459(1) SOUTHALL ABC AMOR SouT 23 BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1955 MARGARET A. GLASS, Medical Officer of Health KING AND HUTCHINGS, LTD., PRINTERS, SOUTHALL 1 BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1955 MARGARET A. GLASS, Medical Officer of Health INDEX PAGE Ambulance Service 9 Antitoxin 21 Area of Borough 6 Atmospheric Pollution 4, 25, 37, 38, 39, 40. 41) 50 B.C.G. Vaccination 4, 17, 19 Bed bugs 28 Births and birth rate 3, 10, 11, 43, 45 British Red Cross Service 8, 22 Bulletin of infectious disease 13 Canal boats 28, 50 Cancer 3, 10, 20, 43, 44, 46 Caravans 31 Carbide 30 Care and after care 9 Catering establishments 35, 50 Cattle market 34 Causes of death 44 Celluloid and Cinematograph Film Act 30 Certificates of Disrepair and Revocation 31 Chest Clinic 8, 9, 17, 18, 19 Children's welfare 9 Chiropody 24, 42 Chlorination 6 Club for Disabled Persons 22 Community Centre 22, 23 Clinics 8,9 Deaths and death rates 3, 10, 15, 17, 19, 43, 44, 45, 46, 47 Deaths in wards 10, 44 Demolition 4, 31 Diphtheria 3, 4, 9, 13, 16, 44 Disinfection 21 Dysentery 3, 13, 15, 46, 47 Deafness 23 Education—Health 4, 25 Employees' medical examinations 42 Factories Act, 1937 28, 29, 50 Film Strip Projector 25 Flannelgraph 25 Food handlers' hygiene 32 Food hygiene 32, 35 Food inspection 35, 36 Food poisoning 3, 13, 25, 32, 35. 46, 47 Food sampling 32, 35, 36, 50 Food shops 34, 35, 50 Free washing facilities 32 Graphs 11, 12, 17, 18, 20, 39, 40 Health education 4, 25 Health visitors 8, 20 Heart disease 3,10,44 Holidays for old people 24 PAGE Holiday rest homes 9 Home accidents 13, 26, 27 Home helps 9, 23 Home nursing 8, 22, 23 Hospital services 8 Houses—number inhabited 6 Housing 17, 31 Housing Repairs & Rents Act 4, 31 Hygiene of food 3, 32 Hygiene—personal 3, 25, 32 Health Forum 4, 25 Ice-cream sampling 32, 50 Immunisation 4, 8, 9, 16 Infant mortality 3, 11, 12, 43, 45 Infectious diseases, prevalence and control of 3, 13-21, 50 Influenza 4, 14, 15, 44 Inspection and supervision of food 32, 33, 34, 35, 36 Inspection of sanitary accommodation in factories 28, 29, 50 Laboratory facilities and work 14,15,20,21 Markets 34 Mass X-Ray 17 Massage, establishments for 42 Maternal morbidity 12 Maternal mortality 3, 10, 12 Maternity and Child Welfare 8 Meals sampling 35 Meals on Wheels 23 Measles 3, 10, 13, 43, 44, 46, 47 Meat and other foods 34 Medical examinations 42 Mental health 8, 9 Middlesex County Council Services 8, 9 Midwifery service 8 Milk licences 32, 34 Mortuary 28 Miscellaneous 42 National Assistance Act, S. 47 23, 24 Notifiable diseases 13-20, 46, 47 Noise nuisance 42 Nursing equipment 8, 22 Old People's Welfare 13, 23, 24 Ophthalmia neonatorum 16 Outworkers 28,29,50 2 PAGE Overcrowding 17, 18, 50 Parks and open spaces 6 Pet Animals Act 42, 50 Personal hygiene 25, 32 Petroleum Acts 30, 50 Physical features of the district 6, 7 Poliomyelitis 3, 10, 13, 14, 44, 46, 47 Population 6, 17 Premature infants 12, 45 Public Control Department 32, 33, 34 Public Health Committee 3 Puerperal pyrexia 12, 46, 47 Rag Flock and Other Materials Filling Act 29 Rateable value 6 Rats and mice 42, 50 Rehousing 4,17,31 Respiratory diseases 44, 45 Rivers—Pollution 42 Road Accidents 10, 25, 26 St. John Ambulance Service 22 Sanitary circumstances 28, 29, 30 Sanitary inspection 28, 60 Sanitation in schools 28, 50 Scabies 21 Scarlet fever 16, 46, 47 School Medical Service 9 Slum Clearance 4 Shops Acts 42, 50 Smallpox 4, 9, 15, 21 Smoke pollution 4, 37, 41, 50 Social conditions 6 Staff 5 Statistics — General and Vital 6 Stillbirths 10,12,43 Street traders 35 Sulphur dioxide pollution 38, 39, 4° Swimming bath 6, 7 Tuberculosis 3, 4, 8, 9, 10, 16, 17, 18, 19, 20, 44, 47, 48 Vaccination 4, 8, 9, 15 Vaccine lymph 21 Verminous persons 21, 39 Vital statistics 10, 11, 12, 43 Water supply and service 25, 28 Welfare — General and Old People's 22,23,24 Whooping Cough 8, 10, 13, 43, 44, 46, 47 THE COUNCIL OF THE BOROUGH OF SOUTHALL, 1955 HIS WORSHIP THE MAYOR *Councillor P. J. Love, J.P. Deputy Mayor: Alderman H. C. Douglas. 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. Cavell, Mrs. I., J.P. Haigh, J. Shepherd, A. H. *Cripps, C. B. Hook, R. E. †*Southey, P. G. Errington, F. G. †*Jones, Mrs. E. W. Steele, T. J. *Godman, A. S. *Love, P. J., J.P. *Ward, J. H. *Griffiths, Mrs. M. C. Salmon, J. *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 59th Annual Report on the health and circumstances of the population of the Borough of Southall. The health of the people continued to be good. The death rate and the infant mortality rate continued to fall, the latter being the lowest yet recorded in the Borough, and there was a slight rise in the birth rate. Although heart disease, coronary disease and cancer were again the principal causes of death, the figures for each showed a slight drop from the 1954 level. Deaths from tuberculosis fell and there were no maternal deaths. Although the figures of infectious disease notifications were very much higher than in 1954, the major part of this increase was due to a measles outbreak which though widespread was not severe in character. The number of cases of dysentery and food poisoning was lower than in 1954 in spite of the hot, dry summer which would normally be expected to encourage the spread of these infections, and this says much for the good standard of hygiene maintained by the general public and by the food traders. There were no cases of diphtheria. Poliomyelitis was more prevalent, however, than it had been for a number of years. 28 cases were notified of which 21 were confirmed as poliomyelitis, 8 of them being of the paralytic type, and two deaths occurred from this disease. Again a hot, dry summer made conditions ideal for the spread of this infection and it was feared that a real outbreak might take place. Every case was investigated very fully and contacts excluded from school or work, and we were fortunate to be able at the end of the year, when assessing the damage done by this disease, to find that the total number of persons affected was lower than in the last difficult year which was 1949. 3 A period of anxiety occurred also in January, over the prospect of an outbreak of influenza coming to this country from the Continent of Europe, and special preparations were made for the bacteriological investigation and isolation of any suspicious case, but the Virus A severe type of influenza did not occur in any member of the public of Southall. The number receiving vaccination against smallpox was slightly increased, but there was a fall in the figures for immunisation against diphtheria and this is giving some concern as the immunised state of the whole child population is falling to the danger level. A record low death rate from tuberculosis and the lowest notification rate since 1942 are figures which give ground for some hope that this deadly and crippling disease is diminishing. It was also interesting to find that the waiting list for sanatorium beds has been obliterated, and that all persons in need of isolation and treatment for tuberculosis can be found hospital accommodation and beds. The research work carried out on tuberculosis prevention by B.C.G. injection has come to an end, and to a satisfactory conclusion. There appears to be no doubt from the findings that a measure of protection can be given by this method, and there will therefore be an increase in the opportunities given to Southall residents and their children to obtain this protection. Progress has been made on the clearance of slums and the re-housing of their occupants. An assessment of the whole problem was made and the report submitted to the Minister as required by the Housing Repairs and Rents Act of 1954. Almost one-third of the total number of slum dwellings were represented for demolition before the end of the year. A great deal of the time of the Sanitary Inspectors had to be taken up during 1955 with observations on smoke pollution. The figures here deteriorated considerably during 1955, and, with smoke and grit as potential causes of lung disease, it was necessary to take energetic action in order to endeavour to improve pollution from particular sources. Health education, or "advertising good health," is getting to be considered a more and more important part of preventive medicine and, in addition to the normal publicity used for this purpose, such as leaflets, posters, film slides and talks to individuals or to meetings of voluntary associations, two particular meetings during the year for the general public were arranged, one for a showing of public health films and one as a Health Forum for the discussion of topics of health and hygiene. I would like to acknowledge with gratitude the help given by 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 Godalming, Sheffield and Westminster, Chief Officers of the Borough Council, the Divisional Education Officer, the directors of many local organisations devoted to social service, officers of the Fuel Research Station, and the general practitioners of Southall, who have so kindly supplied information for use in the Report, and 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, Medical Officer of Health. Manor House, Southall. 4 HEALTH DEPARTMENT STAFF for the year 1955 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. (Resigned 2nd January, 1955). J. C. McManus, Cert. S.I.B., Cert. M. & F. (Appointed 15th March, 1955). Additional Sanitary Inspector: Vacant. Trainee Sanitary Inspector: D. A. C. Davis. General Assistant: W. G. V. Hyde. Clerical Staff: Senior Clerk: Mrs. K. Jones. Clerks, Shorthand-Typists: Mrs. K. N. Malam. Miss C. M. Hately. Miss J. M. Easton. 5 SGENERAL STATISTICS AND SOCIAL CONDITION OF THE BOROUGH Area (acres)2,607762 Population—Registrar-General's estimate (Mid 1955) 533840 Number of inhabited houses according to Rate Book 14,871 Average number of occupants per house 3.62 Sum produced by a penny rate £15846 Rateable Value £444,521 The Council controls 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 Havelock Road Open Space 2.25 acres Jubilee Park 11.13 acres Lady Margaret Road 0.25 acres Land at junction of Windmill Lane and Tentelow Lane 0.48 acres Land on west side of Cranleigh Gardens 1.07 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 254.51 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. 