CHIG 1 library Cbidwell Urban District Council ANNUAL REPORT of the Medical Officer of Health Including the Report of the Senior Sanitary Inspector, For the Year ending December 31st, 1937. BUCKHURST HILL: Printed by John W. Phelp, Queen's Road. CONTENTS OF THE REPORT FOR 1937. PAGES. Public Health Committee; 2 Public Health Staff 2 Statistics and Social Conditions 3—4 Vital Statistics 4—10 General Provision of Health Services 10—11 Midwifery and Maternity Centres (Count)'Council) 10 Sanitary Circumstances of the Area 11—14 Housing 15—18 Inspection of, and Supervision of, Food 18—21 Shops 21—22 Inspection of Factories, etc 23 Prevalence of, and Control over, Infectious Diseases 24—26 Bacteriological Investigations 26 Summary 27 Meteorological Record—Rainfall 28 CHIGWELL URBAN DISTRICT COUNCIL. To the Chairman and Members of the Chigwell Urban District Council. Mr. Chairman, Ladiks and Gentlemen, I have the honour to present my Annual Report upon the health and sanitary circumstances of the District for the year 1937. This is the second report since I was appointed Medical Officer of Health and it is drawn up in accordance with the requirements of Article 17 (5) of the Sanitary Officers (Outside London) Regulations, 1935, and Circular 1650 of the Minister of Health dated 4th October, 1937. There have been no changes in the staff during the year. My best thanks go to all Members and Officers of the Council who have kindly given me their assistance during the year and to the Members of my staff who in addition have all contributed to the compilation of this Report. I am, Your obedient Servant, C. R. DYKES, M.R.C.S., L.R.C.P. 2 CHIGWELL URBAN DISTRICT COUNCIL PUBLIC HEALTH COMMITTEE (As at 31st December, 1937). Chairman: Councillor H. Spurr. Members: Councillor Mrs. G. V. Cross. „ F. S. Foster, J.P., E.C.C. „ C. Jacobs, J.P. „ A. E. Oakden. „ J. Seabrook. „ R. F. J. Smith. „ Mrs. D. V. C. E. Spearman. Meeting. Monday in week preceding ordinary Council Meetings which are held on second Wednesday in each month except April and August. PUBLIC HEALTH STAFF. Medical Officer of Health: C. R. Dykes, M.R.C.S., L. R.C.P. Senior Sanitary and Petroleum Inspector: J. T. Heath, M.R.San.l., M.S.I.A. Royal Sanitary Institutes Certificates for:— (i) Sanitary Inspector. (ii) Inspector of Meat and Other Foods. Sanitary Inspector : W. H. Digweed, A.R.San.I., M.S.I.A. Royal Sanitary Institute and Sanitary Inspectors Joint Board Certificate. Royal Sanitary Institute Certificate for Inspector of Meat and Other Foods. Clerk : Miss O. F. Howard. Medical Officers of Welfare Centres: Buckhurst Hill : C. R. Dykes, M.R.C.S., L.R.C.P. Chigwell and Loughton: I. M. Bell, M.B., Ch.B. Health Visitors: Buckhurst Hill: Miss R. Bartter, S.C.M., R.S.I. Chigwell: Miss Myers, S.R.N., S.C.M., R.S.I. Loughton: Miss E. Glover, S.R.N., S.C.M., R.S.I. Midwives: Buckhurst Hill: Miss R. Bartter, S.C.M., R.S.I. Chigwell: Miss F. E. Guise, S.C.M. Loughton: Miss G. H. Quill, S.C.M. Assistant for Buckhurst Hill and Loughton : Miss G. Jones, S.R.N., S.C.M. 3 Section A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 8,970. Population (at 30th June, 1937. Reg. Gen. figures.) 22,510. Number of inhabited houses 6,757. Number of separate families or separate occupiers, not available. Rateable Value £207,203 0s. 0d. Sum represented by a Penny Rate £,779 0s. 0d. The District comprises the basin of the Roding together with the hills on each side of the valley. The low-lying ground on the west side of the river in the Loughton and Buckhurst Hill wards in certain parts is now filled with rows of small houses. There are no factories of any size in the district. A large part of the area still consists of farm and forest land although the farm land is slowly but surely being built upon. There is good residential property on the hills where development is still slowly proceeding. The population has increased by 1,730 during the present year. Last year the increase was 1,320. This is almost entirely due to occupation of new property. The rateable value has increased by over £15,000. The sum obtained from a penny rate has also increased by the same increase as for 1936. The rate in the pound for 1937/38 was 11/8d. The soil is clay with pockets of gravel usually on the higher ground. Owing to the proximity of the district to London there is a large "dormitory" population, practically all the middle class earn their living in London as do a large proportion of the working class. Local occupations are farming, gardening, railway and transport employment and the usual trades. I have to thank the Manager of the Buckhurst Hill Employment Exchange for supplying me with the following information regarding unemployment. The figures relate not only to this district but also to adjacent areas supervised by the Exchang:— Men. Women. Boys. Girls. TOTAL. Totally Unemployed 1936 298 50 9 4 361 Short Time Workers 1936 4 3 0 0 7 302 53 9 4 368 Totally Unemployed 1937 307 57 5 4 373 Short Time Workers 1937 9 7 0 0 16 316 64 5 4 389 4 The District is a healthy one and there are 110 occupations injurious to health. VI TAL STATISTICS. TOTAL. Male. Female. Live Births. Legitimate. 