Mh AC 4412 (3) PENGE (1) Mr Eyne (2) Library PEN 30 PENGE URBAN DISTRICT Annual Report OF THE Medical Officer of Health TOGETHER WITH THE ANNUAL REPORT OF THE Chief Sanitary Inspector 1952 Penge Urban District Council Chairman: Councillor A. K. Cooke, J.P. Vice-Chairman: Councillor J. W. Croxon. PUBLIC HEALTH COMMITTEE, 1952-53. Chairman: Councillor A. Emery, J.P. Vice-Chairman: Councillor H. A. B. Coppard. Councillor W. J. Abery. Councillor R. J. Brown. Councillor H. T. Chapman. Councillor A. K. Cooke, J.P. Councillor J. W. Croxon. Councillor C. Jones. Councillor O. E. Prince. Councillor R. J. Rogers. Councillor H. Stander. PUBLIC HEALTH DEPARTMENT. STAFF: *Medical Officer of Health: B. E. Hawkins, M.R.C.S. (Eng.), L.R.C.P. (Lond.). Chief Sanitary Inspector: R. T. Pearce, Cert. S.I.E.B. (Lond.). Cert. Insp. of Food, S.I.E.B. (Lond.). Deputy Chief Sanitary Inspector and Shops Act Inspector: E. G. Thomas, Cert. R.S.I. Cert. Insp. of Foody R.S.I. Sanitary Inspector: H. J. Bishop, Cert. R.S.I, and S.I.E. Joint Board Cert. Insp. of Food, R.S.I. Clerks: Mrs. A. L. Sheppard. C. W. Briggs. *Part-time Officer. -ft 3 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1952. Town Hall, Anerley Road, S.E.20. June, 1953. To the Chairman and Members of the Urban District Council of Penge. Mr. Chairman and Gentlemen, I beg to present an Annual Report for the year ended 31st December, 1952, which has been compiled in accordance with Circular No. 2/53 of the Ministry of Health. The Vital Statistics of the district show a welcome improvement again this year and compare favourably with other parts of the country. The birth rate remains high, while infantile mortality and deaths from cancer and tuberculosis are lower than in previous years. There has been an increase in the deaths from respiratory diseases, but this is mainly due to the dense fog which affected this area like other parts of the Metropolitan area in early December. The high percentage of atmospheric pollution associated with this fog caused a large amount of illness among those who suffered in any way with bronchitis or other chest ailments, and especially among the elderly. Once again it is pleasing to record that there have been no maternal deaths. A high proportion of the deaths occurred among those over 65 years of age. The welfare of the old people is very well catered for by various voluntary bodies who provide meals at their homes and clubs for them to meet those of their own age, but the problem of those who are not fit enough to enter old peoples homes and are yet not really suitable for hospital still remains the biggest problem. Accommodation for cases such as the paralysed and those suffering from chronic heart disease is urgently required if these old people are not to be left in conditions which are to be deplored. There has been no case of diphtheria notified during the year, thus making a period of five years since any previous case. It cannot be too strongly emphasized, however, that immunisation remains a very essential precaution to be taken by all those who have the care of children. In this district there is quite an appreciable percentage of children who have not been immunised and it is among these that the possibility of an outbreak is feared. In these days, when diphtheria is not so common, it is possible for a case not to be recognised in its early stages with a fatal result in that case and a rapid spread of infection among the unimmunised. Of the other infectious diseases there is very little change except that measles has shown a large drop as was to be expected after the epidemic of the previous year, and the large number of cases of Sonne Dysentery which occurred in the last two months of the year and which is reported upon more fully later in the report. 4 Tuberculosis shows a decline in the number of primary cases notified, and also in the number of deaths from this disease with a corresponding decrease in the death rate. It is satisfactory to note that each year as a result of improved methods of treatment the death rate from Tuberculosis is dropping steadily and there is every hope that in years to come this progress will continue. In all, Penge can be considered to be above average in its health record in spite of its density of population with its resultant crowded housing conditions. Progress has been made and will continue with new housing projects and one hopes that as the housing situation still further improves the progress made in the figures of the Vital Statistics will be maintained. