AC 4388 WAN 96 Metropolitan Borough of Wandsworth ANNUAL REPORT of the Medical Officer of Health for the Year 1959 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 1959 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Wandsworth Mr. Mayor, Ladies and Gentlemen, I beg to present to you the Annual Report on the health of the Borough for the year 1959. It contains statistical information about the work of the Department but I refer in this introduction to one or two matters of special interest. There was a further increase in the total population of the Borough during the year to 338,800, an increase of nearly 1,000 on the previous year. The crude birth rate was slightly increased over the previous year at 15.7 per thousand and the adjusted birth rate at 15.07 per thousand was also somewhat above the rate for the previous year which was 14.68. The crude death rate was 14.83 per thousand, rather less than the previous year while the adjusted death rate at 10.53 per thousand was also less than the previous year which was 10.75 per thousand. One hundred and four infants aged under one year died compared with 100 in 1958, giving an infant mortality rate for all infants of 19.5 compared with 19.3 the previous year. This figure compares with 22.3 for the administrative County of London and 22.2 for England and Wales. There were three deaths from puerperal causes during the year compared with five last year, giving a maternal mortality rate of 0.55. 1959 was a "measles" year and as a result the total number of infectious diseases notified showed a marked increase over 1958; thus, 5,647 cases of infectious disease were notified of which 3,212 were cases of measles. 329 cases of scarlet fever were notified compared with 300 in the previous year, practically all being comparatively mild cases. Although 73 cases of poliomyelitis were reported to us and investigated, the diagnosis was confirmed in only 2 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 17 cases, of which seven had some form of residual paralysis. There was one death from this disease. The campaign for immunisation against poliomyelitis was continued during the year and approximately 20,000 people in the Borough of varying age groups, have been immunised under the arrangements made by the local Health Division of the London County Council. Eighty deaths were classified by the Registrar General to influenza, compared with 18 in the previous year. The increase in the number of deaths, most of which were in age group 65 and upwards, was attributable to the epidemic of influenza, fortunately comparatively mild, which occurred in the first quarter of the year. It should be noted that under the International Classification of Diseases, deaths from acute influenzal pneumonia are classified under the heading of influenza. The number of cases of tuberculosis brought to our notice was reduced from 589 to 491. The number of primary notifications remained almost steady at 260 compared with 267 in 1958, but there was a big diminution in the number of cases transferred from other authorities, namely, 228 as against 317. As I have pointed out in previous Reports, the extensive building which has, over the past four or five years, been proceeding particularly in the Putney/ Roehampton area of the Borough has partly accounted for the increase in the number of cases transferred from other authorities. As this new building comes to an end, it is to be expected that there will be fewer cases transferred from other authorities and this I think is the reason for the reduction noted here. Last year, for the first time, I introduced a small section into the Report dealing with accidents in the home. I have continued this in the current year and have included figures for 1959 calculated as described in last year's Report. According to these figures, there was an increase in home accidents from a total of 784 to 886 but the proportions of the various types of accidents do not appear to have varied very much. The exact significance of this which, on the face of it, is quite substantial, is a little difficult to understand. As I explained last year, these figures are not absolutely accurate but even allowing for this, one feels that this apparent increase does represent an actual increase in the number of home accidents. Included in the body of the Report is some up-to-date information about the steps taken under the Clean Air Act, 1956. I am glad to be able to report that considerable progress has been made and that during the year the Council's first Smoke Control area came into operation and that work has now been virtually completed in that area. The second Area has already been confirmed and it will come into operation in September, 1960. Meanwhile, work is proceeding on preliminary surveys of further areas and I hope to be able to report next year that a substantial area of the south-west part of the Borough is a Smoke Control area with encouraging progress being made in other parts of the Borough as well. 3 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 It is a pleasure once again to record the help and co-operation I have received during the year. Particularly would I like to thank Councillor Mrs. Olive Haines, the Chairman of the Public Health Committee; the staff of various other departments who have helped us and, of course, my own colleagues in the Health Department, for their good work throughout the year. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your Obedient Servant, J. TUDOR LEWIS Medical Officer of Health. STAFF OF PUBLIC HEALTH DEPARTMENT Medical Officer of Health Deputy Medical Officer of Health Chief Public Health Inspector Deputy Chief Public Health Inspector J. Tudor Lewis, m.d., d.p.h. A. Garland, m.d., m.r.c.p., d.p.h. E. V. Roots C. F. Standish Public Health Inspectors W. H. Jones A. E. Handley J. H. Massey P. P. Leacock J. H. Sands A. J. Lansley S. R. Coomber A. E. Lock C. Jones J. Smith D. J. Hughes P. O'Grady K. J. Winton E. R. Potts A. F. Cayley Trainee Public Health Inspectors J. D. Morritt M. Timlin J. F. Burslem Administrative and Clerical S. F. Jennings A. J. K. Green A. E. Hollis E. Harris W. Pitman F. Chislett S. Taylor A. J. Brown D. H. Barnes N. Lane Mrs. F. Hull Miss J. Eley Mrs. P. McKeown C. F. Harrison J. Weir 4 5 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 STAFF OF PUBLIC HEALTH DEPARTMENT—Continued Disinfecting Station F. Stennings J. Williams H. Coster G. W. Price L. D. Dean A. E. Clement R. A. Levey Mortuary J. Anderson Rodent Operatives J. W. Taylor J. Wells G. J. Langrish W. Maxwell V. T. Athaide The following changes occurred in 1959: Appointments Mr. E. R. Potts, Public Health Inspector. Appointed in December. Mr. J. F. Burslem, Trainee Public Health Inspector. Appointed in August. Resignations Mr. J. W. Marshall, Public Health Inspector. Resigned in February. Mr. J. R. Holloway, Public Health Inspector. Resigned in July. 1 STATISTICS AND SOCIAL CONDITIONS Area 9,201 acres Resident population in 1959 338,800 Wandsworth is the largest of the Metropolitan Boroughs. It has an area of 9,201 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 which have rapidly been added to by the development of new housing estates by the Borough Council and London County Council. The chief industries carried on are the manufacture of gas, electricity and motor accessories, laundries and general engineering. 