6 During 1955, the total number of persons using the bath was 47,616. The average number of persons attending per day (wet or fine) was 313. The maximum number at any one session was 450. 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 fine summer weather during several months of 1955 resulted in a very high attendance at the swimming bath—the numbers being almost double those for the previous year. In the early summer, a paddling pool for young children was opened in Cranleigh Gardens play park—the capacity of the pool is 20,600 gallons and the depth from 3 inches to 12 inches; the water of the pool is free running and is treated by continuous chlorination for hygienic purposes. % 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 2,507 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. During 1955, a new ward was opened at this hospital for the isolation and treatment of cases of tuberculosis occurring either within the hospital or admitted (already suffering from the disease) from outside or from other hospitals. 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 non-pulmonary). Persons may be referred there by their own doctors, from 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 Garden Centre and Featherstone and Whooping Cough Immunisation Road Schod Clinic Clinics Ultra Violet Light Clinic Northcote Avenue Clinic. 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 are carried out by those general practitioners who participate 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 A County Ambulance Service is provided for the removal to hospital, where necessary, of accident and sickness cases. This service is organised in association with the County Fire Service. There is an Ambulance Accident Station situated in Southall beside the Town Hall. (1) 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. Ophthalmic treatment Northcote Avenue Clinic. Physiotherapy Northcote Avenue Clinic and Jubilee Gardens Centre. Ultra Violet Light treatment Northcote Avenue Clinic. Northcote Avenue Clinic. King Street. (Closed for adaptations.) Speech therapy Talbot Road School. Jubilee Gardens Centre. (Until King Street re-opens.) 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 VITAL STATISTICS Total deaths, 642. (Males, 313; Females, 329.) Crude Death Rate, 11.92 (including deaths in St. Bernard's Hospital, Norwood Hall and Vine Cottage); 8.19 (excluding these deaths). For extracts from vital statistics and causes of death, see Appendix, Tables I and II. Deaths and Death Rate The death rate was again reduced in 1955 after a substantial drop from the year 1953, the rate in that year being 13.31, as compared with the 1954 figure of 12.16 and the 1955 figure of 11.92. Heart disease, coronary disease and cancer were again the principal causes of death. Each of these figures, however, shows a slight drop since the previous year, cancer deaths being 109 as compared to 115 in 1954, and diseases of the heart and circulation falling from 351 in 1954 to 330 in 1955. There were no deaths from whooping cough or measles, and no maternal deaths. The deaths from tuberculosis fell from 13 in 1954 to 8 in 1955, and there were two deaths 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 247 (males 136 and females III). Deaths of institution inmates (including patients from Southall addresses and from outside areas) number as follows: St. Bernard's Hospital, 195 (males 77 and females 118); Mount Pleasant Hospital, 24 (all male); Southall-Norwood Hospital, 17 (9 male and 8 female); Vine House, 6 (1 male and 5 female); in addition 4 deaths (2 male and 2 female) occurred of persons belonging to other districts and residing temporarily in Southall. In 1954, it was pleasing to record that no Southall resident had died as a result of injuries received in a road accident. This good record has not been maintained, however, since 4 people died as the result of motor vehicle accidents during 1955. It is interesting to note the death rates for the district over the past 70 years from the time when Southall was a village with just over 4,000 inhabitants until the present time when it is an industrial town of over 50,000. Deaths Death Rate 1885 83 19.9 1895 93 13.9 1905 184 10.3 1915 197 9.9 1925 246 8.2 1935 398 8.25 1945 462 9.26 1955 642 8.19 (excluding institution deaths—which were not included in the statistics until 1953) 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 11.80, including institutional deaths, or 876 excluding these, compared with the rate for England and Wales as a whole, i.e. 11.7. For distribution of deaths in the various wards, see Appendix, Table III. Births and Birth Rate. (Figures for 1954 are given in brackets.) The total number of registered births in the district (as notified under the Births and Deaths Registration Act) was 112 (143). The total number of live births belonging to the district, whether occurring within or outside the district, was 698 (701). The illegitimate live births were 21 (23). There were 12 stillbirths (10), of these 10 were legitimate and 2 illegitimate. 10 A slight rise in the birth rate (live and still births) is recorded from 13.06 in 1954, to 13.19 in 1955. The number of illegitimate births recorded is the lowest since 1932 and as during that year the estimated population was just over 44,000 it can be considered that the 1955 figure is a record low one. The following figures have been extracted from previous Annual Reports showing the trend of occurrence of illegitimate births during the years from 1932 onwards:— Number of Illegitimate Year Live Births 1932 20 1933 27 1934 27 1935 23 1936 24 1937 38 1938 31 1939 34 1940 31 1941 30 1942 38 1943 39 1944 55 1945 60 1946 56 1947 53 1948 53 1949 39 1950 36 1951 28 1952 26 1953 31 1954 23 1955 21 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 12.96 to compare with the corresponding rate for the whole of England and Wales, which was 15.0. Infant Mortality Infant mortality, i.e. the number of children dying before reaching the age of one year per 1,000 live births, again fell in 1955, the rate this year being the lowest yet recorded. Twelve infants died, as compared with 13 during 1954, giving an infant mortality rate of 17.19 per 1,000 live births, as against 18.54 in 1954 Of these 12 deaths, 2 died at home and 10 in hospital. Seven infants (4 male and 3 female) died within the first four weeks after birth. Table V gives the causes of infant deaths under the age of one year. 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 24.9. 11 Infant Mortality Rate from 1900 to 1955 Premature Infants Thirty-eight premature infants were born during the year and there were 2 premature stillbirths. Thirty-four of these premature infants born alive were surviving at the end of one month. Out of the 38 born alive, 35 were born in hospital and 3 at home. The 2 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 5 ½ lbs. at birth. Maternal Morbidity Three cases of puerperal pyrexia were notified during the year. There were no maternal deaths, and no deaths associated with abortion. 12 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES The figure for infectious disease notifications during 1955 was 1,768. This was a high figure but the bulk of the increase over the 1954 figure of 487 was due to measles, the number of measles cases being 1,329. Measles was widespread throughout the first months of the year and considerable numbers of notifications were still being received as late as June. There were, however, no deaths from measles nor from whooping cough. It is noteworthy that there was also an increase in the incidence of other respiratory diseases, the whooping cough figure and the pneumonia figure were both increased over the year 1954, possibly some of these could be attributed to debility caused by the effects of measles on the general systems of the patients. The figures for dysentery and food poisoning were good. There was no outbreak of either of these diseases during the year. There were no notifications of diphtheria. Particulars with regard to individual infectious diseases 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 rose during the year 1955, being 1,329 as compared with 41 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 1946 21 - 1947 334 - 1948 825 1 1949 194 - 1950 701 - 1951 1,129 1952 528 - 1953 931 1 1954 41 - 1955 1,329 - Poliomyelitis Twenty-eight notifications were received of acute anterior poliomyelitis; of these 21 were subsequently confirmed as poliomyelitis, 8 paralytic and 13 non-paralytic. Two deaths occurred from this disease. Particulars of the surviving paralytic cases notified in 1955 and also of those cases notified since 1949, and known to be still showing paralysis in 1954, are as follows:— 1955: Case A. Bulbar paralysis. Adult male. No limbs affected. Full recovery. Case B. Paralysis of left Girl aged 2 years. Recovering well. Still some slight thigh muscles. residual weakness in the left leg. Receiving therapy treatment. Case C. Paralysis of small Boy aged 6 years. Full recovery. muscles of hands Case D. Mild paralysis of all Adult female. Full recovery. limbs. 13 Case E. Paralysis of left leg. Boy aged 5 years. Though limping, is now able to walk and run. Still making progress. Attending hospital for physiotherapy treatment. Case F. Mild paralysis of Boy aged 5 years. Full recovery,both legs. 1954: Case A. Facial and palatial Full recovery,paralysis. 