ORP 10 ORPINGTON URBAN DISTRICT COUNCIL REPORT For the Year 1946 on the Sanitary Conditions and Vital Statistics of the Urban District of Orpington by the Medical Officer of Health. Bromley: kentish district times co., ltd., 22, north street. 1 URBAN DISTRICT COUNCIL OF ORPINGTON. Health Report for 1946. Gentlemen, I have pleasure in presenting my Annual Health Report for the year 1946, this being the twenty-fourth one submitted by me as your Medical Officer of Health. The population of the District at mid-year, as estimated by the Registrar-General, was 56,640. The Birth Rate for the year was equal to 20.0 per thousand of population, as compared with 17.8 last year. A decrease took place in the Death Rate for the year, this being 9.3 per thousand of population as against 10.1 last year. The Infantile Mortality Rate remains on a low level, being 34 per thousand registered births. The Rate last year was 28. During the year, 1,227 Certificates of Notification of Infectious Disease were received as compared with 982 last year. The cases giving rise to the larger number of notifications were Measles 806 and Whooping Cough 153. In submitting this Report, I again desire to express my thanks to the Council for the kind help and assistance I have received from them. In particular, I would desire to express my appreciation of the efficient and loyal 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 - G. Allison Beer, Esq., C.C. Vice-Chairman - H. T. Cox, Esq. C. L. Bruce, Esq. C. F. Bulpitt, Esq. R. E. Clough, Esq. P. W. Dewberry, Esq. A. H. A. Grenger, Esq., J.P. W. E. Hawken, Esq. G. T. May, Esq. P. H. Powell, Esq. L. F. Neal, Esq. E. W. Stevens, Esq. H. C. Vickers, Esq. J. C. Ward, Esq. Representatives on the West Kent Joint Hospital Board. C. L. Bruce, Esq. A. L. Priest, Esq., J.P. Representatives on the West Kent Main Sewerage 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.r.s.i., m.s.i.a., s.i.e.bd. (Chief Sanitary Inspector and Cleansing Superintendent). F. C. Crowe, m.r.s.i., m.s.i.a. (Deputy Chief Sanitary Inspector and Inspector under .the Shops Acts and Food and Drugs Inspector). W. T. Weedy, c.r.s.i., m.s.i.a. (Senior District Sanitary Inspector and Inspector under the Shops Acts). R. Taylor, c.r.s.i., m.s.i.a. (District Sanitary Inspector). D. H. Livesey, m.r.s.i., m.s.i.a. (District Sanitary Inspector). Honorary Salvage Officer: Health Visitor: H. T. Cartmel. Mrs. L. Russell, s.r.n., s.c.m., s.r.f.n. Assistant Nurse (for.treatment of Scabies): Mrs. G. Chapman. Chief Clerk and Shorthand Typist: Miss I. Chamberlain. Part time Domestic Help Supervisor: Mrs. Q. E. Skevington. Clerks: S. Kurn (Junior Shorthand Typist). I. Healey (Office Junior). 3 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area in acres 20,842 Registrar-General's estimate of population, mid-1946 56,640 Number of occupied houses, December, 1946 16,280 Rateable Value of District £489,482 Sum represented by a penny rate £1,970 SECTION B. VITAL STATISTICS. Total. M. F. Birth Kate per 1,000 estimated population Live Births Legitimate 1072 569 503 Illegitimate 65 27 38 20.0 Total Births 1137 596 541 Rate per 1,000 (live and still births) Still-Births % 33 20 13 28.2 Death Rate per 1,000 of estimated population. Deaths 531 271 260 9.3 Deaths from Puerperal causes: Deaths. Rate per 1,000 total (live and still) births. Puerperal sepsis 1 0.8 Other pueperal causes 1 0.8 Total 2 1.6 Death Rate of Infants under one year of age: — All infants per 1,000 live births (39) 34 Legitimate infants per 1,000 legitimate live births (39) 36 Illegitimate infants per 1,000 illegitimate live births — Deaths from Cancer (all ages) 94 Deaths from Measles (all ages) Nil Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea (under 2 years of age) 2 4 HEALTH REPORT FOR 1946. The population of the District as estimated by the RegistrarGeneral at mid-year 1946 was 56,640. VITAL STATISTICS. Births.