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Among other complaints of unsound food investigated by the Food Inspectors, were mould in sausages (4 cases); mould in cakes and pies (3 cases); dirty bread (8 cases); mouldy Jam; mould in a tin of beans; unsound meat (9 cases); maggots In biscuits (2 cases); a piece of rubber in a tin-of peaches found to be a small rubber gasket used at the cannery to make an air-tight seal on cans; a tin of peaches alleged to be the cause of food poisoning; hairs in a meat pie - these were, in fact, bristles from the animal from which the pie was manufactured; a foreign body in a bottle of milk, and a dirty bottle of milk the dirt was found to be on the outside and not the inside of the milk bottle; and ants in a Jar of marmalade. Where necessary the responsible manufacturers or retailers of the foodstuffs were either written to or were interviewed and their attention drawn to the complaints.

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The complainants were subsequently advised of the action taken. Where complaints of stale food are received the shop premises are visited, with the result that in many instances the remaining stock is withdrawn from sale. -45- UNSOUND POOD During the year more than 26,000 individual items of foodstuffs of all kinds weighing 52½ tons were condemned as unfit for human consumption. About 40 tons of this amount represents offal and carcase meat surrendered at the local slaughterhouse. Between May and July when beef from Uraguay was being imported, more than 700 quarters of this beef arrived at a cold store in the Borough. Large quantities of this meat were found on arrival to be mouldy, and subsequently when inspected it was found necessary to condemn more than two tons because of the severity of the mould. MEAT INSPECTION The decline of tuberculosis in cattle, calves, and pigs continues. It is significant that no whole carcases were condemned for this disease.

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However, 111 carcases of pigs, sheep, or calves were condemned because of their unsuitability for human food. Pneumonia in pigs, and parasitic infestations of various kinds were currently the most prevalent cause of condemnation. The overall picture was that animals being presented for slaughter were being received in much better condition than hitherto, and it was noticeable that there was much less bruising of carcases due to better handling during transit. The total number of animals slaughtered and inspected during the year at the Garland Road slaughterhouse was 63,409. Details are as follows:- -44- TABLE NO. 13 CARCASES & OFFAL INSPECTED AND CONDEMNED IN WHOLE OR IN PART, 1962 Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed and inspected.

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10,773 60 7,142 11,865 33,569 All diseases (except Tuberculosis and Cysticerci) - Whole carcases condemned - - 29 5 77 Carcases of which some part or organ was condemned 3,719 20 20 425 8,734 Percentage of the number inspected affected with disease other than Tuberculosis and Cysticerci 34.5 33.3 .68 3.6 26.2 Tuberculosis only - Whole carcases condemned - - - - - Carcases of which some part or organ was condemned 99 2 - - 333 Percentage of the number inspected affected with Tuberculosis .9 3.3 - - .2 Cysticercosis - Carcases of which some part or organ Was condemned and treated by refrigeration. 74 - - - - -45- CLEAN AIR SMOKE CONTROL AREAS Good progress was made in 1962 towards bringing the whole of the Borough under Smoke Control.

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Further Smoke Control Areas were declared, and at the end of 1962 there were 15 Areas in operation and a further four in various stages towards completion. The following Areas, details of which have been previously reported, are now in operation:- St. Mary's Middle Park (South West) St. Mary's No. 2. Clothworker's Wood. St. Mary's No. 3. Coldharbour Abbey Wood New Eltham Abbey Wood (Abbey Estate) Garrison North Abbey Wood No. 2. • Glyndon Abbey Wood No. 3. Horn Park. Middle Park (North East) The following four Areas were declared during the year:- St. Mary's No. 4 This Area is an extension of the existing St. Mary's Areas. It maintains the progress of smoke control in this part of the Borough concurrently with the Council's redevelopment scheme. The Area comprises eight acres and 191 properties.

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Virtually all the properties will be newly erected Borough Council dwellings, therefore no conversions will be necessary. Operative dates- 1st October, 1963. Glyndon No. 2 This Area incorporates the second phase of the Council's Redevelopment Scheme, together with adjacent London County Council redevelopment on the north side of the North Kent Railway line. It comprises 26 acres and will consist of approximately 180 newly erected Borough Council dwellings, 200 newly erected London County Council dwellings, and ten private dwellings. In the Borough Council and County Council dwellings no conversions will be necessary. Operative date:- 1st October, 1963. -46- Rockmount Area This Area adjoins the Abbey Wood No. 3 Smoke Control Area. It comprises that part of the London County Council Rockmount Road Redevelopment Scheme which is not already within the Abbey Wood No. 3 Area. It consists of some five acres and will contain 250 newly erected London County Council permanent dwellings.

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Operative date:- 1st October, 1963. Eltham Area This is a large Area of predominently private property. It comprises 1,550 acres and 5,325 dwellings. Of the total number of properties, 358 are Borough Council permanent dwellings, 763 are London County Council permanent dwellings, and the remainder are private dwellings. In the County Council dwellings and in the majority of the Borough Council dwellings, no works of conversion are necessary. Included in this Area are 423 shops, offices or other non-domestic buildings. Approximately 2,900 private dwellings require 4,320 solid fuel appliances, and a further 623 dwellings require gas ignition only. Operative date:- 1st October, 1964. NEW AREA During the year preliminary work commenced upon a further large area in Eltham, to be known as the Well Hall Smoke Control Area.

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It will comprise 540 acres, involving some 4,200 dwellings, virtually all of which are privately owned. It is estimated that some 3,000 dwellings will require works of conversion. It is anticipated that the operative date will be 1st October,, 1964. GENERAL At the end of the year there were 2,854 acres and 19,473 dwellings within operative Smoke Control Areas, and a further 1,589 acres and 6,159 dwellings within Areas being brought into operation. Details of the acreage and number of properties in these Areas are set out in Table No. 14 and the accompanying map. PROCEDURE As referred to in my previous Annual Report, the Minister of Housing and Local Government has adopted a simpler administrative procedure to enable authorities to obtain preliminary approval for new Smoke Control Areas. During the year the Minister issued a -47- TABLE NO. 14 - SMOKE CONTROL AREAS Ma? Ref. No.

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Name of Area Size (Acres) Premises Date of Declaration Order Confirmed Operative Date 1. St. Mary's 26 595 30.10.57 13. 3.58 1.10.58 2. Abbey Wood (Abbey Estate) 202 2,515 29. 1.58 8. 5.58 1.11.58 3. Abbey Wood 157 1,251 30.10.57 4. 7.58 1.10.59 4. Middle Park (North East) 163 1,122) \ 5. Middle Park (South West) 100 722 30.10.57 9.12.58 1.10.60 6. Abbey Wood No. 2 78 1,150 4. 9.59 15. 2.60 1.10.60 7.

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Clothworkers Wood 260 1,868 4. 9.59 15. 2.60 1.10.60 8. Coldharbour 350 2,806 22. 7.60 18.10.60 1.10.61 9. Abbey Wood No. 3. 580 1,973 22. 7.60 18.10.60 1.10.61 10. St. Mary's No. 2. 26 596 26.10.60 29. 3.61 1.10.61 11. St. Mary's No. 3. 12 Not yet constructed 26.10.60 18. 4.61 1.11.61 12. New Eltham 380 1,916 31. 5.61 22.11.61 1.10.62 13.

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Horn Park 454 2,359 31. 5.61 22.11.61 1.12.62 14. Garrison North 260 350 31. 5.61 7.11.61 1.10.62 15. Glyndon 6 250 1.11.61 1. 2.62 1.10.62 16. Eltham 1,550 5,325 4. 7.62 9.11.62 I.IO.63 17. St. Mary's No. 4. 8 191 24.10.62 - 1.10.63 18. Glyndon No. 2. 26 390 24.10.62 - 1.10.63 19.

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Rockmount 5 253 24.10.62 - 1.10.63 -48- further Circular on the simplification of administrative procedure concurrently with a request that local authorities review their progress in this field and report on their proposals for the period 1962-1966. The revised procedure enables the Council to dispense with the submission of detailed schedules of estimated and final costs so far as private property is concerned. This information continues to be required by the Minister in respect of local authority dwellings. With the advent of the new arrangements there were no staffing or financial difficulties to prevent acceleration of the Smoke Control Programme, and the advancement of the target date for completion. However, any increased rate of progress would also necessitate a greater turnover in the work carried out by private builders and contractors. Many of the local builders are very busy and delays in conversion often occur. Any further acceleration of this work would have aggravated this delay.

