PEN 31 PENGE URBAN DISTRICT Annual Report OF THE Medical Officer of Health together with THE ANNUAL REPORT of the Chief Sanitary Inspector 1953 Penge Urban District Council Chairman: Councillor F. A. Smith, J.P. Vice-Chairman: Councillor A. K. Cooke. PUBLIC HEALTH COMMITTEE, 1953-54. Chairman : Councillor A. Emery, J.P. Vice-Chairman : Councillor E. A. Martin-Clark. Councillor W. J. Abery. Councillor C. Jones. Councillor J. W. Aldridge. Councillor R. J. Rogers. Councillor R. J. Brown. Councillor F. A. Smith, J.P. Councillor H. T. Chapman. 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 Food, 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 3 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953. Town Hall, Anerley Road, S.E.20. June, 1954. 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, 1953, which has been compiled in accordance with Circular No. 1 /54 of the Ministry of Health. Once again the Vital Statistics for Penge compare favourably with those for other parts of the country. The birth rate still remains above that of the whole of the country, while the death rate is lower. The percentage of persons over 75 years of age at death continues to show a small increase. It is to be regretted that for the first time for four years a maternal death has to be recorded. Once again it is a pleasure to record the valuable work done by various voluntary bodies in the provision of welfare services to the old people in the form of clubs, provision of meals, and general help in their difficulties in the home. Some difficulty is still present in obtaining institutional treatment for those cases that require it. There has again been no case of diphtheria notified during the year, thus making it the sixth consecutive year without a case. The immunisation of children is each year being proved to be a very valuable protection against the disease. In spite of this there are in the district too many children who are unprotected and amongst whom it is quite possible for an outbreak to occur as has happened in other parts of the country. Today diphtheria is not so well known to parents and those having the custody of children as it was some twenty years ago, and there is a tendency among some to regard immunisation as an unnecessary precaution, a line of thought which might have tragic consequences. Elsewhere in the report reference is made to the large number of measles cases and to the final stages of the outbreak of Sonne dysentery, which commenced in November of the previous year. Clean food in all its aspects received publicity during the year, both from the Urban District Council and from other quarters. A few cases of food poisoning were notified during the year, further details of which appear elsewhere. I would, however, stress here that clean food can only be obtained by scrupulous attention to hygiene not only in the manufacture and in the retailing, but also in the home, both in the preparation and in the storage of the food. Further progress has been made during the year with new housing projects, and this factor with the resultant lessening of overcrowding should continue to produce satisfactory figures as regard the health of Penge. 4 STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (acres) 770 Population (Census 1931) 27,771 Population (Census 1951) 25,012 Home Population, Mid-Year 1953 (estimated by Registrar-General) 25,510 Rateable Value, 1st October, 1953 £207,138 Sum represented by Id. rate £834 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, the highest point being 370 feet above sea level and the lowest 95 feet above sea level. The density of population per acre is 33.1, this being the highest in the County of Kent. The remains of the Crystal Palace and the greater part of the grounds, occupying 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 130 men and 60 women registered as unemployed at the end of the year. VITAL STATISTICS. Crude Live Birth Rate per 1,000 of estimated Home population 20.97 Adjusted Live Birth Rate for 1,000 of estimated Home population 18.87 Stillbirth Rate per 1,000 of estimated Home population 0.70 Stillbirth Rate per 1,000 total (live and still) births 32.55 Crude Death Rate per 1,000 of estimated Home population 11.32 Adjusted Death Rate per 1,000 of estimated Home population 10.52 Maternal Mortality Rate per 1,000 total (live and still) births 1.80 Death Rate of Infants under One Year of Age. All infants per 1,000 live births 22.43 Legitimate infants per 1,000 legitimate live births 23.71 Illegitimate infants per 1,000 illegitimate live births Nil Births. The live births registered during the year numbered 535. This gives a crude live birth rate of 20.97 per 1,000 Home population, compared with 19.61 for 1952. The area comparability factor calculated by the Registrar-General for the purpose of securing comparability between local birth rates is 0.90. This makes the Adjusted Birth Rate 18.87 compared with 19.02 in 1952. The birth rate for England and Wales was 15.5 and for London 17.5. 