AC 4411(1) 1 In Q 5B 2 Library CHIN 20 CHINGFORD BOROUGH OF CHINGFORD ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH Including the Report of the CHIEF SANITARY INSPECTOR FOR THE YEAR 1955 67956 BOROUGH of CHINGFORD ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH including the Report of the CHIEF SANITARY INSPECTOR for the Year 1955 BOROUGH OP CHINGFORD Committee: June, 1955 - May, 1956 PUBLIC HEALTH COMMITTEE Chairman: Councillor G.H. Smith Vice-Chairman: Councillor W.J. Bowstead Members: Councillor W.J. Buckley " Mrs. 0, Corder " V.D. Hall " A.F. Nicholls " G.C. Robertson " C.H. Staig " Mrs. I. Titley, J.P. The Mayor, Councillor A.T.H. Austin, J.P. (ex-officio) Meeting: Second Monday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1955) 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) (to 28.2.55) D. J. CROSS, M.R.San.I., M.S.I.A. (b) (f) (c) C. DAY, M.S.I.A. (b) (c) (e) (?) (h) (from 1.7.55) Student Sanitary Inspector: E, ISMAY (from 7.4.55) Senior Clerk: Miss V.M. PETTIT Clerks: A. H. GILLIES Mrs. I.A. BAGNES (to 25.11.55) Miss C. RICE (to 26.3.55) Miss V.A, BROOKS (from 6.4.55) Mrs. B. BENNETT (from 5.12.55) (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 (h) Certificate of the Royal Sanitary Institute as Smoke Inspector 1. ANNUAL REPORT FOR THE YEAR 19 5 5 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 1955 upon the health and sanitary circumstances of the Borough. The estimated population for the year was 47,310. Vital Statistics: A further reduction in the birth-rate has occurred, the rate per thousand being 9.9 (in 1954, 11.7): this is a new low record; the total number of births was 472, the average for the previous five years being 602. The death-rate was 7.2 per thousand (in 1954, 8). There were 80 deaths due to cancer and 163 deaths due to heart disease and associated vascular conditions. These two diseases were the cause of more than two deaths out of every three that occurred. Cancer alone caused nearly 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 12.7. As will be seen from the table on page 4, the infant mortality rate is subject to wide fluctuations. The rate for England and Wales was 24.9. Infectious Diseases: The number of cases of measles was 492, compared with 195 in 1954. Poliomyelitis cases numbered 12. It is very gratifying that only 20 cases of pulmonary tuberculosis were notified during 1955; the average number for the previous five years was 36. The B.C.G. vaccination scheme for children aged 13 continued throughout the year: the percentage of children vaccinated out of those eligible remained most satisfactory. The Walthamstow and Chingford Association of Tuberculosis Care Helpers continued its excellent work in bringing practical help in the way of food, clothing, convalescent holidays, etc. to tuberculous persons and their families. 2. The Area Medical Officer, Dr. F.G. Brown, has kindly supplied me with the statistical matter on pages 5 and 6, for which I thank him. My thanks are also offered to the Chairman and Members of the Health Committee for their support and to Mr, J.P. Rogers, Chief Sanitary Inspector, and the Staff of the Health Department for their assistance during the year. I am, Ladies and Gentlemen, Your obedient servant, J. H. CROSBY Medical Officer of Health. August, 1956. 3. SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,868 acres Population - Registrar-General's estimate for mid-year 1955 47,310 Number of inhabited houses and flats (as at 31.12.55) 13,658 Rateable value on April 1st, 1955 £391,555 Product of a penny rate, year ending 31.3.55 £1,590. 5. 2. VITAL STATISTICS M. F. Total 248 224 Birth Rate per 1,000 Live Births Legitimate 243 217 of estimated resident illegitimate 5 7 population: 9.9 Total 4 6 Rate per 1,000 total Stillbirths Legitimate 4 6 (live and still) illegitimate - - (births: 20.7 Crude Death Rate per Deaths 181 162 1,000 of estimated resident population: 7.2 Deaths from puerperal sepsis 0 " " other puerperal causes 0 Death rate of infants under one year of age:- All infants per 1,000 live births 12.7 Legitimate infants per 1,000 legitimate live births 13.0 Illegitimate infants per 1,000 illegitimate live births Deaths from Cancer (all ages) 80 " " Measles (all ages) 0 " " Whooping Cough (all ages) 0 4. 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 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 1955 47,310 472 9.9 343 7.2 6 1 12.7 5. SECTION B GENERAL PROVISION OF HEALTH SERVICES IN THE AREA (a.) Laboratory Facilities Pathological specimens from this district are examined at the Pathological Departments of the St, Margaret's Hospital, Epping, the Connaught Hospital, Walthamstow, and the Whipps Cross Hospital, Leytonstone. Specimens may also be left at the Town Hall, Walthamstow, on weekdays before 2.30 p.m., for collection and delivery to the Central Public Health Laboratory at Colindalc„ The Pathologist at St. Margaret's Hospital has kindly supplied me with the number of specimens examined for the Health Department and the General Practitioners in Chingford during 1955, which is 86. (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, 20, Cranston Gardens, E.4. Larkswood 7078 Miss D.L. Chandler, 87, Friday Hill, E.4. Silverthorn 4968 Miss C. Lovell, 49, The Ridgeway, E.4. " 1460 ø Mrs, P.M. Stenning, 78, Larkswood Road, E.4. " 5414 Miss M, Jones, 49, The Ridgeway, E.4. " 1460 Mrs. E.V. Whiter, 79, Harold Road, E.4, (part-time) " 6194 Mr. Winyard, 13, Durants Park Avenue, Enfield. Howard 4331 6. (c) contd. Number of cases attended by Midlives as:- (a) Midwives - 92 (b) Maternity nurses - 25 117 Number of visits paid by Home Nurses:- 14,432 (d) Health Visiting The total number of visits paid by the Health Visitors during the year was 8,668. (e) Begistered Nursinp, 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 7 and 8. Child Welfare Centres Attendances of children - under 1 year of age - 7,573 " " " - between 1-2 years - 1,717 " " " - " 2 - 5 " - 1.250 Total - 10,540 Ante-Natal Clinics Ante-Natal attendances - 1,109 Post-Natal - 65 Total - 1,174 Women's Welfare Clinic Birth control - 1st visits - 54 " " - revisits - 314 Total - 368 (g) Hospitals The hospitals providing general medical services for Chingford residents are chiefly the Connaught Hospital, Walthamstow, and the Wanstead Hospital, Wanstead. 