Chin 7 BOROUGH OF CHINGFORD ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR TOR THE YEAR 1942 E. G. Ellis & Sons (T.U.) Willow Street, Chingford BOROUGH OF CHINGFORD Committee : November, 1941—November, 1942 PUBLIC HEALTH AND HOUSING COMMITTEE Chairman :— Councillor Mrs. N. HART. Members :— Alderman Miss M. L. MATHIESON, C.C. ” P. S. POWELL ” R. Z. SMITH ” E. E. WAY Councillor H. E. CHINNER ” F. J. KING ” Mrs. S. L. OAKES ” W. P. SOGGEE The Mayor, Cr. A. E. BANFIELD, J.P. (ex-officio). Meeting: Second Tuesday in each month, at 7 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1942). MEDICAL OFFICER OF HEALTH: WM. D. HYDE, M.B., Ch.B., D.P.H. CHIEF SANITARY INSPECTOR : JAMES F. ROGERS, M.R.San.I., M.S.I.A., Certified Inspector of Meat and Other Foods. Superintendent of Refuse Collection and Disposal. Inspector under the Shops Acts and Petroleum Acts. A.R.P.S. Instructor (Special). ADDITIONAL SANITARY INSPECTORS: J. T. S. TEMPLEMAN, A.R.San.I., M.S.I.A. (Military Service from July, 1940). P. W. EDWARDS, C.R.San.I., M.S.I.A. CLERKS: Miss V. M. PETTIT. Miss J. CRACKNELL (to 19.9.42). Mrs. L. M. WALKLIN (to 3.10.42). Mrs. E. S. SALTER (from 24.9.42). A. E. CULPIN (Military Service from 3.9.39). D. G. BLEACH (Military Service from 9.3.42). D. S. TAVERNER. F. WALTON (to 5.9.42). A. MORRIS (from 7.9.42). 1 ANNUAL REPORT FOR THE YEAR 1942 To the Mayor, Aldermen and Councillors of the Chingford Corporation. Mr. Mayor, Aldermen and Councillors, I have the honour to present my second Annual Report upon the health and sanitary circumstances of the District. Owing to the need for economy in time and paper the contents of this Report have been restricted to essentials, and on the grounds of national security, the undesirability of publishing comprehensive statistics has been borne in mind. The general health of the inhabitants has remained satisfactory although the incidence of the infectious conditions—Tuberculosis, Scarlet Fever and Measles—has been higher than of recent years. The incidence of Tuberculosis, in particular, appears to have been influenced by wartime factors. A happy feature of the considerably increased Birth Rate is the absence of any death from puerperal causes, and although the Infant Mortality Rate has increased slightly from last year's low record, the figure is still relatively low. No report of Civil Defence activities is included, but the Health Department has continued to devote a considerable proportion of its time to the Casualty and other Civil Defence Services of the district. I take this opportunity of thanking the Chief Sanitary Inspector, Mr. James F. Rogers, and the staff of the Health Department for their help and co-operation during the year. I am, Ladies and Gentlemen, Your obedient servant, WM. D. HYDE Medical Officer of Health. June, 1943. 2 Section A.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,860 acres Population—Registrar-General's estimate 37,790 Number of inhabited houses, end of 1942 11,475 approx. Rateable value on April 1st, 1942 £330,751 0 0 Sum represented by a penny rate on April 1st, 1942 (gross) £1,378 2 7 Vital Statistics M. F. Live Births Total 355 312 Birth Rate per 1,000 of estimated resident population: 17.6. Legitimate 347 306 Illegitimate 8 6 M. F. Stillbirths Total 7 7 Rate per 1,000 total (live and still) births: 20.6. Legitimate 7 7 Illegitimate M. F. Crude Death Rate per 1,000 of estimated resident population: 7.5 Deaths 154 128 Deaths from Puerperal Sepsis 0 „ „ other puerperal causes 0 Death Rate of Infants under one year of age:- All infants per 1,000 live births 28.5 Legitimate infants per 1,000 legitimate live births 27.6 Illegitimate infants per 1,000 illegitimate live births 71.4 Deaths from Cancer (all ages) 58 Measles (all ages) 1 ,, ,, Whooping Cough (all ages) 0 Diarrhœa (under 2 years of age) 1 ,, ,, Scarlet Fever 0 3 4 Table of Birth and Death Rates Year Population Births Rate per 1,000 population. Deaths Rate per 1,000 population. INFANT MORTALITY Deaths Rate per 1,000 live births 1937 35,970 (estimated) 590 16.3 269 7.6 26 44 1938 37,510 (estimated) 612 16.31 269 7.17 28 45 1939 (a) 39,460 668 16.93 261 6.8 15 22 (b) 38,160 1940 37,220 583 15.66 382 10.26 crude 25 45 13.13 standardised 1941 35,440 503 14.19 312 8.8 9 16 1942 37,790 667 17.6 282 7.5 19 28 Section B.—GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. (a) Laboratory Facilities. Pathological specimens from this district are now examined at the E.C.C. Pathological Laboratory, St. Margaret's Hospital, Epping. Unfortunately, details of the Chingford specimens examined are not available for this year. (b) Ambulance Facilities. Two ambulances and a staff of three paid drivers are maintained. In order to keep both ambulances fully staffed for immediate action, the services of volunteers of the St. John Ambulance Brigade are utilised. The voluntary services of a lady member of the Brigade are also available in connection with the transport of maternity cases. This further evidence of the publicspirited activities of the members of the St. John Ambulance Brigade deserves recognition. The following is a summary of the work performed by the Council's Ambulance Service during 1942:— Total number of calls dealt with during year— Private Hire 827 Accidents 90 Maternity Cases 194 Total 1,111 Total mileage covered by the Borough Ambulances during the year—17,000 miles. In addition the following calls were dealt with by adjoining authorities or other mean's on occasions when the Chingford ambulances were engaged or under repair— Private Hire 10 Accidents 5 Maternity Cases 7 Total 22 (c) Nursing in the Home. The Chingford District Nursing Association has carried on its good work throughout the year. Maternity nursing and midwifery cases, in addition to a large number of general nursing visits, have been undertaken. 5 (d) Clinics and Treatment Centres. See Table of Clinics on page 7. (e) Hospitals. No change. (f) Midwives. Number of County Council practising midwives 1* „ „ midwives employed by Chingford District Nursing Association 3 „ „ independent domiciliary midwives 0 * Mrs. P. M. Stenning, 237, Hall Lane, E.4. (Telephone: Silverthorn 3263). (g) Registered Nursing Homes. There are two registered Nursing Homes in the district receiving maternity and medical patients. These Homes have been inspected regularly and found to be conducted in a satisfactory manner. 6 CLINICS AND TREATMENT CENTRES Clinic or Dispensary Where held When held Diphtheria Immunisation Clinics Church Hall, The Ridgeway, North Chingford. County Council Clinic, Marmion Avenue, South Chingford. Wednesdays 10 a.m. Mondays 11 a.m. Maternity and Child Welfare Clinic County Council Clinic, 16, The Ave., Chingford Tuesdays 1.45 p.m.—3.45 p.m. Maternity and Child Welfare Clinic County Council Clinic, 16, The Ave., Chingford Wednesdays 1.45 p.m.—3.45 p.m. Maternity and Child Welfare Clinic Mission Hall, Sewardstone Road, North Chingford. 2nd, 4th and 5th (if any) Wednesday of each month 1.45 p.m.—3.45 p.m. Toddlers' Clinic County Council Clinic, 16, The Ave., Chingford Thursdays, 10 a.m.—11.30 a.m. Maternity and Child Welfare Clinic Spicer Hall, Buxton Road, North Chingford. Thursdays 1.45 p.m.—3.45 p.m. Ante-natal Clinic 50, Friday Hill, Chingford. 1st and 3rd Mondays 1.45 p.m. Maternity and Child Welfare Clinic 50, Friday Hill, Chingford. 2nd, 4th & 5th Mondays, 1.45 p.m.—3.45 p.m. Ante-natal Clinic County Council Clinic, 16, The Ave., Chingford Wednesday, 9.30 a.m., Fridays, 9.30 a.m., 3rd Friday in each month, 1.45 p.m. Women's Welfare Clinic County Council Clinic, 16, The Ave., Chingford 1st Friday of every month at 2 p.m. Minor Ailment and School Clinic County Council Clinic, 16, The Ave., Chingford Mondays 9.30 a.m.—12 noon Orthopædic Clinic County Council Clinic, 16, The Ave., Chingford Masseuse in attendance, Mondays, 2 p.m., Thursdays, 1.30 p.m. Tuberculosis Dispensary Old Monoux School, High Street, Walthamstow, E.17. New cases— Adults : Weds., 10 a.m.-12 noon. Children : Fri., 10 a.m.-12 noon. Venereal Diseases Prince of Wales Hospital, Tottenham. Oldchurch County Hosp. (The Annexe) Romford. And London Hospitals. Mondays to Fridays, 8 a.m.—6 p.m. Saturdays 8 a.m.—12 noon Tuesdays, 4.30 p.m.—7.30 p.m. Thursdays, 12.30 p.m.—3.30 p.m. 7 Section C.—SANITARY CIRCUMSTANCES OF THE AREA Water Supplies. A hard, pure and constant piped water supply is provided by the Metropolitan Water Board; the supply has been satisfactory in both quality and quantity. One sample of water was taken during the year from a water storage cistern at a private dwelling house; the sample was unsatisfactory but it was found that the storage tank was insanitary and the cleansing of the tank proved all that was necessary to place the water supply in a satisfactory state. Rivers and Streams. No action was necessary during the period under notice in connection with the pollution of streams or watercourses. Public Cleansing. The collection and disposal of house and trade refuse and salvage