE INFECTIOUS DISEASE. Whooping Cough. Again this year no deaths were registered from Whooping Cough. Influenza. Five deaths were registered as compared with 8 last year. DIPHTHERIA IMMUNISATION CLINIC. A Diphtheria Immunisation Clinic was established by the Bromley Rural District Council, and was first opened on the 24th May, 1929. The purpose of this Clinic is to test the susceptibility, or otherwise, of children to Diptheria and to immunise those giving a positive result. The following is a statement of the work carried out during the year :— Number of sessions held 58 Number of attendances 1,923 Number of new cases 374 A similar procedure to that in the previous years has been adhered to, viz.: Each new patient was Schick tested, and the result read the following week. If the result was positive— that is, if the child showed a susceptibility to Diphtheria—he or she then received three injections of an immunising mixture at weekly intervals. (The material used was " Toxoid-Antitoxin Mixture," prepared by Messrs. Burroug-hs and Wellcome). Three months later the child was asked to attend again, and was then re-tested by the Schick method. Practically every child then gave a negative reaction to the 20 re-test, thus showing the previous susceptibility was no longer present, and that the child could now be regarded as immune. In those few cases which showed a persistent positive reaction after three months, one further injection was given of the Toxoid-Antitoxin, and a further test after one month showed that the reaction was now negative. In no case was there any constitutional disturbance reported by parents as a result of these injections. The number of children tested at various age-groups was:— Age groups. Number Tested Number of childreu in each age group. Per cent Positive. M. F. 0—5 102 49 53 88.2 5—10 180 102 78 74.4 10—15 77 50 27 46.7 over 15 15 1 14 60.0 The monthly attendances were:— January 121 February 242 March 372 April 150 May 130 June 115 July 113 August 8 September 76 October 201 November 295 December 100 The number of children attending from each Ward was as follows:— Biggin Hill 67 Clielsfield 6 Crofton 131 Cudham 11 Downe 4 Goddington 58 Green Street Green 7 Knoll 64 St. Mary Cray 26 21 ISOLATION HOSPITAL. This District is served by the West Kent Joint Isolation Hospital. The Hospital, which is situated at Bromley Common, is administered by the West Kent Joint Hospital Board, and in addition to this District, serves the Boroughs of Bromley and Beckenliam, and the Urban District of Chislehurst and Sidcup. In addition to the accommodation provided for the treatment of the ordinary Infectious Diseases, provision has been made for the treatment of cases of Small Pox, on a separate site. During the year 77 cases from this District were admitted to the Hospital, viz.:— Scarlet Fever 49 Diphtheria 20 Typhoid Fever 4 Measles 4 LABORATORY WORK. The Kent County Laboratory at Maidstone carries out the bacteriological work in connection with this District. During the year the following number of specimens have been examined from this area:— Positive Negative Total Swabs for Diphtheria 1 79 80 Swabs for Haemolytic Streptococci 7 44 51 Widals for Enteric Fever 4 2 6 Sputa for Tubercle 26 147 173 Urine and faeces 1 16 17 TOTALS 39 288 327 In addition to the above, the following emergency swabs for diagnostic purposes were examined by Dr. J. Byers at the Laboratory of the West Kent Joint Hospital Board:— 22  Total Positive Negative Swabs for Diphtheria 176 16 160 Swabs for Haemolytic Streptococci 11 6 5 TOTAL 187 22 165 DRAINAGE. The houses in the main portion of the District are on the water carriage system, most of the houses being connected to the public sewer. Where no sewers are available, most of the houses are drained into cesspools. In addition, there are 294 houses with pail closets, and 13 houses with privy middens or earth closets. At the end of the year the number of houses with sanitary conveniences in use were approximately:— Houses with water closets draining to the sewer 11,958 Houses with water closets draining to cesspools 2,936 Houses with earth closets or privy middens 13 Houses with pail closets 294 The provision of main drainage for a portion of Farnborough which is now on cesspool drainage was commenced at the latter part of the year. The work in connection with the provision of main drainage for a portion of the Biggin Hill area was completed at the end of the year. SANITARY STATISTICS. No. of houses connected to the sewer No. of houses not connected to sewers No. of houses not provided with a piped water supply No. of wells still in use for purpose of domestic supply 11958 3143 393 6 Sanitary Conveniences. W.C's. Pan or Pail Closets Midden Privies Ashpits separate from Midden Privies Cesspools No. of No. of houses into 14724 294 13 — 2421 2936 23 WATER SUPPLY. The greater portion of the District is supplied by the mains of the Metropolitan Water Board. In some outlying- portions, however, water is obtained from deep wells or from rain water collected from the roofs of the houses and stored in tanks. During1 the year new mains have been laid