AC 4412 (3) ORP 23 ORPINGTON URBAN DISTRICT COUNCIL MEDICAL OFFICER OF HEALTH'S Annual Report on the HEALTH OF THE URBAN DISTRICT 1959 H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health Telephone : RAVensbourne 4623 Offices : COUNCIL OFFICES, ORPINGTON, KENT. Telephone: Orpington 27661. ORPINGTON URBAN DISTRICT COUNCIL MEDICAL OFFICER OF HEALTH'S Annual Report on the HEALTH OF THE URBAN DISTRICT 1959 H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health Telephone : RAVensbourne 4623 Offices : COUNCIL OFFICES, ORPINGTON, KENT. Telephone: Orpington 27661. 3 CONTENTS Page Members of the Urban District Council 5 Staff 5 Prefatory Letter 6 Section A. Vital and Other Statistics and Social Conditions of the Area. General Statistics 10 Vital Statistics 10 Population 11 Births 11 Deaths 12 Morbidity Statistics 13 Medical Examinations 13 Unemployment 13 Open Air Recreational Amenities 14 Section B. General Provision of Health Services for the Area. Ambulance Service 18 British Red Cross Society—Medical Loan Depot 20 Day Nurseries 18 Diseases of Animals Acts 18 Disinfection 16 District Nursing Service 19 Domestic Help Service 18 Domiciliary Midwifery 18 Health Visiting 19 Hospitals 17 Laboratory Service 17 Local Clinic Services 21 National Assistance Act, 1948 17 Nursing Homes 17 Old People's Welfare Committee 20 Public Mortuary 17 Women's Voluntary Services 19 Section C. Sanitary and Environmental Circumstances of the Area Agriculture (Safety, Health and Welfare Provisions) Act, 1956 24 Atmospheric Pollution—Clean Air Act, 1956 24 Cesspools 24 Complaints 25 Diseases of Animals (Waste Foods) Order, 1957 25 Drainage and Sewerage 26 Factories Acts, 1937 and 1948 26 Heating Appliances (Fireguards) Act, 1952 27 Pet Animals Act, 1951 27 Prevention of Damage by Pests Act, 1949 28 Rag Flock and Other Filling Materials Act, 1951 28 Rivers, Streams and Lakes 28 Sanitary Inspection of the Area 28 Shops Act, 1950 28 Swimming Baths and Pools 29 Verminous Conditions and Uncleanliness 29 Water Supply 30 4 Page Section D. Housing. Clearance Areas 36 Rent Act, 1957 36 Housing Statistics 36 Moveable Dwellings 37 Re-Housing 37 Section E. Inspection and Supervision of Foods. Bakehouses 48 Butchers' Shops 48 Food Complaints 45 Food Hygiene Regulations, 1955 45 Food Premises 46 Food and Drugs Act, 1955—Food Sampling 40 Food and Drugs Act, 1955—Section 16 47 Game Act, 1831 48 General 40 Ice Cream 46 Merchandise Marks Act 48 Milk and Dairies Regulations 48 Restaurants, Hotels and Canteens 48 Slaughterhouses and Slaughtermen 48 Special Samples—Milk, Ice Cream, Water and Egg Products 45 Unsound Food 47 Section F. Prevalence of, and Control Over Infectious and Other Diseases. Acute Anterior Poliomyelitis 50 Poliomyelitis Vaccination 50 Diphtheria and Diphtheria Immunisation 51 Dysentery 51 Food Poisoning 51 General Remarks 50 Measles 52 Meningococcal Infections 52 Other Infectious Diseases 55 Pneumonia 52 Scarlet Fever 52 Smallpox and Vaccination 52 Tuberculosis, Chest Clinic and Mass X-ray 53 Whooping Cough & Whooping Cough Immunisation 54 Section G. Refuse Collection and Disposal. Refuse Collection and Disposal 58 APPENDIX—STATISTICAL TABLES. I. Summary of Statistics 63 II. Causes of Death 64 III. Infant Mortality 65 IV. Notifiable Infectious Diseases—Sex and Age Distribution V. Notifiable Infectious Diseases— 66 Ward Distribution. Attack and Mortality Rates 67 VI. Notifiable Infectious Diseases—Seasonal Incidence 68 VII. Summary of the work of the Public Health Inspectors 69 VIII. Nuisances, Defects and Contraventions abated 71 5 MEMBERS OF THE URBAN DISTRICT COUNCIL (as at 31st December, 1959) * Chairman of the Council : Councillor Mrs. F. G. GARDNER * Vice-Chairman of the Council : Councillor J. W. HARRADINE Councillors R. W. AYLIFFE, F.R.I.C.S. *Mrs. C. M. MEDLYCOTT W. W. BALDING R. L. MUMFORD *Mrs. J. G. BANKS (Vice-Chairman J. F. NUNN of Public Health Committee) C. H. E. PRATT *G. E. BLABER, A.M.I.C.W. C. R. RAYNER H. T. COX Mrs. P. L. ROBERTSON J. DA VIES, C.C. G. G. ROMAIN A. L. FERRIS C. S. SAFFERY E. A. P. HART, J.P. *D. A. SCOLLICK, A.F.I.C.D. W. D. HAYNE, T.D. *G. A. SMITH (Chairman L. F. HENDY, M.B.E. of Public Health Committee) F. S. HOCKEY *Mrs. S. M. STEAD *A. B. HOWARD M. J. A. STEVENS *W. D. KNIGHT Mrs. J. V. WEBB *F. W. LANE *S. W. WELLS *E. H. LUCAS *B. D. WOODMANSEE (* denotes members of the Public Health Committee.) STAFF OF THE PUBLIC HEALTH DEPARTMENT (as at 31st December, 1959) Medical Officer of Health H. B. C. CARTER-LOCKE, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H., (Also Medical Officer of Health for the Borough of Bromley, and Chislehurst and Sidcup Urban District.) Deputy Medical Officer of Health A. J. I. KELYNACK, M.B., B.S., D.P.H. (Also Deputy Medical Officer of Health for the Borough of Bromley, and Chislehurst and Sidcup Urban District.) Chief Public Health Inspector and Cleansing Superintendent F. C. CROWE, M.R.S.H., M.A.P.H.I. Council Offices, Orpington, Kent. Telephone: Orpington 27661. Deputy Chief Public Health Inspector and Deputy Cleansing Superintendent W. T. WEEDY, C.R.S.H., M.A.P.H.I. District Public Health Inspectors K. J. COPPIN, C.R.S.H., M.A.P.H.I. T. E. W. OSBORNE, C.R.S.H., R.I.P.H. A. E. ROBINSON, C.R.S.H., M.A.P.H.I. Note.—All Public Health Inspectors are Inspectors under the Food and Drugs Acts, Shops Act, Rag Flock and Other Filling Materials Act, Pet Animals Act, Heating Appliances (Fireguards) Act, and the Agriculture (Safety, Health and Welfare Provisions) Act, 1956. Pupil Public Health Inspector DAVID P. SEAL Clerical Staff Secretary : Miss C. COOPER. Shorthand Typist: Mrs. G. BOONE. Clerk : Mrs. S. KNIGHT. Outdoor Staff Disinfector : J. MURRAY. Rodent Operative : W. S. MILLS. Assistant Rodent Operative : C. V. POTTER. General Foreman (Refuse) : F. HONESS. 6 To the Chairman and Members of the Orpington Urban District Council. Madam Chairman, Ladies and Gentlemen, Whilst an annual report usually gives a pretty fair account of some of the more important things that are happening in the field of Public Health, no figures are forthcoming to indicate the sheer misery which can be produced by as simple a complaint as the common cold. Whether indeed it justifies the use of the expression "simple complaint" is very doubtful, for when one begins to consider the possible complications, the illness might appear to be quite an alarming one. Fortunately, most colds are uncomplicated, but that does not mean that they are any the less unpleasant and it is therefore encouraging to know that some progress is being made towards finding the means for prevention of this scourge. It may yet be some time before the problem is completely unravelled but it is at least encouraging to know that in the not too distant future it may be possible to take some really effective measures against this illness. From colds, one's mind turns very easily to influenza and its preventive treatment. Here we are faced with a problem in that the type of virus causing the disease varies from time to time and unless sufficient warning of the likelihood of an outbreak of influenza can be obtained it is not possible to prepare and use the appropriate vaccine. Now that waves of influenza are tracked as they cross from one end of the world to the other, it may be possible to produce the necessary vaccine to delay and hinder it on its journey, but it is virtually impossible to immunise everyone in its path. Valuable results might however be obtained by immunising key members of the population, thus producing less disruption in a country's essential services. Another virus disease to which reference should be made is anterior poliomyelitis, of which four cases were notified in 1959. This is a disease which we hope will be mastered entirely in the years to come and if it should be that a safe and effective oral vaccine is produced, many of the difficulties associated with the need for injections would disappear overnight. In the meantime, we have to be satisfied with the injection form of preventive treatment and even at this comparatively early stage of its career, there seems little doubt that it is having the desired effect. This being so, it is surely up to everyone who is eligible for vaccination to take advantage of that right, and these remarks are directed especially to those in the 26—40 age group who have been very slow in coming forward for treatment. As most of the younger members of the community become immune, so the disease will be forced to attack the older age groups who up to now have made little 7 effort to have themselves protected against a disease which formerly was considered one occurring primarily in childhood, hence the now somewhat inappropriate name of "infantile paralysis," and possibly also part of the reason for the lack of enthusiasm on the part of the younger adults to take advantage of the scheme for vaccination. Another field in which advice has frequently been given and apparently as often rejected, is in the association so weightily confirmed statistically, between smoking and lung cancer. One is forcibly reminded of this by the fact that deaths from this disease rose by a further ten compared with 1958, and at 48 in number are by far the highest recorded since statistics were kept. Deaths from cancer in general rose slightly, but most of the increase was due to the above mentioned lung cancer. It is, of course, inevitable that the number of deaths from a disease of this type should increase as the population increases and tends to grow older, but the increase in the lung cancer death rate is out of all proportion after allowance has been made for these factors. I feel that further comment at this stage on this subject is superfluous. However, with regard to cancer in general, I do feel that it is not a sufficiently known fact that it is a disease which treated in its early stages is usually cured completely. Unfortunately, the cases that one hears most about are the unsuccessful ones hence the terrifying reputation of the complaint, but if the warning " if in doubt, seek advice," is heeded early enough there is little doubt that the cancer death rate would be very greatly reduced. One of the biggest problems affecting this country, including the area of this local authority, is bound up in the care of the elderly. The services rendered by both statutory and voluntary bodies are fairly