4411 (3) CHIG 21 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, 1957 Chigwell Urban District Council Public Health Committee: Chairman: Councillor E. G. Perry Members: Councillor K. F. Alder „ H. L. Hole, J.P. „ M. W. Juniper „ Mrs. V. L. M. Martin „ W. A. Nichols, J.P. R. C. O'Malley, A.M.I.M.I. „ S. J. Palfreman „ A. H. Swallow „ S. W. Wayman The Chairman of the Council, Councillor W. J. Halford, J.P., and Vice-Chairman of the Council, Councillor D. G. Bennett, F.R.I.C.S., 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. (until 31.8.1957) B. Fraser Beatson, M.R.C.S., L.R.C.P., D.P.H., D.T.M. & H. (from 18.12.1957) 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) (b) 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, 1957. VITAL STATISTICS The fall in the birth rate continued, and at 11.7 per 1,000 of the population (after correction for differences in the age distribution of the District from the national average) remained well below the average rate for England and Wales (16.1). There was a small increase in the death rate, due mainly to coronary disease, vascular diseases of the nervous system and cancer of the lung and bronchus—although deaths from cancer of other sites were less. At the request of the Ministry of Health, the attention of the Council has been drawn to the Medical Research Council's statement on the causal relationship between the smoking of tobacco and lung cancer. I have advised the Council that although the alleged causal relationship is still controversial, it would be wrong to keep silent pending more conclusive evidence on the matter. On this basis, the Council authorised me to warn the public by means of posters and through the medium of the press that there are very strong reasons for believing that smokers—particularly of cigarettes—run a greater risk of lung cancer than non-smokers. Certainly, this is again borne out this year by local experience as the Chest Physician at St. Margaret's Hospital, Epping (Dr. I. V. Lutwyche) reports: "of the 12 cases of lung cancer diagnosed in 1957— 1 habitually smoked 60 cigarettes daily 3 habitually smoked 40 cigarettes daily 2 habitually smoked 30 cigarettes daily 2 habitually smoked 20 cigarettes daily 2 habitually smoked 15 cigarettes daily 1 was a pipe smoker (quantity not known). 1 no information available 12 Total. INFECTIOUS DISEASES There was a mild outbreak of measles in the Spring. In November, the epidemic of influenza which had been spreading 2 throughout the country arrived in this District, but the illness was fortunately mild and short-lived, in most cases. The epidemic was probably responsible for most of the 34 notifications of primary acute pneumonia received. Dysentery amongst schoolchildren was again troublesome, though also mild. Recent experience suggests that the rigid segregation of healthy carriers—a difficult and wasteful procedure—has had little effect in controlling the spread of this disease. A tightening up of personal hygiene among the population in general—and especially the patient teaching and supervision of hand washing of children after visiting the toilet —are measures which are much more likely to prevent these outbreaks from continuing. Tuberculosis, though now declining, is in my opinion, by far the most pressing public health problem of the moment. It is no matter for complacency that this disease, whose cause and mode of spread have been known for the past seventy years, is still permitted to infect 50,000 new victims in the United Kingdom each year through our failure to apply this knowledge effectively. It is officially estimated that no less than 350,000 names adorn the registers of our Chest Clinics at the present time, and that a further 75,000 untreated or undiagnosed cases form an "unknown infector pool", spreading the disease silently and effectively among their friends and work-mates. The significance of the "unknown infector pool" in this District can readily be seen from a glance at the results of the Mass Radiography Unit's visit in May (See also Section F of this report): Amongst the total of 4,726 persons who attended for Xray, 17 cases of tuberculosis requiring supervision or treatment were discovered, including 6 cases of active disease. Improved techniques in the use of Mass Radiography, tuberculin testing, vaccination and control of milk, are already having beneficial effects, but much remains to be done to bring the spread of tuberculosis under complete control, as has been done in the case of smallpox. It was with this objective in mind that I requested the Council to grant me leave to accept a scholarship from the Danish Government to study the methods in use in that country. I am grateful to all my employing authorities for their ready acceptance of this proposal. NEW LEGISLATION The Housing Act, 1957 came into force on 1st September, 1957. This is to some extent a consolidating Act, but does not cancel previous Housing Acts, though some parts of these are repealed. 