AC. 434(1)SOUTHALL 12/1/ SOUT 25 BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1957 MARGARET A. GLASS, Medical Officer of Health KINO & HUTCHINGS LTD., SOUTHALL AND UXBRIDOE BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1957 MARGARET A. GLASS, Medical Officer of Health INDEX page Ambulance Service 49 Antitoxin 21 Area of Borough 4, 7 Atmospheric Pollution 4, 40, 41, 42, 43, 44, 45 B.C.G. Vaccination 4, 18, 19 Bed Bugs 30 Births and birth rate 3, 4, 10, 50, 52 Blind and partially sighted 5.25 British Red Cross Service 23. 24 Bulletin of infectious disease 12 Canal boats 30 Cancer 3,9, 19, 20,21,28, 50,51,53 Caravans 34 Carbide 32 Care and after care 49 Catering establishments 38 Cattle market 30 Causes of death 51 Celluloid and Cinematograph Film Act 32 Certificates of Disrepair and Revocation 33 Chest Clinic 17,18,48 Children's welfare 49 Chiropody 26 Chlorination 7,8 Clean Air Act 40 Clinics 48 Club for Disabled Persons 24 Community Centre 24 Deafness 25 Deaths and death rates 3, 9, 12, 15, 17, 19, 20, 21, 29, 50, 51 Deaths in wards 51 Demolition 33 Diabetic Club 5,24 Diphtheria 4, 9, 12, 14, 15,48, 51 Disinfection 21 Dysentery 13, 53, 54 Education—Health 28 Employees' medical examinations 46, 47 Factories Act, 1937 31 Film Strip Projector 28 Food & Drugs Act 38 Food handlers' hygiene 38 Food hygiene 4, 28, 35, 36, 37, 38, 39 Food inspection 36, 37, 39 Food poisoning 35, 53, 54 Food sampling 35,36,37 Food shops 30, 38 Free washing facilities 35 Graphs 10, n, 17, 42, 43, 44 Handicapped persons 5, 23, 25 Hard of Hearing Club 5, 24 Health education 28 page Health visitors 19,21,48 Heart disease 9, 51 Holiday rest homes 27 Holidays for old people 27 Home accidents 12, 28, 30 Home Advice Group 24 Home helps 26, 49 Home nursing 23,26,48 Hospital services 48 Houses let in lodgings 33 Houses—number inhabited 7 Housing 16,33,34,57 Housing Repairs and Rents Act 33 Hygiene of food 4, 30, 35. 36, 37. 38, 39 Hygiene—personal 30, 35 Ice-cream sampling 35 Immunisation 4, 14, 15, 49 Infant mortality 3, 10, 11, 5°. 52 Infectious diseases, prevalence and control of 3, 4, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22 Influenza 3, 4, 9, 13, 28, 47, 51 Inspection and supervision of food 35, 36, 37, 38, 39 Inspection of sanitary accommodation in factories 31 Laboratory facilities and work 21, 35 Markets 30, 37 Mass X-Ray 19 Massage, establishments for 46 Maternal morbidity II Maternal mortality 11 Maternity and Child Welfare 48 Meals on Wheels 5, 26 Measles 3, 9, 12, 50, 51, 53, 54 Meat and other foods 37 Medical examinations 46, 47 Mental health 4, 5, 49 Middlesex County Council Services 4, 13, 14, 15, 25, 26, 36, 48, 49 Midwifery service 48 Milk licences 35 Miscellaneous 46, 47 Mortuary 31 National Assistance Act, 5. 47 27 Noise nuisance 46 Notifiable diseases 12, 13, 14, 15,16,17,18,19,20,21,22,53 Nursing equipment 23, 48 Old People's Welfare 4, 5, 26, 27 Ophthalmia neonatorum 15 Outworkers 31 Overcrowding 4, 30, 33 page Paddling Pool 8,35 Parks and Open Spaces 7 Personal hygiene 35 Pet Animals Act 46 Petroleum Acts 32 Physical features of the district 7 Poliomyelitis 4, 9, 12, 13, 51, , 53,54 Population 4, 7 Premature infants 3, 11 Public Control Department 36, 37 Public Health Committee 3 Public Health Inspectors 4, 6, 30 Puerperal pyrexia 11 Rag Flock and Other Materials Filling Act 32 Rateable value 7 Rats and mice 4, 46 Rehousing 33 Respiratory diseases 3,9,13,51 River pollution 46 Road accidents 9, 29, 51 St. John Ambulance Service 23 Sanitary circumstances 4, 30, 31,32 Sanitary inspection 30, 57 Sanitation in schools 30 Scabies 22 Scarlet fever 4, 12, 14, 53, 54 School Medical Service 49 Shops Acts 46 Slum Clearance 4, 33 Smallpox 4,14,21 Smoke pollution 40, 45 Social conditions 7,8 Southall Association for the Occupation of the Elderly 5,12,27 Staff 6,46,47 Statistics — General and Vital 7, 8 Stillbirths 50 Street traders 38 Sulphur dioxide pollution 40, 41, 42, 43, 45 Swimming bath 7,8 Tuberculosis 3, 4, 9, 12, 15, 16, 17, 18, 19, 48, 51, 54, 55 Vaccination 4, 13, 14, 18, 19, 48. 49 Vaccine lymph 21 Verminous persons 4, 22, 56 Vital statistics 9, 10, II, 50 Water supply and service 8, 30, 35 Welfare — General and Old People's 4, 5, 23, 24, 25, 26, 27 Whooping cough 4,9,50,51, 53, 54 THE COUNCIL OF THE BOROUGH OF SOUTHALL, 1957 THE WORSHIPFUL THE MAYOR *Councillor Mrs. I. Cavell, J.P. Deputy Mayor: Councillor J. Haigh Aldermen: f*dane, A. T. (Chairman) Gardner, F. E. t*LowE, J. Douglas, H. C. Hopkins, W. H. *Marks, F. J., J.P. Councillors: Barrett, J. Haigh, J. *Lamb, W. G. *Barton, A. J. f*Jones, Mrs. E. W. Shepherd, A. H. Cavell, Mrs. I., J.P. *Love, P. J. *Southey, P. G. *Cripps, C. B. *Rockhill, F. R. J. Steele, T. J. Day, F. R. Salmon, J. Ward, J. H. *Griffiths, Mrs. M. C. Shiel, E. J. Woodruff, J. A. T. *Members of the Public Health Committee. tMembers 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 67th Annual Report on the health and circumstances of the population of the Borough of Southall. There was a rise in the birth rate, which has been continuing to increase during the past three years. The death rate also showed an increase, principally due to the Circulatory Diseases. On the other hand, deaths from cancer were less by 12% than the number for 1956. The infant mortality rate also rose. Seventeen infants died during the year, compared with thirteen in 1956, and of this larger number, nine were prematurely-born infants, although prematurity was attributed as the cause of death in only five of these. There were 48 premature five births in 1957, as compared with 40 in 1956, and this rising figure is somewhat alarming. When it is considered how great are the facilities for pre-natal advice, care and treatment both in the local health authority clinic service, and in the hospitals themselves, one would like to know if full use is being made of them, or whether some new factor is increasing the tendency to produce immature infants. Notifications of new cases of tuberculosis were fewer during 1957, but the number of deaths from this disease rose from 9 in 1956 to 15 in 1957. Tuberculosis is a curable disease, and this rise in the death rate means that cases are still coming to light after it is too late for treatment. Measles accounted for most of the increase in the notifications of infectious disease. While measles was still on the whole mild in character, there was one death from this cause during the year. Influenza and pneumonia showed a slight increase in the number of deaths recorded. A wave of influenza reached this country from the East towards the end of the year; while investigations of particular cases never demonstrated the presence of a virulent type of 3 influenza in Southall, many people were sufficiently affected to be absent from school or work for short periods, also at the end of the year the incidence of this illness was persisting, and it seemed possible that a major outbreak could still be on the way. There were no deaths from diphtheria, whooping cough or poliomyelitis, and only one case of paralytic poliomyelitis occurred during the year. Smallpox occurred in Middlesex and it was anticipated that there would be an increased demand for vaccination against smallpox, but this did not take place. The figures for smallpox vaccination were only very slightly greater than during 1956. The figures for diphtheria immunisation were down, and are becoming dangerously low. The new poliomyelitis vaccination started by Middlesex County Council in 1956 gained momentum in 1957, and the number of sessions devoted to this form of protection were still increasing at the end of the year. Vaccination with B.C.G. against tuberculosis having been found by the results of the Medical Research Council's investigation to be actively preventive, also began to be more widely used during the year, and was offered to 13-year-old school children, and will be so offered to all school children in future on their reaching the age of 13 in order to obtain a protected adolescent population, i.e., to provide some safeguard for young persons entering industry or student life as they have been found to be particularly liable to develop tuberculosis. The notifications of tuberculosis are again showing the tendency to rise slightly, and it is noticeable that one-sixth of the new cases in Southall during 1957 were natives of India or Pakistan, who had come to live within the Borough. Nevertheless, it is a good sign of the improved position with regard to tuberculosis that Mount Pleasant Hospital, for treatment of tuberculosis in males, was closed down at the end of 1957 to be re-opened as a hospital for the care of old people. This hospital formerly a general infectious disease hospital which was no longer needed for this purpose because of the decline of scarlet fever and diphtheria, in 1949 became a hospital to treat tuberculosis, then a dangerous and increasing disease. Another unsatisfactory feature of the Report is the rise in the number of school children found to be infested with head lice. This is a scourge that it was hoped had been nearly obliterated. The routine work of the Department with regard to sanitation, infectious disease control, food hygiene, rodent control and atmospheric pollution, is severely hampered by what seems to be a permanent shortage of Public Health Inspectors. Great credit is due to our officers that they achieve so much, and the day has not yet come that an emergency is not dealt with at once. Indeed, routine work must give way to emergencies, and who can tell on what day a major outbreak may not result in the whole of the routine sanitary work having to be put aside entirely, because the inspectors are not physically able to do everything at once. The slum clearance programme is proceeding and the number of overcrowded families recorded in the Public Health Department files was lower in 1957. Many are taking the opportunity of removing to New Towns rather than wait in overcrowded conditions to be rehoused by the Council within the Borough. The atmospheric pollution records for 1957 show a pronounced improvement in the clarity of the air above Southall. As the weather was not particularly good during 1957, this could not be due to the absence of domestic fires, and can only be attributed to a general realisation by the public and by industry of the need for cleaner air. While the report on the physical wellbeing of the inhabitants of the Borough is not too satisfactory for the year, when the mental health of the inhabitants of Southall as a whole is considered in the light of the national emphasis being placed on this subject at present, there are grounds for optimism. Southall is a respectable townlet and when reports appear that the young people are undisciplined and running into danger, reference to the statistics show that the illegitimate birth rate is comparatively low and is not rising. Although a Borough with an area of only about 4 square miles and a population of 53,000, that there are over 300 voluntary Associations meeting for social, cultural or philanthropic purposes and often all three, must be quite outstanding, and this desire to be of service to 4 others is another sign of good mental health in the citizens. A great deal of good is done by the members who freely give of their time and money to these Associations. The sick, the poor, the aged, the handicapped of all kinds are being increasingly helped in this way, and the welfare section of this Annual Report shows a widening of these facilities every year. Clubs are established for the hard of hearing, the physically disabled, the diabetic, the blind and the old age pensioners, and the provision of meals on wheels for the housebound grows every year. The work scheme for old age pensioners began to function in April, 1957, and expanded from a membership of ten carrying on two types of work, to forty carrying out six types of work by the end of the year. The Centre, situated in an old Day Nursery in the Municipal Sports Ground at Spikes Bridge, will, it is hoped, provide interest in life and social companionship which will assure the mental wellbeing of those old age pensioners who come to work and may do the same also for those voluntary helpers who come to give assistance with the scheme. I would like to thank everyone in the Public Health Department for most loyal co-operation, not only in the preparation of this Report but throughout 1957, as indeed throughout the previous years. 