comprehensive, but there is the not infrequent problem of dealing with the senior member of society who, having been brought up with a spirit of independence, considers that to seek, or indeed be offered, any form of assistance is a mortal blow to his or her own pride. While this is an admirable trait, yet carried to the extremes that it sometimes is, it can be a great embarrassment to those attempting to help and of course in some cases means that the old person will eventually have to enter an institution—an ultimate result satisfactory to no one. While there is such a shortage of accommodation for old people, both in hospitals and old people's homes, it is most undesirable that any unnecessary cases should have to be admitted, and indeed, unless more and more community care becomes available for the old folk, institutional accommodation will never even keep up with this problem caused by an ageing population. Although it is not a problem which affects the Public Health Committee specifically, it is certainly one affecting the health of 8 the public and one in which we are each and all intimately concerned. I refer to the slaughter which is taking place upon our roads to-day. Twelve persons met their deaths in this way in Orpington during the past year, the highest number during the last five years, and it is surely up to everyone of us to make just that little bit of extra effort in the way of carefulness, which may make all the difference between life and death. Not only of course have we the fatal accidents, but in addition there are a large number of other mishaps, both major and minor, all adding unnecessarily to the invalidism in our midst. One of the outstanding events of the year from the point of view of the Public Health Committee, occurred on the day on which the local authority representatives appeared before, and gave evidence to, the Royal Commission on Local Government in Greater London. Long before the next annual report is published it is expected that the Royal Commission will have made their recommendations and on these may well depend the future activities of the Public Health Committee. Should the outcome of these recommendations be that the Committee are given additional tasks and responsibilities, I am sure they will be accepted with alacrity. It is now time for the ever pleasant task of expressing thanks to a whole host of colleagues who have helped me to fulfil my tasks during the past year. As always, I am deeply grateful to the doctors in both the Hospital and General Practitioner services who have been so co-operative, and to my own deputy, Dr. Kelynack, who is always so cheerful and efficient my special thanks are due. Next, I should like to thank Mr. Crowe for his devotion to duty and to congratulate him on the way he administers the Cleansing services with a minimum of complaints. To Mr. Weedy and the other Public Health Inspectors I am also very grateful for their loyalty and keenness and similar remarks could be made with reference to the clerical staff. Finally, the Chairman and Members of the Public Health Committee have been most helpful and enthusiastic and I am very thankful to them for their attitude which has I think made our meetings a happy occasion for all concerned. I am, Your obedient Servant, H. B. C. CARTER-LOCKE, Medical Officer of Health SECTION A VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA 10 SECTION A VITAL AND OTHER STATISTICS AND SOCIAL CONDITIONS OF THE AREA GENERAL STATISTICS Area of the Urban District (in acres) 20,842 Area of Parks, Open Spaces, etc. (in acres) 283.6 Registrar-General's estimate of total population (mid year 1959) 74,620 Rateable value at 31st December, 1959 £1,246,783 Estimated net product of a penny rate ,1959/1960 £5,050 Total number of valuation assessments at 31st December, 1959 23,797 Mileage of Roads as at 31st December, 1959. County Roads (Class I, II and III) 41.35 miles District Roads 105.89 miles Unadopted roads 31.5 miles Total 178.74 miles VITAL STATISTICS Live Births. Males Females Total Legitimate 699 641 1,340 Illegitimate 19 29 48 718 670 1,388 Crude birth rate per 1,000 estimated total population 18.6 Adjusted birth rate for comparison with other areas (The area comparability factor for births is 0.98) 18.2 Illegitimate live births per cent. of total live births 3.5 Birth rate for England and Wales 16.5 Stillbirths. Males Females Total Legitimate 11 9 20 Illegitimate — 1 1 11 10 21 Stillbirth rate per 1,000 total live and still births 14.9 Stillbirth rate per 1,000 estimated total population 0.28 Total Births (live and still). Males Females Total Legitimate 710 650 1,360 Illegitimate 19 30 49 729 680 1,409 11 Infant Mortality. Males Females Total Legitimate 9 9 18 Illegitimate — 2 2 9 11 20 Infant Mortality rate per 1,000 live births 14.4 Legitimate infants per 1,000 legitimate live births 13.4 Illegitimate infants per 1,000 illegitimate live births 41.7 Neonatal mortality rate (deaths under 4 weeks per 1,000 total live births) 12.2 Early neonatal mortality rate (deaths under 1 week per 1,000 total live births) 11.5 Perinatal mortality rate (still births and deaths under 1 week combined per 1,000 live and still births) 26.3 Infant mortality rate for England and Wales 22.0 Maternal Mortality. Maternal deaths (including abortion) Nil Maternal mortality rate (per 1,000 total live and still births) Nil Maternal mortality rate for England and Wales 0.38 Deaths. Males Females Total 400 351 751 Crude death rate per 1,000 estimated total population 10.1 Adjusted death rate for comparison purposes 11.3 (The area comparability factor for deaths is 1.12) Death rate for England and Wales 11.6 Population. The Registrar General's estimate of the total population of the Urban District, mid-year 1959, was 74,620 which is an increase of 980 over the figure for 1958, and is equivalent to a density of 3.58 persons to the acre. The natural increase of population measured by excess of births over deaths, was 637. This increase continues the trend noted in previous years, and the population of the Urban District has risen by 12,200 during the past ten years. Births. The birth rate for 1959 was 18 6 per 1,000 total population. The adjusted rate for comparison with other areas being 18.2. The rate of 18.6 is .7 higher than that for the previous year, and is well above the figure of 16.5 for England and Wales as a whole. 12 1,388 live births were registered in the Urban District during the year, as against 1,319 in 1958. Of this number 718 were males and 670 females. The illegitimate birth rate was 34.8 per 1,000 live and still births. There were 49 illegitimate births (including 1 stillbirth) 19 being males and 30 females. Of a total of 21 stillbirths registered, 11 were males and 10 females. The stillbirth rate for the year was 14-9 per 1,000 total live and still births, and 0*28 per 1,000 estimated total population. Deaths. Seven hundred and fifty-one deaths appertaining to the Urban District were registered in 1959, giving a death rate of 10.1 per 1,000 total population. The adjusted rate for use when comparing one area with another is 11.3. The rate for England and Wales as a whole is 11.6. Of the Orpington deaths registered, 400 were males and 351 females. The following is an analysis of the ages at death: Under 1 year of age 20 1 and under 5 years of age 3 5 and under 15 years of age 3 15 and under 25 years of age 6 25 and under 35 years of age 10 35 and under 45 years of age 14 45 and under 55 years of age 44 55 and under 65 years of age 120 65 and under 75 years of age 171 75 years and over 360 751 Full details of the causes of death will be found in Table II in the appendix, but the following table, giving details of certain causes of death in the Urban District during the past ten years may prove of interest: 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 Cancer (all sites) 114 120 85 108 108 134 131 131 158 172 Cancer of the lung and bronchus 20 19 9 19 25 23 34 33 38 48 Heart and Circulatory Diseases 342 293 293 285 320 262 264 284 328 348 Respiratory Diseases (excluding T.B.) 66 76 77 81 44 79 135 88 119 107 Tuberculosis 11 19 11 10 5 6 7 4 4 4 Infectious Diseases 1 — 2 4 1 2 1 1 3 3 Road Accidents 9 10 4 5 8 6 6 5 10 12 Other Accidents 9 14 6 3 2 8 10 8 10 6 13 Local Sickness. The following is a summary of the weekly details received from the Ministry of Pensions and National Insurance during 1959:— Four weeks ending Number of First certificates of incapacity received 27th January 1,128 24th February 2,268 24th March 1,345 21st April 655 19th May 586 16th June 546 14th July 554 11th August 490 8th September 445 6th October 592 3rd November 685 1st December 888 29th December 645 These figures once again followed the expected trend, namely, the highest incidence of illness occurred during the first three months of the year, the lowest level was reached in August, after which it began to rise again. Medical Examinations. Seventy-seven members or potential members of the staff were medically examined during the year. Unemployment. I am indebted to the Manager of the Orpington Employment Exchange for the following information with regard to unemployment in the area during 1959:— "The position from January, 1959, showed a steady decrease in the number of unemployed during each month, and they are likely to go down further with the work in the area. The main demands are for good building trade workers. The demands for the Christmas season in the Post Office and retail shops gradually reduced the unemployed figures, and in December to the lowest during the year. The good weather during the year would appear to be the most important contributory factor." 