AC 439(1) 3 Library R/59 TWI 28 DECEMBER, 1961 GOOD HEALTH IN TWICKENHAM The Annual Report of the Medical Officer of Health JOHN MADDISON, M,D., B.S., D.P.H. CONTENTS Page Introduction 2 Malnutrition in Older People 4 Public Health Committee and Staff 5 New Legislation 6 Pest Destruction 7 Keeping the Borough Clean 8 Water Supply 8 Industrial Health 8 Housing . 9 Clean Air Act, 1956 10 General Matters 12 Statistical Tables 17 1 Telephone: TEDdington Lock 2223-4 TEDdington Lock 4411-5 PUBLIC HEALTH DEPARTMENT, ELMFIELD HOUSE, HIGH STREET, TEDDINGTON. To the Mayor, Aldermen and Councillors of the Borough of Twickenham LADIES AND GENTLEMEN, I have the honour to submit my Annual Report for 1961 on the health and sanitary conditions of the Borough together with the supplement containing the statistical tables for 1960 as required by the Ministry of Health. There were 13 babies who died out of every 1000 live babies born. Fifty years ago in some places over 200 babies died for every thousand born. We have come a long way since then. This figure for the Borough this year is very good and reflects the greatest credit on the parents, the welfare services, the education services and all who are concerned in making our Borough healthy, well informed, and with a high social standard of care and responsibility, However, there is room for some greater responsibility amongst some of our people. We generally have about 50 babies born to unmarried mothers each year; but in 1960 we had 77. The rate has gone up from 3.8% to 5.4%. We can all guess some of the reasons for this; but in terms of worry and anxiety, of increased demand for medical and social services of all kinds, there is a rising burden which eventually falls on us as parents, welfare workers, educationalists, councillors and ratepayers. You will see in the report that we have made a start on the task of clearing the Borough of smoke. Fortunately, we in the southwest corner of Middlesex have a favourable position in London. But each year we plan to clear a certain part of the Borough of smoke until eventually the whole town will be free altogether. I have been working hard at the experimental clinic for preventive medicine for older people at Church Road, Teddington. I am busy trying to write a technical report on some remarkable advances we have made in preventing deterioration in the health of older people and I hope this report will be available early in the new year. Dr. James and I have been able to assess the value of various diagnostic procedures, and the relative importance of various types of deterioration. We have been surprised at the amount of vitamin and nutritional deficiency which exists amongst older people; the first section of the report deals with this. Still more have we confirmed that practically everyone over the age of 60 is in need of preventive services. For they all have things wrong with them which can be prevented from progressing or alleviated. We have found a method of overcoming the difficulty of providing for many different sorts of tablets and medicaments where the deficiencies in any person are numerous. We are gradually developing screening techniques for the rapid assessment of deficiencies and we think these will prove of great value. 2 Once again it is a pleasure to acknowledge and commend the untiring zeal and devotion to duty of the staff, both those with me in Elmfield House and those outside in all the branches of the service. I am constantly indebted to Dr. Cormack, Dr.Wilkinson, Mr.Easter, Mr.Pugh, Miss Francis, Miss Greeno and Miss Reeves. I beg to acknowledge my indebtedness to the Chairman and Members of the Public Health Committee for their helpfulness and support, which is always of the greatest encouragement. I desire also, to acknowledge with thanks the friendly co-operation and help which I have always received from my colleagues in the other departments of the Corporation and the other members of the Council. I am, Mr.Mayor, Ladies and Gentlemen, Your obedient sefvant, JOHN MADDISON, Medical Officer of Health. 3 MALNUTRITION IN OLDER PEOPLE In the clinic for preventive medicine for older people at Teddington I frequently get patients attending who show varying degrees of malnutrition - some quite severe. It is not uncommon to find a little wizened old woman whose weight is just about 7 stone. She has a sunken deeply lined face, thin wasted arms and legs, and is exceedingly weak and frail. This condition is usually due to deficiency of intake or utilisation of protein or vitamins. It may be caused by shortage of food; or by defective absorption and utilisation of the protein in the body due to deficiency of muscle building hormones. But the difficulty I frequently encounter is that although I may be able to supply appropriate medicaments this does not compensate for the lack of money to buy a good diet.Itmay be theoretically possible to pay for house and clothes and buy the appropriate amount of meat, fish, eggs, cheese and milk needed for an older person out of the national insurance pension of £2. 17s. 6d. but in practice by the time frailty and weakness have set in, it is almost impossible for a person so afflicted to do the proper shopping, cooking or self-maintenance. I frequently have to apply to the National Assistance Officer for supplementary allowances to be made to these people who are deficient in their diets, But if out of the very minute proportion of the whole of the population of the Borough whom I examine, there exists this noticeable amount of malnutrition, then there must exist a very considerable number whom I have not seen and who are in the same relative position. Some of the older men and women in the late 60's and early 70* s are perfectly capable of working - certainly part-time; and they could easily earn in part-time employment money to supplement their national insurance pensions. It is almost essential that they should do so, because the biggest part of the maintenance of health lies in a good diet, with plenty of first-class protein. But if a man age S5 does go out to work, then for every Is. Od. earned over £3.10s. Od. the pension of £2.17s. 6d. is reduced by 6d. and at £4.10s. Od. he can't improve on £6.17s.6d. until he earns £6.17s.6d, when his pension is wiped out altogether. For women the rule applies at age 80. The rule does not operate after age 70. I believe our older people would be healthier and better off if they were allowed to draw their pensions as of right, as many of us are allowed to do in other forms of employment; and then they could supplement their pensions by such employment as they are able to obtain without sense of guilt or having to pay back part of the pension. It is ridiculous that I should have to apply for extra money for some of these people and it ought never to happen at all. I hope the Minister of Pensions will take an early opportunity of looking at this problem and do something to put it right. 4 MEMBERS OF THE PUBLIC HEALTH COMMITTEE Ex-Officio members: THE MAYOR. ALDERMAN MRS. M. B. DAVIES, J. P. THE DEPUTY MAYOR, COUNCILLOR B. BLIGH, B. A. Chairman: ALDERMAN F.J.EDWARDS, J.P. Vice-Chairman: COUNCILLOR MRS.C.C.CUNNINGHAM-HOWIE Alderman J.H.Knaggs J.P. Councillor L.Defries-Porter, LL. B. , A. M. B. I.M. Councillor C.J.Barnes Councillor F. D. Gil day-Fox Councillor Mrs. G.E. Brightmore Councillor R. H.Mitchison Councillor R.J. Colwell Councillor C. W.Sewell,M. A., Councillor B. S. Dare F. R. Econ. S. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health Dr. J. Maddison, M. D., B. S., D.P.H. (Also Area Medical Officer, Twickenham, Feltham, Staines and Sunbury) Deputy Medical Officer of Health Dr. W. Cormack, M. B., Ch. B., D. P. H. (Also Deputy Area Medical Officer, Twickenham, Feltham, Staines and Sunbury) Chief Public Health Inspector Mr.H.G.Easter Deputy Chief Public Health Inspector Mr. H.D.Smith Specialist Housing Inspector Mr. K.E.Evans Messrs.K.W.Clement, T.C.Coleman, Public Health Inspectors T.A.Dawkins, A.E.G.Walker All the Inspectors hold the Certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board„ and the Meat Inspectors ' Certificate. Chief Clerk Mr.H.J.Pugh (Also Area Chief Clerk, Twickenham, Feltham, Staines and Sunbury) Senior Clerk Mr.R.N.Himson Clerical Staff Mrs.J.Hodgson Mrs. J. Garrett Miss D.Wheeler Senior Rodent Operative Mr. H. T. Jackman Rodent Operative Mr.S.Jackman Disinfector/Drain Tester Mr.E.G.Cooper 5 NEW LEGISLATION The Authorised Officers (Meat Inspection) Regulations, 1960. These regulations prescribe a new qualification, the holder of which will be appointed by a local authority as an authorised officer under the Food and Drugs Act to act in relation to the examination and seizing of meat. The reason for creating the new class of officer is to help over come the difficulty in recruiting meat inspectors for work in large pig slaughterhouses such as bacon factories, but the holders of the new qualification will not be excluded from employment in general purpose slaughterhouses should the need arise. The Meat (Staining and Sterilization) Regulations, 1960. These regulations came into force on 1st November, 1960. They require all butchers meat and imported meat which is unfit for human consumption to be sterilized, and all knacker meat to be stained or sterilized, before entering the chain of distribution. Offices Act, 1960. This Act received the Royal Assent on the 29th July, 1960 although it will not come into force until 1st January, 1962. The Home Secretary is authorised to make regulations specifying the standards as to structure, arrangement and operation to be applied to offices for the protection of health, safety and welfare of persons employed therein. Milk (Special Designation) Regulations, I960. These regulations came into force on the 1st October, 1960 and replace and consolidate, with amendments, the Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954, and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953. The principal changes are that all dealers licences, 6ther than those issued by the Minister, will be issued by the food and drugs authority for the area in which are situated the premises at or from which the milk is sold. A dealer's licence no longer restricts sales to the area of the licensing authority and supplementary licences are therefore discontinued. A new form of licence, the dealer's (pre-packed milk) licence is introduced which may authorise, in a single form of licence, the use of any or all of the appropriate special designations where the milk is obtained by the licensed dealer pre-packed in the container in which it is to be delivered to the consumer. Caravan Sites and Control of Development Act, I960. This Act came into effect on 29th August, 1960 and confers on local authorities effective powers for controlling caravan sites. A new licensing system is introduced, which will be administered by local authorities and it is intended that permission be given on a long term or permanent basis unless there is some definite reason against this. Food Hygiene (General) Regulations, 1960. These regulations amend and consolidate the Food Hygiene Regulations, 1955 to 1957, and bring within their scope the handling and service of food on board "home-going ships" and certain other vessels. The consolidated regulations, except in their application to ships, came into operation on the 1st October, 1980. 6 Food Hygiene (Docks, Carriers, etc.) Regulations, 1960. These regulations prescribe requirements to secure the hygienic handling of food at docks, warehouses, cold stores, carriers" premises and a number of the special types of premises which were excluded from the ambit of the Food Hygiene Regulations, 1955. Public Health (Infectious Diseases) Amendment Regulations, 1960. These regulations, which came into operation on the 1st December, 1960, provide for the notification by medical practitioners to Medical Officers of Health of all cases of Anthrax. In view of the above regulations, it was considered desirable to revoke the local order made on the 27th January, 1921 which extended the application of the Infectious Diseases (Notification) Act, 1889 to Anthrax. Noise Abatement Act, 1960. This Act came into force on the 27th November, 1960. Under section 1 noise or vibration which would amount to a nuisance at Common Law becomes a statutory nuisance which can be dealt with according to the procedure provided in Part III of the Public Health Act, 1935. Under this procedure an abatement notice served on a person causing a noise or vibration nuisance can be enforced by proceedings in a magistrates court. Apart from action by a Local Authority, three or more occupiers of land or premises who are agrieved by a noise or vibration nuisance may make a complaint to a magistrate. The Act does not apply to noise or vibration caused by Aircraft or Statutory Undertakers in the exercise of their powers. Section 2 of the Act deals with the use of loudspeakers in streets. It prohibits their use for any purpose between 9.0 p.m. and 8.0 a.m. except in special circumstances. PEST DESTRUCTION The service provided by the department enables residents in the Borough to have insect pests identified and advice is given as to their eradication. Unusual specimens are sent to the British Museum (Natural History Section) for identification, and I am most grateful to them for their willing assistance. Disinfestation as carried out by this department can be classified under two headings. i. Vermin (bugs, lice, fleas). The Corporation have a statutory obligation to deal with these. ii. Insect Pests (wasps, flies, The Corporation are not crickets, etc.) legally bound to deal with these, but many local authorities attempt to give a service in this respect. For many years only a nominal charge of 10/- had been made for the destruction of a wasps nest, but this charge was increased to £1 per nest so as to ensure that there would be no charge on public funds. It was also decided that when the nest was found to be situated in such a position that the infestation could not be eliminated without 7 interfering with the surrounding property, the work would not be carried out by the Corporation, but the person concerned would be advised to consult one of the contractors who specialise in such work. The normal work of rodent destruction continued during the year. The annual 10% test-baiting of the soil system of sewers was carried out in February, and infested manholes were subsequently treated in March and October. KEEPING THE BOROUGH CLEAN I am obliged to A. S.KnOlles,. Esq., B.Sc», M.Inst.C.E., M.I. Mun.E., Chartered C.E., the Borough Engineer and Surveyor for the following report of Drainage and Sewerage and Refuse Disposal. Drainage and Sewerage. Work in connection with the East Twickenham sewer contract has been completed and, on the evidence at present available, the flooding formerly experienced in this area in times of heavy rainfall has been eliminated. Preliminary investigations into the improvement