1. Mr Gnara Dw 5B 2 library AC 4411(1) CHINGFORD BOROUGH OF CHINGFORD ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH Including the Report of the CHIEF SANITARY INSPECTOR FOR THE YEAR 1954 BOROUGH of CHINGFORD ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH including the Report of the CHIEF SANITARY INSPECTOR FOR THE YEAR 1954 1. BOROUGH OP CHINGFORD Committee: June, 1954-May, 1955 PUBLIC HEALTH COMMITTEE Chairman: Councillor A.T.H. Austin Vice-Chairman: Councillor Dr. Joan Wagstaff Members: Alderman J.W.R. Nation Councillor W.J. Bowstead " W.J. Buckley " A.R. Fiddes " A.F. Nicholls " K.W. Rothwell " Mrs. I. Titley The Mayor, Councillor V.D. Hall, J.P. (ex-officio) Meeting: Second Monday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1954) 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) (to 28.2.54) D. R. CHANIN, M.S.I.A. (b) (to 14.3.54) D. J. CROSS, A.R.San.I., M.S.I.A. (b)(f) (from 9.6.54) Senior Clerk: Miss V.M. Pettit Clerks: A. H. Gillies Miss I. A. Folkes 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 (e) 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 4 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 1954 upon the health and sanitary circumstances of the Borough. The estimated population for the year was 47,600. Vital Statistics: The birth-rate was 11.7 per thousand, which is lower than that for 1953, viz: 12.6, and is, in fact, the lowest yet recorded. The death-rate was 8 per thousand (8.1 in 1953). The principal causes of death were Cancer and Heart Disease. These diseases and conditions associated with them were the cause of two deaths out of every three that occurred. Cancer alone caused one quarter of the total deaths. The infant mortality rate, which is the number of deaths of infants under one year of age per 1,000 live births, was 23.3. This is appreciably higher than in 1953 (13.3) and is accounted for by the increase in the number of infants who died from prematurity during 1954. The rate for England and Wales was 25.5. Infectious Diseases: A reduction in all types of infectious disease was noted during the year, especially in regard to Scarlet Fever, Measles and Whooping Cough. Only one case of paralytic Poliomyelitis occurred, which unfortunately proved fatal. There was no case of Diphtheria. Tuberculosis: The number of fresh cases of Tuberculosis occurring in the Borough was 32, as against 44 in 1953. A significant step forward in the campaign against Tuberculosis was the commencement of B.C.G. vaccination of schoolchildren in the year preceding their fourteenth birthday. Vaccination was offered to all children in this group and the response by parents was very heartening. The Walthamstow and Chingford Association of Tuberculosis Care Helpers continued its admirable work in giving practical help to families of tuberculous persons, in the provision of milk, groceries, clothing, holidays, etc. where help was most needed. Old Persons: The problem of accommodation for the aged has occupied the attention of the Health Committee and approaches are being made to the County Council with a view to a hostel being provided within 3. the borough. New Legislation: Prom the text of the Report it will be seen that the Housing Repairs and Rents Act, 1954, came into operation during the year and work was commenced on the preparation of the proposals for dealing with unfit houses which were required to be submitted to the Minister by August, 1955. The receipt of applications for Certificates of Disrepair was smaller than anticipated. The Pood and Drugs Amendment Act, 1954, received Royal Assent on the 25th November of that year but has not yet come into operation apart from Section 28 which deals with private slaughterhouses. As from the 2nd July, 1954, meat was decontrolled, but the local authority found no reason to make any recommendation as to the provision of slaughtering accommodation. I am indebted to the Area Medical Officcr, Dr. P.G. Brown, for the statistical matter on pages 6 and 7. I record 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 help throughout the year. I am, Ladies and Gentlemen, Your obedient servant, J. H. CROSBY, Medical Officer of Health. August, 1955. 4. SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,863 acres Population-Registrar-General's estimate for mid-year 1954 47,600 Number of inhabited houses and flats (as at 31.12.54) 13,586 Rateable value on April 1st, 1954 £388,376 Product of a penny rate, year ending 31.3.54 £1,579. 19. 10. VITAL STATISTICS M. F. (Total 299 258 (Birth Rate per 1,000 Live Births (Legitimate 294 250 ( of estimated resident (illegitimate 5 8 ( population: 11.7 (Total 7 4 ( Rate per 1,000 total Stillbirths (Legitimate 7 4 ((live and still) (illegitimate - - (births: 19.3 (Crude Death Rate per Deaths 202 180 (1,000 of estimated (resident populations (8.0 Deaths from puerperal sepsis 0 „ " other puerperal causes Death rate of infants under one year of age:- All infants per 1,000 live births 23. Legitimate infants per 1,000 legitimate live births 20.2 Illegitimate infants per 1,000 illegitimate live births - Deaths from Cancer (all ages) 95 „ „ Measles (all ages) 0 „ " Whooping Cough (all ages) 0 5 TABLE OF BIRTH AND DEATH RATES Year Population Births Rate per 1,000 population Deaths Rate per 1,000 population Infant Mortality Deaths Rate per 1,000 live births 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 1952 48,190 567 11.8 394 8.2 10 17.6 1953 47,770 603 12.6 386 8.1 8 13.3 1954 47,600 557 . 