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39290148-6c78-4ae5-aceb-93271413fded | 1 50 per cent. 2 No replies 11 Tf information could be obtained of the earliest cases school closure could then be resorted to with some prospect of success. To attain this object, the information from the schools must be systematical, and notification carefully made during inter-epidemic periods as well as when epidemics of Measles prevail. Unfortunately, there is no satisfactory system by which a teacher becomes aware of the cause of the absence of a pupil. If a note is not received, he is dependent on a hearsay report from any child who happens to live near. The question has been raised on another occasion as to the desirability of adding measles to the Schedule of Notifiable Diseases. The compulsory notification of Measles has, as yet. been tried in only a few towns, and, I believe, that only two towns have published fully the results of such notification. As early as 1881 the Corporation of Aberdeen obtained powers for the compulsory notification of Measles. |
4df66e40-0a14-4eba-b0ba-eafb9bd8d502 | Under the Aberdeen Local Act of 1881, notification by the medical attendant only was required. After the passing of the Infectious Disease Notification Act. 1889. the Town Council adopted it in 1891, in order to obtain the advantage of dual notification, that is, by the medical attendant and by the householder. 32 After a report from the Medical Officer of Health, the compulsory notification of Measles was stopped in February, 1903, as experience appeared to show that the benefits scarcely justified the large cost. No doubt a question may arise as to the completeness of the record of cases of Measles during these years. It must be admitted that the notification of any disease is rarely absolutely complete. Some cases are unrecognised, and others may be wilfully concealed. In Aberdeen, though, the compulsory powers were rigidly applied throughout the whole period, and when required, proceedings were instituted against defaulters. |
e9000851-7ca2-439a-b4bf-e2d0a6d2a67e | The following Table gives the average annual mortality in Aberdeen from Measles for 100.000 inhabitants:— 1856-1872. 1873-1887. 1888-1900. 61 44 51 The conclusion which Dr. Hay, the Medical Officer of Health for Aberdeen comes to is " that it is obvious from these considerations as to the prevalence of Measles, and as to the mortality from the disease, it is impossible to assert with confidence that notification has enabled us to exercise any distinct and effective control; and it can scarcely be urged that we have not made a sufficiently lengthy trial." The other town that tried the compulsory notification was Burtonon-Trent, where Measles was scheduled as a notifiable disease from 1894 to June 30th, 1900. During the period notification was in force, there was no diminution in the number of deaths, nor were the inter-epidemic periods lengthened, as the following table will show: Notification not in Force. |
e87a3fb3-bbf2-4fe2-8f64-a040678fe005 | Deaths from 1887 1888 1889 1890 1891 1892 1893. Measles 8 20 26 2 3 52 7, Births 1565 1.575 1634 1481 1636 1511 1625 Notification in Force. |
e98b5eab-b2d0-490f-8894-4bf562ac3a0e | January 1st to 1894 1895 1896 1897 1898 1899 June 30th, 1900 Deaths 36 2 86 7 31 o 36 Birtns 1533 1572 1512 1430 1463 1429 33 If we compare the six years before, and the same period after notification was adopted, we find that the number of births during 1888-1893 slightly exceeded that of 1894-1899, and, therefore, the number of susceptible children would, if anything, be larger in the former period, but the mortality from the disease was lower during the former period. The result cannot be deemed satisfactory. Dr. Millard, who formerly was Medical Officer of Health for Burton, attributes this want of success to the fact that many cases were unreported, and also to the early stage at which Measles is infectious. |
f954ffcc-597b-4ad1-af28-a8d66eee4745 | A medical attendant is not always called in when Measles makes its appearance in a family; while the householder rarely reports the presence of Measles in his dwelling, whether a doctor has been called in to see the case or not. To this extent, therefore, compulsory notification commonly fails to afford to Sanitary Authorities complete knowledge of all the cases that occur in their district. In view of the experience gained by those towns that have placed Measles amongst the compulsory notifiable diseases, it appeals that success is more probable along other paths, more especially in a development of school notification. The appointment of a Health Visitor enables the Council to utilise the information thus obtained. As soon as a case is reported, the house is visited, and if there is no doctor in attendance, general instructions are given as to the management of the case and isolation of the patient. Circulars are also distributed. Except in exceptional circumstances, disinfection is not carried out. |
5914ee40-62dd-4bdc-bada-6e7faad3b44e | Under the conditions which prevail, we have no choice in the matter, but in the present state of our knowledge of the disease, it is doubtful if disinfection would be of much value. In the case of Diphtheria, Typhoid, and Consumption, we know that the germs which cause these diseases can survive for long periods on articles of apparel or bedding or on the walls of rooms which have not been disinfected. Outside the body, the measles-germ has probably a very short life, and to substantiate this. I may record the result of inquiries made by Dr. Newsholme in Brighton. In the spring of 1904. there 34 was an epidemic of Measles In Brighton, and in August and September of the same year every house was visited in which, during the previous seven months cases of Measles had occurred. No disinfection had been carried out in any of these houses. |
a4f2f1ee-b1c4-4b77-8280-559fba117dce | Six hundred and twenty-five houses had been invaded by Measles; in 534 of these houses the occupants were the same as on the first visit, and no further children had been attacked by Measles. The immunity of the 169 children in these houses, who had not previously acquired Measles, had continued. Of the remaining houses. 23 on investigation were found to be empty, and in 66 of these new families were living or new babies had been born. Eighty-six new children had come into these presumably infected houses, and 27 of them were unprotected and possibly exposed to infection. The duration of their exposure in the presumably infected houses varies from 17 days to 4b months. None of them acquired Measles, and Dr. Newsholme concludes that if there had been a few instances of Measles among the number he should have refrained from pressing a case based on scanty data, even though the majority of the children had escaped infection. |
1d8a297f-77f7-4a14-b8fa-cc5d837764d0 | But in view of the fact that the entire experience points in one direction, it is justifiable to infer provisionally that the infection of Measles is shortlived and that domestic cleansing suffices for disinfection. This conclusion is obviously subject to revision if a series of unfallacious positive facts are forthcoming at any future time in contradiction to the negative facts here adduced. Apart from the expense which disinfection would involve, there are other reasons against adopting it as a general practice. It has been positively stated that Measles is infectious before the disease is recognised, and the children are not kept to one room. Besides, even when recognised, little attempt is made at isolation, and the children are allowed to roam about the house, possibly, before they are free from infection. It would obviously be useless to disinfect the bedroom alone, when other rooms had been exposed to infection. An endeavour was made to impress upon the parents the necessity of keeping the child apart from the other children in a suitable rcom during the infectious period. |
da349958-a4e9-4388-854f-e0c690b7ad5e | In some instances the instructions were not regarded owing to inadequate accommodation in invaded houses. In some districts the difficulty has been met by the 35 removal of Measles to hospital. In Brighton, the Medical Officer of Health recommended that he be authorised, so far as their accommodation would permit, to admit cases of Measles which cannot be properly treated at home. Some saving of life would, doubtless, be secured by this means. I am afraid that here hospital accommodation would not be practicable except on very rare occasions. During the whole of the period that Measles was epidemic last year, our hospital was required for the isolation of other diseases. In the remote possibility that our hospital accommodation would permit it, the Council might consider the desirability of isolating Measles in exceptional circumstances. WHOOPING COUGH. Whooping cough was returned as the cause of 5 deaths. Measles and Whooping Cough occur frequently in association with each other. |
457e5f62-1e07-4b04-88e5-a089aff6c3dc | There is a difference of opinion as to the order of sequence in which the two diseases occur in respect to each other. The disease was most prevalent in the South-West Ward. INFANTILE MORTALITY. It has been explained in previous reports that the infantile mortality is usually expressed as the ratio of deaths in children under one year of age to the total number of births registered. It was stated on a former page that all the births belonging to Acton are not registered within the district, and though an arrangement is now made whereby all the deaths of residents occuring outside the parish are included in the returns of this district, a like system does not obtain in respect of the births. For instance, the death of a child occurred in Queen Charlotte's Hospital within a few hours of birth the death is included in the statistics for this district, but the birth is not. A similar circumstance occurred at th? Isleworth Infirmary. |
4737de01-87a1-4e2d-91c3-3cac2a1f218f | The outside deaths affect the Infantile Mortality to the extent of 5 per 1,000. One hundred and ninety-three deaths under one year of age were registered in the district, and 8 infants under one year of age died in public institutions beyond the district, making a total of 201. This latter figure corresponds to an infantile mortality of 130 per 1.000 births, or a death-rate of 4 per r,ooo inhabitants. In addition 91 deaths occurred between the ages of one and five years. Althgether 42 per cent. of the total deaths in the district occurred among children under five years of age, and 29 per cent. occurred among infants under 12 months old. In 1906, the infantile mortality in England and Wales was 133; in the 76 large towns it amounted to 146, and in the 142 smaller towns it was 138 per 1,000 births. |
