AC 4388 WAN 99 Metropolitan Borough of Wandsworth ANNUAL REPORT of the Medical Officer of Health for the Year 1962 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 1962 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Wandsworth Mr. Mayor, Ladies and Gentlemen, I have the pleasure of presenting to you the Annual Report on the health and sanitary conditions of the Borough for the year 1962, which follows the general form of previous reports, being mainly statistical with comments on some points of interest. As mentioned in last year's Report, the preliminary figures from the 1961 Census, published by the Registrar-General, showed that the population of Wandsworth was nearly 8,000 more than the estimate for the previous year. Since then, more detailed figures have become available and it is, therefore, possible to include in the body of this Report, the Ward populations as at mid-1961. The Registrar-General's estimate for the overall population of the borough as at mid-1962 is 347,810, a slight increase since the Census, and this figure has been used in calculating all the rates shown in this Report. I have also extracted from the 1961 and 1951 Census certain data which throws some light on the variations in the population age groups. Of particular interest is the 28% increase in the number of elderly people over 80 years of age. The crude birth rate was 18.1 per thousand persons living, an increase over the previous year. After taking into account the area comparability factor, the adjusted rate works out at 17.4 as against 16.2 for 1961, so that the upward trend continues. The rate for England and Wales as a whole was 18.0 and for London 19.6. The crude death rate for the year was 14.4 compared with 14.0 for 1961 and the adjusted rate 11.2 as against 10.5. The corresponding figures for England and Wales and London were 11.9 and 12.0 respectively. The number of deaths of children under one year of age was practically the same as the previous year, 122 against 121, giving an infantile mortality rate of 19.3 per thousand live births, as compared with 20.5 for 1961. I am glad to be able to report that the increase in the maternal mortality rate noted last year was not sustained, there 2 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 being only two deaths in 1962 from diseases of pregnancy or child birth, giving a maternal mortality rate of 0.31. With the exception of problems arising from the importation of smallpox into the country, which I will deal with more fully below, 1962 was not a particularly notable year so far as infectious diseases were concerned. It was a "non-measles" year, the number of cases of measles being 691 compared with 4,912 in 1961. In the latter year there had been a reduction in the number of cases of scarlet fever from 172 to 107 and in 1962 this figure was almost unchanged at 109. Similarly, 1961 had shown a considerable reduction in the number of cases of whooping cough from the previous year and this was further reduced to 54 in 1962. No deaths arose from whooping cough or from measles. Of the 12 cases of poliomyelitis reported, two only, after investigation, were confirmed as cases of the illness compared with three in the previous year; one of these cases having some residual paralysis. The position as regards tuberculosis was little changed, there being 192 primary notifications compared with 193 in the previous year. In all, 320 cases of tuberculosis came to our notice compared with 352 in 1961 and of these 126 were transferred from other Authorities. There were 27 deaths from tuberculosis compared with 30 in 1961. Towards the end of 1961, smallpox was once again imported into this country as the result on this occasion of the arrival by air of infected immigrants from Pakistan. The four main foci of the illness were in parts of London, the Midlands, the North and South Wales and although no clinical case of the disease arose in Wandsworth, a considerable amount of work devolved on the Health Department in common with most other public health departments in the country, especially those in populous areas. When smallpox is known to be present in the country, particular vigilance is paid to the early diagnosis of the disease and so we had an increased number of requests from local practitioners to see patients who it was thought might have smallpox. In addition, the greatly increased number of vaccinations which were performed at this time was associated with a number of unusual skin eruptions. In some of the more puzzling and difficult cases we, in turn, called in Dr. McEntee, the infectious disease consultant at St. George's Hospital, Tooting, and I should like to take this opportunity of expressing my thanks and appreciation to Dr. McEntee for the ready and willing help he afforded us at this time. In addition to the requests to see doubtful cases, a considerable effort involved the daily surveillance of persons who had been in contact with one of the cases of smallpox and we were also notified by the Ministry of Health of travellers arriving from Pakistan and who were staying in Wandsworth; these were also kept under surveillance. Another problem, although not directly a matter for the Council, with which we had to deal was the large number of requests for vaccination. Few subjects in medicine and public health engender as much heated discussion as vaccination against smallpox. This has REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 3 always been so and 1962 was no exception. There was never any reason to advise mass vaccination of the population in Wandsworth; in fact, we did all we could to restrain the demand for vaccination. It quickly became apparent, however, that there was a very insistent clamour amongst a proportion of the population for vaccination and this it was felt had to be met. Accordingly, arrangements were made for much extended vaccination clinics and during this period approximately 33,000 people were vaccinated either by general practitioners or the health department of the London County Council. In the event, I think we about struck the happy medium. By discouraging vaccination (except, of course, when it was necessary on public health grounds) the situation never got out of hand although admittedly there were some very long queues; at the same time, public morale was sustained in that anyone who really felt he should be vaccinated was vaccinated. In this connection, it is interesting to note the increased requests for the authentication of International certificates of vaccination which we received from the public. These certificates are necessary for purpose of travel to certain foreign countries and, during the smallpox "scare", it was thought that these certificates would be required for travel on the Continent although normally this is not so. The result was that instead of issuing our "normal" number of International vaccination certificates, namely 2,000 odd, we did, in fact, issue over 15,000. One wonders whether the demand for vaccination in the early months of 1962 was as much to ensure entry into foreign countries as the desire to protect against the illness. It has been my dismal duty in these Reports in past years to refer to the shortage of public health inspectors. This year I find myself in the novel and happy position of being able to state that in 1962 for the first time in many years we were able to recruit up to the full number of our establishment of public health inspectors. Our extra staff did not join us until the second half of the year and the actual statistics may not fully reflect the increased work which was carried out. In any case, bare figures are an inadequate indication of work which is essentially advisory and supervisory in character. What probably is as important as the number of visits shown is the extra time which inspectors could devote to individual problems and here, of course, it is difficult to provide a measure. In one respect, however, the increase in the number of inspectors came at a convenient time in that it coincided with the increased attention which was paid during the year to the problem of houses in multiple occupation. The Housing Act, 1961, provided extra powers to local authorities to deal with houses let in lodgings or in multiple occupation but little progress could be made until the Regulations which the Minister was empowered to make under the Act were actually made. During the year, the Housing (Management of Houses in Multiple Occupation) Regulations, 1962, came into operation. This is a considerable public health and social problem 4 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 larly to be found in large towns and it is likely that in London it is proportionately as large as, if not larger than, elsewhere. In contrast with many of the Midland and Northern cities London has now no large acreage of back-to-back houses which are unfit for human habitation but there are many Victorian houses which have become sub-standard (although not statutorily unfit), most of which are in multiple occupation. The extent of the problem in Wandsworth, although it was thought to be considerable, was not accurately known and it was felt that the first most important task was to ascertain, as far as one could, what exactly is the extent of the problem. The improvement in the staffing situation in terms of public health inspectors enabled us to utilize the services of three inspectors on a comprehensive survey and in due course two reports on the subject were made to the Public Health Committee. In all, over 400 houses comprising different types of property known to be in multiple occupation were carefully inspected and certain facts and data were collected. The main points of interest are shown in tables in the body of the Report. The full details of this survey need not be repeated here since they have