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, 31 ST. 1971 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, 1971 CHIGWELL URBAN DISTRICT COUNCIL Chairman of the Council: Councillor D.W. James Vice-Chairman of the Council: Councillor R.C. O'Malley PUBLIC HEALTH COMMITTEE Chairman: Councillor A.H. Swallow Vice-Chairman: Councillor Mrs. S. Gordon Members: Councillor M.J. Bacon G.P. Claridge N.T.H. Croucher S.J. Palfreman 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): F.L. MITCHELL, M.B., Ch.B., D.C.H. Chief Public Health Inspector and Petroleum Inspector: P.W. RILEY, M.R.S.H., M.A.P.H.I. (a) (b) (c). Deputy Chief Public Health Inspector: A.R. COOK, M.A.P.H.I, (a) (b) (c) . Public Health Inspectors: R.P. STEVENS, M.A.P.H.I. (a) (b). C.M. WEBB, A.M.R.S.H., M.A.P.H.I. (d). T. SALWAY, M.A.P.H.I., (d). ( From 1.12.71). Technical Assistant: A.H. BROWN. Trainee Public Health Inspectors: T. SALWAY (To 30.11.71). MISS C.A. LLOYD (From 1.9.71). 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) Public Health Inspectors' Diploma. -2- To the Chairman and Members of the Chigwell Urban District Council the chairman AND members In accordance with the requirements of the Public Health Officers' Regulations 1959, I have pleasure in presenting the Annual Report of the Medical Officer of Health for the year 1971, which includes the Annual Report of the Chief Public Health Inspector. Much attention continues to be directed to the problems of pollution and overpopulation. These two problems are closely related in that pollution is largely the result of efforts to supply the material needs of more and more people - which means more industrial activity and production of waste, especially if progressively higher material standards of living are being demanded at the same time. On pollution, the Chier Public Health Inspector has very aptly commented in another part of this report. On overpopulation, the message of the statisticians is inescapable - that the present average family size of 2.5 children per family is resulting in an increase of 300,000 inhabitants of the United Kingdom every year. Houses, hospitals, schools, universities and transport must thus be provided for an extra 300,000 every year before any progress can be made in improving or replacing what we already have, or in reducing the pollution problems of the present time. According to authoritative medical opinion, at least two-thirds of the excess of births over deaths are the result of pregnancies which are unwanted at the moment of conception; that is the moment for appropriate action. Although it is perfectly true that a certain proportion of the resulting offspring are accepted by their parents with the passage of time, or are successfully reared by others, this is not in my opinion a good enough reason for denying full knowledge and availability of contraception to everyone. There is growing public pressure to include these services in the new re-organisation of the National Health Service now being planned, and this campaign deserves our full support. I am completely convinced that Birth Control is a more satisfactory alternative for the future than overpopulation, unwanted children, or freely available abortions. VITAL STATISTICS The Birth and Death Rates of the District are both slightly below comparable figures for England and Wales as a whole. Less still-births are, however, as might be expected, offset by deaths of more infants under four weeks of age, those non-viables having been kept alive for a short period by special techniques and care who would otherwise have been registered as still-born. It is encouraging to note a small reduction in the number of deaths from cancer of the lung and of the breast. Heart diseases continue to take their full and increasing toll of life, for which eating and smoking too much at all ages, and insufficient exercise, are undoubtedly contributing causes. /control -3- CONTROL OF INFECTIOUS DISEASES No major outbreaks or deaths from infectious disease occurred. During the early part of the year there was a small outbreak of infective jaundice of a mild form - twenty-one cases in all, of which three required admission to hospital. Local doctors were kept fully informed, and the opportunity was taken to stress the importance of good sanitation and personal hygiene in controlling the spread of this as well as other infectious diseases generally. In November 1971, the Secretary of State accepted the advice of the Joint Committee on Vaccination and Immunisation that vaccination against smallpox need no longer be reconmended as a routine procedure in early childhood. Vaccination continues to be recommended for travellers to and from countries where smallpox is endemic or where eradication programmes are in progress, and for health service staff who may come into contact with patients. MASS MINIATURE RADIOGRAPHY In view of the falling off of significant findings in recent years, open public sessions are no longer regarded as a necessary or economic way of employing the mobile X-ray Units. It is now the national policy to concentrate the Units in places where there is evidence or suspicion of cases or contacts of chest diseases, or where persons may be exposed to special risks due to the nature of their work, or for other reasons; otherwise sessions at factories and in Public Places will only take place as and when time permits. In accordance with this policy, the work done in the District by the Unit during the year was as follows SCHOOLS AND COLLEGES Male Female Total Loughton College of Further Education (Includes 50 Local Authority staff) 373 278 651 Lucton County Secondary School - Contact Group (57 Local Authority staff are also included in these figures) 133 63 196 Total number X-rayed 506 341 847 Requiring further investigation: 3 1 4 Abnormalities discovered: Abnormality of diaphragm 1 - 1 Pulmonary fibrosis (Non Tb) - 1 1 Miscellaneous abnormalities - bony lesion 1 - 1 INDUSTRIAL -4-  INDUSTRIAL Male Female Total Bank of England Printing Works 562 695 1,257 Ozalid Ltd. 386 198 584 Total number X-rayed 948 893 1,841 Requiring further investigation: 2 4 6 Abnormalities discovered: Pulmonary tuberculosis Requiring occasional supervision (Previously known) - 1 1 Presumed healed, discharged - 1 1 Sarcoidosis 1 1 2 Pulmonary fibrosis (Non Tb) 1 _ 1 It has been my opinion for some time that Colleges of