DECEMBER, 1962 GOOD HEALTH IN TWICKENHAM The Annual Report of the Medical Officer of Health JOHN MADDISON, M.D., B.S., D.P.H. NTS. Statistical Tables AC 43401 Refer to year 1961 TWIZ9 CONTENTS Page Introduction 2 Public Health Committee and Staff 5 New Legislation 6 Pest Destruction 6 Keeping the Borough Clean 7 Water Supply 7 Industrial Health 7 Housing 8 Clean Air Act,1956 9 General Matters 9 Statistical Tables 15 1 Telephone: PUBLIC HEALTH DEPARTMENT, TEDdington Lock 2223-4 ELMFIELD HOUSE, TEDdington Lock 4411-5 HIGH STREET, TEDDINGTON. To the UayoTj Aldermen and Councillors of the Borough of Twickenham. LADIES AND GENTLEMEN, I have the honour to present the Annual Report on the work of the Health Department; the statistical tables refer to the calendar year 1961. The supplementary personal health services, and the social and preventive medical work of the health authorities has recently been considered in the Ten Year Plan. We have just had published a report of an independent committee of all branches of the medical service under the chairmanship of Sir Arthur Porritt. Both of these reviews have shown very clearly a serious defect in the health services of this country, which medical officers of health have bitterly complained about ever since 1948. This defect is a fundamental one; it is the division of the service into three separate compartments, It leads to untold administrative difficulties; often misunderstandings, irritations and jealousies between the various staffs; inability to woi together as a team for the benefit of patients; and a consequent unnecessary increase in cost which has never been determined. The Porritt committee's proposal for dealing with this difficulty is a bold one. They would like to see the service reorganised under Area Health Boards under which all doctors, nurses and other staffs of executive councils, hospitals, and local authority health departments would be employed. It is said that this arrangement would simplify the administration of the service and have a profound effect on forward planning which hitherto has been hesitant and piece meal. Here in Twickenham in the district council, we are concerned with only a fragment of the health services administered in our area. The Borough staff of all grades numbers 15, whereas the County staff for Area 10 numbers 430. Members of Twickenham Council have little opportunity for hearing anything about the clinics, the health visiting, nursing, and midwifery service, and the many ancillary and supplementary medical services of all sorts which are undertaken by the local health authority to strengthen and augment the practitioK and hospital services. It is not surprising that many of these activities are overlooked in the Borough Council's deliberations. It is certainly high time these services were brought together as in the new London proposals, and still better if we could be integrated in some way with the hospitals and practitioners. This is my twenty-fourth Annual Report since I came to Twickenham, It is written by statutory authority under Regulation 15 made under Section 108 of the Local Government Act, 1933. These Regulations are "The Public Health Officers Regulations, 1959 ". Regulation 15 states "A medical officer; of health shall, in respect of the district for which he is appointed - 2 (1) inform himself as far as practicable respecting all matters affecting or likely to affect the public health in the district and be prepared to advise the local authority on any such matter: (5) as soon as practicable after the 31st day of December in each year make an annual report to the local authority for the year ending on that date on the sanitary circumstances, the sanitary administration, and the vital statistics of the district, containing in addition to any other matters upon which he may consider it desirable to report, such information as may from time to time be required by the Minister, and furnish the Minister with as many copies of the report as the Minister may from time to time require: Thus by parliamentary regulation I am required to report to you matters of importance which I observe as your medical officer and which affect the health of the population of the Borough. It is a tenet universally accepted that the medical officer in his Annual Report may express himself freely about matters and circumstances which may be detrimental to the health of the inhabitants. So long as this reporting is honest, and scientifically and medically accurate, he should be free to do it without fear or favour, or interference. The pattern of social life is constantly changing; as are also the manners and customs of our young people; and the state of dependency of our old people. It is vitally necessary that we keep these matters under constant review, and if need be, be ready at all times to change our policy in the light of changing circumstances; at the same time we must watch that we do not duplicate services provided by other bodies such as the hospitals or practitioners or by other departments of the local authorities. In last year" s report I commented on the volume of disability, infirmity and malnutrition in older people. As the ageing population increases, this volume is growing to tremendous proportions, and infirmity continues to rise. Another year's work in the experimental clinic for preventive medicine for older people has proved beyond question the existence of a group of disabilities in older people which I have termed the multiple deficiency syndrome of later life. It is a mixture of pathological ageing incorporating deficiency of intake and absorption of adequate foods, deterioration in the supply of hormones from the endocrine glands; and a general deficiency of certain minerals and vitamins which appear to be needed in greater quantity in later life. Much of this deterioration can be prevented; in preventing it we would raise the efficiency and working capacity of our older population; we would relieve the burden of invalid old persons on their younger relatives; we would save money on hospital beds, home helps and home nurses, and on the calls on practitioners. Middlesex County Council have approved plans for more prevention clinics for older people throughout the County - a wonderful step 3 forward in preventive medicine. Now is the time for other departments concerned with the welfare of older people to see that any deleterious