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, Cambridge The Medical Officer of Health, Sheffield The Medical Officer of Health, 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 I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, wargaut a. Glass Manor House, Southall. Medical Officer of Health. Acknowledgments to:— 5 HEALTH DEPARTMENT STAFF for the year 1957 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: J. C. McManus, Cert. S.I.B., Cert. M. & F. (Resigned 25.4.57). A. V. Grantham, Cert. S.I.B. (Resigned 31.5.57). C. R. Southgate, Cert. S.I.B., Cert. M. & F. (Appointed 20.5.57). Additional Public Health Inspector: K. F. Keegan, Cert. S.I.B. (Resigned 23.6.57). J. T. Woolford, Cert. S.I.B. (Appointed 1.7.57). Trainee Public Health Inspectors: D. A. C. Davis. J. E. Attew (Appointed 21.10.57). 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. Piggott. 6 GENERAL STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH Area (acres) 2,607.762 Population—Registrar.General's estimate (Mid 1957) 53,000 Number of inhabited houses according to Rate Book 14,920 Average number of occupants per house 3.55 Sum produced by a penny rate £3,503 Rateable Value £864,920 The Council controls the following parks and open spaces:— Brent Meadow 8.92 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 18.00 acres Southall Municipal Sports Ground 19.78 acres Southall Park 26.77 acres Swimming Bath Site, Dormers Wells 10.50 acres The Manor House 2.00 acres West Middlesex Golf Course 108.oo 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 i.o 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 1957, the total number of persons using the bath was 46,557 (28,652 in 1956). The average number of persons attending per day (wet or fine) was 304. The maximum number at any one session was 600. 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. Although the summer of 1957 was poor in sunshine, the attendances at the bath were nearly up to peak figures, suggesting an increase in the popularity of swimming as a pastime locally. 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. During the year the use of this pool increased greatly. Water samping from the pool showed during July that bacteriological contamination was excessive, so it was necessary to close the pool for a few days for a complete overhaul and cleansing. It was arranged also that work should be done during the winter to enable a more thorough distribution of chlorine through the whole of the pool. 8 VITAL STATISTICS Total deaths, 690. (Males, 342: Females, 348.) Crude Death Rate, 13.02 (including deaths in St. Bernard's Hospital and Vine Cottage); 9.19 (excluding these deaths). For extracts from vital statistics and causes of death, see Appendix, Tables I and II. Deaths and Death Rate The death rate, i.e. the number of deaths per 1,000 total population, which had beei falling gradually each year since 1953, rose in 1956, and again in 1957, the comparativi figures being:— 1 i Year Death Rate 1953 13.31 1954 1216 1955 1192 1956 12.25 1957 . 1302 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 8.53 in 1956 to 9.19 in 1957. The principal causes of death were heart disease, diseases of the circulatory system and cancer. There was a slight rise in the number of deaths from heart disease; the number of deaths from diseases of the circulation, however, showed a very steep rise, particularly coronary disease both in males and females. On the other hand deaths from cancer dropped from 132 in 1956 to 113 in 1957. There were no deaths from whooping cough, diphtheria or poliomyelitis, but there was one death from measles—an infant of eighteen months. A rise occurred in the number of deaths from tuberculosis, the figure, which fell from 13 in 1954 to 8 in 1955, rose to 9 in 1956 and 13 in 1957. Eight people died from influenza and there was a rise in the deaths from pneumonia. 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 259 (males 139 and females 120). Deaths of institution inmates (including patients from Southall addresses and from outside areas) number as follows: St. Bernard's Hospital, 204 (males 80 and females 124); Mount Pleasant Hospital, 4 (all male); Southall.Norwood Hospital, 9 (4 male and 5 female); Vine Cottage, 9 (4 male and 5 female); in addition 6 deaths (2 male and 4 female) occurred of persons belonging to other districts and residing temporarily in Southall. In 1957, eight people died as the result of motor vehicle accidents, as compared with 6 in 1956. It is regrettable that there has not been a year free from motor vehicle accident deaths since 1954. The total number of deaths from violent causes was down on the previous year—23 in 1957 as compared with 27 in 1956. T0 make an approximate allowance for the way in which the sex and age distribution of the local population differs from that of England and Wales as a whole, the crude death rate is multiplied by a comparability factor supplied by the Registrar.General. This, then, gives a comparative death rate of 11.33, compared with the rate for England and Wales as a whole, which was 115. For distribution of deaths in the various wards, see Appendix, Table III. 9 Births and Birth Rate. (Figures for 1956 are given in brackets.) The total number of registered births in the district (as notified under the Births and Deaths Registration Act) was 167 (135). The total number of live births belonging to the district, whether occurring within or outside the district, was 794 (713). The illegitimate live births were 37 (38). There were 15 stillbirths (9), all of these being legitimate. A rise in the birth rate (live and still) is recorded from 13.57 in 1956 to 14.98 in 1957. The birth rate is the number of births per 1,000 of the total population, and the figure in 1957 is the highest since 1949, when it was 15.72. Thirty.seven illegitimate live births were registered during 1957. Th table shows the comparative figures for the past 25 years. Year No. of Illegitimate Live Births 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 1957 38 37 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 corrected live birth rate was 15.43. The corresponding rate for the whole of England and Wales was 16.1. infant Mortality Infant mortality, i.e. the number of children dying before reaching the age of one year, rose in 1957. Seventeen infants died, as compared with 13 during 1956, giving an infant mortality rate of 21 29 per 1,000 live births, as against 18.23 in 1956 Of these 17 deaths, 2 died at home and 15 in hospital. Thirteen infants (7 male and 6 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 17.7, the lowest ever recorded in Middlesex, and the infant mortality rate for England and Wales as a whole was 23.1, the lowest ever recorded in this country. It will be seen that Southall's figure is still lower than the national one, but only three other districts in Middlesex had a higher infant mortality. 10 Graph A Infant Mortality Rate from 1900 to 1957 Premature Infants Forty-eight premature infants were born during the year, 40 were born in hospital and of these, 33 were surviving at the end of one month; 8 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 5! lbs. at birth. Maternal Morbidity One case of puerperal pyrexia was notified during the year. There were no maternal deaths, and no deaths associated with abortion. 11 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES Although the total number of notifications of infectious disease was higher in 1957 than in 1956, this was entirely due to the biennial appearance of measles in epidemic form. The other figures all showed an improvement on those for 1956 except for a rise by two of the numbers notified as suffering from tuberculosis, and a slight rise in the two streptococcal infections, scarlet fever and erysipelas. The measles incidence did not rise to the high peaks reached in the epidemics of 1955 and 1953. There were no notifications of diphtheria and the poliomyelitis notifications dropped to three, two of which were subsequently not confirmed as poliomyelitis. 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 rose during the year i9s7. There was one death from measles, an infant of eighteen months. The following table shows the trend of notifications during the past ten years. Year No. of Cases Deaths 1948 825 1 1949 194 - 1950 701 - 1951 1,129 - 1952 528 1953 931 1 1954 41 - 1955 1,329 - 1956 61 - 1957 674 1 Poliomyelitis Three notifications of suspected anterior poliomyelitis were received in 1957; 1 paralytic and 2 non-paralytic. The non-paralytic cases were confirmed as not being poliomyelitis, but paralytic poliomyelitis was confirmed in the third case—the paralysis being widespread, all limbs, chest, back were affected—the patient made very good progress and has almost full use of her muscles again. 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 - - 2 12 1950 6 - 2 - 4 1951 9 - - - 9 1952 8* 2 - i 4 1953 4 - - 2 2 1954 2 - - i 1 1955 8 1 - 2 5 1956 2 1 - - 1 1957 i 1 - - - *One removed from district—information on progress not obtainable. 12 It will be seen from these figures that of 54 cases of paralytic poliomyelitis occurring during these nine years, 38 recovered completely, regaining full power of every muscle affected. The scheme for vaccination against poliomyelitis inaugurated by Middlesex County Council in 1956 was extended in 1957 and considerable progress made towards the completion of vaccination of the children registered. During 1957, 1,467 children received two injections, and that, added to the figure of 189 in 1956 receiving two injections, made a total of 1,656 considered to have satisfactory protection. As the numbers of cases of poliomyelitis in this Borough have been very small for a number of years it is not likely that any conclusions as to the efficacy of the vaccination will be available for a long time. At the end of the year there were still 1,809 awaiting inoculation, their parents having given consent for the treatment. Influenza During the first part of 1957 extensive outbreaks of influenza occurred in several countries of the Far East. The illness was of a reasonably mild nature, and the fatality rate was not high. Investigation of the organism causing this illness proved it to be a type of Virus A Influenza, and the disease spread slowly across the world in a westerly direction with some increase in the intensity of the illness as it travelled. Observation was kept on passengers travelling from the East into this country, and Medical Officers of Health were warned to look out for the occurrence of influenza in their districts. In Southall general practitioners were notified of all information received from the Ministry of Health and the Port Authorities, and several doctors agreed to co-operate by making special investigations of any case of influenza which was seen in the early stages. The arrangements were that specimens of blood and sputum would be obtained and kept refrigerated at Southall Norwood Hospital (by courtesy of the Matron) until they could be collected by the