Rul 3 RUISLIP-NORTHWOOD URBAN DISTRICT COUNCIL. ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1913. L. W. HIGNETT, M.B., M.R.C.S., D.H.P. (CAMB.), Medical Officer of Health. NORTHWOOD: A. E. Rawlinson, Printer, The Library. Annual Report OF THE Medical Officer of Health, 1913. To the Chairman and Members of the Urban District Council of Ruislip-Northwood. Gentlemen, I beg to submit to you my ninth Annual Report upon the Sanitary condition of your District. As the result of an Inquiry held on January 33rd, 1904, powers were granted by the Local Government Board for the conversion of the Parish of Ruislip (at that time a part of the Rural District of Uxbridge) into an Urban District under the Control of the Ruislip-Northwood Urban District Council. I was appointed Medical Officer of Health on January 1st, 1905. General Characteristic of the District. The Ruislip-Northwood Urban District is situated at the North-West extremity of the County of Middlesex, bounded on the North by the Watford Rural District in 4 the County of Hertford; on the South by the Parish of Northolt; on the East by the Parishes of Pinner and Harrow; and on the West by those of Harefield and Ickenham. For the purposes of this Report I have divided the Districts into three portions, namely:— 1. Northwood. 2. Eastcote. 3. Ruislip. 1. Northwood is that part situated in the northern portion of the District, it is entirely residential and non-manufacturing, and is still growing with rapidity, owing to the excellent train service communication with London supplied by the Metropolitan and Great Central Joint Railway. That this growth goes on is shown by the fact that during the past year plans for 58 houses have been passed by the Council. The majority of the houses in this part of the District are of a fair size with rentals of from £40 a year and upwards. 2. Eastcote. This village is situated towards the East side of the centre of the District. Building development is progressing rapidly here, plans for 54 houses were passed during the year, as compared with 42 in 1912. 3. Ruislip village is on the West side of the centre of the District. Until five years ago this was quite an 5 isolated country village, but owing to the extension of two Railways, the Metropolitan, and Great Western and Great Central Joint Line with Stations in proximity to the centre of the village, growth has been quite rapid, plans for 81 houses and 4 shops have been sanctioned by the Council during the year, as compared with 100 in 1912. The nature of the land throughout the whole of the Ruislip-Nortliwood area is clay, but in several places are patches of sand and gravel, apparently portions of the Reading beds. These sand and gravel beds are on the surface in Northwood at the Golf Links, in the village of Ruislip, and along the bed of the River Pinn at Eastcote. It is interesting to note that upon cutting a new road during 1911, extending south from the EastcoteRuislip main road, just to the east of the Ruislip Parish Schools, a bed of fine yellow sand was found at varying depths of two to eight feet below the surface. With these exceptions the land is stiff, heavy clay, with a varying thickness of loam above it. This clay holds up the water during and after wet weather, and thus tends to make the atmosphere damp, and causes ground mists in Autumn and Winter. It is, therefore, very essential for the health of the dwellers upon this land that sufficient land drainage be provided, and that existing water courses and drains be kept open. Houses built upon this clay are not necessarily unhealthy, provided that the surface of the land around is 6 well drained and that good damp-proof courses are used and the sites covered with some impervious material. The levels of the land in the District vary from 120 feet at the South, to 360 feet at the North. The River Pinn flows from East to West through the centre of the District. Acreage of the District 6585 Number of inhabited houses at the end of June, 1901 704 „ „ „ „ „ „ 1905 903 (The first year of a separate District) „ „ „ „ „ „ 1906 951 „ „ „ „ „ „ 1907 1045 „ „ „ „ „ „ 