influences are reduced to a minimum. These matters concern employment, welfare, housing, flats, flatlets, meals on wheels, pensions, taxes, the rules controlling taxes, and limitations on income. I have now been in the local authority health service for 30 years; and it is sufficiently long for me to see the tremendous advantage of having the health services under one administrative department and chief officer. I do hope that when the new Borough is formed we shall not split into separate departments such things as mental health, welfare, children's department, and environmental health services. All these are so closely concerned with the health and well-being of every household in the Borough that they need staff who feel themselves to belong to one healthgiving organisation and whose members feel themselves to be colleagues in one department. Such an arrangement leads to greater efficiency, greater interest for the members of the staff, and , greater economy of administration; and it avoids the empire builders who thrive under Parkinson's law. Apart from a good many of our older residents, the health of the population is pretty good. There were about 60 more births than last year and the birth rate has risen. There were 88 illegitimate births in 1961, but there were only 55 in 1955. During the war years and just after we averaged about 120. 1206 people died during 1961, which gives a death rate of 11.86 per thousand which is the same as the previous year and has been steady for a number of years. The two principle killers are still diseases of the arteries, causing coronary thrombosis and stroke, and cancer. 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 branches of the service. My deputy, Dr.Cormack, has only just recently left the department after 12 years of devoted service. He served Twickenham faithfully and well and I miss him very much. His successor Dr.Wilkinson has been with me three years and is an able and capable administrator and clinician. I am constantly indebted to her and to the heads of the sections - Mr.Easter and Mr. Pugh. 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, Yours sincerely, JOHN MADDISON, Medical Officer of Health. 4 MEMBERS OP THE PUBLIC HEALTH COMMITTEE Ex-Officio members: THE MAYOR, AIDERMAN J.ff,H.CRANE, J,P. THE DERJTY MAYOR, COUNCILLOR J.E.TOODWARD, O.B.E. Chairman: ALDERMAN F.J.EDWARDS, J.P. Vice-Chairman: COUNCILLOR MRS. C. C.CUNNINGHAM-HOWIE Alderman Mrs.M. B. Davies Councillor F. D. Gil day-Flo x Alderman J.H.Knaggs, J.P. Councillor R.H.Mitchison Cbuncillor P.Blackmore Councillor K.J.Pearce Councillor P.A.Cranswick Councillor G.J.Samuel, M,A. Councillor L.Defries-Porter, LL.B., Councillor B.J.Stops, B. A. M.B.I.M. 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. (Resigned 31.10.62) Dr.Megan E.Wilkinson (commenced 1.11.62) (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 Public Health Inspectors Messrs. K. W. Clement, T.A.Dawkins, A. E. G. Walker, one vacancy 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 Administrative Officer, Twickenham,Feltham,Staines and Sunbury) Senior Clerk Mr.R.N.Himson Clerical Staff Mrs.J.Hodgson Miss D.E.Wheeler One vacancy Senior Rodent Operative Mr.H.T.Jackman Rodent Operative Mr.S.W,Jackman Disinfector/Drain Tester Mr.E.G.Cooper 5 NEW LEGISLATION Public Health (Aircraft) (Amendment) Regulations, 1961 These Regulations came into force on the 17th January, 1961, and slightly amend the Regulations of 1952 and deal with the control of persons arriving in this country by aircraft who may be suffering from certain infectious diseases and illnesses. Authorised Officers (Meat Inspection) Regulations, 1961 These Regulations re-enact, with amendments, those made under a similar title in 1960 which are now revoked. The effect of the amendments is to add two qualifications, the holders of which become eligible for appointment by Local Authorities as authorised officers with full powers in relation to the examination and seizure of meat. Rag Flock and Other Filling Materials Regulations, 1961 These Regulations have been based on the 1960 edition of the standard for cleanliness of filling materials issued by the British Standards Institution, The list of prescribed analysts has been revised and the fees chargeable for tests have been amended making provision for single tests instead of triplicate tests which were previously required. Underground Rooms - Regulations On the 28th August, 1961, the Minister of Housing and Local Government gave his consent to regulations made by the Corporation for securing the proper ventilation and lighting of rooms to which Sub-section (2) of Section 18 of the Housing Act, 1957 applies, and the protection thereof against dampness effluvia or exhalation. Public Health Act, 1961 This Act received the Royal Assent on the 3rd August, 1961. The greater part of it came into force on the 3rd October, 1961. The Act amends certain provisions of the Public Health Act, 1936, and in some cases confers additional powers on the Public Health Committee. Housing Act, 1961 This Act which came into operation on the 24th November, 1961, introduces a new system of housing subsidies and gives to local authorities extensive new powers for dealing with bad living conditions in houses let in lodgings or occupied by members of more than one family. It also makes a number of changes in the law affecting condemned houses, improvement grants to private owners, repairing obligations and town development, PEST DESTRUCTION The service provided by the department not only includes the carrying out of rodent destruction but residents in the Borough are able 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. Rodent Control In February, 1961, the Corporation considered the charges which were being made in respect of the control of rats and mice at 6 residential and business premises. It was decided that, as the cost of the administrative work involved in the preparation of Contracts and the recovery of monies was out of proportion to the small amount of income derived from the work carried out at residential premises, such residential charge should be discontinued. 