staff from Colindale Laboratory. The reason for this special way of dealing with these specimens was because of the extreme fragility of the virus outside of the human body. Arrangements were also made for schools to keep the Department informed of the figures for absence if they rose above the normal percentage of absence for the time of year. In the end of September large numbers of school children began to develop influenza-like symptoms. Although in a few cases specimens were taken, the Virus A Type influenza, colloquially labelled " Asiatic 'flu," was never confirmed in Southall, although it was found in one or two districts in Middlesex. The disease in Southall was not of a very severe character, but during the year the number of deaths attributed to influenza did rise to eight compared with the usual two or three attributed to this cause in previous years. There appeared to be little spread to the adult population until the end of the year, when the incidence of influenzal symptoms and cases of pneumonia led to a heavy demand on hospital bed accommodation, and at the end of the year watchfulness was continuing as it was feared that a heavy outbreak of the really serious type of the disease might still occur. Dysentery Twenty-eight notifications of dysentery were received in 1957. Of these, n were confirmed as caused by Shigella Sonnei, and one as Shigella Flexner. In addition, two cases notified as suspected food poisoning were subsequently confirmed as Sonne Dysentery. Seven of these cases occurred in St. Bernard's Hospital, but no outbreak occurred, rigid precautions being taken after the first positive result, in accordance with experience gained during the outbreak of 1956. Except for one family and the St. Bernard's cases, all the others were single, and in no way connected with each other, the notifications coming in from all parts of the Borough. In one family three members were affected, and it took six weeks to clear this family from infection. 13 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. There was, however, a small outbreak of smallpox within the County of Middlesex, and in July a contact at second-hand of one of the nurses at a Hospital where smallpox cases had been admitted, was visited. He was kept under supervision but did not contract the illness. In July a child with severe chickenpox was suspected by the general practitioner and was visited and specimens taken for bacteriological investigation. These turned out to be negative for smallpox. Vaccination against Smallpox The total figures for vaccination improved in 1957, but the percentage of children receiving vaccination during their first year of life dropped from 45-9 in 1956 to 45 in 1957. Re-vaccinations rose in number, but although smallpox occurred within 10 miles of Southall, there was no rush for vaccination as had been expected. 1957 Age Groups Under 1 year 1-2 years 2-4 years 5-14 years 15 years and over Total Primary Vaccination 364 28 35 48 67 542 Re-vaccination 5 11 154 170 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 Scarlet Fever (Scarlatina) The number of notifications received during the year was 34 as compared with 21 for the previous year. The infection appeared to be of a mild nature, only 4 cases were admitted to hospital for isolation and treatment, while 30 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 the same household. Diphtheria No cases of diphtheria were notified to the Department. The following information supplied by the Area 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 390 119 17 526 136 14 In the following table is shown the number of children at 31st December, 1957, who had completed a course of immunisation against diphtheria at any time before that date:— Age at 31.12.57: Under 1 1-4 5-9 10-14 Total under 15 Number immunised 153 1,929 2,901 3,783 8,766 There was a slight drop in the number of children receiving primary immunisation against diphtheria during the year. The total of protected children, i.e., children under 15 who have had at least one full course of immunisation in their lives, shows a slight increase. 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 79. Other Forms of Tuberculosis The number of new cases notified during the year was 8. Of the total notifications, 3 were received from medical practitioners; 52 from the Uxbridge Chest Clinic; 13 from General Hospitals; and 19 from St. Bernard's Hospital. Deaths from Tuberculosis Tuberculosis of the respiratory system, 13; other forms, 2. For details of new cases notified and deaths in 1957, see Appendix, Table IX, and for the occupation of new cases see Appendix, Table X. Public Health (Prevention of Tuberculosis) Regulations, 1925 Public Health Act, 1936, Section 172 Action under these powers was not necessary during the year. The number of new notifications rose from 85 in 1956 to 87 in 1957. Of the 87, 30 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 57, while in 1956 the number of inward transfers was 24, making the figure for new notifications of Southall residents 61. Although the number of new cases of tuberculosis notified during the year was slightly less than in 1956, the number of deaths rose. This is a much more disturbing figure than if the notifications rose as it is an indication that cases are still being discovered too late for treatment. The figure in 1956 was 9 deaths in total whereas in 1957 the figure rose to 15, nearly double. Of the total number of new notifications in 1957,10 were Indians, while in the previous year out of 61 new notifications, 8 were Indians. There are two possibilities here; one is that coming from areas where tuberculosis is still a grave problem the patients were incubating the disease or had already developed it when they arrived in this country, or, alternatively, conditions of living and climate in this country were such as to lower the resistance to a point where tuberculosis could no longer be resisted. A study of the deaths from tuberculosis, however, does not reveal one single death from this disease among the Indian residents, so the response to treatment must be good. Both the rise in incidence and the apparently satisfactory response to treatment are indications that early case finding should be given the highest priority and that examination of immigrants as they arrive 15 would benefit not only the community which is put at risk by the introduction of infectious persons, but the patients themselves and their families. During the early part of the year it appeared that several notifications, particularly of Pakistanis, were being received concerning workers in a particular factory just outside the Borough boundary in Hayes. By co-operation with the Medical Officer of Health of Hayes and Harlington, Dr. V. Shaw, arrangements were put in hand for a Mass X-ray survey of the factory workers, but this did not reveal that any previously unidentified cases were still working there. 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 two instances. Of these, one was living in overcrowded conditions in temporary accommodation following eviction, and one in a flat with no internal water supply. Rehousing was obtained for the first case on Public Health grounds. Of the six cases found in 1956 to be living in unsatisfactory housing conditions, two have left the district, two have gone to other accommodation, and two remain in their former dwellings, but overcrowding in one case was abated by the rehousing of another family. Second cases occurred during the year in five households, however; in one the house was overcrowded, but rehousing was carried out. 6 Graph B Tuberculosis (All Forms)—Notifications and Deaths from 1930 to 1957 Notifications Deaths For diagnostic purposes, Southall patients are mostly referred either by general practitioners or from hospital doctors to the Uxbridge Chest Clinic, and if tuberculosis is found treatment and following-up is instituted from that Clinic. The Tuberculosis Visitor calls at the home of a patient and submits a copy of her report to the Public Health Department. Contacts are seen by the Visitor and they have suitable tests, either tuberculin tests or X-rays, or both, at the Chest Clinic. If sanitary defects or overcrowding are reported further visiting is carried out from the Public Health Department. 17 Until 24th December, 1957, a hospital for the treatment of male cases of tuberculosis was maintained in Southall, the Mount Pleasant Hospital, but the demand for sanatorium treatment has been falling due to the decline in incidence of tuberculosis, and the Regional Hospital Board decided to close the hospital for tuberculosis and reopen the wards for the treatment of chronic aged sick. Patients still under treatment were transferred to other sanatoria and the out.patient clinic cases transferred to other clinics. At St. Bernard's Hospital, cases of tuberculosis are isolated in Adelaide Ward, which has 24 male and 24 female beds. One of the doctors from Uxbridge Chest Clinic continues to carry out tuberculin testing and B.C.G. vaccination of members of the nursing staff of the hospital. B.C.G. Vaccination B.C.G. vaccination is offered to contacts of cases of tuberculosis, to medical and nursing staffs of tuberculosis wards, and since 1957, as a result of the findings of the Medical Research Council in their Tuberculosis Vaccines Clinical Trial, to children aged 13 and over in Southall schools. Testing with tuberculin is carried out beforehand. The tuberculin test, if positive, shows that infection has occurred at some time during life, and further investigation is undertaken to verify whether this is active, chronic or healed infection, as these all give the same result to the test. When the tuberculin test is negative and in the absence of disease, B.C.G. inoculations are carried out in order to render the individuals tuberculin positive and, therefore, to have immunity to infection by the tuberculous bacillus. The number of children who received B.C.G. through the Chest Clinic was in total 66 during 1957, and the details are as follows:— New born babies 26 Children under 1 year 7 Children 1.4 years 9 Children 5.15 years 21 Over 15 years 3 66 Under the B.C.G. vaccination in schools scheme, details are as follows:— Number invited to take part in the scheme Number of consents received Referred to Chest Clinic Number of children vaccinated with B.C.G. Contacts Positives 432 316 7 26 227 Tuberculosis Vaccines Clinical Trial During 1957 the Tuberculosis Vaccines Clinical Trial continued. This investigation began in 1951, its object being to determine the value of tuberculosis vaccines when used on a mass scale in this country. Twenty.two North London boroughs, including Southall, and areas in the Midlands and North of England are co.operating with the Medical Research Council in the investigation. During 1951/52 pupils aged 14 in Secondary Modern Schools were invited to join the scheme, and 60,000 children eventually took part, including a number from Southall. All the children had a chest X.ray and were given a skin test to decide whether or not they are eligible for vaccination. A proportion of these who were eligible were given either B.C.G. or vole bacillus vaccine. Since then it has been the task of those administrating the scheme to keep in touch with all the participants to find out if the protection conferred by the vaccines is sufficient to make mass vaccination worthwhile. 