Ac 4355 STPAN 107 Metropolitan Borough of Saint Pancras. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1952 DENNIS H. GEFFEN, m.d., b.s., m.r.c.s., l.r.c.p., d.p.h., Medical Officer of Health. Metropolitan Borough of Saint Pancras REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1952 DENNIS H. GEFFEN, m.d., b.s., m.r.c.s., l.r.c.p., d.p.h., Medical Officer of Health. CONTENTS. PAGE Introductory 4 Committee and Officers 12 Section 1.—General Information 15 Section 2.—Population, Births and Deaths 20 Section 3.—Notifiable Diseases 30 Section 4.—Sanitary Circumstances 39 Section 5.—Factories, &c 47 Section 6.—Inspection and Supervision of Food 51 3 INDEX. PAGES Aged persons, care of 9,43 Ambulance facilities 18 Analyst, Public 14 Area of Borough and open spaces 15 Bacteriological examinations 36, 53 Bakehouses, visits to 47 Barbers and hairdressers 6 Basement bakehouses 50 Basement rooms 42 Births— illegitimate 20, 25 numbers and rates since 1918 24 rates 15, 20, 24 registered live, and rate 15, 20, 24 registered still, and rate 20, 25 still—numbers and rates since 1929 25 Blind persons, care of 45 Bodies received at mortuary 45 Burials 43, 44 Cancer, deaths from 27, 28 Chemical examination of food 52 Chief Officers of the Council 12 Cleansing and disinfecting 37 Clerical staff 14 Climatological summary 19 Closing and demolition orders 42 Committee, members of 12 Complaints 39, 41 Compulsory purchase orders 9 Condemned food 55 Coroner's Court 45 Cream, synthetic 54 Day nurseries 16 Deaths— bronchitis 21,22,23,28 cancer 21,27,28 classification, with age distribution 21 heart disease 21, 28 illegitimate children 25 infantile, and rates 15, 22, 24, 25 infantile, with causes, age distribution 22 infantile, with causes, since 1939 23 maternal 26 measles 21,23,33 neo-natal 22, 24, 25 number and rate, all ages 15,20,24 pneumonia 21,22,23,28 puerperal causes 26 tuberculosis 15,21,23,28,29,35 Disinfecting 37, 38 Factories Act, 1937 48 Factories and bakehouses 47 Factory Inspectors 14 Factory Inspectors, work of 47 Food— condemned 55 inspectors 14 inspectors, work of 51 poisoning 55 sampling 52 summonses 54 unsound 55 Foreword by M.O.H 4 General information 15 Health officers 14 visits by 10 Hospitals in the Borough 17 Housing 5 recommendations for 42 Ice cream 52,53, 54 Infantile mortality 15, 22, 23, 24, 25 causes, age distribution 22 causes, since 1939 23 numbers and rates since 1918 24, 25 rates 15, 22, 24, 25 (6134) PAGES Infectious diseases 6, 30 notifications 32 Inquests at Coroner's Court 45 Inspectors—housing, food, factory and district 14 Intimation notices served 40, 41, 47, 51 Legal proceedings 41,54 Marriages 16 Maternal mortality 26 Maternity and Child Welfare centres 16 Measles 6, 32, 33 Meat and other foods—inspections 51 Medical examinations. 45 Milk—Designation and licensing 51, 52 Milk—Inspections, samples, etc. 51, 52, 53 Mortuary and Coroner's Court 45 National Assistance Act, 1948 43 Neo-natal deaths 22, 24, 25 Notices served 40, 41,47,51 Notifiable diseases 6, 30 Notifications—infectious diseases 32 Nurseries, day 16 Nursing Associations 16 Outworkers 49 Overcrowding 42 Persons per acre (estimated average) 15 Pet Animals Act, 1951 46 Pharmacy and poisons 42 Police Court proceedings 41, 54 Poliomyelitis 8, 32 Population of the Borough 15, 20 since 1918 24 Post-morten examinations 45 Prevention of Damage by Pests Act, 1949 46 Public Analyst 14 Public Health Annexe—attendance at 37, 38 Public Health Committee members 12 Public Health (Tuberculosis) Regulations, 1952 34 Puerperal deaths 26 Rag Flock, etc., Act, 1951 5, 50 Rat extermination 46 Rateable value and general rate 15 Registrars of births, deaths and marriages 13 Removal to hospital 31 Rodent control 46 Sanitary circumstances 39 Sanitary inspectors 14 Sanitary inspectors, work of 39 Scabies 37, 38 Scarlet fever 6, 32 School treatment centres 17 Staff 14 Statistics, vital 15,20,24,25 Statutory notices served 40,41,47,51 Stillbirths 20, 25 Summonses—see Legal proceedings. Synthetic cream 54 Tuberculosis— death rates 15,35 deaths 15, 21, 23, 28, 29, 35 chest clinic 16 new cases 34, 35 notification register 9, 36 notifications 9, 34, 35 prevalence and fatality for past fourteen years 35 Underground rooms 42 Unsound food 55 Verminous persons 37, 38 Visits to aged persons 10,40 Vital statistics 15, 20, 24, 25 Water 41 Welfare centres 16 Whooping cough 6, 32 A 2 4 Town Hall, Euston Road, N.W.I. June, 1953. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Pancras. Your Worship, Ladies and Gentlemen, I have pleasure in presenting to you my annual report for 1952. The population in the middle of the year, as estimated by the Registrar-General, was 139,600, which is 500 more than in 1951. The number of births increased from 2,146 to 2,186, the birth rate rising from 15.43 to 15.66. Deaths at all ages were 1,658, showing a decrease of 145, and the death rate fell from 12.96 to 11.87. The number of children dying under the age of 1 year was 56, the infant mortality rate being 25.61 per thousand registered live births. This is .49 less than in 1951. Deaths from tuberculosis fell from 73 to 46, and the death rate from this disease per thousand of the estimated population from .52 to .33. These preliminary figures indicate that, by and large, the health of the inhabitants of the borough was at least maintained during the course of the year. I should find it difficult to attribute to any particular factors the improvement in health over the past years, as evidenced by the lessened incidence of certain illnesses, the lowered mortality rate and the increase in the years of expectancy of life. Undoubtedly the better availability of medical advice and treatment, the advances of science and the improvement in curative methods must be of importance. The public appreciates this, for these services are obvious and in fact they advertise themselves. The value of a healthy environmental background is seldom appreciated as of prime importance. During the year no less than 37,000 visits were paid to private houses on complaint or as part of a routine survey. 5,904 visits were paid to factories, and the conditions of 723 outworkers were kept under supervision. Restaurants and catering establishments received no less than 1,713 visits, and on page 55 will be seen a list of food that has been voluntarily surrendered as unfit for human consumption. The continuous supervision year by year of the homes in which the people live, the factories in which they work and the food on which they are nourished, though unspectacular, forms the basis of improvement in the social life of the inhabitants of the borough. These visits are often interpreted as a bureaucratic interference with the life of the individual, and with the work of the manufacturer and caterer. They are in fact nothing of the sort. They represent co-operation between the Council and the residents of the borough, both in their home and industrial life; they represent a steady improvement in the appreciation of health principles. The food inspector seldom seizes merchandise from a cunning vendor who wishes to unload food unfit for human consumption upon an ignorant purchaser. It is a routine for the food inspectors' services to be sought by a reputable owner of food who wishes to know if his commodity is fit for human consumption and who is almost invariably prepared to surrender it for destruction or for some suitable purpose if the food inspector so advises him. I have been more than satisfied with the willingness of the caterer to take advantage of the advice and help afforded by the public health department. In the same way the owner of a factory is prepared and anxious to improve his premises in order to comply with the best principles of 5 health. The object of the department is not to prosecute successfully; it is to advise and help and thus to secure a better standard of hygiene. At the present time the cost of household repairs makes it difficult to obtain that improvement in rent controlled property which is desirable, but nevertheless improvement has been achieved in the vast majority of cases without recourse to legal proceedings. This, however, is no statement of a complacent attitude of mind. Where it has been necessary, authority has always been forthcoming to take out a summons and prosecute, and the tables in this report will show the number of occasions where this has unfortunately been necessary. I would like to envisage a time when the public health department achieved its object on an intimation notice without any exercise of its statutory powers. It is essential that where a nuisance exists which is dangerous or injurious to the health of the residents of the borough, such residents must be protected as soon as possible. On the other hand it is well to remember that before Court action is taken the person responsible for its remedy receives an intimation notice, a statutory notice, a warning letter and a summons, and sometimes telephone calls as well, so that he has a full opportunity of dealing with the matter in a spirit of co-operation. Housing. I am indebted to Mr. A. W. Davey, the Housing Manager, for the following summary:— During the past year the waiting list has been reviewed and at the 30th April, 1953, the number of applicants totalled 6,025 (the figure at the end of March, 1952, was 10,712). During the period 1st April, 1952, to 31st March, 1953, 311 new flats were completed, and altogether by means of vacancies and transfers the total housing movement affected 713 families. The following figures give an indication of the Council's housing progress:— No. of pre-war flats 1,203 No. destroyed by enemy action 52 Post-war flats occupied, 31st March, 1953 1,386 Post-war flats in course of construction, 31st March, 1953 495 Temporary houses 214 Requisitioned premises, 31st March, 1953 866 No. of tenants:— On estates 2,576 In requisitioned properties 1,626 In temporary houses 214 In other houses owned by the Council 724 5,140 Rag Flock. The Rag Flock and Other Materials Act, 1951, came into operation on the 1st November, last year, so that a full year's experience of its administration has now been gained. Your Chief Sanitary Inspector and those members of the Staff specialising in the supervision of factories took several opportunities of acquainting themselves with the production of filling materials and the making of mattresses by visiting manufacturers throughout the 6 metropolis, and spending some hours with the Government's prescribed analyst. In this way they prepared themselves to carry out their responsibilities under the Act. Rag Flock, by reason of its cheapness, is still one of the most frequently used filling materials. It is produced by washing old rags in cold water and, after drying, tearing them up into small fragments. The need is therefore apparent for sampling rag flock regularly. Barbers' and Hairdressers' Establishments. During 1952 an inspection was made of all barbers' and hairdressing establishments within the borough to ascertain if bye-laws were required similar to those operating in certain areas outside the Metropolis. 