METROPOLITAN BOROUGH OF WOOLWICH ANNUAL REPORT on the Health of the Metropolitan Borough of Woolwich for the Year 1952 BY T. STANDRING, M.D.. B.S., D.P.H., M.R.C.S., L.R.C.P. Medical Officer of Health TABLE OF CONTENTS page Health Committee 2 Preface 3 Staff 5 General Statistics 6 Vital Statistics 7 Sanitary Administration 14 Housing 26 Health Education 29 Inspection and Supervision of Food 30 Prevalence and Control of Infectious Disease (including Disinfection, Disinfestation and Personal Cleansing) 40 Laboratory Facilities 48 HEALTH COMMITTEE At 31st December, 1952. THE WORSHIPFUL THE MAYOR (Councillor Mrs. N. Cooper, j.p.) Councillor G. E. Offord (Chairman) Councillor T. G. Blann (Vice-Chairman) Aldermen— L. A. Heath S. W. Wood Councillors— W. L. G. Austin Mrs. B. R. M. Middleton Mrs. E. Brooks D. S. Ramsey N. G. Burbridge D. F. Ritchie G. S. Dean L. Walker A. H. Gilder, m.b.e., j.p. D. P. Walsh Mrs. A. E. Maxwell 2 PREFACE To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Woolwich. Mr. Mayor, Ladies and Gentlemen, I have pleasure in submitting the Fifty-second Annual Report on the health and sanitary conditions of the Borough of Woolwich. The Report is prepared along the lines indicated by the Ministry of Health. The health of the community has remained generally good. No serious epidemic has occurred and in no infectious disease does the Woolwich mortality rate exceed the average for the administrative County of London. Details of the mortality and morbidity statistics, together with information on the varied work being carried out by the Health Department, covering an increasingly wide field, may be found in the body of the Report. Woolwich is one of the few Metropolitan Boroughs whose population is increasing at the present time. The Registrar General's estimate of the mid-year home population is 151,800, being 2,000 more than the estimate for the previous year. This is accounted for mainly by the movement of population from outside the Borough to the London County Council's new Avery Hill Estate. The vital statistics for 1952 are, on the whole, favourable. Although there has been a small decline in the number of births, the birth rate remains constant at the same average rate as between the war years. The total number of deaths is 71 fewer than occurred in the previous year. There has been a steady increase in the survival rate of persons over the age of 65 years. Seventy-two per cent. of Woolwich people who died were aged 65 years and over, and 42 per cent. of the total deaths were 75 years of age or more. The corrected death rate was 10 4 per 1,000 of the population (compared with 117 in 1951) and compared with 12 6 for London and 11.3 for England and Wales. Slightly fewer than a half of the total deaths took place in hospitals. Despite a sharp rise in the number of deaths immediately following the London fog early in December, deaths from respiratory diseases were slightly less than in 1951. Cancer and heart diseases continue to be the chief causes of death. Cancer accounted for 317 (or 19 per cent.) of the total deaths, being 29 more than in the previous year. There were no deaths as a result of accidents or diseases associated with pregnancy or puerperal pyrexia. The infant mortality rate, always well under the National and London averages, reached a new low record in 1952 at 21 4, the previous lowest being 24 4 in 1950 and 27.2 in 1947. Now, for every 100 live births only two babies fail to reach the age of one year. There were only 37 stillbirths during the year, giving a stillbirth rate per 1,000 total births of 16.8. The incidence of notifiable infectious diseases, with the one exception of measles, was low. It is now six years since there was a death in the Borough from diphtheria, and there have been no confirmed cases of diphtheria occurring during the last three years. Immunisation against diphtheria is best carried out before the child is 9 months old. During the last war years the Borough Council, who were then entirely responsible for this work, in common with other local authorities carried out an intensive campaign directed against ensuring that the vast majority of children were immunised. Whilst this work has been continued since the end of the war there is evidence that throughout the community there has been a falling off of the number of children being immunised. Although the incidence of this disease has not increased recently, there can be no room for complacency whilst this state of affairs exists, and efforts to persuade more and more parents to use immunisation as an adequate safeguard should now be increased. 3 Measles and whooping cough remain infections of high incidence, but there was only one death from whooping cough during the year, and none from measles. Twenty-eight cases of poliomyelitis, of which 24 were paralytic, occurred during the year, and two of these proved fatal. Poliomyelitis is not a new disease, having existed in various forms for many years. However, only since the end of the war has it reached epidemic proportions. The disease, which as the old name of infantile paralysis implies, was popularly regarded as a disease of childhood, now claims more victims in the older age groups. Each notified case is fully investigated and preventive measures taken. There is no reason to believe that Woolwich has had more than its share of cases of this disease. Whilst much has been written about poliomyelitis, there still remain many questions to be answered. The decline in tuberculosis mortality justifies some optimism. For five months of the year the Department was two short in its staff of Sanitary Inspectors. Nevertheless, the Sanitary Inspectors carried out some 32,000 inspections, including re-inspections, of premises during the year. Some 800 fewer complaints were received during 1952, compared with the previous year. This decrease may be accounted for partly by the fact that most of the war damage re-instatement has now been completed. The receipt of fewer complaints, however, does not necessarily mean that there has been an improvement in the housing conditions. It is hoped that the Sanitary Inspectors will soon be able to carry out routine house-to-house inspections on a larger scale than was possible during 1952, to provide more information on this matter. In these days there are many difficulties to be met with in maintaining properties in a reasonable state of fitness. Many hundreds of houses in the Borough, if not fit for immediate demolition, cannot be said to come up to an adequate housing standard. Despite the most vigorous action by local authorities and others to provide more new houses, many privately owned old houses are rapidly deteriorating, and yet it seems that many of these houses will have to be used for years to come. The only answer to this problem would seem to be for the State to give a lead by increasing rents of privately owned houses subject to the Rent Acts, but at the same time safeguarding the adequate maintenance in the future of houses which are today in a fair state of repair, but which are rapidly becoming unfit. It has been necessary for me to represent more individual unfit houses and unfit underground rooms to the Council for formal demolition or closure, there being no alternative to this course of action in these cases. The only pleasant part of this picture is the fact that the Borough Council have again been to the forefront, having built 286 dwellings during 1952. Private enterprise was responsible for a further 66 new houses, and the County Council erected 39 flats and 2 houses on their Avery Hill Estate and 24 flats at Shooters Hill. The section of the Report dealing with housing gives information on the six clearance areas in the Ropeyard Rails area of the Borough, which were represented for clearance during the year. This is the first post-war scheme of slum clearance, any general scheme of slum clearance having been held up because of the shortage of houses. Woolwich is a Borough in which there are large milk processing plants, an abattoir at which 90,000 animals were slaughtered last year, several bakeries, warehouses and wharves, and a well-known open air market, in addition to the many small shops, restaurants and factory canteens. Consequently, much time is devoted by the Sanitary Inspectors to the supervision of the preparation and handling of food. Many more visits are now being made to food premises; in practice those places where the conditions are known to be good are visited at longer intervals than places where the standard is lower. I am pleased to say that the hygienic standard in public houses has improved. At the instigation of the Department several public houses have now installed a constant hot water supply to the bars. Undoubtedly, the individual proprietor of food premises has much to do with the standards found, but the customer's influence is potentially much greater in this direction. Tf he would much more commonly bring to notice doubtful practices he would soon compel the food trader to be more careful. Fifty or so complaints of adulterated food, mostly relating to bread and milk are received by the Health Department each year, and whilst there are many more genuine attempts by local 4 food tradesmen to raise the standard of food hygiene in their premises, in some a satisfactory standard has still to be attained. New Byelaws have been made, which should help to bring about a further improvement. These Byelaws cover not only shops and cafes, but also the sale of food in the open air. However, food cannot be kept clean by Byelaws alone, and we must continue to instil the habit of cleanliness into the minds of all food handlers. Besides the individual efforts of the Sanitary Inspectors to bring about higher standards of food hygiene, the Council's Health Education Unit is constantly working to make the public more clean-food conscious. More than 5,000 people attended health education sessions in the Borough during the year. Emphasis has this year been placed on the health services provided by the statutory and voluntary bodies for the benefit of the community. Judging by the number of enquiries made at the Town Hall there is reason to think that a good deal of this work is not sufficiently well known. Few members of the public have more than a fragmentary knowledge of the authorities administering particular services. However, the set-up of the health services has been one of the most popular subjects discussed at these sessions. The number of serious accidents occurring in the home is of concern to everyone. This type of accident, whilst not so spectacular as the road accident, is responsible for a great loss of life. It is estimated that over 6,000 people die from accidents in the home each year, compared with about 5,000 deaths on the road. Four-fifths of home accident fatalities occur in people over 65 and in children under five. The Council's Health Education work is being directed more and more towards giving publicity on the precautions to be taken in order to avoid these accidents. In conclusion, I am glad to have this opportunity of expressing my indebtedness to the Chairman and Members of the Health Committee, as well as to the Members of the other Committees of the Council for their active interest in all matters concerned with the work of the Department. I desire also to thank members of the staff for their full co-operation and loyal assistance. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, T. STANDRING. HEALTH DEPARTMENT STAFF Medical Officer of Health— T. Standring, m.d., b.s., d.p.h., m.r.c.s., l.r.c.p. Administrative and Clerical— Chief Administrative Assistant—T. H. Prescott. Senior Clerk—A. Healey. Clerical Assistants— R. E. Sweett R. H. Thomas Mrs. E. C. Cooper Miss M. H. Rentall Miss M. N. Prigmore C. Burgess (resigned 27th April, 1952) G. C. Ryan J. E. Kay D. M. Gibbs (appointed 19th May, 1952) K. E. Doubleday (temporary) (with H.M. Forces) Miss E. E. Phillips B. Ordell (temporary; appointed 21st August, 1952) 5 Sanitary Inspectors— Chief Sanitary Inspector C. J. Couch, F.R.San.I., Cert. San. Insp. Exam. Board; Cert. Royal San. Inst.,; Cert. Meat and Other Foods; Cert. Smoke Insp., R.S.I.; Cert. Advanced Inspectors. R.S.I. Sanitary Inspectors— H. W. Pendrill, Cert. San. Insp. Exam. Board ; Cert. Advanced Inspectors, R.S.I. ; Cert. Meat and Other Foods ; Cert. Smoke Insp., R.S.I. F. A. Andrew, Cert. San. Insp. Exam. Joint Board ; Cert. Meat and Other Foods. H. M. Kersey, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods ; Cert. Smoke Insp., R.S.I. F. J. Hoines, Cert. San Insp. Exam. Joint Board ; Cert. Meat and Other Foods. W. F. R. Wheal, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. W. E. McLelland, Cert. San. Insp. Exam. Joint Board ; Cert. Meat and Other Foods. E. R. Rees, Cert. San. Insp. Exam. Joint Board ; Cert. Meat and Other Foods. Miss M. F. Thomas, G.M., Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods ; State Registered Nurse ; State Certified Midwife ; Health Visitors' Cert. R. A. Leach, Resigned 31st August, 1952. W. F. Troughton, Cert. San. Insp. Exam. Joint Board ; Cert. Meat and Other Foods. R. Lincoln, Cert. San. Insp. Exam. Joint Board ; Cert. Meat and Other Foods. K. S. Cooper, Cert. San. Insp. Exam. Joint Board ; Cert. Meat and Other Foods. K. J. Coppin, Cert. San. Insp. Exam. Joint Board ; Cert. Meat and Other Foods. J. A. Orrell, Cert. San. Insp. Exam. Joint Board ; Cert. Meat and Other Foods. K. A. Bennett, Resigned 31st August, 1952. J. B. O'Connell, Cert. San. Insp. Exam. Joint Board. R. H. Pasterfield, Cert. San. Insp. Exam. Joint Board ; Cert. Meat and Other Foods. D. W. Townsend, Cert. San. Insp. Exam. Joint Board; Cert. Meat and Other Foods. Public Analyst (Part-time)— H. Amphlett Williams, Ph.d. (lond.), a.c.g.f.c., f.r.i.c. GENERAL STATISTICS Area of Borough 8,282 statute acres Number of Houses 39,697 Number of persons per acre 183 Rateable Value £1,233,108 Sum represented by a Penny Rate £5,050 6 VITAL STATISTICS Extracts from the vital statistics for the year, with comparative figures for 1951, are shown below: — Table No. 1. 