is carried out under the direction of the Chief Sanitary Inspector. The weekly collection of refuse was resumed with gratifying results. The total weight of refuse disposed of at the Works was 5,333 tons, an increase of 244 tons over the previous year. The net cost per ton for the collection of refuse was 17s. 61/2d. as against 20s. 6d3/4. for the year ended March, 1942, and lis. 61/4d. for the year ended March, 1941. The net cost per ton for the disposal of refuse was nil as against 5s. 6d. for the previous year and 2s. 73/4d. for the year ended March, 1941. Not only was the net cost for disposal nil, due to the income from salvage being nearly £4,000, but a contribution of £276 was set off against the collection costs. Without detracting from the achievement of maintaining the disposal works, including loan charges, at a profit, it will be realised that the costs for the whole service are still high. Nevertheless, conditions during the year were more conducive to efficient working, the position as to labour was somewhat easier and the possession of a spare vehicle considerably reduced lorry hire. The costs for the collection and disposal of refuse during the year under review may be said, therefore, to have a reasonable relationship to those applying in the year immediately before the outbreak of war, that is, a net cost of 16s. 6d. per ton as against 12s. 6½d. for the year ended March, 1940. An examination of the analysis of income for the years shows that of the total of £3,983, no less than £2,227 was received for the sale of waste paper. There was a welcome reduction in the sum received for milk bottles, the income figure being £13 or 9,360 bottles as against £37 or 26,640 bottles in the previous year. Quite apart from the financial aspect, the Council may be said to have made a solid contribution to the war effort in the tonnage 8 of materials collected. In addition to pursuing normal salvage work, the Council has organised during the year two Salvage Drives, the results in each case proving satisfactory. The collection of kitchen waste continued to be an adminis' trative problem and although the communal bins were maintained, the Council found it necessary during the year to put this work out to contract to a local pig breeder. The weighbridge was maintained under contract and the fees during the year amounted to £40 18s. 6d., representing 1,637 weighings as against £42 14s. 6d. or 1,709 weighings in the previous year. The income derived from the collection of trade refuse was £67, which was less than the previous year due to the remission of charges in cases where the material collected had a salvage value. HOUSE AND TRADE REFUSE Table showing costs for the year ended 31st March, 1943. Item. Particulars I—Collection II—Disposal Total Including Depreciation or Loan charges Excluding Loan charges etc. Including Depreciation or Loan charges Excluding Loan charges etc. Including Depreciation or Loan charges Excluding Loan charges etc. (1) (2) (3) (4) (5) (6) (7) (8) Revenue Account (See Note a) (See Note a) (See Note a) A Gross expenditure £4744 4616 3707 3336 8451 7952 B Gross income 67 67 3983 S983 4050 4050 C Net cost £4677 45149 — — 4401 3902 Unit Costs s. d. s. d. s d. s. d. s. d. s. d. D Gross expenditure per ton 17 9½ 17 3¾ 13 10¾ 12 6 31 8¼ 29 9¼ E Gross income, per ton 3 3 14 11¼ 14 11¼ 15 2¼ 15 2¼ F Net cost, per ton 17 6½ 17 0¾ — — 16 6 14 7½ G Net cost, per 1,000 population £ £ £ £ £ £ 124 120 — - 116 98 H Net cost, per 1,000 houses or premises from which refuse is collected 406 395 — — 383 322 1. Total refuse collected (in tons) 5,333 2. Population (Mid-Year) 37,790 3. Weight per 1,000 population per day (in cwts.) 7.7 4. Number of occupied houses and premises (end of year, 1942) 11,475 (approx). Note.—(a) "Loan charges" include interest on loans; repayment of loans; revenue contributions to capital outlay and capital receipts. 