to various new estates. Four samples of the water from the piped supply are taken each month for bacteriological examination, and each report shewed that B.Coli was absent in 100 c.c., and that the water was of good quality. A detailed survey of the premises in the Biggin Hill area which depend upon rain water for their supply, was completed at the end of the year with a view to the improvement in the conditions. PUBLIC CLEANSING. A collection of house refuse is carried out in the whole of the District by direct labour, the greater part of the area having a weekly collection. The refuse is disposed of on the Bradford system. The Council do not undertake the disposal of the contents of earth closets, or the collection of trade refuse. A special cesspool emptying tank is available for emptying cesspools, the contents of which are deposited on agricultural land. HOUSING. 1. Inspection of Dwelling Houses during the year:— (1) (a) Total number of houses inspected for housing defects (under Public Health or Housing Acts) 504 (b) Number of inspections made for the purpose 1537 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 36 (b) Number of inspections made for the purpose 52 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil. 24 (4) Number of dwelling houses (exclusive of those referred to under the preceding- sub-head) found not to be in all respects reasonably fit for human habitation 151 2. Remedy of Defects during the year without Service of Formal Notices:— Number of defective dwelling houses rendered flffit in consequence of informal action by the Local Authority or their Officers 143 3. Action under Statutory Powers during the year:— (a) Proceedings under sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which notices were served requiring repairs Nil. (2) Number of dwelling houses which were rendered fit after service of formal notices:— (a) By owners Nil. (b) By Local Authority in defaidt of owners Nil. (b) Proceedings under the Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 7 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) By owners 7 (b) By Local Authority in default of owners Nil. (c) Proceedings under sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which Demolition Orders were made Nil. (2) Number of dwelling houses demolished in pursuance of Demolition Orders Nil. (d) Proceedings under section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil. 25 (2) Number of separate tenements or underground rooms in respect of which ClosingOrders were determined, the tenement or room having been rendered fit Nil. 4. Housing Act, 1936, Part IV—Overcrowding:— (a) (i) Number of dwelling houses overcrowded at end of year 40 (ii) Number of families dwelling therein 40 (iii) Number of persons dwelling therein 320 (b) Number of new cases of overcrowding reported during the year 1 (c) (i) Number of cases of overcrowding relieved during year 1 (ii) Number of persons concerned in such cases 9 (d) Particulars of any cases in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil. Number of new houses erected during the year:— By the Local Authority Nil. By other persons 1,222 HEALTH VISITOR. The services of one full-time Health Visitor are employed by the Council, and works under the supervision of the Medical Officer of Health. She carries out her duties in a very efficient and tactful manner. The following is a summary of the visits paid by her during the year:— 26  Cases Visited Number of Visits Tuberculosis: Primary—Pulmonary 54 54 Non-Pulmonary 8 8 Revisits—Pulmonary 182 540 Non-Pulmonary 60 104 Measles 248 248 Scarlet Fever 6 16 Small Pox and Diphtheria contacts 97 97 Other visits 320 473 TOTAL 975 1540 The visits to cases of Tuberculosis have been as follows:— Primary Revisits Visits P. N.P. P. N.P. January 1 — 53 9 80 February 9 1 67 9 83 March 1 1 59 9 104 April 6 — 38 11 160 May 6 1 55 7 69 June 4 1 31 9 60 July 3 — 22 8 50 August 4 — 50 10 33 September 2 — 26 8 60 October 4 2 38 8 39 November 6 2 49 10 52 December 8 — 52 6 44 TOTALS 54 8 540 104 834 27 MATERNITY AND CHILD WELFARE. The Maternity and Child Welfare work in this District is under the control of the Kent County Conncil. HEALTH VISITING. T1 ie Health Visiting' is undertaken in the various parts of the area as follows :— St. Mary Cray.—Miss Dobson. Biggin Hill, Chelsfield, Cudham, Downe, Knockholt, Leaves Green and Green-Street-Green. — Miss Jobson. Goddington, Knoll, Crofton and Farnborough.—Miss Beck-Slinn. ANTE-NATAL CLINICS. Ante-Natal Clinics have been established at the undermentioned premises:— Methodist Hall, Orpington. Sessions held on the second and fourth Tuesday in each month at 10.0 a.m. Village Hall, St. Mary Cray. Sessions held on the second and fourth Wednesdays in each month at 2.0 p.m. MATERNITY AND CHILD WELFARE CENTRES. The following Maternity and Child AVelfare Centres have been established to serve this District:— Chelsfield. Heading lloom. Sessions held first and third Tuesday in each month. The Medical Officer in charge is Dr. Hathaway, and the Nurse in charge, Miss Jobson. The total attendances were 516. Cudham (Biggin Hill). Big Teapot Pavilion, Main Road, Biggin Hill. Sessions held on each Thursday afternoon. The Medical Officer in charge is Dr. M. E. Pease, and Miss Jobson attends this Centre. The total attendances were 1,708. Cudham. Village Hall. Sessions held first and third Friday in the month. The Medical Officer in charge is Dr. Hathaway. Miss Jobson attends this Centre. The total attendances were 198. Downe. Gospel Hall. Sessions held second and fourth Tuesday in each month. Dr. Douse, who attends monthly, is the Medical Officer in charge. Miss Jobson attends this Centre. The total attendances were 260. 