Library STPAN III Metropolitan Borough of St. Pancras. St. Pancras Town Hall Report of the Medical Officer of Death for the Dear 1956 Dennis H. Heffen, O.B.C., M.D., D.P.H. CONTENTS Page Introductory 1 Committee and Officers 1 Section 1 - General Information 4 Section 2 - Population, Births and Deaths 9 Section 3- - Notifiable Diseases 3 Section 4 - Sanitary Circumstances 32 Section 5 - Factories etc 42 Section 6 - Inspection and Supervision of Food 49 INDEX Pages Aged persons, care of Xi 40 Air pollution iv Ambulance facilities 7 Analyst, Public 3 Area of borough, wards, open spaces 4 Bacteriological examinations 29, 51 Bakehouses 43, 48 Basement rooms 35 Births:- illegitimate 9,13 numbers and rates since 1920 12 rates 9,12 registered live, and rate 1, 4, 9„ 12 registered still, and rate 9,13 still - numbers and rates since 1929 13 Blind persons, care of viii Bodies received at mortuary 39 Burials 40 Camden motive Power Depot iv Cancer, Deaths from 15, 16 Chemical examination of food 50 Chief officers of the Council 1 Chiropody xii Cleansing and dlsinfesting 30 Clerical staff 3 Climatological summary 8 Closing and demolition orders 35 Committee;, members of 1 Complaints 32 Condemned food 53 Coroners Court 39 Day nurseries 5 Deaths - bronchitis 16 cancer 15,16 classification, with age distribution 10 heart disease 16 illegitimate children 11 11 13 infantile, and rates 1, 4, 11, 12, 13 infantile, with causes, age distribution 11 Infantile - number and rates since 1920 12, 13 maternal 14 measles 22,23 neo-natal 11, 12, 13 number and rate 1,4,9,12 pneumonia 16 tuberculosis 11, 4, 16, 17, 25, 28 Disinfesting 31 Disrepair - certificates 33 Factories Acts, 1937 and 1948 42 Factories 42 Factory Inspectors 3 Factory Inspectors, work of 43, 44 Fireguards v Food;- condemned 53 inspectors 3 inspectors, work of 49 poisoning 53 sampling 50 summonses 52 unsound 53 Food Hygiene Regulations, 1955 54 Foreword by M.0.H. 1 General information 4 Gloucester Avenue - smoke nuisance iv Pages Hairdressers and barbers vi, 37 Health Officers 3 Holidays - aged persons xiI Hospitals in the Borough 6 Ice-cream 50, 51, 52 Infantile mortality - see deaths Infectious diseases iv, 18 Infectious diseases - notifications 20, 21 Inspectors - housing, food, factory and district 3 Invalid meals xii Land Charges Act, 1925 35 Legal proceedings 34, 52 Marriages 5 Mass radiography 1ll Maternity and Child Welfare centres 5 Meal vouchers xii Measles iv, 22- 23 Meat and other foods-inspections 49 Medical examinations 41 Milk Designation and licensing 50 Milk inspections, samples, etc. 49, 50, 51 Mortality - see deaths Mortuary and Coroner's Court 39 National Assistance Act, 1948 40 Neo-natal - see deaths Notices served 33, 43, 49 Notifiable diseases - see infectious diseases Nurseries, Day 5 Nursing Associations xii, 6 Outworkers 45, 46, 47 Overcrowding 36 Persons per acre (estimated average) 4 Pet Animals Act, 1951 vi, 37 Pharmacy and Poisons 37 Poliomyelitis iv, xiii, 24 Population 1,4,9 Population since 1920 12 Post mortem examinations 39 Prevention of Damage by Pests Act, 1949 39 Psittacosis 19 Public Analyst 3 Public Health Annexe - attendance at 30 Public Health Committee members 1 Public Health Department Staff 3 Public Health Inspectors 3 Public Health Inspectors work of 32 Public Health (Tuberculosis) Regulations, 1952 27 Rag Flock etc.. Act, 1951 48 Rainfall 1,8 Rat extermination 39 Rateable value and general rate 4 Registrars of births, deaths and marriages 2 Rehousing and overcrowding 36 Rodent control 39 St Pancras Association for the care of the aged xi Sanitary circumstances 32 Scabies 19, 30, 43 School treatment centres 7 Sewer effluent 48 Slum clearance ix Smoke control area 1 Smoking and cancer x Staff of Public Health Department 3 Statistics, vital 4,9,12,13 Stillbirths 9 Summonses see Legal proceedings Synthetic cream samples 52 Pages Tuberculosis:- deaths - see deaths chest clinic 5 new cases 27 notifications register 29 notifications 11, 25,27, 28 prevalence and fatality for past eighteen years 28 Underground rooms 35 Unsound food 53 Verminous persons 30 Vital statistics 4, 9, 12, 13 Voluntary Visitors xii Water supply 38 Welfare centres 5 Wireless xii X-ray examination - see mass radiography Town Hall, Euston Road, London, N.W.1. July, 1957 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Saint Pancras, Your Worship, Ladies and Gentlemen. I have pleasure in presenting you with my Annual Report for the year 1956. This is the thirteenth report which I have written on the health of the borough of St. Pancras, the 31st report it has been my duty to prepare as a medical officer of health to a local authority. The population in the middle of the year, as estimated by the Registrar General, was 133,100. This compares with a population of 134,500 in the middle of 1955 and means that the number of residents in St. Pancras has fallen by 1,400 during the year The actual census figure for 1951 was 138,377, which is 5,277 more than the present estimated population. Any assessment, however, of the duties and responsibilities for the St. Pancras Borough Council, based on a night time population, is in my opinion fallacious. This fact recently became obvious in preparing the Council's first preliminary scheme for a smoke control area. The area is admittedly small and includes University College, which attracts a number of students from elsewhere. The night time population of the area was found to be 1,626, to which could be added the patients resident in hospital, numbering 750. The total number of persons sleeping in the area was therefore 2,376, In addition to this, however, 7 842 persons entered that particular area to work and 3,700 to study, giving an over -all day population in one small area of nearly 14,000. So gross a difference between day and night time population does not apply uniformly throughout the borough, but it does establish the fact that services and amenities must be provided not only for the 133,100 people who actually sleep in the borough, but for the many thousands in addition whose work and study brings them to St Pancras, a central London borough which is a hive of industry, hospital and university life. 1956 was a rainy year there being recorded 27.28 inches of rain at the Camden Square meteorological station. This was exceeded in 1946 when we had 29.51 inches and in 1951 when there were 32 58 inches. The number of deaths increased from 1,441 to 1,528, and the death rate was 11.5 compared with 10 7 in 1955. On the other hand the births increased from 2,176 to 2,366 and the birth rate from 16 18 to 17.77. The total number of deaths in children under one year was 53 as compared with 50 in the previous year, but in view of the fact that there were 190 more births the infantile mortality rate has been reduced from 22.98 to 22.4 a figure 1 that was bettered only In 1954 when it was 18 Dividing the infantile mortality rate between legitimate and illegitimate children we find that the rate for legitimate children was 24 and for illegitimate children it was 12, This is the first time we have been able to record so surprising a difference Going back to 1939 there have been only two occasions when the infantile mortality rate of illegitimate was lower than that of legitimate children namely in 1941 when the figures were 52 and 44 and in 1949 when the figures were 31 and 30, It is not so long ago since the mortality of illegitimate children was twice that of legitimate children In 1956 we find it was half, This reflects a better understanding of the problems of the unmarried mother, a better appreciation on her part of her responsibility to her child and indeed a tribute to the doctors and the voluntary agencies in the borough who advise and help her. Of the 53 children who died before they attained the age of one year, death occurred in the first day of life in 18 cases 14 between 1 and 7 days, and 6 between the first and fourth weeks It will be seen therefore that the bulk of infantile mortality today is neonatal mortality: occurring during the first four weeks of life. To lower the rate we must look to better understanding of antenatal care and obstetrics Three mothers died of puerperal causes, giving a maternal mortality rate of 1.25 per thousand live and still births Tuberculosis Reference to the graph on page 25 will show a steady diminution in the number of cases of tuberculosis notified each year This graph, however, does not tell the whole story for in fact many of the cases notified were in their early stages and were discovered only as a result of a routine X-ray examination. The bulk of them would therefore have been curable in view of the modern improvements in the treatment of this once much more fatal disease 191 cases were notified during the year. Of these 11 were over 65 and only 14 were individuals under the age of 20 years, the bulk being in the age period 25 to 35 years This group accounted for 66 notifications. Of the 191 primary notifications 58 were in persons over 45 years of age It will be seen therefore that tuberculosis is no longer a disease of young people, and the large proportion of notifications is of individuals about or over middle age. In some cases the condition is already well established and chronic when notified and it is sometimes very difficult to render such patients free from infection. It is possible that the major source of infective tuberculosis in the country today is from this older age group of chronic infectious cases. I have no record of the past history of each individual case notified but have reason to think that an undue proportion of the new notifications is in people who have come to England from abroad. 28 individuals died of tuberculosis during 1956 Of these five were over 75 years of age and four between 65 and 74 There were no deaths in persons under 24 and only two in the age group 25 to 34. This is due to the effects of better treatment. The 28 deaths from tuberculosis represents the smallest number recorded in the borough from this disease and compares with 312 in 1920, when admittedly the resident population at 228,980 was 95 880 more than in 1956, ii Mass Radiography The mass radiography unit of the North West Metropolitan Regional Hospital Board held twelve sessions for industrial firms and the general public in the St. Pancras area during 1956 as follows:- Situation of Unit Date Number examined Male Female Total Royal Veterinary College 30th January 227 26 253 University College 31st January 1st February 1, 800 794 2,594 Stucley Place 5th March 3 109 112 Carreras Ltd. 13th March 694 818 1,512 Howland Street 4th-5th April 228 207 435 Burton Place 10th April 53 - 53 Charlotte Street 23rd April 22 73 95 University College 4 th May 204 68 272 Pitzroy Square 24th September 143 145 288 St. Pancras Station 25th September 255 148 403 St. Pancras Station 31st October 332 75 407 Euston Station lst-7th November 1,402 393 1,795 5,363 2,856 8,219 Of those examined, active tuberculosis was found in 9 cases of whom 8 were males and 1 female In 13 further cases (12 males and one female) occasional supervision was found to be required These 22 cases were contained in age groups as follows- Age group Active pulmonary tuberculosis Occasional supervision Male Female Male Female 14-19 1 - - - 20-24 1 1 1 - 25-34 2 - 1 1 35 44 2 - 2 * 45-54 1 - 4 - 55-64 1 - 4 - 65 plus - - - - Totals 8 1 12 1 The ready co-operation of no less than thirty firms and undertakings, who afforded their employees the opportunity to take advantage of the mass X-ray facilities is acknowledged and appreciated Clearly it is most probable that many of the 8,219 persons examined in Saint Pancras were non-residents of the Borough, On the other hand, many St. Pancras residents were probably X rayed at their place of business in adjoining boroughs iii where the work of the mass radiography unit was also at the service of the public during the year. Infectious disease There were five cases of confirmed acute poliomyelitis (2 paralytic and 3 non-paralytic) as compared with 40 (16 paralytic and 24 nonparalytic) in the previous year. Not one case of diphtheria was notified. 