AC4411(1) CHINGFORD CHIN 15 BOROUGH OF CHINGFORD ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1950 BOROUGH OF CHINGFORD ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1950 BOROUGH OF CHINGFORD Committee: June, 1950 — May, 1951 PUBLIC HEALTH COMMITTEE Chairman : Councillor J. W. R. Nation. Vice-chairman : Councillor Dr. J. Wagstaff. Members : Alderman Mrs. S. L. Oakes. Councillor A. T. H. Austin. „ W. J. Bowstead. „ P. W. E. Clark. „ S. G. Creasey. K. W. Rothwell. „ T. H. Treadwell. The Mayor, Alderman A. Fitzsimmons, J.P., A.M.I.E.E. (ex-officio). Meeting: Second Wednesday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1950) Medical Officer of Health : J. H. CROSBY, M.B., Ch.B., D.P.H. Chief Sanitary Inspector: JAMES F. ROGERS, M.R.San.I., (a) (c) (d) Cleaning 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) (to 31.8.50). K. A. CHESTER, M.R.San.I., M.S.I.A., M.R.I.P.H.H. (b) (c)—May, 1951 (e). C. G. HOWELL, A.R.SanI, M.S.I.A., M.R.I.P.H.H. (from 23.10.50) (b) (c)—May, 1951. Senior Clerk : Miss V. M. PETTIT. Clerks: A. E. CULPIN (to 18.3.50). Miss I. A. FOLKES. A. H. GILLIES (from 27.3.50). Miss O. HURRELL. (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 1950 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 1950 upon the health and sanitary circumstances of the Borough. In the realm of Vital Statistics, the Infant Mortality Rate— i.e., the number of deaths of infants under one year per thousand live births—has reached the record low figure of 11.6. The rate for England and Wales as a whole was 29.8. The birth rate remained virtually the same as the previous year, 14.2 per thousand (14.1 per thousand in 1949). The death rate of 7.7 per thousand was slightly less than in 1949, when it was 8.3. Infectious fevers, on the whole, showed a marked decline, particularly in regard to Measles and Whooping Cough. A single case of Typhoid Fever occurred, the first for 10 years. The Mass Radiography Unit paid its first visit to Chingford during the year : details are set out on page 27. The campaign for Clean Food advanced appreciably during the year. In this connection it is noteworthy that Chingford became its own Food and Drugs Authority on the 1st October, 1950, in lieu of the Essex County Council ; this new administrative power should very materially assist in maintaining the highest standards of food hygiene in the Borough. In conclusion, I am most grateful to the Chairman and Members of the Health Committee for their support and to Mr. J. F. Rogers, Chief Sanitary Inspector, and the Staff of the Health Department for their hard work and assistance during the year. I am, Ladies and Gentlemen, Your obedient servant, J. H. CROSBY, Medical Officer of Health. July, 1951. 2 Section A.— STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,868 acres Population—Registrar-General's estimate (as at 30.6.50) 48,770 Number of inhabited houses and flats (as at 31.12.50) 13,332 Rateable value on April 1st, 1950 £375,233 Sum represented by a penny rate on April 1st, 1950 (gross) £1,563 9 5 VITAL STATISTICS M. F. Live Births Total 367 325 Birth Rate per 1,000 of estimated resident population : 14.2. Legitimate 358 318 Illegitimate 9 7 M. F. Rate per 1,000 total (live and still) births: 18.4. Stillbirths Total 6 7 Legitimate 5 7 Illegitimate 1 — M. F. Deaths 187 187 Crude Death Rate per 1,000 of estimated resident population : 7.7. 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 11.6 Legitimate infants per 1,000 legitimate live births 11.8 Deaths from Cancer (all ages) 77 „ „ Measles (all ages) — „ „ Whooping Cough (all ages) — 3 4 Table of Birth and Death Rates Year Population Births Rate per 1,000 populat'n Deaths Rate per 1,000 populat'n Infant Mortality Deaths Rate per 1,000 live births 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 1950 48,770 692 14.2 374 7.7 8 11.6 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 636 Number of specimens examined for the Chingford Isolation Hospital (to March, 1950) 94 (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 6856. 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) Midwifery and Home Nursing Service. 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. Number of Midwives or Home Nurse/Midwives 5* „ „ Home Nurses 3 Number of cases attended by Midwives as :— (a) Midwives 146 (b) Maternity Nurses 58 204 Number of visits paid by Home Nurses to :— (a) Pre-school children 166 (b) School children 270 (c) Adults 11,033 11,469 *Miss F., A. Clarke, 69, Connaught Avenue, E.4. (Silverthorn 1801). *Mrs. G. E. M. Witter, 87, Friday Hill, E.4. (Silverthorn 4968). *Mrs. P. M. Stenning, 220, Hall Lane, E.4. (Silverthorn 5263). *Miss C. Lovell, 49, The Ridgeway, E.4. (Silverthorn 1460). *Miss D. Waldie, 49, The Ridgeway, E.4. (Silverthorn 1460). 5 (d) 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. (e) Clinics and Treatment Centres. See table of clinics on page 7. (f) 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; or, if no bed is available at either of these hospitals, the Emergency Bed Service arranges admission to the nearest hospital where a bed is available. (g) 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. (h) 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. The total number of hours help supplied during the year 1950 was 31,859. (i) Chiropody Facilities. A Chiropody Clinic for persons of pensionable age only, commenced on 21st December, 1950, being held on Thursday afternoons at the Combined Treatment Centre, Marmion Avenue. 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, 1951 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 Thursdays, 11.30 a.m. Friday Hill House, E.4. 1st Wednesday, 3 p.m. Church Hall, The Ridgeway, North Chingford. Wednesdays, 9.30 a.m. Ante-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. 