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The estimated number of premises to be brought under Smoke Control for the five-year period 1959-1963 has already been exceeded. If the present annual average rate of 4,000 premises is maintained the programme should be completed by 1968. The original target date was 1972. In the light of the Minister's suggestion that sampling or other methods alternative to full-scale survey prior to the establishment of a Smoke Control Area might form a reliable basis upon which to obtain an appreciation of the situation, and an estimate of the present and future fuel consumption, the Council decided to carry out a pilot scheme by postal survey. By this means the householder is requested to complete a simple questionnaire relating to the present appliances in his property and the amount and type of fuel he uses. The pilot scheme was successful and reduced appreciably the number of visits made by the Public Health Inspectors. It is anticipated that postal surveys will be used extensively in new Areas.

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The Minister also issued a list of revised principles applicable to the payment of grant. The Council's policy accords with these revised principles. HARDSHIP CASES The Clean Air Act gives the Council discretion to pay greater than a 7/10ths grant where it considers this to be reasonable, to cover cases of financial hardship. The Council decided to pay the whole cost of reasonable works of conversion in the case of applications from owner/occupiers who are retirement pensioners and who are also receiving National Assistance, and four such payments were made -49- during the year. In addition, four payments were made in respect of retirement pensioners who, although eligible for National Assistance, had not applied for it. MEANS OF IGNITION The installation of integral gas ignition, which is efficient and convenient, is normally eligible for grant. The Council has given every encouragement to the installation of gas ignition as the easiest means of lighting solid smokeless fuel. During the year the Minister informed the Council that abnormally high costs, in excess of £12.

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for an individual dwelling should not be incurred in providing means of ignition. Apart from a slight decrease in the ceiling figure, this did not conflict with the Council's policy. A cost of over £12. has only very rarely been incurred by a resident in a Smoke Control Area. The availability of three makes of electric firelighter has proved to be most useful as an alternative means of ignition for those residents who occupy properties which are not carcased for gas. FUEL SUPPLIES The local supply of proprietary or "premium" smokeless fuels has been maintained. There are several brands from which a choice can be made. The Council continues to advise residents not to place reliance upon any one of these fuels and insist upon the delivery of only one brand. The supply of coke continues to be plentiful throughout the area. PUBLICITY In the Circular previously referred to, the Minister states that changes which local authorities may wish to make in their methods of assessing the fuel requirements, etc.

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may render unnecessary the preliminary visits by the Council's staff. Therefore, it is of even greater importance to keep individual householders fully informed and advised of the Council's activities. Quite apart from the legal requirements as to publicity, the Council notifies residents by individual letters of every stage of the formation of a Smoke Control Area. Every effort is made to ensure that all householders are acquainted with the various stages through which the Smoke Control Order passes. Arrangements were in hand towards the end of the year for the customary Public Meeting to be held early in 1963 in connection with -50- the Eltham Smoke Control Area. Previous meetings in respect of Smoke Control Areas have been very well attended and many questions have been asked. NEW FURNACES Section 3 of the Clean Air Act requires that new furnaces not used mainly for domestic purposes and exceeding a capacity of 55,000 B.T.Us. shall, as far as practicable, be smokeless.

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Any person installing such a furnace must give prior notice to the Council and may submit detailed plans and specifications for the Council's approval before the works of installation take place. During 1962, one application for prior approval was received in respect of the installation of a new boilerhouse at a local factory. In addition, two notifications were received of proposals to alter boiler plant with a maximum rating of less than 55,000 B.T.Us. HEALTH EDUCATION Practical health education takes many forms. Although campaigns and publicity drives are spectacular examples, the information and advice given by public health workers in their day-to-day contact with members of the public in all fields must be relied on to shape the climate of opinion towards better health standards. Many public health measures have the force of law behind them, yet it is often found that persuasion and the removal of ignorance promotes a more lasting change than application of the "iron fist".

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In addition to routine contact, this Council has for many years been active in the promotion of Health Education through the provision of various services designed to inform the public of the health facilities available and to encourage them collectively and individually to make the fullest use of them. Recently, increasing emphasis has been given to the promotion of individual participation in health education and accident prevention, particularly in the home. FILM PROGRAMMES AND TALKS A further increase was noted In visits by the Health Education Unit, in spite of cancellation of a number of bookings due to inclement -51- weather during the winter months. A summary of the work of the Unit is appended below. Average audience figures remained approximately the same as in 1961 with variations from group to group. The largest audiences are found in old people's clubs. Whilst the sound film show still continues to be the most popular, there is increasing interest in informal talks, or talks illustrated by films. This is possibly due to television fulfilling the need for purely visual interest.

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After programmes where films only are shown, questions are asked, demonstrating perhaps that people are no longer merely content to watch but wish to enquire further. Indications of this move towards "participation" have been noted in other fields. Talks alone last about 30 minutes, including time for questions. When combined with films, or films alone, the programme is arranged to last approximately 60 minutes. Subjects are varied and a number of organisations request further visits on realisation of the many aspects that can be illustrated. In response to the increased emphasis on Safety in the Home many programmes were devoted entirely to this problem, and others devoted to another aspect of Public Health included a short film on home accident prevention. Summary of Work of Health Education Unit TABLE I Subject No.

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of Sessions Total Talks Films Both Home Safety 12 24 5 41 Smoke Control 2 4 2 8 Clean Water & Sanitation 2 5 1 8 Infectious Disease & Hygiene 2 7 2 11 Old People's Welfare - 1 1 2 Pests 2 2 _ 4 Food 4 7 - 11 Others 3 31 - 34 27 81 11 119 -52- TABLE II Organisation Afternoon Evening Total Audience Religious 22 18 40 1,767 Old People 4 2 6 925 Political 33 9 42 1,330 Others 11 20 31 2,565 70 49 119 6,587 LEAFLETS AND LITERATURE As in past years there was a continuous distribution of leaflets and literature through the various Council offices and libraries, the subject matter being as topical as possible.

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Other leaflets are included in the monthly distribution of "Better Health" to general practitioners' surgeries and to factories. In addition to seasonal subjects such as "Kill that Fly" campaigns in the summer months, and other general public health information and advice, there is a regular distribution of leaflets and, from time to time, posters on "home accident prevention" and "smoking and health", dealt with more fully below. FOULING BY DOGS - WARNING NOTICES Since 1959 when these notices were first introduced there has been a constant demand for their use. The notices are fixed to lamp-posts in areas where complaints have been received. When it Is felt that the warning has been fully noted they are then transferred to another site. It has frequently been reported that their display in an area results In a material reduction of the nuisance. CLEAN AIR In conjunction with the establishment of Smoke Control Areas, residents affected are kept fully informed on the progress in bringing new Areas into operation.

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In addition, a large selection of leaflets and a display of appliances is made available. A Public Meeting is held in each area when a Smoke Control Order is confirmed and a mobile display unit is sited in selected roads in the area. Fuller details of the Council's Smoke Control programme can be found on Page 46. -53- SMOKING AND HEALTH The Report on "Smoking and Health" by the Royal College of Physicians issued early in 1962 established a definite link between cigarette smoking and the incidence of lung cancer and bronchitis. This was made the subject of a Ministry of Health Circular which urged immediate action by local authorities in bringing the facts to the attention of the public. In conjunction with the national endeavour to give maximum publicity to the hazards of smoking and the adult's responsibility in discouraging the young from forming the habit, leaflets and posters were distributed to local general practitioners' surgeries and factory canteens, and made available in Council offices and libraries.

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In addition, through the courtesy of the Road Safety Committee, posters were exhibited on nearly 40 sites throughout the Borough as they were issued by the Ministry of Health. Posters were also displayed on the Department's transport. The incidence of lung cancer is a matter of grave concern and the Council are willing to co-operate in all campaigns aimed at securing a reduction of the smoking habit and the risk incurred by it, and by making "not smoking" fashionable. ACCIDENTS IN THE HOME (a) Formation of Home Safety Committee The Home Safety Act, 1961 empowers those local authorities which are not local health authorities to carry out Home Safety education. These powers had already been invested in this Council since 1957 by Section 82 of the London County Council (General Powers) Act of that year, and have formed a substantial part of the Health Education activities from that time. However, the Council decided that in order to give increased emphasis and publicity to its efforts in combating this problem a Home Safety Committee should be established.

