AC 4388 Metropolitan Borough of Mandsworth WAN 90 ANNUAL REPORT of the Medical Officer of Health for the Year 1953 by J. TUDOR LEWIS, M.D., D.P.H. together with the Report of the Public Analyst REPORT of the Medical Officer of Health for the year 1953 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Wandsworth Mr. Mayor, Ladies and Gentlemen, I beg herewith to present to you the Annual Report on the health and sanitary conditions of the Borough for the year 1953. The report covers all aspects of our work and should be consulted for details. What I shall do here is to point out one or two matters of more general interest. The slight reduction in the population which I noted last year continued in 1953, being 331,000 as compared with 331,700 in 1952. The live birth rate was 13.54, a slight increase over the previous year; while the death rate was 14.86, which was an increase of 2 over 1952—the possible reason for this is mentioned in the body of the report. The infant mortality rate was 23, which was three points above the figure recorded in the previous year. This is below that for the County of London and England and Wales, which in 1953 was 24.8 and 26.8 respectively. While this figure is below the average, it is one which should be reduced even further. The number of deaths from causes associated with child birth was two, a reduction of one over 1952. There was a slight increase in the number of infectious diseases notified, due to an increased prevalence of measles and especially of whooping cough. The number of cases of tuberculosis, in all its forms, remained almost the same. There were 27 confirmed cases of poliomyelitis and of these 19 were of the paralytic type—unfortunately two of the paralytic cases died. In the previous year there were five deaths from this disease. There were 132 cases of dysentery notified, compared with 230 cases in the previous year. We have continued our special efforts in the investigation and control of this somewhat troublesome, but, fortunately, not severe disease. 2 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 Once again, throughout the year, a good deal of attention was paid to the important subject of food hygiene and the supervision of catering establishments, and in the latter part of the year, after due consideration, the Health Committee decided that the District Sanitary Inspectors should be given specific instructions to participate in the day-to-day work of safeguarding the Borough's food supplies. I am sure this was a wise decision which should pay good dividends. The care and welfare of old people again occupied much of our time, working in close conjunction with both the voluntary bodies which are doing such excellent work for the old people in the Borough, and with the statutory organizations. As the proportion of old people in the population increases, this important part of our work will assume increasing dimensions. One of the great social and health problems of the post-war period has been the housing of the people. Satisfactory and satisfying living conditions are as important to the individual and even more vital to the welfare of the family as a whole, as are the other essentials of wellbeing—good food, pure and wholesome water and fresh air. No community can ever be a really healthy community or can achieve complete social adjustment until it is satisfactorily housed. A great deal of the work of the Health Department is concerned directly or indirectly with the living conditions of the people of the Borough and we act both under the provisions of the Public Health Act and the Housing Act. Since the War, most of our work has been conducted under the Public Health Act, but during the year, action began to be taken to obtain the clearance of certain unfit houses under the Housing Act, and there are signs that shortly a vigorous attack will be made on houses unfit for human habitation. The more I see of Public Health work in its wide sense and the practice of social and preventive medicine in the more narrow sense, the more certain do I become that all our efforts to improve the health, welfare and wellbeing of the people must be conducted as a team effort. I made some slight reference to this last year when I referred to the great help, kindness and co-operation which I had received from everyone concerned with the work of the Health Department, and I have the greatest pleasure in repeating that this kindly help was continued unstinted in 1953. I should like particularly to thank the Chairman of the Health Committee, Councillor T. V. Rowlands, and to acknowledge the courtesy and assistance which I have received from the Committees with whose work I am 3 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 concerned. In the same way, the Chief Officers have done everything to help me, particularly Major Jerman, the Town Clerk. Once again the Officers and Staff of the Health Department in all sections have given me loyal service, and it is a great pleasure to thank particularly the Deputy Medical Officer of Health, Dr. W. G. Harding, and the Chief Sanitary Inspector, Mr. Vickers. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, J. TUDOR LEWIS, Medical Officer of Health. 4 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 STAFF The following changes occurred during the year. Resignations Mr. E. C. George, Sanitary Inspector (service, 4½ years), resigned in March. Mr. J. D. Miles, Sanitary Inspector (service, 1 year), resigned in March. Mr. J. Dallimore, Sanitary Inspector (service 2½ years), resigned in August. Miss M. Richards, Shorthand Typist (service, 18 years), resigned in September. Miss P. Amy, Shorthand Typist (service, 3 months), resigned in March. Mrs. D. Pettit, Rodent Operative (service, 7 years), resigned in October. Mr. S. Boys, Motor Driver, Disinfecting Station (service, 19 years), resigned in July. Appointments Mr. J. Higgs, Sanitary Inspector, appointed in January. Mr. J. Smith, Sanitary Inspector, appointed in June. Mr. A. Norton, Clerk, appointed in April. Miss P. Amy, Shorthand Typist, appointed in January. Miss F. Gunter, Shorthand Typist, appointed in October. Mr. G. Bamborough, Assistant Supervisor, Disinfecting Station, appointed in March. Mr. F. Butcher, Motor Driver, Disinfecting Station, appointed in August. STATISTICS AND SOCIAL CONDITIONS Area 9,107 acres Resident population in 1953 331,000 Wandsworth is the largest of the Metropolitan Boroughs. It has an area of 9,107 acres which includes a number of open spaces, with an approximate combined area of 1,200 acres. The population is a varied one, as the Borough contains residential neighbourhoods in addition to several working-class districts. The chief industries carried on are the manufacture of gas, electricity and motor accessories, laundries and general engineering. 