Journal Rebind Co. Ltd. Grays. Essex. AC 4411(1) chinaford Borough of Chingford CHIN 10 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1945. E. G. Ellis & Sons (T.U.) Willow Street, Chingford BOROUGH OF CHINGFORD Committee : November, 1944—November, 1945 PUBLIC HEALTH AND HOUSING COMMITTEE Chairman:— Councillor Mrs. N. HART. Vice-Chairman:— Councillor A. COLLINS. Members:— Alderman S. F. BRIGG, J.P. „ R. Z. SMITH Councillor H. E. CHINNER „ R. C. LACEY. „ Mrs. S. L. OAKES „ W. P. SOGGEE, „ A. J. STRACHAN. The Mayor, Alderman P. S. POWELL, J.P. (ex-officio). Meeting: Second Tuesday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1945) MEDICAL OFFICER OF HEALTH: WILLIAM D. HYDE, M.B., Ch.B., D.P.H. CHIEF SANITARY INSPECTOR: JAMES F. ROGERS, M.R.San.I., M.S.I.A. (a) (c) (d), 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, M.R.San.I., M.S.I.A. (b) (c) (Military Service from July, 1940). P. W. EDWARDS, M.S.I.A. (b) (c). SENIOR CLERK: Miss V. M. PETTIT. CLERKS: Mrs. E. S. SALTER. Miss P. M. KIMBER. A. E. CULPIN (Military Service from 3.9.39). D. G. BLEACH (Military Service from 9.3.42). R. L. KING (to 20.10.45). Miss M. E. LUCKEN (from 27.12.45). (a) Certificate of the Royal Sanitary Institute as Sanitary Inspector; (b) Certificate of the Royal Sanitary Institute and Sanitary Inspectors' Joint Board as Sanitary Inspector; (c) Certificate of the Royal Sanitary Institute as Meat and Foods Inspector; (d) Certificate of the Royal Sanitary Institute in Advanced Knowledge of duties of Sanitary Inspector. 1 ANNUAL REPORT FOR THE YEAR 1945 To the Mayor, Aldermen and Councillors of the Chingford Corporation. Mr. Mayor, Aldermen and Councillors, I have pleasure in presenting my fifth Annual Report upon the health and sanitary circumstances of the Borough. The Birth Rate has not continued the steep upward trend of the last few years which resulted in the high figure of 21.01 for 1944, and the figure for this year is 16.03, the lowest since 1941. The Infant Mortality rate of 29.7 again compares very favourably with that of England and Wales which is 46. Over the last five years the rate for Chingford has been approximately half that of England and Wales as a whole. The incidence of Infectious Disease was well within normal limits, Measles alone showing any marked increase over the previous year, but being well below the average for the last five years. It is gratifying to note the continued low incidence of Diphtheria, only four cases occurring during the year, but unless the numbers availing themselves of Diphtheria Immunisation are increased, such a continued low rate of cases cannot be guaranteed. 1945 saw the disbandment of the Civil Defence Services with a consequent possibility of the Health Department being able to apply its whole energy to its preventive health functions. In conclusion, I again wish to record the continued loyal service given by the Chief Sanitary Inspector, Mr. James F. Rogers, and the staff of the Health Department. I am, Ladies and Gentlemen, Your obedient servant, WILLIAM D. HYDE, Medical Officer of Health. August, 1946. 2 Section A.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,868 acres Population—Registrar-General's estimate 37,790 Number of inhabited houses, end of 1945 11,420 approx. Rateable value on April 1st, 1945 £329,668 0 0 Sum represented by a penny rate on April 1st, 1945 (gross) £1,373 12 4 Vital Statistics Live Births M. F. Total 316 290 Birth Rate per 1,000 of estimated resident papulation: 16.03. Legitimate 304 283 Illegitimate 12 7 M. F. Stillbirths Total 5 14 Rate per 1,000 total (live and still) births: 30.4. Legitimate 5 14 Illegitimate - - Deaths M. F. Crude Death Rate per 1,000 of estimated resident population: 8.5. 