CHIt 112 Chigwell 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, 1948 Chigwell Urban District Council To the Chairman and Members of the Chigwell Urban District Council Mr. Chairman, Ladies and Gentlemen, I have pleasure in presenting to you the Annual Report, including the report of the Senior Sanitary Inspector, for the year ending 31st December, 1948. In the statistical tables which follow, births and deaths have been corrected for "inward" and "outward" transfers—i.e. they refer only to persons who normally reside in the district, and they include all births and deaths among them wherever occurring. Infectious diseases, however, are allocated to the district in which they arise, irrespective of the place of normal residence of the patient. The health of the population has remained good. The overall death-rate, and also the infant death rate, are well below the comparative figures for the country as a whole. Again there were no deaths of mothers during or resulting from childbirth. Deaths from pneumonia and diseases of the heart and circulation are less than in the previous year, but deaths from cancer and tuberculosis have increased in number. The post-war increase in the birth rate has not been maintained, this figure having fallen from 20.7 per 1000 population in the previous year to 17.5—the lowest recorded since 1942. This may be an indication of worsening economic conditions, which lead to later marriages and smaller families. Although the 1 tion increased from 30,170 to 35,190, this was largely due to immigration, as births only exceeded deaths by 316. The immigrants are for the most part families from the London area which have been selected for occupation of houses completed during the year on the L.C.C. estates. The total number of inhabited houses in the district increased from 8,747 to 10,380 during the year, so that building has kept pace with the population increase, and overcrowding has, in fact, diminished slightly; the average number of occupants per inhabited house was 3.45 in 1947, and 3.39 in 1948. With regard to infectious diseases, the filling up of the new L.C.C. estates has inevitably affected the picture, and until the population becomes stabilised on completion of these estates, the notification rates of certain diseases will be liable to fluctuation. It must be remembered that many of the successful applicants for these houses have been given priority on account of living under very bad conditions in the London area, some with large families of young children, or delicate children, or with tuberculosis in the family. Infections of children such as measles and whooping cough, and tuberculosis, may therefore be expected for a time to be more prevalent among a selected population of this kind than in a normal cross-section of the population, and this is borne out by the tuberculosis and measles figures for the year under review. A noteworthy feature during the year was the inauguration of the Chigwell and Waltham Holy Cross Hygienic Food Traders' Guild, with the object of assisting and encouraging voluntary efforts among traders in foodstuffs towards improved methods of manufacture, distribution and handling of food. It will be recalled that a notable outbreak of food poisoning, affecting about 30 persons, occurred at a wedding feast in this district in 1946, and another larger outbreak is again reported this year (see p. 31). It is therefore not inopportune to intensify our efforts towards a general improvement of food handling methods. The National Health Service Act, which came into operation on July 5th, 1948, has had little effect on the functions of your Council's Health Department other than the transfer of responsibility for the Ambulance Service and the Diphtheria Immunisation Service to the County Council, and the transfer of responsibility for hospitalization of infectious diseases to the North East Metropolitan Regional Hospital Board. In concluding, I would like to record my appreciation to the Chairman and Members of the Public Health Committee for their support and to the staff of the Public Health Department for their help and cooperation. H. FRANKS, M.B., B.S., B.HY., D.P.H., Medical Officer of Health. July, 1949. 