—During the year, 1,137 Births were registered as belonging to the District, of which number 596 were males and 541 were females. This is equal to a Birth Rate of 20.0 per thousand of population, as compared with 17.8 last year. Deaths.—The number of Deaths registered as belonging to the District was 531 (271 males and 260 females). This is equal to a Death Rate of 9.3 per thousand of population, as against 10.1 last year. Infantile Mortality Rate.—During the year 39 Deaths were registered as occurring in Infants under one year of age (all being legitimate births). The Infantile Mortality Rate was equal to 34 per thousand registered births as compared with 28 last year. Orpington Urban District. England & Wales. Birth Rate 20.0 19.1 Death Rate 9.3 11.5 Infantile Mortality Rate 34 43 5 INFECTIOUS DISEASE. The following Table shows the number of cases of Infectious Disease notified during the year, together with the number removed to Hospital, and the total deaths. Table I at the end of the Report shows the incidence of Infectious Disease at various age-groups. Disease. Number notified. Removed to Hospital. Total Deaths. Scarlet Fever 68 53 — Diphtheria 2 2 — Paratyphoid Fever 2 — — Puerperal Pyrexia 25 — — Pneumonia 46 — 20* Erysipelas 22 — — Dysentery 17 — — Cerebro-spinal Fever 3 1 — Poliomyelitis 2 1 — Malaria 1 — — Scabies 80 — — Whooping Cough 153 — 2 Measles 806 5 — TOTALS 1227 62 22 *A11 forms of Pneumonia. DIPHTHERIA IMMUNISATION CLINIC. The following work has been done in connection with the Diphtheria Immunisation Clinic during the year: — Number of sessions held 177 Number of new cases 1379 Number of attendances 5253 OPHTHALMIA NEONATORUM. No cases of Ophthalmia Neonatorum were notified during the year. 6 ANALYSIS OF MORTALITY IN THE YEAR 1946. England and Wales. 126 County Boroughs and Great Towns including London. 148 Smaller Towns (Resident populations 25,000 to 50,000) London Administrative County. Orpington Urban District Rates per 1,000 Civilian Population. Births: Live 19.1 22.2 21.3 21.5 20.0 Still 0.55 0.67 0.59 0.54 0.58 Deaths: All Causes 11.5 12.7 11.7 12.7 9.3 Typhoid and Paratyphoid Fevers 0.00 0.00 0.00 0.00 — Scarlet. Fever 0.00 0.00 0.00 0.00 — Whooping Cough 0.02 0.02 0.02 0.02 0.03 Diphtheria 0.01 0.01 0.01 0.01 — Influenza 0.15 0.13 0.14 0.12 0.07 Smallpox 0.00 0.00 0.00 — — Measles 0.00 0.01 0.00 0.01 — Rates per 1,000 Live Births. Deaths under 1 year of age 43 * 45 37 41 34 Deaths from Diarrhœa and Enteritis under 2 years of age 4.4 6.1 2.8 4.2 1.75 Notifications Rates per 1,000 Civilian Population. Typhoid Fever 0.01 0.01 0.01 0.01 — Paratyphoid Fever 0.02 0.02 0.01 0.01 0.03 Cerebro-Spinal Fever 0.05 0.05 0.04 0.06 0.05 Scarlet Fever 1.38 1.51 1.33 1.42 1.20 Whooping Cough 2.28 2.48 2.05 2.22 2.73 Diphtheria 0.28 0.32 0.31' 0.24 0.03 Erysipelas 0.32 0.25 0.22 0.27 0.28 Smallpox 0.00 0.00 0.00 0.00 — Measles 3.92 4.75 3.70 7.35 14.2 Pneumonia 0.89 1.02 0.74 0.75 0.81 Rates per 1,000 Total Births (i.e., Live and Still). Notifications: Puerperal Pyrexia 8.50 10.35 7.63 1.62 9.68 21.2 Puerperal Fever A dash signifies there were no deaths. (Z TUBERCULOSIS. The following 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 34 31 65 5 6 11 Non-Pulmonary 4 5 9 3 — 3 Total 38 36 74 8 6 14 The Kent County Council carries out the treatment for cases of Tuberculosis, and during the year the following number of patients from this District have received treatment: — Number receiving sanatorium treatment 78 ' Number receiving dispensary treatment 61 Dispensary supervision only 236 PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. PUBLIC HEALTH ACT, 1936 (Section 176). No action was required under the above during the year. 8 BACTERIOLOGICAL WORK. The bacteriological work in connection with this