7. Fersons 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 is one Day Nursery in the district, situated at 136/138, Chingford Mount Road. Regular medical inspection of the children attending this Nursery 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 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, 1956 Clinic Where held When held Diphtheria Immunisation Clinics Primary Hall, Buxton Road, North Chingford. Tuesdays, 2 p.m. St. Erancis' Hall, Hawkwood Crescent, E.4. Wednesdays, 2 p.m. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Thursdays, 11.30 a.m. E.C.C. Health Services Clinic, Hatch Lane, E.4. Wednesdays, 2 p.m. Parish Church Hall, The Ridgeway, North Chingford. Wednesdays, 10 a.m. Ante-Natal Clinics E.C.C. Health Services Clinic, Hatch Lane, E.A. Tuesdays, 2-4 p.m. E.C.C. Health Services Clinic, Marmion Avenue. E .4 Wednesdays, 9.30 a.m. continued:- 8. LOCAL CLINICS AND TREATMENT CENTRES. 1956 (cont:) Clinic Where held When held Child Welfare Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. Wednesdays, 2-4 p.m. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Tuesdays & Wednesdays, 1.45 - 3.45 p.m. Primary Hall, Buxton Road, North Chingford. Tuesdays, 2 - 4 p.m. St.Francis' Hall, Hawkwood Crescent, E.4. Wednesdays, 2-4 p.m. Parish Church Hall, The Ridgewav. North Chingford. Wednesdays, 9.50 - 11.45 a.m. Toddlers' Clinic E.C.C. Health Services Clinic, Marmion Avenue, E.4. Thursdays, 10 a.m. 11.30 a.m. Minor Ailment & School Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. Mondays, 2 - 4 p.m. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Mondays, 10 - 12 noon Orthopaedic Clinics (as arranged by Reg. Hosp. Board) E.C.C. Health Services Clinic, Hatch Lane, E.4. Wednesdays & Thursdays at 2 p.m. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Mondays at 2 p.m. (both by appmt. only) Ophthalmic Clinic as arranged by Reg. Hosp. Board) E.C.C, Health Services Clinic, Hatch Lane, E.4. Friday afternoons (by appointment only) Dental Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. Wednesdays, 9.30 10.45 a.m.(inspections only) E.C.C. Health Services Clinic, Marmion Avenue, E.4. Mondays, 9-10 a.m. (inspections only) Women's Welfare Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. 1st Friday in every mth 10 a.m. - 12 noon, (by appointment only) E.C.C. Health Services Clinic, Marmion Avenue. E.4. 4th Friday in every mth at 10.15 a.m. Chest Clinic Old Monoux School, High Street, Walthamstow, E.17. New cases: Adults, Weds 10 a.m. - 12 noon New cases: Children,Fri 10 a.m. - 12 noon Foot Clinic (Old Age Pensioners only) E.C.C. Health Services 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 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. 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: Copper-mill 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. Rivers and Streams. Twenty seven visits were made during the year in connection with the pollution of water courses. Informal action secured the abatement of minor instances of pollution. Fly Nuisance. As predicted in the report for 1954, the emergence of flies again caused considerable nuisance in the spring of the year. The emergence of the Chironomidae flies was very heavy indeed and was sited on the banks and on land adjoining the King George V Reservoir. Such was the extent of the nuisance that not only the Yfater Board land but also adjoining land in the ownership of the Council was sprayed with insecticide in order to deal with the problem,, A weekly collection of refuse and salvage was maintained and the total v/eight of refuse disposed of at the Works was 11,797 tons as compared with 11,812 tons for the previous year. The Registrar General's estimate of population at the mid-year 1955, the fourth since the census in 1951, indicated a decline, being 47,310 as against the estimate for mid-year 1954- of 47,600. The number of premises from which refuse was collected showed an increase, being 14,537 as against 14,234 for the previous year. The analysis of income on page l4 reveals a total figure of £11,908 as against £10,743 for the previous year. Whilst the sale of waste paper made a major contribution to this figure, notable sums were also received from the sale of metals, both ferrous and nonferrous, cullet, bottles, jars and textiles. The net cost per ton for the collection of refuse was 27/ld as against 25/3d for the year ended March, 1955 and 24/7d for the year ended March, 1954. The increase in the unit cost per ton is due to Wage Awards to the additional men being employed during the year. Five refuse collection vehicles were in daily use, two vehicles 11. maintained as spares. No new vehicles were acquired during the year. The net cost per ton for the disposal of refuse was 4/Sd as compared with 2/lOd in the previous year and 3/9d for the year ended March, 1954. Although this cost is slightly higher than in the previous year, it is still low in relation to the averages for the whole of the country. The net expenditure for the collection and disposal of refuse and salvage, including loan charges, was £18,759 or 3l/9d per ton as against £16,561 or 28/ld per ton for the previous year. The three 24-cell Morrison Electric Trucks continue to function satisfactorily. Maintenance costs were again low as indicated in the following table:- Item 1955/56 (Actual) 1956/57 (Estimated) Electricity £42 £42 Water and Oil 6 6 Cleaning Materials and Equipment 9 9 Repairs 30 45 Tyres 20 30 Maintenance Contract 25 30 Insurance and Licenses 81 81 £213 £243 Road gullies were cleansed by contract as in previous year, 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. 