9 Year ended 31.3.42 ANALYSIS OF INCOME FOR THE YEAR ENDED 31st MARCH, 1943 £ s. d. £ s. d. £ s. d. £ s. d. 1. Sale of Salvaged Articles Fine Ash, Clinker and Screenings Metals: 42 8 7 Aluminium 22 19 7 28 19 9 Copper 14 6 4 80 16 2 Iron 56 19 5 7 5 1 Pewter 4 7 9 18 16 0 Lead 24 13 2 6 17 8 Battery Lead 4 10 4 48 11 10 Brass 32 11 4 12 8 9 Mixed Metals 10 0 7 14 3 6 Unbaled Scrap 21 18 6 86 6 9 Tins 89 14 3 282 1 3 52 2 3 Bones 30 5 8 30 5 8 71 5 6 Broken White Glass 80 2 2 141 8 5 Bottles and Jars 207 10 10 37 15 1 Milk Bottles 13 4 6 9 17 11 Paste Jars 21 14 11 322 12 5 288 16 6 Rags 412 2 6 26 12 3 Carpets 41 3 3 453 5 9 295 11 7 Newspapers 243 19 0 937 7 2 Mixed Waste Paper 1,928 8 6 5 3 2 Magazines 55 6 3 2,227 13 9 7.13 19 2 Pig Food 303 15 9 2 0 Records 5 3 0 1 10 6 Bedding 5 10 0 2 8 0 Rubber 36 17 8 351 6 5 2. Miscellaneous Receipts 8 1 5 1 and Charges 23 4 3 3,690 9 6 47 14 6 3. Weighbridge Fees 40 18 6 39 17 0 4. Subsidy on Sale of Scrap Iron 201 17 4 5. Rents: 30 0 0 Foundry 30 0 0 20 0 0 Proportion of Allotment Rents 20 0 0 £2577 '0 2 £3,983 5 4 5,089 Tonnage 5,333 10 SANITARY INSPECTION OF THE AREA Inspections on Complaint The number of complaints received at the office and recorded in the register was 331, as compared with 436 in the previous year and 260 for the year 1940. The total inspections made on complaint was 414 and the number of defects or nuisances revealed was 273, which are analysed in the following table. Informal notices were at once served on the owners or occupiers of the premises concerned. Table 1 Dirty Premises 8 Defective Eaves, Gutters and Roofs 7 Defective Sinks and Waste Pipes 1 Yard and W.C. Drains blocked 86 Dampness 3 Defective Drainage 19 W.C.'s without proper flushing arrangements 2 Defective Ashbins 17 Defective Floors 3 Defective Firegrates and Stoves 9 Defective Wall and Ceiling Plaster 3 Defective Water-Closets 4 Defective Windows, Woodwork, Doors, etc. 4 Yard and Passage Surfaces Defective 2 Animals kept so as to be a nuisance 2 Water Fittings Defective 5 Insufficient Water Supply 11 Defective Wash Boilers 1 Insufficient Lighting and Ventilation 1 Re Overcrowding 1 Accumulation of offensive matter and water 4 Pollution of Watercourse 1 Blocked Sewers 50 Defective Sewers 15 Defective Lavatory Basins 1 Defective Hot Water Supply Systems 1 Vermin 12 273 11 Summary of Inspections The total number of visits paid by the Sanitary Inspectors to various premises for all purposes is summarised below, together with the number of defects found under specific headings. The visits numbered 2,731, as compared with 2,355 in the previous year; the defects dealt with numbered 606, as compared with 536 in 1941. Table 2 Visits Paid Nuisances or Defects found Housing Act, 1936: Inspections 39 318 Re-Visits rc Notices served 355 Re Overcrowding 2 Re “Permitted Numbers" 7 On complaint 414 273 Miscellaneous 41 Infectious Diseases 555 1 Slaughter-houses 1 Meat and Food Shops 78 Private Slaughtering 7 Factories 16 2 Workshops 1 Bakehouses 17 Cowsheds 4 Dairies and Milk shops 15 Pigsties 17 1 Re New Drainage 11 Re-Inspections re Notices Served 405 Infestation by Rats or Mice 69 8 Public Sanitary Conveniences 3 Shops Act 2 Visits re Water Sampling 2 Collection and Disposal of Refuse & Salvage 291 Re Collection of Kitchen Waste 47 Refuse Tip 13 Inspections of Council Houses 3 1 Inspections re Tenants of Council Houses 4 Schools 2 1 Requisitioned Houses 220 Restaurants, Canteens and Food Stores 21 Civil Defence: Food Decontamination 22 Rest Centres 1 Laundries 2 Depots ... 1 National Fire Service 1 1 First Aid Posts, etc. 9 Repair Garage 32 Emergency Water Supplies 1 2,731 606 12 Nuisances and Defects In the following table is summarised the nuisances and defects dealt with or in connection with which action was commenced during the year under the Housing Acts, Public Health Acts, Byelaws and other Enactments: Table 3 Dirty Premises 47 Defective Roofs, Spoutings and Eaves Gutters 59 Yard and W.C. drains blocked 87 Defective Yard and Passage Surfaces 5 Defective Sinks and Waste Pipes 15 Dampness 17 Defective Drainage 21 W.C.'s without proper flushing arrangements 16 Defective Ashbins 17 Defective Floors 25 Defective Firegrates and Stoves 23 Defective Water closets 11 Animals kept so as to be a nuisance 2 Defective Water Fittings 11 Insufficient Water Supply 10 Defective Wash Boilers 7 Insufficient Lighting and Ventilation 5 Defective External Brickwork and Chimneys 17 Defective Woodwork, Windows, Doors, & c. 37 Pollution of Watercourse 1 Re Overcrowding 2 Rat Infestation 7 Defective Hot Water Supply 1 Lack of Water Supply 1 Insufficient W.C. Accommodation 3 Defective Lavatory Basins 1 Broken Sashcords 7 Defective Flues 3 Defective Internal Brickwork 1 Vermin 13 W.C.'s with Defective Flushing arrangements 6 Defective Wall and Ceiling Plaster 58 Blocked Sewers 50 Defective Sewers 15 606 Table 4 Letters sent out and notices served in connection with sanitary matters. Letters 365 Public Health Acts: Preliminary Notices 96 Secondary Notices 0 Statutory Notices 9 Housing Acts: Preliminary Notices 40 