LIBRARY Chigwell Urban District Council MEDICAL OFFICER OF HEALTH Including the Report of the SENIOR SANITARY INSPECTOR For the Year ending December 31st, 1944 PRINTED BY A. WILLS, THE CAXTON PRESS, WALTHAM CROSS CHIGWELL URBAN DISTRICT COUNCIL To the Chairman and Members of the Chigwell Urban District Council Mr. Chairman, Ladies and Gentlemen, I beg to present the Annual Report for the year 1944 upon the health and sanitary circumstances of the district. I take this opportunity of thanking Professor M. Greenwood and the Staff of the Public Health Department for their help and cooperation during the year. L. S. FRY, M.D., D.P.H. Chigwell Urban District Council. Public Health Committee: The Public Health Committee remains incorporated with the General Purposes, Finance, Housing and Town Planning and Valuation Committees constituted as No. 2 Committee. (As at 31st December, 1944). Chairman: Councillor A. G. Gould Members: Councillor A. S. Adams „ E. C. Finch „ N. V. Fortescue „ A. E. Leach „ H. 1. V. Peters „ J. Seabrook „ R. F. J. Smith „ S. G. Weaver, f.c.a. Public Health Staff: Medical Officer of Health: L. S. Fry, M.D.(Camb.), D.P.H. Senior Sanitary and Petroleum Inspector: J. T. Heath, M.R.San.I., M.S.I.A. Royal Sanitary Institute's 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. (Seconded to Air Raid Precautions Dept, as Controller). Royal Sanitary Institute and Sanitary Inspector's Joint Board Certificate. Royal Sanitary Institute Certificate for Inspector of Meat and Other Foods. Temporary Sanitary Inspector: B. G. Bannington Royal Sanitary Institute Certificate. Clerk: Miss J. Warriner SECTION A. Statistics and Social Conditions of the Area. Area (in acres) 8,970 (14 sq. miles approx.) Population 24,820 The rate in the pound for 1944/45 was 14/2. Vital Statistics. Male Female Total Live births Legitimate 233 222 455 Illegitimate 35 31 66 Total 521 Birth rate per 1,000 estimated resident population 20.9 Male Female Total Still births Legitimate 6 5 11 Illegitimate — 2 2 Total 13 Rate per 1,000 (live and still) births 21.5 Male Female Total Deaths 123 150 *273 Registrar General's figures Death rate per 1,000 estimated resident population 10.99 Deaths from puerperal sepsis and other maternal causes 1 Deaths of infants under 1 year— Male Female Total Legitimate 8 14 22 Illegitimate — 3 3 . Total 25 Death rate of infants under 1 year— All infants per 1,000 live births 48 Legitimate infants per 1,000 legitimate live births 48 Illegitimate infants per 1,000 illegitimate live births 45 3 Deaths from Cancer (all ages) 45 Deaths from Measles (all ages) 0 Deaths from Whooping Cough (all ages) 0 Deaths from Diarrhoea (under 2 years) 3 Deaths from road traffic accidents 0 Deaths from suicide 3 Deaths from other violent causes (including deaths due to enemy action) 23 Analysis of Deaths according to age incidence. Age. No. of Deaths 1944 1943 1942 1941 1940 Under 1 year 25 16 16 17 15 1 and under 2 — 1 — — 1 2 „ „ 5 — — — — 4 5 „ „ 15 7 2 6 4 2 15 „ „ 25 — 7 4 5 7 25 „ „ 35 3 10 8 12 12 35 „ „ 45 13 8 10 27 20 45 „ „ 55 20 24 18 32 28 55 „ „ 65 47 42 40 46 50 65 „ „ 75 62 62 66 68 57 75 and upwards 89 95 80 79 96 Total 266 257 248 290 292 The following table shows the vital statistics for the district for the six war years 1939-44:— Year. Birth Rate. Per 1000 of Population Number of Illegitimate Births. Infantile Mortality Rate. Per 1000 (Live Births) Death Rate. Estimated Population. 