12. COLLECTION AND DISPOSAL OF HOUSE AND TRADE REFUSE COST STATEMENT 1955/56 Item Particulars Collection Disposal Totals Percentage of total gross expenditure 1 2 3 4 5 REVENUE ACCOUNT £ £ £ % 1 GROSS EXPENDITURE: (i) Labour 9028 7602 16630 54 1 (ii) Transport 6608 - 6608 22 iii) Plant, equipment, land and buildings 32 3352 3384 11 (iv) Other items 791 3254 4045 13 (v) Total gross expenditue 16459 14208 30667 100 2 GROSS INCOME 452 11456 11908 - 3 NET COST 16907 2752 18759 - 4 Capital expenditure met from revenue (included above) - 568 568 UNIT COSTS s. d. s. d. S. d. 5 Gross cost per ton, labour only 15. 3. 12. 11. 28. 2. 6 Gross cost per ton, transport only 11. 2. - 11. 2. 7 Net cost (all expenditure) per ton 27. 1. 4. 8. 31. 9. £ £ £ 8 Net cost per 1,000 population 339 58 397 9 Net cost per 1,000 premises 1116 192 1308 13. OPERATIONAL STATISTICS 10. Area (statute acres) - land arid inland water 2868 acres 11. Population at JOth June, 1955 (Registrar- General's Estimate) 47310 persons 12. Total refuse collected (tons) 11797 tons 13. Weight (cwts„) per 1,000 population per day (365 days to year) 13.6 cvvts 14. Number of premises from which refuse is collected 14337 premises 15. Premises from which collections are made at least once weekly 100/5 of tota 16. Average haul, single journey, to final disposal point (including miles by secondary transport) 1 mile 17. Kerbside collection expressed as estimated percentage of total collection Nil^o 18. Total refuse disposed of (of which Nil tons were disposed of for other local authorities) 11797 tons 19. Methods of disposal (Salvage excluded): (a) Crude tipping - % (b) Controlled tipping 51 % (c) Direct incineration -% (d) Separation and incineration 49 % (e) Other methods 100 % 20o Salvage and Trade Refuse. Analysis of income and tonnage Income Tonnage (included in Collected Item 2) (included in Item 12) £ £ Salvage: (a) Raw Kitchen Waste 170 24 (b) Scrap metal 2209 529 (c) Waste paper 6294 609 (d) CJther Salvage 2553 1083 (e) Totals 11226 2245 Trade Refuse: 423 200 14. ANALYSIS OF INCOME FOR THE YEAR Year ended ENDED 31st MARCH. 1956. £. s. d. £. s. d. £. s. d. £. s. Sale of Salvaged Articles: Metals 389. 16. 11. Aluminium 366. 6. 7. 204. 14. 0. Copper 208.13. 1. 277. 0. 3. Iron 161.12.10. 54. 16. 5. Lead 37.15. 5. 13. 2. 5. Battery Lead 8. 9. 4. 23. 19. 1. Lead Type 24.10.10. 287. 19. 0. Brass 282.3.4. 214. 15. 8. Unbaled scrap 181.5.7. 701. 8. 6. Tins 872. 7. 3. 12. 12. 3. Pewter 9.10.0. 19. 12. 4. Zinc 14.12.6. 24. 15. 2. Galvanized Tanks 10.10.8. - Girder 51. 9. 1. 2224.12.0. 2209. 6, 6. 272. 4. 1.White cullet 309. 5.11. 26. 12. 6.Amber Cullet 25. 5. 6. 930. 15. 3.Bottles & Jars 995.16. 0. 1330. 7. 5. 728. 5. 3.Rags 710.14. 4. 111. 2. 8.Carpets & Sacking 118.16. 6. 6. 10. 6.String 4.14. 3. 193. 6. 6.Woollems 239. 4. 1. Flock Bedding 8.15. 0. 1082. 2. 2. 5388. 3. 11.Newspaper & Mixed 6293.14.10. Waste Paper, etc. 26. 16. 0.Bones 28. 5. 9. 117. 3. 5.Pig Food (Bread) 136.16. 7. 20. 11. 6.Rubber Tyres & Tubes 45.17. 5. 3. 0. 0.Unsound Food (disposal) 5. 0. 0. Screenings 94.19. 1. 18. 6.Miscellaneous Items 3.14. 6. 6608. 8. 2. 11230. 4. 3. Miscellaneous Receipts and charges. 15. 0. 6,Weighbridge Fees 34. 1. 6. Rents: 200. 0. 0. Foundry 200. 0. 0. 20. 0. 0. Proportion of Allotment Rents 20. 0. 0. 1. 8. 6. Other Rents 2. 6. 220. 2. 6. Refuse Collection charges: 367. 15. 2.Greengrocers & Butchers 340.18. 0. 89. 1. 3.Others 82.14. 3. 10743. 7. 6. 11908. 0. 6. 15. STREET AND GULLY CLEANSING COST STATEMENT 1955-56 Item Particulars Street Sweeping and Watering Street Gully Cleansing Total Percentage of total grosa expenditure 1 2 3 4 5 REVENUE ACCOUNT £ £ £ % 1 GROSS EXPENDITURE (i) Labour 381,8 1 3849 56 (ii) Transport 2136 5 2141 31 (iii) Plant, equipment, land and buildings, etc. 166 - 16 6 2 (iv) Other items 246 502 748 11 (v) Total gross expenditure 6396 508 6904 100 1 2 GROSS, INCOME (excludii reimbursements from Ministry of Transport and the County Council 23 - 23 - 3 NET COST 6373 508 6881 - 4 Capital expenditure met from revenue (included above) - - - - 5 Gross expenditure on sanding, gritting and snow clearance, not included previously. 765 - - - UNIT COSTS £ 6 Net cost (item 3) per street mile 114 £ £ £ 7 Net cost (item 3) per 1000 street gullies cleansed 66 - 8 Net cost (item 3) per 1000 population 134 11 345 16. OPERATIONAL STATISTICS 9. Mileage of street cleansed 56 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. Percentage of street cleansing done by mechanical means Nil% 12. Number of street gullies cleansed 3269 13. Number of gully cloansings during year, (Number of gullies x number of cleansings) 7742 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 are used for conveyance of sweepings. 