I CHIG 36 Chigwell Urban District Council ANNUAL REPORT of the Medical Officer of Health including the Report of the Chief Public Health Inspector for the year ending DECEMBER, 31ST 1972 CHIGWELL URBAN DISTRICT COUNCIL Chairman of the Council: Councillor R.C. 0 Malley Vice-Chairman of the Council: Councillor R. Garner PUBLIC HEALTH COMMITTEE Chairman: Councillor N.T.H. Croucher Vice-Chairman: Councillor Mrs. S. Gordon Members: Councillor G.P. Claridge A.H. Hilton N. Jacobs B. Mooney 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) (Till 3.10.72). Technical Assistant: A.H. BROWN. Trainee Public Health Inspector: MISS C.A. LLOYD 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 1972, which includes the Annual Report of the Chief Public Health Inspector, VITAL STATISTICS The birth rate and the death rate, after adjustment to take into account the age distribution of the local population, are both lower than the rates for the previous year. Both continue to be well below the average figures for the United Kingdom as a whole. Live births exceeded deaths by 242, but the estimated total increase in the population of the District, allowing for migration, was 300, the mid-1972 population estimate being 54,920. Main causes of death were, as usual, heart diseases and cancers. 1 infant fell into a pond and drowned; another choked on a peach stone. The 1971 Census for England and Wales included the following statistical information about the population of the District - Percentages Chigwell U.D. Essex Living in private households 97.9 97.5 Under age 25 36.4 38.7 Proportion of males 16 and over who are married 72.1 75.2 „ „ females „ „ „ „ „ „ 66.5 69.3 „ „ pensionable age who are living alone 20.9 22.6 Born in UK 95.6 95.6 Born outside UK (including visitors) 4.2(0.7) 3.8(0.2) Proportion aged 15-19 inclusive who are students 47 38 „ living in private households which are - owner-occupied 54.8 55.7 rented from Council 34.2 29 privately rented unfurnished 9.4 12.5 „ „ furnished 1.3 2.7 Proportion of households which - have exclusive use of hot water supply fixed bath and inside flush WC 94.9 89.2 share hot water supply 0.9 1.2 have no hot water supply 2.0 4.5 share fixed bath and shower 1.0 1.8 have no fixed bath and shower 2.6 5.3 /Proportions -3-  Percentages Chigwell U.D. Essex Proportions of households which - share inside WC 1.0 1.5 share outside WC 0.1 0.2 have exclusive use of outside WC 2.9 5.5 have no WC 0.1 1.5 These figures indicate a high general standard of living conditions in the population, the only possibly disturbing figure being the high percentage of elderly persons living alone. One would, however, like to know how many of them have regular and easy contact with relatives, friends and neighbours and live alone by personal choice, before attaching too much importance to this figure. CONTROL OF INFECTIOUS DISEASES This was highly satisfactory, the number of notifications being negligible for a district of this size. The single case of typhoid was infected while on holiday in Spain. Venereal diseases are of course not notifiable, and modern permissiveness combined with replacement of barrier contraceptives by"The Pill" have undoubtedly given rise to some increase in the incidence of these infections in recent years. Its extent is difficult to estimate, as the figures are enlarged by a greater readiness of those exposed to attend the clinics than in former years, and by vigorous chasing up of contacts; so there is less concealment, and the ultimate results should be beneficial. There was in fact a slight fall in the number of new cases seen at clinics in England in 1972 compared with 1971. I would hazard a guess that the number of venereal infections now occurring among residents of this district does not exceed between 20 and 30 per annum. DIESEL EXHAUST FUMES It is surely worth noting that despite the universal declarations of its harmlessness, exhaust from diesel engines has been the subject of numerous recommendations, regulations and continuing research. The general public and