LIBRARY AC 4411(3) CHIGWELL CHIG 16 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, 1952 Chigwell Urban District Council Public Health Committee: Chairman: Councillor E. G. Perry. Members: Councillor K. F. Alder. „ D. G. Bennett, F.R.I.C.S. „ Mrs. G. V. Cross C. J. Moull. Mrs. L. M. Scott. „ L. L. Spain. „ P. H. Stainsby. „ P. A. Stretton. G. J. Wilds. The Chairman of the Council, Councillor W. A. Nichols, J.P., and the Vice-Chairman of the Council, Councillor J. W. Spencer, ex-officio. Public Health Staff: Medical Officer of Health: H. Franks, M.B., B.S., B.Hy., D.P.H. Senior Sanitary Inspector: W. H. Digweed, A.R.San.I., M.S.I.A. (a) (b). Sanitary Inspectors: R. P. Stevens, (a). G. Gingell, A.R.San.I., M.S.I.A. (a) (b). Clerks: Miss J. Warriner. Miss S. Wright. (a) Royal Sanitary Institute and Sanitary Inspectors' Joint Board Certificate. (b) Royal Sanitary Institute Certificate for Inspector of Meat and Other Foods. 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, 1952. VITAL STATISTICS. The birth-rate and general death-rate were both a little smaller than in 1951. The rates have been adjusted to allow for the way in which the sex and age distribution of the local population differs from that for England & Wales as a whole, and it will be observed that, while the local birth rate was about the same as that for England & Wales, the local death rate (6.9) was again very much below the national rate (11.3), as in previous years. There were however, more deaths this year amongst infants under 4 weeks of age, there being more non-surviving cases of congenital defect and prematurity. Live births exceeded deaths by 546. The remaining net increase of population (3,124) was mostly due to rehousing of London residents on the Debden Estate. The winter of 1952/53 was exceptionally sunless, cold and foggy, and this was clearly reflected in the abnormally high incidence of chest diseases towards the close of the year: New claims for National Insurance Sickness Benefits rose sharply during the week ended 13th December (to almost double the previous week's claims), and 19 deaths were registered as compared with 10 in the previous week. The whole of the London area experienced a similar large increase of sickness and mortality at the same time (2,484 deaths compared with 945 in the previous week). Influenza, pneumonia, and other chest diseases were predominant causes of the increase, both locally and in the London area generally. 1 There can be little doubt that the above occurrences were related to the dense fog which enveloped the whole of the London area continuously from 5th to 9th December. During this period, black suspended matter and sulphur dioxide in the air rose to about 15 times their normal amounts for the time of the year, due to absence of wind and of the convection currents which normally carry these impurities away into the upper atmosphere. So devastating are the effects of these visitations—from loss of life, sickness and dislocation of essential services and industries—that one wonders whether it would not be more profitable in the long run to introduce Statutory restrictions on industry during the few days of the year when fog appears imminent. Factories would close down, some fires would go out, some heavy transport would be stopped or diverted by Order under certain well-defined meteorological conditions; there would be discomfort, and loss of time and money comparable in duration with the fog periods; but there would be no aftermath of sickness and death—and no fog! In areas such as London the effect of the increasing use of Diesel fuel is obvious to the most casual observer. The nauseating dense black smoke emitted continuously, at ground level, by many thousands of lorries and buses in built up areas cannot be ignored as an important factor in the production of fog and of irritation of the respiratory and digestive organs. Is this wholesale pollution of the atmosphere of our most thickly populated neighbourhoods really an economic necessity in these days of unlimited petrol? INFECTIOUS DISEASES (See also Section F). Towards the end of the year, a fatal case of diphtheria occurred in a child of 11. This was the first case in the District since 1947. Long-standing debility from chronic ill-health was a contributory cause of the death, and evidence which suggested that the child had never been immunised is also relevant, and is a salutory reminder of the need for constant vigilance. Prompt measures were taken to protect and test all contacts, and no further cases occurred. 2 Otherwise, it was a satisfactory year from the point of view of infectious disease. Measles, whooping cough, dysentery and pneumonia notifications were all considerably less than in the previous year. Of the 7 cases of poliomyelitis notified, 1 case, a man of 23 years, was severe, and is making slow but steady progress; 1 child is still receiving treatment; the other milder cases have made a good recovery. TUBERCULOSIS. The number of established cases of tuberculosis entering the District under re-housing schemes was again considerably reduced—34 compared with 75 in 1951 and 157 in 1950. The incidence of fresh cases among residents of the new estates, which gave rise to some anxiety two or three years ago, can no longer be considered significantly higher than that for the District as a whole. This result