5 6 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 Extracts from Vital Statistics Number of Live Births:— Males Females Total Legitimate 2,173 2,026 4,199 Illegitimate 144 140 284 Total live births 2,317 2,166 4,483 Males Females Total Number of stillbirths 57 50 107 Number of deaths 2,216 2,703 4,919 Birth-rate 13.54 Death-rate 14.86 Rate per 1,000 (Live and Still) Births Deaths from puerperal causes 2 0.43 Infantile mortality per 1,000 live births:— All infants 23 Legitimate infants 21 Illegitimate infants 31 Deaths from Cancer 1,056 „ „ Diphtheria 0 „ „ Scarlet Fever 0 „ „ Measles 1 „ „ Whooping Cough 3 „ „ Tuberculosis 73 Tuberculosis death-rate 0.22 There has been no unusual or excessive mortality during the year. VITAL STATISTICS Population The civilian population at the middle of the year was estimated by the Registrar-General to be 331,000, and all the rates used in this Report are based on this figure. Table I shows the approximate population of each Parliamentary Division, based on the above estimation. TABLE I. Population estimated to middle of 1953 Putney 84,626 Central 95.041 Clapham 79,674 Streatham 71,659 Whole Borough 331,000 Births The total number of births belonging to the Borough registered during 1953 was 4,483, consisting of 2,317 males and 2,166 females. The number for 1952 was 4,374. The birth-rate was 13.54 per 1,000 persons living, compared with 13.18 for 1952. The rate for the whole of London during 1953 was 17.5 and for England and Wales 15.5. Two hundred and eighty-four illegitimate births took place in the Borough compared with 237 in 1952. 7 8 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 Deaths The number of registered deaths which took place in the Borough during the year was 3,659 but 222 of these did not belong to the Borough, while 1,482 Borough residents died outside the Borough. The corrected number of deaths for the Borough, after allowing for these factors, was 4,919 of whom 2,216 were males and 2,703 females. The increase in the number of deaths is very largely accounted for by alterations in the allocation of deaths as set out in the Registrar General's memorandum enclosed with his Circular G.R.O. (M.O.H.) No. 4/1952. The new procedure aims at assigning deaths to the area of the usual residence of the deceased and, as a result, deaths occurring in certain types of hospitals and institutions in the Borough, which, by reason of the patients' original addresses were formerly transferred to other authorities, are now deemed to be not transferable. The crude death-rate for the year was 14.86, compared with 12.36 for 1952, but after taking into account the area comparability factor supplied by the Registrar General, the adjusted rate works out at 12.98. This compares with 12.5 for the whole of London and 11.4 for England and Wales. Table II shows the total number of registered deaths and the death-rates for each division and for the whole Borough. TABLE II. Corrected Deaths Death Rate Males Females Total Putney 528 603 1,131 13.35 Central 681 825 1,506 15.84 Clapham 578 791 1,369 17.18 Streatham 429 484 913 12.74 Whole Borough 2.216 2,703 4,919 14.86 9 VITAL STATISTICS Table III is the general mortality Table for the whole Borough and shows the number of deaths from each cause divided into sexes, age groups and sub-districts. CAUSES OF DEATH DEATHS IN OR BELONGING TO WHOLE DISTRICT AT SUBJOINED AGES DEATHS IN OR BELONGING TO LOCALITIES (ALL AGES) TABLE III. CAUSES OF, AND AGES AT DEATH, DURING THE YEAR 1953 All Ages Males Females Under 1 year 1 and under 5 5 and under 15 15 and under 45 45 and under 65 65 and upwards Putney Central Clapham Streatham Tuberculosis, Respiratory 67 46 21 — — 1 19 18 29 15 18 21 13 Tuberculosis, Other 6 1 5 — 2 1 1 2 — 1 2 3 — Syphilitic Disease 23 14 9 — — — 1 7 15 5 7 7 4 Diphtheria — — — — — — — — — — — — — Whooping Cough 3 — 3 3 — — — — — 1 — 2 — Meningococcal Infections 2 1 1 1 1 — — — — 1 — 1 — Acute Poliomyelitis 2 1 1 — — — 2 — — — — 1 1 Measles 1 1 — — 1 — — — — — 1 — — Other Infective and Parasitic Diseases 14 7 7 — 1 — 2 2 9 1 7 4 2 Malignant Neoplasms 1,056 490 566 1 — 1 67 397 590 223 231 425 177 Leukaemia, Aleukaemia 8 3 5 — — 1 2 1 4 2 2 4 — Diabetes 30 5 25 — — — — 5 25 8 5 11 6 Vascular Lesions of Nervous System 473 172 301 — 1 — 10 97 365 128 130 123 92 Diseases of Heart 1,622 672 950 — — — 18 201 1,403 349 694 306 273 Other Circulatory Disease 250 97 153 — — — 3 34 213 58 68 72 52 Influenza 64 20 44 — — — 3 12 49 14 20 21 9 Pneumonia 261 136 125 11 20 9 6 32 183 58 59 87 57 Bronchitis 353 208 145 3 — — 6 63 281 87 90 92 84 Other Diseases of Respiratory System 37 19 18 — 1 1 7 6 22 10 11 9 7 Ulcer of Stomach and Duodenum 54 36 18 — — — 2 10 42 9 15 18 12 Gastritis, Enteritis, Diarrhoea 20 9 11 5 2 — 1 4 8 5 6 5 4 Nephritis and Nephrosis 43 21 22 — — — 3 11 29 10 12 9 12 Hyperplasia of Prostate 31 31 — — — — 3 9 19 11 6 7 7 Pregnancy, Childbirth, Abortion 2 — 2 — — — 2 — — — 1 1 — Congenital Malformations 31 13 18 19 3 — 6 3 — 12 4 8 7 Other Defined and Ill-defined Disease 324 141 183 59 5 6 19 59 176 92 78 88 66 Motor Vehicle Accidents 25 17 8 — 1 4 7 8 5 2 8 9 6 All other Accidents 75 33 42 1 3 5 11 13 42 19 21 23 12 Suicide 36 17 19 — — — 15 15 6 10 6 10 10 Homicide and Operations of War 6 5 I 1 — 1 4 — — — 4 2 — All Causes 4,919 2,216 2,703 104 41 30 220 1,009 3,515 1,131 1,506 1,369 913 10 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 Infantile Mortality The number of deaths under one year was 104, the infantile mortality rate being 23 per 1,000 births. This compares with a rate of 20 for 1952 and 23 for 1951. For the ten years ending 1943 the average infantile mortality rate was 49 while for the ten years ending 1953 the average rate was 28. Maternal Mortality Two deaths occurred from accidents and diseases of pregnancy or child-birth. This is equivalent to a rate of 0.43 for 1,000 live and still births, compared with 0.67 in 1952. INFECTIVE DISEASES The number of deaths from notifiable infectious diseases, including all forms of tuberculosis, was 167. From all notifiable infective diseases the death-rate was 0.50 per 1,000. Table IV shows the number of cases of the notifiable diseases reported, arranged in age groups, and Table V shows the same figures arranged in the sub-districts in which they occurred. Recent Legislation Public Health (Infectious Diseases) Regulations, 1953 These Regulations came into operation on 1st April, 1953, superseding the Infectious Diseases (London) Regulations, 1927. The new Regulations correspond with the revoked Regulations in requiring notification of malaria, dysentery, acute primary pneumonia, acute influenzal pneumonia, and in prescribing action, in conformity with the present working of the health services, in relation to the prevention and treatment of enteric, typhus and relapsing fever. They amplify however, the precautionary measures provided for in the revoked Regulations against food poisoning, by relating them (instead of to enteric fever and dysentery, as formerly) to other salmonella infections, and to staphylococcal infections liable to cause food poisoning. Smallpox No case occurred in the Borough during the year. Notification is frequently received from Port and Local Authorities of persons coming into the Borough who may have been in contact with Smallpox. Observation for the necessary period is kept on these persons by members of the Public Health Department. Diphtheria There were no confirmed cases. Scarlet Fever, Three hundred and thirty-six cases of Scarlet Fever were notified or reported compared with 563 in 1952, 414 in 1951, and 584 in 1950. The diagnosis was not confirmed in 13 cases. No deaths occurred. Whooping Cough Nine hundred and twenty-five cases were notified during the year. There were three deaths. 