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (acres) 770 Population (Census 1931) 27,771 Population (Census 1951—provisional figure) 25,009 Home Population, Mid-Year 1952 (estimated by Registrar-General) 25,700 Rateable Value, 1st October, 1952 £205,313 Sum represented by 1d. rate £831 The district, situated on the north-west border of Kent, and immediately adjoining the Counties of London and Surrey, is on the slope of a hill, its highest point being 370 feet above sea level and the lowest 95 feet above sea level. The density of population per acre is 33.3, this being the highest in the County of Kent. The remains of the Crystal Palace and the greater part of the grounds occupying approximately 127 acres, are within the district and provide a much needed "lung" for the area. The district is mainly residential although there is an amount of light industrial work in the district, the chief industries being engineering, button making, printing and laundry work. The Manager of the Employment Exchange for the area informs me that there were approximately 200 of the working population unemployed at the end of the year. VITAL STATISTICS. Crude Live Birth Rate per 1,000 of estimated Home population 19.61 Adjusted Live Birth Rate for 1,000 of estimated Home population 19.02 Stillbirth Rate per 1,000 of estimated Home population 0.22 Stillbirth Rate per 1,000 total (live and still) births 11.76 Crude Death Rate per 1,000 of estimated Home population 11.43 Adjusted Death Rate per 1,000 of estimated Home population 10.40 Maternal Mortality Rate per 1,000 total (live and still) births Nil Death Rate of Infants Under One Year of Age. All infants per 1,000 live births 21.82 Legitimate infants per 1,000 legitimate live births 23.35 Illegitimate infants per 1,000 illegitimate live births Nil 5 Births. The live births registered during the year numbered 504. This gives a crude live birth rate of 19.61 per 1,000 Home population, compared with 20.85 for 1951. The area comparability factor calculated by the Registrar-General for the purpose of securing comparability between local birth rates is 0.97. This makes the Adjusted Birth Rate 19.02 compared with 20.22 in 1951. The birth rate for England and Wales was 15.3 and for London 17.6. Stillbirths. The number of stillbirths registered was 6, equal to a rate of 11.76 per 1,000 total births, compared with 29.35 for 1951 and 26.31 for 1950. Deaths. The deaths registered totalled 294, equal to a crude death rate for the year of 11.43 per 1,000 Home population, compared with 11.58 for 1951. The area comparability factor calculated by the Registrar-General for the purpose of securing comparability between local death rates is 0.91. This makes the Adjusted Death Rate 10.40 compared with 10.53 for 1951. The Death Rate for England and Wales was 11.3 and for London 12.6. Deaths among the inmates of an Institution for elderly men numbered 14. It should be noted that a large proportion of the deaths were of elderly people, and of the total deaths 213 or 72.4% were of persons 65 years of age and over, compared with 70.7 % the previous year. Those dying at 75 years of age and over accounted for 43.5% of the total deaths compared with 41.8% in 1951. Cancer. Deaths from cancer totalled 38 giving a death rate per 1,000 Home population of 1.47 compared with 1.93 in 1951. Tuberculosis. The death rate per 1,000 Home population was 0.27 as against 0.39 in 1951 and 0.43 in 1950. Maternal Mortality. For the third year in succession there was no maternal death. The maternal mortality rate for England and Wales was 0.72 per 1,000 total (live and still) births, compared with 0.79 in 1951. Infantile Mortality. The number of deaths under one year was 11, corresponding to a rate of 21.82 per 1,000 births compared with a rate of 24.57 for 1951. The infantile mortality rate for England and Wales was 27.6 and for London 23.8. Six of the 11 infants died under the age of one week, and four died from congenital malformations. 6 Comparative Vital Statistics. The following table shows the comparative figures for 1952:— Rate per 1,000 Home Population Death Rate per 1 ,000 Home Population Deaths under 1 year per 1,000 live Births Live Births Still Births Penge Urban District 19.0 0.22 10.14 21.8 England and Wales 15.3 0.35 11.3 27.6 160 County Boroughs and Great Towns including London 16.9 0.43 12.1 31.2 160 Smaller Towns (resident populations, 25,000 to 50,000 at Census, 1951) 15.5 0.36 11.2 25.8 London Administrative County 17.6 0.34 12.6 23.8 SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The water supply of the area has been satisfactory both in quality and quantity, all the houses in the district being provided with a constant service of water by the Metropolitan Water Board, the water being examined bacteriologically daily by the Board. In addition, the County Pathologist reports that the samples of water submitted to him quarterly were good. The majority of the premises are directly connected to the rising main. Four storage cisterns were renewed, cleansed or covered. Drainage and Sewerage. All the premises in the district are connected to the public sewers, the sewerage of Penge going through the Metropolitan Borough of Lewisham into the London County Council's sewers, and part of the surface water into a local stream which is culverted. No important additions to existing works of sewerage have been made during the year. Rivers and Streams. There are no rivers in the district. There is a stream forming part of the boundary between Penge and Beckenham, the whole of which is culverted. Closet Accommodation. The whole of the premises in the area are provided with waterclosets connected to the main drainage system. 