c 4388 3-OCT 1962 Metropolitan Borough of Wandsworth ANNUAL REPORT of the Medical Officer of Health for the Year 1961 bv 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 1961 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 Wandsworth for the year 1961 which follows, in the main, the form of previous years. I mentioned in last year's Report that the population of the Borough which had been trending slightly upwards was halted in 1960. The preliminary report on the 1961 Census has now been published, according to which the population of Wandsworth is given as 346,790, an increase of 7,990 over the previous figure and in this Report, for the purpose of calculating the rates, this figure has been used. The crude birth rate was 16.9 per thousand persons living, a slight increase over the previous year and after taking into account the area comparability factor, the adjusted rate works out at 16.2 as against 15.6 for 1960, so that the birth rate also is trending slightly upwards. The rate for England and Wales as a whole was 17.4 and for London 18.7. The crude death rate for the year was 14.0 compared with 14.7 for 1960 and the adjusted rate was 10.5 as against 10.8. The corresponding figures for England and Wales and London were 12.0 and 11.9 respectively. No special reference has been made in earlier Reports to the subject of illegitimacy. From time to time, comments appear dealing with the national aspects of this social problem and this year I think it might be looked at from the point of view of Wandsworth. In 1961 there were 630 live illegitimate births, more than 100 greater than in 1960. If this figure of 630 is taken as a percentage of the total live births, we find that in Wandsworth in 1961, 10.7% of all births were illegitimate. No figures are yet available for London and the rest of the country for 1961, but the figure for 1960 for London was 11.4% and for England and Wales 5.4%. It is thus seen that Wandsworth, in common with London generally, has a comparatively high proportion of illegitimate births. That this is a social problem needs no 2 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 emphasis, and it has many facets such as the moral, the educational, the employment of leisure, the spiritual and other related and possibly more abstruse factors. There are, however, well-recognised reasons why a high proportion of illegitimate births is to be expected in London and presumably this would apply to Wandsworth. For instance, there are proportionately more single women in London with an influx of a number who may already be pregnant. The facilities which London provides for an unmarried mother to have her baby away from her own home, possibly without the knowledge of relations and friends, and in many cases almost anonymously, are peculiar to the Metropolis. Particularly good arrangements for antenatal care and for the confinement are available and after the birth, help and support from Moral Welfare organisations can be provided. These are some reasons why London has an attraction for an unmarried woman who has become pregnant. In Wandsworth, for instance, there are five Mother and Baby Homes, all run by voluntary organisations, supported substantially out of public funds, where unmarried mothers are cared for before their babies are born, where they can return with their babies and where arrangements can be made for adoption, if necessary, and for advising and helping the mother. Many of the girls in these Mother and Baby Homes come, of course, from areas outside Wandsworth and excellent work is done by the staff and the moral welfare workers attached to the organisation to help the mothers, some of whom are quite young. Close contact is maintained with the health visitors and the Children's Department, where necessary. Nevertheless, although the problem in Wandsworth probably is much less serious than would appear from the figures, it is one which must tax the resources of educationalists, social workers, moral welfare workers and the churches. I am glad to be able to report that the slight increase in the infant mortality rate which I noted last year was not sustained and the infant mortality rate for 1961 was 20.5 per thousand live births as compared with 22.7 in 1960.1 dealt at some length with the problem of further reducing this rate in my report last year and I will say no more about it now. There were unfortunately five deaths from puerperal causes in 1961, giving a maternal mortality rate of 0.83. Nineteen-sixty-one was a year when an increase in the number of measles cases was expected and duly realised, there being a total of 4,912 cases of this disease notified, making the total of all infectious diseases 6,109 as against 3,032 in 1960. The decline in the number of cases of scarlet fever which I noted last year continued in 1961, there being 107 cases as compared with 172 in 1960. I am also glad to report that the increase in the number of whooping cough cases which I reported last year gave way to a considerable reduction, there being 191 cases. No deaths were reported from whooping cough but there was one death from measles. As regards poliomyelitis, 33 cases were reported to us and investigated but in 30 the diagnosis was not confirmed so that we were left 3 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 with three cases; one case had some paralysis, one made a complete recovery, but the third case unfortunately died. The current year saw the introduction of immunisation by means of an oral vaccine developed by Dr. Sabin of America. There is little to add to what I said last year about the downward trend of tuberculosis in contradistinction to the increase in cases of bronchitis and lung cancer. There were 193 primary notifications of tuberculosis against 218 in 1960 and 260 in 1959 so that the downward trend continues. In all, we became aware of 352 cases of tuberculosis compared with 395 in 1960; of these, 156 were transferred from other authorities. The number of deaths from tuberculosis was 30 as against 34 in the previous year. The figures for home accidents in 1961 do not show any very marked differences from previous years and the arrangements described last year by which the main responsibility for this work devolves on health visitors and public health inspectors remain. Closely allied to home accidents are the number of deaths from motor vehicle accidents, namely 35 males and 15 females. Although this may not primarily be a public health matter as such, it is one which cannot be disregarded and it is one to which the Accident Prevention Committee of the Council gives careful and prolonged consideration. A cause of death which I have not discussed in any previous Report is that due to suicide of which, in 1961, there were 46 cases equally divided between the sexes. The present may be an opportune time to make some reference to this unhappy subject. Until the passing of the Suicide Act, 1961, attempted suicide was a criminal offence although the police interpreted the law in a compassionate way and only brought an action where it was thought this was necessary to help the patient (for in most cases he is a patient) to obtain treatment. This indeed is probably the crux of the problem because most cases of suicide are associated in one way or another with some form of mental illness and to the extent that cases of potential suicide can be treated, then the toll of lost lives in this tragic manner may be reduced. It is here that the Mental Health Act, 1959, which, at the present time, so far as community service is concerned, is administered by the London County Council, is likely to have far reaching effects. This Act came into operation in November, 1960, but already locally a strong and active department has been built up which will almost certainly need to be strengthened and extended in the not distant future. This Department, in keeping with the general outlook of the Mental Health Act, has already brought about many changes, particularly in the spheres of after-care, and care in the community generally. The care, support and treatment of cases of potential suicide are only a comparatively small part of the Department's responsibilities in the field of mental health generally but it is one where material advances may be achieved and, what is important, seen to be achieved. Cases of potential suicide present many complicated 4 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 problems for the psychiatrist