AC 4411(1) CHIN 29 BOROUGH OF CHINGFORD ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH Including the Report of the CHIEF PUBLIC HEALTH INSPECTOR FOR THE YEAR 1964 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 4 BOROUGH OF CHINGFORD PUBLIC HEALTH COMMITTEE: June, 1964 - March, 1965 Chairman: Vic e-Chairman: Members: Councillor M.C. Fish Alderman J.W. Corder Alderman J.W,R. Nation, C.C. Councillor P.A. Bostock Councillor J.H. Davies Councillor Mrs. E.M. Game Councillor Mrs. D,M.E. Linfoot Councillor W.J. Pearmine Councillor S.Jo Silk The Mayor, Alderman W.J. Bowstead, J,P., C.C. (ex officio) Meeting: Second Monday in each month at 7.30 p.m. PUBLIC. HEALTH OFFICERS OF THE AUTHORITY (1964) 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. WARD, M0R.S0H0, M.A.P.H.I. (a) (b) (c) (to 12.8.64) District Public Health Inspectors: R. C. MORTON, M.R.S.H., M.A.P.H.I. (a) (b) (to 1.8.64) T. MATTHEWS, M.A.P.H.I., S.R.N. (a) (b) (to 1.8.64) L. T. PITHERS, M.A.P.H.I. (a) (b) (from 31.8.64) J. R. JONES, M.R.S.H., M.A.P.H.I. (d) (from 1.9.64) Technical Assistant: C. B. WALTON (a) (b) (from 13.4.64) Senior Clerk & Secretary to M.O.H: Administrative Assistant: Miss V. M. PETTIT A. H. GILLIES Assistant Cleansing Superintendent: Assistant Refuse Works Manager: F. CANNON H. FROST Clerks: Rodent Operative: Mrs. C. J. BELL (to 31-3.64) M. J. MURRAY Miss A, M. THOMASON (to 3.3.64) Miss D. C. GOLDING (to 28.12.64) D. R. STEVENS Miss S. CLARK (from 6.4.64) Mrs. J. BIRD (from 6.4.64) (a) Certificate as Public Health Inspector (b) Certificate or Diploma as Meat and Other Foods Inspector (c) Certificate as Smoke Inspector (d) Diploma of Public Health Inspection (including Meat & Foods Inspection) 1. ANNUAL REPORT FOR THE YEAR 1964 To: The Mayor, Aldermen and Councillors of the London Borough of WALTHAM FOREST Mr. Mayor, Aldermen and Councillors, I have pleasure in submitting my Annual Report for the year 1964 upon the health and sanitary circumstances of the Borough of Chingford. This is the last report, covering a full year, which I shall make, as Chingford ceased to be a separate borough on the 31st March, 1965. This fact is an occasion, then, on which to look back over the past eighteen years during which I have held the office of Medical Officer of Health. I joined the staff of the Health Department in 1947 when the immediate effects of the war were being forgotten and plans were being prepared for repair, restoration and reconstruction throughout the country. The years that followed were years of great health and social legislation. One recalls readily to mind the National Health Service Act of 1946 which came into force in July 1948, the numerous He using Acts, the Housing Repairs and Rents Act of 1954, the Food and Drugs Act, 1955, the Clean Air Act, 1956, among others. In 1950 the borough became a Food and Drugs Authority. In the same year the Council adopted the model byelaws made for the Handling, Wrapping and Delivery of Food and Sale of Food in the Open Air. In 1959 the Council submitted to the Ministry of Housing and Local Government a phased programme for the introduction of Smoke Control Areas throughout the borough, In the purely medical field, the introduction in 1956 of a vaccine against poliomyelitis marked a great advance in the control of this disease. B.C.G. vaccination against tuberculosis has been offered to all school children of the 13 year age group since 1954: the response has been very encouraging and the long-term effects of this policy should be apparent in the years to come. So much for a brief review of the past. 2. Population; The estimated population for the year was 46,320. Vital Statistics; In the statistics which follow, the figures in brackets refer to 1963. The birth-rate was 13.0 (13.3) per 1,000, representing 604 (615) births. The number cf deaths was 422 (444), the death-rate being 9.1 (9.6) 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 19.8 (8.1). The rate for England and Wales was 20.0. The table on page 4 shows at a glance the birth, death and infant mortality rates for the years 1959-64. Causes of Death; Three deaths out of every four were attributable to diseases of the heart and circulation, and cancer. The table on page 13 indicates the rise in recent years in the deaths from diseases of the heart and circulation. Infectious Diseases: There was very little infectious illness. Care of the Aged: Year by year the amount of time devoted by the staff of the Health Department to the care of the aged and infirm has been increasing appreciably. Dr. F.G. Brown, Area Medical Officer, Essex County Council, has kindly supplied the statistical matter on pages 5 and 6. I express my thanks to the Chairman and Members of the Health Committee at Chingford for their support and to the staff of the Department especially to the long-service members, in particular to Miss V. Pettit, my secretary, whose loyalty, patience and assistance has been deeply appreciated throughout all my years of service. J. H. CROSBY Medical Officer of Health Health Department, Town Hall, Chingford, E.4. August, 1965 3. STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area 2,868 acres Population: Registrar-General's estimated mid-year home population 46,320 Number of inhabited houses and flats (as at 31.12.64) 14,398 Rateable value on April 1st 1964 £2,149,565 Product of penny rate on April 1st 1964 £8,740 VITAL STATISTICS Live Births: Number (315 males: 289 females) 604 Rate per 1,000 population 13.0 Illegitimate Live Births per cent of total live births 4.1 Stillbirths: Number (8 males: 1 female) 9 Rate per 1,000 total live and stillbirths 14.6 Total live and stillbirths 613 Infant Deaths (deaths under 1 year) 12 Infant Mortality Rates: Total infant deaths per 1,000 total live births 19.8 Legitimate " " " " legitimate live births 18.1 Illegitimate " " " " illegitimate " " 4.0 Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 13.2 Early Neo-natal Mortality Rate (deaths under 1 week per 1,000 total live births) 9.9 Perinatal Mortality Rate (stillbirths and deaths under 1 week combined per 1,000 total live & stillbirths) 24.4 