7 Public Cleansing. House refuse was collected throughout the district once every week by the Council's refuse collection service using modern vehicles and the refuse taken for disposal to the Beckenham destructor. Trade refuse is also dealt with and there is a regular collection of pig food from bins placed in the various roads. There are no cesspools in the district. Sanitary Inspection of the Area. This subject is dealt with under the heading of Housing and in the Report of the Chief Sanitary Inspector. HOUSING. The erection of 38 flats by the local authority was completed during the year. Private builders erected 8 dwellinghouses and 4 maisonettes. 1. Inspection of Dwellinghouses during the Year:— (1) (a) Total number of dwellinghouses inspected for housing defects (under Public Health or Housing Acts) 766 (b) Number of inspections made for the purpose 828 (2) (a) Number of dwellinghouses (included in subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 26 (b) Number of inspections made for the purpose 26 (3) Number of dwellinghouses found not to be in all respects reasonably fit for human habitation 710 2. Remedy of Defects without Service of Formal Notices: Number of defective dwellinghouses rendered fit in consequence of informal action by the Local Authority and their officers 601 3. Action under Statutory Powers: Proceedings under Public Health Acts:— (1) Number of dwellinghouses in respect of which notices were served requiring defects to be remedied 109 (2) Number of dwellinghouses in which defects were remedied after service of formal notices:— (a) by Owners 99 (b) by Local Authority in default of Owners 10 4. Housing Act, 1936—Overcrowding. Although progress has again been made in the erection of houses, maisonettes and flats, there still remains an amount of overcrowding in the district. The Housing Manager reports that 103 families living in overcrowded or unsatisfactory conditions were rehoused during the year. 8 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Diphtheria. For the fifth year in succession no cases of diphtheria occurred in the district. Diphtheria Immunisation. The following is a return of the number of children resident in the district who were immunised against diphtheria during the year:— Children born 1948-1952 Children born 1938-1947 Totals Primary inoculations 422 62 484 Reinforcing 28 342 370 Penge children under the age of 15 years on the 31st December, 1952, who had completed a course of immunisation at any time before that date were as follows:— Aged 0-4 years inclusive 1,538 ,, 5-14 „ „ 3,415 Smallpox. No case was notified and no Penge contacts of cases occurring elsewhere were reported. The following shows the number of Penge residents who were vaccinated against smallpox during the year:— Age at 31/12/52. Under 1 1 to 4 5 to 14. 15 or over Total. Vaccinated 169 137 13 17 336 Re-vaccinated — 1 7 50 58 Scarlet Fever. There were 33 cases of Scarlet Fever notified (as against 43 in 1951) and 23 were removed to hospital. The disease generally was of a mild type and there were three "return" cases. No deaths were recorded. Meningococcal Infection. Four cases were notified and received hospital treatment. One of these cases died and a further death occurred from this disease, the cause being ascertained as a result of a post-mortem examination. Poliomyelitis. No case occurred during the year. 9 Sonne Dysentery. For the first ten months of the year eight cases of Sonne Dysentery were notified, all of them isolated cases. In November the receipt of two notifications revealed a number of children in two local schools with a recent history of some slight intestinal disturbance. Investigations were at once started and a number of these were found to be positive Sonne. A contact of a case in another district was found positive and gave a history of diarrhoea during the summer holidays. This child was a pupil at one of the two schools first investigated. As a result of examination of faecal specimens from all contacts and suspects the outbreak was found to be widespread and in all by the end of the year cases totalling 161 had been found in 76 families. Another 140 families were visited and specimens taken. A total of 1,108 specimens, of which 317 were positive and 791 negative, were obtained by the end of the year. The outbreak was characterized by the mild degree of symptoms, often only diarrhoea for a day, and the persistence of the infection in some cases in spite of medical treatment. Also the rapid spread of infection in families, especially in large ones, and in those whose standard of personal hygiene was not of the highest. It was decided from the start that two negative specimens at weekly intervals were to be obtained before a case was considered clear, and the value of this was shown by the number of cases where the first negative was followed by a further positive specimen. The persistence of the infection is shown by the fact that one case has had 23 specimens taken at weekly intervals, while many others varied between 5 and 20. With regard to size of family, 19 households totalling 138 persons provided 78 cases, the highest being one of twelve with eleven cases, and one of eleven with nine cases. Children of school age provided 81 of the cases, and children under 5 years a