313 167 146 Total Illegitimate. 6 3 3 Total 319 Birth rate per 1,000 of estimated resident population 1937 1936 14.17 14.19 TOTAL. Male. Female. Still Births. Legitimate. 11 7 4 Total. Illegitimate. — Total 11 1937 1936 Rate per 1,000 total (live and still) births 33.33 45.30 Deaths. 1937 - 202. 1936 - 194. Death Rate per 1,000 of estimated resident population Crude. 8.93 9.33 Corrected. 8.57 8.95 Deaths from Puerperal Causes. Deaths. Rate per 1,000 total Births (live and still). 1937 1936. 1937 1936 No. 29. Puerperal Sepsis 0 2 0 6.47 No. 30. Other Puerperal Causes 0 0 0 0 Totals 0 2 0 6.47 1937 1936. Deaths of Infants under 1 year - Legitimate. 8 18 Illegitimate. — - Death Rate of Infants under 1 year of age. All Infants per 1,000 live births. 25.07 61.01 Legitimate Infants, per 1,000 Legitimate births. 25.55 62.5 Illegitimate „ „ „ Illegitimate „ 0 0 1937 1936. Deaths from Cancer (all ages) 37 27 „ ,, Measles (all ages) 0 1 ,, ,, Whooping Cough (all ages) 0 0 „ „ Diarrhoea (under 2 years) 1 1 5 Analysis of Deaths according to Age Incidence. Age. No. of Deaths. 1937 1936. 1935 1934 Under 1 year 8 18 2 8 1 and under 2 1 1 2 — 2 „ „ 5 3 — 1 5 5 „ „ 15 2 5 4 3 15 „ „ 25 2 7 4 5 25 „ „ 35 10 7 8 9 35 „ „ 45 13 9 11 7 45 „ „ 55 24 16 13 17 55 „ „ 65 30 26 42 33 65 „ „ 75 58 36 48 35 75 and upwards 51 69 44 66 Total Deaths 202 194 179 188 The number of deaths during each month of the year were as follows:— In District. Outside District. TOTAL. January 17 2 19 February 6 4 10 March 15 6 21 April 12 4 16 May 16 7 23 June 9 4 13 July 6 5 11 August 6 4 10 September 7 10 17 October 14 10 24 November 9 5 14 December 17 7 24 Totals 134 68 202 It will be noted that of the total slightly over a third died out of the district. This is I think rather a large proportion but is due to the proximity of the metropolis and also to the fact that there are no public assistance institutions in the district. The number of deaths occurring in institutions was as follows:— Epping Infirmary 16 Brentwood Mental Hospital 4 Oldchurch Hospital 3 23 The number of transfers out of the district was 18. 6 The following is the Registrar General's list of Causes of Death CAUSES OF DEATH. All Causes. Male Female. 1. Typhoid and Paratyphoid Fever — - 2. Measles — - 3. Scarlet Fever — - 4. Whooping Cough — - 5. Diphtheria — - 6. Influenza 5 1 7. Encephalitis Lethargica — — 8. Cerebro-Spinal Fever — - 9. Tuberculosis of Respiratory System 4 4 10. Other Tubercular Diseases — — 11. Syphilis 1 — 12. General Paralysis of the Insane, Tabes Dorsalis — — 13. Cancer, Malignant Disease 20 17 14. Diabetes 3 3 15. Cerebral Hæmorrhage, etc. 5 10 16. Heart Disease 19 22 17. Aneurysm — — 18. Other Circulatory Diseases 9 4 19. Bronchitis 8 2 20. Pneumonia (all forms) 6 2 21. Other Respiratory Diseases — 1 22. Peptic Ulcer 1 — 23. Diarrhoea, etc. (under 2 years) 1 — 24. Appendicitis — 1 25. Cirrhosis of the Liver — — 26. Other Diseases of the Liver — — 27. Other Digestive Diseases 3 3 28. Acute and Chronic Nephritis 5 5 29. Puerperal Sepsis — — 7 Causes of Death—All Causes—Continued. Male. Female. 30. Other Puerperal Causes - - 31. Congenital Debility, Premature Birth, Malformations, etc. 2 2 32. Senility — 3 33. Suicide 2 — 34. Other Violence 2 2 35. Other Defined Diseases 13 11 36. I11 Defined or Unknown - — 37. Diarrhoea (2 years and over) - — Total 109 93 Grand Total 202 Special Causes (included in No. 35 above). Smallpox — - Poliomyelitis — - Polioencephalitis — - COMPARATIVE TABLE OF BIRTHS AND DEATH RATE. Year. Estimated Population. Number of Births. Rate per 1,000. N umber of Deaths. Rate per 1,000 (Corrected) Infant Mortality. Number of Deaths. Rate per 1,000 (Live Births). 1934 18,350 212 11.55 188 9 83 8 37.7 1935 19,460 266 13.66 179 7'8 2 7.5 1936 20,780 295 14.19 194 8'95 18 61.01 1937 22,510 319 14.17 202 8"57 8 25.07 TABLE IX.