District is carried out at the County Laboratory, Maidstone, and during the year the following number of specimens have been examined there: — Positive. Negative. TOTAL. Swabs for Diphtheria 3 3 6 Swabs for Haemolytic Streptococci 3 134 137 Sputa for Tubercle 38 — 38 Faeces for Dysentery 14 — 14 Widals for Typhoid — 2 2 Totals 58 139 197 In addition to the above, work has been carried out at the West Kent Joint Isolation Hospital's laboratory by Dr. J. Byers, and at the Ministry of Health Emergency Laboratory at Downe, as follows: — West Kent Joint Hospital Laboratory: — Positive. Negative. Total Swabs for Diphtheria 2 66 68 Ministry of Health Emergency Laboratory, Downe: — Positive. Negative. TOTAL. Swabs for Haemolytic Streptococci 23 35 58 Sputa for Tubercle — 1 1 Faeces for Dysentery — 25 25 Widals for Typhoid Fever 1 15 16 Totals 24 76 100 9 ISOLATION HOSPITAL. Cases of Infectious Disease from this District are admitted to the West Kent Joint Isolation Hospital, and during the year the following number of patients have been admitted: — Scarlet Fever 53 Diphtheria 2 Cerebro-spinal Fever 1 Acute Poliomyelitis 1 Measles 5 Emergency Domestic Help Scheme. The Emergency Domestic Help Scheme administered by the Council in this area under delegated powers from the Kent County Council has progressed a long way during the past 12 months. At the time of my last report it was only in its infancy, but is now a fully fledged Scheme and definitely a well-established addition to the services available to the public. Many problems and difficulties were encountered as throughout most of the period under review new ground was still being broken. A falling off in the number of helpers available was noticed before and during every holiday period. Towards the end of the year it was decided to employ all workers in a part-time capacity even though some worked on an average 40 hours a week. Over 300 formal applications have been dealt with. Forty women have been employed under the Scheme. A total of 130 cases received assistance. 220 home visits were made. Of the cases referred to the department for assistance, approximately 66 per cent, were recommended by Doctors, 20 per cent, by Hospital Almoners, 5 per cent, by District Nurses, and the remaining 9 per cent, from miscellaneous sources, including members of the clergy, Old Aged People's Association and other welfare bodies. This Scheme has obviously filled a long felt want and has come to stay. It is my very earnest wish that it should be developed extensively until the point is reached when anybody who is incapacitated through illness or old age and requires domestic help should be able to obtain same. My experience of the working of the Scheme and of the successful way in which it is now developing leads me to place on record my appreciation of the wisdom shown in delegating powers under this Scheme to the local County District Council. 10 DRAINAGE. The houses in the main portion of the District are on the water carriage system, and most of the houses are connected to the public sewers. Work in connection with the extension of the sewer to Knockholt was completed during the year, and two connections were made to this sewer, one in Knockholt Village and one in Hookwood Road, Pratts Bottom, to drain Council houses. It is anticipated that advantage will be taken by the owners of properties in the Southern area for the connection of houses to the new sewer when conditions become more normal. SANITARY STATISTICS. Number of houses connected to the sewers. No. of houses not connected to the sewers. No, of houses not provided with a piped water supply. No. of wells still in use for purpose of domestic supply. 12719 2948 351 6 Sanitary Conveniences. W.C.'s Pan or Pail Closets. Midden Privies. Cesspools No. of No. of houses connected. 