1939 16.5 6 24 8.0 25,100 1940 15.3 8 39 12.7 24,850 1941 13.2 13 52 11.7 25,070 1942 16.7 23 38 10.0 24,860 1943 19.4 37 33 10 8 24,680 1944 20.9 66 48 10.9 24,820 Total number of civilians killed within the district from 1939-44:— Male Female Unidentified Total 44 26 10 80 4 Birth-rates, Civilian Death-rates, Analysis of Mortality and Case Rates for certain Infectious Diseases in the year 1944 (Provisional figures based on Weekly and Quarterly Returns) England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Resident Populations 25.000 to 50,000 at 1931 Census) London Administrative County Chigwell Rates per 1,000 population:— Births: Live 17.6 20.3 20.9 15.0 20.9 Still 0.50 0.64 0.61 0.42 0.52 Deaths: All Causes 11.6 13.7 12.4 15.7 10.9 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 0.00 Scarlet Fever 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.03 0.03 0.02 0.04 0.00 Diphtheria 0.02 0.03 0.03 0.01 0.00 Influenza 0.12 0.10 0.11 0.08 0.04 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 0.01 0.01 0.01 0.00 0.00 Rates per 1,000 Live Births:— Deaths under 1 year of age 46 52 44 61 48 Deaths from Diarrhœa and Enteritis under 2 years of age 4.8 7.3 4.4 10.1 5.7 Rates per 1,000 Civilian population:— Notifications: Typhoid Fever 0.01 0.01 0.01 0.01 0.00 Paratyphoid Fever 0.01 0.00 0.01 0.01 0.00 Cerebro Spinal Fever 0.05 0.06 0.04 0.06 0.04 Scarlet Fever 2.40 2.41 2.67 1.57 0.97 Whooping Cough 2.49 2.49 2.29 2.90 1.45 Diphtheria 0.58 0.67 0.69 0.31 0.08 Erysipelas 0.29 0.32 0.28 0.37 0.16 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 4.16 4.51 3.94 2.98 2.94 Pneumonia 0.97 1.13 0.82 0.93 0.36 5 SECTION B. General Provision of Health Services in the District. (a) Laboratory Service. E. M. S. Laboratory at St. Margaret's Hospital, Epping—no change. (b) Ambulance Service. Continued use was made of Civil Defence vehicles to supplement the Council's ambulances. The Volunteer Car Pool rendered invaluable service in the conveyance of patients to hospitals, clinics, etc., and it is hoped that it or some similar organisation will be available in the post-war period. AMBULANCE CALLS Number of Calls. Accident or other reason. Urgent Medical. 650 142 508 (c) Nursing in the Home. No change. (d) and (e) Clinics and Treatment Centres. Child Welfare Centres:— Buckhurst Hill: County Council Clinic, Buckhurst Way—Thursdays at 2.30 p.m. Chigwell: St. Winifred's Church Hall, Chigwell —1st and 3rd Wednesdays at 2.30 p.m. Loughton: Union Church Hall, High Road—Fridays at 2.30 p.m. Roding Road Church Hall— Tuesdays at 2.30 p.m. Goldings Hill Mission Hall—1st, 3rd and 5th Tuesdays at 2.30 p.m. Diphtheria Immunisation: Clinics are held once a month at the following Child Welfare Centres:— Buckhurst Hill: County Council Clinic, Buckhurst Way—2nd Thursday at 2.30 p.m. 6 Chigwell: St. Winifred's Church Hall—3rd Wednesday at 2.30 p m. Loughton: Union Church Hall, High Road—2nd Friday at 2.30 p.m. Goldings Hill Mission Hall—3rd Tuesday at 2.30 p.m. Roding Road Church Hall—2nd Tuesday at 2.30 p.m. Tuberculosis Dispensary: Fssex County Council: For patients in the district: Buckhurst Hill: County Council Clinic, Buckhurst Way—2nd and 4th Wednesday at 2.30 p.m. Combined Treatment Centre, Regent Road, Epping —every Tuesday from 9.30 a.m. to 1 p.m. Ante-Natal Clinic: Union Church Hall, Loughton—1st, 2nd, 3rd and 4th (not 5th) Thursdays at 2 p.m. County Council Clinic, Buckhurst Hill—every Friday at 2.30 p.m. ESSEX COUNTY COUNCIL ACT, 1933. List of Establishments for Massage or Special Treatment The following establishments are licensed to 31st March, 1945: Mrs. J. M. Burt, Tresco, Knighton Lane, Buckhurst Hill Miss E. Mackern, 45, Church Hill, Loughton "Madame Pauline," 100, High Road, Loughton These premises have been inspected and are being conducted in a satisfactory manner. 7 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, and this supply is satisfactory. There are a few isolated houses where the the supply is still obtained from wells. Precautions taken to guard against contamination of emergency water supplies remained the same. Every wardens' post in the district had a supply of water steriliser to be made available to the public should necessity arise. Directions as to the proper use of the fluid were at wardens posts. (ii) Drainage and Sewerage. The sewage disposal plants continued to work efficiently and yield a satisfactory effluent. 