3 SECTION 47 NATIONAL ASSISTANCE ACT, 1948 and NATIONAL ASSISTANCE (Amendment) ACT, 1951 8 cases have been under observation during the year. 4 of these were admitted to hospital, (one under a Court Order), 2 died in hospital, the four remaining cases have been kept under observation at home with a view to further action if necessary. SANITARY CONDITIONS In the report of the Chief Public Health Inspector it will be seen that the work of the Department continues to increase. 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 September, 1958. 4 SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA ChigweU Urban District Average England and Wales Area (in acres) 8,972 (14 sq. miles approx.) Civilian population (mid 1957) 60,420 Number of inhabited houses 16,609 Rateable Value £823,369 Sum represented by penny rate £3354 The rate in the pound for 1956-57 was 16/10 VITAL STATISTICS: Live Births Male Female Total Legitimate 365 377 742 Illegitimate 11 13 24 Total 766 Birth rate per 1,000 estimated resident population (corrected) 11.7 16.1 Still Births Male Female Total Legitimate 6 2 8 Illegitimate 0 1 1 Total 9 Rate per 1,000 (live and still births) 10.7 22.4 Deaths Male Female Total 215 203 418 Death rate per 1,000 estimated resident populations (corrected) 10.4 11.5 Deaths from pregnancy, childbirth and abortion 0 0.47* Deaths of infants under 1 year of age: Male Female Total Legitimate 6 12 18 Illegitimate 1 0 1 Total 19 Deaths of infants under 4 weeks of age: Male Female Total Legitimate 4 7 11 Illegitimate 1 0 1 Total 12 *per thousand total births. 5  Chigwell Urban District Average England and Wales Death rate of infants under 1 year of age: All infants per 1,000 live births 24.9 23.4 Death rate of infants under 4 weeks of age 15.7 16.5 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) 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 1957 11.7 24 24.9 10.4 60,420 6 Causes of Death as given by the Registrar General for the year 1957 Male Female Total Coronary disease, Angina 49 22 71 Other disease of heart and circulatory system 24 33 57 Leukaemia, aleukaemia 0 3 3 Cancer of lung and bronchus 23 4 27 Cancer, other than lung and bronchus 24 37 61 Vascular lesions of nervous system 19 42 61 Bronchitis 16 4 20 Pneumonia 8 12 20 Influenza 1 3 4 Other diseases of respiratory system 3 0 3 Disease of prostate 4 0 4 Tuberculosis, respiratory 4 4 8 Ulcer of duodenum or stomach 4 3 7 Congenital malformations 3 5 8 Nephritis and Nephrosis 3 1 4 All other diseases 19 22 41 Motor vehicle accidents 7 0 7 Other accidents 2 4 6 Suicides 2 4 6 215 203 418 Death rates per million population:— Chigwell Urban District Average England and Wales Tuberculosis of respiratory system 132 95 Cancer of lung and bronchus 447 426 Cancer of other organs 1,010 1,668 All causes 10,400 11,500 7 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 9222 2. Welfare: Mr. R. S. Potter, 35, Wanstead Place, E.l1 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. 8 (d) Child Welfare Centres: BUCKHURST HILL: Essex County Council Clinic, Buckhurst Way, Thursday at 2 p.m. (Diphtheria and Whooping Cough Immunisations are carried out on the 2nd Friday in the month at 2 p.m.) CHIGWELL: Village Hall, High Road, 1st Wednesday in the month at 2 p.m. (Weighing Centre—3rd Wednesday in the month at 2 p.m.) All Saints Church Hall, Chigwell Row, 2nd Thursday in the month at 2 p.m. (Weighing Centre). Essex County Council Health Services Clinic, Manford Way, Friday at 2 p.m. (Diphtheria and Whooping Cough Immunisations are carried out on the 1st Wednesday in the month). 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 Immunisations are carried out on the 1st Tuesday in the month). There were 13,356 attendances at child welfare centres during the year of which 9,885 were under 1 year of age. (e) Ante-Natal and Post-Natal Clinics: BUCKHURST HILL: Essex County Council Clinic, Buckhurst Way, Friday, 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 1,764. There were 37 post-natal attendances. 9 (f) Relaxation Classes: BUCKHURST HILL: Essex County Council Clinic, Tuesday at 10.30 a.m., and Friday at 2.30 p.m. (by appointment only). CHIGWELL: Essex County Council Health Services Clinic, Manford Way, Tuesday at 2 p.m. (by appointment only). LOUGHTON: Essex County Council Health Services Clinic, Loughton Hall, Tuesday at 2 p.m. (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 256 attendances during the year. (h) School Clinics: CHIGWELL: Essex County Council Health Services Clinic, Manford Way, alternate Thursdays at 10 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). 