CM IN! ll± BOROUGH OF CHINGFORD ANNUAL REPORT MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1949 OF THE BOROUGH OF CHINGFORD Committee: June, 1949 — May, 1950. PUBLIC HEALTH COMMITTEE Chairman: Councillor J. W. R. Nation. Vice-Chairman: Councillor A. T. H. Austin. Members: Alderman Mrs. S. L. Oakes. Councillor L. A. Bailey. V. D. Hall. „ Dr. J. Wagstaff. „ T. H. Treadwcll. „ Mrs; J. L. L. Woods, J.P. P. W. Wood. K. W. Rothwell. The Mayor, Councillor W. S. Higho, J.P. (ex-officio). Meeting: Second Wednesday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1949) Medical Officer of Health: J. H. CROSBY, M.B., Ch.B., D.P.H. Chief Sanitary Inspector: JAMES F. ROGERS, M.R.San.I., M.S.I.A. (a) (c) (d) Cleansing Superintendent, Inspector under the Shops Acts and Petroleum Acts. District Sanitary Inspectors: R. W. BASHFORD, M.S.I.A. (b) (c). K. V. SPROAT, M.R.San.I., M.S.I.A. (b) (e). D. G. BLEACH (b) (to 30.6.49). K. A. CHESTER, M.R.San.I., M.S.I.A., M.R.I.P.H.H. (b) (e) (from 13.6.49). Senior Clerk: Miss V. M. PETTIT. Clerks: A. E. CULPIN. Miss I. A. FOLKES. Miss E. HOWES (to 26.3.49). Miss O. HURRELL (from 28.3.49). (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 Other Foods Inspector. (d) Certificate of the Royal Sanitary Institute in Advanced Knowledge of duties of Sanitary Inspector. (e Certificate of the Royal Sanitary institute in Sanitary Science. ANNUAL REPORT FOR THE YEAR 1949 To the Mayor, Aldermen and Councillors of the Chingford Corporation. Mr. Mayor, Aldermen and Councillors, I have pleasure in submitting my Annual Report for the year 1949 upon the health and sanitary circumstances of the Borough. A further fall in the birth rate has taken place during the year, the rate being 14.1 per thousand (in 1948 the rate was 15.9). This further reduction is, like that of 1948, associated with a general reduction throughout England and Wales as a whole. The death rate rose from 7.3 per thousand in 1948 to 8.3 in 1949. The infant mortality rate, i.e., the number of deaths of infants under one year per thousand live births, was 24.9 (in 1948 it was 21.5), the rate for England and Wales being 32. Of the more common infectious diseases, Scarlet Fever and Measles both showed a rise in incidence, the number of cases being 105 and 499 respectively. During the latter half of the year several outbreaks of food poisoning, affecting a school in the Borough, occurred. In .all, 24 adults and 80 children were affected. A report of these outbreaks is given in the text. I desire to express my appreciation to the staff of the Health Department and to Mr. J. F. Rogers, Chief Sanitary Inspector, for their assistance to me during the year. . . . I am, Ladies and Gentlemen, Your obedient servant, J. H. CROSBY, Medical Officer of Health. July, 1950. 2 Section A.—STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,868 acres Population—Registrar-Ceneral's estimate 48,510 Number of inhabited houses and flats at end of 1949 13,307 Rateable value on April 1st, 1949 £367,148 Sum represented by a penny rate on April 1st, 1949 (gross) £1,529 15 8 VITAL STATISTICS M. F. Live Births Total 368 316 Birth Rate per 1,000 of estimated resident population: 14.1 Legitimate 361 310 Illegitimate 7 6 M. F. Stillbirths Total 10 8 Rate per 1,000 total (live and still) births: 25.6 Legitimate 10 8 Illegitimate - - M. F. Deaths 200 204 Crude Death Rate per 1,000 of estimated resident population : 8.3 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 24.9 Legitimate infants per 1,000 legitimate live births 23.8 Illegitimate infants per 1,000 illegitimate live births 76.8 Deaths from Cancer (all ages) 72 „ „ Measles (all ages) — „ „ Whooping Cough (all ages) — „ „ Diarrhoea (under 2 years of age) — „ „ Scarlet Fever — 3 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 1944 36,890 775 21.0 320 8.7 24 31 1945 37,790 606 16.03 321 8.5 18 29.7 1946 43,290 884 20.4 329 7.6 24 27 1947 45,430 924 20.3 388 8.5 12 12.9 1948 46,610 743 15.9 340 7.3 16 21.5 1949 48,510 684 14.1 404 8.3 17 24.9 4 Section B.—GENERAL PROVISION OF HEALTH SERVICES IN THE AREA (a) Laboratory Facilities. Pathological specimens from this district are examined at the Pathological Department of the St. Margaret's Hospital at Epping. The Pathologist has kindly supplied me with the following figures of specimens from Chingford examined during the year :— Number of specimens examined for the Health Department and the General Practitioners — 536 Number of specimens examined for the Chingford Isolation Hospital 238 (b) Ambulance Service. The Ambulance Service, maintained and controlled by the Essex County Council, has an Ambulance Station situated at the Fire Station, Town Hall, The Ridgeway, Chingford, which serves this area. The Station is manned continuously; the telephone number being Silverthorn 2222. The general procedure for obtaining an ambulance in emergency is as follows:— Where there is a dialling system in operation in the Chingford area, dial "999." Where there is no dialling system, lift receiver and ask for an ambulance. (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. The hospitals providing general medical services for Chingford residents are chiefly the Connaught Hospital, Walthamstow, and the Wanstead Hospital, Wanstead. Persons with infectious disease, needing admission to hospital, are accommodated at the Chingford Isolation Hospital and the Isolation Hospital at Waltham Abbey. 5 (f) Midwives. Number of County Council practising midwives 5* „ „ midwives practising in the Nursing Homes 4 „ „ maternity nurses practising in the Nursing Homes 2 *Miss E. A. Clarke, 69, Connaught Avenue, E.4. (Silverthorn 1801). *Mrs. G. E. M. Witter, 90, Connington Crescent, E.4. (Silverthorn 4968). *Mrs. P. M. Stenning, 220, Hall Lane, E.4. (Silverthorn 3263). *Miss C. Lovell, 49, The Ridgeway, E.4. (Silverthorn 1460). *Miss D. Waldie, 49, The Ridgeway, E.4. (Silverthorn 1460). (g) Registered Nursing Homes. There are three registered Nursing Homes in the district, two receiving maternity and medical patients, and the third Home receiving medical cases only. The Homes were inspected regularly and found to be conducted in a satisfactory manner. (h) 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. Regular medical inspection of the children attending these Nurseries was carried out during the year. (i) Home and Domestic Help Scheme. There is a Home and Domestic Help Scheme in the Chingford district, under the auspices of the Essex County Council. Application for these facilities should be made to the Health Visitors in the district. (j) Chiropody Facilities. A Chiropody Clinic is held on Tuesday afternoons and all day on Fridays at the Wanstead Hospital, Wanstead, E.11. School children are seen by appointment, which is made through the Clinical Secretary at the Hospital. Adults and children under school age can also be seen at this clinic, but a letter of recommendation from their private or clinic doctor is required. In addition to the above facilities, four persons hold a licence from the Essex County Council to carry on private practice as chiropodists within the borough. 6 Local Clinics and Treatment Centres, 1950 Clinic Where held When held Diphtheria Immunisation Clinics Primary Hall, Buxton Rd., North Chingford. Tuesdays, 2 p.m. Mission Hall, Sewardstone Road, E.4. 2nd, 4th and 5th Wednesdays, at 2 p.m. County Council Clinic, Marmion Avenue, South Chingford. Thursdays, 11.30 a.m. Friday Hill House, E.4. 1st Wednesday, 3 p.m. Church Hall, The Ridge way, North Chingford. Wednesdays, 9.30 a.m. Antc-Natal Clinics Friday Hill House, E.4. Tuesdays, 1.30 p.m.—4 p.m. County Council Clinic, Marmion Avenue, E.4. Wednesdays, 9.30 a.m. 2nd Thursday, 2 p.m. 49, The Ridgeway, E.4. Fridays, 1.30 p.m.—4 p.m. Child Welfare Clinics Friday Hill House, E.4. Wednesdays, 1.30 p.m.—4 p.m. County Council Clinic, Marmion Avenue, E.4. Tuesdays, 1.45 p.m.—3.45 p.m. Wednesdays, 1.45 p.m.—3.45 p.m. Primary Hall, Buxton Rd., North Chingford. Tuesdays, 1.45 p.m.—3.45 p.m. Mission Hall, Sewardstone Road, E.4. 2nd, 4th and 5th Wednesdays, 2 p.m.—4 p.m. Church Hall The Ridgeway, North Chingford. Wednesdays, 9 a.m.—11.45 a.m. Toddlers' Clinic County Council Clinic, Marmion Avenue, E.4. Thursdays, 10 a.m.—11.30 a.m. Minor Ailment School Clinics County Council Clinic, Marmion Avenue, E.4. Mondays, 9.30 a.m. Friday Hill House, E.4. Mondays, 2 p.m.—4 p.m. Orthopiedic Clinics County Council Clinic, Marmion Avenue, E.4. Monday afternoons. 1st, 3rd, 4th and 5th Thursdays, all day, by appointment only. Friday Hill House, E.4. 2nd Thursday, afternoon Dental Clinic Marmion Avenue County Council Clinic, E.4. Wednesdays, 9.45 a.m. (inspection only) or by appointment through schools. Eye Clinic Marmion Avenue County Council Clinic, E.4. Friday afternoons, by appointment only. Women's Welfare Clinics 49, The Ridgeway, E.4. 4th Friday in each month at 10.15 a.m. Friday Hill House, E.4. 1st Friday in each month at 9.30 a.m. Tuberculosis Dispensary Chest Clinic, High Street, Walthamstow, E.17. New cases, Adults : Wednesdays, 10 a.m.—12 noon. New cases, Children : Fridays, 10 a.m.