ef145c57-7999-47de-a1d5-0897841c92c5 | Compared with 1905 there was an increase of infantile deaths from the following diseases : Diarrhoeal Tuberculous Measles Diseases Diseases Overlaying 1905 2 43 7 2 1906 4 80 11 4 Tne following diseases showed a diminished death-rate: Convulsions Bronchitis Pneumonia Wasting Disease 1905 13 13 21 47 1906 6 7 16 46 The only cause of death which shows a marked difference in its mortality is Epidemic Diarrhoea. The Ward distribution was as follows: N. West N. East S. East S. West 34 32 28 107 During the year the district was rearranged into four Wards instead of three, and as the former division has been utilized for statistical purposes, it is not possible to compare the infantile mortality in each Ward with previous years. |
ff08d1e6-d15a-436c-b050-437347ad2000 | Moreover, this year the births for the Wards have been separately arranged, so that the infantile mortality of each Ward can bp expressed as a ratio of deaths under one year to every 1.000 births. In 1905, there were in the North Ward 27 deaths under 12 months old, in the East Ward 60 and in the West Ward 75. The infantile mortality in 1906 in the Wards was: N. West N.East S. East S. West 148 97 110 147 37 Three of the Wards have an infantile mortality of over 100 per 1,000 births, and only one is below that number; but it should be explained that the high mortality of the North-West Ward is due to the large number of deaths which occurred in that portion situate to the south of the High Street and to the East of Gunnersbury Lane. Out of the 34 deaths of infants which occurred in the North-West Ward, this area was responsible for 16. |
a329f49e-380c-49ac-990c-66e231249b38 | The conditions which prevail in the above-mentioned portion of the North-West Ward approximate closely to those of the SouthWest Ward, and one of these is included in the term overcrowding. Overcrowding may embrace such a variety of circumstances that its use is open to misconstruction. The term is here used not in its legal sense, but to denote the aggregation of people under such conditions as to injuriously affect the weakest members of the community. We should clearly distinguish between overcrowding of site and overcrowding of the dwellings. It is sometimes assumed that overcrowding must ensue as a result of the movement of the rural classes to towns, but this emigration in itself, does not always tend to an exalted infantile mortality. If a comparison be made of the South-East and South-West Wards, the distinction between overcrowding of site and overcrowding of rooms will appear clear. The area of the former Ward is 199 acres, and of the latter 240 acres. |
9ef73595-6bb0-41e8-b4a7-1a2d1e7952e7 | The estimated population is 11,000 and 17,000 respectively. The South-East Ward contained 55 persons to the acre, and the SouthWest Ward 74. This difference in the density of the population to the acre is not sufficient to account for an infantile mortality of no per 1.000 in the one, and of 147 per 1,000 in the other. Of more importance is the overcrowding of rooms, which prevents them being efficiently ventilated. It is assumed that a house is overcrowded if the average number of persons per room exceeds two. It is estimated that in average sized rooms the cubic feet of aii space is sufficient for two people, as a change equal to three times per hour is generally all that can be borne under the conditions for warming in this country, or that is practically attainable with natural ventilation. In all tenements with less than four rooms, it usually follows that during the night, the actual number in each room probably reaches, if not exceeds, four. |
709c7654-0073-4fe5-9492-6cd0d5a86130 | This overcrowding of rooms, 38 with its accompanying vitiation of the atmosphere bears a close relation to a high infantile mortality, but it is a common experience to find the overcrowding more marked in three-roomed tenements than in those of one and two rooms. At the Census, only a small percentage of the latter were occupied by families having children, and this fact accounts for the excessive mortality in three-roomed tenements as compared with those containing one and two rooms. Inquiries were directed as to the number of rooms occupied by the family where an infant death had occurred, and of 135 deaths inquired into it was found that 15 families occupied 1 room. 14 families occupied 2 rooms. 81 families occupied 3 rooms. 17 families occupied 4 rooms. 8 families occupied 5 or more rooms. These figures do not represent the true relation which overcrowding bears to infantile mortality. |
9b295747-cec7-4b16-9474-5b876d45d9d4 | Fifty-eight infant deaths were not specially inquired into, and of these the majority occurred in families occupying more than 5 rooms. For our present purpose, it is taken for granted that in all cases not inquired into, the family occupied more than five rooms. With this correction, the percentages work out as follows:— 7.8 per cent, of infant deaths occurred in one-roomed tenements. 7.3 „ „ „ two-romed tenements. 42 „ „ „ three-roomed tenements. 8.8 „ „ „ four-roomed tenements. 34.1 „ „ „ five-roomed tenements and over. At the census of 1901, there were 8.326 separate tenements in the parish, and the number of rooms occupied by each family was as follows:— 612 families occupied 1 room each. 716 families occupied 2 rooms each. 1,512 families occupied 3 rooms each. 1,277 families occupied 4 rooms each. |
5972c7a5-51b7-4c80-97ec-41412457938e | 4.209 families occupied 5 rooms and over. 4.209 families occupied 5 rooms each and over. 39 The following table shows the excessive mortality in the smallersized houses:— Percentage of total tenements at Census. Percentage of deaths under 12 months old in 1906. One-roomed dwelling 7.3 7.8 Two-roomed dwelling 8.3 7.3 Three-roomed dwelling 18 42 Four-roomed dwelling 15 8.8 Five-roomed dwelling and over 50 34.1 But overcrowding is not the only factor in the production of a high infantile mortality in these particular areas and in the smaller houses. Overcrowding, in the sense now used, is inseparably connected with other evils. Both overcrowding and one of its resultants —high infantile mortality—are merely symptoms; the malady lies deeper and involves educational, moral, social and industrial problems which only remotely touch medicine. |
96cb8151-7ed4-427c-b35e-d225adb3c35d | These questions will not be entered into, except as far as the figures at our disposal may serve to illustrate their effect upon the infantile mortality. In a district, such as ours, instruction in domestic subjects is especially necessary. Young women enter upon the responsibilities of motherhood in utter ignorance of the requisites of feeding, clothing and tending of infants. It is not possible to put back the hand of time, and to say that prior to wedlock the woman must be engaged in domestic work. The girl who enters some industry, such as laundry work, has her energies well occupied with her daily task, and when she becomes a mother, enters on her new life with hardly any conception of what its duties consist. It is hardly possible, perhaps, to teach domestic subjects in an elementary school, but the machinery whereby these subjects may be taught should not be beyond the ability of the combined action of the education and health authorities. To imagine that nature can be trusted in these matters is folly. |
e87971bb-9665-4170-8588-db97290816d7 | A mother has not an instinctive knowledge of what is necessary for a child's welfare, no more than the child has an instinctive knowledge of its own requirements. The mortality of first-born children should indicate that a modern woman carries no instinctive system of baby management with her 40 in her brain. Out of 135 deaths, 61 were first-born, and it cannot be argued that this period marks the direst poverty in the history of the family. This ignorance is seen at its worst in the case of illegitimate children, and its results are deplorable. Of the total births, 39 were born out of wedlock, and 22 illegitimate children died before reaching the age of 12 months. These numbers correspond to an illegitimate infantile mortality of 564 per 1,000 births. Eleven of these deaths were due to errors of feeding—10 from Diarrhoea and one from Marsamus. |
63136623-e1db-4177-9366-05a39dcdc2c2 | In spite of the fact that the mortality amongst illegitimate children was more than four times as high as that of children born in wedlock, there was no evidence of any wilful neglect. The standard of living, though, in all instances was low, and there was a lack of personal and domestic cleanliness. All were artificially fed, as the mothers were compelled to earn their own living, and their offspring were deprived of the natural food of the infant. The illegitimate child is exposed to all the disadvantages of married female labour, and derives none of its benefits; as is shown when dealing with Diarrhoea, the hand-fed child fares ill as compared with his bieast-fed brother, but the illegitimate child has to contend with other conditions which are inimical to his welfare. At the present time, it may almost be stated that the only educational work amongst the poorer classes in domestic economy and the elementary laws of hygiene is carried out through the Health Visitor. |
7831b6b4-4f73-487e-b583-0b8ff3e10195 | To render the work of the latter really efficient, it should be supplemental to the work of educational authorities. Direct teaching upon the rearing of infants may be out of place in elementary schools, or even in secondary schools, but the value of a Health Visitor would be greatly augmented if the elementary laws of hygiene had been inculcated into the mothers when they attended school as children. A large number of the mothers have not formed habits of cleanliness and care of the person, and, unfortunately, before the sanitary authority hears of the birth of a child irreparable damage has often been done. In England, a birth need not be registered for a period of six weeks. In Scotland this period has been shortened to three weeks. In France, civil registration has to be 41 made within three days. The Corporation of Huddersfield has succeeded in obtaining power to compel the registration of a birth within 48 hours. |