3 Chigwell Urban District Council Public Health Committee: Chairman : Councillor K. F. Jefferys Members : Councillor Mrs. G. V. Cross „ C. T. Davie „ E. G. Perry „ J. W. Spencer „ A. E. Leach „ W. A. Nichols „ O. J. Dean „ G. P. Guyatt „ Mrs. L. M. Scott W. H. Wilson The Chairman, Councillor F. S. Foster, C.B.E., J.P.. C.C., and the Vice-Chairman, Councillor H. W. A. Woollard, M.P.S., of the Council ex-officio. Public Health Staff: Medical Officer of Health: L. S. Fry, M.D. (CAMB.), D.P.H. Senior Sanitary Inspector and Petroleum Inspector : W. H. Dlgweed, 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. Sanitary Inspectors : R. P. Stevens, M.S.I.A Royal Sanitary Institute and Sanitary Inspectors' Joint Board Certificate. G. Gingell, A.R.SAN.I., M.S.I.A. (from 18/5/48). Royal Sanitary Institute and Sanitary Inspectors' Joint Board Certificate. Clerks : Miss J. Warriner Miss S. Wright 4 SECTION A Statistics and Social Conditions of the Area Area (in acres) 8,970 (14 sq. miles approx). Population 35,190 Number of inhabited houses 10,380 Rateable value £289,768 Sum represented by a penny rate £1,201 2s. 9d. The rate in the pound for 1948/49 is 17/8d. Vital Statistics: Live Births: Male Female Total Legitimate 304 285 589 Illegitimate 12 14 26 Total 615 Birth rate per 1,000 estimated resident population 17.5. Still Births: Male Female Total Legitimate 9 6 15 Illegitimate — 1 1 Total 16 Rate per 1,000 (live and still) births 25.3. Male Female Total Deaths 158 141 299 Death rate per 1,000 estimated resident population 8.5. Deaths from sepsis and other maternal causes 0 Deaths of infants under 1 year: Male Female Total Legitimate 11 4 15 Illegitimate 1 0 1 Total 16 5 Death rate of infants under 1 year: All infants per 1,000 live births 26.0 Legitimate infants per 1,000 legitimate live births 25.5 Illegitimate infants per 1,000 illegitimate live births 38.5 Table of Comparative Birth Rates and Death Rates in the year 1948 (Provisional figures based on weekly and quarterly returns). Rates per 1,000 civilian population:— England & Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Resident Populations 25,000 to 50.000 at 1931 census) London Adm. County Chigwell U.D. Births: Live Births 17.9 20.0 19.2 20.1 17.5 Still Births 0.42 0.52 0.43 0.39 0.45 Deaths : All Causes 10.8 11.6 10.7 11.6 8.5 * Infants under 1 year of age 34 39 32 31 26 * Enteritis and Diarrhoea under 2 years of age 3.3 4.5 2.1 2.4 1.6 * Rates per 1,000 live births. The following table shows the vital statistics for the district for the past five years:— Year Birth Rate. Per 1000 of Population. Number of Illegitimate Births. Infantile Mortality Rate per 1000 (Live Births) Death Rate Estimated Population 1944 20.9 66 48 10.9 24,820 1945 17.7 68 38 11.2 25,170 1946 20.0 44 26 10.4 28,190 1947 20.7 38 32 9.8 30,170 1948 17.5 26 26 8.5 35,190 6 Causes of Death as given by the Registrar-General for the year 1948. Male Female Total Tuberculosis (all forms) 12 3 15 Influenza 1 0 1 †Cerebro spinal fever 0 1 1 Acute poliomyelitis 1 0 1 Cancer (all forms) 38 30 68 Diabetes 0 3 3 Intrecranial vascular lesions 19 21 40 Heart disease 28 38 66 Other diseases of circulatory system 2 6 8 Bronchitis 9 6 15 Pneumonia 6 3 9 *Other respiratory diseases 5 3 8 Ulcer of duodenum or stomach 3 0 3 Diarrhoea under 2 years 1 0 1 Appendicitis 1 1 2 Other digestive diseases 3 5 8 Nephritis 5 4 9 Premature birth 1 2 3 Congenital malformations 3 1 4 Birth injuries Infantile diseases Suicides 1 3 4 Road traffic accidents 1 0 1 Other violent causes 3 2 5 All other causes 15 9 24 158 141 299 † Notified at Plaistow. * Excluding tuberculosis. 