—12 noon. Registrar of Births, Deaths and Marriages : Mr. C. \V. BARRETT, 19 Algers Road, Loughton. (Telephone : Loughton 576). Ollice: Town Hall, Chingford, E.4. (Telephone: Silverthorn 3944). Mondays and Thursdays, 2.30 p.m. to 4.30 p.m. Wednesdays and Saturdays, 9 a.m. to 11 a.m. Duly Authorised Officer: Mr. E. McCRAVE, 73, Dale View Crescent, Chingford, E.4. (Telephone : Silverthorn 4363). Office: Methodist Church Hall, New Road, South Chingford, E.4. (Telephone : Silverthorn 2836). Mondays to Fridays, 9 a.m. to 10 a.m. 4 p.m. to 5 p.m. Social Welfare Officer: 35, Wanstead Place, £.11. (Telephone: Wanstead 0031). National Assistance Board: 12, Church Hill, Walthamstow, E.17. (Telephone: Larkswood 3347). Office Hours : Mondays to Fridays, 9 a.m. to 5 p.m. Saturdays, 9 a.m. to 1 p.m. Ministry of National Insurance: 11a, The Ridgeway, North Chingford, E.4. (Telephone: Silverthorn 2294). Office Hours : Mondays to Fridays, 10 a.m. to 4 p.m. Saturdays, 9 a.m. to 12 noon. 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. Ninety-one visits were paid during the year in connection with the pollution of water courses and these visits had reference to premises wherein sanitary fittings had been incorrectly connected to the Council's surface water sewers. In all instances the necessary adjustments were made and the pollution prevented. Public Cleansing. A weekly collection of refuse and salvage was maintained and the total weight of refuse disposed of at the Works was 11,223 tons. This was an increase over the amount collected in the previous year, namely, 10,862 tons; the population mid-year 1949 was 48,510 as compared with 46,610 for the previous year. The net cost per ton for the collection of refuse was 18s. 4d. as against 16s. 7d. for the year ended March, 1949, and 19s. 9½d. for the year ended March, 1948. The net cost per ton for the disposal of refuse was 7s. 9d. as against 7s. 1d. for the previous year and 8s. 1¾d. for the year ended March, 1948. The net expenditure for the collection and disposal of refuse and salvage was £14,613 as against £12,831 for the previous year. The total income from all sources was £5,967 as compared with £5,156 for the previous year. Of the total income for the year no less than £3,125 was received for the sale of newspapers and mixed waste paper, and it is pleasing to note that although nationally there was some disturbance of Councils'' normal activities in this connection, the Council's contract with the Board Mills was maintained without alteration throughout the year. No reduction in the price of waste paper took place until March, 1950. Considerable attention was given during the year to the disposal of ashes, screenings and clinker from the Refuse Disposal Works, due to the fact that all available land suitable for tipping within the area of the Borough was exhausted. As an interim measure arrangements were made with the Edmonton Corporation for the use of a tip at Wormley, Hertfordshire, but this concession was limited to a period of six months. When it is realised that the operation of the Refuse Disposal Works is entirely dependent on the disposal of ashes, screenings and clinker, the seriousness of the position before the Council will be appreciated. Towards the end of the year, however, negotiations were commenced with the Epping Rural District Council for the 8 use of a tip at Parndon in Essex, and there is every prospect that suitable arrangements can be made for the reception of these materials from the Refuse Disposal Works. The fleet of refuse collection freighters was maintained in good condition throughout the year and one new vehicle was added; the vehicles in use were two Fordsons with Eagle bodies, two Shelvoke and Drury freighters and three Karriers. The Lewin Road Sweeper Collection machine was put into operation in June of the year under review and in consequence the staff of street orderlies was reduced from sixteen to eight. In the light of practical experience with the sweeping machine this reduction in the number of street orderlies was perhaps somewhat drastic, for, although the machine proved to be an efficient unit, the number of miles swept per day did not come up to expectations. Many factors have to be taken into account in the operation of this particular machine and it is anticipated that longer experience in its use will lead to a greater daily output. During the year under review the maintenance and cleansing of trunk roads was transferred from the Ministry of Transport to the Essex County Council and, therefore, this authority ceased to cleanse and maintain that portion of A.406 which lies within the Borough boundary. The collection of kitchen waste from communal bins was continued and, as in previous years, the material was transported to the approved concentration plant at Stapleford Abbots. Petitions were received from residents in the vicinity of the forest asking for the communal bins to be removed owing to disturbance by cattle and representation was made to the Board of Trade. In view of the degree of nuisance caused the Board of Trade agreed that all communal kitchen waste bins in the vicinity of the forest should be removed and a total of 67 bins was subsequently taken from the highways affected. This number was approximately one-third of the total communal bins in the town and it is to be expected, therefore, that the weight of kitchen waste collected from this source will show a decline in future years. Road gullies were cleansed by contract as in previous years, those gullies in main roads being cleansed four times per year and those in district roads twice per year. The Public Sanitary Conveniences were maintained in good condition throughout the year. During Bank Holidays the facilities at the Bury Road Convenience were taxed to the utmost, but the working of additional hours by the attendants coped with the situation. 9 HOUSE AND TRADE REFUSE Table showing costs for the year ending 31st March, 1950. I — Collection II — Disposal Total Including Depreciation or Loan Charges Excluding Loan Charges etc. Including Deprecia' tion or Loan Charges Excluding Loan Charges etc. Including Depreciation or Loan Charges Excluding Loan Charges etc. (1) (2) (3) (4) (5) (6) (7) (8) (See Note a) (See Note a) (See Note a) Revenue Account £ £ £ £ £ £ A Gross Expenditure 11,433 11,433 9,147 7,927 20,580 19,360 B Gross Income 1,139 1,139 4,828 4,828 5,967 5,967 C Net Cost 10,294 10,294 4,319 3,099 14,613 13,393 Unit Costs s. d. s. d. s. d. s. d. s. d. s. d. D Gross Expenditure per ton 20 4 20 4 16 4 14 2 36 8 34 6 E Gross Income per ton 2 0 2 0 8 7 8 7 10 7 10 7 F Net Cost per ton 18 4 18 4 7 9 5 7 26 1 23 11 G Net Cost per 1,000 population £ £ £ £ £ £ 212 212 89 64 301 276 H Net Cost per 1,000 houses 772 772 324 233 1,096 1,005 1. Total refuse collected (in tons) 11,223 2. Population (Mid-year) 48,510 3. Weight per 1,000 population per day (in cwts.) 12.6 4. Number of occupied houses and premises (31.12.1949) 13,307 Note—(a) "Loan charges" include interest on loans; repayment of loans; revenue contributions to capital outlay and capital receipts. 10 ANALYSIS OF INCOME FOR THE YEAR ENDED 31st MARCH, 1950 Year ended 31.3.1949 £ s. d. £ s. d. £ s. d. £ s. d. 1—Metals: 76 5 11 Aluminium 49 2 6 55 19 3 Copper 42 17 2 95 2 4 Iron 101 11 3 42 14 0 Lead 16 17 6 19 0 5 Battery Lead 3 0 0 73 17 7 Brass 36 10 7 8 3 3 Mixed Metals 15 17 7 9 2 2 Unbaled Scrap 41 12 6 118 4 1 Tins 115 8 1 2 13 7 Pewter 13 4 0 436 1 1 43 15 9 Bones 22 5 10 195 8 10 Broken White Glass 227 4 9 4 9 3 Amber Cullet 6 8 0 317 8 4 Bottles and Jars 215 16 9 - 449 9 6 419 0 6 Rags 406 11 6 73 5 6 Carpets and Sacking 54 7 6 - - - Flock Mattresses 11 11 0 472 10 0 2207 7 5 Newspapers and Mixed Waste Paper 2955 6 5 71 9 9 Board of Trade Collection Allowance 169 17 9 3125 4 2 460 15 2 Pig Food (Kitchen Waste) 739 15 7 224 0 10 Allowance (Board of. Trade) 18 11 11 758 7 6 5 ?, 7 Rubber - - - 2 7 8 Old Gramophone Records - - - 4263 18 2 32 18 4 2—Miscellaneous Receipts and Charges 12 19 11 44 10 6 3—Weighbridge Fees 89 8 6 4—Rents : 200 0 0 Foundry 200 0 0 20 0 0 Proportion of Allotment Rents 20 0 0 2 6 Other Rents 2 6 5—Refuse Collection Charges: 189 11 0 Creengrocers 215 7 0 143 3 0 Others 165 11 0 £5155 19 6 £ 5967 7 1 10,862 Tonnage 11,223 11 SANITARY INSPECTION OF THE AREA Inspections on Complaint The number of complaints received at the office and recorded in the register was 358, as compared with 550 in the previous year and 508 for the year 1947. The total inspections made on complaint was 792 and the number of defects or nuisances revealed was 460, 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 2 Blocked yard and W.C. drains 19 Blocked Sewers 189 Defective Sewers 9 Defective Drainage 28 Absence of and Defective Dustbins 12 Defective Water Waste Preventers 12 Defective W.C.'s 6 Lack of Proper Water Supply 2 Defective Water Fittings 3 Verminous Premises 13 Animals Kept So As To Be a Nuisance 8 Offensive Accumulations 20 General Housing Defects 128 Overcrowding 1 Pollution of Water Courses 1 Nuisances from Smoke, etc. 8 460 12 Summary of Inspections The total number of visits paid by the Sanitary Inspectors and other personnel of the Health Department staff to various premises for all purposes is summarised below, together with the number of defects found under specific headings. The visits numbered 6,884 as compared with 6,223 in the previous year; the defects dealt with numbered 1,269 as compared with 1,079 in 1948. TABLE 2. Visits Paid Nuisances or Defects found Housing Act, 1936. Inspections 69 587 Re-visits re Notices served 1340 Re Overcrowding 