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The Committee was appointed on the 4th July, 1962 comprising five Members of the Borough Council and representatives of interested organisations. The Committee was appointed with the following Terms of Reference: -54- "To act tinder the general directions of the Health Committee in the exercise of its powers under the Home Safety Act, 1961, as delegated to it by the Council." The first meeting of the Committee was held on the 19th November, 1962 and agreed to deal with the following matters within the Terms of Reference - "To carry out local propaganda to inform the public of the extent and gravity of the home accident problem. To enlist the support of appropriate public and voluntary organisations in this work. To investigate the causes of local home accidents and possible remedies. To participate in any national Home Safety campaign." The Committee were informed of the past and current activities of the Health Department with regard to Home Safety. Some of these have been the subject of previous Reports; the more recent activities are outlined below.

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Statistics were presented showing the gravity of the problem. A resume of the relevant legislation dealing with aspects of Home Safety was also included for the information of the Committee. Besides deciding to participate in the national Home Safety Training Year, the Committee decided to put a number of measures into immediate effect, notably local store displays, displays at local functions, and lectures to local retail store assistants, youth organisations and schools. (b) Home Accidents - Local Mention is made on Page 14 of this Report of 19 persons who died as a result of accidents at home. Whilst the number of non-fatal accidents is not known with any accuracy, many victims treating themselves or receiving treatment from the family doctor, an indication of the more serious accidents can be gained from the records of the London Ambulance Service. Detailed local information is available only for Division 6 of the London County Council health administrative area, which covers the Boroughs of Woolwich, Greenwich, and Deptford. However, it is known that 463 of the cases referred to occurred in this Borough.

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-55- Figures for Division 6 are as follows:Falls: On same level 77 One level to another 170 Unspecified 407 Poisoning: Gassing 8 Other 43 Burns 11 Scalds 40 Suffocation - Others: Electrical 3 Cutting and Piercing 40 Impact 24 Unspecified 4l 864 (c) The Oil Heaters Regulations, 1962 These Regulations, made under the provisions of the Consumer Protection Act, 1961, make it an offence for any person to sell an oil heater, or have in his possession for sale or letting an oil heater or component part not complying with the Regulations. The Regulations relate to the construction, design and performance of oil heaters generally and provide for their testing. Local authorities may purchase goods for testing. These Regulations are a useful addition to the existing legislation dealing with Home Safety, but it must be remembered that many accidents involving oil heaters are caused through their misuse.

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It is, therefore, important that the attention of the public should be drawn to the fact that the manufacturers' instructions should be followed and that the heaters when in use are placed in a draughtfree position, with adequate ventilation of the room, and the practice of airing clothes on or too near them discouraged. Attention should also be drawn to the care which should be taken when refilling with fuel. (d) Current Activities (i) Film Shows and Talks - It has been mentioned above that a large number of the visits by the Health Education Unit were devoted -56- entirely to Safety in the Home and that a number of other programmes included a short film on this subject. In all 4l visits dealt with the subject in detail, and in 28 others the subject of Home Safety was mentioned. Surprise was often expressed at the gravity of the problem.

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It is believed that this is due to the fact that, in general, home accidents are not "news" and do not attract the same press coverage that the more spectacular road, rail and other accidents receive. There is an urgent need for bringing home the fact that "home is where the accident is" to the public in general. (ii) Leaflets and Literature - The general distribution of leaflets mentioned above received special emphasis in the matter of Home Safety. Much material is distributed during the visits of the Health Education Unit, and by post, to residents of Smoke Control Areas, whilst the Council's Old People's Visitors and Public Health Inspectors offer advice as necessary. (iii) Display - Posters, topical for the time of the year, are displayed on the Department's transport and in the Council offices. In addition, a static display unit was sited where it would catch the notice of members of the public visiting the Department. The display was varied from time to time in order to sustain interest.

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(iv) Duke of Edinburgh's Award Scheme - Further courses of instruction on Home Safety were arranged for candidates for the above scheme. Two courses were arranged, one for the first level and one for the second level. Courses covered four 60-minute periods and involved the use of posters, flannelgraph, filmstrips and films. Five girls sat for the first level of the Award, and all passed. Eight girls sat for the second level of the Award and of these seven passed. One of the girls has since received the Gold Award. These courses, commenced in 1961, are a useful means of training future parents and are particularly appropriate in Home Safety Training Year. It is hoped that further youth groups will take advantage of the facilities offered.

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-57- PREVALENCE AND CONTROL OF INFECTIOUS DISEASE The following diseases are compulsorily notifiable in the Borough:- Anthrax, Cholera, Diphtheria, Dysentery, Encephalitis (Acute), Erysipelas, Enteric Fever, Food Poisoning, Leprosy, Malaria, Measles, Membranous Croup, Meningococcal Infection, Ophthalmia Neonatorum, Pneumonia (Acute Primary), Pneumonia (Acute Influenzal), Poliomyelitis, Polio-encephalitis, 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.

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Cases of infectious disease notified to the Department are immediately visited by the Public Health Inspectors and disinfection is carried out wherever applicable. Where the patient is nursed at home, the Inspectors see that home isolation continues satisfactorily, and at the end of the infectious period, where necessary, the bedding belonging to the patient is removed for treatment at the Disinfecting Station and the room sealed and fumigated. A total of only 301 cases of infectious diseases was notified during the year, being a decrease of 3,051 on the previous year. 119 cases were removed to hospital. The substantial reduction in total notifications is due to the small number of notifications of measles (66, compared with 3,057 the previous year). SMALLPOX For the first time for 29 years the Borough had a confirmed case of Smallpox during the year. The patient, an Insurance Agent of 38 years of age, living In the Woolwich area, first fell ill on the 13th January.

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He took to his bed on the following day and remained there until his admission to Hospital. Chickenpox was prevalent in the district at the time and this highly modified rash with mild general symptoms was therefore not immediately brought to the notice of the Health Department. Viriological confirmation was obtained and he was removed to Long Reach Hospital on the 24th January. -58- The patient's immediate contacts, about 40 persons, included his clients in the Abbey Wood area whom he saw during the morning of the l3th January, his family (five persons), and his medical attendant. These were all placed under surveillance and other necessary precautions were taken. The patient made rapid and uneventful progress and was discharged home 15 days after admission to Hospital. Although the rash remained sparse, its further development in Hospital was in accord with Smallpox and a further series of tests proved positive for Smallpox.

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The patient had been well vaccinated whilst in the Armed Forces, lastly in 1945, and this was probably the main factor in producing this highly modified case. The source of infection was not discovered; all possible clues, including several rumours, were followed up but to no purpose. As vaccination was not likely to be effective in preventing the disease at that late stage, the patient's family and his medical attendant, who had all been in close contact with him during the infectious period were given serum injections in addition to vaccination. A number of cases were referred by General Practitioners for further opinion, but fortunately none proved to be Smallpox. One of these was a young child living in a communal establishment in the Borough containing over 100 families. As the possibility of Smallpox could not be immediately excluded, precautions were instituted in respect of over 300 residents there. The child was removed to Long Reach Hospital and was subsequently found to have Chickenpox.

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In addition to the vaccination of all known contacts, it was found necessary, owing to the public demand, to arrange for mass vaccination. The County Council gave every assistance in arranging emergency vaccination sessions at their clinics and certain schools in the area, and together with the help of all General Practitioners in the Borough, who carried out a large number of vaccinations of their own patients, altogether some 100,000 people were vaccinated during this period. I should like to pay tribute to the excellent work carried out and the co-operation of all concerned. This experience gives further support to the generally held view that Smallpox is not infectious in the incubation period (i.e. before first feeling ill) and tends to support the view that it is also non-infectious in the prodromal stage (i.e. before the rash appears). Further, it seems reasonable to assume that the injection -59- of gamma globulin was a major factor in preventing the disease in the family contacts.

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None had been vaccinated since infancy, and this, combined with excellent first time vaccination "takes" in all, strongly suggests low immunological protection over the period of exposure. DYSENTERY Of the 32 cases originally notified, three were subsequently confirmed and found to be cases of Sonne Dysentery; one was taken to hospital and a further six suspected cases were also removed to hospital. Numerous specimens were obtained for pathological examination, and the positive cases were excluded from work or school as appropriate under the care of their own Doctors until at least two consecutive negative specimens had been produced. The majority of the non-confirmed cases were found to have Gastro Enteritis or Diarrhoea. MEASIES The number of individual cases of Measles notified during 1962 totalled 66, of which three patients were treated in hospital for various complications. All except five of the notified cases were under the age of 15 years.