158 163 Deaths from Puerperal Sepsis 0 „ „ other puerperal causes 1 Death Rate of Infants under one year of age:— All infants per 1,000 live births 29.7 Legitimate infants per 1,000 legitimate live births 30.7 Illegitimate infants per 1,000 illegitimate live births — Deaths from Cancer (all ages) 51 „ „ Measles (all ages) 0 „ „ Whooping Cough (all ages) 1 „ „ Diarrhoea (under 2 years of age) 2 „ „ 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 1940 37,220 583 15.66 382 10.26 25 45 1941 35,440 503 14.19 312 8.8 9 16 1942 37,790 667 17.6 282 7.5 19 28 1943 37,860 715 18.9 313 8.3 17 23 1944 36,890 775 21.0 320 8.7 24 31 1945 37,790 606 16.03 321 8.5 18 29.7 Section B.—GENERAL PROVISION OF HEALTH SERVICES IN THE AREA (a) Laboratory Facilities. Pathological specimens from this district are still examined at the E.C.C. Pathological Laboratory, St. Margaret's Hospital, Epping. Unfortunately details of the Chingford specimens examined are again not available this year. (b) Ambulance Facilities. Two ambulances and a staff of three paid drivers were maintained. The following is a summary of the work performed by the Council's Ambulance Service during 1945:— Total number of calls dealt with during year— Private Hire 1,299 Accidents 111 Maternity Cases 205 Total 1,615 Total mileage covered by the Borough Ambulances during the year—23,214 miles. In addition the following calls were dealt with by transfer to other Ambulance Services on occasions when Chingford ambulances were engaged or under repair:— Hire. Accident. Maternity. Civil Defence 16 12 4 Walthamstow Borough 3 12 6 Woodford Borough 8 2 — Leyton Borough 1 — — Epping Urban 1 — — 29 26 10 Total 65 5 The Chingford ambulances gave assistance in adjoining districts as follows:— Hire. Accident. Maternity. Walthamstow 1 6 2 Chigwell, Loughton, Waltham, Epping, etc 17 1 1 18 7 3 Total: 28 Assistance, by supplying drivers or attendants, was given by the St. John Ambulance Brigade members on 148 occasions. (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. (d) Clinics and Treatment Centres. See Table of Clinics on page 7. (e) Hospitals. No change. (f) Midwives. Number of County Council practising midwives 2* „ „ midwives employed by Chingford District Nursing Association 3 ,, „ independent domiciliary midwives 0 „ „ midwives practising in the Nursing Home 1 *Mrs. P. M. Stenning, 237, Hall Lane, E.4 (Telephone: Silverthorn 3263). *Mrs. Salter, 43, Ainslie Wood Gardens E.4 (Telephone: Silverthorn 1345). (g) Registered Nursing Homes. There was one registered Nursing Home in the district receiving maternity and medical patients. This Home was inspected regularly and found to be conducted in a satisfactory manner. (h) War-time Day Nurseries. There are two Nurseries in the district, one situated in converted premises at 136/138, Chingford Mount Road, and the other, of prefabricated hut construction, in Hatch Lane. 6 CLINICS AND TREATMENT CENTRES, 1946 Clinic or Dispensary Where held When held Diphtheria Immunisation Clinics. The Health Dept., "Tantallon," The Ridgeway (nextto Town Hall) County Council Clinic, Marmion Avenue, South Chingford. Wednesdays 10 a.m. Thursdays, 11.30 a.m. Maternity and Child Welfare Clinic. County Council Clinic, Marmion Ave. S. Chingf'd. Tuesdays 1.45 p.m.—3.45 p.m. Maternity and Child Welfare Clinic. County Council Clinic, Marmion Ave. S. Chingf'd. Wednesdays 1.45 p.m.—3.45 p.m. Maternity and Child Welfare Clinic. Mission Hall, Sewardstone Rd. 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, Marmion Avenue, South 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 Friday Hill House, Chingford. 1st and 3rd Mondays 1.45 p.m. Maternity and Child Welfare Clinic. Friday Hill House, Chingford. 2nd, 4th & 5th Mondays, 1.45 p.m.