18 One of the ways this follow up has been continued has been by annual visits to the homes of the participants. These visits have been carried out by health visitors on the staff of the local health authorities to obtain information about the health of the volunteers. The visits are also of great value in maintaining the interest which has been shown in the scheme by the participants. Another important aspect of the investigation has been the provision of a routine annual chest X-ray for the participants. This examination has been done by a Medical Research Council mobile X-ray unit. Appointments are sent to the participants to attend the unit in the evenings after work. The first progress report of this investigation was published in 1956. The findings provided unequivocal evidence of the value of tuberculosis vaccines in the prevention of tuberculosis in young people for a 4-year period after vaccination. As a result the many local health authorities who had not previously begun B.C.G. vaccination have been encouraged to initiate vaccination schemes. The results published in 1956, however, cover a relatively short period on which to assess the value of a preventive measure for a disease such as tuberculosis, because the manifestations of this disease are often slow to appear. It is hoped, therefore, to keep the young people under observation for a further period, and to continue the close co-operation in the investigation between the local health authorities and the Medical Research Council. Research into Incidence of New Tuberculosis in the Adolescent In previous reports this piece of research has been described, the purpose of it being to ascertain the amount of tuberculosis occurring during the first years in industry or office life of young persons. This is now the fifth year of the experiment and up to date no active cases have been found amongst the school leavers taking part in the investigations in Southall. Mass X-ray During the year two firms in Southall were visited by the Mobile Mass X-ray Unit, 793 persons were X-rayed, and one case of pulmonary tuberculosis was found. There is now available at the West Middlesex Hospital a static Mass X-ray Unit, the second to be introduced in Middlesex, and while primarily intended for the use of hospital patients, there is an open invitation for any member of the public to attend at any time when the Unit is working, for a check. This is a most useful undertaking and supplements the work done during the visits of the Mobile Unit which occur at intervals of from three to four years. It also saves the need, in most cases, of reference by appointment to the Chest X-ray Clinic for a large film to be taken and, therefore, must eventually effect quite a considerable financial saving. Cancer It will be seen by the table of causes of death (page 51) that in 1957 113 cases (58 males and 55 females) died from cancer. See Appendix, Table VI, for an analysis of cancer deaths since 1934. Overleaf is set out in tabular form a classification of the cancer deaths according to the site of the primary growth and in ages. 19 20 Age Groups — Male Site Total Under 10 10—20 20—30 30—40 40—50 so—60 60—70 80 4- '54 '55 '5<: '57 '54 '55 '56 '57 '54 '55 '56 '57 '54 '55 '56 '57 '54 '55 '56 '57 '54 '55 *56 '57 '54 '5 '56 '57 '54 '55 '5 '57 '54 '55 '56 '57 '54 '55 '5tf '57 Lung 20 18 29 24 - 1 - - - 1 - - - - - 1 -1 1 - 1 - 2 - 8 4 9 5 4 5 T7. 13 4 5 5 5 2 - - 1 Stomach 10 14 4 6 - - - - " - - - - - - - - - - - -" 2 - - 1 1 - 1 5 7 I 3 3 4 2 2 I - 1 - Intestine 14 1 1 9 9 - - - - - - - - - - - - - - - - 1 1 - - 1 3 -—- b Bladder 2 2 1 1 - - 1 1 - -- 1 1 1 - --- -- - Prostate 1 3 2 — - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1 1 2 -—- -— 1 - — Breast Other 24 12 22 18 1 - 1 1 1 - - 1 - I 3 3 2 2 1 2 9 4 2 2 6 3 3 5 5 I 7 2 - 1 4 2 Totals 72 60 67 58 1 - - - 1 1 1 1 - - 1 1 2 4 3 4 6 3 2 20 12 12 I 19 21 21 .8 17 21 13 4 2 5 6 Age Groups — Female Site Total Under 10 IC—20 20—30 30—40 40—50 50—60 60—70 70 80 80 + '54 '55 '56 '57 '54 '55 '56 '57 '54 '55 '56 '57 '54 '55 '56 '57 '54 '55 '56 '57 '54 '55 '56 '57 '54 '55 '56 '57 '54 '55 '56 *57 '54 '55 '56 '57 '54 '55 '56 '57 Breast 17 6 t6 10 - - - - - - - - - -- 2 - 1 - 2 2 1 1 5 2 4 2 3 6 1 3 1 4 4 3 - 2 - Lung 2 3 5 7 - - - - - - - - - - - - I - - - - - 2 - 2 2 I 1 1 - I 2 - 2 Stomach 5 9 s 3 2 1 2 x — — — — _ _ Uterus 3 5 6 4 T 1 I 3 1 1 - ?. 2 _ _ Intestine 6 15 11 13 - 3 - 2 1 2 3 S 3 3 3 1 t 5 _ Bladder — Other 10 9 19 18 i - 1 i 5 1 - 1 t 5 2 4 7 4 4 4 3 5 3 - 3 i Totals 43 49 65 55 - " - - - - - 1 - - - - 2 i 2 1 3 7 10 7 8 7 7 4 8 15 23 10 16 10 14 7 6 9 9 5 The total number of deaths from cancer in 1957 fell, being 113 as compared with 132 in 1956. Cancer of the lung in males, although the highest individual figure for site of disease, was five less than in 1956. 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 183 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 the doctor who has submitted the specimen from one of his patients. Details of the work carried out in 1957 are as follows:— Faeces specimens 230 Sputum specimens 3 Blood specimens 10 Urine specimens 44 Swabs (nose, throat, ear and rectal) 53 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 10 Eiderdowns 9 Beds 11 Pillows 27 Blankets 25 Plimsolls (routine disinfection Mattresses 11 during holiday for Feather- Sheets 14 stone Road School) (pairs) 105 Books 19 Miscellaneous articles - Three Wards at Mount Pleasant Hospital, on change of ward use from Male Tuberculosis treatment to Geriatric treatment. 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. 21 Scabies and Lice During 1957 one case of infestation with body lice, and one person suffering from scabies were brought to the Public Health Department for cleansing. Baths and treatment were arranged at Hammersmith Cleansing Station by courtesy of Hammersmith Borough Council. Table XI gives details of head inspections in schools. The figures here are somewhat disappointing. For the last few years it has been possible to record an improvement in the number of children found to be infested with vermin, but in 1957, although 3,000 fewer children were examined, the number found to be infested rose from 28 in 1956 to 68 in 1957. 22 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; Miss E. Hobson, 20, Elmfield Road, Southall, Acting Superintendent, Nursing Division, 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 and First Aid to the Injured. It also lends Nursing equipment for use in the home from the Medical Comforts Depot in Hartington Road, open every evening (except Sunday and Bank Holidays) from 7.30 p.m. to 8.30 p.m. for the issue of articles needed by the public. During the year 469 articles were lent under the scheme—a considerable increase over the 1956 figure of 369. Welfare—General. The St. John Ambulance Brigade carried out trainings in First Aid and Home Nursing for all who cared to take advantage of the service, also special courses for Civil Defence Volunteers and for Scouts and Guides. The members of the Nursing and Ambulance Divisions carried out many other duties including attendance at local cinemas, sports, fairs, Old Folks' Clubs, accompanying old people's group excursions to the seaside, Hospital duties, Camp duties with Girl Guides and Brownies, also Sick Visiting. Members also took part in duties further afield, including London Airport, London theatres, concerts, etc. British Red Cross Society: Southall became a Division on its own once again, when it was separated from Ealing in October, 1956, and Mrs. M. Jerden-Cooke appointed Divisional Director. The small building in the Park, hitherto used only for the distribution of Medical Loan Equipment, was made habitable by the end of the year, following a vain search for more suitable Headquarters. Formerly known as "The Hut," it was renamed "The Green Door," and was soon in use for First Aid lectures, meetings, and general office work, and on the last day of January, 1957, the Handcraft Club for Disabled People was opened, and has steadily increased its membership during the year. Basket-work made by the Club, and entered in the Show held during the Borough's Charter celebrations in August, took all three prizes in its class, and was greatly admired. Throughout the year, the Division has endeavoured to carry out its many and varied activities, in spite of small membership. The one Detachment has worked hard to support the newly formed Division, and there is a strong link of the Junior Red Cross at the Western Secondary Girls' School. Some of the young members assist at the quarterly Blood Donor Sessions, which are held at the Shackleton Hall. They also help at the local Hospital at week-ends. Home-Nursing lectures are held at St. Bernard's Hospital training-school, by kind permission of Matron, the Detachment's Nursing Superintendent. Activities in the Borough include:— Instruction in First Aid, Home Nursing and the training of candidates for the National Hospital Service Reserve. Provision and carriage of books to house-bound tuberculous patients. Welfare visits. Hospital library facilities. Nursing in the home. Escort duties to and from Hospital for the sick, aged, blind people and children. 23 Transport for the sick when requested. Clerical work and other assistance connected with Blood Donor sessions. Handcraft Club for the Disabled. After-care and emergency help (in meeting their needs) to disabled ex-Servicemen. Club for Disabled Persons: A Club, for persons suffering from severe disablement, met weekly and was a social and recreational one for people suffering from any physical handicap. 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 22, the total membership being 28. Members make themselves useful to the Community Centre staff in little ways, and this is of considerable therapeutic value. The Hard of Hearing Club: This Club, which was inaugurated in 1955, continued to make extremely good progress. The membership rose to 130. The Committee is very energetic and the programmes arranged for the members were varied, interesting and often directly useful in helping them to come to terms with their disability. There was an average attendance at each meeting of 70-80. The Club met every Wednesday and there were 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. The programme was arranged so that nearly all the members, many of whom have been deaf or have had limited hearing since childhood, became able to take an active part in the Group and in the work of the Middlesex and Surrey League for the Hard of Hearing. Members who when they first joined the Club were unwilling to come forward in any way because of their disability gradually came to take an active part in the group activities and as a result were able also to live a much fuller life outside of the club. The Welfare Committee continued to do excellent work and they did not only cater for the members, but also for any person in the Borough suffering from deafness or defective hearing. In the past year many have been helped and given advice on hearing aids and how to get the maximum benefit out of the aids. The hospital where Medresco aids are supplied was very co-operative, the group programmes being displayed in the waiting rooms of that hospital. Diabetic Club: The Club for Diabetics, started in 1956, continued to function throughout 1957. This Club was founded to enable sufferers from diabetes to meet together socially, to have the opportunity to discuss their individual problems with fellow sufferers and to hear authoritative talks from speakers particularly interested in diabetes such as doctors, nurses, nutrition experts. The membership continued high and the monthly attendance at meetings was 40-45. Home Advice Group: This Group, created for the purpose of assisting and advising mothers with problems, continued to function throughout the year. Meetings were held weekly in a room at The Grange, The Green, and a programme of interesting discussions, demonstrations and specialist speakers planned by the Co-ordinating Committee responsible for the Group, was carried out during the year. The Group is assisted financially by the Housing Committee of the Borough Council. The membership, though small, reaching during the year about 12, showed an average attendance which was indicative of the interest taken in the activities at the meetings. The original leader of the Group resigned, and another leader took her place. Great interest is taken in this group by the London Council of Social Service who obtained the new leader for the Group and who sent speakers from time to time. 24 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 101 blind and 15 partially-sighted persons. One blind person is training, and 13 are in full-time employment. Of these, 2 are in Workshops for the Blind, and 1 is working as a Home Worker under the scheme of the National Library for the Blind, all 3 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. 