1952: Case C. Paralysis of left leg. Boy now aged 4 years. Slight paralysis persists and growth of left leg is retarded. Still making progress. Family now removed from district into Essex. Case D. Paralysis of both Boy now aged 6 years. Full recovery of power. Some legs. shortening of right leg and foot, but this has decreased during past year. Still making progress. Case F. Paralysis of limbs Adult female. Continues to make slight progress. Both and trunk. legs paralysed, both arms weak. Attends hospital for physiotherapy. Case G. Paralysis of both Boy now aged 15 years. Continues to make progress. legs. Walks well. Wears calliper for right leg, but can do without it for considerable periods. 1950: Case A. Paralysis in left leg. Adult male. Residual partial paralysis left leg. At work. Condition now appears stationary. Case C. Paralysis of arms, Girl now aged 20 years. Residual paralysis in legs. legs and trrnk. Travels in motor wheel chair and wears pelvis support and caliper. Condition appears stationary. 1949: Case B. Paralysis anterior Girl now aged 15 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:— Number of Notified Cases Confirmed Still as Paralytic Making Condition Full Year Poliomyelitis Progress Stationary Died Recovery 1949 14 1 - 2 11 1950 6 1 2 - 3 1951 9 - 9 1952 8 4 - - 4 1953 4 - - 2 2 1954 2 - - 1 1 1955 8 2 -2 4 It will be seen from these figures that of 51 cases of paralytic poliomyelitis occurring during these seven years, 34 recovered completely, regaining full power of every muscle affected. In early September, it appeared that the number of cases of poliomyelitis occurring in the County of Middlesex was becoming very high, and a meeting was held at the Middlesex Guildhall in order that the situation might be discussed and any suitable combined action taken by Medical Officers of Health. However, although poliomyelitis in the County reached a high level, and the number of respirator cases, i.e. cases where the muscles of the lungs and the diaphragm were particularly affected, were as high as they have ever been reported to be, Southall was able to maintain comparatively low figures, the total number of confirmed paralytic cases being less than in the years 1949 and 1951. Influenza In the first week of January, reports received from the Continent of Europe began to indicate the onset of an epidemic of influenza of the severe (Virus A) type. It was noticed also that the sickness incidence figures of the Ministry of National Insurance were rising rapidly. Arrangements were made whereby daily information could be obtained from the local general practitioners concerning the incidence of cases of influenza in their medical practice, and by arrangement with the Ministry of Health, and the Colindale and Ealing Public Health Laboratories, a plan was made whereby one of the local general practitioners should 14 take samples of blood, and nose and throat swabs, immediately on his diagnosing a case as influenza-these specimens to be kept in the refrigerator at Southall-Norwood Hospital until suitable transport could be provided for their undisturbed transference to the Laboratory. It was hoped thereby that the appearance in the Borough of the A type Virus (a very delicate organism) could be detected immediately and measures taken to prevent its gaining ground. In the event, however, the local influenza outbreak diminished, no cases of the Virus A type were found, and only 2 patients who died were considered to have influenza as part of the cause of death. This compared with I influenza death in 1954 and 9 in 1953. Dysentery This disease was not a problem in 1955. 17 notifications were received—16 were confirmed by bacteriological examination but of these 10 occurred in hospital and thus were not a source of danger to other members of the community. Smallpox (Variola) No cases of smallpox occurred in the Borough during the year, but one contact of a case occurring on a ship, was notified from the Port Authorities when he was travelling into Southall; he was kept under observation for the statutory period, but no smallpox developed. On one occasion a patient apparently suffering from severe chicken pox was kept under observation for a short period, and the services of a consultant in smallpox obtained. She was found not to be suffering from this disease. A constant service is maintained within the country whereby at very short notice a smallpox consultant can be obtained to visit the home of any patient who comes under suspicion, either through having symptoms suggestive of smallpox or because he may have been in contact with other smallpox cases. Vaccination The figures for infant vaccination show some improvement in 1955 over the previous year. The percentage of children receiving vaccination during their first year of life has risen from 40.4 to 46.9, although there was no especial campaign for infant vaccination carried out during the year. The re-vaccination figure has also risen, but that is not of great value to the health of the community, as the majority of re-vaccinations are carried out because families are leaving the country to emigrate to places where a vaccination certificate is a compulsory requirement before entry. 1955 Age Groups Under 1 year 1-2 years 2-4 years 5-14 years 15 years and over Total Primary Vaccination 326 17 19 30 44 436 Re-vaccination - - 3 11 89 103 1954 Age Groups Under 1 year 1 - 2 years 2-4 years 5-14 years 15 years and over Total Primary Vaccination 283 19 18 18 24 359 Re-vaccination - - 2 11 63 76 15 Scarlet Fever (Scarlatina) The number of notifications received during the year was 40 as compared with 101 for the previous year. This was one of the best years for scarlet fever we have ever had in the Borough, and the cases tended to be mild in nature, as is instanced by the fact that only 3 cases were admitted to hospital for isolation and treatment, while 37 were nursed at home. Another proof of the mildness of the infection is that there were no secondary cases, i.e. instances in which a second case occurred within three weeks following the notification of a previous case in a household. 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 406 134 22 562 344 In the following table is shown the number of children at 31st December, 1955, who had completed a course of immunisation against diphtheria at any time before that date:— Age at 31.12.55: Under 1 1-4 5-9 10-14 Total under 15 Number immunised 117 1,872 3.646 3.217 8,852 There was a decline in the number of children receiving immunisation against diphtheria during the year, both primary and secondary. This, however, was partly offset by the fact that the number of infants immunised under one year of age had risen by over 30% from 311 in 1954 to 406 in 1955. It will be seen, however, that the total immunisation state of the youthful population, i.e. children under 15, has fallen slightly, the figures for the past five years being, respectively, 8,194 for 1951, 8,138 for 1952, 8,872 for 1953, 8,951 for 1954 and 8,852 for 1955. The Registrar-General cannot supply figures for the number of children age 0-15 living in Southall—but a rough estimate of the percentage immunised can be obtained by using the 1951 census figure. This indicates that 76% is likely to be the figure in Southall for protected children, and as this should not fall below 75%, considered to be the safety margin, the need for an immunisation campaign appears to be urgent. Ophthalmia Neonatorum One case of ophthalmia neonatorum was notified during the year, no blindness or eye complications resulted. Tuberculosis Pulmonary Tuberculosis The number of new cases notified during the year was 62. 16 Other Forms of Tuberculosis The number of new cases notified during the year was 5. Of the total notifications, 8 were received from medical practitioners; 42 from the Uxbridge Chest Clinic; 5 from General Hospitals; and 12 from St. Bernard's Hospital. Deaths from Tuberculosis Tuberculosis of the respiratory system, 8; other forms, nil. For details of new cases notified and deaths in 1955, 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 78 in 1954 to 67 in 1955. This is the lowest notification figure for many years. The last time the number of notifications was below 67 was in 1942, and this figure has been falling steadily since 1952 when the number of notifications was 123. The number of deaths from tuberculosis was 8, the corresponding number for 1954 being 13. This constitutes the lowest figure for deaths from the disease recorded in the past 25 years (see Graph B) during which Southall's population has been increasing steadily. The population was estimated at 37,560 in 1930 as compared with 53,840 in mid-1955. Of the 8 deaths, 2 had previously not been notified as cases of tuberculosis, and, therefore, were carrying the disease without it being suspected. Although these figures give grounds for some satisfaction with regard to the incidence of tuberculosis within the Borough, it is still very disturbing to find that there can be persons carrying the organism in an active state and only discovered to be doing so by post-mortem examination. These are the really dangerous members of the community, although quite innocently so, and it is, therefore, all the more important that the provision of Mass X-ray facilities should be made as widespread as possible since every single unsuspected case discovered by this method must reduce the risk to a considerable number of other members of the population. The National Association for Prevention of Tuberculosis held a Conference during the year attended by doctors, nurses and administrators from all parts of the world, and the progress of tuberculosis, the White Plague, was freely discussed, and experiences were shared on the preventive measures found to be most effective in different places. There are still parts of the world where tuberculosis is an increasingly widespread and fatal disease, and, as with diphtheria and smallpox, such success as has been obtained in the improvement of statistics in this country, must not blind field workers to the fact that vigilance is necessary all of the time. The raising of nutritional and environmental conditions has always a good effect on the lowering of the incidence of tuberculosis, but from the experiences of workers in other countries it seems that the greatest stress must be laid on the discovery of unsuspected cases by Mass X-raying of the general public, particularly the adolescent groups and factory workers, Tuberculin testing of contacts of discovered cases and the B.C.G. inoculation of susceptible persons, as infection can occur even when economic circumstances are very good and where space and other environmental amenities are fully available. 