15378 294 13 2201 2621 WATER SUPPLY. The mains of the Metropolitan Water Board supply the greater portion of the District. In some outlying parts, however, water is obtained from deep wells, and from rain water collected from the roofs of houses and stored in tanks. During the year extensions of the water mains were carried out at Bridge Road, Willersley Avenue, Cray Avenue, Robin Hood Green and Mountfield Estate, St. Mary Cray, and also at Downe. The water supply has been satisfactory both as regards quality and quantity. Bacteriological examinations of the Board's water are made monthly, an average of four samples being collected each month. No contamination of the water was found during the year, and there does not appear to be any risk of plumbo-solvent action. 11 During the year 49 samples of water were examined bacteriologically, and all proved satisfactory. Four chemical analyses of water, other than that obtained from the Board's mains, which were used for drinking purposes were made, of which one proved to be of excellent quality. In the other three cases, one proved to be of fair quality which should be boiled before use, and the remaining two were unsatisfactory and unfit for drinking purposes. PUBLIC CLEANSING. The collection of house refuse throughout the District is carried out by direct labour. The refuse is disposed of by controlled tipping. The frequency of the collection showed some improvement at the end of the yeUr. Every effort is being made towards effecting a weekly collection of house refuse in the Northern Area, and reverting to the pre-War frequency of fourteen days in the Southern rural area. CESSPOOL EMPTYING. The emptying of cesspools is carried out as circumstances permit. 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) 937 (b) Number of inspections made for the purpose 2294 (2) (a) Number of dwelling houses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 — (b) Number of inspections made for the purpose — (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 sub-head) found not to be in all respects reasonably fit for human habitation 324 2. Remedy of Defects during the year without Service of Formal Notices. Number of defective dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers 269 12 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 — (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 24 (2) Number of dwelling houses in which defects were remedied after service of formal notices: — (a) By owners 16 (b) By Local Authority in default of owners — (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 — (2) Number of dwelling houses demolished in pursuance of Demolition Orders — (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 — (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 99 (ii) Number of families dwelling therein 212 (iii) Number of persons dwelling therein 891 (b) Number of new cases of overcrowding reported during the year 68 (c) (i) Number of cases overcrowding relieved during year 47 (ii) Number of persons concerned in such cases , 196 13 (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 — Number of new houses erected during the year: — By the Council— Temporary 139 Permanent 24 By other persons 90 HEALTH VISITOR. The Council employs one full-time Health Visitor, who works under the supervision of the Medical Officer.of Health. During the year she has paid the following number of visits:— Cases of Tuberculosis 277 Cases of Measles 370 Cases of Measles complications 9 Cases of Mumps 1 Cases of Whooping Cough 63 Cases of Chicken Pox 48 Cases of Scabies 49 Cases of Scabies complications 7 Cases of Diabetes 2 Cases of Impetigo 2 Cases of Scarlet Fever 19 Cases of Scarlet Fever complications 3 Cases of Paratyphoid Fever 10 Cases of streptococcal infection 6 Visits to school re Scarlet Fever 4 Ante-natal visits 3 Visits re swabs 4 Visits re