6 7 STATISTICS AND SOCIAL CONDITIONS Extracts from Vital Statistics Number of Live Births: Males Females Total Legitimate 2,469 2,392 4,861 Illegitimate 237 223 460 Total live births 2,706 2,615 5,321 Number of Stillbirths 58 43 101 Number of deaths 2,381 2,645 5,026 Birth-rate—Crude 15.70 Adjusted 15.07 Death-rate—Crude 14.83 Adjusted 10.53 Rate per 1,000 (Live and Still) Births Deaths from puerperal causes 3 0.55 Infantile mortality per 1,000 live births: All infants 19.5 Legitimate infants 20.3 Illegitimate infants 10.8 Deaths from Cancer 855 „ „ Diphtheria 0 „ „ Scarlet Fever 0 „ „ Measles 1 „ „ Whooping Cough 0 „ „ Tuberculosis 38 Tuberculosis death-rate 0.11 There has been no unusual or excessive mortality during the year. 2 VITAL STATISTICS Population The civilian population at the middle of the year was estimated by the Registrar-General to be 338,800 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 1959 Putney 88,000 Central 96,500 Clapham 81,250 Streatham 73,050 Whole Borough 338,800 Births The total number of births belonging to the Borough registered during 1959 was 5,321 consisting of 2,706 males and 2,615 females. The number for 1958 was 5,173 The crude birth-rate was 15.70 per 1,000 persons living compared with 15.30 for 1958. The adjusted rate works out at 15.07 after taking into account the area comparability factor supplied by the Registrar-General. The birth-rate for England and Wales as a whole was 16.5 and for London 17.3. Four hundred and sixty illegitimate births took place in the Borough compared with 422 in 1958. 8 9 VITAL STATISTICS Deaths The number of registered deaths which took place in the Borough during the year was 3,841 but 769 of these did not belong to the Borough, while 1,954 Borough residents died outside the Borough. The corrected number of deaths for the Borough, after allowing for these factors, was 5,026, of whom 2,381 were males and 2,645 females. The crude death-rate for the year was 14.83, compared with 15.37 for 1958, but after taking into account the area comparability factor supplied by the Registrar-General, the adjusted rate works out at 10.53. The death-rate for England and Wales as a whole was 11.6 and for London 11.9. Table II shows the total number of registered deaths and the death-rates for each division based on the approximate population in each division. TABLE II Corrected Deaths Death Rate Males Females Total Putney 589 638 1,227 13.94 Central 896 1,032 1,928 19.98 Clapham 482 519 1,001 12.32 Streatham 414 456 870 11.91 Whole Borough 2,381 2,645 5,026 14.83 10 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 CAUSES OF DEATH DEATHS IN OR BELONGING TO WHOLE DISTRICT AT SUBJOINED AGES DEATHS IN OR BELONGING TO LOCALITIES (ALL AGES) 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. TABLE III. causes of, and ages at death, during the year 1959 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 32 23 9 — — — 4 12 16 8 12 8 4 Tuberculosis, Other 6 4 2 — 2 — — 2 2 1 — 5 — Syphilitic Disease 14 6 8 — — — — 5 9 4 7 1 2 Diphtheria — — — — — — — — — — — — — Whooping Cough — — — — — — — — — — — — Meningococcal Infections 1 1 — — — — 1 — — 1 — — — Acute Poliomylitis 1 1 — — 1 — — — — 1 — — — Measles 1 1 — — 1 — — — — 1 — — — Other Infective and Parasitic Diseases 9 3 6 — — 1 3 2 3 — 4 3 2 Malignant Neoplasm, Stomach 117 62 55 — — — 3 25 89 24 40 38 15 Malignant Neoplasm, Lung, Bronchus 226 191 35 — — — 11 119 96 57 76 53 40 Malignant Neoplasm, Breast 87 1 86 — — — 14 30 43 19 26 25 17 Malignant Neoplasm, Uterus 36 — 36 — — — 3 18 15 8 7 13 8 Other Malignant and Lymphatic Neoplasms 389 193 196 1 — 2 29 138 219 96 102 129 62 Leukaemia, Aleukaemia 23 7 16 — 2 — 4 8 9 5 11 3 4 Diabetes 24 11 13 — — — 2 4 18 3 10 8 3 Vascular Lesions of Nervous System 479 164 315 — — 1 1 82 395 126 183 89 81 Coronary Disease, Angina 695 403 292 — — 10 194 491 190 216 146 143 Hypertension, with Heart Disease 82 33 49 — — — 2 13 67 23 31 17 11 Other Heart Disease 910 334 576 — — — 7 48 855 202 418 126 164 Other Circulatory Disease 240 97 143 — — — 2 41 197 72 114 30 24 Influenza 80 38 42 — — 1 3 15 61 23 35 11 11 Pneumonia 358 138 220 8 6 5 8 30 301 71 112 87 88 Bronchitis 325 217 108 7 3 3 7 65 240 62 160 54 49 Other Diseases of Respiratory System 53 38 15 — — 2 3 16 32 13 16 11 13 Ulcer of Stomach and Duodenum 50 36 14 — — — — 11 39 13 24 5 8 Gastritis, Enteritis, Diarrhœa 25 8 17 3 1 — — 3 18 4 11 5 5 Nephritis and Nephrosis 24 14 10 — — — 3 5 16 6 7 6 5 Hyperplasia of Prostate 38 38 — — — — — 2 36 9 13 9 7 Pregnancy, Childbirth, Abortion 3 — 3 — — — 3 — — 1 — 2 — Congenital Malformations 47 28 19 30 4 3 3 3 4 14 14 13 6 Other Defined and Ill-defined Disease 450 177 274 53 1 11 32 54 300 109 219 64 59 Motor Vehicle Accidents 42 24 18 1 — — 16 5 20 8 11 10 13 All other Accidents 86 47 39 1 — 3 20 17 45 26 29 17 14 Suicide 63 42 21 — — — 16 31 16 22 17 13 11 Homicide and Operations of War 9 1 8 — — — 4 2 3 5 3 — 1 All Causes 5,026 2,381 2,645 104 21 32 214 1,000 3,655 1,227 1,928 1,001 870 11 VITAL STATISTICS TABLE III (a). DEATHS FROM HEART DISEASE, 1959 Males in age groups Females in age groups M. & F. Total 1—5 5—15 15— 45 45— 65 65 up Total 1—5 5—15 15— 45 45— 65 65 up Total Coronary Disease, Angina, etc. — — 9 153 241 403 — — 1 41 250 292 695 Hypertension with Heart Disease — — — 7 26 33 — — 2 6 41 49 82 Other Heart Disease — — 2 23 309 334 — — 5 25 546 576 910 — — 11 183 576 770 — — 8 72 837 917 1,687 Infantile Mortality There were 104 deaths of children under one year giving an infant mortality rate of 19.5 per 1,000 live births. This compares with a rate of 19 for 1958 and 15 for 1957. For the ten years ended 1949 the average infant mortality rate was 37 while for the ten year period ending 1959, the average rate was 20. Maternal Mortality Three deaths occurred from accidents and diseases of pregnancy or child-birth. This is equivalent to a rate of 0.55 per 1,000 live and still-births. 3 INFECTIVE DISEASES The number of deaths from all notifiable infectious diseases was 144. This included 38 from all forms of tuberculosis and 103 from the notifiable forms of pneumonia. There was one death from poliomyelitis. From all notifiable infective diseases the death-rate was 0.42 per 1,000. Table I shows the number of cases of the notifiable diseases reported, arranged in age groups, and Table II shows the same figures arranged in the sub-district in which they occurred. Smallpox No case occurred in the Borough during the year. Notification is 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 Several suspected cases were reported and investigated, but in no case was the diagnosis confirmed. Scarlet Fever Three hundred and twenty-nine cases were notified compared with 301 in 1958 and 235 in 1957. No deaths occurred. Whooping Cough One hundred and eleven cases were notified. There were no deaths. Measles The number of cases notified during the year was 3,212 compared with 1,602 in 1958, 3,802 in 1957 and 677 in 1956. One death occurred. 