AC 439(1) Southall Sout 18 BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1950 MARGARET A. GLASS, Medical Officer of Health KING AND HUTCHINGS, LTD., PRINTERS, SOUTHALL BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1950 MARGARET A. GLASS, Medical Officer of Health INDEX page Ambulance Service 8 Antitoxin 11 Area of Borough 6 Atmospheric Pollution 4, 19, 20, 21 Bed bugs 16 Births and birth rate 3, 9, 23, 25, 26 Canal boats 16 Cancer 11, 23, 27 Carbide 17 Care and after care 7 Catering establishments 4, 19 Cattle market 17 Causes of death 24 Celluloid and Cinematograph Film Act 17 Children's welfare 8 Chiropody 15 Deaths and death rates 3, 23, 25 Deaths in wards 24 Diphtheria 4, 11 Disinfection 11 Employees' medical examinations 15 Factories Act, 1937 16 Film strips 14 Food inspection 18, 19 Food poisoning 4, 17 Food sampling 18 Free washing facilities 18 Graphs 4, 9, 13, 21, 22 Health propaganda 4, 14 Home helps 8 Hospital services 7 Houses—number inhabited 6 Housing 4, 17, 32 Hygiene of food 17, 18 Infant mortality 3, 9, 23, 25, 26 Infectious diseases, prevalence and control of 4, 10. 12, 25, 28 Inspection and supervision of food 18, 19 Inspection of sanitary accommodation in factories 16 Laboratory facilities and work18 Markets 17 Massage, Establishments for 15 Maternal morbidity 10 page Maternal mortality 26 Maternity and Child Welfare 7 Meat and other foods 18 Medical examinations 15 Mental health 8 Middlesex County Council Services 7 Milk Licences 18 Milk sampling 18 Mortuary 16 National Assistance Act, S.47 14 Notifiable diseases 12, 28 Old People's Welfare 5, 14 Ophthalmia neonatorum 12 Outworkers 17 Overcrowding 4, 17, 32 Petroleum Acts 17 Physical features of the district 6 Poliomyelitis 4, 10, 11, 12 Population 6 Premature infants 10 Propaganda—Health 4, 14 Public Health Committee 3 Puerperal pyrexia 10 Rateable value 6 Rats and mice 19 Sanitary circumstances 15 Sanitary inspection 15, 31 Sanitation in schools 15 Scabies clinic 13, 14 Scarlet fever 11 School medical service 4, 8 Shops Acts 17 Smallpox 11 Social conditions 6 Staff 6 Statistics—General and Vital 6 Statutory action 32 Stillbirths 28 Swimming bath 7 Tuberculosis 4, 12, 13, 28, 29, 30 Unfit houses 32 Verminous persons 13, 14 Vital statistics 8, 23, 25 Water supply and service 15 2 THE COUNCIL OF THE BOROUGH OF SOUTHALL, 1950 HIS WORSHIP THE MAYOR *COUNCILLOR A. E. LYE, J.P. Deputy Mayor: Alderman F. G. Smith. Aldermen: †*gardner, F. E. Hamblin, E. B. *Hopkins, W. H. Lowe, J. Luckett, F. H. Smith, F. G. Councillors: †*Cavell, Mrs. I. (Chairman, Health Committee.) cullingworth, F. A. Dane, A. T. *Dormer, J. G. P. Douglas, H. C. *Errington, F. G. Haigh, J. Lockyer, G. P. *Love, P. J. Lye, A. E. Marks, F. J. *Salmon, J. *Shepherd, A. H. Steele, T. J. *Walker, F. C. Ward, J. H. White, H. J. *Williams, Mrs. V. G. I. *Members of the Health Committee. †Members of Area Health Committee (Area No. 9). To the Mayor, Aldermen and Councillors of the Borough of Southall. MR. MAYOR, LADIES AND GENTLEMEN, I have the honour to present the 54th Annual Report on the health and circumstances of the population of the Borough of Southall for the year 1950. The health of the people continued to be good. The birth rate fell again during 1950 to 13.34. It was 15.72 in 1949 and has been falling steadily since 1946. The comparative figure for England and Wales was 15.8. The death rate fell from 9 43 in 1949 to 8.52 in 1950, and this rate also has been decreasing annually since 1945. A new international system of classification of causes of death was brought into operation in 1950, in order that there should be much more accurately comparable statistics not only throughout the world but in this country by encouraging very precise definition of the ultimate cause of mortality in each individual case. There was an increase in the number of deaths from heart disease, but a slight drop in the number of deaths from cancer, the figure for which had been rising since 1947. The infant mortality rate dropped from 40.18 in 1949 to 25.41 in 1950. This is the lowest infant mortality rate ever recorded in the Borough. Of the 20 infant deaths, twelve took place during the first four weeks after birth and these all occurred following hospital confinement. Six of the infants dying before the age of one month were classified as premature, 3 actually being recorded in the deaths register as dying from prematurity. 3 There was a decrease in the number of deaths from tuberculosis, 15 deaths were recorded as compared with 24 in 1949. The number of notifications of new patients suffering from this disease was 84, as compared with 126 in 1949. These figures show a satisfactory decline, but they are still sufficiently high to give cause for anxiety ; in the text of this Report I have analysed the figures of the new notifications and classified them in occupations and in relation to their housing conditions. It is to be noted that the number of cases occurring in houses which are in bad condition or where the families are overcrowded is comparatively small, a rather surprising find, although this must be taken with caution since only one year's figures are considered. The total number of infectious disease notifications in 1950 was 1,139, compared with a total of 477 in 1949. This increase was due to an epidemic of measles with a notification figure of 701, and a fairly high incidence of whooping cough. There was 1 death from diphtheria; this was the only case of diphtheria notified during the year; the child had commenced, but not completed, immunisation. The number of cases of poliomyelitis notified was 6, and no deaths, as compared with 14 in the previous year and 2 deaths. In the same period the total number of notifications from this disease in Middlesex was 285, and over the whole of England and Wales there were 7,753, so that on comparative population figures it can be seen that Southall was rather lightly affected during the 1950 outbreak. In the text of the Report notes are given as to the progress of the individual cases. There were no outbreaks of food poisoning. During the year 16 notifications were received of individual cases, all of a very slight nature. The number of inspections made for housing defects increased from 5,788 in 1949 to 6,809, and as a result of these inspections 11,434 nuisances of a lesser or greater degree, were discovered; 9,861 of these nuisances were abated either as a result of informal action or following statutory enforcement. The remainder were still under review at the end of 1950. Fewer cases of statutory overcrowding were brought to the notice of the Public Health Department. During the year 38 families discovered to be living in conditions of statutory overcrowding were reported to the Health Committee. The number of overcrowded families relieved by Council rehousing during 1950 was 8, as compared with 70 in 1949. Health propaganda was continuous throughout the year, talks being given on health subjects to clubs, youth groups and workers, and these were assisted by the use of film strips projected from a film strip projector machine purchased by the Public Health Department for this purpose. Propaganda posters and leaflets were used as occasion arose, the posters being renewed from time to time and