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 Hall (by appointment only). (k) Establishments for Massage or Special Treatment: The following establishments are licensed under the Essex County Council Act, 1933:— Mr. D. F. Beaton, 50 Church Hill, Loughton. Mrs. J. M. Burt, 6 Knighton Lane, Buckhurst Hill. Mr. A. C. Hallard, 4 Algers Boad, Loughton Miss E. Mackern, 45 Church Hill, Loughton. These premises have been inspected and are being conducted in a satisfactory manner. The following Clinics are held under arrangements with the Begional Hospital Board:— (l) 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). 11 (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: Mrs. J. A. H. Thomas, Essex County Council Clinic, Buckhurst Way (Buckhurst 5180). Miss G. S. O. Whitmore do. CHIGWELL: Mrs. E. Fisk, Essex County Council Health Services Clinic, Manford Way (Hainault 3143). Miss V. L. Gardiner do. LOUGHTON: Miss E. Goodchild, Essex County Council Health Services Clinic, Loughton Hall (Loughton 5222). Miss E. Kenny do. Miss K. E. W. Ward do. Health Visitors made 2044 first visits during the year and 9,414 re-visits. 12 (q) Tuberculosis Health Visitor: Miss M. Hill, Chest Clinic, St. Margaret's Hospital, Epping. (Epping 2224). (r) Home Nurses: BUCKHURST HILL: Miss F. M. Botell, 126 Queens Road (Buckhurst 1331). Mr. H. Jestice, 11 Rous Road (Buckhurst 7249). Mrs. W. Jestice do. do. CHIGWELL: Miss K. M. Proctor, 64 The Lowe (Hainault 3110). Miss J. Skoyles, 9 Coppice Path (Hainault 2108). LOUGHTON: Miss J. Gardner, 20 Crescent View (Loughton 4500). Miss M. Hoather, 46 The Crescent, (Loughton 4815). Mrs. J. P. Sutton, 29 Rochford Avenue (Loughton 5666). Home Nurses made 24,350 visits during the year. (s) Midwives: BUCKHURST HILL: Miss N. Tomlinson, 40 Chestnut Avenue, (Buckhurst 6371). CHIGWELL: Miss J. Skoyles, 9 Coppice Path (Hainault 2108). Miss K. M. Proctor, 64 The Lowe (Hainault 3110). LOUGHTON: Miss M. Sibthorpe, 85 Grosvenor Drive (Loughton 1879). Mrs. S. Camp, 100 Borders Lane (Loughton 4644). Miss J. Story, 31 Rochford Avenue (Loughton 5878). Midwives conducted 260 confinements in the District during the year and attended a further 33 maternity cases. (t) Home Help Organisers: Mrs. J. M. Loveless (Chigwell area) 93 High Road, Woodford E.18 (Buckhurst 9222). Mrs. M. Webb (Buckhurst Hill and Loughton areas), 93 High Road, Woodford, E.18. (Buckhurst 9222). 13 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 16,609 and the estimated population at mid-year was 60,420. Five samples of water were taken during the year and the report was satisfactory in each case. (ii) Drainage and Sewerage Soil drainage from the greater part of the District is by gravity to the main disposal works at Luxborough where there is modern plant constructed in 1938 and considerably enlarged in the immediate post-war years. Further development and increasing water consumption necessitate additional extensions for which a major scheme has been submitted to the Ministry. Due to financial restrictions, approval in principle has only so far been given to the construction of more primary sludge digesters. The works operate reasonably well and produce a fair effluent. Consideration is being given to extra treatment of final effluent to raise the standard of purity. There is one small subsidiary works at Milters Lane which was modernised after the war, and produces a consistently good effluent. One small area drains to the sewers of the Wanstead and Woodford District, and thence to Chingford and the East Middlesex scheme. Most of the Hainault Estate drains to the sewers of the Dagenham district and to that Authority's disposal works. There are four out-lying pumping stations lifting the flow from the low-lying areas up to the main gravity sewers. There is a separate system of drainage in the District except for the older parts where a number of combined sewers still exist. 14 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-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. 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 35 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 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 cu. 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, a charge related to actual cost being made for this service. 