1908 1109 „ „ „ „ „ „ 1908 1158 „ „ „ „ „ „ 1909 1230 „ „ „ „ „ „ 1910 1296 „ „ „ „ „ „ 1911 1340 „ „ „ „ „ „ 1912 1482 Estimated population ;it the end of June, 1905 4515 „ „ „ „ „ „ 1906 4755 „ „ „ „ „ „ 1907 5530 „ „ „ „ „ „ 1908 5656 „ „ „ „ „ „ 1909 5906 „ „ „ „ „ „ 1910 6273 „ „ „ „ „ „ 1911 6480 „ „ „ „ „ „ 1912 6700 „ „ „ „ „ „ 1913 7410 7 Population at the time of the Census, 1901 3560 „ „ „ „ „ „ 1911 6217 Vital Statistics. Estimated population at the end of June, 1913 7410 Number of Births registered during the year 1913 124 Birth rate per thousand of estimated population 1913 16 7 Number of deaths registered during the year 1913 59 Substracting deaths of non-residents dying in public institutions in the District (25) and adding de ths of residents dying outside the District (7) the nett number of deaths is 41 The corrected death rate then is 5.5 [ The birth rate for 1912 was 19.5] [The death rate for 1912 was 9.1] Infectious Diseases. (1) Small Pox—no case. (2) Diphtheria—seventeen cases. (3) Scarlet Fever—twenty-two eases. (4) Erysipelas—one case. (5) Enteric Fever—one case. (6) Puerperal Fever—no case. (7) Pulmonary Tuberculosis—six cases. (8) Poliomyelitis—none. (9) Tuberculosis non-Pulmonary—two cases. 8 Scarlet Fever. Fifteen of the Scarlet Fever cases occurred in the early part of the year among children attending the County Council Schools, Northwood. They were all mild cases, and the infection seems to have been spread by two missed cases, i.e., two children found on examining the children at the Schools to be in the peeling stage of the disease. The type of Scarlet Fever throughout the whole year has been so mild (a slight evanescent rash and no marked illness) that it is probable that many cases were missed, not being notified, as parents hardly noticed that the children were ill. This accounts for the spread of the infection and the difficulty of stamping out the trouble. Diphtheria. There was an epidemic of 9 cases at the Ruislip Church Schools in October and November. The first case was notified by the Medical Officer of the Gt. Ormond Street Hospital for Children, London. It was a case of nasal Diphtheria and was diagnosed by the Bacteriological examination of a swab taken from the child's nose. There were no signs of throat infection. From this child having attended the Schools, eight other cases arose. All children in the School were examined on three different occasions and swabs were examined from all suspicious cases. The School premises were cleaned and disinfected ; at the end of three weeks no new cases were discovered. 9 All cases of Pulmonary Tuberculosis notified have been visited, except those occurring in larger houses and in which the medical man notifying stated that he was satisfied with the sanitary surroundings and that proper precautions were being taken. Many of the cases are being treated in the open-air in shelters ; the surroundings of the cottages and houses in this District are very favourable for the treatment of cases at home, and I have found that the inhabitants of the house in which a case is being treated are quite alive to the importance of taking precautions to prevent the spread of the disease. A stock of Diphtheria Antitoxin is kept for emergency use by the Council, and is supplied free of charge to cases recommended by the medical man attending. The Bacteriological examination of throat swabs is also undertaken free of charge for such cases. A certificated and thoroughly trained midwife resides in Northwood ; she has done very good service among the poorer mothers in the District, teaching them methods of cleanliness and the management of new born infants, and no cases of Puerperal Fever were notified. She also kindly undertook the distribution of leaflets of instructions upon the feeding of infants, printed by the Council. Infant Mortality. Three deaths of Infants under one year of age occurred during the year. 10 The total number of births was 124. The Infant Mortality rate was 24.1 per 1000 births. There was no death from Diarrhœa. This Mortality rate for Infants is very low. Last year the