further 35, while the age group 15-44 years added another 40. The outbreak continued in to 1953 until April, by which time a total of 276 cases had occurred. Measles. Cases notified totalled 71, compared with 468 cases the previous year. There were no deaths from this disease. Whooping Cough. Cases were notified throughout the year and totalled 127 compared with 107 cases in 1951. Disinfection. Verminous rooms disinfested 120 Rooms fumigated 68 Mattresses disinfected 75 Blankets disinfected 164 Pillows disinfected 125 Miscellaneous articles disinfected 139 10 NOTIFIABLE DISEASES (Other than Tuberculosis) during the year 1952. Disease Total Cases notified Cases admitted to Hospitals Total Deaths Scarlet Fever 33 23 — Pneumonia 12 1 19 (all forms) Meningococcal Infection 4 4 2 Erysipelas 8 — — Measles 71 — — Whooping Cough 127 3 — Dysentery 169 3 — Tuberculosis. No action was necessary under the Public Health (Prevention of Tuberculosis) Regulations, 1925, or under Sec. 172, Public Health Act, 1936. Total Primary cases notified Total Cases admitted to Sanatoria and Hospitals Total Deaths Pulmonary (Males) 13 21 7 „ (Females) 12 17 — Totals 25 38 7 Non-Pulmonary (Males) 2 - - ,, ,, (Females) 4 2 — Totals 6 2 — All of the deaths from Tuberculosis were of cases which had been notified. 11 NEW TUBERCULOSIS CASES AND MORTALITY DURING 1952. Age Period *New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary m f m f m f m F 0—1 - - - - - - - - 1—5 1 1 - - - - - - 5—15 3 — — 1 — — — — 15—25 5 6 — 1 — — - - 25—35 5 6 1 1 — — — - 35—45 4 1 — — 1 — — — 45—55 3 1 — — 1 — - - 55—65 2 1 1 — 4 — — - 65 and upwards — — — — 1 — — — Totals 23 16 2 3 7 — — — *Cases previously notified in other districts and transferred to Penge and those restored to the Register are included in these figures. There were 320 cases of tuberculosis on the Register at the end of the year, compared with 296 in 1951. Male Female Total Pulmonary 145 135 280 Non-Pulmonary 17 23 40 162 158 320 There were 7 deaths from tuberculosis and two tubercular cases on the register died from other causes during the year. NATIONAL ASSISTANCE ACT, 1948. On occasions difficulty was experienced in obtaining admission to institutions of aged persons suffering from chronic illness and in need of care and attention. Until sufficient institutional accommodation and staff are provided for the chronic aged sick living alone, the proper care of these elderly people will remain a serious problem, particularly those who are not considered suitable for admission to a residential home for aged people and those whose condition the hospital authorities do not consider warrant admission to hospital. Under Section 50 of the Act, it is the duty of the local authority to arrange for the burial or cremation of the body of any person who has died in their area if it appears that no suitable arrangements for the disposal of the body have or are being made. During the year four bodies were dealt with by the Council under these provisions. 12 FOOD. Regular inspections of food shops, restaurants and stores have been made and advice given in hygienic food preparation and handling, particular stress being paid to the importance of personal hygiene. At the beginning of the year food traders were supplied with printed notices to display in their shops requesting customers, in the interests of hygiene, not to bring dogs into the premises. There is no doubt that the hygienic storage and handling of food has shown improvement. As will be seen in the Ghief Sanitary Inspector's Report, a considerable amount of food has been surrendered by the food traders and their applications for examinations to be made of foodstuffs of which they are doubtful as to the fitness helps to safeguard the purity of the food supply. A large amount of meat and bacon is sent from food stores in other districts to a local food factory for manufacturing purposes and requires carefui examination and trimming before being used. This entails frequent visits being made. No animals were slaughtered in the district. Food Poisoning. No cases of food poisoning were notified during the year. A set of posters illustrating the causes of and advice on how to prevent food poisoning was exhibited in a prominent position in the Public Library. My thanks are due to the Chairman and Members of the Public Health Committee for their cordial support during the year, and also to the staff of the Public Health Department for their ready co-operation. I am, Mr. Chairman and Gentlemen, Your obedient Servant, B. E. HAWKINS, Medical Officer of Health. 13 Notifiable Diseases (other than Tuberculosis) during the Year 1952. Cases Notified at ages—years Cases admitted to Hospitals At all ages Under 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 20 20 to 35 35 to 45 45 to 65 65 and upw'ds Scarlet fever 33 - - 6 3 5 18 - - 1 - - - 23 Dysentery 169 4 13 10 8 25 49 13 5 28 10 3 1 3 Measles 71 1 14 7 6 9 32 — — 1 1 - - - Whooping Cough 127 6 31 19 10 38 19 1 - 3 - - - 3 Pneumonia 12 — — — 1 — 2 1 — - 2 4 2 1 Erysipelas 8 - - - - - - - - - 3 4 1 - Meningococcal Infection 4 2 - - - - - - - - - - - 4 Totals 424 13 58 42 28 78 120 15 5 34 16 11 4 34 Deaths of notified cases:—2 Pneumonia, aged 78 and 89 years. 