CHIG 2 Chiguxll 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, 1938. BUCKHURST HILL: Printed by John W. Phelp, Qceen's Road. CONTENTS OF THE REPORT FOR 1938. PAGES. Report—Medical Officer of Health's Letter 1 Public Health Committee 2 Public Health Staff 2 Statistics and Social Conditions of the Area 3-4 Vital Statistics 4-10 Analysis of Deaths according to age incidence 5 Number of Deaths by Months 5 Causes of Deaths 6 Comparative Table, Birth and Death Rates 7 Table of Birth Rates, Death Rates and Analysis of Mortality 8 Remarks on Vital Statistics 9 General Provisions of Health Services in the District 10-11 Ambulance Calls 10 Sanitary Circumstances of the Area 11-15 Housing Statistics for the Year 15-18 Housing Act, 1936 17 Inspection of, and Supervision of, Food 18-22 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, Ladies and Gentlemen, I have the honour to present my Annual Report upon the health and sanitary circumstances of the District for the year, 1938. This is my third report and it is drawn up in accordance with the provisions of Article 17(5) of the Sanitary Officers (Outside London) Regulations, 1935, and Circular 1728 of the Minister of Health dated October, 1938. The only change in Staff has been due to the absence on account of ill-health of Miss O. F. Howard—Miss J. Warriner having been appointed Clerk temporarily for the period of one year from November, 1938. The work in the Public Health Department has been considerably increased during the year due to the setting up of the Air Raid Precautions Scheme. I have with regret to report two outbreaks of Diphtheria during the year of which details will be found in the Report. My thanks are due to all members and officers of the Council who have kindly given me assistance during the year and to the members of my Staff who in addition have all assisted in the compilation of this Report. I am, Your obedient Servant, R. DYKES, M.R.C.S., L.R.C.P. 2 CHIGWELL URBAN DISTRICT COUNCIL PUBLIC HEALTH COMMITTEE (As at 31st December, 1938). Chairman: Councillor H. Spurr. Members: Councillor Mrs. G. V. Cross. „ F. S. Foster, J.P., E.C.C. ,, E. F. Garner. „ C. F. Housden. „ T. F. Moore. „ H. I. V. Peters. „ 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.I., 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. Clerks: Miss O. F. Howard.-Granted leave without pay until 31/10/39 on account of ill health. Miss J. Warriner.-(Temp.) from 21/11/38. 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 S. J. Myers, S.R.N., S.C.M., R.S.I. Loughton: Miss E. Glover, S.R.N., S.C.M., R.S.I. Midwives practicing in the Area:—County Council 3 District Nurse Midwives 1 Independent 1 Number of Registered Nursing Homes- 3 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. Section A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 8,970 (14 sq. miles approx.). Population (at 30th June, 1938, Reg. Gen. figures.) 23,750. Number of inhabited houses 7,141. Number of separate families or separate occupiers, not available. Rateable Value £220,602 os. od. Sum represented by a Penny Rate £850 os. od. The District comprises roughly 5½ miles of the basin of the River Roding together with the hills on each side of the valley. There are no factories of any size in the district. A large part of the area still consists of farm and forest land but as each year goes by the area of farm land gets smaller and smaller as development of the district proceeds. There is good residential property on the hills, but building here is slow. The establishment of a Balloon Station of the Royal Air Force and the building of two large Schools for the Essex County Council have taken place during the year. The population has increased by 1,140 during the year. Last year the increase was 1,730. This again, as last year, is almost entirely due to the occupation of new property. The rateable value has increased by over £13,000, as against £15,000 in 1937. The sum obtained from a Penny Rate has also increased by £71. The rate in the pound for 1938/39 was n/8d. The soil is clay with pockets of gravel on the higher ground as a rule. There is a large "dormitory" population in the district owing to its proximity to London and practically the whole of the middle and a large proportion of the working classes earn their living in the metropolis. Local occupations are farming, gardening, railway and transport employment and the usual trades. The information