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 Schemes are being prepared for modernising the ejector pumping stations in the Hampton Hill area to deal with the increased volume of sewerage due to the development of the area and to replace the existing worn out equipment. Concurrently, improvements to the pumping station at Bell Hill, Hampton, will be put in hand. Expenditure for these works has been authorised. Refuse Disposal Operation of the Charlton Plant continues satisfactorily except that salvage prices generally have shown a tendency to fall. Alterations to the reception hoppers are in hand to give added storage capacity for the refuse and water sprays in the dustcatchers are to be installed to reduce the emission of grit from the chimney. The construction of a plant for composting refuse is under consideration* 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, Ashford Common., Hanworth Road and Kempton Park. 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 waters are set out on page, The supply is not plumbo-solvent and there have been no important extensions to trunk mains nor changes in the general scheme of supply to your area during 1961. New mains have been laid in Twickenham to the extent of 1,124 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 All factory premises are inspected periodically to see that proper sanitary accommodation is provided and where mechanical power is not used to see that they are kept clean, are not overcrowded, are properly ventilated and that floors are adequately drained. 7 Most of the 3 09 factories in the Borough are engaged in light industries, the number of persons employed ranging from nearly 700 in the largest to one or two in the smallest. Under Section 110' of the Factories Act, 1937, the occupier of every factory has to submit to the local authority twice a year lists of outworkers directly employed by him in the business, outside the factory. HOUSING Progress has been made on the three-year slum clearance programme commencing in January 1961. Five houses were deleted from the list to be dealt with under the current programme following satisfactory execution of works of repair and improvement. Two Closing Orders were determined by the Corporation after the houses were rendered fit. A Clearance Area involving five houses was represented and the appropriate Order later confirmed by the Minister. Four other individual unfit houses were represented and Demolition Orders were served. Houses Let in Lodgings. During the year the Housing Act 1961 came into force, which gave greater powers to Local Authorities to deal with unsatisfactory conditions in houses let in lodgings; there are several hundred of them in this Borough. Rent Act, 1957 During the year 12 applications were received for certificates of disrepair; the table below shows how these applications were dealt with: 1st January to 31st December, 1961 PART I - Applications for Certificates of Disrepair (1) Number of applications for certificates 12 (2) Number of decisions not to issue certificates 4 (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 4 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule (6) Number of Certificates issued 4 8 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 2 (9) Decisions by Local Authority to cancel in spite of tenant's objection 1 (10)Certificates cancelled by Local Authority 3 CLEAN AIR ACT, 1956 Smoke Control Areas During 1961 the Corporation's ten year programme to make the whole of the borough a smoke control area was commenced. The Twickenham (No.1) Smoke Control Order, 1961, made by the Corporation on the 9th May, i961, was confirmed by the Minister on the 27th September, 1961. The area covered by the order is situated in the north west corner of the Borough and covers an area of 300 acres. It is principally residential with 1374 Private and 507 Corporation-owned dwellings and has few industrial or commercial buildings.It is estimated that the cost of conversions will be approximately £12,560 of which £5,024 will be recoverable by way of Exchequer contribution. Every householder in the area was informed of the date when the order would come into force; they were also supplied with detailed information on how to comply with the order and the facilities available if expenditure had to be incurred. Most of the conversions are carried out when the fireplaces are not in use. By the end of the year only about 60 applications for grant had been received; the total cost of these amounted to approximately £500, In September, 1961, a start was made on the detailed survey of Area No.2 with a view to making a smoke control order to come into effect in October, 1963. 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 possible smokeless. During the year 1961, 14 applications to instal furnaces were received and approved. GENERAL MATTERS Shops Act, 1950 Section 38 of this Act deals with provisions for the health and comfort of staff employed in shops. Shop premises are required to be properly ventilated, adequately warmed and sufficiently lighted; they have to have toilet and washing facilities; if the staff take meals on the premises there must be suitable arrangements made for them. Occasionally it happens, as in the case of a small lock-up shop,that it is impossible for the occupier to provide a separate toilet on the premises. Provided that 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. 9 Schools Inspections of the sanitary arrangements and canteens at schools within the jurisdiction of the Divisional Executive were carried out by Public Health Inspectors during the year. The general standard of the canteens is good. It was not necessary to close any schools on account of infectious disease amongst the children. Complaints There were 885 complaints received during 1961. 