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 liable to floods in the area which 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 reach of sewers. (ii) Public Cleansing. House refuse was removed weekly by covered motor vans under contract. The refuse was 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. 8 Precautionary measures were again taken against fly nuisance at and around the refuse tip and appear to have been effective. Salvage operations continued during the year throughout the district. Nearly 469 tons of salvage materials of all descriptions were collected, sorted and disposed of, including over 208 tons of paper. In addition nearly 160 tons of kitchen waste were collected. 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 re-sealed with clean water after emptying. (iii) Sanitary Inspection of the Area. An outline of the work of the Sanitary Inspectors is given below:— Complaints received 90 Inspections made 3314 Nuisances abated 79 Informal Notices served 59 „ complied with 74 Statutory „ served 1 „ „ complied with 1 Legal Proceedings 0 Summary of Nuisances: Defective drains 6 Choked drains 67 Defective W.C.'s 5 Deficient water supply 1 79 Verminous Houses. During the year three houses were found to be verminous, fumigation being carried out and its success verified by subsequent visits. Fourteen visits were made to these and other premises previously dealt with. 9 Smoke Abatement. No action has been necessary during the year. Schools. The sanitary conditions and water supply are satisfactory. Rats & Mice (Destruction) Act, 1919. During the year there has been a considerable fall in the number of complaints and all evidence points to the fact that past efforts have been successful and that there is no serious infestation. Three hundred and ninety-eight visits have been made in continuance of these efforts and baiting and gassing have been used in suitable cases. SECTION D. Housing Statistics for the Year 1944. Number of new houses erected during the year 1944 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) 109 (b) Number of inspections made for the purpose 327 2. (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 Nil (b) Number of inspections made for the purpose Nil 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 59 10 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 51 Action under Statutory Powers during the Year. (a) Proceedings under Section 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 (b) 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 60 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (а) by Owners 1 (b) by Local Authority in default of Owners Nil (c) Proceedings under Section 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 Housing Act, 1936—Part IV—Overcrowding. No formal action. Eighteen inspections were made in cases where a breach of the law was suspected, in several cases the necessary adjustments of occupants were secured. 11 The issue of certificates showing permitted numbers to the end of the year is as follows:— Buckhurst Hill 350 Chigwell 169 Loughton 397 Total to end of 1944 916 Summary of Defects. Defective roofs 19 „ gutters and rain water pipes 12 „ external walls 7 „ yard paving 2 „ drains and vent pipes 9 W.C.'s 5 „ flush tanks 2 „ sinks and waste pipes 6 „ water fittings 6 „ internal walls (plaster) 12 „ floors, doors, etc. 24 „ sash cords 11 „ stoves 8 Dampness 10 Under floor ventilation, lack of 1 Insufficient sanitary conveniences 1 Ashbins, lack of 5 Verminous rooms 8 Dirty walls and ceilings 35 Miscellaneous 1 12 SECTION E. Inspection and Supervision of Food. (a) Milk Supply. There are 12 cowkeepers on the register for the district; 2 produce and retail, and 10 produce and sell wholesale. The number of farms producing graded and ungraded milk are:—Tuberculin Tested (Certified) 1; Accredited 11; Ordinary 4. Total 16. The cowsheds have been kept in a satisfactory condition, to maintain which 203 visits have been made during the year. In the early part of the year 4 samples of milk were taken and proved satisfactory. There are 7 Dairies and Milkshops on the register. To these 93 visits were made. There are 12 retail purveyors of milk registered. (b) Meat and other Foods. There are 7 Slaughter-houses in the district, all licensed under the Food & Drugs Act, 1938. During the year 18 pigs were slaughtered under licence. 