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. Salvage of paper and rags produced sales during the year of 490 tons. 15 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 180 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 Public Health Inspectors is shown below:— Complaints received and dealt with 862 Inspections and visits 7,519 Nuisances abated 409 Informal Notices served 44 Informal Notices complied with 55 Statutory Notices served 13 Statutory Notices complied with 16 Legal Proceedings 2 16 Summary of Nuisances Cesspools, overflowing 3 Drains blocked or defective 151 Defective water closets 15 Defective Water Supply pipes 8 Nuisances from animals and birds 20 Polluted ditches, watercourses and ponds 12 Accumulation of refuse and defective dustbins 47 Vermin (bugs and fleas) 1 Cellars flooded 5 Insect infestations 49 Bees, wasps and hornets 77 Air pollution 21 (iv) Verminous Premises Three houses were reported upon during the year as being verminous. On inspection, two were found not to be infested with vermin and one was doubtful. This one was fumigated with Fumite; it was a private residence, also it was vacant at the time. The improvements in the number of houses found to be verminuos continues as reference to the following figures shows:— Number of houses found to be verminous:— 1951 19 1955 4 1952 12 1956 4 19.53 8 1957 1 1954 8 No. of Visits: 4 17 RODENT CONTROL PREVENTION OF DAMAGE BY PESTS ACT, 1949 2,010 inspections and visits were made in 1957, as against 1,080 in 1956. Yearly figures since the passing of the Act were:— 1955 1,548 1951 1,924 1954 1,308 1950 2,020 1953 1,388 1949 1,833 1952 2,011 It will therefore be seen that the 1956 figure of 1,080 was the lowest, and there has undoubtedly been an increase in the notifications received this year from the general public. The cause of the increase may have been the mild winter of last year. Warfarin is now almost solely used and the results obtained are excellent. Treatment of the Council's soil and surface water sewers was done as usual with the following results:— March, 1957 October, 1957 Manholes baited 219 195 Poison part-takes 57 7 Poison complete takes 7 35 Specially blended oily Warfarin was used for both treatments. The March figures show 29% takes, whilst in October the figure is a little less at 21%, A rather surprising feature is the number of complete takes in October which I think emphasises the palatibility of the Warfarin. 18 SECTION D HOUSING STATISTICS FOR THE YEAR 1957 Number of new houses erected and occupied during the year: Permanent Houses:— London County Council 5 Chigwell Urban District Council 78 Private Owners 230 313 Inspection of Dwelling Houses during the year:— 1 (a) Total number of dwelling houses inspected for housing defects (under Public Health and Housing Acts) 658 (b) Number of visits made for the purpose 547 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 35 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 76 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 71 Action under Statutory Powers during the year:— (a) Proceedings under Sections 9, 10, 12 and 16 of Housing Acts, 1936 and 1957: (1) Number of dwelling houses in respect of which notices were served requiring repairs 4 (2) Number of dwelling houses which were rendered fit after service of Formal Notice by: — (a) Owners 3 (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 8 (2) Number of dwelling houses in which defects were remedied after service of Formal Notices by: — (a) Owners 6 (b) Local Authority in default of owners Nil (c) Proceedings under Sections 11, 13, 16 and 25 of 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) Number of houses or parts of houses closed under:— (1) Sections 12 and 18 of the Housing Acts, 1936 and 1957 Nil (2) Section 10 of the Local Government (Miscellaneous Provisions) Act, 1953 Nil (e) Informal Action:— Number of dwelling houses demolished as result of informal action Nil Note: The Housing Act, 1957 came into force on 1st September, 1957. 20 Re-Housing Priority on Medical Grounds 95 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 24 9 15 Heart disease 9 3 6 Nervous disease (anxiety states, neurasthenia, Neurosis, etc. 27 8 19 Rheumatism 5 2 3 Tuberculosis 5 4 1 Other diseases 25 3 22 95 29 66 Figures for 1953 were 46 22 24 Figures for 1954 were 68 18 50 Figures for 1955 were 100 25 75 Figures for 1956 were 89 26 63 The 66 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 46 W.C.'s 10 „ Flushing Cisterns 8 „ Sinks and waste pipes 5 „ Sash cords 10 Walls 8 „ Gutters and rainwater pipes 14 „ Yard Paving 3 „ Windows 16 „ Drainage and vent pipes 8 „ Gullies 9 „ Internal Walls (plaster) 36 „ Ceilings 26 „ Water Fittings and pipes 6 „ Flooring 10 „ External Walls 14 „ Stoves, boilers and fireplaces 18 „ Dustbins 14 „ Doors 12 Dampness 20 Under floor ventilation lack of 8 Dirty Walls and Ceilings 10 Redecoration after repair 12 22 SECTION E. INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply: The Urban District is a specified area under the provisions of the Food and Drugs Act, 1955, which lays down that only Designated milk may be sold. 18 samples of milk have been taken during the year and all were reported upon by the Public Analyst as genuine. 