Ac 4411 1.1 II CHIN 28 Library BOROUGH OF CHINGFORD ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH Including the Report of the CHIEF PUBLIC HEALTH INSPECTOR FOR THE YEAR 1963 BOROUGH of CHINGFORD ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH including the REPORT of the CHIEF PUBLIC HEALTH INSPECTOR for the year 19 6 3 BOROUGH OF CHINGFORD PUBLIC HEALTH COMMITTEE: June, 1963 - May, 1964 Chairman: Councillor M.C. Fish Vice-Chairman: Alderman J.W. Corder Members: Alderman W.J. Bowstead Councillor P.A. Bostock Councillor J.H. Davies Councillor Mrs. O.M. Game Councillor Mrs. D.M.E. Linfoot Councillor W.J. Pearmine Councillor S.J. Silk The Mayor, Alderman J.W.R. Nation, J.P. (ex officio) Meeting: Second Monday in each month at 7.30 p.m. PUBLIC HEALTH OFFICERS OF THE AUTHORITY (1963) Medical Officer of Health: J. H. CROSBY, M.B., Ch.B., D.P.H. Chief Public Health Inspector, Cleansing Superintendent and Inspector under the Shops and Petroleum Acts: G. HOLMES, M.R.S.H., M.A.P.H.I. (a) (b) (c) Deputy Chief Public Health Inspector: E. W. Y/ARD. M.R.S.H., M.A P.H.I, (a) (b) (c) District Public Health Inspectors: R. C. MORTON, M.R.S.H., M.A.P.H.I, (a) (b) T. MATTHEWS, M.A.P.H.I., S.R.N, (a) (b) Senior Clerk & Secretary to M.O.H: Miss V. M. PETTIT Administrative Assistant: A. H. GILLIES Assistant Cleansing Superintendent: F. CANNON Assistant Refuse Works Manager: H. FROST Clerks: K.L.W. GRIFFITHS (to 4.10.63) Mrs. V.J. DYALL (to 14.6.63) Miss A.M. THOMASON Miss D.C. GOLDING Mrs. C.J. BELL (from 10.6.63) D.R. STEVENS (from 16.12.63) Rodent Operative: M. J. MURRAY (a) Certificate as Public Health Inspector (b) Certificate or Diploma as Meat and Other Foods Inspector (c) Certificate as Smoke Inspector 1. ANNUAL REPORT FOR THE YEAR 1 9 63 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 1963 upon the health and sanitary circumstances of the Borough. The estimated population for the year was 46,230. Vital Statistics: In the statistics which follow, the figures in brackets refer to 1962. The birth-rate was 13.3 (13.l) per 1,000, representing 615 (609) births. The number of deaths was 444 (453). The death-rate was 9.6 (9.7) per 1,000. To enable comparisons in the birth and death rates to be made with other areas and with England and Wales as a whole, it is necessary to make use of comparability factors. These factors are supplied by the General Register Office and they allow for differing sex and age distribution of local populations. The factors for Chingford are: Births 1.10 and Deaths 1.14. The table on page 4 indicates the crude rates and the rates adjusted by the comparability factors. The infant mortality rate was 8.1 (11.4), the rate for England and Wales being 21.0 (21.4). The table on page 4 shows at a glance the birth, death and infant mortality rates for the years 1958-63. Causes of Death: The main causes of death were diseases of the heart and circulation, and cancer. These conditions were responsible for three deaths out of every four. The table on page 13 indicates the rise in recent years in the deaths from diseases of the heart and circulation. Infectious Diseases: Measles and Whooping Cough were predominant among the infectious diseases. The continuing occurrence of 2. Dysentery emphasises once more the urgent need for attention to personal hygiene if this and other bowel infections are to be reduced. Chiropody Service: The chiropody service sponsored by the Chingford Old People's Welfare Committee ceased in December 19&3 and was taken over by the Essex County Council. The service given by the latter appears to lack the personal care and attention given by the chiropodists under the Old People's Welfare Scheme. Numerous complaints have been received about the inadequacy of the County Council's service. Home Safety Exhibition: A Home Safety Exhibition was held in the Chingford Assembly Hall in July. The exhibition was very well presented and displayed. No aspect of home safety was omitted. It was colourful and indicated in a simple, clear and direct manner the dangers and hazards to be avoided to make every home safe. Moreover, as attendances at exhibitions these days go, it was a success numerically with an attendance of 1,300 persons. Fluoridation of Water Supplies: In April 1963, the Council approved arrangements which water undertakings were proposing to raise the fluoride content of water to 1.0 part per million. Dr. F.G. Brown, Area Medical Officer, Essex County Council, has kindly supplied the statistical matter on pages 5 and 6. The reader of this report will be convinced of the vast amount of work that is done in the Health Department, day in and day out, to protect the citizens of Chingford against all those environmental factors which may adversely affect, whether directly or indirectly, their health and well-being. I would like to express my thanks and appreciation to the Chairman and Members of the Health Committee for their support and to the staff of the Department for their co-operation during the year. J. H. CROSBY Medical Officer of Health Health Department, Town Hall, Chingford, E.4. Telephone: Silverthorn 3601 August, 1964 3. STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,368 acres Population: Registrar-General' s estimated mid-year home population 46,230 Number of inhabited houses and flats (as at 31-12.63) 14,356 Rateable value on April 1st, 1963 £2,130,648 Product of penny rate on 1.4.63 £8,640 VITAL STATISTICS Live Births: Number (318 males: 297 females) 615 Rate per 1,000 population 13.3 Illegitimate Live Births per cent of total live births 2.9 Stillbirths: Number (3 males: 3 females) 6 Rate per 1,000 total live and stillbirths 9.6 Total Live and Still Births 621 Infant Deaths (deaths under 1 year) 5 Infant Mortality Rates: Total infant deaths per 1,000 total live births 8.1 Legitimate " " " " legitimate live births 8.3 Illegitimate " " " " illegitimate " " Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 3.2 Early Neo-natal Mortality Rate (deaths under 1 week per 1,000 total live births) 1.6 Perinatal Mortality Rate (stillbirths and deaths under 1 week combined per 1,000 total live & still births) 11.2 Maternal Mortality (including abortion): Number of deaths Rate per 1,000 total live and still births, Total Deaths: Number (243 males: 201 females) 444 Crude death rate per 1,000 population 9.6 Deaths from Cancer (all ages) 105 " " Measles (all ages) - " " Whooping Cough (all ages) - 4. TABLE OF BIRTH AND DEATH RATES Infant Mortality Year Pop'n Births Crude rate per 1,000 pop'n Rate adjusted by comparability factor Rate for England and Wales Deaths Crude rate per 1,000 pop'n Rate adjusted by comparability factor Rate for England and Wales Deaths Rate per 1,000 live births Rate for England and Wales 1958 46,030 535 11.6 12.1 16.4 389 8.4 10.8 11.7 8 14.9 22.6 1959 46,030 566 12.2 12.6 16.5 414 8.9 11.3 11.6 10 17.6 22.2 1960 46,140 607 13.1 13.6 17.1 352 7.6 9.7 11.5 10 16.4 22.0 1961 45,910 612 13.3 13.9 17.4 407 8.8 11.2 12.0 10 16.3 21.4 1962 46,350 609 13.1 13.6 18.0 453 9.7 12.4 11.9 7 11.4 21.4 1963 46,230 615 13.3 14.6 18.2 444 9.6 10.9 12.2 5 8.1 20.9 5. GENERAL PROVISION OF HEALTH SERVICES IN THE AREA (a) Laboratory Facilities Pathological specimens from this district can be examined at the Pathological Departments of the St. Margaret's Hospital, Epping, the Connaught Hospital, Walthamstow, and the Whipps Cross Hospital, Leytonstone. Specimens may (by arrangement) also be left at the Health Department, Town Hall, Walthamstow, on weekdays before 2 p.m. for delivery to the Edmonton Public Health Laboratory, Town Hall, Edmonton, N.9. (b) Ambulance Service The Ambulance Service, maintained and controlled by the Essex County Council, has a Divisional Ambulance Control office at Ilford. All requests for free ambulance transport