06e334e7-baff-49d0-9223-93441fa48114 | Section 73 of the Huddersfield Corporation Act, 1906, provides "that it will be the duty on and after November 1st, 1906, of the father of every child born within the borough, if he is actually residing in the house where the birth takes place at the time of its occurrence, or in his absence of any person in attendance on the mother at the time of birth or within six hours thereafter, to send or give Notice of the birth to the Medical Officer of Health of the borough within forty-eight hours after such birth. Every person required to give or send such notice who fails to give or send the same shall, unless he satisfies the court that he had reasonable grounds to believe that notice had been duly given, be liable, on summary conviction, to a fine of not exceeding twenty shillings, including costs, for each offence." It may be stated that a period of two months now elapses before the premises can be visited by the sanitary authority. |
ba84c9ec-c951-4aed-a695-56cd346e5b2a | Seventy-one deaths occurred before the children reached the age of two months. In other words, the circumstances connected with 71 of the infantile deaths were for all practical purposes beyond the control of sanitary) authorities. But this does not exhaust the inadequacy of the present registration machinery. It has been reported to the Health Committee that the number of wrong addresses given by parents is on the increase. In some districts as high a proportion as five or ten per cent, of the births are not recorded at all. There is no necessity to enumerate the causes which lead to this deception, probably the desire to escape vaccination is one of the most potent. It is sufficient that the practices exist, and with the present registration system they will continue and prosper. The registrar has no means of detecting these abuses. The infantile mortality had decreased between the ages of 3 and 12 months, but under the age of 3 months the rate had been stationary. |
0a6253ea-0a6d-4cc5-9b53-6f764a0dde2e | But to obtain the best results in the prevention of infantile mortality, the work of preventive medicine should commence before even the birth of the child. Last year, there were 25 deaths from Prematurity, 5 from Congenital Defects, 4 from Injury at Birth, 16 42 from Congenital Debility. Besides these. 40 still-births were buried in the public Cemetery. Most of these were due to ante-natal causes, and although it is impossible to obtain definite statistics, there is no doubt but that chronic alcoholism in the parent exerts a most injurious influence upon the offspring. Experimental methods have provided us with proofs that alcohol given to a pregnant animal finds its way to the foetal tissues. Of 120 inebriate women in a Liverpool prison there were born 600 children, of whom 335 died under two years or were deadborn. |
8766a3c2-e4ba-4b8d-9a5f-760a6570feda | Further, there was also found to be a progressive death-rate in the alcoholic family; the number of dead births a iin deaths under two years increased as time went on, these fatalities being more numerous among the later born than the first-born children of these inebriates. But alcoholism is not the only factor, and the necessity of issuing some simple instructions to the expectant mother on the Hygiene of Pregnancy has been informally discussed by the Health Committee. The matter will be again brought before the Committee, so tha> the means and agencies by which these instructions may be issued can be discussed. The vices of alcoholic excess, the use of certain drugs, and the incidence of certain diseases must eventually be overcome by the moralist, but possibly they bulk less largely than the great economic condition of poverty which brings to the mother insufficient food, insufficient rest, excessive work, and extra stimulation. In this district, poverty is the chief cause of married women's labour. |
b332d26d-fb41-4f7c-835a-d338f4ca6389 | The mothers go out to work, not from choice, but from necessity. It is doubtful if work is injurious to the expectant mother, provided it be not heavy or prolonged. The improved food and greater comfort which mis work means, more than counteracts its disadvantages. In view of the tendency to impose further legal restrictions upon married female labour, the subject demands investigation, and before the actual effect of the employment of women on the infant mortality can be determined, we should have exact information not only as to the sanitary surroundings of the selected areas, but also as to the kind of employment. In the laundry industry, the married women work, as a rule, only four days a week, and we have yet to be convinced that this 43 labour, if not carried on later than the seventh or eighth month of pregnancy, exerts a harmful influence upon the offspring. |
6ec527f6-cf67-453c-a658-10b9777cc409 | Miss Anderson, in her evidence before the Committee on Physical Deterioration, cited Acton as a district where inquiry might be profitably made as to the extent and effects of employment of mothers in laundries. Pressure of other work has prevented us from making inquiries as to the extent, but some of the effects were inquired into. Investigations were made into those deaths which were probably due to antenatal causes, and to what extent they were affected by employment of the mother whilst pregnant. The causes of death most profoundly affected by antenatal causes are Prematurity, Congenital Debility and Convulsions, and the incidence of the mortality from these causes in certain districts of the parish is not immaterial to the subject under consideration. The area referred to on a previous page, i.e., the South-West Ward and that portion of the North-West Ward south of the High Street, could be designated as the home of the married female portion of the laundry industry. |
25a7bd62-99a0-467d-a3b5-349c788f9633 | Of the total deaths among infants 111 this area, prematurity was certified as the cause of death in 11per cent., Congenital Debility 3.7 per cent., and Convulsions in 1.5 per cent. In the rest of the district the figures were—Prematurity 15 per cent., Congenital Debility 16 per cent., and Convulsions 3 per cent. Possibly, It would be fairer if these figures were given as a ratio of the deaths from these causes to the births registered in the two areas. The mortality from these causes would be as follows:— Selected area. Rest of District. Prematurity 18 per 1,000 births. 14 per 1.00a births. Congenital Debility 6 per 1,000 births. 15 per 1,000 births. Convulsions 2.4 per 1,000 births. 3 per 1,000 births. |
89c17d2c-ccd5-4854-b5dd-c677047e863d | It is admited, of course, that the number is too small to draw any definite conclusion, but they may be useful in any future investigation upon the infantile mortality. To supplement the above, inquiries were also made as to the occupation of the mother where a child had died from these causes. Thirty deaths were inquired into; of these, in 20 instances the mother was not engaged in any occupation except house work, and in 10 the mother had to leave her house during the day for the 44 pose either to support herself and family or to supplement the earnings of her husband. Seven were employed as laundresses, but in 6 instances the mothers had not been to work for some time prior to her confinement. This period of rest varied from a month to six weeks. Two mothers were employed as charwomen and one as a waitress and the three had continued to work up to within a few days of their confinement. |
64024d9f-3f3d-452b-be44-df7c9e5c801b | These figures cannot be regarded as conclusive evidence of the effect upon the infantile mortality, of employment in a particular industry during pregnancy, as sufficient data are not to hand. Not only the extent of such labour should be ascertained, but the conditions which obtain in the different industries. It would not be feasible to place the same restrictions upon an industry where the work is light and married female labour is limited to 4 or 5 days a week, as upon some of the factories in the Midlands and North of England. DIARRHCEAL DISEASES. The number of deaths from Diarrhoea was 80, which is equal to a rate of 1.5 per 1,000 living. Sixteen deaths were registered as due to Enteritis or Gastritis. |
026116ba-7d6e-4d98-8c8a-2c673e722633 | Since 1900, when the Royal College of Physicians recommended the adoption of the term "Epidemis Enteritis" as a synonym for Epidemic Diarrhoea, and the disuse in medical certificates of death of such terms as Gastro-enteritis, Muco-enteritis, and Gastric Catarrh, the number registered as due to Diarrhœa has increased, whilst the deaths from Gastro-enteritis has apparently diminished. It would be useless, if a comparison be made, extending over a period of years, to limit it to deaths from Diarrhoea, as a number of deaths formerly registered as due to Gastro-enteritis would now be certified as Diarrhoea. The deaths from Diarrhœal diseases in 1906 numbered 96, and of these 80 were under 1 year. As far back as 1887, Dr. Ballard included Diarrhœa among the principal zymotic diseases, but the specific organism has not with certainty been isolated. |
90e65f75-c35f-4691-a9d3-ddaa40f815c0 | The vital manifestations of the organism are 45 in some way closely associated with season. Over 90 per cent, of the deaths occur during the months of July-October. There is a large increase in the number of deaths compared with 1905, and whatever views may be held as to the causation of Diarrhœal diseases, there can be no doubt as to the beneficial influence of an excessive rainfall. The total amount of yearly rainfall bears no direct relation to the mortality; most of the deaths occur during the months of July-October, and the factors entering into their causation would operate most potently during these four months. 1 ne prevalence of Diarrhoea is more closely related to the number of days upon which rain falls than to the actual amount of rainfall; it varies almost inversely with the number of rainy days. Though this ratio does not work out with mathematical accuracy, it is sufficiently close to warrant the assumption that the relation is one of cause and effect. |
651bbef9-7280-4bf8-a2b8-5601f4126615 | The factor may be beyond the control of a sanitary authority, and probably few would be daring enough to wish for a wet holiday season, but the manner in which it operates should teach us something in the prevention of Diarrhœa. The diminished prevalence is probably not due to the purifying action of rain on the atmosphere, as in such circumstances the amount of rainfall would be the determining influence, though it is well known that a heavy shower in summer has a cleansing effect on the air. It is fortunate that such is not the mode of action, as nature could not be imitated in this respect. It is now generally held that the prevalence of Diarrhoea is dependent on the state of the soil. It is probable that the micro-organism has its habitat in the superficial layers of the soil, where, in the form of decaying animal matter, it has its pabulum and manufactures its poison. |