827 notifications of measles were received compared with 1,618 in the previous year. Not one single child has died of measles since 1951 when one death was recorded. It is interesting to note that in 1928 there were 127 deaths recorded as due to measles, This may reflect a diminished virulence of the disease itself, but I think credit must be given to better parental care and understanding of the disease, and expert treatment by the general practitioners of the borough. There were 174 notifications of whooping cough compared with 113 in 1955. Smoke The nuisance from smoke at the Camden Motive Power Depot has continued during the year, and I am unable to report that there has been any substantial improvement I think it is true to say that repeated approach has been made to every politician or government department who might help in any way whatsoever, and this not only by the Council but by the Chalk Farm Tenants' and Residents' Association. No one has attempted to deny that a nuisance exists, and a serious nuisance at that. It has been agreed that the nuisance will be overcome when the railway lines are electrified or alternatively when present steam engines are replaced by diesel-electric engines. It is very hard however, to ask those who suffer from this nuisance to accept it for a period of another 10 years. Alternative suggestions have been made, one for enclosing the depot., extracting smoke and discharging it from a tail chimney How practical this would be I do not know.It would certainly be expensive if expense is to be measured in terms of money, but in any case we have been told that there could be no justification for this outlay in view of the fact that the works would become obsolete after electrification. I think one should consider very carefully how the conditions of the people living in proximity to the depot compare from a health point of view with those applicants who are asking the Council to re house them, or those who are living in areas which are being represented in the slum clearance programme. I have recently been asked to answer this very question. I would say that undoubtedly many of those on the Council s waiting list are housed in conditions which are more injurious to health than the conditions of residents in Gloucester Avenue, and here I refer to families living in one room, and sometimes one underground room On the other hand I think the conditions are worse in Gloucester Avenue than they are in some of our slum clearance areas, and here I am speaking, not of lack of amenities,, but of atmospheric pollution and the inconvenience of iv living in premises that are so frequently polluted with smoke and particles from anything up to 28 engines under steam for many hours. It was suggested at one time that the area should be included as a slum clearance area. This however, is not possible, for an area can only be represented as a slum clearance area if the houses in the area are unfit for human habitation or are by reason of their bad arrangements or the narrowness or bad arrangement of the streets, injurious to the health of the inhabitants. To be unfit for human habitation a house must be so far defective in one or more of the undermentioned matters as not to be reasonably suitable for occupation in that condition;- (a) Repair (b) Stability (c) Freedom from damp (d) Natural lighting (e) Ventilation (f) Water supply (g) Drainage and sanitary conveniences (h) Facilities for storage, preparation and cooking of food and for the disposal of waste water, We are advised, therefore that on legal grounds one could not represent the Gloucester Avenue area as a slum clearance area On the other hand I think that consideration should be given to the possibility of re-housing the people in the area, even if it means some delay in the slum clearance programme: and in the end this may prove the most practical method of dealing with one of the most long lasting and serious nuisances in the borough Special Reports During the last few years various duties have fallen upon the Public Health Department and I am submitting special reports on some of these - Fireguards Protection of the public against the dangers inherent in unguarded electric, gas and paraffin fires is afforded by the Heating Appliances (Fireguards) Act. 1952 This Act makes it an offence for any person to sell expose for sale or let under a hire purchase agreement any relevant domestic heating appliance which is not fitted with a guard of the required standard The Secretary of State is authorised to make regulations defining standards and tests in respect of new and second hand gas electric and oil heaters On the 24th March 1953 the Home Secratary made the appropriate regulations and these became operative on the 1st October of that year Fires manufactured before that date are exempt from the new requirements for a period of one year, but after 1st October 1954 all fires offered for sale, of whatever age, have to comply. Every heating appliance (other than a totally enclosed oil convector heater) must be fitted with a guard securely fixed to the heater and of v sufficient strength and method of construction to comply with certain requirements relative to the spacing of the protective wires, smouldering and ignition capacity, and strength of the guard itself. In the middle of 1954 a circular letter was sent to all known vendors of fires in the borough, of which there are about 48, informing them of the requirements of the regulations. The Council's Public Health Inspectors have kept a constant watch on shop windows to detect any fires displayed without guards, and inspections of stock have been made. There has been little difficulty in connection with the sale of new fires, for they are now provided with a fixed guard by the manufacturers. We do experience some difficulty in connection with the provision of guards for second-hand fires, for the cost of providing and fixing the guard is out of proportion to the sum that can be obtained for the completed article. When dealing with the attitude of the public it is interesting to note that one second-hand dealer maintained that his customers became so guard-conscious that he had been asked to supply guards to customers to whom he had sold fires before the regulations came into force. On the other hand, some individuals have complained that the guard makes it somewhat difficult to light a fire. I doubt if this is a complaint that could be reasonably justified. Pet Animals Act, 1951 This Act came into operation on 1st April, 1952, and makes provision, inter alia for ensuring that animals exposed for sale shall be suitably accommodated supplied with sufficient food and drink, and protected against the spread of infection and danger from fire, Certain forms of street trading and sale to persons under twelve years of age are prohibited. During 1956 seven licences to keep a pet shop were granted six of the shops deal mainly with cage birds and cold water and tropical fish. The other shop carries on an extensive business, and holds a large and varied stock. This shop is inspected monthly, and the smaller shops annually. Hairdressers and Barbers The Borough Council on 22nd June, 1955, made byelaws under the provisions of Section 18(4) of the London County Council (General Powers) Act, 1954, for the control of hairdressers' and barbers" establishments and persons engaged in the work thereof. The byelaws provide for the cleanliness and maintenance of floors, walls, ceilings, chairs, shelves, cabinets, wash-basins, combs, brushes and instruments; for the cleanliness and proper use of towels, wraps, vi gowns and overalls for the use of proper materials for chair coverings, neck wool and hair nets for proper storage and removal of hair clippings: for satisfactory water supply, and for the cleanliness of those engaged in the business in regard to both themselves and their clothing There are 131 establishments registered in the Borough and of these 32 are south of a line drawn along Euston Road and 99 north of this line They comprise - 76 for gentlemen only, 38 for ladies only and 17 for both ladies and gentlemen Persons engaged in these establishments including proprietors total 318 (178 male 140 female) operating at 476 chairs or cubicles,. The number of washbasins in use is 528,, to which, with few exceptions there is a suitable and sufficient supply of hot water, mainly from gas or electric water heaters, though in some cases from domestic hot water boilers. The premises are visited regularly and during the course of the year the following contraventions of the Act and byelaws were discovered:- Certificate of Registration and/or copy of byelaws 49 not displayed Lack of a suitable covered receptacle for hair 16 clippings etc Inadequate supply of hot water: 5 Shop and/or fittings not in cleanly condition 6 Dirty and defective floor covering 1 Untrapped waste pipes to washbasins 1 Protective clothing not reasonably clean 1 Instruments not in satisfactory condition 4 Overalls not reasonably clean 3 Inadequate supply of neck cloths 1 Walls and ceilings in need of cleansing 7 Operatives hands not in clean condition 1 Defective washbasins 1 Dirty washbasins 1 Broken shelves 1 In every instance the proprietors attention was drawn to these contraventions and the requisite work was carried out or put in hand though two of the shops where conditions were generally unsatisfactory were later found to have discontinued business It is not always recognised among hairdressers and barbers that registration with the Local Authority is necessary before commencing business- A recent survey reveaied 14 not registered and four where the business had changed hands. vii By and large the hairdressers and barbers in the Borough carry out their business in a satisfactory and hygienic manner. Whilst this may be due to the fact that the public tends to show discrimination and will cease to go to a hairdresser" s shop where the conditions are patently bad, I think it only right to say that the proprietors them selves have shown a spirit of understanding and co-operation to which I should like to pay tribute The Public Health Department has continued its practise of previous years of visiting all persons in the borough known to the Department as being blind. The total number we have visited is 46, but I have reason to believe that this represents less than a quarter of those on the register of the London County Council. This register is not available to the department and it is only in the event of cases coming to our notice from other sources that we are able to visit. The object of the inspection by the Public Health Inspector is twofold. In the first place he looks for defects that might not be apparent to the blind person and he secures their remedy. In the second place he is an additional visitor who is welcomed as a friend. Those we visited were in the following age groups:- The individual under 15 was at school Of the remainder, 12 were working, 2 at home and 10 elsewhere. Of the six totally blind persons who were employed, one was working at home on basket making and the other on machine knitting The other four worked at the National Institute for the Blind. Of those who were not completely blind, one was a piano tuner one employed in a cafe and the remainder attended the National Institute for the Blind or the London County Council Institute, 60 visits were made during the year,, and in every case the visit was welcomed. That these visits are necessary is illustrated by the fact that it was necessary to serve a sanitary notice in seven cases; in one case a separate water supply was provided to a partially blind person living alone. Prior to the provision of this water supply he had drawn water from a tap on the staircase and disposed of the waste water down the ground floor water closet. He lived on the first floor. In other cases a notice was served for dampness, disinfestation of verminous rooms the repair of a dangerous handrail and floor,, and the redecoration of rooms. Blind persons 0-15 16-30 31-45 46-65 Over 65 1 3 2 14 26 viii Slum Clearance Under the Housing Repairs and Rents Act, 1954, the Metropolitan Borough Councils and the London County Council were required to submit to the Minister of Housing and Local Government within a year of the passing of the Act a joint programme for dealing with unfit property in each borough In accordance with the above requirement, the Borough Council submitted to the London County Council twenty-three areas, comprising 706 houses, and after negotiation and a conference at County Hall it was agreed that fifteen areas comprising 349 houses should be represented during the five years 1955-60, and that the work should be divided as follows - To be dealt with by the Borough Council:- Area No. of houses Bridgeway Street, etc. 39 Bayham Place 23 Ferdinand Street, etc. 29 Model Buildings 15 Curnock Street 28 Wicklow Street 12 Prowse Place 3 Falkland Place 23 Total 172 To be dealt with by the London County Council:- Area No. of houses Aldenham Street 5 Baynes Street, etc. 76 Tovey Place 14 Seaton Place, etc. 27 Raglan Street, etc. 16 King's Terrace 26 Janestown Road 13 Total 177 At the time of writing this report I have represented to the Borough Council the following areas- Area No. of houses Date of Representation Bridgeway street, etc. 39 15, 2,56 Bayham Place 23 19, 9, 56 Ferdinand Street, etc. 29 19, 9,56 Model Buildings 15 5, 6,57 Total 106 A local enquiry was held in respect of the Bridgeway Street, etc., Area on 20th December, 1956 and on 26th April, 1957, the Minister confirmed the Order, omitting therefrom The Neptune" Public House. Local enquiries in respect of the Bayham Place and Ferdinand Street Areas were held on 16th July, 1957. The London County Council have intimated that they are prepared to agree that the Borough Council should deal with the Jamestown Road Area instead of ix themselves as originally arranged and that the houses in Arlington