CHIN 18 BOROUGH of CHINGFORD ANNUAL REPORT OP THE MEDICAL OFFICER OF HEALTH INCLUDING THE REPORT OF THE CHIEF SANITARY INSPECTOR FOR THE YEAR 1953 1. BOROUGH OF CHINGFORD Committee: June, 1953 - May, 1954 PUBLIC HEALTH COMMITTEE Chairman: Councillor Dr. John Wagstaff Vice-Chairman: Councillor W.J Bowstoad Members: Councillor A.T.H. Austin '' W.J Buckley '' A.R Fiddos '' V.D. Hall '' C.E. Moore '' A.F. Nicholls " J.E. Verrior The Mayor, Councillor J.W. Corder, J.P. (ex-officio) Meeting: Sccond Monday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1953) 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 Act and Petroleum Acts. District Sanitary Inspectors: R. W. BASHFORD, M.S.I.A. (b) (c) (f) C. G. HOWELL, M.R.San.I. , M.S.I.A. (b) (c) (e) (f) (g) D. R. CKANIN, M.S.I.A. (b) Senior Clerk: Miss V. M. Pettit Clerks: A. H. Gillies Miss I. A. Polices Miss C. Rice (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 (d) Certificate of the Royal Sanitary Institute in Sanitary Science (f) Diploma of the Royal Institute of Public Health and Hygiene (g) Diploma of the Institute of Shops Act Administration 2. ANNUAL REPORT FOR THE YEAR 19 5 3 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 1953 upon the health and sanitary circumstances of the Borough. The estimated population for the year was 47,770. Vital Statistics: The birth-rate at 12.6 per 1,000 is slightly higher than last year and shows signs of stabilising around this figure, the rates for 1951 and 1952 being 12.2 and 11.8 respectively. The death-rate at 8.1 per 1,000 was little changed from the previous year. The number of deaths of infants under one year of age per 1,000 live births, i.e. the infant mortality rate, was 13.3; this is lower than 1952 which was 17.6 and is less than half the figure for England and Wales at 26.8. Infectious Diseases: For the third successive year no case of diphtheria occurred. The commonest of the infectious diseases were measles, whooping cough and scarlet fever. In regard to whooping cough, I am pleased to report that the Essex County Council now provides facilities for immunisation against this disease at the clinics in the borough; the response has been very good. There were six notifications of poliomyelitis during 1953. Tuberculosis: Forty-four new cases of tuberculosis, pulmonary and non-pulmonary, were reported during the year. The Mass Radiography Unit visited the borough in July. Old Persons: The problem of providing suitable hospital, nursing home or other accommodation for the aged sick and infirm is still very much with us and little or nothing appears to have been done to alleviate the position. In conclusion, I express my thanks 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 loyalty and co-operation throughout the year. 1 am , Ladies and Gentlemen, Your obedient servant, J. II. CROSBY, August ,1954 Medical Officer of Health. 3. SECTION A STATISTICS AND SOCIAL CONDITIONS OP THE AREA Area 2,868 acres Population - Registrar-General's estimate for raid-year 1953 47,770 Number of inhabited houses and flats (as at 31.12.53) 13,511 Rateable value on April 1st, 1953 £387,265 Product of a penny rate, year ending 31.3.53 £1,577. 8s VITAL STATISTICS M. F. Live Births (Total 290 305 ( Birth Rate per ??? (Legitimate 290 296 ( of estimated rosi??? (illegitimate 8 9 ( population: Stillbirths (Total 8 9 (Rate per 1,000 ??? (Legitimate 8 9 ((live and still) (Illegitimate - - (births: Deaths 198 188 (Crude Death Rate (l,000 of estimate (resident population Deaths from puerperal sepsis 0 " other puerperal causes 1 Death Rate of infants under one year of ago:- All infants per 1,000 live births 13.3 Legitimate infants per 1,000 legitimate live births 11.9 Illegitimate infants per 1,000 illegitimate live births 58.8 Deaths from Cancer (all ages) 82 " " Measles (all ages) 0 '' '' Whooping Cough (all ages) 0 4. TABLE OP BIRTH AND DEATH FATES Year Population Births Rate per 1,000 population Deaths Rate per 1,000 population Infant Mortality Deaths Rate per 1,000 live births 1943 46 ,610 743 15.9 340 7.3 16 21.5 1949 48,510 684 14.1 404 8.3 17 24.9 I950 48,770 692 14.2 374 7.7 8 11.6 1951 48,330 (Census) 59c 12.2 423 8.7 14 23.7 1952 48,190 567 11.8 394 8.2 10 17.6 1953 47,770 603 12.6 386 6.1 8 13.3 5. 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 253 Number of specimens examined for the Chingford Hospital nil (b) Ambulance Service The Ambulance Service , maintained and controlled by the Esser??? County Council, has an Ambulance Station situated in Station Road (near The Green) , Chingford, which serves this area. The Station is manned continuously; the telephone number being Silverthorn 68 The general procedure for obtaining an ambulance in emergency 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 Home Nursing Services are administered by the Essex County Council. 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 - 3 * " " Home Nurses - 2 ø * Miss C. Lovcll, 49, The Ridgewoy, E.4, (Silverthorn l460 Miss D. Waldie, " " " " ( " " ) Mrs. P.M. Stenning, 78, Larks wood Road, E.4. (Silverthorn 5414) ø Miss M. Jones, 49, The Ridgeway, E.4. (Silverthorn 1460) Mrs. S. Gent, 4, Maida Way, L.4. (p.t.) 6. (c) Contd. Number of cases attended by Midwives as:- (a.) Midwives - 120 (b) Maternity nurses 28 148 Number of visits paid by Home Nurses to:- (a) Pre-school children (b) School children (c) Adults - 18,330 - 18,330 (d) Health Visiting The total number of visits paid by the Health Visitors during the year was 7,212. (e) Registered Nursing Homes There arc two registered Nursing Homes in the district, one receiving maternity and medical patients, and the other receiving medical cases only. 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 7 and 8. Child Welfare Centres Attendances of children - under 1 year of age 8,260 between 1 and 5 years 3,280 Total 11,540 Ante-Natal Clinics Ante-Natal attendances 1,442 Post-natal attendances 122 Total 1,564 Women's Welfare Clinic Gynaecological 11 Birth control - 1st visits 106 Birth control - re-visits 269 Total 386 (g) Hospitals The hospitals providing general medical services for Chingford residents are chiefly the Connaught Hospital, Walthamstow, and the Wanstead Hospital, Wanstead. 