of the surface water drainage of part of the Teddington area are being made. Refuse Disposal Operation of the Charlton Plant continues satisfactorily and during the year there was an improvement in the price of certain salvageable materials, and improved income for the year is therefore envisaged. Consideration is being given to alterations to the plant to deal with the changing type and density of refuse. WATER SUPPLY All the dwellings in the Borough are supplied from the Metropolitan Water Board's main, and I am indebted to Dr. E.Windle Taylor, M.A., M. D. ,D.P.H. .M.R.C.S. .L.R.C.P. Director of Water Examination, Metropolitan Water Board, for the following report: The source of water is the River Thames and it is stored in the Thames Valley reservoirs at Staines, Littleton and Walton. After storage the water is treated at the filtration works at Hampton. Samples of water are collected at all stages of the purification process at least five times a week and the summary of the analyses of the finished water are set out on page 22. The supply is not piumbo-solvent and there have been no important extensions to trunk mains nor changes in the general scheme of supply to your area. New mains have been laid in Twickenham to the extent of 2,188 yards and all these new as well as repaired mains are disinfected with chlorine before being restored to supply and samples of water from them are tested to establish that its quality is up to that normally supplied. INDUSTRIAL HEALTH Factories There are in the borough as many as 305 factories. Most of them 8 are engaged in light industries such as the manufacture of toys, piston rings, name plates etc. The number of persons employed in these factories ranges from 680 in the largest to one or two in the smallest. All factory premises are periodically inspected to see that proper sanitary accommodation is provided and those factories which do not use mechanical power are inspected for cleanliness, avoidance of overcrowding, adequate ventilation and proper drainage of floors. In 1980 the Inspectors paid 389 visits to factories and in 4 cases the attention of the management had to be drawn to contraventions of the regulations. HOUSING Further progress was made during the year in dealing with unfit houses. The five year programme for slum clearance which commenced in January 1958 was completed by December 1980 and a further list of 139 houses to be dealt with during the next 3 years was submitted to the Minister. One Compulsory Purchase Order and two Clearance Orders were made involving 25 houses and 22 houses respectively and three Demolition Orders and three Closing Orders were made on individual unfit houses. Agreement was reached for demolition and rehousing as regards three houses owned by the Middlesex County Council, Works of repair and improvement were carried out to one house enabling the Corporation to determine an undertaking not to use it for human habitation. Residentialaccommodation for multiple occupation. The problems which arise when houses are let in lodgings or are occupied by members of more than one family are causing concern to many local authorities. Section 38 of the Housing Act 1957 provides that in the above circumstances a local authority may require works to be executed or the number of occupants of the house reduced. The number of houses let in lodgings in the Borough is not known but is probably about 500. During the year the Corporation decided to inform the Middlesex Borough and District Councils' Association who had been considering the matter - that they supported the view that there should be improved legislation to control the multiple occupation of properties. Rent Act, 1957 During the year 9 applications were received for certificates of disrepair and the table below shows how these applications were dealt with: 1st January to 31st December, 1980 PART 1 - Applications for Certificates of Disrepair (1) Number of applications for certificates 9 (2) Number of decisions not to issue certificates 1 9 (3) Number of decisions to issue certificates (a) in respect of some but not all defects 6 (b) in respect of all defects 2 (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 6 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule (6) Number of Certificates issued 1 PART II - Applications for Cancellation of Certificates (7) Applications by landlords to Local Authority for cancellation of certificates 4 (8) Objections by tenants to cancellation of certificates 4 (9) Decisions by Local Authority to cancel in spite of tenant's objection 1 (10) Certificates cancelled by Local Authority 1 CLEAN AIR ACT, 1956 Atmospheric Pollution Investigation On the 14th November 1960 a meeting of the Standing Conference of Co-operating Bodies in the Investigation of Atmospheric Pollution, at which the Corporation was represented, accepted a report of a specialist working party calling for changes in the scheme of measurements in certain directions. The essence of the scheme is the collation of measurements of air pollution of different kinds made by local authorities in various parts of the Country, and the publication of results in a monthly bulletin which is distributed to the participating bodies. The work of collation and publication is undertaken by the Department of Scientific and Industrial Research. Local authorities taking measurements under the scheme are able to assess the degree of different types of pollution in their area or in different parts in their area, and to compare the position in their own area with that in similar areas in other parts of the country. The information thus obtained may help them to decide what remedial measures are necessary and their order of priority. Air pollution measurements also provide a means of judging the success of any remedial measures applied, and may provide a useful basis for publicity in connection with local authorities' smoke control programmes. The scheme of co-operative measurements at that time was not sufficiently comprehensive to provide an accurate picture of the distribution of air pollution in different types of area throughout the country. The working party, which included representatives appointed by the Standing Conference of Co-operating Bodies, drew up a plan for the redistribution of some of the measuring instruments, and for the siting of new instruments, in order both to remedy this defect and to provide a yardstick by which measurements would be compared with the average degrees of pollution by smoke and sulphur dioxi® in various types of area throughout the country. 