68 premises were visited with the following results: Premises not in satisfactory and clean condition 14 Basins without hot water supply 18 Instruments not sterilised— (a) at all 10 (b) after every customer 33 Without neck wool or other materials 13 Towels insufficient 7 Without protection for head rest 15 It must not be thought from the above figures that every barber's shop suffers from one or more defect. In fact in the majority of cases where there was one defect there were many, but by and large the barbers of the borough have generally a reasonable understanding of the requirements of hygiene in the conduct of their trade. I would go further. The trade itself is aware of these requirements and is anxious to see them adopted, and to this effect has prepared a code of hygiene, compiled by the Incorporated Guild of Hairdressers, the National Hairdressers Federation, the Hairdressers Registration Council and other major hairdressing organisations. Infectious Diseases. The figures for infectious diseases will be found on page 32. Measles and Whooping Cough. There were over 1,000 notifications of measles and approximately 250 of whooping cough. These two diseases remain epidemic in the borough and in the country as a whole. They are more serious in severity and fatality in the younger age groups, but I think it is true to say that over the past few years we have seen a milder type of attack. In fact the mortality from these two diseases in the borough shows a definite decline over the years. This may be due to a less virulent type of infection. Taking an optimistic point of view, however, it may be due to a healthier childhood with an increased resistance to disease and a better understanding and education of parents in the care of children suffering from these diseases, thus preventing complications. Scarlet Fever. There were notified during the year 145 cases of scarlet fever. Our attitude to this disease has changed during the past few years, for it appears to be less serious and less prone to spread. Scarlet fever was first made a notifiable infectious disease in 1889. Yearly records in St. Pancras are, however, available as far back as 1856, the figures presumably being obtained by a voluntary arrangement with the medical practitioners. 7 Scarlet fever is caused by an organism called the haemolytic streptococcus, of which there are some 30 types. The bacteria are localised in the throat and produce toxins. Scarlet fever is a disease affecting children chiefly between the ages of one and ten years, and girls appear to be affected more than boys. During the last century and the early part of this one, the disease assumed grave proportions. Between 1890 and 1899 notifications in St. Pancras were in the region of 1,000 a year, and death ensued in 459 cases. In 1893 the number of notifications was 2,465. The severe type of scarlet fever has seldom occurred in recent years. Of the 145 cases notified in the borough during 1952, the diagnosis of four was subsequently revised. Of the 141 true cases only six could be classified as other than mild. There was no mortality. Spread of Infection.—In most of the cases investigated during the year it was difficult to ascertain the source of infection. Where information was available the disease seemed to be caused by direct contact with another sufferer within the home or at school. In the past, epidemics have been recorded where the infection was milk-borne. Such outbreaks involved a series of houses served by the same dairy. There were no such outbreaks in the Borough during 1952. Constant attention to cleanliness and hygiene in milk processing, together with 100 per cent. pasteurisation of milk, in London, have almost eliminated this risk. At one time it was largely believed that infection could be spread by articles which had been in close contact with the patient. The theory to-day is that it is spread from person to person. Analysis of Cases by Age Groups—1952. Ages. Male. Female. Under 1 year — — 1 and 2 7 10 3 and 4 12 20 5 to 9 31 44 10 to 14 8 7 15 to 24 — — 25 and over 2 — Totals 60 81 Place of Treatment.—Ninety-two cases were treated at home. Forty-nine were removed to hospital, remaining there for a period of 10-21 days, except in two cases, when the period of detention was 6 weeks and 8 weeks respectively, due to the onset of complications. Removal to hospital took place for a variety of reasons. In one case there was kidney trouble, in two cases a member of the family was employed in the catering industry or in school maintenance, and in three cases the mother was the child's only attendant, and had to go to work. In the other cases, the reason was lack of proper home isolation mainly due to inadequate accommodation. Complications.—In one case, as stated, there was kidney trouble, in one case measles, whilst in the two cases where treatment in hospital was prolonged, one was complicated by otitis media and septic spots, and the other by angular stomatitis, rhinorrhoea and septic spots. Where the patient was nursed at home no complications are known to have occurred. 8 Isolation.—Of the 92 treated at home it was found possible to isolate the patient completely in 60 instances. In many of the other cases it was found possible to minimise risk of the spread of infection by putting the child in the parents' bedroom. "Secondary" Cases.—There were 7 secondary cases occurring in the same family, and four in the same house. In addition there were two "return cases" (i.e., those occurring in the same house within 28 days of the return from hospital of the original patients. Disinfection.—Disinfection of rooms with their contents and bedding is offered as a routine measure in every case of scarlet fever. Where the patient is removed to hospital, disinfection is carried out the same day that notification of removal reaches the Public Health Department. Where a patient is nursed at home, a letter is sent to the parents giving advice with regard to treatment and isolation. This letter encloses a form which the medical practitioner should sign when the patient has recovered, and, upon its return to the Public Health Department, disinfection is carried out. In 42 cases the forms were not returned and no disinfection was carried out. Little, if any, harm seems to have followed. Of the 13 cases in which secondary infection occurred in the same house, no disinfection was carried out in six of them In 36 cases, therefore, although no disinfection occurred, there were no further cases in that house. It is doubtful if disinfection has any effect in preventing the spread of scarlet fever. It is continued because of the feeling of comfort and security it gives to many households, and reluctance to abandon any preventive measure until it is proved entirely ineffective. A visit is paid to every home where scarlet fever is notified to advise on disinfection, isolation, exclusion from school and general hygiene. In 10 cases sanitary defects were discovered and the requisite notices served. Poliomyelitis. Since 1947 poliomyelitis has been endemic in the country at large, and cases have been regularly notified in St. Pancras. The corrected notifications since 1947 are set out below:— Year. Para. Non-Para. Total. 1947 — — 15 1948 — — 5 1949 — — 45 1950 11 9 20 1951 3 2 5 1952 8 15 23 It was only in 1950 that the notification form distinguished between paralytic and nonparalytic cases. In 1952, of 23 cases 8 were paralytic. The Council will be aware of the Public Health Department's concern as to this disease. It is known to be due to a virus of which there are at least three strains, and it does not appear that the immunity derived from one strain protects against attack by another. There is some definite evidence that the paralysis of poliomyelitis can be prevented by the giving of gammaglobulin (a fraction of the blood serum) during the early incubation period. The practical application of this as a prophylactic measure is, however, difficult. Large sums of money would be involved in giving gammaglobulin to thousands of contacts, but the vast majority of contacts do not develop a paralytic attack of the disease and the giving of gammaglobulin in these cases would be unnecessary and wasteful. Experiments have shown that immunity can be obtained in animals by the giving of a vaccine, and the position for the future is not entirely pessimistic. In our own department we have carried out investigations into certain aspects of the causation of paralysis and hope shortly to 9 publish an article both on this and on the occurrence and severity of poliomyelitis in young children. Tuberculosis. 349 cases of tuberculosis were notified during the year, of which 255 were primary or new notifications. The register shows that at the end of the year there were 1,592 persons in the borough notified as suffering from tuberculosis. This is a decrease of 15 on the previous year. I think these figures over exaggerate the situation, for it is possible that many of the cases have left the district or are now cured and I hope to revise the register in due course. However this may be, it is apparent that approximately 1 per cent. of the population of St. Pancras has at one time or another been notified as suffering from tuberculosis. Insofar as it is wise and possible a visit is paid by the district sanitary inspector to every newly notified case of tuberculosis or to a patient suffering from tuberculosis who has moved into the borough, in order that advice may be given helpful to the patient in the cure of his disease and to the community at large in preventing its spread, by an improvement in environmental conditions. 225 households were visited. The picture is not too satisfactory. In four cases the only accommodation available to the patient or his family was in the basement. Only 71 patients were living in self-contained dwellings. 24 families were statutorily overcrowded, and 51 patients shared a bedroom with children. On the other hand in 135 cases the patient had a separate bed and in 83 of these the patient had a room to himself. Ventilation and lighting were inadequate in 5 cases and dampness was present in 29. Sanitary defects were serious enough in 65 cases to warrant the service of a notice, and in my opinion this alone justifies the visits carried out by the sanitary inspectors. Records show that some 21 families upon whom we reported in 1951, and three investigated during 1952 were re-housed during the year. The Council will appreciate that frequent visits are made to the public health department by persons living in the same house as a patient suffering from tuberculosis, demanding rehousing in order to avoid risk of infection to themselves or their children. Such requests are very easily understandable. I am of opinion, however, that the risk of infection by the use of a common water supply, bathroom or water closet, which is often the case in the borough, is not serious. It is constant contact between the infectious sufferer and, in particular, young children which must be guarded against. I would go further. A sufferer from tuberculosis, by an understanding of his disease and by the practice of simple but strict hygienic precautions, can minimise to a very large extent the chance of his conveying tuberculosis to those with whom he comes in contact. Compulsory Purchase Orders. The Council's Sanitary Inspectors' technical knowledge is utilised in connection with the compulsory acquisition of property. For the purpose of the preliminary report to the Council the area to be acquired is surveyed and certain data collected and tabulated. This informs the Council of the size of the area, the condition of the premises and the number of adults and children in each house and in the area as a whole. The survey also indicates the number and type of new units of accommodation which will be required to re-house the residents. Care of the Aged. The work of the St. Pancras Association for the Care of the Aged has continued during 1952 in happy co-operation with the services of the Council. 