1 Mrs. Loyne Div 5B 2. Mrs. mnonhs this 3 Libery 4411(3) CHIG 17 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, 1953 Chigwell Urban District Council Public Health Committee: Chairman: Councillor J. W. Spencer. Members: Councillor D. C. Bolts. „ N. D. Crafford. „ Mrs. G. V. Cross. „ Mrs. J. I. Edmondson, M.A. „ N. M. Hayward. „ C. J. Moull. „ Mrs. L. M. Scott. „ Mrs. M. H. Smith. G. J. Wilds. The Chairman of the Council, Councillor W. A. Nichols, J.P., and the Vice-Chairman of the Council; Councillor E. G. Perry, 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 Examination 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, 1953. VITAL STATISTICS. The birth rate, at 15.1 per 1,000 of the population, continues to fall from its peak level of 17.7 per 1,000 (in 1949), though the fall is now much more gradual. Deaths, though numerically less than last year, are at a higher rate per 1,000 of the population after correction is made for age and sex differences between the population of this district and that of England and Wales as a whole. It is only by making such a correction, that a true comparison between the Death Rate in the District and that in the whole country can be made. The figure of 9.0 per 1,000 of the population (corrected Death Rate) is thus strictly comparable with the Registrar General's figure of 11.4 per 1,000 for England and Wales. It has been most gratifying to see a substantial reduction in the deaths of infants and in still-births. The very high standard of ante-natal care and midwifery in the District can be deduced by a comparison of the national Still Birth Rate (22.4 per 1,000 corresponding births) with our own (8.6) and the National Infant Mortality Rate (26.8 per 1,000 live births) with our own rate of 16.3. It is interesting to recall here that the average annual rate of Infant Mortality in England and Wales during the period 1936—40 was 55.3 per 1,000 live births. On the other hand, there is a significant increase in deaths attributed to pneumonia and bronchitis. How much this was due to atmospheric pollution and how much to the influenza outbreak of January—February, 1953, it is hard to say. In view of the rapid increase in the use of Diesel engines on our roads in recent years, it was somewhat disturbing to learn, as the result of an enquiry made in November, 1953, that the Medical l Research Council is not aware of any existing evidence of the effect of diesel exhaust gases on health; nor is there any really detailed knowledge of the effect of other atmospheric pollutants on the respiratory tract. It was also interesting to learn (from the Department of Scientific and Industrial Research) that "If a Diesel Engine is maintained in good condition, little or no smoke should be emitted!!" INFECTIOUS DISEASES (See also Section F). The influenza outbreak of January—February, 1953 was widespread over Southern England. Although deaths attributable to influenza were negligible in numbers (3), deaths attributable to bronchitis increased, and the rate of new claims to sickness benefits under the National Insurance Act was much increased during this period. The incidence rates of whooping cough and measles continues to be abnormally high in the District—especially on the L.C.C. Estates. They cannot be dissociated from the abnormally large proportion of young children at the present time, as the rates are per thousand of the total population. Nevertheless, it is hoped that the present introduction of whooping cough vaccination in the clinics, combined with greater care by parents in segregating their infected children from others, will result in an improvement. TUBERCULOSIS. The number of established cases of tuberculosis entering the District under housing schemes is again reduced, viz., Year 1950 1951 1952 1953 No. of cases entering the District 157 75 34 21 By arrangement with the North-East Metropolitan Regional Hospital Board, the Mass Radiography Unit again carried out a survey of Loughton in 1953, with the following results:— Male Female Total Total number of miniatures 620 464 1,084 Recalled for large film 27 30 57 Did not attend for large film 0 2 2 2 Details of Survey. Male Female Total School children Number of miniatures 119 110 229 Recalled for large films 3 4 7 School Staff Number of miniatures 3 1 4 Recalled for large film 1 0 1 Public Sessions Number of miniatures 203 298 501 Recalled for large films 6 19 25 Industrial Workers Number of miniatures 295 55 350 Recalled for large films 17 7 24 Cases of Pulmonary Tuberculosis Discovered Active post-primary lesion 1 1 2 Inactive post-primary lesion 15 6 Inactive primary lesion 0 2 2 Other interesting abnormalities discovered Cardiovascular