CHIG 13 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, 1949 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, 1949. 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 pptient. All rates are based on civilian population as in previous years. The most noteworthy event affecting the health of the population during the year was a severe outbreak of infantile paralysis, details of which are given in Section F of this report. As always with this disease, and because of its tragic effects, public anxiety regarding the adequacy of precautionary measures and of facilities for treatment was evident. It is impossible, and it would be wrong, for complacency to exist in the present limited state of knowledge concerning the prevention and treatment of this dreaded disease, but all the evidence at my disposal clearly indicates that in no case was recovery prejudiced by lack of facilities for treatment, and that the unavoidable short delays which in one or two cases attended the transfer of patients from isolation hospital to 1 remedial treatment centre could not reasonably be regarded as a serious criticism of the services provided. The rapid growth of the new L.C.C. Housing Estates in the district is being watched with interest, chiefly on account of the high proportion of children and of tuberculous subjects among the tenants. The mixture seems very explosive at first sight, and certainly would be dangerous if not offset by the fact that the living conditions as regards fresh air and overcrowding are more favourable than the average, and very superior indeed to those of the alternative environment from which these people have come. It is estimated that one house in 15 on these estates has one or more occupants on' the tuberculosis register, comprising approximately 300 cases in all. Only 56 of these, however, have shown evidence of having been in an infectious condition during the past twelve months, and many of them spend a good deal of their time in hospital and sanatorium. The rate at which new cases of tuberculosis occurred on the estates was no greater than that in other parts of the district, and was less than the general rate of incidence for England and Wales as a whole. There is thus no evidence so far of any increased spread of this disease in the district, but the influx of so many established cases cannot be regarded entirely without anxiety for the future. The high proportion of children of susceptible age on the new estates has again resulted in a relatively high rate of incidence of measles and whooping cough per 1,000 of the population. It is satisfactory to note, however, that these rates are both below the corresponding figures for the previous year. The general health situation in the district has remained satisfactory. The overall death-rate and the infant deathrate are both below the corresponding figures for the previous 2 year, and are less than two-thirds of the average corresponding rates in England and Wales. Death from pneumonia and diseases of the heart and circulatory system have however increased, and a distressing feature is the unusually high number of fatal road accidents (7). The birth rate, at 17.7 per 1,000 of the population, shows little change, and is approximately equal to the average corresponding rate of all similar localities in the country. From mid-1948 to mid-1949, the population is estimated to have increased from 35,190 to 40,940, and by the end of 1949 was approximately 46,520. The increase was mostly due to immigration, as births only exceeded deaths by 401 during the year. The building of new houses has kept good pace with the increase in population, so that taking the district as a whole, overcrowding has not increased. The average number of persons per inhabited house was 3.9, as compared with 3.4 in the previous year. It is worthy of note that no case of diphtheria has been confirmed in this district since May, 1947. The Hygienic Food Traders' Guild made steady progress during the year, in which its organisation was completed and enrolment of membership commenced. No large or serious outbreak of food-poisoning was reported during the year, though there are no doubt many isolated cases which escape notification, and continued efforts to improve conditions under which food is handled are a most valuable contribution to the health of the community. Part III of the National Health Service Act, 1946. The County Council have, so far as possible, adhered to their proposals made as Local