under Section 27 of the National Health Service Act, 1946, should therefore be made to the Divisional Ambulance Control, Aldborough Road, Ilford. (Telephone No. Goodmayes 2311)• The procedure for obtaining an ambulance in emergency is to dial "999" on the telephone. (c) Midwifery and Home Nursing Service The Home Nursing Services are administered by the Essex County Council. Maternity nursing and midwifery cases, in addition to a large number of general nursing visits, have been undertaken. Number of Midwives or Home Nurse/Midwives - 3 * " " Home Nurses 3Ø (Miss D.L. Chandler, 87, Friday Hill, E.4. Silverthorn 4968 * (Miss C. Lovell, 49, The Ridgeway, E.4. " 7838 (Mrs. P.M. Stenning, 78, Larkswood Road, E.4. " 5414 (Mrs. E.V. Whiter, 79, Harold Road, E.4. (part-time) " 6194 Ø (Miss A. 0'Driscoll, 49, The Ridgeway, E.4. " 1460 (Mrs. M. 0'Donoghue, 80, Montalt Road, Woodford Green. Buckhurst 2766 Number of cases attended by Midwives - 187 Number of visits paid by Home Nurses - 13,588 6. (d) Health Visiting The total number of visits paid by the Health Visitors during the year was 5,260. (e) Registered Nursing Homes There are at present no registered nursing homes in the area but there are three private homes for elderly persons all of which are registered with the Essex County Council under the National Assistance Act, 1948 - Section 37. (f) Clinics and Treatment Centres See table of clinics on pages 8 and 9. Child Welfare Centres Attendances of children - under 5 years of age - 12,985 Ante-Natal Clinics Attendances - 1,665 Women's Welfare Clinic Attendances - 137 (g) School Medical Inspections (g) School Medical Inspections No. examined No. referred for: observation (a) treatment (b) 1st age group (school entrants) 544 63 118 2nd age group (11-12 years) 408 67 78 3rd age group (school leavers) 498 99 67 Other age groups and "specials" 80 12 58 Re-examinations 563 - - (h) Hospitals The hospitals providing general medical service for Chingford residents are chiefly the Chingford Hospital, the Connaught Hospital, Walthamstow, the Wanstead Hospital, the North Middlesex Hospital, Edmonton, and the Whipps Cross Hospital, Leytonstone. 7. Persons with infectious disease needing admission to hospital are accommodated at Isolation Hospitals in nearby districts, viz: St. Ann's Hospital, Tottenham, South Lodge Hospital, Winchmore Hill; or, if no bed is available at these hospitals, the Emergency Bed Service arranges admission to the nearest hospital where a bed is available. (i) 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. (j) 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, V/oodford, E.18. (k) Chiropody Facilities Chiropody sessions are held at both Essex County Health Services Clinics in the area (see page 9). Priority is, in the first instance, given to the elderly, physically handicapped and expectant mothers. Appointments for such treatment must be made through the Area Medical Officer, Municipal Offices, High Road, Woodford, E.18. As will be seen from my introductory remarks, chiropody treatment under the Chingford Old People's Welfare Committee ceased as from 9th December, 1963. There had been 15 new applicants during that year, bringing the total number of persons who had applied for treatment since the scheme began in 1956 to approximately 700. Five persons hold licences from the Essex County Council to carry on private practice as chiropodists in the borough. Their premises are inspected annually. (l) Laundry Service for the Incontinent This service is available for cases of faecal incontinence only, by arrangement through the Health Department. 8. LOCAL CLINICS AND TREATMENT CENTRES, 1964 Clinic Where held When held Diphtheria Immunisation Clinics Assembly Hall, Station Road, North Chingford. St. Francis' Hall, Hawkwood Crescent, E.4. E.C.C. Health Services Clinic, Marmion Avenue, E.4. E.C.C. Health Services Clinic, Hatch Lane, E.4. 1st & 3rd Tuesdays, 2 p.m. 4th 'Wednesday, 2 p.m. Thursdays, 11.30 a.m. Wednesdays, 2 p.m. Ante-Natal Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Tuesdays, 2-4 p.m. Fridays, 2-4 p.m. Child Welfare Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Assembly Hall, Station Road, North Chingford. St. Francis' Hall, Hawkwood Crescent, E.4. Wednesdays, 2 - 4 p.m. Tuesdays & Wednesdays, 2-4 p.m. Tuesdays, A.M. & P.M. Wednesdays, 2-4 p.m. Toddlers' Clinic E.C.C. Health Services Clinic, Marmion Avenue, E.4. Thursdays, 9.30 - 12 noon Minor Ailment & School Clinics E.C.C, Health Services Clinic, Hatch Lane, E.4. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Mondays, 2-4 p.m. 2nd, 4th & 5th Mondays, 10 - 12 noon Ophthalmic Clinic (as arranged by Reg. Hospital Board) E.C.C. Health Services Clinic, Hatch Lane, E.4. 1st Monday P.M. & Fri. A.M. (by appointment only) 3rd Wednesday A.M. (by appointment only) Physiotherapy Clinics (as arranged by Reg. Hospital Board) E.C.C. Health Services Clinic, Hatch Lane, E.4. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Weds. & Thurs. 2 p.m. (by appointment only) Mondays, 2 p.m. (by appointment onlv) Dental Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Thurs. A.M. & Fridays (all day) Mons. Tues. Thurs. & Fris. (all day) (continued:) 9. LOCAL CLINICS AND TREATMENT CENTRES, 1964 (continued) Clinic Where held When held Women's Welfare Clinic E.C.C. Health Services Clinic, Hatch Lane, E.4. 1st Friday in each month 9.30 - 12 noon Chest Clinic Whipps Cross Hospital, Leytonstone, E.ll. New cases: Tues. 9.15 a.m. Thurs. 2 p.m. (by appointment only) Chiropody Clinics E.C.C. Health Services Clinic, Hatch Lane, E.4. E.C.C. Health Services Clinic, Marmion Avenue, E.4. Mons. & Thurs. P.M. Tuesdays, all day (by appointment only) Wednesdays, all day Fridays, A.M. Alternate Sats. A.M. (by appointment only) GENERAL INFORMATION (1964) National Assistance Board: 29, Cambridge Park, Wanstead, E.ll. (Wanstead 7721) Office hours: Mondays to Fridays, 9 a.m. to 5 p.m. Saturdays, 9 a«m. to 1 p.m. Registrar of Births, Deaths & Marriages: Mr. G.J. Southam, Town Hall, The Ridgeway, Chingford, E.4. (Silverthorn 7766 and Loughton 1576) Office hours: Mons, Tues, Weds & Fris, 2-5 p.m. National Health Insurance Office: Town Hall, The Ridgeway, Chingford, E.4Office hours: Mondays to Fridays, 10 a.m. to 4 p.m. Saturdays, 9 a.m. to 11.30 a.m. Mental Welfare Officers: E.C.C. Offices, West Avenue, Walthamstow, E.17- (Coppermill Office hours: Mondays to Fridays, 9 a.m. to 5.30 p.m. 2418) Saturdays, 9 a.m. to 12.30 p.m. Social Welfare Department: Crown Buildings, Crows Road, Epping. (Epping 3253/4) Children's Dept. (E.C.C.): Local Office - 326a, Hoe Street, Walthamstow, E.17. (Coppermill 3466) 10. PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Diphtheria For the thirteenth year in succession there has been no case of diphtheria in the borough. Immunisation against this disease is now combined with immunisation against whooping cough and tetanus. The number of children receiving this triple immunisation was 474; booster doses numbered 118, In addition, the following numbers of children received the immunisation indicated Diphtheria alone - primary 21 -booster 233 Diphtheria with - primary 4 Whooping Cough - booster 2 Diphtheria with - primary 5 Tetanus - booster 32 Scarlet Fever Forty-five cases were notified, of which it was necessary to admit only one to hospital. Measles The incidence of measles rose rapidly during the winter and spring of the year, reaching a total of 579 cases. Measles serum was available to medical practitioners on application to the Public Health Laboratory, Colindale, for the treatment of cases and protection of contacts. Whooping Cough The notifications of this condition amounted to 91. Immunisation against this disease is now combined with that against diphtheria and tetanus. The number of children receiving