—3.45 p.m. Ante-natal Clinic County Council Clinic, 16, The Ave., Chingford Wednesdays, 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 4th 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 Orthopaedic 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: Fris., 10 a.m.-12 noon. Venereal Diseases Prince of Wales Hospital, Tottenham. Mondays to Fridays, 8 a.m.—6 p.m. Oldchurch County Hosp. Saturdays 8 a.m.—12 noon Tuesdays, (The Annexe) Romford. 4.30 p.m.—7.30 p.m. Thursdays, And other London Hospitals. 12.30 p.m.—3.30 p.m. Acting Relieving Officcr: Mr. E. McCRAVE, 73, Dale View Crescent, Chingford, E.4. (Telephone No.: Silverthorn 4363.) Relief Office: Methodist Church Hall, New Road, South Chingford. (Telephone No.: Silverthorn 2836). Office hours: 9 a.m. to 10 a.m. and 4 p.m. to 5 p.m. Saturdays 9 a.m. to 1 p.m. for urgent cases only. (Urgent applications may be made at the residence of the Acting Relieving Officer : 73, Dale View Crescent, Chingford, E.4.) Vaccination Officer: Mr. C. W. BARRETT, 19, Algers Road, Loughton. (Telephone No.: Loughton 576.) Registrar of Births and Deaths: Mr. F. JACKSON, "Cromer," Summerhill Grove, Bush Hill Park, Enfield. (Telephone No.: Laburnum 4104.) Attends at the Methodist Church Hall, New Road, South Chingford, E.4. on Mondays and Thursdays, 2.30 p.m. to 4.30 p.m.; and Wednesdays and Saturdays, 9 a.m. to 11 a.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. Rivers and Streams. It was not found necessary to take action in connection with the pollution of 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 fortnightly collection of refuse was maintained but with difficulty. The total weight of refuse disposed of at the Works was 5,943 tons, an increase of 1,067 tons over the previous year. The net cost per ton for the collection of refuse was 16s. 5½d. as against 20s. 2d. for the year ended March 1945 and 21s. 5d. for the year ended March 1944. The net cost per ton for the disposal of refuse was 6s. 9½d. as against 10s. 5¾|d. for the previous year and 5s. 6d. for the year ended March 1944. An examination of the analysis of income for the year shows that of the total of £2,928, no less than £1,112 was received for the sale of waste paper During the year the Council continued to take all kitchen waste collected to an approved Concentration Plant and the income from this part of the Council's salvage scheme was £520. The weighbridge was maintained under contract and the fees during the year amounted to £40 5s. 0d., representing 1,610 weighings as against £35 10s. 0d., or 1,420 weighings in the previous year. The income derived from the collection of trade refuse was £110 3s. 9d. 8 HOUSE AND TRADE REFUSE Table showing costs for the year ended 31st March, 1946 Item. 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 £5065 5065 4938 4938 10003 10003 B Gross income 170 170 2928 2928 3098 3098 C Net cost £4895 4895 2010 2010 6905 6905 Unit Costs s. d. s. d. s. d. s. d. s. d. s. d. D Gross expenditure per ton 17 0½ 17 0½ 16 7½ 16 7½ 33 8 33 8 E Gross income, per ton 7 7 9 101¼ 9 10¼ 10 5¼ 10 5¼ F Net cost, per ton 16 5½ 16 5½ 6 9¼ 6 91¼ 23 2¾ 23 2¾ G Net cost, per 1,000 popu- lation £ 129 £ 129 £ 53 £ 53 £ 182 £ 182 H Net cost, per 1,000 houses 425 425 174¾ 174¾ 599½ 699½ 1. Total refuse collected (in tons) 5,943 2. Population (Mid-Year) 37,790 3. Weight per 1,000 population per day (cwts.) 8.6 4. Number of occupied houses and premises (March, 1946) 11,518 Note.—(a) "Loan charges" include interest on loans; repayment of loans; revenue contributions to capital outlay and capital receipts. 