37 On Complaint 774 460 Infectious Diseases 184 Retail Trade Premises: Meat 81 Fish 37 Fried Fish 27 General Provisions 83 Others 8 Food Preparation Premises 60 Ice Cream Premises 71 45 3 Bakehouses 31 2 Cowsheds and Dairies 4 Pigstyes 39 Re-visits re Notices Served (P. H. Act) 495 Rodent Control 2665 213 Private Slaughtering 3 Shops Acts (Sanitary Conditions) 102 Council Houses 6 Collection and Disposal of Refuse and Salvage 157 Kitchen Waste—Communal Bins 65 Schools 24 Hairdressers' Premises 12 Swimming Pool 10 Miscellaneous Visits 132 Places of Entertainment 3 Public Conveniences 39 Petroleum Acts 4 Outworkers 134 Smoke Observations 32 Pollution of Rivers and Watercourses 91 4 Street Food Vendors 15 Movable Dwellings 5 6884 1269 13 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. Walls and Ceilings dirty 64 Defective Roofs, Spoutings and Eavesgutters 95 Blocked Yard and W.C. Drains 23 Blocked Sewers 231 Defective Sewers 30 Defective Drainage 52 Wall and Ceiling Plaster Defective 116 Absence of or Defective Dustbins 24 W.C.'s Without Proper Flushing Arrangements 14 Insufficient Water Supply 1 Water Closets Defective 15 Dampness 66 Defective Stoves and Firegrates 26 Defective Floors 49 Water Fittings Defective 22 Defective External Brickwork 2 Stairs and Rails Defective 2 Defective Woodwork of Windows and Doors 62 Defective Window Sills 21 Sinks and Waste Pipes Defective 12 Yard Paving Defective 10 Defective Wash Coppers 3 Defective Sash Cords, Glazing, etc. 43 Rat Infestation 213 Animals Kept So As To Be a Nuisance 2 Offensive Accumulations 5 Walls Defective 36 Absence of Proper Foodstores 2 Pollution of Rivers and Watercourses 4 Defective Flues and Chimney Stacks 15 Verminous Premises 9 1269 TABLE 4. Letters sent out and notices served in connection with sanitary matters. Letters 1957 Public Health Acts: Preliminary Notices 37 Secondary Notices 4 Statutory Notices 8 Statutory Notices (re Maintenance of Sewers) 39 Housing Acts: Preliminary Notices 69 Secondary Notices 15 Statutory Notices 10 14 Shops Acts. In conjunction with the Council's Clean Food Campaign a survey of all shops in the area was commenced in relation to the sanitary provisions of Shops Acts. A report on this survey will be included in the report for the year 1950. Smoke Abatement. Mention was made in the report for the previous year of complaints which have been received as to the emission of grit from a chimney stacks. of a factory in the town. After full investigation it was found impossible to provide a grit arrestor which would give that degree of efficiency such as would warrant its installation and, therefore, the use of a better grade of fuel was pursued. This action resulted in a considerable improvement in the emission of grit. Swimming Baths and Pools. Summaries of the daily chlorine and akalinity readings are forwarded weekly to the Health Department by the Pool Superintendent. Samples of the water at the Pool were taken during the year, and these are reported on under the heading "Bacteriological Examinations." Schools. The general condition of and supply of water to Schools has been satisfactory during the year, but in two instances improvements were effected in connection with sanitary accommodation. PREMISES AND OCCUPATIONS WHICH CAN BE CONTROLLED BY BYE-LAWS OR REGULATIONS Offensive Trade Premises. Within the meaning of the Public Health Act there are no offensive trade premises in the district, but there are 10 fish fryers; 2 new fish fryers were established. 15 Bakehouses. There are 8 of these premises within the district. Informal action was necessary in two instances to secure necessary cleansing and limewashing of bakehouses. Factories Act, 1937. Seventy-six visits were paid to Factories, and in three instances action was taken to secure improvements in cleanliness and ventilation of sanitary accommodation. Inspection of Factories and Other Premises. 1.—Inspections for Purposes of Provisions as to Health. Including Inspections made by Sanitary Inspectors. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (1) (2) (3) (4) (5) (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authority 5 4 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 46 66 3 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding Outworkers' Premises) 3 6 — — Total 54 76 3 — 16 2. Cases in Which Defects Were Found. Particulars Number of cases in which defects found No. of cases in which tions were instituted Found Remedied Referred to H.M. Inspector Referred by H.M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S.l.) — - - - - Overcrowding (S.2.) — - - - - Unreasonable temperature (S.3.) - - - - - Inadequate ventilation(S.4.) 1 1 — - - Ineffective drainage of floors (S.6.) - - - - - Sanitary Conveniences (S.7.) (a) Insufficient 1 1 - - - (b) Unsuitable or defective 3 3 - - - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork ) - - - - - Total 5 5 — - — Number and Trade of Outworkers notified during 1949 : Wearing Apparel 40 Downquilts 1 Footwear 2 Box Making 12 Brush-making 5 Novelties 4 Handbags 3 Fancy Goods 8 Toys 2 Pot Scourers 1 Outworkers were notified from the following Areas: Ilford 1 Walthamstow 1 Stepney 1 Bethnal Green 12 St. Pancras 1 Hackney 32 Stoke Newington 3 Shoreditch 10 Leyton 40 Tottenham 5 Islington 6 Finsbury 16 St. Marylebone 12 Chigwell 4 Hornchurch 1 Hampstead 1 Lambeth 2 Poplar 1 Westminster 6 East Ham 1 London Corporation 5 Enfield 2 17 Rats and Mice (Destruction) Act, 1919. The Council continues to employ a full-time Rodent Operative under the Scheme inaugurated by the Ministry of Agriculture and Fisheries. Whilst there was no evidence of major infestations in the town, the Rodent Operative paid many calls to deal with 213 minor infestations at private and business premises in the town. The second maintenance treatment was carried out in October and this treatment also incorporated a 10% test bait. 320 manholes were baited and of these 50% showed complete or partial takes. Scction D.—HOUSING STATISTICS FOR THE YEAR, 1949 1. Number of Houses Erected During the Year. (t) By the LA. (permanent) traditional (including flats) 77 (2) By the L.C.C. (permanent) traditional 115 (3) Cost of works re-buildings by local builders 42 (4) By private enterprise 6 240 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) 1023 (b) Number of inspections made for the purpose 2858 (2) (a) Number of dwelling - houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 1932 69 (b) Number of inspections made for the purpose 1381 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation *210 *Note. This figure includes all houses where defects were found, including those which were inspected and recorded under the Housing Act, 1936. 18 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 133 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 10 (2) Number of dwelling-houses which were rendered fit after scrvice of formal notices: (a) By owners 6 (b) By Local Authority in default of owners 5 B. Proceedings under Sections 11 and 13 of the Housing Act, 1936: (1) Number of Demolition Orders served 5 (2) Number of Undertakings accepted — (3) Number of Undertakings completed 2 C. Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 25 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By Owners 17 (b) By Local Authority 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 6. The number of visits paid to cowsheds and dairies was 4. 19 Milk. (Special Designations) Regulations, 1936—1946. Graded Milks. The following table shows the licences granted during the year for the sale of milk under the special designations, as proxided by the above Regulations: 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. Milk (Special Designations) Regulations, 1949. When these Regulations came into force on the 1st October, 1949, the following licences were issued in addition to the above: 2 dealers' licences to sell milk as Sterilised. 4 supplementary licences to sell milk as Sterilised. 1 supplementary licence to sell milk as Pasteurised. Extraneous Matters in Foodstuffs. In the report for 1948 particulars were given of eleven instances in which the Corporation instituted proceedings on account of extraneous matters in food. It is pleasing to report that for the year under review the Council found it necessary only to take before the magistrates two cases under Section 9 of the Food and Drugs Act, 1938. These two cases are set out below:— No. Offence • Result 12. Nail in steak and kidney pie Fine— £2 Os. Od. 13. Nail in jam tart Fine— £5 Os. Od. Meat and Other Foods. There is one licensed slaughterhouse and twenty-six butchers' shops in the area; the visits paid to these and other retail trade premises numbered 367. 