11 12 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 TABLE IV. NOTIFIABLE DISEASES NO. OF CASES OF INFECTIVE DISEASES GROUPED IN AGE PERIOD Total Under 1 1-3 3-5 5-10 10-15 15-25 25-45 45-65 65 and upwards Smallpox — — — — — — — — — — Diphtheria — — — — — — — — — — Scarlet Fever 323 3 20 67 174 38 18 3 — — Measles 2,850 89 501 432 1,655 118 42 13 — — Whooping Cough 925 109 176 211 314 84 30 1 — — Enteric Fever and Paratyphoid Fever 5 — — — 2 — 2 — 1 — Malaria 5 — — — — — 4 1 — — Dysentery 132 6 13 18 22 6 11 22 16 18 Erysipelas 55 — — — — 1 3 23 17 11 Scabies 39 — 2 1 6 5 9 10 5 1 Puerperal Pyrexia 182 — — — — — 61 121 — — Ophthalmia Neonatorum 4 4 — — — — — — — — Meningococcal Infection 5 2 1 1 1 — — — — — Acute Poliomyelitis 27 3 5 — 3 2 7 5 2 — Acute Encephalitis 2 — — — — 1 — — — 1 Anthrax — — — — — — — — — — Pneumonia:— Acute Influenzal 129 4 5 7 4 2 7 23 37 40 Acute Primary 191 4 12 13 27 3 14 32 45 41 Tuberculosis—All forms 663 — 6 11 20 14 132 325 109 46 Food Poisoning 129 2 4 7 12 6 25 55 18 — Continued Fever — — — — — — — — — — Total 5,666 226 745 768 2,240 280 365 634 250 158 13 INFECTIVE DISEASES TABLE V. NOTIFIABLE DISEASES TOTAL CASES OF INFECTIVE DISEASES OCCURRING IN EACH WARD Whole Borough Deaths PUTNEY CENTRAL CLAPHAM STREATHAM Putney Thamesfield Fairfield West Hill Southfield Earlsfield Springfield Tooting Graveney Bedford Larkhall Clapham North Clapham Park Thornton Balham Streatham Hill St. Leonards Streatham Common Streatham South Furzedown Smallpox — — — — — — — — — — — — — — — — — — — — — — Diphtheria — — — — — — — — — — — — — — — — — — — — — — Scarlet Fever 18 13 23 25 28 24 20 28 18 11 20 14 15 7 7 10 9 16 6 n 323 — Measles 127 73 195 87 160 180 174 260 178 150 172 130 no 122 129 124 110 126 117 106 2,850 1 Whooping Cough 24 42 86 52 49 43 53 123 52 44 68 46 50 19 28 15 20 26 39 46 925 3 Enteric Fever and Paratyphoid Fever 3 — — — 1 — — — — — — — 1 — — — — — — — 5 — Malaria — — 1 — 1 — 1 1 — — — — — — — 1 — — — — 5 — Dysentery 7 4 7 1 4 9 10 41 12 2 5 4 3 3 9 1 3 1 2 4 132 1 Erysipelas 3 2 i 4 2 2 5 7 4 4 2 2 3 — 2 2 2 — 2 2 55 — Scabies — 4 3 2 2 4 — 3 3 1 4 5 2 — 1 3 1 1 — — 39 — Puerperal Pyrexia 2 1 5 2 4 3 3 7 3 7 4 7 56 45 11 9 2 7 2 2 182 — Ophthalmia Neonatorum — — — — — — — — 1 1 — — 2 — — — — — — — 4 — Meningococcal Infection 1 — 2 — — — — 1 — — — — — — 1 — — — — — 5 2 Acute Poliomyelitis 4 2 2 4 I 1 — 1 — — 2 1 — — 3 3 — 2 — 1 27 2 Acute Encephalitis — — — — — — 1 — — — — — — — — — — 1 — — 2 1 Anthrax — — — — — — — — — — — — — — — — — — — — — — Pneumonia:— Acute Influenzal 5 8 5 6 12 8 9 13 5 9 6 8 6 4 5 3 3 5 5 4 129 40 Acute Primary 8 11 12 12 17 18 13 15 5 11 4 10 9 4 4 5 9 8 7 9 191 41 Tuberculosis—All forms 58 24 33 24 28 49 45 49 19 30 22 31 37 34 51 36 18 33 24 23 663 73 Food Poisoning 5 3 29 4 9 21 5 7 5 14 3 1 5 1 3 5 — 4 2 3 129 3 Continued Fever — — — — — — —. — — — — — — — — — — — — — — — Total 265 187 408 223 318 362 339 556 305 284 312 259 314 239 254 217 177 230 206 211 5,666 167 14 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 Measles The number of cases notified during the year was 2,850, compared with 2,290 in 1952, 4,299 in 1951, and 1,720 in 1950. Acute Poliomyelitis Seventy-three cases of this disease were notified or reported during the year, of which 46 were subsequently not confirmed. Of the remaining 27 confirmed cases, 19 were of the paralytic type and 8 non-paralytic. Two of the paralytic cases died. In 1952, 39 cases were confirmed, with five deaths. Acute Encephalitis Of nine cases investigated, two were confirmed. Meningococcal Infection Five confirmed cases were notified. There were two deaths. Fifteen other cases were investigated, but were subsequently not confirmed. In the previous year there were seven cases with one death. Typhoid and Paratyphoid Fever Of seven cases reported during the year, four were subsequently confirmed as typhoid and one as paratyphoid. Diagnosis was not confirmed in the remaining two cases. There were no deaths. Puerperal Pyrexia During the year 182 cases were notified, of which 172 occurred in hospital and 10 at home. Fifty-eight of the hospital notifications referred to patients whose home addresses were outside the borough. Information was also received of 40 cases, referring to Wandsworth residents whose confinements took place in hospitals located in other Metropolitan boroughs. 15 INFECTIVE DISEASES Influenza The number of deaths from Influenza was 64 compared with 26 in 1952, 122 in 1951 and 35 in 1950. Influenzal Pneumonia and Acute Primary Pneumonia These are the notifiable forms of pneumonia. One hundred and twenty-nine cases of acute influenzal pneumonia and 191 cases of acute primary pneumonia were notified. Forty of the former, and 41 of the latter died. The total number of deaths credited to all forms of pneumonia during the year was 261, compared with 180 in 1952. Malaria Five cases were notified. Two were recurrent cases, and three were soldiers who had recently returned to this country from service in Korea. Erysipelas Fifty-five cases were notified. No deaths occurred. Other Infective Diseases Twenty-three deaths occurred from syphilis. Scabies Thirty-nine cases were notified. Ninety-two cases of scabies were treated at the Council's Cleansing Station under the supervision of the two bathing attendants. The majority of the cases were treated by two applications of benzyl benzoate and received a course of two baths each. Forty-nine other persons received cleansing treatment for various conditions. Food Poisoning One hundred and twenty-nine cases were notified during the year. One hundred and four were individual cases, and ten were outbreaks involving two or more persons and comprising 25 cases in all. The majority of the cases were only slightly affected, and where bacteriological investigation was carried out, organisms likely to have caused the illness were discovered in only two cases. An outbreak of diarrhoea among patients at a mental institution in the Borough was reported in June. Bacteriological investigation of the patients affected disclosed the presence of Salmonella typhimurium in six cases. Two of the latter cases died. 16 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 Diseases Reported from Schools A total of 2,156 infective diseases was reported from schools in the Borough throughout the year. The numbers of each disease were:— Scarlet Fever 221 Chicken Pox 606 Diphtheria — Whooping Cough 145 Measles 685 Mumps 426 German Measles 27 Ringworm 5 Poliomyelitis 2 Scabies — Other Disease 39 Disinfection During the year 905 rooms were disinfected after infectious and other disease and 339 rooms disinfested for vermin. Bacteriological Examinations These examinations continued