AC 4411(1) CHINGORD CHIN16 BOROUGH OF CHINGFORD ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH Including the Report of the CHIEF SANITARY INSPECTOR FOR THE YEAR 1951 BOROUGH of CHINGFORD ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1951 1. BOROUGH OF CHINGFORD Committee: June, 1951 - May, 1952 PUBLIC HEALTH COMMITTEE Chairman: Councillor Dr.Joan Wagstaff Vice-Chairman: Councillor V.D. Hall Members: Councillor A.T.H. Austin " W.J. Bowstead " W.J. Buckley " F.H. Holder " R.C. Lacey " G.E. Moore " T.H. Treadwell The Mayor, Councillor J.W.R. Nation, J.P. (ex-officio) Meeting: Second Monday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1951) 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) Cleansing Superintendent, Inspector under the Shops Acts and Petroleum Acts. District Sanitary Inspectors: R.W. BASHFORD, M.S.I.A., (b) (c) (f) K.A. CHESTER, M.R.San, I., M.S.I.A. (b) (c) (e) (f) (to 4.11.51) C.G. HOWELL, A.R. San.I.. M.S.I.A. (b) (c) (e) (f) D.R. CHANIN, M.S.I.A. (b) (from 10.12.51) Senior Clerks Miss V,M. Pettit Clerks: A.H. Gillies Miss I.A. Folkes Miss 0. Hurrell, Certificate of the Royal Sanitary Institute as Sanitary Inspector. 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 (b)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, (f) Diploma of the Royal Institute of Public Health and Hygiene. 2. ANNUAL REPORT FOR THE YEAR 1951 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 1951 upon the health and sanitary circumstances of the Borough. The population of the Borough was 48,330, the figure recorded at the time of the census in April, 1951, The following points in regard to vital statistics are of interest; the birth rate showed a further decline to 12,2 per thousand, the lowest figure ever recorded for the district. The death rate at 8,7 per thousand was slightly higher than the previous year. The infant mortality rate, i.e. the number of deaths of infants under one year of age per thousand live births, rose sharply to 23.7. I pointed out in my report for 1950 that the figure for that year, viz: 11,6 was a record low figure for the district. In any one year there has always been a hard-core of infant deaths due to such causes as prematurity, congenital deformities and failure to survive the stresses and strains of birth; the number of. such deaths will vary from year to year and will naturally cause considerable fluctuation in the infant mortality rate. The table on page 37 illustrates this point. In the matter of infectious diseases, the year saw a great increase in the incidence of measles and whooping cough in the Borough. This rise in incidence was also general throughout the whole country. I am very pleased to be able to report that there were no cases of diphtheria nor poliomyelitis. An outbreak of dysentery occurred in the early part of the year, in which one of the Day Nurseries was involved in addition to cases occurring among the general public: the administrative measures which suppressed the outbreak in the Nursery and allowed it to remain open are described in the text. The problem of the care of the aged continues to cause considerable anxiety. Several persons who were aged, infirm and unable to take care of themselves were referred to me by general practitioners and others during the year. I dislike having to take action under Section 47 of the National Assistance Act, 1948, in such cases: this section empowers me to obtain a court order to have them compulsorily removed to hospital or other place where they will receive care and 3. attention: so far, I have not had to invoke these powers as I was able to persuade the more urgent cases to enter hospital voluntarily. In the other instances the provision of a Home Help met the situation as a temporary measure. During the year several lectures and film shows dealing with Clean Food were given to organised associations. I am much indebted to the Chairman and Members of the Health Committee for their support and co-operation during the year and to the Area Medical Officer for the statistical information in regard to those services provided by the Essex County Council. To the Chief Sanitary Inspector, Mr. J.F. Rogers, and the Staff of the Health Department I tender my sincere thanks 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, 1952. 4. SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,868 acres Population - Registrar - General's estimate (as at 30.6.51) and Census 1951 48,330 Number of inhabited houses and flats (as at 31.12.5l) 13,414 Rateable value on April 1st, 1951 377,907 Product of a penny rate, year ending 31.3.51 £1,533 VITAL STATISTICS M. F. Live Births Total 278 312 Birth Rate per 1,000 of estimated resident populations Legitimate 276 307 Illegitimate 2 5 12.2 Stillbirths Total 5 4 Rate per 1,000 total (live and still) births: Legitimate 5 4 Illegitimate - - 15.0 Deaths 214 209 Crude Death Rate per 1,000 of estimated resident populations 8,7 Deaths from Puerperal Sepsis 0 " " other puerperal causes 0 Death Rate of Infants under one year of ages- All infants per 1,000 live births 23.7 Legitimate infants per 1,000 legitimate live births 22.3 Deaths from Cancer (all ages) 81 " " Measles (all ages) 0 " Whooping Cough (all ages) 2 5. TABLE OF BIRTH AND DEATH RATES Year Population Births Rate per 1,000 population Rate per 1,000 population Infant Mortality Deaths Deaths Rate per 1,000 live births 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 1951 48,330 (Census) 590 12.2 423 8.7 14 23.7 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 Practitioners468 Number of specimens examined for the Chingford Isolation Hospital 2 (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. (See ;next *(page Number of Midwives or Home Nurse/Midwives - 5 Number of Home Nurses - 3 Number of cases attended by Midwives as:- (a) Midwives - 144 (b) Maternity Nurses - 45 189 Number of visits paid by Home Nurses to:- (a) Pre-school children - 100 (b) School children - 247 (c) Adults - 12,435 - 12782 7. (d) Health Visiting The total number of visits paid by the Health Visitors during the year was 7,635. (e) Registered Nursing Homes There were three registered Nursing Homes in the district, two receiving maternity and medical patients, and the third Home receiving medical cases only (now closed). The Homes were inspected regularly and found