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, or returned to the Ministry of Food for processing purposes:— TINNED FOODS etc. Article Quantity Meat 218 tins Fish 189 „ Vegetables 191 „ Fruit 79 „ Golden syrup 2 „ lams 16 „ Milk 195 „ Fillings, etc. 12 jars Sauces, pickles, etc. 55 „ Dried egg 2 pkts. Soups 68 tins 20 OTHER FOODS Article Quantity Fish 95½ stones Pie 4 lbs. Bacon 43½ „ Eggs 186 Cheese 30 lbs. Dates 56 „ Tomatoes 420 „ Pastry Mix 1 pkt. Split peas 54 lbs. Cooking fat 2 „ BACTERIOLOGICAL AND CHEMICAL EXAMINATION OF FOOD Bacteriological Examinations. The Counties Public Health Laboratories, 66, Victoria Street, London, S.W. 1., undertake bacteriological examinations for the Council, through the Essex County Council Bacteriological Laboratory Service. During the year 69 samples were forwarded to the Laboratories for bacteriological examination, 66 being samples of ice cream and 3 samples of Swimming Pool water. Ice Cream. The bacteriological results of ice cream samples are summarised below, and it will be noted that the presence of bacteria coli was detected in five samples. The classification of the samples in relation to the Ministry's Provisional Grading is as follows:— Grade I. Grade II. Grade III. Grade IV. 36 18 8 4 A larger number of samples of ice cream was taken during the year, namely 66 as against 35 in the previous year, and, whilst it is difficult to judge in some cases between the Bacteriologist's findings and the Ministry Grades, it may be stated that the bacterial quality of ice cream sold in the district throughout the year tended to show an improvement. Samples adversely reported upon gave rise to further investigation by the Department and the results of all samples were notified to dealers and manufacturers. Where the source of manufacture was outside the area of the Borough, copies of the Bacteriologist's reports were forwarded to the authorities concerned. The registration of persons as manufacturers or vendors of or merchants or dealers in ice cream or other similar commodity is granted by the Council under Section 158 of the Essex County Council Act, 1933, and the number of persons so registered at the end of the year was sixty. 21 The registration of premises used in connection with the manufacture or sale of ice cream is dealt with under Section 14 of the Food and Drugs Act, 1938, and the number of premises so registered was sixty-one. No. Type Colonies per ml. on Agar @ 37°c in 48 hrs. Coliform Test (3 tubes) Bact. coli. Test ( 3 tubes) Ministry Grade Hours/ Grade 332 Hot mix 28,000 0/3 0/3 4½/I 333 Hot mix 11,000 0/3 0/3 4½/I 334 Hot mix 900 0/3 0/3 4½/I 335 Cold mix 1,800 3/3 0/3 3½/11 336 Hot mix 1,200 0/3 0/3 4½/I 337 Hot mix 1,800 0/3 0/3 4½/1 338 Hot mix 18,000 3/3 0/3 3/II 339 Hot mix 5,800 0/3 0/3 4½/1 340 Hot mix 900 0/3 0/3 4½/1 341 Hot mix 20,000 3/3 0/3 3½/11 342 Hot mix 22,000 0/3 0/3 4½/1 343 Hot mix 12,000 0/3 0/3 4½/1 344 Hot mix 40,000 3/3 0/3 l½/III 345 Hot mix 15,000 3/3 0/3 4/II 346 Cold mix 5,000 2/3 0/3 4½/1 347 Hot mix 3,500 1/3 0/3 4½/1 348 Hot mix 3,000 0/3 0/3 4½/1 349 Hot mix 90,000 3/3 0/3 0/IV 350 Hot mix 30,000 0/3 0/3 4½/1 351 Hot mix 5,000 0/3 0/3 4½/1 352 Hot mix 20,000 3/3 0/3 2/III 353 Hot mix 5,000 2/3 0/3 2½/11 354 Hot mix 9,000 0/3 0/3 4½/1 355 Hot mix (choc. ice) 700 0/3 0/3 4½/1 356 Hot mix 25,000 3/3 3/3 2/III 357 Hot mix 100,000 3/3 0/3 ½/III 358 Hot mix 28,000 3/3 0/3 3/II 359 Hot mix 5,000 0/3 0/3 4½/1 360 Hot mix 36,000 0/3 0/3 2½/11 361 Hot mix 14,000 0/3 0/3 4½/1 362 Hot mix 120,000 3/3 0/3 0/IV 363 Hot mix 200,000 3/3 2/3 2½/11 364 Hot mix (choc. ice) 72,000 3/3 0/3 2½/11 365 Hot mix (choc. ice) 800 1/3 0/3 4½/1 366 Hot mix 36,000 3/3 0/3 l½/III 367 Hot mix 42,000 3/3 3/3 2/III 368 Hot mix 500 0/3 0/3 4½/1 369 Hot mix 110,000 3/3 0/3 0/IV 370 Hot mix 22,000 0/3 0/3 3½/11 371 Hot mix (choc. ice) 6,000 0/3 0/3 4½/1 372 Hot mix (choc. ice) 800 0/3 0/3 4½/1 22 No. Type Colonies per ml. on Agar @ 37°c in 48 hrs. Coliform Test (3 tubes) Bact. coli. Test (3 tubes) Ministry Grade Hours/ Grade 373 Hot mix 100,000 3/3 0/3 0 /IV 374 Hot mix 23,000 3/3 1/3 3 /II 375 Hot mix 1,100 0/3 0/3 4 /II 376 Hot mix 180,000 1/3 0/3 ½/III 377 Hot mix 13,000 3/3 0/3 4½/1 378 Hot mix 40,000 3/3 0/3 3 /II 379 Hot mix 1,600 0/3 0/3 4½/I 380 Hot mix 5,000 0/3 0/3 3 /II 381 Hot mix 1,500 0/3 0/3 2½/11 382 Hot mix 200 0/3 0/3 4½/I 383 Hot mix 400,000 3/3 0/3 ½/III 384 Hot mix 300 0/3 0/3 4½/I 385 Hot mix 8,000 0/3 0/3 4½/I 386 Hot mix 120,000 3/3 0/3 2½/II 387 Hot mix 15,000 0/3 0/3 4½/I 388 Hot mix (choc, ice) 36,000 0/3 0/3. 3½/II 389 Hot mix 700 0/3 0/3 4½/I 390 Hot mix 800 0/3 0/3 4½/I 391 Hot mix 9,500 2/3 1/3 2½/II 392 Hot mix 600 0/3 0/3 4½/I 393 Hot mix 700 0/3 0/3 4½/I 394 Hot mix 7,200 0/3 0/3 4½/I 395 Hot mix 500 0/3 0/3 4½/I 396 Hot mix 800 0/3 0/3 4½/I 397 Hot mix 300 0/3 0/3 4½/I Swimming Pool Water. Three samples of water were taken from the Larkswood Swimming Pool during the season, and were reported on satisfactorily by the Bacteriologist. Chemical Examinations. Dr. Bernard Dyer and Partners Ltd., Peek House, 20, Eastcheap, E.C.3, are the Public Analysts for the district. Two samples were submitted for chemical examination during the year, in supplementation of the Essex County Council's Food and Drugs Service, and these are set out below:— No. Sample Result 312 Curried fish No harmful arsenical or metallic con' tamination. 313 Salad dressing No significant infestation with moulds. Considered to be fit for human consumption. 23 Section F.—PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Diphtheria. The first case of Diphtheria for four years occurred in the borough during 1949. The patient, a girl of 18 years, had not previously been immunised. She made an uneventful recovery. Propaganda for immunisation against Diphtheria was con' tinued throughout the year. The clinic facilities for immunisation are detailed on page 7. In addition, arrangements are made for school children to be immunised at school. Number of children immunised during the year:— Primary immunisations—Under 5 years 646 „ „ —5 to 15 years 74 Total 720 Number of children receiving secondary or rein' forcing injections during the year 153 Scarlet Fever. A total of 105 cases were notified during the year, being 27 more than in 1948. Again, the disease was of a mild type. The reduction in the numbers requiring admission to hospital continued, only 46% being admitted. 1945 1946 1947 1948 1949 Cases notified 62 74 69 78 105 Percentage removed to hospital 77 64 61 52 46 . Measles. 499 cases of Measles occurred in 1949, a rise of 144 on the 1948 figure. Only 6 of the cases needed to be admitted to hospital. Adult Measles serum was available to practitioners through the Health Department for treatment of cases and protection of contacts. Whooping Cough. Whooping Cough notifications showed a reduction of 16 on the 1948 figure, there being 174 cases during the year under review. Only 5 cases required admission to hospital. Poliomyelitis. Unfortunately, for the third year in succession, cases of polio' myelitis occurred in Chingford, there being 5 notifications during the year. The disease was of a severe character, paralysis being extensive in two instances. 24 Dysentery. There were 3 cases of dysentery notified in 1949. The source of infection was unknown. Recovery was rapid in each case. Tuberculosis. I am glad to be able to record a considerable reduction in the number of new cases of tuberculosis, pulmonary and nonpulmonary, notified as occurring in the borough during the year, the total being 35, which is the lowest figure since 1941, although the population now is 13,000 more than it was in that year. In addition to these new cases, 57 persons previously notified in other districts as sufferers from tuberculosis, moved into Chingford. There were 15 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 5.0. Food Poisoning. In addition to 4 cases of food poisoning notified by private practitioners, a series of outbreaks of food poisoning occurred at a school in the south of the borough during the last six months of 1949. The first outbreak, in July, involved 24 adults and 6 children, who complained of vomiting and diarrhoea about six hours after ingestion of the midday school meal. Samples of all food consumed at the lunch were taken and submitted to bacteriological examination, when it was found that some of the beef, salad and potato were heavily infected with bacillus proteus. The probable origin of infection could not be ascertained but it was considered that a contributory factor at the time was the poor food storage facilities available. In October a second outbreak occurred involving 14 persons. Symptoms were similar to the July occurrence. Samples of food examined bacteriologically revealed a heavy infection of a meat pie by food poisoning organisms. All the members of the foodhandling staff were examined as possible sources of contamination, but all swabs taken revealed no link with the organisms causing the symptoms. The last outbreak, the third, occurred in December, in which 60 children complained of illness twelve hours after partaking of the school lunch. Unfortunately, in this instance, no food remained over for examination. In spite of the most exhaustive enquiries and the examination of all the canteen staff and several of the children involved, the organism giving rise to this illness was never discovered. 