10 The following is a short summary of this combined effort: No. of voluntary visitors. (An attempt is made to visit an old person once a week) 90 No. of holidays arranged 124 Total attendance at the Chiropody Clinic 1,396 Total attendance at the Medical Clinic 521 No. of persons provided with a wireless set 61 No. of meals provided in the home 9,914 No. of meals subsidised in restaurants 3,498 No. of visits made by Council's Health Officers 2,494 No. of special cases visited by Deputy Medical Officer of Health together with the Chief Sanitary Inspector 33 Mr. A. W. Davey, the Housing Manager, has given me the following report on the housing of old people: "Careful attention is paid to elderly persons, especially in known cases of hardship, and every endeavour is made to advise and obtain any assistance which may be necessary. Reassessments of supplementary pensions and rent allowances have been obtained and cases referred by the Housing Manager to the National Assistance Board have always received prompt attention, usually resulting in benefit to the applicant. Aged tenants are all well known to the Council's Estate Managers and also have immediate supervision by resident caretakers or responsible tenants. Where old people are living in requisitioned property, however, the position becomes more difficult, but it is largely overcome by the Area Estate Manager having a resident in the house who will contact him should the necessity arise. A property in Albany Street owned by the Council became vacant during the year and was adapted to provide one room accommodation for 8 old people, together with rooms on the top floor for a House Warden. The house is fully occupied by 8 elderly persons (two of whom are blind). Each room has a sink and water supply, gas cooking stove and a gas fire. There is a growing need for this type of accommodation and any suitable property becoming available might with advantage be considered for this purpose. During the past 12 months 89 old people have been rehoused in accordance with the ' Points Scheme' by the Council Over 70 23 single old people. 3 couples. Aged 60 to 70 32 single old people. 14 couples. Of a total of 40 bed-sitting room flats occupied during the last 12 months, 31 have been let to persons over 60 years of age." Conclusion. In my last annual report I referred to the necessity for the closest co-operation between the Public Health Department and the general practitioners attending patients in the Borough, and once again I am happy to express my thanks for the co-operation and friendship I have invariably received. 11 I am sure the Council will be pleased to know that a pilot research project has been planned with a view to ascertaining if there is any correlation between the environmental condition and the particular illness for which the general practitioner has been consulted. I would take this opportunity of thanking the Council and in particular the Public Health Committee for the help, encouragement and courtesy I have at all times received, and to express my gratitude to my colleagues and the members of the public health staff for their ever ready co-operation. I have already acknowledged the help I have received from the doctors in St. Pancras, but I would like to mention in particular Dr. Back, the Chest Physician, the consulting staff at St. Pancras Hospital who have given so much help in the care of the aged, and the staffs of the hospitals in the borough with whom it has been a pleasure to work. I beg to remain, Your Worship, Ladies and Gentlemen, Your obedient Servant, DENNIS H. GEFFEN, Medical Officer of Health. 12 Metropolitan Borough of St. Pancras. PUBLIC HEALTH COMMITTEE. (as at 31st December, 1952.) Councillor Mrs. L. A. Arabin (Chairman); Councillor Mrs. D. B. Damon (Vice-chairman)', The Mayor (Councillor R. C. W. Trill, J.P.); Aldermen Mrs. L. Bartlett and N. Shand Kydd; Councilors T. Barker, N. A. Burton, Mrs. M. Carruthers, Evan Evans, Mrs. M. A. Foster, Mrs. L. M. Jeger, Mrs. G. S. Jones, Miss A. McMaster, R. W. Smith and C. A. Sparks. CHIEF OFFICERS OF THE COUNCIL. Town Clerk and Solicitor R. C. E. Austin, LL.M. Borough Treasurer and Accountant P. C. Taylor, F.I.A.C. Borough Engineer and Surveyor C. S. Bainbridge, M.Inst.C.E., F.R.I.C.S., M.I.Mun.E. Housing Manager A. W. Davey, A.I.H. Borough Librarian F. P. Sinclair, A.L.A. Building Manager A. E. Ullmer. Superintendent Registrar J. M. Lander. 13 REGISTRARS OF BIRTHS AND DEATHS. St. Pancras Town Hall, Euston Road, N.W.I. Superintendent Registrar: John M. Lander. Deputy Superintendent Registrar: Henry J. Millichap. St. Pancras Sub-District. Registrar. Day and Hour of Fixed Attendance. North Edward Denis Muffett Daily, 9.30 a.m. to 12.30 p.m. Monday Tuesday Wednesday Thursday 2 p.m. to 4.30 p.m. Friday, 6 p.m. to 8 p.m. South-East Alice Andrews (Miss) Daily, 9.30 a.m. to 12.30 p.m. Monday Wednesday Thursday 2 p.m. to 4.30 p.m. Friday, 6 p.m. to 8 p.m. South-West Stanley Western Kirkup Daily, 9.30 a.m. to 12.30 p.m. Monday Wednesday Thursday 2 p.m. to 4.30 p.m. Friday, 6 p.m. to 8 p.m. REGISTRARS OF MARRIAGES. Alice K. Kimmance (Mrs.) Joseph Mahoney Edward Denis Muffett St. Pancras Town Hall, Euston Road, N.W.1. Hours of Attendance: Daily, 9.30 a.m. to 4.30 p.m.; Saturdays, 9.30 a.m. to 12.30 p.m. 14 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health ; Dennis H. Geffen, M.D., B.S., M.R.C.S., L.R.C.P., D.P.H. Deputy Medical Officer of Health: Susan M. Tracy, M.R.C.S., L.R.C.P., D.P.H. Public Analyst. C. Harcourt Wordsworth, B.Sc. (Lond.), F.I.C. Chief Sanitary and Housing Inspector. E. W. Winchester. Deputy Chief Sanitary and Housing Inspector. W. B. Dykes. Inspectors of Food and Food Places. (3) S. W. Capel (Senior Food Inspector). R. Warren. R. N. Thomas. Inspectors of Factories. (3) J. A. Hoare. I. Williams. Miss D. M. Richardson. District Inspectors (14). B. V. Cryer. J. E. Davies. C. A. Engledow. E. W. C. George. T. H. Hague. K. J. Lambert. J. Marginson. H. P. Price. E. S. Rushton. A. A. Sleet. D. H. Smith. H. E. Westripp. R. C. Whittaker. J. H. Willett. Clerical Staff (12). V. R. Meurice, Chief Clerk. C. W. Smith, First Clerk. G. F. Peeling. Miss B. Pinnock. J. F. S. Dove. E. Driscoll. N. L. B. Collier. A. J. Wilson. Miss M. J. Barnes. Mrs. J. L. MacKenzie. W. J. Flett. Miss S. Smith. Health Officers (2). Miss J. B. Brooking. Miss A. Mackie. 15 SECTION 1. General Information and Statistical Summary. General. The borough of St. Pancras is about 4 miles long, extending from near Oxford Street in the south to Highgate in the north, and averages about a mile in width, from the Outer Circle of Regent's Park in the west to York Way in the east. Summary of Statistics. Area of the borough 2,694 acres Area of various public open spaces 553 acres Population (1951 Census) 138,364 Population (Registrar General's mid-1952 estimate) 139,600 Number of persons per acre (estimated average) 52 Rateable value £2,114,144 Product of a penny rate about £8,650 General rate in the £ for the year 17s. 8d. Summary of Vital Statistics. Net registered live births 2,186 Birth-rate (per 1,000 of estimated population) 15.66 Deaths, all ages 1,658 Death rate (per 1,000 of estimated population) 11.87 Infantile deaths 56 Infantile death rate (per 1,000 live births) 25.61 Tuberculosis deaths 46 Tuberculosis death rate (per 1,000 of estimated population) .33 16 Marriages. The following table shows the number of marriages which have taken place in the Borough since 1939, and the marriage rates for those years. Year. C. of E. R.C. Chapels. Superintendent Registrar's Office. Total Marriages. Estimated Population. Marriage Rate per 1,000 Population. 1939 741 266 76 1,346 2,429 167,300 29.04 1940 815 221 80 1,235 2,351 133,200 35.30 1941 534 185 56 792 1,567 103,770 30.20 1942 529 152 42 687 1,410 105,900 26.62 1943 445 121 33 602 1,201 108,640 22.10 1944 426 130 32 556 1,144 105,780 21.62 1945 589 175 51 695 1,510 111,400 27.10 1946 471 148 25 853 1,497 129,410 23.12 1947 405 179 32 961 1,577 136,700 23.06 1948 452 170 32 921 1,575 140,200 22.46 1949 389 221 23 934 1,567 141,330 22.17 1950 393 238 31 808 1,470 141,300 20.80 1951 429 245 54 766 1,494 139,100 21.48 1952 369 235 39 786 1,429 139,600 20.46 Maternity and Child Welfare Centres. Telephone St. Pancras School for Mothers, 1, Ampthill Square, N.W.1 EUS 2972 Camden Town Welfare Centre, Barnes House, Camden Road, N.W.1 GUL 1667 Kentish Town Welfare Centre, Raglan Street, N.W.5 GUL 1389 Queen's Crescent Welfare Centre, Queen's Crescent, N.W.5 GUL 2988 Somers Town Welfare Centre, Chamberlain House, Ossulston Street, N.W.1 EUS 2380 South Highgate Welfare Centre, 1, St. Alban's Road, N.W.5 GUL 2008 University College Hospital, Maternity and Child Welfare Department, Huntley Street, W.C.1 EUS 5050 Tuberculosis Chest Clinic. Telephone 26, Margaret Street, W.l LAN 4112/3/4 Day Nurseries. Telephone Caversham Road, N.W.5 GUL 5769 Margaret, 42, Phoenix Road, N.W.1 EUS 1822 254.256, Camden Road, N.W.1 GUL 2910 Coram Gardens, 41, Brunswick Square, W.C.1 TER 6054 1, Ampthill Square, N.W.1 EUS 3686 Kentish Town, 27, Gospel Oak Grove, N.W.5 GUL 2906 South Highgate, Chester Road, N.19 ARC 4921 Regents Park, 4, Prince Albert Road, N.W.1 GUL 4037 Nursing Associations. Telephone North London District Nursing Association, 6 and 7, Canonbury Place, N.l CAN 1955 Hampstead District Nursing Association, 3, Pond Street, N.W.3 HAM 6406 Metropolitan District Nursing Association, 18, Montague Street, W.C.1 MUS 0352 Maternity Nursing Association, 235, Camden Road, N.7 NOR 1723 17 Hospitals in the Borough. Name and Address of Hospital. Telephone Number. Authority under which Functioning. Number of Beds. British Hospital for Functional Mental and Nervous Disorders, 72, Camden Road, N.W.1 GUL 2041 Paddington Group 21 None. Eastman Dental, Gray's Inn Road, W.C.1 TER. 8426 Teaching Hospital (26) 4 Elizabeth Garrett Anderson, 144, Euston Road, N.W.1 EUS 2501 Board of Governors, Royal Free Hospital 138 Hampstead General and N.W. London (Out-Patients' Department), Bayham Street, N.W.1 GUL 1734 Board of Governors, Royal Free Hospital None. Highgate Wing, Whittington, Dartmouth Park Hill, N.19 ARC 3070 Archway Group 19 311 Hostel of St. Luke (Clergy Nursing Home for Clergy of Church of England and their dependants only) 14, Fitzroy Square, W.l. EUS. 1382 Disclaimed hospital 30 Institute of Ray Therapy, 152, Camden Road, N.W.1 GUL 1124 Paddington Group 21 None. London Foot, 33, Fitzroy Square, W.l MUS 0602 Paddington Group 21 None. London Skin, 40, Fitzroy Square, W.l MUS 1411 Paddington Group 21 None. National Temperance, Hampstead Road, N.W.1 