LIBRARY WIM 25 Borough of Wimbledon. Public Health Department ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER, 1952 Printtd by Raynes Park Press, Lambton Road, London, S.W.20. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALLH 1952 Public Health Department, Town Hall, Wimbledon, S.W.19. June, 1953. To The Mayor, Aldermen and Councillors of the Borough of Wimbledon. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit the Annual Report on the work of the Public Health Department for the year 1952. This Report is compiled in accordance with the instructions contained in Circular 2/53 of the Ministry of Health. From the statistics it will be seen that the live birth rate for the Borough in 1952 was 11.67 per thousand of the population, as compared with a rate of 15.3 for England and Wales. The death rate for Wimbledon during the period was 10.63 as compared with a rate of 11.3 for England and Wales. For the fourth year in succession there were no maternal deaths amongst women resident in Wimbledon. The infantile mortality rate for 1952, both for Wimbledon and for England and Wales as a whole, was the lowest on record. Ten Wimbledon children under the age of one year died during the year, 1 giving an infantile mortality rate of 13.60 per thousand live births. Of these 10 deaths, all but one were attributable to congenital defects, birth injuries or prematurity. With regard to infectious diseases, for the third year in succession there were no cases of diphtheria in Wimbledon. Two cases of poliomyelitis were notified, one of them associated with paralysis. There were no deaths from infectious diseases during the year. I should like to take this opportunity of expressing to the Chairman and Members of the Health Committee my appreciation of the consideration and courtesy which they have shown me during the year. My thanks are also due to all members of the staff of the Public Health Department for the loyal and efficient way in which they have carried out their duties. I would like to thank Mrs. Dymott for her work in connexion with the preparation of this Report. I am also indebted to my colleagues in other departments for their ready help on all occasions. I have the honour to be, Your obedient Servant, HAROLD ELLIS, Medical Officer of Health. 2 LIST OF CONTENTS. Page Introduction 1-2 List of Staff 4 SECTION A: STATISTICS AND SOCIAL CONDITIONS: Statistics, etc. 5-7 Births 6 Deaths Registered 8-9 Infantile Mortality 9-10 Summary of Statistics 11 SECTION B: GENERAL PROVISION OF HEALTH SERVICES: Nursing Homes 12 National Assistance Act, 1948 13 Mass Radiography 13-14 Clean Food Campaigns 14 Heating Appliances (Fireguards) Act, 1952 14 SECTION C: SANITARY CIRCUMSTANCES: Water Supply 15 Sanitary Inspectors' Visits 15-16 Notices Served 16 Nuisances abated and defects remedied 16-17 Factories Act, 1937, Part I. 18 Outworkers 19 Bakehouses 19 SECTION D: HOUSING 20 SECTION E: INSPECTION AND SUPERVISION OF FOOD: Milk 21 Ice cream 21 Meat and other Foods 24 Sampling of Food and Drugs 22-24 SECTION F : PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES: Diphtheria Immunisation 26 Notifiable Infectious Diseases, etc 27-28 Tuberculosis 29 3 STAFF Medical Officer of Health: Harold Ellis, M B., B.S.(Lond.), M.R.C.S., L.R.C.P., D.P.H. Senior Sanitary Inspector: D. F. S. Flynn, (b), (c). Deputy Senior Sanitary Inspector: H. R. Fry. (a), (c). Sanitary Inspectors'. J. Hills, (a), (c), (Resigned 22/7/52). P. W. Smith, (a). P. W. Jolly, (a). R. I. W. Owen, (a), (c), (Appointed 6/10/52). Assistant Rodent Officer: F. J. Reddington. Chief Clerk: † Mrs. V. Dymott. Clerks: * J. E. Field. * Mrs. V. Waters. † Miss S. G. Miller. F. R. Brackfield. Miss P. Martin (Temporary appointment). † Transferred to Surrey County Council under National Health Service Act, 1946. Part-time officer to the Wimbledon Borough Council. * Officer of the Wimbledon Borough Council. In part-time employment of the Surrey County Council. (a) Certificate Royal Sanitary Institute and Sanitary Inspectors Examination Joint Board. (b) Certificate Royal Sanitary Institute for Inspector of Nuisances. (c) Certificate Royal Sanitary Institute for Inspector of Meat and other Foods. 