17. SANITARY INSPECTION OF THE AREA Inspection on Complaint. The number of complaints received at the office and recorded in the register was 600, as compared with 505 for 1954 and 543 in 1953. The total inspections made on complaint was 337 and the number of defects or nuisances revealed was 620, which are analysed in the following table. Informal notices were at once served on the owners or occupiers of the premises concerned. TABLE 1. Nuisance from smoke, odour, dust, and bonfires 46 Housing Defects 57 Obstructed Sewers and Drains 206 Defective Sewers 8 Defective Drains 7 Defecoive W. C. 's. 2 Infestations of insects, flies, ants, etc,. 59 Verminous persons 1 Animals kept so as to be a nuisance 5 Rodent Infestations (rats and mice) 154 Insufficient heating to workplace 1 Offensive accumulations 17 Condition of Food 13 Defective and/or insufficient dustbin 6 Water supply 6 Flooding of gardens, houses, etc. 8 Nuisance from water courses 5 Miscellaneous 19 620 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 nuisance s or defects found under specific headings. During the year recruitment of personnel to the inspectorial staff was possible and consequently the number of visits paid increased proportionately. The visits numbered 6253 as compared with 4372 in the previous year, the defects dealt with numbered 1093 as compared with 884 in 1954. TABLE 2. Visits Paid Nuisance or Defects found & dealt with. Housing Act, 1936. Inspections 352 221 Re-inspections re Notices served 258 Certificates of Disrepair 18 Improvement Grants 10 Overcrowding 6 On Complaint 337 620 Infectious Diseases 124 Retail Pood Premises: Meat 139 Fish 36 16 Fried Fish 35 2 General Provisions 158 8 Other Food Shops 250 Restaurant and Other Food preparing premises 109 8 Ice Cream Premises 86 Itinerant Ice Cream Vendors 9 Street Food Vendors 7 Food Sampling: Ice Cream 78 Milk 35 Other Foods 73 Drugs 3 Water 25 Factories 67 Slaught erhouses 35 Bakehouses 19 Dairies 4 Outworkers 461 Rent Restrictions Act. 82 Public Health Act. Visits re. Notices served 436 Other Re-visits 161 Rodent Control 1128 206 c/f: 4511 1081 19.  Visits Paid. Nuisances or Defects found & Dealt with. b/f: 4511 1081 Council Houses 53 Flooding 7 Sewage Disposal Works 4 Reservoirs and flies. 15 Houses let in lodgings. 2 Movable Dwellings 23 Places of Entertainment. 1 Schools 57 Swimming Pools 20 Shops Act: Sanitary Conditions 274 1 Hours of Closing 124 3 Young Persons Employment. 89 Hairdressers' Premises 6 Public & Private Conveniences, 54 Pigstyes, Stables, etc. 7 Petroleum Act. 31 River Pollution 27 5 Smoke Observation 57 Smoke (Special visits) 29 Refuse Collection & Disposal, 229 Interviews 18 Miscellaneous Visits 198 3 Drainage 331 Water Act. 6 Pet Animals Act. 11 Street Cleansing. 69 6253 1093 Nuisances and Defects. In the followirg 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. Nuisance from Animals 1 Offensive Action, Odours, Dust, etc. 166 Walls and Ceilings cleansed. 44 Roofs, Spoutings and Eaves gutters repaired or renewed 72 External Walls repaired 21 Wall and ceiling plaster repaired 63 Floors repaiisi. 21 c/f: 388 20 b/f: 388 Woodwork of doors and sashcords, glazing and sills repaired. 70 Flues and chimney stacks repaired or rebuilt 21 Dampness remedied 65 Drains cleansed 14 Drains repaired 32 Drains - New inspection chambers 5 New Sinks provided 6 Water Closets repaired or reconstructed 6 Water Closet Pedestals fixed 5 Water Closet Flushing Cisterns repaired or renewed 10 Water Storage Tanks and Piping repaired or renewed 4 Hot Water Systems repaired 1 Dustbins provided 18 Rat Infestations 206 Sewers cleansed 206 Sewers repaired 16 Food premises: Limewashcd and cleansed. 9 Washing copper repairs 1 Sub-floor ventilation 2 Stairs 2 Stoves 6 1093 TABLE 4. Letters sent out and notices served in connection with the work of the Health Department. Letters 858 Public Health Act: Preliminary Notices 46 Statutory Notices. 4 Housing Act: Preliminary Notices. 27 Statutory Notice. 1 21. Inspections of Factories and Other Premises. Inspections for purposes of provisions as to health, (including inspections made by Sanitary Inspectors). Premises Number on register Inspections Number of Written Notices. Occupiers Prosecuted. 1 2 3 4 5 (i) Factories in which sections 1,2,3 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 44 - - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding Outworker's premises) 3 2 - - Total 74 46 Shops Act 1950. A total of 813 visits were 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 8th May ana closed on the 10th September, 1955. The total attendance throughout the season was 187,853, "the highest attendance being on the 17th July, 1955 when 12,483 persons were present. Samples 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. 22. Schools. The general condition and supply of water to Schools has been satisfactory during the year. Co-operation 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. Nineteen visits were paid to the eight bakehouses in the district and generally they were maintained in a satisfactory condition. Prevention of Damage by Pests Act, 1949. A full time Rodent Operative is employed for rodent infestation work and whilst there was no evidence of major infestations in the town, 1113 visits were paid to deal with minor infestations at private and business premises and in connection with sewer maintenance. The thirteenth and fourteenth maintenance treatments were carried out in March and September respectively. In March 144 manholes were baited and of these 39.58% showed complete or partial takes; 260 manholes were baited in September, 21,92% of which showed complete or partial takes, NUMBER AND TRADE OF OUTWORKERS