5 Stillbirths. The number of stillbirths registered was 18, equal to a rate of 32.55 per 1,000 total births, compared with 11.76 for 1952 and 29.35 for 1951. Deaths. The deaths registered totalled 289, equal to a crude death rate for the year of 11.32 per 1,000 Home population, compared with 11.43 for 1952. The area comparability factor calculated by the Registrar-General for the purpose of securing comparability between local death rates is 0.93. This makes the Adjusted Death Rate 10.52 compared with 10.40 for 1952. The Death Rate for England and Wales was 11.4, and for London 12.5. Deaths among the inmates of an Institution for elderly men numbered 10. A large proportion of the deaths were of elderly people, and of the total deaths 197 or 68.1 % were of persons 65 years of age and over, compared with 72.4% the previous year. Those dying at 75 years of age and over accounted for 43.9% of the total deaths compared with 43.5% in 1952. Cancer. Deaths from cancer totalled 48 giving a death rate per 1,000 Home population of 1.88 compared with 1.47 in 1952 and 1.93 in 1951. The rate for England and Wales was 1.99. Tuberculosis. The death rate per 1,000 Home population was 0.35 against 0.27 in 1952 and 0.39 in 1951. Maternal Mortality. There was one maternal death during the year, equal to a rate of 1.80 per 1,000 (live and still) births. This was the first maternal death since 1949. The rate for England and Wales was 0.76 compared with 0.72 in 1952. Infantile Mortality. The number of deaths under one year was 12, corresponding to a rate of 22.43 per 1,000 births compared with a rate of 21.82 for 1952. The infantile mortality rate for England and Wales was 26.8 and for London 24.8. Eleven of the twelve infants died under the age of four weeks, three of whom died from congenital malformations. 6 Comparative Vital Statistics. The following table shows the comparative figures for 1953. 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 18.8 0.70 10.5 22.4 England and Wales 160 County Boroughs and Great Towns including 15.5 0.35 11.4 26.8 London 17.0 0.43 12.2 30.8 160 Smaller Towns (resident populations, 25,000 to 50,000 at Census, 1951) 15.7 0.34 11.3 24.3 London Administrative County 17.5 0.38 12.5 24.8 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 26 flats by the local authority was completed during the year. Private builders erected 22 dwellinghouses and converted four houses into 6 flats and one maisonette. 1. Inspection of Dwellinghouses during the Year:— (1) (a) Total number of dwellinghouses inspected for housing defects (under Public Health and Housing Acts) 694 (b) Number of inspections made for the purpose 768 (2) (a) Number of dwellinghouses (included in subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 13 (b) Number of inspections made for the purpose 13 (3) Number of dwellinghouses found not to be in all respects reasonably fit for human habitation 610 2. Remedy of Defects without Service of Formal Notice: Number of defective dwellinghouses rendered fit in consequence of informal action by the Local Authority and their officers 543 3. Action under Statutory Powers: (A) Proceedings under Public Health Acts:— (1) Number of dwellinghouses in respect of which notices were served requiring defects to be remedied 66 (2) Number of dwellinghouses in which defects were remedied after service of formal notices:— (a) by Owners 63 (b) by Local Authority in default of Owners 3 8 (B) Proceedings under Housing Act, 1936:— (1) Demolition Orders made under section 11 1 (2) Parts of buildings closed under section 12 2 (C) Proceedings under Local Government (Miscellaneous Provisions) Act, 1953:— (1) Closing Orders made under section 10 (1) 1 4. Housing Act, 1936—Overcrowding. The Housing Manager reports that 75 families living in overcrowded or unsatisfactory conditions were rehoused during the year. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Diphtheria. For the sixth 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 1949-1953 Children born 1939-1948 Totals Primary inoculations 374 46 420 Reinforcing „ 45 356 401 Penge children under the age of 15 years on the 31st December, 1953, who had completed a course of immunisation at any time before that date were as follows:— Aged 0-4 years inclusive 1,522 or 59.0% „ 5-14 „ 2,994 or 90.2% 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 31/12/53. Under 1 1 to 4 5 to 14. 