—Birth-rates, Death-rates and Analysis of Mortality in the year, 1937. England and Wales, London, 125 Great Towns, and 148 Smaller Towns. | (Provisional Figures, based on Weekly and Quarterly Returns). Rate per 1,000 Population. Annual Death-bate per 1,000 Population. Rate per 1,000 Live Births. Live Births Still Births. All Causes. Typhoid and Paratyphoid Fevers. Small-pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. | Violence. Diarrhœa and Enteritis (under 2 years). Total Deaths under One Year. England and Wales 149 0.60 124 0.00 — 0.02 0.01 0.04 0.07 0.45 0.54 5.8 58 125 County Boroughs and Great Towns, including London 14.9 0.67 12.5 0.01 - 0.03 0.01 0.04 0.08 0.39 0.45 7.9 62 148 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census 1931) 15.3 0.64 11.9 0.00 - 0.02 0.01 0.03 0.05 0.42 0.42 3.2 55 London 13.3 0.54 12.3 0.00 — 0.01 0.01 0.06 0.05 0.38 0.51 12.0 60 Chigwell U.D.C. 14.17 0.49 8.93 (a) 8.57 (b) 0.00 - o.oo 0.00 0.00 0.00 0.26 0.26 3.13 25.07 Puerperal Sepsis Others. Total. The maternal mortality rates for England and Wales are as follows: per 1,000 Live Births 0.97 2.26 3.23 „ „ Total Births. (Live and Still). 0.94 2.17 3.11 Chigwell Urban District Council ,, ,, Live Births 0.00 0.00 0.00 „ ,, Total Births 0.00 0.00 0.00 (b) Crude. (a) Corrected. (I.ive and Still). 9 REMARKS ON VITAL STATISTICS. The Birth rate shows a very slight decrease in comparison with figure for 1936, from 14.19 to 14.17. The infant mortality rate shows a marked decrease from 61.01 to 25.07, the figure for England and Wales for 1937 being 58. Eight legitimate infants died under the age of one year. I am very pleased to be able to record this decrease as the figure for last year was a high one for this district. The causes of death under 1 year was as follows:— (a) Bronchitis (b) Asphyxia from occlusion of the air passages by natural secretions 1 Prematurity 2 Gangrenous Appendicitis 1 Congenital Duodenal Stenosis 1 Meningitis 1 Gastro-Enteritis 1 Broncho-Pneumonia 1 All these deaths with one exception occurred outside the district. I am also glad to say that the figures relating to child birth are satisfactory for the first time for some years. There have been no deaths during the year. The provisional rate for England and Wales given by the Registrar General for deaths from Puerperal causes for 1937 is 3.11. The general death rate shows a decrease, the figure last year being 8 95 as against 8 57 for 1937. Causes of Death:— Heart Diseases continue to account for more deaths than any other group but the number this year is slightly less than 1936—41 as against 45. The deaths from Cancer show an increase—37 compared with 27—but I do not think that this indicates that this disease is becoming more prevalent as the figure for 1935 was 39 out of a total of 179 deaths. Out of the total of 202 deaths, 139 were of persons over 55 years of age, including 51 of 75 years and upwards. It will be seen therefore that of the total deaths over 25% occurred amongst persons of or over the age of 75 years. The deaths from infectious Diseases were:— Pneumonia (all forms) 8 Influenza 6 (Non-notifiable) Pulmonary Tuberculosis 8 Syphilis 1 10 Pneumonia shows an increase in comparison with last year of 5 or over 100^. The figure for 1936 was, however, a low one as the number of deaths from this disease in 1935 was 9. Influenza shows an increase of 1 death above that of last year. The number of deaths from Pulmonary Tuberculosis—8—as against 5 for 1936, 5 for 1935, and 4 for 1934. This is rather a high figure for this district but it must be remembered that the population has increased by over 4,000 since 1934. To sum up I am very pleased to say that the statistics for this year compare very favourably with those for the years since the amalgamation of the districts of Buckhurst Hill, Chigwell and Loughton in 1933. Section B. GENERAL PROVISIONS OF HEALTH SERVICES IN THE DISTRICT. 1. (i) Public Health Officers of the Authority—See page 2. (ii) (a) Laboratory facilities. Under arrangements made by the Essex County Council. (b) Ambulance facilities. An Ambulance is maintained by the Council but is only available for accidents or other urgent cases. It has been in regular use during the year and at the moment is adequate for the District. A reciprocal arrangement has been made with the neighbouring Borough of Wanstead and Woodford for their ambulance service to be available if required and if this is not available an ambulance can be obtained from Messrs. Flack of Epping. Number of ambulance calls received during the year 172. All the ambulance personnel hold the Certificate of the British Red Cross Society. (c) Nursing in the home. No change. (d) Clinics and Treatment Centres. No change. (e) Hospitals, Public and Voluntary. No change. 