28 Farnborough. Parish Hall. Sessions lield every Friday afternoon. The Medical Officer in charge is Dr. Douse, who attends fortnightly. Miss Beck-Slinn attends this Centre. The total attendance was 1,778. St. Mary Cray. Village Hall. Sessions held each Tuesday afternoon. The Medical Officer in charge is Dr. Grant, and Miss Dobson attends. The total attendances were 418. Orpington. Methodist Church Hall, Sevenoaks Road. Sessions held eacli Tuesday. The Medical Officer is Dr. Ledger, and she attends weekly. Miss Beck-Slinn attends this Centre. The total attendances were 4,575. Green-Street-Green. Church Hall, World's End Lane. Sessions held each Friday. The Medical Officer is Dr. Holloway, and the Nurse in charge is Miss Jobson. The total attendances were 1,120. Petts Wood. St. Francis Hall. Sessions are held each Thursday. The Medical Officer is Dr. Simpson, and Miss Beck-Slinn is the Nurse in charge. The total attendances were 1,849.. SCHOOLS. There are fourteen elementary Schools within the District. Medical Inspection. The Kent County Council carries out the medical inspection of school children. Water Supply. All schools are supplied with water by the mains of the Metropolitan Water Board. Inspection. Inspection is made from time to time of all the sanitary accommodation at the schools. During the year Dowiie School was redrained and connected to the main sewer. School Closure. It was found necessary to close the following School on account of the prevalence of Chicken Pox amongst the scholars :— St. Mary Cray Council School, from the lOtli to 12th January (extension of Christmas holiday). No Certificates covering low attendances were issued during the year. MIDWIVES. The Supervising Authority under the Midwives Acts for this District is the Kent County Council. The following midwives have given Notice of Intention to Practice in this area during the year:— 29 Bellamy, E. B., 10, Hayfield Road, St. Mary Cray. Bliat, E. M., Orchard liise, Farnborough. Dagnall, W., 1, Kelvinside, Mount View Road, Orpington. Ellis, Y. E., Rose Dene, 2, Main Road, Biggin Hill. Grieves, E. E., Delmuir, Westerliam Road, Keston. Henry, C. W., Old London Road, Knockliolt. Kerridge, 1\ M. 26, Vine Road, Green-Street-Green. Lewis, N. E., 26, Vine Road, Green-Street-Green. Mortimer, E. M., Cross Ashes, Bromley Road, Downe. Page, M., Lexington, Sandy Lane, Orpington. Williams, L. M., The Bungalow, Old London Road, Knockliolt. REGULATED TRADES. Dairies and Cowsheds. There are 70 premises registered as dairies and cowsheds in this District. During the year 376 visits of inspection were paid, and in 10 instances defects were found. These have all since been remedied. MILK (SPECIAL DESIGNATIONS) ORDER, 1936. The Council granted the following number of licences under the above Order during the year:— Tuberculin Tested ... ... ... ... 8 Pasteurised ... ... ... ... 13 During the year 51 samples of graded and 2 samples of mixed milk were taken at the place of production and submitted for examination. Samples of mixed milk were also taken at the Public Institutions for examination. SLAUGHTERHOUSES. There are 17 licensed Slaughterhouses in this District, this being the same number as last year. During the year 766 visits were paid to these premises, and in 4 instances defects were found. PUBLIC HEALTH (MEAT) REGULATIONS, 1924. The above Regulations came into force on the 1st April, 1925, and under their provisions an opportunity is afforded for the examination of carcases of animals slaughtered for human consumption. 30 The following Table shows the number of animals killed, the number inspected, and the amount of meat destroyed as being unfit for human consumption. MEAT.—CARCASES INSPECTED AND CONDEMNED. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed 149 5 80 901 3126 Number inspected 149 5 80 901 3126 All diseases except Tuberculosis: Whole carcases condemned ... ... ... ... 9 Carcases of which some part or organ was condemned 6 ... ... 5 26 Percentage of the number inspected affected with diseases other than Tuberculosis 4.0 ... ... 55 1.11 TUBERCULOSIS ONLY. Whole carcases condemned ... ... ... ... 6 Carcases of which some part or organ was condemned 7 3 ... ... 51 Percentage of the number inspected affected with tuberculosis 4.69 60 ... ... 1.81 BAKEHOUSES. There are 20 Bakehouses within the District, to which 115 visits were paid during' the year. One defect was found and since abated. PIGGERIES. There are 10 Piggeries in the District, this being one more than last year. One defect was found and since abated. One hundred and fifteen visits were paid to these premises. OTHER FOOD PREPARING PLACES. There are 251 other premises in which food is prepared for human consumption, this being 16 more than last year. During the year 527 visits were paid to these premises. 