their representatives are clearly not convinced that the evidence of their eyes and noses and stomachs can be ignored with equanimity, as the number and size of diesel powered vehicles on the roads continues to increase. Subjective methods of measuring visible smoke are many, but in general they are unreliable. Light obscuration meters, light dispersal meters and filter-soiling meters have been used in many countries under various conditions, to produce a chaotic mass of knowledge, standards and regulations. Although such measurements could perhaps be standardised and form a basis for controlling the amount of unburnt fuel shed into the atmosphere,(and thus generally help to reduce pollution) they do not measure the toxicity or public health hazard of the exhaust emission. Similarly, the only available instrument so far for measuring odour being the nose, it would seem impractical to recommend a control-regulation on this basis on public health grounds. At present there is a lack of information about the minimum atmospheric concentrations of diesel smoke and gases which are really harmful, having regard to the population density of the locality, the climatic conditions -4— /and and the vehicle concentration. It is important to bear in mind that the problems are essentially localised, since the concentration of pollutants rapidly diminishes as distance from the source increases. Vehicles may emit literally hundreds of different complex compounds, and therefore a vigilant attitude must be preserved, and engines would have to conform to arbitrary control values. There would be continual attempts to establish what effect these controls would have, and what additional cost of modifications to existing engines, or of the development and production of new types, could be tolerated. Objection to degrees of visible smoke can be established from subjective assessments by groups of people, but the same method cannot be applied to gases which may be toxic, or which may cause harm to develop slowly. It is clear that the aims for the highest possible efficiency of operation, and for the lowest possible cost of a power unit which will perform a given task must now be sacrificed. While the term "cost effectiveness" has become more widely quoted since legislation of various forms has enveloped motor vehicles, it must be an almost impossible quantity to evaluate, when attempting to weigh up commercial or economic viability against an indeterminate effect of pollution on human, animal and plant life, and the environment. I have submitted a survey of the literature on this subject to the appropriate Committee of the Society of Community Medicine, who will be considering what further action on public health grounds is possible to hasten the abatement of this increasing nuisance. MASS RADIOGRAPHY Work done by the Mass Radiography Unit in the district during the year was as follows:- Male Female Total LOUGHTON HALL (2 Visits) Local Authority staff 107 411 518 Public 15 36 51 Total number X-rayed 122 447 569 Requiring further investigation - 4 4 Pulmonary Tuberculosis- Requiring treatment - 1 1 Requiring close clinic supervision — - — Requiring occasional clinic supervision — 1(previous- 1 ly known) Presumed healed, discharged - - - Group in which significant Tuberculosis was discovered- Requiring treatment - Local Authority staff - 1 1 Other abnormalities discovered- Bacterial and virus infection of lung 1 1 /OTHER -5-  Male Female Total OTHER WORK IN THE AREA J. Sainsbury Ltd. Loughton (Contact Group) (including 28 public) 50 96 146 Requiring further investigation 2 2 4 Pulmonary Tuberculosis - - - Other abnormalities discovered- Bacterial and virus infection of lung 1 - 1 Congenital abnormality of heart 1 - 1 Did not attend for repeat miniature film 2 - 2 In last year's report I commented on the lack of regular health supervision at Colleges of Further Education. It is pleasing to note that under recent proposals for inclusion in the reorganisation of the National Health Service, this gap in the services will be closed. MEDICAL EXAMINATION OF STAFF In connection with their appointment for duties with this Council, 24 officers and staff completed Personal Health Report forms which were duly assessed; 11 received a medical examination. 