11.7 382 8.0 13 23.3 6. SECTION B GENERAL PROVISION OF HEALTH SERVICES IN THE AREA (a) Laboratory Facilities Pathological specimens from this district are examined at the Pathological Department of the St. Margaret's Hospital at Epping. The Pathologist has kindly supplied me with the following figures of specimens from Chingford examined during the year:- Number of specimens examined for the Health Department and the General Practitioners 232 Number of specimens examined for the Chingford Hospital nil (b) Ambulance Service The Ambulance Service, maintained and controlled by the Essex 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 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 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 - 4 * " " Home Nurses - 3 Ø (Mrs. K. Bullibant, 336, Brettenham Road, E.17. * (Miss D.L. Chandler, 87, Friday Hill, E.4. Silverthorn 4968 (Miss C. Lovell, 49, The Ridgeway, E.4. " 1460 (Mrs. P.M. Stenning, 78, Larkswood Road, E.4. „ 5414 (Mrs. M.R. Doxsey, 15, Nelson Road, E.4. (part-time) Ø (Miss M. Jones, 49, The Ridgeway, E.4. Silverthorn 1460 (Mrs. E.V. Whiter, 79, Harold Road, E.4. (part-time) " 6194 7. (c) contd. Number of cases attended by Midwives as:- (a) Midwives - 111 (b) Maternity nurses - 33 144 Number of visits paid by Home Nurses:- 14,737 (d) Health Visiting The total number of visits paid by the Health Visitors during the year was 10,849. (e) Registered Nursing Homes There are 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 8 and 9. Child Welfare Centres Attendances of children-under 1 year of age - 8,439 " " " - between 1-2 years - 1,772 „ „ „ - „ 2-5 " - 1,043 Total. - 11,254 Ante-Natal Clinics Ante-Natal attendances - 1,353 Post-Natal " - 82 Total - 1,435 Women's Welfare Clinic Birth control-1st visits - 90 " " - revisits - 318 Total - 408 (g) Hospitals The hospitals providing general medical services for Chingford residents are chiefly the Connaught Hospital, Walthamstow, and the Wanstead Hospital, Wanstead. 8. Persons with infectious disease, needing admission to hospital, are accommodated at the Honey Lane Hospital at Waltham 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. Note: The Hatch Lane Day Nursery was closed as from 31st July, 1955. (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 age 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, 1955 Clinic Where held When held Diphtheria Immunisation Clinics Primary Hall, Buxton Road, North Chingford. Tuesdays, 2 p.m. St. Francis' Hall, Hawkwood Crescent, E.4. Wednesdays, 2 p.m. County Council Clinic, Marmion Avenue, E.4. Thursdays, 11.30 a.m. County Council Clinic, Hatch Lane, E.4. Wednesdays, 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, E.4. Wednesdays, 9.30 a.m. 9. LOCAL CLINICS AND TREATMENT CENTRES, 1955 (contd.) Clinic Where held When held Child Welfare Clinics County Council Clinic, Hatch Lane, E.4. Wednesdays, 2 - 4 p.m. County Council Clinic, Marmion 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. Wednesdays, 2 - 4 p.m. Church Hall, The Ridgeway, N. Chingford. Wednesdays, 9.30 - 11.45 a.m. Toddlers' Clinic County Council Clinic, Marmion 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 - 12 noon. Orthopaedic Clinics (as County Council Clinic, Hatch Lane, E.4. Wednesdays & Thursdays at 2 p.m. arranged by Reg.Hosp. Board) County Council Clinic, Marmion Avenue, E.4. Mondays at 2 p.m. (both by appmt. only) Ophthalmic Clinic (as arranged by Reg. Hosp. Board) County 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 (inspections only) a.m. County Council Clinic, Marmion Avenue, E.4. Mondays, 9 - 10 a.m. (inspections only) Women's Welfare Clinics County Council Clinic, Hatch Lane, E.4. 1st Friday in every month 10 a.m. to 12 noon County Council Clinic, Marmion Avenue, E.4. (by appointment only) 4th Friday in every month at 10.15 a.m. Chest Clinic Old Monoux School, High Street, Walthamstow. New cases: Adults, Weds. 10 a.m. - 12 noon New cases: Children, Fris. 10 a.m. - 12 noon Foot Clinic (Old Age Pensioners only) County Council Clinic, Marmion Avenue, E.4. Thursdays, 2 p.m. (by appointment only) 10. GENERAL INFORMATION National Assistance Board: 29, Cambridge Park, Wanstead, E. 11. (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 and 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.11. (Telephone: Wanstead 0031) SECTION C. 11. SANITARY CIRCUMSTANCES OF THE AREA. Personal Note. This is the 25th Annual Report I have had the privilege and. honour of assisting in the compilation and I am taking the opportunity of introducing these few personal reminiscences of the quarter of a century I have served in the Public Health Department of the authority. Chingford, it will be recalled, was promoted to the status of an Urban District in the year 1895, to that of a Borough in 1938 and the history of the district may be sharply divided into two periods of about thirty years. Prom the date of the inception of the Urban District until 1924 may be regarded as a period of quiet and steady growth, the population varying between 3,277 (estimated 1895) to 9,958 (estimated 1924). Prom 1925 onwards until 1954, when it could be said that the district was largely built up, the rate of growth was extremely rapid. The 1921 census had shown the population of the then Urban District of Chingford to be 9,482; that of 1931, 22,053, thus gaining for the district the distinction of being bracketted with Dagenham and Hornchurch as areas in the administrative County of Essex where population increases in the decade had exceeded 100%. The respective figures were Dagenham 879%, Hornchurch 160.9% and Chingford 132.6%, By the year 1930, then, the district had definitely gained a more pronounced urban appearance but still there remained much of its former rural charm. To the north stood the Royal Epping Forest, as to-day, inviolate; to the west Chingford Marshes, where Flander's Weir sought to claim an annual victim; to the south-east Roper's Fields with a public footpath leading to Larkshall Road; again to the east the Boothby-Heathcote Estate, carefully retained by its owner notwithstanding offers from prospective developers. No less than eleven dairy farmers raised their cattle on not too restricted pastures. One of these, the octogenarian, Mr.James Soper, still resides at Low Hall Farm and continues, although in a limited manner, the business he commenced sixty years ago. In 1930 Pole Hill was still in private ownership and T.E.Lawrence (Lawrence of Arabia) visited his Retreat near the summit. Just to the north of The Ridgeway was Mount Echo House, formerly in the ownership of Lady Jane Seymour, overlooking fields which subsequently became the Mount Echo Estate. To a young Inspector, coming from the industrial midlands in the spring of 1930, Chingford possessed a freshness and charm which was all the more accentuated by reason of contrast. Not only was the district burgeoning, but