2- (i) Midwifery and Maternity Centres. Administered by the County Council. The centres in Buckhurst Hill and Chigwell have continued to work satisfactorily without change. The venue of the Loughton Centre has been changed to the Union Church. Location of Centres:— Buckhurst Hill: Pelly House Club, Queen's Road. Chigwell: Grange Hill Mission Room. Loughton: Union Church Hall, High Road. 11 ESSEX COUNTY COUNCIL ACT, 1933. Establishments for Massage or Special Treatment. List of Establishments in the Urban District of Chigwell, licensed to the 31st March, 1938. Miss C. Dewar, 100, High Road, Loughton. Miss E. Mackern, 225, High Road, Loughton. Miss N. Chappell, 257, High Road, Loughton. Miss J. G. Morris, " Comrie," 4, Russell Road, Buckhurst Hill. These establishments have been inspected and are being carried on in a satisfactory manner. Scction C. SANITARY CIRCUMSTANCES OF THE AREA. 1. (i) Water— Water is supplied by the Metropolitan Water Board, the supply is satisfactory both in quality and quantity. (ii) Drainage and Sewerage— The scheme for the new intercepting sewer between Loughton existing works and the Luxborough site, where new works are to be constructed, still awaits the sanction of the Ministry of Health. Arrangements have been concluded in the meantime by which the scheme will be extended to include a new intercepting sewer from Loughton works to Debden Green and the permission of the Ministry of Health has been obtained to the inviting of tenders for the complete scheme. These will be advertised for early in 1938. During the year a soil sewer has been laid in Fencepiece Road, Chigwell, with a local pumping station near the district boundary and a rising main back to the existing gravity sewer in Hainault Road. The scheme prepared by and carried out by contract under the supervision of the Council's Engineer and Surveyor, has been in operation for some months and removes the local drainage difficulty in this vicinity. It is very satisfactory that a substantial number of the property owners in Fencepiece Road have connected up their soil drainage to the new sewer provided and dispensed with the previous cesspools. It is anticipated that during 1938 the small Grange Hill Sewage Works will be dispensed with by a scheme involving the provisions of new main sewers and a pumping station in connection with development by the London Passenger Transport Board associated with the electrification of the railway. 12 The various disposal works have been satisfactorily maintained having regard to the unfavourable conditions and the delay in commencing the main sewerage scheme. Loughton works, as is to be expected, is the most difficult case and measures to control the standard of the effluent pending the time when these works can be dispensed with are being considered. 2- Rivers and Streams— The river Roding was in flood during the early months of the year and an aerial photograph was taken in January giving a definite and valuable record of the extent of lands liable to flood in the valley within the district boundaries. Regard will be had to this in defining the area to be placed under building prohibition in the Town Planning Schemes. There are no buildings at present in the area liable to flood. 3. (i) Closet Accommodation— A few Closets on the conservancy system remain in Chigwell and Loughton Wards. They are situated in remote cottages out of the reach of sewers. (ii) Public Cleansing— House refuse is removed weekly by covered motor vans under contract. The refuse is disposed of at the contractors own tip near the district boundary, the contract requiring that the precautions and methods of controlled tipping shall be adopted. Butchers' offal and refuse from fish shops is disposed of at the tip adjoining Loughton Sewage Works, being delivered there by the tradesmen and dealt with under the Engineer and Surveyor's instructions. A small charge is made for the facilities given. Putrescible refuse from greengrocers' shops is deposited at this tip also but is dealt with without charge. Road gullies (in streets under the Council's control) are emptied by a mechanical suction process. The gullies are re-sealed with clean water after emptying and the number of clearances has been increased to three in each year. (iii) Sanitary Inspection of the Area. The Work of the Sanitary Inspectors is given below. Further details will be found in the Summary at the end of the report. No. of Inspections made 5,716 ,, „ Nuisances abated 110 ,, ,, Informal Notices served 94 „ ,, Complaints received Nil „ ,, Informal Notices complied with 106* „ „ Statutory „ „ „ 1 „ „ Summonses or Legal Proceedings Nil * Includes 20 left over from 1936. 13 Summary of Nuisances. Animals improperly kep 4 Cellars Flooded 2 Cesspool Overflows 10 Drains Blocked and Defective 38 Manure from Stables, etc 4 Polluted Ditches 10 Refuse Dumps, etc 10 Rubbish Burning 2 Sheds—Used as habitation 1 Smells from dead animals 2 Water closets defective, etc. 25 Water Supply—Defective or cut off 2 110 Visits 492. Verminous Houses.