lesions (acquired) 1 2 3 Bronchopneumonia 0 1 1 A recent method for discovering cases of tuberculosis—with a view to instituting early treatment and reducing the risk of spread of the disease—is by routine skin testing of all children during their first year at school. Positive reactors have either suffered from, or been in contact with, the disease, and in the latter event an examination of the relatives and other contacts of the child may uncover the existence of a previously unknown case. The test is simple to perform, safe and painless, and arrangements were therefore made through the Education Authority for it to become available in the District during 1954 in conjunction with the routine medical inspecton of school entrants. (Ths scheme is now in operation). The Medical Research Council continues its work of assessing the value of B.C.G. (anti-tuberculosis) vaccine, and it is 3 now considered that all adolescents who are shown (by skin tests) to be susceptible to the disease, should be offered this protection by the School Medical Service. It is anticipated that this service also will become available in this district during the coming year. FOOD POISONING. Only four cases of food poisoning were notified during the year. NATIONAL ASSISTANCE ACT, 1948 and NATIONAL ASSISTANCE (AMENDMENT) ACT, 1951. Eight persons "in need of care and attention" were under observation for possible action under the above Acts. Three of these cases were admitted as voluntary patients, one of which has since died. Three remain at home under continued observation—the other two having died during the year. One case compulsorily removed to hospital under Section 47 of the 1948 Act last year, was kept in hospital by Court Orders until November. She is still a patient but compulsion is not now necessary. This is not by any means the whole story, as it does not include reference to the many aged and infirm persons who are willing to go to hospital or institution, but cannot be found a vacancy, or who require domiciliary attention of a kind beyond that which can be provided by—or reasonably expected from— an ordinary "Home Help". Until we have ONE service responsible for the chronic infirm instead of the many agencies at present concerned with their different aspects (e.g. financial, domiciliary, institutional, hospital, blind, mental) these cases are in danger of remaining without even the simplest comforts for long periods during which their "classification" (often unstable in any event) is being determined. 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 acknowledgments are also made. H. FRANKS, M.B., B.S., B.Hy., D.P.H. Medical Officer of Health. June, 1954. 4 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 8,970 (14 sq. miles approx) Civilian Population (mid- 1952) 57,250 Number of inhabited houses 15,195 Rateable value £415,788 Sum represented by a penny rate £1687 The rate in the pound for 1953-4 was 21/2d. Vital Statistics: LIVE BIRTHS: Male Female Total Legitimate 444 445 889 Illegitimate 15 16 31 Total 920 Birth rate per 1,000 estimated resident population. 15.1 STILL BIRTHS: Male Female Total Legitimate 5 3 8 Illegitimate 0 0 0 Total 8 Rate per 1,000 (live and still births) 8.6 Male Female Total Deaths 191 192 383 Death Rate per 1,000 estimated resident population (corrected) 9.0 Deaths from pregnancy, child birth and abortion 0 Death of infants under 1 year of age: Male Female Total Legitimate 5 10 15 Illegitimate 0 0 0 Total 15 Deaths of infants under 4 weeks of age: Male Female Total Legitimate 3 6 9 Illegitimate 0 0 0 Total 9 5 Death rate of infants under 1 year of age: All infants per 1,000 live births 16.3 Legitimate infants per 1,000 legitimate live births 18.9 Illegitimate infants per 1,000 illegitimate live births 0 Death rate of infants under 4 weeks of age 9.8 Table of comparative Birth Rates and Death Rates in the year 1953, (Provisional figures based on quarterly returns). England & Wales 160 County Boroughs and Great Towns (including London). 160 Smaller Towns (Resident populatior 25,000—50,000 at 1951 Census). London Administrative County Chigwell U.D. BIRTHS: Rates per 1,000 Home Population Live Births 15.5 17.0 15.7 17.5 15.1 Still Births 0.35 0.43 0.34 0.38 0.14 22.4(a) 24.8(a) 21.4(a) 21.0(a) 8.6(a) DEATHS: All causes 11.4 12.2 11.3 12.5 9.0 All causes under 1 year of age (a) 26.8 30.8 24.3 24.8 16.3 Enteritis and Diarrhoea under 2 years of age (a) 1.1 1.3 0.9 1.1 1.0 (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). 