SOUT 24 BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1956 MARGARET A. GLASS, Medical Officer of Health BOROUGH OF SOUTHALL OF THE Medical Officer of Health for the Year 1956 MARGARET A. GLASS, Medical Officer of Health ANNUAL REPORT INDEX page Ambulance Service 47 Antitoxin 20 Area of Borough 7 Atmospheric Pollution 4, 38-43. 55 B.C.G. Vaccination 17 Bed Bugs 28 Births and birth rate 3, 4, 10, 48, 50 Blind and partially sighted 22, 23 British Red Cross Service 21 Bulletin of infectious disease 12 Canal boats 28, 55 Cancer 4, 9, 18, 19, 48, 49, 51 Caravans 31 Carbide 30 Care and after care 47 Catering establishments 36, 55 Cattle market 35 Causes of death 4 Celluloid and Cinematograph Film Act 30 Certificates of Disrepair and Revocation 31 Chest Clinic 16, 17, 18, 46 Children's welfare 47 Chiropody 24, 44 Chlorination 7 Clean Air Act 4 Clinics 13,46,47 Club for Disabled Persons 21 Community Centre 21 Deafness 21,22 Deaths and death rates 3, 4, 9, 12, 15, 16, 26, 27, 48-52 Deaths in wards 49 Demolition 31 Diabetic Club 22 Diphtheria 4, 9, 12, 14, 49 Disinfection 20 Dysentery 4, 12, 13, 14, 51, 52 Education—Health 26 Employees' medical examinations 44 Factories Act, 1937 28, 29, 55 Film Strip Projector 26 Food & Drugs Act 4, 33, 35) 36 Food handlers' hygiene 33 Food hygiene 33-37 Food inspection 36 Food poisoning 4,33,51,52 Food sampling 33, 34, 35, 55 Food shops 36, 55 Free washing facilities 33 Graphs 10, II, 16, 17, 40-42 Handicapped persons 23 Hard of Hearing Club 21, 22 Health education 26 Health visitors 19,46 page Heart disease 4, 9, 49 Holiday rest homes 47 Holidays for old people 22, 24 Home accidents 27 Home Advice Group 22 Home helps 23,24,47 Home nursing 21,24,46 Hospital services 46 Houses let in lodgings 31 Houses—number inhabited 7 Housing 15,16,31,32,55 Housing Repairs and Rents Act 31 Hygiene of food 33-37 Hygiene—personal 33 Ice-cream sampling 33, 34, 55 Immunisation 4, 14, 15, 26, 47 Infant mortality 4,10,11, 48, 50 Infectious diseases, prevalence and control of 4, 12-20,55 Influenza 4,13,49 Inspection and supervision of food 33-37 Inspection of sanitary accommodation in factories 28,29 Laboratory facilities and work 19 Markets 35 Mass X-Ray 4, 15, 17, 18, 26 Massage, establishments for 44 Maternal morbidity 11 Maternal mortality 11, 48, 49 Maternity and Child Welfare 46,47 Meals on Wheels 23, 24 Measles 9,12,48,49,51,52 Meat and other foods 35 Medical examinations 44 Mental health 47 Middlesex County Council Services 22, 23, 24, 34, 35. 46, 47 Midwifery service 46 Milk licences 33 Miscellaneous 44_45 Mortuary 28 National Assistance Act, S. 47 25 Noise nuisance 44 Notifiable diseases 12-20, 51, 52 Nursing equipment 21,46 Old People's Welfare 5, 22, 23, 24, 25 Ophthalmia neonatorum 15, 51. 52 Outworkers 29,55 Overcrowding 4,31,55 page Paddling Pool 8 Parks and open spaces 7 Personal hygiene 33 Pet Animals Act 44, 55 Petroleum Acts 30, 55 Physical features of the district 7, 8 Poliomyelitis 4, 9, 12, 13, 49, 51, 52 Population 3,7, 51 Premature infants 11 Public Control Department 34 Public Health Committee 3 Public Health Inspectors 4, 5, 19, 28, 55 Puerperal pyrexia 11,51,52 Rag Flock and Other Materials Filling Act. 29 Rateable value 7 Rats and mice 44, 55 Rehousing 4 Respiratory diseases 9, 12, 49 River pollution 44 Road accidents 9, 26, 27, 49 St. John Ambulance Service 21 Sanitary circumstances 28, 29, 30 Sanitary inspection 28, 55 Sanitation in schools 28, 55 Scabies 20 Scarlet fever 14,51,52 School Medical Service 47 Shops Acts 44,55 Slum Clearance 4,31 Smallpox 4,14,20 Smoke pollution 38, 43, 55 Social conditions 7 Southall Association for the Occupation of the Elderly 24,25 Staff 6 Statistics — General and Vital 7,9-n Stillbirths 10,48 Street traders 36 Sulphur dioxide pollution 38, 39, 40, 42 Swimming bath 7, 8 Tuberculosis 4, 9, 15, 16, 17, 18, 26, 49, 52, 53 Vaccination 4, 13, 14, 17, 47 Vaccine lymph 20 Verminous persons 20, 54 Vital statistics 9, 10, 11 Water supply and service 28,55 Welfare — General and Old People's 5, 21-25 Whooping cough 9, 48, 49, 51. 52 2 THE COUNCIL OF THE BOROUGH OF SOUTHALL, 1956 HIS WORSHIP THE MAYOR *Alderman H. C. Douglas, J.P. Deputy Mayor: Councillor Mrs. I. Cavell, J.P. †*Dane, A. T. (Chairman) *Douglas, H. C., J.P. Aldermen: Gardner, F. E. Hopkins, W. H. †*LOWE, J. *Marks, F. J., J.P. Councillors : Barrett, J. *Barton, A. J. Cavell, Mrs. I., J.P. Cripps, C. B. Day, F. R. *Griffiths, Mrs. M. C. Haigh, J. †*Jones, Mrs. E. W. *Love, P. J. Rockhill, F. R. J. Salmon, J. *Shiel, E. J. *Shepherd, A. H. *Southey, P. G. Steele, T. J. Ward, J. H. *Williams, Mrs. V. G. I. Woodruff, J. A. T. *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 66th Annual Report on the health and circumstances of the population of the Borough of Southall. This Report was thought to be the 60th in the series, and in order to make comparisons with the first year 1896, the Annual Report for that year was consulted. It was found that in 1896 the then Medical Officer of Health was submitting his 6th Annual Report, and so this book is the 66th in sequence from the first submitted by Doctor J. D. Windle to the Southall-Norwood Urban District Council in 1891. The Urban District of Southall-Norwood has grown in these years from a very small country place with a population of 7,560 to a compact, highly industrialised community with an estimated population of 53,220. In the earliest Annual Report available, that for the year 1893, the birth rate is stated as 34 6, the death rate 115 and the infant mortality 3 rate 74 as compared with birth rate 13.57, death rate 7.25 and infant mortality rate 18.23 in 1956. 1893 was, however, an especially good year for infant mortality since the following year this figure rose again to 146. There were 18 cases of diphtheria, of whom 6 died, 6 cases of typhoid fever of whom none died, and one case of smallpox. These three diseases are no longer a problem, but the Medical Officer of Health then was concerned amongst other things about epidemic influenza, and the overcrowding of dwelling houses, two problems which still require attention to-day. In the year 1956 the health of the population continued to be good. There was a slight rise in the birth rate, a considerable fall in the infectious disease notification rate, and only two notified cases of poliomyelitis, both of whom should make a complete recovery. The crude death rate rose, but the rate, when calculated without the deaths occurring in the long-stay institutions, whose population comes from a very wide area of the Home Counties, showed the rise to be a small one. There was an increase in the number of tuberculosis notifications and a slight rise in the infant mortality rate. The principal causes of death, as in 1955, were again heart disease, diseases of the circulatory system and cancer, and this latter cause of death showed a substantial increase over the figure for the previous year. Dysentery and food poisoning were not considerable in 1956, although there was a small outbreak of dysentery in St. Bernard's Hospital. Dysentery is a disease which spreads very easily in hospitals for cases of mental illness, but by means of quick and energetic control methods undertaken by the hospital staff the outbreak was kept within quite small limits and did not spread outside the hospital. Because of the heavy incidence of poliomyelitis throughout the country during 1955, arrangements were made by Middlesex County Council to start vaccination against this disease, and the first vaccinations were carried out in June of 1956. The amount of vaccine available allowed only for a few vaccinations to be completed during the year. There was a slight fall in the figure for vaccination against smallpox, and a slight rise in the figure for immunisation against diphtheria. Two visits were paid to the Borough by the Mass X-ray Unit in 1956, one to St. Bernard's Hospital and an extended visit in the autumn to X-ray the general public. During the year a total of 14,119 persons, either living in, or working in Southall, had chest X-ray examinations carried out in these surveys, and out of all these only 14 active pulmonary tuberculosis cases were discovered, or 0 99 per 1,000 of persons X-rayed. The work on slum clearance and rehousing of families in condemned property continued and kept pace with the programme submitted to the Minister of Housing and Local Government in the previous year. Atmospheric pollution from domestic and industrial chimneys showed a considerable improvement generally over the year. The new legislation on Food and Drugs and the Clean Air Act meant that a considerable proportion of time had to be directed towards these matters in 1956. During 1956 the Sanitary Inspectors were re-designated as Public Health Inspectors, a step which was a progressive one in that it seemed to make official the fact that the Inspector is no longer concerned only with the physical aspects of sanitation, but that he is a member of the public health team working for the welfare and well-being of the public and trained and 4 interested to recognise and deal with any matter likely to affect adversely the health of individuals, groups or the community. The shortage of Public Health Inspectors continued to make allocation of work difficult, and the Council has adopted the principle of paid pupillage, one trainee inspector being at present on the establishment of the Public Health Department. The plight of old people was very much in the public mind during 1956 and there was a considerable increase in the work done in Southall to help with the problem of old people living alone or in need, and in all of these schemes the Health Department officers were able and willing to assist in many ways. I would like to acknowledge my indebtedness to the many individuals listed below who have helped with this report by supplying information, and I would like also to extend my sincere thanks to the Chief Public Health Inspector and to all members of the Departmental staff for 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, Manor House, Southall. Medical Officer of Health. Acknowledgments to:— The County Medical Officer The County Welfare Officer The County Public Control Officer The Area Medical Officer The Physician Superintendent, St. Bernard's Hospital The Medical Superintendent, Hillingdon Hospital The Medical Officer of Health of Godalming The Medical Officer of Health of Sheffield The Medical Officer of Health of Westminster Dr. J. T. Nicol Roe, Area Chest Physician Dr. T. M. Pollock, Medical Officer of the Medical Research Council Dr. G. Z. Brett, Medical Officer of Mass X-ray Unit 5A Miss B. J. Butcher, Liaison Officer of Mass X-ray Unit 5A Borough Education Officer The Officers of the Fuel Research Station The General Practitioners of Southall Mrs. E. V. Bruce, British Red Cross Society Mrs. E. Wilmot, St. John Ambulance Brigade Mr. J. F. Mashford, Superintendent, Community Centre, Southall Mr. C. P. Sharpe, Honorary Secretary, Diabetic Club Mr. G. C. Evans, Honorary Secretary, Hard of Hearing Club The Chief Officers of the Council 5 HEALTH DEPARTMENT STAFF for the year 1956 Medical Officer of Health: Margaret A. Glass, B.Sc., M.B., Ch.B. (Glasgow), D.P.H. (Cantab.). Public Health Inspection Staff: Chief Public Health Inspector: R. W. McDonald, Cert. S.I.B., Cert. M. & F. Deputy Chief Public Health Inspector: S. Sadler, Cert. S.I.B. Cert. M. & F., R.S.I. Smoke Certificate. District Public Health Inspectors: R. Stockley, Cert. S.I.B., Cert. M. & F., R.S.I. San.Sc. (Resigned 25.1.56). J. C. McManus, Cert. S.I.B., Cert. M. & F. A. V. Grantham, Cert. S.I.B. (Appointed 20.2.56). Additional Public Health Inspector: K. F. Keegan, Cert. S.I.B. (Appointed 10.9.56). Trainee Public Health 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 (Resigned 21.7.56). Miss J. Piggott (Appointed 23.7.56). 