ORP 13 ORPINGTON URBAN DISTRICT COUNCIL ANNUAL REPORT of the MEDICAL OFFICER of HEALTH on the HEALTH OF THE ORPINGTON URBAN DISTRICT 1949 Printed by Bromley Office Supplies & Printing Co. Ltd. East Street, Bromley \ w PUBLIC HEALTH COMMITTEE. Chairman : H. C. VICKERS, Esq. Vice-Chairman: T. GLADWELL, Esq. CHAIRMAN OF THE COUNCIL. VICE-CHAIRMAN OF THE A. R. BAXTER, Esq COUNCIL. F. W. BUCK, Esq. J. R. HENDERSON, Esq. S. V. COX, Esq. L. J. HOLBY, Esq. H. R. FLECK, Esq. E. W. LANE, Esq. Mrs. F. G. GARDNER S. J. L. MURRAY-WHITE, Esq. C. T. GIBSON, Esq. P. H. POWELL, Esq. STAFF OF THE HEALTH DEPARTMENT as at 31.12.49. Medical Officer of Health. K. E. TAPPER, O.B.E., G.M., M.B., Ch.B., D.P.H. Deputy Medical Officer of Health. H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Sanitary Inspectors. F. C. CROWE, M.R.S.I., M.S.I.A., Chief Sanitary Inspector, Cleansing Superintendent and Food and Drugs Inspector. W. T. WEEDY, C.R.S.I., Deputy Chief Sanitary Inspector, Deputy Cleansing Superintendent, and Deputy Food and Drugs Inspector. R. TAYLOR, C.R.S.I., District Sanitary Inspector. T. E. W. OSBORNE, A.R.S.I., R.I.P.H. District Sanitary Inspector. K. AUTY, M.S.I.A., District Sanitary Inspector. Clerical Staff. Mrs. E. M. LAMBERT. Miss J. E. HOLMES. Miss L. E. CLEE. 2 To the CHAIRMAN and MEMBERS of the COUNCIL. Madam and Gentlemen, It is my duty and pleasure to submit to you my second Annual Report as your Medical Officer of Health and the sixteenth such report since Orpington became an Urban District in 1934. With the close of the year 1949 ten per cent, of my duties as Medical Officer for the County Health Services in Area No. 7 were transferred to a whole-time County Officer as a result of a decision reached by the Health Services Committee of the County Council. This action of the County Council destroyed at one blow the link-up between the Personal Health Services and the Environmental Health Services—a result which is, to my way of thinking, not advantageous to either service. I can only hope that I am wrong and that the change in County policy will ultimately react to the manifest advantage of all concerned. Dr. Carter-Locke began his duties as Deputy Medical Officer of Health on January 1st, 1949—giving fifty per cent, of his time as Deputy Area Medical Officer, an arrangement which has since been cancelled. I referred in my Annual Report of 1948 to two matters which aopeared to me to be of paramount importance, viz., the number of houses in the district without main drainage, and the question of food hygiene. During the course of the year the Council decided to undertake a survey of cesspools. The information obtained from it will be invaluable to the Public Health Department, and by next year I hope to be in a position to give you a comprehensive report on cesspools in general. Mr. Crowe and the Sanitary Inspectors have now completed their preliminary survey of cafes, restaurants and places where food is prepared and handled, and the results of their investigations are recorded elsewhere in this report. The Council also decided, during the course of 1949, to adopt the Model Byelaws with respect to the handling, wrapping and delivery of food and the sale of food in the open air. These byelaws should help to raise the standard of hygiene of food delivery and sale in the open air. and the results of the advice tendered to the cafes, etc., by the Sanitary Inspectors cannot help but produce beneficial results if correctly applied. In view of the very satisfactory co-operation of the traders concerned, one feels that the investigation was well worth the trouble and time involved, 3 Turning to the vital statistics, one records that the population is still on the increase, chiefly owing to the developing of the housing estate at St. Paul's Cray. Incidentally, this area is at the moment badly supplied with medical services, but is scheduled to have the first Health Centre in the County—which should prove a great asset. The birth rate was 16.5, compared with 16.7 for the rest of the country. The death rate was 10.7, and the infant mortality rate was 21.5, compared with 19.9 for the previous year and a rate of 32 for the country as a whole. The continued low mortality rate, which is not restricted to Orpington alone, is due to many factors, some known, some conjectured and some unknown. It is not unreasonable to take some of the credit of these lowered rates to the work of Health Departments and those District Councils who have, for the past three decades, been so active in the field of preventive medicine. Full employment and all that follows it is, no doubt, another of the main factors in the uplift of the health of the community. Infectious diseases were most notable for another outbreak of infantile paralysis, to which I shall refer more fully in Section F. A census is due to be taken in 1951—the last census being in 1931, the war years intervening—and only then shall we be able to learn of the real social circumstances of the district; whether full housing use is being made of existing premises or whether the large waiting list is, in fact, a true indication of the housing need of this and other districts ; we shall learn, too, the true relationship between disease and age grouping of your population—all facts which can be obtained only by a census of the population. At the end of the year Downe House, at which the Public Health Department had been located for some years, was vacated, and the Department was transferred to temporary premises behind the Civic Buildings pending a decision as to its final location. In addition, accommodation for the District Organiser of Domestic Help and the Deputy Superintendent Health Visitor was found in the same building. In accordance with my procedure of last year, I have divided the report into the following sections : 4 Section A. Social Conditions of the Area, including vital statistics. Section B. Summary of Health Services. Section C. Sanitary and Environmental Services. Section D. Housing. Section E. Food Protection. Section F. Infectious Diseases. Section G. Other Services of the Health Department. Mr. Crowe, the Chief Sanitary Inspector and Cleansing Superintendent, and the District Sanitary Inspectors—who during the year were appointed Shop Acts Inspectors—have all carried out their work with efficiency and enthusiasm. The Health Committee can look back upon a year of successful and progressive work. I have the honour to be, Your obedient Servant, K. E. TAPPER, Medical Officer of Health. 