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 1953 15.1 31 16.3 9.0 57,250 6 Causes of Death as given by the Registrar General for the year 1953. Male Female Total Heart disease 62 45 107 Other diseases of circulatory system 8 7 15 Cancer (all forms) 36 31 67 Vascular lesions of nervous system 10 30 40 Bronchitis 22 12 34 Pneumonia 11 13 24 Influenza 1 2 3 Disease of Prostate 1 0 1 Tuberculosis (all forms) 5 6 11 Other diseases of the respiratory system 1 1 2 Ulcer of duodenum or stomach 4 3 7 Leukaemia 4 0 4 Congenital malformations 0 1 1 Diabetes 3 3 6 Whooping Cough 0 1 1 Gastritis, enteritis, diarrhoea 1 1 2 All other diseases 15 32 47 Motor vehicle accidents 3 2 5 Other violent causes 4 2 6 191 192 383 — — - I 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 of 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. S. Potter, 35 Wanstead Place, E.ll Tel: Wanstead 0031. (b) Laboratory Facilities: A Ministry of Health Laboratory operates at St. Margaret's Hospital, Epping. Water, 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 for that number 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. 8 (d) Child Welfare Centres: BUCKHURST HILL: Essex County Council Clinic, Buckhurst Way, Thursday at 2 p.m. CHIGWELL: Village Hall, High Road, 1st and 3rd Wednesday at 2 p.m. 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. LOUGHTON: Union Church Hall, High Road. Friday at 2 p.m. Roding Road Church Hall, Tuesday at 2.30 p.m. British Legion Headquarters, Church Hill, Monday at 2 p.m. Essex County Council Health Services Clinic, Loughton Hall Monday and Wednesday at 2 p.m. Diphtheria and Whooping Cough Immunisation is carried out at the above Child Welfare Centres by appointment. There were 17,286 attendances at child welfare centres during the year of which 11,917 were under 1 year of age. (e) Ante-Natal and Post-Natal Clinics. BUCKHURST HILL: Essex County Council Clinic. Buckhurst Way, Friday at 2 p.m. CHIGWELL: Essex County Council Health Services Clinic, Manford Way, Tuesday at 9.30 a.m. LOUGHTON: Essex County Council Health Services Clinic, Loughton Hall, Tuesday and Thursday at 2 p.m. Total ante-natal attendances in the District for the year were 1,727. There were 109 post-natal attendances. 9 (f) Relaxation Classes: CHIGWELL: Essex County Council Health Services Clinic, Manford Way, (by appointment only). LOUGHTON: Essex County Council Health Services Clinic, Loughton Hall (by appointment only). (g) 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 203 first visits and 248 re-visits during the year. (h) School Clinics: CHIGWELL: Essex County Council Health Services Clinic, Manford Way, Thursday at 9.30 a.m. LOUGHTON: Essex County Council Health Services Clinic, Loughton Hall Thursday at 9.30 a.m. (i) 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). 10 (j) 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, (by appointment only). (k) 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. †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. The following clinics are held under arrangements with the Regional Hospital Board:— (1) 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). (m) Orthoptic Clinic: BUCKHURST HILL: Essex County Council Clinic, Buckhurst Way (by appointment only). (n) 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) 11 (o) Chest Clinics: BUCKHURST HILL: Essex County Council Clinic, Buckhurst Way, Wednesday from 2 p.m. to 4.30 p.m. EPPING: Chest Clinic, St. Margaret's Hospital, Epping (Epping 2224). Tuesday 9 a.m.—1 p.m. Wednesday and Thursday 2—4 p.m. (B.C.G. Clinics by appointment). The Forest Area Tuberculosis Care 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). (p) 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. Mrs. Thomas, do. Miss Whitmore, Essex County Council Clinic, Buckhurst Way, (Buckhurst 5180). Health Visitors made 8.646 visits during the year. 12 (q) 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 Hoather, 46, The Crescent (Loughton 4815). Miss Sibthorpe, 29, Rochford Avenue (Loughton 5666). Mrs. Percival, 39, Avondale Drive (Loughton 6021). Home Nurses made 22,713 visits during the year. (r) 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). Midwives conducted 314 confinements in the District during the year and attended a further 49 as maternity nurses. (s) Home Help Organiser: Mrs. M. May, 93, High Road, Woodford, E.18 (Buc 6626). 