15 dairies and milk shops are registered. 8 licences have been issued to firms with premises outside the District to sell 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 233 59 40 329 309 Number inspected 233 59 40 329 309 ALL DISEASES EXCEPT TUBERCULOSIS Whole carcases condemned - - - - - Carcases of which some part or organ was condemned 12 12 - - 3 Percentage of the number inspected affected with disease other than tuberculosis 5.15 20.33 - - 96 23  Cattle excluding Cows Cows Calves Sheep & Lambs Pigs TUBERCULOSIS ONLY Whole carcases condemned - - - - - Carcases of which some part or organ was condemned 3 2 1 - - Percentage of the number inspected affected with tuberculosis 1.28 3 39 2.50 - - Details of meat condemned:— BOVINES:— Tuberculosis 1 head 24 lbs. 3 lungs 33 lbs. 1 forequarter 30 lbs. Nephritis 2 kidneys 8 lbs. Abscesses 1 part liver 4 lbs. Fasciolasis 20 livers and part livers 292 lbs. Actinobacillosis 1 tongue 6 lbs. CALVES:— Tuberculosis 1 lung 6 lbs. PIGS:— Percarditis and pleurisy 1 pluck 6 lbs. Pleurisy 1 lung 5 lbs. Pneumonia 1 lung 6 lbs. Assistance in meat inspection is no longer afforded to the Waltham Holy Cross Urban District as an additional Public Health Inspector has been appointed. There are 30 butchers shops in the district. 42 visits were made. 7 licences to deal in game have been granted. (c) Food Condemned. The foodstuffs listed below were found on inspection to be unfit for human consumpion. Some have been disposed of for animal food and the rest destroyed. 24 FISH Cod, lbs. 28 Rock Lobster, tins 46 Crawfish, tins 1 Salmon, tins 1 Dogfish, lbs. 21 Sardines, tins 1 Lobster spread, tins 1 Shrimps, tins 5 Pilchards ,tins 5 Sild, tins 2 Plaice, lbs. 33 Skate, lbs. 28 Rock eel, lbs. 28 TOTALS: 1954 1955 1956 1957 Tins, etc 25 27 22 62 lbs. 29 145 126 138 The total amount condemned shows an increase over previous years. FRUIT Apricots, tins 51 Pears, tins 41 Apricot jam, tins 1 Pineapple, tins 51 Blackcurrant jam, tins 1 Plums, 101b. tin 1 Cherries, tins 5 Plums, dried, lbs. 6½ Fruit Salad, tins 8 Plums, golden, tins 1 Grapefruit tins 6 Plums red, tins 5 Marmalade, tins 2 Rhubarb, tins 1 Oranges, tins 30 Strawberry jam, tins Peaches, tins 39 and jars 5 TOTALS 1954 1955 1956 1957 Tins, etc 163 174 153 247 lbs. 59 9 36 16½ The 1957 figure shows an increase. MEAT Bacon, shoulder (22 tins) Ham, 4 tins, lbs. 57¼ lbs. 166 Meat pudding, tins 1 Beef, lbs. 289 Ox kidneys, lbs. 14 Beef, corned, 12oz. tins 6 Pork luncheon meat, tins 8 Beef, corned, 6 lbs. tins 3 Pork shoulder, 1 tin, lbs. 12 Beef loaf, tins 1 Steak, tins 6 Beef minced, tins 1 Veal, tins 1 Beef steak & kidney, tins 1 Ham, lbs. 27 TOTALS 1954 1955 1956 1957 Tins, etc. 59 107 49 25 lbs. 950½ 587 1060 583¼ There is a decrease in the amount of meat condemned this year. 25 VEGETABLES Beans, baked, tins 16 Carrots, dried, lbs. 80 Beans, broad, tins 1 (8x10 lbs. tins) Beans, French, tins 3 Mixed vegetables, dried, Beans, runner, tins 1 (3x12 lbs. tins) lbs. 36 Cabbage dried, lbs. Onions dried, lbs. 6 (8x8½ lbs. tins) 68 (1x6 lbs. tin Carrots, tins 4 Onions, pickled, jars 1 Peas, tins 19 Tomatoes, tins 51 TOTALS 1954 1955 1956 1957 Tins, etc. 1ll 476 69 97 lbs. — 336 56 190 The 1957 figures again show an increase OTHER ITEMS Cream, tins 1 Salmon mayonnaise, Jellies, jars 2 tubes 1 Jellies, packets 2 Sandwich spread, jars 6 Milk condensed, tins 1 Spaghetti, tins 2 Milk evaporated, tins 26 Soup, tins 4 Pease pudding, tins 1 Tartex, tins 1 Relish, jars 1 Vinegar, bottles 16 TOTALS 1954 1955 1956 1957 Eggs, lbs. 20 11 42 — Milk tins 77 70 35 27 Tins, etc. 73 172 808 37 lbs. 29 28 465 — There is a very marked decrease in articles condemned under this heading. (d) Food Complaints 27 complaints of food being unfit for human consumption were received as against 31 last year. The foods complained of were:— Bacon 2 Biscuits 1 Bread 10 Chocolate 1 Kippers 1 Meat Faggots 1 Milk 7 Mineral Water 1 Peas, canned 1 Sausage Rolls 1 Strawberries 1 25 Legal action was taken in two instances:— Mineral Water contaminated with Phenol Disinfectant: Manufacturers fined £3 and costs £4. 4. 0d. Baker fined £3 with costs of £2 2. 