rate was 99.9 per 1000 births. Sewage Disposal and Drainage. The methods of Sewage Disposal and Drainage were explained at some length in my report for 1910 and need not be again repeated here. New Sewers. Two short lengths of New Sewers have been laid under the roads of the Ruislip Manor Estate. During the year all the Sewers of the District were tested by the Council's Consulting Engineer, who found that several lengths of the old Sewers and also Manholes were leaking, the Council decided to repair these. Water Supply. There have been no complaints of suspended matter coming through the mains of the Colne Valley Company, during the year. There are no wells used for drinking water in the Northwood area, the whole of this portion of the District being served with the Colne Valley Company's mains. II There are still several surface wells in the Ruislip and Eastcote District, mostly in that part south of the Metropolitan Railway where the houses and cottages are very scattered and the population is small. Extensions of Water Company's Mains during 1913. 1. An extension along the West End Road, Ruislip from Shirley's Farm to the Northolt Junction Estate, about 2 miles in length. 2. And the extension from Crosbie's Farm, Duck's Hill Road, to Hoggett's Farm, a length of about 500 yards. 3. A main connecting up the Ickenham Close Estate with the main in the Ickenham Road, near Ickenham Station, about 300 yards. 4. A short length in Cheney Street, Fastcote of about 50 yards. Isolation Hospital. The accomodation provided at the Isolation Hospital Hillingdon, Uxbridge, is as follows:— 1. An Administration block with eight Nurses' bedrooms, Nurses' sitting room, Matron's sitting room and bedroom, dining room, board room, Doctors' room and kitchens. 12 2. An Observation block, containing:— (a) Male ward, two beds and two cots. (b) Female ward, two beds and two cots. (c) Ward, kitchen and lavatories. 3. A Scarlet Fever block, containing.— (a) Male ward, eight beds and two cots. (b) Female ward, eight beds and two cots. (c) Ward, kitchen and lavatories. 4. The old Scarlet Fever block, containing four male beds, four female beds and eighteen cots. 5. A Discharge block. 6. The old Diphtheria wards in the galvanised iron building containing six male beds and four cots, and six female beds and four cots, with kitchens and lavatories. 7. Laundry and Ironing room. 8. Disinfecting rooms with a Washington Lyons Steam Disinfector. 9. Ambulance Shed. Altogether the accommodation provided is— Scarlet Fever, 24 beds, 22 cots. Diphtheria, 12 beds, 8 cots. Observation wards, 4 beds and 4 cots. 13 Small Pox Hospital. This Hospital is situated at Yeading. Methods of Disinfection. (1) House Disinfection.—Walls are sprayed with five per cent. Lysoform with the Invicta Sprayer. The rooms are then sealed up and fumigated with Formalin in the Alformant lamp (25 tablets per 1,000 cubic feet). After 12 hours the rooms are opened and washed down with Carbolic Lotion. Disinfection is carried out after Tuberculosis, Measles, Whooping Cough, Chicken Pox, and other cases at a small charge per room (no charge is made in cases of poor people unable to pay this fee). (2) Clothing, bedding, etc., are disinfected in the Steam Disinfector at the Isolation Hospital. A covered van is sent for the infected articles, and another light van is used to return the articles when disinfected. Cowsheds and Milk Shops. The Model Regulations issued by the Local Government Board are in force in the District. There are 17 Cowsheds and 5 Dairies on the register. The Colne Valley Water is laid on to all Cowsheds and Dairies except one, and in this one case there is an excellent supply of water from a deep well. 14 There are about 215 milch-cows in the District; all these cows are habitually grazed out except during very severe weather in the winter. All Cowsheds and Dairies have been inspected at frequent intervals. There has been one Dairy added to tlie register during the year. The Veterinary Surgeon has examined all the cows twice during the year, he found that 12 cows showed suspicious symptoms of Tuberculosis and