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 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 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 with 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 rehabilitation, 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, etc., 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. 25 Old People The needs of 28 special cases of old people living in difficult circumstances were investigated during 1957, and what happened to them is recorded in the following list:— Admitted to hospital 5 Admitted to old people's home 4 Remaining at home 17 (a) Home Help provided 2 (b) District Nurse provided 1 (c) Meals provided 1 (d) Refused all help 1 (e) Short term requirements only, i.e. transport, coal, etc. 11 (/) Awaiting entry to Home 1 Died at home 2 The difficulties of the old persons recorded on this list were brought to the notice of the Public Health Department staff either by medical practitioners, interested relations, neighbours or friends, or following complaint by one or other of the statutory authorities. One old person who was brought to the notice of the Department in 1956 was admitted to a County Council home during 1957. 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 1957 was 35. These cases are not usually brought to the notice of the Public Health Department staff undl 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 one who refused all assistance. This lady, who had been refusing help since 1955, had to be kept under observation from time to time so that any change in her condition likely to cause a public health nuisance or to endanger her life could be discovered quickly and compulsory powers used if all else failed. These cases always present great difficulty as it is important to ensure that while individuals are aware of all the facilities which are available for them there should be no interference with their liberty of action so long as they are of reasonably sound mind. Tribute must be paid to the excellent work of the 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 333 Southall people were given Home Help during the year and of these 258 consisted of chronic sick or aged persons, and of 743 persons who were assisted by the Home Nurses, 372 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 housebound old people in need of the service. During the year 7,363 meals were delivered, an increase of 645 over the 1956 figure. The number of old people receiving the meals at any one time was 37-40. The present service is not large enough to deal with a greater number. The cost of the meal was 9d. to the recipient, and for each meal Southall Borough Council made a grant of 1/-. Meals were obtained from the School Canteens and conveyed in a van owned by the Old People's Welfare Association. Chiropody Service for Old People: This service was continued throughout 1957. Five local chiropodists gave their services at cheap rates for Old Age Pensioners. 26 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 1957, and was operated by the various Old People's Clubs in the Borough. In addition 50 old people were given a free holiday as part of the Southall Borough Charter Anniversary Celebrations. Other Services: A service for the provision of cheap laundry and a cheap boot and shoe service are available. The North Thames Gas Board offers a free service of inspection of the gas appliances and service pipes in houses of old age pensioners living alone. The reason for this is to reduce the risk of gas poisoning, a frequent cause of home accidents and fatalities in old people. The offer includes free replacement of faulty pipes and the free repair of faulty appliances. To take advantage of this offer, lists of old people living alone are submitted from the Public Health Department and in due course the homes of the persons nominated on the lists are visited by the Gas Board officers. Fresh lists continued to be supplied from time to time during 1957. Southall Association for the Occupation of the Elderly: This Association which had been formed in 1956, as stated in the Annual Report for that year, in April, 1957 succeeded in starting a Work Centre for the occupation of old age pensioners in a part-time capacity. The purpose of the scheme was social and for rehabilitation, as the problems of loneliness and lack of interest among old people who feel they have dropped out of the stream of life were in need of urgent attention. Funds were obtained from charitable institutions, the Middlesex County Council and Southall Borough Council promised financial support and Southall Borough Council provided an attractive Work Centre situated in the Municipal Sports Ground, one of the public open spaces. The building had been a Day Nursery formerly, and was very easily adapted for the purpose required. The obtaining of work was at first a difficult problem, but this became a little easier after an Organiser had been appointed to take charge of the Centre. Various types of simple work were carried out by the old people in quite a satisfactory way, indeed as the firms supplying the work were expected to pay the proper rate for work, it was essential that the work should be completed to their satisfaction. The numbers of workers starting from 10 increased by the end of the year to 40, and the types of work from two simple processes, one of carding buttons and the other of sorting mixed metallic wastes from a large engineering company, increased so that at the end of the year six types of work were being provided and the old people could be put on the jobs which were most suited to their capabilities. Any old age pensioner was eligible to apply for work and once taken on was kept on whether his or her output could be considered significant or not. It was realised by the workers that a flat rate of 10/- per week for a ten hour week was certainly much less than the younger healthy pensioner would be able to obtain in the labour market, but they also realised that as they grew older or ill and less able to do very much work this wage would not alter. The scheme can never become self-supporting, but it is already showing great benefits in the social and even physical well-being of the people who are working. The friendly and happy atmosphere in the work rooms is quite a remarkable thing to see, and so is the individual improvement of newcomers seen on their first entry when asking to join the scheme and again a few weeks later. National Assistance Act, 1948, Section 47: National Assistance (Amendment) Act, 1951: No case was dealt with under these powers during 1957. 27 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. The principal topics during the year for poster publicity were prevention of colds and influenza, food hygiene, the benefits of sleep, fresh air and exercise, the danger from broken milk bottles, and home safety, i.e. prevention of fire accidents and accidents to old people by falling. In addition a poster concerning cigarette smoking and cancer prepared by the Central Council for Health Education having been brought to the notice of the Public Health Committee was referred to the Divisional Executive with the suggestion that it might be useful for schools. The poster was displayed in the schools of the Borough and comments obtained afterwards from staff and children were very interesting in showing the reactions to sensational publicity. The children appeared to take this in their stride, but it is doubtful whether the poster was likely to influence them very much either way with regard to developing the habit of smoking. The staff appeared to consider that the older children would have this reaction and were on the whole adverse to the showing of this type of propaganda poster to younger children. 28 ROAD SAFETY The number of motor vehicle accidents occurring within the Borough of Southall was greater than in 1956. Seven persons, two of whom were children, were killed in street accidents. Six of these fatal accidents were on the main traffic roads, one only was in a second class road at the junction with another. Four were pedestrians, two pedal cyclists and one a motor cyclist and the details are as follows:— Persons Killed Type of Road User Cause of Accident Age Sex * Pedestrian Pedestrian crossing road knocked down by passing private motor car 76 M Pedestrian Pedestrian crossing road struck by private motor car 65 M Motor Cyclist Private motor car collided with motor scooter at "T" junction 23 M Pedal Cyclist Pedal cyclist fell from machine whilst passing stationary lorry 44 M Pedal Cyclist Collision between London Transport Executive double decker bus and goods truck causing bus to lose control and hit pedal cycle parked by kerb and then boy pedal cyclist 12 M Pedestrian Pedestrian crossing road from North to South on uncontrolled pedestrian crossing knocked down by private motor car travelling East 73 M Pedestrian Child escaped from control and ran from west pavement into path of car travelling south 5.11/12 M Persons Injured Adult School Age Under 5 Serious Slight Serious Slight Serious Slight Pedestrians 20 35 2 9 - 4 Total 55 Total 11 Total 4 Pedal cyclists 10 60 3 9 - - Total 70 Total 12 Total - Private motor car passengers 4 21 - 1 - 1 Total 25 Total 1 Total 1 Private motor car drivers 1 10 Total 11 Motor cyclists 11 80 Total 91 Drivers of other vehicles - 11 Total 11 Passengers in other vehicles 5 44 - 4 Total 49 Total 4 Fatalities Adult Total 312 Children Total 33 Adult Total 5 Children Total 2 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 maintained a full programme of education in road safety in which the Metropolitan Police took an active part. The Southall school children received constant training and exhortation on the use of roads. For the four previous years it had been possible to report that no child died in Southall as a result of a road accident, but this satisfactory state of affairs has not been maintained. There were fewer children injured on the roads, i.e. 33 as compared with 55 in the previous year, but the adult total of persons injured whether seriously or slightly was increased from 289 to 312. Of the seven dying as a result of motor accidents in Southall four were Southall residents including the two children; four other Southall residents died as a result of motor accidents received when they were away from home. 29 HOME ACCIDENTS The number who died as a result of accident other than motor vehicle accident fell from 17 in 1956 to 9 in 1957, and of these accidental deaths only one occurred at home— a man of 81 who fell at home and sustained a fractured pelvis and subsequently died. 