the entire staff of the Department was new - during that year not only was there a newly appointed Inspector, but also a Medical Officer and a new clerk. Even the Town Hall was newly erected and by mid-summer a new plant 12. for the disposal of domestic refuse was completed. By 1931 I had inaugurated a scheme for the collection of refuse by direct labour utilising motorised equipment in place of the contractor's horsedrawn vehicles. The work of the Public Health Department during the past quarter of a century, as with other Departments of the Council, has always been in a constant state of flux, by reason of the continued growth of the district. The steady and unobtrusive administration of the Housing Acts has resulted in the older properties in the town being maintained in such a condition that although in certain areas there are sub'-standard houses, which lack modern amenities such as hot water systems and bathrooms, there are no slums as defined by the Act of 1936. In 1950, following an informal enquiry by a representative of the Ministry of Health, which included an. investigation of local public health administration and an inspection of the Borough, the scope of the Department was extended by the taking over of Pood and Drugs duties formerly carried out by the Essex County Council. In the Public Cleansing Section one of the chief difficulties has been the stabilising of collection districts for refuse collection and an anxiety as to the capacity of the Refuse Disposal Works. Quite clearly, within the next few years, the reconstruction of the refuse disposal plant must receive earnest consideration. The recovery and sale of salvage from the Refuse Disposal Works has always received high priority as can be seen by the income for the year under review amounting to £10,743; during the twenty-five years the contribution to the General Rate Fund has amounted to £100,596, the peak income year being 1951/52 when the amount was £14,144. A newly elected representative on the Council, who was for the year 1930 a member of the Sanitary and Plans Committee, also commenced a period of service which has extended to this day. I refer, of course, to Alderman P.S.Powell, C.C., whose long and distinguished career in local government is unequalled in the Borough and must rank for distinction in the general sphere of local government. Retrospection should not be over-indulged but if this period of my service is classed as only a small page in the history of the Borough, this personal note may not be unacceptable. Chingford began as a small village; quickly, perhaps all too quickly, it grew into a town which by reason of sound government and good administration, gained early promotion to Borough status. It was, and to a large extent still is, a dormitory town and still awaits that indefinable touch to transform it into a nationally well-known municipality. JAMES P. ROGERS, August, 1955. Chief Sanitary Inspector. 13. Water Supplies. A hard, pure and constant piped water supply is provided by the Metropolitan Water Board; the supply has been satisfactory in both quality and quantity. Rivers and Streams. Eight visits we re made during the year in connection with the pollution of water courses. Informal action secured the abatement of minor instances of pollution. Fly Nuisance. For some years past, residents on the western boundary of the Borough have suffered considerable fly nuisance in the spring and the year under review proved no exception; indeed, from the evidence at present available, it would appear that this section of the community must expect an annual recurrence of this irritating and annoying experience. Two types of fly are involved and both, fortunately, are nonbiting and are judged to be harmless from a medical point of view. The first fly to emerge is the Anisopus Fenestralis which, because of its predilection for breeding in sewage filters, is thought to be wind-borne from a large sewage disposal works in an adjoining Borough. The advice of the Water Pollution Research Laboratory of the Department of Scientific and Industrial Research has resulted in the treatment of the filters early each year with liquid gammexane and this has done much to mitigate the nuisance. The second fly, Genus Chironomidae (species Tanytarsus and Chironomus) is known to emerge from the waters of the two large Metropolitan Water Board reservoirs and causes considerable annoyance and discomfort, largely by reason of the myriads of flies which hover about the heads of residents, cluster around doors and windows and generally invade houses. Owners of property in the vicinity of the reservoirs would be unwise to contemplate re-painting until after the emergence of the flies. As the larvae of the fly breeds in the water of the reservoirs, no practical means of control have yet been established, although the Metropolitan Water Board is actively investigating the matter. Once the flies have emerged, however, the prompt and thorough spraying of the banks by the Board with D.D.T. solution has secured an effective but somewhat costly abatement of the nuisance. 14. Public Cleansing. A weekly collection of refuse and salvage was maintained and the total weight of refuse disposed of at the Works was 11,812 tons, as compared with 11,490 tons for the previous year. The Registrar General's estimate of the population at mid-year 1954, 47,600 again indicated a decline as against the estimate for mid-year 1953,47,770. The continued reduction in the population figure from that revealed by the census in 1951 (48,330) has not yet been the subject of careful analysis and enquiry, but with a reasonably stable birthrate and a low deathrate the general indications would point to emigration. The number of premises from which refuse has to be collected, surprisingly enough, shows an increase, the number for the year under review being 14,234 as compared with 14,117 for the year 1953/54. The analysis of income on page 18 indicates a total figure of £10,743 as against £9,595 for the previous year. Tonnages were well maintained and the additional income was due to the increased sale of waste paper, bottles and jars and metals. Unless some remarkable changes occur in market prices it would appear that a sum of about £10,500 must be accepted as an income ceiling, but this locally must at least be regarded as a worthwhile contribution to the General Rate Fund and nationally, if judged by the Costing Returns issued by the Ministry of Housing and Local Government, must compare most favourably with many other local authorities. The net cost per ton for the collection of refuse was 25s.3d as against 24s.7d for the year ended March, 1954 and 24s.lOd for the year ended March, 1953. The increase in the unit cost per ton is due to Wages Awards, no additional men being employed during the year. Transport costs were reduced from 11s.2d per ton to 10s. 5d per ton. 