this triple immunisation was 474. In addition, the following numbers of children received the immunisation indicated:- Whooping Cough alone - primary 1 Whooping Cough with - primary 4 Diphtheria - booster 2 11. Acute Poliomyelitis No cases of poliomyelitis occurred in 1963- Immunisation against this condition resulted in the following number of persons receiving the protection indicated:- No. receiving the two primary injections - 27 No. receiving the third injection - 207 No. receiving fourth injection (special - 370 category, children between 5 & 12 years) No. receiving 3 doses oral - 581 Tuberculosis It is gratifying to be able to report a marked reduction in the number of new cases of pulmonary tuberculosis, only seven being notified. This is the lowest number recorded since 1920 and it continues the downward trend in this disease since the war, as the following table shows:- Year: 1946 1947 1948 1949 1950 1951 1952 1953 1954 Cases: 45 46 42 34 36 44 30 39 30 Year: 1955 1956 1957 1958 1959 1960 1961 1962 1963 Cases: 20 20 32 17 21 14 13 14 7 In the school health service B.C.G. vaccination was offered to all children in their fourteenth year and, as a result of this, 334 children were vaccinated. The Wal thamstow and Chingford Association of Tuberculosis Care Helpers provided financial assistance and assistance in kind to patients and their families who suffered financial loss through the need for prolonged treatment at home or in hospital. This help has, in recent years, been extended to chest and heart cases in addition to sufferers from tuberculosis. The contribution of £50 which the Chingford Borough Council makes annually to this Association is very much appreciated. Dysentery There were 24 cases notified. The annual prevalence of this condition indicates, as I have stressed in several previous reports, that a serious lack of personal hygiene exists in these instances, more especially a failure to wash the hands after each visit to the toilet or before preparing and eating food. This condition, which is very infectious, can be controlled by the simple procedure I have indicated. 12. Food Poisoning Three cases were reported during 1963, them being due to salmonella infection. Food Hygiene All food premises in the borough continued to receive close attention from the Health Inspectorate staff. Vaccination Primary vaccinations against smallpox numbered 107 and revaccinations 134. National Assistance Act, 1948 (a) Section 47: Care of Aged and Chronic Sick. No cases needed statutory action under Section 47. In several instances the provision of a home help obviated the need for hospital care or admission to an old persons' home. (b) Section 50: No burials were arranged by the Council under this section. Medical Examinations During the year 122 examinations were carried out by me in respect of Chingford Council staff and 22 in respect of staff of the Essex County Council. CAUSES OF DEATH AS GIVEN BY THE REGISTRAR-GENERAL FOR THE YEAR 1963 Causes of death Males Females Total Tuberculosis, respiratory 1 - 1 Malignant neoplasm, stomach 10 4 14 Malignant neoplasm, lung, bronchus 29 2 31 Malignant neoplasm, breast - 11 11 Other malignant and lymphatic neoplasms 26 23 49 Leukaemia, aleukaemia - 1 1 Diabetes 1 - 1 Vascular lesions of nervous system 18 37 55 Coronary disease, angina 63 32 95 Hypertension with heart disease 1 2 3 Other heart disease 15 19 34 Other circulatory disease 6 14 20 (continued:) 13. (continuation:) CAUSES OF DEATH AS GIVEN BY THE REGISTRAR-GENERAL FOR THE YEAR 1963 Causes of death Males Females Total Influenza - 3 3 Pneumonia 11 15 26 Bronchitis 25 7 32 Other diseases of respiratory system 2 1 3 Ulcer of stomach and duodenum 2 1 3 Gastritis, enteritis and diarrhoea - 3 3 Nephritis and nephrosis 1 - 1 Hyperplasia of prostate 4 - 4 Congenital malformations 2 2 4 Other defined and ill-defined diseases 16 19 35 Motor vehicle accidents 2 1 3 All other accidents 3 3 6 Suicide 5 1 6 Totals - all causes 243 201 444 Totals - year 1962 215 238 453 DEATHS FROM DISEASES OF THE HEART AND CIRCULATION Year No. of deaths Population No. of deaths per 1,000 population 1948 139 46,610 2.9 1949 171 48,510 3.5 1950 185 48,770 3.7 1951 179 48,330 3.7 1952 183 48,190 3.7 1953 179 47,770 3.7 1954 168 47,600 3.5 1955 163 47,310 3.4 1956 199 46,840 4.2 1957 202 46,450 4.3 1958 182 46,030 3.9 1959 196 46,030 4.2 1960 189 46,140 4.0 1961 203 45,910 4.4 1962 234 46,350 5.0 1963 207 46,230 4.4 14. DEATHS FROM CANCER There were 105 deaths from cancer of which 103 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 - - 17 7 17 7 Lungs and Mediastinum - - 29 2 29 2 G-enito-urinary organs - - 2 3 2 3 Breast - - - 11 - 11 Other sites 1 1 16 16 17 17 Totals 1 1 64 39 65 40 Death rate = 2.27 per 1,000 (2.3 per 1,000 in 1962) TUBERCULOSIS NEW CASES TRANSFERS DEATHS Respiratory NonRepiratory Respiratory NonRespiratory Respiratory Nonrespiratory M. F. M. F. M. F. M. F M. F. M. F. 0-1 year - - - - - -- - - - - - - 1-4 years _ - _ - - - - - - - - - 5-14 years - - - 1 1 1 1 - - - - - 15 - 24 years - - - 2 1 - - - - - - - " 25 - 34 years 1 - - - - 3 - - - - - - 35 - 44 years - - - 2 4 2 - - 1 - - - 45-54 years 3 - - - 1 1 - - - - - - 55 - 64 years 1 - - - - - - - - - - - 65 and upwards 2 - - - - - - - - - - - TOTALS 7 - - 6 7 7 1 - 1 - - - 15. 16. NOTIFIABLE DISEASES (after correction) YEAR Scarlet Fever I Erysipelas j Measles Whooping Cough Tuberculosis Dysentery Puerperal Pyrexia Pneumonia Meningococcal Infection Acute Foliomyelitis Typhoid or Paratyphoid Fever Food Poisoning Malaria Acute Infective Encephalitis Pulmonary Other forms 1958 ' 37 4 214 8 17 1 23 - 21 - 1 - 10 - - 1959 78 8 262 26 21 1 16 1 39 1 1 2 10 - - 1960 138 6 26 93 14 2 43 - 12 1 - - 1 - 2 1961 30 6 1101 26 13 4 7 1 16 - - - 6 1 1 1962 45 5 125 5 14 - 15 3 14 - 1 - 2 - 1 1963 45 4 579 91 7 6 24 1 18 - - - 3 - - 17. 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 1 1 4 3 22 7 4 1 1 - 45 Erysipelas - - - - -- i - - - - - 2 2 4 Measles 15 52 64 65 73 294 9 3 3 1 - - 579 Whooping Cough 4 13 15 12 11 24 7 2 - 2 1 i - 91 Pneumonia - 1 - - - 2 - - 2 2 9 2 18 Food Poisoning - - - - - - - j l 1 1 -1 - 3 Dysentery 1 3 1 1 1 9 1 2 2 3 - - 24 Puerperal Eyrexia - - - - - - - - 1 1 1 - 1 ANALYSIS OF NOTIFIABLE DISEASES (after correction) Diseases • Total cases Total admitted to hospital Scarlet Fever 45 1 Erysipelas 4 1 Measles 579 5 Whooping Cough 91 - Pneumonia 18 8 Food Poisoning 3 - Dysentery 24 1 Puerperal Pyrexia 1 1 ANNUAL REPORT of the CHIEF PUBLIC HEALTH INSPECTOR and CLEANSING SUPERINTENDENT for the year 19 6 3 18. INTRODUCTION The prime physical requirement for a happy and enjoyable life is good health. Health education, so long neglected in the past, is the best method, particularly through the schools, of achieving this aim. Talks I have given on personal hygiene and environmental health have been received with avid interest by older children and have been followed by good and sensible questioning lasting up to half an hour. This surely shows a need which should be met. We would be delighted to receive many more requests for talks at schools than we get at present. The pupils showed the greatest interest towards food and here, education would play a great part towards our protection, both domestically and in food businesses. In the latter, for all our laws and their enforcement, the best cannot be achieved until people so engaged understand the reasons for hygiene and good housekeeping. The same applies in the home but here we can have no statutory powers and all is dependent upon understanding. During the year the food hygiene drive was continued and in my opinion the general standard in this Borough is now above the average in the country. Much however remains to be done as will be seen from the bacteriological examinations of