49, The Ridgeway, E.4. Fridays 2 p.m.—4 p.m. do. (District Nurses) Mondays, 2 p.m.—4 p.m. Child Welfare Clinics Friday Hill House, E.4. Wednesdays, 1.30 p.m.—4 p.m. County Council Clinic. Tuesdays, 1.45 p.m.—3.45 p.m. Marmion Avenue, E.4. Wednesdays, 1.45 p.m.—3.45 p.m. Primary Hall, Buxton Rd., North Chingford. Tuesdays, 2 p.m.—4 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. Orthopaedic Clinics County Council Clinic, Monday afternoons. Marmion Avenue, E.4. 1st, 3rd, 4th and 5th Thursdays, all day, by appointment only. 2nd Thursday, afternoon Friday Hill House, E.4. Dental Clinic County Council Clinic, Marmion Avenue, E.4. Wednesdays, 9.45 a.m. (inspection only) or by appointment through schools. Eye Clinic County Council Clinic, Marmion Avenue, 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. Foot Clinic (old age pensioners only) County Council Clinic, Marmion Avenue, E.4. Thursdays, 2 p.m. (by appointment only). Registrar of Births, Deaths and Marriages : Mr. C. W. BARRETT, 19 Algers Road, Loughton. (Telephone : Loughton 576). Office: 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, E.ll. (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. One sample of drinking water was taken during the year from the storage tank of a dwelling-house, and the Bacteriologist reported it was pure and wholesome, suitable for drinking and domestic purposes, very hard in character although not excessively so. Rivers and Streams. Sixty-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 11,849 tons. This was a slight increase over the amount collected in the previous year, namely, 11,223 tons; the population mid-year 1950 was estimated at 48,770 as compared with 48,510 for the previous year. The net cost per ton for the collection of refuse was 19s. 5d. as against 18s. 4d. for the year ended March, 1950, and 16s. 7d. for the year ended March, 1949. The net cost per ton for the disposal of refuse was 8s. 5d. as compared with 7s. 9d. for the previous year and 7s. 1d. for the year ended March, 1949. The net expenditure for the collection and disposal of refuse and salvage was £16,511 as against £14,613 for the previous year. The total income from all sources was £7,009 as compared with £5,967 for the previous year. Waste paper prices improved during the year and of the total income a sum of £3,696 was received for this commodity. It is interesting to note that the tonnage of paper collected by the Council's employees appeared to decline in relation to price improvements. This general tendency has been noted in past years in relation to other commodities. The average amount of paper collected per month during the year was 38 tons which was 10 tons below the quota figure. Nevertheless, the revenue obtained for the sale of waste paper made a considerable contribution towards the record income of £7,009. In the previous report mention was made of difficulties in the disposal of ashes, screenings and clinker from the Refuse Disposal Works, but during the year this problem was solved when arrangements were made with the Epping Rural District Council 8 for the reception of these materials at the Parndon tip. The agreement in this connection is for a period of three years with option to renew for a further two years. 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 four Karriers, one Shelvoke and Drury freighter and two Fordsons. Street cleansing was maintained under difficulties during the year. The Lewin Road Sweeper functioned satisfactorily but the number of miles swept per hour did not exceed two. Throughout the year, too, street orderlies were called upon to reinforce the refuse collection staff when freighter crews were below strength on account of illness or absence on annual leave. Trials were carried out in the use of a two cubic yard Morrison Electricar utilising this vehicle in conjunction with gang sweeping, and the results of the trials were very satisfactory. It is possible that further mechanisation of the street cleansing service will be considered by the Council as street orderlies are still difficult to recruit. During the year under review the Council again had to give very serious consideration to the use of communal kitchen waste bins on the streets of the Borough. Renewed complaints were received as to the disturbance of these bins by cattle and in addition it had become increasingly evident that from a hygienic point of view such bins were not only undesirable but also insanitary. Furthermore, the amount of kitchen waste which was being collected was so small as to make the whole proposal an uneconomic one. Ultimately the Council resolved that kitchen waste bins should be withdrawn and instructed the Chief Sanitary Inspector to investigate and fully report on a scheme for the collection of kitchen waste in the Borough from individual containers at dwelling-houses. The decision of the local authority in relation to that report will be the subject of comment at a later date, but one important aspect of the matter must be that the burden of kitchen waste collection throughout the country has fallen only on those authorities whose areas are situated within a reasonable distance of a concentration plant. In terms of finality therefore it may be that the whole question of kitchen waste collection must resolve into consideration by the Associations representing the various types of authority. 