13 SECTION C. SANITARY CIRCUMSTANCES OF THE AREA. 1. (i) Water. The water supply for the District is provided by the Metropolitan Water Board except for one house in the ownership of the Conservators of Epping Forest which is situated in the Forest a long way from the water mains supply. The supply of water which is piped has been satisfactory both in quantity and quality. The number of houses is 15,195 and the population at midyear approximately 57,250. Samples of water were taken as follows:— From wells 1 Satisfactory. From swimming baths 2 Fairly satisfactory. From ponds 2 Very inferior organic quality. No sewage contamination. Arrangements are to be made for the ponds to be cleaned out. (ii) Drainage and Sewerage. The reconstruction of the main works at Luxborough has been very largely completed and by the end of the year there remained only incidental works, fencing and clearing up to be done. Gas production from the Digesters has commenced but further time will elapse before this part of the works is fully conditioned and can give its intended performance in quantity treated and nature of sludge delivered to the drying beds. Since February, all effluent samples taken and analysed by Essex Rivers Board have been reported satisfactory. The one other and small works in the District, at Millers Lane, Chigwell has given a satisfactory effluent throughout the year. The five pumping plants, at points in the District where flow has to be raised into a gravity sewer, have been maintained and have operated satisfactorily. Two schemes for relief of overloaded sewers are under investigation and preparation by the Council's Consulting Engineers. 14 2. Rivers and Streams. The River Roding flows through the centre of the Urban District dividing the Ward of Chigwell on the south-east from those of 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. 3. (i) Closet Accommodation and Cesspools. Number of Cesspools and Septic Tanks: Buckhurst Hill 1 Chigwell 76 Loughton 11 Number of Earth or Chemical Closets in Houses: Chigwell 39 Loughton 6 Number of Chemical Closets in Caravans: Buckhurst Hill 2 Chigwell 20 Loughton 2 Premises served by earth closets, chemical closets and cesspools are in areas where no sewer is available. One house previously draining to a cesspool has been connected to the Council's sewer and every opportunity is taken to connect premises to main drainage. Several schemes are in hand with this in view. (ii) Public Cleansing. Domestic refuse has been collected once weekly from all premises in the District during the year in accordance with the established practice. This has been done by the Council's fleet of six 10/12 cubic yard "Fordson/Eagle" covered vehicles and their own manual staff. Additional covered vehicles, of smaller capacity, have been used part-time as and when required to deal with schools and special collections. Trade refuse has been collected at a fixed price per bin, allowing one bin free to each premises. The service is considerably used by local traders. 15 Disposal of refuse has continued to be by controlled tipping at a tip rented from a local contractor. This tip is now practically filled and future tipping sites and space are presenting a serious problem. Refuse has been levelled and compacted by bulldozer, which also deposits and spreads covering material so that only an absolute minimum area is at any time exposed. Measures are taken as and when necessary to prevent infestation by flies and vermin. Salvage recovery, now comprising practically only paper and rags, has been continued. Paper is bought in already separated in trailers attached to the collection vehicles, and is sorted and baled (by hand) by Council employees at the tip. During the year, 480 tons of paper and 6 tons of rags were thus recovered and sold. Kitchen waste, collected from street bins and from school and industrial canteens, has been conveyed to a concentrator plant at Tottenham. The future of this service is uncertain, in view of the possible removal of direction, freer licensing of private collectors and negotiations for continued acceptance at the Plant. 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 786 Inspections 8,184 Nuisances abated 304 Informal Notices served 89 Informal Notices complied with 75 Statutory Notices served 31 Statutory Notices complied with 17 Legal proceedings 6 16 Summary of Nuisances. Drains blocked or defective 183 Defective water closets 8 Defective water supply pipes 4 Nuisances from animals 2 Polluted ditches, watercourses and ponds 9 Accumulation of refuse, etc. 12 Vermin (bugs and fleas) 8 Cellars flooded 1 Fly infestations 4 Cesspools overflowing or defective 16 Wasps and hornets 56 Bats 1 (iv) Verminous Premises. 8 houses were found to be verminous during the year, of these 7 were infested with bed bugs and 1 with fleas. 4 of these houses are privately owned, 2 were houses which had been derequisitioned, 1 was a London County Council house and the other belonged to the Essex County Council. 