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, and of those transferred into the Borough having developed tuberculosis elsewhere, housing conditions were reasonably good in all except five instances. All of these five were living in overcrowded conditions, two of them in slum property, but during 1955 four of these families were rehoused by the Borough Council and it was anticipated that the fifth would be rehoused during 1956. Those cases ascertained in previous years to be living in statutorily overcrowded conditions and containing in the family a tuberculous patient have been rehoused, with 17 the exception of one family who have not applied for Council housing, no doubt for reasons of their own. Second cases occurred during the year in five households, four of which were not overcrowded nor slum property, the fifth, however, being in a family where the house was dilapidated and overcrowded, and this family is one of the rehoused cases. A full report on the work of the Chest Clinic was received. This report, of course, deals with an area which includes but is larger than Southall, but information obtained from it concerned the Mount Pleasant Hospital and St. Bernard's Hospital, situated in Southall. Graph B Tuberculosis (All Forms)—Notifications and Deaths from 1930 to 1955 Notifications Deaths 18 Mount Pleasant Hospital, which is for tuberculous patients only, is under the supervision of the Chest Physician, and the amount of preventive work carried out there, both in teaching the patients the rules of hygiene in preparation for their discharge into the outside world, and in the tracing and training of contacts of patients, is most valuable. Close co-operation is now maintained between the Chest Clinic and St. Bernard's Hospital, and, with the opening of the new tuberculosis ward there, and the increase of X-ray facilities, it is hoped that the risk of undiscovered cases remaining in the general wards will be eliminated. At the Chest Clinic when contacts of cases of tuberculosis are found to be susceptible to the infection they are given preventive inoculation of B.C.G. (Bacillus Calmette-Guerin). The number of Southall contacts so treated during 1955 was 86. Tuberculosis Vaccines Clinical Trial. Information has been obtained with regard to the successful outcome of this piece of research in which Southall young people took part. The report received from Dr. Pollock, of the Medical Research Council, is as follows:— During the last few years the Medical Research Council have been engaged in an extensive investigation to determine whether two tuberculosis vaccines are sufficiently valuable to be used on a mass scale in this country for the prevention of tuberculosis. 22 North London boroughs, including Southall, and also areas in the Midlands and the North of England are taking part. The vaccines used in the investigation are B.C.G. vaccine, which was introduced more than 30 years ago, and a more recent introduction, vole vaccine. Although B.C.G. vaccine has been used for many years in Scandinavian and other countries, it has been difficult to assess its value. Death rates from tuberculosis have been reduced in countries where the vaccine has been widely used, but this decline has been influenced by such things as better housing, better nutrition, and advances in the treatment of tuberculosis. Also, equally good results in the prevention of tuberculosis appear to have been achieved in some communities where the vaccine was not widely used. Thus, to assess the contribution which the vaccine would make to the prevention of tuberculosis it has been necessary to undertake a clinical trial. Between September, 1950, and December, 1952, school children in their last term at Secondary Modern schools were invited to take part in this clinical trial. Those who joined were X-rayed and skin tested, and a proportion of the selected susceptible children were given either B.C.G. vaccine or vole vaccine. Approximately 60,000 young people joined the scheme, of whom roughly 200 came from Southall. Since then it has been essential to keep in touch with the participants to determine if the vaccines were preventing the disease. This has been done by postal enquiries, home visits by Health Visitors and regular X-rays. In addition much assistance has been given by the chest clinics and hospitals in the areas concerned. The follow up has so far been very successful. Over 80% of the postal forms have been returned and more than 95% of the homes regularly visited. Approximately 75% of the young people have taken advantage of the regular X-rays. As a result of this intensive follow up, the investigation has already shown that both vaccines confer a substantial degree of protection in adolescents at least for four years after being given. It is now likely that tuberculosis vaccination will soon be offered to all young people in their final terms at school in Britain, and that tuberculosis in young people will be considerably reduced as a result. The investigation is being continued and it is hoped to find out by continuing to keep in touch with the participants how long protection from the vaccine now lasts, as well as other information which will help to prevent tuberculosis. The co-operation of all concerned has been an important feature of the investigation. It is hoped to continue this co-operation during the next few years. Research into Incidence of New Tuberculosis in the Adolescent. Details of this scheme were reported last year, and up to the end of December there was no new information, the next batch of young people not falling due to be X-rayed until mid 1956, by reason of the scheme of selection being altered slightly. The boys and girls are not now being X-rayed as school leavers, but twelve months after leaving school since it was 19 felt that the risk of contracting tuberculosis while at school was negligible, the bulk of the infection occurring some time after the school leavers had become established in employment. Graph B is a pictorial representation of the statistics of tuberculosis in the Borough from 1930 to 1955. Cancer It will be seen by the table of causes of death (page 44) that in 1955 109 cases (60 males and 49 females) died from cancer. See Appendix, Table VI, for an analysis of cancer deaths since 1931. 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 — Female Site Total Under 10 10-20 20-30 30-40 40-50 50-60 60-70 70-80 80 + '53 ,54 ,55 '53 '54 '55 '53 '54 '55 '53 '54 '55 '53 '54 '55 '53 '54 '55 '53 '54 '55 '53 '54 '55 '53 '54 '55 '53 ''54 '55 Breast 13 17 6 - - - - - - - - - - 2 - 1 2 2 3 5 - 3 2 3 4 3 1 2 3 - Lung 4 2 3 - - - - - - - - - - - - - - - - - - 2 1 1 - 1 1 1 - - Stomach 9 5 9 - - - - - - - - - - - - - - - - 2 1 2 — — 3 3 2 - — 4 Uterus 4 3 5 - - - - - - - - - - - - - - - 1 1 3 — — 2 1 2 — 2 — - Intestine 12 6 15 - - - - - - - - - - - - - - 3 1 - 2 3 3 5 5 - 1 3 - 4 Bladder — — 2 - — — — — — — — — — — — — — - — — — - - - - - 1 - — 1 Other 15 10 9 - - - - - - - - - - - - 3 1 - 3 - 1 4 2 4 4 4 4 1 3 - Totals 57 43 49 - - - - - - - - - - 2 1 5 3 7 9 8 7 14 8 15 17 16 10 12 6 9 These figures are inclusive of the deaths occurring at St. Bernard's Hospital, Norwood Hall and Vine Cottage These tables show that the total number of cancer deaths in 1955 had fallen slightly, the fall occurring in the number of male deaths, those of the females being slightly higher than in 1954. 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 249 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. Laboratory Work Specimens taken for bacteriological or chemical investigation, in connection particularly with infectious disease cases, are brought daily to the Manor House and transported to the Ealing Public Health Laboratory. The necessary investigations are carried out and results reported simultaneously to the Medical Officer of Health and to any doctor who has submitted a specimen from one of his patients. Details of the work carried out in 1955 are as follows:— 20 Age Groups — Male Site Total Under 10 10-20 20-30 30-40 40-50 50-60 60-70 70-80 80+ 53 54 ,55 53 '54 55 53 '54 55 '53 '54 '55 '53 '54 55 '53 54 '55 '53 '54 '55 '53 54 '55 ,53 '54 '55 '53 '54 ,55 Lung 27 20 18 - - - - - - - - - - 1 1 - I 1 9 8 4 7 4 5 7 4 5 1 2 - Stomach 6 10 14 - - - - - - - - - - - - - - 2 1 1 1 2 5 7 3 - 4 — 1 — Intestine 6 14 11 - - - - - - - - - - - - - 1 1 2 1 3 1 6 2 2 5 5 1 1 - Bladder 2 2 2 — — — — — — — — — — — — — — — I 1 — - 1 1 — — 1 1 — — Prostate 6 1 3 - - - - - - - - - - - - - - - - - - 2 — 1 1 1 I 3 — 1 Breast — 1 - — — — — — — — — — — — — — — — — — — - 1 — — — — - - - Other 16 24 12 - 1 - 1 - - - 1 - 1 - 1 1 2 2 5 9 4 4 6 3 2 5 1 2 - 1 Totals 53 72 60 - 1 1 1 - 1 - 1 - 1 1 2 4 4 6 18 20 12 16 13 19 15 18 17 8 4 2 Faeces specimens 124 Sputum specimens 6 Blood specimens 23 Urine specimens 15 Swabs (nose, throat and vaginal) 26 Disinfection In cases of infectious disease, rooms, clothing, etc., were disinfected—rooms by sealing and fumigating with a formalin preparation; clothing, bedding and other infected articles by removal for disinfection in the Council's disinfector at Havelock Road. Lists of premises, articles, etc., disinfected during the year. Rooms 15 Eiderdowns 7 Beds 12 Pillows 16 Blankets 30 Plimsolls (routine disinfection Mattresses 12 during holiday for Sheets 20 stone Road School) (pairs) 228 Books 52 Miscellaneous articles 17 Stnallpox 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. Scabies and Lice During 1955, 10 cases of infestation with scabies, one of infestation with body lice and one with head lice, were brought to the Public Health Department for cleansing. Treatment and cleansing were arranged at Hammersmith Cleansing Station by courtesy of Hammersmith Borough Council. This is a deterioration from 1954, when no cleansings were required. Table XI gives details of head inspections in schools, and here there seems a slight overall improvement. 