Health Authority, and the work over the past year has been conducted on the lines set 3 out under the various sections of the Act, being expanded so far as this has been possible. No major difficulties seem to have arisen, and I think a fair summary would be to say that the year's work has been mainly a continuation of existing services. Details of these services, and of treatment provided during the year, appear in Section B of this report. National Assistance Act, 1948. Seven cases were referred to me during the year for possible action under Section 47 of the National Assistance Act, 1948. All these cases were investigated with the following results:— (a) Court Order under Section 47 1 (b) Removed to institutions permanently 2 With (c) „ „ „ temporarily 2 (d) „ „ other accommodation 1 Patient's (e) Action not completed by end of year 1 consent Total 7 With regard to (a), the reason that the Council took legal action in this case was because the person concerned, an old lady, was infirm, not able to keep her flat clean and was making herself a nuisance to the other tenants and her neighbours by abuse and bad language. She also had a history of mental instability. The period named in the Court Order was three months which was extended for a further three months. It was not necessary to make more applications as the patient is now content to stay in the institution permanently, and has greatly improved in health. The accommodation provided was at St. Margaret's Hospital, Epping (Part III accommodation). 4 It has been my view that aged and infirm persons who cannot be persuaded to accept institutional care should not be dealt with under this Act unless the conditions are extremely bad, and I have advised the Council accordingly. An unfortunate result of this policy is that only those relatives who abandon their aged ones entirely are relieved of responsibility whilst those who struggle on, themselves often in bad health and economic difficulties, to keep conditions tolerable for their old folk, have little hope of any relief or assistance from their heavy burdens. It seems illogical that a State which provides expensive institutional accommodation for aged persons in need of care and attention, and places no obligation on individuals to provide for them, should do nothing whatever to assist relatives and others to keep them out of such institutions as long as possible. Home Helps are usually unobtainable for these long-term cases, but if those married daughters who are obliged to go out to work to supplement the family income were subsidised to stay at home and look after their infirm relatives and babies, much would be saved in nursery and institutional expense, and many staff would be relieved for the care of the sick or for productive work, I believe that a scheme of this kind, applied in appropriate cases, would add unmeasurably to the health, happiness and unity of all members of the families concerned, without loss whatever in national economy or production in the long run. In conclusion, I would again 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 co-operation during the year. For the statistical information which the Area Health and Divisional Educational Departments of the County Council have provided for this report, grateful acknowledgements are also made. . H. FRANKS, MB., B.S., B.HY., D.P.H., Medical Officer of Health. July, 1950. 5 Chigwell Urban District Council Public Health Committee: Chairman". Councillor E. G. Perry Members: Councillor Mrs. G. V. Cross C. T. Davie „ J. W. Spencer K. J. Lindy, f.r.i.b.a. H. W. A. Woollard, m.ps. O. J. Dean, j.p. „ G. P. Guyatt Mrs. L. M. Scott W. H. Wilson The Chairman, Councillor W. A. Nichols, j.p., and the Vice-Chairman, Councillor F. S. Foster, c.b.e., j.p., c.a„ of the Council ex-officio. Public Health Staff: Medical Officer of Health: H. Franks, m.b., b.s., b.hy., d.p.h. Senior Sanitary Inspector and Petroleum 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. Sanitary Inspectors'. R. P. Stevens, m.s.i.a. Royal Sanitary Institute and Sanitary Inspectors' Joint Board Certificate. g. glngell, a.r.san.i., m.s.i.a. Royal Sanitary Institute and Sanitary Inspectors' Joint Board Certificate. Clerks: Miss J. Warriner Miss S. Wright SECTION A STATISTICS and SOCIAL CONDITIONS of the AREA. Area (in acres) 8,970 (14 sq. miles approx.) Civilian Population (mid-1949) 40,940 Number of inhabited houses 11,890 Rateable value £325,360 Sum represented by a penny rate £1,324 19 3 The rate