5 SECTION A. SOCIAL CONDITIONS OF THE AREA. Orpington was made an Urban District of 20,842 acres in 1934, and since that date has developed rapidly from a 33,000 population to a 59,000 population in 1949. The northern part of the district is urban in character ; the southern largely rural. Light industries have developed in the St. Mary Cray Ward. There are now some 165 factories of various characters writhin the district. The south-eastern boundary of the district is defined by a ridge of the North. Downs, and the northern boundary by the main railway line to the N.E. Kent Coast, the area being divided into four main water sheds, all draining towards the north. The administrative centre, with a civic hall for 480 persons, is situated close to the Orpington Railway Station, within easy access of the main populated areas, and readily accessible by bus service from the outlying districts. The Council maintains twelve parks and recreation grounds of some 175 acres ; 1,383 acres have been purchased jointly by the L.C.C. and K.C.C. as part of the Green Belt land, the major portion being leased to and managed by the Orpington Council. Summary of Vital and Other Statistics. Area (in acres) 20,842 Registrar General's estimate of total population year), 1949 59,500 No. of Inhabited Houses and Flats, according to the rate books at the close of the year 18,059 No. of valuation assessments of habitable premises at the close of the year 19,004 Rateable Value (31st December, 1949) £526,006 Product of a Penny Rate for the year ending 31st March, 1950 £2,155 Live Births. Total Male Female Legitimate 928 480 448 Birth Rate, 16.5 per 1,000 Population. Illegitimate 47 23 24 975 503 472 Stillbirths. Total Male Female Stillbirth Rate, 18.1 per 1,000 (Live and Still) Births, Legitimate 18 14 4 Illegitimate — — — 6 Deaths. Total Male Female 636 339 297 Death Rate, 10.7 per 1,000 Population. Deaths from Puerperal Causes. Puerperal Sepsis — Maternal Mortality Rate, 1.01 per 1,000 Live and Still Births. Other Maternal Causes 1 Deaths of Infants Under 1 Year of Age. Total Male Female Legitimate 20 13 7 Infant Mortality Rate, 21.5 per 1,000 Live Births, Illegitimate 1 1 — 21 14 7 Death Rates of Infants Under 1 Year of Age. All infants per 1,000 live births 21.5 Legitimate infants per 1,000 legitimate ive births 21.6 Illegitimate infants per 1,000 illegitimate live births 21.3 Population. The Registrar General gives the population at mid-year 1949 as 59,500, which is an increase of 1,180 on the corresponding figure for 1948, and is equivalent to a density of 2.9 persons per acre. Included in this figure are 310 non-civilians, e.g., serving members of the Royal Navy, Army or Royal Air Force. The average increase of population is, in spite of the housing shortages, approximately 1,000 persons per year. The excess of births over deaths accounts for 338. One awaits with interest the taking of the next census in 1951 (the last census was taken in 1931), when the living conditions of your population will be defined. The population 0-4 is estimated at 5,531 and from 5-14 at 8,719. Births. The Birth Rate for 1949 is 16.5 per 1,000 population. This birth rate is now comparatively stationary for Orpington, and compares with 16.3 of the previous year. The average rate since 1934 is 19 per 1,000, but this was inflated by the immediate post-war years. Of the 975 births registered, 47 were illegitimate. Illegitimate Births. The illegitimate birth rate per 1,000 births for 1949 was 48. This rate varies from year to year. The average rate over the fifteen years from 1934 is 45 per 1,000, compared with an average rate during 1942 to 1947 of 52, 7 Stillbirths. The Registrar General's returns for the year show that the number of stillbirths registered for the area was 18 (after adjustment for inward and outward transfers), which represents a stillbirth rate of 18.1 per 1,000 live and still births compared with 25 of the previous year. Deaths. 636 deaths were recorded during the year, giving a Death Rate of 10.7 per 1,000 population. Of this figure. 339 were males and 297 females. The following table shows the main causes of death : 1949. 1948. Cancer 99 103 Heart and Circulatory Diseases 310 199 Respiratory (non T.B.) 63 39 Tuberculosis 18 18 Infectious Diseases 10 7 Digestive Diseases 24 22 Accident (Road Traffic) 7 6 Other Violent Causes 10 12 Suicide 10 8 Other Causes 85 79 636 493 Infant Deaths. There were 21 deaths of infants under one year of age, giving an infant mortality rate of 21.5 per 1,000 live births. The fall in the infant mortality has been maintained since 1941, when the rate was 51 per 1,000 births, and the average rate since 1934 is 37 per 1,000 births. The highest rate recorded since Orpington became an Urban District was in 1936, when the rate was 64, and the lowest that has been recorded was in 1948, viz., 19. Maternal Mortality. There was one mother who died in childbirth during 1949. 8 SECTION B. SUMMARY OF HEALTH SERVICES. I have again sub-divided the services into Services Rendered by the Council, Services Rendered by the Hospital Boards, and Services Rendered by the County Council under Part III. of the National Health Service Act. In addition, there is a vast amount of voluntary work carried out in Orpington, work which has undisputed beneficial effect upon the health of the District. 1. Health Services Rendered by the Council. Sanitary and Environmental Services. The major services of the Health Department are recorded under Sections C, D, E, F and G, which follow in this report. In the Appendix (Nos. 1, 2, 3, 4 and 5) is a summary of this work of the sanitary inspectors. Inspection of Nursing Homes. The two Nursing Homes in the district came under inspection during the year, and there were no infringements of the Byelaws. The certificate of registration of one of these homes was cancelled towards the end of 1949 at the request of the matron. The remaining home has 10 maternity beds and one other bed. 2. Services Rendered by Hospital Boards. There are two hospitals situated in the District: Farnborough Hospital, with 802 beds, which is within the Bromley Group, and Orpington Hospital, with 933 beds, which is within the Orpington and Sevenoaks Group. 3. Services Rendered by the County Council. Health Visiting. The County Council employ eight Health Visitors and two District Nurses within the district. Their main function is to give domiciliary advice in the care of mother and child, to attend welfare centres and school clinics and school medical inspections. They follow up and advise on immunisation against diphtheria and vaccination against smallpox. Midwifery (Domiciliary). Three full-time midwives, and four others who combine midwifery and Home Nursing, are responsible for this area, 9 Home Nursing Service. In addition to the four nurses mentioned above, there are six Home Nurses plus one part-time nurse. Their services are provided on Medical Practitioners' Certificates, and the service is free. Domestic Help Service. Number of part-time helpers employed 121 Number of cases assisted during 1949 481 Child Welfare Centres. CHELSFIELD Reading Room 1st, 3rd and 5th Tuesday in CUDHAM and BIGGIN HILL Sports Pavilion noon. Thursday—morning and afternoon. DOWNE Gospel Hall 1st and 3rd Wednesday in month—afternoon. FARNBOROUGH Methodist Hall