25 All the adults and children concerned in the three outbreaksmade a rapid recovery, all being free from symptoms within twenty-four hours of onset. Clean Food Campaign. In October, 1949, a public meeting was held at the Larkswood Social Centre to discuss and formulate plans for a Clean Food Campaign in the borough. Smallpox Contacts. In April, 1949, several persons were kept under surveillance for sixteen days as contacts of the smallpox cases which occurred on the steamer "Mooltan." Fortunately, no smallpox occurred in these contacts. Scabies. No persons were in need of treatment during the year at the Scabies Treatment Centre. National Assistance Act, 1948. It was not necessary during 1949 to take action under Section 47 of the National Assistance Act, 1948, which empowers local authorities to remove to hospital persons in need of care and attention. Vaccination. Number of births registered in the district during 1949 513 Number of primary vaccinations 167 Percentage of vaccinations to registered births 32.5 Medical Examinations. During the year 75 examinations were carried out by the Medical Officer of Health in respect of the Superannuation and Sick Pay Scheme of the Chingford Corporation. In addition, 29 medical examinations were carried out in respect of Essex County Council staff. 26 CAUSES OF DEATH AS GIVEN BY THE REGISTRARGENERAL FOR THE YEAR 1949 Causes of Death Males Females Total Cerebro'spinal fever — 1 1 Tuberculosis of respiratory system 7 8 15 Syphilitic diseases — 1 1 Influenza 4 5 9 Cancer of buccal cavity and oesophagus (M) uterus (F) 2 5 7 Cancer of stomach and duodenum 6 5 11 Cancer of breast — 9 9 Cancer of all other sites 30 15 45 Diabetes 1 2 3 Intra-cranial vascular lesions 14 31 45 Heart diseases 45 55 100 Other diseases of circulatory system 15 11 26 Bronchitis 14 6 20 Pneumonia 11 8 19 Other respiratory diseases 5 3 8 Ulcer of stomach or duodenum 4 — 4 Other digestive diseases 4 5 9 Nephritis 4 1 5 Premature birth 1 — 1 Congenital malformation, birth injury, infantile disease 8 8 16 Suicide 3 2 5 Road traffic accidents 3 — 3 Other violent causes 5 4 9 All other causes 14 19 33 Totals—all causes 200 204 404 Totals—year 1948 172 170 342 Tuberculosis. 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 1 — — 1 1 1 — 1 - — — — 5 to 14 years 1 3 — — — 2 1 — - — — — 15 to 24 years 8 4 — — 6 8 — — 1 - — — 25 to 34 years 3 5 — — 8 8 — — - 2 - - 35 to 44 years 1 3 — — 4 3 1 1 2 2 — — 45 to 54 years 2 — — — 6 2 - — — 1 - — 55 to 64 years 1 — — — 1 1 — — 1 — — — 65 and upwards 1 1 - — 1 1 — — 2 1 — — Totals 18 16 - 1 27 26 2 2 6 6 — — Add—Deaths of un-notified cases 3 - — — 9 6 — - 27 Deaths from Cancer. Out of a total of 72 deaths from cancer in 1949, 71 of them occurred in persons over the age of 45 years. The following chart tabulates the sites, age and sex groups:— SITE 0—44 years 45 years & over Totals M. F. M. F. M. F. Gastro-Intestinal Tract — — 15 12 15 12 Lungs and Mediastinum — 1 13 1 13 2 Genito-urinary Organs — — 5 8 5 8 Breast — - — 9 — 9 Other sites — - 5 3 5 3 Totals — 1 38 33 38 34 Death rate = 1.48 per 1,000 (being the same rate in 1948). DEATHS FROM ALL CAUSES AT VARIOUS AGES DURING 1949. Age DEATHS No. of deaths which apply to district No. in district Outward Transfers Inward Transfers Under 1 year 3 1 14 16 1 and under 2 — — 1 1 2 and under 5 3 - — 3 5 and under 15 2 1 1 2 15 and under 25 2 - 4 6 25 and under 35 4 2 5 7 35 and under 45 8 1 10 17 45 and under 55 21 2 22 41 55 and under 65 30 3 32 59 65 and under 75 75 14 56 117 75 and upwards 90 15 57 132 Totals 238 39 202 401 National Health Service Act, 1946. The following table indicates the attendances at local clinics during 1949, the various services being provided by the County Council under Part III of the above Act. In general, the work undertaken has been a continuation of the services already in existence prior to the commencement of the Act on 5th July, 1948. 28 ATTENDANCES AT LOCAL CLINICS DURING 1949. Ante-Natal Clinics: Friday Hill sessions 52 Attendances 545 N. Chingford sessions 51 Attendances 972 Marmion Ave. sessions 55 Attendances 1,049 Infants' & Toddlers' Clinics: Friday Hill sessions 52 Attendances 2,208 (including 102 new infants). Sewardstone Rd. N. sessions 28 Attendances 940 (including 44 new infants). Buxton Road sessions 52 Attendances 2,388 (including 77 new infants). Chingford Ave. sessions Attendances 1,203 Church Ha'l sessions 52 (including 104 new infants). Marmion Ave. sessions: Infants 52 Attendances 5,070 (including 287 new infants). Toddlers' 51 Attendances 1,090 Women's Welfare Clinics . N. Chingford sessions 12 Attendances 175 Friday Hill sessions 12 Attendances 112 Minor Ailment & School Clinics: Marmion Ave. sessions 48 Attendances 718 Friday Hill sessions 48 Attendances 527 Orthopaedic Clinics: Marmion Ave. sessions 135 Attendances 2,094 Friday Hill sessions 5 Attendances 24 Eye Clinic: Marmion Ave. sessions 48 Attendances 579 Visits paid by Health Visitors. 1st Visits Re-Visits 1st Visits Re-Visits Under 1 year 1-5 years Under 1 year 1—5 years 104 93 601 33 2,743 2,928 29 30 DENTAL TREATMENT IN CHINGFORD DURING 1949 Numbers provided with dental care. [ ] Examined Needing treatment Treated Made Dentally fit Expectant Mothers 5 5 5 3 Nursing Mothers 8 8 8 6 Children under 5 years 26 26 18 18 Forms of Dental Treatment provided. Extractions Anaesthetics Fillings Scalings etc. Silver Nitrate Treatment Dressings Dentures Local Gen. Complete al Expectant Mothers 16 — 5 — — - 2 — 1 Nursing Mothers 12 7 3 10 1 — 1 — 2 Children under 5 years 40 - 20 6 — 1 4 — — X-Rays taken: Expectant Mothers, Nil. Nursing Mothers, Nil. 31 NOTIFIABLE DISEASES (after correction) Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Dysentery Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Cerebro-Spinal Fever Acute Poliomyelitis Acute Polio' Encephalitis Pulmonary Other Forms 1944 82 2 5 61 72 42 3 20 2 1 73 2 — — 1945 62 4 9 210 94 33 9 38 3 1 88 2 — — 1946 74 — 9 212 88 45 5 13 2 2 103 3 — — 1947 69 — 10 290 202 46 7 2 5 — 114 1 14 2 1948 78 — 13 355 190 42 7 1 1 1 78 3 4 — 1949 105 1 17 499 174 34 1 3 4 1 83 — 4 1 NOTIFIABLE DISEASES TABULATED ACCORDING TO AGE (after correction) Under 1 yr. 1 2 3 4 5-9 10-14 15-19 20-34 35-44 45-64 65 & over Totals Scarlet Fever 1 2 9 7 7 71 2 4 — 1 1 — 105 Diphtheria - - - - - - - 1 - - - - 1 Erysipelas - - - - - - - - 3 5 8 1 17 Measles 13 47 93 73 64 204 1 — 3 — 1 — 499 Whooping Cough 13 22 24 29 26 55 2 — 2 1 — — 174 Puerperal Pyrexia — — — — — — — — 3 1 — - 4 Pneumonia 1 1 3 2 — 10 2 2 9 6 27 20 83 Dysentery - - - - 1 - - - - - 1 1 3 Acute Poliomyelitis 1 - - - - 1 - - 2 - - - 4 Acute Polioencephalitis - - - - - - - 1 - - - - 1 Ophthalmia Neonatorum 1 - - - - - - - - - - - 1 ANALYSIS OF NOTIFIABLE DISEASES (after correction) Diseases Total cases Total admitted to hospital Scarlet Fever 105 48 Diphtheria 1 1 Erysipelas 17 3 Puerperal Pyrexia 4 4 Pneumonia 83 18 Measles 499 6 Whooping Cough 174 5 Dysentery 3 3 Acute Poliomyelitis 4 4 Acute Polioencephalitis 1 1 Ophthalmia Neonatorum 1 — 32 33 Birth-rates, Civilian Death-rates, Analysis of Mortality, Maternal Mortality and Case-rates for certain Infectious Diseases in the year 1949 (Provisional figures based on Quarterly Returns). England and Wales 126 County Boroughs and Great Towns (including London) 148 Smaller Towns (Resident Pop. 25.000-50,000 at 193 1 Census) London Administrative County Chingrord England and Wales 126 County Boroughs and Great Towns (including London) 148 Smaller Towns (Resident Pop. 25,000-50.000 at 193 1 Census) London Administrative County Chingford Births: Rates per 1,000 Civilian Population:— Deaths: Rates per 1,000 Live Births:— Live births 16.7 (a) 18.7 18.0 18.5 14.1 All causes under 1 year of age 32 (b) 37 30 29 24.9 Still births 0.39(a) 0.47 0.40 0.37 0.36 Deaths: All Causes 11.7(a) 12.5 11.6 12.2 8.3 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 - Enteritis and Diarrhoea under 2 years of age 3.0 3.8 2.4 1.7 — Whooping Cough 0.01 0.02 0.01 0.01 — Diphtheria 0.00 0.00 0.00 0.00 — Tuberculosis 0.45 0.52 0.42 0.52 0.31 Influenza 0.15 0.15 0.14 0.11 0.18 Rates per 1,000 Total (Live and Still) Births Smallpox 0.00 0.00 — — — Notifications (Corrected): Acute Poliomyelitis and Polioencephalitis 0.01 0.02 0.02 0.01 - Puerperal Fever and Pyrexia 6.31 8.14 5.30 6.82 5.69 Pneumonia 0.51 0.56 0.49 0.59 0.39 Notifications (Corrected): Typhoid Fever 0.01 0.01 0.01 0.01 — Paratyphoid Fever 0.01 0.02 0.01 0.01 - Maternal Mortality in England and Wales: Cerebro-spinal Fever 0.02 0.03 0.02 0.02 - Scarlet Fever 1.63 1.72 1.83 1.46 2.16 Whooping Cough Diphtheria 2.39 2.44 2.39 1.70 3.58 0.04 0.05 0.04 0.07 0.02 International List No. and Cause Rates per 1,000 Total (Live and Still) Births Rates per million women aged 15-44 Erysipelas 0.19 0.20 0.19 0.17 0.35 Smallpox 0.00 0.00 0.00 0.00 — Measles 8.95 8.91 9.18 8.54 10.28 Pneumonia 0.80 0.91 0.65 0.55 1.71 140. Abortion with Sepsis 0.11 8 Acute Poliomyelitis 0.13 0.13 0.12 0.18 0.08 141. Abortion without Sepsis 0.05 4 Acute Polioencephalitis 0.01 0.01 0.02 0.01 0.02 147. Puerperal Infections 0.11 142,146, 148,150. Other maternal causes 0.71 Chingford F^ood poisoning 1 0.14 0.16 0.14 0.19 0.08 - (a) Rates rer 1,000 total population (b) Per 1,000 reiated live-births CHIN 14 Waltham Holy Cross Urban District Council PUBLIC HEALTH COMMITTEE, 1949 Chairman: Councillor W. Allen MembersCouncillor Mrs. M. Bird ,, Mr. T. C. Grove ” Mrs. W. J. Porter . ,, A. G. Richardson Chairman of Council ex efficio- Mr. T. Patrick : PUBLIC HEALTH STAFF: Medical Officer of Health: Dk. H. Franks, m.b., b.s., b.hy., d.p.h. Sanitary Inspector: Mr. W. H. Mkyneli, c.r.s.t., m.s.i.a. Clerk: Miss E. J. Tutton WALTHAM HOLY CROSS URBAN DISTRICT COUNCIL To the Chairman and Members of the Waltham Holy Cross Urban District Council Mr. Chairman. Ladies and Gentlemen), I have pleasure in presenting to you the Annual Report, including the Sanitary Inspector's Report, for the year ending 31st