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 26 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 437 visits were made to the 105 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 1961 4 persons were registered and 47 visits were made by Inspectors. Food and Drugs Act, 1955 Sampling The Middlesex County Council is the food and drugs authority for the Borough, J.A.O'Keefe, Esq. 0. B.E., Chief Officer, Public Control Department, has kindly supplied the information in the table on page 33 relating to samples taken in the Borough during the year ended 31st December, 1961. With regard to the samples listed as being unsatisfactory he makes the following comments:- MILK Glasses of hot milk purchased from a cafe were found to contain 45.6% of added water. The purchaser was served from an urn, later admitted to contain half milk and half water. The proprietor of the cafe was prosecuted, fined £2 and ordered to pay £3.12s.0d. towards the costs. CAKES For selling as "cream cakes" cakes which contained artificial cream, a baker was sent a letter of caution. CHEESE A retailer purchased from a London manufacturer "double cream cheese" which was found to contain less milk fat than the 50% standard which has been set by Middlesex courts. The London manufacturer was sent a letter of caution. Similar action was taken in respect of a sample of Ayrshire cream cheese on sale in Twickenham which did not contain the required amount of milk fat. 10 FRUIT For selling Packham pears as "Williams" a firm of greengrocers was prosecuted and fined £6 and ordered to pay £2, 2s Odin costs. VEGETABLES A retailer in Twickenham sold new potatoes which were of Cypriot origin. Investigation showed that in fact the potatoes could not properly be described as "new" having been stored for some time. A letter of caution was sent to the retailer and representations were also made to the Cypriot officials responsible for importation. MERCHANDISE MARKS ACTS, 1887-1953 Inspections are carried out under the above Acts to ensure that the requirements of the various Marking Orders relating to the indication of origin of imported foodstuffs are applied. Inspections were made at 315 premises and a total of 1,072 displays were examined. Minor breaches of the Orders were dealt with by verbal warnings. The Merchandise Marks Act, 1887 makes it an offence to apply false trade descriptions to goods. Modification to the label of an imported brand of canned chicken was secured when it was not apparent from the label that the contents of the cans were not solely chicken but chicken in jelly or broth. For displaying and selling Belfort apples as "Jonathans" for displaying Morroccan grapefruit as "Jaffa" and for displaying Cyprus oranges as "Jaffa" a firm of greengrocers in Twickenham was prosecuted in respect of six offences and was fined a total of £24. and ordered to pay £3.3s. 0d. towards the costs. For selling bleach in bottles which, in addition to being labelled as bleach, were embossed with the names of various wines, a letter of caution was sent to the manufacturer. SAFE MILK From the 1st January, 1961, the County Council became the Licensing Authority for the issue of licences to dealers with premises within its area and 44 such licences were issued in respect of the sale of milk to which the special designations "pasteurised" "sterilised" and "tuberculin tested" could be applied. The period for which these licences were granted has been extended from one year to five years. Forty-seven samples of milk were obtained to test that heat treatment and subsequent storage were properly carried out. All were satisfactory. LABELLING OF FOOD ORDER, 1953 The Labelling of Food Order requires pre-packed food to be marked with the name and address of the packer or labeller or to bear a registered trade mark; to be marked with its common or usual name and to bear a statement of ingredients if the food consists of more than one ingredient. It also controls the manner in which the presence of vitamins and minerals is disclosed. In the Borough of Twickenham a total of 212 premises were visited and 2,376 items of food were examined for compliance with the Order. No infringements were detected. 11 LABELLING AND ADVERTISING INFRINGEMENTS In addition to the foregoing detail, a considerable volume of work was done in the period under review, which did not arise from samples procured in the Borough of Twickenham but which had the effect of protecting the residents in each county district. The matters dealt with were in respect of nationally retailed articles of food. Several manufacturers were required to designate the ingredients on labels of Instant Coffee. As a result of a complaint of the taste of a soft drink, investigations made in my Department showed that there was phenolic contamination which arose from a chemical reaction between chlorinated water and the phenol formaldehyde stopper. The manufacturer has modified the ingredients of this product to prevent the chemical reaction. The manufacturer of a non-alcoholic wine was challenged on the grounds that the description was a contradiction in terms, and the label was amended to "non-alcoholic beverage". The importer of a slimming food was challenged on claims made in advertising literature as to the Vitamin concentration, and the literature was corrected. The manufacturer's claim of slimming properties for "reducing perles" was challenged and the product withdrawn. The claim relied on the presence of purgatives and bladderwrack. The slimming claims made for a lemon juice in a television advertisement were modified after the manufacturer had been challenged as to the efficiency of the product as a slimming agent. Food and Drugs Act, 1955 Food Hygiene (General) Regulations, 1960 The table on page 30 gives details of the work carried out under these regulations. It was found necessary to institute legal proceedings in two cases. A baker was fined a total of £12. with £3.3s.0d, costs in respect of 4 contraventions of the Food Hygiene (General) Regulations, 1960, and another baker was fined £10. with £5.5s.0d. costs for selling bread containing part of a cigarette. Three other cases were reported to the Public Health Committee and in each case a warning letter was sent, 37 complaints were received about unsound food purchased from retailers in the Borough. Establishments for Massage, Chiropody, Electrical and Special Treatment 7 licences in respect of establishments were issued during the year 1961. 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". 