AC 4411(3) 1??? 2??? CHIG 20 Chigwell Urban District Council ANNUAL REPORT of the Medical Officer of Health including the report of the Chief Public Health Inspector for the Year ending DECEMBER 31st, 1956 Chigwell Urban District Council Public Health Committee: Chairman: Councillor J. R. Jeffryes. Members: Councillor N. D. Crafford „ M. W. Juniper „ W. G. C. Langton Mrs. V. L. M. Martin „ W. A. Nichols, J.P. R. C. O'M alley, A.M.I.M.I. „ S. J. Palfreman „ Mrs. L. M. Scott „ J. W. Spencer The Chairman of the Council, Councillor E. G. Perry, J.P., and Vice-Chairman of the Council, Councillor W. J. Halford ex-officio. Public Health Staff: Medical Officer of Health (Part-time): H. Franks, M.B., B.S., B.Hy., D.P.H. Deputy Medical Officer of Health (Part-time): A. W. Forrest, M.A., M.D., Ch.B., D.P.H, Chief Public Health Inspector : W H. Digweed, A.R.S.H., M.A.P.H.I, (a) (b) Public Health Inspectors: R. P. Stevens (a) D. Lloyd Jones, M.A.P.H.I. (a) (b) (c) P. E. Parbery, A.R.S.H., M.A.P.H.I., C & G (Full Tech. Cert.) R.P. (a) (from 8th July, 1956) Student Inspector: P. E. Parbery (till 7th July, 1956) Clerks: Miss J. Warriner Mrs. D. Eaglestone (a) Royal Society of Health and Sanitary Inspectors Examination Joint Board Certificate. (b) Royal Society of Health Certificate for Inspector of Meat and other Foods. (c) Royal Society of Health Smoke Inspectors Certificate. 1 CHIGWELL URBAN DISTRICT COUNCIL To the Chairman and Members of the Chigwell Urban District Council. THE CHAIRMAN, LADIES AND GENTLEMEN, I have pleasure in presenting to you the Annual Report including the report of the Chief Public Health Inspector, for the year ending 31st December, 1956. Vital Statistics The fall in the birth rate continued, and at 12.5 per thousand of the population, the corrected rate was well below the average for England and Wales (15.7). No significant change occurred in the total (corrected) death rate which, at 9.6 per thousand population compared well with the national figure of 11.7 per thousand for a population of the same age and sex distribution. Diseases of the heart and circulatory system and cancer continued to be the main causes of death. Last year's exceptionally high death rate from cancer of the lung and bronchus has not been repeated this year, so that on average, the situation in the District appears to be no worse and no better than in the country as a whole. At my request, the Consultant Chest Physician at St. Margaret's Hospital, Dr. V. U. Lutwyche. kindly provided all the available information on the smoking habits of the twenty-five patients she has treated at the hospital for lung cancer during the past two years, which are tabulated as follows:— Over 40 cigarettes daily 5 20—40 cigarettes daily 14 Approximately 15 cigarettes daily 2 1 oz. pipe tobacco daily 1 Non-smokers 0 No information available 3 25 Dr. Lutwvehe carefully emphasises that no firm conclusions should be drawn from such a small number of cases, but I personally consider it is highly significant that the close association between heavy smoking and lung cancer reported in many large national surveys should be so closely repeated locally. 2 Your Council has authorised me to give due publicity to this important subject and with the co-operation of the press I have repeatedly advocated that it is the duty of parents and teachers to discourage young people from acquiring the smoking habit, and that there is ample evidence to justify the prohibition of smoking in public enclosed spaces such as cinemas, theatres and public vehicles. In addition to 3 fatal road accidents, the same as last year, there were 7 other accidents which gives a total of 10, or 2 less than 1955. This is double the number caused by tuberculosis (5). Infectious Diseases The outstanding feature of the year has been the prevalence of dysentery. Although of a mild type (Sonne), for which few cases required admission to hospital, and none were fatal, the disease caused a good deal of disturbance in some elementary schools, and much more work for the Public Health Department. In addition to the 129 cases and carriers revealed by notification and by routine investigation of contacts, many others undoubtedly escaped detection because of the mildness and brevity of the illlness. Such "missed" or abortive cases are mainly responsible for failure to eradicate this disease, which continues to be widespread in all parts of the country. It cannot be repeated too often that careful handwashing after every visit to the toilet by everybody is the key to the elimination of dysentery and other enteric diseases from the community. Young children require constant supervision and training in this respect. Four cases of paratyphoid fever were notified during the year. Two of these were traced to a known source of infection at a bakery in the neighbouring district, where the use of contaminated Chinese egg products was thought to be the most likely cause. The third case was a contact of one of the above, during the period of infectivity, and was of the same type of infection (S. Paratyphi B, Phage Type Taunton). The fourth case was unrelated to the others (S. Paratyphi B, Phage Type Dundee) and in spite of exhaustive investigation it was not possible to trace the source of this infection. An epidemic of mild whooping cough occurred during the Spring; only five of the 249 notified cases required treatment and there were no deaths. 