6 GENERAL STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH Area (acres) 2,607762 Population—Registrar-General's estimate (Mid 1956) 53,220 Number of inhabited houses according to Rate Book 14,891 Average number of occupants per house 3.57 Sum produced by a penny rate £3,695 Rateable Value £921,598 The Council controls the following parks and open spaces:— Brent Meadow 470 acres Cranleigh Play Park 2.00 acres Dormers Wells Housing Site 2.99 acres Dudley Road Island 0.13 acres Durdans Park 22.48 acres Football Ground, Western Road 3.51 acres Frogmore Green 0.35 acres Glade Lane 27.93 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.oo 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 280.08 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. 7 During 1956, the total number of persons using the bath was 28,652. The average number of persons attending per day (wet or fine) was 188. The maximum number at any one session was 400. As this bath is uncovered, it is only opened for swimmers during the summer months— May to September—and the attendance varies to a great extent according to weather conditions. The cold, wet summer of 1956 resulted in there being low figures for attendance at the swimming bath, the drop being from 47,616 total attendance during 1955. A paddling pool for young children is available 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. 8 VITAL STATISTICS Total deaths, 652. (Males, 324; Females, 328.) Crude Death Rate, 12.25 (including deaths in St. Bernard's Hospital, and Vine Cottage); 8.53 (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, which had been falling gradually each year since 1953, rose in 1956, the comparative figures being:— Year Death Rate 1953 1331 1954 1216 1955 11-92 1956 12-25 This rate is calculated from figures which include the deaths in the long-stay institutions such as St. Bernard's Hospital and Vine Cottage, and since the proportion of former residents of Southall occupying beds in these institutions is comparatively small, particularly as St. Bernard's Hospital has a catchment area extending beyond Middlesex into neighbouring counties, the death rate calculated from the figure excluding these deaths is more nearly accurate. This, however, has also risen from 8.19 in 1955 to 8 53 in 1956. The principal causes of death were heart disease, diseases of the circulatory system and cancer. There was, however, a fall in the number of deaths from heart disease; the number of deaths from circulatory diseases was the same as for 1955 except for an increase of one; cancer figures however, showed an increase of 23, of whom 7 were male and 16 were female, and rising from 109 deaths in 1955 to 132 in 1956. There were no deaths from whooping cough, measles, diphtheria or poliomyelitis. A rise of one in the number of deaths from tuberculosis occurred, the figure, which fell from 13 in 1954 to 8 in 1955, rose to 9 in 1956. The deaths from respiratory diseases including pneumonia, fell considerably from 102 in 1955 to 87 in 1956, probably as a result of the conditions during the winter when no severe frosts or fogs were experienced. 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 270 (males 142 and females 128). Deaths of institution inmates (including patients from Southall addresses and from outside areas) number as follows: St. Bernard's Hospital, 188 (males 86 and females 102); Mount Pleasant Hospital, 12 (all male); Southall-Norwood Hospital, 7 (3 male and 4 female); Vine House, 10 (2 male and 8 female); in addition 11 deaths (2 male and 9 female) occurred of persons belonging to other districts and residing temporarily in Southall. The road accidents figure is disappointing, since in spite of all the work that is being done on road safety within the Borough, the number of road accident deaths rose again. In 1956, 6 people died as the result of motor vehicle accidents, as compared with 4 in 1955, and none in 1954. It is regrettable that the total number of deaths from violence, i.e. road accidents, other accidents and suicide increased from 20 in 1955 to 27 in 1956. 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 10.41, including institutional deaths, or 7.25 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. 9 Births and Birth Rate. (Figures for 1955 are given in brackets.) The total number of registered births in the district (as notified under the Births and Deaths Registration Act) was 135 (112). The total number of live births belonging to the district, whether occurring within or outside the district, was 713 (698). The illegitimate live births were 38 (21). There were 9 stillbirths (12) all of these being legitimate. A slight rise in the birth rate (live and still) is recorded from 13.19 in 1955, to 13.57 in 1956. 38 illegitimate live births were registered during 1956. The following table shows the comparative figures for the past 25 years. Year Number of Illegitimate 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 1956 38 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. The comparability factor for 1956 happened to be one, so that the corrected live birth rate remained at 13.57 which was the crude birth rate and compares with a corresponding rate for the whole of England and Wales, which was 15.7. Infant Mortality Infant mortality, i.e. the number of children dying before reaching the age of one year increased by one in 1956. Thirteen infants died, as compared with 12 during 1955, giving an infant mortality rate of 18.23 Per 1,000 live births, as against 17.19 in 1955. Of these 13 deaths, 1 died at home and 12 in hospital. Ten infants (5 male and 5 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 Middlesex County was 19.1 and the infant mortality rate for England and Wales as a whole was 23.8, the lowest ever recorded in this country. It will be seen that Southall's figure is lower than the national one, and also lower than the average for Middlesex. 10 Graph A Infant Mortality Rate from 1900 to 1956 Premature Infants Thirty-three premature infants were born during the year, 26 were born in hospital and of these, 20 were surviving at the end of one month; 7 were born at home and of these 6 were surviving at the end of one month. There were 6 premature still births, all occurring in hospital. The classification of a premature infant is given to a child born prematurely, or which weighs less than 5A lbs. at birth. Maternal Morbidity Three cases of puerperal pyrexia were notified during the year. There was one maternal death, and no deaths associated with abortion. 11 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES In 1956 the number of infectious disease notifications was low. After a high incidence of measles in the year 1955 notifications of measles were only 61 in the year 1956. Although this was the chief reason for the drop in notifications from 1,768 to 477, the pneumonia figure also fell, from 145 to 94 and the number of notifications of poliomyelitis dropped from 28 in 1955 to 4 in 1956, two of these being finally confirmed as not poliomyelitis. There were no notifications of diphtheria. Sonne dysentery increased during the year, but the increase was due to an outbreak confined entirely to St. Bernard's Hospital. 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, poliomyelitis prevention, Occupation scheme for Old Age Pensioners, etc. Measles Measles incidence was slight during the year 1956. There were no deaths from measles. The following table shows the trend of notifications during the past 10 years. Year No. of Cases Deaths 1947 334 - 1948 825 1 1949 194 - 1950 701 - 1951 1,129 - 1952 528 - 1953 931 1 1954 41 - 1955 1,329 - 1956 61 - Poliomyelitis Four notifications of suspected anterior poliomyelitis were received in 1956; 2 paralytic and 2 non-paralytic. The non-paralytic cases were confirmed as not being poliomyelitis, but the two paralytic cases were confirmed positive. Both positive cases made a fair recovery. Particulars of the surviving paralytic cases notified since 1949, are as follows:— 1956: Case A. Paralysis limbs. Adult male. Residual weakness arms and legs. Having physiotherapy. Case B. Paralysis left arm. Adult female. Residual weakness remaining. Having physiotherapy. 1955: Case B. Paralysis of left thigh muscles. Girl aged 3 years. Recovering well. Still some slight residual weakness in the left leg. Receiving physiotherapy treatment. Case E. Paralysis of left leg. Boy aged 6 years. Still some weakness of left leg, but making progress. 1952: Case D. Paralysis of both legs. Boy now aged 7 years. Full recovery of power. Some shortening of right leg and foot, but this has decreased during past year. Still making progress. Case F. Paralysis of limbs and trunk. Adult female. Died in 1956. Case G. Paralysis of both legs. Boy now aged 16 years. Continues to make progress. Walks well. Has 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 stationary. 12 Case C. Paralysis of arms, legs and trunk. Girl now aged 21 years. Residual paralysis in legs. Travels in motor wheel chair and wears pelvis support and calliper. Condition stationary. 1949: Case B. Paralysis anterior tibials, etc. Girl now aged 16 years. Recovery good. Full power of all limbs except for slight limitation of flexion of left foot. An Analysis of the Progress of all Paralytic Poliomyelitis Cases Occurring in Southall since 1949 is as follows:— Year Number of Notified Cases Confirmed as Paralytic Poliomyelitis Still Making Progress Condition Stationary Died Full Recovery 1949 14 1 - 2 11 1950 6 - 2 - 4 1951 9 - - - 9 1952 8* 2 - 1 4 1953 4 - - 2 2 1954 2 - - 1 1 1955 8 2 - 2 4 1956 2 2 - - - *One removed from district—information on progress not obtainable. It will be seen from these figures that of 53 cases of paralytic poliomyelitis occurring during these eight years, 35 recovered completely, regaining full power of every muscle affected. In the early part of the year a campaign was inaugurated by the County Health Department to obtain the registration of children between the ages of two and nine years for vaccination against poliomyelitis. Supplies of British vaccine were beginning to be made available, and as soon as registration was complete a start was made in the County Clinics with the inoculation of selected groups from among the registered children. The supply of vaccine was very slow in coming through, and although the number of children registered was 1,746, at the end of 1956, 189 children had received two injections and 27 one injection. It had been hoped that the number of children inoculated during the year would have given some guidance as to the percentage effectiveness of this treatment, but the number of vaccinations being very low and also the actual incidence of poliomyelitis being low in this year, no conclusions could be drawn from the local findings. Influenza Influenza was not a problem in 1956. Dysentery 81 notifications of dysentery were received in 1956. Of these, 66 were received from St. Bernard's Hospital, where cases of Sonne Dysentery began to occur towards the end of January. When it was appreciated that several cases had occurred in one ward, and therefore that an outbreak was likely, the Hospital Control of Infection Committee was called together, and the Medical Officer of Health brought into consultation. A plan of action was devised in order to endeavour to contain the infection, but the amount of visiting and inter-ward traffic in the hospital had by this time enabled some cross-infection to occur, and as cases were still occurring in new wards in February, it was decided to close the hospital for visiting and to re-arrange the wards so that admissions could only take place into wards where no infection had occurred. There was a very heavy programme of bacteriological investigation carried out in the hospital's laboratory. Staff and patients were investigated, and no positive case was considered to be clear until three negative faeces specimens had been obtained. By 16th March, it was possible to re-open the hospital to a partial extent and the outbreak was cleared by April, the last notification of a confirmed positive case being received on 20th April, 1956. 