Diphtheria 10 Visits re Nursing Homes 10 Visits re Home Helps 5 Visits re Immunisation Centres 43 Visits re overcrowding 9 Visits re gift furniture 18 Visits re Child Welfare 30 Total Visits 1002 14 MATERNITY AND CHILD WELFARE, The Maternity and Child Welfare work in this District is under the control of the Kent County Council. The following Clinics and Centres have been established in this a: — MATERNITY AND CHILD WELFARE CENTRES. No. of attendances. Name of Centre. Address. Day and time of opening. Number of Sessions. Children under 1 years. Children 1—5 years. Chelsfield Reading Room 1st, 3rd, 5th Thursdays. 28 162 232 CUDHAM Village Hall .. 2nd and 4th Tuesdays. 24 112 122 cudham (Biggin Hill) Sports Pavilion (Formerly First Aid Post) Every Thursday. 51 1,222 800 Downe Gospel Hall 1st and 3rd Wednesdays. 24 215 185 Farnborough Methodist Church Hall Every Friday. 51 1,151 725 Green-Street Green Baptist Schoolroom Every Friday. 50 916 660 Orpington Methodist Church Hall Every Monday, and Tuesday. 106 3,845 2,112 Petts Wood St. Francis Hall Every Monday 60 2,086 1,259 Petts Wood Sports Pavilion (Formerly First Aid Post). Every Thursday. 37 1,314 913 St. Mary Cray Sports Pavilion (Formerly First Aid Post). Every Tuesday and Wednesday. 103 2,999 1,434 ANTE-NATAL CLINICS. Name of Clinic. Address. Day and time of opening. No. of Sessions. Number of attendances cudham (Biggin Hill) Sports Pavilion (Formerly First Aid Post) 2nd and 4th Wednesday. 28 403 Green-Street Green Baptist Schoolroom Every Friday, 2nd, 4th & 5th Thursday. 49 587 Orpington Methodist Church Hall Every Tuesday, Thursday and Friday. 150 2,781 Petts Wood Sports Pavilion (Formerly First Aid Post) Every Tuesday and Wednesday 103 1,218 St. Mary Cray Sports Pavilion (Formerly First Aid Post) Every Friday. 74 1,487 15 NURSING FACILITIES. No change has been made in regard to the nursing facilities for this District. MATERNITY AND NURSING HOMES. The powers under the Public Health Act relating to Nursing and Maternity Homes have been delegated by the County Council to the District Council. There are two registered Homes within the District, which provide 15 beds for maternity cases and 2 beds for other cases. SUMMARY OF REGULATED TRADES. Number. No. of Visits. No. of Defects found. No. of defects remedied. Dairies and Cowsheds 75 141 1 1 Slaughterhouses 17 11 — — Bakehouses 20 11 1 1 Piggeries 27 6 2 2 Other food preparing places 270 524 — — Factories 220 37 4 4 Workshops Workplaces Common Lodging Houses 1 2 1 1 Houses—Let— in Lodgings — — — — TOTALS 430 732 9 9 16 MILK (SPECIAL DESIGNATIONS ORDER), 1936. The Council granted the following number of licences during the year under the above Order: — Principal. Supplementary. Tuberculin Tested 7 1 Pasteurised 9 1 MILK SUPPLY. During the year the following number of samples of milk were examined: — Satisfactory. Unsatisfactory. Tuberculin Tested 48 12 Accredited 12 4 Tuberculin Tested pasteurised 1 Mixed Milk 6 1 MEAT INSPECTION. During the year 16 pigs (14 slaughtered under licence from the Food Office and 2 emergency slaughters) were examined during the year, and found to be fit for human consumption. FOOD AND DRUGS ACT, ,1938. The powers under the Food and Drugs Act, 1938, are under the control of the Council, and during the year 230 samples were taken (17 Formal and 213 Informal). One Formal and five Informal samples were reported as being not genuine. The following Tables show the number and description of the samples taken: — FORMAL SAMPLES. Description of Sample. Number of Samples submitted. Number Genuine. Number not Genuine. New Milk 17 16 1 17 INFORMAL SAMPLES. Description of Sample. Number of Samples submitted. . Number Genuine. Number not Genuine. Anchovies, Essence of 1 1 — Aspirin Tablets 2 2 — Bacon 2 2 — Baking Powder 3 3 — Barley, ground 1 1 — Barley, Kernels 2 2 — Barley, Pearl 