Pc??? 7.12.??? A C 439 (1) South All Sout 22 BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1954 MARGARET A. GLASS, Medical Officer of Health KING AND HUTCHINOS. LTD., PRINTERS, SOUTHALL BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1954 MARGARET A. GLASS, Medical Officer of Health INDEX PAGE PAGE PAGE Ambulance Service 9, 22 Home accidents 13, 47 Antitoxin 19 Home helps 9, 23 Parks and open spaces 6,7 Area of Borough 6 Home nursing 8,22,23 Pet Animals Act 28,45 Atmospheric Pollution 4,24, Hospital services 8 Personal hygiene 28 32, 33, 34, 35, 36, 37, 45 Houses—number inhab- Petroleum Acts 27, 45 ited 6 Physical features of the B.C.G. Vaccination 4 Housing 3, 4, 17,27, 46,47 district 6, 7 Beaver Report 4 Housing Repairs & Rents Poliomyelitis 3, 10, 13, 14, 39, Bed bugs 25,45 Act 4,27 41,42 Births and birth rate 3, 10, 11, Hygiene of food 24, 28, 31 Population 6, 11 38,40 Hygiene—personal 28 Premature infants 11, 12,40 British Red Cross Service 22 Public Control Depart- Bulletin of infectious dis- Ice-cream sampling 28,29, 45 ment 29, 30 ease 13 Immunisation 4, 8, 9, 16 Public Health Committee 3 Canal boats 25 45 Infant mortality 3, 11, 38, 40 Puerperal pyrexia 12, 13, 41, Cancer 10, 18,19, 38, 39, 41 Infectious diseases, pre- 42 Caravans 37 valence and control of 3,4, Rag Flock and Other Carbide 37 13, 14, 15, 16, 17, 18, 19, 20, Materials Filling Act. 26 Care and after care 8, 9 41, 42, 45 Rateable value 6 Catering establishments 30, Influenza 3,14,39,41,42 Rats and mice 32,45 31,45 Inspection and super- Rehousing 27,47 Cattle market 38 vision ot Food 30,31,45 Respiratory diseases 14, 39, Causes of death 10,18,39, Inspection of sanitary ac- 40,41,42 40 commodation in fac- Rivers—Pollution 37 Celluloid and Cinemato- tories 26 Road Accidents 10,39 graph Film Art 27 Irradiation of the Upper Certificates of Disrepair Air in Schools 4,20,21 St. John Ambulance Ser- and Revocation 27 Laboratory facilities and Sanitary circumstances 24,25, Chest Clime 8,9,16,22 work 28 26,27,28,31 Children's welfare 8, 9 Sanitary inspection 24,45 Chiropody 4, 23,2 4 Markets 28 Sanitation in schools 25,45 Chlonnation 7 Mass X-Ray 4, 18 Scabies 19, 44 Club for Disabled Persons 22 Massage, establishments Scarlet fever 15, 21,41, 42 Community Centre 22 for 24 School Medical Service. 9 Day Nurseries 8 Materna morbidity 12 Slum Clearance 4 Deaths and death rates 3, 4, Maternal mortality 10, 12, 38, Shop Acts 28, 45 10, 13, 14, i6, 17, 23, 38, 42 Maternity and Child Wel- 39 Smallpox 4, 9, 14, 19 Deaths in wards 10,39 Maternity and Child Wel- Smoke pollution. 4,32,36, Demolition 27,46 fare 8,9 37,45 Diphtheria 3, 4, 9, 10, 13, 15, Meals on sampling 31 Social conditions 6, 7 16, 19, 39 Meals on Wheels4' 23 Staff 6 Disinfection 19 Measles 10, 13, 21, 38, 39, Statistics — General and Dysentery 3, 13, 14, 28,41, 42 41, 42 Vital 3,10,11,12, 38,46,47 Meat and other foods 30 Statutory action 32,37,46 Education—Health 24 Medical examinations 24 Stillbirths 10,38 Employees' medical ex- Mental health 9 Street traders 30, 31 aminations 24 Middlesex County Coun- Sulphur dioxide pollution cil Services 8, 9 4, 32, 33, 34, 36 Factories Act, 1937 25,45 Midwifery service 8 Swimming bath 7 Film Strip Projector 24 Milk licences 28 Swimming bath 7 Flannelgraph 24 Mortuary 25 Tuberculosis 3,4.8,9,10,16, Food handlers hygiene 14,24, 17, 18, 22, 39, 42, 43 31 National Assistance Act, ., Food hygiene 24, 28, 31 S. 47 23 Unfit houses 46 Food inspection 30,31 Notifiable diseases 3,4,12,13, Vaccination ...4,8,9,15 Food poisoning 28, 31, 41, 42 14, 15, 16, 17, 18, 41, 42, 43 Vaccine lymph 19 Food sampling 28,29,45 Noise nuisance 32 Verminous persons 19, 44 Food shops 30,31,45 Nursing equipment 8,22 Vital statistics 3, 10, 11, 12, 38 Free washing facilities 28 Old People's Welfare 4, 13, Water supply and service Graphs 4, 11, 17, 18, 32, 34, 22, 23 24, 45 35, 36 old People's Welfare Welfare — General and Health education 24 Committee 23 Old People's 22,23 Health visitors 8,18 Ophthalmia neonatorum 16 Whooping Cough 10,13,38, Heart disease 10, 39 Outworkers 25, 26, 31 39,40, 41,42 Holidays for old people 23 Overcrowding 3,4,17,18,27, Women's Voluntary Ser- Holiday rest homes 9 45, 47 vice 23 2 THE COUNCIL OF THE BOROUGH OF SOUTHALL, 1954 HIS WORSHIP THE MAYOR *Councillor J. Salmon, J.P. Deputy Mayor: Councillor P. J. Love. Aldermen: *Dane, A. T. *Gardner, F. E. †*Lowe, J. (Chairman) Douglas, H. C. Hopkins, W. H. Marks, F. J., J.P. Councillors: *Barrett, J. Day, F. R. †*Sheil, E. J. †*Bid well, S. J. Haigh, J. Shepherd, A. H. *Cavell, Mrs. I., J.P. Hook, R. E. Southey, P. G. *Dormer, J. G. P., Love, P. J. Steele, T. J. *Errington, F. G. Lye, A. E. *Ward, J. H. Godman, A. S. *Salmon, J., J.P. *Williams, Mrs. V. G. I. *Members of the Public Health Committee. † Members of the 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 58th Annual Report on the health and circumstances of the population of the Borough of Southall. The health of the people continued to be good. All the vital statistics were satisfactory. A fall in the death rate, a fall in the infant mortality rate, a fall in the infectious disease incidence rate combined with a fall in the number of notifications of tuberculosis suggest a general raising of the resistance to disease and, therefore, an increase in the positive health of the people. The amount of sickness incidence in industry also showed an appreciable reduction over the previous year, although accurate statistics for the Borough as a unit are not obtainable for this since there are many working within the Borough who do not live here, while many of the inhabitants of Southall travel into other districts to work. A slight fall in the birth rate is noted, but is not of importance in a community where there still is difficulty in finding housing accommodation for overcrowded families and where school children are still occupying overcrowded class rooms. Epidemic disease was not a problem in 1954. There was no diphtheria, little influenza and only four cases of poliomyelitis; unfortunately one of the latter proved fatal, but in the other three cases there was full recovery. The occurrence of Sonne dysentery in a Southall school meant vigorous action had to be taken in order to confine the outbreak to as few cases as possible. While the number of patients actually having symptoms was very small, work in tracing contacts who were carrying infectious organisms produced a considerable number 3 of symptomless carriers, but with prompt isolation and treatment of these and the observance of strict hygienic precautions by their relatives and friends, the disease came under control. A fall in the figures for vaccination is apparent, and this is a bad thing as smallpox is still a danger and is a common and fatal disease in some parts of the world. There is an improvement in the figures for immunisation against diphtheria, and this is a good thing, for it is considered that in order to keep a district free from diphtheria, a 75% proportion of infant immunisation is necessary, and this disease which, like smallpox, is a menace in many foreign countries, is also still present in this country, cases and deaths occurring every year. With regard to tuberculosis, it seems from the notifications graph as if at last all the efforts towards the improvement of this disease are beginning to have some effect. New methods of discovery of infected persons, including the wide use of mass X-ray and B.C.G. vaccination, the improvement in housing, improved standards of nutrition, resulting from the increase in the knowledge of the people in the importance of adequate and varied diet as much as from increased prosperity, and the improved methods of isolation and the new drug treatments may all have played their parts in achieving this tuberculosis reduction, which appears to be occurring also in many parts of the British Commonwealth. The disease, however, is by no means conquered yet, and the death rate from tuberculosis for 1954 is no lower than in 1953. The problems of old people living in solitary or neglected conditions are still a matter of concern, and although much work has been done by the voluntary associations in the Borough, there is need for much more. Two matters with regard to the work being done at present give satisfaction, one is the increase in the supply of meals to old persons from one to three per week, and the other is that local chiropodists enthusiastically give much of their time, and charge low fees, to keep the feet of old age pensioners in such a condition as to give them comfort and keep them mobile. The Housing Repairs and Rents Act, which came into force during the year, was welcome as it gave powers for an increase in the work on the clearance of slums, a matter very close to the hearts of all public health officers because of the association of bad housing with ill health and uncleanliness, and a survey of the Borough was started to find how much slum clearance would be necessary and how much could be done at once. If slums are to be cleared there must be housing available for the displaced occupants, and it is to be hoped that no difficulties will arise over this, especially as the problem is not a large one in Southall, which has grown up so rapidly in the years since the First World War. An improvement in the figures for known cases of statutory overcrowding was apparent in 1954, following an increase in the number of Council houses of the larger type becoming available for big families. Atmospheric pollution continued to be a topical subject for consideration in the newspapers, at meetings of the learned societies, and in Parliament where the Beaver Report, a survey of the problem of atmosphere pollution in Britain, was discussed. Continuous work was carried on throughout the year, both in the routine observation of atmospheric pollution as a whole, and on the investigation of particular complaints regarding pollution at individual sites. The figures show a substantial decline in the overall pollution by smoke and sulphur dioxide over the whole of the year in this Borough, but an increase in the amount of grit deposit in the central area. It was interesting to obtain the final report of the experiment on the Irradiation of the Upper Air in Schools, which was carried out in Southall. The results showed that while there was no doubt that disinfection of the air could be carried out by this method, the value of this disinfection in the prevention of the spread of infectious disease seemed not to be such as to justify the provision and maintenance of the rather complicated equipment required. The many findings which were incidental to the experiment concerning the ventilation of rooms, heating currents, etc., were analysed and will continue to be analysed for some time to come, and should be of ultimate benefit in further experiments, and to the community as a whole in many ways. 4 Acknowledgements are due to those who have so kindly supplied information for use in this Report—the County Medical Officer, the Area Medical Officer, the Medical Superintendent of St. Bernard's Hospital, the Medical Superintendent of Hillingdon Hospital, the Physician of Uxbridge Chest Clinic, the County Public Control Officer, the Medical Research