13 There were three deaths in the hospital of aged persons who contracted dysentery during the outbreak. Of the other 15 cases notified as Dysentery, 7 were not confirmed as such. The remaining eight were confirmed bacteriologically as Sonne Dysentery—four in one family in a Corporation Rest Centre for the Homeless, two in another household, and two isolated cases. It is pleasing to be able to report no spread from these families, especially in a Rest Centre where many facilities are communal. Smallpox (Variola) No cases of smallpox occurred in the Borough during the year, and no contacts of smallpox were notified from the Port or Airport Authorities. Vaccination The figures for infant vaccination show a slight fall in 1956. The percentage of children receiving vaccination during their first year of life dropped from 46 9 in 1955 to 45 9 in 1956. The re-vaccination figure has also fallen, but that is not of great importance 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 reauirement before entrv. 1956 Age Groups Under 1 year 1-2 years 2-4 years 5-14 years 15 years and over Total Primary Vaccination 327 21 10 10 53 421 Re-vaccination — — 5 8 81 94 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 3° 44 436 Re-vaccination — — 3 11 89 103 Scarlet Fever (Scarlatina) The number of notifications received during the year was 21 as compared with 40 for the previous year, and 101 in 1954. Scarlet fever appears now to have become a comparatively rare disease, and the cases tended to be mild in nature, as is instanced by the fact that only 2 cases were admitted to hospital for isolation and treatment, while 19 were nursed at home. There was one secondary case, i.e. a second case occurring within three weeks following the notification of a previous case in one 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) Ages at Date of Final Injection Under 1 1-4 5-14 Total 427 145 13 585 317 14 In the following table is shown the number of children at 31st December, 1956, who had completed a course of immunisation against diphtheria at any time before that date:— Age at 31.12.^6: Under 1 1-4 5-9 10-14 Total under 15 Number immunised 153 1,871 3,213 3,488 8,725 There was a slight rise in the number of children receiving primary immunisation against diphtheria during the year. A rough estimate of the percentage of immunised children can be obtained by using the 1951 Census figure of the number of children age 0-15 living in Southall. This indicates that approximately 73% is likely to be the figure in Southall for protected children, still slightly below the agreed safety margin of 75%. Ophthalmia Neonatorum No case of ophthalmia neonatorum was notified during the year. Tuberculosis Pulmonary Tuberculosis The number of new cases notified during the year was 80. Other Forms of Tuberculosis The number of new cases notified during the year was 5. Of the total notifications, 7 were received from medical practitioners; 55 from the Uxbridge Chest Clinic; 9 from General Hospitals; and 14 from St. Bernard's Hospital. Deaths from Tuberculosis Tuberculosis of the respiratory system, 9; other forms, nil. For details of new cases notified and deaths in 1956, 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, 19.6, Section 172 Action under these powers was not necessary during the year. The number of new notifications rose from 67 in 1955 to 85 in 1956. Of the 85, 24 were inward transfers, i.e. they were not resident in Southall at the time of development of disease, and therefore the actual figure of new notifications of Southall residents was 61, while in 1955 the number of inward transfers was 17, making the figure for new notifications of Southall residents 50. The increase during 1956 could be partly attributed to the discoveries made as a result of the two visits of the Mass X-ray unit and partly to the fact that there was an increase in the number of Indian Nationals either suffering from tuberculosis before arrival, or developing tuberculosis as a result of their transfer from India. (Nine of the new notifications were Indians, as compared with three in 1955. When Indian Nationals first came into Southall, the standard of accommodation was very poor and overcrowding existed, but during 1954, the Council laid down an upper limit of accommodation for each dwelling house occupied by Indians, so that statutory overcrowding is less likely to occur, though the position needs careful watching.) 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 six instances. All of these six were living in overcrowded conditions. Those cases ascertained in previous years to be living in statutorily overcrowded conditions and containing in the family a tuberculous patient have been rehoused, except for one family which had their overcrowding abated because of increased accommodation made 15 available to them as the result of the Council rehousing a family from the same house. Second cases occurred during the year in eight households, seven of which were not overcrowded or slum property, the eighth, however, being in a family where the house was dilapidated and overcrowded. 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 1956 Notifications Deaths 16 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, where cases of tuberculosis are now isolated in a special ward, and a Mass Survey by X-ray has been carried out during the year. It is hoped that the risk of undiscovered cases remaining in the general wards has been greatly lessened by these provisions. 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 1956 was 71. Other matters referred to in the Chest Physician's report are that there seems to be again a general rise in the incidence of new tuberculosis, and that the statistics show the occurrence of the disease still to be greatest in the younger age groups and highest in ages 15.24. There also appears to be a rise in the numbers of cases occurring in the over forty-five's. Disappointment is expressed that in spite of all the propaganda and endeavours to obtain cases of tuberculosis in the early stages it is still found that one in every ten discovered has already extensive lung involvement and only four out of every ten discovered are really early cases. Also the number of cases developing as a result of contact of some years distance does not appear to lessen. An appeal is made by the Chest Physician who would like to stress the importance of continued co-operation of the public, with particular regard to chest X-ray and B.C.G. vaccination, for the eradication of pulmonary tuberculosis, which seems to have become a possibility in our lifetime. Tuberculosis Vaccines Clinical Trial The first report of the Medical Research Council's investigation into the value of vaccination against tuberculosis was published during the year. Southall has been cooperating in this investigation since its beginning in 1951. The first report of the investigation has shown that vaccination for children in their fifteenth year substantially reduces the risk of contracting tuberculosis in adolescence. Background of the Investigation: The value of vaccination against tuberculosis has been a matter of dispute since its introduction into France more than 30 years ago. During this time there has been a gradual accumulation of evidence in favour of the vaccine, and by 1949 its value for those exposed to special risk from tuberculosis, such as nurses and contacts with cases of the disease, was generally recognised. In 1949 vaccination for contacts was authorised by the Ministry of Health, and in 1953 vaccination in older school children was introduced at the discretion of each local health authority. However, until the extent of the contribution which B.C.G. vaccination might be expected to make could be accurately assessed, many public health authorities considered that its introduction on a wide scale was not justified, particularly in view of the recent advances made in other aspects of tuberculosis control. The first report establishes beyond question the short-term value of B.C.G. vaccination of young people in this country, and shows that vaccination at the age of 14 and 15 should reduce the number of cases of the disease developing between the ages of 14 and 17 by about half. This represents a valuable contribution to the prevention of tuberculosis. Description of Investigation: The effort to establish the value of these vaccines scientifically has necessitated an extensive investigation, probably the most detailed of its kind ever undertaken. The success achieved has been made possible by close co-operation of Medical Officers of Health and Chest Physicians in many parts of Britain with the Medical Research Council. Beginning in 1950, three special Medical Research Council teams, each equipped with a mass X-ray unit, visited 22 North London boroughs, including Southall, and towns in the Midlands and North of England, With the consent of the parents school children in their 17 15th year were asked to volunteer and a proportion were given tuberculosis vaccines. By December 1952, 56,700 children, of whom 200 came from Southall, had joined the scheme. Since then the participants had been followed by regular X-ray examinations, postal enquiries and annual home visits. The vast amount of home visiting involved has been carried out by the health visitors and school nurses of the local health authorities, who have undertaken the work in addition to their normal duties. The follow-up has been very successful and over two-thirds of the participants continue to return for the X-ray examinations, approximately 75% return postal forms and over 90% have a home visit. The present addresses of over 99% are known. Continuation of the Investigation: The first report included results up to four years. Until the scheme has continued for a further period it will not be possible to say for how long the protection given by each vaccine will last, and whether those protected from tuberculosis in the first few years after vaccination will remain protected in later life. Until more is known of the duration of protection given by the vaccine it is also not possible to decide definitely the most suitable age at which it should be given. Provided the scheme can be successfully continued it is probable that information of great value to the future control of tuberculosis, both as regards vaccination and also many other aspects of tuberculosis as a public health problem, will be obtained. This depends on the continuation of support by the many local authorities concerned. Research into Incidence of New Tuberculosis in the Adolescent In order to ascertain the amount of tuberculosis which occurs in young people leaving school and starting work in industry or offices and so subject to the strains of new conditions, the Mass X-ray Unit 5A staff has been carrying out a programme of research (as described in the Annual Report of 1953) in which school leavers were asked to submit to X-ray examination annually in order that they could be kept under observation. No figures were available at the time of printing the Annual Report for 1955, but it is now known that 585 adolescents were X-rayed during that year, a percentage of 47 of the total invited; during 1956 759 adolescents were X-rayed, a response of 38% of the total invited. No active cases were found amongst ex-school leavers. Graph B is a pictorial representation of the statistics of tuberculosis in the Borough from 1930 to 1956. Visit of Mass X-Ray Unit The Mass X-ray Unit Number 5A came to Southall on 15th October and spent nearly six weeks in the Borough. During the first and last weeks of the visit the Unit was stationed in the grounds beside the Public Health Department, a convenient centre for public sessions. The Unit now being fully mobile, the weeks between were spent in various industrial centres in the Borough. In all 11,298 persons were X-rayed during this visit, 6,224 (2,693 male and 3,531 female) of whom were Southall residents. 