2 2 — Beef Extract 1 1 — Bloater Paste 1 1 — Bicarbonate of Soda 3 3 — Boracic Powder 2 2 — Breadcrumbs 1 1 — Butter 6 6 — Cake Decorations 3 3 — Cake Mixture 1 1 — Camphorated Oil 1 1 — Castor Oil 5 5 — Cayenne Pepper 1 1 — Cheese 5 5 — Cinnamon 1 1 — Cochineal Colour 2 2 — Coffee and Chicory 1 1 — Cooking Fat 4 4 — Cough Elixir 1 1 — Cough Linctus 1 1 — Curry 1 1 — Chocolate Laxative Drops 1 1 — Curry Paste 1 1 — Egg Substitute 2 2 — Epsom Salts 5 5 — Essense of Rennett 1 1 — Fish Paste 2 1 1 Flavouring 1 1 — „ Banana 2 2 — „ Lemon 1 1 — „ Powder 1 1 — „ Pineapple 1 1 — Vanilla 1 1 — Flour, Batter 1 1 — „ Cake 5 5 — Pea 2 2 — Rye 1 1 — Fullers Earth Cream 1 1 — Friars Balsam 2 2 — Gelatine 1 1 — Gelatine, powdered 2 2 — Ginger, ground 1 1 — Glauber Salts 4 4 — Glycerine 2 2 — Gravy Browning 2 2 — Gravy Powder 2 2 — Gravy Salt 3 3 — Gravylets 1 1 — Haricot Beans 1 1 — Horse Radish Cream 1 1 — Horse Radish Sauce 1 1 — 18 INFORMAL SAMPLES (Continued). Description of Sample. Number of Samples submitted. N umber Genuine. Number not Genuine. Herbs, prepared 1 1 — Indigestion Mixture 1 1 — Iodine, Tincture of 6 6 — Jelly Crystals 2 2 — Lemonade Crystals 1 1 — Lemonade Powder 2 2 — Linseed Compound 1 1 — Margarine 7 7 — Meat Extract 1 1 — Meat and Vegetable Ration 1 1 — Milk, Dried 4 1 3 „ New 1 1 — „ Pasteurised 6 5 1 Mustard 3 3 — Mustard Sauce 1 1 — Nutmeg, ground 3 3 — Oats, rolled 3 3 — Oatmeal 2 2 — Oil of Eucalyptus 2 2 — Ointment, Boracic 4 4 — „ Sulphur 3 3 — „ Zinc 5 5 — Onion Substitute 1 1 — Orange Drink Powder 1 1 — Peas Pudding 1 1 — Pepper, Black 1 1 — Pickling Spice, mixed 3 3 — Petroleum Jelly 1 1 — Relish 1 1 — Saccharine Tablets 2 2 — Salad Dressing 1 1 — Sauce 1 1 — Sage and Onion Stuffing 2 2 — Savouree 1 1 — Scone Flour Mixture 1 1 — Semolina 3 3 — Soup Powder 2 2 — Spice, mixed 1 1 — Split Peas 1 1 — Sponge Mixture 1 1 — Sponge Pudding Mixture 1 1 — Sugar 6 6 — Sulphur and Yeast Tablets 1 1 — Syrup of Figs 2 2 — Sulphur Tablets 1 1 — Tea 4 4 — Tonic 1 1 — Tonic Food 1 1 — Vaseline 2 2 — Vinegar, Malt 1 1 — Yeast 1 1 — Zinc and Castor Oil Cream 1 1 — 19 Action taken with regard to samples found to be not genuine: — Number of Sample. Description of Sample. Nature of Adulteration. Action taken. Inf. 258 Pasteurised Milk. Failed Methylene Blue est (Heat treatment) Attention of Retailer drawn thereto and explanation obtained. Inf. 339 Inf. 340 Inf. 381 Dried Milk. Unfit for human consumption. Condemned. Surrendered by owners for disposal. Inf. 380 Fish Paste. Inferior. Attention of manufacturers drawn thereto and explanation obtained. 384 New Milk. 8.3 per cent, extraneous water. Sample taken at Farm. Warning letter to Retailer. SWIMMING BATHS AND POOLS. There is one public swimming bath in the District. One sample of water was examined during the year and found to be satisfactory. SMOKE ABATEMENT. No action was found necessary in connection with the emission of smoke. ERADICATION OF BED BUGS. The following number of houses were found to be infested with bed bugs during the year:— Council Houses 6 Other Houses 8 Disinfestation has also been carried out by the Council in connection with two hostels occupied by building operatives and also in connection with one registered Common Lodging House. Strict supervision is exercised with regard to possible infestations, and advice given where necessary. In all cases where infestations are found, the necessary action is taken. Zaldecide insecticide is used for all premises infested. 