the subject thereof being topical for the season of the year. An additional station for the investigation of atmospheric pollution was erected during 1950, making the total number of observation points three. A graph in the text gives in pictorial form the results of the observations taken from these three points, and it is interesting to note that there is a considerable drop in the pollution, both from smoke and from dust and grit deposited during the summer months when domestic coal fires are at a minimum, although factories are continuing at fairly high pressure. With reference to the clean handling of food, the catering establishments in the Borough were kept under observation and an improved standard of hygiene has been maintained throughout. The Borough Council commenced, on the representation of the Health Committee, a scheme for the provision of free washing facilities in certain of the public conveniences of the Borough. When this scheme came into operation all employers of roundsmen delivering food, and hawkers, were notified of the service and urged to take advantage of it. During the year a survey of the sanitary conditions prevailing in the Southall schools was carried out with the co-operation of the Education Authority, and the Department staff 4 was thanked for this work and asked to keep the school conditions under observation at sixmonthly intervals. With regard to the welfare of old people, in addition to the cases recorded in the text as having been dealt with through the Public Health Department, there were very many individual enquiries concerning problems of old people, and during 1950 the initiation of a Committee for Old People's Welfare in the Borough was very welcome as a central Committee for dealing with all the problems of the old and ageing, and having as its members representatives from all the separate bodies dealing with old people. This ought to lead to an improvement in the speed with which cases of distress can be relieved. I should like to thank all the members of the staff of the Public Health Department for their energy and enthusiasm in the cause of health, for their assistance in the preparation of this Report and for their loyal support at all times. I am, Your Worship, Ladies and Gentlemen, Medical Officer of Health. Manor House, Southall. 5 HEALTH DEPARTMENT STAFF for the year 1950 Medical Officer of Health: Margaret A. Glass, B.Sc., M.B., Ch.B.(Glasgow), D.P.H.(Cantab.). Sanitary Inspection Staff: Chief Sanitary Inspector: R. W. McDonald, Cert. S.I.B., Cert. M. & F. Deputy Chief Sanitary Inspector: L. Mair, Cert. S.I.B., Cert. M. & F., R.S.I. Smoke Certificate. (Resigned 30.4.50.) S. Sadler, Cert. S.I.B., Cert. M. & F., R.S.I. Smoke Certificate. (Appointed 3.7.50.) District Sanitary Inspectors: W. Bowles, Cert. S.I.B., Cert. M. & F. E. J. Crosby, Cert. S.I.B., Cert. M. & F. (Resigned 19.11.50.) J. H. Willis, Cert. S.I.B., Cert. M. & F., R.S.I. Smoke Certificate. Additional Sanitary Inspector: R. Stockley, Cert. S.I.B. General Assistants: R. A. Dean. (Resigned 1.7.50) K. Keegan B. J. Tolworthy. (H.M. Forces) As from September, 1950. Clerical Staff: Senior Clerk: Mrs. K. Jones. Clerks, Shorthand-Typists: Mrs. P. M. Dix. Miss J. S. Snow. Miss S. McAllister. (Appointed 17.7.50.) GENERAL STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH Area (acres) : Land, 2,554 5. Water, 50. Total, 2,604.5. Population—Registrar-General's estimate (Mid-1950) 56,310 Number of inhabited houses according to Rate Book 14,354 Average number of occupants per house 3.90 Sum produced by a penny rate £1,612. 13s. 8d. The Council control the following parks and open spaces:— Southall Park 26 acres Recreation Ground 18 acres Manor House Grounds 2 acres Norwood Green 7.25 acres Wolf Fields 3.33 acres Southall Municipal Sports Ground 20 acres Jubilee Park 11.13 acres Durdans Park 29.5 acres Viaduct Field 4.22 acres Swimming Bath Site 10.5 acres West Middlesex Golf Course 108 acres 6 For general administrative purposes and for the main statistical purposes of this report, the district is divided into six wards, Waxlow Manor, Northcote, Hambrough, Dormers Wells, Glebe and Norwood Green. The majority of the houses in the district are occupied by good-class working people, chiefly engaged in the local factories and workshops. These include food, jam and chemical works, engineering, medical and toilet preparations, paint, dye, and wood works, laundries, etc. There are no trades carried on which are at present scheduled as offensive trades. Southall Borough Council maintains a swimming bath situated in the Recreation Ground, Southall, which is one of the public parks. The surface area of the bath is 3,600 square feet (120 feet by 30 feet), cubic capacity 16,500 cubic feet (110,000 gallons). The water is treated by break point chlorination, and a chlorine content of 4 0 parts per million at the shallow end is maintained in order to obtain a minimum of 2.0 parts per million at the deep end of the bath. Three samples of the water are taken daily by the staff for chlorine testing. As this bath is an open air one, the attendance is affected to a great extent by weather conditions. During 1950 the total number of persons using the bath was 35,230. The average number of persons attending per session (wet or fine) was 50. The maximum number at any one session was 500. HEALTH SERVICES PROVIDED BY OTHER AUTHORITIES North-West Metropolitan Regional Hospital Board Through its Uxbridge Group this Authority maintains two hospitals in Southall. The Southall-Norwood Hospital (30 beds) for treatment of general medical and surgical cases and casualties, and Mount Pleasant Hospital (50 beds) for the treatment of male patients suffering from tuberculosis. County Council of Middlesex—Health Department The County Council of Middlesex is the Local Health Authority under the National Health Service Act, 1946, and provides the following services in the Borough. (a) Care of Mothers and Young Children. Ante-Natal Clinics Post-Natal Clinics Infant Welfare Clinics Diphtheria Immunisation Clinics Ultra Violet Light Clinics At Jubilee Gardens and at Manor House. (b) Midwifery Service. Certified Midwives are employed for attendance on women in their homes in the Borough as midwives or as maternity nurses during childbirth. (c) Health Visitors. Health Visitors are employed to undertake home visiting for the purpose of giving advice on the care of young children, to persons suffering from illness, to expectant and nursing mothers and on the measures necessary to prevent the spread of infection. (The Health Visitors also act as School Nurses.) (d) Home Nursing and Nursing Equipment. Home Nurses are employed to undertake the nursing of persons in their homes. (This work was formerly undertaken by " District Nurses.") Where nursing equipment is required for use in the home, it is available on loan, in the case of large items, direct from the County Council and in the case of smaller items through the British Red Cross Society. (e) Vaccination and Immunisation. In addition to the immunisation of infants and young children carried out at the clinics referred to in (a) above, vaccination against smallpox and immunisation against diphtheria is carried out by those general practitioners who have agreed to co-operate in the County Council's scheme. 