NOTIFIED DURING 1955. Wearing Apparel 216 Knitwear 71 Quilts 4 Upholstery 11 Footwear 24 Trimmings 1 Toys 70 Paper Bags 1 Button Carding 4 Novelties 3 23. Curtains 2 Brushes 1 Artificial Flowers 8 Handbags 4 Stationery/Box Making 20 OUTWOBKERS WERE NOTIFIED FROM THE FOLLOWING AREAS. Finsbury 34 St. Eancras 5 West Ham 3 Islington 6 Shoreditch 84 Bethnal Green 11 Ilford 12 Wood Green 1 Stoke Niewington 4 Chigwell 2 Walthamstow 21 Hackney 95 Wanstead & Woodford 4 Stepney 4 Leyton 72 Bradford 2 Potters Bar 2 St. Marylebone 10 City of London 14 Chingford 28 Tottenham 13 City of Westminster 3 Lambeth 6 Hornehurch 1 Edmonton 1 Ministry of Labour & Mational Service 2 24. SECTION D. HOUSING. HOUSING REPAIRS AND RENTS ACT. 1954. Certificates of Disrepair. Three applications for Certificates were received and in each case application was granted. These Certificates were revoked when the necessary repairs had been completed. Inproverrent Grants. Eight applications for Improvement Grants were received and two were granted but of the two one was not taken up. Proposals in relation to Clearance Areas, etc. As required by Section 1, of the Act, the Council duly submitted its proposals for dealing with houses which appeared to the Authority to be -unfit for human habitation. There are no slums as such in the Borough and accordingly the proposals dealt with action to be taken in connection with fifteen houses with the probable re-housing of thirteen families. It was felt that this problem was small enough to be resolved within five years. Sub-Standard Properties. Quite apart from the properties dealt with in the previous paragraph of this report, there are other properties in the Borough which are sub-standard; that is to say, they lack modern amenities such as bathrooms, hot water systems and other services regarded today as necessities in proper housing accommodation. During the year the Chief Sanitary Inspector prepared two reports on these properties which received preliminary consideration by the Public Health and Housing Committees of the Council. HOUSING STATISTICS FOR THE YEAR 1955. 1. Number of Houses Erected during the year, (1) By the L.A, (permanent) Traditional (including flats) 38 (2) By private enterprise (including flats) 26 64 2. Inspection of dwellinghouses during the year. (l) (a) Total number of dwellinghouses inspected for housing defects (under Public Health or Housing Acts.) 691 25. (b) Number of inspections made for the purpose 889 (2) (a) Number of dwellinghouses (included under sub-head (l) above) which were inspected and recorded under the Housing Consolidated Regulations 1925 and 1932. 53 (b) Number of inspections made for the purpose l6l (3) Number of dwellinghouses found to be in a state so dangerous or injurious to health as to be unfit for human habitation. 4 (4) Number of dwellinghouses (exclusive of those referred to under the preceding sub-ljead) found not to be in all respects reasonably fit for human habitation. 75:X: :X: 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 dwellinghouses rendered fit in consequence of informal action by the Local Authority or their officers, 57 4. Action under Statutory Powers during the year: A. Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936. (1) Number of dwellinghouses in respect of which notices were served requiring repairs. 2 (2) Number of dwellinghouses which were rendered fit after service of formal notices: 2 B. Proceedings under Section 11 and 13 of the Housing Act, 1936. (l) Number of Demolition Orders served, 4 G. Proceedings under Public Health Acts: (l) Number of dwellinghouses in respect of which notices were served requiring defects to be remedied 4 (2) Number of dwellinghouses in which defects were remedied after service of formal notices. 4 26. 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. Thirteen samples of milk were analysed during the year and all were certified to be genuine. Milk (Special Designations) Regulations. 1949. Graded Milks - The following table shows the licenses 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, 3 supplementary licences to sell milk as Pasteurised, 3 " " " " " " Sterilised. J 5 dealers1 licences to sell milk as Tuberculin Tested, 2 supplementary licences to sell milk as Tuberculin Tested, Food and Drugs Act. 1955. 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. Hammence, F.R.I.C., 20 Eastcheap, London. E.C.3. continued as Joint Public Analysts for the area. Samples submitted for Analysis. 115 samples of food and drugs were submitted for analysis, 40 formal and 75 informal and it will be seen by the following table that a reasonably wide field was covered. The table shows that five samples were adversely reported upon. With regard to the four samples of vinegar and non-brewed condiment, three of these were taken as the result of a complaint of 27. the presence of vinegar eels. One sample of vinegar was in fact found to be non-brewed condiment and contained only 2„6% of Acetic Acid and was therefore deficient in strength to the extent of 35% of the minimum quantity of 2$ of Acetic Acid proper to any kind of vinegar. The case was taken before the Court of Summary Jurisdiction and a fine of £3 was imposed. The two samples of non-brewed condiment were related and were follcw-up samples of the vinegar sample which was the subject of legal proceedings. One case of non-genuine non-brewed condiment was also taken to Court and a fine of £10 was imposed, A sample of Sweet Spirit of Nitre was found to contain only approximately one-tvvelfth of the minimum quantity of Ethyl Nitrite required by