15 or over Total. Vaccinated 195 131 9 9 344 Re-vaccinated 4 19 23 9 Scarlet Fever. There were 38 cases of Scarlet Fever notified (as against 33 in 1952) and 20 cases were removed to hospital. The disease generally was of a mild type and there were no "return" cases. No deaths were recorded. Poliomyelitis. Two cases occurred during the year, both being non-paralytic. Sonne Dysentery. The first five months of the year saw a large amount of work done in clearing up the outbreak of Sonne Dysentery which commenced in November of the previous year. A further 115 cases were notified during the year under review making a total of 276 cases in all. Throughout the whole period the symptoms were mild, but a number of cases proved very resistant to treatment. The 115 cases notified involved 33 families, and of these, 14 families comprising 87 persons provided 51 cases. The number of faecal specimens obtained from 303 cases and contacts totalled 1,270 of which number 447 were positive. Lack of personal hygiene and cleanliness of the home contributed to the spread of infection. After the end of April no further cases were notified during the year. Measles. A total of 620 cases were notified during the year compared with 71 in the previous year. In spite of the large increase there were no deaths from the disease which was generally of a mild type. Whooping Cough. Cases were notified throughout the year and totalled 143 compared with 127 cases in 1952. There was one death. Disinfection. Verminous rooms disinfested 104 Rooms fumigated 65 Mattresses disinfected 60 Blankets disinfected 99 Pillows disinfected 118 Miscellaneous articles disinfected 114 10 NOTIFIABLE DISEASES (Other than Tuberculosis) during the year 1953. Disease Total Cases notified Cases admitted to Hospitals Total Deaths Scarlet Fever 38 20 — Pneumonia 11 1 14 (all forms) Poliomyelitis—Non-Paralytic .. 2 2 — Erysipelas 7 1 — Measles 620 11 — Whooping Cough 143 1 1 Dysentery 115 1 — Food Poisoning 7 1 — Malaria 1 — — Tuberculosis. No action was necessary under the Public Health (Prevention of Tuberculosis) Regulations, 1925, or under Section 172, Public Health Act, 1936. Total Primary cases notified Total Cases admitted to Sanatoria and Hospitals Total Deaths Pulmonary (Males) 21 21 4 „ (Females) 10 17 4 Totals 31 38 8 Non-Pulmonary (Males) — — 1 „ „ (Females) 1 1 — Totals 1 1 1 Two of the deaths from Tuberculosis were cases which had not been notified. 11 NEW TUBERCULOSIS CASES AND MORTALITY DURING 1953. Age Period *New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M F M F M F M F 0—1 - - - - - - - - 1—5 - - - - - - - - 5—15 2 2 - - - - - - 15—25 6 6 - - - - - - 25—35 6 4 — 2 — 1 1 — 35—45 4 3 — — — 1 — — 45—55 3 3 — — 2 1 — —- 55—65 7 — — — — 1 — — 65 and upwards 3 — — — 2 — — — Totals 31 18 — 2 4 4 1 - *Cases previously notified in other districts and transferred to Penge and those restored to the Register are included in these figures. There were 339 cases of tuberculosis on the Register at the end of the year, compared with 320 in 1952. Male Female Total Pulmonary 155 145 300 Non-Pulmonary 14 25 39 169 170 339 There were nine deaths from tuberculosis, and two tubercular cases on the register died from other causes during the year. NATIONAL ASSISTANCE ACT, 1948. Difficulty was experienced in obtaining accommodation in one case where it was necessary to take urgent action and obtain a Magistrate's order for removal of an old lady who was ill and incapable of looking after herself. She was eventually removed to hospital where she died soon after admission, some four days after her plight had been discovered. 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 one body was dealt with by the Council under these provisions. 12 FOOD. Under section 14, Food and Drugs Act 1938, 75 premises are registered for the sale of ice-cream and 38 premises for the manufacture or preparation of preserved food. Four dairies are registered under the Milk & Dairies Regulations, 1949. 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. A copy of the comprehensive booklet entitled "Clean Catering" prepared by the Ministry of Food was sent to all catering establishments in the district for information and guidance. The hygienic storage and handling of food continued to show improvement. As will be seen in the Chief 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. No animals were slaughtered in the district. Food Poisoning. There was no outbreak of food poisoning during the year but seven isolated cases were notified. Six of these were caused by organisms of the salmonella group and in the other the cause was not known. No suspected food was available for examination, but sausage meat which had been kept for some days during hot weather in one case, and the remains of a meat pie stored in unhygienic and warm conditions in another, were the likely sources of infection in those instances. 