applied the Tuberculin Test to these, and three failed to pass the test. The owners of these three cows were served with the notice to discontinue selling the milk from them. A supply of pure, clean milk is absolutely essential to the health of the community. Milk that is not kept clean is one of the chief agents in producing fatal diarrhoea in young children. Tubercular disease in children is largely produced bv tuberculous milk. A pure milk supply can only be obtained by a systematic and frequent inspection of the conditions under which it passes from what I may call its source, i.e., the cow to the consumer. I divide these conditions into the following:— i. Condition of the Cows. ii. Condition of the Cowsheds. iii. Methods of Milking. iv. Condition of the Dairies, receptacles and utensils. 15 I.—Condition of the Cows. The Veterinary Inspector appointed by the Council examines all cows twice in the year, and tests any which on examination, seem to him to show any signs of Tuberculosis. I would suggest that all cowkeepers should send notice to the Veterinary Inspector of new cows bought, and that such cows should be examined, and that the cost of this additional inspection be borne by the Council. II.—Condition of the Cowsheds. Very few of the sheds in this District are constructed on modern lines. At least four of the sheds are old barns which have been converted into cowsheds, and are so faulty in construction that I do not consider that it is possible to convert them into up-to-date cowsheds. The occupiers of these sheds keep them in as good a condition as possible under the circumstances; the fault rather lies with the owners of the properties than with the occupiers. III.—Methods of Milking. In this District all milking is done by hand. Circulars containing instructions relating to the cleanliness of the milker's hands and the wearing of clean overalls have been sent out to the cowkeepers, but very strict supervision is necessary. I would suggest that all cowkeepers should be required to construct a small building near or attached to 16 the cowshed in which wash basins with a proper water supply are fixed and where the milkers can keep their overalls. Cleansing of the udders and grooming of the flanks of the Cows is essential to prevent contamination of the milk at the time of milking. IV. Condition of the Dairies, Utensils and Receptacles for Milk. The Dairy, i.e., the place where the milk is stored, should have no communication with the cowshed or farmdairy house; there is a want of proper dairy accommodation at many of the farms. All utensils and receptacles for storing or conveying milk should be scalded out with boiling water before each time of using; we find that the cowkeepers in the District give strict attention to this matter. The method of delivering milk in glass bottles with patent cardboard stoppers is good, but the attention of the consumer must be drawn to the desirability of scalding out the bottles immediately when emptied. Slaughter Houses. The Local Government Board Model Regulations controlling the management of Slaughter Houses have been adopted. 17 There are two Slaughter Houses in the District. They have been inspected six times in the year. There is no Slaughter House at Ruislip. Although the condition in which the two Slaughter Houses in Northwood are kept is good, the buildings in both cases are not suitable for the purpose of slaughtering, they are both in the back yards of shops, in close proximity to the shops and other dwellings. In one case there is no back entrance to the yard and stables except through the slaughter house, this is very undesirable. Properly constructed slaughter houses for Ruislip and Northwood are much needed, and I understand that one of the butchers in Northwood is prepared to erect a model slaughter house for the combined use of those slaughtering in the District provided that he can obtain a suitable site ; I consider that the Council would act wisely if they could assist in this scheme. The provision of a model Slaughter House in a suitable position is an urgent matter. New Buildings. Plans approved: 197 Houses, 4 Shops, 17 Additions to Houses. House Refuse. The collection of house refuse is made once a week throughout the whole district. 