regarding unemployment for 1938 has been supplied by the Ministry of Labour and shows a considerable increase as compared with the two preceding years. The figures relate to the district for which the Exchange operates, of which, the Chigwell U.D. is only a part. Men. Women. Boys. Girls. TOTAL. Total Unemployed, 1936 298 50 9 4 361 Short Time Workers, 1936 4 3 0 0 7 302 53 9 4 368 4 Statistics and Social Conditions of the Area—Continued. Men. Women. Boys. Girls. total. Total Unemployed, 1937 307 57 5 4 373 Short Time Workers, 1937 9 7 0 0 16 316 64 5 4 389 Total Unemployed, 1938 522 89 7 3 621 Temporarily suspended from work, 1938 4 6 1 0 11 526 95 8 3 632 The District is a healthy one and there are no occupations which are injurious to health. VITAL STATISTICS. Male. Female. TOTAL. Live Births. Legitimate. 193 201 394 Illegitimate. 4 8 12 Total 406 Birth rate per 1,000 of estimated resident population 1938. 1937. 17.09 14.17 Male. Female TOTAL. Still Births. Legitimate. 7 2 9 Illegitimate. - - - Total 9 1938. 1937. Rate per 1,000 total (live and still) births 21.68 33.33 Deaths. 1938-222. 1937-202. Death Rate per 1,000 of estimated Crude. 9.34 8.93 resident population Corrected. 8.97 8.57 Deaths from Puerperal Causes. Number. Rate per 1,000 total Births (live and still). 1938. 1937. 1938. 1937. No. 29. Puerperal Sepsis 0 0 0 0 No. 30. Other Puerperal Causes 2 0 4.81 0 Totals 2 0 4.81 0 Deaths of Infants Under i Year 1938. 1937. Legitimate. 10 8 Illegitimate. 1 0 5 Death Rate of Infants Under i Year of age: 1938. 1937. All Infants per 1,000 live births. 27.09 25.07 Legitimate Infants, per 1,000 Legitimate births. 25.38 25.55 Illegitimate „ ,, „ Illegitimate ,, 8.33 0 1938. 1937. Deaths from Cancer (all ages) 43 37 ,, ,, Measles (all ages) 1 0 ,, ,, Whooping Cough (all ages) 0 0 ,, ,, Diarrhoea (under 2 years) 3 1 Analysis of Deaths according to Age Incidence. No. of Deaths. Age. 1938. 1937. 1936. 1935. 1934. Under 1 year 11 8 18 2 8 1 and under 2 3 1 1 2 - 2 ,, „ 5 2 3 - 1 5 5 „ „ 15 3 2 5 4 3 15 „ „ 25 3 2 7 4 5 25 „ „ 35 10 10 7 8 9 35 „ „ 45 14 13 9 11 7 45 „ „ 55 28 24 16 13 17 55 „ „ 65 33 30 26 42 33 65 „ „ 75 58 58 36 48 35 75 and upwards 57 51 69 44 66 Total 222 202 194 179 188 NUMBER OF DEATHS BY MONTHS. In District. Outside District. TOTAL. January 17 7 24 February 14 7 21 March 14 6 20 April 8 13 21 May 17 5 22 June 5 3 8 July 6 8 14 August 10 7 17 September 5 10 15 October 10 8 18 November 8 7 15 December 16 11 27 Totals Totals, 1937 130 134 92 68 222 202 6 The number of deaths occurring in institutions was as follows:— 1938. 1937. St. Magaret's Hospital, Epping 29 16 Brentwood Mental Hospital 2 4 Oldchurch Hospital 3 3 34 23 The number of deaths occuring in the district of people residing outside the district was:— 1938. 1937. 22 18 The following is the Registrar General's list of Causes of Death:— CAUSES OF DEATH. All Causes. Male. Female. 1. Typhoid and Paratyphoid - 1 2. Measles 1 - 3. Scarlet Fever - - 4. Whooping Cough - - 5. Diphtheria - 2 6. Influenza - - 7. Encephalitis Lethargica - - 8. Cerebro-Spinal Fever - - 9. Tuberculosis of Respiratory System 5 3 10. Other Tubercular Diseases - 1 11. Syphilis - - 12. General Paralysis of the Insane, Tabes Dorsalis 2 - 13. Cancer, Malignant Disease 20 23 14. Diabetes 1 1 15. Cerebral Haemorrhage, etc. 4 12 16. Heart Disease 35 22 17. Aneurysm - - 18. Other Circulatory Diseases 3 2 19. Bronchitis 3 2 20. Pneumonia (all forms) 6 6 21. Other Respiratory Diseases 2 2 22. Peptic Ulcer 1 1 23. Diarrhoea, etc. (under 2 years) 2 1 24. Appendicitis - - 25. Cirrhosis of the Liver - 1 26. Other Diseases of the Liver - 3 27. Other Digestive Diseases 6 - 28. Acute and Chronic Nephritis 6 1 29. Puerperal Sepsis - - 4 Causes of Death—All Causes—Continued. Male. Female. 30. Other Puerperal Causes - 2 31. Congenital Debility, Premature Birth, Malformations, etc. 5 - 32. Senility 1 6 33. Suicide 2 1 34. Other Violence 5 2 35. Other Defined Diseases 9 8 36. Ill Defined or Unknown - - 37. Diarrhoea (2 years and over) - - Total 119 103 Grand Total 222 Special Causes (included in No. 35 above). Male. Female. Smallpox - - Poliomyelitis - - Polioencephalitis - - COMPARATIVE TABLE OF BIRTH 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 1938 23,750 406 17.09 222 8.97 11 27.09 8 TABLE IX.