1952 1951 Population (Home, i.e., including members of H.M. Forces stationed in the district) 151,800 149,800 Live Births—Legitimate 2,104 2,163 Live Births—Illegitimate 95 110 Total Live Births 2,199 2,273 Birth Rate 144 15.1 Stillbirths 37 39 Stillbirths—Rate per 1,000 total births 168 17.1 Total Deaths 1,667 1,838 Death Rate per 1,000 population 109 12.3 Maternal Deaths Nil 1 Death Rate from Puerperal Causes per 1,000 total births Nil .44 Deaths of Infants under one year 47 63 Death Rate of Infants under one year 214 21.7 Deaths from Tuberculosis (all forms) 39 57 Deaths from Cancer (all ages) 317 ' 288 Deaths from acute poliomyelitis 2 Nil Births. The number of live births registered in Woolwich during 1952, was 1,925. After correction for inward and outward transfers, the net number of Woolwich live births was 2,199, being 74 less than in the previous year. Of the total births, 1,132 were boys and 1,067 girls. It is known that 1.848 births took place in public institutions in the Borough, of which 1,296 concerned Woolwich mothers. The birth rate was 14.4, which, when adjusted to allow for the differing age and sex distribution of the population in various parts of the country, gives a birth rate of 14 8 compared with the birth rate for England and Wales of 15.3 and for London of 17.6. There were 37 stillbirths during the year under review. Natural Increase in Population (i.e., Excess of Births over Deaths). In 1952 the natural increase in population was 532. In 1951 it was 435, and in 1950, 500. Deaths. The number of deaths registered in Woolwich was 1,283, and after correction for inward and outward transfers the net number was 1,667, giving a death rate of 10 9 for the Borough, compared with 12 3 the previous year. The adjusted death rate for Woolwich was 10 4, compared with 12.6 for London and 11.3 for England and Wales. Deaths of Woolwich residents in hospitals in the Borough totalled 326, whilst 369 died in other hospitals in the London area and 111 in hospitals outside London. Road Safety. There were eight deaths of Woolwich residents during the year due to motor vehicle accidents. No fatal accidents occurred to a child under five years of age. One of the deaths concerned a child of school age and one a young man. Two of the deaths concerned women over 65 years of age. Assistance was again given to the Council's Road Safety Committee by the showing of sound films on this subject at a number of the film sessions presented by the Health Department. 7 Deaths From Cancer. Of the total number of deaths, 317 (or 19 per cent.) were from Cancer, compared with 288 the previous year. One hundred and sixty-six occurred in men and 151 in women. Almost half the cancer deaths (150) took place in hospitals. Since the end of the last war there has been a noticeable increase in the number of deaths occurring locally from cancer of the lung and bronchus, and the following tables give details of this increase, of the increased number of deaths of men from this disease, and other information on the deaths occurring during the year. Table No. 2. Woolwich Deaths from Cancer (including all other specified Malignant Tumours). Year. Men. Women. Total Deaths. Deaths in Hospitals. 1945 134 133 267 88 1946 123 115 238 143 1947 130 130 260 135 1948 138 141 279 138 1949 172 128 300 159 1950 175 155 330 173 1951 149 139 288 152 1952 166 151 317 150 8 Cancer Deaths—Woolwich, 1952. By Age. Age. Males. Females. Total. 1 5 years — 2 2 6 15 years 2 — 2 16 25 years 1 — 1 26 30 years 1 — 1 31 35 years 1 — 1 36 40 years 4 — 4 41 45 years 4 6 10 46 50 years 9 6 15 51 55 years 17 8 25 56 60 years 18 22 40 61 65 years 29 23 52 66 70 years 24 18 42 71 75 years 22 20 42 76 80 years 22 22 44 Over 80 years 11 21 32 Age Unknown 1 3 4 Total 166 151 317 Table No. 3. Woolwich Deaths from Cancer of the Lung and Bronchus, 1945-1952. Year. Male. Female. Total. Deaths in Hospitals. 1945. Lung 17 3 20 7 Bronchus 4 4 8 4 1946. Lung 10 4 14 9 Bronchus 15 2 17 12 1947. Lung 12 7 19 6 Bronchus 18 1 19 15 1948. Lung 13 1 14 3 Bronchus 20 1 21 14 1949. Lung 15 2 17 8 Bronchus 24 5 29 20 1950. Lung 26 4 30 8 Bronchus 33 8 41 36 1951. Lung 17 5 22 9 Bronchus 40 8 48 29 1952. Lung 22 5 27 9 Bronchus 31 10 41 22 Table No. 4. Cancer Deaths—Woolwich, 1952. Seat of Primary Disease. Male. Female. Total. Deaths in Hospitals. Stomach 27 22 49 26 Bronchus 31 10 41 22 Lung 22 5 27 9 Breast 1 36 37 22 Colon 5 16 21 10 Prostate 20 — 20 11 Pancreas 6 9 15 5 Rectum 16 5 21 10 Uterus — 10 10 3 Liver 3 5 8 3 Caecum 2 4 6 4 Ovary — 3 3 1 Vulva — 1 1 1 Bladder 2 2 4 2 Mediastinum 1 — 1 — Gall Bladder — 2 2 — Larynx 3 2 5 4 Brain 1 2 3 1 Jaw 1 — I 1 Glands of Neck — 1 1 — Tongue 3 1 4 2 Oesophagus 3 4 7 2 Peritoneum — 1 1 — Thyroid Gland — 2 2 2 Others and Unspecified 13 4 17 9 Total 166 151 317 150 Maternal Deaths. There were no maternal deaths during the year. In the previous year there was only one maternal death recorded. Inquests. There were 55 inquests held on Woolwich residents during the year, and 396 post-mortems on Woolwich residents were carried out on behalf of the Coroner. 9 Infant Mortality. The infant death rate for 1952 (21 4) was the lowest on record for the Borough, the previous lowest being 24 4 in 1950 and 27 2 in 1947. The 1952 record figure compares very favourably with the London rate of 23 8 and the rate for England and Wales of 27 6 and that for the large towns in England and Wales of 31-2. Of the total of 47 infant deaths during the year, nine were due to premature birth. The number of deaths occurring in the first month of life was 37. The following table gives details of the infant deaths for 1952: — Table No. 5. Deaths under 1 year—1952. Cause of Death Under 1 week 1—2 weeks 2—3 weeks 3—4 weeks Total under 4 weeks 1 month and under 3 months 3 months and under 6 months 6 months and under 9 months 9 months and under 12 months Total deaths under 1 year Premature Birth 9 — — — 9 — — — — 9 Congenital malformation 6 2 — — 8 1 — — — 9 Broncho pneumonia 3 — — — 3 3 3 1 — 10 Atelectasis 7 — — — 7 — — — — 7 Suffocation 2 — — — 2 — — — — 2 Septicaemia 1 — 1 — 2 — — 1 — 3 Meningitis — 1 — — 1 1 — — — 2 Injury at birth 1 — — — 1 — - — — 1 Other causes 4 — — — 4 — — — — 4 37 47 Table No. 6. Nett Deaths during the Calendar Year 1952. Nett Deaths at the subjoined ages of "residents" whether occurring within or without the district. 1 5 15 25 45 65 75 All Ages. Under 1 year. and under 5 years. and under 15 years. and under 25 years. and under 45 years. and under 65 years. and under 75 years. years and upwards. All causes 1667 47 9 9 10 71 417 424 680 Tuberculosis, respiratory 37 - - - 3 8 12 9 5 Tuberuclosis, other 2 - - - 1 - 1 - - Syphilitic disease 7 - - - - - 2 1 4 Diphtheria - - - - - - - - - Whooping cough 1 - - 1 - - - - - Meningococcal infections 4 1 2 1 - - - - - Acute poliomyelitis 2 - - 1 - - 1 - - Measles - - - - - - - - - Other infective and parasitic diseases 3 - - - - 1 1 1 - Malignant neoplasm, stomach 49 - - - - 3 14 14 18 Malignant neoplasm, lung, bronchus 68 - - - 1 4 38 17 8 Malignant neoplasm, breast 37 - - - - 2 17 10 8 Malignant neoplasm, uterus 10 - - - - - 7 - 3 Other malignant and lymphatic neoplasms 153 - 2 2 - 7 56 43 43 Leukaemia, aleukaemia 7 - 1 - - 1 4 1 - Diabetes 16 - - - 1 - 3 5 7 Vascular lesions of nervous system 202 - - - - 4 42 52 104 Coronary disease angina 203 - - - - 5 60 79 59 Hypertension with heart disease 38 - - - - - 4 13 21 Other heart disease 276 - - - 1 8 23 54 190 Other circulatory disease 67 - - - - 1 12 17 37 Influenza 2 - - - - - 1 1 - Pneumonia 85 6 3 1 - 3 15 15 42 Bronchitis 125 - - - - - 28 40 57 Other diseases of respiratory system 27 - - - - - 7 8 12 Ulcer of stomach and duodenum 22 - - - - - 8 8 6 Gastritis, enteritis and diarrhoea 6 3 - - 1 - - 2 - Nephritis and Nephrosis 11 - - - - 2 6 2 1 Hyperplasia of prostate 10 - - - - - - 2 8 Pregnancy, childbirth, abortion - - - - - - - - - Congenital malformations 14 9 - - - 2 2 1 - Other defined and ill-defined diseases 127 28 - 1 - 9 34 26 29 Motor vehicle accidents 8 - - 1 1 3 1 1 1 All other accidents 33 - 1 1 1 4 o 1 16 Suicide 14 - - - - 3 9 9 1 1 1 Homicide and operations of war 1 - - - - 1 - - - 11 The birth and death rates locally and nationally are compared in the following table:— Table No. 7. Birth Rates, Death Rates and Analysis of Mortality in the year 1952. Rate per 1,000 Population. Annual Death Rate per 1,000 Home Population. Rate per 1,000 Live Births. Live Births. Still Births. AU Causes. Tuberculosis. Acute Poliomyelitis including Polio encephalitis. Smallpox. Whooping Cough. Diphtheria. Influenza. Pneumonia. Typhoid Paratyphoid Fevers. Diarrhoea and Enteritis (under 2 years). Total Deaths under 1 year. England and Wales 15.3 0.35 11.3 0.24 0.01 0.00 0.00 000 0.04 0.47 0.00 1.1 27.6 160 County Boroughs and Great Towns, including London 16.9 043 12.1 0.28 0.01 — 0.00 000 0.04 0.52 0.00 1.3 31.2 160 Smaller Towns (Resident Populations, 25,000 to 50,000 at Census, 1951) 15.5 0.36 11.2 0.22 0.00 - 0.00 0.00 0.04 0.43 0.00 0.5 25.8 London 17.6 0.34 12.6 0.31 0.01 — 0.00 0.00 0.05 0.58 — 0.7 23.8 WOOLWICH 14.8 0.24 10.4 0.25 0..00 — 0.00 — 0.00 0.55 — 0.002 21.4 The chief vital statistics for the Borough since 1922 are given in the following table:— Table No. 8. Year. (1) Population estimated to middle of each Year. (2) Births Nett Deaths belonging to the District. Nett Under 1 Year. At all Ages. Number. (3) Rate. (4) Number. (5) Rate per 1,000 nett Births. (6) Number. (7) Rate. (8) 1922 a 142,350 2,941 21.3 184 63 1,603 11.6 b 138,254 1923 a 143,530 2,867 20.5 123 43 1,387 9.9 b 140,000 1924 a 144,400 2,590 18.5 168 65 1,543 11.0 b 139,980 1925 a 145,440 2,582 18.3 141 55 1,519 10.8 b 140,740 1926 a 146,200 2,463 17.4 107 43 1,450 10.2 b 141,900 1927 a 144,770 2,242 15.9 95 42 1,491 10.6 b 140,770 1928 a 146,600 2,269 16.1 114 50 1,554 11.0 b 141,100 1929 a 146,800 2,312 16.3 144 62 1,780 12.6 b 141,600 1930 a 146,800 2,188 15.5 91 42 1,547 10.9 b 141,600 1931 a 147,400 2,155 15.1 128 59 1,654 11.6 b 142,600 1932 a 146,400 2,054 14.0 123 60 1,635 11.1 1933 a 146,200 1,857 12.7 116 62 1,634 11.2 11.3 1934 a 145,520 2,000 13.7 127 63 1,650 1935 a 146,400 2,053 14.0 91 44 1,500 10.2 1936 a 146,500 2,017 13.8 121 59 1,649 11.2 1937 a 149,400 2,125 14.2 86 40 1,660 11.1 1938 a 150,900 2,057 13.6 102 50 1,576 10.4 1939 a 150,800 2,133 14.1 103 49 1,592 11.1 1940 b 124,340 1,846 14.8 66 36 1,854 14.9 1941 b 103,630 1,459 14.0 65 42 1,627 15.7 1942 b 110,140 2,036 18.5 71 34 1,410 12.8 1943 b 112,700 2,174 19.3 77 35 1,558 13.8 1944 b 110,970 2,037 18.3 83 40 1,611 14.5 1945 b 115,270 2,021 17.5 83 41 1,478 12.8 1946 b 134,420 2,903 21.6 91 31 1,531 11.4 1947 b 140,150 3,193 22.8 87 27.25 1,626 11.6 1948 b 142,800 2,527 17.7 74 29.28 1,573 11.0 1949 b 144,000 2,504 17.4 72 28.75 1,572 10.9 1950 c 149,000 2,172 14.6 53 24.40 1,668 11.2 1951 c 149,800 2,273 15.1 63 27.70 1,838 12.3 1952 c 151,800 2,199 14.4 47 21.40 1,667 10.9 a—Total population b—Civil population, c—Home population. Marriages. There were 1,327 marriages in the Borough during 1952, of which 825 took place in churches. The remaining 502 took place at the Woolwich Register Office. Of the number of marriages which took place in churches in the Borough. Registrars of Marriages attended on 101 occasions. 13 SANITARY ADMINISTRATION Sanitary Inspection of the Area. During the year the Sanitary Inspectors carried out 31,932 inspections, including re-inspections. The nature of these inspections is shown in Table No. 9. As a result of these inspections 1,437 intimation notices and 827 statutory notices were served. Complaints. There was a decrease in the number of complaints received during the year— 1,878 compared with 2,676 in 1951. The necessary action was taken where complaints were made or nuisances discovered. Table No. 9. Inspections. Complaints investigated 1,878 Water sampling and testing 148 Complaints reinspected Outworkers' premises 6,404 Rodent Control 2,669 182 Smoke Observations 53 Houses re overcrowding 347 Theatres and cinemas 11 New houses re water suply 444 Urinals accessible to public 65 Houses re infectious disease 691 Women's lavatories 126 Houses re smallpox contacts 8 Rag and bone dealers 9 Houses re vermin 960 Houses re choked drains 149 Woolwich Borough Council housing applicants re vermin 1,314 Houses, visits with owners, builders, etc. 257 Houses re scabies 27 Houses re slum clearance and redevelopment 172 Houses re Housing Acts 303 House-to-house inspections 384 Drainage inspections 1,287 Houses re Rent Restriction Acts 4 Houses re accommodation for immigrants 3 Aged and Infirm persons 2,334 Common Lodging Houses 26 Houses re verminous premises 138 Tents and Vans 42 Rag Flock premises 19 Factories mechanically powered 206 Pet Animals premises 29 Factories non-mechanically powered 48 Houses re requests for permitted numbers 31 Work places 30 Offensive trades 4 Shops re Shops Act 490 Visits re insect and other pests 70 Food premises 4,070 Houses re disinfection or destruction of articles 72 Itinerant vendors 80 Complaints re food 20 Marshes, ditches, pools, watercourses, static water tanks, etc. 50 Shops re Pharmacy and Poisons 27 National Assistance Act re burial Stables 14 of dead persons 8 Miscellaneous visits 1,588 Non-effectual visits 4,642 Table No. 10. Nuisances Abated. Dirty conditions remedied 1,024 Areas and yards paved or repaired 67 Roofs repaired 725 Gutters, rainwater pipes, etc., Drains cleansed 296 paired or renewed 459 Drains repaired 261 Damp walls and other damp Drains reconstructed 16 ditions remedied 2,033 Combined drains repaired or reconstructed 8 Fireplaces, hearths, etc., repaired or renewed 286 Water closets cleansed and repaired 506 Floors, skirtings and other work repaired or renewed 424 Water closet pans and traps fixed 173 Windows repaired or renewed 756 Water supply defects remedied 145 Ceilings repaired or renewed 443 Dustbins provided 128 Walls repaired or renewed 1,715 Foul accumulations remedied 44 Other dilapidations remedied 184 Sites cleared of refuse 3 Lighting and ventilation defects remedied 29 Nuisances from animals abated 10 14 Water Supply. At the end of the year 1952 there were estimated to be 39,697 houses in the Borough, comprising 30,024 privately-owned houses, 7,752 local authority houses, 1,299 prefabricated dwellings and 622 tenements (i.e., buildings divided into flats), and all these premises receive water direct from the public water mains supplied by the Metropolitan Water Board. The water supply was satisfactory in both quality and quantity, the very few complaints received relating to defective cisterns. No complaints regarding the quality of the water were received. All the eight active wells in the Borough are used for trade purposes. Drainage. Some 581 drainage defects were discovered during the year and the Sanitary Inspectors supervised their repair or reconstruction. 