0d. legal fees and costs of £2 for cigarette end in loaf of bread. All complaints were investigated and ten samples were sent to the Public Analyst for report. Three adverse reports were received, all resulting in legal action of which two are pending. (e) Bakeries There are 15 bakehouses in the District, 8 in present use, the other 7 being closed. 2 new bakehouses are proposed, one for London Co-operative Society Ltd., which is in the course of construction and alteration of existing buildings and the other is to be opened at The Broadway. (f) Chemical and Bacteriological Examination of Food & Drugs The following is a list of items submitted to the Public Analyst in 1957:— Beef Suet 1 Genuine Biscottes 1 (1) Biscuits 1 Genuine Blackcurrant Jam 1 „ Bramble Jelly 1 „ Bread 1 „ Butter 1 „ Butter Brazils 1 Genuine Cheese Spread 1 „ Chicken Spread 1 „ Chocolate Spread 1 „ Coffee and Chicory 1 „ Crab Dressed 1 „ Cream 5 „ Energen Fruit Product 1 (2) Fat Cooking 1 Genuine Flour Plain 2 „ Fruit Mixed 1 „ Gravy Powder 1 „ Ice Cream 7 „ Lactochoc 1 „ Lemon Juice 1 „ Linseed and Liquorice Lozenge 1 (3) Margarine 1 Genuine Milk 18 „ 27 Milk Condensed 1 „ Milo Food Drink 1 „ Oranges 1 „ Orange Drink 1 „ Robinade Drink 1 „ Roselle Mixture 1 „ Rusks, Farleys 1 „ Salmon and Shrimp Paste 1 „ Sponge Mixture 2 „ Soups 2 „ Tea Cake Mixture 1 „ Tizer Mineral Water 1 (4) Vinegar 1 (5) Vitacup 1 Genuine Whisky 1 „ Comments on items marked (1) to (5):— (1) Biscottes The Public Analyst when examining this sample found that the formula on the package did not agree with his own findings. It was eventually agreed that the description of the contents on the container was not obligatory. (2) Energen Fruit Products In the Public Analyst's opinion this article should conform to standards laid down for jam, but after considerable correspondence, the Ministry of Agriculture, Fisheries and Food intimated that this was not necessary. (3) Linseed and Liquorice Lozenges The Analyst found a deficiency in the amount of chloroform contained in the lozenges. As this is a volatile material it is difficult to keep to a stated standard and it was agreed that future supplies would be labelled as containing an approximate amount of this drug. (4) Tizer Mineral Water This sample was found to contain an appreciable amount of Phenol. Legal action was taken at Epping on 2nd August, 1957, the manufacturers being fined £3 and £4 4s. Od. costs. (5) Vinegar 38 bottles of vinegar were found to contain a round hard solid mass known in the trade as "Mother." All the bottles were withdrawn from sale. 28 (g) Adulteration No cases were reported or found during the year. (h) Ice Cream 26 visits were made to manufacturers and vendors of ice cream during the year. There are 6 manufacturers and 88 vendors on the register. One manufacturer only now makes ice cream in the district. The following results were obtained on samples of ice cream:— Manufactured in the District: Ice Cream: Excellent Grade I 1 Lollies: Excellent — 3 Very satisfactory — 2 Fair — 1 Manufactured outside the District: Ice Cream: Excellent Grade I 4 Very Satisfactory Grade I 1 Lollies: Excellent — 1 Very satisfactory — 4 All samples were taken by hand to the Counties Public Health Laboratories at 66, Victoria Street, London, within three hours of being obtained. The reports are very good this year. 7 samples, in addition, were taken for chemical analysis and all were 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 4 Bakers 22 5 Greengrocers 31 7 Fishmongers 13 5 Butchers 31 20 Grocery, Provision and General Stores 53 30 Sweet Shops 34 7 Dairies and Milkshops 15 3 Licensed Premises (including Off Licences 40 5 262 86 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 42 Premises in which Ice-Cream is sold 21 Dairies and Milkshops 3 66 (c) Number of visits made to registered food premises:— Butchers 28 Premises in which Ice-Cream is sold 19 Dairies and Milkshops 1 48 (d) Number of visits made to premises under the Food Hygiene Regulations 408. (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) Factories, Shops, etc. (a) Factories and Workplaces. 