was not unexpected as immigration—both total and tuberculous, has declined with the near-completion of the large estates. MASS RADIOGRAPHY: The figures for the Mass Radiography survey held at Manford Way School, Chigwell in January, 1952 were as follows:— Men Women Total Number X-rayed 186 228 414 Larger Films 7 12 19 Cases of pulmonary tuberculosis revealed:— Men Women Active bi-lateral post primary 2 Nil Inactive post-primary Nil 8 Anti-tuberculosis Vaccine Research Trial: During 1952, the Anti-Tuberculosis vaccine Clinical trials, organised by the Medical Research Council, were continued. This scheme has been designed to determine whether an antituberculosis vaccine, BCG, at present used in Britain for nurses and others in contact with the disease, is of sufficient value for the general population for its widespread use to be advised. 3 Over 50,000 volunteers from North London areas, Manchester and Birmingham are taking part. Of these, 389 come from Loughton. The volunteers all entered the scheme during their last terms at Secondary Modern Schools, and all had a chest X-ray and skin test. A proportion were then given the vaccine, and all must now be followed up for three years to determine its value. The follow-up consists of an annual chest X-ray, the first part of which was carried out in the evenings during May, 1952, and January, 1953 at Houghton Hall Health Services Clinic by the Unit's Mobile X-Ray van, and a high proportion of the young people kept their appointments. Dr. J. M. Pollock, Physician-in-Charge of the trials, writes:— "The good response was encouraging both because of the research and also because of the great value to young people of a chest X-ray, at an age when pulmonary tuberculosis is common and often unsuspected. Much of the credit for the good progress made should be accorded to the Health Visitors who visit each volunteer once a year. This work, often involving repeated visits, has been painstakingly and enthusiastically carried out, and the interest of the parents and volunteers in the trial, and their response to the invitation for X-ray, are a reflection of the efforts made. We look forward to working with them during the next two years." SMALLPOX VACCINATION is still declining in popularity, despite repeated warnings of the increasing danger of importation of this disease due to the greater popularity of longdistance air-travel. Less than half the babies born in the district are now vaccinated. Apart from the greater risk of complications when the first (primary) vaccination is delayed until an outbreak of smallpox actually occurs, there is also the added danger that it may then be too late to be effective. Vaccination is of course, a free service provided by the family doctor under the National Health Service and should be carried out as soon as possible after the child is three months old. FOOD POISONING. There were thirteen cases notified. An outbreak of five cases was due to bacterial (Salmonella typhimurium) infection of duck egg; five single unassociated cases were due to Salmonella infections. In three cases no cause could be ascertained. 4 The Hygienic Food Traders' Guild, operated in conjunction with the Waltham Holy Cross Urban District Council, increased its membership from 54 to 66 during the year, and arrangements were put in hand for a course of lecture demonstrations to employers and employees of all food handling establishments in the Districts. (These took place, with very successful attendances, early in 1953). The general standard of cleanliness and hygiene in local food shops still leaves much to be desired. Twenty-seven complaints of contamination were received including gross and obvious contaminants such as insects (4 cases), pieces of glass (3 cases) ,a safety pin, a cigarette end, a nail and a paper label. It is not always clear how, when and where these things get into the food, and in the absence of clear evidence, which the informant is willing to give in Court, prosecution is unlikely to be successful. It was, however, possible to bring a case to Court under the Clean Food Bye-Laws, and a fine of three guineas was imposed on each of the two defendants. The Council recently (1953) resolved to prosecute in every case where evidence of contravention of the Clean Food Bye-Laws was available, and all Food Traders have been individually warned that this will te the Council's future policy. NATIONAL ASSISTANCE ACT, 1948 (SECTION 47) and NATIONAL ASSISTANCE (AMENDMENT) ACT, 1951. Nine persons "in need of care and attention" were under observation for possible action under Section 47. Two of these were eventually compulsorily removed to hospital under the above Acts; three were admitted as voluntary patients and four remain at home under continued observation. 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, M.B., B.S., B.Hy., D.P.H., June, 1953. Medical Officer of Health. 