9 10 Year ended ANALYSIS OF INCOME FOR THE YEAR ENDED 31st MARCH, 1946 31.3.45 £ s. d. £ s. d. £ 6. d. £ s. d. 1. Sale of Salvaged Articles : Fine Ash, Clinker and Screenings Metals: 17 6 10 Aluminium 14 0 0 7 17 8 Copper 11 13 6 25 0 6 Iron 38 18 0 7 12 4 Lead 12 12 7 2 8 11 Battery Lead 9 14 0 Brass 14 9 1 3 4 9 Mixed Metals 31 15 5 4 6 0 Unbaled Scrap 7 5 6 62 9 7 Tins 86 0 2 1 19 10 Pewter 1 17 3 218 11 6 31 6 7 Bones 22 14 11 22 14 11 89 5 8 Broken White Glass 102 18 1 219 16 8 Bottles & Jars 402 4 8 505 2 9 260 2 2 Rags 230 0 3 22 7 0 Carpets 31 8 6 261 8 9 104 5 2 Newspapers 63 18 3 1129 0 2 Mixed Waste Paper 1,036 7 9 Ministry of Supply Coll. Allen 12 9 9 1,112 15 9 516 10 10 Pig Food 520 12 3 520 12 3 25 12 6 Rubber — — — 2. Miscellaneous Receipts 145 17 9 and Charges 196 6 7 2,837 12 6 35 10 0 3. Weighbridge Fees 40 5 0 4. Rents: 30 0 0 Foundry 30 0 0 20 0 0 Proportion of Allotment Rents 20 2 6 £2771 14 11 £2,928 0 0 4876 Tonnage 5,943 SANITARY INSPECTION OF THE AREA Inspections on Complaint The number of complaints received at the office and recorded in the register was 212, as compared with 192 in the previous year and 224 for the year 1943. The total inspections made on complaint was 440 and the number of defects or nuisances revealed was 237, 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 4 Defective roofs, spoutings and eavesgutters 8 Blocked yard and W.C. drains 14 Blocked sewers 88 Defective sewers 43 Defective drainage 3 Defective dustbins 11 W.C.'s without proper flushing arrangements 11 Defective W.C.'s 6 Insufficient water supply 4 Dampness 3 Defective stoves and fire grates 5 Defective water fittings 10 Defective boilers 3 Waste pipes and sinks defective 4 Defective hot water systems 5 Woodwork of windows and doors defective 2 Verminous premises 6 Animals kept so as to be a nuisance 2 Accumulations of offensive matter 2 Defective floors 2 Lack of sanitary accommodation 1 237 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 3,038, as compared with 2,345 in the previous year; the defects dealt with numbered 620, as compared with 398 in 1944. Table 2 Visits Paid Nuisances or Defects found Housing Act, 1936: Inspections 80 360 Re-visits re Notices served 491 Re Overcrowding 8 On Complaint 440 237 Miscellaneous 36 Infectious Disease 379 Meat and Food Shops 119 Factories 24 1 Bakehouses 12 Cowsheds and Dairies 10 Pigstyes 10 Re-visits re Notices served (P.H. Act) 1,118 Infestation by Rats and Mice 25 20 Private Slaughterhouses 9 Shops Act 24 Council Houses 12 Collection and Disposal of Refuse and Salvage 122 Restaurants and Canteens 23 1 Re Building Licences 24 Schools 6 Hostels and Camps 4 Hairdressers' Premises 11 Re Kitchen Waste Collection 41 Petroleum Storage 5 Cinemas 5 1 3,038 620 12 Nuisances and Defects In the following table are 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 11 Defective roofs, spoutings and eavesgutters 49 Blocked yard and W.C. drains 18 Blocked sewers 90 Defective sewers 43 Defective drainage 8 Wall and ceiling plaster defective 61 Ashbins defective 17 W.C.'s without flushing arrangements 22 Insufficient water supply 6 Water closets defective 16 Dampness 27 Defective stoves and firegrates 30 Defective floors 36 Water fittings defective 18 Insufficient lighting and ventilation 1 Defective external brickwork 27 Stairs and rails defective 2 Defective woodwork of windows and doors 66 Sinks and waste pipes defective 11 Yard paving defective 2 Dangerous buildings 2 Rat infestation 20 Defective wash coppers 8 Defective sash cords, glazing, etc. 9 Verminous premises 6 Animals kept so as to be a nuisance 2 Accumulations of offensive matter 2 Lack of sanitary accommodation 1 Defective hot water systems 9 620 Table 4 Letters sent out and notices served in connection with sanitary matters. Letters 586 Public Health Acts: Preliminary Notices 52 Secondary Notices 15 Statutory Notices (re maintenance of Sewers) 22 Housing Acts: Preliminary Notices 65 Secondary Notices 10 Statutory Notices 8 13 Shops Acts. It was not found necessary to take action during the year under the provisions of the Shops Acts. Smoke Abatement. No action was taken in respect of smoke abatement. Swimming Baths and Pools. 