already been reported to the Public Health Committee but for the purposes of record, some of the more salient features observed may be mentioned. For instance, it was estimated that according to the figures collected there were about 1,200 families living in some 4,000 properties who were overcrowded according to the standards laid down by the Housing Act, 1957. But this was not the whole of the story. It is a principle of the legislation enacted in the Housing Act, 1961, that within limits a landlord may choose to reduce the number of tenants in a property rather than to carry out the work considered necessary to comply with the standards adopted by the Council. If landlords choose to reduce the numbers rather than carry out works, this would increase the number of families for which rehousing might be necessary. The number of families so affected could only be estimated but if the standards were to be applied rigorously, it could clearly be substantial and knowing the pressure on housing accommodation, it was apparent that the rehousing of at least 1,200 families could not be seriously considered on a short term basis. Moreover, this took no account of the pressure on housing accommodation on medical and other grounds. This survey confirmed our opinion that a considerable problem exists, and that it is mainly concentrated in one and two room lettings which, for the main part but not exclusively so, are to be found in three or four storey types of property. On the other hand, "squalor" although not defined exactly in the Regulations and open to some differences of interpretation was not found to any great extent in proportion to the number of properties we were dealing with. It should also be said that an agreeably high proportion of houses in multiple occupation were very well maintained and, in many cases, very little was found to criticise. Nevertheless, the investigation demonstrated that the REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 5 tion of Part 2 of the Housing Act, 1961, relating to houses in multiple occupation must be on a planned, deliberate and long-term basis. The Committee adopted certain standards in terms of water closets, baths and cooking facilities etc. and in applying these standards, it was agreed that attention should be focused on the one and two room lettings for the most part in the three and four storey types of premises. The district public health inspectors, so far as they are able in the course of their ordinary work, would carry out inspections of these properties and complete a record in respect of each house. Every effort would be made to obtain Improvements informally and landlords would be informed of what is necessary in order to comply with the standards and permitted numbers in the properties. Management Orders as provided for in the Act would only be made after every effort by informal means failed to obtain the necessary improvements. As to the question of registration of houses in multiple occupation, it is hoped that as the work proceeds a card index register of these properties will gradually be built up, enabling a decision as to registration to be taken in due course. At the time of writing, progress is being made but it is clear that no early or easy solution of this problem of multiple occupation is to be expected. The work in connection with smoke control and the making of Smoke Control Orders proceeded in 1962 and Order No. 4 was confirmed by the Minister. Work is currently proceeding on No. 5 area, which is shown on the map on Page 50. In December a very severe smog was experienced in the London area which, coming almost exactly ten years after the notorious smog of 1952, presented an opportunity to compare the effects in 1962 with those of 10 years earlier. Personal impressions, however unreliable, are worth recording and a number of people confirmed my own opinion that so far as density was concerned, both smogs were almost equally bad but in 1962 the irritation caused to the throat and eyes after being out for any length of time was less in 1962 than in 1952. To obtain some confirmation of these purely personal impressions, certain figures and data are available although they must be interpreted with caution, because Wandsworth is only a comparatively small part of the greater London conurbation and smoke and sulphur dioxide recorded locally at any given time are partly produced in areas outside the Borough, particularly those in the south-west since the predominant winds are from that direction. The figures recorded for smoke and sulphur dioxide in Wandsworth over the period of the 1962 smog are shown in Table III of the Atmospheric Pollution section of the Report. No figures are available for the corresponding period in 1952 because at that time no recording stations were in operation but for comparison purposes, I have shown the figures for the corresponding days in 1959, 1960 and 1961. As already mentioned, these figures are difficult to analyse but they appear to show that as regards both smoke and sulphur dioxide, 6 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 there was a considerable increase in both recordings during the smog of 1962 as compared with 1959, 1960 and 1961. Although it is almost platitudinous to say so, this is entirely as one would have expected. It so happens, however, that a recent report on the 1962 incident covering the administrative County of London is available which shows that the amount of smoke recorded in 1962 was appreciably less than in 1952. So far as sulphur dioxide was concerned, while some reduction was observed, this was not as marked as the reduction in the amount of smoke. As regards the effect of the smog in Wandsworth on mortality, I have also included in this Report charts which appeared in my report to the Committee. These are shown on page 52. These charts bear out what a number of doctors practising in the area told me that in comparison with the smog of 10 years previously, that for 1962 was less lethal. It is tempting to attribute this to the effects of the Smoke Control Orders which have already been made and presumably these would have had some effect but probably of equal importance is the fact that the serious results of smog, particularly to elderly people and those susceptible to chest trouble are now more readily recognised and that wide publicity was given by means of radio and television as to how the effects can be minimised, particularly by staying indoors if subject to chestiness. The general impression from comparing the 1952 and 1962 smogs was that in 1962 there seemed to have been a less irritant effect and that the influence of smoke control measures may be beginning to be felt. It is certainly the case that the total deaths and deaths from bronchitis were appreciably lower in 1962 than was the case in 1952. In past years, I have referred to the work for and care of old people undertaken by voluntary associations and statutory bodies and will this year say no more than that this work continues and is a very important part of the public health social work in Wandsworth. During the year, Mr. J. E. Woodhead, who had been the Council Public Analyst for many years retired from this office and I should like to express the thanks of the Public Health Department for his help and co-operation in food administration problems over many years. As successor to Mr. Woodhead, the Council appointed Mr. Derek Forbes as Public Analyst and the opportunity was taken on Mr. Forbes taking up his appointment to review our existing practice in relation to the sampling of foodstuffs under the Food and Drugs Act. As a result, some comparatively minor alterations were made in the types and proportions of certain commodities to be sampled. Finally, I should like to thank the many people who have assisted the work of the Health Department throughout the year, particularly the Committees and their Chairmen with whom I have been mainly concerned. In the earlier months of the year, the Chairman of the Public Health Committee was Councillor Mrs. Olive Haines, who was followed by Councillor Miss Joan Lestor. I should like to thank both Mrs. Haines and Miss Lestor for their help in the year and also REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 7 to express my appreciation to the members of my own staff in the Health Department and the Chief Officers and staff of other departments of the Council. 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 .. 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 P. O'Grady A. E. Handley K. J. Winton J. H. Massey J. D. Morritt P. P. Leacock R. C. Charlton A. J. Lansley A. Stewart S. R. Coomber S. E. Thelner A. W. Lock G. Pike C. Jones J. B. Sainsbury J. Smith J. F. Burslem D. J. Hughes J. L. Gill Trainee Public Health Inspectors M. Timlin D. S. Burtenshaw Administrative and Clerical S. F. Jennings A. J. K. Green A. E. Hollis E. Harris W. Pitman F. Chislett S. Taylor D. H. Barnes N. Lane G. Harwood Mrs. F. Hull Miss J. Eley 8 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 9 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 W. E. Stringer G. W. Price T. Price A. E. Clement J. C. Prowen Mrs. E. King (part-time) Rodent Operatives J. W. Taylor J. Wells G. J. Langrish W. Maxwell V. T. Athaide The following changes occurred in 1962: Appointments Mr. J. F. Burslem and Mr. J. L. Gill, who qualified as public health inspectors in June, were appointed as such the same month. Messrs. R. C. Charlton, A. Stewart, S. E. Thelner, G. Pike, J. B. Sainsbury, and J. B. Facer, public health inspectors, appointed in June. Mr. D. S. Burtenshaw, student public health inspector, appointed in March. Mr. G. Harwood, General Division clerk, appointed in April. Mr. W. E. Stringer, disinfector apparatus attendant, appointed in April. Resignations and Retirements Mr. J. B. Facer resigned in November. Mr. A. J. Brown, General Division clerk, resigned in May. Mr. H. Coster, disinfector apparatus attendant, retired in March. 