10 Twickenham was one of the towns selected by the statisticians for additional measurements of smoke and of sulphur dioxide by the volumetric method. It was decided that the Lead Peroxide Instrument at York House, Twickenham and the Deposit Gauge at Beveree, Hampton from which monthly readings had been taken# should be removed, and that new sites for the volumetric instrument, from which daily readings could be taken, should be set up at Hampton and Whitton Clinics. Smoke from Furnaces Section 3 of the Act deals with the installation of new furnaces and the requirement that new furnaces shall be so far as practicable smokeless. During the year I960 one application to instal a furnace was received and approved. Smoke Control Areas In January 1959 the Minister of Housing asked all authorities in "black areas" to consider their domestic smoke problem as a whole; decide on the smoke control orders that were needed: in what order or priority they should be made and how many years it was likely to take to finish the job. They should then prepare a phased programme for establishing smoke control areas over the next five years. The Minister confirmed that Twickenham is within a "'black area" and in April, 1959 the Corporation approved in principal the declaring of the whole of the borough to be a smoke control area. In the first instance, it was decided to carry out a pilot survey of the Heathfield district. This completed, a further survey of 10% of the whole of the borough was carried out with a view to preparing a phased programme over the next five years. For the purposes of this survey, the borough was divided into 10 areas. The number of dwellings was 28,475 private dwellings and 2,700 Corporation-owned dwellings. The estimated total cost in respect of the private dwellings was £274,850 of which the cost to the Corporation would be £82,455, and in respect of the Corporation-owned dwellings £22,410 of which the cost to the Corporation would be £13,446. For the purposes of the total programme it could therefore be estimated that the cost to the Corporation would be in the region of £100,000. The survey was completed by the end of September 1960 and the Corporation then informed the Minister of Housing that it was hoped to complete the smoke control programme for the whole of the borough in ten years. Subject to the Minister's approval it was proposed that Area No.7, Heathfield Area, should be the subject of the Corporation's first smoke control order. The detailed survey of this area was completed in April, 1961. It is 300 acres in size and has 1881 dwellings. The total estimated cost of carrying out conversions in the area is £12,560 of which £9,366 is attributed to private dwellings and £3,194 to Corporation dwellings. The cost to the Corporation would be £2,810 in respect of privately owned dwellings and £1,916 in respect of Corporation owned dwellings, making a total estimated cost of £4,726. The order which was made by the Corporation on 9th May, 1961, has been submitted to the Minister. 11 In September, 1961, a start was made on the survey of Smoke Control Area No.2 (Area No. 8). This is an area of 460 acres with 3,656 dwellings. GENERAL MATTERS Shops Act, 1950 Section 38 of this Act deals with provisions for the health and comfort of the staff. Shops must be properly ventilated, adequately warmed and sufficiently lighted, must have toilet and washing facilities and, if the staff take meals on the premises, must have proper arrangements made for them. Sometimes it is impossible for the occupier to provide a separate toilet on the premises, but provided alternative arrangements are made to use a nearby toilet, a certificate of exemption can be granted from the requirements of the Act. There are 22 exemption certificates in force. Schools Inspections of the sanitary arrangements and canteens at the schools within the jurisdiction of the Divisional Executive were carried out by Public Health Inspectors during the year. The table on page 32 gives details of the work carried out under the Food Hygiene (General) Regulations, 1960 and the general standard of the canteens remains good. It was not necessary to close any schools on account of infectious disease amongst the children. Complaints. During 1960 the number of complaints received by the department was 837. Pet Animals Act, 1951 No person is allowed to keep a pet shop except under the authority of a licence granted in accordance with the provisions of this Act. There are 10 licences in force in the Borough and 28 visits were made for the purpose of securing compliance with the licensing conditions. Petroleum Installations Regular inspections are made of all premises where petroleum or petroleum mixtures are stored and in the year 592 visits were made to the 107 premises licensed. Registration of Hawkers of Food and their Premises A strict watch is kept on all street traders selling food, Both the person and the storage premises have to be registered, and if conditions are unsatisfactory registration can be refused. During the year 4 persons were registered and 39 visits were made by Inspectors. 12 Food and Drugs Act, 1955 Food Hygiene (General) Regulations, 1960. The table on page 32 gives details of the work carried out under these regulations. It was found necessary to institute legal proceedings for contravention of the regulations in three cases, A baker was fined £2 with £2. 2. 0. costs and a greengrocer was fined £2 with £1.1.0. costs for smoking whilst handling food and a baker was fined £5 with £2.2.0. costs for selling a loaf of bread with a cockroach in it. Three other cases were reported to the Public Health Committee and in each case a warning letter was sent. 21 complaints were received about unsound food purchased from retailers in the Borough. The Pood & Drugs Act, 1955 provided for the publication of codes of practice for the purpose of giving advice and guidance in connection with the preparation, handling and sale of food. On the authority of the Public Health Committee copies of the booklets ""Hygiene in the retail meat trade" and ""Hygiene in the retail fish trade" were distributed free to all butchers and fishmongers in the Borough. Establishments for Massage, Chiropody, Electrical and Special Treatment 7 licences in respect of establishments for these purposes were issued during the year 1960. The premises are inspected regularly and all well run, Hairdressing Establishments The Corporation have made Byelaws under the Middlesex County Council Act for "the purpose of securing the cleanliness of any premises used for the purpose of carrying on the business of a hairdresser or barber and of the instruments, towels, equipment and materials used in such premises". During the year 61 inspections were made of these premises. It was not found necessary to take any action for contraventions. Swimming Baths Excellent facilities are provided for swimming at the Corporation's three open air baths. Work on enlarging the Hampton open air pool, and the filtration plant, the provision of new changing accommodation, sun terraces and car park, was completed in May, 1981. Twickenham Bath is the largest with a capacity of 280,000 gallons; Hampton Bath has a capacity of 208,000 gallons, and Teddington Bath has a capacity of 180,000 gallons. Water for all three baths is supplied by the Metropolitan Water Board's main and is purified by continuous sand filters with marginal chlorination. The Teddington and Hampton Baths have venturi-induced aeration and the Twickenham Bath has cascade aeration. The whole of the bath water is completely changed at both 13 Twickenham and Teddington every %. hours and that at Hampton every 4 hours. During the 1960 season 36 samples were taken for bacteriological examination. 