7. Persons with infectious disease, needing admission to hospital, are accommodated at the Honey Lane Hospital at Wal tham Abbey or at Isolation Hospitals in nearby districts; or, if no bed is available at 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 pre- fabricated hut construction, in Hatch Lane. Regular medical inspection of the children attending these Nurseries was carried out during the year. (i) Home and Domestic Help Scheme There is a Home and Domestic Help Scheme in the Chingford district, under the auspices of the Essex County Council. Application for these facilities should be made to the Area Medical Officer, Municipal Offices, High Road, Woodford, E.18. (j) Chiropody facilities A Chiropody Clinic for persons of pensionable ago only is held on Thursday afternoons at the Essex County Health Services Clinic, Marmion Avenue, South Chingford. Appointments to attend this clinic must be made through the Area Medical Officer, Municipal Offices, High Road, Woodford, E.18. In addition to the above facilities, six persons hold licences from the Essex County Council to carry on private practice as chiropodists within the Borough. These premises are inspected annually. LOCAL CLINICS AND TREATMENT CENTRES, 1954 Clinic Where held When held Diphtheria Immunisation Clinics Primary Hall, Buxton Road, North Chingford. Tuesdays, 2 p.m. St. Francis' Hall, 2nd, 4th & 5th Hawkwcod Crescent, E.4. Wednesdays, 2 p.m. County Council Clinic, Marmion Avenue, E.4. Thursdays, 11.30 a.m. County Council Clinic, 1st Wednesday in every Hatch Lane, 3.4. month at 2 p.m. Church Hall, The Ridgeway, North Chingford Wednesdays, 10 a.m. Ante-Natal Clinics County Council Clinic, Hatch Lane, E.4. Tuesdays 2-4 p.m. County Council Clinic , Marmion Avenue, B.4. Wednesdays, 9.30 a.m. 8. LOCAL CLINICS AND TREATMENT CENTRES, 1954 (contd.) Clinic Where held When held Child Welfare Clinics County Council Clinic , Hatch Lane, E.4. Wednesdays, 2-4 p.m. County Council Clinic, Mansion Avenue, E.4. Tuesdays & Wednesdays, 1.45 - 3.45 p.m. Primary Hall, Buxton Road, N. Chingford. Tuesdays,2-4 p.m. St. Francis' Hall, Hawkwood Cresc, E.4. 2nd, 4th L 5th Weds. 2-4 p.m. Church Hall, The Ridgeway , N. Chingford. Wednesdays, 9.30 - 11.45 Toclcllcrs' Clinic County Council Clinic, Marrnion Avenue, E.4. Thursdays, 10 - 11.30 a.m. Minor Ailment School Clinics > County Council Clinic, Hatch Lane, E.4. Mondays, 2-4 p.m. County Council Clinic, Marmion Avenue, E.4. Mondays, 10 a.m. 12 noon Orthopaedic Clinics (as arranged by Reg. Hosp . Board) County Council Clinic, Hatch Lane. E.4. Weds. & Thursdays at 2 p.m. County Council Clinic, Marmion Avenue, E.4. Mondays at 2 p.m. (both by appmt. only) Ophthalmic Clinic (as arranged by Reg.Hosp.Board) Countjr Council Clinic, Hatch Lane, E.4. Friday afternoons (by appointment only) . Dental Clinics County Council Clinic, Hatch Lane, E.4. Wednesdays, 9.30 - 10.45 a-.m. (inspections only) County Council Clinic, Marmion Avenue, E.4. Wednesdays, 9-10 a.m. (inspections only) Women's Welfare Clinics County Council Clinic, Hatch Lane, E.4. 1st Friday in every month 10 - 12 noon (by appointment only) County Council Clinic, Marmion Avenue, E.4. 4th Friday in every month at 10.15 a.m. Chest Clinic Old Honoux School, High Street, Walthamstow. New cases: Adults, Weds. 10 - 12 noon New cases: Children, Fris. 10 - 12 noon Foot Clinic (Old age pensioners only) County Council Clinic, Marmion Avenue, E.4. Thursdays, 2 p.m. (by appointment only) 9. GENERAL INFORMATION National Assistance Board. 29, Cambridge Park, Wanstead, E.ll. - (Telephone: Wanstead 7721) Office hours - Mondays to Fridays, 9 a.m. .to 5 p.m. Saturdays, 9 a.m. to 1 p.m. Registrar of Births, Deaths & Marriages: Mr. C.W. BARRETT, Town Hall, Chingford, E.4. (Telephone: Silverthorn 3944 and Loughton 576) Office hours - Mondays and Thursdays, 2.30 - 4.30 p.m. Wednesdays & Saturdays, 9-11 a.m. National. Health Insurance Office: 11a, The Ridgeway, 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. Duly Authorised Officers: Essex County Council Offices, West Avenue, Walthamstow, E.17. (Telephone: Coppermill 2418) Office hours - Mondays to Fridays, 9 a.m. to 5.30 p.m. Saturdays, 9 a.m. to 12.30 p.m. Social Welfare Department: Essex County Council Offices, 35, Wanstead Place, E.ll. (Telephone: Wanstead 0031) 10. 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. Eleven visits were made during the year in connection with the pollution of water courses. Informal action secured the abatement of minor instances of pollution traced to incorrect connections of sanitary fittings. Public Cleansing, A weekly collection of refuse and salvage was maintained and the. total weight of refuse disposed of at the Works was 11,490 tons a slight increase in relation to the amount collected the previous year, namely 11,325 tons. Once again the Registrar General's estimate of the population at mid-year 1953 showed a decrease, namely 47,770 as against 48,190 for the previous year. The analysis of income on page 14 indicates a total figure of £9,595 as against £9,808 for the previous year. Whilst tonnages have been maintained, fluctuating market prices have had the effect of reducing the income. The collection and disposal of all classes of waste paper has proceeded satisfactorily. The net cost per ton for the collection of refuse was 24s.7d as against 24s.lOd for the year ended March, 1953 and 23s.lOd for the year- ended March, 1952. The establishment of refuse collectors remained as in previous years at twenty men and five vehicles were in daily use with two vehicles maintained as spares. No new vehicles were acquired during the year. The net cost per ton for the disposal of refuse was 3s.9d as compared with 5s.7d for the previous year and nil for the year ended March, 1952. During the year under review the Corporation completed the erection of a new 28-ton storage hopper and elevator, in order to give casier loading of vehicles for the transportation of screenings from the plant to a tip outside the area. This scheme has worked satisfactorily and has resulted in the Corporation roe.Giving lower tenders for the transportation of these materials. 