1 house, that belonging to the London County Council, is a new property. The number of houses found to be infested in 1951 was 19, and in 1952, 12, so this shows a continuing decrease. Houses were fumigated with "Fumite" and sprayed with "Zaldecide" or "Cooper's Bed Bug Spray" with excellent results. Number of inspections and visits: 47. RODENT CONTROL. PREVENTION OF DAMAGE BY PESTS ACT, 1949. 1,388 visits were made in 1953, as against 2,011 in the previous year. This seems to indicate a reduction in the rodent population. Farm land certainly seems to be much freer and it 17 is rare for corn stacks to be seriously infested. This improvement can, I think, be attributed to Warfarin which is now widely used. Roof infestations on a new housing estate have been a source of trouble. It is believed to be due to the extensive use of rainwater shoes on downpipes instead of trapped gullies. For this reason, new wire balloons are placed in gutters and sewer baiting has been extended to include surface water sewers. Poisons were used as follows:— Red Squill 10 per cent with Sausage rusk. Zinc Phosphide 2½ per cent with Sausage rusk. Arsenious Oxide 10 per cent with Sausage rusk. Warfarin 0.005 per cent with Oatmeal and occasionally by trapping and the use of Cyanide Gas. Baiting and poisoning of rats in the Council's sewers and surface water sewers (the latter being the more heavily infested) was carried out twice during the year, the results being as follows:— March/ 10% Test September/ April Baiting October September Manholes baited 179 204 177 Pre-bait complete takes 5 3 29 Pre-bait part takes 16 13 7 Poison complete takes 0 0 2 Poison part takes 15 0 29 Poison used was: Arsenic - Zinc Phosphide. The extensive use of mechanical labour for filling and covering-in the Council's controlled refuse tip has resulted in the elimination of rats from the tip face. Minor infestations by the baling sheds have been eliminated by using Warfarin. 18 SECTION D. HOUSING STATISTICS FOR THE YEAR 1953 Number of new houses erected and occupied during the year: Permanent Houses:— London County Council 4 Chigwell Urban District Council 124 Private Owners 115 243 Inspection of Dwelling Houses during the year:— 1. (a) Total number of dwelling houses inspected for housing defects (under Public Health and Housing Acts) 355 (b) Number of visits made for the purpose 1,022 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 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 4 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 118 19 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 75 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 20 (2) Number of dwelling houses which were rendered fit after service of Formal Notice by (a) Owners 12 (b) Local Authority in default of Owners 1 (b) Proceedings under Public Health Acts:— (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 6 (2) Number of dwelling houses in which defects were remedied after service of Formal Notices by:— (a) Owners 4 (b) Local Authority in default of owners Nil (c) Proceedings under Section 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which Demolition Orders were made 1 (2) Number of dwelling houses demolished in pursuance of formal action 1 (d) Informal Action:— Number of dwelling houses demolished as result of informal action 1 20 Medical Grounds. 46 requests for priority for re-housing 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:— Disease Total Applicants Priority Recommended Priority Not Recommended Nervous disease (anxiety states neurasthenia, neurosis, etc.) 7 1 6 Asthma, bronchitis and catarrhal diseases, etc. 13 5 8 Rheumatism 3 2 1 Heart disease 13 8 5 Tuberculosis 1 1 0 Disease of digestive system 1 1 0 Other diseases 8 4 4 46 22 24 Figures for 1952 were 91 31 60 The 24 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). 21 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 1 Summary of Defects. Defective Roofs 87 W.C.'s 8 „ Flushing cisterns 13 „ Sink and waste pipes 14 „ Sash cords 28 Walls 27 „ Gutters and rainwater pipes 50 „ Yard paving 13 „ Windows 98 „ Drainage and vent pipes 22 „ Gullies 11 „ Internal Walls (plaster) 64 „ Ceilings 41 „ Water fittings and pipes 12 „ Flooring 44 „ External Walls 15 „ Stoves, boilers and fireplaces 17 „ Dustbins 8 „ Doors 27 Dampness 53 Under floor ventilation, lack of 9 Dirty walls and ceilings 6 22 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. 58 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. 16' dairies and milkshops are registered. 38 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 Foods. 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 Calves Sheep and Lambs Pigs Number killed Nil Nil Nil Nil 1 Number inspected Nil Nil Nil Nil 1 Condemned Nil Nil Nil Nil Nil 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. 