Road, suggested in the original programme and which by agreement with the London County Council were deferred might be included. It will be seen that of the eight areas, comprising 172 houses,, which constitute the Borough Council s slum clearance programme for the five year period ending 1960 four areas have been dealt with, and that these four areas comprise 106 houses The London County Council have already dealt with the small Aldenham Street Area I am informed that it is hoped to represent the Baynes Street, etc and Tovey Place Areas in the middle of 1957, and that the Seaton Place, etc, and Raglan Street/Crown Place Areas will be dealt with later in the five year period. Smoking and Cancer In view of the report of the Medical Research Council on smoking and cancer of the lung, Dr. Tracy and I feel that we are bound to make some comment on this subject. From all we have read concerning the association of smoking and lung cancer we are satisfied that there is an association which is cause and effect. In other words a heavy smoker, particularly of cigarettes, is more liable to contract cancer of the respiratory tract than the non smoker We do not say that smoking is the only cause of cancer of the lung but it is definitely one of the causes. Obviously in view of the fact that smoking has become a national habit it is essential that research should be undertaken to produce a cigarette that does not influence the growth of cancer. In the meanwhile our advice is this Young people should be discouraged from commencing to smoke, It must be remembered that the older schoolboy and the young adolescent possesses no craving to smoke. He smokes because he sees other boys and girls of his own age doing so, and primarily because he wants to be grown up and one of the crowd Parents should explain to their children that really and truly smoking does not make a girl or boy more grown up and they should explain the risks inherent in smoking stating the case plainly There is little we can say to the confirmed smoker The public already know the situation. It would appear that to those who can afford it a cigar is safer than cigarettes and those who cannot afford the luxury of a cigar, pipe smoking is a lesser risk than cigarette smoking. The choice rests with the individual. Some persons can give up smoking with relative ease and all that is required is the desire to do so In other cases giving up smoking appears to be almost an impossibility and even cutting down the number of cigarettes during the day is a matter of extreme difficulty. The question arises as to whether the desire to smoke is due to the nicotine in the tobacco or whether it is purely and simply a question of habit. We ourselves do not believe that the smoker is a drug addict - by which we mean there is no similarity between the smoker and the patient who is taking either morphia or alcohol. It is a fact that people can stop smoking without showing any of x those crises which are found when the opium addict or the alcoholic is deprived of his drug. We would quote as an example the fact that people who are sent to prison are unable to smoke except to a very limited degree They nevertheless are able to accept the situation without a serious emotional crisis Furthermore there are persons who throughout the whole of their lives, for religious reasons have succeeded in refraining from smoking either on a Saturday or a Sunday, and there are others who cease smoking during the whole of Lent. We doubt if the chronic alcoholic or morphia addict could achieve this. What, then, is the compulsion to smoke? It is the compulsion of a long established habit, and one that is encouraged by poster, advertisement, by fashion and the herd instinct We therefore consider that if a person could be placed in an environment where he was not subjected to the compulsion of smoking he might smoke less Smoking might well be prohibited in buses trams and trains in theatres and in cinemas to the benefit not only of the smoker but of the non-smoker as well We believe that the smoker could adjust him or herself without too much hardship to refraining from smoking in these surroundings for the desire to smoke is very often brought about by environmental factors: the meeting of friends the offer of a cigarette annoyance excitement and the like We ourselves are in a neutral position One of us gave up smoking 20 years ago for reasons other than the fear of cancer and the other is a moderate smoker. We therefore trust that we have been able to give a combined unbiased opinion. S P A C A. The St Pancras Association for the Care of the Aged has now become an integral part of the public health and social amenities of the Borough of St Pancras and once again I make no apology for bringing it within the scope of my annual report S, P AC. A., the name by which it is now so well known has continued its work regularly throughout ^he year increasing it in those directions where it has been found to be weak At the time of writing this report there are four whole time nurses engaged in the routine care of the aged It had been the hope of the Association that the nurses wouia be abxfc to spend most of their time In visiting old people in health advising them and guiding them in order that they might avoid those pitfalls of the latter end of life which tend to make life difficult and uncomfortable. To some extent we are succeeding in this On the other hand the St Pancras Association for the Care of the Aged is now so well known to general practitioners almoners and clergy working in the borough not to mention Councillors County Councillors and Members of Parliament that we receive a regular stream of requests that we visit old people in difficulty in order to advise them As a result much of the time of the nurses is devoted to these special cases, xi I do not think I can repeat too often that one's aim in caring for old people is to keep them in their own homes under healthy and happy conditions. To achieve this there are various services which I think are essential. Of these I consider that the most important is the Home Help Service. The time comes to all old people when they are unable to carry out the heavy work of their own homes to keep their rooms clean and free from nuisance, and the provision of a home help at this time is of paramount importance. The second most important factor is to secure that the old person is provided with adequate meals in order that his nutrition may be safeguarded. The St, Pancras Association for the Care of the Aged provides meals in their homes or meals in restaurants for those people who by reason of age or infirmity or lack of proper amenities cannot provide meals for themselves 9,889 meals were provided to old people in their own homes, and 8,060 meals to others who were unable to provide a meal in their own home but could nevertheless attend at a local restaurant. The third factor which many old people require is a certain amount of nursing and this is provided via the District Nursing Associations in the borough, to whom I would like to express my most sincere gratitude. A clean home, adequate food and a modicum of nursing - these are the three main essentials of the aged. I am reminded, however, that man cannot live on bread alone and it is essential to secure mental and physical comfort. Physical comfort is provided through our chiropody clinics and no less than 5,078 attendances were made during the year. It is difficult to over-estimate the comfort which this brings to those who attend Insofar as mental welfare is concerned, there are many clubs for old people in the borough, and again I would find it hard to exaggerate the benefit which they confer on those old people who belong to them S P.A C A has continued to send old people away for a fortnight s holiday and 129 individuals benefited from this scheme during 1956 The letters I have received testify to the satisfactory arrangements which have been made- Old age can be a very lonely time and few people realise what a difference the provision of a wireless set can make to old persons living alone There are now 106 wireless sets on loan to old people in the borough We seldom get letters of thanks for the provision of a wireless set. On the other hand when, having provided itP the set goes wrong we get letters immediately begging us with all speed to repair it the old person being lost without the company and the interest with which his wireless provides him It is a companion all the week round- Through the visits of our nurses we are able to keep under regular observation some two or three thousand old persons In addition to this all those who attend at our chiropody clinics are seen either by Dr. Tracy or one of the nurses At the*medical and nurses' clinics no less than 4.422 attendances were made. Domiciliary visiting by the nurses amounted to 5 662 but in addition to this a large number of visits were made by voluntary visitors, to whose regular work I would like to pay tribute. In particular I would mention the British Red Cross Society which arranges for a large number of old people to be visited regularly through the services of its members. xii It is interesting to note that towards the total cost of the administration of the St, Pancras Association for the Care of the Aged £680 was raised as a result of voluntary contributions Poliomyelitis At the time of writing this report I have just returned from the fourth International Poliomyelitis Conference held in Geneva and I feel sure that you would like me to give you some indication of the present position concerning the prevention of the disease It is now some three years since Dr. Jonas Salk of Pittsburg America,, produced a vaccine against poliomyelitis which could be manufactured in mass quantities In America no less than 140 million doses of this vaccine have been injected and there is evidence that it reduces materially the risks of contracting paralytic poliomyelitis. Similar vaccines are being used in various other countries. I have had the pleasure of meeting Dr. Salk in Rome, in Pittsburg and in Geneva, and I am sure that he would like me to state that the credit for the production of the vaccine lies with no one individual but in the work of a highly skilled team A similar vaccine is being manufactured in England. It has been given to about 140,000 children, and there is evidence once again that it materially reduces the risk of contracting paralytic poliomyelitis. The vaccine is similar to Salk vaccine except that one of the three types of virus used is less virulent than that used by Dr Salk. I am often asked how long it will be before vaccine will be available to the large bulk of persons in England to whom protection may rightly be afforded. My information is that about 500 000 doses are being manufactured monthly enough to immunise 250 000 children a month or 3 million a year It is possible that when other firms manufacture the vaccine this production may be increased On the other hand strict precautions have to be taken and even this figure may not be achieved I have also been asked whether the American and the English vaccines are safe and to what extent,they are efficacious. I think that both vaccines are safe and efficacious. As regards the American vaccine the injection of 140 million doses without untoward event is in itself adequate proof of safety and strict precautions are taken in America to ensure that the production of the vaccine continues under the most careful and strict control. In England the vaccine prepared has shown itself to be equally safe and the strictest control measures are adopted. The general impression at the Conference was that the vaccine achieved a 75 per cent efficiency: that is that it reduced the incidence of paralytic poliomyelitis to about one quarter of what it otherwise might be. Generally I felt that there was considerable variation and that in some cases it might be higher and in others lower, depending on various environmental factors, and the type of virus causing the epidemic. I have also been asked in view of the time which is bound to elapse before sufficient British vaccine will be available for all those requiring it, whether xiii it is possible to obtain the American vaccine Originally,, correspondence with the Ministry of Health indicated that individuals might obtain vaccine from America,provided the application was supported by a medical practitioner, and that;'dollars would be made available for the purchase of small quantities. I now understand that this is not so, but that it can be obtained only if it is sent as an unsolicited gift. These are the facts as I understand them at present. The vaccines against poliomyelitis that are being used in England, the United States and elsewhere are made of killed virus and are injected. Two workers in America, however Drs, Sabin and Koprowsky., have been working for many years on a live attenuated vaccine which can be given by mouth. They hold that such a vaccine would give a more lasting immunity than that achieved