AC 4388 WAN 101 Metropolitan Borough of Wandsworth ANNUAL REPORT of the Medical Officer of Health for the Year 1964 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 1964. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Wandsworth Mr. Mayor, Ladies and Gentlemen, This Report is presented in the traditional fashion although the Metropolitan Borough of Wandsworth has, at the time of writing, ceased to exist following on the re-organisation of London Local Government. The Council of the London Borough of Wandsworth as the new Authority which has inherited the residual liabilities of the old Authorities under Article 15 of the London Authorities Properties, etc., Order, will be responsible for meeting the cost of printing this Report. By Article 8 of the London Authorities (Health and Welfare Services) Order, 1964, the London Borough of Wandsworth must send copies of this Report to the Minister of Health, to any local health authorities containing any part of the area of the abolished Authority (London Borough of Lambeth) and to the Greater London Council and, no doubt, the London Borough of Wandsworth will desire that this be done. The Registrar General's estimate of the mid-year population for 1964 was 348,450, exactly the same as that estimated for the previous year, 1963. The crude birth rate was 19.16 per thousand persons living, an increase over the previous year; after taking account of the area comparability factor, the adjusted rate works out at 18.39 against 17.5 in the previous year, which is quite an appreciable change. The rate for England and Wales as a whole was 18.4 and for London 17.2. The crude death rate for the year was 12.98 per thousand and the adjusted rate 10.25 as against 11.08 in 1963. The corresponding figures for England and Wales and London were 11.3 and 11.7 respectively. The number of deaths of children under one year of age was 151 and this gives an infant mortality rate of 22.6 which is higher than the figure of 19.6 for the previous year. There were two deaths 2 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 from puerperal causes in 1964 as compared with three in the previous year and this gives a maternal mortality rate of 0.29 per thousand live and still births. The total number of cases of infectious disease notified was less than in the previous year mainly due to the decrease in the number of measles cases, 1,032 as against 3,427 in 1963. There was also a diminution in the number of cases of whooping cough, 219 as against 337 cases. Two cases of typhoid and five of paratyphoid were confirmed during the year. No confirmed case of poliomyelitis arose during 1964. The number of cases of tuberculosis of which we became aware showed a further reduction in 1964, namely, 274 as against 293 in 1963 and 320 in 1962. The number of primary notifications, however, remained the same, the reduction being due to fewer transfers from other authorities. The number of deaths from tuberculosis was the same as in the previous year, namely 25. I am glad to say that the number of deaths from diseases of the respiratory system, particularly bronchitis and pneumonia, were fewer in 1964 compared with 1963. For instance, there were 545 deaths from these diseases in the current year compared with 861 in 1963. The number of deaths from bronchitis was 223 compared with 377; and from pneumonia, all forms, 283 compared with 414 in 1963. In this connection, I referred in my Report for 1963 to the effect of the severe winter of 1962/3 and it is probable that the better mortality figures for the current year reflect the much milder winter which was experienced. Full details of the work of the Department will be found in the body of the Report and need not be mentioned here in detail, except to say that the work in connection with houses in multiple occupation has continued and further progress was made under the Clean Air Act, 1956, towards our objective of making Wandsworth a complete Smoke Control area by 1970. For the greater part of the year, but particularly in the latter half, much time and attention was necessarily given to the problem raised by the re-organisation of London Local Government. Senior staff of the Department in particular were involved and it was necessary to review the work of the Department, to collate information and statistics and to exchange information with the Metropolitan Boroughs of Battersea and Lambeth and generally to do everything to ensure that the change-over of responsibility would be as smooth as possible. I should like to thank my senior colleagues for their help in these tasks. This brings me to the end of my Report for 1964, and the last Health Report to the Metropolitan Borough of Wandsworth. Over the years, the Health Committee through its Health Department has served the people of Wandsworth well and it is confidently hoped and expected that this service will continue with no less an enthusiasm in the future than in the past. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 3 It has been to me a great privilege and a very happy experience to have been the Medical Officer of Health of the Metropolitan Borough of Wandsworth. I would like to take the opportunity of saying how much I have valued the guidance, support and courtesy of the different Chairmen and Members of the Health Committee and also of the other Committees with which I have been concerned, over the period of more than 13 years that I was Medical Officer of Health of the Metropolitan Borough. I also thank my colleagues and the staff of the Public Health Department for their unstinted application over the years to their work and duties. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, J. TUDOR LEWIS, Medical Officer of Health. 4 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 D.S.Burtenshaw (Appt. 1964) J. H. Massey P. P. Leacock A. J. Lansley S. R. Coomber A. W. Lock C. Jones J. Smith D. J. Hughes P. O.'Grady K. J. Winton J. D. Morritt (Resigned 1964) R. C. Charlton A. Stewart A. J. Shields (Appt. 1964) G. Pike J. B. Sainsbury (Resigned 1964) J. L. Gill J. F. Burslem (Resigned 1964) Trainee Public Health Inspectors G. P. W. Chambers T. J. Cordery (Appt. 1964) 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 M. Timlin G. Harwood (Resigned 1964) Mrs. F. Hull Miss J. Eley REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 5 STAFF OF PUBLIC HEALTH DEPARTMENT—continued Technical Smoke Control C. F. Harrison J. Weir L. W. Clifton F. B. Capes Disinfecting Station F. Stennings P. H. Biggs (Appt. 1964) W. E. Stringer G. W. Price A. E. Clement T. Price W. J. Scott (Appt. 1964) Mrs. E. King (part-time) Rodent Operatives J. W. Taylor J. Wells G. J. Langrish W. Maxwell V. T. Athaide (Resigned 1964) 6 1 STATISTICS AND SOCIAL CONDITIONS Area 9,109 acres Resident population in 1964 348,450 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. STATISTICS AND SOCIAL CONDITIONS 7 Extracts from Vital Statistics Number of Live Births: Male Female Total Legitimate 3,059 2,729 5,788 Illegitimate 461 430 891 3,520 3,159 6,679 Rate per 1,000 population: Crude 19.16 Adjusted 18.39 Number of stillbirths 57 38 95 Rate per 1,000 total live and stillbirths 14.0 Number of deaths: All ages 2,127 2,398 4,525 Under 1 year 89 62 151 Puerperal causes — 2 2 Rate per 1,000 population: Crude 12.98 Adjusted 10.25 Infantile Mortality Rates: Total infant deaths per 1,000 total live births 22.60 Legitimate infant deaths per 1,000 legitimate live births 21.94 Illegitimate infant deaths per 1,000 illegitimate live births 26.93 Neo-natal Mortality Rate (deaths under four weeks per 1,000 total live births) 16.9 Early Neo-natal