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PUERPERAL PYREXIA Of the 87 notified cases of Puerperal Pyrexia occurring in the Borough, 2k of the patients were not Woolwich mothers. -60- TABLE NO. 15 NOTIFICATION OF INFECTIOUS DISEASES (EXCLUDING TUBERCULOSIS), 1962 Under 1 yr. 1-4 yrs. 5-14 yrs. 15-44 yrs. 45-64 yrs. 65 and over Total Admitted to Hospital Scarlet Fever _ 5 15 2 1 _ 23 2 Meningococcal Infection _ _ 1 _ _ _ 1 1 Erysipelas _ _ _ 1 8 4 13 1 Dysentery _ _ 1 2 _ _ 3 1 Zymotic Enteritis _ 2 1 _ _ _ 3 1 Pneumonia 3 4 6 12 23 24 72 9 Food Poisoning _ _

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- 1 _ _ 1 _ Puerperal Pyrexia _ _ _ 86 1 _ 87 87 Ophthalmia Neonatorum 10 _ _ _ _ _ 10 10 Whooping Cough 3 10 7 1 _ _ 21 2 Measles 3 27 _ 4 1 _ 66 3 Poliomyelitis __ _ _ _ _ _ _ _ Smallpox _ __ _ 1 _ _ 1 1 Paratyphoid Fever _ _ _ 1 _ _ 1 1 TABLE NO. 16 TUBERCULOSIS Table of Notifications and Deaths compared with Population Borough of Woolwich Year Estimated Civilian Population excluding Army Primary Notifications Deaths from Tuberculosis Deaths per 1,000 of population Total Deaths all Causes Percentage of Tuberculosis Deaths against all Deaths 1952 146,000 195 39 .26 1,667 2.3 1953 146,000 156 29 .20 1,

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569 1.8 1954 145,000 200 21 .14 1,443 1.4 1955 145,000 154 23 .15 1,537 1.4 1956 144,000 155 22 .14 1,524 1.4 1957 143,000 145 22 .14 1,504 1.4 1958 142,000 101 20 .14 1,514 1.3 1959 142,000 86 14 .09 1,542 .9 1960 143,000 72 9 .06 1,424 .6 1961 146,850 56 16 .11 1,616 .9 1962 148,000 63 10 .06 1,580 .6 -61- TABLE NO.

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17 The following is an extract from the Tuberculosis Register for 1962:- Pulmonary Non-Pulmonary M F Total M F Total Cases notified for the first time. 40 16 56 3 4 7 Other additions to Register during the year, including transfers of patients from other areas. 35 44 79 2 4 6 Cases on Register at 31st December, 1962.

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819 673 1,492 40 68 108 The following Table gives the age groups of new cases notified:- Formal Notifications Number of Primary Notifications of New Cases [ 1 1- 4 514 1524 2534 3544 4554 5564 6574 75 & up Total (All ages) PULMONARY - Males - - - 4 5 8 4 13 2 4 40 Females - 1 2 1 3 3 3 - 1 2 16 NON-PULMONARY - Males - - 1 - 1 1 - - - - 3 Females _ - - 2 - 2 _ _ _ _ 4 TOTAL: - 1 3 7 9 14 7 13 3 6 63 MASS X-RAY SERVICE I am indebted to Dr.

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Morgan, the Director of the South East London Mass X-Ray Service for the following information on the work of the Unit in the Borough during 1962. Dr. Morgan writes:- "13,120 people were x-rayed during 1962, and 19 cases of tuberculosis requiring close supervision or hospital treatment were -62- discovered. This gives an incidence of 1.4 per thousand examined, or 1.8 per thousand when the number of repeat six-monthly examinations has been deducted from the total x-rayed. examinations has been deducted from the total x-rayed. A breakdown of these figures is shown in the following Table:- Numbers examined Cases found Men Women Men Women Beresford Square - regular fortnightly visits. 2,692 (Incl. 1,432 "over 45's") 1,047 3 (Incl.

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1 "over 45's") 3 Firms - Routine visits 4,854 1,301 10 2 Firms - Visits mainly in connection with examination of men over fortyfive. 2,04l 6 1 _ Hospitals, etc. 148 602 _ _ Brief public visits, mainly in connection with examination of men over forty-five. 277 152 _ 10,012 3,108 14 5 13,120 19 Two interesting facts arise from this breakdown; first the incidence of significant tuberculosis amongst women x-rayed at Beresford Square, none of whom had been previously examined, was 2.9; and secondly the incidence of men x-rayed at routine visits to firms (six of whom had not been previously examined), was 2.1 per thousand. Of the total of 3,774 not previously x-rayed, 2,479 were men and 1,204 women.

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Eight and five cases respectively of tuberculosis were found in these groups, which gives an incidence of 3.2 amongst men and 3.9 amongst women."

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Other Non-Tuberculous Abnormalities included the following: MEN Carcinoma of bronchus 3 Carcinoma of segmoid Secondaries in liver 1 Pneumoconiosis 1 WOMEN Carcinoma of bronchus 1 Pneumonitis 2 Sarcoidosis 4 Bronchiectasis 1 -63- MEN Spontaneous pneumothorax 1 Pneumonitis 13 Bronchiectasis 3 Chronic Bronchitis and Emphysema 14 Fibrosis of lung 2 Pleural thickening 3 Calcified haemangioma 1 Pericardial cyst 1 Abnormal clavicle 1 Hiatus hernia 1 Raised diaphragm 1 Retrosternal goitre 1 WOMEN Cystic disease 1 Pleural thickening 1 Hernia 1 Fat deposit 1 DISINFECTION AND DISINFESTATION During 1962 the Department disinfected 190 rooms, including the patients' bedding,

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following notification of infectious disease. Of these, 91 rooms were occupied by persons suffering from tuberculosis. A total of 1,586 visits was made by the Public Health Inspectors to check on verminous conditions, and 69 premises were found to have minor infestations of bugs or fleas. Disinfestation was carried out by the Department. Many requests were received"throughout the year from residents wishing to dispose of old or unwanted furniture, mattresses or bedding. The items were almost always old or worn-out and sometimes verminous. Altogether 183 such items, including 27 mattresses, 96 items of furniture, seven beds, and 11 sets of bedding, were collected and disposed of at the Council's Destructor. Certificates of Hygiene were issued to accompany six export consignments of rag wipers which had been washed, cleaned and sterilised by a local firm. Nearly 150 tons of other goods for export were subjected to disinfection by the Department and certificates issued.

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Charges were made for this service to cover the cost of materials used, labour and transport. AUTHENTICATION OF CERTIFICATES OF VACCINATION Persons proceeding abroad are required to produce in certain countries evidence of recent successful vaccination Or inoculation. The signatures on these Certificates are not acceptable by the -64- countries concerned unless authenticated by the Medical Officer of Health as being the bona fide signature of a Doctor practising within the area. During 1962, 2,507 Certificates were authenticated by me; 2,458 related to protection against Smallpox, 28 for Cholera, and 21 for T.A.B. inoculation. PERSONAL CLEANSING The Borough Council maintains two personal Cleansing Stations, one being at Plumstead (adjoining the Turkish Baths in Plumstead High Street), and the other at the Lionel Road Centre, Eltham.

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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 Hither Green Hospital, Lewisham. This service is provided by the Public Health Laboratory Service. 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 local slaughterhouse, and samples of swimming bath water. The following summary relates to the work carried out by the Laboratory on behalf of the Council during 1962:- Type of Specimen No. Examined Food (various, including ice-cream ingredients) 18 Ice-cream (Methylene Blue test) 11 Milk (Statutory tests on Pasteurised, Sterilised and T.T.