5 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 8,970 (14 sq. miles approx) Civilian Population (mid-1952) 56,830 Number of inhabited houses 14,950 Rateable value £403,216 Sum represented by a penny rate £1,600 The rate in the pound for 1951—2 was 19/4d. Vital Statistics: LIVE BIRTHS: Male Female Total Legitimate 442 462 904 Illegitimate 14 16 30 Total 934 Birth rate per 1,000 estimated resident population 15.3 STILL BIRTHS: Male Female Total Legitimate 10 11 21 Illegitimate 0 0 0 Total 21 Rate per 1,000 (live and still births) 20.0 Male Female Total Deaths 204 184 388 Death rate per 1,000 estimated resident population 6.9 Deaths from pregnancy, child birth and abortion 1 Deaths of infants under 1 year of age: Male Female Total Legitimate 16 9 25 Illegitimate 1 2 3 Total 28 Deaths of infants under 4 weeks of age: Male Female Total Legitimate 13 7 20 Illegitimate 1 2 3 Total 23 6 Death rate of infants under 1 year of age: All infants per 1,000 live births 30.0 Legitimate infants per 1,000 legitimate live births 27.8 Illegitimate infants per 1,000 illegitimate live births 100.0 Death rate of infants under 4 weeks of age 24.6 Table of comparative Birth Rates and Death Rates in the year 1952 (Provisional figures based on quarterly returns). England & Wales 160 County Boroughs and Great Towns (including London). 160 Smaller Towns (Resident population 25,000—50,000 at 1951 Census). London Administrative County Chigwell U.D. BIRTHS: Rates per 1,000 Home Population Live Births 15.3 16.9 15.5 17.6 15.3 Still Births 0.35 0.43 0.36 0.34 0.37 22.6(a) 24.6(a) 23.0(a) 19.2(a) 20.0(a) DEATHS: All causes 11.3 12.1 11.2 12.6 6.9 All causes under 1 year of age (a) 27.6 31.2 25.8 23.8 30.0 Enteritis and Diarrhoea under 2 years of age (a) 1.1 1.3 0.5 0.7 0 (a) Rates per 1,000 corresponding births. The following table shows some vital statistics for the district for the past five years:— Year. Birth Rate per 1,000 of Population Number of Illegitimate Births. Infantile Mortality Rate per 1,000 (Live Births). Death Rate Estimated Population (mid-year). 1948 17.5 26 26 85 35,190 1949 17.7 32 19.4 7.9 40,940 1950 17.4 44 17.7 6 9 48,680 1951 16.8 24 15.7 7.4 53,160 1952 15.3 30 30.0 6.9 56,830 7 Causes of Death as given by the Registrar General for the year 1952. Male Female Total Heart disease 44 64 108 Other diseases of circulatory system 8 7 15 Cancer (all forms) 45 31 76 Vascular lesions of nervous system 24 23 47 Bronchitis 12 6 18 Pneumonia 13 9 22 Influenza 1 1 2 Disease of the Prostate 4 0 4 Tuberculosis (all forms) 6 4 10 Ulcer of duodenum or stomach 5 1 6 Leukaemia 2 1 3 Congenital malformations 7 2 9 Diabetes 0 0 2 Syphilis 2 3 5 Meningococcal infections 1 0 1 Nephritis and Nephrosis 3 3 6 Pregnancy, childbirth and abortion 0 1 1 Other infections 1 0 1 All other diseases 17 24 41 Motor vehicle accidents 3 1 4 Suicides 3 0 3 Other violent causes 1 2 3 204 183 387 8 SECTION B. GENERAL PROVISION of HEALTH SERVICES IN THE DISTRICT. (a) Public Health Officers of the Local Authority. (See inside front cover). The County Council Services for the District are administered as follows:— 1. Health: Dr. F. G. Brown, Area Medical Officer, Municipal Offices, High Road, Woodford, E.18. Tel: Buckhurst 4464. 2. Welfare: Mr. R. E. Riche, 35, Wanstead Place, E.ll. Tel: Wanstead 0031. (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. 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 Non-emergency 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 at the Forest Hospital, Buckhurst Hill, and at hospitals in neighbouring districts. 9 (d) Child Welfare Centres. BUCKHURST HILL. Essex County Council Clinic, Buckhurst Way, Thursdays at 2.0 p.m. (Diphtheria immunisation by appointment). CHIGWELL. St. Winifred's Church Hall. 1st and 3rd Wednesday at 2 pm. (Diphtheria immunisation by appointment). All Saint's Church Hall, Chigwell Row, 2nd Thursday at 2 p.m. (Weighing Centre). Essex County Council Health Services Clinic, Manford Way, Friday at 2 p.m. (Diphtheria immunisation by appointment). LOUGHTON. Union Church Hall, High Road, Fridays at 2 p.m. (Diphtheria immunisation by appointment). Roding Road Church Hall. Tuesdays, at 2.30 p.m. (Diphtheria immunisation by appointment). British Legion Headquarters, Church Hill, Mondays 2 p.m. (Diphtheria immunisation by appointment). Essex County Council Health Services Clinic, Loughton Hall. Mondays and Wednesdays at 2 p.m. (Diphtheria immunisation by appointment). There were 16,910 attendances at child welfare centres during the year of which 9,915 were under 1 year of age. (e) Ante-Natal Clinics, etc. BUCKHURST HILL. Essex County Council Clinic, Buckhurst Way, 1st and 3rd Fridays at 2 p.m. CHIGWELL. Essex County Council Health Services Clinic, Manford Way Tuesdays at 9.30 a m. LOUGHTON. Essex County Council Health Services Clinic, Loughton Hall, Tuesdays and Thursdays at 2 p.m. Total ante-natal attendances in the District for the year were 1,860. There were 103 post-natal attendances. 10 (f) Women's Welfare Clinics. BUCKHURST HILL. Essex County Council Clinic, Buckhurst Way, ,1st Friday in month at 10 a.m. (by appointment only). LOUGHTON. Essex County Council Health Services Clinic, Loughton Hall, 3rd Friday morning in month (by appointment only) There were 262 first visits and 188 re-visits during the year. (g) School Clinics. CHIGWELL. Essex County Council Health Services Clinic, Manford Way Thursdays at 9.30 a m. LOUGHTON. Essex County Council Health Services Clinic, Loughton Hall, Thursdays at 9.30 a.m. (h) Dental Clinics. CHIGWELL. Essex County Council Health Services Clinic, Manford Way, (by appointment only). LOUGHTON. Essex County Council Health Services Clinic, Loughton Hall (by appointment only). (i) †Eye Clinics. CHIGWELL. Essex County Council Health Services Clinic, Manford Way, (by appointment only). LOUGHTON. Essex County Council Health Services Clinic, Loughton Hall (by appointment only). (j) †Orthoptic Clinic. BUCKHURST HILL, Essex County Council Clinic, Buckhurst Way, (by appointment only). (k) Speech Therapy. BUCKHURST HILL. Essex County Council Clinic, Buckhurst Way (by appointment only). CHIGWELL. Essex County Council Health Services Clinic, Manford Way (by appointment only). LOUGHTON. Essex County Council Health Services Clinic, Loughton Hall, (by appointment only). 