4 SECTION A. — STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres—Census, 1951) 3,212 Population (Census, 1951) 58,158 Home Population (mid-1952) 58,550 Number of inhabited houses:— 1921 (Census) 11,926 1931 (Census) 13,325 Number of families or separate occupiers:— 1921 (Census) 13,998 1931 (Census) 15,883 Rateable Value:— £826,420. Sum represented by penny rate:—£3,371. Extracts from Vital Statistics of the Year 1952. (Registrar-General's Figures.) Total M. F. Live Births Legitimate 703 363 340 Illegitimate 32 15 17 Total 735 378 357 Total M. F. Stillbirths Legitimate 16 11 5 Illegitimate 1 – 1 Total 17 11 6 Live birth rate per 1,000 of the estimated home population 12.55 Corrected live birth rate per 1,000 of the estimated home population 11.67 Still-birth Rate per 1,000 total (live and still) births 22.61 Total M. F. Deaths 759 346 413 Crude Death Rate per 1,000 of the estimated home population 12.96 Corrected Death Rate per 1,000 of the estimated home population 10.63 Deaths from puerperal causes— Deaths. Rate per 1,000 total (live and still) births. Puerperal and post-abortive sepsis – – Other maternal causes – – Total – – Death Rate of infants under one year of age:— All infants per 1,000 live births 13.60 Legitimate infants per 1,000 legitimate live births 14.22 Illegitimate infants per 1,000 illegitimate live births – Deaths from cancer 127 diphtheria – poliomyelitis – „ „ measles – „ whooping cough – 5 Birth Rates, Death Rates, Analysis of Mortality, Maternal Mortality, and Case Rates for certain Infectious Diseases in the Year 1952. (Provisional Figures based on Quarterly Returns). Wimbledon England and W ales 160 C.B.s and Great Towns including London 160 Smaller towns (resident population 25,000 -50.000 at 1951 Census) London Administrative County Births: — Rates per 1,000 Home Population Live Births 11.67 15.3 16.9 15.5 17.6 Still Births 0.29 0.35 0.43 0.36 0.34 22.6† 22.6† 24.6† 23.0† 19.2† Deaths:— All Causes 10.63 11.3 12.1 11.2 12.6 Typhoid and Paratyphoid — 0.00 0.00 0.00 — Whooping Cough — 0.00 0.00 0.00 0.00 Diphtheria — 0.00 0.00 0.00 0.00 Tuberculosis 0.10 0.24 0.28 0.22 0.31 Influenza 0.03 0.04 0.04 0.04 0.05 Smallpox — 0.00 — — — Acute Poliomyelitis (including Polioencephalitis) — 0.01 0.01 0.00 0.01 Pneumonia 0.58 0.47 0.52 0.43 0.58 Notifications (corrected):— Typhoid Fever — 0.00 0.00 0.00 0.00 Paratyphoid Fever 0.02 0.02 0.02 0.03 0.01 Meningococcal Infection 0.02 0.03 0.03 0.03 0.02 Scarlet Fever 2.19 1.53 1.75 1.58 1.56 Whooping Cough 1.91 2.61 2.74 2.57 1.66 Diphtheria — 0.01 0.01 0.03 0.01 Erysipelas 0.05 0.14 0.15 0.12 0.14 Smallpox — 0.00 0.00 0.00 – Measles 5.76 8.86 10.11 8.49 9.23 Pneumonia 0.41 0.72 0.80 0.62 0.57 Acute Poliomyelitis (including Polioencephalitis)— Paralytic 0.02 0.06 0.06 0.06 0.06 Non-paralytic 0.02 0.03 0.03 0.02 0.03 Food Poisoning – 0.13 0.16 0.11 0.18 Puerperal Pyrexia 6.65† 17.871† 23.94† 10.22† 30.77† Rates per 1,000 Live Births Deaths:— All causes under 1 year of age 13.60‡ 27.6‡ 31.2 25.8 23.8 Diarrhoea and Enteritis (under 2 years of age) — 1.1 1.3 0.5 0.7 t Per 1,000 total (live and still) births. t Per 1,000 related live births. 6 Maternal Mortality in England and Wales. Cause No. of deaths Rates per 1,000 total (live and still) births Rates per million women aged 15-44 Sepsis of pregnancy, childbirth and the puerperium 61 0.09 Abortion with toxaemia 13 0.02 1 Other toxaemias of pregnancy and the puerperium 147 0.21 Haemorrhage of pregnancy and childbirth 59 0.09 Abortion without mention of sepsis or toxaemia 31 0.04 3 Abortion with sepsis 47 0.07 5 Other complications of pregnancy, childbirth and the puerperium 138 0.20 As previously stated in the Report there were no maternal deaths in Wimbledon during 1952. BIRTHS. The statistics supplied by the Registrar-General show that during 1952 the total number of registered live births belonging to Wimbledon was 735. In addition 17 stillbirths were registered. This gives a birth-rate of 12.55 per thousand of the population compared with a rate of 14.26 per thousand for the previous year. A comparability factor has been supplied by the RegistrarGeneral which enables the birth-rate for Wimbledon to be compared with that for England and Wales. The corrected birth-rate for Wimbledon for 1952 is 11.67 per thousand of the population, whilst the rate for England and Wales is 15.3. DEATHS. The total number of Wimbledon residents who died during 1952 was 759, giving a death-rate of 12.96 per thousand of the population as compared with 13.33 per thousand for 1951. The corrected death-rate for 1952 is 10.63 per thousand as compared with a rate of 11.3 per thousand for England and Wales. The number of Wimbledon residents who died outside the Borough was 231, while 238 persons not normally resident in Wimbledon died in institutions, etc., in the Borough. 