7 (f) Prevention of Illness, Care and After Care. The County Council's scheme includes provision for the admission of suitable cases to holiday rest homes. (Such cases should not be in need of medical or nursing care.) The care and after care of tuberculous persons is dealt with through the Welfare Officer at the Chest Clinic. (g) Domestic Helps. Home Help for householders where this is required owing to the presence of a person who is ill, lying in, an expectant mother, mental defective, disabled or aged is provided under the County Council's scheme. (h) Ambulance Service. An Ambulance Service is provided for the removal to hospital, where necessary, of accident and sickness cases. This service is organised in association with the Fire Service. There is one Ambulance Sub-Station situated in Southall beside the Town Hall. (i) Mental Health Service. The Mental Health Service deals with persons suffering from mental deficiency or mental illness. (j) School Medical Service. Medical inspection and dental inspection of school children is arranged by the County Council through the Southall Divisional Executive. Medical treatment and dental treatment is provided by the County Council in the Borough as follows :— Minor ailments treatment Orthopaedic treatment Ophthalmic treatment Physiotherapy Ultra Violet Light treatment North Road School and Featherstone Road School. County Council of Middlesex—Children's Department The County Council through the Children's Department is also concerned in caring for children deprived of a normal home life. Area Children's Officers have been appointed to deal locally with such cases as they arise. VITAL STATISTICS Whole District Total deaths, 480. (Males, 258 ; Females, 222). Crude Death Rate, 8 52. For extracts from vital statistics and causes of death, see Appendix, Tables I and II. Deaths and Death Rate The death rate which has been decreasing over the last few years showed a further drop from 9 43 in 1949 to 8.52 in 1950. The corresponding rate for the whole country was 11.6. Heart disease and cancer were again the principal causes of death. The numbers dying from heart diseases increased from 121 to 142, but there was a slight fall in the number of deaths from cancer since the previous year. There were no deaths from poliomyelitis, but one infant admitted to a general hospital died on the day of admission, and was diagnosed at post-mortem as a case of laryngeal diphtheria. The child had commenced, but not completed, immunisation. The total number of deaths registered during 1950 of persons belonging to the district and dying within the district, at all ages and from all causes, was 277 (males 135 and females 142). For statistical purposes it is necessary to add to this figure the deaths of persons ordinarily resident in the district who died in various London Hospitals, the Hillingdon Hospital, other Middlesex Hospitals and elsewhere outside the district. These "outside" 8 deaths were 203 in number (males 122 and females 81). The total number of deaths, therefore, belonging to the district was 480. The deaths of non-Southall residents in the St. Bernard's Hospital (not included in the above figures) numbered 149 (males 48 and females 101). For the distribution of deaths in the various Wards, see Appendix, Table III, and for the comparison of general birth and death rates and rates of maternity mortality see Appendix, Table IV. Births and Birth Rate. (Figures for 1949 are given in brackets.) The total number of registered births in the district (as notified under the Births and Deaths Registration Act) was 178 (364). The total number of live births belonging to the district, whether occurring within or outside the district, was 787 (871). The illegitimate live births were 36 (39). There were 12 stillbirths (14) and these were all legitimate except 1. The birth rate for Southall continues to fall. It has decreased every year since 1946, and was 14.19 for 1950 compared with 1572 in 1949. The corresponding rate for the whole of England and Wales in 1950 was 15.8. Infant Mortality The infant mortality rate during 1950 fell to 25.41. This is the lowest rate to be recorded in Southall. The graph on infant mortality, attached, demonstrates the dramatic change in the infant mortality rate during the past fifty years, although the fall has not been absolutely continuous, as there was a disappointing increase during 1949. The actual number of deaths occurring in 1950 was 20, 12 of which took place in hospital. It seems that with the falling birth rate either the children are more tenacious of life or the amount of supervision which can be given to each child is greater, and, therefore, more effective in its results on the prevention of death during the first year of life. The national infant mortality rate for 1950 was 29.8. Table VI gives the classification of causes of infant deaths under the age of one year. Graph A. Infant Mortality Rate from 1900 to 1950. 9 Premature Infants Forty-nine premature infants were born during the year, 8 at home and 41 at hospital; of these 43 survived to the end of one month. The classification of premature infant is given to a child born prematurely, or which weighs less than 5½ lbs. at birth. Maternal Morbidity During the year 7 cases of puerperal pyrexia were notified. There was one maternal death, but no death associated with abortion. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES There was a heavy incidence of measles in the district during 1950, occurring late in a country-wide epidemic. The number of cases notified was 701 compared with 194 in 1949. The measles figures for the past few years are shown below for comparison with the 1950 figures. There were no deaths from measles, and the type of case was mild. Year No. of Cases Deaths 1940 309 — 1941 575 — 1942 333 — 1943 293 2 1944 367 — 1945 500 1 1946 21 — 1947 334 — 1948 825 1 1949 194 — 1950 701 — The incidence of all the other notifiable diseases was greater than in 1949. There was double the number of cases notified of whooping cough, with one fatality. The type of cases was of a milder nature and the number of deaths from notifiable infectious diseases was 24, as compared with 37 the previous year. The only figures which show some improvement are those for dysentery and poliomyelitis. The number of poliomyelitis cases occurring was 6 only, with no infective polio-encephalitis. Two of these cases were nonparalytic and discharged from hospital in a very short time with no complications or aftereffects. Four cases showed residual paralysis, details being as follows:— Case A. Paralysis of left leg At the end of year still improving but likely to have remaining disability. Case B. Paralysis of both legs At end of year still improving with remaining only slight weakness in left leg. Case C. Paralysis in arms, legs, dorsal, lumbar At end of year continuing to improve, arms and abdominal muscles almost complete recovery, dorsal and lumbar muscles almost complete recovery, legs still paralysed. Case D. Paralysis of right leg, dorsal, lumbar At end of year continuing to improve, and abdominal muscles still some paralysis in right leg. 10 Of the poliomyelitis cases occurring in 1949 and continuing to show residual paralysis at the end of the year, progress in 1950 is now as follows:— Case A. Right peroneal muscle group No evidence of weakness of the muscles, but the circumference of the right leg was slightly less than on the left side. Case B. Anterior tibials, quadriceps, hamstrings Still a fair amount of paralysis in the right and abductors leg though walking without mental assistance. Case C. Left deltoid Recovered. Case D. Abductors and glutei of the left leg Fairly full recovery with only a slight remaining weakness. Case E. Anterior tibials Complete recovery. One infant, aged one year, was admitted to hospital, died on the day of admission and was diagnosed at post-mortem as a case of laryngeal diphtheria. This child was in process of immunisation when he succumbed to the disease. No positive contacts were found and no subsequent cases occurred. There were 89 cases of scarlet fever notified during the year compared with 74 in 1949. 