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, and the School and Maternity and Child Welfare Clinics. Other posters were displayed on notice boards in the district and at school canteens. Towards the end of the year the Council issued a full statement to the local Press, which they kindly published, calling attention to the need for vendors of food, those engaged in the handling of food and the public generally to observe certain precautions in order to prevent the incidence of food poisoning. The great importance of thoroughly washing their hands after using the watercloset cannot be too strongly emphasised to all persons engaged in handling food, whether in the factory, shop, canteen or the home. 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 at all times. 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 1953. 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 38 — 1 2 2 6 21 6 - - - - - 20 Pneumonia 11 — 1 1 — - - 1 — 2 3 2 1 1 Poliomyelitis 2 — — — — - — — 1 1 — — — 2 Non-paralytic Malaria 1 — - - - - 1 - - - - - - - Whooping Cough 143 11 28 32 27 22 20 2 - - - 1 - 1 Measles 620 7 125 89 94 149 150 2 3 1 — — — 11 Food Poisoning 7 - 3 1 _ - - 1 1 1 - - - 1 Erysipelas 7 — — — — - — - — — 2 5 — 1 Dysentery 115 7 9 5 5 11 31 16 2 16 5 6 2 1 Totals 944 25 167 130 128 188 223 29 6 21 10 14 3 38 Deaths of notified cases :—One whooping cough, aged 2 years. BIRTH-RATES, DEATH-RATES AND ANALYSIS OF MORTALITY IN THE YEAR 1953. 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. 18.8 0.70 10.5 — — — 0.35 0.03 — 0.23 0.55 22.4 England and Wales 15.5 0.35 11.4 0.00 0.00 0.01 0.20 0.01 0.00 0.16 0.55 26.8 160 County Boroughs and Great Towns including London 17.0 0.43 12.2 0.00 0.00 0.01 0.24 0.01 0.00 0.15 0.59 30.8 160 Smaller Towns (Resident Populations, 25,000 to 50,000 at Census 1951) 15.7 0.34 11.3 0.00 0.01 0.19 0.00 0.00 0.17 0.52 24.3 London Administrative County 17.5 0.38 12.5 — - 0.01 0.24 0.0 0 0.15 0.64 24.8 A (—) signifies that there were no deaths. 14 PART I, FACTORIES ACT, 1937. 1. Inspections for purposes of provisions as to health. Premises Number of Number on Register Inspections Written Notices Occupiers prosecuted (I) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 28 34 2 - (II) Factories not included in (1) in which Section 7 is enforced by the Local Authority 99 197 11 - (III) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 9 13 1 - Totals 136 244 14 - 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) 14 14 - 10 - Overcrowding (S.2) — — — - — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4).. — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary conveniences (S.7) (a) insufficient 1 1 - 1 - (h) unsuitable or defective 8 8 — 5 — (c) not separate for sexes — — — — Other offences (not including offences relating to Outwork) 3 3 — 1 — Totals 26 26 — 17 — PART VIII, FACTORIES ACT, 1937—OUTWORKERS. In the August list required by Section 110, seven 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, 1953. Registrar-General's Figures. causes of death males females All Causes 146 143 1. Tuberculosis, respiratory 4 4 2. Tuberculosis, other 1 — 3. Syphilitic disease — — 4. Diphtheria — — 5. Whooping Cough 1 — 6. Meningococcal infections — — 7. Acute Poliomyelitis — — 8. Measles — — 9. Other infective and parasitic diseases — — 10. Malignant neoplasm, stomach 4 1 11. Malignant neoplasm, lung, bronchus 11 1 12. Malignant neoplasm, breast — 1 13. Malignant neoplasm, uterus — — 14. Other malignant and lymphatic neoplasms 14 16 15. Leukaemia, aleukaemia — 1 16. Diabetes 2 — 17. Vascular lesions of nervous system 8 25 18. Coronary disease, angina 28 13 19. Hypertension with heart disease 2 3 20. Other heart disease 15 26 21. Other circulatory disease 8 8 22. Influenza 1 5 23. Pneumonia 9 5 24. Bronchitis 15 8 25. Other diseases of respiratory system — 1 26. Ulcer of stomach and duodenum 1 2 27. Gastritis, enteritis and diarrhoea — 1 28. Nephritis and nephrosis — 1 29. Hyperplasia of prostate 5 — 30. Pregnancy, childbirth, abortion — 1 31. Congenital malformations 1 2 32. Other defined and ill-defined diseases 14 14 33. Motor vehicle accidents 1 - 34. All other accidents — 1 35. Suicide 1 3 36. Homicide and operations of war — — Deaths of infants under 1 year Total 7 5 Legitimate 7 5 Illegitimate — — Live Births Total 267 268 Legitimate 250 256 Illegitimate 17 12 Stillbirths Total 10 8 Legitimate 10 8 Illegitimate — - Home population (estimated middle of 1953 R.G.) 25,510 16 ANNUAL REPORT OF THE CHIEF SANITARY INSPECTOR for the year 1953. Town Hall, Anerley Road, S.E.20. June, 1954. 