18 There are 960 houses on the list for collection. The refuse was carted to Sand Pit Hill Brickfields, where it was screened, the paper and vegetable refuse was burnt in a small destructor and the remainder was tipped into the holes left from the brickfield workings. Medical Inspection of School Children. There are four Schools in the District:— 1. The Holy Trinity Church Schools, Northwood. 2. The County Council Schools, Northwood. 3. The Infant School, Church Road, Northwood. 4. The Church Schools, Ruislip. The inspection of these Schools is carried out by a Medical Inspector appointed by the County Council. The Housing & Town Planning Act, 1909. Systematic Inspections under this Act were begun in May, 1911. 60 premises were inspected in 1911. 101 „ „ „ 1912. 29 „ „ „ 1913. The principal defects found were—dampness of walls, floors and curtilage, due to absence or faults in guttering 19 pipes, insufficient surface water drains, absence of damp proof courses and site concrete, and want of imprevious paving of yards. There are no congested areas in the District, most of the cottages being isolated and having ample air space around them. I still have to report as in 1911 and 1912, that a great lack of proper sanitary cottage accommodation for the working classes throughout the whole District. In Northwood the average rental for cottages is about nine shillings per week, there are practically no cottages with a rental as low as seven and sixpence per week. A rent of nine shillings per week is a high figure for a working man in this district to pay; this lack of cottages at a more reasonable rental leads to dual tenancies in a great number of the cottages; this dual tenancy is an undesirable feature, the cottages are not designed for double occupation, there being only one kitchen, scullery, and W.C., and it apparently is the duty of neither of the tenants to keep yard, scullery and W.C. clean. At Ruislip Common, Ruislip Village and Eastcote many of the cottages are very old, badly lighted and ventilated, have ceilings in some cases as low as 6 ft. 2 ins. floors below the level of the surrounding ground and are in many other respects faulty. 20 During the last two years the Sanitary Inspector and I have inspected all these cottages, and served notices upon the owners to carry out improvements and repairs the results has been an increase of rental to be paid by the occupiers totally out of proportion to the amount spent by the owners on the properties, and the visit of the Sanitary Inspector and Medical Officer of Health is not looked upon as a blessing by the tenants. In fact in many cases the occupiers have asked that no notice should be taken of defects. The Ruislip Manor Cottage Society have built 16 cottages in Northwood which go by the name Manor Cottages, the lowest rental accepted for any of these is 7/6 per week, this minimum rental is too high for the working man to pay, and it seems that these cottages at this rental do not fill the want. The time has arrived when the Council must consider building houses for the working classes throughout the whole District, provided that such houses can be erected to let at a rental of 6/- per week. At a rough estimate I consider that the following number of houses are required: At Ruislip Common 16 At Ruislip Village 10 At Eastcote Village 20 At Northwood 30 21 Cemeteries. Owing to a lack of accommodation in the Burial ground attached to the Holy Trinity Church, Northwood, it has been necessary for the Council to consider the purchase of a site for a Public Cemetery. The L.G.B. held an enquiry early in the year as to the borrowing of money bv the Council for the purchase of land for a Cemetery. The land purchased is situated on the north slope of Haste Hill, near the Metropolitan Railway line. The Burial ground will be opened for interments in 1914. Common Lodging Houses. None in the District. Houses Let in Lodgings. The Local Government bye-laws are in force. Overcrowding. No