7 SECTION B General Provision of Health Services in the District (a) Public Health Officers of the Local Authority, See page 4. (b) Laboratory Facilities. A Ministry of Health Laboratory operates at St. Margaret's Hospital, Epping. Milk and ice cream are examined at the Counties Public Health Laboratory, 66, Victoria Street, London, S.W.1. (c) Ambulance Facilities. As from 5th July, 1948, the transport of the sick, the injured, and maternity cases, is provided free by the Essex County Council under the provisions of the National Health Service Act. In case of accident or emergency (including maternity cases), an ambulance may be called by dialling 999 on the telephone, if automatic, or lifting the receiver and asking the operator in other areas—or, of course, by directly contacting the ambulance station, Old Station Road, Loughton. Nonemergency calls are only accepted from responsible officers of the health service, e.g. doctors, nurses and midwives. As from 5th July, 1948, hospital services are provided by the North East Metropolitan Regional Hospital Board. (d) Child Welfare Centres. Buckhurst Hill. Essex County Council Clinic, Buckhurst Way, Thursdays at 2 p.m. (Diphtheria Immunization—2nd Friday in month). 8 Chigwell. St. Winifred's Church Hall, Wednesdays at 2 p.m. (Doctor in attendance 1st and 3rd Wednesdays). (Diphtheria Immunisation—3rd Wednesday in month). All Saint's Church Hall, Chigwell Row, 4th Friday at 2 p.m. (Weighing Centre). Ashton Playing Fields, Woodford Bridge, Tuesdays at 2 p.m. Bus from Chigwell Row at 1.45 p.m., stopping in Brocket Way at C/Row junction, Manford Way, The Lowe and Grange Hill). Loughton. Union Church Hall, High Road, Fridays at 2 p.m. (Diphtheria Immunisation—2nd Friday in month). Roding Road Church Hall, Tuesdays at 2 p.m. (Diphtheria Immunisation—Tuesdays). Goldings Hill Mission Hall, Tuesdays at 2 p.m. (Diphtheria Immunisation—3rd Tuesday in month). (e) Ante-natal Clinics. Loughton. Union Church Hall, High Road, Thursdays at 2 p.m. Chigwell. 118, Hermon Hill, Wanstead, 1st and 3rd Fridays at 2.30 p.m. (Transport arranged by Health Visitor). Buckhurst Hill. Essex County Council Clinic, Buckhurst Way, Fridays at 2 p.m. Ante-Natal Clinic and Post-Natal Clinic: Loughton. Goldings Hill Mission Hall, Mondays at 2 p.m. 9 Women's Welfare Clinic: Buckhurst Hill. Essex County Clinic, Buckhurst Way, 1st Friday at 10 a.m. (Apply to Health Visitor for appointment). (f) School Clinics. Chigwell. Manford Way Primary School, Manford Way, Tuesdays at 9.30 a.m. Loughton. Union Church Hall, High Road, Thursdays at 9.30 a.m. Dental Inspection: Buckhurst Hill. Essex County Clinic, Buckhurst Way, Mondays from 10a.m.—12 noon. (E.C.C. Schoolchildren; nursing and expectant mothers). Chigwell. Manford Way Primary School, Manford Way, Thursdays at 2 p.m. (Apply to Health Visitor for appointment). (g) Home-Help Organiser. Mrs. M. May, 93, High Road, Woodford, E.18. (Buckhurst 2496). (h) Health Visitors. Buckhurst Hill. Miss Dennis, Essex County Clinic, Buckhurst Way. (Buckhurst 5 180). Chigwell. Miss Moore, Grange Hill Temporary Primary School. (Hainault 2570). 10 Loughton. Miss Ward, Council Offices, Old Station Road, Loughton (Loughton 4479). * Miss Whitmore, Essex County Clinic, Buckhurst Way (Buckhurst 5180). * Roding Estate and Loughton L.C.C. Estate, (i) District Nurses. Buckhurst Hill. Miss Botess, 126, Queen's Road. Chigwell. Apply Mrs. Jones, 33, Manford Way. (Hainault 2108). Loughton. Miss Gardner, 7, Crescent View. Miss Willings, do. do. (Loughton 4500). Midwives: Buckhurst Hill. Mrs. Powis, 47, St. Albans Avenue, Woodford Green. Chigwell. Mrs. Jones, 33, Manford Way. (Hainault 2108). Loughton. Miss Quill, 36, York Hill. (Loughton 225). Miss Casey, 60, Algers Road. (Loughton 953). (j) Tuberculosis Dispensaries. Buckhurst Hill. Essex County Council Clinic, Buckhurst Way, 2nd and 4th Wednesdays at 2.30 p.m. (After June, 1949, every Wednesday). Epping. Combined