3 There were 3 (paralytic) cases of poliomyelitis during the year, all of whom recovered. Immunisation against this disease commenced in the District in May, 1956 for the very first time, but owing to the limited availability of the vaccine, and seasonal factors, only a small proportion of requests for vaccination could be met. The vaccine was administered at the County Council Clinics under arrangements made by the Forest Area Medical Officer No reactions or untoward effects have been reported, and it is to be hoped that the scheme will expand as more vaccine becomes available. The number of newly acquired cases of tuberculosis on the L.C.C. Estates increased to 24 notifications, as compared with 17 in 1955. Public sessions of the Mass Radiography Unit have been arranged as early detection and treatment are the only ways of preventing the spread of infection from unsuspected sources. It is particularly important that men over 40 should be X-rayed, especially those with persistent cough and bronchitis. New Legislation There has been good progress in the implementation of the Food Hygiene Regulations, 1955, made under the Food and Drugs Act, 1955. Details are given later in the report. The Clean Air Act, 1956 has come into operation and the Council are recommending that their River Estate become the first smokeless zone in the Urban District. SECTION 47, NATIONAL ASSISTANCE ACT, 1948 AND NATIONAL ASSISTANCE (AMENDMENT) ACT, 1951 Six cases have been under supervision during the year. One has died, in another case two children of school age have been placed under the care of the County Council, home helps have been obtained for three, and the other case was admitted to an institution on a voluntary basis. Sanitary Conditions In the report of the Chief Public Health Inspector it will be seen that the work of the Department continues to increase mainly for the same reasons as last year, the three principle causes being population increase, epidemic of dysentery and new legislation. 4 Although an increase of staff by one inspector has been authorised, so far, owing to lack of accommodation, the appointment has not been made. In conclusion, I would again like to record my appreciation to the Chairman and Members of the Public Health Committee for their help and co-operation during the year, and to the Staff of the Department for their continued enthusiasm and loyalty. 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 1957. 5 SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA Chigwell Urban District Average England and Wales Area (in acres) 8,! 8,372 (14 sq. miles approx.) Civilian Population (mid-1956) 59,740 Number of inhabited houses 16,683 Rateable Value £842,244 Sum represented by a penny rate £3,409 The rate in the pound for 1955-56 was 15/10 VITAL STATISTICS: Live Births Male Female Total Legitimate 411 360 771 Illegitimate 18 15 33 Total 804 Birth rate per 1,000 estimated resident popualtion (corrected) 12.5 15.7 Still Births Male Female Total Legitimate 8 8 16 Illegitimate 1 0 1 Total 17 Rate per 1,000 (live and still births) 20.7 23.0 Deaths Male Female Total 203 178 381 Death rate per 1,000 estimated resident population (corrected) 9.6 11.7 Deaths from pregnancy, childbirth and abortion 0 0.56* Deaths of infants under 1 year of age: Male Female Total Legitimate 5 4 9 Illegitimate 0 1 1 Total 10 Deaths of infants under 4 weeks of age: Male Female Total Legitimate 5 4 9 Illegitimate 0 1 1 Total 10 *Per 1,000 total births.  Chigwell Urban District Average England and Wales Death rate of infants under 1 year of age: All infants per 1,000 live births 12.4 23.8 Death rate of infants under 4 weeks of age 12.4 16.9 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) 1952 15.3 30 30.0 6.9 56,830 1953 15.1 31 16.3 9.0 57,250 1954 13.7 21 17.7 9.0 57,780 1955 12.8 25 13.8 8.6 58,790 1956 12.5 33 12.4 9.6 59,740 7 Cause of Death as given by the Registrar General for the Year 1956 Male Female Total Coronary disease, Angina 36 13 49 Other disease of heart and circulatory system 30 33 63 Leukaemia, aleukaemia 2 2 4 Cancer of lung and bronchus 13 6 19 Cancer, other than lung and bronchus 33 41 74 Vascular lesions of nervous system 19 33 52 Bronchitis 16 7 23 Pneumonia 9 8 17 Influenza 1 2 3 Syplilitic disease 1 0 1 Disease of prostate 3 0 3 Tuberculosis, respiratory 3 1 4 Tuberculosis, other than respiratory 0 1 1 Ulcer of duodenum or stomach 3 0 3 Congenital malformations 2 1 3 Diabetes 1 6 7 Nephritis and Nephrosis 5 0 5 Gastritis, enteritis, diarrhoea 2 1 3 All other diseases 18 14 32 Motor vehicle accidents 1 2 3 Other accidents 3 4 7 Suicides 2 3 5 203 178 381 Death Rates per million population:— Chigwell Urban District Average England and Wales Tuberculosis of respiratory system 66 109 Cancer of lung and bronchus 319 407 Cancer of other organs 1237 1668 All causes 9545 11700 8 SECTION B GENERAL PROVISION of HEALTH SERVICES IN THE DISTRICT (a) Public Health Officers of the Local Authority: (see page 1) 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.11 Tel: Wanstead 0031. (b) Laboratory Facilities: The Central Ministry of Health Laboratory at Colindale, and the Branch Laboratories at St. Margaret's Hospital, Epping and at Chelmsford and Essex Hospital, Chelmsford, according to requirements. Water, milk, ice-cream and other foods are examined at the Counties Public Health Laboratory, 66 Victoria Street, London, S.W.I. All milk and other food samples taken under the Food and Drugs Act are sent for analysis to the Public Analyst, J. H. Hamence, Esq., Ph.D., M.Sc., F.R.I.C., 20 Eastcheap, London, E.C.3. (c) Ambulance Facilities: The transport of the sick and 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, where 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. 