by a dead vaccine. It is a fact that we do not know yet how long the protection afforded by the Salk vaccine will last, though we have reason to hope that it will be some years. For that matter we do not know how long the immunity derived from a live vaccine would continue, except that it is believed that the immunity so obtained is similar to the natural immunity which is derived by the ordinary individual or by those who have suffered from one attack of the disease. For an attenuated vaccine to be successful and safe, one must be sure that the live virus will not recover its virulence., and in this there seems to be an element of doubt. Further experimental work will be carried out on these vaccines. Conclusion The Committee will realise that the preparation of this Annual Report is not the sole effort of the Medical Officer of Health I am indebted, in particular, to Mr. C.W. Smith who is responsible for preparing the background upon which the report is presented This is a task which is continuous throughout the year, and involves compilation of all figures and statistical tables and graphs I have also received very considerable help from Dr S. Tracy, Deputy Medical Officer of Health and Mr E.W Winchester Chief Public Health Inspector - indeed, all members of the staff are involved I would like to mention in particular Mr D H, Smith, Mr, HP Price, Mr J Marginson and Mr. B V Cryer in connection with the reports on fireguards, the Pet Animals Act hairdressers and blind persons respectively No Medical Officer of Health works in isolation. He is dependent for any success he may achieve on the trust and confidence which is placed in him by the members of the Council, and once again it is my priviiage to thank the Council, and in particular the members of the Public Health Committee, for the encouragement and courtesy I have always received. To my colleagues in charge of the other Departments of the Council I would like to express my thanks for making St. Pancras so happy a place in which to work, I beg to remain. Your Worship Ladies and Gentlemen, Your obedient Servant DENNIS H. GEFFEN Medical Officer of Health xiv METROPOLITAN BOROUGH OF ST. PANCRAS PUBLIC HEALTH COMMITTEE (as at 31st December, 1956) Ex-officio- The Mayor and the Leader of the Council; Councillor Miss E M., Haworth (Chairman) and Councillor J J. Edwards (ViceChairman); Alderman P. J. Jonas, Councillors D. Annison, Mrs. L.A Arabin, T. Barker, Mrs. L. Bartlett, N.A Burton, Mrs. M Carruthers Evan Evans, DC. Jenkins, Mrs. J. L. Jenkins, Mrs. G. S. Jones and S. Phelan. CHIEF OFFICERS OF THE COUNCIL Town Clerk and Solicitor R. C. E. Austin, LL M Borough Treasurer and Accountant J W Cooke F.I.M.T A. ,F S.A.A 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.A.S. A I.Hsg. Borough Librarian W. A. Taylor, m.c. f l.a Building Surveyor and Manager A. E. Ullmer, 1 REGISTRARS OF BIRTHS AND DEATHS St. Pancras Town Hall Euston Road N W 1. Superintendent Registrar Henry J. Millichap Deputy Superintendent Registrar Stanley Western Kirkup 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 2 p.m. to 4.30 p.m. Thursday Friday 6 p.m. to 8 p.m. South-East Joseph Mahoney Daily. 9.30 a.m. to 12 30 p.m. Monday Wednesday 2 p.m. to 4.30 p.m. Thursday Friday, 6 p.m. to 8 p.m. South-West Alice K. Kimmance (Mrs. Daily, 9.30 a.m. to 12.30 p.m. Monday Wednesday 2 p.m. to 4.30 p.m. Thursday Friday, 6 p.m. to 8 p.m. REGISTRARS OF MARRIAGES Alice K. Kimmance (Mrs.) Joseph Mahoney Edward Denis Muffett Thomas Chapman John N. Blane 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. 2 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health Dennis H. Geffen, o b e.u.d.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.r,I.c,. Chief Public Health and Housing Inspector E. W. Winchester Deputy Chief Public Health 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) I. Williams Miss D.M Richardson E W C. George District Public Health Inspectors. (14) J.W.C. Armstrong J. Marginson B.V.Cryer H.P.Price J.E. Davies E. S. Rushton H. R. Dawkins.D. H. Smith C. A Engledow E. Stirk T. H. Hague H. E. Westripp K J. Lambert J H. Willett Clerical Staff (12) V R Meurice, Chief Clerk C. W Smith, First Clerk Miss M. J. Barnes Miss B. Pinnock Miss D Schreiber J. F S Dove Mrs. I.E Burgoyne E. Driscoll W J. Flett N.L.B Collier A.J. Teare J. J. Bevan Health Officers. (4) Miss A. Mackie Miss R. W. Ventress Miss J.M. Minns Mrs. N C. Durkin 3 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 555 acres At census 1951:- Population 138,377 (66,181 males: 72,196 females) Number of households (families) 48,865 Structurally separate dwellings 29,146 Population (Registrar General's mid-1956 estimate) 133,100 Number of persons per acre (estimated average) 49 Rateable value £3,723,700 Product of a penny rate about £14,425 General rate in the £ for the year 14s. 6d Summary of Vital Statistics Net registered live births 2,366 Birth-rate (per 1,000 of estimated population) 17.77 Deaths, all ages 1,528 Death rate (per 1,000 of estimated population) 11.48 Infantile deaths 53 Infantile death rate (per 1,000 live births) 22.40 Tuberculosis deaths 28 Tuberculosis death rate (per 1,000 of estimated population) .21 4 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 1953 338 252 46 794 1,430 138,400 20,66 1954 359 289 45 788 1,481 136,400 21,71 1955 345 269 62 840 1,516 134,500 22,54 1956 322 213 58 743 1,336 133,100 20,08 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.I. GUL 1667 Highgate New Town Clinic Chester Road, N. 19. ARC 3594 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 University College Hospital Maternity and Child Welfare Department Huntley Street, W.C.I EUS 5050 Tuberculosis Chest Clinic Telephone 26, Margaret Street. W 1. LAN 4112/3/4 Day Nurseries Telephone Caversham Road, N W.5. GUL 5769 Margaret. 42, Phoenix Road. N.W.I, EUS 1822 254 256 Camden Road, N.W.I. GUL 2910 Coram Gardens 41, Brunswick Square, W.C,1 TER 6054 Kentish Town, 27, Gospel Oak Grove, N W 5 GUL 2906 South Highgate, Chester Road N, 19. ARC 4921 Regent's Park, 4, Prince Albert Road, N.W.I. GUL 4037 5 Nursing Associations Telephone North London District Nursing Association, 6 & 7, Canonbury Place,, N. 1„ CAN 1955 Hampstead District Nursing Association, 3, Pond Street, N,l 3. HAM 6406 Metropolitan District Nursing Association 18, Montague Street, W,C,1„ MUS 0352 Hospitals 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. V. 1. GUL 2041 Paddington Group 21 None Eastman Dental, Gray's Inn Road, W. C- 1. TER 7251 Teaching Hospital (26) 6 Elizabeth Garrett Anderson, 144, Euston Road, N.W.I. EUS 2501 Board of Governors, Royal Free Hospital 161 Hampstead General and N.W. London (Out-Patients' Department) Bayham Street, N.W.I. GUL 1734 Board of Governors Royal Free Hospital None Highgate Wing, Whlttington, Dartmouth Park Hill, N.19. ARC 3070 Archway Group 19 357 St. Luke's Nursing Home for the Clergy, 14, Fitzroy Square, W. 1. EUS 1382 Disclaimed hospital 30 Medical Rehabilitation Centre, 152, Camden Road, N.W.I. GUL 1124 Paddington Group 21 None London Foot, 33, Fitzroy Square, W. 1. 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 21 142 Obstetric, Huntley Street, W.C 1. EUS 5050 Department of U.C.H. 103 Royal Ear, Huntley Street, W.C 1. EUS 5050 Department of U.C.H. 53 Royal Free, Gray's Inn Road, W.C.I. TER 6411 Teaching Hospital (3) 243 Royal National Throat, Nose and Ear Gray's Inn Road, W C. 1. TER 8855 Teaching Hospital (16) 112 St. Saviours (Women only), 10, Osnaburgh Street, N.W.I. EUS 2770 Disclaimed hospital 20 University College, Gower Street; W.C.I. EUS 5050 Teaching Hospital (4) 669 University College (St. Pancras), St. Pancras Way, N.W.I. EUS 4411 Board of Governors, U C.H 281 -do- for Tropical Diseases EUS 6441 -do- 68 6 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.I. 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.I. Ear, Nose and Throat Royal National Throat Nose and Ear Hospital, Gray" s Inn Road W, C. 1. Whittington Hospital, Highgate Wing Dartmouth Park Hill N. 19. Enuresis Highgate New Town Clinic. Orthoptic Somers Town Treatment Centre, Minor Ailments Highgate New Town Clinic. St Pancras Clinic. Somers Town Treatment Centre, * Children may 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 or places of employment). (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 patient1s admission). Dial "909(or follow the [instructions given on the [telephone instrument) and ask for "AMBULANCE". [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. HOP 7181 Normally if the expectant mother has booked a bed at a hospital or nursing home she is in possession of a white card (Form LAS 23) giving full instructions for summoning the ambulance. (4) Other Illbess. - For the removal to and from hospitals etc. 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 Headquarters 150 Waterloo Road S.E.I. Telephone enquiries relating to the ordering of ambulances to WATerloo 3311 general enquiries to WATerloo 5000, Ext.6950. 7 8 Climatological Summary, Year 1956 Station. Camden Square, N.W.1. - Lat. 51° 33' N. Long. 0° 8' 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.) Air Temperature Mean of - 1011. 5 1025.6 016.0 1015.6 1022.4 1018. 0 1014,1* 1010.5 1015.5 1022.1 1021.6 1018.3 A. Maximum °F 45.8 37.9 52. 7 54. 6 68. 5 65.7 71.1 67.0 68.1 57.9 49.4 47.9 B. Minimum °F 35.9 26.8 38.1 38.2 47.5 50.6 56.4 53.0 53.6 45.1 39.4 40.7 Mean of A and B °F 40.9 32.3 45.4 46.4 58.0 58.1 63.7 60.0 60.9 51.5 44.4 44.3 Difference from average(1921-1950) °F + 0.7 8.3 + 0.8 - 3.2 + 2.2 - 3.5 -1.3 - 4.3 + 1.1 - 0.9 0.6 + 3.2 Mean relative humidity per cent. 87* 79 76 72 65 77.2 79.7 80.8 84.4 87. 5 88. 8 91.1 Earth temperature at 4 ft. depth °F Bright sunshine 44. 9 42.2 41.6 44.9 49.4 53.8 56.7 57.8 56.6 54.9 50.6 47.9 Total observed (daily-mean) Hr 1.15 1.67 3.63 4.21 7.33 4.42 5.23 4.75 3.11 3.03 1.34 0.25 Percentage of average(1921-1950) Rainfall (rain-gauge level, 110 ft.) - 121 104 122 96 121 65 84 84 74 113 98 29 Number of days precipitation 18 10 8 8 4 15 15 25 13 13 10 17 Total fall In 3.60 0.30 0.99 1.16 0.43 2.34 5.90 5.05 2.14 2.24 0.38 2.75 Percentage of average(1881-1915) 194 18 54 75 24 116 248 229 118 85 16 115 Hour of observation 9 a.m. (GMT). The readings for Bright Sunshine are those taken at Regent's Park - no readings being recorded at Camden Square. Year Total Rainfall Days Inches 1945 152 21. 57 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 1953 134 20. 57 1954 170 25. 91 1955 146 21.35 1956 156 27.28 *Pressure figures for July December and Relatire Humidity for January-May are from Kew, those from Camden Square being unavailable SECTION 2 Births and Deaths STATISTICS FOR THE YEAR 1956 Population The civilian population, as estimated by the Registrar-General, mid-1956c was 133,100. Comparable estimates for preceding years are set out on page 12. Registered Live Births M. F. Total Rate per 1,000 of estimated population Legitimate 1,048 1,059 2,107 Illegitimate 137 122 259 1.185 1,181 2,366 17.77 Comparable figures for preceding years are set out on pages 12 and 13. Registered Still Births M. F. Total Rate per 1 000 Live and Still Births Legitimate 16 18 34 Illegitimate 1 4 5 17 22 39 16.21 Comparable figures for preceding years are set out on page 13 Deaths -All Ages M. F. Total Death rate per 1,000 of estimated population 824 704 1,528 11.48 Comparable figures for preceding years are set out on page 12, 9 CLASSIFICATION OF DEATHS, WITH AGE DISTRIBUTION - 1956 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 53 8 8 18 60 378 431 572 824 704 1. Tuberculosis, respiratory - _ _ - 6 10 4 4 20 4 2, Tuberculosis, other - - - - 1 2 - 1 2 2 3. Syphilitic disease - - - - - 3 6 3 11 1 4. Diptheria - - - - - - - - - - 5. Whooping cough - - - - - - - - - - 6. Meningococcal infections - - - - 1 - - - - 1 7..Acute poliomyelitis - - - - - - - - - 8. Measles - 1 - - - - - - - - 9. Other infective and parasitic diseases _ - - - 1 1 - 1 3 - 10. Malignant neoplasm, stomach - - - - 2 9 15 11 14 23 11. Malignant neoplasm, lung bronchus _ - - _ 4 50 31 16 84 17 12. Malignant neoplasm, breast - - - - 3 10 3 4 - 20 13. Malignant neoplasm, uterus - - - - 3 4 2 4 - 13 14. Other malignant and lymphatic neoplasms _ _ 2 2 8 45 42 47 76 70 15. Leukaemia, aleukaemia 1 - 1 2 - 4 - 2 3 7 16. Diabetes - - - - - 1 7 2 3 7 17. Vascular lesions of nervous system _ _ . - - 30 44 85 59 100 18. Coronary disease, angina - - - - 3 58 99 85 142 103 19. Hypertension with heart disease _ _ . . 1 3 17 14 13 22 20. Other heart disease - - 1 - 1 24 21 50 46 51 21. Other circulatory disease - - - - - 11 16 51 30 48 22. Influenza - - - - - 1 2 1 3 1 23. Pneumonia 4 - - - 1 14 20 59 50 48 24. Bronchitis 2 3 1 - 2 29 48 52 87 50 25. Other diseases of respiratory system _ 1 - 1 - 4 8 5 15 4 26. Ulcer of stomach and duodenum . - - - 3 5 13 7 21 7 27. Gastritis, enteritis and diarrhoea - - - 1 - - 1 6 5 4 28. Nephritis and nephrosis - - - - 1 7 1 - 8 1 29. Hyperplasia of prostate - - - - - 4 12 16 - 30. Pregnancy, childbirth, abort ion . . 