2f037bdf-a495-4078-bbeb-2cbfcbc8f373 | Though the theory that the maximum mortality from Diarrhoea coincides with the temperature of the earth at different depths is now doubted, very few doubt the intimate association of the disease and conditions of the soil. If we consider the state of the streets and backyards, the influence of rainy weather is explained. Organic matter is constantly being deposited on the streets; in dry weather this becomes pulverised and carried in the form of dust into the houses. Rain maintains in a condition of moisture collections of dust and refuse, which, in a dry state, would be carried by the wind or other agencies, and deposited in food, more especially in milk. To prevent dust, the surface of the street must be kept 46 clean, but in dry weather, unless the road watering be unstinted, more harm than good will accrue from scavenging, as the dust finds its way into the dwellings. The sweeping should take place while the surface is moist. |
b6bc6db9-b8ac-4b58-ab98-608d3f3543b1 | A more potent factor, probably, is the state of the yards at the rear of the dwellings. Though there is no excuse for the accumulation of refuse around houses, it is surprising how often this nuisance occurs. The air space around the smaller houses is sufficiently limited, but the Inspectors constantly have to draw attention to all kinds of deposits which are allowed to accumulate. It must be admitted, though, that the fault does not always lay with the householder. The backyards of some of the older premises are insufficiently and improperly paved, and however careful one may be, it is almost impossible to prevent the impregnation of the soil with organic matter unless a portion of the backyard be imperviously paved. The work of enforcing the bye-laws as to paving of backyards and open spaces is gradually and continuously carried out. and it is hoped that very soon every house will conform with the enactment. These considerations do not fully explain the coincidence between earth temperature and the incidence of Diarrhœa. |
6cb8be70-2e3d-4eb3-b291-aec037306a75 | High earth temperature means a previous high air temperature, and high air temperature means an enhanced rate of multiplication of the microbes present in milk, together with the formation of dust, which may play a considerable part in the contamination and infection of the food. But a high air temperature commenced towards the latter part of June, 1906, and continued in an intense form throughout July, but the deaths from Diarrhœa did not start until August. During July there was no death from Diarrhœal diseases. Dr. Nash has pointed out that the diarrhoea curve closely follows the life-history of the common house-fly, and he suggests that they art largely responsible for the infection of food, which is the ultimate cause ot the disease. He suggests that if, instead of Ballard's microorganism. we merely say an organism whose manifestations are dependent upon conditions of season, we shall be nearer the truth; and he suggests that this organism is the common house-fly. |
dbe7d393-9d56-4c22-8358-449d177462ac | which, beginning to make its appearance in June, becomes a veritable pest during July and the early part of August; after that its existence tends 47 to become a mere sexual one. and it decreases in number. " This creature is often termed the harmless fly. I ccrtainly give it the first place as a pathogenic agent during the summer months. It is a useful scavenger if kept in its place, but when allowed to fly straight from the dung or refuse heap to commit suicide in the milk bowl, or alight on the lips of a sleeping infant, or walk over meat and other articles of food on the table, I repeat that I consider it the most active pathogenic agent during the summer, and the principal causes of summer Diarrhœa." Dr. Fraser, of Portsmouth, in his Annual Report, also associated an epidemic of Diarrhoea with accumulations of refuse and the usual litter of rubbish associated with the making of bricks in the town. |
26acd459-6d92-437b-873d-53b0277f7c77 | The heat of the refuse and the brickmaking had afforded a breeding ground for millions of flies, that had been passing backwards and forwards from the refuse to the houses, and he attributed the epidemic in a certain district of Portsmouth entirely to the infection of the food in the houses by these insects. This particular epidemic occurred during a period when there had been no deficiency of rain, nor had the heat been excessive. The families that suffered were by no means of the lowest classes, being composed of respectable working and middle classes; their houses were new, clean, and, as a rule, well kept. Curiously, in Acton, the district in the vicinity of the refuse tip and the brick works was the area least affected by Diarrhœa. On page 68 is given a list of the streets, together with the. number of deaths caused by Diarrhœa in these streets. |
f5d7d185-0110-46ea-a764-02e250c8e55e | The figures are admittedly limited, but it does seem curious that so few deaths occurred from Diarrhœal diseases to the north of the Great Western Railway, as undoubtedly this constitutes the fly-infected area of the district. It was stated that the article of food most frequently contaminated is milk. That this is so is suggested by the age incidence of the fatal cases. The following table gives the ages at death:— Under 1 month. 1-2 months. 2-3 months. 3-4 months. 4-5 months. 2 9 10 11 10 5-6 months. 6-7 months. 7-8 months. 8-9 months. 9-10 months. 9 6 4 7 5 10-11 months. 11-12 months. Total under 12 months. 5 1 78 1-2 years. 5-15 years. Over 65 years. |
035ebce7-c291-493e-89f4-c3fb09b662e3 | 11 1 1 48 The comparative immunity of children under 1 month is explained by the fact that in this district the mothers usually suckle the children for about 4 or 6 weeks, and an overwhelming majority of the cases of infantile diarrhoea occur in artificially fed children. All authorities are agreed as to the enormous advantages which infants who have been fed on their mother's milk possess over those who depend on an artificial nourishment. No food, however scientifically prepared and carefully administered, can efficiently take the place of the child's natural sustenance. Nothing replaces human milk in its nutritious qualities for the infant. Most artificial foods are but poor substances for the natural food, unless prepared with the utmost care. The artificial foods, inj a large number of instances, set up digestive disturbances, which render the infant liable to attacks from the bacteria that happen to be present in the food. Not only is the artificially-fed infant more susceptible to attack, but the risk of infection is greater. |
e98d9b61-fe1f-4add-b4ff-6398d99fbfee | Breast milk is comparatively sterile, and it passes direct from the mother to the child, without any intermediate state of transit during which infection may take place. But with artificial feeding infection may lurk in the milk, in the vessels in which it is carried, and in the bottle. Of 75 deaths from Diarrhœal diseases into which inquiries were made, 72 were artificially fed. and only one wholly breast fed, one family had left, and in one the information was refused. It is impossible to give statistics as to the percentage of breastfed to artificially-fed children in the district. It was stated above that a large number is suckled for 4 or 6 weeks, sometimes for a longer period. The numbers given when birth inquiries are made would, therefore, be entirely unreliable. An attempt was made during the year to ascertain the proportion of children amongst the artisan class brought up entirely on the breast for a period of six months after birth, but the obstacles were so great that the work was abandoned. |
e3ed464c-b80c-4ea5-b77f-a8614a00b446 | In this district where a large number of married women are employed in the laundry industry the percentage of breast fed children is small. 49 Of the 72 deaths amongst hand-fed children, 29 of the mothers were employed in some industry which entailed leaving the house and placing the infant under the care of some other person. To what extent can artificial feeding be obviated? Can some means be devised whereby the mothers who are employed in some industries may partially suckle their children? In the past we have endeavoured to instruct the mothers by means of leaflets on the feeding of infants. A selection is made of the birth returns, and the most suitable ones are visited by the Health Visitor, and the following leaflet is left at the house:— URBAN DISTRICT OF ACTON. Feeding and Care of Infants. If possible, Suckle the Child for 7 to 10 months, and wait for cool weather before weaning. |
d18623bd-3272-45e8-8fc8-1c896e9c2fa9 | Do not wean the child because there is not enough milk, but give cow's milk and barley water as well. Feed at regular intervals; never between times. The child may be thirsty, especially in the summer, and water may stop its crying. Wean gradually; after weaning it may have bread and milk and once a day broth or beef tea, a lightly boiled egg, or light milk puddings, but milk should be its principal food up to the age of 18 months. Keep the baby warm; clothing should be of flannel or woollen material, and fairly loose in fit. Use stockings, not socks. Sponge the child all over every morning, and dry it well. Change wet napkins as soon as possible. Give the baby plenty of fresh air. and take him out whenever the weather is fine; keep the windows open. Infants must sleep alone in a cot and not with the parents. 50 ARTIFICIAL FEEDING. |
963141d8-1873-4c54-93c9-366a97615932 | When the baby cannot be suckled, up to the age of 9 months give him nothing but milk and water, or milk and barley-water, sweetened with a little sugar. For the first month feed every two hours. Gradually lengthen the intervals of feeding so that at the end of 3 months the baby is fed every 3 hours. The following proportions are usually required at the different ages:— Age. Quantity at each meal. 1-6 weeks, 1-oz. of milk and 2-ozs. barley-water. 6-12 weeks. Equal parts of milk and barley-water, about 3-azs. of each. 3-6 months. 4-ozs. of milk and 2-ozs. barley-water. 6-9 months. Pure milk may be given, about 6-ozs. at each feed. Boil the milk before using, especially in the summer. |
