I 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 31st DECEMBER, 1967. 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 31st DECEMBER, 1967. CHIGWELL URBAN DISTRICT COUNCIL Chairman of the Council: Councillor R.W. Spurge,F.R.I.C.S. Vice-Chairman of the Council: Councillor A.H. Swallow PUBLIC HEALTH COMMITTEE Chairman: Councillor N.T.H. Croucher Members: Councillor G.P. Claridge Mrs. H.H. Clark C.T. Davie L.A. Davis F.W.J. Kenward N.P. Risdon L.A. Welch The Chairman and Vice-Chairman of the Council, ex-officio. PUBLIC HEALTH STAFF: Medical Officer of Health (Part-time): H. FRANKS, M.B.,B.S.,D.P.H.,B.Hy. (Tel: 01-508-3871). Deputy Medical Officer of Health (Stand-by): B. ERASER BEATSON, M.R.C.S.,L.R.C.P.,D.P.H.,D.T.M., & H. (Tel: Brentwood 990). Chief Public Health Inspector and Petroleum Inspector: R. ROPER, F.R.S.H.,M.A.P.H.I. (a) (b) (c) (d). Deputy Chief Public Health Inspector: A.R. COOK, M.A.P.H.I, (a) (b) (c). Public Health Inspectors: F.W. REEVE, M.A.P.H.I. (a) (b). R.P. STEVENS, (a) (b). Student Public Health Inspectors: C. WEBB J. GIBBS (From 11.9.67). T. SALWAY (From 18.9.67). Chief Clerk: MISS J. WARRINER. Clerk: MISS B. SAMWAYS. (a) Royal Society of Health and Sanitary Inspectors Examination Joint Board Certificate. (b) Royal Society of Health Certificate as Inspector of Meat and Other Foods. (c) Royal Society of Health Smoke Inspectors' Certificate. (d) Royal Society of Health Sanitary Science Certificate. -2- To the Chairman and Members of the Chigwell Urban District Council THE CHAIRMAN AND MEMBERS, I have pleasure in presenting the Annual Report of the Medical Officer of Health for the year 1967, which includes the Annual Report of the Chief Public Health Inspector. This report is compiled in accordance with the Public Health Regulations 1959 and Ministry of Health Circular 1/68. The main new development of benefit to the health of the District has been the opening of the Council's Loughton Swimming Pool, which is being extensively used and much appreciated in all seasons. In August, 1967, the Children's Department of the Essex County Council introduced sessions at Loughton Hall at which advice, guidance and assistance can be obtained from the Child Care Officer. An Adult Training Centre for the mentally handicapped was established by the Essex County Council at St, Gabriel's Church Hall, Grosvenor Drive, Loughton. Children who previously attended the Junior Training Centre for the mentally handicapped at the above premises were transferred to the more modern centre at Harlow. Also during the year, Toc H introduced a scheme whereby emergency warning window lights are being installed in the homes of aged and incapacitated persons living alone. So far, about 70 homes have been so equipped. Health Education was continued as opportunities arose, and in particular, talks and demonstrations on various aspects of public health and on the work of the department have been given to parents, teachers and children in schools and to students engaged in social studies. I received a report which suggested that the test in general use for estimating chlorine in swinming pools (Ortho-tolidine Test) could be potentially dangerous to persons carrying out the tests. Further enquiries from The Chester Beatty Research Institute (Royal Cancer Hospital) confirmed the validity of the report. Steps were therefore taken to withdraw the test from use locally, and to substitute a safe alternative (D.P.D. test). The Society of Medical Officers of Health were also informed, so that the matter could receive attention in other districts. VITAL -3- VITAL STATISTICS The health of the population continues to be satisfactory. The standardised birth-rate for the District (12.1 per 1000) has again fallen, and continues to be considerably less then the comparable rate for the United Kingdom (17,2 per 1000). Due allowance is made in these figures for local differences in age and sex distribution from the national average. The standardised death rate of the District (10.9 per 1000) was slightly less than last year (11,2), and less than the comparable rate for the United Kingdom, which was also 11.2. There were only 2 infant deaths under 1 year of age, and 3 still-births, both of these figures being considerably less than the national averages. Again, for the third year running, there have been no maternal deaths from pregnancy, childbirth or abortion, The number of fatal motor vehicle accidents was 5 as compared with 9 in the previous year. There were 8 deaths from other accidental causes (10 last year) including 1 industrial injury and 3 associated with advanced disease in aged persons. control of infectious diseases Small, mild outbreaks of dysentery occurred in 3 schools, and in isolated family groups, amounting in all to 44 confirmed cases throughout the year. Small outbreaks of diarrhoea and sickness were also reported at 2 Essex County Welfare Department Homes for the Elderly - Beechlands (12 cases) and Ardmore (12 cases). These were very fully investigated and at Beechlands a prevalent virus infection was thought to be responsible, whilst at Ardmore a bacterial culture from food remnants (Staphylococcus Aureus) suggested the possibility of contamination from a small boil which had been observed on the face of one of the kitchen staff a few days previously. These incidents serve to emphasize once more the extreme importance of maintaining the highest standards of personal