1 Meningococcal Infection, aged 3 months. BIRTH-RATES, DEATH-RATES AND ANALYSIS OF MORTALITY IN THE YEAR 1952. Rate per 1,000 Home Population Annual Death Rate per 1,000 Home Population Rate per 1,000 Live Births Live Births Still Births All Causes Typhoid Fever Small-pox Acute Poliomyelitis & Polioencephalitis Tuberculosis Whooping Cough Diphtheria Influenza Pneumonia Total Deaths under one year Penge U.D. 19.0 0.22 10.4 — — — 0.27 — — 0.07 0.73 21.8 England and Wales 15.3 0.35 11.3 0.00 0.00 0.01 0.24 0.00 0.00 0.04 0.47 27.6 160 County Boroughs and Great Towns including London 16.9 0.43 12.1 0.00 - 0.01 0.28 0.00 0.00 0.04 0.52 31.2 160 Smaller Towns (Resident Populations, 25,000 to 50,000 at Census 1951) 15.5 0.36 11.2 0.00 - 0.00 0.22 0.00 0.00 0.04 0.43 25.8 London Administrative County 17.6 0.34 12.6 — — 0.01 0.31 0.00 0.00 0.05 0.58 23.8 A (—) signifies that there were no deaths. 14 PART I, FACTORIES ACT, 1937. 1. Inspections for purposes of provisions as to health. Premises Number on 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 25 47 4 - (II) Factories not included in (1) in which Section 7 is enforced by the Local Authority 93 145 9 - (III) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 8 15 4 - Total 126 207 17 — 2. Cases in which Defects were found. Particulars. Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S. 1) 4 4 - 2 - Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — —- — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) - - - - - Sanitary conveniences (S.7) (a) insufficient 5 5 — 4 — (b) unsuitable or defective 6 6 — 5 — (c) not separate for sexes — — — — — Other offences (not including offences relating to Outwork) 11 11 — 1 — Total 26 26 — 12 — PART VIII, FACTORIES ACT, 1937—OUTWORKERS. In the August list required by Section 110, five outworkers employed in making wearing apparel were notified. -There were no defaults or prosecutions. There were no instances of work in unwholesome premises (Section 111). 15 CAUSES OF DEATH IN PENGE URBAN DISTRICT, 1952 Registrar-General's Figures. CAUSES OF DEATH MALES FEMALES All Causes 161 133 1. Tuberculosis, respiratory 7 — 2. Tuberculosis, other — — 3. Syphilitic disease — 1 4. Diphtheria — — 5. Whooping Cough — — 6. Meningococcal infections 1 1 7. Acute Poliomyelitis — — 8. Measles — — 9. Other infective and parasitic diseases — 1 10. Malignant neoplasm, stomach 3 4 11. Malignant neoplasm, lung, bronchus 12 2 12. Malignant neoplasm, breast — 1 13. Malignant neoplasm, uterus — 1 14. Other malignant and lymphatic neoplasms 8 7 15. Leukaemia, aleukaemia - 1 16. Diabetes 1 1 17. Vascular lesions of nervous system 11 15 18. Coronary disease, angina 21 14 19. Hypertension with heart disease 3 4 20. Other heart disease 29 31 21. Other circulatory disease 4 5 22. Influenza 1 1 23. Pneumonia 10 9 24. Bronchitis 18 6 25. Other diseases of respiratory system 4 3 26. Ulcer of stomach and duodenum 2 1 27. Gastritis, enteritis and diarrhoea 1 1 28. Nephritis and nephrosis 1 2 29. Hyperplasia of prostate 3 - 30. Pregnancy, childbirth, abortion — - 31. Congenital malformations 1 3 32. Other defined and ill-defined diseases 16 13 33. Motor vehicle accidents — 1 34. All other accidents 2 3 35. Suicide 2 1 36. Homicide and operations of war — - Deaths of infants under 1 year Total 6 5 Legitimate 6 5 Illegitimate — — Live Births Total 252 252 Legitimate 236 235 Illegitimate 16 17 Stillbirths Total 2 4 Legitimate 1 4 Illegitimate 1 — Home population (estimated middle of 1952 R.G.) 25,700 16 ANNUAL REPORT OF THE CHIEF SANITARY INSPECTOR for the year 1952. Town Hall, Anerley Road, S.E.20. June, 1953. To the Chairman and Members of the Urban District Council of Penge. Mr. Chairman and Gentlemen, I have the honour to place before you my twenty-fifth Annual Report on the work of the Sanitary Inspectors for the year ended 31st December, 1952. Some owners of property are very reluctant to execute repairs and in consequence occupiers are compelled to lodge complaints with the department for action to be taken to improve the conditions under which they live. During the year 957 complaints (excluding those in connection with rodent infestation) were received, the majority being concerned with housing defects. All complaints are investigated and appropriate action taken when found necessary. The cost of executing repairs is considerably higher than in 1939, and when one considers that the standard rents (excluding rates) of houses are the same now as in that year, it is perhaps not surprising to find owners reluctant to carry out the same amount of work as they formerly did. In addition to verbal intimation of defects in premises, 569 written informal notices and 118 statutory notices were served under the Public Health Act, 1936. Four hundred and fifty-one intimation notices and 108 statutory notices were complied with. The Local Authority, in default of the owners, had carried out the works required by one statutory notice served under Section 94 of the Public Health Act, 1936, two notices served under Section 75, six notices served under Section 39, and one notice under Section 138. The Council also did the work required by 12 notices served under Section 24 of the Public Health Act, 1936, respecting defective public sewers (previously known as combined drains) at 15 premises. A large amount of repair work has been done following action taken by your Inspectors, as will be seen on reference to the list of work executed. It is only after every endeavour has been made informally to have notices complied with that statutory action is taken. In some cases delay was again experienced in getting repairs executed owing to prolonged negotiations between owners and the War Damage Commission. 