the B.P, Codex, and in this case the Council decided to direct a letter of warning to the retail chemist. The four informal samples of Buttered Rolls were taken to ascertain whether or not this much abused term was being used correctly and in one case it was found in fact that margarine was being used, A warning to the cafe proprietor was sufficient to obtain the use of the right designation. Samples of all iced lollies sold in the town continued to be taken and it is pleasing to be able to report that in all cases the lead content was within the prescribed limits, A sample of bread was sent to the Public Analyst in order that certain foreign matter might be identified. Microscopic examination showed that it consisted of rodent excreta but owing to the portion of the loaf being quite small it was not possible for the Council to institute proceedings, Nevertheless the matter was taken up most seriously with the baker concerned whose bakehouse was not within the area of the Borough, Six samples of bread were taken in relation to the claim by the manufacturers that these were protein reinforced. Correspondence took place between the department and the manufacturers in which the views of the Public Analyst were stressed. The result of the analyses generally indicated that the samples were in fact genuine0 28. Samples taken during the Year 1955. Article Number Examined Total Result of Analysis Formal Informal. Genuine Non-Genuine. Milk 12 12 12 Raspberry-flavoured Milk 1 1 1 Margarine 1 1 2 2 - Tea 1 1 2 2 - Pepper - 1 1 1 - Flour Mixture - 1 1 1 - Cheese Spread - 2 2 2 - Soups (3 neat) (l vegetable) 4 4 4 _ Curry Powder 1 1 1 - Glycerine - 1 1 1 - Cordials 1 4 5 5 - Vinegar 2 - 2 1 1 Non-Brewed Condiment 2 - 2 - 2 Glauber Salts - 1 1 1 - Sweet Spirit of Nitre J "" 1 1 - 1 Gelatine - 1 1 1 - Lime Sulphur Tablets - 1 1 1 - Cream - 3 3 3 - Iodine Ointment - 1 1 1 - Buttered Rolls - 4 3 1 Lard - 1 1 1 - Butter 1 1 2 2 - Cheese - 2 2 2 - Orange Drink - 1 1 1 - Sausages (Pork) 3 1 4 4 - Sausages (Beef) 5 1 6 6 - Ice Lollies (15 watez (2 cream) 0 1 - 17 17 17 Ice Cream - 6 6 6 - Lozenges - 1 1 1 - Liquid Paraffin - 1 1 1 - Sulphur Tablets - 1 1 1 - Sweets 1 1 2 2 - Salad Cream - 1 1 1 - Marmalade - 1 1 1 - Cocoa - 1 1 1 - Blancmange - 1 1 1 - Orange Syrup Concenti 'ate 1 1 1 - Bread 6 2 8 7 1 Cauliflower - 2 2 2 - Pastry — 1 1 1 - c/f: 37 74 111 105 6 29 Article Number Formal Examined Informal Total Result oi Gerajine Non-Genuine "b/f: 37 74 111 105 6 Mint Sauce 1 — 1 1 - Mincemeat 1 — 1 1 - Beef Suet 1 - 1 1 - Dressed Crab - 1 1 1 - Totals: 40 75 115 109 6 Five cases were taken before the Magistrates under the Act in relation to the following offences:- Offence Section i Result i Fibrous material in loaf 3. Fine £15, 2 gns costs ' Broken glass in milk bottle . 3. Fine £15 (Note: On Appeal to j Quarter Sessions "alter to conditional discharge") Dirty Milk Bottle Milk & Dairies Regulations 194S Section 26 (l) .ft*- * , 1 Fine £15 (Note; On Appeal to Quarter Sessions "fine reduced to £10"). Vinegar being sold as Non-Brewed Condiment 3. i 1 Fine £3. Non-Brewed Condiment 15% deficiency. 3. I Fine £10, Bye laws - Handling, Wrapping and Delivery of Food. Erogress has continued in the maintenance of hygicnic conditions in food premises in relation to these Byelaws. 808 visits were paid to food premises, including restaurants 30. and other food preparing premises. Inspection of Meat and Other Foods. Public Health (Meat) Regulations 1922<.-52 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, 1955. Cattle 1 Calves Sheep Pigs. Number killed 207 23 Number inspected 3 207 23 i All diseases except Tuberculosis & Cysticerci. i Whole carcases condemned Nil . Nil Nil Nil Carcases of which some part or organ was condemned. Nil Nil 16 2 ; Percentage of the number inspected affected with disease 1,1% 8.7fc Tuberculosis only Whole carcases condemned Nil Nil Nil Nil Carcases of which some part or organ was condemned Nil Nil Nil t Nil Cysticercosis , ' Carcases of which some part or organ was condemned Nil Nil Nil Nil Carcases submitted to treatme by refrigeration. nt Nil Nil Nil Nil Generalised and totally condemned . Nil Nil Nil Nil 31. TINNED AND BOTTLED FOODS Article Quantity Meat 49 tins Fish 41 " Fruit & Vegetables 33& " Orange Juice 0 1 bottle Cheese & Tomato Spread 1 jar Jam & Marmalade 14 jars Spaghetti 2 tins Fish Baste 4 j&rs Creamed Rice 1 tin Olive Oil 2 bottles Vitacup 1 tin Pickles . 3 jars Coffee , ,e 3 tins Peanut Butter .... 1 jar Ground Almonds 1 carton Broth 4 tins Soup 12 tins Milk 50 tins Ham 10 tins Cream 10 tins OTHER FOODS Fish 9 stone 1 lb. Cheese ••••••••••••• 27i lbs. Condemnation certificates were issued in respect of the undermentioned home-killed and impoi"ted meat and offal. Beef 263 lbs. Pork 43 lbs. Liver «... 27^ lbs. Registration of Food Preparing Premises. The registration of these premises is secured by Section 16 of the Food and Drugs Act, 1955 and the number of premises on the register was 107, being ~JG for the manufacture, storage or sale of ice cream and 31 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 32. or merchants or dealers in ice cream or other similar commodity is granted by the Council under Section 758 of the Essex County Council Act, 1933 and the number of persons so registered at the end of the year was 71. 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 thirty-five samples of ice cream were submitted for bacterial examination. The results are itemised below and it is pleasing to note that the majority of the samples were in Grade 1. Grade 1. Grade 11. Grade 111. 