hygiene and regular hand washing in all canteens where food is distributed to children or old persons, who are particularly susceptible to infections. There was also a fairly widespread, though mild, measles outbreak, comprising 371 cases, of which, however, only 2 required to be admitted to hospital. Plans are now well advanced to offer free immunisation against measles under the National Health Service, to all susceptible children up to the age of 15, and there are good prospects that within the next few years the widespread nuisance, and occasional grave complications of this disease, may be removed from our midst. /Immunisations -4- Imnunisations against diphtheria, whooping cough, tetanus, poliomyelitis, smallpox and tuberculosis have continued as before, with satisfactory results: Notifications of all these diseases amounted to only 37 whooping cough and 6 tuberculosis; admissions to hospital 6j deaths 3, which were all cases of tuberculosis. RE-HOUSING PRIORITY ON MEDICAL GROUNDS 111 requests for priority for re-housing on medical grounds were referred to me for assessment, usually supported by a doctor's written certificate. Each case was fully investigated and my recommendations were as follows:- Diseases or Conditions Total Applicants Priority Recommended Priority Not recommended Asthma, bronchitis, catarrhal diseases etc. 20 10 10 Blood pressure 2 2 0 Heart disease 15 11 4 Nervous disease (anxiety states, neurasthenia, neurosis etc,) 31 13 18 Rheumatism 8 8 0 Tuberculosis 4 4 0 Other diseases 6 3 3 Other conditions 25 10 15 111 61 50 Figures for 1963 were 110 34 76 „ „ 1964 „ 113 49 64 „ „ 1965 „ 89 46 43 „ „ 1966 „ 90 46 44 The 50 applicants not recommended for medical priority include (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. -5- /SECTION SECTION 47, NATIONAL ASSISTANCE ACT, 1948, AND NATIONAL ASSISTANCE (AMENDMENT) ACT, 1951 and 1962 Once again, no formal action was considered necessary during the year. 12 persons in possible need of care and attention were investigated. 3 cases were voluntarily removed to appropriate accommodation, either in hospitals or homes for the elderly. The remainder were kept under observation at home with the services of the district nurse, home help, meals-on-wheels and other services, as necessary. MEDICAL EXAMINATION OF STAFF I examined 34 officers and staff of the Chigwell Urban District Council and 6 officers and staff of the Essex County Council on appointment for duties in the District; also 6 Chigwell Urban District Council staff were assessed and reported on for sick-pay and superannuation purposes, following prolonged periods of sick-leave or retirement. Finally, I would again like to express my thanks to the Chairman and Members of the Public Health Committee for their support, and to the staff of the Department for their continued enthusiasm and loyalty. To all who have provided me with statistical and other information for inclusion in this report, my grateful acknowledgements are also made. H. FRANKS,M.B.,B.S.,B.Hy.,D.P.H. Medical Officer of Health. May, 1968. -6- VITAL STATISTICS Estimated Mid-Year Population 56,040 Area Comparability Factors: Births 1.11 Deaths 1,27 Males Females Total Legitimate Illegitimate Total Legitimate Illegitimate Live Births 317 299 18 302 280 22 Stillbirths 3 3 - 3 3 - Deaths of Infants Under 1 year of age 2 2 - 1 1 - Under 4 weeks of age 1 1 - 1 1 - Under 1 week of age 1 1 - 1 1 — Deaths (All Ages) 241 - - 233 - - Live Births Crude rate per 1,000 home population 11.0 Live Births Ratio of local adjusted birth rate to national rate 0.71 Stillbirths Rate per 1,000 total births 10 Deaths of Infants Under 1 year of age Rate per 1,000 live births 5 Perinatal Mortality Rate per 1,000 total births 13 Deaths (All Ages) Crude rate per 1,000 home population 8.5 Deaths (All Ages) Ratio of local adjusted death rate to national rate 0.96 -7- CAUSES OF DEATH AS GIVEN BY THE REGISTRAR GENERAL FOR THE YEAR 1967 Male Female Total Tuberculosis, respiratory 2 1 3 Malignant Neoplasm, stomach 9 4 13 „ „ , breast 0 16 16 „ „ , lung, bronchus 20 5 25 „ „ , uterus 0 2 2 Other malignant lymphatic neoplasms 28 31 59 Leukaemia, aleukaemia 2 2 4 Diabetes 1 1 2 Vascular lesions of nervous system 23 28 51 Coronary disease, angina 62 48 110 Hypertension with heart disease 2 6 8 Other heart disease 14 19 33 Other circulatory disease 3 13 16 Influenza 2 1 3 Pneumonia 12 24 36 Bronchitis 24 6 30 Other diseases of the respiratory system 3 0 3 Ulcer of stomach and duodenum 2 1 3 Gastritis, enteritis and diarrhoea 1 3 4 Nephritis and Nephrosis 3 0 3 Hyperplasia of prostate 1 0 1 Other defined and ill-defined diseases 17 16 33 Motor vehicle accidents 5 0 5 All other accidents 4 4 8 Suicides 1 2 3 TOTAL DEATHS 241 233 474 /PREVALENCE -8- PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES No. of Cases Admissions to Hospitals Deaths Acute Primary Pneumonia 1 1 0 Dysentery 44 1 0 Erysipelas 2 1 0 Food Poisoning 2 1 0 Measles 371 2 0 Scarlet Fever 15 0 0 Tuberculosis, Respiratory 6 4 3 Other 0 0 0 Whooping Cough 37 2 0 478 12 3 TUBERCULOSIS CASE FINDING AMONG SCHOOL ENTRANTS: The results obtained in the District are as follows:- Number to whom offered 533 Number tested and percentage 439 (82.36%) Positive reactors - Known contacts 9 Newly found reactors 13 Total: 22 The new reactors were referred to the Chest Physician for investigation. Where necessary, members of the child's family and other contacts were called for examination, but in no instance was anything of serious significance discovered. /Vaccination -9- VACCINATION AND IMVUNISATION SCHEMES: 1. B.C.G. Vaccination of school children: This scheme for the 13/14 year age groups shows a decrease from 80.8% to 74.06% in the acceptance rate. The table below shows the results for the Chigwell Urban Districts- Number of school children to whom B.C.G, vaccination was offered 1172 Number accepted: 868 (74.06%) Number given skin test and percentage: 817 (69.70%) Number who gave positive reaction to skin test; 83 Number who received B.C.G. 701 Referrals to the Chest Clinic of pupils who gave a positive reaction continued; no significant findings have so far been reported, but some of the children remain under observation. 