88 visits were made to ensure that premises were properly maintained. There are 22 butchers' shops in the district. To these 345 visits were made. 88 visits have been made to the 18 cafes and eating houses in the district which were found to be kept in clean condition. Other food shops, to which 157 visits were made, were well conducted. The following foodstuffs were submitted for our inspection,found unsound,surrendered and where suitable disposed of for animal feeding:— 13 10 tins beef 18 lbs. prunes 65 „ pork 21½ cases and 218 lbs. oranges 4 „ tongue 28 lbs. lemons 17 „ meat and vegetables 12 „ sugar 2 „ meat paste 1 „ tea 35 lbs. sausages 6 „ cake mixture 9 „ sausage meat 38 „ semolina 36 sausage rolls 18 „ flour 42 pork pies 1 pkt. cream barley 94 fruit pies 2 pkts. biscuits 1 tin rabbit 5 doz. and 10 bars chocolate 17 tins salmon 52 pkts. dried egg 117 „ pilchards 673 eggs 24 „ herrings 10½ lbs. bacon 11 „ sardines 12 „ butter and margarine 1 „ shrimps 65 „ cheese 2 „ fish paste 135 tins milk 10 „ peas 31 „ jam 44 „ beans 17 jars jam 2 „ vegetables 1 tin syrup 1 jar piccalilli 45 tins fruit 6 tins soup 2 „ groats All the tinned items were either blown or punctured. The citrus fruits, like the eggs, were parts of consignments which had been unduly delayed in transit. The jars of jam were broken as a result of an accident and various other items were rendered unfit by fouling by rodents or otherwise. In addition to above the following foodstuffs were damaged by broken glass, debris and dust caused by enemy action:— 50 lbs. beef 1 tin vegetables 9 „ cake, etc. 12½ lbs. tea 188 „ sweets 5 „ sugar 14 5 doz. bars chocolate 24 lbs. butter 66 jars jam 4 „ lard 6 tins syrup 5 „ margarine 30 eggs 40 „ oatmeal 10 pks. dried egg 4 „ rice 7 lbs. rolled oats 24 pkts. cereals 7 „ macaroni 58 lbs. biscuits 10 lbs. flour 2 tins cocoa 2 tins milk In dealing with these foodstuffs we co-operated with the Ministry of Food (Salvage Dept.) and the local Food Office and a certain amount has been salved for industrial purposes and the feeding of animals. In the district there are 10 bakehouses to which 155 visits have been paid, but no action has been necessary. (c) Factories. 206 visits have been made to these premises and several minor matters have been satisfactorily dealt with. (d) Outworkers. These again show a diminution due to absorption of workers into more remunerative employment. 77 visits were made and showed that conditions are generally satisfactory. (e) Shops Act, 1934. No infringements were complained of or found. The 20 visits made being chiefly concerned with change of occupation. (f) Adulteration. This is dealt with by the County Council. (g) Chemical and Bacteriological Examination of Food. This is dealt with by the County Council. (h) Nutrition. No action. 15 Summary of Sanitary Inspector's visits during the Year ended 31st December, 1944. General Sanitation. Nature of Visit or Inspection No. of Visits Water Supply 8 Drainage 487 Stables and Piggeries 1 Factories 206 Outworkers 77 Bakehouses 155 Rats and Mice 398 Shops 20 Knackers Yard 20 Petrol 33 Miscellaneous Sanitary Visits 220 1,625 Housing. Under Public Health Acts. Number of houses inspected 105 Visits paid to above houses 326 Under Housing Acts. Number of houses inspected 4 Visits paid to above houses 1 Overcrowding. Number of houses inspected 4 Verminous Premises. Number of houses inspected 3 Visits paid to above houses 11 Miscellaneous Housing Visits 14 468 Infectious Diseases. Inquiries in cases of Infectious Disease 20 Visits re disinfection 1 Miscellaneous Infectious Disease Visits 12 33 16 Meat and Food Inspection. Nature of Visit or Inspection