—Birth-rates, Death-rates and Analysis of Mortality England and Wales, London, 126 Great Towns, and 148 Smaller in the year, 1938. Towns. (Provisional Figures, based on Weekly and Quarterly Returns). rate per 1,000 Population. Annual Death-rate per 1,000 Population. Rate per 1,000 Live Births. All Causes. Typhoid and Paratyphoid Fevers. Small-pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Diarrhoea and Enteritis (under 2 years). Total Deaths under One Year. England and Wales Live Births. Still Births. 15.1 0.60 11.6 0.00 0.00 0.04 0.01 0.03 0.07 0.11 5.5 53 126 County Boroughs and Great Towns, including London 15.0 0.65 11.7 0.00 0.00 0.05 0.01 0.03 0.07 0.10 7.8 57 148 Smaller Towns (Estimated Resident Populations 25,000 to 50,000 at Census 1931) 15.4 0.60 11.0 0.00 0.00 0.03 0.01 0.02 0.06 0.11 3.6 51 London 13.4 0.48 11.4 0.00 0.00 0.06 0.01 0.03 0.05 0.06 13.1 57 Chigwell U.D.C. 17.09 0.37 9.34(a) 8.97(b) 0.04 0.00 0.04 0.00 0.00 0.08 0.00 7.38 27.09 The maternal mortality rates for England and Wales are as follows: Puerperal Sepsis. Others. Total. per 1,000 Live Births 0.89 2.19 3.08 „ „ Total Births 0.86 2.11 2.97 Chigwell Urban District Council (Live and Still). ,, ,, Live Births 0.00 4.92 4.92 ,, ,, Total Hirths (Live and Still). 0.00 4.81 4.81 (a) Crude. (b) Corrected. 9 REMARKS ON VITAL STATISTICS. The birth rate is the highest since the formation of the Chigwell Urban District, the figure this year being 17.09 as against 14.17 last year. The infant mortality rate is slightly higher, 27.09 as compared with 25.07 for 1937—the figure for England and Wales during this period was 57. Eleven infants died under the age of one year of which 10 were legitimate and i illegitimate. These figures are very satisfactory. The causes of death under i year are as follows:— Prematurity 4 Tubercular Meningitis 1 Toxaemia and Gastro-Enteritis 1 Pneumonia 1 Broncho-Pneumonia 1 Cerebral Haemorrhage-Difficult Breech delivery at birth 1 Gastro Enteritis 1 Toxaemia and Exhaustion 1 11 Seven of these deaths occurred outside and four in the District. The figures relating to child birth are not so satisfactory as last year. There were 2 deaths from "Other Puerperal Causes" as against none last year. This gives a rate per 1,000 births of 4.8i as against 2.97 for England and Wales. The general death rate is practically the same as last year the figures being:— 1937 8.57. 1938 8.97. Heart Diseases continue to account for more deaths than any other group. The number of deaths from this cause shows a considerable increase on 1937, which was 41, and in 1938, there were 57. The deaths from cancer also show an increase, 43 as compared with 37 in 1937 Of the 222 deaths, 148 were of persons over 55 years of age, including 57 of 75 years and upwards. Therefore over 25% of the deaths occurred amongst persons of 75 or over, and more than 50^ of the age of 55 or above. The deaths from Infectious Diseases were:— Typhoid 1 Measles 1 Diphtheria 2 Pneumonia (all forms) 12 Other Puerperal Causes 2 Pneumonia again shows an increase compared with last year, the number then being 8. 10 Remarks on Vital Statistics—continued. It is gratifying to record that there were no deaths from Influenza. The deaths from Pulmonary Tuberculosis were the same as for 1937-8. Figures for preceding years were:— 1934 4. 1935 5. 1936 5. 1937 8. The statistics given compare favourably with those shown for England and Wales, particularly the birth rate. 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 and is only available for accidents or urgent Medical cases. It has been in regular use during the year and is at present adequate for the District. The reciprocal arrangements regarding ambulance service made with the Borough of Wanstead and Woodford is satisfactory and in an emergency the Ambulance can be obtained from Messrs. Flack of Epping. The ambulance personnel are efficient and all hold the Certificate of the British Red Cross Society. Number of ambulance calls received during the year 195 as against 172 in 1937. List as follows:— AMBULANCE CALLS. Month Number of Calls. Accident or other reason. Urgent Medical. January 5 5 - February 14 9 5 March 9 4 5 April 13 10 3 May 24 21 3 June 27 19 8 July 11 10 1 August 21 19 2 September 26 19 7 October 14 12 2 November 16 9 7 December 15 11 4 195 148 47 (c) Nursing in the home. No change. (d) Clinics and Treatment Centres. No change. (e) Hospitals, Public and Voluntary. No change. 