December, 1949. In the statistical tables which follow, births and deaths have been corrected for "inward" and "outward" transfersi.e., they refer only to persons who normally reside in the district, and they include all births and deaths among them wherever occurring. Infectious diseases, however, are allocated to the district in which they arise, irrespective of place of normal residence of the patient. All rates are based on civilian population as in previous years. The outstanding features of the year have been the occurrence of outbreaks of measles (203 cases) and infantile paralysis (6 cases). New cases of tuberculosis (15) have also been more than the average notified in recent years. The live birth rate (per 1000 of the population), having risen from 16.9 in 1947 to 18.8 in 1948, has again fallen sharply, to 13.9 in 1949. There has been a general tendency for the birthrate throughout the country to fall, but not to the same extent as locally. As the birthrate is usually a reflection of the economic and social well-being of the community, one f \ wonders to what extent the universally increased cost of living and housing shortages have fallen unduly on the inhabitants of this dislrict in particular. Overcrowding, however, is 3 tainly no worse than in the previous two years, as the average number of inhabitants per house has failen from 3.68 to 3.55, as a result of new building. The excess of female over male births noted last year has again been repeated, so that of a total of 262 live births in the last two years, only 105 were males and 157 were females! The death-rate, at 12.8 per thousand of the population, is higher than last year, but slightly less than in 1947. The main increases have been in deaths from diseases of the heart and circulatory system, and birth injuries. With regard to the review of the working arrangements under Part III of the National Health Service Act, 1946, the County Council have, so far as possible, adhered to their proposals made as Local Health Authority and the work over the past year has been conducted on these lines as set out under the various sections of the Act, being expanded so far as this has been possible. No major difficulties seem to have arisen, and I think a fair summary would be to say that the year's work has been mainly a continuation of existing services. Details of these services, and of treatment provided during the year, appear in Section B of this report. National Assistance Act, 1948. Several cases of old and infirm persons alleged to be in need ot care and attention were referred to me during the year, but in only one case did I certify the need for removal under Section 47 of the Act. In this case the Council subsequently abandoned their resolution to- apply for a Removal Order, in view of improved arrangements for domiciliary care made by the Old People's Welfare Committee and the Home Helps Service of the County Council. 4 It has been my view that aged and infirm persons who cannot be persuaded to accept institutional care should not be dealt with under this Act unless the conditions are extremely bad, and I have advised the Council accordingly. An unfortunate result of this policy is that only those relatives who abandon their aged ones entirely are relieved of responsibility, whilst those who struggle on, themselves often in bad health and economic difficulties, to keep conditions tolerable for their old folk, have little hope of any relief or assistance from their heavy burdens. It seems illogical that a State which provides expensive institutional accommodation for aged persons in need of care and attention (and places no obligation on individuals to provide for them) should do nothing whatever to assist relatives and others to keep them out of such institutions as long as possible. Home Helps are usually unobtainable for these long-term cases, but if some of the women who are obliged to go out to work to supplement the family income were subsidised to stay at home and look after their infirm relatives and babies, much would be saved in nursery and institutional expense, and many staff would be relieved for the care of the sick or for productive work. I believe that a scheme of this kind, applied in appropriate cases, would add immeasurably to the health, happiness and unity of all members of the families concerned, without any loss whatever in national economv or production in the long run. Food Hygiene. The absence of any outbreak of foodpoisoning during the year is no cause for complacency ; it is just a piece of luck. It is true that the District is fortunate in possessing a number of food and catering establishments where the highest standards of hygiene are observed, but there are others where the danger of food contamination is , constantly present. Until an outbreak of food-poisoning illness occurs, the danger goes unrecognised, and by then the 5 damage to health (and to the reputation of the tradesman concerned) is done ! It was with the object of preventing such occurrences that the Hygienic Food Traders' Guild was inaugurated last year under the Council's sponsorship as a medium for bringing the latest and best methods of hygienic technique to the notice of the tradespeople, and discussing their difficulties and problems together. The response of. the tradespeople and the interest of the public in this scheme (in Waltham Holy Cross District) has so far been disappointing, and it would be a pity if, as so often has happened with similar projects in the past, the occurrence of a tragedy must be awaited before business and public opinion is sufficiently stirred to insist on preventive action. In concluding, I would again like to record my appreciation to the staff of the Public Health Department for their. continued help and co-operation, and the Chairman and Members of the Public Health Committee for their support during the year. H. FRANKS, M.B., B.S., B.Hy., D.P.H. Medical Offcer. of Health. 6 SECTION A. Statistics and Social Conditions of the Area. Area in Acres 10,959 Civilian Population (mid-1949) 8,071 Number of inhabited houses 2,277 Rateable Value £64,136 Sum represented by a penny rate &248 The rate in the pound was 20s. lOd. Vital Statistics. Male Female Total Live Births: Legitimate 46 62 108 Illegitimate 2 2 4 Total 112 Birth rate per 1,000 of the population 13.9 Male Female Total Still Births : Legitimate 4 3 7 Illegitimate 0 0 0 Total 7 Rate per 1,000 (live and still) births 58.8 Male Female Total Deaths (all causes) 51 52 103 (Registrar General's Figures) Death rate per 1,000 population 12.8 7 Deaths of Infants under 1 year: Mals Female Total Legitimate 3 3 6 Illegitimate 0 0 0 Total 6 Death rate of infants under 1 year (per 1,000 live births) 53.6 Deaths from Diarrhoea and Enteritis under age 2 years 0 Maternal deaths 1 Causes of Death as given by the Registrar General for the Year 1949 Male Female Total Tuberculosis 3 1 4 Cerebrospinal Fever 0 1 1 Cancer (all forms) 7 6 13 Intracranial vascular lesions 5 8 13 Heart Disease 16 11 27 Other Diseases of Circulatory System 2 3 5 Bronchitis 1 3 4 Pneumonia 3 0 3 Digestive Diseases 2 1 3 Influenza 0 1 1 Nephritis 1 0 1 Infantile Paralysis 0 1 1 Congenital Malformations Birth Injuries 2 2 4 Infantile Diseases Maternal Causes 0 1 1 Premature Birth 0 2 2 Suicide 1 2 3 All other causes 8 9 17 Totals 51 52 103 8 Table of Comparative Birth Kates and Death Rates in the year 1949 (provisional figures based on weekly and quarterly returns). Rates per 1,000 population. England and Wales 126 County Boroughs and Great Towns including London 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 census London Adm. County W.H.C.U.D. Live births 16.7 18.7 18.0 18.5 13.9 Still births 0.39 0.47 0.40 0.37 0.87 Deaths— All Causes 11.7 12.5 11.6 12.2 12.8 Deaths— All causes under 1 year of age 32 37 30 29 53.6 Enteritis and diarrhoea under 2 years of age 3.0 3.8 2.4 1.7 0.0 9 SECTION B. General Provision of the Health Services in the Area (a) Public Health Officers of the Local Authority (see first page). (b) Laboratory Facilities. A Ministry of Health tory operates at St. Margaret's Hospital, Epping. Milk, water and ice cream samples are examined at the Counties Public Health Laboratory, 66 Queen Victoria Street, London, S.W.I. (c) Ambulance Facilities. Transport of the sick and jured and maternity cases is the responsibility of the Essex County Council and is free of charge. In cases of accident or emergency, an ambulance is obtained by dialling 999 on any Waltham Cross telephone. Where there is no dialling system it is sufficient to lift the receiver and ask for an ambulance to be sent to the place required, or to deliver the message personally at the Fire Station, Homeland, Waltham Abbey. Calls of a non-urgent nature are only accepted from responsible persons in the service, e.g. doctors, nurses, etc. The "sitting case" car service previously organised by your Council continues, by consent of the volunteers concerned, to operate in the district as part of the new County Council service. (d) Hospitals. The hospitals serving the area form part of the Forest Group of Hospitals administered by the North-East London Regional Hospital Board. 10 (e) Child Welfare. The Essex County Council (Forest Area) is the Welfare Authority for the district. Clinics are held at the 'following times at "The Cedars," Sewardstone Road, Waltham Abbey:— Child Welfare Centre. Every Friday at 2p.m. School Children (minor ailments). 