case. Factories and Workshops. Factories 6 Workshops, including Laundries 19 (not including Bakehouses) Bakehouses 4 Home Workers' Premises 0 22 TABLE I. VITAL STATISTICS OK WHOLE DISTRICT DURING 1913 AND PREVIOUS YEARS. Year Population estimated to Middle of each year Births Total Deaths Registered in the District Transferable Deaths Nett Deaths belonging to the District of Nonresidents registered in the District. of Residents not registered In the District Under 1 Year of Age At all Ages uncorrec-ed Number Nett Number Rate Number Rate per 1,000 Nett Births Number Rate Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1908 5,606 122 122 21.5 39 6.8 6 8 8 655 41 72 1909 5,908 137 137 23.2 44 7.4 7 8 5 37-3 45 7-6 1910 6,273 122 122 19.4 36 5.7 6 7 3 24 9 37 5-8 1911 6,480 125 125 19.2 54 8.3 89 9 9 720 55 8-4 1912 6,700 131 131 19.5 66 9.8 18 13 13 999 61 9-1 1913 7,410 124 124 16.7 59 7.9 2.5 7 3 24 1 41 5.5 Area of district in acres (exclusive of area covered by water), 6,585. At the Census of 1911:—Total population at all ages, 6,217. Number of inhabited houses, 1,243. Average number of persons per house, 5. 23 TABLE II. CASES OF INFEC TIOUS DISEASE NOTIFIED DURING THE YEAR 1913. Notifiable Disease Number of Cases Notified Total cases removed to Hospital At all Ages At Ages—Years Under 1 1 to 5 5 to 25 15 to 25 25 to 45 45 to 65 65 and upwards. Small-pox Cholera Diphtheria (including membranous croup) 17 2 11 3 1 15 Erysipelas 1 1 Scarlet fever 22 1 3 13 3 Typhus fever Enteric fever 1 1 Relapsing fever Continued fever Puerperal fever Cerebro-spinal Meningitis Poliomyelitis Pulmonary Tubculosis 6 2 2 2 Other forms of Tuberculosis 2 1 1 Totals 49 1 5 24 12 5 2 18 Isolation Hospital—Uxbridge Joint Hospital, Hillingdon, Uxbridge. Total available beds 40; cots 34. Number of Diseases that can be concurrently treated, 2. 24 TABLE III.—Causes of, and Ages at Death during the Year 1913. RUISLIP-NORTH WOOD URBAN DISTRICT. Causes of death 1 Net Deaths at the subjoined ages of "Residents" whether occurring within or without the district. Total Deaths whether of "Residents" or "Non-Residents" in Institutions in the District 11 All Ages. 2 Under 1 year 3 1 and under 2 years 4 2 and under 5 years 5 5 and under 15 years 6 15 and under 25 years 7 25 and under 45 years 8 45 and under 65 years 9 65 and upwards 10 All causes Certified Uncertified Enteric Fever ... ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough 2 2 ... ... ... ... ... ... ... 2 Diphtheria and Croup 1 ... ... ... ... ... ... ... ... ... Influenza 1 ... ... ... ... ... 1 ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Phthisis (Pulmonarv Tuberculosis) ... ... ... ... ... ... ... ... ... 22 Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... 1 Cancer, Malignant Disease 6 ... ... ... ... ... 2 1 3 6 Rheumatic Fever 1 ... ... ... ... 1 ... ... ... 1 Meningitis ... ... ... ... ... ... ... ... ... ... Organic Heart Disease 5 ... ... ... ... ... 1 1 3 7 Bronchitis 2 ... ... ... ... ... ... ... 2 2 Pneumonia (all forms) 2 ... ... ... ... 2 ... ... ... 2 Other diseases of respiratory organs ... ... ... ... ... ... ... ... ... ... Diarrhœa and Enteritis ... ... ... ... ... ... ... ... ... ... Appendicitis and Typhlitis ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver 1 ... ... ... ... ... ... ... ... ... Alcoholism ... ... ... ... ... ... ... ... ... 2 Nephritis and Bright's Disease 3 ... ... ... ... ... 1 1 3 Puerperal Fever ... ... ... ... ... ... ... ... ... ... Other accidents and diseases of Pregnancy and Parturition ... ... ... ... ... ... ... ... ... ... Congenital Debility and Malformation, including Premature Birth ... ... ... ... ... ... ... ... ... ... Violent Deaths, excluding Suicide ... ... ... ... ... ... ... ... ... 1 Suicides 1 ... ... ... ... ... ... 1 ... ... Other Defined Diseases 8 ... ... ... ... ... 3 5 8 Diseases ill-defined or unknown ... ... ... ... ... ... ... ... ... ... Totals 34 2 ... ... 1 3 5 9 14 59 Sub-Entries Cerbro-Spinal Meningitis Poliomyelitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 25 Ruislip-Northwood Urban District. TABLE IV. INFANTILE MORTALITY DURING THE YEAR 1913, Nett Deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 1 month. 