TED 13 DISTRICT OF TEDDINGTON. ANNUAL REPORT OF THE Medical Officer of Healty, TO BE PRESENTED TO THE URBAN DISTRICT COUNCIL OF TEDDINGTON. 1903. TEDDINGTON: Parrott & Ashfield, Printers, The Causeway. ANNUAL REPORT ON THE SANITARY CONDITION OF THE URBAN DISTRICT OF TEDDINGTON. For the Year 1903. To the Chairman and Members of the Urban District Council of Teddington. Gentlemen, I have the honour to place before you my Annual Report on the Mortality, Health, and Sanitary Condition of your District for the year 1903. The total number of deaths which occurred and were registered was 157. To this total must be added 17 being the number of Teddington residents who died in the Workhouse at Kingston during the year. The deaths included— 1 from Scarlet Fever. 2 ,, Diphtheria. 4 ,, Influenza. 5 ,, Diarrhoea. 4 ,, Enteritis. 1 ,, Puerperal Fever. 12 ,, Phthisis. 8 ,, Other Tubercular Diseases. 15 ,, Cancer. 10 ,, Bronchitis. 9 ,, Pneumonia. 4 1 ,, Pleurisy. 1 ,, Other Respiratory Diseases. 6 from Alcoholism and Cirrhosis of the Liver. 9 ,, Premature Birth. 1 ,, Parturition. 23 ,, Heart Disease. 6 ,, Accidents. 2 ,, Suicide. 12 ,, Old Age. 42 „ Various Causes. 174 Of this total 87 were Males and 87 were Females. 43 were under 1 year of age, and 45 were over 65 years of age. From this number of registered deaths we have to deduct 4, as four people who died were non-residents and they had no connection with this district. This brings the number of deaths to 170. The population of the district was according to the last census 14037 but it has considerably increased since 1901 and is now probably over 15000. Taking this figure as approximately correct, the mortality from all causes is at the annual rate of 1T33 per 1000 persons living. The number of births was 419, of which 206 were males and 213 females. The birth-rate was 27.90 and the infant mortality 102 per 1000 births. Comparing these figures with the averages of the last 10 years, we find that the death-rate of 1903 is 1.43 lower, that the infant mortality is 43 lower and that the birth-rate is 2.93 higher. 5 INFECTIOUS DISEASES. I.—Not Notifiable. MEASLES. Early in the year several isolated cases came under my notice but on the whole the district remained free from this disease and no death from it was registered. WHOOPING COUGH. There were a few cases of Whooping Cough during the year; none proved fatal. DIARRHŒA. Five deaths were registered, almost all being infants under one year of age. INFLUENZA. Although 4 deaths from influenza were notified, there was no epidemic. II.—Notifiable. 52 cases of infections disease were notified. In the year 1902, 96 cases were notified, and in 1901 70 cases were notified. SCARLET FEVER. There were 22 cases and one proved fatal. The majority of the cases occured in different localities in the second half of the year. With few exceptions they were all of a mild type. 6 DIPHTHERIA. Twenty cases were notified, and in the year 1902, 35 cases. Two cases proved fatal as against 13 in 1902. The cases were distributed in various localities and occured principally in the autumn months. ENTERIC FEVER. Two cases were notified. One was a child of 8 years of age. No cause could be found in either case. PUERPERAL FEVER. There were 2 cases, one proved fatal. INSPECTION AND OTHER SANITARY WORK. A systematic inspection of the district was made in September, October, and November. Many nuisances were discovered; such as foul accumulations of refuse and manure, dirty and dilapidated water closets, filthy closet pans, choked water closets and drains, badly paved and dirty yards, untrapped gullies, leaky and defective cisterns, dilapidated ash-pits, and absence of dust bins, and broken ventilating pipes. Wherever such defects and conditions existed, verbal or statutory notices were given to owners or tenants and they were duly complied with. A number of different localities and houses were inspected during the year either on account of complaints received, or in connection with infectious diseases. The 8 new houses in Munster Road which were reported last year to be badly drained, were inspected on several occasions and a 7 notice was served upon the owner to abate a nuisance caused by an overflowing cesspit. The nuisance became more serious after a heavy rainfall. As Munster Road is a private road and as the locality is unfit for cess-pool drainage, the owner constructed a drain connecting the houses with the public sewer in the Kingston Road. The excessive rainfall caused many complaints to be received about stagnant water in disused gravel pits. On inspecting the Gravel Pit in the Hampton Road, which covers a large area, I found a large quantity of black water in pools intersected with patches of grass and weeds. Many of the inhabitants in the vicinity complained of the bad smells which emanated from this stagnant water, especially at sunset and in the early morning. Notices were served upon the owners of this property. A