34 of these proved satisfactory and 2 unsatisfactory. The 2 unsatisfactory water samples were taken from Teddington Baths in June and the chlorination dosage was increased immediately. Further samples were taken from this bath and were found to be satisfactory. Sports Arena. Work in connection with the construction of a sports arena at Craneford Way providing a 7-lane running track and all normal field events together with a football pitch will be completed during 1951. Laboratory Work The usual arrangements continued during the year and worked satisfactorily. Type of Sample or specimen No. Taken Result Ice Cream (including Ice Lollies) 95 92 -Grade I-Satisfactory l-Grade II-Satisfactory l-Grade Ill- Unsatisfactory l-Grade IV - Unsatisfactory Water 49 48-Satisfactory 3-Unsatisfactory Faeces 287 Miscellaneous 21 National Assistance Act, 1948, Section 47 National Assistance (Amendment) Act, 1951 It was not necessary during 1980 to remove to suitable premises any person who was in need of care and attention. Health Education Continued use was made of various health education methods, including propaganda by posters, leaflets and lectures illustrated by films and film strips. The Corporation made a contribution of £14.6.0. to the Central Council for Health Education during the year. Mortuary The number of bodies admitted to the Mortuary during the year was 520. It had been the custom for vehicles going to and from the Mortuary to use the entrance in Beards Hill, which is a narrow cul-de-sac. There must of necessity have been a certain amount of disturbance to people in this street and on my advice the Corporation decided to discontinue the use of this entrance and 14 instead use the entrance in Rosehill. Rosehill is wider and vehicles can drive through the library yard into the Mortuary. The rear of the vehicles are away from the houses in Beards Hill making the unloading more private and thus avoiding disturbance to the residents of either Beards Hill or Rosehill. 15 Table 1 Summary Area in acres 7, 078 Population (census 1951) 105.645 Civilian population - estimated to mid-year (as supplied by the Registrar-General) 103,450 Number of inhabited houses 30, 824 Rateable value £1. ! 355,100 Sum represented by a penny rate £7,940 Total M. F. Live Births-Legitimate 1362 694 668 11 legitimate 77 42 35 Total 1439 736 703 Live Birth rate per 1,000 of estimated Civilian Population 13.91 Adjusted Live Birth rate per 1,000 of estimated Civilian population 14 o 33 Total M. F. Still Births-Legitimate 14 9 5 Illegitimate 1 1 - Total 15 10 5 Still Birth rate per 1,000 live and still births 10,32 Total Live and Still Births Infant Deaths (under 1 year of age) 1 454 Total M. F. Legitimate 18 7 11 Illegitimate 1 - 1 Total 19 7 12 Infant mortality rate per 1,000 live births 13.20 Legitimate Infant mortality rate per 1,000 legitimate live births 13.22 Illegitimate Infant mortality rate per 1,000 illegitimate live births 12.99 Neo-Natal deaths Under 4 weeks of age Under 1 week of age Total M, F. Total M. F. Legitimate 17 6 11 15 4 11 Illegitimate 1 - 1 1 - 1 Total 18 6 12 16 4 12 Neo-Natal mortality rate per 1.000 live births 12 .51 Early Neo-Natal-,nortality rate ((deaths under^l week per 1,000 total live births) 11.12 Perinatal mortality rate (stillbirths and deaths under 1 week combined per 1,000 total still and live births) ned 21.32 Illegitimate live births per cent of total live births 5. 35 Maternal deaths Nil Maternal mortality rate per 1,000 live and still births Nil Deaths M. 607 F. 620 1,227 Crude death rate per 1,000 of estimated civilian population 11.86 Adjusted death rate 11.39 17 Population 1943/1960 Table 2. Year Population Population trend Migration excess Total increase or decrease Percentage propcttion Natural increase or decrease Inward Outward 1943 92,780 + 320 + 0,35% + 503 182 1944 88,660 - 4,120 - 4.44% + 507 - 4, 627 1945 91,920 + 3,260 + 3,68% + 424 2, 836 * 1946 102,850 + 10,930 + 11,89% + 835 10,095 - 1947 105, 93 0 + 3,080 + 2.99% + 918 2,162 - 1948 106,700 + 770 + 0.73% + 621 149 - 1949 106,900 + 200 + 0. 19% + 399 - 199 1950 107,600 + 700 + 0.65% + 246 454 - 1951 106,300 - 1,300 -1.28% + 91 - 1,391 19 52 106,500 + 200 +0.19% + 144 56 • 1953 105.300 - 1,200 - 1,13% + 250 - 1,450 1954 104,700 - 600 - 0.57% + 167 - 767 1955 104,300 - 400 - 0.38% + 105 - 505 1956 104,000 - 300 - 0.2 9% + 146 - 446 1957 103,600 - 400 - 0.39% + 217 - 617 1958 103,500 - 100 - 0.10% + 198 - 298 1959 103,600 + 100 + 0.10% + 115 - 15 1960 103,450 - 150 - 0.14% + 212 362 Table 3 Causes of Death. Registrar=General's Official Returns. Causes of Death Males Females Total[ All causes 607 620 1227 1. Tuberculosis, respiratory 4 - 4 2. Tuberculosis, other - - • 3. Syphilitic disease - - - 4. Diphtheria - - - 5. Whooping cough - * ~ 6. Meningococcal infections - - - 7. Acute poliomyelitis - - 8. Measles - - - 9. Other infective and parasitic diseases 1 1 2 10. Malignant neoplasm, stomach 13 10 23 11. Malignant neoplasm, lung, bronchus 53 8 61 12. Malignant neoplasm, breast - 28 28 13. Malignant neoplasm, uterus - 6 6 14, Other malignant and Lymphatic neoplasms 60 69 129 15. Leukaemia, aleukaemia 7 3 10 16. Diabetes 1 3 4 17. Vascular lesions of nervous system 65 98 163 18. Coronary disease, angina 143 87 230 19. Hypertension with heart disease 11 15 26 20. Other heart disease 56 97 153 21. Other circulatory diseases 20 37 57 22. Iiifluenza 4 1 5 23. Pneumonia 30 35 65 24. Bronchitis 33 21 54 25. Other diseases of respiratory system 7 5 12 26. Ulcee of stomach and duodenum 10 2 12 27. Gastritis enteritis and diarrhoea 3 6 9 28. Nephritis and nephrosis 2 2 4 29. Hyperplasia of prostate 12 - 12 30. Pregnancy, Childbirth, abortion - * - 31. Congenital malformations 4 3 7 32. CTther defined and ill-defined diseases 33 54 87 33. Motor vehicle accidents 13 6 19 34. All other accidents 14 14 28 35. Suicide .», 7 8 15 36. Homicide and operations of war 1 1 2 18 Table 4 Main Causes of Death An analysis of the death returns reveals the following main causes of dealth: Disease Percentage of total deaths Death rate per 1, 000 of the population Diseases of heart and circulatory system 37„98 4.50 Vascular lesions of nervous system 13.28 1.58 Bronchitis, Pneumonia, and other respiratory diseases 11.08 1.31 Cancer 20.95 2.48 Accidents, Violence 5.22 0.62 19 Table 5 Infant Mortality (a) The following table, compiled from official registrations, gives details of the causes of death at various ages under one year of age: Under 1 week 1 - 2 weeks 2 - 3 weeks 3-4 weeks Total under 4 week& 4 weeks and under 3mths 3months and under 6mths 6months and under 9mths 9month and under12mth& Total deaths under 1 year All causes: 16 - - 2 18 ° • " 1 19 Smallpox - - - - - - - - - - Chicken-pox - - - - - - -- - - Measles - - - - - - - - - - Scarlet F4ver - - - - - - - - - - Diphtheria and Croup - - - - - - - - - - Whooping Cough - - - - - - - - - - Influenza - - - - - - - - - - Enteritis - - - - - - - - - - Tuberculous Meningitis - - - - - - - - - - Abdominal Tuberculosis - - - - - - - - - - Other Tuberculous Diseases - - - - - - - - - - Congenital Malformations 2 - - - 2 - - - - 2 Premature Birth 7 - - 7 - - - - 7 Atrophy, Debility and Marasmus - - - 1 1 - - - - 1 ^Atelectasis 4 - - - 4 - - - - 4 Injury at Birth - - - - - - - - - - Erysipelas - - - - - - - - - - Syphilis - - - - - - - - - - Rickets - - - - - - - - - - Meningitis (not Tuberculous) 1 - - - 1 - - - 8 8 Convulsions - - - - - - - - - - Gastritis - - - - - - - - - Laryngitis - ° ° " ° - - - Bronchitis - - - - - - Pneumonia (all forms) 1 - - - 1 - - - - 1 Suffocation (overlying) Other causes . .. 1 - - - 2 - - - - 2 Totals 16 - 2 18 - - - 1 19 (b) An analysis of the mortality reveals that neo-natal deaths were responsible for 94.74 per cent, of the total infant deaths. Under 24 hours 1 to 7 days 1 to 4 weeks Total under 4 weeks Percentage total infant deaths 5 11 2 18 94.74 20 Table 6 Review of the Comparative Vital and Mortality Statistics for the Borough of Twickenham. together with those for England and Hales for years 1943-1960 inclusive Year Birth Rate Death Rate Infantile Mortality Rate Twickenham England and Wales Twickenham England ani Vales Twickenham England and Wales 1943 17.7 16.5 12.3 12.1 47.99 49 1944 18.5 17.6 12.8 11.6 37.1 46 1945 16. 