19. During the year 11 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. Twickenham Bath is the largest with a capacity of 280,000 gallons; Hampton Bath has a capacity of 206,000 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 Twickenham and Teddington every 6½ hours and that at Hampton every 4 hours. During the 1961 season 32 samples were taken for bacteriological examination and all the samples proved satisfactory. Laboratory Work The usual arrangements continued during the year and worked satisfactorily. Type of Sample No. Taken Result or Specimen Ice Cream (including 79 77 - Grade I ) Ice Lollies) 2 - Grade II)Satisfactory Water 51 42 - Satisfactory 9 - Unsatisfactory Faeces 237 Miscellaneous 23 National Assistance Act, 1948, Section 47 National Assistance (Amendment) Act, 1951 It was necessary during 1961 to remove to suitable premises one person who was in need of care and attention. Health Education During the year I have given a number of talks on health topics to various associations in the Borough, and the Chief Public Health Inspector and his staff have also shared in the work. Films and filmstrips are used as appropriate, and propaganda by posters and leaflets has been continued. The Corporation again made a contribution of £14.6d.0d. to the Central Council for Health Education. Mortuary The number of bodies admitted to the Mortuary during the year was 582. Common Lodging Houses There are no common lodging houses registered in the Borough. 13 STATISTICAL TABLES for the Year 1961 Table 1 Summary Area in acres 7,078 Population (preliminary census 1961) 100,822 Civilian population - estimated to mid-year (as supplied by the Registrar-General) 101,650 Number of inhabited houses 31,190 Rateable value £1,973,734 Sum represented by a penny rate £8,010 Total M. F. Live Births-Legitimate 1411 750 661 Illegitimate 88 52 36 Total 1499 802 697 Live Birth rate per 1,000 of estimated Civilian Population 14.75 Adjusted Live Birth rate per 1,000 of estimated Civilian Population 15.34 Total M. F. Still Births-Legitimate 17 8 9 Illegitimate 2 2 - Total 19 10 9 Still Birth rate per 1,000 live and still births 12.52 Total Live and Still Births 1,518 Infant Deaths (under 1 year of age) Total M. F. Legitimate 24 15 9 Illegitimate 1 1 - Total 25 16 9 Infant mortality rate per 1,000 live births 16.68 Legitimate Infant mortality rate per 1,000 legitimate live births 17.01 Illegitimate Infant mortality rate per 1,000 illegitimate live births 11.36 Neo-Natal deaths Under 4 weeks Under 1 week of age of age Total M. F. Total M. F. Legitimate 17 12 5 14 10 4 Illegitimate 1 1 - 1 1- Totals 15 013 5 15 11 4 Neo-Natal mortality rate per 1,000 live births 12.01 Early Neo-Natal mortality rate (deaths under 1 week per 1,000 total live births) 10.01 Perinatal mortaiity rate (stillbirths and deaths under 1 week combined per 1,000 total still and live births) 22.40 Illegitimate live births per cent of total live births 5.87 Maternal deaths Nil Maternal mortality rate per 1,000 live and still births Nil Deaths M. F. 564 642 1.206 Crude death rate per 1,000 of estimated civilian population 11.86 Adjusted death rate 11.15 15 Table 2. Population 1938-1961 Year Population Population trend Migration excess Total increase or decrease Percentage proportion Natural increase or decrease Inward Outward 1938 96,550 +2,320 +2.46% +363 1,957 - 1939 97,440 +890 +0.92% +383 507 - 1940 94,070 -3,370 -3.46% -15 - 3,355 1941 91,820 -2,250 -2,39% +38 - 2,288 1942 92,460 +640 +0.70% + 450 190 - 1943 92,780 +320 +0.35% +502 - 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 ,930 +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 1952 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 -0.29% +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 1961 101,650 -1,800 -1.77% +293 - 2,093 16 Table 3 Distribution of Deaths by Age and Cause Registrar General's Official Returns, 1961. Age Group Cause of Death Under 1 1 - 4 5 -14 15-24 25-44 45-64 65-74 75 and over Total Grand Total M F M F M F M F M F M F M F M F M F Tuberculosis, respiratory - - - - - - - - 2 - 2 2 1 - - - 5 2 7 Tuberculosis, other - - - - - - - - - - - 1 - - — — - 1 1 Syphilitic disease - - - - - - - - - - - 1 — — — — — 1 1 Diphtheria - - - - - - - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - - - - - — - - Acute poliomyelitis - - - - - - - - - - - - - - - - - - - Measles - - - - - - - - - - - - - - - - - - - Other infective and parasitic diseases - - — - - - — — - — - - - 1 — - — 1 1 Malignant neoplasm, stomach - - - - - - - - - - 5 3 11 4 3 8 19 15 34 Malignant neoplasm, lung, bronchus - — — — - — - — 1 11 7 14 4 8 7 34 18 52 Malignant neoplasm, breast — - - — - - - - - 2 - 7 - 5 - 10 - 24 24 Malignant neoplasm, uterus - - - - - — — — - 1 - 5 - 2 — 1 - 9 9 Other malignailt & lymphatic neoplasms - - 1 - - - - - 2 2 16 26 12 18 24 22 55 68 123 Leukaamia, aleukaemia - — - - — -- — — — — — 1 - - - 3 - 4 4 Diabetes — - - - — - — - - - 2 — 1 1 1 3 4 4 8 Vascular lesions of nervous system - — - — - - - — 1 — 16 14 l5 20 30 67 62 101 163 Coronary disease, angina - - - - - - - - 4 1 46 23 44 28 37 5l 131 103 234 Hypertension with heart disease - - — - - - - - - 1 1 2 1 3 2 10 4 16 20 Other heart disease — - - — - - — 1 2 - 4 5 14 9 40 82 60 97 157 Other circulatory disease - — — - — - — — - 1 9 2 8 7 14 21 31 31 62 Influenza - - — — — - — - — — — — 1 — 1 3 2 3 5 Pneumonia 4 2 - 1 — - - - - - 3 1 9 6 23 37 39 47 86 Bronchitis — - — — 1 - - - — — 7 3 11 2 20 9 39 14 53 Other diseases of respiratory system — — — — — — — - 1 - 1 — 1 — — 4 3 4 7 Ulcer of stomach and duodenum - - - - - - - - - - 1 2 1 - 3 - 5 4 9 Gastritis, enteritis and diarrhoea — - 1 - - — — — — — — — 1 — — - 2 — 2 Nephritis and nephrosis — — — — - — — — - — 2 — 1 3 — 2 3 5 8 Hyperplasia of prostate - - - - - - - - - - - - - - 4 - 4 - 4 Pregnancy, childbirth, abortion - - - — — - - - — - — — — — — — — - Congenital malformations 1 3 1 1 - 1 - - — — - - — — — — 2 5 7 Other defined and ill-defined diseases 11 4 — — — - 3 1 3 6 13 9 2 8 10 20 42 48 - Motor vehicle accidents - - — - - - 3 — 1 — 3 1 — 1 3 — 10 2 12 All other accidents - - 1 - — - — — 2 - 2 1 — — 2 5 7 6 13 Suicide - — — — — - — — - 4 - 3 — 1 -— - - 9 9 Homicide and operations of war — — — — 1 — — - - - - - - - - - - - - 16 9 4 2 2 1 6 2 19 18 144 119 148 123 225 366 564 642 1206 17 Table 4 Main Causes of Death An analysis of the death returns reveals the following main causes of death: Disease Percentage of total deaths Death rate per 1,000 of the population Diseases of heart and circulatory system 39,22 4.65 Vascular lesions of nervous system 13.52 l.60 Bronchitis, Pneumonia, and other respiratory diseases 12.52 1.49 Cancer 20.40 2.42 Accidents, Violence 2.90 0.34 18 Table 5 Review of the Comparative Vital and Mortality Statistics for the Borough of Twickenham, together with those for England and Wales for years 1938°1961 inclusive Year Birth Rate Death Rate Infantile Mortality Rate Twickenham England and Wales Twickenham England and Wales Twickenham England and Wales 1938 14.4 15.1 (a) 9.91 11.6 45.8 53 (b) 9,8l 1939 14.2 15.0 (a)10.46 12.1 26.4 50 (b)10.35 19.40 14.67 14.6 (a)l4,8 14.3 45.8 55 (b)14.9 1941 13.4 14.2 13.0 12.9 70.95 59 1942 16.49 15.8 11.6 11.6 53.1 49 1943 17 .7 16.6 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)11.72 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)ll.