17 In twenty-eight cases repairs were not executed until legal proceedings against the owners were either threatened or taken. It was found necessary to institute legal proceedings against two owners in order to abate nuisances caused by housing defects with the following results:— Case No. 1.—Nuisance Order made to do work in three months and pay £1 9s. 6d. costs. Case No. 2.—Nuisance Order made to do work in twenty-one days and pay £1 12s. 6d. costs. In both cases the Orders were complied with. The owners of eleven premises appealed against notices served under Section 75, Public Health Act, 1936, requiring the provision of dustbins. The Justices dismissed the first five appeals whereupon the appellants withdrew their appeals in the remaining six cases and subsequently provided the necessary dustbins. Another owner appealed against a similar notice, but during the hearing of the case he asked permission to withdraw his appeal, to which the Justices agreed. He subsequently provided a dustbin. An appeal by an owner's agent was made to the Queen's Bench Division of the High Court of Justice against a Nuisance Order made by the Local Justices in 1951. The appeal was heard by the Lord Chief Justice (Lord Goddard), Mr. Justice Jones and Mr. Justice Parker. They dismissed the appeal with costs against the appellant. The work required by the Nuisance Order was thereupon carried out. Three applications for certificates that houses were not in a reasonable state of repair were received and granted under the Rent Restriction Acts. The drainage systems of 56 premises were wholly or partially relaid and 93 cleared of obstructions. Disinfestation of 120 rooms found to be verminous was carried out and 19 wasps nests destroyed. Five licences to deal in game were issued during the year. In November and December, during the outbreak of dysentery, a great deal of your Inspectors' time was taken up in visiting cases and contacts, obtaining specimens of faeces therefrom periodically and in the multifarious duties arising in connection with the control of the outbreak. 18 SUMMARY OF INSPECTIONS AND VISITS The following summary shows the number of visits and inspections made:— Inspections through complaints received 957 Housing Act 35 Overcrowding and measurement of rooms 38 Infectious diseases 665 Houses-let-in-Lodgings and Common Lodging Houses 140 Bakehouses 84 Dairies 103 Meat Shops 197 Fish frying Shops 47 Ice cream shops 105 Cafes and restaurants 179 Food factories 198 Other food shops, stores and stalls 528 Public conveniences 98 Stables 40 Rats and Mice 193 Factories 207 Outworkers 24 Schools 17 Smoke observations 28 Drain tests 238 Keeping of animals 22 Food and water sampling 191 Movable dwellings 14 Rag Flock and Pet Animals Acts 29 Transferable deaths 109 Revisits and inspections of works in hand 3,751 Miscellaneous visits 222 Shops Acts inspections and patrols 469 SUMMARY OF WORK EXECUTED DURING THE YEAR. Water Supply:— Water supply reinstated to houses 12 Water service pipes repaired 30 Cisterns cleansed, covered or covers repaired 4 Water Closets:— New pans and traps fixed 29 Flushing apparatus renewed or repaired 24 Foul pans and traps cleansed 5 Connection of flushing pipes to pans made good 10 Seats and doors provided or repaired 27 Ventilation provided or improved 3 Walls repaired 5 Flooring or paving repaired 5 Artificial lighting provided 4 19 Drainage:— Drains tested with smoke, water or colour 238 Drains cleared 93 Houses redrained 3 Houses with drains partially relaid 53 Inspection chambers constructed or improved 25 Soil and ventilation pipes fixed or repaired 7 Sinks, lavatory basins and baths provided 11 Sink fillets repaired 3 Waste pipes renewed or provided 14 Waste pipes repaired or trapped 20 Waste pipes cleared 13 Fresh-air-inlets provided or repaired 3 Dampness—Houses with:— Walls repointed or rendered 27 Dampness in ground floor rooms remedied 57 Roofs repaired 134 Gutters repaired or renewed 39 Rainwater pipes repaired or renewed 27 Ventilation under floors provided or improved 5 Water service pipes repaired 30 Window sills repaired 32 Cleanliness:— Dirty rooms, etc., cleansed 428 Verminous rooms disinfected 120 Miscellaneous:— Houses with floors, joists, etc., repaired 70 Houses with skirtings repaired 15 Houses with plaster repaired 134 Houses with new sashlines provided to windows 22 Houses with window frames, etc., repaired 47 Houses with yard or forecourts paved or repaired 11 Houses with scullery paving repaired 6 Houses with chimneys repaired 28 Houses with airbricks renewed 9 Houses with stairs repaired 