11 (l) † Physiotherapy. CHIGWELL. Essex County Council Health Services Clinic, Manford Way (by appointment only). LOUGHTON. Essex County Council Health Services Clinic, Loughton Hall (by appointment only). (m) Home Help Organiser. Mrs. M. May, 93, High Road, Woodford, E.18. (BUC 6626). (n) Health Visitors and School Nurses. BUCKHURST HILL. Miss Gardner, Essex County Council Clinic, Buckhurst Way (Buckhurst 5180). CHIGWELL. Miss Moore, Essex County Council Health Services Clinic, Manford Way (Hainault 3143). Mrs. Fisk. —do.— LOUGHTON. Miss Ward, Essex County Council Health Services Clinic, Loughton Hall (Loughton 5222). Miss Maynard. —do.— Miss Whitmore, Essex County Council Clinic, Buckhurst Way, (Buckhurst 5180). Health Visitors made 9,622 visits during the year. (o) Home Nurses. BUCKHURST HILL. Miss Botell, 126, Queens Road. (Buckhurst 1331). Mr. Jestice, 11, Rous Road, (Buckhurst 7249). CHIGWELL. Miss Proctor, 64, The Lowe, (Hainault 3110). Miss Skoyles, 9, Coppice Path (Hainault 2108). LOUGHTON. Miss Gardner, 20, Crescent View (Loughton 4500). Miss Quill, 36, York Hill (Loughton 225). Miss Hoather, 46, The Crescent, (Loughton 4815). Miss Sibthorpe, 29, Rochford Avenue, (Loughton 5666). Home Nurses made 18,898 visits during the year. 12 (p) Midwives. BUCKHURST HILL. Mrs. Powis, 9, Tamworth Avenue, Woodford Green. (Buckhurst 1032). CHIGWELL. Miss Skoyles, 9, Coppice Path (Hainault 2108). Miss Proctor, 64. The Lowe, (Hainault 3110). LOUGHTON. Miss Seaman, 85, Grosvenor Drive (Loughton 1879). Mrs. Camp, 100 Borders Lane, (Loughton 4644). Miss Boorman, 31, Rochford Avenue, (Loughton 5878). The Midwives conducted 282 confinements in the district during the year and attended a further 94 as maternity nurses. (q) † Chest Clinics. BUCKHURST HILL. Essex County Council Clinic, Buckhurst Way, Wednesdays from 2 p.m.—4.30 p.m. EPPING. Chest Clinic, St. Margaret's Hospital, Epping (Epping 2224) Tuesday 9 a m.—1 p.m. Wednesdays 1.30—4 p.m. Thursdays 2—4 p.m. †Under arrangements with the Regional Hospital Board. (r) Tuberculosis. Forest Area Tuberculosis Care Association- The Association continues to assist cases awaiting admission to sanatoria 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 occupational therapy and, whenever possible, suitable employment for those fit to work. The Honorary Secretary is Mr. A. J. Edwards, 37, Woodland Road, Loughton (Loughton 3698). (s) Establishments for Massage or Special Treatment. The following establishments are licenced under the Essex County Council Act, 1933:— Miss E. Mackern, 45, Church Hill, Loughton. *Mr. A. C. Hallard, 195, High Road, Loughton. *Mrs. M. A. Drummond, la, Lower Road, Loughton. *Chiropody only. These premises have been inspected and are being conducted in a satisfactory manner. 13 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA 1. (i) Water. The water supply for the whole district is provided by the Metropolitan Water Board except for one house occupiea by a forest keeper which is situated deep in Epping Forest. The water supply for this house is obtained from a well. The supply of water has teen satisfactory both in quality and quantity. All houses have a piped supply except the house referred to above. The number of houses is 14,950 and the population at mid-year approximately 56,830. Samples of water were taken as follows:— From wells 1 Satisfactory From swimming baths 7 Satisfactory Some of the samples taken early in the year showed a rather low residual chlorine content and recommendations made resulted in further samples showing the amount required, i.e., between .2 and .5 parts per million. (ii) Drainage and Sewerage. The reconstruction of the main works at Luxborough has made good progress during the year, having regard to the continuing difficulty of slow delivery of essential items of plant and machinery. It is now anticipated that the reconstructed works will be coming into service by stages commencing early in 1953. In the meantime, the works have functioned fairly well, and a reasonable effluent has been produced, in spite of the obvious difficulties. Millers Lane Works has continued to work well and the effluent has been satisfactory throughout the year. The five pumping plants have operated satisfactorily. 2. Rivers and Streams. The River Roding flows through the centre of the Urban District dividing the Wards of Chigwell on the south-east 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 Essex Rivers Board. There has been no serious flooding during the year. The rainfall has been slightly above the average, the wettest month being November. 