99554729-cfb4-4f80-b496-c04f4e8c7bdb | Do not again use the milk that remains after the child has finished. Keep two bottles, and use alternately; after using, wash with hot water and a little soda. Rinse out several times, and keep in cold water until again required. NEVER USE Bottle with rubber tubing. The boat shaped bottle is the best. Dummy teats or comforters. Skimmed milk, always use fresh milk. Teething powders, soothing syrups, gin and other spirits, except by doctor's orders. D. J. THOMAS. Medical Officer of Health. Recipe for Barley-Water.—Put two teaspoonfuls of pearl barley in a saucepan with one pint of cold water. Boil gently for two hours, and strain through muslin. 51 The issue of the above leaflets is justified by the experience which we have gained in our inquiries into these Diarrhœal deaths. |
8c7eec4a-710e-4431-a609-e8f4f29760b7 | As stated in a preceding paragraph, the necessity to emphasize the importance of suckling the child is shown by the fact that only one wholly breast-fed infant died. In 44 instances the mother was not employed in any occupation but housework, and it may be taken for granted that only a small number was compelled to wean the child prematurely for physical reasons. If inability to suckle had been the cause of weaning, one would expect to find some instances where th? child had been partly on the breast and partly on the bottle. The advice to use cow's milk was not generally followed. Thirtyfour were fed on cow's milk, 31 on condensed milk, and 10 on various proprietary foods. The only possible point in favour of the use of condensed milk is that it is rendered sterile in its process of manufacture; but in the majority of the houses where it is used that advantage is destroyed within a few hours of the opening of the tin. In one respect one has to report a great advance. |
753460ce-dadd-4104-8bf4-215d3b28deb6 | The bottle with the rubber tubing is steadily going out of fashion. Thirty-four boat-shaped bottles were in use and 16 bottles with rubber tubing. Nothing can be more objectionable than the latter. It is impossible to keep it clean. The milk and the warm water decompose the rubber, and the exposed rubber becomes a place of deposit for filth. In Infantile Diarrhœa, the most important factor undoubtedly is improper feeding, but it must not be inferred that the whole problem ends with the conditions that obtain within the house of the consumer. The whole question of the milk supply is intimately bound up with the prevention of Summer Diarrhœa. Prior to its delivery to the consumer, the milk may become contaminated at the farm, and during its distribution, and the practical question is, what could be done to secure a milk supply pure enough to be used with safety for infants who are artificially fed? In Acton, the conditions have materially changed within recent years. |
e2b6ab17-bd1e-470e-a77c-88bbe76867d0 | Twenty years ago most of the milk was, produced within the district or in the immediate neighbourhood. At the present time only 52 three retailers keep their own cows. There are altogether 71 purveyors of milk registered, and 68 of them obtain their milk from outside sources. We have to depend upon a supply which is not capable of supervision by our own officials. Apart from this aspect of the question, the difficulty of transport from the farms also arises. It is well known that warm transit means impure decomposing milk. The railway companies do not provide different vehicles for the summer from those used in the winter, and none provide refrigerating vans for milk in this country. These and similar considerations have acted as stimuli in the establishment of Municipal Milk Depots in different parts of the country. At the recent conference on Infantile Mortality., this question was dealt with by flr. McCleary, who gave particulars of the work done at Battersea. |
66a7fd22-1b19-46b9-afbf-d0b608d8669b | Most speakers praised the work done by these depots, but it was admitted that they dealt with a symptom and not with the cause. Some were inclined to believe that our efforts should be aimed at obtaining a pure milk supply, and thus obviate the necessity of pasteurizing and such treatment of the milk. A much stricter supervision of the milk supply is necessary, especially in rural districts, where the conditions under which it is produced leave much to be desired. One word of explanation is necessary as to the objects of these •depots. The argument has been used that their establishment tends to diminish the number of mothers who suckle their babies. The work of a milk depot should not be looked upon as limited to the handing of bottled, modified and more or less sterlized milk over a municipal counter. It is claimed that the milk depot may be made even to promote breast feeding among mothers. |
249bddb8-53c5-4a2e-b89d-8a4336c164b2 | At Battersea, the milk was not supplied for ah infant under 9 months old, unless the mother could produce a written recommendation from a doctor that she was unable to suckle her child. The same objection has been raised to the establishment of Municipal Creches. It has been said that it would discourage breast feeding. It will be remembered that a clause was proposed in the Acton Improvement Act empowering the Council to establish and 53 maintain one or more creches. The Parliamentary Committee, though professing sympathy with the object, refused the application. Under the industrial conditions which prevail in the district, the refusal seems to have been prejudicial to the interests of the Public Health. We are not at present concerned with the economical aspect of Married Female Labour; the effects of such labour are dealt with in another paragraph. |
f09191ef-68f9-4e43-ab02-1f69169963b1 | It was pointed out by Councillor Hunt, Chairman of the Public Health Committee, in a paper read at the Congress of the Royal Institute of Public Health, that "there are in Acton some 450 laundries, employing 4,500 females. No less than 23 per cent, of them arc married women and widows, of whom a large proportion have young families. These young families are often farmed out—or placed out—at rates varying from fourpence to eightpence per head per day. The persons who take charge of these children are generally aged people living in squalor, too often heavy spirit-drinkers, and quite unfit to take charge of infants. Sometimes one old woman will have the care of as many as seven or eight children in one dirty little unventilated room. The children are left very much to chance; they have no regular or proper feeding; the bottles are not kept clean, nor is the food wholesome. |
19b4520c-48c4-4550-a2eb-7799ed749e8c | To try and persuade the baby-minders to be attentive and cleanly is labour in vain." In a report by the London County Council, the advantages connected with creches were shortly summarized as follows :— The creche is usually healthier and cleaner than the child's home, the treatment is more enlightened, and the method of feeding better adapted to the child's tender yars. Every creche can show children who have come there miserably anaemic and suffering from rickets, whose health has visibly improved after some weeks of the creches' treatment. Where no creche exists, the mother who is obliged to go out to work for her living, is compelled either to leave the child during the day where it cannot be properly cared for, or to place it out to nurse in either case at a cost in excess of her means. At the creche the child is taught cleanliness and good habits, becomes stronger and healthier, and is given a better chance in life. |
86912132-0443-4cd1-b3db-efc018bb62b1 | 54 Many creches state that when the children are old enough to go to school, it is possible tc distinguish them from the other children, not only because they are healthier looking, but because they are better behaved, have better manners, and are more obedient. Creches are under medical supervision, and the promptitude with which a case of sickness is treated often prevents more, serious consequences. The mother is required to bring the child clean; better methods of feeding are learnt; and the cleanliness and discipline of the creche insensibly react to the advantage of the home. A misapprehension seems to exist in the minds of some of the opponents as to the nature of a creche. It is assumed that all municipal creches must be of the same pattern and managed in an uniform manner. The establishment of a large creche, which would entail the segregation of a large number of infants, would be a mistake. |
3e1024d8-5bba-4e73-b2a4-cf2827dc2053 | It would expose the children to the risks of infectious disease, as well as depriving the majority of them of their mothers' milk. These results need not follow if the creches are small and if possible numerous. The creches would then be conveniently situated, and the mothers encouraged to attend twice a day or oftener to suckle their infants. A creche has been started in the neighbouring district of Hammersmith through the agency of philanthropic persons. Possibly, some liberal-minded philanthropists may be induced to try the experiment in South Acton. The French, who are the pioneers in this movement, consider that the ideal creche should be conducted by a private body and inspected and partly supported by the municipality. This plan ensures personal interest and proper public supervision and control. Such a creche might also be made an educational centre. |
2556a0a1-25e4-443b-95bb-2ccc5539d4a9 | The Inter-Departmental Committee on Physical Deterioration recommended that wherever it was thought desirable, owing to the employment of married women in factories, or for other reasons, to establish municipal creches, girls over fourteen might be made to attend occasionally, and the teaching of infant management to such girls should be eligible for aid from the grant for public education. 55 CANCER. Forty-four deaths occurred from Cancer or Malignant Disease. The Ward Distribution was as follows:— North-East Ward 13 North-West Ward 10 South-East Ward 8 South-West Ward 13 It is impossible to state accurately the relative prevalence of the disease in the different wards unless we know the age distribution of the population in each ward. Car;er is essentially a disease of advanced years, or, at any rate, of late middle age; 13 of the deaths occurred amongst people under 50 years of age and 30 in those over 50. |
e5f21dc9-9177-436b-92f6-3218b40a7859 | It has been said that the disease is more prevalent in low-lying districts; the distribution of the disease in Acton lends no colour to that theory. It is undoubtedly true that Cancer is on the increase throughout the kingdom. A comparison with past years cannot be made for Acton, as the returns from outside institutions are not available before 1905, and in 1906, 12 out of the 44 deaths occurred outside the district. Seventeen of the deaths were in males and 27 in females. The preponderance of females is entirely due to the number of deaths from Cancer of the Reproductive Organs. In 6 instances the Uterus was affected, in 1 the Ovaries and in 4 the Breast, all in females. It is significant that the greatest increase in recent years has been due to the large number of deaths from Cancer of the Alimentary canal. There were in Acton last year 16 deaths from Cancer of the Stomach and Bowels. |