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. Disinfested, 2. Infested, 7. Disinfested, 7. (2) Methods. Spraying with an 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. 14 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 Bye-laws 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-six visits were paid to Factories. One case of infectious disease occurred at out-workers' premises during the year. Number and Trades of Out-workers notified during 1945. Wearing Apparel 56 Brush Making 3 Paper Bag-making — 2 Leather Goods 1 Box Making 4 Out-workers were notified from the following Areas: Bethnal Green 11 Leyton 19 Chigwell 1 St. Marylebone 7 Corporation of London 7 Shoreditch 8 Hackney 10 Walthamstow 4 Islington 2 15 Section D.—HOUSING STATISTICS FOR THE YEAR 1945 1. Number of Houses erected during the Year: (1) By the L.A. Nil (2) By other L.A.'s Nil (3) Other bodies Nil 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) 919 (b) Number of Inspections made for the purpose 2,528 (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 80 (b) Number of Inspections made for the purpose 571 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 2 (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 288* *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 260 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 8 (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 26 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) by owners — (b) by Local Authority 26 Proceedings under Sections 11 and 13 of the Housing Act, 1936 : Undertakings accepted 1 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 4. The number of visits paid to cowsheds and dairies was 10. Milk (Special Designations) Orders!, 1936 and 1938. 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 : 2 dealers' licences to sell milk as Pasteurised. 2 supplementary licences to sell milk as Pasteurised. 2 dealers' licences to sell milk as Tuberculin Tested. 2 supplementary licences to sell milk as Tuberculin Tested. Meat and Other Foods. There is one licensed slaughterhouse and twentytwo butchers' shops in the area; the visits paid to these premises numbered 119. 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 or used for animal feeding purposes:— 17 TINNED GOODS. No. of Tins Article. Normal Condemnation. War Damage 52 1 Pilchards 6 5 Herrings 1 - Herring Roes 13 - Salmon 5 - Crawfish 35 - Sardines 9 - Mackerel 23 - Luncheon Meat 27 12 Casserole Steak 11 - Chopped Ham 1 - Ready Meal 1 - Spam 1 - Prem 7 - Kam 9 - Sausage Meat 1 - Rolled Beef 13 - Meat and Veg. 1 - Lamb Tongue 2 - Ox Tongue 2 - Brisket Beef 1 - Rabbit 9 - Vegetables 2 - Beetroot 32 - Peas 74 1 Beans 8 - Soups 132 - Milk - 1 Creamed Rice 8 - Jam 5 - Marmalade - 8 Golden Syrup OTHER FOODS. Normal Condemnation War Damage Article - 333 lbs. Flour. - 3 lbs. Batter Flour. 25 pkts. 36 pkts. Cake Flour. 2 pkts. 2 pkts. Yorkshire Pud. Mixt. 7 3/4lbs. ½ lb. Butter. 2lbs. 14 lbs. Margarine. 3/4 lb. 4 lbs. Lard. ½ lb. - Suet. 66 lbs. - Sausages. 2½ lbs. - Chopped Ham. - I 3/4 lbs. Luncheon Meat. - 1 lb. Brisket Beef. - 2 jars. Paste. 118½ lbs. — Beef. 21 lbs. — Lambs' Livers. continued on next page. 18 OTHER FOODS—Continued. Normal Condemnation War Damage Article 23 lbs. - Tripe. 7¼ lbs. - Pork. 37 stones - Fish. 6 ozs. 82½ lbs. Bacon. 6¼ lbs. 22 lbs. Cheese. 48 ¼ lbs. - Cheese Trimmings. 327 lbs. - Oranges. 50 lbs. - Prunes. 338 lbs. 3 lbs. Dates. 60 lbs. 20 lbs. Sultanas. - 14 lbs. Macaroni. 100 lbs. 59 lbs. Semolina. - 52 lbs. Pearl Barley. - 9 pkts. Barley Kernels. - 7 pkts. Breakfast Cereal. - 7 pkts. Sage and Onion Stuffing. - 100 Oxo Cubes. - 122 pkts. Gravy Salt. 107 pkts. 18 pkts. Soup Powder. 