1 STATISTICS AND SOCIAL CONDITIONS Area 9,109 acres Resident population in 1962 347,810 Wandsworth is the largest of the Metropolitan Boroughs. It has an area of 9,109 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. 10 STATISTICS AND SOCIAL CONDITIONS 11 Extracts from Vital Statistics Number of Live Births: Male Female Total Legitimate 2,846 2,741 5,587 Illegitimate 377 348 725 3,223 3,089 6,312 Rate per 1,000 population: Crude 18.1 Adjusted 17.4 Number of stillbirths 52 46 98 Rate per 1,000 total live and stillbirths 18.4 Percentage of illegitimate live births to total live births 11.4 Number of deaths: All ages 2,271 2,739 5,010 Under 1 year 76 46 122 Puerperal causes 0 2 2 Rate per 1,000 population: Crude 14.4 Adjusted 11.2 Infantile Mortality Rates: Total infant deaths per 1,000 total live births 19.3 Legitimate infant deaths per 1,000 legitimate live births 18.6 Illegitimate infant deaths per 1,000 illegitimate live births 24.8 Neo-natal Mortality Rate (deaths under four weeks per 1,000 total live births) 14.8 Early Neo-natal Mortality Rate (deaths under one week per 1,000 total live births) 13.1 Perinatal Mortality Rate (stillbirths and deaths under one week combined per 1,000 total live and stillbirths) 28.0 Maternal Mortality Rate (per 1,000 total live and stillbirths) 0.31 12 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962  Total Number of deaths from Cancer 920 „ „ „ „ Diphtheria 0 „ ,, „ „ Scarlet Fever 0 „ „ „ „ Measles 0 „ „ „ Whooping Cough 0 „ „ „ „ Tuberculosis 27 There has been no unusual or excessive mortality during the year. 2 VITAL STATISTICS Population The overall civilian population at the middle of the year was estimated by the Registrar-General to be 347,810, and all the rates used in this Report are based on this figure. As the Registrar-General has also now published certain detailed figures obtained from the 1961 Census, figures which vary in some degree from estimates formed in the interim period between census years, the opportunity is taken to present in this report his estimates of the Ward populations of the Borough as at mid-1961. These figures are shown in Table I, together with the mid-1962 estimates for the Parliamentary divisions, based on the overall figure. In Table I(a) a comparison is made of the population in five-yearly age groups and sexes for the two census years, 1951 and 1961. TABLE I mid-1961 mid-1962 Putney Putney Ward 35,444] 105,524 105,630 Parliamentary Thamesfield „ 16,902 Division Fairfield „ 14,632 West Hill „ 23,436 Southfield „ 15,110 Central Earlsfield „ 17,236 90,500 90,590 Parliamentary Springfield „ 17,337 Division Tooting 17,933 Graveney „ 20,095 Bedford „ 17,899 Clapham Larkhall 13,778 79,983 80,080 Parliamentary Clapham North „ 14,370 Division Clapham Park „ 17,294 Thornton „ 19,778 Balham „ 14,763 Streatham Streatham Hill 18,120 71,435 71,510 Parliamentary St. Leonards „ 13,116 Division Streatham Common „ 12,636 Streatham South 11,810 Furzedown „ 15,753 347,442 347,810 Births The total number of births belonging to the Borough registered during 1962 was 6,312, consisting of 3,223 males and 3,089 females. The number for 1961 was 5,878. The crude birth-rate was 18.1 per 1,000 persons living compared with 16.9 for 1961. The adjusted rate works out at 17.4 after taking 13 14 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 into account the area comparability factor supplied by the RegistrarGeneral. The birth-rate for England and Wales as a whole was 18.0 and for London 19.6. Seven hundred and twenty-five illegitimate births took place in the Borough compared with 630 in 1961. TABLE I(a) POPULATION IN AGE GROUPS AND SEXES FOR 1951 AND 1961 Age groups Persons Males Females 1951 1961 Variation + or — 1951 1961 1951 1961 0-4 24,956 22,333 - 2,623 12,900 11,397 12,056 10,936 5-9 21,125 20,339 - 786 10,930 10,320 10,195 10,019 10-14 16,640 25,050 + 8,410 8,514 12,947 8,126 12,103 15-19 15,289 23,335 + 8,046 6,570 11,654 8,719 11,681 20-24 20,352 24,090 + 3,738 9,405 11,852 10,947 12,238 25-29 25,602 22,457 - 3,145 12,312 11,758 13,290 10,699 30-34 25,343 21,989 - 3,354 12,226 10,946 13,117 11,043 35-39 27,561 24,607 - 2,954 13,241 11,969 14,320 12,638 40-44 26,946 24,200 - 2,746 12,985 11,524 13,961 12,676 45-49 23,999 26,641 + 2,642 11,196 12,802 12,803 13,839 50-54 21,492 26,085 + 4,593 9,435 12,470 12,057 13,615 55-59 19,640 22,281 + 2,641 8,301 10,312 11,339 11,969 60-64 18,180 18,430 + 250 7,557 7,806 10,623 10,624 65-69 15,867 14,908 - 959 6,208 5,814 9,659 9,094 70-74 12,407 12,620 + 213 4,714 4,549 7,693 8,071 75-79 8,338 9,390 + 1,052 2,980 2,978 5,358 6,412 80-84 4,503 5,598 + 1,095 1,368 1,652 3,135 3,946 85-89 1,767 2,386 + 619 438 573 1,329 1,813 90-94 430 585 + 155 93 123 337 462 95 and up 56 118 + 62 12 19 44 99 330,493 347,442 + 16,949 151,385 163,465 179,108 183,977 Density of population —persons per acre 36.3 38.1 Deaths The number of registered deaths which took place in the Borough during the year was 4,009 but 1,074 of these did not belong to the Borough, while 2,075 Borough residents died outside the Borough. The corrected number of deaths for the Borough, after allowing for these factors, was 5,010 of whom 2,271 were males and 2,739 females. VITAL STATISTICS 15 The crude death-rate for the year was 14.4 compared with 14.0 for 1961, but after taking into account the area comparability factor supplied by the Registrar-General, the adjusted rate works out at 11.2 The death-rate for England and Wales as a whole was 11.9 and for London 12.0. 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 Death Rate Males Females Total Putney 541 579 1,120 10.6 Central 836 1,071 1,907 21.0 Clapham 513 643 1,156 14.4 Streatham 381 446 827 11.5 Whole Borough 2,271 2,739 5,010 14.4 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. 16 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 TABLE III. CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1962 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 26 17 9 — — — — 12 14 7 9 5 5 Tuberculosis, Other 1 — 1 — — — — — 1 — 1 — — Syphilitic Disease 10 4 6 — — — — 3 7 1 4 4 1 Diphtheria — — — — — — — — — — — — — Whooping Cough — — — — — — — — — — — — — Meningococcal Infections 1 1 — 1 — — — — — 1 — — — Acute Poliomyelitis — — — — — — — — — — — — — Measles — — — — — — — — — — — — — Other Infective and Parasitic Diseases 13 2 11 — — — 2 9 2 2 6 2 3 Malignant Neoplasm, Stomach 93 55 38 — — — 1 37 55 24 28 22 19 Malignant Neoplasm, Lung, Bronchus 252 206 46 — 1 — 9 100 142 65 76 56 55 Malignant Neoplasm, Breast 86 — 86 — — — 6 39 41 16 21 33 16 Malignant Neoplasm, Uterus 39 — 39 — — — 2 13 24 8 9 14 8 Other Malignant and Lymphatic Neoplasms 412 209 203 — — — 18 129 265 95 115 128 74 Leukaemia, Aleukaemia 38 20 18 — 1 2 3 16 16 7 11 10 10 Diabetes 27 7 20 — — — 1 4 22 7 7 6 7 Vascular Lesions of Nervous System 560 199 361 — — — 6 73 481 138 180 140 102 Coronary Disease, Angina 856 494 362 — — — 24 215 617 233 241 215 167 Hypertension, with Heart Disease 73 19 54 — — — — 12 61 19 27 13 14 Other Heart Disease 927 302 625 — — — 13 63 851 123 574 127 103 Other Circulatory Disease 223 88 135 — — — 2 37 184 63 72 53 35 Influenza 24 11 13 — — — 3 6 15 5 6 6 7 Pneumonia 312 127 185 23 1 1 8 31 248 61 129 80 42 Bronchitis 271 165 106 1 — — 2 59 209 63 107 65 36 Other Diseases of Respiratory System 31 16 15 — — — 2 9 20 6 14 6 5 Ulcer of Stomach and Duodenum 37 23 14 — — — 1 8 28 9 12 9 7 Gastritis, Enteritis, Diarrhoea 24 9 15 3 — — 2 3 16 8 7 7 2 Nephritis and Nephrosis 22 11 11 — — — 1 9 12 8 4 8 2 Hyperplasia of Prostate 19 19 — — — — — 1 18 7 4 4 4 Pregnancy, Childbirth, Abortion 2 — 2 — — — 2 — — — — 2 — Congenital Malformations 32 16 16 19 1 — 4 6 2 8 9 8 7 Other Defined and Ill-defined Disease 422 156 266 72 3 3 16 73 255 85 190 80 67 Motor Vehicle Accidents 55 32 23 — 1 1 21 13 19 15 10 17 13 All Other Accidents 63 33 30 3 3 1 4 16 36 20 15 20 8 Suicide 59 30 29 — — — 25 23 11 16 19 16 8 Homicide and Operations of War — — — — — — — — — — — — — All Causes 5,010 2,271 2,739 122 11 8 178 1,019 3,672 1,120 1,907 1,156 827 VITAL STATISTICS 17 TABLE III(a). DEATHS FROM HEART DISEASE, 1962 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. — — 22 172 300 494 — — 2 43 317 362 856 Hypertension with Heart Disease — — — 6 13 19 — — — 6 48 54 73 Other Heart Disease — — 6 34 262 302 — — 7 29 589 625 927 Total — — 28 212 575 815 — — 9 78 954 1,041 1,856 Infantile Mortality There were 122 deaths of children under one year, giving an infant mortality rate of 19.3 per 1,000 live births. This compares with a rate of 20.5 for 1961. For the 10 years ended 1952 the average infant mortality rate was 31, while for the 10-year period ending 1962 the average rate was 20. Table III(b) shows causes of death of children under one year of age. TABLE III(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 — 2 3 5 18 23 19 2. Bronchitis — — — — 1 1 1 3. Gastritis, Enteritis, Diarrhoea — — — — 3 3 2 4. Congenital Malformations 8 3 3 14 5 19 16 5. Prematurity 35 15 1 51 — 51 42 6. Other Causes 7 6 3 16 9 25 20 TOTALS 50 26 10 86 36 122 100 APPROXIMATE PERCENTAGE OF TOTALS 41 22 8 71 29 100 100 Maternal Mortality Two deaths occurred from accidents and diseases of pregnancy or child-birth. This is equivalent to a rate of 0.31 per 1,000 live and still-births. 