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milks) 423 Water (from swimming baths, paddling and boating pools) 23 Organs from Animal Carcases (Sections) 10 485 -65- 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 at the Brook Hospital and at the St. Nicholas Hospital. The convenience of this service is much appreciated by the local doctors and by the Department. TABLE OF CONTENTS Page Preface 2 Health Committee 4 Staff 4 General Statistics 7 Vital Statistics 7 Public Health Administration 15 Old People1s Welfare 28 Housing 33 Inspection and Supervision of Food 39 Clean Air 46 Health Education 51 Infectious Diseases (including Disinfection, Disinfestation and Personal Cleansing) 58 Laboratory Facilities 65 -66-

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AC 4372 WOO 63 II METROPOLITAN BOROUGH OF WOOLWICH ANNUAL REPORT on the Health of the Metropolitan Borough of Woolwich for the Year 1963 BY T. STANDRING, M.D., B.S., D.P.H., M R.C.S., L.R.C.P., F.R.S.H. Medical Officer of Health METROPOLITAN BOROUGH OF WOOLWICH ANNUAL REPORT on the Health of the Metropolitan Borough of Woolwich for the Year 1963 by T. Standring, M.D.,B.S.,D.P.H.,M.R.C.S.,L.R.C.P.,F.R.S.H. Medical Officer of Health PREFACE To: The Mayor, Aldermen and Councillors of the Metropolitan Borough of Woolwich. MR. MAYOR, LADIES AND GENTLEMEN, I have pleasure in submitting the 63rd Annual Report on the Health of the Borough of Woolwich.

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The Report is on the general lines indicated by the Minister of Health. During the past decade there has been little movement in the population of the Borough, which was confirmed at the Census in 1961 at 146,603. The estimated population for the year 1963 was 148,690. A gradual rise in the Woolwich birth rate has taken place during the past seven years, the adjusted birth rate for 1963 being 15.6, compared with that- for the County of London of 20.0. Similarly, the local death rate has risen due to a rise in the year of 210 in the total deaths occurring. The adjusted death rate for 1963 was l3.0, compared with 11.4 for the year 1962. The previous excellent infant death rate for Woolwich, however, was not maintained, the rate increasing from 19.5 in 1962 to 28.9 in 1963.

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There were altogether 62 infant deaths, being the highest total 3ince 1951. The cause is not obviously apparent and too much weight must not be given to a single year especially when the total numbers involved are relativexy small. The greatest single cause of infant deaths, both locally and nationally, is now prematurity and research to lessen its incidence continues. Seventeen of the infant deaths resulted from prematurity, ten from pneumonia, 14 from congenital malformation, and the remainder from various other causes. The number of stillbirths registered was 38. However, only one maternal death was recorded. It is regretted that 27 Woolwich residents died from motor vehicle accidents, 13 of the fatalities involving pedestrians and including three boys and ten elderly people. A further 23 deaths were due to other accidents, 17 of these being home accidents. By intensive publicity, the Council is taking every opportunity to bring to the notice of the general public the dangers from home and road accidents.

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The year 1963 saw an appreciable extension in the work of the Health Department, particularly in the further services being made available for old people. The many and varied problems relating to their welfare calls for a good deal of co-operation with other health and welfare workers. The number of old people known to the Council's Visitors as needing the help of the health and welfare services now 2 totals over 5,000. Every effort is being made to increase the home services designed for their assistance. Two more 'meals on wheels' vehicles were brought into service during the year, and three new luncheon clubs were established. All meals are now being supplied by the Council's Catering Department from the central kitchen to the luncheon clubs and 'meals on wheels' service. The Council's incontinent laundry service was doubled. Two more full-time Welfare Visitors were appointed to meet the needs of the elderly.

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The Council's Old People's Welfare Committee had a busy year, and reports excellent support from the various voluntary agencies active in this work in the Borough. The Council's Smoke Control programme received added impetus during the year, with the bringing into operation on the 1st October, 1963 of the Eltham Smoke Control Area, in which there are some 5,500 premises, with a total acreage of 1,550. In addition, the preliminary work for the declaration of the Well Hall Smoke Control Area, comprising over 4,000 dwellings was completed; the operative date for this Area being October, 1964. The various tasks of the Public Health Inspectors concerned with the supervision of the local food supplies, infectious diseases, housing and other environmental health duties continued smoothly. Important new duties were given to the Inspectors for the implementation of the Offices, Shops, and Railway Premises Act, 1963.

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I am pleased to report that the Council's student training scheme for Public Health Inspectors continues to prove its value. With the appointment of a full-time Health Education and Home Safety Officer, who has been able to concentrate on this work, good results have been achieved. Details of the many local publicity measures taken during the year are contained in the Report. At the time of writing, plans for the reform of London Government which affect the work of the Health Department greatly are now well advanced. As we approach the Appointed Day for the transfer of all the County Council Health and Welfare Services, except the Ambulance Service, to the new London Borough of Greenwich, the opportunities which lie ahead for the Members and Officers of the new Borough in the field of Health and Welfare are apparent. The smooth implementation of all the local services will not be an easy one, but I am certain that it will be achieved speedily and effectively.

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It remains for me to thank the Chairman and Members of the Health Committee and other Members of the Council and Chief Officers for their support and interest during the year. I would also like to pay a special tribute to the staff of the Department for their valuable work and support during another busy year. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, T. STANDRNG. 3 HEALTH COMMITTEE at 31st December, 1963 THE WORSHIPFUL THE MAYOR (Councillor D.S. Ramsey, J.P.) Councillor G.E. Offord, J.P. (Chairman) Councillor Mrs. H. Stroud (Vice-chairman) Alderman E. McCarthys Councillors - J.W. Andrews, L.C.C. A.J.J. Ashford Mrs. M.J.M. BradleyMrs. s.M. Bradley Mrs.

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E. Brooks Mrs. E.G. Bunce G.S. Dean L.A. Heath Mrs. W.H.M. Hulbert Mrs. C.B. Jeffrey A.J. Mitchell F.B. Newland H.F. Reilly N.R.J. Sims Mrs. N.A.E. Woods. HEALTH DEPARTMENT STAFF Medical Officer of Health - T. STANDRING, M.D.,B.S.,D.P.H.,M.R.C.S.,L.R.C.P.,F.R.S.H. Chief Health Inspector - F.A. ANDREW, Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods. Public Health Inspectors - F.J. HOINES, Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods - (Senior Food Inspector). W.F.R.

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WHEAL, Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods - (Senior Housing Inspector). W.E. McLELLAND, Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods; Cert.Smoke Insp. - (Smoke Inspector). 4 MISS M.F. THOMAS, G.M., Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods; State Registered Nurse; State Certificated Midwife; Health Visitor's Cert. (Public Health Inspector). E.R. REES, Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods; Cert.Smoke Insp. - (Food Inspector). W.F.N. TROUGHTON, Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods - (Licensed and Registered Food Premises, Disinfection and Disinfestation, etc. Inspector). K.S.

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COOPER, Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods - (District Inspector). J.B. O'CONNELL, Cert.P.H.Insp.Exam.Joint Board; Cert. Smoke Insp. - (Smoke Control Inspector). R.H. PASTERFIEID, Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods - (District Inspector). J. HACKER, Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods - (Food Inspector). J.H. LOTT. Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods - (Food Inspector) (Resigned 31.l0.63). J. HILLS, Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods; Cert.Smoke Insp. - (District Inspector). N.E.

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BROOM, Cert.P.H.Insp.Exam.Joint Board; Cert.Smoke Insp. - (Smoke Control Inspector). B. TAYLOR. Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods; Cert.Smoke Insp. - (District Inspector). J.W. DENNARD, Cert.p.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods; Cert,Smoke Insp. - (Rodent inspector;. D. SIMPSON, Cert.P.H.Insp.Exam.Joint Board; Cert.Meat and Other Foods; Cert.Smoke Insp. - (District Inspector). C. OAKINS, Cert.P.H.Insp.Exam.Joint Board - (District Inspector). -5- Student Public Health Inspectors P. COONEY S. OFFORD (Appointed 2.9.63) Public Health Welfare Visitors - MISS P.A.D.

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ELLISON, State Registered Nurse; Sociology Diploma of University of London; Health Visitor's Cert. (Resigned 28.7.63). MISS E. COE, State Registered Nurse; Queen's Inst, of District Nursing Cert; Health Visitor's Cert. (Resigned 29.12.63). MRS. V. ALIEN, State Registered Nurse; Health Visitor's Cert. (Appointed 7.1.63). MISS 0. EWYER, State Registered Nurse; Health Visitor's Cert. (Appointed 2.12.63). MRS. C.A. QURESHI, State Registered Nurse; Health Visitor's Cert. (Appointed 30.12.63). Hygiene Assistant - MRS. L. RISBY. Public Analyst (Part-time) - H. AMPHLETT WILLIAMS, Ph.D. (LOND.), A.C.G.F.C.,F.R.I.C.