— Twelve houses were found to be verminous during the year. Council Houses 3 Other Houses 9 Two of the Council Houses were first treated with "Cimex" by the Council's workmen under the supervision of the Sanitary Inspector but this was not satisfactory, probably because not enough units were used and also that the houses are constructed of hollow blocks. They were then treated with "Vermicine" by two applications, an interval of a fortnight between each. The work was done by contractors. No trace of vermin has been seen since. " Cimex " was used for the other Council house and for the nine other houses. In every case a satisfactory result was obtained. The work in the Council house was done by the Local Authority and in the other houses by contractors or the occupiers. Number of inspections and visits—48. 14 Rats and Mice (Destruction) Act, 1919. A great deal of time has been devoted to the destruction of rats during the year with a varying amount of success. It is very difficult to deal with rats when they are reported as "overrunning" premises when on visiting no holes can be discovered. In this district where there is still a great deal of building going on and also as a large proportion of the district is forest and farm land frequently it is found that rats appear to have a " visiting list " without having a permanent abode near the places where they obtain food. This food is usually thrown out for birds and a rat was actually seen to catch a bird and drag it off from the lawn on which the bird was feeding, the rat presumably preferring the bird to the other food. The methods used for the destruction of rats in this district are : — 1. Gassing by means of a Cyano Gas Pump. 2. Baiting with Red Squill bait. The first method is very successful when the rats are "at home" and in one instance when the machine was used in farm buildings 18 full grown rats were found dead, huddled together in a small space, when wall boards were removed. It is interesting to note that the younger the rats are the less the gas appears to effect them though it is deadly to the full grown rodent. Baiting is not as successful as it ought to be owing apparently to the rats having access to food. Where it is possible to ensure that rats are unable to get anything else to eat the red squill bait has been the means of clearing them away. Special efforts were made during Rat Week from 1st to 6th November, 1937. Posters were exhibited at prominent places in the district and a slide was shown at the Loughton Cinema. Refuse dumps have been under careful observation throughout the year and in one hunt arranged at the refuse dump at Buckhurst Hill about 30 rats were destroyed. The firm owning this dump also possess a Cyano Gas Pump and take regular and active measures to destroy rats. The Council's sewage works and sewers are fairly free and no undue increase of signs of rat infestation have been noticed. Rat bait has been supplied free to residents on application at the Council Offices. Number of visits—449. (iv) Smoke Abatement—No action taken. 4. Schools— The sanitary conditions and water supply continue to be satisfactory. 15 Section D. HOUSING STATISTICS FOR THE YEAR 1937. Number of new houses erected during the year 1937. (a) Total (including numbers given separately under (b), 1. By Local Authority N 2. By other Authorities Nil 3. By other bodies and persons 622 (b) With State assistance under the Housing Acts. 1. By Local Authority Nil 2. By other bodies or persons Nil Inspection of Dwelling Houses during the Year. 1. (a) Total number of Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 125 (b) Number of Inspections made for the purpose 632 2. (a) Number of Dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 44 (b) Number of Inspections made for the purpose 296 3. Number of Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 123 Remedy of Defects During the Year without Service of Formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 122 Action under Statutory Powers during the Year. (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936 (1) Number of dwelling-houses in respect of which notices were served requiring repairs 1 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) by Owners 1 (b) by Local Authority in default of Owners Nil 16 (b) Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied Nil (2) Number of Dwelling-houses in which defects were remedied after service of formal notices:— (a) by Owners Nil (b) by Local Authority in default of Owners Nil (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936. (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (d) Proceedings under Section 12 of the Housing Act, 1936. (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil Housing Act, 1936—Part IV—Overcrowding. (a) (i) Number of dwellings overcrowded at the end of the year 21 (ii) Number of families dwelling therein 21 (iii) Number of persons dwelling therein 156 (b) Number of new cases of overcrowding reported during the year Nil (c) (i) Number