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, 1951 I — Collection II — Disposal Total Including Depreciation or Loan Charges (see Note a) Excluding Loan Charges etc. Including Depreciation or Loan Charges (see Note a) Excluding Loan Charges etc. Including Depreciation or Loan Charges (see Note a) Excluding Loan Charges etc.] (1) (2) (3) (4) (5) (6) (7) (8) Revenue Account £ £ £ £ £ £ A Gross Expenditure 12,392 12,392 11,128 10,362 23,520 22,754 B Gross Income 872 872 6,137 6,137 7,009 7,009 c Net Cost 11,520 11,520 4,991 4,225 16,511 15,745 Unit Costs s. d. s. d. s. d. s. d. s. d. s. d. D Gross Expenditure per ton 20 11 20 11 18 9 17 6 39 8 38 5 E Gross Income per ton 1 6 1 6 10 4 10 4 11 10 11 10 F Net Cost per ton 19 5 19 5 8 5 7 2 27 10 26 7 G Net Cost per 1,000 population £ £ £ £ £ £ 236 236 102 86 338 322 H Net Cost per 1,000 houses 864 864 374 317 1,238 1,181 1. Total Refuse collected (in tons) 11,849 2. Population (Mid-year) 45,770 3. Weight per 1,000 population per day (in cwts.) 13.3 4. Number of occupied houses and premises (31.12.50) 13,332 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, 1951 Year ended 31.3.50 £ s. d. £ s. d. £ s. d. £ s. d. 1—Metals : 49 2 6 Aluminium 205 15 3 42 17 2 Copper 125 11 10 101 11 3 Iron 113 18 8 16 17 6 Lead 41 17 4 3 0 0 Battery Lead 5 2 4 36 10 7 Brass 125 3 0 15 17 7 Mixed Metals 15 14 2 41 12 6 Unbaled Scrap 22 0 6 115 8 1 Tins 156 9 3 13 4 0 Pewter 20 4 4 - - - Zinc 9 14 2 841 10 10 22 5 10 Bones 18 0 5 227 4 9 Broken White Glass 320 2 5 6 8 0 Amber Cullet 18 2 6 215 16 9 Bottles and Jars 229 5 3 567 10 2 406 11 6 Rags 584 17 5 54 7 6 Carpets and Sacking 102 12 9 11 11 0 Flock Mattresses 22 7 3 709 17 5 2955 6 5 Newspapers and 3696 0 4 169 17 9 Board of Trade Collection Allowance - - - 3696 0 4 739 15 7 Pig Food (Kitchen Waste) 506 3 4 18 11 11 Allowance (Board of Trade) - - - 506 3 4 - - - Rubber 8 3 0 - - - Old Gramophone Records - - - 8 3 0 6347 5 6 12 19 11 2—Miscellaneous Receipts and Charges 5 0 0 89 8 6 3—Weighbridge Fees 72 14 0 4—Rents : 200 0 0 Foundry 200 0 0 20 0 0 Proportion of Allotment Rents 20 0 0 2 6 Other Rents 3 6 5—Refuse Collection Charges : 215 7 0 Greengrocers 268 8 0 165 11 0 Others 95 12 0 £5967 7 1 £7009 3 0 11,223 Tonnage 11,849 11 SANITARY INSPECTION OF THE AREA Inspections on Complaint The number of complaints received at the office and recorded in the register was 330, as compared with 358 in the previous year and 550 for the year 1948. The total inspections made on complaint was 745 and the number of defects or nuisances revealed was 447, which are analysed in the following table. Informal notices were at once served on the owners or occupiers of the premises concerned. TABLE 1. General Housing 87 Blocked Sewers 180 Defective Sewers 22 Defective Water Fittings 5 Defective Water Waste Preventers 2 Blocked Yard and W.C. Drains 13 Defective Drainage 26 Unsound Food 12 Absence of and Defective Dustbins 38 Lack of Proper Water Supply 1 Nuisance from Poultry 6 Noise, etc., Factory Premises 2 Verminous Premises 11 Alleged Pollution of Water Supply 1 Offensive Accumulations 18 Nuisance from Flies 2 Nuisance from Smoke, etc. 6 Animals kept so as to be a Nuisance 7 Dirty Premises 1 Road Cleansing 2 Overcrowding 4 Defective Water Closets 1 447 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 nuisances or defects found under specific headings. The visits numbered 6,852, as compared with 6,884 in the previous year; the defects dealt with numbered 947, as compared with 1,269 in 1949. TABLE 2. Housing Act, 1936. Visits Paid Nuisances or Defects found and dealt with Inspections 48 285 Re-inspections re Notices served 596 Re Overcrowding 22 On Complaint 745 447 Infectious Diseases 124 Retail Trade Premises : Meat 137 Fish 63 Fried Fish 46 General Provisions 173 Other Food Shops 131 Restaurants and other Food-Preparing Premises 59 Ice Cream Premises 50 Factories 134 17 Bakehouses 35 1 Dairies 8 Pigstyes 14 Re-visits re Notices Served (P.H. Act) 589 Rodent Control 2,702 197 Private Slaughtering 1 Shops Acts (Sanitary Conditions) 8 (Hours of closing) 135 (Young Persons Employment) 33 Council Houses 133 Collection and Disposal of Refuse and Salvage 145 Kitchen Waste—Communal Bins 56 Schools 27 Hairdressers' Premises 15 Swimming Pool 6 Miscellaneous Visits 287 Places of Entertainment 8 Public Conveniences 14 Petroleum Acts 6 Outworkers 214 Smoke Observations 14 Pollution of Rivers and Watercourses 61 Street Food Vendors 9 Movable Dwellings 4 6,852 947 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 cleansed 50 Roofs, Spoutings and Eavesgutters repaired or renewed 89 External Walls repaired 20 Wall and Ceiling Plaster repaired 48 Floors repaired 28 Stairs and Stair Rails repaired 3 Windows repaired (including Sashcords, Glazing and Sills) 75 Stoves and Firegrates repaired or renewed 9 Flues and Chimney Stacks repaired or rebuilt 17 Dampness remedied 33 Yard Surfaces repaired or relaid 2 Offensive Accumulations removed 2 Nuisances from Animals abated 1 Verminous Premises disinfested 13 Drains repaired or reconstructed 42 Soil and Ventilating Pipes repaired or renewed 9 Water Closets repaired or reconstructed 12 Water Closets cleansed and limewashed 20 Water Closet Pans fixed 7 Water Closet Flushing Cisterns repaired or renewed 9 Water Storage Tanks and Piping repaired or renewed 7 Dustbins provided 45 Rat Infestations 197 Offensive Trades found and stopped 1 Sewers cleansed 280 Sewers repaired 22 Nuisances from Smoke Emission abated 6 947 TABLE 4. Letters sent out and notices served in connection with the work of the Health Department. Letters 1,632 Public Health Acts : Preliminary Notices 53 Statutory Notices 13 Statutory Notices (re Maintenance of Sewers) 15 Housing Acts : Preliminary Notices 58 Statutory Notices 9 14 Shops Act, 1950. A survey of all shops in the area was continued during the year with particular reference to sanitary conditions and the general administration and application of the Act. Whilst few contraventions were observed improvements were secured in connection with washing facilities for shop assistants, seats for female