29 4 2 No. Type. Colonies per ml.on Agar @ 37°C in 48 hours Coliform Test 3 Tubes Bact. Coli 3 Tubes Ministry Grade. 1 Wrapped brickette 500 0/3 0/3 1 2 Wrapped brickette 400 0/3 0/3 1 3 Wrapped brickette 100 0/3 0/3 1 4 Wrapped brickette 400 0/3 0/3 1 5 Wrapped Brickette 300 0/3 0/3 1 6 Wrapped brickette 200 0/3 0/3 1 7 Wrapped brickette 1800 1/3 0/3 1 8 Loose from bulk 4800 0/3 0/3 1 9 Choc-Bar 1200 0/3 0/3 1 10 Choc-Bar 800 0/3 0/3 1 11 Bumper Brickette 2800 0/3 0/3 1 12 Wrapped Brickette 1600 0/3 0/3 1 13 Wrapped brickette 1400 0/3 0/3 1 14 Wrapped brickette 500 0/3 0/3 1 15 Loose from bulk 13000 2/3 0/3 11 16 Wrapped Pola Maid 300 0/3 0/3 1 17 Loose from bulk 3800 1/3 0/3 1 18 Wrapped brickette 800 0/3 0/3 1 19 Wrapped brickette 2800 2/3 0/3 11 20 Wrapped brickette 56000 3/3 0/3 111 21 Wrapped Pola Maid 100 0/3 0/3 1 33 22 Wrapped brickette 8500 2/3 V3 11 23 Wrapped, brickette 300 0/3 0/3 1 24 Loose from bulk 200 0/3 0/3 1 25 Wrapped brickette 100000 3/3 0/3 111 26 Wrapped Brickette 100 0/3 0/3 1 27 Wrapped Brickette 800 0/3 0/3 1 28 Loose from bulk 2000 0/3 0/3 1 29 Wrapped brickette 400 0/3 0/3 1 30 Loose from bulk 3500 0/3 0/3 1 31 Wrapped Brickette (chocolate) 1000 0/3 0/3 1 32 Wrapped brickette 12000 2/3 0/3 11 33 Wrapped brickette 700 1/3 0/3 1 34 Wrapped brickette 2500 1/3 0/3 1 35 Wrapped brickette 1800 1/3 0/3 1 34 SECTION F PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Diphtheria No case of diphtheria was notified to the Health Department during the year. The last confirmed case in the borough was in 1949. The following figures indicate the number of children immunised against diphtheria:- Primary immunisations - under 5 years - 357 " " - 5 to 15 years - 27 Total - 384 Number receiving secondary or reinforcing injections - 485 Scarlet Fever Scarlet Fever cases were down to 33, compared to 64 in the previous year. All the cases were of a mild character. The following table indicates the cases notified during the past five years and the precentage of cases removed to hospital 1951 1952 1953 1954 1955 Confirmed cases 81 181 168 64 33 Percentage removed to hospital 48 47 37 17 27 Measles There was a sharp rise in the incidence of measles in 1955, viz: 492 notifications, as against 195 for 1954. There were no deaths from this disease. Four cases were admitted to hospital for treatment. 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 Notifications of whooping cough were very considerably reduced, there being only 14 compared to 138 for 1954. From enquiries made, there is increasing evidence of the value of immunisation against this disease, both in preventing the onset of illness and in mitigating the severity of the attack. During the year 217 children completed the full course of immunisation. 35. Acute poliomyelitis Twelve cases of poliomyelitis were confirmed during 1955, eight of which were paralytic. Of the latter, one has severe residual paralysis, two have moderate paralysis and five have fully recovered. In addition, a child of six years developed severe paralytic poliomyelitis the day after he left Chingford for a holiday in the south of England; his illness had obviously been contracted in the borough. He is still in hospital with severe residual paralysis. The following advice will materially assist in reducing the incidence of this disease:- (1) Avoid overcrowded places during outbreaks. (2) Pay strict attention to personal hygiene, particularly the washing of hands after all visits to the lavatory and before preparing or eating food. (3) It is known that prolonged or severe exercise increases the risk of paralysis in those who contract the disease. Therefore undue fatigue and tiredness should be avoided by all, adults and children alike, (4) Poliomyelitis often presents itself as a two-phase illness: an initial illness with rise of temperature, headache, perhaps some stiffness of the neck, or nothing more than fever, sore throat, or mild gastric upset. Recovery from these symptoms takes place after two or three days, only to be followed, after a further short interval, by the second phase, the onset of true poliomyelitis. It is with particular reference to these initial, mild, indefinite illnesses that my remarks about avoiding undue fatigue apply with special force and emphasis: anyone complaining of the symptoms referred to, ought to be particularly careful to avoid all forms of strenuous exercise during the ensuing fortnight; he may not avoid contracting poliomyelitis should his initial illness have been due to the virus of polio, but his chances of full recovery from the paralytic form of the disease will be greatly enhanced. Tuberculosis The figures of 20 fresh cases of pulmonary tuberculosis which were notified in 1955 represents a marked reduction in regard to the previous year which was 30, and is considerably below the average of 36 notified each year from 1950-54. The vaccination of children in the 13-14 year group, against tuberculosis, continued; the number of children vaccinated was most satisfactory, viz: 313 out of 624 who were eligible. 