76 16.1 12.15 11.4 48.02 46 1946 19.01 19.1 10.89 11.5 26.09 43 1947 19.72 20.5 11.05 12.0 40.21 41 1948 15.86 17.9 10. 04 10.8 20.69 34 1949 14.99 16.7 (a) 11.26 11.7 21.21 32 (b) 11.03 1950 (a)13.34 15.8 (a) 11.05 11.6 20.10 29.8 (b)12.54 (b) 10.72 1951 (a)12.82 15.5 (a) 11.97 12.5 24.98 29.6 (b) 12.05 (b) 11.61 1952 (a)12.54 15.3 (a) 11.18 11.3 20.22 27.6 (b) 11.79 (b) 10.84 1953 (a) 13.26 15.5 (a) 10.88 11.4 20.06 26.8 (b) 13.53 (b) 10.01 1954 (a) 12.73 15.2 (a) 11.14 U.3 14.25 25.5 (b) 12.98 (b) 10.25 1955 (a) 12.13 15.0 (a) 11.12 11.7 22.92 24.9 (b) 12.37 (b) 10.23 1956 (a) 12.77 15.7 (a) 11.37 11.7 10.54 23.8 lb) 13.15 (b) 10.92 1957 (a) 12.86 16.1 (a) 10.76 11.5 16.52 23.0 (b) 13.25 (b) 10.33 1958 (a) 13.29 16.4 (a) 11.38 11.7 17.44 22.5 (b) 13.69 (b) 10.81 1959 (a) 13.23 16.5. (a) 12.12 11.6 16.78 22.0 (b) 13.63 (b) 11.51 1960 (a) 13.91 17.1 (a) 11.86 11.5 13.20 21.9 (b) 14.33 (b) 11.39 (a) Crude (b) Adjusted 21 22 AVERAGE RESULTS GP THE CHEMICAL EXAMINATION OP WATER SUPPLIED TO THE BOROUGH OF TWICKENHAM DURING I960 Milligrammes per litre (unless otherwise stated) Description of the Sample No. of samples Ammonia Nitrogen Albuminoid Nitrogen Oxidised Nitrogen Nitrate Chlorides as Cl Oxygen abs. from Permanganate 4 hrs, at 27°C. Turbidity units Colour m.m. brown 2 ft. Tube BurgessDs Tintometer Hardness (Total) Hardness (non"carbonate) pH Value Phosphate as POt, Silicate as S1O2 Sulphate as SOtj Fluoride as F Magnesium as Mg Surface Active Material as Manoxol B.OcD* 5 days at 20^C Electrical Conductivity (gemmhos) River Thames derived (Southern Group) 156 0.038 0.080 4.0 28 1.26 0.3 14 254 68 7.8 1.00 9 58 0.25 4 0.12 525 BACTERIOLOGICAL RESULTS - YEARLY AVERAGES,, 1960 Source of supply After Treatment Number of Samp Ies Agar plate count per ml„ Coliform count EoColi count 20=24 hours at 37°CI 3 days at 22°C* Per cent» samples negative in 100 mlo Per cento samples negative in 100 ml, River Thames derived (Southern Group) 1,874 8,6 99.57 100o0 Table 7 Table 8 Analysis of Complaints Received Nature of Complaint Number Received Housing defects 192 Choked and defective drains 260 Accumulation of offensive matter 27 Unsound Pood 102 Verminous and other Infested premises (a) Bugs 24 (b) Rats and Mice 349 (c) Wasps 70 (d) Others 49 Keeping of Animals 3 Unsatisfactory milk supplies 6 Smoke nuisances 33 Fumigation of rooms following Infectious diseases 16 Miscellaneous 55 Total 1.186 23 Table 9. Summary of Visits, Inspections, etc. Housing Acts: Number Clearance Areas 842 Individual Unfit Houses 526 Underground Rooms 68 Overcrowding 14 Housing Applications 371 Rent Act Certificates 105 Public Health Act: Drain testing . 106 Provision and maintenance of drainage systems 960 Public Sewers 896 Septic Tanks and Cesspools 11 Provision of dustbins 6 Dirty/verminous premises and articles 208 Verminous persons and clothing 8 Wasps, flies and insects 231 Sanitary accommodation at Licensed Premises 6 Statutory nuisances relating to Premises 2838 „ „ „ „ Animals 106 „ „ „ „ Accumulations 224 „ „ „ „ Dust and Effluvia 91 „ „ „ Workplaces 1 Infectious Disease 843 Tents, Vans, Sheds 20 Outside Interviews 433 Miscellaneous matters 613 Factories Acts: Factories with mechanical power 349 Factories without mechanical power 20 Outworkers - Rodent Control 101 Clean Air Act 614 Clean Air Act Survey 4851 Shops Acts 6 water A6t 71 Pet Animals Act 28 24 Table 9 continued Rag Flock Act - Petroleum Regulations 59 2 Milk and Dairies Regulations 26 Noise Nuisances 137 Supervision of Food Supplies: Inspection of Meat 27 Inspection of Other Foods 154 Manufacturing and Wholesale Premises 51 Bakehouses 162 Butchers Shops 417 Grocers Shops 53 8 Fishmongers Shops 66 Fried Fish Shops 66 Sweet Shops 152 Bakers Shops 85 Greengrocers 281 Restaurants 688 Licensed Premises 129 Factory and School Canteens 153 Ice-Cream Premises 90 Preserved meat and fish preparation premises 9 Sampling: Ice-Cream 5 Domestic water supplies 9 Swimming bath water 18 Middlesex County Council Act: Places of public entertainment 95 Hawkers, Vehicles and Premises 39 Halrdressing Establishments 61 Total number of visits and inspections 19,617 25 Table 10 Sanitary Improvements Effected Number Offensive accumulations removed 1 Nuisance from keeping of animals remedied 2 Chimney flues repaired 1 Chimney stacks repaired 5 Dampness to walls remedied 82 Downspouts repaired 12 Drains repaired 17 Drains unstopped 14 Dustbins provided 6 Eavesgutters repaired 22 Filthy condition of premises remedied 1 Fireplaces repaired 10 Floors repaired 22 Gullies repaired 4 Plaster to walls and ceilings repaired 56 Roofs repaired 62 Sashframes and sashcords repaired 12 Sinks provided and repaired 3 Sink waste pipes repaired 9 Soil pipes repaired 3 Stairs repaired 1 Walls (external) repaired 6 Water closets repaired 13 Water closet cisterns and fittings provided 13 Water closet accommodation provided 1 Yard paving repaired 1 Private sewers repaired 3 Other works carried out .., 61 26 Table 11. Housing Statistics HOUSES IN CLEARANCE AREAS AND UNFIT HOUSES ELSEWHERE Return for the Year ended 31st December, 1960. A. HOUSES DEMOLISHED In Clearance Areas: Houses Demolishedo Displaced during Quarter Persons Families (1) Houses unfit for human habitation 7 9 3 (2) Houses included by reason of bad arrangement, etc. - - - (3) Houses on land acquired under Section 43(2) Housing Act, 1957. - - - Not in Clearance Areas: (4) As a result of formal or informal procedure under Section 17(1) Housing Act,1957. 1 1 1 (5) Local Authority owned houses certified unfit by the M.O.H, - - - (6) Houses unfit for human habitation where action has been taken under local Acts. - - - (7) Unfit houses included in Unfitness Orders - - - B. UNFIT HOUSES CLOSED Number (8) Under Sections 16(4),17(1) and 35(1) Housing Act, 1957. 4 - - (9) Under Sections 17(3) and 26,Housing Act, 1957 - - - (10) Parts of buildings closed under Section 18, Housins Act. 1957,, 1 - - C. UNFIT HOUSES MADE FIT AND HOUSES IN WHICH DEFECTS WERE REMEDIED (11) After informal action by local authority By Owner By Local Authority 189 - (12) After formal notice under (a) Public Health Acts 16 1 (b) Sections 9 and 16 Housing Act, 1957. 1 - (13) Under Section 24, Housing Act, 1957. • - D. UNFIT HOUSES IN TEMPORARY USE (Housing Act, 1957) Position at end of year Number ,of houses Number of separate dwe11ings contained in column (1) (14) Retained for temporary accommodation (a) under Section 48 (1) (2) - - (b) under Section 11(2) - - (c) under Section 46 - - (15) Licensed for temporary occupation under Sections 34 or 53 - - E. PURCHASE OF HOUSES BY AGREEMENT Number h °f nouses Number of occupants of houses in column (1) (16) Houses in Clearance Areas other than those included in confirmed Clearance Orders or Compulsory Purchase Orders, purchased in the year (1) (2) - - 27 Table 12 Notices Served Administrative action was taken during the year td secure abatement of nuisances and to enforce the appropriate statutory enactments, as follows: Subject of Notice Public Health Act Food and Drugs Act Number of Informal Notices served 215 98 Number of Informal Notices complied with 189 87 Number of Statutory Notices served 9 - Number of statutory Notices complied with 16 - 28 Table 13 Prevention of Damage by Pests Act, 1949 Report for 12 months ended 31st December, 1960. Type of Property Non-Agricultural . 