1-3 months. 3-6 months. 6-9 months. 19-12 months. Total Deaths under 1 year. All Causes Certified ... ... ... ... ... ... ... ... ... ... Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet fever ... ... ... ... ... ... ... ... ... ... Whooping-cough ... ... ... ... ... ... 11 ... ... 2 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... 1 ... ... 1 ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... Pneumonia (all forms) . ... ... ... ... ... ... ... ... ... ... Diarrhœa ... ... ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... ... ... ... ... ... Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... Atelectasis ... ... ... ... ... ... ... ... ... ... Congenital Malformations ... ... ... ... ... ... ... ... ... ... Premature Birth ... ... ... ... ... ... ... ... ... ... Atrophy, Debility and Marasmus ... ... ... ... ... ... ... ... ... ... Other causes ... ... ... ... ... ... ... ... ... ... Totals ... 1 ... ... 1 ... 2 ... ... ... Nett Births in the vear legitimate 122. Nett Deaths in the year of legitimate infants 3 illegitimate 2. legitimate infant - 26 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH For the year 1913, for the Urban District of Ruislip-Northwood, Middlesex, On the administration of the Factory and Workshop Act, igoi. in connection with FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK I.—INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions (4) Factories including Factory laundries 6 ... ... Workshops including Workshop laundries 15 2 ... Workplaces Other than Outworkers' premises included in Part 3 of this Report None in the District. Total 21 2 — 27 H.—DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. (1) Number of Defects Number of Prosecutions (5) Found (2) Remedied (3) Referred to H.M Inspector (4) Nuisances under the Public Health Acts:—* Want of cleanliness ... ... ... ... Want of ventilation ... ... ... ... Overcrowding . ... ... ... ... Want of drainage of floors ... ... ... ... Other nuisances 2 2 ... ... Sanitary accommodation— Insufficient ... ... ... ... Unsuitable or defective Not separate for sexes ... ... ... ... Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s. 101) ... ... ... ... Breach of special sanitary requirements for bakehouses (ss. 97 to 100) ... ... ... ... Other Offences Excluding offences relating to outwork which are included in Part 3 of this Report ... ... ... ... Total 2 2 - - * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act as remediable under the Public Health Acts. 28 III. REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. (1) Number. (2) Workshops 25 Total number of workshops on Register 25 IV.—OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 0 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s 5):— Notified by H.M. Inspector 0 Reports (of action taken) sent to H.M. Inspector 0 Other 0 Underground Bakehouses (s. 101):— Certificates granted during the year 0 In use at the end of the year 0 I am, Gentlemen, Your obedient Servant, L. W. HIGNETT, M.B., D.P.H., Medical Officer of Health. SANITARY WORK, 1913. No. 3. District. Drainage and Sewerage of existing buildings. Disinfection. Dust. Sundry Nuisances Abated. Remarks as to any other matters or in explanation of previous columns. Water Closets. Percentage of Houses provided with Water Closets. Drains. Cesspools. Percentage of Houses Draining into Sewers. Number of Water Closets substituted for Dry Receptacles. Repaired, Supplied with Water, or otherwise Improved. Examined, Tested, Exposed, &c. Unstopped, Repaired, Trapped, &c. Waste Pipes, Rain Water Pipes Disconnected, Repaired, &c. New Soil Pipes or Ventilating Shafts fixed. Existing Soil Pipes orVentilating Shafts repaired. Disconnecting Traps or Chambers Inserted. Reconstructed. - ■ • Rendered Impervious, Emptied, Cleansed, &c. Abolished, and Drain connected to Sewer. Rooms Disinfected. Rooms Stripped and Cleansed. Articles Disinfected or Destroyed. New Bins provided. How frequently is dust removed from each