9 (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 Saints 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 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 11,971 attendances at child welfare centres during the year of which 8,828 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, Wednesday at 2 p.m. LOUGHTON: Essex County Council Health Services Clinic, Loughton Hall, Tuesday at 2 p.m. Total ante-natal attendances in the District for the year were 9,925. There were 235 post-natal attendances. 10 (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: LOUGHTON: Essex County Council Health Services Clinic, Loughton Hall 3rd Friday morning in month (by appointment only). There were 55 first visits and 247 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: 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 (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 Hall (by appointment only). (k) Establish nents 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, 4 Algers Road, Loughton (Chiropody only) Mrs. J. M. Burt and Miss M. Guise, 195 High Road, Loughton. 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: LOUGHTON Essex County Council Health Services Clinic, Loughton Hall (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) (o) Chest Clinics: The District is served by the following clinics. Patients and contacts are seen by appointment only. EPPING: Chest Clinic, St. Margaret's Hospital, Epping (Epping 2224) ILFORD: Chest Clinic, 130 Cranbrook Road, Ilford (Valentine 3067) WOODFORD: Chest Clinic, Harts Hospital, High Road, Woodford Green. (Buckhurst 7244). 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 Whitmore, Essex County Council Clinic, Buckhurst Way (Buckhurst 5180). Mrs. Thomas do. CHIGWELL: Miss Gardiner, 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 Tarling do. Miss Kenny do. Health Visitors made 9,429 visits during the year. 13 (q) Tuberculosis Health Visitor: Miss Hill, Chest Clinic, St. Margaret's Hospital, Epping. (Epping 2224) (r) Home Nurses: BUCKHURST HILL: Miss Botell, 126, Queens Road (Buckhurst 1331). Mr. Jestice, 11 Rous Road (Buckhurst 7249). Mrs. Jestice do. 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 25,296 visits during the year. (s) Midwives: BUCKHURST HILL: Mrs. Tomlinson, 40 Chestnut Avenue (Buckhurst 6371). CHIGWELL: Miss Skoyles, 9 Coppice Path (Hainault 2108) Miss Proctor, 64, The Lowe (Hainault 3110). LOUGHTON: Miss Sibthorpe, 29 Rochford Avenue (Loughton 5666). Miss Seaman, 85 Grosvenor Drive (Loughton 1879). Mrs. Camp, 100 Borders Lane (Loughton 4644). Miss Story, 31 Rochford Avenue (Loughton 5878). Midwives conducted 249 confinements in the District during the year and attended a further 51 maternity cases. (t) Home Help Organisers: Miss J. M. Loveless (Chigwell area) 93 High Road, Woodford, E.18 (Buckhurst 6626). Miss N. Keay (Buckhurst Hill and Loughton areas) 93 High Road, Woodford, E.18 (Buckhurst 6626). 14 SECTION C SANITARY CIRCUMSTANCES OF THE AREA 1. (i) Water The water supply of the District is provided by the Metropolitan Water Board except for one house in the District where it is drawn from a well. This house is in the ownership of the Conservators of Epping Forest and is situated in the forest a long way from the mains supply. The water is piped and has been satisfactory both in quality and quantity. The number of houses is 16,683 and the estimated population at mid-year was 59,740. Five samples of water were taken during the year and the report was satisfactory in each case. (ii) Drainage and Sewerage The main works at Luxborough have operated satisfactorily and with reasonable effluent standard, although the need for certain items to be completed and others to be extended (particularly for sludge treatment) is being increasingly felt. Flow is still increasing from development and the rising water consumption per head of population. A major scheme for further extensions has been submitted to the Ministry but except for a few items has not yet been authorised to proceed. The new relief outfall sewer to divert flow from the Northern Outfall sewer has also been submitted to the Ministry but deferred on account of financial restrictions. This scheme has a direct relation to certain items of the Luxborough improvement scheme. The small subsidiary works at Millers Lane has continued to operate satisfactorily and produces a good effluent. The number of outlying pumping stations has reduced to four and these have given adequate service throughout the year. A scheme for replacing one of the older and smaller stations with a new one is in course of preparation. Another is intended to be replaced by a new and larger one in the course of the Northern Outfall relief sewer scheme. The problem of older sewers remains but no progress towards solution is practicable whilst financial restrictions continue. 