meat products (page 3l) Only two out of eight routine food samples, taken from the shop counter, were satisfactory. These foods were contaminated through bad handling and had deteriorated because of bad storage. The Council was very much concerned and instructed me to take such action as was necessary to improve matters. This is being done. It is a long and difficult task, but one that is welcomed by the staff. The ancient methods of adulteration of food have decreased as detection has improved. However, we are now faced with new potential dangers such as the increasing use of artificial colouring and chemical additives in our processed foods, and the relatively uncontrolled spraying of growing crops with poisonous insecticides. These hazards will be an important feature of our future investigations and research. Detection can be difficult and costly. An ever greater difficulty appears to be in getting the Minister of Agriculture, Fisheries and Food to do anything about these hazards when they are found. A case in point was nicotinic acid (reported under 'Food Complaints' on page 29). This was being used by butchers solely for the purpose of keeping the appearance of their meat bright and fresh despite its age and condition. The public were thus not only being misled, they also stood a considerable risk of suffering very unpleasant symptoms. 19. Representations calling for this substance to be banned were made to the Ministry by the Chingford Borough Council and various eminent national associations. These brought forth polite replies. It was left to the 'Daily Mail' to arouse public opinion. On the eighth day of their vigorous campaign, supported by other newspapers, radio and television, the Government announced that nicotinic acid and associated products would be banned - in fresh meat. They can still be used in processed meats which includes our ubiquitous and doubtful, though much beloved, sausage. Further representations have, as before, brought forth only more polite replies. Perhaps we ought to write to a newspaper. The press sometimes misreports, usually because it has not been given all the facts and background; it has often caused pain and embarrassment and some of the national newspapers may even be rather wicked on occasions. Nevertheless, for all its sins and omissions, it has an enormous power and will to do good and I think that its full co-operation should be sought to that purpose. The press were largely responsible for the public exposure of 'Rachmanism' - the cruel and vicious exploitation of those in need of housing and of existing tenants who, were forced out of their homes by rapacious landlords. The empty houses were then filled with fresh tenants at high rents, sometimes a family to each room or up to 1+0 lettings in a single house. These ant-hills are termed "Houses in Multiple Occupation". Some have sprung up in Chingford and more can be expected. So far they have not been overcrowded by the standards of the Statute but they have lacked many of the amenities and safeguards called for by the Housing Act, 1961. Some of the powers in this Act are pitifully inadequate to prevent this type of exploitation. We shall have to be given more and stronger pavers but of course the real solution is more houses. The year saw the arrival of some much needed and long overdue legislation which will improve the working lives of approximately 8,000,000 people: the Offices, Shops and Railway Premises Act, 1963. It comes into force in 1964 and for the first time, it will be possible to compel employers in these concerns to provide proper conditions of health, welfare and safety for their staffs. It is a hopeful sign that, though many employers will be put to a great deal of trouble and expense, they seem to welcome the Act, as do their employees. 20. This new Act differs from the Shops Act, 1950, which continues to be unpopular and which conflicting case law has made sensible enforcement of a large part of it virtually impossible. For instance, legal opinions have stated that you can buy razor blades at certain times to cut corns but not to shave with; that you can buy butter but not margarine on Sundays; that you can buy all manner of foods as refreshments out of normal shop trading hours, but not these same foods if they are not for refreshment - meaning an immediate meal. It is like 'Alice in Wolderland' except that it is real. The prolonged freeze-up in the early part of the year caused a serious shortage of all solid fuels, particularly the premium smokeless fuels for which people commonly had to wait six weeks. Because the cold would have produced more suffering than the smoke, the prohibition on burning coal in the smoke control areas was relaxed during the fuel crisis. The Government set up a Committee to enquire into the solid fuel supply and the smoke control programme, A White Paper was issued which concluded that the supply of solid smokeless fuel for open fire grates would not meet future demands. Later information modified this pessimism and the industry is now confident that it can meet demands provided that householders in future smoke control areas are given freedom of choice of appliances. This will be the pattern for new Areas. Grants will be given towards more expensive fire grates, electric, gas and oil heaters. The cost of the programme will therefore be increased considerably but those persons who instal openable stoves will eventually show a saving over the open fire because of the greater efficiency of the former appliances. Likewise there will be a further diminution in air pollution resulting from the decrease in the amount of fuel burnt. The next problem to tackle in this field is the pollution caused by vehicle exhausts. The present scale of action by Police and Ministry of Transport officials, under the Motor Vehicle (Construction and Use) Regulations, is merely scratching the surface. This is not their fault for, whatever their sympathies, clean air is not their business. Furthermore the above regulations are not really suited to the control of air pollution, being designed for other purposes. In my opinion completely new powers, enforceable by Local Authorities, are necessary for effective control. 21. Street cleansing is 'becoming more and more difficult because of the impossibility of recruiting sufficient sweepers. The establishment allows for twenty men but on many days as few as seven were available for this work. Consequently the target of each road being swept once per week has not been attained. It follows that when they are swept at longer intervals there is more dirt to pick up, particularly after gritting, which again retards the programme. It is patently clear that mechanical aid must be enlisted to supplement the manual labour force. This will be much easier and more economical for the large organisation that the Borough of Waltham Forest will have. A further method of augmenting the labour force may be in the employment of women sweepers. A few Councils have already done this with success. Costs and operational statistics of street and gully cleansing are set out in Appendix 'C'. During 1963 the Council continued the transition from side-loading and moving floor refuse collection freighters to the more efficient and larger capacity compression vehicles. They cost more but three will do the work of six of the others and by their use, the collection staff has been reduced by almost 10^o despite a big increase in the volume of refuse. There has been a financial saving but much of this has been masked by wage increases, the additional cost of taking refuse to the tip at Broxbourne and the tipping charges there. This tipping was introduced to lessen the load on the incineration plant at the Refuse Works so that a water spray could be installed to reduce grit and ash emission from the chimney. The spray has been most successful in doing this but only closure of the Works will eliminate all nuisance to the neighbourhood. Cost and operational statistics of collection, disposal and salvage are set out in Appendices 'D' and 'E'. G. HOLMES Chief Public Health Inspector. 