139 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. One certificate has been issued during the year. (b) Outworkers: 250 visits have been made. (c) Shops Act: 71 visits have been made. 30 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 or occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authority 6 9 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 89 162 2 (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 16 16 - - Total: 111 187 2 32 SECTION 47, NATIONAL ASSISTANCE ACT. 1948 and FACTORIES ACT, 1937 2. CASES IN WHICH DEFECTS WERE FOUND Premises Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of cleanliness (S.l.) 7 6 - 2 - 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 2 2 — — (c) Not separate for sexes — — — — Other offences against the Act (not including offences relating to Outwork) 1 - 1 - - Total: 10 8 1 2 - RIDING ESTABLISHMENT ACT, 1939 The annual report of the veterinary officer is as follows:— "I have pleasure to report that the quarterly inspections of Riding Establishments, under the control of your authority, were carried out during the year ended 31st December, 1957. The inspections, whilst being made in each quarter of the year, were made at irregular periods and at varying times without prior notice to the owners, special attention being given to those times when the Riding Schools were anticipated to be busy, such as during school holidays and on Saturdays and Sundays in some instances. Conditions were generally satisfactory although in one case the management deteriorated to such an extent that one became rather apprehensive, as the premises were under the control of a minor. Fortunately, this was corrected towards the end of the year when an experienced person took over the Riding School and conditions materially improved as a result. During the year under review, a new but small riding school was opened at the Paddock Stables adjoining the Country Club at Chigwell Row, but this has since closed. Below is set out the Riding Schools operating during the year with the owners or persons in charge and the average number of horses on each premises:— Nightingale Riding School, Buckhurst Hill Mr. T. Robinson, 74 Field Road, Forest Gate 12 horses plus 4 horses at livery. Buckhurst Riding School Miss du Barry—resides adjacent. 7 plus 2 at livery. Braeside, Connaught Avenue, Loughton Mrs. Westby, 120 Hillyfields, Loughton 5 plus 5 at livery. J. & B. Stables removed from Chigwell Row to Winters Farm, The Limes, Manor Road Miss Joyce Noble, The Tea Rooms, Lambourne Road and Mr. W. M. Scanes, 32 Ichneild Drive, Ilford 10 riding horses and 6 colts. The Paddock Stables, Near Country Club, Grove Lane Chigwell Mr. J. W. Jarvis, 24 May Cottage, Gravel Lane 4 horses plus 6 at livery. Forest Riding School, Chigwell Row. Miss M. Isles, 37 Cleve Walk, Barkingside. 11 horses plus 4 at livery. Signed: H. E. BYWATERS." 33 Summary of Public Health Inspectors' visits during the year ended 31st December, 1957 General Sanitation Water Supply/Swimming Pools 13 Drainage 353 Fried Fish Shops 13 Tents, Vans and Sheds 6 Pests, other than Rats and Mice 213 Factories 139 Workplaces 3 Outworkers 250 Bakehouses 39 Licensed Premises 20 Refuse Collection 10 Refuse Disposal 9 Rats and Mice 2,010 Atmospheric Pollution 57 Schools 1 Shops 71 Knackers Yard 113 Petrol 58 Agricultural Act 3 Miscellaneous Sanitary Visits 721 4,102 Housing Under Public Health Acts: Number of houses inspected 471 Visits paid to above houses 463 Under Housing Acts: Number of houses inspected 187 Visits paid to above houses 84 Filthy and Verminous Premises: Visits paid to above houses 4 Miscellaneous Housing Visits 565 Rent Act, 1957 68 1,842 34 Infectious Disease Inquiries in cases of infectious disease 139 Miscellaneous Infectious Disease visits 292 431 Meat and Food Inspection Visits to:— Slaughterhouses 255 Butchers 42 Canteens 17 Dairies and Milk Distributors 3 Fishmongers and Poulterers 16 Grocers 55 Greengrocers and Fruiterers 24 Ice Cream Premises 21 Restaurants 33 Sampling: Milk-Bacteriological 1 Ice Cream 26 Food and Drugs 36 Food Hygiene Guild 2 Food Hygiene Regulations 406 Miscellaneous Food Visits 207 1,144 7,519 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 35 SECTION F PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES (See also pages 2 & 3 ) No of Cases Admission to Hospitals Deaths Acute Encephalitis Post Infective 1 1 Acute Poliomyelitis Paralytic 3 3 Non-paralytic 1 1 Actue Primary Pneumonia 34 5 Dysentery 40 5 Erysipelas 3 — Food Poisoning 10 1 Meningococcal Infection 1 — Measles 1040 11 Puerperal Pyrexia 1 1 Scarlet Fever 51 1 Tuberculosis Respiratory 32 8 8 Meninges and C.N.S. — — — Others 4 1 — Whooping Cough 38 2 1,259 40 8 Tuberculosis 36 new cases. of tuberculosis were notified among residents in the District during the year, with the following distribution: Respiratory Non-Respiratory L.C.C. Debden Estate 17 1 Old Loughton 7 1 L.C.C. Hainault Estate 3 1 Chigwell (excl. L.C.C. estate) 4 0 Buckhurst Hill 1 1 32 4 In addition, notifications in respect of 33 cases transferred into the District were received, of which no less than 25 were new arrivals on the L.C.C. estates (i.e. Debden 13, Hainault 12). The statutory obligation of the M.O.H. to keep a Register of Tuberculosis cases ceased in 1952, since when greater reliance has been placed by the Ministry of Health on the Registers and