2. Smallpox: 351 primary vaccinations were performed and 33 persons were revaccinated during the year, 3. Diphtheria/Pertussis/Tetanus: 557 completed a course during the year. 509 re-inforcing injections were also administered. 4. Poliomyelitis: 662 children completed a primary course of immunisation against poliomyelitis. 668 re-inforcing immunisations were given. -10- GENERAL PROVISION OF HEALTH AND WELFARE SERVICES IN THE DISTRICT PUBLIC HEALTH OFFICERS OF THE LOCAL AUTHORITY: (See page 2) The Essex County Council Services for the District are administered as follows:- County Medical Officer of Health: Dr. J.A.C. Franklin, 85-89 New London Road, Chelmsford (0245-53233) Area Medical Officer and Divisional School Medical Officer: Dr. I.G. Yule, West Essex Area, Moot House Annexe, The Stow, Harlow (027-96-25331) Area Welfare Officer: (including services for the blind, partially sighted, physically handicapped; provision of accommodation for the elderly and infirm, and temporary accommodation for the homeless) Mr. R.N. Weston, Crown Buildings, Crows Road, Epping (EP 5-3253/4) Senior Mental Welfare Officer: Mr. C.E.S. Connors, Sydenham House, Monkswick Road, Harlow (027-96-27421 or 26791 outside office hours) Area Psychiatric Social Worker: Mr. B.G. Garner, Sydenham House, Monkswick Road, Harlow (027-96-27421 or 26660 outside office hours) Children's Officer: Miss G.M. Wansbrough-Jones,O.B.E., Children's Department, 91-99 London Road, Chelmsford (0245-55251) Also at: Bentham House, Hamstel Road, Harlow (027-96-25538) and: Loughton Hall Health Services Rectory Lane, Clinic, Loughton (Tuesdays 2 p.m. 4.30 p.m.) (01-508-6295/9) /Home -11- Home Help Organiser: Mrs. W. Johnston, West Essex Area, Moot House Annexe, The Stow, Harlow (027-96-25331) Registrar of Births and Deaths: Mr. G.J. Southam, Crown Buildings, Crows Road, Epping (EP 5-4423) Hours of attendance: Monday, Tuesday and Thursday 9.30 a.m. - 12.30 p.m. Friday 9 a.m. - 10 a.m. 19 Algers Road, Loughton (01-508-1576) Monday, Thursday and Friday 2 p.m. - 4.30 p.m. Wednesday 9 a.m. - 10 a.m. 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 also on occasion examined at the Counties Public Health Laboratory, Thresh House, Verulam Street, Gray's Inn Road, London, W.C.I, All milk and other food samples taken under the Food and Drugs Act, are sent for analysis to the Public Analyst, Dr. J.H. Hamence,Ph.D.,M.Sc., F.R.I.C., 20 Eastcheap, London, E.C.3. 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. 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. HEALTH CENTRES: The County Council has three health Centres serving the District, as follows:- BUCKHURST HILL: Essex County Council Clinic, Buckhurst Way (01-504-5180) -12- /LOUGHTON: LOUGHTON: Essex County Health Services Clinic, Loughton Hall Rectory Lane (01-508-6295/9) Essex County Health Services Clinic, The Drive (01-508-5776) At each of these centres there are clinic sessions for expectant mothers, infants, school children etc., and details of these may be had on application to the centre or to the Council Offices. Each centre has two or more health visitors or school nurses who call upon mothers in their own homes in addition to giving advice at the centres. In addition to the above, infant welfare centres are also held at the following CHIGWELL: St. Winifred's Hall, Manor Road. All Saints House, Chigwell Row. LOUGHTON: Roding Road Church Hall. SCHOOL HEALTH SERVICE: The following extracts from the Annual Report of the School Medical Officer for the West Essex Division are of interest:- "I am again pleased to report that the health of schoolchildren in West Essex remains at a very satisfactory level. The number of children discovered to have defects which are not already under observation or treatment continues to decline, and the need for a more selective approach on the part of the School Health Service is becoming increasingly apparent. In view of the improved medical staffing situation an increased number of children were examined during the year, and in 12% of cases pupils were found to have defects requiring or under treatment. Cleanliness Surveys: 8,655 inspections were carried out during the year, infestation being discovered in only 15 cases (0.18%). This figure represents a further decrease from the numbers recorded in the past 2 years. Enuresis: The problem of enuresis or bed-wetting is usually indicative of a degree of emotional disturbance, although physical causes are occasionally found. Children showing evidence of severe emotional -13- /disturbance disturbance are referred to the Child Guidance Clinic, but in cases where the emotional element is slight enuresis alarms are provided through the School Health Service. During the year, alarms have been loaned to 111 children, and special follow-up visits are arranged in order that the school medical officer may assess progress. Special Schools: In last year's report I commented on Woodcroft Special School, Loughton, which is a private school registered by the Department of Education and Science. Special provision is made there for the education of autistic, spastic, brain-damaged and otherwise disturbed children; the aim being to bring them up to a standard whereby they will ultimately fit into an appropriate special school suited to their age and ability. 