employees, hours of employment for young persons and observance of the weekly half-holiday requirements. Smoke Abatement. Fourteen observations were taken of a chimney connected with a Pumping Station in the town and improved stoking methods and supply of a superior quality of fuel resulted in the abatement of the nuisance. Swimming Pool. Summaries of the total chlorine and alkalinity readings are forwarded weekly to the Health Department by the Pool Superintendent. The Pool was opened on the 6th May and the bathing season ended on the 10th September, 1950. The climatic conditions were not such as to cause the Pool to be used to full capacity throughout the season; the highest attendance recorded was on the 9th July when 6,498 persons used the Pool. During the 1949 season some concern was expressed as to the amount of organic debris which was gaining access to the water and as a result of improvements carried out this condition did not arise during the year. Four samples of water were taken from the Pool and submitted for bacteriological examination. The report in each case was to the effect that the water was of high standard of bacterial purity, suitable for bathing purposes. Schools. The general condition and supply of water to Schools has been satisfactory during the year. In co-operation with the School Medical Officer quarterly visits were paid to the canteens attached to all Schools under the control of the Essex County Council and reports were furnished of defects existing. Whilst some improvements were effected the rate of progress in the execution of necessary repairs and improvements was not all that could be desired. Offensive Trades. Within the meaning of the Public Health Act there are no offensive trade premises in the district, but there are 10 fish fryers. 15 Bakehouses. Periodical visits were paid to the eight bakehouses in the district and generally they were maintained in a satisfactory condition. In one instance premises were re-conditioned and modernised. Factories Act, 1937. One hundred and thirty visits were paid to Factories, and in 17 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 Inspector.) 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 - - - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 46 129 3 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding Outworkers' Premises) 3 5 - - Total 49 134 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.J.) - - - - - Inadequate ventilation (S.4.) - - - - - Ineffective drainage of floors (S.6.) - - - - - Sanitary Conveniences (S.7.) (a) Insufficient - - - - - (b) Unsuitable or defective 17 17 - - - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork ) - - - - - Total 17 17 - - - Number and Trade of Outworkers Notified during 1950 : Wearing Apparel 50 Downquilts 1 Knitwear 28 Box-making 8 Footwear 2 Novelties 6 Brush-making 6 Trimmings 3 Handbags 12 Millinery 1 Leather Goods 2 Outworkers were notified from the following Areas : Ilford 2 Walthamstow 4 Stepney 1 Edmonton 1 St. Pancras 2 Hackney 30 Stoke Newington 6 Shoreditch 10 Leyton 61 Tottenham 6 Islington 5 Finsbury 39 St. Marylebone 4 Chigwell 4 Hornchurch 1 Wood Green 2 Westminster 3 East Ham 1 London Corporation 5 Enfield 3 17 Prevention of Damage by Pests Act, 1949. A full-time Rodent Operative is employed for rodent infestation work and whilst there was no evidence of major infestations in the town, 2,702 visits were paid to deal with minor infestations at private and business premises. The third and fourth maintenance treatments were carried out in March and September respectively. In March 202 manholes were baited and of these 50% showed complete or partial takes. Prior to the fourth maintenance treatment a 10% test-bait of the whole of the manholes in the Borough showed the need for treatment in only one small area. Accordingly 45 manholes were treated and of these 68.8% showed complete or partial takes. Section D.— HOUSING STATISTICS FOR THE YEAR, 1950 1. Number of Houses Erected During the Year. (1) By the L.A. (permanent) traditional (including flats) 83 (2) By the L.C.C. (permanent) traditional - (3) Cost of works re-buildings by local builders 3 (4) By private enterprise 30 116 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) 1072 (b) Number of inspections made for the purpose 2257 (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 48 (b) Number of inspections made for the purpose 644 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation - (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation *189 *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 92 4. Action Under Statutory Powers During the Year : A. Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which notices were served requiring repairs 14 (2) Number of dwelling-houses which were rendered fit after service of formal notices : (a) By owners 5 (b) By Local Authority in default of owners 3 B. Proceedings under Sections 11 and 13 of the Housing Act, 1936: (1) Number of Demolition Orders served 2 (2) Number of Undertakings accepted — (3) Number of Undertakings completed — C. Proceedings under Public Health Acts : (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 53 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 8 (b) By Local Authority — Section E.— INSPECTION AND SUPERVISION OF FOOD Milk Supply. The milk supply is from several large firms with dairy premises outside the Borough boundaries, and is mainly pasteurised. 19 Milk (Special Designations) Regulations, 1949. 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 Regulations: 2 dealers' licences to sell milk as Pasteurised. 2 dealers' licences to sell milk as Sterilised. 4 supplementary licences to sell milk as Sterilised. 