Treatment Centre, Regent Road, Tuesdays at 9 a.m. 11 (k) Tuberculosis. Forest Area Tuberculosis Care Association The Association continues to assist cases awaiting admission to sanatorium in various ways and arranges also for the admission of child contacts to convalescent homes. It concerns itself also with the after-care of patients by assistance in obtaining materials for occupation therapy and whenever possible, suitable employment for those fit for work. The Honorary Secretary is Mr. A. J. Edwards, 37, Woodland Road, Loughton. (1) Establishments for Massage or Special Treatment. The following establishments are licensed under the Essex County Council Act, 1933. 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. 12 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. There are a few houses where the supply is obtained from wells. The supply to the area has been satisfactory both in quantity and quality. Most of the houses in the district have a piped water supply and it has not been found necessary to take samples for bacteriological examination, to test plumbo-solvency or contamination. Houses supplied by piped main supply 10,375 Houses supplied from standpipes Nil Houses supplied from wells 5 3 samples of well water were submitted during the year for bacteriological and chemical examination. Sample No. 1. Unsatisfactory. The use of the well has been discontinued as mains supply now available. Sample No. 2. Satisfactory. Sample No. 3. Unsatisfactory. This water has now to be either chlorinated or boiled before use. Main water supply will be available in the near future. (ii) Drainage and Sewerage. The sewage disposal plant at Luxborough has worked efficiently and has given a satisfactory effluent although the effects of increased flow due to rapid 13 development in the district is being felt. The scheme for the first stage of enlargement, mainly to assist the treatment of sludge has commenced during the year, and the next stage for complete enlargement related to the large increase in population by L.C.C. and local Council development is approaching the invitation of tenders. The reconstruction of Millers Lane Works which are small and obsolete will be definitely put in hand during 1949. The five pumping plants have functioned efficiently during the year. 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 river area which is under the jurisdiction of the Roding Catchment Board. 3. (i) Closet Accommodation. A complete survey of the district has been carried out and all earth and elsan closets noted. 48 dwellings are affected, 4 cottages have already been provided with water carriage drainage by their owners and a scheme is being prepared to convert 4 more. It has been decided to plot the positions of all cesspools in the district and the whole position is to be reviewed. (ii) Public Cleansing. Housing refuse was removed weekly throughout the district by the Council's own covered vehicles, with paper salvage trailers attached. Three of these 10/12 cubic yard "Fordson" lorries with "Eagle" bodies and one 6 cubic yard similar vehicle are in service. 14 Trade refuse continued to be collected on a scale of charges and has been dealt with satisfactorily. This service is used by a substantial number of traders in the district. Refuse was disposed of at a tip rented from a local contractor, who provides certain buildings, covering material and labour for levelling. The Council's own employees sort and handle salvage at this tip. Measures were taken against fly and vermin infestation. Salvage operations, directed in particular to the recovery of paper, rags and bottles, continued during the year throughout the district. The total material salvaged, sorted and disposed of was 280 tons, including 262 tons of paper. In addition 250 tons of kitchen waste were collected and conveyed to a concentrator plant at Stapleford Abbotts. Additional kitchen waste bins have been placed on the streets to cover new development, and a new "Karrier" covered lorry now makes the collection from the bins. 