22. SANITARY CIRCUMSTANCES OF THE AREA Water Supplies Under the provision of Section 138 of the Public Health Act, 1936 (as amended by the Water Act, 1945) it is the duty of the Local Authority to ensure that every dwelling in the district is provided with a suitable and sufficient water supply. In this district the water is supplied by the Metropolitan Water Board whose Dr. Windle-Taylor, Director of Water Examination, has submitted the following information:- "I can state that the water supplied to the Borough of Chingford has been satisfactory in quality and quantity during 1963. The main source of supply is River Lea derived water from the Board's Lee Bridge works but in addition there is admixture of water from the Board's wells at Chingford and Ferry Lane. The water is not plumbo-solvent. I regret that I have no record of the number of dwelling houses supplied but all supplies are direct to the houses and none are permanently supplied by standpipe. (There are 15,053 dwelling houses in the Borough and all are supplied with water direct to the house by the Metropolitan Water Board. C.P.H.I.) No new sources of supply were instituted by the Board in your Borough during 1963 nor were there any extensions of important trunk mains. There were no changes in the general scheme of supply during the year but new service mains were laid to the extent of 142 yards. All new and repaired mains are disinfected with chlorine before being passed for service and the water in them is tested to ensure that it is up to the quality normally supplied." Fluoride The average natural content of fluoride in the water supplied in the Borough is 0.3 milligrams per litre. The accepted amount necessary for protection against dental caries is 1.0 milligrams per litre. 23. Larkswood Swimming Pool The pool was opened on the 11th May and closed on the 31st August, 1963. The total attendance throughout the season was 124,672, the highest attendance being on the 9th June when 9,046 persons were present. Summaries of the total chlorine and alkalinity readings are forwarded weekly to the Health Department by the Borough Engineer and Surveyor. The Department has taken samples of water from the pool for chemical and bacteriological examination and in all cases the results have been perfectly satisfactory. Sewerage and Sewage Disposal The Borough Engineer and Surveyor has submitted the following report "Sewerage The sewerage system of the Borough continues to be adequate and it is anticipated that part of the system will be connected to the new gravity sewer to Deephams towards the end of October, 1964 This connection will eliminate the risk of flooding in the one isolated instance where this is possible. A certain amount of backing up of open water courses due to the gratings of culverts being blocked by rubbish thrown into the water course has taken place from time to time. Provision has been made in estimates for the piping in of the remaining water courses which are subject to this kind of obstruction. Sewage Disposal Works The present surcharging of the works will be alleviated by the connection referred to in the preceding paragraph and this should improve the quality of the effluent. It is expected that the whole of the sewage will be transferred to the Edmonton Works of the Middlesex County Council before the end of 1964. In the meantime everything possible is being done to ensure a good standard of purification." 24. SANITARY INSPECTION OP THE AREA During the twelve month period under review 1,012 complaints were received and are summarised in Appendix "A". In addition it is estimated that some 1,800 members of the public, including builders, trade representatives, etc., were interviewed on health matters. The number of complaints from the public may be directly related to the time spent on the district by the Inspectors since it is a fact that many people, particularly younger tenants, are quite unaware until they are visited by the Inspector that they have any legal right to ask the landlord to carry out essential repairs to the property. During 1963 the Department was fortunate in being fully staffed and it is evident from the reports on the various activities that we were able to widen public health control. 10,672 visits were made and are summarised in Appendix "B". Most of the improvements effected following these visits were carried out willingly on the advice of the Inspectorate. Only rarely did matters have to be reported to the Council for authorisation of statutory action. Rodent and Pest Control 208 complaints of rat and mice infestations were received and 1,126 visits were made in carrying out treatment at 655 premises. In addition, poisoned baits were placed in the sewers in the known areas of infestation. 6 complaints were made of nuisance from pigeons which resulted in considerable work. A trap was made and proved successful in some instances, although there were difficulties such as bird loving ladies surreptitiously releasing the pigeons and luring them away from the trap by attractive but "unofficial" meals. Eventually the Minister of Agriculture, Fisheries and Food authorised the use of narcotics. Grain is soaked in Alpha-Chloralose and is put out under careful supervision for the birds in the early morning. The treatment is quite painless and humane as the birds just fall into a sleep which lasts a few hours. The R.S.P.C.A. come along to see fair play. Birds who are "under the influence" are picked up and any that are identifiable are allowed to wake up and are then taken to a local pigeon club whose members return them to their owners. 32 pigeons were caught in all. 32 wasp nests were destroyed and many other insect infestations were eradicated. 25. Factories Act. 1961 During 1963 there were 83 factories, all using power, on the district register. It was not found necessary to take any statutory action under this Act; such defects as were discovered were remedied informally by the managements. Outworkers At the end of the year the number of outworkers carrying out work in the Borough was 182. The work in which these people were engaged is itemised as follows:- Wearing Apparel manufacturers 113 Artificial Flower manufacturers 4 Cardboard box manufacturers 7 Lamp-shade manufacturers 2 Upholsterers 5 Brush manufacturers 2 Footwear manufacturers 17 Toy manufacturers - 32 Total no. employed: 182 No contraventions of employment were observed and the statutory lists of workers were received. Petroleum Acts. 1928 and 1936 Two petroleum stations were re-built following discovery of defective underground petroleum storage tanks and pipe lines and a third station is in the process of being re-developed following failure of the tanks on routine testing. Generally speaking, the standard of compliance with the Acts in Chingford is good but there is still much carelessness on the part of both motorists and petrol attendants alike, particularly with regard to smoking. As new stations are built the distance of the petrol pumps from the public footpaths has been increased to comply with the Regulations. There are still examples in Chingford of petrol being dispensed in the roadway and over the pavement from swinging arms. This is an obsolete and dangerous practice and is being discouraged. 