181 (123 male and 58 female) were recalled for further investigation because of doubtful shadows on their miniature X-ray pictures, five of these failed to attend, and the result was that 140 were discharged as satisfactory, and 36 were referred to the Chest Clinic. Four Southall residents were found to be suffering from active pulmonary tuberculosis, three male, one female, 5 persons resident in neighbouring districts were discovered to have active tuberculosis, four had lung tumours of a malignant nature. Earlier in the year the Unit had visited St. Bernard's Hospital where 1,771 patients and 291 staff were X-rayed, a total of 2,062, out of whom 5 cases of active pulmonary tuberculosis were discovered and 10 other conditions of which one was cancerous. The figure for new cases of positive tuberculosis discovered is 0.8 per thousand over the whole investigation, and 0.64 per 1,000 of Southall residents, 18 Cancer It will be seen by the table of causes of death (page 49) that in 1956 132 cases (67 males and 65 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 — Male Site Total Under 10 I0-20 20-30 30-40 40-50 50-60 60-70 70-80 80 + 54 55 5<> 54 55 56 54 55 56 54 55 56 54 55 56 54 55 56 54 55 56 54 55 56 54 55 56 54 55 56 Lung 20 18 29 _ 1 _ _ 1 _ _ _ _ 1 1 1 1 1 2 8 4 9 4 5 12 4 5 5 2 _ _ Stomach 10 14 4 - - - - - - - - - - - - - 2 - 1 1 - 5 7 1 3 4 2 1 — 1 Intestine 14 1 I - - - - - - - - - - - - 1 1 - 1 3 - 6 2 5 5 5 4 1 _ - Bladder 2 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 - - 1 1 - - 1 1 - — - Prostate 1 3 2 - - - - - - - - - - - - - - - - - - - 1 - 1 I 2 - 1 - Breast 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Other 24 12 22 1 - - - - 1 1 - - - 1 3 2 2 1 9 4 3 6 3 3 5 1 7 - 1 4 Totals 72 60 67 1 1 - - 1 1 1 - - 1 2 4 4 6 3 20 12 12 23 19 21 18 17 21 4 2 5 Age Groups — Female Site Total Under 10 10-20 20-30 30-40 40-50 50-60 60-70 70-80 80 + 54 55 56 54 55 56 54 55 56 54 '55 56 54 55 56 54 55 56 54 55 56 54 55 56 54 55 56 54 55 56 Breast 17 6 16 - - - - - - - - - 2 - 1 2 2 1 5 - 2 2 3 6 3 1 4 3 - 2 Lung 2 3 5 - - - - - - - - - - 1 - - - - - - 2 1 1 1 1 1 2 - - — Stomach 5 9 8 - - - - - - - - - - - - - 2 - 2 1 - - - 4 3 2 3 - 4 1 Uterus 3 5 6 - - - - - - - - - - - - - - 1 1 3 1 — 2 2 2 — 1 — — — Intestine 6 15 11 - - - - - - - - - - - - - 3 3 - 2 1 3 5 3 3 I 1 - 4 3 Bladder - 2 - - - - - - - - - - - - - - - - - - - - - - - - - 1-- — Other 10 9 19 - - - - - - - - - - - - 1 - 5 - 1 1 2 4 7 4 4 3 3 - 3 Totals 43 49 65 - - - - - - - - - 2 1 2 3 7 10 8 7 7 8 15 23 16 10 14 6 9 9 These figures are inclusive of the deaths occurring at St. Bernard's Hospital, Norwood Hall and Vine Cottage. The total number of deaths from cancer in 1956 rose, being 132 as compared with 109 in 1955. There was a 60% increase in the deaths from cancer of the lung in males from 18 in 1955 t0 29 in 1956, the rest of the increase occurring evenly between males and females in the unclassified cancer deaths, these being in various sites, larynx, oesophagus, pancreas, genital organs, bones, brain, etc., only one or at the most two for each site. The increase was greater in females than in males, i.e. 65 female cancer deaths in 1956 as compared with 49 for 1955 and 67 male deaths from cancer in 1956 as compared with 60 in 1955. 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 Public Health Inspectors paid 174 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 1956 are as follows:— Faeces specimens 282 Sputum specimens 19 Blood specimens 11 Urine specimens 12 Swabs (nose, throat, ear and rectal) 29 19 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. Lists of premises, articles, etc., disinfected during the year. Rooms 7 Eiderdowns 4 Beds 7 Pillows Blankets 17 Plimsolls (routine disinfection Mattresses - during holiday for Feather- Sheets 14 stone Road School) (pairs) 180 Books 60 Miscellaneous articles ... - Smallpox Disinfection: In the event of smallpox occurring within the district and disinfection being required on a considerable scale, arrangements have been made whereby this could be carried out. An agreement was made with the North-West Metropolitan Regional Hospital Board whereby in such an event the staff of St. John's Hospital, Uxbridge, would carry out this work. Provision of Antitoxin and Vaccine Lymph The Council provides diphtheria antitoxin and tetanus antitoxin free to local practitioners in the district. These antitoxins are obtainable from the Public Health Department during office hours and by direct request to the Medical Officer of Health at other times. In the event of emergency supplies of vaccine lymph being required, they are obtainable at very short notice. Scabies and Lice During 1956 one case of infestation with body lice was brought to the Public Health Department for cleansing. Baths and treatment were arranged at Hammersmith Cleansing Station by courtesy of Hammersmith Borough Council. No cleansing for scabies or head lice were required during the year. Table XI gives details of head inspections in schools, and here there seems a continuing improvement each year, except that the number of compulsory cleansings necessary in 1956 was 16 as compared with 9 the year before. This figure, however, is still a reasonably low one. zo 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. Mary Ellis of Lansdowne House, High Street Harlington, 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 the 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 369 articles were lent under the scheme—a decrease of 53 on the 1955 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. British Red Cross Society: The headquarters of the British Red Cross Society, Ealing Area Division, which included Southall during 1956, 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, met weekly and was a social and recreational one for people suffering from any physical handicap, and transport was provided for those members who were unable to make their own way to the Club premises, which were at the Southall Community Centre. The approximate number attending weekly was 16, the total membership being 20. The Hard of Hearing Club: This Club, which was inaugurated in 1955, has been showing good progress and has already been of considerable service to some of its members. The membership is now 40 21 with an average attendance at each meeting of 25-30. The Club meets every Wednesday and there are lip reading sessions for about 20 minutes at each meeting. The Club has a Welfare Committee with individual members allocated to certain areas of the Borough, and in this way absentee members of the Club can be visited and perhaps helped if they are in any need. Three Old Age Pensioner members were sent for a holiday at reduced charges during 1956, and the Club was able to raise sufficient money during 1956 to purchase an amplifier for the meetings. The Club Secretary reports that already some of the members, as the result of their constant attendance at this Club, are taking a much more active interest than formerly in doing things and taking part in discussions. Diabetic Club: In October 1956 a Club for diabetics residing in Southall and the surrounding districts was inaugurated in Southall. There was a public opening meeting with the Mayor of Southall in the Chair, at this meeting the aims and works of the British Diabetic Association were explained, and the new branch formed. The main purpose of the Club, in addition to holding social meetings with fellow sufferers from this disease, will be to have specialist talks, on subjects of particular interest to the group, each month, and to help individual members with particular problems. The response was very good and at the end of the year the membership of this club was 147 with a monthly attendance varying between 40 and 70 at each meeting. Home Advice Group: In July 1956 a meeting was held of social workers interested in problem families, at which a talk was given by a member of the London Council of Social Service on Home Advice Groups as they are operating in different parts of the country. Those present agreed to become members of a Committee to deal with this subject. The constitution of this Committee was the Housing Estates Manager, Area Children's Officer, Area Welfare Officer, Inspector, National Society for the Prevention of Cruelty to Children, Area Health Visitor, Secretary, London Council of Social Service, Area Officer, National Assistance Board, Vicar, St. John's Church, Southall, and Senior Probation Officer. The Housing Estates Manager reported that the Southall Borough Council was willing to sponsor a Home Advice Group and that premises and a leader would be found shortly, and the Group actually started functioning on the 4th October, 1956 in a room at The Grange, Southall. The Group leader, trained in this type of work, began the Group as a little social gathering where mothers could bring their children and their problems and be given help in the solution of home making difficulties, financial worries and so on. By the end of the year the membership of this Group was about 19 of whom 9 were regular attenders. The main function of the Committee was to supply membership for the group by informing any mothers with problems of the facilities available. Welfare of the Blind and Partially Sighted: The County Council is responsible under the National Assistance Act, 1948, for the provision of welfare services for the blind and partially-sighted. There are resident in the Borough 99 blind and 14 partially-sighted persons. 13 blind people are in full-time employment. Of these, 2 are in Workshops for the Blind, and receiving augmentation and supplementation of earnings from the County Council, and one is working as a Home Worker under the Scheme of the Royal London Society for the Blind, and is also receiving augmentation of earnings from the County Council. The majority of blind people are not available for, or not capable of, training and employment owing to age or infirmity or for some other reason. The County Council provides a Home Teaching Service for the visitation of blind and partially-sighted people in their own homes. The duties of the Home Teachers are to advise blind and partially-sighted persons in all problems relating to their welfare and of all the available social services to assist them in overcoming the effects of their disabilities, to give instruction in Braille and Moon systems of raised type, in communication by means of the deaf-blind manual alphabet, and in handcrafts. A handcrafts class is held fortnightly at the King's Hall Methodist Church, South Road, Southall. 22 The object of the Home Teaching service is to enable blind people to lead as full and active lives as their severe handicap allows. The County Council works in close co-operation with Voluntary Organisations, including the Social Club for the Blind which meets fortnightly at the Labour Hall, The Broadway, Southall, and with the Middlesex Association for the Blind, who maintain a Holiday Home at Littlehampton, two Residential Homes for the Blind, and assist financially and by way of gifts to individual necessitous blind persons. Blind persons are eligible for the loan of a wireless receiver through the British Wireless for the Blind Fund, and the County Council has a scheme for assisting blind and partiallysighted persons in the maintenance of wireless sets. Other services provided directly by the County Council or through a registered agency, include facilities for the placement of blind persons in employment, courses of residential re-habilitation, training courses for mothers with blind babies, the supply of embossed literature, special equipment and handcraft materials, assistance in the disposal of handcrafts, and assisted holidays for those in need. Welfare of Handicapped Persons other than Blind: Schemes for the welfare of handicapped persons other than blind and partially-sighted are operated by the County Council's Welfare Department under the National Assistance Act, 1948; these cover the deaf and dumb and hard of hearing, and other persons who are substantially and permanently handicapped by crippling diseases or congenital deformity. Services to the deaf and dumb and the hard of hearing are provided by appropriate voluntary organisations, to whom the County Council makes grants in aid. The County Council's Welfare Department has provided a Welfare Visitor for persons in the Borough who are suffering from substantial and permanent handicaps other than those already mentioned, and she works under the direction of the Area Welfare Officer. She visits such persons in their own homes, with a view to assisting them to obtain from statutory or voluntary sources (or both) facilities, appliances, &c., which may benefit them. The help afforded, may, for example, enable the disabled person to take part in social activities, attend handcraft classes, obtain a needed holiday, or, by provision of ramps for mechanical chairs, handrails, and the like, give a previously non-existent measure of mobility to a person who was chair-bound or house-bound. Advice and guidance regarding personal problems is given, and membership of a voluntary organisation catering for a particular handicap is facilitated. Residents of the Borough needing any of the County Welfare Services briefly referred to in this Report should apply to the Area Welfare Officer, Mr. H. S. Wright, at the Local County Offices, Great West Road, Brentford. Old People The needs of 17 special cases of old people living in difficult circumstances were investigated during 1956, and the action taken is recorded in the following list:— Admitted to hospital 2 Admitted to old people's home 6 Remaining at home 9 (a) Home Help provided 1 (b) District Nurse provided 1 (c) Home Help and meals provided 1 (id) Refused all help 2 (e) No action required 3 (f) Out-patient at Hospital, treatment arranged 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. 