12 13 INFECTIVE DISEASES TABLE I NOTIFIABLE DISEASES NO. OF CASES OF INFECTIVE DISEASES GROUPED IN AGE-PERIOD Total Under 1 1-2 3-4 5-9 10-14 15-24 25-44 45-64 65 and upwards Anthrax — — — — — — — — — — Diphtheria — — — — — — — — — — Dysentery 403 13 61 69 95 34 30 81 20 — Encephalitis, Acute 5 — — — 2 1 1 — 1 — Erysipelas 33 — — — — 2 3 5 14 9 Food Poisoning 648 4 25 37 145 210 126 43 42 16 Malaria — — — — — — — — — — Measles 3,212 86 613 874 1,559 45 20 15 — — Meningococcal Infection 8 3 1 — 2 1 1 — — — Ophthalmia Neonatorum 3 3 — — — — — — — — Pneumonia: Acute Influenzal 134 2 3 10 9 8 12 18 38 34 Acute Primary 132 2 4 8 5 10 9 18 44 32 Poliomyelitis, Acute 17 — 3 3 6 1 2 1 1 — Puerperal Pyrexia 99 — — — — — 43 56 — — Scabies 14 — — — 2 3 1 8 — — Scarlet Fever 329 4 20 63 166 55 16 5 — — Smallpox — — — — — — — — — — Tuberculosis 491 2 8 4 11 12 106 200 114 34 Typhoid Fever and Paratyphoid Fever 8 — 1 — 1 1 — 3 1 1 Whooping Cough 111 10 36 29 32 3 1 — — — Total 5,647 129 775 1,097 2,035 386 371 453 275 126 14 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 TABLE II NOTIFIABLE DISEASES TOTAL CASES OF INFECTIVE DISEASES OCCURRING IN EACH WARD Whole Borough Deaths PUTNEY CENTRAL CLAPHAM STREATHAM Putney Thamesfield Fairfield West Hill Southfield Earisfield Springfield Tooting Graveney Bedford Larkhall Clapham North Clapham Park Thornton Balham Streatham Hill St. Leonards Streatham Common Streatham South Furzedown Anthrax — — — — — — — — — — — — — — — — — — — — — — Diphtheria — — — — — — — — — — — — — — — — — — — — — — Dysentery 21 4 10 13 8 26 26 50 72 52 11 4 9 14 20 17 15 11 18 2 403 — Encephalitis, Acute 2 — — — — — — 3 — — — — — — — — — — — — 5 — Erysipelas 3 1 2 — — 4 3 6 3 3 2 2 1 1 1 — — — — 1 33 — Food Poisoning 22 1 45 3 4 80 7 396 49 2 2 3 5 2 5 16 1 2 — 3 648 — Malaria — — — — — — — — — — — — — — — — — — — — — — Measles 782 134 153 215 95 177 210 155 223 125 144 167 166 171 117 109 122 122 95 230 3,212 1 Meningococcal Infection 1 — 1 — — 1 — 2 — — 2 — — — — — — — — — 8 1 Ophthalmia Neonatorum 1 — 1 — — — — — — 1 — — — — — — — — — — 3 — Pneumonia:— Acute Influenzal 6 8 7 15 4 13 18 9 8 11 5 8 5 3 4 2 2 1 1 4 134 45 Acute Primary 5 6 5 8 1 9 2 7 14 9 17 5 4 3 9 6 5 6 6 5 132 58 Poliomyelitis, Acute 2 2 1 5 — — 3 2 — 1 — — — — — — 1 — — — 17 1 Puerperal Pyrexia 1 — 1 1 1 1 1 3 4 9 2 9 17 18 10 3 1 1 1 13 99 — Scabies — — 1 — 1 1 — 1 1 — 6 1 — — 1 — — 1 — — 14 — Scarlet Fever 10 8 16 29 6 75 34 23 10 14 31 34 18 8 5 8 13 16 11 10 329 — Smallpox — — — — — — — — — — — — — — — — — — — — — — Tuberculosis—all forms 20 13 20 19 20 19 28 29 73 31 28 28 24 18 26 29 19 18 19 10 491 38 Typhoid Fever and Paratyphoid Fever — — — — — — — 1 — 2 — — — 4 — — — — — 1 8 — Whooping Cough 12 1 4 1 1 8 3 10 4 9 9 1 9 10 5 3 4 9 2 6 111 — Total 438 178 267 309 141 364 335 697 411 269 259 262 258 252 203 193 183 189 154 285 5,647 144 15 INFECTIVE DISEASES Poliomyelitis Seventy-three cases of this disease were reported and investigated during the year, compared to 65 in the previous year. In 56 cases the diagnosis was not confirmed. Of the remaining 17 confirmed cases, 13 were of the paralytic type and four non-paralytic. One death occurred, in a male aged two years. Main incidence of the cases occurred in the months of July to September. The figures of poliomyelitis from 1947 to 1959, the period during which the incidence of the disease in this country has been high, is shown in the following table:— 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 No. of cases reported as suspected poliomyelitis and investigated 119 31 89 71 29 73 73 41 104 85 147 65 73 No. of cases confirmed (a) paralytic 78 15 58 40 4 23 19 5 22 24 43 11 13 (b) non- paralytic 7 16 8 2 27 15 28 9 4 Deaths 4 6 4 7 — 5 2 — 1 2 4 1 1 Meningococcal Infection Eight confirmed cases were notified, none of which proved fatal. Fifteen other cases were investigated but these were subsequently not confirmed. In addition, one death, actually occurring outside the borough, of a Wandsworth resident, was allocated to Wandsworth by the Registrar General. In 1958 there were 13 confirmed cases with no deaths. Acute Encephalitis Of 11 cases reported, one was confirmed as acute lymphocytic meningitis (acute infective encephalitis) and four as post-infectious encephalitis. Total five cases for this year. Three of these cases related to patients resident outside the borough, but notified by hospitals in the borough and included in the weekly returns to the Registrar General's Office in accordance with the regulations. The remaining six cases investigated were not confirmed. No deaths occurred. 16 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 Typhoid and Paratyphoid Fever Of 12 cases reported during the year, five were subsequently confirmed as typhoid and three as paratyphoid. Two of the former had been previously living abroad. Diagnosis was not confirmed in the four remaining cases. One death occurred in a male aged 58 years. Puerperal Pyrexia During the year 99 cases were notified, of which 95 occurred in hospital and four at home. Thirty-four of the hospital notifications referred to patients whose home addresses were outside the borough. Information was also received of 34 cases, referring to Wandsworth residents whose confinements took place in hospitals located in other Metropolitan boroughs. Sonne Dysentery In addition to the cases for which formal notifications were received and which, in the main, were single unrelated cases, a number of other cases were discovered by investigation of diarrhoea outbreaks which occurred at five Day Nurseries and two Schools in the Borough. Details of positive cases, and the number of faecal specimens examined from actual and suspected cases before the outbreaks were finally cleared are given below. General practitioners co-operated fully with the Health Department in its investigation and systematic follow-up of all cases of dysentery throughout the year. Date Outbreak No. of cases discovered No. of specimens examined from cases and contacts January 1 (D.N.) 25 130 January 2 (S.) 30 114 March 3 (S.) 38 140 April 4 (D.N.) 10 36 June 5 (D.N.) 29 133 November 6 (D.N.) 28 220 December 7 (D.N.) 4 116 Influenza, Acute Influenzal Pneumonia and Acute Primary Pneumonia Acute influenzal pneumonia and acute primary pneumonia are the notifiable forms of pneumonia. One hundred and thirty-four cases of the former and 132 cases of the latter were notified. Deaths classified under influenza were 80 and this figure includes 17 INFECTIVE DISEASES 45 deaths attributable to acute influenzal pneumonia. Deaths in previous years were 18 in 1958, 58 in 1957 and 30 in 1956. The number of deaths from acute primary pneumonia was 58 and this figure, together with deaths from other forms of pneumonia, made a total of 358 compared with 295 in 1958. Malaria No cases were reported. Erysipelas Thirty-three cases were notified. Other Infective Diseases Fourteen deaths occurred from syphilis. Scabies Fourteen notifications were received. Thirty-one treatments were given at the Council's Disinfecting Station during the year. At the Battersea Cleansing Station, a total of 154 treatments for scabies and verminous conditions was given to women residents (and children under school age) of Wandsworth in accordance with the arrangements made by this Council with the Battersea Borough Council in 1955. Food Poisoning Two hundred and sixty-one formal notifications were investigated during the year. Two hundred and nineteen were single unrelated cases and 42 comprised 24 minor family outbreaks involving two or more persons. The majority of the single cases were only slightly affected and where bacteriological examination was carried out, organisms likely to have caused the illness were discovered in 24 cases. The organisms isolated were Salmonellae typhimurium (18), thompson (2), munchen, newport, enteriditis and bovis morbificans. In 21 of the minor outbreaks it was not possible to identify the causative agent and in the remaining three, the organism Salmonella typhimurium was isolated. In addition to the above cases, two other outbreaks were reported, one occurring at a hospital in the borough and the other at a school. These outbreaks involved a total of 387 persons, 371 of whom constituted the hospital outbreak. The remaining one involved 16 persons. From bacteriological investigation of a number of those affected, it appeared that both of these outbreaks were due to heat resistant Clostridium welchii. Full reports were submitted to the Ministry of Health in accordance with the M.O.H. revised Memo. 188/Med. 18 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 Diseases Reported from Schools A total of 2,418 infective diseases was reported from schools in the Borough throughout the year. The numbers of each disease were: Scarlet Fever 224 Measles 986 German Measles 92 Poliomyelitis 9 Chicken Pox 563 Whooping Cough 45 Mumps 152 Dysentery 157 Other Diseases 