AC.439(1) SOUT26 BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1958 MARGARET A. GLASS, Medical Officer of Health KING A HU1CHINGS LTD., SOUTHALL AND UXBRIDGE BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1958 MARGARET A. GLASS, Medical Officer of Health INDEX page Ambulance Service 54 Antitoxin 25 Area of Borough 9 Atmospheric Pollution 6, 34, 45, 46, 47, 48, 49, 50 B.C.G. Vaccination 20, 21, 22 Bed Bugs 34 Births and birth rate 5, 6, 11, 12, 56, 58 Blind and partially sighted 27, 28 British Red Cross Society 26 Bulletin of infectious disease 14 Canal boats 34 Cancer 5, 11, 23, 24, 57, 59 Caravans 38 Carbide 36 Care and after care 54 Catering establishments 43 Cattle market 34, 42 Causes of death 57 Celluloid and Cinematograph Film Act 36 Certificates of Disrepair and Revocation 33, 37 Chest Clinic 20, 21, 22, 23, 53 Children's welfare 55 Chiropody 29 Chlorination 9, 10 Clean Air Act 6, 34, 45, 46 Clinics 53 Club for Disabled Persons 26, 27 Community Centre 27 Deafness 27 Deaths and death rates 5,6, 11, 14, 17, 18, 19, 23, 24, 31, 32, 56, 59, 60 Deaths in wards 57 Demolition 37 Diabetic Club 27 Diphtheria 5, 11, 14, 16, 17, 57 Disinfection 25 Dysentery 14, 15, 59, 60 Employees' medical examinations 52 Factories Act, 1937 35 Food & Drugs Act 43 Food handlers' hygiene 42 Food hygiene 6, 40, 41, 42, 43, 44 Food inspection 43, 44 Food poisoning 14, 15, 40, 59, 60 Food sampling 40 Food shops 43 Free washing facilities 40 Graphs 13, 19, 45, 48, 49, 50 Handicapped persons 28 Hard of Hearing Club 27 Health education 31 page Health visitors 23, 53 Heart disease 11, 57 Holidays for old people 30 Home accidents 31 Home Advice Group 27 Home helps 29, 54 Home nursing 29, 54 Hospital services 53 Houses let in lodgings 38 Houses—number inhabited 9 Housing 18, 37, 38, 39 Housing Repairs and Rents Act 33,37 Hygiene of food 40, 41, 42, 43, 44 Hygiene—personal 40 Ice-cream sampling 40 Immunisation 5, 16, 17, 54 Improvement grants 34, 37 Indian immigrants 15, 18, 21, 22, 23 Infant mortality 5, 12, 13, 56, 58 Infectious diseases, prevalence and control of 5, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 Influenza 11,15,57 Inspection and supervision of food 42, 43 Inspection of sanitary accommodation in factories 35 Laboratory facilities and work 25 Markets 34, 42 Mass X-Ray 21,23 Massage, establishments for 51 Maternal morbidity 13 Maternal mortality 13 Maternity and Child Welfare 53, 54, 55 Meals on Wheels 29 Measles 5, 14, 56, 57, 59, 60 Meat and other foods 42 Medical examinations 52 Mental health 54 Middlesex County Council Services 53, 54, 55 Midwifery service 53 Milk licences 40 Miscellaneous 51, 52 Mortuary 34 National Assistance Act, S. 47 30 Noise nuisance 51 Nursing equipment 54 Old People's Welfare 29, 30 Ophthalmia neonatorum 17 Outworkers 35 Overcrowding 6, 18, 22, 37, 63 page Paddling Pool 10, 40 Parks and Open Spaces 9 Personal hygiene 40 Pet Animals Act 51 Petroleum Acts 36 Physical features of the district 9 Poliomyelitis 5, 11, 14, 15. 57. 59. 60 Population 6, 9, 21, 59 Premature infants 5, 13, 58 Public Control Department 41, 42 Public Health Committee 5 Public Health Inspectors 8, 23 Puerperal pyrexia 13, 59, 60 Rag, Flock and Other Materials Filling Act 36 Rateable value 9 Rats and mice 51 Rehousing 37, 38 Respiratory diseases 57 River pollution 51 Road accidents 5, 11, 32, 57 St. John Ambulance Service 26 Sanitary circumstances 33, 34, 35, 36 Sanitary inspection 33, 34, 63 Sanitation in schools 34 Scabies 25 Scarlet fever 14, 16, 59, 60 School Medical Service 54, 55 Sewerage 33 Shops Acts 51 Slum Clearance 37 Smallpox 16, 25 Smoke control area 6, 34, 46 Smoke pollution 45, 46 Social conditions 9 Southall Association for the Occupation of the Elderly 30 Staff 6, 8 Statistics — General and Vital 9,10,11,12,13 Stillbirths 11, 56 Street traders 43 Sulphur dioxide pollution 45 Swimming bath 9, 10 Tuberculosis 5, 11, 17, 18, 19, 20, 21, 22, 23, 57, 60, 61 Vaccination 5, 15, 16, 21, 54 Vaccine lymph 25 Verminous persons 25, 62 Vital statistics 6, 11, 12, 13 Water supply and service 33. 40 Welfare — General and Old People's 26, 27, 28, 29, 30 Whooping cough 11,56,57, 59, 60 THE COUNCIL OF THE BOROUGH OF SOUTHALL, 1958 THE WORSHIPFUL THE MAYOR *Councillor Johnson Haigh, J.P. Deputy Mayor: Councillor T. J. Steele Aldermen: †*dane, A. T. (Chairman) *Gardner, F. E. †*LowE, J. Douglas, H. C. Hopkins, W. H. Salmon, J. Councillors: *Barrett, J. Haigh, J., J.P. *Rockhill, F. R. J. Barton, A. J. †* Jones, Mrs. E. W. Shiel, E. J. *Cavell, Mrs. I., J.P. Lamb, W. G. *Southey, P. G. *Cripps, C. B. Love, P. J. Steele, T. J. Day, F. R. Mee, H. J. Ward, J. H. *Griffiths, Mrs. M. C. *Pollard, C. J. Woodruff, J. A. T. *Members of the Public Health Committee. †Members of the Area Health Committee (Area No. 9). To the Mayor, Aldermen and Councillors of the Borough of Southall. MR. MAYOR, LADIES AND GENTLEMEN, I have the honour to present the 68th Annual Report on the health and circumstances of the population of the Borough of Southall. The birth rate continued to rise in 1958, almost reaching post-war level. The death rate fell, but there was an increase in the number who died from circulatory diseases and from cancer. Fewer deaths occurred from road accidents. A slight fall occurred in the infant mortality rate, but there was a considerable rise in the number of premature infants born. Research would appear to be required into the reason for this, whether the strain of modern life, or the physical state of the environment, or special nutritional factors are to blame. The incidence of infectious disease was not high in 1958 apart from the persistence of measles throughout the year. There were no outbreaks of infectious illness. No diphtheria was notified, one case of paralytic poliomyelitis occurred. The County Council vaccination scheme for the prevention of poliomyelitis was greatly expanded in the year and given precedence over other forms of immunisation; and new sections of the community were brought into the scheme, including adolescents and young adults. There was a slight fall in the number of notifications of tuberculosis, and the figure for deaths from tuberculosis in 1958 was the lowest ever recorded in the Borough. 5 The problem of overcrowding of houses with its resultant threat to public health showed little sign of abating, and indeed the number of persons coming to live in the Borough compared to the number leaving for other districts, combined with the rise in birth rate, suggests that the estimated population figure supplied by the Registrar-General, which is calculated from the 1951 Census figure corrected according to the vital statistics of each successive year, is most probably below the actual population figure for Southall. In addition to routine environmental and food hygiene control the attention of the Public Health Inspectors was particularly directed during the year towards the preparation for the setting-up of the first Smoke Control Area in accordance with the directions of the Clean Air Act, 1956. On reviewing the figures for atmospheric pollution throughout the year the deterioration in purity of the atmosphere over this Borough gives added urgency to the need for establishment of smoke control, and also of the control of poisonous chemical substances produced from domestic fires and industrial furnaces. Much time in the past has been spent in making schemes for the improvement of the health of expectant mothers, infants, school children and the elderly, and the local services for these sections of the community are developing very well, but viewing the death rates, the continuing rise of deaths from stress diseases gives emphasis to the need for examination of the causes of diseases such as coronary or cerebral thrombosis and mental breakdown resulting in invalidism or death in the middle years of life. Work for public health is always changing and as old problems become solved fresh ones appear, and while vital statistics of the present day compare so favourably with those of 50 years ago there is still too much sickness, too much chronic ill health, too many who die untimely. I would like to thank the whole of the staff of the Public Health Department for all the good work done during the year and for their loyal support. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, Iuarganl a. glqu Medical Officer of Health. Manor House, Southall. Telephone Numbers: SOU 3621-2. SOU 5060. 6 Acknowledgments to:— The County Medical Officer The County Welfare Officer The County Public Control Officer The Area Medical Officer The Physician Superintendent, St. Bernard's Hospital The Medical Superintendent, Hillingdon Hospital The Medical Officer of Health, 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 Miss E. L. Jansen, St. John Ambulance Brigade Mr. H. G. Hallett, Secretary-Warden, 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 7 HEALTH DEPARTMENT STAFF for the year 1958 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: C. R. Southgate, Cert. S.I.B., Cert. M. & F. Additional Public Health Inspector: J. T. Woolford, Cert. S.I.B. Trainee Public Health Inspectors: D. A. C. Davis. J. E. Attew (Resigned 28.2.58). 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 (Resigned 8.2.58). Miss J. E. Szabo (Appointed 4.2.58). 8 GENERAL STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH Area (acres) 2,607762 Population—Registrar-General's estimate (mid 1958) 52,380 Number of inhabited houses according to Rate Book 14,890 Average number of occupants per house 3.52 Sum produced by a penny rate £3,950 Rateable Value £984,865 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 2.22 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 108.00 acres Western Road 0.17 acres Wolf Fields 3.33 acres Wolf Green 0.18 acres Land to North-West of Kingsbridge Crescent 0.12 acres Spencer Street (Nos. 18-28) 0.23 acres 280.40 acres For general administration purposes and for the main statistical purposes of this report, the district is divided into six wards, Waxlow Manor, Northcote, Hambrough, Dormers Wells, Glebe and Norwood Green. The majority of the houses in the district are occupied by good-class working people, chiefly engaged in the local factories and workshops. These include food, jam and chemical works, engineering, medical and toilet preparations, paint, dye and wood works, laundries, etc. There are no trades carried on which are at present scheduled as offensive trades. Southall Borough Council maintains a swimming bath situated in the Recreation Ground, Southall, which is one of the public parks. The surface area of the bath is 3,600 square feet (120 feet by 30 feet), cubic capacity 16,500 cubic feet (110,000 gallons). The water is treated by break point chlorination, and a normal chlorine content of 1.0 parts per million at the shallow end, and 07 at the deep end, is maintained. During peak periods this 9 is increased to 4 0 parts per million at the shallow end in order to obtain 2.0 parts per million at the deep end. Three samples of the water are taken daily by the staff for chlorine and other chemical testing. During 1958, the total number of persons using the bath was 28,967 (46,557 in 1957). The average number of persons attending per day (wet or fine) was 188. The maximum number at any one session was 350. 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. A drop in the total figures of over 17,000 from the previous year's figures is the result of a summer which was abnormally wet and cold. The popularity of swimming has been increasing in the Borough, and swimming is a most healthful exercise, so this big drop in attendances is somewhat disappointing. 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 continued to increase. 10 VITAL STATISTICS Total deaths, 636. (Males, 321: Females, 315.) Crude Death Rate, 12 04. 