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Administrative and Clerical - Chief Assistant - A. HEALEY, LL.B.,A.C.C.S. Senior Assistant - R.E. SWEETT, D.M.A. Assistants - J.E. KAY, D.M.A. G.C. RYAN R.E. BROWN D.M. GIBBS MRS. W.E. ELLISON MRS. J. BARYLSKI W.H. MAY MRS. F.E. WEBB MRS. A.V. FORBES (Resigned 14.7.63) 6 Assistants (cont'd) MISS A. SHERING (Resigned 24.11.63) MISS 0. ANDERSON MRS. F.P. HOLMES MRS. G.A. WREN (Resigned 10.11.63) MRS. M.E.

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CHAPMAN (Resigned 3.3.63) MISS M.E. HUDSON (Appointed 13.5.63) MISS V. CHASTEAUNEUF 3,W. SAXBY (Resigned 6.10.63) P.J. BINGHAM (Resigned 20.10.63) MISS M.G. DOYLE (Appointed 3.9.63) MISS P. WILLMOTH (Appointed 3.9.63) MISS S.M. CLARKE (Appointed 30.9.63) MISS J.M. PASTON (Appointed 28.10.63) MRS. B.Y.

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I0B1 (Appointed 11.11.63) GENERAL STATISTICS Area of Borough: 8.282 statute acres Number of dwellings; 45,529 Number of Persons per acre; 17.9 Total Rateable Values £8,153,789 (including Government property) Product of Id. rate: £32,805 VITAL STATISTICS Extracts from the vital statistics for the year, with comparative figures for 1962 are shown in the following Table 7 TABLE NO. 1 1962 1962 Estimated mid-year Home Population 148,140 148,690 Live Births - Legitimate 2,101 2,249 Illegitimate 147 159 Total Live Births 2,248 2,4o8 Birth Rate 15.1 16.2 Stillbirths 32 38 Stillbirths - Rate per 1,000 total births 14.2 15.5 Total Deaths 1,580 1,790 Death Rate per 1,

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000 population 10.7 12.0 Maternal Deaths 1 1 Death Rate from Puerperal Causes per 1,000 total births 0.4 0.4 Deaths of Infants under one year 44 62 Death Rate of Infants under one year 19.5 28.9 Neo-natal Mortality Rate 13.3 17.0 Deaths from Tuberculosis (all forms) 10 16 Deaths from Cancer (all ages) 305 327 BIRTHS The number of live births registered in Woolwich during 1963 was 3,159. After correction for inward and outward transfers, the net number of Woolwich live births was 2,408, being 160 more than the previous year. Of the total births 1,221 were boys and 1,187 girls. The adjusted birth rate was 15.6 compared with the birth rate for London of 20.0 and that for England and Wales of 18.2.

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There were 38 stillbirths during the year. MARRIAGES There were 1,087 marriages in the Borough during 1963, of which 715 took place in Churches;, the remaining 372 took place at the Woolwich Register Office. Of the number of marriages which took place in Churches in the Borough, Registrars of Marriage attended on 124 occasions. 8 DEATHS The number of deaths registered in Woolwich was 1,790 and after correction for inward and outward transfers the net number was 1,761 giving a death rate of 12.0 for the Borough, compared with 10,7 the previous year. Of the total deaths, 795 (or 44 per cent.) ware over 75 years of age. The adjusted death rate for Woolwich was 15.0 compared with the figure of 12.5 for London, and of 12.2 for England and Wales.

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Deaths of Woolwich residents in hospitals in the Borough totalled 562;,whilst 574 died in other hospitals. MATERNAL DEATHS There was one maternal death during 1963, and one in the previous year. NATURAL INCREASE IN POPULATION (i»eo excess of Births over Deaths) In 1963 the natural increase in population was 618; in 1961 It was 540; and in 1962 it was 668. INQUESTS Sixty-three inquests were held on Woolwich residents during the year, and 476 post-mortems on Woolwich residents were carried out on behalf of the Coroner. INFANT MORTALITY There were 62 infant deaths during the year, being 18 more than in the previous year. The infant death rate was 28.9 compared with 21.1 for England and Wales, and 22.0 for London. The following Table gives details of the infant deaths in Woolwich during 1963.

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9 TABLE NO. 2 DEATHS UNDER 1 YEAR - 1963 Causes of Death Under 1 Week 1-2 Weeks 2-3 Weeks 3-4 Weeks Total under 4 Weeks 1-3 Months 3-6 Months 6-9 Months 9-12 Months Total Deaths under 1 Year.

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Premature Birth 16 1 - - 17 - - - - 17 Congenital Malformation 3 - - 1 4 1 - 2 1 8 Pneumonia - - 1 1 2 3 5 - - 10 Bronchitis - - - - - l l - - 2 Atelectasis 2 - - - 2 - - - - 2 Other Causes 14 1 1 - 16 2 5 - - 23 41 62 DEATHS FROM CANCER Of the total number of deaths, 319 were from Cancer (excluding Sarcoma), being 14 more than in the previous year. Of these, 166 occurred in men, and 153 in women. More than half the Cancer deaths (166) took place in hospitals. The following Tables give details of Woolwich deaths from Cancer. 10 TABLE NO.

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3 CANCER DEATHS BY AGE - WOOIWICH, 1963 Age Men Women Total Deaths in Hospitals Under 30 years 4 4 _ 31-45 years 6 3 9 9 46-55 years 11 13 24 16 56-65 years 53 28 81 32 66-75 years 55 49 104 60 76-80 years 26 24 50 25 Over 80 years 15 32 47 24 Totals: 166 153 319 166 TABLE NO.

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4 WOOIWICH DEATHS FROM CANCER OF THE LUNG AND BRONCHUS, 1953-1963 Year Lung Bronchus Total Deaths in Hospitals Male Female Male Female 1953 16 2 40 9 67 38 1954 11 6 31 8 56 40 1955 17 4 43 4 68 56 1956 23 3 43 4 73 50 1957 18 9 48 5 80 38 1958 15 9 46 12 82 48 1959 17 4 37 9 67 49 1960 18 1 50 6 75 46 1961 22 4 49 9 84 54 1962 26 7 44 7 84 44 1963 19 4 45 8 76 41 11 TABLE NO. 5

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WOOLWICH DEATHS FROM CANCER (Including all other specified Malignant Tumours) Year Men Women Total Deaths Deaths in Hospitals 1943 153 115 246 79 1944 128 95 279 116 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 1955 184 125 309 169 1954 145 148 293 193 1955 186 130 316 219 1956 176 137 313 183 1957 158 155 313 158 1958 168 149 317 151 1959 158

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140 298 176 1960 162 154 316 188 1961 200 138 338 211 1962 188 127 315 162 1965 169 158 327 166 TABLE NO. 6 CANCER DEATHS (EXCLUDING SARCOMA) WOOLWICH 1963 - SEAT OF PRIMARY DISEASE Male Female Total Deaths in Hospitals Stomach 34 26 60 33 Bronchus 45 8 53 33 Lung 19 4 23 8 Breast - 29 29 18 Colon 16 10 26 15 Pancreas 2 6 8 6 Rectum 11 10 21 12 Uterus - 11 11 1 Prostate 9 - 9 7 Ovary - 7 7 5 Bladder 8 - 8 5 Liver 3 1 4 1 Caecum - 3 3

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3 Oesophagus 5 3 8 7 Kidney 4 - 4 3 Larynx - - - - Tongue 2 - 2 1 Others and Unspecified 8 35 43 24 Total: 166 153 319 166 12 TABLE NO. 7 - NET DEATHS DURING THE CALENDAR YEAR 1963 Causes of Death All Ages Under 1 Year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and under 75 years 75 years and upwards All causes: 1,790 62 6 6 15 55 399 452 795 Tuberculosis,respiratory 13 - - - - 3 6 1 3 Tuberculosis,

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other 3 - - - - - 1 1 1 Syphilitic disease 5 - - - - - 1 2 2 Other infective and parasitic diseases 3 - - - 1 - 2 - - Malignant neoplasm,stomach 60 - - - - 1 22 14 23 Malignant neoplasm,lung, bronchus 76 - - - - 5 44 24 3 Malignant neoplasm,breast 29 - - - - l 11 6 11 Malignant neoplasm,uterus 11 - - - - - 1 5 5 Other malignant and lymphatic neoplasms 151 - 1 - - 5 32 55 58 Leukaemia,