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 2s.l0d as compared with 3s.9d for the previous year and 5s.7d for the year ended March, 1953. The net expenditure for the collection and disposal of refuse and salvage, including loan charges were £16,56.1 or 28s. Id per ton as against £16,286 or 28s.4d per ton for the previous year. The new scheme for street cleansing utilizing three 24-cell Morrison Electric Trucks with a driver and three orderlies to each truck continued to prove satisfactory apart from difficulties in obtaining personnel. The running and maintenance costs were again 15. remarkably low as indicated in the following table. The item for repairs was larger than anticipated, but this was due to the fitting of additional seating accommodation for the orderlies. Item 1954/55 (Actual) 1955/56 (Estimated) £ £ Electricity 36 42 Water and Oil 6 6 Cleaning Materials and Equipment 9 9 Repairs 75 30 Tyres - 30 maintenance Contract 29 30 Insurance and Licences 81 81 236 228 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, but wilful damage continued at the three conveniences which have not full-time attendants. The hours of opening at the South Chingford Public Convenience were extended during the year to 11.30 p.m. from Mondays to Thursdays and until mid-night on Fridays, Saturdays and Sundays. The following list indicates the public sanitary conveniences in the Borough with the accommodation available. Situation. Accommodation for Females. Accommodation for Males. Albert Crescent 6 w. cs. 6 w. cs. 21'0" urinal space The Green 3 w. cs. 2 w. cs. 9'0" urinal space Rangers Road 4 w. cs. 2.w.cs. 11'6" urinal space The Hatch 4 w. cs. 2.w. cs. 11'6" urinal space 16. COLLECTION AND DISPOSAL OP HOUSE AND TRADE REFUSE. COST STATEMENT - 1954-55. Item Particulars 1 Collection 2 Disposal 3 Totals 4 Percentage of total gross expenditure 5 £ £ £ % 1 REVENUE ACCOUNT. GROSS EXPENDITURE: (i) Labour 8424 6797 15,221 56 (i.O . Transport 6174 - 6,174 22 (iii) Plant,equipment, land and buildings 24 2133 2,157 8 (iv) Other items 734 3018 3,752 14 (v) Total gross. expenditure 15,356 11,948 27,304 100 2 GROSS INCOME 451 10,292 10,743 - - 3 NET COST 14,905 1,656 16,561 - 4 Capital expenditure met from revenue (included above) - 82 82 UNIT COSTS. s. d. s. d. s. d. 5 Gross cost per ton, labour only 14. 3. 11. 6. 25. 9. 6 Gross cost per ton, transport only 10. 5. - 10. 5. 7 Net cost (all expenditure) per ton 25. 3. 2. 10. 28. 1. £ £ £ 8 Net cost per 1,000 population 313 35 348 9 Net cost per 1,000 premises 1,047 116 1,163 17. OPERATIONAL STATISTICS. 10. Area (statute acres) - land and inland water 2,868 acres 11. Population at 30th June, 1954 (Registrar-General's Estimate) 47,600 persons 12. Total refuse collected (tons.) 11,812 tons 13. Weight per 1,000 population per day (365 days to year) 14 cwts 14. Number of premises from which refuse is collected L 14,234 premises 15. Premises from which daily collection is made - % of tot 16. Average haul, single journey, to final disposal point 1 mile 17. Kerbside 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 authorites) 11,812 tons 19. Methods of disposal (Salvage excluded): Percentage (a) Crude tipping - (b) Controlled tipping 53 (c) Direct incineration - (d) Separation and incineration 47 (e) Other methods — 100 20. Salvage and Trade Refuse. Analysis of income and tonnage: Income (included in Item 2) (I Tonnage Collected included in Item 12) £ Tons Salvage: (a) Raw Kitchen Waste 147 18 (b) Scrap Metal 2225 541 (c) Waste Paper 5388 658 (d) Other Salvage 2290 322 (e) Totals 10,050 1,539 Trade Refuse 457 204 18. ANALYSIS OF INCOME FOR THE YEAR Year ended ENDED 31st MARCH, 1955. 31.3.54. £. s. d. £. S. d. £. s. d. £. s. d. l.Sale of Salvaged Articles: Metals: 388. 9. 1. Aluminium 389. 16. 11. 192. 11. 9. Copper 204. 14. 0. 237. 3. 0. Iron 277. 0. 3. 39. 12. 4. Lead 54. 16. 5. 5. 17. 11. Battery Lead 13. 2. 5. 24. 11. 6. Lead Type 23. 19. 1. 196. 10. 0. Brass 287. 19. 0. 182. 12. 6. Uribaled Scrap 214. 15 0 8. 651. 14. 6. Tins 701. 80 6. 18. 11. 6. Pewter 12. 12. 3. 15. 7. 9° Zinc 19. 12. 4. -. -. —. Galvanised Tanks 24. 15. 2. 1,953. 1. 10. 2,224. 12. 0. 330. 19. 2. White Cullet 272. 4. 1. 35. 2. 8. Amber Cullet 26. 12. 6. 414. 0. 0. Bottles and Jars 930. 15. 3. 1,229. 11. 10. 667. 11. 3. Rags 728. 5. 3. 112. 13. 1. Carpets and Sacking 111. 2. 8. 10. 0. 6. String 6. 10. 6. 291. 3. 6. Woollens 193. 6. 6. 4. 5. 0. Flock Bedding -. -. -. 1,039. 4. 11. Newspaper and Mixed 4,766. 5. 10. Waste Paper etc. 5,388. 3. 11. 33. 19. 3. Bones 26. 16. 0. 119. 6. 4. Pig Food (Bread) 117. 3. 5. 30. 10. 9. Rubber Tyres and Tubes 20. 11. 6. 4. 0. 0. Unsound Food (Disposal) 3. 0. 0. 3. 5. 6. Miscellaneous items 18. 6. 10, 050. 2. 1. 2. Miscellaneous Receipts and Charges 125. 0. 0. Sale of Screenings -. —. -. 37. 17. 0.3. Weighbridge Fees 15. 0. 6. 4. Rents: 200. 0. 0. Foundry 200. 0. 0. 20. 0. 0. Proportion of Allotment Rents 20. 0. 0. 8. 6. Other Rents 1. 8. 6. 221. 8. 6. 5. Refuse Collection Charges: 347. 18. 6. Greengrocers and Butchers 367. 15. 2. 88. 10. 6. Others 89. 1. 3. 456. 16. 5. £9,595. 18. 11. / c* £10, 743. 7. 6. 