to be conducted in a satisfactory manner. (f) Clinics and Treatment Centres See table of clinics on pages 9 & 10. Child Welfare Centres Attendances of children - under 1 year of age 7871 between 1 and 5 years 2940 Total 10811 Ante-Natal Clinics Ante-natal attendances 1453 Post-natal attendances 89 Total 1542 Women's Welfare Clinic Gynaecological 16 Birth control - 1st visits 63 Birth control - re-visits 197 Total 276 (g) 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 or * Miss E.A. Clarke, 69, Connaught Avenue, E.4. (Silverthorn 180l) Mrs. G.E.M. Witter, 87, Friday Hill, 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) 8 (g) Hospitals (Contd.) the Honey Lane 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. (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. Number of attendances of childreni:- Babies - 1128 Tweenies - 7945 Toddlers - 11220 Total - 20,293 (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. The total number of hours help supplied during the year was 31,083. (j) Chiropody Facilities A Chiropody Clinic for persons of pensionable age only is held on Thursday afternoons at the Combined Treatment Centre, Marmion Avenue. Appointments to attend this clinic must be made through the Area Medical Officer at Woodford, In addition to the above facilities, seven persons hold licences from the Essex County Council to carry on private practice as chiropodists within the Borough. These premises are inspected annually. 9. LOCAL CLINICS AND TREATMENT CENTRES, 1952 Clinic Where held When held Diphtheria Immunisation Clinics Primary Hall, Buxton Road, N. Chingford Tuesdays, 2 p.m. Mission Hall, Sewardstone Road, E.4. 2nd, 4th & 5th Weds, at 2 p.m. County Council Clinic, Marmion Avenue, E.4. Thursdays, 11.30 a.m. County Council Clinic, Hatch Lane, E.4. Church Hall, The Ridgeway, N. Chingford. 1st Wed. in every month at 3 p.m. Wednesdays, 10 a.m. Ante-Natal Clinics Co-ynty Council Clinic, Hatch Lane, E.4. (Tuesdays, 2-4 p.m. (Fridays, 2-4 p.m. County Council Clinic Marmion Avenue, E.4. Wednesdays, 9.30 a.m. Child Welfare Clinics County Council Clinic, Hatch Lane, E.4. Wednesdays, 2-4 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 Road, No Chingford. Tuesdays, 2 - 4 P.m. Mission Hall, Sewardstone Road, E.4. 2nd, 4th & 5th Weds. 2 - 4 p.m. Church Hall, The Ridgeway, N,Chingford Wednesdays, 9.30 a.m. 11,45 a.m. Toddlers CIinic 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, 10 a.m. 12 noon. County Council Clinic, Hatch Lane, E.4. Mondays, 2-4 P.m. Orthopaedic Clinics County Council Clinic, Marmion Avenue, E.4. Monday afternoons. 1st, 3rd, 4th & 5th Thursdays, all day, by appointment only. Dental Clinic County Council Clinic, Marmion Avenue, E.4. Wednesdays, 9.45 a.m. (inspection only) or by appointment through schools. 10. LOCAL CLINICS AND TREATMENT CENTRES, 1952 (CONTD.) Clinic Where held When held Eye Clinic County Council Clinic, Marmion Avenue, E.4. Friday afternoons, by appointment only. Women's Welfare Clinics County Council Clinic, Marmion Avenue, E.4. 4th Friday in every month at 10.15 a.m. County Council Clinic, Hatch Lane, E.4. 1st Friday in every month 10 a.m. to 12 noon. Chest Clinic High Street, Walthamstow, E.17 New cases: Adults, Weds, 10 a.m. 12 noon. New cases: Children, Fridays, 10 a.m. to 12 noon. Foot Clinic (old age pensioners only) County Council Clinic, Marmion Avenue, E.4. Thursdays, 2 p.m. (by appointment only) GENERAL INFORMATION Registrar of Births, Deaths and Marriages: Mr. C.W. BARRETT, 19? Algers Road, Loughton. (Tel: Loughton 576) Office: Town Hall, Chingford, E.4. (Tel: Silverthorn 3944) Mondays and Thursdays, 2.30 p.m. to 4.30 p.in. Wednesdays and Saturdays, 9 a.m. to 11 a.m. Duly Authorised Officer: Mr. E. McCRAVE, 73, Dale View Crescent, E.4. (Tel: Silverthorn 4363) Office : E.C.C. Offices, West Avenue, Walthanstow, E,17 (Tel: Keystone 4440) Mondays to Fridays, 9 a,m. to 5.30 p.n. Saturdays, 9 a.m. to 12.30 p.m. Social Welfare Officer: 35, Wanstead Place, E.ll. (Tel: Wanstead 0031) National Assistance Board: Wanstead Area Office, 29, Cambridge Park, Wanstead, E.ll. (Tel: Wanstead 7721) 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, N. Chingford, E.4. (Tel: Silverthorn 2294) Office Hours: Mondays to Fridays, 10 a.m. to 4 p.m. Saturdays, 9 a.m. to 12 noon. 11. 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. No samples of drinking water were submitted for bacterial examination during the year. Rivers and Streams Fifteen visits were paid during the year in connection with the pollution of water courses, and six visits were largely in reference to minor pollutions of the Council's surface water sewers due to incorrect connections of sanitary fittings. In all instances the necessary adjustments were made and pollutions prevented. Public Cleansing A weekly collection of refuse and salvage was maintained and the total weight of refuse disposed of at the Works was 11,584 tons. This was a slight decrease over the amount collected in the previous year, namely 11,849 tons. The fifteenth census of the population of England and Wales was taken on the 8th April, 1951 and the results which were published in June of that year showed that the population of the Borough was 48,330. This figure was somewhat below the Registrar General's estimated figure for the previous year, namely 48,770. The year under review was a remarkable one in relation to the collection and disposal of salvage. Income was at such a high level that not only were disposal costs, including loan charges, completely covered but there remained a credit balance on the refuse disposal service account of £865. In the history of the Borough this has only occurred once beforefor the year ended March, 1943 when there was a credit balance of £276. Whilst it is only right to report that economic conditions favoured the relatively easy disposal of salvage at high prices, much credit is due to the staff, both in the refuse collection and disposal services, for the zeal and enthusiasm displayed during this year. The net cost per ton for the collection of refuse was 23s.10d as against 19s.5d for the year ended March 1951 and 18s.4d for the year ended March 1950. Although unit costs are higher in respect to this service this is due to certain wage awards and a considerably higher amount of commission paid, but it should be appreciated that the income from the sale of salvaged articles is credited to the disposal service and the beneficial results of the high salvage returns are reflected in the net expenditure for the whole service. No additional staff were employed in the collection of house refuse and salvage. 