23 The County Council has the duty, under the National Assistance Act, 1948, of providing residential accommodation for aged and infirm persons in need of care and attention which is not otherwise available to them; and it can do this by providing its own Homes or by arrangements with registered Voluntary Organisations. The County Council's Welfare Department administers the County Homes, and the number of persons admitted to such Homes from the Borough in 1956 was 25. 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 help was able to be found for each of the cases except for the two who refused all assistance. They, along with the two who refused help in 1955, 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, and in fact one of the two from 1955 was admitted to an old people's home. 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 Area Welfare Officer and the Home Help Organiser in helping to deal with these cases and their problems. It has been ascertained from the Area Medical Officer that 271 Southall people were given Home Help during the year and of these 216 consisted of chronic sick or aged persons, and of 901 persons who were assisted by the Home Nurses, 439 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 four days per week were provided for all known housebound old people who wished to take advantage of the service. During the year 6,718 meals were delivered. The cost of the meal was 9d. to the recipient, and for each meal Southall Borough Council made a grant of 1/-. Arrangements were made for the cooking and issuing of meals to be carried out at Beaconsfield Road School Canteen, and later at George Tomlinson School Canteen. Chiropody Service for Old People: This service was continued throughout 1956. Six local chiropodists gave their services at cheap rates for Old Age Pensioners. Holidays for Old People: The holiday scheme whereby old people get a seaside holiday during off season months of May and September, at reduced rates, continued during 1956, and was operated by the various Old People's Clubs in the Borough. Other Services: A service for the provision of cheap laundry and a cheap boot and shoe service are available. In March, 1956, the North Thames Gas Board offered a free service of inspection of the gas appliances and service pipes in houses of old age pensioners living alone. The reason for this was in order to reduce the risk of gas poisoning, a frequent cause of home accidents and fatalities in old people. The offer was to include free replacement of faulty pipes and the free repair of faulty appliances. To take advantage of this offer, lists of old people living alone were submitted from the Public Health Department and in due course the homes of the persons nominated on the lists were visited by the Gas Board officers. Fresh lists continued to be supplied from time to time. Southall Association for the Occupation of the Elderly: A scheme for providing work for old age pensioners as a means of physical and mental maintenance and rehabilitation had been under consideration for some considerable time, and the Public Health Committee of the Southall Borough Council was interested in the scheme and anxious to support it as much as possible. 24 In April, an inaugural meeting was held of representatives of Local Associations interested in Old People's Welfare, to introduce the idea of the scheme and to ascertain the amount of support likely to be forthcoming. The Mayor of Southall was in the Chair. When a Voluntary Committee, named the Southall Association for the Occupation of the Elderly, was formed in September, the Chairman of the Public Health Committee was elected as Chairman, the Medical Officer of Health as Honorary Secretary, and the Borough Treasurer as Honorary Treasurer. Work proceeded throughout the year in an endeavour to raise funds for the scheme, to obtain a Work Centre, and to make the industrialists and the general public aware of the facilities which were to be offered. As the scheme was planned for old persons of varying capacity for work, it was known that it should never be a selfsupporting concern, but must always be a semi-charitable one. By the end of the year premises had been offered by Southall Borough Council in the Municipal Sports Ground and sufficient funds for starting the scheme had been obtained from the local Council, Middlesex County Council and other sources, and it was hoped that a start could be made to operate the scheme in the following spring. National Assistance Act, 1948, Section 47: National Assistance (Amendment) Act, 1951: No case was dealt with under these powers during 1956. 25 HEALTH EDUCATION During the year work on the education of the general public in matters of health and hygiene continued by means of personal communication between Public Health Department staff and individuals, talks to Associations illustrated by topical film strips, poster publicity and leaflet distribution. In the spring of the year, special publicity was given to Anti-Diphtheria Immunisation, and for the first time the managers of the local factories were asked to display public health publicity material. The response was very good and during the period of the campaign for the immunisation against diphtheria, posters were displayed in factory canteens and offices. In the autumn, before the visit of the Mass X-ray Unit, all publicity was focussed on the importance of X-ray examination in the ascertainment of tuberculosis in the early stages when cure is much more easy to obtain. In February of 1956, the Central Council for Health Education held a Seminar for Medical Officers on the subject of Public Relations and the Health Department, at which Public Relations was discussed in various aspects. The speakers included a Public Relations Consultant, the Editors of two newspapers, a Public Relations Officer of the National Association of Local Government Officers, Officers of the Central Council for Health Education, and various Medical Officers of Health. Group discussions were held, and notes compared as to the value of various publicity methods as assessed from results obtained. Results of Health Education of course, are not easily assessable, as indeed can be said of all the results of preventive health work, since any improvement in the health of the community is not immediately able to be measured by increased height, weight, or lessening of the frequency of illness, and individual person well-being is never a measurable factor although it is so important. There was general agreement that there was room for improvement in the Public Relations work of most Public Health Departments and that more co-operation between Councillors and Department staffs, between Corporation Departments and between members of the Department staff themselves are desirable, as it seems unlikely that the general public will be knowledgable about Public Health if the authority and its officers are not well aware of all the changing facets of the work in the Public Health Department. ROAD SAFETY The number of road accidents occurring within the Borough of Southall showed a slight improvement over 1955, and for the fourth year in succession it is possible to report that no child died in Southall as the result of a road accident. There were twelve fewer road accidents than in 1955, but the number of children suffering injury in these was the same as in that year. In Southall six people died as the result of motor accidents, but only three road accidents resulting in death actually occurred within the Borough boundaries. None of the victims were children. The number of persons injured, whether seriously or slightly, was 289 adults and SS children. The classification of the casualties is as follows:— Persons Killed Type of Road User Cause of Accident Age Sex Private motor car driver Private motor car swerved and skidded to avoid dog, and hit telegraph post 55 M Public service vehicle passenger Passenger fell as she alighted from trolley-bus at bus stop 72 F Pedestrian Pedestrian stepped off footway into path of private motor car 77 M 26 Persons Injured Adult School Age Under 5 Serious Slight Serious Slight Serious Slight Pedestrians 11 26 7 22 - 5 Total 37 Total 29 Total 5 Pedal cyclists 11 7i 1 15 Nil Total 82 Total 16 Total Nil Private motor car passengers 3 16 - 2 1 - Total 19 Total 2 Total 1 Passengers in other vehicles 4 28 1 - - 1 Total 32 Total 1 Total 1 Private motor car drivers 8 17 Total 25 Motor cyclists 6 65 Total 71 Drivers of other vehicles 5 18 Total 23 Adult Total 289 — Children Total - 55 The majority of these accidents were on the two main roads through Southall which carry a very heavy traffic. The Road Safety Committee of the Borough Council maintains a full programme of education in road safety in which the Metropolitan Police take an active part. The Southall school children receive constant training and exhortation on the use of roads and the fact that no child was killed on the Southall roads may perhaps be considered a successful result of the work done, but 55 injured children is serious enough to emphasize the need for constant care on the roads by all road users. HOME ACCIDENTS The results of home accidents as of road accidents constitute a very high proportion of the mortality and morbidity of the population throughout the country and, as every home accident is preventable, the failure to prevent them is a constant reproach to all concerned with the health of the people. Education and example are the only weapons in the warfare against carelessness in the home, and so from time to time poster and leaflet campaigns are carried out on particular topics of home safety, such as the prevention of fire burns by the use of suitable guards, and the need for satisfactory and safe electrical and gas appliances and fittings, the keeping of dangerous drugs and poisons out of the reach of children, the care of polished floors which can endanger the elderly, etc. It is a fact that the very young and the very old are the greatest sufferers from home accidents and it is encumbent on those who care for them to keep them away from danger. Details were received concerning a few of the home accidents within the Boroueh, and thev are as follows:— Age Nature of Injury Cause of Injury Known to have Died and Place of Death 78 yrs. Fractured spine Fall — 72 yrs. Fractured right femur Fall — 71 yrs. Fractured ribs Fall Vine Cottage 82 yrs. Fractured femur Fall Hillingdon Hospital 74 yrs. Burn to right hand and wrist Hot fat from frying pan — 81 yrs. Concussion Fall — 6£ yrs. Burn to left thigh Dress caught fire from gas ring in fireplace - 17 yrs. Asphyxia due to carbon monoxide House caught fire King Edward Memorial Hospital 79 yrs. Pulmonary Embolism following thrombosis of the right femoral vein Fall Hillingdon Hospital 11 yrs. Extensive burns of back and left side Leant on gas cooker— clothes caught fire - 83 yrs. Fracture Fall - 2 yrs. Scald on back Sat in bucket of boiling water The number who died as a result of accident other than motor vehicle accident rose from 10 in 1955 to 17 in 1956 and of these accidental deaths 9 occurred at home. 