11 2. (i) Midwifery and Maternity Centres. Administered by the Essex County Council. There is a centre at each ward in the district: Buckhurst Hill: Pelly House Club, Queen's Road. Chigwell: Grange Hill Mission Room. Loughton: Union Church Hall, High Road. All these centres have worked satisfactorily during the year. ESSEX COUNTY COUNCIL ACT, 1933. List of Establishments for Massage or Special Treatment. These establishments are licensed to 31st March, 1939. Miss E. Mackern, 45, Church Hill, Loughton. Miss J. G. Morris, i6oa, Queen's Road, Buckhurst Hill. Miss N. Chappell, 257, High Road, Loughton. Miss C. Dewar, 100, High Road, Loughton. These premises have been inspected and are being carried on in a satisfactory manner. Section C. SANITARY CIRCUMSTANCES OF THE AREA. 1. (i) Water— The water supply for almost the whole district is derived from the Metropolitan Water Board. This supply is very satisfactory both in quality and quantity. There are a few isolated houses where the supply is from wells. In one instance the present supply from a well to three houses is unsatisfactory and instructions have been issued for all water to be boiled before use, and in one of the houses it is being chlorinated. It is hoped to connect these premises to the main supply during 1939. (ii) Drainage and Sewerage— The scheme for the new intercepting sewer between Debden Green and Luxborough, and the construction of new outfall works on the Luxborough site, has been commenced during the year and very satisfactory progress has been made. The completion of this scheme will enable the use of the present Loughton and Buckurst Hill Works, and the small works at Debden, to be discontinued, and the pumping stations at Rous Road and Monkhams Estate, Buckhurst Hill, to be dispensed with. Present indications point to the new scheme being in operation some time in the Autumn of 1939. 12 The only other sewage works in the area, additional to Luxborough, will then be the small installation at Millers Lane, Chigwell Row, for which some reconstruction and improvement is also contemplated. The scheme at Grange Hill has also made substantial progress during the year. Early in 1939 the small Grange Hill sewage works and the small works near to it (owned by the L.N.E.R.) will be dispensed with, by the completion of the scheme for new sewers connecting to a pumping station on the southern boundary of the district near Fencepiece Road. The various disposal works have been satisfactorily maintained having regard to the difficult conditions and the heavy load imposed on them. Loughton works has naturally presented the most serious problem, and it was deemed desirable to adopt the precaution of chlorinating the effluent. A plant was installed early in the year, and this effluent has been receiving this treatment ever since. 2- Rivers and Streams— The river Roding is the only one passing through the centre of the district dividing the wards of Chigwell on the south east side and Buckhurst Hill and Loughton on the north west side. There are no buildings at present in the area liable to floods and this is under the jurisdiction of the Roding Catchment Board. 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. 13 Road gullies (in streets under the Council's control) are emptied by a mechanical suction process. The gullies are cleared three times in each year and are re-sealed with clean water after each emptying. (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 4,252 „ ,, Summons or Legal Proceedings Nil „ ,, Cesspools cleaned 7 „ „ ,, dispensed with 9 „ „ Nuisances abated 154 „ „ Formal Notices served 1 ,, „ Informal Notices served 84 „ „ Informal Notices complied with 71 „ „ Formal Notices complied with 1 ,, „ Complaints received Nil Summary of Nuisances. Animals improperly kept 2 Cellars Flooded 1 Cesspool Overflows 12 Drains Blocked or Defective 72 Manure from Stables, etc. 3 Polluted Ditches and Streams 19 Refuse Dumps, etc. 23 Rubbish Burning 1 Sheds used for habitation 1 Smells from dead animals 2 Water closets defective 8 Water Supply—defective or cut off 10 154 Visits, 492. 14 Verminous Houses.