1st and 3rd Monday in each month at 10a.m. Diphtheria Immunisation. 1st and 3rd Monday in each month at 11a.m. No charge is made. Ante-Natal Clinic. 1st and 3rd Tuesday in each month at 2p.m. Women's Welfare. By appointment only. Dental Clinic. By appointment only. Eye Specialist. By appointment only. Physiotherapist. By appointment only. Day Nursery continues to be available for children under school age. Application for admission should be addressed to "The Matron, Day Nursery, The Cedars, Sewardstone Road." Home visiting is carried out by the County Council's Health Visitors in the area. (f) School Health Service. The Education Authority is the Essex County Council. School nurses inspect the children regularly, and there is a medical inspection at each school not less than once per year. Advice and treatment are provided at the Combined Treatment Centre at the appropriate sessions as listed above. 11 (g) Tuberculosis Service. Tuberculosis Dispensary at Waltham Abbey Isolation Hospital every Monday at 2p.m. During the year the Care Association for the area covering the Chigwell, Epping, Waltham Abbey and Ongar districts continued to function. The Association assists cases awaiting admission to sanitorium 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 tlierppy and whenever possible, suitable employment for those lit for work. The Association is supported by voluntary contributions and receives also a grant from the County Council. The Honorary Secretary is Mr. A. J. Edwards, 37 Woodland Road, Loughton. (h) District Nurses' and Midwves' Services are provided by the Essex County Council, and administered locally by the Forest Area Health Sub-Committee of the Council. Visits paid by Health Visitors. 1st Visits. Re-Visits. Under 1 year 176 Under 1 year 485 1—5 years — 1—5 years 895 Others 44 Others 17 Attendances at Ante-Natal Clinics. Ante-Natal 408 . Post- Natal 9 Attendances at Child Welfare Clinics. Attendance of Mothers 2,008 Infants under 1 year 959 Children 1—5 years 502 12 Numbers provided with Dental Care. Examined Needing treatment Treated Made Dentally Fit Expectant Mothers 15 19 19 13 Nursing Mothers 9 10 10 2 Children under 5 years 56 27 27 27 Forms of Dental Treatment Provided. Extractions Anaesthetics— Local Anaesthetics— General Fillings Scalings, etc. Silver Nitrate Treatment Dressings Dentures— Complete Dentures— Partial Expectant Mothers 40 Nil 12 7 3 Nil 4 1 1 Nursing Mothers 58 Nil 16 14 Nil Nil 5 Nil 1 Children under 5 23 Nil 14 42 Nil Nil 5 Nil Nil X-rays taken Expectant Mothers Nil Nursing Mothers Nil 13 Report of the Sanitary Inspector (Sections C, D & E) SECTION C. Sanitary Circumstances of the Area 1. (i) Water Supply. The district is within the Metropolitan Water Board's area of supply. There are outlying parts of the district which do not receive the benefit of this supply and depend solely on water from shallow wells. Samples obtained from these wells during the year were reported upon satisfactorily. At Claverhambury, the Clapton Stadium Ltd. supply their dwelling houses and kennels, together with an adjoining dairy farm, with water obtained from an artesian well. The water is satisfactory in quality and quantity. (ii) Sewerage and Sewage Disposal. Sewage from the urban parts of the area, together with that from parts of Upshire and High Beech, is conveyed by both gravitation and electric pumps to the Main Works at Brooker Road. The treatment here comprises screening, sedimentation and aeration in circular lilteri, after which the effluent is irrigated and finally discharged into Cobbins Brook, a tributary of the River Lee. A similar works on a small scale serves the Sewardstonebury area, whilst the sewage from about 25 dwellings in Sewar.lstone gravitates to a small works consisting of septic tanks and rectangular filters, together with an internal combustion pump for lifting sewage up to the filters and final irrigation channels. • The remainder of the district is not sewered, drainage going mainly to cesspools which are emptied quarterly under a Council contract. 14 The scheme mentioned in the last Annual Report for the drainage of the hamlet of Sewardstone has been submitted to the Ministry of Health for approval. The Council has now been informed that they may proceed with the preparation of the contract documents. Briefly, this scheme entails the laying of sewers and the construction of a pumping station fitted with two electrically operated pumps which will be used to lift the sewage to the existing gravity sewer opposite Grange House. The area to be served consists of approximately 73 dwelling units inclusive of farms, these latter being allotted a certain number of units dependent on their size and type. The system has been designed with the ultimate intention of serving approximately 225 dwelling units in an area from the Grange on the North to the "Royal Oak" on the South, and to a point approximately 400 yards along Mott Street on the East. (iii) Rivers and Streams. The River Lee and Cobbins Brook which flow through the area, are under the control of the Lee Conservancy Board. The Board's Officers have been extremely diligent in dealing with all possible sources of pollution. 2. (i) Closet Accommodation. A few closets on the conservancy system remain in the area. They are situated in premises remote from the sewer. (ii) Public Cleansing. Refuse and salvage arc now 'collected each week by a 10 cubic yard S.D. freighter, supplemented by a 5 cubic yard Fordson freighter. It will be seen that the Council has now put into operation a weekly collection promised in the last Annual Report. Trade refuse is collected separately once a week at a quarterly charge basis on the rate of 6d. per bin. 15 All refuse is sorted for salvage material. Paper, metals, glass and bones are separated and sold to produce a substantial revenue and assist in the present shortage of raw materials. Refuse disposal is by a two-cell forced draught incinerator. Waste food is collected by a contractor from bins distributed throughout the district and is used after sterilisation for pig feeding. Council maintained streets are scavenged and gullies are emptied by direct labour. County Council roads are not delegated and these are cleansed by the County Council workmen working under the County Surveyor. The Urban District Council's Engineer and Surveyor is Mr. George Clarke, A.R.1C.S., M.l.Mun.E. (iii) Sanitary Inspections of the Area. Number of Inspections made during 1949 430 Number of Nuisances outstanding from 1948 Nil Number of Nuisances abated during 1949 145 Number of Summonses or other Legal Action Nil Number of Statutory Notices Nil Disinfection :— Number of Visits re cleansing and disinfection after infectious disease 30 Petroleum Acts and Orders: — Licenses granted during 1949 30 Rats and Mice (Destruction) Act, 1919 :— The Sanitary Inspector is the Rodent Officer acting for the Local Authority under the Act. Systematic baiting of sewers was commenced during January, and a first treatment successfully concluded. The work then came to an end owing to the death of the operative. 16 Efforts to obtain another operative during the year were unsuccessful. Agricultural premises are dealt with by the Essex Agricultural Executive Committee. (iv) Shops Acts, 1934 All premises under this heading were visited and found to comply with the provisions of the Acts. (v) Camping Sites. Number of sites for which licences have been issued by the Local Authority 24 Number of sites used for camping during 1949 10 Number of Campers during 1949 (approximately) 400 The sites are provided with separate privy accommodation for the sexes ; an adequate supply of pure water and also covered receptacles for refuse. There was a tendency during the year to substitute the trailer type of caravan for tents on the sites. Unfortunately, the tendency has further developed to make these caravans permanent homes. Apparently, the acute housing shortage has driven young couples to obtain this kind of home and obtain the privacy they desire. (vi) Smoke Abatement. The Sewardstone area continues to be polluted at times with smoke and grit from the Eastern Electricity Board's Power Station at Brimsdown. Representations to the appropriate authority to take the necessary steps to abate the nuisance proved unavailing. An unsatisfactory state of affairs continues to exist. 