1 cwt. - Soup Mixture. - 14 lbs. Butter Beans. - 10 lbs. Lentils. - 24 lbs. Dried Peas. - 1 cwt. Haricot Beans. 493 19 Eggs. - 9 pkts. Dried Egg. - 72 pkts. Egg Substitute. - 3 3/4 lbs. Baking Powder. 5 cwts. 9 lbs. Custard Powder. - 29 pkts. Junket. 103½ lbs. 91¼ lbs. Sugar. 9 lbs. 165¼ lbs. Sweets. 298 98 Bars Chocolate. - 24 bots. Essences. - 18 bots. Cordial. 32 - Cakes. - 11 lbs. Slab Cake. - 151 lbs. Rolled Oats. - 26 lbs. Rice. 4 lb. 34 lbs. Tea. - 1 pkt. Cocoa. - 24 pkts. Cafe au Lait Powder. 288 pkts. 372 pkts. Salt. - 6 tins Mustard. - 1 lbs. Pudding Spice. - 6 lbs. Peas. 38 lbs. - Potatoes. - 4 lbs. Apple Rings. - 18 lbs. Marmalade. - 95 lbs. Jam. 7 jars 101 jars Pickles. - 108 jars Sauce. - 2 jars Beetox. - 13 bots. Salad Cream. - 3 bots. Coffee. 19 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 was forwarded for bacteriological examination during the year:— No. Sample. Result. 241 Pasteurised Milk Satisfactory. Food and Drugs Act, 1938. The following articles were submitted for chemical examina' tion during the year in supplementation of the Essex County Council's Food and Drugs service:— No. Sample. Result. 273 Margarine Contained only 0.04% free fatty acid but definite evidence of rancidity. 274 Household Milk Commercially sterile. Acidity normal. Slightly "off" flavour due to long storage. 275 Condensed Milk (mach. skimmed) Satisfactory. 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:— 1941 1942 1943 1944 1945 Cases notified 32 186 376 82 62 Percentage removed to hospital 91 82 72 64 77 During the year the number of notifications of Scarlet Fever fell to a lower figure than the previous year's comparatively low number. The percentage of cases removed to hospital increased. This reflects the difficult housing conditions prevailing, as in many cases where home nursing and isolation are possible, it is medically sound to have home isolation rather than in hospital wards. 20 Diphtheria. During the year only four cases of Diphtheria occurred, the patients being boys aged 7, 8, 8 and 10 years, one of whom had been immunised. Diphtheria Immunisation. Number of children immunised during the year:— Under 5 years 531 Between 5 and 15 years 84 Total 615 The number of children immunised during the year showed an increase over the previous year, but the numbers accepting this service are not sufficiently high to warrant any sense of security. It is estimated that in Chingford 61% of children under 5 years and 73% of children aged between 5 and 15 years had been immunised at 31st December, 1945. Efforts during the year were again concentrated on securing the immunisation of children as soon as possible after their first birthday. The material used in all instances was Diphtheria Alum Precipitated Toxoid, the dosage being 0.2 c.c. and 0.5 c.c. at an interval of four weeks. Measles. There was an increase in the number of cases of Measles, but only 5 cases were admitted to hospital. Scabies. With the disbandment of the Civil Defence Services, the arrangements for treatment of cases of Scabies at the First Aid Post terminated. Certain minor adaptations were made to the former Civil Defence Gas Cleansing Station at Green Farm, whereby a portion of this building, now in use as a Public Convenience, is available for the treatment of Scabies, under the direction of a Nurse who is employed on a sessional basis as required. 