3 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. Food and Drugs Act, 1938. Food and Drugs Authority. During the year the Council renewed the application which had been made previously to the Ministry of Health in 1939. The application was under the provisions of Section 64 of the Food and Drugs Act, 1938, and following an informal enquiry by a representative from the Ministry, which included an investigation of local public health administration and an inspection of the Borough, the application of the Council was granted with effect as from the 1st October, 1950. Public Analyst. When the Council became the Food and Drugs Authority approval was given to the appointment of : Mr. George Taylor, F.R.I.C., 20, Eastcheap, London, E.C.3 and Dr. J. H. Hamence, F.R.I.C., 20, Eastcheap, London, E.C.3 as joint Public Analysts for the area. Samples Submitted for Analysis. During the short period of the year in which the Council was acting as Food and Drugs Authority the following samples were submitted to the Public Analyst, and no adulterations were reported and neither were excessive or prohibitive preservatives found. Article Number Examined Formal Informal Private Total Liquid Egg - 1 - 1 Milk - 3 - 3 Beef Sausages - 10 - 10 Pork Sausages - 2 - 2 Ointment - 2 - 2 Yeast Tablets - 1 - 1 Sweets - 1 - 1 Total — 20 - 20 20 Extraneous Matters in Foodstuffs. Six cases were taken before the Magistrates under Section 9 of the Act in relation to extraneous matters found in foodstuffs. The Council feel that the presence of such matters in foodstuffs indicates lack of proper supervision on the part of the management or carelessness by the staff handling food for human consumption, and the hope is expressed that the need for such summary action will, in due course, disappear. Offence. Result. Bread rolls containing ash Fine—£3 0s. 0d. Splinter of wood in sweet Case dismissed on payment of £2 2s. 0d. costs. Splinters of wood in bread Fine—£10 0s. 0d. and costs. Splinter of wood in bun Fine—£10 0s. 0d. Metal screw in bun-round Fine—£10 0s. 0d. Fibre material in bread Fine—£5 0s. 0d. Costs 10s. 0d. Byelaws— Handling, Wrapping and Delivery of Food. The Council adopted the byelaws made for the Handling, Wrapping and Delivery of Food and Sale of Food in the Open-air and these came into force on the 14th August, 1950. The model byelaws issued by the Ministry of Food were adopted without amendment, and whilst it is not possible to indicate what ultimate beneficial results may be achieved by reason of the adoption of these byelaws the traders concerned appear to accept the various requirements as reasonable and practicable. Survey of Food Premises. In conjunction with the Council's Clean Food Campaign a survey of all food premises in the area was completed during the year. The premises inspected numbered 215 and various trade premises are itemised below :— Butchers 25 Grocers 47 Greengrocers 26 Bakers : Shops 11 Bakehouses 8 Fishmongers : Wet 6 Fried 5 Both 5 Confectioners 32 Dairies 4 Restaurants 27 Factory Canteens 7 Licensed Houses 12 215 21 Generally the condition of food premises was good and the works which were carried out have been divided into three categories :— Enforceable Work Completed : Walls and/or ceilings cleansed 10 Repainting of doors and windows 2 Floors relaid 4 Floors repaired 4 Roofs repaired 2 Drainage defects remedied 4 Floors cleansed 1 Sanitary accommodation cleansed 5 Sanitary accommodation defects remedied 2 Refuse storage facilities provided 7 Food stores provided 2 Washing facilities provided 2 Hot water supply provided 6 Towels provided 2 Lighting improved 1 Walls repaired 1 Other Work Completed : Walls and/or ceilings decorated 25 Wall surfaces improved 4 Refuse storage facilities improved 3 Floors re-surfaced 2 Repainting of doors and windows 5 Lighting improved 2 Sanitary accommodation re-decorated 6 Ventilation improved 1 Improvements Effected : Constant hot water provided : Geyser 10 Other 3 Defective or unsuitable utensils replaced 3 New cold-stores provided 2 Existing cold-stores renewed 1 Extra washing facilities provided 1 Re-arrangement of equipment 4 Glass counter screens provided 3 Impervious surrounds to sinks provided 3 Other improvements 9 Wrapping of fish in greaseproof paper 3 The proprietors of establishments used for the preparation, storage or sale of food co-operated with the officers of the local authority in every possible way to secure that their premises were in good order and it is felt the successful prosecution of the Clean Food Campaign must now rest on the gradual education of all persons engaged in the handling of food, coupled with a determination on the part of the public to insist on hygienic methods of distribution. 22 Inspection of Meat and Other Foods. There is one private licensed slaughter-house in the Borough which is not in normal use at the present time and 26 butchers' shops in the area ; the visits paid to these and other retail trade premises numbered 137. 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 Article Quantity Meat 217 tins Fish 97 „ Fruit and Vegetables 480 „ Syrup 3 „ Soups 33 „ Marmalade 9 „ Milk 253 „ Puddings 4 „ Jams 34 jars Mincemeat 2 „ Vinegar 6 bottles Sauces 6 Pickles 2 jars Fish-paste 44 „ OTHER FOODS Article Quantity Fish 50 stones Corned Beef and Mutton 96 lbs. Sausages 7 „ Offal 14 „ Milk Powder 7 cwts. Assorted Confectionery 70 lbs. Dried Peas 81 „ Bacon 82 „ Eggs 791 23 Condemnation certificates were issued in respect of the undermentioned home-killed meat and offal :— Sheeps Heads 176 lbs. Calves Heads 78 „ Registration of Food Preparing Premises. The registration of these premises is secured by Section 14 of the Food and Drugs Act, 1938, and the number of premises on the register was 90, being 64 for the manufacture, storage or sale of ice cream and 26 for the preparation or manufacture of sausages or preserved food, etc. Registration of Manufacturers or Vendors of Ice Cream. 