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, fell in 1958. Below is shown the comparative figures for the past six years. Year Death Rate 1953 13.31 1954 12.16 1955 11.92 1956 12.25 1957 13.02 1958 12.04 The principal causes of death were heart disease, diseases of the circulatory system and cancer. There was a fall in the number of deaths from heart disease, but a rise in deaths from circulatory diseases. Deaths from cancer rose from 113 in 1957 to 139 in 1958 including a rise in deaths from lung cancer from 31 in 1957 to 38 in 1958. There were no deaths from whooping cough, diphtheria or poliomyelitis. A fall occurred in the number of deaths from tuberculosis from 13 in 1957 to 5 in 1958. This is the lowest level yet reached. Three people died from influenza. 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 250 (males 142 and females 108). Deaths of institution inmates (including patients from Southall addresses and from outside areas) number as follows: St. Bernard's Hospital, 167 (males 64 and females 103); Mount Pleasant Hospital, 7 (4 male and 3 female); Southall-Norwood Hospital, 10 (7 male and 3 female); Vine Cottage, 5 (all female); in addition 3 deaths (2 male and 1 female) occurred of persons belonging to other districts and residing temporarily in Southall. In 1958, three people died as the result of motor vehicle accidents, as compared with 8 in 1957. 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 one less than in 1957—22 in 1958 as compared with 23 in 1957. To make an approximate allowance for the way in which the sex and age distribution of the local population differs from that of England and Wales as a whole, the crude death rate is multiplied by a comparability factor supplied by the Registrar-General. This, then, gives a comparative death rate of 101, compared with the rate for England and Wales as a whole, which was 117—the Southall rate is well below that of the nation as a whole. It is interesting to note from a study of the County statistics that only one Borough in the County had a lower death rate than Southall in 1958. For distribution of deaths in the various wards, see Appendix, Table III. Births and Birth Rate. (Figures for 1957 are given in brackets.) The total number of registered births in the district (as notified under the Births and Deaths Registration Act) was 168 (167). The total number of live births belonging to the district, whether occurring within or outside the district, was 831 (794). The illegitimate live births were 42 (37). There were 11 stillbirths (15), 10 legitimate, 1 illegitimate. 11 A rise in the birth rate (live and still) is recorded from 14 98 in 1957 to 15-73 *n J958The birth rate is the number of births per 1,000 of the total population, and the figure in 1958 is the highest since 1949, when it was 15-72. Forty-two illegitimate five births were registered during 1958. The following table shows the comparative figures for the past 25 years. Year No. of Illegitimate Live Births 1934 27 1935 23 1936 24 1937 38 1938 31 1939 34 1940 31 1941 30 1942 38 1943 39 1944 55 1945 60 1946 56 1947 53 1948 53 1949 39 1950 36 1951 28 1952 26 1953 31 1954 23 1955 21 1956 38 1957 37 1958 42 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 16.2. The corresponding rate for the whole of England and Wales was 16.4. The illegitimate birth rate was 50.5 compared with a figure of 49 per 1,000 five births for England and Wales. Infant Mortality Infant mortality, i.e. the number of children dying before reaching the age of one year, fell in 1958. Seventeen infants died, giving an infant mortality rate of 20.46 per 1,000 live births, as against 21.29 in 1957. Of these 17 deaths, 3 died at home and 14 in hospital. Thirteen infants (8 male and 5 female) died within the first four weeks after birth. Table V gives the causes of infant deaths under the age of one year. Graph A, on infant mortality rates, shows the trend of the infant mortality rate since 1900. The infant mortality rate for Middlesex County was 18.8, and the infant mortality rate for England and Wales as a whole was 22.5, the lowest ever recorded in this country. It will be seen that Southall's figure is still lower than the national one. 12 Premature Infants Sixty premature infants were born during the year; 49 were born in hospital and of these, 41 were surviving at the end of one month; 8 were born at home and all of these were surviving at the end of one month. There were three 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 5½ lbs. at birth. Maternal Morbidity Three cases of puerperal pyrexia were notified during the year. There were no maternal deaths, and no deaths associated with abortion. 13 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES There was a drop in the total number of notifications of infectious diseases during 1958, but the usual reduction expected, because of the characteristic variations of measles which in the past has only assumed epidemic form every alternate year, did not occur. The number of measles cases was almost as great in 1958 as in 1957, and this persistence suggests either a change in the character of the infection or an absence of the immunisation in the community which seems to occur during most outbreaks of infectious disease. The incidence of measles seemed to continue throughout most of the year also, which was another rather unusual characteristic. This, of course, may have been due to the fact that there was no recognisable warm summer spell during the whole of 1958. There was a slight rise in the incidence of dysentery and food poisoning. Scarlet fever seems to be showing a slight tendency to revive. The numbers of notifications have been increasing though not greatly in the past couple of years. There were no notifications of diphtheria, and the number of poliomyelitis notifications dropped from three in 1957 to one in 1958. This case, however, was confirmed as paralytic 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. Measles Measles incidence fell during the year 1958. There were no deaths from measles. The following table shows the trend of notifications during the past ten years. Year No. of Cases Deaths 1949 194 - 1950 701 - 1951 1,129 - 1952 528 - 1953 931 1 1954 41 - 1955 1,329 - 1956 61 - 1957 674 1 1958 476 - From these figures it can be seen that the figures for the two past years together make a total approximating to the peaks of 1955, 1953, and I951. Poliomyelitis One notification of suspected anterior poliomyelitis was received in 1958. The disease was confirmed as paralytic poliomyelitis—the paralysis being widespread, all limbs, chest, back were affected. The patient, a young adult male not immunised against poliomyelitis, made some progress, but was still in hospital at the end of the year. After three months illness he was, however, by that time able to do without his respirator. 14 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* 1 1 1 4 1953 4 - - 2 2 1954 2 - - 1 1 1955 8 - 1 2 5 1956 2 1 - - 1 1957 1 1 - - - 1958 1 1 - - - *One removed from district—information on progress not obtainable It will be seen from these figures that of 55 cases of paralytic poliomyelitis occurring during these ten 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 1958, the age range was lengthened and plans made for a third dose to be given to those already immunised with two injections. During 1958, 5,631 children received two injections, and that, added to the previous figure of 1,656 receiving two injections in the two previous years, made a total of 7,287 considered to have satisfactory protection. In addition 174 persons aged 15-25, 219 expectant mothers, 15 from general practitioners' families, 9 ambulance officers and 6 hospital staff received two injections. The third injection was given to 2,389 persons of whom 2,357 were children of 15 or under. 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. Influenza Influenza was not a serious problem during 1958. The outbreak at the end of 1957 carried over into the first months of the year, but it had become greatly reduced and no Virus A influenza was traced within the Borough. In December, there seemed to be some indications that influenza was coming again into the Borough, but there had been little effect on school attendances or hospital admissions by the end of the year. Head Teachers were warned to exclude school children even on very mild symptoms so that, if influenza was to come into the Borough, it should be limited as much as possible from the earliest days. Dysentery Forty notifications of dysentery were received in 1958. Of these, 14 were confirmed as caused by Shigella Sonnei, one as amoebic dysentery. In addition, five cases notified as suspected food poisoning and two notified as gastro-enteritis were subsequently confirmed as Sonne Dysentery; dysentery was not confirmed in the other cases. The amoebic dysentery occurred in an Indian immigrant and contacts were found to be clear of the disease. Of the other confirmed cases, in six instances two members of one family were affected and in one instance three members, but the infection was contained in each case, so no outbreak resulted. 15 Smallpox (Variola) No cases of smallpox occurred in the Borough during the year. One contact of smallpox was notified from the Port Authorities. Routine visiting was carried out and no infection developed. Vaccination against Smallpox The total figures for vaccination showed no improvement in 1958, but the percentage of children receiving vaccination during their first year of life rose from 45 in 1957 to 52 in 1958, and as this figure has been falling for years it is satisfactory to find an upward trend this time. 1958 Age Groups Under 1 year 1-2 years 2-4 years 5-14 years 15 years and over Total Primary Vaccination 412 21 18 26 40 517 Re-vaccination - - 1 11 106 118 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 Scarlet Fever (Scarlatina) The number of notifications received during the year was 45 as compared with 34 for the previous year. There were two secondary cases, i.e. occurring within three weeks following the notification of a previous case in the same household. This infection appears to have become a little more widespread lately, and although the cases are mostly mild, there is now and again one more severe with ear, heart or kidney complications, so that it is still a disease to be treated with considerable care and good isolation. All the cases were, however, nursed at home. In September the incidence of colds and sore throats at one school in the Borough caused the Head Teacher to telephone the Department for advice. There had been cases of scarlet fever and, therefore, a visit was paid to the school in order to examine and if necessary take swabs from the throats of any children in the infants classes showing symptoms. Twenty throat swabs were taken and two of the children were found to have infectious germs in their throats and were sent for treatment. No further cases of scarlet fever occurred. 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. 16 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 475 127 5 607 63 In the following table is shown the number of children at 31st December, 1958, who had completed a course of immunisation against diphtheria at any time before that date:— Age at 31.12.58: Under 1 1-4 5-9 10-14 Total under 15 Number immunised 177 1,965 2,700 3,911 8,753 There was a slight rise in the number of children receiving primary immunisation against diphtheria during the year. The total protected children, i.e. children under 15 who have had at least one full course of immunisation in their lives, is slightly down, from 8,766 in 1957 to 8,753 in 1958. 