190 Disinfection During the year 540 rooms were disinfected after infectious and other disease, 496 rooms disinfected for vermin, and 41 rooms for miscellaneous conditions. Bacteriological Examinations All bacteriological examinations are 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 693 Faeces for the typhoid and dysentery groups 3,498 Miscellaneous specimens 13 Total 4,204 Contacts of Infectious Disease—Exclusion from work It is sometimes considered necessary, in order to prevent the spread of infection, to exclude from work for a period certain contacts of infectious disease. This applies particularly to persons engaged in food handling and the requisite authority for the Medical Officer of Health to exclude such persons from work is given under regulations made under the National Insurance Act, 1946, and the Public Health (Infectious Disease) Regulations, 1953. During the year three contacts of infectious disease were excluded from work and issued with certificates enabling them to draw National Health sickness benefit. NON-INFECTIVE DISEASES The total number of deaths from cancer and malignant disease was 878, the number of males being 454 and females 424. The death rate was 2.58 per 1,000. The number of deaths in 1959 was 296 less than in the previous year. This fall in cancer deaths is due to the fact that at the beginning of 1959 a revision was made by the Registrar General in the allocation of deaths at one of the hospitals in the borough. Deaths previously allocated to Wandsworth are now allocated to the areas in which the patients were previously living. Deaths from diseases of the heart and circulatory system were 1,927 compared with 1,955 in 1958. Of these deaths 1,610 were of persons of 65 years of age and above. There were 736 deaths from diseases of the respiratory system compared with 646 in 1958. The number of deaths from bronchitis was 325 compared with 305 in 1958, and from pneumonia (all forms) 358 compared with 295 in 1958. Two hundred deaths were due to violence, 42 of them being due to motor accidents, 63 to suicide and 95 to other forms of violence. CERTIFICATES OF VACCINATION AND INOCULATION Two thousand, two hundred and ninety-four 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 11 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 nine cases it was found necessary to recommend superannuation. Sixty shorter reports on members of the staff who were sick were obtained from doctors and hospitals at the request of the departments concerned. 19 TUBERCULOSIS Notifications The total number of new cases which came to the notice of the Department during 1959 was 488 compared with 589 in 1958. The sources of information regarding the new cases were as follows: Primary notifications on Form A 260 Notifications from H.M. Forces 1 Unnotified at death 2 Transfers from other sanitary authorities 228 Total 491 Four hundred and eighty-nine cases were added to the notification register during the year and 208 cases who had removed, recovered or died, were taken off. The number remaining on the register at the end of the year was 6,061. Deaths The number of deaths certified as due to various forms of tuberculosis was 38. Particulars of the new cases and deaths during the year, classified by sexes and age-groups are given in the following table: Age Periods New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under 1 year 2 — — — — — — — 1-2 6 1 1 — — — 1 1 2-5 3 1 — — — — — — 5-10 4 7 — — — — — — 10-15 3 9 — — — — — — 15-25 42 55 2 7 — — — — 25-45 94 99 5 2 3 1 — — 45-65 86 26 1 1 9 3 1 1 65 and upwards 19 10 2 3 11 5 2 — Totals 259 208 11 13 23 9 4 2 20 4 SANITARY INSPECTION OF THE BOROUGH Work of the Public Health Inspectors A summary of the inspections carried out by the Inspectors is given in Table I. TABLE I Inspections ReInspections Total To investigate complaints 5,986 12,870 18,856 Inspections under Shops Act 231 — 231 Infectious Diseases 2,020 708 2,728 Inspections under Factories Act.. 2,040 — 2,040 Housing Clearance Area Scheme 187 — 187 Housing Reports 309 — 309 Hairdressers 221 — 221 Other inspections 8,478 2,124 10,602 Totals 19,472 15,702 35,174 Smoke observations 315 Legal proceedings, attendances at court 34 Table II gives details of the sanitary operations carried out in the Borough during the year. The number of drains which were tested was 423 and 956 were cleansed or repaired. The drains of nine houses were reconstructed, and 140 drains were partially reconstructed. Damp conditions have been remedied in 779 premises, and in two of these damp courses were inserted. 21 22 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 Table II Putney Central Clapham Streatham Whole Borough 1. Premises cleansed and repaired 128 270 214 83 695 2. Drains tested 83 134 76 130 423 3. Drains cleansed or repaired 265 277 163 251 956 4. Water closets cleansed, repaired or renewed 62 127 96 116 401 5. Soil pipes altered or repaired 8 27 7 11 53 6. Waste pipes provided, altered or repaired 52 88 57 79 276 7. Rainwater pipes repaired 13 26 10 14 63 8. Roofs and gutters repaired 95 181 110 74 460 9. Damp courses inserted 1 1 — — 2 10. Damp conditions otherwise remedied 97 155 146 72 470 11. Yards drained or paved 3 11 4 4 22 12. Dustbins provided 6 38 29 13 86 13. Water cisterns cleansed, covered or repaired 5 3 5 2 15 14. Water supply reinstated 53 50 41 62 206 15. Defective stoves and fireplaces remedied 15 33 13 11 72 16. Animals improperly kept — 3 3 1 7 17. Accumulations of rubbish, etc., removed 2 26 8 14 50 18. Urinals cleansed or repaired — 3 2 4 9 19. Smoke nuisances 11 16 8 2 37 20. Other nuisances 5 16 13 7 41 Total 904 1,485 1,005 950 4,344 Number of Preliminary Notices served 252 478 374 188 1,292 Number of Preliminary Notices complied with 250 526 367 202 1,345 Number of Nuisance Notices served 62 147 116 45 370 Number of Nuisance Notices complied with 71 184 98 60 413 23 SANITARY INSPECTION OF THE BOROUGH Water Supply—Cutting-off Notices During the year notices with respect to 220 premises were received from the Metropolitan Water Board stating that the supply had been withdrawn. In 52 premises the water supply was cut off for non-payment of rates, and in 168 premises because of defects in the service. Dustbin Accommodation—Section 105, Public Health (London) Act, 1936, and Section 12, London County Council (General Powers) Act, 1954 Action was taken under the above-mentioned Acts in respect of 82 premises and during this period 79 dustbins were provided. Dustbins were also provided at seven premises without the necessity of action under the Acts. Rodent Control One thousand, seven hundred and eighty-five rat and mice complaints were received during the year. Following is a summary of the work of the rodent operatives: Number of operatives' visits to premises 8,925 „ „ premises treated with "Warfarin" 927 „ „ premises "Warfarin" laid and found not troubled 87 „ „ premises investigated and found not troubled 163 „ „ "Warfarin" baits laid 4,463 „ „ drains tested by Public Health Inspector 314 „ „ drains found defective 237 „ „ rats estimated killed 2,357 At the close of the year, there were five rodent operatives and one clerk engaged on rodent control duties under the supervision of a Public Health Inspector. Public Swimming Baths There are in the Borough the following public swimming baths: Four indoor swimming baths owned by the Borough Council. One open air swimming bath owned by the Borough Council. One open air swimming bath owned by the London County Council. 