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. One sample of tap water was taken by Departmental staff by request of the householder and found to be satisfactory. Seven bacteriological and seven chemical samples were taken from artesian wells in the Borough. All were satisfactory. Sanitary Inspections of the District The total number of inspections of premises made during the year by the Public Health Inspectors was 6,948. The number of inspections showed a slight decrease in 1957. Visits to food premises rose considerably, but there was a smaller demand for work on overcrowding and vermin infestation, and for inspections following complaints of housing defects. A good deal of attention was required at the Market in the High Street where a weekly horse and cattle sale is held on Wednesdays and a general sale of produce and goods is held on Saturdays. The result of much visiting produced considerable improvements in hygiene. Table XII gives an analysis of the number and nature of such inspections. School Sanitation Forty 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 1957. 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 6 (1) found to be infested 3 (2) disinfested during the year 3 Canal Boats No work was necessary on canal boat inspection during the year—the main docks for the boats on the Grand Union Canal are in the two neighbouring boroughs, so that routine inspections are carried out there while the boats are stationary. 30 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. Two hundred and fifty-seven 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 Borouch:— Inspections Factory Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted Non-Mechanical 17 17 - - Mechanical 155 188 1 - Totals 172 205 1 — Defects Found Particulars Number of cases in which defects were found Found Remedied Referred Number of cases in which Prosecutions were instituted To H.M. Inspector By H.M. Inspector Want of cleanliness - - - - - Overcrowding - — — — — Unreasonable temperature - — — — — Inadequate ventilation - — — — — Ineffective drainage of floors - — — — — Sanitary Conveniences— (a) Insufficient - — — — — (b) Unsuitable or defective 8 7 — 3 — (c) Not separate for sexes 1 - — 1 — Other offences against the Act (not including offences relating to outwork) — — — - - Totals 9 7 — 4 — Outworkers Nature of Work Section 110 Section 111 No. of outworkers in August List required by Section no (1) (c) No. of Cases of Default in sending Lists to the Council No. of Prosecutions for failure to supply Lists No. of Instances of Work in Unwholesome Premises Notices served Prosecutions Wearing Apparel—Making 16 - - - - - Lampshades 1 — — — — — Totals 17 — — — — — 31 The Rag Mock and Other Filling Materials Aet, 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. Petroleum and Carbide During the year licences were in force in respect of 64 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 two licences in force for the purpose of stripping and making celluloid solution from cinematograph films. Inspections have revealed no infringements. 32 HOUSING Of the 83 houses recommended for slum clearance in the provisional programme for the years 1955 to i960, the majority are now either demolished or under sentence of demolition as soon as all occupying families have been housed. Properties already dealt with on the list submitted to the Ministry of Health are:— Numbers 1 and 2, Bells Cottages, and 1 to 6, Pluckington Place Numbers 1, 2, 3 and 4, Killarney Cottages Demolished 12 Numbers 5 to 18, Featherstone Terrace Awaiting demolition 14 Numbers 6 to 16, Spencer Street Demolished Numbers 2 to 4 and 18 to 28, Spencer Street Awaiting demolition 14 Dagmar Cottage Allowed to remain provided no human habitation Numbers 9 to 15, The Crescent Awaiting demolition 15 One cottage was brought up to suitable standard by the owner and is still inhabited. Certificates of Disrepair During the year 60 applications have been received, of which 17 were granted. There was also one application for Certificate or Revocation which was granted. Overcrowding The number of persons asking for assistance in obtaining housing on grounds of overcrowding was as high as in 1956, 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 from 79 in 1956 to 56 in 1957. Rehousing of Applicants for Council Dwellings Council Housing within the Borough Total number of families obtaining Council accommodation for the first time in 1957: 57 families, including 16 from Slum Clearance Areas. New Town Housing The total number of families removing to New or Expanded Towns: 25 families nominated under the Industrial Selection Scheme up to April, 1956, since when the Council has had to pay subsidy for every family moving from this Borough to New or Expanded Towns. The total number of families who have moved to New or Expanded Towns since that date is a further 133. 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. The number of houses owned by coloured immigrants and occupied by them as lodging houses had reached a figure of 48 by the end of 1957. Control by the application of Section 90 of the Housing Act, 1957, is continued. 33 Middlesex County Council Act, 1944—Section 345 The caravan site at the junction of Regina Road and Pluckington Place continues to be used as the winter quarters of a member of The Showmen's Guild. One of the two families occupying caravans near the Grand Union Canal has been rehoused. 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 1957 Since the end of the War (including 1957) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Dwellings — — 35 - Houses — — 310 136 Flats 15 — 354 132 Prefabricated Houses - - 299 - Built by Private Enterprise During the Year 1957 Since the end of the War (including 1957) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Bungalows 1 - 17 - Houses 2 — 225 — Flats 30 — 78 - Prefabricated Houses - — - - HYGIENE OF FOOD Food Poisoning Of the 9 cases notified as food poisoning, 4 were not confirmed as bacteriologically so. With regard to the other 5, 4 were members of one family and all returned specimens positive for Salmonella Bredeni, the other single case was one of Salmonella Typhi Murium. No spread of infection took place from any of these persons and the family was pronounced clear of infection after 16 weeks, and the single case after 1 week. Personal Hygiene The free washing facilities in the public conveniences, which were brought into operation in September, 1950, continued to be available throughout 1957. During that period 10,600 paper towels were issued free, and also 3,878 linen towels, which are provided at a cost of 2d. per person. The paper towel issue has doubled during 1957. 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 22 for the sale of Pasteurised Milk 25 for the sale of Sterilised Milk 23 Supplementary Licences 20 90 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. Food Sampling The bacteriological analyses of 198 food samples, taken during the year, were carried out by the Public Health Laboratory Service. 144 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 54 Satisfactory 75 Doubtful 4 Unsatisfactory 11 35 samples were taken of Imitation Cream. The results of these were all satisfactory, except on three occasions when there was a slight increase in the Plate Count, but to a very small degree. Seven samples of Egg Albumen were tested. On two occasions Salmonella Typhi Murium was found and the offending material was confiscated. Seven samples of Artesian Well water and one of tap water, and three samples of water from the Paddling Pool were tested during the year. The water from the Paddling Pool having been found to contain organisms, no further samples were taken until the Pool had been closed, cleansed and refilled. Subsequent tests were satisfactory. The remaining sample was of the washings from ice cream preparation and was satisfactory. The Artesian Well water was subjected to chemical analysis as well as bacteriological, and there was no evidence of pollution following either test. 35 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) 34 12 Milk (various) 70 - Bread Roll 1 1 Butter 2 - Cakes 7 — Cheese 2 1 Cooked Meat 3 1 Cream 5 — Fish and Fish Products 6 — Fruit (fresh) 6 2 Fruit (canned) 12 - Fruit Squash, etc 2 - Garden Peas 11 - Liver 2 - Meat and Meat Products 6 - Preserves 4 - Sausages and Sausage Meat 7 - Spirits 2 - Sweets 2 - Vinegar 5 - Miscellaneous 21 - Totals 210 17 New Milk. 11 of the unsatisfactory samples were from one farmer who was consigning milk to a Depot in this district. The samples were found to be deficient both in milk fat and solids-not-fat. There was no evidence of any added water. The attention of the farmer concerned was drawn to these deficiencies and the circumstances were also reported to the Milk Marketing Board in order that the farmer might receive the benefit of the Board's advisory service. Another sample of new milk from a different farmer was found to be slightly deficient in milk fat. Associated samples from the same source were all found to be satisfactory and no further action was called for. Fresh Fruit. A retailer was found to be describing Dunn's Seedlings as "Newtown" apples. Proceedings were instituted and the retailer was fined £3. There was a further summons against this trader for falsely describing Packham Triumph pears as "Williams." He was also fined £3 for this offence and ordered to pay costs of £2 2s. od. The proceedings in respect of the pears were instituted without a sample having been procured. A sample of lemons imported from California was found to have the rinds treated with a fungicide and preservative, the use of which is prohibited in this country. A full investigation was made into this matter when it was found that no offence against the above Act had been committed in Middlesex. The importers concerned were written to and full information given to the Ministry of Agriculture, Fisheries and Food. Bread Roll. A sample of a bread roll was found to contain a small quandty of oil and grease. This was in no way harmful and had come from the machinery used in the bakery. Such machinery is invariably lubricated with grease specially manufactured for this purpose and which is harmless. An official caution was sent to the baker concerned. 36 Meat Products. A sample of black pudding was found to contain a pig's eyelashes. Investigations indicated that this inclusion was the result either of the incomplete preparation of a pig's head or by the eyelashes accidentally falling back into the mixture during the skinning of the pig's head. The Public Analyst for Middlesex certified that this foreign matter was quite harmless although objectionable. A letter of caution was sent to the manufacturers. Cheese. A sample of a cheese spread was found to bear a label which was likely to mislead as to the fat content of the cheese. A letter was addressed to the importers concerned who took immediate steps to secure a satisfactory amendment of the label. Merchandise Marks Acts, 1887-1953. 67 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. 171 separate displays of meat, apples, tomatoes and dried fruit were examined. No serious infringement was disclosed and verbal cautions were given in respect of those minor infringements which were detected. The Labelling of Food Order, 1953. At 71 premises 255 articles of pre-packed food were examined to see that they bore a label which gave a clear statement of the designation of the food and, in the case of compound foods, the ingredients, and also the name and address of the packer or labeller. No infringement of this Order was detected. False or Misleading Descriptions. As in previous years a considerable amount of work has been done in the detailed scrutiny of advertisements and the labels on pre-packed foods, and taking suitable action 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 the whole County irrespective of where within the County offences may be detected. During the year under review corrective action has been secured in respect of salmon with potato salad, crystallised jelly pineapple slices, pure egg mundelech, cherry juice, lime juice, imitation cream filled biscuits, cream filled Easter eggs and cheese. In every case the person responsible agreed to make necessary suitable amendments to labels as a result of representations. In no case was it necessary to institute proceedings. Special Designated Milk. During the year in question 2 licences were issued by Middlesex County Council in respect of the use of the special designation "Pasteurised" for milk processed within this area. Each of these premises was regularly inspected and compliance with the requirements of the Act and of the appropriate Regulations was maintained. 