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 69. Other Forms of Tuberculosis The number of new cases notified during the year was 11. Of the total notifications, which include new cases and inward transfers from other districts, 5 were received from medical practitioners; 49 from the Uxbridge Chest Clinic; 13 from General Hospitals; and 13 from St. Bernard's Hospital. Deaths from Tuberculosis Tuberculosis of the respiratory system, 4; other forms, 1. For details of new cases notified and deaths in 1958, see Appendix, Table IX, and for the occupation of new cases see Appendix, Table X. Public Health (Prevention of Tuberculosis) Regulations, 1925 Public Health Act, 1936, Section 172 Action under these powers was not necessary during the year. The number of new notifications fell from 87 in 1957 to 80 in 1958. Of the 80, 25 were inward transfers, i.e. they were not resident in Southall at the time of development of the disease, and, therefore, the actual figure of new notifications of Southall residents was 55, while in 1957 the number of inward transfers was 30, making the figure for new notifications of Southall residents 57. 1958 was a better year for tuberculosis. The number of notifications of new cases in the Borough dropped again to a small extent after falling slightly the previous year, and an 17 even more satisfactory fact is that the deaths dropped from 13 in 1957 to 5 in 1958. This is the lowest number of deaths from this cause yet recorded in any year in the Borough. The amount of tuberculosis amongst Indian residents rose again in 1958, comparative figures for the last three years are:— Year New Notifications Number of Indians 1958 57 14 1957 61 10 1956 61 8 In two of the houses occupied by Indian patients there were second cases associated with overcrowded living conditions, but no deaths occurred from this disease amongst the Indian population. The analysis of the housing conditions of new cases shows that of the notified patients living in Southall, exclusive of the St. Bernard's Hospital notifications, housing conditions were reasonably good in all except four cases. In each of these there was statutory overcrowding. No abatement of the overcrowding had been obtained by the end of 1958. In four families, there were second cases of tuberculosis, and in one of these, three patients were suffering from the disease at the same time. This family was one of those living in overcrowded conditions. One case remaining in overcrowded conditions since 1956 was still not ameliorated at the end of the year. There were no overcrowded families with tuberculosis in the household remaining from 1957. 18 19 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. 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 108 during 1958, and the details are as follows:— New born babies 12 Children under 1 year 31 Children 1-4 years 30 Children 5-15 years 30 Over 15 years 5 108 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 858 555 11 146 358 Tuberculosis Vaccines Clinical Trial During 1958 the Tuberculosis Vaccines Clinical Trial continued. In the Autumn of 1950 the Medical Research Council, in conjunction with many local authorities in North London, the Midlands and the North of England, began a national investigation into the value of vaccination against tuberculosis. In 1950 B.C.G. vaccine was known to be of mass value to those in contact with the disease, for example nurses, and children living in the same home as a case of tuberculosis. However, there was disagreement as to whether the vaccine should be used on a wide scale for children who were not contacts. A clinical trial was, therefore, begun to assess the contribution likely to be made to the prevention of tuberculosis by widespread vaccination. Children who at that time were aged fourteen and were in their last terms at Secondary Modern Schools were invited to take part 20 in the trial. Between September, 1950, and December, 1952, approximately 60,000 of these children entered the scheme. All were X-rayed on entry and after preliminary skin-tests a proportion of the children were vaccinated with one of two tuberculosis vaccines. Since then these young people have been followed up to find out if the vaccines have in fact prevented tuberculosis. A regular postal enquiry form has been sent to each participant and a regular visit to the home has been made by one of the nurses on the staff of the Local Health Authority concerned. The visits by the nurses have been especially valuable since it has been possible to remind the volunteers and their parents of details about the scheme as well as to get essential medical information. These home visits, which have been carried out in addition to the normal duties of the nurses, have been very successful; much credit is due to the nurses concerned for the able and conscientious way in which this work has been done. A further feature of the follow-up has been the provision made for the regular X-raying of the participants. A mass radiography unit from the Medical Research Council has visited the areas at regular intervals and participants have been invited to attend for X-ray in the evening. By 1956 the findings showed that B.C.G. vaccine confers a substantial measure of protection against tuberculosis and the first report of the investigation was published in 1956. As a result Local Health Authorities in England and Wales have been encouraged to offer vaccination to thirteen-year-old children and it is probable that this measure will effect a considerable reduction in the frequency of tuberculosis in young people in future. During 1958 one visit was paid to Brentford clinic by the mass radiography unit. Eighteen young people from Southall were invited to attend and of these 13 attended and had an X-ray. Although the investigation has shown the vaccine to be effective it is desirable to know whether protection only persists for a few years after vaccination or whether such induced resistance lasts for a considerable period. The investigation is, therefore, being continued for the present. 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 sixth year of the experiment and up to date no active cases have been found amongst adolescents taking part in the investigations in Southall. Tuberculosis in Indian Immigrants An interesting report has recently been published (Tubercle, Lond., (1959), 40, 387) by Doctor J. T. Nicol Roe, and is included herewith:— Since 1954 the borough of Southall, an industrial area, with a population of 53,000, within the purview of Uxbridge Chest Clinic, has experienced an influx of Indian immigrants; in 1958 they were estimated to be about 1,050. Between 1954 and 1958 there was also a steady increase in the number of Indians notified each year as suffering from tuberculosis; by the end of 1958 the total had reached 40, enough to call for further investigation by the health authorities, particularly with regard to prevention. Treatment presented little problem as there were sufficient beds in hospitals and sanatoria to accommodate them. The case records of 35 patients (32 males, 3 females) were available for analysis. Five patients had left the district. Primary Lesions Ten patients had obvious primary lesions with manifest lymph node enlargement; a further 4 had pleural effusions. There was also 1 who developed miliary tuberculosis without an evident primary complex; 2 of the patients with an obvious primary complex also developed miliary lesions. 21 "Post-Primary" Lesions Fifteen had lesions which appeared "post primary"; 8 were unilateral (2 with cavities) and 7 bilateral (3 with cavities). Five had non-pulmonary lesions—3 nodes of neck, 1 knee and 1 kidney. Contact Examinations In spite of a very wide investigation of home contacts it was impossible in any instance to discover a specific source case. Fifteen men were married but only 2 had their wives and families in this country and none of the contacts had a tuberculous lesion. The husband of one of the women with pulmonary tuberculosis had a primary lesion and it was thought that he had acquired the infection from his wife. Social and Environmental Most of the patients were Sikhs; the 3 women were all from villages and had been associated with farming; 23 men were from village or country—18 were farmers. Only 6 men were from town or city. Five patients were diagnosed within a year of arrival in this country, 7 in one to two years, 8 in two to three years, 7 in three to four years and 2 in four to five years; 4 had been here over five years. Information was not obtained in 2 patients. The date of infection was roughly estimated from the time lapse after arrival in this country and the clinical and radiographic type of disease at notification. Also considered were the history of previous disease in India (admitted by none), and contact or family contact in India (admitted in 2 cases). Of the 35 patients, 21 were thought to have acquired the disease in this country and 2 possibly to have acquired it here; 12 persons probably had the disease on entry—10 pulmonary and 2 non-pulmonary. Comment Springett and others (1958) in Birmingham decided that amongst Asians there (Indians and Pakistanis) the disease was predominantly of chronic pulmonary type; in their opinion most were already tuberculous on arrival. The Uxbridge experience, on the other hand, appears to indicate that the majority of the local Indian immigrants acquired the disease in this country. This appeared to be confirmed by the large proportion with primary disease, pleural effusion and miliary tuberculosis of the lungs (15 of 35), as compared with the Birmingham series. From September, 1958, 44 Indians referred to the chest clinic for X-ray were Mantoux tested (O.T. 1 in 1,000): of these, 29 were tuberculin negative and only 15 tuberculin positive; it was thus apparent that a high proportion had not been infected prior to arrival. These findings might be related to the fact that most came from isolated country districts in India. The health of the coloured immigrants is a problem which the health authorities in this country are having to face. Their standard of living is generally lower than that of the British people of comparable economic status. Efforts are therefore necessary to ensure that this is improved, particularly with regard to the overcrowded conditions in which they live. In attempting to control the problem close co-operation between the public health department, the general practitioner, factory medical officers and the chest clinic is essential. The local Indian Workers Association can be encouraged to co-operate with propaganda and education. All Indians should be X-rayed as soon after arrival as possible. At the same time they could be tuberculin-tested and those proving tuberculin negative should be offered B.C.G. vaccination. In a small compact community this programme can be carried out reasonably well, as has been the experience at this clinic where the co-operation of the Indians has been very good. 22 Conclusion There is apparently a high incidence of tuberculosis in Indian immigrants in Southall. This analysis suggests that more than half appear to have acquired the infection in this country. The fact that the majority are Sikhs from rural areas who often may be tuberculosis negative on arrival affords a possible explanation. Mass X-ray During the year a school in Southall was visited by the Mobile Mass X-ray Unit, to survey the Southall school leavers in connection with the research into incidence of new tuberculosis in the adolescent. 712 school leavers were X-rayed—244 male and 468 female. 