2 1 - - - - 3 31. Congenital malformations 13 1 - 1 3 - 1 10 10 32. Other defined and illdefined diseases 30 2 - 2 7 16 20 34 50 61 33. Motor vehicle accidents - - - 3 2 3 1 4 9 4 34. All other accidents 2 - - 5 5 15 3 11 30 11 35. Suicide - - - - 3 14 3 - 10 10 36. Homicide and operations of war - 1 2 - - 2 - 4 1 10 DEATHS OF INFANTS UNDER 1 YEAR OF AGE - 1956 from stated causes with age distribution Cause of death Age Under 1 day 1 day to 1 week 12 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 4 weeks and Under 3 months 3-5 months 6-8 months 9-12 months Total deaths under 1 year M. F. Acute Leukaemia unspecified- type - - - - - - - - - 1 - 1 Acute Otitis Media without mention of Mastoiditis - - - - - - 1 - « - - 1 Lobar Pneumonia - - - - - - 1 - - - - 1 Broncho Pneumonia - - - - - - - - 1 - - 1 Bronchitis - - - - 1 1 - - 1 - 1 1 Exompholus - 1 - - 1 1 - - - - - 1 Diaphragmatic Hernia 1 - — - - 1 - - - - 1 - Volvulus - 1 - - - 1 - - - - 1 - Gastro Enteritis - - * - - - - 1 - - 1 - Abscess of Scalp - - - - - - 1 - - - 1 - Congenital Malformations 3 3 1 2 - 9 1 1 2 - 8 5 Intracranial and Spinal Injury at Birth 1 4 - - - 5 - - - - 4 1 Other Birth Injury 1 - - - - 1 - - - - 1 - Atelectasis 8 - 1 - - 9 1 1 - 5 6 Pneumonia of Newborn - 2 - - - 2 - - - 1 1 Haemolytic Disease of Newborn Haemorrhagic Disease of 1 - - - - 1 - - - ~ - 1 Newborn 1 - - - - 1 - - - - 1 - Immaturity Accldential Mechanical Suffocation In bed and 2 3 5 1 3 3 cradle - • 1 • " 1 - 1 - - 2 - All Causes 18 14 3 2 1 38 6 4 4 1 30 23 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 1956 24 12 22 21 24 1955 20 45 23 23 25 1954 16 32 18 21 25 1953 24 30 24 25 27 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 12 and 13 11 z1 vital Statistics of St. Pancras since 1920 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 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 213,300 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 1953 138,400 2,123 15.3 1,399 10.1 52 24 39 18 1954 136,400 2,168 15.9 1,338 9.8 39 18 29 13 1955 134,500 2,176 16.2 1,441 10.7 50 23 37 17 1956 133,100 2,366 17.8 1,528 11.5 53 22 38 16 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 (Illegit lmates 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 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 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 Records suspended 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 1953 37 (3) 17.3 236 11.1 7 30 6 25 1954 45 (7) 20.3 221 10.2 7 32 6 27 1955 32 (6) 14.5 221 10.2 10 45 9 41 1956 39 (5) 16. 2 259 10 9 3 12 3 12 13 Maternal Mortality in Borough of St. Pancras in 1956 Cause of Death Ages Conditions 15-19 20-24 25-29 30-34 35-39 40 44 45 and upward Married Single Widowed Ectopic Pregnancy without Sepis - - - - 1 - - 1 - - Abortion with Sepis (induced) - 1 - - - - - - - - Delivery conplicated by Postpartum Haemorrhage - 1 - - - - - 1 - - Deaths from Puerperal Causes during 1956 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 1953 - 1 1 - 0.46 0.46 1954 - 1 1 - 0.45 0.45 1955 - 1 1 - 0.45 0.45 1956 1 2 3 0.42 0.83 1.25 14 Deaths from Cancer of St. Pancras Residents during 1956 Situation of Disease Ages Totals 0-14 15-19 20-24 25-34 35-44 45 54 55-64 65-74 75-84 85 and up M. F. Tongue - - - - - - - - 1 - 1 - Salivary Gland - - - - - 1 - - - - - 1 Mouth (palate) - - - - - - - 1 1 - 1 1 Oral Mesopharynx - - - - - - 2 - - - 1 1 Hypopharynx - - - - - - 1 1 - - - 2 Pharynx unspecified - - - - - - 2 - - - 1 1 Oesophagus - - - - - - - 4 1 - 4 1 Stomach - - - - 2 5 4 15 9 2 14 23 Small Intestine Including Duodenum - _ _ _ - - 1 _ 1 - 2 - Large Intestine except Rectum - - 1 - 2 1 5 10 6 3 13 15 Rectum - - - - - - 3 5 8 1 8 9 Liver - - - - - - - 1 - - - 1 Biliary Passages - - - - 1 - 1 1 1 2 2 Pancreas - - - - 1 1 1 2 2 1 4 4 Peritoneum - - - - - 1 - - - 1 - Maxillary Antrum - - - - - 1 - - - - 1 - Larynx - - - - - - 1 - 1 - 2 - *Lung and Bronchus - - - 4 18 32 31 14 3 84 18 Breast - - - 1 2 5 5 3 4 - - 20 Cervix Uteri - - - 1 2 1 2 2 4 - - 12 Corpus Uteri - - - - - - 1 - - - - 1 Ovary - - - - - 1 1 2 1 1 - 6 Prostrate - - - - - - 2 4 1 7 - Penis - - - - - - 1 - - - 1 - Kidney - - - - - 1 3 1 1 - 4 2 Bladder - - - - - - - 4 1 2 3 4 Urethra - - - - - - - 1 - - 1 - Skin - - - - - - 1 2 - 1 1 3 Brain 2 - - - - 1 1 - - - 2 2 Thyroid Gland - - - - - - - - 1 - - 1 Adrenal Gland - - - - - - 1 - - - 1 - Sacrum - - - - - - - - 1 - - 1 Hip - - - - - - - 1 - - - 1 Multiple Generalised - - - - 1 1 1 1 2 - 1 5 Lymphatic Tissues - - 1 3 1 1 8 2 - - 11 5 Haematopoietic Tissues 2 - 2 - - 1 3 - 2 - 3 7 Gall Bladder - - - - - - 1 1 2 - 3 1 All Sites 4 - 4 5 15 40 82 92 69 16 177 150 * Includes 1 Secondary Lung Cancer Undetermined primary (F.75-84) 15 The following table shows the number of deaths of St. Pancras persons from certain diseases during the years 1920 to 1956- Year Cancer Tubercu losis Heart Disease Pneumonia (all forms) Bronchitis Population 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 337 163 579 216 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 323 127 399 113 145 111,400 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 344 105 453 118 127 141,330 1950 344 76 482 87 106 141,300 1951 338 73 533 118 158 139,100 1952 343 46 439 78 148 139,600 1953 266 39 422 85 149 138,400 1954 296 38 439 60 102 136,400 1955 332 34 456 60 133 134,500 1956 327 28 455 98 137 133,100 16 17 Deaths from Tuberculosis of St. Pancras Residents during 1956 Situation of Disease Under 1 year 1-2 years 2-4 years 5-9 years 10-14 years 15-19 years 20-24 years 25-34 years 35-44 years 45-54 years 55 64 years 65-74 years 75 and upwards Total M. F. M. P. M. P. M. P. M. F. M. F. M. P. M. F. M F. M. F. M P. M P. M. P, M. P. Pulmonary - - - - - - - - - - - - - - - 1 4 1 4 2 4 - 4 - 4 - 20 4 Intestine - - - - - - - - - - - - - - - - - - - - - - - - - 1 - Peritoneum - - - - - - - - - - - - - - - - - - - - - - - - - - - 1 Vertebral Column - - - - - - - - - - - - - - - - - - - - - - - - - - - 1 Lymphatic system - - - - - - - - - - - - - - - - - - - - - - - - - - - - All sites - - - - - - - - - - - - - - - 2 4 1 4 2 5 1 4 - 5 - 22 6 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 Diptheria Enteric Fever (including typhoid and paratyphoid), Erysipelas Membranous Croup Relapsing Fever Scarlatina or Scarlet Fever Small-pox (Variola) Typhus Fever B. Under Regulat ions made by the Minister of Health under powers contained in the Public Health Act, 1936 (Sections 143-146) Acute Encephalitis (Regulation No.2259s 1949) Acute Influenzal Pneumonia (Regulation No.299, 1953) Acute Poliomyelitis (Regulation No.2259 1949) Acute Primary Pneumonia (Regulation No.299, 1953) Dysentery (Regulation No 299 1953) Leprosy (Regulation No 1036 1951) (See (a) below) Malaria (Regulation No.299 1953) Measles (Regulation No,1100 1938) Meningococcal Infection (Regulation No,2259, 1949) Puerperal Pyrexia (Regulation No.1081 1951 and No.1691 1954) Scabies (Regulation No. 101-6 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) 18 D. Under Food and Drugs Act., 1955 (Section 26) 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. 1,. and the appointed factory doctor, (a) Notifiable to the Chief Medical Officer Ministry of Health. (b) Also Regulations No 971 made by Minister of Health (1 10.26'* amended by S R 0 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 St. Pancras Gardens Pancras Road N. W. 1 'Telephone EUS. 2368) between the hours of 9 a m and 4 p, m and on Saturday 9am to 12 noon Psittacosis is not compulsorily notifiable, but information may be given to Ministry of Health.. Savile Row W. 1. 19 Removal to Hospital Removal to hospital in certain circumstances of cases of Chicken-pox, 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 application should be made direct to the Emergency Bed Service (HOP, 7181). NOTIFICATIONS OF INFECTIOUS DISEASES 1956 (with 1955 comparison) Showing number of revised diagnoses Disease Notifications Diagnosis Subsequently revised Under 1 1 and over Totals 1955 1956 1955 1956 1955 1956 1955 1956 Acute Influenzal and Acute Primary Pneumonia - 4 59 65 59 69 1 - Acute Poliomyelitis 1 - 46 9 47 9 7 4 Diphtheria and membranous croup - - 1 - 1 - 1 - Dysentery 9 10 166 81 175 91 5 - Encephalitis. Acute - - 1 12 1 12 - 1 Enteric or Typhoid Fever - - 6 2 6 2 1 1 Erysipelas - - 13 11 13 11 - - Food Poisoning 1 2 98 61 99 63 - - Malaria - - 6 13 6 13 - - Measles 60 37 1,558 790 1,618 827 8 - Meningococcal Infection 1 - 4 3 5 3 1 " Ophthalmia neonatorum 6 9 - - 6 9 - * Puerperal Pyrexia - - 53 27 53 27 - - Scabies - - 29 42 29 42 - - Scarlatina or Scarlet Fever - 2 55 70 55 72 4 4 Whooping Cough 20 28 93 146 113 174 6 1 20 Notification of Infectious Diseases since 1927 Population 213,200 206,000 204,400 204,400 195,600 194,000 190,900 187,540 185,300 183,900 181,900 179,400 167,300 133,200 103,770 105,900 108,640 105,780 111,400 129,410 136,700 140,200 141,330 141,300 139,100 139,600 138,400 136,400 134,500 133,100 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 Acute Influenza and Influenzal Pneumonia 121 65 208 24 79 68 111 55 44 46 79 39 31 20 38 26 44 34 136 123 97 87 112 94 121 104 103 63 59 69 Acute Primary Pneumonia 178 282 250 170 193 178 211 300 151 182 150 166 168 86 103 89 79 89 Acute Poliomyelitis 3 2 2 1 1 4 7 2 4 2 8 5 2 1 3 2 3 - 5 3 36 7 66 26 7 27 36 5 47 9 Anthrax 1 - - - - - - - - - - - - - - - - - - _ - - - - -_ - - - - - Meningococcal infection 3 3 4 7 12 13 8 4 5 2 6 13 12 37 29 14 5 10 8 9 7 6 6 6 7 6 3 5 5 3 Diphtheria or Membranous Croup 390 407 374 568 334 301 363 456 440 487 614 374 157 84 118 101 99 58 104 94 41 37 11 8 12 11 8 4 1 - Dysentery 1 5 3 1 1 4 1 30 51 57 84 63 10 2 19 54 31 56 155 92 24 61 66 44 160 84 161 171 175 91 Encephalitis Lethargica 9 8 4 5 2 - » 1 - - - - - - 2 - - - - - (e) - _ - 1 12 Enteric or Typhoid Fever 21 21 16 7 13 8 5 6 7 11 10 7 6 7 12 3 2 1 5 5 2 1 - 5 3 - 3 2 6 2 Erysipelas 98 97 110 120 96 117 121 156 92 81 64 86 51 50 43 56 72 56 60 53 38 46 37 31 24 25 26 18 13 11 Food poisoning - - - - (a) 16 28 22 10 22 65 8 4 1 7 2 15 3 8 9 7 2 12 41 40 19 30 80 99 63 German Measles 60 83 1074 116 68 65 486 191 145 78 120 355 (b) - - - - - - - - - - - - - - - - Malaria 2 2 1 2 1 1 3 29 51 22 16 5 1 - - - 1 2 4 7 1 - 1 1 - 2 11 5 6 13 Measles 417 3876 591 3476 430 2865 437 3638 120 2975 638 2337 85 285 616 1492 1082 798 1025 1115 902 1361 1146 1057 1993 1185 1371 398 1618 827 Ophthalmia Neonatorum 38 32 36 32 45 74 42 33 23 31 26 22 23 16 19 21 12 6 10 33 23 19 19 16 7 29 7 3 6 9 Puerperal Fever 22 19 23 19 24 30 20 14 24 9 14 7 6 5 8 8 6 16 19 6 5 6 (d) - - - - - _ - Puerperal Pyrexia 47 40 71 52 38 46 45 27 19 23 30 37 34 28 23 29 32 27 34 47 35 34 15 15 51 124 100 81 53 27 Relapsing Fever - - - - - - - - - - - - - - - - - - - - _ - - - - - - - - - Scabies - - - - - - - - - - - - - (C) 546 931 887 699 300 138 65 48 45 52 45 36 29 42 Scarlatina or Scarlet Fever 527 618 668 659 435 517 653 705 354 434 364 333 253 100 136 173 408 184 245 244 124 132 181 190 114 145 182 86 55 72 Small pox - 3 87 175 4 5 - - - - - - - - - - - - - - - - - - - - - Typhus - - - • - - - - - - - - • - - - - - 2 - - - - - 1 - - - - - Whooping cough - - - - - - - - - - (b) 113 526 45 342 480 439 575 183 511 484 363 320 432 399 257 385 108 113 174 NOTES - (a) Pood poisoning notifiable from 12th July 1932 (b) Whooping cough notifiable and German measles ceased to be notifiable from 1st October,, 1938. (c) Scabies notifiable from 1st August, 1943, (d) Puerperal fever ceased to be notifiable from October 1948 (e) Superseded by acute Encephalitis as from 1st January 1950 21 22 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 - - - - - 105,780 1944 50 748 798 7.5 - 3 - - 4 3. 7 111,400 1945 71 954 1, 025 9.2 - - 1 - - - 129,410 1946 74 1,041 1,115 8.6 1 - - - 1 1.0 136,700 1947 56 846 902 6.6 - 1 - - 2 1.8 140,200 1948 69 1,292 1,361 9.7 - 2 - - 2 2. 2 141,330 1949 65 1,081 1,146 8.1 1 1 - - 1 0.7 141,300 1950 39 1 018 1,057 7.5 - - - 1 0.8 139,100 1951 104 1,889 1,993 14.3 - - - - - - 139,600 1952 27 1,158 1,185 8.5 - 1 - - 1 0.5 138,400 1953 74 1,297 1,371 9.9 - - - - - - 136,400 1954 13 385 398 2.9 - - - - - - 134,500 1955 60 l,558 1,618 12.0 - - - - - - 133,100 1956 37 790 827 6.2 - - - - - - MEASLES - ST. PANCRAS Mortality Rate per 1,000 notifications -------- Notifications—— POLIOMYELITIS - ST. PANCRAS NOTIFICATIONS DEATHS TUBERCULOSIS - ST. PANCRAS NOTIFICATIONS DEATHS WHOOPING COUGH - ST. PANCRAS Tuberculosis Public Health (Tuberculosis) Regulations 1952 The number of primary notifications of tuberculosis those which became known by means of death reports and transfers from other districts are given in the following 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 - 2 - 1 4 11 38 20 16 20 11 123 Females - - - - 2 13 22 6 7 3 * 53 Non-pulmonary- Males - - - - - 1 2 - 1 - - 4 Females ~ 1 4 - - 2 4 - " " - 11 Totals - 3 4 1 6 27 66 26 24 23 11 191 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 - 1 - - 1 5 20 10 10 2 3 52 Females - - - - 3 3 13 3 2 - 2 26 Non-pulmonary- Males - - - - - - - - - 1 2 3 Females .