3 INFECTIVE DISEASES The number of deaths from all notifiable infectious diseases was 68. This included 27 from all forms of tuberculosis and 40 from the notifiable forms of penumonia. There was one death from meningococcal meningitis. From all notifiable infective diseases the death-rate was 0.19 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. In this connection, a great deal of additional work was placed on the public health staff owing to the importation of smallpox from Pakistan during December 1961 and January 1962, leading to the distribution of infected immigrants in a number of towns in England and Wales, including London. Secondary cases occurred in some of these areas and the infection was not finally extinguished until the end of April. All travellers from infected areas of Pakistan who came into the Borough were kept under the strictest surveillance for the relevant periods. In many cases, daily examination of these persons was carried out by the Deputy Medical Officer of Health and in most of the other cases, daily contact was maintained by the public health inspectors. It was also necessary to carry out a medical examination of a number of patients suffering from diseases requiring differentiation from smallpox. Diphtheria Several suspected cases were reported and investigated but in no case was the diagnosis confirmed. Whooping Cough Fifty-four cases only were notified during the year. With one exception, that of 1940, this is the lowest number notified in any year since 1901. No death occurred. 18 INFECTIVE DISEASES 19 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 175 4 19 18 88 12 14 14 4 2 Encephalitis, Acute 2 — — — 1 1 — — — — Erysipelas 21 — — 1 — 1 1 4 9 5 Food Poisoning 70 3 3 5 3 2 13 20 20 1 Malaria — — — — — — — — — — Measles 691 26 139 161 280 38 32 15 — — Meningococcal Infection 6 3 — — 2 — — — 1 — Ophthalmia Neonatorum 5 5 — — — — — — — — Pneumonia: Acute Influenzal 25 2 — — 1 — — 5 9 8 Acute Primary 118 5 5 4 5 3 6 13 30 47 Poliomyelitis, Acute 2 — — — — 2 — — — — Puerperal Pyrexia 71 — — — — — 43 28 — — Scabies 8 — 1 1 1 — 3 — 2 — Scarlet Fever 109 1 8 24 56 13 6 1 — — Smallpox — — — — — — — — — — Tuberculosis 320 2 4 6 5 8 57 131 92 15 Typhoid Fever and Paratyphoid Fever 4 2 — — 1 — 1 — — — Whooping Cough 54 10 15 10 13 2 1 3 — — Total 1,681 63 194 230 456 82 177 234 167 78 20 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 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 43 4 4 4 2 4 6 14 9 13 23 13 4 11 5 14 — — — 2 175 — Encephalitis, Acute — — — — — — — — — — 1 — — 1 — — — — — — 2 — Erysipelas 1 — 1 — 3 2 6 — 1 — — 1 1 — — — — 1 2 2 21 — Food Poisoning 5 1 7 3 1 25 5 6 2 3 1 1 1 — 4 1 1 2 — 1 70 — Malaria — — — — — — — — — — — — — — — — — — — — — — Measles 44 57 58 34 22 69 95 57 23 31 36 28 6 21 17 25 12 17 33 6 691 — Meningococcal Infection — — 1 4 — 1 — — — — — — — — — — — — — — 6 1 Ophthalmia Neonatorum — — — — — 1 — — 1 2 — — — — — — — — — 1 5 — Pneumonia, Acute Influenzal — 2 — 3 2 — 1 — — 5 1 2 1 — 3 — 1 1 1 2 25 6 „ Acute Primary 2 — 3 6 4 7 12 5 5 30 1 2 2 14 11 — 1 — 4 9 118 34 Poliomyelitis, Acute — — — 1 — — — — — — — — — — 1 — — — — — 2 — Puerperal Pyrexia 1 — 1 1 — 3 2 2 3 8 5 2 13 8 13 3 1 1 — 4 71 — Scabies 1 — — 1 — 1 — — 1 2 1 — — — — — — — 1 — 8 — Scarlet Fever 4 2 10 12 4 13 8 8 3 2 8 5 3 2 3 1 7 7 4 3 109 — Smallpox — — — — — — — — — — — — — — — — — — — — — — Tuberculosis—all forms 18 9 16 9 11 16 13 30 14 22 14 15 20 15 33 25 14 12 7 7 320 27 Typhoid Fever and Paratyphoid Fever 1 — — — — — 1 — — 1 — — — 1 — — — — — — 4 — Whooping Cough 3 — 9 2 3 2 2 4 3 5 2 — — — 6 2 2 2 2 5 54 — Total 123 75 110 80 52 144 151 126 65 124 93 69 51 73 96 71 39 43 54 42 1,681 68 INFECTIVE DISEASES 21 Measles The number of cases notified during the year was 691 compared with 4,912 in 1961, 825 in 1960 and 3,212 in 1959. Poliomyelitis Twelve cases of this disease were reported and investigated during the year, compared with 33 in the previous year. In 10 cases the diagnosis was not confirmed. The remaining two confirmed cases were of the paralytic type. The figures of poliomyelitis from 1947 to 1962, 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 1962 No. of cases reported as suspected poliomyelitis and investigated 119 31 89 71 29 73 73 41 104 85 147 65 73 31 33 12 No. of cases confirmed: (a) paralytic 78 15 58 40 4 23 19 5 22 24 44 11 13 1 2 2 (b) nonparalytic 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 Six confirmed cases were notified, one of which proved fatal. Thirty-five other cases were investigated but these were subsequently not confirmed. In 1961 there were five confirmed cases with one death. Acute Encephalitis Two cases occurred during the year. Typhoid and Paratyphoid Fever There were four confirmed cases of paratyphoid fever during the year. Scarlet Fever One hundred and nine cases were notified compared with 107 in 1961 and 172 in 1960. No deaths occurred. 22 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 Puerperal Pyrexia During the year 71 cases were notified, of which 64 occurred in hospital and seven at home. Twenty of the hospital notifications referred to patients whose home addresses were outside the Borough. Information was also received of 12 cases, referring to Wandsworth residents whose confinements took place in hospital located in other Metropolitan boroughs. Sonne Dysentery A figure of 175 cases was finally arrived at for the year, compared with 93 for 1961, but many other cases, suspected as being dysentery, were investigated before the provisional diagnosis was eliminated by bacteriological examination. Although the majority of the cases investigated were single unrelated cases, minor outbreaks did occur at five schools and one day nursery in the Borough. Details of positive cases and numbers of stools specimens examined in these outbreaks from actual and suspected cases is given below: No. of cases discovered No. of faecal specimens taken Date Outbreak Jan. Day Nursery 10 123 June School 19 120 July „ 23 164 Sept. „ 13 87 Oct. 32 156 Oct. 18 98 It is pleasant to record, once again, the help and co-operation received by the department from general practitioners throughout the Borough. Influenza, Acute Influenzal Pneumonia and Acute Primary Pneumonia Acute influenzal pneumonia and acute primary pneumonia are the notifiable forms of pneumonia, and in 1962, 25 of the former and 118 of the latter were notified, as compared with 96 and 122 respectively for the previous year. Deaths attributable to acute influenzal pneumonia were 6; this figure is classified under influenza in the death table on page 16. Acute primary pneumonia accounted for 34 deaths, making a total of 312 deaths for all forms of pneumonia compared with 325 in 1961. Deaths in 1961 from acute influenzal pneumonia and acute primary pneumonia were respectively 28 and 45. Malaria No cases were reported. Erysipelas Twenty-one cases were notified. INFECTIVE DISEASES 23 Other Infective Diseases Ten deaths occurred from syphilis. Scabies Eight notifications were received. Sixteen treatments were given at the Council's Disinfecting Station during the year. At the Battersea Cleansing Station, a total of 54 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 One hundred and thirty-six notified or otherwise reported cases were investigated during the year. Of these, 77 were found to be not food poisoning after laboratory examination of faecal specimens from those affected. Fifty-three of the remaining notifications were single unrelated cases and six involved two or more persons. The majority of the cases were only slightly affected and where bacteriological examination was carried out, organisms likely to have caused the illness were found in 30 cases. The organisms isolated were Salmonella typhimurium (18), heidelberg (7), bredeney (4) and menston. Diseases Reported from Schools A total of 3,132 infective diseases was reported from schools in the Borough throughout the year. The numbers of each disease were: Scarlet Fever 77 Scabies 3 Measles 216 Whooping Cough 14 German Measles 1,058 Mumps 261 Poliomyelitis 4 Dysentery 82 Chicken Pox 1,118 Other complaints 299 Disinfection During the year 218 rooms were disinfected after infectious and other disease, 234 rooms disinfested for vermin, and 25 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. 24 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 The following is a summary of examinations made during the year: Nose and throat swabs 823 Faeces and urine for the typhoid and dysentery groups 2,283 Miscellaneous specimens 10 Total 3,116 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 compliance with the request of the Medical Officer of Health. During the year, no case arose that necessitated action under this Act but three contacts of infectious disease who were excluded from work were issued with certificates enabling them to draw National Health sickness benefit. TUBERCULOSIS Notifications The total number of new cases which came to the notice of the Department during 1962 was 320 compared with 352 in 1961. The sources of information regarding the new cases were as follows: Primary notifications on Form A 192 Unnotified at death 2 Transfers from other sanitary authorities 126 Total 320 Three hundred and eighteen cases were added to the notification register during the year and 137 cases who had removed, recovered or died, were taken off. The number remaining on the register at the end of the year was 6,690. INFECTIVE DISEASES 25 Deaths The number of deaths certified as due to various forms of tuberculosis was 27. 