to be carried out by the Camberwell Public Health Laboratory until the closing of that laboratory on the 30th September, when its Director, Dr. Guy Bousfield, retired. The association of the Camberwell Laboratory with this Borough has covered a long period, both in its private capacity prior to 1948 and in its public capacity since that year when it came under the administration of the Medical Research Council as a Public Health Laboratory. During the whole of this period, Dr. Bousfield has provided an excellent personal service, giving unstinted help and advice to this department in matters connected with bacteriological work. The happiest relations and closest liaison have existed between his staff and this department. All bacteriological examinations are now carried out at the Public Health Laboratory at County Hall under its Director, Dr. A. J. H. Tomlinson. The following is a summary of examinations made during the year:— Nose and throat swabs 319 Faeces for the typhoid and dysentery groups 652 Miscellaneous specimens 6 Total 977 NON-INFECTIVE DISEASES The total number of deaths from cancer and malignant disease was 1,056, the number of males being 490 and females 566. The deathrate was 3.19 per 1,000. The number of deaths in 1953 was 251 more than in 1952. Deaths from disease of the heart and circulatory system were 1,872 compared with 1,504 in 1952. Of these deaths 1,616 were of persons of 65 years of age and above. There were 651 deaths from diseases of the respiratory system compared with 577 in 1952. The number of deaths from bronchitis was 353 compared with 365 in 1952, and from pneumonia (all forms), 261 compared with 180 in 1952. Further particulars relative to pneumonia are given on page 15. One hundred and forty-two deaths were due to violence, 25 of them being due to motor accidents, 36 to suicide and 81 to other forms of violence. CERTIFICATES OF VACCINATION AND INOCULATION Eight hundred and thirty-six requests were received from residents in the Borough for a certificate of vaccination or inoculation to be authenticated for the purpose of travel abroad. The signature of the person issuing the certificate was verified in each case as that of a registered medical practitioner practising in Wandsworth and the certificate was endorsed accordingly. STAFF MEDICAL EXAMINATIONS At the request of the Committees and Chief Officers concerned, arrangements were made during the year for 15 members of the Council's staff to undergo special medical examinations. In the majority of cases the purpose of the examination was to determine the employee's future fitness for his occupation, following serious illness, and in one case it was found necessary to recommend superannuation. Twenty-seven shorter reports on members of the staff who were sick were obtained from doctors and hospitals at the request of the departments concerned. 17 18 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 TUBERCULOSIS Notifications The total number of new cases which came to the notice of the Department during 1953 was 663 compared with 666 in 1952. The sources of information regarding the 663 new cases were as follows:— Primary notifications on Form A 388 Notifications from H.M. Forces 4 Unnotified at death 18 Transfers from other sanitary authorities 253 Total 663 Deaths The number of deaths certified as due to various forms of tuberculosis was 73. Particulars of the new cases and deaths during the year, classified by sexes and age groups are given in the following table:— TABLE VI. Age Periods New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under 1 year — — — — — — — — 1-2 — 3 — 1 — — — 1 2-5 5 3 1 4 — — — 1 5-10 10 3 3 4 — 1 — 1 10-15 7 3 2 2 — — — — 15-25 56 66 6 4 1 3 — — 25-45 149 156 9 11 8 7 1 1 45-65 77 28 3 1 13 5 — 1 65 and upwards 35 11 — — 24 5 — — Totals 339 273 24 27 46 21 1 5 SANITARY INSPECTION OF THE BOROUGH Work of the Sanitary Inspectors A Summary of the inspections carried out by the Inspectors is given in Table VII:— TABLE VII. Inspections ReInspections Total To investigate complaints 7,987 28,572 36,559 Housing Reports 951 358 1,309 Notifiable diseases 1,199 462 1,661 Piggeries 13 — 13 Factories, Workplaces, etc. (including Outworkers) 1,747 50 1,797 Sanitary conveniences 75 2 77 Mews and stables 256 — 256 Other inspections 5,534 1,616 7,150 Totals 17,762 31,060 48,822 Smoke observations 75 Legal proceedings, attendances at court 17 Table VIII gives details of the sanitary operations carried out in the Borough during the year. The number of drains which were tested was 701 and 1,075 were cleansed or repaired. The drains of 33 houses were reconstructed. Damp conditions have been remedied in 1,857 premises, and in 70 of these damp courses were inserted. 19 20 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 TABLE VIII. Putney Central Clapham Streatham Whole Borough 1. Premises cleansed and repaired 439 400 446 226 1,511 2. Drains tested 132 120 246 203 701 3. Drains cleansed or repaired 281 303 247 244 1,075 4. Water closets cleansed or repaired 129 146 161 95 531 5. Soil pipes repaired 25 26 39 9 99 6. Waste pipes altered or repaired 38 49 68 70 225 7. Rainwater pipes repaired 36 21 34 18 109 8. Roofs and gutters repaired 298 316 248 145 1,007 9. Damp courses inserted 14 37 14 5 70 10. Damp conditions otherwise remedied 289 285 349 182 1,105 11. Yards drained or paved 19 6 9 16 50 12. Dustbins provided or repaired 24 33 39 44 140 13. Water cisterns cleansed, covered or repaired 17 15 14 7 53 14. Water supply reinstated 44 17 25 5 91 15. Defective fireplaces remedied 65 116 65 43 289 16. Defective coppers remedied 2 1 1 — 4 17. Accumulations of rubbish, etc., removed 13 16 19 6 54 18. Urinals cleansed or repaired 1 3 3 — 7 19. Animals improperly kept 1 1 — 3 5 20. Smoke nuisances 5 — 1 — 6 21. Other nuisances 94 78 61 104 337 Total 1,966 1,989 2,089 1,425 7,469 Number of Preliminary Notices served 701 894 868 484 2,947 Number of Preliminary Notices complied with 776 930 829 510 3,045 Number of Nuisance Notices served 176 191 228 113 708 Number of Nuisance Notices complied with 235 226 235 135 831 21 SANITARY INSPECTION OF THE BOROUGH Water Supply—Cutting-off Notices During the year, notices with respect to 91 premises were received from the Metropolitan Water Board stating that the supply had been withdrawn. In 28 premises the water supply was cut off for non-payment of rates, and in 63 premises because of defects in the service. Dustbin Accommodation—Section 105, Public Health (London) Act, 1936 During the year action was taken under Section 105 of the Public Health (London) Act, 1936, in respect of 140 premises, and 114 dustbins were provided. Dustbins were also provided at 26 premises without the necessity of action being taken under the Act. Rodent Control Energetic measures for rodent control continued throughout the year, the system followed being that of prebaiting laid down by the Ministry of Agriculture and Fisheries. Rat and mice complaints received during the year totalled 2,027. Following is a summary of the work of the rodent operatives. Number of operatives' visits to premises 10,608 „ „ premises prebaited and treated with poison 1,115 „ „ premises prebaited and found not troubled 241 „ „ premises investigated and found not troubled 2,137 „ „ prebaits laid 24,138 „ „ poison baits laid 5,882 „ „ drains tested by Sanitary Inspector 410 „ „ drains found defective 209 „ „ rats estimated killed 8,576 At the close of the year there were six rodent operatives and one clerk engaged on rodent control duties under the supervision of a Sanitary Inspector. 