Mortality Rate (deaths under one week per 1,000 total live births) 14.3 Perinatal Mortality Rate (stillbirths and deaths under one week combined per 1,000 total live and stillbirths) 28.1 Maternal Mortality Rate (per 1,000 total live and stillbirths) 0.29 Total Number of deaths from Cancer 899 „ „ „ „ Tuberculosis 25 There has been no unusual or excessive mortality during the year. 8 2 VITAL STATISTICS Population The overall civilian population at the middle of the year was estimated by the Registrar-General to be 348,450, and all the rates used in this Report are based on this figure. Table I below shows the mid-1964 estimate of population for the Parliamentary Divisions of the Borough, based on the overall figure, and also shows the more detailed ward figures of the 1961 Census. In Table 1(a) a comparison is made of the population in fiveyearly age groups and sexes for the two census years, 1951 and 1961. TABLE I mid-1961 mid-1964 Putney Parliamentary Division Putney Ward 35,444 105,524 105,800 Thamesfield „ 16,902 Fairfield „ 14,632 West Hill „ 23,436 Southfield „ 15,110 Central Parliamentary Division Earlsfield „ 17,236 90,500 90,750 Springfield „ 17,337 Tooting „ 17,933 Graveney „ 20,095 Bedford „ 17,899 Clapham Parliamentary Division Larkhall „ 13,778 79,983 80,250 Clapham North „ 14,370 Clapham Park „ 17,294 Thornton „ 19,778 Balham „ 14,763 Streatham Parliamentary Division Streatham Hill „ 18,120 71,435 71,650 St. Leonards „ 13,116 Streatham Common „ 12,636 Streatham South „ 11,810 Furzedown „ 15,753 347,442 348,450 Births The total number of births belonging to the Borough registered during 1964 was 6.679, consisting of 3,520 males and 3,159 females. The number for 1963 was 6,402. The crude birth-rate was 19.16 per 1,000 persons living compared with 18.3 for 1963. The adjusted rate works out at 18.39 after taking into account the area comparability factor supplied by the Registrar-General. The birth-rate for England and Wales as a whole was 18.4 and for London 17.2. Eight hundred and ninety-one illegitimate births took place in the Borough compared with 785 in 1963. VITAL STATISTICS 9 TABLE 1(a) POPULATION IN AGE GROUPS AND SEXES FDR 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 3,504 but 949 of these did not belong to the Borough, while 1,970 Borough residents died outside the Borough. The corrected number of deaths for the Borough, after allowing for these factors, was 4,525 of whom 2,127 were males and 2,398 females. The crude death-rate for the year was 12.98 compared with 14.9 for 1963, but after taking into account the area comparability factor supplied by the Registrar-General, the adjusted rate works out at 10.25. The death-rate for England and Wales as a whole was 11.3 and for London 11.7. Table II shows the total number of registered deaths and the death-rates for each division based on the approximate population in each division. 10 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 TABLE II Corrected Deaths Death Rate Males Females Total Putney 495 500 995 9.4 Central 805 933 1,738 19.1 Clapham 451 541 992 12.3 Streatham 376 424 800 11.1 Whole Borough 2,127 2,398 4,525 12.9 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. VITAL STATISTICS 11 TABLE III. CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1964 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 24 18 6 - - - 4 12 8 5 8 8 3 Tuberculosis, Other 1 1 — — - — — 1 — — - 1 - Syphilitic Disease 11 6 5 — — — 1 — 10 2 4 3 2 Diphtheria — — — — — — — — — — — — - Whooping Cough — — — — — — — — — — — — - Meningococcal Infections — — — — — — — — — — — — — Acute Poliomyelitis — — — — — — — — — — — — — Measles — — — — — — — — — — — — — Other Infective and Parasitic Diseases 5 2 3 - - - 1 - 4 1 2 2 - Malignant Neoplasm, Stomach 98 53 45 — - — 2 27 69 31 23 27 17 Malignant Neoplasm, Lung, Bronchus 253 208 45 — — — 6 116 131 80 79 50 44 Malignant Neoplasm, Breast 96 — 96 — — — 5 42 49 26 21 23 26 Malignant Neoplasm, Uterus 31 — 31 — — — 4 15 12 12 7 6 6 Other Malignant and Lymphatic Neoplasms 396 207 189 — — 3 13 131 249 109 115 92 80 Leukaemia, Aleukaemia 25 13 12 — - 1 4 7 13 8 7 5 5 Diabetes 27 12 15 — - - 2 8 17 6 7 6 8 Vascular Lesions of Nervous System 500 177 323 — - 1 4 65 430 123 171 114 92 Coronary Disease, Angina 795 456 339 — — — 20 197 578 210 240 190 155 Hypertension, with Heart Disease 43 13 30 — - — — 6 37 12 15 10 6 Other Heart Disease 711 215 496 — - — 9 54 648 115 398 87 111 Other Circulatory Disease 262 113 149 — - - 3 36 223 70 90 63 39 Influenza 7 3 4 — - - 3 - 4 2 2 2 1 Pneumonia 283 118 165 22 4 - 3 22 232 66 100 71 46 Bronchitis 223 149 74 3 1 - 1 47 171 50 70 56 47 Other Diseases of Respiratory System 32 17 15 — - - 1 9 22 9 9 8 6 Ulcer of Stomach and Duodenum 31 22 9 — - - 2 3 26 10 10 7 4 Gastritis, Enteritis, Diarrhœa 21 10 11 1 — — - 3 17 6 8 4 3 Nephritis and Nephrosis 21 12 9 — — 1 1 8 11 7 5 6 3 Hyperplasia of Prostate 24 24 — — — — - 1 23 8 7 4 5 Pregnancy, Childbirth, Abortion 2 — 2 — - - 2 - - - 1 1 - Congenital Malformations 43 27 16 32 2 - 1 4 4 14 13 8 8 Other Defined and Ill-defined Disease 374 145 229 89 3 6 24 76 176 104 111 87 72 Motor Vehicle Accidents 47 30 17 1 1 2 14 9 20 8 15 12 12 All other Accidents 72 40 32 2 4 2 25 12 27 21 16 20 15 Suicide 66 36 30 — - - 25 23 18 19 20 14 13 Homicide and Operations of War 1 — 1 1 — — — — — 1 - - - All Causes 4,525 2,127 2,398 151 15 16 180 934 3,229 1,135 1,574 987 829 12 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 TABLE 111(a). DEATHS FROM HEART DISEASE, 1964 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. - - 16 158 282 456 - - 4 39 296 339 795 Hypertension with Heart Disease - - - 4 9 13 - - - 2 28 30 43 Other Heart Disease — — 4 27 184 215 — — 5 27 464 496 711 Total — — 20 189 475 684 — — 9 68 788 865 1,549 Infantile Mortality There were 151 deaths of children under one year, giving an infant mortality rate of 22.6 per 1,000 live births. This compares with a rate of 19.6 for 1963. For the 10 years ended 1954 the average infant mortality rate was 26, while for the 10-year period ending 1964 the average rate was 20. Table 111(b) shows causes of death of children under one year of age. TABLE 111(b). DEATHS OF CHILDREN UNDER ONE YEAR OF AGE Cause of Death Under 24 hours 1-7 days 1-4 weeks Total under 4 weeks 1-12 months TOTAL DEATHS UNDER 1 YEAR 1. Pneumonia — 1 6 7 15 22 2. Bronchitis — — — — 3 3 3. Gastritis, Enteritis, Diarrhœa — — 1 1 — 1 4. Congenital Malformations 11 9 3 23 9 32 5. Prematurity 32 17 5 54 — 54 6. Other Causes 13 13 2 28 11 39 TOTALS 56 40 17 113 38 151 Maternal Mortality Two deaths occurred from accidents and diseases of pregnancy or child-birth. This is equivalent to a rate of 0.29 per 1,000 live and still-births. 13 3 INFECTIVE DISEASES Fifty deaths occurred from the notifiable infectious diseases, 25 from all forms of tuberculosis and 25 from notifiable forms of pneumonia. From all notifiable infective diseases the death-rate was 0.14 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 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 staff of the Public Health Department. Additional work in connection with smallpox now devolves on the public health staff by reason of the fact that, under the Public Health (Aircraft) Regulations, 1952-63, persons arriving in this country by air, who are not in possession of valid international certificates of vaccination against smallpox, must be placed under surveillance for up to 14 days. It is now the prevailing practice of the Airport Health Control Units to inform local authorities of any persons arriving by air who are proceeding to addresses in their areas, in order that those authorities may arrange the necessary surveillance. With the ever increasing flow of air travel, more and more people come to this country to stay, permanently or otherwise, and consequently, many notifications are received by the Health Department from Airport Authorities in accordance with the Regulations. Diphtheria Several suspected cases were reported and investigated but in no case was the diagnosis confirmed. Whooping Cough Two hundred and nineteen cases were notified during the year. No deaths occurred. 