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 62. 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 55 samples were forwarded to the Laboratories for bacteriological examination, 50 being simples of ice cream, 4 samples of Swimming Pool water and 1 sample of drinking water. Ice Cream. The bacteriological results of ice cream samples are summarised overleaf, and it will be noted that the presence of bacteria coli was not detected in any sample. It is pleasing to record that no samples fell into Grade IV and only four into Grade III. The bacteriological standard of ice cream sold in the Borough during the year was superior to that sold in 1949. Grade I. Grade II. Grade III. Grade IV. 31 15 4 — Samples adversely reported upon gave rise to further investigations by the Department and the results of all samples were notified to dealers and manufacturers. 24 Where the source of manufacture was outside the area of the Borough, copies of the Bacteriologist's reports were forwarded to the authorities concerned. 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 1 Hot mix 400 0/3 0/3 4½I 2 Hot mix 900 0/3 0/3 4½/I 3 Hot mix 120,000 3/3 0/3 2 /III 4 Hot mix 1,200 0/3 0/3 4½/I 5 Hot mix 1,200 0/3 0/3 4½|/I 6 Hot mix 500 0/3 0/3 4½/I 7 Hot mix 130,000 0/3 0/3 4½/I 8 Hot mix 1,600 0/3 0/3 4½/I 8a Hot mix 11,000 0/3 0/3 4½/I 9 Hot mix 5,200 0/3 0/3 4½/1 9a Hot mix 7,300 0/3 0/3 4½/I 10 Hot mix (choc. ice) 8,200 0/3 0/3 4½/I 11 Hot mix 5,400 0/3 0/3 4½/I 12 Hot mix 3,300 0/3 0/3 4½/I 13 Hot mix 56,000 0/3 0/3 4½/1 14 Hot mix 600 0/3 0/3 4½/I 15 Hot mix 17,000 0/3 0/3 3 /II 16 Hot mix 4,800 0/3 0/3 4½/I 17 Hot mix (choc. ice) 12,000 0/3 0/3 3 /II 18 Hot mix 1,300 0/3 0/3 4½/I 19 Hot mix 2,200 0/3 0/3 4½/I 20 Hot mix 9,500 2/3 0/3 3 /II 21 Hot mix 25,000 0/3 0/3 3 /II 22 Hot mix 30.000 1/3 0/3 2 /III 23 Hot mix (choc. ice) 32,000 0/3 0/3 4½/I 24 Cold mix 1,500 0/3 0/3 4½/I 25 Hot mix 60,000 2/3 0/3 3 /II 26 Hot mix 1,400 0/3 0/3 4½/I 27 Hot mix 7,800 0/3 0/3 4½/1 28 Hot mix 15,000 2/3 0/3 3 /II 29 Hot mix 28,000 3/3 0/3 3 /II 30 Hot mix 13,000 0/3 0/3 3 /II 31 Hot mix 8,000 1/3 0/3 4½/I 32 Hot mix 9,000 0/3 0/3 4½/I 33 Hot mix 15,000 3/3 0/3 1½/III 34 Hot mix 5,000 2/3 0/3 2½/II 35 Hot mix 1,600 2/3 0/3 2 /III 36 Hot mix 600 0/3 0/3 4½/I 37 Hot mix 4,000 1/3 0/3 2½/II 38 Hot mix 52,000 1/3 0/3 3½/II 39 Wrapped lolly 38,000 2/3 0/3 2½/II 40 Hot mix 6,800 2/3 0/3 2½/II 41 Hot mix 5,200 1/3 0/3 4½/I 42 Hot mix 1,400 0/3 0/3 4½/I 43 Hot mix 5,000 0/3 0/3 4½/I 44 Hot mix 100 0/3 0/3 4½/I 45 Hot mix 700 0/3 0/3 4½/I 46 Hot mix 22,200 2/3 0/3 2½/II 47 Hot mix 400 0/3 0/3 4½/I 48 Hot mix 200 0/3 0/3 4½/I 25 Section F.— PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Diphtheria. One confirmed case of Diphtheria was notified to the Health Department in 1950. This was very mild in character and occurred in a seven-year-old child who, although having been immunised in infancy, had not received a reinforcing dose at age 5 years. Recovery was rapid and uneventful. Propaganda for immunisation against Diphtheria was continued during 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 561 „ „ —5 to 15 years 167 Total 728 Number of children receiving secondary or reinforcing injections during the year 407 Scarlet Fever. Notifications of 62 cases were received during the year under review. This was a decrease of 43 on the figure for 1949. As in many years past, the fever was of a very mild character. 1946 1947 1948 1949 1950 Cases notified 74 69 78 105 62 Percentage removed to hospital 64 61 52 46 65 Measles. Measles declined very appreciably in 1950, the number of cases, 267, being 47% less than in 1949. Only 3 cases needed admission to hospital. A circular letter to the general practitioners in the Borough was sent by the Health Department informing them that Irradiated Adult Serum and Immune Serum Globulin was available, on application to the Public Health Laboratory at Colindale, for the treatment of cases and the protection of contacts. Whooping Cough. Here also a considerable reduction took place, 134 cases being notified, which was 40 less than the previous year. Five cases were admitted to hospital. 26 Poliomyelitis. The number of cases of acute poliomyelitis notified in Chingford during 1950 was 6. Of this number, 3 were non-paralytic in character, 3 being paralytic. It is gratifying to report that 2 of the latter cases were of a very mild character, the third being more severe. All, however, have made a full and complete recovery from their illness, there being no residual paralysis. Tuberculosis. A rise of 5 occurred in the total number of fresh cases of tuberculosis, pulmonary and non-pulmonary, which were notified during the period under review, the number being 40. In addition, 17 persons who had previously been notified in other districts as suffering from tuberculosis, came to reside in Chingford. Mass Radiography. For the first time in the history of the Borough, a mass radiography unit visited Chingford towards the end of the year and remained for three weeks, giving ample opportunity to all to avail themselves of this facility for X-ray examination. The table below gives the full details in regard to the numbers who attended and the X-ray findings. Details of Mass Radiography Survey carried out in November. Male Female Total Number of miniature films taken 1317 1448 2765* Number requiring large films 69 48 117 Pulmonary Tuberculosis : Active Post Primary 2 — 2 Inactive Primary 17 39 56 Inactive Post Primary 28 13 41 Other Abnormalities Discovered : Pneumonia 1 — 1 Bronchiectasis 1 1 2 Pneumoconiosis 1 — 1 Carcinoma of Bronchus 1 — 1 Cardiovascular lesions—Congenital — 2 2 ,, Acquired 3 5 8 Lung Abscess 1 — 1 * This number includes 724 schoolchildren. There were no cases of active Pulmonary Tuberculosis discovered among these schoolchildren. Dysentery. Five cases of Dysentery came to the notice of the Health Department during the year. All were of a very mild character. Enquiries failed to elicit the source of infection. 