19. STREET AND GULLY CLEANSING. COST STATEMENT - 1954-55. Item Particulars 1 Street Sweeping and Watering 2 Street Gully Cleansing 3 Total 4 Percentage of total gross expenditure 5 REVENUE ACCOUNT. £ £ £ % 1 GROSS EXPENDITURE: (i) Labour 2956 1 2957 50 (ii) Transport 2047 2 2049 35 (iii) Plant, equipment land and buildings etc. 160 — 160 3 (iv) Other items 223 475 698 12 (v) Total gross expenditure 5,386 478 5,865 100 2 GROSS INCOME (excluding reimbursements from Ministry of Transport and the County Council) 20 - 20 - 3 NET COST 5406 478 5,884 - 4 Capital expenditure met from revenue (included above) - - - 5 Gross expenditure on snow clearance not included previously 1,823 - - - UNIT COSTS £ [ 6 Net cost (item 3) per street mile 97 - - - £ £ £ 7 Net cost (item 3) per 1,000 street gullies cleansed - 63 - - 8 Net cost (item 3) per 1,000 population 114 10 124 - 20. 0PERATIONAL 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 - % l1. Percentage of street clcansing done by mechanical means Nil % 12. Number of street gullies cleansed 3223 13. Number of gulley cleansings during year. (Number of gullies x number of cleansings) 7595 14. Percentage of gully cleansing done by mechanical means 100% 15. Remarks Item 1 (iv) Gully Cleansing is carried out by Contractors and the figure includes labour and transport. Item 11 Sweeping not by mechanical means, but is carried out by manual labour and three electric trucks used for conveyance of sweepings. SANITARY INSPECTION OF THE AREA. 21. Inspection on Complaint. The number of complaints received at the office and recorded in the register was 505, as compared with 543 in the previous year and 301 for the year 1952. The total inspections made on complaint was 309 and the number of defects or nuisances revealed was 466, 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 45 Blocked Sewers 210 Defective Sewers 1 Defective Water Fittings 6 Insufficient Water Closets 4 Defective Water Closets 3 Blocked Rainwater Gullies 9 Flooding of Gardens, Dwellings and Houses 8 Defective Drainage 7 Absence of and Defective Dustbins 5 Offensive Accumulations 1 Nuisance from Smoke, Dust, Odours etc. 30 Complaints re Condition of Food 27 Nuisance from Insects 11 Animals Kept so as to be a Nuisance 3 Vermin in Premises 1 Dirty Premises 2 Overcrowding 1 Rodent Infestations 92 466 22. 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. It will be observed that the number of visits paid during the year is considerably below that for other years due to the inability of the Corporation to recruit personnel to fill vacancies on the establishment. The visits numbered 4,372 as compared with 7,622 in the previous year; the defects dealt with numbered 884 as compared with 890 in 1953. TABLE 2. Visits Paid Nuisances or Defects Found & Dealt With Housing Act, 1936: Inspections 73 312 Re-inspections re Notices served 291 Re overcrowding 13 On Complaint 309 466 Infectious Diseases 112 Retail Food Premises: Meat 151 Fish 19 Fried Fish 16 General Provisions 139 Other Food Shops 35 Restaurant and Other Food Preparing Premises 121 Ice Cream Premises 1 Food Sampling: Ice Cream 16 Milk 11 Other Foods 76 Drugs 3 Factories 48 11 Slaughterhouses 29 Bakehouses 14 Dairies 4 Pigstyes 23 Re-visits re Notices served (P.H.Act) 149 Other re-visits 196 Rodent Control 1595 92 Shops Act: Sanitary Conditions 141 Hours of Closing 83 Young Persons Employment 55 Council Houses 61 Collection and Disposal of Refuse and Salvage (Carried Forward) 120 3904 881 23. TABLE 2 (contd.) 23. Visits Paid Nuisances or Defects Found & Dealt With (Brought Forward) 3904 881 Street Cleansing 62 Sohools 21 3 Hairdresser's Premises 7 Swimming Pool 5 Miscellaneous Visits 67 Places of Entertainment 12 Public Conveniences 3 Petroleum Acts 19 Outworkers 161 Smoke Observations 20 Pollution of Pavers and watercourses 8 Street Food Vendors 9 Movable Dwellings 8 Merchandise Marks Act 4 Pet Animals Act 50 Water Act 6 Sewage Disposal Works 6 4372 884 24. TABLE 3 (oontd.) (Brought Forward) 374 Water Closets repaired or reconstructed 6 Water Closet Pedestals fixed 3 Water Closet Flushing Cisterns repaired or renewed 5 Water Storage Tanks and Piping repaired or renewed 4 Hot Water Systems repaired 1 Dustbins provided 4 Rat Infestations 92 Sewers cleansed 381 S ewers repaired 2 Food Premises: Limewashed and cleansed 1 Factories, and Workplaces: Limewashed and cleansed 1 Lighting and Ventilation improved 1 Additional Sanitary Accommodation 1 Separate Accommodation for sexes 1 Unsuitable or defective 1 Other Contraventions of Act 6 884 TABLE 4. Letters sent out and notices served in connection with the work of the Health Department: Letters 1030 Public Health Acts: Preliminary Notices 28 Statutory Notices - Housing Acts: Preliminary Notices 21 Statutory Notices 6 25. 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 71 42 - - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding Outworker's Premises) 3 6 - - Total 74 48 — - 2. - Cases in which defects were founds. 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.I.) 1 1 - - - Overcrowding (S.2.) - - - - - Unreasonable temperature (S.3.) - - - - - Inadequate ventilation & lighting (S.4.) 1 1 - - - Ineffective drainage of floors (S.6.) - - - - - Sanitary Conveniences (S.7. (a) Insufficient 1 1 - - - (b) Unsuitable or defective 1 1 - - - (c) Not separate for sexes 1 1 -- - - Other offences against the Act (not including offences relating to Outwork) 6 6 - - - Total 11 11 - - - 26. Shops Act, 1950. A total of 279 visits was paid to shops and generally conditions were found to be satisfactory. 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 9th May and closed on the 12th September, 1954. The total attendance throughout the season was 73,929, the highest attendance being on 1st September when 4,080 persons were present. The number of persons attending the Pool indicates the very unfavourable weather which persisted throughout the summer. Sanples of water were taken from the Pool during the months of June, July and August and the results in all cases 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 continued progress was made in the execution of "works of repair and maintenance. 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® Factories Act, 1937. Forty-eight visits were paid to factories and in five instances action was taken to secure improvements in cleanliness and provision of sanitary accommodation. 27 NUMBER AND TRADE OF OUTWORKERS 2 NOTIFIED DURING 1954. Wearing Apparel 65 Stationery 1 Knitwear 72 Artificial Flowers 9 Footwear 12 Box-making 5 Buttons 1 Down Quilts. 