- " ** " 1 " " 1 * 2 Totals - 1 - - 4 9 33 13 12 4 7 83* * 9 of these cases came to knowledge by means of special death reports, and 74 by transfer from other districts. 27 The following table gives particulars of the prevalence and fatality of tuberculosis during the past 18 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 1953 138,400 322 33 355 2.32 0.24 2.56 37 2 39 0.27 0.01 0. 28 1954 136,400 274 24 298 2.01 0.17 2.18 36 2 38 0.26 0.02 0.28 1955 134,500 295 28 323 2.19 0.21 2.40 31 3 34 0.23 0.02 0.25 1956 133,100 254 20 274 1.91 0.15 2.06 24 4 28 0.18 0.03 0.21 28 Tuberculosis Register The following table gives a summary of the changes in the register during the year 1956:- Pulmonary Non-Pulmonary Total Number of cases on the Register at the commencement of the year. 1401 177 1,578 Number of new cases during the year. 295 21 316 1,696 198 1,894 Number of cases removed from the Register during the year (by death or other causes). 279 34 313 Number of cases remaining on the Register at the end of the year. 1,417 164 1.581 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 by either the Public Health Laboratory Service (at Colindale or County Hall), or the Royal Institute of Public Health and Hygiene, 23, Queen Square, W.C.I. Positive Negative Total Diphtheria - 49 49 Dysentery 8 8 16 Food Poisoning 3 1 4 Haemolytic Streptococci 6 1 7 Pathogenic organisms 10 157 167 Tuberculosis 3 20 23 Vincent's Organisms 1 - 1 Totals 31 236 267 29 CLEANSING AND DISINFESTING 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 1956 Total 1955 St. Pancras 195 94 32 245 566 374 Ex St. Pancras 17 31 6 - 54 20 No fixed abode - - - - - - Totals 212 125 38 245 620 394 (2) Verminous Conditions Men Women Children under 5 Schoolchildren Total 1956 Total 1955 Head lice St. Pancras - 26 14 453 493 666 Ex St. Pancras - - - - - - No fixed abode - - - - - - Body lice St. Pancras 931 6 - - 937 670 Ex St. Pancras 54 - - - 54 76 No fixed abode 21 1 - - 22 54 Totals 1 006 33 14 453 1,506 1,466 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 Educational Act. 1944 As from 1st July 1956 payment is made by the London County Council at the rate of three shillings per child in respect of both verminous conditions and scabies subject to a minimum annual payment of £250 30 Disinfesting 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 Dysentery 69 5 10 54 Encephalitis 7 - 10 - Enteric Fever 5 2 3 - Erys ipelas 1 - - 1 Measles 25 2 2 21 Meningococcal Infection 10 2 9 - Other diseases 267 14 19 237 Poliomyelitis 12 8 5 1 Scabies 6 2 2 3 Scarlet Fever 22 7 14 2 Tuberculosis 71 59 11 8 Vermin 439 33 527 118 Totals 934 134 612 445 31 SECTION 4 Sanitary Circumstances Visits by District Public Health Inspectors during 1956 Complaints received 4,919 Complaints Investigated Whole house inspections 378* Whole house re-inspections 504 Part of house inspections 4,541 Part of house re-inspections 13,628 House to House Inspections Tenement house inspections 168* Tenement house re-inspections 313 Dwelling house inspections 63* Dwelling house re-inspections 41 Infectious Disease:- Investigations 322 Inspection of premises 4* Re-inspections 10 Drainage - (a) Under Notice. Plans, Supervision, etc. 1,945 (b) Voluntary 4,581 (c) New building 2,925 (d) Tested - (i) After infectious disease 3 (ii) For other reasons 322 Shops Acts - First inspections 1 Re-inspections 4 Pharmacy and Poisons First inspections 53 Re-inspections 85 Public Houses - Inspections 25 Smoke Observations Smokeless zone survey 256 32 Visits by District Public Health Inspectors - Continued Environmental Visits - (a) Old and Infirm (Section 47, National Assistance Act, 1948):- First visits 4 Subsequent visits 1 (b) Blind persons 60 (c) Old Age Pensioners 24 (d) Tuberculous persons 194 (ej Housing applications 1,995 Mews and Stable Yards 1 Housing Repairs and Rents Act 1954:- Inspections 35 Re-inspections 176 Prevention of Damage by Pests Act 1949:- Inspections 86 Re-inspections 33 Section 11, Housing Act 1936 - Inspections 11 Re-inspections 15 Section 12 Housing Act, 1936 - Inspections (other than underground rooms) 10 Re-inspections 23 Underground rooms 260 Re-inspections 1,489 Section 59 Housing Act, 1936 - Overcrowding offences 17 Re-visits 25 Overcrowding abated 19 Special Survey and C.P.0 inspections 148 Other inspections and re-inspections 2,585 Total 37,488 * Recorded as house-to-house inspections Ineffective visits 4,088 Intimation Notices Served (i) Housing and sanitary defects 3,506 (ii) Additional water supply to tenement houses (included in (i) 46 Number of Statutory Notices 1,703 Housing Repairs and Rents Act 1954 - Part II - Certificates of disrepair issued 30 Revocation certificates issued 27 33 The following table gives a summary of this branch of the work of the department during the past nine years. 1948 1949 1950 1951 1952 1953 1954 1955 1956 Number of complaints received 7,136 6,981 6,734 6,094 5,144 4,670 4,800 4,008 4,919 Number of visits 45,209 43,731 43,143 41,988 37,657 39,294 40,753 33,154 37,488 Intimation notices served 6,567 5,486 5,415 5,377 4,286 3,646 3,597 3,122 3,506 Statutory notices served 3,498 2,848 2,957 3,277 2,437 2,028 1,987 1,501 1,703 Number of police court proceedings 212 139 117 194 230 165 144 117 104 Costs and/or fines 162 116 92 157 154 96 107 103 86 Amount of fines £166 £148 £138 £212 £296 £218 £854 £330 £306 Amount of costs £229 £205 £156 £216 £305 £219 £265 £258 £212 The above police court proceedings were taken under the following statutes or regulations:- 1948 1949 1950 1951 1952 1953 1954 1955 1956 Public Health (London) Act 1936 158 126 107 148 181 144 135 110 98 L.C.C. Lodging House By-laws 40 5 8 38 39 13 5 - - L.C.C. Water Closet By-laws 5 1 - 4 4 1 - - - L.C.C. Drainage By-laws 5 2 - 3 2 5 3 6 2 Public Health (London) Act. 1891 (Vestry By-laws) 3 3 1 - 1 1 - - - L.C.C. Rag and Bone Dealers By-law 1 - - - - - - - - Housing Act, 1936 - 1 1 1 3 1 1 - 4 L.C.C. (General Powers) Act 1954 - - - - - - - 1 - 34 CLOSING AND DEMOLITION ORDERS The following is a summary of the work carried out during the year in regard to unfit basement and other rooms:- Number of rooms reported unfit 173 Number of rooms closed for all purposes 137 Number of rooms closed for human habitation but permitted to be used for other purposes 7 Number of rooms made fit without the necessity of a Closing Order 9 Number of existing Closing Orders varied to permit of use other than human habitation 21 Number of existing Closing Orders determined 22 Closing orders are operative upon a total of 1 439 rooms in the borough to which bi annual visits of inspection are made. LAND CHARGES ACT, 1925 It is the practice of solicitors to enquire from the Town Hall as to certain particulars regarding property which they are purchasing on behalf of their clients. The information is provided by the Town Clerk, and is regulated by the Land Charges Act, 1925. This involves certain information which is required from the Public Health Department and is as follows:- 1. Have any notices been served by the Public Health Department in respect of the above named premises which remain uncomplied with? If so please give particulars including number and date of Intimation and Statutory Notice. 2. (a) Is the property drained separately into the main sewer? (b) If not are the premises drained by an approved combined operation with any other premises. 3. (a) Have any notices been served under the Housing Act 1936 in respect of the property? (b) Is the property included in any clearance area? 4. Any additional enquiry. During the course of the year the Public Health Department provided 1,259 reports answering the enquiries set out above. 35 REHOUSING AND OVERCROWDING Requests were received from the London County Council during 1956 for investigations to be made of alleged statutory overcrowding in respect of 18 applications for rehousing. Reports forwarded in reply confirmed overcrowding in 14 cases. During the early part of 1956 the Council resolved that rehousing priority should be determined entirely on a basis of need, and it was resolved to adopt a points scheme as follows:- General (i) The basis will be only that of need. (ii) In the event of two or more cases attracting the same number of points, then time on the waiting list will be the determining factor in the order of housing, (iii) No points will be awarded for service in H,M. Forces or "bombed out'?. (iv) Lettings from the waiting list will be made by a Sub-Committee of the main Committee, but subject to the latter's approval. (v) One point will be awarded for each year on the waiting list. (Subject to (ii) above.) Points qualifications other than for time Health - Points to a maximum of 10 to be awarded at the discretion of the Medical Officer of Health. Condition of property - Maximum of 10 points. Living condition - Maximum of 15 points to be awarded as follows:- 5 points for shared or inadequate kitchen facilities 5 points for shared lavatory 5 points for shared bath or no bath Room deficiency - 10 points for each room deficiency on the basis that there is required a separate living room and a bedroom for each two members of the family, allowance being made for segregation of sexes. It will be seen that insofar as the officials are concerned the maximum number of points that can be awarded are determined by the scheme. No points scheme however can be entirely fair and equitable and in order to meet this situation the Lettings Sub- Committee is empowered to allocate points entirely at its discretion. During the course of the year 2 114 applications were investigated by the staff of the Public Health Department following a visit by a Public Health Inspector. Medical points were awarded either by me or Dr. Tracy: the Deputy Medical Officer of Health. 36 PHARMACY AND POISONS ACT, 1933 The following applications were received during 1956 for retention.or entry in the Council:s.list of persons entitled to sell poisons included in Part II of the Poisons List:- Retentions 126 New entries 7 PET ANIMALS ACT 1951 This Act has been in force since the 1st April, 1952, and requires that no person shall keep a pet shop unless licensed by a local authority. Seven licences were in force during 1956 and no contraventions were reported, HAIRDRESSERS AND BARBERS By-laws made by the St. Pancras Borough Council pursuant to section 18(4) of the London County Council (General Powers) Act 1954 render it illegal for any person to carry on the business of Hairdresser or Barber in the Borough unless he and the premises are registered by the Borough Council, The by-laws also govern the cleanliness of the premises, instruments, towels materials and equipment used as well as that of the persons employed and their clothing. They also require an adequate fresh water supply and washing facilities. At the end of the year under review 130 persons and premises were registered. 37 WATER The water supply in the borough is provided by the Metropolitan Water Board, as the statutory authority for London, and has been satisfactory in quality and quantity. WELL WATER There are five wells in use in the borough, four being on factory premises and one at the Council's swimming baths at Prince of Wales Road. In addition, certain wells are situated outside the borough are a source of supply to various points on the railway system centred on Euston Station. Eight samples of water were taken during the year and submitted for chemical and bacteriological examination. All proved satisfactory. SWIMMING BATHS AND PONDS There are three swimming baths in the borough Parliament Hill Lido (L.C.C.), Prince of Wales Road (Borough Council), and one private. Seven samples of water were taken during the year There are also two swimming ponds one ladies" and one mens' at Parliament Hill. Six samples were taken- All samples proved satisfactory after chemical and bacteriological examination.. 