and the social worker but it is hoped that as the years go by, it will be possible to report a reduction in the number of cases of suicide, many of them occurring under tragic circumstances. Modern society has long recognised that the care and welfare of old people is a responsibility of the community which is likely to become even more important in the years ahead. Last year, I was happy to acknowledge the great help we receive from the various statutory organisations concerned with the care of old people and it is a pleasure to report that the help we have come to expect from the geriatricians at St. Benedict's Hospital, St. John's Hospital and the South Western Hospital, together with the officers of the Welfare Department of the London County Council, continue. This year, I feel I should pay an equal tribute to the outstanding work which is carried out by the various voluntary organisations in the Borough, particularly the Wandsworth Old People's Welfare Council, the Wandsworth Old Folks Trust and the Women's Voluntary Service. On page 26 I deal a little more fully with the great contribution made to the welfare of the old people of Wandsworth by these organisations. This year, I have included in the section dealing with smoke abatement and control a map showing the parts of the Borough which have already been made Smoke Control Areas and the areas where it is hoped and expected Smoke Control Areas will be declared over the next 10 years. I should like, once again, to thank the many people who have assisted the work of the Health Department during the year, not least the Chairman of the Public Health Committee, Mrs. Olive Haines, and the Members of that Committee. I should like also to express my appreciation to all the members of the Health Department staff and to the Chief Officers and the staffs of other departments with whom we have continued a happy and close liaison. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your Obedient Servant, J. TUDOR LEWIS Medical Officer of Health. 5 STAFF OF PUBLIC HEALTH DEPARTMENT Medical Officer of Health J. Tudor Lewis, m.d., d.p.h. Deputy Medical Officer of Health A. Garland, m.d., m.r.c.p., d.p.h. Chief Public Health Inspector E.V. Roots Deputy Chief Public Health Inspector C.F. Standish Public Health Inspectors W.H. Jones A.E. Handley J.H. Massey P.P. Leacock A. J. Lansley S.R. CooMber A.W. Lock C.Jones J. Smith D.J. Hughes P.O'Grady K.J. Winton J.D. Morritt Trainee Public Health Inspectors M. Timlin J.F. Burslem J.L. Gill 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 6 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 STAFF OF PUBLIC HEALTH DEPARTMENT—continued Technical Smoke Control C.F. Harrison J. Weir L.W. Clifton F.B. Capes Disinfecting Station F. Stennings J. Williams H. Coster G.W. Price A.E. Clement J.C. Prowen Mrs. E. King (part-time) Mortuary J. Anderson Rodent Operatives J.W. Taylor J. Wells G.J. Langrish W. Maxwell V.T. Athaide The following changes occurred in 1961: Appointments Mr. J. D. Morritt, qualified as Public Health Inspector in July, and appointed the same month. Mrs. E. King, part-time Bathing Attendant, appointed in September. Resignations Mr. A.F. Cayley, Public Health Inspector, resigned in April. Mr. E.R. Potts, Public Health Inspector, resigned in December. Mrs. P.V. McKeown, Typist, resigned in August. 1 STATISTICS AND SOCIAL CONDITIONS Area 9,201 acres Resident population in 1961 346,790 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. 7 8 STATISTICS AND SOCIAL CONDITIONS Extracts from Vital Statistics Number of live births: Male Female Total Legitimate 2,712 2,536 5,248 Illegitimate 322 308 630 3,034 2,844 5,878 Rate per 1,000 population: Crude 16.9 Adjusted 16.2 Number of stillbirths 62 46 108 Rate per 1,000 total live and stillbirths 18.0 Percentage of illegitimate live births to total live births 10.7 Number of deaths: All ages 2,242 2,629 4,871 Under 1 year 73 48 121 Puerperal causes 0 5 5 Rate per 1,000 population: Crude 14.0 Adjusted 10.5 Infantile Mortality Rates: Total infant deaths per 1,000 total live births 20.5 Legitimate infant deaths per 1,000 legitimate live births 19.6 Illegitimate infant deaths per 1,000 illegitimate live births 28.5 Neo-natal Mortality Rate (deaths under four weeks per 1,000 total live births) 15.8 Early Neo-natal Mortality Rate (deaths under one week per 1,000 total live births) 13.6 Perinatal Mortality Rate (stillbirths and deaths under one week combined per 1,000 total live and stillbirths) 31.4 Maternal Mortality Rate (per 1,000 total live and stillbirths) 0.83 9 STATISTICS AND SOCIAL CONDITIONS 9  Total Number of deaths from Cancer 876 „ „ „ „ Diphtheria 0 „ „ „ „ Scarlet Fever 0 „ „ „ „ Measles 1 Whooping Cough 0 „ „ „ „ Tuberculosis 30 There has been no unusual or excessive mortality during the year. 2 VITAL STATISTICS Population Population figures obtained from the 1961 census have now been published by the Registrar-General. The population of Wandsworth is now given as 346,790, a considerable increase not only on the previous (1951) Census figures but also on the interim yearly estimates of the Registrar-General's office since then. All the rates used in this Report and the approximate population shown in Table I of each Parliamentary division are based on the new figure. TABLE I Population estimated to middle of 1961 Putney 91,000 Central 98,000 Clapham 83,000 Streatham 74,790 Whole Borough 346,790 Births The total number of births belonging to the Borough registered during 1961 was 5,878, consisting of 3,034 males and 2,844 females. The number for 1960 was 5,540. The crude birth-rate was 169 per 1,000 persons living compared with 16.3 for 1960. The adjusted rate works out at 162 after taking into account the area comparability factor supplied by the RegistrarGeneral. The birth-rate for England and Wales as a whole was 17.4 and for London 18.7. Six hundred and thirty illegitimate births took place in the Borough compared with 522 in 1960. 10 11 VITAL STATISTICS Deaths The number of registered deaths which took place in the Borough during the year was 3,875 but 1,015 of these did not belong to the Borough, while 2,011 Borough residents died outside the Borough. The corrected number of deaths for the Borough, after allowing for these factors, was 4,871, of whom 2,242 were males and 2,629 females. The crude death-rate for the year was 14.0 compared with 14.7 for 1960, but after taking into account the area comparability factor supplied by the Registrar-General, the adjusted rate works out at 10.5. The death-rate for England and Wales as a whole was 12.0 and for London 11.9. Table II shows the total number of registered deaths and the deathrates for each division based on the approximate population in each division. TABLE II Corrected Deaths Rate Males Females Total Putney 534 580 1,114 12.2 Central 827 1,062 1,889 19.3 Clapham 493 542 1,035 12.5 Streatham 388 445 833 11.1 Whole Borough 2,242 2,629 4,871 14.0 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. The larger number of deaths shown in the Central Division as compared with the other Parliamentary Divisions is due mainly to the fact that in that area are located a number of hospitals for the mentally disordered. Such hospitals are classified by the RegistrarGeneral for the purpose of deaths statistics as non-transferable and consequently, deaths occurring in these Institutions are allocated to this area. 12 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 TABLE III. CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1961 CAUSES OF DEATH DEATHS IN OR BELONGING TO WHOLE DISTRICT AT SUBJOINED AGES DEATHS IN OR BELONGING TO LOCALITIES (ALL AGES) 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 25 20 5 - - - 2 11 12 6 6 6 7 Tuberculosis, Other 5 2 3 1 1 - - 2 1 1 2 1 1 Syphilitic Disease 17 9 8 - - - - 3 14 6 5 4 2 Diphtheria - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - Meningococcal Infections 1 - 1 - 1 - - - - 1 - - - Acute Poliomyelitis 1 - 1 - - - 1 - - - 1 - - Measles 1 1 - - 1 - - - - - 1 - Other Infective and Parasitic Diseases 9 4 5 - - 3 3 1 2 2 3 2 2 Malignant Neoplasm, Stomach 85 36 49 - - - 1 24 64 21 23 22 19 Malignant Neoplasm, Lung, Bronchus 234 189 45 - - - 6 104 124 62 73 57 42 Malignant Neoplasm, Breast 76 - 76 - - - 5 24 47 15 24 21 16 Malignant Neoplasm, Uterus 41 - 41 - - - 8 17 16 6 13 15 7 Other Malignant and Lymphatic Neoplasms 420 214 206 - - 2 32 126 260 100 104 122 94 Leukaemia, Aleukaemia 20 10 10 1 1 3 2 4 9 6 6 