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 to Southall, 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. Dr. J. T. Nicol Roe, Chest Physician, Uxbridge Chest Clinic, reports that in spite of the steady diminution of new cases of Pulmonary Tuberculosis, it still remains a considerable public health problem which must continue to be attacked by all means at our disposal. There is no doubt that treatment is best carried out in hospital, especially in the early stages. The stay in hospital is less than was necessary some years ago. The taking of anti-tuberculous drugs must continue for a few years and it is most important that they are taken conscientiously. With regard to prevention and early detection of cases, contacts both at home and factory or workshop should have regular X-rays and/or Tuberculin Tests. Full use should continue to be made of the Mass X-ray Unit's visits to the Borough. Cancer It will be seen by the table of causes of death (page 57) that in 1958 139 cases (91 males and 48 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. The total number of deaths from cancer in 1958 rose, being 139 as compared with 113 in 1957. Cancer of the lung in males, again the highest individual figure for site of disease, was nine more than in 1957. 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 244 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. 23 24 CLASSIFICATION OF CANCER DEATHS IN SITES AND AGES Site Age Groups — Male Total Under 10 10—20 20—30 30—40 40—50 50—60 60—70 70—80 80 + '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 Lung 18 29 24 33 1 - - - 1 - - - - - - - 1 1 - 3 1 2 - 2 4 9 5 12 5 12 13 7 5 5 5 8 - - 1 1 Stomach 14 4 6 16 - - - - - - - - - - - - - - - - 2 - - - I — 1 4 7 1 3 5 4 2 2 6 — 1 — 1 Intestine 11 9 9 13 - - - - - - - - - - - - - - - - 1 - - 1 3 - 3 2 2 5 - 7 5 4 3 2 - - 3 1 Bladder 2 1 1 3 - - - - - - - - - - - - - - - - - - - - - - - 1 1 - — 1 1 1 l 1 - — — — Prostate 3 2 — 4 - - - - - - - - - - - - - - - - - - - - - - - - 1 - - 2 1 2 — 2 1 — — — Breast - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Other 12 22 18 22 - - - - - 1 1 1 - - 1 1 1 3 3 2 2 1 2 1 4 3 2 6 3 3 5 3 1 7 2 7 1 4 2 1 Totals 60 67 58 91 1 - - - 1 1 1 1 - - 1 1 2 4 3 5 6 3 2 4 12 12 11 25 19 21 21 25 17 21 13 26 2 5 6 4 Age Groups — Female Site Total Under 10 10—20 20—30 30—40 40—50 50—60 60—70 70—80 80+ '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 '55 '56 '57 '58 Breast 6 16 10 10 - - - - - - - - - - - - - 1 - - 2 1 1 - - 2 4 3 3 6 1 - 1 4 4 4 - 2 - 3 Lung 3 5 7 5 - - - - - - - - - - - - 1 - - - - - 2 - - 2 2 2 1 1 - - 1 2 1 2 - - 2 1 Stomach 9 8 3 5 - - - - - - - - - - - - - - - - 2 - 1 - - - - - - 4 - 1 2 3 2 2 4 1 — 2 Uterus 5 6 4 1 - - - - - - - - - - - - 1 - - - 1 1 - 3 1 1 — 2 2 2 1 — 1 — — — — — — Intestine 15 11 13 8 - - - - - - - - - - - - - - - - 3 3 1 - 2 1 2 3 5 3 3 1 1 1 5 3 4 3 2 1 Bladder 2 — - — — — — — — — — — — — — — — — — — — — — — — — — — — — — — 1 — — — 1 — — — Other 9 19 18 19 - - - - - - 1 - - - - - - - 1 1 - 5 1 1 1 1 5 6 4 7 4 3 4 3 5 4 - 3 1 4 Totals 49 65 55 48 - - - - - - 1 - - - - - 1 2 1 1 7 10 7 1 7 7 14 4 15 23 10 6 10 14 17 15 9 9 5 11 Laboratory Work Specimens taken for bacteriological or chemical investigations, 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 1958 are as follows:— Faeces specimens 331 Sputum specimens 5 Blood specimens 24 Urine specimens 45 Swabs (nose, throat, ear, rectal and vaginal) 63 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 remaining in the room for disinfection. Lists of premises, articles, etc., disinfected during the year. Rooms 11 Books 59 Beds 8 Eiderdowns 3 Blankets 20 Pillows 20 Mattresses 11 Miscellaneous articles 1 Sheets 16 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 obtained 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. 25 Scabies and Lice During 1958 one case of infestation with scabies and one contact of this case 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 still disappointing. For the years before 1957 it has been possible to record an improvement in the number of children found to be infested with vermin, but in 1958, although 3,000 fewer children were examined, the number found to be infested rose from 28 in 1956 to 68 in 1957, and again in 1958 with 1,168 fewer examinations carried out, 30 infested heads were discovered. 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 Sundays 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 489 articles were lent under the scheme—an increase over the 1957 figure of 469. 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, also Sick Visiting. Members also took part in duties further afield, including London Airport, London theatres, concerts, etc. British Red Cross Society: The Southall Red Cross Division continues to progress in work and in membership, which is now well over 100. A Girls' Cadet unit was formed in the autumn, and had doubled its numbers before Christmas. Attendance was excellent, in spite of the hazards of illness and bad weather. Some of the older girls now assist at the local Hospital. Courses of First Aid and Home Nursing were given to Civil Defence personnel during the year, with very good results in the examinations. The Handcraft Club for Disabled people now has 20 members, having started in 1957 with only 4. The small premises in which the Club is held are no longer large enough for comfort and convenience. The main activities in the Borough are:— Instruction and Examinations in First Aid and Home Nursing. Welfare visiting. Medical Loan Depot. Nursing in the Home. Escort duties to and from Hospitals both distant and near at hand, for the sick, aged, blind people and children. Transport for the sick when required. Clerical work and other duties connected with the National Blood Transfusion Service, at the regular local sessions. Handcraft Club for the Disabled. After-care and emergency help for 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 26 at the Southall Community Centre. The approximate membership, after a temporary breakdown in the operation of the club, had returned to over 20 by the end of 1958. 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, continues to be popular and useful to its members, who number about 40. 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 meets every Wednesday and 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. The Club also arranged social events for its members and one of these was a party for thirty deaf children from the Heston School for the Deaf. Diabetic Club: The Club for Diabetics, started in 1956, continued to function throughout 1958. 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 was 45 and the attendance at monthly meetings averaged about 35 but altogether some 120 diabetics have enjoyed the benefits of the club since its formation in 1956. 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 at first in a room at The Grange, The Green, and after April in a room at the Work Centre for the Elderly in the Municipal Sports Ground. A programme of interesting discussions, demonstrations and specialist speakers was carried out during the year. The Group is assisted financially by the Housing Committee of the Borough Council and is under the direction of a Co-ordinating Committee of officials of the various bodies concerned with welfare of the family. The membership increased to 16 by the end of the year, with an average attendance of 12. Welfare of the Blind and Partially Sighted: The welfare services for blind and partially-sighted are the responsibility of the County Council under the National Assistance Act, 1948. The County Council's Welfare Department provides a Home Teaching service, the object of which is to enable blind and partially-sighted people to lead as full and active lives 27 as their handicap allows, by assisting them in overcoming the effects of their disabilities. The Home Teachers visit all blind and partially-sighted persons in their own homes, hospitals and residential homes, advise on all problems relating to their welfare and keep them in touch with available social services. Instruction is given in Braille and Moon systems of raised type, in handcrafts and where appropriate, in the Deaf-Blind manual alphabet. A handcraft class is held fortnightly at the King's Hall Methodist Church, South Road, Southall. Close co-operation is maintained between the County Council and Voluntary Organisations including the Social Club for the Blind, which holds fortnightly meetings 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 individual necessitous blind people. 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 are provided by the County Council either directly or through a registered agency and these 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. There are resident in the Borough 112 blind and 11 partially-sighted persons. One blind person is training, and 11 are in full-time employment. Of these two are in Workshops for the Blind, and one is working as a Home Worker. Those employed in Workshops or as Home Workers have their earnings augmented by the County Council. The majority of blind persons are not available for, or not capable of, training and employment owing to age or some other reason. 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 and a Home Work Organiser for persons in the Area (which includes the Borough) who are suffering from substantial and permanent handicaps. They work under the direction of the Area Welfare Officer. The Welfare Visitor visits handicapped 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, result in adaptations to make accommodation more suitable for the handicapped occupier, 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. The Home Work Organiser endeavours to procure from Industry appropriate assembly work and arranges for this to be carried out by handicapped persons where this is considered to be suitable and of assistance to the individuals concerned. Residents of the Borough needing any of the County Welfare Services briefly referred to in this Report should apply to the Area Welfare Officer, at the Local County Offices, Great West Road, Brentford. Residents of the Borough needing any of the County Welfare Services briefly referred to in this Report should apply to the Area Welfare Officer, at the Local County Offices, Great West Road, Brentford. 28 Old People The needs of 11 special cases of old people living in difficult circumstances were investigated during 1958, and what happened to them is recorded in the following list:— Admitted to hospital Admitted to old people's home 4 Remaining at home 7 (a) Home Help and District Nurse provided 1 (b) Social problem eased 1 (c) Referred to Welfare Visitor 1 (d) Awaiting housing for old people 2 (e) Awaiting entry to Home 1 (f) Died at home 1 The difficulties of the old persons recorded on this list were brought to the notice of the Public Health Department staff either by medical practitioners, interested relations, neighbours or friends, or following complaint by one or other of the statutory authorities. It is interesting to note that although more visiting was being done by voluntary agencies who might have found a greater number of desperate cases, the number referred to the Public Health department was very much lower than in previous years, which suggests that the available services are getting known and are being used in such a way that urgent requests for the removal of elderly neglected persons are not having to be made. It seems as if in Southall our elderly house-bound solitary people are being cared for better now. One old person who was brought to the notice of the Department in 1957 was admitted to a County Council home during 1958. 