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 Non- Non- Pulmonary Pulmonary Pulmonary Pulmonary M. F. M. F. M. F. M. F. Under 1 year 2 - - - - - - - 1-2 2 1 — 1 — — — — 3-4 2 3 — 1 — — — — 5-9 2 3 - - - - - - 10-14 3 3 2 - - - - - 15-24 31 22 3 1 — — — — 25-44 72 53 3 3 — — — — 45-64 64 25 1 2 7 5 — — 65 and upwards 11 3 1 — 10 4 — 1 Totals 189 113 10 8 17 9 — 1 NON-INFECTIVE DISEASES The total number of deaths from cancer and malignant disease was 920, the number of males being 490 and females 430. The death-rate was 2.65 per 1,000. The number of deaths in 1962 was 44 more than in the previous year. Deaths from diseases of the heart and circulatory system were 2,079 compared with 1,953 in 1961. Of these deaths, 1,713 were of persons of 65 years of age and above. There were 638 deaths from diseases of the respiratory system compared with 653 in 1961. The number of deaths from bronchitis was 271 compared with 260 in 1961, and from pneumonia (all forms) 312 compared with 325 in 1961. One hundred and seventy-seven deaths were due to violence, 55 of them being due to motor accidents, 59 to suicide and 63 to other forms of violence. CERTIFICATES OF VACCINATION AND INOCULATION Fifteen thousand, one hundred and seventy-eight 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. The great increase in 1962 in the number of international certificates dealt with was due to two factors (1) the importation of smallpox from Pakistan referred to earlier in this Report which brought about a public demand for vaccination with a corresponding increase in the number of certificates asked for and (2) the added restrictions placed upon travellers by Continental countries, consequent upon the aforementioned importation of smallpox. 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 nine 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. Forty-five shorter reports on members of the staff who were sick were obtained from doctors at the request of the departments concerned. 26 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 Re- Inspections Total To investigate complaints 5,103 12,292 17,395 Inspections under Shops Act 372 — 372 Infectious Diseases 1,075 776 1,851 Inspections under Factories Act 1,798 — 1,798 Housing Clearance Area Scheme 157 — 157 Housing Reports 5,483 — 5,483 Hairdressers 349 — 349 Other inspections 7,946 3,807 11,753 Totals 22,283 16,875 39,158 Smoke observations 283 Legal proceedings, attendances at court 47 Table II gives details of the sanitary operations carried out in the Borough during the year. The number of drains which were tested was 363 and 1,077 were cleansed or repaired, and 107 drains were partially reconstructed. Damp conditions have been remedied in 650 premises, and in three of these damp courses were inserted. 27 28 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 TABLE II Putney Central Clapham Streatham Whole Borough 1. Premises cleansed and repaired 184 222 261 69 736 2. Drains tested 90 119 68 86 363 3. Drains cleansed or repaired 254 232 215 376 1,077 4. Water closets cleansed, repaired or renewed 78 75 93 82 328 5. Soil pipes altered or repaired 4 23 29 6 62 6. Waste pipes provided, altered or repaired 42 68 66 52 228 7. Rainwater pipes repaired 15 14 25 6 60 8. Roofs and gutters repaired 101 111 144 39 395 9. Damp courses inserted 1 — 2 — 3 10. Damp conditions otherwise remedied 97 130 134 40 401 11. Yards drained or paved 2 9 13 — 24 12. Dustbins provided 6 14 42 10 72 13. Water cisterns cleansed, covered or repaired 2 2 4 1 9 14. Water supply reinstated 96 65 18 54 233 15. Defectivestovesandfireplacesremedied 11 21 11 5 48 16. Animals improperly kept 1 — 1 — 2 17. Accumulations of rubbish, etc., removed 1 31 23 10 65 18. Urinals cleansed or repaired — 1 2 — 3 19. Smoke nuisances 8 3 6 2 19 20. Other nuisances 9 19 27 8 63 Total 1,002 1,159 1,184 846 4,191 Number of Preliminary Notices served .. 224 315 301 139 979 Number of Preliminary Notices complied with 260 363 374 144 1,140 Number of Nuisance Notices served 48 76 112 26 262 Number of Nuisance Notices complied with 64 78 123 24 289 SANITARY INSPECTION OF THE BOROUGH 29 Water Supply—Cutting-off Notices During the year notices with respect to 235 premises were received from the Metropolitan Water Board stating that the supply had been withdrawn. In 53 premises the water supply was cut off for non-payment of rates, and in 182 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 44 premises and during this period 63 dustbins were provided. Dustbins were also provided at 9 premises without the. necessity of action under the Acts. Rodent Control One thousand, three hundred and forty-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 8,219 „ „ premises treated with "Warfarin" 1,219 „ „ premises "Warfarin" laid and found not troubled 37 „ „ premises investigated and found not troubled 65 „ „ "Warfarin" baits laid .. .. .. .. 4,672 „ „ drains tested by Public Health Inspector 194 „ „ drains found defective 149 „ „ rats estimated killed 1,922 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. All the public swimming baths in the Borough now 30 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 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; slight deviations from normal were found initially in a few samples but subsequent tests all proved 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 Subject to special circumstances, the Council has authority under the National Assistance Act to make application for the removal to a hospital or Home of an aged, infirm, or physically incapacitated person who is suffering from a chronic disease or is living in insanitary conditions. That compulsory removal has not been required is doubtless largely attributable to the care and welfare services supplied by statutory and voluntary organisations such as the Geriatric Departments of hospitals and the District Nursing Associations. The work of the general practitioner in this connection is closely co.ordinated not only with these services but also with the health visiting services for the area. Among voluntary organisations the Wandsworth Old Folks Trust has established a successful scheme for providing holidays for old people and the Wandsworth Old Peoples Welfare Council has a most impressive record of major activity in many fields. For example, 45 social clubs throughout the Borough are affiliated to the Welfare Council and the five lunch clubs at Tooting, Central Wandsworth, Balham, Roehampton and Streatham have served more than 100,000 meals. Five vans are utilized for the Meals on Wheels service to bring 50,000 meals to the homes of the housebound. Six chiropody clinics provide a useful addition to the clinics available through statutory sources. More detailed accounts of these activities and of other developments are described in the Annual Report of the Welfare Council and the monthly publication entitled The News. A study of the report shows the vast amount of voluntary work devoted to the care and welfare of old people. Bathing Attendance Reference was made in last year's Report to the appointment of a part.time woman bathing attendant whose duty it is to visit the SANITARY INSPECTION OF THE BOROUGH 31 homes of frail old people who require and would like assistance with bathing in their own homes. During the year under review, this service continued and has been greatly appreciated by the majority of those old people who have requested assistance. As was anticipated when the service commenced, more and more old people who come within its scope have requested our help and it was hoped that in course of time, it would be possible to obtain the services of a second bathing attendant to cope with the increasing demand. Unfortunately, it has not been possible to make a further appointment and the work has continued to be carried out by the one attendant who, I am happy to record, has proved to be a most capable and suitable person for this work. At the close of the year, she was visiting a total of 35 homes. Laundering of Bed Linen of Aged and Infirm The additional facilities provided at the Disinfecting Station in the latter part of the previous year, by the installation of a tumbler drier and the construction of an airing room, enabled the disinfecting staff, during 1962, to deal with a greater number of fouled bed linen and personal effects of aged and incontinent persons. At the beginning of the year collections and washing of bed linen in respect of 13 cases were being dealt with and a further 67 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 1,461 lots of fouled linen were collected and cleansed in 1962, an increase of 27% over 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 92 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 one family was dealt with during the year. Bedding is not subjected to hydrogen cyanide but is disinfested by steam at the Council's Disinfecting Station. 32 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 Mortuary The arrangements made in 1956, between this Council and the Battersea Borough Council, whereby the latter undertook, on agreed terms, to use their mortuary for the reception of bodies of Wansworth residents, continued and is working satisfactorily. A revision of the financial terms with Battersea became necessary, however, in view of decisions made by this Council in regard to the future use of the Wandsworth mortuary. Since the inception of the arrangement made in 1956, Wandsworth had retained its mortuary at York Road as a reserve in case of an emergency occurring for which the facilities at the Battersea mortuary might prove inadequate. Experience having shown, however, that ample accommodation and facilities exist at the Battersea mortuary for dealing with bodies from both boroughs under all normal circumstances, the possibility of the York Road mortuary ever being required appeared remote. After consultation, therefore, firstly with Her Majesty's Coroner, who indicated that he saw no purpose in retaining the Wandsworth mortuary, and secondly with the Battersea Borough Council, who indicated that they were satisfied that their mortuary accommodation and facilities were adequate for both boroughs, the Council decided that the York Road mortuary be closed down and demolished. Agreed new financial terms were, therefore, made with the Battersea Borough Council with effect from 1st April, 1962. During the year 745 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, 1,490 cremations were authorized during 1962, compared with 1,375 in 1961. 