91b078a5-40d9-4420-b460-137fecc466be | It is probable that some of these deaths in former years would not have been correctly diagnosed, and the apparent increase may have been partly due to improved methods of diagnosis. According to all experience, this does not entirely explain the relative frequency with which the digestive organs are attacked. Cancer of the Alimentary canal is now of more frequent occurrence than formerly. 56 The seat of the disease in the others was as follows:— Tongue 3. Lower Jaw 2 Bladder 2 Face, Foot, Femur, Omentum, Retro-peritoneum, Kidney, Gall Bladder, Mediastinum, 1 each. In two instances the seat of the disease was not mentioned. INQUESTS. |
665548b3-0bac-4541-b530-8f41f75b5b99 | Thirty-two deaths were certified by the Coroner, the cause of death being :—• Suicide 4 Fall from bicycle 1 Overlaying 4 Injury to throat 1 Gas Poisoning 2 Want of attention at birth 1 Fall from a train 2 Syncope 8 Run over by a cart 2 Diphtheria 1 Run over by a motor car 1 Convulsions 1 Run over by a train 1 Laryngitis 1 Fall in street 1 Strangulated Hernia 1 MORTUARY. Thirty-three bodies were removed to the Mortuary, and 15 postmortem examinations were made. With one exception, all the bodies deposited in the Mortuary were the subject of a Coroner's inquiry. The body upon which an inquest was not held was removed from a house in Hooper's Mews last August on account of decomposition. ISOLATION" HOSPITAL. |
35a85ab0-bac8-4dc3-b30c-613a9ac48fea | An account of the Council's Isolation Hospital at Friars Place was given in last year's report, and the most important improvement to note is the installation of an apparatus to heat the pavilions by means of hot water. It was reported that the heating was not entirely satisfactory; tenders were invited, and the work was carried out by Messrs. Haden. During the year 197 patients were admitted. On January 1st, 1906, there were 10 patients remaining under treatment, and on January 1st, 1907, 19. During the year 180 patients were discharged and 8 died. 57 Diphtheria. Thirty-seven cases of Diphtheria were admitted; 34 of these were from Acton, and 3 from outside districts. The only death from Diphtheria was of a child admitted from Hendon. In 3 instances a mistake in diagnosis was probably made; at any rate, the results of a bacteriological examination proved negative. |
9efe7af4-9c85-4d43-b451-fb9571ccab76 | Thirty-four cases of true Diphtheria were therefore treated in the Hospital with 1 death, or a fatality of 3 per cent. Scarlet Fever. 152 cases of Scarlet Fever were admitted—150 from Acton, I from Slough and I from Hendon. Six deaths occurred. Three "return" cases were admitted. The conditions under which these occurred have been detailed in a preceding paragraph of the report. The percentage of " return " case^is not high compared with other districts, but when the conditions under which the patients sometimes have to be discharged are considered, the results are very gratifying. There is no discharge block at the Hospital. When possible the observation block is used as a discharge block, and the patients are quarantined there for a few days prior to discharge. The difficulty arises when for some reason the observation block is not available, and the " return " cases occurred when more than two diseases were being isolated at the Hospital. |
1eef1950-7007-4474-8cd6-e55e30767ab1 | In such circumstances, the patients have to be discharged directly from the wards, and as the pavilions have no separation wards, there is no possibility of keeping the acute and convalescent patients apart. Enteric Fever. Five cases of Enteric Fever were admitted, and three deaths occurred. Erysipelas. One case of Erysipelas was admitted. Erysipelas is not usually isolated in the Hospital, but the circumstances of this case rendered it absolutely necessary that he should be nursed away from his house, and he was removed to the Hospital at the request of his medical attendant. 58 One other patient was admitted. She was admitted as a doubtful case of Enteric Fever, and succumbed. A post mortem examination was allowed, and the cause of death was Cirrhosis of the Liver. DAIRIES AND MILKSHOPS. |
f439222f-6d2d-4b7b-bddd-ecacfa606141 | There are 71 names of persons 011 the register, who carry on the trade of dairymen or purveyors of milk in the district, or an average of 1 milk store to every 732 persons. In London, this number varies from 1 store to every 205 persons in Stepney, to 1 to every 839 in Paddington. These figures seem to suggest that we compare favourably with neighbournig districts in respect to the conditions in which the milk is sold. Twenty-five of those registered are dairies or shops selling dairy produce only, and the other 46 are general shops selling milk in addition to a variety of articles, including, in some instances, soap, firewood, and other articles liable to create a dusty atmosphere. If 1 London the latter class constitutes about 80 per cent, of all the milk-selling premises compared with 65 per cent, in Acton. |
dff47236-2b1d-4e5c-a93f-aea0c04d745f | It is a very difficult matter to keep the milk clean in these general shops, but, unfortunately, there is no direct power conferred on local authorities of refusing to grant registration to unsuitable shops. Clause 6 of the Dairy Order of 1885 enacts that every local authority shall keep a correct register of all milk sellers and purveyors in their district, and they shall register every such person who applies. Under the regulations, the Council has power to insist upon certain conditions of cleanliness to be observed. In most instances the counterpan is covered with muslin, and this prevents the grosser forms of contamination. Our power of control over the milk supply is limited bv the fact that most of the milk consumed in the district comes from outside sources. Of the 71 persons registered, 3 only are cowkeepers, and this constitutes a need not for more legislation, but for a more direct and uniform enforcement of the legislation which now exists. COMMON LODGING HOUSES. |
e810c2e1-d993-4e9f-82b8-fdf926fae28b | There are two registered common lodging houses in the district, with accommodation for 150 lodgers. Under the Acton Improvement Act, 1904, the registration of a common lodging house or of the keeper of a common lodging house, shall operate for one year 59 only, and application for the renewal of such registration shall be made to the Council on or previous to the fifteenth day of May in each year. Application for the renewal of both was made last year and granted. OFFENSIVE TRADES. Three offensive trades were registered. One application was received during the year and granted. The premises are situated on the canal bank near WiUesden Junction, and are utilized for the manufacture of a chemical fertilizer. Owing to accidents to the machinery, complaints were received as to a nuisance, but recently no cause for complaint has arisen. The other two offensive trades are carried on in South Acton, and were established before 1875. |
b388f194-27f7-4fdd-a302-7184b428d27e | The premises are used for the purpose of fat extraction, and their construction leaves much to be desired. Notices have been served upon the occupiers, and proceedings are pending. SEWAGE DISPOSAL. The disposal of the sewage of the district is in a transition stage, and the works authorised in the Acton Sewage Act of 1905 are in hand. The development of the district rendered it absolutely necessary that arrangements should be made to deal with the increasing volume of sewage, as the treatment which it undergoes at present cannot be deemed adequate or efficient. Prior to 1855, the sewage of the district emptied untreated into the Thames, the rain water falling upon a small margin of the district along the western boundary drained into the Sutton Lane watercourse, which conveyed it through Chiswick into the Thames. Most of the houses existing in Acton in 1855 drained into the Stamfcrd Brook, which coursed through Acton, Fulham and Hammersmith and emptied into the Thames at the latter place. |
aadcf48c-e4b6-43c2-a1bf-6f2ce400c0bd | Under the Metropolitan Management Act of 1855, the Stamford Brook sewer, together with other sewers, was vested in the Metropolitan Board of Works. The latter body diverted the Stamford Brook from the Thames and connected it with the sewers of the Metropolitan Main 60 Drainage System, thereby causing the sewage and drainage of Acton to flow into the Metropolitan system of sewers. No difficulty arose until the district developed towards the late seventies, but in 1882 an injunction was obtained to prevent the district of Acton from sending any further soil water into the Stamford Brook. The population of the district at that time was estimated at 18,000 inhabitants. In consequence of the injunction, a provisional order was obtained, which authorised the Local Board of Health to acquire landsand to construct and maintain thereon works for the purification and disposal of the sewage and drainage coming from part of the parish. These works, when they were opened, provided for the treatment of the sewage by the International Sewage Purification Company's process. |
be69ff1c-971a-4636-9806-34b79d824243 | The sewage was precipitated in tanks by ferrozone, and wasfiltered through a polarite filter. These tanks—3 in number—had a capacity of about 500,000 gallons. Subsequently the works were altered, and the tanks were utilised as septic tanks, in which the sewage was first treated. It was then distributed over coke breeze filters, and the effluent discharged into the Thames. For a time,, this system answered well, and produced good results, but as the district developed, the amount of sewage passing through the tank and filters increased, and the results became less satisfactory. The Council was unable to enlarge the tanks or the filters, but under the Act of 1905, power was obtained to send the whole of the soil sewage into London, and to discharge the storm overflow water into the Thames. The contractors at the present time are engaged in altering the works and constructing a large storm water sewer through Acton and Chiswick into the Thomas. |