returns of Chest Clinics. The latter do not, however, give an accurate picture of the local situation, as many local residents travel some distance from their homes for treatment at clinics in other areas— either because they used to reside elsewhere, or work elsewhere, or for private reasons. I have therefore attempted to maintain our own register by regular follow-up and checking at clinics and hospitals as far as possible, and although I cannot guarantee its accuracy it contains the names and number of persons who are believed to be living in the district and receiving treatment or supervision for tuberculosis at some hospital or clinic. It must be clearly pointed out, of course, that by no means all of these persons are a source of possible infection to others: some are isolated in bed or hospital; most are infective only occasionally or intermittently, and have been thoroughly instructed on the measures they should adopt to limit the risk of spread. Nevertheless, the problem is a serious one and particularly so by reason of the undoubted existence of persons capable of spreading the infection who are not under supervision or treatment—the so-called "unknown infector pool" of undiscovered cases and defaulters 37 The community's best means of protection against these are:— 1 Good living conditions. 2 A high standard of hygiene 3 Mass Radiography 4 Vaccination. Mass Radiography At my request, the Unit visited the District in May, 1957, following which the organising secretary wrote as follows:— "I am writing to let you know the figures for the Loughton and Debden Estate Mass Radiography survey. At the Crown Hotel, Loughton we X-rayed a total of 1395 Bank of England Debden Estate 918 Hillyfields, Debden Estate 311 Golden Lion, Borders Lane, Debden Estate 498 The Broadway, Debden Estate 1095 making a total for the Loughton survey of 4,217 At Buckhurst Hill we X-rayed 509 on the 30th May. I think you will agree that all these figures are most satisfactory. I would like to take this opportunity to thank you and your department most sincerely for all your did to help us in the arrangements and in publicising our visit." The following is an analysis of the results of the survey: 38 39 Pulmonary Tuberculosis Address Number Examine Recalled for large film Recalled for Clinical Interview Did not attend for large film or interview Carcinoma of Bronchus Presumed Healed Occasional Clinic Supervision Requiring immediate treatment Cardiovascular lesions Other Abnormalities Crown Hotel, Loughton 1395 30 17 0 1 7 4 0 0 5 Hillyfields, Loughton 311 8 6 0 1 1 0 0 1 2 Golden Lion, Debden 498 4 2 0 1 1 1 0 0 0 Broadway, Debden 1095 29 16 2 0 6 3 4 1 5 Bank of England (Printing Works) Debden 918 15 4 0 0 1 1 0 0 2 Buckhurst Hill 509 9 2 0 0 2 2 0 2 0 4,726 95 47 2 3 18 11 6 4 14 It will be seen that three cases of cancer, 4 cardiovascular lesions, and 14 other abnormalities were discovered, in addition to 17 cases of tuberculosis requiring supervision or treatment, and 18 presumed healed. Vaccination and Immunisation Schemes: 1. Tuberculosis (B.C.G.) Vaccination against tuberculosis was offered to all children aged 13 years. The acceptance rate of this offer was 66.97%. Number of school children to whom B.C.G. Vaccination was offered 884 Number of school children undergoing tuberculin test after parents' consent had been received 592 Number of school children who received B.C.G 514 Number of cases of post-vaccination complications reported on Form B.C.G.8 Nil 2. Smallpox 906 primary vaccinations were performed and 411 persons were re-vaccinated during the year. This is an increase on the previous year's figures of 317 and 243 respectively. 3. Diphtheria 727 children completed a course of diphtheria immunisation during the year. 484 re-inforcing injections were also administered. 4. Whooping Cough 353 children completed a course of immunisation against whooping cough. 5. Poliomyelitis 2,575 children completed a course of immunisation against Poliomyelitis. 40 APPENDIX RAINFALL IN INCHES FOR MONTHS 1957 Metropolitan High Beech Water Board Buckhurst Hill Chigwell Luxborough S.D. Works U.D.C. Loughton Depot January 1.55 1.49 1.19 1.36 February 2.99 3.06 2.92 2.94 March 1.18 1.26 0.84 1.21 April 0.16 0.24 0.09 .25 May 0.76 1.25 0.90 1.49 June 0.79 0.82 0.89 .89 July 3.17 3.77 3.81 3.40 August 2.30 1.90 1.56 2.01 September 2.62 2.40 2.11 2.36 October 1.99 1.96 1.59 1.83 November 2.26 2.07 2.13 1.97 December 1.86 1.66 1.43 1.64 21.63 21.88 19.46 21.35 AVERAGE RAINFALL FOR THE LAST FIVE YEARS 1953 — 20.81 1954 — 25.44 1955 — 21.44 1956 — 25.10 1957 — 21.08 The highest point in the district is 372 O.D. and the lowest 44 O.D. Hickman, Printers. Louehton