12. Net expenditure for the collection and disposal of refuse and salvage, including loan charges, was £12,963 or 22s.5d per ten as against £16,511 or 27s,10d per ton for the previous year. The total income from all sources was £14,144 as compared with £7,009 for the previous year. Once again the largest income was received for the sale of newsprint and mixed waste papers and in the light of conditions prevailing in the year 1952 it is doubtful whether the high prices paid by the Mills for this class of material during the year under review were really justified. One innovation which proved highly successful was the sorting out and the sale of woollens; just over 3 tons of woollens were sold at £300 per ton and the experiment was fully justified. The following extract from a report by the Borough Treasurer shows the percentage increases in weight and'value in the year 1951/52 over 1950/51 in the main sources of salvage:- Weight Value Paper 2% 124% Ferrous Metals 14% 292% Non-Ferrous Metals 31% 61% Bottles and Jars 155% 172% Cullet 17% 17% Textiles 36% 216% The fleet of refuse collection freighters was maintained in good condition throughout the year; two new Harrier vehicles were acquired and the two Fordson freighters became redundant. The fleet comprises six Karrier 10 cubic yard side-loading vehicles and one 10 cubic yard Shelvoke and Drewry freighter. Street cleansing was maintained under difficulties during the year. The efficiency of the Lewin Road Sweeper was impaired during the year not only by reason of staff changes and absences through sickness but also by reason of the fact that the machine itself had to undergo a.major overhaul. It is now reasonably clear that any form of mechanical sweeper can only be an adjunct to the normal manual service provided by street orderlies. Further, any scheme is prone to disturbance which has to rely on only one machine being maintained in a constant state of efficiency. Nevertheless, in spite of the difficulties mentioned, the general condition of the streets was satisfactory. 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. The Council had under consideration during the year the provision of a new convenience near the Royal Forest Hotel in order to adequately cater for the influx of visitors at holiday times, and also an additional sanitary convenience at Chingford Hatch to serve the London County Council Estate. 13. HOUSE AND TRADE REFUSE Table showing costs for the year ending 31st March, 1952 1 Collection 11 Disposal Total Incldg, Depreciation or Loan Charges (see note a) Excldg. Loan Charges etc. Incldg. Depreciation or Loan Charges (see note a) Excldg. Depreciation or Loan Charges (see note a) Incldg, Depreciation or Loan Charges (see note a) Excldg, Loan Charges etc. (1) (2) (3) (4) (5) (6) (7) (8) Revenue Account £ £ £ £ £ £ A Gross Expenditure 14193 14193 12914 1180 4 27107 25997 B Gross Income 365 365 13779 13779 14144 14144 C Net Cost 13828 13828 - - 12963 11853 D Net Income - 865 1975 - — s. d s. d. s. d. s. d s. d s. d E Gross Expenditure per ton 24. 6 24. 6 22. 4 20. 4 46.10 44.10 F Gross Income per ton 8 8 23. 9 9 24. 5 24. 5 G Net Cost per ton 23.10 23.10 - 22. 5 20. 5 H. Net Income per ton - - 1. 5 3. 5 - — £ £ £ £ £ £ I. Net Cost per 1000 population 286 28 6 - - 268 245 J. Net Income per 1000 population - - 18 41 - _ K. Net Cost per 1000 houses 1031 1031 .- _ 967 884 L. Net Income per 1000 houses - - 64 147 - - 1. Total Refuse Collected (in tons) 11584 2. Population (Mid year) 48330 3. Weight per 1000 population per day (in cwts) 13.1 4. Number of occupied houses and premises (31.3.52) 13405 Note (a) Loan Charges include interest on loans; repayment of loans; revenue contributions to capital outlay and capital receipts. 14. ANALYSIS OF INCOME FOR THE YEAR ENDED 31st MARCH, 1952 Year ended 31.3.51 £. s. d £. s. d £. s. d £. s. d. 1 - Sale of Salvaged Articles: Metals: 205. 15. 3 Aluminium 439. 17. 10 125. 11. 10 Copper 185. 11. 11 113. 18. 8 Iron 174. 5. 9 41. 17. 4 Lead 112. 10. 4 5. 2. 4 Battery Lead 8. 6. 8 125. 3. 0 Brass 247. 6. 8 15. 14. 2 Mixed Metals 22. 0. 6 Unbaled Scrap 70. 8. 11 156. 9. 3 Tins 453. 6. 8 20. 4. 4 Pewter 20. 17. 5 9. 14. 2 Zinc 56. 15. 0 1769. 7. 2 18. 0. 5 Bones 44. 10. 10 320. 2. 5 Broken White Glass 359. 14. 8 18. 2. 6 Amber Cullet 36. 18. 10 229. 5. 3 Bottles and Jars 622. 14. 0 1019. 7. 6 584. 17. 5 Rags 1037. 7. 6 102. 12. 9 Carpets and Sacking 203. 14. 6 22. 7. 3 Flock Mattresses 49. 11. 3 - Woollen Stockings 955. 8. 11 2246. 2. 2 3696. 0. 4 Newspapers and Mixed Waste Paper 8375. 19. 10 506. 3. 4 Pig Food (Kitchen Waste) Unsound Food (Disposal) 3. 0. 0 8. 3. 0 Rubber 11. 11. 4 - Boots and Shoes 9. 6. 0 13479. 4. 10 2 - Miscellaneous Receipts and Charges: - Sale of Jubilee Trucks 20. 0. 0 — Sale of Kitchen Waste Bins 10. 0. 6 - Fire Claim Dec. 1951 5. 13. 0 5. 0. 0 Other items 2. 9. 0 72. 14. 0 3 - Weighbridge Fees 50. 11. 0 4 - Rents: 200. 0. 0 Foundry 200. 0. 0 20. 0. 0 Proportion of Allotment Rents 20. 0. 0 3. 6 Other Rents 3. 6 5 - Refuse Collection Charges 268 8. 0 Greengrocers and Butchers 2 62. 16. 0 95. 12. 0 Others 92. 12. 9 £7009. 3. 0 £14,143. 10. 7 ■ SANITARY INSPECTION OF THE AREA Inspections on Complaint The number of complaints received at the office and recorded in the register was 413, as compared with 330 in the previous year and 358 for the year 1949. The total inspections made on complaint was 466 and the number of defects or nuisances revealed was 384. 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 Defects 68 Blocked Sewers 178 Defective Sewers 5 Defective Water Fittings 9 Defective Water Waste Preventers 2 Blocked Yard and W.C.. Drains 35 Defective Drainage 39 Unsound Food 4 Absence of and Defective Dustbins 5 Offensive Accumulations 3 Nuisance from Flies, Cockroaches etc. 11 Nuisance from Smoke, Dust, Odours etc. 12 Animals kept so as to be a Nuisance 3 Overcrowding 3 Defective Yard Paving 2 Burning of Rubbish 1 Unsound Food 4 384 16. 