of cases of overcrowding relieved during the year 5 (ii) Number of persons concerned in such cases 35 (d) Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report Nil 17 Summary of Defects. Defective Ceilings 91 „ Roofs 90 „ Walls 178 „ Gutters and Rain-Water Pipes 64 „ Floors (Wood) 77 „ Paving 27 Insufficient Light 3 „ Ventilation 46 Defective Sash Cords 58 „ Plaster 2 Blocked or defective Drains 38 Dampness 56 Defective Water Closet 25 „ Water Waste Preventer 13 Sink and Waste Pipes 79 Cleansing of Walls and Ceilings 145 New Water Waste Preventers installed 18 Miscellaneous, including stoves 260 Housing Act, 1936— The number of houses overcrowded at the end of the year, 1937, was:— Buckhurst Hill 7 Chigwell 6 Loughton 8 21 The scheme for re-housing these families has been prepared but the work has not yet commenced. It is proposed to provide the following houses:— Buckhurst Hill 20 Chigwell 8 Loughton 20 48 18 This will allow for houses to be offered to families who have or who are likely to become overcrowded owing to age or family increases and the scheme also provides for the re-housing of families now living in houses for which Clearance Orders will be made. The issue of certificates showing permitted numbers is almost complete and the number of certificates issued at the end of the year is:— Buckhurst Hill 301 Chigwell 148 Loughton 282 731 Record of new property is made as soon as assessed and most of the new houses are found to be owner occupied. Number of visits 1.770. Section E. INSPECTION AND SUPERVISION OF FOOD. (a) Milk Supply— There are 15 cowkeepers on the register for the district, 7 produce and retail and 8 produce and sell wholesale; 204 visits have been made during the year. No visits were made during November and December owing to the prevalence of Foot and Mouth Desease in the County. I am glad to say no farms in this district were affected. The cowsheds have been maintained in a satisfactory condition. Two farms have closed down during the year, one being taken over by the Royal Air Force and the other comes within the area of the London County Council building scheme in Chigwell. Six samples of milk were taken and submitted to the County Laboratories for examination and report which was as follows:— Satisfactory 5. Unsatisfactory 1. In the case of the unsatisfactory sample the matter was taken up with the producer concerned and a later sample taken by the County Council was satisfactory. 19 44 samples of Tuberculin Tested and accredited milk were taken by the County Council during the year and were reported on as follows:— Satisfactory 33. Unsatisfactory 11. Further samples were taken where the result was unsatisfactory and in 9 cases a satisfactory report was obtained. In the other 2 cases samples do not appear to have been taken probably owing to the suspension of routine work due to Foot and Mouth Disease in other parts of the County. Licenses granted to produce Tuberculin Tested and Accredited Milk have all been renewed during the year. The number of farms producing Graded and Ungraded milk are— Tuberculin Tested (Certified) Accredited Ordinary 1 11 3 Of the producers of ordinary milk, 1 farm has only 2 or 3 cows in milk and the other 2 producers do not at the moment desire to take the necessary steps to arrive at the required standard for production of Accredited Milk. There are 18 Dairies and Milk Shops on the register and 119 visits have been made. 44 retail purveyors of milk are on the register. The following licenses have been issued under the Milk (Special Designations) Order 1936:— Principal Licenses— Accredited Bottling 1 Licenses— Tuberculin Tested 7 Accredited 3 Pasteurised 4 Supplementary Licenses— Tuberculin Tested 6 Accredited 3 Pasteurised 6 Milk and Dairies Consolidation Act, 1915— 11 samples of milk, under this Act, were taken by the County Council during the year, 10 were satisfactory and 1 positive (T.B.) Action was taken in the latter case, the cow producing positive milk was isolated and dealt with under the Tuberculosis Order. 20 Milk to Schools— All milk supplied to Schools during the year was Accredited. Biological examinations were made in respect of three samples taken, of which two were satisfactory. As regards the unsatisfactory report arrangements are to be made to supply Pasteurised Milk at this School. (b) Meat and other Foods— There are seven Slaughterhouses in the district, six registered and one licenced. Regular Inspections are made and the number of visits was 701. The following animals were slaughtered during the year:— CARCASES INSPECTED AND CONDEMNED. Cattle, excluding Cows. Cows. Calves. Sheep and Lambs. Pigs. Number Killed 183 12 123 1,254 614 Number Inspected 183 12 123 1,254 614 All diseases except Tuberculosis. Whole carcases condemned Nil. Nil. Nil. Nil. Nil. Carcases of which some part or organ was condemned 9 Nil. Nil. Nil. 1 Percentage of the number inspected affected with disease other than Tuberculosis 491 Nil. Nil. Nil. 16 Tuberculosis only Whole carcases condemned Nil. Nil. Nil. Nil. Nil. Carcases of which some part or organ was condemned 4 Nil. Nil. Nil. Nil. Percentage of the number inspected affected with Tuberculosis 2.18 Nil. Nil. Nil. Nil. In addition 25 stone 2½ lbs. of Beef (imported) was condemned as unfit for human consumption. 