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)111.14 11.3 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 (b)13.15 (b) 10. 9 2 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, i (a) 11. 86 11.5 13,20 21.9 (b)14.33 (b)11.39 1961 (a)14.75 17.4 (a)ll.86 12.0 16.68 21.4 (b)15.34 (b)11.15 (а) Crude (b) Adjusted 19 AVERAGE RESULTS OP THE CHEMICAL EXAMINATION OP WATER SUPPLIED TO THE BOROUGH (F TWICKENHAM DURING 1961 Milligrammes per litre (unless otherwise stated) Description of the sample No. of samples Ammonia Nitrogen Albuminoid Nitrogen Oxidised Nitrogen Nitrate Chlorides as CI. Oxygen abs. from Permanganate 4 hrs. at 27°C. Turbidity units Colour a.m. brown 2 ft. Tube Burgess's Tintometer Hardness (Total) Hardness (non-carbonate) pH Value Phosphate as PO4 licate as SiO2 Surface active material as Manoxol Sulphate as SO4 Natural Fluoride as F Magnesium as Mg B.O.D. 5 days at 20°C Electrical Conductivity (Micromhos) Hampton 52 0.045 0.080 4.1 26 1.06 0.2 13 268 52 7.9 0.95 9 0.11 50 0.20 6 525 Ashford Common 52 0.055 0.084 3.9 26 1.14 0.2 13 278 52 8.0 0.95 9 0.11 50 0.20 6 550 Hanworth Road 52 0.022 0.076 3.9 26 1.02 0.3 12 276 50 7.9 0.80 8 0.11 50 0.20 6 550 Kempton Park 52 0.023 0.077 4.0 26 1.08 0.3 12 276 50 7.9 0.90 8 0.11 50 0.20 6 550 BACTERIOLOGICAL RESULTS - NEARLY AVERAGES. 1961 Source of Supply Number of SampIes After Treatment ' Agar plate count per ml. Coliform count E.coli count 20-24 hours at 37°C 3 days at 22°C Per cent, samples negative in 100 ml. Per cent, samples negative in 100 ml. Hampton 1,066 11.7 99.91 100.0 Ashford Common 765 24.1 99.87 100.0 Hanworth Road Kempton Park 579 12.5 99.83 99.83 Table 6 20 Table 7 Analysis of Complaints Received Nature of Complaint Number Received Housing defects 185 Choked and defective drains and sewers 294 Accumulation of offensive matter 42 Unsound Food 114 Verminous and other Infested premises (a) Bugs 10 (b) Rats and Mice 487 (c) Wasps 54 (d) Others 55 Keeping of Animals 5 Unsatisfactory milk supplies 6 Smoke nuisances 31 Noise nuisances 31 Fumigation of rooms following Infectious diseases 6 Miscellaneous 52 Total 1,372 21 Table 8. Summary of Visits, Inspections, etc. Number Housing Acts: Clearance Areas 169 Individual Unfit Houses 304 Underground Rooms 46 Overcrowding 27 Housing Applications 361 Rent Act Certificates 83 Public Health Act: Drain testing 59 Provision and maintenance of drainage systems 588 Public Sewers 1,166 Septic Tanks and Cesspools 2 Provision of dustbins 33 Dirty/verminous premises and articles 207 Verminous persons and clothing 10 Wasps, flies and insects 273 Sanitary accommodation at Licensed Premises 6 Statutory nuisances relating to Premises 3,528 „ „ „ „ Animals 117 „ „ „ „ Accumulations 346 „ „ „ „ Dust and Effluvia 149 „ „ „ „ Workplaces - Infectious Disease 924 Tents, Vans, Sheds 43 Outside Interviews 610 Miscellaneous matters 555 Factories Acts: Factories with mechanical power 118 Factories without mechanical power 6 Outworkers - Rodent Control 110 Clean Air Act 403 Clean Air Act Survey 6,579 Shops Acts 3 Water Act 34 Pet Animals Act 26 22 Table 8 continued Petroleum Regulations 437 Milk and Dairies Regulations 16 Noise Nuisances 612 Supervision of Food Supplies: Inspection of Meat 36 Inspection of Other Foods 227 Manufacturing and Wholesale premises 13 Bakehouses 127 Butchers Shops 272 Grocers Shops 380 Fishmongers Shops 65 Fried Fish Shops 40 Sweet Shops 46 Bakers Shops 79 Greengrocers 118 Restaurants 514 Licensed Premises 60 Factory and School Canteens 73 Ice-Cream Premises 30 Preserved meat and fish preparation premises 17 Sampling: Ice—Cream 27 Domestic water supplies 12 Swimming bath water 11 Middlesex County Council Act: Places of public entertainment 41 Hawkers, Vehicles and Premises 47 Hairdressing Establishments 11 Total number of visits and inspections 20,196 23 Table 9 Sanitary Improvements Effected Number Offensive accumulations removed – Nuisance from keeping of animals remedied – Chimney flues repaired 1 Chimney stacks repaired 5 Dampness to walls remedied 51 Downspouts repaired 12 Drains repaired 7 Drains unstopped 9 Dustbins provided 5 Eavesgutters repaired 18 Filthy condition of premises remedied 1 Fireplaces repaired 4 Floors repaired 22 Gullies repaired 2 Plaster to walls and ceilings repaired 44 Roofs repaired 82 Sashframes and sashcords repaired 9 Sinks provided and repaired 1 Sink waste pipes repaired 13 Soil pipes repaired 13 Stairs repaired 3 Walls (external) repaired 8 Water closets repaired 21 Water closet cisterns and fittings repaired 8 Water closet accommodation provided 2 Yard paving repaired – Private sewers repaired – Pail closets renewed 2 Other works carried out 32 24 Table 10 Housing Statistics HOUSES IN CLEARANCE AREAS AND UNFIT HOUSES ELSEWHERE Return for the Year ended 31st December, 1961 A. HOUSES DEMOLISHED In Clearance Areas: Houses Demolished. Displaced during quarter Persons Families (1) Houses unfit for human habitation – 66 19 (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 3 4 3 (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. – 5 2 (9) Under Sections 17(3) and 26, Housing Act, 1957 – – – (10) Parts of buildings closed under Section 18, Housing Act, 1957 – 3 1 C. UNFIT HOUSES MADE FIT AND HOUSES IN WHICH DEFECTS WERE REMEDIED By Owner By Local Authority (11) After informal action by local authority 172 – (12) After formal notice under (a) Public Health Acts 7 – (b) Sections 9 and 16 Housing Act, 1957 3 – (13) Under Section 24, Housing Act, 1957 – – D. UNFIT HOUSES IN TEMPORARY USE (Housing Act, 1957) Position at end of year Number of houses (1) Number of separate dwellings contained in column (1) (2) (14) Retained for temporary accommodation (a) under Section 48 – – (b) under Section 17(2) – – (c) under Section 46 – – (15) Licensed for temporary occupation under Sections 34 or 53 – – E. PURCHASE OF HOUSES BY AGREEMENT Number of houses (1) Number of occupants of houses in column (1) (2) (16) Houses in Clearance Areas other than those included in confirmed Clearance Orders or Compulsory Purchase Orders, purchased in the Year – – 25 Table 11 Notices Served Administrative action was taken during the year to 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 