4 4 Diabetes 28 14 14 - - - - 6 22 4 13 7 4 Vascular Lesions of Nervous System 521 187 334 - 1 - 11 82 427 140 176 110 95 Coronary Disease, Agina 783 439 344 - - - 10 196 577 235 220 168 160 Hypertension, with Heart Disease 64 18 46 - - - - 11 53 20 23 13 8 Other Heart Disease 855 310 545 - - - 14 68 773 135 518 95 107 Other Circulatory Disease 251 102 149 - - - 5 38 208 64 80 65 42 Influenza 41 15 26 1 3 - 1 7 29 9 11 11 10 Pneumonia 325 130 195 16 4 3 7 25 270 55 155 75 40 Bronchitis 260 182 78 4 1 - 3 56 196 60 85 60 55 Other Diseases of Respiratory System 27 17 10 - - - - 5 22 6 12 4 5 Ulcer of Stomach and Duodenum 41 23 18 - - - - 6 35 9 17 9 6 Gastritis, Enteritis, Diarrhoea 23 7 16 2 1 - - 2 18 4 10 4 5 Nephritis and Nephrosis 24 13 11 - 1 - 1 16 6 8 7 5 4 Hyperplasia of Prostate 23 23 - - - - - 2 21 6 8 5 4 Pregnancy, Childbirth, Abortion 5 - 5 - - - 5 - - - 2 1 2 Congenital Malformations 32 17 15 21 1 - 4 4 2 5 5 11 11 Other Defined and Ill-defined Disease 462 166 296 72 3 3 17 62 305 82 250 90 40 Motor Vehicle Accidents 50 35 15 - 2 1 21 6 20 15 9 15 11 All Other Accidents 73 34 39 3 1 3 14 13 39 19 16 20 18 Suicide 46 23 23 - - - 16 22 8 12 10 12 12 Homicide and Operations of War 2 2 - — — — 1 1 - - 2 - - All Causes 4,871 2,242 2,629 121 22 18 190 940 3,580 1,114 1,889 1,035 833 13 VITAL STATISTICS TABLE III(a). DEATHS FROM HEART DISEASE, 1961 Males in age groups Females in age groups M. & F. Total 1-5 5-15 1545 4565 65 up Total 1-5 5-15 1545 4565 65 up Total Coronary Disease, Angina, etc. - - 10 154 275 439 - - - 42 302 344 783 Hypertension with Heart Disease - - - 6 12 18 - - - 5 41 46 64 Other Heart Disease — — 11 33 266 310 — — 3 35 507 545 855 TOTAL — — 21 193 553 767 — — 3 82 850 935 1,702 Infantile Mortality There were 121 deaths of children under one year, giving an infant mortality rate of 20.5 per 1,000 live births. This compares with a rate of 22.7 for 1960. For the 10 years ended 1951 the average infant mortality rate was 33, while for the 10-year period ending 1961 the average rate was 20. Table 111(b) shows causes of death of children under one year of age. TABLE 111(b). DEATHS OF CHILDREN UNDER ONE YEAR OF AGE Cause of Death Under 24 hours 1-7 days 1-4 weeks Total under 4 weeks 1-12 months TOTAL DEATHS UNDER 1 YEAR Approximate Percentage of Total 1. Pneumonia — 1 3 4 12 16 13 2. Bronchitis — — 1 1 3 4 3 3. Gastritis, Enteritis, Diarrhoea 1 1 1 2 2 4. Congenital Malformations 7 6 3 16 5 21 17 5. Prematurity 20 12 5 37 — 37 31 6. Other Causes 12 10 5 27 14 41 34 TOTALS 39 29 18 86 35 121 100 APPROXIMATE PERCENTAGE OF TOTALS 32 24 15 71 29 100 100 Maternal Mortality Five deaths occurred from accidents and diseases of pregnancy or child-birth. This is equivalent to a rate of 0.83 per 1,000 live and still-births. 14 3 INFECTIVE DISEASES The number of deaths from all notifiable infectious diseases was 106. This included 30 from all forms of tuberculosis and 73 from the notifiable forms of pneumonia. There was one death from meningococcal meningitis, one from poliomyelitis and one from measles. From all notifiable infective diseases the death-rate was 0.30 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. Investigation was also made in connection with a number of confirmed cases which occurred in an adjoining Borough. Close liaison was maintained with the Borough concerned and an intensive follow-up made of contacts living in the Wandsworth area. Whooping Cough One hundred and ninety-one cases were notified, compared with 492 cases in 1960. There were no deaths. Measles The number of cases notified during the year was 4,912 compared with 825 in 1960, 3,212 in 1959 and 1,602 in 1958. 15 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 93 8 18 9 15 5 13 15 8 2 Encephalitis, Acute 1 — — — 1 — — — — — Erysipelas 24 — — — 1 — 2 3 13 5 Food Poisoning 86 2 10 5 6 5 17 18 17 6 Malaria 1 — — — — — 1 — — — Measles 4,912 124 948 1,355 2,345 75 36 26 3 — Meningococcal Infection 5 — 2 — 1 — 1 1 — — Ophthalmia Neonatorum 6 6 — — — — — — — — Pneumonia: Acute Influenzal 96 — 1 — 2 1 4 19 34 35 Acute Primary 122 5 7 2 4 3 7 14 38 42 Poliomyelitis, Acute 3 — — — — — — 3 — — Puerperal Pyrexia 98 — — — — — 54 44 — — Scabies 12 — — — — 5 4 3 — — Scarlet Fever 107 — 12 23 47 13 11 1 — — Smallpox - — — — — — — - — — Tuberculosis 352 1 1 3 7 5 79 156 79 21 Typhoid Fever and Paratyphoid Fever — — — — — — — — — — Whooping Cough 191 17 44 48 64 10 2 6 — — Total 6,109 163 1,043 1,445 2,493 122 231 309 192 111 16 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 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 Earlsfield Springfield Tooting Graveney Bedford Larkhall Clapham North Clapham Park Thornton Balham Streatham Hill St. Leonards Streatham Common Streatham South Furzedown Anthrax - - - - - - - - - - - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - - - - - - - - - - - Dysentery 8 — 5 6 — 20 5 6 9 5 4 3 1 1 10 3 5 2 — — 93 - Encephalitis, Acute - - - - - - - 1 - - - - - - - - - - - - 1 - Erysipelas 3 — — — 1 4 2 5 1 — — 1 — — 1 1 1 2 2 — 24 - Food Poisoning 4 2 5 3 — 28 6 3 7 5 5 3 1 1 4 — 2 2 1 4 86 - Malaria - - - - 1 - - - - - - - - - - - - - - - 1 - Measles 360 170 236 530 353 266 285 390 351 145 274 209 213 146 167 131 118 151 189 228 4,912 1 Meningococcal Infection — 2 1 - - - - - - 1 - - - - 1 - - - - - 5 1 Ophthalmia Neonatorum — — — — 1 — — 2 - 2 - - — — 1 — — — — — 6 - Pneumonia, Acute Influenzal 1 5 1 5 4 3 6 6 4 25 6 1 3 3 12 5 1 2 2 1 96 28 Acute Primary 1 8 7 6 11 11 14 11 7 12 9 7 4 4 9 1 2 - 1 2 122 45 Poliomyelitis, Acute - - - - - - - - - 2 1 - - - - - - — — — 3 1 Puerperal Pyrexia 2 — 3 2 — 3 1 6 3 11 1 5 16 18 11 6 2 3 1 4 98 — Scabies — — 1 — 1 2 — 2 — 1 1 — — — 1 2 — 1 — — 12 — Scarlet Fever 3 2 - 12 4 8 7 6 1 7 12 6 9 4 5 6 1 5 6 3 107 - Smallpox - - - - - - - - - - - - - - - - - - - - - - Tuberculosis—all forms 40 13 11 15 9 20 13 19 20 27 25 15 21 14 26 21 12 10 10 11 352 30 Typhoid Fever and typhoid Fever - - - - - - - - - - - - - - - - - - - - - - Whooping Cough 3 2 15 6 10 4 11 16 11 8 15 13 9 6 12 1 3 17 12 17 191 — Total 425 204 280 585 395 369 350 473 414 251 353 263 277 197 260 177 147 195 224 270 6,109 106 17 INFECTIVE DISEASES Poliomyelitis Thirty-three cases of this disease were reported and investigated during the year, compared with 71 in the previous year. In 30 cases the diagnosis was not confirmed. Of the remaining three confirmed cases, two were of the paralytic type and one nonparalytic. One death occurred. The figures of poliomyelitis from 1947 to 1961, 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 1960 1961 No. of cases reported as suspected poliomyelitis and investigated 119 31 89 71 29 73 73 41 104 85 147 65 73 31 33 No. of cases firmed: (a) paralytic 78} 15} 58} 40} 4 23 19 5 22 24 43 11 13 1 2 (b) non-paralytic 7 16 8 2 27 15 28 9 4 4 1 Deaths 4 6 4 7 — 5 2 — 1 2 4 1 1 — 1 Meningococcal Infection Five confirmed cases were notified, one of which proved fatal. Thirty-two other cases were investigated but these were subsequently not confirmed. In 1960 also there were five confirmed cases with one death. Acute Encephalitis No cases resident in the Borough were reported, but one case resident elsewhere was admitted to a hospital in this area. Typhoid and Paratyphoid Fever Two suspected cases were investigated during the year, but neither was subsequently confirmed. Scarlet Fever One hundred and seven cases were notified compared with 172 in 1960 and 329 in 1959. No deaths occurred. 18 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 Puerperal Pyrexia During the year 98 cases were notified, of which 94 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 27 cases, referring to Wandsworth residents whose confinements took place in hospitals located in other Metropolitan boroughs. Sonne Dysentery Only one outbreak occurred during the year; this comprised 19 cases at a day nursery in the Borough. The bulk of the remaining cases investigated were single unrelated cases. The final overall total of 93 cases for the year, although considerably lower than the previous year, when 315 cases were confirmed, does not reflect fully the amount of work involved in visiting and following up. It was often considered necessary to arrange for the bacteriological examination of stools specimens from family contacts, and many other suspected cases reported were investigated but subsequently not confirmed. Influenza, Acute Influenzal Pneumonia and Acute Primary Pneumonia Acute influenzal pneumonia and acute primary pneumonia are the notifiable forms of pneumonia, and in 1961 96 of the former and 122 of the latter were notified, as compared with 15 and 124 respectively for the previous year. Deaths attributable to acute influenzal pneumonia were 28; this figure is classified under influenza in the death table on page 12. Acute primary pneumonia accounted for 45 deaths, making a total of 325 deaths for all forms of pneumonia compared with 301 in 1960. Deaths in 1960 from acute influenzal pneumonia and acute primary pneumonia were respectively four and 26. Malaria One recurrent case was notified, that of a person who had been living in India. Erysipelas Twenty-four cases were notified. 