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 resealed 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 and dealt with 631 Inspections made 9,534 Nuisances abated 261 Informal Notices served 160 Informal Notices complied with 186 Statutory Notices served 29 Statutory Notices complied with 28 Legal Proceedings 4 15 Summary of Nuisances. Drains blocked or defective 105 Defective water closets 10 Defective water supply pipes 14 Nuisance from animals 8 Polluted ditches and watercourses 6 Accumulation of refuse, fish boxes, etc. 16 Vermin, bugs and fleas 6 Cellars flooded 6 Fly infestations 2 Smells from animals, etc. 12 Cesspools overflowing or defective 8 Crickets 10 Wasps and hornets 56 Insanitary practices 2 261 Verminous Houses. 6 houses were found to be verminous during the year. These houses were fumigated with 'Thermatox' and sprayed with 'Zaldecide' with satisfactory results. Number of inspections and visits, 33. Rats and Mice Destruction Acts. There was again a rise in the number of complaints. 1751 visits were made and energetic action taken to exterminate the rodents by means of gassing with 'Cymag' gas, baiting with red squill, arsenic, zinc phosphide and by trapping. There is no serious infestation, but the presence of rats and mice is still being reported from all over the district particularly where houses are situated near open spaces such as farm and forest land. Baiting and poisoning of the Council's sewers is carried out twice yearly. 16 SECTION D Housing Statistics for the year 1948 Number of new houses erected and occupied during the year:— Permanent Houses:— For London County Council Loughton 600 Chigwell 808 —1408 For Chigwell U.D.C. 211 For Private Owners 14 Total 1633 Inspection of Dwelling Houses during the Year: 1. (a) Total number of dwelling-houses inspected for housing defects (under Public Health and Housing Acts 363 (b) Number of inspections made for the purpose 1686 2. (a) Number of dwelling-houses (included in 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 1 4. Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 28 17 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 LocalO! Authority or their Officers 186 Action undbr 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 5 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) by Owners ... ... ... ... 3 (b) by Local Authority in default of Owners 2 (b) Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 23 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) by Owners 21 (b) by Local Authority in default of Owners 2 (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936. (1) The number of dwelling-houses in respect of which Demolition Orders were made 1 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil 18 Housing Act, 1936—Part IV—Overcrowding. No formal action was taken owing to the general housing shortage. 13 inspections and visits were made, but the acute housing shortage in the district has made the alleviation of overcrowding a matter of great difficulty. The issue of certificates showing permitted numbers to the end of the year is as follows :— Buckhurst Hill 350 Chigwell 169 Loughton 397 Summary of Defects. Defective roofs 110 ,, W.C.'s 20 ,, water waste preventers 30 ,, sink and waste pipes 13 ,, sash cords 24 „ flank walls 4 „ gutters and rain water pipes 41 „ yard paving 3 ,, window and door cills 8 ,, drainage and vent pipes 10 „ gullies 10 ,, internal walls (plaster) 70 ,, ceilings 51 ,, water fittings and pipes 12 ,, flooring and doors 18 „ external walls 10 ,, stores and boilers 4 „ fireplaces 30 „ dustbins 35 Dampness 71 Under floor ventilation, lack of 2 Dirty walls and ceilings 40 Miscellaneous 46 19 SECTION E Inspection and Supervision of Food (a) Milk Supplies. 