4 Handbags 7 Trimmings 1 Christmas Crackers 1 Art Needlework 1 OUTWORKERS WERE NOTIFIED FROM THE FOLLOWING AREAS. City of Bradford 1 St.Marylebone 5 St. Pancras 3 Hackney 34 Stoke Newington 4 Shoreditch 14 Leyton 72 Tottenham 8 Islington 4 Finsbury 27 Westminster 3 Wood Green 1 London Corporation 5 West Ham 1 Edmonton 2 Chigwell 2 Bethnal Green 6 Lambeth 1 Potters Bar 2 Walthamstow 1 Prevention of Damage by Peste 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, 1,595 visits were paid to deel with minor infestations at private and business premises and in connection with sewer maintenance treatments. The eleventh and twelfth maintenance treatments were carried out in March and September respectively. In March 220 manholes were baited and of these 18.18% showed complete or partial takes; 271 manholes were baited in September, 12.17% of which showed complete or partial takes. 28. SECTION D. HOUSING. HOUSING REPAIRS AND RENTS ACT, 1954. This Act came into operation on the 30th August, 1954 and additional work devolving on the Department was concerned with the preparation of proposals for dealing with unfit houses, the issue of Certificates of Disrepair and the inspection of property following applications for improvement grants. Five applications were received for Certificates of Disrepair and in each case the application was granted. During the year under review works were carried out in one instance to enable the Council to revoke the Certificate. Two applications for improvement grants were made, but neither of these was granted. HOUSING STATISTICS FOR THE YEAR. 1954. 1. Number, of. Houses Erected During the Year. (1) By the L.A.(permanent) Traditional (including flats)153 (2) By private enterprise (Including flats) 11 164 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) 555 (b) Number of inspections made for the purpose 1191 (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 73 (b) Number of inspections made for the purpose 291 (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 92 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 57 29. 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 3 (2) Number of dwelling-houses which were rendered fit after service of formal notices:- (a) By owners 3 (b) By Local Authority in default of owners - B. Proceedings under Section 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 undertaking given by the owners under Section 11 - C. Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied - (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners - (b) By Local Authority - SECTION E. INSPECTION AND SUPERVISION OF FOOD. Milk Supply. The milk supply is from several large firms with dairy premises outside the Borough boundaries and is mainly pasteurised. Seven samples of milk were analysed during the year and all were certified to be genuine. 30. 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. 2 supplementary licences 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. Eighty-three samples of foods and drugs were submitted for analysis, twenty-one formal and sixty-two informal and it will be seen by the following table that a reasonably wide field was covered. The table shows that in six instances samples were adversely reported upon. One sample of machine skimmed milk was submitted as a result of a complaint of abnormal taste and smell. The milk was submitted to a chemical and bacteriological examination which failed to disclose any objectionable contamination or deterioration. The unusual odour was, in the analyst's opinion, reminiscent of a lacquer which may have been picked up during the canning process. The remaining stocks were withdrawn from sale. 31. One sample of beef chipolatas (cooked) was submitted as a result of a complaint of a bitter taste. On analysis this sample was found to contain fifty parts per million of Sulphur Dioxide. The Analyst was of the opinion that the original preservative content was sufficiently high in the uncooked chipolatas to account for the "taste" trouble. Formal followup samples were taken at the retail shop in question and these were certified to be genuine and to contain preservative within the prescribed limits. Continued attention was given to the metallic contamination of ice lollies and although the Revised Recommendations of the Food Standards Committee (Ministry of Food) prescribed a limit of 1.0 p.p.m. lead in ice cream and ice lollies, the Council resolved that as a general principle 0.5 p.p.m. be accepted as a reasonable standard for these commodities sold in the area. Further, the Chief Sanitary Inspector was instructed to write to vendors and manufacturers and also the local authority in whose district the lolly or ice cream was manufactured where a sample indicated a lead content greater than this amount. Samples of ice lollies were taken from the main sources of supply coming into the Borough and of these one fruit flavoured lolly was found to contain 1.4 p.p.m. lead content and the subsequent follow-up sample a lead content of 2.0 p.p.m. This rather high contamination was taken up vigorously with the manufacturers concerned, whose factory is situated in a neighbouring Borough. The management gave immediate and wholehearted co-operation, so much so that manufacture was suspended until the equipment had been thoroughly overhauled and in part renewed. Follow-up samples, not taken within the year under review, indicated that the lead content was considerably reduced and within the limits set by the Council. Four other samples of ice lollies exceeded 0.5 p.p.m. and routine action was taken to secure a reduction in contamination. A sample of bottled still laucnade was certified to contain 0.3 p.p.m. lead content which slightly exceeded the limit of 0.2 p.p.m. fixed by the Analysts, The manufacturers were contacted and were of the opinion that natural lemon juice imported from Italy contained the excess lead as all manufacturing plant was comprised of stainless steel® One sample of glycerine was found to have a specific gravity of 1.244 as against 1.260 as stated on the labels of the bottles in which the glycerine was sold, equivalent to the addition of approximately 6% of water. The