181 combined drains were also cleared. Thirty-four smoke tests were carried out on suspected defective drains, and 17 of these produced a positive result, 11 proved to be negative and the remaining six were in respect of old, disused drains which, when found, were permanently sealed off. Seven combined drains were found to be defective, and after the service of the necessary notices under Section 40 of the Public Health (London) Act, the Borough Engineer's Department carried out the work of reinstatement, the cost being apportioned among the owners responsible. In one instance the work was carried out by a contractor on behalf of all the interested owners. Six private drains were also cleared, and for this work charges totalling £6 15s. Od. were made upon the responsible persons. Building Licences. During the year, 714 applications for building licences were received by the Borough Engineer, compared with 1,444 during 1951. Altogether, 843 licences were issued during the year, covering a total value of £307,530. Provision of Dustbins. Under Section 105 of the Public Health (London) Act, 1936, if any house is found to be without an adequate dustbin the Council may serve a notice on the owner or the occupier requiring the supply of a dustbin at the house. A person aggrieved may appeal to the Magistrate's Court. For many years, except in exceptional circumstances, the Council has regarded the provision of a dustbin as a matter for the owner of the house. However, following decisions in recent court cases, the Health Committee decided in 1951 that in future where an objection was raised by a person receiving a notice under the Byelaws requiring him to provide a dustbin, the circumstances of each case should be reported to the Committee, together with information as to the type of tenancy, the rental, the number of tenants, details of any sub-letting, whether there had been any negligent usage of the previous dustbin, the financial circumstances of the occupier and the owner, and any other relevant information, to enable the Committee to decide whether the notice under the Public Health Act should be served on the owner or on the occupier. During 1952, in thirteen cases owners objected to their providing a dustbin. Each of these cases was carefully considered by the Health Committee, and in ten it was decided that the owner ought properly to be required to provide the new dustbin. Notices were accordingly served under Section 105 of the Public Health (London) Act, 1936, on these persons. No appeals were made against the Council's decisions. There were 16 instances following the service of a notice under the Byelaws requiring the provision of a dustbin, where the owner, although not objecting, nevertheless did not provide the dustbin, and the Health Committee authorised the sending of a cautionary letter to the owners concerned. Dustbins were subsequently provided at each of the premises. 15 Pharmacy and Poisons Act, 1933. This Act places upon Metropolitan Borough Councils the duty of enforcing the provisions of the Act relating to poisons in Part II of the Poisons List. At the end of the year the number of sellers of Part II poisons (other than registered pharmacists) on the list maintained by the Council was 139. This number included ten new registrations during the year. Rent and Mortgage Interest (Restrictions) Acts. During 1952, the Health Committee authorised the issue of certificates in respect of two houses, the houses in question not being in a reasonable state of repair. The Committee also considered two applications for revocation of existing certificates of unfitness and authorised the issue of such certificates on being satisfied that the necessary repairs to put the houses concerned in a reasonable state of fitness had been executed. Factories Act, 1937. Table No. 11. Details of inspections carried out during 1952 are as follows:— Premises. No. on Register. Number of Inspections. Written Notices. Occupiers prosecuted (/) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 41 48 3 - 07) Factories not included in (i) in which Section 7 is enforced by the Local Authority 338 206 17 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 1 2 Total 380 256 20 — Cases in which defects were found and remedied:— Particulars. Number of Cases in which defects were found. Number of cases in which prosecutions were instituted. Referred Found. Remedied. To H.M. Inspector. By H.M. Inspector. Want of cleanliness 2 2 — — Overcrowding — — — — Inadequate ventilation 1 1 — — — Ineffective drainage of floors — — — — — Sanitary Conveniences:— (a) Insufficient 2 2 — 2 — (b) Unsuitable or defective 30 30 — 6 (c) Not separate for sexes 2 2 — — Other offences against the Act (not including offences relating to Outworkers) - - - - - Total 37 37 — 8 — 16 Outworkers. Outworkers within the Borough are visited periodically by the woman Sanitary Inspector. The number of outworkers and the nature of their work in the list prepared in August, 1952, was as follows:— Wearing apparel (making) 92 Household linen, etc. 15 Curtains and furniture hangings 1 Artificial flowers 2 Feather sorting 3 Stuffed toys 2 Lampshades 11 Rats Once again measures for the destruction of rats were continued throughout the year. A total of 1,803 complaints were received, and in addition to the investigation of the premises concerned in the complaints, the systematic inspection under "block control" principle was continued. 12,781 premises were inspected under the block control system. The total number of properties found to be infested by rats or mice or both totalled 1,484, including 154 business and industrial premises. All infestations coming to light are systematically treated and where the cause of the trouble is found to be due to defective drains or other defects in the building the owner is requested to effect the necessary repairs. During the year "Warfarin" was used in addition to the other poisons available for rodent control. As previously reported, this poison is a blood coagulant, which was originally found in spoiled, sweet clover. It is relatively harmless to man and domestic animals in the concentration used and creates no prejudice or bait shyness in rats. It has proved to be a welcome alternative poison. Towards the end of the year a request was received from the Ministry to carry out some experimental treatments using arsenious oxide from one of the approved suppliers. One experiment was conducted at a small factory infested by the common rat. Bread rusk was used for prebaiting and 20 points were selected. "Takes" were recorded at eight points and these were poison baited. There were three complete takes of poison bait and two partial takes. A week later these eight points were baited with sausage rusk and no takes were recorded. The Council continued its practice of carrying out free treatment in respect of infestation of rodents in private dwellings. A charge is made for treatment carried out by the Council at business premises. Once again, with the co-operation of the Borough Engineer's Department, two sewer treatments and one test baiting were undertaken during 1952 and in this way the number of rats in the sewers has been kept under control. In spite of the kill obtained at each treatment there is a build-up between treatments, as survivors will continue to breed. The only limiting factors appear to be the length of time elapsing between treatments and the amount of food available. 17 The following table shows the percentage of takes recorded in the maintenance treatments:— Table No. 12. Maintenance Treatments for Rodent Infestation. Year. Month. Baits taken 1945. January 43 per cent. June 39 „ „ 1946. January 47 „ „ June 43 „ „ December 55 „ „ 1947. June 52 „ „ December 69 „ „ 1948. May 57 „ „ November 62 „ „ 1949. June 64 „ „ December 57 „ „ 1950. June 55 „ „ December 61 „ „ 1951. June 54 „ „ December 52 „ „ 1952. June 60 „ „ December 52 „ „ Rag and Bone Byelaws. During 1952 the Council instituted legal proceedings in two cases for offences against the London County Council Byelaws respecting the business of rag and bone dealer. In one instance a man was seen in Brenley Gardens, Eltham, to exchange toys with small children for bundles of old rags. The other offence took place in Henwick Road, Eltham. Fines totalling £10 5s. Od. were imposed, with costs of £5 5s. Od. Offensive Trades. There are two offensive trades being carried on within the Borough at the present time. During the year, the Council approved an application for the renewal of one tripe boiler licence, this business being carried on at the Plumstead Abattoir and being subject to continuous inspection. The other offensive trade, which has been approved by the Council.is that of slaughterer of poultry. These premises are inspected periodically. Rag Flock. Under provisions contained in the Rag Flock and Other Filling Materials Act, 1951, which is designed to secure the use of clean filling materials in upholstery, etc., the Council is required to register premises where filling materials are used and to licence premises where rag flock is manufactured and stored. Among the Council's duties under this Act, apart from the licensing and registration of premises, is the sampling of rag flock and the inspection of the premises and materials therein, together with the inspection of records kept by the occupiers of these premises to see that records are kept up to date. One application for the renewal of a licence to manufacture rag flock was approved by the Council during the year. There are three registered premises within the Borough, where filling materials to which the Act applies are being used. Satisfactory reports were received from the Prescribed Analyst on three samples of rag flock and one sample of coir fibre submitted for analysis during the year. A sample of woollen felt was found to be slightly below the specified minimum standard for this material, but the Analyst reported that this was regarded as a "quality" rather than a "cleanliness" issue. 18 The Analyst reported that a sample of feathers failed to meet the standard of cleanliness prescribed by Regulations made under the Rag Flock and Other Filling Materials Act, the sample not being objectionable but probably not having been processed satisfactorily, as the result of the analysis indicated incomplete washing or rinsing or both. A cautionary letter was sent to the manufacturers concerned, who withdrew the remaining stocks for re-purification. A further sample of feathers processed by the same firm was later obtained for analysis and the Analyst's report showed that the sample failed to meet the required standard of cleanliness, the total average impurities figure being 2.3 per cent., compared with the permitted maximum of 2 per cent. The result indicated insufficient processing. However, owing to variations in the analysis results between the samples analysed from the same batch of materials and the third portion of the formal sample held by the Council, the matter was taken up with the Prescribed Analyst and with the Analyst acting for the manufacturers, and it was found that one firm of analysts was carrying out a different form of testing technique. In view of this, it was decided not to institute legal proceedings in this case. All the analysts concerned agreed that in future all such tests on samples of feathers would be carried out in a uniform manner. The processing firm were further warned regarding any future sample found to be below the required standard of cleanliness. Mosquitoes. During 1952 the spraying of stagnant ponds, marsh ditches and allotment holders' water butts and wells in the Abbey Wood area was again carried out. Fewer complaints were received of nuisance from mosquitoes. Other Pests. A number of complaints from all parts of the Borough were received of infestations of insects such as cockroaches, crickets, beetles, silver fish, Pharaoh's ants, etc., and advice and treatment were given, where necssary. Charges totalling £41 7s. 4d. were made upon the responsible persons for treatment carried out. In one particularly serious infestation of woodworm, hydrogen cyanide was used to treat all the furniture in the house and the woodwork was sprayed with insecticide. A charge of more than £31 was made for this work. During the latter part of the summer several complaints were received from householders of wasps nesting in their houses or gardens. Wasps often construct their nests in eaves of roofs, behind ventilators in the sub-floor space, beneath concrete paths, and in rockeries in the garden. The destruction of a nest must, of course, be carried out with care, and should preferably be done at dusk after a preliminary survey has been made. The point of the wasps' entry into the nest, which is usually a hole about one inch in diameter, is noted and a sulphur bomb is opened and pushed into the hole. If the nest is in the garden, a shovelful of earth is used to seal the hole. The canister contains a volatile liquid form of sulphur under pressure and when opened and exposed to the air it vaporises and is driven into the nest. The next morning the operators return and, if possible, remove the nest. If the nest is inside the roof space or in some other inaccessible place where a bomb cannot be used, insecticide spray is employed. Besides being less efficient, spraying in inaccessible places is often hazardous to the operators. During the year, 33 wasps' nests were destroyed and removed, and charges amounting to £23 were made upon the occupiers of the premises concerned. Common Lodging Houses. There are two licensed Common Lodging Houses in the Borough and they are licensed annually by the Council, in accordance with the provisions of the Public Health (London) Act, 1936. The premises concerned are situated at 60, Beresford Street and at 102, Woolwich High Street and accommodate 50 and 22 men respectively. The premises are visited regularly from the public health point of view. The Common Lodging House at 60, Beresford Street is included in one of the six areas in the Ropeyard Rails district represented for slum clearance. 19 Licensing of Pet Shops. There are eight pet shops in the Borough, and these are licensed annually by the Council and are visited periodically by the Sanitary Inspectors, to ensure that the requirements of the Pet Animals Act, 1951, and the conditions subject to which licences are issued, are being complied with. Twenty-nine inspections of pet shops were carried out during the year. Some minor amendments in the licences issued to persons to keep a pet shop were made by the Council during the year. Heating Appliances (Fireguards). Legislation to prohibit the sale or letting of certain heating appliances without an effective fireguard was introduced by the Heating Appliances (Fireguards) Act, 1952. Regulations have now been made by the Home Secretary to come into operation on the 1st October, 1953, which require fireguards to be fitted to gas fires, electric fires and oil heaters which are so designed that they are suitable for use in residential premises and which are of such type that without a guard there is a likelihood of injury by burning. The Regulations specify the standards of construction and the fitting for guards and the tests to be employed in ascertaining whether guards comply with these standards. Heating appliances other than imported appliances manufactured before the coming into operation of the Regulations and not fitted with the requisite guard, may be sold or let until 1954. There are exceptions exempting certain classes of sale or letting from the provisions of the Act: for example, sales for export and letting on hire which is incidental to the letting of premises. The Act confers on duly authorised local authority officers powers of inspection and testing in respect of the heating appliances covered by the Regulations, and local authorities are empowered to institute legal proceedings for offences under the Act committed in their area. The Council has authorised the Medical Officer of Health and the Council's Sanitary Inspectors to carry out the duties of duly authorised officers under the Act. Fouling of the Pavement by Dogs. During 1952 the Council instituted proceedings against the owner of a dog for an offence against the Council's Byelaws regarding the fouling of the pavement by dogs. A fine of 5s. was imposed. Legal Proceedings. During 1952 it was found necessary to institute legal proceedings in 21 cases in order to obtain compliance with notices served by the Sanitary Inspectors under the Public Health (London) Act, 1936, and other relevant Acts, Regulations and Byelaws. Of the total summonses, five were withdrawn, the work necessary to comply with the notices being in hand at the time of the hearing, seven summonses were adjourned, and in the remaining cases six Abatement Orders were obtained. Fines totalling £9 and £14 10s. Od. costs were imposed. Public Houses. Two of the Sanitary Inspectors carry out the inspection and supervision of the hygienic conditions in public houses. There were 478 inspections carried out at the 149 licensed premises, and as a result of these inspections 278 defects were found which necessitated the service of 32 informal notices and three formal notices. The defects were subsequently remedied. Relaxation of building licences resulted in structural improvements in 15 cases. Brewers generally are eager to improve washing facilities and sanitary accommodation, and works of this nature have been carried out voluntarily. 