15 2. Rivers and Streams The River Roding flows through the centre of the District dividing the Ward of Chigwell on the south-east from those of Buckhurst Hill and Loughton on the north-east side. There are no buildings at present liable to floods in the river area which is under the jurisdiction of the Essex Rivers Board. The extent of flooding is practically nil and therefore very much less than in former years. 3. (i) Closet Accommodation and Cesspools Number of Cesspools and Septic Tanks: Buckhurst Hill 1 Chigwell 79 Loughton 12 Number of Earth or Chemical Closets in Houses: Chigwell 37 Loughton 6 Number of Chemical Closets in Caravans: Buckhurst Hill 3 Chigwell 12 Loughton 1 Premises which have earth closets, chemical closets, cesspools and septic tanks are in areas where no sewer is available. One large house previously drained by a cesspool has been connected to the Council's sewer during the year. Every opportunity is taken to connect premises to main drainage and schemes are in hand with this in view. (ii) Public Cleansing Domestic refuse has been collected once weekly throughout the District by the Council vehicles and labour. A fleet of seven 10/12 c.yd "Fordson/Eagle" covered lorries, each drawing a covered trailer for salvage, is constantly employed, supplemented by further vehicles for individual special collections. Trade refuse has also been collected at scale charges. Refuse is disposed of by controlled tipping at a tip provided by a contractor. Payment to the firm is per load and includes levelling, compacting and covering, a bulldozer and the covering material being provided in the price. The area exposed at any one time is kept to a low minimum and measures are taken against flies and vermin as necessary from time to time. 16 Salvage of paper and rags produced sales during the year of 558 tons. Kitchen waste collected from Schools and Industrial Canteens has continued to be taken to Tottenham Plant for processing, the total so disposed of during the year being 162 tons. Road gullies (in adopted district roads) have been emptied and re-sealed with clean water by machine three times during the year by contract. (iii) Sanitary Inspection of the Area An outline of the work of the Sanitary Inspectors is shown below:— Complaints received and dealt with 868 Inspections and visits 6101 Nuisances abated 456 Informal Notices served 80 Informal Notices complied with 83 Statutory Notices served 19 Statutory Notices complied with 14 Legal Proceedings 3 Summary of Nuisances Drains blocked or defective 232 Defective water closets 16 Defective water supply pipes 6 Nuisances from animals and birds 15 Polluted ditches, watercourses and ponds 4 Accumulation of refuse and defective dustbins 43 Vermin (bugs and fleas) 10 Cellars flooded 7 Insect infestations 39 Bees, wasps and hornets 63 Bats 5 Air pollution 16 (iv) Verminous Premises Four houses were found to be verminous during the year, three of these were infested with bed bugs and the other with fleas. Two houses were privately owned, one by the London County Council at Debden and one by the Chigwell Council on the River Estate. 17 There is a great reduction in recent years of premises found to be verminous and atlhough this year the figure is the same as 1955 it is still a big improvement on what things used to be. The number of houses found infested in previous years is as follows:— 1951 19 1952 12 1953 8 1954 8 Average 9. 1955 4 The same fumigants were used as last year, viz., Fumite and Coopers Bed Bug Spray. Two premises had to be resprayed, the final results being satisfactory. Number of visits: 10. RODENT CONTROL PREVENTION OF DAMAGE BY PESTS ACT, 1949 1,080 inspections and visits were made in 1956 as against 1,548 in 1955, 1,308 in 1954 and 1,388 in 1953. This is about a 30 per cent decrease on last year and also a decrease on the two previous years. The extensive use of Warfarin may be the reason. Zinc Phosphide and Arsenic was used for baiting the sewers. Treatment of the Council's soil and surface water sewers was done as usual with the following results:— March 1956 October 1956 Manholes 110 88 Pre-bait takes 22 35 Pre-bait part takes — 7 Poison complete takes 2 8 Poison part takes 18 17 Poison or Bait used Arsenic Zinc Phosphide 18 SECTION D HOUSING STATISTICS FOR THE YEAR 1956 Number of new houses erected and occupied during the year: Permanent Houses:— London County Council 1 Chigwell Urban District Council 92 Private Owners 463 556 Inspection of Dwelling Houses during the year:— 1 (a) Total number of dwelling houses inspected for housing defects (under Public Health and Housing Acts) 573 (b) Number of visits made for the purpose 639 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 29 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 70 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 69 Action under Statutory Powers during the year:— (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which notices were served requiring repairs 1 (2) Number of dwelling houses which were rendered fit after service of Formal Notice by:— (a) Owners 1 (b) Local Authority in default of owners Nil (b) Proceedings under Public Health Acts: — (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 10 (2) Number of dwelling houses in which defects were remedied after service of Formal Notices by:— (a) Owners 10 (b) Local Authority in default of owners Nil (c) Proceedings under Sections 11, 13 and 25 of the Housing Act, 1936:— (1) Number of dwelling houses in respect of which Demolition Orders were made (2) Number of dwelling houses demolished in pursuance of formal action 13 (d) Number of houses or parts of houses closed under:— (1) Section 12 of the Housing Act, 1936 1 (2) Section 10 of the Local Government (Miscellaneous Provisions) Act, 1953 1 (e) Informal Action:— Number of dwelling houses demolished as result of informal action 20 20 Re-Housing Priority on Medical Grounds 89 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 investigated by the Medical Officer of Health and recommendations made were as follows:— Disease Total Applicants Priority Recommended Priority Not Recommended Asthma, bronchitis, catarrhal disease etc. 26 5 21 Heart disease 6 3 3 Nervous disease (anxiety states, neurasthenia, neurosis, etc. 17 3 14 Rheumatism 6 2 4 Tuberculosis 9 9 — Other diseases 25 4 21 89 26 63 Figures for 1953 were 46 22 24 Figures for 1954 were 68 18 50 Figures for 1955 were 100 25 75 The 63 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); (4) Repeated requests already assessed. 21 Summary of Defects found on Housing Inspections Defective Roofs 36 „ W.C.'s 6 „ Flushing Cisterns 9 „ Sinks and waste pipes 4 „ Sash cords 7 Walls 3 „ Gutters and rainwater pipes 12 „ Yard Paving 2 „ Windows 14 „ Drainage and vent pipes 6 „ Gullies 3 „ Internal Walls (plaster) 27 „ Ceilings 16 „ Water Fittings and Pipes 5 „ Flooring 4 „ External Walls 11 „ Stoves, boilers and fireplaces 19 „ Dustbins 12 „ Doors 8 Dampness 10 Under floor ventilation lack of 5 Dirty walls and ceilings 5 Redecoration after repair 6 22 SECTION E. INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply The District is a Specified Area under the provisions of Section 37 of the Food and Drugs Act, 1955, which means that only Designated Milk may be sold. 5 samples of milk have been taken during the year and all were reported upon as genuine. 15 dairies and milkshops are registered. 9 licences have been issued to firms with premises outside the district to purvey milk in the District. (b) Meat and other Foods SLAUGHTERING AND BUTCHERS' SHOPS There are 4 slaughterhouses in the District, all licensed under Section 62 of the Food and Drugs Act, 1955. In addition, there is one Knacker's Yard also licensed under this Act. CARCASES INSPECTED AND CONDEMNED Cattle excluding Cows Cows Calves Sheep & Lambs Pigs Number killed 338 66 52 260 136 Number inspected 338 66 52 260 136 ALL DISEASES EXCEPT TUBERCULOSIS Whole carcasses condemned - - 1 - - Carcasses of which some part or organ was condemned 20 14 1 8 1 Percentage of the number inspected affected with disease other than tuberculosis 5.91 21.21 1.92 3.07 .73 23  Cattl excluding Cows Cows Calves Sheep & Lambs Pigs TUBERCULOSIS ONLY Whole carcasses condemned - - - - - Carcasses of which some part or organ was condemned - 3 - - - Percentage of the number inspected affected with tuberculosis - 4.84 - - - Details of meat condemned:— Bovines:— Tuberculosis 1 Head 30 lbs. 2 Lungs 24 lbs. Pneumonia 1 Lung 12 lbs. Pleurisy 1 Lung 12 lbs. Fluke 2 Lungs 22 lbs. 21 Livers 276 lbs. Abscesses 5 Livers 49 lbs. Cirrhosis 5 Livers 76 lbs. Calves:— Fevered Condition 1 Carcase 40 lbs. Pleurisy and Enteritis Cirrhosis 1 Pluck 8 lbs. Sheep:— Pneumonia 1 Lung 3 lbs. Abscesses 3 Lungs 18 lbs. Fluke 1 Liver 8 lbs. Necrosis 1 Pluck 12 lbs. Parasitical Infection 2 Plucks 12 lbs. Pigs:— Pneumonia 1 Pluck 5 lbs. During the year assistance in meat inspection has been afforded to the Waltham Holy Cross Urban District Council. 46 visits were made during the year. There are 30 butchers shops in the District. 25 visits were made to these premises. 7 licences to deal in game have been issued. 24 (c) Food Condemned The foodstuffs listed below were found on inspection unfit for human consumption. Some have been disposed of for animal food and the rest destroyed. FISH Anchovy Fillets, tins 1 Rock-Eel, lbs. 84 Bristling, tins 1 Salmon, tins 3 Dogfish, lbs. 42 Sardines, tins 3 Herrings, tins 1 Shrimps, tins 5 Pilchards, tins 7 Tunny Fish, tins 1 TOTALS 1953 1954 1955 1956 Tins and jars 31 25 27 22 lbs. 30 29 145 126 Figures for 1956 are about the same as tor last year, but both show increases over the two previous years. FRUIT Apricots, tins 14 Peaches, tins 27 Blackcurrants, tins 2 Pears, tins 13 Currants, packets 4 Pineapple, tins 42 Fruit salad, tins 2 Pineapple Juice, tins 1 Gooseberries, tins 1 Plums, tins 6 Grapefruit, tins 7 Prunes, tins 3 Grapefruit Juice, tins 3 Prunes, lbs. 36 Grapefruit Marmalade, tins 1 Rhubarb, tins 1 Tam, tins 1 Raspberries, tins 1 Oranges, tins 19 Strawberries, tins 4 Orange Juice, tins 1 TOTALS 1953 1954 1955 1956 Tins, Jars, etc. 355 163 174 153 lbs. 381½ 59 9 36 The amount of fruit condemned continues to decline though the figures