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 1958 was 19. It has been ascertained from the Area Medical Officer that 349 Southall people were given Home Help during the year and of these 288 consisted of chronic sick or aged persons, and of 732 persons who were assisted by the Home Nurses, 404 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 house-bound old people in need of the service. During the year 7,956 meals were delivered, an increase of 593 over the 1957 figure. The number of old people receiving the meals at any one time was 46, and the total number of old people helped in this way by the provision of one, two, three or four meals weekly was 86. The present service is being stretched to its uttermost to meet the need which continues to grow. 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 Southall Old People's Welfare Association. Chiropody Service for Old People: This service was continued throughout 1958. Five local chiropodists gave their services at cheap rates for Old Age Pensioners. 29 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 1958, and was operated by the various Old People's Clubs in the Borough. A few old persons in great need were sent on a holiday free of charge through the Southall Old People's Welfare Association. 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 1958. Southall Association for the Occupation of the Elderly: The Work Centre for the Elderly situated in the Municipal Sports Ground, and maintained by a voluntary association supported in part by Middlesex County Council and Southall Borough Council, continued to operate throughout 1958. 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 had risen by the end of the year to 46, and various types of work were carried out, carding buttons, sorting mixed metallic wastes from a large engineering company, trimming and stamping of metal bolts, trimming of rubber, assembly of ball point pens, etc., and the old people could be put on the jobs which were most suited to their capabilities. Any old age pensioner is eligible to apply for work under this Scheme and once taken on is kept on whether his or her output can be considered significant or not. It is realised by the workers that a flat rate of 10/- per week for a ten hour week is certainly much less than the younger healthy pensioner would be able to obtain in the labour market, but they also realise that as they grow older or ill and less able to do very much work this wage will continue the same. The scheme can never become self-supporting, but it is showing great benefits in the social and even physical well-being of the people who are working. There is a very happy atmosphere in the work rooms. National Assistance Act, 1948, Section 47: National Assistance (Amendment) Act, 1951: No case was dealt with under these powers during 1958. 30 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. A great deal of publicity both National and local was given to the subject of vaccination against poliomyelitis, and there is no doubt that this mass suggestion, combined with newspaper publicity on individual cases of illness and death, had a powerful effect in inducing the public to apply for protection. A special campaign entitled " Guard that Fire " was set on foot by the Royal Society for the Prevention of Accidents and Southall Borough Council supported by purchasing publicity material and having it spread throughout the Borough as widely as possible— the shopkeepers assisted by placing stickers with a bright colour and slogan in their windows. HOME ACCIDENTS The number who died as a result of accident other than motor vehicle accident rose from 9 in 1957 to 14 in 1958. Of these accidental deaths five were the result of accident in the home, and 6 from accidents in Hospital. Of these eleven two were infants who died in a fire, one age 50 died from coal gas poisoning. The other eight were over 70—seven of these (male 2, female 5) died after falls and one from coal gas poisoning. 31 ROAD SAFETY The number of motor vehicle accidents occurring within the Borough of Southall was greatly increased in 1958 compared with previous years, but the number of fatalities was less. Five persons, none of whom were children, were killed in street accidents. Details are as follows:— Persons Killed Type of Road User Cause of Accident Age Sex Motor cyclist Collision between solo motor cycle with passenger, and 21 M motor cycle combination. Both vehicles travelling Pillion passenger J South, the latter turning East 24 M Pedestrian Private motor car travelling West collides with woman pedestrian crossing the road from South to North 67 F Motor cyclist Motor cyclist travelling West runs into rear of stationary motor lorry standing without lights 50 M Motor scooter rider Crossroads collision. Woman rider of motor scooter travelling South collides with motor lorry travelling East 40 F Persons Injured Adult School Age Under 5 Serious Slight Serious Slight Serious Slight Pedestrians 17 28 5 24 2 3 Total 45 Total 29 Total 5 Pedal cyclists 19 74 4 11 Total 93 Total 15 Private motor car passengers 7 23 1 2 i 3 Total 30 Total 3 Total 4 Private motor car drivers 3 20 Total 23 Motor cyclists 13 71 Total 84 Drivers of other vehicles 4 25 Total 29 Passengers in other vehicles 4 24 Total 28 Horse rider i Adult Total 333 Children Total 60 Children Total - Fatalities Adult Total 5 Although there were no children killed the number of children injured on the roads was nearly twice as many as in 1957. 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. Of the five dying as a result of motor accidents in Southall one was a Southall resident; two other Southall residents died as a result of motor accidents received when they were away from home. 32 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. Sewerage Middlesex County Council provides the facilities for purification of sewage from the Borough at the Mogden Sewage Works. The amount of congestion occurring in the drains and sewers of the Borough, partly as a result of increase in the number of houses and shops and partly due to the fact that improved knowledge of hygiene results in an increased use of water for cleanliness, meant that problems have arisen of overcharging of sewers, and of flooding during periods of heavy rain. Measures to relieve this have had to be taken, and the latest position with regard to these improvements is as follows:— The completion of the Northern Soil Relief Sewer was carried out in December, 1958, flooding of High Street and The Broadway has thereby been relieved and conditions in South Road have been improved as a result of the new relief scheme. The construction of the Tentelow Lane Surface Water Outfall Sewer has just commenced. This outfall sewer will discharge into the water course and thence into the River Brent the surface water from the Havelock Road Housing Estate which has until now been discharged into the Canal. It will also be able to take surface water from the surface water sewers which will ultimately be provided in the parts of Tentelow Lane which at present have no surface water sewer. Tenders will shortly be invited for the provision of a soil sewer in part of Glade Lane and part of Havelock Road. This will enable properties which at present have no main drainage facilities to be connected to the public sewer. The Council has accepted the Consultant's report on the proposed Southern Soil Relief Sewer and the Consultants have been instructed to prepare an application to the Ministry of Housing and Local Government for approval of the scheme. This proposed sewer will relieve surcharging in the area of the Borough bounded by King Street and The Green in the East, the Railway in the North and the Canal in the South. It will also improve conditions in Norwood Road and Tentelow Lane. Sanitary Inspections of the District The total number of inspections of premises made during the year by the Public Health Inspectors was 6,826. Table XII gives an analysis of the number and nature of such inspections. The number of inspections showed a slight decrease in 1958. It will be seen that there is a considerable rise in the figure for inspections of houses under the Housing and Rent Acts. Some of the increase was due to inspections for Certificates of Disrepair permitted to be granted before increases of rent could be obtained by landlords of properties. 33 There was an increase also in the number of inspections of properties for which Improvement Grant was claimed, and a certain amount of house to house visiting to bring the housing records a little more up-to-date was carried out when possible. It will be seen also that the figure under the heading of Atmospheric Pollution inspections was greatly increased. That was only to be expected since the operations of the Clean Air Act had begun to come into force, and preparations were being made for the declaration of the first Smoke Control Area. Also the publicity consequent upon the Clean Air Act made the public more " smoke " conscious and many more complaints of dark smoke emissions from factory premises were received in the department and investigated. Market There is a market, part open, part covered, in the High Street where a weekly horse and cattle sale is held on Wednesdays and a general sale of market produce and goods is held on Saturdays. Special attention needs to be paid to the hygienic provisions and maintenance here. In addition, travelling fairs and circuses spend periods in the Borough, three to four times a year, and require supervision. School Sanitation Five 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 1958. Eradication of Bed Bugs Statistics for the year:— (a) Number of Council houses (1) found to be infested 6 (2) disinfested during the year 6 (b) Number of other houses Total 14 (1) found to be infested 8 (2) disinfested during the year 8 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. 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 three bodies were deposited in the Mortuary at Acton for post-mortem purposes and coroner's inquest if necessary. 34 Factories Act, 1937 The following tables give details of the work done in connection with the factories and outworkers in the Borough:— Inspections Factory Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted Non-Mechanical 5 2 - - Mechanical 173 134 5 — Totals 178 136 5 — Defects Found Particulars Number of cases in which defects were found Found Remedied Referred Number of cases in which Prosecutions were instituted To H.M. Inspector By H.M. Inspector Want of cleanliness 1 1 - - - Overcrowding — — - — - Unreasonable temperature - - - - - Inadequate ventilation - - - - - Ineffective drainage of floors - - - - - Sanitary Conveniences- (a) Insufficient 1 - - - - (b) Unsuitable or defective 5 5 - 1 — (c) Not separate for sexes - — — Other offences against the Act (not including offences relating to outwork) - — - - - Totals 7 6 — 1 — Outworkers Nature of Work Section 110 Section III No. of outworkers in August List required by Section 110 (1) (c) No. of Cases of Default in sending Lists to the Council No. of Prosecutions for failure to supply Lists No. of Instances of Work in Unwholesome Premises Notices served Prosecutions Wearing Apparel—Making 18 - - - - - Boxes—making 1 — — — — - Totals 19 — — — — — 35 The Rag Flock and Other Filling Materials Act, 1951 There are no premises in the Borough subject to registration or licence under this Act. Premises where upholstery is reconditioned and secondhand articles sold are included in the list of general inspections. Petroleum and Carbide During the year licences were in force in respect of 69 installations for petroleum, and 2 for carbide of calcium. Celluloid and Cinematograph Films Act, 1922 There are two licences in force for the purpose of stripping and making celluloid solution from cinematograph films. Inspections have revealed no infringements. 