Friday—afternoon. GREEN ST. GREEN Baptist Schoolroom Friday—afternoon. KNOCKHOLT The Institute 2nd and 4th Tuesday in month—afternoon. ORPINGTON Methodist Church Hall Monday and Tuesday —afternoon. CROFTON St. Paul's Church Hall Monday—afternoon. PETTS WOOD Sports Pavilion, Recreation Ground Monday and Thursday —afternoon. ST. MARY CRAY Sports Pavilion, Recreation Ground Tuesday and Wednesday —afternoon. Ante-Natal Clinics. CIJDHAM and BIGGIN HILL Sports Pavilion 2nd and 4th Wednesday in month—morning. GREEN ST. GREEN Baptist Schoolroom Friday, 2nd and 4th Thursday in month— morning. ORPINGTON Methodist Church Hall Tuesday and Friday— morning. PETTS WOOD Pavilion, Recreation Ground Tuesday afternoon. Wednesday morning. ST. MARY CRAY Sports Pavilion, Recreation Ground Friday — morning and afternoon. Women's Welfare Clinics. CUDHAM and BIGGIN HILL Sports Pavilion 3rd and 5th Wednesday in month—morning. ORPINGTON Methodist Church Hall 2nd and 4th Thursday in month—morning. ST. MARY CRAY Sports Pavilion, Recreation Ground 3rd Tuesday in month— afternoon. 10 Minor Ailment Clinics (Schools). The School House, Chislehurst Road, Orpington—Saturday morning. Dental Clinics. The School House, Chislehurst Road, Orpington—Monday to Friday (all day), Saturday morning. Dental clinics are also held in the country areas—Farnborough, Cudham, Westerham, Biggin Hill, Downe, Green Street Green, Knockholt, etc. Immunisation and Vaccination. This is carried out at the Child Welfare Centres as listed above, and in addition, by special appointment, at Chislehurst Road School, Orpington, on Tuesday afternoons. Ambulance Service. There is an ambulance depot at Farnborough Hospital, where there are eight ambulances and three sitting-case cars. Laboratory Service. Farnborough Hospital, with whom there is close co-operation in matters of urgency, provides a full laboratory service. Routine medical specimens are done by Maidstone Laboratory, and also samples of milk and foods. Day Nurseries. There is a Day Nursery at Scad's Hill House, Orpington, with accommodation for approximately 75 children under five years of age. Specialist Clinics. Ear, Nose and Throat : Farnborough Hospital. Ophthalmic : School House, Chislehurst Road. Orthopaedic : Orpington Hospital. Speech Defects : School House, Chislehurst Road. Medical Loan Depot. Arrangements have been made with the British Red Cross Society for the continuation of the Medical Loan Depots. A full range of nursing requisites is available at these depots, which are additional to the loan cupboards kept by Home Nurses. Applications for loans of such equipment for Orpington inhabitants should be made to Mrs. M. M. Jones, 39, Willett Way, Petts Wood (ORP 2083), or to Mrs. M. Brown, of 31, Willett Way, Petts Wood (ORP 1847). 11 SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES I am indebted to the Director of Water Examination, Metropolitan Water Board, for the following statement and for the details of analysis of water supplies, which are set out in Appendix 6 : " The supply to the district of Orpington is derived from seven wells, namely, Orpington, North Orpington, Jewels Wood, Sundridge, Eynsford, Shortlands and Bexley. " Bacteriological analyses of these wells are made five times a week, and consistently satisfactory results have been obtained. Chemical analyses of well supplies are also made at regular intervals. " All supplies are treated with chlorine on the works, but any excess remaining after a period of contact is removed completely or reduced to an amount that will not be perceptible to the consumer. " All new and repaired mains are disinfected with chlorine before being restored to supply, and samples of water from them are analysed to establish that the water in them is up to the normal standard of water in the distribution system. " None of the supplies is plumbo-solvent." There are certain residential areas within the district that are without main piped water supply, no less than 213 houses being dependent upon underground tank or well supply. During the year 58 houses previously devoid of main supply were connected to water mains, and the Metropolitan Water Board laid considerable lengths of service mains, the chief of which were to the new L.C.C. Housing Estate at St. Paul's Cray, Orpington Garden Estate and Windsor Drive Estate. In April, 1949, the Council adopted conditions for financial assistance from the Council towards the cost of connecting houses to main water supply—the amount of the loan not exceeding £10 per house. The presence of a large number of cesspools in the area is a potential danger to water contamination where water is drawn from wells in the chalk strata. Drainage. Main drainage is under the control of the West Kent Main Sewerage Board. There were no extensions of the mains during the year. i2 Cesspools. At the year's end there were 2,539 houses drained to 2,123 cesspools; 215 houses had pail closets. This continues to be the most serious Public Health problem in the district, and until the whole area is properly sewered, which is an expensive matter involving large capital expenditure, and all houses with cesspools connected to main drainage, the sanitary state for the district cannot be considered at all satisfactory. During the year only 51 cesspools were connected, and at this rate of progress it will take years to abolish cesspools, even where there are existing sewers available. In spite of the magnitude of this problem, 23 new houses were erected with cesspool drainage. During October the Council approved the undertaking of a survey of cesspools, and this work is now proceeding. At the time of writing it has been found that in the case of no less than 60 per cent, of cesspools inspected, no attempt had been made to have them emptied. There is, thus, presumptive evidence that the cesspools are leaking into the subsoil. Those that are emptied under the assisted scheme are so infrequently dealt with that percolation must be suspected. The following is an analysis of the cesspools in the area Cesspools abolished and connections made to sewer 51 Number of cesspools at end of year 2,123 Number of cesspools where sewer is available 532 Number where sewer is not at present available 1,591 Of these, 2,123 Cesspools on line of projected new sewers 357 Cesspools in unsewered private streets 480 Rivers and Streams. Supervision has been kept over the two streams, Cray and Kidbrook. No complaints were received which required Committee action. The supervision of these streams now rests with the Kent River Board. Swimming Baths. The public are admitted to one swimming bath in the district, and samples taken from time to time were satisfactory. Factories and Workshops. There are 168 factories, mainly situated in the Cray Valley. The one notice issued by the Local Authority was complied with. Noxious fumes are issued from one factory in the Cray Valley which comes under the classification of alkali works and which was subject to close investigation, with some little improvement, although not remedied. 