Council, the Medical Officers of Health of Godalming, Sheffield and Westminster, Chief Officers of the Borough Council, the directors of many local organisations devoted to social service, officers of the Fuel Research Station, and the general practitioners of Southall. I should also like to extend my sincere thanks to the Chief Sanitary Inspector and to all members of the Departmental Staff in acknowledgement of their help in the preparation of this Report, and for their loyal support at all times. I am, your Worship, Ladies and Gentlemen, Your obedient Servant, Margaret a. glass Medical Officer of Health. Manor House, Southall. HEALTH DEPARTMENT STAFF for the year 1954 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: S. Sadler, Cert. S.I.B., Cert. M. & F., R.S.I. Smoke Certificate. District Sanitary Inspectors: R. Stockley, Cert. S.I.B., Cert. M. & F., R.S.I. San. Sc. F. G. S. Hill, Cert. S.I.B., Cert. M. & F., Cert. I. San. E., R.S.I. San. Sc. B. J. Parsons, Cert. S.I.B., Cert. M. & F. (Resigned 25th April, 1954). Additional Sanitary Inspector: Vacant. General Assistant: B. E. Coleman. (Resigned 12th September, 1954.) M. J. Moore. (Appointed 23rd August, 1954. Resigned 30th November, 1954.) W. G. V. Hyde. (Appointed 13th December, 1954.) Clerical Staff: Senior Clerk: Mrs. K. Jones. Clerks, Shorthand- Typists: Mrs. W. M. Crosfield. (Resigned 31st January, 1954.) Miss J. E. Castell-Evans. (Resigned 7th November, 1954.) Mrs. K. N. Malam. Mrs. J. F. Nichol. (Appointed 15th February, 1954. Resigned 31st March, 1954.) Miss C. M. Hately. (Appointed 12th April, 1954.) Miss J. M. Easton. (Appointed 18th October, 1954.) GENERAL STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH Area (acres) 2,607.762 Population—Registrar-General's estimate (Mid-1954) 54,440 Number of inhabited houses according to Rate Book 14,586 Average number of occupants per house 3.73 Sum produced by a penny rate £1,767 Rateable Value £432,916 The Council control the following parks and open spaces:— Brent Meadow 4.70 acres Cranleigh Gardens 2.00 acres Dormers Wells Housing Site 2.99 acres Dudley Road Island 0.13 acres Durdans Park 29.55 acres Football Ground, Western Road 3.51 acres Frogmore Green 0.35 acres Jubilee Park 11.13 acres 6 GENERAL STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH—continued. Lady Margaret Road 0.25 acres Lea Road 0.13 acres North Road Island 0.35 acres Norwood Green 7.25 acres Queen's Road 0.13 acres Recreation Ground 18.00 acres Southall Municipal Sports Ground 19.78 acres Southall Park 26.77 acres Swimming Bath Site, Dormers Wells 10.50 acres The Manor House 2.00 acres Viaduct Field 4.22 acres West Middlesex Golf Course 108.00 acres Western Road 0.17 acres Wolf Fields 3.33 acres Wolf Green 0.18 acres 250.71 acres For general administration 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 normal chlorine content of 1.0 parts per million at the shallow end, and 0.7 at the deep end is maintained. During peak periods this is increased to 4.0 parts per million at the shallow end in order to obtain 2.0 parts per million at the deep end. Three samples of the water are taken daily by the staff for chlorine and other chemical testing. During 1954, the total number of persons using the bath was 27,057. The average number of persons attending per day (wet or fine) was 117. The maximum number at any one session was 400. As this bath is uncovered, it is only opened for swimmers during the summer months— May to September, and the attendance varies to a great extent according to weather conditions. The number using the bath was greatly reduced from that in 1953, probably because in 1954 there was a very poor summer, cool with frequent rain. 7 HEALTH SERVICES PROVIDED BY OTHER AUTHORITIES North-West Metropolitan Regional Hospital Board Through the Uxbridge Group Management Committee this authority maintains two hospitals in Southall, the Southall-Norwood Hospital (28 beds) for treatment of general medical and surgical cases and casualties, and Mount Pleasant Hospital (79 beds) for the treatment of male patients suffering from tuberculosis. St. Bernard's Hospital is managed by its own Committee and is for the reception of cases of mental and nervous disorders; it has 2,475 beds and takes patients from an extensive area, comprising parts of Berkshire, Buckinghamshire and Middlesex, including the Borough of Southall. Voluntary, temporary and certified patients of all types are admitted, and all modern forms of treatment are carried out. Other hospitals outside the Borough which are used to a considerable extent by patients from Southall are Hillingdon Hospital, West Middlesex Hospital, and King Edward Hospital, Ealing. The Uxbridge Chest Clinic is the regional centre to which residents of the Borough of Southall may be referred regarding chest disorders. It is also the regional centre for the diagnosis, treatment, after-care and prevention of tuberculosis (both pulmonary and nonpulmonary). Persons may be referred there by their own doctors, from Borough Clinics, etc. Special "X-ray only" Clinics are available without appointment, otherwise persons are seen by appointment. There are female beds under the surveillance of clinic physicians at Hillingdon Hospital and male beds at Mount Pleasant Hospital. At this latter Hospital, special treatment clinics are available for the convenience of Southall patients. 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 Jubilee Gardens Centre, Northcote Avenue, Infant Welfare Clinics and Featherstone Road School Clinics. Diphtheria Immunisation, Vaccination Jubilee Gardens Centre and Featherstone and Whooping Cough Immunisation Road School Clinics Clinics Ultra Violet Light Clinic Northcote Avenue Clinic. Day Nursery Spikes Bridge, Municipal Sports Ground. Priority Dental Service for expectant and nursing mothers and children under school age. (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 own homes. (This work was formerly undertaken by "District Nurses.") Where nursing equipment is required for use in the home, it is available on loan through the British Red Cross Society. 8 (e) Vaccination and Immunisation In addition to the vaccination and immunisation of infants and young children carried out at the clinics already referred to, vaccination against smallpox and immunisation against diphtheria is carried out by those general practitioners who have agreed to co-operate in the County Council scheme. (f) Prevention of Illness, Care and After Care The County Council's scheme includes provision for the admission of suitable cases to recognised recuperative 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, aged, or a child not over compulsory school age within the meaning of the Education Act, 1944, 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 an Ambulance Accident 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 are arranged by the County Council through the Southall Divisional Executive. Medical treatment and dental treatment are provided by the County Council in the Borough as follows:— Minor ailments treatment Northcote Avenue and Featherstone Road School Clinics. Orthopaedic treatment Northcote Avenue Clinic and Jubilee Gardens Centre. Ophthalmic treatment Northcote Avenue Clinic. Physiotherapy Northcote Avenue Clinic and Jubilee Gardens Centre. Ultra Violet Light treatment Northcote Avenue Clinic. Northcote Avenue Clinic. 13, King Street. Talbot 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. 9 B VITAL STATISTICS Whole District Total deaths, 662. (Males, 336; Females, 326.) Crude Death Rate, 12.16 (including deaths in St. Bernard's Hospital, Norwood Hall and Vine Cottage); 8.39 (excluding these deaths.) For extracts from vital statistics and causes of death, see Appendix, Tables I and II. Deaths and Death Rate There is a substantial reduction in the death rate for 1954, the total number of deaths including those in the long-stay institutions being 662 as compared with 731 the previous year. Heart disease, coronary disease and cancer were again the principal causes of death. There was a slight fall in the number dying from cancer, from 120 in 1953 to 115 in 1954, but there is again an increase in the deaths from heart disease, circulatory disease and coronary disease, the total increase from these conditions, which are all related to each other, being from 346 to 351. The rising toll of deaths from these conditions is thought to be due to the increase in pace of modern living, and although on analysis, it is found that the majority dying from these causes are in the older age groups, there is still a substantial number especially of males, dying in the middle ages suddenly from one or another of these conditions. Since 1942, only one death has occurred in the Borough from diphtheria, and that was in 1950. There were no deaths from whooping cough or measles, but there was one maternal death in hospital following confinement. The deaths from tuberculosis rose from 12 in 1953 to 13 in 1954, and there was one death from poliomyelitis. The number of outside deaths, i.e. of Southall residents who died in Hillingdon Hospital, other Middlesex hospitals and hospitals outside the County boundaries, including various London hospitals, was 234 (males 137 and females 97). Deaths of institution inmates (including patients from Southall addresses and from outside areas) number as follows: St. Bernard's Hospital, 190 (males 73 and females 117); at Mount Pleasant Hospital, 24 (all male); Southall-Norwood Hospital, 20 (8 male and 12 female); Norwood Hall, 10 (all female); Vine House, 7 (1 male and 6 female); in addition 2 deaths (1 male and 1 female) occurred of persons belonging to other districts and residing temporarily in Southall. A very pleasing thing to note in this year's figures is that no Southall resident died as a result of involvement in road accident. This, however, does not mean that the Southall roads were accident free, as five persons belonging to other districts died as a result of road accidents occurring in Southall. Of these five, two were motor cyclists, one a motor cycle pillion passenger, one a motor cycle sidecar passenger and one a pedestrian. To make an approximate allowance for the way in which the sex and age distribution of the local population differs from that of England and Wales as a whole, the crude death rate is multiplied by a comparability factor supplied by the Registrar-General. This, then, gives a comparative death rate of 13.01, including institutional deaths, or 8 98 excluding these, compared with the rate for England and Wales as a whole, i.e. 11.3. For distribution of deaths in the various wards, see Appendix, Table III. Births and Birth Rate. (Figures for 1953 are given in brackets.) The total number of registered births in the district (as notified under the Births and Deaths Registration Act) was 143 (145). The total number of live births belonging to the district, whether occurring within or outside the district, was 701 (713). The illegitimate live births were 23 (31). There were 10 stillbirths (13), of these 5 were legitimate and 5 illegitimate. 