44 visits have been made to slaughterhouses. There are 27 butchers' shops in the District 298 visits have been made to these premises. 7 licenses to sell game have been issued. 23 (c) Restaurants. 84 visits have been made to restaurants and cafes. A statutory notice was served on a restaurant in Loughton which resulted in the closing of the cafe pending compliance with the notice. (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 Roes, tins 4 Crab, tins 4 Salmon, tins 4 Fish Fillets, lbs. 14 Sardines, tins 6 Herrings, tins 4 Silds, tins 1 Lobster, tins 1 Skate, lbs. 16 Pilchards, tins 6 Totals 1950 1951 1952 1953 Tins and Jars 97 51 35 31 lbs. 377 190 70 30 FRUIT. Apple & Raspberry Jam, tins 1 Marmalade, tins 2 Oranges, tins 13 Apples, tins 1 Orange juice, tins 1 Apricots, jars 4 Pears, tins 11 Apricots, lbs. 17½ Peaches, jars 4 Apricots, tins 25 Peaches, tins 13 Apricot Jam, tins 4 Pineapple, jars 1 Blackcurrants, tins 42 Pineapple, tins 19 Cherries, tins 34 Pineapple, juice, tins 3 Currants, lbs. 180 Plums, tins 129 Damsons, jars 5 Prunes, tins 14 Damsons, tins 4 Raisins, lbs. 72 Figs, tins 1 Raspberries, tins 1 Fruit Salad, jars 4 Strawberries, tins 7 Greengages, tins 5 Sultanas, lbs. 112 Jam, tins 3 Two Fruits, tins Loganberries, tins 2 Totals: 1950 1951 1952 1953 Tins & Jars 72 227 311 355 lbs. 500½ 445½ 226½ 381½ MEAT Bacon, lbs. 3½ Luncheon Meat, tins 17 Beef, 1bs. 1,838 Ox Tongue, (tin) lbs. 6 Beef Corned, 61b. tins 3 Pork, lbs. 26½ Beef Corned, 12 oz. 10 Pork, tins 14 Beef Loaf, tins 1 Pork Sausages, lbs. 21½ Beef Minced, tins 2 Pork Sausages, tins 35 Beef Sausages, lbs. 70 Rabbit, tins 1 Brawn, jars 1 Steak, tins 28 Ham, lbs. 132 Suet, lbs. ½ Lamb, lbs. 6 Turkeys, lbs. 58 Liver, Pigs, lbs. 323 Veal Jellied (tinned) lbs,58 Totals: 1950 1951 1952 1953 Tins 72 227 182 112 lbs. 500¼ 445½ 1315 2543 VEGETABLES. Asparagus Tips, tins 1 Onions, jars 1 Baked Beans, tins 15 Peas, tins 39 Butter Beans, tins 5 Tomatoes, tins 44 Carrots, tins 2 Totals: 1950 1951 1952 1953 Tins & Jars 123 228 161 107 lbs. — — 54 — OTHER ITEMS. Apple & Blackcurrant Pie 71b. tins 3 Mustard, lbs. 2½ Morfat Whip, tins 1 Beans & Sausages, tins 1 Neopolitan Cream Cereal Mixed, lbs. 30 Sweets, lbs. 18¾ Cheese, lbs. 12 Peanut Butter, jars 3 Chocolate Spread, tins 1 Pease Pudding, tins 1 Chocolate Tea Cakes, ½ tin 1 Porridge Oats, pkts. 1 Chutney, Bots. 1 Rice, lbs. 30 Cream, tins 5 Sauce, bots. 1 Eggs. No. 463 Savourmix, pkts. 1 Milk Condensed, tins 14 Soup, tins 6 Milk Evaporated, tins 44 Spaghetti, tins 3 Milk Skimmed, tins 1 Steak Pudding, tins 1 Mincemeat, jars 2 Tomato Paste, lbs. 29¾ Veal Spread, jars 1 Totals: 1950 1951 1952 1953 Eggs 4,518 833 1,810 463 Milk Tins 455 99 34 59 Packages 113 341 113 92 lbs. 95 204 283 123 All the tinned goods were blown or damaged. Meat condemned was mainly due to decomposition (bone taint). 25 (d) (2) Food Complaints. 17 complaints of food unfit to eat were received during the year. In each case the matter was taken up with the vendor and the manufacturer. The goods affected were: Brawn 1 Biscuits and Cakes 3 Bread 4 Curry Powder 1 Flour 1 Fruit 1 Milk 2 Sweets 3 General 1 (e) Bakeries. There are 14 Bakehouses in the District, 2 of which are not in use. 171 visits have been made. (f) Chemical and Bacteriological Examination of Food. This is mainly dealt with by the County Council but we may and do take samples for analysis, if necessary. (g) Adulteration. This continues to be dealt with by the County Council until 1st April, 1954. (h) Ice-Cream. 107 visits were made to ice-cream manufacturers and vendors for routine inspections and sampling. There are 8 manufacturers and 104 vendors of ice-cream 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 Fair Grade 2. 2 The following results were received on samples of ice-cream manufactured outside the District:— Excellent Grade 1. 8 Very satisfactory Grade 1. 20 Satisfactory Grade 1. 4 Satisfactory Grade 2. 6 Fair Grade 2. 2 Poor standard Grade 3. 1 Total Samples taken: 47. Grade 1. 35 75 per cent Grade 2. 11 23 per cent Grade 3. 1 2 per cent 26 This is the first time since the end of the war that the "unsatisfactory" label has not been applied to any sample of ice cream taken in this District. 