13 Outworkers. No list of outworkers was received during the year. The link between the Factory Inspector of the Home Office and the Health Department must be a close one. There is another aspect where the Local Health Department could be of value to the welfare of the employee, and there is the relation between the home circumstances of the employee and the factory management. Much of the illness and the periodic loss of employment of the worker is related to the home environment. Smoke Abatement. It seems desirable to point out the importance of what is bound to be considered a somewhat dull and uninteresting subject. A smoke-laden atmosphere reduces the amount of sunlight and increases the tendency to fog, which is, in itself, almost certainly conducive to a big increase in the seasonal incidence of all catarrhal conditions of the naso-pharyngeal and bronchial mucous membranes. Nor must one overlook the bad psychological effect produced by chimneys belching forth smoke and grit and the damage inflicted on buildings thereby. In view of all this, the deposit gauge at St. Mary Cray fulfils a useful function in informing us of any drastic alterations in the amount of smoke produced monthly. But it is only by comparing the figures for the corresponding months of successive years that we can deduce any concrete facts, and observations over a number of years will be necessary before we can reach any useful conclusions. 272 observations were made by the Sanitary Inspectors during the year. Shops Acts. An increase in the work of the Inspectors under the Shops Acts occurred during the year and a complete survey began at the year's end. A summary of the work in 1949 shows : Inspections 169 Absence of Statutory Forms 19 Inadequate Working Accommodation 5 The necessary statutory notices were issued to comply with the Acts. Cleansing of Persons. The cleansing unit was closed wThen the Health Department transferred from Downe House. The 17 cases of verminous premises were corrected by the Sanitary Inspectors. 14 Sanitary Inspection of the Area. The whole district comes under surveillance by the Sanitary Inspectors, either by routine visiting or in the following up of complaints. A detailed summary of the work in the area during the year is shown in the Appendix, from which I have extracted the following figures : HOUSING. Number of Inspections 3,617 Number of Premises in which defects were found 918* INFECTIOUS DISEASES. Number of Inspections 384 FOOD PREMISES. Number of Inspections 2,198 Number of Premises in which defects were found 101 FACTORIES AND WORKSHOPS. Number of Inspections 127 Number of Factories in which defects were found 13 SAMPLING. Total number of samples taken—407, as follows: Food and Drugs Act 243 Designated Milks 52 Mixed Milk 1 Ice Cream 57 Water 54 TRADE PREMISES Number of Inspections 411 Number of Premises in which defects were found 57 * This includes a figure of 370 for leaking cesspools, as shown in Appendix I. Rodent Control. The year's figures show a steady increase in the number of occupiers who have availed themselves of the rodent control service provided bv the Local Authority. The following statistics are of work carried out following complaints and by routine investigation : No. of Infested Premises Inspections Found Cleared Refuse Tips 32 4 4 Other Council Premises 338 24 24 Trade Premises 301 33 33 Private Premises 5,141 137 137 Refuse Collection and Disposal. House refuse is collected weekly in the district, with the exception of the rural part of the area, which receives a fortnightly service. 15 Trade refuse is not collected by the Council, but shopkeepers are allowed to deposit their trade refuse (mainly food tins) at the Council's tip on payment of a small fee. Refuse is disposed of by controlled tipping, average distance of haulage being four miles. Four teams of collectors now operate in the northern area, each with two vehicles, and the relay system is worked. One vehicle is hired for the collection of refuse in the rural areas. One vehicle is used for the collection of kitchen waste, a limited number of bins being distributed throughout the district to allow for their being emptied three times each week. During the year three side-loading refuse collecting vehicles of seven cubic yard capacity were purchased, and this made it possible to operate another collecting team in the district, and also to undertake the collection of the waste from the two large hospitals in the area, this work having previously been carried out by a contractor. The cost of the collection and disposal of the refuse was equivalent to a rate poundage of 7.27d. The average cost of collection and disposal for each dwelling house per annum being approximately 18s. 4d. During the year it became difficult to sell waste paper, and a large stock of mixed paper bales accumulated at the salvage depot. The price paid for waste paper dropped considerably, and the Council had to give consideration to the whole question of salvage collection. After full consideration of all the facts the Council decided to discontinue the collection of all salvage other than kitchen waste as from October 15th. This decision was reached as it was not possible to continue the collection on an economical basis and there were no assured outlets for the salvage collected. 977 tons 11 cwts. 11 lbs. of all salvage were sold for £4,431. Included in the above total was 558 tons 16 cwts. 3 quarters of kitchen waste sold for £1,677. 16 SECTION D. HOUSING The Orpington Local Authority is well up in the list of Authorities who have been successful in the provision of new houses. To cope with the yearly increase of population alone, and not taking into consideration the alleviation of overcrowding nor the replacement of aged and sub-standard houses, requires over 300 new houses each year. In certain populated areas in the district there are many houses over 150 years old, crowded into small spaces, and not up to the standard of modern ideas which make for a good home. It is the duty of the Health Department to see that houses are kept in a reasonable state of repair and of enforcing by statutory action the abatement of nuisances in the houses. It has not been practicable to abate overcrowding in houses while the general housing shortage over the country exists. That the department officers have not been inactive is indicated by the following lollowing table extracted rrom ngures appearing m the Appendix : Premises inspected 422 Number of visits 2,289 Premises with defects 402 Rendered fit by informal action 361 Rendered fit by formal action 15 Re-Housing. I am indebted to the Housing Manager for the following details of re-housing so effectively carried out by the Local Authority : Prior to 1949 During 1949 Total as at Dec. 1949 1. (a) No. of permanent dwellings built by the L.A. (excluding 402 old-type pre-1939 Council houses) 555 326 881 (b) No. of prefabricated dwellings built by L.A 319 319 (c) No. of dwellings held under requisition by the L.A 275 — 252 II. (a) No. of families occupying I. (a) — — 881* (b) „ „ „ I. (b) — — 319 (c) „ „ „ I. (c) — — 367 III. Total No. of families rehoused during 1949 — — 326 * Plus lodgers. 