Maternal Mortality (including abortion): Number of deaths - Rate per 1,000 total live and stillbirths - Total Deaths: Number (215 males: 207 females) 422 Crude death rate per 1,000 population 9.1 Deaths from Cancer (all ages) 99 " " Measles (all ages) - " " Whooping Cough (all ages) 4. TABLE OF BIRTH AND DEATH RATES 1959/64 Year Pop'n Births Crude rate per 1,000 pop'n Rate ad- : justed by comparability factor i ! Rate for England and Wales Deaths Crude rate per 1,000 pop'n Rate adjusted by comparability factor Rate for England and Wales Infant Mortality Deaths Rate per 1,000 live births Rate for England and Wales 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 1964 46,320 604 13.0 14.19 18,4 422 9.1 10.37 11.3 12 19.8 20.0 5. GENERAL PROVISION OF HEALTH SERVICES IN THE AREA (a.) Laboratory Facilities Pathological specimens from this district were examined at the Pathological Departments of the St. Margaret's Hospital, Epping, the Connaught Hospital, Walthamstow, and the Whipps Cross Hospital, Leytonstone. Specimens were (by arrangement) also 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 were administered by the Essex County Council. Maternity nursing and midwifery cases, in addition to a large number of general nursing visits, were undertaken. Number of Midwives or Home Nurse/Midwives - 3 * " " Home Nurses - 4? (Miss C. Lovell, 49, The Ridgeway, E.4. Silverthorn 7838 * (Miss D.L. Chandler, 87, Friday Hill, E.4. " 4968 (Mrs. P.M. Stenning, 78, Larksvrood Road, E.4. " 5414 (Mrs. M. Ford, 103, Cadogan Gardens, Woodford,E.18. Wanstead 6346 ? (Miss A. O'Driscoll, 49, The Ridgeway, E.4* Silverthorn 1460 (Mrs. M. O' Donoghue, 80, Montalt Road, Woodford Gn.Buckhurst 2766 (Mrs. B. Harrison, 12a, Forest Court, Whitehall 'Silverthorn 1057 Road, E.4. Number of cases attended by Midwives - 208 " " visits paid by Home Nurses - 13,453 6. (&) Health Visiting The total number of visits paid by the Health Visitors during the year was 4,834. (e) Registered Nursing Homes There are at present no registered nursing homes in the area but there are four private homes for elderly persons all of which are registered with the Local Authority under the National Assistance Act, 1948 - Section 37. (f) Clinics and Treatment Centres See table of clinics on pages 8 and 9. These are listed as being under the control of the Essex County Council until 31st March, 1965; it is unlikely there is little variance in sessions within the new Authority - the London Borough of Waltham Forest as from 1st April, 1965. Child Welfare Centres Attendances of children - under 5 years of age - 13,446 Ante-Natal Clinics Attendances - 1,564 Women's Welfare Clinic Attendances - 119 (g) School Medical Inspections No. referred for: No. examined (a) treatment (b) observation 1st age group (school entrants) 460 27 79 2nd age group (11-12 years) 391 47 76 3rd age group (school leavers) 434 56 26 Other age groups and "specials" 53 7 27 Re-examinations 583 - - 7. (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. 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. There is one Day Nursery in the district, situated at 136/133, 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: this was under the auspices of the Essex County Council until 31st March, 1965, and is now controlled by the London Borough of Waltham Forest. (k) Chiropody Facilities Chiropody sessions are held at both Health Services Clinics in the area (see page 9). Priority is, in the first instance, given to the elderly, physically handicapped and expectant mothers. Five persons held licences from the Essex County Council to carry on private practice as chiropodists in the borough. Their premises are inspected annually. (1) 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 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 only) 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. Mons. & Fris. (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. Mons. A.M. & Thurs. P.M. Tuesdays, all day. Fridays, P.M. (by appointment only) E.C.C. Health Services Clinic, Marmion Avenue, E.4. Wednesdays, all day. Fridays A.M. & Mons. P.M. Alternate Sats. A.M. (by appointment only) GENERAL INFORMATION (1965) National Assistance Board: 29, Cambridge Park, Wanstead, E.11. (Wanstead 7721) Office hours: Mondays to Fridays, 9 a.m. to 4 p.m. Registrar of Births, Deaths & Marriages: Mr. D. Hunting, 11, The Ridgeway, Chingford, E.4. (Silverthorn 7766) Office hours: Mons, Tues, Thurs & Fris. 2 - 4.30 p.m. National Health Insurance Office: Municipal Offices, The Ridgeway, Chingford, E.4« Office hours: Mondays to Fridays, 10 a.m. - 1 p.m. 2-4 p.m. Mental Welfare Officers, Education & Welfare Departments: Health Department, Municipal Offices, High Road, Leyton, E.10. (Leytonstone 3650) Office hours: Mondays to Fridays, 9 a.m. to 5.30 p.m. Saturdays, 9 a.m. to 12 noon. Children's Department: 12, Church Hill, Walthamstow, E.17. (Coppermill 8141/4) Office hours: Mondays to Fridays, 9 a.m. to 5.30 p.m. Saturdays, 9 a.m. to 12 noon. 10. PREVENTION AND CONTROL OF INFECTIOUS AND OTHER DISEASES Diphtheria For the fourteenth 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 703; booster doses numbered 224. Scarlet Fever There were 22 cases, all of them being of a mild character, without complication. Of the 91 cases notified to the department, only one needed hospital admission. 