38 PREVENTION OP 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., with figures for 1955 in brackets:- Premises Total Private Business Complaints received 800 (965) 117 (142) 917 (1,107) Investigations made 1,718 (2,333) 435 (383) 2,153 (2,716) Infestations found ( Rats 438 (630) 75 (103) 513 (733) ( Mice 319 (268) 42 (25) 361 (293) Treatments ( Rats 616 (626) 106 (80) 722 (706) ( Mice 290 (303) 57 (29) 347 (332) Advice only 1 (7) 4 (3) 5 (10) The staff employed on this work consists of one rodent officer and five operatives. MORTUARY AND CORONER S COURT The following table shows the work undertaken during the year with the corresponding figures for 1955- Post-Mortem Examinations Received for Viewing or Convenience only Total Resident and died in St. Pancras 246 (243) - (4) 246 (247) Died in St Pancras Resident elsewhere 81 (107) 1 (3) 82 (110) Resident in St. Pancras died elsewhere 48 (46) 1 (2) 49 (48) Resident and died elsewhere 822 (813) 4 (32) 826 (845) 1,197 (1,209) 6 (41) 1,203 (1,250) Inquests held at Coroner s Court 689 (475) 39 NATIONAL ASSISTANCE ACTS, 1948 AND 1951 Section 47 Care of the Aged Investigations were made during the year of the living conditions of seven persons of retirement age. In one case it was found necessary to obtain a Magistrate's Order under the Act. The source of information and action taken are sh0own in the following table:- Reported by No. of cas0es ACTION TAKEN Voluntarily removed to hospital or institution Kept under observation at home together with the provision of various types of help Deceased Chiropody clinic 2 2 - - Health officers 3 1 2 - Neighbour 1 - 1 - 6 3 3 - The remaining case (No.212) was one in respect of which it was found necessary to obtain a Magistrate s Order under the National Assistance Acts. The case was first brought to the notice of the Council in October, 1955. Mrs. J. aged 84, was not without financial means and owned the house in which she lived. The services of a home help were afforded throughout, together with the provision of dinners, in an effort to enable the woman to remain in her own home„ Unfortunately conditions deteriorated Mrs, J refused to wear warm clothing or to eat adequate food and wandered into the street not properly clothed. Her removal to an institution therefore became necessary but she refused to allow arrangements to be made. The provisions of the Acts were invoked and Mrs. J was removed to Luxborough Lodge on the 9th October 1956, I have visited her there on two occasions. She remains disorientated and unfit to look after herself. Section 50 - Burials During the year 1956 the department carried out 80 burials at a gross cost of £824. 8s. 7d which represents an average of £10. 6s. 1d per burial. £772. 5s. 9d was recovered from the following sources:- £ s. d Hospitals 320. 0. 7 Death grants 166. 6. 1 Assurance Companies 89.7. 1 Private persons 62. 9.11 Employers 35.18. 2 Ministry of National Insurance 26. 3. 7 National Assistance Board 3.14. 5 Post Office Savings 6. 1 Treasury Solicitor 9.19. 0 Coroner's Officers 38. 9.10 Nigerian Government 11. 1. 0 Sale of Effects 8. 10. 0 40 Pull recovery of costs together with administrative charges was secured in sixty-five cases,, and varying amounts in six others. In nine cases nothing was recovered.. The net cost to the Council was thus £52,, 2s.l0d an average of 13s. per burial. MEDICAL EXAMINATIONS During the course of the year Dr. Tracy and I carry out a number of examinations to determine whether new entrants to the Council s service are fit for superannuation purposes- We also examine personnel for the London Electricity Board the Metropolitan Boroughs Standing Joint Committee and the Valuation Panel, During the year I have been asked on two occasions to examine persons living in the neighbourhood who were accepting positions in Borough Councils elsewhere. I have carried out these examinations for it is the usual practice for Councils to help each other in this way on a reciprocal basis. The number of special examinations is stated as 8 but I would inform the Council that a vast amount of correspondence has to be carried out with private doctors and with hospitals to ascertain the fitness of members of the staff who have been off duty for some while. The conditions we have to deal with cover a wide range of disease including cases of cancer tuberculosis, diseases of the eye, surgical and medical conditions The Committee will realise that information we receive is of course entirely confidential and we can only give to the Committee medical details provided we have the authority of the person concerned. By and large we have to confine ourselves to stating whether in our opinion the person is rightly off duty, when he is likely to return and the extent to which in future he will be able to carry out his duties The following table summarises the work that has been carried out during the year:- NEW ENTRANTS Fit 98 Unfit 5 Total 103 Special Examinations Fit to resume work 3 Unfit for work 5 Total 8 The Total of 111 is made up as follows:- Borough Council staff 69 Electricity Board staff 37 S.P.A.C.A 1 Valuation Panel 2 Examination for Cornwall 1 Examination for York 1 Total 111 41 SECTION 5 Factories The provisions of the Factories Acts, 1937 and 1948 are administered by H.M. Inspector of Factories of the Ministry of Labour and National Service, in conjunction with the local sanitary authority. Close co-operation is maintained between the two, and defaults found in the course of visits to factories are notified between one and the other according to the body responsible for remedial measures. The principal duties of the sanitary authority are the enforcement of Sections 1,2,3,4,6 and 7 of the Factories Act, 1937 insofar as non-power factories are concerned, and Section 7 only in respect of power factories. The requirements of these sections may be summarised as follows-- Section 1 Every factory to be kept clean , and free from any effluvia arising from any drain, sanitary convenience or nuisance, and lays down the frequency with which cleansing must be undertaken. Section 2 A factory shall not be so overcrowded as to cause risk of injury to health of the persons employed therein. Section 3 Effective provision to be made for securing and maintaining a reasonable temperature in each work-room. Section 4 Effective and suitable provision for securing and maintaining adequate ventilation of each work-room, and for rendering harmless all fumes, dust and other impurities generated in the course of any work. Section 6 Effective drainage of floors where wet processes are carried on. Section 7 Provision of sufficient and suitable sanitary conveniences properly lighted, with separate accommodation for the sexes. 42 Particulars of inspections and other work carried out by the Factory Inspectors during 1956 are given in the following table:- Number of visits:- Factories (with mechanical power) 2,706 Factories (without mechanical power) 1,159 Bakehouses 236 Restaurants 1,017 Outworkers' premises 1,762 Rag Flock Act 20 Scabies and vermin cases 126 Smoke observations 259 Water sampling 27 Public Health Annexe 174 Other visits 55 Total 7,541 Intimation Notices served relating to Statutes under which served Factories Act, 1937 >ublic Health (London) Act, 1936 Food and Drugs Act, 1938 Factories (with mechanical power) 191 30 - Factories (withont mechanical power) 12 - - Bakehouses _ - 40 Restaurants and canteens - - 118 Totals 203 30 158 Statutory notices served 23 3 6 43 The following particulars are furnished in accordance with section 128(3) of the 1937 Act, with respect to matters under Part I and Part VIII:– Part 1 of the Act 1. Inspections, etc. Premises Number on Register Number of Inspections Written Notices Occupier Prosecuted (i) Non-power factories, in which Sections 1,2,3,4 and 6 are enforced by Local Authorities 766 1,159 12 Nil (ii) Power factories in which Section 7 is enforced by the Local Authority 1,737 2,706 191 Nil (iii) Other Premises in which Section 7 is enforced by the Local Authority, excluding out-workers' premises Nil Nil Nil Nil Totals 2,503 3,865 203* Nil *Not Including 30 notices served under the Public Health (London) Act, 1936. 2. Cases in which defects were found Particulars Found Remedied Referred Number of procecutions To H.M. Inspector By H.M. Inspector Want of cleanliness (S. 1) 143 148 - 5 - Overcrowding (S.2) 9 6 3 – - Unreasonable temperature (S.3) 5 2 3 - - Inadequate ventilation(S.4) 6 2 4 - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 4 4 - - - (b) Unsuitable or defective 82 90 - 8 - (c) Not separate for sexes 3 3 - - - Other offences against the act (not Including offences relating to Outwork) 3 - 3 - - Totals 255 255 13 13 Nil 44 Part VIII of the ACT Outworkers The law in relation to outworkers is contained in the Factories Act, 1937, Sections 110 and 111. Section 110 requires the occupier of every factory and every contractor employed by him to send to the Borough Council during the months of February and August in each year, lists showing the names and addresses of all outworkers employed by him outside the factory, and the places where they are employed. Failure to comply with this requirement renders the occupier liable to a fine not exceeding £10. The Council is required to forward the name and address of any outworker in this list whose address is not in St. Pancras to the local authority concerned. Section 111 applies to premises where work is carried on which, in the Council's opinion, is injurious or dangerous to the health of the persons employed therein and in such cases the Council is empowered to give notice of the circumstances, in writing, to the occupier of the factory. If, after the expiration of ten days, the occupier continues to give out work to those premises, he is guilty of an offence. A Schedule to the Act states that if the occupier of a factory knowingly allows a woman or girl to be employed therein within four weeks after she has given birth to a child, he shall be liable to a fine. If the occupier of a factory or his contractor allows wearing apparel to be made, cleaned or repaired in any place where an inmate is suffering from scarlet fever or smallpox, and cannot prove that he was unaware of the existence of the disease, he shall be liable to a fine not exceeding £10. The Council has power to forbid work being given out to premises where an inmate is suffering from an infectious disease, and an occupier or contractor upon whom such an order has been served shall be liable to a fine not exceeding £10 if he contravenes such order. The industries contained in the list of trades in connection with outworkers are as follows:- (1) Making, cleaning, washing, altering, ornamenting, finishing and repairing of wearing apparel; (2) Making up, ornamenting finishing and repairing of table linen, bed linen, or other household linen (including in the term linen, articles of cotton or cotton and linen mixtures); (3) Making, ornamenting, mending, and finishing of lace and of lace curtains and nets; (4) Making of curtains and furniture hangings; (5) Cabinet and furniture making and upholstery work; (6) Making of Electro plate; (7) Making of files; 45 (8) Manufacture of brass and of any articles or parts of articles of brass (including in the term brass any alloy or compound of copper with zinc or tin; (9) Fur-pulling; (10) Making of iron and steel cables and chains; (11) Making of iron and steel anchors and grapnels; (12) Making of cart gear, including swivels, rings, loops, gearbuckles, mullin bits, hooks, and attachments of all kinds; (13) Making of locks, latches, and keys. (14) Making or repairing of umbrellas, sunshades, parasols, or parts thereof; (15) Making of artificial flowers; (16) Making of nets other than wire nets; (17) Making of tents; (18) Making or repairing of sacks; (19) Covering of raquet or tennis balls; (20) Making of paper bags; (21) Making of boxes or other receptacles or parts thereof made wholly or partially of paper, card-board, chip, or similar material; (22) Making of brushes; (23) Pea-picking; (24) Feather sorting; (25) Carding, boxing, or packeting of buttons, hooks and eyes, pins, and hair pins; (26) Making of stuffed toys; (27) Making of baskets; (28) Manufacture of chocolates or sweets; (29) The making or filling of cosaques. Christmas crackers, Christmas stockings, or similar articles or parts of articles; (30) The weaving of any textile fabric; (31) And any processes incidental to the above. There are two types of outworker. There are those who take in work not only for themselves but sometimes for the whole family and other individuals. Such a contracting outworker is really then a secondary factory owner and comes under supervision, not only as a person employing outworkers, but also as a factory owner. In this latter capacity the responsibilities of the Council will depend on whether he employs power or not. The other type of outwork is that undertaken by an individual in his own home, and probably a better term here would be "homework". There is little but good to say for such homework. It fulfils a useful function, both for the employer and the worker, and offers some people, especially the housewife with one child, the disabled and the elderly, a chance to add to the family income and increase domestic comfort whilst working at times convenient to the out-worker. Weekly earnings vary according to the ability of the worker and the time that can be spared for the work. There has been no evidence of overcrowding, and the conditions of the homes appear to depend not on whether the women do homework but on whether they are good housewives. 46 During 1956 no less than 836 people were on the register, employed in the following trades:- Wearing apparel 540 Household linen 21 Lace, lace curtains and nets 2 Curtains and furniture hangings 12 Furniture and upholstery 10 Fur pulling 27 Artificial flowers 40 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 32 Brush making 4 Feather sorting 31 Carding of buttons 7 Toy making 21 Basket making 15 Cosaques, Christmas crackers, Christmas stockings, etc. 45 Lampshades 29 The number employed in the Borough during each year since 1950 was as follows:- Year Number 1950 664 1951 573 1952 723 1953 766 1954 760 1955 811 The following table shows the number of visits paid in 1956 and each year for the previous six years and a resume of the action taken. Year Visits DEFAULTS * Failure to supply list ø Premises in an unwholesome condition 1950 1,750 4 10 1951 1,601 12 11 1952 2,008 12 45 1953 2,136 13 20 1954 1,766 15 12 1955 1,618 12 17 1956 1,762 9 7 * In these cases the lists were forthcoming after a letter from the Department. ø In each case the factory concerned was notified that the sending of work to the premises must cease, and the outworker was told by letter that this action was being taken owing to the unwholesome conditions under which he or she was working. 