36 HOUSING Of the 83 houses recommended for slum clearance in the provisional programme for the years 1955 to 1960, 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 1 Numbers 1, 2,3 and 4, Killarney Cottages Demolished 12 Numbers 5 to 18, Featherstone Terrace Awaiting demolition 14 Numbers 2 to 4 and 18 to 28, Spencer Street Numbers 6 to 16, Spencer Street Demolished 14 Dagmar Cottage Allowed to remain provided no human habitation 1 Numbers 9 to 15, The Crescent Awaiting demolition 15 One cottage was brought up to suitable standard by the owner and is still inhabited. Improvement Grants (Housing Act, 1949, as amended by the Housing (Financial Provisions) Act, 1958) Three applications were received and all were approved for grant for property improvement. The improvements in standards of housing resulting from the use of this type of grant and from the repair conditions by which increased rents can be obtained under the Rent Act, 1957, make a useful although not extensive advance in the attainment of good environmental conditions for healthy living. Certificates of Disrepair (Rent Act, 1957) During the year 75 applications have been received, 75 proposals to issue Certificates were approved. Twenty-one certificates were issued and 17 certificates cancelled. Cancellation and issue are not necessarily related. Overcrowding There was an increase in the number of families referred to the Public Health Department. Thirty-three cases of new overcrowding were confirmed in 1958, a rise of 12 over the previous year, which had been the lowest since 1944. Twenty-six cases of overcrowding were relieved during the year—this figure was 44 in 1957. The number remaining on the Department's register of overcrowding at the end of the year was 63 dwellings. For further detail see Table XIII, page 63. Rehousing of Applicants for Council Dwellings Council Housing within the Borough Total number of families obtaining Council accommodation for the first time in 1958: 78 families, including 14 from Slum Clearance Areas, 6 from derequisitioned properties, and 12 moved into old people's dwellings. 37 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 168. There were 426 more houses built between 1930 and 1936 which still had old ranges with hot water supply, except where the tenants themselves installed modern fireplaces. 99 of these ranges were replaced by the Council up to the 31st December, 1958. These houses all have an electricity supply but most of them are without lavatory basins unless the tenants have fitted them. This year the Council has made plans to provide 48 more old people's dwellings. Until now bungalows have been built for old people but this time 4 blocks of 2 storey flats have been designed round a green fronting on Havelock Road and surrounded by families who have already settled on the Estate. Thirteen of these flats are to have the bedroom separate and the rest consist of bedsitting room, bathroom and kitchen. The staircases are to be made as easy as possible with good handrails and the more spritely tenants will have the upper flats. Dustbins are in alcoves on the balconies but there will be drying grounds and room for gardens at the back for those who like. Inside, the flats will be light and draught free. The living rooms and bed-sitting rooms are to be warmed by fireplaces with back boilers for water heating and are to have electric points as well. The bedrooms will have electric points and so will the kitchens. In bedrooms, bed-sitting rooms and bathrooms there are to be also alarm switches for use in emergency which will set a large bell ringing in the hall, where there will be an indicator to show the source of the call. By this means it is hoped that any tenant in distress will be able quickly to attract the attention of a neighbour. The baths are to have two hand grips inset to lessen the effort of getting in and out. Lighting on the staircases and balconies will be by fluorescent tube and kept on day and night so that at no time will it be necessary to find one's way in the dark. Twelve of these dwellings were completed by the end of 1958 and twelve old people's lettings arranged. The last of the houses built with gas lighting will have been modernised by early 1959; 72 houses in Greenford Avenue being dealt with in this year's programme. All the 349 houses built before 1929 will then have been wired for electricity, had modern fireplaces fitted and hot water supply and lavatory basins installed where necessary. Houses Let in Lodgings The Council applied the provisions of Section 12 of the Housing Repairs and Rents Act, 1954, houses let in lodgings. A permitted number, based on floor area, is 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. The number of houses owned by coloured immigrants and occupied by them as lodging houses had reached a figure of 102 by the end of 1958. Control by the application of Section 90 of the Housing Act, 1957, is continued. 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 family still occupies a caravan near the Grand Union Canal, at Bull's Bridge. 38 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 Bogh Council During the Year 1958 Since the end of the War (including 1958) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Dwellings 12 47 Houses — — 310 136 Flats 36 — 390 132 Prefabricated Houses - - 299 - Built by Private Enterprise During the Year 1958 Since the end of the War (including 1958) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Bungalows 3 20 Houses 2 — 227 - Flats — 78 - Prefabricated Houses — — - - 39 HYGIENE OF FOOD Food Poisoning Of the 9 cases notified as food poisoning, 5 were confirmed bacteriologically as Salmonella Typhimurium. Three of these cases occurred in one family. Personal Hygiene The free washing facilities in the public conveniences, which were brought into operation in September, 1950, continued to be available throughout 1958. During that period 10,100 paper towels were issued free, and also 3,626 linen towels, which were provided at a cost of 2d. per person. Milk The following licences under the Milk (Special Designation) (Raw Milk) Regulations, 1949 and 1950, and Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 and 1950, were issued:— for the sale of Tuberculin Tested Milk 22 for the sale of Pasteurised Milk 25 for the sale of Sterilised Milk 23 Supplementary Licences 18 88 Food Sampling The bacteriological analyses of 202 food samples, taken during the year, were carried out by the Public Health Laboratory Service. 156 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 73 Satisfactory 56 Doubtful 6 Unsatisfactory 21 In the Ealing Laboratory, which serves the Department for bacteriological investigations, the standard is bacteriological, whereas over the rest of the county the standard is a chemical one, the Methylene Blue Test. Our tests are more exacting, and although comparatively we may show worse figures, in fact we are applying better control. 44 samples were taken of Imitation Cream. The results of these were all satisfactory. Two samples of Pork Brawn and two samples of cooked mutton were tested. All were satisfactory. One sample of domestic tank water, and three samples of water from the Paddling Pool were tested during the year. All tests were satisfactory. 40 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) 31 2 Milk (various) 59 - Arrowroot 3 2 Cakes 4 — Cream 12 — Cooked Meat 4 — Drugs 8 - Fish and Fish Products 5 - Fruit—Fresh and Canned 8 4 Ice Cream 9 - Meat and Meat Products 10 - Preserves 4 - Sauce and Pickles 3 — Vinegar 13 - Miscellaneous 18 1 191 9 Milk. The new milk contained in two churns forming part of a consignment from a dairy farmer to a milk processing depot in this area was found to be slightly deficient in milk fat. The milk in all the remaining churns was satisfactory and as the average composition of the whole consignment was above the presumptive minimum standard no further action was taken. Arrowroot. Two samples of arrowroot from the same source were found to be an admixture of arrowroot and maize starch. A full investigation was made at the premises of the wholesale packer to whom an official caution was sent. Fresh Fruit. One trader was found to have Keiffer pears displayed for sale marked " Williams." He sold Keiffer pears from this display when William pears had been requested. Proceedings were instituted and the trader was fined a total of £4 and ordered to pay 2 guineas costs. Another trader had displayed Pond's Seedlings plums for sale marked " Victorias," and served from this display when a purchaser asked for Victoria plums. This trader was also prosecuted and the fines and costs imposed totalled £9 3s. od. Butter. A sample of butter purchased from a retail shop was found to be rancid. Enquiries showed that the retailer had received this butter from his wholesale supplier some time earlier and it appeared likely that the butter had become rancid whilst in the retailer's possession. This matter was dealt with by an official caution being sent. Merchandise Marks Acts, 1887-1953. The majority of the inspection work carried out under the provisions of the above Acts relates to ensuring that the requirements of the various Marking Orders made under the provisions of the Act of 1926, and which relate to the 41 marking with an indication of origin of certain imported foodstuffs when exposed for sale or sold, are complied with. Inspections were made at no separate premises of 531 displays of meat, apples, tomatoes, poultry and dried fruit. One retail potato merchant was found to be selling old potatoes described by means of a ticket as " New Potatoes", an official caution was sent. Labelling of Food Order, 1953. This Order requires pre-packed food to be marked with the name and address, or with the registered trade mark, of the packer or labeller. It also requires such food to be labelled with its common or usual name (if any) and with the names of the ingredients of a compounded food. It also controls the manner in which the presence of vitamins and minerals is disclosed and prescribes specific labelling of certain foods. A total of 441 articles of pre-packed food was examined at 116 premises to ascertain whether the above requirements were complied with; no serious infringements of this Order were detected. False or Misleading Descriptions. As in previous years food advertisements and labels have been scrutinised for false or misleading statements and descriptions. Much of this scrutiny of food labels can be combined with inspection work under the Labelling of Food Order. No serious infringements were disclosed. Corrective action was secured in relation to descriptions applied to " milk block," " Double Tea," an imitation cream powder, cakes filled with a mixture of butter and sugar, canned mixed vegetables, raspberry syrup, powdered soup mixes, medium red salmon, gorgonzola cheese spread and cheese spread. Special Designated Milk. During 1958, Middlesex County Council issued one Dealer's (Pasteuriser's) licence in respect of premises within this area where milk is processed. These premises were regularly inspected, and compliance with statutory requirements was well maintained. A total of 52 samples of designated milk were taken, one of which failed to satisfy the methylene blue test for keeping quality; an official caution was sent to the processors concerned. Safe Milk. In addition to the foregoing, 15 samples of raw milk were procured within this Borough and submitted to test for the presence of tubercle bacilli. None was found contaminated. Meat Inspections There is a slaughterhouse at St. Bernard's Hospital, under the control of the North West Metropolitan Regional Hospital Board. 220 pigs were slaughtered during the year to meet the needs of the institution. All were inspected and 120 lbs. of pig meat were condemned. 