31 COMMON LODGING HOUSES AND HOUSES LET IN LODGINGS. There is one Common Lodging House within the District, to which two visits have been paid. There are no Houses let in lodgings in this District. FACTORIES. There are 171 premises within the District. During the year 130 visits were paid, and on two occasions defects were found. These have since been remedied. A detailed list of the Factories and Workshops remaining at the end of the year is shown in the following Table:— 1. List of Factories at end of 1938. Trade. Total. Saw Mills 4 Laundries 10 Cycle Works 10 Carriage Makers and Wheelwright 2 Printing Works 3 Carpenters and Builders 25 Undertakers 1 Shoeing Forges 8 Dressmakers and Tailors 12 Upholsterers 3 Bakeries 20 Paper Mills 1 Harness Makers 2 Bootmaking and Repairing 19 Chaff Cutting and Corn Grinding 1 Motor Repairers 21 Sculptural Factory 1 Basket Makers 1 Wireless 6 Breeze Block Makers 1 Tile Makers 1 Builders' Merchants 4 Electrical Engineers 2 Plumber 1 Rag Sorters 2 Brick Works 1 Cooperage 1 Gas Mask Works 1 Leathercloth Works 1 Varnish Works 1 Chalk Quarries 2 Felt Works 1 Car Breakers 2 171 32 INSPECTION OF FACTORIES. 1. Inspections for purposes of provisions as to health. Including' Inspections made by Sanitary Inspectors. Premises. Number of Inspections Written Notices Occupiers prosecuted (1) (2) (3) (4) Factories witli mechanical power 130 — — Factories without mechanical power 2 — Other Premises under the Act (including: works of building and engineering construction but not including outworkers' premises) — — — Total 130 2 — 2. Defects found. Particulars Number of Defects. Number of defects in respect of which Prosecutions were instituted Found Remedied Referred to H.M. Inspector (1) (2) (3) (4) (5) Want of cleanliness Overcrowding Unreasonable temperature 1 1 Inadequate ventilation Ineffective drainage of floors Sanitary conveniences insufficient 1 1 unsuitable or defective Uiot separate for sexes Other offences (Not including offences relating to Homework or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and reenacted in the Third Schedule to the Factories Act, 1937). Total 2 2 33 SUMMARY OF REGULATED TRADES. Number No. of Visits No. of Defects found No. of Detects remedied Dairies 70 376 10 10 Cowsheds Slaughterhouses Licensed 17 766 4 4 Registered Bakehouses 20 115 1 1 Piggeries 10 115 1 1 Other food preparing places 251 527 — — Factories 171 130 2 2 Common Lodging Houses 1 2 — — Houses let in Lodgings — — — " — TOTAL 540 2031 18 18 SHOPS ACTS, 1912-1934. Regular inspection of shops is made. During- the year 337 visits were paid to shops in the District, and it was not found necessary to take any formal action. SWIMMING BATHS AND POOLS. There is one Public Swimming' Pool in the District. This pool is a modern one, being equipped with filtration, aeration and chlorination plant. There is also one privately owned swimming bath owned by the London Boy Scouts' Association. Inspections were made during the year, but no action was found necessary. 34 CAMPING SITES. The various camping sites in tlie District received periodical inspection during the periods in which they were occupied. The number of licences issued was 13, and the maximum number of campers was 648. ERADICATION OF BED BUGS. The following work was carried out during the year in connection with the eradication of bed bugs:— Number of Council houses found to be infested 4 Number of other houses found to be infested 4 Number of Council houses disinfested 4 Number of other houses disinfested 4 The methods employed for freeing infested houses were by spraying the woodwork, walls, furniture, etc. with Zaldecide Insecticide, the work of disinfectation being carried out by the Local Authority. The premises of prospective tenants of Council houses and their personal effects are inspected, and, where necessary, disinfestation works are carried out. Special supervision is exercised by the responsible official in regard to possible public infestations, and every advice and assistance is given in connection therewith. WATER COURSES. All watercourses within the District receive constant supervision. The principal stream running through the District is the Kiver Cray which rises in Orpington, and runs through Orpington and the Crays. AMBULANCE FACILITIES. The following ambulances are available for use in this District:— For Infectious Cases.—Four motor ambulances are provided by the West Kent Joint Hospital Board for the conveyance of cases of Infectious Disease to the Isolation Hospital. For Accident and General Cases.—The Council have provided a motor ambulance for the removal of accident and general cases. 