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. All inhabited houses are supplied from public water mains and there are no standpipes in use on mains. Under Section 35, Middlesex County Council Act, 1956 provision is made for immediate action to be taken by the Local Authority to restore a water supply which has been cut off for some default. Sanitary Inspections of the District Under Section 38, Middlesex County Council Act, 1956, provision is made for immediate action to be taken by the local authority to obtain the clearance of stopped up drains. The total number of inspections of premises made during the year by the Public Health Inspectors was 7,144. The number of inspections showed a slight decrease in 1956. Visits for housing defects and to food premises rose considerably, but there was a smaller demand for work on overcrowding and vermin infestation. Table XII gives an analysis of the number and nature of such inspections. School Sanitation Nine visits were paid to schools during the year. As co-operation between the Education Department, Schools and Public Health Department staffs is excellent, these visits are usually made following requests from the Education Officer or School Head Teacher, and are usually because of emergency sanitary defects. Information was received from the Divisional Education Officer that no major works on school sanitation were undertaken during 1956. Eradication of Bed Bugs Statistics for the year:— (a) Number of Council houses (1) found to be infested 3 (2) disinfested during the year 3 (b) Number of other houses Total 12 (1) found to be infested 9 (2) disinfested during the year 9 Canal Boats One boat was inspected in transit on the canal. The condition of boat 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. 182 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 18 11 Mechanical 164 143 — — Totals 182 154 — — 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 3 3 Overcrowding — — — — Unreasonable temperature — — — — Inadequate ventilation — — — — Ineffective drainage of floors — — — — Sanitary Conveniences— (a) Insufficient — — — — (b) Unsuitable or defective 1 3 — — (c) Not separate for sexes — — — Other offences against the Act (not including offences relating to outwork) — — — Totals 4 6 — — — Outworkers Nature of Work Section 110 Section 111 No. of outworkers in August List required by Section no (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 22 — — — — — Cosaques, Christmas Crackers, Christmas Stockings, etc. 2 — — — — — Totals 24 — — — — — 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 sold are included in the list of general inspections. 29 Petroleum and Carbide During the year licences were in force in respect of 65 installations for petroleum, and 2 for carbide of calcium. There was a considerable increase in the holding of petrol, and a corresponding increase in the number of inspections. The responsibility for this work is found to interfere with general public health routine work, and consideration may have to be given to the transfer of these duties away from the Public Health Department. 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 Representation of the remaining properties on the Council's housing programme proceeded, and active steps were taken before the end of the year for the acquisition of some of the properties represented. In the course of the year, the rehousing of all families in property represented in 1951 was carried out, and the properties were demolished. In 1956, 49 houses were represented for demolition and 4 for closure. In respect of 12 of these houses, a County Court appeal decided the acceptance of an undertaking to render the houses fit. 16 families were rehoused during 1956 from these condemned properties. The preliminary programme of slum clearance submitted to the Minister of Housing and Local Government in August, 1955, is nearing completion. Certificates of Disrepair During the year 4 applications have been received, of which 3 were granted. There were also 9 applications for Certificates of Revocation, 7 of which were granted and 2 rejected. Since the Act came into force 59 applications for Certificates of Disrepair have been received, and 23 applications for Certificates of Revocation have been granted and 5 rejected. Overcrowding The number of persons asking for assistance in obtaining housing on grounds of overcrowding was as high as in 1955, but the number confirmed on inspection as being statutorily overcrowded was lower, and the number remaining on the Department register of overcrowded families was reduced in 1956. Houses Let in Lodgings Towards the end of 1954 several houses were purchased and occupied as lodging houses by male coloured immigrants, the usual arrangement being for a number of beds to be placed in each room and all the occupants of the house to share a communal kitchen. The Council were concerned about conditions generally and the excessive number of men accommodated in these houses, and decided to apply the provisions of Section 12 of the Housing Repairs and Rents Act, 1954. A permitted number based on floor area, was fixed for each room regarded as suitable for sleeping accommodation and formal notice of these standards served on the person having control of the house. These notices have been accepted and the conditions observed by the persons concerned and have proved a useful means of control. Occupation of further houses continues, and 20 houses were dealt with during 1956, making a total of 41. 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. 31 New Housing The following details have been supplied by the Borough Engineer, outlining the complete amount of house building for Southall since the end of the war. Built by Southall Borough Council During the Year 1956 Since the end of the War (including 1956) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Dwellings — — 35 — Houses 3 — 310 136 Flats 84 30 339 132 Prefabricated Houses - - 299 Built by Private Enterprise During the Year 19:6 Since the end of the War (including 1956) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Bungalows 2 — 16 — Houses 7 — 223 — Flats - — 48 — Prefabricated Houses — - - 3* HYGIENE OF FOOD Food & Drugs Act, 1955 The operation of the Food & Drugs Act, 1955, called for a considerable amount of work in securing the provision of proper washing facilities in food shops. It is gratifying to record that the initiative in the provision of these facilities was taken in a considerable number of cases. Food Hygiene Regulations The Food Hygiene Regulations 1955-1956 have enabled the generally high standard of food premises in the Borough to be improved still further, and have supported more vigorous action in a few intransigent cases. Due to shortage of staff the principal and important types of food premises were visited in the early days following the coming into operation of the Regulations, the remainder being given attention as soon as possible afterwards. On the whole the co-operation of the occupiers has been good. Food Poisoning The total number of persons notified as cases of food poisoning by general practitioners was 17 in 1956. The results of bacteriological investigations of the notified cases are as follows:—12 cases Salmonella Typhi Murium by bacteriological examination, 1 case confirmed Salmonella Derby, 1 case notified as Enteric confirmed Salmonella Typhi Murium and 2 cases food poisoning confirmed as Sonne Dysentery. All cases were individual and widely scattered except that in one family five persons were affected—but the infection was contained within the family. Personal Hygiene The free washing facilities in the public conveniences, which were brought into operation in September, 1950, continued to be available throughout 1956. During that period, 5,000 paper towels were issued free, and also 3,887 linen towels, which are provided at a cost of 2d. per person. Both of these issues show an increase on the 1955 figure. 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 21 for the sale of Pasteurised Milk 24 for the sale of Sterilised Milk 23 Supplementary Licences 20 Total 88 Ice Cream The Ice Cream (Heat Treatment etc.) Regulations 1947-1952. As there were no manufacturers in the Borough temperature control observations, as laid down in these Regulations, were not required. Routine work was carried out under Article 4 of the 1947 Regulations to check the conservation of ice-cream in cinemas. In one case observations had to be continued. Food Sampling The bacteriological analyses of 150 food samples taken during the year, were carried out by the Public Health Laboratory Service. 116 of these specimens were ice-cream samples, covering 9 makes of ice-cream, and following bacteriological analyses the ice-creams were graded as follows:— Excellent 60 Satisfactory 39 Doubtful 6 Unsatisfactory 11 33 During 1956, the Director of the Public Health Laboratory serving this area decided to base his sampling results on a bacteriological count in place of the Methylene Blue Test used generally as a standard throughout the rest of the country, and while this may render our statistical results less satisfactory in appearance it should result in a raised standard of purity because of the more exact measurement of contamination. Satisfactory communication has been maintained during the year with the County Public Control Department, and the report on the work carried out in Southall by the staff of that Department is as follows:— Article Total Samples Procured Unsatisfactory Milk, new 23 1 Milk, various 63 2 Bread 1 1 Butter 9 - Cakes 4 - Cooked Meats 5 - Cream 11 - Drugs 9 - Fish and fish products 35 1 Fruit, fresh 2 - Fruit, canned 4 - Fruit Juice 3 - Ice Cream 4 - Liver 6 - Margarine 3 - Meat and meat products 11 - Miscellaneous 8 - Non-brewed condiment 3 - Peas, canned 4 - Pickles and sauces 4 - Preserves 6 - Soups 2 - Suet 2 - Sweets 4 - Vinegar 7 3 Wines and Spirits 10 — Totals 243 8 Milk. A sample of new milk was deficient in fat, but follow-up samples proved to be genuine and no further action was taken. Two bottles of milk, from different sources, contained pieces of glass. Proceedings were instituted and in one case the processors were fined £5 os. od. and ordered to pay £3 3s. od. costs—in the other, the case was dismissed. Bread. A loaf of bread contained dirt and mineral oil. The bakers were issued with an official caution. Fish and fish products. Canned salmon, described on the label as "Middle Cut Salmon," was found to contain portions of tail. An official caution was issued. Vinegar. Three samples sold as " vinegar " were found to be non-brewed condiment. In one case the follow-up sample was found to be genuine and no further action was taken. In the remaining two cases, procured from the same retailer, an official caution was issued. 34 The Food & Drugs Act, 1955, in Section 47, contains new provisions concerning the descriptions which can be applied to certain substances which resemble cream in appearance but are not cream. This has necessitated the making of many inspection visits and the giving of advice to all traders likely to be concerned to ensure that they are fully aware of these new requirements. Merchandise Marks Act, 1887-1926. 132 inspections of shops were undertaken to ensure that the Marking Orders relating to certain imported foodstuffs made under the Merchandise Marks Act, 1926, were complied with. 1,126 separate displays of meat, apples, tomatoes, poultry, butter and dried fruit were examined. Verbal cautions were given in respect of minor infringements not being found so serious as to warrant more stringent action. No serious infringements were disclosed. 