20 The Department carries out its own test for free chlorine estimation, and tests for the pH value. 1 set out below details of samples of water taken. Baths. No. of Samples taken. No. of Bacillus Coli. Average pH factor. Average Free Chlorine. Average Temperature. Woolwich 13 0 7.5 1.83 75° Plumstead 19 0 7.54 1.75 75° Eltham 19 0 7.73 1.76 75° Boating and Paddling Pools. 1 reported in 1951 that a series of macroscopical and bacteriological tests of the water in the four boating and paddling pools in the Borough had been carried out. To bring about a satisfactory method of purification of the water, chlorination experiments were carried out during 1952, and it is anticipated that the regular addition of chloride of lime to the water in the pools will control satisfactorily the bacteriological content of the water. Welfare of Aged and Infirm Persons. There are estimated to be over 10,000 old people living in the Borough at present, and it can be assumed that their numbers will continue to increase, and perhaps be almost doubled, in the next 25 years. The Health Department's work relating to old people is concerned mainly with their health and the conditions in which they are living. The Council's woman visitor, who is a Sanitary Inspector and a qualified nurse, is now spending almost the whole of her time on the work of visiting the elderly. Much of this work requires a careful approach. Often where an elderly person is found to be living in insanitary conditions and without proper care and attention it has been possible to persuade the person to enter a home or a hospital, and this has usually been arranged. During the year it was not necessary to apply for a Magistrate's Order for the compulsory removal of a person under Section 47 of the National Assistance Act, 1948. This year the number of visits made by the Council's visitor to the elderly was greater than in the previous year, increasing from 1,620 to 2,334 visits. In this way the Department has been able to exercise fairly regular supervision of the most needy cases coming to its attention. Whilst it is the duty of the general practitioner to arrange admissions to hospital for appropriate cases, it is found by experience that removal to a hospital is often expedited by the Council's liaison with the hospital authority and as a result of our reports on the patient's home circumstances. Close co.operation with all the bodies working for the welfare of the elderly in the Borough is maintained. Woolwich Old People's Welfare Committee. The Woolwich Old People's Welfare Committee, which is a Standing Committee of the Woolwich Council of Social Service, concerns itself with the whole field of welfare work for the local aged. Representatives of various statutory and voluntary organisations in the Borough are members of this Committee. The day.to.day practical voluntary work for old people is carried out through special committees concerned with the meals service, the old people's clubs and the visitors' panel, and through the Personal Service Committee, whose work to a very large extent consists of dealing with the problems of old people. There is also a special committee which is formed with the object of establishing a voluntary Home in the neighbourhood for active old people. 21 Old People's Lunch Clubs. The Old People's Lunch Club at the Central Hall. Plumstead, which was formed in 1943, continues to serve some 80 mid-day meals daily to old age pensioners on six days of the week. The charge to the old people is l0d. per head for a two course meal, and the balance of 8d., to meet the full cost of the meal, is contributed by the London County Council's Welfare Committee. The Eltham Lunch Club, which operates from the Woolwich Labour Party hut in Well Hall Road, was formed at the end of 1951. The Club is open on six days a week and approximately 300 meals are served weekly. Meals are supplied to the Plumstead Lunch Club from the Borough Council's Restaurant at Plumstead Baths, and to the Eltham Club from the County Council's restaurant in Eltham High Street. The Borough Council has made a grant of £1,030 for the year 1952/53 towards the cost of this work. Home Visiting. Schemes for friendly visiting and minor services to old people have been in operation in the Borough for some time. This work is mainly undertaken by the Women's Voluntary Services and the British Red Cross Society and by members of other organisations, including the Rotary Clubs and the Soroptimists. Churches of all denominations are also very active in this work. To help supplement the work of these voluntary organisations, the Old People's Welfare Committee has its own voluntary visiting scheme, which has recently been extended, and there are now 30 visitors, which ensures more regular visiting to the aged. Clothing and bedding for old people can be obtained through the Personal Service Committee of the Woolwich Council of Social Service, and other services rendered include those of obtaining household requirements, the provision of wireless sets, help with transport when required and at Christmas time, and assistance in obtaining medical apparatus. I am indebted to the Woolwich Council of Social Service for the information concerning the work of this body. Other Old People's Welfare Services. The London County Council have chiropody sessions at four of their health centres in the Borough, and although there is no mobile chiropody service, the County Council ambulances take the elderly people to these clinics for treatment. There has been no "Meals on Wheels" service in the Borough during the past few years. The use of two mobile canteens which were at one time operated by the Council of Social Service had to be discontinued for financial reasons. Suggestions are now being made by local voluntary organisations that this service, if possible, be re-started, even on a small scale. The Council's mobile library is available for use by elderly people. A plan has been formulated by the Old People's Welfare Committee for a recreational club for old people which would open daily (probably afternoons and evenings) and would meet the needs of many active old people for "somewhere to go " for companionship and recreation. Concerts are arranged by the Borough Council, in conjunction with voluntary organisations, and voluntary artistes attend at the local Old People's Clubs. In the matter of outings the elderly are well catered for locally; excursions are arranged by several local voluntary bodies, including the local pensions branches and the lunch clubs. Although the Borough Council has no holiday home, the Council of Social Service has often been able to arrange for a small number of elderly persons to go on holiday. It is hoped that these arrangements can be extended in the future. The County Council's Domestic Help service continues to do very valuable work in this field. The Borough Council provides a free slipper bath to pensioners on one day a week at three of its bathing centres, and the number of attendances of pensioners and the unemployed during the twelve months ended March, 1952, was 3,935. 22 Atmospheric Pollution. It is considered that some improvement has been effected during 1952 at the factory premises giving cause for complaint in the previous year. Observations have continued to be made, mainly at some half a dozen factories where the trouble has persisted. However, it was not necessary to serve any formal notices during the year. Numerous complaints of carbon dust emitted from a factory in the Plumstead area have been received in the past three years, and various suggestions made to mitigate this problem have been acted upon by the owner. Several observations were again made by the Council's Smoke Inspectors at this factory. Complaints received during 1952 related also to smoke. Night observations have been carried out at this factory on complaint from nearby residents that the trouble has occurred mainly outside normal working hours; no nuisance was observed and observations continue. Several complaints have again been received from the railway staff at the Abbey Wood Railway Station, of excessive smoke from a nearby factory, and particularly from old furnaces situated near the railway station. The matter was discussed with representatives of the firm, who informed the Council that these old furnaces would not be used again, as new plant had been installed. Smoke Inspectors have carried out further observations, and although at times smoke has been noticed coming from the small furnaces, it has not, in the opinion of the Smoke Inspectors, been of such a nature as to constitute a nuisance. The emission of excessive smoke and grit from a riverside factory was the subject of further complaint during the year. Considerable improvement has, however, been effected at this factory, on the suggestions of the Department. The London Fog. The dense fog which occurred during December 1952 was one of the worst on record, and affected Woolwich in common with other parts of the London area. At the time of the fog there was a low ground temperature and little air movement, and the sulphur dioxide content of the air was very much increased. There was a sharp rise in the number of deaths due to influenza, pneumonia and other respiratory diseases. The National Smoke Abatement Society has stated that only on four occasions during the past one hundred years have the number of weekly deaths in the County of London exceeded those in the week following the fog. During the four weeks in question the deaths were due to cholera, fog and influenza (two weeks). Deaths occurring locally during the fog period and immediately following were spread over the whole of the Borough, although there was some concentration in the Plumstead area, in an area bounded by Plumstead Common Road, Herbert Road. Plumstead High Street and Wickham Lane. The following table gives details of the total deaths registered in the Great Towns of England and Wales, in the administrative County of London, and in Woolwich during the period of the London fog, with comparative figures for 1951. Table No. 13. Total Deaths—All causes. Week ending Great Towns London Administrative County. Woolwich 1952 1952 1951 1952 1951 1952 1951 1st Nov 5,027 5,180 714 850 30 30 8th Nov 4,803 4,881 693 762 27 44 15th Nov 4,975 4,674 747 753 32 29 22nd Nov 5,302 4,530 753 680 35 34 29th Nov 6,042 4,638 853 687 26 28 6th Dec 6,647 4,591 945 720 29 27 13th Dec 9,452 5,117 2,484 855 55 26 20th Dec 7,701 5,685 1,523 951 65 41 27th Dec. 6,472 5,033 1,029 816 45 37 3rd Jan. 1953 7,842 6,190 1,372 909 42 34 Information on the nature of the local deaths has been forwarded to the Department of Scientific and Industrial Research. 23 Measurement and Recording of Atmospheric Pollution. At the end of the year the Council decided to set up five stations in various parts of the Borough, for the measurement and recording of atmospheric pollution. Each station will consist of a deposit gauge and a lead peroxide instrument. The deposit gauge collects the grit, ash and finer particles of matter which are deposited over the area, and the lead peroxide instrument measures the activity of sulphurous gases (gases which penetrate the masonry of buildings) on a specially prepared cylinder. Monthly readings are to be taken and the information made available to the Department of Scientific and Industrial Research. The Council considered that the setting up of these stations would be of assistance to the Health Department in dealing with complaints of atmospheric pollution and would arouse interest generally in this work. Suitable sites for the stations from the point of view of accessibility and proximity to sources of pollution have been selected in the following parts of the Borough:— Warspite Road (Dockyard Area) Municipal Offices (Central Woolwich) Abbey Wood Bus Garage Shooters Hill Golf Club Eltham High Street area National Smoke Abatement Society. During the year the Council decided to become an Associate Member of the National Smoke Abatement Society. This membership is in addition to the Council's representation on the London and Home Counties Smoke Abatement Advisory Council. At the Annual Conference of the National Smoke Abatement Society the Conference passed a resolution that " this Conference welcomes, among other proposals that will promote smoke prevention, the recommendation of the Ridley Committee for the setting up of further smokeless zones and the increased production of solid smokeless fuel. Accordingly, and in view of new evidence that the dangers to health from domestic smoke may be greater than have previously been recognised, the Conference urges the Minister of Housing and Local Government to grant permission for the establishment of proposed smokeless zones; urges the Minister of Fuel and Power to do everything possible to develop the availability of smokeless solid fuel of all kinds for domestic purposes; and invites all Local Authorities to support these requests. The Council's attention was also drawn to a further resolution adopted at the Conference that "all persons who have charge of the operaton or maintenance of power plant, whether steam, oil, gas or electrical, should possess sufficient theoretical knowledge and practical experience eventually to be recognised by the holding of a certificate, to ensure that such plant shall be worked with maximum efficiency and safety." Burial or Cremation of the Dead. In accordance with the provisions of Section 50 of the National Assistance Act, 1948, the Borough Council is required to make arrangements for the burial or cremation of the body of any person who has died or been found dead in their area, where it appears to the Council that no other suitable arrangements have been made or are being made for this purpose. Expenses incurred in such burial may be recovered from the estate of the deceased person or from "a liable relative." Responsibility for the interment or cremation of the majority of persons who die in hospitals in the Borough is now that of the local Hospital Management Committee. During 1952, arrangements were made by the Council for the burial of ten persons. 