7 The three principal causes of death were as follows:— Percentage of total deaths Diseases of the heart and circulatory system 54% Cancer 17% Diseases of the respiratory system 11% Total 82% The following is an analysis of the causes of death:— Cause Males Females Total 1. Respiratory tuberculosis 4 2 6 2. Other tuberculosis — — — 3. Syphilitic disease 2 4 6 4. Diphtheria — — — 5. Whooping cough — — — 6. Meningococcal infections — — — 7. Acute poliomyelitis — — — 8. Measles – – – 9. Other infective and parasitic diseases 1 – 1 10. Malignant neoplasm, stomach 8 7 15 11. Malignant neoplasm, lung, bronchus 12 11 23 12. Malignant neoplasm, breast – 13 13 13. Malignant neoplasm, uterus – 4 4 14. Other malignant and lymphatic neoplasms 30 42 72 15. Leukaemia, aleukaemia 2 3 5 16. Diabetes 5 2 7 17. Vascular lesions of nervous system 30 66 96 18. Coronary disease, angina 71 60 131 19. Hypertension with heart disease 11 11 22 20. Other heart disease 49 77 126 21. Other circulatory disease 20 15 35 22. Influenza 2 – 2 23. Pneumonia 14 20 34 24. Bronchitis 24 20 44 25. Other diseases of respiratory system 2 4 6 26. Ulcer of stomach and duodenum 8 4 12 27. Gastritis, enteritis and diarrhoea – 1 1 28. Nephritis and nephrosis 4 5 9 29. Hyperplasia of prostate 9 – 9 30. Pregnancy, childbirth, abortion – – – 31. Congenital malformations 3 1 4 32. Other defined and ill-defined diseases 21 29 50 33. Motor vehicle accidents 2 3 5 34. All other accidents 4 8 12 35. Suicide 8 1 9 36. Homicide and operations of war – – – Totals 346 413 759 8 INFANTILE MORTALITY. During 1952 there were 10 deaths in infants under one year of age, giving an infantile mortality rate for Wimbledon of 13.60 per thousand live births, as compared with a rate of 27.6 for England and Wales. Six of the 10 deaths occurred during the first four weeks of life, giving a neo-natal death-rate of 8.16 per thousand live births. The following table shows the causes of and ages at death. Cause of death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 1-3 months 3-6 months 6-9 months 9-12 months Total Deaths under 1 year Congenital defect or birth injury 3 — — — 3 3 — — — 6 Prematurity 3 — — — 3 — — — — 3 Pneumonia — — — — — — 1 — — 1 Total ... 6 — — — 6 3 1 — — 10 9 Infantile Mortality during the last 10 years. Cause of death 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 Prematurity 8 6 4 6 6 8 5 5 3 3 Congenital defects or birth injuries 9 6 8 12 10 5 12 2 9 6 Diseases of the newborn – 1 – – – – – 1 2 — Gastro-enteritis 6 5 3 1 — — 1 2 — — Pneumonia 7 5 6 2 2 1 1 — 1 1 Bronchitis 3 – – – – – – 2 – – Whooping cough 1 1 – – — — 1 — — — Meningococcal Meningitis 2 – – 1 – – – – – – T.B. Meningitis — — 1 — — — — – – — Pneumococcal Meningitis – – – – – – – – – – Septicaemia – – – – – – – 1 1 — Encephalomyelitis 1 – – – – – – – – – Pyelonephritis 1 – – – – – – – – – Asphyxia (unknown cause) – – – – 1 – – – – – Accidental death 2 – – 2 1 3 2 1 1 — Inattention at birth – 1 – – – – – – – – Fractured skull (unknown newborn child) 1 – – – – – – – – – Infanticide 1 1 1 – – – – – – – Other causes – – 6 – – – – – – – 42 26 29 24 20 18 22 14 17 10 Total neo-natal deaths included above 20 15 17 17 13 14 14 8 14 6 11 Summary of Statistics. The following table shows the birth-rates and death-rates for Wimbledon as compared with England and Wales since 1939. Year Live-Birth Rate (per thousand home population) Still-birth Rate (per thousand home population) Death-Rate (per thousand home population) Maternal Mortality Rate (per thousand total (live and still) births) Infantile Mortality Rate (per thousand live births) Wim. E. & W. Wim. E.& W. Wim. E.&W. Wim. E.&W. Wim. E.&W. 1939 10.86 15.0 0.37 0.59 10.53 12.1 1.57 2.82 29.41 50 1940 12.20 14.6 0.42 0.55 13.92* 14.3 1.67 2.16 43.40 55 1941 12.82 14.2 0.29 0.51 11.92* 12.9 — 2 23 41.15 59 1942 15.46 15.8 0.47 0.54 12.44* 11.6 — 2.01 41.95 49 1943 17.69 16.5 0.27 0.51 14.37* 12.1 1.18 2.29 50.17 49 1944 15.62 17.6 0.53 0.50 13.21* 11.6 2.76 1.93 37.14 46 1945 17.01 16.1 0.42 0.46 13.38* 11.4 2.42 1.79 36.20 46 1946 18.90 19.1 0.64 0.53 13.51* 11.5 — 1.43 23.14 43 1947 19.39 20.5 0.42 0.50 13.64* 12.0 0.88 1.17 18.03 41 1948 16.33 17.9 0.26 0.42 11.56* 10.8 1.04 1.02 19.03 34 1949 14.99 16.7 0.39 0.39 10.72 11.7 — 0.98 25.14 32 1950 12.46 15.8 0.24 0.37 10.37 11.6 — 0.86 18.13 29.8 1951 13.26 15.5 0.24 0.36 10.93 12.5 — 0.79 20.41 29.6 1952 11.67 15.3 0.29 0.35 10.63 11.3 — 0.72 13.60 27.6 * From 1940 to 1948 the local death-rate could not be corrected as the publication of an area comparability factor was suspended. Consequently it is not strictly possible to compare the death-rate for Wimbledon with that for England and Wales for those years. SECTION B. — GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. PUBLIC HEALTH ACT, 1936, PART IV. — NURSING HOMES. The Wimbledon Borough Council