21 Number of cases treated at the Church Hall First Aid Post up to 6th June, 1945:— Pre-school age 1 School age 1 Adults — Total 2 Only one, the school age child, returned for the second treatment. From information and notifications received in the Health Department, it does not appear that the incidence of Scabies was unusually high during the year. Dysentery. During the year there was an increase in the number of cases of Dysentery. In all cases where specimens were examined bacteriologically and the infection confirmed, the type of infection was found to be Sonne, and in most cases the illness was of short duration and mild upset. Infection appeared to be from contact with patients and no source of infection relative to general milk or food supplies could be traced. Tuberculosis. There were 50 cases of all forms of Tuberculosis notified during 1945 (a decrease of 7 on the previous year) and of these, 8 cases (16%) were transfers from other districts. There were 16 deaths from Tuberculosis during the year; 5 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 3.2. Malaria. During the year there was one case of Malaria notified. This was a relapse in a soldier who had returned from service overseas. Food Poisoning. Three cases of food poisoning were notified during the year, two of which occurred concurrently in one family. Investigations in these two cases pointed to the likelihood of duck eggs having carried the infection, but conclusive evidence was not obtained. In the other isolated case, investigations failed to reveal any definite source of infection. Diabetes. There are two elderly ladies receiving free supplies of Insulin under Ministry of Health Circular No. 2734. 22 Vaccination. The Vaccination Officer for the area has furnished the following return for 1945:— Births registered 270 Successfully vaccinated 84 Percentage vaccinated 31.1 Insusceptible — Exemptions 110 Died before vaccination 9 Postponed 14 Removed—new address unknown 5 Removed—address known and V.O. notified 8 Outstanding 40 Medical Examinations. During the year 16 examinations were carried out by the Medical Officer of Health in respect of the Superannuation and Sick Pay Scheme. CAUSES OF DEATH AS GIVEN BY THE REGISTRAR-GENERAL FOR THE YEAR 1945 Causes of Death. Males. Females. Total. Whooping Cough 1 — 1 Diphtheria 1 — 1 Tuberculosis of respiratory system 6 6 12 Other forms of tuberculosis 3 2 5 Syphilitic diseases 2 — 2 Influenza 1 — 1 Cancer of buccal cavity and oesophagus (M) uterus (F) 5 2 7 Cancer of stomach and duodenum 6 4 10 Cancer of breast — 4 4 Cancer of all other sites 15 15 30 Diabetes 2 1 3 Intra-cranial vascular lesions 16 27 43 Heart disease 26 37 63 Other diseases of circulatory system 8 10 18 Bronchitis 9 8 17 Pneumonia 7 6 13 Other respiratory diseases 2 1 3 Ulcer of stomach or duodenum 3 — 3 Diarrhoea under 2 years — 2 2 Other digestive diseases 4 9 13 Nephritis 4 3 7 Maternal causes (excluding puerperal and post-abortive sepsis) - 1 1 Premature birth 3 — 3 Congenital malformation, birth injury, infantile disease 9 2 11 Suicide 2 1 3 Road traffic accidents — 3 3 Other violent causes 11 10 21 All other causes 12 9 21 Totals—all causes 158 163 321 Totals—year 1944 158 160 318 23 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 to 4 years - - - 2 - - - - - - - - 5 to 14 years - 3 - 2 - - - - - - - 1 15 to 24 years 4 4 1 1 1 3 - - - 1 1 - 25 to 34 years 4 4 - 1 2 1 - - - 1 - - 35 to 44 years 3 5 2 - 1 - - - 2 1 1 - 45 to 54 years 2 3 - - - - - - 1 - - - 55 to 64 years - - - - - - - - - 1 - - 65 and upwards - 1 - - - - - - - - - - Totals 13 20 3 6 4 4 - - 3 5 2 1 Add—Deaths of un-notified cases 3 - - 2 6 5 2 3 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-lntestinal Tract - - - - - - 2 2 14 8 16 10 26 Lungs and Mediastinum - - - - - - 2 - 3 - 5 - 5 Genito-urinary organs - - - - - - - 1 - 3 - 4 4 Breast - - - - - - - - - 2 - 3 3 Other sites - - - - 1 1 2 2 2 5 5 8 13 Totals - - - 1 1 1 6 5 19 18 26 25 51 Death rate =1.34 per 1,000 (as compared with 1.54 per 1,000 in previous year). 