49 of these cases were nursed at home and 25 cases were admitted to the nearest hospital, which is in Uxbridge, but on 15 occasions admission was not possible to this hospital and cases were admitted to hospitals in various places, sometimes as far away as 14 miles from Southall. There were 3 secondary cases. Provision of Antitoxin and Vaccine Lymph The Council provides diphtheria antitoxin and tetanus antitoxin free to local practitioners in the district. These antitoxins are obtained from the Health Department during office hours and by direct request to the Medical Officer of Health at other times. In the event of emergency supplies of vaccine lymph being required, it is obtainable at very short notice. Disinfection In cases of infectious disease, rooms, clothing, etc., were disinfected—rooms by sealing and fumigating with formalin preparation; clothing, bedding and other infected articles by removal for disinfection in the Council's disinfector at Salisbury Road Depot. List of premises, articles, etc., disinfected during the year:— Rooms 42 Quilts 5 Beds 48 Eiderdowns 1 Blankets 32 Pillows 43 Books 64 Sheets 56 Cancer It will be seen by the table of causes of death (page 24) that in 1950 90 cases (52 males and 38 females) died from cancer. (See Appendix, Tables VII and VIII.) Special Infectious Diseases Smallpox (Variola). No patients with smallpox, but 4 contacts of cases of smallpox were notified to the Department from the Port Authorities during the year. The contacts were kept under supervision for the requisite period, but no illness developed. Scarlet Fever (Scarlatina). The number of notifications received during the year was 89, as compared with 74 for for the previous year. Diphtheria. One case of diphtheria was notified to the Health Department. Immunisation had not been completed. 11 Ophthalmia Neonatorum. Two cases of ophthalmia neonatorum were notified during the year. Acute Poliomyelitis. Six cases of poliomyelitis were notified in the Borough during the year. Four cases were left with residual paralysis and further treatment by physiotherapy was arranged for these cases. New Regulations with regard to the notification of poliomyelitis, polio-encephalitis and meningococcal infection were issued by the Ministry of Health during December, 1949, in which it was laid down that special certificates should be used for these diseases in order to obtain more satisfactory figures, both as to the occurrence of the disease and the types, and the Registrar-General's returns were altered to include the new headings as laid down by the Regulations. Notifiable Diseases during the Year For the incidence of various infectious diseases, notified during the year, under age groups and locality, see Appendix, Tables IX and X. Infectious Disease Visits During the year, the Sanitary Inspectors paid 203 visits with reference to cases of infectious disease. In addition, the County Health Visitors did a certain amount of home and school visiting in connection with infectious diseases. Tuberculosis Pulmonary Tuberculosis. The number of new cases notified during the year was 80. Other Forms of Tuberculosis. The number of new cases notified during the year was 4. Of the total notifications 27 were received from institutions (County Council hospitals, 8; general hospitals, 19). Deaths from Tuberculosis. Tuberculosis of the respiratory system, 14; other forms, 1. For details of new cases notified and deaths in 1950, see Appendix, Table XI, and for the occupations of new cases see Appendix, Table XII. Public Health (Prevention of Tuberculosis) Regulations, 1925. Public Health Act, 1936, Section 172. Action under these powers was not necessary during the year. Table XIII shows the housing particulars of 65 of the 84 cases of tuberculosis notified in 1950. Of the 19 cases remaining, 8 were permanent residents of an institution at the time of development of the disease and the other 11 could not be followed up either because of immediate removal from the district or some similar reason. In 6 instances there were found to be 2 infected persons in one house, but in 2 of these instances only was the house crowded, and statutory overcrowding was confirmed in one of these two. Graph B demonstrates the incidence of tuberculosis notifications and deaths for the past twenty-one years. 12 Graph B. Tuberculosis Notifications and Deaths from 1930-1950. Scabies Clinic There was a satisfactory decline in the numbers attending for cleansing from scabies and vermin infestation. While this reduction was pleasing, there was still a hard core of cases becoming reinfested and requiring cleansing two or three times during the same year. Also certain new verminous cases were found to be heavily infested at the time when they were first seen, with secondary infection of the scalp or trunk, giving evidence that the infestation had been in existence for a considerable period of time. The fact that these heavily infested cases can still occur shows the ever present need for vigilance and particularly with regard to the adolescent and adult contacts of such cases, who are often averse to examination, and yet after submitting to this may be found to be carrying live vermin. As a general rule, there are few who default from reattendance at the Clinic when they have been asked to return, but this does occur sometimes, and these cases require to be followed up as they are likely to be a source of danger to others. There is a certain amount 13 of liaison with the County Health Staff, whereby the Health Visitors can be asked to visit the home, and the schools attended by any members of the defaulting family, and while attendances at the Clinic cannot be enforced, such visiting usually results in treatment being obtained. The total number of attendances at the Clinic for treatment of scabies and other skin conditions during 1950 was 1,480. Details of the cases were as follows:— First Visit Reattendances Total Scabies 28 71 99 Other skin conditions 145 740 885 Verminous heads 268 228 496 Baths (292 treatment baths; 169 ordinary) 461 Total attendances for all purposes 1,941 Total attendances for treatment 1,480 OLD PEOPLE'S WELFARE Eighteen cases of old people living in difficult circumstances were brought to the notice of the Department during 1950. These cases were investigated carefully and on no occasion was it necessary to use the powers provided in the National Assistance Act, 1948, Section 47, for compulsory removal to institutions. Details of the cases are as follows:— 3 admitted to hospital. 