17 During 1949, in addition to the above, 63 houses were built by private enterprise and 16 war damaged houses rebuilt. At some future date, when the present housing shortage is no longer a problem, action will be required for the replacement of sub-standard and outworn houses and for the clearance and rebuilding of certain crowded areas within the district. Some of these areas had already been scheduled before 1939, and it is hoped that in the near future consideration will be given to this matter. 18 SECTION E. INSPECTION AND SUPERVISION OF FOOD The need for a higher standard in cleanliness of food production and food handling becomes more evident as the years pass—we lag behind many other countries. The Department is active in this branch of their duties, and we can safely say, owing to the happy relations we have with the proprietors and traders, that progress has been made in 1949. In the following section an endeavour is made to record the work of the past year. Food and Drugs Act, 1938. Two hundred and forty-three samples of food were taken for analysis under the above Act, 32 samples being formal. In the Appendix 5 will be found a tabulation. Nine samples (one formal) were found to be adulterated, and the following gives a brief description of the action taken. Sample Cakes (Informal) Tincture of Iodine (2) (Informal). Tin of Orange Juice (on request from Hospital Store). Veal and Ham Paste (Informal). Loaf of Bread (on complaint from consumer). Meat Paste (Informal) Analysts Report Contained 1.2% Mineral Oil Complied with old British Pharmacopoeia, but not the new. Lacquer stripped from inside of tin. Adulterated with If grs. of tin per lb. Meat content 47%. Prescribed standard, 55%, with a tolerance of 5%. Small blackened area, consisting of dough with hair and jute fibres. Meat content, 50%. Prescribed standard, 55%, with a tolerance of 5%. Action taken Vendors agreed to discontinue practice of greasing tins with Mineral Oil. Attention of vendors drawn to new formula. Remainder of stock condemned. Result alleged to be due to the use of a considerable proportion of very young veal (Bobby Veal) with a low protein value. Analyst advised warning only, and this was given. Full investigation made at the bakery as to the cause, and a satisfactory explanation was given and accepted. Enquiries made, from which it appeared that the inferior quality of the sample was due to the imperfect mixing of the paste when in bulk. Warning given, 19 Sausages (Informal). New Milk (Formal). Fat had high rancidity, 13.8% oleic acid. 2.75% fat and 8.3% non -fatty solids, against a prescribed standard of 3% and 8.5%. Full investigation made. Deterioration alleged to be due to the use of Dutch Lamb that had been "held up" during the "go slow " strike in the meat market. Strict warning given to submit meat of suspicious quality for examination. Border - line case. A follow - up sample proved to be satisfactory. Inspection of Food Premises. During the year these premises were subject to routine inspection, and a total of 2,198 visits was made, as shown in Appendix 1. MEAT INSPECTION. Slaughterhouses. There are 10 licensed slaughterhouses in the district, to which the Meat Inspectors made 83 visits. The following is a summary of the carcases inspected. Under Food Control regulations the slaughtering of animals other than pigs is carried out centrally. Carcases Inspected and Condemned. Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed (if known) — — — 3 139 Number inspected — — — 3 77 All diseases except T.B.— Whole carcases condemned — — — — 1 Carcases of which some part or organ was condemned — — 1 Percentage of the number inspected affected with disease other than T.B — — — — 2.6% Tuberculosis only— Whole carcases condemned — — — — — Carcases of which some part or organ was condemned _ 3 Percentage of the number inspected affected with tuberculosis — — — — 3.9% Butchers' Shops. There are 40 retail butchers' shops, and in no case was there unsound meat exposed for sale ; 278 inspections were made. 20 Bakehouses. Twenty-one premises came under inspection on 87 occasions. The standard generally is good, although 12 of the premises required notices for cleansing and repairs. Dairies and Cowsheds, Etc. With the coming into force of the new Milk and Dairies Regulations on October 1st, 1949, the execution and enforcement of the regulations on dairy farms (except where they relate to diseases communicable to man) became the responsibility of the Ministry of Agriculture and Fisheries, while the Local Authorities retained responsibility, generally speaking, for the retail distribution of milk, the registration of dairies which are not situated on the farms of production, the registration of milk distributors, and for those provisions relating to diseases communicable to man. There are some 24 farms, producing milk, and 33 dairies ; 231 visits were made, and 53 samples of milk taken for analysis. The following figures show results of Methylene Blue Test for cleanliness : Sample No. Passed Number Failed T.T 43 38 5 Accredited 9 6 3 Mixed Milk 1 1 — The samples not complying with the test were followed up, and, as a result of action taken, were remedied. Ice Cream. Sixty-seven premises are registered for the sale of ice cream, and six are registered for the manufacture of Ice Cream. Once again attention has been paid to the purity of Ice Cream during the year. The possibility of presenting a legal standard of composition for ice cream is still in abeyance. Ice cream manufacturers who have availed themselves of additional supplies of sugar and, in certain cases, fats, through Ministry channels have been required to sign an undertaking that their ice cream will have a minimum fat content of 2½ per cent. Ten samples were taken, nine containing more than per cent. fat. The remaining sample was ½ per cent, under the standard suggested by the Ministry of Food, and the manufacturer was advised on the mixing of ingredients so as to satisfy this standard. The average fat content of the ten samples was approximately 6 per cent. 21 Of the 47 other samples taken during the year the grading was as follows: Grade I 22 Grade III 9 Grade II 13 Grade IV 3 Investigations were made and advice given in the cases of samples graded as III. and IV., and further samples were taken which showed a distinct improvement. In no case was pathogenic organisms cultivated. Restaurants, Hotels, Canteens, Etc. Fifty-three Restaurants, Canteens and Cafes came under detailed survey during the year, 262 visits being