for last year are about the same. VEGETABLES Baked Beans, tins 8 Pease Pudding, tins 1 Broadbeans, tins 1 Pickles, jars 1 Carrots, tins 2 Tomatoes, tins 33 Onions, jars 1 Tomato Juice, tins 1 Peas, Split lbs. 56 Vegetables, Mixed, tins 1 Peas, tins 19 Vegetable Salad, tins 1 TOTALS 1953 1954 1955 1956 Tins and Jars 112 111 476 69 lbs. - - 336 56 There is a marked decrease as compared with last year. 25 MEAT Bacon, lbs. 4½ Lambs Livers, lbs 60 Bacon, Shoulder, 22 tins 2621bs Lambs Tongues, tins 1 Beef, lbs. 149 Meat Paste, jars 1 Beef, Corned 61b. tins 3 Meat Luncheon, tins 2 Beef, Corned 12oz. tins 10 Pork Luncheon Meat Beef, Curried 6 lb tins 1 5 lbs. 9 oz. tins 95 lbs. 528 Beef, Kideny, lbs. 4½ 4 lb. tins 12 Beef, Loaf, tins 1 2 lb. tins 3 Beef, Steak Pudding, tins 1 1 lb. tins 2 Calves Livers, lbs. 40 Pork. Sausages lbs. 6 Cornish Pasty 1 Steak, Stewer tins 8 Ham, lbs. 11 Veal, Tellied, lbs. Ham, tins, 17 lbs. 6oz. 1 6 lb. tins 2 TOTALS 1953 1954 1955 1956 Tins etc. 112 59 107 49 lbs. 2.543 950½ 587 1060 The increase in condemned meat consists mainly of bacon and pork luncheon meat. OTHER ITEMS Biscuits, lbs. 325 Milk Skimmed, tins 3 Cheese, lbs. 20 Munchmallow, No. 227 Chocolate Bars, No. 79 Oxo Cubes, No. 264 Chocolate Marshmallows, No. 48 Pepper, drums 36 Potato Crisps, packets 65 Cream, tins 4 Rice, lbs. 38 Eggs, Frozen lbs. 42 Soup, tins 7 Farinoca. lbs. 23 Spaghetti, tins 2 Fat Cooking, boxes 1 Spice Mixed, tins 72 Horseradish, jars 1 Tapioca lbs. 59 Jelly, jars 1 Vinegar, bottles, 1 Milk Evaporated, tins 32 TOTALS 1953 1954 1955 1956 Eggs 463 201bs 11 42 Milk tins 59 77 70 35 Packages 92 73 172 808 lbs. 123 29 28 465 The increase for 1956 was caused by a flood at a shop in The Broadway, Loughton. (d) Food Complaints 31 complaints of food being unfit for human consumption were received during the year as against 24 last year. This is the highest recorded, the next highest being in 1952 when 27 complaints were received. 26 The foods complained of were:— Bread 6 Cakes 3 Cereals 1 Fish 1 Fruit, Dried 1 Fruit, Juice 2 Ice Cream 1 Jam 2 Meat 4 Meat Pies 2 Milk 6 Mineral Water 2 31 Legal action was taken in two instances against dairy firms for non-compliance with Section 26 of the Milk and Dairy Regulations, 1949. In both instances, the firms pleaded guilty, one being given an absolute discharge on payment of £5. 5. 0. costs, the other was fined £2 and £2.2.0. costs. All complaints were investigated and five samples were sent to the Public Analyst for report. In two instances an adverse report was made, one of which resulted in Legal action referred to above. (e) Bakeries There are 15 bakehouses in the District, 8 are in use, the other 7 having been closed. A new bakehouse for the London Cooperative Society, Ltd., is being built in Loughton. 27 (f) Chemical and Bacteriological Examination of Food & Drugs The following is a list of items submitted to the Public Analyst in 1956. Almonds, Ground 1 Anchovy Fish Paste 1 Aspirin Tablets 2 Backache Pills 1 Banana Whip 1 Beef Loaf Minced 1 Beef Sausages 1 Blackcurrant Juice 1 Bread Rolls Buttered 1 Browning 1 Cake Mix 1 Cheese Pasteurised 1 Cheese spread with ham 1 Cheese spread with onion 1 Chocolate Nestle Milk Bar 1 Condiment Non-Brewed 1 Crab dressed 2 Crab Tinned 1 Foie Gras Paste 1 Flour Self-Raising 1 Fruit Pie 1 Gin 1 Ginger Marmalade 1 Gluton Nutmeat 1 Honev 1 Horseradish Relish 1 Ice Cream 2 Tarn Apricot 1 Tam Blackcurrant 2 Telly Strawberry 1 Kilkof Bottle 1 Kilkof Cones 1 Lemon Flavouring Essence 1 Lemon Juice 1 Lime Juice Cordial 1 Margarine 1 Milk Channel Island 1 Milk Evaporated 1 Milk Pasteurised 3 Milk Sterilized 1 Mint Sauce 1 Pork Luncheon Meat 1 Pork Sausages 2 Prawns in Aspic 1 Rice Pudding Tinned 1 Salmon and Shrimp Paste 1 Salmon Spread 1 Sausage Cocktail 1 Sausage Vienna 1 Soup Cream of chicken 1 Soup Cream of Tomato 1 Soup, Dessicated Brown 1 Soup Oxtail 1 Steak Stewed, Irish 1 Sugar Puffs 1 Sweets Bubblegum 1 Sweets, Butter Brazils 1 Sweets, Butter Macaroons 1 Sweets Pola Maid 1 Sweets Vanmelle Fruit 1 Tartex Sandwich Spread 1 Whisky 1 All the samples were reported by the Analyst to be genuine except the sample of Lemon Juice. Stocks of this article were withdrawn from sale and destroyed. (g) Adulteration No cases of adulteration were reported during the year. (h) Ice Cream 27 visits were made to manufacturers and vendors of ice cream for inspection of premises and sampling. There are 6 manufacturers and 88 vendors on the register. Only one of these manufacturers is now making ice cream. 