4 remained in their own homes because of improvement of conditions, i.e. by assistance from Home Helps and District Nurses. 5 died before hospital or hostel admission. 6 remaining under observation. Excellent co-operation was obtained from the Home Help Service Department and Welfare Department of the County Council, and the Almoners of the local Hospitals. During the year 1950 a voluntary Old People's Welfare Committee was set up in the Borough, through which it was possible to obtain items of domestic equipment, i.e., fireguards, walking-sticks, etc., which were of great value in enabling individuals to have their home conditions improved, or to make them more mobile. The Meals on Wheels Service undertaken by the Women's Voluntary Service, with a grant aid from the Borough Council funds, supplied 1,200 meals to old people during 1950. At Christmas, many voluntary associations assisted in the provision of special comforts for the aged of the Borough, not only for those in their own homes, but for those removed to Institutions in the near neighbourhood. HEALTH PROPAGANDA During the year propaganda was continuous in factories, canteens, youth organisations, adult associations, and to small groups. Members of the Health Department staff were always ready to address meetings on health subjects when asked to do so, and it is an integral part of the work of all members of the Health Department staff to spread propaganda concerning personal and communal hygiene wherever they are working. A series of poster exhibits, appropriate to the time of the year in each case, was displayed on the public notice boards. In order to assist propaganda the Council authorised the purchase of a film strip 14 projector and slowly a library of suitable film strips is being built up. These are used as adjuncts in talking to groups, and it is considered that they have very great value in leaving a pictorial record in addition to an auditory one in the minds of the audiences. Film strips were obtained on food hygiene and atmospheric pollution, and were used on a number of occasions during 1950. Letters from the Department containing advice with regard to health and descriptive sections on the work of the Department were inserted in the Borough Civic News Sheet, which commenced publication in March, 1950. These News Sheets are issued free to any ratepayer and are published at three-monthly intervals. ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT Nine establishments were inspected for licence under this heading and all were found satisfactory for the purpose which was intended. Details are as follows:— Purpose No. of Licences Massage only 1 Chiropody only 3 Massage, Chiropody and Electrical Treatment 2 Massage and Electrical Treatment 3 MEDICAL EXAMINATION OF BOROUGH COUNCIL EMPLOYEES During 1950 a total of 73 employees received medical examinations. Twenty-three were examined with regard to suitability for employment on the Council's permanent staff. Forty-four were examined for entry in the Council's Sickness Pay Scheme. Six, reaching completion of their Sickness Pay entitlement, received special medical examination and reports were made to the appropriate Committees of the Council. SANITARY CIRCUMSTANCES OF THE BOROUGH Water Supply and Water Services Water is supplied to nearly the whole of the district by the South-West Suburban Water Company. The Metropolitan Water Board supplies a small area in the southern part of the district, and the Rickmansworth and Uxbridge Valley Water Company a small area in the northern part. The supply is satisfactory both in quality and quantity. Sampling: One sample was taken during the year and found to be satisfactory. Reports on sampling carried out by the Metropolitan Water Board are issued from time to time. Number of houses supplied from public water mains 14,354 Per cent. of houses supplied from public water mains 100% Number supplied direct to houses 14,354 Number of standpipes on mains Nil Sanitary Inspections of the District The total number of inspections of premises made during the year by the Sanitary Inspectors was 11,380, an increase on the corresponding figure for 1949, which was 9,427. Table XIV gives an analysis of the number and nature of such inspections. School Sanitation During the year 1950 a survey was made of the sanitary facilities in Southall Schools, and certain deficiencies were brought to the notice of the Education Authority. This work appeared to be appreciated in that the Department was asked to furnish regular reports of inspection at six-monthly intervals. 15 Eradication of Bed Bugs Statistics for the year:— (a) Number of Council Houses Total: 38 (1) Found to be infested 171 (2) Disinfested during the year 17 (b) Number of other houses (1) Found to be infested 21 (2) Disinfested during the year 21 Canal Boats Visits were paid to the canal but only one boat was inspected. The condition of both boat and occupant was satisfactory. There were no complaint notices issued by other authorities. Mortuary and Post-Mortem Room The mortuary, situated in Havelock Road, provides adequate accommodation for the Borough. Five bodies were deposited in the mortuary during the year. Factories Act, 1937 The following tables give details of the work done in connection with the factories and outworkers in the Borough:— Inspections Factory Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted Non-Mechanical 10 33 Nil Nil Mechanical 196 176 9 Nil Totals 206 209 9 Nil Defects Found Particulars Number of cases in which defects were found Found Remedied Referred Number of cases in which Prosecutions were instituted To H.M. Inspector By H.M. Inspector Want of cleanliness 1 1 - - - Overcrowding - — - - - Unreasonable temperature — — - - - Inadequate ventilation — — - — — Ineffective drainage of floors — — - — — Sanitary Conveniences— (a) Insufficient 3 3 - — — (b) Unsuitable or defective 3 3 - — — (c) Not separate for sexes 1 1 - — — Other offences against the Act (not including offences relating to outwork 3 3 - - — Totals 11 11 — — — 16 Outworkers Nature of Work Section 110 Section 110 No. of outworkers in August List required by Section 110 (1) (c) No. of Cases of Default in sending Lists to the Council No. of Prosecutions for failure to supply Lists No. of Instances of Work in Unwholesome Premises Notices served Prosecutions Wearing Apparel 22 — — — — — Upholstery 1 — — — — — Toys 3 — — — — — Boxes 1 — — — — — Petroleum and Carbide During the year 64 applications for licences to store petroleum were granted, and 5 applications were granted for licences to store carbide of calcium. Celluloid and Cinematograph Films Act, 1922 There are two licences in force for the purpose of stripping and making celluloid solution from cinematograph films. Housing Four hundred and forty-four investigations revealed 38 cases of overcrowding (Housing Act, 1936). Other cases of overcrowding, though not statutory, were recommended on social grounds in the interests of Public Health. Of the 91 cases of statutory overcrowding remaining in the Health Department records at the end