in the pound for 1949/50 is 17/4d. Live Births: Male Female Total Legitimate 377 314 691 Illegitimate 10 22 32 Total 723 Birth rate per 1,000 estimated resident population 17.7 Vital Statistics: Still Births: Male Female Total Legitimate 4 6 10 Illegitimate 0 0 0 Total 10 «' _____ Rate per 1,000 Qive and still) births 13.7 Male Female Total Deaths " 144 178 322 Death rate per 1,000 estimated resident population 7.9 Deaths from sepsis and other maternal causes 2 Deaths of infants under 1 year: Male Female Total Legitimate 6 7 13 Illegitimate 1 0 1 Total 14 7 Death rate of infants under 1 year: All infants per 1,000 live births 19.4 Legitimate infants per 1,000 legitimate live births 18.8 Illegitimate infants per 1,000 illegitimate live births 31.3 Table of Comparative Birth Rates and Death Rates in the year 1949 (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 16.7(a) 18.7 18.0 18.5 17.7 Still births 0.39(a) 0.47 0.40 0.37 0.24 Deaths: All Causes 1l.7(a) 12.5 11.6 12.2 7.9 Deaths: All causes under 1 year of age 32(b) 37 30 29 19.4 Enteritis and diarrhoea under 2 years of age 3.0 3.8 2.4 1.7 0 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 (mid-year) 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 1949 17.7 32 19.4 7.9 40,940 8 Causes of Death as given by the Registrar-General for the year 1949. Male Female Total Tuberculosis (all forms) 7 9 16 Influenza 1 3 4 Acute poliomyelitis 0 2 2 Cancer (all forms) 34 33 67 Diabetes 0 2 2 Intercranial vascular lesions 9 28 37 Heart disease 34 41 75 Other diseases of circulatory system 4 9 13 Bronchitis 8 9 17 Pneumonia 9 8 17 *Other respiratory disease 3 1 4 Ulcer of duodenum or stomach 7 1 8 Syphilitic diseases 1 0 1 Digestive diseases 4 4 8 Nephritis 5 1 6 Premature birth 2 2 4 Congenital malformations 2 5 7 Birth injuries Infantile diseases Suicides 0 1 1 Road traffic accidents 4 3 7 Other violent causes 2 3 5 All other causes 8 11 19 144 178 322 * Excluding tuberculosis. 9 SECTION B GENERAL PROVISION of HEALTH SERVICES in the DISTRICT (a) Public Health Officers of the Local Authority. See page 6. (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.I. (c) Ambulance Facilities. 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. 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). 10 Chigwell. St. Winifred's Church Hall, Wednesday at 2 p.m. (Doctor in attendance 1st and 3rd Wednesdays.) (Diphtheria Immunisation— 3rd Wednesday in month). All Saint's Church Hall, Chigwell Row, 2nd Thursday at 2 p.m. (Weighing Centre). Elmbridge Road Temporary Clinic, Tuesdays at 10 a.m. (150 bus route stops at The Lowe). Loughton. Union Church Hall, High Road, Fridays at 2 p.m. (Diphtheria Immunisation— 2nd Friday in month). Roding Road Church Hall, Tuesdays at 2.30 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. Essex County Council Clinic, Buckhurst Way, Mondays at 2 p.m. Chigwell. Elmbridge Road Temporary Clinic, Fridays at 2 p.m. (150 bus route stops at The Lowe). 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. 11 Women's Welfare Clinic: Buckhurst Hill. Essex County Clinic, Buckhurst Hill, 1st Friday at 10 a.m. (Apply to Health Visitor for appointment). (f) School Clinics. Chigwell. ' Manford Way Primary School, Manford Way, Thursdays 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, Tuesdays and Wednesdays. (By appointment only). (g) Home-Help Organiser. Mrs. M. May, 93, High Road, Woodford, E.18. (Buckhurst 6626). (h) Health Visitors. Buckhurst Hill. Miss Dennis, Essex County Clinic, Buckhurst Way. (Buckhurst 5180). Chigwell Miss Moore, Elmbridge Road Temporary Clinic (Hainault 3419). Loughton. Miss Ward, Council Offices, Old Station Road, Loughton (Loughton 4479). 12 *Miss Whitmore, Essex County Clinic, Buckhurst Way (Buckhurst 5180). *Roding Estate and Loughton L.C.C. Estate (Borders Lane to Oakwood Hill). (i) District Nurses. Buckhurst Hill. Miss Botell, 126, Queens Road, (Buckhurst 1331). Chigwell. Miss Proctor, 64, The Lowe (Hainault 3110). Loughton. Miss Gardner, 20, Crescent View (Loughton 4500). Miss Willings, 12, Forest View Road (Loughton 665). Midwives: Buckhurst Hill. Mrs. Powis, 47, St. Albans Road, Woodford Green (Buckhurst 1032). Chigwell. Mrs. Jones, 33, Manford Way- (Hainault 2108). Loughton. Miss Casey, 85, Grosvenor Drive. Miss Clark, 69, Connaught Avenue, Chingford (Silverthorn 1801). (j) Tuberculosis Dispensaries. Buckhurst Hill. Essex County Council Clinic, Buckhurst Way, every Wednesday at 2.30 p.m. Epping. Chest Clinic, St. Margaret's Hospital (Epping 2251). Tuesdays 9 a.m. to 1 p.m., old cases (by appointment) and new cases. 