21 WELFARE General St. John Ambulance Association 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, open every evening 7.30 p.m. to 8.30 p.m. for the issue of articles needed by the public. During the year 422 articles were lent under the scheme—a decrease of 213 on the 1954 figure. 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:— 1,079 hours of unpaid duty, including transport duties, hospital dudes by the Voluntary Aid Detachment and National Hospital Service Reserve members. 692 hours of paid First Aid duty. 7,144 hours duty in factories as Industrial First Aiders. British Red Cross Society 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. 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 20. 22 The Hard of Hearing Club. A club for the deaf and partially deaf was started during the year. There was an inaugural meeting, at which the Mayor was in the Chair, and representatives from the Middlesex and Surrey League for the Hard of Hearing described the advantages likely to accrue from the formation of a local branch. There was a very good response to this, and a club was formed which has been meeting regularly since, the number of members now being 30, and the average attendance at each meeting between 20 and 25. In addition to the social activities of this Club, practical advice is given with regard to the obtaining and the management of hearing aids. Old People The needs of 17 cases of old people living in difficult circumstances were investigated during 1955, and the action taken is recorded in the following list:— Admitted to hospital 3 Removed to hospital (under National Assistance Act powers) Removed to mental institution Admitted to old people's home 3 Died at home Remaining at home 11 (a) Home Help provided 1 (b) Home Help and District Nurse provided 1 (c) Home Help and meals provided 2 (d) Meals only provided 2 (e) District Nurse provided 1 (f) Refused all help 2 (g) Recovered and returned to work 1 (h) Awaiting admission to Home 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. These cases are not usually brought to the notice of the Public Health Department staff until someone feels they should be removed compulsorily from the circumstances in which they are living, and it is very satisfactory to be able to report that in spite of this some other solution was able to be found in each one of the cases except for the two who refused all help. These had to be kept under observation from time to time so that any change in their condition likely to cause a public health nuisance or to endanger their lives could be discovered quickly and compulsory powers used if all else failed. These cases always present great difficulty as it is important to ensure that while individuals are aware of all the facilities which are available for them there should be no interference with their liberty of action so long as they are of reasonably sound mind. Tribute must be paid to the excellent work of the Home Help Organiser and the Area Welfare Officer in helping to deal with these cases and their problems. It has been ascertained from the Area Medical Officer that 290 Southall people were given Home Help during the year and of these 215 consisted of chronic sick or aged persons, and of 852 persons who were assisted by the Home Nurses, 431 were of age 65 or over. Many voluntary associations contributed to provide Christmas parcels or special comforts for old people. Meals on Wheels Service During the year mid-day meals on three days per week were provided for all known housebound old people who wished to take advantage of the service. During the year approximately 4,900 meals were delivered. The cost of the meal is 9d. to the recipient, and for each meal Southall Borough Council makes a grant of 1/-. Arrangements were made during the year for the cooking and issuing of meals to be carried out at Beaconsfield Road School Canteen. 23 Chiropody Service for Old People This service was continued throughout 1955. Five 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 1955, and was operated by the various Old People's Clubs in the Borough of which there are six. Other Services A service for the provision of cheap laundry and a cheap boot and shoe service are available. National Assistance Act, 1948, Section 47 National Assistance (Amendment) Act, 1951 No case was dealt with under these powers during 1955. 24 HEALTH EDUCATION The education of the public in matters of health and hygiene seems to become a more and more important part of preventive work every year. It is difficult for the individual to avoid dangers about which he has no knowledge, and as preventive medicine is an ever changing subject, unless information on new hazards to health, and on the discoveries of the means of preventing disease, is spread to the public who need the protection, then the ideal state of perfect health in a community cannot be attained. For instance, those living in Southall in the year 1875 needed to be told constantly of the dangers of polluted drinking water and polluted food as a source of cholera infection, whereas in 1955 it is the responsibility of the Local Authority to ensure that there is a pure supply of drinking water and that food cannot be polluted with cholera germs. In 1875 it was not realised how easily self contamination or the contamination of others with the germs of food poisoning could be prevented by the lack of personal hygiene particularly in washing, and that knowledge needs to be passed on now in 1955; only individuals (by their personal cleanliness) can help protect the community from food poisoning, no Local Authority will ever be able to do this for them. Other diseases have faded away because of the spread of hygienic methods in this country, yet the same diseases may be widespread in other parts of the world. The ease of communication between the different countries of the world has one unfortunate result, in that diseases formerly confined to tropical and sub-tropical countries may be brought into Great Britain, if constant care and watchfulness, and the education in health matters of the population and also of immigrants, are not maintained. The most valuable method of health education remains, and probably will continue to remain, word of mouth information from person to person, and this goes on constantly wherever the Health Department staff may be. During the year posters were displayed on the public notice boards on subjects of health interest and leaflets issued by the Central Council of Health Education on various subjects were made available free of charge at the Council's various offices and the Libraries. Hanging cards advertising Immunisation against Diphtheria were supplied to the general practitioners for use in their waiting rooms. Talks were given to Associations on health subjects, sometimes accompanied by the use of film strips or the flannelgraph as visual aids. At the request of the North Thames Gas Board, a public meeting was arranged at which short speeches were made by the Mayor, the Chairman of the Public Health Committee, the Medical Officer of Health, and the Chief Sanitary Inspector, on Atmospheric Pollution and its dangers, and the film " Guilty Chimneys " was shown with in addition short films on other health topics. This meeting was attended by about 90 people, many of whom represented large voluntary organisations, and much interest was shown in the matters discussed. Health Forum In February, a public meeting was arranged in the form of a Health Forum, and the general public was invited to attend and submit questions on any matters of health to a panel consisting of the Director of the Central Council of Health Education, Chairman of the Uxbridge Group Hospital Management Committee, a Council member of the Public Health Committee and the Medical Officer of Health. About 70 members of the public attended, many of whom were representing local organisations and, after short speeches from the members of the panel, questions were raised and answered. The discussion was very lively. ROAD SAFETY The rising number of accidents on the roads resulting in loss of life or in some form of physical disability whether greater or smaller becomes an increasing matter of concern all over the country, particularly as so many of the victims are children or young people. In Southall there were 7 deaths from road accidents, none of these were children, but in addition there were 356 persons injured in road accidents, 55 of whom were children. The classification of the casualties is as follows:— 25 Persons Killed Type of Road User Cause of Accident Age Sex Pedal cyclist Cyclist travelling west knocked down and run over by trolley bus also travelling west 25 M Pedestrian Private motor car knocked down two pedestrians crossing the road 21 M Motor cyclist Motor cycle and light goods vehicle collided head-on 18 M Pedal cyclist Cyclist going west collided with private motor car going south towards Norwood Road 73 M Private motor car driver Private motor car collided with rear of trolley bus 45 M Pedal cyclist Cyclist collided with private motor car going in same direction 65 M Motor scooter rider Motor scooter and sidecar going south collided with lorry going north 47 M Persons Injured Adult School Age Under 5 Serious Slight Serious Slight Serious Slight Pedestrians 15 Total 52 37 6 Total 23 17 2 Total 8 6 Pedal cyclists 9 Total 89 80 4 Total 18 14 Total 1 1 Private motor car passengers 3 Total 24 21 Total 3 3 Total - Passengers in other vehicles 4 Total 27 23 Total 1 1 1 Total 1 - Motor cyclists 14 Total 63 49 Private motor car drivers 2 Total 21 19 Drivers of other vehicles 5 Total 25 20 Adult Total 301 — Children Total 55 Age Nature of Injury Cause of Injury Known to have Died 74 yrs. Fractured neck of right femur Fall—slipper caught in carpet — 87 „ Fractured right femur Fell few yards from home — 78 „ Head injuries—fractured femur Fall — 2 „ Burn on right arm Reached out for meat tin when father took it out of oven — 13 „ Burns to left index, middle and ring fingers Hot steam — 8 „ Burn to left ankle Hot gravy from plate — 2J „ Burn to left cheek Moderately hot poker — 27 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 chemical 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 7,661. The number of inspections to ascertain defects or nuisances showed an overall increase over the previous year. Table XII gives an analysis of the number and nature of such inspections. School Sanitation Twenty-four 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. There is a progressive and constant improvement in the sanitary conditions of schools, and these inspections have now taken on the nature of routine work dealing with individual defects as and when they occur. Information was received from the Divisional Education Officer that no major works on school sanitation were undertaken during 1955. Eradication of Bed Bugs Statistics for the year:— (a) Number of Council houses (1) found to be infested 6 (2) disinfested during the year 6 (b) Number of other houses Tota 15 (1) found to be infested 9 (2) disinfested during the year 9 Canal Boats Four boats were inspected in transit on the canal. 