5. , 1 2 4 Local Authority Dwelling Houses(incli CounciI Houses) 411 other ( inch Business Premises) Total °t cols 1,2, & 3 Agricultural 1.Number of properties in Local Authority's District 135 30,710 4,976 35,p21 30 2.Number of properties inspected as a result of: (a) notification 31 262 136 429 - (b) survey under the Act 56 3,201 614 3,871 - (c) otherwise (e.g. when visited primarily for some other pur pose) 2 7 5 14 - 3.Total inspections carried out including re" inspect ions 272 5,137 1,615 7,024 - 4.Number of properties insp. (in Sect.2)whlch were found to be infested by: (a) Rats 25 209 46 280 - (b) Mice 5 46 11 62 - 5.No. of infested properties (in Sect.4) treated by L A 30 251 56 337 - 6.Total treatments carried out Including retreatments 30 263 62 355 - 7.No. of notices served under Sect.4 of the Act (a) Treatment - 4 1 5 - (b) Structural Work (i.e. Proofing) - - - - - 8.No.of cases in which default action was taken following issue of a notice under Section 4 of the Act - - - - - 9.Legal Proceedings - - - - - 10.No. of block control schemes carried out 12 29 30 Eradication of Insect Pests. D.D.T. and Other Special Treatments Number of Infestations Treated Type of Premises Bugs Wasps Fleas Woodworm Ants Cockroaches Totals Dwelling-houses 30 21 5 1 . 57 Workplaces 1 1 - - - - 2 Food Shops - — • - - —• - Miscellaneous 4 2 5 8 Totals »»<, 31 23 5 1 2 5 67 Total income for D.D.T. and other special treatments, £63,6,9, Table 14 Table 15 Disinfections, etc. Number Premises, disinfected after infectious diseases 14 Premises disinfected after other diseases - Persons (children and adults) treated for Scabies at cleansing station - Table 16 Housing Act, 1936. Overcrowding Number New cases of overcrowding referred to the Housing Committee during the year 12 (1) Cases of overcrowding relieved during the year 9 (2) Persons concerned in such cases 35 Table 17 Milk and Dairies (General) Regulations, 1959 The necessary registration of persons and premises, has been effected in accordance with the following table: Milk and Dairies (General) Regulations, 1959 Persons registered as distributors 31 Premises registered as dairies (not being dairy farms) 14 31 Table 18 Food and Drugs Act, 1955 Food Hygiene (General) Regulations I960. Public Health Act, 1936, Section 89 INSANITARY CONDITIONS IN POOD PREMISES Number of premises found with insanitary conditions ... 98 Number of premises remedied ... 87 Insanitary conditions found in premises above Number a>J defects ■Number of defects remedied Equipment not kept in good order 27 24 Pood so placed as to involve risk of contamination 7 8 Pood placed within eighteen inches of the ground and not adequately protected Absence of personal cleanliness 1 - Insufficient ventilation to W.C. 6 8 Absence of ""Wash your Hands" notices to W.C.s Absence of suitable and sufficient wash-hand-basins 9 2 5 4 Absence of hot water at a suitably controlled temperature over wash-hand-basins 2 4 Absence of soap, nail brushes, clean towels, etc, near wash-hand-basins 5 3 Absence of first aid materials 6 9 Absence of accommodation for clothing not worn during working hours 8 8 Absence of suitable and sufficient sinks for the washing of food and equipment - 1 Absence of hot water at a suitably controlled temperature over sinks . 3 3 Absence of soap, clean Cloths, etc,, at sinks - 1 Absence of suitable and sufficient lighting in food roan - - Absence of suitable and sufficient ventilation in food room .,, .,. 2 Walls, etc., in food room not kept clean 30 40 Walls, etc.,in food room not kept in good order 30 29 Walls etc., in other rooms not kept in good order 33 38 Accumulation of refuse, etc. 8 10 Defective Floor covering 15 10 Yard not kept in good order 7 6 Miscellaneous 71 56 Totals 272 267 SCHOOLS Number of defects Equipment not kept in good order - Insufficient ventilation to W^C. Absence of suitable and sufficient wash-hand-basins - Absence of hot water at a suitably controlled temperature over wash-hand-basins - Absence of accommodation for clothing not worn during working hours - Absence of suitable and sufficient sinks for the washing of food and equipment - Absence of suitable and sufficient lighting in food room ° Absence of suitable and sufficient ventilation in food room Walls, etc., not kept clean o.. - Walls, etc., not kept in good order 1 Accumulation of refuse, etc. - Miscellaneous 1 Total 2 32 Table 19 (a) Meat-Carcases Inspected and Findings at Private Slaughter houses in the Borough Cattle excl. cours Cows Calves Sheep ana Lambs Pigs Horses Number killed (if known) - - • - - Number inspected - - - - - - All diseases except Tuberculosis and Qysticerci: Whole carcases condemned - Carcases of which some part or organ was condemned - - - - - - Percentage of the number inspected affected with disease other than tuberculosis and cysticerci - - - - - - Tuberculosis only: Whole carcases condemned - - - - - - Carcases of which some part or organ was condemned - - - - - - Percentage of the number inspected affected with tuberculosis - - - - - - Cysticercosis: Carcases of which some part or organ was condemned - - - - - _ Carcases submitted to treatnent by refrigeration - - - - - Generalised and totally condemned - - - - - - (b) Other Carcases Inspected NIL 33 Table 20 (a) Meat Diseased and unsound conditions found in meat caused the detention and surrender for destruction of: lbs Beef 296 Mutton and Lamb - Pork 35 Other Meats 8 Total 339 (b) Other Foodstuffs. The following foodstuffs, other than meat, being unfit for human consumption, were voluntarily surrendered for destruction. lbs. Bacon 83 Cheese 75 Pish 636 Fresh Fruit - Offal 83 Poultry 162 Sausages 4 Tapioca 28 Vegetables 4,505 Dried Skimmed Milk 56 5.632 Jars Paste 7 Pickles, Sauce etc. 10 Preserves 28 45 Tins Cream 13 Fish 50 Fruit & Fruit Juices 463 Meat 194 Milk 64 Puddings 8 Soup 42 Vegetables 113 Ot her 4 Preserved Meat 14 965 Pkts. Dried Fruit 21 Soft Drink Tablets 1,460 1,481 34 Table 21 Factories Acts, 1937 and 1948. Part I of the Act. 1. INSPECTIONS, FOR PURPOSES OF PROVISIONS AS TO HEALTH Premises Number on Register Number of Inspect tions Written Notices Occupiers prosecuted (i) Factories in which Sections I„2 3,4,and Bare to be enforced by Local Authorities 25 20 - (ii) Factories not included in(i) in which Section 7 is enforced by the Local Authority 280 349 4 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - - • Totals 305 369 4 - 2. CASES IN WHICH DEFECTS WERE FOUND Particulars Number of cases in which defects were found Number of cases in • which prosecutions were instituted Found Remedied Referred To H M, Inspector By Inspect tor Want of cleanliness (S„l) - 2 - 1 - Overcrowding (S„2) - - - - - Unreasonable temperature (S3) - - - - - Inadequate ventilation (S„4) 1 1 - • Ineffective drainage of floors (So 6) - - - - - Sanitary Conveniences (S07) - (a) Insufficient ... 1 - • (b) Unsuitable or defective • 1 - - - (c) Not separate for sexes - I - Other offences against the Act (not including offences lating to outwork) 2 5 - 1 - Totals 4 10 2 - Part VIII of the Act, Outwork Nature of the Work Lampshades Wearine appareL Electric Fuse Makers Carding• etc. of Buttons Cardboard boxes Section 110: Number of outworkers in August list required by Section 110 (1) (c) 10 28 96 1 1 Number of cases of default in sending lists to Council - - - - - Number of prosecutions for failure to supply lists - - - - - Section 111: Number of instances of work in unwholesome premises - - - - - Notices served - - - - - Prosecutions ... - - - - - 35 Table 22 Infectious Diseases. Incidence and Mortality DIPHTHERIA, SCARLET FEVER AND ENTERIC FEVER 1943-1960 Year Diphtheria Scarlet Fever Enteric Fever No. of Cases Case Bate per 1,000 pop. No. of Deaths Death Bate per 1,000 pop. No. of Cases Case Rate per 1,000 pop. No. of Deaths Death Bate per 1,000 pop. No. of Cases Case Rate per 1,000 pop, No. of Deaths Death Rate per 1,000 pop. 1943 4 0, 04 1 0. 