6 Houses with front and back steps repaired 10 Houses with fireplace jambs and mantels repaired 7 Houses with brickwork repaired 12 Kitchen stoves repaired or renewed 7 Scullery coppers repaired or renewed 3 Other stoves repaired or renewed 46 Hearths renewed or repaired 4 Doors and frames repaired or renewed 20 Ventilation and lighting of rooms improved 12 New dustbins provided 85 Premises with miscellaneous defects repaired 18 Animal nuisances abated 5 Accumulations removed 18 Smoke nuisances abated 2 Wasps nests destroyed 19 20 INSPECTION AND SUPERVISION OF FOOD The supervision of premises and stalls where foods are prepared, stored or exposed for sale has been regularly carried out, 1,496 visits being made in this connection. In a few cases warnings were given relating to contraventions of the byelaws made under Section 15, Food & Drugs Act, 1938, but in no case was it found necessary to take statutory action. Various improvements have been made in food shops particularly in regard to the hygienic storage and display of meat products, and the provision of a constant supply of hot water. Your sanitary inspectors continued to give advice to occupiers of food premises on matters relating to food and general hygiene. Communications were sent to the occupiers of 14 food premises regarding defects found, and in each case the work was carried out after informal action. The attention of the department was drawn on a few occasions to the presence of a foreign body in, or contamination of, food purchased in the district. The shopkeepers concerned were interviewed and the circumstances fully investigated. In each case a warning was given. The amount of food surrendered and condemned as unfit for human consumption after examination by your inspectors was 4 tons, 6 cwts., 2 qrs., 2 lbs. The foods condemned were as follows:— Bacon 3,296 lbs. Peas 15¾ lbs. Beef 2,390 „ Pork 224½ „ Biscuits 5 „ Rabbits 150 „ Butter 224 „ Sausage casings 6 „ Cheese 103¾ „ Sugar confectionery 107 „ Chickens 109 „ Whalemeat 60 „ Dried fruits 489 „ Bottled fruit 1 bot. Fish 766 „ Coffee 51 bots. Flour 306 „ Eggs 1,474 Ham 6 „ Pickles 53 bots. Honey ½ „ Tinned fish 10 tins Jam 5½„ Tinned fruit 233 „ Lard 212 „ Tinned meat 209 „ Liver 80 „ Tinned milk 17 „ Margarine 180 „ Tinned sausages 3 „ Mutton 457 „ Tinned soup 82 „ Ox Hearts 137 „ Tinned tomato juice 9 „ Tinned vegetables 152 „ Condemnation certificates totalled 252. The co-operation of the food traders in bringing to the notice of the department the existence of suspected unsound food has been maintained. 21 Milk Supply. There are no cowsheds or pasteurising plants in the district. All milk sold in the district is special designated milk in sealed containers. Milk (Special Designations) Orders. The following licences were issued:— Dealers' Licences: Tuberculin tested milk 5 Pasteurised milk 8 Sterilised milk 15 Supplementary Licences: Tuberculin tested milk 6 Pasteurised milk 6 Sterilised milk 5 Milk Sampling. Samples of milk submitted to chemical analysis totalled 60 and all proved to be genuine. The samples gave the following averages:— Fat—3.54% (standard 3.0%). Solids not fat—8.85% (standard 8.5%). Thirty-seven samples of pasteurised milk and fourteen samples of tuberculin tested (pasteurised) milk were submitted to the Phosphatase test and they all satisfied the test. Forty-five of these samples also satisfied the Methylene Blue test, the testing of the other six samples being invalid as the atmospheric shade temperature at the time was in excess of 65° F. Nine samples of sterilised milk were examined and satisfied the Turbidity test. Ice-Cream. There are no manufacturers in the district, but a large number of premises are registered for the sale of ice-cream, the shopkeepers obtaining their supplies from well-known manufacturers. In the great majority of cases the ice-cream is delivered to the premises and sold in cartons or wrapped. Sixty-seven samples of ice-cream were taken and submitted to the Methylene Blue test with the following results:— Grade 1—54; Grade 2—8; Grade 3—4; Grade A—1. Where samples were found to be in Grades 3 or 4 the dealers concerned were given advice regarding precautions to be observed and in each case subsequent samples were found to be satisfactory. Slaughterhouses. No animals were slaughtered in the district. 22 Bakehouses. Defects found in one bakehouse were remedied after informal action. Adulteration. The Kent County Sampling Officers took 110 samples of various foods and drugs in this district. Included in the total were 30 samples of milk, 17 of drugs and 10 of spirits. All the samples were genuine with the exception of the following:— Article: Analysis: Remarks: Pork Sausages 18.5% deficient in meat Pork Sausages 24.6 % deficient in meat No action was taken concerning these samples because the evidence as to whether the sample was representative of a very large bulk delivery was not satisfactory. Follow-up samples which were taken were genuine. Milk Contained 5.5% added water Written caution. Cut Mixed Peel Sugar 40 % (should be 60%) Very old stock. Further sample unobtainable. Your inspectors obtained 60 informal samples of milk, the Analyst