made by the Inspectors. The result of this survey was not only of value to the Department, but will, with the continued help and co-operation of the proprietors, bring hygienic improvements to the trade. The problem is not easy to solve, for many of the premises are too small for the trade that has been developed. The cramped spaces of the kitchens leads to depressing working conditions, the atmosphere becomes humid unless adequately ventilated, and in many cases it does not permit of good siting of equipment nor permit of necessary equipment being provided—for example, dish washing, if it is to be effective, requires three sinks and an adequate supply of water at high temperature; 36 of the 53 food premises inspected had only one sink, and in 21 of these premises there was no space for another. In 24 of the restaurants there was no provision for refrigeration, refrigerators being in short supply. In two of these premises food is prepared overnight. As so much of the prevention of food contamination is dependent upon cleanliness of personnel, it was distressing to note that in 21 canteens there was no separate hot water hand washing basins for the staff. These are all factors which require correction, but I do not wish to leave any impression whatever that it is unsafe to partake of food in any of these restaurants, cafes, etc. The proprietors and staff, in spite of working under difficulties, some beyond their control, are taking, through good management, all reasonable action to provide with safety what the public require. The difficulties of the proprietors are aggravated by the public themselves, many of whom have no consideration for the care and attention given by the proprietors to the clean handling of food and to the cleanliness of their premises. Petty thieving is not uncommon—the casual employee is seldom hygienically minded. The field of work to improve food hygiene is a wide 22 one, and our efforts must begin in the homes and in the schools, and not be limited to the Restaurants, Cafes, Canteens and such establishments. Unsound Food. During 1949, 739 condemnation certificates were issued, affecting in quantity 4 tons 8 cwts. of varied articles of food. No prosecutions were necessary, and the condemned food was utilised either for animal food or, where this was impracticable, destroyed. The co-operation of the traders was in all cases complete. 186 tins Fish. 319 „ Meat. 1 „ Pork Brawn. 656 „ Milk. 748 „ Vegetables. 138 „ Soup. 287 „ Fruit. 213 „ Preserves. 6 „ Tomato Ketchup. 6 „ Christmas Puddings. 4 „ Coffee. 16 „ Tomato. 1 „ Crawfish. 14 „ Peas. 10 „ Beans. 1 „ Paste. 2 „ Spaghetti. 2 „ Syrup. 1 „ Ovaltine. 2 „ Meat and Vegetable. 3 „ Fruit Juice. 192 „ Orange Juice. 1 „ Vegetable Stew. 52 „ Sausages. 10 lbs. Soya Flour. 1 cwt. 5 lbs. Cake. 21 cwt. 96 lbs. Pigs' Feet. 9 cwt. 96 lbs. Barley Flakes. 11 cwt. 105 lbs. Fish. 8 cwt. 84 lbs. Meat. 20 lbs. Preserves. 6 „ Fat. 20 „ Poultry. 56¾ „ Bacon. 10 „ Salami Sausage. 4½ „ Bones. 42 lbs. Chicken (Irish). 2 „ Oats. 6¾ „ Flour. 1 cwt. 22 lbs. Sweet Fat. 1 cwt. Dried Milk. 5 stone Witches. 5 lbs. Rice. 8½ lbs. Luncheon Sausage. 2 cwt. 24 lbs. Cereal. 90 lbs. Rabbit. 4¼ „ Butter. 1¾ „ Margarine. 53 „ Sugar. ½ „ Tea. 10 „ Pickles. 84 „ Apples. 3 „ Semolina. 1 cwt. 74½ lbs. Cheese. 8½ lbs. Cheese Trimmings. 6 ozs. Biscuits. 10 botts. Sauce. 31 botts. Salad Dressing. 2 jars Marmite. 19 jars Pickles. 2 jars Ginger. 2 pkts. Dried Grapes. 1 pkt. Creamola. 4 pkts. Cereal. 44 boxes Cheese. 51 Eggs. 1 Goose. 1 Chicken. 2 Pheasants. 1 Pig. 2 Pigs' Heads. 9 Powders, 23 SECTION F. INFECTIOUS DISEASES. 1,642 notifications of infectious diseases, excluding T.B., were received in 1949, a rate equivalent to 27.7 per 1,000 population. No less than 1,049 of these were due to mild types of measles. The recurrence of poliomyelitis during 1949 was milder in character than in the previous year, although there was one death. Scarlet Fever was mild but prevalent. Diphtheria continues to be in the trough of its wave of incidence. The general picture of infectious diseases is that they have decreased in virulence ; the reason is as yet unknown, but an underlying biological factor is, no doubt, operating. We find the same in the general improvement of death rate and in the physique of children. It may well be that the Local Authorities who have been so active in the work of Public Health over many years are now getting results. Anterior Poliomyelitis. In common with the rest of the country, we had an outbreak of infantile paralysis in the summer and autumn of 1949. On such occasions as this theories as to the spread of the disease are many and varied, but there are none which stand the test of rational argument better than the old-fashioned one—that the complaint is spread by healthy carriers. This would seem to be the only explanation of the fact that more than one case in family is the exception rather than the rule. In this feature it differs entirely from, e.g., measles, which if picked up by one child in a family usually affects all the rest of the household who have not been immunised by a previous attack. In view of our comparative ignorance of the spread of this malady, preventive means are naturally difficult, but I did think it worth while drawing up a short letter, which was handed to all known contacts, advising them of the reasonable precautions open to them. The local doctors were also circularised, and a film showing the most recent advances in the diagnosis and treatment of the disease was shown at Beckenham, and all the local general practitioners were invited to its showing. An interesting point which has arisen recently is the discovery of a new virus disease which has been designated lymphocytic choreo-meningitis. This condition is not fatal, but is similar in its symptomatology to abortive anterior poliomyelitis, and may have accounted for some of the pre-paralytic cases of anterior poliomyelitis which were notified. 24 During the year there were 56 cases of poliomyelitis notified, but these cases were notified in the stage of preliminary illness, and were not confirmed except where cases were admitted to hospital with transient and abortive paralysis and one case died of polio encephalitis. The notification of unconfirmed cases by the general practitioner is, perhaps, a wise procedure during times of epidemic, but it does inflate the returns, give a false picture, and cause some public anxiety. Scarlet Fever. 245 cases were notified, 171 of which were home-nursed and 74 treated in hospital. Scarlet Fever is one of the many manifestations of hæmolytic streptococcus infections which account for the large number of cases notified year by year. At present the type of disease is mild. Diphtheria. Two cases were notified during the year, both being admitted to hospital. No complications developed. The percentage of the 14,250 children under 15 who have been immunised since 1935 is 77. The percentage has always been high since immunisation was undertaken by the Local Authority prior to 1948. While immunisation plays a large part in the prevention of the disease, there are other biological factors, at present unknown, affecting the disease itself. Whooping Cough. 