2 p.m. to 3.30 p.m. (by appointment). (k) Tuberculosis. Forest Area Tuberculosis Care Association. The Association continues to assist cases awaiting admission to sanatorium in various ways and arranges also 13 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 to 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. A. C. Hallard, 195, High Road, Loughton. These premises have been inspected and are being conducted in a satisfactory manner. CHiGWELL URBAN DISTRICT Visits Paid by Health Visitors. 1st. Visits Under 1 year 732 1—5 years 36 Other 257 Re-Visits Under 1 year 1722 1—5 years 2467 Other 9S Attendances at Ante-Natal Clinics. Ante Natal 2224 Post Natal 58 Attendances at Child Welfare Clinics. Attendance of Mothers 14024 Infants under 1 year .. 8020 Children 1—5 years 6821 Attendances at Women's Welfare Clinic. 1st. Visits 94 Re-Visits ' 6 14 CHIGWELL URBAN DISTRICT Numbers provided with Dental Care (new cases). Examined Needing Treatment Treated Made Dentally Fit Expectant Mothers 27 27 23 12 Nursing Mothers 31 31 26 19 Children under 5 years 24 21 20 18 Forms of Dental Treatment provided. Extractions L. Anaesthetics G. Anaesthetics Fillings Scalings etc. Silver Nitrate Treatment Dressings Dentures complete Dentures partial Expectant Mothers 152 27 43 97 6 — 15 6 14 Nursing Mothers 125 14 31 61 11 — 21 9 18 Children under 5 19 4 11 43 2 9 — — — X-rays taken. Expectant Mothers - Nil Nursing Mothers - 2 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 is one house where the supply is obtained from a well. The supply to the area has been satisfactory both in quantity and quality. All but one 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 plumbosolvency or contamination. Houses supplied from standpipes Nil Houses supplied from wells 1 Two samples were obtained from the well referred to above for chemical and bacteriological analysis. The results were as follows:— 1. Satisfactory.— Water wholesome and suitable for drinking and domestic purposes. 2. Unsatisfactory.— Water not of the standard desirable for drinking and domestic purposes. Arrangements were then made by the owner of the premises concerned (which are in the forest area, some 700 yards from the nearest water supply main) to convey water from the Metropolitan Water Board's main to a 100-gallon storage tank at the house. A sample obtained from this source was submitted foe analysis, with the following result: Satisfactory— Water suitable for drinking and domestic purposes. Further samples will be obtained during 1950. 16 (ii) Drainage and Sewerage. The sewage disposal plant at Luxborough has given a reasonably satisfactory effluent having regard to the continued and rapid increase in population and flow resulting primarily from development of the L.C.C. Estate at Dedben. The first stage of enlargement, to assist the disposal of sludge, has been practically completed during the year. Sanction to proceed with the remainder and major part of the scheme has been applied for but has been so far deferred on account of restrictions on capital expenditure. In the meantime the need for the scheme is becoming progressively greater. The reconstruction of Millers Lane Works has proceeded during the year and the new works will be put into service in the early part of 1950. The five pumping plants have continued to function satisfactorily. 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 and Cesspools. A terraced block of 4 cottages has been converted from earth closets to main drainage. Properties still served by earth and Elsan closets and cesspools are in areas where no sewer is available. As development takes place every opportunity is taken to arrange for premises which are not at present connected to a sewer, to be so connected. 