reporting all samples to be genuine. FACTORIES ACTS, 1937 and 1948 Visits paid to factories totalled 207 and in addition to verbal intimations regarding small defects, 17 written notices were served and complied with. These dealt mainly with insufficient and defective sanitary conveniences and want of cleanliness. Notices were received in respect of 19 Penge residents who were employed in certain trades in their own homes but working for occupiers of factories in other districts. In no case was it found that work was being done in unwholesome premises. PREVENTION OF DAMAGE BY PESTS ACT, 1949. Complaints numbering 246 were received from all parts of the district and investigated. In no case was a major infestation discovered, and this is no doubt due to the employment of a rodent operative during recent years. Rats are prolific breeders, however, and constant action against them is necessary. In several cases defective drains and sewers were the cause of rat infestation and the keeping of animals contributed to the number of infestations. When considered necessary the drains of premises were tested with smoke and colour and all defects found made good. 23 The foul-water sewers were treated during June, 1952, and February, 1953, pre-bait and poisoned bait being laid in the manholes and side entrances. In June, 325 manholes were baited and pre-bait takes recorded in 84. The second treatment of the sewers due in December was not done until February, 1953, owing to the pressure of work in connection with the outbreak of dysentery in the district. The figures for this treatment were 330 manholes baited and pre-bait takes recorded in 127, the longer interval between the treatments no doubt contributing to the increased number of takes. One full-time rodent operative is employed and the following is a summary of the work carried out by him at premises in the district:— Inspections and re-inspections made 3,480 Premises treated for rats 345 Premises where rat poison bait taken 292 Premises re-treated for rats 281 Estimated number of rats poisoned 1,067 Number of rats trapped 10 Premises treated for mice 91 Premises re-treated for mice 77 It was necessary to treat some premises on three or more occasions and the total treatments for the destruction of rodents numbered 794. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 This Act and Regulations made thereunder came into force on the 1st November, 1951. The object of the Act is to secure the use of clean filling materials in upholstered articles and other articles which are stuffed or lined. Four premises are registered in connection therewith. Following a complaint regarding the rag flock of a mattress manufactured in this district, the mattress was returned to the makers and a sample taken therefrom. The prescribed Analyst under the Act reported that the tests showed the sample to be satisfactory and complied with the requirements of the regulations. MOVABLE DWELLINGS. The camping and caravan site of nearly three acres in the Crystal Palace Grounds, managed by and under the joint auspices of the Camping and Caravan Clubs of Great Britain and Ireland during the period of the Festival of Britain in 1951 was re-established during 1952. Suites of waterclosets and lavatory basins are provided in a brick building on the site, and as before suitable arrangements were made for the collection and disposal of refuse, etc. Agreement was reached regarding the provision of additional drainage facilities for the disposal of waste water and the work in this connection was carried out early in 1953. Periodical inspections were made of the camp and no cause for complaint arose during the year. 24 PET ANIMALS ACT, 1951. This Act came into force on the 1st April, 1952, and regulates the sale of pet animals. Licences were granted to three applicants subject to conditions laid down by the Council, these conditions being based on those recommended by the R.S.P.C.A. In one instance a warning was given regarding a contravention of the conditions of licence. SHOPS ACT, 1950. YOUNG PERSONS (EMPLOYMENT) ACT, 1938. Mr. E. G. Thomas, Deputy Chief Sanitary Inspector and Shops Act Inspector, reports as follows:— Number of visits made 388 Number of evening patrols carried out 57 Number of Sunday patrols carried out 24 Number of premises where young persons employed 19 Number of premises where official forms relating to staff not posted up 22 Number of "mixed shops" where poster relating to Sunday trading not exhibited 7 Letters of warning were sent with reference to contravention of the Acts relative to the non-exhibition of forms relating to "mixed shops" when open for Sunday trading, and for failing to post up official forms regarding employment of shop assistants and young persons. During the year the "war time" provisions relative to the hours of evening closing of shops were revoked. I should like to express my thanks to the Chairman and Members of the Public Health Committee for their courtesy and assistance and to the Staff for their great help and efficient service during the year. I am, Mr. Chairman and Gentlemen, Your obedient servant, R. T. PEARCE, M.S.I.A., Chief Sanitary Inspector.