of 1949, 7 have been relieved at the end of 1950, leaving 84, which with 38 new cases, one of which was also relieved during the year, makes a total of 121 cases now awaiting relief. For statistics see Table XV in the Appendix. Administration of the Shops Acts A considerable increase will be noted in this branch of the work, which is now coming more into routine. For particulars see Table XIV. Markets The only market held in Southall is a small weekly one for the sale of horses, pigs, poultry and other livestock. This is kept under supervision. Action was taken to secure the regular removal of manure. HYGIENE OF FOOD No outbreak of food poisoning occurred during 1950. Sixteen individual cases of food poisoning were notified to the Department during 1950. In 11 cases no causative organism was isolated, 5 showed Salmonella. Four cases of dysentery were also notified, 2 of which were identified as being due to Shigella sonnei. While certain foods were mentioned as being suspected, the fact that others who shared the same risk did not suffer illness made the suspected source of infection very doubtful, and food sampled as the result of investigation, in all these cases, produced no positive results. 17 A recommendation was made by the Health Committee during the year that the Borough Council should consider the provision of free washing facilities in public conveniences in Southall. This provision, although for all ratepayers of the Borough, was originally suggested to enable health propaganda, with regard to personal cleanliness amongst handlers of food, to be emphasised by their being able to make ready use of these washing facilities without having to pay for them and without having to wait for the issue of special soap and towels by an attendant. The Borough Council agreed to initiate these services for an experimental period, and it was commenced on the 18th September, 1950. Prior to its commencing, every firm in Southall employing roundsmen or delivery boys was notified of the service and the information was also conveyed to itinerant hawkers of meat, fish, fruit, and vegetables, ice-cream, etc. Milk Licences. The following licences under the Milk (Special Designations) (Raw Milk) Regulations, 1949, and Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, were issued:— for the sale of Tuberculin Tested (Pasteurised) Milk 1 for the sale of Tuberculin Tested Milk 17 for the sale of Pasteurised Milk 19 for the sale of Sterilised Milk 16 Supplementary Licences 26 Total 79 Sampling. Fourteen samples of milk were sent during the year for bacterial count, all of which were reported as satisfactory. The examinations are carried out by the Public Health Laboratory Service. Food Sampling The bacteriological analyses of 280 food samples taken during the year were carried out by the Public Health Laboratory Service. The County Council is the Food and Drugs Authority. Seventy-four of these specimens were ice-cream samples, covering 35 makes of ice-cream, and following bacteriological analyses the ice-creams were graded as follows:— I 22 II 32 III 11 74 IV 9 Food Inspections Inspections are made of the carcases of slaughtered animals at St. Bernard's Hospital, (L.C.C.) slaughterhouse and pig clubs, and of premises where meat and other foods are sold or prepared for sale. There is no registered slaughterhouse or public abattoir in the district, and most of the meat supplied comes from the Ministry of Food Distribution Centre. 18 FOOD INSPECTIONS Total Inspected (lbs.) Sound Unsound Total (lbs.) Stock (lbs.) Production (lbs.) Consumption (lbs.) Total (lbs.) Animal Feeding (lbs.) Byproducts (lbs.) Destruction (lbs.) Canned 328,042 46,236 — 41,620 4,616 281,806 98,729 216 182,861 Raw 81,321 26,278 — — 26,278 55.043 49,347 1,762 3.934 Totals 409,363 72,514 — 41,620 30,894 336,849 148,076 1.978 186,795 Catering Establishments The total number of catering establishments in the Borough is 183. One hundred and seventy-seven of these establishments were found to be operating in a satisfactory manner. Twenty-nine establishments required improvement in certain minor details, and these were done by arrangement without the requirement of formal notice. Seven establishments had defects sufficient to require the service of preliminary notices and these notices were complied with. The service of statutory notices in respect of insufficient watercloset accommodation, repair of premises, cleansing of premises, the provision of hot water or sinks, was found necessary in one instance only where a summons was served, but the work was completed before the hearing. New Byelaws with respect to the Handling, Wrapping and Delivery of Food became operative on the 17th July, 1950, and work was immediately commenced under Article 4(a): " take all such steps as may reasonably be necessary to protect the food from dust, dirt, mud, filth, dirty water, animals, rodents, flies, insects and other sources of contamination, including contamination by other persons, and in particular shall cause the food to be so placed as to prevent risk of contamination from such sources"; and many traders have co-operated by covering exposed food, although a great deal of work still remains to be done before the ideal is attained of having no uncovered food in any shop exposed so as to be in danger of contamination by persons or by flies. Half-yearly inspections are made of schools and the opportunity is taken to secure improvements in school canteens. RODENT CONTROL Local policy may be regarded as follows:— (1) No "agreements" exist between the Council and local business premises. From the date when this work became the responsibility of the Council, it has been considered inadvisable that local food factories should, so to say, contract out of their legal obligation to keep these premises free from rodent infestation or invasion. The managements of local food factories, and other business premises, instead submit to the Public Health Department measures proposed by their pest contractors; these are indicated on plan, and the work is supervised. (2) Private dwellings are treated free of cost. (3) Sewer treatments are carried out twice yearly. 19 ATMOSPHERIC POLLUTION In 1949 two observation points for the estimation of sulphur dioxide by the leadperoxide method were set up, one in the north and one in the south of the Borough. In 1950 an additional observation point was established in Hortus Cemetery, and the two lead-peroxide instruments were re-sited, one in Jubilee Gardens and one in the Recreation Ground. In the Hortus Cemetery a deposit gauge was installed for the measurement of matter deposited from the air. By means of the lead-peroxide instruments, sulphur pollution from surrounding chimneys covering an area of one to two square miles is measured, and with the deposit gauge an analysis is made of atmospheric contaminants, such as soot, grit, etc., which are deposited from the air. The attached graph "C" shows in diagramatic form the rise and fall of pollution throughout the year in the various districts. From the Fuel Research Monthly Bulletin, graph "D" has been compiled giving a pictorial representation of the sulphur dioxide pollution in Southall as compared with the best district in which similar measurements are made, which is