14 Open Air Recreational Amenities. Approximately 283.6 acres of land have been secured for public recreational purposes within the Urban District, as under:— Parks and Recreation Grounds. Ward. Acreage. Biggin Hill Biggin Hill 10.7 Chelsfield Chelsfield 0.50 Cudham Village Cudham 10.39 Cudham Lane Green-Street-Green 6.5 Downe Downe 3.0 Famborough Famborough 10.0 Glentrammon Green-Street-Green 13.5 Goddington Goddington South 63.95 Grassmeade Goddington North 9.6 Knockholt Knockholt 0.75 Petts Wood Crofton North 12.27 Poverest Knoll 17.5 Prattsbottom Playground Green-Street-Green 0.055 St. Mary Cray St. Mary Cray 19.0 Willett Petts Wood 6.1 Famborough (Opp. New Inn P.H.) Famborough 0.134 Public Gardens. Broxbourne Gardens Knoll 0.82 Riverside Gardens St. Mary Cray 10.3 The Priory Gardens Goddington North 14.03 Open Spaces. Okemore Gardens St. Mary Cray 3.75 Wotton Green St. Mary Cray 2.25 Common Land. Biggin Hill Green Biggin Hill 1.47 Broomhill Common Knoll 1.89 Darrick Common Crofton South 1.88 Famborough Common Famborough 16.72 Green-Street-Green Green-Street-Green 15.6 Prattsbottom Green-Street-Green 0.52 Leaves Green Common Leaves Green 19.55 Tugmutton Green Famborough 4.39 Old Hill Green-Street-Green 1.8 Gumping Common Crofton South 4.25 Sparrow Common Petts Wood 0.50 The contribution which the open spaces can make towards the health of the place is, of course, incalculable, and by its provision of a large number of open-air recreational facilities, the Council has made arrangements for both young and old alike. The younger generation are given the opportunity to enjoy their sports and pastimes, and for those who enjoy less active pursuits, every chance is given to take full advantage of the restfulness of a summer evening or week-end. Such amenities for both recreation and relaxation can only have beneficial effects on the population in general. SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 16 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. PUBLIC HEALTH SERVICES RENDERED BY THE COUNCIL. Major services of the Public Health Department, to which reference is made in later sections of this report are :— Atmospheric Pollution. Enquiries into Complaints, and Abatement of Nuisances. Health Education and all matters covered by the headings of Sanitary and Environmental Services. Housing. Inspection of Food and Food Premises. Inspection and Examination of Water and Milk Supplies. Inspection of Factories and Shops. Infectious Diseases (Prevention and Notification). Rodent Control. Refuse Collection and Disposal. Disinfection. The disinfecting station is situate at the Council Offices and details of the work carried out during 1959 are as under:— Disinfections— Premises visited 59 Rooms disinfected 38 Articles disinfected 688 Disinfestations— Premises visited 29 Rooms disinfested 90 Articles disinfested 165 Articles treated. Articles destroyed. Beds 106 — Mattresses 103 1 Pillows 170 — Bolsters 32 — Bedclothes (batches) 71 — Clothing (batches) 72 — Cushions 46 — Hangings 125 — Carpets 88 — Library Books 40 — 853 1 17 In the case of disinfection, rooms and furniture are treated with Formalin vapour and, if necessary, liquid spray. Some articles are steam treated with a pressure of 20 lbs. per square inch. Bedding is steam treated with a similar pressure. For disinfestation purposes, rooms and furniture are sprayed with a proprietary brand of insecticide containing five per cent D.D.T. Laboratory Service. Routine medical and Food and Drugs samples are forwarded to the Public Health Laboratory at Maidstone, and the following is a summary of the work carried out on behalf of the Council during 1959:— Faeces 107 Food Samples, etc 237 Water Samples 50 Miscellaneous 4 398 NATIONAL ASSISTANCE ACT, 1948. Section 47. Although several cases were visited and investigated during the year, it was not necessary to apply to the Court for an Order for compulsory removal of any of the persons concerned. Section 50. Under this section of the Act, a duty is placed on the local authority to arrange for the burial or cremation of the body of any person who has died or been found dead in their area, if it appears that no suitable arrangements for the disposal of the body have or are being made. During the year, two bodies were dealt with by the Council under this Section of the Act. Nursing Homes. There are no registered Nursing Homes within the area. Public Mortuary. There is no public mortuary in use in the district. Facilities have been given for the use of the mortuaries attached to Famborough and Orpington Hospitals. SERVICES RENDERED BY THE HOSPITAL BOARDS. (a) Famborough Hospital.—Provides a general hospital with 736 beds. 18 (b) Chest Clinic.—There is no Chest Clinic in the area, all patients being referred to the Clinic at Tiger Lane, Bromley. The above are under the control of the Bromley Group Hospital Management Committee, whose offices are at Famborough Hospital. (c) Orpington Hospital.—General Hospital with provision for 809 beds, including Part III residential accommodation for County use. This Hospital is controlled by the Orpington and Sevenoaks Group Hospital Management Committee and their offices are at Orpington Hospital. (d) Venereal Diseases.—Patients are referred to the various hospitals with specialist clinics for dealing with these diseases. SERVICES RENDERED BY THE KENT COUNTY COUNCIL. Ambulance Service. The main depot for the area is at 12, Hayes Lane, Bromley. At the present time there are twenty-seven ambulances and twenty-two sitting case cars available for use at this depot, and the majority of these are radio controlled. Day Nurseries. There are no day nurseries in the district. Diseases of Animals Acts. There is an officer stationed at Bexley who carries out the functions of this service. Domiciliary Midwifery. Six full-time Midwives and five Home Nurse Midwives are employed in the Urban District. The services of a Midwife may be obtained on direct application or through the patient's private doctor. Domestic Help Service. The District Organiser's office is at 102A, High Street, Orpington. The following is a summary of the cases assisted during 1959:— Maternity (Expectant Mothers) 104 Tuberculosis 2 Aged 233 Others 143 482 19 Family Help Service. This service is provided to deal with the care of children in their own homes when they are temporarily deprived of the care of their mother or a female guardian. Twenty-five cases were assisted during 1959. Night Attendant Service. This service is for old people in their own homes, and arrangements include evening service and preparation for sleep, preparation for meals, attention to fires and night service. Twenty-seven cases received assistance during the year. Child Help Service. Assistance under this scheme was given to three families in the area during 1959. District Nursing Service. There are six District Nurses and four District Nurse Midwives employed in the area. No night service is provided. The services of a District Nurse may be obtained on medical certification. Health Visiting. Nine Health Visitors/School Nurses, one full-time School Nurse and one Tuberculosis Health Visitor are employed in the area. In addition to their school work, Health Visitors are responsible for the Maternity and Child Welfare Clinics, Home Visiting, Mental Health Visiting, Immunisation and Vaccination Clinics, etc. SERVICES RENDERED BY VOLUNTARY AGENCIES. The St. John Ambulance Brigade. Over 60's Clubs. The invaluable work carried out by these agencies continued during the year. Women's Voluntary Service. The County Organiser has kindly furnished the following information:— 20 "Meals on Wheels." Orpington W.V.S. members served 7,745 meals during 1959, an increase of 1,345 over the previous year. A free Christmas dinner, with the addition of fruit and sweets was sent round at Christmas. The old people still only pay 1/- for their meal. Deliveries are made three times a week. The Almoners at Orpington Hospital frequently appeal for help, when re-habilitating some old person. Darby and Joan Clubs. The Famborough Club has a membership of 50, but as many of the members are infirm, cars are laid on to enable them to get to the Club once a week. The Rookery Club at St. Mary Cray has a slightly larger membership. The leaders and helpers, besides working at the Clubs, take a personal interest in the members, caring for them when they are sick and befriending them in every way. General Welfare Work. Many appeals for help are received from the Almoners of the local hospitals. The requests vary from visiting, shopping, and to car escorting. 318 car escort journeys were carried out during 1959. an increase of 75 on the 1958 figure. The Trolley Shop continues its valuable work at Famborough Hospital—some of the profits were used to provide curtaining for a ward and also garden seats and a shelter for the Psychiatric Ward. Orpington and District Old People's Welfare Committee. The Honorary Secretary has kindly furnished the following report:— " The Orpington and District Old People's Welfare Committee continues to provide a means of regular contact between the many organisations that help old folk in Orpington, and to foster locally a general interest in the care of the elderly. It also provides a liaison between the dozen Old People's Clubs that brighten the lives of old folk in the Orpington area. The Committee's Benevolent Fund, fed by donations, relieves genuine distress among the elderly people living in all parts of the Urban District of Orpington." British Red Cross Society—Medical Loan Depot. One medical loan depot is in operation in the area, where a full range of nursing requisites is held and articles are available to local residents. A small charge is normally made, but, in necessitous cases, and for most old age pensioners articles are loaned free. 21 The address of this depot is 1, Birch wood Road, Petts Wood, and it is open by appointment. Application should be made to Mrs. Jones of that address—telephone number Orpington 22083. LOCAL CLINIC SERVICES. Child Welfare Centres. Chelsfield Village Hall 1st, 3rd & 5th Tuesday in month—afternoon. Cudham & Biggin Hill Sports Pavilion, Biggin Hill Thursday—afternoon. Downe Village Hall 1st & 3rd Friday in month —afternoon. Farnborough Methodist Hall Friday—afternoon. Green-Street-Green Baptist School Room Friday—afternoon. Knockholt The Institute 2nd & 4th Tuesday in month—afternoon. Orpington Methodist Church Hall Monday, Tuesday & Friday—afternoon. St. Giles Church Hall, Leamington Avenue Wednesday—afternoon. Crofton St. Paul's Church Hall Monday—afternoon. Petts Wood G.E.A. Hall, Woodhurst Avenue Monday & Thursdayafternoon. St. Mary Cray Temple Congregational Church Hall Tuesday & Wednesday —afternoon. Pratts Bottom Village Hall 2nd & 4th Thursday in month—afternoon. Poverest Coronation Hall, Bridge Road, St. Mary Cray Each Thursday afternoon. Ante-Natal Clinics. Cudham & Biggin Hill Sports Pavilion, Biggin Hill 1st, 3rd & 5th Wednesday in month—morning. Relaxation, Mothercraft & Post Natal—2nd & 4th Wednesday morning in each month. Green-Street-Green Baptist School Room .... Friday —morning. (Also Relaxation Class.) Orpington Methodist Church Hall Tuesday & Friday— morning. Petts Wood G.E.A. Hall, Woodhurst Avenue 1st, 3rd and 5th Tuesday afternoon, 1-2.30 p.m. Wednesday afternoon, Relaxation Class. St. Mary Cray Temple Congregational Church Hall Friday—afternoon. 