35 employees were re-assessed and reported on for sick-pay and superannuation purposes, following prolonged periods of sick-leave or retirement. 4 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 10 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, social services, meals-on-wheels, as necessary. Subsequently, 3 cases were voluntarily removed to hospital, where 1 died. RE-HOUSING PRIORITY ON MEDICAL GROUNDS 90 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 -6- Diseases or Conditions Total Applicants Priority Recommended Priority Not recommended Asthma, bronchitis, catarrhal diseases etc. 14 9 5 Blood pressure 2 2 0 Heart disease 8 7 1 Nervous diseases (anxiety states neurasthenia, neurosis etc.) 27 9 18 Rheumatism, arthritis etc. 5 5 0 Tuberculosis 3 3 0 Other diseases 9 6 3 Other conditions 22 11 11 90 52 38 The 38 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. RE-ORGANISATION OF THE NATIONAL HEALTH SERVICE This will involve the transfer of the main functions of the Medical Officer of Health from Local Grovernment to the National Health Service as from 1st April, 1974. At the time of writing it seems probable that the County of Essex will become a Region/Area on its own in the re-organised National Health Service, containing 5 Administrative Districts named, Harlow, Chelmsford, Basildon, Colchester and Southend. The "Harlow" National Health Service District will include the new Local Government Districts of Epping Forest, Harlow and Uttlesford (i.e. Saffron Walden and Dunmow Districts). Detailed plans for co-ordinated action on such matters as prevention and control of infectious diseases, nuisance and pollution control, health education, safety of food and water supplies, staffing etc., are to be worked out by the Joint Consultative Committees under guidance to be provided from the appropriate Government Departments during the period of change-over. In the meantime, extensive consultations are constantly taking place between all concerned to ensure as far as possible that the medical services after re-organisation will be adequate, and fully co-ordinated with the work of all the Departments of the new Local Authorities. 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 all the staff of the Public Health Department for their enthusiasm and loyalty. H. FRANKS, M.B., B.S., B.Hy.,D.P.H. Medical Officer of Health June, 1973 -7- VITAL STATISTICS Estimated Mid-Year Home Population: 54,920 England and Wales: 49,028,900 Chigwell U.D.C. England and Wales (Total) Males Females Total LIVE BIRTHS: Total 357 329 686 725,405 Legitimate 341 307 648 662,907 Illegitimate 16 22 38 62,498 STILL BIRTHS: Total 5 4 9 8,794 Legitimate 5 3 8 7,846 Illegitimate 0 1 1 948 TOTAL LIVE AND STILL BIRTHS: Total 362 333 695 734,199 Legitimate 346 310 656 670,753 Illegitimate 16 23 39 63,446 DEATHS OF INFANTS: Under 1 year of age- Total 4 2 6 12,494 Legitimate 3 2 5 11,177 Illegitimate 1 0 1 1,317 Under 4 weeks of age- Total 2 2 4 8,373 Legitimate 1 2 3 7,503 Illegitimate 1 0 1 870 Under 1 week of age- Total 1 2 3 7,142 Legitimate 1 2 3 6,365 Illegitimate 0 0 0 777 DEATHS - ALL AGES 259 232 491 591,907 /LIVE -8-  Chigwell U.D.C. England and Wales LIVE BIRTH RATES, ETC. - - Live births per 1,000 home population (crude rate) 12.5 14.8 Area comparability factor 1.05 1.00 Local adjusted rate 13.1 14.8 Ratio of local adjusted rate to national rate .89 1.00 Illegitimate live births as percentage of all live births 6 9 STILL BIRTH RATE: Still births per 1,000 total live and still births 13 12 INFANT MORTALITY RATES: Deaths under 1 year per 1,000 live births 9 17 Deaths of legitimate infants under 1 year per 1,000 legitimate live births 8 17 Deaths of illegitimate infants under 1 year per 1,000 illegitimate live births 26 21 Neonatal mortality rate- Deaths under 4 weeks per 1,000 live births 6 12 Early neonatal mortality rate- Deaths under 1 week per 1,000 total Live births 4 10 Perinatal mortality rate- Still births and deaths under 1 week combined, per 1,000 total live and still births 17 22 DEATH RATES ETC.