21 There are 10 Bakehouses in the district and all these are kept in good condition. I closed down during the year. Number of visits—129. There are four Fish Friers in the urban district and the premises, etc., are in good order. Number of visits—16. The food shops are kept under observation. Number of visits—92. (c) Ice Cream—Essex County Council Act, 1933. (Part XI). Number of Registrations, on 31st December, 1937. Manufacturer. Vendor. Dealer. Buckhurst Hill Ward 5 8 - Chigwell Ward 3 11 - Loughton Ward 9 21 1 17 40 1 A bad report was received from another district on a sample of Ice Cream produced in this district. The premises were inspected, advice given and a further sample taken on which a satisfoctory report was obtained. No. of Visits—88. (d) SHOPS ACT, 1934. Class of Shop. Lock-up. Otherwise. Total. Buck. Hill. Chigwell. Loughton. Buck. Hill. Chigwell. Loughton. Animal Clinic - - 1 - - - 1 Art - - 1 - - - 1 Art Needlework - - 1 1 - 1 3 Bakers - - 1 4 2 8 15 Boots and Shoes 4 1 5 3 - 2 15 Builders' Merchant 1 - 1 1 - - 3 Butchers 2 1 9 4 2 5 23 Chemists 3 - 3 - 1 2 9 China, Glass and Hardware - - 1 1 - 2 4 Coal Merchants 2 - 2 - - - 4 Confectioners - - 5 - 1 3 9 Cooked Food Stores 1 - - - - 2 3 Costumiers - - 4 - - - 4 Cycle and Radio 1 - 1 1 - - 3 Cycle and Sports - - - - - 1 1 Dairy - - 2 2 - - 4 Draper 1 - 2 5 2 3 13 Dressmaker - - - 1 - - 1 Dyers and Cleaners - - 2 - - - 2 Electrical and Radio 1 - 3 - - 3 7 16 2 44 23 8 32 125 22 Class of Shop. Lock-up. Otherwise. Total. Buck. Hill. Chigwell. Loughton. Buck. Hill. Chigwell. Loughton. Brought forward 16 2 44 23 8 32 125 Electric Supply — — 1 — — — 1 Fishmongers — — 2 2 — 1 5 Florist 1 — — — — 1 2 Fried Fish — — — 2 — — 2 Furniture — — 2 1 — — 3 General Merchants 1 — 2 — — — 3 General Stores 2 — 3 7 7 9 28 Golf Club - — — — 1 — 1 Greengrocer 2 — 5 3 — 7 17 Grocer - — — 5 1 2 8 Grocer and Provision Merchant 3 - 5 2 - 5 15 Hairdresser 2 1 5 4 — 1 13 Ironmonger — — 3 2 — 1 6 Jewellers — — 2 — — — 2 Library — — 1 1 — — 2 Licensed Premises — — — 11 8 12 31 Newsagent 1 — 1 2 — 3 7 Newsagent and Tobacconist - 1 - 2 2 2 7 Off Licence - - - - - 3 3 Optician 1 — — — — — 1 Outfitters — — 2 1 — 3 6 Provision Merchant — — — — — 1 1 Saddler — — 1 — — — 1 Stationer — — 1 — — 1 2 Tailor — — 2 — — — 2 Teashops — 3 4 4 9 7 27 Tobacconist 1 — — — — 2 3 Tobacconist and Confectioner 3 2 8 3 6 22 Toys and Fancy Goods — — 1 — — 1 2 Watchmaker and Jeweller - - - 1 - - 1 Wine and Spirit Merchants — — — 1 — 1 2 Totals 33 7 89 82 39 101 351 Additional Water Closet Accommodation 1. Number of Visits 65. (e) Adulteration—This is dealt with by the County Council. (f) Chemical and Bacteriological Examination of Food— This is dealt with by the County Council. (g) Nutrition—No action. 23 TABLE. 1.—INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by the Sanitary Inspector. Premises. Number of Inspections. Written Notices. Occupiers Prosecuted. Factories (including Factory Laundries) 19 None None Workshops (including Workshop Laundries) 100 None None Workplaces (other than Outworkers' Premises) None None None Totals 119 None None 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts :— Want of Cleanliness None None None None Want of Ventilation None None None None Sanitary accommodation unsuitable or defective 1 1 None None Other Nuisances None None None None Offences under the Factory and Workshops Acts None None None None Totals 1 1 None None 24 Section F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. The figures for Scarlet Fever, 34, is nearly double that for 1936, which was 19. It, however, approximates to the number of cases in 1935—31. The cases were spread over the year as follows:— January 4 February 1 March 2 April 2 May 2 June 6 July 4 August 3 September 2 October 1 November 3 December 4 Of the 6 cases which occurred in June, 4 were boys of about the same age from the school in Princes' Road, Buckhurst Hill. Precautions were taken and the school kept under observation, and I am pleased to say that there were no more cases. The number of cases of Diphtheria—6—are very much less than in 1936; the number then being 15. This is very gratifying and compares favourably with previous years, the figures for which are:— 42 1934—28, 1935—8, 1936—15, and 1937—6. Summary of Cases of Infectious Diseases, showing Number of Cases, Admission to Hospital and Deaths. Infectious Disease. Total Cases (Notified). Admissions to Hospital. Deaths. Scarlet Fever 34 24 — Acute Influenzal Pneumonia 3 - 8 All forms Acute Primary Pneumonia 1 — Acute Lobar Pneumonia 1 — Erysipelas 5 — — Puerperal Fever 1 1 — Puerperal Pyrexia 2 2 — Diphtheria 6 5 — *Chicken Pox 1 1 — Ophthalmia Neonatorum 1 1 — Typhoid 2 2 — Paratyphoid 1 1 — Dysentery 1 - — *Influenza — - 6 *Syphilis — - 1 59 37 15 * Non-Notifiable. 