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-sixth Annual Report on the work of the Sanitary Inspectors for the year ended 31st December, 1953. During the year 812 complaints (excluding those in connection with rodent infestation) were received, the great majority being concerned with housing defects and nuisances. All complaints were investigated and appropriate action taken when found necessary. It appears to be the practice of some owners of property to ignore the requests of their tenants to have repairs carried out and to await the receipt of notices from the local authority before attempting to do essential work. This is a mistaken policy and one which usually results in extra expenditure. There is no doubt that the very high cost of repair work, coupled with the fact that the standard rents of houses have remained static since 1939, has a bearing upon this matter. In addition to verbal intimation of defects in premises, 513 written informal notices and 74 statutory notices were served under the Public Health and Housing Acts, 1936. 439 intimation notices and 70 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, Public Health Act, 1936, one notice served under Section 75, and one notice served under Section 39; also one notice served under Section 9, Housing Act, 1936. The Council also did the work required by 10 notices served under Section 24, Public Health Act, 1936, respecting defective public sewers (previously known as combined drains) at 16 premises. The amount of repair work done following action taken byyour Inspectors will be seen on reference to the summary of work executed. Every endeavour is made informally to have notices complied with before statutory action is taken. In thirty-two premises repairs were not executed until legal proceedings against the owners or agents were either threatened or taken. 17 It was found necessary to institute legal proceedings against the owners or agents of 21 properties in order to abate nuisances caused by housing defects, with the following results:— case no. result I, 2, 6 and 8 Nuisance Order made to do work in 28 days in each case. (a) Non-compliance with Nuisance Orders. Fined £5 0s. 0d. in each case. 3, 4, 5, 7 and 9 Nuisance Order made to do work in 28 days in each case. (a) Non-compliance with Nuisance Orders. Fined £5 0s. 0d. in each case. (b) Continued non-compliance with Nuisance Orders. Fined £1 0s. 0d. in each case. Work done prior to hearing. 10, 16, 17, 18, 19, 20 and 21 Nuisance Order made to do work in 28 days in each case. II,12 and 13 Nuisance Order made to do work in 21 days in each case. 14 Nuisance Order made to do work in 28 days. (a) Non-compliance with Nuisance Order. Fined £5 0s. 0d. (b) Continued non-compliance with Nuisance Order. Fined £90 0s. 0d. (c) Owner appealed to Quarter Sessions against viction (b). Appeal dismissed and owner ordered to pay £21 0s. 0d. costs. 15 Nuisance Order made to do work in 28 days. (a) Non-compliance with Nuisance Order. Fined £1 0s. 0d. Work done prior to hearing. In all these cases the defendants were ordered to pay Court costs. A Demolition Order was made under section 11, Housing Act, 1936, regarding one house and shop. A Closing Order was made under Section 10, Local Government (Miscellaneous Provisions) Act, 1953, in respect of one four-storied semidetached house. Closing Orders were made under section 12, Housing Act, 1936, respecting two basement flats which did not comply with the regulations as to underground rooms and could not be made fit for human habitation at a reasonable cost. Two applications for certificates that houses were not in a reasonable state of repair were received and granted under the Rent Restriction Acts. The drainage system of 38 premises were partially relaid and 63 cleared of obstructions. Disinfestation of 104 rooms found to be verminous was carried out. Five licences to deal in game were issued during the year. From January to April, 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 812 Housing Act 52 Overcrowding and measurement of rooms 28 Infectious diseases 631 Houses-let-in-lodgings and Common lodging houses 133 Bakehouses 66 Dairies and milk distributors 107 Meat shops 166 Fish frying shops 45 Ice cream shops 109 Cafes and restaurants 187 Food factories 143 Other food shops, stores and stalls 570 Public conveniences 73 Stables 39 Rats and mice 198 Factories 244 Outworkers 28 Schools 17 Smoke observations 24 Drain tests 