11. The net expenditure for the collection and disposal of refuse and salvage, including loan charges, was £16,286 or 28s.4d per ton as against £317,226 or 30s.5d per ton for the previous year. As mentioned in the Report for 1952 the Council introduced a now street cleansing scheme, using three 24-cell Morrison Electric Trucks with a driver and three orderlies to each Truck, The scheme came into operation in August, 1953 and has proved to "be practicable and efficient. The running and maintenance costs of these vehicles were as excellent as had been forecast and this can be seen from the table given below:- Item 1953/54 (part Year). 1954/55 (estimated) £ £ Electricity 30 48 Water and Oil 4 6 Cleaning Materials and Equipment 12 15 Repairs 15 45 Tyres - 24 Maintenance Contract 15 30 Insurance end Licences 67 90 Total 143 258 Two factors upset the smooth running of the scheme and disturbed what otherwise would have been the regular routine weekly cleansing of all roads. The first serious obstacle affecting the new scheme occurred late in the financial year and was caused by a fairly long period of snowy and frosty weather which necessitated the putting down of many hundreds of tons of grit and a considerable time elapsed before the street cleansing personnel were able to collect this additional material. The second adverse factor was the use of street orderlies to replace refuse collection personnel absent through sickness and in future years it would appear to be necessary to consider some early reinforcement of the street orderlies when such conditions arise. 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. Two new public conveniences were completed, namely one at Rangers Road and one at Green Farm. The convenience at Rangers Road was opened in August, 1953 end has the services of fulltime attendants during all weekends throughout the summer. Green Farm convenience was opened in September, 1953. 12. COLLECTION AND DISPOSAL OF HOUSE AND TRADE REFUSE. COST STATEMENT - 1953-54. Item particulars Collection Disposal Totals percentage of total gross expenditure 1 2 3 4 5 £ £ £ % REVENUE ACCOUNT. 1 GROSS EXPENDITURE: (i) Labour 7397 5973 13,370 i 51.7 (ii) Transport 6442 - 6,442 24.9 (iii) Plant, equipment land and builclings 52 1689 1,741 6.7. (iv) Other items 702 3627 4.329 16.7 (v) Total gross expenditure 14,593 11,289 25,882 100 2 GROSS INCOME (including £4 received from other local authorities 444 9,152 9,596 _ 3 NET COST 14,149 2,137 16,286 _ 4 Capital expenditure met from revenue (included above) . _ _ _ _ UNIT COSTS s. d. S. d. s . d. 5 Gross cost per ton, labour only 12. 11. 10. 5. 123. 4. 6 Gross cost per ton, transport only 11. 2. _ 11. 2. 7 Net cost (all expenditure) per ton 7. 3 9. 28. 4. £ £ £ 8 Net cost per 1,000 population 296 45 341 9 Net cost per 1,000 premises 1002 152 1154 13. OPERATIONAL STATISTICS. 10. Area (statute acres) - land and inland water 2868 acres 11. Population at 30th June, 1953 (Registrar General's Estimate) 47,770 persons 12. Total refuse collected 11,490 tons 13. Weight per 1,000 population per day (365 days to year) 13.18 cwts 14. Number of premises from which refuse is collected 14,117 premises 15. Promises from which daily collection is made - % of total 16. Average haul by collection vchicle to disposal point (single journey) 1 mile 17. Kerb side collection, if practised, expressed as estimated percentage of total collection - % 18. Total refuse disposed of (of which nil tons were disposed of for other local authorities) 11.490 tons 19. Methods of disposal (Salvage excluded): percentage (a) Crude tipping - (b) Controlled tipping 51 (c) Direct incineration - (d) Separation and incineration 49 (c) Other methods - 100 20. Salvage and Trade Refuse. Analysis of income and tonnage; Income (included in Item 2) Tonnage Collected (included in Item 12) Salvage: £ Tons (a) Raw Kitchen Waste 153 18 (b) Scrap Metal 1951 493 (c) Waste paper 4768 617 (d) Other Salvage 2029 1121 (e) Totals 8901 2249 Trade Refuse 437 203 14. ANALYSIS OF INCOME FOR THE YEAR ENDED 31st MARCH, 1954. Year ended 31.3.53. £. s. d. £. S. d. £. s. d. £. s. d. 1.Sale of Salvaged Articles: Metals: 511. 15. 4. Aluminium 388. 9. 1. 190. 9. 4. Copper 192. 11. 9. 300. 3. 8. Iron 237. 3. 0. 51. 10. 5. Lead 39. 12. 4. 9. 11. 9. Battery Lead 5. 17. 11. 46. 11. 2. Lead Type 24. 11. 0. 279. 12. 11. Brass 196. 10. 0. 148. 18. 1. Unbaled Scrap 182. 12. 6. 631. 12. 6. Tins 651. 14. 6. 19. 17. 10. Pewter 18. 11. 6. 28. 6. 9. Zinc 15. 7. 9. 1953. 1. 10. 513. 18. 2. Broken White glass 330. 19. 2. 41. 7. 11. Amber Cullet 35. 2. 8. 616. 10. 3. Bottles & Jars 414. 0. 0. 780. 1. 10. 1062. 17. 0. Rags 667. 11. 3. 144 15. 6. Carpets & sacking 112. 13. 1. 5. 5. 0. String 10. 0. 6. 481. 5. 0. Woollens 291. 3. 9. - - - Flock Bedding 4. 5. 0. 1085. 13. 7. 3936. 12. 8. Newspaper & Mixed Waste Paper etc. 4766. 5. 10. 70. 0. 2. Bones 33 19. 3. 49. 13. 3. Pig Food (bread) 119. 6. 4. 3?. 3. 13. Rubber Tyres & Tubes etc. 30. 10. 9. 4. 0. 0. Unsound Food (Disposal) 4. 0. 0. — - - Miscellaneous Items 3. 5. 6. 8776. 4. 11. 2.Miscellaneous Receipts & Charges 2. 0. Sale of Screenings 125. 0. 0. 24. 9. 0. 3.Weighbridge Fees 37. 17. 0. 200. 0. 0. 4.Rents: Foundry 200. 0. 0. 20. 0. 0. Proportion of Allotment Rents 20. 0. 0. 2. 6. Other Rents 8. 6. 220. 8. 6. 304. 17. 4. 5.Refuse Collection Charges: Greengrocers & Butchers 347. 18. 1 6. 82. 1. 0. Others 88. 10. 6. 436. 8. 6. £9808. 10. 5. £.9595. 18.1 .1. 