20 RAT INFESTATION. Up to May, the work of disinfestation continued to be carried out part-time by the Council's disinfector. A whole-time operative was then appointed, but continued in the Council's service for about three weeks. A new operative commenced his duties in October. During the year disinfestation of the lands and premises under the Council's ownership or control was carried out as necessary ; this included the sewers vested in the Council. The number of inspections carried out by the Public Health staff was 572. The Council have in operation a special Scheme for disinfestation, at the cost of applicants, of private premises, and during the year 61 such cases were dealt with. RIVERS AND STREAMS. All watercourses within the District receive constant supervision, and during the year it was found necessary to take action in connection with the pollution by oil from factory premises of a water course in the Crays Area. CAMPING SITES. During the year two licences were granted by the Council with regard to camping sites. SHOPS ACTS. During the year 87 inspections were made, and on no occasion was it found necessary to take formal action. CLEANSING OF PERSONS Provision has been made at the Cleansing Station, High Street, Orpington, and the Biggin Hill Sports Pavilion for the treatment of Scabies. Patients are referred to the Clinics by Doctors, Health Visitors or the School Nurses. During the year eight treatments have been given to cases of Scabies at the Biggin Hill Sports Pavilion, and 549 treatments have been carried out at the High Street Cleansing Station. The number of home visits paid by the Nurse was 219. A nurse is employed at the Cleansing Station solely for the treatment of Scabies and home visiting when necessary. 21 LEGAL PROCEEDINGS. Legal proceedings were instituted in one case during the year for default in compliance with the requirement of an abatement notice. An Order was obtained requiring the work to be carried out within three months and £3 3s. Od. costs were awarded to the Council. ADOPTIVE ACTS AND BYE-LAWS. No Acts or Byelaws were adopted during the year. zz TABLE 1. CASES OF INFECTIOUS DISEASE NOTIFIED DUR ING THE YEAR 1946. Disease. At all ages. At ages—years. Removed to Hospital. Total Deaths. Under 1 year. 1 to 2 2 to 3 3 to 4 4 t o 5 5 to 10 10 to 15 15 to 25 25 to 45 45 to 65 65 and over. Scarlet Fever 68 .. 1 3 8 6 35 9 2 4 .. .. 53 .. Diphtheria 2 .. .. .. .. .. 2 .. .. .. .. .. 2 .. Puerperal Pyrexia 25 .. .. .. .. .. .. .. 8 17 .. ... .. .. Pneumonia 46 .. 1 2 2 .. 3 3 1 8 18 8 .. .. Measles 806 12 68 86 69 93 438 26 8 4 2 .. 5 .. Whooping Cough 153 7 18 21 26 24 58 .. .. 1 .. .. .. .. Erysipelas 22 .. .. .. .. .. .. .. 2 8 11 1 .. .. Dysentery 17 1 1 2 .. .. 3 1 .. 8 .. 1 .. .. Cerebro-spinal Meningitis 3 .. .. .. .. .. .. 1 .. .. 2 .. 1 .. Poliomyelitis 2 .. .. .. .. .. .. .. 2 .. .. .. 1 .. Scabies 80 .. 3 1 3 5 18 6 13 24 5 2 .. .. Paratyphoid 2 .. .. .. .. 1 1 .. .. .. .. .. .. .. Malaria 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. TOTALS 1227 20 92 115 108 129 558 46 36 75 38 12 62 .. 23 TABLE II. DEATHS REGISTERED DURING THE YEAR 1946. Cause of Death Males. Females. TOTALS. Typhoid Fever — — — Cerebro-spinal Fever — — — Scarlet Fever — — — Whooping Cough 1 — 1 Diphtheria — — — Tuberculosis of respiratory system 5 6 11 Other Tuberculous diseases 3 — 3 Syphilitic diseases 1 2 3 Influenza 4 — 4 Measles — — — Poliomyelitis and Polioencephalitis — — — Acute Infantile Encephalitis — — — Cancer of bronchial cavity 5 6 11 Cancer of Stomach and Duodenum 7 3 10 Cancer of the Breast — 10 10 Cancer (all other forms) 32 31 63 Diabetes — 1 1 Inter cranial vesc. lesions 28 38 66 Heart Disease 75 76 151 Other Diseases of Circulatory System 6 11 17 Bronchitis 12 3 1/ Pneumonia 11 9 20 Other respiratory diseases 5 2 7 Ulcer of Stomach and Duodenum 5 1 6 Diarrhoea (under 2 years) 2 — 2 Appendicitis — 1 1 Other digestive diseases 4 5 9 Nephritis 6 3 9 Post and post-abort, sepsis — 1 1 Other maternal causes — 1 1 Premature birth 10 4 14 Congenital malformation and birth injury 10 7 17 Suicide 2 2 4 Road traffic accidents 2 — 2 Other violent causes 5 3 8 All other causes 30 32 62 TOTALS 271 260 531