14 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 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 187 13 22 19 43 13 10 48 14 5 Encephalitis, Acute - - - - - - - - - - Erysipelas 11 - - 1 - - - - 4 6 Food Poisoning 29 - 1 2 2 2 5 9 7 1 Malaria - - — - - - - - - - Measles 1,032 52 236 245 429 35 22 12 1 - Meningococcal Infection 6 3 1 — — - 1 - 1 - Ophthalmia Neonatorum 6 6 — — — - — - - - Pneumonia: Acute Influenzal 15 1 1 1 — - — 4 4 4 Acute Primary 65 2 1 2 4 4 6 10 19 17 Poliomyelitis, Acute - - - - - - - - - - Puerperal Pyrexia 25 - - - - - 12 13 - - Scabies 6 - - - - 1 2 3 - - Scarlet Fever 136 - 8 31 76 13 7 1 - - Smallpox - - - - - - - - - - Tuberculosis 165 2 2 1 5 5 30 68 39 13 Typhoid Fever and Paratyphoid Fever 7 - - - 2 - 2 3 - - Whooping Cough 219 19 63 54 72 6 1 4 — — Total 1,909 98 335 356 633 79 98 175 89 46 INFECTIVE DISEASES 15 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 5 1 16 10 8 71 30 3 2 10 1 2 7 5 7 1 2 3 2 1 187 - Encephalitis, Acute - - - - - - - - - - - - - - - - - - - - - - Erysipelas 1 - - - 1 - 1 1 1 2 2 - - - - - - 1 - 1 11 - Food Poisoning 1 - 1 1 2 10 7 - - - 1 1 - 2 2 - - - - 1 29 - Malaria - - - - - - - - - - - - - - - - - - - - - Measles 72 47 69 97 63 38 40 93 79 68 64 48 24 49 71 26 19 22 21 22 1,032 - Meningococcal Infection 1 2 - - - - - - 1 - - 1 - 1 - - - - - - 6 - Ophthalmia Neonatorum - - - - - - - 1 - 1 - 1 - 2 1 - - - - - 6 - Pneumonia, Acute Influenzal - - 1 - - - - 1 1 1 4 1 1 1 2 1 1 - - - 15 2 „ Acute Primary - 2 1 6 7 4 13 7 2 8 2 1 2 3 5 - 1 - 1 - 65 23 Poliomyelitis, Acute - - - - - - - - - - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - 2 1 2 1 1 1 1 13 1 - 1 - - 1 25 - Scabies - - - - - - 1 - 2 - - 1 1 1 - - - - - - 6 - Scarlet Fever 3 3 3 16 6 9 20 11 5 5 11 12 7 8 6 2 2 2 2 3 136 - Smallpox - - - - - - - - - - - - - - - - - - - - - - Tuberculosis-all forms 10 10 8 9 7 9 5 6 8 9 8 9 8 10 11 12 7 7 3 9 165 25 Typhoid Fever and Paratyphoid Fever 1 - - - - - 1 - - 1 1 - - - 1 - 1 1 - - 7 - Whooping Cough 6 5 13 9 9 7 35 29 6 20 13 6 2 9 14 2 15 7 5 7 219 - Total 100 70 112 148 103 148 155 153 109 126 108 84 53 104 121 44 49 43 34 45 1,909 50 16 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 Measles The number of cases notified during the year was 1,032 compared with 3,427 in 1963, 691 in 1962 and 4,912 in 1961. Poliomyelitis No cases were confirmed during the year. The figures of poliomyelitis from 1947 to 1964, the period during which the incidence of the disease in this country has been high, is shown in the following table: No. of cases reported as suspected poliomyelitis and investigated No. of cases confirmed: Deaths 1947 119 78 4 1948 31 15 6 1949 89 58 4 1950 71 40 7 (a) (b) paralytic non-paralytic 1951 29 4 7 — 1952 73 23 16 5 1953 73 19 8 2 1954 41 5 2 — 1955 104 22 27 1 1956 85 24 15 2 1957 147 43 28 4 1958 65 11 9 1 1959 73 13 4 1 1960 31 1 4 — 1961 33 2 1 1 1962 12 2 — — 1963 6 — — — 1964 1 - - - Meningococcal Infection Six confirmed cases were notified, none of which proved fatal. A number of other cases were investigated but these were subsequently not confirmed. In 1963 there were six confirmed cases with one death. Acute Encephalitis No cases occurred during the year. Typhoid and Paratyphoid Fever Two cases of typhoid fever and five cases of paratyphoid fever were confirmed during the year. In three cases the patients had been recently on the Continent, and this was presumed to be the source of infection, but in the remaining cases, the source was not established. INFECTIVE DISEASES 17 In addition to the surveillance of contacts of the cases notified to the department, it was also necessary to keep under surveillance a number of other persons who had been in contact with confirmed cases resident in other areas. Scarlet Fever One hundred and thirty-six cases were notified compared with 89 in 1963 and 109 in 1962. No deaths occurred. Puerperal Pyrexia During the year 25 cases were notified, of which 22 occurred in hospital and three at home. Four of the hospital notifications referred to patients whose home addresses were outside the Borough. Sonne Dysentery Investigation and systematic follow-up of all cases of dysentery, in which general practitioners co-operated fully with the Health Department, continued throughout the year and where it was considered necessary, stool specimens were obtained from family contacts for bacteriological examination. Approximately two-thirds of the total cases for the year were single unrelated cases and the remaining cases were made up of minor outbreaks which occurred at two day nurseries in the borough. Details of these minor outbreaks are given below : Date Outbreak No. of cases No. of faecal specimens examined from cases and contacts April Day Nursery 38 183 May „ „ 20 121 The figure of 187 cases finally arrived at for the year does not reflect fully the amount of work involved on visiting and following up. Many other cases reported as dysentery were investigated. Most of these proved negative on bacteriological examination. In 1963, there were 247 cases Influenza, Acute Influenzal Pneumonia and Acute Primary Pneumonia Acute influenzal pneumonia and acute primary pneumonia are the notifiable forms of pneumonia, and in 1964, 15 of the former and 65 of the latter were notified, as compared with 43 and 97 respectively for the previous year. 18 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 Deaths attributable to acute influenzal pneumonia were 2; this figure is classified under influenza in the death table on page 11. Acute primary pneumonia accounted for 23 deaths. There were 283 deaths from all forms of pneumonia compared with 414 in 1963. Deaths in 1963 from acute influenzal pneumonia and acute primary pneumonia were respectively 13 and 35. Malaria No cases were reported. Erysipelas Ten cases were notified. Other Infective Diseases Eleven deaths occurred from syphilis. Scabies Six notifications were received. Seven treatments were given at the Council's Disinfecting Station during the year. At the Battersea Cleansing Station, a total of 46 treatments for scabies and verminous conditions was given to women residents (and children under school age) of Wandsworth in accordance with arrangements made by this Council with the Battersea Borough Council in 1955. Food Poisoning Investigations were made in 113 notified or otherwise reported cases during the year. Eighty of these were deemed to be not food poisoning after laboratory examination of faecal specimens from those affected. The remaining notifications were single unrelated cases. As a result of bacteriological examination, causative agents were found in 18 cases. The organisms isolated were Salmonellae brandenburg (7), muenchen (5), typhimurium (2) and one each of infantis, orienberg, panama and tuebingen. Diseases Reported from Schools A total of 2,320 infective diseases was reported from schools in the Borough throughout the year. The numbers of each disease were: Scarlet Fever 80 Measles 300 German Measles 370 Chicken Pox 500 Whooping Cough 50 Mumps 780 Dysentery 40 Other Complaints 200 19 INFECTIVE DISEASES Disinfection During the year 183 rooms were disinfected after infectious and other disease, 291 rooms disinfested for vermin, and 79 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 during the year. A total of 3,406 bacteriological examinations were carried out during the year. Contacts of Infectious Disease—Exclusion from work It is sometimes considered necessary, in order to prevent the spread of infection, to exclude from work for a period certain contacts of infectious disease. This applies particularly to persons engaged in food handling and the requisite authority for the Medical Officer of Health to exclude such persons from work is given under regulations made under the National Insurance Act, 1946, and the Public Health (Infectious Disease) Regulations, 1953. 