Further Education require regular health supervision because staff and students of susceptible ages from many different countries and cultures mix together and are not always able to obtain the food, clothing and sleeping accommodation which they need or have been accustomed to. Essex County Council has recently established a service of part-time Counsellors for Further Education Establishments, with consultation available from Psychiatric Social Workers - the nucleus of a Student Mental Health Service. The Loughton College does not however enjoy the statutory school health services, or those of organised industry or the universities, and for the time being therefore, I shall continue to recommend a routine visit of the Mass Radiography Unit to the College each year. MEDICAL EXAMINATION OF STAFF In connection with their appointment for duties with this Council, forty-six officers and staff completed Personal Health Report forms which were duly assessed; fourteen received a medical examination. Seven employees were re-assessed and reported on for sick-pay and superannuation purposes, following prolonged periods of sick-leave or retirement. Eight employees were examined in connection with their employment as heavy goods vehicle drivers. SECTION 47, NATIONAL ASSISTANCE ACT, 1948 AND NATIONAL ASSISTANCE (AMENDMENT) ACT, 1951 and 1962 Eleven cases in possible need of care and attention were investigated by this Department during the year and kept under observation with the services of the district nurse, home help, meals-on-wheels, as necessary. One case was voluntarily removed to hospital. RE-HOUSING -5- RE-HOUSING PRIORITY ON MEDICAL GROUNDS Eighty requests for priority for re-housing on medical grounds were referred to rae 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 ADDlicants Priority Recommended Priority Not recommended Asthma, bronchitis, catarrhal diseases etc. 7 6 1 Blood pressure 1 1 - Heart disease 6 4 2 Nervous diseases (anxiety states, neurasthenia, neurosis etc.) 35 11 24 Rheumatism 8 6 2 Other diseases 4 3 1 Other conditions 19 9 10 80 40 40 The forty 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. SOCIAL SERVICES As required by the Local Authority Social Services Act, 1970, Essex County Council set up their Social Services Committee on 1st January, 1971. This Committee, and the Department serving it, assumed responsibility during the year for the functions previously exercised by the Children's and Welfare Committees of the County Council, and parts of those of the Health Committee. LOCAL GOVERNMENT RE-ORGANISATION At the time of writing, the machinery by which the National Health Service of the future will provide the new Local Government Authorities with the clinical and advisory services hitherto carried out by their own Medical Officers of Health has not been clearly defined. It is to be hoped, however, that the special role of the Medical Officer of Health in small and medium sized areas as a kind of interpreter between clinicians and the public, accessible and accepted as an authority on a wide range of medical and social matters, will not disappear from the scene. The number of people who come to the Medical Officer of Health with a wide variety of complaints and discontents, as well as requests for guidance, can be quite embarrassing at times, but this function, as well as his power to act in some instances, 6 and and his Annual Reports, are important public relations instruments for which it is essential that provision; be made in the new set-up. Again I would like to express my grateful thanks to the Chairman and Members of the Public Health Committee for their continued support, and to the staff of the Public Health Department for their enthusiasm and loyalty. I am particularly grateful to Mr. Riley who commenced his duties as Chief Public Health Inspector in May, 1971, for the efficient way in which he has assumed his responsibilities and established the best of working relationships with all Departments and outside bodies concerned. H. FRANKS, M.B., B.S., B.Hy., D.P.H. Medical Officer of Health June, 1972. -7 VITAL STATISTICS Estimated Mid-Year Home Population: 54,620 England and Wales: 48,815,000 Chigwell U.D.C. England and Wales (Total) Males Females Total LIVE BIRTHS: Total 369 342 711 783,165 Legitimate 350 3111 661 717,491 Illegitimate 19 31 50 65,674 STILL BIRTHS: Total 3 3 6 9,898 Legitimate 3 3 6 8,826 Illegitimate 0 0 0 1,072 TOTAL LIVE AND Total 372 345 717 793,063 STILL BIRTHS: Legitimate 353 314 667 726,317 Illegitimate 19 31 50 66,746 DEATHS OF INFANTS: Under 1 year of age - Total 8 8 16 13,726 Legitimate 8 7 15 12,140 Illegitimate 0 1 1 1,586 Under 4 weeks of age - Total 5 8 13 9,113 Legitimate 5 7 12 8,121 Illegitimate 0 1 1 992 Under 1 week of age - Total. 3 7 10 7,750 Legitimate 3 6 9 6,903 Illegitimate 0 1 1 847 DEATHS - ALL AGES 269 200 469 567,345 -8- LIVE  Chigwell U.D.C. England and Wales LIVE BIRTH RATES, ETC. Live births per 1,000 home population (crude rate) 13.0 16.0 Area comparability factor 1.11 1.00 Local adjusted rate 14.4 16.0 Ratio of local adjusted rate to national rate Illegitimate live births as percentage of all .90 1.00 live births 7 8 STILL BIRTH RATE: Still births per 1,000 total live and still births 8 12 INFANT MORTALITY RATES: Deaths under 1 year per 1,000 live births 23 18 Deaths of legitimate infants under 1 year per 1,000 legitimate live births 23 17 Deaths of illegitimate infants under 1 year per 1,000 illegitimate live births 20 24 Neonatal mortality rate - Deaths under 4 weeks per 1,000 live births 18 12 Early neonatal mortality rate - Deaths under 1 week per 1,000 total live births 14 10 Perinatal mortality rate - Still births and deaths under 1 week combined per 1,000 total live and still births 22 22 DEATH RATES ETC. - ALL AGES: Deaths per 1,000 home population (crude rate) 8.6 11.6 Area comparability factor 1.27 1.00 Local adjusted rate 10.9 11.6 Ratio of local adjusted rate to national rate .94 1.00 -9- CAUSES CAUSES OF DEATH AS GIVEN BY THE REGISTRAR GENERAL FOR THE YEAR 1971 Male Female Total Malignant neoplasm, buccal cavity etc. 0 1 1 " " , oesophagus 3 3 6 " " , stomach 9 5 14 " " , intestine 6 9 15 " " , larynx 2 0 2 " " , lung, bronchus 29 2 31 " " , breast 0 7 7 " " , uterus 0 2 2 " " , prostate 2 0 2 Leukaemia 3 5 8 Other malignant neoplasms etc. 18 13 31 Benign and unspecified neoplasms 1 1 2 Diabetes mellitus 