ORP 3 ORPINGTON URBAN DISTRICT COUNCIL REPORT For the Year 1939 on the Sanitary Conditions and Vital Statistics of the Urban District of Orpington by the Medical Officer of Health. Bromley: THE BROMLEY PRINTING CO., BROMLEY, KENT. 1 Health Report for 1939. Gentlemen, I beg' to present my Annual Report for the year 1939, this being the sixth one presented by me as your Medical Officer of Health, but the seventeenth one in respect of the District concerned. In accordance with the request of the Ministry of Health this Report lias been reduced as far as possible, and only contains such information as it is essential to record. The population of the District for mid-year 1939, as estimated by the Registrar-General was 49,570, as compared with 46,320 last year. The Birth Rate for the year remained very steady, being 19.4 per thousand of population, as against 19.3 last year. The Death Rate showed a slight increase, this being 9.0 per thousand of population, as compared with 8.3 last year. An increase in the Infantile Mortality Rate also occurred, this being 43 per thousand births, as compared with 28 last \ ear. This Rate is liable to fluctuation from year to year owing* • • P to the small numbers involved. From the point of vie v of incidence of Infectious Disease the year 1939 was a very satisfactory one, the number of cases notified being 189 as against 458 last year. This is chiefly due to a large decrease in the number of cases of Measles notified, but there was also a drop in the number of cases of Scarlet Fever and Diphtheria notified. In presenting this Report I would like to express my thanks for the help and assistance I have received from the members of the Council and its Officers. In particular I would like to express my appreciation of the loyal and efficient services rendered by all members of the Public Health Department. I am, Gentlemen, Your obedient Servant, P. N. CAVE, Medical Officer of Health, 2 URBAN DISTRICT COUNCIL OF ORPINGTON. Public Health Committee. Chairman: P. W. H. Twyman, Esq. Vice-Chairman: J. R. Guthrie, Esq. Lt.-Col. K. M. Kirkhope, c.i.e. F. J. Bell, Esq. C. L. Bruce, Esq. C. S. Hammarton, Esq. H. J. Lester, Esq., f.s.a.a. W. E. P. Lor vine, Esq. G. T. May, Esg. F. W. Moore, Esq., t.p., f.c.a. P. IT. Powell, Esq. A. L. Priest, Esq., .t.p. W. J. Tarry, Esq. Representatives on the West Kent Main Sewerage Board: C. L. Bruce, Esq. A. L. Priest, Esq., .t.p. Representatives on the West Kent Joint Hospital Board: C. L. Bruce, Esq. A. L. Priest, Esq., .t.p. STAFF: M\edical 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.r.s.i., m.s.i.a. (Chief Sanitary Inspector and Cleansing Superintendent). F. C. Crowe, m.r.s.i., m.is.i.a. (Deputy Chief Sanitary Inspector, Housing Inspector and Inspector under the Shops Acts). W. T. Weedy, c.r.s.i., m.s.i.a. (Senior District Sanitary Inspector and Inspector under the Shops Acts). D. H. Livesey, m.r.'s.i., m.s.i..a. (District Sanitary Inspector). E. Taylor, c.r.s.i., m.s.i.a. (District Sanitary Inspector). Health Visitor: Mrs. L. Russell. Cleric and Shorthand Typist: Miss M. E. Stimson and subsequently Miss I. Chamberlain, 3 VITAL STATISTICS, ETC. Area (in acres) 20,842 Population. Registrar-General's estimate for midyear, 1939 49,570 Number of occupied houses 15,797 Rateable Value of District, December, 1939 £440,440 Sum represented by a penny rate, December, 1939 £1,790 Total M F. Birth Rate per 1,000 of estimated population. Live births Legitimate 930 475 455 Illegitimate 34 16 18 19.4 Total Births 964 491 473 Rate per 1,000 (live and still) births Stillbirths 32 16 16 32.1 Death Rate per 1,000 of estimated population. Deaths 448 225 223 9.0 Deaths Rate per 1,000 total, (live and still) births. Deaths from puerperal causes: Puerperal Sepsis 1 1.00 Other puerperal causes 3 3.00 Deaths of Infants under one year of age. Deaths. Infantile Mortality Rate. Number of infant deaths 42 43 Legitimate infants 30 32 Illegitimate infants 13 352 4 INFECTIOUS DISEASE. The year 1939 was a satisfactory one from the point of view of incidence of Infections Disease, the nnmber of cases notified being- 189, as compared with 458 last year. The following- Table shows the number of cases notified, together with the number removed to Hospital and the number of deaths registered: — Disease Number Notified Number Removed to Hospital Total Deaths Scarlet Fever 78 58 — Diphtheria 11 10 — Typhoid Fever 4 2 — Erysipelas 14 — — Cerebro-spinal Fever 1 — — Puerperal Pyrexia 21 — — Pneumonia 31 — 22* Acute Poliomyelitis 1 — — Dysentery 9 — — Whooping Cough 4 — 5 Measles 15 — — TOTALS 189 70 27 *A11 forms. DIPHTHERIA IMMUNISATION CLINIC. A Diphtheria Immunisation Clinic was established by the Bromley Knral District Council, and was first opened on the 24th May, 1929. During the year 1939, the following work has been carried out:— Number of sessions held 56 Number of new attendances 714 Number of new cases 195 5 Birth-rates, Death-rates. Analysis of Mortality, Maternal Mortality, and Case notes fo certain Infectious Diseases in the year 1939. England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns Resident Populations 25,000 to 50,000 at 1931 Census London Administrative County Orpington Urban District Rates per 1,000 Population Births:— Live 15.0 14.8 15.6 12.3 19.4 Still 0.59 0.59 0.57 0.44 32.1 Deaths:— All causes 12.1 12.0 11.2 11.9 9.0 Typhoid and Paratyphoid fevers 0.00 0.00 0.00 0.00 0.00 Smallpox — — — — 0.00 Measles 0.01 0.01 0.01 0.00 0.00 Scarlet Fever 0.01 0.00 0.00 0.00 0.00 Whooping Cough 0.03 0.03 0.02 0.03 0.10 Diphtheria 0.05 0.05 0.04 0.02 0.00 Influenza 0.21 0.19 0.20 0.18 0.16 Notifications:— Smallpox 0.00 — — — — Scarlet Fever 1.89 1.96 1.78 1.53 1.43 Diphtheria 1.14 1.21 1.16 0.98 0.22 Enteric Fever 0.04 0.03 0.04 0.03 0 08 Erysipelas 0.34 0.40 0.31 0.37 0.28 Pneumonia 1.02 1.21 0.89 0.99 0.66 Rates per 1,000 Live Births Deaths under 1 year of age 50 53 40 48 43 Deaths from Diarrhoea and Enteritis under 2 years of age 4.6 6.3 3.0 8.2 1.03 Maternal Mortality:— Puerperal Sepsis 0.77 Not available 1.03 Others 2.16 3.11 Total 293 4.14 Rates per 1,000 Total Births (Live and Still) Maternal Mortality:— Puerperal Sepsis 0.74 Not available 1.00 Others 2.08 3.01 Total 2.82 4.01 Notifications:— Puerperal Fever 14.35 17.26 12.99 3.31 21.08 Puerperal pyrexia 14.22 6 TUBERCULOSIS. The following1 table shows the number of new cases of Tuberculosis notified, together with the number of deaths registered. NOTIFIED DEATHS Males Females Total Males Females Total Pulmonary 23 10 33 9 7 16 Non-Pulmonary 7 9 16 - 1 1 TOTAL 30 19 49 9 8 17 PUBLIC HEALTH ACT, 1936 (Sec. 176), and the PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. No action under the above was required during the year. ISOLATION HOSPITAL. This District is served by the West Kent Joint Hospital Board. During' the year 70 cases were removed from this District: Scarlet Fever 58 (10 non-civilians). Diphtheria 10 (1 do. ). Enteric Fever 2 LABORATORY WORK. The bacteriological work in connection with this District is carried out at the Kent County Laboratory, Maidstone, and during the year the following number of specimens have been examined there:— 7  Positive Negative Total Swabs for Diphtheria 7 163 170 Sputa for Tubercle 25 133 158 Widals for Typhoid — 5 5 Other Typhoid specimens — 1 1 Miscellaneous 17 55 72 TOTAL 49 357 406 111 addition, the following emergency swabs for diagnostic purposes were examined by Dr. J. Byers, at the West Kent Joint Hospital Board's Laboratory. Positive Negative Total Swabs for Diphtheria 8 130 138 Swabs for Haemolytic Streptococci 0 2 2 TOTAL 8 132 140 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 sewers. During the year the provision of main drainage for a portion of Farnborough was completed, and premises previously on cesspool drainage were connected to the sewer. SANITARY STATISTICS. No. of houses connected to the sewer No. of houses not connected to sewers No. of houses not provided witli a piped water supply No. of wells still in use for purpose of domestic supply 12929 3048 393 6 8 Sanitary Conveniences. W.C's. Pan or Pail Closets Midden Privies Ashpits separate from Midden Privies Cesspools No. of No. of houses into 15614 294 13 — 2326 2741 WATER SUPPLY. The greater part of the District is supplied by the mains of the Metropolitan Water Board. Four samples of the piped supply are examined bacteriologically each month, and the results in each case showed that B.Coli were absent in 100 c.c., and that they were good waters. Three samples of rainwater stored for domestic purposes were submitted for chemical analysis, of which two were found to be unsatisfactory. The necessary action was taken in each case. PUBLIC CLEANSING. The collection of house refuse throughout the District is carried out by direct labour, the greater part of the area having a weekly collection. The refuse is disposed of on the Bradford system. HOUSING. 