17 (ii) Public Cleansing. House refuse has been removed once weekly from all premises throughout the district by the Council's own covered vehicles. A further 10/12 cu. yd. "Fordson" lorry with "Eagle" body has been added to the previous three, and one 7 cu. yd. similar vehicle has also been needed for part-time service in the latter part of the year. Trade refuse has been again collected on a scale of charges and a substantial number of traders in the district utilise this service. Refuse was disposed of by controlled tipping at a tip rented from a local contractor, who provides certain buildings and part of the material and labour for levelling and covering. Measures were taken against fly and vermin infestation. The Council's own employees sort and handle salvage at this tip. Recovery, particularly of paper (brought in by trailers attached to refuse vehicles) an drags, has been ocntinued during the year. There was a period of a few months when only a reduced quota of paper was accepted by purchasers, which caused some difficulty. The total material salvaged, saved and disposed of was 300 tons, including 279 tons of paper. Kitchen waste collection from street bins has also been continued and 287 tons were conveyed to a concentrator plant at Stapleford Abbotts. Additional bins have been put out to cover new development and a commencement has been made with measures to secure the bins against overturning and to attach the lids to the bins by hinges. Road gullies (in streets repairable by the inhabitants at large) are emptied by mechanical suction process under contract. Gullies are cleared three times in each year and resealed with clean water after emptying. 18 (iii) Sanitary Inspection of the Area. An outline of the work of the Sanitary Inspectors is given below:— Complaints received and dealt with 604 Inspections made 9,070 Nuisances abated 270 Informal Notices served 117 Informal Notices complied with Ill Statutory Notices served 20 Statutory Notices complied with 16 Legal Proceedings 2 Summary of Nuisances. Drains blocked or defective 92 Defective water closets 9 Defective water supply pipes 18 Nuisance from animals 22 Polluted ditches and watercourses 6 Accumulation of refuse, fish boxes, etc. 8 Vermin, bugs and fleas 10 Cellars flooded 4 Fly infestations 10 Smells from animals, etc. 17 Cesspools overflowing or defective 18 Crickets 12 Wasps and hornets 40 Insanitary practices 4 Verminous Houses. 270 10 houses were found to be verminous during the year. These houses were fumigated with 'Thermatox' and sprayed with 'Zaldecide' or Bed Bug Spray, with satisfactory results. Number of inspections and visits, 72. Rats and Mice Destruction Acts. There was again a rise in the number of complaints. 1,833 visits were made and energetic action taken to exter- 19 minate 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 was carried out twice during the year with the following results:— Manholes baited 193 128 Pre-bait (part takes) 55 5 (complete takes) 52 15 Poison (part takes) 35 11 (complete takes) 16 — Dead rats picked up — — The poison and bait bases used were as follows:— 1st treatment— Sausage rusk 2½% Zinc Phosphide. 2nd treatment— Bread mash 10% Arsenic. 20 SECTION D HOUSING STATISTICS for the YEAR 1949 Number -of new houses erected and occupied during the year:— Permanent Houses:— For London County Council Loughton 1,050 Chigwell 367 - 1,417 For Chigwell U.D.C. 222 For Private Owners 25 Total 1,664 Inspecteon of Dwelling Houses during the Year: 1. (a) Total number of dwelling houses inspected for housing defects (under Public Health and Housing Acts) 452 (b) Number of inspections made for the purpose 1,371 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 5 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 15 21 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 Aurthority or their Officers 11l 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 10 (2) Number of dwelling houses in which defects were remedied after service of formal notices: (a) by Owners 9 (b) by Local Authority in default of Owners 1 (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 Nil (2) Number of dwelling houses demolished in pursuance of Demolition Orders Nil 22 Housing Act, 1936—Part IV— Overcrowding. No formal action was taken owing to the general housing shortage. 38 inspections and visits were made, but the acute housing shortage in the district has made the alleviation of overcrowding a matter of great difficulty. Summary of Defects. Defective roofs 96 W.C.'s 18 water waste preventers 26 sink and waste pipes 11 „ sash cords 30 flank walls 12 gutters and rain water pipes 32 yard paving 2 window and door cills 12 drainage and vent pipes 4 gullies 18 internal walls (plaster) 94 ceilings 40 „ water fittings and pipes 8 „ flooring and doors 16 external walls 19 „ stores and boilers 2 „ fireplaces 27 dustbins 44 Dampness 80 Under floor ventilation, lack of 6 Dirty walls and ceilings 24 Miscellaneous 16 23 SECTION E INSPECTION and SUPERVISION of FOOD (a) Milk Supplies. With effect from the 1st October, 1949, the control and inspection of milk producing farms was undertaken by officers of the Ministry of Agriculture and Fisheries. Up to that date the number of farms producing graded and ungraded milk was: Tuberculin Tested 6; Accredited 6; ordinary 4; Total 15. The cowsheds have been kept in a satisfactory condition whilst under the control of the Local Authority and 72 visits have been made. 27 samples of milk were taken for bacteriological examination by the County Council, Public Health Department, and 9 of these were reported as being unsatisfactory. 