1 2 3 Avitaminoses etc. 1 0 1 Other endocrine etc. diseases 0 1 1 Anaemias 0 1 1 Other diseases of nervous system etc. 1 0 1 Chronic rheumatic heart disease 3 6 9 Hypertensive disease 5 4 9 Ischaemic heart disease 71 34 105 Other forms of heart disease 8 15 23 Cerebrovascular disease 19 25 44 Other diseases of circulatory system 13 8 2L Pneumonia 17 22 39 Bronchitis and emphysema 22 7 29 Asthma 2 2 4 Other diseases of respiratory system 1 2 3 Peptic ulcer 1 0 1 Intestinal obstruction and hernia 7 3 10 Other diseases of digestive system 2 1 3 Nephritis and nephrosis 2 3 5 Hyperplasia of prostate 1 0 1 Other diseases, genito-urinary system 3 2 5 Diseases of musculo-skeletal system 2 2 4 Congenital anomalies 4 3 7 Birth injury, difficult labour etc. 3 3 6 Other causes of perinatal mortality 0 2 2 Motor vehicle accidents 3 0 3 All other accidents 3 2 5 Suicide and self-inflicted injuries 1 2 3 TOTAL DEATHS 269 200 469 Prevalence -10- PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES No. of Cases Admissions to Hospitals Deaths Acute Meningitis 1 1 0 Dysentery 4 0 0 Food Poisoning 7 0 0 Infective Jaundice 21 3 0 Malaria 1 1 0 Measles 106 0 0 Scarlet Fever 4 0 0 Tuberculosis - Respiratory 12 2 0 Other 2 1 0 Whooping Cough 13 0 0 171 8 0 VACCINATION AND IMMUNISATION SCHEMES: 1. B.C.G. Vaccination of School Children: This scheme for the 13/14 year age groups shows an increase from 76.14% to 88.55% in the acceptance rate. The table below shows the results for the Chigwell Urban District Number of school children to whom B.C.G. vaccination was offered: 970 Number accepted: 859 (88.55%) Number given skin test and percentage: 851 (87.78%) Number who gave positive reaction) to skin test: 39 Number who received B.C.G. 802 Pupils who gave a significant positive reaction were referred to the Chest Clinic; no significant findings have so far been reported, but some of the children remain under observation. -11- 2. 2. Smallpox; 299 primary vaccinations were performed and 74 persons were revaccinated during the year. 5. Diphtheria/Pertussis/Tetanus: The following number of injections were given during the year:- Primary Boosters Triple vaccine 1,001 194 Diphtheria/Tetanus 56 630 Tetanus 75 101 Diphtheria 1 5 Pertussis 0 0 4. Poliomyelitis: l,006 children completed a primary course of immunisation against poliomyelitis. 727 re-inforcing immunisations were given. 5. Measles: 651 primary vaccinations were performed. 6. Rubella: 614 primary vaccinations were performed. -12- GENERAL PROVISION OF HEALTH AND SOCIAL 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. A. Afnan, West Essex Area, Moot House Annexe, The Stow, Harlow (027-96 25331) Director of Social Services: Mr. Walter E. Boyce, 73 Springfield Road, Chelmsford (0245 53627) Area Social Work Organiser: (Including Home Help Service, Mental Health Service and all Services previously provided by the Welfare and Children's Departments) Miss D.P. Webb, 319 High Street,(temporary office Epping (375 3632/3725) (To contact Duty Social Worker outside office hours, telephone Princess Alexandra Hospital 027-96 26791) Registrar of Births and Deaths: Mr G.T. Rayment, Crown Buildings, Crows Road, Epping (375 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) Hours of attendance: Monday, Thursday and Friday 2 p.m. - 4.30 p.m. Wednesday 9 a.m. - 10 a.m. LABORATORY FACILITIES: The Central Public 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. -13- All 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 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. CLINICS: The County Council has 3 clinics serving the District, as follows:- BUCKHURST HILL: Essex County Council Health Services Clinic, Buckhurst Way (01-504 5180 and 0405) Health Visitors and School Nurses: Miss Foxon Miss Talbot Mrs. Preston(Chigwell area) Miss Rule ( " " ) Mrs. Poulter(Clinic Nurse) LOUGHTON: Essex County Council Health Services Clinic, Loughton Hall, Rectory Lane (01-508 6295/9) Health Visitors and School Nurses: Miss Conroy Miss Richards Mrs. White (Clinic Nurse) Essex County Health Services Clinic, The Drive (01-508 5776) Health Visitors and School Nurses: Mrs. Green Mrs. Prudden At each of these clinics there are sessions for expectant mothers, infants, school children etc., and details of these may be had on application to the clinic or to the Council Offices. The health visitors or school nurses call upon mothers in their own homes, in addition to giving advice at the clinics. In addition to the above, child health clinics are also held at the following:- CHIGWELL: St. Winifred's Hall, Manor Road. All. Saints House, Chigwell Row. -14- LOUGHTON LOUGHTON: St. Michael's Church Hall, Roding Road. 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. B. Alderson, 87 The Drive (01-508 1782) Miss E.M. Cyba, 29 Rochford Avenue (01-508 2777) Mrs. O.M. Forrest, 12a Chequers Road (01-508 7591) Mrs. E.J. Hennah, 26 Audley Gardens (01-508 2864) MIDWIVES: BUCKHURST HILL: Mrs. N. Warwicker, 40 Chestnut Avenue (01-504 6371) Mrs. P.M.T. Clancy, 7 Starling Close (01-504 5922) LOUGHTON: Miss M. Sibthorpe, 12 Harewood Hill, Theydon Bois (849 2067) Miss J.R. Harding, 31 Rochford Avenue (01-508 5878) Mrs. D.R. Jarvis (part-time), 21 Green Glade, Theydon. Bois (849 2902) Summary of Attendances and Visits Number of attendances: Child Health Clinics 9,326 Ante-natal and Post-natal Clinics 1,146 Number of visits made by: Health Visitors and School Nurses 5,083 Revisits 4,601 Home Nurses 21,769 Midwives (Confinements) 110 CHEST -15- 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 (375 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 F. Abbott, Chest Clinic, St. Margaret's Hospital, Epping (375 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 are licensed under the Essex County Council Act, 1933:- BUCKHURST HILL; Mr. and Mrs. R.L.A. Carr, 96 Queens Road (Chiropody) LOUGHTON: Mr. A.C. Hallard, 4 Algers Road ( " ) Mr. P.F. Brock, 4 Brook Road ( " ) Mr. N. Warren, 156 Church Hill (Sauna Bath) FOOT CLINICS: Chiropody treatment at Essex County Council Health Services Clinics is available for certain priority groups, and appointments should he made through the Area Medical Officer, Moot House Annexe, The Stow, Harlow. Voluntary -16- VOLUNTARY ORGANISATIONS: BRITISH RED CROSS SOCIETY: Divisional President: Mr. C.P. Attwood, 48 Chigwell Park Drive, Chigwell (01-500 6666) CITIZENS' ADVICE BUREAU: Loughton