194 45 Number of Informal Notices complied with 172 59 Number of Statutory Notices served 9 – Number of Statutory Notices complied with 10 – 26 Table 12 Prevention of Damage by Pests Act, 1949 Report for 12 months ended 31st December, 1961 Type of Property Non-Agricultural 5 Agricultural 1 Local Authority 2 Dwe11ing Houses (incl. Council Houses) 3 All other (incl. Business Premises) 4 Total of cols 1,2 & 3 1.Number of properties in Local Authority's District 136 31,119 5,191 36,446 29 2.Number of properties inspected as a result of: (a) notification 23 524 68 615 – (b) survey under the Act 28 2,813 446 3,287 – (c) otherwise(e.g.when visited primarily for some other purpose) – 8 2 10 – 3.Total inspections carried out including re-inspections 167 5,307 1,224 6,698 – 4.Number of properties insp. (in Sect.2)which were found to be infested by: (a) Rats 22 484 61 567 – (b) Mice 8 12 7 27 – 5.No.of infested properties(in Sect.4)treated by L.A. 30 495 66 591 – 6.Total treatments carried out including retreatments 30 564 59 653 – 7.No. of notices served under Sect.4 of the Act (a) Treatment – 1 2 3 – (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 1 27 Table 13 Eradication of Insect Pests. D.D.T. and Other Special Treatments Number of Infestations Treated Type of Premises Ants Bugs Cockroaches Fleas Wasps Miscellaneous Totals Dwelling-houses 1 8 3 13 29 4 58 Workplaces – – – – 4 1 5 Food Shops – – 1 – – – 1 Miscellaneous 5 – – – 6 2 13 Totals 6 8 4 13 39 7 77 Total income for D.D.T. and other special treatments, £62. 0. 5d. 28 Table 14 Disinfections, etc. Number Premises disinfected after infectious diseases 5 Premises disinfected after other-diseases - Persons (children and adults) treated for Scabies at cleansing station - Table 15 Housing Act, 1936. Overcrowding Number New cases of overcrowding referred to the Housing Committee during the year 21 (1) Cases of overcrowding relieved during the year 7 (2) Persons concerned in such cases 37 Table 16 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 35 Premises registered as dairies (not being dairy farms) 14 29 Table 17 Food and Drugs Act, 1955 Food Hygiene (General) Regulations 1960. Public Health Act, 1936, Section 89 Public Health Act, 1961, Section 80 INSANITARY CONDITIONS IN POOD PREMISES Number of premises found with insanitary conditions 45 Number of premises remedied 59 Insanitary conditions found in premises above Number of defects Number of defects remedied Equipment not kept in good order 11 20 Food so placed as to involve risk of contamination 1 - Food placed within eighteen inches of the ground and not adequately protected 1 1 Absence of personal cleanliness - - Insufficient ventilation to W.C. 1 4 Absence of "Wash your Hands" notices to W.C.s 1 4 Absence of suitable and sufficient wash-hand-basins 1 - Absence of hot water at a suitably controlled temperature over wash-hand-basins 1 3 Absence of soap, nail brushes, clean towels, etc. near wash-hand-basins 3 3 Absence of first aid materials - 2 Absence of accommodation for clothing not worn during working hours - 3 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 2 2 Absence of soap, clean cloths, etc., at sinks - - Absence of suitable and sufficient lighting in food room - - Absence of suitable and sufficient ventilation in Food room - 2 Walls, etc., in food room not kept clean 21 15 Walls, etc., in food room not kept in good order 12 21 Walls etc., in other rooms not kept in good order 11 13 Accumulation of refuse, etc. 4 3 Defective Floor covering 7 15 Yard not kept in good order 4 4 Miscellaneous 27 33 Totals 108 149 30 Table 18 (a) Meat-Carcases Inspected and Findings at Private Slaughter houses in the Borough Cattle excl. cows Cows Calves Sheep and Lambs Pigs Horses Number killed (if known) - - - - - - Number inspected - - - - - - All diseases except Tuberculosis and Cysticerci: Whole carcases condemned - - - - - - Carcases of which some part of 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 treatment by refrigeration - - - - - - Generalised and totally condemned - - - - - - (b) Other Carcases Inspected Nil 31 Table 19 (a) Meat Diseased and unsound conditions found in meat caused the detention and surrender for destruction of: lbs Beef 206 Pork 19 Other Meats 85 310 (b) Other Foodstuffs The following other foodstuffs, being unfit for human consunption, were voluntarily surrendered for destruction. lbs. Bacon 640 Butter 6 Cheese 96 Fish 232 Offal 98 Poultry 258 Sausages 21 1,351 Jars Paste 6 Pickles, Sauce, etc. 16 Preserves 71 93 Tins Cream 16 Fish 160 Fruit and Fruit Juices 1,106 Meat 255 Milk 100 Puddings 15 Soups 109 Vegetables 200 Others 25 1,988 Pkts. Frozen Foods 721 Mallow Creams 1,569 Oats 99 Cheese 8 2,397 32 Table 20 Food and Drugs Act 1955 Sampling Article Total Samples Taken Unsatisfactory Milk 35 2 Butter 25 Cakes and Bread 5 3 Cheese 6 3 Coffee 3 Cream 20 Drugs 4 Fish and Fish Products 33 Fruit (fresh) 28 1 „ (canned & preserved) 10 Ice Cream 22 Liver 14 Margarine 4 Meat and Meat Products 43 Mustard and Papper 4 Preserves 4 Sausages 10 Soft Drinks and Fruit Juices 3 Spirits 7 Sauces and Pickles 3 Sweets 7 Vegetables 4 1 Vinegar and N.B.C. 10 Miscellaneous 15 319 10 33 Table 21 Factories Acts, 1937 to 1959, Part I of the Act. 1. INSPECTIONS, FOR PURPOSES OF PROVISIONS AS TO HEALTH Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted (i) Factories in which Sections 1, 2,3,4, and 6 are to be enforced by Local Authorities 22 6 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 287 118 2 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - - - Totals 309 124 2 - 2. CASES IN WHICH DEFECTS WERE FOUND Particulars Number of cases in which defects were found Number of cases in which prosecutions were ed Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) 1 1 - - - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) - - - - - (a) Insufficient - 1 - - - (b) Unsuitable or defective 1 - - - - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences lating to outworks) - - - - - Totals 2 2 - - - Part VIII of the Act, Outwork Nature of the Work Lampshades Wearing apparel Electric Fuse Makers Cardboard boxes Section 110: Number of outworkers In August list required by Section 110 (1) (c) 13 34 62 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 - - - - 34 Table 22 Infectious Diseases. Incidence and Mortality DIPHTHERIA, SCARLET FEVER AND ENTERIC FEVER 1938-1961 Year Diphtheria Scarlet Fever Enteric Fever No. of Cases Case Rate per 1,000 pop. No. of Deaths Death Rate per 1,000 pop. No. of Cases Case Rate per 1,000 pop. No. of Deaths Death Rate per 1,000 pop. No. of Cases Case Rate per 1, 000 pop. No. of Deaths Death Rate per 1,000 pop. 1938 70 0.72 5 0. 