- Five houses were found to be verminous during the year: Council Houses 2 Other Houses 3 The Council Houses were a pair of semi-detached "parlour" type houses and had been fumigated some years ago. They were treated with "Zaldecide" by the Council's workmen each house being sprayed twice with an interval of 14 days between each spraying. One house was empty at the time. The houses are now both occupied and no reports have heen received as to presence of vermin. Of the other houses one was treated similarly to the Council Houses and a satifactory result obtained. The other two houses were semi-detached and were fumigated with " Cimex." Number of inspections and visits, 40. Rats and Mice (Destruction) Act, 1919. The destruction of rats continues to take up a considerable amount of time as it is carried on throughout the year though during rat week as much time as can be spared is devoted to this purpose. The rat population must be gradually decreasing as building operations encroach upon farm land and private estates, but with such a large area of forest it is difficult to take other than palliative measures to exterminate these pests. There are a few places in the district where it seems impossible to get rid of all the rats—these are farms and similar places ; and as much help as possible is given to keep the rats from unduly increasing. There is one refuse dump in the district where rat hunts were organised periodically and now the contractors who dump on this site have engaged a firm who specialize in rat destruction to deal with the problem and 1 understand that considerable progress has been made. The methods used for rat destruction have not been changed, they are:— 1. Gassing by a Cyano Gas Pump. 2. Baiting with Red Squill. The first method continues to give satisfactory results and at the rear of one business premises over twenty rats were killed during rat week in just over an hour. Baiting is done where it is dangerous to use the Gas Pump and the results obtained are, on the whole, very good. 15 During Rat Week posters were exhibited in prominent places throughout the district calling the attention of everyone to the importance of destroying rats and intimating that help and advice can be obtained on application to the Public Health Department. The usual slide was also shown at the Loughton Cinema. Several visits have been made to the Council's sewage works and a few rats have been killed. Where evidence of the presence of rats is noticed immediate steps are taken to ''gas" the ''workings." The sewers are kept under observation and special bait for use in sewers has been obtained. The baits are watched and renewed where necessary. Rat bait is still supplied free on application. Number of visits—319. (iv) Smoke Abatement—No action taken. 4. Schools— The sanitary conditions and water supply is satisfactory. In one school the flush to the boys' urinal has been renewed. Section D. HOUSING STATISTICS FOR THE YEAR 1938. Number of new houses erected during the year 1938. (a) Total (including numbers given separately under (b)) 1. By Local Authority 16 2. By other Authorities 2 3. By other bodies and persons 430 (b) With State assistance under the Housing Acts. 1. By Local Authority 16 2. By other bodies and persons Nil Inspection of Dwelling Houses during the Year. 1. (a) Total number of Dwelling-houses inspected for housing defects (under Public Health and Housing Acts) 31 (b) Number of Inspections made for the purpose 311 2.(a) Number of Dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 9 (b) Number of Inspections made for the purpose 218 3. Number of Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 7 16 (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 40 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 31 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 Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) by Owners Nil (l>) by Local Authority in default of Owners Nil (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 II and 13 of the Housing Act, 1936. (1) Number of dwelling-houses in respect of which Demolition Orders were made 7 (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 17 Housing Act, 1936—Part IV—Overcrowding. (a) (i) Number of dwellings overcrowded at the end of the year 21 (it) Number of families dwelling therein 21 (iii) Number of persons dwelling therein 153 (b) Number of cases of overcrowding reported during the year 6 (c) (i) Number of cases of overcrowding relieved during the year 6 (ii) Number of persons concerned in such cases 41 (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 Licences for 2 families shown under (c) (1) have been issued permitting the house to be overcrowed for a period of one year. The overcrowding in each case was only by ½ equivalent adult. Summary of Defects. Defective Ceilings 7 ,, Roofs 34 Walls 40 „ Gutters and Rain-Water