and District Organiser: Rev. K.A. Vine, St. Mary's Parish Centre, High Road, Loughton (01-508 9153) Monday, Wednesday, Friday and Saturday: 10 a.m. - 12 noon Tuesday: 2 p.m. - 4 p.m. 7.30 p.m. - 9 p.m. WOMEN'S ROYAL VOLUNTARY SERVICE (including Meals-on-Wheels): Deputy Centre Organiser: Mrs. E. Boyes, Loughton Hall, (temporary ) Rectory Lane, (accommodation) Loughton (01-508 8311 Ext. 24) Tuesday, Wednesday and Thursday: 10 a.m. - 1.30 p.m. LOUGHTON FAMILY PLANNING ASSOCIATION: E.C.C. Health Services Clinic, The Drive, Loughton Monday: 7 p.m. - 8 p.m. E.C.C. Health Services Clinic, Loughton Hall, Rectory Lane, Loughton Friday: 10 a.m. - 12 noon. THE METROPOLITAN ESSEX MARRIAGE GUIDANCE COUNCIL: Hon. Appointments Secretary: Mrs. Gwen Verriour, Kirkdale Centre, Kirkdale Road, Leytonstone, E.ll. (01-539 2939) Monday to Friday: 10 a.m. - 1 p.m. SPASTICS SOCIETY: Hon. Secretary; Mrs. D. Latham, 22 The Meadway, Buckhurst Hill (01-504 0680) NATIONAL BLOOD TRANSFUSION SERVICE: Organiser: Miss Grace Wilkinson, 5 The Avenue, Loughton (01-508 2972) Regional Depot N.B.T.S. Crescent Drive, Brentwood. -17- To the Chairman and Members of the Chigwell Urban District Council Mr. Chairman, Ladies and Gentlemen, In this, my first annual report, I have endeavoured to present a brief account of the activities carried out by your Public Health Inspectorate in connection with environmental health matters; also included are the statistics required by various Government Departments. Co-operation among Senior Officers and the staff of all Departments of the Council is not solely confined to times of crisis but is very evident at all times and I wish to record my appreciation to my colleagues in this respect. Thanks are also due to the Public Health Department staff, particularly the Medical Officer of Health, Dr. H. Franks, for the outstanding help and support given and to Members of the Council for the confidence shown in the Department. The 'doomwatch' boom accelerated by 'European Conservation Year - 1970' continued unabated, achieving even greater proportions during 1971. This awakening of public concern and participation has done considerable good but care should be taken to avoid over emphasis or over reaction, both potentially harmful. That serious problems exist is beyond doubt, but the general public do not seem to be aware that the battle of the environment has been fought by responsible organisations, particularly Local Government, during past years and our increasing longevity is no accident, nor is the fact that the United Kingdom remains generally an attractive place in which to live. The ever increasing awareness by the public that 'standard of living' includes not only an increase in the pay packet, a new car or coloured television, but also leisure, tranquillity, beauty and a clean environment must help because it is with the public that the final solution rests. It is therefore of paramount importance to present the public with authentic and balanced information upon all aspects of pollution, unfortunately this does not always happen. Pollution of the environment by the motor car is an example, much being made of exhaust emission whilst the physical presence of the motor car caused the deaths of 7,696 and the injury of 344,390 people in the United Kingdom during 1971. The motor car also makes extravagant demands on land, particularly in towns and areas of scenic beauty. People, particularly children, are driven from the use of streets for social enjoyment, playing games, walking and cycling, by the noise, dirt and smells and fear of accidents. But few people would be willing to restrict their use of such a flexible and personal mode of transport, even with a much improved public transport system. The effects of past and present serious pollution problems demand alertness to the possibility of further threats to the environment, prevention being always better than cure. This fact has been well publicised but still we suffer from very basic 'grass roots' problems. Until every person lives in accommodation which is suited to their needs, equipped with all essential amenities and situated in decent, clean surroundings, we must not be at all complacent. P. W. RILEY, M.R.S .H. ,M.A.P.H.I. Chief Public Health Inspector -18- 1. INSPECTION OF THE AREA The work of the Public Health Inspector is founded on the principle that people are entitled to a healthy environment with clean and wholesome food, clean air, pure water, decent living and working conditions in order to secure for them a state of physical, mental and social well-being and not merely an absence of disease and infirmity. During the year, 6,743 visits were made to a variety of premises. Complaints totalling 1,494 were received covering a wide range of subjects. The public are encouraged to take advantage of the skilled services available at the Department as any trend towards requesting advice must result in higher standards being attained and the prevention of contraventions against the law. SUMMARY OF VISITS (a) DWELLINGS Disrepair 526 Multiple occupation 96 Overcrowding 3 Improvement grants 173 Rent Act 5 Infectious diseases and food poisoning 755 Noise abatement 128 Filthy or dirty houses 191 Water jupply 37 Mortgages 53 Miscellaneous 82 (b) COMMERCIAL Caravan sites 35 Offices, Shops and Railway Premises 280 Factories (including outworkers) 51 Massage establishments 6 Petroleum installations 285 Hairdressers 23 Swimming pools 19 Bakehouses and shops 90 Butchers 103 Catering premises 209 Confectioners 32 Fish shops 34 Greengrocers 44- Grocers 113 Vehicles 22 Wholesalers 13 Food complaints 109 Food sampling 44 Unsound food 187 Miscellaneous 13 /(c) -19- (c) OTHER. Animals and birds 47 Ditches, ponds, drainage and flooding 647 Refuse 158 Smells 100 Atmospheric pollution 264 Pest Control 1,584 Miscellaneous 168 2. HOUSING (a) Unfitness: An unfit dwelling may be dealt with by asking the owner to carry out the works necessary to make it fit, by making a closing order, by making a demolition order or by including it in a clearance area. The state of repair of the dwelling, its internal and external arrangement, the possibility of improvement, the effect on neighbouring property and the financial implications are fully considered, together with the opinions of both the owner and occupier before a decision is made as to the procedure to adopt. Unfit dwellings found 