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 7,250 as compared with 6,852 in the previous year; the defects dealt with numbered 919 as compared with 947 in 1950. TABLE 2. Visits Paid Nuisances or Defects found and dealt with Housing Act, 1936 Inspections 55 339 Re-inspections re Notices served 779 Re overcrowding 12 On Complaint 466 384 Infectious Diseases 90 Retail Pood Premises Meat 116 Fish 43 Fried Fish 19 General Provisions 150 Other Food Shops 130 41 Restaurant and Other Food paring Premises 156 Ice Cream Premises 21 Food Sampling Ice Cream 70 Milk 13 Other Foods 94 Drugs 8 Factories 201 15 Bakehouses 40 Dairies 2 Pigstyes 10 Re-visits re Notices served (p.H.Act) 690 Other re-visits 172 Rodent Control 2513 118 Shops Acts (Sanitary Conditions) 257 10 (Hours of Closing) 162 (Young Persons Employment) 126 Council Houses 129 Collection and Disposal of Refuse and Salvage 153 Carried Forward 6677 907 17. TABLE 2 (Contd.) Visits Paid Nuisance or Defects found and dealt with Brought Forward 6677 907 Schools 39 12 Hairdressers' Premises 41 Swimming Pool 5 Miscellaneous Visits 204 Places of Entertainment 5 Public Conveniences 32 Petroleum Acts 30 Outworkers 134 Smoke Observations 18 Pollution of Rivers and Watercourses 15 Street Food Vendors 3 Movable Dwellings 7 Merchandise Marks Act 40 7250 919 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 58 Roofs, Spoutings and Eavesgutters repaired or renewed 107 External walls repaired 25 Wall and ceiling Plaster repaired 59 Floor Repaired. 17 Stairs and Stair Rails Repaired 2 Windows Repaired 23 Woodwork of Doors and Sashcords Glazing and Sills repaired 31 Stoves and Firegrates repaired or renewed 12 Flues and Chimney Stacks repaired or rebuilt. 8 Dampness remedied 27 Yard Surfaces repaired or relaid 7 Offensive Accumulations removed 5 Nuisances from Animals abated 1 Carried Forward 382 18. TABLE 3 (Contd.) Brought Forward 382 Verminous Premises disinfested 13 Drains Repaired or Reconstructed 13 Drains cleansed 13 Drains repaired 17 Drains - New Inspection Chambers 10 New Sinks Provided 1 Sink Waste Pipes - Trapped or Renewed 11 Smoke Nuisances 2 Soil and Ventilating Pipes repaired or renewed 8 Water Closets repaired or reconstructed 10 Water Closets cleansed and limewashed 3 Water Closet Pedestals fixed 11 Water Closet Flushing Cisterns repaired or renewed 13 Water Storage Tanks and Piping repaired or renewed 11 Sufficient Water Supply Provided 5 Hot Water Systems repaired 3 Dustbins provided 14 Rat infestations 118 Sewers cleansed 178 Sewers repaired 14 Food Premises: Limewashed and cleansed 15 Improvements 26 Factories and Workplaces: Limewashed and cleansed 7 Lighting and ventilation improved 5 2 Separate accommodation for sexes 1 Shops: Additional Sanitary accommodation 3 Washing facilities provided 1 Lighting and Heating improved 6 Places of Entertainment: Repairs to Sanitary Accommodation 2 Cleansing of Sanitary Accommodation 1 919 TABLE 4. Letters sent out and notices served in connection with the work of the Health Department. Letters 1585 Public Health Acts Preliminary Notices 64 Statutory Notices 2 Housing Acts: Preliminary Notices 44 Statutory Notices 10 19. Nuisance - Effluvia Caused by Manufacturing Processes. During the year under review a considerable amount of time and energy was expended by officers of the Department in relation to the emission of effluvia from a factory in the Borough. The emissions were such as to be considered by the Public Health Committee a nuisance to the inhabitants of the neighbourhood and formal notice was served on the Company to abate the nuisance under Section 93 of the Public Health Act, 1936. The factory premises from which the effluvia emanated were used for the manufacture of a patent constructional unit, either in steel or in alloy, and in the case of the former material protection by painting became necessary in order to prevent oxidization. This protection was achieved by submitting the material to three initial processes following which the slotted angle or shelving was dipped in paint which contained a high proportion of driers. The subsequent processes involved the drying and stoving of the finished product. The proprietors of the factory unsuccessfully made many efforts to abate the nuisance and in addition they stated that new factory premises outside the area of the Borough had been acquired and that ultimately the offending processes would be removed entirely. At the end of the year 1951 the Council was satisfied that the nuisance still continued and authority was given to institute proceedings. At this stage the Council called in the services of a Consultant Chemist and after investigation of the processes and analysis of the jaint he reported that this had a methyl-methacrylate thermoplastic base. When heated this paint base would give off a considerable amount of acrolein which has a most penetrating and disagreeable odour. In addition there was also the possible discharge into the atmosphere of xylene, trichlorethylene and other substances. The case came before the local Magistrates in January, 1952 when Defending Counsel informed the Bench they had called in the services of a firm of noted Chemical Engineers and that they were at that time experimenting with one of three processes which had been recommended. By agreement between the two parties and with the approval of the Magistrates the hearing was adjourned for three months. Before the case came up for hearing again, however, the firm had removed the painting processes to a factory outside the Borough boundary, the painting tanks were dismantled and the nuisance thereby abated in the best possible way to the Council and to those residents who had found cause to complain. 20. Shops Act, 1950 The inspection of all shops was completed during the year under review. A total of 545 visits was paid and generally conditions were found to be satisfactory. Smoke Abatement Nine observations were taken of a chimney stack, particularly with regard to grit emission, and subsequently a water-trap type grit arrestor was installed. 