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 one contact of infectious disease who was excluded from work was issued with a certificate enabling him to draw National Health sickness benefit. 20 TUBERCULOSIS Notifications The total number of new cases which came to the notice of the Department during 1964 was 274 compared with 293 in 1963. The sources of information regarding the new cases were as follows : Primary notifications on Form A 165 Unnotified at death 6 Transfers from other sanitary authorities 103 Total 274 Deaths The number of deaths certified as due to various forms of tuberculosis was 25. Particulars of the primary notifications and deaths during the year, classified by sexes and age-groups, are given in the following table:— Age Periods Primary Notifications Deaths Pulmonary Non- Pulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under 1 year - - - - - - - - 1- 4 2 2 - - - - - - 5-9 3 2 - - - - - - 10-14 3 1 1 - - - - - 15-24 16 8 4 2 1 - - - 25-44 27 26 2 6 2 1 - - 45-64 27 12 2 1 8 4 1 - 65 and upwards 12 2 1 3 7 1 - - Totals 90 53 10 12 18 6 1 - 21 NON-INFECTIVE DISEASES The total number of deaths from cancer and malignant disease was 899, the number of males being 481 and females 418. The death rate was 2.58 per 1,000. The number of deaths in 1964 was 10 less than in the previous year. Deaths from disease of the heart and circulatory system were 1,811 compared with 2,098 in 1963. Of these deaths 1,486 were of persons of 65 years of age and above. There were 545 deaths from diseases of the respiratory system compared with 861 in 1963. The number of deaths from bronchitis was 223 compared with 377 in 1963 and from pneumonia (all forms) 283 compared with 414 in 1963. One hundred and eighty-six deaths were due to violence, 47 of them due to motor accidents, 66 to suicide and 73 to other forms of violence. CERTIFICATES OF VACCINATION AND INOCULATION Two thousand, nine hundred and forty-six requests were received from residents in the Borough for a certificate of vaccination or inoculation to be authenticated for the purpose of travel abroad. The signature of the person issuing the certificate was verified in each case as that of a registered medical practitioner practising in Wandsworth and the certificate endorsed accordingly. As referred to in last year's Report, the risk of importation of smallpox to countries by travellers from smallpox endemic areas has caused a tightening up by most countries of their regulations in regard to vaccination, and in consequence, many more requests than was previously the case are now made to Health Departments for the authentication of international certificates. Occasional requests were also received by the Medical Officer of Health for a certificate to the effect that no recent cases of smallpox have occurred in the area. Such requests are made by persons proceeding to the U.S.A. who do not wish to be vaccinated. STAFF MEDICAL EXAMINATIONS At the request of the Committees and Chief Officers concerned, arrangements were made during the year for four members of the Council's staff to undergo special medical examinations. The purpose of the examination was to determine the employee's future fitness for his occupation, following serious illness, and in one case it was found necessary to recommend superannuation. Fifty-seven shorter reports on members of the staff who were sick were obtained from doctors at the request of the departments concerned. 22 4 SANITARY INSPECTION OF THE BOROUGH Work of the Public Health Inspectors A summary of the inspections carried out by the Inspectors is give in Table I. TABLE I Inspections ReInspections Total To investigate complaints 5,474 13,011 18,485 Inspections under Shops Act 787 — 787 Infectious Diseases 1,081 787 1,868 Inspections under Factories Act 2,501 — 2,501 Housing Clearance Area Scheme 53 — 53 Housing Reports 3,364 — 3,364 Hairdressers 291 — 291 Other inspections 13,667 5,482 19,149 Totals 27,218 19,280 46,498 Smoke observations 318 Legal proceedings, attendances at court 24 Table II gives details of the sanitary operations carried out in the Borough during the year. The number of drains which were tested was 200 and 945 were cleansed or repaired, and 121 drains were partially reconstructed. Damp conditions have been remedied in 681 premises, and in two of these damp courses were inserted. 23 SANITARY INSPECTION OF THE BOROUGH TABLE II Putney Central Clapham Streatham Whole Borough 1. Premises cleansed and repaired 187 239 287 94 807 2. Drains tested 23 73 78 26 200 3. Drains cleansed or repaired 235 300 233 177 945 4. Water closets cleansed, repaired or renewed 69 96 104 79 348 5. Soil pipes altered or repaired 10 28 8 18 64 6. Waste pipes provided, altered or repaired 61 95 87 88 331 7. Rainwater pipes repaired 22 11 20 5 58 8. Roofs and gutters repaired 79 116 131 18 344 9. Damp courses inserted — — 1 1 2 10. Damp conditions otherwise remedied 112 137 128 56 433 11. Yards drained or paved — 7 1 — 8 12. Dustbins provided 4 26 28 12 70 13. Water cisterns cleansed, covered or repaired 6 4 — 1 11 14. Water supply reinstated 120 64 35 61 280 15. Defective stoves and fireplaces remedied 5 12 15 3 35 16. Animals improperly kept 1 2 2 5 10 17. Accumulations of rubbish, etc., removed 17 28 29 6 80 18. Urinals cleansed or repaired 2 — 1 1 4 19. Other nuisances 27 34 36 20 117 Total 980 1,172 1,224 671 4,147 Number of Preliminary Notices served 208 268 310 156 942 Number of Preliminary Notices complied with 243 307 399 166 1,115 Number of Nuisance Notices served 70 95 105 49 314 Number of Nuisance Notices complied with 65 98 101 45 309 Water Supply—Cutting-off Notices During the year notices with respect to 289 premises were received from the Metropolitan Water Board stating that the supply had been withdrawn. In 79 premises the water supply was cut off for non-payment of rates, and 210 premises because of defects in the service. 24 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 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 50 premises and during this period 59 dustbins were provided. Dustbins were also provided at 11 premises without the necessity of action under the Acts. Rodent Control One thousand, five hundred and sixty-one 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 8,275 „ „ premises treated with " Warfarin" 1,364 „ „ premises "Warfarin" laid and found not troubled 59 „ „ premises investigated and found not troubled .. 125 „ „ "Warfarin" baits laid 4,851 „ „ drains tested by Public Health Inspector 62 „ „ drains found defective 31 „ „ rats estimated killed 2,050 At the close of the year there were four rodent operatives and one clerk engaged on rodent control duties. 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 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. 