15. STREET AND GULLY CLEANSING. COST STATEMENT-1953-54 Item Particulars Street Sweeping and watering Street Gully Cleansing Total Percentage of Total Gross Expenditure l 2 3 4 5 £ £ £ % 1 REVENUE ACCOUNT GROSS EXPENDITURE: (i) Labour 3435 2 3437 54.8 (ii) Transport 2051 1 2052 32.7 (iii) Plant, equipment, buildings etc. 146 - 146 2.3 (iv) Other items 212 428 640 10.2 (v) Total gross expenditure 5844 431 6275 100 2 GROSS INCOME (excluding reimbursements from Ministry of Transport ana the County Council 20 - 20 - 3 NET COST 5824 431 6255 . — 4 Capital expenditure met from revenue (included above) - - - 5 Gross expenditure on snow clearance not included previously 582 - - " UNIT COSTS s. d. s. d. 6 Net Cost (item 3) per street mile cleansed 35. 6. - 7 Net Cost (item 3) per 1,000 street gullies cleansed £ - £ 58 £. - 8 Net Cost (item 3) per 1,000 population 122 9 131 16. operational statistics. 9. Mileage of streets cleansed 55.89 10. Frequency of cleansing: (a) At least once daily -% (b) Three to five times weekly 5 % (c) Twice weekly - % (d) Once weekly 95% (e) Less than once weekly -% 11. Total miles cleansed during year. (Mileage x number of cleansings) 3279 12. Percentage of street cleansing done "by mechanical means 75 % 13. Number of street gullies cleansed 3195 l4. Number of gully cleansings during year. (Number of gullies x number of cleansings) 7501 15. Percentage of gully cleansing done by mechanical means 100 % 16. Weight of street and gully refuse (e) 1100 tons 17. Gully cleansing is carried out by Contractors and this figure includes labour and transport. Item 12. Revised scheme operated from August,1953. Mechanical Sweeper ceased operation and work carried out by manual methods and use of electric trucks. 17. sanitary inspection of the area. Inspection on Complaint. The number of complaints received at the office and recorded in the register was 543, as compared with 301 in the previous year and 413 for the year 1951. The total inspections made on complaint was 483 and the number of defects or nuisances revealed was 328, 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 55 Blocked Sewers 188 Defective Sewers 2 Defective Water Fittings 9 Defective Water Closets 5 Blocked Rainwater Gullies 10 Blocked and Contaminated Watercourses 1 Defective Drainage 4 Absence of and Defective Dustbins. 5 Offensive Accumulations 8 Nuisance from Smoke, Dust,Odours etc 23 Nuisance from Insects 14 Animals Kept so as to be a Nuisance 4 Vermin in Premises 1 Overcrowding 1 Nuisance from Caravans 1 Dangerous Structures 1 328 18. 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 7,622 as compared with 7,693 in the previous year; the defects dealt with numbered 890 as compared with 1,014 in 1952. TABLE 2. Visits Paid Nuisances or Defects Pound & Dealt With Housing Act, 1936: Inspections 126 439 Re-inspections re Notices served 646 Re overcrowding 39 On Complaint 483 328 Infectious Diseases 276 Retail Pood Premises: Meat 181 Pish 44 Pried Pish 32 General Provisions 175 Other Pood Shops 80 10 Restaurant and Other Pood preparing Premises 175 Ice Cream Premises 142 Pood Sampling: Ice Cream 41 Milk 15 Other Foods 117 Drugs 15 Factories 105 22 Bakehouses 14 Dairies 3 Pigstyes 7 Re-visits re Notices served (P.H. Act) 220 Other re-visits 329 Rodent Control 2519 84 Shops Act: Sanitary Conditions 290 3 Hours of Closing 233 1 Young persons Employment 148 Council Houses 164 Collection and Disposal of Refuse and Salvage 115 Street Cleansing 35 (Carried Forward) 6769 887 19. TABLE 2 (contd.) Visits Paid Nuisances or Defects Found & Dealt With (Brought Forward) 6769 887 Schools 62 3 Hairdressers' Premises 17 Swimming Pool 7 Miscellaneous Visits 203 Places of Entertainment 62 Public Conveniences 48 Petroleum Acts 90 Outworkers 242 Smoke Observations 23 Pollution of Rivers and Watercourses 11 Street Food Vendors 2 Movable Dwellings 50 Merchandise Marks Act 5 Pet Animals Act 11 Water Act 19 Sewage Disposal Works 1 7622 890 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 41 Roofs, Spoutings and Eavesgutters repaired or renewed 62 External Walls repaired 7 Wall and Ceiling plaster repaired 42 Floors repaired 7 Stairs and Stair Rails repaired 1 Woodwork of Doors and Sashcords, Glazing and Sills repaired 47 Flues and Chimney Stacks repaired or rebuilt 6 Dampness remedied 16 Yard Surfaces repaired or relaid 2 Offensive Accumulations removed 3 Verminous Premises disinfested 2 Drains reconstructed 8 Drains cleansed 9 Drains repaired 13 Drains - New Inspection Chambers 5 (Carried Forward) 271 20. table 3 (conta.) (Brought Forward) 271 New Sinks provided 3 Sink Waste pipes - trapped or renewed 3 Water Closets repaired or reconstructed 9 Water Closets cleansed and limewashed 5 Water Closet Peaestals fixed 10 Water Closet Flushing Cisterns repaired or. renewed 2 Water Storage Tanks ana Piping repaired or renewed 1 Sufficient Water Supply provided 2 Hot Water Systems repaired 2 Dustbins provided 13 Rat Infestations 177 Sewers cleansed 320 Sewers repaired 23 Food Premises: Limewashed ana cleansed 17 Improvements 7 Factories and Workplaces: Limewashed and cleansed 5 Lighting ana Ventilation improved 3 Additional Sanitary Accommodation 2 Separate Accommodation for sexes 1 Other Contraventions of Act 11 Shops: Washing Facilities provided 3 890 TABLE 4. Letters sent out ana notices served in connection with the work of the Health Department: Letters 1330 Public Health Acts: Preliminary Notices 55 Statutory Notices 5 Housing Acts: Preliminary Notices 38 Statutory Notices 5 21. Inspections of Factories and Other Premises. 1. - Inspections for Purposes of Provisions as to Health. (Including Inspections made by Sanitary Inspector). Premises Number on Register Inspections Number of 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 99 - - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding Outworkers' Premises) 3 6 - _ Total - 49 105 - - 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. Inspr. Referred by H.M. Inspr. (1) (2) (3) (4) (5) (6) Want of cleanliness (S.l.) 5 5 - - - Overcrowding (s. 2.) - _ - - - Unreasonable temperature (s.3.) - - - - - inadequate ventilation & lighting (S.4.) 3 3 - - - Ineffective drainage of floors (S.6.) - - - - Sanitary Conveniences (S.7.) (o.) 