10 A slight fall in the birth rate (live and still births) is recorded from 13.22 in 1953, to 13.06 in 1954. To make an approximate allowance for the way in which the sex and age distribution of the local population differs from that for England and Wales as a whole, the birth rate is multiplied by a comparability factor supplied by the Registrar-General. This gives a live birth rate of 12.75 to compare with the corresponding rate for the whole of England and Wales, which was 15.2. Infant Mortality After a slight check in 1953, the fall in infant mortality was resumed in 1954—the rate this year being the lowest yet recorded. Thirteen infants died, as compared with 21 during 1953, giving an infant mortality rate of 18.54 Per 1,000 live births, as against 29.45 in 1953. Of these 13 deaths, 1 died at home and 12 in hospital. Ten infants (6 male and 4 female) died within the first four weeks after birth. Table V gives the causes of infant deaths under the age of one year. The drop in deaths due to prematurity from 9 in 1953 to 1 in 1954, is most satisfactory. Graph A, on infant mortality rates, shows the trend of the infant mortality rate since 1900. The infant mortality rate for England and Wales as a whole was 25.5. Infant Mortality Rate from 1900 to 1954 11 Premature Infants Thirty-eight premature infants were born during the year and there were 7 premature stillbirths. Thirty-seven of these premature infants born alive were surviving at the end of one month. Out of the 38 born alive, 31 were born in hospital and 7 at home. All of the premature still births were born in hospital. The classification of a premature infant is given to a child born prematurely, or which weighs less than 5½ lbs. at birth. The weight of one infant who died of prematurity within four weeks of its birth was 1 lb. 8 oz. Maternal Morbidity No cases of puerperal pyrexia were notified during the year. There was one maternal death, from toxaemia, and in spite of operative interference. No deaths were associated with abortion. 12 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES The total number of infectious disease notifications received during the year was very low, 487 compared with 1,836 the previous year. This was a very good year for infectious disease as not only was the number of notifications low, but those who did develop symptoms were affected more lightly than in other years, also in many cases the notification was not confirmed by further investigation, so that the total amount of infection was actually less than shown by these figures. As it has been observed that measles occurs usually with a high incidence in alternate years, this seems to agree with the figures in this Borough, for following the notification figure of 931 for measles in the previous year, there were only 41 notifications from this disease in 1954. Whooping cough dropped from 563 to 65, and there was a drop in most of the other figures also. The only disease which showed a notable increase in the notification figure was dysentery, which went up from 12 in 1953 to 115 in 1954. There were no notifications of diphtheria and none of puerperal pyrexia. Particulars with regard to individual notifications are mentioned specially under separate headings. Monthly Bulletins of Incidence of infectious Disease These bulletins were circulated monthly to all general practitioners in the Borough, and, in addition to information with regard to infectious diseases occurring during the previous month, any topical matter, or incident of mutual interest to general practitioners and the Public Health Service, was also included; for instance, Home Accidents statistics, Old People's Welfare information, etc. Measles Notifications of measles fell during the year 1954, being 41 as compared with 931 the Previous year. There were no deaths from measles. The following table shows the trend of notifications during the past 10 years. Year No. of Cases Deaths 1945 500 1 1946 21 - 1947 334 - 1948 825 1 1949 194 - 1950 701 - 1951 1,129 - 1952 528 - 1953 931 1 1954 41 - Poliomyelitis Six notifications were received of acute anterior poliomyelitis; of these 4 were subsequently confirmed as poliomyelitis, 2 paralytic and 2 non-paralytic. One death occurred from this disease, of a notified paralytic case. Particulars of the surviving paralytic case notified in 1954 and of the cases notified since 1949 and known to be still showing paralysis in 1953 are as follows :— 1954: Case A. Facial and pala- Full recovery. tial paralysis. 1952: Case C. Paralysis of left Boy now aged 3 years. Paralysis persists and growth of leg. leg is retarded. Continuing physiotherapy. Case D. Paralysis of both Boy now aged 5 years. Full recovery of power. Some legs. shortening of right leg and foot. Has physiotherapy treatment. 13 1952: Case F. Paralysis of limbs Adult female. Continues to make progress. Both legs and trunk. paralysed, both arms weak. Attends hospital for physiotherapy. Case G. Paralysis of both Boy now aged 14 years. Continues to make progress. legs. . Walks well. Wears calliper for right leg, but can do without it for short periods. 1950: Case A. Paralysis in left Adult male. Residual partial paralysis left leg. At work, leg. Case B. Paralysis in both Boy now aged 7 years. Fully recovered. legs. Case C. Paralysis in arms, Girl now aged 19 years. Continues to make slight proetc. gress. Residual paralysis in legs. Continues therapy treatment and travels in motor wheel chair and wears pelvic support and calliper. 1949: Case B. Paralysis anterior Girl now aged 14 years. Recovery good. Full power of tibials, etc. all limbs except for slight limitation of flexion of left foot. An Analysis of the Progress of all Paralytic Poliomyelitis Cases Occurring in Southall since 1949 is as follows:— Year Number of Notified Cases Confirmed as Poliomyelitis Still Making Progress Died Full Recovery 1949 14 1 2 11 1950 6 3 - 3 1951 9 — - 9 1952 8 4 - 4 1953 4 - 2 2 1954 4 - 1 3 It will be seen from these figures that of 45 cases of paralytic poliomyelitis occurring during these six years, 32 recovered completely, regaining full power of every muscle affected. Influenza Influenza was not a problem in 1954. There was one death attributed to influenza as compared with 9 in 1953. Dysentery In the beginning of the year it was noticed from the figures supplied by the Registrar General each week that cases of dysentery were occurring throughout the country and information was received during February that three children attending one of the schools in the Borough, and said to be partaking of school dinners, had been diagnosed as suffering from Sonne Dysentery. The Sanitary Inspector then visited the school and gave general instructions on hygiene. Faeces specimens were obtained from the canteen workers and these were all returned as bacteriologically negative. In the meantime, all contacts had been traced and specimens taken, and further positives were found. Arrangements were made by the Education Officer for individual paper towels to be issued to the Infants' School and the Head Mistress was instructed not to re-admit children after absences unless there was satisfactory evidence of non-infectivity. Cases occurred in the Junior School and the supply of individual paper towels was arranged for that Department. In all during this outbreak, 82 persons, the majority symptom free, were found to be bacteriologically positive. These being traced, isolated, and treated, we were able to consider the epidemic as having ended by the end of April, although sporadic cases and persistent carriers were still requiring attention for a further two months. Smallpox (Variola) No patients with smallpox, and no contacts of cases of smallpox were notified to the Department from the Port Authorities during the year. 14 Vaccination The figures for infant vaccination, after a splendid improvement in 1953, show some deterioration for this year. In the table below, it will be seen that the total of primary vaccinations is 359; this compares with 413 the previous year. The figure of 283 for infants under a year of age is lower by 37 than that for the previous year. Of 701 children born, a figure of 283 receiving vaccination during the first year of life gives a percentage of 40 4, and this is not a satisfactory proportion. There was no especial campaign for infant vaccination carried out during the year 1954, and it may be that it is now time for further activity with regard to this. Figures supplied by the Area Medical Officer show that 144 children under the age of 5 received primary vaccination at County Council Clinics in Southall during the year 1954. 1954 Age Groups Under 1 year 1-2 years 2-4 years 5-14 years 15 years and over Total Primary Vaccination 283 19 15 18 24 359 Re-vaccination - - 2 11 63 76 1953 Age Groups Under 1 year 1-2 years 2-4 years 5-14 years 15 years and over Total Primary Vaccination 310 24 22 33 24 413 Re-vaccination - - 4 9 88 101 Scarlet Fever (Scarlatina) The number of notifications received during the year was 101 as compared with 131 for the previous year. 16 cases were admitted to hospital for isolation and treatment, and 85 were nursed at home. Secondary cases occurred in 6 instances where the first case was nursed at home, and in most of these cases isolation was very poor—parents are becoming increasingly careless about this disease and on one occasion the brother of the case was found still to be attending school three days after scarlet fever had been diagnosed. Diphtheria No cases of diphtheria were notified to the Department. The following information supplied by the County Medical Officer shows the number of children immunised against diphtheria during the year. Number of Children who completed a full course of Primary Immunisation in Southall during the year Number of Children who were given Secondary or Reinforcing Injection during the year (i.e. having in a previous year received a complete full course) Age at Date of Final Injection Under 1 1-4 5-14 Total 311 273 43 627 453 15 In the following table is shown the number of children at 31st December, 1954, who had completed a course of immunisation against diphtheria at any time before that date:— Age at 31.12.54: Under 1 1-4 5-9 10-14 Total under 15 Number immunised 105 1,944 3,745 3,157 8,951 There is a sizeable increase in the number of children receiving a full course of primary immunisation during 1954, the figure being 627 as compared with 536 the previous year. The number of children receiving a secondary reinforcing injection fell by 132, but it is satisfactory to note that in the past few years the immunisation state of the children under 15 has improved, i.e. the proportion who have received at least one successful course of antidiphtheria immunisation injections during their lifetime. The figures are respectively:— 8,194 for 1951, 8,138 for 1952, 8,872 for 1953 and 8,951 for 1954. Ophthalmia Neonatorum No cases of ophthalmia neonatorum were notified during the year. Distribution of Infectious Disease Notifications For the incidence of various infectious diseases notified during the year, under age groups and locality, see Appendix, Tables VII and VIII. Infectious Disease Visits During the year, the Sanitary Inspectors paid 735 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 71. Other Forms of Tuberculosis The number of new cases notified during the year was 7. Of the total notifications, 7 were received