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 is :—Tuberculin Tested 3 ; Accredited 6 ; Ordinary 4 ; total 13. The cowsheds have been kept in a satisfactory condition during the year and 105 visits have been made. 47 samples of milk were taken for bacteriological examination by the County Council, Public Health Department and 6 of these were reported as being unsatisfactory. 42 samples of milk were taken by the Weights and Measures Department of the County Council during the year. 4 samples of milk were taken by the Public Health Department of this Authority and all were reported upon as genuine. There are 7 dairies and milkshops registered 50 visits to these premises were made. There are 10 registered retail purveyors of milk (b) Meat and Other Foods. Slaughtering. There are 7 slaughterhouses in the district all licensed under the Food and Drugs Act, 1938. 12 pigs were slaughtered and inspected during the year. No carcases or organs were condemned. Slaughtering in the main for this district is carried out 20 elsewhere in centralized Ministry of Food Slaughterhouses at which inspections and condemnations are the responsibility of the district in which situated. 23 visits were made to slaughterhouses. There are 22 butcher shops in the district and 382 visits were made to these premises. 80 visits have been made to restaurants and cafes and considerable improvements in cleanliness, etc. has been achieved. The following food-stuffs were inspected and found unsound or unfit for human consumption. Some items were returned to suppliers for reprocessing, others disposed of for animal food, or for manufacturing purposes and the remainder destroyed :— FISH Hake, tins 6 Salmon, tins 9 Cape fish, tins 1 Coalfish, 5 stones Catfish,5 stones Sardines, tins 7 Pilchards, tins 10 Whiting, tins 4 Haddock, 5 stones Whelks, jars 3 Kippers, lbs. 84 ,, stones 8 Cod ,, 6 Plaice ,, 1 „ lbs. 5 Skate wings, stones 9½ Dabs, lbs. 5 Sea bream, stones 5 Snoek, tins 1 Cod-roes, tins 2 MEAT Beef, lbs. 386 Pork, lbs. 60¾ Mutton, lbs. l,524½ Veal, lbs. 6 Meat and vegetable, tins 2 Ox tongues, tins 1 ,, sweetbreads, 28½ lbs. Calves foot jelly, tins 1 Corned beef, 6 lb. tins 101 Corned beef, 12 oz. tins 47 Turkey, 2 lb. 3 oz. Whale steak, tins 1 Corned mutton, tins 2 Lambs' tongues, tins 1 21 Ox tongue trimmings, lbs. 42 ,, liver, lbs. 28½ Brawn, tins 9 Sausage meat, tins 3 Sausages, tins 2 Veal loaf, tins 2 Rabbits, lbs. 142 Chicken, lbs. 160 Stewed steak, tins 4 Meat pies, 72 Meat, lunch, tins 7 Mixed beef loaf, tins 3 Bacon, lbs. 15½ „ tins 1 Pin tail, 1 Wild duck, 3 Teal, 1 FRUIT Peaches, tins 7 Cherries, tins 7 Strawberries, tins 1 Plums, tins 85 Apples, tins 5 Cherry plums, tins 1 Prunes, tins 6 Figs, 1 lb. 14 oz. Pears, tins 1 Grapes, tins 2 Oranges, 72 Dates, lbs. 90 Grapefruit, tins 3 VEGETABLES Potatoes, tins 2 Peas, tins 48 Tomatoes, tins 6 Mixed vegetables, tins 10 Carrots, tins 12 Potato flour, tins 3 OTHER ITEMS Milk, evaporated, tins 136 Milk, condensed, tins 13 Melon & lemon jam, tins 3 Soup, turtle, tins 1 Apricot jam, tins 1 Dried egg, packets 4 Marmalade, tins 2 Spaghetti, tins 3 Crab paste, tins 1 Baked beans, tins 13 Syrup, tins 1 Bread,loaves, 290 Chocolate, packets 6 Toffee, 10 lbs. 6 ozs. Eggs, Danish, 545 Butter, lbs. 18 Rolled oats, lbs. 460 Tomato juice, tins 4 Soyaghetti, tins 1 Orange juice, tins 2 Grapefruit marmalade, tins 7 Date pudding, tins 1 22 Soup, tins 2 Broth, tins 2 Sausage lunch,lbs. 112 Sweet corn, tins 1 Cake, fruit, lbs. 4 Boiled sweets, lbs. Celery bits, tins 1 Cheese, lbs. 6 All the tinned goods were either blown or punctured. Some items were rendered unfit by fouling by vermin. In the district there are 11 bakehouses; 110 visits have been made to these premises. (c) Factories. 316 visits were made. Cellulose paint spraying still gives cause for complaint, but efforts are being made to minimize the fumes and some improvement has been noted. 23 24 Factories Act, 1937. 