24 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 The source of water for one of the Borough Council's baths is from an artesian well and for the other baths, including that owned by the London County Council, from the Metropolitan Water Board's supply. Up to 18 months ago, one of the Borough Council's baths was operated on the "fill and empty" system but a modern filtration and chlorinating plant has now been installed so that all the public swimming baths in the Borough now operate a modern process of continuous circulation through a filtration plant with chlorination of the water. The same process operates in the case of the London County Council open air swimming bath. During the year bacteriological samples were taken from the Borough Council baths and the bacteriological reports were satisfactory. In the case of the London County Council open air bath, I am informed that samples were also taken which also were found to be satisfactory. In addition to the public swimming baths, there are four private swimming baths in the Borough, to one of which the public may be admitted. These all have continuous filtration and chlorination plants and some bacteriological samples were taken during the year which proved to be satisfactory. 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 neccessity of having to take action under Section 47 of the National Assistance Act, 1948. Laundering of Bed Linen of Aged and Infirm Facilities have been made available by the Council for the cleansing of fouled bed linen and personal effects of aged and incontinent persons living alone. At the beginning of the year collections and washing of bed linen in respect of three such cases were being dealt with and a further 18 cases were investigated during the year. In the majority of these, it has been necessary to arrange for the articles to be collected at regular intervals for cleansing and return to the owners. A total of 401 lots of fouled linen were collected and cleansed in 1959. 25 SANITARY INSPECTION OF THE BOROUGH Eradication of Bed Bugs The methods employed for freeing infested houses includes 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 236 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 Under the arrangements made in 1956 with Battersea Borough Council, their mortuary continued to be used for the reception of bodies of Wandsworth residents. During the year, in addition to the reception of bodies of persons dying in Battersea, the mortuary received 659 bodies of persons who died in Wandsworth. Crematorium Under the Crematorium Regulations, 1930, 1,582 cremations were authorised during 1959, compared with 1,495 in 1958. 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 1959 was 31. 5 HOUSING STATISTICS RELATING TO HOUSING Public Health (London) Act, 1936 Number of houses inspected on account of complaints or illness 8,006 Re-inspections 13,578 Number of statutory notices served: Intimation notices 1,292 Nuisance notices 370 Number of houses in which nuisances were abated 1,306 The number of cases referred to the Solicitor for legal action during 1959 was 121 The following is a summary of Police Court proceedings: Number of summonses served 47 „ „ „ withdrawn 18 „ „ „ adjourned 10 „ „ „ dismissed 1 „ „ Orders made for abatement of nuisances 18 Housing Acts, 1936 and 1957 Demolition Orders (a) Demolition Orders made under Section 17 (1) of the Housing Act, 1957 1 (b) Houses demolished as the result of formal or informal procedure Nil (c) Houses closed in pursuance of an undertaking given by the owner and still in force Nil Closing Orders (a) Closing Orders made under Sections 16 (4), 17 (1) and 35 (1) Housing Act, 1957 5 (b) Closing Orders made on parts of buildings under Section 18, Housing Act, 1957 11 (c) Closing Orders determined 2 (d) Undertakings not to use parts of buildings for human habitation accepted Nil Slum Clearance Number of houses included in representations under Section 157 of the Housing Act, 1957 24 Number of houses demolished following action under Section 25 of the Housing Act, 1936 50 26 27 HOUSING Overcrowding Number of families found to be living in overcrowded conditions 23 Number of overcrowded families who have obtained alternative accommodation 8 New Accommodation Number of dwellings erected:— (a) by the Borough Council 129 (b) by the L.C.C 138 (c) by other persons 165 The Rent Act, 1957 Applications for Certificates of Disrepair. One hundred and twenty-four applications were received for Certificates of Disrepair and were dealt with as follows:— (a) In four cases it was decided not to issue Certificates of Disrepair as the premises were not in disrepair by reason of defects. (b) In one hundred and twenty cases it was decided to serve notices on landlords proposing to issue Certificates of Disrepair unless undertakings to do repairs were given. (c) Seventy-two undertakings were received from landlords to remedy defects proposed to be included in Certificates of Disrepair. (d) Forty-three Certificates of Disrepair were issued. Applications for Cancellation of Certificates. (a) Sixty-nine applications were received from landlords for the cancellation of Certificates of Disrepair. (b) Thirty-two objections were received from tenants for cancellation of Certificates. (c) In eight cases it was considered that the tenants' objections were not justified and the Certificates cancelled. (d) Thirty-seven Certificates of Disrepair were cancelled. 28 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 Housing Accommodation—Medical Priority During the year 881 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 165 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. UNFIT HOUSES SLUM CLEARANCE The following properties were declared Clearance Areas following my representations: 91/99 (odd) Alma Road, 165/169 (odd), 177/187 (odd), 189/189a, 193/195 (odd), Clapham Park Road and 129/141 (odd), 143/165 (odd) Garratt Lane. INDIVIDUAL UNFIT HOUSES OR BASEMENTS Closing Orders were made on premises at 28 Courland Grove, 18 Crescent Grove, 3 Fernlea Road, 43 Fernlea Road, 45 Fernlea Road, 46 Fernlea Road, 48 Fernlea Road, 7 Grafton Square, 82 Mount Nod Road, 5a Old Town, 6 Pitcairn Street, 10 Pitcairn Street, 20 Rectory Grove, 477 York Road, 6a Zennor Road and 10a Zennor Road. In each case the owners had been invited to submit proposals to render the premises fit for human habitation, but none were received. In addition, a Demolition Order was made in respect of the premises at 82 Putney Bridge Road. 6 FOOD AND FOOD PREMISES 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 up to date. 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 2,739 and during 1959 they were visited on 8,790 occasions. Table I has been drawn up to show the number of visits to various food premises in different parts of the Borough. Supervision of the food supply is carried out by four senior Inspectors who each procure samples of food and drugs for analysis by the Public Analyst and the Public Health Laboratory. They also supervise premises where food is sold, stored, manufactured or prepared for sale and carry out the duties required under the Pharmacy and Poisons Act 1933 and Pharmacy and Medicines Act, 1941. District inspectors holding the additional certificate of Inspector for Food and Drugs carry out the day-to-day supervision of the catering establishments in their respective areas. Food Hygiene Regulations, 1955 The work in connection with food hygiene was continued throughout the year to premises in the Borough where food is handled. Occupiers of food premises were, on the whole, co-operative and receptive to suggestions made by the Inspectors for necessary improvements, and a good deal of work was completed during the year. A Court summons was taken out against a local trader for the presence of foreign matter in food. Costs of £3 3s. were awarded by the Court. The following list shows the number and type of premises in the Borough where food is sold, stored or prepared:— Dairies and Milk Depots 9 Food