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aleukaemia 13 - - 1 - 3 3 1 5 Diabetes 15 - - - - - 1 7 7 Vascular lesions of nervous system 169 - - - - 2 32 53 82 Coronary disease,

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angina 387 - - - - 7 99 120 161 Hypertension with heart disease 29 - - - - - 4 7 18 Other heart diseases 166 - - 1 - 5 24 25 111 Other circulatory diseases 102 - - - 2 23 20 57 Influenza 5 - - - - - - 3 2 Pneumonia 143 10 - - - 1 18 20 94 Bronchitis 151 2 - - - 1 26 49 73 Other diseases of respiratory system 9 1 - - - 1 3 l 3 Ulcer of stomach and duodenum 21 - - - - - 8 3 10 Gastritis,

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enteritis and diarrhoea 9 1 - - - - 1 5 2 Nephritis and Nephrosis 11 - - - 1 3 2 2 3 Hypherplasia of prostate 10 - - - - - - 2 8 Pregnancy, Childbirth, Abortion 1 - - - - 1 - - - Congenital malformations 17 14 1 - - - 2 - - Other defined and ill-defined diseases 115 33 1 1 2 7 18 15 38 Motor vehicle accidents 27 - 1 2 8 4 4 2 6 All other accidents 23 1 2 1 2 2 3 4 8 Suicide 15 - - - - 1 8 5 1 Homicide 1 - - - 1 - - - - 13 The chief Vital Statistics for the Borough since 1943 are given in the following Table TABLE NO.

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8 Year Population estimated to middle of each Year BIRTHS Net Net Deaths of the District Under 1 Year At all ages No. Rate No. Rate per 1,000 net Births No. Rate 1943a 112,700 2,174 19.3 77 35 1,558 13.8 1944a 110,970 2,037 18.3 83 40 1,611 14.5 1945a 115,270 2,021 17.5 83 41 1,478 12.8 1946a 134,420 2,903 21.6 91 31 1,531 11.4 1947a 140,150 3,193 22.8 87 27.2 1,626 11.6 1948a 142,800 2,527 17.7 74 29.2 1,

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573 11.0 1949a 144,000 2,504 17.4 72 28.7 1,572 10.9 1950b 149,000 2,172 14.6 53 24.4 1,668 11.2 1951b 149,800 2,273 15.1 63 27.7 1,838 12.3 1952b 151,800 2,199 14.4 47 21.4 1,667 10.9 1953b 151.000 2,090 13.8 48 22.9 1,569 10.4 1954b 149,700 2,035 13.5 37 18.1 1,443 9.6 1955b 148,500 1,971 13.2 39 19.7 1,537 10.

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3 1956b 147,500 1,953 13.2 37 18.9 1,524 10.4 1957b 146,200 2,038 13.9 53 26.0 1,504 10.3 1958b 144,600 2,003 13.8 40 20.0 1,514 10.5 1959b 144,800 1,972 13.6 41 20.8 1,542 10.6 1960b 145,470 2,179 14.9 37 16.9 1,424 9.8 1961b 146,850 2,156 14.7 38 17.6 1,616 11.0 1962b 148,140 2,248 15.1 44 19.5 1,580 10.

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7 1963b 148,690 2,408 16.2 62 28.9 1,790 12.0 a - Civil population b - Home population (Civil and resident Armed Forces) 14 MOTOR VEHICLE FATALITIES Twenty-seven people died on the roads of this Borough in 1963, four more than in the previous year. Eleven of these were over 60 years of age. Thirteen of the accidents involved pedestrians and included three boys and ten old people. Collisions between vehicles accounted for a further five deaths, the victims being one elderly man and four young men between the ages of 15 and 24. The vehicles involved were cars, a 'bus, a coach, a lorry, and a motor cycle. Collisions with stationary objects resulted in five fatal accidents. On two occasions the vehicles involved were cars and the remainder motor oycles. Objects collided with included stationary vehicles, a tree, lamp-posts, and a bus stop standard.

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The ages of the victims ranged from 17-45 years. The remaining four deaths were caused by two youths being thrown off a motorcycle, a young lorry driver whose lorry ran off the road, and a middle-aged man who fell from his motor cycle under a heavy goods vehicle. OTHER ACCIDENTS Accidents other than road accidents accounted for 23 deaths, 11 less than in 1962. Seventeen of these accidents occurred in the home, and in 11 cases persons over 60 were the victims. Five elderly ladies died from falls at home, while one other and two elderly men died from accidental carbon monoxide poisoning. Two elderly women died from burns, and one elderly man from drowning when he collapsed in his bath. A young man was accidentally poisoned in his home, and a young mother and her four children died in a fire at their home. There was one case of drowning, and two cases involving a train. Five others met their deaths from miscellaneous causes.

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15 CENSUS 1961: COUNTY OF LONDON REPORT In March, 1963 the Registrar General issued the County of London Report giving information on the Census taken in April, 1961. The Report contains sections dealing with the distribution of population by age, sex, and wards of the Borough; marital conditions; nationality of residents; and housing conditions in the area. Since the last Census in 1951 a decrease of 147,472 in the population of the County area has taken place. The population of the Borough at the time of the Census was 146,603 (comprising 71,170 males and 75,433 females), compared with 147,891 at the 1951 Census, and 146,881 at the 1931 Census. The following Table gives details of the increases and decreases in the population by various wards of the Borough during the last ten years TABLE NO. 9 Wards Persons 1951 Persons 1961 Increase Decrease Persons per acre Abbey Wood 6,

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285 14,544 8/259 - 11.9 Avery Hill 5,428 5,096 - 332 9.9 Burrage 6,425 5,109 - 1,316 42.2 Central 7,527 6,621 - 906 50.9 Coldharbour 7,076 9,775 2,699 - 23.6 Eltham Green 5,542 5,297 - 245 31.5 Falconwood 2,753 5,868 3,115 - 13.0 Glyndon 6,076 4,383 - 1,693 47.6 Herbert 8,393 8,731 338 - 43.7 Horn Park 6,219 6,648 429 - 15.0 Middle Park 7,333 7.550 197 - 17.4 New Eltham 8,382 8,340 - 42 18.

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7 River 6.477 4,6l4 - 1,863 4.8 St. George's 8,425 5,844 - 2,581 15.9 St. Mary's 8,132 5,241 - 2,891 23.7 St. Margaret's 8,062 7,572 - 490 20.2 St.

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Nicholas 6,884 6,085 - 799 48.7 Sherard 6,152 5,684 - 468 28.0 Shooters Hill 5,970 5,290 - 680 9.8 Slade 7,144 7,005 - 139 25.8 Well Hall 5,478 4,834 - 644 32.7 Winns Common 7,728 6,492 - 1,236 15.1 16 The average number of persons per acre was 17.7 (compared with 17.9 in 1951), the 1961 figure being the lowest in the County area and closely followed by Greenwich with 22.1 persons per acre. The following Table gives a summary of the population of the Borough by age and sex. For comparative purposes the number of persons in 1951 is also shown. TABLE NO.

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10 Age Group (Age last Birthday) Persons 1951 1961 Males Females Total No. of Persons 0-4 12,522 5,261 4,841 10,102 5-14 19,227 11,853 11,197 23,050 15-34 41,847 17,883 17,549 35,432 35-54 42,351 21,206 21,887 43,093 55-59 8,607 4,552 4,846 9,398 60-64 7,459 3,664 4,259 7,923 65 and over 15,878 6,751 10,834 17,585 There were thus 21,844 people of pensionable age (women over 60 and men over 65) at the time of the Census.

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The total population of the Borough over the age of 65 (17,605), compared with 15,828 at the 1951 Census. There were 3,254 women aged 60 and over living alone in the Borough, and 592 men aged 65 and over also living alone. There were 23,552 males and 22,108 females under the age of 21 years. The largest single yearly group in this age range related to those whose age on their last birthday at the time of the Census in April 1961 was 14 years. The birthplaces of persons in the Borough on the Census night are recorded as follows:- England 134,182; Wales 1,895; Scotland 2,162; Northern Ireland 696; Irish Republic 2,240; Canada 145; U.S.A.