26. HOUSING Unfit houses 263 houses were inspected and 203 found to be unfit. The latter were dealt with as follows:- Repaired after negotiation with the owners 172 " " service of statutory notices 29 Condemned after being found not repairable at reasonable cost 2 Because of the acute shortage of Council houses to accommodate the occupants of the above 2 houses, demolition was deferred until 1964. Dilapidated house Under a new statute in the Public Health Act, 1961, the Council required the owner to put in order an empty house which was in a seriously dilapidated condition and detrimental to the amenities of the neighbourhood. The house is now in a satisfactory condition and occupied. Improvement of sub-standard houses The Council approved grants for the improvement of 27 houses; 21 by standard and 6 by discretionary grants. A group of 25 houses was surveyed with a view to making an "Improvement Area" in which all the houses would be provided with at least the standard grant amenities of an internal water closet, a proper food store and a hot water supply to a sink, wash basin and bath. The houses were about 60 years old, in a reasonable state of repair and well worth improvement. Six already had the above amenities, four had some and fifteen had none. The former had been improved with a grant and are now attractive and comfortable homes, contrasting greatly with the remainder. Difficulties were soon found. Some of the houses were fully occupied, allowing little or no room for adaptation. In others the tenants were reluctant to pay more rent for additional amenities and in most tenanted properties, the owners were unco-operative. I believe we could have accomplished this task, given full support by the Ministry of Housing and Local Government. However, further difficulties arose because of conflict with the County Development Plan and the Council resolved to defer the scheme for the time being. CLEM AIR ACT. 1956 27. Smoke Control Areas - Phased Programme The following details summarise the programme and show the number of Smoke Control Orders in operation. As a result of recent instructions from the Ministry it has been necessary to revise the phased programme. Orders confirmed after 31st December, 1963 will be considerably more expensive and it has therefore been decided by the Council to reduce the size of Area Number 4. The programme for 1965 onwards will be decided by the new Council for Waltham Forest. Chingford Smoke Control Order (No.l) 1960. 38 acres; 387 dwelling houses. Operative date 3rd Nov. 1960. An area bounded on the south side by and including Yardley Lane and on the north side by the Borough boundary. Chingford Smoke Control Order (No. 2) 1962. 227 acres; 2,000 dwelling houses. Operative date 1st Nov. 1962. An area bounded by on the north side by and including Priory Avenue and Priory Close and on the south side by but not including Hampton Road, and on the east side by Old Church Road and Chingford Mount Road. Chingford Smoke Control Order (No. 3) 1963. 258 acres; 1,500 dwelling houses. Operative date 1st. Dec. 1963. An area bounded on the north side by and including Hampton Road and on the south and west side by the Borough boundary and on the east side by Chingford Mount Road. Chingford Smoke Control Order (No. 4) 1964. 93 acres; 726 dwelling houses. Date of operation: 1st Dec. 1964. An area bounded by the south side of Ainslie Wood Road and Inks Green and both sides of Ropers Avenue and East View, the west side of Larkshall Road, the ChingfordWalthamstow boundary and the east side of Chingford Mount Road. The index at the end of my report shows the roads which are in the areas covered by Smoke Control Orders Nos. 1 to 4. Daily volumetric readings of smoke and sulphur dioxide have been taken and show a reduction in air pollution. This gives encouragement to establishment of future Smoke Control Areas. 28. FOOD CONTROL FOOD COMPLAINTS Complaint Action taken 1. Lemonade tasting of disinfectant. Found to be contaminated with phenols and unfit. Legal proceedings. Manufacturer undertook to cease using returnable caps. Granted an "absolute discharge". 2. Dirty milk bottle. Dairy Company fined £5. 0s. 0d. 3. Metal and rubber in a chocolate biscuit. Manufacturer granted an "absolute discharge" in view of excellent record. 4. Mouldy meat pie. Retailer fined £10. 0s. 0d. 5. Rodent excreta in a tin of creamed rice. Legal proceedings not advised because of uncertainties as to when and where the excreta entered the tin. letter to manufacturers. 6. Mouldy bread. Retailer fined £15. 0s. 0d. 7. Foreign matter in bread. Found to be burnt pieces of dough. Letter to baker requesting greater care in preparation. 8. Mouldy tasting bread. Complaint judged to be unfounded. 9. Mouldy "Swiss jam roll". Complainant declined to give evidence, Warning letter to manufacturer and retailer. 10. Mouldy bread. Distributors fined £25. 0s. 0d. 11. Mouldy chocolate sponges. Retailer fined £5. 0s. 0d. 29. Complaint Action taken 12. Rancid butter. Found to be satisfactory. The strong odour was natural to the butter. 13. Foreign matter in bread. This was discoloured dough. Letter to baker requesting greater care in manufacture. 14. Sour cream. Complainant declined to give evidence. Warning letter to retailer. 15. Foreign matter in bread. Manufacturers fined £5. 0s. 0d. 16. Foreign matter in bread. Complainant declined to give evidence. Warning letter to bakers. 17. Mouldy bread. Mould was found to be patches of flour on bread. 18. Brass nut in butter. Impossible to determine when nut got into butter. No further action. 19. Foreign matter in sausage. Found to be a piece of connective tissue. Letter to manufacturer. 20. Unpleasant symptoms experienced after eating a meal of condensed soup, minced beef, oxo and tinned peas. Suspected to have been caused by nicotinic acid in the minced beef but this could not be isolated by the Public Analyst. Butcher admitted using Salox containing nicotinic acid, in order to "make the meat look nice and red". Would not agree to discontinue but said he would take great care in its use. Representations made to A.M.C. and Ministry requesting that nicotinic acid be banned. 21. Complaint as above (4 months later and same butcher). Minced beef found to contain heavy proportion of nicotinic acid so as to be objectionable. Butcher fined £25. 0s. 0d. for selling meat which was not of the substance demanded in that it contained an excess of nicotinic acid. Further representations to A.M.C. and Ministry. 30. SAMPLING OF FOOD AND DRUGS A total of 86 samples of a wide variety of food and drugs were purchased from shops and submitted to Dr. J. H. Hamence, F.R.I.C., the Council's Public Analyst, for examination. Five were found to be unsatisfactory, namely; Pork sausages: These contained Sulphur Dioxide, a preservative. The retailer failed to exhibit the statutory notice informing purchasers that preservatives were being used. The butcher was warned of the contravention and has since exhibited a notice. Minced beef; This was found to contain a small amount of added nicotinic acid for the purpose of keeping the meat a bright red colour, so masking possible deterioration. The butcher was warned that the Council took a serious view of this and was requested to cease using the substance. Milk: Glasses of milk were purchased in a cafe and the milk was found to contain 27% of added water. Legal proceedings were taken resulting in a fine of £5. 0s„ 0d. and Advocate's Fee of £3. 3s. 0d. Mixed dried vegetables: These were found to be wrongly described on the label. The manufacturers were informed and corrected the labels. Tinned raspberries: These were found to contain insufficient fruit. The manufacturers were informed and subsequent samples were satisfactory. 