15 children from the Division are placed at Woodcroft, and one of the school medical officers visits regularly and is responsible for the medical supervision of the children in attendance. School Psychological Service: Dr. L.F. Lowenstein, the Psychologist working in the Loughton area reports:- "During the year 1967 the clinic at Loughton has been going at full stretch. There is still a part-time Psychiatrist and Psychiatric Social Worker, part-time Social Worker, and one full-time Psychologist. The area being covered is Loughton, Waltham Abbey, Chigwell and Epping. Work with the schools and work in the clinic is about twice as high and there has been some increase in advice to parents and schools on handling children, and advice on curriculum. Cases seen Total 799 In Clinic At School and Home Visits January to March 105 116 April to June 103 112 July to September 87 93 October to December 107 76 402 397" /Physical -14- Physical Education: Swi inning: It has long been the policy of the Division that all fourth year primary pupils and all first year secondary pupils shall have regular weekly swimming instruction. In all but 2 secondary schools and 6 primary schools this is adequately carried out, and in a large number of schools many more pupils, including the infants in some primary schools with their own baths, receive swimming instruction. 3 secondary schools have covered, heated baths. 4 secondary schools and 2 special schools have open air baths, and 15 primary schools have learner pools, 4 of which were opened in 1967. Covered heated public baths are used in Saffron Walden, Harlow, Chelmsford, and since September 1967, at Loughton. The number of pupils permanently excused swimming on medical grounds is negligible, but there is still a small number of parents who do not give the necessary encouragement to children who shirk swimming. The results of swimming instruction are, generally speaking, very satisfactory in all areas. Plantar Warts: Bare-foot work is encouraged in gyimasia and halls where floors are smooth and well-kept, and where the teachers concerned keep a strict watch for any sign of plantar warts among pupils. During the summar term notes prepared by the Divisional School Medical Officer on the recognition of plantar warts were sent to all schools, together with instruction to exclude from bare-foot work, including swimming, all pupils suspected of suffering from plantar warts or other infection. It is disturbing to find that in some cases a child's own doctor has not upheld the Divisional Medical Officer's ruling, but stated that the child may continue with swimming if the infected area is covered with a plaster." /HOME -15- HOME NURSES: BUCKHURST HILL: Mrs. J. Turner, 55 Walnut Way (01-504-7689) Mr. H. Jestice, 11 Rous Road (01-504-7249) Mrs. W.J. Jestice, 11 Rous Road (01-504-7249) Mrs. H. Bow (part-time), 8 Walnut Way (01-504-7604) CHIGWELL: Miss D.E. Lyon, 9 Coppice Path (01-500-2108) LOUGHTON: Mrs. M. Gunn, 29 Rochford Avenue (01-508-2777) Mrs. O.M. Forrest, 12a Chequers Road (01-508-7591) Mrs. E. Hennah, 26 Audley Court (01-508-2864) Miss E.M. Cyba, 100 Borders Lane (01-508-4644) MIDWIVES: BUCKHURST HILL: Mrs. N. Warwicker, 40 Chestnut Avenue (01-504-6371) CHIGWELL: Mrs. A. King, 64 The Lowe (01-500-3110) LOUGHTON: Miss M. Sibthorpe, 82 Goldings Road (01-508-1879) Mrs. M.J. Harrison, 31 Rochford Avenue (01-508-5878) Summary of attendances and Visits Number of attendances at:- Child Welfare Centres 9,295 Ante-natal and Post-natal Clinics 1,187 Women's Welfare Clinics 120 Number of visits made by:- Health Visitors and School Nurses 4,131 Revisits 5,438 Home Nurses 20,987 Midwives (Confinements) 147 /CHEST -16- 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 (EP 5-2224) ILFORD: Chest Clinic, 130 Cranbrook Road, Ilford (01-554-0071) woodford: Chest Clinic, Harts Hospital, High Road, Woodford Green (01-504-7244) The Care Association for Diseases of the Chest continues to assist cases awaiting admission to hospital 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 Hon. Secretary is Miss H. Abbott, Chest Clinic, St. Margaret's Hospital, Epping (EP 5-2224). There are special health visitors for tuberculosis, who can be contacted at the Chest Clinics. ESTABLISHMENTS FOR MASSAGE OR SPECIAL TREATMENT: The following establishments for chiropody treatment are licensed under the Essex County Council Act, 1933:- LOUGHTON: Mr. A.C. Hallard, 4 Algers Road. Mr. P.F. Brock, 4 Brook Road. Mr. and Mrs. M.L. Harris, 21 The Broadway. FOOT CLINICS: Chiropody treatment at Essex County Council Health Services Clinics is available for certain priority groups, and appointments should be made through the Area Medical Officer, Moot House Annexe, The Stow, Harlow. /VOLUNTARY -17- VOLUNTARY ORGANISATIONS: BRITISH RED CROSS SOCIETY: Divisional Secretary: Mrs. W.T. Jones, 17 Albion Park, Loughton. (01-508-7156) CITIZENS' ADVICE BUREAU: St. John's Church Rooms, St. John's Road, Epping (EP 5-4989). Mondays 10 a.m. - 12 noon; 2 p.m. - 4 p.m. Fridays 2 p.m. - 4 p.m. SPASTICS SOCIETY: Hon. Secretary: Mrs. D. Latham, 22 The Meadway, Buckhurst Hill. (01t504-0680) WOMEN'S ROYAL VOLUNTARY SERVICE (including Meals-on-Wheels): Centre Organiser, Union Church, High Road, Loughton (01-508-7228) TOE METROPOLITAN ESSEX MARRIAGE GUIDANCE COUNCIL: Hon. Appointments Secretary: Mrs. V.M. Brown, 31 New Wanstead, Wanstead, E.ll. (01-989-3143) Counselling centre: 9 Station Road, Loughton. LOUGHTON FAMILY PLANNING ASSOCIATION: E.C.C. Health Services Clinic, The Drive, Loughton. Mondays: 7 p.m. - 8 p.m. NATIONAL BLOOD TRANSFUSION SERVICE: Miss H.M. Mathieson, 7 Crescent Road, Chingford, E.4. (01-529-1027) Regional Depot N.B.T.S. - Crescent Drive, Brentwood. -18- SANITARY CIRCUMSTANCES OF THE AREA Report of the Chief Public Health Inspector 1. WATER SUPPLY. Dr. Windle Taylor, the Director of the Water Examination Department of the Metropolitan Water Board, has kindly supplied the following information regarding the water supply for the district:- "1. (a) The supply was satisfactory both as to quality and quantity throughout 1967. (b) All new and repaired mains are disinfected with chlorine, after a predetermined period of contact the pipes are flushed out and refilled; samples of water are then collected from these treated mains; and the mains are returned to service only after results are found to be satisfactory. The quality control from these laboratories is carried out by means of daily sampling from sources of supply, from the treatment works or well stations, from the distribution system, and through to the consumer. Any sign of contamination or any other abnormality is immediately investigated. (c) (i) The Board has no record of the number of structurally separate dwellings supplied in your area, but the population supplied direct according to the Registrar General's estimates at 30th June, 1967, was 56,022. (ii) No houses were permanently supplied by standpipe. (d) No fluoride was added, and where the fluoride content is indicated in the analyses it represents the naturally occurring fluoride in the water. 2. (a) The supply was mainly Lee-derived water via Lee Bridge works, with some well water from time to time from Chingford Mill and a little from Ferry Lane and Waltham Abbey. Between May and September some water was derived from the interim supply from the new Coppermills works. There were no changes to the general scheme of supply in your area. The number of sairples collected and the bacteriological and chemical analyses of the supply from the above sources after treatment are shown on the attached sheets. 19 (b) " (b) The Board's river and well sources have not been considered to have a plumbo-solvent action, on account of their hardness content and alkaline reaction. It should, however, be appreciated that all types of water pick up varying amounts of metal from piping, particularly when it is newly installed; this applies to copper, zinc, iron and also lead. Tests for lead have been carried out in connection with chemical analyses of samples of running water collected from premises in the distribution system and I set out below the information obtained over the period 1st January to 31st December,1967:- Lead content (mg/1. Pb) water from main taps in consumers' premises Number of samples Percent. Less than 0.01 64 66.7 0.01 22 22.9 0.02 3 3.1 0.03 4 4.2 0.04 2 2.1 0.05 0 - 0.06 1 1.0 96 100.0 The above figures apply to the whole of the Board's area but it should be pointed out that the general characteristics of the water are similar throughout the area so that the findings are applicable to individual Boroughs. The regular system of examination for lead in water in domestic premises will continue during 1968. /Water 20 "Water Samples: (a) Average results of Chemical Examination. Milligrammes per litre (unless otherwise stated):- Lee Bridge Coppermills Chingford Mill Ferry Lane Waltham Abbey No. of samples taken during the year 52 7 4 4 4 Ammoniacal Nitrogen 0.025 0.028 0.105 0.165 0.175 Albuminoid Nitrogen 0.105 0.123 0.052 0.044 0.046 Nitrate Nitrogen 4.7 4.3 0.5 0.6 0.2 Oxygen abs. from KMnO4 4 hours at 27° C 1.19 1.21 0.39 0.33 0.42 Hardness (total) CaCO3 335 319 309 369 281 Hardness (non-carbonate) CaCO3 105 100 94 127 62 Magnesium as Mg 7 7 14 36 25 Sodium as Na 33.4 33.4 23 47 26 Potassium as K 7.2 7.2 5.8 11.5 5.7 Chloride as C1 43 41 30 35 24 Phosphate as PO4 2.7 2.3 - - - Silicate as SiO2 8 7 - - - Sulphate as SO2 104 104 110 180 84 Natural Fluoride as F 0.35 0.35 0,55 0.85 0.70 Surface-active material as 0.03 0.03 - - — CO2 - - 22 27 16.5 Turbidity units 0.2 0.1 0.0 0.1 1.1 Colour (Burgess units) 14 10 3 3 6 pH value 8.1 8.3 7.5 7.4 7.5 Electrical Conductivity (mi cromhos) 720 730 560 840 580 (b) 21 "(b) Results of Bacteriological Examination:- Lee Bridge Coppermills Chingford Mill Ferry Lane Waltham Abbey BEFORE TREATMENT - No. of samples - - 191 159 250 Agar plate count per ml.:20-24 hours at 37° C. - - 0.2 3.0 0.1 3 days at 22°C. - - 21 - 8 Coliform count:Per cent. samples negative in 100 ml. - - 100.0 99.37 100.0 Escherichia coli count:Per cent. samples negative in 100 ml. - - 100.0 100.0 100.0 AFTER TREATMENT - No. of samples 513 48 195 *- 255 Agar plate count per ml.:20-24 hours at 37° C. 29.1 92.4 0.3 - 0.0 3 days at 22°C. - - 79 - 13 Coliform count: Per cent. samples negative in 100 ml. 99.42 100.0 100.0 - 99.61 E. coli count;Per cent. samples negative in 100 ml. 100.0 100.0 100.0 - 100.0 *Mixed with filtered river-derived water before chlorination. 