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 20 premises 65 articles of pre-packed food were examined. No proceedings were taken in respect of any of the infringements detected and manufacturers took immediate steps to correct unsatisfactory labels as soon as their attention was drawn to them. False or Misleading Descriptions. A considerable amount of work is carried out each year in scrutinising advertisements and the labelling of pre-packed food and taking such action as is possible to secure satisfactory amendments in those cases where a label or advertisement contains a false or misleading description of the food to which it relates. This work is of benefit to all districts of Middlesex, irrespective of where the offending advertisement or label is discovered, and during the year under review corrective action has been taken in respect of cherry wine, biscuits, chocolate Easter eggs, flour and sugar confectionery, imitation caviare, blackcurrant punch, fruit juice drinks and creme de menthe. Special Designated Milk. During the year in question one licence was issued by the Middlesex County Council in respect of the use of the special designation " pasteurised " for milk processed within your Borough. The premises were inspected regularly and compliance with the requirements of the Act or Regulations was maintained. 55 samples were taken, all of which were certified as being satisfactory. Safe Milk. In addition to the foregoing, 13 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, under the control of the North West Metropolitan Regional Hospital Board. 239 pigs were slaughtered during the year to meet the needs of the institution. During 1956 no meat was required to be surrendered as being affected by disease. There is no registered slaughterhouse or public abattoir 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. The work on the proper paving and drainage of the market area was completed during 1956, bringing this up to a fair hygienic standard. Individual food stall holders have been persuaded to keep at hand a clean supply of water, soap and towels. Inspections are made morning and afternoon each Saturday. 35 Food Premises—Inspection Food premises, including the large food factories where meat and other food are prepared for sale, are regularly inspected and the figures of food surrendered are in the appended table. The number of food premises in the Borough by type of business is shown as follows:— Shops 326 Greengrocers 50 Grocers 113 Confectioners 92 Fish Friers 11 Bakers 18 Butchers 30 Fishmongers 12 Catering Establishments (including Canteens) 124 Food Factories 18 Total 468 Premises required to be registered are as follows:— Food & Drugs Act, 1955, Section 16 Fish Curing 5 Manufacture of Sausages or Preserved Food 38 Manufacture of Ice-cream Sale only of Ice-Cream 114 Manufacture and Sale of Iced-Lollies Middlesex County Council Act, 1950, Section 11 Premises of Street Traders 20 Milk and Dairies Regulations, 1949 Dealer/Processors 1 The number of inspections of registered food premises during the year was 359. Standards in food premises generally continue to be high. One of the older cafes in connexion with which continued efforts had been made to secure improvements was demolished during the year. The direct method of education in food hygiene in the course of inspections is continued. 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 55,150¾ 5,040 — - 5,040 50,110¾ 45,365¼ 4.745½ Raw 34,972½ 26,830 562 — 26,268 8,142½ 7,125 — 1,017½ Totals 90,123¼ 31,870 562 - 31,308 58,253¼ 52,490¼ — 5,763 36 Unsound Food The following table shows items of unsound food which were investigated during the year, and the action taken. Vendor (and Source) Subject of Enquiry Action Local Dairy (bottled outside Southall) Alleged glass in bottle of milk Complaint not confirmed Local Dairy (bottled outside Southall) Alleged glass in bottle of milk Complaint not confirmed Local Bakery Alleged mildew in portion of loaf Contamination reported by Analyst to be edible grease. Delivered by Dairy outside Southall Glass in bottle of milk Warning letter Evidence doubtful. No action Local Shop (baked outside Southall) Grease (edible) in loaf of bread Warning letter Local Shop (made outside Southall) Glass in " Fish Finger " Warning letter Delivered in Southall by outside Bakery String and wood in loaf of bread Warning letter Local Dairy (bottled outside Southall) Glass in bottle of milk Warning letter. (Legal proceedings were authorised by Council but complainant refused to testify) 37 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, lead peroxide method gauges for the measurement of the sulphur gases in the air were 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. A lead peroxide method gauge was transferred from Jubilee Gardens to the Railway allotments site because of the constant complaint from the residents of neighbouring streets that heavy pollution was coming from the locomotive sheds and sidings. The results obtained from these gauges are tabulated on page 39. The figures for atmospheric pollution are better than in 1955 except for a very slight rise in Sulphur dioxide pollution in the Jubilee Gardens area. It is still, however, apparent, that the amount of grit and dust deposited from the Railway sidings is very heavy as compared with that falling in the north and south of the Borough. It is anticipated that the future alteration from coal burning to diesel and electrified systems may clear up this pollution problem, but this may be a long term cure, and meantime much effort is required to try to limit the present output of smoke and grit. There was a two day fog in January when it was thought that there was a real risk of a smoke and fog incident as in 1952, and this accounts partly for the high figures seen in the Westminster figures in the comparative graph, but Southall was not affected in so severe a manner. The Clean Air Act, 1956, which became law on the last day of the year, is under consideration by the Borough Council and by the officers of the Middlesex Boroughs in consultation. Comparison of seven years' averages at Hortus Cemetery. Total solids Deposited:— 1950 1350 1953 10.67 1951 1295 1954 14.30 1952 11 93 1955 16.94 1956 12.93 38 39 Atmospheric Pollution Estimation Month of Year Sulphur Trioxide-Lead Peroxide Method Milligrams per day per 100 square cms DEPOSIT GAUGES Rainfall in inches Tons per Square Mile per Month Soluble Insoluble Total Jubilee Gardens Recreation Ground Railway Allotments Hortus Cemetery New Primary School Railway Allotments Hortus C:m:tery New Primary School Railway Allotments Hortus Cemetery New Primary School Railway Allotments Hortus Cemetery New Primary School Railway Allotments 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 1956 1955 January 2.5 1.87 1.8 3.3I 87 39 67 29 81 43 8.41 4.79 6.02 6.11 9.04 7.24 4.89 7.41 4.35 4.82 11.34 13.02 13.3 12.22 10.37 10.93 20.38 20.26 February 1.6 1.67 3.1 2.97 2 24 0.3 17 3.0 22 2.0 4.32 4.16 2.9 1.90 4 .40 5.16 5.87 1.67 3.03 4.77 9.60 7.16 10.19 5.84 5.93 6.67 14.0 March 1.84 1.5 3.29 2.8 19 19 1 15 22 5 .79 7.I4 3.71 14.33 5.18 9.13 4.25 17.06 12.43 14.92 7.96 31.39 17.61 April 1.2 0.7 2.3 1.2 21 10 7 22 II 6.13 2.81 3.76 5.23 5.14 7.51 10.23 5.37 11.27 11.62 13.64 13.04 9.13 16.5 16.76 May 0.49 0.6 1.06 1.1 3.0 88 0.4 81 1.0 95 2.02 19 .3 1.96 15.2 2.45 12.1 7.18 8.8 5.74 6.o 10.40 10.1 9.2 28.1 7.7 21.2 12.85 22.2 June 0.36 o.5 0.89 1-3 43 44 40 41 44 46 6.13 10.95 6.51 5.8 4.69 6 .64 11.65 18.62 4.12 3.3 11.6l I4.49 17.78 29.57 10.63 9.1 16 .3 21.13 July 0.36 0-35 0.68 0.9 100 93 98 3.56 2.81 6.73 7.45 4.06 10.34 11 .01 6.89 17.07 August 0.36 0.4 0.61 1.0 106 15 93 7 100 19 12.46 7.4 6.18 3.2 9.21 3.5 8.27 11.1 4.50 6.2 9.24 I3.6 20.73 18.5 io.68 9.4 18.45 17.1 September 0.57 0.35 1.31 0.7 93 42 91 38 93 45 5.47 6.7 8.15 6.7 7.10 6.7 8.33 8.7 4.37 45. 10.38 10.6 13. 8 15.4 12.52 II.2 17.48 17.3 October 1.1 1.97 1.7 2.15 23 89 20 80 22 87 4.39 4.5 5.39 7.8 4.08 8.0 4.21 4.4 3.51 3.4 6.51 10.7 8.61 8.9 8.9 11.2 10.59 18.7 November 1.3 2 .68 2.5 2.53 10 34 8 31 10 33 4.94 5.1 5.75 7.2 4.75 7.0 7.98 8.5 3.48 4.0 6.29 11.1 12.92 13.6 9.23 I1-2 11-.04 18.1 December 1.6 1.84 2.1 2.85 65 49 63 41 58 45 5.67 11.27 8.74 7.44 9.11 9.25 4.43 8.64 5.67 4.37 16.89 9.68 10.1 19.91 14.41 II-8I 26.0 18.92 Average for Year 1. 03 0.99 1.71 1.8 2.77 50 41 43 37 46 42 5.59 7.66 5.4 6.61 6.56 6.83 7.18 9.23 4.19 4.5 10.51 11.54 12-93 1694 9.55 11.11 17.05 18.37 Graph C Atmospheric Pollution by Sulphur Oxides (Lead Peroxide Method) Lead Peroxide Gauge at Jubilee Gardens [Atmospheric Sulphur Dioxide S03(Mgs/Day/1oo/Cms2)] Lead Peroxide Recreation Ground [Atmospheric Sulphur Dioxide S03(Mgs/Day/1oo/Cms2)] Lead Peroxide Railway Allotments [Atmospheric Sulphur Dioxide S03(Mgs/Day/1oo/Cms2)] MILLIGRAMS PER DAY PER 100 SQUARE CMS. 40 Graph D Atmospheric Pollution Estimation—Deposit Gauges at Hortus Cemetery, Railway Allotments and New Primary School Total solids, soluble or insoluble (Tons per square mile per month) 41 Graph E 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. 42 Details of the observations made because of particular subjects of complaint and the results of these observations can be seen in the following table. Number of sites of observation 5 (3 deposit gauges and 2 lead peroxide gauges) Number of complaints of nuisance from smoke, 21 complaints re 15 premises smell or grit and number of premises concerned Number of places kept under observation 17 Number of half-hour observations made 51 Number of times black smoke was detected 11 Total time of black smoke emissions 52½ minutes Number of times moderate smoke observed 37 Total time of moderate smoke emissions 419 minutes 43 MISCELLANEOUS Noise Nuisance Six complaints were received of alleged nuisance from noise, three of which were from factories. All were confirmed and abatement secured without the necessity for formal 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 Non-Confirmed. 213 88 Business and Industrial 33 Domestic 180 Rats 69 Mice 66 Total number of visits in 1956, 1,119 Sewers 1st Treatment 2nd Treatment Total number of manholes baited 89 88 Number of poison takes 40 48 The increase of "takes'' in sewers over 1955 may be attributed to the substitution of the 1:4:8 routine, i.e. the setting of baits on the 4th and 8th days after the first baiting, for the 1:3:5 routine, i.e. the setting of baits on the 3rd and 5th days after the first baiting. Pet Animals Act, 1951 Six establishments were licensed during the year. Compliance with the schedule of conditions of the Royal Society for the Prevention of Cruelty to Animals was secured, and no formal action was necessary. Administration of the Shops Acts Routine inspections continued, but this work had to be kept down because of shortage of staff. River Pollution Reports of samples taken from the River Brent at the three points of junctions with the Grand Union Canal within the Borough are received from the Middlesex County Council from time to time. Establishments for Massage and Special Treatment Eight 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 4 Medical Examination of Borough Council Employees During 1956, a total of 90 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 154 members of the indoor establishment, 41 had some sick leave during the year, the total number of days of sickness being 1,366. Of the outside staff totalling 311 full-time 44 and part-time, the number of persons requiring sick leave was 184, and the total number of days of sick leave 5,406. The corresponding figures for 1955 were, 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 cutside staff totalling 252 the number of persons requiring sick leave was 198, and the total number of days of sick leave 5.047. Thtre is an improvement generally on the sickness absence figures both among the indoor staff and the outdoor staff. The reason for the hi?h number of days of sickness amongst the indoor staff was that three of the indoor staff suffered illnesses of such a major nature that each one was absent for the greater proportion of the year. 45 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 (79beds) 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. Other hospitals outside the Borough which are used to a considerable extent by patients from Southall are Hillingdon Hospital, West Middlesex Hospital, and King Edward Hospital, Ealing. The Uxbridge Chest Clinic is the regional centre to which residents of the Borough of Southall may be referred regarding chest disorders. It is also the regional centre for the diagnosis, treatment, after-care and prevention of tuberculosis (both pulmonary and nonpulmonary). Persons may be referred there by their own doctors, from 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 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, and 13, Infant Welfare Clinics King Street. Diphtheria Immunisation, Vaccination and Jubilee Gardens Centre and Whooping Cough Immunisation Clinics 13, King Street. 