19 INFECTIVE DISEASES Other Infective Diseases Seventeen deaths occurred from syphilis. Scabies Twelve notifications were received. Nine treatments were given at the Councl's Disinfecting Station during the year. At the iBattersea Cleansing Station, a total of 57 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 Investigation was made in 146 notified or otherwise reported cases during the year. Seventy of these were deemed to be not food poisoning after laboratory examination of faecal specimens from those affected. Of the remaining notifications, 67 were single unrelated cases while there were nine minor outbreaks involving two or more persons, making the total number of cases notified and confirmed 86. Most of the single cases were only slightly affected and where bacteriological examination was carried out, causative organisms were discovered in 24 cases. The organisms involved were Salmonellae typhimurium (17), enteriditis (3), and brandenburg. In three cases, heat resistant Clostridium welchii was isolated. In eight of the minor outbreaks, Salmonellae typhimurium (4), brandenburg, richmond, blockley and saint paul were isolated; it was not possible in the remaining one to identify the causative agent. There were, in addition to the above cases, two other outbreaks reported, one, involving 100 persons, occurring at a hospital in the Borough and the other, involving 10 persons, occurring at a Mother and Baby Home. In the first of these outbreaks, bacteriological investigations indicated the causative agent as staphylococcus aureus and the second as heat resistant Clostridium welchii and full reports were submitted to the Ministry of Health in accordance with existing procedure. Diseases Reported from Schools A total of 2,900 infective diseases was reported from schools in the Borough throughout the year. The numbers of each disease were: Scarlet Fever 71 Measles 1,491 German Measles 266 Poliomyelitis 2 Chicken Pox 522 Scabies 1 Whooping Cough 58 Mumps 158 Dysentery 27 Other complaints 304 20 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 Disinfection During the year 214 rooms were disinfected after infectious and other disease, 291 rooms disinfested for vermin, and 97 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, to whom I would like to express thanks for the help and assistance that he and his staff have given to my Department since the inception of the Public Health Laboratory. The following is a summary of examinations made during the year: Nose and throat swabs 1,078 Faeces and urine for the typhoid and dysentery groups 1,669 Miscellaneous specimens 16 Total 2,763 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 diseases. 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. In connection with such exclusions from work, it should be noted that since the inclusion of Section 26 in the London County Council (General Powers) Act, 1959, it is now possible, if the borough council sees fit, to compensate persons for any loss occasioned by their com- . pliance with the request of the Medical Officer of Health. During the year, no case arose that necessitated action under this Act but one contact of infectious disease who was excluded from work was issued with a certificate enabling him to draw National Health sickness benefit. TUBERCULOSIS Notifications The total number of new cases which came to the notice of the Department during 1961 was 352 compared with 395 in 1960. 21 NON-INFECTIVE DISEASES The sources of information regarding the new cases were as follows: Primary notifications on Form A 193 Notifications from H.M. Forces 1 Unnotified at death 2 Transfers from other sanitary authorities 156 Total 352 Three hundred and fifty cases were added to the notification register during the year and 126 cases who had removed, recovered or died, were taken off. The number remaining on the register at the end of the year was 6,508. Deaths The number of deaths certified as due to various forms of tuberculosis was 30. Particulars of the new cases and deaths during the year, classified by sexes and age-groups, are given in the following table: New Cases Deaths Age Periods Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under 1 year 1 — — — — — 1 — 1-2 1 — — — — — — 1 3-4 1 2 — — — — — — 5-9 4 3 — — — — — — 10-14 2 3 — — — — — — 15-24 36 39 3 1 — — — — 25-44 86 55 7 8 1 1 — — 45-64 52 22 — 5 10 1 1 1 65 and upwards 15 5 1 — 9 3 — 1 Totals 198 129 11 14 20 5 2 3 NON-INFECTIVE DISEASES The total number of deaths from cancer and malignant disease was 876, the number of males being 449 and females 427. The deathrate was 2.52 per 1,000. The number of deaths in 1961 was 76 less than in the previous year. Deaths from diseases of the heart and circulatory system were 1,953 compared with 2,050 in 1960. Of these deaths, 1,611 were of persons of 65 years of age and above. There were 653 deaths from diseases of the respiratory system compared with 574 in 1960. The number of deaths from bronchitis was 260 compared with 211 in 1960, and from pneumonia (all forms) 325 compared with 301 in 1960. One hundred and seventy-two deaths were due to violence, 50 of them being due to motor accidents, 46 to suicide and 76 to other forms of violence. CERTIFICATES OF VACCINATION AND INOCULATION Two thousand, three hundred and twenty-nine 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 endorsed accordingly. Occasional requests were also received by the Medical Officer of Health for a certificate to the effect that no recent cases of smallpox have occurred in the area. Such requests are made by persons proceeding to the U.S.A. who do not wish to be vaccinated. STAFF MEDICAL EXAMINATIONS At the request of the Committees and Chief Officers concerned, arrangements were made during the year for four 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 three cases it was found necessary to recommend superannuation. Twenty-six shorter reports on members of the staff who were sick were obtained from doctors at the request of the departments concerned. 22 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 5,422 12,455 17,877 Inspections under Shops Act 451 — 451 Infectious Diseases 929 345 1,274 Inspections under Factories Act 1,753 — 1,753 Housing Clearance Area Scheme 59 — 59 Housing Reports 1,710 — 1,710 Hairdressers 347 — 347 Other inspections 8,457 3,925 12,382 Totals 19,128 16,725 35,853 Smoke observations 282 Legal proceedings, attendances at court 31 Table II gives details of the sanitary operations carried out in the Borough during the year. The number of drains which were tested was 515 and 860 were cleansed or repaired. The drain of one house was reconstructed, and 136 drains were partially reconstructed. Damp conditions have been remedied in 909 premises, and in five of these damp courses were inserted. 