29 samples of milk were taken by the Weights and Measures Department of the County Council during the year. There are 7 dairies and milkshops registered, 40 visits to these premises were made. There are 11 registered milk purveyors in the district, licensed under the Milk (Special Designation) (Pasteurised and Sterilised) Regulations, 1949. (b) Meat and Other Foods. Slaughtering. There are 7 slaughterhouses in the district all licensed under the Food and Drugs Act, 1938. 26 pigs were slaughtered and inspected during the year. No carcases or organs were condemned. Slaughtering in the main for this district is carried out elsewhere in centralised 24 Ministry of Food Slaughterhouses at which inspections and condemnations are the responsibility of the district in which situated. 62 visits were made to slaughterhouses. There are 24 butcher shops in the district and 251 visits were made to these premises. 105 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 uusound 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 Skate stones 64 Salmon, tins 3 Pilchards, tins 6 Cod roes, lbs 7 Catfish, stones 6 „ tins 10 Fillets, tins 1 Crab, tins 4 Prawn paste, tins 1 „ paste, tins 3 Crawfish, tins 3 Cod, stones 1 Halibut, stones 1½ Brislings, tins 3 Whiting, tins 1 Sardines, tins 12 Tunny, tins 1 MEAT Corned beef, 12oz. tins 5 Pork, tins 1 „ „ 61bs. „ 30 Luncheon meat, tins 3 Rabbit, tins 1 Jellied veal, tins 2 lbs 626½ Beef, lbs 121 Brawn, tins 5 Mutton, lbs 53 Corned mutton, 61b tins 1 Beef, jellied, tins 1 Bacon, lbs 33£ Ox tongues, lbs. 53 Pigs trotters, lbs 112 „ „ tins 1 25 FRUIT Plums, tins '8 Apples, tins 5 bottles 1 Dates, lbs. 140 Peaches, tins 8 Grapes, tins 3 Pears, tins 9 Rhubarb, tins 2 Pineapples, tins 2 VEGETABLES Macedoines, tins 6 Peas, tins 25 Spinach, tins 1 Tomatoes, tins 4 Beans, tins 33 Beetroot, tins 10 Vegetable salad, tins 1 OTHER ITEMS Milk, evaporated, tins 181 Chocolate, lbs. ½ „ condensed, 10 Sago, lbs 28 „ skimmed, „ 5 Spaghetti pearls, lbs. 109 unsweetened, „ 2 Semolina, lbs. 37½ fullcream „ 12 Pickles, bottles 2 „ powdered, „ 2 Marmalade, tins 9 „ puddings, „ 2 Jam, lbs. 7 Eggs 276 „ tins 2 Fruit puddings, tins 2 Onions, tons 1 Tomato soup, tins 6 Olives, jars 1 Macaroni, lbs. 30 Salt, packets 1 Pearl barley, lbs. 91 Soup, tins 9 Orange juice, tins 12 Pate foie, tins 2 Grapefruit juice, tins 4 Syrup, tins 1 Egg powder, tins 3 Dripping, lbs 5 Sauce, bottles 2 Soya flour, lbs. 28 tins 2 Barley flakes, lbs. 27 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; 111 visits have been made to these premises. 26 Clean Food Campaigns. The Chigwell and Waltham Holy Cross Hygienic Food Traders Guild was formed in 1948. An Advisory Committee has been set up and has formulated the policy of the Guild. Codes of Practice have been drawn up for each type of trade including Licensed Premises and Mobile Ice Cream Vendors. The Advisory Committee meets six times a year to receive reports from the Sanitary Inspectors concerning applications for membership and to discuss new problems and suggestions. The Committee is comprised as follows:— Councillors 5 Food Traders 7 Trade Union 1 Employees 1 Technical Officers: Medical Officer of Health 1 Sanitary Inspectors 2 35 Food Traders have applied and been admitted to membership. The Certificate of Membership and employees' badges have been issued in each case. The members represent the following trades:— Grocers and Provision Merchants 8 Fishmongers 3 Butchers 9 Confectioners 3 Bakers 2 Restaurants 3 Greengrocers 3 General Stores 3 Dairies 1 Arrangements are being made to show three short films to Food Traders early in 1950. A series of lectures has been given by the Medical Officer of Health to senior classes at local schools. The subjects discussed were General Public Health Administration, Personal Hygiene, Infectious Diseases and Food and Kitchen Hygiene. 27 (c) Factories. 