22 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 Swimming Baths and Bathing Pools There are four public swimming bath establishments and one open air swimming pool belonging to the Council, one open air swimming bath owned by the London County Council, one public swimming pool privately owned, and a number of private bathing pools in the Borough. The Queensmere pond on Wimbledon Common has also for many years past been a recognized bathing pond. In four of the Borough Council's swimming baths, the water is purified by a process of continuous circulation through a filtration plant whereby the whole of the water is dealt with every three to four hours and chlorinated automatically during its circulation from the filtration plant to the bath. In the other bath belonging to the Council, each bath is emptied of water as often as necessary and refilled with fresh water which is continuously circulated and chlorinated automatically the whole time the bath is in use. Disinfection and Fumigation of Clothing and Rags for Export At one factory in the Borough rags are washed and disinfected prior to export, under the supervision of the Council's Inspector, and certificates are issued for which a charge is made. During 1953, 158 certificates were issued and the amount received by this department was £47 8s. 0d. Disinfection in bulk of clothing intended for export was carried out at the Disinfecting Station and £8 was received for this service during the year. Removal to suitable premises of persons in need of care and attention— National Assistance Act, 1948, Section 47 In dealing with the problems of the many aged and infirm persons in the Borough, close liaison has been maintained between the Public Health Staff and those members of the London County Council divisional staff who are concerned with the care of the aged. This co-operation with the County Council has meant that in dealing with the large number of aged persons whose capacity to look after themselves adequately was in question, it was again possible to make satisfactory arrangements for their care and attention without the necessity of having to take action under Section 47 of the National Assistance Act, 1948. SANITARY INSPECTION OF THE BOROUGH 23 Eradication of Bed Bugs The methods employed for freeing infested houses include the stripping of all paper from the walls, the removal of wooden mouldings and skirtings and application of a blow lamp to the room surfaces. Candles are often used by house owners and the spraying of rooms by the disinfecting staff of the Council is carried out, proprietary insecticides being used. Infested bedding is removed to the Disinfecting Station and treated by steam. During the year 184 houses were found to be infested with bed bugs and disinfestation was carried out in all cases. Special steps are taken to ensure that the furniture and clothing of families about to be accommodated in the Council's houses or flats are freed from vermin. Hydrogen cyanide gas is used for the disinfestation of the furniture, which is placed in special vans constructed for the purpose, the process being carried out by a contractor. Bedding is not subjected to hydrogen cyanide but is disinfested by steam at the Council's Disinfecting Station. Mortuary and Crematorium The Mortuary at Wandsworth was used throughout the year and 342 bodies were received there. Under the Crematorium Regulations, 1930, 1,175 cremations were authorised during 1953 as compared with 1,239 in 1952. Burial of the Dead Under Section 50 of the National Assistance Act, 1948, it is the responsibility of the Council to arrange for the burial of persons who die or are found dead in the Borough, and for whom no suitable burial arrangements are made or are being made. The number of persons buried under the provisions of the Act during 1953 was 26. 24 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 HOUSING STATISTICS RELATING TO HOUSING Public Health (London) Act, 1936 Number of houses inspected on account of complaints or illness 9,186 Reinspections 29,034 Number of statutory notices served:— Intimation notices 2,947 Nuisance notices 708 Number of houses in which nuisances were abated 3,001 The number of cases referred to the Solicitor for legal action during 1953 was 148 The following is a summary of Police Court proceedings:— Number of summonses served 31 „ „ „ withdrawn 17 „ „ „ adjourned 12 „ „ Orders made for abatement of nuisances 2 Costs awarded in respect of two cases £2 2s. 0d. HOUSING ACT, 1936 Number of houses inspected—house to house (Housing Consolidated Regulations, 1925) Nil Repair of Houses Number of notices served under Section 9 of the Housing Act 1936 Nil Number of houses made fit for habitation:— (a) by owners Nil (b) by Local Authority in default of owners Nil Demolition Orders Number of orders made under Section II of the Housing Act 1936 Nil Number of houses demolished:— (a) as the result of such order Nil (b) voluntarily Nil Closing Orders (other than underground rooms) Number of houses closed (Local Government (Miscellaneous Provisions) Act 1953) Nil Number of such orders determined Nil Number of rooms in respect of which Closing Orders were made under Section 12 of the Housing Act 1936 Nil Number of such orders determined Nil HOUSING 25 Closing Orders (underground rooms) Number of rooms found to be unfit for habitation 28 Number closed or modified occupation approved 26 Number of Closing Orders determined 1 Slum Clearance Number of houses included in representations under Section 25 of the Housing Act 1936 37 Number of houses demolished following such action 16 Overcrowding Number of families found to be living in overcrowded conditions 93 Number of overcrowded families who have obtained alternative accommodation 104 New Accommodation Number of dwellings erected by the borough council during the year 346 Byelaws in Respect of Houses Let in Lodgings Number in Borough (Registered since 1946) 3 Number of inspections made 15 Number of notices served Nil Number of prosecutions Nil Number of complaints remedied Nil Housing Accommodation—Medical Priority During the year, 1,206 of the applications made to the Council for rehousing were referred to me for consideration of additional points on health grounds in accordance with the Council's Points Scheme. I also made 168 recommendations for transfer on health grounds in respect of applications received from tenants of Council's permanent and requisitioned properties for the provision of more suitable alternative accommodation. 