17 SECTION D. Housing The year 1949 saw the completion of a further 110 dwellings by the Local Authority, and 6 by private enterprise. I am indebted to Mr. E. H. Entwisle, A.R.V.O., Rehousing Officer, for the following information relating to premises administered by the Council :— Estate. No. of Houses. Denny Avenue 62 Harold Estate 50 Upshire Road 36 Tennyson Avenue 20 Eastbrook Road 10 Forest Close 10 Beechfield Walk 24 Princesfield Estate 146 358 Beechfield Walk and Lodge Lane Prefabricated bungalows 50 50 Requisitioned premises 45 Avey Lane Camp 15 60 GRAND TOTAL 468 Total number of families rehoused during the year was 141, incorporating 391 persons in all. 18 SECTION E. Inspection of Food Milk Supply. All premises where milk is produced or retailed are visited regularly and strict supervision is exercised to ensure the clean production and handling of milk. Number of Cowkeepers on the register 19 Number of Producer-Retailers 9 Number of Retailers only 7 Number of Inspections 278 Approximate number of milch cows 950 Number of premises producing Accredited Milk 1 Number of premises producing Tuberculin Tested Milk 9 Supplementary licences for the sale of milk under the Milk (Special Designations) Orders, 1936/43, were granted as follows :— Tuberculin Tested Milk 4 Pasteurised Milk 5 Dealers licences were granted as follows :— Tuberculin Tested Milk 2 Pasteurised Milk 2 With the coming into operation of the various Milk Regulations, 1949, the position altered slightly:— Number of Distributors 9 Supplementary Licences 16 Dealers Licences The transfer from Local Authorities to the Ministry of Agriculture and Fisheries of the Authority to control and 19 supervise the production of milk was, in my opinion, a retrograde step. It is freely admitted that there is not available adequate trained personnel to do the work efficiently. Further, ualess a sample reveals that milk from an undesignated herd is below standard, the premises concerned are unlikely to ever again be inspected. Essex County Council Act, 1933. (Ice Cream Regulations). Number of persons registered as manufacturers and vendors 9 Number of persons registered as vendors only 60 The number of vendors continues to increase year by year. Fortunately, the Ice Cream (Heat Treatment) Regulalations, 1947, have deterred these vendors from becoming manufacturers and they obtain their supplies from manufacturers who comply with the requirements of the Regulations. Of the nine manufacturers licensed, only two in fact do manufacture. Samples obtained during the year were reported upon satisfactorily. Twentv-six persons were stopped selling ice cream in the area during the year, as they were not registered under the Act. A number of them subsequently made application and were accordingly registered. Meat and other Foods. A cattle market and a general market are held on Tuesday of each week, where the sale of food is supervised. The practice of washing and disinfecting vehicles conveying livestock to and from the market was effected during the year as required by the Transit of Animals (Amendment) Act, 1931. 20 All slaughtering is effected at the Ministry of Food Slaughterhouse, Sewardstone Street, Waltham Abbey. Inspections in the main are effected outside office hours. The following animals were inspected during the year:— 775 Steers and heifers 304 Cows 34 Bulls 652 Calves 1917 Sheep 221 Pigs 3903 Total The following were surrendered as being unfit for human consumption:— 28 Bovine carcases 7 Calves carcases 27 Sheep carcases 14 Pig carcases 11 Fore-quarters beef 7 Hind-quarters beef 3 Top pieces beef 5 Briskets beef 559 lbs. bruised flesh 245 Bovine livers 18 Bovine hearts 2 Bovine kidneys 143 Bovine lungs 13 Bovine spleens 105 Bovine head and tongues 45 Sets bovine offal complete 5 Calves plucks 21 1 Calf head 64 Sheep plucks 85 Sheep livers 26 Sheep heads 29 Pig plucks 2 Pig heads 2 Pig livers Total weight of meat, thus surrendered : 14 tons, 15 cwts., 3 quarters, 23½ lbs. Carcases Inspected and Condemned :— Cattle, excluding Cows Cows Calves Sheep and Lambs Pigs Number killed 809 304 652 1917 221 Number inspected 809 304 652 1917 221 All Diseases Except Tuberculosis: — Whole carcases condemned 2 6 5 24 12 Carcases of which some part or organ was condemned 286 114 18 175 SO Percentage of the . number inspected affected with diseases other than tuberculosis 35.6% 39.5% 3.53% 10.38% 28.05% 22 Tuberculosis Only :— Whole carcases condemned 9 11 2 2 Carcases of which some part or organ was condemned 101 45 8 175 24 Percentage of the number inspected affected with tuberculosis 13.59% 18.4% 1.53% 9.13% 11.76% Slaughter of Animals Act, 1933. There are nine slaughtermen licensed under the Act. Food and Drugs Act, 1938. All premises where food is prepared, stored or exposed for sale were inspected. The following articles were surrendered as being unfit for human consumption :— 1 tins apple jelly 4 tins peaches 1 ,, apricot jam 16 „ peas 21 lbs. bacon 3 „ pears 14 pkts. bailey pudding 34 ,, pilchards powder 1 ,, plums 2 tins beans 4 ,, potatoes 3 ,, brawn 3 „ salmon 1 ,, carrots 29 ,, sardines 1 „ cherries 1 „ scam pork 2½ lbs. cheese 1 tins cod fish 3 ,, spices (pork, beef, gelatine) 5 „ corned beef 3 „ tomatoes 8 ,, corned mutton 2 ,, veal loaf 3 „ craw fish . 1 „ Xmas pudding 23 1 tins herring roe 3 „ luncheon meat 1 ,, meat lunch 6 ,, milk (condensed) 57 „ milk (evaporated) 3 „ milk (full cream) Imported and Canned Meats :— 1¼ lb. tin meat (in gravy) 2¼ lb. tin lunch meat Chemical and Bacteriological Examination of Food. The Essex County Council deal principally with matterscoming under this heading. I am informed that all samplestaken for examination in this area were found to be satisfactory. In addition, a number of samples of milk were taken for bacteriological examination. Factories Act, 1937. There are forty-two factories on the register ; seventythree visits were made to these premises'. Minor defectsfound to exist were remedied at request. There are four outworkers in the district. Factories surveyed in conjunction with the County Fire Brigade 5 Factories which have been requested to carry out extra works to comply with requirements 5 Factories which have had a certificate issued 0 W. H. MEYNELL, c.r.s.i., m.s.i.a., Sanitary Inspector. 24 25 FACTORIES ACTS, 1937 and 1948 PART I OF THE ACT 1.—INSPECTIONS for purposes of provisions as to health (inc. inspections made by Sanitary Inspectors) Premises M/c line No. Number on Register Inspections Number of Written notices Occupiers prosecuted M/c line No. (1) (2j (3) (4) (5) (6) (7) (i) Factories in which Sections 1, 2, 3, 4 & 6 are to be enforced by Local Authorities 1 16 23 3 nil 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 2 26 50 12 nil 2 (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding 3 nil nil nil nil 3 TOTAL 42 73 15 nil 26 2.—CASES IN WHICH DEFECTS WERE FOUND (If defects arc discovered at the premises on two, three or more sepai ate occasions they should be reckoned as two, three or more "cases") Particulars M/c line No. Number of cases in which defeats were found Number of cases in which prosecutions were instituted M/c line No. Found Remedied Referred To H.M. Inspector By H.M. Inspector (1) (2) (3) (4) (5) (6) (7) (8) Want of cleanliness (S.l) 4 1 1 nil nil nil 4 Sanitary Conveniences (S.7) (a) insufficient 9 2 3 nil 1 nil 9 (b) Unsuitable or defective 10 3 8 nil 5 nil 10 (c) Not separate for sexes 11 1 1 nil nil nil 11 Other offences against the Act (not including offences relating to Outwork) 12 nil 2 nil 2 nil 12 Total 60 7 15 nil 8 nil 60 OUTWORK Nature of work M/c line No. Section 110 Section 111 No. of out-workers in August list required by Sect. 110 (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 Noticos served Prosecutions M/c line No. (1) (2) (3) (4) (5) (6) (7) (8) (9) Wearing apparel— Making, etc. 13 4 nil nil nil nil nil 13 SECTION F. Prevalence of, and Control over, Infectious Diseases. Cases notified Cases admitted to Hospital Deaths Measles 203 3 0 Whooping Cough 9 1 0 Acute Primary Pneumonia 5 0 0 Scarlet Fever 6 6 0 Dysentery 1 1 0 Poliomyelitis and Polioencephalitis 6 6 1 Cerebrospinal Fever 1 1 1 Tuberculosis. Fifteen cases of tuberculosis were notified during the year. Mai.es. Females. Pulm. Non-Pulm. Pulm. Non-Pulm. 6 2 3 4 There were four deaths from this disease, 3 pulmonary and one non-pulmonary. Diphtheria. There were two cases notified during the year. Neither case was confirmed. 97 children completed a course of immunisation during the year, and a further 30 received re-inforcing injections of diphtheria prophylactic. Food Poisoning. No cases were notified to me during the year. 27 Comparative Tables of Infectious Disease Notification and Death Rates per 1,000 of the population in 1949 (Provisional figures based on Weekly and Quarterly Returns) 1. Notifications per 1,000 popuSation England and Wales 120 County Boroughs and Great Towns including London 148 Smaller Towns (Resident Populations 25,000 to 50,000 at J931 Census) London Adm. County W.H.C.U.D. Notifications [Corrected) Tvphoid Fever 0 01 0.01 001 0.01 0.00 Paratyphoid fever 0.01 0.02 0.01 0.01 0.00 Cerebrospinal fever 0.02 0.03 0 02 0.02 0.12 Scarlet fever 1.63 172 1.83 1.46 0.74 Whooping cough 2.39 2.44 2.39 1.70 1.11 Diphtheria 0.04 0.05 0.04 0.07 0.00 Erysipelas 0.19 0.20 0.19 0.17 0.00 Smallpox 0.00 0 00 0.00 0.00 0.00 Measles 8.95 8.91 9.18 8.54 25.15 Pneumonia 0.80 0.91 0.65 0.55 0.62 Acute poliomyelitis 0.13 0.13 0.12 0.18 0.50 Acute polioence phalitis 0.01 0.01 0.02 0.01 0.24 Food poisoning 0.14 0.16 0.14 0.19 .— 2. Deaths per 1,000 population Typhoid and paratyphoid 0.00 0.00 0.00 0.00 0.00 Whooping cough 0 01 0.02 0.01 0.01 0.00 Diphtheria 0.00 0.00 0.00 0.00 000 Tuberculosis 0.45 0.52 0.42 0.52 0.50 Influenza. 0.15 0.15 0.14 0.11 0.12 Sinillpox 0.00 0.00 — — 0.00 Acute poliomyelilis and polioencephalitis 0.01 0.02 0.02 0.01 0.74 Pneumonia 0.51 0.56 0.49 0.59 0.37 Some Notifiable Diseases during the last five years Disease 1945 1946 1947 1948 1947 Scarlet fever 5 6 13 4 6 Diphtheria 0 0 1 0 0 Typhoid and Paratyphoid 0 0 0 0 0 Pneumonia 1 1 2 13 5 Erysipelas 1 3 7 6 0 Puerperal Fever & Pyrexia 3 0 1 1 0 Measles 60 14 91 20 203 Whooping Cough 15 19 19 21 9 Cerehro-Spinal Meningitis 0 0 0 0 1 28