drain was opened, the quantity of water was considerably reduced and no more complaints were received. Similar nuisances were dealt with in Munster Road and Holmesdale Road, where house refuse had been deposited in gravel pits. In October 1 inspected 12 cottages in York Road and made a special report to the Council about their condition. I found that the roofs of the cottages were formed of porous tiles through which water percolated whenever there was a heavy fall of rain, consequently the upper rooms were in a damp and unhealthy condition. The owner was communicated with, and the cottages were re-roofed. Two cottages at Lavender's Farm were found to be in a dilapidated and insanitary condition. The roof of the cottages was very defective and the drainage was unsatisfactory, one cottage was overcrowded. It was found necessary to condemn the 8 cottages as being unfit for human habitation. A statutory notice was served upon the lessee to put the buildings in a sanitary and habitable condition, and although not complied with, the inhabitants of both cottages were ejected, and the cottages have not since been occupied. The premises of a private boarding school containing about 30 children, were found to be in an insanitary condition, the schoolroom was overcrowded, the bedrooms were dirty, the water closet accommodation was insufficient, and the drainage was objectionable. The owner was served with a notice to connect the house with the main sewer and to remedy the other insanitary conditions. This notice was after some delay complied with. The footpath between Stanley Gardens and Victoria Terrace is still in a very dirty condition, and many of the back yards belonging to the cottages in those roads are very untidy and muddy. The galvanised iron dust-bins have in some cases been taken away by out-going tenants, in other cases they are without covers or partially destroyed. The windows of empty cottages were found to be broken, the fences destroyed and other damage done. It would be advisable for the owner to remove and refuse to let the cottages to undesirable tenants. FACTORY AND WORKSHOP ACT. A thorough inspection has been carried out. There are 5 factories in this district where machinery is used. They were all found to be in good order as regards cleanliness, air-space, ventilations and sanitary accommodation. In 9 addition, 152 workshops and workplaces were inspected. There are 6 establishments where some of the employed sleep on the premises. In all these cases the bedroom accommodation was found to be good with plenty of air-space and ventilation. The others are mostly small workshops and workplaces where the work is done by one or more of the family. There were few defects, and the premises have in nearly all cases been kept in good order. BAKEHOUSES. A letter was received from the Secretary of State, Home Office, calling attention to the provisions of the Factory and Workshop Act, 1901, Sect. 101, which came into operation on Jan. 1st, 1902, making it illegal for an underground bakehouse to be used unless it has been certified by the District Council to be suitable. There were two underground bakehouses in the district. One had to be condemned on account of want of light, want of ventilation, low ceiling, and unsuitable provision for storing flour. The owner's attention was called to these defects and this resulted in a new bakehouse being built in place of the underground one. The other underground bakehouse forms part of the premises which stand on a slope, and the bakehouse is on one side level with the garden and is therefore only partially underground. As this bakehouse is in a good sanitary condition and in other respects meets the requirements of the Act, your Council, on my recommendation, did not require any alteration to be made to it. The other 10 bakehouses were periodically inspected and were found to be maintained in good 10 sanitary condition. In some instances verbal notices were given and attended to as regards better accommodation for storing flour, defective ceilings and roofs and limewashing. LAUNDRIES. There are two Laundries in the district where machinery is used to assist manual labour, and there are six laundries where outworkers are employed. Besides these there are twenty places where the work is done by one or more members of the family. They were all inspected and were found clean, well drained, and well ventilated. DAIRIES AND COWSHEDS. Many inspections were made during the year. In four cases nuisances have been found arising from the dirty and insanitary condition of the cowsheds and yards. In some cases the stored milk was not protected from dust. A statutory notice was served in one case and verbal notices in others. In every case these notices were attended to. In my last report I drew attention in the case of one dairyman to the unsatisfactory and unsuitable condition of his premises. Representations were made to the owner to provide more sanitary and more modern accommodation. The cowsheds have since been re-built, the yard repaved and properly drained, and guttering provided for all out buildings in order to carry off the rainwater. SLAUGHTER HOUSES. These have been frequently inspected, and nothing regarding them has called for the intervention of your inspector. 