from Medical Practitioners; 55 from the Uxbridge Chest Clinic; 2 from General Hospitals; and 14 from St. Bernard's Hospital. Deaths from Tuberculosis Tuberculosis of the respiratory system, 12; other forms, 1. For details of new cases notified and deaths in 1954, see Appendix, Table IX, and for the occupation of new cases see Appendix, Table X. Public Health (Prevention of Tuberculosis) Regulations, 1925 Public Health Act, 1936, Section 172 Action under these powers was not necessary during the year. The number of new notifications fell from 91 in 1953 to 78 in 1954. This constitutes a record low figure for notifications of this disease. The number of deaths from tuberculosis was 13, the corresponding number for 1953 being 12. Of the 13 deaths, 6 had not previously been notified as cases of tuberculosis. The number of cases notified is not yet so small that very stringent precautions against infection can be diminished as there still occur sad cases where two, three, or even four members of the same family have become infected one after the other, and there still 16 occur deaths from this disease where the cases are found after death to have been infectious and not discovered during life. Each one of these undiscovered cases is of course an immense reservoir of infection for other people who come in contact. The analysis of the housing conditions of new cases shows that of the notified patients living in Southall exclusive of the St. Bernard's Hospital notifications, housing conditions were reasonably good in all except three. Three patients were living in overcrowded homes, Graph B Tuberculosis (All Forms)—Notifications and Deaths from 1930 to 1954 Notifications Deaths 17 in two cases amounting to statutory overcrowding, but during the year re-housing of the families of these patients was effected through the Council's Housing Department. In only one of the cases were any sanitary defects found in the house and that was in one of the overcrowded homes which was affected with dampness. This family was one of the ones to be rehoused. There were multiple notifications in two homes, in each of these the new patient was the third person to be affected with the disease. All of these figures show some improvement on last year's findings. There are fewer overcrowded homes, fewer affected by dampness or other sanitary defect and fewer multiple notifications. It is pleasing to be able to record that of the eight newly notified cases in 1953, found to be living in overcrowded conditions, six were rehoused in 1954. During the year the Tuberculosis Vaccines Clinical Trial in which Southall, with many other areas, is co-operating with the Medical Research Council, was continued. The scheme is designed to determine the value of tuberculosis vaccination when used on a large scale in Britain, and it entails keeping in touch with over 50,000 young people from many areas taking part. Twenty-three of these volunteers come from the Borough of Southall, and during the year each was sent a postal form and received an invitation for X-ray. In addition each was visited by a Health Visitor on the staff of the Area Medical Officer. As in previous years, the co-operation between all those taking part in the trial has been very close, and it has been found possible to keep in close touch with the very great majority of those concerned. The scheme is a long-term one and it is hoped to continue the follow up for a longer period. Research into Incidence of New Tuberculosis in the Adolescent. A trial scheme for the investigation of high incidence of tuberculosis among young adults, by means of an examination of school leavers, and an annual review of those subsequently volunteering to enter the scheme, was begun in October, 1952, by the staff of the Mass X-ray Unit. Part of the scheme also consists in preliminary propaganda in the schools and the distribution of explanatory letters to parents. Ten education areas in Middlesex were brought into this scheme, including Southall. In 1953, 523 consented to take part in the scheme (258 boys and 265 girls), and in 1954, 585 (241 boys and 344 girls). This response is very good. The full results of this scheme will not, of course, be available for a number of years as it is designed to cover a 10-year age group, i.e. ages 15 to 24, and the incidence of tuberculosis morbidity during the 10 years after leaving school, and the value of these results will depend, to a great extent, on the continued co-operation of the individuals concerned in the survey. Graph B is a pictorial representation of the statistics of tuberculosis in the Borough from 1930 to 1954. Cancer It will be seen by the table of causes of death (page 39) that in 1954 115 cases (72 males and 43 females) died from cancer. See Appendix, Table VI, for an analysis of cancer deaths since 1930. Below is set out in tabular form a classification of the cancer deaths according to the site of the primary growth and in ages. Age Groups — Male Site Total Under 10 10-20 20-30 30-40 40-50 50-60 60-70 70-80 80+ 52 53 54 52 53 54 52 53 54 52 53 54 52 53 54 52 53 54 52 53 54 52 53 54 52 53 54 52 53 54 Lung 15 27 20 — — — — — — — — — — — 1 1 3 1 7 9 8 7 7 4 — 7 4 — 1 2 Stomach 12 6 10 — — — — — — — — — — — — 2 — — 5 1 1 2 2 5 2 3 — — — 1 Intestine 7 6 14 — — — — — — — — — — — — — — — — 2 1 2 1 6 2 2 5 2 1 1 Bladder 3 2 2 — — — — — — — — — — — — — — - 1 1 1 2 - 1 - - - - 1 - Prostate 4 6 1 - - - - - - - - - - - - - - - - - - - 2 — 2 1 1 2 3 — Breast — — 1 — — — — — — — — — — — — — — — — — — — — 1 — — — — - - Other 13 16 24 - - 1 - 1 - - - 1 - 1 - 2 1 2 4 5 9 2 4 6 4 2 5 I 2 - Totals 54 63 72 - - 1 - 1 - - - 1 - 1 1 6 4 4 17 18 20 16 16 23 10 15 18 5 8 4 18 Age Groups — Female Site Total Under 10 10-20 20-30 30-40 40-50 50-60 60-70 70-80 80 + 52 53 '54 52 53 54 52 53 54 52 53 54 52 53 54 52 53 54 52 53 54 52 53 54 52 53 54 52 53 54 Breast 18 13 17 - - - - - - - - - - - 2 3 1 2 5 3 5 3 3 2 5 4 3 2 2 3 Lung 3 4 2 - - - - - - - - - - - - - - - 1 1 — 1 2 1 — — 1 1 1 — Stomach 7 9 5 - - - - - - - - - - - - - - - - - 2 2 2 - 4 3 3 - 3 - Uterus 5 4 3 - - - - - - - - - - - - - - - - 1 1 2 — — 2 1 2 1 2 — Intestine 6 12 6 - - - - - - - - - - - - - - - - 1 - 3 3 3 i 5 3 1 3 - Bladder - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Other 18 15 10 - - - - - - 1 - - - - - 1 3 1 3 3 - 6 4 2 6 4 4 1 1 3 Totals 57 57 43 - - - - - - 1 - - - - 2 5 5 3 10 9 8 17 14 8 18 17 16 6 12 6 These figures are inclusive of the deaths occuring at St Bernard's Hospital, Norwood Hall and Vine Cottage. The Tables show over the last three years a predominance of lung cancer in the male and of breast cancer in the female. Disinfection In cases of infectious disease, rooms, clothing, etc., were disinfected—rooms by sealing and fumigating by a formalin preparation; clothing, bedding and other infected articles by removal for disinfection in the Council's disinfector at Havelock Road. List of premises, articles, etc., disinfected during the year. Rooms 28 Eiderdowns 9 Beds 24 Pillows 12 Blankets 60 Plimsolls (routine disinfection Mattresses 20 during holiday for Feather- Sheets 40 stone Road School) (pairs) 381 Books 75 Miscellaneous articles 20 Smallpox Disinfection. In the event of smallpox occurring within the district and disinfection being required on a considerable scale, arrangements have been made whereby this could be carried out. An agreement was made with the North-West Metropolitan Regional Hospital Board whereby in such an event the staff of St. John's Hospital, Uxbridge, would carry out this work. Provision of Antitoxin and Vaccine Lymph The Council provides diphtheria antitoxin and tetanus antitoxin free to local practitioners in the district. These antitoxins are obtainable from the Public 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, they are obtainable at very short notice. Vermin and Scabies During 1954, no cases of vermin infestation were brought to the Public Health Department for cleansing. Treatment and cleansing can be arranged, if necessary, at Hammersmith Cleansing Station by courtesy of Hammersmith Borough Council. The figures appear to suggest a satisfactory state of freedom from infestation in Southall, and this is also indicated by the fact that according to the findings in Table XI, more children were examined for vermin in the schools and very many fewer found to be infested as compared with 1953. This information is available by courtesy of the County Medical Officer. 19 EXPERIMENT ON THE IRRADIATION OF THE UPPER AIR IN SCHOOLS The report has now been published of the results of the investigation, made in six schools in the Borough of Southall, on the effect of Ultra Violet Irradiation of the upper air on the disinfection of the school atmosphere and its effect on the occurrence of illness amongst schoolchildren. The investigation was carried out by the Air Hygiene Committee of the Medical Research Council and three of the schools were used as experimental premises having the Ultra Violet lamps installed while the other three were used as controls, with dummy lamps, in order that a full comparison could be made. By agreement with the Medical Research Council and the permission of the Controller of H.M. Stationery Office having been obtained, a summary of the conclusions obtained from the experiment is quoted below. It win be seen that although it was thought that the results obtained in the reduction of the incidence and transfer of infectious disease did not justify the use of ultra violet lighting of the upper air as a general practice, that much information with regard to the ventilation, heating and other requirements in schools was secured and indeed a great deal of information was obtained during this piece of research which is still being examined and which will no doubt be of great value not only in future experiments, but also in the design of new schools. An Extract from Report 283 of the Medical Research Council on Air Disinfection with Ultra-Violet Irradiation Summary All the classrooms and assembly halls of the Infant and Junior departments of each of three primary schools in the borough of Southall, a suburban area of Greater London, were equipped with ultra-violet lamps to irradiate the air in the upper part of the room. Three similar schools were observed as non-irradiated controls. The child population of the irradiated schools was about 1,550, and that of the control schools about 1,860. Observations were continued for a period of three years from January, 1946 to December, 1948, the irradiation being maintained during school hours throughout the whole period. Records were kept of all the absences and the reasons for absence of any child who was away from school for one whole day or more. In general, reliance was placed upon parents' diagnoses but in any case of doubt the home was visited for further inquiry. Throughout the three years daily visits were made to a random sample of classrooms, while they were occupied in the ordinary way, for the determination of the temperature, humidity, ventilation rate and bacterial content of the air. Measurements were also made at intervals of the ultra-violet intensity in the rooms. The average ultra-violet intensity in the upper region of the irradiated rooms was 8 to 13 microwatts per sq. cm. At desk level the intensity varied between 0.1 and 2 microwatts per sq. cm. according to the nature of the ceiling. The irradiation produced no ill-effects among either children or teachers. Although differing somewhat in structure, the irradiated schools did not on the average differ from the control schools in temperature or humidity, and were not materially different in size of class or area per child; their average ventilation rate (676 air changes per hour) was slightly greater than in the control schools (6.17). During the investigation the general bacterial count in the air was about 16 per cent. lower in the irradiated schools than in the control schools. The count of Str. salivarius, studied as an index of the degree of mouth pollution of the air was reduced by as much as 70 per cent.