1. Inspection of Dwelling Houses during the year. (1) (a) Total number of houses inspected for housing defects (Under Public Health or HousingActs) 384 (b) Number of inspections made for the purpose 1972 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 48 (b) Number of inspections made for the purpose 126 (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation - (4) Number of dwelling houses (exclusive of those referred to under the preceding slib-head) found not to be in all respects reasonably fit for human habitation 244 9 2. Remedy of Defects during the year without service of formal notices:— umber of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers 214 3. Action under Statutory Powers during the Year:— (ay Proceedings under Sections 9, 10 and 10 of the Housing- Act, 1930:— (1) dumber of dwelling houses in respect of which notices were served requiring repairs — (2) Number of dwelling houses which were rendered fit after service of formal notices: (a) By owners — (b) By Local Authority in default of owners — (b) Proceedings under the Public Health Acts: (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 9 (2) Number of dwelling houses in which defects were remedied after service of formal notices:— (a) By owners 5 (b) By Local Authority in default of owners — (c) Proceedings under Sections 11 and 13 of the Housing Act, 1930:— (1) Number of dwelling houses in respect of which Demolition Orders were made — (2) Number of dwelling houses demolished in pursuance of Demolition Orders — (d) Proceedings under Section 12 of the Housing Act, 1930:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made — (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit — 4. Housing Act, 1936. Part IV. Overcrowding:— (a) (i) Number of dwelling houses overcrowded at end of year 38 (ii) Number of families dwelling therein 38 (iii) Number of persons dwelling therein 310 (b) Number of new cases of overcrowding reported during the year — 10 (c) (i) Number of cases of overcrowding relieved during year 2 (ii) Number of persons concerned in such cases 10 (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 — By other persons 876 HEALTH VISITOR. The Council employs the services of one full-time health Visitor, who works under the supervision of the Medical Officer of Health. During the year she has visited 520 cases, and paid a total of 962 visits. MATERNITY AND CHILD WELFARE. The Maternity and Child Welfare work in this District is under the control of the Kent County Council. The following Centres have been established in this District: — ANTE-NATAL CLINICS. Address. Methodist Hall, Orpington. Village Hall, St. Mary Cray. Sessions held. Tuesdays and Fridays at 10 a.m. Second and fourth Wednesdays at 2 p.m. MATERNITY AND CHILD WELFARE CENTRES. Chelsfield, Reading Room. Cudham (Biggin Hill). (BigTeapot Pavilion, Main Road, Biggin Hill). Cudham, Village Hall. Downe, Gospel Hall. Farnborough, Parish Hall. St. Mary Cray, Village Hall. Orpington, Methodist Church Hall, Sevenoaks Road. Green - Street - Green, Church Hall, Worlds End Lane. Petts Wood, St. Francis Hall. First and third Tuesdays. Tuesday afternoons. First and third Wednesdays. Second and fourth Tuesdays. Friday afternoons. Tuesday afternoons. Monday and Tuesday afternoons. Fridays. Thursdays. 11 SCHOOLS. There are 14 elementary schools within the District. No schools were closed during the year in consequence of infectious disease occurring amongst the scholars. MIDWIVES. The supervision of midwives is carried out by the Kent County Council. REGULATED TRADES. Number No. of Visits No. of Defects found No. of Defects remedied Dairies 70 303 8 8 Cowsheds Slaughterhouses Licensed 17 989 — — Registered Bakehouses 20 82 4 4 Piggeries 10 159 — — Other food preparing places 270 402 1 1 Factories | 171 63 — — Workplaces Common Lodging Houses 1 2 — — Houses let in Lodgings — — — — TOTALS 559 2000 13 13 MILK (SPECIAL DESIGNATIONS) ORDER, 1936. The Council granted the following number of licences under the above Order during 1939:— Tuberculin Tested 8 Pasteurised 11 12 Fifty-eight samples of graded milk were taken at tlie place of production and submitted for examination. In addition, six samples of graded milk were collected from public institutions for examination. MEAT. The following Table shows the number of carcases 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 (if known) 180 14 174 1166 3963 Number inspected 180 14 174 1166 3963 All diseases except Tuberculosis: Whole carcases condemned ... ... ... ... 6 Carcases of which some part or organ was condemned 14 1 ... 4 54 Percentage of the number inspected affected with diseases other than Tuberculosis 7.7 7.14 ... 