1. INSPECTION for purposes of provisions as to health (including inspections made by Sanitary Inspectors). Premises. Number on Register. Inspections. Number of Written Notices. Occupiers prosecuted. (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 10 80 Nil Nil (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 70 236 2 Nil (iii) Other Premises in which Section 7 is enforced by the Local Authority Nil Nil Nil Nil Total 80 316 2 Nil 25 2. CASES IN WHICH DEFECTS WERE FOUND. Particulars. Number of cases in which defects were found Number of cases in which prosecutions were instituted. Found. Remedied. Referred To H.M. Inspector. By H.M. Inspector. Want of cleanliness (S.l) 1 1 — — — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7):— (a) Insufficient 3 1 — 1 — (b) Unsuitable or defective 16 14 — 1 — (c) Not separate for sexes 1 1 — — — Other offences against the Act (not including offences relating to Outwork) 6 6 4 — — Total 27 23 4 2 Nil (d) Outworkers. 263 visits were made during the year. (e) Shops Act. 156 visits were made during the year. (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. A few samples of milk were, however submitted for examination. (h) Nutrition. No action. (i) Ice Cream. 249 visits to premises were made during the year. There are 6 manufacturers and 58 vendors on the register. Of the former, only one manufactures on a large scale and all samples taken from him proved to be very satisfactory. All premises have been visited regularly and advice given concerning production and hygienic methods of sale. 47 samples were taken and submitted for examination with the following results:— Satisfactory Unsatisfactory Manufactured in the district 12 Nil Manufactured outside district 30 5 Of the total of 42 satisfactory samples, 25 were classified Grade I under the Ministry of Health's provisional grading scheme. In all cases dealers were informed of the results of the analyses and when samples were manufactured outside the district relevant information was sent to the Public Health Department concerned. 26 Summary of Sanitary Inspector's visits during the Year ended 31st December, 1948. Gbneral Sanitation. Nature of visit or inspection. Total No. of visits. Water supply 3 Drainage 526 Fried fish shops 40 Tents, vans and sheds 40 Factories 316 Workshops 15 Workplaces 23 Outworkers 263 Bakehouses 135 Public conveniences 4 Refuse collection 16 Refuse disposal 157 Rats and mice 1751 Smoke observations 43 Shops 156 Petrol 33 Knackers yards 69 Conservancy system 108 Miscellaneous sanitary visits 1519 5217 Housing. Under Public Health Acts. Number of houses inspected 298 Visits paid to above houses 1357 Under Housing Acts. Number of houses inspected 65 Visits paid to above houses 329 Overcrowding. Number of houses inspected 12 Visits paid to above houses 1 27 Verminous Premises. Number of houses inspected 15 Visits paid to above houses 33 Miscellaneous housing visits 808 2918 Infectious Disease. Inquiries in cases of Infectious Disease 56 Visits re disinfection 12 Miscellaneous Infectious Disease Visits 36 104 Inspection of Meat and Food. Visits to slaughter-houses 23 „ „ other premises 4 ,, „ butchers 382 ,, ,, fishmongers and poulterers 121 „ grocers 45 ,, ,, greengrocers and fruiterers 87 ,, „ cowsheds 105 ,, ,, dairies and milkshops 50 ,, ,, ice cream premises 249 ,, „ food preparing premises 2 ,, ,, restaurants ... 80 Miscellaneous food visits 76 Visits in connection with milk sampling 2 Visits in connection with food and drugs samples 69 1295 9534 House refuse was collected under the supervision of Mr. G. Holbourn, A.M.Inst.C.E., Engineer and Surveyor. (Signed) W. H. Digweed, A.R.San.I., M.S.I.A. Senior Sanitary Inspector. 