25 SANITARY INSPECTION OF THE BOROUGH 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. Welfare of Old People The general pattern of work for the care and welfare of old people continued much along the same lines as in previous years. Close liaison and co-ordination of effort was maintained by the various voluntary organisations and statutory bodies concerned in this vital work, resulting in the continued provision of amenities such as Meals-on-Wheels and luncheon clubs, holidays, home visits and chiropody. Due, doubtless, to the efforts of various agencies, combined with the substantial amount of visiting of old people by health visitors and public health inspectors, it is pleasant to record that no case arose during the year under review of any old person found in such a state as to necessitate action being taken for compulsory removal to a hospital or home. This is a procedure always contemplated with the utmost reluctance and taken only as a last resort. Bathing Attendance A woman bathing attendant is employed to visit the homes of frail old people who require assistance with bathing in their own homes. During the year under review, this service continued and was greatly appreciated by those old people who requested assistance; at the close of the year, the attendant was visiting at weekly intervals 37 such old persons. Cleansing of Soiled Linen of Aged and Infirm The number of requests for assistance under this service again rose throughout the year. The soiled bed linen or clothing of 110 separate elderly and infirm persons were dealt with, involving the collection, cleansing and return of approximately 2.500 lots of linen during the year. 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. 26 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 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. Mortuary During the year 704 bodies of persons who died in Wandsworth were received in the Battersea mortuary. Crematorium Under the Crematorium Regulations, 1930, 1,518 cremations were authorized during 1964, compared with 1,672 in 1963. 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 1964 was 36. 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. 27 5 HOUSING STATISTICS RELATING TO HOUSES Public Health (London) Act, 1936 Number of houses inspected on account of complaints or illness 6,555 Re-inspections 13,798 Number of statutory notices served : Intimation notices 942 Nuisance notices 314 Number of houses in which nuisances were abated 1,113 The number of cases referred to the Solicitor for legal action during 1964 was 45 The following is a summary of Police Court Proceedings : Number of summonses served 21 „ „ „ withdrawn 9 „ „ „ adjourned 4 „ „ Orders made for abatement of nuisances 8 Housing Acts, 1936 and 1957 Clearance of Unfit Houses : Number of houses included in representations under Section 157 of the Housing Act, 1957 9 Number of houses included in declared Clearance Areas under Section 42 of the Housing Act, 1957 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 Nil 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 Nil Closing Orders: Number of Closing Orders made on houses under Section 17(1) of the Housing Act, 1957 1 Number of houses closed in pursuance of an undertaking given by the owner under Section 16(4) of the Housing Act, 1957 1 Number of Closing Orders made on parts of buildings under Section 18 of the Housing Act, 1957 10 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 1 28 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 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 1955 Built by 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 Total (a) Borough Council 575 431 263 215 353 180 408 316 339 640 3,720 (b) L.C.C. 1,613 735 1,012 1,224 152 170 227 261 74 207 5,675 (c) Private persons 69 26 39 75 169 294 493 328 415 557 2,465 HOUSES IN CLEARANCE AREAS AND UNFIT HOUSES ELSEWHERE Clearance Areas The following properties were declared Clearance Areas following my representations : 32-48 (even) Putney Bridge Road. Demolition Order A Demolition Order was made in respect of one house as follows : 148A Larkhall Lane. Unfit Houses Closed A Closing Order was made in respect of a whole house as follows: 58 Courland Grove. Closing Orders were made in respect of parts of buildings as follows : Premises 181 Bedford Hill. 39 and 41 Byrne Road. 26, 39 and 49 Fernlea Road. 7 Fitzwilliam Road. 142 Larkhall Lane. 156 Lower Richmond Road. 40 Rossiter Road. 29 HOUSING 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 the whole house in respect of 12 Ferrier Street and an undertaking was given by the owner to close part of the building in respect of 44 Fernlea Road. HOUSES IN MULTIPLE OCCUPATION Statistical results of the survey made of houses in multiple occupation were included in last year's Report and the opportunity is now taken to show below further results and work done up to the end of 1964 : 1962 1963 1964 Total Total number of primary visits made 1,500 1,287 1,490 4,277 Total number of houses fully inspected 453 789 1,224 2,466 Total number of revisits — 841 905 1,746 Work Done Baths provided 19 W.C's provided 16 Sinks provided 65 Cooking facilities provided 70 Water supply (cold) provided 66 Water supply (hot) provided 57 New dustbins provided 9 Food Stores or Refrigerators provided 42 Staircases, landings, etc., redecorated 8 W.C's redecorated 8 Bathrooms redecorated 11 Accumulations of rubbish removed 3 Electric heating points provided 19 Direction limits applied 10 Fire precautions 18 Control of Movable Dwellings London County Council (General Powers) Act, 1959 In accordance with the provisions of the London County Council (General Powers) Act, 1959, two Licences were granted during the year in respect of sites for movable dwellings. The total number of dwellings permitted on these sites was 12. 30 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 The Rent Act, 1957 Applications for Certificates of Disrepair. Twenty-eight applications were received for Certificates of Disrepair and were dealt with as follows: (a) In three cases it was decided not to issue Certificates of Disrepair as the premises were not in disrepair by reason of defect. (b) In twenty-eight cases it was decided to serve notices on landlords proposing to issue Certificates of Disrepair unless undertakings to do repairs were given. (c) Fifteen undertakings were received from landlords to remedy defects proposed to be included in Certificates of Disrepair. (d) Nine Certificates of Disrepair were issued. Applications for Cancellation of Certificates. (a) Eleven applications were received from landlords for the cancellation of Certificates of Disrepair. (b) No objections were received from tenants for cancellation of Certificates. (c) Eleven Certificates of Disrepair were cancelled. Housing Accommodation—Medical Priority During the year 1,147 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 202 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. 31 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 2.570 and during 1964 they were visited on 10,533 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. A Court Summons was taken out by the Council against a trader for the presence of foreign matter in food and a fine of £10 was awarded by the Court. A Court Summons was also taken out by the Council against a street trader for not having his name and address displayed on his vehicle and a fine of £2 and costs of £2 2s. Od. were awarded by the Court. 