24 The total expenses in respect of cases dealt with during 1952 amounted to £114 17s. 7d., of which £38 5s. Id. was recovered. Mortuary Facilities. Woolwich has its own public mortuary at Sunbury Street, which has been little used of late owing to the centralisation in London of Coroner's Courts. Coroner's post-mortem cases are sent to the public mortuaries at either Deptford or Lewisham. Cemeteries. Three cemeteries are owned by the Borough Council and administered by the Town Clerk's Department. The following table gives details of interments during the last three years at these cemeteries: Table No. 14. Cemetery. Number of Interments. 1950 1951 1952 Woolwich 416 503 410 Plumstead 600 641 513 Eltham 348 386 337 Street Cleansing. Each main thoroughfare is cleansed daily, secondary roads twice weekly and district roads once weekly. There are 86 road sweepers employed on the work and, in addition, a mechanical sweeper and sprinkler is used to sweep the roads in the shopping areas adjacent to Powis Street, Plumstead High Street, and Eltham High Street. House and Trade Refuse. During the year under review 44,179 tons of refuse were collected by the Council's vehicles and 53,592 tons disposed of at the Council's Refuse Destructor. The difference between the two weights is largely the quantity of refuse delivered to the Destructor from the Royal Arsenal and Army Barracks. Material salvaged weighed 1,687 tons and was sold for £10,289. In addition, 2,861 tons of kitchen waste were collected within the Borough and, with the kitchen waste collected by neighbouring Authorities, was processed into pig food at the Council's Plant at White Hart Road. A system of house-to-house collection of kitchen waste has been instituted in an area approximately equal to one sixth of the Borough and an extension of the system to a further area is to be made. Attractive aluminium containers are issued to householders and result in the removal of communal bins from the streets and in the obtaining of an increased quantity and an improved quality of kitchen waste. Public Conveniences. Fourteen conveniences for men and a similar number for women are maintained throughout the area, hours of opening and closing varying with local requirements. In the town centre, for example, the conveniences are open from 5.30 a.m. Normally, however, this service is available between the hours of 6.30 a.m. and 11 p.m. These were inspected regularly throughout the year. In all the conveniences water closets are now free. The information regarding Street Cleansing, Refuse Disposal and Public Conveniences has been kindly supplied by the Borough Engineer. 25 Public Baths and Wash-houses. The Council has four bathing establishments in the Borough. A full description of this service, which includes swimming baths, slipper baths, Turkish baths and massage, wash-houses and the use of the premises for social and sporting activities during the winter months, was included in my Annual Report for 1949. The Baths Superintendent has informed me that, during the twelve months ended 31st March, 1952, there was an increase of 36,283 compared with the previous year in the total number of attendances. Attendances during that period were as follows:— Swimming 365,394 Slipper Baths 154,673 Turkish baths and massage 16,112 Public wash-houses 13,007 Free baths to old age pensioners and unemployed 3,935 HOUSING In December, 1952, there were estimated to be 39,697 houses in the Borough. The number inspected for housing defects under the Public Health or Housing Acts was 9,046, compared with 11,238 in 1951. The number found not to be in all respects reasonably fit for habitation was 1,501. Some 947 houses were rendered fit in consequence of informal action by the Sanitary Inspectors, including the service of intimation notices. House-to-house inspections were carried out under the Housing (Consolidated) Regulations, 1925, 384 dwelling houses being inspected under these Regulations in 1952. Overcrowding. Upon application being made by either landlord or occupier, the Council is under an obligation to give in writing the permitted number of persons in respect of any dwelling house, and measurements of dwellings were taken on 475 occasions compared with 718 in 1951. In all, a total of 99 families were found to be living in overcrowded conditions, and overcrowding reports were made to the London County Council on behalf of these persons. In 42 cases the London County Council provided other accommodation. A further 206 families were visited following a complaint of overcrowding or at the request of the London County Council, and reports were sent to the Council's Housing Department and to the London County Council, setting out details of the housing applicant's present accommodation. Individual Unfit Houses. Eleven houses were represented during the year as being unfit for human habitation and incapable of being made fit at reasonable expense, and formal notices were served on the owners under the provisions of the Housing Acts. After consideration of each case, Demolition Orders were made by the Council in respect of nine of these houses, and undertakings not to use the premises for human habitation, accepted in respect of the remaining two houses. Details of the houses dealt with are as follows:— 24, Kingsman Street Demolition Order dated 21st May, 1952. 1, Railway Court Demolition Order dated 21st May, 1952. 2, Railway Court Demolition Order dated 21st May, 1952. 32, Ropeyard Rails Demolition Order dated 27th June, 1952. 33, Ropeyard Rails Demolition Order dated 27th June, 1952. 2, Hull Place Demolition Order dated 29th June, 1952. 3, Hull Place Demolition Order dated 29th Dec., 1952. 5, Hull Place Demolition Order dated 29th Dec., 1952. 6, Hull Place Demolition Order dated 29th Dec., 1952. la, Kempt Street Undertaking dated 20th Nov., 1952, accepted. 149, Kingsman Street Undertaking dated 30th Dec., 1952, accepted. 26 During the year the Council made Closing Orders in respect of unfit rooms at a further fourteen premises and accepted an undertaking from the owner of another house that one of the basement rooms would not be used for human habitation. One Closing Order was subsequently determined on the satisfactory completion of works necessary to render the rooms fit for habitation. The following are the details of the rooms closed by the Council during the year:— 8, Nightingale Place losing Order on the underground rooms made 24th March, 1952. Determination of Closing Order on 22nd July, 1952. 225, Plumstead High St. Basement back and back addition rooms.— Closing Order dated 19th March, 1952. 27, Waverley Road Basement front room.—Closing Order dated 19th March, 1952. 1, Borgard Road Whole basement.—Closing Order dated 20th February, 1952. 13, Brookhill Road Undertaking given by owner not to use basement back room for human habitation. Specified works to other parts of basement carried out by owner. 4, Coupland Terrace Basement front and back rooms.—Closing Order dated 17th April, 1952. 18, Heverham Road Basement front and back rooms.—Closing Order dated 21st May, 1952. 11a, Woolwich Common Basement front and back rooms.—Closing Order dated 21st May, 1952. 49, Nightingale Vale Basement front room.—Closing Order dated 19th June, 1952. 12, Fennell Street Basement front room.—Closing Order dated 25th June, 1952. Undertaking to erect a substantial partition between the basement front and back rooms given by the owner. 4, Fennell Street Basement front and back rooms.—Closing Order dated 19th June, 1952. 12, Brookhill Road Basement front and back rooms.—Closing Order dated 19th June, 1952. 72, Eltham Hill Basement front east and west rooms and back west room.—Closing Order dated 29th December, 1952. 126, Ancona Road Basement back room.—Closing Order dated 27th October, 1952. 25, Cantwell Road Basement back room.—Closing Order dated •27th October, 1952. Formal action under the Housing Acts was also being taken at the end of the year in respect of a further four individual unfit houses and in respect of underground rooms at three other houses. Areas for Clearance On the 1st October, 1952, the Council dealt with the Ropeyard Rails area, situate between Warren Lane and Woolwich High Street, on the basis that part of the site would be used for the provision of a temporary Car Park and the remaining land, as may be appropriate, for a proposed relocation area for light industrial and commercial business likely to be displaced from the St. Mary's Redevelopment Area, or for such other purpose as may be determined. 27 In accordance with the Council's decision to assume responsibility for the slum clearance of the various occupied and unoccupied houses remaining in the area, the Health Committee considered representations made by me under Part III of the Housing Act, 1936, in respect of 33 properties, as follows:— Area No. Properties 1. Nos. 4, 5, 6, 7, 8 and 9, Warren Lane and Nos. 22, 23, 24, 25, 26 and 27, Ropeyard Rails. 2. Nos. 74, 75, 76 and 77, Woolwich High Street. 3. Nos. 1, 2, 3, 4 and 5, Ropeyard Rails. 4. Nos. 75, 76, 77 and 78, Beresford Street. 5. Nos. 52, 53 and 54, Beresford Street. 6. Nos. 60, 61, 62, 62a and 62b, Beresford Street. This area is generally the worst housing area in the Borough, most of it being represented in 1939 by the County Council and the work of clearance having been abandoned owing to the outbreak of war. A number of properties in the Ropeyard Rails area had been previously represented to the Health Committee and had been the subject of Demolition Orders, and a certain number had already been cleared under war damage. The County Council has agreed to the Council's proposal that the proposed Clearance Areas should be dealt with by the Borough Council. The County Council has stated that they are prepared to assist in the rehousing of the occupants of the existing houses, upon the understanding that any accommodation granted should be regarded as a loan which the Borough Council would repay by an exchange of nominations at a later date. The Council approved my representations of these six Clearance Areas and decided to proceed with the clearance of these areas by the compulsory purchase of these lands, and of certain surrounding land so far as may be necessary. Housing Progress The number of new houses built in the Borough during 1952 is summarised as follows:— By Woolwich Borough Council 286 By private enterprise 66 In addition, 39 flats and two houses were erected by the London County Council on their Avery Hill Estate, and 24 flats at Campbell House, Shooters Hill. Apart from the erection of houses and flats by the County Council, at the end of the year schemes were in hand for the erection of a further 220 dwellings by the Borough Council. Number of applications on Register at 1st January, 1952 5,485 Number of applications received during year 1,465 6,950 Number of applicants rehoused during year:— (1) By Borough Council 356 (2) By nomination to L.C.C. 8 (3) Direct by L.C.C. 115 479 6,471 Number of applications cancelled or withdrawn (applicants moved, found own accommodation, etc.) ... 1,356 Number of applicants on " live " Register at 31st Dec., 1952 ... 5,115 28 Properties under the Council's control:— 1951 1952 At 31st December, tenancies totalled:- In pre-war houses 4,317 4,317 In rebuilt houses 147 147 In new post-war houses 1,548 1,834 In temporary dwellings 986 986 In S.D.A.A. properties in possession 35 35 In requisitioned properties 1,043 1,014 In other properties 71 182 8,147 8,515 The weekly rent roll at the end of 1952 was £8,472 13s. 9d., compared with £8,289 8s. 4d. at the end of 1951. I am indebted to the Director of Housing for the above information concerning the Borough Council's housing progress. HEALTH EDUCATION Informal Talks and Film Shows Special attention has again been paid to the important subject of clean food and hygienic food handling, not only to ensure that the precautions taken to see that when food arrives at the consumer it is in good hygienic condition, but also that the consumer does not expose himself to danger from food poisoning by slovenly habits. During the year the Council's work relating to health education was stepped up considerably and there was again a large increase in the number of requests for visits from the Department's film unit. During the summer months, owing to the difficulty of blacking out halls, and a fall off in demand for this service during the better weather, the opportunity was taken to circulate a large number of organisations having meeting places within the Borough to arrange for visits by the unit during the winter months commencing from October and continuing until the following April. During 1952, the Council's film unit visited several Youth Clubs, and films dealing with health education have been shown along with films on recreation and travel to give added interest to the programmes. It has now become easier to obtain suitable films since the hiring charges have been imposed by the Central Film Library. Every opportunity is taken to use suitable films concerned with health education which have been made by various organisations, including large food firms, and these are usually loaned free of charge. In all cases where a Youth Club has been visited further programmes have been requested. At the time of the Civic Exhibition in October, 1951, it was felt that some permanent record of the occasion should be made, and the Council authorised the making of a 16 mm. colour film. This is a silent film, but by playing a commentary on a tape recorder to synchronise with the projection of the film, the effect of a sound film is achieved. The various departments of the Council chose a particular aspect of their work to be illustrated in the film. One aspect of the work of the Health Department used in the film illustrates a Sampling Officer sampling milk from a roundsman and the subsequent report on the sample by the Public Analyst. All the scenes depicted in the film were recorded within the Borough. The film has been shown on a number of occasions during the last winter season, and has aroused wide interest. Once again, as in the past three years, a number of informal talks were given by members of the staff of the Health Department, and in most cases the subject matter was illustrated by the showing of a film on the same subject. 