glycerine was found to be old stock and the remainder was withdrawn from sale. 32, Samples Taken During the Year 1954. Article Number Examined Total Result of Analysis Formal Informal Genuine Non-Genuine Milk 7 - 7 7 - Lacto Choc Drink 1 - 1 1 - Sugar - 2 2 2 - Soft Drinks - 5 5 4 1 Crab Paste - 1 1 1 - Sweetened Skimmed Mill - l 1 - 1 Fish Paste - 5 5 5 - Vinegar 1 - 1 1 - Non-brewed Condiment 1 - 1 l - Mussels - 1 1 1 - Tea - 1 1 1 - Sauce - 1 1 1 - Coffee 1 - 1 1 - Pepper 1 - 1 1 ~ Processed Cheese - 2 2 2 - Custard Powder - 2 2 2 - Flavoured Cornflour - 1 1 1 - Semolina - 1 1 1 - Tapioca Flakes - 1 1 1 - Canned Gooseberries - 1 1 1 - Chipolatas 2 1 3 2 1 Mint Jelly - 1 1 1 - Table Jelly - 2 2 2 - Vegetable Fat - 1 1 1 - Cocoa - 1 1 1 - Jam - 1 1 1 - Jelly Crystals - 1 1 1 - Meat Paste - 1 1 1 - Margarine 2 - 2 2 - Butter 1 - 1 1 - Welsh Rarebit - 1 1 1 - Synthetic Cream Powder - 1 1 1 - Plain Flour - 1 1 1 - Canned Meat - 1 1 1 - Fruit Flavoured Lollies 2 3 5 3 2 Creamy Lollies 2 2 4 4 - De-hydrated Veg etables - 1 1 1 - Gelatine - 1 1 1 - Barley Water Crystals - 1 1 1 - Mincemeat - 1 1 l - Minced Turkey - 1 1 1 - Boracic Powder - 1 1 1 - Glycerine, Lemon & Honey - 1 1 1 - Olive Oil - 1 1 1 - Sulphur Ointment - 1 1 1 - Glauber Salts - 2 2 2 - (Carried Forward) 21 54 75 70 5 33. Article Number Examined Total Result of Analysis Formal Informal Genuine Non-Genuine (Brought Forward) 21 54 75 70 5 Glycerine - 2 2 1 1 Cough Mixture - 3 3 3 - Camphorated Oil - 1 1 1 - Castor Oil - 1 1 1 - Glycerine,Lemon & Ipecacuanha - 1 1 1 - Totals: 21 62 83 77 6 Legal Proceedings. One case was taken before the Magistrates under Section 9 of the Act in relation to the sale of fishcakes unfit for human consumption. A conviction was recorded resulting in a fine of £10 and costs amounting to £1. 10s. 0d. Byelaws - Handling, Wrapping and Delivery of Food. Progress has continued in the maintenance of hygienic conditions in food premises in relation to these Byelaws. 482 visits were paid to food premises including restaurants and other food-preparing premises. Inspection of Meat and Other Foods. Public Health (Meat) Regulations, 1924-52. Following the decontrol of meat by the Ministry of Food, private slaughtering was permitted as from the 2nd July, 1954. The Council duly considered the implication of the Ministry of Food circular M.F.5/54 and from enquiries made it was ascertained that the majority of butchers desired to avail themselves of the facilities of Smithfield Market, Under these circumstances it was decided that no recommendation should be made with regard to the provision of slaughtering accommodation. There is one private licensed slaughterhouse in the Borough and twenty-six butchers, and the following table shows the number of animals slaughtered and inspected up to the 31st December, 1954. Beasts. Sheep. Pigs. Calves. 117 13 All carcases were found fit for human consumption. 34. TINNED FOODS. Article. Quantity. Meat 168 tins Sausages 158 " Fish 12 " Fruit and Vegetables 511 " Pickles and Sauces 7 jars Milk 6l tirs Jams and Marmalade 14 jars Steak Pudding 3 tins Mincemeat 1 " Soup 10 " Meat Paste 1 " Broth. 3 " Pease Pudding 1 " Honey 1 tin and 2 jars. Goffee 27 tins Baby Food 1 " Cream 23 Yoghaut 1 bottle OTIIER FOODS. Fish 9½ stone Fruit and Vegetables 60 lbs. Eggs 2160 Cheese 18 lbs. Condemnation certificates were issued in respect of the undermentioned home-killed and imported meat and offal:- Mutton 2 lbs. Beet lbs. Pork 6 292¾ lbs. Liver 114½ lbs. Registration of Food Preparing Premises. The registration of these premises is secured by Section 14 of the Food and Drugs Act, 1938 and the number of premises on the register was 102, being 74 for the manufacture, storage or sale of ice cream and 28 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 and the number of persons so registered at the end of the year was 71. 35. BACTERIOLOGICAL EXAMINATIONS. The Counties Public Health Laboratories, 66, Victoria Street, London, S.W.1. undertake bacteriological examinations for the Council through the Essex County Council Bacteriological Laboratory Service. Ice Cream. During the year fifteen samples of ice cream were submitted for bacterial examination; two samples of fruit lolly and one of canned sterilised cream. The results are itemised below and it is pleasing to note that the majority of the samples were in Grade 1. Grade 3. Grade 11. Grade 111. Grade IV, 12 2 1 0 Two samples of fruit lolly not graded. The sample of sterilised cream 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. No: Type Colonies per ml. on Agar @ 37°C ill 48 hrs. Conform Test 3 Tubes. Bact. Coli 3 Tubes. Ministry Grade. 1 Wrapped brickette 1,800 0/3 0/3 1 2 Wrapped brickette 1,900 0/3 0/3 1 3 Wrapped brickette 29,000 0/3 0/3 11 4 Wrapped chocice 1,600 0/3 0/3 1 5 Wrapped brickette 800 0/3 0/3 1 6 Fruit lolly Nil 0/3 0/3 Excellent standard. 7 Wrapped brickette 2,100 0/3 0/3 1 8 Wrapped brickette 500 0/3 0/3 1 9 Wrapped lolly 700 1/3 0/3 Satisfactory standard. 10 Wrapped brickette 1,400 0/3 0/3 1 11 Loose from can 4,000 1/3 0/3 1 12 Loose from can 60,000 2/3 0/3 111 13 Loose from bulk 1,800 3/3 0/3 11 14 Wrapped choc ice 100 0/3 0/3 1 15 Wrapped brickette 200 0/3 0/3 1 16 Loose from bulk 200 0/3 0/3 1 17 Wrapped brickette 400 0/3 0/3 1 36. SECTION F PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Diphtheria There was no case of diphtheria in the borough during 1954. It is now five years since the last case was confirmed. The number of children being presented for immunisation remained very satisfactory. The details are:- Primary immunisations - under 5 years - 486 " " - 5 to 15 years - 109 Total - 595 Number receiving secondary or reinforcing injections - 562 Scarlet Fever A very marked reduction in the number of cases of scarlet fever was noted, viz: 64 as against 168 in 1953. For many years past the type of scarlet fever prevalent generally throughout the country has been very mild and 1954 was no exception to the usual pattern. Only 17% of the cases needed admission to hospital. The following statement shows the total cases notified and the precentage removed to hospital during the last five years:- 1950 1951 1952 1953 1954 Confirmed cases 62 81 181 168 64 Percentage removed to hospital 65 48 47 37 17 Measles A sharp reduction, amounting almost to 50%, was a feature of the incidence of measles during the year, 195 cases being recorded compared to 380 in the previous year. Only four cases were admitted to hospital. No deaths occurred from this disease. 