32 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 TABLE I SUMMARY OF VISITS TO FOOD PREMISES Putney Central Clapham Streatham Whole Borough Dairies 10 19 57 52 138 Restaurant Kitchens 518 498 409 443 1,868 Ice Cream Premises 49 65 14 31 159 Butchers' Shops 292 166 186 101 745 Greengrocers' Shops 171 101 146 86 504 Fishmongers' Shops 42 33 62 41 178 Fried Fish Shops 71 84 109 11 275 Market Stalls 163 1,191 726 129 2,209 Grocers' Shops 677 575 662 425 2,339 Confectioners' Shops 258 250 284 221 1,013 Bakehouses 89 37 56 19 201 Other Premises 366 185 241 112 904 Total Visits 2,706 3,204 2,952 1,671 10,533 The following shows the number and type of premises in the Borough where food is sold, stored or prepared : Dairies and Milk Depots 8 Food Factories 22 Restaurants, Cafes and Canteens 574 Bakers and Confectioners 476 Butchers 192 Greengrocers 206 Fishmongers 64 Fish Friers 55 Bakehouses 49 Grocers 540 Off Licences 93 Public Houses 148 Stalls 143 2,570 The amount of work completed during 1964 to comply with the requirements of the Regulations is indicated in the following details : Wash hand basins provided 84 Sinks provided 31 Provision of hot water over sink and wash hand basin 57 Accommodation for clothing provided 14 Soap, towel and nailbrush 6 Premises repaired or redecorated 118 Adequate protection for open food 7 Notices to employees 15 Dustbins 6 W.C. accommodation 63 First Aid Materials 7 33 FOOD AND FOOD PREMISES 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 51 applications were received from persons to be registered as distributors of milk. In each case the certificate of registration was granted. Fifty-two notices of cancellation of registration were received. At the end of the year there were 241 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 eight samples of milk were submitted for analysis. Of these 29 were samples of Channel Island and South Devon milks with an average fat content of 4.45 per cent. The remaining 179 samples had an average fat content of 3.67 per cent. The Milk (Special Designation) Regulations, 1963 These regulations re-enact with amendments the Milk (Special Designation) Regulation, 1960, and one of the principal changes is that on and after 1st October, 1964, "Untreated" replaced "Tuberculin Tested" as the special designation for raw milk. The special designations "Pasteurised" and "Sterilised" remained in force. In accordance with the regulations, the licences which had been issued in respect of special designation " Tuberculin Tested " were cancelled and new licences in respect of " Untreated " milk were applied for. The following licences were, therefore, granted during the year Dealer's (Prepacked Special Designation Milk) Licence " Pasteurised" 54 " Sterilized " 46 "Tuberculin Tested" (before 1st October, 1964) 28 "Untreated" (after 1st October, 1964) 134 Meat There are 192 butchers' shops in the Borough. The majority are registered under Section 16 (1) (b) of the Food and Drugs Act, 1955, for the preparation or manufacture of sausages or potted, preserved, pickled or pressed foods. There were 745 visits made to these shops during the year. 34 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 Slaughter of Animals There are no private slaughterhouses in the Borough. Slaughter of Animals Act, 1958 Section 3 of this Act provides that no animals 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 Forty-eight varieties of foodstuff suspected to be unsound were examined at the request of the owners and afterwards either destroyed or released for animal feeding. The owners were granted a certificate to this effect. Pharmacy and Poisons Act, 1933, and Pharmacy and Medicines Act, 1941 These Acts provide for the listing with the local authority of all persons dealing in poisons included in Part II of the Poisons List. The number of persons on the Council's list at the end of 1964 was 270, and 288 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 61 69 Drug stores 16 7 Grocers 183 202 Hairdressers 5 5 Nurserymen and florists 5 5 Total 270 288 Bakehouses There are 49 bakehouses in the Borough, of which 10 are in basements and subject to the provisions of Section 70 of the Factories Act, 1961. Two hundred and one visits by the Food Inspectors were made to these premises during the year. Certificates of suitability under the Factories Act, 1961, were granted in respect of 9 underground bakehouses in 1963. 35 FOOD AND FOOD PREMISES A certificate of suitability was granted in 1964 in respect of the one remaining underground bakehouse where certain work had been carried out to bring it up to the required standard. 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 98,000, and the population of 348,450 in the Borough are supplied from water piped direct to houses. It is not known if any standpipes are still in existence. Registration of Premises The Food and Drugs Act, 1955 Section 16(1) of the above Act provides that no premises shall be used for : (a) the sale, or manufacture for the purpose of sale, of ice-cream or the storage of ice-cream intended for sale; or (b) the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale, unless they are registered under this section for that purpose with a local authority. During the year 92 applications for registration under the provisions of Section 16(1)(a) and 21 applications for registration under the provisions of Section 16(1 )(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 One hundred and eighty-four samples were examined bacteriologically at the Public Health Laboratory during the year. They were as follows : Swimming Milk Ice-cream Pool Others Total Waters 102 40 32 10 184 36 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 Milk Of the 102 samples of milk, 48 were submitted to the phosphatase test, 48 to the methylene-blue test, and 6 to the turbidity test. These samples were reported satisfactory. Ice-cream The 40 samples of ice-cream 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 21 2 5 3 9 4 5 Total 40 Examination of Water from Swimming Baths Thirty-two samples were submitted for examination. Satisfactory results were obtained in 28 samples. In the remaining samples there were slight deviations from normal, but subsequent tests proved satisfactory in all cases. Others The ten miscellaneous samples proved to be free of pathogenic organisms. Analysis of Food and Drugs During the year 1,000 samples of food and drugs were procured for analysis; 208 samples of milk, 751 other foodstuffs and 41 drugs. Of these, 132 were submitted as formal samples, while 868 were purchased informally. No adulteration was found in the formal samples, but 69 or 7.93 per cent, of the informal samples or 6.90 per cent, of the total samples submitted were found to be adulterated or not up to standard. The 69 samples found to be adulterated were: Seven samples of pork sausages, six samples of buttered rolls, five samples each of bread and fried chips, four samples each of milk and beef sausages, three samples of chopped ham with pork, two samples each of friars balsam, ammoniated tincture of quinine, chicken in jelly, canned milk pudding and borax and honey and 37 FOOD AND FOOD PREMISES one sample each of meat paste, rice, chicken broth, meat, butter, cake decoration, lemon glucose, Shandy, braised kidneys, milk bottle, seidlitz powder, cottage cheese, biscuits, canned curry beef, lemonade, sulphur ointment, cheese flavoured crisps, fruit and nuts, cake, canned carrots, mixed fruit, horseradish sauce, margarine and canned soft drink. Noise Abatement Act, 1960 Court summonses were taken out against five traders for the sounding of chimes; in three instances a fine of £2 was awarded by the Court; in one instance a fine of £1 and costs of £1 1s. 0d. and in the other instance, a fine of £4 and costs of £1 ls. 0d. were awarded by the court. 