14 3. (i) Closet Accommodation and Cesspools. Number of Cesspools and Septic Tanks: Buckhurst Hill 1 Chigwell 76 Loughton 12 Number of Earth or Chemical Closets in Houses: Chigwell 39 Loughton 6 Number of Chemical Closets in Caravans: Buckhurst Hill 2 Chigwell 26 Loughton 1 Premises served by earth, chemical closets and cesspools are in areas where no sewer is available. Every opportunity is made to connect premises to the sewer as opportunity offers and several schemes are in hand with this in view. (ii) Public Cleansing. Collection of house refuse once weekly throughout the district has been continued during the year, by the Council's own covered vehicles and manual staff. The service has required the full-time use of five 10/12 cubic yard "Fordson" lorries with "Eagle" tipping bodies and a substantial part of the time of a similar vehicle of 7 cubic yard capacity, particularly to deal with an increasing number of schools and special collections. Trade refuse has been collected on a scale of charges related to quantity and this service has continued to prove acceptable and used by many local traders. Refuse has been disposed of by controlled tipping at a tip rented from a local contractor. A bulldozer is used for levelling and compacting and for prompt application of covering material. Measures have been taken as and when necessary against fly and vermin infestation. 15 Salvage recovery, principally of paper and rags, has continued at the tip by Council employees. Paper is brought in already separated in trailers attached to the collection vehicles and is sorted and handbailed. During the year the total tonnage of useful salvage recovered and disposed of was 394 tons, including 334 tons of paper. Kitchen waste has been collected from street bins and 317 tons have been conveyed during the year to a concentrator and sterilising plant at Tottenham. Road gullies (in streets maintainable by the inhabitants at large) are emptied three times each year and re-sealed with clean water. This is done by mechanical suction process under annual contract. (iii) Sanitary Inspection of the Area. An outline of the work of the Sanitary Inspectors is shown below:— Complaints received and dealt with 755 Inspections made 8,428 Nuisances abated 297 Informal Notices served 89 Informal Notices complied with 65 Statutory Notices served 24 Statutory Notices Complied with 12 Legal Proceedings 6 Summary of Nuisances. Drains blocked or defective 163 Defective water closets 11 Defective water supply pipes 10 Nuisances from Animals 3 Polluted ditches and watercourses 7 Accumulation of refuse etc., 7 Vermin, bugs and fleas 18 Cellars flooded 5 Fly infestations 2 Cesspools overflowing or defective 7 Wasps and hornets 49 Bats 1 16 (iv) Verminous Premises. 12 houses were found to be verminous during the year, of these 10 were infested with bed bugs and 2 with fleas. Four of these houses are privately owned, four are London County Council houses and four are Chigwell Urban District Council houses. Six of the infested council houses, i.e., 4 L.C.C. and 2 Chigwell U.D.C. are new properties. The number of houses found to be infested in 1951 was 19, so there is a decrease in the figures for this year. These houses were fumigated with "Fumite" and sprayed with "Zaldecide" or "Coopers Bed Bug Spray" with excellent results. Number of inspections and visits: 49. RODENT CONTROL. PREVENTION OF DAMAGE BY PESTS ACT, 1949. 2,011 visits were made during 1952. Treatment was by poisons as follows:— Red Squill 10 per cent with Sausage rusk. Zinc Phosphide 2½ per cent „ „ Arsenious Oxide 10 per cent „ „ Antu 2 per cent „ „ Warfarin 0.005 per cent, with oatmeal. and occasionally by means of trapping or use of Cyanide Gas. There is no serious infestation in the district, but the presence of rats and mice continue to be reported from each Ward. Baiting and poisoning of rats in the Council's sewers was carried out twice during the year, the results being as follows: (A) (B) Manholes baited 214 148 Pre-Bait complete takes 12 13 Pre-Bait part takes 26 30 Poison complete takes 2 7 Poison part takes 25 31 (A) First Treatment—March. (B) Second Treatment—September. 17 SECTION D. HOUSING STATISTICS FOR THE YEAR 1952. Number of new houses erected and occupied during the year:— Permanent Houses:— For London County Council (Loughton) 433 For Chigwell Urban District Council 127 For Private Owner 78 638 Inspection of Dwelling Houses During the Year:— 1. (a) Total number of dwelling houses inspected for housing defects (under Public Health and Housing Acts) 216 (b) Number of visits made for the purpose 973 2. (a) Number of dwelling houses ("included in subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 Nil (b) Number of visits 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 6 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 165 18 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 131 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 16 (2) Number of dwelling houses which were rendered fit after service of Formal Notice by (a) Owners 21 (b) 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 5 (2) Number of dwelling houses in which defects were remedied after service of Formal Notices by: (a) Owners 3 (b) Local Authority in default of Owners Nil (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which Demolition Orders were made 1 (2) Number of dwelling houses demolished in pursuance of Formal action 5 (d) Informal Action:— Number of dwelling houses demolished as result of Informal action Nil 19 Medical Grounds. 