is responsible for the registration and supervision of nursing homes in the Borough. One home was registered during the year. Two homes were exempted, on an annual basis, from registration under Section 192 of the Public Health Act, 1936. The position at the end of 1952 was as follows:— Number of homes on the register:— Maternity Nil Others 7 Number of beds provided 82 Number of visits of inspection during the year 10 12 NATIONAL ASSISTANCE ACT, 1948. Under Section 47 of this Act, power is given to the Councils of County Boroughs and County Districts to apply to a Court of Summary Jurisdiction for an Order for removal and detention, in a suitable hospital or other place, of persons who (a) are suffering from grave chronic disease, or, being aged, infirm or physically incapacitated, are living in insanitary conditions; and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention. At the beginning of 1952 there were two patients already in County Welfare Establishments as the results of Orders made previously by the local Court under this Section. These Orders were not renewed during the year as both patients were reported to have adjusted themselves well to their surroundings and were prepared to remain voluntarily in the County Welfare Establishments for an indefinite period. It was not found necessary for the Council to make application to the Court for any new Orders during the year. MASS RADIOGRAPHY. The Mass Radiography Unit of the Regional Hospital Board made two visits to the Wimbledon area during 1952, in February and again in November. As in previous years facilities were offered to all persons over the age of 15 years for X-ray examination of the chest. I am indebted to the Secretary of the Mass Radiography Unit for the following details of persons who attended for examination. As the facilities were available to all, the statistics do not necessarily relate to Wimbledon residents only. Number of persons examined: February November Males 1,499 1,435 Females 1,807 1,874 3,306 3,309 A bnormalities discovered: (i) Active pulmonary tuberculosis: Males 3 7 Females 3 4 6 11 (ii) Inactive pulmonary tuberculosis: Males 52 55 Females 62 64 114 119 13 February November (iii) Non-tuberculous conditions: Males 45 47 Females 40 30 85 77 (iv) Awaiting final diagnosis: — 9 CLEAN FOOD ADVISORY COMMITTEE. Five meetings of the Clean Food Advisory Committee were held during 1952. The main subject under consideration was the formation of a Clean Food Guild. It was decided to hold a general meeting, to which all food traders and employees were to be invited, the meeting to be presided over by the Mayor. This meeting was held in October. There appeared to be complete unanimity amongst all food traders regarding the need for the observance of hygiene in the handling of food, and a genuine desire to comply with the Codes of Practice which had been adopted by the Clean Food Advisory Committee in 1951. At the same time, most traders expressed themselves as not in favour of the formation of a Clean Food Guild. The Clean Food Advisory Committee subsequently decided, in view of this lack of support, to postpone further consideration of the matter for a period of six months. HEATING APPLIANCES (FIREGUARDS) ACT 1952. This Act received the Royal Assent on 1st August, 1952, although it does not come into force until a date to be fixed by the Secretary of State. By the Act, the sale or letting of certain heating appliances without an effective fireguard is prohibited. The Wimbledon Borough Council have authorised the Sanitary Inspectors to carry out the duties, imposed by the Act, of inspecting and testing appliances required to be fitted with guards, and inspecting appliances kept on any premises for the purpose of sale or letting. Duties in connexion with the foregoing will start as soon as the Regulations, following the coming into operation of the Act, are received from the Home Office. 14 SECTION C. — SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The Metropolitan Water Board is responsible for the supply of water to the Borough and regular periodical examinations are made by them. With three exceptions all the dwelling houses in Wimbledon are supplied from public water mains direct to the houses. Corporation Swimming Baths— Sampling of water. During the year eight samples of water were taken for bacteriological examination. All samples were reported as being bacteriologically satisfactory. Sanitary Inspection of District. The following is a statement showing the number and nature of inspections made during 1952:— Reason for Visit. No. Infectious Diseases, investigations, etc. 