27 Food Poisoning. All the seven persons notified as having suffered from food poisoning during 1950 were isolated cases. Various items of food were alleged to be responsible in each case, but unfortunately none of the patients had retained any remnants of food for examination. The illness in each case was of short duration. Food Hygiene. During the year the campaign to improve food hygiene in the Borough was pressed forward. The following programme was arranged :— (a) A series of lectures both for the food handling trade and the public were given, but unfortunately these lectures were very poorly attended. (b) A Clean Food Exhibition followed shortly afterwards, in May. This was most attractively displayed in the Town Hall and attracted considerable attention. About 2,000 members of the general public visited the Exhibition during the six days it was open ; in addition, the Medical Officers of Health and Sanitary Staffs from all the adjoining districts attended and were most impressed with all that they saw. The Exhibition covered every aspect of food hygiene and indicated the methods to be adopted to prevent food becoming infected. (c) Model Byelaws: During 1950 the Chingford Borough Council adopted the Model Byelaws of the Ministry of Food concerning the Handling, Wrapping and Delivery of Food and Sale of Food in the Open Air. These byelaws came into force on the 14th August, 1950. A copy of them has been sent to every food trader in the Borough. Typhoid Fever. Early in January, 1950, a person was notified in the Borough as suffering from Typhoid Fever. Prompt enquiries were instituted and a detailed history of the patient's movements during several weeks previously was obtained, with particular reference to places where food was consumed. It was noticed from the Registrar-General's returns of infectious diseases that cases of Typhoid Fever had been notified in an adjoining borough and in several London boroughs during the previous few weeks and enquiries from them focussed attention on a particular cafe in the adjoining borough. The Medical Officer of Health of the latter was informed and as a result of his investigations a member of the staff employed at this cafe was found to be excreting typhoid organisms of the same type as the Chingford case, viz. : phage type E.l. 28 It is interesting to note that the discovery of this typhoid carrier, following on the investigations carried out at Chingford, was instrumental in bringing to light several other cases in areas of Essex and Middlesex, whose source of infection had remained a mystery. The cafe employee concerned was suspended under the Public Health (Infectious Diseases) Regulations, 1927. I was informed by the Medical Officer of the Isolation Hospital to which the Chingford patient was transferred, that the infecting typhoid organism was of a particularly virulent character. I am glad to be able to report that the patient made a complete recovery after a very prolonged illness and that no further cases occurred in the Borough. Smallpox Contacts. During the year, several persons were kept under surveillance for sixteen days as contacts of cases or suspected cases of smallpox imported into the country from abroad. Scabies. No persons were in need of treatment during the year at the Scabies Treatment Centre. National Assistance Act, 1948. (a) Section 47: It was not necessary during 1950 to take action under this section of the Act, which empowers local authorities to remove to hospital persons in need of care and attention. (b) Section 50: The Chingford Council took action under this section in one instance during the year. Part of the cost of burial of the child concerned was recovered by the Council. Vaccination. Number of births registered in the district during 1950 378 Number of primary vaccinations 279 Number of re-vaccinations 78 Percentage of vaccinations to registered births 74 Medical Examinations. During the year 18 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, 33 medical examinations were carried out in respect of Essex County Council staff. 29 CAUSES OF DEATH AS GIVEN BY THE REGISTRAR. GENERAL FOR THE YEAR 1950 Causes of Death Males Females Total Tuberculosis, respiratory 7 5 12 Syphilitic disease 1 — 1 Other infective and parasitic diseases 1 — 1 Malignant neoplasm, stomach 3 9 12 „ „ lung, bronchus 10 3 13 breast — 5 5 uterus — 3 3 Other malignant and lymphatic neoplasms 20 24 44 Diabetes 2 1 3 Vascular lesions of nervous system 20 29 49 Coronary disease, angina 28 17 45 Hypertension with heart disease 4 6 10 Other heart disease 23 42 65 Other circulatory disease 8 8 16 Influenza 1 1 2 Pneumonia 7 2 9 Bronchitis 15 5 20 Other diseases of respiratory system — 2 2 Ulcer of stomach and duodenum 5 2 7 Gastritis, enteritis and diarrhœa — 1 1 Nephritis and nephrosis 1 2 3 Hyperplasia of prostate 2 — 2 Pregnancy, childbirth, abortion — 1 1 Congenital malformations 2 2 4 Other defined and ill-defined diseases 22 10 32 Motor vehicle accidents 2 1 3 All other accidents 1 1 2 Suicide 2 5 7 Totals—all causes 187 187 374 Totals—year 1949 200 204 404 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 - - - - - - - - — 5 to 14 years 1 1 — — 1 — - — — — — — 15 to 24 years 5 6 1 1 — 4 — — —: — — - 25 to 34 years 5 5 - — 2 7 — — — 1 — — 35 to 44 years 4 5 - 1 2 — — — 2 3 — — 45 to 54 years 3 — — — 1 — — — 2 1 1 — 55 to 64 years 1 - - - - - - - 2 1 - - 65 and upwards - - - - - - - - - - - - Totals 