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56; India 1,026; Other European Countries 1,056; Malta 163; Australia 96; Gibraltar 68; Jamaica 111; Other Caribbean Countries 113; Cyprus 90; Pakistan 69; Nigeria 76; South Africa 124; Other African Countries 81. 17 The total number of private households in the Borough (i.e. comprising a person living alone, or a group of persons living together taking meals prepared together and benefiting from a common housekeeping) was recorded as 47,551, being 2,185 more than ten years ago. Altogether 45,001 structurally separate dwellings were occupied, being an increase of 5,04l since the last Census. Of the total population of 146,603, 143,804 (or 98 per cent.)

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were residing in private households, 888 were in hospitals, 292 in hotels, 167 in homes for the aged and disabled, 55 in places of detention, 27 in children's homes, 27 in educational establishments, 4ll in defence establishments, 440 in civilian ships, boats and barges, and 491 in miscellaneous communal establishments. Woolwich had a high percentage of wholly residential permanent buildings containing one dwelling (87 per cent, of total households), and also a high proportion of owner/occupiers (42 per cent, of total households). The Borough had almost the lowest percentage in the County of London of rented furnished accommodation.

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There were 45,549 structurally separate dwellings in the Borough containing a total of 47,098 household spaces; 20,932 were owner/ occupied; 13,464 were rented from the local authorities; 10,560 were rented unfurnished; 1,082 were held by virtue of employment; 775 were rented furnished; and 285 were rented together with business premises. Almost 40 per cent, of the total accommodation in the Borough consisted of five-roomed accommodation. At the time of the Census 548 dwellings were unoccupied. The density of occupation (persons per room) for the Borough was 0.68, compared with 0.73 at the 1951 Census, and is the lowest density in the County area. Twelve per cent, of Woolwich households are one-person households; 29 per cent, two-person households; 22 per cent, three-person households; and 19 per cent, four-person households.

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The percentage of Woolwich persons living at more than 1½ per room was 3.8, compared with 6.1 in 1951. This latest figure is the lowest percentage of any Borough in the County, the County average being 11.5 per cent. It is pleasing to report that the number of households in the Borough without a fixed bath has been substantially reduced in the last ten years and is now 9,727 (20 per cent.) compared with 15,534 at the time of the 1951 Census. A further 2,393 households (5 per cent.) compared with 4,119 ten years ago, were sharing a fixed bath with another household. 18 At 32,922 households (70 per cent. of households), all three amenities, i.e., piped hot water supply, water closet, and fixed bath, were available, and the occupiers had exclusive use of all three facilities.

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A total of 9,951 households (21 per cent.) were without a piped hot water supply, and a further 1,094 households (2 per cent.) were sharing this amenity. With regard to the provision of fixed baths, however, only eight Boroughs in the County area compared more favourably than Woolwich; on the provision of a piped hot water supply, in only two Boroughs was the standard higher. PUBLIC HEALTH ADMINISTRATION PUBLIC HEALTH INSPECTION OF THE AREA The Public Health Inspectors carried out 27,180 inspections, including reinspections, during 1963. The nature of the inspections is shown in Table 11. As a result of the inspections made, 775 Intimation Notices and 380 Statutory Notices were served.

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TABLE NO.11 - INSPECTIONS Complaints investigated 1,670 Tents and Vans 83 Complaints (reinspections) 3,19 Stables 4 Outworkers' premises 125 Public Houses 78 Houses re overcrowding 111 Theatres and Cinemas 13 New Houses re water supply 738 Hairdressers and Barbers 48 Houses re infectious diseases 1,706 Houses re disinfection or destruction of articles 68 Houses re vermin 109 Council housing applicants check re vermin 963 Factories mechanically powered 97 Housing Act inspections 242 Factories non-mechanically powered 24 Housing Act - Improvement Grants 306 Shops Act inspections 233 Houses re Certificates of Disrepair 79 Food Premises 783 Complaints re food 37 Water sampling and testing 29 Houses, visits with owners, builders, etc.

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283 Rodent Control 540 Atmospheric Pollution 1,178 Houses re Slum Clearance and Redevelopment 178 Houses re Smoke Control Areas 182 Pet Animals Premises 53 Houses re Smoke Control Areas (reinspections) 3,707 Visits re insect and other pests 424 Men's lavatories 49 Shops re Pharmacy and Poisons 158 Women's lavatories 56 Houses re choked drains 335 Miscellaneous visits 3,614 Drainage inspections 725 Non-effectual visits 4,416 19 TABLE NO. 12 - NUISANCES ABATED Dirty conditions remedied 133 Ceilings repaired or renewed 57 Roofs repaired 245 Walls repaired or renewed 379 Gutters, rainwater pipes, etc. repaired or renewed 327 Lighting and ventilation defects remedied 304 Damp walls and other damp conditions remedied 474 Areas and yards paved or repaired 34 Fireplaces, hearths, flues etc. repaired or renewed 66 Sinks, S.W. pipes, etc.

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repaired or renewed 77 Floors, skirting and other woodwork 148 Drains cleansed 357 Drains repaired or reconstructed 86 Water closets cleansed and repaired 41 Dustbins provided 40 Water closet pans and traps fixed 24 Other dilapidations remedied 110 Water closet seats repaired or renewed 37 Foul accumulations remedied 43 Water supply defects remedied 133 Houses repaired following informal action 568 Windows repaired or renewed 337 Houses repaired following formal action 277 PUBLIC HEALTH (LONDON) ACT, 1936 - LEGAL PROCEEDINGS Following failure to comply with requirements of Notices served under the aforementioned Act, 12 summonses were taken out at the Woolwich Magistrates Court during the year against the responsible landlords. Seven of the summonses were subsequently withdrawn, the necessary work having been completed prior to the Hearing.

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In two other cases the summonses were adjourned - one sine die as the repairs had been carried out, and the other case until the New Year as the owner concerned had entered hospital and was no longer capable of administering his own affairs. The Magistrate made Abatement Orders of 28 days in respect of two Nuisance Notices, and for contravention of a Byelaw Notice one landlord was fined £5 and the Council were awarded £10.10.0. costs. WATER SUPPLY Water supply for domestic purposes is supplied to the dwellinghouses in the Borough exclusively by the Metropolitan Water Board. 20 The water supplied in this Borough is not subject to plumbo-solvent action. Bacteriological, chemical and radio-activity tests of the water are carried out as a matter of routine by the Board and the results of these tests are regularly forwarded to the Council.

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No complaints were received during the year as to either quantity or quality from any of the occupiers of the estimated 45,529 dwellings in the Borough. In addition to water supplied to them by the Metropolitan Water Board, local industries take water for industrial and firefighting use from seven wells which are still in use in the area. Well water is also used at the Council's swimming baths at Woolwich and Plumstead. Samples of well water taken for bacteriological examination showed that the water was satisfactory. DRAINAGE Drainage defects found during the course of 1963 totalled 445, and the work of repair or reconstruction was supervised by the Public Health Inspectors. A total of 58 private or combined drains were tested with smoke, and of this number 22 were found to be defective. Of the defective drains two were subsequently discovered to be disused, and they were accordingly exposed and sealed off by the Health Department staff.

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Two of the 28 combined drains tested were found to be defective, and the necessary repairs were carried out by the responsible owners. PUBLIC BATHS AND SWIMMING POOLS Water used in the Council's swimming baths is continuously filtrated and chlorinated, and samples from paddling pools as well as the swimming baths are taken regularly for testing. Samples of water were submitted to the Southern Group Laboratory, Hither Green Hospital for bacteriological examination, and further samples of the water were tested by the Health Department staff for chlorine content and pH reaction. 21 The average result of the examinations and tests are shown belows- Probable No. of Bacillus Coli per 100 m.l. Average pH. Value Average free Chlorine p.p.m. Average Temperature . Plate Count. Yeastrel agar 2 days at 37°C. aerobically per m.l. Swimming Baths 0 7.5 1.73 80°F.

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4 Paddling and Boating Pools 17 8.0 0.15 - 250 The nature of the work undertaken is as follows:- Nature of Work No. of Outworkers in August list required by Sec. 110(1)(c). No. of cases of default in sending lists to Council. Prosecutions for failure to supply lists. No. of instances of work in unwholesome premises Notices served. Prosecutions. Wearing apparel (Making etc.cleaning and washing).