36. The Walthamstow and Chingford Association of Tuberculosis Care Helpers gave valuable assistance to tuberculous persons and their families by the provision of milk, groceries, clothing, bedding, etc. in necessitous cases. This Association deserves the utmost support and, indeed, receives an annual grant from the Council and donations from many organisations in the borough. Dysentery Seven cases of dysentery were notified to the department. All were isolated cases. Food Poisoning The nine cases of food poisoning which occurred were all investigated but in only two of these was the causal agent identified. In addition to the nine notified cases, an outbreak, suggestive of food poisoning, in a school in the borough, was reported, affecting 72 children and staff. It was considered, after investigation, that this was due to 'epidemic vomiting' caused by a virus infection. Food poisoning was suspected, but the causal organism was not identified, when 23 members out of a party of 32, belonging to an association in the town reported ill after partaking of a meal in a restaurant in London. The circumstances were reported to the Medical Officer of Health of the London borough concerned: his investigations yielded no result. Considerable concern was felt by the occurrence of cases of paratyphoid 'B' fever in an adjoining district and, indeed, in several parts of the country, due to the use of Chinese egg products in the preparation of cakes, etc. It was found that these egg products carried paratyphoid 'B' infection. The Ministry of Health issued instructions as to the treatment of these materials before use in food preparation: a copy of these instructions was issued to all bakeries in the district. It cannot be too strongly emphasised that cases of dysentery and food poisoning will continue to occur so long as the standard of personal hygiene remains low in many cases. Both these diseases can largely be prevented by strict attention to personal cleanliness, particularly hand washing after all visits to the lavatory. Food Hygiene The Health Department maintained close contact with all food premises in the borough. 37. Smallpox contacts Surveillance of one person, who was a possible contact of a smallpox case, was carried out for the required period. Vaccination During the year 285 persons received primary vaccination and 80 persons were re-vaccinated. National Assistance Act, 1948 (a) Section 47: Care of Aped and Chronic Sick. 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. In a few other instances the provision of a home help obviated the need for hospital care. (b) Section 50: No action was required under this section, which requires the local authority to arrange for the burial of persons for whom no arrangements have or are being made. Medical Examinations During the year 86 examinations were carried out by me in respect of Chingford Council staff and 39 in. respect of staff of the Essex County Council. CAUSES OF DEATH AS GIVEN BY THE REGISTRAR-GENERAL FOR THE YEAR 1955 Causes of death Males Females Total Tuberculosis, respiratory 2 - 2 Syphilitic disease 2 - 2 Malignant neoplasm, stomach 7 5 12 Malignant neoplasm, lung, bronchus 15 3 18 Malignant neoplasm, breast - 11 11 Malignant neoplasm, uterus - 1 1 Other malignant & lymphatic neoplasms 24 14 38 Leukaemia, aleukaemia 3 1 4 Vascular lesions of nervous system 12 31 43 Coronary disease, angina 38 14 52 Hypertension with heart disease 5 4 9 Other heart disease 21 27 48 Other circulatory disease 6 5 11 Influenza - 2 2 Pneumonia 9 8 17 Bronchitis 9 8 17 Carried forward 153 134 287 38. CAUSES OF DEATH (continued) Causes of death Males Females Total Brought forward 153 134 287 Other diseases of respiratory system. 4 - 4 Ulcer of stomach and duodenum - 3 3 Gastritis, enteritis & diarrhoea. 3 1 4 Hyperplasia of prostate 1 - 1 Congenital malformations 3 1 4 Other defined & ill-defined diseases 8 17 25 Motor vehicle accidents 3 1 4 All other accidents 2 2 4 Suicide 4 3 7 Totals - all cases 181 162 343 Totals - year 1954 202 180 382 DEATHS FROM CANCER There were 80 deaths from cancer, 77 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 - - 19 14 \ 19 14 Lungs and Mediastinum - - 15 3 15 3 Genito-urinary organs - 1 4 3 4 4 Breast - - - 11 - 11 Other sites 2 - 6 2 8 2 Totals 2 1 44 33 46 34 Death rate - 1.69 per 1,000 (as compared with 1.99 per 1,000 in 1954) 39. 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 to 4 years - — — — — — — — — — — ! 5 to 14 years 1 _ - - . _ 1 ~ - - — - 15 to 24 years — 5 - - 1 1 — — - - — — 25 to 34 years 2 4 - - 2 3 — - - - - 35 to 44 years 2 1 - 1 2 2 — — - — — - 45 to 54 years 3 — 1 - - — 1 - 2 - — — 55 to 64 years 2 — — — — — — — 2 - — — 65 and upwards - — — — — — — — — — — - TOTALS 10 10 1 1 5 7 1 - 4 - - - Add - deaths of un-notified cases - - - - 4 - - - Note: 2 of the deaths recorded above were not attributable to tuberculosis, though occurring to notified patients. 40. NOTIFIABLE DISEASES (after correction) Year Scarlet Fever Diphtheria Erysipelas Measles Whooping Cough Tuberculosis Dysentery Puerperal Pyrexia Pneumonia Meningococcal Infection Acute Poliomyelitis Acute PolioEncephalitis Acute Infective Encephalitis Typhoid or ParaTyphoid Fever Food Poisoning Malaria Pulmonary Other forms 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 - 1954 64 - 5 195 138 30 2 17 2 17 - 4 - - - 3 1 1955 33 - 5 492 14 20 2 7 1 18 1 12 - - j- 9 - 41. 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 - 3 2 1 1 23 1 2 - - - - 33 Erysipelas - - - - - - - - - 1 4 - 5 Measles 10 33 40 55 66 282 4 - 1 - 1 - 492 Whooping Cough 2 - 1 5 2 4 - - - - - - 14 Pneumonia - - - - - 2 - - 2 1 8 5 18 Dysentery - - 1 - 1 2 - - - - 2 1 7 Food Poisoning - - - - - - - - 3 1 5 - 9 Meningococcal Meningitis - - 1 - - - - - - - - - 1 Acute Poliomyelitis 1 - - 2 - 4 1 2 2 - - — 12 Puerperal Pyrexia — — — — — — —~ — 1 — — — 1 ANALYSIS OF NOTIFIABLE DISEASES (after correction) Diseases Total cases Total admitted to hospital Scarlet Fever 33 9 Erysipelas 5 1 Measles 492 4 Whooping cough 14 1 Pnsumonia 18 10 Dysentery 7 - Food Polsoning 9 2 Meningococoal Meningitis 1 1 Acute Poliomyelitis 12 12 Puerperal Pyrexia 1 -