284 inspections have been made. Considerable improvement has been noted concerning the nuisance from cellulose paint spraying. The plant concerned is visited regularly, and the management have shown their willingness to co-operate in this matter. We have, however, been receiving numerous complaints owing to the nuisance from stove enamel paint spraying. A double-booth water wash plant has been installed and the improvement noted. An order has been placed for a further triple booth water wash plant and it is hoped that it will be installed in the near future. Inspections have been carried out of factory premises in connection with means of escape in case of fire. We have been assisted by Officers of the Essex County Fire Brigade (Fire Prevention Branch), and a technical representative from the Engineer and Surveyor's Department of this Authority. I wish to record my thanks for their assistance and cooperation during these important inspections. Eleven certificates have been issued by this Authority certifying that in each case the means of escape in case of fire have been adequate. 28 29 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 12 73 Nil Nil (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 80 211 2 Nil (iii) Other Premises in which Section 7 is enforced by the Local Authority Nil Nil Nil Nil Total 92 284 2 Nil 30 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.1) 5 4 - - - Overcrowding (S.2) — — — — - Unreasonable temperature (S.3) — — — — - Inadequate ventilation (S.4) 1 1 — — - Ineffective drainage of floors (S.6) — — — — - Sanitary Conveniences (S.7):— (a) Insufficient 1 1 - 2 — (b) Unsuitable or defective 10 8 - — — (c) Not separate for sexes - - - — — Other offences against the Act (not including offences relating to Outwork) 13 12 3 4 - Total 30 26 3 6 Nil (d) Outworkers. 220 visits were made during the year. (e) Shops Act. 75 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. 299 visits have been made to ice-cream vendors and manufacturers during the year in connection with routine inspections and sampling. There are six manufacturers and 70 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. The plant is inspected regularly and the process is in conformity with the Ice Cream (Heat Treatment, etc.) Regulations, 1947 and 1948. 59 samples were taken and submitted for examination with the following results:— Satis- Unsatisfactory factory Manufactured in the district 11 Nil Manufactured outside the district 39 9 31 The samples were classified under the Ministry of Health's provisional grading scheme as follows:— Grade I Grade II Grade III Grade IV 38 9 8 4 The samples were also submitted for chemical analyses (fat content) as requested by the Ministry of Food. In every case the fat content exceeded the 2½% minimum requirement. 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. Inspections were also carried out on Sundays, and samples obtained from mobile vans, tricycles and stalls. In all cases, including Sundays, the samples were delivered to the laboratory within three hours of being obtained from the vendors. Summary of Sanitary Inspector's visits during the Year ended 31st December, 1949. General Sanitation. Nature of visit or inspection. Total No. of visits. Water supply 34 Drainage 667 Stables and piggeries 4 Fried fish shops and vans 51 Tents, vans and sheds 34 Factories 284 Workplaces 6 Outworkers 220 Bakehouses 111 Public conveniences 11 Places of entertainment 1 32  Total No. of visits Refuse collection 29 Refuse disposal 172 Rats and mice 1,833 Smoke observations 14 Schools 2 Shops 75 Petrol 31 Knackers yards 58 Cesspool survey 131 Food Hygiene Guild 170 Miscellaneous sanitary visits 1,426 5,364 Housing. Under Public Health Acts. Number of houses inspected 412 Visits paid to above houses 1,296 Under Housing Acts. Number of houses inspected 40 Visits paid to above houses 75 Overcrowding. Number of houses inspected 33 Visits paid to above houses 5 Verminous Premises. Number of houses inspected 22 Visits paid to above houses 50 Miscellaneous housing visits 308 2,241 Infectious Disease. Inquiries in cases of Infectious disease 103 Visit re disinfection 45 Miscellaneous Infectious Disease Visits 90 238 33 Inspection of Meat and Food. Visits to slaughter-houses 62 „ other premises 4 „ „ butchers 251 „ „ fishmongers and poulterers 86 grocers 70 „ „ greengrocers and fruiterers 52 „ „ cowsheds 72 „ „ dairies and milkshops 40 „ „ ice cream premises 199 „ restaurants 105 Miscellaneous food visits 186 Visits in connection with milk sampling 100 Visits in connection with food and drugs samples 1,227 9,070 34 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. 