05 274 2.83 1 0.01 - - - - 1939 25 0.25 3 0.03 93 0.95 - - 2 0.02 - - 1940 18 0.19 3 0.03 38 0.41 - - 2 0.02 - - 1941 25 0.27 3 0.03 78 0.85 - - 7 0.07 - - 1942 7 0.08 1 0.01 125 1.35 - - - - - 0.01 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 - - - - - - 1961 - - - - 32 0.31 - - - - - - 35 Table 23 Ophthalmia Neonatorum, years 1938-1961. The following table shows the number of cases notified and result of treatment: Year Cases notified Cases Treated Vision unimpaired Vision impaired Total blindness Deaths At home In hosp. 1938 12 11 1 12 - - - 1939 7 7 - 7 - - - 1940 4 3 1 4 - - - 1941 5 2 3 5 - - - 1942 4 4 - 4 - - - 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 - - - - - - - 1961 - - - - - - - 36 Table 24 Cases of Infectious Diseases Notified during the Year 1961 Disease CASES NOTIFIED AT VARIOUS AGES (YEARS) Total cases notified Deaths. Under 1 Year 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-25 25-35 35-45 45-65 Over 65 Age not known Diphtheria - - - - - - - - - - - - - - Nil - Dysentery - - 2 3 1 2 - - - - 2 - 1 - 11 - Erysipelas - - - - - 1 - - 1 - - 4 3 - 9 - Food Poisoning - - - - - - - - - - - - - - Nil - Malaria - - - - - - - - - - - - - - Nil - Measles 27 72 121 146 144 540 36 6 1 3 1 - - - 1097 - Meningococcal Infections - - - - - 1 - - - - - - - - 1 - Ophthalmia Neonatorum - - - - - - - - - - - - - - Nil - Pneumonia - 1 1 1 - 2 1 - - 3 3 8 12 - 32 86 Poliomyelitis - - - - - - - - - - - - - Nil - Puerperal Pyrexia - - - - - - - 1 3 2 - - - - 6 - Scarlet Fever - - 8 4 6 12 1 3 1 2 - - - - 32 - Smallpox - - - - - - - - - - - - - - Nil - Typhoid & ParaTyphoid - - - - - - - - - - - - - - Nil - Whooping Cough 3 6 6 6 2 8 1 - - - - 1 - - 33 - Totals 30 79 133 160 153 566 39 10 6 10 6 13 16 - 1221 86 37 Table 25 Monthly Incidence of Infectious Diseases during the Year 1961 DISEASE NUMBER OF CASES TOTAL Jan« Feb. March April May June July August Sept. Oct. Nov. Dec. Diphtheria - - - - - - - - - - - - Nil Dysentery 3 2 - 1 - 2 2 - - 1 - - 11 Erysipelas - - 1 1 1 1 - 2 1 1 1 - 9 Food Poisoning - - - - - - - - - - - - Nil Malaria - - - - - - - - - - - - Nil Measles 32 139 242 198 233 171 54 21 5 - 1 1 1097 Meningococcal Infections - - - - 1 - - - - - - - 1 Ophthalmia Neonatorum - - - - - - - - - - - - Nil Pneumonia 4 13 5 2 1 - - - 2 - 1 3 32 Poliomyelitis - - - - - - - - - - - - Nil Puerperal Pyrexia - 2 - 1 - 1 - - - - 2 - 6 Scarlet Fever 2 1 3 1 2 8 2 3 2 2 4 32 Smallpox - - - - - - - - - - - - Nil Typhoid and ParaTyphoid - - - - - - - - - - - - Nil Whooping Cough 6 5 8 8 3 1 - 2 - - - - 33 Totals 47 162 259 212 241 184 59 28 10 4 7 8 1221 38 Table 26 Ward Distribution of Infectious Diseases Notified during the Year 1961 Diseases Heathfield Whitton West Twickenham Central Twickenham South Twickenham East Twickenham Hampton Hampton Hill Upper Teddington Lower Teddington Hampton Wick Total Diphtheria - - - - - - - - - - - Nil Dysentery 1 2 1 - - 1 1 1 1 1 2 11 Erysipelas - - - - - - - - 2 5 2 9 Food Poisoning - - - - - - - - - - - Nil Malaria - - - - - - - - - - - Nil Measles 86 57 77 77 66 109 246 117 118 104 40 1097 Meningococcal Infections - - - - - - - 1 - - - 1 Ophthalmia Neonatorum - - - - - - - - - - - Nil Pneumonia 5 1 2 - 2 - 2 10 8 - 2 32 Poliomyelitis - - - - - - - - - - - Nil Puerperal Pyrexia 1 1 - 1 - - 1 2 - - - 6 Scarlet Fever 1 1 - 1 2 2 5 8 6 2 1 32 Smallpox - - - - - - - - - - - Nil Typhoid and Para-Typhoid - - - - - - - - - - - Nil Whooping Cough 1 - - - 5 1 9 11 3 3 - 33 Totals 95 62 83 79 75 113 264 150 138 115 47 1221 39 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 – – – – – – 1 - 4 1 1 – – – – – – 5 - 9 – 1 – – – – – – 10 - 14 1 – – – – – – – 15 - 19 – 1 – – – – – – 20 - 24 – – – – – – – – 25 - 34 2 5 1 1 2 – – – 35 - 44 2 2 – 1 – – – – 45 - 54 6 4 – – 2 2 – – 55 - 64 5 1 – – – – – – 65 and over age unknown 1 1 – 1 1 – – – Totals 18 17 1 3 5 2 - 1 PRIMARY NOTIFICATIONS OF TUBERCULOSIS 1938-1961 INCLUSIVE 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 Pulmonary 100 106 114 127 112 119 133 118 120 132 117 115 96 107 79 105 88 70 58 57 54 31 45 35 Non- Pulmonary 30 19 12 14 18 18 18 18 19 11 17 5 15 14 20 14 12 11 3 7 7 5 3 4 Totals 130 125 126 141 130 137 151 136 139 143 134 120 111 121 99 119 100 81 61 64 61 36 48 39 40 Table 27 Table 28 Table 29 Food Poisoning Food Poisoning Notifications 3rd Quarter Nil 4th Quarter Nil Total Nil 1st Quarter Nil 2nd Quarter Nil OUTBREAKS DUE TO IDENTIFIED AGENTS: Nil Number of cases Nil Outbreaks due to: Chemical Poisons Salmonella organisms Staphylococci (inc. toxin) Cl.Welchii OUTBREAKS DUE TO UNDISCOVERED CAUSE Nil Number of cases Nil SINGLE CASES: Nil Due to identified agents: Chemical Poisons Number of cases Nil Salmonella organisms Staphylococci P.Morgani Due to undiscovered cause Nil Number of cases Nil Total all cases Nil 41 Table 30 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 Immunisation. C - Chiropody (Middlesex County Council and/or Voluntary Organisations) F - Distribution of Welfare Foods J - Geriatric S - School Health G - Child Guidance M - Mental Health T - Talking and Speech Therapy 0 - Orthopaedic V - Environmental Health 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, Bedfont A B C D F I S T Church Road, Teddington B D P J I Stanwell Road, Ashford A B C D E Council Offices , Green Street, Sunbury V P I 0 S T Hospital Bridge Road, Whitton A B C F The Grange, A B D E P Duddington House, A B C D F I S Gresham Road, Staines G I M 0 P Green Street, Sunbury X S T S T 20 Seymour Road. B D F I Village Hall, Laleham. B F I Chertsey Road, A B C D F Hampton Wick. P S 0 Ashford Common I S T Stanley Road, Teddington A C D E I S 12 Tilley's Lane, High Street, Staines F Laleham Road, B C D P I Shepperton. S T 24 Station Road, Hampton. B C D F Council Offices Hanworth Road, Feltham. V New Hall, Upper Halliford B P I I S York House, Richmond Road, A B C D E Cardinal Road, Feltham A B C D E P 1A Staines Road West, Sunbury F F I S I S P T 58 Hampton Road, Twickenham. G T Grove Crescent, Hanworth A B C D P Hadrian Way, B C D F I I S T Stanwell. S T In addition to the premises listed above there is a mobile clinic in use in the area. 42