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 1962 was 31. Sewerage The arrangements for sewerage and sewage disposal in the district are reasonably adequate although occasional flooding has occurred in the Borough due to surcharging of sewers following periods of heavy rain. 5 HOUSING STATISTICS RELATING TO HOUSING Public Health (London) Act, 1936 Number of houses inspected on account of complaints or illness 6,178 Re-inspections 13,068 Number of statutory notices served: Intimation notices 979 Nuisance notices 262 Number of houses in which nuisances were abated 1,120 The number of cases referred to the Solicitor for legal action during 1962 was 66 The following is a summary of Police Court proceedings: Number of summonses served 38 „ „ „ withdrawn 15 adjourned „ „ Orders made for abatement of nuisances 15 Housing Acts, 1936 and 1957 Clearance of Unfit Houses Number of houses included in representations under Section 157 of the Housing Act, 1957 84 Number of houses included in declared Clearance Areas under Section 42 of the Housing Act, 195 27 Number of houses demolished following action under Section 25 of the Housing Act, 1936 9 Number of houses demolished following action under Section 42 of the Housing Act, 1957 18 Number of houses demolished following action under Section 43(2) of the Housing Act, 1957 22 Demolition Orders Number of Demolition Orders made under Section 17(1) of the Housing Act, 1957 1 Number of houses demolished as a result of formal or informal procedure under Section 17(1) of the Housing Act, 1957 2 33 34 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 Closing Orders Number of Closing Orders made on houses under Section 17(1) of the Housing Act, 1957 2 Number of houses closed in pursuance of an undertaking given by the owner under Section 16(4) of the Housing Act, 1957 Nil Number of Closing Orders made on parts of buildings under Section 18 of the Housing Act, 1957 5 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 5 New Accommodation The following table shows the number of new dwellings built by the Wandsworth Borough Council, the London County Council and private persons over the past 10 years. NUMBER OF NEW DWELLINGS ERECTED IN THE BOROUGH SINCE 1953 Built by 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 Total (o) Borough Council 346 777 575 431 263 215 353 180 408 316 3,864 (A) L.C.C 1,536 2,023 1,613 735 1,012 1,224 152 170 227 261 8,953 (c) Private persons 70 72 69 26 39 75 169 294 493 328 1,635 HOUSES IN CLEARANCE AREAS AND UNFIT HOUSES ELSEWHERE Clearance Areas The following properties were declared Clearance Areas following my representations: 196A, 196B, 196C, 196D, 196E, 196F Beechcroft Road. 198A, 198B, 198C, 198D, 198E, 198F Beechcroft Road. 200A, 200B, 200C, 200D, 200E, 200F Beechcroft Road. 202A, 202D, 202F Beechcroft Road. 1.9 (odd) Rashleigh Street. 48 Heath Road. HOUSING 35 Unfit Houses Closed A Demolition Order was made in respect of 147 Nightingale Lane. Closing Orders were made in respect of whole houses as follows: 35 Burtop Road 22 Putney Bridge Road Closing Orders were made in respect of parts of buildings as follows: Premises 42 Rossiter Road 44 Rossiter Road 13 Fernlea Road 27 Fernlea Road 35 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. An undertaking was given by the owner to close part of the building in respect of 4 Pitcairn Street. HOUSES IN MULTIPLE OCCUPATION TABLE I STATISTICAL RESULTS OF SURVEY No. of houses wholly inspected 453 „ „ „ occupied by immigrant families 77 „ „ „ partly occupied by immigrant families 36 „ „ „ where owner resides on premises 112 Total number of separate lettings 1,696 (includes parts of premises occupied by the owners). Furnished Unfurnished Total No. of 1 room lettings 617 52 669 No. of 2 101 282 383 No. of 3 51 421 472 No. of 4 9 104 113 No. of 5 2 34 36 No. of 5+ „ 0 23 23 Total 780 916 1,696 Water Supply No. of separate lettings having their own water supply 1,223 „ „ „ „ sharing their water supply 473 Sinks No. of separate lettings having their own sink 1,317 „ „ „ „ sharing sink 353 „ „ „ „ having no sink 26 36 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 Cooking Facilities No. of separate lettings having their own cooking facilities 1,296 „ „ „ ,, sharing cooking facilities 400 „ „ gas stoves on landings—62 gas stoves shared by 85 lettings. W.C. Accommodation No. of separate lettings having sole use of W.C 469 „ „ „ „ sharing W.C. accommodation 1,227 Baths No. of separate lettings having sole use of bath 125 „ „ „ „ sharing bath 1,003 „ „ „ „ having no bath 568 Food Storage Very few lettings having their own food store. Provision of Means of Escape from Fire In only two cases was provision for escape from fire made in houses of more than two storeys. TABLE II CLASSIFICATION OF VARIOUS TYPES OF DWELLING IN RELATION TO THE NUMBER OF PEOPLE HOUSED, CORRELATED WITH OVERCROWDING AND NON.SEPARATION OF THE SEXES Number of rooms Occupied by Overcrowding or Nonseparation of sexes 1 ROOM 1 Persons 343 2 Persons 227 82 More than 2 Persons 999 2 ROOMS 1 Person 81 2 Persons 126 45 More than 2 Persons 176 3 ROOMS 1 Person 88 2 Persons 175 4 More than 2 Persons 209 4 ROOMS 1 Person 10 2 Persons 18 1 More than 2 Persons 85 5 ROOMS 1 Person 2 2 Persons 4 0 More than 2 Persons 30 5+ ROOMS 1 Person 1 2 Persons 3 0 More than 2 Persons 19 HOUSING 37 TABLE III CLASSIFICATION OF HOUSES INSPECTED IN FOUR GROUPS ACCORDING TO CONDITIONS FOUND CATEGORY A. Premises where all facilities are available and no action is indicated 107 B. Premises which fall short of a satisfactory standard in some minor aspect not requiring immediate action 276 C. Premises where action will be necessary to require provision of additional facilities or abatement of overcrowding 68 D. Premises where squalor exists and where it may be necessary to make Management Orders 2 Total 453 The Rent Act, 1957 Applications for Certificates of Disrepair. Twenty.six 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 defect. (b) In 22 cases it was decided to serve notices on landlords proposing to issue Certificates of Disrepair unless undertakings to do repairs were given. (c) Thirteen undertakings were received from landlords to remedy defects proposed to be included in Certificates of Disrepair. (d) Twelve Certificates of Disrepair were issued. Applications for Cancellation of Certificates. (a) Twenty.six applications were received from landlords for the cancellation of Certificates of Disrepair. (b) Twelve objections were received from tenants for cancellation of Certificates. (c) In six cases it was considered that the tenant's objections were not justified and the Certificates cancelled. (d) Twenty.one Certificates of Disrepair were cancelled. Housing Accommodation—Medical Priority During the year 843 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 156 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 2,668 and during 1962 they were visited on 9,249 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 Inspectors for Food and Drugs carry out the day.to.day supervision of the catering establishments in their respective areas. Food and Drugs Act, 1955, and Food Hygiene (General) Regulations, 1960 Work in connection with food hygiene continued throughout the year, and as has been generally found to be the case, since the Food Hygiene Regulations of 1955 came into operation, occupiers of food premises were co.operative and receptive to suggestions made by the inspectors for necessary improvements to their premises. Court summonses were taken out by the Council in the following instances: (a) Against five traders for the presence of foreign matter in food. One case was dismissed; a fine of £15 and costs of £5; a fine of £10; a fine of £5 and costs of £3 3s. and a fine of £8 and costs of £6 6s. were awarded by the Court respectively in the other four cases; (ft) against a local trader for the presence of mould in food. A fine of £5 and costs of £3 3s. were awarded; (c) against a local trader for smoking a cigarette whilst handling open food. A fine of £5 was awarded; (d) against a local dairy for the sale of milk in a dirty bottle. A fine of £3 and costs of £6 6s. were awarded; (e) against three street traders for not having their names and addresses displayed on the vehicles; a fine of £1 and costs of 10s. were awarded by the Court in two instances and a fine of £1 10s. and costs of 10s. in the third case. 38 FOOD AND FOOD PREMISES 39 TABLE I SUMMARY OF VISITS TO FOOD PREMISES Putney Central Clapham Streatham Whole Borough Dairies 7 18 34 30 89 Restaurant Kitchens 484 407 433 402 1,726 Ice Cream Premises 42 76 10 59 187 Butchers' Shops 313 201 252 89 855 Greengrocers' Shops 160 44 68 58 330 Fishmongers' Shops 49 7 27 14 97 Fried Fish Shops 123 30 117 18 288 Market Stalls 197 1,283 741 204 2,425 Grocers' Shops 618 311 434 333 1,696 Confectioners' Shops 254 168 114 140 676 Bakehouses 87 58 22 16 183 Other Premises 336 158 113 90 697 Total Visits 2,670 2,761 2,365 1,453 9,249 40 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 The following list shows the number and type of premises in the Borough where food is sold, stored or prepared: Dairies and Milk Depots 8 Food Factories 23 Restaurants, Cafés and Canteens 571 Bakers and Confectioners 505 Butchers 199 Greengrocers 225 Fishmongers 71 Fish fryers 57 Bakehouses 52 Grocers 568 Off Licences 94 Public Houses 151 Stalls 144 2,668 The amount of work completed during 1962 to comply with the requirements of the Regulations is indicated in the following details: Washhand basins provided 23 Sinks provided 14 Provision of hot water over sink and washhand basin 21 Accommodation for clothing provided 2 Soap, towel and nailbrush 1 Premises repaired or redecorated 81 Adequate protection for open food 5 Notices to employees 8 Dustbins 5 W.C. accommodation12 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 26 applications were received from persons to be registered