28 The following results were obtained on samples of ice cream: MANUFACTURED IN THE DISTRICT: Excellent Grade I 1 MANUFACTURED OUTSIDE THE DISTRICT: Excellent Grade I 8 Very satisfactory Grade I 5 Satisfactory Grade I 7 Satisfactory Grade II 2 Fair Grade II 3 Fair Grade III 1 —26 LOLLIES: Very satisfactory 3 Satisfactory 1 Fair 2 — 6 The samples listed above were taken from all the four Wards in the District and from various types of premises. All the samples were delivered by hand to the Public Health Laboratories at 66 Victoria Street, London, on the same day as they were obtained and within three hours of being taken. I am glad to say there was no unsatisfactory sample this year. As regards the samples reported on as fair, repeat visits were made to the shops concerned, another sample was taken and in every case a satisfactory report was given by the Laboratory. Two samples of Ice Cream were sent for chemical examination and each were reported upon as being genuine. (i) (a) Clean Food Campaign Number of food premises in the District by type of business showing number belonging to the Food Hygiene Guild. Restaurants, Cafes, etc. 23 3 Bakers 22 4 Greengrocers 31 7 Fishmongers 13 5 Butchers 31 21 Grocery, Provision and General Stores 53 31 Sweet Shops 34 7 Dairies and Milkshops 15 3 Licensed Premises (including Off Licences 40 6 262 87 29 (b) Number of food premises registered under Section 16 of the Food and Drugs Act, 1955, and number of dairies registered under the Milk and Dairies Regulations, 1949:— Butchers 31 Premises in which Ice-Cream is sold 88 Dairies and Milkshops 15 134 (c) Number of visits made to registered food premises:— Butchers 25 Premises in which Ice-Cream is sold 26 Dairies and Milkshops 1 — 52 (d) Number of visits made to premises under the Food Hygiene Regulations 166. (j) Disposal of Condemned Food Meat: Collected by Messrs. John Knight for conversion into non-edible fat for manufacture of soap, etc. Tinned goods: Buried at the Council's refuse tip at Buckhurst Hill. Other Items: Disposed of for animal food if possible, if not. buried at the Council's refuse tip. (k) Special Examination of Stock or of a Consignment of Food: An inspection after a flood in the store of a mutiple grocer and provision merchant led to the condemnation of:— Biscuits lbs. 325 Chocolate Bars No. 79 Chocolate Marshmallows No. 148 Currants Packets 4 Farinoca lbs. 23 Munchmallows No. 227 Oxo Cubes No. 264 Peas Split lbs. 56 Pepper Drums No. 36 Potato Crisps Packets 65 Rice lbs. 38 Spice Mixed Tins 72 Tapioca lbs. 59 All the above were damaged by sewerage water due to a defect in the drain which has now been remedied. Arrangements have also been made to store items like biscuits and chocolate at about 2 feet above floor level. 30 (1) Factories, Shops, etc. (a) Factories and Workplaces. 147 visits have been made. Inspection is carried out by this Department in connection with the provision of means of escape in case of fire in accordance with paragraph 60 of the Public Health Act, 1936 and the Factories Acts, 1937 and 1948. Assistance in this work is given by the Essex County 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. 2 certificates have been issued during the year. (b) Outworkers: 341 visits have been made. (c) Shops Act: 118 visits have been made. 31 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 (1) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authority 6 6 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 94 140 - - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 34 38 - - Total: 134 184 — — 32 SECTION 47, NATIONAL ASSISTANCE ACT, 1948 and FACTORIES ACT, 1937 2. CASES IN WHICH DEFECTS WERE FOUND Premises Found Number of cases in which defects were found Number of cases in which prosecutions were instituted Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of cleanliness (S.1.) - — - - - Overcrowding (S.2.) — — — — — Unreasonable temperature (S.3.) — — — — — Inadequate ventilation (S.4.) — — — — — Ineffective drainage of floors (S.6.) - - - - - Sanitary Conveniences (S.7.): (a) Insufficient - - - - - (b) Unsuitable or defective 9 10 — 1 - (c) Not separate for sexes — — — — - Other offences against the Act (not including offences relating to Outwork) - - - - - Total: 9 10 — 1 - 33 RIDING ESTABLISHMENT ACT, 1939 The annual report of the veterinary officer is as follows: "Report of the Inspection of Riding Establishments for the year ended 31st December, 1956. Quarterly inspection of the riding schools in the district of your authority have been made during the year under review— on the lines of the previous years—and generally speaking, the conditions are satisfactory. When this work originally commenced there were three riding schools. A further one was established during the previous year and, during the last quarter of the year under review, it was found that a further riding school at Chigwell Row had been in existence for some time past without knowledge of the authority. This establishment has since been included in the normal routine visits which are made—within the quarters of each year—at irregular periods and times to maintain the element of "surprise visits." Five riding schools are now thus regularly visited. There is no obligation under the Riding Establishment Act for owners to notify the local authority of their existence and it would assist if members of the public would notify the Council of any such stables which may be opened in order that they may be suitably supervised. In this connection, it is of interest to record that a private members Bill is prepared for presentation to Parliament, when the opportunity is ripe, requiring all occupiers of the riding establishments to register their premises with the Local Authority. It is to be hoped that such an enactment may eventually be placed upon the Statute Book. Below is set out a list of the premises included in the routine inspections together with the average number of horses kept on in the stables. Yours faithfully, (signed) H. E. BYWATER." 