EUS 5206 Paddington Group 21 158 Royal Ear, Huntley Street, W.C.1 EUS 5050 Department of U.C.H. 53 Royal Free, Gray's Inn Road, W.C.1 TER 6411 Teaching Hospital (3) 244 Royal National Throat, Nose and Ear, Gray's Inn Road, W.C.1 TER 4311 Teaching Hospital (16) 112 St. Saviour's (Women only), 10, Osnaburgh Street, N.W.1 EUS. 2770 Disclaimed hospital 20 University College, Gower Street, W.C.1 EUS 5050 Teaching Hospital (4) 678 University College (St. Pancras), St. Pancras Way, N.W.1 EUS 4411 Board of Governors, U.C.H. 341 Do. for Tropical Diseases EUS 4411 do. 86 School Treatment Centres in St. Pancras. (By appointment only. Application in first instance to Divisional Treatment Organiser.) Vision Highgate New Town Clinic, Chester Road, N.19. St. Pancras Clinic, 26, Prince of Wales Road, N.W.5. Somers Town Treatment Centre, Chalton Street, N.W.1. Dental Highgate New Town Clinic. St. Pancras Clinic. Somers Town Treatment Centre. Nutrition Highgate New Town Clinic. Somers Town Treatment Centre. Rheumatism Hampstead General Hospital, Bayham Street, N.W.1. Ears Royal National Throat, Nose, and Ear Hospital, Gray's Inn Road, W.C.1. (6134) B 18 School Treatment Centres in St. Pancras—continued. Tonsils and Adenoids Whittington Hospital, Highgate Wing, Dartmouth Park Hill, N.W.5. Enuresis Highgate New Town Clinic. Audiology Somers Town Treatment Centre: * Minor Ailments Highgate New Town Clinic. St Pancras Clinic. Somers Town Treatment Centre. * Children can attend for treatment without appointment and are seen by the doctor, if necessary, on his next attendance. Ambulance Facilities. In accordance with the provisions of the National Health Service Act, 1946, the London County Council, as the local health authority for the Administrative County of London, provides the following ambulance services free of charge:— (1) Accidents (wherever occurring) Sudden illness (in the streets, public places orplaces of employment.) Dial "999" (or follow the instructions given on the telephone instrument) and ask for '* AMBULANCE." (2) Very urgent illness at home (provided a medical practitioner certifies that the case is one of life or death and arrangements have been made with a hospital for the patient's admission) Telephone— WATerloo 6000 CENtral 6301 REGent 4000 RELiance 3622 or NEW Cross 2645 (3) Maternity cases.—Direct applications for removal cannot be accepted for removal to hospital except in emergencies occurring in the street or other public place, when—see (1) above. A doctor or midwife should apply to the Emergency Bed Service Normally, if the expectant mother has booked a bed at a hospital or nursing home, she is in possession of a white card (Form L.A.S.23) giving full instructions for summoning the ambulance. MONarch 3000 (4) Other Illness.—For the removal to and from hospitals, &c., of sick persons, provided the ambulance is ordered by the hospital authority, by the Emergency Bed Service or, in certain circumstances, by a private doctor. Application should be in writing or by telephoning WATerloo 3311 Further particulars may be had on application to the Officer-in-Charge, London Ambulance Service, County Hall, S.E.1. Telephone enquiries relating to the ordering of ambulances to WATerloo 3311; general enquiries to WATerloo 5000, Ext. 6950. 19 (6134) Climatological Summary, Year 1952. Station, Camden Square, N.W.1—Lat. 51° 33' N. Long. 0° 08' W. January February March April May June July August September October November December Barometer— Mean Pressure at 32° F. mbs. (reduced to M.S.L.) 1011.4 1020.6 1010.4 1016.2 1016.6 1017.2 1019.2 1012.4 1014.1 1011.0 1013.4 1012.3 Air Temperature. Mean of— A. Maximum °F. 44.1 44.6 51 .5 62.2 69.9 72.1 75.0 72.5 62.8 56.4 46.4 43.1 B. Minimum °F. 34.5 33.9 40.4 44.2 51.0 53.9 58.0 57.4 47.6 44.9 36.1 34.5 Mean of A and B °F. 39.3 39.3 45.9 53.2 60.5 63.0 66.5 64.9 55.2 50.7 41 .3 38.8 Difference from average (1906.1935) °F. —1.0 —1.2 +2.2 + 4.9 + 4.1 + 2.0 + 2.2 + 1.2 — 3.8 — 1.2 — 2.8 — 2.7 Mean relative humidity per cent. 85 85 85 73 67 67 65 73 79 85 86 90 Earth temperature at 4 ft. depth °F. 45.1 41.6 43.7 46.3 51.7 55.7 59.3 59.9 57.8 59.3 49.5 44.1 Bright sunshine— Total observed (daily mean) Hr. 1 .91 1.79 2.18 5.46 6.65 7.65 6.29 5.39 4.02 2.41 1.63 0.68 Percentage of average 205 112 77 130 107 116 102 96 95 93 126 85 Rainfall (rain-gauge level, 110 ft.)— Number of days precipitation 15 10 19 14 12 11 5 12 15 16 15 18 Total fall In. 1.64 0.90 2.97 1.25 1 .07 1 .59 0.70 2.54 2.76 2.61 3.85 2.38 Percentage of average (1881-1915) 88 54 162 81 61 79 29 115 152 99 163 100 Hour of observation, 9 a.m. (G.M.T.). The readings for Bright Sunshine are those taken at Regent's Park—no readings being recorded at Camden Square. Year Total Rainfall. Inches Days 1946 166 29.51 1947 140 20.98 1948 146 23.48 1949 111 17.61 1950 165 24.68 1951 185 32.58 1952 162 24.26 z e 20 SECTION 2. Births and Deaths. STATISTICS FOR THE YEAR 1952. Population. The civilian population, as estimated by the Registrar-General, mid-1952, was :—139,600. Comparable estimates for preceding years are set out on page 24. Registered Live Births. Rate per 1,000 of estimated population. M. F. Total. Legitimate 1,017 956 1,973 Illegitimate 107 106 213 1,124 1,062 2,186 15.66 Comparable figures for preceding years are set out on pages 24 and 25. Registered Still Births. Rate per 1,000 Live and Still Births. M. F. Total. Legitimate ... 20 14 34 Illegitimate ... 5 1 6 25 15 40 17.97 Comparable figures for preceding years are set out on page 25. Deaths—All Ages. M. F. Total Death rate per 1,000 of estimated population 913 745 1,658 11.87 Comparable figures for preceding years are set out on page 24. [To face page 20 LIVE BIRTH RATE DEATH RATE For the Borough, per 1,000 Population. 21 CLASSIFICATION OF DEATHS, WITH AGE DISTRIBUTION—1952 Causes of death Ages—Both Sexes Under 1 year 1 and under 5 5-14 15-24 25—44 45-64 65-74 75- Totals M. F. All Causes 56 8 5 13 91 457 475 553 913 745 1. Tuberculosis, respiratory — — — 1 9 19 11 3 32 11 2. Tuberculosis, other — — — — — 2 1 — 3 — 3. Syphilitic disease — — — — 2 5 7 1 9 6 4. Diphtheria — — — — — — — — — — 5. Whooping cough — 1 — — — — — — 1 — 6. Meningococcal infections — 1 — — — — — — — 1 7. Acute poliomyelitis — — — — 1 — — — 1 — 8. Measles — — — — — — — — — — 9. Other infective and parasitic diseases — — — — — 3 1 2 1 5 10. Malignant neoplasm, stomach — — — — 2 8 14 13 19 18 11. Malignant neoplasm, lung, bronchus — — — — 3 45 31 12 76 15 12. Malignant neoplasm, breast — — — — 2 15 7 4 — 28 13. Malignant neoplasm, uterus — — — — 2 6 2 1 — 11 14. Other malignant and lymphatic neoplasms — — 2 1 11 58 54 50 101 75 15. Leukaemia, aleukæmia — — 1 1 1 3 1 3 5 5 16. Diabetes — — — — — 3 1 1 2 3 17. Vascular lesions of nervous system — — — — 3 41 55 86 68 117 18. Coronary disease, angina — — — — 3 61 85 70 136 83 19. Hypertension with heart disease — — — — — 4 8 15 13 14 20. Other heart disease — — — — 5 30 37 121 72 121 21. Other circulatory disease — — — — 2 17 24 34 38 39 22. Influenza — — — — — 2 — 2 3 1 23. Pneumonia 8 1 — 1 2 18 23 25 51 27 24. Bronchitis 1 — 1 — 1 45 54 46 94 54 25. Other diseases of respiratory system — 1 — — 1 7 4 6 14 5 26. Ulcer of stomach and duodenum — — — — — 4 9 3 15 1 27. Gastritis, enteritis and diarrhœa 4 — — — 1 2 3 7 6 11 28. Nephritis and nephrosis — 1 — 1 4 4 3 3 10 6 29. Hyperplasia of prostate — — — — — 1 2 5 8 — 30. Pregnancy, childbirth, abortion — — — — — — — — — 3 31. Congenital malformations 8 1 — — 5 — 1 — 10 5 32. Other defined and ill-defined diseases 34 1 — 3 9 33 26 27 71 62 33. Motor vehicle accidents — — — 1 3 3 2 2 8 3 34. All other accidents 1 1 1 2 8 5 5 10 25 8 35. Suicide — — — 1 7 13 4 1 20 6 36. Homicide and operations of war — — — 1 1 — — — 1 1 22 DEATHS OF INFANTS UNDER 1 YEAR OF AGE—1952 from stated causes with age distribution. Cause of death Age Under 1 day 1 day to 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 4 weeks and under 3 months 3-6 months 6-9 months 9-12 months Total deaths under 1 year M F Bronchitis — — — — — — 1 — — — — 1 Congenital Malformation of Digestive System — 3 1 — — 4 — — — — 4 — Congenital Malformation of Heart — — 1 — — 1 2 — — — 1 2 Erythroblastosis — 1 — — — 1 — — — — 1 — Gastro-Enteritis — — — — — — 2 1 — 1 1 3 Immaturity with Anoxia — 1 — — — 1 — — — — 1 — Immaturity, Unqualified 5 4 — — — 9 — — — — 7 2 Intracranial and Spinal Injury at Birth 5 3 2 — — 10 — — — — 9 1 Lack of Care 1 — — — — 1 — — — — 1 — Meningo-Encephalitis — — — — — — — 1 — — 1 — Meningocele — 1 — — — 1 — — — — 1 — Mongolism — — — 1 — 1 — — — — 1 — Other Birth Injury 2 1 — — — 3 — — — — 1 2 Pneumonia 1 2 — — — 3 3 1 — 1 7 1 Post Natal Asphyxia and Atelectasis 7 1 — — — 8 — — — — 4 4 All Causes 21 17 4 1 — 43 8 3 — 2 40 16 Death Rates of Infants under 1 year of age. Year. Legitimate Infants per 1,000 legitimate live births. Illegitimate Infants per 1,000 illegitimate live births. All infants per 1,000 live births. All infants: Death rates comparison. London Administrative County. England and Wales. 1952 25 28 26 24 28 1951 25 32 26 26 30 1950 28 52 31 26 30 1949 31 30 31 29 32 1948 36 42 37 31 34 1947 30 61 34 37 41 1946 37 47 38 41 43 1945 40 65 44 43 46 1944 57 105 64 51 45 1943 66 99 71 51 49 1942 59 117 66 51 51 1941 52 44 51 58 60 1940 52 86 56 49 57 1939 46 94 52 48 51 See also tables on pages 24 and 25. [To face page 22 INFANTILE DEATH RATES FOR THE BOROUGH INFANTILE NEO-NATAL ILLEGITIMATE (under the age of 12 months) (,, ,, ,, 4 weeks) (,, ,, ,, 12 months) Per 1,000 Registered Live Births. Per 1,000 Illegitimate Live Births. 23 Deaths of Infants under 1 year of age, from stated causes, since 1939. 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 Measles — — 1 — 1 — — 1 — — 1 — — — Whooping cough 5 — 8 3 1 2 3 — 4 1 — 1 1 — Influenza — — 1 1 1 — — 1 — — 1 — — — Cerebro-spinal fever — 1 — — — — — — — — — — — — Syphilis 1 1 — — 1 1 — — 1 — — — — — Tuberculosis — — — 1 — — — — 1 — 1 1 — — Meningitis — 1 — — 3 1 — 1 1 — 2 2 — 1 Meningococcal infection — — — — — — — — — — — — 1 — Convulsions 1 — — 1 — — — — — — — — — — Bronchitis 3 4 1 6 6 3 1 8 2 2 4 2 4 1 Broncho-pneumonia 13 16 — 10 10 20 — 7 13 7 7 7 8 — Pneumonia (not stated) 2 2 9 2 3 1 12 — 1 — 1 3 3 8 Enteritis and diarrhœa 30 29 9 23 18 20 24 13 13 4 2 5 1 4 Congenital malformations 11 10 8 13 10 13 6 8 8 13 5 11 9 9 Premature birth 30 17 19 27 28 25 7 24 15 20 12 7 4 10 Injury at birth 4 3 2 3 8 7 4 12 9 9 13 7 9 13 Atelectasis 2 5 4 5 8 6 13 11 7 21 11 8 8 8 Hæmorrhage from umbilicus 1 — — — — — — — — — — — — — Lack of care of newborn 1 — — 3 — 1 — — 2 — 1 — — 1 Violence — 9 — 3 — 6 4 3 7 — 1 — — — Mikulier's disease — — 1 — — — — — — — — — — — Maternal toxaemia — — 1 — — — — — — — — — 2 — Melæna neonatorum — — 1 — — — — — — — — — — — Icterus gravis — — 1 — — — — — — 4 — — — — Septicæmia — — — — — 1 — — 1 — — — — — Bacillary dysentery — — — — — 1 — — — — — — — — Intussusception — — — — — — — — — — — — 1 — Hæmolytic disease of newborn — — — — — — — — — — — — 3 1 Other diseases peculiar to first year of life — — — 8 — 4 2 1 3 — 3 3 — — Other causes 10 10 8 8 32 11 10 5 7 10 5 10 2 — Totals 114 108 74 117 130 123 86 96 95 91 70 67 56 56 24 Vital Statistics of Borough of St. Pancras since 1918. Year Population estimated at middle of each year Nett Registered live births belonging to the borough Nett deaths belonging to the borough At all ages Under 1 year of age Under 4 weeks. Number Rate per 1,000 of estimated population Number Rate per 1,000 of estimated population Number Rate per 1,000 nett live births Number Rate per 1,000 nett live births. 