91 requests for priority for re-housing and issue of building licences on medical grounds were referred to the Medical Officer of Health for assessment, usually supported by a doctor's written certificate. Each case was fully and personally investigated and recommendations made were as follows:— Total Priority Priority Disease. Applicants Recom- Not Recommended. mended. Nervous disease (anxiety states, neurasthenia, neurosis, etc ) 14 3 11 Asthma, Bronchitis and Catarrhal Diseases, etc. 13 3 10 Rheumatism 10 6 4 Heart Disease 11 4 7 Tuberculosis 5 3 2 Poliomyelitis 10 1 Diseases of digestive system 6 4 2 Diseases of Circulatory System (excluding Heart) 4 0 4 Cancer 3 3 0 Other Diseases 24 5 19 91 31 60 Figures for 1951 were: 72 40 32 The sixty applicants not recommended for medical priority included (1) Illness not aggravated by housing conditions (2) Temporary indispositions; (3) Those pleading the discomforts of overcrowding and structural defects (i e., grounds other than medical). 20 Housing Act, 1936. Part IV—Overcrowding. The housing shortage in the District is still acute. No formal action has been taken during the year. Number of visits made 5 Summary of Defects. Defective Roofs 89 WC.'s 23 „ Flushing cisterns 13 „ Sink and waste pipes 15 Sash cords 29 Walls 28 „ Gutters and rainwater pipes 51 Yard paving 13 „ Windows 96 „ Drainage and vent pipes 23 „ Gullies 11 „ Internal Walls (plaster) 65 Ceilings 41 „ Water fittings and pipes 12 ,, Flooring 45 External Walls 15 „ Stoves, boilers and fireplaces 17 ,, Dustbins 9 Doors 28 Dampness 54 Under floor ventilation, lack of 9 Dirty walls and ceilings 5 21 SECTION E. INSPECTION AND SUPERVISION OF FOOD. (a) Milk Supply. The district remains a specified area under the provisions of Section 23 of the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950. 81 samples of milk were taken by the Weights and Measures Department of the Essex County Council during the year and all were reported upon as genuine. 13 dairies and milkshops are registered. 40 visits to these premises have been made. 9 licences have been issued to firms with premises outside the district to purvey milk in the District- There are 12 registered milk purveyors licensed under the Milk (Special Designation) (Pasteurised and Sterilised) Regulations 1949 and the Milk (Special Designation) (Raw Milk) Regulations 1949. (b) Meat and Other Poods. SLAUGHTERING AND BUTCHERS' SHOPS. There are 4 slaughterhouses in the District all licensed under Section 57 of the Food and Drugs Act, 1938. In addition there is one Knackers Yard also licensed under this Act. Carcases inspected and meat condemned. Cattle excluding Cows Cows Sheep and Calves Lambs ] Number killed Nil Nil Nil Nil 4 Number inspected Nil Nil Nil Nil 4 Condemned Nil Nil Nil Nil Nil 22 Slaughtering for this District is carried out in centralised Ministry of Food slaughterhouses situated outside the District. During the year assistance in meat inspection has been afforded at the Ministry of Food slaughterhouse, Waltham Abbey. 42 visits have been made to slaughterhouses. There are 27 butchers' shops in the District and 296 visits have been made to these premises. 7 licences to sell game have been issued. (c) Restaurants. 211 visits have been made to restaurants and cafes. One cafe has been completely renovated- (d) (1) Food Condemnation. The following foodstuffs were inspected and found unfit for human consumption. Some items were returned for reprocessing, some disposed of for animal food or for manufacturing purposes and the remainder destroyed. FISH Bristling, tins 1 Kippers, stone 1 Cod, stone 4 Lobster, tins 3 Crab, tins 1 Pilchards, tins 2 Crab Paste, tins 2 Roes, tins 5 Crawfish, tins 1 Salmon, tins 3 Herrings, tins 6 Sardines, tins 11 Totals: 1950 1951 1952 Tins and Jars 97 51 35 lbs. 377 190 70 23 FRUIT Apples, tins 35 Loganberries, tins 1 Apricots, lbs 30 Mandarins, tins 3 Apricots, tins 7 Oranges, tins 16 Bananas, tins 2 Orange Juice, tins 3 Blackcurrants, tins 2 Peaches, jars 6 Cherries, tins 41 Peaches, tins 2 Cherries Glace, lbs. 3½ Pears, tins 1 Damsons, tins 11 Peel Mixed, lbs 16 Figs, lbs. 16½ Pineapple, tins 10 Fruit Salad, jars 2 Plums, tins 113 Gooseberries, tins 1 Prunes, lbs 153 Grapefruit, tins 7 Prunes, tins 16 Grapefruit juice, tins 3 Strawberries, tins 6 Grapes, tins 4 Sultanas, lbs, 7½ Greengages, tins 19 Totals: 1950 1951 1952 Tins and Jars 72 227 311 lbs. 500½ 445½ 22£½ MEAT Bacon, lbs. 30 Luncheon Meat, tins 30 Beef, lbs. 643£ Mutton, lbs. 354 Beef Minced, lbs. 110 Pork, lbs. 1174 Beef Minced, tins 3 Pork Meat, tins 76 Brawn, tins 4 Sausages, tins 6 Chicken, tins 8 Steak Stewed, tins 10 Ham, large tins 26 Tongue, tins 2 Ham, small tins 2 Veal, tins 9 Kidneys, tins 3 Veal and Ham, tins 3 Lamb, lbs. 86 Totals: 1950 1951 1952 Tins 72 227 182 lbs. 500½ 445½ 1315 24 VEGETABLES Beans, tins 49 Peas Split, lbs 54 Beetroot, tins 8 Spinach, tins 10 Carrots, tins 2 Tomatoes, tins 47 Peas, tins 44 Tomato Juice, tins 1 Totals: 1950 1951 1952 Tins and Jars 123 228 161 lbs. 54 OTHER ITEMS Baby Foods, tins 12 Mincemeat, jars 2 Biscuits, lbs. 78½ Morfat, tins 4 Broth, tins 3 Peanut Butter, jars 2 Chocolate, bars 12 Pearl Barley, lbs 55 Cod Liver Oil, tins 23 Piperium, jars 1 Eggs 1,810 Pickles, jars 2 Jam, tins 13 Rice, lbs 28 Macaroni, tins 1 Soup, tins 20 Marmalade, tins 2 Soya Flour, lbs 112 Milk Condensed, tins 12 Soyhetti, lbs 9½ Milk Evaporated, tins 22 Spread, tins 4 Totals: 1950 1951 1952 Eggs 4,518 833 1,810 Milk, tins 455 99 34 Packages 113 341 113 lbs. 95 204 283 25 All the tinned goods were either blown or damaged. Meat condemned was due to decomposition (bone taint). Cereals and dried fruit were infested by insects and their larvae. (d) 2. Food Complaints. 