Pipes 23 ,, Floors (Wood) 15 „ Paving 7 ,, Sash Cords 7 ,, Plaster 10 Blocked or defective Drains 72 Dampness 36 Defective Water Closet 13 ,, Water Waste Preventer 13 Sink and Waste Pipes 22 Cleansing of Walls and Ceilings 14 Miscellaneous, including stoves 68 Housing Act, 1936— The number of houses overcrowded at the end of the year, 1938, was:— Buckhurst Hill 6 Chigwell 5 Loughton 10 21 The total is the same as last year, six new cases of overcrowding being reported and six cases of overcrowding relieved during the year. 18 The building of the 46 houses to accommodate the occupants of overcrowded houses and houses to be demolished was commenced early in the year and a few houses were made ready for occupation in January, 1939. All the houses being built are semi-detached. The accommodation to be provided is as follows:— 14 in family 1 12 „ „ 1 9 „ „ 16 6 „ „ 26 4 „ „ 1 2 „ ,, 2 flats— 2 each 1 46 The issue of certificates showing permitted numbers to the end of the year is as follows:— To the end of To the end of 1937. 1938. Buckhurst Hill 301 327 Chigwell 148 157 Loughton 282 341 Number of visits, 426. Section E. INSPECTION AND SUPERVISION OF FOOD. (a) Milk Supply— There are 15 cowkeepers on the register for the district, 8 produce and retail and 7 produce and sell wholesale; 176 visits have been made during the year. The cowsheds have been maintained in a satisfactory condition. In one case, increased light and ventilation was made. One sample of milk was taken and submitted to the County Laboratories for examination and the result was satisfactory. The County Council took 49 samples of Tuberculin Tested and Accredited milk which were submitted to the Methylene Blue Test, 40 were satisfactory, 9 unsatisfactory. A further 9 samples were taken in the case of the unsatisfactory ones, which proved to be satisfactory, making a total of 58 samples. 19 Licences 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 There are 17 Dairies and Milkshops on the register,one having been closed down during the year. 92 visits have been made. There are 35 retail purveyors of milk on the register. The following licences have been issued under the Milk (Special Designations) Order, 1936:— Principal Licences— Nil. Licences— Tuberculin Tested 1 Accredited 2 Pasteurised 5 Supplementary Licences— Tuberculin Tested 7 Accredited 1 Pasteurised 6 Milk and Dairies Consolidation Act, 1915— Four samples of milk under this Act were taken by the County Council during the year, 3 were satisfactory and 1 positive (T.B.). Action was taken in the latter case and the cow producing positive milk was removed from the herd. Milk to Schools— All milk supplied to Schools during the year was Accredited and Pasteurised. Biological examinations were made in respect of the samples taken and all were satisfactory. (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 628. 20 The following animals were slaughtered during the year:— CARCASES INSPECTED AND CONDEMNED. Cattle, excluding Cows. Cows. Calves. Sheep and Lambs. Pigs. Number Killed 171 Nil. 148 1,276 489 Number Inspected 171 Nil. 148 1,276 489 All Diseases except Tuberculosis. Whole carcases condemned Nil. Nil. Nil. Nil. 1 Carcases of which some part or organ was condemned 13 Nil. Nil. Nil. Nil Percentage of the number inspected affected with disease other than Tuberculosis 7.60 Nil. Nil. Nil. .20 Tuberculosis only. Whole carcases condemned Nil. Nil. Nil. Nil. Nil. Carcases of which some part or organ was condemned 3 Nil. Nil. Nil. Nil. Percentage of the number inspected affected with Tuberculosis 1.75 Nil. Nil. Nil. Nil. In addition 1, 6 lb. tin of corned beef and 2 tins of chicken were condemned as unfit for human consumption. There are 10 Bakehouses in the district and all these are kept in good condition. Number of visits—106. There are four Fish Friers in the urban district and the premises are in good order. Number of visits—14. The food shops are kept under observation. 