2. DRAINAGE SEWERAGE AND PUBLIC CLEANSING. Mr. R.W„ Edwards, C.Eng.,A.M.I.C.E.,M.I.Mun.E., Engineer and Surveyor, has kindly supplied the following information - (a) Drainage and Sewerage: The soil drainage from the greater part of the District gravitates to the main disposal works at Luxborough Lane which was improved in 1938, was extended after the war and recently has been further improved with the addition of final effluent and storm water treatment lagoons. A scheme for a further extension is now being prepared consisting of more filters and humus tanks. A smaller part of the District drains to the Millers Lane Sewage Disposal Works from where the Council has now decided to lay a trunk sewer to take the flow to the Luxborough Lane Works, thereby eliminating the need for a second Disposal Works at Millers Lane. 22 /The The completion of these improvements is expected to result in a continued higher standard of purity in the effluent to be discharged to the River Roding, As regards sewerage, the Council is faced not only with the increasing foul flows from the new development, but also with some ageing and unsatisfactory sewers which contribute to the flooding difficulties referred to below. Generally, there is a separate system of drainage in the District except in the older parts where combined sewers still exist. These combined sewers have caused flooding at various points in the District and work has started on the laying of new surface water sewers to remove part of the flow from the combined sewers in South Loughton and Buckhurst Hill and thus from the Sewage Treatment Works. 2 large schemes - in The Avenue area, Loughton, and in central Buckhurst Hill - have been completed this year. A small area of Buckhurst Hill drains into the sewers of the London Borough of Redbridge at Woodford, thence via Chingford and to the East Middlesex Scheme. Part of Chigwell Row drains to the London Boroughs of Redbridge and Barking. There are 5 outlying pumping stations lifting the flow from low lying areas up to the main gravity sewers. (b) Public Cleansing: Domestic refuse is being collected once weekly throughout the District by the Council's vehicles and labour. A fleet of 7 compressing type refuse collection vehicles is constantly employed, supplemented by further vehicles for special collections, including a FREE service for removing bulky domestic articles (e.g. mattresses, bedsteads etc.) on request from householders. THIS FREE SERVICE CANNOT BE PUBLICISED TOO MUCH as it is provided to combat the other alternative of tipping old mattresses, etc., into ditches or onto forest land or roadside verges. The new Civic Amenities Act will also be of help in combatting this problem. Trade refuse also is collected, a charge related to actual cost being made only for refuse, the character of which is clearly not domestic. Refuse is at present disposed of by controlled tipping in Chigwell at a site leased to the Council. The refuse is covered with spoil, hardcore or other innocuous filling, and during tipping, only a very small surface of refuse remains uncovered. Measures are taken against flies, etc., as necessary from time to time, but this rarely happens. /As 23 As this tip is rapidly being filled, further and more long term arrangements for refuse disposal are being made at great cost to the ratepayers because other possible controlled tip sites are not available within the District, transportation of refuse in bulk to tips in outer Essex is planned and work is well advanced, with completion due in the autumn of 1968 for a transfer depot for use by 3 new and large bulk transporter vehicles. Salvage of paper continues to produce sales during the year. Trailers have been purchased for attachment to the refuse vehicles so that salvage can be better pre-separated before tipping. Nearly 5,000 road gullies in County and District roads are emptied (and re-sealed with clean water) by machine regularly during the year by contract. (c) Swimming Pool: The Council's new covered swimming pool was finished in the summer of 1967, and has had a very successful start: it is a real asset to the District, particularly for children and clubs. 3. RIDING ESTABLISHMENTS ACT, 1964. The riding establishments in the area have been inspected and Mr. H.E. Bywater, M.R.C.V.S.,F.R.S.H. reports as follows:- 'I have pleasure in submitting the annual report of inspection made at varying intervals, and without preliminary notices, during the quarters of the yearended 31st December, 1967. Conditions at all the establishments continued to be satisfactory at the times of my visits and no changes in occupations of the schools have occurred since my last report. Premises inspected are as follows:- Nightingale Riding School, Epping New Road, Buckhurst Hill; Owned and managed by Mr. T. Robinson, 74 Field Road, Forest Gate, E.7. An average of 29 horses are kept, of which 23 are owned by the school, 5 are at part livery, and 1 at full livery (not hired out). Forest Riding School, North End, Buckhurst Hill: Owned and managed by Miss A.O. de Berry, who lives adjacent to the school. 