Secondary Notices 0 Statutory Notices 14 Letters sent out by the Chief Sanitary Inspector on all matters (including letters and notices listed above) 1,250 13 Shops Acts. It was not necessary to take action, during the year, with regard to the public health -provisions of the Shops Acts. Smoke Abatement. Owing to the continuance of war conditions no action was taken in respect of smoke abatement. Swimming Baths and Pools. Samples of water from the Larkswood Swimming Pool were taken during the bathing season, and all these were found by the Bacteriologist to be satisfactory and suitable for swimming bath purposes. Summaries of the daily chlorine and alkalinity readings are forwarded weekly to the Health Department by the Pool Superintendent. Eradication of Bed Bugs (1) The following table gives information on the action taken for the eradication of bed bugs : Council Houses Other Houses Infested, 2. Disinfected, 2. Infested, 4. Disinfested, 4. (2) Methods. Spraying with a contact insecticide is the general rule, following the removal of architraves, skirtings and picture rails. Papered rooms are stripped. (3) Inspectional Methods. Before any tenant moves into a Council house, the prospective tenant's house and belongings are thoroughly inspected by a Sanitary Inspector, as is also the Council house into which the family is to move. (4) Disinfestation. Fumigation with Hydrogen Cyanide is always carried out by a contractor; other disinfestations are carried out by the Local Authority. Schools The sanitary condition and water supply of Schools has been satisfactory during the year. All cases of notifiable infectious disease amongst school children are notified to the head teachers, as are also contacts. It was not necessary during the year to close any schools on account of infectious disease. PREMISES AND OCCUPATIONS WHICH CAN BE CONTROLLED BY BYELAWS OR REGULATIONS Offensive Trade Premises The offensive trade premises on the register number 8, all being fish fryers. Offensive trades are controlled by Byelaws adopted by the Council. Bakehouses There are 8 of these premises within the district and they have been maintained in a satisfactory condition during the year. Factories Act, 1937. Thirty-four visits were paid to Factories. This number is small, due to pressure of work in other directions. No case of infectious disease occurred at outworkers' premises during the year. 14 INSPECTION OF FACTORIES & OTHER PREMISES 1.—Inspections for Purposes of Provisions as to Health. Including Inspections made by Sanitary Inspectors. Premises Number of Inspections Written Notices Occupiers Prosecuted (1) (2) (3) (4) Factories with mechanical power Factories without mechanical 34 2 — power — — — *Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) - - - *Electrical Stations should be reckoned as factories. TOTAL 34 2 — 15 2.—Defects Found. Particulars. Number of Defects No. of defects in respect of which Prosecutions were instituted. Found Remedied Referred to H.M. Inspector (1) (2) (3) (4) (5) Want of cleanliness (S.l) — — — - Overcrowding (S.2) — — — — Unreasonable (S.3) temperature - - - - Inadequate ventilation (S.4) Ineffective drainage of - - - - floors (S.6) — — — - Sanitary Conveniences (S.7) insufficient 1 1 — — unsuitable or defective 1 1 — - not separate for sexes - - - - Other offences — — — - (Not including offences relating to Home Work or offences under the Sections mentioned in the Schedule to the Ministry of Health (Fac tories and Workshops Transfer of Powers) Order, 1921, and re enacted in the Third Schedule to the Factories Act, 1937). TOTAL 2 2 — - Section D.—HOUSING STATISTICS FOR THE YEAR 1942 1. Number of New Houses erected during the Year: (1) By the L.A. — (2) By other L.A.'s — (3) Other bodies — 2. Inspection of Dwelling-Houses during the Year : (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,025 (b) Number of Inspections made for the purpose 1,785 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 39 (b) Number of Inspections made for the purpose 394 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 137* *Note.—This figure includes all houses where defects were found, including those which were inspected and recorded under the Housing Act, 1936. 3. Remedy of Defects during the Year without Service of Formal Notices: Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 121 4. Action under Statutory Powers during the Year : A. Proceedings under sections 9, 10 and 16 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which notices were served requiring repairs 14 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners 12 (b) By Local Authority in default of owners 1 16 B. Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 9 (2) Number of dwelling-houses in which defects . were remedied after service of formal notices: (a) by owners 9 (b) by Local Authority in default of owners — Proceedings under Sections 11 and 13 of the Housing Act, 1936: Demolition orders made — Houses demolished — Proceedings under Section 12 of Housing Act 1936 : Closing orders — Closing orders determined — Section E.—INSPECTION AND SUPERVISION OF FOOD Milk Supply. There is only one cowshed on the register for the Chingford district; the number of retail purveyors of milk is 30 and one wholesale purveyor. The number of visits paid to cowsheds, dairies and milkshops was 19. Milk (Special Designations) Order, 1936. Graded Milks. The following table shows the licences granted during the year for the sale of milk under the special designations, as provided by the above Order: 5 dealers' licences to sell milk as Pasteurised. 3 supplementary licences to sell milk as Pasteurised. 3 dealers' licences to sell milk as Tuberculin Tested. 2 supplementary licences to sell milk as Tuberculin Tested. 1 supplementary licence to sell milk as Accredited. 1 dealer's licence to pasteurise and bottle milk. 1 dealer's licence to bottle and sell milk as Tuberculin Tested. Ice Cream—Registration of Manufacturers and Vendors. There were no applications for registration for the manufacture of ice cream under Section 14 of the Food and Drugs Act, 1938. The number of persons registered at the end of the year was as follows : For the manufacture, storage and sale 19 For the storage and sale only 28 17 Meat and Other Foods There is one licensed slaughterhouse and twenty-two butchers' shops in the area ; the visits paid to these premises numbered 79. There were five pigs' carcases inspected at registered slaughterhouses and seven pigs' carcases inspected at private houses. The following list gives details of the diseased or unsound meat and other articles found unfit for human consumption, which were voluntarily surrendered and destroyed :— Article Condition Weight 551 tins Evaporated Milk Unsound ... ... 82 tins Condensed Milk ” ... ... 1 tin Unsweetened Milk ” ... ... Dog Fish ” ... ... 6 stones Whiting ” ... ... 5 stones Cod ” ... ... 15 stones Megrim „ ... ... 5 stones Haddock ,, ... ... 12 stones Hake ” ... ... 2 stones Ling ” ... ... 7 stones 40 tins Pork Luncheon Meat ” ... ... 15 tins Pork Sausage Meat ” ... ... 1 tin Meat Roll ” ... ... 1 tin Chopped Pork ” ... ... 3 tins Chopped Ham ” ... ... 1 tin Veal and Ham Roll ” ... ... 3 tins Chicken & Ham Roll ,, ... ... 1 tin Minced Beef Loaf ,, ... ... 1 tin Tongue ” ... ... 6 lbs. 2 tins Prepared Meal ” ... ... 1 tin Ox Tongue ,, ... ... 1 lb. 72 tins Beans ,, ... ... 34 tins Peas ” ... ... 8 tins Carrots ” ... ... 17 tins Apples ” ... ... 30 tins Pineapple ” ... ... 14 tins Plums ” ... ... 49 tins Peaches ,, ... ... 1 tin Strawberries ” ... ... Figs ” ... ... 14 lbs. 30 tins Pilchards ” ... ... 6 tins Salmon ” ... ... 3 tins Herrings ” ... ... 1 tin Gooseberries ” ... ... 3 tins Sardines ” ... ... 45 tins Tomatoes ” ... ... 1 tin Meat and Vegetables ” ... ... 4 tins Vegetable Salad ” ... ... 1 tin Vegetables in Gravy ,, ... ... 8 tins Steak and Vegetables ,, ... ... 86 tins Stewed Steak ,, ... ... 18 Article. Condition Weight 5 tins Casserole Stewed Steak Unsound ... ... 21 tins Soup „ ... ... 4 tins Mixed Vegetable „ ... ... 3 tins Beetroot „ ... ... Cheese Trimmings „ ... ... 5 stone 5 lbs. 2 tins Macaroni ... ... 1 jar Mayonnaise „ ... ... 1 tin Celery Heart ,, ... ... 2 tins “Mor " Sound but mis-shaper ... 22 tins Lemon Curd Unsound ... ... 8 tins Hot Pot „ ... ... Mincemeat „ ... ... 2 lbs. 7 tins Quick Meal „ ... ... 1 pot Chicken & Ham Paste „ ... ... 17 Rabbits „ ... ... 1 tin Brisket „ ... ... 14 lbs. 1 tin Roast Pork & Stuffing „ ... ... 3* lbs. Bacon „ ... ... 4 stone 2f lbs. 1 tin Rabbit „ ... ... Salted Beef „ ... ... 12J lbs. Beef in pieces „ ... ... 182 lbs. 1 Boiling Fowl „ ... ... Madiera Cake „ ... ... 18 lbs. 193 Eggs „ ... ... 4 tins Crawfish 5 9 ... ... 2 tins Grape Fruit „ ... ... Chemical and Bacteriological Examination of Food. The Counties' Public Health Laboratories, Gidea Park College, Gidea Park, Essex, undertake bacteriological examinations for the Council. Dr. Bernard Dyer and Partners, Peek House, 20, Eastcheap, E.C.3, carry out the chemical analysis of food and drugs. The following were forwarded for bacteriological examination during the year: No. Designation Result. 