as distributors of milk. In each case the certificate of registration was granted. Nineteen notices of cancellation of FOOD AND FOOD PREMISES 41 registration were received. At the end of the year there were 240 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 4.55 per cent. The remaining 220 samples had an average fat content of 3.67 per cent. The Milk (Special Designation) Regulations, 1960 These Regulations which 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" 29 "Sterilized"22 "Tuberculin Tested" 23 Total 74 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 199 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 855 visits made to these shops during the year. 42 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 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.two varieties of foodstulf 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 1962 was 313, and 549 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 Domestic stores, ironmongers, etc. 80 93 Drug stores 19 21 Grocers 205 422 Hairdressers 8 8 Nurserymen and florists 5 5 Total 313 549 Bakehouses There are 52 bakehouses in the Borough, of which 10 are in basements and subject to the provisions of Section 70 of the Factories FOOD AND FOOD PREMISES 43 Act, 1961. One hundred and eighty.three 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 10 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 97,000, and the population of 347,810 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, picked or preserved food intended for sale, unless they are registered under this section for that purpose with a local authority. During the year 114 applications for registration under the provisions of Section 16(l)(a) and 42 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 forty.seven samples were examined bacterio. logically at the Public Health Laboratory during the year. They were as follows: 44 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 Artesian Swimming Milk Ice.cream Well Pool Others Total Waters Waters 213 47 4 76 3 343 Milk Of the 213 samples of milk, 96 were submitted to the phosphatase test, 96 to the methylene.blue test, and 21 to the turbidity test. These samples were reported satisfactory. Ice.cream The 47 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 16 3 5 4 7 Total 47 Examination of Water from Artesian Wells Four samples were submitted for examination, and were reported satisfactory. Examination of Water from Swimming Baths Seventy.six samples were submitted for examination. Satisfactory results were obtained in 64 samples. In the remaining samples there were slight deviations from normal, but subsequent tests proved satisfactory in all cases. Others The three miscellaneous samples proved to be free of pathogenic organisms. FOOD AND FOOD PREMISES 45 Analysis of Food and Drugs During the year 1,000 samples of food and drugs were procured for analysis; 260 samples of milk, 677 other foodstuffs and 63 drugs. Of these, 240 were submitted as formal samples, while 760 were purchased informally. No adulteration was found in the formal samples, but 32 or 4.21 per cent, of the informal samples or 3.20 per cent, of the total samples submitted were found to be adulterated or not up to standard. The 32 samples found to be adulterated were: Four samples of ammoniated tincture of quinine, three samples each of dirty milk bottles, bread and milk, two samples each of mayonnaise, beef sausages and fruit cocktail and one sample each of ricory, margarine, cut peel, Indian poppadums, pork chipolatas, beef chipolatas, pork luncheon meat, iced bun round, Yoghurt, glycerine, lemon and ipecac, sausage seasoning, cut mixed peel and savoury minced beef. Noise Abatement Act, 1960 Court summonses were taken out against six traders for the sounding of chimes; in four instances a fine of £1 and costs of 10s. were awarded by the Court and in the other two cases a fine of £1 10s. and costs of 10s. 46 7 FACTORIES ACT, 1961 Prescribed particulars required by Section 153 (1) 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 419 150 2 - (2) Factories not included above in which Section 7 of the Act is enforced by the Local Authority 1,128 1,014 15 - (3) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' Premises) 298 47 - - Total 1,845 1,211 17 — (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 3 1 - — — Overcrowding — — — — — Unreasonable temperature — 1 — — — Inadequate ventilation — 1 — — — Ineffective drainage of floors — — — — — Sanitary Conveniences: (a) insufficient 8 1 — 2 — (6) unsuitable or defective 45 30 — 11 — (c) not separate for sexes — — — — — Other offences against the Act (not including offences relating to outwork) - - — — — Total 56 34 — 13 — FACTORIES ACT, 1961 47 PART VIII OUTWORK (SECTIONS 133 AND 134) Nature of Work Section 133 Section 134 No. of outworkers in August list required by Section 133 (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. 595 — — - — Curtains and furniture hangings 9 - - - - Umbrellas, etc. 3 — - - - Artificial flowers 6 — - - - Paper bags 7 — - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 16 - - - - Carding, etc., of buttons, etc 6 - - - - Stuffed toys 1 — - - - Cosaques, Christmas stockings, etc. 14 - - - - Lampshades 199 — — — - Total 856 — — — — 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 19 new registrations were made, and the total number on the register at the end of the year was 283. Pet Animals Act, 1951 Thirty licences were issued by the Council in relation to premises subject to the provisions of this Act. 8 ATMOSPHERIC POLLUTION AND CLEAN AIR During the year, a fourth Smoke Control Order was confirmed by the Minister of Housing and Local Government and at the date of writing, a fifth Order made by the Council has been submitted to the Minister for his approval. The preliminary survey of Area 6 is nearing completion. A map of the Borough showing areas covered by Smoke Control Orders and areas in which it is proposed to make Orders in future years, incorporated in this Annual Report for the first time last year, is again reproduced in the following pages. In accordance with the provisions of Section 12(2) of the Clean Air Act, 1956, one notice was served in connection with premises within the Council's third Smoke Control Area, requiring works of adaptation to fireplaces, and one notice was served in respect of Section 11 of the Act relating to offences in a Smoke Control Area. Furnaces Notices of intention to install a furnace were received in respect of eight 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. The figures recorded for smoke and sulphur dioxide over the period of the 1962 smog with figures for the corresponding periods in the preceding three years are shown in Table III and the charts following Table III show the effects of the smog on mortality. 48 49 ATMOSPHERIC POLLUTION AND CLEAN AIR TABLE I Station Roof— Municipal Buildings Valley Road, S.W.I6 Tooting Library Queen Mary's Hospital, Roehampton South London Hospital, Clapham Month—1962 Smoke so2 Smoke so2 Smoke SO2 Smoke SO2 Smoke So2 January 93 271 158 204 39 323 96 226 14 340 February 55 245 179 228 69 207 212 371 57 182 March 31 326 135 216 102 301 83 224 47 238 April 76 510 65 123 116 290 46 134 87 265 May 50 191 8 74 47 142 32 104 42 151 June 18 135 32 31 23 105 14 115 15 93 July 41 141 20 64 65 169 16 66 30 95 August 28 150 21 65 31 69 8 23 20 66 September 35 130 19 106 40 91 19 36 31 64 October 76 373 101 137 87 121 84 174 62 195 November 89 310 166 249 102 304 175 247 92 280 December 229 498 158 240 248 289 149 397 189 314 Average 68 273 89 144 80 201 78 176 57 190 50 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 MAP OF SMOKE CONTROL AREAS IN WANDSWORTH 51 ATMOSPHERIC POLLUTION AND CLEAN AIR TABLE III ATMOSPHERIC POLLUTION smoke and so, concentration over the period of the 1962 smog compared with corresponding periods in 1959, 1960 and 1961 Period ending 1959 1960 1961 1962 Smoke SO2 Smoke SO2 Smoke SO2 Smoke SO2 December Municipal Buildings 3rd 340 294 40 80 28 91 57 423 4th 250 452 40 80 28 91 1,208 1,266 5th 120 326 56 81 95 265 1,716 1,920 6th 180 229 120 304 99 236 1,128 2,524 7th 180 229 140 307 91 386 1,712 1,290 8th 220 90 180 191 70 388 824 420 Tooting Library 3rd 560 151 98 338 52 133 315 337 4th 340 246 98 338 111 133 820 1,332 5th 330 306 90 336 78 250 1,724 2,174 6th 190 144 100 509 70 261 1,572 2,388 7th 190 131 330 441 63 293 1,380 1,860 8th 270 138 130 200 91 329 206 214 South London Hospital 3rd 230 298 47 223 116 311 164 433 4th 190 217 47 223 116 311 1,164 1,180 5th 130 330 40 210 69 282 1,960 1,506 6th 170 208 160 261 63 525 1,132 1,772 7th 170 208 70 383 81 252 1,228 2,228 8th 170 210 270 290 53 230 276 226 Queen Mary's Hospital, Roehampton 3rd 90 130 30 97 16 291 280 348 4th 180 111 34 58 112 291 868 1,068 5th 170 140 34 102 16 81 568 1,553 6th 80 54 30 151 28 207 856 2,405 7th 80 54 36 151 124 258 1,044 1,707 8th 80 45 32 148 288 425 132 227 United Dairies Depot, Streatham 3rd 350 207 100 153 136 161 52 197 4th 860 221 40 57 132 161 972 985 5th 750 167 40 57 52 89 2,220 2,607 6th 750 116 90 159 80 71 1,064 1,860 7th 200 116 420 301 212 339 1,360 2,128 8th 190 115 610 791 172 309 144 385 This table gives the concentrations of smoke and sulphur dioxide (SO2) in microgrammes per cubic metre of air. "Fog" conditions were noted in the weather reports on: 1st and 2nd December, 1959. 7th and 8th December, 1960. 4th, 5th and 6th December, 1962. 