21 Two cases of food poisoning were investigated during the year. In one case no food was obtainable to be sent for analysis, in the other case, tins of Brisling were sent to the Counties Public Health Laboratories who reported as follows:— "Apart from examination for bacteria of the Salmonella group, search was also made for staphylococcus aureus, streptococci, B. coli and B. welchii with negative results in all cases." Further tins were sent to the Analytical Laboratory who reported as follows:— "I find no chemical evidence of any objectionable impurity." Number of visits—95. (c) Ice Cream—Essex County Council Act, 1933. (Part XI). Number of Registrations, on 31st December, 1938. Manufacturer. Vendor. Dealer. Buckhurst Hill Ward 3 15 1 Chigwell Ward 2 13 - Loughton Ward 7 28 2 12 56 3 No. of Visits—75. (d) SHOPS ACT, 1934. Class of Shop. Lock-up. Otherwise. Total. Buck. Hill. Chigwell. Loughton. Buck. Hill. Chigwell. Loughton. Animal Clinic — — I — — — 1 Art — I - - - 1 Art Needlework 2 - 2 - - 1 5 Bakers - - 2 5 2 8 17 Bazaar - - 1 - - - 1 Boots and Shoes 3 1 7 3 1 3 18 Builders' Merchant 1 - 4 1 - - 6 Butchers 3 1 8 6 2 5 25 Chemists 3 - 4 - I 2 10 China, Glass and Hardware - - 2 1 - 2 5 Coal Merchants 2 — 3 - - - 5 Confectioners — — 2 — 1 4 7 Cooked Food Stores 1 - - — - 1 2 Costumiers — — 1 — - — 1 Cycle, Radio and Sports 3 — 4 1 - 3 11 Dairy — — 2 1 1 2 6 Draper 1 - 3 4 2 2 12 Dressmaker — — 1 1 - - 2 Dyers and Cleaners — 1 4 - - - 5 Electrical Showrooms — - 1 — - - 1 19 3 53 23 10 33 141 22 Class of Shop. Lock-up. Otherwise. Total Buck. Hill. Chigwell. Loughton. Buck. Hill. Chigwell. Lough ton. Brought forward 19 3 53 23 10 33 141 Fishmongers - - 2 2 - 1 5 Florist I — 1 - - 1 3 Fried Fish - - - 1 - - 1 Furniture — - 2 2 - - 4 General Merchants 1 - 2 - - - 3 General Stores 1 - 2 8 7 7 25 Golf Club - - - - 1 - 1 Greengrocer 1 — 5 5 - 9 20 Grocer 1 - 2 2 1 1 7 Grocer and Provision Merchant 4 - 4 2 - 6 16 Hairdresser 1 1 7 4 — 2 15 Ironmonger - 2 2 4 - 2 10 Jewellers - - 2 - - - 2 Library — — 2 1 - - 3 Licensed Premises - - 1 11 9 11 32 Newsagent - - 1 1 - 1 3 Newsagent and Tobacconist - - - 2 2 2 6 Off Licence - - - 1 1 3 5 Optician 1 — — — — - - Outfitters — — 1 1 — 5 7 Photographer — — 1 — — - 1 Provision Merchant — - — - — 2 2 Saddler - - 1 - — — 1 Sewing Machines — — 1 — — — 1 Stationer 1 — 1 1 — 2 5 Tailor — — 1 - — — 1 Teashops - 3 4 4 6 5 22 Tobacconist - - - - - 2 2 Tobacconist and Confectioner 3 - 3 6 5 6 23 Toys and Fancy Goods - - 1 - - 2 3 Watchmaker and Jeweller - - - 1 - - 1 Wine and Spirit Merchants - — — 1 — 1 2 Totals 34 9 102 83 42 104 374 Additional Water Closet Accommodation 1. Number of Visits 65. (e) Adulteration—This is dealt with by the County Council. (J) Chemical and Bacteriological Examination of Food— This is dealt with by the County Council (g) Nutrition—No action. 23 TABLE. i.—INSPECTION OF FACTORIES AND OTHER PREMISES. Including Inspections made by the Sanitary Inspector. Premises. N umber of Inspections. Written Notices. Occupiers Prosecuted. Factories with mechanical power 12 None None Factories without mechanical power 128 None None Other Premises None None None Totals 140 None None 2.—DEFECTS FOUND. Number of Defects. Particulars. Found. Remedied. Referred to H.M. Inspector. Number of Prosecutions. Want of Cleanliness 1 1 None None Overcrowding None None None None Unreasonable Temperature None None None None Inadequate Ventilation None None None None Ineffective drainage of floors None None None None Sanitary Conveniences:— Insufficient None None None None Unsuitable or defective None None None None Not separate for sexes None None None None Other offences None None None None Totals 1 1 None None 24 Section F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. This year has been abnormal in regard to Infectious Disease, particularly as regards Diphtheria. Early in the year 17 cases were notified at St. John's Open Air School, all cases were removed to the Waltham Joint Hospital. All possible precautions were taken, the school being put under quarantine and all visitors stopped. Consultations were held with the County Medical Officer of Health. A further outbreak in the Autumn resulted in the notification of 44 cases, originating at the Loughton Senior School. Strict investigations were made, close contact was kept with the Ministry of Health and the County Medical Officer of Health and daily inspections were carried out of the scholars attending the school. I was gratified to know that the Ministry of Health were satisfied that the Public Health Department were carrying out their duties in an efficient manner. The cases were spread over the year as follows:— January 17 February 10 March 8 April 6 May 8 June 6 July 7 August 5 September 14 October 36 November 8 December 9 Including 3 cases of Measles. 