47 BASEMENT BAKEHOUSES Only two such bakehouses remained in operation at the end of 1956. Four years is allowed in one case in which to cease baking. The certificate of suitability continues to operate in the case of the other, subject to certain improvements being carried out to the satisfaction of the Medical Officer of health. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 This Act requires (a) the registration of premises where specified filling materials are used, and (b) the annual licensing of premises where rag flock is manufactured or stored. Twenty-eight premises were on the Council's register at the end of the year, and two licences were renewed in respect of storage for the year 1957. During 1956 the Council's Public Health Inspectors paid 20 visits to these premises and took 10 samples, as follows, all of which were subjected to the tests prescribed by the Regulations and found to be satisfactory:- Washed layered flock 1 Black Algerian fibre 1 White Cotton felt 2 Washed flock - loose 1 New curled hair and curled fibre mixture (loose) 1 Felt pads 1 New curled hair (loose) 1 Millfly No.8 stock 1 Re-cleansed and dyed black hair 1 LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1953 Trade Effluent to Sewers Six samples of trade effluent were taken during the year and submitted to the Public Analyst for examination. Reports were forwarded to the Borough Engineer. Four were satisfactory but in two cases the matter was reported as likely to interfere with the free flow of the contents of the sewer. 48 SECTION 6 Inspection and Supervision of Food Particulars of the inspections carried out by the Council's Food Inspectors during 1956 are given in the following table:- Number of visits to - Milk distributors 477 Ice cream premises 347 Slaughterhouses 8 Butchers' shops 792 Prepared meat premises 376 Fishmongers' shops 197 Fried fish shops 131 Fish curers' premises 46 Other premises where food and drugs are sold 1,497 Catering establishments 919 Market streets and places 633 Railway goods yards, warehouses 92 Attendances at Police Court 2 Re-inspection after Intimation Notices 247 Other visits 810 Total 6,574* * These visits do not include visits made for the purpose of taking samples. Intimation notices served 121 Statutory notices served 10 49 MILK SUPPLY (a) Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949-1953. (b) Milk (Special Designation) (Raw Milk) Regulations, 1949-1954. The following licences were issued in respect of the year 1957 in accordance with these Regulations:- Principal licences Supplementary licences Pasteurised milk 200 28 Sterilised milk 210 28 Tuberculin Tested milk 137 27 Milk distributors on the register and holding the above licences 230 32 ICE-CREAM The number of premises registered in accordance with Section 16 of the Pood and Drugs Act, 1955, as being used in respect of the storage and sale of ice-cream is 525. FOOD SAMPLING Chemical Examination 747 samples (133 formal and 614 informal) were taken during 1956 and sent to the Public Analyst for chemical examination, of which three formal and nine 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 109 - 86 3 Drugs - - 70 2 Sausages and meat products - 1 95 1 Spirits 19 - 1 - Ice-cream - - 34* - Others 2 2 319 3 The formal samples which were unsatisfactory were dealt with as follows:- Beef sausages Summons pending. Glace Apricots Summons pending. Dried Fruit Remainder destroyed and warning letter sent. 50 The 34 samples of ice-cream marked * above showed a fat content as follows:- Fat content per cent. Number of samples. Percentage of total samples 14-15 1 2.9 13-14 2 5.9 12-13 2 5.9 11-12 5 14.7 10-11 5 14.7 9-10 7 20.6 8-9 1 2.9 7-8 6 17.7 6-7 3 8.8 5-6 2 5.9 The figures for total solids and sugar content in each case complied with the legal standard. Bacteriological Examination In addition to the samples of food submitted to the Public Analyst for chemical examination, 223 samples were taken by the Council's Food Inspectors and submitted to the Central Public Health Laboratory, Colindale, for bacteriological examination, as follows:- (a) Milk 118 samples were subjected to the phosphatase test which indicates the efficiency of the method of heat treatment, and the methylene blue test which indicates the keeping quality of the milk. All complied with the appropriate regulations relating to designated milk. Details of the samples are given in the following table:- T.T. (Past) Past Ster. H.T. Totals Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Hospitals - - 15 - - - - - 15 - L.C.C, Schools and Institutions - - 61 - - - - - 61 - Day Nurseries 3 - 17 - - - - - 20 - Distributors 2 - 6 - 14 - - - 22 - Totals 5 - 99 - 14 - - - 118 - 51 (b) Ice-cream 82 samples were taken, mostly from manufacturers, of which 78 reached grades 1 or 2 when subjected to the methylene blue test. The following table shows the detailed results of these examinations for the year 1956 and preceding years:- 1952 1953 1954 1955 1956 Samples % Samples % Samples % Samples % Samples % SatisfactoryGrade I 92 59.35 101 81.45 77 74.78 70 70 67 81.48 Grade II 40 25.81 14 11.29 16 15.52 23 23 11 13.58 Unsatisfactory Grade III 14 9.03 6 4.84 6 5.82 4 4 2 2.47 Grade IV 9 5.81 3 2.42 4 3.88 3 3 2 2.47 Totals 155 100.00 124 100.00 103 100.00 100 100.0 82 100.00 (c) Synthetic cream 23 samples were reported to be satisfactory. LEGAL PROCEEDINGS The following 3 prosecutions were undertaken during 1956 under the Food and Drugs Act, 1955:- Date of Hearing Offence Result of Proceedings Fines Cost £ s. d £ s. d 11.9.56 Loaf of bread containing broken glass 10. 0. 0 2. 2. 0 16.10.56 Milk containing foreign matter 2. 0. 0 2. 2. 0 16.10.56 * Insanitary condition of premises 20. 0. 0 2. 2. 0 (* Contrary to Regulation 5 of the Food Hygiene Regulations, 1955) 52 POOD POISONING Food Poisoning Notifications (corrected) 1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total 17 10 12 24 63 Outbreaks due to Identified Agents - Outbreaks - 1 Cases - 51 Outbreaks of Undiscovered Cause Outbreaks - Nil Cases - Nil Single Cases Notified Agents identified 14 Unknown cause 49 UNSOUND POOD CONDEMNED AND DESTROYED During the year 1956, the undermentioned unsound or diseased food was surrendered by the owners and dealt with by the Pood Inspectors. Most of this was destroyed, the remainder being used for pig food. Articles Canned foods (miscellaneous) Meat and meat products Canned ham and meats Pish and fish products Poultry and Game Vegetables Fruit and fruit products Milk products Synthetic cream Fats Egg products Flour and flour confectionary Rolls and Pies Preserves Pickles, Sauces, Condiments Cereals Legumes Dried soup powder Beverages Sugar and sugar confectionary Quantities 6,983 tins 1 ton 6cwt. 2qrs. 24lbs. 5 cwt. 3qrs. l½lbs. + 197 tins (1 ton 7cwt. 8st. 9lbs. (+ 117 jars: 1,410 tins: 45 cases. 2cwt. 2qrs, 6lbs. 5cwt. 1qr. 21lbs. 2 ton 9cwt. 3lbs. 1cwt. 20lb. + 3½gal. + 48 cartons. 1cwt. 2qrs. 8lbs. 5cwts. 3qrs. 3lbs. 8cwts. 8lbs. (1 ton 12cwt. 1qr. 16lbs. (+3 crates + 174 packets. 49 5cwt. 3lbs. (l0cwt. 3qrs. l9lbs. (+1 232 jars: 756 bottles 1 case. 3cwt. 2qrs. 12lbs. 4cwt. 12lbs. + 16 packets. 7 cartons: 7lbs. 3gal. + 48 cartons + 110 tins + 54 bottles. 7cwt. 2qrs. 53 THE FOOD HYGIENE REGULATIONS, 1955 These regulations came into operation during 1956, mostly on the 1st January, and copies were distributed by the Public Health Department to food traders in the borough together with the following letter which draws the attention to the major items in the regulations. January, 1956. Dear Sir (or Madam) THE FOOD HYGIENE REGULATIONS, 1955 I enclose herewith a copy of the above-mentioned Regulations, most of which came into operation on the 1st January, 1956. There are various major matters which are new and to which I would particularly draw your attention. These are set out below, but it is emphasised that this is not a complete summary, and you are urged to make a full and careful study of the printed copy of the Regulations in order that you may be fully aware of your responsibilities under them. REQUIREMENTS AFFECTING FOOD HANDLERS Personal cleanliness (Regulation 9) Persons handling food must - (a) Keep their hands and clothing, (including overalls) clean, (b) cover open cuts and abrasions with a waterproof dressing, (c) refrain from spitting, and (d) refrain from smoking or taking snuff when handling food or when in any room where there is open food. Protection of food from contamination - (Regulation 8) (e) food shall not be so placed as to involve risk of contamination, and (f) food in or about any forecourt, yard, market or stall must not be placed lower than 18 inches from the ground. Wrapping of food - (Regulation 10) (g) unclean or printed wrapping material must not be allowed to come into contact with food. Persons suffering from certain infections - (Regulation 11) (h) any person engaged in the handling of food who is suffering from or is a carrier of certain infectious conditions must inform:- (1) the occupier of the food premises, and (2) the owner of the food business (i) the owner or occupier when given this information must notify the Medical Officer of Health immediately. REQUIREMENTS RELATING TO FOOD PREMISES Sanitary Conveniences - (Regulation 14) (j) no room which communicates with a sanitary convenience may be used for:- (1) the handling of food, or (2) the cleaning of equipment (k) a notice requesting users to wash their hands must be displayed at every sanitary convenience 54 Water Supply - (Regulation 15) (1) a constant, clean and wholesome water supply must be provided Wash basins - (Regulation 16) (m) suitable and sufficient wash-basins must be provided, together with a supply of hot and cold water, soap, nailbrush and clean towels. First-aid materials - (Regulation 17) (n) suitable and sufficient bandages, dressings and antiseptic must be provided and maintained. Accommodation for clothing - (Regulation 18) (o) sufficient and suitable cupboard or locker accommodation for clothing and footwear must be provided. Facilities for washing food and equipment - (Regulation 19) (p) suitable and sufficient sinks, together with an adequate supply of hot and cold water, soap or other suitable detergent, and of clean cloths must be provided, and in addition adequate and suitable cleaning and drying facilities. Lighting and ventilation of food rooms - (Regulations 20 and 21) (q) lighting and ventilation of food rooms must be adequate and satisfactory. Temperatures at which certain foods are to be kept - (Regulation 25) (r) food consisting of meat, fish, gravy or imitation cream, or prepared from or containing these substances, or any egg or milk, must be kept in accordance with the temperatures set out in Regulation 25 (page 8). REQUIREMENTS RELATING TO STALLS General requirements - (Regulation 26) (s) every stall must bear conspicuously the name and address of the person carrying on the business, and (t) stalls must be kept clean and in good repair. Covering of certain stalls and receptacles for waste - (Regulation 27) (a) meat and fish stalls must be covered over and screened at the sides and back, and a covered metal refuse bin must be provided for all waste trimmings. Supply of water for stalls - (Regulation 28) (v) stalls used for the supply of open food for immediate consumption must be provided with suitable and sufficient sinks for washing food and equipment, together with a supply of hot and cold water soap, nailbrush, clean towels and drying cloths. PENALTIES (w) a person guilty of an offence against any of these Regulations shall be liable to a fine not exceeding £100 or to imprisonment for a term not exceeding three months, or to both, and, in the case of a continuing offence, to a further fine not exceeding £5 for each day during which the offence continues after conviction. 55 Food hygiene is recognised in the food and catering industries as sound commercial practice for it serves business interests and benefits Public health. The Regulations can only achieve success with the full support of the trade, and your earnest co-operation is sought in order that they may be brought into operation to the advantage of all. If there is any point on which you are in doubt or would like further advice, please communicate with my Department. Yours faithfully, DENNIS H. GEFFEN, Medical Officer of Health To all Food Traders and Food Handlers In the Metropolitan Borough of Saint Pancras. 56