226 Pasteurised ... ... Satisfactory. 227 ,, ... ... ,, 228 ,, ... ... 229 „ ... ... 230 „ ... ... Milk satisfactory but ” put into dirty milk ” bottle. 231 Water ... ... Unsatisfactory. The unsatisfactory samples of milk were brought to the notice of the producers concerned, and the necessary action was taken. 19 Food and Drugs Act, 1938. The following articles were submitted for chemical examination during the year in supplementation of the Essex County Council's Food and Drugs service. No. Sample. Result. 264 Custard Powder Satisfactory. 265 Sausages Fit for human consumption. 266 Lime Juice Cordial Contained objectionable quantities of zinc. 267 Fairy Cake Mixture Nothing harmful or injurious present in mixture. 268 Do. Do. 269 "Handy" Brand Machine Skimmed Milk Suitable for human consumption. PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Scarlet Fever The following table shows the total number of cases notified during the year, the percentage of cases removed to hospital and the corresponding figures for the previous four years : 1938 1939 1940 1941 1942 Cases notified 66 144 47 32 186 Percentage removed to hospital 72 66 72 91 82 Towards the end of the year Scarlet Fever became prevalent in this district as it was generally throughout the country. The disease was mild in type and in many cases, in the absence of a well-defined rash, was apt to be considered lightly by parents and isolation was not effected; consequently, control of the spread of infection was difficult. Diphtheria. During the year four cases of Diphtheria occurred, of which three were removed to hospital. These patients, none of whom had been immunised, were aged 5½ years, 8 years, 15 years and 36 years. This equals the low level of cases reached the previous year. Immunisation against Diphtheria must surely be given some credit for this continuing improvement. 20 Diphtheria Immunisation. Number of children immunised during the year: Under 5 years 721 Between 5 and 15 years 838 Total 1,559 The number or children immunised during the year reached a new high level and it was estimated that at the end of the year 70% of the children in the Borough had been immunised within recent years. This result is most encouraging and if maintained should lead to further diminution in the number of cases of Diphtheria recorded in future years. The material used in all instances was Diphtheria Alum Precipitated Toxoid, the dosage during the first half of the year being 0.1 c.c. and 0.3 c.c. at an interval of four weeks, but subsequently increased on the recommendation of the Ministry of Health to 0.2 c.c. and 0.4 c.c. or 0.5 c.c. at the same interval. Measles. In common with other parts of the country, Measles was again prevalent in this district, but fortunately few of the cases were of a serious nature, only 12 requiring admission to Hospital. Prophylactic use of Adult Measles Serum was made by many Doctors with satisfactory results, the material being supplied through the Health Department from the stock held in the Central Emergency Pathological Laboratory from the pool organised by the Medical Research Council. Scabies. From information and notifications received in the Health Department, it does not appear that the incidence of Scabies was unusually high during the year. Tuberculosis. There were 70 cases of all forms of Tuberculosis notified during 1942 (an increase of 22 on the previous year), and of these, 11 cases (15.7 per cent.) were transfers from other districts. There were 25 deaths from Tuberculosis during the year ; 3 of these had not been previously notified as suffering from Tuberculosis. The ratio of non-notified tuberculous deaths to total tuberculous deaths is 1 to 8.3. 21 Tuberculosis. Age periods. NEW CASES TRANSFERS DEATHS Respiratory NonRespiratory Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. M. F. M. F. 0 to 1 year 1 1 — - — — — — — 1 1 — 1 to 4 years — 1 2 — — — — — — — — — 5 to 14 years 9 2 2 1 1 — — 1 - 2 — — 15 to 24 years 9 9 1 1 1 — 1 1 — 2 — — 25 to 34 years 4 7 — — 1 3 — — 1 3 1 — 35 to 44 years 3 2 1 1 1 1 — — 1 4 — 1 45 to 54 years 4 — 1 - - - - - 2 1 — — 55 to 64 years 3 — 1 — — — — — 1 1 - — 65 and upwards — — — — — - - - - - - Totals 26 22 8 3 4 4 1 9 5 14 2 1 Add—Non-notified Cases ... ... 