0.34 1.51 TUBERCULOSIS ONLY. Whole carcases condemned 1 1 ... ... 8 Carcases of which some part or organ was condemned 11 6 ... ... 81 Percentage of the number inspected affected with tuberculosis 6.6 5.0 ... ... 2.24 FACTORIES. There are 171 Factories and Workplaces within the District. 13 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 63 — — Factories without mechanical power †Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) — — fElectrical Stations should be reckoned as Factories. — — — Total 63 — — 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 (S. 1) NIL Overcrowding (S. 2) Unreasonable temperature (S. 3) Inadequate ventilation (S. 4) Ineffective drainage of floors (S. 6) Sanitary conveniences tS. 7) insufficient — unsuitable or defective — not separate for sexes — Other offences (S. 7) (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 14 SHOPS ACTS. During the year 325 visits were paid to shops in the District. No formal action was required. SWIMMING BATHS AND POOLS. There is one Public Swimming Pool and one privately owned swimming bath in the District. Inspections were made during the year, but no action was found necessary. CAMPING SITES. There are 13 sites for camping in the District. The number of sites for which licences were issued under Section 209 of the Public Health Act, 1936, was 13. The estimated number of campers resident in the area during the summer season was 1,570. SMOKE ABATEMENT. Observations over a lengthy period were made as a result of complaints with respect to the excessive emission of smoke from two factories, and with the co-operation of the owners concerned considerable improvement occurred. ERADICATION OF BED BUGS. The following work was carried out during the year: — Number of houses found infested: — Council houses 5 Other houses 6 Number of houses disinfested : — Council houses 5 Other houses 6 AMBULANCE AND NURSING FACILITIES. No change has been made in the ambulance and nursing facilities in this District during the year. 15 LEGAL PROCEEDINGS. It was found necessary in one case to institute legal proceedings, viz., for allowing ground to be used as a site for moveable dwellings. The defendant was convicted and fined £3, with £4 costs. NURSING AND MATERNITY HOMES. The powers in relation to Nursing and Maternity Homes have been delegated to the District Council. At the end of the year there were two registered Homes within the District, the number of beds available being 13, of which 8 were for maternity cases and 5 for other cases. ADOPTIVE ACTS AND BYELAWS. In addition to the adoptive Acts and Byelaws set out in my Report for 1938, the following Byelaws were adopted during 1939: — Supplementary Table of fees, payments and sums in respect of Burial Grounds, which came into operation on the 9th March, 1939. Building Byelaws, which came into operation on the 29th July, 1939. 16 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1939. Disease Number of cases notified Total Cnses 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 ana over Scarlet Fever 78 — 1 3 4 6 29 11 5 14 4 1 — 58 — Diphtheria 11 1 — — 1 1 2 2 1 3 — — — 10 — Typhoid Fever 4 — — — — 1 1 — — 1 — 1 — 2 — Erysipelas 14 — — — — — — -- — 1 1 9 3 — — Cerebro-spinal Fever 1 — — — 1 — — — — — — — — — — Puerperal Pyrexia 21 — — — — — — — 3 16 2 — — — Pneumonia 31 4 1 1 3 1 2 — 2 6 4 3 4 — 22 Acute Poliomyelitis 1 — — — — — — 1 — — — — — — — Dysentery 9 4 1 — — — 1 1 — 2 — — — — — Whooping Cough 4 — 1 — 1 — 2 — — — — — — .— 5 Measles 15 6 1 — — 1 3 2 1 1 — — — — — TOTALS 189 15 5 4 10 10 40 17 12 44 11 14 7 70 27 17 DEATHS REGISTERED DURING THE YEAR 1939. Cause of Death Males Females Total Typhoid fever etc. — — — Measles — — — Scarlet fever — — — Whooping cough 3 2 5 Diphtheria — — — Influenza 4 4 8 Encephalitis lethargica — — — Cerebro-spinal fever — — — Respiratory tuberculosis 9 7 16 Other tuberculosis diseases — 1 1 Syphilis — — — General paralysis of the insane etc. — 1 1 Cancer 26 42 68 Diabetes 4 1 5 Cerebral haemorrhage 6 11 17 Heart disease 66 58 124 Aneurysm — — — Othercirculatory diseases 12 12 24 Bronchitis 4 13 17 Pneumonia 10 12 22 Other respiratory diseases 4 1 5 Peptic ulcer 2 2 4 Diarrhoea etc. (under 2 years) — 1 1 Appendicitis 1 2 3 Cirrhosis of liver — — — Other diseases of liver 1 1 2 Other digestive diseases 6 3 9 Nephritis 5 9 14 Puerperal sepsis — 1 1 Other puerperal causes — 3 3 Congenital debility, etc. 19 6 25 Senility 4 4 8 Suicide 3 — 3 Other violence 14 6 20 Other defined causes 22 20 42 Causes ill-defined or unknown — — — Totals 225 223 448