Godalming, Surrey; the County Hall, Westminster, London; and the district showing the heaviest pollution by this method, which is Sheffield. In spite of the fact that complaints of smoke nuisance are frequently brought to the notice of the Department it appears that for an industrial area Southall compares extremely favourably with even Central London. It is noteworthy that during the summer months when domestic coal fires are at a minimum the amount of deposit is very low. Atmospheric Pollution Estimation 1950 Sulphur Trioxide-Lead Peroxide method. Milligrams per day per 1,000 squared centimetres Deposit Gauge Month of year Jubilee Gardens Recreation Ground Hortus Cemetery Rainfall Tons per square mile per month mm. Insoluble Soluble Total January Before recording commenced February 19.3 20.02 64.44 8.95 5.12 14.07 March 18.57 20.38 15.55 9.28 3.80 13.08 April 11.52 14.96 52.8 8.64 6.31 14.95 May 14.10 11.31 38.3 24.0 6.65 30.65 June 6.74 6.43 9.15 20.0 3.29 23.29 July 3.54 4.53 82.79 7.90 5.24 13.14 August 3.95 5.19 130.3 5.58 5.15 10.73 September 6.75 5.98 67.47 6.02 4.82 10.84 October 16.6 17.42 12.01 7.25 3.68 10.93 November 23.48 23.63 112.4 5.85 6.71 12.56 December 23.25 25.11 21.16 4.80 3.05 7.85 20 Graph C. Atmospheric Pollution Estimation 21 Graph D. Atmospheric Pollution Comparison with other Districts 22 APPENDICES EXTRACTS FROM VITAL STATISTICS Table I. Total Male Female Comparative Figures for 1949 Live Births—Legitimate 751 404 347 832 Illegitimate 36 16 20 39 Stillbirths—Legitimate 11 7 4 14 Illegitimate 1 1 — Deaths 480 258 222 531 Birth rate (live and stillbirths) per 1,000 of the estimated population 14.19 15.72 Stillbirth rate per 1,000 total (live and still) births 15.02 15.82 Crude death rate per 1,000 of the civilian population 8.52 9.43 Deaths from Puerperal Causes (Headings 29 and 30 of the Registrar-General's Short List):— Deaths Rate per 1,000 total (live and still) births No. 29. Puerperal sepsis — — - No. 30. Other puerperal causes 1 1.25 Total 1 1.25 Death rate of infants under 1 year of age:— All infants per 1,000 live births 25.41 40.18 Legitimate infants per 1,000 legitimate live births 23.97 40.87 Illegitimate infants per 1,000 illegitimate live births 55.56 25.64 Deaths from cancer (all ages) 90 100 Deaths from measles (all ages) — — Deaths from whooping cough (all ages) 1 2 Deaths from diarrhœa, etc. (under 2 years of age) 1 4 23 Causes of Deaths, 1950 Table II Male Female Total 1950 Total 1949 1. Typhoid fever, etc. - - - - 2. Cerebro-spinal fever — — — - 3. Scarlet fever — — - - 4. Whooping cough — 1 1 2 5. Diphtheria 1 — 1 — 6. Tuberculosis—Respiratory 9 5 14 23 7. Other tuberculosis — 1 1 1 8. Syphilitic diseases 3 1 4 2 9. Influenza 2 2 2 10. Measles — - — 11. Ac. poliomyelitis and polioencephalitis — — — 2 12. Ac. inf. encephalitis — — — — 13/16 Cancer (all forms) 52 38 90 100 17. Diabetes 2 2 4 18. Intra-cran. vase, lesions 17 36 53 49 19. Heart disease 80 62 142 121 20. Other circulatory diseases 10 9 19 23 21. Bronchitis 25 15 40 37 22. Pneumonia (all forms) 9 13 22 33 23. Other respiratory diseases 1 1 2 6 24. Ulcer of stomach or duodenum 3 1 4 4 25. Diarrhoea, etc. (under 2 years) - — - 4 26. Appendicitis — — — 4 27. Other digestive diseases — — — 16 28. Nephritis 3 4 7 8 29. Puerperal sepsis — — - — 30. Other maternal causes — 1 1 1 31. Premature birth 3 — 3 3 32. Congenital malformations, Birth injuries, Infant diseases 5 4 9 24 33. Suicide 1 2 3 1 34. Road traffic accidents 4 1 5 - 35. Other violence 8 4 12 15 36. All other causes 22 21 43 43 Total Deaths 258 222 480 531 Deaths in Wards Table III Ward Male Female Total Waxlow Manor 23 26 49 Northcote 35 32 67 Hambrough 60 51 111 Dormers Wells 50 32 82 Glebe 45 43 88 Norwood Green 45 38 83 Total 258 222 480 24 Table IV Vital Statistics compared with other Areas BIRTH-RATES, CIVILIAN DEATH-RATES, ANALYSIS OF MORTALITY, MATERNAL DEATH-RATES, AND CASE-RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1950. (England and Wales, London, 126 Great Towns and 148 Smaller Towns.) (Provisional Figures based on Weekly and Quarterly Returns) England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 Census) London Administrative County Southall Rates per 1,000 Civilian Population Births: Live 15.8 17.6 16.7 17.8 13.98 Still 0.37 0.45 0.38 0.36 0.21 Deaths: All causes 11.6 12.3 11.6 11.8 8.52 Typhoid and Paratyphoid fevers 0.00 0.00 0.00 0.00 0.00 Pneumonia 0.46 0.49 0.45 0.48 0.39 Smallpox — — — — — Whooping Cough 0.01 0.01 0.01 0.01 0.02 Diphtheria 0.00 0.00 0.00 0.00 0.02 Influenza 0.10 0.09 0.10 0.07 0.04 Tuberculosis 0.36 0.42 0.33 039 0.27 Acute poliomyelitis and polioencephalitis 0.02 0.02 0.02 0.01 0.00 Notifications (corrected): Smallpox 0.00 0.00 — — — Scarlet fever 1.50 1.56 1.61 1.23 1.58 Diphtheria 0.02 0.03 0.02 0.03 0.02 Typhoid fever 0.00 0.00 0.00 0.01 0.00 Erysipelas 0.17 0.19 0.16 0.17 0.09 Pneumonia 0.70 0.77 0.61 0.51 0.99 Measles 8.39 8.76 8.36 6.57 12.45 Whooping Cough 3.60 3.97 3.15 3.21 4.53 Paratyphoid Fever 0.01 0.01 0.01 0.01 - Acute Poliomyelitis (including Polioencephalitis): Paralytic 0.13 0.12 0.11 0.08 0.07 Non.Paralytic 0.05 0.05 0.06 0.05 0.04 Food Poisoning 0.17 0.16 0.14 0.25 0.28 Rates per 1,000 Live Births Deaths under 1 year of age 29.8 33.8 29.4 26.3 25.41 Deaths from Diarrhoea and Enteritis under 2 years of age 1.9 2.2 1.6 1.0 — Rates per 1,000 Total (Live and Still) Births Notifications (corrected): Puerperal Fever 5.81 7.43 4.33 6.03 3.75 Puerperal Pyrexia 25 MATERNAL MORTALITY (England and Wales). Per 1,000 Live and Stillbirths. Abortion with Sepsis Abortion without Sepsis Puerperal Infections Other 0.09 0.05 0.03 0.15 Abortion—Mortality per Million Women aged 15-45 (England and Wales). With Sepsis Without Sepsis 7 4 Table V Monthly Registration of Births. The monthly registration of births classified as to Wards is given in the following table:— Waxlow Manor Northcote Hambrough Dormers Wells Glebe Norwood Green Total January 2 - 3 3 7 2 17 February 2 3 3 5 4 3 20 March 1 4 - 1 3 3 12 April 1 2 2 2 1 2 10 May 3 1 4 6 1 2 17 June 3 5 1 — 1 1 11 July 3 2 2 2 8 1 18 August 3 3 6 4 5 — 21 September 1 3 — 1 1 3 9 October 3 3 1 8 1 2 18 November - 1 4 3 - 3 11 December 2 2 4 2 3 1 14 Total 24 29 30 37 35 23 178 Table VI Causes of Death Under One Year of Age. Certified Cause of Death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 1-3 months 3-6 months 6-9 months 9-12 months Total deaths under I year Bronchitis, pneumonia, etc. 1 2 - - 3 1 4 - - 8 Congenital malformations, etc. 1 - - 1 2 1 1 — - 4 Gastro-enteritis, diarrhoea, etc. — — — - - - - - - Prematurity 3 - - - 3 - - - - 3 Asphyxia due to misadventure - - - - - 1 - — - 1 Asphyxia (Atelectasis) 3 - - - 3 - - - - 3 Birth Injury 1 - - - 1 - - - - 1 Totals 9 2 - 1 12 3 5 - - 20 Live Births. Legitimate 751 Illegitimate 36 Infant Deaths. Legitimate 18 Illegitimate 2 26 Table VII Deaths from Cancer Year Male Female Total Estimated Population Rate per 1,000 population 1927 13 13 26 33,480 0.77 1928 18 27 45 35.340 1.27 1929 12 10 22 35,370 0.62 1930 17 29 46 37,560 1.22 1931 20 28 48 39,280 1.22 1932 22 23 45 41,530 1.08 1933 23 28 51 44,780 1.13 1934 22 27 49 46,693 1.04 1935 30 27 57 48,270 1.18 1936 22 30 52 49,550 1.05 1937 42 28 70 51,560 1.35 1938 27 30 57 52,400 0.51 1939 33 41 74 52,430 