23 24 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 TABLE II Putney Central Clapham Streatham Whole Borough 1. Premises cleansed and repaired 195 268 285 83 831 2. Drains tested 85 233 78 119 515 3. Drains cleansed or repaired 190 308 206 156 860 4. Water closets cleansed, repaired or renewed 97 120 137 54 408 5. Soil pipes altered or repaired 24 45 19 17 105 6. Waste pipes provided, altered or repaired 87 119 82 68 356 7. Rainwater pipes repaired 27 18 36 11 92 8. Roofs and gutters repaired 111 122 149 53 435 9. Damp courses inserted 2 1 1 1 5 10. Damp conditions otherwise remedied 116 113 175 49 453 11. Yards drained or paved 2 6 3 4 15 12. Dustbins provided 7 23 21 14 65 13. Water cisterns cleansed, covered or repaired 6 4 3 1 14 14. Water supply reinstated 105 50 44 67 266 15. Defectivestovesandfireplacesremedied 6 13 14 3 36 16. Animals improperly kept — 2 1 2 5 17. Accumulations of rubbish, etc., removed 10 41 22 7 80 18. Urinals cleansed or repaired — 3 6 — 9 19. Smoke nuisances 10 14 8 5 37 20. Other nuisances 16 34 27 3 80 Total 1,096 1,537 1,317 717 4,667 Number of Preliminary Notices served 284 434 430 113 1,261 Number of Preliminary Notices complied with 290 443 432 131 1,296 Number of Nuisance Notices served 103 104 166 32 405 Number of Nuisance Notices complied with 99 121 157 56 433 25 SANITARY INSPECTION OF THE BOROUGH Water Supply—Cutting-off Notices During the year notices with respect to 274 premises were received from the Metropolitan Water Board stating that the supply had been withdrawn. In 47 premises the water supply was cut off for non-payment of rates, and in 227 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 48 premises and during this period 54 dustbins were provided. Dustbins were also provided at 11 premises without the necessity of action under the Acts. Rodent Control One thousand, eight hundred and sixty-four 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 9,157 „ „ premises treated with "Warfarin" 1,379 „ „ premises "Warfarin" laid and found not troubled 59 „ „ premises investigated and found not troubled 117 „ „ "Warfarin" baits laid 5,140 „ „ drains tested by Public Health Inspector 319 „ „ drains found defective 247 „ „ rats estimated killed 2,538 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 The position remains much the same as described in my Report last year. 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. 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 approximately three years ago, one of the 26 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 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 plants but continuous chlorination operates in two only. In the two baths remaining, chlorine is added by hand. Samples of water taken from these baths during the year all proved satisfactory on bacteriological examination. Care of Old People The general pattern of work for the care of old people was not greatly altered in 1961. One addition to the facilities, however, was the appointment by the Borough Council in October of a part-time woman bathing attendant whose duty it is to visit the homes of frail old people who require and would like assistance with bathing. By the end of the year she was visiting 20 homes and giving a service which has proved to be very successful. Many old people appreciate the help that can be given and it is expected that the scope of the service will be extended considerably in the future. The care and welfare of old people is, of course, a joint venture of voluntary and statutory organisations. Apart from the professional services supplied through the District Nursing associations and the geriatric departments of hospitals, the Wandsworth Old People's Welfare Council organises visiting of old people, setting up of clubs, meals-on-wheels and chiropody, while the Wandsworth Old Folks Trust has inaugurated a scheme for providing holidays for old people. A very substantial amount of visiting of old people is carried out by the health visitors in the area and the public health inspectors are often able to be of assistance. As a result, undoubtedly, of the efforts of these many agencies, no old person was found in such a state that compulsory removal to a Home or hospital was necessary under the powers provided by the National Assistance Act. Action under this Act, although on occasions necessary as a last resort, is something which, if at all possible, we like to avoid and it is through the regular day-to-day routine of 27 SANITARY INSPECTION OF THE BOROUGH caring for and helping old people that action of this kind can be avoided. I have referred above to the work of the Wandsworth Old People's Welfare Council and the Wandsworth Old Folks Trust. It is not possible to do full justice to these organisations in a short report such as this but the Annual Report of the Wandsworth Old People's Welfare Council for the year ending 31st March, 1962, is an impressive document. In it, the Chairman of the Council, Councillor Mrs. Olive Haines, presents an account of the way in which grants from the Wandsworth Borough Council and the London County Council are utilised. On retirement, for instance, every pensioner receives a card which records the available services and which can be completed if any help is needed and this can be obtained from the office of the Welfare Council at 16 South Side, S.W.4. Under the chairmanship of Alderman Mrs. A. Bush, the Meals Committee organises the meals-on-wheels service and the Women's Voluntary Service, under Mrs. M. Nutting, M.B.E., is responsible for the detailed arrangements. The success of these arrangements can be gauged by the fact that there are now five vans in use and 1,000 meals are delivered each week. The Jordan, Lebanon, Lochinvar and Roehampton luncheon clubs are now open and enable elderly people to enjoy a meal in congenial and pleasant surroundings. The aim of the Clubs Committee, under the chairmanship of Mrs. E. Peacock, M.B.E., is to ensure that there is a club within easy reach of every old person and in this way much is done to combat loneliness which is one of the factors which so often troubles the elderly. At present, there are 38 clubs in the Borough. The pioneer work of Mrs. M. Lumley in the visiting of old people was continued by the recruiting of voluntary visitors and, to augment this work, a full-time organiser has now been appointed. Another feature of the Welfare Council's activities is the publication monthly of its magazine under the title of The News which has reached a circulation of about 900 copies. Edited by the General Secretary of the Association, Mr. A. N. Bransom, this paper contains news and topics of importance to old people generally and serves to stimulate comment and interest and thus to open the way to new ideas and developments. All in all, the work of these organisations presents an outstandingly impressive example of voluntary activity in a field of human endeavour, the importance of which it is difficult to overstate. Laundering of Bed Linen of Aged and Infirm The facilities available at the Disinfecting Station for the cleansing of fouled bed linen and personal effects of aged and incontinent persons living alone were extended during the year by the installation of a tumbler drier and the construction of an airing room. At the beginning of the year collections and washing of bed linen 28 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 in respect of 11 cases were being dealt with and a further 37 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 1,143 lots of fouled linen were collected and cleansed in 1961. 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. Spraying of rooms by the disinfecting staff of the Council is carried out, proprietary insecticides being used and infested bedding is removed to the Disinfecting Station and treated by steam. During the year 122 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. The furniture of 14 families was dealt with during the year. Bedding is not subjected to hydrogen cyanide but is disinfested by steam at the Council's Disinfecting Station. Mortuary The arrangement, made in 1956, between this Council and Battersea Borough Council, whereby the latter undertook, on agreed terms, to use their mortuary for the reception of bodies of Wandsworth residents, continued and is working satisfactorily. During the year 688 bodies of persons who died in Wandsworth were received in the Battersea mortuary in addition to the reception of bodies of persons dying in Battersea. Crematorium Under the Crematorium Regulations, 1930, 1,375 cremations were authorised during 1961, compared with 1,565 in 1960. 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 1961 was 22. 29 SANITARY INSPECTION OF THE BOROUGH Sewerage The arrangements for sewerage and sewage disposal in the district are reasonably adequate although flooding has occurred in the Borough due to surcharging of sewers following periods of heavy rain. A comprehensive sewer survey of the Borough which has been made by the Borough Engineer and Surveyor's Department over the past few years is now virtually complete and consequent upon the findings of this survey, a start has been made on an extensive capital works programme of sewer reconstruction. 