28 SECTION F Prevalence of, and Control over, Infectious and other Diseases Summary of Cases of Infectious Diseases notified, showing number of Cases, Admissions to Hospital and Deaths. Total Cases Notified (Civilian Cases Only) Admission to Hospital Deaths Acute Poliomyelitis 3 2 1 Acute Primary Pneumonia 19 1 — Erysipelas 13 4 — Measles 532 6 — Ophthalmia Neonatorum 1 1 — Puerperal Pyrexia 1 1 — Scarlet Fever 30 11 — Typhoid Fever 1 1 — Whooping Cough 160 3 — 760 30 1 29 Comparative Tables of Infectious Disease Notification and Death Rates per 1,000 of the population in 1948. (Provisional figures based on Weekly and Quarterly Returns). England and Wales 126C.B's and Great Towns including London 148 Smaller Towns (Resident pop. 25,000—50,000 at 1931 Census) London Admin. County Chigwell Urban District Notifications (Corrected) Typhoid fever 0.01 0.00 0.01 0.00 0.03 Paratyphoid fever 0.01 0.01 0.01 0.01 0.00 Cerebro-spinal fever 0.03 0.03 0.02 0.03 0.00 Scarlet fever 1.73 1.90 1.82 1.37 0.85 Whooping cough 3.42 3.51 3.31 3.13 4.55 Diphtheria 0.08 0.10 0.09 0.10 0.00 Erysipelas 0.21 0.23 0.21 0.22 0.37 Smallpox – – – – – Measles 9.34 9.75 8.84 9.17 15.12 Pneumonia 0.73 0.84 0.60 0.57 0.54 Acute Poliomyelitis 0.04 0.05 0.04 0.04 0.09 Acute Polioencephalitis 0.00 0.00 0.00 0.00 0.00 Deaths Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 0.00 Whooping cough 0.02 0.02 0.02 0.01 0.00 Diphtheria 0.00 0.00 0.00 0.01 0.00 Tuberculosis 0.51 0.59 0.46 0.63 0.42 Influenza 0.03 0.03 0.04 0.02 0.03 Acute Poliomyelitis and Polioencephalitis 0.01 0.01 0.01 0.00 0.03 Pneumonia 0.41 0.38 0.36 0.54 0.28 30 Diphtheria. No cases of diphtheria were notified during the year. The free immunization of children at clinics has continued and the Council's scheme for free immunization by general practitioners was superseded from 5th July, 1948, by the provisions of the National Health Service Act. 519 children completed a course of immunization during the year. At December 31st, 1948, out of the total child population of 8,872, 4,328 ( = 48.8%) had at some time received protection by immunization. Tuberculosis. 77 new cases of lung tuberculosis, and 13 of tuberculosis of other organs, were notified during the year. The comparable figures for 1947 were 57 and 10 respectively, and for 1946 were 35 and 6. On further analysis of the figures, it was found that 39 of the 1947 notifications and 60 of the 1948 notifications were established cases from other districts who came to live in this area during the year concerned; in general, their entry into the district can be directly attributed to the growth of the new L.C.C. housing estates, in which high priority is necessarily given to applicants from the London area suffering from this disease. There were 15 deaths from tuberculosis during the year, compared with 8 in 1947 and 10 in 1946. Food Poisoning. One outbreak of food poisoning occurred during the year at a school and involved 305 children and 19 members of the staff. The food was supplied in closed containers from a civic restaurant situated in another district. 31 Those affected experienced diarrhoea 2 —4 hours after the meal, and all cases recovered within 48 hours. It was impossible to submit samples of the food for analysis as all residues had been removed before the investigations were carried out. Streptococcal infection is believed to have been the cause of the outbreak. The foods concerned were mincemeat, potatoes, cabbage, steamed suet pudding and custard. No other cases were reported from other establishments receiving food from the same source. APPENDIX. Rainfall in Inches by Months for 1948. Metropolitan Water Board High Beech Buckhurtt Hill Luxborough S.D. Works. C.U.D.C Loughton Depot January 4.41 4.32 3.57 3.98 February 1.96 1.64 0.78 1.15 March 0.69 0.71 0.70 0.63 April 1.67 1.51 1.83 1.42 May 2.07 2.23 1.29 2.37 June 2.32 2.23 2.44 2.31 July 0.81 0.87 1.37 0.78 August 3.56 3.55 3.88 3.69 September 1.37 1.35 1.08 1.57 October 1.96 1.88 2.06 1.87 November 2.17 2.16 1.98 2.22 December 2.51 2.41 1.18 2.32 25.50 24.86 22.16 24.31 The highest point in the District is 372 O.D., and the lowest 44 O.D. 32 Printed by The Caxton Press Waltham Cross