11 TENT AND CARAVAN DWELLERS. Complaints were received from residents of a nuisance arising on a piece of land in Princes Road. This land had been let to Tent and Caravan dwellers. After a considerable amount of trouble these people were removed and the owner undertook not to let the land in future to such an undesirable class of tenants. OVERCROWDING. Several cases of reported overcrowding have received attention. They were dealt with by verbal notice to the owners and occupiers. In one case, however, a statutory notice had to be served, and this was complied with. DUST AND HOUSE REFUSE. The collection of the house refuse of the district becomes a more serious problem every year as far as the financial aspect is concerned. Demands for a more frequent collection than once a fortnight become more imperative, in fact the applications were so persistent that the Council deputed a special committee to enquire into the matter. As a result of its deliberations an experiment is being made in a portion of the district with the object of ascertaining the cost and applicability of a daily system of collection. The removal of refuse is of great importance, and the more frequently this is carried out the better will be the sanitary condition of the district. SEWERAGE AND DRAINAGE. The cleansing and relaying of portions of the surface water system has been effected in Kingston Road, Broad Street, Broom Road, Bridgeman Road and Hampton Road. 12 Several complaints of offensive smells from the ventilators of the sewerage system have been received, and they were remedied by thorough flushing. The complaints were made in Broad Street, Waldegrave Road, Cambridge Road and Victor Road. The flushing of the sewers has been well maintained, and the manholes on the system were thoroughly washed down once during the year. The erection of 263 new houses has accounted for 61 connections with the public sewer. According to the report of your inspector there were still 127 houses unconnected with the public sewer in January, 1903. SEWAGE DISPOSAL WORKS. The management of these works has been conducted in a satisfactory manner. The list of complaints comprises two of smells, one of smoke and another concerning the pumping of the flood water from the sewers direct on to the filtration areas. In each instance satisfactory explanations were furnished to the complainants. PRIVATE ROADS. The re-construction of Langham Road, St. Winifred's Road and Stanley Gardens Road has been carried out during the year, and the Council has now given attention to the condition of Bushey Park Road, Fairfax Road and Atbara Road. ISOLATION HOSPITAL. In April, the Twickenham Council was approached with a view to forming a joint Isolation Hospital District. They stated in their reply that 13 they were not prepared to consider the question. In December a letter was received from the Clerk of the Tolworth Joint Hospital Board stating that their Board was contemplating an enlargement of the Hospital area and consequent additional Hospital accommodation, and enquiring whether the Teddington Council was disposed to discuss any proposals with a view to enter into a combination for the provision of such accommodation. In reply your Clerk was instructed to obtain some particulars as regards cost of maintenance and capital expenses in connection with the Hospital. A statement was received in January, 1904, which is still under consideration. I remain, Gentlemen, Your obedient Servant, TH. GÜNTHER, M.D., Medical Officer of Health. Teddington, February, 1904. 14 INQUESTS DURING 1903. Date. Age. Verdict. Feb. 7 18 days Accidental suffocation in bed. April 3 35 years Aneurism of Aorta natural causes. April 6 21 days Asphyxia caused accidentally. April 29 45 years Syncope from heart disease accelerated by a heavy meal. June 4 33 years Suffocation from a clot of blood in the heart June 6 4 years Shock and hœmorrhage from rupture of the liver, caused by being accidentally knocked over by horse and van. July 26 37 years Syncope, fatty heart. Aug. 11 11 weeks Improper feeding. Sept. 7 47 years Hung himself while of unsound mind. Sept. 15 50 years Syncope, fatty heart. Sept. 17 40 years Did hang himself while of unsound mind. Sept. 26 65 years Fractured neck from accidental fall. Sept. 26 5½ months Perforating ulcer of the stomach. Oct. 31 2 years Accidentally run over by tramcar. Nov. 21 12 years Clot of blood on the heart. Dec. 3 64 years Syncope from heart failure. Dec. 22 65 years Syncope from chronic bronchitis. 