38 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 283 250 — — (2) Factories not included above in which Section 7 of the Act is enforced by the Local Authority 1,019 1,642 4 — (3) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' Premises) 67 114 — — Total 1,369 2,006 4 — (2) DEFECTS Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness 6 6 — 1 — Overcrowding — — — — — Unreasonable temperature — — — — — Inadequate ventilation — — — — — Ineffective drainage of floors — — — — — Sanitary Conveniences: (a) insufficient 1 1 — — — (b) unsuitable or defective 45 43 — 7 — (c) not separate for sexes — — — — — Other offences against the Act (not including offences relating to outwork) 4 4 2 — — Total 56 54 2 8 — 39 FACTORIES ACT, 1961 FACTORIES ACT, 1961 PART VIII OUTWORK (SECTIONS 133 AND 134) Section 133 Section 134 Nature of Work 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. 190 - - - - Curtains and furniture hangings 9 - - - - Brass and brass articles 1 - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 4 - - - - Stuffed toys 1 - - - - Textile weaving 1 - — — — Lampshades 49 - — — — Total 255 - — — — 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 26 new registrations were made, and the total number on the register at the end of the year was 306. Pet Animals Act, 1951 Twenty-seven licences were issued by the Council in relation to premises subject to the provisions of this Act. 40 8 ATMOSPHERIC POLLUTION AND CLEAN AIR During the year, a sixth Smoke Control Order was confirmed by the Minister of Housing and Local Government and at the date of writing, a seventh Order made by the Council had been submitted to the Minister for his approval. The preliminary survey of Area 8 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 past three years, is again reproduced in the following pages. Measurement of Atmospheric Pollution Daily readings of the concentration of smoke and sulphur dioxide (SO2) 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. Recordings at Queen Mary's Hospital, Roehampton, were suspended for a period of six months, whilst the premises were under repair. A comparison of smoke and SO2 concentration for the past two years is shown in Table II. MAP OF SMOKE CONTROL AREAS IN WANDSWORTH Smoke Control Areas 1 to 6 — Orders confirmed and in operation Smoke Control Area No. 7 — Order made and awaiting confirmation Remaining Areas — Orders yet to be made in the years shown 41 ATMOSPHERIC POLLUTION AND CLEAN AIR TABLE I Station Roof— Municipal Buildings Valley Road, S.W.16 Tooting Library Queen Mary's Hospital, Roehampton South London Hospital, Clapham Month—1964 Smoke SO2 Smoke SO2 Smoke SO2 Smoke SO2 Smoke SO2 January 218 354 213 312 219 282 104 129 212 275 February 130 299 215 281 180 172 154 217 156 186 March 82 140 81 197 98 126 No recordings 76 116 April 58 125 47 134 79 121 „ 70 122 May 62 54 36 123 36 29 „ 32 49 June 47 114 31 78 51 71 „ 40 74 July 30 130 38 77 35 58 13 85 23 70 August 31 109 49 63 33 84 No recordings 27 83 September 34 124 23 84 35 80 „ 28 57 October 64 161 46 142 118 187 67 88 111 199 November 107 485 86 132 137 193 57 98 92 232 December 231 448 177 298 252 31 140 237 199 303 Average 91 212 87 160 106 120 89 142 89 147 42 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 43 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 1964, calculated as described in the 1958 Report. HOME ACCIDENT CASES DURING 1958 to 1964 TABLE I Cause of Accident 1958 1959 1960 1961 1962 1963 1964 FallOn stairs 122 130 131 109 76 92 89 From ladder 12 19 20 8 9 19 11 From chair 21 29 21 22 19 16 17 Outside 16 35 21 17 24 29 18 In garden 25 43 35 34 30 23 21 In bath 1 4 2 2 2 3 3 From one level to another 33 32 35 45 52 45 42 On same level 105 115 110 110 86 103 56 Unspecified 255 268 338 373 387 392 465 Hit by object 14 16 20 21 32 28 24 Cooking stove 13 17 15 13 12 17 20 Teapots 6 7 7 6 6 6 7 Other boiling water 12 17 13 16 25 26 18 Electric shock 1 3 2 3 3 6 5 Poisoning 24 24 48 48 45 45 48 Gassing 12 19 12 14 13 33 31 Knife-like wounds 36 47 48 38 45 38 44 Fires 24 11 10 15 16 22 28 Windows 6 9 7 7 4 4 4 Suffocation 2 10 3 2 5 5 6 Not specified 44 31 39 41 41 59 42 Totals 784 886 937 944 932 1,011 999 Rate per 10,000 population 23.2 26.2 27.6 26.9 27.1 29.0 29.4 TABLE II AGE GROUPS AND PERCENTAGES 1958 % 1959 % 1960 % 196 % 1962 % 1963 % 1964 % Under 1 14 1.7 11 1.3 12 1.3 14 1.6 14 1.7 18 1.6 21 20 1- 29 3.7 31 3.4 33 3.6 35 3.9 36 4.0 35 3.4 43 4.4 2- 30 3.8 35 3.8 35 3.9 82 8.6 84 9.0 96 9.5 104 8.6 3 and 4 36 4.6 40 4.5 45 4.8 83 8.7 84 8.9 83 8.2 92 7.2 5-19 84 10.8 102 11.8 110 11.6 71 7.4 69 7.3 77 7.6 78 7.6 20-59 239 30.5 268 30.5 280 30.4 129 13.7 123 13.2 141 14.0 132 13.1 60-69 82 10.5 102 11.6 110 11.8 168 17.7 167 17.8 188 187 171 18.1 70-79 141 17.9 155 17.3 157 16.4 124 13.0 124 13.3 134 13.3 117 12.8 80+ 129 16.5 142 15.8 155 16.2 238 25.4 229 24.8 239 23.7 241 26.2 Totals 784 100 886 100 937 100 944 100 930 100 1,011 100 999 100 44 10 REPORT OF THE WORK OF THE PUBLIC ANALYST FOR 1964 The Public Analyst, D. G. Forbes, b.sc., f.r.i.c., reports as follows: By virtue of the requirements of the Food and Drugs Act, 1955, 1,000 samples were examined during the year ended 31st December, 1964; 959 were articles of food and the remaining 41 drugs. All were submitted by the Council's Food Inspectors, 132 having been taken with the formalities required by the Act and 868 informally. Samples of the following substances were analysed: fats (butter, margarine, etc.), 81; beverages (cocoa, coffee, tea, etc.), 36; cereal preparations, 44; cheese products, 24; confectionery, 89; cream, 32; fish (canned, etc.), 33; fruit (canned and dried), 31; ice-cream, 3; meat products (including sausages), 126; milk, 208; pickles and condiments (including spices), 79; preserves, 35; soup, 24; vegetables, 41; aspirin tablets, 4; Friar's balsam, 5; Linctus, 5; ointments, 4; tincture of quinine, 3; seidlitz powders, 3; borax and honey, 5. 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 166 Ammoniated tincture of quinine 75 per cent. deficient in ammonia 207 Friar's balsam Low total solids content 230 Buttered rolls Contained fat other than butter 242 do. do. 244 do. do. 245 Rice Parboiled brown rice 278 Friar's balsam Low total solids content and labelling offence 287 Ham and beef paste 6.5 per cent. deficient in meat 301 Pork sausages 12 per cent. deficient in meat 302 Beef sausages 10 per cent. deficient in meat 304 Pork sausages 10.5 per cent deficient in meat 305 Chicken broth Discolouration by iron compounds 307 Meat Blue pigment, probably ultramarine 323 Milk Not less than 5.5 per cent. deficient in milk fat 376 Bread Contained black stains of fine carbon particles 403 Lemon Glucose drink Contained excess saccharin 405 Shandy (canned) Defective tin 406 Sugar crystals (cake decorations) Contained non permitted colouring matter 410 Fried chips Rancid fat 422 Pork sausages Deficient in meat content 45 REPORT OF THE PUBLIC ANALYST FOR 1964 Case No. Nature of Sample Nature of Report Informal 427 Chopped chicken in jelly Deficient in meat content 431 Buttered rolls Contained fat other than butter fat 432 Butter Contained fat other than butter fat 448 Pork chipolatas Deficient in meat content 449 Beef sausages Deficient in meat content 452 Fried chips Rancid fat 461 Braised kidneys Meat virtually absent 467 Fried chips Rancid fat 483 Dirty milk Suspected spot of blood 486 Chopped ham and pork Deficient in meat content 487 Chopped ham and pork Deficient in meat content 488 Boned chicken in jelly Deficient in meat content 496 Frozen chips Rancid fat 497 Frozen chips Rancid fat 506 Extra Strong Seidlitz Powder Incorrectly