25 Table showing Ages of Persons notified as Infectious Disease. Under 1 year 1 1 and under 2 years — 2 „ „ 3 „ 1 3 „ „ 4 „ 3 4 „ „ 5 „ 3 5 „ „ 10 „ 23 10 „ „ 15 „ 6 15 „ „ 20 „ 4 20 „ „ 35 „ 6 35 „ „ 45 „ 6 45 „ „ 65 „ 6 59 Disinfecting is carried out by spraying and fumigating with "Formalin." Clothes, bedding, etc., are steam disinfected. 22 cases of Scarlet Fever and 4 cases of Diphtheria were admitted to the Waltham Joint Hospital, Waltham Abbey, for treatment. Quite a number of the cases of Scarlet Fever were very slight which accounts for the large number nursed at home. There is growing tendency for doctors not to send mild cases to hospital where it is possible for the patient to be properly looked after at home. The number of cases of Pneumonia notified continues to decrease. There were 5 this year as against 8 in 1936. Immunization against Diphtheria is still being carried out if desired, 69 children being done during the year. The total number of deaths from Infectious Disease, excluding Tuberculosis, show a slight increase, 15 as against 12 in 1936. Table shewing Cases of Infectious Disease sent to Hospitals or Nursed at Home. Class of Case. Waltham Joint Hospital. Other Hospitals. Nursed at Home. Total. Scarlet Fever 22 1 11 34 Acute Influenzal Pneumonia - - 3 3 Acute Primary Pneumonia — — 1 1 Acute Lober Pneumonia — — 1 1 Erysipelas — — 5 5 Puerperal Fever — 1 — 1 Puerperal Pyrexia — 2 — 2 Diphtheria 4 1 1 6 Chicken Pox 1 - — 1 Opthalmia Neonatorum — 1 — 1 Typhoid 1 1 — 2 Paratyphoid — 1 — 1 Dysentery — 1 1 1 Totals 28 8 23 59 26 TUBERCULOSIS. Age. New Cases. Deaths. Respiratory. Non-Respiratory. Respiratory. Non-Respiratory. M F M F M F M F Under 1 year - - - - - - - - 1 and under 5 - - - - - - - - 5 „ „ 15 — — 1 — — — — — 15 „ „ 25 3 1 2 — — 1 — — 25 „ „ 35 2 5 — 2 2 1 — — 35 „ „ 45 3 2 — 1 1 1 — — 45 „ „ 55 — 1 — — — 1 — — 55 „ „ 65 — — — — — — — — 65 and upwards - — — - 1 — — — Totals 8 9 3 3 4 4 - — M.— Male. F.— Female. Notification is satisfactory. The return of deaths by the Registrar-General agrees with the local figure. Laboratory Specimens Examined during the Year. Specimen. By the County Bacteriologist. Diphtheria 61 Sputa 49 Typhoid 6 General 31 Milk 6 Ice Cream 1 Water 2 Total 156 27 GENERAL SANITATION. HOUSING. INFECTIOUS DISEASES. MEAT AND FOOD INSPECTION. Summary of Sanitary Inspector's Visits during the Year ended 31st December, 1937. Nature of Visit or Inspection. No. of Visits. Water Supply 16 Drainage 436 Stables and Piggeries 5 Fried Fish Shops 16 Tents, Vans and Sheds 3 Factories 19 Workshops 100 Outworkers 23 Bakehouses 129 Refuse Collection 8 Refuse Disposal 120 Rats and Mice 449 Smoke Observations 1 Schools 1 Shops 65 Knackers Yard 19 Petroleum 91 Miscellaneous Sanitary Visits 260 1,761 Under Public Health Acts. Number of houses inspected 81 Visits paid to above houses 336 Under Housing Acts. Number of houses inspected 44 Visits paid to above houses 296 Verminous Premises. Number of houses inspected 12 Visits paid to above houses 36 Miscellaneous Housing Visits (a) 1,770 2,575 Inquiries in cases of Infectious Disease 58 Visits re Disinfection 82 Miscellaneous Infectious Disease Visits 16 156 Visits to Slaughterhouses 701 „ „ Butchers 62 „ „ Fishmongers and Poulterers 14 „ „ Grocers 10 „ „ Greengrocers and Fruiterers 6 „ „ Cowsheds 204 „ „ Dairies and Milkshops 119 „ „ Ice Cream Premises 88 Visits in Connection with Sampling. Milk—Bacteriological 10 Miscellaneous Food Visits 10 1,224 Total 5,716 House refuse is collected under the supervision of Mr. G. Holbourn, A.M.Inst., C.E., Engineer and Surveyor. (Signed) J. T. HEATH, M.R.San.I., M.S.I. A., Senior Sanitary Inspector (a) Including visits made under Housing Act, 1936. 28 APPENDIX. RAINFALL IN INCHES BY MONTHS FOR 1937 Buckhurst Hill. High Beech. January 3.49 3.92 February 4.11 4.11 March 2.44 2.64 April 2.88 3.08 May 2.71 2.86 June 1.98 2.04 July 1.82 2.63 August 2.32 1.72 September 1.66 1.48 October 2.06 2.13 November 1.41 1.55 December 4.11 3.60 Totals 30.99 31.76 The rainfall this year is higher than that for 1936, and is the highest recorded since 1927. The average for the last eleven years is 25.88. The highest point in the District is 372 O.D., and the lowest 44 O.D.