26 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 UNFIT HOUSES Basement Premises Closing Orders were made on basement premises at 24b Old Devonshire Road, 8 Carlton Drive, 19a Putney Hill, 15 Newby Street, 140 Upper Richmond Road, 21 Christchurch Road, 2 St. Nicholas Mansions, Trinity Crescent, 199a Bedford Hill and 4 Ulva Road. In each case the owners had been invited to submit proposals to render the premises fit for human habitation, but none were received. My predecessor represented the basement premises at 861a Garratt Lane in 1950, and a Closing Order was made. As a result of alterations by the owner, these premises have now been rendered fit for habitation, and the Closing Order was determined on 20th October. Clearance Areas The Council, on 27th January, declared the Dormay Street Area a Clearance Area, after consideration of my official representations submitted on 21st October, 1952. The Council's decision was subsequently confirmed by the Minister of Housing and Local Government on the 18th August. The Putney Bridge Road and Matrimony Place Areas were similarly declared Clearance Areas on the 24th February and confirmed as such by the Minister on the 12th December. On the 15th December, I submitted official representations under Part III of the Housing Act, 1936, upon the condition of the properties, Nos. 2331 (odd) Hazelhurst Road, and, in accordance with the usual practice, the Council formally notified the London County Council that a proposal to declare these properties a Clearance Area was under consideration. FOOD AND FOOD PREMISES There are four Inspectors engaged wholly in the supervision of the food supply. One of them is the Food and Drugs Inspector of the Borough who is occupied in procuring samples of food and drugs for analysis by the Public Analyst and the Public Health Laboratory and the supervision of dairy premises. The other three Inspectors are designated Food Inspectors and supervise other premises where food is sold, stored, manufactured, or prepared for sale. Onethird of the Borough is allocated to each Inspector. The three Inspectors also carry out the duties required under the Pharmacy and Poisons Act, 1933, and the Pharmacy and Medicines Act, 1941. In November the Council agreed with my proposal that the district Sanitary Inspectors holding the additional certificate of Inspector for Food and Drugs should take over the daytoday supervision of the catering establishments in their respective areas. With the object of ensuring that all food businesses are supervised systematically, a register of all premises where a food business is carried on has been compiled and is kept uptodate. This Register includes not only those premises which are subject to some form of legal control, but also all other premises in which a food business of any description is carried on. The total number of food premises on the register in the Borough is 2,716 and during 1953 they were visited on 40,796 occasions. Table IX has been drawn up to show the number of visits to various food premises in different parts of the Borough. Milk Supply The Milk and Dairies Regulations, 1949 These Regulations came into force on 1st October, 1949, and require local authorities to keep a register of all persons carrying on the trade of distributor in their district and of all premises within their district which are used as dairies, not being dairy farms. During the year 24 applications have been received from persons to be registered as distributors of milk. In each case the certificate of registration was granted. Fifteen notices of cancellation of registration have been received. At the end of the year there were 207 persons on the register, including 17 persons with premises outside the Borough. There were 31 dairies on the register at the end of the year. The bulk of the milk sold by retail within the Borough is sent out in bottles filled in properly constructed dairies and its quality is good. 27 28 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 TABLE IX. SUMMARY OF VISITS TO FOOD PREMISES Putney Thamesfield Fairfield West Hill Southfield Earlsfield Springfield Tooting Graveney Bedford Larkhall Clapham North Clapham Park Thornton Balham Streatham Hill St. Leonards Streatham Common Streatham South Furzedown Whole Borough Dairies and Shops distributing Milk 42 146 71 49 93 83 49 101 135 35 161 142 132 102 158 83 55 153 51 65 1,906 Restaurant Kitchens 69 127 89 43 47 46 30 141 72 31 96 146 73 105 113 33 195 35 18 20 1,529 Ice Cream Premises 80 71 50 31 52 41 43 82 178 14 78 157 89 110 82 57 182 26 48 70 1,541 Butchers' Shops 253 290 209 126 212 187 50 145 293 56 214 173 90 237 145 124 399 44 63 215 3,525 Greengrocers' Shops 78 62 35 43 33 59 28 72 246 53 121 96 26 125 227 23 71 15 62 46 1,521 Fishmongers' Shops 24 40 28 25 17 35 22 102 83 11 86 74 42 116 88 36 121 9 35 28 1,022 Fried Fish Shops 3 25 10 1 20 18 12 13 50 1 98 52 — 16 3 9 2 5 16 35 389 Market Stalls 334 800 324 386 506 254 1,043 1,765 8,853 — 145 617 71 5,337 613 — 948 — — 198 22,194 Other Premises 269 352 805 163 383 290 196 408 564 92 471 508 221 730 345 221 491 96 206 314 7,125 Slaughterhouses — 5 — — — — — — — — 39 — — — — — — — — — 44 Total Visits 1,152 1,918 1,621 867 1,363 1,013 1,473 2,829 10,474 293 1,509 1,965 744 6,878 1,774 586 2,464 383 499 991 40,796 FOOD AND FOOD PREMISES 29 Food and Drugs Act, 1938 Two hundred and sixtyfive samples of milk were submitted for analysis. All were reported as genuine; 39 were samples of Channel Island and South Devon milks with an average fat content of 4.30 per cent. The remaining 226 samples had an average fat content of 3.61 per cent. The Milk (Special Designation) (Raw Milk) Regulations, 194950, and the Milk (Special Designation) (Pasteurized and Sterilized Milk) Regulations, 1949 50 These regulations, which came into force on 1st October, 1949, provide for the issue of licences to persons who sell milk under any of the following designations:— "Accredited" "Pasteurized" "Sterilized" "Tuberculin Tested" The following licences for the sale of milk under these designations were eranted durine the vear:— Dealers' Dealers' Supplementary Total Accredited Nil Nil Nil Pasteurized 168 33 201 Sterilized 232 32 264 Tuberculin Tested 128 32 160 Total 528 97 625 Three dealers' (pasteurizers') licences were granted during the year and are included in the above figures. A person who holds a "Tuberculin Tested" licence and a "Pasteurized" or "Sterilized" licence may use the designations "Tuberculin Tested (Pasteurized)" or "Tuberculin Tested (Sterilized)" as the case may be. 30 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 Meat There are 216 butchers' shops in the Borough. The majority are registered under Section 14(l)(b) of the Food and Drugs Act, 1938, for the preparation or manufacture of sausages or potted, preserved, pickled or pressed foods. There were 3,525 visits made to these shops during the year. Slaughter of Animals There are three private slaughterhouses in the Borough and they were visited on 44 occasions during the year. One pig carcase was inspected after slaughter. Slaughter of Animals Act, 193351 Section 3 of this Act provides that no animal shall be slaughtered or