Factories 24 Restaurants, Cafes and Canteens 467 Bakers and Confectioners 536 Butchers 217 29 30 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 TABLE I SUMMARY OF VISITS TO FOOD PREMISES Putney Central Clapham Streatham Whole Borough Dairies and Shops distributing Milk 37 60 74 116 287 Restaurant Kitchens 552 445 371 378 1,746 Ice Cream Premises 23 49 4 30 106 Butchers’ Shops 331 117 152 103 703 Greengrocers’ Shops 122 27 50 62 261 Fishmongers’ Shops 82 8 14 25 129 Fried Fish Shops 66 17 46 31 160 Market Stalls 137 1056 776 141 2,110 Grocers’ Shops 635 491 476 526 2,128 Confectioners’ Shops 197 107 117 90 511 Bakehouses 56 25 51 7 139 Other Premises 189 129 137 55 510 Total Visits 2,427 2,531 2,268 1,564 8,790 31 FOOD AND FOOD PREMISES Greengrocers 255 Fishmongers 76 Fish fryers 61 Bakehouses 57 Grocers 639 Off Licences 98 Public Houses 151 Stalls 149 2,739 The amount of work completed during 1959 to comply with the requirements of the Regulations is indicated in the following details Washhand basins provided 66 Sinks provided 16 Provision of hot water over sink and washhand basin 23 Accommodation for clothing provided 3 Soap, towel and nailbrush 1 First-aid materials provided 1 Premises repaired or redecorated 48 Adequate protection for open food 12 Notices to employees 9 Dustbins 3 W.C. accommodation 9 Smoking 6 Milk Supply The Milk and Dairies General Regulations, 1959 These Regulations came into force on 8th March, 1959, 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. 32 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 During the year 32 applications were received from persons to be registered as distributors of milk. In each case the certificate of registration was granted. Forty-two notices of cancellation of registration were received. At the end of the year there were 221 persons on the register, including 20 persons with premises outside the Borough. There were two 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. Food and Drugs Act, 1955 Three hundred and fifteen samples of milk were submitted for analysis. Of these 32 were samples of Channel Island and South Devon milks with an average fat content of 4.42 per cent. The remaining 283 samples had an average fat content of 3.59 per cent. The Milk (Special Designation) (Raw Milk) Regulations, 1949-1954, and the Milk (Special Designation) (Pasteurized and Sterilized Milk) Regulations, 1949-1953. 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: "Pasteurized" "Sterilized" "Tuberculin Tested" The following licences for the sale of milk under these designations were granted during the year: Dealers’ Dealers’ Supplementary Total Pasteurized 198 28 226 Sterilized 216 32 248 Tuberculin Tested 144 27 171 Total 558 87 645 Two distributors’ (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. 33 FOOD AND FOOD PREMISES Meat There are 217 butchers’ shops in the Borough. The majority are registered under Section 16 (1)(b) of the Food and Drugs Act, 1955, for the preparation or manufacture of sausages or potted, preserved, pickled or pressed foods. There were 703 visits made to these shops during the year. Slaughter of Animals There are no private slaughterhouses in the Borough. Slaughter of Animals Act, 1933-1954 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 no applications from persons desirous of acting as slaughtermen were received by the Council. Unsound Food Sixty-eight 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. 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 1959 was 372, and 632 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 II. The majority of the listed sellers are also purveyors of food. 34 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 TABLE II PART II OF POISONS LIST Principal Business Number of Premises Number of Visits Confectioners 3 6 Domestic stores, ironmongers, etc. 72 73 Drug stores 15 15 Grocers 261 517 Hairdressers 13 13 Nurserymen and florists 8 8 Total 372 632 Bakehouses There are 57 bakehouses in the Borough, of which 11 are in basements and subject to the provisions of Section 54 of the Factories Act, 1937. One hundred and thirty-nine visits by the Food Inspectors were made to these premises during the year. Certificates of suitability under the Food Hygiene Regulations, 1955, were granted in 1958 in respect of the 11 underground bakehouses. 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, 1955 Section 16 (1) of the above Act provides that no premises shall be used for: (a) the sale, or manufacture for the purpose of sale of ice-cream or the storage of ice-cream intended for sale; or (b) the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale, unless they are registered under this section for that purpose with a local authority. During the year 73 applications for registration under the provisions of Section 16 (l)(a) and 23 applications for registration under the provisions of Section 16 (l)(b) were submitted to the Council. In all cases the premises were found to be satisfactory and the registration granted. 35 FOOD AND FOOD PREMISES Bacteriological Examination of Food and Waters Two hundred and eighty samples were examined bacteriologically at the Public Health Laboratory during the year. They were as follows: Milk Ice-cream Imitation Cream Artesian Well Waters Swimming Pool Waters Others Total 216 37 7 6 11 3 280 Milk Of the 216 samples of milk, 96 were submitted to the phosphatase test, 96 to the methylene-blue test, and 24 to the turbidity test. These samples were reported satisfactory. Ice-cream The 37 samples of ice-cream were tested in accordance with the technique suggested by the Ministry of Health and Public Health Laboratory Service. These samples were examined at the Public Health Laboratory. The following table gives a summary of the results: Methylene-Blue Reduction Test Provisional Grade Number of Samples 1 19 2 11 3 — 4 7 Total 37 Imitation Cream Seven samples were examined for the presence of pathogenic organisms, and all were reported satisfactory. Examination of Water from Artesian Wells Six samples were submitted for examination, and were reported satisfactory. 36 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 Examination of Water from Swimming Baths Eleven samples were submitted for examination, and all were reported satisfactory. Others The three miscellaneous samples proved to be free of pathogenic organisms. Analysis of Food and Drugs During the year 1,000 samples of food and drugs were procured for analysis: 315 samples of milk, 638 other foodstuffs and 47 drugs. Of these, 312 were submitted as formal samples while 688 were purchased informally. One or 0.32 per cent. of the formal and 21 or 3.05 per cent. of the informal samples were found to be adulterated or not up to standard. The total adulterations reported were 22 or 2.2 per cent. of the samples submitted. The 22 samples found to be adulterated were: Three samples of butter. Two samples each of camphorated oil, bread and small rice and one sample each of milk bottle, dried apricots, cooked pork, new biskoids, gravy salt, ground cloves, instant coffee, shredded suet, bun, orange fruit cup, stoned raisins, beef chipolatas and pork sausages. 