643 Inspections under Housing Act, 1936, Part IV 120 House to House Inspections (Section 91, Public Health Act, 1936):— (a) number of houses inspected 195 (b) number of revisits 148 House Inspections 8,257 Inspections of Factories, Workplaces and Outworkers' premises 369 Inspections of Dairies 36 Inspections of Food, and Food Premises 1,338 Obtaining samples of Food and Drugs 125 Inspections under the Shops Act 1950 275 Inspections under the Petroleum (Regulation) Acts, 1923 and 1936 57 Applications of Tests to Drains 207 Inspections under The Prevention of Damage by Pests Act, 1949 2,714 Smoke Observations 57 Miscellaneous Inspections (including visits to Nursing Homes, Caravans, Piggeries, Stables, Hairdressers' premises and Watercourses) 926 Total 15,467 15 Notices Served. Preliminary notices or intimations 2,155 Statutory Notices 425 Result of Service of Notices. (a) Legal proceedings. As a result of non-compliance with abatement notices legal proceedings were instituted in three cases. In two instances nuisance orders were made, and in the remaining case the summons was withdrawn as the work had been finished. It was agreed that the defendant should pay £1. 5s. 6d. in payment of the Corporation's costs in connection with the proceedings. The costs awarded in the other two cases amounted to £4. 1s. 6d. (b) Work carried out in default. Seven dustbins were supplied by the Corporation in default of the owners or occupiers. The Corporation executed the necessary work to abate a nuisance in one case where a nuisance order had been made by the Court but had not been complied with by the owner. Nuisances abated and defects remedied. The following table gives a summary of the nuisances abated and the sanitary improvements carried out, together with the defects remedied under the supervision of the sanitary inspectors:— Drains, new, provided 6 Drains, altered or repaired 42 Drains, cleared 104 Fresh air inlets, provided or repaired 11 Gullies, new, provided 4 Gullies, curbs, provided or repaired 18 Gutters, renewed or repaired 160 Inspection chambers, new, provided 5 Inspection chambers, altered or repaired 13 Rainwater pipes, new provided 2 Rainwater pipes, repaired or cleared 36 Soil pipes and vents, new provided 5 Soil pipes and vents, repaired 23 Waste pipes, new, provided 1 Waste pipes, repaired, cleared or trapped 36 W.C. accommodation, provided or improved 3 W.C. accommodation, ventilated lobbies provided 6 W.C. accommodation, apartments cleaned or repaired 4 Water-closets, new, provided 26 Water-closets, cleared, cleansed or repaired 47 Flushing cisterns, new, provided 4 Flushing cisterns, repaired or regulated 58 Sinks or lavatory basins provided 8 16 Urinals provided 1 Urinals, cleansed or repaired 1 Accumulations removed 30 Animal nuisances abated 3 Dustbins provided 152 Manure receptacles provided 1 Brickwork, repaired or repointed 70 Dampness remedied 379 Roofs, renewed or repaired 312 Yards, paved 4 Yards, repaired 17 Floors, renewed or repaired 212 Floors, ventilated 7 Fireplaces or ranges, repaired or renewed 122 Rooms, walls and ceilings, cleansed or redecorated 371 Rooms, plasterwork repaired 634 Staircase handrails provided 4 Ventilated food cupboards provided 1 Water pipes, repaired 16 Water supply restored 2 Water storage cisterns, repaired, cleansed or covered 12 Windows, repaired 154 Windows, sills, renewed or repaired 53 Windows, sashcords renewed 179 Factories or Workshops, cleansed 2 Food Rooms, cleansed 21 Smoke nuisances abated 10 Other nuisances abated 438 Rooms disinfected 253 Total 4,083 Work executed by the Borough Surveyor and rechargeable under Section 24 of the Public Health Act, 1936. Twelve sewers vested in the Local Authority by Section 20 of the Public Health Act, 1936, were cleared or repaired. 17 FACTORIES ACT, 1937. PART I. 1. Inspections for Purposes of Provisions as to Health. Premises Number on Register Number of Inspections Written Notices Prosecutions Factories without mechanical power 106 91 5 — Factories with mechanical power 212 230 19 — Other premises under the Act (including works of building and engineering construction but not including outworkers' premises) 4 9 — Totals 322 330 24 — 2. Defects Found. Particulars Number of Defects Prosecutions Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of Cleanliness (S.1) 6 2 — — — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate v e n t i 1 a tion (S.4) 1 1 — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7) Insufficient 3 — 1 Unsuitable or Defective 24 14 — 7 — Not Separate for Sexes 1 1 — 1 — Other Offences (Excluding offences relating