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) 11 11 - - - Total - 22 22 - - - 22. Shops Act, 1950. A total of 671 visits was paid to shops and generally conditions were found to be satisfactory. Smoke Abatement. Twenty-three observations were taken at chimney stacks and informal action taken when excessive smoke emission was considered due to faulty stoking. 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 10th May and closed on the 6th September, 1953. The full use of this attractive open-air Swimming Pool depends largely on weather conditions and the summer again was not such as to enable full attendances to be recorded. The total attendance throughout the season was 121,615, the highest attendance being on the 5th July when 7,460 persons were present. Samples of water were taken from the Pool during the months of June, July and August 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 eight fish fryers. Bakehouses. Fourteen 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 Pood and Drugs Act, 1938, three 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 five visits were paid to factories and in eleven instances action was taken to secure improvements in cleanliness and provision of sanitary accommodation. 23. number and trade op outworkers notified during 1953. Wearing Apparel 97 Knitwear 49 Footwear 11 Brush-making 2 Handbags 6 Buttons 1 Stationery 1 Artificial Flowers 4 Plastics 1 Box-making 7 Down Quilts 3 Trimmings 2 OUTWORKERS WERE NOTIFIED FROM THE FOLLOWING AREAS. Ilford 3 St.Pancras 3 Stoke Newington 6 Leyton 52 Islington 5 Westminster 4 London Corporation 4 Edmonton 4 Penge 1 Bethnal Green 5 Hackney 38 Shoreditch 9 Tottenham 3 Finsbury 27 Wood Green 1 West Ham 3 Enfield 3 East Ham 1 Chigwell 2 Lambeth 2 Prevention of Domage 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, 2,519 visits were paid to deal with minor infestations at private and business premises and in connection with sewer maintenance Treatments. The ninth and tenth maintenance treatments were carried out in March and September respectively. In March 502 months less were baited and of these 25.9% showed complete or parti all takes; 410 manholes were baited in September, 13.6% of which showed complete or partial takes. 24. SECTION D. HOUSING STATISTICS FOR THE YEAR,1953. 1. Number of Houses Erected During the Year. (1) By the L.A.(permanent) Traditional (including flats) 7 (2) Cost of works re-buildings by local builders - (3) By private enterprise (including flats) 7 14 2. Inspection of Dwelling- Houses During the Year. (1) (a) Total number of dwelling-houses spected for housing defects (under Public Health or Housing Acts) 1088 (b) Number of inspections made for the purpose 1954 (2) (a) Number of dwelling-houses (included under sub-head (l) above) which were inspected and recorded under the Housing Consolidated Regulations 1925 and 1932 126 (b)Number of inspections made for the purpose. 772 (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 sub-head) found not to be in all respects reasonably fit for human habitation 123 * * 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 60 25. 4. Action Under Statutory Powers During the Year: A. Proceedings under Sections 9, 10 and 16 of the Housing Act, 193o: (1) Number of dwelling-houses in respect. of which notices were served requiring repairs 5 (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 - B. Proceedings under Sections 11 and 13 of the Housing Act, 1936: (1) Number of Demolition Orders served - (2) Number of dwelling-houses demolished - (3) Houses closed in pursuance of an taking given by the owners under Section 11 1 C. Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 5 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 6 (b) By Local Authority 0 SECTION E. INSPECTION AND SUPERVISION OP FOOD Milk Supply. The milk supply is from several large firms with dairy premises outside the Borough boundaries and is mainly pasteurised. Eleven samples of milk were analysed during the year and all were certified to be genuine. 26. 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: 5 dealers' licences to sell milk as Pasteurised. 12 dealers' licences to sell milk as Sterilised. 2 supplementary licences to sell milk as Pasteurised. 3 supplementary licences to sell milk as Sterilised. 5 dealers' licences to sell milk as Tuberculin Tested. 1 supplementary licence to sell milk as Tuberculin Tested. 1 supplementary licence to sell milk as Tuberculin Tested (Pasteurised). 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. 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. continued as joint Public Analysts for the area. Samples Submitted for Analysis. One hundred and fourteen samples of foods and drugs were submitted for analysis, twenty formal and ninety-four informal and it will be seen by the following table that a reasonably wide field was covered. The table shows that in five instances samples were adversely reported upon; three of the five samples being cream lollies which contained insufficient quantity of fat to justify the description "cream" lolly. The Analyst adopted an unofficial standard of 2½% fat; the samples in question did not contain more than 0.1% fat in two instances and 2.l% fat in the third sample. The labelling of these lollies was taken up with the manufacturers who subsequently altered the wording so as to exclude any reference to "cream". The remaining two samples adversely reported upon were marshmallows, the subject of complaints concerning palatability. These were found to be rancid due to long storage and remaining stocks were withdrawn from sale. 27. Attention was given to the metallic contamination of iced lollies and fourteen samples were taken and submitted to the Public Analyst primarily for lead content. The Metallic Contamination Sub-Committee had recommended that the limit of lead contamination for solid foods was 2.0 parts per million and for liquids 0.2 p.p.m.'and some argument took place as to whether a frozen lolly was in fact a solid or a liquid. The Public Analyst decided that it would be wise to regard this commodity as a solid with a presumptive limit of 2.0 p.p.m. of lead. Of the fourteen samples taken only in one instance did the lead content amount to 2.0 p.p.m. and in the majority of instances it varied between 0.2 and 0.6 p.p.m. Arising out of the examination of these samples generally, which covered the bulk of the iced lollies coming into the area from various manufacturers, at least one important fact was proved. In almost every case when the attention of manufacturers was drawn to high lead content defects were found in the manufacturers' equipment or processes which were resulting in a greater lead content than was otherwise unavoidable. In one instance it was found that a sample of orange syrup taken before being mixed with water showed a. lead content of 0.4.p.p.m. Clean Food Campaigns. 