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. No bodies were deposited in the mortuary during the year. 181 bodies were deposited in the mortuary at Acton for post-mortem purposes and coroner's inquest if necessary. Factories Act, 1937 The following tables give details of the work done in connection with the factories and outworkers in the Borough:— 28 Inspections Factory Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted Non-Mechanical 16 5 - - Mechanical 161 106 - — Totals 177 111 — — 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 — 1 — — — (b) Unsuitable or defective 7 11 — — — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to outwork) — — — — — Totals 7 12 — — — Outworkers Nature of Work Section 110 Section 111 No. of outworkers in August List required by Section 110 (I)(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 19 - - — — — Artificial Flowers 2 — — — — — Stuffed Toys 4 — — — — — Totals 25 — — — — — 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. 29 Petroleum and Carbide During the year licences were in force in respect of 61 installations for petroleum, and 2 for carbide of calcium. In January, a tank formerly containing petrol that had been disused for 27 years blew up while steel cutters were being worked in the proximity of the tank. There were no casualties. In July, a spillage of approximately 200 gallons occurred at another depot which immobilised transport work at the site. The tank was taken out but residual vapour interfered with normal routine for some months afterwards. 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. 30 HOUSING This problem appears to be less acute, because of acceleration of Council house-building, provision of New Town housing, and movement of population. Work under the Housing Repairs and Rents Act, 1954, in Southall has been up to the end of 1955 in respect of individual demolitions and closures only. In the course of the year, of 8 families living in houses represented in 1951 for demolition, 5 were rehoused. In 1955, 33 houses were represented for demolition and 4 for closure. In respect of one of these houses, a County Court appeal decided the acceptance of an undertaking to render the house fit. Thirty applications for Certificates of Disrepair were received and 30 granted, and, of those, 5 revocations were later granted. Middlesex County Council Act, 1944—Section 345 There are two sites in the Borough on which caravans are used as living accommodation. The first, on the junction of Regina Road and Pluckington Place, has been established for many years as the winter quarters of a member of the Showmen's Guild. On the second, in the south-westerly corner of the Borough, at the junction of the two branches of the Grand Union Canal, are two caravans occupied, with the approval of the Local and County Authorities, for a limited period of five years from 1954. 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. New Housing Built by Southall Borough Council During the Year 1955 Since the end of the War (including 1955) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Dwellings — — 35 — Houses 206 74 307 136 Flats 45 54 255 102 Prefabricated Houses 299 Built by Private Enterprise During the Year 1955 Since the end of the War (including 1955) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Bungalows - — 14 — Houses — — 216 — Flats — — 48 — Prefabricated Houses - - - - 31 HYGIENE OF FOOD Food Poisoning The total number of persons notified as cases of food poisoning by general practitioners was 19 in 1955. This was less than one-half of the number occurring in 1954, an unexpected figure as the summer, being a very hot and dry one, might have been expected to produce favourable conditions for the breeding of food poisoning bacteria. The results of bacteriological investigations of the notified cases were that only six were confirmed and the organism found in each case was salmonella typhi murium. Personal Hygiene The free washing facilities in the public conveniences, which were brought into operation in September, 1950, continued to be available throughout 1955. During that period, 4,600 paper towels were issued free, and also 3,730 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 20 for the sale of Pasteurised Milk 24 for the sale of Sterilised Milk 22 Supplementary Licences 20 Total 86 Food Sampling The bacteriological analyses of 209 food samples taken during the year were carried out by the Public Health Laboratory Service. One hundred and twenty-two of these specimens were ice-cream samples, covering 10 makes of ice-cream, and following bacteriological analyses the ice-creams were graded as follows:— Satisfactory 92 Doubtful 19 Unsatisfactory 11 32 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, various 191 25 Butter 9 - Cakes 9 - Cake Mixture 1 - Chocolate Drink 1 - Cooked Meats 2 - Cream 3 - Curry Powder 1 - Drugs 7 - Fish 5 - Fruit Squash 1 - Ice Cream 1 - Liver 11 - Margarine 1 - Marmalade 1 - Marzipan 1 - Meat 1 - Meat Pie 1 - Minced Meat 6 - Non-brewed Condiment 1 - Orange Drink 1 1 Peas 1 — Rum Flavouring 1 - Sausages 9 3 Sweets 1 - Table Creams I - Tea 1 - Vinegar 10 2 Victoria Plums 4 - Wines and Spirits 3 - Totals 286 3i Milk. Twenty-three of these samples were of new milk slightly deficient in fat. Seven farmers were involved, and in 4 cases associated samples were found to be genuine and therefore no action was taken. In the other 3 cases, the deficiencies appeared to be from natural causes and an informative letter was sent to the farmer in each case. The remaining 2 samples were of hot milk procured from a cafe in the Borough and which contained added water. The proprietor was prosecuted and fined £1, and ordered to pay £1 is. od. costs. Orange Drink. This sample, taken from a large firm of retail grocers, was found to contain mould. An official caution was issued. Vinegar. Two samples, procured from one vendor, were deficient in acetic acid. An official caution was given. Sausages. Three samples of sausages, from different retailers, contained undeclared preservative. In 2 cases, when a follow-up sample was procured, the presence of preservative was disclosed. In the third case, an official caution was issued. Merchandise Marks Acts, 1887-1926. 245 inspections of shops were undertaken to ensure that the Marking Order relating to certain imported foodstuffs made under the 33 Merchandise Marks Act, 1926, were complied with. 1,352 separate displays of meat, apples, tomatoes, poultry, dried fruit, and butter were examined. Verbal cautions were given in respect of minor infringements not being found so serious as to warrant more stringent action. In one case, proceedings were taken against a greengrocer for displaying Dutch tomatoes marked " English," a mixture of Dutch and English tomatoes similarly marked, and Dutch tomatoes not marked with the indication of origin. He was fined £3 and ordered to pay £3 3s. od. costs. Defence (Sale of Food) Regulations, 1943. One greengrocer had a display of Australian Packham Pears falsely described as " Selected Williams." Proceedings were authorised and a fine of £1 was imposed. No costs were awarded. The Labelling of Food Order, 1953. This Order requires 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 16 premises, 54 articles of pre-packed food were examined. No proceedings were taken but in respect of infringements found, see paragraph " False or Misleading Descriptions " below. False or Misleading Descriptions. In addition to the foregoing activities which arise specifically from inspections in this area, a considerable amount of work has been done, for the benefit of all districts of Middlesex equally, in scrutinising advertisements and the labels of pre-packed foods and correcting false or misleading descriptions or errors in statement of composition found therein. Corrective action during the year in question includes biscuits, confectionery, spirits, sausages in brine, cereals, fruit squashes, margarine, ginger wine, imitation cream, liver puree, iced lollies, cheese spreads, tinned fruit and vegetables. Special Designated Milk. During the year, two licences were issued by Middlesex County Council in respect of the use of the special designation " pasteurised " for milk processed within the Borough of Southall. Each premise was inspected regularly and compliance with the requirements of the Act or Regulations was maintained in each case. 102 samples were taken, all of which were correct. Safe Milk. In addition to the foregoing, 17 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 There is a slaughterhouse at St. Bernard's Hospital, formerly under the control of London County Council. With rare exceptions, only pigs are slaughtered to meet the needs of the institution. During 1955, only 17 lbs. of meat were surrendered as being affected by diseases other than tuberculosis or cysticerci. There is no registered slaughterhouse or public abbattoir in the district. Markets There is a livestock market held once weekly (Wednesday). In April, 1955, a general market (Saturday) was commenced. This comprises a mobile canteen, two mobile butchers, three stalls of packaged foodstuffs, four greengrocery stalls, one stall for the sale of sweets and other stalls of general merchandise. The private management of the market provided a newly constructed building containing male and female water closets, wash basins with hot water. Further plans were pending for the proper paving and drainage of the market area. In 1955, a new steel structure covered a good section of the market. Inspections are made morning and afternoon each Saturday, and it was necessary on only one occasion to accept surrender for foodstuff; the stall was discontinued. Food Premises—Inspection Food premises, including the large food factories where meat and other foods are prepared for sale, are regularly inspected and the figures of food surrendered are in the appended table. 