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 Although the number of cases of whooping cough fell from 181 in 1953 to 138 in 1954 it is too early yet to say whether this can be 37. attributed to the campaign for whooping cough immunisation. Parents are bringing their children for immunisation in everincreasing numbers, a total of 445 children receiving a full course during the year. Acute Poliomyelitis Four cases were notified and confirmed. Of these, only one developed paralysis which, unfortunately, proved rapidly fatal. Tuberculosis Fresh notifications of tuberculosis numbered 32, and, in addition, 31 persons who were already known cases of tuberculosis in other areas, came to reside in the borough. The most important step taken in 1954 was the commencement of B.C.G. vaccination of school-children in the year preceding their fourteenth birthday. The response on the part of parents was most encouraging and a total of 67 children out of 130 eligible, were vaccinated. The excellent work carried out by the Falthamstow and Chingford Association of Tuberculosis Care Helpers was continued. This Association is deserving of the utmost support and, indeed, receives an annual grant from the Council, apart from donations from many organisations in the borough. Its work is mainly of a practical nature, providing needy families of tuberculous persons with groceries, milk, bedding, coal, etc. during the long period of the patient's illness and his subsequent rehabilitation. Dysentery Of seventeen notifications of this disease, only three needed hospital admission. Food Poisoning Only three persons were notified as suffering from food poisoning: all these were isolated instances and were not linked with one another. Food Hygiene Close contact was maintained by the Health Department with all food premises in the borough; these contacts provided ample opportunity for the discussion of problems relating to cleanliness in the handling and preparation of food. Smallpox contacts Surveillance of several persons, who were contacts or 38. possible contacts of smallpox cases, was carried out for the required period. Vaccination Number of primary vaccinations during the year 303 " " re-vaccinations during the year 115 National Assistance Act, 1948 (a) Section 47: No statutory action was required tinder 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 1954. 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 two instances during the year. The whole of the cost of burial in each case was recovered by the Council. Medical Examinations During the year 38 examinations were carried out by me in respect of Chingford Council staff and 56 in respect of staff of the Essex County Council. CAUSES OF DEATH AS GIVEN BY THE REGISTRAR-GENERAL FOR THE YEAR 1954 Causes of death Males Females Total " Tuberculosis, respiratory 3 1 4 Syphilitic disease 1 - 1 Acute poliomyelitis - 1 1 Malignant neoplasm, stomach 6 5 11 Malignant neoplasm, lung, bronchus 15 3 18 Malignant neoplasm, breast - 14 14 Malignant neoplasm, uterus - 1 1 Other malignant & lymphatic neoplasms 21 30 51 Leukaemia, aleukaemia 2 1 3 Diabetes 1 4 5 Vascular lesions of nervous system 18 27 45 Coronary disease, angina 39 14 53 Hypertension with heart disease 1 2 3 Other heart disease 21 27 48 Other circulatory disease 8 11 19 Influenza - 1 1 Pneumonia 6 8 14 Bronchitis 13 9 22 Carried forward 155 159 314 39. CAUSES OF DEATH (continued) Causes of death Males Females Total Brought forward 155 159 314 Other diseases of respiratory system 4 - 4 Ulcer of stomach and duodenum 3 1 4 Gastritis, enteritis & diarrhoea. 1 - 1 Nephritis and nephrosis - 5 5 Hyperplasia of prostate 4 - 4 Congenital malformations 3 1 4 Other defined & ill-defined diseases 21 8 29 Motor vehicle accidents 5 2 7 All other accidents 2 1 3 Suicide 4 3 7 Totals - all causes 202 180 382 Totals - year 1953 198 188 386 DEATHS FROM CANCER There were 95 deaths from cancer, 85 of them having 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 2 9 16 10 18 Lungs and Mediastinum - 1 15 2 15 3 Genito-urinary organs 2 1 2 3 4 4 Breast - 3 - 11 - 14 Other sites - - 13 14 13 14 Totals 3 7 39 46 42 53 Death rate - 1.99 per 1,000 (as compared with 1.71 per 1,000 in 1953) 40. TUBERCULOSIS NEW CASES TRANSFERS DEATHS Respiratory NonReso iratory Respiratory NonResp iratory Respiratory NonResp iratory M. F. M. F. M. F. M. F. M. F. M. F. 0 to 1 year - - - - - - - - - - - - 1 to 4 years - 1 - - - - - - - - - - 5 to 14 years 1 1 - - - 1 - - - - - - 13 to 24 years 3 6 1 1 - 3 2 - - - - - 25 to 34 years 1 8 - - 6 4 - - - 1 - - 35 to 44 years 4 - - - 1 3 - - 1 - 1 - 45 to 54 years 1 - - - - 1 - - - - - - 55 to 64 years 3 - - - - - - - 2 - - - 65 and upwards 1 ~ - - - - - - 2 " - - | TOTALS 14 16 1 1 7 12 2 - 5 1 1 - Add - deaths of un-notified cases 1 - - - 6 1 1 1 Note: 3 of the deaths recorded above were not attributable to tuberculosis, though occurring to notified patients. 41. 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 Malaria Pulmonary Other Forms 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 - 1 34 1 6 - 1 - 5 - 1954 64 - 5 195 138 30 2 17 2 - 17 - 4 - - - 3 - 42. 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 - - 1 6 6 46 4 1 - - - - 64 Erysipelas - - - - - 1 - - - - 2 2 5 Measles 9 26 20 22 24 89 3 1 1 - - - 195 Whooping Cough 11 10 12 17 17 66 2 1 1 1 - - 138 Pneumonia - - - - 1 1 - - 11 5 4 5 17 Dysentery - - - - - 8 - 1 6 1 - - 17 Food Poisoning - - 1 - - - - - 2 - - - 3 Malaria - - - - - - - - l - - - 1 Acute Poliomyelitis. - - - - - 3 - - l - - - 4 Puerperal Pyrexia - - - - - - - - 1 1 - - 2 ANALYSIS OF NOTIFIABLE DISEASES (after correction) Diseases Total cases Total admitted to hospital Scarlet Fever 64 11 Erysipelas 5 1 Measles 195 4 Whooping Cough 138 8 Pneumonia 17 11 Dysentery 17 3 Food Poisoning 3 - Malaria 1 1 Acute Poliomyelitis 4 4 Puerperal Pyrexia 2 2 2 as out-patients only