1. The number of food premises in the area by type of business:- Restaurants and Cafes 27 Licensed Premises 12 Fish shops, including fish fryers 16 General grocers 48 Bakers 11 Greengrocers 22 Sugar confectionery 35 Milk distribution depots (bottled only). 4 2. The number of food premises by type registered under Section 14 of the Food and Drugs Act, or under Local Acts: (a) Butchers 26 General provisions 3 Baker 1 Ice Cream premises 73 103 (b) Number of dairies registered under Milk and Dairies Regulations, 1949 Nil 3. Number of inspections of registered food premises 323 4. No spocial educational activity. 28. 5. Method of disposal of condemned food is by burning at Refuse Disposal Works, except in the case of meat and fat which is collected and utilised through trade channels. 6. No special examination of stock or of a large consignment was found necessary during the year. Samples Taken for Analysis During the Year 1953• Article Number Examined Result of Analysis Formal Informal Total Genuine Non-Genuine Milk 8 3 11 11 - Condensed Milk - 1 1 1 - Canned Cream - 1 1 1 - Double Cream 1 - 1 1 - Ice Cream 1 1 2 2 - Confectioncry Cream - 3 3 3 - Filling Sausages 3 - 3 3 - Saccharin - 1 l 1 - Sponge Mixture - 2 2 2 - Pish Paste - 1 1 1 - Meat Paste - 1 1 1 - Vegetable Soup - 3 3 3 - Meat Soup — 1 1 1 - Almond Essence - 1 1 1 - Carraway Seeds - 1 1 1 - Grape Pruit Squash - 1 1 1 - Canned Beans - 1 1 l - Shortbread Mixture - 1 1 1 - Canned Mincemeat - 2 2 2 - Cake Mixture - 1 1 1 - Tapioca Dessert - 1 1 l - Malt Vinegar 1 - 1 l - Beef Suet - 3 3 3 - Mixed peel - 1 1 1 - Mixed Herbs - 2 2 2 - Coffee - 1 1 1 - Table Jellies - 3 - 3 - Tea 2 - 2 2 - Ground Rice - 2 2 2 - Ground Cinnamon - 1 1 1 - Cocoa 1 1 2 2 - Ground Almonds - 1 1 1 - Canned Fruit - 2 2 2 - Dried Fruit — 2 2 2 - Horseradish Sauce - 1 1 1 - Marmalade - 1 1 1 - Gelatine - 1 1 1 - Carried forward 17 49 66 66 - 29. Article Number Examined Result of Analysis Formal Informal Total Genuine Non-Genuine Brought forward 17 49 66 66 - Jam - 3 3 3 - Processed peas - 1 1 1 - Tonic Water - 1 1 1 - Self-raising Flour - 2 2 2 - Orange Squash Cordial - 1 1 1 - Marshmallows - 2 2 - 2 Confectionery - 4 4 4 - Paprika - 1 1 1 - Cochineal Solution - 1 1 1 - Butter - 1 1 i - Margarine - 1 1 1 - Cheese - 1 1 l - Water Lollies - 5 5 5 - Cream Lollies - 9 9 6 3 Whisky 1 - 1 1 - Rum 1 - 1 1 - Iodine Ointment - 1 1 1 Cream of Tartar - 1 1 1 - Tincture of Iodine - 1 1 1 - Glauber Salts - 1 1 1 - Seidlitz Powder - 1 1 1 - Licorice powder - 1 1 1 - Friars Balsam - 1 1 1 - Lime Sulphur Tablets - 1 1 1 - Bicarbonate Soda - 1 1 1 - Sodium Bicarbonate - 1 1 1 - Digestive Tablets - 1 1 1 - Tincture of Rhubarb - 1 1 1 - Liquid Paraffin 1 - 1 1 - Totals: 20 94 114 109 • 5 Legal Proceedings. Two cases were taken before the Magistrates under Sections 3 and 9 of the Act in relation to extraneous matters found in foodstuffs. Convictions resulted m each case. 30. Byplays - Handling, trapping and Delivery of Food. Progress has continued in the maintenance of hygienic conditions in food premises in relation to these Byelaws. 829 visits were paid to food premises including restaurants and other food-preparing premises. Inspection of Kent and Other Foods. There is one private licensed slaughter-house in the Borough which was not in normal use and twenty-six butchers' shops. The visits paid to these premises numbered 181. 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:- TIMED FOODS. Article. Quantity. Meat 140 tins Sausages 81 " Fish 33 " Fruit and Vegetables 922 " Peas 2 " pickles 1 jar Milk 63 tins Jams 26 jars Mincemeat 2 " (contd.) Offence. Section. Result. Meat pie contaminated with fly larvae. 9 £3.fine. No costs. Cheese gnawed by mice. 3 £2.fine. No costs. 31. TINNED FOODS (contd.) Article. Quantity. Horseradish Cream 1 jar Salad Dressing 1 tin Honey 2 jars Coffee 2 jars Cream 3 tins OTHER POODS. Rice 32 lbs. Oatmeal 43 lbs. Sponge Mixture 58 lbs. Ham 238½ lbs. Fish 49 stone. Semolina 94 lbs. Dried Fruit 3,024 lbs. Fruit and Vegetables 123 lbs. Milk powder 75 lbs. Pearl Barley 23 lbs. Cheese 10 lbs. Flour 39 lbs. Marshmallows 157 lbs. Condemnation certificates were issued in respect of the undermentioned home-killed and imported meat and offal:- Mutton 141½ lbs. Beef 2,427¼ lbs. Veal 3¾ lbs. Pork 174¼ lbs. 32. Registration of Food Preparing Premises. The registration of these premises is secured by Section 14 of the Pood and Drugs Act, 1938 and the number of premises on the register was 99, being 73 for the manufacture, storage or sale of ice cream and 26 for the preparation or manufacture of sausages or preserved foods. 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 the number of persons so registered at the end of the year was 68. 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 36 samples of ice cream were submitted for bacterial examination; four samples of fruit lolly and one of confectioner cream filling. The results are itemised below and it is pleasingto note that the majority of the samples were in Grades 1 or 11. Grade 1. Grade 11. Grade 111. Grade IV. 24 9 2 1 Pour samples of fruit lolly not graded. The sample of confectionery cream filling was reported by the Analyst to be of a satisfactory bacteriological standard. 