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 19th May and closed on the 9th September, 1951. Once again vagaries of the weather detracted from the full use of this very delightful open-air Swimming Pool. The total attendance throughout the season numbered 112,559, the highest attendance being on the 22nd July when 4,901 persons were present. Samples of water were taken from the Pool during the months of May, June, July and August, five samples in all, and the results in each case were to the effect that the water was of a 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. Co-operation was continued with the School Medical Officer and reports were forwarded to that Officer following quarterly visits paid to the canteens attached to all Schools. During the year the rate of progress of the execution of necessary works and improvements was expedited. 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. Bakehouses Forty visits were paid to the eight bakehouses in the district and generally they were maintained in a satisfactory condition. In another section of this report, dealing with action taken under the Food and Drugs Act, 1938, six cases involved food which had been prepared in bakehouses, but only in one instance were the premises situated within the Borough. Factories Act, 1937 One hundred and eighty-six visits were paid to Factories, and in 8 instances action was taken to secure improvements in cleanliness and ventilation of sanitary accommodation. 21. Inspections of Factories and Other Premises 1. - Inspections for Purposes of Provisions as to Health (including Inspections made by Sanitary Inspector). Premises plumber on jRegister f 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 46 178 1 3 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding Outworkers' Premises) 3 8 - - Total 49 186 3 - 2. - Cases In Which Defects Were Found. Particulars Number of cases in which defects found No. of Cases in which Prosecutions 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) 7 7 - - - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) ■ - - - - Inadequate ventilation (S.4) 5 5 - - - Ineffective drainage of floors (S,6) • - - - - - Sanitary Conveniences (S.7) (a) Insufficient 2 2 - - - (b) Unsuitable or defective - - - - - (c) Not separate for sexes 1 1 - - - Other offences against the Act (not including offences relating to Outwork) 4 4 - - - Total 19 19 - - - 22. NUMBER AND TRADE OF OUTWORKERS NOTIFIED DURING. 1951 Wearing Apparel 72 Knitwear 32 Footwear 3 Brush-making 4 Handbags 13 Leather Goods 2 Artificial Flowers 1 Box-making 3 Novelties 7 Trimmings 2 Toys 1 Paper Bags 1 OUTWORKERS WERE NOTIFIED FROM THE FOLLOWING AREAS; Ilford 1 Stepney 1 St.Pancras 3 Stoke Newington 8 Leyton 50 Islington 16 Hornchurch 1 Westminster 4 London Corporation 2 Poplar 1 Croydon 2 Walthamstow 5 Hackney 13 Shoreditch 6 Tottenham 6 Finsbury 5 Wood Green 1 West Ham 3 East Ham 1 Enfield 4 Wanstead and Woodford 2 Chigwell 2 Lambeth 4 Bethnal Green 7 Prevention of Damage by Pests Act, 1949 23. A full-time Rodent Operative is employed for rodent infestation work and whilst there was no evidence of major infestations in the town, 2,513 visits were paid to deal with minor infestations at private and business premises. The fifth and sixth maintenance treatments were carried out in March and September respectively. In March 334 manholes were baited and of these 36.5% showed complete or partial takes; 337 manholes were baited in September,,48.1% of which showed complete or partial takes, SECTION D, HOUSING STATISTICS FOR THE YEAR 1951 1. Number of Houses Erected during the Year, (1) By the L.A. (permanent) traditional (including flats) 120 (2) Cost of works re-buildings by local builders 6 (3) By private enterprise 17 151 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) 752 (b) Number of inspections, made for the purpose 1934 (2) (a) Number of dwelling-houses cluded under sub-head (l) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and'1932 55 (b) Number of inspections made for the purpose 834 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 1 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 134* * Note: This figure includes all houses where defects were found, including those which were inspected and recorded under the Housing Act, 1936, 3. Remedy of Defects During the Year Without Service of Formal Notices : Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 63 24. 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 16 (b) By Local Authority in default of owners 0 B. Proceedings under Sections 11 and 13 of the Housing Act, 1936: (1) Number of Demolition Orders served 1 (2) Number of dwelling-houses demolished 1 C. Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 2 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 3 (b) By Local Authority 0 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. Seven samples of milk were analysed during the year and all were certified to be genuine. 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: 3 dealers' licences to sell milk as Pasteurised. 5 dealers' licences to sell milk as Sterilised. 3 supplementary licences to sell milk as Sterilised. 2 supplementary licences to sell milk as Pasteurised. 3 dealers' licences to sell milk as Tuberculin Tested. 1 supplementary licence to sell milk as Tuberculin Tested, Food and Drugs Act, 1938 Food and Drugs Authority The Council is the Food and Drugs Authority for the district and during the year samples approximating in number to two per thousand of the population were taken and submitted to the joint Public Analysts, Public Analyst 25- 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.J, continued as joint Public Analysts for the area. Samples Subnitted for Analysis One hundred and nineteen samples of foods and drugs were submitted for analysis, twenty-seven formal and ninety-two informal and it will be seen by the following table that a reasonably wide field was covered The Public Analysts were consulted from time to time as to interpretation of analytical results and generally with regard to the type of samples submitted. The table shows that in seven instances samples were adversely reported upon and in one case proceedings were instituted as to the mouldy condition of meat patties. Of the seventeen samples of sausages analysed one informal sample was certified to be 4.6 deficient in meat content. A follow-up formal sample was taken which proved to be genuine. One.informal sample of dried mixed herbs was certified to contain sand highly in excess of that ordinarily found in that product, indicating that the herbs had been insufficiently cleaned. A formal sample from the same source