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 Thirty-seven cases were notified, Immunisation against this disease is now combined with that against diphtheria and tetanus. The number of children receiving this triple immunisation was 703; booster doses given numbered 224. In addition, 19 children received whooping cough immunisation alone. Acute Poliomyelitis There was no case of this disease during the year. In addition, the following numbers of children received the immunisation indicated:- Diphtheria alone - primary- 19 — booster 144 Diphtheria with - primary 9 Tetanus booster 23 Measles Immunisation against this condition resulted in the following numbers of persons receiving the protection indicated:- 11. No. receiving the two primary injections - 24 No. receiving the third injection - 8 No. receiving fourth injection (special category, children between 5 & 12 yrs) - 38 No. receiving 3 doses of oral vaccine - 617 Tuberculosis Again there were very few new cases of pulmonary tuberculosis. The downward trend in this disease since the war is shown m the following table:- Year: 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 Cases: 45 46 42 34 36 44 30 39 30 20 Year: 1956 1957 1958 1959 I960 1961 1962 1963 1964 Cases: 20 32 17 21 14 13 14 7 8 In the school health service B.C.G-. vaccination was offered to all children in their fourteenth year and, as a result of this, 351 children were vaccinated. The Walthamstow 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 Council has made annually to this Association has been very much appreciated. Dysentery Fifteen cases were notified during the year. Food Poisoning Salmonella infection was found to be the cause of the two cases notified during 1964• Food Hygiene All food premises in the borough continued to receive close attention from the Health Inspectorate staff. Vaccination Primary vaccination against smallpox numbered 362 and re-vaccinations 226. 12. 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. this section. No burials were arranged by the Council under Medical Examinations During the year 107 examinations were carried out by me in respect of Chingford Council staff and 25 in respect of staff of the Essex County Council. CAUSES OF DEATH AS GIVEN BY THE REGISTRAR-GENERAL FOR THE YEAR 1964 Causes of death Males Females Total Tuberculosis, respiratory 2 - 2 Syphilitic disease 1 1 2 Malignant neoplasm, stomach 7 4 11 Malignant neoplasm, lung, bronchus 25 4 29 Malignant neoplasm, breast - 7 7 Malignant neoplasm, uterus - 1 1 Other malignant & lymphatic neoplasms 22 28 50 Leukaemia, aleukaemia 1 - 1 Diabetes 1 2 3 Vaacular lesions of nervous system 14 30 44 Coronary disease, angina 67 43 110 Hypertension with heart disease 1 6 7 Other heart disease 12 25 37 Other circulatory disease 7 16 23 Influenza 1 - 1 Pneumonia 8 7 15 Bronchitis 17 7 24 Other diseases of respiratory system. 1 1 2 Ulcer of stomach and duodenum 3 2 5 Gastritis, enteritis and diarrhoea 1 _ 1 Hyperplasia of prostate 2 _ 2 Congenital malformations 4 2 6 Other defined and ill-defined diseases 10 18 28 Motor vehicle accidents 5 - 5 All other accidents 3 3 6 Totals - all causes 215 207 422 Totals - year 1963 243 201 444 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 19 53 179 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 1964 221 46,320 4.7 13- DEATHS FROM CANCER There were 99 deaths from cancer of which 92 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 0 1 10 14 10 15 Lungs and Mediastinum 1 - 23 4 24 4 Genito -urinary organs - - 3 6 3 6 Breast - - _ 7 - 7 Other sites 3 2 15 10 18 12 Totals 4 • 3 51 41 55 — 44 Death rate = 2.1 per 1,000 (2,27 per 1,000 in 1963) 14. TUBERCULOSIS NEW CASES TRANSFERS DEATHS Age groups Respiratory NonRespira tory Respiratory NonRespira tory Respiratory NonRespira tory M. F. M. F. M. F. M. F. M. F. M. F. 0-1 year - - - - - - - - - - - - 1-4 years - - - - - - - - — _ - - 5-14 years - _ - - - - - - - - - - 15-24 years - 1 - - - 1 1 - - - - - 25 to 34 years 1 2 - - 1 2 _ - - - _ - 35 to 44 years - - - - 2 3 - _ _ - - - 45 to 54 years 1 1 - - 1 - - - - - - - 55 - 64 years 1 - ~ - 1 - - - 2 - _ - 65 and upwards 1 - - - - - - - - - - - TOTALS 4 4 _ - 5 6 1 - 2 - - - 15. NOTIFIABLE DISEASES (after correction) Year Scarlet Fever Erysipelas Measles Whooping Cough Tuberculosis Dysentery Puerperal pyrexia Pneumonia Meningococcal Infection Acute Poliomyelitis Typhoid or Paratyphoid Fever Food Poisoning Malaria Acute Infective Encephalitis Pulmonary Other forms 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 - - 1964 22 5 91 37 8 - 15 3 3 2 - - 2 - - 16. 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 6 1 12 1 - - - - - 22 Erysipelas - - - - - - - 2 - 1 2 5 Measles 3 6 13 12 13 39 5 - - - - - 91 Whooping Cough 3 2 3 11 5 11 - 1 - 1 - i 37 Pneumonia - - - - - - - - - - 1 2 3 Food Poisoning - - - - - 1 - 1 - - - 2 Dysentery - _ 2 1 6 1 — 2 3 - - 15 Puerperal Pyrexia - - - - - - - - 3 - - - 3 Meningococcal Infection 1 1 - - - - - - - - - - 2 ANALYSIS OF NOTIFIABLE DISEASES (after correction) Diseases Total cases Total admitted to hospital Scarlet Fever 22 - Erysipelas 5 - Measles 91 1 Whooping Cough 37 - Pneumonia 3 1 Food Poisoning 2 - Dysentery 15 1 Puerperal pyrexia 3 1 Meningococcal Infection 2 2 ANNUAL REPORT of the CHIEF PUBLIC HEALTH INSPECTOR and CLEANSING SUPERINTENDENT for the year 19 6 4 17 INTRODUCTION I submit this last annual report on the environmental health and cleansing sections of the department with sincere regret. It has been enjoyable for us to work for the Borough of Chingford, and we feel that our efforts have been worthwhile. From their support and encouragement, we believe that the Council valued them. This was much appreciated. So also was the Council's good advice and judgement in the many difficult problems that arose. Next year we shall be endeavouring to give the new Borough at least as good a service. In time I believe we can better this by virtue of the greater resources and influence of the larger organisation An example is slum clearance which must be a first priority to obtain land for rehousing and redevelopment. For that reason I welcome the amalgamation whilst, at the same time, regret the break-up of the Chingford team, incorporating both the officers and the Councillors. The past year has seen achievements in various fields, notably in bacteriological food control (pages 24 and 25). Several of the conclusions reached as the result of our extensive sampling were later to be confirmed by the Milne Report on Typhoid in Aberdeen. These lessons were translated to the food handlers in the shops to good effect, and the interest created was demonstrated by the attendance of 250 traders at one of our food hygiene lectures. Similarly, a great improvement was seen in the hygiene of meat deliveries by the carriers. The lower standards generally accepted elsewhere did however make it