19 17 2 2 6 11 - - 6 6 1 — Add—Deaths of un-notified cases 2 - — - 8 6 1 — 30 Deaths from Cancer. Out of a total of 77 deaths from cancer, 69 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 — 2 11 13 11 15 Lungs and Mediastinum 3 — 8 2 11 2 Genito- urinary organs - 2 3 11 3 13 Breast - — — 5 — 5 Other sites 1 — 7 9 8 9 Totals 4 4 29 40 33 44 Death rate = 1.57 per 1,000 (as compared with 1.48 per 1,000 in 1949). DEATHS FROM ALL CAUSES AT VARIOUS AGES DURING 1950. Age DEATHS No. of deaths which apply to district No. in district Outward Transfers Inward Transfers Under 1 year 5 1 4 8 1 and under 2 - - 1 1 2 and under 5 - - 2 2 5 and under 15 — — — — 15 and under 25 3 1 5 7 25 and under 35 3 — 3 6 35 and under 45 12 2 14 24 45 and under 55 19 2 20 37 55 and under 65 33 5 32 60 65 and under 75 78 15 46 109 75 and upwards 113 25 32 120 Totals 266 51 159 374 National Health Service Act, 1946. The following table indicates the attendances at local clinics during 1950, 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. 31 ATTENDANCES AT LOCAL CLINICS DURING 1950. Ante-Natal Clinics : Friday Hill sessions 51 Attendances 562 49, The Ridgeway sessions 51 Attendances 489 Marmion Avenue sessions 51 Attendances 663 Infants' & Toddlers' Clinics : Friday Hill sessions 51 Attendances (including 69 new infants) 2,049 Sewardstone Road sessions 28 Attendances (including 87 new infants) 1,043 Buxton Road sessions 51 Attendances (including 93 new infants) 2,782 Church Hall, The Ridgeway sessions 51 Attendances 1,089 Marmion Avenue sessions— Infants 102 Attendances 4,056 (including 259 new infants) Attendances 1,121 Toddlers 51 Minor Ailment & School Clinics : Friday Hill House sessions 47 Attendances 906 Marmion Avenue sessions 47 Attendances 968 Women's Welfare Clinics : 49, The Ridgeway sessions 12 Attendances 118 Friday Hill House sessions 12 Attendances 130 Orthopaedic Clinics : Marmion Avenue sessions 109 Attendances 1,368 Friday Hill House sessions 7 Attendances 158 Eye Clinic : Marmion Avenue sessions 43 Attendances 674 Dental Clinic : Marmion Avenue sessions 126 Attendances 1,393 Speech Therapy Clinic : Attendances 1,020 Marmion Avenue sessions 170 Health Visiting. The total number of visits paid by Health Visitors during the year was 8,153. 32 33 NOTIFIABLE DISEASES (after correction) Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Dysentery Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Meningococcal Infection Acute Poliomyelitis Acute Polio-encephalitis Typhoid Fever Food Poisoning Pulmonary Other Forms 1945 62 4 9 210 94 33 9 38 3 1 88 2 — - — 3 1946 74 — 9 212 88 45 5 13 2 2 103 3 — — — 1 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 — 4 1950 62 1 11 267 134 36 4 5 2 — 29 3 6 - 1 7 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 3 5 13 34 5 1 — — — — 62 Diphtheria - - - - - 1 - - - - - - 1 Erysipelas — — — — — — — 1 - 4 5 1 11 Measles 6 20 24 36 25 154 1 — 1 — — — 267 Whooping Cough 13 15 13 13 31 44 1 — 2 2 — — 134 Puerperal Pyrexia - - - - - - - - 2 - - - 2 Pneumonia 1 — — 1 — 6 1 1 6 3 6 4 29 Dysentery — 1 — — — 1 — 1 1 1 — — 5 Acute Poliomyelitis - — 1 — 1 2 — 1 1 - — — 6 Meningococcal Infection 1 - - - — 1 —- — — 1 — — 3 Typhoid Fever - - - - - - - - - 1 — — 1 Food Poisoning - - - - - - 1 - - 1 4 1 7 ANALYSIS OF NOTIFIABLE DISEASES (after correction) Diseases Total cases Total admitted to hospital Scarlet Fever 62 40 Diphtheria 1 1 Erysipelas 11 3 Puerperal Pyrexia 2 2 Pneumonia 29 8 Measles 267 3 Whooping Cough 134 5 Dysentery 5 1 Acute Poliomyelitis 6 6 Meningococcal Infection 3 3 Typhoid Fever 1 1 Food Poisoning 7 - 34 35 in the year 1956 based on Quarterly Returns). England and Wales 126 County Boroughs and Great Towns (including London) 148 Smeller Towns (Resident Pop 25,000-50,000 at 1931 Census) London Administratis County Chingford England and Wales 126 County Boroughs and Great Towns (including London) 148 Smaller Towns (Resident Pop. 25,000-50,000 at 1931 Census] London Administrative County Chingford Births: Rates per 1,000 Home Population:— Deaths: Rates per 1,000 Live Births: — Live births 15.8 17.6 16.7 17.8 14.2 Still births 0.37 0.45 0.38 0.36 0.26 All causes under 1 year of age 29.8 (a) 33.8 29.4 26.3 11.6 Deaths: All Causes 11.6 12.3 11.6 11.8 7.7 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 - Enteritis and Diarrhœa under 2 years of age 1.9 2.2 1.6 1.0 — Whooping Cough 0.01 0.01 0.01 0.01 — Diphtheria 0.00 0.00 0.00 0.00 — Tuberculosis 0.36 0.42 0.33 0.39 0.26 Influenza 0.10 0.09 0.10 0.07 0.04 Rates per 1,000 Total (Live and Still) Births Smallpox - - - - - Notifications (Corrected): Acute Poliomyelitis (including Polioencephalitis) 0.02 0.02 0.02 0.01 - Puerperal Fever and Pyrexia 5.81 7.43 4.33 6.03 2.83 Pneumonia 0.46 0.49 0.45 0.48 0.18 Notifications (Corrected): Typhoid Fever 0.00 0.00 0.00 0.01 0.02 Paratyphoid Fever 0.01 0.01 0.01 0.01 Maternal Mortality in England and Wales: Meningococcal infection 0.03 0.03 0.02 0.03 0.06 Scarlet Fever 1.50 1.56 1.61 1.23 1.27 International List No. and Cause Rates per 1,000 Total (Live and Still) Births Rates per million women aged 15-44 Chingford Whooping Cough 3.60 3.97 3.15 3.21 2.74 Diphtheria 0.02 0.03 0.02 0.03 0.02 Erysipelas 0.17 0.19 0.16 0.17 0.22 Smallpox 0.00 0.00 — — — 651. Abortion with sepsis 0.09 7 - Measles 8.39 8.76 8.36 6.57 5.47 Pneumonia 0.70 0.77 0.61 0.50 0.59 650, 652. Other abortion 0.05 4 - Acute Poliomyelitis (including Polioencephalitis) 640-649, 670-678. Complication of pregnancy and delivery 0.54 - 1.41 681. Sepsis of childbirth and the puerperium 0.03 - - Paralytic 0.13 0.12 0.11 0.08 0.06 Non-paralytic 0.05 0.05 0.06 0.05 0.06 680, 682-689. Other complications of the puerperium 0.15 - Food poisoning 0.17 0.16 0.14 0.25 0.14 (a) Per 1,000 related live-births.