1918 196,883 3,318 16.8 3,914 22.3 340 102 98 30 1919 228,585 3,824 16.7 2,930 13.4 336 88 143 37 1920 228,980 5,934 25.4 2,895 12.4 435 73 171 29 1921 212,900 4,764 22.4 2,778 13.0 360 76 135 28 1922 212,500 4,559 21.5 3,107 14.6 337 74 117 26 1923 214,400 4,348 20.3 2,585 12.1 272 63 129 30 1924 214,600 4,112 18.8 2,848 13.0 303 74 96 23 1925 216,300 3,880 17.9 2,745 12.7 280 72 95 24 1926 216,800 3,612 16.7 2,680 12.4 274 76 98 27 1927 213,200 3,299 15.5 2,621 12.3 205 62 85 26 1928 206,000 3,274 15.9 2,618 12.7 261 80 82 25 1929 204,400 3,170 15.5 3,126 15.3 262 83 95 30 1930 204,400 3,208 15.4 2,478 11.9 194 60 75 23 1931 195,600 2,955 15.1 2,601 13.3 200 68 71 24 1932 194,000 2,684 13.8 2,545 13.1 186 69 64 24 1933 190,900 2,589 13.6 2,608 13.7 151 58 69 27 1934 187,540 2,449 13.1 2,408 12.8 160 65 70 29 1935 185,300 2,466 13.3 2,219 12.0 155 63 60 24 1936 183,900 2,389 13.0 2,478 13.5 190 79 52 22 1937 181,900 2,364 13.0 2,329 12.8 154 65 48 20 1938 179,400 2,433 13.5 2,063 11 .5 156 64 57 23 1939 167,300 2,187 12.3 2,170 13.0 114 52 49 22 1940 133,200 1,948 14.6 2,728 20.5 108 56 41 21 1941 103,770 1,434 13.8 2,055 19.8 74 51 39 27 1942 105,900 1,785 16.9 1,730 16.3 117 66 55 31 1943 108,640 1,836 16.9 1,842 17.0 130 71 66 36 1944 105,780 1,914 18.1 2,001 18.9 123 64 52 27 1945 111,400 1,957 17.6 1,806 16.2 86 44 37 19 1946 129,410 2,494 19.3 1,717 13.3 96 38 51 20 1947 136,700 2,793 20.4 1,916 14.0 95 34 47 17 1948 140,200 2,447 17.4 1,596 11.3 91 37 65 26 1949 141,330 2,290 16.2 1,774 12.5 70 31 45 20 1950 141,300 2,188 15.5 1,630 11.5 67 31 39 18 1951 139,100 2,146 15.4 1,803 13.0 56 26 32 15 1952 139,600 2,186 15.7 1,658 11.9 56 26 43 20 25 Still Births, Illegitimate Births, and Deaths of Illegitimate Children. Year. Still Births. Illegitimate Births. Deaths of Illegitimate Children. Under 1 year. Under 4 weeks. Number (Illegitimates in brackets.) Rate per 1,000 births (live and still). Number. Rate per cent. of live births. Number. Rate per 1,000 Illegitimate births. Number. Rate per 1,000 Illegitimate births. 1918 — — 310 9.5 75 237 18 57 1919 — — 302 8.4 69 216 17 53 1920 — — 332 5.6 68 212 15 46 1921 — — 264 5.5 46 178 15 58 1922 — — 254 5.6 40 157 7 28 1923 — — 247 5.7 44 177 15 60 1924 — — 242 5.9 36 147 8 33 1925 — — 243 6.3 31 129 10 42 1926 — — 226 6.3 31 135 10 43 1927 — — 228 6.9 33 142 15 65 1928 — — 238 7.3 37 152 17 70 1929 114 (17) 34.7 246 7.8 31 123 8 32 1930 103 (16) 31.1 269 8.4 29 105 12 43 1931 104 (13) 33.9 245 8.3 29 114 12 47 1932 78 (13) 28.2 214 8.0 27 121 10 45 1933 88 (15) 32.8 227 8.8 23 99 17 73 1934 77 (8) 30.4 239 9.8 28 114 14 57 1935 94 (11) 36.7 218 8.8 21 95 11 50 1936 103 (9) 41.3 233 9.7 28 120 12 52 1937 78 (14) 31.9 221 9.3 28 121 10 43 1938 83 (17) 32.9 282 11.6 27 94 9 31 1939 60 (6) 26.7 265 11.7 26 94 Records suspended. 1940 66 (10) 32.8 197 9.8 17 86 1941 34 (6) 23.2 159 10.8 7 44 1942 48 (8) 26.2 188 10.2 22 117 1943 47 (11) 25.0 274 14.5 27 99 1944 59 (13) 29.9 287 14.5 30 105 1945 56 (13) 27.8 325 16.1 21 65 1946 64 (11) 25.0 297 11.6 14 47 1947 70 (8) 24.4 313 11.2 19 61 1948 46 (6) 18.4 281 11.5 12 42 1949 46 (3) 19.7 234 10.2 7 30 1950 37 (11) 16.6 230 10.1 12 52 7 30 1951 42 (6) 19.2 219 10.2 7 32 3 14 1952 40 (6) 18.0 213 • 9.7 6 28 4 19 26 Maternal Mortality in Borough of St. Pancras in 1952. Cause of Death. Ages. Conditions. 15-20. 20-25. 25-30. 30-35. 35-40. 40-45. 45 and up. Married. Single. Widowed. Septic Cystitis during Pregnancy — — — — — 1 — 1 — — Induced Abortion without mention of Sepsis or Toxaemia — — — — 1 — — 1 — — Delivery Complicated by Antepartum Haemorrhage — — — 1 — — — 1 — — All Causes — — — 1 1 1 — 3 — — Deaths from Puerperal Causes during 1952 and preceding years. Year. Sepsis. Other Causes. Total. Rate per 1,000 Live and Still Births. Sepsis. Other Causes. Total. 1939 1 2 3 0.44 0.89 1.33 1940 3 3 6 1.49 1.49 2.98 1941 1 3 4 0.68 2.04 2.72 1942 5 3 8 2.73 1.63 4.36 1943 — 1 1 — 0.53 0.53 1944 2 4 6 1.01 2.03 3.04 1945 3 2 5 1.49 0.99 2.48 1946 2 2 4 0.78 0-.78 1.56 1947 1 — 1 0.35 — 0.35 1948 3 — 3 1.20 — 1.20 1949 4 1 5 1.71 0.43 2.14 1950 2 1 3 0.89 0.45 1.34 1951 1 2 3 0.45 0.90 1.35 1952 1 2 3 0.45 0.90 1.35 27 Deaths from Cancer of St. Pancras Residents during 1952. Situation of Disease. Ages. Totals. 0-15. 15-20. 20-25. 25-35. 35-45. 45-55. 55-65. 65-75. 75-85. 85 and up. M F Lip — — — — — — 1 — — — 1 — Tongue — — — — — 1 1 — 2 — 2 2 Salivary Gland — — — — — — 1 — — — 1 — Floor of Mouth — — — — — — — 1 — — 1 — Alveolus — — — — — — — — — 1 1 — Tonsil — — — — — — — 1 1 1 1 1 Nasopharynx — — — — — — — 1 — — 1 — Hypopharynx — — — — — — 1 — — — — 1 Oesophagus — — — — — 1 1 4 3 — 6 3 Stomach — — — 1 1 2 6 14 11 2 19 18 Large Intestine (except Rectum) — — — — 2 3 4 5 8 2 8 16 Rectum — — — — 2 3 2 7 8 — 14 8 Biliary Passages — — — — — 1 2 1 1 — 3 2 Liver — — — — — — 1 2 2 — 5 — Pancreas — — — — 1 1 3 5 4 1 8 7 Peritoneum — — — — — 1 — 1 — — 1 1 Accessory Sinuses — — — — — 1 1 — — — 1 1 Larynx — — — — — 1 2 — — — 8 — Lung and Bronchus — — — 1 2 12 33 31 10 2 76 15 Breast — — — 1 1 7 8 7 3 1 — 28 Uterus — — — 1 1 2 4 2 1 — — 11 Ovary — — — — — 1 3 2 1 — — 7 Vagina — — — — — — — 1 — — — 1 Vulva — — — — — — — — 1 — — 1 Prostate — — — — — — 2 6 4 — 12 — Testis — — — 1 1 — 1 — — — 3 — Kidney 1 — — — — 1 2 2 1 — 4 3 Bladder — — — — — 2 1 4 4 1 8 4 Skin — — — — 1 — — 2 — 1 1 3 Eye — — — — — — 1 1 — — — 2 Brain 1 1 — — — 2 1 — — — 3 2 Thyroid Gland — — — — — — 2 — — — 1 1 Suprarenal Gland — — — — — — — 1 — — — 1 Bone — — — — — 1 1 1 1 — 1 3 Multiple Generalised — — — — — — 1 2 — — 3 — Lymphatic Tissue — — — 2 1 1 2 4 2 1 8 5 All Sites 2 1 — 7 13 44 88 108 68 12 196 147 28 The following table shows the number of deaths of St. Pancras persons from certain diseases during the years 1918 to 1952— Year. Cancer. Tuberculosis. Heart Disease. Pneumonia, (all forms). Bronchitis. Population. 1918 269 485 378 376 228 196,883 1919 245 341 360 179 301 228,585 1920 299 312 423 197 236 228,980 1921 290 304 411 173 276 212,900 1922 302 315 431 265 308 212,500 1923 319 272 394 201 223 214,400 1924 298 271 398 200 304 214,600 1925 324 231 381 204 274 216,300 1926 301 212 388 155 259 216,800 1927 292 217 448 207 227 213,200 1928 321 216 465 181 138 206,000 1929 297 250 603 295 255 204,400 1930 357 189 430 160 106 204,400 1931 355 206 553 203 143 195,600 1932 359 189 590 184 99 194,000 1933 354 195 656 168 100 190,900 1934 336 173 574 212 84 187,540 1935 326 139 607 156 68 185,300 1936 361 165 582 182 90 183,900 1937 337 162 579 216 81 181,900 1938 344 133 556 151 52 179,400 1939 359 130 581 146 85 167,300 1940 310 160 585 176 226 133,200 1941 260 123 414 153 129 103,770 1942 255 147 398 118 130 105,900 1943 288 117 416 141 168 108,640 1944 294 128 458 137 158 105,780 1945 287 127 399 113 145 111,400 1946 275 98 441 116 167 129,410 1947 342 105 447 149 170 136,700 1948 321 98 378 82 94 140,200 1949 345 105 453 118 127 141,330 1950 347 76 482 87 106 141,300 1951 343 73 533 118 158 139,100 1952 353 46 439 78 148 139,600 29 Deaths from Tuberculosis of St. Pancras Residents during 1952. Situation of Disease. Under 1 year 1-2 years 2-5 years 5-10 years 10-15 years ' 15-20 years 20-25 years 25-35 years 35-45 years 45-55 years 55-65 years 65-75 years 75 and upwards Total M F M F M F M F M F M F M F M F M F M F M F M F M F M F Respiratory System — — — — — — 1 3 1 4 1 5 4 9 1 9 2 2 1 32 11 Hip — — — — — — — — — — 1 — — 1 Kidney — — — — — — — — — — 1 — — 1 Liver — — — — — — — — — — — 1 — 1 All Sites — — — — — — 1 3 1 4 1 5 4 11 1 10 2 2 1 35 11 30 SECTION 3. Notifiable Diseases. The undermentioned diseases are compulsorily notifiable in St. Pancras A. Under the Public Health (London) Act, 1936 (Sections 192 and 304). Cholera. Continued Fever. Diphtheria. Enteric Fever (including typhoid and paratyphoid). Erysipelas. Membranous Croup. Relapsing Fever. Scarlatina or Scarlet Fever. Smallpox (Variola). Typhus Fever. B. Under Regulations made by the Minister of Health under powers contained in ihc Public Health Act, 1936 (Section 143). Acute Encephalitis (Regulation No. 2259, 1949). Acute Influenzal Pneumonia (Regulation No. 1207, 1928). Acute Poliomyelitis (Regulation No. 2259, 1949). Acute Primary Pneumonia (Regulation No. 1207, 1928). Dysentery (Regulation No. 1207, 1928). Leprosy (Regulation No. 1036, 1951). (See (a) below.) Malaria (Regulation No. 1207, 1928). Measles (Regulation No. 1100, 1938). Meningococcal Infection (Regulation No. 2259, 1949). Puerperal Pyrexia (Regulation No. 1081, 1951). Scabies (Regulation No. 1016, 1943). (See (c) below.) Tuberculosis (Regulation No. 704, 1952). Whooping Cough (Regulation No. 1100,1938). C. Under London County Council Order—Public Health (London) Act, 1936 (Sections 192 and 305). Anthrax (1909). Glanders (1909). Hydrophobia (1909). Ophthalmia Neonatorum (1910). (See (b) below.) 31 D. Under Food and Drugs Act, 1938 (Section 17, as amended by National Health Service Act, 1946, Tenth Schedule)— Food Poisoning. E. Under Public Health Act, 1936 (Section 143)—(Regulations of Local Government Board, 1900). % Plague. F. Under Section 66 of the Factories Act, 1937, the following conditions are notifiable to the Chief Inspector of Factories— Poisoning due to lead, phosphorus, arsenic, mercury, carbon bisulphide, aniline, benzine, manganese. Anthrax. Toxic Jaundice due to the use of certain industrial preparations. Epitheliomatous-ulceration due to the use of tar and other materials. Chrome ulceration. Compressed air illness. Toxic anaemia. If the case occurs in a factory the occupier of the factory must notify both the District Factory Inspector, whose address is 324, Gray's Inn Road, W.C.I, and the appointed factory doctor. (a) Notifiable to the Chief Medical Officer, Ministry of Health. (b) Also Regulation No. 971 made by Minister of Health (1.10.26) amended by S.R.O. No. 419 (1928) and No. 35 (1937). (c) Scabies is not notifiable where to the knowledge of the medical practitioner a case has occurred in the house and has been notified within the 28 days immediately preceding the date on which he first became aware of the disease in the case he is attending. Cases of Scabies and Vermin may be treated free of charge at St. Pancras Public Health Annexe, Prospect Terrace, Gray's Inn Road, W.C.I, (opposite Royal Free Hospital) (Telephone : TERminus 8567) between the hours of 9 a.m. and 4 p.m. and on Saturdays 9 a.m. to 12 noon. Removal to Hospital. Removal to hospital under certain circumstances of cases of Chickenpox, German Measles, Measles, Mumps and Scarlet Fever may be effected by telephoning to the Public Health Department (TERminus 7070). In the case of other infectious diseases applications should be made direct to the Emergency Bed Service (MONarch 3000). 