27 complaints of food were received and dealt with during the year. Legal action was taken in one case and a conviction obtained. A fine of three guineas each, including costs, was imposed on the two defendants. (e) Bakeries. There are 16 bakehouses in the District, one of which is not in use. 165 visits have been made. (f) Chemical and Bacteriological Examination of Food. This is mainly dealt with by the County Council, but occasionally samples are taken by the Sanitary Inspectors and sudmitted for analysis. (g) Adulteration. This continues to be dealt with by the County Council- (h) Ice Cream 104 visits were made to ice cream manufacturers and vendors for routine inspections and sampling. Ihere are 8 manufacturers and 91 vendors on the register. Only one firm manufactures in the District and the laboratory reports on this firm's products were as follows:— Excellent Grade 1. 1 Very satisfactory Grade 1. 1 Satisfactory Grade 1. 2 Very Satisfactory Grade 2. 1 Unsatisfactory Grade 2. 1 Fair Grade 3. 1 The laboratory reported that the unsatisfactory sample was probably contaminated after manufacture and advice was given, both at the factory and at the shop where the ice cream was sold, on clean methods of handling. This plant is frequently inspected and the process and the premises comply with the requirements of the Food and Drugs Act, 1938, and the Ice Cream (Heat Treatment, etc.) Regulations, 1947, and 1949. 26 The following results were received from the laboratory of samples taken of ice cream manufactured outside the Districts- Excellent Grade 1 9 Very Satisfactory Grade 1. 20 Satisfactory Grade 1. 4 Satisfactory Grade 2. 2 Fair Standard Grade 2. 2 Satisfactory Grade 3. 1 Fair Standard Grade 3. 1 Fair Grade 4. 1 Unsatisfactory Grade 4. 1 Total samples taken: 48. Grade 1. 37 77 per cent. Grade 2 6 12 per cent. Grade 3 3 6 per cent. Grade 4. 2 4 per cent. The unsatisfactory sample was taken from a vehicle in Chigwell. It was manufactured at Romford and that Local Authority was immediately contacted. The Public Health Department reported that the conditions at the factory and the manufacturing processes were satisfactory. Samples taken of this firm's ice cream by us since then have been satisfactory. 4 samples of ice lollies were taken during the year and the following reports were received:— Made in the District:— Very Satisfactory 1 Made outside the District:— Excellent 1 Satisfactory 1 Unsatisfactory 1 The matter of the unsatisfactory sample was taken up with the Local Authority concerned who gave a good report of the processes of manufacture and the premises. The vendor changed his supplier when he received the unsatisfactory report and it was not possible to take further samples. A sample from the new supplier received an excellent report. The standard for ice cream was amended in July, 1952 and is now as follows:— Fat 4 per cent. Sugar 10 per cent. Milk Solids other than fat 5 per cent. 27 Fruit Ices. As above, or total content fat, sugar and milk solids other than fat to be not less than 21 per cent of the fruit ice cream with a minimum of 6 per cent fat, 10 per cent sugar and 2 per cent milk solids other than fat- Parev (Kosher) Ices. Fat 8 per cent. Sugar 14 per cent. The County Council are responsible for submitting samples to the analyst. The number taken during the year was 21 and all were reported as being genuine. The samples taken by this Authority were obtained from all four Wards and from all kinds of premises and types of vehicles. Samples were delivered to the laboratory in Victoria Street, London within three hours of being taken. Factories, Shops, etc. (a) Factories and Workplaces. 133 visits have been made. Inspection is carried out where necessary in connection with means of escape in case of fire. Assistance in this work is afforded by the Essex County Fire Brigade (Fire Prevention Branch and a technical officer from the Engineer and Surveyor's Department of this Authority to whom I am very grateful for the help given. 7 certificates have been issued during the year under Section 34 of the Factories Acts, 1937 and 1948. (b) Outworkers- 85 visits have been made. (c) Shops Act. 81 visits have been made. As soon as the 1951 census figures for the District are published this Local Authority becomes responsible for the administration of the whole of the Shops Act, 1950. 28 29 FACTORIES ACT, 1937. 1. INSPECTION for purpose of provisions as to health (including inspections made by Sanitary Inspectors). Premises. Number on Register Number of Inspections Number of written Notices Number ot Occupiers Prosecuted (i) Factories in which Section 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 13 20 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 95 267 - - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - - - Total 108 287 - - 30 FACTORIES ACT, 1937. 