- ALL AGES: Deaths per 1,000 home population (crude rate) 8.9 12.1 Area comparability factor 1.11 1.00 Local adjusted rate 9.9 12.1 Ratio of local adjusted rate to national rate .82 1.00 /CAUSES -9- CAUSES OF DEATH AS GIVEN BY THE REGISTRAR GENERAL FOR THE YEAR 1972 Male Female Total Tuberculosis of respiratory system 1 0 1 Other infective and parasitic diseases 0 1 1 Malignant neoplasm, stomach 9 5 14 „ „ , intestine 7 8 15 „ „ , larynx 1 0 1 „ „ , lung, bronchus 25 7 32 „ „ , breast 0 13 13 „ „ , uterus 0 5 5 „ „ , prostate 6 0 6 Leukaemia 0 3 3 Other malignant neoplasms 16 19 35 Benign and unspecified neoplasms 1 2 3 Diabetes mellitus 2 3 5 Other endocrine etc. diseases 1 0 1 Mental disorders 0 1 1 Multiple sclerosis 1 0 1 Other diseases of nervous system 3 2 5 Chronic rheumatic heart disease 0 5 5 Hypertensive disease 5 7 12 Ischaemic heart disease 70 52 122 Other forms of heart disease 9 14 23 Cerebrovascular disease 24 33 57 Other diseases of circulatory system 9 5 14 Influenza 2 2 4 Pneumonia 24 19 43 Bronchitis and emphysema 10 5 15 Asthma 1 0 1 Other diseases of respiratory system 4 0 4 Peptic ulcer 1 2 3 Intestinal obstruction and hernia 1 3 4 Cirrhosis of liver 1 1 2 Other diseases of digestive system 1 3 4 Nephritis and nephrosis 6 1 7 Hyperplasia of prostate 1 0 1 Other diseases, genito-urinary system 0 2 2 Congenital anomalies 4 0 4 Birth injury, difficult labour etc. 1 1 2 Other causes of perinatal mortality 0 1 1 Symptoms and ill defined conditions 1 0 1 Motor vehicle accidents 4 0 4 All other accidents 2 3 5 Suicide and self-inflicted injuries 4 3 7 All other external causes 1 1 2 TOTAL DEATHS 259 232 491 /Prevalence -10- PREVALENCE OF, AND CONTROL OVER INFECTIOUS AND OTHER DISEASES Number of Cases Admissions to Hospitals Deaths Acute Meningitis 1 1 0 Dysentery 7 1 0 Food Poisoning 2 0 0 Infective Jaundice 6 0 0 Measles 27 0 0 Scarlet Fever 2 0 0 Tuberculosis- Respiratory 6 6 1 Other 2 1 0 Typhoid Fever 1 0 0 Whooping Cough 4 0 0 58 9 1 VACCINATION AND IMMUNISATION SCHEMES: 1. B.C.G. Vaccination, of School Children: This scheme for the 13/14 year age groups shows a decrease from 88.55% to 84.50% 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: 991 Number accepted: 833 (84.50%) Number given skin test and percentage 787 (80.0% Number who gave positive reaction to skin test: 43 Number who received B.C.G. 691 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. 2. Smallpox: 112 primary vaccinations were performed and 97 persons were revaccinated during the year. -11- /3. 3. Diphtheria/PertussisAetanus: The following number of injections were given during the year:- Primary Boosters Triple vaccine 1,050 186 Diphtheria/Tetanus 55 481 Tetanus 92 152 Diphtheria 0 0 Pertussis 0 0 4. Poliomyelitis: 1,140 children completed a primary course of immunisation against poliomyelitis. 599 re-inforcing immunisations were given. 5. Measles: 709 primary vaccinations were performed. 6. Rubella: 319 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 Health Area, Terminus House, The High, Harlow (027-96 34714) Director of Social Services: Mr. Walter E. Boyce, Kensal House, 77 Springfield Road, Chelmsford (0245 67181) 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, 309 Willingale Road, Loughton (01-508 9311) (To contact Duty Social Worker outside office hours, telephone Princess Alexandra Hospital027-96 26791) Registrar of Births and Deaths: Mr. G.T. Raymerit, 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. Area Social Work Office, 309 Willingale 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) Mrs. Ross („ " ) LOUGHTON: Essex County Council Health Services Clinic, Loughton Hall Rectory Lane (01-508 6296/9) Health Visitors and School Nurses: Miss Conroy Miss Richards Mrs. White (Clinic Nurse) Mrs. Dell („ „) Essex County Health Services Clinic, The Drive (01-508 5776) Health Visitor and School Nurse: Mrs. Green 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 /Loughton -14- 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. M. Bow (Part-time), 8 Walnut Way (01-504 7604) CHIGWELL: Miss D.E. Lyon, 9 Coppice Path (01-500 2108) LOUGHTON: Mrs. M. Happe, 13 Buckingham Road, South Woodford, E.18 (01-505 0481) 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) Mrs. W.J. Jestice, 11 Rous Road (01-504 7249) MIDWIVES: BUCKHURST HILL: Mrs. N. Warwicker, 40 Chestnut Avenue (01-504 6371) CHIGWELL: 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 Roch ford 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 9,501 Ante-natal and Post-natal Clinics 960 Number of visits made by: Health Visitors and School Nurses 9,831 Home Nurses 22,394 Midwives (Confinements) 125 /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 be made through the Area Medical Officer, Terminus House, The High, Harlow (027 96 34714). Aoluntary -16- VOLUNTARY ORGANISATIONS: BRITISH RED CROSS SOCIETY; Divisional President: Mr. C.P. Attwood, 48 Chigwell Park Drive, Chigwell (01-500 6666) CITIZFNS' ADVICE BUREAU: Loughton and District Organiser: Rev. K.A. Vine, St. Mary's Parish Rooms, 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 (01-508 3785) St. Mary's Parish Rooms, High Road, (temporary accommodation) Loughton (01-508 7228) Tuesday: Wednesday and Thursday: 10 a.m. - 2 p.m. 10 a.m. - 4 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: Counselling Centre: Mrs. Gwen Verriour, Kirkdale Centre, Kirkdale Road, Leytonstone, E.ll. (01-539 2939) St. Mary's Parish Rooms, High Road, Loughton Tuesday morning and Friday afternoon (by appointment) SPASTICS SOCIETY: Acting Hon. Secretary: Mrs. W.A. McAllister, 68 Forest Drive, Theydon Bois (849 3177) NATIONAL BLOOD TRANSFUSION SERVICE: Hon. Secretary: Mrs. M. Hipkin, 6 Little Plucketts Way, Buckhurst Hill (01-504 9643) 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, I am pleased to present my annual report for the year 1972, which includes a statistical account of the activities of your public health inspectorate and information required by various Government departments. I take this opportunity to express my appreciation of the co-operation received from officers of all departments and to Members for the help and support given during the year. P.W. RILEY, M.R.S.H.,M.A.P.H.I. Chief Public Health Inspector -18- 1. INSPECTION OF THE AREA During the year, 1,396 formal complaints and approximately 14,000 queries were received. 7,828 visits were made, as detailed in the following table. The staff of the department are always prepared to offer their help to any member of the public requiring advice or assistance with an environmental health problem. The large number of queries received is welcomed, as contact with the public is essential to the effectiveness of the department. SUMMARY OF VISITS (a) DWELLINGS State of repair, improvement etc. 1,173 Multiple occupation, overcrowding 104 Infectious diseases and food poisoning 759 Noise abatement 140 Filthy or dirty houses 94 Water supply 30 Miscellaneous 408 (b) COMMERCIAL Caravan sites 34 Offices, Shops and Railway Premises 256 Factories (including outworkers) 172 Massage establishments 4 Petroleum installations 185 Hairdressers 19 Swimming pools 23 Food shops 481 Vehicles 29 Food complaints 110 Food sampling 41 Unsound food 135 Miscellaneous 37 (c) OTHER Animals and birds 89 Ditches, ponds, drainage and flooding 1,029 Refuse 145 Smells 124 Atmospheric pollution 195 Pest control 1,681 Miscellaneous 331 2. HOUSING During the year, 1,173 visits have been made to identify unfitness, lack of amenity and disrepair, to inform householders of the services offered by the Council and to secure improvements in living conditions. The programme of routine visiting has identified three main obstacles to securing the provision of basic amenities in all houses. Firstly, despite the publicity given to the improvement grant schemes, there are still people who -19- /are are not aware of the