15 Sanitary Work done by the Inspector of Nuisances during 1903. Complaints Received 36 Total number of Houses Inspected and re- Inspected (about) 2095 Letters written 89 Cautionary Notices given 12 Statutory Orders Issued 25 Houses, Premises, etc. cleansed and repaired 34 Periodical Inspections of Schools monthly. Periodical Inspections of Slaughter Houses half-yearly. Houses Closed 2 Periodical Inspections of Cow Sheds frequently. Contravention of Bye-laws 14 Periodical Inspections of Dairies and Milk Shops half-yearly. Cisterns cleansed, repaired, covered, etc. 24 Cisterns, new provided 6 16 Water Closets:— New apparatus provided 28 Repaired, cleansed, etc. 43 Supplied with water, or supply rendered efficient 80 Ventilated 22 Drains examined, tested exposed, etc. 17 Drains unstopped, repaired, trapped 176 Soil Pipes and Drains ventilated 8 Cesspools emptied, cleansed, etc. 11 Rooms fumigated 37 Rooms stripped and cleansed 10 Dust-bins repaired 32 New Dust-bins provided 33 Roofs of Houses repaired 55 Guttering and Rain Pipes repaired 68 Accumulation of Refuse 27 Stagnant water 12 Defective Urinals 2 Foul pigs and other animals 2 Insanitary Privies 2 Other nuisances 20 TABLE I. For Whole District. Year. Population estimated to Middle of each year. Births. Deaths under One Year of Age. Deaths at all Ages. Total Deaths in Public Institutions in Dis. Deaths Nonresidents registered in District. Deaths of Residents registered beyond District. Deaths at all Ages. Nett. Number. Rate* Number. Rate per 1,000 Births registered. Number. Rate* Number. Rate* 1 2 3 4 5 6 7 8 9 10 11 12 13 1893 11,000 277 25.18 47 169 163 14.81 163 14.81 1894 11,000 298 27.09 41 137 140 12.72 2 138 12.55 1895 11,187 269 24.05 55 204 178 16 178 16 1896 12,100 260 21.48 34 130 136 11.24 136 11.24 1897 13,000 294 22.60 42 143 156 12 156 12 1898 14,000 287 20.28 41 144 149 10.66 2 147 10.50 1899 14,425 351 27.70 45 128 167 11.65 4 163 11.29 1900 14,500 353 24.35 53 150 213 14.70 2 211 14.35 1901 14,029 359 25.67 40 111 130 9.26 5 2 6 134 9.55 1902 14,037 351 25.00 49 139 206 14.60 2 204 14.50 Average for years 1893-1902. 12,928 310 24.34 44.7 146 164 12.76 2.3 163 12.67 1903 15,000 419 27.93 40 95 157 10.46 13 i 17 170 11.33 * Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Note.—The deaths to be included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths to be included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died elsewhere. Area of District in Acres (exclusive of area covered by water) 1,214 Total population at all ages (at Census of 1901) 14,037 Number of inhabited houses (at Census of 1901) 2,754 Average number of persons per house ,, 5.09 TABLE II.—Vital Statistics of Separate Wards in 1903 and previous years. Names of Localities. Fulwell Waed. Upper Teddington Ward. Lower Teddington Ward. South Teddington Ward. Year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. 1902 1,943 30 11 6,710 111 27 3,591 44 7 1,793 21 4 1903 1,943 22 6 6,710 77 23 3,591 36 6 1,793 18 5 Note.—The 17 Teddington Residents who died in the Workhouse Infirmary at Kingston are not included in this table. TABLE III. Cases of Infectious Disease notified during the Year 1903 in Teddington District. Notifiable Disease. Oases Notified in Whole District. Total Cases Notified in Each District. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. Fulwell Ward. Upper Teddingt'n Lower Teddingt'n South Teddingt'n Fulwell Ward. Lower Teddingt'n South Teddingt'n Upper Teddingt'n Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards Small-pox Cholera Diphtheria 20 10 9 1 7 7 1 5 Membranous Croup Erysipelas 6 1 2 2 1 2 1 3 Scarlet Fever 22 3 15 4 12 2 5 3 Typhus Fever Enteric Fever 2 1 1 1 1 Eelapsing Fever Continued Fever Peurperal Fever 2 2 1 1 Plague Totals 52 13 26 6 6 1 20 11 9 12 No Isolation Hospital in this District. TABLE IV. Causes of, and Ages at, Death during Year 1903. Causes of Death. Deaths in whole District at subjoined ages. Deaths in or belonging to Localities (at all ages). Total Deaths in Public Institutions in District. All ages. Under 1. 1 & under 5. 5 & under 15. 15 & under 25. 25 & under 65. 65 & upwards. Fulwell. Upper Teddington. Lower Teddington. South Teddington. Workhouse Infirmary. Small-pox Measles Scarlet fever 1 1 1 Whooping-cough Diphtheria and membranous croup 2 2 1 1 Croup Fever— Typhus Enteric Other continued Epidemic influenza 4 2 2 1 1 2 Cholera Plague Diarrhœa 5 4 1 1 3 1 Enteritis 4 3 1 1 1 2 Puerperal fever 1 1 1 Erysipelas Other septic diseases Phthisis 12 1 1 10 8 2 1 1 Other tubercular diseases 8 1 2 2 1 2 6 2 2 Cancer, malignant disease 14 9 5 3 4 4 2 1 1 Bronchitis 10 2 1 2 5 6 3 1 1 Pneumonia 9 4 1 1 1 2 1 6 2 1 Pleurisy 1 1 1 Other diseases of respiratory organs 1 1 1 Alcoholism Cirrhosis of liver 6 5 1 1 2 2 1 Venereal diseases 1 1 1 Premature birth 9 9 4 1 2 2 Diseases & accidents of parturition 1 1 1 Heart diseases 21 1 14 6 10 5 3 3 2 Accidents 6 2 2 2 1 2 1 2 1 Suicides 2 2 1 1 Old Age 12 12 2 3 2 2 3 All other causes 40 16 1 2 11 10 5 22 8 2 3 5 All causes 170 43 9 7 4 62 45 22 77 36 18 17 13