16 Dwellings included in clearance areas 12 Closing orders made 2 Demolition orders made 2 Closing orders rescinded (house made fit) 1 Houses demolished 5 (b) Disrepairr Under the provisions of the Public Health and Housing Acts, 526 visits have been made in connection with disrepair in houses. Maintaining property in good repair ought to be a priority with landlords to protect their investments. Unfortunately, this is not the case with a few owners who will only carry out repairs under the threat of legal action. As a result some properties drift into serious disrepair warranting consideration as to their future life. A cause for concern is the absence of satisfactory enforcement procedure to ensure a standard of good repair in houses when qualification certificates have been granted, particularly where a grant has also been given by the Local Authority. When disrepair does not constitute a public health nuisance the only remedy would seem to be for the tenant to apply to the Rent Officer for a reduction in the rent, which action does not secure the repair of the house. The power given in the Housing Act 1969 to deal with disrepair is not available for the remedying of minor defects but is intended to deal with defects which have led to a cumulative deterioration in the property, apparently permitting one to close the stable door after the horse has bolted. -20- /c) (c) Houses in Multiple Occupation: Defined as houses occupied by persons who do not form a single household they are causing problems for many Local Authorities. The amenities these houses require include natural and artificial lighting; ventilation, water supply; personal washing facilities; sanitary conveniences; facilities for the storage, preparation and cooking of food and for the disposal of waste water; installations for space heating or for the use of space heating appliances. Unfortunately, many of these houses possess a general lack of amenity, disrepair, overcrowding, danger and general squalor. Within this area few such houses are found but to prevent their proliferation they are searched for and the owners encouraged to take advantage of the grants which are available to provide suitable units of accommodation. If an owner does not wish to improve his property a direction is given which reduces the occupancy to suit the amenities provided by prohibiting, when any person ceases to reside in the house, any other person "taking up residence until the appropriate level is reached. (d) Overcrowding: The statutory standard for overcrowding is laid down in the Housing Act 1957, this standard has not improved since 1936 and cannot be believed to be an adequate standard for the present time. In 1936 when the problem of overcrowding was acute the standard offered much improvement but now, 35 years later, is obviously out-dated. A house consisting of 2 living rooms and 3 bedrooms may acconmodate 3 couples each having 2 children under the age of 10 years and any number of infants under the age of 1 year, and still have room for a lodger. However, the Housing Act 1957 states that what accommodation for overcrowded families is provided by the Local Authority such a 3 bedroomed house would only provide accommodation for 5 persons. It seems logical that a similar standard ought to be introduced as a basis for all overcrowding. 3. FOOD AND DRUGS (a) Sampling: The selection of samples for analysis is selective with preference for food which is suspicious, unusual or produced within the Chigwell Urban District area. The following is a summary of the samples submitted to the Public Analyst during 1971, which are only part of the total number of food items examined by members of the Department:- Type of Food No. of Samples Samples found to be not genuine Milk, Milk products 54 4 Sausages, Meats, Fish 53 - Vegetables 13 3 Confections, Cakes, Puddings 20 4 Sauces, Spices 16 - Fruits, Jams 10 - Drinks 7 2 Medicines 8 - 181 13 -21- /These These samples were obtained from 44 premises and represent the produce of 111 manufacturers. 10 of the samples reported as not genuine were the result of food complaints and the remaining 3 were labelling offences. Consultations take place with Chief Public Health Inspectors in South Essex in order to avoid excessive duplication. In this consultative area 2,387 samples were obtained during 1971 of which 128 were found to be not genuine; labelling offences being the most common, followed by unsatisfactory compositional standards of meat products and milk products. Samples obtained in Chigwell and duplicated elsewhere were confined to 1 bottle of pasteurised milk, 1 can of condensed milk and 1 can of processed peas. (b) Food complaints: During 1971, 32 food complaints were received. These may be divided into the following groups (i) 10 complaints which justified further action and the complainants were willing to attend Magistrate's Court. In 7 instances legal proceedings were instituted and 6 convictions obtained. (ii) 9 complaints which justified further action but the complainants were not willing to attend Magistrate's Court. (iii) 13 complaints which did not justify any further action. (c) Food Hygiene; The Food Hygiene Regulations impose obligations in respect of the construction, repairs and maintenance of food premises; the facilities to be provided including sinks and wash-hand basins; the cleanliness of food handlers and their clothing and the action to be taken if they are suffering from or are carriers of certain diseases; and the temperature at which certain foods must be kept. 704 visits were made to places in the district where food is kept for sale. The most effective way to achieve high standards of hygiene in food premises is frequent inspection incorporating education of food handlers. In general, the food premises are satisfactory but taking the view that the Regulations impose a minimum standard it is always possible to secure improvement. The continuing absence of adequate temperature control regulations is mystifying. It would seem that the campaign for date-stamping is taking priority at the moment but a date can never give a guarantee of fitness or quality. Any date must always be qualified by a "subject to satisfactory keeping" condition. I am not suggesting that date-stamping should not be introduced but rather that adequate temperature control is essentially of greater importance. Consider a humble