34 The number of food premises in the Borough by type of business is shown as follows:- Shops 335 Catering Establishments 122 Factories 21 Premises required to be registered are as follows:— Food and Drugs Act, 1938, Section 14 Fish Curing 8 Manufacture of Sausages or Preserved Food 52 Manufacture of Ice-Cream 5 Sale only of Ice-Cream 120 Manufacture and Sale of Iced-Lollies 3 Middlesex County Council Act, 1950, Section 11 Premises of Street Traders 27 Milk and Dairies Regulations, 1949 Dealer/Processors 2 The number of inspections of registered food premises during the year was 296. 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 93 ,064¾ — — — — 93,064¾ 68,323¾ — 24,741 Raw 16,630 11,577 1,905 350 9,322 5,053 3,718 — 1,335 Totals 109,694¾ 11,577 1,905 350 9,322 98,117¾ 72,041¾ — 26,076 Unsound Food The following table shows items of unsound food which were investigated during the year. Vendor (and Source) Subject of Enquiry Action Local Dairy Sediment in opened bottle of milk No action following report of Analyst Not known Grub in can of Italian tomatoes Importers notified Local Shop Alleged illness from cream and jam cake Not confirmed on investigation Local Shop (made outside Southall) Glass in banbury cake Court proceedings. Fined 10 guineas with 3 guineas costs Local Shop (made outside Southall) Insect eggs in wrapped biscuits Warning letter Local Shop and Bakery Horsehair on outside of Hovis loaf Warning letter Local Shop and Bakery Match in bun Warning letter Local Shop and Bakery Mice excreta in sliced loaf Warning letter Local Dairy (bottled outside Southall) Glass splinters in bottle of milk Warning letter Delivered in Southall (baked outside Southall) Mould in sliced, wrapped loaf Warning letter Local Shop (bottled outside Southall) Glass splinters in bottle mineral water Warning letter Local Shop (made outside Southall) Chewing gum found in sausage after cooking Warning letter Local Shop (made outside Southall) Unsound steak and kidney pie Warning letter Local Shop (made outside Southall) Metal in sausage Warning letter Local Shop (made outside Southall) Piece of wire in brown loaf Warning letter Delivered in Southall (bottled outside Borough) Unsound orange juice Referred to Middlesex County Council as Food and Drugs Authority and appropriate Local Authority Local Shop (packed outside Southall) Insect and grub in carton of glace cherries Warning letter Delivered in Southall (baked outside Borough) Beetle in white loaf Warning letter Baked in Southall Glass in brown bread Warning letter 36 ATMOSPHERIC POLLUTION Measurement of the pollution of the atmosphere continued to be carried out regularly month by month at separate stations set up on five 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, on the Railway-side allotments and at Dormers Wells Primary School, deposit gauges for measuring the quantity of grit and dust dropping from the atmosphere. The results obtained from these gauges are tabulated on page oo, and where on these tables " NR " is marked, this means that due to some technical difficulty at the Laboratory, an estimation could not be carried out. The figures for atmospheric pollution are not good for the year 1955. At each of the sites, the average for the whole year is worse than in the previous year, and at the times of low pollution in mid-summer, the lowest level reached was still considerably higher than in 1954. The new gauges situated on the Railway allotments and at the Dormers Wells Primary School demonstrated clearly that there is heavy pollution from the Railway sidings, the average for the year being over 50% higher at the railway site than at Dormers Wells School. The worst month of the year as recorded for deposits of smoke and grit was May, when very heavy figures were obtained at all three deposit gauge sites, the worst individual figure, for the year, however, being obtained not from the railway sidings, but from the Hortus Cemetery gauge in June. Comparison 6 years' averages at Hortus Cemetery. Total solids Deposited:— 1950 1951 1952 13.50 12.95 11.93 1953 1954 1955 10.67 14.30 16.94 37 Atmospheric Pollution Estimation Month of Year Sulphur Trioxid.Lead Peroxide Method Milligrams per day per 100 square cms DEPOSIT GAUGES Annual Rainfall Tons per Square Mile per Month Soluble Insoluble Total Jubilee Gardens Recreation Ground Hortus Cemetery New Primary School Railway Allotments Hortus Cemetery New Primary School Railway Allotments Hortus Cemetery New Primary School Railway Allotments Hortus Cemetery New Primary School Railway Allotments 1955 1954 1955 1954 1955 1954 1955 1954 1955 1954 1955 1954 1955 1954 1955 1954 1955 1954 1955 1954 1955 1954 1955 1954 1955 1954 1955 1954 January 1.86 1.68 3.31 2.65 39 22 29 43 4.79 3.71 6.11 7.24 7.43 4.70 4.82 13.02 12.22 8.41 10.93 20.26 February 1.67 1 64 2.97 2.15 24 49 17 22 4.32 12.29 2.9 4.40 5.87 12.71 3.03 9.60 10.19 25.0 5.93 14.0 March 1.5 1.44 2.8 2.16 19 53 22 7.14 7.59 5.18 6.57 12.43 14.16 17.61 April 0.7 098 1.2 1.22 10 7 7 11 2.81 1.37 3.76 5.14 1023 1.5 5.37 11.62 13.04 2.87 9.13 16.76 May o.6 0.69 1.1 1.10 88 52 81 95 19.3 16.65 15.2 12.1 8.8 12.13 6.o 10.1 28.1 28.78 21.1 22.2 June 0.5 0.41 1.3 0.60 44 96 41 46 10.95 10.76 5.8 6.64 1862 11.29 3.1 14.49 29.57 22.05 9.1 21.13 July o.35 0.41 0.9 0.46 56 4.47 4.43 August 0.4 0.31 1.0 0.53 15 85 7 19 7.4 8.16 3.2 3.5 11.1 5.37 6.2 13.6 18.5 1383 9.4 17.1 September 0.35 0.54 0.7 0.46 42 59 18 45 6.7 7.23 6.7 6.7 8.7 6.25 4.5 10.6 15.4 1348 11.2 17.3 October 1.1 0.94 1.7 0.73 89 61 80 87 4.5 6.78 7.8 8.0 4.4 3.07 3.4 10.7 8.9 11.2 18.7 November 1.3 1.35 2.5 1 .65 34 84 31 83 33 85 5.1 9.58 7.2 9.27 7.0 9.11 8.5 4.71 4.0 5.02 11.1 17.28 13.6 1429 11.2 1429 18.1 26.39 December 1.6 1.59 2.1 1.71 49 41 41 36 45 36 11.27 6.65 7.44 7.57 9.25 7.44 8. 64 3.33 4.37 3.41 9.68 9.40 19.91 998 11.81 10.98 18.92 16.84 Average for Year 0.99 1.0 1.8 1.29 41 55 37 59 42 60 7.66 7.96 6.61 8.42 6.83 8.27 9.23 6.34 4.5 4.21 11.54 13.34 16.94 14.3 11.11 12.63 18.37 25.61 Graph C Atmospheric Pollution by Sulphur Oxides (Lead Peroxide Method) Lead Peroxide Gauge at Jubilee Gardens [Atmospheric Sulphur Dioxide S03(Mgs/Day/100 Cms2)] Lead Peroxide Gauge at Recreation Ground [Atmospheric Sulphur Dioxide SO3(Mgs/Day/100 Cms2)] 39 Graph D Atmospheric Pollution by Sulphur Oxides determined by the Lead Peroxide Method Comparison with other Districts These figures are printed with the permission of the Authorities concerned Godalming Southall (average of 2 observation points) Sheffield (average of 23 observation points) Westminster (average of 9 observation points) 40 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. In addition to routine observation of factory 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. Number of sites of observation 5 (3 deposit gauges and 2 lead peroxide gauges) Number of complaints of nuisance from smoke, 13 complaints re 12 premises smell or grit and number of premises concerned Number of places kept under observation 13 Number of half-hour observations made 70 Number of times black smoke was detected 12 Total time of black smoke emissions 72½ minutes Number of times moderate smoke observed 48 Total time of moderate smoke emissions 425 minutes 41 MISCELLANEOUS Noise Nuisance Seven complaints were received of noise from factories. These were confirmed and abated after informal action. Rodent Control The following table gives details of work carried out in accordance with the policy of the Council, as outlined in previous reports. Reports Confirmed 202 Non-Confirmed. 189 Business and Industrial 33 Domestic 358 Rats 106 Mice 96 Total number of visits in 1955, 1352. Sewers 1st Treatment 2nd Treatment Total number of manholes baited 35 70 Number of poison takes 14 32 Pet Animals Act, 1951 Ten 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. Administration of the Shops Acts With a diminution of staff, it was found necessary to group shops in an order of priority for attention. The inspections, therefore, represent direct work rather than routine inspections and it is gratifying to record that improvements were secured in all instances. River Pollution Reports of samples taken from the River Brent at the three points of junction with the Grand Union Canal within the Borough are received from the Middlesex County Council from time to time. Pollution from fermentable waste discharged from the premises of one of the national undertakings was checked during the year and abatement measures put in hand. 