5 HOUSING STATISTICS RELATING TO HOUSING Public Health (London) Act, 1936 Number of houses inspected on account of complaints or illness 6,351 Re-inspections 12,800 Number of statutory notices served: Intimation notices 1,261 Nuisance notices 405 Number of houses in which nuisances were abated 1,285 The number of cases referred to the Solicitor for legal action during 1961 was 105 The following is a summary of Police Court proceedings: Number of summonses served 52 „ „ „ withdrawn 22 „ „ „ adjourned 12 „ „ Orders made for abatement of nuisances 18 Housing Acts, 1936 and 1957 Clearance of Unfit Houses Number of houses included in representations under Section 157 of the Housing Act, 1957 Nil Number of houses included in declared Clearance Areas under Section 42 of the Housing Act, 1957 Nil Number of houses demolished following action under Section 25 of the Housing Act, 1936 46 Number of houses demolished following action under Section 42 of the Housing Act, 1957 24 Demolition Orders Number of Demolition Orders made under Section 17(1) of the Housing Act, 1957 Nil Number of houses demolished as a result of formal or informal procedure under Section 17(1) of the Housing Act, 1957 1 Closing Orders Number of Closing Orders made on houses under Section 17(1) of the Housing Act, 1957 Nil Number of houses closed in pursuance of an undertaking given by the owner under Section 16(4) of the Housing Act, 1957 1 Number of Closing Orders made on parts of buildings under Section 18 of the Housing Act, 1957 5 30 31 HOUSING Number of undertakings given by owners to close parts of buildings under Section 16(4) of the Housing Act, 1957 1 Number of Closing Orders determined under Section 27 of the Housing Act, 1957 8 Overcrowding Number of families found to be living in overcrowded conditions 25 Number of overcrowded families who have obtained alternative accommodation 31 New Accommodation For some years past, figures of new houses built in the Borough by the Council, the London County Council and other persons have appeared in this Annual Report. In this present report, the opportunity is taken to present a picture of the housing development in the Borough over the past 10 years. In the following table, figures of new dwellings built by the Council, the London County Council and private persons are shown and in future Annual Reports the then current year's figures will be incorporated in the table to provide a running record of the previous decade. NUMBER OF NEW DWELLINGS ERECTED IN THE BOROUGH SINCE 1952 Built by 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 Total (a) Borough Council 343 346 777 575 431 263 215 353 180 408 3,891 (b) L.C.C 543 1,536 2,023 1,613 735 1,012 1,224 152 170 227 9,235 (c) Private persons 92 70 72 69 26 39 75 169 294 493 1,399 Unfit Houses Closed Closing Orders were made in respect of parts of buildings as follows: Premises 33 Mount Ephraim Road 10 Pitcairn Street 88 Putney Bridge Road 90 Putney Bridge Road 8 Shrubbery Road In each case the owners had been invited to submit proposals to render the premises fit for human habitation, but none were received. 32 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 The Rent Act, 1957 Applications for Certificates of Disrepair. Forty-four applications were received for Certificates of Disrepair and were dealt with as follows: (a) In all 44 cases it was decided to serve notices on landlords proposing to issue Certificates of Disrepair unless undertakings to do repairs were given. (b) Twenty-four undertakings were received from landlords to remedy defects proposed to be included in Certificates of Disrepair. (c) Seventeen Certificates of Disrepair were issued. Applications for Cancellation of Certificates. (a) Thirty applications were received from landlords for the cancellation of Certificates of Disrepair. (b) Fifteen objections were received from tenants for cancellation of Certificates. (c) In four cases it was considered that the tenant's objections were not justified and the Certificates cancelled. (d) Eighteen Certificates of Disrepair were cancelled. Housing Accommodation—Medical Priority During the year 824 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 229 recommendations for transfer on health grounds in respect of applications received from tenants of the Council's properties for the provision of more suitable alternative accommodation. 6 FOOD AND FOOD PREMISES With the object of ensuring that 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 2,637 and during 1961 they were visited on 8,981 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. 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. Court summonses were taken out by the Council against two local traders for the presence of foreign matter in food. A fine of £4 and costs of £3-3-0 and a fine of £10 and costs of £5-5-0 were awarded by the Court respectively in these two cases. Court summonses were also taken out against local traders for the presence of mould in food. A fine of £2 and costs of £5-5-0 and a fine of £5 and costs of £2-2-0 were awarded by the Court respectively in these two cases. Further Court summonses were taken out against two local traders for smoking cigarettes whilst handling open food. A conditional discharge and costs of £1-10-0 and a fine of £1-10-0 and costs of £1-10-0 were awarded by the Court respectively in these cases. The following list shows the number and type of premises in the Borough where food is sold, stored or prepared: 33 34 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 TABLE I SUMMARY OF VISITS TO FOOD PREMISES Putney Central Clapham Streatham Whole Borough Dairies 10 25 41 36 112 Restaurants Kitchens 487 343 407 337 1,674 Ice Cream Premises 37 68 4 49 158 Butchers' Shops 320 147 175 45 687 Greengrocers' Shops 182 43 77 53 355 Fishmongers' Shops 57 19 33 30 139 Fried Fish Shops 88 37 83 9 217 Market Stalls 144 1,355 746 195 2,440 Grocers' Shops 567 353 490 352 1,762 Confectioners' Shops 254 167 152 124 697 Bakehouses 69 36 19 17 141 Other Premises 271 143 100 85 599 Total Visits 2,486 2,836 2,327 1,332 8,981 35 FOOD AND FOOD PREMISES Dairies and Milk Depots 9 Food Factories 23 Restaurants, Cafes and Canteens 466 Bakers and Confectioners 519 Butchers 207 Greengrocers 235 Fishmongers 73 Fish fryers 58 Bakehouses 54 Grocers 599 Off Licences 96 Public Houses 151 Stalls 147 2,637 The amount of work completed during 1961 to comply with the requirements of the Regulations is indicated in the following details: Washhand basins provided 40 Sinks provided 13 Provision of hot water over sink and washhand basin 23 Accommodation for clothing provided 6 Soap, towel and nailbrush 1 First-aid materials provided 1 Premises repaired or redecorated 64 Adequate protection for open food 12 Notices to employees 10 Dustbins 6 W.C. accommodation 14 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. During the year 45 applications were received from persons to be registered as distributors of milk. In each case the certificate of registration was granted. Thirty-seven notices of cancellation of registration were received. At the end of the year there were 233 36 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 persons on the register. 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 Two hundred and sixty samples of milk were submitted for analysis. Of these 40 were samples of Channel Island and South Devon milks with an average fat content of 4.46 per cent. The remaining 220 samples had an average fat content of 3.64 per cent. The Milk (Special Designation) Regulations, 1960 These Regulations which, as described in last year's Report, came into force on 1st October, 1960, provide for the issue of Dealer's (Prepacked Milk) Licences for the sale of milk under any of the following designations: "Pasteurized" "Sterilized" "Tuberculin Tested" where milk is obtained by the dealer in the container in which it is to be supplied to the consumer or is pasteurized or sterilized by the dealer. The following licences for the sale of milk under these designations and which will be valid for a period of five years, were granted during the year: Dealer's (Prepacked Milk) Licence "Pasteurized" 261 "Sterilized" 252 "Tuberculin Tested" 172 Total 685 Two Dealers' (Pasteurizers') Licences were also granted during the year. 