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. The hygienic standards of this market were improved in 1956 and in 1958 routine inspections were maintained to ensure the maintenance of good standards. Food Premises—Inspection High priority continued to be given to this work and although the staffing position remained unsatisfactory, the number of visits paid to food premises showed an increase over the 1957 figure. The standard of premises, equipment, and hygiene continued to be generally good. 42 The number of food premises in the Borough by type of business is shown as follows:— Shops 334 Greengrocers 49 Grocers 117 Confectioners 95 Fish Friers 11 Bakers 17 Butchers 33 Fishmongers 12 Catering Establishments (including Canteens) 128 Food Factories 20 482 Premises required to be registered are as follows:— Food & Drugs Act, 1955, Section 16 Fish Curing 7 Manufacture of Sausages or Preserved Food 28 Manufacture of Ice-cream - Sale only of Ice-cream 128 Manufacture and Sale of Iced-Lollies - Middlesex County Council Act, 1950, Section 11 Premises of Street Traders 9 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 64.142½ — — — — 64,142 ½ 42 — 64,100 ½ Raw 38,084½ 31,873 - — 31,873 6,211½ 3,164 — 3,047 ½ Totals 102,227 31,873 - - 31,873 70,354 3,206 — 67,148 Food Hygiene Food & Drugs Act, 1955 Food Hygiene Regulations, 1955-1956 The general standard of food premises in the Borough is good and visits to all premises are carried out from time to time to secure that the standard should be maintained. One prosecution, details of which are overleaf, was taken under Section 2 of the Food & Drugs Act, 1955, and was successful. 43 Unsound Food The following table shows items of unsound food which were investigated during the year, and the action taken. Vendor (and Source) Action Local Shop (made outside Southall) Bristle in icing of cake Agreement between customer and baker. Local Shop Cyst in sheep's kidney Prosecution—£10 fine. Cyst in ox livers Prosecution—Case dismissed. Local Shop (baked outside Southall) Grease in loaf Edible grease—Warning letter. Local Shop Wire in sliced corned beef Warning letter. Cafe Glass in spring greens served with meal Warning letter. Local Shop (baked outside Southall) Mould in gateau Warning letter. Local Shop (baked outside Southall) Mould in meat pie Warning letter. Delivered by outside dairy Ants in orange juice Insufficient evidence to support prosecution. Local Shop (baked outside Southall) Metal filing in loaf Warning letter. Local Shop Tin strained beef broth alleged unsound Not confirmed. Delivered by outside baker Mould in fruit pie Warning letter. 44 ATMOSPHERIC POLLUTION The amount of smoke, grit and sulphur dioxide in the atmosphere over the Borough of Southall continued to be recorded during the year 1958 at the five sites at which recordings have been carried out for previous years. Following reasonable improvement during 1957, the figures for 1958 were extremely disappointing, the averages for the year at all areas were up, only in the months of August and September was a general improvement shown and even that was spoilt by the figures obtained at the Railway Allotments site. The rainfall figures were heavy for all the months of the year and heavy rainfall brings down more of the atmospheric dust into the deposit gauges so probably the figures for 1958 give a truer picture of the amount of pollution entering the atmosphere from the industrial and domestic chimneys of the Borough than in a year when shortage of rain permits more dissipation of the atmospheric dust into other areas and into the higher atmosphere, and it is obvious from these figures that a much more strenuous method of prevention of atmospheric pollution is without doubt necessary. 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 47 and graphs prepared from the figures on the tables are to be found on pages 48-50. Comparisons with three other places, i.e. Westminster, Cambridge and Sheffield, still show that Southall is not atmospherically as impure as that in a highly industrial area, but the Borough is included in a large ring around and including London itself designated as a black area for atmospheric pollution under the Clean Air Act, 1956. Observations of individual factory chimneys seeming to be emitting smoke or grit to excess were continued throughout the year and some deterioration was also found in this respect, although much work and many improvements were carried out by the owners of offending premises. A greater number of spot checks on infringements were carried out and the resultant increase in the amount of black smoke emissions required attention. In no instance, however, was pollution so intense as to indicate the need for legal sanctions and in no instance was any difficulty experienced with owners of premises to whom these infringements were pointed out. Comparison of seven years' averages at Hortus Cemetery. Total solids Deposited:— 1952 11.93 1956 12.93 1953 10.67 1957 10.66 1954 14.30 1958 13.83 1955 16.94 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 smoke, smell or grit and number of premises concerned 34 complaints re 23 premises Number of places kept under observation 15 Number of observations made 83 Number of times black smoke was detected 16 Total time of black smoke emissions 13¾ minutes Number of times dark smoke observed 47 Total time of dark smoke emission 249 ¾ minutes Minimum time of observations 1 minute Maximum time of observations 35 minutes Total time of observations 1,276 minutes 45 In anticipation of the implementation of the Clean Air Act, the method of recording of observations was altered and the use of the Ringelmann Chart became part of the normal routine. There was a very considerable increase in the number of observations taken. The findings during 1958 were:— that on 16 occasions black smoke (Ringelmann 4) was detected from 10 industrial premises; on 47 occasions dark smoke (Ringelmann 2-4) was detected from 14 industrial premises. One of the firms giving out black smoke was in a neighbouring Borough and the matter was referred to the Medical Officer of Health of that Borough for action. In all the other instances, discussions took place with the owners of the appropriate firms and in most cases some improvement was achieved during the year. In four cases the requirements were likely to be extensive and discussions were continuing as to the best method for improving the nuisance caused. In no instance was black smoke emission of sufficient quantity to warrant prosecution. The coming into operation of the section of the Clean Air Act, 1956, on Smoke Control Areas meant that Southall had to be divided into districts to form a plan for the gradual obtaining of complete smoke control, and in 1958 work was started on the assessment and preparation of a scheme for the first Smoke Control Area in Southall, an area of 62 acres on the southern side of the Borough comprising 353 houses, 7 industrial premises and 8 other premises. 46 47 Atmospheric Pollution Estimation Month of Year Sulphur Trioxide Lead Peroxide Method, Milligrams per day per 100 sq. cms. DEPOSIT GAUGES Rainfall in mms. Tons per Square Mile per Month Soluble Insoluble Total 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 1958 1957 1958 1957 1958 1957 1958 1957 1958 1957 1958 1957 1958 1957 1958 1957 1958 1957 1958 1957 1958 1957 1958 1957 1958 1957 1958 1957 January 7.13 1.5 10.42 2.9 60 37 52 32 52 31 8.3 6.0 60 54 5.16 8.1 69 8.2 3.79 4.7 11.68 14.0 15.2 14.2 9.8 10.1 16.85 22.1 February 3.5 5.32 2.1 52 68 50 67 51 62 5.33 6.3 6.25 7.9 8.47 6.3 6.62 7.0 4.46 4.5 12.15 12.4 11.94 13.3 10.71 12.4 20.62 18.7 March 3.38 3.7 4.07 2.6 29 24 25 23 29 22 5.0 3.3 5.89 3.6 5.0 6.3 9.33 4.2 5.27 6.5 9.33 14.9 14.33 7.5 11.16 10.1 I4.33 21.2 April 1. 76 1.6 1.77 1.3 30 1 20 1 30 2 4.46 0.8 5.08 1.1 5.92 1.9 14.9 7.9 36.1 3.8 12.74 8.5 19.4 8.7 41.1 4.9 18.67 10.4 May o.73 1.2 2.02 1.7 59 15 48 10 54 15 5.03 3.4 3.74 3 .4 4.66 5.3 4.89 6.4 4.19 4.3 17.46 13.1 9.93 9.8 7.92 7.7 22.12 I8.1 June 0.89 1.0 2.0 1.5 107 18 90 3 102 10 10.8 2.9 6.78 2.3 7.92 3.7 8.08 9.3 3.66 4.0 17.75 5.0 18.88 12.2 10.45 6.3 25.67 8.7 July 1.11 1.0 1.34 1.4 62 87 43 68 59 78 5.21 2.1 11.22 8.4 6.61 6.0 16.45 6.3 3.5 4.6 20.79 10.6 21.65 8.4 14.72 13.0 27.41 16.6 August 0.54 1.0 1.45 1.9 78 57 52 41 71 43 0.73 3.5 0.86 6.7 0.61 8.9 5.68 5.4 3.39 3.7 11.54 9.4 6.41 8.9 4.25 10.4 12.15 18.3 September I.01 1.2 2.0 3.4 119 56 108 45 113 52 o.81 4.5 0.66 4.9 11.52 6.1 3.3 6.3 2.4 3.6 7.23 10.4 4.15 10.8 3.06 8.5 18.75 16.5 October 1.35 1.9 2.35 2.5 58.5 47 56.5 44 58 45 5.38 3.2 10.89 5.0 6.36 4.1 2.32 9.2 2.24 4.2 7.29 8.2 7.70 12.4 13.13 9.2 13.64 12.3 November 2.9 2.79 2.8 53.5 56 57 49 54 50 16.09 4.3 9.97 6.2 18.42 6.2 9.14 2.0 2.93 4.7 8.2 6.0 25.23 6.3 12.91 10.9 26.6 12.2 December 2.94 2.1 3.2 3.9 83 38 77 32 79 36 4.4 4.6 6.9 6.6 12.75 6.0 6.86 10.9 4.56 4. 1 12.52 18.9 11.3 15.5 11.46 10.5 25.27 24.9 Average for Year 1.98 1.7 3.33 2.33 66 42 56.5 34.6 62.5 38.6 5.96 3.74 6.19 5.1 7.78 5.75 7.87 6.92 6.37 4.4 12.39 10.95 13.83 10.66 12.56 9.5 20.17 16.7 Graph C Atmospheric Pollution by Sulphur Oxides (Lead Peroxide Method) 48 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) JAN. FEB. MAR. APR. MAY. TUN. JUL AUG. SEP. OCT. NOV. DEC. Hortus Cemetery New Primary School Railway Allotments 49 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. JAN FEB MAR APR MAY TUN JUL AUG SEP OCT NOV DEC. Cambridge Southall Sheffield Westminster 50 MISCELLANEOUS Noise Nuisance Eight complaints of noise were received, seven of which concerned 4 factories, and in each case abatement of the nuisance was obtained, but in the remaining case the complaint was 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 152 321 Business and Industrial 19 Domestic 133 Rats 96 Mice 56 Total number of visits in 1958: 1,553 Sewers 1st Treatment 2nd Treatment Total number of manholes baited 69 50 Number of poison takes 17 11 There was a considerable improvement in the figures for rat infestation during 1958. 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 Negotiations concerning pollution of the River Crane by two industrial premises using a joint discharge pipe was satisfactorily concluded by the provision of new effluent pipes with suitable interception. A new branch sewer was provided at the eastern end of the Borough, the effect of which was that domestic waste and some surface water drainage from a Club and two business premises were diverted into the main sewerage system with the consequent reduction of the pollution of the River Brent. A redevelopment at a factory from which oily waste had been percolating into and polluting the River Brent included the installation of petrol and oil interceptors and stopped pollution from that source. Establishments for Massage and Special Treatment Seven 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 3 Massage, Chiropody and Electrical Treatment 4 51 Medical Examination of Borough Council Employees During 1958, a total of 48 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 permament staff, for entry into the Sickness Pay Scheme, or for review after prolonged periods of sick leave. A survey of sickness absence amongst Borough Council staff during the year showed that of 154 members of the indoor establishment, 37 had some sick leave during the year, the total number of days of sickness being 1,183. Of the outside staff totalling 292 full-time and part-time, the number of persons requiring sick leave was 125, and the total number of days of sick leave 5,128. The corresponding figures for 1957 were, 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 the number of persons requiring sick leave was 194, and the total number of days of sick leave 5,509½. The amount of sick leave required by Council staff, both outdoor and indoor, was considerably less than during the previous year. In 1957 52% of the indoor staff required some period of sick leave during the year, while in 1958 the percentage was only 24. With regard to the outdoor staff 64.9% required in 1957 to have some period of sick leave while in 1958 this figure was reduced to 42 8%. The total number of days of sick leave over the whole establishments was reduced by 624½ days which, based on a 5½ day working week, is as the equivalent of one man working a 5½ day week for 2 years and 68½ days. 52 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 (59 beds) for the treatment of geriatric cases. 