stunned in a slaughterhouse or knacker's yard by any person who is not the holder of a licence granted by a local authority and in force under this section. During the year one application from a person desirous of acting as a slaughterman was submitted to the Council and granted. Piggeries There are now seven piggeries in this Borough and they were inspected on 13 occasions. Unsound Food One hundred and seventytwo varieties of foodstuff suspected to be unsound were examined at the request of the owners and afterwards either destroyed or released for animal feeding. The owners were granted a certificate to this effect. FOOD AND FOOD PREMISES 31 Pharmacy and Poisons Act, 1933, and Pharmacy and Medicines Act, 1941 These Acts provide for the listing with the Local Authority of all persons dealing in poisons included in Part II of the Poisons List. The number of persons on the Council's list at the end of 1953 was 399, and 783 visits were made to the premises of the listed persons by the Food Inspectors. The principal business conducted on the premises of these applicants is shown in Table X. The majority of the listed sellers are also purveyors of food. TABLE X. PART II OF POISONS LIST. Principal Business Number of Premises Number of Visits Confectioners 3 4 Domestic stores, ironmongers, etc. 104 208 Drug stores 25 51 Grocers 242 461 Hairdressers 19 45 Nurserymen and florists 6 14 Total 399 783 Bakehouses There are 82 bakehouses in the Borough, of which 20 are in basements and subject to the provisions of Section 54 of the Factories Act, 1937. One hundred and eightytwo visits were made to these premises by Food Inspectors during the year. 32 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 Water Supply The bulk of the water supply in the Borough is provided by the Metropolitan Water Board and this has been satisfactory, both in quality and quantity. Registration of Premises The Food and Drugs Act, 1938 During the year 86 applications for registration under the provisions of Section 14(l)(a) and 14 applications for registration under the provisions of Section 14(l)(b) were submitted to the Council. In all cases the premises were found to be satisfactory and the registration granted. Public Health (London) Act, Sec. 144 During the year three applications for the renewal of licences under the provisions of Sec. 57 (1) (a), to use premises as slaughterhouses were submitted to the Council and granted. Bacteriological Examination of Food Seven hundred and twentyfive samples of food were examined bacteriologically at the Public Health Laboratory during the year. They were as follows:— Milk (including Raw Raw Milk) Fresh Cream Synthetic Cream (Shops and Factories) Cake Fillings (other than synthetic cream) Artesian Well Waters Ice Cream Others Total for 1953 453 25 72 45 16 80 34 725 FOOD AND FOOD PREMISES 33 Milk Of the 453 samples of milk, 199 were submitted to the phosphatase test, 214 to the methylene blue reduction test, and 23 to the turbidity test. All these samples have been reported as complying with the prescribed tests. Fifteen samples of raw milk were examined for the presence of Mycobacterium tuberculosis and Brucella abortus. In each case negative results were obtained. Of two samples submitted on receipt of complaints of ratepayers both complaints were found to be justified. Fresh Cream Twentyfive samples were examined for the presence of pathogenic organisms. All were reported free of contamination. Synthetic Cream Seventytwo samples were examined for the presence of pathogenic organisms. All were reported free of contamination, with the exception of two, both of which had high bacterial counts and nonfaecal coli. These have since been rechecked and found free of contamination. Cake Fillings Fortyfive samples from six shops were examined for the presence of pathogenic organisms. Thirtynine of these were reported free of contamination. In the remaining six staphylococcus aureus was found. The cake fillings manufactured at the six shops have been rechecked and found free of contamination. Artesian Well Water Sixteen samples were submitted for examination, eleven were reported satisfactory, of the remaining five, all had a small plate count and three of these contained nonfaecal coli. The five have been rechecked and four of them are now satisfactory. The water from the remaining well is not now being used for drinking purposes. Icecream During the year 80 samples of icecream were tested in accordance with the technique suggested by the Ministry of Health and Public Health Laboratory Service. In two cases the laboratory was unable to carry out the methylene blue reduction test due to the presence in the icecream of certain colouring matters. These samples were examined at the Public Health Laboratory, Camberwell. 34 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 The following table gives a summary of the results:— Methylene Blue Reduction Test Coliform Test Provisional Grade Number of Samples Coliform in l/10th ml. (nonfaecal) Number of Samples 1 33 Bacillus coli—absent 40 2 4 „ „ —present 0 3 1 4 0 Total 38 Total 40 In addition, one sample of ice loliie was submitted to the coliform and methylene blue reduction tests. Bacillus coli was not isolated and provisional grading was grade 1. Others The remaining miscellaneous samples were all reported free of pathogenic organisms. Analysis of Food and Drugs During the year 1,000 samples of foods and drugs were procured for analysis: 265 samples of milk, 638 other foodstuffs and 97 drugs. Of these 251 were submitted as formal samples while 749 were purchased informally. None of the formal samples, and 2.0 per cent. of the informal samples, were found to be adulterated or not up to standard. The total adulterations reported were 15 or 1.5 per cent. of the samples submitted. The 15 samples found to be adulterated were:— three samples of tomato ketchup, two of icecream and one each of butter, cakeoma, fizz powder, peppermint flavour, canned beans, fish powder, canned sliced apples, soused herrings, bread, and lemonade powder. It was not necessary to take Police Court proceedings in any of the above cases of adulterated samples. FACTORIES ACT, 1937 Prescribed particulars required by Section 128 PART I. (1) INSPECTIONS. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (1) Factories in which Sections 1, 2, 3, 4 and 6 of the Act are to be enforced by Local Authorities 528 335 8 — (2) Factories not included above in which Section 7 of the Act is enforced by the Local Authority 1,065 1,026 15 — (3) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 7 7 1 — Total 1.600 1,368 24 — (2) DEFECTS. 