182 cases were notified, giving a rate of 3.1 per 1,000 population. Six cases were admitted to hospital, and all recovered. Measles. 1,049 cases were notified, giving a rate of 17.7 per 1,000 population. It was mild in type, and only ten cases required removal to hospital, and all recovered. Tuberculosis. The Ministry of Health has now decided to try out B.C.G. vaccination on selected groups of volunteers, and we must hope the results will justify the expectations placed in this form of prophylaxis. The group selected are nurses and medical students, and in addition appropriate specialists will be allowed to use the vaccine at their own discretion, such as in suitable cases of home contacts of a case of open tuberculosis. The reason, of course, for choosing such groups as nurses and medical students is that they are particularly exposed to the risk of infection from tuberculosis, and in the majority of cases are of an age which is peculiarly liable to this infection, 25 Continental workers have been using this form of prophylaxis over a number of years, and are enthusiastic about its efficiency; but one must not think that because a person is vaccinated against tuberculosis and does not develop the disease, he or she would necessarily have had it in any case. Sixty primary notifications of tuberculosis were received during the year, 57 of them being of the lungs and three other forms. The total number on the Tuberculosis Register at the year's end, so far as local records are concerned, was 583, which is equivalent to 9.8 per 1,000 population. The following tabulation gives an indication of the tuberculous state of the population: Pulmonary Non-Pulmonary Total Cases M F M F (a) No. of cases of Tuberculosis on the register at the commencement of year 230 159 60 62 511 (b) No. of cases notified under the Public Health (Tuberculosis) Regulations for the first time during the year 24 33 3 60 (c) No. of cases restored to the register during the year — 1 — — 1 (d) Other additions to the register during the year 17 14 2 — 33 (e) No. of cases removed from the register during the year 10 10 2 — 22 (f) No. of cases remaining on the register at the end of the year 261 197 63 62 583 Public Health (Prevention of Tuberculosis) Regulations, 1925. Public Health Act, Section 172. No action was taken in 1949 under this Act, which provides for the compulsory removal of cases to hospital. Food Poisoning. During the year ten cases of food poisoning were notified— all separate instances, and none affecting more than one person. In one case there was identification of organism associated with a school outbreak in Bromley, where Cl. Welchii was identified. One case was admitted to hospital, with quick recovery. In eight cases there was doubt as to confirmation that the cause was due to food. 26 If investigation is to be successful, no time must elapse between diagnosis or onset of illness and notification to the Medical Officer of Health; otherwise, one is unable to obtain samples of the suspected food or to relate the organisms discovered. General practitioners were informed of this need, which is of such great importance in severe outbreaks and where there is likelihood of some common supply of food being involved. 27 SECTION G. OTHER SERVICES Diseases of Animals Acts. This is a service carried out by the County Council. Registries for Female Domestic Servants. There is one person so registered, and there was only one minor contravention. Regulation of the Use of Movable Dwellings. There has been an increasing use of caravans in the district, partly due to the shortage of houses and partly due to the attractive nature of the countryside in the southern part of the district. Licences have been issued under Town Planning for some four caravan sites with a total accommodation for 100 caravans and tents, and four caravans on isolated plots of land. Each caravan is subject to the approval and licence of the Health Committee under the Public Health Acts. In addition there is an unspecified number of caravans and movable dwellings which are exempt from licences under Section 269 of the Public Health Act, 1936. 28 APPENDICES. 1. SANITARY INSPECTORS' INSPECTION OF DISTRICT- VISITS AND DEFECTS. 2. HOUSING INSPECTION—DEFECTS REMEDIED. 3. INFECTIOUS DISEASES—NOTIFICATIONS AND AGE GROUPS. 4. FACTORIES ACTS—OFFICIAL RETURN. 5. FOOD AND DRUGS. 6. WATER SUPPLY ANALYSIS. 29 APPENDIX 1, SHOWING THE NUMBER OF VISITS PAID TO VARIOUS PREMISES AND THE NUMBER OF DEFECTS AND CONTRAVENTIONS FOUND. Housing Inspection. No. of Inspections No. of Premises at which Defects or Contraventions were found For defects and nuisances 2,289 402 Verminous conditions 59 17 Water supply 142 22 Cesspools 706 370 Common Lodging Houses 22 — Drainage 399 107 (3,617) (918) Infectious Diseases. Inquiry Visits 384 — Aircraft Passenger Contacts Inspections 12 — Food Premises. Dairies 145 11 Cowsheds 86 — Bakehouses 87 12 Restaurants, Canteens, etc 262 31 Butchers 278 9 Fishmongers and Poulterers 132 16 Grocers 226 1 Greengrocers and Fruiterers 18 4 Ice Cream 293 9 Slaughterhouses 83 2 Fried Fish Shops 73 2 Hawkers' Carts, Stalls and Street Vendors 190 4 Visits in connection with sampling 229 — Miscellaneous 96 — (2,198) (101) Factories. Factories with Mech. Power 103 8 Factories without Mech. Power 17 5 Other premises classified as Factories 7 — (127) (13) Emission of Smoke and Fumes 272 5 Trade Premises. Shops (for Shops Acts) 169 31 Registry Office 2 1 Piggeries 129 18 Camp Sites 111 7 (411) (57) 30 Miscellaneous. Rodent Control—Trade Premises 301 33 Private Premises 5,141 137 Council Premises 370 28 Swimming Baths—Public 8 2 Private 5 2 Suspected Food Poisoning 15 — Dust Emission 4 1 Keeping of Animals 14 4 Offensive Trades 1 — „ Accumulations 67 5 Schools 23 1 Public Conveniences 33 1 Theatres and Places of Entertainment 7 — Unclassified 349 — 13,359 1,308 Samples Taken. Milk: Bacteria Test (Graded) 52 „ Tuberc. Test 1 „ Phosphatase Test 15 „ Fat Content Test 29 Food and Drugs (ex. Milk) 199 Ice Cream: Fat Content Test 10 Bacteria and Pathological Test 47 Water: Bacteria Test 50 „ Chemical Test 4 407 31 APPENDIX 2. HOUSING INSPECTION: DEFECTS, ETC., CORRECTED DURING 1949. Drainage. Defective drains re-laid 10 F.A.I, provided 1 Manhole covers provided 5 New drains provided 3 Choked drains cleared 40 Cesspools emptied 38 Defective W.C. buildings repaired 7 renewed 3 New covers to cesspools 2 Soil pipes repaired 3 Cesspools repaired 1 Dampness. Roofs repaired 61 New gutters fitted 16 Walls re-rendered 17 New damp courses provided 1 Water Supply. Burst water pipes repaired 6 Water supply reinstated 5 Rainwater tank