5 samples of ice lollies were taken during the year and the following reports from the laboratory were received:— Made in the Chigwell area:— Very satisfactory 2 Made outside the district:— Very satisfactory 1 Fair 2 The samples reported upon above were obtained from all four Wards in the District and from all kinds of premises and types of vehicles. In every instance samples were delivered to the Public Health Laboratories in Victoria Street, London, S.W.I, within three hours of being taken. The standard for ice-cream was again altered in May, 1953, and is now:— Fat 5 per cent Sugar 10 per cent Milk solids other than fat 7½ per cent Provided that:— (i) ice-cream containing any fruit, fruit pulp or fruit puree shall either conform to the standard set forth above or, alternatively, the total content of fat, sugar and milk solids other than fat shall be not less than 25 per cent of the ice-cream including the fruit, fruit pulp or fruit puree, as the case may be, and such total content of fat, sugar and milk solids other than fat shall include not less than 7½ per cent fat, 10 per cent sugar and 2 per cent milk solids other than fat: (ii) "Parev" (kosher) ice sold, offered or exposed for sale under that description shall contain not less than 10 per cent fat and not less than 14 per cent sugar, and the standard of the ice-cream set forth above shall not apply to this product. For the purpose of the standard prescribed above "sugar" means sucrose, invert sugar or the solids of any sweetening material derived from starch so however that no ice-cream shall contain less than 7½ per cent Sucrose. Each reference in this Schedule to any proportion or percentage means that proportion or percentage by weight. The County Council submit samples for chemical examination to the analyst. The number of samples taken during the year was 22 and all were reported upon as being genuine. 27 (i) Clean Food Campaign. (a) Number of food premises in the District by type of business:— Members of Food Hygiene Guild. Restaurants, Cafes, etc. 26 4 Bakers 22 5 Greengrocers 27 6 Fishmongers 15 5 Butchers 31 16 Grocery, Provisions, and General Stores 60 20 Sweet Shops 26 6 Dairies and Milkshops 16 3 Licensed Premises 37 3 Total 260 68 (b) Number of food premises registered under Section 14 of the Food and Drugs Act, 1938 and number of dairies registered under the Milk and Dairies Regulations, 1949. Butchers 28 Ice Cream 112 Dairies and Milkshops 16 Total 156 (c) Number of visits made to registered food premises:— Butchers 298 Ice Cream 107 Dairies and Milkshops 38 (d) The Chigwell and Waltham Holy Cross Hygienic Food Traders' Guild arranged a course of three lectures for food traders and their employees in February, 1953. All the lectures were well attended, averaging over 100 people at each lecture. On the conclusion of the course a certificate was awarded for full attendance and 67 certificates were presented. A series of advertisements commenced in local newspapers in December, 1953. 28 (j) Disposal of Condemned Food. Meat: Collected by Messrs. John Knight for conversion into non-edible fats for manufacture of soap etc. Tinned goods: Buried at the Council's refuse tip in Buckhurst Hill. Other items: Disposed of for animal food, if possible, if not buried at the Council refuse tip. (k) Special examination of stock or of a consignment of food. Nil. (i) Factories, Shops, etc. (a) Factories and Workplaces. 145 visits have been made. Inspection is carried out by this Department in connection with the provision of means of escape in case of fire. Assistance in this work is afforded by the Essex Council 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. Three certificates have been issued during the year under the provisions of the Factories Acts, 1937 and 1948. (b) Outworkers. 35 visits have been made. (c) Shops Act. 135 visits have been made. This Local Authority becomes responsible for the administration of the Shops Act, 1950 on April 1st, 1954. 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 of occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authority. 11 24 - - ( ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. 94 286 1 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises). 13 6 — — TOTAL: 118 316 1 — FACTORIES ACT, 1937. 2. CASES IN WHICH DEFECTS WERE FOUND. Premises Found Number of cases in which defects were found Number of Remedied Referred to H.M. Inspector Referred by H.M. Inspector cases in which prosecutions were instituted Want of cleanliness (S.1.) 2 2 2 - Overcrowding (S.2) — — — - Unreasonable temperature (S.3.) i— — — - Inadequate ventilation (S.4.) — — — - Ineffective drainage of floors (S.6). — — - — - Sanitary Conveniences (S.7): (a) Insufficient 2 2 — - (b) Unsuitable or defective 5 4 2 - (c) Not separate for sexes — — — — - Other offences against the Ac1 (not including offences relating to Outwork) t 2 2 — 1 — TOTAL: 11 10 5 - Summary of Sanitary Inspectors' visits during the year ended 31st December, 1953. General Sanitation. Total No. Nature of visits or inspection of visits Water supply 49 Drainage 906 Fried Fish Shops 1 Tents, Vans and Sheds 92 Factories 145 Workplaces 6' Outworkers 35 Bakehouses 171 Public Conveniences 25 Licensed Premises 2 Refuse