—from 0.191 colonies per cu. ft. in the control schools to 0.053 colonies per cu. ft. in the irradiated schools. The count of haemolytic streptococci, made over a period of about six months was reduced by about 80 per cent. There was no appreciable effect on the total sickness absence recorded in either the Infant or the Junior departments. Examination of individual causes of absence suggested, however, that the irradiation probably reduced the number of absences due to certain 20 diseases, by amounts between 15-45 per cent. These diseases were mumps and chickenpox; asthma; gastritis and gastro-enteritis, and "gastric 'flu"; scarlet fever, acute pharyngitis and tonsillitis, otitia media and earache. Secondary-attack rates following single-case introductions of measles, mumps and chickenpox were apparently lower in the irradiated schools. The absences due to the diseases named above, which seemed to be affected by the irradiation, form only a small part of the total sickness absence. The effect of irradiation on total sickness absence is therefore small, and the results would not appear to justify wide use of irradiation as a hygienic measure for the control of infection in primary urban day schools. 21 WELFARE—GENERAL The local headquarters of the St. John Ambulance Association are situated at Hartington Road, Southall, and the honorary officers are Dr. C. J. P. Seccombe, 20, Western Road, Southall, Divisional Surgeon; Mrs. E. Wilmot, 18, Hartington Road, Divisional Superintendent; and Mr. H. S. King, 44, Northcote Avenue, Southall, Divisional Superintendent, Ambulance Division. The work carried out is as follows :— Home Nursing and Nursing Equipment. The St. John Ambulance Nursing Division has been trained in Home Nursing. It also lends Nursing equipment for use in the home from its Medical Comforts Depot in Hartington Road. During the year 635 articles were lent under this scheme—an increase of 101 on the 1953 figure. Ambulance Services. The St. John Ambulance Brigade maintains an ambulance that is available for private hire, and which is also used on public duties in connection with the St. John Ambulance Brigade. Welfare—General. The St. John Ambulance Association carried out trainings in First Aid and Home Nursing for all who cared to take advantage of the service, and also for Civil Defence volunteers. The members of the Nursing and Ambulance Divisions carried out many other duties including attendance at local cinemas, sports, fairs, Old Folks' clubs, and accompanying old people's group excursions to the sea-side. Members also took part in duties further afield including London Airport, London Theatres, Concerts, Ice Shows. Figures for the voluntary work carried out by the Nursing Division are as follows:— Of 1,155 hours—764 were spent on public duties, 6 on transport duties, 144 on hospital duties, 241 on other duties such as Medical Comforts, Depot Attendances, Nursing Aid, etc. The headquarters of the British Red Cross Society, Ealing Area Division, which includes Southall, is Florence Nightingale House, 85, Uxbridge Road, Ealing, W.5. The Divisional Director is Mrs. E. V. Bruce, and the work carried out is as follows:— Training Red Cross Juniors and Seniors in First Aid and Home Nursing, and also training candidates for the National Hospital Service Reserve. Occupational Therapy when requested for the disabled ex-service pensioners and for Chest Clinic cases. Hospital duty during epidemics. Provision and carriage of books to tuberculous home-bound patients. Welfare visits which are increasing. Hospital Library facilities and Picture Library. Nursing Aid. Nursing in the home. Escort duty to and from hospitals for the sick, aged, blind people and children. Medical loan, providing comforts for sick people. Transport for the sick when requested. Blood transfusion. Civil Defence basic first aid training. Accommodation in Red Cross Homes for chronic aged and sick. Club for Disabled Persons. A Club, known as the Happy-Go-Luckies, meets weekly and is a social and recreational one for people suffering from any physical handicap, and transport is provided for those members who are unable to make their own way to the Club premises, which are at the Southall Community Centre. The approximate number attending weekly is 16, the total membership being 25. WELFARE—OLD PEOPLE The needs of 14 cases of old people living in difficult circumstances were investigated during 1954, and the action taken is recorded in the following list:— 22 Removed to hospital 4 Removed to hospital (under National Assistance Act powers) Removed to mental institution - Removed to old people's home 3 Died at home 4 Remaining at home 3 (a) Home Help provided and awaiting vacancy in old people's home 2 (b) Special problem—provision of transport of chronic sick and aged person to visit husband in hospital 1 The difficulties of the old persons recorded on this list were brought to the notice of the Public Health Department staff either by interested relations, neighbours or friends, or following complaint by one or other of the statutory authorities. Although most of the cases brought for the attention of the Public Health Department staff were in need of care and attention, there was in no instance any need to invoke compulsory powers of removal under the National Assistance Act. Other methods of dealing with each case were found by means of the willing co-operation of the various statutory authorities. The Home Help Service is invaluable for this type of case and is becoming more generally appreciated. Some proof of this is evidenced by the fact that in previous years it has always been found that a number of old people would steadfastly refuse to consider having home help assistance, in 1953, this number amounted to 6, while in 1954, no-one refused home help. One aged man was very unwilling to accept it for some time, but did so finally. It has been ascertained from the Area Medical Officer that 312 Southall people were given Home Help during the year and of these 223 consisted of chronic sick or aged persons, and of 982 persons who were assisted by the Home Nurses, 394 were of age 65 or over. Many voluntary associations contributed to provide Christmas parcels or special comforts for old people. Meals on Wheels Service The Meals on Wheels service for persons of pensionable age continued under the control of the Women's Voluntary Service Association from January until the end of May, 1954. Meals were provided at a cost of 9d. per meal for the recipient and during those 5 months, meals were supplied to 58 individual recipients, the total number of meals supplied during that time being 1,114. The Old People's Welfare Committee took over this service on 1st June. The price of the meals continued at 9d., that being the cost to the recipient, with the Borough Council making a grant of 1/- to cover the full cost of providing and transporting the meal. Under the new scheme, the number supplied to each person increased from one a week under the old scheme to two per week, and before the year was ended, this had been increased still further and meals were being supplied three times per week. The exact number of meals supplied under this new scheme was not available, but it is understood that approximately 2,400 meals were supplied from the 1st June to the 31st December, 1954. Chiropody Service for Old People This service was continued throughout 1954. Six local chiropodists gave their services at cheap rates for Old Age Pensioners. Holidays for Old People The holiday scheme whereby old people could get a seaside holiday during off season months of May and September, at reduced rates, continued during 1954, and was operated by the various Old People's Clubs in the Borough of which there are six. National Assistance Act, 1948, Section 47 National Assistance (Amendment) Act, 1951 No case was dealt with under these powers during 1954. 23 HEALTH EDUCATION Health Education was carried out through the year on general subjects all the time and at particular seasons with more concentration on topical subjects, for instance, atmospheric pollution as a greater problem during the winter, food infection in the summer. This work consisted of talks to individual persons, talks to selected groups, leaflet and poster publicity. In addition to making use of the Department's film strip projector during talks to special groups, another device to assist the lecturer and make more clear the meaning of a subject was brought into use. This was the flannelgraph, which has been found very effective in school teaching and seems to be likely to be equally helpful for public health propaganda. In the early part of the year, a request was made from the Education Department for some hygiene instruction for the Canteen workers in the School Meals Service. Following this request, a course was arranged and began, in the early part of the summer, with a general talk and film strip demonstration to the assembled canteen workers, and on this occasion a coloured film strip on food hygiene prepared by the Medical Officer of Health of Ealing, was used. Time was allowed for discussion at the end of the meeting. Following this inaugural talk, the District Sanitary Inspectors arranged to visit each school canteen individually in order to explain the rules of hygiene as they applied at the particular premises and to answer questions which might have been raised in the minds of the workers during the general talk. ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT Ten 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 Chiropody only 5 Massage, Chiropody and Electrical Treatment 5 MEDICAL EXAMINATION OF BOROUGH COUNCIL EMPLOYEES During 1954, a total of 85 medical examinations were carried out on applicants for Borough Council employment or members of the Borough Council staff. These examinations were carried out with regard to suitability for employment on the Council's permanent staff, for entry into the Sickness Pay Scheme, or for review after prolonged periods of sick leave. 