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. 33. No. Type. Colonies per ml.on /Agar @ 37°C in 48 hrs. Coliform Test 3 Tubes. Bact. Coli. 3 Tubes. Ministry Grade. 1 Loose from can 200 0/3 0/3 1 2 Wrapped choc ice 2,400 0/3 0/3 1 3 Wrapped brickette 300 0/3 0/3 1 4 Wrapped brickette 8,000 1/3 0/3 1 5 Y/rappcd brickette 200 0/3 0/3 1 6 Confectionery Cream Filling 50,000 Positive in 1/10th ml. in 2 out of 3 tubes. 0/3 Not Graded 7 Loose from can 2,400 0/3 0/3 1 8 Loose from bulk 2,200 0/3 0/3 1 9 Wrapped brickette 700 2/3 0/3 11 10 Cream lolly 120 0/3 0/3 Not Graded 11 Loose from can 800 0/3 0/3 1 12 Loose from can 1,700 0/3 0/3 1 13 Loose from can 500 0/3 0/3 1 14 Wrapped brickette 2,000 0/3 0/3 11 15 Tub 28,000 0/3 0/3 111 16 Portion from carton 9,200 2/3 0/3 11 17 Wrapped brickette 24,000 2/3 0/3 111 18 Wrapped choc ice 3 ,200 0/3 0/3 1 19 Wrapped brickette 7,800 0/3 0/3 1 20 Portion from carton 5 ,200 1/3 0/3 1 21 Wrapped brickette 7 ,000 2/3 0/3 ! 11 22 Cream lolly 5,000 1/3 0/3 Not Graded 23 Wrapped brickette 6,000 1/3 0/3 11 24 Wrapped brickette 1,600 0/3 0/3 l 25 Wrapped brickette 4,400 1/3 0/3 11 26 Wrapped brickette 20,000 3/3 0/3 11 27 Wrapped brickette 1,800 0/3 0/3 l 28 Wrapped choc ice 4,700 0/3 0/3 l 29 Portion from carton 8,500 1/3 0/3 11 30 Wrapped brickette 1,800 0/3 0/3 1 31 Water lolly 4,800 1/3 0/3 Not Graded 32 Wrapped brickette 2,000 0/3 0/3 1 33 Water lolly Nil 0/3 0/3 Not Graded 34 Loose from bulk 2,000 0/3 0/3 1 35 Loose from can 1,500 0/3 0/3 11 36 Wrapped brickette 400 0/3 0/3 1 37 Loose from can 60,000 3/3 0/3 IV 38 Brickette 900 0/3 0/3 1 39 Portion of Gateau 6,000 1/3 0/3 1 40 Wrapped brickette 15,000 0/3 0/3 1 41 Wrapped brickette 1,500 0/3 0/3 1 34. SECTION F PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Diphtheria No case of diphtheria occurred in the borough during 1953. Facilities for immunisation against this disease are detailed on page 7. 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 - 362 " " - 5 to 15 years - 102 Total - 464 Number of children receiving secondary or reinforcing injections - 515 Scarlet Fever There was a slight reduction in the number of confirmed cases during the year, there being 168 compared to 181 in 1952. The following statement shows the total cases notified arid the percentage removed to hospital during the last five years:- 1949 1950 1951 1952 1953 Confirmed cases 105 62 81 181 168 Percentage removed to hospital 46 65 48 47 37 Measles 380 cases were notified to the Health Department; this was a very marked reduction from the previous year. Only 2 of the cases needed admission to hospital. There were no deaths. 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 There was a considerable rise in the incidence of whooping cough, viz: 181 cases notified as against 66 for the previous year. No case needed admission to hospital and there were no deaths. During the year the Essex County Council arranged for 35. immunisation against whooping cough to be available at the clinics in the borough. We now have an immunising agent of proved value and so it is hoped that in the course of the next few years the incidence of this disease will fall appreciably. The response by the parents has been most encouraging: 168 children were immunised at the Council's clinics during the year. Acute Poliomyelitis Six cases of poliomyelitis were notified and confirmed during the year. Four of these were paralytic and two non-paralytic. None of the four paralytic cases was left with any serious degree of paralysis. Tuberculosis The incidence of fresh cases of tuberculosis continues to fluctuate within fairly narrow limits; there were 44 notifications during the year. In addition, 22 persons who were already known cases of tuberculosis in other areas, came to reside in the borough. Mass Radiography The mass radiography unit paid a visit to the borough during the summer. The following table indicates the number who attended and the conditions found on examination:- Male Female Total Total number x-rayed by miniature 461 749 1210 Number recalled for large film 19 44 63 Number recalled for clinical interview 4 18 22 Did not attend for large film 1 1 2 Abnormalities discovered Abnormalities of Bony Thorax 5 6 11 Bronchitis 1 2 3 Bronchiectasis - 3 3 Pulmonary fibrosis - 4 4 Basal fibrosis 1 - 1 Pleural thickening 5 5 10 Cardiovascular Lesions - acquired 3 8 11 Azygos Lobe 1 1 2 Fractured Right Clavicle - 1 1 Cases of Pulmonary Tuberculosis Active Post Primary - 1 1 Inactive Post Primary 6 10 16 36. In addition, a survey was carried out at one of the larger factories in the district, where a total number of 841 persons were examined. Dysentery Twenty-two notifications of dysentery were received. Food Poisoning Only five persons were notified as suffering from food poisoning; all these were isolated instances and were not linked with one another. Food Hygiene Lectures were given to recognised organisations during the year. The Sanitary Inspectors maintained close contact with all food premises in the district; I feel that this personal contact, where problems can be discussed and advice given, is the best method of educating all those concerned in the handling and preparation of food. Smallpox Contacts Surveillance of several persons, who were contacts or possible contacts of smallpox cases, was carried out for the required period. Vaccination Number of primary vaccinations during year - 299 Number of re-vaccinations during the year - 203 National Assistance Act, 1948 (a) Section 47: No statutory action was required under Section 47 of this Act during the year. Hospital accommodation, or accommodation in hostels for the aged, was arranged for several aged and infirm persons during 1953. In a few other instances the provision of a home help obviated the need for hospital care. (b) Section 50: The Chingford Council took action under this section in one instance during the year. The whole of the cost of burial was recovered by the Council. Medical Examinations During the year 37 examinations were carried out by me in respect of Chingford Council staff and 59 in respect of staff of the Essex County Council. 