35 NURSING FACILITIES. The local District Nursing- Associations, which are affiliated to the Kent County Nursing- Association, provides nursing- facilities for this District. NURSING HOMES. The powers in relation to Nursing* Homes have been delegated to the District Council by the Kent County Council. At the end of the year there were four Nursing and Maternity Homes, the number of beds available being 19, of which 12 were for maternity cases and 7 for other cases. LEGAL PROCEEDINGS. It was necessary to institute proceedings against a Butcher for the following- infringements of the Public Health (Meat) Regulations, 1924:— (a) Failure to notify Intention to slaughter. (b) Failure to notify diseased condition of meat. Defendant was fined £10 in respect of each infringement, and also £5 5s. Od. Costs imposed. As the result of the installation of new plant for the pulverisation of chalk at Keston Lime Works, Leaves Green, a serious nuisance occurred affecting residents in the locality owing to the persistent discharge of chalk dust from the works. Persuasive efforts on the part of the Council failing to have the desired effect, the Council ultimately decided to apply for an Injunction. The case came before the High Court on the 9 th December, when the Court granted an Interlocutory Injunction restraining Defendant from using his premises in such a way as to be a nuisance or injurious to the health of the neighbourhood. ADOPTIVE ACTS AND BYELAWS. ACTS. No new Acts were adopted during the year. Public Health Acts Amendment Act, 1890.—Sections 10, 17, 18, 19, 20 (i), 21, 24, 25, 26, 27, 28, 32, 33, 35, 38, 39, 40, 42, 43, 44, 45, 46, 47, 48, 49, 81, 85, 87, 89, 90 and 91. Public Health Act, 1925.—Sections 17, 18, 20, 23, 24, 26, 29, 33, 36, 37, 38, 40, 41, 42, 45, 46, 47, 48, 49, 50, 55 (unrepealed provisions). 36 Public Health Act, 1907.—Sections 21, 22, 44 and 51 to 54. Slaughter of Animals Act, 1933—Section 1, made to apply to sheep, ewes, wethers, rams and lambs as from the 1st September, 1934. Bye-laws. Bye-laws with respect to the management of a mortuary. Bye-laws with respect to new streets and buildings. Bye-laws with respect to Nursing Homes to come into force 1st January, 1937. Bye-laws with respect to Parking Place to take effect from 1st February, 1937. Bye-laws with respect to Slaughterhouses (slaughter of pigs, etc.), made during 1937. Bye-laws with respect to Hop-Pickers' Accommodation, made during 1937. Bye-laws with respect to Pleasure Grounds, made during 1937. Bye-laws with respect to Registries for Female Domestic Servants, which came into force on the 1st October, 1938. Bye-laws with respect to Public Sanitary Conveniences, which came into force on the 1st October, 1938. Bye-laws with respect to the Emission of Smoke, which came into force on the 1st October, 1938. 37 ORPINGTON URBAN DISTRICT COUNCIL. Report of Chief Sanitary Inspector. Gentlemen, I have pleasure in presenting my Annual lleport for the year ended 31st December, 1938. Nuisances. Public Health, Housing1, etc. Acts. The number of premises inspected during the year for the detection of nuisances, etc. was 504, and 1537 inspections and revisits were made thereto. Nuisances as follows, numbering 292, were discovered at 208 premises:— Defective and damp houses 115 Defective drainage and appurtenances 54 Defective refuse receptacles 47 Defective or overflowing cesspools 23 Offensive accumulations 11 Inadequate or inefficient water supplies 16 Verminous houses 4 Keeping of animals 1 Tents, Yans and Sheds 2 Rat Infestations 19 247 Informal Notices were served on Owners or Occupiers in connection with the existence of nuisances, and in five instances only was it necessary to follow with the service of Statutory Notices, the latter being complied with without having* to resort to legal proceedings. Disinfection. The number of premises disinfected was 109, after the following diseases:— Scarlet Fever 61 Diphtheria 21 Typhoid Fever 6 Measles 1 Tuberculosis 13 Cancer 5 Impetigo 2 The method employed in connection with the above, as in former years, was the use of formaldehyde, both as a spray and in gaseous form. Eleven batches of bedding were also steam disinfected with the assistance of a neighbouring Authority. Rats and Mice (Destruction) Act, 1919. The number of visits paid during the year in connection with infested premises was 152, and where the existence of the vermin was proved, advice and assistance on methods of disinfestation was given and the necessary steps were taken by the Occupiers of the premises concerned. 38 Prior to the National Rat Week held during the first week in November, double crown posters were displayed on various posting- stations throughout the District, and also exhibited on the Council's vehicles and by various tradesmen in their shops, drawing attention to the week in question and asking for special efforts to be made for the destruction of the vermin. A supply of Buletin No. 30 issued by the Ministry of Agriculture and Fisheries was also available in the Department for supply to applicants.. Special attention was given by the Department during Rat Week in connection with private and business premises suspected of being infested, and I am sure the publicity given each year is responsible for the destruction of a large number of rats, particularly during the week in question. Common Lodging House. Visits were made