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, and Southall cases for geriatric treatment may be admitted to St. John's Hospital, Uxbridge. 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, aftercare 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 male and female beds under the surveillance of clinic physicians at:— (1) Harefield Hospital for the treatment of pulmonary tuberculosis; and at (2) Hillingdon Hospital for the treatment of other chest disorders. County Council of Middlesex—Health Department The County Council of Middlesex is the Local Health Authority under the National Health Service Act, 1946, and provides the following services in the Borough. (a) Care of Mothers and Young Children Ante-Natal Clinics Infant Welfare Clinics Diphtheria Immunisation, Smallpox Vaccination, Whooping Cough Immunisation, Poliomyelitis Vaccination Clinics Ultra Violet Light Clinic Priority Dental Service for Expectant and Nursing Mothers and Children under School Age Poliomyelitis Vaccination Jubilee Gardens Centre, Northcote Avenue and 13, King Street. Jubilee Gardens Centre and 13, King Street. Northcote Avenue Clinic. Northcote Avenue and 13, King Street. Northcote Avenue Clinic. (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.) 53 (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. (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. Northcote Avenue Clinic and Physiotherapy Jubilee Gardens Centre. Ultra Violet Light treatment Northcote Avenue Clinic. 13, King Street, Talbot Road School and Speech Therapy Jubilee Gardens Centre. 54 Dental treatment Northcote Avenue and 13, King Street. Diphtheria and Whooping Cough im- munisation, Smallpox and Poliomyelitis Jubilee Gardens and 13, King Street. vaccination Poliomyelitis vaccination Northcote Avenue Clinic. 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. 55 APPENDICES EXTRACTS FROM VITAL STATISTICS Table I Total Male Female Comparative Figures for 1957 Live Births—Legitimate 778 399 379 757 Illegitimate 42 20 22 37 Stillbirths— Legitimate 10 7 3 15 Illegitimate 1 - i - Deaths 636 321 315 690 Birth rate (live and stillbirths) per 1,000 of the estimated population 1573 15.26 Stillbirth rate per 1,000 total (live and still) births ... ... 13.24 18.54 Crude death rate per 1,000 of the civilian population ... ... 12.04 13.02 Deaths from Puerperal Causes (Heading 30 of the Registrar-General's Short List):— Deaths No. 30. Pregnancy, Childbirth, Abortion — Rate (live - per 1,000 and still) - total births - - Death rate of infants under 1 year of age:— All infants per 1,000 live births ... ... 20.73 21.41 Legitimate infants per 1,000 legitimate live births ... ... 19.28 21.14 Illegitimate infants per 1,000 illegitimate live births ... ... 47.62 27.03 Deaths from cancer (all ages) ... ... 139 113 Deaths from measles (all ages) ... ... - 1 Deaths from whooping cough (all ages) ... ... - - Deaths from diarrhoea, etc. (under 2 years of age) ... ... 1 1 56 Causes of Death, 1958 Table II Male Female Total 1958 Total 1957 1. Tuberculosis, respiratory 3 1 4 13 2. Tuberculosis, other 1 - 1 2 3. Syphilitic disease - 1 1 2 4. Diphtheria - - - - 5. Whooping cough — — — — 6. Meningococcal infections — — — — 7. Acute poliomyelitis — — — — 8. Measles — — — 1 9. Other infective and parasitic diseases 1 — 1 3 10/15. Cancer (all forms) 91 48 139 113 16. Diabetes — 1 1 5 17. Vascular lesions of nervous system 24 45 69 56 18. Coronary disease, angina 46 51 97 116 19/20. Heart disease 33 49 82 122 21. Other circulatory disease 27 33 60 49 22. Influenza 1 2 3 8 23. Pneumonia 17 26 43 64 24. Bronchitis 28 9 37 38 25. Other diseases of respiratory system 6 6 12 3 26. Ulcer of stomach and duodenum 6 2 8 10 27. Gastritis, enteritis and diarrhœa 2 1 3 3 28. Nephritis and nephrosis 2 1 3 7 29. Hyperplasia of prostate 3 — 3 6 30. Pregnancy, childbirth, abortion - — - — 31. Congenital malformations 5 2 7 3 32. Other defined and ill-defined diseases 16 24 40 43 33. Motor vehicle accidents 2 1 3 8 34. All other accidents 7 7 14 9 35. Suicide — 5 5 5 36. Homicide and operations of war — — - 1 Total Deaths 321 315 636 690 Deaths in Wards Table III Ward Male Female Total Waxlow Manor 33 17 50 Northcote 40 37 77 Hambrough 46 30 76 Dormers Wells 96 135 231 Glebe 62 43 105 Norwood Green 44 53 97 Total 321 315 636 57 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 2 2 3 3 16 February 7 3 — i 2 2 15 March 2 2 4 4 3 1 16 April 3 1 - 3 5 1 13 May 3 — 3 3 2 3 14 June 2 3 1 3 — 3 12 July 2 1 — 3 4 3 13 August 4 2 1 4 2 2 15 September 3 — 2 3 — 3 11 October 2 4 4 3 4 4 21 November 1 1 1 - 2 4 9 December 6 r — 3 — 3 13 Total 39 20 18 32 27 32 168 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 4 - - - 4 - - - - 4 Birth Injury 2 - - - 2 - - - - 2 Bronchitis, pneumonia, etc. - — — — - 2 — — — 2 Cerebrospinal infections - - - - - - - - - - Congenital malformations and congenital heart disease 4 - 1 - 5 1 - - - 6 Gastro-enteritis - - - - - - - - - - Haemorrhagic diseases of newborn - - - - - - - - - - Prematurity 2 - - - 2 - — - - 2 Peritonitis — — — — — — 1 — — 1 Total 12 - 1 - 13 3 1 - - 17 Live Births. Legitimate 778 Infant Deaths. Legitimate 15 Illegitimate 42 Illegitimate 2 58 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 3° 52 49,550 1.05 1937 42 28 70 51,560 1.35 1938 27 30 57 52,400 0.51 1939 33 4i 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 1958 9i 48 139 52,830 2.63 Table VII Notifiable Diseases during the Year 1958 (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 2 5 5 - 1 5 8 6 1 3 1 40 _ Encephalitis Acute-Infective - - - - - - 1 - 1 - - - 2 - Erysipelas 1 - - - - - - - 2 - 6 4 13 - Food Poisoning - 1 - - - 3 1 - 1 - 3 - 9 - Malaria - - - - - - - - 1 - 1 - Measles 5 37 51 41 66 261 9 2 2 2 - - 476 - Meningococcal Infection - 1 - - - - - - - - - - 1 - Pneumonia 2 2 2 - 1 13 1 8 5 6 14 10 67 3 Poliomyelitis Paralytic - - - - - - - 1 - - - - 1 - Puerperal Pyrexia - - - - - - - 2 1 - - - 3 - Scarlet Fever 1 - - 2 6 26 7 2 - 1 - - 45 - Whooping Cough 10 11 11 12 15 82 7 - 1 - - - 149 - Total 21 57 69 58 89 390 29 23 19 11 26 15 807 3 Dysentery 14 cases confirmed Shigella Sonnei by bacteriological investigation 1 case confirmed amoebic dysentery 2 cases notified as gastro-enteritis confirmed Shigella Sonnei 5 cases originally notified as suspected food poisoning confirmed Shigella Sonnei Food Poisoning 5 cases confirmed Salmonella Typhi Murium 1 case originally notified as dysentery confirmed Salmonella Typhi Murium Poliomyelitis — 1 confirmed case—paralytic 59 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 40 17 6 2 2 12 1 - Encephalitis Acute-Infective 2 1 - 1 - - - - Erysipelas 13 1 1 2 4 5 - - Food Poisoning 9 4 1 - 3 - 1 - Malaria 1 - - - - 1 - - Measles 476 107 49 93 185 9 33 - Meningococcal Infection 1 - - - - 1 - - Pneumonia 67 3 8 9 23 19 5 3 Poliomyelitis (Paralytic) 1 - 1 - - - - - Puerperal Pyrexia 3 - 1 - - 2 - - Scarlet Fever 45 4 9 5 17 5 5 - Whooping Cough 149 3° 50 24 39 3 3 - Tuberculosis 80 9 13 16 25 9 8 5 Total 887 176 139 152 298 66 56 8 Dysentery — 14 cases confirmed Shigella Sonnei by bacteriological investigation 1 case confirmed amoebic dysentery 2 cases notified as gastro-enteritis confirmed Shigella Sonnei 5 cases originally notified as suspected food poisoning confirmed Shigella Sonnei Food Poisoning — 5 cases confirmed Salmonella Typhi Murium 1 case originally notified as dysentery confirmed Salmonella Typhi Murium Poliomyelitis — 1 confirmed case—paralytic 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 4 1 - - - - - - 5-10 - 1 - - - - - - 10-15 1 - - - - - - - 15-25 3 6 1 - - - - - 25-35 16 4 4 - 1 - - - 35-45 9 1 1 — — — — — 45-65 14 8 3 2 2 - - - 65+ - 1 — — — 1 1 — Unknown — — — — - — - — Total 47 22 9 2 3 1 1 - 60 Table X The occupations of the new cases are as follows:— Occupation Pulmonary Non-Pulmonary Male Female Male Female Assistant Nurse 1 - - - Airport Marshaller 1 - - - Accounts Clerk - - 1 - Accounting Machine Mechanic 1 - - - Bakery Worker - - 1 - Barber 1 - - - Barge Worker 1 - - - Boiler Operator 1 - - - Cable Jointer 1 - - - Carpenter - - 1 - Child 1 - - - Clerk - 1 - - Clerk 1 - - - Clerk 1 - - - Clerk 1 - - - Civil Servant 1 - - - Cost Clerk 1 - - - Draughtsman 1 - - _ Electrician 1 - - - Electrician 1 - - - Engineer 1 - - - Factory Assembler - 1 - - Factory Hand 1 - - - Factory Worker 1 - - - Factory Worker - - 1 - Factory Worker - - 1 _ Fitter - - - - Gear Grinder 1 - - - General Labourer 1 - - - Housewife - 7 - 2 Labourer 3 - 1 - Locker-Room Attendant 2 - - - Machine Operator 3 - - - Mental Patient 6 5 - - Pre-School 2 1 - - Process Engraver - - 1 - Schoolchild 1 1 - - Shop Assistant - 1 - - Shorthand Typist - 1 - - Student - 1 2 - Student Nurse 1 1 - - Unknown 4 1 - - Warehouseman 1 - - - Wood Finisher - 1 - - Total 47 22 9 2 61 Table XI Examinations for Verminous Conditions and Children Found to be Verminous Attending Maintained Schools in Southall during 1958 and 1957 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 1958 1957 1958 1957 1958 1957 1958 1957 Beaconsfield Road, J.M. 858 976 - 4 - 2 - 1 Beaconsfield Road, I. 446 478 1 4 1 2 1 1 Clifton Road, J.M. 725 667 - 2 - 1 - - Clifton Road, I 423 576 1 7 - 4 - 2 Dormers Wells, J.M. 772 824 2 - 1 - - - Dormers Wells, I. 438 430 - - - - - - *Dormers Wells, S.B. - - - - - - - - *Dormers Wells, S.G. - - - - - - - - Featherstone Road, J.M. 724 972 2 10 - 3 - - Featherstone Road, I. 627 535 2 3 - - - - George Tomlinson, J.M. & I. 1413 1,471 1 4 - 1 - - *Featherstone Road, S.B. - - - - - - - - Lady Margaret, J.M. 1,283 1.379 1 2 1 2 1 1 Lady Margaret, I. 746 811 5 - 3 - 1 - North Road, J.M. 826 1,079 6 3 6 3 5 - North Road, I. 456 492 10 2 9 1 7 1 St. Anselm's R.C. 1,178 998 7 2 5 1 1 1 *Talbot Road, Mixed - - - - - - - - Talbot Road, Specials 156 149 - - - - - - Tudor Road, J.B. 1,124 1,193 1 12 1 6 1 6 Tudor Road, J.G. Tudor Road, I. 629 667 6 8 3 2 1 I Western Road, J.M. & I. 230 525 - 5 - - - - *Western Road, S.G. - - - - - - - - †Routine Medical Inspections - - - - - - - - Total 13.054 14,222 45 68 30 28 18 14 * Not inspected t Figures are included in school totals 62 Table XII Sanitary Inspections—Classification of Visits Houses, Public Health Act, 1936 3,297 Houses, Housing and Rent Acts, 1936-1957 814 Overcrowding 239 Disinfestation 78 Pet Animals Act, 1951 18 Vans, Sheds 52 Shops Act, 1950 27 Food Shops 303 Fried Fish 16 Cafes, etc. 231 Factories (Mechanical) 134 Factories (Non-Mechanical) 2 Outworkers 35 Food Factories 151 Smoke 162 Offensive Trades - Bakehouses 19 Dairies 6 Water Sampling 3 Ice-Cream Sampling 183 Other Foods Sampling 42 Schools 5 Stables 3 Offensive Accumulations - Hairdressers 1 Petrol 82 Canal Boats 6 Slaughterhouses 80 Rats and Mice 155 Infectious Diseases 244 Atmospheric Pollution 309 Markets—Saturday and General 129 6,826 Table XIII HOUSING—GENERAL Statistics Housing Act, 1936—Overcrowding : (a) (1) Number of dwellings overcrowded at the end of the year 63 (2) Number of families dwelling therein 86 (3) Number of persons dwelling therein 354 (b) Number of new cases of overcrowding reported during the year 33 (c) (1) Number of cases of overcrowding relieved during the year 26 (2) Number of persons concerned in such cases 134 (<1) 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 63