134 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 24 19 - All Forms. Registrar General's Figures. Acute Influenzal 12 Pneumonia 2 - Acute Primary Pneumonia 2 — Acute Lobar Pneumonia 2 — Erysipelas 6 i - Puerperal Pyrexia 3 2 - Diphtheria 87 87 2 Ophthalmia Neonatorum i - - Typhoid - - 1 Dysentery 3 3 - *Measles 3 3 1 Anterior Poliomyelitis 1 1 — * Non-Notifiable 134 116 16 25 Table showing Ages of Persons notified as Infectious Disease. Under 1 year ... ... ... 2 1 and under 2 years ... ... ... 1 2 ,, ,, 3 „ ... ... ... 2 3 „ „ 4 „ ... ... ... 7 4 „ „ 5 „ ... ... ... 2 5 „ „ 10 „ ... ... ... 52 10 ,, „ 15 „ ... ... ... 32 15 „ „ 20 „ ... ... ... 8 20 ,, ,, 35 „ ... ... ... 14 35 „ „ 45 „ ... ... ... — 45 „ „ 65 „ and over ... ... 14 Including 3 cases of Measles. 134 Disinfecting is carried out by spraying and fumigating with "Formalin." Clothes, bedding, etc., are steam disinfected, Immunization against Diphtheria is still being carried out if desired, 153 children being done during the year. The total number of deaths from Infectious Disease, excluding Tuberculosis, was 16. 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 19 - 5 24 Acute Influenzal Pneumonia - - 2 2 Acute Primary Pneumonia - - 2 2 Acute Lobar Pneumonia - - 2 2 Erysipelas 1 - 5 6 Puerperal Pyrexia 2 - 1 3 Diphtheria 87 — — 87 *Measles 3 — — 3 Opthalmia Neonatorum - — 1 1 Typhoid - — — — Dysentery 3 — — 3 Anterior Poliomyelitis 1 — — 1 Totals 116 — 18 134 * Not Notifiable. 26 TUBERCULOSIS. Age. New Cases. Deaths. Respiratory. Non- Respiratory. Respiratory. Non-Respiratory. M F M F M F M F Under i year - - - - - - - 1 I and under 5 - - 1 — — — — — 5 „ „ 15 - - - - - - - - 15 „ „ 25 4 - - - 1 — — — 25 „ „ 35 3 3 — — 2 2 — — 35 „ „ 45 0 1 — — 1 — — — 45 „ „ 55 1 — — — 1 1 — — 55 „ „ 65 - 1 — — — — — — 65 and upwards - - - - - - - - Totals 14 5 - — 5 3 - 1 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 ... ... ... ... ... 407 Sputa ... ... ... ... ... 30 Typhoid ... ... ... ... ... - Ringworm ... ... ... ... ... - General ... ... ... ... ... 53 Milk ... ... ... ... ... 1 Ice Cream ... ... ... ... ... - Water ... ... ... ... ... - Sewage ... ... ... ... ... - Total 491 27 Summary of Sanitary Inspector's Visits during the Year ended 31st December, 1938. Nature of Visit or Inspection. No. of Visits. Water Supply ... ... ... ... 32 Drainage ... ... ... ... ... 646 Stables and Piggeries ... ... ... ... ... 23 Fried Fish Shops ... ... ... ... ... 14 Tents, Vans and Sheds ... ... ... ... ... 2 Factories ... ... ... ... ... 12 Workshops ... ... ... ... ... 128 Outworkers ... ... ... ... ... 24 Bakehouses ... ... ... ... ... 106 Refuse Collection ... ... ... ... ... 24 Refuse Disposal ... ... ... ... ... 64 Rats and Mice ... ... ... ... ... 319 Schools ... ... ... ... ... 4 Shops ... ... ... ... ... 64 Knackers Yard ... ... ... ... ... 22 Petroleum ... ... ... ... ... 112 Miscellaneous Sanitary Visits ... ... ... ... 349 1,945 GENERAL SANITATION. Under Public Health Acts. Number of houses inspected ... ... ... 22 Visits paid to above houses ... ... ... 93 Under Housing Acts. Number of houses inspected ... ... ... 9 Visits paid to above houses ... ... ... 218 Verminous Premises. Number of houses inspected ... ... ... 6 Visits paid to above houses ... ... ... 34 Miscellaneous Housing Visits (a) ... ... ... 426 80S Inquiries in cases of Infectious Disease ... ... ... 191 Visitsre Disinfection ... ... ... 168 Miscellaneous Infectious Disease Visits ... ... ... 73 432 Visits to Slaughterhouses ... ... ... 628 ,, ,, Butchers ... ... ... 57 ,, ,, Fishmongers and Poulterers ... ... ... 14 ,, ,, Grocers ... ... ... 5 ,, ,, Greengrocers and Fruiterers ... ... ... 9 ,, ,, Cowsheds ... ... ... 176 ,, ,, Dairies and Milkshops ... ... ... 92 ,, ,, Ice Cream Premises ... ... ... 75 Visits in Connection with Sampling. Milk—Bacteriological ... ... ... 1 Miscellaneous Food Visits ... ... ... 10 1,067 Total 4,252 MEAT AND FOOD INFECTIOUS HOUSING, INSPECTION. DISEASES. 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 1938. Buckhurst Hill. High Beech. January ... ... 2.91 2.94 February ... ... .69 .83 March ... ... .35 .56 April ... ... .13 .16 May ... ... 1.62 1.98 June ... ... .42 .47 July ... ... 1.54 1.85 August ... ... 1.51 1.49 September ... ... 3.38 3.13 October ... ... 2.66 2.88 November ... ... 3.27 3.46 December ... ... 3.31 3.51 Totals 21.79 23.26 The rainfall this year is lower than that for 1937. The average for the last ten years is 25.27. The highest point in the District is 372 O.D., and the lowest 44 O.D.