difficult to maintain the improvement, necessitating constant vigilance. The investigation into undesirable substances in plastic toys (pages 26 and 27) showed that we must be on the look out for fresh hazards to our environment, produced by the new technologies of this age. For instance, as I mentioned in my last report, new potential dangers are appearing such as the relatively uncontrolled spraying of growing crops with highly poisonous insecticides, some of the methods used in the intensive rearing of livestock and the use of complex additives in our processed foods. Control is necessary albeit difficult and costly. The Offices, Shops and Railway Premises Act, 1963 (page 28) became operative during the latter half of 1964. After an intensive effort, all premises were registered by the end of the year, Chingford being the only London Borough to accomplish this. Over half the premises received detailed inspections and in nearly all cases notices of contraventions were necessary, some being substantial. Undoubtedly, the inspections are resulting in better working conditions for large numbers of people, and it is pleasant to report that we were welcomed by the majority of proprietors and, of course, by all their staffs. It is also worthwhile noting that conditions in the food premises, which are inspected frequently, were far above the average. 18 I am glad to report that the Council's forthright action in dealing with cases of exploitation of tenants of houses in multiple occupation has had the desired effect. Bad treatment and unjust evictions ceased as did the spread of this type of occupation. It does appear that the 'bad' news that they were unwelcome in Chingford reached the ears of that minority of rapacious landlords who were so heartlessly exploiting the housing shortage. The Cleansing Section had a most difficult year because of shortage of suitable labour in the Borough. Many of our staff are recruited from Walthamstow and Leyton, and the amalgamation may ease the situation by introducing a greater degree of flexibility of labour movement. In the circumstances, the meagre available force did a fine job under the excellent leadership of the resourceful Mr. Cannon, my Assistant Superintendent. In conclusion, and on behalf of all my staff, I wish to thank the Council, the Public Health Committee and its Chairman in particular, for the whole-hearted support they gave us during my term of office. Also the officers of the Council from the Town Clerk and the Medical Officer of Health down to the office juniors whose full co-operation we enjoyed in every one of our joint operations. Finally, I wish to record my sincere and grateful thanks to my own staff for their loyalty and hard work. I know we were a happy team, and I think that we can also claim to have been successful in our endeavours to serve well the people of Chingford. G-. HOLMES Chief Public Health Inspector and Cleansing Superintendent 19 SANITARY CIRCUMSTANCES OF THE AREA Water Supplies The following report is submitted from Dr Windle-Taylor, Diroctor of Water Examination, Metropolitan Water Board:- "I can state that the water supplied to the Borough of Chingford has been satisfactory in quality and quantity during 1964. The main source of supply is predominantly River Lee - derived water from the Board's Lee Bridge works repumped at Woodford Pumping Station, with the addition of well water from Chingford Mill and, in the south west corner of the Borough, a supply derived from Perry Lane works in varying and unpredictable proportions from the well at that station, the River Lee and the New River. The average analyses of the water passing into supply from these sources are set out on the attached sheets. The water is not plumbo-solvent. I regret that I have no record of the number of dwellinghouses supplied, but all supplies are direct to the houses and none is permanently supplied by standpipe. (There are 15,095 dwellinghouses in the Borough and all are supplied by the Board with water direct to the house. C.P.H.I.) No new sources of supply were instituted by the Board in your Borough during 1964 and there were no 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 855 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. 20 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. Because of difficulties which have arisen in connection with the new plant at Edmonton Works of the Middlesex County Council, the anticipated diversion of part of the sewage has not taken place, but it is anticipated that this will be possible early in 1965. During the year piping of two water courses has reduced the risk of flooding due to blocked gratings, and application has been made for loan sanction in respect of the piping of two further water courses. Sewage Disposal For the reasons stated above, the transfer of sewage to Edmonton has not taken place and the actual date when the whole of the sewage of Chingford can be transferred is uncertain, but it is hoped that this will be during 1965. In the meantime, everything possible is being done to ensure as good a standard of purification as possible." Refuse Collection and Disposal Labour shortage remains the problem, affecting chiefly the street cleansing programme and the maintenance of refuse disposal works. It has sometimes been difficult to find sufficient labour to get the refuse in and dispose of it. Despite these difficulties, a regular weekly collection was maintained, even through the heavy snows which made the steep inclines, some 1 in 5, hazardous. Three quarters of the refuse is incinerated and the remainder tipped. The Council's plan to completely reorganise the disposal works was first postponed in the National financial squeeze, and is now deferred pending the imminent amalgamation with the Boroughs of Walthamstow and Leyton. Further details of the services are set out in appendices B C and D 21 SANITARY INSPECTION OF THE AREA During the twelve month period under review, 1,067 complaints were received and investigated. A total of 11 ,261 visits and inspections were made by the department (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. 