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 & Uxbridge Valley Water Company a small area in the northern part. The supply is satisfactory, both in quality and quantity. Reports on sampling carried out by the Metropolitan Water Board are issued from time to time. A sample of drinking water which had been the subject of complaint was taken from one house during the year for bacteriological examination and reported as satisfactory. All inhabited houses are supplied from public water mains and there are no standpipes in use on mains. Sanitary Inspections of the District The total number of inspections of premises made during the year by the Sanitary Inspectors was 7,593. There is an all round reduction in the figures of inspection carried out except for infectious disease contacts investigations. Although there was a shortage of two Sanitary Inspectors throughout the year, all matters of urgency or arising from complaints were investigated immediately. Table XII gives an analysis of the number and nature of such inspections. 24 School Sanitation Twenty-seven visits were paid to schools during the year. As co-operation between the Education Department, Schools and Public Health Department staffs is excellent, visits are usually made following requests from the Education Officer or School Head Teacher, and are usually because of emergency sanitary defects. Towards the end of the year the inspection of sanitary accommodation at all schools was completed, and deficiencies were reported to the Public Health Committee and transmitted to the Divisional Executive for the necessary action. This review showed that much work had been completed since the first main inspection in the years 1949 and 1950, when it was found necessary to state that in general, the sanitary conditions in the Southall schools were far from satisfactory. While there still remains certain defects in the total provision of watercloset accommodation as compared with the standards laid down in the School Premises Regulations, this is considerable only in three of the schools. In two of these, provision has been made by the Education Divisional Executive of money for building of new sanitary accommodation in the forthcoming year, and in the third, the number of schoolchildren will be reduced very greatly by the substitution of a new school which is in course of erection and is likely to be ready towards the end of 1955. In 1954, two modern schools for infants and juniors were opened, one in the north and one in the south of the Borough. This relieved the congestion in four of the older schools, and therefore brought the lavatory and watercloset provision in these schools more in line with the Regulations. Improved washing facilities have been provided in four of the older schools in Southall, and plans are prepared for similar provision in three more. In many of the infant schools, provision has been made in recent years for individual towels to be used by the children, and now a scheme has been approved for all schools to be supplied with paper towels for the use of the pupils. This is a most important improvement in school hygiene whereby it is hoped that the risk of transfer of many of the infectious diseases will be greatly reduced. Eradication of Bed Bugs Statistics for the year:— (a) Number of Council houses (1) Found to be infested 4 (2) Disinfested during the year 4 (b) Number of other houses (1) Found to be infested 8 (2) Disinfested during the year 8, Total 12 Canal Boats Visits were paid to the canal, and 5 boats were inspected. The condition of boats and occupants 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. One body was 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:— 25 Inspections Factory Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted Non-Mechanical 16 7 - - Mechanical 161 60 1 - Totals 177 67 1 - 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 - - - - - Overcrowding - - - - - Unreasonable temperature - - - - — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — — Sanitary Conveniences— (a) Insufficient 3 — — 1 — (b) Unsuitable or defective 13 5 — — — (c) Not separate for sexes - - — — — Other offences against the Act (not including offences relating to outwork) - - - - - Totals 16 5 - 1 - Outworkers Nature of Work Section IIo Section III No. of outworkers in August List required by Section no (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—Making 11 - - - - - Carding, etc., of buttons, etc. 1 — — - — — Stuffed Toys 2 — — - — — Cosaques, Christmas Crackers, Christmas Stockings, etc. 1 - - - — — Totals 15 - — — — — The Rag Flock and Other Filling Materials Act, 1951 There are no premises in the Borough subject to registration or licence under this Act. Premises where upholstery is reconditioned and secondhand articles are sold are included in the list of general inspections. 26 Petroleum and Carbide During the year licences were in force in respect of 61 installations for petroleum, and 3 for carbide of calcium. Celluloid and Cinematograph Films Act, 1922 There are 2 licences in force for the purpose of stripping and making celluloid solution from cinematograph films. Inspections have revealed no infringements. Housing Overcrowding begins to lose its serious features and rehousing by the Council and by the private efforts of individuals now appears to be balancing any increase. The Housing Repairs and Rents Act, which came into force on the 31st August, 1954, called for a review of the total housing needs of the community with particular reference to the clearance of slums and the improvement of sub-standard housing. A report was to be prepared for approval of the Council and submission to the Ministry of Housing and Local Government, and the work for this began during the latter part of 1954. Also under this Act, during the course of the year, 29 applications were received for certificates of disrepair, 27 of these were granted, 1 refused and 1 withdrawn. Thirteen applications for certificates of revocation were made, ten were granted, two were deferred but subsequently granted, and one was rejected. No Demolition Orders were made during the year. Middlesex County Council Act, 1944—Section 345 On several occasions during the year the establishment of caravans in contravention of the above Act was encountered. Removal of these was obtained without the necessity for formal action except in one case where three caravans occupied a site on the canal side. The occupier appealed to the Minister of Housing and Local Government, who granted him permission for one caravan to remain for a limited period of five years. The following details have been supplied by the Borough Engineer, outlining the complete amount of house building for Southall since the end of the war. Built by Southall Borough Council During the Year 1954 Since the end of the War (including 1954) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Dwellings — — 35 — Houses - 22 101 62 Flats 17 - 210 48 Prefabricated Houses - - 299 - Built by Private Enterprise During the Year 1954 Since the end of the War (including 1954) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Bungalows 1 - 14 - Houses 6 — 216 — Flats — — 48 - Prefabricated Houses — — - - 27 Administration of the Shops Acts There was a sharp reduction in the number of inspections, the result of shortage of staff, but it is still possible to say that every emergency occurring was dealt with immediately that notice of it was received in the Public Health Department. Markets The general sanitary conditions at the livestock market, held once weekly, were kept under supervision. There is no other market in the Borough. Pet Animals Act, 1951 Six establishments were licensed during the year. Compliance with the schedule of conditions of the Royal Society for the Prevention of Cruelty to Animals was secured, and no formal action was necessary. HYGIENE OF FOOD Food Poisoning The total number of persons notified as cases of food poisoning by general practitioners was 45 in 1954, and of these, only one was discovered subsequently to have faeces containing food poisoning organisms, namely salmonella typhi-murium. No outbreaks of nonnotified food poisoning occurred, and a sharp outbreak of Sonne dysentery in one of the Southall Schools was clearly traced as being in no way connected with the school meals or those handling them. Personal Hygiene The free washing facilities in the public conveniences, which were brought into operation in September, 1950, continued to be available throughout 1954. During that period, 5,500 paper towels were issued free, and also 3,472 linen towels, which are provided at a cost of 2d. per person. Milk The following licences under the Milk (Special Designation) (Raw Milk) Regulations, 1949 and 1950, and Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 and 1950, were issued :— for the sale of Tuberculin Tested Milk 13 for the sale of Pasteurised Milk 22 for the sale of Sterilised Milk 20 Supplementary Licences 21 Total 76 Food Sampling The bacteriological analyses of 232 food samples taken during the year were carried out by the Public Health Laboratory Service. One hundred and seventeen of these specimens were ice-cream samples, covering 15 makes of ice-cream, and following bacteriological analyses the ice-creams were graded as follows:— Grade I 98 Grade II 6 Grade III 6 Grade IV 2 Five samples were not graded as Methylene Blue tests were not carried out. Ice-cream was manufactured locally at 3 premises at intervals during the year. Premises and plant were inspected and checked and no infringement of the Ice-Cream (Heat Treatment, etc.) Regulations, 1947-52, was recorded. 28 Satisfactory communication has been maintained during the year with the County public Control Department and the report on the work carried out in Southall by the staff of that Department is as follows:— Article Total Samples procured Unsatisfactory Milk, New 87 10 Milk, Various 44 — Butter 11 — Cakes 12 2 Cooked Meat 2 - Cream 5 — Dried Egg 1 - Drugs 3 - Fish 9 - Fruit Juice 1 - Gelatine 1 - Glace Cherries 1 — Ice-Cream 4 - Ice-Cream Mix 1 1 Iced Lolly 5 - Jelly 2 - Lard 1 - Liver 2 - Margarine 1 - Meat Pie 1 — Minced Meat 3 - Mint Sauce 1 - Mixed Peel 1 — Non-brewed Condiment 2 - Pickles 3 - Potatoes 1 - Sausages 9 - Soup 1 - Suet 3 - Sweets 3 - Tomato Juice 1 - Victoria Plums 6 - Vinegar 4 - Wines & Spirits 24 - Totals 256 13 with the promise of stringent steps to prevent any recurrence happening, and in all the circumstances the County Council decided to take no further action in the matter. Ice-Cream Mix. The sample of ice-cream mix was named " Milkreem " and contained no milk fat. A summons was issued at the instance of the County Council alleging a misleading description as to the substance of the article, contrary to the Defence (Sale of Food) Regulations, 1943. The case was dismissed. Merchandise Marks Acts, 1887-1926. 145 inspections of shops were undertaken to ensure that the Marking Order relating to certain imported foodstuffs made under the Merchandise Marks Act, 1926, were complied with. These Orders require that certain imported foods shall, on exposure for sale by retail, bear by clear indication a note as to whether the food is Empire or foreign. 