repaired 2 Domestic boiler provided 2 Domestic boiler repaired 1 General Items. New fire grates fixed 7 Defective fireplaces repaired 10 Floors repaired 18 Ceiling plaster repaired 25 Wall plaster repaired 16 Doors repaired 7 Dustbins provided 13 Gulleys renewed 4 Rainwater soakaways constructed 3 Flushing cisterns repaired 9 Additional sanitary accommodation provided 1 Waste pipes repaired 12 Sinks renewed 1 Rainwater pipes repaired 5 W.C. seats provided 2 W.C. pans renewed 3 Defective chimneys repaired 15 Chimney flashings renewed 7 Walls re-pointed 7 Defective supply pipes repaired 2 New storage tanks fitted 1 Ball valves repaired 5 Main supply provided 14 Houses disinfested 12 Windows repaired 27 Premises cleansed 4 Sash cords renewed 9 Staircase renewed 2 Coppers repaired 2 Defective paving 3 NUISANCES ABATED AND DEFECTS REMEDIED FOLLOWING FORMAL ACTION, 1949. Defective roofs, causing dampness 5 Defective glazing to windows and doors 7 Defective drains 2 Broken rainwater pipes 2 Defective fire grates 2 Defective water fittings 1 Penetrating or rising dampness 3 Overflowing cesspools 1 Defective sanitary fittings 6 Defective plasterwork 8 Defective windows 8 Defective floors 5 Defective doors 2 32 APPENDIX 3. CASES OF INFECTIOUS DISEASE NOTIFIED DURING 1949. At all ages Removed to Hospital Total Deaths Under 1 year 1-2 2-3 3-4 4-5 5-10 10-15 15-25 25-45 45-65 65 and over Scarlet Fever 245 1 2 23 16 28 141 25 7 2 — — 74 — Whooping Cough 182 20 14 33 28 20 56 4 1 5 1 — 6 — Measles 1049 23 70 122 146 114 541 8 9 14 2 — 10 — Puerperal Pyrexia 19 — — — — — — — 6 13 — — 18 — Dysentery 2 — — — — — 1 — — 1 — — 1 — Erysipelas 12 — — — 1 — — — — 3 7 1 1 — Pneumonia 56 1 1 — 4 2 5 3 3 15 11 11 19 — Poliomyelitis 56 — — — 3 — 32 13 1 6 1 — 3 1 Diphtheria 2 — — — — — 1 1 — — — — 2 — Paratyphoid 3 — — — — — 2 — 1 — — — 3 — Cerebro-spinal Fever 3 1 — — 1 — — 1 — — — — 1 1 Food Poisoning 10 — — — — 2 — — 1 4 2 1 1 — Malaria 1 — — — — — — — — 1 — — — — Pemphigus Neonatorum 1 1 — — — — — — — — — — — — Ophthalmia Neonatorum 1 — — — — 1 — — — — — — — — Totals 1642 47 87 178 199 167 779 55 29 64 24 13 139 2 33 APPENDIX 4. FACTORIES ACTS 1937 AND 1948. PART I. OF THE ACT. 1. INSPECTIONS FOR PURPOSES OF PROVISIONS AS TO HEALTH. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 21 17 5 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 137 103 8 — {iii) Other premises in which Section 7 is enforced by the Local Authority *(excluding outworkers' premises) 10 7 — — Total 168 127 13 — * i.e. Electrical Stations (Section 103 (1)), Institutions (Section 104), and sites of Building Operations and works of Engineering Construction (Sections 107 and 108). 34 APPENDIX 4 (contd.) 2. CASES IN WHICH DEFECTS WERE FOUND. (If defects are discovered at the premises on two, three or more separate occasions, they should be reckoned as two, three or more "cases"). Particulars Number of Cases in which defects were found Found Remedied Referred Number of cases in which prosecutions were instituted To H.M. Inspector By H.M. Inspector Want of cleanliness (S. 1) 5 5 — — — Overcrowding (S. 2) — — — — — Unreasonable temperature (S. 3) — — — — — Inadequate ventilation (S. 4) 1 1 — — — Ineffective drainage of floors (S. 6) 1 — — — — Sanitary Conveniences (S. 7)— (a) Insufficient 1 — — 1 — (b) Unsuitable or defective 1 1 — — — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to Outwork) 3 3 — — — Total 12 10 — 1 — 35 APPENDIX 5. FOOD AND DRUGS. Articles Formal Samples Informal Samples Aspirin Tablets — 1 Barley Crystals — 1 Beecham's Powders — 1 Barley Kernels — 1 Boracic Ointment — 1 Boric Acid Powder — 2 Boric Acid Ointment — 1 Baking Powder — 3 Bun Flour — 1 Barley Malt Dates — 1 Bread — 1 Beef Broth — 1 Bacon — 4 Butter — 4 Butter Drops — 1 Children's Cough Mixture — 1 California Syrup of Figs — 1 Cocoa — 3 Cakes — 3 Chocolate Covering Mixture for Choc Ices — 1 Custard Powder — 3 Cake Flour Mixture — 2 Coffee: Coffee and Chicory Extract — 4 Coffee Extract — 1 Pure Coffee — 1 Crunchets — 1 Cake Flour — 2 Chopped Peel — 1 Cupkaff — 1 Cough Mixture — 1 Cordial: Blackcurrant — 1 Orange — 1 Cooking Fat — 4 Cheese — 4 Crab: Dressed Sandwiches — 1 Epsom Salts — 1 Evaporated Milk — 1 Flavouring Essence: Almond — 1 Coco-nut Emul. — 1 Strawberry — 1 Lemon — 2 Vanilla — 1 Frizets — 1 Foam Crystals — 1 Fruit Pectin — 2 Ground Cinnamon — 1 Ground Ginger — 1 Gravy Salt — 1 Gin 1 — Goat's Cheese — 1 36 Articles Formal Samples Informal Samples Gelatine — 1 Glace Fruit — 1 Glace Cherries — 1 Horseradish: Vitacream — 2 Sauce — 3 Relish — 1 Herrings: Canned — 1 Health Salts — 1 Ice Cream — 10 Jam: Victoria Plum — 1 Apricot — 1 Bramble Seedless — 1 Lemon, Glycerine & Honey Mixture — 1 Liver Salts — 1 Magnesia Tablets, Cream of — 1 Macaroni — 1 Magnesia, Milk of — 1 Milk: Pasteurised — 15 New 29 8 Malted Milk Tablets — 1 Mustard — 2 Meat Broth — 1 Marmalade — 1 Margarine — 4 Meat: Galantine — 1 Pork Brawn — 1 Luncheon Meat — 1 Orange Juice — 1 Paste: Anchovette Fish — 1 Fish — 4 Meat — 9 Pickles: Mixed — 1 Zesto — 1 Sweet — 1 Piccalilli — 1 Pastry Mixture — 1 Rennet, Essence of — 1 Raising Powder — 1 Rennies Digestive Tablets — 1 Rum 1 — Soup: Cream of Tomato — 1 Vegetable — 1 Kidney — 1 Powdered Oxtail — 1 Sponge Pudding Mixture — 2 Steamed Pudding Mixture — 3 Semolina — 1 Savora — 1 Sauce: Tomato — 2 Tomato Ketchup — 1 Meat — 2 Salad Cream — 7 Sausages — 1 Sponge Flour Mixture — 2 Sponge Cake Mixture — 2 Spice, Mixed — 1 3? Articles Formal Samples Informal Samples Syrup: Eastons — 1 Famel — 1 Spaghetti — 1 Seidlitz Powder — 1 Tapioca — 1 Teaseed Oil — 1 Tomato Dainty Spread — 2 Tartaric Acid — 1 Tincture of Iodine — 3 Vinegar, Malt — 3 Vermicelli — 1 Whisky 1 — Zinc Ointment — 2 32 211 38 APPENDIX 6. AVERAGE RESULTS OF THE CHEMICAL AND BACTERIOLOGICAL EXAMINATION OF THE WATER SUPPLY TO ORPINGTON URBAN DISTRICT 1949. PARTS PER MILLION (unless otherwise stated). Description of the Sample No. of Samples Ammoniacal Nitrogen Albuminoid Nitrogen Oxidised Nitrogen Chlorides as Cl Oxygen abs. from Permanganate 3 hrs. at 80°F. Turbidity in terms of Silica Colour m m. brown, 2 ft. tube Burgess's Tintometer Hardness (Total) Hardness (Perm) pH Value Conductivity Nitrite Nitrate Orpington Well 4 0.000 0.025 — 7.5 16.1 0.05 — 0 283 83 7.1 450 North Orpington 3 0.007 0.022 — 4.5 15.7 0.17 — 0 281 62 7.1 400 Jewels Wood 2 0.008 0.014 — 2.8 11.5 0.03 — 0 257 49 7.2 375 Sundridge 5 0.039 0.017 — 2.2 16.8 0.15 — 0 226 79 7.3 350 Eynesford 3 0.005 0.025 — 3.7 15.3 0.06 — 0 271 76 7.2 425 Shortlands 5 0.001 0.038 — 4.7 22.3 0.40 — 5 261 95 7.3 450 Bexley 2 0.000 0.023 — 4.8 16.3 0.04 — 3 285 91 7.1 450 BACTERIOLOGICAL RESULTS. No. of samples Percentage of samples negative to Bact. coli in 100 ml. Bact. coli Test Bact. coli per 100 ml. Orpington 254 100.0 Nil North Orpington 237 100.0 Nil Jewels Wood 115 100.0 Nil Sundridge 254 100.0 Nil Eynesford 367 100.0 Nil Shortlands 255 99.2 0.016 Bexley 234 100.0 Nil