7 FACTORIES ACT, 1937 and 1948 Prescribed particulars required by Section 128 (3) 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 426 298 14 _ (2) Factories not included above in which Section 7 of the Act is enforced by the Local Authority 989 1,209 5 _ (3) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' Premises) 190 63 _ _ Total 1,605 1,570 19 — (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 6 2 2 Overcrowding _ — _ _ _ Unreasonable temperature _ — _ _ _ Inadequate ventilation 1 — _ 1 _ Ineffective drainage of floors — — _ — _ Sanitary Conveniences (a) insufficient 3 2 _ (b) unsuitable or defective 42 38 _ 17 _ (c) not separate for sexes 1 1 _ 1 _ Other offences against the Act (not including offences relating to outwork) 12 9 Total 64 52 — 21 — 37 38 38 FACTORIES ACT, 1937 AND 1948 PART VIII OUTWORK (SECTIONS 110 AND 111) Nature of Work Section 110 Section 111 No. of outworkers in August list required by Section 110 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Prosecutions Wearing apparel— making, etc. 552 _ _ _ _ Wearing apparel— Cleaning and washing 2 _ _ Household linen 1 _ _ — — Lace, lace curtains and nets 1 _ _ _ _ Curtains and furniture hangings 2 _ _ _ _ Umbrellas, etc. 3 _ _ _ _ Artificial flowers 3 _ _ — — Paper bags 10 _ _ — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper 16 _ _ _ _ Brush making 1 _ _ — — Carding, etc. of buttons, etc 3 _ Stuffed toys 4 _ _ — — Cosaques, Christmas stockings, etc. 25 _ Lampshades 179 — — — — Total 802 — — — — London County Council (General Powers) Act, 1954 Hairdressers and Barbers Section 18 of the above Act requires, inter alia, that, no person shall carry on a business as a hairdresser or barber on any premises in a borough unless he or those premises are registered by the Borough Council. During the year 16 new registrations were made, and the total number on the register at the end of the year was 257. Pet Animals Act, 1951 Thirty-four licences were issued by the Council in relation to premises subject to the provisions of this Act. 8 ATMOSPHERIC POLLUTION AND CLEAN AIR Since the Clean Air Act, 1956, came into operation, considerable attention has been given by the Department to the problem of clean air and implementing the Act, particularly those sections dealing with Smoke Control areas. The work has been carried out in the closest co-operation with the Town Clerk's Department and it is a pleasure to acknowledge the help which the Town Clerk's staff have given. In the early stages, members of the Council's staff were employed part-time out of office hours in order that experience could be obtained of the work. Subsequently, however, two technical officers were appointed to my staff to undertake work under the Clean Air Act, 1956, and since the end of the year two more officers have been appointed so that we now have four technical officers in the Health Department engaged under the general direction of the Chief Public Health Inspector, on this work. The Council has, so far, made Smoke Control Orders as follows:— No. 1 area—west of the district railway line to south east of West Hill, Kingston Road and Roehampton Vale. In operation from 1st September, 1959. No. 2 area—that part of the Borough which extends to west of Roehampton Lane, i.e. adjoining and to the north of the first smoke control area. In operation from 1st September, 1960. In addition, application has been made to the Minister for preliminary approval of the Council's proposals for Smoke Control area No. 3, and this has now been received, comprising:— That part of the Borough which extends to the east bounded by King's Avenue, parts of Atkins Road and Weir Road, Trouville Road and Elms Crescent. At the time of writing, a preliminary survey is being undertaken covering Smoke Control area No. 4 comprising the area of the Borough adjoining No. 2 area, west of Putney Park Lane. Thus, already, an extensive coverage of the Borough has been converted into Smoke Control areas and these will be further increased in the current year. Work in connection with the preliminary inspections and surveys has to be carried out meticulously since on the estimates provided by the technical officers will be decided such questions as how much grant the Council can approve and also an estimate of the amounts of smokeless fuels which will be required in the area. This work can be considerably forwarded (and correspondingly impeded) by the attitude of the public and the individual householders so that it is a pleasure to be able to state that so far the 39 40 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 public and householders have been most co-operative with the Council's staff. There does indeed seem to be a general realisation that the time has come when the air of London must be cleared of smoke and while it is yet early days (perhaps one should say early years), if this work proceeds with the same impetus as it has started, our original forecasts of the time it would take for the whole of the Borough to be converted into a Smoke Control area might prove to have been pessimistic rather than optimistic. In accordance with the provisions of Section 12(2) of the Clean Air Act, 1956, six notices were served in connection with premises within the Council's first smoke control area requiring works of adaptation to fireplaces. These works were considered reasonably necessary in order to avoid contravention of the provisions of Section 11 relating to offences in smoke control areas. The notices have been complied with. New Furnaces Under Section 3 of the Clean Air Act, application may be made to the local authority for prior approval to the installation of a furnace. Five applications, together with plans or specifications, were received during the year and as the Council were satisfied that the proposed installations conform with the provisions of the Act, approval was given in each case. In accordance with the provisions of Section 3(3), notices of intention to install a furnace were received in respect of seven premises. Measurement of Atmospheric Pollution The investigations into atmospheric pollution have continued in collaboration with the Department of Scientific and Industrial Research. There are five stations of recording apparatus in different parts of the Borough and the concentrations of smoke and sulphur dioxide (S02) in the atmosphere is recorded daily. The results are averaged over a month and the monthly returns are made to the Department of Scientific and Industrial Research. This work has been proceeding for the last three or four years and when readings from many areas are collated, considerable information of value will ultimately be available and it will be interesting to see what effect the Clean Air Act may have on these figures. The readings of smoke and sulphur dioxide (S02) taken during the year for the five stations is given in Table 1. In connection with the readings, a chart is given in Table II which shows for comparison the recordings taken at Fairfield Street and at Streatham. 41 ATMOSPHERIC POLLUTION AND CLEAN AIR TABLE I Station Roof— Municipal Buildings Valley Road, S.W.16 Tooting Library Queen Mary's Hospital, Roehampton South London Hospital, Clapham Month—1959 Smoke SO2 Smoke SO2 Smoke SO2 Smoke SO2 Smoke SO2 January 24.2 20.9 74.5 16.6 30.2 16.4 23.0 11.6 30.0 17.9 February 20.2 17.7 61.6 12.0 26.2 17.3 37.0 12.2 24.1 17.3 March 12.1 9.5 21.0 5.8 16.0 8.4 10.6 5.2 13.0 3.0 April 9.0 9.5 17.0 4.7 12.0 6.8 5.0 4.75 10.0 4.3 May 6.0 5.3 16.0 3.6 10.0 5.8 5.0 5.2 8.0 6.8 June 6.0 5.0 10.0 3.4 8.0 3.9 3.0 3.0 4.0 4.2 July 5.0 3.7 10.0 2.7 7.0 3.1 3.9 2.1 4.0 2.7 August 5.0 5.3 14.25 3.3 8.0 3.3 3.4 2.7 4.0 3.3 September 10.0 4.6 15.0 3.3 11.0 5.6 7.4 5.7 6.0 4.5 October 9.0 8.1 16.0 3.5 11.0 5.0 10.0 5.6 5.0 5.3 November 22.0 13.6 19.0 8.4 22.0 8.7 21.8 8.2 15.0 12.0 December 23.3 9.8 55.0 6.6 21.5 7.3 15.0 6.3 14.0 6.6 Average 12.633 8.583 27.44 6.158 15.24 7.63 12.18 6.05 11.42 7.33 42 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 TABLE II 9 ACCIDENTS IN THE HOME Tables showing figures of accidents in the home, introduced for the first time last year, are reproduced below, and include figures for 1959, calculated as described in the 1958 Report. HOME ACCIDENT CASES DURING 1956 to 1959 TABLE I Cause of Accident 1956 1957 1958 1959 Fall- On stairs 120 112 122 130 From ladder 