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 30 30 2 Acute Primary Pneumonia 15 1 0 Erysipelas 14 1 0 Measles 541 7 0 Scarlet Fever 41 6 0 Typhoid Fever 1 1 0 Whooping Cough 156 6 0 798 52 2 35 Comparative Tables of Infectious Disease Notification and Death Rates per 1,000 of the population in 1949 (Provisional figures based on Weekly and Quarterly Returns) England and Wales 126 C.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 0.01 0.01 0.01 0.02 Paratyphoid fever 0.01 0.02 0.01 0.01 0.00 Cerebro-spinal fever 0.02 0.03 0.02 0.02 0.00 Scarlet fever 1.63 1.72 1.83 1.46 1.00 Whooping cough 2.39 2.44 2.39 1.70 3.81 Diphtheria 0.04 0.05 0.04 0.07 0.00 Erysipelas 0.19 0.20 0.19 0.17 0.34 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 8.95 8.91 9.18 8.54 13.21 Pneumonia 0.08 0.91 0.65 0.55 0.37 Acute poliomyelitis 0.13 0.13 0.12 0.18 0.70 Acute polioencephalitis 0.01 0.01 0.02 0.01 0.02 Food poisoning 0.14 0.16 0.14 0.19 0.83 Deaths Typhoid and paratyphoid 0.00 0.00 0.00 0.00 0.00 Whooping cough 0.01 0.02 0.01 0.01 0.00 Diphtheria 0.00 0.00 0.00 0.00 0.00 Tuberculosis 0.45 0.52 0.42 0.52 0.39 Influenza 0.15 0.15 0.14 0.11 0.10 Smallpox 0.00 0.00 — — — Acute poliomyelitis and polioencephalitis 0.01 0.02 0.02 0.01 0.05 Pneumonia 0.51 0.56 0.49 0.59 9.41 36 Poliomyelitis. The district was amongst many areas visited by epidemics of infantile paralysis in the summer of 1949. From June onwards reports of outbreaks in various parts of the country were being received, and preparations were put in hand by the appropriate authorities for the diagnosis and isolation of patients. Public appeals were made through the press and local cinemas, Rotary and the Hygienic Food Traders' Guild, in an effort to improve the general standard of personal and domestic hygiene, with particular emphasis on the control of house flies. It was not till early September that the first case in the district occurred, but from then until the end of the year, a total of 30 cases were notified. Two cases ended fatally after a very brief illness; 10 had made a complete recovery by the end of the year; the remainder (18) are left with some degree of disability. Smallpox. Two contacts of a fatal case of smallpox returned to their homes in the district on disembarking from an infected ship. Both were vaccinated and kept under surveillance during the danger period. This should serve as a salutory reminder of the continuing need for vigilance against this disease, and the decline in the numbers of infants undergoing vaccination is rather disturbing. Total vaccinations performed in the district during the year was only 176, and 50 re-vaccinations of persons proceeding overseas. Diphtheria. No cases of diphtheria occurred during the year. The free immunization of children by general practitioners and at clinics has been maintained. 543 children completed a course of immunization during the year. 130 re-inforcing injections were also administered. 37 Tuberculosis. 33 new cases of lung tuberculosis, and 4 of tuberculosis of other organs, were notified during the year. In addition to these new cases, however, no less than 121 established cases of tuberculosis, originally acquired in other areas took up residence in this district during the year; 113 of these are new residents on the L.C.C. estates. There were 16 deaths from tuberculosis during the year, compared with 15 in 1948 and 8 in 1947. Food Poisoning. (a) Total number of outbreaks 6 (b) Number of cases 33 (c) Number of deaths Nil (d) Organisms or other agents responsible:— Proteus Vulgaris 11 cases Conform bacillus Salmonella Typhimuruim 1 case Unidentified organisms 21 cases (e) Foods involved:— Minced beef that had been cooked the day before it was minced, and warmed up again before being served. No. of outbreaks 1(11 cases) Cockles purchased at Southend suspected. No. of outbreaks 1 (4 cases) Unidentified foods causing 4 outbreaks. 38 APPENDIX Rainfall in Inches by Months for 1949. % Metropolitan High Beech Water Board Buckhurst Hill Lux borough S. D. Works C.U.D.C. Loughton Depot January 1.13 .97 1.80 .96 February 1.14 1.05 .90 1.06 March .08 0.87 .80 .81 April 1.42 1.52 1.38 1.42 May 1.96 1.94 1.72 1.86 June 0.71 0.71 0.73 1.12 July 1.54 1.29 1.54 1.04 August 1.93 1.36 1.02 1.48 September 0.28 0.51 0.86 .48 October 5.50 4.90 4.83 4.83 November 2.54 2.27 1.90 2.25 December 1.55 1.56 ; 1.40 1.49 19.78 18.95 , 18.88 18.80 The highest point in the District is 372 O.D., and the lowest 44 O.D. 39