22 Minor Ailment Clinics (Schools). The School House, Orpington Chislehurst Road Every Thursday— afternoon. Dental Clinics. The School House, Orpington Chislehurst Road Monday, Tuesday, Wednesday, Thursday and Friday—all day. Dentist attends full time each day. Dental Clinics are also held in the country areas—Famborough, Cudham, Westerham, Biggin Hill, Downe, Green-StreetGreen, Knockholt, etc. Immunisation and Vaccination. This is carried out at the Child Welfare Centres as listed above, and, by special appointment at Chislehurst Road School, Orpington, on Tuesday afternoons. SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. 24 SECTION C. SANITARY AND ENVIRONMENTAL CIRCUMSTANCES OF THE AREA. Agriculture (Safety, Health and Welfare Provisions) Act, 1956. The main object of this Act is to make provision for securing the safety, health and welfare of farm workers and avoiding accidents to children arising out of the use of agricultural equipment. Atmospheric Pollution. There are only light industries in the northern part of the district and they are confined to a small area at St. Mary Cray, and with many of these and also the two large Hospitals converting their boiler plants from solid fuel to oil fuel burning, there is very little smoke emission into the atmosphere from industrial premises. The district, which comprises some 20,000 acres, has many open spaces, parks and recreation grounds, and is not subjected to excessive smoke pollution from domestic premises, particularly in the southern part of the area which is rural in character. During the year, some 545 observations and visits were made by the Public Health Inspectors in connection with atmospheric pollution and in only five cases was it necessary to call attention to infringements. The Council co-operates with the Fuel Research Station acting under the Department of Scientific and Industrial Research in the measurement of atmospheric pollution. There are two sites in the district at one of which a deposit gauge is positioned for the measurement of solid matter suspended in the atmosphere and at the other a Lead Peroxide Cylinder for the measurement of sulphur dioxide. At monthly intervals, samples are forwarded to the Council's Analyst and reports thereon are submitted to the Fuel Research Station. The Council is represented by the Chairman of the Public Health Committee and the Chief Public Health Inspector on the London and Home Counties Smoke Abatement Advisory Council, the National Smoke Abatement Society, and the Standing Conference of Local Authorities which co-operate with the Department of Scientific and Industrial Research. The Chief Public Health Inspector has been appointed to the Executive Council of the Smoke Abatement Advisory Council. Cesspools. The bulk of the work this year in connection with the abolition of cesspools, has been carried out in the Biggin Hill area where sewers have been installed as part of private street works. 25 Letters were sent to well over 100 owners of properties explaining the advantage of connecting to the new sewers before the roads were made up, and many visits were made in answer to enquiries. Due to the painstaking work of the District Inspector, it can be said now that results were highly satisfactory but the actual record of connections will appear in my next Report. Thirty-eight cesspools were abolished and these were mainly at premises where connections were made to existing sewers in other parts of the district. One of the limiting factors affecting the speedy completion of this programme is the apparent shortage of drainage contractors to tackle the volume of work and several owners have reported that letters to more than half a dozen contractors have brought no replies whatever. Nevertheless, a steady progress is being made and it is anticipated that the number of conversions in 1960 will far exceed the annual figure of past years. Number of cesspools at 31st December, 1959 : (1) On line of sewer 101 (2) Not on line of sewer 2,375 Number of cesspools abolished and main drainage provided during the year 38 Number of houses with pail closets converted to cesspool drainage 1 Number of new houses erected with cesspool drainage 48 Number of loads removed from cesspools :— On private properties 5,129 On requisitioned properties 136 On Council properties 565 5,830 Complaints. During the year, 28 complaints were received from residents, but in no case was it necessary to take formal action to secure abatement of the nuisance. Diseases of Animals (Waste Foods) Order, 1957. Briefly the object of this Order is to prevent the spread of Foot and Mouth and other diseases of animals. The Order provides, inter alia, that where persons collect waste foods for feeding to animals or poultry, the foods must first be boiled for one hour in a Plant licensed by the Local Authority. Three Boiling Plants were licensed during 1959, making a total of forty-one licences issued under this Order. 26 Drainage and Sewerage. The trunk soil sewerage system is under the control of the West Kent Main Sewerage Board. Branch main soil sewers and main surface water sewers have been provided during the year by the Local Authority as under :— Private Estate Development: 1,685 lineal yards of 6" Foul Water Sewer. 329 lineal yards of 9" Foul Water Sewer. 148 lineal yards of 6" Surface Water Sewer. 64 lineal yards of 9" Surface Water Sewer. Council Construction : 122 lineal yards of 6" Surface Water Sewer. 959 lineal yards of 9" Surface Water Sewer. 107 lineal yards of 12" Surface Water Sewer. 237 lineal yards of 15" Surface Water Sewer. Factories Acts, 1937 and 1948. There are 145 factories on the Council's register at the present time. Ninety-seven visits of inspection were made by the Public Health Inspectors during the year, only four defects being found, which were remedied. The following gives particulars of the work carried out during 1959 : 1. Inspection for purposes of provisions as to heatlh : Premises No. on Register Number of Inspections Written Notices iers Prosecuted (a) Factories in which Section 1, 2, 3, 4 and 6 are to be enforced by the Local Authorities 14 8 — — (b) Factories not included in (a) in which Section 7 is enforced by the Local Authority 116 66 1 — (c) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises)* 15 23 — — 145 97 1 — * Building sites on Estate development. 27 2. Cases in which defects were found : Number of cases in which defects were Referred Number of cases in which prosecutions were Instituted Found Remedied to H.M. By H.M. Inspector Inspector Want of cleanliness (S.l) 1 1 — — — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7): (a) Insufficient 2 2 — — — (b) Unsuitable or defective 1 1 — — — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to outwork) — — — — — Total 4 4 — — — Outworkers. Twenty lists of Outworkers were received during the year, and the following are details of the trades involved, together with the number of persons employed. Trade f outworkers employed Clothing 81 Cardboard boxes 1 Jewellery 2 Surgical Appliances 4 88 Heating Appliances (Fireguards) Act, 1952. No contraventions were found during the course of the year. Pet Animals Act, 1951. Licences in respect of five premises were granted or renewed during 1959 and fourteen visits were made by the Public Health Inspectors. No nuisances or defects were found. The pets sold from these shops consist mainly of birds, fish and tortoises. 28 Prevention of Damage by Pests Act, 1949. The number of inspections and treatments carried out was as follows : Total number Number of of inspections. Infestations cleared. Local Authority's property 50 7 Dwelling houses (incl. Council Houses) .... 5,540 606 Business premises 99 16 In addition, the Council's sewers were test-baited in the year to ascertain the areas of infestation and this was followed up by treatment with poison bait in February. The degree of infestation was very slight. Rag Flock and Other Filling Materials Act, 1951. This Act is designed to secure the use of clean filling materials in upholstered articles and other articles which are stuffed or lined, or for purposes connected therewith. No contraventions were found under this Act during 1959. Rivers, Streams and Lakes. Since 1950, the Kent Rivers Board has been responsible for the supervision of the two rivers in this area, i.e. the Cray and the Kydbrook. Sanitary Inspection of the Area. Total number of Inspections and visits No of premises at which defects or contraventions were found Housing 2,363 146 Infectious Diseases 403 — Food Premises 1,704 36 Factories (including Smoke Observations, Outworkers) 646 9 Rodent Control (Public Health Inspectors only) .... 253 201 Trade Premises 583 49 Miscellaneous 1,139 2 7,091 443 Shops Act, 1950. During the year, 382 inspections of shops were made and the following contraventions were found and subsequently remedied by the shop-keepers : Neglect in displaying Statutory Forms .... 45 Contravention of hours of closing .... .... 