considerable assistance offered by the Council towards providing amenities and improvements for the home. Secondly, that certain people, particularly the elderly, do not wish to suffer any disturbance which may be caused by the installation of amenities. These opinions are respected and it is only ensured that such persons are fully informed of the facilities available to them. Thirdly, confusion as to the future life of their house dissuades some from taking advantage of the improvement schemes. The exemplary record of the Council towards house improvement is evident in that 94.9% of households in the district enjoy the exclusive use of amenities. A planned approach with continuing publicity, direct public contact and possibly improvement areas will soon ensure that of the remaining 5.1% of households, only those so wishing will remain without the exclusive use of basic amenities. The 1971 census figures relating to household amenities provide the following information Households without exclusive use of at least 1 of the basic amenities of hot water supply, fixed bath or shower and inside w.c. 927 Households without hot water supply 363 Households sharing hot water supply 163 Households without a fixed bath or shower 472 Households sharing a fixed bath or shower 181 Households sharing outside w.c. 18 Households sharing inside w.c. 181 Households with exclusive use of outside w.c.527 Households with no w.c. 18 Unf itness: Unfit dwellings found 20 Dwellings included in clearance areas 6 Closing orders made 6 Demolition orders made 2 Closing orders rescinded (house made fit) 1 Houses demolished 4 3. FOOD AND DRUGS (a) Sampling for chemical analysis 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 1972, 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 24 4 Sausages, Meats, Fish 32 3 Vegetables 7 2 Confections, Cakes, Puddings Sauces, Spices 24 15 5 1 Fruits, Jams 4 - Drinks 6 - Medicines 7 - 119 15 -20- /The The samples included 8 taken as part of a national survey for pesticide residues. 13 of the samples reported as not genuine were the result of food complaints, 1 was a labelling offence and 1 sample obtained was found to be mouldy. (b) Food complaints COMMODITY Foreign Matter Mould Unfounded complaint Home produced food Imported food Milk 2 - - 1 Butter - 1 - - Cheese - 1 - - Bread 7 - 3 - Canned Meat 1 - - 1 Cooked Meat - - - - Fresh Meat - - - 1 Meat Pies 1 - - - Fish - - - - Fruit 1 - - - Jam 4 1 - - Vegetables 1 - - 1 Cereals - - - - Sweets - - 1 - Flour confectionery 2 - - 2 Other Food 2 — 1 — Prosecutions were taken in respect of sour cream, mouldy bread and condiment found to contain sulphur dioxide. Fines totalling £73 were imposed. (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. 686 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 -21- The number of food premises in the district is as follows:- Bakehouses and shops 17 Fish shops 12 Butchers' shops 26 Greengrocers' shops 23 Catering premises 108 Grocers' shops 40 Confectioners 37 Wholesalers 2 Premises registered for the manufacture or sale of preserved foods 25 Premises registered for the sale of ice cream 87 Itinerants „ „ „ „ „ „ „ 5 „ „ „ „ „ „ food: 36 (d) Sampling for bacteriological analysis Ice cream 9 Sausages 3 Meats 14 Fish 2 Vegetable dishes 2 Soup 1 Milk 11 Water 3 All 45 samples were found to be free from undesirable organisms. (e) Milk Supplies - Brucella Abortus No raw milk is retailed in the district. (f) Poultry Inspection There are no poultry processing premises within the district. (g) Food Inspection In addition to the routine inspection of food offered for sale a total of 4.155 tonnes and 79.00 litres of food was examined and rejected during the year. The details are as follows:- Carcase meat 128.72 kg Cooked meat and meat products 9.51 kg Canned meats 65.28 kg Other canned foods 347.90 kg Frozen foods due to cabinet breakdown 1,334.15 kg and 18.34 litres Other foods 2,269.41 kg and 60.66 litres 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. -22- 1. (a) The supply was satisfactory both as to (i) quality, and (ii) quantity throughout 1972. (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 distributing 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, 1972, was 54,920. (ii) No houses were permanently supplied by stand-pipe. (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 Mainly river-derived water from Coppermilis; with some well water from Chingford Pumping Station from time to time, and a little from Waltham Abbey Pumping Station. No new sources of supply were instituted and there were no changes to the general scheme of supply in your area. 