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 Peat Control The Ministry of Agriculture, Fisheries and Food reported that rodent control in the Borough continued to be excellent. The use of sodium fluoracetate in the sowers has been of great assistance to Mr. Murray, the Rodent Operative, in achieving this result. The widespread infestation of Feral Pigeons was virtually eradicated with the use of the narcotic Alpha-Chloralose. The public approved of this treatment, and only one verbal complaint was received. Factories Act, 1961 During 1964- there were 86 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 186. The work in which these people were engaged is itemised as follows:- Wearing apparel manufacturers 114 Artificial flower manufacturers 4 Cardboard box manufacturers 8 Lamp-shade manufacturers 2 Upholsterers 5 Brush manufacturers 2 Footwear manufacturers 19 Toy manufacturers 32 Total number employed 186 No contraventions of employment were observed and the statutory lists of workers were received. 22 FOOD COMPLAINTS 47 complaints about food were received during 1964. This is a record number and shows that the public have become aware of the protection afforded them by their Council. They are thus responding to the efforts and publicity of the Health Department. All complaints were fully investigated and most showed up various defects in food preparation and in retail housekeeping. The Department was thus able to see that these matters were rectified. Many of them would have remained undiscovered but for the co-operation of the public. Legal Proceedings under the Food & Drugs Act, 1955 for the sale of food which was not of the nature, quality or substance demanded. Complaint Result of Proceedings Sour Milk Fine £10. Foreign matter in milk Absolute discharge Foreign matter in bread Absolute discharge Mouldy prunes Absolute discharge Decomposed shrimps Fine £5: Costs £3.3s.0d. Metal in bread Fine £5: Costs £3.18s.0d. Decomposed offal Fine £30. Sour cream Fine £5. Mouldy steak and kidney pie Fine £1 0. Maggots in school dinners Fines £20: Costs £l0.10s.0d. Infestation in chocolates Fine £5: Costs £3 10s. Od. Infestation in chocolates Fine £5: Costs £3.10s.0d. Finger dressing in custard tart Fine £50: Costs £3.10s.0d. Wire in sausage Fine £25 Wood in bread Fine £20. 23 FOOD HYGIENE INSPECTIONS The regular and frequent inspection of all food premises, stalls and vehicles was continued. In particular the drive to improve the hygiene of meat carriers' vehicles was sustained. The majority of the food trade co-operated in practice and in spirit and a high standard of cleanliness was observed generally. Regretfully, a minority of traders were neglectful and legal proceedings were taken as follows:- Fine Dirty restaurant kitchen £30: Costs £5-5s.Od. Dirty meat van £25 Dirty meat van £20 Dirty ice cream van £14 Dirty restaurant kitchen £98 CHEMICAL EXAMINATION OF FOOD AND DRUGS 65 samples of food were examined by Dr. J.H. Hamence, F.R.I.C., and Mr. P.S. Hall, F.R.I.C., the Council's Public Analysts. 53 of these samples were purchased at random from shops in the Borough and all were found to be genuine and satisfactory. The remaining 12 were the subject of purchasers' complaints. One of the latter, a canned orange drink, was found to contain an excess of lead and iron which had resulted from the action of the acid in the drink on the metal of the can. This made the drink unfit for human consumption. Further tins were examined and the contents found to be similar. As the result of this one complaint, hundreds of thousands of tins were withdrawn from all over the country for destruction, and the Ministry of Agriculture, Fisheries and Food is giving serious attention to the canning of acid products. UNSOUND FOOD 2,304 lbs. of various meats, 403 tins and 371 packages of food were found to be unfit for human consumption. This food was condemned by the Public Health Inspectors and destroyed under their supervision. 24 BACTERIALOGICAL EXAMINATION OF FOOD Results of Sampling in 1964 Bacteriological Quality Food Tested Excellent Very Satisfactory Satisfactory Fairly Satisfactory Unsatisfactory (high bacterial content) Totals Cooked Meats 1 2 19 19 21 62 Meat Pies 5 - 2 1 1 9 Sausages 2 3 4 - 1 14 Ice Cream 5 - 1 - 1 7 Miscellaneous Foods 1 - - 2 1 4 TOTALS 14 5 26 26 25 * 96 Last year five out of eight foods tested were found to be unsatisfactory because of the presence of too many bacteria. In an attempt to improve on this ratio, considerable effort was put into the education of retailers in the hygiene of food handling. One lecture was attended by over 250 food traders and their staffs. Sampling was increased twelvefold, emphasis being placed upon cooked meats because it was known that these were particularly vulnerable. It will be seen from the table that there was an improvement, but nothing to be complacent about, especially as regards the cooked meats. We did, however, feel that we knew where we were going The cleanliness of food handling improved. Though there were still instances of contamination from unhygienic methods, particularly whilst slicing, and sometimes over-long storage, the cause of most of the high counts of bacteria was storage at too high a temperature. Of course, most of the bacteria are relatively harmless, but high numbers of even these types are most undesirable and can cause illness. The great danger is that one day, as happened in Aberdeen, you might buy poisonous bacteria. Then you are in trouble. Your safeguards are hygiene, freshness and refrigeration. * The relatively high percentage of poor samples is due to the expertise of the Inspectors in perceiving and testing substandard practices. Had the sampling been representative of the standard throughout the Borough, the percentage would have been very much smaller. 