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. 46 (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 combined with the County Fire Service. There is an Ambulance Accident Station situated in Southall beside the Town Hall. (i) Mental Health Service The Mental Health Service deals with persons suffering from mental deficiency or mental illness. (J) School Medical Service Medical inspection and dental inspection of school children are arranged by the County Council through the Southall Divisional Executive. Medical treatment and dental treatment are provided by the County Council in the Borough as follows:— Minor ailments treatment Northcote Avenue and 13, King Street. 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. Speech therapy 13, King Street. Talbot Road School. County Council of Middlesex-Children's Department The County Council, through the Children's Department, is also concerned in caring for children deprived of a normal home life. Area Children's Officers have been appointed to deal locally with such cases as they arise. 47 APPENDICES EXTRACTS FROM VITAL STATISTICS Table I. Compara tiue Figures for Total Male Female 1955 Live Births—Legitimate 675 331 344 677 Illegitimate 38 19 19 21 Stillbirths—Legitimate Illegitimate 9 4 5 10 2 Deaths 652 324 328 642 Birth rate (live and stillbirths) per 1,000 of the estimated population 13.7 13.19 Stillbirth rate per 1,000 total (live and still) births 12.47 16.90 Crude death rate per 1,000 of the civilian population 12.25 11.92 Deaths from Puerperal Causes (Heading 30 of the Registrar-General's Short List) :— Rate per 1,000 total Deaths (live and still) births No. 30. Pregnancy, Childbirth, Abortion 1 1.39 Death rate of infants under 1 year of age :— All infants per 1,000 live births 18.23 17.19 Legitimate infants per 1,000 legitimate live births 16.83 17.19 Illegitimate infants per 1,000 illegitimate live births 26.32 — Deaths from cancer (all ages) 132 109 Deaths from measles (all ages) — — Deaths from whooping cough (all ages) — — Deaths from diarrhoea, etc. (under 2 years of age) — — 48 Causes of Death, 1956 Table II Total Total • Male Female 1956 1955[/##] 1. Tuberculosis, respiratory 5 4 9 8 2. Tuberculosis, other — — — — 3. Syphilitic disease 4 — 4 1 4. Diphtheria — — — — 5. Whooping cough — — — — 6. Meningococcal infections — — — — 7. Acute poliomyelitis — — — 2 8. Measles — — — — 9. Other infective and parasitic diseases — — — — 10/15. Cancer (all forms) 67 65 132 109 16. Diabetes 1 — 1 1 17. Vascular lesions of nervous system 29 35 64 77 18. Coronary disease, angina 53 32 85 86 19/20. Heart disease 41 7i 112 125 21. Other circulatory disease 29 28 57 42 22. Influenza 1 1 2 2 23. Pneumonia 18 26 44 56 24. Bronchitis 20 18 3» 41 25. Other diseases of respiratory system 4 1 5 5 26. Ulcer of stomach and duodenum 4 3 7 12 27. Gastritis, enteritis and diarrhoea 4 2 6 1 28. Nephritis and nephrosis 5 — 5 5 29. Hyperplasia of prostate 3 — 3 4 30. Pregnancy, childbirth, abortion — 1 1 — 31. Congenital malformations, birth injuries, etc. 3 2 5 5 32. Other defined and ill-defined diseases 21 24 45 40 33. Motor vehicle accidents 5 1 6 4 34. All other accidents 5 12 17 10 35. Suicide 2 2 4 6 36. Homicide and operations of war — — — — Total Deaths 324 328 652 642 Deaths in Wards Table III Ward Male Female Total Waxlow Manor 3° 24 54 Northcote 47 30 77 Hambrough 23 32 55 Dormers Wells 123 146 269 Glebe 61 41 102 Norwood Green 40 55 95 Total 324 328 652 49 Table IV Monthly Registration of Births The monthly registration of births classified as to Wards is given in the following table:— Waxlow Manor North cote Hambrough Dormers Wells Glebe Norwood Green Total January — 1 1 — 1 1 4 February — 2 4 2 1 2 11 March 2 6 1 i 2 2 14 April 1 4 2 3 4 1 15 May 1 2 — 1 1 2 7 June 1 4 2 3 4 1 15 July 1 - — 2 — 3 6 August 2 2 1 1 3 3 12 September — 1 3 3 5 1 13 October 1 — — 1 2 4 8 November 3 3 2 3 1 5 17 December i 3 1 4 1 3 13 Total 13 28 17 24 25 28 135 Table V Causes of Death Under One Year of Age Certified Causes of Death Under I 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. I - - 1 Cerebrospinal infections i - - - 1 - - - 1 Congenital malformations and tal heart disease I - - - 1 1 - - - 2 Prematurity 6 - - - 6 - - - - 6 Otitis media - 1 1 Icterus Gravis rhesus incompatibility 1 - - - 1 - . - - 1 Total 10 _ 1 _ 10 1 1 - 1 13 Live Births. Legitimate 675 Infant Deaths. Legitimate 12 Illegitimate 38 Illegitimate 1 50 Table VI Deaths from Cancer Year Male Female Total Estimated Population Rate per 1,000 population 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 including long stay hospital deaths 54 57 111 1953 63 57 120 54,910 2.19 1954 72 43 5 54,440 2.11 1955 60 49 10? 53,840 2.02 1956 67 65 132 53,220 2 48 Table VII Notifiable Diseases during the Year 1956 (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 - - i 6 - 4 4 5 16 44 81 3 Encephalitis — — — — — — — — — — — — — — Enteric Fever - - - - - - - - - - - - 1 - Erysipelas - - - - - - - - 3 - 2 1 6 - Food Poisoning - 1 1 1 1 2 2 1 4 1 3 - 17 - Malaria — — — — — — — — — — — — — — Measles 5 10 9 4 5 22 2 2 1 - 1 - 61 - Meningococcal Infection 2 — — — — — — — — — — — 2 — Ophthalmia Neonatorum - - _ — - - - - - — — - - — Pneumonia 4 2 6 - 6 23 - 2 12 5 23 11 94 2 Poliomyelitis: Paralytic - - - - - - - 1 i - - - 2 - Non-Paralytic - - - - - 2 - - - - - - 2 - Puerperal Pyrexia - - - - - - - 1 2 - - - 3 - Scarlet Fever - - - - 4 10 6 1 - - - - 21 - Whooping Cough 13 9 15 10 11 35 5 2 i _ 1 - 102 - Total 24 23 31 15 28 100 15 14 29 11 46 56 392 5 Poliomyelitis — Paralytic 2 confirmed cases I confirmed case Non-Paralytic I confirmed tonsillitis otitis media Food Poisoning — 12 cases confirmed Salmonella Typhi Murium by bacteriological examination 1 case confirmed Salmonella Derby by bacteriological examination 1 case notified as Enteric confirmed Salmonella Typhi Murium by bacteriological examination 2 cases Food Poisoning confirmed as Sonne Dysentery Dysentery — 66 cases confirmed Shigella Sonnei from St. Bernard's Hospital 7 cases notified as Dysentery—not confirmed 51 The number of cases of infectious diseases (including Tuberculosis) notified during the year, according to the locality, are shown below:— Table VIII Diseases Total Waxlow Manor Northcote Hambrough Dormers Wells Glebe Norwood Green Total Deaths Dysentery 81 8 2 70 1 - 3 Encephalitis - - — - - - - Enteric Fever 1 — — 1 - — — — Erysipelas 6 4 - - 1 1 - - Food Poisoning 17 1 — 1 5 10 - - Malaria - - — - - - - - Measles 61 7 5 25 12 3 9 - Meningococcal Infection 2 1 1 - - - Ophthalmia Neonatorum - - - - - - - - Pneumonia 94 10 7 8 39 17 13 2 Poliomyelitis: Paralytic 2 - - - - 1 1 - Non-Paralytic 2 — - - 1 1 - - Puerperal Pyrexia 3 1 - - 1 1 - - Scarlet Fever 21 6 5 1 4 1 4 - T uberculosis 85 13 11 8 30 10 13 9 Whooping Cough 102 9 24 21 7 29 12 - Total 477 59 53 68 170 75 52 14 Poliomyelitis Paralytic 2 confirmed cases Non- Paralytic i confirmed case i confirmed tonsillitis otitis media Food Poisoning — 12 cases confirmed Salmonella Typhi Murium by bacteriological examination 1 case confirmed Salmonella Derby by bacteriological examination 1 case notified as Enteric confirmed Salmonella Typhi Murium 2 cases Food Poisoning confirmed as Sonne Dysentery Dysentery — 66 cases confirmed Shigella Sonnei from St. Bernard's Hospital 7 cases notified as Dysentery—not confirmed Table IX Tuberculosis Notifications—Ages and Classifications Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pi lmonary Male Female Male Female Male Female Male Female 0-1 _ _ _ _ - - - 15 - - - - - - - - 5-1 - 1 - - - - 10-15 2 - - - - - - — 15-25 3 9 1 - - - - - 25-35 19 3 2 - - - - - 35-5 10 6 - - - 1 - - 45-65 14 5 - 2 - 2 - - 65+ 4 3 - - 4 1 - - Unknown 1 - — - 1 - — — Total 53 27 3 2 5 4 - - 52 The occupations of the new cases are as follows:— Occupation Pulmonary Non-Pulmonary Male Female Male Female Auditor's Clerk I _ Baker I _ _ __ Biscuit Packer _ 1 _ _ Bricklayer I _ _ _ Clerk 2 1 _ _ Convenience Attendant _ _ _ 1 Cork Processor 1 _ _ Electrical Engineer 1 - _ _ Electrician 1 _ _ _ Engineer 2 _ _ _ Factory Hand 2 _ _ _ Garage Hand 1 _ _ _ Grocery Manageress - 1 _ _ Home Help — 1 _ -- Housewife _ 12 _ _ Housekeeper - 1 _ _ Insurance Inspector 1 _ _ Labourer 6 _ 1 _ Laundry Maid — 1 _ Laundress _ 1 _ _ Loader, British Railways 1 - _ _ Local Government Officer 1 _ _ _ Mental Patient 12 5 _ _ Motor Driver 1 _ _ Metal Worker 1 _ _ _ Machinist 1 _ _ _ Mechanic 1 _ _ _ Male Nurse 1 _ _ _ Moulder 1 _ _ Nurse - 1 _ Probation Officer 1 _ _ Printing Machine Minder 1 _ _ _ Petty Officer 1 _ _ _ Progress Engineer 1 _ _ _ Retired 2 _ _ _ Rubber Worker 1 _ _ _ Schoolchild 2 1 _ Shoe Repairer 1 _ _ Student - __ 1 _ Tea Blender 1 _ - Toolmaker 1 _ _ Typist - 1 _ _ Unknown 1 _ 1 _ Widow - - - 1 Total 53 27 3 2 53 Table XI Examinations for Verminous Conditions and Children Found to be Verminous Attending Maintained Schools in SouthAll during 1955 and 1956 [School Total number of examinations 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 1955 1956 1955 1956 1955 1956 1955 1956 Beaconsfield Road, J.M. 1,166 1,039 2 1 2 1 _ _ Beaconsfield Road, I 650 555 - 2 - 1 - - Clifton Road, J.M. 910 851 2 3 1 2 - 2 Clifton Road, I. 562 471 1 - 1 - - — Dormers Wells, J.M. 770 836 1 - - - - - Dormers Wells, I. 772 519 - - - - - - Dormers Wells, S.B. 1,486 436 - - - - - - Dormers Wells, S.G. 1,696 569 5 - 3 - 1 - Featherstone Road, J.M. 888 926 4 6 3 6 2 6 Featherstone Road, I 590 400 5 - 3 — 1 - George Tomlinson, J.M. & I 1,015 1,484 1 - - - - Featherstone Road, S.B. 1,091 37i - - - - - - Lady Margaret, J.M 1,624 1,518 - - - - - - Lady Margaret, I. 989 881 1 - 1 - 1 - North Road, J.M. 1,066 997 2 - 1 — - - North Road, I. 540 549 2 2 1 2 - 1 St. Anselm's R.C. 1,378 1,098 2 1 2 - 1 - Talbot Road, Mixed - - - - - - - - Talbot Road, Specials 385 367 4 - 4 - 1 - Tudor Road, J.B. 698 1,261 - 1 - 5 - 3 Tudor Road, J.G. 648 1 - — Tudor Road, I. 819 834 1 2 - 1 - 1 Western Road, J.M. & I. 1,012 917 3 3 1 3 - 2 Western Road, S.G. 914 366 6 1 4 1 2 1 Routine Medical Inspections 1 - 1 - - - - Total 21,670 17,245 44 28 27 22 9 16 54 Table XII Sanitary Inspections—Classification of Visits Houses, Public Health Act, 1936 4,542 Houses, Housing Act, 1936-1954 306 Overcrowding 169 Disinfestation 72 Pet Animals Act, 1951 7 Vans, Sheds 10 Shops Act, 1950 115 Food Shops 370 Fried Fish 10 Cafes, etc 216 Factories (Mechanical) 143 Factories (Non-Mechanical) 11 Outworkers 32 Food Factories 205 Smoke 114 Offensive Trades - Bakehouses 11 Dairies 12 Water Sampling 2 Ice-Cream Sampling 102 Other Foods Sampling 32 Schools 9 Stables 13 Offensive Accumulations Hairdressers 1 Petrol 138 Canal Boats 1 Slaughterhouses 96 Rats and Mice 109 Infectious Diseases 174 Atmospheric Pollution 122 7,144 Table XIII HOUSING—GENERAL Statistics Housing Act, 1936—Overcrowding:— (a) (1) Number of dwellings overcrowded at the end of the year 79 (2) Number of families dwelling therein "3 (3) Number of persons dwelling therein 444 (b) Number of new cases of overcrowding reported during the year 33 (c) (1) Number of cases of overcrowding relieved during the year 37 (2) Number of persons concerned in such cases 160 (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 M Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report... _ 55