29 It is interesting to observe that there seems to be a tendency for organisations to request an informal talk on a particular subject which has been illustrated by films at a previous meeting. For example, a number of women's meetings have requested a film on the sampling of milk after seeing the short sequence in the Borough Council's film mentioned above. There is no doubt that women's organisations in particular are interested in the work being carried out by their local Health Department. The number of Health Education sessions (94 film shows and 12 informal talks) given during 1952 was almost double that in the previous year, and there is every indication that the interest being shown by local organisations will bring about a further increase in the amount of this work. Subjects dealt with during the year covered the following:— The local health services. Clean food. Housing. The spread of disease. Tuberculosis. Pest Control. Health and Hygiene. Local Government Services. Home Accident prevention. Road Accident prevention. Clean milk and water supply. Slides, Film Strips and Photographs With a view to augmenting the cinema films dealing with health education matters being shown to local organisations, and in order to illustrate more adequately the work of the Health Department, the Health Committee decided during the year that a series of film strips, slides and photographs should be produced dealing with the work of the Borough Council and that of other public bodies in relation to public health and hygiene. Photographs obtained locally of the various public services in operation are being produced. It is hoped in this way to stimulate further interest in the work of the Local Authority. During the year the Council decided to purchase a 35 mm. camera for use in connection with this work. The slides and film strips will be shown on the Department's epidiascope. Leaflets and Posters As in previous years, 500 copies of the booklet "Better Health" were distributed monthly from the Council's libraries and other public buildings. The Council's two large poster sites were used to display posters obtained from the Central Council for Health Education. The Council have again made an annual contribution of £20 towards the funds of the Central Council for Health Education. Portable Exhibition Stand During the year the Council obtained from the Central Council for Health Education a portable exhibition stand to be used for the display of posters and leaflets on various health subjects. The first of these displays dealt with diphtheria immunisation. INSPECTION AND SUPERVISION OF FOOD Premises where Food is Prepared or Offered for Sale The total number of inspections of all food premises during the year amounted to 4,070. In addition to canteens, there are some 236 restaurants and eating houses in the Borough. The number of premises registered for the preparation or manufacture of sausages and potted, pressed, pickled or preserved food at the end of the year was 169. The following is a summary of the food premises in the Borough at the end of 1952, with the number of inspections carried out in the year. 30 Table No. 15 Description. Number in Borough on 31st December, 1952. Number of Inspections. Dairies 5 25 Distributors of Milk 122 242 Ice Cream Premises 257 855 Premises where Food is Prepared, other than above 169 1,084 Restaurants and Eating Houses 236 1,015 Markets 2 Daily Bakehouses 29 52 Itinerant Vendors — 80 Milk Supply Within the area of the Borough there are five dairy premises and 96 registered distributors of milk. The Council has also approved the registration of a further 26 distributors of milk who sell in the Borough from premises outside. One hundred and fifty-six Dealer's licences and 68 Supplementary licences have teen issued under the provisions of the Milk (Special Designation) Regulations, 1949, authorising the use of the Special Designations Tuberculin Tested, Pasteurised and Sterilised. All of the 214 samples of milk submitted to the Public Analyst for chemical analysis contained three percent, or more of fat. Actual figures were:— No. of Samples. 4 5 per cent, and over 1 4 per cent, and under 4.5 per cent. 3 3 5 per cent, and under 4 per cent. 118 3 per cent, and under 3.5 per cent. 92 Below 3 per cent. 0 During the year, 286 samples of pasteurised and tuberculin tested pasteurised milk were submitted to the methylene blue test for the keeping quality of milk, and all samples were reported to be satisfactory. A further 286 samples of pasteurised and tuberculin tested pasteurised milk submitted to the phosphatase test for adequate pasteurisation were all reported as satisfactory. Twenty-three samples of sterilised and tuberculin tested sterilised milk were submitted for the turbidity test and satisfactory reports were received in each case. The methylene blue, phosphatase and turbidity tests are prescribed tests under the Milk (Special Designation) Regulations, 1949. In accordance with the practice carried out for many years in Woolwich, samples of milk were obtained from milk roundsmen in the early hours of the morning during deliveries to schools, hospitals and institutions in the Borough. Fifty-one such samples were obtained and of these five were submitted for chemical examination, 23 for the phosphatase test and 23 for the methylene blue test. During the routine visits to milk distributors, 11 defects to their premises were found and remedied, and five informal notices were served upon the responsible persons. 31 Catering Establishments A great deal of satisfactory work was accomplished during the year for the improvement of conditions prevailing in restaurants, cafes and canteens in the Borough, and this has resulted in a higher standard of cleanliness and hygiene. A total of 1,015 inspections of restaurants and cafes, and 299 inspections of factory and school canteens were made. Essential work to kitchen and food storage rooms was carried out at 170 establishments. Over 560 defects were remedied during the year. Instantaneous water heaters to washing-up sinks were installed in 32 establishments and suitable washing facilities for food handlers were provided in 16 establishments. The occupiers of most of the catering establishments were co-operative and willing to improve the facilities and condition of the premises. Notices were served only when it was found that there was a lack of co-operation. Ninety such notices were served during the year requiring certain work to be carried out and in only 17 instances was it necessary to serve a formal notice under the Food and Drugs Act, 1938, to gain compliance with the Sanitary Inspector's request. In no case was it found necessary to institute legal proceedings. Details of applications for new catering licences are forwarded to the Department by the Ministry of Food in order that the premises may be inspected by officers of the Council to ensure that they comply with the Council's requirements before the issue of food licences. The proprietors of a number of these food establishments were required by notice to carry out essential work to their kitchens and food storage rooms in order to bring them up to the required standard. Dogs in Food Shops, Restaurants, etc. During the year, some 300 notices over the name of the Medical Officer of Health were issued for display in food premises in the Borough, requesting that, in the interests of food hygiene, customers should not take their dogs into premises where food is sold. The majority of these notices were given to grocery and provision stores and to butchers' shops. During their routine calls, the Sanitary Inspectors checked to see that these notices were being displayed. Several food traders reported that the public had responded extremely well to this request. Food Complaints—Foreign Bodies in Food Forty-four complaints relating to alleged unsound food were received and investigated by the Food Inspectors during 1952. Seven of the complaints related to bottles of milk alleged to contain added water or to contain milk of unsatisfactory quality. All these articles of food were found to be genuine. An object thought to be dirt in a milk bottle proved to be "soft glass" and there was no contamination. A bottle of sour milk was replaced by the retailer. Another complaint of dirt in a milk bottle was substantiated and the Council decided to institute legal proceedings against the retailer, who was subsequently fined £2. Seven complaints concerned dirty bread alleged to contain the following foreign matter : a beetle; a fly; string; dirt; mould, and wood (two cases). Improvements at the bakery in question were carried out in a number of these cases, on the suggestion of the Food Inspectors. The "string" in bread was found to be dough. The Food Inspector investigating the complaint of a fly in bread could find no evidence of contamination. Investigations into three of the complaints relating to unsound bread failed to produce sufficient evidence for a prosecution. Other complaints of unsound food received during the year concerned the following articles: needle in cocoa; glass in cake; glass in cordial; mould on cheese; fly in meat pasty; ants on cake; unsound bacon; unsound butter; unsound sausage roll; stale sausage rolls; maggots in bacon, in nuts and in currants; unsound meat; worm in pork brawn; unsound sweets; a nail in Christmas pudding. Eight of the 32 above-mentioned articles of food were found by the Food Inspectors to be genuine. In the other cases, those responsible for the preparation of the unsound food were warned, where necessary, there being insufficient evidence to support a prosecution, and suggestions for improvements in the preparation and handling of the food concerned were made. The Public Health Laboratory Service at the Park Hospital, Hither Green, carried out laboratory examinations of samples of unsound food. Byelaws for the Protection of Food During the year, the London County Council made revised Byelaws under Section 15 of the Food and Drugs Act, 1938, for securing the observance of sanitary and cleanly conditions and practices in connection with the handling, wrapping and delivery of food sold or intended for sale, for human consumption. The Byelaws were confirmed by the Minister of Food in October, 1952, and came into force on the 3rd November. They repealed the Byelaws made by the County Council under Section 6 of the London County Council (General Powers) Act, 1932. The new Byelaws strengthen the law by being more specific, particularly on the following points:— (a) No person suffering from any disease shall handle, wrap or deliver food so as to give rise to the risk of the spread of disease; (b) All food shall be protected from dirt, dust, insects and other forms of contamination, both in handling and transport; (c) No food shall be wrapped so as to be in contact with newsprint, including periodicals, magazines, etc.; (d) All reasonable precautions shall be taken where food is displayed for sale, both indoors and in the open air, to ensure that food is displayed on clean counters, trays, fittings, etc. Ice Cream There were 257 registered ice cream premises in the Borough at the end of the year, of which 15 were used for the manufacture of ice cream. Most of the dealers sell only prepacked ice cream. Periodic visits are made to all premises and inspection of all new premises is carried out before registration is approved to ensure that they are satisfactory and that the requirements relating to heat treatment are fully understood. Defects at 37 premises were found and remedied during 1952. During the year, 83 samples of ice cream were submitted for grading by the methylene blue test, and the results were as follows:— Grade I 58 Grade II 23 Grade III 2 Grade IV — In addition, three samples were submitted for chemical analysis and fat content, and the results were as follows:— 10—15 per cent. fat 1 5—10 per cent. fat 2 Under 5 per cent. fat — Meat Inspection Slaughtering has continued on a large scale at the Plumstead Abattoir. A total of 90,002 carcases were examined during the year, this number approaching twice the number of the previous year. Even after allowing for the fact that two pigs can be inspected in the time needed for the examination of one cow or heifer, this represents a considerable increase in the work of inspection carried out at the abattoir. All the carcases were inspected immediately after slaughter, examinations being conducted in accordance with Ministry of Food Memorandum 3/Meat. 33 The following table gives details of the number of animals slaughtered and inspected during the last twenty years at the Rochdale Road Abattoir, Abbey Wood, from 1932 to 1937 and, after 1937, at the Garland Road Abattoir, Plumstead. Table No. 16. Meat Inspection: Comparative Table Year. Cattle (including Cows). Cows. Calves. Sheep and Lambs. Pigs. Total. 1932 2,304 — 426 18,986 14,597 36,313 1933 2,386 — 213 21,128 14,072 37,799 1934 2,595 — 105 19,146 14,903 36,749 1935 3,145 — 672 18,939 15,607 38,363 1936 3,331 — 767 19,112 16,503 39,713 1937 3,244 — 604 15,069 15,466 34,383 1938 3,015 — 307 22,481 16,901 42,704 1939 4,922 — 70 25,099 19,253 49,344 1940 2,018 — — 44,001 43,490 89,509 1941 253 — — 41,986 18,745 60,984 1942 Abattoir closed. 1943 1944 1945 1946 1947 8,576 — 1,215 16,010 217 26,018 1948 (excluding Cows) 10,639 3,678 3,257 17,985 256 35,815 1949 10,164 3,933 2,563 27,352 1,971 45,983 1950 12,638 4,453 3,103 27,359 2,392 49,945 1951 19,024 2,973 1,901 19,200 15,612 58,710 1952 12,471 1,413 2,410 22,680 51,028 90,002 Changes in lay-out, equipment and staffing, which have taken place recently and since the Ministry of Food took over the Abattoir, are facilitating quicker and smoother working from the slaughterer's point of view rather than from the Inspector's point of view. The main changes are:— (1) The electric hoists for lifting the animals to the bleeding rail after stunning have been speeded up and two new dropping points have been fixed so that the animals after bleeding can be instantly dropped to the floor. (2) A completely new method of sheep dressing is now in operation. It is a continuous rail operation with the carcase always hanging clear of the floor during the whole process of dressing. (3) Two teams of slaughtermen are now continuously working, and the slaughterhouse is large enough for cattle and sheep, or pigs or calves to be slaughtered at the same time. Other improvements have been made to obtain a more hygienically finished carcase, and it is considered that the standard of hygiene of the carcases leaving the Abattoir compares very favourably with that at any other abattoir. Nevertheless, the accommodation at the premises is now being used at full capacity. 