2 Contravention of regulations regarding Employment of Young Persons 1 29 Swimming Baths and Pools. There is only one swimming bath in the district to which the public are admitted, and this is situated at Darrick Wood, Lovibonds Avenue, Orpington. It is owned by the Kent Education Committee, but is operated by Orpington Urban District Council in conjunction with the Committee under a financial arrangement during the summer months, whereby, although it is normally reserved for the use of school children, the general public are admitted at certain times. The charge for admittance is 1/- for adults and 6d. for children. It is an indoor swimming bath covered with white glazed tiles. The water, supplied by the Metropolitan Water Board, is heated, chlorinated and then filtered continuously, this cycle taking eight hours. Three visits of inspection were made during the year by the District Public Health Inspector and a sample of the water taken for analysis proved to be satisfactory. The Analyst reported as follows : Physical Characters. Colour—Nil. Odour—Chlorine. Deposit—Nil. pH 7.52 (Results expressed in parts per million). Chemical Examination. Solids in suspension (Dried at 180°) 1,030 „ „ „ After ignition 820 Chlorides calculated as Chlorine 295 Bicarbonate Alkalinity 70 Total Hardness 240 Free and Saline Ammonia (as Nitrogen) 0.16 Albuminoid Ammonia (as Nitrogen) 0.8 Nitric Nitrogen (as Nitrates) 8 Nitrous Nitrogen (Nitrites) 0 Oxygen absorbed in i hour at 26.7°C 0.36 „ „ „ 4 hours at 26.7°C 1.7 Toxic Metals .... .... .... .... .... .... .... not detected Free and combined residual Chlorine on receipt 0.75 Bacteriological Examination. Number of Colonies developing upon Agar : (a) in 24 hours at 37°C 1 per ml. (b) in three days at 22°C 13 per ml. Presumptive Coliform Count 0 per 100 ml. Including faecal coli .... .... .... .... .... .... —per 100 ml. OPINION : FIT FOR USE. Verminous Conditions and Uncleanliness. No cases of unclean premises were found during the year, but twenty-nine verminous premises were dealt with by the Department's Disinfector. 30 Water Supply. During the year, eleven premises were connected to the main water supply, having previously been dependent upon stored rainwater. Of approximately 24,000 dwellings, only 36 are not provided with a main piped water supply. Of these, 22 are situated where a water main is not available in the roads fronting their premises. These are in isolated parts of the district and generally dependent upon rain-water collected from roofs and stored in underground tanks, but three premises obtain their source of supply from a private well. The remaining fourteen premises are not connected to a main water supply although it is available in the roads on to which they front. Some of these are a considerable distance from the road, but nine premises are within 80 feet of the Metropolitan Water Board main. Fifteen week-end bungalows are not connected to a main water supply. The total number of premises still dependent upon underground tank or well supply is made up as follows : Ward Number of premises with Stored Rainwater Wells Biggin Hill 21 — Chelsfield 2 — Cudham 4 — Downe 2 — Farnborough 2 1 Green St. Green 3 — Knockholt 1 — 35 1 The Metropolitan Water Board supplies the mains water for the whole of the district. The Public Health Department obtain samples of this water at monthly intervals from various dwelling houses throughout the district. Forty-two samples were taken and the Analyst's reports show that they were all satisfactory. The Director of Water Examination, Metropolitan Water Board, has kindly reported on the water supply to the Urban District during the year 1959 : " The water supply to the district of Orpington during 1959 was derived from six local wells, namely, Orpington, North Orpington, Sundridge, Eynsford, Westerham and Lullingstone. In addition there 31 was a certain amount of Thames-derived filtered water supplied to the area. Bacteriological analyses of these wells are made five times a week and consistently satisfactory results have been obtained from samples of water passing into supply. Chemical analyses are also made at regular intervals. All supplies are treated with chlorine at 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. The following table gives the results of chemical and bacteriological analyses of the various supplies to Orpington during 1959, including analyses of water before treatment." 32 Result of the Bacteriological Examination of the Water supplied to Orpington during the Year 1959. Parts per million (unless otherwise stated) BACTERIOLOGICAL RESULTS Source of supply BEFORE TREATMENT AFTER TREATMENT Number of samples Agar plate count per ml. Coliform count Escherichia coli count Number of samples Agar plate count per ml. Coliform count E. coli count 20-24 hours at 37°C. 3 days at 22°C. Per cent, samples negative in 100 ml. Count per 100 ml. Per cent, samples negative in 100 ml. Count per 100 ml. 20-24 hours at 37°C. 3 days at 22°C Per cent, samples negative in 100 ml. Per cent, samples negative in 100 ml. Orpington 252 0-2 3 93-25 0-2 99-60 257 0-1 7 99-22 99-6 North Orpington 245 2-3 23 17-55 20-0 33-47 100 250 0-9 2 100 100 Eynsford Well 229 0-1 9 81-22 1-4 99-13 — } 258 0-1 25 100 100 Eynsford Borehole 175 01 3 100 — 100 Lullingstone 252 0-1 3 99-60 100 — 257 0-3 25 100 100 Sundridge No. 2 ... 250 0-1 3 100 100 — } 253 0-1 6 100 100 Sundridge No. 4 ... 45 — 3 100 — 100 — Westerham 250 01 41 100 — 100 — 255 0-1 9 98-04 100 Thames derived -- — — 3,344 9-8 99-46 99-97 33 Average Results of the Chemical Examination of the Water supplied to Orpington during the Year 1959. Milligrammes per litre (unless otherwise stated) Description of the Sample No. of Samples Ammoniacal Nitrogen Albuminoid Nitrogen Oxidised Nitrogen Chlorides as CL Oxygen abs. from Permanganate 4 hrs. at 27°C. Turbidity in terms of Silica Colour, mm. brown 2. ft. Tube Burgess's Tintometer Nitrate Orpington well ... 4 0010 0020 6-9 16 002 Nil Nil N. Orpington well 4 0014 0 027 5 0 14 006 Nil Nil Eynsford well ... 8 0 009 0 026 41 16 Nil Nil Nil Lullingstone well ... 4 0013 0 024 4-3 14 008 0.1 Nil Sundridge No. 4 well 4 0 007 0 020 3 0 16 0 04 Nil Nil Westerham well ... 4 0010 0 023 5 0 13 0 02 Nil Nil Thames derived ... 386 0030 0 074 3-6 28 104 0.4 9 Description of the Sample Hardness (Total) Hardness (noncarbonate) pH. Value Phosphate as po4 Silicate as SiO, Sulphate as so4 Fluoride as F Magnesium as Mg. Potassium as k B.O.D. 5 days at 20°C. Electrical Conductivity (Gemmhos) Orpington well 278 44 7-2 1.6 525 N. Orpington well 262 30 7-2 ... — 1.7 475 Eynsford well 258 34 7-2 — 1.4 — 475 Lullingstone well 248 26 7-2 —- 1.2 475 Sundridge No. 4 well 210 42 7-4 —- 2.0 425 Westerham well 258 32 7-2 _ _ 1.1 500 Thames derived 254 56 7-8 090 9 54 0-2 4.0 — 525 SECTION D. HOUSING. 36 SECTION D. HOUSING. Clearance Areas and Individual Unfit Dwellings. Under Section 1 of the Housing Repairs and Rents Act 1954, local authorities were asked to carry out surveys of unfit dwellings in their areas, to submit returns showing the estimated number of such houses, and to make proposals for programmes of clearance extending over the five years beginning in January 1956 and ending in December 1960. It is estimated that by the end of 1960, there may still be a little work in hand on the current programme but this will be completed as soon as possible and further proposals made as found necessary. Rent Act, 1957. This Act came into force on the 6th July, 1957. The role of the Health Department in the administration of the Act is confined almost entirely to the consideration of applications made by tenants of controlled houses for Certificates of Disrepair. In broad terms, the possession of this Certificate enables a tenant to resist the rent increase permitted by the Act and the granting of a Certificate is justified only where the dwelling is in disrepair by reason of defects which ought reasonably to be remedied " having due regard to the age, character and locality of the dwelling." The work involved in the operation of this Act eased considerably during 1959, only eight applications being received. In four cases, undertakings were received from the landlord to remedy the defects but in the remaining four cases, Certificates of Disrepair were issued to the tenants. Housing Statistics for the year 1959. Total number of valuation assessments, houses and flats, at 31st December, 1959 .... .... .... .... .... 23,797 (1) (a) Total number of dwelling houses inspected for defects (under the public Health or Housing Acts) 132 (b) Number of inspections made for the purpose .... 823 (2) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 — (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation .... .... .... .... .... 10 (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 120 37 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 .... 115 Number of dwelling houses demolished during the year 10 Moveable Dwellings. During 1959, four licences were renewed embracing a total of 111 caravans and ten tents for both the summer and winter months. Ninety-five visits were made to the various sites by the Public Health Inspectors. Re-Housing. I am indebted to the Housing and Estates Manager for the following statistics on re-housing carried out by the Local Authority :— Prior to 1959 During 1959 Total as a* Dec. 1959 1. (a) Number of permanent dwellings built by Local Authority (excluding 402 old type pre-1939 council houses) 2,314 57 2,379 (b) Number of pre-fabricated dwellings built by Local Authority 319 319 (c) Number of dwellings requisitioned by Local Authority 2 — 2 2. (a) Number of families occupying 1 (a) 2,379 and lodgers (b) Number of families occupying 1 (b) 319 (c) Number of families occupying 1 (c) 18 3. Total number of families re-housed during 1959 in (a) 57 (b) Nil (c) 3 4. Number of families on waiting list at 31st December, 1959, in various categories (a) Families in urgent need of other accommodation .... 145 (b) Families whose applications require early consideration 312 (c) Families whose applications are less urgent 280 737 (d) Families with varying degrees of housing need 320 5. Number of families on waiting list living in overcrowded conditions ; it is not possible to give an exact figure in this connection, but approximately 457 of the families included in 4 above are living in crowded conditions. SECTION E. INSPECTION AND SUPERVISION OF FOODS. 