52 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 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 1962, calculated as described in the 1958 Report. HOME ACCIDENT CASES DURING 1956 to 1962 TABLE I Cause of Accident 1956 1957 1958 1959 1960 1961 1962 Fall- On stairs 120 112 122 130 131 109 76 From ladder 21 18 12 19 20 8 9 From chair 18 18 21 29 21 22 19 Outside 32 18 16 35 21 17 24 In garden 45 31 25 43 35 34 30 In bath 1 3 1 4 2 2 2 From one level to another 42 42 33 32 35 45 52 On same level 77 57 105 115 110 110 86 Unspecified 222 240 255 268 338 373 387 Hit by object 45 15 14 16 20 21 32 Cooking stove 15 7 13 17 15 13 12 Teapots 4 2 6 7 7 6 6 Other boiling water 18 25 12 17 13 16 25 Electric shock 2 2 1 3 2 3 3 Poisoning 27 34 24 24 48 48 45 Gassing 9 9 12 19 12 14 13 Knife-like wounds 69 51 36 47 48 38 45 Fires 24 10 24 11 10 15 16 Windows 7 5 6 9 7 7 4 Suffocation 1 3 2 10 3 2 5 Not specified 13 53 44 31 39 41 41 Totals 812 755 784 886 937 944 930 Rate per 10,000 population 240 22.4 23.2 26.2 27.6 26.9 27.1 TABLE II age groups and percentages 1956 % 1957 %. 1958 % 1959 % 1960 % 1961 % 1962 % Under 1 10 1.2 10 1.4 14 1.7 11 1.3 12 1.3 14 1.6 14 1.7 1- 26 3.2 25 3.3 29 3.7 31 3.4 33 3.6 35 3.9 36 4.0 2- 30 3.7 26 3.4 30 3.8 35 3.8 35 3.9 82 8.6 84 9.0 3 and 4 31 3.8 35 4.6 36 4.6 40 4.5 45 4.8 83 8.7 84 8.9 5-19 96 11.7 81 10.7 84 10.8 102 11.8 110 11.6 71 7.4 69 7.3 20-59 252 31.0 232 30.7 239 30.5 268 30.5 280 30.4 129 13.7 123 13.2 60-69 93 11 .6 91 12.0 82 10.5 102 11.6 110 11.8 168 17.7 167 17.8 70-79 150 18.5 133 17.7 141 17.9 155 17.3 157 16.4 124 13.0 124 13.3 80+ 123 15.3 122 16.2 129 16.5 142 15.8 155 16.2 238 25.4 229 24.8 Totals 812 100 755 100 784 100 886 100 937 100 944 100 930 100 53 10 REPORT OF THE WORK OF THE PUBLIC ANALYST FOR 1962 Mr. J. E. Woodhead, B.sc., f.r.i.c., f.p.s., resigned his parttime appointment as the Council's public analyst as from June and in his place, his deputy, Mr. D. G. Forbes, b.sc., f.r.i.c., was appointed by the Council. Mr. Forbes 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, 1962; 937 were articles of food and the remaining 63 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.), 56; beverages (cocoa, coffee, tea, etc.), 60; cereal preparations, 45; cheese products, 30; confectionary, 76; cream, 11; fish (canned, etc.), 33; fruit (canned and dried), 62; ice-cream, 2; meat products (including sausages), 74; milk, 260; pickles and condiments (including spices), 57; preserves, 47; soup, 27; vegetables, 44; aspirin tablets, 6; Beecham's powders, 3; Friar's balsam, 4; Glaubers salts, 4; ointments, 7; linctus, 6; tincture of quinine, 7; sal volatile, 3; Seidlitz powders, 3. 54 55 REPORT OF THE PUBLIC ANALYST FOR 1962 Adulterated Samples Particulars of the samples reported as adulterated or not up to standard are given in the following table: Case No. Nature of Sample Nature of Report Informal 139 Milk bottle Dirty: atmospheric dust including soot 150 Sausage seasoning Sulphur dioxide, 720 parts per million 174 Cut peel Low sugar content, 50 per cent. 212 Mayonnaise Benzoic Acid, 100 parts per million 216 Bread Rancidity affecting smell and taste 261 Mayonnaise Benzoic Acid, 215 parts per million 268 Indian Poppadums 5.8 per cent. salt not declared on label 272 Chipolatas, pork Meat content 55 0 per cent. 273 Chipolatas, beef Meat content 44.5 per cent. 274 Sausages, beef Meat content 43.5 per cent. 275 Milk bottle Dirty: inefficient removal of milk solids 375 Bread Foreign matter, chiefly fibres from sacking 403 Beef sausages Foreign matter, soil including portions of small worms 447 Pork luncheon meat One lead shot pellet present 505 Iced bun round Rodent contamination 506 Milk in bottle Common dirt present 562 Ammoniated tincture of quinine 33 per cent. deficient in ammonia 606 Dirty milk bottle Hyphae and spores of mould present 649 Slices of bread Fragment of glazed porcelain 662 Bottle of milk Small film of mould floating in milk 671 Cut mixed peel 9.3 per cent. deficient in soluble solids 693 Savoury minced beef Labelling offence. Order of ingredients not as stated on label 718 Fruit cocktail Labelling offence. Order of ingredients not as stated on label 742 Margarine One per cent. extraneous water 743 Bottle of milk Dirt attached to glass 746 Ammoniated tincture of quinine 17.5 per cent. deficient in ammonia 751 Ammoniated tincture of quinine 17.5 per cent. deficient in ammonia 759 Ricory Labelling offence. Sulphur dioxide in excess 771 Fruit cocktail Labelling offence. Order of ingredients not as stated on label 774 Yoghurt Labelling offence. Misleading 804 Glycerin, lemon and ipecac Labelling offence. Quantitative particulars omitted on label 817 Ammoniated tincture of quinine 5.8 per cent. deficient in ammonia Adulteration The amount of adulteration detected during the year was: For formal samples nil For informal samples 4.21 per cent. For all samples 3.20 per cent. 56 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 Complaint Samples Case No. 139. Milk Bottle. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 180. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 194. Wheat Embryo. Submitted on the complaint that it caused sickness. The complaint was considered not justified. Case No. 245. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 275. Milk Bottle. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 361. Bread. Submitted on the complaint that it had an objectionable flavour. The complaint was considered not justified. Case No. 375. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 387. Horseradish. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 403. Beef Sausages. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 445. Apples. Submitted on the complaint that it caused sickness. The complaint was considered not justified. Case No. 446. Pork Luncheon Meat. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 505. Iced Bun Round. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 506. Milk in Bottle. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 535. Tinned Corned Beef. Submitted on the complaint that it contained a liquid. The complaint was considered not justified. Case No. 592. Corned Beef. Submitted on the complaint that it had a sour taste. The complaint was considered not justified. Case No. 606. Milk bottle. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. 57 REPORT OF THE PUBLIC ANALYST FOR 1962 Case No. 621. Bottle of Guinness. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 635. Custard Tart. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 649. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 662. Bottle of Milk. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 715. Liqufruta. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 743. Bottle of Milk. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 775. Herrings in Sauce. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 812. Bovril. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 816. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. 58 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 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 25 12.63 3.79 8.84 February 21 12.46 3.73 8.73 March 19 12.67 3.83 8.84 April 20 12.52 3.78 8.74 May 25 12.43 3.64 8.79 June 20 12.44 3.61 8.83 July 20 12.38 3.62 8.76 August 25 12.56 3.81 8.75 September 20 12.80 3.87 8.93 October 25 12.71 3.87 8.84 November 20 12.98 4.09 8.89 December 20 12.92 4.07 8.85 The average composition of the 260 samples of milk analysed during the year and returned as genuine was as under: Total milk solids 12.62 per cent. Milk fat 3.81 per cent. Non-fatty solids 8.81 per cent. The average composition of the 40 samples of Channel Island and South Devon milks was as under: Total milk solids 13.68 per cent. Milk fat 4.55 per cent. Non-fatty solids 9.11 per cent. 59 INDEX page Accidents, Deaths from 22 Accidents, Home 53 Acute Encephalitis 21 Analyst, Report of 54 Atmospheric Pollution 48 Bacteriological Examinations of Milk 44 „ „ of Ice-cream 44 Bathing Pools and Swimming Pools 29 Bed Bugs, Eradication of 31 Births, Birth-rates 13 Butchers'Shops 41 Cancer 26 Care of Old People 30 Childbirth, Deaths from 17 Circulatory Diseases 26 Clean Air 48 Closing Orders 35 Crematorium 32 Cutting-off Notices—Water Supply 29 Deaths, Causes of 16 Death-rates Death-rate from Infective Diseases 18 Death-rate, Infantile Deaths, Number of 15 Diphtheria 18 Disinfection 23 Dysentery, Sonne 22 Enteric Fever 21 Erysipelas 22 Factories Act, 1961 46 Factories and Workshops 46 Food Hygiene Regulations 38 Food and Drugs Act, 1955 43 Food Poisoning 23 Food, Supervision of 38 Food Places, Inspection of 39 Food Places, Number on Register 38 Hairdressers and Barbers 47 Home Accidents 53 Houses in Multiple Occupation 35 Houses and Premises Inspected 27 Housing Act, 1936 33 Housing Statistics 33 Hydrogen Cyanide Disinfection 31 Illegitimate Children, Births of 14 Infant Mortality 17 Infective Diseases 18 Infective Diseases, Cases of 19 Infective Diseases, Death-rate from 18 Influenza, Deaths 22 Influenzal Pneumonia and Acute Primary Pneumonia 22 60 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1962 PAGE Malaria 22 Maternal Mortality 17 Meat 41 Meningococcal Infection 21 Milk Analysis 58 Milk, Bacteriological Examination of 44 Milk Premises, etc., on Register 39 Milk (Special Designations) Regulations, 1960 41 Mortuary 32 Non-Infective Diseases, Deaths from 26 Notification of Infective Diseases 19 Old People, Care of 30 Outworkers 47 Pet Animals Act 47 Pharmacy and Poisons Act, 1933 42 Pharmacy and Medicines Act, 1941 42 Poliomyelitis 21 Population Pregnancy, Deaths from Accident and Diseases of Public Analyst, Report of 54 Puerperal Pyrexia 22 Pulmonary Tuberculosis, Notification of cases of 24 Rent Act 37 Rodent Control 29 Samples, Formal and Informal, Number of 54 Sanitary Inspection of Borough 27 Scabies 23 Scarlet Fever 21 Slaughter-houses 42 Slaughter of Animals Acts, 1933-1954 42 Smallpox 18 Smoke Control Areas 50 Staff 8 Statistics for the Borough 11 Suicide, Deaths from 26 Swimming Baths and Bathing Pools 29 Syphilis, Deaths from 23 Tuberculosis 24 Unfit Houses 34 Unsound Food 42 Water Supply 43 Water Supply, Cutting-off Notices 29 Whooping Cough 18 Geo. Gibbons Ltd., Leicester