c53695d4-20d6-420e-af22-6cdbe682f265 | The works are under the direction of Sir Alexander Binnie, and will probably be completed in about a year's time. REFUSE DISPOSAL. A small amount of refuse is taken daily to the Brentford Destructor, where it is burnt, but the larger portion is deposited on land to the north of the Great Western Railway, near the cemetery, This land has been used for this purpose for many years, and a more ungainly heap does not exist in the parish. Throughout last summer the houses within a radius of half-a-mile were pestered with flies generated partly on this refuse heap. Refuse accumulations in this 61 way not only create inconveniences, but sometimes, possibly, are capable of infecting neighbouring houses. It is impossible even to mitigate the evil by the use of disinfecting and deodorizing substances; it has been found in other places that they constitute but a very slight palliative, the cost of which would not be justified by the results obtained. |
e3129375-7bf6-49da-863c-0b5744646c45 | Moreover, the methods employed to disinfect the refuse are most difficult of application. The Council is fully aware of the utter unsuitability of the site for tipping purposes, and the question of a refuse Destructor has been discussed for many years. It was originally intended to erect a Destructor on the Friar's estate, purchased by the Council. The consent of the vendors was refused, and a site selected in Southfield Road. The consent of the Local Government Board to erect a •destructor on the latter site was withheld. Finally, the Council purchased a site adjoining "The Friars," and a Committee of the Council is now making arrangements for the erection of the Destructor. The consent of the Local Government Board has been obtained, and it is hoped that an advance will now be made, and the practice now carried out will soon be abandoned. The amount of refuse to be disposed of yearly exceeds 12,000 tons. 62 Table 1. |
3d6cdb69-9866-4c33-8b60-7ea867ddb1f1 | VITAL STATISTICS OF WHOLE DISTRICT DURING 1906, AND PREVIOUS YEARS. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deatns in Public Institutions in the District. Deaths of Non-residents registered in Public Institutions in District. Deaths of Residents registered in Public Institutions beyond District Nett Deaths at all Ages belonging to the District. No. Kate * Under 1 Year of Age. At all Ages. No. Rate per 1,000 Births registered. No. Rate* No. Rate* 1 2 3 4 5 6 7 8 9 10 11 12 13 1896 30,564 894 29.2 151 170 435 14.2 . . 29 464 15.1 1897 31,952 973 30.4 193 198 470 14.7 . |
51683b26-0faa-4af1-91c6-d0450968df23 | . . . . 1898 33,404 995 29.8 181 182 507 15.2 . . . . . 1899 34,901 1,068 30.6 200 187 509 14.6 . . . . . 1900 36,508 1,080 29.5 182 168 528 14.4 15 . . . . 1901 38,373 1,211 31.5 206 170 519 13.5 6 . . . . 1902 41.000 1,242 30.3 186 150 593 14.4 12 . . . . 1903 43,802 1,422 32.4 150 105 430 9.8 8 . . . . 1904 46,780 1,450 30 207 143 576 12.3 9 . . . . |
49a40496-0cb8-4884-abe8-2e4a589eb57d | 1905 50,000 1,527 305 162 106 537 10.7 27 1 92 628 12.5 Averages for yrs 1896-1905 387,284 11,862 30.6 1,818 153 5,104 132 . . . . . 1906 52,000 1,533 29.4 193 125 597 11.5 29 7 97 687 13.2 * Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Total population at all ages at Census of 1901, 37,744. Number of unhabited houses at Census of 1901, 6,114. Average number of persons per house at Census of 1901, 6.1. Area of District in acres (exclusive of area covered by water) 2.304. |
8e48fef8-b2e8-4e09-8cab-2e6c2f7dcbd4 | Union Infirmary, not in District. Outside Institutions, see body of report. 63 Table 2. VITAL STATISTICS OF SEPARATE LOCALITIES IN 1906. ACTON. Population estimated to middle of year 52,000 Births registered 1,533 Deaths at all ages 687 Deaths under 1 year 201 North East Ward. Population estimated to middle of year 13,000 Births registered 325 Deaths at all ages 137 Deaths under 1 year 32 North West Ward. Population estimated to middle of year 11,000 Births registered 229 Deaths at all ages 135 Deaths under 1 year 34 South East Ward. Population estimated to middle of year 11,000 Births registered 255 Deaths at all Ages 122 Deaths under 1 year 28 South West Ward. Population estimated to middle of year 17,000 Births registered 724 Deaths at all ages 293 Deaths under 1 year 107 64 Table 3. |
c7518436-855a-4923-b92b-5186afda711e | CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1906. NOTIFIABLE DISEASE. Cases notified in whole District. Total Cases notified in each locality. Number of Cases removed to Hospital from each locality. At all Ages. At Ages—Years. North-East. North-West. South-East. South-West. North-East. North-West. South-East. South-West. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox . . . . . . . . . . . . . . . Cholera . . . . . . . . . . . . . . . Diphtheria 46 . 11 23 5 7 . 15 5 15 11 1.3 3 9 9 Membranous Croup . . • • • • • • . |
ce5985bc-d425-44c8-97b7-70e95ace9554 | . Erysipelas . 35 2 8 2 19 7 3 12 13 1 Scarlet Fever 170 40 1C7 17 5 62 29 37 42 61 25 26 38 Typhus Fever . . . . . Enteric Fever 12 . . 3 3 5 . 1 3 5 3 . 2 1 3 Relapsing Fever . . . . . . . . . . . . . . . Continued Fever 1 . . . . 1 . . . . 1 . . . . Puerperal Fever 3 . . . . 3 . 1 . 1 1 . . . . Plague . . . . . . . . . . . . . . . Chicken Pox 3 . 2 1 . .• . 1 . . 2 . . . . Phthisis 6 1 . . 3 2 . |
c53e75e6-cd61-443c-ab85-a7d7837178e8 | 3 1 2 . . . . . Totals 276 2 55 142 30 42 5 90 41 72 73 74 30 37 50 65 Table 4. CAUSES OF, AND AGES AT, DEATH DURING YEAR 1906. Causes of Death. Deaths at the Subjoined Ages of " Residents," whether occurring in or beyond the District. Deaths at all Ages of "Residents" belonging to Localities, whether occurring in or beyond the Parish Total Deaths whether of " Residents" or "NonResi dents" in Publiclnstitutions in the District. All Ages Under 1 year. 1 and under 5 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. North-East Ward. North-West Ward. South-East Ward. South-West Ward. Small-pox . . . . . . . . . . . . |
15abff7c-09cc-4e17-aa80-db747861e1f3 | Measles 27 4 21 2 . . . 1 2 3 21 . Scarlet Fever 7 . 3 3 . 1 . . 1 4 2 6 Whooping-cough 5 3 2 . . . . 1 . 1 3 . Diphtheria and Membranous croup 2 . . 2 . . . 1 . 1 . 1 Croup . . . . . . . . . . . . Fever— Typhus . . . . . . . . . . . . Enteric 3 . 1 2 . . . . 2 . 1 3 Other continued . . . . . . . . . . . . Epidemic Influenza 6 . 2 . . 3 1 3 . . 3 . Cholera . . . . . . . . . . . . Plague . . . . . . . . . . . . |
a39ce5ba-8644-4758-a152-2f274323a2aa | Diarrhœa 80 70 9 . . . 1 10 15 16 45 . Enteritis 16 10 2 2 . 1 1 3 4 4 5 . Puerperal Fever 3 . . . . 3 . . . 1 2 . Eyrsipelas 1 . . 1 . . . . . . 1 . Other Septic Diseases 6 . . . . 5 1 1 2 . 3 l Phthisis (Pulmonary Tuberculosis) Other Tubercular 48 . 1 . 6 36 5 9 8 6 25 . Diseases 26 11 10 3 . 2 . 9 2 7 8 . Cancer, Malignant Disease 44 . . . . 28 16 13 10 8 13 2 Bronchitis 42 7 6 . |
15b5ea8e-d00c-4c0b-8f5d-f552b55c7ff1 | 1 9 19 7 6 7 22 1 Pneumonia 55 17 17 2 2 8 9 5 13 7 30 2 Pleurisy 2 . . . . 2 . 1 . 1 . . Other Diseases of Respiratory Organs 6 2 2 . . 1 1 1 1 1 3 1 Alcoholism— Cirrhosis of Liver 10 . . . . 8 2 3 3 3 1 1 Venereal Diseases 3 2 . . 1 . . . 1 1 1 . Premature Birth 25 25 . . . . . 4 6 2 13 . Diseases and Accidents of Parturition 4 . . . 2 2 . 1 1 . 2 . Heart Diseases 44 2 . |
835e3cdf-18c1-4407-b398-1f3ea9363e90 | 4 3 18 17 11 10 11 12 2 Accidents 15 4 1 1 1 6 2 3 6 . 6 3 Suicides 4 . . . . 4 . . 2 1 1 1 All other Causes 203 44 14 4 3 57 81 50 40 43 70 5 All Causes 687 201 91 26 19 194 156 137 135 12 2 293 29 66 67 Table 5. INFANTILE MORTALITY DURING THE YEAR 1906. Deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 week 1-2 weeks. 2-3 weeks. 3-4 weeks Total under 1 month. 1-2 months. 2-3 months. 3-4 months. |
b0337990-b911-4b5e-aa41-b271be2308d1 | 4-5 months. 5-6 months. 6-7 months. 7-8 months. 8-9 months. 9-10 months. 10-11 months. 11-12 months. Total Deaths under One Year. Common Infectious Diseases. |
eab123aa-6f47-482e-9a0e-89db2491a1c9 | Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 2 4 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria : Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 3 Diarrhœa, all forms ... ... ... 1 1 7 6 11 9 9 6 2 7 6 3 3 70 Diarrhœal Diseases. - Enteritis, Muco-enteritis. |
2446972e-a9c9-4b7e-af3a-c92b52d41e36 | Gastro-enteritis ... ... 1 ... 1 1 3 ... ... ... ... 1 ... ... 1 ... 7 Gastritis, Gastro- intestinal Catarrh ... ... ... ... ... 1 1 ... 1 ... ... ... ... ... ... ... 3 Premature Birth. 12 3 1 7 23 1 ... ... ... ... ... 1 ... ... ... ... 25 Congenital Defects 4 ... ... ... 4 ... 1 ... ... ... ... ... ... ... ... ... 5 Wasting Diseases. |
d2ffb8c6-c3e0-46d5-a941-72a40bd08979 | Injury at Birth 4 ... ... ... 4 ... ... ... ... ... ... ... ... ... ... ... 4 Want of Breast-milk, Starvation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atrophy, Debilitv, Marasmus 4 1 1 1 7 3 2 2 ... ... 1 ... ... 1 ... ... 16 Tuberculous Meningitis ... ... ... ... ... ... ... ... 1 ... ... 2 ... ... ... ... 3 Tuberculous Peritonitis: Tuberculous Diseases. Tabes Mesenterica . . . . . . . 2 . 1 1 1 . . . 1 6 Other Tuberculous Diseases . . . . . . 2 . . . . . . . . . 2 Ervsipelas . . . . . . . . . . . . . . . . . Syphilis . . . 1 1 . 1 . . . . . |
346d1855-8888-4526-889e-07c0fef29d47 | . . . . 2 Rickets . . . . . . . . . . . . . . . . . Meningitis (not Tuberculous) . . . . . . . 1 . . 1 1 . 1 . 1 5 Convulsions 1 2 1 . 4 . 1 . . . . . 1 . . . 6 Bronchitis . . . . . 2 1 . 1 . . 1 . . 1 . 7 Laryngitis . . . . . . . . . . . . . . 1 1 2 Pneumonia . 1 . . 1 . 1 1 1 . 1 1 4 3 l 3 17 Suffocation, overlaying 3 . . . 3 . . . . 1 . . . . . . 4 Other Causes . . 1 1 2 4 2 . 1 . . . . . . |
b809e154-83cb-4b7c-8e47-c60ae5955794 | 1 10 28 7 5 11 51 19 21 18 14 13 10 10 12 12 8 13 201 Population estimated to middle of 1906, 52,000. Deaths from all Causes at all Ages 687. Births in the year legitimate 1,494. legitimate infants 179. illegitimate 39. Deaths in the year of illegitimate infants 22. 68 TABLE VI. List of streets, together with the number of Diarrhœal deaths in those streets :— Osborne Road 6 Davis Road 1 The Steyne 6 Antrobus Road 1 Stirling Road 4 Southfield Road 1 Hanbury Road 4 Priory Road 1 Colville Road 4 Mansell Road 1 Bollo Lane 4 Beaconsfield Road 1 Bollo Bridge Road 3 Church Road 1 Somerset Road 3 Wolseley Road 1 Bridgman Road 2 Mill Hill Terrace1 Leythe Road |
b515cb2c-c43e-4641-9401-3fd17bc16965 | 2 Junction Road 1 Berrymead Gardens 2 Cock and Crown Yard 1 Packington Road 2 Winchester Street 1 Petersfield Road 2 Valetta Road 1 Brouncker Road 2 Wilcott Road 1 Rothschild Road 2 Florence Road 1 Church Path 2 Grove Road 1 Bolton Road 2 Neal's Cottages 1 Seymour Road 2 Brookfield Road 1 Beaumont Road 2 Birkbeck Grove 1 Acton Lane 2 Bayham Road 1 Chaucer Road 2 Alexandera Road 1 Shaftesbury Road 1 Alfred Road 1 Mills Row 1 Stanway Road 1 Strafford Road 1 Maldon Road 1 Berrymede Road 1 Birkbeck Avenue 1 Park Road East 1 Hereford Road 1 Mill Hill Road 1 York Road 1 The Parade 1 Victoria Road 1 Agnes Road 1 69 FACTORIES AND WORKSHOPS ACT, 1901. |