to the one Common Lodging House in the District, and the premises were conducted in a satisfactory manner. Temporary Shelters for Fruit and Vegetable Pickers. These shelters are periodically visited during the season of occupation, and the requirements of the Byelaws in respect to cleansing and sanitary accommodation, etc. duly observed. The majority of these temporary workers have now their own caravans, and a few only of the shelters at the farms were used for living or sleeping purposes. Tents, Vans, Etc. A good deal of trouble was experienced, particularly during the spring and autumn months, by persons of the gipsy type occupying caravans, taking unauthorised occupation from time to time of waste land and portions of undeveloped building sites in the District. Constant inspection was necessary of the areas favoured by these persons, and when their presence was discovered on any land, assistance from owners or estate developers in their removal was readily forthcoming. Shops Acts. 337 Visits and Observations were carried out in connection with these Acts. 134 infringements were discovered, the bulk of which being the absence of forms as prescibed by the Acts, and these were provided by the defaulters in all cases upon informal action. Particulars of infringements :— Shops not closed on half-day as fixed 4 Selling goods after Statutory hours 7 Absence of form re half-holiday 45 Absence of form re hours of working 24 Absence of record re Sunday Employment 1 Absence of Abstract of Act 23 Absence of Notice re seats for females 30 39 Registries for Female Domestic Servants. Byelaws in connection therewith came into force on October 1st. All premises concerned were duly visited, and the Byelaws found to be complied with. Factories. The total number of inspections made was 130, and two defects were discovered and afterwards remedied. New Registers were in course of preparation at the end of the year in order to comply with the requirements of the new Factories Act. Smoke Abatement. During the year numerous complaints were received respecting- smoke nuisances arising from factories in the Northern portion of the district, one factory in particular being a source of trouble. Byelaws dealing with the emission of smoke were adopted by the Council, and following the operation of these a very marked improvement occurred in conditions, and it was unnecessary to resort to legal proceedings in any instance. 139 visits were made in connection therewith. Housing Act, 1936, Part III. During the year the Department was busily engaged in the inspection of properties throughout the District, and the submission of detailed reports on their condition with a view to action being taken under Part III of the Housing Act, 1936. The Council submitted to the Ministry of Health for confirmation, 17 Clearance Areas, involving 92 premises and the displacement of 272 persons. All Orders were subsequently confirmed by the Minister following a Public Inquiry. Housing Act, 1936, Part IV. 26 Applications were received from Owners of property in the District applying for Certificates under Section 62, and during the year 217 such Certificates were issued, embracing 286 properties. Encampments. Licences under Section 269 (1) of the Public Health Act, 1936, were granted in respect of 13 camping sites in the District, providing for a maximum number of campers of 648. There are also three permanent camps in the area under the control of recognised organisations, and Certificates of Exemption under S.S. 6 were granted by the Ministry of Health to the Associations concerned. Inspections were made of all sites during their period of occupation, the number of visits made being 81, and the camps generally appeared to be conducted in a satisfactory manner. 40 Drainage. During tlie year 41 premises were re-drained and connected to the main sewer, the cesspools previously in use being abolished. A survey involving; 685 inspections was made in the Northern area of the District of all properties still on cesspool drainage, but where the main sewer was available, and detailed reports thereon were submitted to your Council. Water Supplies. During- the latter part of the year a survey was carried out of all properties in the Biggin Hill area having no main supply of water for drinking and domestic purposes. In connection with this survey, detailed inspections of 318 dwelling houses having stored rainwater only available for the use of the inmates were made, this work necessitating a total of 563 visits and revisits being paid to the premises concerned. Forty-five samples of water from the supply of the Metropolitan Water Board were submitted for analysis during the year, all of which were found satisfactory on examination. Three samples of stored rainwater used for drinking and domestic purposes at 3 premises were also submitted to the Laboratory for examination, the reports of the Public Analyst in all cases being to the effect that the water was of fair organic quality, and suitable for drinking purposes. One sample of water from an Artesian Well at factory premises was submitted to the Public Analyst for examination, and