32 NOTIFICATIONS OF INFECTIOUS DISEASES, 1952 (with 1951 comparison). Showing number of revised diagnoses. Disease Notifications Diagnosis subsequently revised Under 1 1 and over Totals 1951 1952 1951 1952 1951 1952 1951 1952 Acute Influenzal and Acute Primary Pneumonia 4 5 117 99 121 104 2 1 Acute Poliomyelitis — — 7 27 7 27 2 4 Diphtheria and membranous croup — — 12 11 12 11 11 8 Dysentery 12 2 148 82 160 84 7 7 Enteric or Typhoid Fever — — 3 — 3 — 2 — Erysipelas — — 24 25 24 25 2 — Food poisoning 1 1 39 18 40 19 — — Malaria — — — 2 — 2 — — Measles 104 27 1,889 1,158 1,993 1,185 3 6 Meningococcal Infection 1 1 6 5 7 6 — 2 Ophthalmia neonatorum 7 29 — — 7 29 — — Puerperal Pyrexia — — 51 124 51 124 — — Scabies 1 — 44 52 45 52 — — Scarlatina or Scarlet Fever — — 114 145 114 145 11 4 Typhus — — 1 — 1 — — — Whooping Cough 48 31 351 226 399 257 8 6 33 Measles. Particulars of the cases, deaths and incidence and mortality rates of Measles since 1926 are given in the following table:— Estimated population Year Cases Deaths Under 1 year Over 1 year Total Incidence rate per 1,000 population Under 1 year 1-5 years 5-15 years Adults Total Mortality rate per 1,000 cases 216,800 1926 260 3,474 3,734 17.2 25 38 2 — 65 17.4 213,200 1927 40 377 417 1.9 — 5 — — 5 12.0 206,000 1928 234 3,642 3,876 18.8 30 87 10 — 127 32.7 204,400 1929 28 563 591 3.0 — 4 3 — 7 11.8 204,400 1930 179 3,297 3,476 17.1 3 26 2 — 31 8.9 195,600 1931 31 399 430 2.2 1 1 — — 2 4.7 194,000 1932 135 2,730 2,865 14.8 6 21 — — 27 9.4 190,900 1933 38 399 437 2.2 — 4 — — 4 9.2 187,540 1934 195 3,443 3,638 19.4 8 23 1 — 32 8.8 185,300 1935 23 97 120 0.6 — 1 — — 1 8.3 183,900 1936 180 2,795 2,975 16.2 3 12 2 — 17 5.7 181,900 1937 28 610 638 3.5 — 1 — — 1 1.5 179,400 1938 166 2,171 2,337 13.0 5 6 1 — 12 5.1 167,300 1939 14 71 85 0.5 — — — — — 133,200 1940 20 265 285 2.1 — 1 — — 1 3.5 103,770 1941 45 571 616 5.9 1 — 1 — 2 3.2 105,900 1942 91 1,401 1,492 14.1 — — — — — — 108,640 1943 89 993 1,082 9.9 1 3 — — 4 3.7 105,780 1944 50 748 798 7.5 — — — — — — 111,400 1945 71 954 1,025 9.2 — — 1 — 1 1.0 129,410 1946 74 1,041 1,115 8.6 1 1 — — 2 1.8 136,700 1947 56 846 902 6.6 — 2 — — 2 2.2 140,200 1948 69 1,292 1,361 9.7 — 1 — — 1 0.7 141,330 1949 65 1,081 1,146 8.1 1 — — — 1 0.8 141,300 1950 39 1,018 1,057 7.5 — — — — — — 139,100 1951 104 1,889 1,993 14.3 — 1 — — 1 0.5 139,600 1952 27 1,158 1,185 8.5 — — — — — — Measles—Mortality Rate per 1,000 Cases. 34 Tuberculosis. Public Health (Tuberculosis) Regulations, 1952. The number of primary notifications of tuberculosis and those which became known by means of death reports and transfers from other districts, and deaths during the year, are given in the following three tables:— Number of Primary Notifications. Age periods 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Totals Pulmonary— Males — 4 5 — 17 20 25 27 24 15 12 149 Females — 3 5 1 14 13 23 10 6 2 1 78 N on-pulmonary— Males — 1 2 2 2 1 3 1 2 — 2 16 Females — — 2 — 1 3 4 — 2 — — 12 Totals — 8 14 3 34 37 55 38 34 17 15 255 Number obtained from Special Death Reports and by Transfer from other districts. Age periods 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Totals Pulmonary— Males — — — — 2 5 17 12 3 3 7 49 Females — 1 — — 1 10 18 6 1 — — 37 N on-Pulmonary— Males — — — — 1 1 — — — 3 — 5 Females — — — — 1 1 1 — — — — 3 Totals — 1 — — 5 17 36 18 4 6 7 94* • 10 of these cases came to knowledge by means of special death reports, and 84 by transfer from other districts 35 Number of deaths of Tuberculous patients. Age periods 0 to 1 1 to 5 5 to 10 10 to 15 15 to 25 25 to 45 45 to 65 65 and up Totals Pulmonary— Males — — — — 7 14 11 32 Females — — — — 1 2 5 3 11 Non-Pulmonary— Males — — — — — — 2 1 3 Females — — — — — — — — — Totals — — — — 1 9 21 15 46 The following table gives particulars of the prevalence and fatality of this disease during the past 14 years:— Year Estimated Population Notifications Notification Rate per 1,000 population Deaths Death Rate per 1,000 population Pulmonary Other forms All forms Pulmonary Other forms All forms Pulmonary Other forms All forms Pulmonary Other forms All forms 1939 167,300 310 44 354 1.87 0.26 2.13 118 12 130 0.70 0.07 0.77 1940 133,200 292 45 337 2.19 0.33 2.52 144 16 160 1.08 0.12 1.20 1941 103,770 283 40 323 2.72 0.38 3.10 113 10 123 1.08 0.09 1 .17 1942 105,900 274 42 316 2.58 0.39 2.97 134 13 147 1.26 0.12 1.38 1943 108,640 273 44 317 2.51 0.40 2.91 111 6 117 1.02 0.05 1.07 1944 105,780 320 38 358 3.02 0.35 3.37 115 13 128 1.08 0.09 1.17 1945 111,400 298 39 337 2.67 0.35 3.02 117 10 127 1.05 0.08 1.13 1946 129,410 308 47 355 2.45 0.36 2.81 92 6 98 0.71 0.04 0.75 1947 136,700 320 41 361 2.34 0.30 2.64 96 9 105 0.70 0.07 0.77 1948 140,200 318 45 363 2.27 0.32 2.59 90 8 98 0.64 0.06 0.70 1949 141,330 314 38 352 2.22 0.27 2.49 99 6 105 0.70 0.04 0.74 1950 141,300 344 32 376 2.43 0.23 2.66 69 7 76 0.48 0.05 0.53 1951 139,100 353 40 393 2.54 0.28 2.82 67 6 73 0.48 0.04 0.52 1952 139,600 313 36 349 2.24 0.26 2.50 43 3 46 0.31 0.02 0.33 c 2 (6134) Tuberculosis Register. The following table gives a summary of the changes in the register during the year 1952:— Pulmonary Non-Pulmonary Total Number of cases on the Register at the commencement of the year 1,396 211 1,607 Number of new cases during the year 335 36 371 1,731 247 1,978 Number of cases removed from the Register during the year (by death or other causes) 333 53 386 Number of cases remaining on the Register at the end of the year 1,398 194 1,592 Bacteriological Examinations. To aid in diagnosis and to detect contact or carrier cases, the borough council provides bacteriological diagnosis free of charge in connection with certain diseases. This work is carried out either by Central Public Health Laboratory, Colindale, or the Royal Institute of Public Health and Hygiene, 23, Queen Square, W.C.I. Positive Negative Total Diphtheria 9 192 201 Dysentery 13 29 42 Food Poisoning 12 7 19 Hæmolytic Streptococci 2 4 6 Paratyphoid Fever — 3 3 Pathogenic organisms — 26 26 Tuberculosis 2 31 33 Typhoid Fever — 4 4 Totals 38 296 334 37 CLEANSING AND DISINFECTING. Cleansing. The number of attendances at the Council's Public Health Annexe during the year was as follows:— (1) Scabies. Men Women Children under 5 Schoolchildren Total 1952 Total 1951 St. Pancras 79 51 21 99 250 372 Ex St. Pancras 2 — — — 2 5 Totals 81 51 21 99 252 377 (2) Verminous Conditions. Men Women Children under 5 Schoolchildren Total 1952 Total 1951 Head lice St. Pancras — 26 49 1,429 1,504 1,807 Ex St. Pancras — 1 — — 1 12 No fixed abode — — — — — — Body lice St. Pancras 766 11 — 777 666 Ex St. Pancras 75 — — — 75 62 No fixed abode 51 — — — 51 22 Totals 892 38 49 1,429 2,408 2,569 The majority of the children included in the above tables were brought by school officers of the London County Council under powers conferred upon them by the Education Act, 1944. Payment is made by the London County Council at the rate of two shillings per child in respect of verminous conditions, and one shilling per bath for those suffering from scabies. 38 Attendances at Public Health Annexe. Disinfecting. Figures set out below show the number of houses, rooms, etc., dealt with after infectious diseases or following complaints of vermin:— Cause. Number of Cases Sprayed and Fumigated Number of Rooms and Contents Rooms only Contents only Diphtheria 21 16 5 1 Dysentery 38 11 13 18 Enteric fever 1 1 — — Erysipelas 4 1 1 2 Measles 122 4 7 115 Meningococcal Infection 9 7 2 — Other diseases 307 13 5 290 Poliomyelitis 26 24 3 1 Scabies 2 1 — 1 Scarlet fever 101 53 45 6 Tuberculosis 119 107 30 4 Vermin 688 33 832 191 Totals 1,438 271 943 629 39 SECTION 4. Sanitary Circumstances. Visits by District Sanitary Inspectors. Complaints received 5,144 Complaints Investigated— Whole house inspections 112* Whole house re-inspections 207 Part of house inspections 5,032 Part of house re-inspections 16,560 House to House Inspections— Tenement house inspections 75* Tenement house re-inspections 21 Dwelling house inspections 27* Dwelling house re-inspections 35 Infectious Disease— Investigations 434 Inspection of premises 19* Re-inspections 62 Drainage— (a) Under Notice. Plans, Supervision, etc. 3,809 (b) Voluntary 3,721 (c) New buildings 1,874 (d) Tested— (i) After infectious disease 5 (ii) For other reasons 417 Shops Acts— First inspections 4 Re-inspections 1 Pharmacy and Poisons— First inspections 73 Re-inspections 77 Public Houses— First inspections 16 Re-inspections 110 Smoke Observations 67 40 Visits By District Sanitary Inspectors—continued Environmental Visits— (a) Old and Infirm (Section 47, National Assistance Act, 1948)— First visits 21 Subsequent visits 4 (b) Blind persons 96 (c) Old Age pensioners 125 (d) Tuberculous persons 274, (e) Housing applications 863 Mews and Stable Yards 18 Rent Restriction Acts— Inspections 5 Re-inspections 1 Offensive and Regulated Trades 2 Prevention of Damage by Pests Act, 1949— Inspections 119 Re-inspections 53 Section 12, Housing Act, 1936— Inspections (other than underground rooms) 4 Re-inspections 28 Underground rooms 261 Re-inspections 1,195 Section 59, Housing Act, 1936— Overcrowding offences 39 Re-visits 30 Overcrowding abated 44 Other inspections and re-inspections 1,717 Total 37,657 * Recorded as house-to-house inspections. Intimation Notices Served— (i) Housing and sanitary defects 4,286 (ii) Additional water supply to tenement houses (included in (i)) 154 Rent Restriction Acts Certificates 2 Number of Attendances at Police Court— (a) Applications for summonses 120 (b) Hearings 128 Ineffective visits 4,111 Number of Statutory Notices 2,437 41 The following table gives a summary of this branch of the work of the department during the past eight years:— 1945. 1946. 1947. 1948. 1949. 1950. 1951. 1952. Number of complaints received 3,832 5,689 7,550 7,136 6,981 6,734 6,094 5,144 Number of visits 17,251 29,578 37,375 45,209 43,731 43,143 41,988 37,657 Intimation notices served 2,709 4,487 5,760 6,567 5,486 5,415 5,377 4,286 Statutory notices served 1,388 2,580 3,912 3,498 2,848 2,957 3,277 2,437 Number of Police Court proceedings 17 57 133 212 139 117 194 230 Costs and/or fines 13 55 120 162 116 92 157 154 Amount of fines 1s. £3 £40 £166 £148 £138 £212 £296 Amount of costs £31 £86 £171 £229 £205 £156 £216 £305 The above police court proceedings were taken under the following statutes or regulations:— 1945. 1946. 1947. 1948. 1949. 1950. 1951. 