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 -23- Water Samples (a) Average results of Chemical Examination. Milligrammes per litre (unless otherwise stated):- Lee Valley derived Chingford Mill Waltham Abbey No. of samples taken during the year 104 4 4 Ammoniacal Nitrogen 0.017 0.230 0.190 Albuminoid Nitrogen 0.092 0.030 0.22 Nitrate Nitrogen 8.5 0.8 0.6 Oxygen abs. from KMnO4 4 hours at 27 C 1.28 0.30 0.50 Hardness (total) CaCO3 306 288 278 Hardness (non-carbonate) CaC03 95 72 58 Magnesium as Mg 6 17.0 22.0 Sodium as Na 34.6 - - Potassium as K 7.3 - - Chloride as C1 47 27 25 Phosphate as PO4 3.7 - - Silicate as SiO2 10 - - Sulphate as SO4 72 - - Natural Fluoride as F 0.17 0.45 0.43 Surface-active material as Manoxol OT 0.02 - — Turbidity units 0.1 0.1 0.2 Colour (Burgess Units) 14 6 9 pH value 7.9 7.3 7.5 Electrical Conductivity (micromhos) 670 550 550 /(b) -24- (b) Results of Bacteriological Examination: Lee Valley derived Chingford Mill Waltham Abbey BEFORE TREATMENT - No. of samples 2,439 251 250 Agar plate count per ml:20-24 hours at 37oC 58.9 0.2 0.1 3 days at 22°C - 12 12 Coliform count:Per cent. samples negative in 100 ml 39.93 99.60 99.60 Count per 100 ml. 15.3 - - Escherichia colicount:Per cent. samples negative in 100 ml. 60.00 100.0 99.60 Count per 100 ml 3.9 - - AFTER TREATMENT - No. of samples 510 251 251 Agar plate count per ml.:20-24 hours at 37°C 13.3 0.1 0.1 3 days at 22°C - 13 9 Coliform count:Per cent. samples negative in 100 ml. 99.80 100.0 100.0 E. coli count:Per cent samples negative in 100 ml. 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 as 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 /LOUGHTON: -25- LOUGHTON: Loughton County High School, 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. During the year, new licensing conditions were introduced in respect of Debden House. The intention being to recognise the fact that the site is essentially for the use of touring rather than static units, to bring tents and caravans within one set of conditions and to remove the vagaries incorporated in the existing licenses. With the co-operation of the licensee it was possible to produce realistic conditions which provided the highest level of amenity and protection for the camper consistent with retaining the essential atmosphere of outdoor life. 7. CLEAN AIR The Clean Air Acts give the power to Local Authorities to control the emission of certain pollutants to the atmosphere. In the industrial sphere periodic observations are made to ensure that the provisions of the Acts relating to dark smoke are complied with. Inspections are made to ensure that emissions of grit and dust are minimised. Proposals for the installation of new furnaces and the construction of new chimneys are examined in detail. The Council adopted in 1956 the power to require the fitting of approved fireplaces in new houses. Since 1956 they have participated in the National Survey for Smoke and Sulphur Dioxide, the latest figures are given below. The possibility of introducing smoke control areas has been kept under continuous consideration. It was sensible that "black area" authorities should have priority for the financial and smokeless fuel resources until their problems were solved and the production of smokeless fuels increased to a level sufficient to satisfy demand. This situation has now been reached and the Council made the decision in principle to proceed with the establishment of smoke control areas