2. CASES IN WHICH DEFECTS WERE FOUND. Premises Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of cleanliness (S.l) 4 4 - 1 - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7):— (a) Insufficient 1 - - - - (b) Unsuitable or defective 7 7 — 1 - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) 2 2 - 1 - Total 14 13 - 3 - 31 Summary of Sanitary Inspectors' visits during the year ended 31st December, 1952. General Sanitation. Total No. Nature of visits or inspection of visits. Water supply 86 Drainage 803 Stables and Piggeries 4 Tents, Vans and Sheds 92 Factories 122 Workplaces 11 Outworkers 85 Bakehouses 165 Public Conveniences 21 Licensed Premises 4 Refuse collection 50 Refuse Disposal 124 Rats and Mice 2,011 Atmospheric Pollution 23 Schools 1 Shops 81 Knackers Yard 83 Petrol 72 Food Hygiene Guild 34 Miscellaneous Sanitary Visits 1,394 5,266 Housing Under Public Health Acts. Number of houses inspected 125 Visits paid to above houses 247 Under Housing Acts. Number of houses inspected 91 Visits paid to above houses 726 Overcrowding. Number of houses inspected 3 Visits paid to above houses 2 Filthy or Verminous Premises. Number of houses inspected 18 Visits paid to above houses 31 Miscellaneous Housing Visits 160 1,403 Carried Forward 6,669 Brought Forward 6,669 Infectious Disease. Inquiries in cases of infectious disease 304 Visits re disinfection 8 Miscellaneous Infectious Disease visits 228 540 Meat and Food Inspection. Visits to Slaughterhouses 42 „ „ Butchers 296 „ „ Canteens 8 „ „ Dairies and Milk Distributors 40 „ „ Fishmongers and Poulterers 86 „ „ Grocers 134 „ „ Greengrocers and Fruiterers 51 „ „ Ice Cream Premises 104 „ „ Restaurants 211 „ „ Food and Drug Samples 65 Miscellaneous Food Visits 182 1,219 Total 8,428 House refuse was collected under the supervision of the Engineer and Surveyor, Mr. G. Holbourn, A.M., Inst.C.E., to whom I am indebted for the information regarding drainage, sewerage, and public cleansing. (Signed) W. H. DIGWEED, A.R.San.I., M.S.I.A. Senior Sanitary Inspector. 32 SECTION F. PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. (See also Page 2) Summary of Cases of Infectious Diseases notified, showing Number of Cases, Admissions to Hospitals and Deaths. Total cases Admission Deaths Notified to Hospital Acute Poliomyelitis 6 6 0 (Paralytic) Acute Poliomyelitis 1 1 0 (Non-paralytic) Acute Primary Pneumonia 26 5 0 Diphtheria 1 1 1 Dysentery 17 0 0 Erysipelas 5 0 0 Food Poisoning 13 2 0 Meningococcal Infection 2 1 1 Measles 620 5 0 Puerperal Pyrexia 2 2 0 Scarlet Fever 213 22 0 Whooping Cough 213 5 0 Pemphigus 1 1 0 1,120 51 2 33 Comparative Tables of Infectious Disease Notification and Death Rates per 1,000 of the population, 1952. (Provisional figures based on Weekly and Quarterly Returns) NOTIFICATIONS (Corrected). 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 Adm. County Chigwell U.D. Typhoid Fever 0.00 0.00 0.00 0.00 0.00 Paratyphoid Fever 0.02 0.02 0.03 0.01 0.00 Meningococcal infection 0.03 0.03 0.03 0.02 0.03 Scarlet Fever 1.53 1.75 1.58 1.56 3.75 Whooping Cough 2.61 2.74 2.57 1.66 3.75 Diphtheria 0.01 0.01 0.03 001 0.02 Erysipelas 0.14 0.15 0.12 0.14 0.09 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 8 86 10.11 8.49 9.23 10.90 Pneumonia 0.72 0.80 0.62 0.57 0.46 Acute poliomyelitis (including polioencephalitis) Paralytic 0.06 0.06 0.06 0.06 0.11 Non-paralytic 0.03 0.03 0.02 003 0.02 Food poisoning 0.13 0.16 0.11 0.18 0.23 Puerperal pyrexia 17.87(a) 23.94(a) 10.22(a) 30.77(a) 2.10 (a) notifications per 1,000 related births). DEATHS. Typhoid & Paratyphoid 0.00 0.00 0.00 0.00 0.00 Whooping cough 0.00 0.00 0.00 0.00 0.00 Diphtheria 0.00 0.00 0.00 0.00 0.02 Tuberculosis 0.24 0.28 0.22 0.31 0.17 Influenza 0.04 0.04 0.04 0.05 0.03 Smallpox 0.00 0.00 0.00 0.00 0.00 Acute poliomyelitis(including polioencephalitis) 0.01 0.01 0.00 0.01 0.00 Pneumonia 0.47 0.52 0.43 0.58 0.39 34 Diphtheria. One case occurred during the year. The free immunisation of children by general practitioners and at clinics has been maintained. 857 children completed a course of immunisation during the year. 707 re-inforcing injections were also administered. Tuberculosis. 52 new cases of lung tuberculosis, and 4 of tuberculosis of other organs were notified during the year. 28 of these new cases occurred amongst residents of the L.C C. Estates. In addition to these new cases, 34 established cases of tuberculosis, originally acquired in other areas, took up residence in this district during the year; 29 of these are new residents on the L.C.C. Estates. There were 10 deaths from tuberculosis during the year compared with 9 in 1951 and 14 in 1950. Vaccination Schemes. Tuberculosis (B.C.G.) See pages 3 and 4. Smallpox. 424 primary vaccinations were performed, and 128 persons were re-vaccinated during the year. This is again a decrease on previous years, as primary vaccinations were only 45 per cent of the total number of live births, compared with 62 per cent in 1951- (See comment on page 4). 35 APPENDIX. RAINFALL IN INCHES FOR MONTHS IN 1952. Chigwell U.D.C. Metropolitan Water Board Luxborough Loughton High Beech Buckhurst Hill S.D. Works Depot January 2.09 1.73 1.41 1.61 February 0.83 0.81 0.68 0.74 March 3.62 3.36 2.50 2.45 April 1.14 1.21 1.05 1.01 May 1.22 1.60 1.10 1.91 June 1.43 1.40 1.60 1.82 July 0.71 0.67 0.63 0.63 August 3.94 2.85 2.58 3.59 September 3.38 3.08 1.95 3.12 October 2.56 2.80 2.91 2.34 November 3.84 3.87 4.44 3.73 December 2.46 2.47 2.23 2.14 27.22 25.85 23.08 25.09 AVERAGE RAINFALL FOR THE LAST FIVE YEARS 1948 - 24.21 1949 - 19.10 1950 - 24.86 1951 - 31.11 1952 - 25.31 The highest point in the District is 372 O.D. and the lowest 44 O.D. 36 Hickman, Printers, Loughton.