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 H.M. Inspector Want of cleanliness 4 3 1 4 Overcrowding — — — — — Unreasonable temperature 1 1 — 1 — Inadequate ventilation 2 1 — 1 — Ineffective drainage of floors — — — — — Sanitary Conveniences (a) insufficient 3 3 2 (b) unsuitable or defective 77 42 — 24 — (c) not separate for sexes — — — — — Other offences against the Act (not including offences relating to outwork) 18 14 5 4 Total 105 64 6 36 — 35 36 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 PART VIII. SECTION 110. OUTWORK. Nature of work Number of outworkers in August list Number of cases of default in sending lists to the Council Number of prosecutions for failure to supply lists Wearing apparel—making, etc. 588 — — „ „ cleaning and washing 2 — — Fur pulling — — — Furniture and upholstery 21 — — Umbrellas, etc. 1 — — Artificial flowers 4 — — Household linen 5 — — Paper bags 12 — — Boxes or other receptacles made wholly or partially of paper 23 — — Brush making — — — Feather sorting 1 — — Carding, etc., of buttons, etc. 1 — — Stuffed toys 4 — — Cosaques, Christmas crackers, etc. 15 — — Lampshades 34 — — Lace, lace curtains and nets 1 — — Basket making 1 — — Total 713 — — REPORT OF THE WORK OF THE PUBLIC ANALYST FOR 1953 The Public Analyst, J. E. Woodhead, B.Sc., F.R.I.C., Ph.C. reports as follows. By virtue of the requirements of the Food and Drugs Act 1938, 1,000 samples were examined during the year ended 31st December, 1953, 903 of these were articles of food, and the remaining 97, drugs. All were submitted by the Council's Food Inspector, 251 having been taken with the formalities required by the Act and 749 informally. Samples of the following substances were analysed:—Beverages (cocoa, coffee, etc.) 14 samples; cereal preparations, 21; cream, 40; fish, canned, 34; fruit, canned, 46; icecream, 22; milk, 265pickles and sauces, 36; saccharin tablets, 10; spices and condiments, 19; suet, 3; vegetables, canned, 36; water ices, 23; aspirin tablets, 6; iodine solutions, 7; ointments, 11; seidlitz powders, 10. 37 38 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 Adulterated Samples Particulars of the samples reported as adulterated or not up to standard are given in the following table:— Case No. Nature of Sample Nature of Report Informal 1100 Tomato ketchup Copper on total solids 100 parts per million 1123 Canned beans Tin. 4 grains per lb. 1146 Tomato ketchup Copper on total solids 96 parts per million 1159 Fish paste Tin punctured, contents unfit for consumption 1199 Canned sliced apples Tin, 5.1 grains per lb. 1218 Tomato ketchup Copper on total solids, 25 parts per million 1352 Icecream 50% deficient in fat 1380 Cakeoma Rancid 1395 Butter Acid value too high, becoming rancid 1441 Icecream 13 % deficient in milk solids not fat 1456 "Fizz Powder" Contains free sodium bicarbonate 1466 Peppermint Flavour Dirty particles derived from cork 1611 Soused Herrings (canned) Unfit for consumption 1716 Lemonade Powder Contained undisclosed calcium acid phosphate. 1720 Bread Foreign matter; agglutinated fibres Adulteration The amount of adulteration detected during the year was:— For formal samples None For informal samples 2.0 per cent. For all samples 1.5 per cent. REPORT OF THE PUBLIC ANALYST FOR 1953 39 Complaint Samples Case No. 1154. Milk Coffee Chocolate. The nature of the complaint was that the article did not taste of coffee and the texture was not sufficiently smooth. Analysis proved that all the ingredients stated on the label were present and the article compared favourably with similar articles which have a wide sale. Case No. 1568. Yeastless Sausage Rusks. The complaint was considered not justified. Case No. 1612. Dried Skim Milk Powder. Submitted on the complaint that it was sour. The complaint was considered not justified. Special Sample—Ambrosia Chocolate. Submitted on the complaint that it caused poisoning. Analysis of this sample failed to reveal any poisonous metal or other substance likely to cause the stated symptoms. The complaint was considered not justified. Case No. 1283. Tinned Red Cherries. Submitted on the complaint that they were of poor quality. The complaint was considered not justified. Cases Nos. 1810 and 1811. Milk. Submitted on the complaint that they were sour. The complaint was considered justified. Milk The average composition of the samples of milk submitted during each month of the year and returned as genuine was as under:— Month Number Total solids Milk fat Nonfatty solids January 6 % % % 12.37 3.60 8.77 February 39 12.35 3.58 8.77 March 36 12.21 3.48 8.73 April 9 12.12 3.34 8.78 May 12 12.13 3.37 8.76 June 12 13.18 4.20 8.98 July 12 12.12 3.48 8.64 August 12 12.08 3.43 8.65 September 18 12.43 3.66 8.77 October 41 12.54 3.68 8.86 November 36 12.63 3.79 8.84 December 18 12.51 3.74 8.77 The average composition of the 226 samples of milk analysed during the year and returned as genuine was as under:— Total milk solids 12.39 per cent. Milk fat 3.61 per cent. Nonfatty solids 8.78 per cent. The average composition of the 39 samples of Channel Island and South Devon milks was as under:— Total milk solids 13.39 per cent. Milk fat 4.30 per cent. Nonfatty solids 9.09 per cent. INDEX PAGE Accidents, Deaths from 9 Acute Encephalitis 14 Analyst, Report of 37 Bacteriological Examinations of Milk 33 „ „ of Icecream 33 Bathing Pools and Swimming Pools 22 Bed Bugs, Eradication of 23 Births, Birth Rates 6 Butchers' Shops 28 Cancer 17 Childbirth, Deaths from 10 Circulatory diseases 17 Closing Orders 26 Crematorium 23 Cuttingoff Notices—Water Supply 21 Deaths, Causes of 9 Death Rates 8 Death Rate from Infective Diseases 11 Death Rate, Infantile 10 Deaths, Number of 9 Diphtheria 11 Diseased or Infirm Persons, Removal of 22 Disinfection 16 Enteric Fever 14 Erysipelas 15 Factories Act, 1937 35 Factories and Workshops 35 Food and Drugs Act, 1938 29 Food Poisoning 15 Food, Supervision of 27 Food Places, Inspection of 28 Food Places, Number on Register 27 Houses and Premises Inspected 19 Housing Act, 1936 24 Housing Statistics 24 Hydrogen Cyanide Disinfection 23 Illegitimate Children, Births of 6 Infant Mortality 10 41 42 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1953 PAGE Infective Diseases 11 Infective Diseases, Cases of 12 Infective Diseases, Death Rate from 11 Infirm or Diseased Persons, Removal of 22 Influenza, Deaths 15 Influenzal Pneumonia and Acute Primary Pneumonia 15 Insanitary Areas 26 Malaria 15 Maternal Mortality 10 Meat 30 Meningococcal Infection 14 Milk Analysis 40 Milk, Bacteriological Examination of 33 Milk Premises, etc., on Register 27 Milk (Special Designations) Regulations, 194950 29 Mortuary ., 23 Noninfective Diseases, Deaths from 17 Notification of Infective Diseases 12 Outworkers 36 Overcrowding 25 Pharmacy and Poisons Act, 1933 31 Pharmacy and Medicines Act, 1941 31 Piggeries 30 Poliomyelitis 14 Population 5 Pregnancy, Deaths from Accident and Diseases of 10 Preserved Meat, etc., Manufacture of 30 Public Analyst, Report 37 Puerperal Pyrexia 14 Pulmonary Tuberculosis, Notification of cases of 18 Ragwashing and Sterilization, Certificates 22 Rodent Control 21 Samples, Formal and Informal, Number of 37 Sanitary Inspection of Borough 19 Scabies 15 Scarlet Fever 11 Slaughterhouses 30 Slaughter of Animals Acts, 1933 30 Smallpox 11 Statistics for the Borough 6 Suicide, Deaths from . . 17 INDEX 43 PAGE Swimming Baths and Bathing Pools 22 Syphilis, Deaths from 15 Tuberculosis 18 Unsound Food 30 Water Supply 32 Water Supply, Cutting-ofF Notices 21 Whooping Cough 11 Printed by Geo. Gibbons Ltd., Leicester