181 Keeping of animals 21 Food and water sampling 192 Movable dwellings 14 Rag Flock and Pet Animals Acts 34 Transferable deaths 105 Revisits and inspections of works in hand 3,429 Miscellaneous visits 215 Shops Act inspections and patrols 442 SUMMARY OF WORK EXECUTED DURING THE YEAR. Water Supply:— Water supply reinstated to houses 5 Water service pipes repaired 40 Cisterns cleansed, covered or covers repaired 4 Water Closets :— New pans and traps fixed 19 Flushing apparatus renewed or repaired 31 Foul pans and traps cleansed 8 Connection of flushing pipes to pans made good 11 Seats and doors provided or repaired 14 Ventilation provided or improved 2 Walls repaired 3 Flooring or paving repaired 7 Artificial lighting provided 4 19 Drainage:— Drains tested with smoke, water or colour 181 Drains cleared 63 Houses with drains partially relaid 38 Inspection chambers constructed or improved 18 Soil and ventilation pipes fixed or repaired 8 Sinks, lavatory basins and baths provided 4 Sink fillets repaired 4 Waste pipes renewed or provided 6 Waste pipes repaired or trapped 23 Waste pipes cleared 6 Fresh-air-inlets provided or repaired 4 Dampness—Houses with:— Walls repointed or rendered 21 Dampness in ground floor rooms remedied 46 Roofs repaired 138 Gutters repaired or renewed 17 Rainwater pipes repaired or renewed 21 Ventilation under floors provided or improved 4 Water service pipes repaired 40 Window sills repaired 12 Cleanliness :— Dirty rooms etc. cleansed 325 Verminous rooms disinfested 104 Miscellaneous:— Houses with floors, joists, etc. repaired 59 Houses with skirtings repaired 12 Houses with plaster repaired 132 Houses with new sashlines provided to windows 35 Houses with window frames etc. repaired 39 Houses with yard or forecourts paved or repaired 8 Houses with scullery paving repaired 4 Houses with chimneys repaired 25 Houses with airbricks renewed 6 Houses with stairs repaired 9 Houses with front and back steps repaired 13 Houses with fireplace jambs and mantels repaired 7 Houses with brickwork repaired 14 Kitchen stoves repaired or renewed 12 Scullery coppers repaired or renewed 1 Other stoves repaired or renewed 23 Hearths renewed or repaired 4 Doors and frames repaired or renewed 10 Ventilation and lighting of rooms improved 5 New dustbins provided 52 Premises with miscellaneous defects repaired 15 Accumulations removed 15 Smoke nuisances abated 2 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, 1,393 visits being made in this connection. In a few cases the attention of the persons concerned was drawn to contraventions of the byelaws made under section 15, Food & Drugs Act, 1938, but in no case was it considered necessary to take statutory action. 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 vendors concerned were interviewed and the circumstances fully investigated. In two cases concerning textile fibres on a loaf of bread and a piece of glass in a mince pie, legal proceedings were taken under section 3, Food & Drugs Act, 1938, and the iMagistrates imposed a fine of £5 0s. Od. in each case. In other cases a warning was given. The amount of food surrendered and condemned as unfit for human consumption after examination by your inspectors was 4 tons, 3 cwts., 1 qr., 27 lbs. The foods condemned were as follows:— Bacon 370 lbs. Beef 6,911 „ Cake 10 „ Cake flour 130 „ Carrots 112 ,, Cheese 57 „ Dried vegetables 95 „ Eggs 300 Fish 724 lbs. Fruit 3 jars Ham 7 lbs. Honey 2 jars Mincemeat 22 lbs. Mincepies 28 Mutton 11 lbs. Oatmeal 13 „ Offal 988 „ Ox Tongues 40 lbs. Pickles 46 jars Pork 11 lbs. Rabbits 52 „ Rice 3„ Sausages and sausage meat 186 „ Sugar confectionery 84 „ Tinned cheese 24 tins „ fishpaste 1 tin „ fruit 279 tins „ ham 49 „ „ jam 1 tin „ meat 150 tins „ meat puddings 2 „ „ milk 57 „ „ pudding mixture 1 tin „ soup 1 „ vegetables 8 tins Condemnation certificates totalled 267. The condemned foods were disposed of by incineration or by use for industrial purposes. 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. There are four dairies on the register and 26 persons are registered as distributors. Milk (Special Designations) Orders. The following licences were issued:— Dealers' Licences: Tuberculin tested milk 6 Pasteurised milk 9 Sterilised milk 16 Supplementary Licences: Tuberculin tested milk 6 Pasteurised milk 6 Sterilised milk 6 Milk Sampling. Samples of milk submitted to chemical analysis totalled 69, and all proved to be genuine. The samples gave the following averages:— Fat—3.53% (standard 3.0%). Solids not fat—8.74% (standard 8.5%). Forty-eight samples of pasteurised milk and thirteen samples of tuberculin tested (pasteurised) milk were submitted to the Phosphatase