31. BACTERIOLOGICAL EXAMINATION OF FOOD Ten samples of ice cream were examined and all found to be satisfactory. Various processed meats were sampled from shop counters and display cabinets, namely: Quick frozen steaklets Satisfactory Steakettes Unsatisfactory Liver sausage Fairly satisfactory Ham Unsatisfactory Luncheon meat Unsatisfactory Corned beef Satisfactory Sausage lb.) Unsatisfactory Sausage lb.) Unsatisfactory The unsatisfactory samples were found to contain excessively large numbers of bacteria. In a few cases these were of excretal origin but fortunately none were pathogenic. None of these foods can be sterile because they have to be handled, but the number of bacteria can and should be low. Excretal organisms should not be present. They were in an unsatisfactory condition because of poor methods of handling, storage at too high a temperature and overlong storage. All the retailers were surprised at the results because their premises were apparently clean and satisfactory. They now understand that their methods also have to be improved and are readily accepting the advice and instructions of the Public Health Inspectors to this end. Merchandise Marks Act. 1887 A greengrocer was found to be selling Dutch tomatoes as English. He was fined £10. 0s. 0d. for this offence and £2. 0s. 0d. for other labelling offences. Unsound food 2,146 lbs. of various meats, 389 tins and 356 packages of food were condemned and destroyed. 32. INSPECTION OF FOOD PREMISES The Food Hygiene (General) Regulations. 1960 Informal notices were served in respect of contraventions of the Regulations:- Regulation No. of notices (6) Dirtiness of equipment 16 (8) Failing to protect food from risk of contamination 14 (9) Lack of personal cleanliness 6 (12) Drain ventilating pipe in food room 1 (14) Dirty and defective sanitary conveniences 29 (16) Absence of wash hand basins, hot water supply, etc. 36 (17) Absence of first aid materials 14 (18) Absence of accommodation for clothing 5 (19) Unsatisfactory facilities for washing food and equipment 11 (21) Poor ventilation of food rooms 2 (23) Lack of cleanliness and disrepair of food roans 36 (24) Accumulation of refuse 7 (26) Lack of cleanliness of stalls and vehicles 6 (29) Unsatisfactory condition of meat transport vehicles 17 (30) Meat porters wearing dirty overalls and failing to wear head covering 19 TOTAL: 219 33. A particular drive was made to improve the hygiene of meat transport. The floors of many vehicles were found to be defective and in almost all of them, much of the meat was stacked on the floor over which the porters had to walk while loading and unloading the vehicles. Unfortunately the poor method of handling and other bad practices at the markets are a very poor example to the drivers of these vehicles and without exception, they were quick to point this out. However, I now think that they are beginning to understand that a high standard is expected in this Borough and there has been a considerable improvement. Legal Proceedings under the Regulations A transport cafe: Regulation Fine (6) Dirty equipment £3 (14) Insufficiently lighted W.C. Dismissed (16) Absence of conveniently accessible wash hand basin £3 (23) Dirty walls, woodwork and windows Dismissed Total: £6 A grocer: Regulation Fine (14) (i) Dirty sanitary convenience £5 (34)(ii) Dirty and insufficiently lighted room containing W.C. £5 (23) Failing to keep clean and in good order the structure and food rooms £20 (24) Excessive accumulation of refuse in a food room £20 Total: £50 The Magistrates also made an order for costs of £6. 6s. 0d. 34. An ice cream hawker: Regulation Fine (6) Dirty equipment £3 (26) Dirty ice cream vehicle £3 (28) Absence of hot water supply £3 Total: £9 A grocer: Regulation Fine (6) Dirty equipment £25 (14) Dirty walls of W.C. £5 (16) Absence of nail brush and towel £20 (17) " " waterproof dressings £10 (23) Dirty walls, floor and windows of a food room £10 Total: £70 A butcher: Reflation Fine (6) Dirty equipment £20 (8) Food placed as to involve risk of contamination £10 (34) (2) Insufficient light in a W.C. £10 (14) (5) Failing to exhibit notice in W.C. regarding washing of hands £2 (16) Absence of soap, nail brush and towel £20 (23) Dirty walls, floor and windows in a food room £10 (24) Excessive deposit of refuse in a food room £3 Total: £75 35 APPENDIX A Summary of complaints received during 1963 The number of complaints received and investigated by the department was 1,012 The total defects or nuisances revealed and resulting in the carrying cut of works or the service of various notices on the owners and occupiers was 982. NATURE OP COMPLAINT No. Defective dwelling houses 36 Obstructed sewers and drains 563 Defective drains and sewers 3 Frozen and burst pipes 8 Flooding of gardens, houses, etc. 3 Infestations of insects, flies, ants, etc. 18 " " wasps, bees, hornets 50 " " rats and mice 208 Nuisances caused by smoke, dust and odour 21 " " " noise 8 " " " offensive accumulations 12 " " " dogs, etc. 7 " " " pigeons 6 Complaints of unsound or contaminated food 21 Public conveniences 7 Broken manholes 20 Road sweeping 14 Neighbour nuisance 7 TOTAL 1,012 36. APPENDIX B Summary of inspections and visits Subject of visit or inspection No. of visits or inspections No. of cases, nuisances or defects remsdied PUBLIC HEALTH ACTS. 1956 and 1961 In connection with notices served 680 472 Re-inspections, work in progress etc. 677 Drainage 822 749 Rodent and insect control 1,226 727 Infectious disease 65 4 River pollution 15 3 Noise nuisance 14 7 Swimming pools 11 Hairdressing premises 25 2 Places of entertainment/licensed premises 33 11 Schools 21 3 Infestations from reservoirs 16 8 Pigstyes, stables, watercourses and ditches 36 5 Public conveniences 509 31 Street cleansing 98 29 Gully cleansing 32 18 Refuse collection and disposal 121 76 Flooding of gardens, houses, etc. 24 12 Inadequate and defective water supplies 6 4 Nuisances caused by offensive accumulations 35 27 " " " the keeping of animals 10 5 " " " pigeons 55 6 Verminous houses 4 1 HOUSING ACTS. 1954. 1957. 1959 and 1961 Dwelling houses inspections 263 203 " " re-inspections 302 Improvement Grant work 75 19 Overcrowding 15 5 Rent Act, 1957 - Certificates of Disrepair 4 1 SHOPS ACT. 1950 General sanitation and working conditions 189 23 Hours of closing 143 5 Employment of young persons 112 7 Carried forward 5,638 2,463 37. Subject of visit car inspection No. of visits or inspections No. of cases, nuisances or defects remedied Brought forward 5,638 2,463 PETROLEUM ACTS AMD REGULATIONS thereunder Inspection of licensed premises Re-inspection of licensed premises in connection with contraventions, tank testing, etc. 113 44 21 FACTORIES ACT. 1961 & REGULATIONS thereunder Inspections of registered factories Re-inspections in connection with work in progress, contraventions, etc. Inspection of outworkers premises 101 39 15 112 MISCELLANEOUS e.g. PET ANIMALS ACT, 1951, LICENSING ACT, 1961, RIDING ESTABLISHMENTS ACT, 1939, HEATING APPLIANCES (FIREGUARDS) ACT. 1952. BUILDING BYELAWS. WATER ACT. 1945 etc. Inspections carried out Re-inspections in connection with work in progress, contraventions, etc. 241 129 53 CLEAN AIR ACT. 1956 Smoke control area inspections Survey of proposed smoke control area 1,683 180 FOOD AND DRUGS ACT. 1955 AND ASSOCIATED LEGISLATION Butchers, shops 244 46 Fish (wet and fried) shops 107 11 General provision shops 397 46 Bakehouses and vans 41 5 Dairies and milk floats 22 Mixed businesses (food shops) 363 27 Restaurants and Cafe's 173 33 Public houses and licensed premises/restaurants 79 21 School kitchens 64 9 Food delivery vehicles 91 31 Ice cream Vendors 341 25 Hawkers of food and Chingford Fairground 84 19 Samples of food, milk and water 110 Merchandise Marks Acts and Orders 376 39 TOTAL 10,672 2,864 38. APPENDIX C STREET AND GULLY CLEANSING COST STATEMENT 196 3/64 Item Particulars Street Sweeping and Watering Street Gully Cleansing Total Percentage of Total gross expenditure 1 2 3 4 5 £ £ £ % REVENUE ACCOUNT 1. GROSS EXPENDITURE (i) Labour 6,317 46 6,363 (ii) Transport 4,377 – 4,377 (iii) Plant, equipment, land & buildings 196 – 196 (iv) Other items 600 769 1,369 (v) Total gross expenditure 11,490 815 12,305 100 2. GROSS INCOME (excluding reimbursements from Ministry of Transport and the County Council) 87 – 87 – 3. NET COST 11,403 815 12,218 - 4. Capital expenditure met from revenue (included above) – – – – 5. Gross expenditure on sanding, gritting and snow clearance, not included previously 487 – – – 6. UNIT COSTS Average net cost per street mile cleansed per annum Item 3 Item 9 £ 190 – – – £ £ £ 7. Net cost per 1,000 street gully cleansings Item 3 Item 13 - 98 - - 8. Net cost (item 3) per 1,000 population 247 17 264 - 39. OPERATIONAL STATISTICS 9. Mileage of streets cleansed 60 10. Frequency of cleansing: (a) At least once daily - % (b) Three to six times weekly 5 % (c) Twice weekly - % (d) Once weekly 35 % (e) Less than once weekly 60% 11. Percentage of street cleansing done by mechanical means Nil % 12. Number of street gullies cleansed 3,523 13. Number of gully cleansings during year. (Number of gullies x number of cleansings) 8,342 14. Percentage of gully cleansing done by mechanical means 100 % 15. Remarks Item 1 (iv) Gully Cleansing is carried out by Contractors and the figures include labour and transport. Item 11 Sweeping carried out by manual labour only and four electric trucks are used for conveyance of sweepings. 40. APEENDIX D COLLECTION At© DISPOSAL OF HOUSE AND TRADE REFUSE COST STATEMENT 1963/64. Item Particulars Collection Disposal Total Percentage of total gross expenditure 1 2 3 4 5 £ £ £ % 1. REVENUE ACCOUNT GROSS EXPENDITURE (i) Labour 14,638 11,072 25,710 55 (ii)Transport 10,930 – 10,930 23 (iii) Plant, equipment, land & buildings 104 4,724 4,828 10 (iv) Other items 446 4,918 5,364 12 (v) Total gross expenditure 26,118 20,714 46,832 100 2. GROSS INCOME 612 12,481 13,093 — 3. NET COST 25,506 8,233 33,739 - 4. Capital expenditure met from revenue (included above) — 74 74 UNIT COSTS s. d. s. d. s. d. 5. Gross cost per ton, labour only 24. ll 18.10 43.9 6. Gross cost per ton, transport only 18. 7 — 18. 7 7. Net cost (all expenditure) per ton 43. 4 14. 0 57.4 £ £ £ 8. Net cost per 1,000 population 552 178 730 9. Net cost per 1,000 premises 1,694 547 2,241 41. OPERATIONAL STATISTICS 10. Area (statute acres) - land and inland water 2,868 acres 11. Population at 30th June, 1963 (Registrar-General's Estimate) 46,230 persons 12. Total refuse collected 11,763 tons 13. What percentage of total refuse collected (tons) is weighed 100% 14. Weight (cwts.) per 1,000 population per day (365 days to year) 13.9 cwts. 15. Number of premises from which refuse is collected 15,053 premises 16. Premises from which collections are made at least once weekly 100% of total 17. Average haul, single journey, to final disposal point (including nil miles by secondary transport) 10 miles 18. Kerbside collection expressed as estimated percentage of total collection Nil % 19. Total refuse disposed of (of which nil tons were disposed of for other local authorities) 11,763 tons 20. Methods of disposal (Salvage excluded): (a) Crude tipping 29 % (b) Controlled tipping - % (c) Separatior/controlled tipping - % (d) Direct incineration - % (e) Separation and incineration 71 % (f) Other methods (state nature) - % 100 % 21. Salvage. Analysis of income and tonnage: Income (included in Item 2) Tonnage Collected (Included in Item 12) £ Tons (a) Raw Kitchen Waste 4 1 (b)Scrap Metal 3,037 526 (c) Waste Paper 7,307 868 (d) Other Salvage 1,572 279 (e) Totals 11,920 1,674 22. Trade Refuse: (a) Income £909 (b) Tonnage 1,000 tons 42. APPENDIX E ANALYSIS OP SALVAGE INCOME FOR THE YEAR ENDED 31st MARCH. 1964 Year ended 31.3.63 £. s. d. Sale of Salvaged Articles: £. s. d. £. s. d. £. s. d. Metals 286. 3. 2 Aluminium 305. 16. 0 213. 9. 0 Copper 241. 0. 3 152. 16. 10 Iron 197. 4. 9. 61. 12. 11 Lead 72. 5. 7 9. 3. 3 Battery Lead - - - 222. 8. 7 Unbaled Scrap 221. 15. 4 2,009. 9. 6 Tins 1,716. 14. 4 13. 6. 2 Pewter 24. 12. 10 12. 15. 1 Zinc 12. 0. 8 239. 14. 11 Brass 229. 0. 7 3,037. 1. 9 137. 6. 0 White Cullet 188. 0. 4 21. 0. 1 Amber Cullet 28. 16. 3 442. 5. 0 Bottles and Jars 369. 4. 0 586. 0. 7 348. 9. 6 Rags 407. 13. 0 119. 1. 3 Carpets and Sacking 166. 5. 8 218. 5. 11 Woollens 210. 5. 10 85. 8. 0 Flock Bedding 122. 7. 4 7. 11. 3 Gunny 2. 0. 6 908. 12. 4 6,329. 14. 3 Newspapers & Mixed Paper 7,306. 17. 6 3. 0. 0 Bones - - - 41. 11. 6 Bread (Pig Food) 41. 19. 7 23. 4. 0 Rubber Tyres & Tubes 22. 5. 0 4. 0. 0 Unsound Food 4. 0. 0 72. 10. 11 Screenings 11. 4. 0 5. 15. 5 Miscellaneous 1. 10. 6 11,919. 11. 3 38. 14. 0 Weighbridge Fees 44. 0. 0 Rents 200. 0. 0 Foundry 200. 0. 0 20. 0. 0 Proportion of Allotment Rents 20. 0. 0 2. 6 Other Rents 2. 6 220. 2. 6 Refuse Collection Charges 451. 9. 10 Greengrocers & Butchers 515. 10. 4 301. 0. 3 Others 393. 18. 6 909. 8. 10 £12,091. 9. 1 £13,093. 2. 7 43. APPENDIX F SMOKE CONTROL AREAS 1960-1964 - STREET/YEAR INDEX Ainslie Wood Crescent 1964 Ainslie Wood Gardens1964 Ainslie Wood Road 1964 Albert Avenue 1962 Antlers Hill 1960 Ashley Road 1963 Bateman Road 1963 Boardman Avenue 1960 Burnham Avenue 1963 Burnham Road 1963 Chase Gardens 1962 Cherrydown Avenue 1962 Cherrydown Close 1962 Chingford Mount Road Boundary to Hampton Rd. West Side 1963 Hampton Rd. to Hall Lane " " 1962 Churchill Terrace 1962 Coningsby Gardens 1962 Cranston Gardens 1964 Deer leap Grove 1960 East View 1964 Edward Avenue 1964 Frances Road 1964 Frankland Road 1962 George Road 1963 Gilwell Close 1960 Hall Gardens 1962 Hall Lane North Circular to Hampton Road 1963 Remainder 1962 Hampton Road 1963 Hollywood Road 1962 Hurst Avenue 1962 Hurst Close 1962 Inks Green Road 1964 Leonard Road 1963 Lower Hall Lane Hall Lane to Pumping Station 1962 Pumping Station to Nth. Circular Road 1963 Marmion Approach 1962 Marmion Avenue 1962 Marmion Close 1962 May Road 1963 Middleton Avenue 1962 laddieton Close 1962 Norbury Road 1962 North Circular Road 1963 Norton Close 1962 Old Church Road Albert Cresc. to Priory Avenue West Side 1962 Priory Avenue 1962 Eriory Close 1962 Rolls Park Avenue 1964 Rolls Park Road 1964 Ropers Avenue 1964 Royston Avenue 1964 Russell Road 1962 Sewardstone Gardens 1960 Sinclair Road 1963 Tufton Road 1962 Waltham Way Hall Lane to Priory Avenue 1962 Warwick Avenue 1963 Warwick Road 1963 Waver ley Avenue 1962 Westward Road 1963 Woodside Gardens 1964 Yardley Close 1960 Yardley Lane 1960 York Avenue 1963 York Road Westward Rd. to Hampton Road 1963 Remainder 1962 CONTENTS Page Acreage 3 Ambulance facilities 5 Births 3,4 Cancer 14 Children's Department 9 Chiropody 1,7 Clean Air Act 27 Clinics 6,8,9 Complaints - summary of 35 Day Nurseries 7 Deaths 1,4,12,13 Factories - inspection of 25 Fluoride & Fluoridation 1,22 Food - bacteriological examinations 31 Food - complaints 28,29 Food & Drugs - sampling 30 Food Poisoning & Hygiene 12 Food premises - inspection of 32,33,34 Food - -unsound 31 Heart - deaths 13 Health visiting 6 Home Help Service 7 Home Safety 1 Hospitals 6,7 Housing 26 Immunisation 10,11 Infectious diseases 1,10,11,16,17 Inhabited houses & flats 3 Inspections 24 Inspections and visits - summary of 36,37 Introduction 1,18 Infant mortality 3,4 Page Laboratory facilities 5 Laundry service 7 Medical examinations 12 Mental welfare 9 Merchandise Marks Act 31 Midwives and Nurses 5 National Assistance 9,12 National Health Insurance 9 Nursing Homes 6 Outwork 25 Population 3,4 Petroleum Acts 25 Rateable value 3 Refuse collection and disposal 40,41 Registrar of Births and Deaths 9 Rodent and pest control 24 Salvage income - analysis of 42 School medical inspections 6 Sewerage 23 Smoke control areas 43 Social welfare 9 Street and gully cleansing 38,39 Swimming Pool 23 Tuberculosis 11,15 Vaccination 12 Vital statistics 1,3,4 Water supplies 22