155436d9-ad15-467a-bd19-3cad151551fe | Section 132 of this Act reads :— "The Medical Officer of Health of every District Council shall, in his annual report to them, report specifically on the administration of this Act in workshops and workplaces, and he shall send a copy of his annual report or so much of it as deals with this subject to the Secretary of State." In the case of factories, the duties of a District Council are few. The Council is charged with the duty of seeing that every factory ir its district is provided with means of escape in case of fire. This duty is carried out by the Surveyor's department. The other duty in regard to factories is the enforcement of Section 22 of the Public Health Amendment Act, 1890. The inspection of factories comes within the province of H.M. Inspector of Factories. |
ff1c2974-4fba-4158-bd3f-b947851dc5cb | Where any sanitary defect is discovered by him in a factory, which is remediable under the law relating to public health, and not under the Factory and Workshop Act, he informs the Council of the defect, and it is the duty of the Council to arrange for the remedy of the defect. The Factory Inspector also notifies to the local authority any matter coming under his notice which should be attended to by the local authority. Ten such references from H.M. Inspector of Factories were received during the year; 3 related to want of separate sanitary accommodation for the sexes, I to insufficient sanitary accommodation, and I to a defective water closet. There was one reference to each of the following conditions :— Defective drainage of washhouse floor, Dirty roof of washhouse, Defective floor of washhouse, Excessive steam in washhouse, Unventilated gas-heater in workroom. LAUNDRIES. |
7f0f77a5-718a-4ad6-9b30-4f3612c839b6 | Laundries do not come within the definition of factory and workshop; but under section 103 of the Act, they are, as far as sanitation and means of escape from fire are concerned, to be treated as factories if mechanical power is used; if mechanical power is not used, as 70 shops. Certain laundries are excluded from the Act, such as laundries worked by inmates of a prison, reformatory school, religious institutions, or by members of the same family dwelling on the premises, and in which not more than two persons from outside assist the members of the family. The latter class of laundry is termed a domestic laundry, and where they exist, are a standing menace to the public health. They not only escape the attention ©f the Factory Inspector, but are also outside the cognisance of the local sanitary authority, and so go without supervision. |
79db7f1c-6c7f-48bf-958a-72e9e792de1f | The clean and dirty linen comes into close contact in the narrow passage and in other parts of the house, and there is every opportunity for infection to be conveyed from one article to the other. The actual washing is done in some small outbuilding reeking with steam and in an atmosphere loaded with all forms of impurity. Where the domestic laundry survives, there is no means of knowing where it exists. It is unregistered, and a list compiled to-day would be practically worthless in six months time; they spring up, change their abodes, or die out from month to month. The importance of keeping laundries under observation is recognised, but instead of noting where the real danger obviously lies, there has been a tendency to harass the already much regulated and inspected big laundry. In some districts the Medical Officer of Health is given power to require laundrymen to furnish him with lists of their customers. |
ffff2e13-6d38-4c5f-9772-f0e35bfcfebb | This is simply a source of exasperation to the wellconducted laundries, which are the only ones really affected, whilst the precaution is almost useless in the interests of public health. On several occasions it has been shown that although infection may reach a big laundry, when some of those who sort the foul linen may contract the disease, yet it never gets beyond the washhouse. The temperature in modern rotary washing machines is sufficiently high, and thorough treatment is carried on for a sufficiently long time to sterilize the linen. In a laundry properly planned and built for the purpose, the sorting room, where the foul linen is received, and the packing room, where it is put into hampers for delivery, are quite distinct. They are frequently separated by the whole length of the laundry, so that the risk of direct infection conveyed from the foul to the clean linen is practically non-existent. Fortunately, in Acton, there are not many domestic laundries, and practically all places where laundry work is carried on. |
8efd9a11-4dce-4191-8526-5e41c3092e1c | are under 71 supervision. There are 285 laundries registered as workshops, and 207 other houses registered as places where home work is being done. Possibly, the list of out-workers is not complete, but the danger of infection is not so great as in the case of domestic workshops. The risk only occurs when a case of infectious disease occurs in the house. There is no mixing of foul and clean linen, and infection cannot be spread in that way. All the linen has been sorted and washed before it arrives at the outworkers' premises, and the subsequent delivery is undertaken by the laundry proprietor. As a rule, only one cass of work is done by each outworker; for instance, blouses may be given out to one outworker, and dresses to another, but the articles are always washed at the laundry, and simply prepared and ironed by the outworker. WORKSHOPS AND WORKPLACES. The District Council has to keep a register of all workshops within its district. |
7fd95ab8-de7e-4271-9c58-00762ab3c4f5 | To assist the Council in keeping the register, the Factory Inspector forwards any notices of occupation of a workshop which may be sent to him. During the year 23 notices of occupation were received by the Council. At the end of the year there were 420 workshops on the register. A majority of these consisted of workshop laundries. As will be seen on the table at the end of the report, 37 defects were found on the premises, nearly half of which referred to want of cleanliness. There are 27 bakehouses on the register. 8 of which are underground. A special report was presented upon the condition of the underground bakehouses when the certificates were granted. Only one breach of the special sanitary requirements for bakehouses was found, and this consisted of a drain communicating directly with the bakehouse. HOMEWORK. |
34f95e08-9ef7-4391-8952-207028ce2657 | Section 107 of the Act prescribes that the occupier of every factory or workshop engaged in certain kinds of work—to be specified in an Order of the Home Office shall keep in a prescribed form and manner lists of the names and addresses of all persons directly employed by him outside the factory or workshop, and the places where 72 they are employed; and also that he shall send, on or before the 1st day of February and the 1st day of August in each year copies of those lists to the Council. The last Home Office Order placed the following classes of work in this category:— 1. Making, cleaning, washing, altering, ornamenting, finishing and repairing of wearing apparel and any work incidental thereto. 2. Making, ornamenting, mending, and finishing of lace and of lace curtains and nets. 3. Cabinet and furniture making and upholstery work. 4. Making of electro-plate. 5. Making of files. 6. Fur-pulling. |
30906a4c-5d2c-42d0-bd12-74aa32ee7fac | 7. Making of iron and steel cables and chains; making of steel anchors and grapnels. 8. Making of cart-gear, including swivels, rings, loops, gear buckles, mullin bits, hoops and attachments or all kinds. 9. Making of covers for, and the covering, finishing, altering or repairing of, umbrellas, sunshades, parasols, and articles of a similar character, and any work incidental thereto. 10. Making of paper bags and paper boxes. 11. Brush making. 12. Making of stuffed toys. Throughout the country there is a general complaint that lists are very irregularly sent in, and though Acton compares favourably with most similar districts, it is probable that our list of outworkers is an incomplete one. In October, a circular was received from the Home Office, in which the Secretary of State directed the attention of the Council to the enforcement of the provisions of the Factory Act, that dealt with the subject of homework. |
9aa1b9fe-b1d6-4d64-9112-06b5c1af368a | This circular was considered by the Health Committee in November, and the requirements of the latest Order on the subject were advertised in the local papers. Occupiers who had formerly sent in lists were also circularised, and the Health Visitor makes inquiries into the subject of homework in the course of her ordinary visits. The Council has done everything that is practically possible to obtain a complete and accurate list. 73 Altogether 153 lists were received; 136 of these were received from occupiers in the district, and 17 from other Councils. In 13 instances the place of employment was in another district, and the names and addresses were forwarded to the Council, in whose district the premises were situated. One hundred and forty of the lists referred to premises situated within the district, and these lists contained the addresses of 282 outworkers' premises. |
f981d094-acea-4942-afb0-1ecc4938adef | On the Table supplied by the Home Office will be found a list of the different kinds of homework carried on in the district, and it will be observed that 248 out of the 282 outworkers were engaged in the making, cleaning or washing of wearing apparel. In this class of work the Council may, if a case of infectious disease has occurred in a house where homework is done, prohibit an employer or contractor from giving out such work to any person living or working in the house during such time us the Council may fix. Four cases of Infectious Disease occurred in houses where home work was done, and although the Council made no order under Section no of the Act, the employers did not send work to the house until the patient had been removed to Hospital and the premises disinfected. In bringing this review of the year's work to a close, I beg to thank not only the other officials of the Health Department, but also of the ouier Departments, for their kindly assistance and co-operation. |
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