40 SECTION E. INSPECTION AND SUPERVISION OF FOODS. General. During the year, food premises were subject to routine and specialised inspection and a total of 1,704 visits were made, as shown in Table VII in the appendix. On the whole, the standard of cleanliness in these premises is good and there is little doubt that the full enforcement of the Food Hygiene Regulations since they came into operation four years ago has resulted in substantial improvements. The Inspectors continue to receive the fullest co-operation from the shop-keepers and our requirements are accepted with the minimum of friction. With regard to new premises, when plans are submitted to the Engineer and Surveyor, an opportunity is given to us to comment on the proposed lay-out in relation to Regulations so that the owner is fully aware of the requirements from the outset. Food and Drugs Act, 1955. Food Sampling. Details of the 214 Informal Samples of food and drugs taken for analysis are as follow :— Food and Drugs Sampling. Number examined Number unsatisfactory Formal Informal Formal Informal Anchovy Essence — 1 — — Aspirin Tablets — 1 — — Bacon — — — — Baking Powder — l — — Beechams Powders — 1 — — Beef Sausages — 3 — 1 Beef Suet — 1 — — Bicarbonate of Soda — 1 — — Blancmange Powder — 1 — — Bread Rolls — 1 — — Butter — 3 — — Butter Sweet Confectionery — 4 — — Cake — 1 — 1 Cheese — 1 — — Cheese Spread — 3 — — Chocolate Bar — 1 — 1 Chopped Chicken — 1 — — Coffee and Chicory — 2 — — Cold and Influenza Mixture — 1 — — Condensed Milk — 1 — — Cough Elixir — 1 — — 41  Number examined Number unsatisfactory Formal Informal Formal Informal Cough Syrup — 2 — Cream of Tartar — 1 — — Curry Powder — 1 — — Double Orange Squash — 1 — 1 Doughnuts — 1 — — Evaporated Milk — 1 — — Fish Paste — 13 — — Fruit Pies — 1 — — Fruit Salts — 1 — Glace Cherries — 1 — — Glucose Fruit Tablets — 1 — — Glycerine, Lemon and Honey — 1 — — Ground Almonds — 1 — — Health Drink — 2 — 1 Horseradish Relish — 2 — — Juisoda Fruit Drink — 1 — — Lemon Curd — 1 — — Lemon Drink — 6 — — Lemon Pie Filling — 1 — — Liquid Paraffin — 2 — — Margarine — 4 — — Marmalade — 2 — — Meat Paste — 14 — — Milk — 61 — — Milk Food — 1 — — Mincemeat — 1 — — Mustard — 2 — — Olive Oil — 2 — — Orange Drink — 3 — — Pearl Barley — 1 — — Pickled Onions — 1 — — Pineapple Milk Shake — 1 — — Pork Sausages — 3 — 1 Potted Crab with butter — 1 — — Pudding Mixture — 1 — — Rice — 1 — 1 Rissoles — 1 — — Saccharin Tablets — 1 — — Self-Raising Flour — 5 — — Soup — 4 — — Steak Pies — 2 — — Steak and Kidney Pie — 2 — — Sugar — 2 — — Swedish Milk Diet — 1 — — Table Jelly — 2 — — Tea — 5 — — Tinned Plums — 1 — — Tinned Strawberries — 1 — —. Tomato Ketchup — 7 — — Vinegar — 6 — — Vitamin Tablets — 1 — — Weight Increasing Preparation — 1 — — — 214 — 7 42 Serial No. Article Formal or Informal Nature of adulteration Observations 908 Rice Informal Adulterated— Contained 11 pellets of rodent droppings. The rice concerned was packed at premises in a neighbouring district. The Local Authority's Rodent Operative dealt with a small mouse infestation on the premises and a serious warning was given to the proprietors. 909 Cake Informal Inferior— Contained small black fragments which have the appearance and character of " bakery char." The necessary action was taken at the bakery concerned. 923 Beef Sausages Informal Inferior— Fat 30 ; lean 33. Total meat 63% SO2 160 ppm. Declaration of preservative not in accordance with Regulations. The Manufacturers agreed to make the necessary alteration to the label. 924 Pork Sausages Informal Inferior— Fat 27 ; lean 38. Total meat 65% SO2 140 ppm. Declaration of preservative not in accordance with Regulations. The Manufacturers agreed to make the necessary alteration to the label. 43 Serial No. Article Formal or Informal Nature of adulteration Observations 925 Double Orange Squash Informal Inferior— Soluble solids 34; indicated juice content 29 per cent. Benzoic acid 460 ppm. Double Orange Squash would be expected to have at least twice the minimum juice content. The Manufacturers agreed to make the necessary alteration to the label. 982 Health Drink Informal Inferior— The description "lactoserum" is neither a dictionary nor a scientific word. The makers agreed to substitute the term "deproteinised whey." 993 Chocolate Bar Informal Inferior— The surface of the bar, particularly the under surface had a " dirty " appearance. Under the microscope the "dirt" was, in fact, shown to be an optical illusion caused by crystals of sugar embedded No action. 44 Serial No. Article Formal or Informal Nature of adulteration Observations in the surface and appearing black by total internal reflection of light. Some granules on the surface were coloured red, blue, orange. Also present, a little starch, mainly maize, and a few vegetable fibres. No rodent hairs, mineral or other debris detected. It was thought the bar had come into contact with the type of "dust" that might be found in a confectionery factory. Two bars purchased in Maidstone were normal. 45 Food Hygiene Regulations, 1955. There were no prosecutions under the above Regulations during 1959. A total of 1,053 inspections were made by the District Inspectors during the year. As a result of these inspections, 30 informal notices were served on the proprietors, and by the end of the year the following works had been carried out at various food premises :— Walls and ceilings cleansed 3 Structural repairs 1 Sanitary accommodation— hand washing notices affixed 2 Wash-hand basins provided 2 Wash-hand basins cleansed 1 Hot water supply provided 9 First aid equipment provided 4 Clothing accommodation provided 1 Refuse storage 4 Soap, towels and nailbrush provided 6 Protective clothing provided 2 Miscellaneous 1 Food Complaints. Thirty-five complaints of unsound condition and/or contamination of foodstuffs were received from the public during the year as under:— Biscuits 1 Bread 11 Cakes 6 Cheese Spread 2 Chocolate Bar 1 Dried Fruit 1 Meat Pies 4 Milk 4 Orange Drink 1 Rice 1 Sausages 1 Tinned Fish 2 35 Special Samples of Milk, Ice Cream, Water. In addition to the samples previously mentioned, a further 125 samples were taken for bacteriological and pathological examination and other special tests as under :— 46 Milk (Tuberculin Tested) Bacteriological Examination 1 Milk (Pasteurised) Phosphatase Test 33 Milk (Sterilised) Turbidity Test 23 Ice Cream—Bacteriological and Pathological Examination 23 Water—Bacteriological Examination 42 Water—Chemical Examination 3 125 Ice Cream. At the end of the year 179 premises were registered for the storage and sale of ice cream, but none for the manufacture of this commodity. One hundred and nine inspections were made and conditions were found to be satisfactory. Twenty-three samples were sent for bacteriological and pathological examination. The following is an analysis of the results obtained during the past three years :— Year No. of samples taken Grade I Result Grade II Grade III 1957 30 22 8 — 1958 33 30 2 1 1959 23 20 3 — No pathogenic organisms were found in any of the 23 samples and the bacteriological grading was highly satisfactory. Food Premises. Bakers and Confectioners 13 Butchers 48 Chemists 21 Clubs and Hotels 7 Confectionery 62 Cooked Meat Shops 1 Dairies 12 Fishmongers (Wet, Dry and Fried) 20 Greengrocery 51 Grocery 89 Hospitals 2 Industrial Canteens 16 Public Houses 43 Restaurants 49 School Canteens 15 Street Vendors 12 461 47 Food and Drugs Act, 1955—Section 16. Two hundred and twenty-six shops and food premises have been registered under the above Act, as under :— Ice Cream Stores 179 Fish Shops 7 Butchers' Shops 39 Fish and Meat Paste Factory 1 226 Unsound Food. During the year a total of 16 tons 8 cwts. 5 lbs. of varied articles of food were condemned and destroyed and 548 Food Condemnation Certificates were issued. 70 lbs. Bacon 14 lbs. Biscuits 19 lbs. Butter 47 lbs. Cereals 100 lbs. Cheese 149 lbs. Chickens 4 lbs. Coffee 7 lbs. Cordials 2 lbs. Cream 105 lbs. Fish 46 lbs. Fish (tinned) 6 lbs. Flour 732 lbs. Fruit (tinned) 5,764 lbs. Fruit 2 lbs. Fruit (dried) 14 lbs. Kidneys 10 lbs. Liver 48 lbs. Margarine 1,120 lbs. Meat (tinned ) 357 lbs. Meat 3 lbs. Meat Pies 131 lbs. Milk (tinned) 6 lbs. Pickles 77 lbs. Preserves 110 lbs. Sausages 3 lbs. Sauces 115 lbs. Soups 1 lb. Suet 2 lbs. Sugar 1 lb. Sweets 335 lbs. Vegetables (tinned) 27,341 lbs. Vegetables 48 Milk and Dairies Regulations. Twelve dairies have been registered under the above Regulations. Details of the licences issued during 1959 are :— Tuberculin Tested Pasteurised Sterilised Dealer's Licences 13 Supplementary Licences 3 Dealer's Licences 26 Supplementary Licences 4 Dealer's Licences 31 Supplementary Licences 3 Twelve visits were made to the dairies in the district during 1959. Slaughterhouses and Slaughtermen. No slaughterhouses were licensed during the year, but licences were issued to nine slaughtermen under the Slaughter of Animals Act, 1958. Restaurants, Hotels and Canteens. One hundred and thirty visits were made to these premises during the year. In ten cases defects requiring the attention of the owner were dealt with by informal action. Butchers' Shops. One hundred and sixty-eight detailed inspections were made of the 48 retail butchers' shops in the area. The butchers work in close collaboration with the Public Health Department and during the year called upon the services of the District Inspectors in connection with carcase meat suspected of being unsound, as a result of which 357 lbs. of meat was condemned as being unfit for human consumption. In no case was there any evidence of unsound meat being exposed for sale. Bakehouses. Twenty-seven inspections were made of the 13 premises during the year, and in only two cases were defects found which required the attention of this department. Merchandise Marks Act. Forty-seven visits were paid to premises during the year in connection with this Act. No contraventions were detected. Game Act, 1831. Three licences were renewed during the year. SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. 