meat pie which, following manufacture, is transported in a refrigerated vehicle to a town far from the bakery, there it is decanted on a garage forecourt (luxuriously termed a depot) into an unrefrigerated vehicle, which advertises for all to see that the products are "fresh daily", there it remains in possibly hot and humid conditions until the driver arrives in the morning. It is then delivered to a local shop where it is again placed under refrigeration until the shop opens to the public. Following advice from the manufacturer, the pie is placed in a huge pyramid by the door (and probably in the sun) in order to promote sales, but who will have the courage to disturb this work of art by the shopkeeper and in any case our clever housewife will surely prefer a pie from the unartistic but cool display on the refrigerated counter. At the end of -22- /the the day our now rather tired pie returns to the refrigerator until the procedure is repeated the next day and the day after that. If we are lucky the pie is now so covered in mould no person would eat it, if not somebody is going to suffer and from eating a pie which had an unexpired date!! The number of food premises in the district is as follows Bakehouses and shops 17 Fish shops 12 Butchers' shops 27 Greengrocers' shops 24 Catering premises 108 Grocers' shops 38 Confectioners 42 Wholesalers 3 Premises registered for the manufacture or sale of preserved foods 26 " " " " sale of ice cream 85 Itinerants " " " " " " " 5 " " " " " " food 34 (d) Food Inspection: In addition to the routine inspection of food offered for sale many requests are made by local food traders for examination of food items. Comment is sometimes made that such requests have only a commercial basis and concern unmarketability rather than unwholesomeness. This is probably true but improving and safeguarding the public's food is one of the most important of a Public Health Inspector's duties and any action which assists this work is considered to be worthwhile. The difference between unmarketable and unwholesome is always tenuous and the principle must be to reject doubtful food rather than place the community at risk. A total of 3.787 tonnes and 238.14 litres of food was rejected during the year. The details are as follows:- Carcase meat 178.63 kg Offal 17.68 kg Cooked meat and meat products - Canned meats 10.61 kg Other canned foods 2,669.40 kg Fish (fresh) 41.75 kg Fruit and vegetables (fresh) - Frozen foods due to cabinet breakdown 319.32 kg and 216.14 litres Other foods 549.72 kg and 22.00 litres (e) Imported Food: On occasions food is imported directly into the district without examination at the port of entry. When this occurs the Port Health Authority are obliged to notify the Local Authority but there is no obligation on the importer to retain the food for inspection or to notify its arrival. Consequently, the Inspector must be prepared to wait at the importer's premises at any time of day or night when food is expected, presuming of course that the notification arrived before the food. Fortunately, a good relationship has been established with the importer in this district, all food imported during the year was inspected and within reasonable hours. However, a legal requirement that an importer must notify the Local Authority of the arrival of uninspected food and -23- /that that such food must remain sealed and not be removed from his premises until seen by the Public Health Inspector is the only method of ensuring that imported food is properly controlled. Details of imported food inspected areas follows:- Food Examined Rejected Canned tomatoes 27.6 tonnes 0.02 tonnes Canned orange juice 71.228 tonnes 0.085 tonnes Canned grapefruit juice 14.228 tonnes 0.012 tonnes Totals: 113.056 tonnes 0.117 tonnes 4. WATER SUPPLIES It is the duty of the Local Authority to ascertain the sufficiency and wholesomeness of water supplies in the district. The Metropolitan Water Board supply the whole of the district and report on their supplies as follows:- '1. (a) The supply was satisfactory both as to quality and quantity throughout 1971. (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 the analytical 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, 1971 was 54,620. (ii) No houses were permanently supplied by standpipe. (d) No artificial fluoride is being 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 derived from the following works and pumping stations:- Lee Bridge Works and, during the summer, Coppermills Works. Well water from Chingford Mill and Waltham Abbey pumping stations. No new sources of supply were instituted and there were no changes to the general scheme of supply in your area. -24- /The The number of samples collected and the bacteriological and chemical analyses of the supply from the above sources after treatment are shown on the attached sheets. (b) On account of their hardness content and alkaline reaction the Board's river and well water supplies are shown to be not plumbo-solvent. It should, however, be appreciated that all types of water pick up varying amounts of metal from the material of water piping particularly when it is newly installed; this applies to copper, zinc, iron and also to lead. Water Samples:- (a) Average results of Chemical Examination. Milligrammes per litre (unless otherwise stated):- Lee Bridge Coppermills Chingford Mill Waltham Abbey No. of samples taken during the year 52 49 4 4 Ammoniacal Nitrogen 0.014 0.020 0.20 0.190 Albuminoid Nitrogen 0.096 0.105 0.021 0.040 Nitrate Nitrogen 6.7 6.8 0.2 0.2 Oxygen abs. from KMnO4 4 hours at 27°C 1.14 1.16 0.27 0.33 Hardness (total) CaC03 297 304 276 273 Hardness (non-carbonate) CaCO3 99 109 64 66 Magnesium as Mg 6 6 - - Sodium as Na 31.0 31.0 - - Potassium as K 6.4 6.4 - - Chloride as Cl 39 43 27 27 Phosphate as PO4 3.2 3.4 - - Silicate as SiO2 10 10 - - Sulphate as SO4 78 78 - - Natural Fluoride as F 0.20 0.20 0.45 0.65 Surface-active material as Manoxol OT 0.03 0.03 - - Turbidity units 0.2 0.1 0.1 0.2 Colour (Burgess Units) 15 12 6 6 pH value 7.9 7.6 7.4 7.4 Electrical Conductivity (micromhos) 620 630 560 550 /(b) -25- (b) Results of Bacteriological Examination: Lee Bridge Coppermills Chingford Mill Waltham Abbey BEFORE TREATMENT - No. of samples 2,698 693 250 251 Agar plate count per ml:20-24 hours at 37°C 59.7 14.5 0.1 0.2 3 days at 22°C - - 12 9 Coliform Count:Per cent. samples negative