34 The following table gives details of the number of animals slaughtered during the year:— Table No. 17. Carcases Inspected and Condemned, 1952 Cattle, excluding Cows. Cows. Calves. Sheep and Lambs. Pigs. Number killed 12,471 1,413 2,410 22,680 51,028 Number inspected 12,471 1,413 2,410 22,680 51,028 All diseases except Tuberculosis:— Whole carcases condemned 3 1 4 13 84 Carcases of which some part or organ was condemned 2,964 427 13 1,576 5,978 Percentage of number inspected affected with disease other than Tuberculosis 23.8 30.3 .7 7 11.8 Tuberculosis only:— Whole carcases condemned 33 23 6 — 104 Carcases of which some part or organ was condemned 1,222 420 — — 1,583 Percentage of number inspected affected with Tuberculosis .. 10.06 31.4 .2 — 3.3 Slaughter of Animals Act, 1933 Slaughterhouses are subject to annual licensing and there are now only two licensed slaughterhouses in the Borough, one of which is not being used at the present time. During 1952 one new licence was granted to a person working in the Borough to act as a slaughterman, and 15 applications for renewal of existing slaughtermen's licences were approved. Unsound Food The Council's food inspectors are required to examine food suspected of being unsound and if considered unfit for human consumption the food is surrendered and a certificate of condemnation issued. Once again a large number of such certificates were issued during the year. Whilst no food was seized and formally condemned during the year, some 33,163 articles of food, weighing approximately 86 tons, were voluntarily surrendered as unfit for human consumption. The majority of these articles, weighing approximately 74 tons, were from the large abattoir in the Borough. The food was utilised for animal feeding or for fertilisers. 35 Sophistication of Food During the year ended 31st December, 1952, 742 samples (i.e., 525 informal and 217 formal samples) were submitted for analysis to the Public Analyst. Of these, 31 formal and 18 informal samples were reported to be adulterated or otherwise not complying with the statutory requirements, giving a percentage of 6.6, compared with 4.0 in 1951 and 7.1 in 1950. No private samples were examined during the year. Tabic No. 18. The following table gives details of adulterated samples:— Sample No. Article. Formal or Informal. Result of Analysis. Result of legal proceedings or other action. 715 Confectionery, Jam ' Doughnuts. Informal Contained jam, not more than 0.1 per cent., insufficient to justify the description. Formal sample obtained. 708 Pork Sausages Formal Contained sulphur dioxide, 400 parts per million. The presence of preservative was not declared. Referred to Ministry of Food. 800 Pork Sausages Formal Contained sulphur dioxide, 50 parts per million. The presence of preservative was not declared. Referred to Ministry of Food. 703 Pork Sausages, Preserved. Formal Deficient in meat 9 per cent. Referred to Ministry of Food. 706 Pork Sausages Formal Meat content 58 per cent. 707 Pork Sausages Formal Meat content 61 per cent. 747 Pork Sausage, Preserved. Formal Soya bean flour 2 per cent., meat content 58 per cent. 748 Pork Sausage Formal Meat content 57 per cent. 749 Pork Sausage, Preserved. Formal Soya bean meal 10 per cent., meat content 45 per cent. Prosecution by Ministry of Food. Fined £11 and £7 7s. costs 750 Pork Sausage, Preserved Formal Meat content 60 per cent. Referred to Ministry of Food. 767 Pork Sausages Formal Meat content 54 per cent. 768 Pork Sausage Meat Formal Meat content 60 per cent. 769 Pork Sausages Formal Meat content 58 per cent. 793 Pork Sausages Formal Meat content 61 per cent. Warning letters sent to the manufacturer and the supplier. 798 Pork Sausages Formal The presence of preservative was not declared. Legal proceedings instituted. 799 Pork Sausages Formal Meat content 50 per cent. 757 Flaked Tapioca Informal Consisted of a Tapioca substitute made from potato starch. Formal sample obtained. 776 Flaked Tapioca Formal Warning letter sent to vendor. 36 Sample No. Article. Formal or Informal. Result of Analysis. Result of legal proceedings or other action. 126 Desiccated Coconut Informal Contained 35 percent. of sugar. The presence of sugar was not disclosed on the label. Formal sample obtained. 179 Desiccated Coconut Formal Contained 40 per cent. of sugar. The presence of sugar was not disclosed on the label. Details forwarded to Ministry of Food. 209 Prunes Informal Deteriorated prunes. The prunes were mouldy and unfit for human consumption. Sale on part of consignment stopped. 189 Ice Lolly Informal Contained alginic acid 0.1 per cent. The alginic acid was in the form of an insoluble fibrous mass, resembling J and tasting like paper pulp. Warning letter sent to manufacturers. 192 Ice Lolly Informal 169 Meringue Mixture Informal An imitation meringue mixture consisting of a coloured and flavoured solution of a synthetic gum (methyl cellulose). Genuine meringues are made from sugar and white of egg, and since the samples contained neither and were virtually devoid of nutritive value the term "Meringue Mixture" was a false description. Formal sample obtained. 204 Meringue Mixture.. Formal An imitation meringue mixture consisting of a coloured and flavoured solution of a synthetic gum (methyl cellulose). No further action. 210 Meringue Mixture.. Formal 123 Beef Sausages Formal Contained sulphur dioxide 85 parts per million. The presence of preservative was not declared. Warning letter sent to suppliers. 128 Soup, Canned, Tomato Cream. Informal Contained edible oil and fat 2.9 per cent., tin 2.0 grains per pound. Under the agreed Code of Practice, Tomato Cream Soup should contain at least 3.5 per cent. of edible oil and fat. A proportion of tin approaching 2 grains per pound is regarded as excessive. Formal sample obtained for analysis. 180 Soup, Canned, Tomato Cream. Formal Contained edible oil and fat 2.0 per cent. A warning letter sent to manufacturer. 256 Fruit Bars Informal Contained insect remains, derived from small beetles, larvae and ants, in the proportion of approximately 100 insect fragments per 100 grammes. Formal sample obtained. 37 Sample No. Article. Formal or Informal . Result of Analysis. Result of legal proceedings or other action. 288 Fruit Bars Formal Contained insect remains, derived from small beetles, larvae and mites, in the proportion of approximately 50 insect fragments per ounce. Cautionary letter sent to manufacturers. 231 Ice Lollies Formal Contained an insoluble fibrous mass, having the character of alginic acid and weighing, when dried, 52 milligrams (0.1 percent.). Taken up with manufacturers. 232 Ice Lollies Formal Contained an insoluble fibrous mass, having the character of alginic acid and weighing, when dried, 73 milligrams (0.14 per cent.). Taken up with manufacturers. 281 Pastry Mixture Informal The fat in the sample was rancid and contained 4.5 per cent. of free fatty acids. Edible fats do not contain more than 2 per cent. of free fatty acids. Formal sample obtained. 292 Pastry Mixture Formal The fat in the sample was rancid and contained 4.4 per cent. of free fatty acids. Manufacturers informed. 299 "Pickapeppa" Sauce. Informal Contained dead mites approximately 70 per ounce. Formal sample obtained and proved to be genuine. 301 Tomato Cream Soup Formal Contained edible oil and fat 2.6 per cent., tin 2.1 grains per pound. Under the agreed Code of Practice, Cream Soups should contain at least 3.5 per cent. of edible oil and fat. The proportion of tin was excessive. Cautionary letter sent to manufacturers asking them to withdraw all stock affected. 302 Tomato Cream Soup, Informal Contained edible oil and fat 2.5 per cent. Formal sample obtained. 423 Fruit Bar (Sugar Confectionery) Informal Contained insects and fragments of insects, derived from mites, small beetles and their larvae, 250 per ounce. Formal sample obtained. 448 Fruit Bar (Sugar Confectionery) Formal Contained insects and fragments of insects, 220 per ounce. Warning letter sent to manufacturers. 519 Butter Balls (Sugar Confectionery) Informal Contained butter-fat, not more than 0.1 per cent. These sweets should contain at least 4 per cent. of butter-fat. Formal sample obtained. Result— genuine. 521 Iodine Paint Informal The proportion of Potassium Iodide was 53 per cent. excessive, and the Boric Acid, 35 per cent. excessive as compared with the formula printed on the label. No further action. 38 Sample No. Article. Formal or Informal. Result of Analysis. Result of legal proceedings or other action. 391 Condensed Full Cream Milk, Sweetened. Informal Composition satisfactory, but the label contravened the Condensed Milk Regulations as the type used was too small. Formal sample obtained. Result— genuine. 605 Mixed Peel Informal Contained glucose, 20 per cent. The peel was stated to contain sugar but not glucose. Formal sample obtained. 477 Christmas Pudding Informal Contained carcases of mites and insect larvae, approximately 600 per ounce. Formal sample obtained. 512 Christmas Pudding Formal Contained carcases of mites and insect larvae, approximately 350 per ounce. Matter taken up with manufacturers and the Ministry of Food. 579 Rice Formal Contained wheaten product 2.5 per cent. The wheaten product consisted of small pieces of a form of spaghetti, cut to about the size of rice grains. Warning letter sent to manufacturers. 513 Pork Sausages Formal Meat content 59 per cent. Pork sausages should contain not less than 65 per cent. of meat. Warning letter sent to manufacturers. 514 Beef Chipolata Sausages, Preserved. Formal Contained sulphur dioxide, 1,450 parts per million. Sausages should not contain more than 450 parts per million of sulphur dioxide. Legal proceedings instituted: fined £5 with £2 2s. costs. The foods examined were:— Ale and Stout 2 Coconut, Desiccated 5 Almonds, Ground 7 Coffee 11 Arrowroot 2 Confectionery, Flour 61 Baking Powder & Golden Confectionery, Sugar 22 Raising Powder 4 Cooking Fat 1 Barley, Pearl 1 Cornflour 1 Blancmange & Dessert Powders 8 Cream, Imitation 4 Bread 7 Curry Powder 1 Butter 3 Custard Powder 6 Cake Decorations & Icing Paste 4 Drinks, Soft 9 Cake & Pudding Mixtures 6 Fish 15 Cereals 11 Fish Paste 4 Cheese 1 Flavouring Essence 2 Cheese Spread 4 Flour 8 Chewing Gum 1 Fruit, Candied & Crystallised 4 Chocolate Spread, Canned 1 Fruit, Canned & Bottled 18 Cocoa 1 Fruit, Dried 13 39 Fruit Juice 3 Peanut Butter 2 Fruit Pies 3 Peas, Split 1 Fruit Puree 1 Peel, Candied 4 Groats 1 Pepper 7 Honey 4 Pickles and Sauces 18 Horseradish 2 Potato Crisps 3 Ice Cream 5 Proprietary Foods 2 Ice Lollies 8 Proprietary Medicine 14 Jam 22 Pudding, Christmas 11 Jellies 14 Rice (including ground) 6 Lard 2 Salad Cream 1 Lemonade Powder & vescing Tablets 6 Sausages & Sausage Meat 30 Soda, Bicarbonate of 1 Margarine 3 Soups 16 Marmalade 4 Soya Flour 2 Marzipan 1 Spaghetti, Canned 2 Meat Products 10 Spices 3 Meat Paste 2 Suet, Shredded 5 Meringue Mixtures 4 Sugar 2 Milk 214 Tea 2 Milk, Condensed 3 Vegetables 11 Mincemeat 2 Vinegar 6 Mustard 2 Welsh Rarebit & Mixture 2 Oatmeal 2 Wine, Alcoholic 1 Pastry Mixture 3 Yeast Flakes & Tablets 2 Others 19 PREVALENCE AND CONTROL OF INFECTIOUS DISEASE The following diseases are notifiable in the Borough: Anthrax, Cholera, Continued Fever, Diphtheria, Dysentery, Encephalitis Lethargica, Erysipelas, Enteric Fever, Food Poisoning, Glanders, Hydrophobia, Malaria, Measles, Membraneous Croup, Meningococcal Infection (C.S.M.), Ophthalmia Neonatorum, Pneumonia Acute Primary, Pneumonia Acute Influenzal, Poliomyelitis (Acute), Polioencephalitis (Acute), Plague, Puerperal Pyrexia, Relapsing Fever, Scabies, Scarlet Fever (or Scarlatina), Smallpox, Tuberculosis (all forms), Typhoid Fever (including Paratyphoid), Typhus Fever, Whooping Cough and Zymotic Enteritis. All infectious diseases notified to the Department are visited by the Sanitary Inspectors at the earliest opportunity, and disinfection is carried out wherever applicable. Where the patient is nursed at home, Sanitary Inspectors visit to see that home isolation is carried out satisfactorily, and at the end of the infectious period the bedding, etc., belonging to the patient is removed for treatment at the Disinfecting Station and the rooms sealed and fumigated. 40 Scarlet Fever There were 259 notified cases of scarlet fever occurring in the Borough during the year, being 53 more than occurred in the previous year. The disease was usually very mild. The great majority of patients (72 per cent.) were satisfactorily isolated at home. Frequent visits were made by the Sanitary Inspectors to ensure that proper precautions were being taken. Measles Of the total of 2,356 infectious disease notifications received during 1952, measles notifications accounted for 1,417 or 60 per cent. of these notifications. There were no fatal cases. Eighty-nine per cent. of the notified cases of measles concerned children of school age. However, the number of notifications received showed a sharp decrease as compared with the previous year (2,940), and this conforms to the two-year cycle associated with the disease. Whooping Cough Notifications totalled 325. One case proved fatal. Forty-three of the patients were admitted for hospital treatment owing to complications or because of lack of suitable nursing facilities at home. Diphtheria For the third year in succession there were no known cases of diphtheria occurring within the Borough. Altogether, 13 cases were notified by medical practitioners, in each case the diagnosis being revised. Seven patients were found subsequently to have tonsillitis, two to have bronchitis, one Vincent's Angina, one glandular fever and two patients no known disease. Zymotic Enteritis Of the 69 cases of this disease which were notified, 39 occurred in children under one year. Three deaths of children under one year were attributable to enteritis, gastritis or diarrhoea. Malaria Eight confirmed cases of malaria occurred in the Borough during the year, of which five related to members of H.M. Forces stationed in the Borough who had been abroad recently. Another case was that of a girl of eight years who had been in this country only a short time, and two infections related to civilians who had also been abroad. Six of the patients concerned were admitted to hospital. Acute Poliomyelitis. During 1951 there had been a pleasing decline in the number of cases of poliomyelitis, but this was not maintained during 1952, when there were 24 confirmed cases of this disease in its paralytic form and four in its non-paralytic form. In only one instance was there any connection between notified cases, two members of the same family being ill at the same time Two of the notified cases proved to be fatal. 41 Table No. 19. Notifications of Infectious Diseases (excluding Tuberculosis), 1952. Diseases. Number of Cases (after correction of diagnosis) Age Groups Under 1 year. 1 and under 3 years. , 3 and under 5 years. 5 and under 10 years. 