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 4 Massage, Chiropody and Electrical Treatment 6 Medical Examination of Borough Council Employees During 1955, a total of 79 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. A survey of sickness absence amongst Borough Council staff during the year showed that of 147 members of the indoor establishment, 52 had some sick leave during the year, the total number of days of sickness being 922. Of the outside staff totalling 252, the number of persons requiring sick leave was 198, and the total number of days of sick leave 5,047. It is interesting to note that the proportion of sickness reckoned in days of absence per employee in the case of the outside workers is roughly three times higher than that in the internal staff and the reason for this must be sought. 42 APPENDICES EXTRACTS FROM VITAL STATISTICS Table I. Comparative Figures for Total Male Female 1954 Live Births—Legitimate 677 357 320 678 Illegitimate 21 9 12 23 Stillbirths—Legitimate 10 5 5 10 Illegitimate 2 2 — — Deaths 642 313 329 662 Birth rate (live and stillbirths) per 1,000 of the estimated population 13.19 13.06 Stillbirth rate per 1,000 total (live and still) births 16.90 14.06 Crude death rate per 1,000 of the civilian population 11.92 12.16 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 - 1.41 Death rate of infants under 1 year of age:— All infants per 1,000 live births 17.19 18.54 Legitimate infants per 1,000 legitimate live births 17.19 17.70 Illegitimate infants per 1,000 illegitimate live births — 43.48 Deaths from cancer (all ages) 109 115 Deaths from measles (all ages) — — Deaths from whooping cough (all ages) — — Deaths from diarrhoea, etc. (under 2 years of age) — — 43 Causes of" Death, 1955 Table II Male Female Total 1955 Total 1954 1. Tuberculosis, respiratory 6 2 8 12 2. Tuberculosis, other — — — 1 3. Syphilitic disease 1 — 1 1 4. Diphtheria — — — — 5. Whooping cough — — — — 6. Meningococcal infections — — — — 7. Acute poliomyelitis 1 1 2 1 8. Measles — — — — 9. Other infective and parasitic diseases — — — 5 10/15. Cancer (all forms) 60 49 109 "5 16. Diabetes — 1 1 2 17. Vascular lesions of nervous system 35 42 77 84 18. Coronary disease, angina 56 30 86 86 19/20. Heart disease 41 84 125 131 21. Other circulatory disease 16 26 42 50 22. Influenza — 2 2 1 23. Pneumonia 18 38 56 43 24. Bronchitis 26 15 41 36 25. Other diseases of respiratory system 5 — 5 5 26. Ulcer of stomach and duodenum 9 3 12 7 27. Gastritis, enteritis and diarrhoea 1 - 1 2 28. Nephritis and nephrosis 4 1 5 4 29. Hyperplasia of prostate 4 — 4 3 30. Pregnancy, childbirth, abortion — — — 1 31. Congenital malformations, birth injuries, etc. 2 3 5 4 32. Other defined and ill-defined diseases 17 23 40 49 33. Motor vehicle accidents 4 - 4 - 34. All other accidents 4 6 10 13 35. Suicide 3 3 6 6 36. Homicide and operations of war - — — — Total Deaths 313 329 642 662 Deaths in Wards Table III Ward Male Female Total Waxlow Manor 25 26 51 Northcote 31 28 59 Hambrough 51 32 83 Dormers Wells 116 145 261 Glebe 46 45 91 Norwood Green 44 53 97 Total 313 329 642 44 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 Atelectesis 1 - - - 1 - - - - 1 Bronchitis, pneumonia, etc. - - - - - - - - 1 1 Birth Injury 1 - - - 1 - - - - 1 Cerebrospinal infections — — — — — 1 1 — — 2 Congenital malformations and congenital heart disease - - - 1 - - - - - 1 Otitis media - - - - - - - 1 - 1 Prematurity 4 - - - 4 1 — — - 5 Total 6 - - 1 7 2 1 1 1 12 Live Births. Legitimate 677 Infant Deaths. Legitimate 12 Illegitimate 21 Illegitimate — 45 Table VI Deaths from Cancer Year Male Female Total Estimated Population Rate per 1,000 population 1931 20 28 48 39,280 1.22 1932 22 23 45 41,530 1.08 1933 23 28 51 44,780 1.13 1934 22 27 49 46,693 1.04 1935 30 27 57 48,270 1.18 1936 22 30 52 49,550 1.05 1937 42 28 70 51,560 1.35 1938 27 30 57 52,400 0.51 1939 33 41 74 52,430 1.41 1940 28 36 64 51,670 1.23 1941 34 37 71 50,280 1.41 1942 34 38 72 50,350 1.43 1943 51 46 97 49,730 1.95 1944 37 32 69 48,970 1.41 1945 39 44 83 49,880 1.88 1946 40 54 94 54,440 1.64 1947 45 32 77 56,240 1.36 1948 48 36 84 56,130 1.49 1949 46 54 100 56,350 1.77 1950 52 38 90 56,310 1.60 1951 48 46 94 55,620 1.69 1952 46 49 95 55,430 2.01 1952.1 including long stay hospital deaths 54 57 111 1953 63 57 120 54,910 2.19 1954 72 43 115 54,440 2.11 1955 60 49 109 53,840 2.02 Table VII Notifiable Diseases during the Year 1955 (other than Tuberculosis) Diseases Ages Total cases notified Deaths Under 1 year 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 65 65 and over Dysentery - - - - - 1 1 - 4 6 3 2 17* - Encephalitis - - - - - 1 - - - - - - - - Erysipelas - - - - - - — - - 2 3 - 5 - Food Poisoning - 1 - 2 - 3 2 2 1 5 - 1 19† - Malaria — — - - - - - 1 - - - - - - Measles 27 105 143 145 206 680 8 11 2 1 1 - 1,329 - Meningococcal Infection 1 1 - - - 1 - - - - - - 3 - Ophthalmia Neonatorum 1 — — — — - - - — - - - - - Pneumonia 3 4 1 3 2 20 7 14 15 15 33 28 145 2 Poliomyelitis: Paralytic 1 - 1 1 - 1 2 2 - 1 - - 9 - Non.Paralytic - 1 1 1 2 7 — 4 2 1 -_ - 19 - Puerperal Pyrexia - - - - - - - 1 1 1 - - 3 + - Scarlet Fever - - 2 4 6 26 2 - - - - - 40 - Whooping Cough 9 13 14 10 18 40 2 1 - 1 1 - 109 - Total 42 125 162 166 234 780 24 36 27 33 41 31 1,701 4 8 notified as bacillary dysentery from St. Bernard's 16 confirmed Salmonella typhi murium by Hospital. bacteriological examination. 2 notified as Sonne dysentery from University College ‡1 case diagnosed as streptococcal ton. Hospital. sillitis. Paralytic Poliomyelitis Non.Paralytic Poliomyelitis 5 confirmed cases—2 died. 12 cases confirmed including 1 clinically. 3 non.paralytic cases confirmed paralytic. 1 case notified as paralytic confirmed non.paralytic. 46 Table VIII Diseases Total Waxlow Manor Northcote Hambrough Dormers Wells Glebe Norwood Green Total Deaths Dysentery †l7 5 — — 9 1 2 — Encephalitis 1 - — - 1 — - - Erysipelas 5 1 1 1 2 - - - Food Poisoning *19 2 - 2 10 3 2 - Malaria 1 — — — - 1 - - Measles 1,329 203 220 183 215 285 223 - Meningococcal Infection 3 1 — - 1 1 - - OphthalmiaNeomatorum 1 - — 1 - - - - Pneumonia 145 7 10 14 36 43 35 2 Poliomyelitis: Paralytic 9 3 - 1 1 3 1 2 Non-Paralytic 19 5 1 3 8 1 1 - Puerperal Pyrexia 13 1 1 1 — - - - Scarlet Fever 40 13 10 5 3 3 6 - Tuberculosis 67 8 7 10 21 10 11 8 Whooping Cough 109 14 11 12 18 35 19 - Total 1,768 263 261 233 325 386 300 12 The number of cases of infectious diseases (including Tuberculosis) notified during the year, according to the locality, are shown below:— †8 notified as bacillary dysentery from St. Bernard's Hospital. 2 notified as Sonne dysentery from University College Hospital. *6 confirmed Salmonella typhi murium by bacteriological examination. ‡1 case diagnosed as streptococcal tonsillitis. 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 - - - - - - - - 1-5 - - - - - - - - 5-10 — 1 1 - - — - - 10-15 - - - - - - - - 15-25 7 5 - - - - - - 25-35 10 4 3 - — - - - 35-45 6 3 - 1 - - — - 45-65 16 7 - - 3 1 - - 65+ 2 1 — — 3 1 — — Total 41 21 4 1 6 2 - - 47 Table X The occupations of the new cases are as follows:— Occupation Pulmonary Non-Pulmonary Male Female Male Female Aircraft Fitter 1 - - - Bricklayer 1 - - - Carbon Factory Worker 1 - - - Carpenter 1 - - - Cutter Grinder 1 — - - Dental Attendant - 1 - - Draughtsman 1 - - - Dressmaker - 1 - - Electrical Engineer - - 1 - Engineer 3 - - - Factory Inspector i - - - Factory Worker 1 1 - - Fitter 1 - - - Foreman 1 - - - Gate Keeper 1 - - - Housewife - 13 - 1 Labourer 3 ... 1 - Lorry Driver 1 - - - Machine Minder - 1 - - Mental Patient 10 i - - Plumber 1 - - - Printing Operator 1 - - - Receptionist - 1 - - Retired 1 — — — Scholar - 1 1 - Sheet Metal Worker - - 1 - Toolgrinder 1 - - - Tractor Driver 1 - - - Unknown 8 1 - - Total 41 21 4 1 48 Table XI Examinations for Verminous Conditions and Children Found to be Verminous Attending Maintained Schools in Southall during 1954 and 1955 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 1954 1955 1954 1955 1954 1955 1954 1955 1954 1955 Beaconsfield Road, J.M. 1,241 1,166 - 2 - 2 - 2 - - Beaconsfield Road, I. 805 650 - - - - - - - - Clifton Road, J.M. 919 910 6 3 5 2 4 1 3 - Clifton Road, I 829 562 2 1 2 1 2 1 - — Dormers Wells, J.M. 418 770 - 1 - 1 - - - - Dormers Wells, I. 630 772 - - - - - - - - Dormers Wells, S.B. 1,005 1,486 1 - 1 - 1 - - - Dormers Wells, S.G. 1,548 1,696 4 7 3 5 2 3 1 1 Featherstone Road, J.M. 960 888 10 5 9 4 7 3 1 2 Featherstone Road, I. 1,223 590 14 6 12 5 10 3 5 1 George Tomlinson, J. M. & I. 724 1,015 1 3 1 1 1 - - - Featherstone Road, S.B. 974 1,091 1 - 1 - 1 - - - Lady Margaret, J.M. 1,648 1,624 - - - - - - - - Lady Margaret, I. 1,002 989 - 1 - 1 - 1 - 1 North Road, J.M. 1,150 1,066 1 3 1 2 1 1 - — North Road, I 525 540 2 1 2 2 1 1 - — St. Anselm's R.C. 1,456 1,378 4 2 4 2 2 2 1 1 Talbot Road, Mixed 536 - 6 - 6 - 6 — 3 - Talbot Road, Specials 3 385 3 5 2 4 - 4 - 1 Tudor Road, J.B. 740 698 - - - - - - - — Tudor Road, J.G. 707 648 6 1 2 1 2 - 2 - Tudor Road, I. 883 819 - 1 - 1 - - - - Western Road, J.M. & I. 1,033 1,012 3 3 3 3 3 1 - - Western Road, S.G. 1,276 914 14 6 14 6 13 4 8 2 Routine Medical Inspections 2 1 2 1 2 1 1 - - - Total 22,237 21,670 80 52 70 44 57 27 24 9 49 Table XII Sanitary Inspections—Classification of Visits Houses Public Health Act, 1936 3,809 Houses, Housing Act, 1936-1954 467 Overcrowding 492 Disinfestation 158 Pet Animals Act, 1951 9 Vans, Sheds 26 Shops Act, 1950 177 Food Shops 347 Fried Fish 19 Cafes, etc 107 Factories (Mechanical) 106 Factories (Non-Mechanical) 5 Outworkers 16 Food Factories 163 Smoke 101 Offensive Trades - Bakehouses 13 Dairies 10 Water Sampling 43 Ice-Cream Sampling 104 Other Foods Sampling 56 Schools 24 Stables 3 Offensive Accumulations 109 Hairdressers 1 Petrol 238 Canal Boats 4 Slaughterhouses 49 Rats and Mice 621 Infectious Diseases 249 Atmospheric Pollution 135 7,661 Table XIII HOUSING—GENERAL Statistics Housing Act., 1936—Overcrowding:— (a) (1) Number of dwellings overcrowded at the end of the year 83 (2) Number of families dwelling therein 106 (3) Number of persons dwelling therein 419 (b) Number of new cases of overcrowding reported during the year 60 (c) (1) Number of cases of overcrowding relieved during the year 105 (2) Number of persons concerned in such cases 493 (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 — 50