21 18 12 19 From chair 18 18 21 29 Outside 32 18 16 35 In garden 45 31 25 43 In bath 1 3 1 4 From one level to another 42 42 33 32 On same level 77 57 105 115 Unspecified 222 240 255 268 Hit by object 45 15 14 16 Cooking stove 15 7 13 17 Teapots 4 2 6 7 Other boiling water 18 25 12 17 Electric shock 2 2 1 3 Poisoning 27 34 24 24 Gassing 9 9 12 19 Knife-like wounds 69 51 36 47 Fires 24 10 24 11 Windows 7 5 6 9 Suffocation 1 3 2 10 Not specified 13 53 44 31 Totals 812 755 784 886 Rate per 10,000 population 24.0 22.4 23.2 26.2 TABLE II AGE GROUPS AND PERCENTAGES 1956 % 1957 % 1958 % 1959 % Under 1 10 1.2 10 1.4 14 1.7 11 1.3 1- 26 3.2 25 3.3 29 3.7 31 3.4 2- 30 3.7 26 3.4 30 3.8 35 3.8 3 and 4 31 3.8 35 4.6 36 4.6 40 4.5 5-19 96 11.7 81 10.7 84 10.8 102 11.8 20-59 252 31.0 232 30.7 239 30.5 268 30.5 60-69 93 11.6 91 12.0 82 10.5 102 11.6 70-79 150 18.5 133 17.7 141 17.9 155 17.3 80+ 124 15.3 122 16.2 129 16.5 142 15.8 Totals 812 100 755 100 784 100 886 100 43 10 REPORT OF THE WORK OF THE PUBLIC ANALYST FOR 1959 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, 1955, 1,000 samples were examined during the year ended 31st December, 1959, 953 were articles of food and the remaining 47 drugs. All were submitted by the Council's Food Inspector, 312 having been taken with the formalities required by the Act and 688 informally. Samples of the following substances were analysed: fats (butter, margarine, etc.), 62, beverages (cocoa, coffee, tea, etc.), 31; cereal preparations, 12, cream, 26, fish (canned etc.), 25; fruit (canned and dried), 49; meat products (including sausages), 49; milk, 315; pickles and condiments (including spices), 41; preserves, 29, soup, 24; vegetables, 37; bicarbonate of soda, 9; iodine solutions, 5; ointments, 9; seidlitz powders, 4. 44 45 REPORT OF THE PUBLIC ANALYST FOR 1959 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 Formal 90 Camphorated Oil 28 % deficient in camphor Informal 969 Camphorated Oil 27 % deficient in camphor. 992 Sliced bread Contained piece of chewing gum 1,018 Milk bottle Coated on inside with dust 1,041 Dried apricots Some soil and miscellaneous organic matter 1,096 Cooked pork Portion contaminated with blue dye 1,104 New Biskoids Labelling offence 1,123 Butter Water, 0.5% in excess 1,135 Sliced bread Contained piece of dirty cardboard 1,196 Gravy salt In unlined rusty tin 1,251 Ground cloves 6.3% siliceous matter 1,280 Small rice Weed seeds and other foreign matter present 1,282 Instant coffee Sulphur dioxide, 400 parts per million 21 Small rice Weed seeds and other foreign matter present 23 Shredded suet Deficient in beef fat 5 % 34 Bun Sacking fibres, sand and other dirt 61 Orange fruit cup Flavour spoilt, due to fermentation 69 Stoned raisins Contained dead ants and mites, etc. 98 Beef chipolatas Meat content 38½ % 99 Pork sausages Meat content 44% 110 Butter Contained excess water (0.2%) 138 Creamery butter Mould developed on exposed cut surface Adulteration The amount of adulteration detected during the year was: For formal samples 0.32 per cent. For informal samples 3.05 per cent. For all samples 2.2 percent. 46 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1959 Complaint Samples Case No. 886. Pork Luncheon Meat. Submitted on the complaint it contained a foreign matter. The complaint was considered not justified. Case No. 931. Milk. Submitted on the complaint that the milk had an unusual taste. The complaint was considered not justified. Case No. 962. Eggs. Submitted on the complaint that they were tainted. The complaint was considered not justified. Case No. 963. Bread. Submitted on the complaint that it was of bitter taste. The complaint was considered not justified. Case No. 992. Sliced Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1070. Salmon Canned. Submitted on the complaint that it caused sickness. The complaint was considered not justified. Case No. 1096. Pork. Submitted on the complaint that it contained a foreign matter. The complaint was considered justified. Case No. 1199. Corned Beef. Submitted on the complaint that it had a metallic taste. The complaint was considered not justified. Case No. 1279. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 34. Bun. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 61. Orange Fruit Cup. Submitted on the complaint that it caused sickness. The complaint was considered not justified. Case No. 138. Creamery Butter. Submitted on the complaint that it contained a mould. The complaint was considered justified. 47 REPORT OF THE PUBLIC ANALYST FOR 1959 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 Non-fatty solids January 21 12.49 3.74 8.75 February 22 12.27 3.60 8.67 March 28 12.29 3.60 8.69 April 22 12.13 3.46 8.67 May 19 12.01 3.29 8.72 June 26 12.07 3.37 8.70 July 21 12.12 3.50 8.62 August 26 12.20 3.56 8.64 September 24 12.15 3.53 8.62 October 24 12.55 3.80 8.75 November 23 12.56 3.79 8.77 December 27 12.58 3.79 8.79 The average composition of the 283 samples of milk analysed during the year and returned as genuine was as under: Total milk solids 12.28 per cent. Milk fat 3.59 per cent. Non-fatty solids 8.69 per cent. The average composition of the 32 samples of Channel Island and South Devon milks was as under: Total milk solids 13.45 per cent. Milk fat 4.42 per cent. Non-fatty solids 9.03 per cent. INDEX PAGE Accidents, Deaths from 19 Accidents, Home 43 Acute Encephalitis 15 Analyst, Report of 44 Atmospheric Pollution 39 Bacteriological Examinations of Milk 35 „ „ of Ice-cream 35 Bathing Pools and Swimming Pools 23 Bed Bugs, Eradication of 25 Births, Birth-rates 8 Butchers' Shops 33 Cancer 19 Childbirth, Deaths from 11 Circulatory Diseases 19 Clean Air 39 Closing Orders 26 Crematorium 25 Cutting-off Notices—Water Supply 23 Deaths, Causes of 10 Death-rates 9 Death-rate from Infective Diseases 12 Death-rate, Infantile 11 Deaths, Number of 10 Diphtheria 12 Diseased or Infirm Persons, Removal of 24 Disinfection 18 Dysentery, Sonne 16 Enteric Fever 16 Erysipelas 17 Factories Act, 1937 and 1948 37 Factories and Workshops 37 Food and Drugs Act, 1955 32 Food Poisoning 17 Food, Supervision of 29 Food Places, Inspection of 30 Food Places, Number on Register 29 Food Hygiene Regulations 29 Hairdressers and Barbers 38 Home Accidents 43 Houses and Premises Inspected 21 Housing Act, 1936 26 Housing Statistics 26 Hydrogen Cyanide Disinfection 25 Illegitimate Children, Births of 8 Infant Mortality 11 Infective Diseases 12 Infective Diseases, Cases of 13 Infective Diseases, Death-rate from 12 48 49 INDEX Infirm or Diseased Persons, Removal of 24 Influenza, Deaths 16 Influenzal Pneumonia and Acute Primary Pneumonia 16 Insanitary Areas 28 Malaria 17 Maternal Mortality 11 Meat 33 Meningococcal Infection 15 Milk Analysis 47 Milk, Bacteriological Examination of47 Milk Premises, etc. on Register 31 Milk (Special Designations) Regulations, 1949-54 32 Mortuary 25 Non-infective Diseases, Deaths from 19 Notification of Infective Diseases 13 Outworkers 38 Overcrowding 27 Pet Animals Act 38 Pharmacy and Poisons Act, 1933 33 Pharmacy and Medicines Act, 1941 33 Poliomyelitis 15 Population 8 Pregnancy, Deaths from Accident and Diseases of 11 Preserved Meat, etc., Manufacture of 33 Public Analyst, Report 44 Puerperal Pyrexia 16 Pulmonary Tuberculosis, Notification of cases of20 Rent Act 27 Rodent Control 23 Samples, Formal and Informal, Number of 45 Sanitary Inspection of Borough 21 Scabies 17 Scarlet Fever 12 Slaughter-houses 33 Slaughter of Animals Acts, 1933-1954 33 Smallpox 12 Staff 4 Statistics for the Borough 7 Suicide, Deaths from 19 Swimming Baths and Bathing Pools 23 Syphilis, Deaths from 17 Tuberculosis 20 Unfit Houses 28 Unsound Food33 Water Supply 34 Water Supply, Cutting-off Notices 23 Whooping Cough 12 Printed by Geo. Gibbons Ltd., Leicester & London