10 and under 15 years. 15 and under 25 years. 25 and under 35 years. 35 and under 45 years. 45 and under 65 years. 65 and over. Age Unknown Total Total No admitted to Hosp. Diphtheria - - - - - - - - - - - - - Scarlet Fever 1 22 48 171 9 6 2 — — — — 259 74 Paratyphoid Fever — — 1 — — — — — — — — 1 1 Meningoccocal Infection — 1 — — — — — — — — — 1 1 Acute Poliomyelitis (Paralytic) 1 3 3 6 3 3 3 1 1 — — 24 23 Acute Poliomyelitis (non paralytic) — 1 — 1 1 1 — — — — — 4 3 Erysipelas — — — 2 — 2 2 3 8 4 — 21 7 Dysentery — 4 3 6 3 5 5 1 1 2 — 30 22 Zymotic Enteritis 39 15 7 5 — — 2 — 1 — — 69 51 Scabies — 1 1 1 — — — — 1 — — 4 — Acute Pneumonia 8 9 5 18 4 8 11 18 26 15 1 123 33 Food Poisoning — 1 2 2 1 2 4 1 3 4 — 20 4 Puerperal Pyrexia — — — — — 13 26 9 — — — 48 48 Ophthalmia Neonatorum 1 — — — — — — — — — — 1 — Whooping Cough 24 75 76 128 4 — 2 2 1 — 13 325 43 Measles 32 280 384 654 23 14 1 1 1 — 27 1,417 50 Typhoid Fever — — — — - — — — - — — — — Malaria — — — 1 — 4 3 — - — — 8 6 Acute Encephalitis - - - - 1 — — - — — 1 1 42 Puerperal Pyrexia. The revised definition of this disease contained in the Puerperal Pyrexia Regulations made in 1951, has accounted for the increase in notifications received, there being 48 cases compared with 31 during the previous year. Any case occurring in a hospital in the Borough is notified to me as required by the Regulations, and not to the Medical Officer of Health in the area in which the patient normally resides, although several such cases, of course, relate to mothers normally resident within the Borough. All except five of the notifications were received from the largest maternity hospital in the Borough. Puerperal pyrexia must not be confused with puerperal fever. The condition puerperal pyrexia is an increase of temperature in accordance with the definition, following childbirth. The causes of such an increase are many and often trivial. The disease puerperal fever is a bacterial infection of the genital tract associated with childbirth. Pneumonia. Of the various forms of pneumonia, only acute primary and acute influenzal pneumonia are notifiable infectious diseases. The number of cases occurring during the year was 123, being slightly less than the number notified during the previous year. Deaths from pneumonia totalled 85, against 100 in 1951. Dysentery. The thirty cases of dysentery occurred mostly in private families, and there were no major outbreaks of the disease. Each notified case was carefully investigated by the Health Department staff and an officer of the department obtained faecal specimens for examination from each patient and from contacts of the patient. Fifty such specimens were analysed, and in those cases where the result was positive the patient's doctor arranged for further treatment. Food Poisoning. During the year 20 confirmed cases of food poisoning were notified. These included four small outbreaks, each outbreak being confined to an individual family and involving a total of 11 persons. In two of the outbreaks the food suspected as causing the poisoning was plums, a member of two different families having eaten stewed plums just prior to illness. None of the patients was seriously ill. Sheep's heart, obtained from the family butcher, was the food suspected as causing another small outbreak of food poisoning. The food had been bought from the butcher on the Wednesday morning, had been cooked the following day and then stored in a saucepan overnight to be re-heated on the Friday for lunch that day. Two members of the family who had eaten the greater portion of the sheep's heart had been ill. It was not possible to obtain a specimen of the food suspected. There were 11 single cases of food poisoning reported by General Practitioners. In the case of one family ducks eggs left in mistake for hens eggs by a tradesman were suspected as causing the illness. One of the eggs had been lightly boiled and the patient was caused some discomfort. The Laboratory examination disclosed that the illness was due to salmonella typhimurium. 43 Tuberculosis. The number of primary notifications of tuberculosis (195) was a decrease of 51 on the previous year's total. The following table gives the age groups of new cases notified: Table No. 20. Age Periods. Formal Notifications. Number of primary notifications of new cases. 0—1 1—2 2—5 5—10 10—15 15—20 20—25 25—35 35—45 45—55 55—65 65—75 75 and upwards Total (all ages) Pulmonary— Males - - 2 5 4 8 6 19 13 17 13 3 5 95 Females 1 1 3 3 3 9 20 18 5 10 2 2 1 78 Non-Pulmonary— Males - 1 1 2 2 1 - 3 3 - - - - 13 Females - - - 1 - - 2 3 1 2 - - - 9 Total 1 2 6 11 9 18 28 43 22 29 15 5 6 195 The following is an extract from the Tuberculosis Register for 1952: Table No. 21. Pulmonary. Non-Pulmonary. M. F. Total M. F. Total Cases notified for the first time 95 78 173 13 9 22 Other additions to Register during the year, including transfers of patients from other areas 46 50 96 4 2 6 Cases on Register at 31st December, 1952 847 702 1,549 120 99 219 The Public Health Department is responsible for the duties connected with the prevention of the spread of tuberculous infection, and to enable these duties to be performed General Medical Practitioners notify all new cases coming to their knowledge. The Department carries out the disinfection of the patient's rooms and possessions. The two Chest Clinics in the Borough which are at Maxey Road, Plunistead, and Carnecke Gardens, Eltham, are administered by the Regional Hospital Board, who are responsible for the diagnosis and treatment of the disease. During 1952 the Minister of Health made new Regulations, the Public Health (Tuberculosis) Regulations, 1952, which revoke and replace the Public Health (Tuberculosis) Regulations, 1930. In a circular to local authorities the Minister has stated that whilst County Councils and County Borough Councils must be regarded as the bodies predominantly responsible for the prevention of tuberculosis, other local authorities have statutory functions as sanitary authorities under the Public Health Acts, or as housing authorities, some of which have an important part in preventing the spread of tuberculous infection. The Minister emphasises that co-operation between the various types of authority is essential. 44 The new Regulations no longer require a Medical Officer of Health to keep a register of tuberculosis notifications, but, in the Minister's view, he may naturally be expected to do so—and the Minister urges that he should—in the same way that he keeps a record, for his own purposes and without any legal requirements, of notifications of other diseases. The requirement contained in the 1930 Regulations for providing information of a tuberculous patient entering or leaving a sanatorium or hospital is also omitted from the present regulations. However, the Minister has asked Hospital Boards and Committees to ensure that this information (as for any patient with a notifiable disease) is sent by the institution concerned to the Medical Officer of Health of the district to which the patient belongs. During the last decade there has been a considerable reduction in the Tuberculosis mortality rate. The following table shows the incidence of Tuberculosis and the decline in the number of deaths from this disease during the last 12 years. Table No. 22. Table of Notifications and Deaths compared with Population. Year. Estimated Civilian Population excluding Army. Primary Notifications Deaths from Tuberculosis. Deaths per 1,000 population. Total Deaths all causes. Percentage of Tuberculosis Deaths against all Deaths. 1941 103,630 258 127 1.22 1,627 7.8 1942 110,140 249 102 .92 1,410 7.2 1943 112,700 292 102 .90 1,558 6.5 1944 110,970 248 100 .90 1,611 6.2 1945 115,270 260 90 .70 1,478 6.0 1946 . 134,420 247 83 .61 1,531 5.4 1947 140,150 297 101 .72 1,626 6.2 1948 142,800 230 82 .57 1,573 5.2 1949 144,000 256 59 .41 1,572 3.7 1950 144,000 205 58 .40 1,670 3.4 1951 144,000 246 57 .39 1,838 3.1 1952 146,000 195 39 .26 1,667 2.3 Mass Radiography. The Mass Radiography Unit of the South Eastern Regional Hospital Board visited the Borough during the whole of May and during the visit a total of 19,404 persons attended for X-ray examination. This total is 3,405 more than were examined on the occasion of the previous visit of the Unit, and those X-rayed included 422 men and 54 women employed by the Borough Council. Details of the total examinations made are as follows:— Centre Men Women Total Old Town Hall 5,167 7,050 12,217 Royal Arsenal 5,898 1,289 7,187 11,065 8,339 19,404 With regard to the examinations at the Old Town Hall only 207 women were recalled for further examination, and of these, 61 showed no abnormality and 51 required no further action. 167 men were recalled for further examination and 42 showed no abnormality, whilst 50 others required no further action. As on the occasion of previous visits of the Unit, the Health Department assisted by arranging a large number of bookings. As part of the Council's Health Education work, films dealing with Mass X-Ray were shown to local organisations during the weeks preceding the visit of the Mass X-Ray Unit. 45 Tuberculosis Care Work. The Woolwich Tuberculosis Care Committee, on which are represented various official bodies, continued to carry out most useful work amongst patients and their families. Financial help is also being given by the National Assistance Board in certain cases. Disinfection and Disinfestation. The work of reconstruction of the Disinfecting Station at White Hart Road, Plumstead, which was damaged during the war, was commenced in September, 1952, the cost of this work being recoverable from the War Damage Commission. In addition to the external repairs to the building being carried out, the plant and electrical wiring is also being overhauled. The Greenwich Borough Council kindly permitted the joint use of their Disinfecting Station until repairs are completed. During 1952, the Department carried out disinfection of 517 rooms after cases of infectious diseases, and of these 208 premises had been occupied by tuberculous persons. Altogether, 960 inspections regarding verminous conditions were made, and 604 rooms were disinfested for vermin. 44 van loads of furniture were fumigated during the year. The number of articles disinfected at the Disinfection Station to the 6th September, 1952, was 6,435, details of the type and number of articles disinfected there being as follows:— Beds 134 Rugs 27 Palliasses 774 Books 182 Pillows 1,214 Bags 65 Bolsters 128 Wearing apparel 500 Quilts 297 Boots 2 Sheets 610 Slippers 4 Blankets 1,472 Toys 55 Curtains 24 Cushions 83 Carpets 4 Sundries 750 Many requests were again received from residents of the Borough wishing to dispose of bedding and furniture which was often in a dirty and sometimes verminous condition, and formerly used by persons removed to hospitals and institutions, or deceased. This furniture and bedding was removed to and destroyed at the Plumstead Destructor. Seventy-seven cases were dealt with during the year and the following articles were removed and destroyed:- Beds 21 Mats 3 Pillows 34 Couches 12 Bedsteads 11 Chairs 28 Bedspreads 7 Cushions 10 Blankets 6 Tables 2 Bed-ends 1 Chest of Drawers 3 Sheets 7 Wearing Apparel 48 Wash Stand Pitchers 2 Gramophones 1 Dressing Tables 1 Books 12 Lino 1 Bins of Rubbish 2 Sundries 97 A total of 29 requests was received from residents in the Borough for the disinfection of rooms and bedding or both, following the occurrence of a noninfectious disease, or the death of a member of the family, and for other reasons. Charges totalling £18 12s. Od. were made for this work. 46 Personal Cleansing. The personal cleansing stations are situated adjacent to the Turkish Baths in Plumstead High Street and at the Eltham Hill Health Centre, Sherard Road. The number of persons cleansed during 1952 was 1,134, and the number treated for scabies was 70. Each case of scabies is visited by the Sanitary Inspector and, wherever possible, all the members of the families concerned attend for treatment. The total number of attendances at the Cleansing Stations was 1,392. Details of the number of cases and attendances at the two Cleansing Stations are given below. Treatment of Verminous Persons. Pre-School Children. School Children. Adu lts. Totals. Boys. Girls. Boys. Girls. Men. Women. Number of Cases 17 53 246 696 16 106 1,134 Number of Treatments 17 54 254 849 14 113 1,301 Treatment of Scabies. Pre-School Children. School Children. Adults. Totals. Boys. Girls. Boys. Girls. Men. Women. Number of Cases 5 4 12 16 8 25 70 Number of Treatments 7 5 18 21 8 32 91 Authentication of International Certificates of Vaccination and Inoculation. A person proceeding abroad is required to carry a certificate of recent successful vaccination and inoculation and, in order to prove to the health authorities abroad that the signature of the person issuing the certificate is that of a registered medical practitioner known to the Medical Officer of Health, authentication of the certificate by the Medical Officer of Health is required. The signatures of medical practitioners signing such certificates was authenticated by me during the year in respect of nearly 200 certificates. 47 LABORATORY FACILITIES A large part of the Council's pathological and allied work in relation to the diagnosis, prevention and control of infectious diseases is undertaken at the Southern Group Laboratory at the Park Hospital, Lewisham. This service is provided by the Public Health Laboratory Service on behalf of the Medical Research Council. Specimens sent to this laboratory include samples of milk and ice cream, samples of food in suspected food poisoning cases, specimens of meat from the abattoir and samples of swimming bath water. The following summary relates to the work carried out by the laboratory on behalf of the Council during 1952:— Food (which includes animal specimens from abattoirs, etc.) 50 Ice Cream (Methylene Blue Test) 83 Milk (Methylene blue and phosphatase, also turbidity) and milk bottles (colony count), milk caps (culture) 322 Faeces 31 Sputum 1 Water—from swimming baths, children's paddling pools and boating lakes 84 Throat swab 1 572 The examination of specimens of human origin (mainly swab examinations) for the general practitioners in the Borough, and also specimens referred to the hospital from local clinics, is undertaken by the Woolwich Group Hospital Management Committee. The work was formerly carried out at the Woolwich Memorial Hospital laboratory, but is now being undertaken at the Brook Hospital. General practitioners referred 30 sputum specimens for examination and the hospital carried out 159 other sputum examinations during the year. One hundred and thirty-two nasal and throat swabs were referred to the hospital by general practitioners for examination, and 21 other specimens. This laboratory also carried out the examination of 50 faecal specimens. Chas. F. Thorn & Son, Ltd. (T.U.) Woolwich, S.E.I8