in 100 ml. 35.29 34.63 99.20 99.20 Count per 100 ml. 11.3 10.4 - 0.1 Escherichia coli count:Per cent samples negative in 100 ml. 59.30 52.67 100.0 100.0 Count per 100 ml. 2.1 2.7 - - AFTER TREATMENT - No. of samples 278 240 254 254 Agar plate count per ml.:20-24 hours at 37°C 27.4 9.9 0.1 0.8 3 days at 22°C - - 8 17 Coliform count:Per cent samples negative in 100 ml. 99.64 100.0 100.0 99.61 E. coli count:Per cent samples negative in 100 ml. 100.0 100.0 100.0 100.0 5. SWIMMING POOLS Periodic visits are made to ascertain the standards of water treatment, bacteriological control and hygiene. Water samples are taken and advice is given when found necessary. There are 13 swimming pools within the area situated, as follows Buckhurst Hill: Roding Valley Tennis Club, 200 Buckhurst Way. Chigwell: West Hatch Technical High School, High Road. Chigwell School, High Road. Chigwell County Primary School, High Road. High View Residential School, Lambourne Road. Buckhurst Hill County High School, Roding Lane. Grange Farm Centre, High Road. Girl Guides' Camp, Lambourne Road. -26- /Loughton Loughton: Loughton County High School for Girls, Alderton Hill. St. Nicholas Infants' School, Borders Lane. Davenant Foundation Grammar School, Chester Road. Lucton County Secondary School for Girls, Homecroft Gardens. Loughton Pool, Traps Hill. 6. CARAVAN AND CAMPING SITES There are 2 recreational caravan and camping sites within the area. Grange Farm, which is owned and operated by the Council, and Debden House, which is licensed by the Council. The licensing system makes it possible for the Local Authority to secure adequate conditions on caravan sites by restricting the number of caravans; controlling the type of caravan; regulating the position of caravans, vehicles, structures and tents; taking of steps to preserve or enhance the amenity of the land; ensuring adequate measures for fire prevention and fire fighting; securing adequate sanitary and other facilities for the persons using the caravans. 7. CLEAN AIR It is generally accepted that there exists a definite relationship between atmospheric pollution and lung cancer and bronchitis. Pollution of the air also damages buildings and materials and has an adverse effect upon agriculture and horticulture. The Clean Air Acts have undoubtedly resulted in a remarkable decrease in air pollution, one has only to remember how smog has decreased over the past few years for this to become evident. Although domestic chimneys are the major contributors towards air pollution much attention is given to industrial plant. Notice of intention to install new industrial plant is obligatory, in addition, the person installing the plant has an option to submit plans for approval. This enables advice to be given at an early stage and assists in preventing further pollution. 8. NOISE ABATEMENT The Noise Abatement Act 1960 enables a Local Authority to deal with noise and vibration as statutory nuisances and also prohibits the use of loudspeakers on' the highway, subject to certain exceptions. Advertising the sale of perishable food by loudspeaker is permitted between 12.00 and 19.00 hours but it is suspected that many ice cream vendors exceed this period. As a result of complaints, 128 visits were made at all times of day and night to investigate noise nuisances. It was possible to solve most problems to the satisfaction of the complainants. The solution to many complaints is simple. For example, road drills are extremely noisy but can be quietened by using a muffler which is cheap, efficient and easily fitted. The pile driving in connection with the M.ll/London Transport bridge caused nuisance to many and the cessation of night working alleviated the problem albeit without a reduction in the actual noise emitted. /There -27- There is no doubt that noise is detrimental to the environment and the general public can help themselves to. a great extent by being generally aware that noise upsets people and not slamming doors, playing radios and musical instruments too loud etc., in effect practising good neighbourliness 9. PETROLEUM The Petroleum Acts encompass all matters concerning the safety of the individual and the general public where petroleum is stored, transported, delivered, sold or handled. Although the Home Office gives guidance to the Local Authority, the ultimate responsibility for establishing conditions in respect of petroleum installations, and their enforcement, lies with the Council. The conditions introduced by the Council and the non-licensing of installations which fail to reach the required standard are having the desired effect of attaining safer conditions. There are 41 premises licensed and routine visits were made to all of them to ensure that safety precautions were being observed. Advice has been given on the installation of new storage tanks, pumps and electrical fittings, the rendering safe of disused storage tanks and matters concerning the delivery of petroleum. Testing of all new installations was carried out with satisfactory results. 10. PEST CONTROL It is the duty of occupiers of lands and premises to notify the Local Authority of infestations by rats or mice and their own responsibility to destroy them. The Local Authority are obliged to see that this is done. However, there is no doubt that the best results are achieved when the Local Authority carry out pest control as a service, as is done in this district, to ensure that only proper materials and methods are used. This service is available to householders free of charge and to occupiers of business premises for a small fee. Warfarin resistant rats are present in various parts of the country. The rise in numbers of such rats could have disastrous results on the efforts to control the rat. Warfarin properly used is an extremely efficient poison giving little hazard to man or domestic animals and is used almost exclusively in carrying out treatments. The alternative poisons used to treat warfarin resistant rats are more difficult to use and can be hazardous to man and domestic animals. It is of utmost importance that should the presence of warfarin resistant rats be suspected the Department be notified in order that appropriate action may be taken. Although no such rats have been discovered in the district, in common; with many areas warfarin resistant mice have been found and successful treatment by narcotics has been possible. 