37 samples of pasteurised milk were taken and 3 of these were certified as not being satisfactory. 2 failed to pass the phosphatase test for heat treatment and the third failed to pass the methylene blue test for keeping quality. An official caution was sent in respect of each of these breaches of licence conditions. Safe Milk. 15 samples of raw milk were procured in this district and submitted to test for the presence of tubercle bacilli. All were found to be free of such contamination. Meat Inspections There is a slaughterhouse at St. Bernard's Hospital, under the control of the North West Metropolitan Regional Hospital Board. 166 pigs were slaughtered during the year to meet the needs of the institution. During 1957 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 weekly on Wednesdays and a general weekly market on Saturdays. Work on improving the hygienic standards of this market was completed in 1956 and in 1957 routine inspections were maintained at least twice weekly to ensure the maintenance of good standards. 37 Food Premises—Inspection High priority continues to be given to this work and although the staffing position remains unsatisfactory, the number of visits paid to food premises show an increase of some 25% over 1956. The standard of premises, equipment, and hygiene continues to be generally good. One sub-standard cafe ceased to operate during the year. The number of food premises in the Borough by type of business is shown as follows:— Shops 326 Greengrocers 48 Grocers 115 Confectioners 93 Fish Friers 11 Bakers 17 Butchers 30 Fishmongers 12 Catering Establishments (including Canteens) 126 Food Factories 18 470 Premises required to be registered are as follows:— Food & Drugs Act, 1955, Section 16 Fish Curing 7 Manufacture of Sausages or Preserved Food 26 Manufacture of Ice-cream - Sale only of Ice-Cream 116 Manufacture and Sale of Iced-Lollies - Middlesex County Council Act, 1950, Section 11 Premises of Street Traders 15 Milk and Dairies Regulations, 1949 Dealer/Processors 1 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 38,668½ — - - — 38,668½ 19,163½ - 19,505 Raw 25,991½ 19,453 - - 19,453 6,538½ 4,812 — 1,726½ Totals 64,660 19,453 - — 19,453 45,207 23,975½ — 21,231½ 38 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 n Local Shop(made outside Southall) Glass in jar of jam Warning letter Local Shop(made outside Southall) Mould in piece of pork pie Warning letter Delivered by local bakehouse Grease in loaf of bread Edible grease. Warning letter Local Shop(made outside Southall) Mould in meat pies No action following correspondence and discussions with retailer and manufacturer Local Shop(bottled outside Southall) Foreign material in mineral water Material consisted of fragments of filter pads. Letter to manufacturer 39 ATMOSPHERIC POLLUTION The instruments set up at five sites for the recording of Atmospheric Pollution continued to function throughout the year and it is pleasing to note that during 1957 the highest amounts of deposit recorded on every site were considerably below the highest amounts recorded during the previous year. Taking the year as a whole, the greatest improvement was found at the Hortus Cemetery site, but there was a definite reduction on the Railway Allotments site, which had been the source of trouble for some years. During the year a considerable planting of young Poplar trees was made on the edge of the Railway property in order to provide a preventive screen in the future for the houses which were most severely affected by smoke and grit from the railway sidings. The results obtained from the five sites, i.e., Recreation Ground and Railway Allotments, lead peroxide method; Hortus Cemetery, New Primary School, Railway Allotments, deposit gauges; are tabulated on page 41 and graphs prepared from the figures on the tables are to be found on pages 42-44. Comparisons with three other places, i.e. Westminster, Cambridge and Sheffield, show that while Southall has to improve a good deal before it can be classified as atmospherically even moderately pure, the figures are lower than an industrial area and in the centre of London, although in Westminster a smoke control area is already established. Work was carried out during the year on various sections of the Clean Air Act, 1956, and the Council gave consideration to the possibility of declaring a smoke controlled area. At the end of the year no decision had been reached as to the siting of this. Observations on individual factory chimneys seeming to be emitting smoke or grit to excess continued throughout the year, and while no major infringements requiring legal action took place, various improvements were called for. It is likely that the continuing work done in this respect has resulted in the improved figures shown overall in the table. Comparison of seven years' averages at Hortus Cemetery. Total solids Deposited:— 1951 12.95 1954 14.30 1952 11.93 1955 16.94 1953 10.67 1956 12.93 1957 10.66 40 41 Atmospheric Pollution Estimation Month of Year Sulphur Trioxide Lead Peroxide Method, Milligrams per day per 100 sq. cms. DEPOSIT GAUGES Rainfall in Inches Tons per Square Mile per Month Soluble Insoluble T otal Recreation Ground Railway Allotment Hortus Cemetery New Primary School Railway Allotment Hortus Cemetery New Primary School Railway Allotment Hortus Cemetery New Primary School Railway Allotment Hortus Cemetery New Primary School Railway Allotment 957 1956 1957 1956 1957 1956 1957 1956 1957 1956 1957 1956 1957 1956 1957 1956 1957 1956 1957 1956 1957 1956 1957 1956 1957 1956 1957 1956 January 1.5 1.8 2.9 37 87 38 67 31 81 6.0 8.41 5.4 6.02 8.1 9.04 8.2 4.89 4.7 4.35 14.0 11.34 14.2 13.3 10.1 10.37 22.1 20.38 February 3.5 3.1 2.1 68 2 67 0.3 62 3.0 6.3 2.0 7.9 4.16 6.3 1.90 7.0 5.16 4.5 1.67 12.4 4.77 13.3 7.16 12.4 5.84 18.7 6.67 March 3.7 3.29 2.6 24 19 23 1 22 15 3.3 5.79 3.6 3.71 6.3 14.33 4.2 9.13 6.5 4.25 14.9 17.06 7.5 14.92 10.1 7.96 21.2 31.39 April 1.6 2.3 1.3 1 21 1 2 22 0.8 6.13 1.1 1.9 5.23 7.9 7.51 3.8 8.5 11.27 8.7 13.64 4.9 10.4 16.5 May 1.2 1.06 1.7 15 3 10 0.4 15 1.0 3.4 2.02 3.4 1.96 5.3 2.45 6.4 7.18 4.3 5.74 13.1 10.40 9.8 9.2 7.7 7.7 18.1 12.85 June 1.0 0.89 1.5 18 43 3 40 10 44 2.9 6.13 2.3 6.51 3.7 4.69 9.3 11.65 4.0 4.12 5.0 11.61 12.2 17.78 6.3 10.63 8.7 16.3 July 1.0 0.68 1.4 87 100 68 93 78 98 2.1 3.56 8.4 2.83 6.0 6.73 6.3 7.45 4.6 4.06 10.6 10.34 8.1 11.01 13.0 6.89 16.6 17.07 August 1.0 0.61 1.9 57 106 41 93 43 100 3.5 12.46 6.7 6.18 8.9 9.21 5.4 8.27 3.7 4.50 9.4 9.24 8.9 20.73 10.4 10.68 18.3 18.45 September 1.2 1.31 3.4 56 93 45 91 52 93 4.5 5.47 4.9 8.15 6.1 7.10 6.3 8.33 3.6 4.37 10.4 10.38 10.8 13.8 8.5 12.52 16.5 17.48 October 1.9 1.97 2.5 2.15 47 23 44 20 45 22 3.2 4.39 5.0 5.39 4.1 4.08 9.2 4.21 4.2 3.51 8.2 6.51 12.4 8.61 9.2 8.9 12.3 10.59 November 2.68 2.8 2.53 56 10 49 8 50 10 4.3 4.94 6.2 5.75 6.2 4.75 2.0 7.98 4.7 3.48 6.0 6.29 6.3 12.92 10.9 9.23 12.2 11.04 December 2.1 1.84 3.9 28.5 38 65 32 63 36 58 4.6 5.67 6.6 8.74 6.0 9.11 10.9 4.43 4.1 5.67 18.9 16.89 15.5 10.1 10.5 14.41 24.9 26.0 Average for Year 1.7 1.71 2.33 2.77 42 50 34.6 43 38.6 46 3.74 5.59 5.1 5.4 5.75 6.56 6.92 7.18 4.4 4.19 10.95 10.51 10.66 12.93 9.5 9.55 16.7 17.05 Graph C Atmospheric Pollution by Sulphur Oxides (Lead Peroxide Method) 42 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) 43 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. 44 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 routine observation 5 (3 deposit gauges and 2 lead peroxide gauges) Number of complaints of nuisance from 21 complaints re 15 premises smoke, smell or grit and number of premises concerned Number of places kept under observation 14 Number of half-hour observations made 39 Number of times black smoke was detected 8 Total time of black smoke emissions 8¾ minutes Number of times moderate smoke observed 30 Total time of moderate smoke emissions 265¾ minutes 45 MISCELLANEOUS Noise Nuisance Eight complaints of noise were received, seven of which concerned factories. In four cases, the complaints were justified and abatement was obtained, but in the remaining cases the complaints were not confirmed. 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 172 80 Business and Industrial 31 Domestic 141 Rats 67 Mice 87 Total number of visits in 1957, 1,636 Sewers 1st Treatment 2nd Treatment 3rd Treatment Total number of manholes baited. 99 52 33 Number of poison takes 29 22 7 There was a considerable improvement in the figures for rat infestation during 1957, coupled with a deterioration in those for infestation with mice. It has been remarked in other areas that a fall in the rat population may be associated with an increase in mice and other small mammals. The third treatment this year was necessary because of the use of a new bait (oily Warfarin). Pet Animals Act, 1951 Seven establishments were licensed during the year. The number of animals kept in each case is small and conditions have remained satisfactory. Administration of the Shops Acts Because of the continued staff shortage and priority given to other duties, visits to shops in connection with Shops Acts Regulations show a further decrease. River Pollution Reports of samples taken from the River Brent at the three points of junctions with the Grand Union Canal within the Borough continue to be received from the Middlesex County Council from time to time. Following an unsatisfactory report on an effluent discharging to the River Brent, one factory in the Borough installed a settlement tank and a petrol interceptor, and some improvement in the river resulted. 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 1957, a total of 91 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. 46 A survey of sickness absence amongst Borough Council staff during the year showed that of 156 members of the indoor establishment, 81 had some sick leave during the year, the total number of days of sickness being 1,426. Of the outside staff totalling 299 full-time and part-time, the number of persons requiring sick leave was 194, and the total number of days of sick leave 5,509½. The corresponding figures for 1956 were, 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 the number of persons requiring sick leave was 184, and the total number of days of sick leave 5,406. The total amount of sick leave in 1957 was slightly higher than in 1956, but did not increase to the extent that might have been anticipated since a very large proportion of the staff had at least a few days and some two or three weeks sickness during the influenza outbreak, which although not verified as Asiatic influenza, still had the effect of incapacitating individuals, also in many cases persons developing this sickness relapsed after return to work and had to have further periods of sick leave. 