gave a genuine result. One sample of medicated mint tablets was analysed following a complaint made to the office. The Public Analyst reported that the tablets had a calcium carbonate base and as the mints were described as "medicated" the use of this base was justified, but this active constituent was not stated on the label. The matter was taken up with the manufacturers who expressed surpise that these mints were still being sold as it was more than two years since the manufacture was discontinued. One local trader sought advice of the Department with regard to a small stock of red cherries in sugar syrup and on the sample being submitted for analysis the Analyst certified that the sulphur dioxide preparation in the cherries was breaking down yielding sulphur compounds, thu3 producing discolouration of the cherries and tin. In view of this objectionable condition the Analyst recommended that the cherries should not be used for human consumption and the trader was notified accordingly. One informal sample of malt extract with cod-liver oil, which was unused owing to the presence of what appeared to be a compacted mould growth, was procured from an Essex County Council Clinic. Microscopic examination by the Public Analyst, however, showed that the top layer consisted not of mould growth but of a crystallised mass produced by drying out of the preparation. The oil in the sample was not rancid but having regard to the obvious effect of storage of the contents the Analyst reported that it was no longer suitable for this particular purpose. The stocks were subsequently withdrawn. 26. 26. Pood and Drugs Act, 1938 Samples Taken for Analysis During the Year, 1951 Article . Number Examined Result of AnaLysis Formal Informal Total Genuine Non-genuine Milk 7 - 7 7 - Ice Cream 1 8 9 9 - Cream, 2 - 2 2 - Sausages 7 10 17 16 1 Malt Vinegar 1 2 3 3 - Non-brewed condiment 1 1 2 2 - Dried Herbs 1 8 9 8 1 Medicated Mint Tablets - 1 1 - 1 Mixed Spi.ee - 2 2 2 - Tomato Soup - 1 1 1 - Palm Kernel Oil - 1 1 1 - Baking Powder - 1 1 - 1 Gin — 1 1 1 - Whisky 1 1 2 2 - Rum 1 — 1 1 - Dessert Powder - 1 1 1 Flour Mixture — 2 2 2 - Fish Paste - 7 7 7 - Cooking Fat - 1 1 1 - Tea - 2 2 2 - Coffee & Chicory I 5 4 4 - Pastry Mix 1 1 1 - Custard Powder — 2 2 2 - Meat Patty - 2 2 - 2 Jam 2 3 5 5 - Fruit Squash - 1 1 1 - Salad Cream - 2 2 2 - Table Jelly 1 1 2 2 - Mustard - 1 1 1 - Flour - 2 2 2 - Saccharin Tablets - 1 1 1 - Beans in Tomato Sauce - 1 1 1 - Horseradish Cream - 1 1 1 - Mincemeat - 1 1 - Cherries in Syrup 1 1 - 1 Gelatine — 1 1 1 - Olive Oil - 1 1 1 - Cake Mixture - 3 3 3 - Bi-carbonate Soda - 1 1 1 - Tapioca - 1 1 1 - Ground Almonds - 1 1 1 Curry Powder - 1 1 1 - Pepper and Pepper flavoured: compound 2 2 2 - Malt Extract - 1 1 1 - Household Drugs Zinc Ointment - 1 1 1 - Liquid Paraffin - 1 1 1 - Boracic Powder - 1 1 1 — Eucalyptus Oil - 1 1 1 - Sulphur Ointment - 1 1 1 - Glycerine - 1 1 1 - Epsom Salts - 1 1 1 - Tartaric Acid - 1 1 1 TOTALS:- 27 92 119 112 7 27. Legal Proceedings Eight cases were taken before the Magistrates under Section 9 of the Act, six in relation to extraneous matters found in foodstuffs and two cases in connection with the mouldy condition of meat patties and cream buns Two cases were dismissed, one ..relating to a small piece of wire in a boiled sweet and in this instance-the Magistrates felt that every care had been taken by the defendant to secure a wholesome product. In the case of the mouldy condition of the meat patties the Magistrates were not satisfied with certain conflicting evidence as to the actual purchase. Offence Result. Cigarette-end in loaf of bread. Pine - £15. 0. 0. Safety-pin in sponge cakq. .Pine - £10.. 0. 0 . Costs • 15. 0 Non-metallic material in small Pine.- £10. 0. 0 iced cake- Costs 1.12. 6 Wire in boiled sweet. Case dismissed. Nail in jar of mincement. Pine - £2. 0. 0 Costs J. 3. 0 Mouldy condition of meat patties. Case.dismissed. Mould on cream buns. Pine - £5. 0. 0 Cigarette-end in loaf of bread Pine. - £25. 0. 0 Byelaws - Handling, Wrapping and Delivery of Food Progress has continued in the maintenance of hygienic conditions in food premises in relation to these Byelaws. 593 visits were paid to food premises including restaurants and other food-preparing premises. Inspection of Meat and Other Foods. There is one private licensed slaughter-house in the Borough which is not in normal use, and twenty-six butchers' shops. The visits paid to these premises numbered 116. 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 Pood for processing purposes:- 28. TIMED FOODS Article Quantity. Meat 147 tins Sausages 4 " Fish 21 " Fruit and Vegetables 328 " Soups 16 " Marmalade 11 " Milk 47 " Puddings 3 " Jams 7 " Mincemeat 3 " Sauces 1 bottle Paste 14 jars Spaghetti 3 tins Baby Food 97 tins OTHER FOODS Article Quantity Fish 49¾ stone Offal 19 lbs. Assorted Confectionery 28 lbs. Ham 131 lbs. Dried Fruit 235 lbs. Margarine 6 lbs. Butter 4½ lbs. Blancmange 13 pkts. Condemnation certificates were issued in respect, of the undermentioned home-killed and imported meat and offals- Mutton 27 lbs, Beef 994½- lbs. Pork 18 lbs. Calves Heads 5½ lbs. 29. Registration of Food Preparing Premises The registration of these premises is secured by Section 14 of the Food and Drugs Act, 1958 and the number of premises on the register was 91, being 65 for the manufacture, storage or sale of ice cream and 26 for the preparation or manufacture of sausages or preserved foods 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 150 of the Essex County Council Act, 1933 and the number of persons so registered at the end of the year was 63. BACTERIOLOGICAL EXAMINATIONS The Counties Public Health Laboratories, 66, Victoria Street, London, S.W.l undertake bacteriological examinations for the Council, through the Essex County Council Bacteriological Laboratory Service. Ice Cream. During the year 57 samples of ice cream were submitted for bacterial examination and one sample of fruit lolly. The results are itemised below and it is pleasing to note that the majority of the samples were in Grades 1 or 11. Grade 1 30 Grade 11 18 Grade lll 5 Grade IV 4 One sample of fruit lolly not graded. Samples adversely reported upon gave rise to further investigations 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. 