to outwork) 4 — 1 — — Totals 39 18 1 9 — 18 PART VIII. OUTWORK — SECTIONS 110 & 111. Nature of work Section 110 Section 111 No. of outworkers in Auggust list required by Sec. 110 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwhole some premises Notices served Prosecutions Wearing Apparel — Making etc. 11 — — — — — Others — — — — — — Total 11 — — — — — Number of addresses received from other Councils 55 Number of addresses forwarded to other Councils 14 Number of premises where outwork was carried on at the end of 1952 95 Inspections of outworkers' premises 49 Outwork in infected premises (Section 153 Public Health Act, 1936) Nil OTHER MATTERS. Failure to affix Abstracts of Act notified to H.M. Inspector of Factories 2 Underground bakehouses in use at the end of the year 2 19 SECTION D. — HOUSING. Housing Act, 1936, (Part IV) — Overcrowding. The following table shows the position in Wimbledon at the end of 1952 with regard to overcrowding. (a) (i) Number of dwellings known to the partment to be overcrowded at the end of the year 60 (ii) Number of families dwelling therein 68 (iii) Number of persons dwelling therein 353 (b) Number of new cases of overcrowding ported during the year 15 (c) (i) Number of cases of overcrowding known to have been relieved during the year 21 (ii) Number of persons concerned in such cases 101 (d) Particulars of any cases in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding — Rehousing. I am indebted to the Housing Manager for the following information regarding rehousing in Wimbledon:— No. of houses requisitioned since the beginning of the war, and still held under requisition at the end of 1952 454 No. of prefabricated bungalows provided since the end of the war 71 No. of families rehoused by the Council, or by private owners at the Council's instigation, since the beginning of the war 1,827 No. of live applications on the housing waitinglist 2,396 New houses erected, etc. I am indebted to the Borough Engineer and Surveyor for the following information:— No. of new houses erected in Wimbledon during 1952:— Private enterprise 14 Local Authority 84 No. of new flats created by conversion during 1952:— Private enterprise 59 Local Authority 2 20 SECTION E. — INSPECTION AND SUPERVISION OF FOOD. Milk. Under the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949 and 1950, and the Milk (Special Designation) (Raw Milk) Regulations 1949 and 1950, the following licences were granted to retailers by the Council:— Pasteurisers' Licences Nil Dealers' Licences— Tuberculin Tested Milk 17 Pasteurised Milk 19 Sterilised Milk 23 Supplementary Licences— Tuberculin Tested Milk 8 Pasteurised Milk 9 Sterilised Milk 7 83 During the year 39 samples of designated milk were sent for bacteriological examination. The results were as follows:— Class of Milk. Satisfactory. Unsatisfactory. Pasteurised 33 — Tuberculin Tested (Pasteurised) 4 — Tuberculin Tested 1 — Sterilised 1 — Four samples of tuberculin tested milk were sent to various Laboratories for animal inoculation. All four samples were found to be negative for tubercle bacilli. Ice Cream. On the 7th July, 1952, the Food Standards (Ice-Cream) (Amendment) Order, 1952, came into operation. This Order modified the standard for ice-cream which was introduced in March, 1951, by reducing the minimum fat content of ice-cream from 5% to 4%, and the minimum non-fat milk solids content from 7½% to 5%. Six samples of ice-cream were sent for analysis during the year and were found to comply with the standards laid down. 21 A further 33 samples of ice-cream were sent for bacteriological examination during the year. The results of these samples were as follows:— Grade 1 19 Grade 2 6 Grade 3 6 Grade 4 2 Total 33 The results of the methylene blue test divide ice-cream into four grades. If ice-cream consistently fails to reach Grades 1 and 2 in the test, this is regarded as indicating a defect of manufacture or handling which calls for further investigation. Repeated visits were made to premises from which unsatisfactory results had been received. Eleven applications for registration were received, and registration was granted in ten cases. The remaining application was refused because of the lack of sufficent supply of hot water within reasonable distance of where the ice-cream was to be sold. In all, 80 visits were paid during 1952 to premises where the manufacture or sale of ice-cream was being carried on. Meat and Other Foods. The following inspections of food premises etc. were made by the Sanitary Inspectors during 1952:— Inspections of dairies 36 Inspections of food premises 699 Inspections of