5 horses, none at livery, /Riding 24 'Riding Centre for the Disabled, Grange Farm Sports Centre, High Road. Chigwell; Managed by Mr. J.A. Davies who resides on the premises. 12 horses and 1 owned by Mr. Davies. Chigwell Riding School, Chase Lane. Chigwell: Owners are Mr. and Mrs. J. Lucus, 26 Ann Way, Hainault, Ilford. Managed by Mrs. Lucus. Normally 28 horses are kept on the premises, in addition to some 5 at livery. These are subject to some changes as an average of 6 additional horses are periodically at rest on other premises at Lambourne.' 4. SANITARY INSPECTIONS OF THE AREA, The following statistics indicate the work of the Public Health Inspectors during the year - (a) 1,352 complaints were received and dealt with. (b) Summary of complaints; Food 83 Sewage 6 Polluted ditches, watercourses and ponds 14 Flooding 14 Defective or blocked drains 268 "water closets 22 " water supply pipes 13 Dampness 31 Defective roofs and gutters 19 Accumulation of refuse 23 Defective dustbins 15 Insanitary conditions 23 Vermin 3 Rodents 418 Wasps 191 Other insect infestation 43 Smoke 32 Smells 48 Noises 16 Animals and birds 12 Miscellaneous housing defects 32 Miscellaneous 25 /(c) 25 (c) Summary of visits and inspections: Public Health Acts: Animals 45 Birds 10 Cesspools 7 Closets (chemical and pail) 4 Dampness 371 Disrepair 355 Ditches and ponds 38 Drainage 1,156 Flooding 19 Infectious diseases 160 Insanitary conditions 196 Noise 116 Refuse accommodation and accumulation 202 Smells 178 Swimming pools 65 Verminous premises 7 Water supplies 53 Miscellaneous 212 3,194 Housing 544 Food Control 853 Factories and Offices. Shops and Railway Premises Acts 473 Petroleum Acts 182 Other Acts and duties 3,199 Total visits and inspections 8,445 (d) Summary of notices served and complied with: Served Complied Public Health Acts: Statutory Notices 1 2 Informal " 97 90 Housing Acts: Statutory " 3 - Food & Drugs Act: Informal " 15 19 26 /5. 5. INFECTIOUS DISEASES AND FOOD POISONING. 160 enquiries and revisits were made during the year regarding notifications of the following infectious diseases:- Scarlet Fever 15 Food Poisoning 2 Sonne Dysentery 44 6. RODENT CONTROL, WASPS AND INSECT INFESTATION. During the year, 418 complaints regarding infestation by rats and mice were received. These complaints were investigated and treatment carried out where required, calling for 2,297 visits for baiting and treatment. There were 174 enquiries regarding infestation by wasps and other insects. 7. ATMOSPHERIC POLLUTION. 113 observations have been made on industrial plants in the area under the Clean Air Act, 1956 to control the emission of smoke from furnaces and incinerators, and 77 visits made to the premises in connection with the installation of plant or incinerator and to give advice to the operators. The use of volumetric apparatus in the Public Health Department to measure daily pollution of smoke and gaseous contamination has been continued throughout the year, the results are forwarded to the Warren Spring Laboratory of the Ministry of Technology at the end of each month. 27 HOUSING STATISTICS 1967 1. REDEVELOPMENT. 40 houses were demolished during the year and redevelopment of the cleared sites with permanent housing commenced. 2. New HOUSES. 187 new dwellings were erected during the year. By the Chigwell Urban District Council 33 By private builders 154 3. INSPECTION OF DWELLING HOUSES. 1. (a) Total number of dwelling houses inspected for housing defects (Under Public Health and Housing Acts) 1,680 (b) Number of visits made for the purpose 3,124 2. Number of dwelling houses (included in subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 383 3. Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 4. Number of dwelling houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 97 4. RENT ACT, 1957 1 application was received for a Certificate of Disrepair during the year. 5. REMEDY OF DEFECTS WITHOUT SERVICE OF FORMAL NOTICES: Defects to dwelling houses remedied by informal action 90 6. ACTION UNDER STATUTORY POWERS: (a) Proceedings under Sections 9,10,12 and 16 of Housing Act, 1957: (1) Number of dwelling houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling houses which were rendered fit after service of Formal Notice Nil (b) 28 (b) Proceedings under Public Health Acts: (1) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 1 (2) Number of dwelling houses in which defects were remedied after service of Formal Notices by:- (a) Owners 1 (b) Local Authority in default of owners Nil (c) Proceedings under Section 16,17,34 and 42 of Housing Act, 1957; (1) Number of dwelling houses in respect of which Demolition Orders were made 3 (2) Number of dwelling houses demolished in pursuance of formal action 7 (d) Number of houses or parts of houses closed under: (1) Section 17 of the Housing Act, 1957 3 (2) Section 18 of the Housing Act, 1957 Nil (e) Informal Action: Number of dwelling houses demolished as a result of informal action Nil 29 FOOD CONTROL 1. FOOD HYGIENE (GENERAL) REGULATIONS, 1960 During the year 953 visits were made to the premises of manufacturers, vendors and hawkers. Informal action has been taken in 15 instances to secure compliance with the Regulations. 