34 Nightingale Riding School, Buckhurst Hill: Occupier: Mr. T. Robinson, 74 Field Road, E.7. 12 horses and ponies, plus 2 horses at livery (owned privately, but fed and boarded on the premises). Buckhurst Hill Riding Schoool: Occupier: Miss de Berry, resides adjacent to the school. 6 horses plus 3 at livery. Braeside, 1 Connaught Avenue, Loughton. Occupier: Mrs. E. W. Westby, 120 Hillyfields, Loughton. 4 horses plus 5 at livery. Forest Riding School, Chigwell Row: Occupier: Miss Margaret Isless, 37 Cleve Road, Ilford. 11 horses and ponies plus 4 at livery. J. & B. Stables, Chigwell Row: Occupier: Miss Joyce Noble, Bungalow Tea Rooms, Lambourne Road, Chigwell and William M. Scanes, 32 Inchneild Drive, Ilford. 10 riding horses and 6 colts. 35 Summary of Public Health Inspectors' visits during the year ended 31st December, 1956. General Sanitation Water supply 2 Drainage 403 Tents, vans and sheds 7 Pests, other than Rats and Mice 132 Factories 147 Outworkers 341 Bakehouses 37 Licensed Premises 2 Refuse Collection 3 Refuse Disposal 4 Rats and Mice 1,080 Atmospheric Pollution 41 Schools 5 Shops 118 Knackers Yard 84 Petrol 20 Food Hygiene Guild 22 Miscellaneous Sanitary Visits 628 3,076 Housing Under Public Health Acts: Number of houses inspected 416 Visits paid to above houses 462 Under Housing Acts: Number of houses inspected 157 Visits paid to above houses 177 Filthy and Verminous Premises: Number of houses inspected 4 Visits paid to above houses 6 Miscellaneous Housing Visits 436 1,658 Infectious Disease: Inquiries in cases of infectious disease 165 Miscellaneous infectious disease visits 357 522 Carried forward 5,256 36 Brought forward 5,256 Meat and Food Inspection Visits to: Slaughterhouses 334 Butchers 25 Canteens 37 Dairies and Milk Distributors 1 Fishmongers and Poulterers 8 Grocers 17 Greengrocers and Fruiterers 11 Ice Cream Premises 26 Restaurants 1 Sampling: Ice Cream 29 Food and Drugs 27 Food Hygiene Regulations 166 Miscellaneous Food Visits 162 844 6,100 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 and to Mr. Bywaters, M.R.C.V.S. for his report on Riding Establishments. (signed) W. H. DIGWEED, A.R.S.H., M.A.P.H.I. Chief Public Health Inspector. 37 SECTION F PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES (See also Page 3) Number of Cases Admission to Hospitals Deaths Acute Poliomyelitis: Paralytic 3 3 — Non-Paralytic — — — Acute Primary Pneumonia 17 2 — Dysentery 129 11 — Erysipelas 4 1 — Food Poisoning 4 2 — Meningococcal Infection 2 2 — Measles 55 — — Ophthalmia Neonatorum 1 — — Paratyphoid B 4 3 — Puerperal Pyrexia 2 — — Scarlet Fever 45 1 — Tuberculosis: Respiratory 40 11 4 Meninges and C.N.S — — — Other 6 2 1 Whooping Cough 249 5 — 561 43 5 38 Diphtheria: There were no cases during the year. The free immunisation of children by general practitioners and at clinics has been maintained. Tuberculosis: 40 new cases of lung tuberculosis and 6 of tuberculosis of other organs were notified during the year. 24 of these new cases occurred amongst residents of the L.C.C. Estates. In addition to the new cases 20 established cases of tuberculosis originally acquired in other areas, took up residence in this district during the year. 13 of these new residents are on the L.C.C. Estate. There were 5 deaths from tuberculosis during the year, compared with 10 in 1955 and 6 in 1954. Mass Radiography: On notification that three schools in the District had contacts of tuberculosis, the School Health Authority made special arrangements for the Mass Radiography Unit to visit the schools concerned, with the following results:— PUPILS: Miniatures taken 1,320 Number recalled for large film 14 STAFF: Miniatures taken 93 Number recalled for large film 2 Vaccination and Immunisation Schemes: 1. Tuberculosis (B.C.G.) Number of school children to whom B.C.G. Vaccination was offered 846 Number of school children undergoing tuberculin test after parents' consent had been received 529 Number of school children who received B.C.G. 451 Number of cases of post-vaccination complications reported on Form B.C.G. 8. Nil 2. Smallpox 589 primary vaccinations were performed and 168 persons were re-vaccinated during the year. This is an increase on the previous year's figures of 269 and 74 respectively. 3. Diphtheria 916 children completed a course of diphtheria immunisation during the year. 741 re-inforcing injections were also administered. 4. Whooping Cough 338 children completed a course of immunisation against whooping cough. 12 re-inforcing injections were given. 39 APPENDIX RAINFALL IN INCHES FOR MONTHS 1956 Metropolitan High Beech Water Board Buckhurst Hill Chigwell U.D.C. Luxborough S.D. Works Loughton Depot January 3.56 3.43 2.85 3.46 February 0.46 0.45 Nil .35 March 1.05 1.17 1.06 .93 April 1.08 1.18 1.03 .99 May 0.71 0.65 0.69 .64 June 3.58 3.02 3.00 3.21 July 4.24 4.20 3.62 3.29 August 4.74 4.42 4.35 4.12 September 2.23 2.08 1.70 1.90 October 2.45 1.91 2.08 2.02 November 0.67 0.62 0.47 0.57 December 2.91 2.62 2.18 2.49 27.68 25.75 23.03 23.97 AVERAGE RAINFALL FOR THE LAST FIVE YEARS 1952 — 25.31 1953 — 20.81 1954 — 25.44 1955 — 21.44 1956 — 25.10 The highest point in the District is 372 O.D. and the lowest 44 O.D 40 Hickman, Printers. Loughton