358 complaints of rats or mice were made during the year and all were promptly investigated and the appropriate treatment carried out. 309 complaints of other pests were received, including 229 of wasps. The Department helps in these complaints whenever possible by practical assistance or advice. /11. -28- 11. OFFICES, SHOPS AND RAILWAY PREMISES ACT The Act is designed to promote the safety, health and welfare of employees, and requires that offices, retail shops, wholesale departments, warehouses, fuel storage depots, catering establishments and canteens be registered when persons are employed. Satisfactory conditions have to be maintained in these premises in respect of cleanliness, overcrowding, temperature, lighting, ventilation, sanitary conveniences, washing facilities, drinking water, accommodation for clothing, seating arrangements, eating facilities, floors, passages and stairs, cleaning, maintaining and fencing exposed machinery, prohibition of heavy work, first aid, dangerous conditions and practices and fire precautions. At the end of the year, 473 premises were registered, employing 1,118 males and 1,664 females. 30 minor contraventions were found during the year and the co-operation of the occupiers in complying with the requirements was readily obtained. 7 accidents to employees were notified to the Department and advice was given in order to prevent any recurrence. It is considered that the question of temperature should be dealt with in more detail by the Act. The minimum temperature of 60.8 degrees fahrenheit is too low for many employments, in particular, office work. A maximum temperature is also needed as astonishing levels of heat can be attained in some premises. 12 ANIMAL CARE (a) Riding Establishments Acts: Persons keeping riding establishments must obtain, a licence from the Local Authority. The Act requires that the licensee be a suitable person; that the horses are suitable for the intended use and are kept in a state of good health and physical fitness; that the accommodation for the horses is of suitable construction and of adequate size for the occupants, has adequate light, ventilation and drainage, and is kept clean; that suitable food, drink and bedding material is provided; that the horses are exercised, groomed, rested and visited at suitable intervals; that precautions are taken to prevent the spread of infectious disease; that first aid facilities and medicines are kept; that adequate fire precautions are taken; that inexperienced riders be properly supervised; also that the licensee be insured against liability for any injury sustained by persons using the horses. Inspections have been made during the year by the Public Health Inspectorate and Mr. H.E. Bywater,M.R.C.V.S. ,F.R.S.H. ,who reports that conditions continue to be of reasonable standard and that no changes in the occupation or location of the following premises took place:- Nightingale Riding School. Epping New Road. Buckhurst Hill: Owned and managed by Mr. T. Robinson, 74 Field Road, Forest Gate, E.7. 13 horses and 4 part livery used in the school. 8 other horses not used in the school - average during the year. /Forest -29- Forest Riding School, North End, Buckhurst Hill: Owned and managed by Miss O. de Berry who lives on the premises. 4 horses and ponies in the school and 1 at full livery. Riding Centre for the Disabled, Grange Farm Sports Centre, High Road, Chigwell; Owned by the Pony Riding for the Disabled Trust. Managed by Mr. J.A. Davies who lives on the premises. 10 ponies and horses. Chigwell Riding School. Chase Lane, Chigwell: Owned and managed by Mr. D.G. Cowlqy, 3 Elms, Greensted, near Ongar. 26 horses used in the school. 7 at full livery, 7 breeding animals, 4 foals and 3 donkeys also on. the premises. (b) Pet Animals Act: No person may keep a pet shop without a licence granted by the Local Authority. 5 such shops are licensed subject to conditions in respect of suitable accommodation, food and drink, that animals will not be sold at too early an age, prevention of spread of infectious disease and fire precautions. 13. SCRAP METAL DEALERS ACT It is the duty of the Local Authority to maintain a register of persons carrying on the business of scrap metal dealers. There are 2 such dealers in the area who are obliged to maintain records of dealings. 14. FACTORIES AND WORKPLACES The Local Authority are responsible for enforcing satisfactory conditions in respect of cleanliness, overcrowding, tenperature, ventilation, drainage of floors and sanitary conveniences in respect of factories where mechanical power is not used and in respect of sanitary conveniences where mechanical power is used. A total of 97 factories and workplaces are registered in the district. (See APPENDIX A. on pages 31and 32). -30- APPENDIX A. 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 5 - - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 81 10 - - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 11 - - - Total 97 10 - - 2. CASES IN WHICH DEFECTS WERE FOUND: Particulars Number of cases in which defects were found Number .of cases in which cutions were Instituted Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector Want of cleanliness (S.l.) - - - - - 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 - 1 - - - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) - - - - - Total - 1 - - - /OUTWORK -31- 3. OUTWORK (SECTIONS 133 and 134) Nature of Work Section 133 Section 134 No. of outworkers in August list required by Section 133 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing apparel making etc. 22 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 60 - - - - - Cosaques, Christmas stockings etc. 5 - - - - - Total 87 - - - - - -32- APPENDIX B. RAINFALL IN MILLIMETRES FDR YEAR 1971. METROPOLITAN WATER BOARD CHIGWELL U.D.C. High Beech Buckhurst Hill Luxborough S.D. Works Loughton Depot January 73.90 75.69 72.20 69.90 February 13.70 12.70 12.19 7.91 March 59.40 51.56 44.40 52.82 April 38.00 37.84 34.49 38.10 May 53.30 61.70 67.84 52.43 June 104.60 101.85 97.73 96.92 July 26.67 24.13 17.52 25.38 August 101,30 102.70 103.00 101.60 September 14.00 16.90 16.51 13.10 October 58.20 56.60 56.20 57.26 November 76.90 72.80 64.26 77.80 December 28.30 29.90 24.33 27.10 648.27 644.37 610.67 620.32 AVERAGE RAINFALL FOR THE LAST FIVE YEARS 1967 658.00 1968 717.20 1969 580.80 1970 664.40 1971 630.90 -33-