01 238 2.56 - - - - - - 1944 5 0.06 3 0.03 121 1.37 - - - - - - 1945 4 0.04 1 0.01 97 1. 06 - - - - - - 1946 4 0.04 - - 60 0.58 - - - - - - 1947 4 0.04 1 0.01 60 0.58 - - - - - - 1948 1 0.01 - - 99 0,93 - - - - - - 1949 - - - - 128 1. 20 - - - - - - 1950 - - - - 115 1,07 - - - - - - 1951 - - - - 64 0. 60 - - - - - - 1952 - - - - 135 1.28 - - - - - 1953 - - - - 100 0.95 - - - - - 1954 - - - - 64 0.61 - - - - - - 1955 - - - - 97 0.93 - - - - - - 1956 - - - - 51 0.49 - - - - - - 1957 - - - - 17 0.16 - - - - - 1958 - - - - 38 0,37 - - - - - - 1959 - - - - 116 1.11 - - - - - - 1960 - - - - 49 0.47 - - - - - - 36 Table 23 Ophthalmia Neonatorum, years 1943-1960 The following table shows the number of cases notified and result of treatment: Year Cases notified Cases Treated Vis ion unimpaired Vision impaired Total blind ness Deaths At Home In hospc 1943 6 6 - 6 - - - 1944 8 8 - 8 - - - 1945 2 2 - 2 - - - 1946 3 2 1 3 - - - 1947 5 5 - 5 - - - 1948 4 4 - 4 - - - 1949 - - - - - - - 1950 2 2 - 2 - - - 1951 8 6 2 8 - - - 1952 4 3 1 4 - - - 1953 4 4 - 4 - - - 1954 2 2 - 2 - - - 1955 5 2 3 5 - - - 1956 4 - 4 4 - - - 1957 5 5 - 5 - - - 1958 2 1 1 2 - - - 1959 1 1 - 1 1960 - - - - - - - 37 38 Cases of Infectious Diseases Notified during the Year I960. Disease CASES NOTIFIED AT VARIOUS ACES (YEARS) To tal cases iottfi ed Deaths Under 1 Year 1-2 2-3 3-It 4-5 5-10 10-15 15-20 20-25 25-35 35-45 45-65 Over 65 Age not known Diphtheria - - - - - - - - - - - - - ~ Nil - Dysentery 1 2 - 3 3 15 5 - 1 9 5 2 2 - 48 _ Erysipelas - - - - - - - - - - - 3 5 . 8 - Pood Poisoning - - - - - - - - - - - - - - Nil - Malaria - - - - - - - - - - - - - - Nil - Measles 2 4 5 4 4 9 3 - - - - - - - 31 . Meningococcal Infections - . - - . . - - - - -_ - - - Nil - Ophthalmia Neonatorum - - - ° - - - - - - - - - - Nil - Pneumonia - 1 - - - 4 - - - 2 3 8 7 - 25 65 Poliomyelitis - - - - - - - - - - - - - - Nil - Puerperal Pyrexia - - - - - - - - - - .. — - Nil - Scarlet Fever - 1 1 7 8 22 7 2 - 1 - - - - 49 . Smallpox - - - - - - - - - - - - - - Nil - Typhoid & Para Typhoid - 1 - 1 - - 1 - - 1 - - - - 4 - Whooping Cough 9 8 11 5 10 28 4 - 1 ** 1 - -- ~ 77 - Totals 12 17 17 20 25 78 20 2 2 13 9 13 14 -- 242 65 Table 24 39 Monthly Incidence of Infectious Diseases during the Year 1960. DISEASE NUMBER OF CASES TOTAL Jan. Feb. March Apr il May June July August Sept. Oct. Nov. Dec. Diphtheria - - • - - - - • - - - • Nil Dysentery 2 4 10 4 5 8 6 2 - 1 - 6 48 Erysipelas 2 1 1 1 - - - - 1 - 1 1 8 Pood Poisoning - - - - - - - - - - - - Nil Malaria - - - - - - - - - - - - Nil Measles 1 1 2 6 3 3 5 2 2 - 2 4 31 Meningococcal Infections - . - - - - - - - - - - Nil Ophthalmia Neonatorum - - - - - - - - - • - - Nil Pneumonia 2 6 3 4 4 1 1 1 - - 1 2 25 Poliomyelitis - - - - - - - - - - - - Nil Puerperal Pyrexia - - - - - - - - - - - - Nil Scarlet Fever 5 5 4 16 5 5 - - 2 2 - 5 49 Smallpox - - - - - - - - - - - Nil Typhoid and ParaTyphoid - • - - - 2 1 1 - - - - 4 Whooping Cough 3 2 - 9 9 16 7 13 9 3 4 2 77 Totals 15 19 20 40 26 35 20 19 14 6 8 20 24 2 Table 25 40 Ward Distribution of Infectious Diseases Notified during the Year 1960 Diseases Heathfield Whit ton )Ces t Twickenham Central Twickenham South Twickenham East Twickenham Hampton Hampton Hill Upper Teddington Lower Teddington Hampton Wick Total Diphtheria - - - - - - _ _ Nil Dysentery 5 1 3 3 1 4 12 15 2 - 2 48 Erysipelas 1 1 - - - - 2 1 2 - 1 8 Pood Poisoning - - - - - - - - - - - Nil Malaria - - - - - - - - - - - Nil MeaSies 4 2 4 4 - - 7 1 3 1 5 31 Meningococcal Infections - - - - - - - - - - Nil Ophthalmia Neonatorum - - - - - - - - - - - Nil Pneumonia - 1 2 - - 2 9 4 5 1 1 25 Acute Poliomyelitis - - - - - - - - - - - Nil Puerperal Pyrexia - - - - - - - - - - - Nil Scarlet Fever 7 2 3 1 1 4 10 7 4 1 9 49 Smallpox - - - - - - - - - - - Nil Typhoid and para-typhoid - - - 2 1 - - - - 1 - 4 Whooping Cough 4 7 3 4 7 2 24 8 6 7 5 77 Totals 21 14 15 14 10 12 64 36 22 11 23 242 Table 26 Table 27 Tuberculosis The following tables have been compiled from the notifications received. NEW CASES AND MORTALITY Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary Male Female Male Female Male Female Male Female Under 1 - - - - - - - - 1-4 2 1 - 1 - - - - 5-9 - 2 - - - - - - 10 - 14 1 - - - - - - - 15 - 19 2 1 1 - - - - - 20 - 24 2 1 - 1 - - - - 25" 34 5 2 - - - - - - 35 - 44 8 1 - - - - - - 45 - 54 3 1 - - 2 - - - 55 - 64 8 3 - - - - - - 65 and over 1 1 - - 2 - - - age unknom - - - - - - - - Totals 32 13 1 2 4 - - - Table 28 PRIMARY NOTIFICATIONS OF TUBERCULOSIS 1943-1960 INCLUSIVE 1943 1944 1945 1946 1947 1948 1949 195( 1951 1952 1953 1954 1955 1956 1957 1958 1959 I960 Pulmonary 119 133 118 120 132 117 115 96 107 79 105 88 70 58 57 54 31 45 NonPu] nunary 18 18 18 19 11 17 5 15 14 20 14 12 11 3 7 7 5 3 Totals 137 151 136 139 143 134 120 111 121 99 119 100 81 61 64 61 36 48 41 Table 29 Food Poisoning Pood Poisoning 1st Quarter Nil Notifications 2nd Quarter Nil 3rd Quartt Nil r 4th Quatter Nil TOTAL Nil OUTBREAKS DUE TO IDENTIFIED AGENTS Nil dumber of cases Nil Outbreaks due to: Chemical Poisons Salmonella organisms Staphylococci (inc. toxin) Cl.Welchil OUTBREAKS DUE TO UNDISt COVERED CAUSE Nil Number of cases Nil SINGLE CASES: Nil Due to identified agents: Chemical Poisons Salmonella organisms Staphylococci P. Morgan! Number of cases Nil Due to undiscovered cause Nil Number of cases Nil Total all cases Nil 42 43 Enquiries should be made at the appropriate address for particulars as to persons eligible, special conditions as to services and the time the premises are open. Elmfield House, High Street, Teddington H V Council Offices, Bridge Street, Staines V Imperial Road,.Bedfonto A B C D F I S T Church Road, Teddington A B C D F J Stanwell Road, Ashford A B C D E Council Offices. V I 0 F I 0 S T Green Street, Sunbury Hospital Bridge Road, Whitton A B C F The Grange, Gresham Road, Staines A B D E F I S G I H 0 P Duddington House, Green Street, Sunbury A B C D F S T I S T 20 Seymour Road, Hampton Wick. A B D F I Village Hall, Laleham, B F I Chertsey Road, A B C D F P S Ashford Common r S T Stanley Road, Teddington C D E I S 12 Tilley's Lane, High Street, Staines P Laleham Road, Shepperton. B C D F I S T 24 Station Road, Hampton. A B C D F I S Council Offices Hanworth Road, Feltham, V New Hall, Upper Halliford A B F I York House, Richmond Road, Twickenham, A B C D E F I s Cardinal Road, Feltham A B C D E F 1A Staines Road West, Sunbury. F I S P 58 Hampton Road, Twickenham. G T Grove Crescent, Hanworth A B C D F Hadrian Way, Stanwell. B C D F I I S T S T In addition to the premises listed above there is a mobile clinic in use in the area. Premises concerned with Health Services in Area 10 A - Ante-natal and post-natal care of mothers D - Dental H - Headquarters Personal Health P - Family Planning (provided by Voluntary Organisation). B - Baby Welfare E - Eye testing I - Vaccination and Immunisa- t ion. C - Chiropody (Middlesex County Council and/or Voluntary Organisations) F - Distribution of Welfare Foods J - Geriatric S - School Health M - Mental Health T - Talking and Speech Therapy G - Child Guidance 0 - Orthopaedic V - Environmental Health Table 30