premises where ice-cream is manufactured or sold 80 Visits to obtain samples of food and drugs 105 Visits to obtain samples of designated milk 37 Visits to obtain samples of ice-cream 19 Inspections of other foods 509 No carcases were inspected or condemned during the year. Unsound Food. The following is a list of the unsound food surrendered during the year:— Almonds (ground) 6 lbs. Bacon 21½ lbs. Baking powder 2 lbs. Biscuits 6 lbs. Cereals 26 lbs. Cereals 27 pkts. 22 Cheese, Processed 14 cartons. Coconut 6 lbs. Coffee 4 bottles Confectionery 7 lbs. Dates 26 boxes Eggs 108 Figs 74 boxes Fish 33 stones Fish 88 tins Fish cakes 2 boxes Flour 16 packets Fruit 33 jars Fruit 1,193 tins Fruit squash 24 bottles Ham 29½ lbs. Ham 85 tins Meat 2,825 lbs. Meat 684 tins Milk 253 tins Mint sauce 1 bottle Mussels 1 sack Paste 19 tins Paste 2 jars Peanut butter 2 jars Piccalilli 2 jars Pickle 19 jars Pickled onions 2 jars Preserves 62 jars Preserves 131 tins Prunes 66 lbs. Puddings 18 tins Rabbits 540 lbs. Salad cream 1 bottle Salmon 20 tins Sauce 6 bottles Sausages 42 lbs. Sausages 21 tins Soups and stews 55 tins Sponge mixture 46 packets Sultanas 112 lbs. Tomatoes 42 tins Vegetables 307 tins Vinegar 1 bottle Legal Proceedings. There were three prosecutions under Section 3 of the Food and Drugs Act, 1938, for the sale of pork sausages with a low meat content. In two instances the cases were proved and the defendants were given an absolute discharge. They were each ordered to pay £3. 3s. Od. costs. In the third case, upon application by the defendant, the sausages were analysed by the Government Analyst, and at the adjourned hearing the case was proved. The defendant was given an absolute discharge and ordered to pay £6. 10s. 0d. costs. 23 Sampling of Food and Drugs. During 1952 samples were taken for analysis as under:— Articles Analysed Inferior or Adulterated Formal Informal Total Formal Informal Total Almond flavouring - 1 1 - - — Beetroot and red-currant jelly - 1 1 - - — Bev. coffee - 1 1 - - — Butter 1 — 1 - - — Caraway seeds — 1 1 — — — Celery — 1 1 — — — Celery salt — 1 1 — — — Cocoa — 1 1 — — * Coffee and chicory essence — 6 6 — — — Compound turtle extract — 1 1 — — — Cream of chicken soup — 1 1 — 1 1 Cream of mushroom soup — 1 1 — — — Culinary oil — 1 1 — — — Curry powder — 1 1 — — — Dessicated coconut — 1 1 — — — Epsom salts — 1 1 — 1 1 Glycerine — 1 1 — — — Glycerine, honey and lemon — 1 1 — — — Honey — 3 3 — — — Horseradish cream — 2 2 — — — Horseradish sauce — 1 1 — — — Ice-cream 6 — 6 — — — Lemon juice — 2 2 — — — Maralyn — 1 1 — — — Milk 22 29 51 — — — Mincemeat — 1 1 — — — Mint jelly — 1 1 — — — Olive oil — 1 1 — — — Orange squash — 2 2 — — — Paste bloater — 1 1 — — — Pepper — 1 1 — — — Pepper flavoured compound — 1 1 — — — Pickled walnuts — 1 1 — — — Pineapple sweetened — 1 1 — — — Prepared German mustard — 1 1 — — — Prepared parsley — 1 1 — — — Rennet essence — 1 1 — — — Rice — 1 1 — — — Salad cream — 3 3 — — — Sausages, beef 2 — 2 — — — Sausages, liver — 1 1 — — — Sausages, pork 7 — 7 3 — 3 Self-raising flour — 1 1 — — — Strawberry jam — 1 1 — — — Suet, beef — 2 2 — — — Synthetic cream — 1 1 — — — Tapioca — 2 2 — — — Tea — 1 1 — — — Tomato chutney — 1 1 — — — Tomato ketchup — 1 1 — — — Vegetable salad — 1 1 — — — Vinegar 1 5 6 — — — Whisky 11 — 11 — — — Totals 50 94 144 3 2 5 * Coconut supplied by mistake for Cocoa. 24 SECTION F. — PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Notifications of Infectious Disease. During the year there were 649 cases of infectious disease notified, as compared with 1158 cases during 1951. Poliomyelitis. Two cases of poliomyelitis ocurred during the year, one of them associated with paralysis. Both patients were removed to hospital for treatment. Seven other persons were admitted to hospital as suspected cases of poliomyelitis, but the diagnosis was not sustained. The final diagnosis of these seven cases is given below:— Infective hepatitis 2 Tonsillitis 1 Acute rheumatism 1 Myalgia 1 Physical exhaustion 1 Behaviour problems 1 7 Paratyphoid fever. One case of paratyphoid fever was notified. The family had recently returned from holiday at a seaside resort in Kent. Upon investigation it was found that two other cases of paratyphoid, which had occurred elsewhere, were also associated with this resort. It was therefore considered likely that the patient had contracted the disease there. Salmonella enteritidis. Following the occurrence of a number of cases of infection by salmonella enteritidis in a nearby hospital, 21 patients discharged from this hospital to their homes in Wimbledon were kept under supervision by