50 SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. General. One thousand, eight hundred and ninety notifications of infectious diseases were received during the year, a large increase on the 498 notifications recorded during 1958. This is accounted for by the number of cases of measles which reached a figure of 1,570 during the year compared with a mere 74 in 1958. Despite a year in which weather conditions would appear to have been ideal for encouraging its spread, the number of cases of anterior poliomyelitis, namely, four was exactly the same as in the previous year. Of these cases, two were paralytic and two nonparalytic. There were no major outbreaks of any other infectious disease and most of the cases reported were of a mild type. Acute Anterior Poliomyelitis and Vaccination. During the year, only four cases were notified, the same figure as was recorded in the previous year. Two cases were confirmed as being paralytic and two nonparalytic, and all were admitted to hospital. No deaths from this disease were recorded. The following figures which have been supplied by the County Medical Officer, show the numbers of Orpington residents who were vaccinated against this disease in 1959:— Year of Birth Given second injections Third injections 1959 177 — 1958 928 509 1957 238 801 1956 132 695 1955 114 623 1954 109 704 1953 109 738 1952 109 699 1951 121 673 1950 107 701 1949 102 751 1948 123 741 1947 155 790 1946 148 739 1945 130 609 1944 163 516 1943 177 364 Before 1943 2,836 929 Others 802 533 Total 6,780 12,115 51 Diphtheria and Diphtheria Immunisation. For the tenth consecutive year, I am pleased to be able to report a complete absence of this disease in the Urban District. The County Medical Officer informs me that a total of 1,136 children resident in the area, received primary immunisation against this disease and 586 reinforcing inoculations during 1959. A total of 14,729 children under the age of 15 years on 31st December, 1959, had completed a course of immunisation at some time prior to that date. Dysentery. Only four cases of dysentery were notified during the year, two being admitted to hospital. The name dysentery has a somewhat fearsome ring to many people, and it is therefore appropriate to point out that the type of dysentery in these four cases was of a mild character. Food Poisoning. A total of thirty-eight cases were notified during the year, 36 being single cases. The remaining two cases occurred during a small family outbreak when one death was recorded. In four cases, the agent identified was Salmonella Newport and in two cases Salmonella Typhimurium. Three cases were removed to hospital and the remainder home nursed. The following is a copy of the annual return of Food Poisoning notifications (corrected) forwarded to the Ministry of Health. (1) First Quarter 11 Second Quarter 9 Third Quarter 9 Fourth Quarter 9 38 (2) Cases otherwise ascertained 1 (3) Symptomless Excreters 1 (4) Fatal Cases 1 (5) Particulars of Outbreaks: No. of cases notified 2 No. of cases otherwise ascertained 1 Agent identified—Salmonella Newport 3 (6) Single cases : Agent identified: Salmonella Typhimurium 2 Salmonella Newport 1 Unknown 33 (7) Salmonella Infections, not foodborne Nil 52 There were no major outbreaks of this illness, and the total of single cases showed an improvement compared with the previous year. Prevention of foodborne illness remains, of course, largely a matter of personal hygiene, particularly in ensuring the cleanliness of hands before handling food. Measles. One thousand, five hundred and seventy cases were notified during the year, nine being admitted to hospital. This figure is a big increase on the seventy-four cases which occurred during 1958. There was one death from this disease recorded in the area during 1959, but in most instances the illness today is not of a serious nature. Meningococcal Infections. No cases occurred in the area during 1959. Pneumonia. Thirteen cases of pneumonia were notified during 1959, as against thirty-three in 1958, and four of these were admitted to hospital. There were sixty-five deaths from pneumonia. This figure includes people normally resident in the Urban District but who died outside the area. Scarlet Fever. One hundred and six cases were notified during the year, thirteen being removed to hospital and the remainder home nursed. This is an increase on the twenty-nine notifications received during 1958. No deaths occurred from this disease during 1959 but there was one "return case." Generally speaking, the illness retained the milder characteristics evident in recent years. Smallpox and Vaccination. No cases of smallpox occurred in this area, but one contact was kept under surveillance for the requisite period during the year. During the year, two hundred and fifteen International Certificates of Vaccination passed through the hands of the department for purposes of authenticating doctors' signatures. The County Medical Officer informs me that a total of 1,028 residents in the Urban District received primary vaccination and 86 re-vaccination during 1959. All members of the staff of the Public Health Department have had their usual annual opportunity of being vaccinated. 53 Tuberculosis. The following is a copy of the recordings in the register at 31st December, 1959:— Respiratory. Other Forms. Total No. of cases. M. F. M. F. On register at 1st Jan., 1959 507 452 71 79 1,109 New cases notified during 1959 21 14 1 6 42 Number of cases coming to knowledge after death 1 — — — 1 Restored to register 1 — — — 1 Inward Transfers 19 25 1 — 45 549 491 73 85 1,198 Deletions, deaths, removals, recoveries, etc. 64 60 9 3 136 485 431 64 82 1,062 New Cases and Mortality, 1959. Age Groups New Cases notified or otherwise revealed. (Not including Inward Transfers)* Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. Under 5 — 1 1 — — — — — 5-14 3 — — 1 — — — — 15-24 2 3 — — — — — — 25-44 6 8 — 4 — 1 — — 45-64 6 2 — — 3 1 — — 65 and over 3 — — 1 2 — — — Age unknown 1 — — — 1 ■— — — 21 14 1 6 6 2 — — *Inward Transfers 19 25 1 — 40 39 2 6 The number of new cases of tuberculosis notified during the year was 42, and there were four deaths from this disease in 1959. This maintains the low level of new cases noted last year and is a further indication of the progress being made in the control of this disease. Chest Clinic. Dr. D. G. Madigan, Physician in Charge, has kindly furnished the following details:— 54 New cases attending the Chest Clinic for the first time during 1959:— Adults. Children, under 15 yrs. of age. M. F. M. F. Pulmonary tuberculosis 25 30 1 — Non-Pulmonary tuberculosis — 4 — 1 Non-tuberculous 50 50 38 48 New contacts examined during 1959 (not included in the above figures):— Non-tuberculous, 271. Tuberculous, 2. B.C.G. Vaccination of contacts, 96. Number of patients who completed a course of hospital or sanitorium treatment during 1959, 45. Public Health (Prevention of Tuberculosis) Regulations, 1925. Section 172, Public Health Act, 1936. No action was taken by the Local Authority under these Regulations during 1959. Mass X-ray. A Unit of the South East London Mass X-Ray Service visited the area at various times during 1959. 12,261 persons were examined ; 5,527 men and 6,734 women. 162 people with abnormalities were discovered, but of these only 50 required treatment. Further analysis of these cases showed that 44 were considered to be tuberculous, of which 18 were previously known cases, 17 required close supervision or treatment, 9 occasional supervision, and the remaining 6 were cardio vascular conditions. Although only 17 serious cases were discovered, nevertheless 17 sources of production of the tubercle bacillus have been or will be eliminated, and thus a material advance in the defeat of tuberculosis has been achieved. Whooping Cough. Fifty cases were notified during the year, as against one hundred and fifty-two cases in 1958. Thirteen cases were admitted to hospital and the remainder home-nursed. No deaths from this disease were recorded in the area during 1959. The County Medical Officer informs me that 1,192 children resident in the area were immunised against Whooping Cough during 1959. 55 Other Infectious Diseases. In addition to those previously mentioned, notifications were received as under :— Erysipelas—3 cases, two of which were admitted to hospital. Puerperal Pyrexia—60 cases (58 were institutionally treated and two home nursed). SECTION G. REFUSE COLLECTION AND DISPOSAL. 58 SECTION G. REFUSE COLLECTION AND DISPOSAL Mr. Crowe reports:— I am pleased to report that a regular weekly service of refuse collection was maintained throughout the year except for the inevitable disruption of the collections for short periods immediately prior to and following Bank Holidays. Following the Bank Holidays, particularly Easter and Christmas, the work is very heavy as in addition to the loss of working days, there is a large accumulation of refuse awaiting collection. Every endeavour is made to make up the arrears and revert to the normal day of collection and this is achieved by working overtime. The daily rounds of each refuse collecting team are arranged so that regular weekly visits are made to premises at about the same time. This is essential, in my view, if a satisfactory service is to be given, particularly in a residential district such as this, where many premises are left unoccupied during the day. Many residents like to lock their side gates and only unlock them on the day of collection. The refuse collecting teams are also keen to maintain the regular collection and working under their foreman have supported me well during the year. A special word of praise is due to the foreman for his good work and the excellent example he has shown throughout. Unfortunately, the regularity of the service has the effect of giving rise to complaints when the service is disrupted particularly at Bank holiday times. Numerous telephone calls are then received at the office but the majority of residents appreciate our difficulties and endeavours to get back to normal. Complaints are received regarding the use of skips by the collectors. A considerable saving in labour is made by this method as only one visit to each house is normally necessary. This district has many premises well back from the road and, with wide grass verges in addition to footpaths, the distance between the refuse vehicle and dustbin position at the side of the house is considerable. In addition to the collection of household refuse from some 24,000 premises, collection of trade refuse is made from approximately 236 shop premises and offices. A vehicle with driver and a collector are engaged on this work and an annual charge is made for this service. Frequent collections are made each week from the two large hospitals and weekly collections from the numerous schools, vehicles and personnel apart from the normal teams being engaged on this work. The Council owns a fleet of sixteen refuse collecting vehicles, one of which is of the dual-tip rear loading type and as replacements 59 take place, it is hoped that with the addition of more of these vehicles, the loading will be carried out in a more cleanly manner, especially on windy days. Refuse is disposed of by means of controlled tipping on low lying land of poor agricultural value at Budgin's Hill, Pratts Bottom. The refuse is deposited in layer formation, consolidated, covered and sealed in accordance with modern principles of controlled tipping, laid down by the Ministry of Housing and Local Government. The layer formations are arranged so that the final layer emerges with the contours of the site. Completed sections are covered with soil and then sown with grass seed. In this way, the beauties of the countryside are not marred and valuable pasture land is provided. Two men are employed at the tip, a Major Tractor Muledozer being used for the levelling process and approximately 19,000 tons of refuse is deposited annually. Forty-seven workmen and one foreman are engaged on the work of collection and disposal. The cost of collection and disposal compares favourably with districts of comparable size and characteristics. The costing returns of the Ministry of Housing and Local Government published in 1959 show that the net cost per 1,000 population for collection and disposal of house refuse was £531 and the net cost per 1,000 premises for collection and disposal was £1,684. The Abstract of Accounts prepared by the Council's Treasurer for the year ended 31st March, 1959, showed that on a unit basis, the cost of house refuse collection and disposal was £1 15s. 1d. per dwelling per annum. APPENDIX. STATISTICAL TABLES. 