collection 76 Refuse Disposal 128 Rats and Mice 1,388 Atmospheric Pollution 228 Schools 15 Shops 135 Knackers Yard 96 Petrol 64 Food Hygiene Guild 93 Miscellaneous Sanitary Visits 1,125 4,780 Housing. Under Public Health Acts: Number of houses inspected 224 Visits paid to above houses 344 Under Housing Acts: Number of houses inspected 131 Visits paid to above houses 678 Overcrowding: Number of houses inspected 1 Filthy or Verminous Premises: Number of houses inspected 18 Visits paid to above houses Miscellaneous Housing Visits 427 1,852 Carried forward 6,632 32 Brought forward 6,632 Infectious Disease: Inquiries in cases of infectious disease 165 Visits re disinfection 7 Miscellaneous Infectious Disease visits 313 485 Meat and Food Inspection: Visits to Slaughterhouses 44 „ „ Butchers 298 „ „ Dairies and Milk Distributors 38 „ „ Fishmongers and Poulterers 80 „ „ Grocers 181 „ „ Greengrocers and Fruiterers 32 „ „ Ice Cream Premises 107 „ „ Restaurants 84 Ice Cream Sampling 81 Miscellaneous Food Visits 152 1,097 Total 8,214 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. 33 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 Notified Admission to Hospital Deaths Acute Encephalitis (infective) 1 1 0 Acute Poliomyelitis (Paralytic) 2 2 0 Acute Poliomyelitis (Non-Paralytic) 4 4 0 Acute Primary Pneumonia 32 4 0 Dysentery 18 3 0 Erysipelas 6 1 0 Food Poisoning 4 1 0 Malaria 1 1 0 Meningococcal Infection 3 3 0 Measles 1,108 9 0 Ophthalmia Neonatorum 1 1 0 Puerperal Pyrexia 2 2 0 Scarlet Fever 72 7 0 Whooping Cough 432 7 1 1,686 46 1 34 Comparative Tables of Infectious Disease Notification and Death Rates per 1,000 of the population, 1953. (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 0.01 0.00 Paratyphoid Fever 0.01 0.01 0.01 0.01 0.00 Meningococcal infection 0.03 0.04 0.03 0.03 0.05 Scarlet Fever 1.39 1.50 1.44 1.02 1.26' Whooping Cough 3.58 3.72 3.38 3.30 7.55 Diphtheria 0.01 0.01 0.01 0.00 0.00 Erysipelas 0.14 0.14 0.13 0.12 0.10 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 12.36 11.27 12.32 8.09 19.34 Pneumonia 0.84 0.92 0.76 0.73 0.56 Acute poliomyelitis (including polioencephalitis) Paralytic 0.07 0.06 0.06 0.07 0.03 Non-paralytic 0.04 0.03 0.04 0.03 0.07 Food poisoning 0.24 0.25 0.24 0.38 0.07 Puerperal pyrexia 18.23(a) 24.33(a) 12.46(a) : 28.61(a) 2.17 (a) notifications per 1,000 related births). DEATHS: All Causes (corrected) 11.4 12.2 11.3 12.5 9.00 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.01 0.01 0.00 0.00 0.02 Diphtheria 0.00 0.00 0.00 0 00 0.00 Tuberculosis 0.20 0.24 0.19 0.24 0.17 Influenza 0.16 0.15 0.17 0.15 0.05 Smallpox 0.00 0.00 0.00 0.00 0.00 Acute poliomyelitis (including polioencephalitis) 0.01 0.01 0.01 0.01 0.00 Pneumonia 0.55 0.59 0.52 0.64 0.45 35 Diphtheria. There were no cases during the year. The free immunisation of children by general practitioners and at clinics has been maintained. Tuberculosis. 57 new cases of lung tuberculosis and 5 of tuberculosis of other organs were notified during the year. 38 of these new cases occurred amongst residents of the L.C.C. Estates. In addition, to the new cases, 21 established cases of tuberculosis originally acquired in other areas, took up residence in this District during the year; 13 of these new resdents on the L.C.C. Estates. There were 11 deaths from tuberculosis during the year, compared with 10 in 1952 and 9 in 1951. VACCINATION AND IMMUNISATION SCHEMES:— 1. Tuberculosis (B.C.G.) See pages 3 and 4. 2. Smallpox. 335 primary vaccinations were performed, and 98 persons were re-vaccinated during the year. This is again a decrease on previous years, as primary vaccinations were only 36 per cent of the total number of live births, compared with 45 per cent in 1952. 3. Diphtheria. 703 children completed a course of diphtheria immunisation during the year. 829 re-inforcing injections were also administered. 4. Whooping Cough. 249 children completed a course of immunisation against whooping cough. 19 re-inforcing injections were also given. 36 APPENDIX. RAINFALL IN INCHES FOR MONTHS IN 1953. Chigwell U.D.C. Metropolitan Water Board Luxborough Loughton High Beech Buckhurst Hill S.D. Works Depot January 1.08 1.09 0.43 0.98 February 1.79 1.79 1.84 1.72 March 0.51 0.48 0.27 0.42 April 2.81 2.56 1.73 1.70 May 1.38 1.33 1.96 2.12 June 1.34 1.49 1.53 1.49 July 4.28 3.56 2.80 3.73 August 2.02 1.78 2.30 1.89 September 1.89 1.98 1.86 1.81 October 3.27 3.28 2.79 2.97 November 1.11 1.02 1.28 1.45 December 0.68 0.66 0.42 0.58 22.16 21.02 19.21 20.86 AVERAGE RAINFALL FOR THE LAST FIVE YEARS 1949 — 19.10 1950 — 24.86 1951 — 31.11 1952 — 25.31 1953 — 20.81 The highest point in the District is 372 O.D. and the lowest 44 O.D. Hickman, Printers, Loughton.