to complete the programme of atmospheric pollution control established by the Council. Smoke Sulphur Dioxide Summer mean 19 57 Winter mean 48 118 microgrammes per cu. metre Annual mean 33 88 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, it is suspected that many ice cream vendors exceed this period but complaints are rarely made. - 26 - /140 140 visits were made during the year to investigate noise nuisance. It is frequently found that lack of thought is the reason and the perpetrators are generally co-operative in finding a solution. The modern liking for loud music has been the cause of several complaints and it seems that many people are giving little, if any, thought to the long term effect on their hearing. 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. Number of complaints received: Industrial premises 6 Commercial premises 10 Roadworks, construction, demolition etc. 2 Domestic premises 13 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. 406 complaints of rats or mice were made during the year and all were promptly investigated and the appropriate treatment carried out. 162 complaints of other pests were received, including 53 of wasps. The department helps in these complaints whenever possible by practical assistance or advice. /11. -27- 11. OFFICES, SHOPS AND RAILWAY PREMISES ACT Class of Premises Number registered during the year Total registered at end of year Offices 7 122 Retail shops 20 304 Wholesale shops, warehouses - 6 Catering establishments open to the public, canteen 2 43 Fuel storage depots - 2 TOTALS 29 477 Contraventions Cleanliness 1 Seats (sedentary workers) - Overcrowding - Eating facilities 1 Temperature - Floors, passages, stairs 1 Ventilation 1 Fencing of exposed machinery 3 Lighting 3 Protection of young persons - Sanitary conveniences - Training of young persons - Washing facilities 5 Prohibition of heavy work - Drinking water - First Aid 12 Clothing accommodation - Hoists and lifts 3 Sitting facilities - Other matters 28 TOTAL 58 Accidents Retail Shops Wholesale Warehouses Catering Establishments etc. Falls of persons 4 1 - Handling goods 2 - - Struck by falling object 1 - 1 -28- /12. 12. SUMMARY OF LICENSES ISSUED DURING THE YEAR Caravan Site Licence Private Residential - 4 Recreational - 1 Game Dealer's Licence 3 Licence to keep a Pet Shop 5 Licence to keep Petroleum Spirit 41 Licence to keep a Riding Establishment 4 13. FACTORIES AND WORKPLACES The Local Authority are responsible for enforcing satisfactory conditions in respect of cleanliness, overcrowding, temperature, 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 94 factories and workplaces are registered in the district. (See APPENDIX A. on pages 30 and 31). -29- 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 3 1 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 85 71 - - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 6 1 - - Total 94 73 - - 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.) . - - - - - 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 11 11 - - - (c) Not separate for sexes - - - Other offences against the Act (not including offences relating to - - - - - Total 11 11 - - - /OUTWORK -30- 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. 21 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 39 - - - - - Cosaques, Christmas stockings etc. 4 - - - - - Total 64 - - - - - -31- APPENDIX B. RAINFALL IN MILLIMETRES FOR YEAR 1972 METROPOLITAN WATER BOARD CHIGWELL U.D.C. High Beech Buckhurst Hill Luxborougb S.D. Works Loughton Depot January 75.00 67.80 70.16 66.43 February 46.70 45.40 45.00 48.18 March 51.90 49.60 38.25 47.38 April 57.70 53.20 51.35 55.32 May 31.90 36.00 29.71 31.90 June 24.00 31.50 37.86 29.13 July 40.20 37.80 41.43 39.05 August 21.80 21.00 39.05 23.41 September 34.90 32.60 34.68 34.68 October 10.80 8.80 8.25 8.73 November 73.30 58.10 59,29 72.78 December 62.60 61.90 58.49 60.14 530.80 503.70 513,52 517.13 AVERAGE RAINFALL FOR THE LAST FIVE YEARS 1968 - 717.20 1969 - 580.80 1970 - 664.40 1971 - 630.90 1972 - 516.28 -32-