24 Deaths from all causes at various Ages Age DEATHS No. of deaths which apply to district No. in district Outward Transfers Inward Transfers Under 1 year 9 3 12 18 1 and under 2 1 — 2 3 2 and under 5 2 1 — 1 5 and under 15 5 4 5 6 15 and under 25 7 — 3 10 25 and under 35 6 5 5 6 35 and under 45 6 — 13 19 45 and under 55 17 — 16 33 55 and under 65 22 1 30 51 65 and under 75 32 1 43 74 75 and upwards 50 — 46 96 Totals 157 15 175 317 ATTENDANCES AT LOCAL CLINICS DURING 1945 Ante-Natal Clinics: Friday Hill Sessions 21 Attendances 222 16, The Avenue Sessions 105 Attendances 1,824 Infants' & Toddlers' Welfare Clinics: Friday Hill Sessions (including Infants & Toddlers) 23 Attendances (including 33 new infants). 386 Sewardstone Road Sessions (including Infants & Toddlers 26 Attendances (including 41 new infants). 598 North Chingford Sessions (including Infants & Toddlers 49 Attendances (including 112 new infants) 1,885 Marmion Avenue & 16, The Avenue Sessions: Infants 97 Attendances 4,477 Toddlers 49 Attendances 767 Specialist Obstetric Clinic: 16, The Avenue Sessions 10 Attendances 59 Women's Welfare Clinic: 16, The Avenue Sessions 12 Attendances 81 Minor Ailment & School Clinics: 16, The Avenue Sessions 44 Attendances 833 Whitehall Road School: Sessions by Nurse 87 Attendances 887 Sessions by Doctor 11 Orthopaedic Clinic: 16, The Avenue Sessions (not available). Patients treated (not available). 25 NOTIFIABLE DISEASES (after correction) Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Dysentery Encephalitis Lethargica Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Cerebro-Spinal Fever Enteric Fever Pulmonary Other Forms 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 — 1943 376 13 16 189 83 55 7 2 - 2 1 88 3 — 1944 82 2 5 61 72 52 5 20 - 2 1 73 2 — 1945 62 4 9 210 94 41 9 38 — 3 1 88 2 — 26 NOTIFIABLE DISEASES TABULATED ACCORDING TO AGE. (after correction). Under 1 year 1 2 3 4 5-9 10-14 15-19 20-34 35-44 45-64 65 and over Totals Scarlet Fever 1 - 5 2 8 39 4 - 1 2 - - 62 Diphtheria - - - - - 3 1 - - - - - 4 Erysipelas - - - - - - - - 1 3 5 - 9 Measles 4 15 26 21 28 106 8 1 1 - - - 210 Whooping Cough 7 12 21 12 13 27 2 - - - - - 94 Puerperal Pyrexia - - - - - - - - 3 - - - 3 Pneumonia 6 6 6 - 1 10 5 2 4 5 21 22 88 Cerebrospinal Fever 1 - - - - - - - 1 - - - 2 Dysentery - 3 5 - 3 6 5 2 7 4 2 1 38 Ophthalmia Neonatorum 1 - - - - - - - - - - - 1 ANALYSIS OF NOTIFIABLE DISEASES AND DEATHS. (after correction). Diseases Total cases Total admitted to hospital Total Deaths Scarlet Fever 62 48 - Diphtheria 4 4 1 Erysipelas 9 5 - Puerperal Pyrexia 3 1 - Pneumonia 88 20 13 Cerebro-Spinal Fever 2 2 - Measles 210 5 - Whooping Cough 94 2 1 Dysentery 38 13 - Ophthalmia Neonatorum 1 1 - 27 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality and Case rates for certain Infectious Diseases in the Year 1945. (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 16.1 19.1 19.2 15.7 16 46 54 43 53 29.7 Still 0.46 0.58 0.53 0.40 0.5 Deaths : All Causes 11.4 13.5 12.3 13.8 8.5 Deaths from Diarrhœa and Enteritis under 2 years of age 5.6 7.8 4.5 7.6 3.3 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 - Scarlet Fever 0.00 0.00 0.00 0.00 — Whooping Cough 0.02 0.02 0.01 0.02 0.03 Diphtheria 0.02 0.02 0.02 0.01 0.03 Influenza 0.08 0.07 0.07 0.07 0.03 Rates per 1,000 Total Births (Live and Still) Smallpox - - - - - Measles 0.02 0.02 0.02 0.01 - Notifications: Notifications: Typhoid Fever 0.01 0.01 0.01 0.01 — Puerperal Fever 9.93 12.65 8.81 3.60 4.8 Paratyphoid Fever 0.01 0.00 0.01 0.00 — Cerebrospinal Fever 0.05 0.05 0.05 0.06 0.05 „ Pyrexia *15.87 Scarlet Fever 1.89 2.02 2.03 1.57 1.64 Maternal Mortality: Whooping Cough 1.64 1.65 1.47 1.25 2.49 Diphtheria 0.46 0.52 0.56 0.31 0.11 Erysipelas 0.25 0.28 0.24 0.31 0.24 Maternal causes (excluding Abortion and Puerperal Infections) 1.22 Not available. 1.6 Smallpox 0.00 0.00 - 0.00 — Measles 11.67 10.89 11.19 9.03 5.56 Pneumonia 0.87 1.03 0.72 0.78 2.33 *Including Puerperal Fever. 28