1.41 1940 28 36 64 51,670 1.23 1941 34 37 71 50,280 1.41 1942 34 38 72 50,350 1.43 1943 51 46 97 49,730 1.95 1944 37 32 69 48,970 1.41 1945 39 44 83 49,880 1.88 1946 40 54 94 54,440 1.64 1947 45 32 77 56,240 1.36 1948 48 36 84 56,130 1.49 1949 46 54 100 56,350 1.77 1950 52 38 90 56,310 1.60 The following table shows the age distribution of the cancer deaths:— Table VIII Ages at Death in Cancer Cases Age 0-15 15-30 30-40 40-50 50-60 60-70 70-80 80+ Total Male 1 4 12 18 15 2 52 Female - - - 5 9 8 13 3 38 Total - - 1 9 21 26 28 5 90 27 The following table shows the various infectious diseases (other than Tuberculosis) notified during the year and also their age incidence:— Table IX Notifiable Diseases during the Year (other than Tuberculosis) Diseases Ages Total cases notified Deaths Under 1 year 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 65 65 and over Dysentery - - - - - - - - - 1 3 4 - Erysipelas - - - - - - - - - 1 3 1 5 - Food Poisoning - - 3 3 1 1 - 1 5 1 1 - 16 - Laryngeal Diphtheria — 1 — — — — — — — — — — 1 1 Measles 25 48 83 114 87 337 5 - 2 - - - 701 - Meningococcal Infection - - - - - - - - 1 - - - 1 - Ophthalmia Neonatorum 2 - — - - - - - - - - - 2 - Pneumonia - 2 1 2 4 11 2 4 6 10 8 3 56 22 Poliomyelitis - - - 1 2 - 1 1 1 - - 6 - Puerperal Pyrexia - - - - - - - 2 4 1 - - 7 - Scarlet Fever 1 2 3 6 9 55 8 3 1 1 - - 89 - Whooping Cough 14 18 28 44 32 113 2 — 4 — - — 255 1 Totals 45 71 118 170 135 517 18 10 24 15 13 7 1,143 24 The number of cases of infectious diseases (including Tuberculosis) notified during the year, according to their locality, are shown below:— Table X Diseases Total Waxlow Manor Northcote Hambrough Dormers Wells Glebe Norwood Green Total Deaths Dysentery 4 - - - 4 - - - Erysipelas 5 1 1 - 1 1 1 - Food Poisoning 16 5 2 - 1 8 - - Laryngeal Diphtheria 1 - - - 1 - - 1 Measles 701 57 179 127 201 81 56 - Meningococcal Infection 1 - - - - 1 - - Ophthalmia Neonatorum 2 2 - - - - - — Pneumonia 56 6 8 9 11 13 9 22 Poliomyelitis 6 1 - 1 4 - - Puerperal Pyrexia 7 - 1 2 1 3 — — Scarlet Fever 89 20 8 14 21 11 15 - Tuberculosis 84 16 15 12 18 16 7 15 Whooping Cough 255 38 46 30 60 58 23 1 Totals 1,227 146 260 195 323 192 111 39 28 Table XI Tuberculosis Notifications—Ages and Classifications Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary Male Female Male Female Male Female Male Female 0-1 - - - - - - - - 1-5 2 — - 1 - - - - 5-10 - 2 - - - - - - 10-15 3 - 1 1 - - - - 15-25 12 13 - 1 - 2 - - 25-35 7 12 — - - 1 - - 35-45 4 3 — — 2 1 - - 45-65 9 9 — - 4 2 - - 65+ 2 2 — — 3 — — — Totals 39 41 1 3 9 6 - - Table XII The occupations of the new cases are as follows:— Occupations Pulmonary Non-Pulmonary Male Female Male Female Building and decorating trades 1 - - 1 Schoolchildren 2 3 1 1 Clerical work 6 13 - - Domestic duties — 11 — — Factory hands 10 1 - - No occupation 10 8 - 1 Various 10 5 - — Totals 39 41 1 3 29 Table XIII Home Conditions of Cases of Tuberculosis Notified in 1950 No. of Case Type of Dwelling Condition of Property No. of Rooms Occupants Overcrowding Adults + 10 - 10 1 House Good 5 5 1 2 Yes 2 House Good 5 3 - - - 3 House Good 5 3 2 1 Yes 4 Flat Good 2 2 - 1 - 5 Flat Good 2 2 - 1 - 6 House Good 5 2 2 1 - 7 House Average 5 2 2 1 - 8 House Good 5 5 — 1 - 9 House Bad 6 4 1 2 - 10 House Good 5 3 - - - 11 Flat Average 2 2 - - - 12 House Good 5 4 1 - - 13 House Average 5 3 - - - 14 House Good 5 5 - - - 15 House Average 4 3 1 - - 16 House Average 4 2 1 2 - 17 House Average 5 4 - - - 18 House Good 5 3 — 1 - 19 House Average 5 5 1 1 Yes 20 House Bad 5 3 2 3 Yes 21 Flat Average 3 2 - - - 22 Flat Good 1 2 — 1 Yes 23 House Good 5 5 - 2 Yes 24 House Good 3 2 - - - 25 House Good 5 3 - - - 26 House Average 4 5 - 1 Yes 27 House Good 5 7 1 1 Yes 28 Flat Average 3 2 - 2 - 29 House Average 5 5 - 2 Yes 30 Flat Average 3 3 — — - 31 House Good 5 3 - 2 - 32 House Good 4 2 - 3 - 33 House Good 4 2 2 1 - 34 House Average 5 2 - 1 - 35 Flat Good 2 2 — - - 36 House Good 5 5 - 1 - 37 House Average 5 4 - - - 38 Flat Average 2 2 1 - - 39 House Average 5 2 - - - 40 House Average 5 3 — - - 41 House Bad 4 5 - - - 42 House Good 5 3 1 1 - 43 House Average 5 3 - 1 - 44 House Average 4 2 - 4 - 45 Flat Average 5 4 - 1 - 46 House Average 4 5 - - - 47 House Average 5 2 - - - 48 House Good 5 3 - - - 49 Flat Good 2 2 - - - 50 House Good 5 3 - - - 51 House Average 5 4 - - - 52 Flat Good 1 1 - - - 53 House Good 3 2 1 1 - 54 Flat Good 6 3 1 - - 55 Flat Good 2 2 - - - 56 House Good 5 3 — 1 - 57 House Good 5 3 1 - - 58 House Average 5 2 1 2 - 59 House Good 5 3 1 - - 60 House Good 5 5 1 1 Yes 61 House Good 5 2 - 1 - 62 House Good 5 4 - - - 63 House Average 5 2 - - - 64 House Good 5 5 - - - 65 House Good 5 3 - - — 30 Table XIV Sanitary Inspections—Classification. Houses, Public Health Act, 1936 6,686 Houses, Housing Act, 1936 123 Overcrowding 444 Disinfestation 173 War Damage 5 Vans, Sheds 36 Shops Act 892 Food Shops 552 Fried Fish 25 Cafes, etc. 308 Factories (Mechanical) 176 Factories (Non-Mechanical) 33 Outworkers 37 Food Factories 237 Smoke 321 Offensive Trades 12 Bakehouses 43 Dairies 36 Water Sampling 3 Milk Sampling 17 Other Foods Sampling 281 Schools 20 Stables 49 Accumulations 101 Hairdressers 2 Slaughterhouses 69 Rats and Mice 401 Petrol 109 Canal Boats 1 Infectious Diseases 203 Atmospheric Pollution 95 11,490 31 Table XV Statistics HOUSING—GENERAL 1. Inspection of dwelling-houses during the year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,945 (b) Number of inspections made for the purpose 6,809 (2) (a) Number of dwelling houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 - (b) Number of inspections made for the purpose — (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation - (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 1,043 2. Remedy of defects during the year without service of formal notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the local authority or their officers 806 3. Action under statutory powers during the year:— (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs - (2) Number of dwelling-houses which were rendered fit after service of formal notices (a) By owners — (b) By local authority in default of owners — (b) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 239 (2) Number of dwelling-houses in which defects were remedied after service of formal notices (a) By owners 279 (b) By local authority in default of owners 3 (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which Demolition Orders were made (2) Number of dwelling-houses demolished in pursuance of Demolition Orders - (d) Proceedings under Section 12 of the Housing Act, 1936:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made - (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement room having been rendered fit 4. Housing Act, 1936—Overcrowding:— (a) (1) Number of dwellings overcrowded at the end of the year 121 (2) Number of families dwelling therein 184 (3) Number of persons dwelling therein 698 (b) Number of new cases of overcrowding reported during the year 38 (c) (1) Number of cases of overcrowding relieved during the year 8 (2) Number of persons concerned in such cases 36 (d) Particulars of any case in which dwelling-houses have again become overcrowded after the local authority have taken steps for the abatement of overcrowding - 32