house? Number of Complaints of NonRemoval received. Method of Disposal. Overcrowding. Smoke. Accumulation ol Refuse. Foul Ditches, Ponds, &c., and Stagnant Water. Foul Pigs and other Animals. Dampness. Yards repaved or repaired. Other Nuisances. Ordinary infectious diseases. Phthisis. Ordinary infectious disease. j Phthisis. Destructor. By 'l ipping. Other, state method. RuislipNorthwood U.D.C. 2 6 90% 63 23 15 - 17 - 20 2 - 85 % 103 5 - - - 16 weekly 12 - yes - - - 5 2 2 15 17 32 No. 2. SANITARY WORK, 1913. No. 2. District. Canal Boats used as Dwellings. Movable Dwellings, Caravans, Tents, &c. Bakehouses. Slaughter-houses. Cow-sheds. Dairies and Milkshops. Unsound Food. Offensive Trades. Water Supply and Water Service. Wells. Percentage ol Houses supplied from Public Water Service. Cisterns. Draw-Taps placed on Mains. Percentage of Houses supplied on Constant Svstem. Number of Samples obtained for analysis. Number Registered under the Acts. Number of Contraventions of Regulations. Number Observed during theYear. Number of Nuisances therefrom Abated. Number Removed from District. Number in District. Contraventions of Factory Acts. Number on Register. Number of Inspections made. Frequency of Inspection. Contraventions of Bye-Laws. Number 011 Register. Number of Inspections made. Frequency of Inspection. Centraventions of Regulations. Number of Milch Cows in District. Number on Register. Number of Inspections made. . I'requency of Inspection. Contraventions of Regulations. ] Meat (including organs) seized and surrendered. (Approximate weight in pounds). Poultry and Game seized and surrendered. (Approximate weight in pounds). Fish seized and surrendered. (Approximate weight in pounds). Fruit and Vegetables seized and surrendered. (Approximate weight in pounds). Other Articles seized and surrendered. (Approximate weight in pounds). Method of disposal. Number of Premises in District. Number of Inspections made. Contraventions of Bye-Laws. New Sunk. Cleansed, Repaired, &c. Closed as Polluted. New Provided. Cleansed, Repaired, Covered, &c. From Local Wells. From Public Supply. RuislipNorthwood U.D.C. - - - - - 4 None. 2 6 Quarterly. - 17 34 Twice yearly. 6 215 5 10 Twice per vear. None. - - - - - - - - - - - - 85% - - 2 Constant System laid throughout the District. - - No.1. SANITARY WORK, 1913. No. 1. Adoptive Acts, and Bye-laws, in force in District. Particulars as to Staff employed in Sanitary Department, specify if Inspectors are engaged in any duties, and if so, what. Inspections. Action taken (Other than under H. and T.P. Act.) Dwelling Houses and Action under H. and T.P. Act, 1909. Houses let in Lodgings. (Tenement Houses.) Common Lodging Houses. Public Health Acts, Amendment Act, 1890. Public Health Acts, Amendment Act, 1907. Private Street Works Act, 1892. Bye-laws, Houses let in Lodgings Bye-laws, New Streets, and Buildings Bye-laws, Dairies, Cowsheds and Milk Shops. Bye-laws, Slaughter Houses. Bye-laws, Removal of Snow. J. T. DEWHURST, C.R.S.I. Sanitary Inspector and Asst. Surveyor. Number of Premises Inspected on (1) Complaint. Number of Premises Inspected in connection with Infectious (2) Diseases. Number of Premises under (3) Periodical Inspection. Houses Inspected from House-to(4) House (H. and T.P. Act). Total Number of Inspections (5) and Re-inspections made. Cautionaryor Intimation Notices Given. Statutory Orders Issued. Summonses Served. Convictions Obtained. I Number of Houses dealt with under Sect. 15. Number of Houses found to be in a state Dangerous or Injurious to Health (Sect.l 7). Number of Representations made by M.O.H. (Sect. 17). Number of Houses made Habitable without Closing Orders. Number of Houses closed Voluntarily. Number of Closing Orders made by L.A. (Sect. 17.) Number of Closing Orders determined after Repairs (Sect. 17) Number of Houses Demolished (а) bv order of L.A. (Sect. 17). (б) Voluntarily. Illegal Underground Rooms Vacated. Number Registered under ByeLaws. Number of Contraventions. Number Registered under ByeLaws. Number of Inspections made. Number of Contraventions. 28 45 60 29 378 75 2 — — - 29 - 29 — — - - — - — - — —