labelled B.P.C. 507 Ammoniated tincture of quinine Deficient in ammonia and excessive quinine content 511 Sulphur ointment Deficient in sulphur 514 Pork sausages Deficient in meat content 527 Bread Fragment of mould present 543 Cottage cheese Misdescribed 545 Margarine Incorrect size of type used for name of the food 565 Cream Sago pudding Decomposed and acid 581 Beef sausages Deficient in meat content 594 Bread Contained a furniture beetle 632 Milk 53 per cent. deficient in fat 635 Milk 22 per cent. deficient in fat 650 Lemonade Contained a piece of paper and some mould 658 Beef curry At least 6 per cent. deficient in meat 666 Creamed Rice pudding Unpleasant taste and high acid value due to souring milk 673 Borax and honey Deficient in borax. Wrongly labelled B.P.C. 701 Beef chipolatas 6 per cent. deficient in meat 702 Pork chipolatas 14 per cent. deficient in meat 709 Bread Contained pieces of metallic zinc 739 Borax and honey Wrongly labelled B.P.C. 769 Cheese flavoured Incipient rancidity detected 787 puffs Pork sausages 4.5 per cent. deficient in meat 833 Buttered roll Contained 40 per cent. margarine 834 Buttered roll Contained 70 per cent. margarine 874 Fruit and nuts 85 per cent. nuts—should be labelled "Nuts and Fruit" 885 Milk Contained piece of polythene lining 886 Cake Contained mouse excrement 899 Horseradish Poor flavour; deficient in mustard oil 901 Chopped ham with pork Deficient in meat 914 Sauce Mould present on cap liner and in neck of bottle 46 46 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 Case No. Nature of Sample Nature of Report Informal 918 Mixed fruit Raisins present but not declared on label 922 Instant orange Label misleading 951 Tinned carrots Mould and particles of potato present 971 Bread Contained oil and metal particles from machinery Complaint Samples Case No. 245. Rice. Submitted on the complaint that it had an objectionable odour. The complaint was considered justified. Case No. 305. Chicken Broth. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 307. Meat. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 367. Tinned Peas. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 376. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 431. Buttered Rolls. Submitted on the complaint that they did not contain butter. The complaint was considered justified. Case No. 432. Butter. Submitted on the complaint that it was not of the quality demanded. The complaint was considered justified. Case No. 461. Braised Kidneys. Submitted on the complaint that it was not of the quality demanded. The complaint was considered justified. Case No. 483. Milk Bottle. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 565. Cream Sago Pudding. Submitted on the complaint that it was sour. The complaint was considered justified. Case No. 527. Bread. Submitted on the complaint that it contained mould. The complaint was considered justified. Case No. 594. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. 47 REPORT OF THE PUBLIC ANALYST FOR 1964 Case No. 607. Luncheon Meat. Submitted on the complaint that it was of poor quality. The complaint was considered not justified. Case No. 650. Lemonade. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 666. Creamed Rice Pudding. Submitted on the complaint that it had an objectionable taste. The complaint was considered justified. Case No. 709. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 804. Butter. Submitted on the complaint that it was rancid. The complaint was considered not justified. Case No. 805. Butter. Submitted on the complaint that it was rancid. The complaint was considered not justified. Case No. 885. Milk in Carton. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 886. Madeira Cake. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 914. Sauce. Submitted on the complaint that it contained mould. The complaint was considered justified. Case No. 916. Canned Fruit. Submitted on the complaint that it contained foreign matter. The complaint was considered not justified. Case No. 951. Tinned Carrots. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Case No. 971. Bread. Submitted on the complaint that it contained foreign matter. The complaint was considered justified. Milk The average composition of the samples of milk submitted during each month of the year and returned as genuine was as under : Month Number Total solids Milk fat Non-fatty solids January 16 12.56 3.87 8.69 February 16 12.46 3.83 8.63 March 20 12.25 3.65 8.60 April 16 12.25 3.66 8.59 May 15 12.26 3.51 8.75 June 21 12.64 3.87 8.77 July 16 13.03 3.82 9.21 August 16 12.67 3.70 8.97 September 20 12.44 3.78 8.66 October 16 12.69 3.84 8.85 November 16 12.72 3.99 8.73 December 20 12.61 3.86 8.75 48 48 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 The average composition of the 208 samples of milk analysed during the year and returned as genuine was as under : Total milk solids 12.55 per cent. Milk fat 3.78 per cent. Non-fatty solids 8.77 per cent. The average composition of the 29 samples of Channel Island and South Devon milks was as under : Total milk solids 13.40 per cent. Milk fat 4.45 per cent. Non-fatty solids 8.95 per cent. 49 INDEX PAGE Accidents, Deaths from 21 Accidents, Home 43 Acute Encephalitis 16 Analyst, Report of 44 Atmospheric Pollution 40 Bacteriological Examinations of Milk 36 „ „ Ice-cream 36 Bakehouses 34 Bathing Pools and Swimming Pools 24 Bed Bugs, Eradication of 25 Births, Birth-rates 8 Butchers' Shops 33 Cancer 21 Care of Old People 25 Childbirth, Deaths from 12 Circulatory Diseases 21 Clean Air 40 Closing Orders 28 Crematorium 26 Cutting-off Notices—Water Supply 23 Deaths, Causes of 11 Death-rates 9 Death-rate from Infective Diseases 13 Death-rate, Infantile 12 Deaths, Number of 9 Diphtheria 13 Disinfection 19 Dysentery, Sonne 17 Enteric Fever 16 Erysipelas 18 Factories Act, 1961 38 Factories and Workshops 39 Food Hygiene Regulations 31 Foods and Drugs Act, 1955 31 Food Poisoning 18 Food, Supervision of 31 Food Places, Inspection of 32 Food Places, Number on Register 31 Hairdressers and Barbers 39 Home Accidents 43 Houses in Multiple Occupation 29 Houses and Premises Inspected 22 Housing Act, 1936 27 Housing Statistics 28 50 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1964 PAGE Hydrogen Cyanide Disinfection 26 Illegitimate Children, Births of 8 Infant Mortality 12 Infective Diseases 13 Infective Diseases, Cases of 14 Infective Diseases, Death-rate from 13 Influenza, Deaths 11 Influenzal Pneumonia and Acute Primary Pneumonia 17 Malaria 18 Maternal Mortality 12 Meat 33 Meningococcal Infection 16 Milk Analysis 47 Milk, Bacteriological Examination of 36 Milk Premises, etc., on Register 33 Milk (Special Designations) Regulations, 1960 33 Mortuary 26 Non-Infective Diseases, Deaths from 21 Notification of Infective Diseases 14 Old People, Care of 25 Outworkers 39 Pet Animals Act 39 Pharmacy and Poisons Act, 1933 34 Pharmacy and Medicines Act, 1941 34 Poliomyelitis 16 Population 8 Pregnancy, Deaths from Accident and Diseases of 12 Public Analyst, Report of 44 Puerperal Pyrexia 17 Pulmonary Tuberculosis, Notification of cases of 20 Rent Act 30 Rodent Control 24 Samples, Formal and Informal, Number of 44 Sanitary Inspection of Borough 22 Scabies 18 Scarlet Fever 17 Slaughter-houses 34 Slaughter of Animals Acts, 1933-1954 34 Smallpox 13 Smoke Control Areas 42 Staff 4 Statistics for the Borough 7 Suicide, Deaths from 21 Swimming Baths and Bathing Pools 24 Syphilis, Deaths from 18 Tuberculosis 20 Unfit Houses 28 Unsound Food 34 Water Supply 35 Water Supply, Cutting-off Notices 23 Whooping Cough 13 Rowling & Sons Ltd. (t.u.), 34 & 36 York Road, S.W.11