2 — 1 — 7 14 3 1 cancer. deaths from cancer Site 0-25 25-35 35-45 45-55 55- Totals M. F. M. F. M. F. M. F. M. F. M. F. Gastro-Intestinal Tract — — — 1 - — 1 7 12 8 13 21 Lungs and Mediastinum 1 — — — 1 1 2 — 5 — 9 1 10 Genito-urinary organs — — 1 1 - — 1 5 6 6 8 14 Breast - - - - - 1 1 3 — 5 1 9 10 Other sites — 1 — — 1 — — — 1 — 3 3 Totals 1 1 — 1 3 3 3 5 17 24 24 34 58 Death rate = 1.53 per 1,000 (as compared with 1.41 per 1,000 in previous year). 22 Deaths from all causes at various Ages Age No. of Deaths Under 1 Year 19 1 and under 2 1 2 and under 5 — 5 and under 15 8 15 and under 25 6 25 and under 35 11 35 and under 45 20 45 and under 55 28 55 and under 65 50 65 and under 75 63 75 and upwards 76 Total deaths 282 ATTENDANCES AT LOCAL CLINICS DURING 1942 Ante-Natal Clinics: Friday Hill Sessions 23 Attendances 339 Marmion Avenue and 16, The Avenue Sessions 94 Attendances 1,517 Infants' & Toddlers' Welfare Clinics: Friday Hill Sessions 23 Attendances 607 (including Infants & Toddlers) (including 50 new infants). Sewardstone Road Sessions 28 Attendances 656 (including Infants & Toddlers) (including 51 new infants). North Chingford Sessions 50 Attendances 2,169 (including Infants & Toddlers) (including 130 new infants). Methodist Church Hall, New Road & 16, The Avenue Sessions— Infants 104 Attendances 3,641 (including 311 new infants). Toddlers 53 Attendances 663 Specialist Obstetric Clinic: 16, The Avenue Sessions 12 Attendances 76 Women's Welfare Clinic: 16, The Avenue Sessions 11 Attendances 49 23 24 NOTIFIABLE DISEASES Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Dysentery Encephalitis Lethargica Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Cerebro'Spinal Fever Enteric Fever Acute Poliomyelitis Pulmonary Other Forms 1937 61 21 10 — — 51 6 4 — 7 1 34 1 11 3 1938 66 7 7 — — 38 5 11 — 10 2 23 2 2 — 1939 144 26 10 3 — 53 17 1 — 8 28 1 — — 1940 47 6 14 30 1 56 5 1 5 1 44 4 2 — 1941 32 4 4 311 197 41 7 - — 1 - 54 7 — — 1942 186 4 8 504 75 56 14 1 1 3 — 64 3 — — NOTIFIABLE DISEASES TABULATED ACCORDING TO AGE. Under 1 year 1 2 3 4 5-9 10-14 15-19 20-3 4 35-44 45-64 65 and over Totals Scarlet Fever - 2 11 9 20 114 21 - 6 3 — — 186 Diphtheria - — — — - 2 — 1 1 — 4 Erysipelas . - — — — — 1 — - — 1 6 — 8 Measles 15 23 26 51 81 281 19 4 - — 1 — 504 Whooping Cough 7 3 8 12 11 33 1 — — — — — 75 Puerperal Pyrexia - - - - - - - - 2 1 - - 3 Pneumonia 4 3 1 — 2 7 3 2 9 8 11 14 64 Cerebro-Spinal Meningitis - - 1 - - 2 - - - - - - 3 Dysentery - - 1 - - - - - - - - - 1 Encephalitis Lethargica - - - - - - - - - 1 — 1 ANALYSIS OF NOTIFIABLE DISEASES AND DEATHS. Diseases Total cases notified Total admitted to hospital Total Deaths Scarlet Fever ... 186 152 - Diphtheria 4 3 — Erysipelas 8 2 — Puerperal Pyrexia 3 3 - Pneumonia 64 18 16 Cerebro-Spinal Meningitis 3 3 - Measles 504 12 1 Whooping Cough 75 1 — Dysentery 1 1 — Encephalitis Lethargica 1 1 1 25 26 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality and Case rates for certain Infectious Diseases in the Year 1942. (Provisional figures based on Weekly and Quarterly Returns). England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns Resident Pop.: 25,000—50,000 (1931 Census) London Administrative County Chingford England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns Resident Pop.: 25,000—50,000 (1931 Census) London Administrative County Chingford Births: Rates per 1,000 Civilian Population:— Deaths under 1 year of age Rates per 1,000 Live Births:— Live 15.8 | 17.3 18.4 14.0 17.6 49 59 46 60 28.5 Still 0.54 1 0.66 0.62 0.48 0.37 Deaths: Deaths from Diarrhœa and Enteritis under 2 years of age 5.2 7.5 4.8 8.6 1.5 All Causes 11.6 13.3 12.1 13.9 7.5 Typhoid and Paratyphoid 1 0.00 1 0.00 0.00 0.00 Scarlet Fever 0.00 1 0.00 0.00 0.00 Whooping Cough- 0.02 0.03 0.02 0.04 — Diphtheria 0.05 0.06 0.04 0.02 - Rates per 1,000 Total Births (Live and Still) Influenza 0.09 0.09 0.10 0.07 0.05 Smallpox —- — — — — Measles 0.01 0.02 0.01 0.01 0.03 Maternal Mortality: (Excluding Abortion) Notifications: Typhoid Fever 0.01 0.01 0.01 0.02 — Puerperal Infection (No. 147) Paratyphoid Fever 0.01 0.01 0.01 0.01 — 0.42 Not available. Cerebro-Spinal Fever 0.14 0.17 0.12 0.15 0.08 Others 1.59 — Total 2.01 — Scarlet Fever 2 19 2.49 2.34 1.86 4.92 Notifications: Whooping Cough 1.73 1.97 1.58 2.72 1.98 Diphtheria 1.05 1.35 0.91 0.76 0.11 Erysipelas 0.30 0.36 0.26 0.43 0.21 Smallpox 0.00 0.00 — 0.00 — Puerperal Fever 12.61 15.94 10 80 3.10 4.4 Measles 7.46 9.27 7.39 8.62 13.3 „ Pyrexia Pneumonia 1.07 1.30 0.94 0.94 1.7 17.69 A dash (—) signifies that there were no deaths.