2. SUMMARY OF VISITS TO FOOD PREMISES. Type Number of Premises Inspections Bakehouses 6 44 Bakers' shops 18 26 Butchers 33 79 Cafes and restaurants 22 100 Canteens - industrial and otherwise 16 19 Canteens - schools 28 56 Confectioners 39 34 Fishmongers and friers 8 26 Greengrocers 31 94 Grocers 62 113 Ice Cream 104 113 Licensed premises 39 23 Poultry processing premises - Visits in connection with food complaints 92 " " " " " Sampling 34 " " " " unsound food 53 Inspection of food hawkers 6 Other visits 41 953 3. REGISTRATION OF FOOD PREMISES UNDER SECTION 16, FOOD AND DRUGS ACT, 1955. Ice cream manufacturers 1 " " vendors 104 Premises where meat or fish is cooked, pickled, preserved etc. 38 4. REGISTRATION OF DAIRIES UNDER MILK AND DAIRIES REGULATIONS, 1963. Milk Distribution Depots 3 Milkshops 22 /5. 30 5. UNSOUND FOOD. Foodstuffs, as listed below, were examined during the year and found to be unfit for human consumption. The food was condemned and disposed of by incineration or by burial at the Council's refuse tip:- Meat 296 lbs. Tinned fruit 83 lbs. Chickens 35 lbs. Frozen Foods: Meat 195 lbs. Offal 38 lbs. Fish 477 lbs. Preserves 82 lbs. Vegetables 500 lbs. Miscellaneous groceries 77 lbs. pastry, cakes, mousse etc. 95 lbs. Tinned meat 241 lbs. "vegetables 11 lbs. 6. FOOD SAMPLES. (a) Chemical Analysis: 175 samples of foodstuffs were submitted to the Public Analyst for examination, who reported on the samples, as follows:- Submitted Unsatisfactory Almond essence 1 - Almond flavouring 1 - Almonds, ground 1 - Arrowroot 1 - Bacon grill 1 - Bacon and mushrooms in white sauce 1 - Beef dripping 2 - *Biscuits 2 1 Black currant health drink 1 - Blancmange powder 1 - Blue food colour 1 - Braised steak in gravy 1 - *Bread 6 4 Browning 1 - Butter 8 - Butter beans 1 - Cheese 2 - Cheese spread 1 - Cheez whiz 1 - Chicken and ham spread with butter 1 - Chocolate flavoured drink 1 - Christmas pudding 1 - Cinnamon, ground 1 - Coffee and chicory 1 - 39 5 c/f 31  Submitted Unsatisfactory Brought forward 39 5 Condensed milk 1 - Cream 8 - Cream of Tartar 1 - Custard 1 - Decaf 1 - Demerara sugar 1 - Dressed crab 2 - Dried mint 1 - Evaporated milk 3 - Fish spread 1 - Flake tapioca 1 - Flavouring essence 1 - Food colour 2 - *Foreign matter in grape fruit juice 1 1 *Foreign matter from bread 1 1 *Foreign matter on bread and wrapping 1 1 Fruit salad 2 - Honeycombe mould mix 1 - Horseradish relish 1 - *Jam 3 1 Jelly 2 - Lard 5 - Lemon food flavouring 1 - Lobster and mayonnaise 1 - Luncheon meat 1 - *Madeira wine 1 1 Malt vinegar 2 - Margarine 4 - Marmalade 1 - Marzipan 1 - *Material 1 1 Meat pudding 1 - *Milk 25 1 Milk, Channel Island 12 - Milk shake syrup 1 - Milk top 1 - Milo chocolate drink 1 - Minced beef 1 - Mutton curry 1 - *Nuts and raisins 1 1 Olive oil 1 - Orange drink 1 - Orange juice 1 - Peas 3 - Pepper, ground 1 - Picnic pork 1 - 145 13 32 c/f  Submitted Unsatisfactory Brought forward 145 13 Pie fillings 3 - Pork luncheon meat 1 - *Pork pie 2 1 Potatoes creamed 1 - Potted beef with butter 1 - Rice 1 - Salmon 1 - Sausages, pork chipolata 1 - Sliced runner beans 1 - Steak and kidney pie 1 - Steakburgers with onions 1 - Sweets 1 - Tea 7 - Tomato ketchup 1 - Tongue pate 1 - Top of the milk 1 - Vinegar 2 - White pepper, ground 2 - Yoghurt 1 - 175 14 * Includes food complaints. (b) Bacteriological Examination: Pork pie 1 Satisfactory Steak and kidney pies 2 " 7. FOOD COMPLAINTS. 37 complaints regarding the quality, nature and substance of food were received during 1967, as follows:- Apples 1 Mince meat 1 Beef 1 Muesli 1 Biscuits, shortcake 1 National dried milk 1 Bread 9 Nuts and raisins 1 Cake 1 Orange juice 1 Christmas pudding 1 Orange juice concentrated 1 Grapefruit juice 1 Pie filling, raspberry 1 Jam, apricot 1 Pickles 1 Kidney 1 Pies, pork 2 Madeira wine 1 Pies, steak and kidney 1 Meat pie 1 Sausages 2 Milk 1 Tart, raspberry 1 Milk bottle 3 /These 33 These complaints were all investigated and in 4 cases formal action was taken. Legal proceedings were instituted in the following cases:- Contraventions Result of Proceedings Steak and kidney pie Fine £15. 0. 0d. Costs £ 5. 5. 0d. Rodent excreta in wrapped Fine £10. 0. 0d. loaf of bread Costs £ 5. 5. 0d. Iron bolt in raspberry tart Fine £25. 0. 0d. Costs £10. 0. 0d. Mouldy bread Fine £20. 0. 0d. Costs £ 5. 0. 0d. 34 35 FACTORIES ACT. 1961. 1. INSPECTION FOR PURPOSES OF PROVISIONS AS TO HEALTH (including inspections made by Public Health Inspectors). Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 6 24 5 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 101 102 5 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 10 41 2 - Total 117 167 12 - 36 FACTORIES ACT, 1961. 2. CASES IN WHICH DEFECTS WERE FOUND: Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted. Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of cleanliness (S.l.) 3 3 - - 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 7 5 - - - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) - - - - - Total 10 8 - - - 3. OUTWORKERS: 45 visits were paid to the Outworkers in the District. APPENDIX RAINFALL IN INCHES FOR YEAR 1967 METROPOLITAN WATER BOARD CHIGWELL U. D. C. High Beech Buckhurst Hill Luxborough S.D. Works Loughton Depot January 1.45 1.58 1.43 1.50 February 2.65 2.50 2.02 2.57 March 1.20 1.36 1.23 1.16 April 2.60 2.56 2.17 2.50 May 3.66 3.39 0.99 3.59 June 1.45 1.64 1.61 1.49 July 1.54 1.43 1.15 1.22 August 2.06 2.13 1.57 1.86 September 2.39 2.08 1.94 2.42 October 4.86 5.22 4.00 4.62 November 1.71 1.77 1.39 1.62 December 2.24 2.16 1.89 2.03 27.81 27.82 21.39 26.58 AVERAGE RAINFALL FOR THE LAST FIVE YEARS 1963 - 24.28 1964 - 21.08 1965 - 29.40 1966 - 27.09 1967 - 25.90 The highest point in the District is 372 O.D., and the lowest 44 O.D. 37