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. Meat There are 207 butchers' shops in the Borough. The majority are registered under Section 16 (l)(b) of the Food and Drugs Act, 1955, for the preparation or manufacture of sausages or potted, preserved, pickled or pressed foods. There were 687 visits made to these shops during the year. 37 FOOD AND FOOD PREMISES 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 Fifty-four 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 1961 was 328, and 512 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. TABLE II PART II OF POISONS LIST Principal Business Number of Premises Number of Visits Confectioners 3 4 Domestic stores, ironmongers, etc. 73 74 Drug stores 17 17 Grocers 226 416 Hairdressers 5 7 Nurserymen and florists 4 4 Total 328 522 Bakehouses There are 54 bakehouses in the Borough, of which 11 are in basements and subject to the provisions of Section 54 of the Factories 38 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 Act, 1937. One hundred and forty-one 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. The water to the whole of the area is piped by the Metropolitan Water Board. It is known that this large undertaking carries out bacteriological and chemical tests of raw water and after treatment. No specific action has been necessary in respect of contamination of the water supply but in the case of individual premises, following inspection by public health inspectors, close liaison is maintained with the Metropolitan Water Board whenever necessary. All dwelling houses, approximately 96,000, and the population of 346,790 in the Borough are supplied from water piped direct to houses. It is not known if any standpipes are still in existence. 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 86 applications for registration under the provisions of Section 16(l)(a) and 26 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. Bacteriological Examination of Food and Waters Three hundred and seven samples were examined bacteriologically at the Public Health Laboratory during the year. They were as follows: 39 FOOD AND FOOD PREMISES Milk Ice-cream Artesian Well Waters Swimming Pool Waters Others Total 216 44 5 35 7 307 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 44 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 30 2 7 3 5 4 2 Total 44 Examination of Water from Artesian Wells Five samples were submitted for examination, and were reported satisfactory. Examination of Water from Swimming Baths Thirty-five samples were submitted for examination, and all were reported satisfactory. Others The seven miscellaneous samples proved to be free of pathogenic organisms. 40 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 Analysis of Food and Drugs During the year 1,000 samples of food and drugs were procured for analysis; 260 samples of milk, 707 other foodstuffs and 33 drugs. Of these, 240 were submitted as formal samples, while 760 were purchased informally. Five or 2.08 per cent, of the formal and 22 or 2.76 per cent, of the informal samples were found to be adulterated or not up to standard. The total adulterations reported were 27 or 2.7 per cent, of the samples submitted. The 27 samples found to be adulterated were: Six samples of bread, five dirty milk bottles, four samples each of glace cherries and milk, two samples each of cream and prepared sauce and one sample each of rum truffles, tobler-o-rum chocolate, blackcurrant drink and canned butter beans. 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 435 158 9 - (2) Factories not included above in which Section 7 of the Act is enforced by the Local Authority 1,120 956 19 - (3) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' Premises) 279 46 2 - Total 1,834 1,160 30 — (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 1 1 Overcrowding — — — — — Unreasonable temperature 1 — — — — Inadequate ventilation 1 — — — Ineffective drainage of floors Sanitary Conveniences: — — — — — (a) insufficient 8 8 — — (b) unsuitable or defective 61 31 — 13 — (c) not separate for sexes 1 1 — 1 — Other offences against the Act (not including offences relating to outwork) 7 7 — Total 80 48 — 14 — 41 42 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 PART VIII OUTWORK (SECTIONS 110 AND 111) Section 110 Section 111 Nature of Work 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. 640 — — — — Wearing apparel— cleaning and washing 4 — — — — Curtains and furniture hangings 7 — — — — Umbrellas, etc. 2 — — — — Artificial flowers 4 — — — — Paper bags 8 — — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper 22 Brush making 1 — — — — Carding, etc., of buttons, etc 4 _ _ — Stuffed toys — — — — — Cosaques, Christmas stockings, etc. 31 — Lampshades 180 — — — — Total 903 — — — — 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 21 new registrations were made, and the total number on the register at the end of the year was 278. Pet Animals Act, 1951 Thirty-five licences were issued by the Council in relation to premises subject to the provisions of this Act. 8 ATMOSPHERIC POLLUTION AND CLEAN AIR Progress continues to be made in implementing the Clean Air Act, 1956. In addition to the three Smoke Control Orders already made by the Council, a fourth Order has been submitted to the Minister of Housing and Local Government for his approval. The preliminary survey of the proposed Smoke Control Area No. 5 has been completed. On the following page there is depicted a map of the Borough showing the areas already covered by Smoke Control Orders and the areas in which it is proposed to make Orders in future years. 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 third Smoke Control area, requiring works of adaptation to fireplaces. These works were considered necessary in order to avoid contravention of the provisions of Section 11 relating to offences in Smoke Control areas. 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. Seven applications, together with plans or specifications, were received during the year and as the Council was satisfied that the proposed installations conform with the provisions of the Act, approval was given in each case. Notices of intention to install a furnace were received in respect of 13 premises, in accordance with the provisions of Section 3(3) of the Act. Measurement of Atmospheric Pollution Daily readings of the concentration of smoke and sulphur dioxide (S02) in the atmosphere were continued during the year at the five stations in different parts of the Borough where recording apparatus has been set up, and as in the previous year, a record of these readings for the year under review is given in Table I. A comparison of smoke and S02 concentration for the past two years is shown in Table II. 43 44 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 TABLE I Station RoofMunicipal Buildings Valley Road, S.W.I6 Tooting Library Queen Mary's Hospital, Roehampton South London Hospital, Clapham Month—1961 Smoke SO2 Smoke SO2 Smoke SO2 Smoke SO2 Smoke SO2 January 105 222 130 169 77 241 120 187 74 173 February 93 285 100 325 123 239 76 180 71 163 March 83 233 92 237 96 173 80 96 81 189 April 44 177 59 109 55 166 31 149 40 173 May 36 154 40 117 44 162 23 111 34 175 June 11 74 24 92 14 83 17 66 13 120 July 10 63 23 73 10 95 13 66 15 113 August 11 65 13 67 10 63 19 72 8 82 September 16 56 34 108 No Readings 39 110 10 85 October 21 164 47 125 39 206 34 88 30 180 November 27 265 112 186 39 126 126 258 40 245 December 126 341 76 525 105 321 57 357 76 242 Average 48 175 62 177 55 170 53 145 41 161 MAP OF SMOKE CONTROL AREAS IN WANDSWORTH 45 ATMOSPHERIC POLLUTION AND CLEAN AIR 9 ACCIDENTS IN THE HOME Tables showing figures of accidents in the home, introduced for the first time in 1958, are reproduced below, and include figures for 1961, calculated as described in the 1958 Report. HOME ACCIDENT CASES DURING 1956 to 1961 TABLE I Cause of Accident 1956 1957 1958 1959 1960 1961 Fall. On stairs 120 112 122 130 131 109 From ladder 21 18 12 19 20 8 From chair 18 18 21 29 21 22 Outside 32 18 16 35 21 17 In garden 45 31 25 43 35 34 In bath 1 3 1 4 2 2 From one level to another 42 42 33 32 35 45 On same level 77 57 105 115 110 110 Unspecified 222 240 255 268 338 373 Hit by object 45 15 14 16 20 21 Cooking stove 15 7 13 17 15 13 Teapots 4 2 6 7 7 6 Other boiling water 18 25 12 17 13 16 Electric shock 2 2 1 3 2 3 Poisoning 27 34 24 24 48 48 Gassing 9 9 12 19 12 14 Knife.like wounds 69 51 36 47 48 38 Fires 24 10 24 11 10 15 Windows 7 5 6 9 7 7 Suffocation 1 3 2 10 3 2 Not specified 13 53 44 31 39 41 Totals 812 755 784 886 937 944 Rate per 10,000 population 24.0 22.4 23.2 26.2 27.6 26.9 TABLE II AGE GROUPS AND PERCENTAGES 1956 % 1957 % 1958 % 1959 % 1960 % 1961 % Under 1 10 1.2 10 1.4 14 1.7 11 1.3 12 1.3 14 1.6 1. 76 3.2 25 3.3 29 3.7 31 3.4 33 3.6 35 3.9 2. 