test and all satisfied the test. Sixty of these samples also satisfied the Methylene Blue test, the testing of the other sample 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. Two samples of pasteurised milk were tested for tubercle bacilli with negative results. Ice-Cream. There are no manufacturers in the district, but 75 premises are registered for the sale of ice-cream, the shopkeepers obtaining their supplies from wellknown manufacturers. In the great majority of cases the ice-cream is delivered to the premises and sold in cartons or wrapped. Forty-seven samples of ice-cream were taken and submitted to the Methylene Blue test with the following results:— Grade 1—28; Grade 2—16; Grade 3—nil; Grade 4—3. 22 Slaughterhouses. No animals were slaughtered in the district. Bakehouses. Minor defects found in five bakehouses were remedied after informal action. Adulteration. The Kent County Sampling Officers took 111 samples of various foods and drugs in this district. Included in the total were 30 samples of milk, 16 of drugs and 10 of spirits. All the samples were genuine with the exception of the following:— article analysis action taken Hot Milk Contained 49 % added water Prosecution. Fine £5 and costs £3 3s. 0d. Hot Milk .. Contained 14% added water Prosecution. Fine £2 and costs £1 1s. 0d. Gin Contained 2.2% excess water .. Written caution issued. Your inspectors obtained 69 informal samples of milk, the Analyst reporting all samples to be genuine. FACTORIES ACTS, 1937 and 1948. Visits paid to factories totalled 244 and in addition to verbal intimations regarding small defects 14 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 28 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 240 regarding rats and mice were received from all parts of the district and investigated. In no case was a major infestation discovered, due no doubt to the constant war which has been waged against the rodent population during recent years. Rats are prolific breeders, however, and continued action against them is necessary. In several cases it was found that defective drains and sewers were associated with rat infestations and the keeping of animals contributed to the number of infestations. When considered necessary the drainage systems of premises were tested with smoke and colour and all defects found made good. 23 As in previous years, the foul-water sewers were treated during June and December, pre-bait and poisoned bait being laid in the manholes and side entrances. In June, 330 manholes were baited and pre-bait takes recorded in 77. The figures for the December treatment were 336 manholes baited and pre-bait takes recorded in 104. 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 3,365 Premises treated for rats 329 Premises where rat poison bait taken 280 Premises re-treated for rats 268 Estimated number of rats poisoned 789 Number of rats trapped 12 Premises treated for mice 88 Premises re-treated for mice 68 It was necessary to treat some premises on three or more occasions and the total treatments for the destruction of rodents numbered 753. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 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. Three samples of rag flock and one of cotton felt were obtained and the prescribed Analyst under the Act reported that the tests showed the samples 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 and continued during 1953. Suites of waterclosets and lavatory basins are provided in a brick building on the site and there are suitable arrangements for the collection and disposal of refuse. Additional drainage for the disposal of waste water was provided early in the year. 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. No contraventions were observed. 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 359 Number of evening patrols carried out 56 Number of Sunday patrols carried out 27 Number of premises where young persons employed 44 Number of premises where official forms relating to staff not posted up 21 Number of " mixed shops " where poster relating to Sunday trading not exhibited 14 Number of shops where toilet facilities were provided following service of intimation notice 1 Number of shops where heating facilities were rendered satisfactory following service of intimation notice 1 Legal proceedings were instituted under The Young Persons (Employment) Act, 1938, against one firm for employing a young person longer than the permitted hours and for failing to keep official records. The Bench imposed fines of £2 and £1 respectively. 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. 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.