47 HEALTH SERVICES PROVIDED BY OTHER AUTHORITIES North-West Metropolitan Regional Hospital Board Through the Uxbridge Group Management Committee this authority maintains two hospitals in Southall, the Southall-Norwood Hospital (28 beds) for treatment of general medical and surgical cases and casualties, and Mount Pleasant Hospital (79 beds) for the treatment of male patients suffering from tuberculosis. St. Bernard's Hospital is managed by its own Committee and is for the reception of cases of mental and nervous disorders; it has 2,507 beds and takes patients from an extensive area, comprising parts of Berkshire, Buckinghamshire and Middlesex, including the Borough of Southall. Voluntary, temporary, and certified patients of all types are admitted, and all modern forms of treatment are carried out. 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 until the end of 1957 male beds at Mount Pleasant Hospital. At this latter Hospital, special treatment clinics were 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 Infant Welfare Clinics Avenue and 13, King Street. Diphtheria Immunisation, Vaccination and Whooping Cough Immunisation Jubilee Gardens Centre and Clinics 13, King Street. Ultra Violet Light Clinic Northcote Avenue Clinic. Priority Dental Service for Expectant Northcote Avenue and and Nursing Mothers and Children under School Age 13, King Street. (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. 48 (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 Ultra Violet Light treatment Northcote Avenue Clinic. Speech therapy . 13, King Street. Talbot Road School, jubilee Gardens. Dental treatment Northcote Avenue, 13, King Street. Diphtheria and Whooping Cough immunisation, Smallpox and Poliomyelitis vaccination Jubilee Gardens. 13, King Street. 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. 49 APPENDICES EXTRACTS FROM VITAL STATISTICS Table I Total Male Female Comparative Figures for 1956 Live Births—Legitimate 757 376 381 675 Illegitimate 37 21 16 38 Stillbirths— Legitimate 15 11 4 9 Illegitimate — — - — Deaths 690 342 348 652 Birth rate (live and stillbirths) per 1,000 of the estimated population 15.26 13.57 Stillbirth rate per 1,000 total (live and still) births 18.54 12.47 Crude death rate per 1,000 of the civilian population 13.02 12.25 Deaths from Puerperal Causes (Heading 30 of the Registrar-General's Short List):— Deaths Rate per 1,000 total (live and still) births No. 30. Pregnancy, Childbirth, Abortion — — 1.39 Death rate of infants under 1 year of age:— All infants per 1,000 live births 21.41 18.23 Legitimate infants per 1,000 legitimate live births 21.14 16.83 Illegitimate infants per 1,000 illegitimate live births 27.03 26.32 Deaths from cancer (all ages) 113 132 Deaths from measles (all ages) 1 — Deaths from whooping cough (all ages) - — Deaths from diarrhoea, etc. (under 2 years of age) 1 — 50 Causes of Death, 1957 Table II Male Female Total 1957 Total 1956 1. Tuberculosis, respiratory 6 7 13 9 2. Tuberculosis, other 1 1 2 — 3. Syphilitic disease 1 1 2 4 4. Diphtheria — — — — 5. Whooping cough — — — — 6. Meningococcal infections — — — — 7. Acute poliomyelitis — — — — 8. Measles 1 — 1 — 9. Other infective and parasitic diseases 1 2 3 — 10/15. Cancer (all forms) 58 55 113 132 16. Diabetes 3 2 5 1 17. Vascular lesions of nervous system 25 31 56 64 18. Coronary disease, angina 64 52 116 85 19/20. Heart disease 48 74 122 112 21. Other circulatory disease 21 28 49 57 22. Influenza 2 6 8 2 23. Pneumonia 37 27 64 44 24. Bronchitis 22 16 38 38 25. Other diseases of respiratory system 3 — 3 5 26. Ulcer of stomach and duodenum 7 3 10 7 27. Gastritis, enteritis and diarrhœa - 3 3 6 28. Nephritis and nephrosis 5 2 7 5 29. Hyperplasia of prostate 6 — 6 3 30. Pregnancy, childbirth, abortion — — — 1 31. Congenital malformations 1 2 3 5 32. Other defined and ill-defined diseases 17 26 43 45 33. Motor vehicle accidents 6 2 8 6 34. All other accidents 4 5 9 17 35. Suicide 3 2 5 4 36. Homicide and operations of war — 1 1 — Total Deaths 342 348 690 652 Deaths in Wards Table III Ward Male Female Total Waxlow Manor 24 32 56 Northcote 36 32 68 Hambrough 49 34 83 Dormers Wells 120 160 280 Glebe 55 43 98 Norwood Green 58 47 105 Total 342 348 690 51 Table IV Monthly Registration of Births The monthly registration of births classified as to Wards is given in the following table:— Waxlow Manor Northcote Hambrough Dormers Wells Glebe Norwood Green Total January 4 2 3 3 2 3 17 February 4 1 — 2 3 6 16 March 2 1 1 2 4 4 14 April 1 3 2 2 2 3 13 May 2 5 2 4 4 7 24 June 2 4 — 1 2 1 10 July 1 1 2 3 4 2 13 August — 2 2 3 1 i 9 September 5 — 2 5 1 7 20 October 2 3 4 2 2 3 16 November 2 2 2 2 1 2 11 December 2 1 — 2 — — 5 Total 27 25 20 31 26 39 168 Table V Causes of Death Under One Year of Age Certified Causes of Death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 1-3 months 3-6 months 6-9 months 9-12 months Total deaths under 1 year Atelectesis 1 - - - 1 - - - — 1 Birth Injury 2 - - - 2 - - - - 2 Bronchitis, pneumonia, etc. — 1 — — 1 1 2 — — 4 Cerebrospinal infections - - - - - - - - - - Congenital malformations and congenital heart disease 1 2 - - 3 - - - - 3 Gastro-enteritis - - - - - 1 - - - 1 Haemorrhagic diseases of newborn - - 1 - 1 - - - - 1 Prematurity 5 - - - 5 - - - - 5 Total 9 3 1 - 13 2 2 - - 17 Live Births. Legitimate 757 Illegitimate 37 Infant Deaths. Legitimate 16 Illegitimate 1 52 Table VI Deaths from Cancer Year Male Female Total Estimated population Rate per 1,000 population 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 43 115 54,440 2.11 1955 60 49 109 53,840 2.02 1956 67 65 132 53,220 2.48 1957 58 55 113 53,000 2.13 Table VII Notifiable Diseases during the Year 1957 (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 5 4 - - 2 - - 3 6 2 6 - 28 - Erysipelas - - — - - - - 2 - 1 5 2 10 - Food Poisoning - - - - - - 2 1 - 2 4 - 9 - Measles 14 60 75 75 97 343 8 1 - 1 - - 674 1 Pneumonia 4 - 1 2 4 7 14 4 7 11 21 17 92 5 Poliomyelitis Paralytic - - - - - - - - - 1 - - 1 - Non-Paralytic - - - - - - 1 1 - - - - 2 - Scarlet Fever - - - 4 3 24 2 1 - - - - 34 - Whooping Cough 11 7 9 11 11 27 2 - - - 1 79 - Total 34 71 85 92 117 401 29 13 13 18 36 20 929 6 Dysentery — 4 cases confirmed Shigella Sonnei by bacteriological examination 1 case confirmed Salmonella Newcastle Manchester variety 7 cases notified from St. Bernard's Hospital as Shigella Sonnei 2 cases originally notified as suspected food poisoning confirmed Shigella Sonnei 2 cases originally notified as enteritis confirmed Shigella Sonnei Food Poisoning — 4 cases confirmed Salmonella Bredeney by bacteriological examination 1 case confirmed Salmonella Typhi Murium Poliomyelitis — Paralytic 1 confirmed case Non-Paralvric J 1 case confirmed Bell's Palsy Non 1 aralytic j I cas(, confirmed Acute Coryza 53 The number of cases of infectious diseases (including Tuberculosis) notified during the year, according to the locality, is shown below:— Table VIII Diseases Total Waxlow Manor Northcote Hambrough Dormers Wells Glebe Norwood Green Total Deaths Dysentery 28 - - 3 8 1 5 - Erysipelas 10 2 — - 2 3 3 - Food Poisoning 9 2 - 1 4 2 - - Measles 674 123 118 34 111 111 177 1 Pneumonia 92 5 8 8 33 19 19 5 Poliomyelitis: Paralytic 1 — - - - - 1 - Non-Paralytic 2 — - — - 1 1 - Scarlet Fever 34 - 8 6 3 6 11 - Whooping Cough 79 19 18 2 7 24 9 - Tuberculosis 87 7 11 14 32 14 9 15 Total 1,016 169 163 68 200 181 235 21 Dysentery — 4 cases confirmed Shigella Sonnei by bacteriological examination 1 case confirmed Salmonella Newcastle Manchester variety 7 cases notified from St. Bernard's Hospital as Shigella Sonnei 2 cases originally notified as suspected food poisoning confirmed Shigella Sonnei 2 cases originally notified as enteritis confirmed Shigella Sonnei Food Poisoning — 4 cases confirmed Salmonella Bredeney by bacteriological examination 1 case confirmed Salmonella Typhi Murium Poliomyelitis — Paralytic 1 confirmed case Non-Paralvric 1 case confirmed Bell's Palsy 1 case confirmed Acute Coryza Table IX Tuberculosis Notifications—Ages and Classifications Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary Male Female Male Female Male Female Male Female 0-1 - - - - - - - - 1-5 1 1 - — — — — — 5-10 — - - 1 - - - - 10-15 - - 1 - - - - - 15-25 8 9 2 - - 1 - - 25-35 12 5 1 1 - - - - 35-45 10 7 - 1 - - - - 45-65 17 4 1 - 4 4 1 - 65+ 2 3 — - 2 2 — 1 Unknown - - - - - - - - Total 50 29 5 3 6 7 1 1 54 Table X The occupations of the new cases are as follows:— Occupation Pulmonary Non-Pulmonary Male Female Male Female Airman 1 - - - Assistant Chemist 1 - - - Accountant 1 - - - Bricklayer's Improver 1 - - - Bakery Assistant 1 - - - B.B.C. Engineer 1 - - - Bar Assistant - 1 - - Clerk 2 1 - - Child 1 - - - Driver 1 - - - Engine Fitter 1 - - - Electro-Plater 1 - - - Foundry Foreman - - 1 - Factory Worker 4 1 - - Food Factory Worker 1 - - - Gas Worker 1 - - - Housewife — 8 - 2 Laundry Packer - 1 - - Labourer 1 - 1 - Lorry Driver 1 - - - Mental Patient 8 7 - - Mill Hand 1 - - - Machine Operator - 1 - - Motor Fitter 1 - - - Orderly 1 - - - Oil Stoker 1 - - - Progress Chaser 1 - - - Painter — - 1 - Pensioner - 1 - - Planning Engineer 1 - - - Retired 2 - - - Royal Navy 1 - - - Shipping Foreman 1 - - - Sales Manager 1 - - - Shorthand Typist - 1 - - Shop Assistant - 1 - - Schoolchild - ~ 1 1 Teacher — 1 - - Taxi Driver 1 - - - Unknown 8 4 1 - Universal Grinder 1 - - - Welder 1 - - - Wages Clerk - 1 - - Total 50 29 5 3 55 Table XI Examinations for Verminous Conditions and Children Found to be Verminous Attending Maintained Schools in Southall during 1957 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 1957 1956 1957 1956 1957 1956 1957 1956 Beaconsfield Road, J.M. 976 1,039 4 1 2 1 1 — Beaconsfield Road, I. 478 555 4 2 2 1 1 - Clifton Road, J.M. 667 851 2 3 1 2 - 2 Clifton Road, I 576 471 7 - 4 - 2 - Dormers Wells, J.M. 824 836 - - - - - - Dormers Wells, I. 430 519 - - - - - - *Dormers Wells, S.B. - 436 - - - - - - *Dormers Wells, S.G. - 569 - - - - - - Featherstone Road, J.M. 972 926 10 6 3 6 - 6 Featherstone Road, I. 535 400 3 - - - - - George Tomlinson, J.M. & I. 1,471 1,484 4 - 1 - - - *Featherstone Road, S.B. - 371 - - - - - - Lady Margaret, J.M. 1,379 1,518 2 - 2 - 1 - Lady Margaret, I. 811 881 - - - - - - North Road, J.M. 1,079 997 3 - 3 - - - North Road, I. 492 549 2 2 1 2 1 1 St. Anselm's R.C. 998 1,098 2 1 1 - 1 - *Talbot Road, Mixed - - - - - - - - Talbot Road, Specials 149 367 - - - - - - Tudor Road, J.B. 1,193 1,261 12 7 6 5 6 3 Tudor Road, J.G. Tudor Road, I. 667 834 8 2 2 1 1 1 Western Road, J.M. & 1. 525 917 5 3 - 3 - 2 *Western Road, S.G. - 366 - 1 - 1 - 1 †Routine Medical Inspections - - - - - - - - Total 14,222 17,245 68 28 28 22 14 16 * Not inspected † Figures are included in school totals 56 Table XII Sanitary Inspections—Classification of Visits Houses, Public Health Act, 1936 3,726 Houses, Housing Act, 1936-1954 336 Overcrowding 237 Disinfestation 85 Pet Animals Act, 1951 11 Vans, Sheds 26 Shops Act, 1950 62 Food Shops 519 Fried Fish 5 Cafes, etc. 315 Factories (Mechanical) 188 Factories (Non-Mechanical) 7 Outworkers 24 Food Factories 172 Smoke 95 Offensive Trades 1 Bakehouses 29 Dairies 11 Water Sampling 16 Ice-Cream Sampling 182 Other Foods Sampling 39 Schools 40 Stables 13 Offensive Accumulations - Hairdressers 1 Petrol 236 Canal Boats — Slaughterhouses 61 Rats and Mice 101 Infectious Diseases 183 Atmospheric Pollution 96 Markets—Saturday and General 131 6,948 Table XIII HOUSING—GENERAL Statistics Housing Act, 1936—Overcrowding: (a) (1) Number of dwellings overcrowded at the end of the year 56 (2) Number of families dwelling therein 74 (3) Number of persons dwelling therein 311 (b) Number of new cases of overcrowding reported during the year 21 (c) (1) Number of cases of overcrowding relieved during the year 44 (2) Number of persons concerned in such cases 242 (d) Particulars of any case in which dwelling-houses have again become overcrowded after the local authority have taken steps for the abatement of overcrowding - (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report - 57