581 separate displays of meat, apples, poultry and dried fruit were examined. Verbal cautions were given in respect of minor infringements, none being found so serious as to warrant more stringent action. Defence (Sale of Food) Regulations, 1943. One greengrocer was given an official caution for falsely describing by label Craig Royal potatoes as " King Edwards." The Labelling of Food Order, 1953. The above Order requires, inter alia, that in general pre-packed foods shall bear on the label a clear statement of the designation of the food and in the case of compound foods the ingredients. It also requires that the name and address of the packer or labeller appears. At 57 premises, 212 articles of pre-packed food were examined. No substantial infringements were discovered. Special Designated Milk. During the year in question two persons were licensed by the County Council to use the special designation " pasteurised " in respect of milk processed at premises within the Borough of Southall. Each of the premises was inspected regularly and compliance with the requirements of the Act or Regulations was maintained in each case. 120 samples were taken, all of which, excepting in one instance, were correct. In one case there was a failure of the methylene blue test for keeping quality and the County Council issued an official caution. Safe Milk. In addition to the foregoing, 12 samples of raw milk were procured within the Borough and submitted to test for the presence of tubercle bacilli. None was found contaminated. Meat Inspections Inspections are made of the carcases of slaughtered animals at St. Bernard's Hospital slaughterhouse, and of premises where meat and other foods are sold or prepared for sale. There is no registered slaughterhouse or public abbatoir in the district. FOOD INSPECTIONS Food Premises The number of food premises in the Borough by type of business is shown as follows :— Shops 327 Catering Establishments 120 Factories 22 Premises required to be registered are as follows:— Food and Drugs Act, 1938, Section 14. Fish Curing 9 Manufacture of Sausages or Preserved Food 54 Manufacture of Ice-Cream 5 Sale only of Ice-Cream 125 Manufacture and Sale of Iced-Lollies 5 Middlesex County Council Act, 1950, Section 11. Premises of Street Traders 24 Milk and Dairies Regulations, 1949. Dealer/Processors 2 30 The number of inspections of registered food premises during the year was 524. Standards found on inspection are high, with the exception of storage premises of street traders, which require constant checking. Education in food hygiene continued in food shops, catering establishments and school canteens, and the canteens in schools and in certain factories were kept supplied with meals specimen jars, samples being retained for 48 hours after each meal. As food poisoning cases did not occur in the factories or schools, the value of having these jars was not tested. The following table shows the quantity of food examined and the disposal of condemned food. Total Inspected (lbs.) Sound Unsound Total (lbs.) Stock (lbs.) Production (lbs.) Consumption (lbs.) Total (lbs.) Animal Feeding (lbs.) Byproducts (lbs.) Destruction (lbs.) Canned 82,369 6 6 — — 82,363 33,424½ 1 48,937½ Raw 56,576½ 8,571 3,007 50 5,514 48,005½ 21,423 — 26,582½ Totals 138,945½ 8,577 3,013 50 5,514 130,368½ 54,847½ 1 75,520 The following table shows items of unsound food which were investigated during the year. Vendor (and source) Subject of Enquiry Action Local Shop (made outside Southall) Piece of glass in sausage No action Local Shop Maggot in chocolate powder Letter to manufacturers Local Shop (made outside Southall) Grease in brown loaf Referred to Health Department controlling Bakehouse Bottled outside Southall Dirt or Rust in bottle of milk Referred to Health Department controlling dairy Local Shop (canned in South Africa) Maggot in tinned peas Referred to Importers Local Shop (made outside Southall) Matchstick in sandwich cake Warning letter to maker Local Shop (made outside Southall) Insect in bread loaf No action Bottled and sold in Southall Black particles adhering in empty milk bottle No action Made and sold in Southal Drawing pin in cake No action Local Shop (made outside Southall) Mould in wrapped bread loaf No action Local Shop (made outside Southall) Grease in sliced loaf No action Local Shop (made outside Southall) Particles of glass in pickles Warning letter to manufacturers Local Shop Fruit cake alleged to be tainted Not confirmed Local Shop (made outside Southall) Wasp in sugar lollipop ... Warning letter to manufacturers Local Shop (made outside Southall) Piece of string in wholemeal loaf Warning letter to baker Local Shop Can corned beef alleged to be unsound Not confirmed 31 RODENT CONTROL There was no change during the year in the Council's policy of carrying out work free of cost at domestic premises; offering technical services to business and industrial premises where a commercial operator was retained, or carrying out the work at economic charge where it was within the scope of the Council staff. Sewers were test baited twice during the year, in June and December. 10 per cent, of the total sewer manholes were tested and maintenance (i.e. pre-baiting and poisoning) treatments were carried out immediately after each test. Infestation of the sewer by rats remained slight. NOISE NUISANCE Seven complaints were received of noise from factories, in some cases involving visits at night or early morning. Two complaints were not confirmed, four were abated after informal action, and one after service of Statutory Notice. ATMOSPHERIC POLLUTION Measurement of the pollution of the atmosphere has been carried out regularly month by month at separate stations set up on three sites in the Borough. At Jubilee Gardens on the north side and Recreation Ground on the south side, gauges for the measurement of the sulphur gases in the air are in operation and in Hortus Cemetery a machine for estimating the quantity of grit and dust deposited from the atmosphere. In view of the number of complaints received concerning the alleged smoke nuisance from the railway sidings, plans were approved for further deposit gauges to be erected in the railway allotments and a new primary school further west which would give a comparison between the atmospheric pollution at those sites, against that found in parts of the Borough. The figures from this are recorded for November and December and are shown in the Table on page 33. The figures obtained for atmospheric pollution by sulphur gases show a slight improvement over the year, especially during the months of March, September and October and the usual mid-summer dip in the figures for pollution by sulphur gases appears. The results from the deposit gauges were by no means satisfactory, however. There was a considerable increase in the total amount of solids deposited, in fact, this was the worst year as yet recorded in this respect, figures from 1950 being as follows :— Total solids deposited—average for each year: 1950 1350 1953 1067 1951 1295 1954 14'30 1952 1193 It will be seen that the figures were decreasing regularly until this year. A great deal of work was carried out during 1954 with regard to complaints of pollution from individual factories, and the railway sidings. Details can be found in the table on page 37. It can be seen, however, from Graph E that the pollution in Southall still compares very favourably with that in the centre of London and in industrial Sheffield. 32 Atmospheric Pollution Estimation Years 1954/1953 Sulphur Trioxide-Lead Peroxide method. Milligrams per day per 100 square centimetres Deposit Gauge Hortus Cemetery Month of Year Jubilee Gardens Recreation Ground Rainfall Tons per square mile per month mms. Insoluble Soluble Total 1954 1953 1954 1953 1954 1953 1954 1953 1954 1953 1954 1953 January 1.68 1.62 2.65 2.03 22 21 470 4.23 3.71 2.80 2.41 7.03 February 1.64 1.56 2.15 2.29 49 31 12.71 9.19 12.29 3.59 25.00 12.78 March 1.344 2.09 2.16 3.17 53 10 6.57 11.66 7.59 4.88 14.16 16.54 April 0.98 0.93 1.22 1.48 7 59 1.5 8.06 1.37 4.69 2.87 12.75 May 069 0.56 1.10 0.92 52 31 12.13 6.76 16.65 3.55 28.78 10.31 June 0.41 0.34 0.60 0.58 96 47 11.29 6.42 10.76 2.72 22.05 9.14 July 0.41 0.30 0.46 0.31 56 77 4.43 8.00 4.47 4.44 8.9 12.44 August 0.31 0.45 0.53 0.55 85 52 5.37 7.43 8.46 3.26 13.83 10.69 September 0.54 1.07 0.46 0.83 59 51 6.25 7.54 7.23 3.41 13.48 10.95 October 0.94 1.01 0.73 1.88 61 88 3.07 7.01 6.78 5.04 9.85 12.05 November 1.35 1.63 1.65 1.70 84 14 4.71 2.89 9.58 3.11 14.29 6.00 December 1.59 1.54 1.71 No figures available 41 14 3.33 3.48 6.65 3.92 9.98 7.40 Average for Year 1.00 1.09 1.29 1.43 55 41 6.34 6.89 7.96 3.78 14.3 10.67 1954 Months of Tons Per Square Mile per Month Insoluble Soluble Total Railway Allotments New Primary School Railway Allotments New Primary School Railway Allotments New Primary School November 17.28 5.02 9.11 9.27 26.39 14.29 December 9.40 3.41 7.44 7.57 16.84 10.98 Graph C Atmospheric Pollution by Sulphur Oxides (Lead Peroxide Method) 34 Graph D Atmospheric Pollution Estimation—Deposit Gauge at Hortus Cemetery 35 Graph E Atmospheric Pollution by Sulphur Oxides Determined by the Lead Peroxide Method Comparison with Other Districts (Year 1954) Details of the observations made because of particular subjects of complaint and the results of these observations can be seen in the following table. On no occasion was black smoke observed to continue long enough to be considered as a statutory nuisance. 36 In addition to routine observation of factor)' chimneys, 13 complaints of nuisances from smoke or grit were investigated, in some cases by the use of grit plates or Petri dishes, and informal action taken at the premises secured their abatement. During the first four months of the year special investigations by the use of grit plates were made, principally during weekends, into emissions from Southall Locomotive Sheds. Subsequently two additional Deposit Gauges were installed to cover this area. In one case a Court Order was obtained in connection with emission of spirit and oil fumes from clothes cleaning premises. Alterations to the premises were still in progress at the end of the year. Number of sites of observation 3 (1 deposit gauge and 2 lead peroxide gauges) (2 additional deposit gauges came into use on 1st November, 1954) Number of complaints of nuisance from smoke, smell or grit and number of premises concerned 23 complaints re 12 premises Number of places kept under observation 17 Number of half-hour observations made 95 Number of times black smoke was detected 5 Total time of black smoke emissions 5 minutes Number of times moderate smoke observed 53 Total time of moderate smoke emissions 487 ½ minutes RIVER POLLUTION Reports continued to be submitted by the officers of the Middlesex County Council throughout 1954, of the results of sampling at various points on the River Brent. Three of these points were situated within the Borough of Southall, namely one where the River crosses the Uxbridge Road, one up-stream of the junction with the Grand Union Canal, and one down-stream of the junction with the Grand Union Canal. Twelve reports in all were submitted during the year, and in the majority of these conditions were found to be satisfactory, but in a few of the reports, especially after very heavy rainfall, a certain amount of unsatisfactory deposit was obtained from these samples. On certain occasions by the united efforts of the officers of the Borough Council with those of the Middlesex County Council, defaulting property owners were traced and arrangements made whereby pollution should be prevented and as on some occasions oil was found to be polluting the water from garage yard washings, negotiations with the owners of these premises were undertaken in order that other arrangements for the deflection of the surface water into the sewerage system might be made. The two last reports received at the end of the year were both satisfactory at each of the three Southall sites of sampling. 