1952. Public Health (London) Act, 1936 16 41 81 158 126 107 148 181 L.C.C. Lodging House By-laws 1 15 28 40 5 8 38 39 L.C.C. Water Closet By-laws — 1 11 5 1 — 4 4 L.C.C. Drainage By-laws — — 10 5 2 — 3 2 Public Health (London) Act, 1891 (Vestry By-laws) — — 1 3 3 1 — 1 Defence (General) Regulations, 1939, Scabies Order, 1941 — — 1 — — — — — Public Health (London) Act, 1891 (Rag Flock Regulations, 1912) — — 1 — — — — — L.C.C. Rag and Bone Dealers Bye-law — — — 1 — — — — Housing Act, 1936 (Sec. 168) — — — — 1 1 1 3 Water. The bulk of the water in the borough is supplied by the Metropolitan Water Board and has been satisfactory in quality and quantity. In addition, wells situated outside the borough are a source of supply to various points on the railway system centred on Euston Station. There are also five wells in the borough, four being on factory premises and one at the Council's swimming baths at Prince of Wales Road, and from these a total of seven samples were taken during the year and subjected to chemical and bacteriological examination by the Public Analyst. Examinations were also made of samples of water taken from Parliament Hill Lido, Ken Wood open air ponds, the Council's swimming baths and a private swimming bath. 42 Pharmacy and Poisons Act, 1933. The following applications were received during 1952 for retention or entry in the Council's list of persons entitled to sell poisons included in Part II of the Poisons List:— Retentions 132 New entries 6 Closing and Demolition Orders. A room, the floor of which is 3 ft. or more below the level of the adjoining street, or more than 3 ft. below the surface of any ground within 9 ft. of the room, is an underground room within the meaning of section 12 of the Housing Act, 1936, and the Borough Council is given powers in that section for the placing of closing orders upon such rooms unless they comply with the appropriate regulations. In brief, these regulations provide that there shall be (a) a certain size window to afford adequate natural light and ventilation, (b) concrete over the site, and (c) an efficient damp-proof course in all walls in contact with the ground. A basement room altered to comply with the regulations is a dry and light room, but there remains the disadvantage that it continues to be ventilated at, or slightly above, street level. It thus receives air vitiated by street dust and fumes. The present policy of the Borough Council is to institute closing order procedure upon only the very worst type of basement room; and other basement rooms as they become empty. This restricted policy is temporary and was adopted because of the general shortage of housing accommodation. During 1952 the condition of 94 underground rooms was reported to the Public Health Committee, resulting in closing orders being placed upon 73 of them. Thirteen rooms were altered to comply with the regulations and no closing orders were necessary. The balance remained to be concluded in the ensuing year. Thirteen existing closing orders were determined. Applications were made for permission to use 16 rooms for storage purposes. Such applications are generally granted provided food is not to be stored and the rooms are made rat proof. There are now 1,120 basement rooms in the borough upon which closing orders are operative. These are all visited by the district sanitary inspectors twice annually. Any infringement of the closing order discovered which cannot be dealt with administratively is reported to the Public Health Committee for permission to take proceedings to secure compliance with the Order. One demolition order was made during the year. Overcrowding. Requests were received from the London County Council during 1952 for confirmation of statutory overcrowding in respect of 162 applications for re-housing. Investigations were made by the Council's Sanitary Inspectors and details forwarded to the London County Council. 114 of these families were found to be overcrowded. In addition 554 cases were referred to me by the Borough Council's Housing Department during the year and my recommendations were as follows:— Certificate "A" 281 " B " 92 "C" 127 "D" 54 43 National Assistance Act, 1948. Section 47—Care of Old. Persons. The living conditions of 33 persons of retirement age were reported during the year as being in need of investigation. In no instance was it found necessary to obtain a Magistrate's Order under the Act. The source of information and action taken are shown in the following table:— Reported by No. of cases ACTION TAKEN Voluntarily removed to hospital or institution Kept under observation at home together with the provision of various types of help Deceased Relatives 1 — 1 — Medical practitioners 9 6 2 1 Friends and/or neighbours 6 2 4 — Sanitary Inspectors 8 2 6 — National Assistance Board 3 — 2 1 L.C.C. Visitor to the Blind 1 — 1 — Member of Borough Council 1 — 1 — Hospital Almoner 1 1 — — District Nursing Association 2 2 — — London Council of Social Service 1 — 1 — 33 13 18 2 Section 50—Burials. During the year 1952 the department carried out 74 burials. The gross cost was £612 lis. 6d. which represents an average of £8 5s. 6d. per burial. £546 10s. 3d. was recovered from the following sources:— £ s. d. Hospitals 197 18 3 Death grants 143 8 6 Assurance Companies 40 6 7 Employers 3 9 Private persons 92 3 11 Ministry of Labour 1 12 6 Ministry of Pensions 3 16 5 Ministry of National Insurance 17 4 6 National Assistance Board 3 6 0 Post Office Savings Department 18 14 7 Treasury Solicitor 9 8 6 Coroner's Officers 18 6 9 The net cost to the Borough Council for the year's working was thus £66 Is. 3d., being an average of 17s. 10d. per burial. From the date the Act came into force (July, 1948) until the end of 1952, 339 burials have been carried out. National Assistance Act, 1948. Section 50. Year No. of burials Gross cost Reimbursement obtained Net cost to Council Amounts Average per burial Amounts Average per burial Percentage of initial outlay Amounts Average per burial Percentage of gross cost £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. £ s. d. 1948 37 284 6 5 7 13 8 156 10 1 4 4 7 55.04 127 16 4 3 9 1 44.96 1949 55 445 2 6 8 1 10 291 5 0 5 5 11 65.43 153 17 6 2 15 11 34.57 1950 84 699 10 0 8 6 6 668 17 5 7 19 3 95.6 30 12 7 0 7 3 4.4 1951 89 767 15 6 8 12 6 714 8 1 8 0 6 93.09 53 7 5 0 12 0 6.91 1952 74 612 11 6 8 5 6 546 10 3 7 7 8 89.21 66 1 3 0 17 10 10.79 Full period 339 2,809 5 11 8 5 9 2,377 10 10 7 0 3 84.63 431 15 1 1 5 6 15.37 44 45 Blind Persons. As in previous years your sanitary inspectors have continued to visit blind persons living in St. Pancras with a view to taking such steps as might be necessary to improve their environmental conditions. There are 73 blind persons on the register. In all but three cases the conditions under which they were living were reasonably satisfactory. Rehousing was required in one case and the appropriate recommendation was passed to the Housing Department. In the second case conditions were improved as a result of help afforded by the Public Health staff and the other blind person was removed to hospital. He has now returned and steps will be taken to help him. During the year two blind people died and one moved away from the district. Medical Examinations. Eighty-three medical examinations were carried out by myself and Dr. Tracy to ascertain whether personnel were fit for entry into superannuation or sick pay schemes, or for special purposes. The following table sets out the results of such examinations:— New entrants— Fit 68 Unfit 2 To be examined again in a year's time 1 Referred for further investigation 1 Special examinations— — 72 Fit to continue duty 2 Fit in a short time 3 Unfit 1 Unfit for work as a bricklayer 1 Unfit for work as a stonemason, but fit for work as a sweeper 1 Unfit for work as a caretaker but fit for work as street inspector 1 Fit for A.R.P. course 1 Fit for surrender of superannuation 1 — 11 83 Mortuary and Coroner's Court.— The following table shows the routine work undertaken during the year with, in brackets, the corresponding figures for 1951:— Post-Mortem Examinations. Received for Viewing or Convenience only. Total. Resident and died in St. Pancras 223 (258) 3 (2) 226 (260) Died in St. Pancras, resident elsewhere 112 (131) 7 (4) 119 (135) Resident in St. Pancras, died elsewhere 18 (39) 5 (1) 23 (40) Resident and died elsewhere 597 (715) 37 (51) 634 (766) 950 (1,143) 52 (58) 1,002 (1,201) Inquests held at Coroner's Court ... ... ... ... •• 442 (496) 46 Rodent Control. (Prevention of Damage by Pests Act, 1949.) Details of the work carried out during the year in respect of rats and mice are given in the following table:— Premises. Private. Business. Total. Complaints received 976 235 1,211 Investigations made 3,193 485 3,677 Infestations found—Rats 627 150 777 Mice 328 43 371 Treatments 940 178 1,118 Advice only 15 15 30 The staff employed on this work consists of five operatives and one rodent officer working under the supervision of a sanitary inspector. Pet Animals Act, 1951. This Act, which came into force on the 1st April, 1952, regulates the sale of pet animals (which term includes any vertebrate), and provides that no person shall keep a pet shop unless licensed by a local authority. It further provides that, before granting such licence, the local authority shall secure that the premises are suitable, that animals will be adequately accommodated and fed, will not be sold at too early an age, and that reasonable precautions will be taken to prevent the spread of disease. The Act makes it an offence to sell pets to children under the age of 12 years, and forbids the sale of pets in a street or public place except at a stall or barrow in a market. Licences expire on the 31st December each year, and cost 10s. Appeal against a refusal to license may be made to a Court of Summary Jurisdiction. Local authorities have power to prosecute offenders and the penalties which may be imposed on summary conviction include fines and/or imprisonment. During 1952 licences were granted to five applicants. No offences were reported. 47 SECTION 5. Factories and Bakehouses. Particulars of inspections and other work carried out by the Factory Inspectors during 1952 are given in the following table:— Number of visits— Factories (with mechanical power) 3,652 Factories (without mechanical power) 1,048 Workplaces 744 Bakehouses 349 Restaurants 1,149 Power laundries 11 Laundry receiving offices 100 Outworkers' premises 2,008 Rag Flock Act 53 Geriatric 190 Scabies and vermin cases 151 Food control enquiries 21 Water sampling 37 Public Health Annexe 146 Other visits 41 Attendances at Police Court 1 Total 9,701 Intimation Notices served relating to Statutes under which served. Factories Act, 1937. Public Health (London) Act, 1936. Food and Drugs Act, 1938. Factories (with mechanical power) 205 47 4 Factories (without mechanical power) 35 12 — Workplaces 10 5 — Bakehouses — — 41 Restaurants and Canteens — 2 136 Totals 250 66 181 Statutory notices served 32 24 10 48 Factories Act, 1937. The following particulars are furnished in accordance with Section 128(3) of the above Act, with respect to matters under Part I and Part VIII:— Part I of the Act. 1. Inspections, etc. Premises Number on Register. Number of Inspections. Written Notices. Occupiers Prosecuted. (i) Non-power factories, in which Sections 1,2,3, 4 and 6 are enforced by Local Authorities 441 1,048 35 Nil. (ii) Power factories in which Section 7 only is enforced by the Local Authority 1,510 3,652 205 Nil. (iii) Other Premises, excluding out-workers' premises 451 744 10 Nil. Totals 2,402 5,444 250* Nil. * Not including 64 notices served under Public Health (London) Act, 1936. 