62 STATISTICAL TABLES, 1959 TABLE I—Summary of Statistics. TABLE II—Causes of Death. TABLE III—Infant Mortality. TABLE IV—Notifiable Infectious Diseases—Sex and Age Distribution. TABLE V—Notifiable Infectious Diseases—Ward Distribution. Attack and Mortality Rates. TABLE VI—Notifiable Infectious Diseases—Seasonal Incidence TABLE VII—Summary of the work of the Public Health Inspectors. TABLE VIII—Nuisances, Defects and Contraventions Abated 63 TABLE I. SUMMARY OF STATISTICS, 1959 Population (mid-year, 1959) per Registrar General 74,620 Birth Rate (Crude) 18.6 Death Rate (Crude) 10.1 Maternal Mortality Rate Nil Infant Mortality Rate 14.4 Number of Births (live) 1,388 Number of Stillbirths 21 Number of Deaths 751 Number of Maternal Deaths Nil Number of Infant Deaths (under 1 year) 20 Number of Deaths from Infectious Diseases 3 Death Rates:— Respiratory Diseases 1.43 Tuberculosis 0.05 Cancer (all forms) 2.31 Cancer of the lung 0.64 Infectious Diseases 0.04 Notifications of Infectious Diseases: Diphtheria Nil Dysentery 4 Erysipelas 3 Food Poisoning 38 Measles 1,570 Poliomyelitis (paralytic) 2 Poliomyelitis (non-paralytic) 2 Puerperal Pyrexia 60 Pneumonia (all forms) 13 Scarlet Fever 106 Tuberculosis (new cases and including Inward Transfers) 87 Typhoid and Para-typhoid Fever — Whooping Cough 50 Number of Visits made by Public Health Inspectors 7,091 64 TABLE II. CAUSES OF DEATH. 1955 1956 1957 1958 1959 Male Female Total 1. Tuberculosis—Respiratory 6 3 3 3 2 1 3 2. Tuberculosis—Other — 4 1 1 — 1 1 3. Syphilitic Diseases — 2 — 3 — — — 4. Diphtheria — — — — — — — 5. Whooping Cough — — — — — — — 6. Meningococcal Infections — — — — — — — 7. Acute Poliomyelitis 2 1 — 1 — — — 8. Measles — — 1 — -— 1 1 9. Other infective and parasitic diseases — — — 2 — 2 2 10. Malignant neoplasm, stomach 11 17 12 24 10 6 16 11. Maligant neoplasm, lung bronchus 23 34 33 38 42 6 48 12. Malignant neoplasm, breast 15 10 16 23 — 14 14 13. Malignant neoplasm, uterus 5 6 2 7 — 5 5 14. Other malignant and lymphatic neoplasms 80 64 68 66 48 41 89 15. Leukaemia, Aleukaemia 7 3 4 6 3 3 6 16. Diabetes 3 3 2 4 3 — 3 17. Vascular lesions of nervous system 74 64 73 75 39 45 84 18. Coronary disease, angina 106 111 96 133 89 50 139 19. Hypertension with heart disease 10 11 16 17 10 10 20 20. Other heart disease 60 50 61 68 25 48 73 21. Other circulatory disease 26 28 38 35 14 18 32 22. Influenza 1 2 4 2 4 1 5 23. Pneumonia 43 70 52 83 30 35 65 24. Bronchitis 31 50 31 31 22 14 36 25. Other diseases of respiratory system 5 15 5 5 3 3 6 26. Ulcer of stomach or duodenum 15 13 6 7 6 2 8 27. Gastritis, enteritis and diarrhoea 2 4 3 3 1 1 2 28. Nephritis and nephrosis 8 4 7 6 3 — 3 29. Hyperplasia of prostate 9 4 9 6 3 — 3 30. Pregnancy, childbirth, abortion — — 1 — — — — 31. Congenital malformations 3 4 7 9 5 5 10 32. Other defined and ill-defined diseases 59 48 56 60 25 30 55 33. Motor vehicle accidents 6 6 5 10 8 4 12 34. All other accidents 8 10 8 10 3 3 6 35. Suicide 5 5 8 9 2 1 3 36. Homicide and operations of war 1 2 — — — 1 1 All causes 624 648 628 747 400 351 751 65 TABLE HI. INFANT MORTALITY, 1959. (Compiled locally from Registrar's Death Returns.) CAUSES OF DEATH Under 1 Week 1 and under 2 Weeks 2 and under 3 Weeks 3 and under 4 Weeks Total under 4 Weeks 1 month and under 3 months 3 months and under 6 months 6 months and under 9 months 9 months and under 12 months Total Deaths under 1 year Atelectasis 2 — — — 2 — — — — 2 Congenital Heart Disease 4 — — — 4 — — — — 4 Prematurity 4 — — — 4 — — — — 4 Respiratory Diseases 2 1 — — 3 — — — — 3 Gastro-Enteritis — — — — — — — — 1 1 Cerebral Haemorrhage 1 — — — 1 — — — — 1 Meningitis 1 — — — 1 — — — — 1 Other Causes 2 — — — 2 2 — — — 4 Totals 16 1 — — 17 2 — — 1 20 66 TABLE IV. NOTIFIABLE INFECTIOUS DISEASES, 1959. Sex and Age Distribution. Disease Totals Under 1 1-2 3-4 5-9 10-14 15-24 25 and over Age Unknown M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Measles 768 802 19 12 151 144 190 190 385 419 13 19 4 6 - 1 6 11 Whooping Cough 19 31 3 2 5 5 4 8 5 12 2 2 — — — 1 — 1 Scarlet Fever 52 54 — — 4 1 4 4 36 42 8 7 — — — — — — Dysentery 1 3 — — — — — — — — — 1 — — 1 2 — — Poliomyelitis (Paralytic) 1 1 — — — — — — — — — — — 1 1 — — — Poliomyelitis (Non-Paralytic) 1 1 — — — — — — — — — — — 1 1 — — — 842 892 22 14 160 150 198 202 426 473 23 29 4 8 3 4 6 12 Under 5 5-14 15-24 25-44 45-64 65 and over Age Unknown M. F. M. F. M. F. M. F. M. F. M. F. M. F. Pneumonia 11 2 2 —— — — 1 — 1 -— 1 1 6 1 — — Erysipelas — 3 — — — — — — — — — — — 3 — — Food Poisoning 19 19 4 4 4 4 1 3 9 4 1 2 — 2 — — Puerperal Pyrexia — 60 — — — — — 21 — 37 — — — — — 2 Tuberculosis (Pulmonary) 21 14 — 1 3 — 2 3 6 8 6 2 3 — 1 — Tuberculosis (Non-Pulmonary) 1 6 1 — — 1 — — — 4 — — — 1 — — 52 104 7 5 7 5 4 27 16 53 8 5 9 7 1 2 894 996 67 TABLE V. NOTIFIABLE INFECTIOUS DISEASES, 1959. Ward Distribution. Attack and Mortality Rates. Diseases Total WARDS Cases removed to Hospital Attack rate per 1,000 population No. of Deaths Death rate per 1,000 population Biggin Hill Crofton South Crofton North Chelsfield Cudham Downe Farnborough Green-Street-Green Goddington South Goddington North Knockholt Knoll Leaves Green Petts Wood Poverest St. Mary Cray Measles 1570 21 267 94 1 9 14 ?6 132 211 241 14 101 5 39 104 291 9 21.04 1 0.01 Whooping Cough 50 3 2 - 1 - - 7 9 - 7 - 2 5 - 8 6 1 0.67 — —_ Scarlet Fever 106 3 17 17 — 1 7 4 3 22 6 4 8 5 3 6 13 1.42 — — Pneumonia 13 2 — 5 — — — — — — — — _ — 3 — 3 4 0.17* 65 0.87 Dysentery 4 — 2 — — — — — — — _ — 1 — — 1 — 2 0.05 — — Erysipelas 3 — 1 — — — — — — 1 — — — — — — — 2 0.04 — — Food Poisoning 38 1 21 — — _ 1 1 1 — 2 2 2 — — 4 — 3 0.50 1 0.01 Poliomvelitis (Paralytic) 2 — — 1 — — — — — — — — — — 1 — — 2 0.03 — — Poliomyelitis (Non-Paralytic) 2 -— — — - 3 — —— _ — — — 1 — — — 1 2 0.03 — — Puerperal Pyrexia 60 _— — — 1 — — 56 — — 2 — — — — 1 — 58 42.58† — — Tuberculosis (Pulmonary) 35 1 3 3 _ — 2 1 2 2 3 — — — 4 2 7 16 0.47 3 0.04 Tuberculosis (Non-Pulmonary) 7 -— 1 — — — — — — — — — — — 1 1 2 5 0.09 1 0.01 Totals 1890 31 314 120 3 13 24 95 154 236 261 20 115 10 54 124 316 117 25.33 71 0.95 † Based on 1,000 total births and not population. * Includes all forms of Pneumonia. 68 TABLE VI. NOTIFIABLE INFECTIOUS DISEASES, 1959. Seasonal Incidence. Disease Jan. Feb. March Apr. May June July Aug. Sept. Oct. Nov. Dec. Total Measles 21 118 281 603 288 187 46 16 2 3 2 3 1570 Whooping Cough 1 3 — 3 1 2 — 17 17 3 3 — 50 Scarlet Fever 7 6 4 9 10 6 13 1 2 6 22 20 106 Pneumonia — — 8 4 — 1 — — — — — — 13 Dysentery — — — — — — — — 1 — 1 2 4 Erysipelas 1 — — — — — — — — 1 — 1 3 Food Poisoning 5 5 1 3 4 2 7 2 — 3 1 5 38 Poliomyelitis (Paralytic) 1 — — — — — — — — 1 — — 2 Poliomyelitis (Non-Paralytic) 1 — — — — — — 1 — — — — 2 Puerperal Pyrexia 6 9 7 2 5 1 4 4 3 9 6 4 60 Totals 43 141 301 624 308 199 70 41 25 26 35 35 1848 69 TABLE VII SUMMARY OF THE WORK OF THE PUBLIC HEALTH INSPECTORS. No. of Inspections No. of premises at which defects or contraventions were found Housing Inspection. For defects and nuisances 823 120 Verminous conditions 9 2 Water Supply 158 — Cesspools 88 3 Common Lodging Houses 2 — Drainage 1,228 12 Under Rent Act, 1957 55 (2,363) 9 (146) Infectious Diseases. Inquiry Visits 340 — Disinfection 63 (403) (—) Food Premises. Bakehouses 27 2 Butcher 168 4 Dairies and Milkshops 12 — Fishmongers and Poulterers 24 2 Fish Fryers 18 — Food Preparing or Manufacturing Premises 41 — Greengrocers 54 1 Grocers 427 12 Ice Cream Premises 109 2 Restaurants, Hotels, Canteens 130 10 Slaughterhouses 3 — Street Vendors and Hawkers' Carts 40 3 Visits in connection with sampling 167 — Miscellaneous 484 (1,704) (36) Factories. Factories with mechanical power 66 3 Factories without mechanical power 8 1 Other premises classified as factories 23 — Emission of smoke, grit and fumes 549 (646) 5 (9) Rodent Control. Miscellaneous premises 253 (253) 201 (201) Trade Premises. Shops (for Shops Act) 382 48 Piggeries 52 1 Caravan Sites 95 — Hairdressers 54 (583) (49) 70 Miscellaneous. [/$$$] Swimming Baths 3 — Suspected Food Poisoning 42 — Keeping of Animals 14 — Noxious accumulations 3 2 Schools — — Public Conveniences 48 — Rivers, Streams, etc 13 (123) (2) Unclassified. 1,016 (1,016) (—) 7,091 443 71 TABLE VIII. NUISANCES, DEFECTS, CONTRAVENTIONS, ETC., ABATED OR REMEDIED IN 1959. Drainage. Drains repaired 2 Water closets cleansed Drains Cleansed 71 Water closets repaired or reconstructed 1 Inspection chamber covers repaired or renewed 1 Water closet seats repaired or renewed 1 Ventilation improved or repaired 4 Flushing cisterns repaired or renewed 4 Overflowing cesspools emptied 7 Water closets provided with supply of water 1 Dampness. Roofs made watertight 3 Rainwater gutters repaired or renewed 2 Walls made waterproof 5 Rainwater downpipes repaired or renewed 8 Water Supply. Main water supply provided 5 Ball valves repaired or renewed 4 Pipes repaired or renewed 3 Storage tanks repaired or renewed 1 Hot water provided to wash-hand basin 2 Hot water provided to sink 1 General Items. Wall plaster repaired 6 Chimney flues cleansed 1 Floors repaired 8 Dustbins provided 13 Rooms cleansed or decorated 11 Nuisance from animals abated 1 Windows and doors repaired 5 Noxious accummulations removed 5 Glazing repaired 2 Ventilation improved 3 Overcrowding abated 1 Fire surrounds and grates repaired or renewed 2