25 The public would be wise to buy their cooked meats and similar meat products from clean shops which keen these foods in refrigerated cabinets. Even then one has to be selective. We found several of these cabinets where the temperature was still too high. The better shops keep a thermometer in the cabinet, and this should read about the 40 F mark. Restaurants and catering establishments are required by law to keep these foods under refrigeration and similar legislation is long overdue in the remainder of the food industry. It should embrace both the producer and wholesaler, as well as the retailer, because our sampling revealed that many of these foodstuffs were delivered to the retailer in an unsatisfactory condition. It is also recommended that it should be obligatory to provide and use an effective system of sterilisation for utensils and equipment which are liable to come into contact with the meats- Education of staff is also a necessity, and it would be helpful if, whenever practicable, persons engaged in handling these foods were given a specialist status This would make training easier and control better. TYPHOID IN ABERDEEN The outbreak in May soon produced effects in Chingford. When the Medical Officer of Health of Aberdeen announced that the origin was corned beef, I asked the Ministry of Agriculture, Fisheries and Food to supply the names of the brands concerned. They stated that there was no evidence that corned beef was the cause of the outbreak and advised no action. This could not be accepted, and all retailers in the Borough, on the advice of the Public Health Department, withdrew their stocks. They were, without exception, anxious to co-operate. Subsequently, the Minister of Health concluded that corned beef was the origin of the typhoid and advised withdrawal of various suspect brands. These were searched out and other stocks were eventually released. The Milne Report on the outbreak confirmed the firdings of our bacteriological investigation, reported above, that refrigeration of cooked meats at or below 40 F is essential. The Milne Report only recommends refrigeration "on display for sale". This would be better than nothing, which is the present position. However, bacterial contamination and multiplication can and does take place at all stages between manufacture and display for sale. This we have found from sampling at the point of delivery to shops. In my view, those food products which are ideal media for bacterial growth should be protected by refrigeration at all practicable times and statutory bacteriological standards laid down for them to comply with. 26 LEAD IN PLASTIC TOYS An investigation was made into the toxicity of plastic toys sold in the Borough, and it was found that a high proportion of chose imported from Hong Kong, 9 out of 14 sampled, contained excessive lead contents, Some also had an excessive copper content. The majority of the cheap plastic toys sold in this country are manufactured in Hong Kong. These toys are commonly sucked and chewed by children. Many of the cheaper types are so soft that appreciable amounts can be, and are, eaten. The Council's Public Analyst therefore simulated stomach conditions in his tests and reported that, although the amounts of lead would not be sufficient to give rise to acute lead, poisoning, they were sufficient, to add significantly to the daily intake of lead. This would be most undesirable because lead is not eliminated from the body, it is accumulated. Some typical results of these tests are given below:- Toy Total Lead Estimated amount extractable in the stomach In parts per million Busy Boy Tool Sat (1) 1500 250 Busy Boy Tool Set (2) 2000 100 Clown Pile up Set 1 900 120 Housewares 1 900 1 00 Cowboy and Indian Knife 1500 200 Total Copper Soluble Copper 5000 3000 The latter toy was particularly bad because the copper in the form of a paint could be licked off the knife and sheath, The Lead in Food Regulations are designed to keep the daily intake of lead as low as possible. 100 grams of a food which contains the common maximum possible amount of lead, viz. 2 parts per million, would contribute 0.0002 grams of lead to the daily intake. The ingestion of only 0.1 gram of a part of these toys containing 1500 parts per million of lead would contribute nearly the same amount Lead was not the only hazard. Even more objectionable materials are used, such as various of the plasticisers and other metals such as the copper paint in the knife reported above. The Council considered these reports and requested the Home Office to prohibit the sale of plastic toys containing objectionable materials. The information was also sent to the Association of Municipal Corporations and to the British Safety Council, requesting their support. 27 The Home Office replied that their tests showed that only minute quantities of lead could be extracted and ingested by children chewing or sucking the toys. Nevertheless, they had recommended to the trade that the lead content of plastic toys should not exceed 250 parts per million. They had, however, taken note that our tests had shown that lead could be extracted in significant amounts, thus demonstrating a definite health hazard. At their request, full details of our tests were sent to them. The practical effect of the sampling in the Borough was that every retailer willingly co-operated in removing from sale all toys which we found to have a high lead or otherwise objectionable content. The last nine samples were all satisfactory. One of the largest retailing organisations in the country removed similar toys from sale in all their stores throughout the country. Their Managing Director then flew to Hong Kong to check up on the factories supplying his organisation. 