the Health Department. Dysentery. Thirty-six cases of dysentery were notified during the year. These included a number of children and one teacher from a local infants' school where a mild outbreak of the disease occurred during the early part of the summer. As a result of investigations carried out at this school 29 children were excluded on clinical grounds. Thirteen of 25 these, and one teacher, were subsequently notified as suffering from Sonne dysentery. Three contacts of these children were also found to be suffering from the disease. Diphtheria. Two patients suspected to be suffering from diphtheria were admitted to hospital. One was found on investigation to be suffering from glandular fever, and the other from cervical adenitis. Immunisation against Diphtheria. The authority responsible for immunisation in this area is the Surrey County Council. The following table shows the number of children in Wimbledon under the age of 15 years who have been immunised against diphtheria. Age at 31/12/52 No. immunised Under 1 year 23 1 year 451 2 years 531 3 years 640 4 years 696 Total under 5 years 2,341 5-9 years 3,627 10 - 14 years 2,391 Total 5-14 years 6,018 26 27 Notifiable diseases during 1952. DISEASE Number of Cases Notified in Various Age Groups Total Cases Notified Total Cases removed to Hospital Total Deaths Under 1 1-2 3-4 5-9 10-14 15-24 25-44 45-64 65 and over Scarlet Fever — 10 25 83 4 5 1 — — 128 46 _ Measles 7 54 87 170 4 8 7 — — 337 9 — Whooping Cough 6 28 26 49 — — 3 — — 112 1 — Acute Poliomyelitis (Paralytic) — _ — — — — 1 — — 1 1 — „ „ (Non-paralytic) — — — — — — 1 — — 1 — — Meningococcal Infection — — 1 — — — — — — 1 — — Puerperal Pyrexia — _ — — — 4 1 — — 5 4 — Dysentery 1 1 1 24 2 — 3 4 — 36 1 — Paratyphoid Fever — _ — — — 1 — — — 1 1 — Erysipelas — — — — — — 1 2 — 3 — — Pneumonia (Acute Primary or Influenzal) 2 — — 2 1 1 8 5 5 24 — 34* TOTALS 16 93 140 328 11 19 26 11 5 649 63 34 * All forms. 28 Notifications of Infectious Disease during the last 10 years. DISEASE 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 Diphtheria 20 24 8 7 4 4 6 — — — Dysentery — 89 18 4 2 — 2 7 53 36 Encephalitis Lethargica, acute — — — — — 1 — — — — Enteric Fever (including Paratyphoid) — — — — — 1 — 3 — 1 Erysipelas 11 11 11 12 5 2 7 1 5 3 Food Poisoning — — 1 — — 5 2 — 4 — Malaria — 1 1 7 — — — — 1 — Measles 272 57 586 339 253 481 707 364 758 337 Meningococcal Infection 10 3 6 5 5 3 2 3 2 1 Ophthalmia Neonatorum 6 9 10 8 4 2 2 1 — — Pneumonia 30 25 27 26 32 15 19 20 27 24 Poliomyelitis — 1 4 2 25 4 10 12 4 2 Puerperal Pyrexia 9 6 8 10 3 5 8 1 2 5 Scarlet Fever 186 77 46 37 51 95 55 68 136 128 Whooping-cough 115 117 54 114 157 231 149 181 166 112 659 420 780 571 541 849 969 668 1,158 649 Tuberculosis:— Pulmonary 59 66 76 84 87 87 96 102 93 84 Non-Pulmonary 12 10 16 12 8 6 10 13 6 5 TUBERCULOSIS. During the year 89 cases of tuberculosis were added to the Register as compared with 99 in 1951. Of these, 61 were new cases and 28 were transfers from other areas. An analysis of the notifications received is given overleaf. The following cases were removed from the Register:— Pulmonary Non-Pulmonary. M. F. M. F. Deaths 4 2 — — Recovered cases 3 2 2 — Removals from district 21 17 1 1 28 21 3 1 Towards the end of the year investigations were carried out at a Youth Club in Wimbledon where one of the seniors had developed tuberculosis. With the co-operation of the Mass Radiography Unit of the Regional Hospital Board, arrangements were made for Club members to undergo an x-ray examination of the chest. Of the 109 persons invited to undergo this x-ray examination 63 attended, and in all cases the results were negative. 29 30 TUBERCULOSIS — 1952. AGE GROUPS CASES ADDED TO THE REGISTER DEATHS Primary Notifications (Form A) Cases Discovered otherwise than by Notification Total Cases added to the Register Pulmonary NonPulmonary Pulmonary NonPulmonary Pulmonary NonPulmonary Pulmonary NonPulmonary Males Females Males Females Males Females Males Females Males Females Males Females Males Females Males Females Under 1 Year - - - - - - - - - - - - - - - - 1 — 4 Years 1 2 - - - - - - 1 2 - - - - - - 5—9„ - 2 - - - - - - - 2 - - - - - - 10—14 „ - - - - - - - - - - - - - - - - 15 — 19 „ 1 1 - - - - - - 1 1 - - - - - - 20 — 24 „ 5 2 - - 1 3 - - 6 5 - - - - - - 25 — 29 „ 7 5 - - 5 3 - 1 12 8 2 1 - - - - 30 — 34 „ 7 2 - - 5 3 1 - 12 5 1 - - 1 - - 35 — 44 „ 5 1 - - 2 1 - - 7 2 - - 1 - - - 45 — 54 „ 6 2 - 1 2 - - - 8 2 - 1 1 - - - 55 — 64 „ 3 - - - 1 1 - - 4 1 - - 1 1 - - 65 and Over 4 - - - - 1 - - 4 1 - - 1 - - - 39 17 2 1 16 12 1 1 55 29 3 2 4 1 - - 56 3 28 2 84 5 6 - 59 30 89 6