30. No. Type Colonies per ml. on Agar @ 37°c. in 48 hrs. Coliform Test 3 tubes Bact Coli. 3 tubes MinistryGrade Hours/ Grade 49 Hot mix (tub) 1,100 0/3 0/3 4½/1 50 Hot mix choc ice (wrapped) 600 0/3 0/3 4½/11 51 Hot mix loose 1,600 3/3 0/3 3½/11 52 Hot mix choc ice (wrapped) 1,800 0/3 0/3 4/11 53 Hot mix loose 4,200 1/3 0/3 4½/1 54 Hot mix (tub) 1,200 0/3 0/3 4½/1 55 Hot mix loose 13,000 0/3 0/3 4½/1 5 6 Hot mix loose 15,000 2/3 0/3 4/11 57 Hot mix wrapped 800 0/3 0/3 4½/1 58 Hot mix wrapped brickette 700 0/3 0/3 4½/l 59 Hot mix loose 800 0/3 0/3 4½/1 60 Hot mix loose 13,000 0/3 0/3 4½/l 61 Hot mix choc ice (wrapped) 6,300 1/3 0/3 4½/1 62 Hot mix cut from block 2,800 1/3 0/3 4½/1 63 Hot mix wrapped 1,200 0/3 0/3 4/1 64 Fruit lolly- 30 03 0/3 not grade 65 Hot mix loose 900 0/3 0/3 4/1 66 Hot mix wrapped 1,400 0/3 0/3 4/1 67 Hot mix (tub) 1,500 0/3 0/3 4/1 68 Hot mix wrapped brickette 5,000 0/3 0/3 4 /1 69 Hot mix wrapped 800 0/3 0/3 4 /1 70 Hot mix wrapped 14,000 0/3 0/3 3½/11 71 Hot mix loose 700 2/3 0/3 4 A 72 Hot mix wrapped 5,500 1/3 0/3 4 /1 73 Hot mix wrapped 800 2/3 0/3 3½/11 74 Hot mix wrapped 6,000 0/3 0/3 4 /1 75 Hot mix loose 1,100 3/3 0/3 3½/11 76 Hot mix wrapped 1,500 0/3 0/3 3½/ll 77 Hot mix wrapped 1,700 0/3 0/3 4/1 78 Hot mix wrapped 1,200 0/3 0/3 4/1 79 Hot mix cut from block 500 1/3 0/3 4/1 80 Hot mix choc ice (wrapped) 600 1/3 0/3 3½/11 81 Hot mix cut from block 30,000 2/3 0/3 3½/11 82 Hot mix cut from block 40,000 1/3 0/3 4/A 83 Hot mix cut from block 4,000 2/3 0/3 3½/11 84 Hot mix (loose) 2,000,000 3/3 0/3 0/IV 85 Hot mix (loose) 60,000 0/3 0/3 3½/11 86 Hot mix (loose) 48,000 3/3 0/3 1/111 87 Cold mix loose 4,000 13 0/3 4/1 88 Hot mix (wrapped) 900 0/3 0/3 4/1 89 Hot mix cut from block 400 0/3 0/3 4½/1 90 Hot mix(loose) 180,000 2/3 0/3 2/111 91 Hot mix cut from block 9,500 2/3 0/3 2 /111 92 Hot mix loose 12,000 3/3 0/3 0 /1V 93 Hot mix loose 2,400 0/3 0/3 3½/11 94 Hot mix loose 18,000 3/3 1/3 0 /1v 95 Hot mix loose 5,600 2/3 0/3 3½/11 96 Hot mix wrapped brickette 3,000 2/3 0/3 3½/11 97 Hot mix cut from block 200 0/3 0/3 4 /1 98 Hot mix (loose) 40,000 3/3 1/3 0/1v 99 Hot mix (loose) 400 2/3 0/3 3½/11 100 Hot mix(loose) 60,000 3/3 0/3 2 /111 101 Hot mix cut from block 30,000 3/3 0/3 l /111 102 Hot mix wrapped brickette 5,000 0/3 0/3 4/1 103 Hot mix (loose) 4,500 0/3 0/3 3½/ll 104 Hot mix cut from block 2,000 0/3 0/3 3½/ll 105 Hot mix choc ice (wrapped) 3,200 0/3 0/3 4 /1 106 Hot mix cut from block 2,500 0/3 0/3 4/1 31. 32. SECTION F. PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Diphtheria No cases of diphtheria occurred in the Borough during 1951. The facilities for immunisation against diphtheria are detailed on pages 9 &10. In addition, arrangements are made for school children to be immunised at school. The numbers of children immunised during the year were;- Primary immunisations - under 5 years 515 " " 5 to 15 years 55 Total 570 Number of children receiving secondary or reinforcing injections 224 Scarlet Fever. There was an increase of 19 in the notifications received during the year as compared with 1950* The numbers of cases and the percentages removed to hospital during the previous five years are as follows: 1947 1948 1949 1950 1951 Cases notified 69 78 105 62 81 Percentage removed to hospital 61 52 46 65 48 Measles Measles was the most prevalent of the infectious diseases during 1951. The number of cases, 940, was the highest recorded since it become notifiable. Only 13 cases needed hospital care. As in previous years, measles serum was available to general practitioners on application to the Public Health Laboratory at Colindale for the treatment of cases and the protection of contacts. Whooping Cough As in the case of measles, the number of cases of whooping cough notified to the Health Department, viz: 463 as the highest since this disease became notifiable. Of this figure only 9 cases required hospital treatment. 33 Acute Poliomyelitis It is a pleasure to record that there were no confirmed cases of poliomyelitis notified in Chingford during 1951. Tuberculosis The number of fresh cases of Tuberculosis, pulmonary and nonpulmonary, notified during 1951 was 50. In addition, 11 persons previously suffering from tuberculosis, moved into this district. Dysentery. An outbreak of dysentery (Sonn6 type) occurred in the borough in the spring of 1951. Of the 39 persons involved, 11 cases were among children and staff of one of the Day Nurseries. I was anxious that, if at all possible, the Nursery should remain open and consulted with the Area Medical Officer, Forest Division Essex County Council, as the Nursery was under the control of the latter It was decided that the following administrative procedure should be adopted for thewith: specimens were taken from all staff and children. All positive cases were excluded and referred to their own doctor for treatment. All remaining staff and children were given prophylactic treatment with Succinylsulphathiazole which, I am pleased to report, aborted this local outbreak and thus permitted the Nursery to remain open. This was a great boon to many anxious mothers. All 39 cases made a rapid recovery from their illness. Food Poisoning. Only 5 persons were notified to the Health Department as suffering from food poisoning during 1951. The source of infection was not traced. All made a rapid recovery from their illness. Food Hygiene. Several, lectures, supported by films, dealing with cleanliness in the preparation and handling of food, were given to Associations in the Borough during the year. They were very much appreciated by the housewives who attended. Smallpox Contacts Several persons who had arrived in Chingford from abroad, from areas where smallpox was prevalent, were kept under surveillance -until the danger period was passed. Vaccination Number of primary vaccinations during the year - 326 Number of re-vaccinations during the year - 99 34. Scabies ✓ No persons wore in need of treatment during the year at the Scabies Treatment Centre. National Assistance Act, 1948 (a) Section 47 No statutory action was required under Section 47 of this Act during the year. Several aged and infirm persons who came to the notice of the department accepted voluntary admission to hospital or were provided with a Home Help to assist them. (b) Section 50 The Chingford Council took action under this section in one instance during the year. The whole of the cost of burial of the person concerned was recovered by the Council. Medical Examinations. During the year 20 examinations were carried out by me in respect of the Superannuation and Sick Pay Scheme of the Chingford Corporation. In addition, 48 medical examinations were carried out in respect of Essex County Council staff. 