28 OFFICES, SHOPS AND RAILWAY PREMISES ACT. 1963 Table A: Registrations and General Inspections Class of Premises Number of Premises Registered During 1964 Total Number of Registered Premises at the end of 1 964 Number of Registered Premises Receiving a General Inspection from Aug. to Dec., 1964. Offices 81 80 63 Retail Shops 303 299 197 Wholesale Shops, Warehouses 8 8 2 Catering Establishments 30 30 8 Fuel Storage Depots 1 1 — Totals 423* 418* 270 Table B: Number of Visits to Registered Premises 329 Table C: Analysis of Persons Employed in Registered Premises Class of Workplace Number of Persons Employed Offices 449 Retail Shops 1,451 Wholesale Departments, Warehouses 63 Catering Establishments open to the Public 226 Canteens 4 Fuel Storage Depots 3 Total 2,196 Total Males 920 Total Females 1,276 *Some businesses had closed down. Contraventions: Notices requiring works were served in respect of 265 premises during the year. 29 HOUSING Unfit Houses 249 houses were inspected and 1 79 found to be unfit. Housing repair work was enforced as follows:- Repaired after negotiation with the owners 138 Repaired after service of statutory notices 25 Improvement of Sub-standard Houses The Council approved grants for the improvement of 21 houses; 13 by standard and 8 by discretionary grants. Every effort was made to encourage improvement of houses by prompt and personal attention to applications. As a result of detailed estimating of costs for discretionary grants, hundreds of pounds were saved to the Council in grants. Owners were also often saved considerable amounts of money, for it was found that, in most cases, builders' original estimates were voluntarily reduced after negotiation. The schemes for promoting "Improvement Areas" were again deferred pending the amalgamation with the Boroughs of Walthamstow and Leyton. Houses in Multiple Occupation Vigorous action by the Department, fully backed by the Council, was taken during the year both to improve conditions in this type of occupation and to stop exploitation. The Register of Electors was gone through from beginning to end, and all houses showing large numbers of occupants were visited Those in multiple occupation were dealt with under the provisions of the Housing Acts. Initially some evictions took place, but ceased upon the Council deciding to compulsorily purchase in these cases. 30 CLEAN AIR ACT, 1956 Smoke Control Areas - Phased Programme The following details show the number of Smoke Control Orders in operation:- Chingford Smoke Control Order (No.1) 1960. 38 acres. 387 dwellinghouses. Operative date 3rd November 1 960 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 dwellinghouses. Operative date 1st November 1962. An area bounded 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 dwellinghouses. Operative date 1 st December 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 dwellinghouses. Operative date 1st December 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 Chingford-Walthamstow 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. 31 SMOKE CONTROL AREAS 1960/1 964 - STREET/YEAR INDEX Ainslie Wood Crescent 1964 Marmion Approach 1962 Ainslie Wood Gardens 1964 Marmion Avenue 1962 Ainslie Wood Road 1964 Marmion Close 1962 Albert Avenue 1962 May Road 1963 Antlers Hill 1960 Middleton Avenue 162 Ashley Road 1963 Middleton Close 1962 Bateman Road 1963 Norbury Road 1962 Boardman Avenue 1 960 North Circular Road 1963 Bumham Avenue 1963 Norton Close 1962 Burnham Road 1963 Chase Gardens 1 962 Old Church Road Cherrydown Avenue 1 962 Albert Crescent to Priory Cherrydown Close 1962 Avenue West Side 1962 Chingford Mount Road Boundary to Hampton Road 1963 Priory Avenue 1962 West Side: Hampton Road to Hall Lane West Side 1962 Priory Close 1962 Churchill Terrace 1962 Rolls Park Avenue 1964 Coningsby Gardens 1962 Rolls Park Road 1964 Cranston Gardens 1964 Ropers Avenue 1964 Deerleap Grove 1 960 Royston Avenue 1964 Russell Road 1962 East View 1964 Sewardstone Gardens 1960 Edward Avenue 1964 Sinclair Road 1963 Frances Road 1 964 Frankland Road 1962 Tufton Road 1 962 George Road 1963 Waltham Way - Hall Lane to Priory Avenue 1962 Gilwell Close 1960 Warwick Avenue 1963 Hall Gardens 1 962 Warwick Road 1963 Hall Lane Waverley Avenue 1962 North Circular to Hampton Rd 1963 Westward Road 1963 Remainder 1 962 Woodside Gardens 1964 Hampton Road 1963 Hollywood Road 1 962 Yardley Close 1960 Hurst Avenue 1962 Yardley Lane 1960 Hurst Close 1 962 York Road Inks Green Road 1964 Westward Road to Hampton Road 1963 Remainder 1962 Leonard Road 1963 York Avenue 1963 Lower Hall Lane Hall Lane to Pumping Station 1962 Pumping Stn. to N.Circular Rd 1963 32 APPENDIX 'A' Summary of Inspections and Visits Subject of Visit or Inspection No. of Visits or Inspections No. of Cases Nuisances or Defects Remedied PUBLIC HEALTH ACTS, 1936 and 1961 In connection with notices served 701 483 Re-inspections, work in progress, etc. 695 Drainage 841 780 Rodent and Insect Control 1 ,320 817 Infectious Disease 51 3 River Pollution 9 2 Noise Nuisance 12 7 Swimming Pools 13 1 Hairdressing Premises 16 1 Places of Entertainment/Licensed Premises 31 8 Schools 23 6 Infestations from Reservoirs 12 2 Pigstyes, stables, watercourses and ditches 43 8 Public Conveniences 543 29 Street Cleansing 101 35 Gully Cleansing 23 15 Refuse Collection and Disposal 1 01 61 Flooding of Gardens, Houses, etc. 8 5 Inadequate and Defective Water Supplies 5 4 Nuisances caused by offensive accumulations 51 35 Nuisances caused by the keeping of animals 8 3 Nuisances caused by Pigeons 91 11 Verminous Houses 3 - HOUSING ACTS, 1954, 1957, 1959, 1961 and 1964 Dwellinghouses Inspections 249 163 Dwellinghouses Re-inspections 282 - Improvement Grant Work 69 20 Overcrowding 23 7 Rent Act, 1957 - Certificates of Disrepair 6 2 Houses in multiple occupation 153 33 OFFICES, SHOPS & RAILWAY PREMISES ACT, 1963 - SHOPS ACT, 1950 General sanitation and working conditions 449 284 Hours of closing 98 4 Employment of Young Persons 163 14 Carried forward 6,193 2,843 33 ' Subject of Visit or Inspection No. of Visits or Inspections No. of Cases Nuisances or Defects Remedied Brought forward 6,193 2,843 PETROLEUM ACTS AND REGULATIONS thereunder Inspection of Licensed Premises 128 - Re-inspection of Licensed Premises in connection with contraventions, tank testing, etc. 49 19 FACTORIES ACT, 1961 & REGULATIONS thereunder Inspections of registered factories 145 - Re-inspections in connection with work in progress, contraventions, etc. 35 16 Inspection of outworkers' premises 98 — 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 259 - Re-inspections in connection with work in progress, contraventions, etc. 141 61 CLEAN AIR ACT, 1956 Smoke Control Area Inspections 1,259 11 Survey of Proposed Smoke Control Area 301 15 FOOD AND DRUGS