37. CAUSES OP DEATH AS GIVEN BY THE REGISTRAR-GENERAL FOR THE YEAR 1953 Causes of death Males Females Total Tuberculosis, respiratory 10 3 13 Tuberculosis, other - 1 i Meningococcal infections 1 - 1 Other infective & parasitic diseases 1 1 2 Malignant neoplasm, stomach 5 6 11 Malignant neoplasm, lung, bronchus 15 1 16 Malignant neoplasm, breast - 16 16 Malignant neoplasm, uterus - 5 5 Other malignant & lymphatic neoplasms 14 20 34 Leukaemia, aleukaemia - 1 1 Diabetes 1 1 2 Vascular lesions of nervous system 18 27 45 Coronarjr disease , angina 35 20 55 Hypertension with heart disease 5 2 7 Other heart disease 28 28 56 Other circulatory disease 7 9 16 Influenza 2 5 7 Pneumonia 11 12 23 Bronchitis 17 5 22 Other diseases of respiratory system 2 - 2 Ulcer of stomach and duodenum 2 1 3 Gastritis, enteritis and diarrhoea 2 3 5 Nephritis and nephrosis - 1 1 Hyperplasia of prostate 3 - 3 Pregnancy, childbirth, abortion - 1 1 Congenital malformations 2 2 4 Other defined and ill-defined diseases 9 11 20 Motor vehicle accidents 2 - 2 All other accidents 3 3 6 Suicide 3 3 6 Totals - all causes 198 188 386 Totals - year 1952 201 193 394 DEATHS FROM CANCER There were 82 deaths from cancer, 76 of them having occurred in persons over the age of 45 years. 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 j M. P. M. P. M. P. Gastro-Intestinal Tract 2 1 8 13 10 14 Lungs and Mediastinum 1 14 1 15 1 Genito-urinary organs - 1 5 11 5 12 Breast ... ... ... ... - 1 - 15 - 16 Other sites ... ... ... j - - 4 5 4 5 Totals 3 3 31 45 34 48 Death-rate = 1.71 .per 1,000 (,as compared with lo5 per 1,000 in 1952; 38. TUBERCULOSIS NEW CASES TRANSFERS DEATHS Respiratory NonResp iratory Respiratory NonResp iratory Respiratory NonResp iratory M. F. M. F. M. F. M. F. M. F. M. F. 0 to 1 year 1 — 1 — — — — — 1 — — — 1 to 4 years — — — — — 1 — — — — — — 5 to 14 years 1 1 1 — — — — 1 — — — — 15 to 24 years 6 6 1 — 2 3 — — — — — — 25 to 34 years 4 5 1 — 6 7 — — 2 1 — — 35 to 44 years 2 2 — 1 1 1 — — 2 1 — 1 45 to 54 years 5 — — — — — — — 5 — — — 55 to 64 years 4 1 — — — — — — 1 — — — 65 and upwards 1 — — — — — — — — — — — TOTALS 24 15 4 1 9 12 — 1 11 2 — 1 Add - deaths of un-notified cases — 1 — — 11 3 — 1 39. NOTIFIABLE DISEASES (after correction) Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Dysentery Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Meningococcal Infection Acute Poliomyelitis Acute PolioEncephalitis Acute Infective Encephalitis Typhoid or Paratyphoid Fever Food Poisoning Pulmonary Other forms 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 1952 181 - 6 893 66 30 4 10 1 - 24 1 4 - - 1 4 1953 168 - 9 380 181 39 5 22 - - 34 1 6 - 1 - 5 40. NOTIFIABLE DISEASES TABULATED ACCORDING TO AGE (after correction) Diseases Under 1 year 1 2 3 4 5-9 10-14 15 - 19 20 - 34 35-44 45 - 64 65 & over Totals Scarlet Fever - - 11 6 15 121 9 3 2 1 - - 168 Erysipelas - - - - - - - - - 6 3 9 Measles 11 41 46 48 71 154 3 2 3 1 - - 380 Whooping Cough 8 13 16 18 20 95 6 - - 5 - - 181 Pneumonia - 1 1 - 1 1 2 1 2 7 13 5 34 Dysentery - 1 - 2 - 11 2 1 4 1 - - 22 Food Poisoning - - - 1 - 1 - 1 1 - - 1 5 Meningococcal infection - 1 - - - - - - - - - - 1 Acute Poliomyelitis - 1 - - 2 1 - 1 - - 1 - 6 Ac. infective Encephalitis - - - - - - - 1 - - - 1 ANALYSIS OF NOTIFIABLE DISEASES (after correction) Diseases Total cases Total admitted to hospital Scarlet Fever 168 62 Erysipelas 9 2 Measles 380 2 Whooping cough 181 - Pneumonia 34 15 Dysentery 22 3 Food Poisoning 5 - Meningococcal infection l 1 Acute Poliomyelitis 6 6 Ac. infective Encephalitis 1 1 41. BIRTH-RATES, DEATH-RATES, ANALYSIS OP MORTALITY, MATERNAL MORTALITY AND CASE-RATES FOR CERTAIN INFECTIOUS DISEASES in the YEAR 1953. PROVISIONAL FIGURES BASED ON QUARTERLY RETURNS England and Wales 160 County Boroughs & Great Towns (including London) 160 Smaller Towns (Resident Population 25000-50000 at 1951 Census) London Administra- tive County Chingford Rate per 1,000 Home Population Births: Live Births 15.5 17.0 15.7 17.5 12.6 Still Births 0.35 0.43 0.34 0.38 0.35 22.4 (a) 24.8 (a) 21.4 (a) 21.0 (a) 27.4(a) Deaths: All Causes 11.4 12.2 11.3 12.5 8.1 Typhoid & Paratyphoid 0.00 0.00 - - - Whooping Cough 0.01 0.01 0.00 0.00 - Diphtheria 0.00 0.00 0.00 - - Tuberculosis 0.20 0.24 0.19 0.24 0.29 Influenza 0.16 0.15 0.17 0.15 0.14 Smallpox 0.00 0.00 0.00 - - Acute poliomyelitis (including polioencephalitis) 0.01 0.01 0.01 0.01 - Pneumonia 0.55 0.59 0.52 0.64 0.48 Notifications (Corrected): Typhoid Fever 0.00 0.00 0.00 0.01 - Paratyphoid Fever 0.01 0.01 0.01 0.01 - Meningococcal infection 0.03 0.04 0.03 0.03 0.02 Scarlet Fever 1.39 1.50 1.44 1.02 3.51 Whooping Cough 3.58 3.72 3.38 3.30 3.78 Diphtheria 0.01 0.01 0.01 0.00 - Erysipelas 0.14 0.14 0.13 0.12 0.18 Smallpox 0.00 0.00 0.00 - - Measles 12.36 11.27 12.32 8.09 7.95 Pneumonia 0.84 0.92 0.76 0.73 0.71 Acute poliomyelitis (including polioencephalitis) Paralytic 0.07 0.06 0.06 0.07 0.08 Non-paralytic 0.04 0.03 0.04 0.03 0.04 Pood poisoning 0.24 0.25 0.24 0.38 0.10 Puerperal pyrexia 18.23(a) Rates 24.33(a) per 1,000 12.46(a) Live Births 28.6l(a) - Deaths: All causes under 1 year of age 26.8 (b) 30.8 24.3 24.8 13.2 Enteritis & diarrhoea under 2 years of age 1.1 1.3 0.9 1.1 - (a) per 1,000 Total (Live and Still) Birtns. (b) per 1,000 related Live Births. 42. 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 (a) A115 Sepsis of pregnancy, Childbirth and the puerpcrium 68 0.10 - - Abortion with toxaemia 7 0.01 1 - A116 Other toxaemias or pregnancy and the puerperium 166 0.24 - - A117 Haemorrhage of pregnancy and childbirth 90 0.13 - - A118 Abortion with- out mention of sepsis or toxaemia 30 0.04 3 - A119 Abortion with sepsis 39 0.06 4 - A120 Other complications of pregnancy, childbirth and the puerperium 125 0.18 - 1.61 (a) per 1,000 Total (Live and Still) Births.