35. CAUSES OF DEATH AS GIVEN BY THE REGISTRAR-GENERAL FOR THE YEAR 195] Causes of Death Males Females Total Tuberculosis, respiratory 7 6 13 Tuberculosis, other - 1 1 Syphilitic disease - 1 1 Whooping Cough - 2 2 Acute Poliomyelitis - 1 1 Other infective and parasitic diseases - 1 1 Malignant neoplasm, stomach 8 4 12 Malignant neoplasm, lung, bronchus 16 2 18 Malignant neoplasm, breast - 7 7 Malignant neoplasm, uterus - 3 3 Other malignant & lymphatic neoplasms 20 21 41 Leukaemia, aleukaemia 3 1 4 Diabetes 4 1 5 Vascular lesions of nervous system 15 32 47 Coronary disease, angina 31 18 49 Hypertension with heart disease 8 6 14 Other heart disease 27 31 58 Other circulatory disease 1 10 11 Influenza 3 3 6 Pneumonia 7 12 19 Bronchitis 19 9 28 Other diseases of respiratory system 2 3 5 Ulcer of stomach and duodenum 3 - 3 Gastritis, enteritis and diarrhoea - 1 1 Nephritis and nephrosis - 1 1 Hyperplasia of prostate 3 - 3 Congenital malformations 2 2 4 Other defined and ill-defined diseases 18 23 41 Motor vehicle accidents 3 1 4 All other accidents 5 3 8 Suicide 8 3 11 Homicide and operations of war 1 - 1 Totals - all causes 214 209 423 Totals - year 1950 187 187 374 36. TUBERCULOSIS NEW CASES TRANSFERS DEATHS Respiratory NonResp iratory Respiratory NonResp iratory Respiratory NonResp iratory M. P. M. F. M. F. M. F. M. F. M. F. 0 to 1 year - - - - - - - - - - - — 1 to 4 years - 1 . -. 2 - - - - - - - 1 5 to 14 years 2 - - - - - - - - - - 15 to 24 years 3 8 - 1 1 1 — - - 1 - - 25 to 34 years 5 9 .- 1 2 - - - 2 2 - - 35 to 44 years 5 - - - 1 2 - - - - - - 45 to 54 years 5 2 - 1 1 1 - - 1 1 - - - 55 to 64 years. 2 - 1 - - 2 - - - 1 - - 65 and upwards 2 2 - - - - : - 4 - - - TOTALS 22 22 1 5 5 6 ~ - 7 5 - 1 Add - Deaths of un-notified cases 2 1 - - 9 6 - 1 37. INFANT MORTALITY Number of deaths of infants under one year, due to Prematurity, Congenital Defects and Failure to survive the stresses and strains of "birth, for the years 1946-1951 Year Deaths Infant Mortality Rate 1946 18 27 1947 6 12.9 1948 12 21.5 1949 13 24.9 1950 6 11.6 1951 10 23.7 DEATHS FROM CANCER Out of a total of 81 deaths from cancer, 74 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 and over Total M. F. M. F. M. F. Gastro-Intestinal Tract. 1 1 14 8 15 9 Lungs and Mediastinum. - - 16 3 16 3 Genito-urinary organs. - 1 3 11 3 12 Breast. - 1 - 6 - 7 Other sites. 3 - 7 6 10 6 TOTALS 4 3 40 34 44 37 Death rate = 1.67 per 1,000 (as compared with 1.57 per 1,000 in 1950) 58. NOTIFIABLE DISEASES (after correction) Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Dysentery Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Meningococcal infection Acute Poliomve litis. Acute Polioencephalitis Typhoid Fever Food Poisoning. Pulmonary Other forms 1946 74 - 9 212 88 45 5 13 2 2 103 3 - - - 1 1947 69 - 10 290 202 46 7 2 5 - 114 l 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 1951 81 - 8 940 463 44 6 39 1 - 54 - - - - 3 39. NOTIFIABLE DISEASES TABULATED ACCORDING TO AGE (after correction) Diseases Under 1 yr. 1 2 3 4 5 - 9 10 - 14 15 - 19 20 - 34 35 - 44 45 - 64 65 and Over Totals Scarlet Fever - 3 5 3 12 50 4 1 1 2 - - 81 Erysipelas - - - - - - - - 1 4 2 1 8 Measles 17 68 111 131 153 434 11 7 6 1 1 - 940 Whooping Cough 32 59 57 52 80 183 4 4 2 5 4 1 463 Puerperal Pyrexia - - - - - - - - - 1 - - 1 Pneumonia 1 1 - - : 2 6 3 1 5 10 17 8 54 Dysentery 1 4 2 3 7 7 1 3 5 5 1 - 39 Food Poisoning - - - - - 1 - - 1 1 - - 5 ANALYSIS OP NOTIFIABLE DISEASES (after correction) ' Diseases Total cases Total admitted to hospital Scarlet Fever 81 39 Erysipelas 8 2 Puerperal Pyrexia 1 1 Pneumonia 54 16 Measles 940 13 Whooping Cough 463 9 Dysentery 39 - Food Poisoning 3 1 40. BIRTH-RATES, DEATH-RATES, ANALYSIS OF MORTALITY, MATERNAL MORTALITY AND CASE RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1951. Provisional figures based on Quarterly Returns. England and Wales 126 County Boroughs & Great Towns (including London) 148 Smaller Towns(Resident Population 25000-50000 at 1931 Census.) London Administrative County hingford Rates per 1,000 Home Population. Births: Live Births 15.5 17.3 16.7 17.8 12.2 Still Births 0.36 0.45 0.38 0.37 0.18 Deaths: All Causes 12.5 13.4 12.5 13.1 8.7 Typhoid and paratyphoid 0.00 0.00 0.00 - - Whooping cough 0.01 0.01 0.01 0.01 0.04 Diphtheria 0.00 0.00 0.00 0.00 - Tuberculosis 0.31 0.37 0.31 0.38 0.28 Influenza 0.38 0.36 0.38 0.23 0.12 Smallpox 0.00 0.00 0.00 - - Acute poliomyelitis (including polioencephalitis) 0.00 0.01 0.01 0.00 0.02 Pneumonia 0.61 0.65 0.63 0.61 0.39 Notifications (Corrected): Typhoid fever 0.00 0.00 0.0,0 0.01 - Paratyphoid fever 0.02 0.03 0.02 0.01 .- Meningococcal infection 0.03 0.04 0.03 0,03 - Scarlet fever 1.11 1.20 1.20 1.10 1.67 Whooping Cough 3.87 3.62 4.00 3.11 9.57 Diphtheria 0.02 0.02 0.03 0.01 - Erysipelas 0.14 0.15 0.12 0.15 0.16 Smallpox 0.00 0.00 0.00 - - Measles 14.07 13.93 14.82 14.64 19.44 Pneumonia 0.99 1.04 0.96 0.72 1.11 Acute poliomyelitis (including polioencephalitis ) . . Hi v:^ Paralytic 0.03 0.03 0.03 0.02 - Non-Paralytic 0.02 0.02 0.03 0.02 - Food poisoning 0.13 0.15. 0.08 0.23 0.06 Deaths: Rates per 1,000 live births. All causes under 1 year of age 29.6 (a) 33.9 27.6 26.4 23.7 Enteritis and diarrhoea under 2 years of age 1.4 1.6 1.0 0.7 1.7 Rates per 1,000 Total (Live and Still) Births Notifications(Correcte Puerperal fever and pyrexia a) 10.66 13.77 8.08 14.90 1.66 (a) Per 1,000 related live births. 41. Maternal Mortality in England and Wales Intermediate List No. and cause Number of Deaths Rates per 1,000 Total (Live and Still)Births Rates per million women aged 15-44 Chingford A115 Sepsis of pregnancy, childbirth and the puerperium — 70 0.10 - A116 Abortion with toxaemia 3 0.00 0 - Other toxaemias of pregnancy and the puerperium 167 0.24 - A117 Haemorrhage of pregnancy and childbirth 91 0.13 - All8 Abortion without mention of sepsis or toxaemia 37 0.05 4 - A119 Abortion with sepsis 66 0.09 7 - A120 Other complications of pregnancy, childbirth and the puerperium 125 0.18 - '