ACT, 1955 AND ASSOCIATED LEGISLATION Butchers' Shops 275 45 Fish (wet and fried) Shops 1 01 8 General Provision Shops 426 53 Bakehouses and Vans 57 8 Dairies and Milk Floats 19 1 Mixed Businesses (food shops) 383 31 Restaurants and Cafes 169 35 Public Houses and Licensed Premises/Restaurants 68 16 School Kitchens 76 15 Food Delivery Vehicles 125 27 Ice Cream Vendors 301 24 Hawkers of Food and Chingford Fairground 91 17 Samples of Food, Milk and Water 209 12 Merchandise Marks Acts and Orders 353 33 TOTAL 11 ,261 3,290 34 APPENDIX B STREET AND GULLY CLEANSING COST STATEMENT 1964/65 Item Particulars ' 0) Street Sweeping and Watering (2) Street Gully Cleansing (3) Total (4) Percentage of total gross expenditure (5) REVENUE ACCOUNT £ £ £ % 1 GROSS EXPENDITURE (i) Labour 6,703 2 6,705 55 (ii) Transport 3,374 1 3,375 28 (iii) Plant, equipment, land & buildings 172 1 72 2 (iv) Other items 1,001 847 1 ,848 15 (v) Total gross expenditure 11,250 850 12,100 100 2 GROSS INCOME (excluding reimbursements from Ministry of Transport and the County Council) 87 - 87 - 3 NET COST 11,163 850 12,013 - 4 Capital expenditure met from revenue (included above) - - - - 5 Gross expenditure on sanding, gritting and snow clearance, not included previously 1,630 - - - UNIT COSTS 6 Average net cost per street mile cleansed per annum Item 3 Item 9 184 - - - 7 Net cost per 1 ,000 street gully cleansings Item 3 Item 13 - 98 - - 8 Net cost (item 3) per 1,000 population 241 18 ! 259 - 35 OPERATIONAL STATISTICS 9 Mileage of streets cleansed 60.6 miles 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 20% 12 Number of street gullies cleansed 3623 13 Number of gully cleansings during year (number of gullies x number of cleansings) 8773 14 Percentage of gully cleansing done by mechanical means 100% 15 Population at 30th June 1964 (Registrar-General's Estimate) 46,320 16 Remarks: Item: 1 (iv) Gully cleansing is carried out by contractors and the figures include labour and transport. Item: 11 Eighty per cent of sweeping carried out by manual labour only and four electric trucks are used for conveyance of sweepings. 36 APPENDIX C COLLECTION AND DISPOSAL OF HOUSE AND TRADE REFUSE COST STATEMENT 1964/65 Item Particulars (1) Collection (2) Disposal ' (3) Total (4) Percentage of total gross expenditure (5) £ £ £ % REVENUE ACCOUNT 1 GROSS EXPENDITURE (i) Labour 13,715 10,813 24,528 51 (ii) Transport 11,629 - 11,629 24 (iii) Plant, equipment, land & buildings 703 4 264 4,967 11 (iv) Other items 491 6,311 6,802 14 (v) Total gross expenditure 26,538 21,388 47,926 100 2 GROSS INCOME 667 11,81 7 12,484 - 3 NET COST 25,871 9,571 35,442 - 4 Capital expenditure met from revenue (included above) 640 - 640 - UNIT COSTS s. d. s. d. s. d. 5 Gross cost per ton, labour only 24. 2. 19. 1. 43. 3. 6 Gross cost per ton, transport only 20. 6. - 20. 6. 7 Net cost (all expenditure) per ton 45. 8. 16. 11. 62. 7. 8 Net cost per 1,000 population £ £ £ 559 207 776 9 Net cost per 1,000 premises 1,713 634 2,347 37 OPERATIONAL STATISTICS 10. Area (statute acres) - land and inland water 2,868 acres 11. Population at 30th June 1964 (Registrar-General's Estimate) 46,320 persons 12. Total refuse collected 11,335 tons 13. What percentage of total refuse collected (tons) 100 io 14. Weight (cwts.) per 1 ,000 population per day (365 days to year) 13.4 tons 15. Number of premises from which refuse is collected 15,105 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) 12 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) 16,335 tons 20. Methods of disposal (salvage excluded): (a) Crude tipping nil % (b) Controlled tipping 29 % (c) Separation/controlled tipping nil % (d) Direct incineration nil % (e) Separation and incineration 71 % (f) Other methods (state nature) nil % 21. Salvage. Analysis of income and tonnage: Income (included in Item 2) Tonnage Collected (included in Item 12) £ Tons (a) Raw Kitchen Waste 37 3 (b) Scrap Metal 2,793 380 (c) Waste Paper 7,539 885 (d) Other Salvage 963 138 (e) Totals 11,332 1,406 22. Trade Refuse: (a) Income £91 2 (b) Tonnage 1,383 tons 38 APPENDIX D ANALYSIS OF SALVAGE INCOME FOR THE YEAR ENDED 31st MARCH 1965 Metals £ s d £ s d £ s d Aluminium 292 17 4 Copper 205 16 5 Iron 175 9 10 Lead 87 18 6 Battery Lead 10 4 4 Lead Type - - - Unbaled Scrap 330 1 0 2 Tins 1,447 11 10 Pewter 13 16 10 Zinc 15 18 11 Brass 212 8 7 2,792 12 9 White Cullet 166 4 8 Amber Cullet 30 13 1 Bottles and Jars 232 8 0 429 5 9 Rags 232 5 10 Carpets and Sacking 122 8 6 Woollens 62 19 1 Flock Bedding 76 4 9 493 18 2 Newspaper and Mixed Paper 7,538 19 4 Bread (Pig Food) 31 6 10 Rubber Tyres and Tubes 7 4 6 Unsound Food 4 0 0 Miscellaneous 3 1 9 11,300 9 1 Machinery Insurance Claim 20 15 9 Rents Foundry 200 0 0 Proportion of Allotment Rents 20 0 0 Other Rents 2 6 220 2 6 Refuse Collection Charges Greengrocers and Butchers 505 3 0 Others 407 2 6 912 5 6 £12,453 12 1Od CONTENTS Page Acreage 3 Ambulance facilities 5 Births 3, 4 Cancer 13 Children's Department 9 Chiropody 7 Clean Air Act 30,31 Clinics 6,8,9 Day Nurseries 7 Deaths 4,12,13 Factories - inspection of 25 Fluoride 19 Food - bacteriological examinations 24,25 Food - complaints 22 Food & Drugs - sampling 23 Food Poisoning 11 Food premises - inspection of 23 Food - unsound 23 Heart - deaths 13 Health visiting 6 Home Help Service 7 Hospitals 5, 7 Housing 29 Immunisation 10,11 Infectious diseases 10,11,16,17 Inhabited houses and flats 3 Inspections and visits - summary of 32,33 Introduction 1,17 Infant mortality 3, 4 Page Laboratory facilities 5 Laundiy service 7 Medical examinations 1 2 Mental welfare 9 Midwives and Nurses 5 National Assistance 9,12 National Health Insurance 9 Notifiable diseases 15,16 Nursing Homes 6 Offices, Shops & Railway Premises 28 Outwork 21 Plastic toys, lead content 26,27 Population 3, 4 Rateable value 3 Refuse collection and 20 36, disposal 37,38 Registrar of Births and Deaths 9 Rodent and pest control 21 Salvage income - analysis of 38 School medical inspections 6 Sewerage 20 Smoke control areas 31 Social welfare 9 Street & gully cleansing 20,34.35 Tuberculosis 11,14 Vaccination 11 Vital statistics 3, 4 Water Supplies 19 JRI/68