this proved to be of good organic quality. Legal Proceedings. It was necessary to institute proceedings against a Butcher for the following infringements of the Public Health (Meat) Regulations, 1924:— (a) Failure to notify Intention to Slaughter. (b) Failure to notify diseased condition of meat. Defendant was fined £10 in respect to each infringement, and also £5 5s. Od. costs imposed. As the result of the installation of new plant for the pulverisation of chalk at Keston Lime Works, Leaves Green, a serious nuisance occurred affecting residents in the locality owing to the persistent discharge of chalk dust from the works. Persuasive efforts on the part of the Council failing to have the desired effect, the Council ultimately decided to apply for an Injunction. The case came before the High Court on the 9tli December, when the Court granted an Interlocutory Injunction restraining Defendant from using his premises in such a way as to be a nuisance or injurious to the health of the neighbourhood. 41 INSPECTION AND SUPERVISION OF FOOD. Dairies and Cowsheds. 376 visits were made during' the year to these premises. Ten defects were discovered and remedied upon the Occupiers' attention being called thereto. The number of occupied ])airy Farms at the end of the year was 29, the number of Dairies and Cowsheds being- 70. Two farms were removed from the Register owing to the premises becoming vacant, and two Farms changed hands. Five Retail Purveyors were added to the Register. There are 8 Farms in the District licensed for the production of milk under the Milk (Special Designations) Orders, viz.:— Tuberculin Tested ... ... ... 5 Farms Accredited ... ... ... ... 3 Farms The Cowsheds, etc., were generally found in good order, the half-yearly cleansing and limewashing of the premises being carried out as required, and the cows kept in a clean condition. Forty-five samples of graded milk, as follows, were taken at the places of production :— Tuberculin Tested 30 Accredited 15 All samples passed the prescribed tests with the exception of two Tuberculin Tested and four Accredited. Investigations were made in these cases as to the probable reason for the unsatisfactory samples, and the necessary action taken at the premises concerned to improve conditions affecting production. Subsequent samples taken at the Farms in question proved satisfactory on examination. Six samples of Pasteurised milk were taken at Public Institutions, four proving satisfactory on examination. Respecting the two unsatisfactory samples, investigations revealed that the high bacterial count was due to dirty churns. The matter was taken up with the suppliers, and subsequent samples satisfied the prescribed tests. Slaughterhouses. There are 17 Licensed Slaughterhouses and one Knackers Yard in the District, to which 766 visits were made. Four defects were remedied following informal action. Licences were issued to 31 Slaughtermen under the Slaughter of Animals Act, 1933, and all slaughtering, as far as could be ascertained, was carried out satisfactorily and in a humane manner. 42 Public Health (Meat) Regulations, 1924. The total number of Notices of Slaughter received during the year was 900. The carcases examined thereunder being:— Beasts 154 Calves 80 Sheep and Lambs 901 Pigs 3126 One ton, 6 cwt. 0 qrs. 26 lbs. of meat was condemned owing to disease, this being voluntarily surrendered by the Owners. Particulars respecting meat condemned :— Beef. 10 part carcases or -organs affected with . . Tuberculosis. 6. part carcases or organs affected with diseases other than Tuberculosis. Mutton. 5 part carcases or organs affected with diseases other than Tuberculosis. Pork. 6 whole carcases and organs, and 51 part carcases or organs affected with Tuberculosis. 9 whole carcases and organs, and 26 part carcases or organs affected with diseases other than Tuberculosis. The smaller portions of condemned meat were destroyed by burying or burning, and arrangements were made with a neighbouring Authority for the destruction of condemned whole carcases and large portions of meat at their Refuse Destructor Works. Piggeries. There are 10 premises in the District at which pig keeping is carried on to a large extent, and 115 visits were made thereto. One nuisance was abated upon informal action. Food Shops and Food Preparing Places. 527 Inspections were made to these premises. They were found in a clean and satisfactory condition, and no diseased or unsound food exposed for sale was discovered. Unsound Food. 13 rabbits (29 lbs.), 2 lbs. frozen salmon, and 24 lbs. of soft herring roes were voluntarily surrendered, • and these were destroyed as unfit for human consumption. Bakehouses. There are 20 Bakehouses in the District, and 115 .Inspections were made of these premises. One minor defect was discovered at one Bakehouse, this being remedied upon the Occupier's attention being called thereto, ancj the premises generally were kept in a clean and satisfactory condition. 