37 APPENDICES EXTRACTS FROM VITAL STATISTICS Table I. Total Male Female Comparative Figures for 1953 Live Births—Legitimate 678 321 357 682 Illegitimate 23 11 12 31 Stillbirths—Legitimate 10 5 5 10 Illegitimate — — — 3 Deaths 662 336 326 731 Birth rate (live and stillbirths) per 1,000 of the estimated population 13.06 13.22 Stillbirth rate per 1,000 total (live and still) births 14.06 17.91 Crude death rate per 1,000 of the civilian population 1216 13.31 Deaths from Puerperal Causes (Heading 30 of the Registrar-General's Short List):— Deaths Rate per 1,000 total (live and still) births No. 30. Pregnancy, Childbirth, Abortion 1 1.41 1.38 Death rate of infants under 1 year of age :— All infants per 1,000 live births 18.54 29.45 Legitimate infants per 1,000 legitimate live births 17.70 30.79 Illegitimate infants per 1,000 illegitimate live births 43.48 — Deaths from cancer (all ages) 115 120 Deaths from cancer (all ages) — 1 Deaths from whooping cough (all ages) — 1 Deaths from whooping cough (all ages) — — Causes of Death, 1954 Table II Male Female Total 1954 Total 1953 1. Tuberculosis, respiratory 10 2 12 12 2. Tuberculosis, other — 1 1 — 3. Syphilitic disease 1 — 1 3 4. Diphtheria — — — - 5. Whooping cough — — — 1 6. Meningococcal infections — — — — 7. Acute poliomyelitis 1 — 1 2 8. Measles — — — 1 9. Other infective and parasitic diseases 1 4 5 1 10/15. Cancer (all forms) 72 43 115 120 16. Diabetes 2 — 2 5 17. Vascular lesions of nervous system 36 48 84 75 18. Coronary disease, angina 54 32 86 81 19/20. Heart disease 55 76 131 133 21. Other circulatory disease 28 22 50 57 22. Influenza — 1 1 9 23. Pneumonia 17 26 43 50 24. Bronchitis 20 16 36 57 25. Other diseases of respiratory system 3 2 5 3 26. Ulcer of stomach and duodenum 6 1 7 2 27. Gastritis, enteritis and diarrhoea — 2 2 5 28. Nephritis and nephrosis 2 2 4 4 29. Hyperplasia of prostate 3 — 3 6 30. Pregnancy, childbirth, abortion — 1 1 1 31. Congenital malformations, birth injuries, etc. 1 3 4 11 32. Other defined and ill-defined diseases 14 35 49 56 33. Motor vehicle accidents - - - 7 34. All other accidents 8 5 13 22 35. Suicide 2 4 6 7 36. Homicide and operations of war — — — — Total Deaths 336 326 662 731 Deaths in Wards Table III Ward Male Female Total Waxlow Manor 22 20 42 Northcote 49 32 81 Hambrough 40 36 76 Dormers Wells 110 142 252 Glebe 54 36 90 Norwood Green 61 60 121 Total 336 326 662 39 Table IV 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 3 2 2 3 — 1 11 February 1 — 3 4 2 — 10 March 1 3 2 3 4 1 14 April 1 1 2 3 3 1 11 May 3 3 2 4 3 1 16 June — 1 2 2 2 1 8 July 3 4 1 4 1 2 15 August 1 — — 1 4 1 7 September 2 1 1 2 2 1 9 October 2 — 1 2 3 3 11 November 2 4 — 4 2 1 13 December 3 2 — — 10 3 18 Total 22 21 16 32 36 16 143 Table V Causes of Death Under One Year of Age Certified Causes 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 1 year Diseases of circulation and blood 1 - - - 1 - - - - 1 Atelectesis - - - 1 1 — — - - i Asphyxia - - - - - - - - - - Bronchitis, pneumonia, etc. - - - - 1 1 - - 2 Congenital malformations and tal heart disease 2 1 1 - 4 1 - - - 5 Gastro-enteritis, diarrhoea, bowel order 1 - - - 1 - - - - 1 Prematurity 1 - - - 1 - - - - 1 Birth injury 2 - - - 2 - - - 2 Whooping cough - - - - - - - - - - Total 7 1 1 1 10 2 1 - - 13 Live Births. Legitimate 678 Infant Deaths. Legitimate 12 Illegitimate 23 Illegitimate . 1 40 Table VI Deaths from Cancer Year Male Female Total Estimated Population Rate per 1,000 population 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 48,970 141 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 1.6o 1951 48 46 94 55,620 1.69 1952 46 49 95 55.430 201 1952 including long stay hospital deaths 54 57 11 1953 63 57 120 54.910 2.19 1954 72 43 115 54,440 211 Table VII 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 3 2 2 7 8 54 8 4 6 12 5 4 115 - Encephalitis - - - - - - - - - - — - — — Erysipelas - - - - - - - - 2 4 4 - 10 — Food Poisoning 3 4 1 4 2 7 11 3 2 4 3 1 ‡45 — Malaria - - - - - - - - - - - i 1 - Measles 4 5 5 1 3 21 1 1 - - - - 41 - Meningococcal Infection 1 - - - - - - 1 - - - - 2 - Paratyphoid - - - - - 1 - - - — - - 1 — Pneumonia 3 1 5 2 4 8 7 8 10 18 23 11 100 — Poliomyelitis: Paralytic - - - - - 1 - - - - 1 - 2 1 Non-Paralytic - - 1 - *2 - - 1 - - - — 4 - Puerperal Pyrexia - - - - - - - - - - - - - — Scarlet Fever - - 5 6 14 †70 5 - 1 — - - 101 - Whooping Cough 7 7 7 8 11 20 2 — 2 — 1 — 65 — Total 21 19 26 28 44 182 34 18 23 38 37 17 487 1 *One not confirmed; one diagnosed as influenza. † One case diagnosed as follicular tonsillitis. ‡ Only one was bacteriologically positive, the organism found was salmonella typhi-murium. 41 The number of cases of infectious diseases (including Tuberculosis) notified during the year, according to the locality, are shown below:— Table VIII Diseases Total Waxlow Manor Northcote Hambrough Dormers Wells Glebe Norwood Green Total Deaths Dysentery 115 79 8 11 1 10 6 _ Encephalitis - — — - — — - - Erysipelas 10 — - 1 3 4 2 - Food Poisoning ‡45 3 5 — 35 1 1 — Malaria 1 - — — — 1 - Measles 41 6 3 2 16 3 11 - Meningococcal Infection 2 1 - - 1 - - - Paratyphoid 1 - - - - 1 - - Pneumonia 100 11 12 7 32 27 11 — Poliomyelitis: Paralytic 2 1 - - 1 — — 1 Non-Paralytic 4 1 — ‡1 *1 1 — - Puerperal Pyrexia - - — - - - — - Scarlet Fever 101 15 3 18 12 §36 17 - Tuberculosis 78 13 15 7 23 11 9 13 Whooping Cough 65 5 4 8 18 15 15 - Total 565 135 50 55 143 109 73 14 †Finally diagnosed as influenza. *Not confirmed. §One case finally diagnosed as follicular tonsillitis. ‡Only one was bacteriologically positive, the organism found was salmonella typhi-murium. Table IX 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 - - - - - - - 1-5 — — — — — — — — 5-10 1 2 - - - - - - - 10-15 - - - - - - - - 15-25 4 10 - 1 - - - - 25-35 19 6 1 2 1 i - - 35-45 6 3 - 1 2 - - - 45-65 9 4 2 — — i - — 65+ 7 - - 7 - - 1 Total ... 48 23 3 4 10 2 - 1 42 Table X The occupations of the new cases are as follows:— Occupation Pulmonary Non-Pulmonary Male Female Male Female Aircraft Fitter 1 _ - - Apprentice Engineer 1 - - - Assistant Accountant 1 — - — Bench Han 1 - - - Bus Driver 1 - - - Calculating Machine Operator 1 - - - Cashier - 1 - — Chargehand 1 - - - Civil Servant - - - - Clerk 1 2 - - Cost Clerk 1 - - — Dressmaker - 1 - - Electrical Wireman 1 - - — Electrician ... 1 - - - Electronic Engineer 1 - - - Factory Hand 2 - - - Farm Worker 1 — — — Grocery Manager 1 - - - Hairdresser 1 - - - Housewife - 8 - 2 Labourer 1 - - - Lorry Driver - - 1 - Maintenance Worker 1 - - - Mental Patient 10 3 - - Office Cleaner - 1 - — Packer (Bread Factory) 1 - - - Painter 1 - — - Porter—British Railways 1 - - - Pre-schoolchild 1 - - - Printer 1 - - - Punch Operator - - - 1 Retired 2 - - - Secretary - 1 - - Schoolchild 2 - - — T urner 1 - - - Telephonis - - - 1 Unknown 7 6 2 — Total 48 23 3 4 Table XI Examinations for Verminous Conditions and Children Found to be Verminous Attending Maintained Schools in Southall during 1953 And 954 School Total number of examinations Total number of individual pupils found to be infested for the first time during the year Total number of instances of infestation among pupils Number of individual pupils in respect of whom cleansing notices were issued Number of individual pupils in respect of whom cleansing orders were issued 1953 1954 1953 1954 1953 1954 1953 1954 1953 1954 Beaconsfield Road, j.M. 1,309 1,241 - — - — - - - - Beaconsfield Road, I. 832 805 - - - - - - - - Clifton Road, j.M. 1,033 919 7 6 9 5 5 4 3 3 Clifton Road, I. 859 829 2 2 3 2 2 2 - - Featherstone Road, J.M. 1.037 960 1 10 1 9 1 7 - 1 Featherstone Road, I. 842 1,223 1 14 1 12 1 10 - 5 Lad\ Margaret, J.M. 1,616 1,648 - - - - - - - - Lady Margaret, I. 1,257 1,002 2 - 2 - 2 - 1 - North Road, J.M. 1,375 1.150 1 1 1 1 1 1 - - North Road, I 777 525 - 2 - 2 - 1 - - St. Anselm's R.C. I.417 1,456 1 4 1 4 1 2 - 1 Tudor Road, J.B. 702 740 - - - - - - - - Tudor Road, J.G. 723 707 4 6 7 2 5 2 3 2 Tudor Road, I. 1,236 883 1 - 1 - - — - - Western Road, J.M. & I. 1,099 1,033 4 3 4 3 4 3 2 - Dormers Wells, I. - 630 - - - - - - - — Dormers Wells, J.M. — 418 - - - - - - - - George Tomlinson, J.M. & I. 222 724 - 1 - 1 - 1 - - Dormers Wells, S.B. 1,386 1,005 - 1 - 1 - 1 - - Dormers Wells, S.G. 1,592 1,548 4 4 4 3 2 2 - 1 Featherstone Road, S.B. 995 974 - 1 - 1 - 1 - - Western Road, S.G. 969 1,276 1 14 1 14 - 13 - 8 Talbot Road, Mixed - 536 - 6 - 6 - 6 - 3 Talbot Road, Specials 360 3 3 3 4 2 3 - 1 - Routine Medical Inspections - 2 - 2 - 2 - 1 - - Total 21,638 22,237 32 80 39 70 27 57 10 24 44 Table XII Sanitary Inspections—Classification of Visits Houses, Public Health Act, 1936 4,135 Houses, Housing Act, 1936-1954 275 Overcrowding 209 Disinfestation 66 Pet Animals Act, 1951 9 Vans, Sheds 13 Shops Act, 1950 63 Food Shops 441 Fried Fish 8 Cafes, etc 120 Factories (Mechanical) 60 Factories (Non-Mechanical) 7 Outworkers 31 Food Factories 142 Smoke 86 Offensive Trades 1 Bakehouses 26 Dairies 7 Water Sampling 16 Ice-cream Sampling 112 Other Foods Sampling 116 Schools 27 Stables 10 Offensive Accumulations 29 Hairdressers 1 Petrol 75 Canal Boats 5 Slaughterhouses 27 Rats and Mice 395 Infectious Diseases 735 Atmospheric Pollution 343 7,590 45 Table XIII HOUSING—GENERAL Statistics 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) 1,129 (b) Number of inspections made for the purpose 4,038 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 197 (b) Number of inspections made for the purpose 231 (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 644 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 711 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 114 (2) Number of dwelling-houses in which defects were remedied after service of formal notices (a) By owners 157 (1b) By local authority in default of owners — (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 - 46 4. Housing Act, 1936—Overcrowding:— (a) (1) Number of dwellings overcrowded at the end of the year 128 (2) Number of families dwelling therein 159 (3) Number of persons dwelling therein 570 (b) Number of new cases of overcrowding reported during the year 43 (c) (1) Number of cases of overcrowding relieved during the year 24 (2) Number of persons concerned in such cases 122 (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 - (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report - Table XIV Home Accidents, 1954 Age Nature of Injury Cause of Injury Known to have died 87 years Injury right tibia Fall 2 years Scald right forearm and hand Teapot fell over 3½ years Burn right thigh and right leg Hot iron fell on child 2 years Laceration root of nose Hit with kettle in kitchen 7 years Burn right foot Put foot in metal box in which fire had been lit 78 years Injury right hip Fall off chair 90 years Fractured right femur and wrist Fell down stairs 35 years Burn Pot of porridge fell over 8 years Fracture right forearm Fell off garden wall 80 years Fractured left femur Fall 76 years Fractured right femur Fall 47