2. Cases in which defects were found. Particulars. Found. Remedied. Referred. Number of prosecutions. To H.M. Inspector. By H.M. Inspector. Want of cleanliness (S.1) 193 198 — 5 — Overcrowding (S.2) 16 14 2 — — Unreasonable temperature (S.3) 3 3 — — — Inadequate ventilation (S.4) 3 2 1 — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7)— (a) Insufficient 3 4 — 1 — (b) Unsuitable or defective 118 130 — 12 — (c) Not separate for sexes 8 9 — 1 — Other offences against the Act (not including offences relating to Outwork) 38 12 27 1 — Totals 382 372 30 20 Nil. 49 Part VIII of the Act. Outworkers. In certain industries specified in the Act, if work is given out by employers or contractors to be done by workers outside the factory, lists containing the names and addresses of such workers must be forwarded to the Local Authority in February and August, with the object of preventing work being carried out in premises which are insanitary or in which infectious disease is present. The following table sets out the number of premises in which outworkers are working in the Borough, in accordance with the nature of the work carried out:— Wearing apparel 453 Household linen 19 Lace, lace curtains and nets 4 Curtains and furniture hangings 11 Furniture and upholstery 9 Fur pulling 21 Artificial flowers 31 The making of boxes or other receptacles or parts thereof made wholly or partially of pper 27 Brush making 4 Feather sorting 17 Carding, etc., of buttons, etc. 16 Basket making 10 Chocolates and sweetmeats 36 Cosaques, Christmas crackers, Christmas stockings, etc. 35 Lampshades 30 Total 723 In twelve cases there was failure to send a list of outworkers, and this matter was dealt with by informal action. In 45 cases work was being carried out in unwholesome premises, and on appropriate action being taken such outwork ceased. The number of outworkers rose from 573 in 1951 to 723 in 1952. Only one-third of the outworkers in the Borough might be said to be regular in their employment. The remainder take on seasonal work and often change the type of work they receive. In these circumstances it is particularly necessary to visit as soon as possible after the lists are received from the factories in order to secure a satisfactory standard of cleanliness, freedom from infection and to advise as to the placing of machines, in order to get the maximum light, to avoid undue noise and to secure proper storage of work in the home. Homes which have a low standard of cleanliness are visited frequently and the outworkers are warned that unless a definite improvement in hygiene is forthcoming there is a possibility that outwork will be withdrawn for them. A practice arose during the year of employing outworkers on the wrapping and packaging of sweets. Successful action to prevent this was taken. (6134) D 5o There would appear to be a very definite increase in the number of factories in the Borough of St. Pancras employing outworkers. Basement Bakehouses. In accordance with the requirements of the Factories Act, 1937, an inspection of underground bakehouses must be carried out every five years, and such a survey was completed in 1949. Each case was considered by the Public Health Committee in July, and August, 1950, Section 54 of the Act provides that a basement bakehouse shall not be used unless it was so used at the date of the passing of the Act—1st July, 1938—and a certificate of suitability has been issued by the Borough Council. The Council agreed the period for which each bakehouse should be in operation. The position is as follows:— Basement bakehouses in use in August, 1950 26 Basement bakehouses in use in December, 1952 14 Basement bakehouses which will be in use in August, 1953 10 Basement bakehouses which will be in use in August 1954 6 Basement bakehouses which will be in use in August, 1955 4 Rag Flock and Other Filling Materials Act, 1951. This Act came into force on the 1st November, 1951, and requires inter alia— (a) the registration of premises where specified filling materials are used in manufacturing bedding, toys, baby carriages and other articles of upholstery, and (b) the annual licensing of premises where rag flock is (i) manufactured or (ii) stored for distribution to registered premises. The object of the Act is to secure the use of clean filling materials in upholstered articles and other articles which are stuffed or lined. Twenty-three certificates of registration and one licence had been issued up to the end of 1952. During the year the Council's Sanitary Inspectors paid 53 visits to such premises and took 14 samples. Cotton felt 2 Woollen felt 2 Hair 4 Half down 1 Coir fibre 2 Rag flock 3 Upon analysis all samples were found to be satisfactory. 51 SECTION 6. Inspection and Supervision of Food. Particulars of the inspections carried out by the Council's Food Inspectors during 1952 are given in the following table:— Number of visits to— Dairies 523 Milk distributors 200 Ice cream premises 639 Slaughterhouses 13 Butchers' shops 810 Prepared meat premises 596 Fishmongers' shops 154 Fried fish shops 148 Fish curers' premises 78 Other premises where food and drugs are sold 1,475 Market streets and places 769 Railway goods yards, warehouses 105 Catering establishments 564 Attendances at Police Court 34 Re-inspection after Intimation Notices 244 Other visits 704 Total 7,056* * These visits do not include visits made for the purpose of taking samples. Intimation notices served 55 Statutory notices served 3 Milk Supply. The Number of dairies and milk distributors on the Register at the end of the year was:— Dairies 110 Milk distributors 286 Itinerant milk distributors 36 The number of persons registered for the sale of cream and artificial cream was 11 52 (a) Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949. (b) Milk (Special Designation) (Raw Milk) Regulations, 1949. These Regulations require the licensing of traders selling (a) pasteurised and sterilised milks and (b) tuberculin tested milk. The following licences were issued at the end of the year in respect of the year 1953:- Main Licences Supplementary Licences Pasteurised milk 171 24 Sterilised milk 186 25 Tuberculin Tested milk 118 24 Ice Cream. The number of premises registered in accordance with Section 14 of the Food and Drugs Act, 1938, as being used in respect of the storage and sale of ice cream is 414. Food Sampling. Chemical Examination. 830 samples (299 formal and 531 informal) were sent to the Public Analyst for chemical examination, of which six formal and seven informal were found to be unsatisfactory. examination, of which six formal and seven informal were found to be unsatisfactory. Details of the nature of all samples are shown in the following table:— Formal. Informal. Genuine. Unsatisfactory. Genuine. Unsatisfactory. Milk 175 2 84 — Drugs 2 1 102 3 Sausages and meat products 70 2 46 2 Spirits 40 — — — Ice Cream — — 59* — Others 6 1 233 2 The formal samples which were unsatisfactory were dealt with as follows:— Milk (2) Summons in each case. Drugs (1) Warning letter sent. Sausages (2) Summons in each case. Pepper (1) Warning letter sent. 53 The 59 samples of ice cream marked * above showed a fat content as follows:— Fat content per cent. Number of samples. Percentage of total samples. Over 14 1 1.70 13-14 1 1.70 12-13 — — 11-12 2 3.38 10-11 7 11.86 9-10 1 1.70 8- 9 7 11.86 7-8 12 20.34 6- 7 16 27.12 5- 6 12 20.34 In each case the sugar and milk solids content conformed with the appropriate order. Bacteriological Examination. In addition to the samples of food submitted to the Public Analyst for chemical examination, 337 samples were submitted to the Central Public Health Laboratory, Colindale, for bacteriological examination, as follows:— (a) Milk. 147 samples of milk were taken from hospitals, from dairies and from London County Council schools, institutions and day nurseries in the Borough to ascertain whether they complied with the appropriate regulations relating to specially designated milks. The samples were subjected to the phosphatase test which indicates the efficiency of the method of heat treatment, and the methylene blue test indicating the keeping quality of the milk. All complied with the phosphatase test, and 143 proved satisfactory in regard to the methylene blue test. Appropriate action was taken in the remaining four cases, and the follow-up samples were satisfactory. An analysis of these samples is given in the following table:— T.T. (Past) Past. Ster. H.T. Totals Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Hospitals — — 19 — — — — — 19 — L.C.C. Schools and Institutions — — 59 4 — — — 59 4 Day Nurseries 1 — 20 — — — — — 21 — Dairies 8 — 26 — 10 — — — 44 — Totals 9 — 124 4 10 — — — 143 4 54 (b) Ice Cream. Of 155 samples of ice cream submitted for bacteriological examination, 132 reached grades 1 or 2 when subjected to the methylene blue reduction test. The following table shows the detailed results of these examinations during the year and preceding years:— — 1948 1949 1950 1951 1952 Samples % Samples % Samples % Samples % Samples % Satisfactory — Grade I 75 41.7 59 32.4 59 44.7 86 48.31 92 59.35 Grade II 38 21.1 52 29.0 40 30.3 47 26.41 40 25.81 Unsatisfactory— Grade III 31 17.2 44 24.6 15 11.4 26 14.61 14 9.03 Grade IV 36 20.0 25 14.0 18 13.6 19 10.67 9 5.81 Totals 180 100.0 180 100.0 132 100.0 178 100.00 155 100.00 (c) Synthetic cream. 32 samples of synthetic bakery filling cream were examined, all of which were reported to be satisfactory from a bacteriological point of view. (d) Other commodities. There were also three other samples, all of which were satisfactory. Legal Proceedings. The following 17 prosecutions were undertaken during 1952 under the Food and Drugs Act, 1938:— Court and Date of Hearing. Offence. Result of Proceedings. Fine Costs. £ £ s. 1 Marylebone 30.1.52 Paper clip in sausage 2 3 3 2 Marylebone 14.2.52 Filth and refuse on bakehouse floor, &c. 101 3 ,, Dough mixer in dirty condition 10 5 5 4 ,, Bread subject to contamination 5 5 ,, Contamination of food by mice, dirt, &c. 10 6 Marylebone 1.4.52 Loaf unfit for human consumption 20 5 5 7 ,, Failure to prevent risk of contamination to food in store 5 3 3 8 ,, Accumulated filth in mixing room 5 3 3 9 ,, Failure to keep storage bin clean 5 3 3 10 Marylebone 4.6.52 Sausages deficient in pork 3 5 5 11 Clerkenwell 16.4.52 Pork sausages deficient in meat 5 5 5 55 Court and Date of Hearing. Offence. Result of Proceedings. Fine. Costs. £ £ s. 12 Marylebone 5.9.52 Water added to milk — 5 5 13 Clerkenwell 10.9.52 Nail in loaf of bread — 1 1 14 Marylebone 17.9.52 Beetle in loaf of bread 10 3 3 IS Clerkenwell 29.9.52 Razor blade in bun 15 5 5 16 Clerkenwell 13.10.52 Metal bolt in marshmallow biscuit — 2 0 17 Marylebone 26.11.52 Water added to milk (5.8 per cent.) 10 5 5 Food Poisoning. Outbreaks due to identified agents— Total outbreaks 2 Total cases 22 Outbreaks of undiscovered cause— Total outbreaks None Total cases None Single cases— Agents identified 4 Unknown cause 4 Total 8 Unsound Food Condemned and Destroyed. During the year 1952, the undermentioned unsound or diseased food was surrendered by the owners and dealt with by the Food Inspectors. Wherever possible the food was used for cattle feeding. Articles. Quantity. Beverages 205 lbs. Canned foods (miscellaneous) 17,324 tins. Cereals 1,571 lbs. Cheese and cheese spread 221 lbs. Confectionery 133 lbs. Eggs 540. Fats 167 lbs. Fish and fish products 563 stone. Flour confectionery 62 lbs. Frozen foods (miscellaneous) 592 packets. Fruit and fruit products 23 crates: 8,856 lbs. Articles. Quantity. Canned ham and meats 5,981 lbs. Ice cream briquettes 413. Legumes 517 lbs. Meat and meat products 12,587 lbs. Milk, condensed 496 tins. Pickles and sauces 1,927 jars. Poultry, game, &c. 10 cases: 580 lbs. Preserves 66 lbs. Shellfish 248 lbs. Soup and Gravy powders 430 lbs. Sugar 39 lbs. HARRISON AND SONS. LIMITED. PRINTERS TO THE LATE KING GEORGE VI, LONDON: HAYES (MX.): HIGH WYCOMBE (6134)