43 SUMMARY. VISITS. TOTAL number of Inspections and Visits of all kinds made during tlie year 8491 VISITS under Public Healtli and Housing Acts 1537 ,, ,, llats and Mice (Destruction) Act 152 ,, ,, Sliops Acts- 337 ,, ,, Factories Act 130 ,, ,, Smoke Abatement Byelaws 139 ,, in connection with Holiday Encampments 81 ,, ,, ,, ,, Cesspools and Drainage Works 901 ,, ,, ,, ,, Water Supplies 611 ,, ,, ,, ,, House Refuse Collection and Disposal 1782 ,, to Dairies, Cowsheds, etc. 376 ,, ,, Slaughter Houses 766 „ Piggeries 115 ,, ,, Food Preparing Places and Food Shops . 527 ,, ,, Bakehouses .115 ,, of Miscellaneous Nature 895 WORKS EXECUTED. Dampness remedied 27 Walls and ceilings repaired and cleansed 34 Floors repaired or renewed 8 Staircases repaired 3 Water Supplies: insufficient or absence of 16 Verminous premises disinfested 4 Poof and guttering repaired or renewed 20 Defective or inadequate yard paving 3 Dustbins provided 47 Waterclosets, sinks, and gullies repaired or renewed 41 Defective soil drains repaired 2 Obstructed soil drains cleared and cleansed 11 Overflowing cesspools emptied 23 Cesspools abolished 41 Xuisances from the keeping of animals 1 Offensive accumulations removed 11 Rat infestations abated 19 Miscellaneous defects remedied 22 44 REMOVAL AND DISPOSAL OF HOUSE REFUSE. The work lias been carried out by the Council by direct labour and with their own appliances since April, 1930, Contractors previously being employed both in connection with collection and disposal. Collections are made weekly from all premises in the District with the exception of the former parishes of Cudham, Downe, and Knockholt, which, prior to the formation of the Urban District in April, 1934, had no collection whatever. In the latter area the work is carried out once a fortnight. The vehicles in use at the end of the year were: One 10-c. yard capacity self-contained Karrier Freighter, six 9-c. yard and one 7-c. yard capacity Eagle two-wheeled hydraulic end-tipping trailers, adaptable for either horse or mechanical power haulage. Owing to the growth of the District, the purchase of an additional self-contained Freighter was under consideration at the end of the year. Haulage of full Trailers to the Dump and the conveyance of empty vehicles to Collecting Teams is carried out by two International Tractors which have been in constant use since 1930. House-to-house collection by Trailers is done by horse haulage, horses and driver for this work being* hired under a yearly contract. From January to September three teams with horse-drawn Trailers, with a total of nine Collectors (horse drivers included), and one Freighter with two Collectors (driver excluded), were employed full time on collection. From October one additional Trailer Team with two Collectors and driver were engaged to supplement the staff, owing to the increased work. The work of collection has been carried out satisfactorily and regularly throughout the year by the teams concerned. It is true complaints have been received from residents objecting to the use of skeps in the removal of refuse from their premises, on the ground that the method is insanitary, and alleging refuse is spilled thereby. With a view to overcoming any objection in this direction, an endeavour is always made with complainants for a compromise, whereby bins are emptied direct into the collecting vehicle, but the return of the empty bin to the rear of the premises made by the occupiers. If every occupier would be willing to assist in this way the general use of skeps could be dispensed with, and a saving thereby effected in the cost of collection. 45 A census of houses visited is taken each half-year, a normal week's work being- the basis. The following- are the figures ascertained for the year 1938, together with the figures for the corresponding period of the previous year for comparison:— Apl. 1938 Apl. 1937 Oct. 1938 Oct. 1937 TOTAL number of separate premises visited 13,917 12,385 14,729 13,412 TOTAL number of dustbins emptied 14,466 12,771 15,318 13,961 No decision was arrived at during the year in connection with a special collection of trade refuse being inaugurated. During- 1938 the two International Tractors travelled a distance of 13,522 and 14,997 miles respectively, and the Karrier Vehicle, 6,325 miles. During the year 1,782 visits were made by the Department in connection with the work of supervision, etc. Disposal. Disposal of the refuse from the whole of the District continued to be carried out strictly according to the Bradford System in the old gravel pits at Green-Street-Green. The remaining area available at the end of the year for disposal purposes was unfortunately of limited extent, and the acquisition of another site suitable for disposal by the controlled system is of vital concern. No complaint was received during the year of any alleged nuisance from the dump. The number of men permanently employed on the disposal was three, and from the 1st January to the 31st December the total number of loads and part loads received and dealt with was 3,945, representing approximately 33,532 cubic yards of refuse. I am, Gentlemen, Your obedient Servant, JETHEO A. CAPON, Cert. R. San. Inst. Cert. San. I. Exam. Bd. (Meat and Foods). M.S.I.A. Chief Sanitary Inspector. C lea n si ng Superin tenden t.