30 3.7 26 3.4 30 3.8 35 3.8 35 3.9 82 8.6 3 and 4 31 3.8 35 4.6 36 4.6 40 4.5 45 4.8 83 8.7 5.19 96 11.7 81 10.7 84 10.8 102 11.8 110 11.6 71 7.4 20.59 252 31.0 232 30.7 239 30.5 7.68 30.5 280 30.4 129 13.7 60.69 93 11.6 91 120 82 10.5 102 11.6 110 11.8 168 17.7 70.79 150 18.5 133 17.7 141 17.9 155 17.3 157 16.4 124 13.0 80+ 124 15.3 122 16.2 129 16.5 142 15.8 155 16.2 238 25.4 Totals 812 100 755 100 784 100 886 100 937 100 944 100 46 10 REPORT OF THE WORK OF THE PUBLIC ANALYST FOR 1961 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, 1961, 967 were articles of food and the remaining 33 drugs. All were submitted by the Council's Food Inspectors, 240 having been taken with the formalities required by the Act and 760 informally. Samples of the following substances were analysed: fats (butter, margarine, etc.), 40; beverages (cocoa, coffee, tea, etc.), 48; cereal preparations, 40; cheese products, 32; confectionery, 77; cream, 22; fish (canned, etc.), 30; fruit (canned and dried), 32; ice-cream, 2; meat products (including sausages), 84; milk, 260; pickles and condiments (including spices), 65; preserves, 70; soup, 40; vegetables, 42; aspirin tablets, 5; Beecham's powders, 3; glaubers salts, 7; ointments, 6; linctus, 8; tincture of quinine, 3. 47 48 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 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 432 Glace cherries Sulphur dioxide 205 parts per million 433 ,, ,, ,, „ 205 ,, ,, ,, 434 ,, ,, ,, „ 145 ,, ,, ,, 435 ,, ,, ,, ,,75 ,, ,, ,, 59 Milk 72% extraneous water Informal 930 Double cream Calcium compound with aliphatic acids present 932 Rum truffles Rum, one part in 930 parts only 935 T obler-O-Rum chocolate Rum, one part in 1500 parts only 983 Bread Contaminated with dirty mineral grease 984 Bread Contaminated with dirty mineral grease 1178 Blackcurrant drink Deficient in ascorbic acid 1207 Cream Contained finely divided iron 1208 Slice of bread Contained mineral grease 1237 Bread Contained lime-fruit sweet or jelly 1238 Canned butterbeans Contained fibres from sacking 1252 Milk bottle Contained moulds and miscellaneous dirt 1253 Milk bottle Contained a slug 1314 Bottle of milk Mycelium and spores of mould present 1330 Prepared sauce Olive oil replaced by arachis oil 1372 Slices of bread Mould (Monilia sitophila) present 1373 Prepared sauce Olive oil replaced by arachis oil 1401 Milk bottle Mycelium and spores of mould present 1429 Milk bottle Extraneous matter of the nature of cement 1457 Milk bottle Dirt, probably atmospheric 1541 Bottle of milk 8 inches of insulated lighting cable present 1589 Bottle of milk Atmospheric dirt and live yeast cells present 71 Slice of bread Cotton material with vegetable oil embedded in crumb Adulteration The amount of adulteration detected during the year was: For formal samples 2.08 per cent. For informal samples 2.92 per cent. For all samples 2.70 per cent. 49 REPORT OF THE PUBLIC ANALYST FOR 1961 Complaint Samples Case No. 930. Double Cream. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 944. Half a Chicken. Submitted on the complaint that the contents were not as advertised. The complaint was considered not justified. Case No. 973. Strawberry Jam. Submitted on the complaint that it contained insufficient fruit. The complaint was considered not justified. Case No. 983. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 984. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 985. Butter. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 1012. Milk Bottle. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 1207. Cream. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1208. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1237. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1238. Canned Butterbeans. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1252. Milk Bottle. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1253. Milk Bottle. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1275. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 1289. Canned Crab. Submitted on the complaint that it was not crab. The complaint was considered not justified. Case No. 1302. Bottle of Milk. Submitted on the complaint that it contained foreign matter, The complaint was considered not justified, 50 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1961 Case No. 1314. Bottle of Milk. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1315. White Walnut Cake. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 1344. Tinned Pineapple. Submitted on the complaint that the contents were tainted. The complaint was considered not justified. Case No. 1372. Bread. Submitted on the complaint that it contained mould. The complaint was considered justified. Case No. 1401. Milk Bottle. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1429. Milk Bottle. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1457. Milk Bottle. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1541. Bottle of Milk. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 1589. Bottle of Milk. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 34. Lime Drops. Submitted on the complaint that contents were stale. The complaint was considered not justified. Case No. 71. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 88. Frozen Steak and Kidney Pie. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. 51 REPORT OF THE PUBLIC ANALYST FOR 1961 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 20 12.65 3.81 8.84 February 25 12.51 3.72 8.79 March 20 12.39 3.64 8.75 April 20 12.22 3.48 8.74 May 25 12.46 3.62 8.84 June 20 12.46 3.65 8.81 July 25 12.56 3.78 8.78 August 20 12.58 3.83 8.75 September 20 12.50 3.75 8.75 October 25 12.71 3.90 8.81 November 21 12.93 4.02 8.91 December 19 12.93 4.03 8.90 The average composition of the 260 samples of milk analysed during the year and returned as genuine was as under: Total milk solids 12.39 per cent. Milk fat 3.64 per cent. Non.fatty solids 8.75 per cent. The average composition of the 40 samples of Channel Island and South Devon milks was as under : Total milk solids 13.57 per cent. Milk fat 4.46 per cent. Non.fatty solids 9.11 percent. INDEX PAGE Accidents, Deaths from 21 Accidents, Home 46 Acute Encephalitis 17 Analyst, Report of 47 Atmospheric Pollution 43 Bacteriological Examinations of Milk 39 „ „ of Ice-cream 39 Bathing Pools and Swimming Pools 25 Bed Bugs, Eradication of 28 Births, Birth-rates 10 Butchers' Shops 36 Cancer 22 Care of Old People 26 Childbirth, Deaths from 13 Circulatory Diseases 22 Clean Air 43 Closing Orders 30 Crematorium 28 Cutting-off Notices—Water Supply 25 Deaths, Causes of 12 Death-rates 11 Death-rate from Infective Diseases14 Death-rate, Infantile 13 Deaths, Number of 12 Diphtheria 14 Disinfection 20 Dysentery, Sonne 18 Enteric Fever 17 Erysipelas 18 Factories Act, 1937 and 1948 41 Factories and Workshops 41 Food and Drugs Act, 1955 36 Food Poisoning 19 Food, Supervision of 33 Food Places, Inspection of 34 Food Places, Number on Register 33 Food Hygiene Regulations 33 Hairdressers and Barbers 42 Home Accidents 46 Houses and Premises Inspected 23 Housing Act, 1936 30 Housing Statistics 30 Hydrogen Cyanide Disinfection 28 Illegitimate Children, Births of 10 Infant Mortality 13 Infective Diseases 14 Infective Diseases, Cases of 15 Infective Diseases, Death-rate from14 Influenza, Deaths 18 Influenzal Pneumonia and Acute Primary Pneumonia 18 52 53 INDEX PAGE Malaria 18 Maternal Mortality 13 Meat 36 Meningococcal Infection 17 Milk Analysis 51 Milk, Bacteriological Examination of 39 Milk Premises, etc., on Register 35 Milk (Special Designations) Regulations, 1949-5436 Mortuary 28 Non-Infective Diseases, Deaths from 22 Notification of Infective Diseases 15 Outworkers 42 Overcrowding 31 Pet Animals Act 42 Pharmacy and Poisons Act, 1933 37 Pharmacy and Medicines Act, 1941 37 Poliomyelitis 17 Population 10 Pregnancy, Deaths from Accident and Diseases of 13 Preserved Meat, etc., Manufacture of 36 Public Analyst, Report of 46 Puerperal Pyrexia 18 Pulmonary Tuberculosis, Notification of cases of 21 Rent Act 32 Rodent Control 25 Samples, Formal and Informal, Number of 48 Sanitary Inspection of Borough 23 Scabies 19 Scarlet Fever 17 Slaughter-houses 37 Slaughter of Animals Acts, 1933-1954 37 Smallpox 14 Smoke Control Areas 43 Staff 6 Statistics for the Borough 8 Suicide, Deaths from 22 Swimming Baths and Bathing Pools 25 Syphilis, Deaths from 19 Tuberculosis 21 Unfit Houses 31 Unsound Food 37 Water Supply 38 Water Supply, Cutting-off Notices 25 Whooping Cough 14 Geo. Gibbons Ltd., Leicester