No. of Visits Visits to Slaughter-houses 88 „ „ Butchers 345 „ „ Fishmongers and Poulterers 12 „ „ Grocers 129 „ „ Greengrocers and Fruiterers 16 „ „ Cowsheds 203 „ „ Dairies and Milkshops 93 „ „ Restaurants 88 „ Food Preparing Premises 1 Miscellaneous Food Visits 209 Visits in connection with Sampling. Milk—Bacteriological 4 1,188 Total 3,314 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., Senior Sanitary Inspector. SECTION F. Prevalence of, and Control over, Infectious and other Diseases. Scarlet Fever. The incidence of the disease was low compared with 1943 and 38% of the cases notified were nursed at home. Diphtheria. Four cases notified, 2 were service personnel, 1 at a residential school, the remaining case was in a child, aged 12 years, who had not been immunised. 17 Immunisation. Numbers of children reciving a full course of treatment in 1944 at clinics and from general practitioners are given below: Under 5 years 5—15 years Total 286 115 401 Estimated percentage of child population immunised at end of 1944:— 62% 56% In addition to the above, 31 children who had been immunised in infancy received a re-enforcing dose of 0.3 c.c. A.P.T. on starting school. Summary of immunisation work done during past three years:— Number treated. 1942 762 1943 408 1944 401 1,571 Scabies. The disease has been notifiable in the district since September, 1943, and the arrangements for treatment at the First Aid Posts in Loughton and Buckhurst Hill were continued. Nearly all the cases were treated with two applications of Benzyl Benzoate at one week's interval with a satisfactory result and particulars of these are given in the following table:— Number of persons treated. Male. Female. Under 15 Over 15 Under 15 Over 15 Total 39 19 39 57 154 18 Summary of Cases of Infectious Diseases notified, showing number of Cases, Admissions to Hospital and Deaths. Infectious Disease. Total Cases notified (Civilan Cases only). Admissions to Hospital. Deaths Scarlet Fever 24 15 — Erysipelas 4 2 1 Scabies 89 — — Cerebro-Spinal Fever 1 1 — Acute Primary Pneumonia 9 1 — Diphtheria 2 2 — Dysentery 1 1 — Measles 73 2 — Whooping Cough 36 — — 239 24 1 Tuberculosis. Age Period new cases deaths Respiratory Nonrespiratory Respiratory Nonrespiratory M. F. M. F. M. F. M. F. Under 1 year 1 and under 5 — 1 5 „ „ 15 4 — 1 — — — — — 15 „ „ 25 4 4 — 1 — — — — 25 „ „ 35 4 4 — — — 1 — — 35 „ „ 45 3 2 — 1 — — — — 45 „ „ 55 3 — — — 1 1 — — 55 „ „ 65 1 — — 1 1 1 — — 65 and upwards — — — — 1 — — — Totals 19 11 1 3 3 3 — — Note.—30 new cases of pulmonary tuberculosis and 4 of non-pulmonary were notified as compared with 27 and 5 in 1943. There were 6 deaths compared with 12 in 1943. 19 APPENDIX. Rainfall in Inches by Months for 1944. Metropolitan High Beech. Water Board. Buckhurst Hill. Luxborough S.D. Works C.U.D.C. Loughton Depot. January 1.80 1.71 1.51 1.52 February 1.01 0.89 0.80 0.37 March 0.14 0.10 0.04 0.05 April 1.41 1.41 1.55 1.35 May 0.41 0.48 0.33 0.63 June 1.76 1.99 1.83 1.61 July 1.70 1.77 1.79 1.74 August 3.09 2.61 1.54 2.79 September 3.10 3.39 2.41 2.76 October 3.65 3.30 3.00 3.50 November 3.93 3.99 3.23 3.58 December 1.38 1.31 1.04 1.02 Totals 23.38 22.95 19.07 20.92 The highest point in the District is 372 O.D., and the lowest 44 O.D. 20 CONTENTS OF THE REPORT FOR 1944. Report- Medical Officer of Health's Letter 1 Public Health Committee 2 Public Health Staff 2 Statistics and Social Conditions of the Area 3 Vital Statistics 3-4 Analysis of Deaths according to age incidence 4 Comparative Table, Birth and Death rates 4 Table of Birth Rates, Death Rates and Infantile Mortality 5 General Provisions of Health Services in the Districts 6 Ambulance Calls 6 Clinics, Treatments Centres and Hospitals 6-7 Sanitary Circumstances of the Area 8 Housing Statistics for the Year 10-11 Inspection and Supervision of Food 13-14-15 Shops 15 Summary of Inspector's Visits 16-17 Prevalence of, and Control over, Infections Disease 18-19 Meteorological Record- Rainfall 20